HomeMy WebLinkAbout11-28-06
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of MARIE R. FONTENOY
also known as
File Number
d'
D l.o \ ()'t'S'
, Deceased
Social Security Number 194-14-7665
BARBARA A. POOLE (formerly, Barbara Breon)
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
IZI A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the contingent Executrix named in the
last Will of the Decedent dated November 13,1978 and codicil(s) dated None
(Decedent's husband, the first named Exeutor, is deceased. Decedent's daughter, Barbara A. Poole, formerly Barbara Breon, is the contingent
Executrix).
(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 instrument(s) otTered
for probate. was not the victim of a killing and was never adjudicated an incapacitated person: None
o B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente 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: (If
Administration, c. t.a. or d. b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Name
Relationshi
Not applicable
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
o
~'.J_ ~.)
Decedent was domiciled at death in Cumberland
4837 E. Trindle Road. Mechanicsburg, P A 17055
(List street address. townlcity, township. county, state, zip code)
County, Pennsylvania with his / her last principal (G:~i(\ence at
f..._~_1
Decedent, then 82
Mechanicsburg, PA 17055.
years of age, died on November II, 2006,
at Country Meadows Assisted Living, 4837 E. Trindle Road,
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
$ "2-8,6" () ~
$
$
$
3CI':'.OO
0.00
0.00
0.00
situated as follows: None
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:
Barbara A. Poole, 17 S. 26th Street, Camp Hill, P A 170 II.
Pnrm RW_n? rpv In I ~ nf>
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
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 the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed
be~,for\e me the oZ ~ day of
Iy~.~~~m~~.uN' Colo
For the R,~g~s
t ~WLf^d.~1.d C2 ~ ~~ e
of Personal Representative
Signature of Personal Representative
Signature ofPersnnal Representative
File Number: ~ ~ ~ ~..Q ~ U~
Estate of MARIE R. FONTENOY
Deceased
Social Se~cu(rity Number: 194-14-7665 Date of Death: November 11, 2006
AND NOW, ~ ~, ~; `l2 iT1 ~~ ~ ~ ~~C:~U . , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT [S DECREED that Letters Testamentary
are hereby granted to Barbara A. Poole, Executrix,
in the above estate
and that the instrument(s) dated November 13, 1978,
described in the Petition be admitted to probate and Sled of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ............. .. $ ~~ ~
Short Certificate(s) .... .... $ 3~ , l~
Renunciation(s) ...... .... $
MCP .. $ to ~~
.. $
.$
.. $
.. $
.. $
.. $
TOTAL .......... .... $ `~~
~~,D~
Form RW-OZ rev. 10.13.06
Regis r nf~Wil/s _ • ~ ~~J
Attorney Signature: ~ ;/~JZ~..=~. ~~--~~~ }
Attorney Name: S. Berne Smith, Esq
Supreme Court LD. No.: 7254
Address: 107 North 24th Street
;j ~_
Camp Hill, PA U011-36Q~ ~~~
;,=. _ -
-' ~....,
Telephone: 717-737-6789 - --
_t
--i
Page 2 of 2
iIU).1'SI)) KLV JiIlJ
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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Fee for this certificate. $6.00
