HomeMy WebLinkAbout08-29-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
also known as
FileNumber~ I-Ol-O~O;L
Estate of BONNIE H. ROSE
, Deceased
Social Security Number 206-32-0747
Petitioner(s), who is/arc 18 years of age or older. apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
[{] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / arc the CO-EXECUTORS
last Will of the Decedent dated AUGUST 16,2007 and eodieil(s) dated
'... )
c .; named in the;
"II
(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 ofthe:;i~sirumellt(s) offered
for probate, \vas not the victim of a kiJling and was never adjudicated an incapacitated person: _oj '_-':J
o B. Grant of Letters of Administration
C',
(lfapplicable, enter: c.I.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 db.n.c.t.a., enter date of Will in Section A above and complete list ofheirs.)
Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in CUMBERLAND
27 FAIRFIELD STREET, CARLISLE, PA 17013
(List street address, townleity, township, county, state, ~ip code)
County, Pennsylvania with his / her last principal residence at
Decedent, then 65
years of age, died on AUGUST 22, 2007
at CARLISLE REGIONAL MEDICAL CENTER
Decedent at death owned property with estimated values as fiJllows:
(I I' domiciled in P A) All personal property
(lfnot domiciled in PA) Personal property in Pennsylvania
(lfnot domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
25,000.00
125,000.00
situated as follows: 27 FAIRFIELD STREET, CARLISLE, PA 17013
Wheret(lre, Petltioner(s) respectfully request(s) the prohate of the last Will and Codlcil(s) presented with this Petition and the grant of letters in the appropnate form to
the undersigned
T ed or rinted name and residence
CYNTHIA L. DARR
7 HAMILTON ROAD, CARLISLE, PA 17013
JODI L. WHISTLER
134 HASSINGER ROAD, NEWBURG, PA 17240
Form RW-02 rev. 10.13.06
Page I 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 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
/) Cyf U
before me the (;1\ day of
a~* . (}..C01 ,
,-,0' L~ ~ QA..~ ~J CJcPXt-(j
I For the Register Signature of Personal Representative
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File Number: c:l\-C;l-O\50a.
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Estate of BONNIE H. ROSE
, Deceased
Social Security Number: 206-32-0747 Date of Death: 08-22-2007
AN D NO W, Cl~ 8c'1 ,CJci:) 7 , ; ",o",;d"at;oo of Ihdo"go;og P"tltoo, "'t,,,oto'1' pmof
having been presented fore me, IT IS DECREED that Letters TESTAMENTARY
are hereby granted to CYNTHIA L. DARR and JODI L. WHISTLER
in the above estate
and that the instrument(s) dated AUGUST 16,2007
described in the Petition be admitted to probate and filed ofre~or& ~s the la,;;t Will ~lind Codicil(s)) ofpecede?t.
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FEES i ".{ ~nOlo- lL{,
Register 0
Letters ...............
$t9LQO .CD
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Attorney Signature:
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......... $
W\\\ $ IS-.~
, \CP $ \0 LV
C' ~A~ -t ~L'CJ(()'f'..-; $ C:-~ <-50
$
$
$
$
$
$
TOTAL ........ . . . . . . $
Attorney Name:
WILLIAM A. DUNCAN
Supreme Court J.D. No.: 22080
Address:
1 IRVINE ROW
CARLISLE, PA 17013
Telephone:
717-249-7780
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Form RW-II] rev. 111.13.116
Page 2 of2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this coPy bV photostat or photograph..
