HomeMy WebLinkAbout03-01-06
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of HANSEN, JAMES DONALD
also known as
No. ?-OO(o.'oOg3
, Deceased
Social Security No. 391306570
BRUCE JAY HANSEN
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
GJ
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or
Decedent, dated 10/30/1997 and codicil(s) dated
named in the Last Will of the
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 incapacitated:
o
B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I " I
Name Relationship Residence "
...--
#,""".'.-""
. ..
...- ,-'"
. .
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in MechanicsburQ, Cumberland
residence at 814 North Arch Street, MechanicsburQ, PA 19143
(list street, number and municipality)
years of age, died October 26 ,2005, at Pottstown, PA
'--"1
rc....,~:.
County, Pennsylvania, with his/her last family or principal
Decedent, then 70
(Location)
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 ........................................................................................ $
Total ..................................................................................................................... $
/9'-( OIl
i;~y- g~r.~~\)
Real Estate situated as follows:
814 North Arch Street, Mechanicsburg, PA 19143
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:
ure
Typed or printed name and residence
Bruce Ja Hansen 5020 Hazel Avenue Philadel hia PA
RW-7
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, ersonal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate aGcording to I
Sworn to and affirmed and subscribed
before me this
\u.'r
B
day of
( OA-Q d~ M~
- . ~
DECREE OF REGISTER
Estate of HANSEN. JAMES DONALD
also known as
Deceased
2-00 (p .~ 00 8.3
No.
Social Security No: 391306570 Date of Death: 10/26/2005
AND NOW, ~ I 51- :UJDb ,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
are hereby granted to BRUCE JAY HANSEN
(c.t.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoritate)
in the above estate and that the instrument(s), if any, dated October 30, 1997
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters .................................... $
Short Certificate( s) .. J Q......
WI' H
Ronunoiotion ..... .....................
$
$
$
$
$
$
Inventory & Tax Forms............. $
aulo
Other ...................................... $
Affidavit (
) .......................
)..............
Extra Pages (
Codicil.................................
JCP Fee .................................
TOTAL .............................$
RW-7 A
3' 00
lOi
+0,00
J6.00
10,00
5.00
38'0.00
,~ -1aAAUl ~~
fJA ~~fW~./bj . -
Attorney
Attorney: David M. Frees, III
1.0. No: 43962
Address: 120 Gay Street
Phoenixville
PA 19460
Telephone: 6109338069
/; '" I sf 00 J_
DATE FILED: '--Y1IltU~1 J ) 2. (p
HIO'i.XO'i 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.
Fee for this certificate, $6.00
p
.tiLl. ? D,h; q q ur\ 5
- b. '\.)V,&
No.
35.143 Rev. 2/87
~C!~
(", Local Registrar
OCT 2 8 2005
Date
NAME OF DECEDENT (First, Middle, Last)
COMMONWEALTH OF PENNSYLVANIA 0 DEPARTMENT OF HEALTH 0 VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
MOTHER'S NAME (First, Middle, Maiden Sumame)
19. Clara N. Hnilicka
INFORMANTS MAILING ADDRESS (Street, CitylTown, State, Zip Code)
20b.5020 Hazel Avenue Philadel hia PA 19143
PLACE OF DISPOSITION. Name of Cemetery, Crematory LOCATION. CitylTown. State, Zip Code
or Other Place Cremation Society
21c. of PA Cremator 21dKin of Prussia PA 19406
~~4EioOAD;~~~~~~~~R~Mar ~~~ri~Nf ~ ~Ae!710~vs.
LICENSE NUMBER DATE SIGNED
(Month, Day, Year)
23b. yQ.
WAS CASE REFERRED T~ A
26, Yesi
27. PART I: Enter the dlso..es, Injuries or complications which caused tho d.ath. Do nol enler the mod. of dying. such as cardiac or respiralory a..est, shock or heart failur.. : Approximate PAR I: ther nilicant conditions contributing to death, but
lilt only ono caUle on each IIno. . InteNal between not resulting in the underlying cause given in PART I.
: onset and death
Yes 0 No 0
30a. 30b. M. 30c.
PLACE OF INJURY. At home, farm. street, factory. office
building, etc. (Soecify)
30e.
BIRTHPLACE (City and
State or Foreign Country)
. 8b. Be.
