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HomeMy WebLinkAbout11-07-08PETITION FOR PROBATE AND GRANT CIF LETTERS REGISTER OF WILLS OF ~~~~ COUNTY, PENNSYLVANIA Estate of ~~ ~CI.N1 C.Z, ~ r ~ d dV`P~-- File Number e~ I ~ V~5 ' 1 ~ V~ also known as ~J ~,~ Deceased Social Security dumber ~ Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) A. Probate and Grant of Lette s Testa ntar and aver that Petitioner(s) is /are the ~~~ ~~ ~'V'e.ti named in the last Will of the Decedent dated S - ~~~~ and cgdicil(s) dated n~~~Qcs - ~~,~. cam{ 1,.. e~ ~i -} ~e.aa~ Q. ,~ (x.~d r~ciS b-t 1`t`fi an1Vr ~ }sh (State relevant circumstances, e.g., renunciation, death of executor, etc.J N O Except as follows, Decedent did not many, was not divorced, and did not have a child born or adopted after executi~ a instrument(s) o~~retY for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~ x ~'~~ ~ ~~~ t" ~ f~~z t'' 1 B. Grant of Letters of Administration _~ ~.,~ -: ~~ (If applicable, enter: c. t. a.; d. b.n.at.a.; pendente lire; durante absentia; >oritate~ C-l± ~" -rr Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the followin e (if any~~and h~r~: ' Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in SectionA above and complete list of heirs.) ~~ ~ ,, t----, . j; Name Relationshi Residence (COMPLETE INALL CASES:) Attach additional sheets if necessary. . Decedent,,w~as~domiciled at th m ~~~aV1'A~ County, Pennsylvania with his /her last principal residence at ~dL~~ca A~ ~ ~ e, ~'RSI.~a 1J~C~~C ~ ~7~~~~.~n•-~<'-'~rsn (List street address.7bisn/city. tox~nship, county, state, _ip code) Decedent, then ~-years of age, died on ~ ~ ~.;(~[`j ~{ at ~ ~ +~ t t rl DS p ~ ~ A Decedent at death owned property with estimated values as follows (If domiciled in PA) All personal property $ ~OUtfX~ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania g situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Wil] and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: ~~ namr T ed or rinted name azid residence ~Ic z L. ~ oav~ ~M~.~~L,~~ ~,~ A 11G~Sb ~-~- 62~ -R'SS~' Form RW-02 rev. 10.13.06 P2ge 1 Of 2 RW-02 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA ~1 SS COUNTY OF l -~'YY~ ~U I~t-1 U/~ 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 to or affirmed and subscribed before me the (yfil'1 day of L / ///J~,~ For the Re ster c of Pe on 1 Representative Signature of Personal Kepresentative Signature of Personal Representative tv Q ••J ~j X ~ _ ~~ ~..~ File Number: - ~ f'ri Estate of ~r ~ I ~ ~ _ ~ _ U ~~ ,Deceased Social Secu~~ri(ty Num~ ber: Date of Death:~~Uem ~ ~~ ~~ AND NOW, 7~ 1 V ~L~U ! i~ ~~~ '- , in consideration of the foregoing Petition, satisfactory proof having been presented be ore me, IT IS DECREED that Letters ~ ~ ~"Q/[~ are hereby granted to ~ ~~ ~/~` ~- in the above estate and that the instrument(s) dated q - a 5 -- X99( a described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent FEES Letters ............... $ Short Certificate(s) ........ $ O?C~. Renunciation(s) .......... $ I I ... $ I~, OD ... $ V. ... $ ~• ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ ,-9~99- Attorney Name: Supreme Court I.D. No.: Address: Telephone: Form RW-02 rev. 10.13.06 Page 2 of 2 RW-02 Attorney Signature: mx c0^ 4!'V IOUn'I ~I -(~~-i~(1~% LOCAL., REGISTRAR'S CERTIFICATION IMF DEATH WARNING: It is illegal to duplicate this copy by photostat or' photograph. ~ Fee for this certificate, $6.00 I P 14809067 Certification Number "Phis is to certify that the information here gi~~en is correctly copied from an original Certificate o1~ Death duly filed with me as Local Registrar. "I~he original certificate will be forw~~irded to the State Vita( Rec~yrd.s Office for permanent filing. ,~ d--- NOV 0 4 Lcl l3eglstrar Date Issued ~~ I REV 17/2006 PRINT IN AANENT CK INN COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) ,..._~ ~„ ~ ,,,,.,.,~.. r.