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Estate 0 f
PETITION FOR PROBATE AND GRANT OF LETTERS
Cu~hb/~
:J1'fv.t~ g~ !~/3 S/
REGISTER OF WILLS OF
COUNTY, PENNSYL VANIA
also known as
File Number
Jk Dg, 118
/7 Z ~;;'t-971()
, Deceased
Social Security Number
Petitioner(s), who is/are] 8 years of age or older, apply(ies) for:
(CO:l1PLETE 'A' or 'f]' BEl. OW:)
~ Prohate and Grant of Letters Tes amentary and aver that Petitioner(s) is I are the
last Will of the Decedent dated I. :5" ..:> -- and codicil(s) dated
named in the
(State releval/t circumstal/ces. e.g.. rel/unciatioll, 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 ,.CU; the instrume\!) offered _~
for probate, was not the victim of a killing and was never adjudicated an incapacitated person::-:. C ..,.,
-.; ~--=1 r"f'l'
. J:~ (] {):J
o B. Grant of Letters of Administration . "', ;2J '
-
(lfapplicable. ellter: c.t.a.; d.b.n.c.t.a.; pelldente lite; durallle absentia; duran/e.-:J7,hlb"ftate)
I ,-.H__'. (-) -0
Petitioner(s) after a proper search has I have ascertained that Decedent left no Will and was survived by the following spou~e~U:1iliy) antHieirs: (If
Administration, c.t.a. or d.b.n.c.t.a.. enter date of Will in Section A above and complete /ist of heirs.) :~!
;:) , '\
Name Relationship Residence cJ1
(COMPLETE IN ALL CASES:) Attach additiollal sheets ifllecessary.
Decedent was domiciled at death in
~U"1t,, 'fl.'!"'"
ty, Pe nsylv~ia with his I her last principal residence at
I"t~ ( I
(List street address, towlllcity, township, COUllty, state, zip code)
Decedent, then 7" years of age, died on / It", ?oo lr at
n41::- A~ /lltA$lYJ J ~n-ItJ c~1u
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in P A) Personal property in Pennsylvania
(If not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
II :'<00/ 000
$
$
$
$
100.000
.
si tuated as follows:
Wherefore, Petit;oner(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:
Ty ed or rinted name and residence
(7~-S-
Forl/l RW~02 rev /0./3.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
COUNTY OF
LUVv1hed*-J
SS
The Petitioner(s) above-named swear(s) or affiml(s) that the statements in the foregoing Petition are true and con-ect 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 the
day of
i'._~
Sworn to or affirmed and subscribed
1ST
~,__.(lOO~
, '. . . '-:2, 0. aiJ ~-U
\' '.. .... . For the Register ;j
Signature of Personal Representati ve
Signature of Personal Representative
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File Number: [2 / - O~ - / / R
::5Awze:> 2JyYfV-<:~ l/f,(I3SJ
Social Security Number: 19 '1- J '1- q Lj 7'0 Date of Death: ~l.A-ij /('" 'Po.;) tr
AND NOW, I$t , ,9 Q{)K_, in consideration of the foregoing Petition, satisfactory proof
having been presented befor me, IT IS DECREED at Letters 1P~+V yYlelTf-7lr t<f
are hereby granted to \.-10 mes btJ V, d t-lc.r1:2sr J
--;
w
Estate of
, Deceased
U)
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed ofrecor
Letters ............... $
Short Certificate(s) . . . . . . . . $
Renunciation(s) .......... $
~_ ... $ ISO/)
- h $-'(~.DO
m1uon $ '- ') · ()()
$
$
$
$
$
$
TOTAL .............. $ q I O. tfD
'6 ~D, Db
J,Dl}J
FEES
Attomey Signature:
Attomey Name:
Supreme Court J.D. No.:
Address:
Telephone:
Form RW-O] rev 10.13.06
Page 2 of2
q"\"sn:" ?'=,V rn'/n'"'l
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
Certification Number
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.
