HomeMy WebLinkAbout02-01-06
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Sylvia S. Kauffman
also known as
No.
21-06-
iDLt
, Deceased
Social Security No. 204-30-8635
Sharon B. Miller
Petitioner(s), who is/are 18 years of age or older, appl(ies) for:
(COMPLETE 'A' or 'B' BELOW)
[El A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
the Decedent, dated 12/13/2005 and codicils dated
Executrix
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 document~.-
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
None
D
B. Grant of Letters of Administration
\..C.
(c.t.a; d.b.n.c.t.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
Relationship
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 25 Wilson Street, Borough of Carlisle
(list street, number, and municipality)
Decedent, then
67
-
years of age, died
01/11/2006
at 25 Wilson Street, Carlisle, PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl 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
10,000.00
$
$
$
$
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 appropriate form to the undersigned:
Sharon B. Miller
Typed or printed name and residence
585 Carlisle Road
Newville, PA 17241
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
th, "'''''"', P,,"oo,,(,) "'" ",II '"' truly ,'ml""te, th, ..ta~"","g to ~'Wll AI ~
Sworn to or affirmed and subscribed jAJlJj J j' I ! L-'
Sharon B. Miller
I
rreF{ LCAiZ'1
~tMttfWUA' "
~e ~lster
WrY\ w.
before me this
day of
~. ~:-..
No.
21-06- /0 lo
Estate of
Sylvia S. Kauffman
, Deceased
also known as
'~'.J
Social Security No: 204-30-8635
Date of Death:
01/11/2006
, ':AO() (p
, in consideration
AND NOW,
Fl2B I
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [!] Testamentary D of Administration
(c.I.a.; d.b.n.c.l.a; pendente lite; durante absentia; durante minoritate)
are hereby granted to Sharon B. Miller, Executrix
in the above estate and that the instrument(s) dated
12/13/2005
Short Certificate(s)...................... $
20.00
Attorney:
Regisier of Wills
R~~q
1.0. No: 21458
described in the Petition be admitted to probate and filled of record a
FEES
Letters.......................................... $
45.00
Renunciation............................... $
Affidavits ( )...........................$
Extra Pages ( )......................$
Said is, Flower & Lindsay
Address: 2109 Market Street
Codicil.......................................... $
JCP Fee....................................... $
15.00
Camp Hill, PA 17011
Telephone9 (717) 737-3405
Inventory...................................... $
E-Mail:
Other............................................ $
15.00
TOTAL............................ $
95.00
Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1(1991)
Hj()).~(j:" REV I/O."
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 Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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Local Registrar
Fee for this certificate, $6.00
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JAN 1 3 2006
Date
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Hl05.143Rev.Ol106
TYPEIPfllNT IN
PERMANENT
aLACK INK
\ Name of Decedenl (Firsl. middle. lasll 1'S", 3. 204'"""N30 I:' 0"00' 0"1h (Moo'h, d,y. y.")
Sylvia S. Kauffman Femal 8635 January 11, 2006
- -
5 Age (Laslbirthday) 6. Unde/l ear Under 1 da 7. DateofBirlh MOllth,dav,vear 8. Birlhlace and slaleor lOr-;;;ncou""'iiiiii\ Sa. Place 01 Dealh Chackon ono
67 I Monlhs 0'1" Hours 1 Minutes I 5/17/1938 IAltoona PA 1-~os~Il~~tenl o ERIOulrn lienl o DOA I ~~~rSinn Home 1fYResidence o 0Ihe<..<""';",
Vm.
~ Bb. CoUnlyof Dealh 8c. City, Bore. lwp. 01 Dealh I ~ gO'wil';~~"'.St"'''''''' """",,) 9. Was Decedenl 01 Hispan-= Origin? 10. Race: Amer-=an Indian, Black, WMe, etc.
Cumberland Carlisle 'K No o Yes (!I yes, specify Cuban, WM'te
Mexican. PtJerlo Rican. elc.)
.
11. Decedent's Usual OccllMlion Kind of work done dutin most of workinn ~le: do nol slate retired 12. Was Decedent ever in the US 13 Decedent'sEducalion~on h'hesl adeco teted 14 Mar~al Status: Married. Never ma/tied, 15 Surviving Spouse (If wire, gi'le maidtfl namel
~xecur,!~k I Kind 01 BusineSSl1ndustry .Armed Forces? r ElemenlarylSecondary(Q-.12) 1 CoI1ege (1-4 or 5+) Wldowed,DiYorced(~
ecre ar Shoe Factory o Yes Xi No 12 4 Divorced
. 16. Decedent's Mading Address (Slreel, cityllown, slale, zip code) Decedent's PA Did Decedellt
~Vi lson Actual Residence 17a. Slale Uvema 17c.O Yes, Decedenllilledin Twp.
