HomeMy WebLinkAbout02-02-06
Register of Wills of CUMBERLAND
Pennsylvania
Petition for Probate and Grant of Letters
Estate of 6~7<R JlbL=- /f/V,N';L--');: tiT Z--r
a/so known as 6, A/VH'~- ;{ LI/Z..
No.
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, Deceased.
The petition of the undersigned respectfully represents that:
Your petitioner(s) is/are 18 ~ ars of age or older and the execu~",/??' 11(
decedent, dated ~ J7~1'"""'"
Social Security No. /a - 2-f? - 317'
,
named in the last will of the above
and codicil(s) dated
at
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Except as follows, decedent did not marry, was not divorced and did not ave a child born or adopted after execution 0
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
~ /:5ti"
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$
$
$
$
situated as follows:
Wherefore,
letters cp~/ .c-3??~~j
Signatures:
petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of
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(testamentary, administration C.T.A.; administration d.b.n.c.t.a.)
Typed or printed names and residences:
~Q~ /ffJlleffe r(4t-2- ---
'cQ 07 fE't)Y} Grq'1l- Rr-/ Leu'., cQ::,kr-;V/(/7fo02-
f:w~rtl:l ~'t~.
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(over)
thereon.
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Commonwealth of Pennsylvania
C f ~;~r:r~nJ
ounty 0
Oath of Personal Representative
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The petitioner(s) above-named swear(s) or affjrm(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 above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
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before me this
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For the Register
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No.
Fees
, Deceased
Estate of
Probate Letters Etc.
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Short Certificates (S ). . . . . . .
ReftHR,iatioA :~:\~...... $
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ATfORNEY
Filing Inventory . . . . . . . . . ., $
Filing D & D's . . . . . . . . . . ., $
.>~~. .~ .~~~. S~~. .. $
(Sup. Ct. J.D. No.)
ADDRESS
TOTAL
Filed
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PHONE
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Register ofWiHs of Cumberland County
SENTATIVE
COUNTY OF CUMBERLAND
COMMONWEAL TH OF PENNSYL V A
SS:
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The petitioner(s) above-named swear(s) 0 ffirm(s) t t the statements in the foregoing petition are true and
correct to the best of the knowledge and be 'ef ofpetitioner(s d that as personal representative(s) of the above
decedent petitioner(s) will well and trul administer the estate ac rding to law.
Sworn to or affirmed and subscri d
Before me this day of
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Register
No. ~ \ -~~ -~''\\J
Estate of ~X~\~\J'l:l<C ~\\\\~ ~\:n"L , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
FEES
Probate, Letters, Etc. ............. $
Will............................. .... $
Renunciation... . . . . . . . . . . . . . . . . . . . . $
Short Certificates (s) ............ $
JCP. . . .... .... . . . .. .. .. . . ... . . . .. .. .. $
Automation Fee................... $
Bond. .. . ... . . . . .. . . .. .. . ... . . . .. . .... $
Total $
Filed ).. -'~ - 20~
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RegisterofWillsq '~~0~'tl ~
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Attorney (Sup. Ct. I.D. No.)
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HIOqO< REV 1/0< C)... '\ ._ '::':<,,! _ r0 \ '\ 'C:;
This is to certify that the information here given is correctly copied from an original certificate oj 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.
Fee for this certificate. $6.00
p
12224829
No.
1 Rev, 01106
PRINT IN
IANENT
CKINK
1 Name 01 Decedent (First middle, las!)
~io/~
Local Registrar
JAN 2 7 2006
Date
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
cr"',
Gertrude Anne
5, AQe (Lasl birthday) 6 Under 1 vear
9 6 Yrs I Months Days
7 Date 01 Birth Month, dav,vear I a
Anril 27. 19091
I 2 SelC 3. Social Security Nurrber
Ifemale 186 - 28 - 3476
Birtholace CiIv and stale or Ioreion counlN\ I 8a Place 01 Dealh Check ontv one
!Hosprtal: IClhar
Shelby, New York 0 IM,lienl 0 ERlQuln'li,nl 0 DQA I';;' Nu""nH",,,
ad. Facility Name (II not institution, give sIres1 and nurrtler) 9. Was Decedent of Hispanic Origin?
~ No 0 Yes (If yes, specify Cuban,
Mexican. Puerlo Rican,etc.)
