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Home My WebLink About03-10-08 Estate of Lh.cuJ e:> to h r e L<J 100... Ke ( Sf. also known as t.~f1 r If S ~ re....:> \;) n l( '" r PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF ell ('{) b e r I an cJ COUNTY, PENNSYLVANIA dl ~O~ -Od~~ File Number , Deceased Social Security Number ,;( 0 9 - / ;;; - (p :J / l.o Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) ~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the Pe n n y fJ 0 S.5 last Will of the Decedent dated ..2 ~ 3, q rr 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 ~tIlImeiJ&>) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: Al 0 . . l.) D B. Grant of Letters of Administration (If app[icable. enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) ~,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 -I (COMPLETE IN ALL CASES:) Attach additioual sheets ifuecessary. County, Pennsylvania with his / her last principal residence at "=? J 7 A > Decedent, then 8'.2 years of age, died on march ~ oK'- at 3 :5D Am Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property (If not domiciled in PAl Personal property in Pennsylvania (lfnot domiciled in PAl Personal property in County Value of real estate in Pennsylvania $ ~s, 000 $ $ $ situated as follows: N)A 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: Ty ed or rinted name and residence POll '7 A South I Ci. Dc C no lo... a. Po~ S Form RW-02 rev. [0.[3.06 Page 1 of2 ~---------,------ ------ Oath of Personal Representative COMMONWEALTH OF PENNSYL VANIA COUNTY OF Cllm bpr land The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and conect to the best of the knowledge and belief ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly : SS 17(P-5~--/31.o5 administer the estate according to law. PJl~ "1lo~ '< B~ tJ ANu, Signature of P nal Representallve Sworn to or affirmed and subscribed before me the IOtl1 Ailwll-h ,Jtf)g CrnLhlf q~~~ day of ..>..) Signature of Personal Representative :...._"~"' Signature of Personal Representative r--.:' File Number: Estate of Lhor Ie s \:J ~\f't.LJba.ker Sr. ,;) () 9 -/,;). ~ /0 d I & Date of Death: , Deceased AND NOW, having been presentee! b~re 111 ~, IT are hereby granted to I-"'r:r) ()~Lj Olat'ch 4. 08- I c aaJ8 ' in consideration of the foregoing Petition, satisfactory proof DECREED that Letters -restam~ Pt. !\loss . - and that the instrument(s) dated described in the Petition be admitted to probate and filed of recOf9J as in the above estate FEES :~ I c).DD lO.m . c- ,<,\^ . "") . Cd'u Letters Short Certificate(s) . . . . . . . . 100(') ... ....... Attorney Signature: $ $ $ $ $ .. . $ .. . $ $ .. . $ $ TOTAL .............. $ Attomey Name: Supreme Court LD. No.: Address: Telephone: 00. (JQ Forl/1 RW-02 rev IO.J3.06 Page2of2 d.{ -() g ''OJ.& r LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee tm thi., 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 14123084 .~ /1l ~MAR 0/6 ZO~ Local Registrar Date Issued o CJ'j V 11/2006 liNT IN ~ENT INK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and examples on reverse) 8b. County of Death &:I. Facility Name (If not instrtution, give street and number) STATE FILE NUMBER 1. Name 01 Decedent (First, middle. last, suffix) lliarles N. Brewbaker Sr. Yffl 12 6216 4. Dale of Death (Month, day, year) March 4, 2008 5. Age (Last Birthday) 6, Dale of Birth (Month, day, year) 82 8/17/1925 Silver Spring 'lWp. PA Other o Nursing Home I[] Residence 0 Other. Specify 9 Was Dec~nl of Hispanic Origin? &J No 0 Yes 10. Race: American Indian, Black, While, ele. ~~~:~~~~~~~:~, elc.) ttr~e CwiJer land 'lWp' 317 South Enola Drive 11, Decedent's Usual 0cclJ lion Kind of work done duM most 01 workin life. 00 no! state retired Press ~~~t'~ M:Fa~~ne~ 16. Decedent's Mailing Address (Street, city ftown, state, zip code) 12. Was Decedent ever in the U.S. Armed Forces? 