HomeMy WebLinkAbout03-30-06
CL4.'Yl\ b fR.L,9.~9
Register of Wills of.J;lI~lIl><lin County I Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
lk /.. tV IJJ ,
,--
I /,({k1 N'~ {L
No.
also known as
I Deceased
Social Security No. ";( ,..'{ Cl 3 <:::L. , <(
Pelitiooe'(M). who is/a,e 18 years of age or older, apply(iesl for:
(COMPLETE" A" OR "B" BELOW:)
~
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executo "r
Decedent, dated n~ <.. ~4) \ e; t'.\ 7 and codicil(s) dated
named in the Last Will of the
State relevant circumstances, e.o., 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:
~
B. Grant of Letters of Administration
(c.t.... <I.b.n.c.l.a.: pendente lile; duranle ebsenlia; du,ante minoriulle)
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:
Name
Relationship
Residence
Decedent was domiciled at death in
residence at ) 08 5(N 4 t~ A~
c. ~ v-h ~....I~" cA County r Pennsylvania, with his/her last family or principal
~.", gc~ Ct;fy1t JI' (hll tJ" 17o.l{
,
(list streel. numbe, elld municipalityl
Decedent, then ~ r- years of age, died
2/1'1
, 20 ~, at ,) 141"'1 'S~'" or") ~/"" I A t..
localion)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property .............................. $ ~ 0 uj U 0 d-
(If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . $
(If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of real estate in Pennsylvania ...............................,............... $
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Real Estate situated 8S followD:
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:
RW-7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Dauphin
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 and that, as anal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the state a rdi g to
Sworn to and affirmed and subscribed
,
before me this , 7 f ~ day of
1~~~
DECREE OF REGISTER
Estate of 1-1 el en
M. 'TrcDfln ler
I
also known as
. Deceased
2oo/..p - 0 2 ~5
No.
Social Security No: 2-0t../ - 03 - (P Zft:;,-/- Date of Death: F cb /4-, 2 00 (P
AND NOW, March BotYl , 20 ~ , in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters oa-r-estamentary 0 of Administration
are hereby granted to Ronald 1-, Jrepa/)Ier
(c.I.a.. d.b.n.c.t.; pendente lite; durame absentia; durante minorllate)
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of rQecedent.
~:)-- -
--'.') .
FEES
Letters.......................... .
Short Certificate(s)..........
Renunciation................. .
Affidavit ( ).................
Extra Pages ( )............
Cod i c i I. . . . . . . . . . . . . . . . . . . . . . . . . .
JCP Fee........................
Inventory & Tax Forms...
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . .
TOTAL............... .
RW-7a
$ _\~.()O
$ aD~
$
$
$
$
$ \5 OD
$
$ ()~,CO
~tt1NUA~~ ...
~~.'Of Wills....,
drl ....
f' .":
ca
Attorney: l{ll>J{~V\L~ )...(~~Y\
1.0. No: \\)\.()'7- ~-
Address: \ ~O\ ~,RC)"-\' ~\ .
tt.Q... "\ V' \...\. Iou f ~ i t\ \I \ (Ye
Telephone: '( \, 'L- ~\...\ ~ ~
DATE FILED:
$ .~\() cD
1I1l1".S(l~ RrV I/()~
Thi s 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.
t2wn, /J( ~r--
Fee for this certificate, $6.00
Local Registrar
p
12225953
FEB 1 6 2006
Date
I Rev. 01106
PRINT IN
IANENT
CKINK
1. Name of Decedent (First, middle, last)
Helen M. Trepanier
5. Ai;)e (Last birthday)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
85
Yrs.
7. Dale of Birth Month, da , ear
3. Social Security Nurmer
204 _ 03
()t16
8. Birth IaGe Cit and state or foreion COUll
ad. Facil~y Name (if nol instnution, give street a~d nurmer)
Other:
o ERIOutoatienl 0 DOA 0 Nursin Home 0 Residence 0 Other - S
9. Was Decedent ot Hispanc Origin? 10. Race: Amercan Indian, Black. Whne, etc.
~ No 0 Yes (If yes. specify Cuban, (Specify)
Mexican, Puerto Rica~, etc.) Wh i t e
Dauphin
Harrisburg
Harrisburg Hospital
12. Was Decedent ever in the US
Armed Forces?
