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Home My WebLink About02-24-05 Estate of Register of Wills of Dauphin County, Pennsylvania PETITION FOR GRANT OF LETTERS tel f'./A rCt~(j No. cQ)-D~- /~0 also known as , Deceased Social Security No. J7v-3t-/1_30 Pet;'inne'l.l. whoi~I.,.. 18 YUf.Ofage..,older.llflply(i"") too; (COMPLETE "A" OR "B" BELOW:) p A. Probate and Grant of Letters and aver that Petitioner!sl islare the execut~ eamed in the Last Will of the Decedent, dated ..\v I'{ 'J., /0q Z and codicil{s} dated v.1 A Slate relevaol Gircum.'aoc.... e.g., renunciatIon, de.lhole~eculor.eU; Except as follows, Decedent did not marry. was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: Q B. Grant of Letters of Administration lC_I.._. d.b.n.c.<.a.: pend"."" lite; dutllO'e abe.."';"; du.""." n~""ri'.'el Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the1,,'tQllowing spouse (if any) and heirs:'J"" Name Relationship Resideno'e~ IC ttac a ItlOna s eets I necessary. Decedent was domiciled at death in residence at I' 0 ~ In""" [Ii9ta"eel," be.... rnunicip",it Decedent, then Q. years of age, died }p h ( J v I\{ . I , 20QS;" at Sf If' I' ~~ )/- "p;::~J. bo 10 I A Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property .........._....... ......$ ~ ()(){)..(JO (If not domiciled in ?A) Personal property in Pennsylvania. . . . . . . . . - . . . . . . . . . . . . $ , (If not domiciled ir\ PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . $ Value of real estate in Pennsylvania ...........,..............,.................... $ Real Estate situatedT:~a;Oli~~~:' . . . . . . . . . . . . . . . . . . . . . . . . tJ;;... ~. . . . . . . . . . . . . . . . . . . . . . . . . -. $ with his/her last family or principal '1 Wherefore, Petitioner(sl respectfully requestlsl the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Iq T7- RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County of Dauphin The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and cor~ct to the best of the knowledge and belief of Petitioner(sl and that, as personal representative(s) of the Decedent, M'",.", .m~"." """ "m'""'" '" ,~.. ~'"!"')l> W ,.w.~ Sworn to and affirmed and subscribed y:.. I" / cq L / before me this ().. 01--- day of '-*-~ 20()~ ~~*nw.~~ DECREE OF REGISTER Estate of ~ uP ""VI Fa ~ i ') also known as Deceased No. ~I-o~ - 1&1 /] Social Security No: II Lf - 3 b - b q 50 Date of Death: Ie ~jJc-/7 9,. 100> AND NOW, ' 20 _, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that letters 1fR Testamentary 0 of Administration are hereby granted to Yr, ,} I d J. tr, $ ;.:?J (c.t.H.;d.b.fl.c;.,.;peflderllehle;duraoteabsentie;durante""norita'cl in the above estate and that the instrument(sl. if any, dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES letters.......................... . Short Certificate(s).. 3..... Renunciation................. . Affidavit ( )................. Extra Page.s ( )............ ~..~............ JCP Fee........................ Inventory & Tax Forms... 9#te~.9.~I.o:f.>.. ~ TOTAL................ RW-7. $ 45', G\) '- l:\..QOA^~' ~~,^_(_~bOUll,(1.l~~ Register of Wills ~ ~ ~ lDtM $ 0- 6\) $ $ $ $ \S. lSO $ \C\.~ $ $5"00 Attorney:-=!h 0 'I'" ~> f Garf; I.D. No:~ll~ $b If Address: Po () 0 y. I). 'f en IJ"(/d~J/", fA f/09J Telephone: / /1-). 37 - r;Oq j DATE FilED: ;:). - d.. Y - 0':;- $ Y;7 ()'O IIII)<;..~(I'; Rj-V Il()~ This is to certify that the information here given is correctly copied from an original certificate of death duly. filed with me as Local Registrar. The original certificate will be forwarded to the State VIlal Records Office for permanent flhng. WARNING: It is illegal to duplicate this copy by photostat or photograph. p 11333994 t:h".