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HomeMy WebLinkAbout03-16-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Estate of Isabelle L. Hoffinan also known as Deceased COUNTY, PENNSYLVANIA File Number (J~ 1 ~~~ l.i ~r~ 1 Social Security Number 178-16-5378 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 /are the Executors last Will of the Decedent dated January 28, 1992 and codicil(s) dated (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(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d. b. n.c.t.a.; pendente life; durante absentia; durance minoritate) ., a ~7 -._, (COMPLETE INALL CASES:) Attach additional sheets if necessary. `-~ „ -~~. ~ ~ , "; _:- _ F~ Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal ~~si~nce at ~_~~~ 782 Oak Oval Mechanicsburg Upner Allen Township PA 17055 ~' Pd----~ (List street address, town city, township, county, state, zip code) Q Decedent, then 89 years of age, died on January 16, 2009 at Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 65,000.00 Qf 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: CUMBERLAND 0.00 named in the Formt2W-oa rev.lo.rs.o6 Page 1 oft 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: (lf Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) 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: ~ Oath of Personal Representative COMNfONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Representative 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 before me the ~ day of ? ~ "1 ~' t ~ L-'~_ r the Register u Signature of Personal Representative File Number: ~ \ ~ ~JE`-~ ~r=, `7 ,. _, _:r; ~3- Estate of Isabelle L. Hoffrnan ,Deceased -~ ~~ :~ "~ 7.9 tv O . .i `: ~ -; -r , Social Security Number: 178-16-5378 Date of Death: January 16, 2009 AND NOW, ~ ~~ ~' ' ' ~~ ' `~ , ~, in consideration of the foregoing Petition, satisfactory proof having been presented before , IT IS DECREED that Letters Testamentary are hereby granted to David E. Hoffman and Christine A. Cole in the above estate and that the instrument(s) dated January 28, 1992 described in the Petition be admitted to probate and filed of recgrli ~s the last Will (an,~ Codicil(s)) of ]J~e~edent, ~ FEES Letters ....~r.`5.; ~X-~... $ ,~:~ Short Certificate(s) ...~.... $ ~~ Renunciation(sj .......... $ JC ... $ ~a I-*l,l. ... $ Jr ... $ ... $ ... $ ... $ ... $ _ ... $ TOTAL .............. $ ~ ~1 X~ 0.00 SS Signature of Personal Representative Attorney Signature: ~-~- ~-_~"'-~ Attorney Name: t , John R. Fenstermacher Supreme Court LD. No.: 29940 Address: 51 15 East Trindle Rcad Mechanicsburg, PA 17050 Telephone: 717-691-5400 Form Rw oz rev. 10.13.06 Page 2 of 2 oc~~ RE~~sTRA~~~ c~~~r~~scaT~+~n~ o~ ~~~~~ WARNlN~: !t is illegal to duplicate this ropy by photostat or phato~raph, )'~., 111'" ihit ±.-I [(f.iL'L1til'. ", i:'=.(. ){? i~~rd? ;:_ p~jN s3F ~~ ;~ ~l I~ ~( lift! s r- ii l ilt1?[lix tl n" it k _.Et C7 ,> ~ ~ ~~ ~ ' ~ , .~' ,. (i;ls L c; 1) IC; ctn ~c-llr h) ~,i n _ina t / ;, ~ ~ ~~'~ .~ ;'~ ~zr S :; duly tic^.4 ~~ ,!~ _, ' 11 ~I )Z~ f r~,j I t ~ r,) u,.,i l { L't'}~ l~, l, i {7. '. k~~-( IZ ~' L . a 1 I ll l v. _ l L r_t P 1t~0023~5 ~ ~~ I,t`t ~~r JAN~1 9 2Q09 J~~ _ _ _.- _ -~ ~. - - `~? ~ ;:: _~= _ _} rn .~ -- __ _ =~ ~ _~ , . ~ tv O REV tt/zoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS nnriEaiTN CERTIFICATE OF DEATH cK INK (See instructions and examples on reverse) STATE FILE NUMBER ~\ ~~ ~ ~~~~` 1. Name of Decedent (First, middle, last. suRixl 2. Sex 3. Social SeCUdly Number 4. Date of Death (Month, day, year) Isabelle L. Hoffman F 78 -16 1--5378 anuary 16, 2009 5. Age (Last Birthday) Under I year Under 1 day 6. Date of Blnh (Month, day, year) 7. Birthplace (City and stale or foreign country) 8a. Place of Death (Check only one) i -_ - er 89 Xlonth' °ay' "°°rs "'ioa1~ December 27, 1919 Sunbury, PA "°spi'a''o~fn y Yrs ^ Inpatient ^ ER /Outpatient ^ DOA Ip Nursing Home ^ Residence ^Other - Specdy 8b. Courtly of Death 8c. City, Boro, Twp. of Death Btl. Facility Name (II not Instituflbn, give street and number) 9. Was Decedent of Hispanic Orlginn ~] No ^ Yes t0 Race: American Indian, Black white etc ° Cumberland Upper Allen 7~ITp. f ecLh v,~x <~ G (If yes, specity Cuban. M i n P Ri t rt Ispeay l~ttite , ex ca , ue can, e c.) o 11. Decedent's Usual Occu anon iKind of work d one tlurin moll of wakin Ille. Do not slate retired 12. Was Decedent ever in the 13. Decedent's Etlucalioo(specity cnly highest Bade compl eted) 14. Marital