25 Street Townsh~?
- Carlisle PA 17013 \7b.COlm~ Cumberland 17d]l: No. Decedent Lived within Carlisle
h:l:ualLimitsof City/80ro
18. Father's Name(Firsl,rOOdle, IaSI) 19 Mother's Name (First middle, maiden surname)
John Stabnau Mary Kirk
208. Informant's Name (TYP8ltlrinl) Sharon Miller lOb. lnroSstSMaiH(! ~~i{t;''iity~wn'RIa6 ~ dodel
Newville, PA 17241
218. ~:=: DL5POS~io~tematK,n 21bi iei'6fs7s2io806' day, year) 2"- "'",' 0"1'9".' IN,,,,,,, "moI,~. ,,,.."",, oth.. ,..,,) I ~..'t''ri"IY^,wn, .tel.. Z._I 17059
. o Removal trom Slate o Donahon Westminister Presbyterian 1 lntown, PA
o Other - Specifv: Cemeterv
~ 22<1. sign~~neral Srice Uce~e (Of::;L achng as such) ~ 1 ~~<"i 38'9 5 1'2Egogr@<1!'ddii'l!I'1'fe'ral Home Inc 15 Blg Sprlng Ave
- ' ,}- (/'tV1. / :. . ---- A /I L Newville PA 17241
~tel\ems239'ConJyWhancerlifying ~'~S10ImyknOwledga,deathocCUfredatlhelime,daleandPIaCeslat9d,{Signalure and lillel 23b. License NulTtler 23c. Dale Signed (Month,day, year)
phys-=ian is nol available al lime of death 10
certily cause 01 death
. Ilems 24.26 must be OOflllleted by person 24 Time 01 Death 125 Date Pronounced Dead (Monlh. day, year) 26. Was Case Referred to a Medical Exami/lElflCoroner?
~ who pronounces dealh. II ~al-lIJM )Il"No
DYes
CAUSE OF DEATH (See Instructions ,md examples) Approximate interval Part II: Enter other sionificanl condilions conlribulinll 10 dealh, 28. Did Tobacco Use Cor1trilute 10 Death?
lIem27. Part!: Enlerlhe~-diseases.injuries,orcorTlllicalions-thaldirectlycausedthedeath.DO NOT enter terminal events such as cardiac arrest, onset to death but nol resulting In the undarlying cause given in Part I. DYes o Probably
respiratory arrest, or venlTicular ribr~lalilJn without showing the eliology. DO NOT abbreviate. Enter only one cause on a tine. ..,.. No o Unknown
IMMEDIATE CAUSE (Fina! disease or t""''<.~I'"!..'~''''' ~""(..~L- c.. ~':lt'''''''''<~ 29. IfFemale:
conclnion resulting in daalh) ----3> ,. ~NlItpregnanlwilhinpastyear
Due \0 (or asa consequenca oQ: o PTegnanlat!imeoldeath
Sequentiallyistcondilions, if any, b. o Nol pregnant. but pregnant within 42 days
Ie.adinglolhecauselisledoolWlea. Due 10 (or as a consequellCeoQ:
- Enter Ihe UNDERLYING CAUSE oldealh
. (disease or injury lhat iIliliated the ,. o Not pregnant, bul pregnant ~ days 10 1 Y9ll.r
ev8fl1s resulling in dealh) LAST. Due 10 (or as a consequence oQ: beloredealh
d. o Unknown if pregnant within Ihe past year
308. Was an Autopsy 3Ob. Were Aulopsy Findings ". Manner of Death 32a. Date of Injury (Molllh, day, year) 32b. Describe how Injury Occurred: 32c. Place of Injury: Horne, Farm, SlTaet, Faclory, Offica
Performed? Available Prior 10 CorTllletion '~Natural o Homcide Building, elc. (SpeciM
of Cause 01 Dealh? \
o V" ~No DYes o No o Paidenl o Pending Investigation 321. If Trallsportation Illjury{.$p9cif)1
32d. TIme of Injury 13"",;o~'IW"k? 32g. Location (Straet,cityAoWfl,slate)
o Suicide o Could Not Be Detemined DYes 0 No o DriverlOperator 0 Passenger
M. o Pedestrian POIhe<-Specify,
33a. Certifier (Check only one) 330. S~C,"~(rO
~:~:Z:i:r:~=:na:~Uy~~~: ~~~:~~=~~~h:a~:r~; ~:~~~M~~~"~~'~'~~~'~~~:'~~""'''''''''''''''''''_''''''...."......H....._..H..........;' .!>.,
PronouncIng and certIfyIng physician (F'tlysician both pronouncing death and cerlilying 10 cause of death) 33c.L-=en~r'u 33d. 0.18 Sir I"":~Y; Y''')
To the best of my knowledge, deatl1 occurred at the time, date, and place, and due to the cause(s} and manner as stated.............................. ............................_........0 t) _3Cc.:'>"'\-'1'::>-t..-. \ f~ (It,.
