HomeMy WebLinkAbout04-11-06
PETITION FOR PROBATE and GRANT OF LETTERS
J \- 0 (g- D:~~
Jeannette I. Hertzler
Estate of
also known as
No.
To:
Register of Wills for the
, Deceased. County of Cumberland in the
Social Security No. 168 - 2 6 - 2 7 3 0 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executr i x
in the last will of the above decedent, dated November 4. 2003
and codicil(s) dated None
named
~)J:9_
(state relevant circumstances, e.g. renunciation, death of executor, etc:.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h er _ last family or principal residence at 492 Glenn Street, Borough of
Mechanicsbura
(list street, number and muncipality)
Decendent, then 74 years of age, died March 30,. 2006 , ~~ ,
at Holv Spirit Hospital, East Pennsboro Townshlp, Cumberland C9unt, PA.
Except as follows, decedent did not marry, was not divorced and did not hav(: a child born or adopted
after execution of the wiltQffered for probate; was not the victim of a killing and was never adjudicated
incompetent: Non.e
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ 211, 200. 00
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ 48,680 . 00*
situated as follows: Borouqh of Mechanicsburq, Cumberland County, PA.
*Va11]e based on Cumberland County Real Estate Tax Assessment.
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters te stamen tarv
theron.
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
'"
<r
u
c
OJ
~3
'" ....
0::'"
c
-00
c';:
~'':::
--OJ
~c..
'" '-
:; 0
~
c
OJ)
Vi
f(~p~:. r.~~
4 Conway Drive
'Mpr'hrln;r~hl1rg. P7\ 1701:)1:)
"}
-
. :::;:<
OA TH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ') ss
COUNTY OF CTIMRF.PT.7\ND j
N
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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
{ 7{~p~ T~ f
~
B:
Sworn to or affirmed and subscribed
before me this II day of
jj{,o~i,-% ~ ~O(~f~,:f;~
I~Q {(u teet { )1' ~Re 0~
__ ' P J
No.
~
Estate of
JEANNETTE I. HERTZLER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW llpri 1 / l 010;2006, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated November 4, 2003
described therein be admitted to probate and filed of record as the last will of
Jeannette I. Hertzler
and Letters Tp~+-~mFmtary
are hereby granted to
Rose M. Levosky
.-4/~"" #I~=:A-~ /lL~~~ c
42vt {~(:r:c~~ /1' l}1!.f{~:Aj.9
SNiLBA ~eg~ T' AN, p( c.
Probate, Letters, Et:~~~. . . . ., $ 3 ( 0
$ /J 0
Short Certificates(5) . . . . . . . . . . ;t::::.
R~lluu~jOl iJ .~\11 ~:0 'DJ' .. ~ ~ 2
II TOTAL - sz,& r)
Filed .~. H O.~.........................
By
44 'West-\1Mgl1rjfY~~&i.D. No.)
Mechanicsburg, PA 17055
ADDRESS
(717) f1q7-Rl1?R
PHONE
1(1'\;0;11" RE\' 1/f).'\
This is to certify that the information here given is correctly copied from an original certificate of death du}y 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
D
I
12338347
No.
~J4~.tL
Local Registrar
(~rj". [ 3 I 'dJ3G0
Date
1"""
H1Q5 143 Hev Ol,uo
TYPEJPRIHT IN
PERIIANENT
BLACK INK
1-- Name of Decedenl (FilS!. middle.lasl)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATEFILE NUMBER
~,lf;;eh"Y3'~ 200
5 ~ (Lasl blrlhday)
74
y"
EibCountYoTD~Ih----
Cumberland
East Pennsboro
I. _~~..____.___
i, J~_ DecedenL~_~~ Oce allOll Km(j 01 work done dUflll mosl 01 ~ hie, do 001 slate lehred) __ 12
. Boo k k '\("e' eOp e r T d'ts BpSOSY:'tug~t ion
16. Decedent's Ma~lfloJ Addc'ess (Sireel.e'~liown~ stale, Z4> code)
492 Glenn Street
Mechanicsburg PA,
18 Fathe"s Name (FIlS!, nlddle.laSl)
DYes
Decedenl's
klualResidefICl!
17'd.. Slale
PA
Cumberland
17055
17b County
19. Mother's Name (First, middle, maiden slHname)
17" l(l ~;~~::~''''.'hill .~C h~n~<:_~~~u!:.~G"'\loIO
William E. Hertzler
OIher
lierlt 0 DCA 0 NUlS Home 0 Rnidence 0 Other c
9 Was Decedent 01 HispanM: Origil? 10. Rac,' Ame,ican Indian. Black, Whte. ek:
I)( No 0 Yes(" ,es, _ity Cuban . (Sj>oeil)j
MeKlCin, Puel10 RICan, ek;.)
