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Home My WebLink About08-16-07 PETITION FOR PROBATE AND GRANT OF LETTERS COUNTY, PENNSYLVANIA File Number 21-07- !)'1'1S REGISTER OF WILLS OF Estate of Edward Anthony Born also known as CUMBERLAND , Deceased Social Security Number 209-22-2215 Jacqueline L. Born Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) 00 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the last Will of the Decedent, dated 08/10/1979 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 (If applicable, enter: c.I.a.; d.b.n.c.t.a.; pedente me; durante absentia; durante mmontate) 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 Relationship Residence w .c:- (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his / her last principal residence at 4 Sussex Road, Camp Hill, Lower Allen, Cumberland, PA 17011 (List street address, town/city, township, county, state, zip code) Decedent, then 75 years of age, died on 07/27/2007 at 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 situated as follows: 49,000.00 $ $ $ $ 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: Typed or printed name and residence Jacqueline L. Born 4 Sussex Road Camp Hill, PA 17011 Form Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of2 Oath of Personal Representative } SS } COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland 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. before me this day of '7 Sworn to or affirmed and subscribed Signature of Personal Representative o ::.0 ;--";""1 . ~'-T:: C") ,.-,':<.;'Tl .~----: ::(:.\ (j;: :~.;<::.:. ~ = ......... ;po. r- r.-) 0'\ ., Signature of Personal Representative .;~) C~) '~"-''1 :0-:-- ,I I '. '- - :::q -'-') co w .c- File Number: 21-07- oq,$" Estate of Edward Anthony Born , Deceased Social Security Number: 209-22-2215 Date of Death: 07/27/2007 AND NOW, IlJ :trot , in consideration of the foregoing Petition, satisfactory proof Testamentary are hereby granted to Jacqueline L. Born in the above estate and that the instrument(s) dated 08/10/1979 described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent. FEES Letters..........~...OO~.......... $ Short Certificate(S).......~............. $ 90.0b ~ DC JJh1\UVlV--.-~~(A1j)L~ AlIomey S~oat",e flVJJJ Z ,;bp Attorney Name: Michael L. Bangs Renunciation(s)............................. $ W\\\ $ IS DO ~Cr $ lOcD ~ --\0 $ S Ob $ Supreme Court I.D. No.: 41263 Address: 429 South 18th Street $ $ $ $ $ Camp Hill, PA 17011 Telephone: 717/730-7310 TOTAL.................................... $ \ J800 Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 H105.805 REV 101/071 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. 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. Fee for this certificate, $6.00 jU~ 3 1 ~07 Date Issued P 13770810 ~~g~' Certification Number l'.) = <= -.l :eo- c en C) So "'- :.0 . ',"-0 :~;IP ,.:;: fTl ",:J;~ Joo )Q-Tl .J'-- . ::D ::u--l ..;> en :0- :x co w . COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH (See Instructions snd .xsmples on renrss) ,1 RE\ll1l2OOll ; 1 PRINT IN 'lMANENT .AC1(lN!( l._oI_(firS._.IlIsI.tuIIx) Edward Anthony Born 5. "I' (Last Bithday) 75 v"- 81>. County of lleattl . Cumberland 14.=:~Married. 15. &JrviYlngSpouse ("wife. give_name) Married acqueline L. Wilce ~~I 17C.~Ves._LivedInLower Allen Township? 17d.O No. __ Lived_ AcIuaIL.Inilsol _01 ".OOnot_ U.~~1n<Ulry 11._'Usual Klndol__ Civil ~mce Pennsylvania Cumberland . 16.-.r.MslIIngAddN88(SheI,cHyl_......zIp-) 4 Sussex Road Camp Hill. Pennsylvania 17011 18. F_S_(firS._. 1881, IlJlIil<l Matthew Borinski 208.