HomeMy WebLinkAbout01-12-09PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of LARRY G. 'I'UBBS
also known as
REGISTER OF WILLS OF CUMBERLAND
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
COUNTY;, PENNSYLVANIA
File Number _ ~- ~ ~~~ " ~ ~~/}~J
Deceased Social Security Number 397-66-5747
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the PERSON named in the
last Will of the Decedent dated SEPTEMBER 10, 1997 and codicil(s) dated N/A Lary G. Tubbs and Tammy M. Tubbs were divorced on
11/1/2005 in Cumberland County, PA to 2004 Civil 6115 Judv Andres is successor named in the Will Rachel S. Cooper, daughter of decedent
is the sole heu.
(State relevant circumstances, e.g., renunciation, death ojexecutor, 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: Divorced 11!1/2005.
B. Grant of Letters of Administration
tyappttcao[e, enter: c.t.a.; d. b.n.c.t.a.; pendentelite; duranteabsentia; duranteminoritate)
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.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Decedent, then 47 years of age, died on July 16, 2007 at Carlisle Regional Medical Center, Carlisle, PA 17013
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 1,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania Q
situated as
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 forth to
the undersigned:
Judy Andres 11273 Bell Road, Wisconsin Rapids, WI 54494
Form RW-02 rev. 10.13.06
Page I of 2
(COMPLETEINALL C:ASES:) Attach additional sheets if necessary. _~ ~ :,yfr„ _
Decedent was domiciled at death in Cumberland ~ !J? ~ ~
County, Pennsylvania with his /her last principa~estdence at ~_'~s
106 "A" Street Carlisle PA 17013
(List street address, town/city, township, county, state, zip code) T
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY 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 persona] 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 '~~ day of
~1~.
Fort Register
Signature ojPersona! Representative n N
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Signature of Personal Representative
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Fstate of LARRY G. TUBBS ,Deceased
Social Security Number: Date of Death: JULY 162007
AND NOW, 1~ ~ ~ ~,(,-
I ~I~J ,inconsideration of the foregoing Petition, satisfactory proof
having been presented before IS ECREED at Letters TESTAMENTARY
are hereby granted to _ JUDY ANDRES _
in the above estate
and that the instrument(s) dated SEPTEMBER 10, 1997
described in the Petition be admitted to probate and filed of rec r as the last Will (and Codicil(s;l) of Decedent.
FEES ~ ll/~y"(,.
Letters ............... $_e . ~.? ~i Register of I~3lls ~ ~ ~ e •_,
Short Certificate(s) ........ $ . (~ /~ ~„~~ NJ ~~7
Attomey Signature: ~~_
Renunciation(s) .......... $ ~
1 _ $ - ~ ~ Attomey Name: DALE F. SHUGHART, `
_...$ 0,1
Supreme Court I.D. No.: 19373
..$ r
$ Address: 10 WEST HIGH STREET
' ' ' $ CARLISLE, PA 17013
_ ... $
_ ... $
- ~~~ $ Telephone: 717-241-4311
_ ... $
TOTAL .............. $ Lola . ~
Form RW-02 rev. 10.13.06
Page 2 of 2
CaCAL REGISTRAR'S CERTIFICATIGN IMF DEATH
'tNARNW~: It is illegal to duplicate this copy by photostat or photograph.
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
lSee Insrrurrlnnc anrr nvn..a..te- ..., .e.........x
' INIt tILt NUMBER
I. Name of Decedent (First. mitltlle, 1a51, suffix)
2. Sex 3. Sot I Security Number 4. Data of Deets (Month, day, year)
Larry G Tubbs
Male Unknown - July 16
2007
s
A
,
.
ge (Leal BMhaay) urrderl yee~ wdar, tla aDarememn MonA, da,
y ( Y yea9 .7. BMhpleca (CNy and state a toregn ceunlry) Ba. Place of DeaA (Check only one)
MpMa mva Hours MMMe
s Fbspilal: Other:
47 vra Feb. 25, 1960 Wisconsin Rapids
rx~A
^ Inpetienl I[yER; Outpatient ^ DOA ^ Nursing Flume ^ Residence ^Othet ~ S
ecif
Bb
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f D
h
p
y,
.
ounty o
eat
&. Clry, , Twp. Death Bd. Facility Name (II trot instilNion, gbq slr9el antl numbarj 9. Was Decedent of Hispanic On in? ~ Np
g ^ Yes 10. Race: American In6en, Black, White
etc
,
.