MedlcJllexamlnerfearonlr
On the basis of examination and/or Invesll91tlon, In my opinion. death occurred al the time, date, and place, and due to the cause(s) and manner as stated .........0 ". Name and Address of Person Who Coflllleted Cause of Death (1Iem 27) TypeiPrinl .-
35 '''tS:::''~:IV~~ _'- _ _ _ . Id:F:~~"h~;~~)(_ "L"1..c. 1wo;a',t...,l...r.oI" ~~"
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
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(See instructions and examples on reverse)
SAIDIS
SHUFF, FLOWER
& LINDSAY
ATfORNEYSoAToLAW
26 W. High Street
Carlisle. P A
L
LAST WILL AND TESTAMENT
OF
C: j
\ l
SYLVIA S. KAUFFMAN
I, Sylvia S. Kauffman, of Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking all other Wills
and Codicils heretofore made by me.
FIRST
I direct the payment of my just debts and expenses of my las
illness and funeral from my estate as soon after my death a
conveniently may be done.
I direct my body be interred in th
Presbyterian Cemetery, Mifflintown, Pennsylvania.
Further, I authorize my personal representative to expen
funds from my estate, in such amount as my personal representativ
shall consider necessary and desirable for the purchase, erectio
and inscription of a suitable marker for my grave.
SECOND
A. I give and bequeath the sum of one thousand
1$1,000.00) dollars to my nephew, Adam J. Miller, and the sum of
one thousand ($1,000.00) dollars to my niece, Abigail M.C.
Miller.
B. I glve, devise and bequeath all the rest, residue and
remainder of my estate to my beloved sister, Sharon B. Miller.
SAIDIS
SHUFF, FLOWER
& LINDSAY
AITORNEYSoAToLAW
26 W. High Street
Carlisle, P A
1-
THIRD
During the lifetime of my sister, Sharon B. Miller, Trustee
shall:
A. Pay and distribute to her or for her benefit, the
entire net income therefrom, which payments shall be
made not less frequently than quarterly; and
B. My sister shall have the right to withdraw annually
the greater of $5,000 or five (5%) percent of the
principal of this trust valued at the end of the
calendar year in which the withdrawal is made. The
right of withdrawal shall be exercised only in writing
and delivered to the Trustee during the lifetime of my
sister, and the right of withdrawal shall be non-
cumulative; and
C. Trustee shall, from time to time, pay to my sister,
Sharon B. Miller, or shall apply directly for her
benefit, as much of the principal of the trust as
Trustee may consider desirable for her health,
maintenance and support the manner of living of which
she is accustomed, after taking into consideration all
of her other readily available assets and income from
all sources; and
D. On the death of my sister, Sharon B. Miller, fifty
(50%) percent to Bosler Memorial Library and fifty
(50%) percent to WITF, Inc.
2
SAIDIS
SHUFF, FLOWER
& LINDSAY
AITORNEYSeATeLAW
26 W. High Street
Carlisle. P A
I
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.'
FOURTH
In the event my sister, Sharon B. Miller, fails to survive
me by 60 days, I hereby give, devise and bequeath all the rest,
residue and remainder of my estate as follows:
A. Fifty (50%) percent to the Bosler Memorial Library;
and
B. Fifty (50%) percent to WITF, Inc.
FIFTH
I direct that any and all inheritance, estate, and transfer
taxes imposed upon my estate passing under this Will or
otherwise shall be paid out of the principal of my residuary
estate.
