HomeMy WebLinkAbout02-17-09PETITION FOR PROBATE and GRAN OF ~ETTERS
Estate of FRANCES A. RASMUSEN No, 21- ~{ ~
also known as ~ To:
,Deceased.
Social Security No. 174-20-2953
Register of Wills for the
County of ,CUMBERLAND th the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older and the execut RIX named
in the last will of the above decedent, dated 10/17/2002
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with
h Is last family or principal residence at 321 JUNIPER STREET. CARLISLE. CUMBERLAND
COUNTY. PENNSYLVANIA 17013.
(list street, number and municipality)
Decedent, then 82 years of age, died 1/16/2009
at MANORCARE HEALTH SERVICES. CARLISLE, PA
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(Tf 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:
$ _ 42.050.00
$ 0.00
$ 0.00
$ 0.00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented here ith and the grant of letters testamentary
thereon. `~- (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
' 321 JUNIPER STREET
~~ ~ - !/' CARLISLE PA 17013
RANGES A. RASMSSEN
b
~v
x;
b C
C~..O
vl y
~aj-~ fl.
Y-+ 4r
O
qN
bA
T'~J
'~~ C~
C_.~
~ ~
_
J
.-~ -~
~:..t
=- c :~
_ -, -,
-~-- ,_.
-~
,
OATH OF PERSONAL REPRESENTATIVE ;~~_~
COMMONWEALTH OF PENNSYLVANIA `y =``-=
COUNTY OF CUMBERLAND } SS r?
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 o pe ' 'oner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and y administer the estate according to law.
Sworn to or afl'umed and subscribed ~~~~~ ~ i~ ~' ~?
before tue this _ 1?~'~'" day of
EBI~UARY 2009 ~
Register
-t7
0
r
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or phots~graph.
f-ce for this certificate, ~fi,UO
P ~._50~36?_C~_
Certification Number
r
,H105-1d3 REV 112006
TYPE /PRIM IN
PERMANENT
BLACK INK
This is tLt c~crait : that the infornr,itit~n t)ere ~i~ cn
cori-ect1~ copir;~Li 1z~ont ,Ln uri~in(ts C'criil3~•ttte oi~ Idea[
duly filed ~~eiti~ ;~~~ as Local Reei,n-ar. I'he <yri<zin~
certificate ~~ill be for~~rarcied Io the State Vitr
Records Oi~fiicc ii)i~ permanent fifn(s*.
L'~~~c~Ei~~~ JAt~ 1 8~ '1_pU
_1__~-
i.ocal Relzisu~clr Datr Is~:~ued
s~~
c:~
~ ~^~
_
Y ~ ..n -
"
'
*
i
-:
t -
~- T-1 -- I
- T"
- ,..! _
-
, ~ ~ . j
- ,,-,
__.,
~
_ ;)
_ ;~
,;~
. - _
__.. ;_,.
~
~
.~'
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
f. Name of Decadent (first. middle, last. sufixy 2. Sex 3. Serial Secunry Number 4. Date of Death (Month, day, year)
M 174 - 20 -2953 ~~~~'~ tU -~°°9
Robert H. Rasmussen
5. Age ILasl Birthday) Under 1 year Under 1 day 6. Date d Binh (Month, day, year) 7. BinhpWce (Cfly and stale a kregn country) M. Place of Deem (Check only one)
Mondw rays Hours Mirwks H°aPilal: Other:
82 yra. 12/22/1926 Carlisle, PA ^Inpefient ^ER/Outpatient ^DOA Nwsing Herne ^Residence ^Other-Specify:
County of Dea1H &. Gity, Boro, Twp. d Death
eb 8d. FaciYry Name (11 not iregMion, give slreat and number] 9. Was Decedent of Hispertic Origin? }~ No ^ Yes 10. Race: American Indian, Black, Where, etc.
. (If yes, slxwity Cuban (Speury)
CLmtberland uth Middleton ManorCare Health Services Mexico", P°an° Rya"• °".) White
11. Dewdem's Usual Occu !tort Kind of work done tlud most ql wM' life. Do rot state retired 12. Was Decedent ever in the 13. Decedents Education (Specify only Highest grede completed) 14. Marital Status: MartieQ Never Mame4 76. Surviving Spouse (If wife. gNe maiden name)
Divorcetl (Spad/yj
Wrtlowed
Kind d Wok Kind of Brksiness (hWudry
Computer Technician Blue Cross/Shield ,
US. Armed Forces? Elementary / SecoMery (0-12) College (7 < or 5+)
®vea ^N° 1 Married Frances A. Beblo
76. Decedent's Mailing Address (Street, city! town, state, zip eoael DecedenYS Did Decedent
PA Live in a 17c
Decedent Lived in Twp.
