Loading...
HomeMy WebLinkAbout06-02-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of FRANCES L. BRUBAKER File Number ~, 1 ~-'C~ ~D also known as Deceased Social Security Number 203-10-9307 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 RICHARD V. BRUBAKER named in the last Will of the Decedent dated May 26, 2006 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 liter durante absentia; durance Heinoritate) - ~~ ~:,:~ Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spop~ {413 any) and~irs: (If' Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ___. «-. _ 1 Name Relationshi Residence'. ~i/' ~~. r` _.s;> ---! .. ~- - el.'> (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at Mallard Run Apt 508 Camp Hill (Lower Allen Township) Pennsylvania 17011 (List street address, town/city, township, county, state, zip code) Decedent, then 87 yeazs of age, died on March 15, 2009 at Golden Living West Shore, East Pennsboro Twp. Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 50,000.00 (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 follows: NONE 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: Si nature T ed or rinted name and residence f J ~ ~ / _ i ~ RICHARD V. BRUBAKER, 669 Gaumer Road, New Cumberland, PA 17070 Form RW-02 rev. 10.13.06 Page 1 Of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF ~,~,~ 1`l~~f \~ 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 rep ntative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. ~_ ~ l Sworn to or affirmed and subscribed before me the ~_ day of 1~ or the Register Sigrdxture of Personal Representative" - ~ '~ LJ _`~~ G~ ~ E' Signature of Personal Representative _ _: y i _. ...'? .~' R.~ Signature of Personal Representative File Number: r~ ~ ~~ ~ ~%~ Estate of FRANCES L. BRUBAKER - ~ ~ ~ ~• -~i ~ -. , Deceased ~, Social Security Numb(e~r: 203-10-9307 ~ ~l Date of Death: MARCH 15, 2009 AND NOW, 11~t t' t !-~'~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before , IT IS DECREED that Letters are hereby granted to RICHARD V. BRUBAKER in the above estate and that the instrument(s) dated May 26, 2006 described in the Petition be admitted to probate and filed of FEES 0 '' Letters .... ~~i ~...... $ Short Certificate(s) .. ~.... $ Renunciation(s) .......... $ _...$ ~~J ... $ ... $ ~~. ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ l ~~ as the 1a19t Will (and ~'gdicil(~s)) of Attorney Signature: Attorney Name: MARVIN BESHORE, ESQUIRE Supreme Court I.D. No.: 31979 Address: 130 State Street, P.O. Box 946 Harrisburg, PA 17101-0946 Telephone: (717) 236-0781 Form Rw-oz rev. 10.13.06 Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. t=ee tin- thi rertiticate. ~%~.{)t) /,,rr~~H (1Fp~ f ~ Th)s ), by L~rtifti t:)at the infvrmatil~n h~r~ ~i~~en i~ l C iti u t~ D th l h i l iy =_ /~~j ~~ ~ ert c c u ea l In an o Ig na y cut~le~ contct ;~x`o~/ ~` =~ duly tiled ~'v)th ~~~~ its Locx>1 EZeglst)ar. The on<_rir~al "~~ `w~ .; ~ certificate t~'ili he ftllwarded ttt th% State Vital , ~?° ; ~a~ ~ Recc/rds Office t~tr pcrmal~ent fitin<~. -... ,._ , ,t 1 * ~ \_ O -- - -- Certificaticyn Nurnher -- Mme-- '"7,Inl% - Vii, ra Date l~ssue;d -_:, ~ ~ ~--v i7 -;.~ ~ -; ~ .. ..~ .. t-- - ~~ :~ r., = ~~ _ - t.: ~~- - -. z 1...1J ~`", , ~ -~ -- REV 112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS 7 PRIM IN tANENT :K INK CERTIFICATE OF DEATH (See Instructions and examples on reverse) (iJ sTATE FILE NUMBER (~ \ ~ ~ ~~C~ 1. Name of Decetlem (First, middle, last, sufix) 2. Sex 3. Social Secunry Number t 4. Date of Death (Month, day, year) Frances L. Brubaker Female 203 - 10 - 9307 March 15, 2009 5. Age (Last BirMday) Under 1 year UIMer 1 day 6. Date of Binh (Monts, day, year) 7. Birthplace (City aM state a for ego country) be. Place of Death (Check only one) Monts, Days Hours rxnute¢ Hospftal: Other. 