P 14120501
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oc al e gi s trar
JANflB Z~
Date Issued
....,.,
j"rt
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REV 1112006
I PRtNT IN
IAANENT
.CK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
STATE FILE NUMBER
w
u;
Lawrence Twp.
11. Decedenl's Usual ion Kind of work dooe du' mas! of 1ft. Do not slate retired
1\ild00Wo~ "lJ!lola.-./1rdJ1lIY
FinanCIa! Advisor . ~xpress rinan
. 16. Decedenfs Mailing Address (Street, city Ilown, slate, ~ code)
380 North 29th Street
Camp Hill, Pa 17011
18. Father's Name (First, middle, last suffix)
David K. Herbst
208. Informanfs Name (Type , Print)
James D. Herbst
12. Was Decedent6\l'8r In the
U.S. Armed Forces?
ia~vos ONe
13. _fs Educalion (Specify only hl\1lBSl grade oompIellld)
Elementary/ Secondary (0-12) C'4age (1.4 or 5+)
14. Mamal Status: Married, Never Married,
W_.D_(~
Widowed
Dacedenfs
Aclual Residence 17a. Slate
17b. County
PA
Did Decedenl
Uve ina
Township?
17ciJi Yes, Decedent Lived in
17d. 0 No, Decedent Lived within
ActualLimilsof
T.RtJ,..ll:Ionf"p
Twp.
r.l"Rrfi"ltl
19. MoIher's Name (First, middle, maiden sumame)
Naomi w
2Ob. Informanl's MalNng Address (9reet, clIy flown, ldate, zip code)
1766 Kendall Drive Mechanicsbur Pa 170 5
21c. P1aca 01 ~ (Name 01 CllITlOI8ry, crematory or oIher place) 21d. localion (Cily Itown, sta~, lip code)
CIty/Bora
M ers-Harner
23aTO~~10l0)
Items 24-26 must be completed by P8fSOO me of Death 25. Date Pronounced Dead (Month, day, year)
whopmnouncesdaa~ 20: 50 M. jA1\.U.A-t.Ad lCD, l-OOs.
CAUSE OF DEATH (See In.tructIon. and e:umpkJa)
Item 27. Part I: Enlef the ~ - diseases, injuries, or complications thai directly caused the death. 00 NOT enter tem1inaI events such as cardiac arrest,
respiratory arrest, or ventricular fibrHlalion without showing !he etiology. Ust only one cause on each line.
Funeral Home Inc
26. Was Case Referred to Medical Examiner I Coroner for a Reason Other than Crematioo Of Donation?
OVa, MNo
Rolling Green Cemetery
220. Name and Addrasa 01 Fadlty
~=i~1')tI~
I)Ee,;' I\. t.J r /Ie IL' IIC'(
b. D"" to (0' as. consaq""'", o~, t' ~~. 7T A-
Due 10 (or as a consequence 01):
Approximate interval: Part II: Enter OCher sIonificanl condIions conlributino 10 dealh, 28. 0icI Tobacco Use Contribute to Death?
Onset 10 Oaath but no! .....ting " Iha oodarlying cause given " Part I. 0 Vas 0 Probably
o No 0 Ur>known
~E7- (c-c-.':' i:" 1,,/t:7-/y.L>llrill.
OVos ONo
31. Ma.?r 01 Death
!2f Na_ 0 Hom_
O AccldanI 0 Pendng Invastigalion
O~ OCooidNolbaDat~
(..~cc: ~,'i.A'".t'A'
jf.IU'._,
o Not pregnant within past year
~~~lall;rTlflotdealh
rl Not pregnant, bill pregnant within 42 days
aldeath
o Not pregnant, but pregnant 43 days to 1 year
before death
o Unknown if pregnant within the paSI year
32t. Place oIl.njury: Home, Farm, Sl.ree~ Faclaiy,
Offlce BUilding, etc. (Specify)
Sequentlalylislcondllions,i1any,
~~J;:oWRr~'1:~~ a.
~~~'t~~1he
:...-c7P[' t y'7L ,,/h /;:4'
Due to {or as a consequence oQ:
d.