Kutz
Under 1 da
Hours I Minutes I
Be. City, Boro. Twp. of Death
Bb. County or Death
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Cumberland
Messiah Village
Upper Allen Township
11 Oecedenl'5 Usual OccuDalion Kind or work done durin most 01 workino file; do not stale relired
~ Kind of Work I Kind of BusinesSilndustry
! School Teacher Education
~ 16 Deced,nl's Mailing Addre" (SI,..I, c~Aown, s~te, z~ Cod,)
T4 Dale of Death (Month, ,jay, year)
Januarv 25 2006
o Residence 0 other - Sr'lIlcihr
10. Flace: American Indian, Black, White, etc.
(SpecffyJ
white
12. Was Decedent ever in the US 13 Decedenrs Education SoeCiiVOnlv hiohest orade cormleled
Armed Forces? I ElementarylS1"'20ndary (()'12) I College jl.4 or 5+)
o Yes iii No 6
Decedent's Did Decedent
Actual Residence 17a, Slate PennAyl vRni R Uveina
Townsh4J?
14 Mar~81 Slatus: Married, Never married,
Widowed, Divorced (Specify)
Widowed
15. Surviving Spouse (If wile, give maiden name)
100 Mt. Allen Drive
Mechanicsburg, PA 17055
17b. County
Cumberland
19. Mother's Nama (First middle, maiden surname)
18 Falher's Name (Firs!, middle, last)
Charles Woolston
17c. III Yes, Decedent Lived in
Upper Allen
Twp
17d. 0 No, Decedent Lived witilin
Actual Limits or
Cityl8oro
Annie Feulner
2Ob. InlorlMnt's Mailing Address (Street, cityt1own, slate, zip code)
208. Informant's Name (Typalprint)
Jean K. Henry
1207 Penn Grant Road, Lancaster, PA 17602
. 21a. Method or Disposition 21b. Date of Disposition (Month, day, year)
! ~ ~;~_SDlIC~Gremal~n 0 R'''''''',"omS',I, 0 Don,tion January 27, 2006
! 22a.s~~of7t1.,'nse'~acl~9assuchl l22b;ns~N~~er 340 L
i_ Co"lllete Ilems 23a--c only when Cer1ifying 23a. To Ihe best 01 rrrt knowledge, death occurred at the time, dale and place slated. (Signature and litle)
physician is not available at lime of death to
cerlifycauseotdaalh
~ :~;o~n::~:tC:rfllleted by person
21C, Place 01 Disposition (Name of cemetery, crematory or other place)
r 21d. Location (Cifyl\Qwn, slale, zip code)
Schaefferstown, PA 17088
Evans Crematory
/22C. Name and Address 01 Facility P t h FH
ar emore & CS, Inc.
P.O. Box 431, New Cumberland, PA 17070-0431
23b. license NUrOOer 2&. Date SigMd (Month, day, year)
29. ~~nIW~hinpastyear
o Pregnanl allime of dealh
o Not pregnant, but pregnanl wilhin 42 days
or death
o NOI: pregnant, but pregnant 43 days 10 1 year
beloredeath
o Unkoown n pregnant within the past year
328. Date of Injury (Month, day. year) /32b Describe how Injury Occurred: 32c. Place of In;ury: Home, Farm, Street. Factory, Office
Buildinn, ele. (Specify)
132e. Injury al Work? 321 If Tlansportation Injury (Specify) 32g. Location (Str~et, cilyl1own, state)
DYes 0 No 0 DriverlOperator 0 Passenljler lac:? .f''YI/ ,:; IIt'j 1 /.2r.?/vc...
M 0 Pedestnan 0 OIher-Spedfy: j/?'1C-L-ht:,/'"1/C Sb ,,""rt:) /.4
v'/~t:'5- 0/
3b';Yn8IUre and rnle or Certifier . . ,'} r~ ..:>
cS(-ti.A26!'vt:rlt..-If-:J.-tv /17 (/ .
33<:. License Nurmar
1110 'IdS' ,/::;-<;"
24 Time of Death
125. Dale Pronounced Dead (Month, ~ay, year)
;:> M. I I-&. ~ - 6(0
CAUSE OF DEATH (See Instructions and examples)
Item 27, Part!: Enter the ~ - diseases, inPJrles, or cOrT1>lications - thaI directly caused the death. 00 NOT enler terminal events such as cardiac arrest,
respiratory arrest, or ventricular fibrillation wilhoul showilg the etiology. DO NOT abbreviate. Enter only one cause on a line.