P 13196250
NOV 16 2006
Date
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H105.1~3REV.02/'2IXS
TYPE I PRNT ---.... \
,=:r \ J
1. Nane or (F~L middle, last. s~
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COMMONWEALTH OF PENNS"LVANIA ~ DEPARTMENT OF HEALTH. VITAL FEGORDS
CERTIFICATE OF DEATH
-~;:J
co
6. Dare 01 Birth Monln, d ,'e3I'
83. Place olJcctfl (Chr cf; c~. one)
Hcspillll: I Olhoc
Olnpalient DER/"'~_ ODOA flNU11>lngH"",
'J. \VasD<>",~lI"'Hi_~OIigin? 12I No oy.,
lIfyes, s ~iy Cuban,
Country L'ieacows F.ssisted Liv lllg M.""", Pm""R"n.""'l
12. WrBDecMerrtevarlltM 1; Decede:tl'SEducallon(SpeclfyOO'yh1g~lgrOOeoomp~!ec~') 14. 'JarltaIStalus:Marrled,NeverMa'1i<<l,
U.S.^,"""Fo=? EIeoIleJ!laY!So<xni"l'IC~12} CoIOge (1-4 or 5+) 'J'~jd....-ed,DlYorcedd (SpecIfj1
DYes BlNo 1;G VI. owe
Oecedeni's Did Decedf fit
ActuOResid""" 17".S... .l2ennsylvania lM>ina '7e.0 y...Da:edontUvedln
Tmvnshlp? ~7d. ["'J No, DecedentUved wiltln
'7b.C)UIIIy Cumberland !Ii' _.Umtlsof
7. Bi:1h~lIaoo{C
3. SodaJ 8eclJrity NUl lber
194 _. 2.4 - 7665
STATE PILE NUMBER
4. Date JfDealh (MJrlUl, day, year)
November II, 2006
82
Sb. County of Dea8l
October 30, 1924
Frenchville, PA
o Ra.Mp-nee 0 O:her. Specify:
10. R~: AlreriC8lllndi8l\, Black, V~(e, elc
(Sp'ciI}J
wl1i te
8d. Facility Name (If MI ilSfibJlion, give streel and numOOr)
\
CDmbeJ:land Mechanicsbur
11~lJl'tl;:i (t<ij'(jof\lKlfl(OOIlf!Ourtn~of IlIA. On nott'!lale re11re(!
Kind of Won: Kind of Business Iln:lllslry
Office Clerk School
. 1G. ~sMamngAd~(S1realcilyl\owrr,slaIe,zipooda)
4837 E. Trindle Road
Mechanicsburg, PA 17055
Twp.
Mechanicsburg
Clly I BolO
18. Father'sName(FlfSl,rrid::!e,laslsl.ilix)
Jerome Rou eDX
20a iDmIrIfs N"", (Type/Pril1Q
Barbara Poole
Ii 21a ur5i~,~;isposD~O(Wl\I:,]f"vn ~I:>l"
I
o
~
!!J.
;i
19. Mothel"s Name (Fi"5l, mkldle, maden SUfflam€
Cecelia Coudriet
2Ob. inform",r. MaItng Add""" (SIme, d~ I loW! . ,"to zip cOOe)
17 S 26th Street, C=unp HilL PA 17011
,2ie. Plao.::ufDt:,JD~~J(R1(N~ofCi.il'"ill-'1,cr&r ollli!.Oio:Jltti pi""",,)
I ~'iu. lo!.;a\iull (Gi;y I tOWI!, 51ai6, dp c.'X:;e)
I Clearfield, PA 16830
Kev in A. .E,~ar'd::;l~y Funer:'a1 HOll\~, Inc.
113 N. Thir:d S::reet, Clearf:leld, PA 16830
!b. Lic-'lfl3e Number 23r~ [late Signed (Month, day, year)
i?i,) 35&;).11J... L //-/ J- 2o()(f'
26. : N<*Case Referred 10 Medical Examiner IC)f'OflerfOl' a Fetl$On Olhcrthal1 C'~mation or Donalion?
] (f$ ~ No
: Approximate t11ervaJ' F'art It Enle oth~lf" sianifJr.antronditions mnlnbnlinllln d<>"a1h. ! 2f. Did Tobacco Use C~ntrlbule 10 De3th?
: Onseito Dealh 1\ but rf.ll rlSlllUng iJ the undertytngcoosegivoo In Pm 1.1 r ~,. ~~~ ~t:~:nOWll
~2ntwilhmpaSlycar
o PregnaolatUrreofdeall
I 0 Nolprt>!JI1Hf11,h'Jlpreg~anIwithIn42days
of death
.. '. ..11. [] ~fo~~:nnnl but pr~nanl43 d, 3YS 10 1 year
.^ _~ , [] Unknown i' ~re-~rant within the nast year
'=11"' PI"" oIl~.T Hom,. Pann, Street, Pec1oly.
omce BUI!::bng, elG (Specify)
32g. L.ocalioo of InJLI;' (s.mel. city ItO't'T, state)
CoovlOIe '- ZJa.ccriywhenrerl;fying
physi:iao is not crr.iJJIt:! a lime of deWlllo
criy""",ofdealh
tloms 2ol~26 _beromplo\.tby"""",
....m~de9lh.
