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HomeMy WebLinkAbout08-15-13 � rcesez PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropriate form: Decedent's Information Q o� Name: KATHRYN E.MIXELL File No: p�' — '3� �0 �✓ a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 171-28-2099 Date of Death: JIJNE 28,2013 Age at death: 79 Decedent was domiciled at death in CUMBERLAND County, pENNSYLVANiA (Sta.re) with his/her last principal residence at 991 N. MIDDLETON RD..CARLISLE 17013 N.MIDDLETON TOWNSHIP CUMBERLAND Street address,Post Office and Zip Code City,Township or Borough County Decedent died at CARLISLE REGIONAL MEDICAL CENTER,CARLISLE 17013 CARLISLE CUMBERLAND PA Street address,Post Office and Zip Code City,Township or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania.. .. .. . . . . . . . . . . . . . . . . .. . . . . All personal property $ 4G,000.00 If not domiciled in Pennsylvania. . . . . . . ... . . . . .. . . . . . . . . Personal property in Pennsylvania $ If not domiciled in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . . . Personal property in County $ Value of real estate in Pennsylvania... . . . . . . . . . . . . . . . . .. . . . . . . . . . . ........ . . . . . . .. . . . . . . .. . . $ 2p�,ppp.pp TOTAL ESTIMATED VALUE. . .. $ 240.000.00 Real estate in Pennsylvania situated at: 991 N.MIDDLETON RD CARLISLE 17013 N.MIDDLETON TOWNSHIP CUMBERLAND (Attach additiona[sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County � A. Petition for Probate and Grant of Letters Testamentarv Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated MARCH 31,2010 and Codicil(s) thereto dated State relevant circumstances(e.g.renunciation,death of executoq etc.J Except as follows: after the execution of the instrument(s)offered for probate Decedent did not marry,was not divorced,was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S. § 3323(g),and did not have a child bom or adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. Q NO EXCEPTIONS O EXCEPTTONS `= %=rts C--�; 4^r�� 0 B. Petition for Grant of Letters of Administration (If applicable) �,., - �_' ` ` :" c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente li�du_�z��absenlia,durante'minoritate � - f_� If Administration,c.t.a. or d.b.n.c.t.a.,enter date of Will in Section A above and�a�p,l�te lis€-b�f heirs. ` Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divo�ce had been�stablished as defined in 23 Pa.C.S. §3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated pers�a.�: .' --_� = ,� _ , Q NO EXCEPTIONS Q EXCEPTIONS ' -'•-'! ��' J� 4,1 Petitioner(s),after a proper searoh has/have ascertained that Decedent left no W ill and was survived by the fo�'owing spouse�.�any)andl4�eirs(attach additional sheets, if necessary): Name Relationshi Address Form RW-01 rev. 10/II/2011 Page 1 of 2 Oath of Personal Representative Official Use Only , COMMONWEALTH OF PENNSYLVANIA }' } SS: COUNTY OF CUMBERLAND } Petitioner(s)Printed Name Petitioner(s)Printed Address RONALD M. MIXELL I 10 HC?Y ROAD CARLISLE PA 17013 CHRIST{}PHER.T.C}RTH 114 HOY ROAD,CARLISLE,PA 17fl i 3 The Petitioner(s}above-named swear{s}or affirrn(s}t statem nts in the foregoing Petition are true and carrect to the best af the knawiedge and belief ofPetitianer(s)and that,as Personal Representative(s af the ecedent,the Petitioner(s)wil]well and truly administer the estate according to law. Sworn ta ar affirmed a d subscrib d befare ' Date ��_1� _ me t ay of ,�/� � � ���e /`�"'e��!