308. Was an Autopsy
Performed?
OVas g(
JOb. Were Au10psy Findings
A\lailable Prior 10 Completion
01 Cause of Dealh?
32d. Trne 01 Injury
M.
321. 11 Transpo<1allon Injl<y (Spacily)
o Driver / Operalor 0 P....'gar Op_,rtan
OIha, . 5p<<I1y,
33b. Sl!;w1alure and TItle of Certifier
32g. Location 01 Injury (Street, cily , town, statel
330. C<<II1ier (chad< only ana)
~~~~=~c::e~:~W:u=:r:~~~~_a~~~~e~~~_____..___....__..___ ~ -~
~=:~~'= ~ ~clano:u=~:;:e~~':c:=1o ao:=~~~~ manner II lilted.. _ _ _ _ _ _.. _.... _ _ _ _ _ _ _ 0
Medical EXlminlt' I Coroner
On the bals of eXlmination Ind I or Investigation, in my opinion, delth occurred at the time. dim, Ind ptace, and due to the cause(s) Ind manner as Sllted_ 0
33c. License Nul1ber
/'-t.1.J a J.-7 Ff',r- E
I dl /1 ~I / I /1
34. Name and Address of Person Who Completed Cause 01 Death (Item 27) Type I Print
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Last Win and Testament'
. "
1
OF
JAMES E. HERBST
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I, JAMES E. HERBST, of the Borough of Camp Hill, Cumberland
County, Pennsylvania, do make, publish and declare this to be my Last Will and
Testament, hereby revoking all Wills and Codicils by me heretofore made.
(..)
-..1
ITEM I: Familv Information. I am married to MARY
B. HERBST and all references to my wife in this Will are to her. I have one son:
JAMES D. HERBST. He is described in this Will as "my child," or as "a child of
mine." The terms "grandchild" and "issue" shall be construed to include only issue
of mine who are related to me by blood and not by adoption.
ITEM II: Death Taxes. I direct that all inheritance
and estate taxes becoming due by reason of my death, whether payable by my
estate or by any recipient of any property, shall be paid by the Executor out of the
residue of my estate, as an expense and cost of administration of my estate, except
that no taxes shall be charged against any gift qualifying for the marital or
charitable deduction in my estate. The Executor shall have no duty or obligation to
obtain reimbursement for any such tax so paid, even though on proceeds of
insurance or other property not passing under this Will.
ITEM III: Debts and Final EXDenses. I direct the
Executor to pay the expenses of my last illness and funeral expenses from the
residue of my estate as an expense and cost of administration of my estate.
Page 1
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ITEM IV: Tang-ible Personal Property. If I die before
my wife, MARY B. HERBST, I give to her all my tangible personal property,
including but not limited to, all of my household furniture and furnishings, books,
pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of
household or personal use or adornment and all policies of insurance thereon. If I
do not die before my wife, I may leave a written list in my safe deposit box or
elsewhere disposing of certain items of my tangible personal property. The
Executor shall dispose of items of my personal property as specified in the written
list. If no written list is found in my safe deposit box or elsewhere and properly
identified by the Executor within thirty (30) days after the probate of my Will, it
shall be presumed that there is no other statement or list. Any subsequently
discovered list shall be ignored. If I survive my wife, I give any property of the type
described in this Item and not set forth in a written list to my son, JAMES D.
HERBST. If my son does not survive me, I make this gift to my daughter-in-law,
KIMBERLY A. HERBST.
ITEM V: Residue. I give the residue of my estate, not
disposed of in the preceding portions of this Will, to my wife, MARY B. HERBST, if
she survives me. If she does not survive me, I give the residue to my son, JAMES
D. HERBST. If neither my wife nor my son survive me, I make this gift to my
daughter-in-law, KIMBERLY A. HERBST. If none of the foregoing survive me, I
make this gift to my grandchildren, to be divided between them in equal shares.
