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PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
COUNTY, PENNSYL VANIA
Estate of Elmer S. Brewbaker
also known as
File Number
oZl- Dl- 10lO
, Deceased
Social Security Number 172-24-9462
Petitioner(s), who islare 18 years of age or older, apply(ies) for:
(COMPLETE ~ ' or 'B' BELOW:)
IZJ
Executor
narned in the
l:.er
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
.~..)
(Ifapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante ~~ritate)
(" -)
--_l
I "_.,_
Petitioner(s) after a proper search has 1 have ascertained that Decedent left no Will and was survived by the following spouse (irady) andfieirs: (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.) I
\,.,-,,,
. .
I Name Relationshio Residence .---:- - 1
_.
-::; ...........-
..
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-.
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in Cumberland
50 Bi S rin Ave Newville P A 17241
(List street address, town/city, township, county, state, zip code)
County, Pennsylvania with his 1 her last principal residence at
Decedent, then 84
years of age, died on 515/2005
at 50 Big Spring Ave, Newville, P A 17241
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(lfnot domiciled in PA) Personal property in Pennsylvania
(lfnot domiciled in PA) Personal property in County
Value ofreal estate in Pennsylvania
2-400.00
$
$
$
$
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 d or rinted name and residence
Nolan E Brewbaker 7 Maple Ave, Walnut Bottom, PA 17266
FormRW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEAL TH 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 beliefofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn t~ or a11irmed and subscribed
before'me tile ': ~ day of
Signature of Personal Representative
'I-
Ji/Z-6~
~ .~~I Signature of Personal Representative
. ~~"f"k) 1St.~.~t.:, ~ &...... o{p,_., R<F"'""'~
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File Number: {21- 0\ - \DLO
C.,)
Estate of Elmer S. Brewbaker
, Deceased
Social Security Number: 172-24-9462
Date of Death: 5/5/2005
f"__""
AND NOW, ~~ ~ , J..OO'l , in consideration of the foregoing Petition, sati~ctory proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Nolan E Brewbaker
in \tlie'above estate
and that the instrument(s) dated October 2,1981
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)
.....:.' .~. ,.....
"" "
FEES
Letters ............... $ 3J . OCJ
Short Certificate(s) . . . . . . . . $ LJ .00
Renunciation(s) .......... $ la, 00
~J.j ... $ l~ -00
~ '" $ I(). ()Q
Cl._ iliON.. $ 5.cfU
.. . $
... $
.. . $
... $
...$
.. . $
TOTAL ............. . $ , l1. o~ ~
Attorney Signature:
Attorney Name: Y
Supreme Court I.D. No.: '& 3/100
Address: 104 S Hun over st
CUv h s le. 'PA 11013
Telephone: II, - 2- L} 3 - 74- 37
FormRW-02 rev, 10.13.06
Page 2 of2
H105.905MS REV.(Ol/03)
This is to certifY that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~II~
Charles Hardester
State Registrar
0621841
MAY 23 200S
Date
(.)
HiQS. 143 Rev. 2187
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
c;
TYPE/PRINT
IN
PERMANENT
BLACK INK
~\
STATE FILE NUMBER
I.
COUNTY OF DEATH
84 Yrs.
BIRTHPlACE (City and
State or FOreign CCU'ltry)
1fraklin Co
lb. Cumberland
DECEDENTS USUAL OCCUPA nON
(Of~ng~~UHr~r:r
. 111. Ma i n tance llaFeed M' 11
DECEDENT'S MAILING ADDRESS (Street, CilylTown. Stat.. Z'" Code) DECEDENT'S
ACTUAL
RESIDENCE
(See instructions
on other side)
MARITAL STATUS - Married.
N~:':~S=ed,
M
~~:~f)ll 0
RACE. American tndian. Black, \I\t1ite, at
(Specify)
white
SURVIVING SPOUSE
Ofwlfe.givemeldennlme)
178. State
Did
decedent
Iivelne
township?
i7e. 0 Yes. decedent fived in
twp
17b. County f" 11 m 'h
citylboro
28.
