HomeMy WebLinkAbout01-17-07
PETITION FOR PROBATE AND GRANT OF LETTERS
Register of Wills of Cumberland County, Pennsylvania
Deceased
File No. ~ \
Social Security No.
6\ OD~-'
089-22-3781
Estate of
MAXINE D. CARSON
DONALD K. CARSON
Petitioner, who is 18 years of age or older, applies for:
(COMPLETE "A" OR "B" BELOW:)
o A. Probate and Grant of Letters Testamentary and aver that Petitioner) is the Executor
named in the Last Will of the Decedent, dated June 16th, 2006 and codicils(s) dated N/A
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) offered for probate; was not the victim of a killing and was never adjudicated an incapacitated person:
o
B.
Grant of Letters of Administration
(if applicable, enter: c.t.a.; d.b.n.c.t.a.; pendent elite; durante absentia; durante minoritate
Relationship
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(COMPLETE IN ALL CASES): Attach additional sheets if necessary.
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Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with her last family or princij:>afresiden~t
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301 Messiah Circle, Upper Allen Township, MechanicsburQ, Cumberland CoJ~tv, PenmMvani~ '11055
(List street, address, town/city, county. state, zip code)
Decedent, then 77
years of age, died on
January 1. 2007
at
Messiah VillaQe, Mechanicsbura. PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property.....................................................................$ 4,500.00
(If not domiciled in PAl Personal property in Pennsylvania.....................................$
(If not domiciled in PA) Personal property in County....................................................$
Value of real estate in Pennsylvania ......................................................................................................................$
Total......................................................................................................... $ 4 ,500.00
Real Estate situated as follows:
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:
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T ed or rinted name and residence
DONALD K. CARSON
301 Messiah Circle
Mechanicsburg, PA
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
The Petitioner above-named swears or affirms that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the
Decedent, Petitioner will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
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. NA K CARSON ...,
FileNo.
Estate of
MAXINE D. CARSON
, Deceased.
Social Security No: 089-22-3781
Date of Death:
January 1, 2007
AND NOW, \ 'l ~ ,2007, in consideration of the foregoing Petition, satisfactory
proof having been presen d before me, IS DECREED that Letters Testamentary are hereby
granted to DONALD K. CARSON. Executor in the above estate and that the instrument dated
June 16th, 2006 described in the Petition be admitted to probate and filed of record as the
Last Will and Testament of the Decedent.
Letters........................... $
30-00
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Register of Wills ~~~-i ~
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FEES
Short Certificate(s) $
ReIIURG~n.wil.l... $
Affidavit ().................. $
Extra Pages ()....... $
CodiciL.......................... $
JCP Fee.....J\..:J6.... $
.-!n"".,ntory..l::J(............... $
Other.............................. $
TOT AL......... $
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Attorney: ~ G.~
1.0. No: 20558
Address: Johnson. Duffie. Stewart & Weidner,
301 Market Street. P.O. Box 109, Lemovne. PA 17043-
Telephone: 717-761-4540
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HJ05.8t15 REV 1/05
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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Local Registrar
Fee for this certificate. $6.00
P 13104388
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o 3 2007
Date
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
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REV 1112006
PRINT IN
AANENT
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1-22-1929
Hastings, PA
STATE FILE NUMBER
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1. Name of Decedent (Arsl, middle, last, suffix)
- 22
3781
4. Date or Death (Month, day, year)
1-1-2007
6. Dale of Birth (Month, day, year)
Twp.
8d. FaciUty Name (If not institution, give street and number)
me ":) '3 '( O-h. \l \ \ \ 0-..0 t:-
Sa. Place of Death (Check only one)
Hospital: Other:
o Inpatien' 0 EA I OUlpa,ent 0 DOA KJ Nursing Home 0 Aesidence o01her" Spec;~'
9. Was Decedent of Hispanic Origin? [XJ No 0 Yes 10. Race: American Indian, Black., W'hile, elc
(If yes, specify Cuban, (Specify)
Mexican, Ptierto Rltan, etc,) whi t e
11. Decedenfs Usual Ox lion Kind of worl< done durin most of work' me, Do nol stale retir
Kind of Work Kind 01 Business I Industry
procurement officer state government
12. Was Decedent ever in the
U.S. Armed Forces?
oVes ~o
13. Decedent's Education (Specify only highest grade completed)
Elementary I Secondary (0-12) College (1-4 or 5+)
+1
14. Marital Status: Married, Never Married,
Widowed. Oivorced (Specifyj
married
Carson
. 16. Decedenfs MaiUng Address (Street, city ftown, state, zip code)
301 Messiah Circle, Mechanicsburg, PA
- 17055
~~'~afi"'.g~81~)
~~ 17aStale Pennsylvania
17ti.Coun~ Cumberland
Did Decedent
Live in a
Township?