012747-L ~
23a Tolhe best of my kII<MIedge. dea~ """ired a1~,timo.daloand p""'" 00. (Sigllablre and 1iIIa)
k r~ [VL.-1'Y] L,./cA"-"'-1'_1 e,f'r'/')
24. TIme 01 Death 25. DateProoouncedOea:l(IbnIll,day,yea-}
5 () '3 ..1 " j'J 0 fit.. /;1 lJ.t/' / I,
20t60
CAUSE OF DEATIf (See Instructions and eumpllJS)
1lern'lI. PART I: Enter1he ~- oJSeaSeS,In)OOes, orcomplicaOOns-1hcrtdIrecOycaused 1he death. DO NOT en!.ertEr nInal even~;sud1 as ca:diw.; aJreSl,
~ralcry <IIT83t, ocventrlcu\oc fibri~8lio,1 wItIlout showing the etiology. Us\ ooly one C<J.tSe eft earJ1 [<TIe.
=~~~=--+ /J ~ .-./J ;"
Due 10 (or as B consequence of):
=is1_""'l"
ID cause IM!d Ofl ine a
EII'or UII7ERL YlNG GAl 'SE
(~t1iniurvlhal.inkiakldthe
evm~ resullIlg In deaIh ) LAST.
b.
Due 10 (or as a consequence 01').
30a w~ an Autopsy
Pl>mMd7
.
.
.
30b !~E~~3i. :~DSaih ~~'11fflo-13"" D""-nlln;i~ iN.ooJi.dai:",,'j 3ib 0;.,,"," HOWinj"~o,;,.,,,;,j
Dhridool DPoodinglnv:l5ligatlon 32d. TiOOOi~~2E.lnJUry<tW~1<.7. 32f.llTrnflsporl3lionlnju)'(s.,eciry)
DYes 0 No
o Suidde 0 Co,",'''' bo n._1nM IJ y", 0 No O"".,/()pe<aJo, 0"""09"
M. DOIh".S~'
- 331l. Signalufl~;xTfiij;'@(:;m;
~
'~
'i.
s:-
Due 10 (or BS a co.1seQuenca of):
d.
Ov", I1\lNo
~
~
~
o
~
33a. C.r1l1w (dle:k only OM)
CertlyIng pflp:ldan (P11Y'ici31 certifytlg Catllteddeath Mlen anollerphyaicia1 has ;xoooonooddllalh snd COlT;pIetcd 1l::fll23)
TotMbettofmykoowledste, r:MethoceunwldlMltoltttcau18(I) .ndlTllnnllr..~_ __ _ _ ___.._ ,_ _ _ _ __ _ _____._ ___ _ _ _ ___ --G4
,;::u=':::r:::'~::DlJ:~=~a~:==U~:~~drmJ1nNa;,lq(l_ __________ _.. __ __..D
,
_"""",../Co<oII.. ...D
On the _II of examlnatlon and I or InvNtiglUOn, In my 0 I dMth OCW~ at tht Ume, Nte, and pllC8, all( due to th& cauaa{t1) and manner ll$ &tatfIt_