, Approximate
: interval bttwee
: onset end death
He oF):
t..
\J
Sequentially li,t conditions { b.
tf any, leading to Immediate
caUle. Enter UNDERLYING
CAUSE (D1seas8 or iriury c.
that Initiated events
resulting on death) LAST d.
WAS AN AUTOPSY WERE AUTOPSY FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
DU
(0
A C NSEau NC OF);
0j
DUE TO (OR AS A CONSEQUENCE OF,;
MANNER OF DEATH
No Ii1:J
Natural
Accident
Suicide
.eJ>
o
o
DATE OF INJURY
(Monti. Day. Yeer)
TIME OF INJURY
INJURY AT v.JORK? DESCRIBE HOW INJURY OCCURRED.
'"'
-
--
LD
YesO NOW
Ye.O
Homicide
Pending Investigation
Could not be determined
o
o Ye.O NOD
O 300. 3Ob. M. 3Oc.
PLACE OF INJURY - At home. 'ann. sveel, factory, office
tQIdIng.etc.(S~M
308.
34.
21.. 28b.
CERTIFIER (Check only one)
~f~~~'ir':tGJ~~\!~~~~5~~:a. cg~~u,:g 8:~~=(:r~3~~~~~h~.'d'~~~~.~.~~~~.~.~~~~~~.~.i~~~.~~).
21.
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.P.rOO~~=I~Gm~~~;~:J:r.~::J:~~:f= ~~:I~ne~~~~~~~,d.e':d~r:t:~Z~~u~~i:': ::~~er I. ltated,
"MEDICAL EXAMINERlCORONER
On the bul. of examlnltton Indlor Investigation, In my opinIon, death occurred at the tlm., date, and place, and due to the cau.el(l' and
manner.. sblted. ....... ....................... ...... .......... ..................... .............................
31a.
REGISTRAR'S SIGNATURE AND NUMBER
1~1l 1;).11 101
RENUNCIATION
Cumberland
REGISTER OF WILLS
COUNTY, PENNSYL VANIA
Estate of Elmer S. Brewbaker
()
- 'J
I
,. ,.....
, peceased
C')
Co-Executor
I, Norman Elmer Shughart
(Prim Name)
, in my cap~~ty/relatlqnship as
1 ..
of the above Decedent, hereby:r~nounce t~ right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Nolan Ezra Brewbaker
I () ,:') f'- C' 7
(Date)
nf:~
(Signature)
551 Middle Road
(Street Address)
Newville, PA 17241
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this day
of
Deputy for Register of Wills
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission)
FormRW-06 rev. 10.13.06
RENUNCIATION
Cumberland
REGISTER OF WILLS
COUNTY, PENNSYL V ANI~
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Cd
-_1
C,)
Estate of Elmer S. Brewbaker
, ,
--,
, Deceased
,.."J
Co-Executor
I, Judy Davis formerly Judy Mae Shughart
(Print Name)
C)
, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Nolan Ezra Brewbaker
(Date)
l (')~ 01-
~
~ature)
~
~
19325 Erin Tree Court
(Street Address)
Gaithersburg, MD 20879
(City. State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renuncia~n for the
purpo,ses stated within on this _2~.__ day
of NHe.mh(!J'L- . ;"007 .
.
~~
Nota ublic
My Commission Expires: April t./, 200cr
Deputy for Register of Wills
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
tl>TARIALSEAL
.lOO1( S. SMITH, M>TARY flUBUC
CIIisk:. !3oro. QJnbeItent' ~
lilt CclrrmsaIon &pns April" 2008
Form RW-06 rev. 10.13.06
"
..
LAST WILL AND TESTAMENT OF ELMER S. BREWBAKER
I, ELMER S. BREWBAKER, of the Borough of Newville, Cumberland
County, Pennsylvania, declare this instrument to be my Last Will
and Testament, in manner and form following:
1. I hereby expressly revoke all Wills and Codicils
heretofore made by me.
