HomeMy WebLinkAbout02-25-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of RUTH HOROWITZ
also known as
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
COUNTY, PENNSYLVANIA
File Number ~ ~ U r~ y ~~;~.-~
Social Security Number 110-] 8-6244
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the
last Will of the Decedent dated and codicil(s) dated
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(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~e instrun~gQt(s) o~'fee~i_-?
for probate, was no[ the victim of a killing and was never adjudicated an incapacitated person: ~ bd
.~'
B. Grant of Letters of Administration
(Ijapp[icable, 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.)
Name Relationship Residence I
BRUCE HOROWITZ ~ SON ~ 75 CHESTER ST.,CARLISLE, PA 17013
IRA HOROWITZ I SON_ 117056 RINALDI ST,GRANADA HILLS, CA 91344
LARRY HOROWITZ SON 15952WETHERBURNRD,CHESTERFIELD,M06301
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at
75 CHESTER STREET, CARLISLE, PA 17013 (NORTH MIDDLETON TOWNSHIP)
(List street address, town/city, township, county, state, zip code)
Decedent, then 80 years of age, died on 10/04/2005 at MANORCARE HEALTH SERVICES
940 WALNUT BOTTOM ROAD CARLISLE PA 1701E
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 $
situated as fo
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:
BRUCE HOROWITZ 75 CHESTER STREET, CARLISLE, PA 17013
Form RW-02 rev. 10.!3.06 Page 1 of 2
\~~
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 personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed
`nature of Personal Representative ~ N
before me the ~s _ day of ~~ ~' ""
'`~ ? ^ 4~,.' ~~ Signature of Personal Representative _-' ('~ ~ L_,
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'° For the Register Signature of Personal Representative ~ t~`'~ yam,
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File Number: ;
Estate of RUTH HOROWITZ ,Deceased
Social Security Number: 110-18-6244 Date of Death:l0/04/2005
AND NOW, ~' " fir' ' ~ ~~ , in consideration of the foregoing Petition, satisfactory proof
having been presented before m T IS DECREED th etters OF ADMINISTRATION
are hereby granted to BRUCE HOROWITZ
and that the instrument(s) dated N/A
described in the Petition be admitted to probate and filed of
FEES
Letters ...... ~ t ~~<, . .
Short Certificate(s) .:~.... .
Renunciation(s) ... ~-.... .
t~_~ ...
~~~~ .. .
~~
$ tZ
$ ~~
$ ~~
J
... $
... $
... $
... $
... $
... $
... $
TOTAL .............. $ ~`~~'~'~ ~-
as the last Will and Codicil(s))
rl.f"U-R._~
Register of i~
Attorney Signature:
in the above estate
Attorney Name: DALE F. SHUGHART, JR~ j ~
Supreme Court I.D. No.: 19373
Address: 10 WEST HIGH STREET
CARLISLE, PA 17013
Telephone: 717-241-4311
Form RW-02 rev. /0.13.06 Page 2 of 2
I(15s04 REV' I/us
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 Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
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No.
Local f2cgistrar
[ICT 6 2005,_
Date
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH ~ ~ ~,q T,,~Cr~
H705.143 Rev. 2/87
NENT
INK """` ~~ """ "' inBA mwcie, uas[J SEX SOCIAL SECURITY NUMBER DATE OF DEATH (Month, Day, Vear)
~
Ruth Horowitz
.
zFanale 3. 110 - 18 - 6244 a 10/4/2005
AGE (Lest Birthday) N ER 1 YEAR UN ER 1 DAV DATE OF BIRTH
BIRTHPLACE (City and PLACE F DEATH Ch k onl one -see in M1v ti n sitl
Monma Deys HwB Mmutes (Month, Day, Year) State or Foreign Country) HOSPITAL'
OTHER'
80 vra'
1/14/1925 Brooklyn, NY InpaLeN ~ ER/Oatp.ibnl ^ DDA ^ Nare~,
• 6
6
7• ea. Npm, ® ae.benee ^
' COUNTY OF DEATH Isoedry) ^
CITY, BORO, TWP OF DEATH FACILITY NAME (If not institution, give street and number) WAS DECEDENT OF HISPANIC ORIGINS RAGE -Ame
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an, Black, White, et
No Yes ^ I(yes, specify Cuban, (SPerJry)
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eb. Cumberland 6~South Middleton
ManorCare Health Services M
ew
a
n, Puerto Rican, etu ,0 White
DECEDENTS USUAL OCCUPATION KIND OF BUSINESS /INDUSTRY AS DECEDENT EVER IN DECEDENTS EDUCATION
MARITAL STATUS -
(cweu,wawon,aon.aw r Marnetl, SURVIVING SPOUSE
or workin ufa: ao not uu nPpse U.S. ARMED FORCES? (sp.dry omy n' neu areas comgetaa (
s' ) ) Never Married
Widowed
nwiro
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,
,
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rY ma
en name)
Yes No EiamenierylSeconaary Callepe Divorced (Specify)
t,e. Accountin ,1#jpt Available
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1~„' "~°r")
,2.