DECEDENTS USUAL OCCUPATION KIND OF BUSINESS /INDUSTRY
(~~v:O~~i~:~J:~~o d~~eu~~ri~~:gt
- 11a. St. Ma' or 11b. US Arm
DECEDENTS MAILING ADDRESS (Slreet. CitylTown, State, Zip Code) DECEDENT'S
814 North Arch Street ~~~~~NCE
(See instructions
16. Mechanicsburg, PA 19143 on other side)
FATHER'S NAME (First, Middle, Last)
1L ve H. Hansen
INFORMANTS NAME (Type/Print)
20a.
PA
17a. State
Did
decedent
live in a
township?
17b. Countv Cumberland
L
24.
Ene!
Sequentially list conditions
if any. leading to immediate
cause. Enter UNDERLYING
CAUSE (Disease or injury
. that initiated events
resulting on death) LAST
[ ::
d.
DUE TO (OR AS A CONSEQUENCE OF):
DUE TO (OR AS A CONSEQUENCE OF)'
WERE AUTOPSY FINDINGS MANNER OF DEATH
AVAILABLE PRIOR TO ~., 0
COMPLETION OF CAUSE Natural Homicide
OF DEATH? 0 0
Accident Pending Investigation
Yes 0 N~ Suicide 0 Could not be determined 0
DATE OF INJURY
(Month, Day. Year)
28a. 28b.
CERTIFIER (Check only one)
"~~~~F:~~tGor~~11~~~3g';r,s~~~t\,cg~~~i~~J':K~: teg g,e:~a~~~~(:r~~j'J~X~i~~a~s h:t~f:~~~~~~~.~. ~~~:~. .~~~ .~~.r:'.~~:::.~ .i.t~~ ?~).... . . ,... .. ... , ,.
29.
.P.fo~~~~~~I~:"m~Nk~;';I~J~r:;I~e~~H~~~~~:~ ~~~~:i~!~"e~~~t~.'~~~u~F~~~,d:~~h d~n: t~e~~i~~ut~e~(~)~~~ ~:~~er as stated...................... 0
"MEDICAL EXAMINER/CORONER
~:~~:~::I:~:e~~~~I.~~.~I~~. ~~.~~~.~ ~~~~~~~~.~~~~~: .l~. ~~. .~~i.~~~.~: .~~~~~ .~~~~~~~.~. ~~. ~~~. ~i.~~:. ~.~~~:. ~.~~ .~~~.~~'. ~~.~ .~~~. ~~ .t.~~ .~~~~.~~.(.~~ ,~~~.. 0
31a.
REGISTRAR'S SIGNATURE AND NUMBER
vt'~ ~~~~_~(;ff301
MARITAL STATUS - Married.
Never Married, Widowed,
. Divorced (Specify)
14. Widower
~~:ify) 0
RACE. American Indian, Black. White, et .
(Specify)
White
SURVIVING SPOUSE
(If wife. give maiden name)
17e. 0 Yes, decedent lived in
twp.
17d.1XI ~~hj~e;~~~~\i~i~~ of
Mechanincsbure:
citylboro.
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
~\-
34.
OCT 2 8 2005
f
JAMES D. HANSEN
I, JAMES D. HANSEN of the BOROUGH of MECHANICSBURG,
COUNTY of CUMBERLAND, COMMONWEALTH of PENNSYLVANIA,
being in good bodily health and of sound and disposing mind and memory, and not
acting under duress, menace, fraud, or undue influence of any person whomsoever,
merely calling to mind the frailty of human life, and being desirous of disposing my
worldly goods while I have the strength and capacity so to do, I do make, publish
and declare this my LAST WILL AND TESTAMENT. I hereby revoke, cancel
and annul all my former Wills and Testaments, including codicils thereto, by me at
any time made, and declare this alone to be my LAST WILL AND TESTAMENT.
AS TO SUCH ESTATE AS IT HAS PLEASED GOD TO ENTRUST ME
WITH IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS,
VIZ:
ITEM 1. I direct that my Executors hereinafter named, pay and discharge all of
my just debts, funeral and testamentary expenses.
ITEM 2. I order and direct that my bodily remains be cremated. Further, I
order that my remains be placed for permanent burial at the Fort Indiantown Gap
Military Cemetery.