`k. -s ��3 B � �� R�f i7�. .y _ . . --, ., � For the Register , � -.�' �.., Date '; � .. ! �,f i , � 7 - ' t.. BOND Reyuired: Q YES Q NO To the Register of Wills: , ,_� � - FEES: Please enter my appearance by�y.s.�gnature-�elow: � Letters. . . . . . . . . . . . . . . . . . . . . . $ 310A0 Attorney Signature: �-r ` ;s -- . .� ( 4) Short Certificate(s).. . . . . 20.00 ��- ``� "+ ,,-.y ;_, { )Renunciation(s).. . . . . . . . `�� ; �1 , �-���. ( )Codicil(s). . . . . . . . . . . . . f { }Af�davit{s).. . . . . . . . . . . Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: ROGER . IRWIN, ESQUIRE Commissian. . . . . . . . . . . . . . . . . . Supreme Court Other . , . . . . . . ID Number: ��$2 WILL . . . . . . . . 15.00 INVENTORY . . . . . . . 15.00 Firm Name: IRWIN&McKNIGHT,P.C. INH TAX RETURN . . . . . . . . 15.00 Address: �0 WEST POMFRET STREET . . . . . . . . �`ARI�i�� R, PA 1701"i . . . . . . . Phone: (717}249-2353 Automation Fee. . . . . . . . . . . . . . . 5.00 Fax: (717)249-6354 JCS Fee. . . . . . . . . . . . . . . . . . . . . 23.50 Ema'rl: TOTAL. . . . . . . . . . . . . . . . . . . . . $ 403.50 DECREE OF THE REGISTER Estate of KATHRYN E.MIXELL File No: ti,;G�"-/�'�_i���l�'� alkla: AND NC1W, �� 1 , ,in consideration of the foregoing Petition, satisfactary praof having been presente efore me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to RC}NALD M.MIXELL AND CHRISTOPHER J.C}RTH in the above estate and(if applicable)that the instrument{s}dated MARCH 3i 2Q10 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s))of Deceden . egister of"V4�is �. ���� . Farm RW-02 rev. 10111/207t � g�2 Q�2 -�,fr�.�..,�.���_,� .,..�,� ...�, �«����..�.��,,�. �- � ,��.��.�.._�.����,� �_ .m,,,�.��;�_ - �.e�,«�..,�,,..��,�. ��,W���...,�..�,.�, H105.805 RtiV(9f11} LOCAL REGISTRAR'S CERTIFICATItJN OF DEATH WARNING: It is illegal to duplicate this Copy by phdtostat or photagrapM. Fee for this certifi����;�0- '} ' _ ,,n��r'""" --- This is to certify that the information here given is ��� �,TH Qf p`'"�. � , s�`��'���- ���'J'j; duly filed �h me as Loca11R g strar.The4onginat �i��.. � u> ; � `�'� �� certificate will be forwarded to the State Vital �'�;j 3 ;,�;� �� � 'i + t!; �° � ' a� Recards Office for permanent filing. J� 8 � � Y{ t iv �� ��'�4 i �O� ��,,1` w � ti,�'�'' .��.. `���0'{.�i � �g� "�9j�'1ENT0���,� �0,,...,.�-'�.�..��a,e�._....`. �� � �2t'Ci�Cat10Il�YYbttTl�Ed's`J� �_;'��r;` """�'°""�+ Local Registrar Date Issued [, Typa/Print I� ,� Vi'V�(.��(�(�/.`y��� ��If' ?�� COMMONWEAL.TH OF PENNSYIVANIA•DEPARTMENT OF MEAI.TH.VITAI RECORDS � � Psiacki�kt - CERTlFtCATE OF DEATFI Sia#e Flle Number. 1.D4GedenYS Le&al Name(Firat,Middle,LasS,SuPftx) 2.Sex 3.Socfal5ecurity Num6er 4.Date vf 6eattr{MO/Da fYr {$p�}�Mo) �.tr�� E_ rlix�ii �z� z�i-as-ao�9 .7,�,e Zs, z�ii� � Sa.Age-lasi BlHhday(Vrs) Sb.Under 1 Year Sc.Under 3 Da 6.date of Birth(Mo/Da LYe�ar)(Spell Manth) 7a_91rthp1 p�(C �d 5 atv*or Fqre{gn GbuMry} 79 nnonxns osrs Ho.,rx nm.,�tes JunB 11� 19Y-34 Car�is�ie f �A � � � � ]b.Birthplace(COUnty}� ' Sa.R4sfde,�ti,3c�e State or Pareign Cauntry) 8b�s�qaQtg{StS�i ber-It�tClu�daAnt No,) $c.