HomeMy WebLinkAbout02-23-08
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ~Pt~ G.. l~G\<A\-\ ~'::.Q~~~ o2/~ c2([)g -c2JO
lalso known as To:
Sp....~~ 3..... \\::)\=~SD~kEJC Register of Wills for the
. ", Deceased. County of <....Q\'<".'oQ..r-\e0-C in the
Social Security No.\ \ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut r ,,'{....
in the last will of the above decedent, dated ~~ \ I
and codicil(s) dated
named
,I9'~\
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cv ~~ \cr-~. . Coun1-Y" Pennsylvania, with
h...Q.r last family or pri~ipal residence at 14.<; 0'::> Lc.."'>\- T("" vI'~~ ~()<::cl-. ~()~. C;~
\^-C'.~;;....('\.L">\o.J I; ~ \ V A \ l OS'U 'l:-\CJ;~~eA'\ \LJ'~"'c..'0--I.~ \ I
(list street, number and muncipality)
Decendent, then \ 0 \ years of age, died \=~'o
at (j:) \\-\-( e~cu~ ~~uCS e:.. \.\~\..SL ~. \. b0f .
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) 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
situated as follows:
$ \ ~s aD\). ()::)
\
$
$
$
""T1
r'1
co
'",.rei N
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will l.\riQ3 Wdici~
presented herewith and the grant of letters ,"e5.=,-T ~~.\'\""\"CJ ~ .:<::'-,.,
(testamentary; administration c.t.a.; administrati,~~~n.c.t:aJ:)
C)
-:=Q
;-",,)
~
!.....,...,}
C~
. .~~_: ~-)
theron.
1'0
.......-1
'"
~
OJ
U
C
OJ
-0 ~
.- '"
"'-
OJ ....
~"
C
-00
C'=
CU"=
~OJ
~c.
OJ '-
:; 0
;;
c
00
en
OJ
~~.~~
\-\- ,,\\ E.. -R.."uC'&
\\. ~ '-0\.:...U~\- ~c....e...\-
'2. O. \=Q\:)~ \ \ ~J
\\r-..I\\.~'o0 r~. YJ;. \"\ \D~ -\.~l
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAtlH ~SYLVANIA 1.. ss
COUNTY OF ~, J
The petitioner(s) above-named swear(~) 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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to ~r affir Jed~nd subscribed ~ . ~ ~~ ~
before me thiS ~'-J day 0 '~N ~ ~. \ u. ~
I::l
-
;:::
~
~
NO.c}!/ ~ nl(JJ?- o/(]Q
Estate of Sp.R~ 6.lNCoRA'0. \:-\D~\=-S.()\--\.~€R-. , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW t70~ . 'd' f h . .
_, In conSI eratIon 0 t e petItIon on
the reverse side hereof, satisfactory p 0 f having been pre nted before me,
IT IS DECREED that the instrument s) date vI{)O
described therein be admitted to probate and filed of record as t
and Lette~a IltlJttj,AA.J /-==
are hereby granted t~- --rJnf7~ 1:.:
/lrl~
~rs
Probate, Lett"', Et;'ES...... ~(j J
Short Certificates( ).... 11. . .. $ c2J ~ Q
n_~ /tflf /.:- .
IWOuncmtlOn .... .l'<'-:'rt). . .. $
VJ If -J$ 10. c:@
TOTAL I- ~
Filed ...................................
P\{',i) E:. .K."u~~_ L\q'-o~ \
ATTORNEY (Sup. Ct. I.D. No.)
\'. C) . ~~ \ \Q}\I
-\-\ c::.-r " \~~1~ES,S P ~ \l \ CJs; _ \ ~l
I \ I-:L~~~ \\'~ )
PHONE
HI05Y()~ REV ,D\I07)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
p
14121656
This is to certify that the information here given i
correctly copied from an original Certificate of Deat
duly filed with me as Local Registrar. The origin<
certificate will be forwarded to the State Vit2
Records Office for permanent filing.
Fee for this certificate, $6.00
Certification Number
FEB 0 8 J008 /
Date Issued
o
r~-;:g
-:1
i'l
OJ
1'''
<J1
-':1
._t.
REV 11/2006
I PRINT IN
~ANENT
,CK INK
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
-.-.;
N
STATE FILE NUMBER
CD
I. Name of Decedent (Rrst. m~:kIle, last, suffix)
Sara 1. HoffsOJIIIIler
5. Age (La~ Birtllday)
164 - 50
2169
6 2008
6. Dale of Birth (Month, day, ar)
8a. Place of Dealh (Check only one)
Hospital: Other:
o I"""tie'" 0 ER I Oulpalienl 0 DCA kl Nu"ing Home 0 Residence OOther. SpeciN
9. Was Decedent of Hispanic Origin? :KJ No 0 Yes
(" yes, specify C.man.
