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Home My WebLink About09-12-08File Number: ~_~ ~ - ,i~ '/~ / 7 Cumberland Register of Wills of County, Pennsylvania PETITION FOR PROBATE AND GRANT OF LETTERS Estate of Rose A. Lemke also known as: Deceased Social Security # 195-07-7293 Petitioner(s): John D. Lemke who is/are 18 years of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' as applicable: aA. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/21re the executor(s) named in the last Will of the Decedent, dated November 5, 2007 and codicil(s) datl~d (State relevant circumstances, e.g. renunciation, death of executoir, etc.) ~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instruments offered for probate; was not the victim of a killing and was never adjudicated incapacitated: ~B. Grant of Letters of Administration (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived by the follOWing SpOUSe (If any) and hell's: (If Administration c.t.a. or d.b.n.c.t.a. enter date of Will in Section A and complete list of heirs) Name Relationshi to Decedent Address rv » J,~^ l~ ~ll,r ~:r:. r-- ~, _ _~ .... _ ~J - - ::x7 PV ---~ _ THIS SECTION MUST BE COMPLETED: ns -. 0 Decedent was domiciled at death in Chester County, Pennsylvania, with his/her last family or principal residence at _914 Indiana Ave., Lemoyne, PA 17043 Lemoyne Borough Street address with Post Office and Zip Code Municipality: Township, Borough, City Decedent, then 91 years of age, died October 31, 2008 at Camp Hill, PA Month, Day, Year of death City and State where death occurred Estimated value of decedent's property at death - If domiciled in PA All personal property $ 150,000.00 - If not domiciled in PA Personal property in Pennsylvania $ - If not domiciled in PA Personal property in County $ - Value of Real Estate in Pennsylvania $ 250,000.00 Total Estimated Value $ 400, 000.00 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 914 Indiana Ave., Lemoyne, PA, Lemoyne Borough, Cumberland County Revised: 10/25/2007 File Number: ~~- i ~~;~~~~~-1117 Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and/or the Grant of Letters in the appropriate form to the undersigned: Si natur of Petitioners Address of Petitioner s 7737 Villa e Trail Dallas, TX 75240 OATH OF PERSONAL REPRESENTATIVE Commonwealth of Pennsylvania County of Chester The Petitioner(s) above-named swear or affirm 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 t law. ~ Sworn to or affirmed and subscribed before me this ~ day of ;-> ~p m r ~• ~; T ~- , 'iA. L - ? -"- r~ ~~-~ - - Deputy for Register of Wills }`-== `~ '-` ru 0 FEES Letters ..................... $ 360.00 Attorney's Name: L. Peter Temple, Esquire Short Certificates Attorney ID #: 17573 (~ @ $10.00 each 24.00 Address: Larmore Scarlett LLP Renunciations P.O.13ox 384 (_~ @ $ 5.00 each Kennett Square, PA 19348 Inventory ..................... Inheritance Tax............ _ _ Telephone: 610-444-3737 Wi11 ........................... 15.00 Automation ................. 5 . ()() ................................. ................................. Subtotal State Computer Fee........ 10.00 Formal Letters:®/ Yes ~No TOTAL ................... $ 414.00 Revised: 10/25/2007 '~~ Oath of Personal Representative COIvI~10NbVEALTH OF ~NSYLVANL4 SS COUNTY OF 'The Petitioner(s) above.