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Home My WebLink About09-20-05 Register of Wills of Cumberland____ County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Jack W. Richardson also known as No. 21-05- ~?,~ , Deceased Social Security No. 193-12-9434 James W. Richardson Petitioner(s), who isfare 18 years of age or older, appl(ies) for: (COMPLETE 'A' or 'B' BELOW) ~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor the Decedent, dated 02/23/2005 and codicils dated named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. 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 o B. Grant of Letters of Administration (c.l.a; d.b.n.c.l.a; pedente lite; durante absentia; durante minoritate) 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: I Name Relationsnlp Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family or principal residence at 20 North 12th Street, Apt. 104, Lemoyne Borough (list street, number, and mUnicipality) Decedent. then 84 - years of age. died 07/07/2005 at Holy Spirit Hospital, East Pennsboro Township, Cumberland County (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in PAl Personal property in County Value of real estate in Pennsylvania $ $ $ $ 6,000.00 situated as follows: Wherefore. Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropnate form to the undersigned: Typed or printed name and resi ence James W. Richardson. '~1 Tuscany Court .J Camp Hill, PA 17011 Lr ~r.. v -l..) U:: ,_:.!,) Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the est~ding to law. :Jl~~ Sworn to or affirmed and subscribed X ~~, t James W. Richardson .... ~, .>,\, before me this .....'S day of ~'"'-~ .~""-'\., ~'l ~\:\~ S C:S~~~~, ~,3\, For the Register ~ ~ .$,~ ~ ",-" ~ ~ ~ - No. 21-05- ~ '3 ~ Estate of Jack W. Richardson , Deceased also known as Social Se~urity No: 193-12-9434 07/07/2005 Date of Death: AND NOW. "::,"-1.;\ ",<,~x.'l ~~ , ~'-'l'\.\S , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary 0 of Administration (c.I.a.; d.b.n.c.l.a.: pendente lite; durante absentia: durante minoritate) are hereby granted to James W. Richardson, Executor in the above estate and that the instrument(s) dated 2/23/2005 described in the Petition be admitted to probate and filled of record as the last Will of Decedent. FEES Letters........ ...... ........ ..................$ \ 1.. (;-~ ~.~;.. ~~:~~~ ~\ Register of Wills ~,~~\ ~$" ~~t.~'''\ Attorney: Edward P. Seeber, Esq, ~ ~\) ~~\,\ ~~ ~~~~ 1.0. No: 76084 James, Smith, Dietterick & Connelly Address: 134 Sipe Avenue ...1 C' '\ ,) t -6) Short Certificate(s)...\.................$ Renunciation.... ................. ......... $ Affidavits ( )...........................$ Extra Pages ( )....................$ ~......~.\l,.I,........................$ "s. \~ - Hummelstown, PA 17036 Telephone4 717/533-3280 JCP Fee.....................................$ Inventory.............................on.... $ E-Mail: lu Other......~~~.,.x"-:~.... ........$ os, L~' .., '-I -,..) :~,,:) -10JV TOTAL............................ $ ~''\ .~~ , 3",J.C' '...,!.__J Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group. Inc. Form RW-1(1991) "'?>,,\<:::;,S. o;;.,;~, .... J \,j "fhi' 10., to certify that the information here given is correctly copied from an original certificate of ciLath dui\' filed with me as l.dc,1i Registrar. The original certificate will be forwarded to the Slate Vilal Records Office fllr pem,anent I ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. bee for thi:; ccrlilieate. $h.OO F' -1 .J'! ,... 1.Lo.. No. (17")' ,r ,,"OJ' I.ocal Ri..~gistrar Dale Rev. 1191 1130-040 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (Coroner) NAME OF DECEDENT (First. MIddle, Lasl) Jack ST,Iij"E flLE NUMaeR SEX ISOCIAL SECURITY NUMBER ,. Male 3.1 93- I 2 - 9434 UNDER 1 DAY DATE OF BIRTH BIRTHPLACE (City and PLACE OF DEATH (Check only one see in!\tructions en othGr siue) Hours Minules (MOllth, Day. Year) Staleo. Foreign Counlry) HOSPITAl: I:THER Dee. 3,1920 Ak r 0 n, P A InpaHenl JQ. ERlOutpalienlD DOA D ~~~~g 0 la... 7. ... CIT'!'. BOR~F DEATH [FACILITY NAME (II not iMtituhon, give streel and number) !:WAS DECEDEN! o. F HISPA. N~C ORIGIN? East Pennsboro Holy Spirit Hospital N.ex y.JJIlY""POC'~C"b"", Mexican. Puerto RIcan, etc k.