Meadows Mexican, Puerto Rlcen, etc.)
13. Decedent's Educanoo I~ only highest grade completed) 14. Marital Status: Married, Never Married,
Elemental'! I Secondal'! (0-12) College (1-4 or,.) Widowed. Divorced (Specify)
9 Widowed
. 101 v".
8b. County 01 Death
Cumberland
11.Decedent'sU$1J81 0011 KindnlworXdoneoo'
!<ild 01 Worl\.
Housewife
. 16. Decedent's Ma~ing Address (Street. City Ilown, stale, zip code)
4905 East Tdndle Road, Apt. 93
_'s
ActuaJAesOlence 17..Slate ppnn~lvania
17b. Coonty Cumberland
Old Decedent
Uve ina
Townsnip?
1a. Falher's Name (First middle, ,suffix)
John G. Ingr8JII
20a. Inlormant's Name (TVpe I Pnn!}
17c. riI Yes, Decedent Uvedil'\ R::I1I\Ptlpn
17d.D No, o...oenl LNedwilhin
AcluaJUmils01
Twp.
City/Boro
19. Mother's Name (Rrsl, middle, maiden sumame)
Sara B. Scull
2Ob. Informant's Mailing Addr9ss (Street, city flown. slate, zip code)
1802 Brandt Avenue
21c. Place 01 DispositiOn (Name of cemetery, CremalOlY or other place)
FA 17070
of PA
Items 2:4-26 must be com~ b) person
:' wt\Q!)l'OOOUl'ICes.death.
26. Was Case Referred to Medical Examiner I Coroner lor a Reasoro. Oth9l' than Cremation or Donation?
OVes ~
=:~~'~~8.
Enter !he UNDERLYING CAUSE
~~~~Ttrsf"
a. I ~LaN.tl\ (I ~)
b. Due 10 (or j\{M8\11 \ ~.
Due to (or -as a consequence of):
iwL
j 1~\
~~eme.Ie:
1EJ Not prggrIMlI wilhin past year
o ?regnant at time 01 death
o Not pregnant, bul pregnant within 42 days
olcleath
o Not Pf'89rIanl, but pregnant 43 days \0 1 year
be""" death
o Ur.k.nowr. ~ pregnant within the past year
32c. Place 01 Injury: Home, Fann, Street, Factory,
Office Building. etc. (Specify)
32d. Trneof In;ury
I Approximate interval:
I Onset to Oealh
1
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
Pact ll: Ent9l" other siQnlficant conditions conlnbutina 10 death,
1M not resulting in the undertying cause given In Par! 1.
~=S~=)dise::;.
Due 10 (or as a consequence of}:
d.
[Jves ONo
31. Manner 01 Death
)l'(Nslulll' 0 Homicide
o Accident 0 Pending Investigation
0- 0 Could Not be Dele!1llined
32a_ Date of IniutllMonth. day, year)
308. Was an AutopGy
Peflo!med'?
3(1). Wenl Autopsy Findings
Avail1able Pnor 10 Completion
clC~oIDea:th'?
OVes ~ No
32g. localion of Injury (Street. city !lown, statel
M.
338. C'-(cl1ecI<ornyone)
Certifytng physlc:lan (Physician certifying cause 0' dealh when anot/ler physician has pronounced death and completed l1.em 23)
To the-best ot rrrtknow)&dge, death occurred due to lhe eauae(.) and manner as stated...... _ __...... __.................... -.... -_...............
Pronouncing and COl1l!yIng physlclan (Plty5lcian bo~ pronouncing death .nd certifying 10 cause of dealhl '
To the but of my ~., death occurred a1 the ttme, date, and placei, and due 10 the cause(s) and manner as stated.-........ ................ _........ 0
~::~..~~~C::~: and I or Investlqatlon. In my opinion, death occurred at the time, ttate, and place, and due to 1M cause(s).nd manner as slated_ 0
1\110
(Mon~, day, year)
:Jje'
35. Registrar's Signatur
~
I Q I / I ;2..1 II II
34. Name and of Person Who IjPmPteled Cause of Death (Ilem 27) Type I Prinl
S \A P 1< \ 't oL-t !l (i _i 11 .J Ctvv'1)
.' ':h) \ Vi'lI av..~ ,-I- ~d1 I 1') I
hJtI
Disposition Permil No.