1tJyOS ONo 13. Decedent's Education (Specify ooly highest grade completed) Elementary I ~econdary (0-12) College (1-4 or 5+) 14. Marital Status; Married, Never Married, Widowed, Divorced (Specify) Married Alice M. Williamson 317 South Enola Drive Enola PA 17025 18, Fat~~~gJFi~;~~~~iX) Decedent's Actual Residence 17a. Slate 17b. County PA G..Il:ber land Did Decedent live in a Township? He. IX! Yes, Decadent Uved in F..g~t ppnn~hnrn 17d. D No, Decedent Uvedwithin Actual limits 01 Twp. City/Boro 19. Mother's Name (Firs!, middle, maiden surname) Ida Mae Rudy 2Oa. Informant's Name (Type f Print) Penney A. Ibss 2Ob. Informant's Mailing Address (Streel. city / town, state. zip code) 317 South Enola Drive Enola, PA ] 7025 , PA 17112 21a Method of Disposition 21c. Place of Disposition (Name or cemetery, crematory or other place) Blue Ridge M:mJrial Gardens 22c. Name and Address 01 Facility Richardson Funeral ibne Inc. 29 S. Enola Dr. Enola, 3'58~bL --OJ Items 24-26 must be completed by person wIlo pronounces death 26. Was Case Referred 10 Medical Examiner f Coroner lor a Reason Other than Cremation or Donation? D Yes ~NO CAUSE OF DEATH (See Instructions and examples) l1em 27, Pan I: Enter the ~ - diseases, injunes, or complications - thai directly caused the death, DO NOT enter terminal events such as cardiac arrest respiratory arrest, or ventricular fibrillation without showing the eliology, Ust only one cause on each line. Approximate interval' Pan II: Enter other sionificanl conditions conlributino to death, Onset 10 Death but not resulting in the unclertying cause given in Part ! =~~T:sJ:~~~ ~~~\ dise~ . 1"rt,,,,,;I'ho;) 0..\ c:~t\ c.o..Y'"'~"\V\otv.la of b\Q.c!d.Q.(' Due 10 (or as a consequence of) II MOtft"bi A$C-VD 28. Did Tobacco Use Contribute to Death? o Yes 0 P"'''''~y D No D Unknown 29. If Female' D Nolpregnanlwithinpaslyear D Pregnanl at lime of death o Notpregnanl,bulpregnantwilhin42days 01 death o Not pregnant. but pregnant 43 days 10 1 year belore death o Unknown if pregnant within the past year 32c. Place 01 Injury: Home, Farm, Street. Factory, Office Building,elc. (Specify) Sequentially Iisl con6tions, " any, leading to the cause lisled on line a. Enter !he UNDERLYING CAUSE (disease or il)jury thaI initiated the events resulting In death) LAST. Due to (or as a consequence o~: Due to (or as a consequence of) d. 321. If Transportation Injury (Specify) o Driver I Operator D Passenger D Pedestrian M DOther. Specify' 33a. Certifier (dleck only Q(le) 33b, Signature and Ti Certifying physician (Physician certifying cause 01 death when another phYSician has pronounced c1ealh and completed Item 23) ""'- To Ihe best 01 my knowledge, death occurred due to the cause(s) and manner as ,staled.. - .. .... - -.. -.. - - - - - - .. - - - - _ .. .. _.. _ _ .... .... -,.e5\ ,.. ~:;:u:~~,a~ r=~~hJ::a~c~~=:; t~~I~~~:~;n~e;::c:~~~:~~;~ot~a~:~~:~~ manner as slated- .. .. .. .. .. .. _ _ .. .. .. .. _ _ _ _ _ 0 33c. Lk;ense Number Medical Examiner I Coroner M 0 ,. On the baals of elimination and I or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner 85 slated_ D DSuicide D Could Not be Determined 32d lime of In;ury 32g. Location 01 Injury (Street. city ftown. stale) JOa, Was an Autopsy Perlormed? JOb. Were Autopsy Findings Available Poor 10 Completion of Cause of Death? 31. Manner of Death D Natural D Homicide D Yes 'p!"~o OVos ONo o Accident D Pending Investigation 33d. Dale Signed (Month. day, year) tJE 35. Registrar's Si~e and District ~ ~, I,.JI/I.).I II II 34. Name and Address 01 Person Who Compla!ed Cause 01 Dealh (Item 27) Type I Prin! Dr. Bruce Cohick MD 2151 Lingelstown Rd. Suit 100 Harrisburg, PA 17] 10 DiSpositioo Permit No 0 I q S" 9 .- ) LAST WILL AND TESTAMENT OF , - ~,I :'-.. .., ~v CHARLES N. BREWBAKER o --'-"1 I, CHARLES N. BREWBAKER, of the City of Harrisbu'?g, Dauphin County, Pennsylvania, being of sound mind, memory and understanding do make, publish and declare this to be my Last will and Testament, hereby revoking all other Wills and Codicils to Wills heretofore made by me. I. I order and direct the payment of all my just debts and funeral expenses as soon as conveniently may be made after my decease. II. I direct that gift, estate, inheritance and succession taxes on property passing by virtue of my death, whether under this Will, or by inter vivos settlements, power of appointment, tenancies by the entireties, other co-tenancies, or otherwise, shall be paid out of the principal of my general estate to the same extent as if said taxes were an expense of administration, and all legacies, devises, and other gifts of principal and income made by this will shall be free and clear thereof. In the absolute discretion of my Executrix or Successor Executrix, she may pay such taxes immediately, or may