~. 9. DECEDENT'S USUAL OCCUPATION KIND OF BUSINESS/INDUSTRY WAS DECEDEONT EVEA IN r m [JECED!=N!,SEDUCATION.. I MARITAL STATUS. Married IG -, d d r I, U.S.ARMEDF-'JRCES? I Is~r onl hKlheslnradecom letedl Never Married,Widowed, ,Iva kind," wOfk-~~e urin~ mos . 118. ~J~~'f~100fftr~ec~'br 11~ichardson F.H. In h YOIIIXJ NoD 11::amanl~ci~condary I 2(1~.tO~~~) 114. Wi~I~:e;~pec'~/) DECEDENT'S MAILING A.DDRESS (Streel, CilyfTowl"'. State, Lip COOO) ~~~G~ENrs 17a. Stat~, P A ,)id 17c.~ Yes, dElcedenttived In 20 N. 12 th St. Apt. 104 RESIDENCf: decedunt (Seeinslructions !iveine 16 Essex House, Lemoyne PA 17043 on other sidA) 17b,Gounry Cumberland tow'lship? 17d.rn:h~~:~:i~:~Of Lemoyne F-"J"HER'S NAME (F,r~1 Middle, L.as!; MOTHER'S NAME (First, Middle. Meiden Surname) m James T. Richardson _ Florence Fahnestock INFORMANT'S NA.ME (TypelPrinll IINFORMANT'S MAILING ADDRESS (Slrlffit, Cityrrown. Slate, Zip Code) I,... .bmpo W Ricn~Y"onn :,,,,,51 Tuscany Court Camp Hill, PA :7011 METHOD OF DISPOSITION J I:DATE OF DISPOSITION PLACE OF (')ISPOSITION. Name of Cemetery, Crematory I:OCATlON _ CltyfTown, Slale, Zip Code . Burial lXI Cremation D AelTJlJvallrorr. State U (Month. Day, Year) or Other Place . 2~~lltionD Other (Sceciry\ - D 21b. July 12, 2005 21c. Highspire Cemetery 21d. Highspire, PA 17034 SIGNATURE OF..FUNjRAl S~VIC~ UCEN~E OR PERSON ACTING AS SUCH liCENSE NUMBER INAME AND ADDRESS OF FACILITY . ".,V)h, i'~#.tl'V'f'. Uk. h..A 22bFD 012774-L 122l-ichardson F.H. INc. 29 S.EnolaDr. EnolaPA 17025 Complete .items 23a-c only wnen certifying l'l~~lh: SIt of my knowledge, death occurrtld at the lime, date and place staled UCENSE NUMBER I:OATE SIGNED phySJdalllS not evailablll at Ume 01 death to (5. re and Title, (Month. Day, Year) certify couse 01 deeth 23&. '23b. 23c. 11effi$ 24-26 must be completed by TIME OF DEATH IDPJE PRONOUNCED DEAD ~Month, Day, Year) WAS CASE REFERRED TO ME~L EXAMINER/CORONER? person Who pronounce1l death 24. 11: 25 P. M, 125. July 7, 2005 26. Yes}Q NoD 27, PART 1. Enter th9 diseases, Injuries or ccmprlcallons which cBused :t-e death 00 not enter the mode of dying, such as cardiac or reliplratcry arreSI, shock or heart failure I Appro.dmate PART II: Other signincanl conditions contrlbuting to daath, but List only one r"..'llJ.'le on ~ach line : interval between not resulting in the underlying cause given in PART I IMMEDIATE CAUSE (Final ! onsel and death di~OfcOlldrtion resullingindearhl--' 1. w Richardson IDATE OF DEATH (Month, Day. Year) I' July 7, 2005 AGE (Last Birthday) UNDER 1 YEAR Months Days 84 y~ Resldenea [J g;:ify)0 5. . COUNTY OF DE.4:rH Cumberland I:RACE - American Indian, Black, White, etc (Spec,ty) White ,.. SURVIVING SPOUSE (llwile,givemaidonnamej Sb. L rw.. cltyfboro. SeQuentially!;stcondltions ilany,leaClingtOimmediale causa Fnter UNDERLYING CAUSE (Disease 01 injury II1Af ,nitiateo events re8lJlting in ooatr1) LAST ,. Closed Head Injury DUE TO (OR AS ,t.. CONSEQUENCE OF) Fall DUE TO :OR />S '" CONSEQUENCE CF) '- DUE TO (OR AS A CONSEQUeNCE OF) WAS AN AUTOPSY PERFORMED? d. WERE AUTOPSY FINDINGS AVAlL....BLE PRIOR TO COMPLETION OF CAUSE OF DEATH? MANNER OF DEATH 'MEDICAL !XAMINEAlCORONER On the basis of examination and/or Investigation. In my opinion. death OCCurred 81 the time. date, and place. and due to the cauae(a) and menneras stated...",....,......, .......,.,....,.,.,., ...........,......... 31.. D-"J"E OF INJURY ~F :~URY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED (Month Day,Year) ~ Aprx. Fall from standing Natur;ll C Homicide 0 July 7, 2005 I Yes ~ NO~ on patio AcCident;gJ.. Pllfldinglnvesllgali{\n 0 3aa. 3Ob. 3: 30 PM. 301:. 3Od. Yes 0 No ~ Yft..~ 0 No 0 0 0 ~JURY. At home, farm, street, factory, ottlcEI LOC~I~N (Street, CityrTown, State) 2a.. 28b. 2~~iCide Could not be determined ~~~ing,"'tc,(SpecIIY) Home J'''''; ~ eet t Lemoyne t CERTIFIERrChoc.o.....,yone) SIGNATUAEA~ ,W"1~ .~:~~:~~, ~yy~~~:J::~~~:i~ C;~~~~~d~u.;:I~l ~eea~Il:;(!I)~~~~~~~~~; :~~~~~cunCed death and corr'Piel~ ~I~~. ~:). . . . . . . . [J 31b. -.........