HomeMy WebLinkAbout02-19-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of ANNA V. BROUGHER
also known as
File Number
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. Deceased
Social Security Number 170-32-3370
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE ',4' or 'B' BELOW:)
III A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the CO-EXECUTORS
last Will of the Decedent dated FEBRUARY 12, 1998 and codicil(s) dated
named in the
o B. Grant of Letters of Administration
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(State relevant circumstances. e.g.. renunciation. death of executor, etc.) ~J $: f-'2 CO
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of~ OOtj]inent(~ffered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: -; ~j ~ ~ (
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(If applicable. enter: c.t.a.; d.b.n.c.t.a.: pendente lite; durante absentia; durante"'minoritate)
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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
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last principal residence at
825 NORTH COLLEGE STREET. CARLISLE BOROUGH. CUMBERLAND COUNTY. PENNSYLVANIA 17013
(List street address. townlcity, township, county. state. zip code)
Decedent, then 98 years of age, died on FEBRUARY 10,2008
CARLISLE. PENNSYLVANIA 17013
at CARLISLE REGIONAL MEDICAL CENTER,
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
128,000.00
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 or rinted name and residence
JAMES R. FULTON, 911 WEST SOUTH STREET, CARLISLE, PA 17013
MARTHA S. FULTON, 911 WEST SOUTH STREET, CARLISLE, PA 17013
Form RW-02 rev. 10.13.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
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 ofPetitioner(s) and that, as personal representative(s) ofthe Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affIrmed and subscribed
before me the J q+n day of
~ qelYt~lLt Y . c:200 ~
v(')i/UJJh J1e Q ~
For the egister
Signature of Personal Representative
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File Number:
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Estate of ANNA V. BROUGHER
, Deceased
Social Security Number: 170-32-3370 Date of Death: FEBRUARY 10,2008
AND NOW, jqt111J~~ 8~ 8-DQ\?, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, TIS ECREED that etters TESTAMENTARY
are hereby granted to JAMES R. FULTON AND MARTHA S. FULTON
in the above estate
and that the instrument(s) dated FEBRUARY 12, 1998
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES .;jeJ~ l!jtwwv ~~
$ 260.00 Register of Wills p&r ,
~:::~~i~~~~~(~) : : : : : : .. $ 8.00 Attorney Signature: ~-?,
Renunciation(s) .......... $ ROGER B. ,ESQUIRE
JCP . . . $ 10.00 Attorney Name:
AUTOMATION FEE . . . $ 5.00 Supreme Court I.D. No.: 6282
WILL . . . $ 15.00
... $
... $
... $
... $
... $
... $
TOTAL. . .. . .. . .. .. . . $
Address:
60 WEST POMFRET STREET
CARLISLE, PA 17013
Telephone:
(717) 249-2353
298.00
Form RW-02 rev. 10.13.06
Page 2 of2
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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 Certi:icate of Death
duly filed with me as Local Registf3l'. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
P 14125422
\\. ~b.)..~~.. ~FI~~l Y 2008
Local Registrar ~ Date Issued
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H10&143 REV 11!.?006
TYPE I PRINT IN
PERMANENT
BLACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
Dickinson Twp.
STATE FILE NUMBER
'-""""~-IFirII,_,...,suftbc)
Anna V. Brou
5. ""'" ILul e;""'yl
98
B. Dele of Birth (Month, day, ar)
Vrs.
May 18, 1909
81. Place of Death (Check one)
Hoopltal: 0It00r.
_ 0 ER 100000tionl 0 OOA 0 Nursing Home 0 Roo"""" 00ttle<. Spoafy:
8d. FaciIty Name (II not 9. Was Decedent 01 Hispanic Origin? (i] No 0 Yes 10. Race: American 1ncI8n, Black, WMa, ale.
Carlisle Regional Medical Center =:;'~=,"') (Specif)lwhite
12. ~==inthe 13, Oecedent'. Education (SpecIfy only hirI1estgradll compI8ted) 14. =~Marr~~;;.rMarried, 15. SurvtvingSpouse (If wife, give maiden name)
'Ov.. [iN. 8y;.~/Seco"daryCO-12) College (,.......) widowed
::""'~ 17" Sla. Pennsv 1 vania rI:'. ~ 17,.0 Yos, Docedenlllvod"
Townah~? ...
17b. COumy r."mhpr 1 Ani! 17d.~~=~lIvod_ Car lisle Boro.