Slalus: Married, Never Marrieq t5. Surviving Spo use (If wAe, give maiden name) Kind of work Kintl of Business I Industry U.S. Armed Forces? Elementary /Secondary (0-12) Colle a (1-4 or 5+) Widowed. Divorced (SpeciF/l Homemaker Own Home ^Yes ~Np ~ idowed 16. Decedents Mailing Address (Street city /town, stale, zip code) Decedent's Did Decedent Pennsylvania Live in a 170~^ Yes Upser Allen ~ etl i Decedent L l R id 17 St t T A 782 Oak Oval p . , rv n ence a. a e wp. ctua es Townshi ~ rib cppnyCumberland rid. ^ Np, oepedem lived within Mechanicsburg, Pennsylvania 17055-840 Actual Llrllli$ of City I Boro 18. FaMer's Name (First, middle, last, suAlx) 19. Mother's Name (First, middle, maiden surname) Bruce B. Lefever C. Helen Hertzler 20a. Informant's Name (Type / Print) 20b. InfonnanYS Mailing Address (Street, city /town, state, zip code) Mr. David E. Hoffman 6 East Red Gold Circle, Cam Hill, Penns lvania 17011 21 a. Matted of Disposkion ®Cremation ^ Donation 21 b. Date of Disposition (Month, day, year) 21 c. Place of Disposttion (Name of cemetery, crematory or other place) 21 d. Location ICiry I town, stale, zip code) _ ^ Banal ^ RemovallromState !WesCremetlonorponationAuthorizedrT~ Januar 19 2009 Cremation Societ of PA Harrisbur PA 17109 ^ Other -Specify j by Medical Examiner I Coroner? Ug Yes ^ No y s y g ~ 22a. Si a of Fu era! Servicey~censee (or person acting as such 22b. License Number 22c. Name and Address of FacilityAuer Cremation Services of Pennsylvania , IIIC . . ~ ~29('~'1( PAFD138453 4100 Jonestown Road, Harrisbur , Penns lvania 17109 Cornpl Items 23ac Doty wren cenitying 23a. To Me Desf of my knowledge, death oceurted at the time, date and place staled (SynaNm and title) 23b. License Number 23c. Dale Signed (Monts. day, year) physician is not available at tlrtie of death to certify cause of death. Items 2426 must be completed by person 24. Time of Death 25, Date Pronounced Dead (Month, day, year) 26. Was Case Referred to Medical Examiner i Coroner for a Reason Other than Cremation or Donation? who pronounces death. ,'1 e~ ~r~~ ~I M, L `)~L,y3 /~ ~~~_'~ ^ Ves ^ No CAUSE OF DEATH (See Instructions and examples) 1 Approximate interval: Pan IC Enter other 5ignificanl conditions coninbutlnq to death, 28. Did Tobacco Use Contribute Ip DeatM Item 27. Pan I: Enter the jai v - diseases, injuries, or complk:ations -that directly caused the deaM. DO NOT enter terminal events such as cardiac arrest, i Onset to Death but not resulting In the underlying rouse given In Pan I. ^ Yes ^ Probaoly respiratory arrest, or ventricular fibrillation without showing the etiology. fist only one cause on each line. r ^ No ~ Unknown IMMEDIATE CAUSE 1Final cisease or 1 ~~ ~..,.JJ~ ~± (>Ce ~y Ge / J r ~ _f ~ ~L ~ - ' p~ 29. II Female. L.G . V1 r/G(j: L. t conditbn resuaing In death) / -~ a. G ! r Due to (or as a consequence o0'. r _ L Not pragoam wimm past year Sequentially Ilst conditions, it any, o ~ V~ ( Pregnant at lime of death leaangg to Me rouse listed al lira a. Due to (or as a consequence of): ^ Not pregnant, but pregnant within 42 days Enter the UNDERLYING CAUSE r of death (disease or injury Mat insiatetl the c r events resulting in deaM) LAST. ~ nce off D t ^ Not pregnant. out pregnant 43 days to f year o (or as a conseque . ue before death d. ^ Unknown if pregnant wlhrn the oast year 30a. Was an Autopsy 30b. Were Autopsy Findings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Descdbe How Injury Occurred 32c. Place of Injury'. Home Farm Street, Factory. _ Pedormed? Available Prior to Completbn r~ Office Building, etc. !Specify) of Cause of DeaM? ~j Natural ^ Homicide ~ ^ Accident ^ Pending Investigation 32d. Time of Injury 32e. Injury at Work? 321. If Transportafion Injury (Specify) 32g. Location of Injury (Street city l sown, stale) 1 Na ^ Yes 7F' ^ Yes ^ No ^ Yes ^ No ^ Driver I Operator ^ Passenger ^ Pedestrian ^ Suicide ^ Catd Not oe Determined M ^Other Speciy: 33a- Certifier (check only ono) mrwuncetl death and completed Item 23) of death when another h sician has i i rtif i P 336. SI netu a and Ttle of Certifier / , J -~-~ / ~( ~ ! ~- ~ t x' '7 7 ~ %~ l ~ p y p ng cause an ce y • Certifying physician ( hys c To the best of my knowledge, death occurred due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ , . r . . ,,. / i r: ~ - .- - • Pronouncing and cenitying physician (Physician both Dronouncing death arts cenitying to cause of death) To the best of my knowledge, death occurred at the time, date, and place, end due to the cause(s) end manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _' ^ 33d License Number (~~ (/ ~ ~ , LI ~~ c.