Did Decedent
llvema
Tatvnship?
17c 0
Yes Decedemlrved II
T..
Emma Mae Wagoner
20b Informanl's MailUlg Address (Slreet. clyl1own, stale, z~, code)
2Oa.lnlormanrsName(Jypel~
o
w
U)
=>
U)
<t:.
~
Rose Levosky
211 MelhodofDisposlt1Oll
)6 8tJflil 0 Cremallon
o
21b Dale 01 DispqsllioniMoolll, day, year)
4-4-20u6
4 Conway Drive Mechanicsbur PA 17055
21c. Place 01 Disposition (Name 01 cemetery, cremalOly Of ctlher place) 21d. location (C4y""Wll, stall, zipc:ode)
Mechanicsburg Cemetery Mechanicsburg PA 17055
32. ';;';~lln~'y (Month, ,.y~~~=t D.;';,~ t;;;;;;JUf\'o;;,u~
32d Time 01 Injury 32e. lOlLII)' al Work? 321. 1/ T.ansportallon InjUry ,~;pea,>>
DYes 0 No 0 Dlivef~rato' C Pas$enge'
o Pooasllian 0 Oth8I' - SpeClfy__
330 Signalwe and Title 01 Ce.rtifi8l"-
I: / jt--- niP.
331;: l~~f1r-----_.'-~
22b. license NurTtler
\Jr!.
~)
. =p;:~~n::~,~,~un~~''''b,pe'wn 2</7~lq~o ~-t 7:r;;~"h~th"3":;~ ;2 OO~,
CAUSE OF DEATH lSee klslrucllons.and eump6es) , -~-:~rolCimale interval
hem27 Part r Enler thi ~ - dlSeases, inJ.lnes 01 cor~ltcall(mS -that dir9ClIy r.'d.~tld lhe dttalh 00 NOT enlellerminalevllnls such as caldiac all6sl, : onset to d6alh
rupiraloiy all6st, Of venlretHar fibrillatIOn without shuwllg Ihe etiology DO NOT abuleviale Enter only OClecaUS8 on a line
=~~;~:~~~S:~:~~dL5QG~ a ~._._ A .~.~~_f_~.~ _~.H_+~.J~..C1 ,~~(~___ ~_~ \I' k a~" r-
Oue t-i~/~s a consequence o~ ...f
ill
, I.
~
- ~,
...:c
<.)
'f.)
')-,
~)
c..:
c
dl
\ \);
I. )
>-
Z
UJ
o
W
~
o
U
o
w
::i:
<t:.
z
$equenllalty lasl conditions, It any
IeaOlf"lg to lhd cause IIslod un I ine a
- Elilel the UHOERl YING CAUSE
. (dl.S~eOlinfurylhatlllitldledIllEl
events resullng in death) LAST
Due It) {Of as a consequence on
Due 10 tOl as a consequence on
..__________ _ d
30a Was an Aulopsy JOb Wile Autopsy FindinQs
Perto/Jrlild' Avalli:lble PflOllo Coff1)letlOn
01 Cau~e 01 Dttdlh1
31 MannerolD6alh
)( Natural 0 Honliclda
o Awdunl 0 Pending Invesligation
o Suicide 0 Could Nol Be D6t6rmmitd
o Yes ~ No
DYes 0 No
33a Certlhe. (check onty one)
Certifying physk;i;ln (PhYSICIdIl cer1Jtyil1g cause ofdealh when another phYSICian has PIOOOUnced dealh and CO~1611ld Ittlm 23)
To the best 01 my knovdedge, death occurred due 10 the cause(sj and manner as 'liled ,,.
Pronouncing and certifying physki.an (PhYS,lCliln wlh proliouocmg death and ceni4'lll'J 10 cause 01 death)
To the besot of my knowledge. dealh occlIrred at the lime, l'Ialt, and plict, and due 10 the UlISe(S) and manne, as stated..
Mt.-dil:al eumine,/coronef
On the basis 01 eUnWtion andl nvestigOltion, In my opinion, death occurret' at the time, dale, OInd place, 0100 due 10 the caose(51 and maone, as slaled.. .....0
3~llJt~~'~~~_~_~_~ ~.~~=--=~~-~~~g-;!~';:r~:2~~lo
(See instructions and examples on reverse)
o Yes A. No
Parlll: EnlSI other allilicanl cOIJditi:ms conlrDulina 10 death,
but nol 18suling irllh8 underlying cause gNIR in Pin I.