�Oid O �ced8rtt i.tve in a TaWnship7 � � . � � 1. SV t7 c��e`gon tf �'] �v�s,aQZ�egncu�edin N. MidddS.eton � ���tN,P. stl.Reslaence(tounty)� .. � . � . . . �T�T����-�nC� 8e.Residence(Zip Cod9) 1„7�13� �����No;deCedGnt Iived wlChin Ilmits of city/boro. 9.Ever in VS Armed Fortes? 10.Marltal 5iatu5 af Time 4f Dbath 0 Married W{dowed 11.SurvivMg Spovse's Name(tf wife,givo Ytame prtorto flrst marr;age} 0 Ves L3[No (�Unknqwn (� Divorced Q Ncver Marrfed �Unknow . 12.Father's ryame(Flrst,MldCle,Last,Sutfix) 13.Mothmr's Name Prlor to First Marr;age(fies;,Middta,LastJ Fran}c Ho Eth�el Burget� � 14a.Informank'S Name y.46.RelatipnsHlp to�ecedent 14c.Informant's Mailing Address(Street and Number�City,StaYe Z! Code} g Ronald M. Mixe11 son 110 Hoy Rd_, Carlisle, PA 17{�1�3 � _ "' - -` - - - - - - i a. ��e o o_ac � �o���o.,aa . . . �. . If Death Occurrrd in a��Hpxpitel: � �Inpatient �if CTeath OcCVrred Somewhera t'rytfiBrThatt a HoSpftai: ��Naspice Facitlty� �.�.�7 Dtrtedent's Home �S � Emergcncy RoqmfCiutQaNertt � .0 i,70ad wn A�rtval � � Nursfn Home/long-TmYm Carg pacili{y �Other(5pecify) � 1sn.�e�mcy ru me(i o�tct�na g�ve:cr eF a�d �r) is�.cny ro s ^a�y�fl`�?Oi5 is�i���i�id � Carl�.s�.e R 3ona� Mec�zca���n�er �ar�3s`�e, �, 16a.MetM1ad f Dlsposition Burial � CremaHOn lBb.Daie oi DisposlClqn 16c.Place of IspaslHOn(Na F c tery,cremx�iory,or otfier piace) � � O Re•,,ov �rt��m sc�z� t� oa�etio., .?u1y 3. 2013 Westm�raat�:r �'em�`��ry q�ocn ��sPe�c � � � � � 1fid Lacatlor+of DlsROSiHqn�[Gity pr Towrt,State,and Z{PJ 17a_51 of FunGrat S4rviCe ee or in Charg�af lrrtermcnX i7b. Carlisle, PA i7013 � ,,,� `� e '�`}`.�'���7�` . . w+[c�ti�'l � � S7c.Name and Compieta Addross of Funerat FacNity Haffman-E2oth E`urteral Homa & Cremator , 219 North Hanov�r Streat, Carli�le� PA 17013 �' 19.Decetleni's EduCacion-Ch4ck the box that best dascribes the 13.DecedCnt of Htspanic 4rig{�_Check Yhe 2�.DeCtdertYs Race-Check ONE OR MORE races to indica2e what Mgfieat de$ret or Ievei of scho.ai compieted ai the time of death, box tMrat besi descri4es whether the deccdent thw decedent considered himself or hersrlf to be. ' � $th grade or Iess Is SpanisM1/Hispanic/laiina. Check the"No" �White � Korean Q No dipioma,9th-12th grade bax!f decddent is not SpantshfHtspanicftatMa, �gtack ar Afriean America� q Vietnamese �$High School graduata or G£D GompietCd � No.not Spanish/Hispanlc/4aHno �Amrorican Indiqn or Alaska NeHVC �] Other Aslan O Soma college credit,b�t no dogree []Yes,Mmxicdn,Mcx{can ArtYerlcan,Ghicatfo C�Asian lrtdian Q Netivc Hawaitan Q A55oCtatt degr�Ge{C.$.AA,AS) �j Y9S,Puerto Rican �Chinsse � Gusmanian br Chamcfrro O Bachelor'a degrvee(e.g.BA,A8,BS) CJ ves,Guban p Fillpino Q Samoan � Master's drgrpe(e.g.MA,M5,MEng,MEd,MSW,MBA} �I Yes,othcr SpanishjNispaniclE.atirto �Japanese O Oth¢r PaNflc is�ander 0 boctOrate(e.g.PhD�Edp)or professlonai dwgree (Specify) � Other(SpecifyJ e. .MO ODS DVM,4LB JO � 21.DacedenYS Single Race Saif-0esignatto�-CM1�Ck ON�Y ONE to InCitaxe what the decadan[considered tiimseif or harself to 4e. 22a.DecedenYS UsuBl OCCUpation-Indicace*ype of wp�k �White � �Japanese [] Samosn done C�aring mbst of workirtg ilfe. p0 Nt?T ll5E REftRE�. [� Bfack nr AfNcan Amgricbn � Karean � 4ther paciftc ish�dar � �AmeAcan intlian or A7atka Native �Vielnamese [] Dpn't KnoW/NOt Sure �L'�G"K�L1Ct3-Ol"Y MCJ1^' �As�anindian p ocherASlan (� R�ef�sed .ij �Ct+inese � Natfve Mawaliart [� Other(Specifyj __ �2b.Kind of 8uxfnessJlnd�stry � � FmPino O Guamanian ar Chamorro ShOe M£t�. ITEMS Z3a-2 Mi! � E COMPLETED 23a.Dake Pronou ¢tl Oea�dj{p�pJpaY fI 23b.SignatUre of Parson PronounCing beath(Oniy wh4n appli�ca le) .2 c�..LICRns@ NUmbe.r � GERT[FIESN EATH PRONOUNCES OR . (,�p� �i"�" �DI.J � �. . . . � . � 23C.6ate.Stgnetl(h»o/DaY/}'t.? . 