17c.:K] Yes. Deceden' Uved In lJppp r A 11 pn
17d.O No, Decedent Uved within
Actual Umitso/
Twp.
City f Boro
19. Mother's Name {First, middle, maiden surname}
Ruth Nichol
2Ob. In/ormanfs Mailing Acldress (~, city I town, state, zip code)
301 Messiah Circl~, Mechanicsburg, PA 17055
21c. Place of Oj~ (Name ofcernetery, cremalery or other place) 21d. Location (City I town, state, zip code)
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Evans Cremat6~~ Scheafferstown, PA
22c. Name and Address of Facility
arthemore FH&CS, New Cumberla~d, PA 17070
238. To /he best of my knowledge, death occurred at llle time, date and place stated. (Signature and line)
23b. licenSe Nu'il~r
23c. Date Signed (Month, day, year)
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25. Dale Pronounced bead (Month, day, year)
) - I - dOO
26. W~ ~e Referred to Medical Ex~r I Coroner for a Aeasoo Other than Cremation or Donation?
[Sl'ies oNo g,v.o ~.~
Approximate interval: Paril!: Enter other sionificant conditioM conlributioo 10 death, 28. Did Tobacco U~e Contribute 10 Death'?
Onset to Death but not resulting In lhe underlying cause given in Pari L 0 Yes gProbably
o No 0 Unknown
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29. !!..!Jmale:
'bG... Not pregnant within past year
o Pregnant at time of death
o Not pregnant, but pregnant within 42 days
of death
o Not pregnant, but pregnanl43 days to 1 year
before death
o Unknown if pregnant within the past year
32c. Place of Injury: Home, Farm, Street. Factory,
Office Building, ale. (Specify)
24. Time 01 Death
CAUSE OF DEATH (See Instructions and examples)
Item 27. Part I; Enter the ~ - diseases, injuries, or compClC8tions -/tIal direcl1y caused the death. 00 NOT enler terminal events such as cardiac arrest,
respiratory arrest, or ventricular fibrillation without showing the etiology. List only one cause on each nne.
~~)'.E,J,t~~~~:m'ldisea~ a. tV/Z ' cCt/l Cei,<2- -CJ"/rt.g..e:( Ce:-L-.<-
Due to (0
consequence of):
Sequentially Iislconditions, if any,
~~:r:~~~x~~a.
(disease or injury that initialed the
events resulfiilg 1/'1 death) LAST.
b.
Due 10 (or as a consequence of):
Due to (or as a consequence of):
d.
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32d. lime of Injury
329. Location 01 Injury (Street, city f town, stale)
3Qa. Was an Autopsy
-
3Ob. Were Autopsy Findings
AvaIlaDlePnortoCoolpJetion
01 Cause of Dealh?
DYes r;i No
oVes DNa
31. Manner of Death
~alura' 0 Homicide
o Accidenl 0 Pending Investigation
o Suk:ide 0 COO, Not be Detel!1llned
M.
3330. Certifier (check only one)
Certlfytng physician (Physician certifying caUSt'! of death Vthen another physician has pronqunced death and compfeJed Jlem 23)
To the best of my knowledge, death occurred due to the cause(s) and manner as statecL.. _ _.. .. _.. .. _.... _ _.. ........ _ _.. .... .. ...... .. _.. _.. 0
=::.: =~::~~=:~ :d~~~n:ndOO::::~:~~;~ol~:ca~~~~~ manner as stated_...... ...... ................ .._~~~'D
Medical examiner J Coroner ,/
On the basil of examination and I of investigation, in my opinion, death occurred at the time, date, and pface, and due to the cause(s) and manner as slated.. 0
!-
ni!'loosition Pennll No.
Last Will and Testament
OF
MAXINE D. CARSON
I, MAXINE D. CARSON, of Upper Allen Township, Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby revoking and making void any and all
Wills or Codicils at a..'1y time heretofore made by me.
ARTICLE I
DEBTS
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I direct the payment of all my legal debts and the expenses of my last illness..-and fuileral
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from my Estate as soon after my death as conveniently may be done.
