HomeMy WebLinkAbout01-27-05
PETITION FOR PROBATE ami GRANT OF LETTERS
Estate of Atlne C. 8/C:d(els No. cJl-() \-I)D77
also known as To:
Register of Wills for the t1
County of t'.I.NIIt./offfQJ1. in the
Commonwealth of Pennsylvania
Deceased.
Social Security No.t:>ID<I. -~;;l- q5bt
The petition of the undersigned respectfully represents that: ,
Your petitioner(s), who islare 18 years of age or I'ldlr an the executl"\ X
in the last will of the above deTe~lnt, dated Ill- z.~ q"
and codicil(s) dated ~J.CiI- 7007
named
,19_
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in CI /~~ County/ Pennsy(vl},Ilia, with
h ,r last family or principal residence at 5 ~ A2.r1J (CIA l/c.l..( ~
liD (3
(list street, number and muncipality)
Dec".l!<:!ent, t en -.---3.L- ' ~ 2.005 ,
at 0fi \..(.
Except as follows, decedent did not arry, was not divorced and did not have a child born or adopted
after execution of the will offered for pr bate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania t
situated as follows: "J q..
$ 12..cXV.OO
$ /
$
$.
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
theron.
~ament~drninistration c.La.; administration d.b.n.c.t.a.)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEA~TH OF PENNSYLVANIA "I ss
COUNTY OF \. "'"'''''....lo....nA . J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of th: above decedent petitioner(s) will well and truly administer the estate according to law.
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Sworn to or
bef e me this
affirmed and
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Estlllte o>f Q)/\ (\ Q C, Auo k'p to
, Deceased
DECREE OF PROBATE, AND GRANT OF LETTERS
AND NOW
M_. in consideration of the petition on
the reverse side reaf, satisf ctory proof having been preseilted before me,
IT IS DECREED that the instrument(s) dated \ \ - c2 - q to
described therei be admitted to pr ate and filed of record as the last will of
and Letters
are hereby granted to
(\6.\ J\ \ '5. GO
\ FEES \5.00
W'\ Lv
Probate, Letters, .Etc. ......... $ D,()()
. . cQ4 c.f)
Short Certlficates( ).......... $ .
h_~""~;c",,"l\ . _u~ \'leA. $ 5 00
"-"''''....'"'''''....t'l-l:'(Q'.r.o:nC>1:\:1''... .
~p $ 10.00
TOTAL _ $
Filed 1...dJ.o.-:a s:-. ......................
L;}dPiOcW ~~n"*~
. Re,glster of .. .
ATTORNEY (Sup. Ct. J.D. No.)
ADDRESS
PHONE
This is to rertify that the information here given is rorrcctJy copied from an original certificate of death duly filed with me as
Lxal Registrar. The original certilkale \vill he forwarded to thr State Vital Rerords Orfice for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph,
Fcc for this certificate, S2.00
No.
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JAN 1 9 2005
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
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CERTIFICATE OF DEATH
STATE FilE NUMBER
SOCIAL SECURITY NUMBER
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NAME ()F DECEDENT (Fi'SI,Mkldle, Lasl)
,,,
Anne C. Breckels
S"
2. Female
BIRTHPLACE (C,ty and A F AT
Stale or Foreign CouoloyJ HOSPITAl.
InpatiOf1tD
7.Dobbs Ferry, NY 8a.
,. 064
22 -
4501
DATE OF DEATH (Monlh, Day, Year)
.,Jan\lar 18, 2005
..
AGE lLast B.rthdii~)
00'
6. 91
COUNTY OF DEATH
DOAD
R.,;<jeo<<O ;:~:~iryl 0
RACE-Arnericanlnd'an, Black, lMlile,el
ISpecil~)
lb. Cumberland
DECEDENT'S USUAL OCCUPATiON
(~7~~;~t;:~~d~.,,:",~,:).t
0<.
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White
SURVIVING SPOUSE
(lfwilo,go,."""d.n"'"'.1
11... Housewife 11b. Domestic
DECEDENT'S MAILING ADDRESS (Streat C1tyfTown, Stale, Zil'Code) DECEOENTS
210 Big Springs Road ~g~ELNCE
Newville, PA 17241 (SeainslNCtiOllS
011 olher side)
AS DECEDENT EVER IN
U.S. ARlAED FORCES?
