Loading...
HomeMy WebLinkAbout03-13-09PETITION FOR PROBATI E AND ,GRANT OF LETTERS REGISTER OF WILLS OF ~~i yh Der 1a•vt d COUNTY, PENNSYLVANIA Estate of ~~~ ~~ /~'~ . ~/~r~ ~~~ z,~ File Number ~ ~ ~ if t - V/2~ also known as Deceased Social Security Number /~S' 1' ~~Y -.5.59 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 ~X PC's Gt7E-'I'S named in the last Will of the Decedent dated (u -/ -.~ d and codicil(s) dated _ (State retevmrt 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 (!f applicable, enter: c.t.u.; d.b.n.c.[a.; pendente lire; durance a.hseretia; durance n:inoritate) Petitioner(s) after a proper search has /have ascertained [hat Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Adrninistratiort, c. t. a. ord.b.tt.c.t.a., enter date of Will in Section A above and complete list of heirs.) Name Rela[ionshi Residence (CONIPLETEINALL CASES:) Attac/z additiotzal sheets t necessary. Decedent w s domiciled at death i U 2 ~Gt ~ County, Pennsylvani wi his /her last rincipal residence a ~ (Lis •treel address, town/city, township, county, stale, zip code) Decedent, then ~ years of age, died on 3 8 ~JQ at ~ S a I Q ~ l ,~ Decedent at death owned property with estimated values as follows: ~a // (If domiciled in PA) All personal property $ ~1 -) lD5 , (If not domiciled in PA) Personal property in Pennsylvania $ C?' (If not domiciled in PA) Personal property in County $ C`' Value of real estate in Pennsylvania $ situated as follows: ~ GUS t-l w ~~ •~ 1 td67~ '~// Fa'nt RW-03 rev. !0.!3.06 KI:iCOK_UID C)F^F^I(f.~: Of ItF;GIS"I"F,R OF ~~.TI,I.,S 2009 MARCH 13 (:I.I•;KK UFO OKPf i<i'\S' CC~LK"T Page 1 of 2 Wherefore, Petitioner(s) respectfully request(s) the prrobate 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 COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con~ect 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 06°! For the Register Signature ojPersonal Representative ~~~~ ~ ~ ~~ Signature ajPersonal Representative Signature ojPersonal Representative Fil(e~Number:p~ ~ - (~Q -~~~ ~ Estate of WlV `~Yl \r1.~~p t Q,x~, ,Deceased Social Security Number:I ~q - { 0 - ~ ~ ~} ~o Date of Death: ~ -" Q - 0 t AND NOW, fib,-rC.~ ~ ~ UUq , iu consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters 1 are hereby granted to ~OU~t S l1'l,L.b t ~ ~ 1.-1-'~ C . t bOlti.~ _ in the above estate and that the instrument(s) dated ~Q - ~ ~{ - (S described in the Petition be admitted to probate and filed of recory} as the last ~Vi~l (and Codicil($j)lof Decedent. FEES Letters ............... $ ~5 -Old Short Certificate(s) ........ $ \~ -00 Renunciation(s) .......... $ C..P ... $ io ~ y~ l~t'~"ol r ... $ J , 6i~ ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ I .- Fornr RW-0' rev. !0.13.06 Attorney Signature: Supreme Court I.D. No.: Address: Telephone: KE:C;OKD13D O1^FI(;l? OI~ REGIS'I'F..R OF ~~71.L,~', 2009 MARCH 13 (,.ERIK C)1~ ORPIL:INS' C;C)URT C:L`~113FRL;~'~D CO., P:\ Page 2 of 2 Attorney Name: OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 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 RecordsaOffir permanent filing. P 15187848 ~ ~''//// BAR 1~ 100 Certification Number Local Registrar ., s, ->= `~ i1 ..i ~ ;~ , ., ^~~~ cr. /. <C =: ~ -r C ~J N v '~i x ~; 3 REV Ii/2W6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS / PRINT IN 3MANENf CERTIFICATE OF DEATH ACK INK (See Instructions and examples on reverse) STATE FlLE NUMBER 1. Name d Decetlent (First, midtlk, last. wdu) Annamae M. Trubiani Sex Female 3 Seanry Number 1 _ 18.._ 5596 4. Date of Death (Monet, de , ear) March 8, ~~09 5. Age (Last &nltdey) Under i r Udder 1 day 6. Date of Sirlh (Month, day year) 7. Blnhpbce (City and stale a for e' wunlry) Ba. Place of DeaM (Check tint one) 89 Yn t4one,e Deus wars tAauwa 5/26/1919 Harrisburg Hospdal: ~inpetkm ^ER/Outpatient ^DOA Other ^NUraing Rprta ^Residence ^Other. Spedy: 6b. County d Death &. City, Boro, Twp. of Death 6d. Facility Name (il rat msWdion, give street and number) 9. Was Dacetlenl of Hiapenk Origin? ^ No ®Yes 10. Race: American letlien, Black. White, etc. Cumberland East Pennsboro 'Itap. Holy Spirit Hospital nfyea.apacifyCuban IsPeplr» Mexican, Puerto Rican, ek.) White 11. Decedel's Usual lion Kka of work done tlun most of world Yle. Do not stele reti 12. Wes Decedent ever in the 13. Decedent's Educetkn (Speciry Dory highest grede completed) 14. Merllel Smlus~ Marneq Never Marred, 15. Surviving Spouse (II wife, give maitlen name) Kktd d Work Kind d Business! Industry Clerk Groce St U.S. Armed Forou? EIe~te bry! Secondary (0-12) Cotiega (1-4 or 5a) Wklowed, Divorcetl (Spea7y) ~ ry ore ^Yes ~flo 1 Widowed - 16. s Me ' Qdrasg (Sreet ' /town, slate, zp code) ~o en~iving tenter 17011 Decedent's Did Decedent sore PA Live in a t7 ~s t Pennsboro Tt,rp A~u~l RBaide~a 17a ~] Y D d 770 Poplar Church Rd., Camp Hill, PA . . T,~ c. es, ece ent Lived in Cumberland Township? i7tl. ^ No, Decedam Lived wthin 17b. County gptual Urtkb of CirylBoro 19. Famer's Name (Fins, middle, tut sud'a) Joseph A. Gill 19. Mother's Name (Pint middk, maiden surname) Minnie Guyer 20a. lniortnant's Name (Type /Print) 20b. InlotmanYS Mailing Atltlress ISlreet city /town, able, rip cotle) Linda C. Cribari 1312 Well Drive, Hill PA 17011 21 a. McMOtl of DispasiEOn ®Cremalbn ^ Donatan 21b. Date d Disposition (MOnM, day, year) 21c. Place of Disposition (Name d cemetery, crenlalory or timer pkce) 21d. Locetlon (City l sown, stale, zip cotle) ^ Burial ^ RemovellromSrete i~ wuCnmadonorponatlonAUthorizetl ^ Omer - Spetlty: ;try Madcal Examiner /Coroner? Yea ^ No 3/10/2009 Con-O-Cite Crematory Schaefferstown, PA anent Service ~ ading es sucnj 22b. Licerae Number 22c. Name and Address d Fadliry - - _ ~`~ FD013945L Neumyer Funeral Home, Inc., 1334 North 2nd St., Harrisburg, PA 1710 Complete Items 23ac Dory when cenirying 23e. 7o the test of my ,Beam occured at tm time, date one place abletl. (Signature end title) 23b. Lkense Number 23c. Date Signetl (Monet, day, year) physlddt k rid avekade el tune of deem to mtiry cause of deem. - 7 ~-•.I C~ S 6 ("> ~~~ •_...-~.. ~.•~•i._\>,_,~ ~4z-~ -31 SS' `~ 9 :7 "'t Items 2426 runt be txmplHed by person 24. Time of Deam 25. Date Pronounced Dead (Month, day, year) 26. Was Case Referred to ediCel Examiner I Coroner for a Reawn Other than Cremation or Donatkn? wta prorouncu deem. ,7 U.~ ~ l-~, M. ~ ~ ^Yes CAUSE OF DEATH (See instruetlons and eltemplas) t Approximere imerrel: Pad II: Enter filar sani6cant condilkns cartkidalnc to tleam, 26.Oitl Tdaacw Use Contribute to DeaM? Item 27. Part l: Enter Me dais of events - tlisnses, injunu, or complicatims -Mel directly ceuaed the death. W NOT solar terminal events such ae certlac areal. t Orset to Death fill not resulting in Me undenying cause given in Pan I. ^Yes ^ Probably respiratpy arrest, a venlncdar fibnlletron widad showing Me etiology. Usl only orre cause on each line. ; > > IMMEDIATE CAUSE /1Fi l tli ^ No ^ lJnkrown uase or 7 q na ~e ~r1 ~.,c~ cmdtkn resulting in deaM) ~ r~l ~ ° `~Sf ! f lY•'~~ ~ ~J \Y ~~• i I 29. If Femak'. r _' a. Due to (or as a n equence o : ~ c o s ^ N01 pregnant wihin past year ~ ~ e 7 ~ Serpnntialry Nat rgndegns, a airy, h. f~P-~1 ~~ ~G, ~`y' }-- /'fit Z-.L.) ~~_ ~ ketlrq to tiro cause listed on line a ^ Pregnant al lime of deem . Eder Me UNDEt~YING CAUSE Duero (or es a consequerce d): I di ~ '~ ~ t nanL but pregnant vamin 42 days ^ ( l--~ uue a kMwY Mel kttiieled me c erertn resulting n tleeM) LAST ~ of deem Due to (W as a COIISaquenCe Of): ^ N01 pr I, but egnan pregnanl43 days to 1 year d ~ eelore deem ^ Unknown d pregnant within me pest year 30a. Wes an Autopsy 30h. Were Auopsy Rndirgs 31. Manner d Deem 32a. Dale d Inury (MOmh, day, year) 32b. Describe Fktw Irqury Oaured 32c. Place of Injury: Fkrra, Farm, Street Factory, Penomatl? Availabk Prior to Completan _ QTIaWral ^ Homidde Olftce BuiMi etc. ~' (SVerihl of Cause d Death? ^ Yes ©'No ^ Ves [/]'No ^ Accident ^ Pentling Imntrgatkn 32d. Time of Injury 32e. Injury al WorN7 321. II Transponation Ir{ury (Spedtyl 32g. Locatkn of Inury (Sireel, city I town, slate) ^ Suicae ^ Could Nd he Debrtninetl ^Yes {] No ^ Driver / Operetor ^ Passenger ^Pedestrian M Other - Spetily: 33e. Certifier Idredt Dory oriel 33b. Signature and Ttie of Certifrer • CerUlyag phyaklan (Physican cerarying cause of deem when andher physkian has pronancetl tleaM and cortpktetl Nem 23) - l i~ ~ l J To the Ent d my knowledge, duet occurred due to the cwu ee(sl and murroruabtad_________________________________ ^ ` ` • Pronouncirq and ceNlykg physkian (Physician bah praatncing death and ceniryirg a ceuu of tleeM) T fM h t d k kd d M d d M U d l t d d h ^ 33c. Ucense Number 33tl. Dale Sigrletl (Month, say, year) o ea my tlow ge, u occure e na, e, en a p ace, an due to t e csuaga) and manner a atabd_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ • Medkel Eaaminerl Caster ~ --~ ,Z C/ '=- C:- c' e 1v1'>~ !>~l ":- ~fi.3 __~ On Me bash d exrrdnstkn and ! a inreetlgetkn, In my opinion, tlaeM occurred H Me time, dab, and plea, aM dw b ms uusa(e) end manner ae sta0ed_ ^ p ~ ~ None aM Adkeas of Per s ~ n Who Campkled Cause al DeaM (Item 27) Type /Prim 35. Reglstry+~gneture aM u -~ r ~ -'~ ~ 36. Date Filed IM , tlay, Year ~ 1 e cl ~ ~ ~ ~ ~ ~ t~-z~~l ' UI ~ ~"'~' -~ 1~ V.~ L ~ ti s~`r ~ ' d~ r te-- I I I / I ~ I - ~~ ~~a>,r 5~-> z~=a P . ) , ~-s I~ , z4 l-? i l ~ c~ I 1 v Diapoaaion Permit Np. 0332182 M. ~ ~ . WILL OF ANNAMAE M. TRUBIANI I, Annamae M. Trubiani, Cumberland County, Pennsylvania, declare this to be my last Will and hereby revoke all prior Wills and Codicils. 1. I direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. I direct that all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. I direct that my entire estate be distributed as follows: ~ ~ ~, ~"i~~ ~~ A. I leave my antique desk to Ann Marie Gilcrease. ,. H ~ M ^ J v ~ ~; V ~,/ v ~~x~s B. I leave the remainder of my estate to be divided ~~dw ~ ~ ~ ~~ ~' equally between Ann Marie Gilcrease Louis ~ ?-~ Q , Trubiani, and Linda Cribari. Should Ann Marie N ~- ~ ~ ~ ~ ;_; Gilcrease, Louis Trubiani, or Linda Cribari x `' predecease me, their share shall lapse and be divided equally between the survivors. 4. I appoint both Linda Cribari and Louis Trubiani jointly as Executors of this my last Will. 5. The Executor of this ~JVill shall have the power to distribute my estate in kind or in cash, or partly in either. 6. I direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. IN W SS WHEREOF, I have hereunto set my hand this ~ day of , 2004. LAW OFFICES OF G~~ - -~~` STEPHEN J. HOGG - :~= - Annamae M. Trubiani 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and one other page was on the day and date hereof signed, published and declared by Annamae M. Trubiani, as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. ~/ ~ WIT ESS TNESS ~• ~. ACKNOWLEDGMENT LAW OFFICES OF s'rEr~v J. xoc,~ 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 State of Pennsylvania County of Cumberland ss I, Annamae M. Trubiani, the 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 as my free and voluntary act for the purposes therein expressed. '+ °~ before me by Annamae _ , ~(~~~~ ablic/Attorney Notarial Seal Judith A. Skoda, Notary Pubiic East Pennsboro Twp., Cumberland Cour~t~ My Commission Expires Oct 2.i, '~700.:~ ~fIAfT't1B!. PBf1r3S~'~'J~nl:^ ;5:::..:7"t ~lir~n . ~.N+_.__,..._ County of Cumberland We, $ra2anhe ~. G1^v~nd:~an ~ ;' U 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 the testatrix sign and execute the instrument as her last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; 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. .i(/' Annamae M. Trubiani Sworn to or affirmed an~~~.~nowled~ M. Trubiani, the testatrix, this day of ! 2004. otary PI AFFIDAVIT State of Pennsylvania SS Sworn to or affir nd subscribed to before me by witnesses, this ~ day of , 2004. tary Public/Attorney Notarial Seal Judith A. Skoda, Notary Public East Pennsboro Twp., Cumberland County My Commission Expires Oct. 22, 2005 Memtx;r PPnnsylv:~nia Ase,~.xiat~on Of Notaries