\llfllnlIII'4'._ITypeIPllnl) Ms. Christine L. Born 21a._0I1l1opoolllon Top. 17b. County Cllyf_ 19._' N8me (firS._._sumame) Anna Hassa 2llb.inklnnant'sMaillng_lSlrall,cilyl_._.zIp_1 11195 StonebrookDrive. Manassas. 21~ Place 01 0l0p00Ill0n (Name 01_. CIaIMDy or_place) $. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cremation or Donation? Ov.. ONo PartU:..EnleIl'other~r.mrMwJ.c:mIrbiilo:lDdIIdh 28.OIdTob8cco~~etoOealh? IMAnoImUllnvlnlhelJldel1jlngcause!ivOninP811L 0 V.. ~ o No 0 lJnkncwn 29."_: o NoIIlIAIJ1anl-peIIl"'" o PrllgnanlBtllmeol_ o NoIIlIAIJ1anl.butlllAlJ1anl_42d1ys ol_ D NoIIlIAIJ1anl.butlllAlJ1anl43d1ystol year -- OU_HllIAIJ1anlwllhinlhepostjllllr 32~ Place 01 Injury. ...... Fann. _. Fac\oly. 0lIicll1kMng. ate. (~) ,\ppIolcillIIta- 0nsaI to Ilealh =~=)-:;. ~~-=~~a _Iho UNDEIIlY1llG CAUSE =-~~~~ c. Due 10 (or as a COIllllICllJOII 01): d. 3lI>. _ AuIopoy FlncIngo A_ _to Comt>eIlon 01 Cause 0I1lealh? o v.. ~. 31. __ 01 Ooath ~O- o _I 0 PandIng Inwsllgalion 0- OCooldNolbellelemllnad :lOa. was an AuIopoy - 3211. LocaIlOn oIlnju~ ISlIllat. cily llown. slale} 32d. Tine oIlnj\J1y Ov.. ~ M. 33&. Ce<lIfillr (oheCk <<*/ one) . COIItfyfng p1IyIlc1oI1 (PI1ys<l8n COItifying cause 01_ when anoIher physidan haap_ _ and compJated IIeln 23) Tollltbetlofmylcnowladgt,- _duetollltcauoo(.)snd -.. -- - - - - --- - - -- - - - -- - - - - - - - -- - -- - - -- . ===':=~~:"~snd~=loto:-~=ma_..___________________ 0 . ::: ='=sndlorilw8ltlgat1on, In myoplnlon,__ a1thetlme, _snd~, sndduelollltcauoo(.)snd-" -- 0 3S.RllgIs1rar'.~1II1d1llslrlclHuJi?) ~ .. .~ /',/ . lott Ilispoeillon PonnR No. ~,,~~,...c.,...,..-"---...-,.-.._-~ '; 'W, !:gPnW 1t~., ~-- f#:, ,l'Jl ..... .. c') C;o :0 -', ':::to 't>i- ---:--;r fii 1-....;) ~5 -..' .:::.:.~ GJ BE IT RIM" BBDD 'l'RAT :.:- 'J , '~c'" 0\ r,--) 1"--..., " ,.-, ~-' :r". I, EDWARD A. BOD, of the County of CUllberland and ~lth Df -).....; -- ._Q --/ 9? " I penn.ylvania, beinq of sound Iliad, ....ry and UftderstandiD9, do wik., pabUsh ana .s:- declare this to be w.y LIST WILL aDd '.fBS'1'JII Blft', benby rnokiR9 aDd -.Jtiaq DUll and 'WOid BY aDd all 1Iills aad COdicil., or writiDqa 1a ~ aaUIre tMno~, at allY ti_ bereto~ore ad_ by M. PlRS'.f: As w.y personal repr..entati..., I lIOIIiaate and appoint w.y wife, JACQUBLIRE L. BORN, to be the Ex.cutrix of thi. LAS'.f WILL. In the ...t JACQtELItIB L. BORN i. unable or cease. to act for any na.on whatsoever, I noainate and ap- point MICHAEL M. BORIRSlCI to succeed as Executor of this LIST WILL. SECOIID: I direct that lIlY debt. and fun.ral .xpen... be paid a. soon after ay death a. is practicabl. by lIlY Executrix out of ay ..tate, but not from any a...ts, funds, death bene~i ts or insurance proceed. which are otherwi.. .x. cludabl. or exe.pt f..- w.y gro.. estate for federal ..tate valuation or tax purpo.... 'l'RIRD: I direct that all estate, succes.ion, legacy, inheritance or other trusf.r tax.., hoInIver designated, that .hall beCOM payable by reaeon of lIlY death in nspect .f all property COIIIPri.iD9 w.y gros. .state for death tax purposes, whether or not such property passes Uftder this LAS'.f WILL, .hall be paid by way Executrix out of lIlY estate, but not from any a...ts, funds, death benefit. or in.uranc. proceed. which are otherwise excludable or ex.rpt from w.y 9J:O.. .state for federal tax purpos... 