YesO No~
12. 13.
171. Slate Pennsylvanifl
MARITAL STATUS - Malried,
NeverMarriad,Widowed
DIVOlced(Specily)
14, Widow
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FAHtER'SNAME(F"sl,Middle, Last)
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INFORMANT'S NAME (TypeJPrinl)
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METHOD OF DISPOSITION
DonaliOll 0 Burial 0 Cremabon [Xhemovall,om Slale D
Oiher(Sl'eaM
Cumberland
Did
decedenl
Iivaina
townShip?
17c.fX.IYeS,decadanIJivod,n
WP.Rt Pp.nnRhoro
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17b. Countv
17d.0 ~~~~e~I':~1i~":i~oI
Cllylboro
.
DATE OF DISPOSITION
o ~~:""'''''' / -;J /.J./J06
MOTHER'S NAME (Fi,st, Middle, Malden Surname)
1a Concetta Ciano
INFORMANT'S MAILING ADDRESS (Street, CitylTown, State, Zil' Code)
2tIb. 525 Greason Road, Carlisle, PA 17013
PLACE OF DISPOSITION- Name 01 Cemeter)'. Crematory LOCATION. C1tylTown. Stale, Zil' Code
or Other Place Cremation Society
21c. of PA Cremator
NAME AND ADDRESS OF FACILITY uer emor ,a
22c. Services. Tnc., Harrisbur
UCENSENUMBER
A'
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1?l09
orne Crematlon
PA 1?l09
PATE SIGNED
o L (Monlh, Day, Y~ ~(lO S-
,,,,/\IJ 5;;1;;1.023 '" I ('6,
WAS CASE REFERRED TO A MEDICAL EXAMINER ICORONER?
26. Yes I8J JT, No 1sa'
; ApproXImate PART II: OthersigmlicanlcOlldiUonscontribulingto death,but
"nteIValbelween nol ,esulting in the undertying cause given ,n PART I
: onset and death
James Raffa
Diane S. Ba.rna
27. PART I: EO..'....dl......,inju.....o'complic.lJo<,.wtIidlcau.........d......
h'l""'"OM cau........ch_
Sequenlially'slcondilions
ifany,leadingtolmmedlate
_ cause Ente,UNDERlYING
CAUSE (Disease Q('fljuoy
Ihat imtialed events
resulting on dealh) LAST
WAS AN AUTOPSY IlllERE AUTOPSY FINDINGS
PERFORMED? AVAilABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
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OIJ.ETO(Ofl:ASACOi'lSEQUENCEOF)
MANNER OF DEATH
DATE OF INJURY
(M"'lh,D,y,Y..rl
TIME OF INJURY INJURY AT VIORK? DESCRIBE HOW INJURY OCCURRED
Natural
Accident
Hom,cide
o
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o ~~:CE OF INJURY
b""..,,~, .r, ISp.ci~)
30e.
YesO NoD
30b. M 30e. JOd.
LOCATION (Stree1. CllylTown, Slate)
YeSD No
Yes 0
'0119
Su.cide
o
o
Pendu--.glnvestigallon
RE~R'SSIGN~~MBER
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.ftl/l>ll/I/I
o
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Could not l:ja determined
28a. 21b.
CERTIFIER (Ched<.onlyonel
.f~~J~FJ~~IGor~~~I~~~~[[ghJ."~~:~h cg~g~i:;'i,'i':J';f: t~ 8.e:~I~~~:)'~l~3'J~X~i~~. h:'~f:~~~~~ce,d.d~a.t~ .a~_d .~0f11_~~.1~.~ .i.t~.~ .::).
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.PRONOUNCING ANO CERTIFYING PHYSICIAN (Physician both I'rorh"".cinll death and certify"'9 10 cause of death)
To It._ b_st of my knowledg_, death occurred It the lime, dlte, su,j plIU, and due 10 the csusu{_land msnner II Itlled...
