HomeMy WebLinkAbout09-26-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYLVANIA
Estate of Tona R. Gabbard
File Number d I - 0,- (\~f( J
also known as
, Deceased
551-77-1058
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
( -)
-_,---.i
o A. PI"obate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the
last Will ofthc Decedent dated and codicil(s) dated
n,\ll1l;d in the
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
Exccpt as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution oftheinstrument(s) o~~ed
for probate, was not the victim ofa killing and was never adjudicated an incapacitated person:
..L:) (/1&7
I]J B.GrantofLettersofAdministration~1"I~ -+-^ 1.:........ '2r.nA _C
(lfapplicable, enter: c.I.a.; d.b.l1.c.t.a.; pendente lite; durante absentia; durante minoritate)
Petitioner(* after a proper search hasXK~X 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.et.a., enter date of Will in Section A above and complete list of heirs.)
I Name Relationship Residence I
Carl T. Gabbard, Jr. Husband 4506 Woods Way, Mechanicsburg,PA 1
Brianna Mae Gabbard Daughter 4506 Woods Way, Mechanicsburg,PA 1
Jacob Orville Gabbard Son 4506 Woods Way, Mechanicsburg,PA 1
7055
7055
7055
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent \I,'as domiciled at dt:a1h..ip Cumberland _ County, Pennsylvania with RiX/ her last principal residence at 4506 Woods Way
MechanlcsDurg, PA l/UJS-
(List street address, town/city, township, county, state, zip code)
Decedent, then
39
years of age, died on May 21, 2007
at
M:S. Hershey Medical Center
Decedcnt at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
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:
T ed or rinted name and residence
Carl T. Gabbard Jr.-4506 Woods Wa , Mechanicsbur , PA 17055
Form RW-02 rev. 10.13.06 Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF.
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
before me the Z 19-t- L~ day of
~un\~,- . 2(x)1
~~ -~~~
o \ If For the Register
-I
Signature of Personal Representative
~~.
- . \Signature of Personal Representative
r'" ';
t..1 ,
I~'
{}
File Number: 6< I - 01 . 0 '/6/
Estate of
Tona R. Gabbard
, Deceased
Social Security Number: 551-77-1058
AND NOW, (.,be p::.x.-mJu/'-. /) (0 , c9.oo /
having been presented before me, IT IS DECREED that Letters
are hereby granted to Carl T. Gabbard, Jr.
Date of Death: May 21, 2007
, in consideration of the foregoing Petition, satisfactory proof
in the above estate
Letters ............... $ ,"0 0 . CO
Short Certificate(s) . . .. . . . . $ ~~O(,b
Renunciation(s) .......... $
~(!p ... $
l\l),--tn,\"~,--"t; D--(\ . . . $
.. . $
$
$
... $
. .. $
$
$
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
Jft. to ~~t
;:;_Hft-) .
Attorney Signature: __ ~
2_.4
Attorney Name: ~ F. McLaughlin,
FEES
~
10 cv
<;.<..0
III, Esq.
Supreme Court I.D. No.: 25039
Address:
n?l npK~lh Srrppr
Norristown, PA
19401
610-272-4600
Telephone:
TOTAL
$ SS.(,C) ~
Form RW-02 rev. ]0.1306
Page 2 of2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING' It is illegal to duplicate this copy by photostat or photograph.
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1105.143 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)
STATE FilE NUMBER
1. Nama of Deceo.lenl (Flr:;t, middle, last. :;ulll~)
TONA R.
GABBARD
5, Age (las1 BU1hday)
6 Date 01 8111n (Month, day, year)
- 39 y"
1967
Fort Bragg, NC
Bb COUfltyot Dealtl
8Cl Facility Name (11 not Instltullon, gl'o'e slreel and liumber)
Dau
,S, Hershey Medical Center
t2. Was Decedent ever inlhe
us Armed Forces?
Dv" DINo
13, Decedent's Education (Speclty only highasl grade completed)
Elemenlary I Secondary (0-12) College (1-4 Or 5+)
12 1
4506 Woods Way
Mechanicsburg, PA 17055
Decedent's
Aclu.i:lIResidence 17a Slale
Penna.
Cumberland
17b Counly
18 Falher's Name (FIrSl, mlddte, last, sulllx)
James G. Ra mond, Jr.
20a Inlmmanfs Name (Type I Pnnt)
Carl T. Gabbard, Jr.