Cumberland South Middleton Carlisle Regional Medical Center °lyea'apepllycuba'' (sp~piy,
Mexican, Puerto Rican, etc.j Wh 1 t e
11. Decedent's Usual fun Kintl W work dung dorm most of wokin Ige. Dq not stale retired 12. Was Decedent ever In the 73. Decedent's Education (Spenfy only Nghesl gentle cpmpletad) 14
Marit
l Sl
l
~ M
i
.
a
a
us
an
ad, Never Marred 15. Surviving Spouse (II wlle, give maklen name(
KIrM cl WoA Kits of Business /Industry US. Amled Forces? Elementary /Secondary (0-72) Cdlege (1-4 ar 5aj Widowetl, Dlvorcetl (SpecilH
Tow Motor Driver Warehouse
®vea ^Nq -------12____ _ Divorced
------------
- 16. Decedents Meikrg Address (SIreeL city r lows. state, zip code) Decedent's Did Decedent
9ale Pennsylvania E
106 "A" Street AdaalReaitlenpe 17a
.
wgme na^vea,Depedemwaem
Township? TwP
Carlisle, Pa 17013 nb.cppnty Cn
C3lNp
d nd
Derxdemu~¢dwdN"
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l
,
.
m
ar
an
Carlisle
AcNal Limits of
City l8oro
18. falher5 Name (First, mitltlla, last, suaixj
•
19. Mmheis Name (Flml, middle, maiden sumamel
Glen D
Tubbs
.
Jean Ott
20a. Informant's Name (Type / PrinQ
20b InlormanY6 Melling Address (SIreeL Illy /lawn, slate, zip cxk)
Judy Andres
11273 Bell Road, Wiscoc3sin Rapids, WI 54494
21 a. Marled of Disposieon ! ^ Cremation ^ ppnalion 216. Date al Disposition (Month, day, year) 21c. PWce pf DispoaNon (Name pl cemetery, crematory or olhx place) 21d. Loralgn (City /town
slate
zip code)
Burial ® Removal from St
l
!
,
,
a
e
Was Cremation or Dawdon ANhortred
^ Other-Speciy- bYMedicelExaminer/Coroner? ^vea^Np July 20, 2007 Forest Hill Cemetery Wi
sconsin Ra ids W154494
22a. Signature natal Servke rlsee (a actin
P
es such)
g
22b. Lk;gnse Number 22c. Name antl Address pl Fecillty
- - - FD-012909-L Ronan Funeral Home 255 York Road, Carlisle, Pa 17013
Complete I( s 23a~c only when ceditying 23a. T" Me best of my knowledge, death oauned at the lime, tlele and place staled (Slgnalure and lillel
physkian is rid available al lime of death to
23b. license Number 23c. Dale Signetl (Month, tlay, year)
cenay cause of death.
I~ems 24-26 muss be cum eted b
W y person
rip ponounces death 24. Time of DeaA
8:29 A
M
25. Date Pronounced Deatl (Month, tlay, year)
Jul
16
2007 2fi. Was Case Relened Ip Metlical Examiner I Coroner for a Reason Other roan Cremation or Donaf ?
.
. y
, ~vea ^Np
CAUSE OF DEATH (See Inebuctlana and examples) l Approximate Interval:
Item 27. Pan L Enter the pnaA n' events -diseases, injuries, or complicaaans -that directly causetl the tleeA. DD NOT enter terminal events such as ramiac artesl Pan tl: Enter other 5jgpjjjganl mlltlilions canlrib ~t 1 =(h, 28. atl Tobacco Usa Confnbute to Death?
,
raspirelory angst, or vemricuMr libnllaaon wiNaa showing die eliobgy List poly one reuse an each Ime. Onset to Death trot resultin Ina untled
b,M1, gin yirg cause given M Pan I.
