HomeMy WebLinkAbout01-13-14 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 I
Name: IRENE M. LENDA File No: c "- 14-0o3to
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 114-10-1887
Date of Death: 11/2/2013 Age at death: 96
Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (State) with his/her last
principal residence at 21 AMHERST DRIVE 17011 LOWER ALLEN TOWNSHIP CUMBERLAND
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 4831 E. TRINDLE ROAD 17050 HAMPDEN TOWNSHIP CUMBERLAND PA
Street address,Post Office and Zip Code City,Township or Borough County State
Estimate of value of decedent's property at death:
Ifdomiciled in Pennsylvania................................All personal property $ 5,000.00
If not domiciled in Pennsylvania.............................Personal property in Pennsylvania $
If not domiciled in Pennsylvania.............................Personal property in County $
Valueof real estate in Pennsylvania.............................................................. $
TOTAL ESTIMATED VALUE.... $ 5.000.00
Real estate in Pennsylvania situated at:
(Attach additional sheets,if necessary.) Street address,Post Office and Zip Code City,Township or Borough County
M A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated 51211.090 and Codicil(s)
thereto dated
State relevant circumstances(e.g.renunciation,death of executor,etc.)
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 born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
M NO EXCEPTIONS ❑EXCEPTIONS
❑ B. Petition for Grant of Letters of Administration Of applicable)
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,durante minoritate
If Administration,al.& or d.b.n.e.t.a.,enter date of Will in Section A above and complete list of heirs.
Except as follows: Decedent 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 was neither the victim of a killing nor ever adjudicated an incapacitated person.
❑ NO EXCEPTIONS ❑EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse(if any)and heirs(attach
additional sheets,if necessary):
Name Relationship Address
Form RW-02 rev.10/11/2011 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
21 AMHEREST DRIVE
GENEVIEVE COLLINS CAMP HILL PA 17011
The Petitioner(s)above-named swear(s)or affirm(s)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 Representative(s)of the Decedent,the Petitioner(s)will well and truly administer the estate according to law.
Sworn tXd med and subscribed b�e�fo��r11e�� �� Lf�T� =-� Date
me this y of .Ur l Date
BY Date
For the Register Date
BOND Required: ❑ YES )( NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters..................... .. $ Q Attorney Signature:
( q )Short Certificates(s) ...... I'D Q
( )Renunciation(s).......... _
( )Codicil(s) ..............
( )Affidavit(s)... ..........
Bond .................. .......
Printed Name: SUSAN H. CONFAIR
Commissiop .................... Supreme Court
Other �n( � }�j ID Number: 70241
,N
�'-�`�J 105 Firm Name: REAGER &ADLER• PC
45
Address: 2331 MARKET STREET
"" ""' CAMP HILL PA 17011
••••••••• Phone: 717-763-1383
......••• Fax: 717-730-7366
Automation Fee ........ . ...... .. S Email: SCONFAIRO-REAGERADLERPC.COM
JCS Fee .........:.............
TOTAL ................ ......$
DECREE OF THE REGISTER
Estate of IRENE M. LENDA File No:
a/k/a:
AND NOW, 1 3 ,C � ,in consideration of the forego ing Petition,
satisfactory proof ha)i g been presente before me,IT IS D CREED that Letters I , W 011IYl�l�
are hereby granted to ��/l eV� r I I n5
in the above estate and(if applicable)that
the instrument(s)dated
described in the Petition be admitted tO probate and filed of record a the last Will(and Codicil(s))of Decedent.
Reg t r of Will
Form RW-O2 rev.10/11/201/
&OArPage 2 of 2
H 105.805 REV(9/11)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.,
Fee for this certificate. $6.00 ',,lfffff"'�---- This is to certify that the information here given is
�tH OFp
duly filed copied th me asaLo al Registrar.Certificate
cThe original
z certificate will be forwarded to the State Vital
°' a Records Office for permanent filing.
