HomeMy WebLinkAbout10-15-13 1!�' Z Reset
PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF C'.��1�-�'1���,r I G�Y1 C� COUNTY,PENNSYLVANIA
Petitioner(s) named below, who is/are 18 yeazs of age or older, apply(ies) for Letters as specified beiow, and in
support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropriate form:
Deeedent's Information 1� � - '�'�(�
Name: �. ��a i�"E?_ ��_..�,�.`�i'Yl taV�i 1��(��������V File No: � � ���— �� ! �
a/k/a: (Assigned by Regist�r)
a/k/a:
a/k/a: Social Security No:� �
Date of Death: ��fic��-►t�t" h '7�J 13 Age at death: ���a
Decedent was domiciled at death in C rn�j�r'� r� County, (srare)with his/her last .
principal residence at t't� c3r� I G C- - -`� °� � r ►� e G �G`� :�1i' - - ��,-�nyx-
Street address, ost Oftice an 'p Code City,Tawnship or orough ounty
Decedent died at���� `r7 ZL=� ��v r� ;Y�'- 1`�I " �Y1� c' �� � c� C,urnl�� +"I can�. �
Street address,Pest Office ae�7sp Code City,Tewes4ip or Boreugb Couaty te
Esrimate of value of decedenYs property at death:
If domici[ed in Pennsylvania............................ All personal property $ �4T�f�O
Ijnot domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $
Ijnot domiciled in Pennsylvania. ....---...-•---........ Personal property in County $
Value of rea!estate in Pennsylvania.....................................................•••• $
TOTAL ESTIMATED VALUE. ... $ t j���� 0.00
.
Real estate in Pennsylvania situated at:
(Attach additional sheets,if necessary.) Street address,Poat OtSee aed Zip Code City,Township or Borough Couaty
�A. Petition for Probate and Grant of Letters Testamentarv
Peti6oner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of We Decedent,dated �,�}2 •L 3 r� �'�] and Codicil(s)
thereto dated —�—T—T
Stste relevant circumstaaces(ug.renwwciaben,death of execrrtor,etG)
Except as follows: after the execution of the insuument(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 born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
�TO EXCEPTIONS Q EXCEPTIONS
� B. Petition for Grant of Letters of Administration (If applicable)
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,duranie minoritate
If Administration,c.�a or d b.n.c.�a.,enter date of Will in Section A above and complete list of heirs.
Except as follows: D�edent was not a party to a pending divorce proceeding whenein the grounds f6f�divorce had l�n esta�ilixhed as defined
in 23 Pa C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated�eiCS� ` � `µ",
� t::S
Q NO EXCEPTIONS �EXCEPTIONS `-`" ' - - ` ' ""�
Petitioner(s),after a proper search has/have ascertained that Decedent left no W ill and was survived by the�fbllt>wiiag spot��s��if azry)'ai�i'dheirs(attach
additionalsheets,ifnecessary): �w, ,,.,
, .._
Name Relationshi E#dc�ress -�-� -
-,_, s�i
�,.,
_', ':.,, �..
. --J �1
Form RW-02 rev.10/Il/2011 Page 1 of 2
Oath of Personal Representative ot��;ai u�cfi�y
COMMONWEALTH OF PENNSYLVANIA
} SS: �
COUNTY OF Li l'11�7�if'IC.�1'1L� }
Petitioner(s)Printed Name Peritioner(s)Printed Address
c�t� ►� �S c � '7 1r�r� t,_ c?n ; �`�c�'c� . i �f�3 U��(� I ��
� � � � ��� � � Z, � .�-� - :�;- ti� � � �� i��-
The Peririoner(s)above-named swear(s)or affirm(s)the statements in the faregoing Petition are tn�e�d correct�t�e be�of the k�wledge�d belief
of Peritioner(s)and that,as Personal Representative(s)of tt►e Decedent,the Petitioner(s)will we11 and troly a�ter t6e estste accor�d"mg t�law.