LAST WILL AND TESTAMENT
OF
SARA G. INGRAM HOFFSOMMER
, -)
",,-,
Ul
-'j
r"J
1
I, SARA G. INGRAM HOFFSOMMER, of 728 South 28th Stregy,
Harrisburg, Dauphin County, Pennsylvania, being of sound mind,
memory and understanding, do hereby make, publish and declare this
to be my Last will and Testament, hereby revoking any and all
former wills and Codicils by me at any time theretofore made.
ITEM I: I direct that all my funeral expenses and estate or
inheritance taxes be paid by my hereinafter named Executrix as soon
after my death as may be found convenient.
ITEM II: I give all my tangible personal property, including
but not limited to,
any and all automobiles,
furniture,
furnishings, china, silverware, jewelry, ornaments, works of art,
books, pictures and wearing apparel, but excluding cash on hand and
tangible evidences of intangible personal property, to my children,
ROBERT D. HOFFSOMMER, JR., JON R. HOFFSOMMER and BARBARA L. MARK,
to be divided among them as they shall agree.
ITEM III: All the rest, residue and remainder of my estate,
both real and personal, wherever situate, I give, devise and
bequeath as follows:
A. One-third (1/3) to my son, ROBERT D. HOFFSOMMER, JR.
In the event that my son, ROBERT D. HOFFSOMMER, JR.,
predeceases me, I give, devise and bequeath his one-third (1/3)
share to his wife, if she survives me. If his wife does not
survive me, then his one-third (1/3) share shall be divided equally
among his children surviving at the time of my death.
B. One-third (1/3) to my son, JON R. HOFFSOMMER.
In the event that my son, JON R. HOFFSOMMER,
predeceases me, I give, devise and bequeath his one-third (1/3)
share to his wife, if she survives me. If his wife does not
survive me, then his one-third (1/3) share shall be divided equally
among his children surviving at the time of my death.
C. One-third (1/3) to my daughter, BARBARA L. MARK.
In the event that my daughter, BARBARA L. MARK,
predeceases me, I give, devise and bequeath her one-third (1/3)
share to her son, MICHAEL D. KAUFFMAN.
ITEM IV: I nominate, constitute and appoint ANN E. RHOADS, as
Executrix of this my Last Will and Testament.
ITEM V: I direct that no personal representative hereunder
shall be required to provide security, surety or bond in any
jurisdiction for the faithful performance of any duty under this
Will. This clause is applicable only to such personal
representatives as are specifically named in this Will.
ITEM VI: Any word in the test of this Will shall be read as
the singular or the plural and as the masculine, feminine or neuter
gender as may be appropriate under the circumstances then existing.
2
IN WITNESS WHEREOF, I, SARA G. INGRAM HOFFSOMMER, have set my
hand and seal to this, my Last Will and Testament, this t7 day of
\~~
, 2001.
J~cfL~.~f~~~3~!f~~~/'
SARA G. ING HOFFSO ~R
* * * * * * * * * *
Signed, sealed, published and declared by SARA G. INGRAM
HOFFSOMMER, the Testatrix, as and for her Will, in the presence of
us, who, at her request, in her presence and in the presence of
each other, we believing her to be of sound mind, memory and
understanding, have hereunto subscribed our names as witnesses.
C~'A~--
i-,i~
OF l-tv {Y\{V0lJ ){,..)-0"-" I (J-A
/ /J ,/~,l /1 ilt~(j;
OF
it 91/J? /&;Z_,/1 Okt>( (
I,J
/-J
//;t::<l
3
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF DAUPHIN
We, SARA G. INGRAM HOFFSOMMER, Testatrix, /1//1''' C
;;) ./ __, ._."f '^
/ ,j/?',c:Jct3
/I
, and ~ / /7,'/,) / z/~1 ~ /:' ('
, witnesses, respectively,
whose names are signed to the attached or 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 Testament and that she had signed willingly, and
that she executed it as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence
and hearing of the Testatrix, signed the Will as witnesses and that
to the best of their knowledge, the Testatrix was at that time
eighteen (18) years of age or older, of sound mind and under no
constraint or undue influence.
ga/L~-!f; ~L~~~~~
SARA G. ING HOFFSO ER - Testatrix
~--')l-~
t:. \ ~~~
--!;(: J ,/a
(~
I
/ i //7,/:) -<- fI
/
Subscribed, sworn to and acknowledged before me by SARA G.
INGRAM HOFFSOMMER, the Testatrix, and subscribed and sworn to
before me by AfI/7 E. ;?Aw c/.$ and L/>7 c(C<..
/lJPill/7e, witnesses, this /7/1 day of , 2001.
J/'/J~ c1
NOTARY BLIC
frl cry
T~~~
Notarial Seal
Jenn~ A. Tobias, Notary Public
Hamsburg, Dauphin County
My Commission Expires Feb.15, 2005