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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYL VANIA
Estate of EMMALINE C. BRENNEMAN
also known as
File Number :2/ - 0 '7 - 0 5 5~
, Deceased
Social Security Number 179-12-4690
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 CO-EXECUTORS
last Will of the Decedent dated DECEMBER 15, 2003 and codicil(s) dated
named in 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 oftheillStrurnerrt(-s) offered
. I
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.; pendente lite; durante absentia; durante-Iti,inoritate) ":::
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any),an.d 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
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last principal residence at
300 CORNMAN ROAD. CARLISLE. NORTH MIDDLETON TOWNSHIP. CUMBERLAND COUNTY. PENNSYLVANIA 17013
(List street address, town/city, township, county, state, zip code)
Decedent, then 88
years of age, died on MAY 9, 2007
at CARLISLE REGIONAL MEDICAL CENTER
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) 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
$
$
$
$
41,000.00
260,000.00
situated as follows: 300 CORNMAN ROAD AND 331 CORNMAN ROAD, CARLISLE, N. MIDDLETON TWP, CUMBERLAND COUNTY PA
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:
Si ature
T d or rinted name and residence
C. LEROY BRENNEMAN, JR. 430 CRANES GAP RD CARLISLE PA 17013
VICKEY L. BABNER, 311 CORNMAN ROAD, CARLISLE, PA 17013
BETTY A. RUTTER, 501 WAGNER DRIVE, CARLISLE, PA 17013
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct t~:..the best of
the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and1,ruly
administer the estate according to law.
Sworn to or affirmed and subscribed
before me the (~ ~ day of
~jJ1J . ~7
L~tlflQ Cl~
FO;#-R~~i~; '-"
c
File Number:
2/ - D7- 05Sl(J
Estate of EMMALINE C. BRENNEMAN
. Deceased
Social Security Number: 179-12-4690 Date ofDeath:MA Y 9, 2007
AND NOW, Co K DalA~.a'~U7 (...' ,r:Y-DD7 . in considemtion of the foregoing Petition, satisfactory proof
having been presented before me, IS C ED that Letters TESTAMENTARY
are hereby gmnted to C. LEROY BRENNEMAN. JR., VICKEY L. BABNER, BETTY A. RUTTER AND SANDRA E. PRICE
in the above estate
and that the instrument(s) dated DECEMBER 15, 2003
described in the Petition be admitted to probate and filed ofrec rd as the last Will (and Codicil(s)
\ f-tL '[
FEES
"
~.d~<
~
Letters
$
360.00
8.00
L5lO
10.00
5.00
Attorney Signature:
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......... $
JCP ... $
AUTOMATION FEE . . . $
...$
.. . $
.. . $
.. . $
.. . $
.. . $
. .. $
TOTAL . . . . . . . . . . . . . . $
Attorney Name:
, ESQUIRE
Supreme Court I.D. No.: 6282
Address:
60 WEST POMFRET STREET
CARLISLE, PA 17013
Telephone:
(717) 249.2353
~
.3<1&.00
Form RW.02 rev. 10.13.06
Page 2 of2
Name and Residence
Sandra E. Price, 1450 Newville Rd., Carlisle, PA 17015
C~
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UI".C;;.~/l~ >Z-C::V 1//l:,
H - ----:-fl ~ 1\7- f\ 5i;T,
Thi~ is to certify that the information here given is correctly copied from an original certifica~-;lfjeath d~iy'jt:d with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanen: filing
WARNING: It is illegal to duplicate this copy by photostat or photogralph.
No.
~
Fee for this certificate, $6.00
p
13446084
MAY 112007
Date
.rtt' jV\ ~~
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H1CJ5..143 REV 1112006
TYPE I PRINT IN
PERMAIENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA 0 DEPARTMENT OF HEALTH 0 VITAL RECORDS
CERTIFICATE OF DEATH
(See InslNctlons and examples on reverse)
(-". ;
STATE FILE NUMBER
Yrs..
Brenneman
6" 0... of Ill"" (Month. da . year)
4" 0aIll of 0eaIll (Mon'h. day. year)
4690 May 9, 2007
,. Name of _IR.... m_.Iast, suftix)
Err.maline C.
5. Ago (Last BlI1hday)
Other.