~ J'l {;.,~ r~ ~ Local Registrar r Fee for this certificate, $6.00 FES 1 7 2005 Hl05.143Rev_2J87 KINT No. Date f"-; ;l(-o~- ;?5f.o COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS ;"",) (J'j CERTIFICATE OF DEATH STATI;FILEN.JMBER SOCIAL SECURITY NUMBER ,. t 74 36 DATE OF DEATH (Moolh, Day, Year) ... February 9, 2005 ,lENT ". NAME Of DECEDENT (Fnl. MkJdIe,lasl) 1. AGE (LaIIBlrthdey) 82 '" ,. COUNTY OF DEATH ". Cumberland DECEDENT'S USUAL OCCUPATION (or~:~;do~~':3)"t 6930 ". White SURVIVING SPOUSE (lfv.;'-.g1-,lI\IIl<Ionn.mej BIRTHPLACE (City and Sla\e or Foreign COullry) ~ Inp.~.nt IX] ... FACILITY NAME (11noI inslrtutlon. gwe streelalld number) ERIO\<fpohnlD _0 R.oldon..D ="'jD RACE. Amarican Indian. Biack, Wlite, el (Spedfy} k.East Pennsboro KIND OF BUSINESS I INDUSTRY Select Specialty Hospital MARIT Al STATUS - Married, Nev~::~s=lId. 14. Widow :A.S DECEDENT EVER IN U,S. ARMED FORCES? YesD Nofll ". Co"~ (1-1...5+) 2 11.. Nurse 11b. Health Care DECEDENT'S MAiliNG ADDRESS (Street CltylTown, Stale, Zip Code) DECEDENTS 110 November Dr., Apt. 1 ~~~:t~NCE Camp Hill, PA 17011 ~~e:l:I=r1 ". 171.Stala ". Pennsylvania 17c.DYes,dflcedenllivedin "' decedent livelna townlhip? ~P 17d.1XJ ~~e=\i~~oI 17b. COOnlv Cumberland Camo Hill cilyiboro ". FA THER'S NAME (First. Middle, lnl) ". INFORMANT'S NAME (TypeiPrlnt) .... METHOD OF DISPOSITION Donlllio<1D Burial 0 Cremation ~ImO'llllfrorn Stile 0 . 211. 01 (SpICIly) . SIGNATURE OF FUNE VI MOTHER'S NAME (Firsl, Middle, Mlidon SUffilme) ". INFORMANTS MAILING ADDRESS (Stfllll. ClIylTown, Stele, Zip Code) 2~. 1941 Mountain Road, Middletown PA 17057 Pl.ACE OF DISPOSITION- NlfIIe 01 CamlIliIfY.J Crematory lOCATION - CitylTown. Slate. Zip Code orOlherPleceCremat~on SOC.Lety of 1,penns lvania Cremator 21d. Harrisbur PA 17109 NAME.4NDADORESSQFFACllITY uer emor a orne rema 22c. Services, Inc., Harrisbur PA 17109 liCENSE NUMBER DATE SI NED (Month. Dav. Yller) on Edmund Ashworth Sara Turner David Fasi NS DATE OF DISPOSITION (Month. Cay,V...) Februar 15, 200 LICENSE NUMBER ,,,,. FDOt3376-L ealh OCCUT8datlhlltime,dale and ptaca Ilatlld ORP ". 27. PART I: EnW....dlM.......,.rInor........_.whlc:hauood...d U.lonIyOfteCOUHon__ 23b. 23c. WAS CASE REFERRED TO A MEDICAL EXAMINER /CORONER? 28. Ylli Kl JL No 0 . Do nol-...........oldr\n.....""...,onIlocOJ...plratory....ot..hocko,h..nJoI"'... :Approximala PARTiI: Olhersignilicanlcondilions conliibuling 10 dealh. bul ,inlllrvalbelween not reaulling in lhe undertying cause given in PART I : onsel and death Sequefl\illly~llcondItionl ifanV.lflldiogtolmmediate CIUII, EnlefUNDERLYlNG CAUSE (DiSlllle or irjuiy It\ellnllillldlV8l'llt resullirlg ondaalh) LAST WAS AN AUTOPSY IroERE AUTOPSY FINDINGS PERFORMED? AVAILABLE PRIOR TO COMPlETION OF CAUSE OF DEATH? t l: TIME OF INJURY INJURY AT VIORK? DESCRIBE HOW INJURY OCCURRED NNER OF DEATH DATE OF INJURY (ldon", o.y, V..r) Natural Accident IiO o o 30a. PLACE OF INJURY b<.i_~,.te.(Sp'''''') ".. o o o HomJcide YuD NoD ",. Pendinglnvestigalion Gooldnolbedaterrnined 3Gb. M .Alhome, farm. slreet, factory, omce YeiD NO[XI YesD 21.. 211I. CERTIFIER (Chedlonly one) 'l~~~tGJ~~=Ifu~s~~:t1 ~~~~: t~e:bh.~=:r~mrr.g~~~a~lh~r.~~~.~.~.~~.I~..~~.~.~~~~.r~.~.i.~?~). NOIXl Su;ode n. ................0 'PRONDUNCING AND CERTIFYING PHYSICIAN (Physicien bolh pronouncing death and certifying 10 cauia of death) To tha but of my knowladge, daath occurred II tha time, date, and placa, and due 10 thl UUlelll' nd mnner al Itlted,_... DEATH 'MEDICAL EXAMINER/CORONER ~~~:.rb::,::::..~mlnMlon .ndJor Invuttgltlon, In my opinion. death occlIrr"d.1 the lime. date. nd place, and due to Ihe ulI.e.I.' and 0 31a. REGISTRA \.