2. I hereby direct my Executrix to pay all my just debts,
funeral and administrative expenses out of my estate, as soon as
practicable after my death.
3. Should my wife, Elizabeth K. Brewbaker, survive me for
a period of thirty days following my death, I devise and bequeath
the remainder of my estate to Elizabeth K. Brewbaker.
4. Should my wife, Elizabeth K. Brewbaker, predecease me or
die on or before the thirtieth day following my death, I devise
and bequeath the remainder of my estate as follows:
A. I give and bequeath the sum of One Dollar
($1.00) to my daughter, Linda Darlene Brewbaker, absolutely.
B. I devise and bequeath the remainder of my estate
to my son, Nolan Ezra Brewbaker, and to my stepchildren,
Norman Elmer Shughart and Judy ~1ae Shughart, in equal
shares, share and share alike; and to the issue, per
stirpes, of any child or stepchild who shall predecease me.
5. I nominate and appoint Farmers Trust Company, Carlisle,
Pennsylvania, Trustee of the share of any beneficiary who may be
a minor. The income and/or principal of said trust may be
accumulated or expended for the maintenance, education and
support of such beneficiary as my Trustee in its sole discretion
may determine; and my Trustee, in the expenditure ~~ incocl~ and/
-- ,."-.... "~--.J
or principal for such purposes, may, at its discret~6hJ" apply the
I
same directly without the intervention of a guardian of pay the
same to any person having the care or control of said bene_ficiary
or with whom the beneficiary resides, without duty 0n the.part of
c:.
the Trustee to supervise or inquire into the application of the
( ,
funds by any person to whom any payment is so made. The balance
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"
of such income and/or principal shall be paid to such beneficiary
upon reaching majority, or to such beneficiary's estate in the
event of death prior thereto.
6. I nominate and appoint my wife, Elizabeth K. Brewbaker,
as Executrix of this my Last Will and Testament; and as
substitute Executors I nominate and appoint my son, Nolan Ezra
Brewbaker, and my stepchildren, Norman Elmer Shughart and Judy
Mae Shughart.
7. I direct that my personal representative and Trustee, as
well as their successors, shall not be required to file bond or
security in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this
2 V\..AI\
day of October, 1981.
WITNESS:
14?;:# ~ A~~~y---
Elmer S. Brewbaker
(SEAL)
~fl,", 1t111~
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COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
I, Elmer S. Brewbaker, 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 Will, that I signed it will-
ingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by Elmer S.
Brewbaker, Testator, this 1.-,~ day of October, 1981.
,d'Lk "
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I~Z~ 'l?.d/.~/
Testator ...
~r:w."V(. \\~
, 1\ ~'''rr- r- 1-'''''''
.' r~ "-, '.~' I ""<T71.J?R, NOTARY PUBLIC
! ' 1 -r- ~~1''',''''1 ("n(l:ty Carlisle, PA
len Expires January 27, 1983
- 2 -
II
C01~10NWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
We, Roger M. Morgenthal and Tom H. Bietsch, the witnesses
whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we
I were present and saw Testator, Elmer S. Brewbaker, sign and
I execute the instrument as his Last Will; that he signed will-
. ingly and that he executed it as his free and voluntary act for
the purposes therein expressed; that both of us in the hearing and
sight of the Testator signed the will as witnesses, and that to
the best of our knowledge the Testator was at that time 18 or more
years of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed to and subscribed to before me by Roger M.
Morgenthal and Tom H. Bietsch, witnesses, this ~ day of
() ~ ,1981.
~ (2~ Yh~
'. Tfl( t~s
~IJ~
Witness
~~ '-t. ~~~
JA~'ICF E. Pl=OT7LFR, 'NOTARY PI In, 'C-
t"", ,l"\....h..,,~.(""- -I r....,.nty Carlisle, p'
N\.y Commission Expires January 27, 1983
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