HomeMy WebLinkAbout04-09-08
PETITION FOR PROBATE AND GR,:\NT OF LETTERS
REGISTER OF WILLS OF
C Gt 7"7.<5C7fZ u</.-1.,/(J
COlJNTY, PENNSYLVANIA
Estate of ')0 ~/I/ r iJL/./Z-(
also known as
File Number
:J 1- Ov ;If) 5l!l
, Deceased
Social Security Number d)o1- L! (/J- ~7 S "
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COI"'fPLETE 'A' or 'B' BELOW:)
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1st A. Probate and Grant of Lettert Tys:amentary and aver that Petitioner(s) is,/ a1 thr C-<:t..?'?:Jv-W J- ~7~i~.tlal11;tj,;~~
~1l1 of the Decedent dated o? iL JddO 7 and codtcll(s) datcd d( LL ld//? 7 (""'<2.-- -'U '"", ( _;
, , I I c~~'r~ ~' ;-:'i~.~5"
(Slale relevalll circumstallces, e.g., rellullciatioll, death of executor, ele.) ;-: '.,:,' 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 Oflp~; i~l1Jme~se) off~'ei
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ,.~.:: '5 ~.
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o B. Grant of Letters of Administration
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(lfapplicable, ell tel': c.I.a.; d.b.n.c.t.a., pelldellte lile; durallte abselllla. durallle /ill/lOr/tate)
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.bn.c.t a., ellter date of Will ill Section A above alld complete list of heirs.)
Name
Relationship
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Residence
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(COMPLETE IN ALL CASES:) Attach additiollal sheets if lIecessaJ:Y.
Decedent was domiciled at death in ~0aif">>1.' ~~ County, Pennsylvania with his / her last principal residence at_l.i~~
,/Y7~i.-1I ~t7/7 rc.-r L. /..1 Ik-t/V'j I'll- ,I 711 ~S-
(Lis I slreeladdress. lowl/leay, toWl/sA,p, cOUIlly, slale, zip code) I
Decedent, then _S- ~
years of age, died on t(-,-~ -d!
at
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Decedent at death owned property with estimated values as follows:
(If domicil.~d in P A) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(I f not domiciled in P A) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
Wheretore, 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 rll1ted name and residence
~
~
ForI/! R W-02 rei'. 10.13.06
Page 1 0[2
COMMO,\i\VEA!!:; (If I'E:'f:\iSYL VANIA
Oath of Personal Representative
COll,\iTl' OF _CU~~__
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rill' Pc: .',:",';; ,I .l"':"',<L~:'Il'd""c':I:;';) c1;' ,;"[:tll1(s) that the statements in the foregoing Petition are tIlle and conect to the best of
ril: k, ai'el he'l of F'diuOlll'r,,; <l!'d thill, :1S personal representative(s) of the Decedent, Petitioner(s) will well and truly
admimsler the estate according to law.
,{/J .. 0 y - () (3q q
Jo~~r L/u/~
Social Security Number ;}01- L-( 0 - ;JuS f.r
AND NOW, {/ +i-) L , :J ('Of; , in consideration of the foregoing Petition, satisfactory proof
haVIng been presented before me, TIS ECREE;:D that Letters Tt sJ c. fn-cntC,--vcf
are hereby g,anted to C \'{" C'd C> rL~.::I-ch k:::n L(jJl J
kbr l V' l 0) ..
Sworn to or affirmed and subscribed
before me the
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,17H
day of
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Fo
File Number:
Estate of
and that the !nstrument(s) dated
described 1Il the Petition be admitted to probate and
FEES
Letters ...
Short Certificate(s)
Renunciation{s) . ........