Sworn to or affirmed and sub cribed before , �-C�� Date � �� - 15 - f�
me �s ���`'` day of C � : < Date /r, �/.S'�,/�
By: i ' Date
For the Register �
BOND Required: Q YES (�NO To the Register oJ Wills:
FEES' Please enter my appearance b�yny signature belov�� ��::'
J _,. ` :�}
Letters. . . . . . . . .. . . . . . . . . . . . . $ /�� Attomey Signature: ='° � ° "
� C.: __, , ,;,,
( )Short Certificate(s).. . . . . . t��k - c '
_.� .
( )Renunciation(s).. . . . . . . . �=-: :, . ' }--.-' s
( )Codicil(s). . . . . . . . . . . . . c.�'? , .
� )Affidavit(s).. . . . . . . . . . . f_:� � :.^..� -' :y.;
_. .. .,
Bond.. . . . . . . . . . . . . . .. . . . . .. . Printed Name: _. _> _.. ..
Commission. . . . . . . . . . . . . . . . . . Supreme Court "' ' ,-, ''
: , - c.._, ,�
O he . . . .. . . . ID Number: " -- � '
. . . i S.�T;t � ,� -;�
. . . . . _�
� . . . ��.�(�1� Firm Name:
j�`1 Ut°y1 Yll . . . . . . . . I�.� Address:
. . . . . . . Phone:
Automation Fee. . .. . . . . . . . . .. . �23 ,�U Fax:
JCS Fee. . . . . . . . . . . . . . . . . . . . . �.1� Email:
TOTAL. . . .. . . .. . . . . . . . . . . . . $ .�83'..��:OD�
DECREE OF THE REGISTER
Estate of C.�Gt I t"P.� � . � .V�► }��I File No: ��-��� �(�/�
a/k/a:
AND NOW, ���/�'�T(}�,Y� ,�13 ,in consi tian of e foregoing Petition,
satisfactory proof having been presented before me,FT IS DECREED that Letters S 1'�
are hereby granted to �
' in the above estate and(if applicable)that
the instrum t(s)dated
described in the Petition be 'tted to probate and filed of record as the last Will(and Codicil(s))of Decedent
�a
Register of Wills�I�V r��I �'� �"i __ .
Form RW-02 reu 10/ll/2D11 Page 2 of 2
HIOS.SOS REV(9/1 q
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WQRNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00 ;`u s°`�, F � �T �-`� ,n���"" This is to certify that the information here given is
,,,,�����p�,ZH UF pE';y._ correctly copied from an original Certificate of Death
t'�` `` � � �� � ` �� - _`f�` duly filed with me as Local Registrar. The original
���
_ � � ,.�,� c � � � `; Z; certificate will be forwarded to the State Vital
::� J � '.: + �� � � � ,° � n; Records Office for permanent filing.
'_* *;
�Y � 9 � � � � � � _... �`�''Oq,9 - . �.P'����1, W,��''� E� � � �0� �I � �,�
� 1 . _., . '--TMENIOF„���°
Certification Number ���� � Local Registrar Date Issued
�rino in V�J�t;J L 1\�I-S I r)
iCOMMbNW�RITH�F GENNSVLVr1NIA•DEPAflTMENT Of HE�LTH•VITAI FECORDS
k;�k` CERTIFICATE OF DEATH Sb[lFIIlNUmblc
1.D en['s Le{al Nam Irst,M EI,La t�u t) 1.Sex Ial kcuriry Nu ber 1 a af Death�M�Oay r)�Spe I Mo)
Sa. fast Birthday(Yrs) 56.Under 1 0. .u�eer i oa 6 Date ot Birth(MO,Tay/Yea��(Spell MonM�, ]a place�fJty an t te o orcig
�� Months Days Mo�n Minutes �,1y�� ( � . . .
