HomeMy WebLinkAbout04-21-09PETITION FOR P /R~OBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ('~~rn~l~(~ COUNTY, PENNSYLVANIA
Estate of ~ 1 File Number O~ I '~ V L ~~~~~
also known as
-- Deceased Social Se~urityNumber~'7 ~~ .„~~ X ()
Petitioner(s), who is/are 1$ years of age or older, appiy(ies) for:
{COMPLETE 'A' or 'B' BELOW.)
A. Probate and Grant of Letters Testaments T d aver that Petitioner(s) is /are the ~ ~P C it ~~ named in the
1 Will of the Decedent dated ~ and codicil(s) dated
(State relevant circumstances, e.g., rerrr<-ttiatiorb death ojexecutor, eta)
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: rv
C~ ~ - 'i
^ B. Grant of Letters of Administration -"' ~ ~'" ~ t' • ~ ~
(If applicable, enter.• c.ta; d.b.n.c.ta; pendente life; durarrte absentia; dur~t~~•itate)~ ~ ~_
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following any)'~td heirs (~-
Administration, c. t.a. or d. b. n. c.t.a., enter date of Will in Section A abrrve and complete list of heirs.) '-- ' ~ -~ ~-~
Name Relationshi Res~etide~ • --
.~'
(COMPLETE W ALL CASES.) Attach arfditlowo! sheets if -recessary.
cedent was domiciled at death in County, Pennsyl 'a with his /her last principal residence at ~ ~ [ ~(
y
(List stntet address, town/city, reship, cavnry, state, zip code) ~i• ~`~
Decedent, then ~ ~ y f age, died on .,~, L~~~q at _I ~ ~3~ G 2.Amr~n (~~ e SFr ~(~ (~
Decedent at death owned rty with estimated values as follows:
(If domiciled in PA) All personal property $ ~ Q ~ ~}(~( ~
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PAj Personal property in County $
Value of real estate in Pennsylvania S .- ('j
PAI~Q~
,715
Form RW-02 rev. 10.13.06 Page 1 of 2
situated as follows: _ ~
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the of letters in the appropriate form to
the undersigned:
105 905MS RF,V. 9/OR ~ ~ ~ ~~ _ ~~ I V ~~ ~ ~~
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Divist~ot>/o it.zl scot s accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Military
Status
1727020
No.
~~.~ ~ ,~~
Frank Yeropoli
State Registrar
MAR 172009
Date
H105943 flF411 fL006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
TYPE I PRINT IN
PERMANENT CERTIFICATE OF DEATH
BLACK INK (See Instructions and examples on reverse) rwr~ F„ ~ ,,,,xao~o
a~
1. Name d Deuwlenl (Prat, mdtlm, lest, sulfa) 2. Sex 3. Sodel Sewnry Number 4. Date of Deam (Month, tlay, yrer)
JOSEPH G. STUBLJAR Male 179 - 12 - 3488 March 5 2009
s. Age (last t9idrxmyj under 1
" under 1 da 6. Dde d airtn (MOnm, tla , e 7. Binnpmce (coy and dam or tar si country) ea. Piece of Daam (cn.ck my one)
87 """"" °° "°"" """°' March 6, 1921 Steelton, PA "°'pild °pia` Assisted Lavin
Vrs. ^ InpaNmt ^ ER / OulpaNent ^ DOA ^ Nu rshg Hare ^ Resitlenm ®Other - Specify:
Bb. County of DeaM fic. City, Bao. Twp. of Oealh 6tl. Faplity Name (If rid r stMrbon, grva street and mater( 9. Was Oecetlenl of Hispanic Origk? ~ No ^ Ves 1 D. Race: American Intlian, sack, White, ak.
Cumberland Hampden 'Itap (If yes, spell/ Cuban.