87 Yra. June 24, 1921 Harrisburg, PA ^lnpatiem ^ER/Outpatient ^ DOA Nursirg Home ^ Residence ^Other - Specity-. 6b. County of DeaM tk. Ciry, Boro. Trop. of DeaM 6d. Fadfiry Name (If not inslfiu6m, give street and number) 9. Was Decedent of Hispana Origin? No ^ Yes 10. Race: American Indian, Black, Wnlle, etc. Cumberland E. Pennsboro Twp. Golden Living Center of W. Shore ( nPPo n lspe"y) white Mexica enoRira n,etc.) 11. Decedent's Usual Occ lion Kira of wade d one du' most of INe. Dona stale retired 12. Was Decedent ever in the 13. Decedents Education (Spadty any highest grade compl eted) 14. Mamal Status: Married, Never Married, 15. Surviving Spo use (II wife, give maiden name) Kind a Work Kind of Business /Industry U.S. Armed Faces? Elementary /Secondary (0-12) College (1d or Sr) Widowed, Divorced (Specil» Dress Manufact. ^Yes ~"^ 10 Widowed • 16.Decedent's MailingAdtlress(Sreet,city/town, state,zgcode) Decedents Penns lvania Daoeceaent Lower Allen y 17c ®V D c d t L tl l R id t7 Sl t A Mallard Run , Apt . 5 0 8 . es, e e en rve ence a. a e m Twp ctua es Townshry Camp Hill, PA 17011 t7b.county Cumberland 17d ^ ~~I°~; ~^o;i"'d'"`"n cm/Ba^ Y6. FaMa's Name (First middle, Wet salix) 19. Monrer's Name (Post, maAe, maiden surname) Charles D. Malone Mary A. Shearer 20a. IMormant's Name (Type /Print) 20b, Informants MaiMg Address (Street city I town, stab, zip co0e1 Richard V. Brubaker 669 Gaumer Road, New Cumberland, PA 17070 21a. Method of Duposilbn ^ Cremation ^ Donalan 21b. Date of Disposition (Monts, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or o111er place) 21 d. Location (Ciry /town, state, zip code) ^ Bural f-l Ramoralr~.msata ;~ waecrematimaDonanonamlar~aa • 2009 March 20 Rolling Green Cemetery Lower Allen Twp. ,PA 17011 ®Other - svaa~y: Entombment i by Madcnl Examiner / Coraner7 ^vaa ^ No , 22a. Signature M F rel S Lkensee ( person ~ng as such) ?2b. Lirerue Number 22c. Name and Address of Facility FS 012 849 L New Cumberland PA 17070 Box 431 Inc P O Parthemore FH & CS . ~ ` ,q _ , , ., . . , Cortplete Hems 23at on ce ' ' g 23a. To the best of my krrovAetlge, death occured at the tlme, data aM place stated. (Signaure aM tltla) 23b. License Number 23c. Date Signed (Month, day, year) - plrysidan is trot ava8able al ii of tleaM to ~ - ,f ~, v ceNfy cause of death. (~~ ' ttems 21.26 must be completed M person 2d. Tone of DeaM 26. P Dead (MOmh, day, yeaQ 26. Was Case Relertetl to Medical Examiner / Caoner for a Reason Other Than Cremat or Donation? • woo proraunces deaM. i Q M. ~ •~ QD . ^ Yes ^ No CAUSE OF DEATH (See inetruetions end examples) r Approximate interval: Pan II'. Enter abet siglificant conditions conMbufna to deaM, 26. Ditl Tobacco Use Contribute to Death? Item 27. Pan I: Enter Ibe chain al events -diseases, injures, a compkcatans -Met dkedy caused the deaM, DO NOT enter terminal events such as caNiec artest r Onset to DeaM but not resoling In Me uakryirg rouse given in Pan I. ^ Ves ^ Probably resgretory artest a ventricular fanlla[bn without showing the elioagy. List any one cause on each tae. ~ [~No ^ Unknown 111MEDIATE CAUSE (fFinal disease or t condition restating ~n deaM) ~ a. ~~ S p ~ /f ~ j/~ ~ ~ q ,~ r ~k / ~ G3S.r-.. n rig / ~{~ R'~$/ N ~ 29. Irf Fyemale. i N !