U��U �� � Jb.Birthplatt�COUnty)
!a. ence(Sbte a Foreign Counlry) Bb.Pesidmce�5[ree[and Number�Include Apt o.� &,..,./Dld Oecedent lWe in a T�/��h107 ( � � �
� I ��e6,deUtleMlhedin IJ./I(�1����,1� IwR_ . � . �
.Raldence( unry) � . .
( Be.0.esidena�2lpCOde� ��G ❑NO,deceAentllvetlwRhlnBmitsof ciry/6pro.
9.EVerInUSArmedFOrcesl 10.MarIblStetu�a[Tlmeo�Death ❑Marcied Widowetl 11.5urvNIn65pouse'sName�1fw11e,gWenamepriortaAntmarriase�
❑Yes �NO ❑Unknawn ❑Divorced ❑NeverMarned ❑UnFnown
1].F r'sN m�Fo-rt,�n�ema�:twm.l 13.MOthMiNamePrlor[oFlrstM rrlage�Flrst,Mldtlle,Last�
�..
19.Iybrmant's� e 1 .Aelation�hioto�ecedent 16c.lniorman�'sMailin drcss�5[reetandN�m r,C ,Statt,ZlpCOde� ���
�
1 ry
i� 1 a. ace o Deat�
............. ...................... ....................................�.w.....................................�..°^...�e............................... .................................... .......�......................:...
i IfDeaMDUUrreElnaHOSpital'. In lent ;IlDeaMOCC�rteESamewhereOtherThinaHOSD�b1'. �S�HOSpiceiacllity [�]DecedenYsHOme � .
�....�t
❑Em<rBenc�Poom/OUlpalie^1 ❑OeaE on Arrlval [3'NUr�sing Nome/LOng-Term Gre F�acility Other(Spetlfy) . �
f 1 f Name�Ilnetl an,gHesheetantlnumber', �1 CiryorTOwn,State,anE2lpCOEe � .Coun ofDe[h � � �.
' � �� ��� ����r� � �
� I6a.M<t d o Dis osRion uri�l Crematbn l6b Da[ fq Ooskion 6. e ol D1 oittlon(Name o(cemetery,c em tory,aro[her 01 ceL
o p�m�.�,.om 5���. o��,�,o� io�'7/aol3 �� -
- rnher�soeuryl
location oi Disposmm��Ciry n iown,Swte,and Ziol Il SI oturo ot i�me I S i� unnsee or v in c e o1 intermem i .ucerise Humbar .
) � �4
, `r
,���.(�� �.` --���`..,.
3 okte dr ofFUnera F 111ry � J / C` ' .l, i .t" �/ �C���
�
e 18. cedent's Eduntlo� eck[he boK that best dexrlbes the 19.Oecedent of Ispanlc Orlein- heck Ihe 0.Decedent's Nace�[hecM ON N MORE reces fo indkah whal
� highnt depee or level o xhool canple[ed at[he Hme of dea[h. box thal best dexHEes wheNer Me deceEenl Me deceEent considared hlmsdf or hxxl�m be.
❑Bth6ndearkss isSD+��sh/NISO+�W����o.Checkthe'NO' [�WhHe ❑Korean
❑Nodlploma,9th-llthgrade boxNdtteEentlsrwt5pa�lsh/Hlspanle/LaH�w. ❑BbckorAtrlcannmerlon ❑Vle[namese
❑Hlg�uhoolgnduateorGEOCOmplereE �NO,notSpanish/Hlspanlc/La[Ino ❑FmMwnlndlanuRlaskaNatNe ❑OlherASlan
❑Some wlkge creAlt but no Eegrce ❑Yes,MeMlcan,Malnn American,Chlcano ❑Atlan InEbn ❑NatNe Hawalian
❑ASSOCia[edeyree�e.y.M,�15) ❑Yes,PUertoPican ❑Ulnex ❑GUamanlanorChamorta
�❑ xheloi 5 Aqree�e.y.BA,A8,85) ❑res,c�n.� ❑rnin��o �❑s.mo.o
Master's de6rte�e.B�MA,M5,MEn`,MEd,MSW,MBR� ❑Yes,othe�Spanish/Hlspanic/latlna ❑IaOanese ❑Othe/Paclflc Islantler
❑ooc�ooce le.e�vno,eeol or v.ore,:�o�i enr�. �soenM__ ❑ome�(sP«iryl
e..MD DDS DVM lLB 1D
IS.Deutlent's Sin{le Nace Sell-�esignation-Check ONLY ONE to IMicate what Me Jecetlent w�slEered himself or herul/[o be. 7Ia.Decedent's U�ual O<cupation-Indicatt type of work
�W�ih ❑/apanese ❑Samoan do Euring mml of working Iik.DO NO1i''USE N(ETIRED.