-: // ~ Co r- one r lICENSEN'lJMBE~ [6Ar.EStGNEDIMOntr1gDay. Yio-'- '~:~~~r;yA~~~~~~'=:~:~~~I(~~~~~:e~~~~~~~~O~~;~~?~~~f~:;~Oc;h:'~~~~~(~)~s:dO~~~raSSlated." 0 31c. !31d July, 05 NAME AND ADDRESS OF PERSQN WHQ COMPLETED CAUSj: OF DE~H (Item 27) Type or Print Michael L. Norr1.s, Coroner ~ 6375 Basehore Road, Suite #1 .f'/. 32. Mechanicsburg, Pa. 17050 DATE FILED (Month, nay. Year) 34. (L~..t. J I o (J' PA REGISTRAR'~GNATURE A~~M~_' '_', 3.1. ~- /-"(' %7../.l<"~e... V p7V~I/( I d ~c:J.s- Last Will of JACK W. RICHARDSON I, JACK W. RICHARDSON, the Testator, a resident of Cumberland County, Pennsylvania, declare that this is my Last Will. I hereby revoke all my previous wills and codicils. Article One Introductory Provisions Section 1. Marital Status I am presently unmarried. Section 2. Children a. My Children I have one child whose name and birth date is: Name Birth Date JAMES W. RICHARDSON February 13, 1952 Article Two Appointment of My Personal Representatives Section 1. Nomination of My Personal Representatives I appoint the following to be my Personal Representative(s) in the order of priority in which their names appear: JAMES W. RICHARDSON; THEN ADAM M. RICHARDSON If, for any reason, the Personal Representative(s) named above are unable or unwilling to serve, the next successor Personal Representative(s) shall serve in the order of priority listed until the list has been exhausted. Unless otherwise specified, if Co-Personal Representatives are serving, the next named successor Personal Representative shall serve only after all of the Co-Personal Representatives cease to act as Personal Representatives. Section 2. Waiver of Bond No bond or undertaking shall be required of any Personal Representative nominated in this Last Will. Section 3. General Powers My Personal Representative shall have full authority to administer my estate under the laws of the Commonwealth of Pennsylvania relating to the powers of fiduciaries. My Personal Representative shall have the power to administer my estate under the Pennsylvania Probate, Estates and Fiduciaries Code. Article Three Disposition of My Property Section 1. Estate Planning Letter or Memorandum To the extent permitted by state law and not necessary to fully utilize my Unused Applicable Credit Equivalent, my Personal Representative shall distribute such of my personal or household items to such persons as I may direct by a written instrument signed by me and delivered to my Personal Representative. Section 2. Distribution to My Revocable Living Trust I give all the rest, residue and remainder of my property of whatever nature and kind and wherever located to the then acting Trustee(s) of my revocable living trust of which I am a Trustor known as the: JACK W. RlCHARDSON LIVING TRUST, dated July 29,1997, and any amendments thereto I executed said revocable living trust prior to the execution of this Last Will. Section 3. Alternate Disposition If my revocable living trust is not in effect for any reason, I give all of my property to my Personal Representative under this will as Trustee who shall hold, administer and distribute my property as a testamentary trust the provisions of which are identical to those of my revocable living trust on the date of execution ofthis Last Will, or as thereafter amended. Article Four Death Taxes Section 1. Definition of Death Taxes The term "death taxes," as used in this will, shall mean all inheritance, estate, succession, and other similar taxes that are payable by any person on account of that person's interest in the estate of the decedent or by reason of the decedent's death, including penalties and interest, but excluding the following: a. Any additional to the federal estate tax for any "excess retirement accumulation" under Internal Revenue Code Section 4980A. b. Any additional tax that may be assessed under Internal Revenue Code Section 2032A or 2057; and c. Any federal or state tax imposed on a Generation Skipping Transfer, as that term is defined in the federal tax laws, unless the applicable tax statutes provide that the Generation Skipping Transfer Tax is payable directly out of the assets of my gross estate. Section 2. Payment of Death Taxes Pursuant