HomeMy WebLinkAbout08-21-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of NICHOLAS L. GOBLE
also known as
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COtYIPLETE 'A' or 'B' BELOW.)
COUNTY, PENNSYLVANIA
File Number ~ ~ ~ U ~~
Social Security Number
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the ALTERNATE EXECUTRIX
last Vb'ill of the Decedent dated 7/24/2007 and codicil(s) dated
(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 instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
B. Grant of Letters of Administration
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; 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) and heirs: (If
Administration, c.t.a. ord. b. n. c.t.a., enter date of Will in Section A above and complete list of heirs.) r-..~
Decedent, then 72 years of age, died on AUGUST 12, 2008 at HOLY SPIRIT HOSPITAL
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 50,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 100,000.00
situated as follows: 42 RIDGEWAY DRIVE, MECHANICSBURG, PENNSYLVANIA 17050
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:
Si nature T ed or rinted name and residence
MICHAELLA A. PLACIDO, 1001 Oak Street, Hood River, OR 97031
named in the
Form,RW-01 rev. 10./3.06 Page 1 of 2
(COtVIPLETE INALL CASES:) Attach add tional sheets if necessary. ~ ~"
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Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principa~,#esidence at
42 RIDGEWAY DRIVE, MECHANICSBURG, SILVER SPRING TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA r
(List street address, town/city, township, county, state, zip code)
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUN"TY OF CUMBERLAND
SS
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 of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn 1:0 or affirmed and subscribed
before ine the a,~ day of
For the Register
of Personal Representative
Signature of Personal Representative
Signature of Personal Representative ,`--~
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File Number: ~~ ~ O ~1 olJtl '~_` ~ _
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Estate of NICHOLAS L. GOBLE , DeceaSj rv
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Social Securi Number: Date of Death: AUGUST 12, 2008 '~' i ry
AN:D NOW, l in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IS DECREED that Letters TESTAMENTARY
are hereby granted to MICHAELLA A. PLACIDO
and that the instrument(s) dated NLY 24, 2007
described in the Petition be admitted to probate and filed
FEES
Letters ... ~ ~~ 4~.. $ a~pT}
Short Certificate(s) .. ~ ~... $ ~}~
Renunciation(s) .......... $
~
~
...
u.
l~ $ ~5
...
J $ -o
r
_L ... $
... $
... $
... $
... $
... $
... $
TOTAL .............. 00 ~.g~.r
$ O .
as the last W~11(and Codici<l(s)) of Decedent.
in the above estate
er of Wills j v ` I~ O"
Attorney Signature: v ~-
Attorney Name: LIS MARIE COYNE
Supreme Court I.D. No.: 53788
Address: 3901 Market Street
Camp Hill, PA 17011-4227
Telephone: 717-737-0464
Form RW=02 rev. 10.13.06 Page 2 of 2
IOS.ROS REV 101/07l
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
.P 14542723
Certification Number
.v ,moos
RIN7 IN
NENT
;INK
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
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1. Name d Decedent First, midge, 4sst, suRz 2. Sex 3. Social Security Number 4, Dale of Death (Month, tlay. year)
Male
obl
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e
las L• G
Nich
3 3 - 38 -' 22 1 Au ust 12 2008
5. Age (Last Binhday) Under 7 year Under t day 6. Date of Binh (Month, day, year) 7. Birthplace (City antl slate or foreign country) fie. Place of Death (Check only one)
72 "~"lw nay, man ~~"~ May 3, 1936 Hnaplat aner
yrs_ Vincennes, IN Inpatient ^-ER/Outpatient ^DOA ^Nursing HOme ^Residence ^Other-Spaclty:
W. Gounry of Deets iic. City. Boo, Twp. d Death Bd. Facility Name 1h not insfnNbn, give street antl number) 9. Was Decedent of Hispanic Origin? No ^ Yes 10. Race'. American IM1lan, Black, While, etc.
pf yes, spedry aban, ( fb
r
Cumberland E. Pennsboro T Hot S irit Hos ital Mexican,PuenoPkan,etc.) ite
11. Deceden's Usual Occ ibn Kind of work d ote tlurin most of wo ~ tae. Do not state retlred 12. Was Decedent ever in the 13. Decedent's Education (Specify Doty highest grade compl eted) 14. Marital Status: Monied, Never Marred, 15. Surviving Spo use (If wife, give maioen name)
iptlq~~u~rlgsy1
Kind of WOM
In`~~
d
K U.S. Armed Forces?
