HomeMy WebLinkAbout11-14-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of Gertrude Benjamin
also known as
COUNTY, PENNSYLVANIA
File Number ~ ~ `~ j) ~' ~' ~~
Deceased Social Security Number 176-18-1836
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 / m~ethe
last Will of the Decedent dated January 22, 1996 and codicil(s) dated N/A
Executrix
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 instrument t(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: None r~ °o
C-- _; --
.O
^ B. Grant of Letters of Administration ~ r--~
(If applicable, enter.• c. t. a.; d. b. n. c.t.a.,~ pendente life; durante absentia;
~% CIS
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following 5p~xsj
Administration, c. t. a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) -i
__, ~._
-,-
(COMPLETE IN ALL CASES:) Attach additional s/eeets if necessary.
'fate)""' ! `_' ; . ~
F- _.. _7
any},~d hens: • (fjf-~t
- '::~
v.~ ~
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
Apt. 227, 824 Lisburn Rd., Camp Hill PA 17011
(Gist street address, town/city, township, county, state, zip code)
Decedent, then 94 years of age, died on October 31, 2008 at Jewish Home of Greater Harrisburg, 4000 Lingiestown Rd.
Harrisburg, PA 17112
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 395 , 000
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows: NOne
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:
or printed name and residence
Eileen Forman, 2302 Scarborough Dr., Harrisburg, PA 17112
Form RW-02 rev. 10.13.06 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF Cumberland
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 affirmeld'and subscribed
before me the ~ `I~~~ day of
Y t/I 1 L -(
~~~ .a
r the Register
` ~!
Sign'a e of Personal Representat e
Signature of Personal Representative
r~.?
Signature of Personal Representative ~ 0 ~D "_
`~~ ~ ~ ')
• __,
'~ -= C7 -mC
~y I2 1-.C.%
File Number: ~ ~ ` ~ ~ ' I ~ o~ ~ %`> -T-;
c. ~T
Estate of Gertrude Benjamin -'~
Decea~d
Social Security Number: 176-18-1836
Date of Death: October 31, 2008
W - _.
cT
AND NOW, ~ ~~ ~ (, (j1/ , in consideration of the foregoing Petition, satisfactory proof
having been presented before , I S DECREED that Letters Testamentary
are hereby granted to Eileen Forman
and that the instrument(s) dated January 22, 1996
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ............... $ V~
Short Certificate(s) ... (6~.. $ .~
Renunciation(s) .......... $
... $ r
... $ .~~
:.. $ 4.~
... $
... $
... $
... $
... $
... $
TOTAL .............. $ ~_
Attorney Signature:
Attorney Name: Elliot A. Strokoff
Supreme Court I.D. No.: 16677
Address: Strokoff & Cowden, PC
in the abova estate
132 State Street, Harrisburg, PA 17101
Telephone: 717-233-5353
Form RW-02 rev. /0. /3.06 Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
FL~c ft>I Ihi. I~ertiFia(te. y6.0O
P 14886485
Certitieatiun Number
Thi,~ is to certify that the information here ~ieen is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrm-. The original
certific,_Ue will he forwarded to the State Vital
Reami< Office For permanent filing.
~~~~7 NOV X008
Local I:egistrar Date Issued
n N
v
~?~ ~ ~
_
-~ ~ ~ i`i
<.~L ~~
')
~
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS W -` _-~ .'
n
CERTIFICATE OF DEATH '
~
~
(See Instructions and examples on reverse) STATE FILE NUMBER _
H705-143 REV 11/20(16
TYPE / PRINT IN
PERMANENT
BLACK INK
0
z
1. Name of Decedent (RrsL middle, last, suRz) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year)
F 176 - 18 -1836 10/31/2008
5. Age (Last Birhtlay) odor 1 year Untler 1 day 6. Dale of Birth (Month, day, year) 7. Binhplace (City antl state or foreign country) Ba. Place of Deeth (Check only one)
MonMS pays Hwrs MinNes Hospital: Other
9 4 Yrs. 5 / 17 / 1914 Phi 1 a d e 1 p h i a , PA ^ Inpatlent ^ ER I Oulpatiem ^ DOA ~/ ursing Home ^ Residence
tp}N ^Other-Speciry:
8b. Counry of Death &. Ciry, Boro, Twp. of Death Bd. Facility Name Qf rwt institution, gNe street and number) 9. Wes Decedent of Hispanic Origin? No ^ Yes 10. Race: American Indian, Black, Whke, etc.