19, Mother's Name (first, middle, maiden surname)
JoCarol Hora
2Qb, lntOfmanl's Mailing Address (Slreet, clly flown, stale, lip code)
21d, Localion (City I town, state, lip coda)
4. Date of Death (Month, day, year)
77 - 1058
Ma 21, 2007
Otrlel
o Nursing Home 0 Residence OOlher. Specify
9. Was Decedenl at HispaniC Origin? em No 0 Ves 10. Race AJTlerican Indian, Black, While. ate
~:'~:;~~~~:;;,e1C) ISpecllj1 white
14. Mantal Status: Marued, Never Mafllw,
Widowed, Divorced (Speci/y)
married
T. Gabbard, Jr.
Lower Allen
Twp
17e.X):ves, Decedent Lived in
17d. D No, Oecedentli'fed within
ActualUmilsol
Clty/Soro
4506 Woods Wa , Mechanicsbur , PA 17055
a
~
00
~
~
::i
22c. Name and Address of Facillly
21b Dilte 01 DiSpoSition (Month, day, year) 21c, Place of DispoSllioll (Name 01 cemetery, crematory or olher place)
Harrisburg, PA 17112
Hoover F H & Crematory, Inc.
Inc.
POBox
Hoover Funeral Home & Cremator
Items 24.26 must be rompleted by person
. who pronounces dealh
24. Time of Dealh
. \ \ So \)<V\
M
)..0 c, 7
CAUSE OF DEATH (See Instructions and examples)
Item 27, Pan I: Enter Ihe r,;,t)gJn Q! 11~ - diseases, inluries, or complications - that directly caused Ihe death 00 NOT enter ternimal events such as W!(diac arresl,
respuatory arresl, or ventnculallib'llIallon wilhout showin91he ellology. Ust ooly OM cause on eaen tine
Approximale Interval:
Ooselto Death
~:~tPc;~~e;S1~n~~~ d~:I) dise:;
\ ) (I-. '-, (' "I. \ h , Z\ {( l ~ <\
D", 10 ~ a coo;e,",o"oI1
b '.( (>..,J'\ '\ \,\.:v...l.I'"",,"(;...
Due~r as d consequence ~
-(t,__\"<, t;;'\.}.... \k
Due to (or as a consequence otl
Sequenlially list conditionS, if any
~~t~I~~~O S:DERl~I~~~rU~~ a
(disease or IfIjury lhallnlllateO lhe
events resultlllg III death) lAST.
30a Was an AU10PSY
Pertormed?
:JOb Were Aul0psy Fmdmgs
Avarlable Prior 10 Complelion
01 Cause 01 Dealh?
31. Manner of Dealh
~atural o Homicide
o Acciat.nt 0 Pendmg tnvestiga110n
o SUicide 0 Cuuld Not be Determmed
M
~ves DNo
DVes ~NO
32d Tlmeo! Infury
33a Certifier (c1It'Ck onty one)
Certifying physician (PhySICian certifying cause of death when anottler phySICian has pronounced dealh and CGmpleted Item 23)
To the besl of my knowledge, dealh occurred due 10 Ihe cause(sj and manner as slilte<L _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D
Pronouncing and cerlifying phyaician (PhYSician both plOOOUl'IClflg dei:lth and certitYlng 10 cause at death)
To lhe best of my knowledge, dealh occurred al the lime, date, and place, and due 10 the cause(s) and manner as staled_ _ _ _ _ _ _ _ _ - - - - - - - - -
~~~~:~;:~sm~;::~~~::I~:~ and I or investigation, in my opinion, death occurred at the lime, date, and ptace, and due 10 the cause(s) and manner as slated_ 0
PA 17033
23li. license Number
26. Wasj;ase ReI [fed to Medical Examiner I CoronellOf a Reason Other lhan Cremation or Donation?
'l'Jv.~t No
PaIlU:Enterothe'~~,
but nol resulling in the underlying cause given in Pall I.
28 Old Tobacco Use Contribute to Death?
D Ves ...l:J-'ProoablY
~ 0 Unknown
29. II Female
G Not pregnanl within pasl year
o PJ"fnant at time of dealh
~ot pregnant, but pregnant within 42 days
01 death
D Not pregnant, but pregnant 43 days 10 1 year
beloredeath
o Unknown II ~e9nant Within lhe pasl year
32c. Place at Injury: Home, Farm, Slreel. Faclory,
Office Building, ele (Specify)
32g.localloooftnjury (Slieet, city/lawn. slale)
I ~ ~ J.l .:>-1 '(
\-
)4, Name and Address ot per~Wno Completed Cause 01 Death (Hem 27) Type I PUlll .
1\ ", 'vV::!V'- ~ QJ\j l}. ~ '<.Jv...c,'lJ'P, M,S, Hershey Medical elr,
.. '\ Hershey, PA 17033
OI~r()~III()Jl Pl'~illl1 ~ju