Lo
alton of Creekview (Specify)
. y
Mexican,PUenoRimn.ek.j White
11. DsedenYS Usual Omu Lion Kn0 of wok dme tlu' mod d vpdd tiro. Da rid dam relketl 12. Was Decedent ever in ma 13. Decedem's Etlumtbn (Spacity Doty highest gratle mmpleletl) 74. Mantel Slelus: Mazrieq Nerer MaMad 15. Survivrrtg Spouse (11 wile, give maiden name)
KFd d Work Kind of Business I Intluslry
Steelworker Steel Industry U.S. Armetl forces? Elemenmry /Sao tlary (0.12) Cdlege (1-4 or 5F) ~~~' Divorcatl (~~
®Yaa ^NO 12 Widowed
16 DeCetlenYS Maimp Atbress (Stied. ciy! town, date. ap coda) Decedent's pA Did Decedent T~,~~,,~~~
LO al ton of Creekvi ew Aclud Reddeme 17a. Seta Us'e In a 17c. ~ Yes, Decedent Uwitl in un+! }~sen 7~.
- 11 0 GXa on Wa Townsnip7 17tl. ^ Nb, Dxatled Lhetl wiNb
,7b coanty CjJ[~$ERI,ANp
Adad urdmd ptylBae
18. Fetlrer's Nane IRrsi collide, I. suffix)
Mato Stubljar 19. Momefs Neme (F 'dam, maiden wmame)
Anna Benlcovic
20a. Inlamard's Name (7ype / Prmtl
Roseann M. Cerjanic 2gb Inbrmenfe McNmg Aotlrme IStred, cNy / twm, smm, zip coda)
39 Logans Run, Enola, PA 17025
21 a. Methotl or D'epositbn ^ DlelMtlal ^ Wretlbn 210. Dale of D'epbdtibn (Mann. der. yeerl 21 c. Place d DNpositlm (Nacre d cemetery. aemabry or ether plapel 21 d. lacatlm ICiN I taws dam, zip coda)
® Burial ^ RenrbvalhomSmte Wub«natbnarDOnaaanAuUxanmtl
^ gher - Spedly by Matllul Eaarrirw I CuonerT ^ Yes ^ No
~ March 9 2009 Resurrection Cemetery Harrisburg, PA 17112
22a. Signetae d F b Licensee (ar person adHg a9 s ( 220. Licerge Number 22c. Name arq Atltlress of Facility
- ~ --~c~Gm~.~ c~ O/Odd/ ~~- WIEDEMAN FUNERAL HOME 357 S 2nd St Steelton PA 17113
OeniPleta Hems 23at qtly whm wrNying
pryakdan is M avaimde at ome of deem 1° 23a. To the bed d my krewletlge, deem sccaretl at Nre time. dale and place elel•d. (Signatae all Ntle) 23b. License Number 23c. bete Sgrred (MOnm, dry, year)
cerNly cause d tbam.
Hems 2d-Z6 must be mmpbletl by person 2d. Time of Deam , 25. Dale Pmmaiced Dead (Mmlh, day, yearl 26. Was Ceee Referred to Medical Examirer! Coroner for a Reasm Other Nan Cremation a Donation?
was pmrmncea deem. f ~ 0 4 /f- M March 5 , 2009 ^Yaa ~
CAUSE OF DEATH (See Irutrualbns erM saemplee) , Approximate InmNd: Pan II: Enter abet s~[Yfic~^r mod 1. s cm!•4• ~gp ro sea.", 28. Oid ToNacca Use C°nlMde tc DaaM?
Hem 27. Part L Eller me Main devents - tlkeazes. injuries, a axnplicetiore -mat tlirecdy wuaed me roam. DO NOT steer terminal evMm SUdI u certlmc artaat, Onset to Deam but rid remMrg n me untlartying cause gben in Pan I. ^ Ws ^ Pr°babty
reapdtory amed, or ventriaAar fibdsaNm warod ahawirg Nre etlobgy. Lid mly me rauw m each Ire.