Qf yes, speciry Cu>an, (SpeclM
Dauphin Lower Paxton Jewish Home of Greater Harrisburg Mexican,PuedoFican,eta) White
11. Decedents Usual Occu Lion Kind o1 work done B urin most of workin life. Do not state reliredl 12. Was Decedent ever in the 13. Decetlenl's Education (Specify only highest grade comp leted) 14. Marital Status: Marred, Never Marred, 15. Surviving Spo use (If wile, give maiden name)
Kind of Work Kind of Business I Industry U.S. Armed Forces? Elemenury /Secondary (0-12) College (1-4 or Sa) Witlowed, Divorced (SpeciM
Proprietor Childrens Wear ^Yea 12 Widowed
16. Decedent's Mailing Address (Street, city /town, slate, zip cotle) Decedent's Did Dc ,edeM
'
4000 Li ngl estown Rd ~Yes, Decedent Lived in j nwor Da vtnn Twp.
AGUal Residence 17a. Slate Pann cal vania Townshi
? 17c.
H
i
b
PA 17112 p
176. Counry D a u p h ~ n ~' ~ ~ 17d. ^ No, Decedent UveO within
arr
s
urg, AaualLimtlsof Ciry/Boo
16. Fathai s Name (First, middle, last, suffix) 19. Mother's Name (First, mkldle, maiden surname)
Jose h Rovner I a Unk o
20a. Inlornanl's Name (Type I Pdnq 20b. Informant's Mailing Address (Street, city /town, slate, zip code)
Eileen Forman 0
21 a. Melhotl of Disposition ^ Cremation ^ Donation 21 b. Date of Disposition (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or other place) 21 tl. Locatlon (City /lawn, state, zip code)
llI~.~~-pq1~~ Buda) ^ Removal Iran Stale i Was Cremation or lbnatlon Aulhodzatl
^Odier-SpeciM by tAShccal Examinerl Coronert ^Yea^No
11/2/2008
Mt. Sharon Cemeter
S rin field PA
22a. Signature of Funeral Service Licensee (a person acting as such] 22b. Ucense Number 22c. Name end Address of Fadliry GOLDSTEINS' ROSEPIBERG'S RAPHAEL-SACKS
INC
-
loi9a-L ,
.
3105ECONDS ~~
Co a Items 23ac oNy en codifying 23a. To the bast of my knowledge, death oaurred al the lime, tlale and place staled. (Sgnatae and title) 236. License Number 23c. Date Signetl (Month, day, year)
physidan is rid available at bme of death la
cerary cause d Beam.
Items 24-26 must be completed by person 24. Time of Death
~~ 25. Date Prono tl onth, day, year Z`~,,,,~
~ ~'"V C' 26. Was Case Referred to edlcal Examiner! Coroner for a Reason Other than Cremation a Donation?
who pronounces Beam. 7 Aq. ^Ves
YY
CAUSE OF DEATH (S Instructions and examples) r Approximate interval, Pan II: Enter aher gsui uwlicao
t condo ons conldbulingfo death, 28. Did Tobacco Use Contdhule to Death?
Ilwn 27. Pad I: Enter the Lhain of events -diseases, injuries, a compliratkns -that directly causetl the death. DD NOT enter lertninal a vents such as cardiac arrest, r Onset to Death but not resulting m the untledying cause given in Patl I. ^Ves ^ Probably
respiratory arrest, or venldwlar 'Nation wimout stowing the etiolagy~List any one cause ach line. ^ No known
IMMEDIATE CAUSE Final disease or
condlion resulting in ~eam) _~ a I
29. If Fem
Due to (or as onsequence o0: ~ at pregnant within past year
Sequentiallyy list condidms, tl any, b r
m
l
~ ^ Pregnant al lime of death
leedng to
s cause 6aletl on
ine a.
Enter the UNDERLYING CAUSE Due to (or as a consequence ol): ^ Not pregnant, but pregnant wihin 42 days
(dsease a injury mat Inidatetl the a r
events rewtling to death) LAST
I
of death
.