P 20083523 ; "`y
Certification Number ''-l!yEN10E�;11'
II
Local Registrar Date Issued
permanent t COMMONWEALTH OF PENNSYLVANIA•DEPARTMENT OF HEALTH
i Permanent VITAL RECORDS
Black ink CERTIFICATE OF DEATH
1.Decedent's Legal Name(First,Middle,last,Suffix) State File Number:
2.Sex 3.Social Secu rl ty Number 4.Data of Death(Mo/Day/Yr)(Spell Mo)
Irene M_ Lends :E 114-10-1887 November
5a,Age-Last Birthday(Yrs) Sb.Under 1 Year c.Untl.r 1 Da 6.Data of Birth(Me/'IY/Year S 2. 2013
MOnths Days ' Hours Minutes )(Spell Month) 7a.Birthplace(CRY antl State or Foreign Country)
96 March 25, 1917
go.Residence(State or Foreign CO unt 7b.Birthplaee(County) Manhattan
Country) Sb.Rasitlene¢(Street antl Number-Include Apt No.) 8c.Did pecedent Live In a Townshl 7
Penns lvania p
8d.Residence(Count ) 2 1 Amherst Dr._ Q Yes,decedent lived m two.
Cumber Land Be.Residence(Zip Code) q,decedent lived within llmlts gfCamA H i 11
9.Ev.r in VS Armed Force,I 10.Marital Status st Tl me of Death city/bore.
Q Yes JrDQJO Q Unkn Own Q DivOrc¢d Q Marri.tl JOKWidowetl Ile Surviving Spouse's Name(If wife,glue name prior to first marriage)
Q Never Married Q Unknown ___
12.Father's Nam (First,Mitldle,Last,Suffix) 13.Mother's Nama Prior to First Marrla
Alexander Marchewlca ge(First,Middle,Last)
24a,Informant's Nam¢ Eva Pomichowska
14b.Relationship to Decedent 14c.Informant's Mailing Address(Street and Number,Clty,State,21p Code)
c Genevieve C011ins dau hter 21 Amherst Dr_ Cam Hi11 Pod 1 If Death 6 curretl Ina Hospital - - - - - - - -1 a. ace o eat' ec o a --
d Inpatient I IT Death Occurred Somewhere Otlie Than a Hospital: ❑Hospice Facility t]p¢c¢tlent's Home
O Emergency Room/OUtpatlent Q Dead on Arrival Nursing Nom¢/Long-Term Care Facility Q Other(Specl
a ISb.Facility Name(If nOt InstltutiOn,give street antl number) t Is..City or Town,State,and Zip Code )
_ Countr Meadows 15d.County of Death
16a.Methqd pr Dlspq,Inpn - Mechanicsbur PA 1 7050 Cumberland
® Burial Q Cremation y(b,Date of piW5ltlot' 16c.Place of DlsposRlon(Name of cemetery,ere m ate
y O Removal from State O Donation LV O `< mLM o ry,or other place)
g o ocher(spe-1 > 201 3 Gethsemane Cemetery
16d.LOCation of DlspOSitiOn(Qty or Town,State,antl Zlp) 17n.Signatur F eral S e L
PA 1 $Q 4-5
-or, ^In Charge of Interment 17b.License Number
Palmer TwpFD138497
aEE 17c.Name and Complete Address of Funeral Facility
� highest hest degree Education-Check the box that best
describes the 19.Deced¢nf of His pant rigin-Check LjajQ
the 20.Decedent's Race-Check ONE 1 R MORE races to indicate what
highest tlegree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be.
Q 8th grad or less Is Spanish/Hispanic/Latino. Check the"NO" Whl[e Q Korean
E3 No diploma,9th-12th grade box If tlecedent Is not S
High school panish/Hispa nle/Latino. Q Black or African American Cl Vietnamese
Nt g graduate or GED Completed (t No,not SPanlsh/Hispsnlc/Latino Q American Indian Or Alaska Native Q Other Asian
Q Some college credit,but no degree 0 Yes,Mexican,Mexican American,Chicano Q Asian Indian Q Native Hawaiian
Q Associate degree(e:8,AA,AS) O Yes,Puerto Rican
Q Bachelor's degree(e.g.BA,AB,BS) 0 Chinese 0 Guamanian or Chamorro
Q Mast¢r'S do Yes,Cuban Q Filipino � Samoan
degree(e.g.MA,MS,IVEng,MEd,MSW,MBA) Q Yes,other SP..Ish/Hispanic/Latino Q Japanese Q Other Pacific Islander
Q Doctorate(e.g.PhD,Ed D)or Professional degree (specify) 0 Other(Specify)
.MD DDS DVM LLB JD)
21.Decedent's Single Race Self -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a.Decedent's Usual Occupation-Indicate type of work
29 White Q Japan— E3 Samoan
Q Black or African American M Korman done during most of working life. 00 NOT USE RETIRED.