and Disbid Number
II 111\
WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH ViTAL RECORDS
~, ()\..Q \~
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. T 5 564 7 4 5
__-~',i7;ri;.'IFA ,", '>'..
,,;,;:<'~~,\ ~__Qf p/j;'--:,->-
'/ ~'\-- .. ----~~.1.'p (1~~~
Jt'~/ . '~~---::"
i' ~,: '.L--~\
if~~i)
\~ *'f:~,." -' ".- Sf
\\ ~\ ..,,'=- ;~
\~,~.?~i,;,.-.. ,---",,~\s>
~(,:?I;l1i::~;,. r\ ~\,\\'/
"~"'''''.-:', ll\, J /li1,',,--
....,:?~~:~:,!!/.J!!.'!-~ -
DEe 2 3 2003
-~ Oa!e-ct'~;~;;,-;t.l.his c~~tifu.~;L;;----------
Name of Decec!e-lt
Paul
- _ -- __~_~~I_!~~___~________ __E'_ 0 I]:!~:,n_~r_______ __om __ _
--------~~_._-~------------------
r::.",,;
E-;ex____l1~~~______Social Security No. -___2~_-=-__g_~_=__?_?~_i______ Date cf Death De~~~~er_~_~~__~g?3
Date of Birth ~~Et~mber_.?_4, .191 %irthplace ____f_~_~nc_1'1y} l~_e,_~~_________________________________
Place of DEa;h C1earfie1d Ho i tal
C1earfie1d County
C1earfie1d Boro.
whi te Occupation ____La!:.or~_~__________________ Armed Forces? (Yes or No) ___~-=_~_______
. d Decedent's
Mantal Status _II1.?.E_rl_~__ Mailing Address 607 Fletcher Street, Clearfiel~-,___~~_~_68_~__~__
~d-,\' ,',...,
Imormant. Marie Fontenoy
----~_._- ---_._--_.~---
Name and Address of
Funeral Establishment
_ _____ __ Funeral D,rector Kevin A. Beardsley
- --'-~-'-'------~'----~-----'--- ---~'----'--'--'--"-
Kevin A. Beardsley Funeral Home, Inc.
113 N. Third St:-;--elearfiera;t>1\ 16830--
---- -""'--'~'------,-~,~,-- -..-. --.--.--
,
i="-'art I:
ir'lrned'ate Cause
Intervai Bmweer'
, Onset and DeaHl
fa)
Congestive Heart Failure
2 wks
ibj _________
COPD
---,._------------~---_._._-~----_..._.__.._._.-._----_.._---_._~._---_.-.._-_.- ----,-'------ - -_.~_....-..__.__._--- -.-.--.---..--------..,.---
years
Part Ii:
-----
'. d) _____~__________________________
Other Significant Conditions
Manner of Death
Qescribe how Injury occurred
'~atural
LX
Homicide
Pending Investigation
Could not be Determined
Accideni
.SUicide
Address
820
Baltazar L. Corcino C~ -- )
--------------------~~-~------------- -~~-.~--:---------,--+_t-------~--
_qM,D.. 0,0', Coroner, IAE_!
Turnpike Ave., C1earfie1d, PA 16830 - '
-------------------------- ------------------,-------- ---________.J:X.'_________
Name and Tltie of Certfier
Dr.
Thl::; I~, 1'1 certify that the InformatIon here given IS correctly cop'ed flOm3'n .Jrlglnal certificatE:
of ,j,,)Sih duly filed with me as Local Registrar, Tile fl9'nal cerUlcate III b? forwarded to th
State Vital Records Office for permanent ~II , .'
17-179
--- - ---- ---
k,t',;::h
December 23, 2003 C1earfie1d Lawrence
---.- -r-:::-:~;R;~;-~::.~::;;jh:,~JC:d! q':;--J~~a--~~
I, MARIE R. FONTENOY, of Clearfield Borough, Clearfield
County, Pennsylvania, declare this to be my last will and
revoke any will previously made by me.
ITEM I:
I direct that all my just debts and funeral
expenses shall be paid from the assets of my estate as soon
as practicable after my decease.
ITEM II:
I devise and bequeath the residue of my
estate of every nature and wherever situated to my husband
Paul C. Fontenoy providing he shall survive me by sixty (60)
days.
ITEM III: Should my husband Paul C. Fontenoy predecease
me or die on or before the sixtieth day following my death,
I devise and bequeath the residue of my estate of every
----- ~...~
nature and wherever situated to such of my children, Barbara
.....
Breon, Donna Franz and Suzanne Modlo, as may be living at
the time of my death and to the lssue then living of such of
my children as may then be dead per stirpes.