,3.
„Widowed -
DECEDENTS MAILING ADDRESS
75
(Street, Ciry/7own, State, Zip Code) DECEDENTS
'
17a
PA
. slate
17c. ® Ves, decedent lived in North Middleton
75 Chester
St
.
. RES DENCE decedent trop.
76.Carlisle, PA 17013 (See insauctions Iiva ins No, decedent lived
on other side) ,7b. Counry Ctiunberland township? 17d. ^
w,min actual limits of
FATHER'S NAME (First, Middle, Last) ciN/boro.
MOTHER'S NAME (First, Middle, Maiden Surname)
,e. Adolph Schrenzel
,g. Bella Fuchs
INFOR
MANTS NAME (Type/Print) INFORMANTS MAILING ADD ESS (Sheet, Ciry/TOwn, State, Zip Code)
2oa. Bruce Horowitz
75 Chester SRt
. ,
zob.
METHOD OF DISPOSITION Carlisle, PA 17013
_
rr--77~~ DATE OF DISPOSITION PLACE OF DISPOSITION- Name of Cemetery, Crematory LOCATION - Clry/Town, State, Zip Code
Donation ^ Budal ®Cremation LJtemovel from State ^ (MOnN, Dey, rear) or Other Place
2,a. Gtnar(Spaafy) ^ 2tb10/07/2005 21Tanple Beth Shalan Ct~nete
Mechanicsburg, PA
21d
' SIGNATU F F 'SERVI E LICENSEE O AC.2tpG A SUCH LICENSE NUMBER
S* NAME AND ADDRESS OF FACIUTV
': 2zb. FD 012633 L 2z~wing Brothers Funeral Home, Inc.
Carlisle
PA
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md
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ems 23aa only en cemying To the best of owletlge, death occurred at the time, date end lace statetl.
physician is not available al time of deem to (Si
p LICENSE NUMBER DATE SIGNED
nature
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' eertily cause o(deam. ~
/a~/ ~ ~ p q ~)' / / t~ / (Month/lD~ay, Vear) [~
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23D.
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Items 24-26 must be corn tad b 2Jc.
O L `4%C,~ T r7BLO.f
Bon who TIME OF DEATH DATE PRO
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UNC
ED
D
EA
• pe pronounces Beam.
D (MOnm, Day, Vear) WAS CASE REFERRED TO A MEDICAL EXAMINER /CORONER
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24. Q T 7 ~ M. 25. 28
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27, PART 1: u.e on y eana ea ~. an a. n iM.~mpautlon. ,.nleM1 aauapd qa e.an, pe not enter tM moap of aylna, puoM1 o uralee or r.aplr.tory ampr, anopM or M1aan /allure. ~ gppmxlmala PART II: Omar signl8eanl conditions wnMbuting to deaM
but
,
. interval beMreen not resulting in the undedying cause given in PART I.
IMMEDIATE CAUSE (Final onset and deem
'
disease or condiDon cc ~
re ulting in deem)-i a. v '~'J c/ -yL CZ ~ r'ti'~ ~ Gi CL.Cl` ~ `
CL ~' -c,! <'~~ G7,
OUE TO 10R AS A CONSEQUENCE OF):
Sequendalry 8st conditons b.
If any, leading 10 immadlBla DUE TO (OR AS A LONSEpUENCE OF):
cause. Enter UNDERLYING
CAUSE (Disease or lnryry c'
' met lnitiatetl ovanB OUE TO (OR ASACONSEOUENCE OF):
_ resultng on deem) LAST d.
WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEA
DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED
PERFORMED? AVAILABLE PRIOR TO
N,
m
D
~
(
on
.
,
ay, rear)
COMPLETION OF CAUSE NatuBl Homicide ^
OF EATH7
Accident ^ Pantling Investigation ^ Vas ^ No ^
Yes ^ No Vas ^ NO ^ Suidde ^ Could not be determined 30a. 30b. M. 30c. JOd.
^
PLACE OF INJURY - Al home, farm, street, factory, office LOCATION (Street, Ciry/Town, State)
evnalrp
as (sp.cxy)
28a
2
,
.
8b.
28. 30e. 30f.
