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HomeMy WebLinkAbout09-27-05 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of No. 'J...\ - ~S - ~~ \ Mary E. Ambrose also known as , Deceased Social Security No. 215-44-8593 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) ~ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executor named in the Last Will of the Decedent, dated June 8. 1994 and codicil(s) dated December 31 , 2004 Stale relevant circumstances, e_~_, 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: No exce p-nCA.S ~ B. Grant of Letters of Administration (c.I.a., d.bn.c.t.a.: pendente lite; durante absenlia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if and heirs: Name Relationshi Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 402 Bethany Drive, Mechanicsburq, PA 17055 (Lower Allen Township) (list street, number and municipality) Decedent, thenM years of age, died September 17, 2005, at Bethanv Villaqe, Lower Allen Township, Cumberland Countv, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property .......................... . . . . . . . . . . . . . . . . .. $ 465,000.00 (If not domiciled in P A) Personal property in Pennsylvania . . . . . . . . . . . . . " . . . . . . . . . . . . . . . . . . . . " .. $ (If not domiciled in PA) Personal property in County. . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . " . . . . $ Value of real estate in Pennsylvania .........................."............................." $ Total ......................,................................,..................,,, $ 465,006:00 Real Estate situated as follows: ,",' Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the gr~nt{)f lett~ri;in the appropriate form to the undersigned: r'-,,-j David M. Ambrose 12706 Westchester Plaza Omaha, Nebraska 68154 o Form RW-1 Page I of 2 (Dauphin County - Rev. 9/92) (,.-,', Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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 estate ",,,mding to law. ~ _ , ~ n Sworn to and affirmed and subscribed ~ .I.~~ .I. before me this ....~ J..~ day of -.::-::,~\"{,J~~ \ 2005 ~~ ~~~ ~~i~ , C\.< '<. ~~ l.. oj D "0~ ~ \ \ Estate of Mary E. Ambrose DECREE OF REGISTER No. :l. " - ~ S - ~\, \ Deceased also known as Social Security No: 215-44-8593 Date of Death: September 17. 2005 r~-.. " -.J AND NOW, 'S'e"'~\.~ J.... "I , 2005, in consideration of the Petition on. the,reyerse side hereon, satisfactory proof haying been presented before me, IT IS DECREED that Letters l8J Testamentary 0 of Administration \ {) c,) (e.t.,a.; d.b,n,c.t.: pendentA lit.p; durante absentia; dunmte minoritate) are hereby granted to David M. Ambrose in the above estate and that the instrument(s), if any, dated ---S\o.~ ~ ...~~u, ~ ,,~- ~\ - ~\-\ described in the Petition be admitted to probate and filed of record as 'the last Will of Decedent. FEES Letters.......................... . $ "\\~ Short Certificate(s) (;2).... $ ~ '''''::' \ \"l \'5 RCHU~",eiati8fl ( )............ $ M?i"J~~At{ ).................. $ ,,~ ~.....~~~\~\~ $ S Extra agOG ( ........... Codicil...... ........... .......... $ JCP Fee........................ $ ,~ Inventory & Tax Forms... $ Other.... .~~~.\~.~.. ....... $ 'S \~ ~.\Z~\ ~....~ ~~ Attorney: J.D. No: Address: Elyse E. Rogers 41274 415 Fallowfield Rd. Suite 301 Camp Hill. PA 17011 717-612-5801 TOTAL..... ........... $ '-\\,~ .~t:::, Telephone: DATE FILED: REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS J... \ - ~ S . ~~ \ Patricia K. Ambrose a subscribing witness to the Codicil presented herewith, having been duly qualified according to law, depose(s) and say(s) that she was present and saw MARY E. AMBROSE, the Testatrix, sign the same and that she signed as a witness at the request of Testatrix in her presence and (in the presence of each other) (in the presence ofthe other subscribing witness(es)). "':,~~\o'\.,,'( ,2005. ~~~ ~~,~~~,'.