E3 American Indian orAlask.Native Q Don't homema3cer
O Other Asian an O Don't Know/NO<SUre
Q Asian Indian �Other ASlan C3 ReTUS¢tl
Q Chines. Q Native Hawal lee Q Other(Specify) 22b Kind
home
Q Filipino 3 Guamanian or Ch.Morro
ITEMS 29a-28d MUST BE COMPLETED 23a.Date,Pro nO....d Dead(MO Day yr) 23b.Signs Cure,of Person Pronouncing Death Only when applicable) 23C.License Number
CE PERSON WHO PRONOUNCES OR ,
CERTIFIES OEATN N t30 I '? � ly[ �N x-7 3 3L
23tl.Date Slgnetl(MO/Day/vr) 24.Tim.of Deat
.� 2S.Was Medical Examiner or Coroner Contaetetl _ Q Yma No
CAUSE OF DEATH
26.Part I. Enter the chain of t d1seases,Injuries,Or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest, Approzlmate
Interval:
respiratory arrest,or ventricular fibrillation without showing the etlology. DO NOT ABBREVIATE. Enter only one cause On a line.Add additional lines If necessary. Onset to Death
1
IMMEDIATE CAUSE ---------------- a. S� f
(Flnal discs•e or condition Due to(or as e e sequence of): I
resulting in death) on ,
4.
Sequentially list conditions, Due to(or ms a consequence of):
if any,loading to the cause
listed on line a. Enter the c. -
UNDERLYING CAUSE - Due to(Or as a consequence of): -
W (tlisease or injury that ;
F initiated the,events resulting d.
1.death)LAST. Due To(Or as is Consequence of):
2..P.-R. Ent<r other sianlFlCa nt eonditlona con[rib Rinn to death but not resulting In the underlying cause given In Part 1. 27.Was n autopsy p¢rforydT
15 Yes Q�F
28.Were autopsy firstlings available
' � t0 doe,plate plate the taus.�ttf7
O Yes O�No
.� 29.If F¢m 30.Dltl Tobacco Us Contribute t0 Death? 31.Man � math
E o[pregnant wlthln past year Q No Probajply�� aturel E3 Pending S Q pregnant at time of death Q No ��ry}{'� Q Accident Q Pending Investigation
oQ Not pregnant,but pregnant wlthln 42 days of death 0 Sul..d. E3 Could not be determined
I- Q Not pregnant,but pregnant 43 days to 1 year before death 32.Date,of Injury(MO/Day/Y,)(Spell Month)
Q Unknown if pregnant within the pas[year
33.Time o1 lnJury
34.Place of Injury(e-g.home;construction site;farm;school) 3S,Location of Injury(Street and Number,City,County,State,Zip Cod.)
36.Injury at Work 37.I1 Transportation lnJury,Specify: 36.Describe How Injury Occurred:
Q Yms Q Driver/Operator Q Pedestrian
Q No E3 Passenger E3 Other(Specify)
39a.Ce -physicla n,certified nurse practltlon metlleal eza miner/tor er(Check only on.):
¢rtlfying only-To the best of my knowle death occurred due to the cause(,)and Mann Cede
Q Pronouncing&Certifying-To the best o knowledge,death occurred at the time,date,and place,and due to the cause(s)and manner stated.
Q Medical Examiner/Coroner-On the b Is f examination and/or Investigation,In my opinion,death occurred at the time,pate,and place,and due to the cause(,)and manner stated.