~ (( 33d Date Signed (Month, day, yearf J/ ~ G. (`; y; i /C E ` C r ~ C~ ner oroner Medical xam On the basis o1 examination and I or Investigation, In my opinion, death occurred at the lime, date, and place, and due to the cause(s) end manner as stated_ ^ erson Who Comple~~d Cause of Death (Item 27) Type /Print 34. Nams acrd Address of 35. ' tray's Signatura~ry'~I a bar I ~ I ~ I ~ I / l I 3~~ Fi~ (Month tlay~ar) f /v ~, ,~ ~. ~~ a~~j,-< c f vL /C - Disppsdipn Permit N 0332195 LAST WILL AND TESTAMENT I, ISABELLE L. HOFFMAN, a resident of York County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my LAST WILL and TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I I declare that I am married to EARL M. HOFFMAN, and that I have two (2) children, CHRISTINE A. COLE and DAVID E. HOFFMAN. II I direct that my debts and funeral expenses be paid as soon after my death as is practicable by my Executor out of my residuary estate, but not from any assets, funds, death benefits ~ insu~~ance-~ .~_~, 2~ r~ ~~ proceeds which are otherwise excludable or exempt frc~mt_7;my dross:: estate for federal estate valuation or tax purposes.- , ~ ~{' III ;~ =-', ~ -' ~~-; :~- N .-, , I direct that all estate, succession, legacy, inherita~e or other transfer taxes, however designated that shall become payable by reason of my death in respect of all property comprising my gross estate for death tax purposes, whether or not such property passes under this LAST WILL, shall be paid by my Executor out of my residuary estate, but not from any assets, funds, death benefits or insurance proceeds which are otherwise excludable or exempt from my gross estate for federal estate valuation or tax purposes. IV I give, devise and bequeath all my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment to my husband, EARL, provided that he survives me by thirty (30) days. V If my husband, EARL, should predecease me, I give and bequeath items of personal property to individuals as I have set forth in a list which I have prepared, signed and maintained with this Will. VI If my husband, EARL, should predecease or fail to survive me by thirty (30) days, I give, devise and bequeath all the rest, residue and remainder of my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment, to my daughter, CHRISTINE, and my son, DAVID, in equal shares, per stirpes. VII I nominate, constitute and appoint my husband, EARL, as Executor of this LAST WILL, to serve without bond. If my husband is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my daughter, CHRISTINE, and my son, DAVID, as Co-Executors of this LAST WILL, to serve without bond. If either CHRISTINE or DAVID are unable or unwilling to act in that capacity, then the other may act alone as Executor. IN WITNESS WHEREOF, I, ISABELLE L. HOFFMAN, have set my hand ,~_.~ to this LAST WILL this ; ~~ day of ,_ ..- r -, ; 1992 . ISABELLE L. HOFFMAN~~ Signed, sealed, published and declared by the above-named ISABELLE L. HOFFMAN, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence, and in the presence of each other, have hereunto subscribed our names. as witnesses . ~ '~ /~ ~// ' / r' l• G ~ ~~ ~' ~- -- ;. ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. I, ISABELLE L. HOFFMAN, 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 as my free and voluntary act for the purposes therein expressed. ISABELLE L. HOFFMA~N~ Sworn or affirmed to and acknowledged before me by ISABELLE L. HOFFMAN, Testatrix, this o2~-~h day of ~-~~~c,~cc r ~ , 1992. Notary Public Notarial Seal Carla F. Brokenshire, Notary PubNc Mechanic~xg Boro, Cumberland County I My Commission E~ires April 1,19rs5 1 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. We, ~1~~,~~N_ l ~~ ~2~~ ~f~r'~5 , .~ and 1~<<~~c, ~ .' ~ 1 , -~.>> ; ~ , the witnesses whose names are"signed to the attached or foregoing instrument being duly 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 ISABELLE L. HOFFMAN 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 the time 18 years of age or more, of sound mind and under no constrant.'or undue influence. ,, ,; ,~ / ~ 3 ` J l` / 1 F / / Sworn or affirmed to and acknowledged before me this ~ ~~h day of ~:J~ti7lstc.f'~ 1992 . ~ ~ No ary Public Notarial seal l Carla F. Brokenshire, Notary Pubec Mec~tarticsburg i3oro, Cumberland County My Commission Expires April 1,195