Elementary/Secondary (D-12)
College (t-4 or 5+) Wkbwe4 Divorced (Specify)
PA
ar
JC.:IIUUl
De ut Exec. Direct r [Yea ^Np 5+ Widowed
16. Decedent's Mailing Address (Strsrel, city /Town, state, zip code) Decedents Did Decade"' Silver Spring Twp .
[
PA
42 Ridgeway Dr .
~ Yes, Decedent lived m
Twp
Actual Resitlence 17a. Slate
Townsh P? 17c.
Mechanicsburg, PA 17050 ,7b. caaty (:ilmharlancl 17°. AcWaBL~~ dived wimin Ciry/BOro
18. Famar's Nartx (First, midde. last, suffix) 1g. Momer's Name (First, middle, maiden surname)
Iva -Unknown-
20a. Informants Name (Type / Pnnl; 20b. Inlorment's Mailing Address (SneeL city /town, state, zip code)
Nicholas Goble 36 S. 39th St. Ca Hill PA
21 a. Method of Disposition ~ ^ Cremation ^ Donation
. 21 b. Date of Disposdan (Month, day, year) 21c. Place of n (Name of cemetery, crematory a other place) 21 d. Location ICity !town, slate, zry code)
[~ Burial ^ Removal from State
' Was Cremelfon or Donation Authorized us t 18
2008
u Indian town Gap National Cemetery Annvi l le
PA
^
^ Other -Specify: i by MMlcal Examiner / ner7 ^ Ves No ,
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22a. S' Funeral Service ~ensee (or sane such) 22b. License Number 22d. NOma and AdNeaa of FapgilyMyers -Harper Funeral Home
014819 L 1903 Market St. Hill PA 17011
e Items 23a-c Dory when mniiying 23a. Te the best of my knowledge, deem occurred at me lime, date and place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, tlay, yeatl
Ph ' 'an is cwt avaaaMe at time of death tD
cerlay cause of Beam.
Items 24-26 muss be completed by pawn 2d. Time of Deam
~ 25. Date Pramunmd Dead (Month, day, year) 26. Was Case Refened to Medical Examiner I Coroner for a Reeson Other than Cremation or Donation?
who pronounces Beam. U ~1
M.
1. 5 / A U u 1' •~ I 'Z r '- p O ~ ^ Yes [~ No
CAUSE OF DEATH (See InstruMions and examples) l Approximate interval: Pad II: Emer othensionT~m t conditions canto ai"q to deaM, 28. Db Tobacco Use ConfribNe to Death?
Item 27. Pan 1: Enter ttte n Of QVar~7, -diseases, mjunes, or complications - [hat drectly reused the deem. W NOT enter femoral events such as cardiac artesL 1 Onset to Deam but not resulting in the untledyirg cause given in Pan I. ^ Yes ^ Probabty
respi2lory anesl, or ventricular fibndafion wnhoul snowing Ifre e8ology. List oMy one muse an each line. ~
r ^ No 'Unknown
IMMEDIATE CAUSE Final disease or n Iv r
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~ 29. If Female:
conrghon resukmg in
ath) _~, a
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Due to~dT•p~sHa conse~quence ol): qq r
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uential list cand'Abns, it an r _. _..~
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Seq ry Y b J
p~t'~( i2
I1. ~
f J 1 M pregnant w
n past yeah
th
^ Pregnant al lime of deals
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leadingg to the muse listed on line a r
Due W (or as a consequence ory~. r , ^ Nm pregnant, but pregnant within 42 tlays
Enter the UNDERLYING CAUSE
(disease or injury that Indialed the c i of death
events resulting m death) LAST.
' I ^ Not pregnant, but pregnan143 tlays l0 1 year
pue to (or as a consequence ol} before deem
d ^ Unknown it pegnaM within the past year
.
Was an Autopsy
30a 30h. Were Autopsy Findings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occuhed 32c. Plain of Injury: Hone, Farm. Street, Factory,
.