Signature Of certifier: Title of c¢rti(ler: f7 L License Number: GS O t El 7 3
39b.Nam,,Address and 21p Code of Person Completing Cause,of O¢a h Item 26) 39c,Date Signed(MO/Day/Yr)
(=c2c� iFztztcl � 02 QE_' `a `c er+"L({ a�-�� .eivw utt(( v(r3
41.Registrar's District Number 41.Registrar s Sig Tur. 42.Registrar FI.Date(MO Day Yr)
43.Amendments
!Eaot 30ill an'br CLe �xx ex
OF
IRENE M. LENDA
I, IRENE M. LENDA, of the County of Northampton and State of
Pennsylvania, being of sound and disposing mind, memory and understanding, do
hereby make, publish and declare this to be my Last Will and Testament, hereby
revoking any and all former wills heretofore made by me.
FIRST: I direct that my funeral and testamentary expenses shall be
paid as soon after my death as shall be convenient.
SECOND: All of the rest, residue and remainder of my estate, of
whatsoever kind and nature, real, personal or mixed, and wheresoever situate,
of which I may die seized or possessed or to which I may be entitled at the
time of death, I give, bequeath and devise to my husband, ALEXANDER A. LENDA,
absolutely and forever.
THIRD: In the event that my said husband, ALEXANDER A. LENDA, shall
predecease me, or in the further event that we shall die simultaneously, I
give, bequeath and devise all of the rest, residue and remainder of my estate
in equal shares to my children surviving me or to the issue, per stirpes, of
any child of mine who fails to survive. me leaving issue surviving.
FOURTH: I do hereby nominate, constitute and appoint my said husband,
ALEXANDER A. LENDA, as the Executor of this my Last Will and Testament. I
give to my said Executor full power and authority to sell, mortgage, lease,
exchange or otherwise encumber or dispose of at public or private sale, and
upon such terms and conditions, as he may see fit, any and all real estate and
personal property of any kind wheresoever situated, at any time forming part
of my estate, and to execute and deliver good and sufficient deeds and any
other instruments that may be necessary therefor and to distribute the
proceeds thereof in accordance with the provisions of this, my Last Will and
Testament. In the event that my said husband predeceases me, or shall, for
any reason, be unable or unwilling to serve as Executor of this my Last Will
and Testament, then I hereby appoint my daughter, GENEVIEVE COLLINS, as
Alternate Executrix, with the same powers as previously given. In the event
that my said daughter is unable or unwilling to serve as Alternate Executrix
for any reason, then I hereby appoint my son, JOSEPH LENDA, as Alternate
Executor with the same powers as previously given.
FIFTH: I direct that no bond or other security shall be required of my
said Executor in any court or jurisdiction where it may be necessary to
probate this, my Last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this y day of
1990.
(SEAL)
IRENE M. LENDA
SIGNED, SEALED, PUBLISHED and DECLARED by IRENE M. LENDA, the
above-named Testatrix, 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,
all being present at the same time, have hereunto subscribed our names as
witnesses.
/ idyl
N E ` ADDRESS
1 r�� ea44'
N E AD RESS
OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBERLAND COUNTY,PENNSYLVANIA
Estate of IRENE M. LENDA , Deceased
FREDRIC C. JACOBS BARBARA JACOBS , (each a subscribing witness to
(Print Names)
the OX Will ❑Codicil(s)presented herewith, (each)being duly qualified according to law, depose(s) and
say(s)that she/he/they was/were present and saw the above Testator/Testatrix sign the same
and that she/he/they signed the same and that she/he/they signed as a witness at the request of
the Testator/Testatrix in her/his presence and in the presence of each other.
(Signature) A7� < (Signature) /
e'tw/�d 1 Z 7i/I/ ,
(Street Address) (Street Address)
bKA'4 (fwd IzeLl ` 7'-W 4 97� — .� zd'
(City,S14 Zip)
(City,St e,Zip)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Sworn to or affirmed and subscribed
before me this day before me this c2� -;"� day
of of c;2013
Deputy for Register of Wills otary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths.Show date of expiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s)at time of notarization.
LORETTA VAN ZANDT
Form RW-03 rev. 10.13.06 MY COMMISSION S EE157788
EXPIRES:January 08,2016
a'
.800�7M0'CARY F7.Notary wmt Dia AUM Co.
1