ITEM VI: Administrative Powers. In addition to the
powers granted at law, the Executor shall possess the following powers, each of
which shall be construed broadly and may be exercised without court approval, but
in a fiduciary capacity only:
Page 2
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'I
I,
(a) Retain Investments. To retain any investments I have at
my death, including specifically those consisting of stock of any bank
even if I have named that bank as the Executor.
(b) Vary Investments. To vary investments and to invest in
bonds, stocks, notes, real estate mortgages or other securities or in
other property, real or personal, without being restricted to so-called
"legal investments", and without being limited by any statute or rule of
law regarding investments by fiduciaries.
(c) Division of Assets. In order to divide the principal of my
estate or make distributions, the Executor is authorized to distribute
personal property and real property partly or wholly in kind, and to
allocate specific assets among beneficiaries so long as the total market
value of each share is not affected by the division, distribution or
allocation in kind. The Executor is authorized to make, join in and
consummate partitions of lands, voluntarily or involuntarily, including
giving of mutual deeds, or other obligations, with as wide powers as an
individual owner in fee simple.
(d) Sell Assets. To sell either at public or private sale any or
all real or personal property severally or in conjunction with other
persons, and to consummate sale(s) by deed(s) or other instrument(s)
to the purchaser(s), conveying a fee simple title. No purchaser shall be
obligated to see to the application of the purchase money or to make
inquiry into the validity of any sale. The Executor is authorized to
make, execute, acknowledge and deliver deeds, assignments, options or
other writings as necessary or convenient to carry out the powers
conferred upon the Executor.
Page 3
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(e) Encumber Real Estate. To mortgage real estate, and to
make leases of real estate.
(f) Borrow Money. To borrow money from any person,
including the Executor, to pay indebtedness of mine or of my estate,
expenses of administration or inheritance, legacy, estate and other
taxes, and to assign and pledge assets of my estate.
(g) Pav Costs. To pay all costs, taxes, expenses and charges
in connection with the administration of my estate.
(h) Distributions Without Court Order. To make
distributions of income and of principal to the proper beneficiaries,
during the administration of my estate, with or without court order, in
such manner and in such amounts as my Executor deems prudent and
appropriate.
(i) Vote Stock. To vote shares of stock which form a part of
my estate, and to exercise all the powers incident to the ownership of
securities.
(j) Reorg-anize. To unite with other owners of property
similar to property in my estate to carry out any plans for the
reorganization of any company whose securities form a part of my
estate.
(k) Disclaim. To disclaim any interest in property which
would devolve to me or my estate by whatever means, including but
not limited to the following means: as beneficiary under a will, as an
Page 4
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appointee under the exercise of a power of appointment, as a person
entitled to take by intestacy, as a donee of an inter vivos transfer, and
as a donee under a third-party beneficiary contract.
(1) Tax Returns. To prepare, execute and file tax returns of
any type required by applicable law, and to make all tax elections
authorized by law.
(m) Allocate Expenses. To allocate administrative expenses
to income or to principal, as the Executor deems appropriate.
However, no allocation to income shall be made if the effect of the
allocation is to cause a reduction in the amount of any estate tax
marital deduction or estate tax charitable deduction.
(n) Emplov Advisors. To employ custodians of property,
investment or business advisors, accountants and attorneys as the
Executor deems appropriate, and to compensate these persons from
assets of my estate, without affecting the compensation to which the
Executor is entitled.
(0) Adiust Basis. To make any adjustment to basis
authorized by law, including, but not limited to increasing the basis of
any property included in my estate, whether or not passing under this
Will, by allocating any amount by which the bases of assets may be
increased. The Executor shall be under no duty and shall not be
required to allocate basis increase exclusively, primarily, or at all to
assets which pass as part of my probate estate as opposed to other
property for which a basis adjustment is allowable. The Executor shall
allocate basis increase equitably among those beneficiaries receiving
Page 5 ~
property as a result of my death, but shall not be liable to any person,
nor subject to removal or surcharge, for any reasonable allocation of
basis increase.
(P) Compromise Claims. To compromise claims.