Pedomxd? Available Prior to Completion
of Cause of Death? ~
atonal ^ Homicide OM!ce Building, etc. (Specify)
' ^ Accident ^ Pending Investigation 32d. Time of Injury 32e. Injury al Work? 321. If Transportation Inlury (Specltyl 32g. Lomtion of Inpay (SlreeL city /town, slate)
^ Yes /~NO !es ^ No
^
^ Suicide ^ Coultl Not be Determined
^ yes ^ No
^ Dover /Operator ^ Passenger ^Pedeslnan
M ^Other - $peClfy:
'
33a. Cenfier (check Doty one) 33b. Sgnefure en
C irrer
• Certirying physician (Physkdan mrtirying cause of death when another physbian has pronounced tleam and completed Item 23}
death occurred due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
knowbtlge
To the best of m , ~ ~~ 4'~
1 ~
y
,
• Pronouncing end cerfgyirg physcian (Physk:ian both pmnouroing death and cenirying to cause of deaM)
- -
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the causeie) and manner u stated
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d d 33c. Li a Number
dd
1 p -"• 33d. Date Signed (Month, day, yeap
_
_ _ _ _ _ _ _ _ _ .. _ _ _
p
ace, an
ue
o
To the hest o1 my krowtetlge, deem occurred al me time, dale, an ~~
NI ,~ ~ ~' I ~-~ :l ~7 S ;{~ ?) (' '~
• Medleal Examiner /Coroner
On the basis of examinallon and / or investigation, In my opinan, death oeeuned at the lime, date, and plxe, and due to the cause(s) and manner as stated_ ^ on Who Completed Cause of Deam (Item 27) Type Pnnl '
~ Name and
tltlress of Pers
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Registrar's ~ afore and Dis
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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
R/e~cords Office for permanent filing.
Local Registrar D ssued
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I, NICHOLAS L. GOBLE, of the Township of Silver Spring, County of Cumberland,
of Pennsylvania, declare this to be my Last Will and revoke any Will or Codicil
iously made by me.
ITEM 1: Upon my demise, I direct that my body be buried at Fort Indiantown Gap
ational Cemetery, Annville, Lebanon County, Pennsylvania.
ITEM 2: I direct that all my just debts and funeral expenses be paid as soon as practical
my death.
ITEM 3: I direct that all taxes that may be assessed in consequence of my death, of
nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of
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expense of the administration of my Estate.
ITEM 4: I give, devise and bequeath all the rest, remainder and residue of my estate of
every nature and wherever situate, together with all insurance thereon, to my beloved wife, MARGARET
GOBLE, provided she survives my death by thirty (30) days.
ITEM 5: Should my beloved wife, MARGARET ANN GOBLE, predecease me or fail to
survive my death by thirty (30) days, then I give, devise and bequeath all the rest, remainder and residue
of my estate of every nature and wherever situate, together with all insurance thereon, in equal shares, to
Page 1 of 6
my children, MICHAELLA A. PLACIDO of 1001 Oak Street, Hood River, OR 97031, MARK K.
GOBLE of 3413 East Pratt Street, Baltimore, MD 21224 and NICHOLAS TOBIAS GOBLE of 36 South
39th Street, Camp Hill, PA 17011, per capita.
ITEM 6: My Executrix or her successors shall have the following powers in addition to
those given by law to be exercised by her in her absolute discretion, which powers shall be applicable to
all property held by her, effective without the order of any court and until the actual distribution of all
such property:
a. To retain any investments at discretion including stock of any corporate fiduciary
or of a holding company controlling it;
b. To invest and reinvest in the executrix's discretion as permitted under Act 28 of 1999, as
amended, the "Prudent Investor Act," with the specific right to invest in stocks, bonds and real estate,
including non-income producing residential real estate for the occupancy of any present income
beneficiary or beneficiaries, and in such diversified, proprietary money market and mutual funds,
including such mutual funds of any corporate fiduciary hereunder or those of any successor or affiliated
or a holding company controlling it, as my executrix deems appropriate;
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c. To sell, to grant options for the sale of, or otherwise convert any real or personal property
interest therein, at public or private sale, for such prices, at such time, in such manner and upon such
as they may think proper, and to execute and deliver good and sufficient conveyances, assignments
and transfers thereof without liability of any purchaser to see to the application of the purchase money;
d. To borrow money and to secure the repayment thereof by mortgage of real or personal
property, pledge of investments or otherwise, without liability on the part of the lenders to see to the
application thereof;
e. To compromise claims by or against my estate or any trust created hereunder;
f. To allocate and distribute different kinds or disproportionate shares of property or
ided interests in property among beneficiaries or trusts, in cash or in kind, or partly in each;
g. To register investments in the name of a nominee or to hold the same unregistered in such
that they will pass by delivery;
h. To join in any recapitalization, merger, reorganization or voting trust plan affecting
to deposit securities under agreement; to subscribe for stock and bond privileges; and
to exercise all rights of security holders;
i. To manage, operate, repair, alter or improve real estate or other property, and to lease real
