HomeMy WebLinkAbout03-04-15 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 requests the grant of Letters in the appropriate form:
Patricia J. M.Gruen
Decedent's Information fr�
Name: Richard H.Malone File No: 21 -15
a/k/a: Richard Hicks Malone (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 02/27/2015 Age at Death: 77
Decedent was domiciled at death in Cumberland County, PA (State)with his/her last
principal residence at 579 Dogwood Drive,Mechanicsburg 17055 Upper Allen Township Cumberland
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at Holy Spirit Hospital,503 N.21st Street Camp Hill 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 $ 5^,000..09
if not domiciled in Pennsylvania.................. Personal property in Pennsylvania $ —r\
if not domiciled in Pennsylvania.................. Personal property in County $
Value of real estate in Pennsylvania........... $
TOTAL ESTIMATED VALUE $ 50,000.00
Real estate in Pennsylvania situated at NONE
(Attach additional sheets,if necessary.)
Street address,Post Office and Zip Code City,Township or Borough County
❑x A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s)aver(s)that he/she/they is/are the Executor(s)named in the Last Will of the Decedent,dated 01/02/2015 and Codicil(s)
thereto dated
(State relevant circumstances,e.g.,renunciation,death of executor,etc.)
Except as follows:after the execution of the instruments offered for probate,Decedent did not mar was not divorced,was not a pparty 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 cfiild born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
❑X NO EXCEPTIONS ❑ EXCEPTIONS
❑ B. Petition for Grant of Letters of Administration (If applicable)
c.t.a.;d.b.n.;d.b.n.c.t.a.;pedente lite;durante absentia;durante minoritate
r 1.7
If Administration,c.t.a or d.b.n.c.La.,enter date of Will in Section A above and complete list of heirs.
C) 1711
Except as follows:Decedent was not a party to pending divorce proceeding wherein the grounds for divorce had been esta6i heO)as defined G' C7
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person. y 1
❑ 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 heirs4 tach
additional sheets,if necessary): -
Name Relationship Address
Form RW-02 rev.10-11-2011 — Copyright(c)2011 form software only The Lackner Group,Inc. Page 1 of 2
Oath of Personal Representative Official Use only
COMMONWEALTH OF PENNSYLVANIA }
}
COUNTY OF Cumberland } SS:
Petitioner(s)Printed Name Petitioner(s)Printed Address
Patricia J.M.Gruen 4378 Danube Drive
King George,VA 22485-5703
C7 iter" i`t7
C:)
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The Petitioner(i)abo4 named swear(s)or affirm(s)the statements in the foregoing Petition are true and correct to the best of the knowled and
belief"of Petitioner(s)and that,as Personal Representative(s)of the-9e eden�*s�l well a d t my administer the estate according to law. f
Sworn t�o affirmed a subscribed before , �n�r Date ?AlS
me this 17clay ofV Date
By ( ` �n D Date
Fu',the.f�Agister -1 Date
BOND Required? Yes [Sr__NL To the Register of Wills:
FEES Please enter my appearance my signature below:
Letters............................................ $ Attorney Signature:
( )Short Certificate(s)...........
( )Renunciation(s)...............
( )Codicil(s).........................
( )Affidavit(s)....................... Printed Name: K - h D Wagner
Bond............................................... Supreme Court
Commission................................... ID Number: 43891
Other
�1 )5 Firm Name: Brinser,Wagner&Zimmerman
15 Address: 6 E.Main Street
P.O.Box 323
Palmyra,PA 17078
Phone: 717/838-6348
Automation Fee.............................. Fax: 717/838-6912
JCSFee......................................... o
TOTAL........................................... $ E-mail: keith@bwzlaw.com
DECREE OF THE REGISTER
Date of Death: 02/27/2015
Social Security No: 179-30-3720
Estate of Richard H.Malone File No: 21 -16 - 2H
a/k/a: Richard Hicks Malone
AND NOW, N4CrC��\ -1 .2 Gl�L_ ,in consideration of the foregoing Petition,
satisfactory proof having been presented before me,IT IS DECREED that Letters Testamentary
are hereby granted to Patricia J.M.Gruen
1
in the above estate and(if applicable)that the instrument(s)dated 01/02/2015
described in the Petition be admitted to probate and filed of record as the last Will(and Cod,il(s))of Decedent.