=-r Due to (a as a conseyqu~exe of): r Sequenbaky fist condkans, tl arty, b. ~{ N /~ /~ x U ^' (y ~ ~7 C `'~ L. /Gr! b" r-t ~ ~r1P~"+N~ f ot pregnant w thin past year Ly. ^ Pregnant a1 time of death r leadng a the cause listed on line a. D ^ Not pregnant, Mil pregnant within 62 days ue to (or as a consequence oQ: Enter Me UNDERLYMG CAUSE of death (disease or ury'ury that initiated Me c ~ i ~ - events resulting m deaM) LAST. - Due to (or as a consequence of): , - ^ Not P rant. ha rant 43 da rag Pm9 ys to 1 year r d. f belore death ^ unknown if pregneM within the past year 30a. Was an Autopsy 300. Were Autopsy Frcdngs 31. Manner of DeaM 32a. Date of Injury (Monts, day, year) 32b. Desaiba tiow Injury Occurte0 32c. Place of Inryry: Hone, Farm, Street Factory, Pedomled? Available Pray to Completan of Cause of DeaM7 ~y 'C} Natural ^ Homicide Office Balding, etc. (SpeciyJ ^ AcCdenl ^ Pentlmg Inveshganon 32d. Time of 11qury 32e. Inryry at Work? 32f. tt Transponanon Injury (Specity/ 32g. Localan of Injury (Shaer, city /town, sUte) ^ Yes ~ No ^ Yes ^ No ^ Suaae ^ Could Not be Determined ^ yes ^ No ^ Dover I Operate ^ Passenger ^ Pedestrian M ^OMer - Speci(y~ 33a. Cerfifier (check Dory one) 33b. Sign tae Tiae o/ GeNliar • Certifying phynieien (Physidan certiying cause of death when anolber physician has pronounced deeM and cempletetl kern 23) death occurred due to the cause(el arld manner as alaMd_ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ To the beat of my knowledge ' B~ . • Pronouncing aM cednying phyeldan (Physician bah proneundng death and certifying to cause of death) ~ io the beat of my knowledge, death occurred N the time, date, and place, and due to tM cause(s) and manner as ataterL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33c. License Number _ ~~~~ ~7 ~) ~ r / CJ ICJ !~ 33d. Date Sgggpppeeeddd (Mon ,day, year) ~ /'G,~~~ 9 // ((( • laedkal Examiner I Gaoler On the basis of examinatkn and I a investigatbn, in my opinion, death occurred at the rime, date, and place, and due to the cause(s) and manner u stated_ ^ ~ Name and Address of P wbeCortplated use of DeaM Qlem 27) Typa /Print ~ nts da ear) 36 D l Fil d M Inct ~ 36. Registrar's ~ a ~ ~ ~ / i ~ ~ / I / I , y, y . a e e ( o o / ~x(~o~` ~,}~ ~ 7d ~ Q ~'`/~ ~ ~~ ~' / ~•F o1Gc ~, G i JW . /Y/G I d\ ©c~G~L~I LAST WILL AND TESTAMENT ~-A c7 ~: .~:, '-._ O c._ of - _~ C- ,.-~ ... -~ ~ ,_, _ ~., FRANCES L. BRUBAKER - ~- ~ ~~ - - :~~ L~ _ -+ .. ,~ <..: I, FRANCES L. BRUBAKER, of the Township of East Pennsboro, County of Cumberland, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. 1. I direct that the expenses of my burial and all my debts be paid as soon after my death as may be convenient to my Executor or Executrix hereinafter named. 2. I nominate, constitute and appoint my husband KENNETH V. BRUBAKER to be the Executor of this, my Last Will and Testament. If my husband does not survive me, or is unable or unwilling to serve for any reason, I nominate, constitute and appoint my son, RICHARD V. BRUBAKER to be Executor hereof. 3. I give all of my property, real personal and mixed to my husband, KENNETH V. BRUBAKER, if he survives me by more than thirty (30) days. 4. If my husband does not survive me by more than thirty (30) days, I give all of my property, real, personal and mixed as follows: (1) to my son RICHARD V. BRUBAKER, I give 30% of my estate, if he survives me; (2) to my son KENNETH A. BRUBAKER, I give 30% of my estate, if he survives me; (3) to my son CHARLES F. BRUBAKER, I give 30% of my estate, if he survives me; and (4) to my granddaughter, TINA M. BRUNER, I give 10% of my estate. If any of my sons do not survive me, I direct that such son's share be divided among those sons Jp, 2 ~ who do survive me. 5. I give to my Executor the following powers which are to be construed in the broadest manner consistent with validity and their duties as fiduciaries. I give the powers stated herein, in addition to those granted by law, and I give them to Administrators and Trustees who succeed the fiduciaries I have appointed. a. To retain any or all of the assets of my estate, real or personal, without regard to any principle of diversification or risk. b. To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, as they deem proper without regard to any principle of diversification or risk. c. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sale, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. d. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. e. To borrow money from any person or institution, and to mortgage or pledge any or all real or personal property as my Executors or Trustees, in their sole discretion shall choose, without regard for the dispositive provisions of this instrument. f. To register securities in street name or in the name of a nominee or in such manner that title shall pass by delivery and to vote, in person or by proxy, securities held hereunder and in such connection to delegate discretionary powers. g. To compromise any claim or controversy. - 2 - ~ ~ /3 h. To choose the optional valuation date for federal estate tax purposes. i. To exercise any law-given option to treat administrative expenses either as income or as estate tax deductions, without regard to whether the expenses were paid from principal or income. j. To exercise any law-given option to pay death taxes in installments, the payment of interest due on such installments to be a charge against principal. k. To make distribution in cash or in kind, or partly in cash and in kind, and in such manner as they may determine, and at valuation finally to be fixed by them. 6. Death taxes: All federal, state and other death taxes payable on the property forming my gross estate for those purposes, whether or not it passes under this Will, shall be paid out of the principal of my probate estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. This provision shall not apply to any property over which I have a general power of appointment for federal estate tax purposes. 7. To the extent that such requirements can be legally waived, I direct that my Executor shall not be required to post bond or give any security in connection with their duties hereunder, whether in the Commonwealth of Pennsylvania or any other jurisdiction. IN WITNESS WHEREOF, I, FRANCES L. BRUBAKER, have hereunto set my hand and seal to this, my Last Will and Testament which consists of,~ typewritten pages, this day of , 2006. FRANCES L. BRUBAKER - 3 - ~~~ Signed, sealed, published and declared by the above-named, Frances L. Brubaker, as her Last Will and Testament in the presence of us, who at her request, in her presence and in the presence of each other have hereunto subscribed our names as witnesses. of ~l( ~7~~v~-- b W tness w. Cam/" T ~"/ ~ 7d ~ ~C~ of ~ y, `G(fYR.(~ C~~ . Witne ~J icS~iu~ P(1 `-l ~'1 ~ - 4 - ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ss. COUNTY OF C~~fZL~NP> ) I, FRANCES L. BRUBAKER, 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 this instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. FRANCES L. BRUBA R Sworn or affirmed to and acknowledged before me, by Frances L. Brubaker, this°~~ day of , 2006. Notary Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal Anne Marie Beshore, Notary Public City of Harrisburg, Dauphin County My Commission Expires Apr. 5, 2008 Member, Pennsylvania Association of Notaries - 5 - AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ss. COUNTY OF ~~-~~ ) We, `VIJI/ .~~S}~14,E" and ~~i~~~'"~ ~~,r~~',~i~5'~, the witnesses whose names are signed to the attached and 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 she signed willingly and that she executed it as her free and voluntary act for the purpose 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 that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by these witnesses, this~~ day of 2006. COMMONWEALTH OF PENNSYLVANIA Notarial Seal Anne Marie Beshore, Notary Public City of Harrisburg, Dauphin County My Commission Expires Apr. 5, 2008 Member, Pennsylvania Association of Notaries - 6 - Notary Public