'MEDICAL EXAMINER/CORONER
On Ihe buls of eumlnaUon and/or Investigation, In my opinion, d~ath occurred st Ihe lime, date, and pllce, and due to the clusn(s) and
311~lnn"'"S5t"led 0
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ED(Monlh,Day.Year)
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Codicil to Last Will and Testament
of
Anne C. Breckels
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I hereby declare this to be a codicil to my Last Will and Testament da~~ EEi
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November 2, 1996.
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I appoint my niece, Diane S. Barna, currently residing at 525 Greason Rd.,
Carlisle, P A 17013 as my sole executor of this will. If she does not serve
or complete administration of her duties, I appoint my niece, Lynne B. Hunt,
currently residing at 9991 Arthur Lane, Highlands Ranch, CO. 80130 in her
place.
IN WITNESS WHEREOF, I, Anne C. Breckels, have to this codicil subscribed
my name and set my seal this /5 7Ic day of :l,- b ru..dr 'Y
, in the year
Two Thousand and Two.
a~ (, k ~d, 1..1-_
Anne C. Breckels
Severally sworn to before me this
/srL day of'-i':Uc1.<''''r-' 2002
iLL - / qY;fJ~""
. I
Notarial Seal
VlctcI L HopkIns, NolaIy Public
West 1'\"..obu.~ ~CurnlMlI1and County
My Con,n.lsskM. res Jan. 1'5, 2004
M8mber, Fetw;syMulla ~. 01 NOIlU1e8
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LAST WILL AND TESTAMENT
OF
ANN BRECKELS
I,
ANN
d'-DS-- 00/1
BRECKELS, currently residing in the Village
of
Dobbs Ferry, County of Westchester, State of New York, do make,
publish and declare
this to be my Last Will and Testam~t,
Q g ~)
wills and codicils at any time~'h<eretof:ore ril r)~
>~ ~~~ P ~;;?; (~~ S~1
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hereby revoking all
made by me.
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FIRST:
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I direct that my funeral expenseS
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and "'the ,-: rn
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(;"j
general
expenses
of my last illness, if any, be paid out of my
estate.
SECOND:
I give all my tangible personal property
to my husband, JAMES BRECKELS, or if he does not survive me, to
my nieces, LYNNE G. HUNT, residing at 9629 Timberhawk Circle,
Highlands Ranch, Colorado 80126, DIANE BARNA, residing at 525
Greasom Road, Carlisle, Pennsylvania 17013, and nephew DR.
JAMES BARNA, currently residing at 2539 Gary Circle, Dunedin,
Florida 34698, who survive me, to be divided equally between
them as they may agree. All charges for storing and insuring
any of this property for a reasonable amount of time and for
packing and Shipping it to my legatees shall be paid out of my
residuary estate as expenses of administration.
THIRD :
I give all real property which I own or
have a partial and shared interest in at the time of my death
to my husband, JAMES BRECKELS. If he does not survive me, I
direct my executors to sell such property and to add the
proceeds to my residuary estate.
atZ3
FOURTH: I give my residuary estate, both real and
personal, to my husband, JAMES BRECKELS, or if he does not
survive me, to my nieces, LYNNE G. HUNT, DIANE BARNA and
nephew, DR. JAMES BARNA in equal shares, per stirpes.
FIFTH: I appoint my husband, JAMES BRECKELS,
currently residing at 29 Livingston Avenue, Dobbs Ferry, New
York, to be the executor of this Will. If he does not serve or
complete administration of his duties, I appoint my niece
DIANE BARNA, currently residing at 525 Greasom Road, Carlisle,
Pennsylvania 17013, and nephew DR. JAMES BARNA, currently
residing at 2539 Gary Circle, Dunedin, Florida 34698, to be
co-executors in his place. Any individual executor acting
hereunder may resign as such at any time without the permission
of any court or person.
I direct that no bond or other security be
required of any fiduciary acting hereunder for the faithful
performance of duties in any jurisdiction. The term "executor"
as used herein shall include the executor or executors acting
hereunder from time to time.