-named swear(s) o ffirm(s) that the statement- 'n the foregoing Petition are ttve and correct to the best of the knowledge and belief of Petitioner(s) and that, as rsonal repre [ative(s) of the Decedent, Petitioner(s) will well and tru]y administer the estate according to law. Sworn to or affirmed and subscribed Signahrre of Persona! before me the day of Signnture of Persor7a! Representntive C the Register Signnture of Personal Representative File Number: ~~, ' (~~- I Estate of ~ ~S ~ ~ • ~~ ~~~ ,Deceased Social Security Number: ~~ ~ - O I ' 1~, ~^ Date of Death: I (~~ 3 ~ ~ p~ o~g AND NOW, ~ ~~~ , ~~~ rn I~JPI't ~, S~(.~wx , in consideration of the foregoing Petition, satisfactory proof having been presented before me, T DECREED that Letters~~ ( Y are hereby granted to in the above estate and that the instrument(s) dated ~ I - ~~ U Z______ - _ ____ _ _~ described in the Petition be admitted to probate and filed of record as the Last Will (and Codicil(s)) of Decedent. r qq h ((--77~~ FEES ~ ~ ~~~ ~~yi'[~ L.'1- _ ~ _ $ ~2 / ~ ~C~O ~ Register of Wills 11~y' ~'~ ~1E'~_ Letters ............... ~JLP - ~"' 3 Short Certificate(s) ........ $ ~~-- Dy Renunciation(s) .......... $ i I I ... $ l I5~.. ~D^~y~.D` T $- ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ ~ . ~~~ Attorney Signature: Attorney Name: Supreme Court LD. No Address: Telephone: Furor RW-0? rev. !0.!3.U( Page 2 of 2 LOCAh REGISTRAR'S CERTIFICATION OF ~EAT[~~ WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Fee for this certificate, $6.00 'P 14809007 Certification Number I tEV 11Y2006 PRINT IN ANENT :K INK "Phis i5 ro certify that the into»-motion here given is correctly, ct~pied from an ori~in.al Certifictue of Death duly filed with Ina as Local Registrar. The original certificate will he for~~arded to the State Vital Records Office for pern)anent filing. ,y ~:~ ~'~%~ ~~ op zoos Local Registrar Date Issued r~.a _ __ ~ ~ -- t7 `~ ' s , n ~ _~ ~ ;, '; -- .z_: N .. ~_-:~ ., COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~'? t~l _ r ~ .~ CERTIFICATE OF DEATH ~ 1 ~ _ t. N ~ ~ ' ~ " (See Instructions and examples on reverse) ~r•r< <, ~ ~,,,,,,, ~~ r .. _.-) ~..~~~~ v. w,.w.,n tnra, mwOie, last surtixl 2. Sex 3. Social Secunry Number 4. Date of Death (Month, tlay, year) female 195 -07 :7293 Oct.31,2008 5. Age (Lest Bimrtlay) UrNer 1 year Under t day 6. Date of Binh (Month, day, year) 7 Birthplace (City and slat l a . e or or gn country] 8a. Place of Death (Check onty one) ksonuu ~~ ~~' Mlmxes Hospital: Other: 91 yrs Apr.2, 1917 Chambersburg, PA ,--.,/ ati LEA In t ^ ER / ^ p en Oulpatiem DOA ^ Nursing Home ^ Residence ^Other ~ Specify: Bb. County of Death 8c. Ciy, Boro, Twp. of Death ed. Fadlity Name (II not institution give slrcel and number) , 9. Was Decedent of His anir, On in7 P g No ^Yes 10. Raca~ Amencen Indian, Black. Whhe, etc. Cumberland East Pennsboro Hol S irit mye9, apepity c°can, Y p Mexican, Puerto Rican, el: j Yl(1 L 2 11. Decedent's Usual Occu Nan Kind of worN do ne du' moss of worki life. Do rat state retired 12. Was Decedent ever In the 13 Decedent's Educati n (S if l h Kind m Work Ki d m B i U S Armed F ? . pec o y on y ighest grade completed) 14. Marital Status. Married, Never Married, 15. Survivin 9 Spouse (tl wile ive maiden n n us ness I Industry . . orces Elementary /Secondary (0-12) College (1-4 or 5+) (SpaGM Widpwed, DWprred , g ame) sewifa own home ^Yee ~r,p 12 widow:~d • 16. Decedent's Mating Address (Street, city /town, state, zip code) Decedent's Did Decadent 4 8 3 7 E. T r i n d l e R d.,# 5 6 2 AdUal Residence 17a. slate -_ P P n n R