88
4/13/1919
11.Decedent'sUsual
KindofWolk
HanEmaker
mostotwo. NIe.Oonolstalll'8lired
Ki'ld of Busi'1ess {Industry
Her own heme
Carlisle Regional MediCal Center
12. Waa __;n 1110 13. Decedent. Educ:aIion (Specify only high'" grade COlI11ple18d)
U$. A/mId Forcaa? EJemonlaJy I Secoodary (0-12) College (1.4 Of 5+)
Dv.. KINo 8
:=dence 17L Slate PA
1?b.Counly Cumberland
Doltlar.Specify:
10. Race: American IncIan, Black, Whitt, etc.
(Specifll
White
14, Marital Slaws: Married, Never Married, 15. Surviving Spouse (If wife, give maiden name)
W_. Oivon:ed (SpecifIl
WidcMed
Bb. County of Death
Cumberland
~
~
Did_'
Uveina
Townsh;p?
17c. [3. Yes, Decedent l.Ned in
17d"D No,_Livedwilllin
AduaI umos of
North Middleton
Twp.
CilyIBaro
19. Ma1hor's Name lFilSl. _.'- sumama)
Velva Finke
2llb. 'nIoI1nanr. MalIng Addrasa (SIraa1, cily 1_. _. zip coda)
430 Cranes Gap Rd., Carlisle, PA 17013
21c.PlacaofDispoallion(Nameof__ororharplaca) 21~l.ocaIionICilyI-'_,zIpcoda)
estminster Marorial Gardens
Carlisle, PA 17013
~
<;t
~
~
~
.\..)
:c-
~
~ 22a. S9taturI 01 F
. ~
CompIoIe lt8ms 23a-c "'" when corlllying
phyIIcianiBnotavailableatlinecid8attllo
CI!1lIy causa of_.
Items 24.26 musl ba ~ by parson 24" TIma of eeath ..-; 4 .r 25. Oata Pronounc:od Oaod (Mon~. day. year)
_pIlll1llllIlCl5daalh. \\i~O">'" 7 (lA. It' .,.;- If) ,... ~O.
CAUSE OF DEATH ISH lnolnlcllona ond oxo_l
Item 27. Part I: Enter !he ~ -liseases, injuries, or compIica1ions - that dr8dIy caused h death. 00 NOT enter tetminaI events such as cardiac atr8St,
respifalory arresl, or venbicular fibriIIaIion wiIllout showing !he etidogy. list onty one cause on each line.
~~=~
Hare, Inc., Carlisle, PA 17013
23b. Ucense Number
23c. 0010 Signed It.tonlh. day. year)
26. Was Case Referred to MedIcal ExamNr I Coroner for a Reason Other than Cremation or 00n8Ii0n?
Dvas ~
Approximaleinterval:
Onset to Oaath
Part II: EnSer oIher sianiti:anllXlnlition& coolribulina 10 deadt
but not resullllg in the underlying cause given in Part I.
28. Did Tobacco Use Conlribute to Death?
D Vas DP-
~No 0 Unknown
29. If Female:
)iirNolpragnan,withlnpaslyaar
Dpregnan'attlmaofdaalh
D Not prll!Jl'll1\"'_ wilNn 42 days
~daalh
D Notpragnant. but prll!Jl'lIl'43 days to 1 '18M
beloradaalh
D Unknown;,_wlIIiin1l1opaslyaar
32c~=,:n(~jSlreel.FscIory.
-"'-.'sny.
leading to hcaull& liated on linea.
En,", 1110 UNDI!lILYING CAUSE
=:a~n~rm:1ha
Due 10 JOf ItS aa.sequence o!}j
b. ~f"-VfV~(L7
Due to (or as a consequence 01):
[,.0r''-8-0 v( rrtlktl.'f r (In' '-....Il~
~(l.ftYfL-7 II ,) efl<( ,{'
,
.\.1
~
-I
-..{
it
Doe to (I)( as a consequence 01):
d.
IdZ II 102.1' 10
32d. TIfI'I8 of In;..y
~
:::..
DVaa Q/:""
n. Were Aulops., Firldngs 31. Manner of Death
~=;;rO:th~ ~tural DH_
0-1 0 P.rt<W1gI"",.tigation
o &Jidda D Couto Not ba De<em;nod
Ov.. ONo
301. Was an Autopsy
Parlormed?
lot
321. UT....portlIlionIfIjwy (Specify)
D Driv.,1 Operator D Paesengo< OPedes .