^ vas ^ Probably
IMMEBIATE CAUSE (Final dksease or
ppndihonmapningin Aj
Ath
l ^ No ^ Unknown
erosc
a
~
erotic Cardiovascular Disease E
rdi
l ~''rFemaM:
Due Ip (or a5 a cpnsequence op ,
,3
omega
y
.
Sequa (W 151 mndllms
it an _ ^ NM Dregnanl within pest year
,
y, b
katlirg b the cause listed on ling a- Due to Sequ )
Enter the UNDEgLYING CAUSE (or as a con ence of ^ Pregnant al lima d daaA
.
(dseese or injury Aar intliEletl the
^ Not pregmm, bIA pregnant within 42 days
vents resWirg in death) LAST p
Due to (or as a cpnsequance c0 of tleeA
.
d ^ Not pregrent but pregnan143 days 101 year
' j before death
30a. Wes an Aul
oDSY
30b. Were Aulppsy Findings
31. Mamwt d DeaA
32a
D
l
f I
M ^ Unknown if pregnant within AB past year
Panormed?
available Prior la Cpmpklion .
a
e o
njury (
Ontn, tlay, year) 32b. Describe How In
fury Occuned
32c. Place of Injury: Hama, Farm, Sreat, Fegory,
W Cause d Death? ~NaN21 ^ Hgnidtle Ollie BuiMing, etc. (Specify)
Yes ^ No ~l yqs ^ qp
T" ^ Aaitlanl ^ PerMirg Invasligalion 32d. Tme of Injury 32e. Injury al Wqk? 321. II Transpatelpn Injury (Spenly) 32g. Lgcation of Inlury (Strq¢L dly / Ioxn, slate)
^ Suicide ^ Count Not be Determined M ^ Yes ^ No ^ Driver /Operator ^ Passenger ^Pedestnan
omen spgpiry:
33a. Camber (cfleclc Dory anej
• Cutaying phyalcian (Physiran cerlilying cause of death when anner
To die best of my Mrwwktlge, dead) occurrLW due to the eau Wrysiian has Dmnamced cealh antl mmpletetl Item 23j
ee(s)arM manner as eteted-------------
~ 336. Slgnalure and ii
GO r one r
-
--------------------
• Pmrlouncing and cedlrying physlckn (Physitn both Prornurxdrg tleaA and cedilying Io cause d death)
To the Feat of my knowledge, death otxrlrred at the lime, date, and place, rid due to the cauae(e) and manlier as slatM_ _ _ _ _ _ _ _ _ _ _ _ _
^ 33c. License Number
33d. Dale Signetl (MIXllh, tlay, year)
_ _ _ _ _
• wdkalExnnmer/coroner
Dn /M heals of exemkwtbn and / or Invgdgallon, In my oplnbn, deaM oceuned m the time, date, erld place, arts due to the Cauae(6) alts manner es shted_ July 17, 2007
3d Name and Atltlress pl Parsan Wtw Completed Cause f DBaA (Ite m 27) Type /Print
35. Reg sgpatp,e an ,'"bar n,~..- `
~
- ~
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3s. DaleFilea(MOnm.aay,y¢ar) Michael L. Norr:Cs, Coroner
6375 Baseh
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Disposition Permit Np. ~ J ` a~-y-~ l't'~
..
LAST WILL AND TESTAMENT OF
LARRY G. TUBBS
I, Larry G. Tubbs, of North Middleton Towns]zip, Cumberland
County, Pennsylvania, declare this to be my Last Will and
Testament and revoke all Wills and Codicils previously made by
me.
ITEM I: I direct that all my legally enforceable debts and
funeral Expenses, including all expenses of my last illness,
shall be paid from my residuary estate as soon a:~ practicable
after my decease as a part of the expense of the administration
of my estate.
ITEM II: I bequeath any automobiles or motor vehicles I may
own at my death, my personal effects, such household goods i:~ any
as may be my individual property and not the property of my wife
or owned jointly by me with her, and other tangible personal
property of like nature (not including cash or securities),
together with any existing insurance thereon, to my wife,
Tammy M. 'Tubbs, providing she survives me by thirty (30) days.