1loT")u~ 1- "'1''11 ~ 1DUR'.fR: ~ IIY expres. d_in and I hereby authorize aDd direct IIY Executrix to arraDCJe for lIlY Olited States Air Ibrce id_tification ta98, lIlY baseball UOphy, and w.y red wao4en .haf~ qolf ~r to be l:Nried with_~ PIPfth I give, devise add bequeath all of lIlY .state, both nal and peZ'IIODal, vherrftr .ituate, in which I may have any interest at the tu. of Jay death, lncludiD9 any property over which I ...y haft a power of appoin~t, to 'aY wif., JACQtELDIB A. BOD. s:rx~; In the event that my wt:ee fatls to survtve mef then I gtvef devtse and bequeath all of my estate, both real and persona1f wherever sttuate, tn which I may have any interest at the tbne of my death, tncludtng any property over which I'may have a power of appointment, to my daughter, CHRISTINE L~ BORN. SEV'EN'l'lh :en the event my rite and daughter fail to survive me, then I give, devise and ~equeath all my estate, real and personal, wherever situate, to my descendants per stirpes, their heirs and assigns forever. EIGHTH: If any part of my estate shall vest in a person under twenty- one (21) years of age, the Executrix may, with absolute discretion, deltver such part, or any portion thereof, without bond, to the parent or guardian of such person to be held for such person until he or she reaches twenty....one (21) years of age. The receipt of such parent or guardian shall be a complete discharge and acquittance of the Executrix and shall be final and binding on all persons in interest. N~H; II any legatee, beneficiary, or devisee other than my wife shall fa!). to survive me by thirty (301 days, I direct that I shall be deemed to have sur~ived such legatee, beneficiary or devisee and that this LAST WILL and all tts pX'Qvi:smnsf except where spectfica11y stated otherwisef shall be construed on t~ assumption notwithstanding the provisions of any law establishing a con- trary presUmption. TENTH; ~ direct that no Executrix or Executor nominated and appointed by the pJ:1ovtsions of this LAST WILL shall be required to give any bond or post any secut'ity, and that if, notwithstanding this direction, any bond or security is requn-ed by any law or order of court, no sureties be requi.red thereon. , ( ~. E~.: I' direct that my Executrix or Executor, whenever they may need legal counsel tn the settlement of my estate for the purposes ex- pressed. in .DJY' UST W!I.L consult ALBERT Z. BOGERT, ESOUIRE, he having intimate knowledge of -my affairs, views and wishes in many matters that may arise in the settlement afmy estate. I'N ~S WHEREOFf I have subsc:dbed my name and affixed my seal this 10 d day of ~7 UA-4f- ,1979, ~1lM II. j;;;;:J EDWARD A. BORN COMMONWEALTH OF PENNSYLVANIA ss. CoUNTY OF CUMBERLAND I, EDWARD A. BORN, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I' signed and executed the instrument as my LAST WILLi that I signed it willingly, and that I' signed it as my free and voluntary act for the purposes there:tn expressed. ~fkZd I).~ EDWARD A. BORN Sworn or affirmed to and acknowledged before me, by EDWARD A. BORN, Testator this /0 'I::h day Of~.-..4-;g- ,1979. ~~4 -y Notary Public 7" ANITA L BOGC'RT, Nofary Pubiic Mechenic,L .,\,, c"~!,, rl.-nd C".. Pa. My Coll'mihion bp"'" Aug. ,29, tnfl tj g I AFFIDAVIT . . COMMONWEALTH OF . PENNSYLVANIA COUNTY OF CUMBERMNP We, .1M 3E tf-{ 2. BOfE- K-c/, 4, and 12-ob~r~ 0 II") y\ LeG , the witnesses whose names are signed to the attached or foregoing instrument, being duly quaUfied according to laW'r do depose and say that we were present and saw Testator sign and execute the instrument as his LAST WILL; that EDWARD A. EQRN signed willingly and that he' executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the ~LL as witnesses; and that to the best of our knowledge the Testator was at the time 18 years or more of age, of sound mind and under no cons- traint or undue influence. /~..;7G5.~. ~ . t;7 LZ '. fia,<w~~ .~~./ Sworn Qr affirmed to and acknowledged before me this ~d~ day of ~ ,1979. ~X Notary Public ANITA r. BOGERT, JIlotary Publio Mechenicsburg, Cu!'\berlend Co.. Pa. My Colllmiasion Expires Aug. 29. JJWfJ981