to the terms of my revocable living trust, all death taxes whether or not attributable to property inventoried in my probate estate shall be paid by the Trustee from my Trust. However, ifmy Trust does not exist at the time of my death or if the assets of my Trust are insufficient to pay the death taxes in full, I direct my Personal Representative to pay any death taxes that cannot be paid by my Trustee from the assets of my probate estate by equitably prorating and apportioning those taxes among the beneficiaries of this will. Unless specifically provided otherwise in my Trust, all death taxes incurred by reason of assets being transferred outside of my Trust or probate estate shall be assessed against those persons receiving such property. Article Five General Provisions Section 1. No Contest Clause If any person or entity singularly or in conjunction with any other person or entity, directly or indirectly, contests in any court the validity of this Last Will including any codicils thereto, then the right of that person or entity to take any interest in my estate shall cease and the demise of that person (and his or her descendants) or entity shall be deemed to have occurred prior to mine. Section 2. Captions The captions of Articles, Sections and Paragraphs used in this Last Will are for convenience of reference only and shall have no significance in the construction or interpretation of this Last Will. Section 3. Severability Should any of the provisions of this Last Will be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this will and all invalid provisions shall be wholly disregarded in interpreting this Last Will. Section 4. Governing Law This Last Will shall be construed, regulated and governed by and in accordance with the laws of the Commonwealth of Pennsylvania. 1 signed this, my Last Will, on FEB 2 3 2005 I " 7, /'; /'., . "1 /, r ' . ) /4>:I'1f..' ,''--(:1f'7/ Jld{w R~HArUJS'6~' ;' . ATTESTATION CLAUSE On this FEB 2 3 2005 , JACK W. RICHARDSON, Testator, personally Published and Declared the foregoing instrument, as and for his Last Will and Testament, in the presence of each of us and all of us together, who, at his request, in his presence, and in the presence of each other, also signed the said instrument as witnesses. We further state that each of us believes that at the time he executed the foregoing instrument he was of sound mind and memory, of lawful age, and did so execute it as his own free act and deed and not under the constraint or undue influence of any person. J j m /I'} ~{~e~~O')l . (~~ J~ I q ~)l11i:.f ~ ,0iU l~~' Street Address , ''-./1 J /10:3.:3 p ~af]~~ Witness 9 d '1 &P'J2""~~ tU . Street Address ~~~te,~p 17u?.r COMMONWEALTH OF PENNSYL VANIA COUNTY OF DAUPHIN We, JACK W. RICHARDSON, ~::)ll,(~" tV!. (~/(t.itilc.r./(O and ~ Ck:;.i.-C":: Wo&-r.~t-""l - }:,~""''-h , the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being duly first sworn, do hereby declare to the undersigned authority that we were present and saw the Testator sign and execute the foregoing instrument as his Last Will; that the Testator signed it willingly, or directed another to sign it for the Testator, that it was executed as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the presence and hearing of the Testator signed the Last Will as a witness; and that to the best of our knowledge the Testator was at the time of sound mind and memory, of lawful age, and under no constraint or undue influence. ;/ ."-, ,/ /3", /) /. t::t~ / -f../J 11/, -,' ~ >-JI/';I!t . .I<kb~ /7.,.~ )f\CK W. RICHA SON J ~ ~ , / ~J( ,(VI ')1 tr)l'flLfpt7"[.C Wlt~ryS . ( JlldJ~_=~ Witness SUBSCRIBED, SWORN TO and ACKNOWLEDGED before me, a notary public, by JACK W. RICHARDSON, the Testator, and 5~QI') (')'1. ~ .J(l~~Lyje and iVl ""..;, l--. L, }G..jf""-r ~ *'" , the witnesses, on this FEB 2 3 005 t~~x~ Ndtary Public LJ~OMM~='E:J.'IV;':~;;"T:;":..'I~;~.;f:C::J'C'.'!!:Y-AJNIA Linda L~-';:.),l~~;:~,"':~:.'i. ;~. I,~;~'~:l:..~.'. P - ut.>!iC [}.?rry T t"1p , D~upr~:~lC:~)!.mty My Ccmrrlls'I'A1L'.'H'.'", r'''''1 8.200'7 ..._.._.,--_._--_._._._._.,-~_._--,- Membei", Pe!!r;"6\'iV'c':1ill:" .L\;;SOCi;"'!\l11 Of Notaries