Should my said wife predecease me or die on or before the
thirtieth day following my death, I bequeath such tangible
personal property and insurance thereon to such o:E my children as
are living on the thirty-first day after my death,, to be divided
among them by my personal representative(s) with due regard for
their personal preferences in as nearly equal shares as
practical. I direct that any of the foregoing articles not
selected by such children shall be sold at public or private salmi
by my personal representative(s), and I further direct th~t~~>the
.~~
net proceeds thereof shall be administered and distributed a~ a (__'
part of the residue of my estate. = .'-'~` ---
G / - _t~
~~ , .
.~- ~., --
ITEM II: I devise and bequeath the residue of my estate of
every nature and wherever situate, including any property over
which I shall have any power of appointment, in equal shares to
my wife, Tammy M. Tubbs, and to my daughter, Rachel S. Cooper.
Should either my said wife or my said daughter predecease me, I
devise and bequeath her share of my estate to the=_ other.
ITEM III: I appoint my wife, Tammy M. Tubb;, guardian of
any property which passes, either under this Will or otherwise,
to a minor and with respect to which I am author_Lzed to appoint a
guardian and have not otherwise specifically donE~ so, provided
that this appointment of a guardian shall not supersede the right
of an fiduciary in its discretion to distribute a share where
possible to the minor or to another for the minor's benefit.
Such guardian(s) shall have the power to use principal, as well
as income, from time to time for the minor's support, health and
medical care, and education (including college education, both
undergraduate and graduate), or to make payment for these
purposes, without further responsibility, to the minor or to any
person taking care of the minor. Should my said wife predecease
me or fail to qualify or cease to act as guardian, I appoint my
sister, Judy Andres, of Wisconsin Rapids, Wisconsin, guardian of
the property.
ITEM IV: All Federal, State and other death taxes payable
because of my death, with respect to the property forming my
y~ross est~tite for tax purposes, whether passing under this Will or
otherwise, including any interest or penalty impo~~ed in
connection with such taxes, shall be considered a part of the
expense of the administration of my estate and shall be paid out
of the principal of my residuary estate without a~,portionment or
right of reimbursement.
ITEM V: I appoint my wife, Tammy M. Tubbs, Executrix of
this my last Will. Should my said wife fail to qualify or cease
l' ~
to act as Executrix, I appoint my sister, Judy Andres, Executrix
of this my last Will.
ITEM VI: I direct that all fiduciaries acting under this
Will, whether or not named herein, shall not be .required to give
bond for the faithful performance of their duties in any
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my ~Zand and seal,
this ~ ~~"''`
.~~ day of ~_r>12b~.~ ~' 19,97.
C~; /'~
[SEAL]
The preceding instrument, consisting of this and two (2)
other typewritten pages, each identified by the signature of the
Testator, was on the date thereof, signed, published and declared
by Larry G. Tubbs, the Testator therein named, as and for his
last Will, in the presence of us, who, at his request, in his
presence and in the presence of each other, have .subscribed our
names as witnesses hereto.
f ~ ~
..-
~.,! ~,~
~~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND ss.
We, Larry G. Tubbs, William A. Addams and Mary M. Price, the
Testator and the witnesses, respectively, whose :names are signed
to the 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 has signed
willingly, and that he executed it as his free acid voluntary act
fcr the purposes therein expressed, and that eacYi of the
witnesses, in the presence and hearing of the Testator, signed
the Will as witness and that to the best of his/her knowledge the
Testator was at that time eighteen years of age or older, of
sound mind and under no constraint or y~idue influence.
~''-~
~_:
-~- Testator
e.. ~ -
itness
G ~ ~
~iy i ~( ~cc~E.
~~ Witness
Subscribed, sworn to and acknowledged before me by Larry G.
Tubbs, the' Testator, and subscribed and sworn to before me by
William A. Addams and Mary M. Price, the witnesses, this 10th
day of September, 1997.
i~i
vim' ~-
Notary Public
r
MICHAEL RNRUNOLE, NOTARY PlIB11C
BORO OF CARLISLE, CUMBERLAND COUgTY
`:~n,~~~~`=,~M11 Fyp;;R~S GFCEt~iBER 20. 1998