Regis er o Wills
Copyright(c)2011 form software only The La er Group nc. age 2 of 2
H105.805 REV(9/11)
�QPALk ggJSTRAR'S CERTIFICATION OF DEATH
RECRE G1
�/�►RNIMfa 1I9t 'illegal to duplicate this copy by photostat or photograph.
r
Fee for this certificjR 1150 This is to certify that the information here given is
correctly copied from an original Certificate of Death
LL O F duly filed with me as Local Registrar. The original
O 1R Q h A N J' N J^j c� - y certificate will be forwarded to the State Vital
V.�l C A • " Records Office for permanent filing.
P 21403268
Certification Number
Local Registrar Date Issued
Typ</Ninl In COMMONWEALTH OF PENNSYLVANIA•DEPARTMENT OF HEALTH•VITAE AECORDS
Pef1nanent CERTIFICATE OF DEATH
Black Ink State Fide Number:
Decadent's Legal Name(Fk+l,Middle,Hs1,SWRx) 2.Sex 3. IS<cIN Num r a.Date ol0<aN(Mo/Day/''r(Speg Mo)
10 r a
5a.Age-last Birthday(Yrs) Sb.Under 1 Year Sc.Under 1 D 5.Date W Birth Mo ay ear Saa Month) 7a.81rt a(CHr a e w Foreign tryj
�r Mon1M Days Hours Ming" M.
14 7E.Birthplam ICoumv)
Tunt 3.
Mlence(State or fssssf+CourUM Bb.Rbdenct(SUeel and Number-InWde Apt No.) ac Decedent lNeM T hipt
.• - ndeced,m lhed hl�6 Tel l' twpDqDYL .
.Re3deMe(County) I
- &.16-dencel I O No,decedent 9,ed MtW llm(ts of city/boyo.
9.-In USJAwn.'n-Farces? 30.Marital Status at V(?,f Death ❑Hardee 0 W dowse 11.Survhhg Spouse's Name(If wide,aide name pdw to Brst m,Mage)
❑
Yet IJ No 0 Unkm,_ 0 Dhmced m Never M.rIM ❑wk-
Ca��ther'[
<"'It,M .H L SWNx .Mothels N,me P r to F rst M rdage IFht,Middle,last)
(rin
a.lnl many[ ame ]aE.Relatbn+hlp 1p Deceeent la.Mf rmant'+Ma1INa Addre+f(S1rNsendN 474"M
,Ury,Stale Zlp I
UrGruen Nem 2r
___________
151. ace al as ____
V If Death OccumedlnoHosaal: Ltl ingiknt IIf Oe,Ih Occwred Somewhere Other Thana Mospkal----Q Noipke£acuity )•]DeCedenYs lbme__
O Em.rgenp Room/Cwoatlent 0-Deadon MWal 1 ONwsing Nome/lorlg T.rm GnFaciliry 0other(sacl -
_ S.F.cRiry ame(if t 'tit .a"sthutandnumber) .Uty or sets, I r of Death
land
16a.M hodfONp.t. Burial ❑Cremation 16b.Dale fDisposition 16c.Platt of Dlsposhbn(Name of cemetery,cory,or other place)
0 Be from 5ta. 0 Ooatlon
f. C'3 Other lSmdHl
.. Z 1 .location olOha[Rbn(UIV of Town,State,and 2M) 1 115
7,. WFu 15ervke/kens enon In[harg<of lnlednM[17b.lkeme Number
a I L
NisNam Co [e ss of Funeral Fa '
�' 18, orient's Fdua •Check the boa That best describes the 19.0. mof Hbamc Odgk-Check the 2D.Decedent's Race• ONE OR MORE races 1.Ndkak what
r highest depee or level of school compsewd at Me Ome of death, lloa that best desDwe'whether the decadent =ft. nt..aldered hkneu a hentll to tr.
❑at
A gndewkss HSPaMsh/Nlfpank/latkq.Check he*No' IN Whke ❑aorean
❑No diploma,9th-120,grace bo)Il deceOenlh notSamsh/NI'arOc/latMo. ❑alackm African Amedun ❑Vktameu
❑HlghschoWaraduateor GEOcwnpleted ®No.not SphHh/H1s nk/UHno O AmMYanlndianor Abfaa NaWe OOther Aston
0 Swn.coaege Crodk but a degree 0Yet.Meak,n,Medan American,ChAm- (3Asian Indian 0 N.We Haw,ilan
0 Associate degree lei.AA,ASI O Y.,Puerto Rican O Chinese 0 Guamanian w c amomo
�B.&~.degre<(e.g.B/AIL 85) 0 Yes,Cuban 0 Felp.o 0 Samoan
Matmes degree feat.MA,MS,MEng.MEd,MSW.MBA) 0 Y<',.UsNSWMsh/HNWnkA III. 0Isnu ese O Other Pacific Islander
O Ocetwate(e.g.PhD,Edo)w Professional degree ISpedfy) ❑Other(swity)
e MD 005 OVM IEa 10
21.D/�edm1'.We Race 5• -0ealgaOon-Check ONLY ONE to kdkate what the decedent cwademd!Mmsell w herself.be. 22a.Decedent's lhu,l Dwnation•ledkate type of wwk
rjwhke 0Japanese 0Samoan done duA�most of-,Airy M.00 HOT USE RETIRED.