ITEM 3. All the rest, residue and remainder of my entire estate, wheresoever
situate, and whatsoever it may consist of, I give, devise, and bequeath, absolutely,
and in fee, to my dearly beloved wife, ARLIS Y. HANSEN. In the event my
dearly beloved wife dies with me in a simultaneous disaster, or fails to survive my
death by thirty (30) days, then I give, devise, and bequeath my entire estate,
wheresoever situate, and whatsoever it may consist of, to BRUCE J. HANSEN,
provided BRUCE J. HANSEN survives by thirty (30) days. In the event that
BRUCE J. HANSEN does not survive my death by thirty (30) days, then I give,
devise, and bequeath my entire estate, wheresoever situate, and whatsoever it may
consist of, to ALFRED T. DENNY, per stirpes.
~'lJ,tI~
JAMES D. HANSEN
, "
Page 1 of 3
ITEM 5. I nominate and appoint ARLIS Y. HANSEN as Executrix of this
my LAST WILL and TESTAMENT. Should the Executrix named fail to qualify
or cease to act as Executrix then I appoint BRUCE J. HANSEN as Executor in her
stead. In the event that BRUCE J. HANSEN, cannot serve, then I nominate and
appoint ALFRED T. DENNY, in his stead.
ITEM 6. I hereby direct that all my personal representatives, as well as their
successors, shall not be required to give bond for the faithful performance of their
duties in any jurisdiction.
ITEM 7. I order and direct that my Personal Representative(s) named herein
use the legal services of JAMES M. BACH, as Attorney for my Estate.
ITEM 8. I direct that all estate, succession, legacy, inheritance or other transfer
taxes, however designated that shall become payable by reason of my death in
respect of all property comprising my gross estate for tax purposes, whether or not
such property passes under this LAST WILL, shall be paid by my Executrix out of
my residuary estate.
ITEM 9. I grant to my personal representatives herein named, in addition to,
but not in limitation of those powers vested by law, to be exercised without prior
application to or approval of any court, the power and authority to retain
indefinitely any property, to invest and reinvest any assets or the proceeds derived
from the sale of assets, although said investments may not be of the. character
prescribed by law, to sell, convey, assign, transfer and encumber any property, to
pay, settle or compromise all claims, to make distribution or divisions in cash or in
kind, and in general to exercise all powers in the management of any property
hereunder which any individual could exercise in the management of similar
property owned in his own right, and to execute and deliver any and all instruments
and to do all acts which may be deemed necessary and proper.
i:-'~ lJ.f) ~
. / JAMES D. HANSEN
WITNESS~ JJ ~SL
1\ M. W ADGE
====================END====================
Page 2 of 3
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
) ss
COUNTY OF CUMBERLAND )
I, JAMES D. HANSEN, the TESTATOR, wh?~e 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;
that I signed it willingly; and that I signed it as my free and voluntary act for the
purpose therein expressed.
Sworn to or affirmed and acknowledged before me, by: JAMES D. HANSEN, the
TESTATOR this 30TH day of October ,1997.
8~H~~t1~
NOT AAfAL SEAL
ATTORNEY JAMES M. BACH. NotaryPubnc
Cumberland County
My Commission Expires May 13, 1999
J S M. BACH, ESQUIRE
NOTARY PUBLIC
Mechanicsburg, PA 17055
My Commission Expires: 05/13/99
AFFIDA VIT
COMMONWEALTH OF PENNSYLVANIA )
) ss
COUNTY OF CUMBERLAND )
We, JOHN NUGENT and LISA WADGE, the witnesses whose names
are signed to the attached or foregoing instrument, being duly qualified according to
law, do depose and say that we were present and saw TESTATOR sign and execute
the instrument as his LAST WILL; that the TESTATOR signed willingly and that
he executed it as his free and voluntary act for the purpose therein expressed; that
each witness in the hearing and sight of the TESTATOR signed the WILL as
witnesses; and that, to the best of our knowledge, the TESTATOR was, at the time,
18 or more years of age, of sound mind and under no constraint or undue influence.
Sworn to or affirmed and acknowledged before me, by: JOHN NUGENT and
::~~ da::~:::ber , ,;" Jt,
o ~ NT LISA W ADGE
111.
ES M. BACH, ESQUIRE
NOTARY PUBLIC
Mechanicsburg, PA 17055
My Commission Expires: 05/13/99
Page 3 of 3