^ Ves
321 Juniper St . .
,
Actual Restler¢a 17a. state
r ""~'ip? ,Td. N°, De°eaem LNed whhln
Carlisle
Ctmlberland ~
- Carlisle, PA 17013 ,?b. cogmry
ciry/Bom
Acual umnsm
16. FelhaYs Name (First, mitlde, IesL suRa) f 9. Mother's Name (First, mitldle, maiden sumeme)
E
Shearer
Alt
William Rasmussen .
a
20a. InlormanYs Name (Type / Pdnt) 20b. Informant's Mahing Address (Street, dry / Nwm, state, zip coda)
Frances A. Rasmussen 321 Juniper St., Carlisle, PA 17013
21 a. Memotl of Disposition I ^ Crematbn ^ Doretpn 21b. Date m Olsposilion (Month, day, year) 21 c. Place of Disposdron (Name of cemetery, crematory or other place) 21tl. Lowllon (City! town, state, zip code)
- ^ ~} eun~ [] Removal from Slate ~ byMadkal'Examlrro~'Cororter?~~^ves^NO 1/21/2009 Ashland Gamete Carlisle . PA 17013
~ 22a. Signature of Furs I e Licensee (ape s ~ 22b. license Number 22c. Name and Address of FadN'ty
-- FD 2 L Ew• B H I
23
c
D-ata Signetl IMonth, day, year)
Complete hems 23ac mh when ceMying 23a. Tp the best m my . deem aaurted at tl1e tmre, date antl place staled. (BigrtaNre arM tine) 236. License Number
-
7
C.
pHysiden is ,rot availade at tlme of death to ~
.
~ ~ ~ V C1.:v~u...C>•.~-.. (~a / a G (J c7
'
rV t ~ ~
/~i t C' ~4LvC ~ l5 ~
L~
-~,
, J
0
1._Q~L l_ .
cer0ly pose M seam.
Hems 2426 mull ba wmpktetl M person 24. Time pf DeaM 26. Date Pronounced Dead (fAOmfi, day, year) 26. Wes Case Referred fo Medical Examiner /Coroner for a fieason Other than Cmmalwn or Donation? .
^ Y
N
who Pronounces death. ,~ ~ 4 S M. ~ Q~y~~q-p~.i' l L,a ~ LO O ~P es ~
o
CAUSE OF DEATH (See inazrucilona and examples) r Approximate interval: Pad II'. Enter amm simfiraM contllaorxs comdbWng to death, 26. Did Tobacco Use Contdbme to Deam?
Item 27, Pan L Emer the chain of events -diseases, injures, a complicadans- That daecuy caused the Beam. DO NOT enter terminal events such as cardiac artest, Onset to Death OW not resuding M the undedying cause given In Pan 7. [] Yes ^ Probably
respiretay artesl, or ventricular fifxillatbn whhoul showing me adabgy. List only one cause al eazh tare. ^ No ^ Unknown
IMMEDIATE GAUGE /Rnal tlisease or
, ~((-~r - 0
~
~
~ 29. If Female:
,
cmdAion restating in Beam) ,y `~ ; C ` ~ ~~ d~ '\I - 4
a
~
'
"~- ^ Nol pregnant within past year
Due to (or as a consequence oD.
^ Pregnant al tlme of deem
Sequentially lost coridtans, it arty. b.
leadmg W the cause §sted on line a. D
nce op:
n
t
^ No pregnant, but pregnant within 42 days
o (or as a co
seque
ue
Enter Me UNDERLYING CAUSE of death
(dsease a Injury that initiateedd the
erents rewding m death) LASL
°
^ Not pregnant, but pregnant 63 days to 1 year
Due to (a as a consequence op: helore deem
~
d
- ^ Unknown it pregnant within me Asst year
30a. Was an AMOpsy 3W. Were Autopsy Findngs 31. Manner of Deam 32a. Dale of Injury (MOnlh, day, year) 32b. Describe How Inryry Occurted 32c. Place of Injury: Name, Farts, Stmet, Faclay,
Offxe BuNdmg, etc. (SPacdl']
Penomred? Available Prior to Complelien
am? ~aWral ^ HamicMe
l D
C
ause d
e
a ^ Acdtlent ^ Penanq Investigation 32d. Tune of frMm/ 32e. fn'ryry al Woa? 32f. II Transportation Injury (Spea'yl 329. Location of Inlury ISlreet city /town, state)
^ v¢s ~io ^ Yea ^ Ob
^Yes ^ No ^ Driver / Op¢reta ^ Passenger ^Petlaslnan
GuicWe ^ Could Not ba Delerminetl M Olher~ Gpecity:
33a. Certifier (check Doty one) 336. Signalu I CeMfier --_ ~ rO
• CrrtYtyhrg phyaklan (PHysician cerVlying cause a death when afalher pnyskian has prorrourcetl deem aM complete0 hem 23)
_
_ _ _ _ _ - _ -
and manna as statad
e(
t
th
h
d d
_
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.. _ _ _ _ _
o
e caus
s)
occurre
ue
To the bes5 of my knowledge, deM
in
to cause of death)
tle9th acid ceral
r
in
th
l
Ph
id
b 33c. Llc 33d. Dale Sgned (Monm, day. year)
g
g
y
an
o
prawu
w
an I
ys
• PronWttcing amt candying phyak
Ta the beat of my knowledge, death occurred et lne time, date, alyd place, and due to me ceuae(a) end manner as sYated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ N~ (/\ ~- I f' ._ ~