OBIxMOrAtricanAmerlcan ❑NOrean ❑OMerVacifclsla�'.e� ���, Y `�-CIA.�.�I //l ��1��
❑Rmerlcan Indlan erAlasMa NatNe ❑Vletnamese ❑Oon[Nnaw/NOt Sure
❑Aslan In01an ❑Other AsNn ❑Pefused 11b.Kindf�(Business ndustry
❑CAlnese ❑Na[NeHawallan ❑Othe��50ecl/y)_. ' I��`II�`` _.I�.,^�`
❑flllpino ❑Guamanbn or Chamorro � I/L � ��i ti-. �
ITEMS 3a- MUSTEECOMYIFfE� 23a.0attPronounceEDtaE�MoDay r� ]3b.51gnatureofPatsonPronouncingOCatb�Onh/whenapplicable� 23c.11censeNVmber'� . . .
BY VEq50N WNO vqONOUNCES OR .
CERTIFIESDEATX �O'��Y�C7D�'3 � r � ��a�ry�3�
73d.Datt Signed I�o/Day/Yr� 20.Time at Oea[O3`�
J O O(p �p� J 25. u Medinl Eyamineror Coroner Conh ❑Yei No �
CAUSE Of DEATH � i nop,o.im:n �
]6.V�rtLEnterMethainofevents�diseases,lnju�ies,or<ompllo[ions--tha[direc[IyrausMthedeath,DONOTmterterminaleventssuchascardiacarrest Interval:
resqntaryarresl,orven�ACUlarflbrillationwlthoues�owingthee[iology.DONOTqBBRkVIATE.EnteronlYOnecauseonallne.AEdaddi[lonallinesilnecessary ; OnsettoDeath
�MMEDIATE UUSE ------������a .. I N 4'Nl?�.171J �
�FinalEluaseorconditlon Du{e�to�or saconseau -e1o�:
,�.�m�ei�a.,m� S�f.��l� J`GYYI�C../U t�� �
e.
sewe�e�nuyn:e�o�ae�om, ouero(oraaaconseouenceory: � . . �
it airy,leading ta the c�use .
Ilstetl on IMe a.En[er t�e � .
UNDEPlY1NGUUiE Dueta(ar�sacanseQUenceo� .
3 idi,e.:e o��n�un�na� . �
- inRla[edtheeventsresultin8 tl._
yindeath�LASt. Dueto�orasaconsepuenttal��.
g ]6.P�/rt�lls.Enteroll�e/rslpan�f ����I�M^�ltl�ofmcontnbutinvtodeathbu[�atresul[In6�^«unEerNingcauseglveninVartl 11.WasanauroosYO�HarmedT
�QLI'+C� l./`•"VG I� � ❑Y<s Np .