CE
RTIFIER (Check only one)
RC
NATO T CERTIFIER
•ToRha WlslGol mYSlkrCw~wN (Physician certiying cause of deem when enom6r physician has pronounced deem and completed item 23) I/~l
Y ledpa, tleath occumetl due to the uuses(a) antl manner as statad.. ................................
f ~
• .............................. 316. . r
'PRONOUNCING AND CERTFYING PHYSICUIN (Phyciden both pronoundng death and certifying to rouse of tleeth) LIC UMBE DATE SIGNED Mynm, Day, Vear)
To the W st of my knowledge
death xeurred at the Lima
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,
a
e, an
p
ace, and duo tome eausea(e) and manner ae s4tad ...................... ^ 3,e.
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'MEDICAL EXAMINER/CORONER NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
' On the basis of examination and/or Investlgatlon, In my opinion, deem occurred el the time, date, and place, and due to the ewses s (item 27) Type or Print
Y~O-CC, \
Gk.sZw. ~ y
)and
~
manner as stated .......................................................................................................................... ~~^
.......................!.
3,a.
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32.
C..(.~S
REGISTRAR'S SIGNATURE AND NUI ,/ n~
DATE FILED (Month, Day, Yeer) J
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33. C.~ s"fl. \ ~-
'lJ~. i~Ll i Ir7U 1 I VI 34. ~~. ~'.._ CJ(\ 11 FJ
RENUNCIATION t-~
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REGISTER OF WILLS ~ r' `-
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CUMBERLAND COUNTY, PENNSYLVANIA ,
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Estate of RUTH HOROWITZ
I, Ira Horowitz
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Deceased
in my capacity/relationship as
(Print Name)
son and one-third residuary beneficiary of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Bruce Horowitz, of 75 Chester Street, Carlisle, PA 17013
~ ~ ~~ , 2009
(Date)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of
day
Deputy for Register of Wills
`~ - ,,~
r.
(S lure)
17056 Rinaldi Street
(Street Address)
Granada Hills, CA 91344
(City, State, Zip)
Executed out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this day
of
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date ofexpiration of Notary's Commission.)
Form RW-06 rev. 10.13.06
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of
Los Angeles
On ~ f _ ~-~ ~ ~ before me, Patrick Lyman, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared ~ ~ °- ~ `'' "`'~ ~ ~--
Name(s) of Signers)
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fvrJ e ARY ~'U3LIC - C~1LiFOF;PdiR
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LGS,3PVGELES COUNTY
My Comm. Expires June 18, 20I I
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who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the
instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand a fficial seal.
Signature ~-
Place Notary Seal Atxwe Signature of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
!: ~ Individual
^ Corporate Officer -Title(s):
^ Partner - ^ Limited ^ General _. , •
^ Attorney in Fact
^ Trustee Top of thumb here
Guardian or Conservator
J Other:
Signer Is Representing:
Number of Pages:
Signer's Name:
^ Individual
^ Corporate Officer -Title(s): _
Partner - ^ Limited ^ General
^ Attorney in Fact
^ Trustee
^ Guardian or Conservator
^ Other:
Signer Is Representing:
Top of thumb here
®2007 National Notary Associalion • 9~0 De Soto Ave., P.O. Box 2402 • Chatsworth. CA 9131 &2402 • www.NationalNofary.org Item k5907 Reorder Call Tdl-Free 1-800-876-6827
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RENUNCIATION
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REGISTER OF WILLS ~ ' ~ '
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CUMBERLAND COUNTY, PENNSYLVANIA _ - r w -
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Estate of RUTH HOROWITZ ,Deceased
I, Larry Horowitz , in my capacity/relationship as
(Print Name)
son and one-third residuary beneficiary of the above Decedent, hereby renounce the right to
administer the Estate of the Decedent and respectfully request that Letters be issued to
Bruce Horowitz, of 75 Chester Street, Carlisle, PA 17013
~~
~' ~ 3 ~ , 2009
(Date) (Signature) ' -
15952 Wetherburn Road
Executed in Register's Office
Sworn to or affumed and subscribed
before me this
of
day
Deputy for Register of Wills
Form RW-06 rev. /0.13.06
(Street Address)
Chesterf eld, MO 63017
(City, State, Zip)
Executed. out of Register's Office
Before the undersigned personally appeared the
party executing this renunciation and certified
that he or she executed the renunciation for the
purposes stated within on this 3 ~ day
of ~~ `~
Notary Pub
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
JOSE JUDE RUIZ IIl
No~ry publk -Notary Soai
State of Mts~outi
Commissioned for res J. une 12, 2009
AAy Corrtmission57~56