V/ 1 V J ( ~ 1 '1_
T
• Metlleal Examiner / Caona
On the basis of azaminetlon and / a invesllgmion, in my oplnien, death occurred of the Lima, dale, aM place, end due to the tauaG{a) and manrrer as srated_ ^ 3d Name aritl Addreas of Person Who Cornpteled Cause of Death (Item 27) Type / Pdnl
35. Registrar's and Dia ~ 'Date Filed (MOnm, day, yea» Darryl Guistwite, D.O. , Carlisle, PA 17015
Disposhion Partnfl NO. \'A7f ~IP/
LAST WILL AND TESTAMENT
I, ROBERT H. RASMUSSEN, of 321 Juniper Street, Carlisle, Cumberland
County, Pennsylvania 17013, do hereby make, publish and declare this to be my last
will and testament, hereby revoking all wills heretofore made by me.
1. I direct my personal representative to pay all of my debts, funeral and
administrative expenses as soon as convenient after my decease.
2. I authorize and empower my personal representative to sell any realty
and/or personalty owned by me at my death and not specifically devised or bequeathed
herein, at public or private sale or sales and to give good and sufficient deeds and/or
bills of sale therefor, in fee simple, as I could do if living. My representative is
authorized and empowered to engage in any business in which I may be engaged at
my death, for such period of time after my death as seems expedient to said
representative.
3. I give, devise and bequeath all of my estate of whatever nature~~nd
wherever situate to my spouse, Frances A. Rasmussen. ~ __ ~-r} -
-c ~
a~ -
.,
~, __.. ;
~_
_:~-,
4. If my spouse does not survive me by a period of at least s~xty~60) d~rs,
then my estate I give, devise and bequeath to Thomas Rasmussen, Gar~~2asmus~en, `
Donna Hicks, Diane McCalister, Laura Duncan, and Lisa Lewellen, share and share
alike, the child or children of any deceased beneficiary taking the share their parent
would have taken if living.
5. Other than the mortgage which I hold on real property in Massachusetts
which is owned by Teresa O'Sullivan, I hereby forgive any remaining indebtedness of
any family members or friends to whom I have loaned money in my lifetime.
6. I nominate and appoint my spouse to be the personal representative of
my estate, to serve without bond. if my spouse cannot or does not serve, then I appoint
Laura Duncan to be the substitute personal representative, also without bond.
7. I suggest that my personal representative retain the services of Harold S.
Irwin, III, Carlisle, Pennsylvania in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~ day
of October, 2002.
-\~~ (~ ~at~....~.~a~ (SEAL)
ROBERT H. RASMUSSEN
Signed, sealed, published and declared by the above-named person as and for a
last will and testament, in our presence, who at said person's request, in said person's
presence and in the presence of each other have hereunto set our names as
subscribing witnesses.
z/,.,~/ ~ F.~~
. ~v~)
ACKNOWLEDGMENT AND AFFIDAVIT
WE, ROBERT H. RASMUSSEN, HEATHER A. BARBOUR and RHONDA S.
IRWIN, the testator and 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 had signed willingly, and that he executed it as his free and voluntary act for the
purpose herein expressed, and that each of the witnesses, in the presence and hearing
of the testator, signed the will as a witness and that to the best of their knowledge the
testator was, at that time, eighteen years of age or older, of sound mind and under no
constraint or undue influence.
ROBEJRT H. RASMUSSEN ,,~
HEATHER A. BARBOUR
S.I
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
:sa:
Subscribed, sworn to and acknowledged before me by ROBERT H.
RASMUSSEN, the testator herein, and subscribed and sworn to befor me by
HEATHER A. BARBOUR and RHONDA S. IRWIN, witnesses, this f 7 T~ day of
October, 2002.
Notary Public
t
NOTMUiI SEAL
BONNIE L COYLE, NOTARY PUBLIC
eQAO OF CARLISLE, CUidBERLAND COUNTY
MYCOMMtSSiONEXP'IRE3OCTOBERt~ 2W2