~ , FOT the RegisteT " ~ ~.\Z~, l.~t> ~~ ~7A~~~ / L?~, , (Name) 12706 Westchester Plaza, Omaha, NE 68154 (Address) Sworn to or affirmed and subscribed ~~ before me this "J...'l.. day of (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS Elvse E. Rogers a subscriber hereto, having been duly qualified according to law, depose(s) and say(s) that she is familiar with the signature of MARY E. AMBROSE, Testatrix of (one of the subscribing witnesses to) the Codicil herewith and that she believe(s) the signature on the Codicil is in the handwriting of MARY E. AMBROSE to the best of her knowledge and belief. Sworn to or affirmed and subscribed (Name) 254 S. Lewisberrv Road, Mechanicsburg. P A 17055 (Address) before me this day of ,2005. FOT the Register (Name) (Address) Register of Wills of Cumberland County OATH OF NON-SUBSCRIBING WITNESS Estate of (flc..'1 ~ ttrnbrtlSE-. No. ":l \ . ~ 5 . ~~ \ Also known as , Deceased f'{J Ie' f Qo:y' ~ (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that S te I ~ familiar with the signature of fV('A ('1 ~ A.rn lo (0 ~ e , testat-.G..i. of (oRe efth0 subscribing mitnesses to) the codicil/will presented herewith and that iJ& b~elieves the signature on the codicil/will is in the handwriting of {{(c..r '1 r A:n. ~ fO ) (" to the best of If) p..- knowledge and belief. u~ z: Sworn to or affirmed a~ub.scribed Bef~e me this ;;1 ~ day of :0 ef5Ci' n~l') :; __ , 20 () ~ J4t~.VdO.~fU'1 J /I, ~.a-ba.t~ Regist~r ~ rJ. ;::-P-x 1\ -- l:tlV) +- Deputy , (Name) L{ I S teA- {({1<..J;'l e leY (Address) VAfT'P H l ~ \ (Name) (') i~ ' -I (Address) ,--.,: ('. ; ".:--'"'- 'J) C~J ",,'::J :~ -I -rl ,~-) I"r') , ~') "1"1 Register of Wills of Cumberland County, Pennsylvania RENUNCIATION Estate of MARY E. AMBROSE "l\-~S -~\\ No. also known as The undersigned, Robert E. Ambrose Son/Co-Executor (Relationship) (Capacity) of the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to DAVID M. AMBROSE Witness ~ hand this f2. L... day of ~l~~~ .....20~ ~~Z ~~'-2- (Signature) 182 Ambrose Road Stahlstown, PA 15687 (Address) (Signature) (Address) COMMONWEALTH OF PENNSYLVANIA NOT ARIAL SEAL CYNTHIA J RULE, Notary Public Camp Hill Bore, Cumberland County My Commission Expires February 3, 2008 rL.L. (Signature and seal of Notary or other of notaryDs commission, official qualified toadminlster oaths. Show date of expiration of notaryDs commission) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. Form RW-4 (Dauphin County) - Rev. 9/92 ,,_..... "-,,> C) "~" ", '---.J ")., \ - ~ s - ~l..:, \ Till' 1,,10 certifv that the information here given is correctly copied from an original certirieate 01' ekalh elly filed with me as 1.\H.,1I Rcgistrar~ The original certificate will he forwarded to the State Vilal Records Officc for pCl'Jllanelll riling. WARNING: It is illegal to duplicate this copy by photostat or photograph. lJ6;3998~j_ No, tZvn_ /J! ~<!M~~ - (. Local Registrar Fee for this certificale. $6,00 P I SEP 1 9 2005 Date r....,) :-~..., , , Fl j-f I') ,.~--J ,-) C,.) 3 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER NAME OF DECEDENT (First, Middle, Last) SEX 2. f emaie J. BIRTHPLACE (City and PLAGEOFDEATH Che k nl n State or Foreign Country) HOSPITAL' Wa..6hingto n, DC !npallenl 0 ER/Oulpa1ient 0 7. 8a. FACiliTY NAME (If not institution, give street ana number) DATE OF DEATH {Month, Day, Year} 4SeJOtembvr. 17, 2005 ~~:~Iy) 0 RACE - American Indian, Black, While, at (Specify) Wh.i.te 10, MARITAL STATUS. Married, SURVIVING SPOUSE Never Merried, Widowed, (If wife, give maiden name) Divorced (Specify) 4. V{,vO/[cced 15, L owvr. ALien twp city/boro. C O.lut E. CJtum 15687 SeQuentially list conditions if any, leading to immediate cause. Entar UNDERLYING CAUSE (Disease or injury that initiated events resulting on dealll ) LAST r :~proKimate ; Interval between ,onset and death IMMEDIATE CAUSE (Final disease or condition resulting in death)---+ C,/Jc? Co,"'D Natural Accident DATE OF INJURY (Month. Day. Y8a.) TIME OF INJURY DUE ra (OR AS A CONSEQUENCE OF) WAS AN AUTOPSY PERFORMED? WERE AUTOPSY FINDiNGS AVAILABLE PRIOR TO CO PLETION OF CAUSE DEATH? INJURY AT WORK? Yes 0 No Yes 0 No Suicide o o Pending Investigation Could not be determined o o o 30a. 30b. PLACE OF INJURY. At home, rann, street, faCio bullcllnll.8Ic.