24:Time af beaT � ... � � 25.W8s MedtCal Examiner or Caroner ContaCteA? [�'Yes Mp � �� . . . . �. CAU5E C3F DEATFf� . �' .. � .: :� ... � .apv�.,ximata 26.Part 1. Enker the ch8in Of evenis--diseases,inJuries,or compltcailons-that dlrecNy caused the deafh, b0 NOT eflter terminal events such as cardlac arresf, t IMervai: YesA�rafory arros[,af veMrlcular flbr{ilatlon wtthout showing Che etiology, f?O NOT ABBREVIATE. EnTer o�#y one caus4 en m Iine. Atld additianet iines If nece5sary. i Onxet tp Death ,�fZ [7 � ' IMMEDIATE CAU5E '""--"'--"'> ,g, � i L dA�S {Rnal discase or tondilbn Cru�to{ar as a consoq�anc�afl: � rosuiting in droeth) � . 1 b. ' 1� riAVc se4uentiallv tist wnaftia..s,� - oue to tor as a tonsma.,ene. . . ' afl: �; If anY.I�ad1n�7 to.th�cause . . . . � �� . . . � . � .. Ifst+e�d on llne s. Entfr Tht , � G.. � � �. � UNbERlYiN6 CAL75E . � - � . pue to(Or 85 a Gon50quCflce Ofl: � . � � � � � �� � � � (disease or InJurv that �.. � � . . . . . . . � . ��. . . � Init4�ted Yhe ewant3 raSVlEing tl. 1 � in death)tAS'1'. bue Y4(or as a consequance of): . . . .. � � .25�AaK II. E»tev othcr;igntfl � tlttt n ont tbt[CI t de th but not ras�iting in Ytse underlying cause gtv4n In part I � � 27�,W8s an�mutopsy pertorme47 �au es No � . . . - � 2H'.W . topxy flndings availabie ���tp cpmplate the caus�of death? ��J �. . �. �.. . . � .-.�. .O Yes No . � 29.if Femafe: 30.bitl Tabacco iJSe Contribt�te So Death? 33.Manner Of Oeath � �]."'NOt pregr�ank within past year � Yes Q Probabl C] Pregnant at tlme of death Q Vnkno� "�NBtura/ � HomlCitle e.� � Not pre$nant,6ut Q�egnant withln 42 days af death �N� d A<cFdent � Pending InVesttgatlpn No# [] Suicide � Coultl not be datermi�ed ti Q pregnant,but pregllant 43 dmys to 1 year before de2th 32.Date of Injury(Ma/Day/Yr)(5pe11 Month) �-_ Q Unknown if pregnant WStMn the pasi year 33.Time of Injury � Y 34.Place ot InJury(e.g,home;CanstrucTibn site;farm;schoal) 35,lacatian of Injury(Street anct Number,Qty,CpunTy,State,Zip Cade} 36.Injury at Work 37.If Frbnsportation tn)ury,$pecify:, 38.Dascribe How injury 4ccurred= � � Q Ye5 Q Oriver/OpBratoe (� PeticsYrian `� � No � Pass@nger O �kher{Spaelfy) � 34a.CerHfle -physiclan,certiffetl nurse pracNklonef,medl<al e aminer/corbner(Check only one): O Cenify�ng anly-To che best of my knowledge,death occurreC due co tt�e cause(x}and manncr ziated � � ,�FronouncFng s.CartifyFr�g-To the besc af my k�owietlge,death occurretl at the time,daxe,and piaee,and dum co xhe cause(s}and manner s2ated. O Medlcal Exsminer/COronc - n the basis f e ac n and/or In�astigatlon,in my op�nlon,death occur�rye�d qat xhe t�me,da2e,and place,and due ta ihe causeis)and manner sXatod. 5ignaiu�eoficertiffer: Tit�eofcertlfler. /:/iJ LicenseN�+.mber.,�n u/4/.�I��r ' 34b.Nime,AddYess�and�Zi Cod of person GampleNng Gausa of peath(ltem 26)� � � 39c.OAte St sd( /Oay(Y}: _ :. � . � .- C' IF O �E. . � ' �' A � '�o �� �di o/�' : 4p.Reglstrar s Distr(ct N�mber � 41.Regist�ar's Signacu�a � ,��^. �.. :�� � 42:R. istrar Feie ate(MO Day r} � .o'`�t-o�i�� `K'".�r.vc#�.'��.*�..�.�'"o.r.