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TOTAL
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, Deceased
Date of Death:
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in the above estate
Attomey Signature:
Attomey Name:
Supreme Court LD. No.:
Address:
Telephone:
Page 2 of2
RENUNCIATION
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REGISTER OF WILLS
(2(r>7/.Jf:Yl~O COUNTY, PENNSYLVANIA
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Estate of
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., Deceased
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(Print Name)
/Y7tJ 7'1-11'-~
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, in my capacity/relationship as
of the above Decedent, hereby renounce the right to
administer the Estate 0 f the Decedent and respectfully request that Letters be issued to
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(Street Address)
(Date)
/21C,U1/h/Z/iUI'~&(;c&) Iff 17.1. c;-:.C-
(City, State, ZIp)
Executed ill Register's Office
Sworn to or affirmed and subscribed
befo~~1 n:e thi~ >\/(" _', . day
of ~l !,YLd , (!:JDG!.
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
( 'I ( ) l).l / L ( (
Deputy for Register of;
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./3.06
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNiNG: It IS illegal to duplicate this GOpy bIt photostat or photograph.
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tilt' 1I1lol"l1atioll here given I"
.ill i>li!C1llal Cl'rtilicate of Death
ii, Lill,i1 Regi"trar The' Original
'n\drded 1(\ the Slate Vital
filillg.
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REV 11/2006
PRINT IN
v1ANENT
CK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STATE FILE NUMBER
1. Name of Decedent (First, middle, last suffix)
JoAnn
APR 0 7 2008
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2056
209 - 46
5 Age (Last Birthday)
Harrisburg Hospital
6. Date of Birth (Month, day, year)
52
Carlisle, PA
Other
D Nursing Home D Residence [)Olhef - Specify
9. Was Decedent of Hispanic Origin? XJ No DYes 10. Flaea: ArnE'rican Indian, Black, White, ete
~:X~:~~,P~~rt~~~:;~, etc,) (Specify) whi te
May 28, 1955
Yes
8b. County of Death
8d. Facility Name (Ii rto! inslhution, give street and number)
Dauphin
Harrisburg
11. Decedent's Usual Oceu tion Kind 01 wOIk done durin most of wor\(in lite. Do no! slate retired
Kind of Wori< Kind 01 Business/'nduSlry
Da Care Aid Education
14. Marital Status: Married. Never Mamed,
Widowed, Divorced (SpecifYJ
Widowed
12. Was Decedent ever in the
U.S. Armed Forces?
D Yes llaNo
13. Decedent's Education (Specify only highest grade completed)
Elementary I Secondary (0-12) College (1-4 or 5+)
12 4
- 16. Decedent's Mailing Address (Street, city! tOWI1. state, zip code)
1521 Main Street
Mechanicsburg, PA 17055
Decedent's
Actual Residence 17a, Slate
Pennsylvania
Cumberland
17c.0 Yes, Decedenl Lived !r'
17d. D No, Decedent Lived within
Actual Limits 01
17b County
Lisburn
1 B. Father's Name (First, middle, last. suffix)
19. Mother's Name (First. middle. maiden surname)
Armillda F. Frownfelter
Creedon J. Fertenbaugh
20a. In/orrnanl's Name (Type J Print)
Creedon J. Fertenbaugh
20b. Informant's Mailing Address (Slreel, city flown, state, zip code)
615 South York Street, Mechanicsburg, PA 17055
21c. Place of Disposition (Name of cemetery, cremalory or other place)
21d.localion (City I town, statl~, zip cadi,)
Upper Allen Twp., PA 17055
7, 2008
Gate of Heaven Cemetery
Twp
CilyI 8oro
23a To the best at my Knowledge, dealh occurred at t"e lime, date and place stated (Signature and tille)
23b. License Number
22c Name and Address of Facilily
Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland., PA 17070
23c. Date Signed (Mon;h, clay, year)
ApproximaleinleNal
Onset 10 Death
Pert II: Enterolhersionificanl conditions contrihutino to death,
but not resulting in the underlying cause given in Parll
26. Was Case Referred to Medical Examiner..' Coroner for a Reason Oth'or than Cremation or Donation?
DYes [iJH\'"
Sequentially list conditions, if any
~~t~~~~o J~eD~~t~i~~~~~~~e a
(disease or injury Ihat initiated lhe
events resullll1g In death) LAST.