Due to (or as a consequence ofl~. r ^ Not pregnant, but pregnant 43 days to 1 year
d ; before death
^ Unknown if pregnant wtlhin the past year
30a. Was an ANOpsy 306. Were Autopsy Findings 31. Manner mf Death 32a. Data of Inlury (Month, day, year) 32b. Describe How Injury Occurte0 32c. PWce of Injury: Hans, Farm, Street, Factory,
Pedormed? Available Pdor to Completion
^ Office Building, etc. (Speciy)
of Cause of Daath? atuaJ
Homicide
-/
^ Yes I ~f No
"' ^ Yes ~].No ^ Accident ^ Pending Investigation 32d. Time of Injury 32e. Injury al Work? 32f. II Transporlatbn Injury (Specify) 32g. laation of Injury (SlreeL city r lawn, stale)
YYY ^ Suicitl=, ^ Could Not be Delemlined ^ Yes ^ No ^ Driver I Operator ^ Passenger ^Pedaslrian
M ^Other - Speciy:
33a. Cadifier (check only oriel 33b. Signature and Title of
• CMltying physician (Physician cerirying cause of death when enamor physician has pronounced death and completed Item 23)
To the hest of my knowledge, deamr occurted due to the cause(s) end manner ae staled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Pronouncing end ceNlying physican (Physician both pronouncing death end cerirying to cause of death]
I
f
l
^ 33c. License Number ~ 33 ate ~I a Ih, day, year)
Te Ne but o
my knowledge, deem occurred at the
lme, dale, and p
ace, and due to the cause(s) end manner as abted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Medical Examiner / Canner ~~~„ 0~ .... 1 .y1
`6 v Jl
the bests of axaminadon end / or invuUgation, In my opinion, Both occurred et the Ume, date, end place, and due to the cause(s) and manner es ahled_ ^ 34. me and Address of Person Who Complet Cause of Death (Item 27) Type I Print
t 's Signet and isl ~ ale Fi (MOM day, year) ~ I ~ ~ liz
v
Disposition Permit No. Q 2 -I 14(..J (J ~ ~/
v
r .'.7~ Q ~~"'~
LAST WILL AND TESTAMENT ~-~? ~ `;
r: ~. r , -
GERTRUDE BENJAMIN ~ `" ~ .c- ~ ~~:.
I, GERTRUDE BENJAMIN, currently of Phille~lphia.r. ' ``'-,
Pennsylvania, being of sound mind, memory and understanding, do
publish and declare this to be my Last Will and Testament, hereby
revoking any and all wills and codicils heretofore made by me.
I.
I direct that all taxes that may be assessed in conse-
quence of my death, of whatever nature and by whatever jurisdiction
imposed, shall be paid from my estate as part of the expense of the
administration of my estate.
II.
I direct that all my just debts and funeral expenses be
paid from my estate as soon after my decease as may be convenient.
III.
I give, devise and bequeath all the rest, residue and
remainder of my estate, whether real, personal or mixed, whatsoever
kind or wheresoever situate, as follows:
a. Ten percent (10%) thereof to my Trustee, for ((~~,,
the benefit of my Granddaughter, Mindy ~• Forman; ~~J
b. Ten percent (l00) thereof to my Trustee, for
the benefit of my Grandson, Matthew Forman; and
c. Eighty percent (80%) thereof to my Daughter,
Eileen Forman, provided she survives me by a period of
thirty days. In the event that my Daughter, Eileen
Forman does not survive me for a period of thirty days,
then one-half of this bequest to her shall go to my
Trustee for the benefit of my Granddaughter, Mindy ~~ ~ ,~
V
Forman, and the other one-half of this bequest to Eileen
~.,~ j
- Page 1 of 5 - ~ `" ~ ~ ' 7
Forman shall go to for the benefit of my Grandson,
Matthew Forman.
IV.
I direct that my Trustee shall use whatever income and so
much of the principal from each trust as in her/his sole discretion
she/he shall deem desirable for the health, welfare, support and
education (including vocational, college, graduate or professional
schooling) for said Grandchild.
a. In the event that my Daughter, Eileen Forman,
shall survive me for a period of thirty days, I direct
that when each Grandchild shall reach the age of Twenty-
Seven (27), she/he shall receive One-third (1/3) of the
principal of her/his Trust then remaining; at each
Grandchild's Thirty-third (33rd) birthday, she/he shall
receive One-half (1/2) of the principal then remaining
and each Trust shall terminate at each's Fortieth (40th)
birthday, with the distribution of remaining principal
and undistributed income to said Grandchild at that time.
b. In the event my Daughter, Eileen Forman, does
not survive me by Thirty (30) days, I direct that each
Grandchild shall receive fifteen percent (150) of the
original principal of her/his Trust, on each's Twenty-
seventh (27th), Thirty-third (33rd), Fortieth (40th) and
Forty-fifth (45th) birthdays with each Trust to terminate
upon her/his Fiftieth (50th) birthday respectively, with
the distribution of remaining principal and undistributed
income to said Grandchild at that time.
c . If any of my Grandchildren dies before termina-
tion of his/her Trust, leaving issue, his or her issue
shall succeed to his/her rights under the Trust, per
stirpes, with all of the provisions of said Trust to
apply to said Great-Grandchild(ren), including the
- Page 2 of 5- V n r
,_~~-9(~
provisions for partial distribution of principal when
reaching the specified ages.
d. If either of my Grandchildren die without
issue, the balance remaining in her/his separate Trust
shall be distributed to the Trust for the benefit of my
surviving Grandchild unless said Trust has already been
terminated according to the provisions hereof, in which
instance the balance remaining in her/his separate Trust
shall be distributed to my surviving Grandchild outright.
f. These Trusts shall be subject to the laws of
the Commonwealth of Pennsylvania.