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13745438
2007
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H105-H3 REV 11/2006
TYPE I PRINT IN
PERMANENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
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C'l
8b COUfllyol Death
80. Fac:ililyName (II not ins!i1u!ion, give slreet and number)
STATE FILE NUMBER
1. Name 01 Decedent (First. middle, lasl, suffix I
v"
BONNIE H. ROSE
6. Date of Birth (Month, day, year)
32-0747
2007
5. Age {lasl Birthday)
65
Augu s t 29, 1941
Carlisle, Pa
o Nursing Home 0 Residence OOthe!. Specify
9 Was Deceden! 01 Hispanic Origin? KJ No 0 Yes 10. Race: American Indian, Black, White, elc.
(ll yes. specifyCubarl, (Specify)
Mexican, Puerto Ricarl, elc.) Wh i t e
Cumberland
Carilsle Regional Medical Center
11. Decedent's Usual Occu alinn Kind ot work done duri mosl 01 worki life. Do i'lOt slate refired
Kind 01 Work Kind of Business I Irrdustry
Secretar Manufacturin
- 16. Decedent's Maiting Address (Street, city Itowrr, state, zip code)
27 Fairfield Street
Carlisle, Pa 17013
12. Was Decedent ever H'I the 13. Decedent's Education (Specify only highest grade completed) 14. Marital Status: Married. Never Married,
U.S. Armed Forces? Elementary I Secondary (0-12) Coilege (H or 5+) Widowed, Divorced lSpecify)
Dv" IK]No ------12----- ------------- Widowed
Decedent's
Actual Residence 17a. State
t7b. Counly
Pennsylvania
Cumberland
Did Decedent
li....eina
Township?
17c.89 Yes, Decedent lived in South Middleton
t 70. 0 No, Decedent Lived within
ActualUmitsof
Twp
18. Father's NamelFirsl, middle, last, suHI~)
Vnaldra D. Hockenberry
Cily/Boro
20a. Informanl'sName (Type/Prinl)
Cynthia Darr
19. Mother's Name (First, middle, maiden surname)
Dorothy Penner
. ~ {
20b. Informant's Mailing Address (Streel, city I town, state, zip code)
7 Hamilton Road, Boiling Springs, Pa 17007
o
~
~
~
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21c. Place o~ Disposition (Name of cemetery, crematory Of other place)
21d.localion ICity/town, state, zip code)
Hollinger Fnneral HarE & Crematory Inc.
22c. Name and Address of Facility
Mt. Holly Springs, Pa 17065
Ronan Funeral HarE 255 York Road, Carlisle, Pa 17013
I-I./>O 7Cr3 Z L L
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23b. License Number
Items 24-26 must be completed by persOfl
whoprollOUncesdeath.
26. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cremation or Donation?
CAUSE OF OEATH (See instructions and examp es)
Item 27. Part I: Entel the ~ - diseases, injuries, or comp/ications- that directly caused the death, DO NOT enter terminal events sl.lGh as cardiac arrest,
respiratory arresl,orventricularlibrillation wilhoul showing the et iology. List ooly Of18 cause on each line
~~~~~:;e~&t~n~~~ ~~~\ dise~
Appro~imale inlerval:
Onset to Death
DYes ~o
Part II: Enter other sionificant conditions r.ontrltxJtino to death, 28. ~ Jibacco Use C01ltribule \0 Death?
but nol resultirlg in the underiying cause given in Part 1. GIVes OPrOOably
o No 0 Unknown
29. If Female
o Not pregMntwithin past year
o Pregnanl at time of death
o Not pregMn!,but pregnant within 42 days
01 death
o Not pregnant, but pregnanl 43 days to 1 year
beloredeath
D Unknown ilpregnant within the pasl year
32c. Placeo/lnjury: Home, Farm, Street, Factory,
Office Building, etc. (Specify)
Dv" Q(No
DYes [;}'No
31. MannerotDeath
[U.1faiural o Homicide
o Accident DPendinglnvestigalion
o Suicide D Cooid Not be Determined
32d. Tlmeo!lrrjury
oJ
Sequentiallh list condhioos, d any,
~~1~~~~0 JNeD~~r~I~~e~~U~Ee a
(diseaseorinjurythatimtiatedlhe
evenls resuNlngIn deatlJ) LAST.
'1
o
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30a.WasanAutapsy
Perfol'lTllld'J
JOb. Were Autapsy Findings
A....ailable Prior to Completioo
o!Causeof Deatt1?
M.