postpone the payment of such taxes on future or remainder interest until the time of possession thereof accrues to the beneficiary. ~ .. :J.. - J" rr " III. I hereby give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, wheresoever situate to my wife, Alice Margaret Brewbaker, provided she shall survive me by thirty (30) days. IV. In the event that my wife, Alice Margaret Brewbaker, does not survi ve me by thirty (30) days, I hereby give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, wheresoever situate in equal shares to my daughter Penny Noss, of Enola, Pennsylvania, my son Robert Brewbaker, of Camp Hill, Pennsylvania, my son Charles Brewbaker, Jr., of DuBois, Pennsylvania, and my granddaughter Sherry Bucher, of West Fairview, Pennsylvania, or their issue per stirpes. V. I nominate, constitute and appoint, my wife, Alice Margaret Brewbaker, as Executrix of this, my Last Will and Testament. In the event she is unable or unwilling to serve as Executrix, I nominate, constitute and appoint, my daughter, Penny Noss, as Successor Executrix. VI. I direct that my Executrix or Successor Executrix shall not be required to enter security of bond in any jurisdiction in which she may act; but if, notwithstanding this direction, a bond is required, I direct that a surety bond shall not be required. 2 ~. ).c'" r -.e; y' \ ... VII. My Executrix and Successor Executrix shall have the following powers in addition to those vested in her by law and by other provisions of my Will, applicable to all property, whether principal or income, exercisable without court approval, and effective until actual distribution of all property: (a) to retain any or all of the assets of my estate, real or personal, without regard to any principle of diversification or risk; (b) to invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investment authorized for Pennsyl- vania fiduciaries, as she may deem proper, without regard to any principle of diversification or risk; (c) to sell at public or private sale, to exchange or lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as she deems proper; (d) to allocate receipts and expenses to principal or income or partly to each as she from time to time may think proper; (e) to borrow money from any person or institution and to mortgage or pledge any or all real or personal property as my Executrix or Successor Executrix, in her sole discretion, shall choose, without regard for the dispositive provisions of this instrument; (f) to register securities in street names or in the name of a nominee or in such manner that title shall pass by delivery and to vote, in person or by proxy, securities held hereunder and in such connection to delegate discretionary powers; (g) to compromise any claim or controversy; 3 t/1t{!, ). JO J# if r .. . .' '. (h) to choose the optional valuation date for estate or inheritance tax purposes; (i) to exercise any law-given option to treat administrative expenses either as income or as estate tax deductions, without regard to whether the expenses were paid from principal or income; (j) to exercise any law-given option to pay death taxes in installments, the payment of interest due on such installments to be charged against principal; and (k) to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as she may determine, and at valuations finally to be fixed by her. VIII. I direct that all legacies, shares or interests in my estate, whether principal or income, while in the hands of my Executrix or Successor Executrix, shall not be subject to execu- tion, attachment, judgment, sequestration or any other process for any debt, obligation, contract or engagement of any beneficiary, and shall not be subj ect to pledge, assignment, conveyance of anticipation, and the personal receipt of the beneficiary shall be sufficient and only discharge of my Executrix or Successor Executrix for paYment of either principal or income. this IN(WITNESS WHEREO , I have hereunto set my hand and seal 31 -vV<--.... day of ~ , 1998. /~1~~ <--CHARLES N. BREWBAKER 4 The foregoing ins~yume~t was in our presence signed ~ CHARLES N. BREWBAKER and declared by him to be his Last will and Testament. We, at his request and in his presence and in the presence of each other, all being present at the same time, have herewith submitted our names as witnesses. a --- 1- ~ II A / ~ A(/ j / / '. 