y l V a n i a Liva in e 17c~yils Decedent Lived in H a m p d e n Mechanicsburg, PA 17050 , Township? T'wV. 17h. County Cumberland nd ^NO, Deceeem Lived wanin Actual Limh f 1B. Fathers Norma (First, midde, last, sulNx) e o City I Boro William Dalbey II 19. Homer's Neme (First, middle, maiden surname) Helm Shaubla 20a. Informant's Name (Type / Pnnt) 20b. InlortnanYs Mailing Address (Street, city /town, stele, zip code) Constance Arnold 286 Walter Rd.,Cochrztnville,PA 19330 27a. Method of Dispwhbn ^ Cremation ^ Donation 21 b. Date of DisposNan (Month, day, year) 21c. Place of Disposton (Name of cemaery, crematory or other place) 21 d. location C I town, slate zi code ry(I Bunal Removal from Seta (dY p ) ta ^ ~ , i Wee Cremation or Donation Authorized Cam H i 11 , P A 17 O 1 1 ^ Obrer~5peciy' byMetllcalExsminer/Coroner? pYe9^No IJov.6, 2008 Rolling Green Cemetery p ~ ~ 22a. re•N Furerel se Licensce (or person actlng as slrch) 22b. License Number 22c. Name and Address of FacNity ~ ~ '- ~.LCIU° ' FD-013163-L Musselman FH&CS,324 Hummel i~ve.,Lemo ne PA 17043 h • , ems 23ea onty when rerNtying 23a. To the bell of my knowledge, death occurtetl at Nre time, dale and place stead. (Sgnature and Nile) 23b. License Number physidan re not avaiMde at lime of deaM to 23c. Dale Signed (Month, day, year) certNy rouse m death. ' harts 244fi must be completed b Y Parson • wM Dronolxaes deem 24. Time of Death "n M 25. Date Praaunced Dead (Month, tlay, year) z 26. Was Case Retorted to Medical Examiner /Coroner for a Reason Other than Crematon Or Donation? . G/ ~/ vC~ ~ E ^Yes ~No CAUSE OF DEATH (See Inatru ctlona end examples) A r pproximate interva: ttem 27. Pan I: Emer the NaNI W events -diseases, inryrxs, w compkcaNOns - that dredy reused me deem. DO NOT enter temanal evens such as cardiac artast Pan II'. Emer mbar g~Nor,s crnlnbulFO to deem, 26. Did Tobacco Use Comnbute to Death? , r Onset t0 Deam respiratory arrest or ventricular 6tKi4ation witlwm showing the etiology. Lst onty one reuse on each Nne, bn rat resuhing in the uMedying reuse given in Pan I. ^Yes ^ Probabty IM~ME~A ~A 9$^ Final) dsease or ^ D r/ /~ / , ; -y"") ~ y ~ / ^ No ^ Unknown ~ ~ ~ a. n l C'~ 4 C(~ / 1 I ~4 ( ( ue to ( as a canaequance oQ: 29. h Female. ~ Sequsnlialry Nsl mndNpns, if arty, b ~ ^ No1 pregnant within pest year leadrq to IM wwe listed on Gne a. Enter the UNDERLYING CAUSE Due to (or as a consequence op: ~ ^ Pregnant al lime of death (disease a injwy Ihat inlNeted the c ^ No~pregnanl, but pregnant wihin 42 days events resuAing m death) LAST. Dua to (or es a consequence of). d ^ Not pregnant, but pregnant 43 days to 1 year ~ before death 30a. Was en Aul ^ Unknown N pregnant whhin the past year opsy 30b. Wert Autopsy Findings 31. Manner of Death 32e. Date of Injury (Month, day, year) 32b. Descnhe How Injury Occurred 32 Penomsd? Available Prior to Completbn Pl c. ace of Injury Home, Fartn, Sreel, Factory, OI Cause of Death? ^ Natural ^ Homidtle Ollice Building, etc. (SpepyJ ^ Yes L~ ~ ^ yes ~p ^ Acdtlem ^ Pendng Imestigatbn 32tl. Time of Injury 32e. Injury at Work? 32f. If Transporretbn Injury (Specityl 3?g. Loretlon of Injury (Sheet, city I town, stale) ^ Suicide ^ Could Not be Determined ^Yes ^ No ^ Dnver /Operator ^ Passenger ^Pedestnan M. ^Other- Speciyy: ' 33a. Certil sr (check onty one) • Cemlynng physielan (Physican renitying cause of death when anoUer 33b. Sgneture an ills of C ~-' - ~ To the boat of m lOaw Physican has pronounced