SIXTH: In addition to, and not by way of
limitation of, the powers vested by law in fiduciaries, I
hereby expressly grant to my Executor with respect to my estate
the powers hereinafter enumerated, all of such powers so
conferred or granted to be exercised by him/her as may deem
advisable, in his/her sole and absolute discretion:
al2
-2-
(1) To retain, purchase or otherwise acquire, whether
originally a part of my estate or subsequently acquired, any
variety of real or personal property, any and all stocks,
bonds, notes or other securities, inclUding securities of any
corporate fiduciary, or any successor or affiliated
corporation, interests in common trust funds and securities of
or other interests in investment companies and investment
trusts, and partnerships (participating therein as a general or
limited partner), whether or not such investments be of the
character permissible for investments by fiduciaries and
without regard to degree of diversification;
(2) To sell, lease, pledge, mortgage, transfer, lend,
exchange, convert or otherwise dispose of, or grant options
with respect to, any and all property at any time forming a
part of my estate, in any manner, at any time or times, for any
purpose, for any price and upon any terms, credits and
conditions; and to enter into leases which extend beyond the
period fixed by statute for leases made by fiduciaries;
(3) To borrow money from any lender, including any
corporate fiduciary acting hereunder, for any purpose deemed
appropriate, inCluding the exercise of stock options, and as
security to mortgage or pledge upon any terms and conditions
any real or personal property of which I may die seized or
possessed; and
(4) To exercise any stock options which I may own at
the time of my death and to retain the underlying stock
purchased on the exercise of such options; and to exercise all
other powers with respect to such stock as though such stock
had formed a part of my estate at the time of my death
SEVENTH:
All
estate,
inheritance,
legacy,
succession,
transfer or other death taxes (including any
interest or penalties thereon) imposed by any domestic or
foreign tax authority with respect to any property owned by me
at the time of my death and passing under this Will (other than
any tax imposed by reason of Chapter 13 of the Internal Revenue
Code of 1986, as amended, or any successor thereto, and any
comparable tax imposed by any other taxing authority), shall be
paid out of my residuary estate with no right of reimbursement
from any recipient of any such property.
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IN WITNESS WHEREOF, I, ANN BRECKELS, have to this my
Last Will and Testament subscribed my name and set my seal
this~day of /11 t)'l, in the year One Thousand Nine Hundred
,
and Ninety-six.
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WITNESSES:
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SIGNED, SEALED, PUBLISHED AND DECLARED by the
above-named Testator as and for her Last Will and
Testament, before us, who at her request, in her
presence, and in the presence of each other, have
hereunto set our hands as witnesses this~~L day
of M'--"'^.J::>cr, 1996.
\1'. (\II Ve\SD0 residing at dl\ Ll \J I ~ S tOf\
Dobbs fer,{
Ale
N- "I.
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/C-LvY'e.hC<..J:) F;-"",kC/1 residing at Ii.{ !Vtc../;'" 5fr€.___+
Oo!hJ [;yr:;, A/:J. IDS),).
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AFFIDAVIT
STATE OF NEW YORK)
:ss.:
COUNTY OF WESTCHESTER)
Each of the undersigned, individually and severally,
being duly sworn, deposes and says:
The within will was subscribed in our presence and
sight at the endd thereof by ANN BRECKELS, the within named
Testator on the Ol. " day of /th~ber ,1996. Said Testator
at the time of making such Subscription declared the instrument
so described to be her subscription declared the instrument so
subscribed to be her Last Will and Testament. Each of the
undersigned thereupon signed his or her name as a witness at
the end of said Will, at the request of said Testator and in
her presence and sight of each other.
Said Testator was, at the time of so executing said
Will, over the age of eighteen years and, in the respective
opinions of the undersigned, of sound mind, memory and
understanding and not under any restraint or in any respect in
competent to make a will. The Will was executed as a single,
original instrument and was not executed in counterparts.
Each of the undersigned was acquainted with said
Testator at such time, and makes this affidavit at her request.
The within will was shown to the undersigned at the time this
affidavit was made, and was examined by each of them as to the
signatures of the Testator and of the undersigned.
J..e~ (n, ~Y-
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Severally sworn to before me
this.;l"" day of /LJov......~ , 1996.
~~
Notary Public
KENNETH THOMAS
Notary PublIC, State of New York
No.02TH5026338
Qualified In New York County 00'
CommiSSion Expires April 1 a. 19-'-"