(q) Other Acts. To do all other acts in the Executor's
judgment deemed necessary or desirable for the proper and
advantageous management, investment and distribution of the estate.
ITEM VII: Beneficiarv Under Ag-e 25. If a beneficiary
under the age of twenty-five (25) years is entitled to receive assets under this Will,
the person who served as Executor of my estate shall retain those assets as
Custodian for the beneficiary under the Pennsylvania Uniform Transfers to Minors
Act. The Custodian may receive and administer all assets authorized by law, and
shall have full authority as provided in the Pennsylvania Uniform Transfers to
Minors Act to use assets in the manner the Custodian deems advisable for the best
interests of the beneficiary. I also designate the person who served as Executor of
my estate as successor Custodian of any property for which I am custodian under
any Uniform Gifts to Minors Act or Uniform Transfers to Minors Act.
ITEM VIII: Survival. Any person who has died within
thirty (30) days of my death, or under such circumstances that the order of our
deaths cannot be established by proof, shall be deemed to have predeceased me.
ITEM IX:
Executors. I make the following provisions
with respect to Executors:
Page 6
'1
(a) Primarv Executor. I appoint my wife, MARY B.
HERBST, to be the Executor.
(b) Conting-ent Executor. In the event that MARY B.
HERBST is unable or refuses to serve as Executor, my son,
JAMES D. HERBST, shall serve as Executor. In the event that
JAMES D. HERBST is unable or refuses to serve as Executor my
daughter-in-law, KIMBERLY A. HERBST, shall serve as Executor.
(c) Compensation. The Executor shall have the right to
receive reasonable compensation for services rendered and
reimbursement for reasonable expenses.
(d) Standard of Care. No Executor shall be liable or
accountable for any loss that may result from the good faith exercise of
the authority granted in this Will.
(e) Security. The Executor is specifically relieved from the
duty of filing bond or entering security.
IN WITNESS WHEREOF, I have set my hand and seal to this, my
Last Will and Testament, consisting of this and the preceding six (6) pages, at the
end of each page of which I have also set my initials for greater security and better
..- Tl.. /1i. / ,-
identification this IS, - day of I {Q/1 [~ , 20 ('s.
/~~/~(SEAL)
.1
We, the undersigned, hereby certify that the foregoing Will was signed,
sealed, published and declared by the above-named Testator as and for his Last
Will and Testament, in the presence of us, who, at his request and in his presence
and in the presence of each other, have hereunto set our hands and seals the day
and year first above written, and we certify that at the time of the execution
thereof, the said Testator was of sound and disposing mind and memory.
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(SEAL) Residing at 61; ~~J ~
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(SEAL) Residingat d:;y s. ~~&.
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF )
I, JAMES E. HERBST, 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 and
Testament; that I signed it willingly; and that I signed it as my free and voluntary
act for the purposes therein expressed.
~c: ~EAL)
/; AMES E. HERBST
Sworn to and subscribed before
me this t Sk day of ~
, 20 OS
~~fL4
Notary PublIc
My Commission Expires:
(SEAL)
COMMONWEAL TH OF PENNSYLVANIA
NO T ARIAl SEAL
CYNTHIA J. RULE, Notary Public
Camp Hill Bom, , Cumberland,County
M Commission Expires Febru 3, 2008
. I
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF )
WeJIL/f J. d/tTI/
and
the Witnesses whose names are signed to the attached or foreg ing instrument,
being duly qualified according to law, do depose and say that we were present and
saw Testator, JAMES E. HERBST, sign and execute the instrument as his Last
Will and Testament; that Testator signed willingly and that he executed said Will
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 Will as Witnesses; and that to the
best of our knowledge the Testator was at that time eighteen (18) or more years of
age, of sound mind and under no constraint or undue influence.
ajJJ;~' d. dd-tL
Witness
Sworn to and subscribed before
me this tSfL day of ~
, 20D1
~~eL
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
CYNTHIA J RULE, Notary Public
Camp Hill Bora.. Cumberland County
M Commission Expires F 3, 2008