~ 0 c~ 0 a Y t.: z 7; ;..tr) r- ; :' 1 (':~: i ~J 1 _i -~~ i i ~'-. ' ~~ ':a: - ~=_; _ = t-~-, - 'a 7. Name of Decedent (First, middle, last, suAlx) 2. Sex 3. Social Secury Number 4. Date of Dealn (Month, day, year) Bernice P. Hoover Female 203 ~- 10 =7938 November 2, 2008 5. Age (last BinhdayJ Under 7 year U~tler 1 day 6. Dale of Birth (Morin, Oay, year) 7. Binhplace (City antl slate or loreign country) Ba. Place of Death (Check only one) MonIM Days Hours Mim~hs HOepltd: Other. 96 Yra Janua 9 1912 Wellsville PA ®Inpalienl ^ ER /Outpatient ^ DOA ^ Nursing Home ^ Residence ^Other Speciy 86. County of Death &. City. Boro, Twp. of Deam Bd. Facilely Name (If iwl institution, giro street and number ) 9. Was Decedent of Hispanic Origin? ~ No ^ Yes 10. Race:American Indian, Black, White, etc. UI yes, specify Cuban, (sPen~M Cumberland East Pennsboro Hol S irit Hos ital Mexican, Puenq Rican, vp.) White 11. Decedent's Usual Occu lion Kind of work tlone dun most of wolxi INe. Do not slate retired 12. Was Decedent ever in the 13. Decedent's Education (Specify only highest grade completed) 14. Madtal SWlus: MarnaQ Never Married, I5. Surviving Spouse IIt wife, give maiden name) Kind of Work KiM of Business / IMustry U.S. Armed Forces? Elementary /Secondary (012) College (1-4 or 5a) Widowed, Divorcetl (SpeciM Secrete Public Schools ®rea ^Nd 12 Widowed 16. Decedent's Maikrg Atldress (Street, city 1 town, state, zip code) Dacetlenl's Did Decedent 1680 Revere Drive r~ Actual Residence ,?a. STate __Pennsylvania Live Ina pc. Lq Yes, Decetlenl Lrved in Hampden rwp Mechanicsburg PA 17050 17b. County Cumberla Township? 1?d. ^ No, Decedent Livetl wdhin nd , Actual Limits of Ciryl Boro 18. Father's Neme (First, middle, last, sudiz) 19. Mother's Name (First, midtlle, maiden surname) Ro M. Pi her Beulah Wentz 20a. Infomant's Name (Type r Print) 20b. Informant's Mailing AtlMess IStreel, city /town, state, zip code) Mr. Geor a L. Hoover 1680 Revere Drive, Mechanicsburg, PA 17050 21 a. Method of Oispos9ion ®Cemation ^ Donation 21 b. Date of Disposition (Month, day, year) 21c. Ponce of Disposition (Name of cemetery, crematory or other p12ce) 210. Laalion (City /town, stale. zip cotlel ^ Burial ^ Removal from Stale i Was Cremation ar Donatlon Authorized ^ Omer-SpeciM~ byMr!tlicalEZamirerlCOroner? fgvea^Nd November 4, 2008 Cremation Societ of PA Harrisburg, PA 17109 22a. Sign e F al Serv Licensee (or person acting as <uch) 22b. Lk:ense Number 22c. Name and Address of Facility Auer Cremation Services of Pennsylvania, lIIC . ~ ~ "`~ FD-013376 i., 4100 .Tonestown Road, Harrisbur PA 17109 Cam le s 23a< only when (lying _ 23a. To the best nl m knowled death occurtetl al the time, dale a rid title y 9e~ pMCe sUl g urea ) 23b. License Numbs 23c. Date Signetl (Month tlay, year) physidan is not available at tqn of deem to cenirycauseofdeath. _ l//y ~ 'I ' ~ ~ ' r'Ir '/~ ~.J ~ ,(~ - ~~ (~ , L . J IL~l ,S ~ t/r' _ l/ ) lV 1.1 x Items 2x26 muss be rompetad by person 2d. rme 01 Death 25. Date Prorauriced (Norm, day, year) 26. Was Case Refer ad to Medical Examiner !Coroner for a Reason Other Than Cremator or Donation? wtro pronounces death. / ~ ~~'S~' I)7 M. i~(rj7%7C .