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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY,PENNSYLVA}ilA
Estate of Olive M. Humbert
also known as
File Number ~/ -01- OD"Y"] 0
, Deceased
Social Security Number 177-24-7003
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
III A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is I are the executor
last Will of the Decedent dated September 2004 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 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
(ffapplicable, enter: c.t.a.; db.n.c.t.a.; pendente lite; durante absentia; durante mi1Writate)
Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was SlJAfived by the following spouse (if any) and heirs: (If
Administration, c.t.a. or db.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) <),. .
Name
Relationship
, ~~
,-
Residence;J; __
-- .: -.,... (')
.~-;;
-: j j
(COMPLETE IN ALL CASES:) Attach additiolUll sheets ifnecessary.
County, Pennsylvania with his I her last principal residence at
( )
Decedent was domiciled at death in Cumberland
875 Messiah VilIa2e, Mechanicsbum, P A 17055
(List street address, town/city, township, county, state, zip code)
Decedent, then 90
years of age, died on May 27,2007
at Holy Spirit Hospital
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
(Ifnot domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
8,000.00
situated as follows:
Wherefore, Petitioner(s) respectfuIly 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:
Richard W. Humbert
T
102 James Street, Leola, PA 17540-1426
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
: SS
COUNTY OF Cumberland
The Petitioner(s) above-named swear(s) or atlinn(s) that the statements in the foregoing Petition are true and correct to the best of
the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, petitioner(s) will well and truly
Sworn to or atlinned and subscribed
~~l!! Ul/..
administer the estate according to law.
before me the
day of
~- )
Signature of Personal Representative
Signature of Personal Representative
. '.r
File Number: 6Lt - DI - 0 Sf"] 0
(.,
Estate of Olive M. Humbert
, Deceased
Social Security Number: 177-24-7003
Date of Death: May 27, 2007
AND NOW, \~ ~ -. . in consideration of the foregoing Petition, satisfactory proof
having been pres before me, IT IS DECREED that LetterS? 'S..\C\tv\Et-:SI ~ ~
are hereby granted to ,
in the above estate
and that the instrument(s) dated ~ - - cXx:>4
described in the Petition be admitted to probate and filed of re
FEES
Letters ............... $ t-\5 -CO
Short Certificate(s) . . . . . . . . $ ~ -CO
Renunciation(s) .......... $
~\\\ ... $ \5' _\::>\J
~ ... $ ICJ-.(J\:J
~ lTY'-- ... $ 5"-00
... $
... $
... $
... $
... $
... $
TOTAL .............. $<&5..(p~
Attorney Signature:
Attorney Name:
Supreme Court I.D. No.: 6351
Address:
Market Square Building
Mechanicsburg, PA 17055
Telephone:
717-766-3172
Form RW-02 rev. 10.13.06
Page 2 of2
H105.805 REV 1/05
" This is to certify that the information here given is correctly copied fro~ 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 fihng.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
k[~ (l.i{~
Local Registrar
Fee for this certificate, $6.00
p
13524594
11a. r ~ c; ) "), 0 a 7
Date
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H105.143 REV 1112006
TYPE,' PAINT IN
PERMANENT
BlACK ~K
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
STATE FilE NUMBER
1. Name 01 Decedent (First, middle,last suffix)
Olive M. Hl.IDbert
ar)
7.BiIt
(C' andSlaleOf
-7003
one)
llb. Coun~
17Cc;t;...._..-. Upper Allen
17< 0 No. _..-....
AdulilIlmIsQl
Top
18. Father's Name (First middle, last. suffix)
ROy HI.IDbert
19. Mo1her's Name (Firsl, midlie, maiden surname)
Annie Rivel
2Ob. Informanrs UaiIing AddJeas (SlreeI, city f town, s1ale, zip code)
102 James street Leola, PA 17540
21c. Place of Oisposilion (Name of cemetery, crematory 01' OCher place) 21d. location ICity I town, 5Ia&e, zip code)
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PA
22c Nam~' _ .-~ ~ : Ie,..::, j f.l~jlfty
. ~
Funeral Hane
ZlIl. License Number
230. Dale Signed IMont!I. day, year)
IIems 24.26 musl be completed by person
~ whGprOOOUflC8$death t;,
24. Tme of Dealh 25. Date Pronounced Dead (Month. day, year)
/1 :cJO -f.M Ma 27 2007
26. Was Case RefefJed to Medical Examiner I Coroner lor a Reason Other ItIan CNmation or Donation?
OY.. ONo
CAUSE OF DEATH (See lnetructiGM end eumplea)
I1Qm 27. Pari I: Enler #le~ -~,~, Of compIIcalians Ihal dir'ecIIy caosedfltdeath. 00 NOT emertermioallNents such as card5ac arrest,
respiratory ilrfHl, or venlficular liIdaIion ~ showing Ihe etiOlogy. UsI only me cau&e on each line
=~~.t:I~ . Si.'-~ Sl~""'c,. S4~'OrO"\A,<!.