06bckwAfrlun American 0Kwe.n ❑Other Padfk Islander
o ❑AmMcanlndlanor Alaska N.L. 0Metamne O Don't Know/NW Sure
O Adan Indian 0 Other Asian 0 Refused 22b.U' f SwIma,11 d.try
eese --
v! 0[M 0 Native H.-lUn 0 Other(Speclh) /�e
0 F110. ❑Guama 4.r.,Chamorro j\-
ITEMS 23a•23d MUST BE C NuPIETEO 23a.Date Pronounced Dead(../D,Y rj 23b.Siaruture al Person P-ciuncing Death(O h when appanbk) 23c.Me-Number.
BYptnum
CTWNO MIONWNCPS OR
PTIFIES DEATN X-1 c7 CX. Ltik� -k•+J JJ'Y��
. 23d.Ba e5lgadlMO/DaY/Yr 2a.Tkne of Death
. �q,• l b15 �, •.1 IT :s.wa'MeelralEMminerorewonereonnece - ❑ re' Cr No
CAUSE OF DEATH 1 Appoxlm a
• 26.Part I.Entwthe OLf091 Mnb--0Nease+,InJWes,w amppatbru-that dbectly caused the death.DO NOT enter tbmMal-.1s uct-mIl..nest, Inteml:
nNolnum.nest,w KntriMar FaIM,don Wfl, +hmmsg the etb.gy.DONOTABBREMATE.E,wonhonecaus<Ona Me.Addaddtbrallmau fnecessary. 1 Onset.Death
1
;MMFDIATECAUSE ?:±� - -
,Final e1- ouo(waconsequneof:
e'uhha hdarh)e �1
1
b ;
.. Sepuen"111 a+t conditdm. Due to for as a comeouence
V.,Ijeadbrg.the<au+e - -.
Rated on One a.Enter the I.
r UNDUMMKICAUSE Due.I.,H Prat..IH: -
(dJ...or lnWry tMi - -
G Imllated the even(,resultlry d.
Indtathl LAST. 0.tolbya+.Fms1oo_oq:
26.P,d It,Oder other 2jgnilkant rondil.m conMbulla to death bat al nsulOry In[Me erMnt a se glum in Parti. 27.was an sutopsY adermed7
- a - ore+ CLhp
' - I 28.were awoyrfkdiryi mlbbk
,. toI-,Ie,e the uuseo death?
❑Yet
Y 29.If Female: 30.Did Tobacco Use Contribute to Death? 31.Manner of Beth
❑Not Onananl Mlh.oast Kar 0 Yj+ 0 Probably m.46 tura 0 Homklde
+ .•� ❑Prean.m at anis of death �Fj 0 W'known 0 A,eIrINt 0 PenaklglmestWtan
1s 0 Not pregn.nt,but pregnant MthIn 42 dm of death 0 Sul de [IMd Cnrot be determined
C3Not Pregnant,but program a3 days to s Kar heron death 32.Date of kdury(MOIOaylYr)(Sped Month)
0 Unknown R Pregnant Mthln the past Kar 33.Time of Injury
34.Place W Inlury(at home;conswus on site;fam1;school) 35.LocatkM of Injury(Street and Number,Ory,County,State,DO Code)
�l
M.InjM.t Wwk 37.I1 1-p-don Injury,Specify: 38.Describe How lnNny Occurred:
-- C3Ye' 0 Drher/Operator 0 Pedestrian
r� ❑No 0 P.-M., 0 aherlsarlhl
'1 39a, diner-physkl.%certlfkdmtne Pracdl.her,nodical asmhusUcmaner(EAeekonhone):
�CertlfYiry Drab•To the best of my knowle0g<,Beath wcbrred sue to the apu([I andmanner stated.
