HomeMy WebLinkAbout10-22-07
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
File Number 21-07 - 0 q@
Estate of Helen C. Bender
also known as
, Deceased Social Security Number
211-22-6581
Timothy J. Fuhrman
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
I!l A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the
last Will of the Decedent, dated 12/03/1981 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:
D B. Grant of Letters of Administration
(If appllcaOle, enter. c,t.a; d.O.n.c.t.a.; pedente lite; durante aOsentla; 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
o
...::.::..:,)
(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
770 Poplar Church Road, Camp Hill, East Pennsboro Twp., Cumberland, PA 17011
(List street address, town/city, township, county, state, zip code)
Decedent, then 77 years of age, died on 10/02/2007 at
Decedent 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:
$
$
$
$
150,000.00
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
Timothy J. Fuhrman 9632 Carriage house Lane
Sandy, UT 84092-2549
Form
Rev. 10-13-2006
Copyright (cl 2006 form software only The Lackner Group, Inc,
Page 1 of 2
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
Oath of Personal Representative
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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
Timothy J. Fuhrman
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before me this ~ day of
,~7
Signature of Personal Representative
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Signature of Personal Representative
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File Number:
21-07- oQSa
Estate of Helen C. Bender
, Deceased
Social Security Number:
211-22-6581
Date of Death: 10/02/2007
AND NOW, , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Timothy J. Fuhrman
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent.
Letters...
$ 8.lo0.()O
8n.oO
FEES
Short Certificate(s)........................ $
Renunciation(s)...... ...................... $
Attorney Signature:
wd\
{\Cp
lhr\ 0 l'r\Cltt'r1v\
$ \5 .00
$ -,0. 00
$ - 00
n.
Attorney Name: Michael L. Bangs
Supreme Court I.D. No.: 41263
TOTAL...............
$
$
$
$
$
$
$ 3\{),OO
Address:
429 South 18th Street
Camp Hill, PA 17011
Telephone:
717/730-7310
Form RW-02 Rev. 10-13-2006
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 2 of 2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
fee for this certificate, $6.00
P 13859151
Certification Number
This is to certify that the information he-e given is
correctly copied from an original Certlfica.e of Death
duly filed with me as Local Registrar. Tle original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
OCT ~ 100/
I~.mg~ Date Issued
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REV 11/2006
. PRINT IN
~ANENT
CK INK
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reversal
STATE FILE NUMBER
,. Name of Decedent (First, middle. Ias!, suffix)
H. Carole
Bender
5 Age (La'1 BlrthdaYI
West Shore Health & Rehab
6. Dale of Birlt1 (Month, da, ar) 7. Birthplace (el and slale or
77
Yrs.
November 5, 1929 Johnstown, PA
Sd. Facility Name 111 not institution, rjve alreel and number)
Cumberland
Pennsboro Twp.
11.OecedenfsUsua1Occ tion Kinclolwork done du, moslof llIe.Oonotstaierelired
Kind 01 Work Kind 01 Business I Industry
Registered Nurse Healthcare
. 16. Decedent's ~ai11ng Address (Street, city flown, stale, zip code)
512 S. Arlington Avenue
Harrisburg, PA 17109
18. Father's Name (First, mickle, last, suffIX)
Thomas W. Bender
12. Was Decedenlever in the
U.S. Armed Forces?
DYes lXINo
Dtcedenrs
Actu8I Residence 178, Stale
17b. County
13. O._nr. Educat~ (Spedfy on~ hlghe.t grade compIe1sd)
Elementary f Secondary (0-12) College (1,4 or 5+)
12 4
Pennsylvania
Dauphin
3. Social security Number
211 - 22
6581
4. Dale of Death (Month, day, year)
October 2, 2007
8a. Place of Death (Check onty one)
Hospttal: Other:
o Inpatient 0 ER I Ou1pat~nt 0 DCA 1!9 Nursing Hom. 0 Residence oOth". Speoi~:
9. Was Decedent of Hispanic Origln? ~ No DYes 10. Race: American lillian, Bl&ck, Wh~e, ete.
(II yes, specify Cuban, (Sped/yI
Mexican, Puerto Rican, etc.) white
14. Marital Status: Married, Never Married,
W_sd, Olvo_ (Spociflj
Never Married
Twp.
Old Decedent
Live ina
Township?