Xl Yes 0 No
Decedent's
Actual Residence 17a. State
13. Decedent's Educatior, S eci on hi hest rade co Ieted
Elemenlary/Secoooary (0-12) College (1-4 or 5+)
12
PA
14. Marnal Status: Married. Never married,
Widowed, Divorced (Specify)
15. Surviving Spouse (ttwite, give maiden name)
11. Decedent's Usual Occ ation Kind of work done durin most 01 workin lite; do not stale retired
Kind 01 Work Kind 01 Business/1ndustry
Homemaker Home
16. Decedent's Ma~ing Address (Street, citynown, state, zip code)
208 Senate Avenue, Apt.804
Camp Hill, PA 17011
17b. County
Cumberland
Did Decedenl
Live in a
Township?
17c. 0 Yes, Decedent Lived in
Twp.
17d. 5{ ~;u~~~~~iived wnhin
Camp Hill
CitylBoro
18. Father's Name (Firs!. middle, last)
Frank J. Freistak
19. Mother's Name (First. middle, maiden surname)
Frances V. Jacobs
lOa. Informant's Name (Type/print)
Ronald L. Trepanier
20b. Informant's MaiUng Address (Street. citynown, state. zip code)
1300 Doral Road, San Angelo, Texas 76904
21a Method of Disposnion
R Burial 0 Cremation 0 Removal from State
OS; :
22a. S~ t::::?~(orp~g,
te Items 23a-<: only when certifying
ph ian is not available at time of death to
~ certify cause ot death.
21~. Date of Disposnion (Month, day, year)
ZlC. Place of Disposnion (Name ot cemetery, crematory 01 other place)
21d. Location (CityAown, state, zip code)
o Donation
ebruary17,2006
-FUC'!nS8 NtllTober
~ 0'12342-L
edge, death occurred ~t the lime, date and place stated (Signatu~e and tnle)
Holy Cross Catholic Cerneter
22c. ~ame and Address 01 Faciflty
Harrisburg, PA 17111
24.
Stone&MurrayFH408 3rd St New Cumberland, PA 17070
23b. Lit:ense Nurmer
23c. Date S~ned (Month, day. year)
26. Was Cas9 Relcrred to a Medical ExamiMr/Coroner?
CAUSE OF DEATH (See tl1$tructlol1$ and examples)
Item 27. Part I: Enlar the chain of events - diseases, injuries, or co~lications - that directly caused the death. DO NOT e~te' terminal events sur.h a cardiac arresl,
respiratory arrest, or ventrICular fibrillatIOn without shoWIng the ellOlogy DO NOT abbreViate Enter cnfy oie use fk ~
IMMEDIATE CAUSE (Final dISease or -;- A ~ .L, /l /J /J fleA I? tl 'tf!./:7J(},.e IC v? e.
cond~lOn resuhlng In death) -7 a ~~ C-L ___
Due to (or as a consequence on
Sequenhally list cond~lOns, II any.
. leading to the cause Iisled on Line a.
- Enter the UNDERLYING CAUSE
. (disease or injury that inniated the
events resulting in death) LAST.
~ //f ~ cJtJ&
I : Approximale interval:
: onsello death
o Yes
No
Part II: Enter other sianiticant c()nd~ions conlnbutino to death
but not resuhin~ in the underfying calL'~ given in Part I
I 28. Did Tobacco Use Contribute to Death?
DYes 0 Probably
]I( No 0 Unknown
29. " Female:
'a( Not pregnant wnhin past year
o Pregnant at time 01 death
o Not pregnant, but pregnant within 42 days
01 death
o Not pregnant, but pregnant 43 days to 1 year
before dealh
o Unknown" pregnant within the past year
32c. Place ot Injury: Home. Farm. Street, Factory, OIfice
Building. etc. (Specify)
Due to (or as a consequence on:
Due to (or as a consequence on.
o Yes ~ No
d
3Ob. Were Autopsy Findings
Available Prior to Completion
of Cause 01 Death?
DYes 0 No
31 . Manner of Death
32a. Dale of Injury (Monlh, dey, year)
32b. Describe how Injury OccUlTed:
3Oa. Was an Autopsy
Performed?