IMMEDIATE CAUSE (Final disease or /l 'J . ,_. , F "'"
condb~n resuning in death) -7 ,. fit { V /'f::. ro.? '"f7'? f i VL,...
Due 10 (or as a consequence 00:
AdVCt nCKo! AI.?!:-~7(:;YJ1r::/ ~ d-f',/J//eF'7f14
Due to (or as a consequence oQ:
! 0: S-O
: Approximale interval:
: onset to death
Wee-I<. s
Sequentially list conditions, if any,
leading 10 the cause listed on line a.
- Enler the UNDERl YlNG CAUSE
. (disease or injury thaI in~ialed Ihe
events resu~jng in death) LAST
;tntln"1
l' 'je.~I;S.
b.
Due to (or as a consequence 00
3Oa. Was an Autopsy
Performed?
DYes ~
d
n. Were Autopsy FindirlgS
Available Prior to Co~letion
of Cause 01 D?,h?
DYes /Zf'No
32d. Time of Injury
31 Man~mealh
~allJraJ o Homicide
o Accident 0 Pending Investigation
o Suicide 0 Could Not Be Determined
33<1_ CertJfler (Check only one)
CertIfying physician (Physician certifying cause of dealh~hen soother physician has pronounced death and OO"llleled nem 23)
To the besl ot my knowledge, death occurred dUE! to the CIUSe(S) and manner as slated ................. ............ ..........., ................ ....... ...... ..................................
Pronouncing and certifying physician (Physician both pronouncing death and certifying 10 cause of death)
To the best of my knowledge, death occurred at the time, d.te,.nd place, and due to the c.use{S) and manner <IS slated ........,........ ......... ..................... ......... .....0
Medical examinerlcoroner
On the buls of examin.llon andlor Investigation, in my opinion, death occurred at lhe time, d.te,.nd place, and due to the cause(s) and manner as stated ........0
m~
35. Aegislrar'~alure and Dis\o/Y~~
1/h1/y) /'? 7M A - _.-~_
(/
I ~I /1,;lJ /1 /1
136;/;(;/;~
(See Instrucllons and examples on reverse)
26. Was Case AelerTed 10 a Medical Examiner/Coroner?
,I'N ~\J
t:t'~~l.> 0 No
Part If: Enter olher sionilicarlt cond~ions contributino to death,
but not resufting in the underlying cause given in Part I.
28. Did Tobacco Use Conlribule 10 Dealh?
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.5JyOk:t> {,UI-rt--J he/YItjJlt>g''.--,
()OI7JnOYt"f a"I-c,ry
../ di~aK
33d. Dale Signed fMonlh. day, year)
t'/- ~2 7- 200&
34. . Name and Add!~s 01 Person WhAl.Co!!Jl!:led Calise of Death (lIem 27) TypelPrin
~Ml-JI-I NP&.0:3PK-3U
/tJO ,rr-If /1-11("'1'1 ne,.VC'
f)t:L/-IAr/1{95I/JfC- I'/t {70)'5'
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New Cumberland, Pa. i
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STONE, SAJER
8: STEWART
Attorneys at Law
414 Bridge Street
17070
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LAST WILL AND TESTAMENT
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OF
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GERTRUDE ANNE KUTZ
I, GERTRUDE ANNE KUTZ, of the Borough of New Cumberland, C~~ty of
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Cumberland, and Commonwealth of Pennsylvania, declare this to be rny last will
f'
and revoke any will previously made by me.
ITEM I: I devise and bequeath all of my estate of every nature and
wherever situate in equal shares to such of my children, JEAN ~:TTE KUTZ
HENRY, of Lancaster, Pennsylvania, and RICHARD LEE KUTZ of Burtonsville,
Maryland, as survive me by thirty days.
ITEM II: Should my daughter, JEAN ANNETTE KUTZ HENRY or my son,
RICHARD LEE KUTZ, predecease me or die on or before the thirtieth day
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following my death, I devise and bequeath the share of such child to his or
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her issue, per stirpes, living on the thirty-first day following m~ death;
should any either my daughter, JEAN ANNETTE KUTZ HENRY or my son RICHARD LEE
KUTZ, leave no such issue living on the thirty-first day following my death,
I devise and bequeath the share of such child to my other child or his or her
issue per stirpes, living on the thirty-first day following my death.