(Sp8clly) 30e, o<s- 28a 2ab. CERTIFIER (Check only one) ~~~~~~F~~tGor~~~R~~e~~s~~:rh C~~~~i~%J~~: t~ f~:~a'i:i'~:~(:)g~3~~X~~~8:s h:t~r:~~~~~~~.~ ,~~~.t~. .~~~ .~~.~~~::~.~ .I.t~.r;:.~~.~ 29. .PRONOUNCING AND CERTIFYING PHYSICIAN (Plwsician both pronouncing deatn and certifying 10 cause of death) To the best of my knowledge, death occurred at the time, date, and phu;;e, and due to thtl clluses(z) and manner as stated. "MEDICAL EXAMINER/CORONER ~:~~:rb::I:t~:e~~~mln~t.i~~. .~~.~~~.r. ~~.~~~~Igatlon, In my opinion, death occurred a,t. ~~~. ~l,~~:. ~.~~~:.~.~~ .p~~~~.'. ~~~.d.~~_ ~~ .t.h~ .~~.~~.~~.(.~~ .~~~,. 0 31a. REGISTRA~ S"TURE AND NUMBER JJ {Uvn..;;; :;:---'1'.<:(' '" Mi /1 "" /VJ 34. "l \ - ~ 5 . ~~ i Addendum to Last Will and Testament I, Mary E. Ambrose, as of the date noted below do amend my Will as follows: All proceeds that were directed to the children of my son, David M. Ambrose, Sr., according to the original will dated 4NY't. 'l. J If 'f~ are not to be distributed but placed in a trust for the education and speCial needs of the grandchildren of David M. Ambrose, Sr. David M. Ambrose, Sr., or his designee, will act as the trustee and his decisions are considered as absolute, final and complete. The type of trust is to be determined at the time of the execution of my Will according to what form best accommodates the proceeds as of that date. The intent is to maximize the proceeds that will accrue to the trust beneficiaries and minimization of tax impositions. 1r7 ~fl: ~> ~ Mary Ambrose 1:2. Is/ lorl Dated 12:b:u-'A./ --;f' ~ , . WItness ) ,- ': C',) .......l \....r') C~) Great Grandchildren: Meredith (David and Debbie) Kira and Elise (Linda and Patrick) Anna and Natalie (Keith and Jenefer) Ashley and Blake (Corey and Gina) Sophie (Jamie) lOt l. -c. T~,,; n ] I LJi. ~ ~. _ d LUll) , ) Children that are bom subsequent to this document to the above name families. I have made my wishes known by initialing each of the lines to which I desi1:e the proceeds of my will to be directed. All other changes, deletions, or additions, are likewise noted. I1tL~ ~ ~ Mary . Ambrose J219#/~ Dated as of ,q~~~/y~ Witness ,',',,,-, "', ~ ~_1 . " \.'0 Cl N lEast ~ill nnb Wcstamcnt OF MARY E. AMBROSE I, MARY E. AMBROSE, of Lower Allen Township, C'Jmberland County, Pennsylvania, do make, publish and declare this to'be my Last Will and Testament, hereby revoking all Wills and Codicils bv me at any time made. ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shall be paid by the Executor out of the property passing under ITEM III of this Will, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this will. ITEM II: I give and bequeath to my sons, ROBERT E. AMBROSE and DAVID M. &~BROSE, or the survivor of them, absolutely and in fee simple, all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon, to be divided between them as they shall agree. ITEM III I give, devise and bequeath the rest, residue and remainder of my estate, not disposed of in the preceding portions of this Will, as folloo/s: '.'": ;" 0... ...' " 1_. ,,/ _'........ :;,,;v 1,( c' ,; "i; Z tv Page 1 I (i) TEN (10%) PERCENT to my son, ROBERT E. AMBROSE; (ii) TEN (10%) PERCENT to my son, DAVID M. AMBROSE; (iii) TEN (10%) PERCENT to BETHANY VILLAGE CARE ASSURANCE FUND, Mechanicsburg, Pennsylvania; (iv) THIRTY-FIVE (35%) PERCENT to the then living issue of my son, ROBERT E. AMBROSE, per stirpes; and (v) THIRTY-FIVE (35%) PERCENT to the then living issue of my son, DAVID M. AMBROSE, per stirpes. Division of the residue shall be made after the payment of all applicable death taxes, including, but not limited to Pennsylvania inheritance taxes. ITEM IV: In addition to powers given by law, the Executor shall have the following discretionary powers, effective without court order: (a) To retain any property received by the Executor; (b) To sell real estate for any purposes, publicly or privately, for such prices and on such terms as the Executor deems proper, without liability on the purchasers to see to application of the purchase moneys; Page 2 ,~,/.' r d . c( ~ I : (c) To compromise controversies; (d) To distribute income or principal in cash or in kind, or partly in each, at valuations fixed by the Executor at such times as are deemed appropriate; (e) To hold investments in the name of a nominee; and (f) To undertake all other acts in the Executor's judgment deemed necessary for the proper and advantageous administration and settlement of my estate. ITEM V: Any person who shall have died at the same time as I shall have, or in a common disaster with me, or under such circumstances that the order of our deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased me. ITEM VI: I hereby nominate, constitute and appoint my sons, ROBERT E. AMBROSE and DAVID M. AMBROSE, to be the Executors, herein collectively referred to as "Executor". The Executor is specifically relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding two (2) pages, at the end of each page of which I have Page 3 ~A,C ~Z~ also set my initials for identification this ~ greater security day of \}'Z;",,-,.C / and better 1 CJfL(. .;,rr ~7 ~R&;" /y, ~~ (SEAL) We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix as and for her Last will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory. C \-; ~(~ ~~~' - - \~~'- (SEAL) ------" ( ," "--.. ',.)) " A/'/ "~~~&g:/j'" 6/-4'~ta-:;P'/(SEAL) /,-:- 'C / (/ {' //. I / \ J J / // ;.J /,,/ ( Lj" ({l ) (- ~) // (SEAL) I (Ol( ACKNOWLEDGEMENT COMMONWEALTH,~F PENNS;LVANIA SS: COUNTY OF /y~.,.Upt((., I I, MARY E. AMBROSE, 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 and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. --'1,,"1/} }) /7 / 1'/, /,~ /'" ,,"A '.-:I' f/ / {l'l~,f <.u. 0<-.-ci. ,. ir" J.,;JL.--'--- MARY! E. fMBROSE (SEAL) Sworn to and sub~cr~bed befo-'7-81 me this Y tv'.. day of . )'i./)\,( , 199''1..( r I{ /({.u>l blffi:yc.( Not ry Public My Commission Expires: ( SEAL) L Notarial Seal Margaret L. Boyd, Notary Public Harnsburg, DaUphin County My CommiSSion Expires June 27, 1996 M'''YI!:xl" Penn:ylvania AG6cCiation of Notaries I : . . . . AFFIDAVIT COMMONWEALT~QF PE~I!/ Y, LVANIA /,(f) i <I) Lt "11 COUNTY OF ' "'\.,, 7' SS: :_-(' We ::;_, ~)(""\ I \ C:'-::<~~ '. \['t" ' L /,t~./(.1 ..{./ . 6~>j)1r9 ( / and <' ,(\(7 <' /'['>('/)() ,- the W~tnesses whose names are signed t~the atta~hed or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix, MARY E. AMBROSE, sign and execute the instrument as her Last Will and Testament; that Testatrix signed willingly and that she executed said Will 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 Witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and unde~~no constraint or undue influence. I ...., /'", //--\ \ \ ,\ ' ~~/ /' /; L{~ ( \\\ ~"- /' '~ \. '/\ C'~ ) ;:?ltdi( ",;/' 1. N.b/~.ffit-V- .' .- \ Witne,$s, /' Witness /' '\ "~~-. Ss~" ~,) ,'" ./ / ;;- / , /' \ "--___,_) ::: ,"--oJ., -..)/J (- f": (L ( I Witness \ ,,----) Sworn to and SUb~cZibed befoF,~ .,me, ~,hiS t t (day of ,!lC,1-U" , 1#/1. , -J/2/L~ ,'. / ,I /'l If\{~'1f1{,L/li: fA r<2yc"/(, Noiary Public ' My Commission Expires: (SEAL) L Notarial Seal Margaret L. BoYd Not P . M Hamsburg, DaUphin acr ublic ,. Y Cornrnission Expires J ou2nty 11 ---- une 7 1996 Ii f.iri1tx3r. PQnn.ylv.;nn;Q K......;:-:::. ! ---.....tiQl'1 Of NOI/\l1es