F � 18.WereautopsyMEingsavallabk �
N QNV M�M K} co�omo�ere me A�:.oro�sont
E £ :4N V SE/?S� ❑v.: no
� 19.If Femak: 30.DiE ToEacco Uu Conlribule to UeaMi 31.Manner of pea[h
E a No[Oregnantwkhinpastyeai ❑Yes ❑Probably m NaWral ❑HamlclEe
� �Pregnant at tlme of death ❑No �Unknown ❑Accitlent ❑Ventliny Inves[IyaHOn
�Not pregnant,but pregnan[within a2 days of Eeath �Suitide �Could not be determined
_ ❑qot pregnant,sut pregnant 03 days m 1 yor bebre deatl 32.Date ot Injury�Ma/DaY/�r�(Spell Month) �
❑Unknaxn if Oregnant within Me past yeai 33.Time of Injury
3/.Flare at Injury�e.8�home,mnstruction sire;hrm;uAOOI� 35.Locatian o!In�ury�Streel anE Number,Ciry,5[ah,Zip Code)
36.In�uryatWOrk 37.ItTnnsportatlonln��ry,SOK�N� 38.DeicribeHowln�ury0ccurred:
❑Yes ❑Dmer/Operator ❑Pedesttlan
❑No ❑Vastt�per ❑Other(Specily)
39a.CertlNtt�Geck only one�:
g ceniryvK onvsician-ro ene besc o�my knowiee`e,eeam occunea due ro�he causelsl a�d manner smcea
❑Vrorwuncing 6 CMifyin`Ohysician�To the best of my knowleEge,deaM occunetl at the Hme,date,and D���e,anG due to the cause�s)and manner sbled
❑MedlolE�aminer/Cwa er�OnMeEasiso/evaminatlon,and/orinvesUgatbn,lnmyopinion,deathoccurredatthe[Ime,date,and0lace,anddueroNeauys�e�s�an�tl(J ar bmE
Signatureafcertifler: TIIleofnMfier M� llcenseNUmber:M�.1�v�1^I �� �
39E.Name,AOErass and 2 e f V Co IeHng Cauu o(DeatM1(Item]6� � h/1 �f�. S'� 39c.Da[e gneE( /Da/Y I
���i�.,d�c °Q%oa�' a r� G� � i o o� ��i3
90.PKlshats�syrlct N��� Ol.�trar's F6�ature � Q dl.Peglst ar Flle ate��ay r . . . �
d {j cYC""'� 1 o i'`I i�i
ea.a�<�em��e: �
Dlioositlon Pertnit No.� 1•�� 1� 1 . .. H105-103
REV 01/2011
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LAST WILL AND TESTAMEIsiT : ; � _� W r��
_.J �-, r..:�
` c^ ..
�"" c:� `n
I, CLAIRE C. McVITTY, of the Township of Upper Allen,
County of Cumberland and Commonwealth of Pennsylvania, being of
sound and disposing mind, memory and understanding, do make,
publish and declare this as and for my Last Will and Testament,
hereby revoking and making void all former wills and codicils by
me at any time heretofore made.
FIRST. I order and direct that all my just debts and
� funeral expenses be paid by my Executor, Executors or Executrix,
` as the case may be, hereinafter named, as soon as conveniently
�
� may be done after my decease.
�
^,�
� SECOND. I give, devise and bequeath all the rest, residue
�.
and remainder of my Estate, real , personal and mixed, whatsoever
� and wheresoever situated, unto my husband, LAWRENCE F . . McVITTY,
� absolutely and in fee simple if he survives me by as many as
sixty ( 60 ) days .
THIRD. If my husband, LAWRENCE F. McVITTY, does not
survive me by as many as sixty ( 60 ) days , then and in that
event, I give, devise and bequeath all the rest, residue and
remainder of my Estate, real , personal and mixed, whatsoever and
wheresoever situated, in equal shares unto my two children,
namely, KAREN M. SCHAEFFER and WILLIAM J. McVITTY, share and
share alike, absolutely and in fee simple .
If either of my said children should predecease me, I
order and direct that the foregoing residuary share of such
deceased child shall be distributed unto her or his issue per
stirpes by representation and not per capita, but subject,
LAW OFFICES
SNELBAKER, however, to the protective provisions in Item Fourth hereinbelow
ELICKER & SILVER
event that one should fail to qualify or cease so to serve) , to
be the Executors hereof, each and all to serve without bond or
other security as a condition of qualification hereunder .