28 Did ToOacco Uae Conll'Welo Death?
o Yes 0 Pr~
P(NO 0 Unknown
29 If Femakl
/:. Noli p18gnan1 wth~ pas! ~aar
o Pregnant illlml of dUlh
o Not j)fugnant.lKA p1egnanl wrnin 42 days
ofdealh
o Not preonant but plegnanl -43 days 10 1 year
balore dealh
o UnkllOWfl iI plegnanl wtIlin thi past year
32c. Piaceoti\jufy: HomI, Farm. Skeet, Fac\Ofy.Ot6ce
BuiIOIlg,II<(SpeciI>>
.2fVl
32g location (Skeel. dy~wn. stale)
Jot
33d Dala Signed (Moolh. day. yeal)
ijlll)"!.
.0
(100101,0,-1-
~Name and Addre5s ~;s;;nvihO.CO~"ledCause 01 Dealh (116m 27) lype/PJinl
L-.- n." L ,,", I r-1. \,;;>,
J'b; 1 "t,l, 11'f5 L'7:....0i"<c.l PIt170+=~___.
-- -~I
~ I- O&'"b3?:?-
LAW OFFICES
SNELBAKER.
BRENNEMAN
& SPARE
..
LAST WILL AND TESTAMENT
I, JEANNETTE 1. HERTZLER, of the Borough of Mechanicsburg, County of
Cumberland, and Commonwealth of Pennsylvania, being of sound ;md disposing mind, memory
and understanding, do make, publish and declare this as and for my Last Will and Testament,
hereby revoking and making void all former wills and codicils by me at anytime heretofore
made.
FIRST. I order and direct that all my just debts and funeral expenses be paid by my
Executrix or Executor, as the case may be, hereinafter named, as soon as conveniently may be
done after my decease.
SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate,
real personal and mixed, whatsoever and wheresoever situated unto my friend, namely, ROSE
M. LEVOSKY, absolutely and in fee simple if she survives me.
If the said ROSE M. LEVOSKY should predecease me, then and in that event, I give
devise and bequeath my said residuary estate unto her husband, namely, BERYL LEVOSKY,
absolutely and in fee simple, ifhe survives me.
If both of the above-named persons shall predecease me, then and in that ultimate
event, I give, devise and bequeath my said residuary estate unto the issue of ROSE M.
LEVOSKY and BERYL LEVOSKY, per stirpes, by representation and not per capita.
LASTLY. I nominate, constitute and appoint my friend, ROSE M. LEVOSKY, to be the
Executrix of this, my Last Will and Testament, but if for any reason she should fail to qualify as
such Executrix or cease so to serve, then and in that event, I nominate, constitute and appoint her
husband, namely, BERYL LEVOSKY, to be the Executor hereof, In the event that both ofthe
above-named persons should fail to qualify as my personal representative hereunder or cease so
to serve, then and in that ultimate event, I nominate, constitute and appoint THOMAS
LEVOSKY and PATTI BETHEL (two of the children of Rose and Beryl Levosky) to be ~
Executors hereof.
=--'
I order and direct that none of the above-named persons shall be required to post b&nd or
other security as a condition of qualification hereunder.
: l
CJ
c::2. (-{) t -{):5-;} ;L
...
IN WITNESS WHEREOF, I, JEANNETTE I. HERTZLER, have hereunto set my hand
and seal to this my Last Will and Testament, which consists of two (2)) typewritten pages to
each of which I have affixed my signature this 4th day November, A.D., Two Thousand Three
(2003).
QDA ~ ~ llA-I::-tJ.. - (SEAL)
tf'- JEANNE{;;i~t.ER
The preceding instrument, consisting of this and one (1) other typewritten page, each
identified by the signature of the Testatrix, was on the date thereof signed, sealed, published and
declared by JEANNETTE I. HERTZLER, the Testatrix therein named, as and for her Last Will
and Testament, in the presence of us, who, at her re s in her presence and in the presence of
each other, have subscribed our names as witnesse e
!{
t~7
I
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND
)
We, JEANNETTE I. HERTZLER, RICHARD C. SNELBAKER and JANE J. COONEY,
the Testatrix and the witnesses, respectively, whose names are signed to the attached or
foregoing 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 had
signed willingly, and that she executed it 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 a witness and that to the best of his or her knowledge, the Testatrix was at that time
eighteen years of age or older, of sound mind and under no constraint or undue influence.
-~.k--
Witness
LAW OFFICES
SNELBAKER.
BRENNEMAN
& SPARE
f- &e~)
Subscribed, sworn to and acknowledged before me by JEANNETTE I. HERTZLER, the
Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANE J.
COONEY, the witnesses, this 4th day of November, 2003.
r ~^..,."r-.,"':,'" :"""~"'~""~~l
"'--'~... .~....... --.,....,......,.,.,-..~-
. .
Nol8rta1 Seal
~~ Showers, Notary P\dc
AJi.";~~'V Boro, Cumberland County
'~'Y VVllIlJrlSSlon Expires Nov. 22.2002, !