~ Let
,
,
,
,
,
,
,
,
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,
,
,
,
,
28. Did Tobacco Use Contribute to Death?
DYes [JProeab-y
DNa DJnknOwn
29.UFemale
~pregI1antwithillpaslyea(
D Pregnant al lime 01 death
o Notpregl1ant,bul pregnar1lwithin 42 days
afdeath
o NOlpregl1an!,tlUt pregnant 43 days to 1 year
be'oredE'ath
o Unknown if pregnant within the pasl year
Horne, Farm, Street. Factory.
elc (Specify)
nl
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~~d~g~AJe~~t~n~~~ '~I~~ dise:;
b.
Due to (arasa consequence of)
3Oa. Was an Autopsy
Performed?
3Ob. Were Aulopsy Findings
Available Prior to Completion
01 Causeo! Death?
DYes [3'No
31. Manner of Death
o Natural [J Homicide
o Accident 0 Pending Investigation 32d Time of InjUl)'
o Suicide [J Could Not be Determined
M.
DYes 12I No
32g. Locatiol'lollnjury (Street. City i tOWI'l, slalel
33a. Cerlifier (check only one)
;:7~Z:;si~r~~I~~~~~:~i:nd~:~~Y~~~~:~= ~~:~~t~h:~:nu:~f~~~rn~I~~~~~rh:: ~~~~eodu~~~ d~~h_a~d ~~m~I~~ ~e~ ~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 ..
~~~~~ubne~~~t~~ :::r~~::hJ:~~~a~c(:u~:~i~~ t:~i:~~~~~:nagn~e;lt;c~~~~:rt~:~ot~hcea~:~z~(~~a;~~ manner as slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
Medical Examiner / Coroner
On the basis of examination and f or investigation. in my opinion, death occurred althe lime, date, and place, and due 10 tile cause(s) and manner as stllted_ 0
35R1gis\rar's
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Disposition Permll No
LAST WILL AND TESTAMENT
OF
JOANN F. DUM
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I, JOANN F. DUM, of Mechanicsburg, Cumberland County, PennsylVagia, do
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make, publish and declare this to be my Last Will and Testament, hereby re~1hg atk
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Wills and Codicils by me at any time made.
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ITEM I:
I direct that all inheritance and estate taxes becoming due by reason
of my death, whether such taxes may be payable by my estate or by any recipient of any
property, shall be paid by the Executor out of the property passing under ITEM III of this
Will, as an expense and cost of administration of 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 II: I direct the Executor to pay my just debts and the expenses of my
last illness and funeral expenses from the property passing under this Will as an expense
and cost of administration of my estate.
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ITEM III: I devise and bequeath the rest, residue, and remainder of the estate to
my parents, ARMILLDA F. FERTENBAUGH and CREEDON J. FERTENBAUGH,
or the survivor of them. In the event both of my parents predecease me, I direct my estate
be divided equally between their issue, per stirpes.
ITEM IV: In the settlement of my estate, my Executor shall possess, among
others, the following powers:
(a) To retain any investments I may have at my death, as long as the Executor
may deem it advisable to my estate to do so;
(b) To sell either at private or public sale and upon such terms and conditions
as the Executor may deem advantageous to the estate, any or all real or personal property
or interest therein owned by the estate;
( c ) To pay all costs, taxes, expenses and charges in connection with the
administration of my estate;
(d) To compromise controversies; and
2
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(e) 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 V:
Any person who shall have died at the same time as I shall have, or
in a common disaster with me, or under circumstance that the order of deaths cannot be
established by proof, or within thirty (30) days of my death, shall be deemed to have
predeceased me.
ITEM VI: I appoint my father, CREEDON J. FERTENBAUGH, to be
Executor of my Estate. In the event my father, CREEDON J. FERTENBAUGH,
cannot act or refuses to act as Executor for any reason, I nominate, constitute and appoint
my mother, ARMILLDA F. FERTENBAUGH, as alternate Executrix. In the even my
mother, ARMILLDA F. FERTENBAUGH, refuses to act as alternate Executrix, I
nominate, constitute and appoint my brother, CRAIG E. FERTENBAUGH, as alternate
Executor. The Executor(trix) is specifically relieved from the duty or obligation of filing
any bond or other security.