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33a Certilier(check onlyonej
Certifying physician IPt1yslcian certifying cause of death when another ph ysician has pronounced death and completed Item 23)
To Ihe besl or my knowledge, death occurred due tathe cause(s) and manner as stated.- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D
~~~~u:~~~la~~ ~~~=~hJ:~~~a~c~;:r:~~ t~:~,~~:~:n~n~e;'~C~~~~~~nio!~hc:~~:;~(~~a~~~ manner as statecL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
Medical E~amlner/Coroner
On the basis of examinalion and I or invesligalion, in my opinion, death occurred at the time, date, and place, and due 10 lhe cause(s) and manner as steted_ 0
1j,llldlllOI
DispOSition Permit No
LAST WILL
&
TESTAMENT
I, BONNIE H. ROSE, of 27 Fairview Street, Carlisle, Cumberland County, Commonwealth
of 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 any and all other
wills and codicils heretofore made by me.
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FIRST. I direct that all my just debts and funeral expenses be paid from my~l<tstate ~~
soon after my death as practically and conveniently may be done. . , r)
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SECOND. I direct that my remains be cremated and disposed of by my familyin a~~Drd
with my expressed wishes. !.')
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THIRD. I authorize my personal representative to expend funds from my estate, inc~uch
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath all of my estate of whatever nature, be it real,
personal or mixed, and wherever situate unto my children: JODI L. WHISTLER, CYNTHIA L.
DARR, BRENDA L. ROSE and ROBERT L. ROSE, JR., in equal shares, per stirpes.
FIFTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my
estate passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
SIXTH I hereby nominate, constitute and appoint JODI L. WHISTLER and CYNTHIA
L. DARR as Co-Executors of this my Last Will and Testament I hereby relieve my Co-
Executors from the necessity of posting security in connection with their duties, as such, in any
jurisdiction in which they may be called upon to act insofar as I am able by law to do so. In
addition to the powers conferred by law, I authorize my Co-Executors, in their absolute
discretion, to retain in the form received, and to sell either at public or private sale any real or
personal property owned by me at the time of my death.
SEVENTH. If any of the beneficiaries of this, my Last Will and Testament, shall be
under the age of Twenty-Five (25) at the time of my death, then any portion of my estate in
which they share shall be held in trust for them with ROBERT L. ROSE, JR. as Trustee. The
trusteeship shall end when the child attains the age of twenty-five (25) years. As Trustee,
ROBERT L. ROSE, JR. shall provide for the care, maintenance and education of said children
and shall from time to time use either principal or income from the inheritance to provide for
these needs.
EIGHTH. I have made, or may from time to time make, a written memorandum
expressing my desire to give certain items of personal property to specific persons. I urge my
Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be
stored in conjunction with this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Wi
Testament, consisting of two typewritten pages this ,It? day of
,2007.
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BONNIE H. ROSE
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Signed, sealed published and declared by the above named Testatrix BONNIE H. ROSE as and
for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
V\}-t'Y '
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COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I, BONNIE H. ROSE, Testatrix 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 Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
p~ fI f(~
BONNIE H. ROSE
Sworn or affirmed to and
acknowledged before me, by
BONNIE H. ROSE this J (g day
of {\." . j ,2007.
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ci~~iC d Jt)t\i'm,moJ
No'nul SnI
Kathy L. Mwnmert, Notary Public
Carlisle Borough, Cumberland County, PA
My Commission Expires August I I, 201 I
COMMONWEALTH OF PENNSYLVANIA
:SS.
COUNTY OF CUMBERLAND
We, \V;tlt~m. f\' D0~\(Qll and -SOOC\ 1) f\-dums
the witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw BONNIE H. ROSE
sign and execute the instrument as her Last Will; that she signed willingly and that she executed
as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the
Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no
constraint or undue influence.
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Sworn or affirmed to and
subscribed before me by
Lv (' I ! (' OJ"(\ A DuV\. (oJ\. and
-S dO (\D f-\1CA IA:9
, witnesses,
this 16 day of P\U5 i)") (' ,2007.
<~ c} rY\~.
Notary ~
NofariaI Seal
Kathy L. M1IDmert, Noeary Public:
Carlisle Borough, Cumberllnd County, PA
My Commission Expires August 11,2011