\' t\ f?,., I bl) 1"1'/1-"1/11 I , LAST WILL AND TESTAMENT OF EDNA FASIG I, EDNA FASIG, of the Borough of Camp Hill, (F, Cumberland Count.y, Pennsylvania, declare this to be my Last Will and hereby revoke all prior wills and codicils made by me. FIRST: I direct that all my just debts and funer- al expenses be paid out of my estate as soon as practicable after my death. SECOND: All the rest, residue and remainder of my estate, of whatever nature and wherever situate, I give, devise and bequeath in the following manner: 1. I give devise and bequeath all of the money in my checking account and certificate of deposit to my son, David G. Fasig, presently of Middletown and my daughters Sara J. Derr, presently of Mechanicsburg 1\1 e I' and Susan ~. Sellers, presently of Mechanicsburg, to be divided among them in equal shares, share and share alike. ~ Z Q ~ Ii I 2. I give, devise and bequeath my grandmother clock and Craftmatic Beds to my daughter, Susan M. Sellers. 3. I give, devise and bequeath my dining room set with hutch to my son, David G. Fasig. 4. I give, devise and bequeath my reclining chair, roll top desk, milk glass dishes and bedroom vanity to my daughter, Sara J. Derr. 5. It is my expressed desire to keep within the family chain, my diamond ring (value $2,000). Therefore, at the time of my death, I wish the ring to go to my daugh- ter, Sara J. Derr, with the proviso that at her death, the ring be willed to my granddaughter, Salena Erin Derr, presently of Mechanicsburg. Should my daughter, Sara J. Derr predecease my granddaughter, Salena Erin Derr, the ring is to go directly to Salena. It is hoped that should Salena have a daughter, that the ring be passed to her. 6. I give, devise and bequeath all of my remaining household goods and personal effects to my three chil- dren and my grandchildren, in equal shares, share and share alike, particular items to be allocated among 2 them as they decide, or if they cannot, as my personal representative shall determine. THIRD: If any of my children shall have prede- ceased me, the share that otherwise would be distributed to the predeceased child of mine shall pass instead to the issue of the predeceased child who survive me, per stirpes and not per capita. FOURTH: If a child of mine predeceases me leaving no issue or if no issue of such child survive me, the share which would be otherwise distributed to such child or such child's issue shall instead be distributed to my surviving children, in equal shares, share and share alike. FIFTH: I nominate, constitute and appoint my son, David J. Fasig, as the Executor of this my Will. Should he be unwilling to serve or should he be unable to serve for any reason, then I nominate, constitute and appoint June Fasig as Executrix of this my will. SIXTH: I confer on my Executor and successor Executrix in addition to those powers granted by law, the following powers to be exercised in a prudent manner and applicable to all property constituting a part of my Estate: 3 ii i' A. Power to Invest: To retain and to invest in all forms of real and personal property, regardless of any limitations imposed by law on investments by fiduciar- ies, to exercise all the rights ordinarily belonging to the owner of or investor in such property, to register investments in the name of a nominee and to keep such property in such good order and repair as they deem expedient. B. Power to Sell, Lease, Mortgage, etc. To sell at public or private sale, to exchange, to mortgage, to lease or to extinguish any mortgage, lease or loan for any period or periods of time, to repair, alter and improve any real or personal property upon such terms as to cash, credit or options as they in their sole discretion may deem appropriate and to do all things necessary or ordinary in achieving these ends, without liability on the part of any third party to see to the application of the funds given therefor. C. Power to Borrow, Pledge and Compromise. To borrow money from any source or sources, to pledge any assets as security therefor and to compromise claims. D. Power re Administrative Expenses. To treat adminis- trative expenses either as income tax or as estate tax deductions, without regard to whether the expenses were paid from principal or income, and without requiring reimbursement. 