�or�c- e�c- ;� � 43.Amsndmenis. - .. � Z DlSposiiion permltWb._y) _L"�l 7f�'�'/ H305-143 LAST WILL AND TESTAMENT I, KATHRYN E. MIXELL, of North Middleton Township, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. 1. I direct my Co-Executars to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Co-Executors of my estate. 2. My Co-Executors may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. 3. I authorize and empower my Co-Executors to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My Co-Executars are authorized and empowered to engage in any business_in which c� . - . �..� -.� I may be engaged at my death, for such period of time after my death as seem��xpedie�rt to'sai'd' - � , ,_; _ , r.,.< , � � :�� � � Co-Executors. �� F—, � " .. _ � . �;-, .. y; , ._ . . . , � . � � �, � � . .. �:_: : : � � ::� , � c...� - t;t ..� __, . �-� _^ "�� =�r F--► � 4. I give, devise and bequeath all of my estate of whatever nature and wherever situate as follows: a. Fifty Percent(50%)to my son, RONALD M. MIXELL; b. Seventeen Percent(17%) to my grandson, CHRISTOPHER J. ORTH; c. Seventeen Percent (17%)to my grandson, CORY A. OSBORNE; and d. Sixteen Percent (16%)to my grandson, NICHOLAS R. ORTH. 5. If any beneficiary entitled to share in any distribution under the terms of this my Last Will and Testament becomes an adverse party in any proceeding to contest the probate of this Last Will and Testament, such beneficiary shall forfeit his entire interest inherited hereunder and all provisions in favor of such beneficiary shall be declared void and of no effect. The share of such beneficiary so forfeited shall be distributed as part of the residue pursuant to Paragraph No. 4. hereof, except that if such beneficiary is entitled to share in the said residue, that interest shall be distributed proportionately to the other residuary beneficiaries. 6. I nominate and appoint RONALD M. MIXELL and CHRISTOPHER J. ORTH to be the Co-Executors of this my Last Will and Testament. 7. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. 8. No Co-Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 2 9. No beneficiary may assign, anticipate or pledge his interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. 10. I hereby suggest that my personal representatives retain the services of Irwin & McKnight, P.C. as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 3�'� day of March 2010. . ► : (SEAL) T YN E. MI Signed, sealed, published and declared by KATHRYN E. MIXELL, the above-named Testatrix, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other have hereunto set our names as subscribing witnesses. W / � � ,c;r'�'�'r�c' �''�� �:-�%z.c%z��,�e/ 3 - ' , �. ACKNOWLEDGMENT AND AFFIDAVIT WE, KATHRYN E. MIXELL, KAREN S. NQEL and SHARON L. SCHWALM,the Testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. l �.- � KAT YN E. MIXELL ��✓�'i-.. REN S. NOEL `�7JL//�'(�'Z.. (.��.ii'�LL/�y�y�t� SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA : . SS: COUNTY OF CUMBERLAND . Subscribed, sworn to and acknowledged before me by KATHRYN E. MIXELL, the Testatrix herein, and subscribed and sworn to before me by KAREN S. NOEL and SHARON L. SCHWALM,witnesses, this 3�"' day of March 2010. �, � � N ta Public COMMl7hIW�AL OF PENNSYLVANIA Notarial Seal Roger E1.Irv�in,Notary Public Carlisie Boro,Cumbe�land County �ly Commission Expires Oct.3,2012 Member,Penns�rivania As�ociaiion of Notaries