IN WITNESS WHEREOF, I, CLAIRE C. McVITTY, have hereunto
set my hand and seal to this, my Last Will and Testament which
consists of three ( 3 ) typewritten pages to each of which I have
affixed my signature this �� r� day of {�p r i 1 , A.D. ,
One Thousand Nine Hundred Eighty- even (1987) .
,
� �� � '. �� � . �� ' ,(.SEAL)
The preceding instrument, consisting of this and two ( 2 )
other typewritten pages, each identified by the signature of the
Testatrix, was on the date thereof signed, sealed, published and
declared by CLAIRE C. McVITTY, the Testatrix therein named, as
and for her Last Will and Testament, in the presence of us , who,
at her request, in her presence, and in the presence of each
other, have subscribed our names as witn sses hereto.
�
.u�.� _.,G.��,l�.�._/
, ��.'�'ti�
LAW OFFICES
SNELBAKER,
ELtCKER & SILVER
with respect to any beneficiary who has not attained the age of
twenty-three ( 23 ) years at the time of my death .
FOURTH. I order and direct that the distributive share
under Item Third hereinabove of any beneficiary who has not
attained the age of twenty-three ( 23) years at the time of my
death shall be delivered unto THE FIRST BANK AND TRUST COMPANY
OF MECHANICSBURG, PA. , as my testamentary trustee, IN TRUST,
NEVERTHELESS, to hold, manage, invest and reinvest for the
r
� ultimate use of such beneficiary and until said beneficiary
.
` • attains the age of twenty-three ( 23 ) years , at which time said
� Trust shall be terminated and the remaining net balance thereof
,�
�
� and accumulated interest thereon shall be distributed and paid
� over unto the beneficiary absolutely.
�
During the existence of any such protective trust, I
� authorize and empower my said Trustee to use, consume and apply
from time to time such amounts of income and principal as my
said Trustee in the sole exercise of its discretion shall deem
to be necessary and proper for the beneficiary's education,
� taking into consideration the primary obligation of the
beneficiary's surviving parent to provide for such education.
The term "education" shall be deemed to mean college or other
post-highschool training which is intended to enhance the
beneficiary's productivity as an adult or to improve his or her
quality of life .
LASTLY. I nominate, constitute and appoint my husband,
LAWRENCE F. McVITTY, to be the Executor of this, my Last Will
and Testament, but if for any reason he should fail to qualify
LAWOFFICES as such Executor or cease so to serve, then and in that event, I
SNELBAKER,
ELICKER & SILVER nominate, constitute and appoint my tH1� children, namely, KAREN
M. SCHAEFFER and WILLIAM J. McVITTY (or either of them in the
COMMONWEALTH OF PENNSYLVANIA)
. SS:
COUNTY OF CUMBERLAND)
WE, CLAIRE C. McVITTY, RICHARD C. SNELBAKER and JANET M.
FORRY, the Testatrix and the witnesses, respectively, whose
names are signed to the attached or 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 Testament and that she had signed willingly, and
that she executed it as her free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the Will as
witness and that to the best of his or her knowledge the
Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence .
,
�
� �? � C� �ZL��
- 'T,�statrix
�
1 �%C+[�-�"�' �` . !��
Witness
��
�__. �.
a�� .
, Witness �
Subscribed, sworn to and acknowledged before me by CLAIRE C.
McVITTY, the Testatrix, and subscribed and sworn to before me by
RICHARD C. SNELBAKER and JANET FORRY, witnesses,
this �3 �d day of ��`v""� , 1987 .
C��trw,=c�_ � �O-rcQ.c.vi�-L
�W OFFICES Notary Public
SNELBAKER,
ELICKER & SILVER ��1N����'��F. F�'�z�a�P.Np1�,�RY P�BLIC
�e°.���iGS�U�r 6p�a,Cf9�R8£R1A�'D CUUNTY
�Y�Q�MiSS10N EXPIRES fFR.17, �590
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