Duo~Io(O".~a~'lol),.~ '71
SeQuentialylistcondtions,i1Wfy, b. Ct"\GA.~i oor_
I8aitinolohcauseli$ledonlrlea
E_hUNOElllYIlGCAIISE ~101 ~~oI),
=~lfl~~re ~.~
Duo.. 1 a~oI),
Ii
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32f. IlTransportalon"'"" (SpociIy)
o "'"""lOpe",,,,, 0 Passenga< Op-
M. Olhe<._
33a. Certifier (check only one) 33b.
=r:r==:~~::"oo~~:..c~=~~..~~..a~..~~~~..~_......___.................... 0 ...
. PrOAOUnCtng and certifying physic.. (Physician boil pronouncing death and certifying to cause of dealh) ~ 33c. license
. ~u:..~:.: =' cIHlh occ:wrtd..the timI, dIIt, and pAace, and due 10 the ClUse(.) and manner as ltllecL............................ - - - .A.\t>'t-~;~ .
On the bIsIs of examination and lor JnveltigaUon, in my opinion, death CKCuned II the time, ate, and place, and due to the ClUN(I) and I1\IftIW II st.lecL 0 34. Name and~ess of Person Wb8 CompIeled Cause of Death (Hem 27)
f"\Vc."'~ Jq....~.....
':>0.1 II. .: I S' SJre..1
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OY"~No
. ApprOKimatelrdeNaI:
: Onsello OealtJ
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Part II: Enterolhwsill'lilicanl!condiIionI~k:l~
but not resuling in 1helRi8ftyingc:&uM gNren It Part I
28. Did TobIa:o Use ~ to 0eaI\?
DYes OP_
ONo~
29.>> Female:
~pt~l""iIhirlpaslyeat
o P,_al lime 01_
o NoIpr~,butpr~wiltWt42lJaY5
ol_
0"'",_."",,,,_,,,..,...,_
beIoro.....
0-.",__........_
"" Place 01 """" Home. Fann, Skeel. Fadoly.
~1luOing."'.(SpociIy)
~
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301. Was an AWlpsy
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DYes JSt'o
3CIl._AulopoyF.... "_ofDaalh
~v=~~~Ih~1ioo .~Nalural DHon\iOOe
0- 0 PanOnglnv_
OSuocide OC"",,,NolbeDelamvnad
32d. Tmeof"*"Y
32g. l"""""'oI "'"" 1_, cilyl_._1
o
Disposition Permit No.
LAST WILL AND TESTAMENT
OF
OLIVE M. HUMBERT
I, OLIVE M. HUMBERT, ofthe Township of Upper Allen, County of Cumberland
and State of Pennsylvania, being of sound and disposing mind, memory and understanding,
do make, publish and declare this my Last Will and Testament, hereby revoking and making
void any and all former Wills by me at any time heretofore made.
1.
,_.._,
'---.~.~ '~~.....;
I direct the payment of all my just debts and funeral expenses as soon after,ttfy
--,.. ,,-,
,..":.' c."._
decease as the same can be conveniently done.
l......j
2.
'1
(
I give and bequeath all my household furniture, personal belongings and tangible C
personal property, to my brother, RICHARD W. HUMBERT.
3.
I give and bequeath seventy (70%) per cent. of my residuary estate then remaining, to
my brother, RICHARD W. HUMBERT.
4.
I give and bequeath the remaining thirty (30%) per cent. of my estate to my sister,
DOROTHY A. VARNER, my sister, MABEL A. HESS, my brother, ELMER
HUMBERT and to my sister, EFFIE M. CLARK, or to the survivor of said four (4)
- 1 -
legatees, should any of them predecease me, share and share alike.
LASTLY, I nominate, constitute and appoint my brother, RICHARD W.
HUMBERT Executor of this my Last Will and Testament and direct that he be excused
from posting bond or other security for the faithful performance of his duties, in any
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
day of
September, A. D. 2004.
I,..., ,
. L.;/ ~~ 'VrJ ,
Olive M. Humbert
I~
(SEAL)
Signed, sealed, published and declared by the above named OLIVE M. HUMBERT
as and for her Last Will and Testament, in the presence of us who have subscribed our
names hereto as witnesses, at her request, in her presence and in the presence of each other.
-2-
OATH OF NON-SUBSCRIBING WITNESS(ES)
Cumberland
REGISTER OF WILLS
COUNTY, PENNSYLVANIA
C)I-O/-S"(O
Estate of Olive M. Humbert
. Deceased
Richard W. Humbert
and Lorraine L. Humbert
(each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were well-
acquainted with Olive M. Humbert and am/are familiar
with the handwriting and signature of the decedent, and that the signature of Olive M. Humbert
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
Olive M. Humbert is in his/her own proper handwriting.
~~//I/ U;-
102 James Street
(Street Address)
~L )I~~
~ 'gnature)
102 James Street
(Street Address)
Leola
(City, State, Zip)
PA
17540
Leola
(City, State, Zip)
PA
17540
Executed in Register's OffICe
Sworn to or affirmed and subscribed
\ -\-\..-
before me this ~ day
of Jl..LN"\C> , ~()01 .
r,-,
C,')
c."
Form RW-04 rev. 10.13.06