19. MoIher's Name (ArsI, midcIe, maId8n surname)
Fann M. Sennet
2Ob,_'Mo"'<l_C_,clty/lown,_,2lp_)
911 W. South St. Carlisle, PA 17013
21<Placo~-"I"",,"ol_,_"'_ptocol
Mt. Holly Springs Cemetery
7._ICityaoo_",
., D,. ~ Death (MoIlth, lilly, year)
Feb. 10, 2008
11.Oeced8nl'sU_ lion ITlOItolWlll1l' Ih.DonollMle
K"'~WO<k "",~_,_
Housekee er Hos ital
. 16. Decedenrs MaIlIng Addre&& (3reet, city floWn, stale, zip coos)
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825 North College St. Carlisle,
PA 17013
18. Falher's Name (FIl'St, midde, last, suffb:)
John H. A. Sheaffer
201.. InformanrlName (TypefPrtnt)
James R. Fulton
OCBmatim 0- 21b,OoIe~IliIposItloo(_day,year)
WoaCNmotloll.._A_ Feb. 2008
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City/Bo<o
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31. Manner 01 Death
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OStictda OCouldNotbo~
WoxtmaI8 i1tIrYII: Part H: Enter other IianiIcInI ClInltIImI 0l'II'ItrhJtm In dMlh 28. Old Tobacco Use Cor1rtbuIe 10 Death?
DnHtloDHIl ...""'_""'_"lI.....,...,, Part I, 0 Yos OP-
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29. II Female:
o Not__"""year
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o Not_bIlt_<3 daY' 10 1 year
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O-'__tho"""...,
320. PIoce~ "iw'r""" Film, _,Foctory,
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21d. location ICIly I town,stale, ~ cocIe)
Mt. Holly Springs, PA
N.H~g6v r
22c. Name andAddntas 01 FaclIity
Hoffman Roth Funeral Home and
23b. lIcen8e Number
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PA 170 3
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lothe bellaI myknowlldga, dIIth occtI'I.t due to the '*1111(1) Ind InIMIr -............................................................................. _... _ 0
. PronauncIngInd __I_both~_ ....certllylnglo....~_1
To the'*' aim, IcnowIIdgI, ~ ClCCtI'Nd Itthe1lme, dde, Ind ptIce. anddul to theCMlll(I)encllIWlnII' 1I1tItId.................. _..........................
. IIedIclII ex.nInIf I CoroNr
On the ba6s of ~ Indl or IrrveIIlgIIIon, In m, opinion, deIth 0CCI.I1'ed lib lime, dlde,encI pIIce. Ind due totheClUll(sl1lld IMMIl'IIItIled.. 0
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I, ANNA V. BROUGHER, of the Borough of Carlisle, Cumberlari~ Coun~
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Pennsylvania, declare this to be my Last Will and Testament, hereby expressly revoking all Wi~
LAST WILL AND TESTAMENT
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and Codicils heretofore made by me.
1. I direct my executors to pay all of my debts, funeral and administrative expenses as
soon as may be done conveniently after my decease.
2. I authorize and empower my executors to sell any realty owned by me at my death and
not specifically devised herein, at either public or private sale, and to give good and sufficient
deeds therefor, in fee simple, as I could do if living.
3. I give, devise and bequeath all of my estate of every nature and wherever situate as
follows:
(a) $2,500.00 to Mary Lindsay, 54 Parsonage Street, Newville, Pennsylvania
17241.
(b) $2,500.00 to The First Lutheran Church, 21 South Bedford Street, Carlisle,
Pennsylvania 17013.
(c) All the rest, residue and remainder to James R. Fulton and Martha S. Fulton,
share and share alike.
4. Should the gift in Paragraph No. 3(c) not take effect, I give, devise and bequeath all of
my estate of every nature and wherever situate to Paul Sheaffer, of Etters, Pennsylvania.
5. I nominate and appoint James R. Fulton and Martha S. Fulton to be the executors of
. . .
this my Last Will and Testament; they are to serve as such without bond. Should they die before
my death, renounce or refuse to serve for any reason, or die leaving any of my estate
unadministered, I nominate and appoint Paul Sheaffer, as substitute executor, also to serve as
such without bond, with the same powers as are given herein to my executors.
6. I hereby suggest that my personal representatives retain the services of Irwin,
McKnight, & Hughes, as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 12TH day of
February, 1998.
~ llIi i3~hI. (SEAL)
ANNA V. BROUGHER
Signed, sealed, published and declared by ANNA V. BROUGHER, the testatrix above
named, as and for her Last Will and Testament, in the presence of us, who at her request, in her
presence and in the presence of each other have subscribed our names as witnesses hereto.
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ACKNOWLEDGMENT AND AFFIDAVIT
WE, ANNA V. BROUGHER, CHERYL L. CLELAND and MARTHA L. NOEL,
the testatrix and witnesses respectively, whose names are signed to the foregoing instrument,
being fIrst duly sworn, do hereby declare to the undersigned authority that the testatrix signed
and executed the instrument as her Last Will, and that she had signed willingly, and that she
executed it as her free and voluntary act for the purpose herein expressed, and that each of the
witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the
best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound
mind and under no constraint or undue influence.
a~ tV) !B~VA-
ANNA V. BROUGHER
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'2(ai!:r{l?J::f
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by ANNA V. BROUGHER, the
testatrix herein and subscribed and sworn to before me by CHERYL L. CLELAND and
MARTHA L. NOEL, witnesses, this 12TH day of February, 1998.
0.~
alSeal
Roger B. Irwin, Notary Public
Carlisle Boro, Cumberland County
My Commission Ellplrea Oct. 3, 2000
Member Pennsylvania Association Of Notaries