Lower Paxton
Fe. IKI Yes, Decedenl Uved in
17d. 0 No, Dscedenl Lived within
ActusJLOlitsol
City/BolO
208. lnform&nYs Name (Type! Prinl)
Olivia B. Fuhrman
19. Mother's Name (RBI, middle, maiden surname)
Anne C. Plumkett
2Ob. Inmanrs Mailflg Address (Street, ctty! town, slale, zip code)
307 Sixteenth Street,
21c. Place 01 Disposition (Name of cemetel'y, crematory or other place)
Holy Cross Cemetery
New Cumberland, PA 17070
21d. Location (Crty I town, state, zip cocIe)
Swatara Twp., PA 17112
22c. Name and Address of Facility
Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
24. lime of Death
(y,5-0
AM
25. 0ll1S P""""""sd Dead (Month. dey, yssn
16.2,'<17
CAUSE OF DEATH (See Instruction. and examples)
lIem 27. Pari I: Enter the ~ - dseases. injuries. or complications - thet directly caused the death. 00 NOT enter terminal eventB such as C8JdIac arrest,
respiratory arrest, Of ventricular fibrillation wllhoul showing the eIioIogy. Us! only one caLIM on 8ICh irl.,
(,t <.: ut t.. Nt .F-o~.
b oueto(or~tn~lL. 6 b sf\..,-, L.
c. Ou.to(orasaconseque . or~I?&.s.:.~
ouelo~ti~i~o~ it\,
Approximate Interval:
Onset to Death
=-r:J.~~~ trm~ djse~
I
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I
""C'W-(/;~:
I
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I
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a.
~uen:r~~=,~ ~~ a.
Entsr 1: UNDERLYING CAUSE
(dsease Of i~ry that initiated Ihe
events resulting In death) LAST.
304. Was an Autopsy
Performed?
328. Dale of Injury (Month, day, year)
n. Were Al.IlopSy Findings
Available Prior 10 Completion
01 Cause 01 Dealt1/
DYes [3'No
o Hom"~.
o Accldenl 0 Pending Investigation
o S<olclde 0 C<oldd Nof be Oste""ned
DYes ~.
32d. Time of Injury
M.
338. Certilier(checicontyOll8)
Certlfytng physician (Physician certifying cause of death when another physician has pronounced death and completed nem 23)
To the Mslot my knowledge, death occurred due to the cauee(s)and manner as state<L _.... _.............................. _ _.......... _ _........ 0
Pronouncing and certlfyfng phytk:lan (Physician both pronooocing death and cerlilying 10 ca\JS& of death)
To the best of my knowledge, death occurred allhe time, datI, and place, and due 10 the cause(a) and manner as slated.. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. _
Medletl EllImlner I COf'oner
On lhe basis of Ixamlnltion and! or investigation, In my opinion, death occurred at the Ume, date, and place, and due 10 tlle eauae(s) and manner as stlted.. 0
10<1 I) <::>71 / 1,1
o;sposllionPerm~No. 0(')'7('>":"'112.
23b. UceI'tS6 Number
23c, Date Signed (Month, day, year)
26. Was CaS& Referred 10 Medical Examiner! Coroner lor a Reason Other than Cremation Of Donation?
DYss ~
Pall II: Enler other sionlllcanl COl'1dIions conlributlna 10 death,
but not resulting in the uncIertying cause g+ven in Part I.
B 6 ~i:i--y1(,~ ~s ~ l>~
28. Did Tobacco Use Conlribule to Death?
o Yes o.~roba~y
~D Unknown
~8~"
I.!::t"'NoI pregnant within past year
D Pregnanl allime of/__th
D Not pregnant but pregMnt within 42 days
01 death
o NoI pregnant. but pregnant 43 days to 1 year
belore death
o Unknown if pr9gn8rn within Ihe past year
32c. Place 01 Injury: Home, Farm, Street, Faelory,
OIIice Building, elc. (Specify)
32g. location of Injury (Street cHy I town, stale)
la~t Bill aM QJt~tcutttnt
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-,
OF
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HELEN CAROLE BENDER
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I, HELEN CAROLE BENDER, domiciled in Cumberland County in the State of
Pennsylvania, being of lawful age and of sound mind and memory, and not acting under
duress, menace, fraud, or undue influence of any person whatsoever, do make, publish
and declare this to be my Last Will and Testament.
I hereby revoke any and all former Wills and Codicils to any Wills hereto-
fore by me made, and I hereby declare this to be my only true existing Will and
Testament.
I hereby direct that all my just debts, including the expenses reasonably
incurred in the administration of my estate and the expenses of last illness, fun-
eral and burial, inlcuding a suitable grave site and grave marker, be paid out of
my gross estate, in such amount as my Executor, hereinafter named, may deem proper
and without regard to any limitation in accordance with the priority of payments
set forth in the applicable law.
I direct that all estate, inheritance, legacy, succession or transfer
taxes, imposed by any law with respect to all property taxable under this my Last
Will and Testament, and whether such taxes shall be payable by my estate or by the
recipient of any such property, shall be paid by my Executor, hereinafter named,
out of my gross estate with no right of reimbursement from any recipient.
This Will and every part thereof is made with reference to the presently
existing laws of the State of Pennsylvania relating to Wills and estates and trusts
and trust with distribution by Will, and without regard to the laws and regulations
of any state or county where I may happen to be at the time of decease, or where
any portion of my estate may be situated.
I therefore direct that, to any extent permissible by law, this Will and
every part thereof shall be construed and interpreted and its validity and effect
determined, with reference to the law of the State of Pennsylvania, no matter in
what jurisdiction my Will may be probated.