3
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IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last
Will and Testament, consisting of this and the preceding three (3) pages, at the end of
each page of which I have also set my initials for greater security and better identification
this 1st day of February, 2007.
'1
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JOANrF. DUM
We, the undersigned, hereby certify that the foregoing Will was signed, sealed,
published and declared by the above-named Testatrix as and for her Last Will and
Testament, 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 Testatrix was of sound mind and memory.
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((';, ' ' ,\, J\ /\, -'l
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Laura 1. Hu~es" '\
Residing at: 123 Seventh Street
New Cumberland, P A 17070
{2/?l(!:Lbl~ :j' J!;Ut{i J
Amanda L. Souders
Residing at: 129 Herman Avenue
Lemoyne, P A 17043
4
ACKNOWLEDGEMENT
COMMONWEAL TH OF PENNSYL VANIA
: SS.
COUNTY OF CUMBERLAND
I, JOANN F. DUM, Testatrix 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.
j./
NO Y PUBLIC
My Commission Expires:
(SEAL)
NOTARIAl SEAl
BARBARA SUMPLE-SULLIVAN
Notary Public
NEWCUMBERLAND BOROUGH
CUMBERLAND COUNTY
My commission Expires Nov 15. 2007
/-) dC }-:fi~
JOANNj. DUM
(SEAL)
5
AFFIDA VIT
COMMONWEAL TH OF PENNSYL VANIA
: SS.
COUNTY OF CUMBERLAND
We, Laura J. Hughes and Amanda L. Souders, the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified according to law, do
depose and say that we were present and saw Testatrix, JOANN F. DUM, sign and
execute the instrument as her Last Will and Testament; that Testatrix signed willingly and
he/she executed said Will as her free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the Testatrix signed the Will as
Witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen
(18) or more years of age, of sound mind and under no constraint or undue influence.
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WITNESS
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Sworn to and subscribed
before me this L day
of FeblJlatY
(/
NOTARY PUBLIC
My Commission Expires:
(SEAL)
NOTARIAL SEAl
BARBARA SUMPlE-SUllIVAN
Notary Public
NEWCUMBERLAND BOROUGH
CUMBERLAND COUNlY
My Commission Expires Nov 15. 2007
6
BEFORE THE REGISTER OF WILLS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF JOA~'N F. DUM,
Deceased
NO. 21-08-00399
DECREE OF THE REGISTER
AND NO\V, this 8th day of April, 2008, upon consideration of the Petition for Probate and Grant of
Letters of Creedon J. Fertenbaugh and Craig E. Fertenbaugh, IT IS DECREED THAT Letter Testementary shall
be issued to Creedon J. Fertenbaugh as per the Last Will and Testament of Joann F. Dunn, Item VI. Creedon J.
Fertcnbaugh shall have all the rights and duties of a fiduciary under the laws of Pennsylvania and shall
proceed with the administration of this estate according to law.
Glenda Farner Strasbaugh, Register of
Is
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In Re: JOANN F DUM, DECEASED
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-08-0399
CERTlFICA TE OF SERVICE OF ORDER
ORDER DATE: 4/8/08
JUDGE'S INITIALS: GFS
TIME ST AMP DATE: 4/9/08
IN RE: DECREE OF THE REGISTER
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SERVICE TO:
CREEDON J FERTENBAUGH
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
rgJ USPS
DRRR
o HAND DELIVERED
o OTHER_
o PETITIONER
o JUDGE
rgJ CLERK OF ORPHANS COURT
MAILED: 4/9/08
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SERVICE TO:
METHOD OF MAILING:
ENVELOPES PROVIDED BY:
o USPS
DRRR
o HAND DELIVERED
o OTHER_
o PETITIONER
o JUDGE
o CLERK OF ORPHANS COURT
MAILED:
! i\ ~U1 N\l
Deputy
Clerk of Orphans' Court
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