1 11 "l4 " I //1/ ? ,S-L\< . > ::.~ S~ ~-tflSf If! J/rtt., c-V- ~-m .-/ esiding at ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN I, CHARLES N. BREWBAKER, the Testator whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. c& 11 ~~ CHARLES N. BREWBAKER Sworn to and subscribed before me this ~r d day '1l - of ,"U)UlC''1 ' 1998. k' fl!l.. '" . '. '" f; / " ' .j It ilL!. if; N [t' Jet; Z( Notary Public My Commission Expires: COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN We, [if.. ILr 'j/~{:k'th~: and [JSll 1)/'fDtK':,i)l{ , the witnesses, respectively, whose names are signed to the attached or fore- going instrument, being duly quali- fied according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his Last Will; that the Testator signed willingly and executed it as his free and volun- tary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testator signed the will as a witness; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of ag~o sound mind and under no c nst int or undue inflUenCj- . ,I , k I and Notarial Seal Diane M. Stubblebine. Notal'l Public worn to and subscribed Harri~byrg. Da~phin County efore me this 3, d day My Commission Expires Aug. 10. 1998 f '---1,' Member, PennsylvaniaAssodalion of NotarieS '-c-E::i. ~w I L L'/_ , 1 9 9 8 . /JJj~d~ Jidml~/'( (SEAL) My Commission Expires: (SEAL) 5 Notarial Seal Diane M: Stubblebine. Notary Public Hamsburg, Dauphin County My Commission Expires Aug. 10, 1998 Member, PennsylvaniaAssociation of Notifies ,. NOTICE THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY. YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS. A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY. THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 20 PA.C.S. CH. 56. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS. Date: Cth~ rJill ~J~ ALICE MAR Y\f:T /BREWBAKER) /1/:U/6f ,~ ~! ;;; C) -n 1"',,) . . DURABLE GENERAL POWER OF ATTORNEY I, ALICE MARGARET BREWBAKER, residing at 317-A South Enola Drive, Enola, Cumberland County, Pennsylvania, do hereby nominate, constitute and appoint PENNY A. NOSS, of Enola, Cumberland County, Pennsylvania, my true and lawful attorney-in- fact, to act in my name, place and stead, to do and perform any act whatsoever that I might legally perform through an attorney- in-fact or that I myself might perform if I were personally present. This Power of Attorney shall go into effect immediately on the date I sign this Power of Attorney and shall not be affected by my subsequent disability or incapacity. If incompetency proceedings for my person or estate are instituted, I hereby nominate the same PENNY A. NOSS, my attorney-in-fact named above, as guardian of my person and estate. c(Jr7 () (C-i Executed ,this IJi day of ~~~ , Cu0er lu.n c-l County, p;;r;syl vania. , 2004, at Oi<Q~ I~ Witness 6t. '11;1 a~ ..A t...> J CE MARGARET BREWBAKER ~' ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA CO UN T Y 0 F t. 'V..-yr..~'e..r \ "'--~ j) SS: On this '2...22~ day of NO\J~e..r' , 2004, before me, the undersigned officer, personally appeared ALICE MARGARET BREWBAKER known to me to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. ~~t~'YC:~~ L My Commission Expires: (SEAL) "-11II .... .... ~c.:: MIle Lower ADen Twp.. IIIMI eo..ty My Commillioa &piNI .... 1. 2006 Member.~~NotlId8I . . ~. AGENT'S ACKNOWLEDGMENT I, PENNY A. NOSS, have read the attached power of attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the power of attorney or in 20 Pa.C.S. when I act as agent: I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. DATE: //-c?3cJ !/ " '~-, .-.IJ RENUNCIA TION REGISTER OF WILLS Gi ron/II n. I\.d COUNTY, PENNSYLVANIA ;2/-08'- {);),u5 (' i r'-.:; Estate of C'\\{'trle<, to i?)(e..wbCL\<er Sr. , Deceased I, ~"ft \I~:~ A 1\J"5~ (P int Name) lD,f'p A\,c-r (Y\ brewbaKer , 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 _pp r'l('\ ~\.I Pt ~"'IDSS , _m(i(~ 10) 08;- (Date) QO/VV()01t Q -1Lo CU) f oA- (Signature) U 317 A SDc.)~ E 11 0 I c~ Dr, (Street Address) E(Jnlo (City, State, Zip) PC( I / I DdS' Executed in Register's Office Sworn to or affirmed and subscribed befo~ me this I om day of rulJr.lh ' .J-OO~ 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 tr 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.) Form RW-06 rev. 10.13.06