4 ~ z o ~ E. Power to Distribute, Allocate and Value. To make distributions in cash or in kind or partly in each, to allocate property to persons entitled thereto and to fix the value of property. SEVENTH: My Executor, his successors, or any other fiduciary named, constituted or appointed in this my will or during the administration of my estate, shall be excused from posting bond in all jurisdictions regardless of any law or rule of court to the contrary. EIGHTH: All gifts of any kind herein made shall be delivered directly to the beneficiaries free from antici- pation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. Such gifts shall not be subject to the assignment or antici- pation or pledge by the beneficiary, or to execution, attach- ment, or any other process for the enforcement of judgments or claims of any sort against them. NINTH: If my estate has insufficient assets to pay all of the gifts provided for in this will so that it is necessary to abate the gifts herein, I direct that my Execu- tor abate the gifts in a pro rata manner. 5 -~, ' " ---- . ':' '\ i ~-_ 1 --- TENTH: If any of the items specifically devised or begueathed in this will are not a part of my estate at the time of my death, such devise or beguest shall lapse. ELEVENTH: All inheritance, estate, succession or transfer taxes, whether State, Federal or otherwise, or any other tax in the nature thereof, which may be payable by reason of my death, shall not be apportioned but shall be paid, together with any interest or penalties, out of my residuary estate as if such taxes were administration expens- es. IN WITNESS WHEREOF, I, EDNA FASIG, have to this my Will, typewritten on nine (9) sheets of paper, the first five (5) of which bear my signature in the margin for pur- pose of identification, set my hand and seal at the end thereof this :l day of ~ ' 1992. d~ rr~-"/;t EDNA FASIG 6 SIGNED, SEALED, PUBLISHED and DECLARED by the above- named Testatrix, EDNA FASIG, as and for her Last Will and Testament, in the sight and presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, all being present at the same time have hereunto set our hands as witnesses. Name l~", j&Z#,oowng", #',V,/~~'O' ,J?, Name ~ (? ~ Residing at J;;LA~~ O? NamO{kJ) Q 9 I~~U Residing at N J' U-Cz MV\ , f!4 7 I, COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~44JjI' 17 SS I, EDNA FASIG, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ;rr~ F a.ab~ EDNA FASIG Sworn or affirmed to and acknowledged before me, by EDNA FASIG, the Tentrix, /lnd 1 'I' this d day of ,_ .ALii (I // //) .J ~/ ,V / /" I n~ , 1992. (SEAL) 'My- I MY-r__l:. , 8 , aIJ':!!=1'\b~M 1 l~l ,.~~l:~S"~.. ii COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF ,~1cph'V) We, /JOlv/dt4 T...1'AI~/'~, #LMfJ I? /~ and LQu~'C{ A. 41!1~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix, EDNA J. FASIG, sign and exe- cute the instrument as her Last Will; that she signed will- ingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as wit- nesses; and that to the best of our knowledge the Testatrix, was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. (::jiO-UJ) 'Z.. o J~Lt1A - Sworn or affirmed to and subscribed to before me by .~ }) t7l7/JtL !J. '-< hoo") I!J~( ,-nOI7 P l!e/-i c// :; . '1/ and ;!,"J/,j f-j1. f//J1e- , witnesses this ;11'(1 day of ~ ' 1992. it)?> I 4 / / L~71 ~42./ No~ary Phblic ' / My Co ssion Expires: ~ 9 '..iM=r~j