R
~IEpATE CAUSE (Fi
d
~
~ []'NO ^ Unknown
,
na)
iseas~ a
/
carrdlibn resdNng In deem ~ a. V 29. H Femem:
'I
Due to la ea mgrencwa d)J Jd pregrenl wimp pest Year
~
SepuartNaW Yp mrrdHms, d anY, b. ~~/' J" ///a~j ~r~~ ~~~~C
~LA~+-Yf
leadrq b the lisl•tl on line a
- ^ Pregnant at Hme al deem
~c~
, Due b
Ertmr ma UNDERLYING CAUSE saPrer¢e d1: ^ Nd pregnard, but pregned within 42 days
(deans or'nNry met In Nw
wmm resuHing n dean) LAST
c °f death
Due b (a as a consequenm dj'. ^ Not pregnnl, bN pregned 63 days 10 1 year
d. betas deem
^ Unlmbwn it pregrem wehin the peat year
30a. Was an Adapsy 3gb. Wen Aubpsy Findings 31. Metros d Death 32a. Date d Inlury (Month, tlay, year( 32b. Describe Fbw Injury Occunetl 32c. Race d Injury: Home, Fenn, SlreeL Fsday,
Pedmmd! Avalebm Prbr to Completlar
~ NaW21 ^ Nomkba OHCe Bdlding etc. (Speedy)
of Cause of Deem?
^ Yes [~ Nb ^ Yes ^ No ^ Amkbd ^ Pending Invesfigetim 32tl. T e d Inlury 32e. Iryury al WaN? ffil. II Transpormlim Injury (Sped N1 32g. Laatim of Injury (Steel, city I town, date)
^ Sukide ^ Cbdtl Nbl b° Ddennine0 ^ Yes ^ No ^ Dover I Operator ^ Penerger ^Pedadrian
M ^aner-seedy:
33e. Certifier Mackin one
ier
33b 5 abre
9n
• CMHylrp phyaldan (Physican ceddNn9 cause of deep, when anomar physician has proraunced tladh ell compldetl Hem 23) ~
To the ben or my kmwletlgA dnm xcurted art to the csuae(e)antl menrrer a°smlatl_________________________________ [`.~( -
,
• Pronwroing sod c°rtlfying physican (Physician bah prmdarcirg tleam end cednyng Ib cause d death)
To the best of my knowMdge, fketh xmrcb el ttr time, tlala, and plxa, ell tlw to the oase(s) antl manner ae amled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
aWkd E
i
• 33c. Ucenn Nu
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s~ ~,
' 33d. Date Signetl (Month, day, ea I
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um
rnr/Coroner v`
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On tlr bola d exeMnatlon and / a inveadgaUm, m my oplnlm, tlnlh occurred a11M tins, dale, antl Platt, antl Due b tM uueda) and nunrcr ae steterL ^ ~ rya
r„e antl Atltlresa d Perron
W1
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omplelatl Cauw~g(jkalh
C Qle m 27
f~r Print _
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35. R Signature all
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
,,~/~ ~~1 SS
COUNTY OF ~ ,~ A Y 1 ~~ I ,t l
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 ` ,an~~d- subscribed
before me the -" day of
Signal ofjPdrsaml Representative
Si lure of Personal Representative
Signature of Personal Represeretatrve
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File Number: ~ ~ ` ~~- 0 3 ~ 3 _
Estate of Deceased
Social Security Number: (~ Date of Death:
AND NOW, ~s~ ~ 1 . ~~1 , in considerati n of the foregoing Petition, satisfactory proof
having been presented before , IT D 'CREED that Letters
are hereby granted to
in the above estate
and that the insttvment(s) dated
described in the Petition be admitted to probate and fried
FEES
Letters ............... $ (Q0. ~ ~
Short Certificate(s) ........ $_„~_
Renunciation(s) .......... $
~~ ... $ 1b.Q~
~~Zl~ ... $ 5~oa
... $
..$
... $
... S
... $
... $
TOTAL .............. $~~°_~
Attorney Name:
Supreme Court I.D. No.:
Address:
Telephone:
Form Rw-oz rev. 10.13.06 Page 2 of 2
Attorney Signature:
LAST WILL AND TESTAMENT
OF
JOSEPH G. STUBLJAR
f~~
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I, JOSEPH G. STUBLJAR, presently of 4591 Larch Drive,
Apartment A37, Harrisburg, Dauphin County, Pennsylvania 17109,
being of sound mind, memory and understandin do make and ubl'
g, p ish
this my Last Will and Testament, hereby revoking and making void
all former Wills by me at any time heretofore made.