SIXTH
In addition to the powers conferred by law, I authorize any
personal representative acting under this instrument, in their
absolute discretion:
A. To retain In the form received, or to sell either at
public or private sale any real or personal property;
B. To exercise any options to subscribe for stocks,
bonds, or other investments;
C. To join in any plan of lease, mortgage,
consolidation, exchange, reorganization or foreclosure of
any corporation in which my estate or any trust may hold
stocks, bonds or other securities;
3
SAlOIS
SHUFF, FLOWER
& LINDSAY
ATIORNEYS-AT-LAW
26 W. High Street
Carlisle, P A
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D. To sell, transfer, convey, mortgage, pledge, lease
or exchange any property, real or personal, which at any
time may form part of my estate, for the payment of debts
or taxes, or for any purpose of administration or
distribution, for such prices and upon such terms as my
personal representative, in their sole discretion, may deem
wlse, and to execute and deliver deeds of conveyance or
transfer thereof;
E. To make settlements and compromises on such terms as
my personal representative in their sole discretion may
deem wise without the necessity of obtaining any court
approval thereof;
F. To make distribution hereunder either in cash or
kind, as my personal representative in their discretion may
deem wise.
SEVENTH
I do hereby nominate, constitute and appoint my sister,
Sharon B. Miller, to act as Executrix of this my Last Will and
Testament.
Provided, however, that if Sharon B. Miller is
unwilling or unable to act as Executrix, I direct the duties of
Executor to be performed by Manufacturers and Traders Trust
Company.
EIGHTH
I direct that no personal representative, guardian, trustee
or other fiduciary appointed under this instrument shall be
4
SAlOIS
SHUFF, FLOWER
& LINDSAY
AITORNEYSoAToLAW
26 W. High Street
Carlisle, P A
required to give bond for the faithful performance of their
duties In any jurisdiction.
IN WITNESS WHEREOF, I, Sylvia S. Kauffman, have hereunto
set my hand and seal to this my Last Will and Testament,
consisting of four typewritten pages, the first three of which
i3 rIi
bear my signature in the margin for identification, this
day of ~~-v-.....
2005.
( ()." ~ ! \!. / .'
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. (&
Sylvia S. Kauffman
Signed, sealed, published and declared by the above-named
Sylvia S. Kauffman, Testatrix, as and for her Last Will and
Testament In the presence of us, who have hereunto subscribed
our names at her request as witnesses thereto, In the presence
of said Testatrix and of each other.
~iL;~/tl.,,",~
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ADDRESS
26 West High Street
Carlisle, PA 17013
;:::J'7L1;0 )1,/}~f I,t.. ADDRESS
,. (/
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26 West High Street
Carlisle, PA 17013
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SAlOIS
SHUFF, FLOWER
& LINDSAY
ATTORNEYS-AT-LAW
26 W. High Street
Carlisle, P A
COMMONWEALTH OF PENNSYLVANIA
COUNTY
OF
CUMBERLAND
We, Sylvia S. Kauffman,
Susan Spero
and
Phyllis McCoy
, the Testatrix and witnesses,
respectively whose names are signed to the foregoing or attached
instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testatrix signed and executed the
instrument as her Last Will and Testament and that she signed
willingly and that executed as her free and voluntary act for
the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the Testatrix signed the Will as
witnesses and that to the best of their knowledge the Testatrix
was at the time eighteen (18) or more years of age, of sound
mind and under no constraint or undue influence.
.-. . > /' ). ..)
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- . .'~'
S lvia S. KauGfman
j ^
/
j/'{(/J--t'l/}J ~jL.( /1 /'0~
Susan Spero ,Wl tness
Subscribed, sworn to and acknowledged before me by Sylvia
S. Kauffman, the Testatrix, and subscribed to and sworn or
affirmed to before me by Susan Spero and
Phyllis McCoy , witnesses, this ;3 rliday of ~-v-..
2005. ~c:. ~ ,,,jn L '8
Notarv Pub~~~
NOTARiAl SEAL
GEORGE F. DOUGLAS, m, NOTARY PU91JC
CARLISLE BORO, CUMBERLAND COUNTY
MY COMMISSION EXPIRES JUNE 26,2007
NOTARIAL SEAL
GEORGE F. DOUGLAS, m, NOTARY PUBLIC
CARLISLE BORO, CUMBERLAND COU\iTY
MY COMMISSION EXPIRES JUNE 262""-
6