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ARTICLE II
TANGIBLE PERSONAL PROPERTY
I give and bequeath my motor vehicles(s), household and personal effects and other
tangible personalty of like nature (not including cash or securities), together with any existing
insurance thereon, unto my husband, DONALD K. CARSON, provided she survives me by
thirty nO) days. In the event that my husband, DONALD K. CARSON, is not living on the
thirty-first (31st) day following my death, I give and bequeath the same unto those of my children
who are then living, to be divided between them in as nearly equal shares as practical. If there be
disagreement as to the disposition of any item or items described in the Article, I direct that it
shall be disposed of in accordance with Article III hereof.
ARTICLE III
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever
nature and wherever situate, unto my husband, DONALD K. CARSON, provided she survives me
by thirty (30) days. Should my husband, DONALD K. CARSON, not be living on the thirty-first
(315t) day following my death, I give, devise and bequeath the same in equal shares unto my
daughters, DONNA M. SHAFFER and JEANNE C. KOSANOVIC, provided that should either
daughter not be living on the thirty-first (31st) day following my death, I give, devise and bequeath
such deceased daughter's share unto her then-living issue, per stirpes.
ARTICLE IV
UNIFORM TRANSFER TO MINORS
In the event any beneficiary of my Will has not reached the age of twenty-five (25) years
at the time for distribution of his or her share, distribution of said share may be made in the
discretion of my Personal Representative after considering the age and needs of the beneficiary,
either directly to the beneficiary or to a Custodian for such beneficiary until age twenty-five (25)
under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5301 et seq., or the
applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of
residence of such beneficiary as the case may be. My Personal Representative may designate as
such Custodian any institution or person, induding my Personal Representative, qualified to act
as a Custodian for such beneficiary under such Act in effect at the time such distribution is made.
A receipt for any payment or distribution so made shall be a full discharge therefor to my
Personal Representative, who shall not be responsible to see to, or be liable for, the application of
such proceeds thereafter.
2
ARTICLE V
POWERS OF PERSONAL REPRESENT A TIVE
My Personal Representative(s) (Executrix or Successor) shall have the following powers
in addition to those vested in them by law and by other provisions of my Will applicable to all
property, whether principal or income, including property held for minors, exercisable without
court approval and effective until actual distribution of all property:
A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in
such manner as they may determine.
B. To retain any or all of the assets of my estate, real or personal, without restriction
to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to
any principle of diversification or risk.
C. To invest in all forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification
or risk.
D. To sell at public or private sale, to exchange, or to lease for any period oftime any
real or personal property and to give options for sales, exchanges or leases, for such prices and
upon such terms or conditions as they deem proper.
E. To allocate receipts and expenses to principal or income or partly to each as they
from time to time think proper.
F. To compromise any claim or controversy.
G. To make such elections, decisions, concessions and settlements in connection
with all income, estate, inheritance, gift, generation skipping or other tax refunds and the
payment of such taxes as my Personal Representative shall deem appropriate, without obligation
to adjust the distributive share of any person thereby affected.
3
ARTICLE VI
PERSONAL REPRESENT A TIVE
I name, constitute and appoint my husband, DONALD K. CARSON, Executrix of this
my Last Will and Testament. Should my husband, DONALD K. CARSON, fail to qualify or
cease to so act, I name, constitute and appoint my daughters, DONNA M. SHAFFER and
JEANNE C. KOSANOVIC, alternate Co-Executrices to complete the administration of my
Estate. Should either fail to qualify or cease to so act, I direct that the other complete the
administration of my estate. I direct that no fiduciary appointed herein shall be required to post
bond for the faithful administration of the duties required in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, this I()]dayof ~ 200:
(SEAL)
Signed, sealed, published and declared by the above-named Testatrix as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
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AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEAL TH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
We, MAXINE D. CARSON, ~\l "t..~be~ SttO\ler and
fck..Vl1.u.rUl. G. VVt~e ('-5 , 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 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 witness and that to the best of hislher knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under no constraint or undue influence.
~At'Mt ~,~
MAXIN~ARStN
0i~j~d ~
Wim~
Wimess ~
Subscribed, sworn to and acknowledged before me by MAXINE D. CARSON, Testatrix,
and subscribed and sworn to before me by f.. \ \ zcJ.,dk. S ~ 0 V-e v and
'2 J..V'A.I.A..ut G. Yk'1 e.r" , witnesses, this 112.!! day of J~
2006.
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Notary Public
5
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
GAIL J. MAHONEY. Notary Public
lemoyne Boro.. Cumberland County
My Commission Expires Feb. 19. 2010