V.
I direct that my Executrix and Trustee, or their
successors, shall not be required to enter bond or security in any
jurisdiction in which he or she may act; but, if a bond is required
notwithstanding this direction, I direct that a surety bond shall
not be required.
VI.
My Executrix and my Trustee under this Will or any
Codicil hereto shall have the following powers in addition to those
granted by law and by other provisions of this Will, applicable to
all property, whether principal or income, exercisable without
court approval, and effective under 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 of risk.
b. To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds,
authorized for Pennsylvania fiduciaries, as he deems
proper.
- Page 3 of 5 -
~' J
1- aa- ~~
c. To sell at public or private sale, to exchange
or to 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 he deems proper.
d. To allocate receipts and expenses to principal
or income or partly to each as he from time to time deems
proper.
e. To borrow money from any person or institution,
and to mortgage or pledge any or all real or personal
property, as he is his sole discretion shall choose.
f. To compromise any claim or controversy.
g. To choose the optional valuation date for
federal estate tax purposes.
h. 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.
i. To exercise any law-given option to pay death
taxes in installments and to pay interest due on such
installments as a charge against principal.
j. To make distribution in cash or in kind, or
partly in cash and partly in kind, in such manner as he
may deem fair, at valuations finally to be fixed by him.
k. To contract with a qualified investment advisor
for investment advice.
VII.
I direct that all legacies, shares or interest in my
estate, whether principal or income, while in the hands of my
Executrix or Trustee, or their successors, shall not be subject to
executions, attachment sur judgment, sequestration or any other
process for any debt, obligation, contract or engagement of any
beneficiary, and shall not be subject to pledge, assignment,
- Page 4 of 5 -
'~ 4
-- s. a- ~~
conveyance, or anticipation, and the personal receipts of the
beneficiary shall be the only discharge of my Executrix or Trustee
for payment of either principal or income.
VIII.
I name my Daughter, EILEEN FORMAN, as Executrix of this,
my Last Will and Testament.
I name my Daughter, EILEEN FORMAN, as my Trustee. Should
she fail to survive me, or should she refuse or be unable to serve,
I designate my son-in-law, STEVEN FORMAN, as my Trustee.
IN WITNESS WHEREOF, I, the said GERTRUDE BENJAMIN, have
to this my Last Will and Testament, affixed my hand and seal this
?~~' day of January, 1996.
G R E E IN
The preceding instrument consisting of five other
typewritten pages, was on the date thereof signed, published, and
declared by GERTRUDE BENJAMIN, the TESTATRIX therein, as and for
her Last Will and Testament, in our presence, who at her request,
i~ presence and in the resence of each other, have subscribed
our n mes as witnesses her to.
/~ ~
13 ~S S
.~ ~
//~
NAME
ADDRESS r1
--~s-,r- ~ S of G ~ ~ ~v l
3 y c ~ G rea. S~ .
ADDRESS
C~M.,p l~-; t i~~ I ~ o ~ t
- Page 5 of 5 -
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF DAUPHIN
I, GERTRUDE BENJAMIN, 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; that I signed it willingly, and
that I signed it as my free and voluntary act for the purposes
therein expressed.
Sworn or affirmed to and ac nowledged before me, by
GERTRUDE BENJAMIN, Testatrix, this ~n day of January, 1996.
GERTRUDE BENJAMIN
Notarial Seal ivc~t
Diane M. Stubblebine, Notary Public
Harrisburg, Dauphin County
My Commission Expires Aug. 10, 1998
Aember,~Pennsylvania Association of Notarie
P>!ib~ i c
COMMONWEALTH OF PENNSYL
COUNTY OF DAUPHIN
SS.
the witnesses whose names are signed to the attached or foregoing
instrument being fully qualified according to law, do depose and
say that we were present and saw Testatrix sign and execute the
instrument as her Last Will; that she signed willingly and that she
executed it 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 18 or more years of age,
of sound mind and under no constraint or undue influence.
Sworn or~~~af firmed to' and ~
sses, this~~~~~ day of January
scribed to before me by the
996.
/ ~ l
WITNESS
/,t~ /~ ~~~~~~~Q„i Notarial Seal
ary Pudoll Diane M. Stubblebine, Notary Public
Harrisburg, Dauphin County
My Commission Expires Aug. 10, 1998
Member, Pennsylvania Association of NotariF