tlrein and completed Item 23) ~ r; n - y ledge, deem ocanetl due to the cau9e(9l and manner es 9Vled,- ~~~ p/~~ ~ ~ / ~ l """"""""""_""""_" ^ • Pronounclrg end nnllying phyclclan (Physician both proncungng deem arld certifying to cause m death) ~ ~ i To rile best of my knowledge, death occurred at the Ilme, date, end pace, and due to the cau 33c. Lic a umber 33d. Date Si y, year) se(a) aM manner as atated_ _ _ _ _ _ _ _ ^ . ~ ~/ -x , ~ O I l / • AledMSl Examiner I Coroner _ _ _ _ _ _ _ _ _ _ /~ / ~/ ~ n~ rX f(( ~ On the ha91c of examinatlon end ! Or inveMlgetion, In my opinion, death Occurred at the time, date, arM place, and due 10 the reuse(s) and manner as stated_ ^ . Name and Addr?ss o~arson Why Complelptl Cause of Daalh (Item 27) TYpa / Pnm '~ 35 R slrer's sl a 1l u N Q 1 nd Di L° /`~C»7~~~~ ~Z t i `-~ ~ ` ~ a s r ~ ct r A , JJ (i 36 Date F led ( onln, day, year) / I ~ ~ ~ ~ ~ 7 :,/ ~~ . ~oof L~`l (N -ro~c% s/:~~ !/ii,3l~..-,f'!~/7izl Z Disposition Permit No. LJ .J V Lr / G l WILL I, ROSE A. LEMKE, of Mechanicsburg, Cumberland County, Pennsylvania, do make this my last Will, hereby revoking alll prior Wills and Codicils. ITEM I. I direct my Executor or my Executri:~ hereinafter named (and hereinafter referred to as Executor) to pay all my just debts ,end funeral expenses as soon after my death as maybe convenient. ITEM II. I give all of my tangible personal property including my household furnishings, vehicles and personal effects (exclusive of cash, claims, stocks, bonds and all other tangible evidences of intangible personal property), together with all policies of insurance on the said tangible personal property ~~gainst any loss of whatsoever kind, to my children living at my death, to be divided among; them as my Executor so decides. However, notwithstanding the foregoing, I direct that my said tangible personal property, in part or all of it, be distributed in accordance with any separate memorandum that I may leave. ITEM III. I give and bequeath the sum of Two Thousand Five Hundred Dollars ($2,500.00) to each of my grandchildren who survive me. ~~ ITEM IV. I give, devise and bequeath all the rest, residue remader of ~ ~' _ -,~, :~- ~ -~ my estate, together with any property over which I may have the right to ~~s'ise any _Cr~n N ___ _ C , `-; _' =r7 -~ _ ~_ ~' _r -~ ~l~J N F 1 ~~ ~ .. ~} _-i power or powers of appointment, not hereinbefore disposed. of effectively, hereinafter together referred to as my residuary estate as follows: A. One-fifth (1/5) to my son, JOHN D. LElV[KE, or if he does not survive me, then to his then living spouse and, if none, then to his issue, per stirpes; B. One-fifth (1/5) to my son, TIMOTHY A. LEMKE, or if he does not survive me, then to his then living spouse and, if none, then to his issue, per stirpes; C. One-fifth (1/5) to my daughter, CONSTA:~TCE ARNOLD, or if she does not survive me, then to her then living spouse and, if none, then to her issue, per stirpes; D. One-fifth (1/S) to my son, PHILIP C. LEP/IKE, or if he does not survive me, then to his then living spouse and, if none, then to his issue, per stirpes; and E. One-fifth (1/5) to my son, CHRISTOPHER T. LEMKE, or if he does not survive me, then to his wife, PATRICIA M. LEMKE. ITEM V. I appoint my son, JOHN D. LEMR:E, Executor of this Will. Should he predecease me or for any reason be unable to act nor to continue to act, I appoint my daughter, CONSTANCE ARNOLD, Executrix in his place and stead. ITEM