ITEM I. I direct that all my just debts
and inheritance taxes which may become due as a result of my death
be fully paid and satisfied as soon as conveniently may be after my
(decease.
ITEM II.
All the rest, residue and
remainder of my property and estate, both real and personal, of
whatsoever kind and wheresoever situated, which I may own at the
(time of my death, I give, devise and bequeath unto my wife, MARY A.
C. STUBLJAR, if she survives me by thirty (30) days.
ITEM III.
In the event my wife shall not
survive me by thirty (30) days, I then give, devise and bequeath
all the rest, residue and remainder of my property and estate unto
my four (4) children, JAMES J. STUBLJAR, THEODORE W. STUBLJAR,
ROSANNE M. CERJANIC and MAGDALENE M. HENCH, in four (4) equal
portions, share and share alike.
ITEM IV.
I hereby nominate, constitute
and appoint my wife, MARY A. C. STUBLJAR, to be the Executrix of my
estate with the power to sell all real and personal property at
private or public sale. In the event my wife shall not survive me,
or shall otherwise fail to qualify as my Executrix, I then
nominate, constitute and appoint my daughters, ROSANNE M. CERJANIC
and MAGDALENE M. HENCH, co-Executrices, to serve in her place and
stead.
IN WITNESS WHEREOF, I, JOSEPH G. STUBLJAR, the Testator, have
to this my Last Will and Testament, written on one side only of two
(2) sheets of paper, set my hand and seal this ~ day of
/t//~ veNC~~I~ 1998.
J PH STUBLJAR
2
The preceding instrument, consisting of this and two other
typewritten pages, was on the date thereof signed, published and
declared by JOSEPH G. STUBLJAR, 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.
~~~~~ ~ ,,M~~ Residing at III
j
7 /7
_~ ~ %~''~ , {GJ Residing at '
~i ~n
3
COMMONWEALTH OF PENNSYLVANIA
~Gz~G / 4 S S
COUNTY OF
I, JOSEPH G. STUBLJAR, Testator, 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 that
II signed it as my free and voluntary act for the purposes therein
expressed.
IN WITNESS WHEREOF,qq I, JOSEPH G.STf/UBLJAR, have hereunto set
my hand and seal this dd day of /VU~/t'^/~J~~ 1998.
JO PH STUBLJAR
SWORN TO and subscribed
before me this ~L day
of ~~~P~J 1998.
Notary Public
NOTARIAL SEAL
NANCY L. BRESKI, Notary Public
Harrisburg, Dauphin County
My Commission Expires March 16, 2000
4
COMMONWEALTH OF PENNSYLVANIA
,n S S
COUNTY OF ~(
We , ~ r b f'~~ ti~~ and Ja,..._.1 ~) ~~ ~: ii Jr
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 Testator sign and execute the
instrument as his Last Will; that he signed willingly and that he
executed it as his free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the Testator
(signed the Will as witnesses; and that to the best of our
knowledge, the Testator was at the time eighteen (18) or more years
of age, of sound mind and under no constraint or undue influence.
f~~ ~ ~
SWORN TO and subscribed
before me this o?O1~j day
of 1998.
No~Jary Public
~'~ ` ~'
-~ l ,
89-581/106355-1
NOTARIAL SEAL
NANCY L. BRESKI, Notary Public
Harrisburg, Dauphia~ County
My Commission Expires `:parch 16, 2000
5