ITEM III: I appoint my executors or their successors guardian of any
property which passes either under this will or otherwise to a minor and with
respect to which I am authorized to appoint a guardian and have not otherwise
specifically done so, provided that this appointment of a guardian shall not
supersede the right of any fiduciary in its discretion to distribute a share
where possible to the minor or to another for the minor's benefit. Such guar-
dian shall have the power to use principal as well as income from time to time
Page 1 of 4 pages
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STONE, SAJER
Be STEWART
Attorneys at Law
414 Bridge Street
New Cumberland, Pa.
17070
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for the minor's support and education (including college education, both gra-
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duate and undergraduate) without regard to his or her parent's abiLlity to pro-
vide for such support and education, or to make payment for these purposes,
without further responsibility, to the minor or to the minor's parent or to
any person taking care of the minor.
ITEM VI: I direct that all taxes that may be assessed iIll consequence
of my death, of whatever nature and by whatever jurisdiction imposed, shall be
;[ paid from my residuary estate as a part of the expense of the administration
of my estate.
ITEM V: I appoint my children, JEAN ANNETTE KUTZ HENRY and RICHARD
LEE KUTZ, co-executors of this my last will.
ITEM VI: I direct that my executors or guardian or their successors
shall not be required to give bond for the faithful performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I, GERTRUDE ANNE KUTZ, Testatrix, have hereunto
set my hand and seal this {p ~ day of ,9l17 ' 1985.
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_ i"., ''1lr;;:{.!k {~...(~( SEAL 1
GERTRUDE ANNE KUTZ r. I
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New Cumberland, Pa.
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STONE. SAJER
Be STEWART
Attorneys at Law
414 Bridge Street
17070
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SIGNED, SEALED, PUBLISHED and DECLARED
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by GERTRUDE ANNE KUTZ, the i
and Testament, and in the pre- !
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Testatrix above named, as and for her Last Will
sence of us, who at her request, in her presence and in the presence of each
other, have subscribed our names as witnesses.
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Address -
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attached or foregoing instrument, having been duly qualified according to law I
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i will; that I signed it willingly and that I signed it as my free and voluntary I'
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Ii act for the purposes therein contained.
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COMMONWEALTH OF PENNSYLVANIA:
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:SS:
I, GERTRUDE ANNE KUTZ, the Testatrix whose name is signed to the
do hereby acknowledge that I signed and executed this instrument as my last
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4,~a~
GERTRUDE ANNE KUTZ
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Sworn to or affirmed to and acknowledged before me by GERTRUDE ANNE
KUTZ, the Testatrix, this ~ zx, day of
~~ ' 1985.
~L.L ~ ~~
Notary Publ1(~
fETH ANN HECKMAN, Notary Publ'
New Cumberland, Cumberland Cril
My Commission Expires Feb. Il, 1 'H
Page 3 of 4 pages
STONE. SAJER
& STEWART
Attorneys at Law
414 Bridge Street
New Cumberland, Pa.
17070
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i! COMMONWEALTH OF PENNSYLVANIA
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:SS:
COUNTY OF CUMBERLAND :
we~~
and ~()rn ~S~Il';~
the witnesses whose names are signed to the attached or foregoing instrument, I
being duly qualified according to law, depose and say that we were present and I
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saw Testatrix sign and execute the instrument as her last will; that Testatrix I
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signed willingly and that she executed it as her free and voluntary act for
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the will as witnesses; that to the best of our knowledge, I
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the purposes therein expressed; that each of us in the hearing and sight of
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the Testatrix signed
the Testatrix was at that time eighteen or more years of age, of sound mind
and under no constraint or undue influence.
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Sworn to or affirmed to and acknowledged before me by
t!//ARa-s ,h{ STcf/tl,c and MV/A 1-1.
this ~T.A.. day of ~? ' 1985.
, )/OA//=
, witnesses,
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;a,--Zt, ~~ ~~
Notary Public
['~TH ANN HECKMAN, Notary Public
New Cumberland, Cumberland Co" i'"
My Commission Expires Feo. 8, 1988
Page 4 of 4 pages