~, :~~1~1~ ^Yas ~~No CAUSE OF DEATH (See Instructions and examples) hem 27. Pan I: Enter the chain of events -diseases, Injures, or complications -Nat tliredly caused the tleam W NOT solar lertninal events such as cardiac arre r Approximate interval: st Pad IL Enter dher ~ i i Lcordilions contdbutino to Beam, 28. Did Tobacco Use Contribute to Death? . respiratory artesl, or venlncular fibrillation willam showing the etkNOgy. List only one cause on each line. , t Onset to Death but not resulting in the underlying cause given m Pan I. ^Ves ^ Probably IMMEDIATE CAUSE Final disease or , ~ ^ No ^ Unknown am) _~ '~ V' contlition resuttirg in ~ a 29. II Female'. Due to (or as a consequence off: ^ Nol pregnant within past year Sequentially list caMrans, tt any, b r ^ Pregnant at lime of death . leading to Me cause toted al line a. Due l0 or as a copse Enter the UNDERLYNIG CAUSE ( quanta of): r ^ Not pregnant, but pregnant within 42 days (dsease a injury Ihal iNgated the c of death evenly rewtting in death) LAST. Due to (or as a consequence oit: , ^ rJ01 pregnant, but pregnant 43 days to I year d. I batons death r ^ Unknown it pregnant wilnin the past year 30a. Was an Autopsy Pedomietl? 30b. Were Autopsy Findings Available Prior to Corriplelion 31. Manner of Death 32a. Date of Injury (Month, day, year) 326. Describe How Injury Occumetl 32c. Place of Injury. Home, Farm, Street, Factory, of Cause of Death? ~ Natural ^ Homicide Otitis Bulltlln etc. (S c 9~ Pe ~tyl ^ Yes ~ No ^ yes ^ No ^ Accident ^ Pending Investigation 32d. Tme of Injury 32e. Injury al Work? 321. If Transponation Injury (Specity) 32g. Location of Injury (Street, city /town, stale) ^ Sucitle ^ Could Nol be Delermirletl ^Ves ^ No ^ Dmer/Operator ^ Passenger ^Pedeslnan M. ^Olher~ Specdy: 33a. Cenifler (check only one) 33 `Igoe Ire am 41 Cep ler • Certifying physician (Physician ceNtying cause of death when arrolher physician has pronounced death antl completed Item 23) N:r ~ /~ To the best of my knowledge, death occurretl due to the cause(s) and manner as sleted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Pronouncin and c rtif i h i i Ph i i b h _ _ _ _ _ _ ^ ~ _ ~ Y4 , ~ g e y ng p ys c an ( ys an c ot pronouncing death and ceditying to cause of death) 33c. License bar ~ 33tl Dale Si eel Month da ea ) n ( To the best of my knowledge, tleath occurred at the lime, date, aM lace, and due to the tau P se(s)and manner as statrxL_________________, ^ • M di l E i /C ~ / _ M r . , r y, y 9 e ca xam ner oroner On tM ba i f i ti d / I ~ cf /_ CI . r s s o exam na on an or nvestigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as slated_ ^ 34. Name aM Adtlress oI PPerson Who Comp k led Cause of Deam (Item 271 Type / Pnnl 35 stmr's Signatu i ~ 38 Date Fi eel (MO h, day, year) 1 lI 1 ~ Y [J ~ ~J -? ~' ` r ~ F~I e S ~~ ~ *Ll Diappsnim, Permel Np 0308934 ~O u r t."• -: ' _ -,s ~ t~~ LAST WILL AND TESTAMENT '~C7~ ~. ~.f~ =~_ ~~ ~ _ ~ ~, -- ~~~ .. I, BERNICE P. HOOVER, of the Borough of Mechanicsburg, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and ~. '.. ~~. funeral expenses be paid by my Executor, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath a:ll the rest, residue .