P Natural
o Accident
o Suicide
o Homicide
o Pending Investigation
o Could Not Be Delermined
32d. Time of Injury
32e. Injury at Work?
DYes 0 No
321. If Transportalion Injury (Specify)
o Driver/Operator 0 Passenger
o Pedestrian 0 Other - Specify:
Jab. Signal.:u1 a~ Hie 01 Certifier
j i'YlD
33c. License Nurmer
32g. Location (Street, cilynown, state)
M.
338. Certl1ler (check only one)
. ~:~~~:sror~~~~:nd:~~fy:~= ;~~~I~~n=~~~r~h:,~~::: ~~=~~.~~.:~,.~~..~~~~~~.~~~.~~!...m......m..................,....................................1
Pronouncing and certifying physician (Physician bolh pronouncing death and certifying 10 cause of death)
To the best 01 my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner as stated..............................................................._..._._.O
Medical examlner/coroMr
On the basis of examination and/or Investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manMr as stated .........0
trar's SignaIUr8t~ist~9'NUmbe. r
/;( ~0~../~'".t
lo2.l/l~l/v
..
LAST WILL AND TESTAMENT
OF
HELEN M. TREPANIER
I, HELEN M. TREPANIER, now domiciled in Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
including any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement from any
person. This provision is not a waiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of any property over which I have the power
of appointment.
~
L~ ~ .--.i
~//r1.!f:
...
Article III
I give, devise and bequeath in accordance with any memorandum which I have either
handwritten or signed, located with my will or with my valuable papers and found within 30 days of
the probate of my will. Gifts may only be to persons who survive me or to organizations which exist
at my death, and if there is a conflict, the memorandum having the latest date shall govern.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath according to the following schedule:
Sixteen and two-thirds (16 2/3) percent of the value of my estate to my brother, RICHARD
FREISTAK, of Cumberland County, Pennsylvania. In the event that RICHARD FREISTAK
predeceases me or fails to survive me by thirty (30) days, I give, devise, and bequeath his share of
my estate to ST. TERESA'S CATHOLIC CHURCH, of Cumberland County, Pennsylvania.
Sixteen and two-thirds (16 2/3) percent of the value of my estate to my sister-in-law,
VIRGINIA FREISTAK of Cumberland County, Pennsylvania. In the event that VIRGINIA
FREIST AK predeceases me or fails to survive me by thirty (30) days, I give, devise, and bequeath
her share of my estate to DANIEL C. FREIST AK ofY ork County, Pennsylvania, PER STIRPES.
Thirty-three and one-third (33 1/3) percent of the total value of my estate to my brother,
FRANK FREISTAK of Cumberland County, Pennsylvania. In the event that FRANK
FREIST AK predeceases me or fails to survive me by thirty (30) days, I give, devise, and bequeath
his share of my estate to DANIEL C. FREIST AK. ofY ork County, Pennsylvania, PER STIRPES.
cjj /)11- r
Thirty-three and one-third (33 1/3) percent of the value of my estate to my son, RONALD
TREPANIER of San Angelo, Texas. In the event that RONALD TREPANIER predeceases me or
fails to survive me by thirty (30) days, I give, devise, and bequeath his share of my estate to his
surviving issue, PER STIRPES.
If RONALD TREPANIER leaves no surviving issue, I give, devise and bequeath his share
IN EQUAL SHARES to my two brothers, FRANK FREIST AK and RICHARD FREIST AK, PER
STIRPES.
Article V
I nominate, constitute, and appoint my son, RONALD TREPANIER, of Cumberland
County, Pennsylvania as Executor of my Last Will and Testament. In the event of the renunciation,
death, or inability to act, for any reason whatsoever of my Executor, I nominate, constitute and
appoint PATTI BYRA FREIST AK as successor Executrix of my Last Will and Testament. I direct
that my Executor or successor Executrix be permitted to serve without bond and in addition to those
powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares
and to file any qualified disclaimer I could have filed if living. My Executor or successor Executrix
shall receive reasonable compensation for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Executor and successor Executrix,
in hislher absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate or
personal property except that which I specifically bequeath herein,
- 3 -
h
j-t, 7h. ~.