VI. I hereby authorize and empower m:y Executor: A. To retain any property received, including any stock or other investment; B. To sell real and personal property, at public; or private sale, for cash 2 and/or credit; C. To distribute in cash or kind, or partly in each at valuations fixed by them; D. To serve as my personal representative in any foreign jurisdiction in which ancillary administration of my Estate maybe necessary; and E. To carry on any business owned or controlled by me at my death for whatever period of time he shall think proper, and he shall have the power to do any and all things he deems necessary or appropriate, the power to borrow and to pledge assets contained in my estate as security for such borrowing and the power to close out, liquidate or sell the business at such time and upon such terms as to him shall seem best. ITEM VII. I direct that no fiduciary acting hereunder shall be required to give any bond or enter any security in any jurisdiction in which such fiduciary may act. ITEM VIII. I direct that all taxes and interest and penalties thereon that may become payable by reason of my death, with respect to the property comprising my gross estate for tax purposes, whether or not such property passes under this Will, shall be paid out of the principal of my residuary estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ A/ day of ~~/ o ~~~ >"~ c' ~ 2007. ~/ ~~. °~~~ (SEAL) ROSE A. LEMKIE SUBSCRIBED AND SEALED by the above-named Testatrix, ROSE A. LEMKE, in the presence of us and of each of us and at the same time published, declared and acknowledged by her to us to be her Last Will and Testament, and thereupon we, at the request of the said Testatrix, in her presence and in the ~-resence of each other, have hereunto subscribed our names as attesting witnesses the day and year last above written. -f' /~ ", _ of ~~~~~•~tr~r ~~ of C~`Q cfvr~ y Nn ~ ~ r7v ~-c,~~' CoiV1MONYVEALTM of PENNSYLVANIA Notarial Seal Donna E. Grimwood, Notary Public Lower Allen Twp., Cumberland County My Commission Expires June 19, 2010 ^QFmbBr, Penewluanin Assor_i?f ~ of Not2rie~ ti~ ~~ l.~ 4 COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CHESTER ~ BEFORE ME the subscriber on this day pe sonally appeared ROSE A. LEMKE, ~~-nom-rte ~ ~~ _.~`'e.e.~t-e.- ,and ~ ~ ~~ ; -~, known to.riie to be the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, and, all of these persons being by me first duly sworn, ROSE A. LEMKE, the Testatrix, declared to me and to the witnesses in my presence that the instrument is her Last Will and Testament and that she had willingly signed or directed another to sign for her, and that she executed it as her free and voluntary act for the purposes therein expressed, and each of the witnesses stated to me, in the presence and hearing of the Testatrix., that he or she signed the Will as witnesses and that to the best of his or her knowledge the Testatrix was eighteen years of age or over, of sound mind and under no constraint or undue influence. COMMONW~ALT`M G~ PENNSYLVANIA Notarial Seal Donna E. Gnmwood, Notary Public Lower Allen Twp., Cumberland County My Commission Expires June 19, 2010 ~rlemher, !~Pnnsylvania ?ssociation of IJot2ries 0 ROSE A. LEMKE ¢'' ,, 7 / fitness Witness Subscribed, sworn and acknowledged bef re me ~"y RO A. LEMKE, the Testatri subscrib d and sworn before me by ~' ~-i.~~ C ~~e/~ and ~a , this ~ day of ~~.~' .~ c A.D. ~` 007. ~~ Notary Public