~ and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated unto my husband, namely, A. EUGENE HOOVER, absolutely and in fee simple, if he survives me by as many as sixty (60) days. THIRD. If my husband, A. EUGENE HOOVER,, does not survive me by as many as sixty (60) days, then and in ghat event, I order and direct that all the rest, residue and rE~mainder of my Estate, real, personal and mixed, whatsoever and whearesoever situated, be divided into three (3) equal parts, which parts are to be distributed and disposed of as follows: A. I give, devise and bequeath orie (1) such part LAW OFFICES SNELBAKER BRENNEMAN of my residuary estate unto STANLEY K. ALTLAND and B. JANE ALTLAND, husband and wife, c-r unto the survivor of them in the event either should predecease me, absolutely and in fee simple. If both of said persons should U L .._~ ,,~ LAW OFFICES S NELBAKER BRENNEMAN predecease me, then and in that ultimate event, I give, devise and bequeath said share unto the issue of B. Jane Altland per stirpes by representation and not per capita. B. I give, devise and bequeath one (1) such part of my residuary estate unto GEORGE L. .HOOVER, absolutely and in fee simple. If the said GEORGE L. HOOVER should predecease me, I order a:nd direct that said share shall be distributed unto his issue per stirpes by representation and not per ~~apita. C. I give, devise and bequeath one (1) such part of my residuary estate unto KENNETH A. PIPHER, absolutely and in fee simple, if he survives me. If the said KENNETH A. PIPHER does not survive me, then and in such event, I order and direct i~hat this disposition shall lapse and such share shall be added to and distributed as part of the disposition in Paragraphs A and B immediately above. LASTLY. I nominate, constitute and appoint my husband, A. EUGENE HOOVER, to be the Executor of this;, my Last Will and Testament, but if for any reason he should fail to qualify as such Executor or cease so to serve, then andl in that event, I nominate, constitute and appoint GEORGE L. HOOVER to serve as Executor hereof, each and both personal representatives to serve without bond or other security as a condition of qualification hereunder. IN WITNESS WHEREOF, I, BERNICE P. HOOVER, have hereunto set hand and seal to this, my Last Will and Testament which -2- consists of three (3) typewritten pages to each of which I have affixed my signature this r7f ~ ~ day of,.~-' /~~,; ,-n, -:~;~t~~' A.D., One ,! ^~' Thousand Nine Hundred Ninety-six (1996). ,t - ~;~ .E~ !- d L c. ~°<: f '`;' `~_ t``. L, `.~ Gt SEAL) Bernice P. Hoover The preceding instrument, consisting o1. this and two (2) other typewritten pages, each identified by the signature of the Testatrix, was on the date thereof signed, :pealed, published and declared by BERNICE P. HOOVER, the Testatri}: therein named, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence, a the presence of each other, have subscribed our names s tnesse;,s--hereto. r ~. ..; ~ LAW OFFICES SNELBAKER BRENNEMAN -3- COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) We, BERNICE P. HOOVER, RICHARD C. SNELBAKER and JANET R. STEGNER, the Testatrix 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 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, signead the Will as a witness and that to the best of his or her ~:nowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~. Subscribed, sworn to and acknowledged before me by BERNICE P. HOOVER, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANET R. STEGNER, witnesses, this .:~ ~ day o f ~~~.~.,.,~-C~'.~.. /1 , 19 9 6 . __ e Nota -y Public LAW OFFICES SNELBAKER & --- 6RENNEMAN P~Ci2ric! S2aI ~aYriCla J_ Thuns©rl, «o9ary Public ;,;eche,,ics^~urcy f~oro, Gumberl~nd bounty II 'v`v C ammissicn Expires Dec 31 ? 999 ~- ~ ~~, Wait-one-s