and other property upon such terms and for such period as my executrix deems advisable even for
than five (5) years and beyond the duration of any trust;
j. To deduct administration expenses upon either the federal estate tax return or fiduciary
le tax return with or without adjustment as between principal and income, as my corporate or
executrix shall determine;
k. To associate with them in the absence of a corporate fiduciary, an accountant, custodian
and investment advisor, and other agents and to compensate them from principal or income or both, as my
executrix shall determine, such compensation to be a reduction of the compensation of my executrix;
W 1. To associate with her at any time, in her absolute discretion and of her choice, a corporate
~J- p fiduciary which shall have the same powers as my executrix, such designation by my executrix and
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a acceptance by a corporate fiduciary to be in writing;
m. To combine, without prior court approval, any trust herein with any other trust with
U substantially similar provisions, although such other trust may have been created by separate instruments
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and by different persons, and, if necessary to protect different future interests, to value the assets at the
time of such combination and to record the proportionate interest of each separate trust in the combined
Page 3 of 6
fund; provided however, that no such combination shall be permitted if the effect of such combination
would be (1) to violate the applicable rule against perpetuities; (2) to disqualify any interest in one or
more of such trusts for a deduction for federal estate tax purposes which would otherwise be allowable; or
3) to cause the loss of the exempt status of one or more of such trusts from the imposition of the
generation-skipping tax;
n. To exercise any stock options which they may receive; to borrow such funds from any
source as my executrix may deem necessary for the exercise of such options; and to pledge assets as my
deems appropriate for this purpose;
o. No trustee shall be required to qualify before, be appointed by, or, in the absence of a
of trust, account to any court (and failure to account alone shall not be considered such a breach);
nor shall trustee be required to obtain the order or approval of any court in the exercise of any power or
decision granted hereunder;
p. To allocate any generation-skipping transfer tax exemption from the federal generation-
transfer tax to any property to which I am deemed the transferor under the provisions of Section
2(a) of the Internal Revenue Code of 1986 and its successors, including any property transferred under
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my will and any property not in my probate estate and any property transferred by me during life as to
which no allocation was made prior to my death, to the extent necessary to cause the inclusion ratios
applicable to such transfers to be zero;
q. To disclaim any interest in property without court approval; and
r. To do all other acts and things necessary or appropriate in the management,
and distribution of my estate or trust.
ITEM 7: Until distributed, no gift or beneficial interest shall be subject to anticipation or
voluntary or involuntary alienation.
Page 4 of 6
ITEM 8: I appoint my wife, MARGARET ANN GOBLE, Executrix, of this my Last Will.
the event my wife, MARGARET ANN GOBLE, predeceases me, fails to qualify or ceases to act as
I appoint my daughter, MICHAELLE A. PALCIDO, first alternate Executor of this my Last
ill. In the event my daughter, MICHAELLE A. PALCIDO, predeceases me, fails to qualify or ceases
act as Executrix, I appoint my son, NICHOLAS TOBIAS GOBLE, second alternate Executor of this
Last Will.
ITEM 9: I direct that my personal representative or successors, shall not be required to
bond for the faithful performance of her duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
['estament, this 2 ~tday of , 2007.
f
~LA~
NICHOLAS L. GOBLE
Signed, sealed, published and declared by the above-named Testator as and for his Last Will and
in our presence, who, at his request, in his presence and in the presence of each other, have
subscribed our names as attesting wifiesses.
~h
residing at /t+y ~ ,~• ~ti~~~~ ,~ i ~o/~
residing at r- n.• t ~ o s s - m~ ~
Page 5 of 6
MMONWEALTH OF PENNSYLVANIA )
ss:
LINTY OF CUMBERLAND )
We, NICHOLAS L. GOBLE, /~ a a E ~ • (ton. ~ ~cZ, and
J• ~Tr-.+c,~., SEA~z.~ s-s- ,the Testator and the 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 Testator signed and executed the instrument as his Last Will and that he had signed
willingly, and that he executed it as his free and voluntary act for the purpose therein expressed, and that
each of the witnesses, in the presence and hearing of the Testator, signed the will as witness and that to
the best of his or her knowledge, the Testator was at the time eighteen (18) years of older, of sound mind
and under no constraint or undue influence.
Subscribed, sworn and acknowledged before me (-~ ~--ari.•F F~ Co-c ~ E by
LAS L. GOBLE, the Testator, and subscribed and sworn to before me by
N tit • ~ arz. -..~ ~ 2 -and ~l . /~--La,--rL-t E,,.~ S c-~ crR.. ~ :-, the witnesses, this
of ~,( , 2007. `
Notary Public ' (~AL)
NOTARIAL SEAL
kENRY F. COYNE, NOTARY PUBLIC
Pa e 6 of 6 HAMPOEN TWP., CUMBERlANO COUNTY
g MY COFAMISSION IXPIRES tUNE 11, 200
Witness
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Witness