I hereby appoint TIMOTHY J. FUHRMAN, my nephew, to be the Executor of this
my Last Will and Testament. The Executor shall have such powers, rights and duties
as set forth hereinafter.
Last Will and Testament
Helen Carole Bender
I
I
- 2 -
The Executor shall not be liable for any loss or damage which may result to
my estate by reason of the exercise of any discretionary powers conferred upon such
Executor, except in the case of willful default or bad faith.
The said Executor shall serve without bond being required and without comp-
ensation except for expenses or costs reasonably incurred within the scope of his
duty as Executor.
In the event that any provisions of this Will should be held invalid, the
invalidity of such provision or provisions shall not affect any of the other provisions
hereof, it being my intention that each of the provisions shall be independent of
each of the others, so that all valid provisions shall be strictly enforced, irre-
spective of the invalidity of any of the others.
It is my express intent that any beneficiary not specifically provided for
in this Will shall be excluded herefrom.
All of my property both real, personal and mixed, wherever situated, of
which I may die seised or possessed or in which I may in any way entitled, or in
which I have any interest at the time of my death, including property over which I
have power of appointment, I grant, give, devise and bequeath to my sister, ANNE C.
BENDER, absolutely and in fee simple.
If ANNE C. BENDER shall not be alive at the time of my death, then all of
my property shall pass to the Executor to be distributed in his sole discretion.
My Executor, while in possession and control of my estate during administra
tion is hereby authorized to retain, hold, sell, encumber, convey, lease, invest,
reinvest, and keep invested according to his sole discretion in such securities or
other properties, personal or real, and upon such terms and for such length of time,
as to him shall seem advisable, without any limitation upon his power or authority to
do so, either by statute or rule of law. I further authorize and empower my Executor
in the distribution of my estate, in his sole discretion to make division or distri-
bution in kind or partly in kind or in money.
I, HELEN CAROLE BENDER, domiciled in Cumberland County, State of Pennsylvan a,
do hereby make, publish and declare this as and for my Last Will and Testament, here-
by revoking any and all former Wills and Codicils at any time heretofore made by me.
I
(Last Will and Testament
IHe1eh Cardle Bender
I
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- 3 -
IN WITNESS WHEREOF, I have hereunto subscribed my name this
,
_.I
day of
1\ (,
..{!j .I2A__<:::',Je-J
, 1981.
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/'--J.l..-Cfi/t-LC1auJ q ~) ~t:( clc/}--
HELEN CAROLE BEN~ER
(SEAL)
The foregoing instrument was on this
,J day of
() ..
U J2<!-e---l:...,. ~ /
1981, subscribed at the end thereof by HELEN CAROLE BENDER, the above named Testator,
and by her signed, sealed, published, and declared to be her Last Will and Testament,
in the presence of us and each of us, who thereupon at her request, in her presence,
and in the presence of each other, have hereunto subscribed our names as attesting
witnesses thereto.
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ADDRESS I
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ADIfR-ESS /
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Last Will and Testament
H~l~n Ca~ole Bender
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- 4 -
STATE OF PENNSYLVANIA
COUNTY OF
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Before me, the undersigned Notary Public in and for the State and County
aforesaid, on this day personally appeared HELEN CAROLE BENDER, LU~J-~'/-. e'717':.,-7-/1/
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, and If~'"J~;;>"--U"h.-Lt:L'1.-L
known to me to be the Testator and the witnesses, respectively, whose names are
signed to the attached or foregoing instrument and, all of these persons being by me
first duly sworn, HELEN CAROLE BENDER, the Testator, declared to me, and to the
witnesses in my presence, that said instrument is her Last Will and Testament and
that she had willingly signed the same, and executed it in the presence of said
witnesses as her free and voluntary act for the purposes therein expressed; that
said witnesses stated before me that the foregoing Will was executed and acknowledged
by the Testator as her Last Will and Testament in the presence of said witnesses,
who, in her presence, and at her request, and in the presence of each other, did
subscribe their names thereto as attesting witnesses on the day of the date of said
Will, and that the Testator, at the time of the execution of said Will, was over the
age of eighteen (18) years, and of sound and disposing mind and memory.
/ /,1 C" 131
I C(-f.-~Et/G all}.( t " <i'C'Ld Lt/}../
HELEN CAROLE BENbER
(SEAL)
.~~
JJJ (~~~f~~J. ~ efIef (SEAL)
(SEAL)
'1t!l~fi Wuc!i//
WI NESS
(SEAL)
Subscribed, sworn and acknowledged before me by HELEN CAROLE BENDER, the
Testator; and subscribed and sworn before me by
I(() . /, '"
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\..) day of
, and
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, the
witnesses, this
IJ u e-~-<-/
, 1981.
My Commission Expires:
/:', "
Y;;'~ .-! ;f~A-J'
NOTARY PUBLIg'
RUTH RYAN, NOTARY PUBLIC
My Commission Expires Dee, 19, 1981
Camp Hill. PA Cumberland Co.