QIhw- Specify:
33b. Signature and Title or
t.I
~
fa
~
i
33ll. Celtilie< (check only one)
Certtty1ng phyak:ian (Physician certifying cause of death when another physician has prollClUJ"lC8d death and completed Item 23)
To Iht best of myknow*'9t. dMth occurrecI due 10 the cauee(1)and mIMfN' II lilted.. _ _ _ _ _ __ _ ___ _ _ __ _ _ _ __ _ __ _.. _ _ _ _ _ _ _ 0
Pronounclng.net cert1fyIng phytk:1an (PhyslQan both pronouncing death and certifyilg 10 cause of dHIt1)
To the best of my knowledge, deIIh occumtd It the time, dIIe, and ptace, and due 10 the ClUse(I) and mIMIt' II slIlecL _ _ _ _ .. _ _ _ _ _ _ _ _ _ _ _ _
Medlcat Exam_I CoIoner
On the bull of examination and I or investigation, In my opinion, death OCCUlTed at the lime, dI., and piece, Il'Id due to ttIt ClUll(II and mann..... ItItId... 0
33d Oa~;~da';~
34. Name end ~ ~ Po"1l ~ ~p.Jld C.... olOaath (Uem 211..1,pe 1 Prinl
p~:(~4 ~~,~.aev~r ~v
'1.--'2.--0 (It'J' LS':> /'V;T' Cfr/,U.-.. 'S if ('I" \ ? ~ f j
Disposition Permit No.
LAST WILL AND TESTAMENT
I, EMMALINE C. BRENNEMAN, of North Middleton Township, Cumberland
County, Pennsylvania, declare this to be my Last Will and Testament, hereby expressly revoking
all Wills and Codicils heretofore made by me.
1. I direct my Executors to pay all uf my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my Executors to sell any realty owned by me at my death
and not specifically devised herein at either public or private sale, and to give good and sufficient
deeds therefor, in fee simple, as I could do if living.
3. I give, devise and bequeath all of my estate of every nature and wherever situate as
follows:
(a) The sum of $1,000.00 to my sister, VIRGINIA I. BUTCHTER, and
if she is not living that the time of my death, the gift shall lapse;
(b) The sum to $400.00 to each of my grandchildren living at the time
of my death, except $1,000.00 to my grandson, C. LEROY BRENNEMAN,
III;
(c) My property located at 331 Cornman Road, Carlisle (North (M!4dleton:_.;
j J (
Township) to my grandson, C. LEROY BRENNEMAN, III; and
.
C'J
C-,
<-
(c) All the rest, residue and remainder to my four (4) children, share
and share alike, the child or children of any deceased child taking the share
their parent would have taken if living.
4. I nominate and appoint BETTY A. RUTTER, SANDRA E. PRICE, VICKEY L.
BABNER and C. LEROY BRENNEMAN, II to be the Executors of this my Last Will and
Testament; they are to serve as such without bond.
5. I hereby suggest that my personal representatives retain the services of Irwin,
McKnight & Hughes as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this I" .. day of
December, 2003.
~~ c-~~,- (SEAL)
EMMALINE C. BRENNEMAN
Signed, sealed, published and declared by EMMALINE C. BRENNEMAN, the
Testatrix above-named, 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 subscribed our names as
witnesses hereto.
2
ACKNOWLEDGMENT AND AFFIDA VIT
WE, EMMALINE C. BRENNEMAN, JACQUELINE L. DRAWBAUGH and
MARTHA L. NOEL, the Testatrix and witnesses respectively, whose names are signed to the
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, that she had
signed willingly, that she executed it as her free and voluntary act for the purpose herein
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 their knowledge the Testatrix was, at that time, eighteen
years of age or older, of sound mind and under no constraint or undue influence.
COMMONWEALTH OF PENNSYLVANIA
: SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by EMMALINE C. BRENNEMAN,
the Testatrix herein, and subscribed and sworn to before me by JACQUELINE L.
"
DRAWBAUGH and MARTHA L. NOEL, witnesses, this l'f' day of December, 2003.
Public
Notarial Seal
Ropt' B. Irwin. Notary Public
CvUllt BOlO, CUmberland County
My Commlaaton Expires Oct. 3. 2004
~.,~yt4IIl1a~",otNolarie8
3