....
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such return
prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death, and
G) to receive reasonable compensation in accordance with their standard schedule of fees in
effect while their services are performed.
-4-
cj/~fJ
'.
e.
IN WITNESS WHEREOF, I, HELEN M. TREPANIER, hereby set my hand to this my
Last Will and Testament, on ~M dO 1999, at Harrisburg, Pennsylvania.
t1/) ,
?Ld.... ?no ~~
HELEN M. TRE ANIER
In our presence, the above-named HELEN M. TREPANIER signed this and declared this to
be her Last Will and Testament and now at her request, in her presence, and in the presence of each
other, we sign as witnesses.
Name
~AMULtJl. ~lkmd
'f~~) w. lk~i>a/ll.aA{~
Address
~'6 ~ \V\IDl\D.~ Li~ 17/0 ~
~'I5 .$i1 Lhom~ ('~ 7/~) fJ/J /?LOi
- 5 -
I, HELEN M. TREPANIER, Testatrix, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my Will,
and that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
DEAN M. TREPANIER, the Testatrix
on ~ Ol6 1999.
cf!l~({;ifo-
. ... (/jI ,
%~~~, ~"~/'] J
HELEN M. T ANIER
Notarial Seal
Marielle F. Hazen, Notary Publir
Lower Paxton Twp.. Dauphin COL.
My Commission Expires Sept. 23, ~
Notarial Seal
Marielle F. Hazen, Notary Public
Lower Paxton Twp., Dauphin County
My Commission Expires Sept. 23, 2002
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
by e.S5:'. I
and J{risJ;() W~ '
witnesses, on . c:2v
, 1999.
,
.)
(~J-'~
N tary Public
Notarial Seal
Mariena F. Hazen, Notary Public
Lower Paxton Twp., Dauphin County
My Commission Expires Sept. 23, 2002
- 6-
~ &: ~, !!M.
COUNSELORS AT LAW
1101 NORTH FRONT STREET
HARRISBURG, PENNSYLVANIA 17102-3324
Sanford A. Krevsky
Lawrence J. Rosen
Kenneth F. Lewis, Of Counsel
Tel. (717) 234-4583
Fax (717) 234-3650
March 10, 2006
REGISTER OF WILLS
CUMBERLAND COUNTY COURTHOUSE
ONE COURTHOUSE SQUARE
CARLISLE, P A 17013
Re: Estate of Helen M. Trepanier
To Whom It May Concern:
Enclosed please find an original and two (2) copies of the Petition for Grant of
Letters and Estate Information Sheet for filing at your office. Additionally, enclosed
please find the Original Death Certificate and Last Will and Testament of Helen M.
Trepanier.
Please return copies of the documents with the Short Certificates in the self-
addressed stamped envelope.
If you have any questions or require anything further, please contact my office. I
look forward to hearing from you; until then, I am
Very truly yours,
~\c~ {Y\. ~b-JLY loJL
Jos~~. Goldberger
JMG:alr
Enclosure
8+1 :~: I
~ &:~, ~
COUNSELORS AT LAW
1101 NORTH FRONT STREET
HARRISBURG, PENNSYLVANIA 17102-3324
Sanford A. Krevsky
Lawrence J. Rosen
Kenneth F. Lewis, Of Counsel
Tel. (717) 234-4583
Fax (717) 234-3650
March 21, 2006
ClJMBERLAND COUNTY REGISTER OF WILLS
C/O MELISSA
ONE COURTHOUSE SQUARE
CARLISLE, P.I\ 1. 7013-3387
RE: Helen Trepenier, Deceased
Dear Melissa:
Enclosed please find the check in the amount of $260.00 for probate fee for the
Helen Trepenier estate. Please accept my apologies not having it enclosed with the
documents.
Thank you for your assistance in this matter. Please call my office with any
questions or concerns.
V er y. t.r.u.. 1 y. yours.,. . . \. \S. '..' 1.. \ ^.... "....."...... f~"'. ". )
. 'I ~ ~~ txJL' 9J)J:\
y\J>\\L\.ll fl". /-. V J
\_/
Joshua M. Goldberger
JMG;srg
Enclosure