ITEM IV:
I direct that all taxes that may be assessed
in 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 husband Paul C. Fontenoy, Executor,
of this my last will.
Should my husband Paul C. Fontenoy
fail to qualify or cease to act as Executor, I appoint my
daughter Barbara Breon Executrix of this my last wil~~
(-.......
/1 .')
,/,</ /../ ;( I/-l'( '>, /
~~RIE R. FONTENOY
_ -'J/
//
c~.
ITEM VI:
I direct that my personal representative
shall not be required to give bond for the faithful perfor-
mance of his duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this
. ) C.(_j
"
day of November, 1978.
/"'<
// ~/;c --A/ / /
MARIE R. FONTENOY
/
The preceding instrument, consisting of this and one
other typewritten page each identified by the signature of
the Testatrix was on the day and date thereof signed, published,
and declared by Marie R. Fontenoy the Testatrix therein
named as and for her last will, in the presence of us, who,
at her request, in her presence, and in the presence of each
other have subscribed our names as witnesses hereto.
"
#\!~)
~. ~/ VI.
-A J ,-/ I L i
...\{/VL~~ 'J'~' /~A~/n/l',-/'i/'/
I .
-7-
~ \ D CD \ b LtS
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
<::: (). n (3=(1 L AAdl COUNTY, PENNSYLVANIA
Estate of
m~( " t:
R. ~OI/.te.nO~
, Deceased
Dos \xu- G- CA ? b6 k
and
K \ cY\CI--J"' ~ --0 90 ok
(each) being duly qualified according to law, depose(s) and say(s) that she.l fle / they w..a&-/ were well-
acquainted with (1 A po, I <.: (j( , r (j iN '/ c= rJ 0 7 and am/are familiar
with the handwriting and signature of the decedent, and that the signature of (l (41l1 If If, FC/V 1i.~1-l Lf
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of n PJ ff I d d~", ro tV ., t: N C> y
is in hisfher own proper handwriting,
~l ~ h~.A/ (~ . (]'r~
(. 19nature
~\)~
(Signature)
Vl S... 2. (, -'" Sf.
(Street Address)
CC~~ 1-\:\1 PA 116// ,-cjbn~
(City, Stat~, ZiP)' ,
17 Su '2b~S>T
(Street Address)
~ ,~t\ Q4 IjOll -'fill-
(City, State, Zip) )
Executed in Register's Office
Sworn to or affirmed and subscribed
i".....__~
before me this .J 8
of f'JbU€...p....bR.....r
o
~}
-r~
day
,;l.cXJlp
i"",..)
"-..'
~5te~
OJ
Fnrm Rw-n4 rpv In Il nti
~ \ D Lo \ ()~~
S. BERNE SMITH
Attorney-at-Law
107 N. 24th Street
Camp Hill, PA 17011-3602
PHONE: (717) 737-6789
FAX: (717) 737-6783
September 21, 2005
In re: Estate of Marie R. Fontenoy; DOD 11-11-2006; SS# 194-14-7665; EIN: 20-7160965
PA File No.
File: 206002
f"......)
Ms. Glenda Farner Strasbaugh
Register of Wills
Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
f'J
Ci'.J
--,'
-- :~)
Dear Ms. Strasbaugh:
0)
Please find enclosed the following items with respect to the probate of the will of Marie R.
F ontenoy:
1. The original and one copy of the Petition for Probate.
2. The original of the will, and a copy ofthe will. You will note that this was not a self-
proving will. We will present two witnesses to attest to the signature of decedent.
3. The Registry Statement.
4. We will present to you all necessary proofs to establish that Barbara A. Poole is the
contingent Executrix named in the will.
We have not enclosed a check, because we will be presenting this petition for probate in
person and will be prepared to make payment of fees at that time. We want to order eight (8) short
certificates. Ifwe are not able to receive the short certificates when the will is probated, please send
them to the undersigned.
Thank you for your help in the case. It is a pleasure to work with your Staff.
/
Sincerely yours,
/t.? /J' )
iDe~~/ ..k-v.-,,-VL
S. Berne Smith
Enclosures:
cc: Barhara A. Poole. Executrix