0 P-mesciwa Certifying-To the best of"knowledge,death occurred at the llm.,data,and Pace,and due to the cause(,)and manner stated.
1 0 Medical Eaaminer/Coroner-On the MMilt
of exams atdvn�and/w Ime0gatdn,h my apmon,death.-red at the One,date,and pace,and due Io tin-seal+land manner[toted.
Siga ,tu of.,ttfkr: \\' _` / TM.W camf er: M n Umn.Nunber:.
39b.,me,Aderess•MV'Code of Person Cwnpletklg Cause of Oveth(item 26) - - 39c.Dan 51am4(MO/Day/Yrl
Is
40.ReghlnYs CM,kt Number - al,Reghtra - k a2.R [nr iik DatelMo/OW/Yr)
UXW M
e3.AmendmcnN
nkmaNhn Mmu,Nn ! /4✓rT H1ninn'
RFv ntnm7
WILL ,
rn
OF
RICHARD H. MALONE
...; ..�
I, RICHARD H. MALONE, currently of Upper Allen Township, �Cur-lerland j
County, Pennsylvania, declare this to be my Last Will and Testament,, hereby fevok`ng,
any and all prior Wills and Codicils made by me. CD
I. I direct that all my just debts and funeral expenses be paid from the assets of my
estate as soon as practicable after my demise.
II. I direct that all estate and inheritance taxes that may be assessed in consequence
of my death, shall be paid out of the principal of my general estate to the same effect as if
said taxes were expenses of administration and all property includable in my taxable
estate whether or not passing under this Will shall be free and clear thereof.
III. I intend to keep with this my Will a separate memorandum concerning
disposition of certain items of tangible personal property. I bequeath the items on said
memorandum to the persons designated.
IV. I bequeath all of my remaining tangible personal property (exclusive of any
motor vehicles) unto my nieces, Patricia J. M. Gruen and Emma A. Persigehl, to be
divided between them as they may agree.
V. I bequeath my shares in High Valley Gun Club, Inc., Woodward, Centre County,
Pennsylvania, unto the High Valley Gun Club, Inc.
VI. All the rest, residue and remainder of my estate, of whatever nature and wherever
situate, including property over which I hold a power of appointment, I devise and
bequeath as follows:
A. Ten percent (10%) unto Mechanicsburg Presbyterian Church,
Mechanicsburg, Pennsylvania, to be used for its Snyder Mission Fund;
B. Ten percent (10%) unto Messiah Lifeways at Messiah
Village, Mechanicsburg, Pennsylvania, to be used in its Endowment Fund;
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C. Eighty percent (80%) to be divided equally between my
nieces, Patricia J. M. Gruen and Emma A. Persigehl, or their issue per
stirpes.
VII. I appoint my niece, Patricia J. M. Gruen, Executrix of this my Will. In the event
that she fails to qualify or ceases to act as Executrix, I appoint my niece, Emma A.
Persigehl, Executrix of this my Will.
VIII. I direct that no bond be required of my fiduciaries for the faithful performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I, RICHARD H. MALONE, herewith set my hand to
this my Last Will, typewritten on two (2) sheets of paper including the attestation clause
and signatures of witnesses, this day of January, 2015.
4 VA (SEAL)
RICHARD H. MALONE
Signed by RICHARD H. MALONE, by him declared to be his Will in our
presence, who have hereunto subscribed our names as witnesses in his presence and at his
request this day of January, 2015.
residing at
residing at
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF L-lr i5A P40 M :
WE, RICHARD H. MALONE, GERALD J. BRINSER and PATRICA .3.rA GKUGN
the testator and the witnesses, respectively, whose names are signed to the attached or
foregoing instrument, being first duly affirmed, do hereby declare to the undersigned
authority that the testator signed and executed the instrument as his Last Will and that he
signed willingly (or willingly directed another to sign for him), and that he executed it as
his free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the testator, signed the Will as witnesses and
that to the best of our knowledge the testator was at that time eighteen years of age or
older, of sound mind and under no constraint or undue influence.
RICHA H. ,ALONE
W&NESS
WITNESS
Subscribed, sworn or affirmed and acknowledged before me by RICHARD H.
MALONE, the testator, GERALD J. BRINSER and 21G�{ ►�f 1U�(�I ,
witnesses, this a K1 day of January, 2015.
EAL)
Notary Publ c
—j
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
WENDY L.CRAWFORD,Notary Public
Palmyra Boro.,Lebanon County
My Commission Expires September 10,201
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