HomeMy WebLinkAbout06-18-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Estate of Pauline F. Bobb
also known as
Deceased
Social Security Number 201-18-6461
Joyce A. Rehm and Brenda D. Orr
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 Co-Executors
last Will of the Decedent dated June 24, 2003 and codicil(s) dated n/a
(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
(/f applicable, enter: c.t.a.: d.b.n.c.t.a.: pendentelite; duranteabsentia; duranteminoritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following sp~se (if any) ar~eirs: (/f
Administration, c. t. n. ord. b. n. c. t. a., enter date of Wil! in Section A above and complete list of heirs.) ,~ C7 t.v ~.
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Name
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at ~
935 Old Gettysburg Pike Mechanicsburg Silver Spring Township Cumberland County Pennsylvania 17055
(List sb eet address. townicity, township, county, state, zip code)
Decedent, then 91 years of age, died on May 27, 2009 at Bridges at Bent Creek, Mechanicsburg, Silver Spring
Township, Cumberland County, Pennsylvania
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 90,000.00
situated as follows: 3812 Seneca Avenue, Camp Hill, Cumberland County, Pennsylvania
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
Joyce A. Rehm, 935 Old Gettysburg Pike, Mechanicsburg, PA 17055
~ ~~~ ` Brenda D. Orr, 3812 Seneca Avenue, Camp Hill, Pennsylvania 1701 I
File Number ~ \ ~ v, b ~~
named in the
Form nrv-oa re~~. lo.l3.n~ Page I of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA •. SS
COUNTY OF CUMBERLAND '
ed swear(s) or affirm(s) that the statements in the foregoing Petition are true an~dll w ll and t u best o
The Petitioner(s) above-nam of the Decedent, Petitioner(s)
the knowledge and belief of Petitioner(s) and that, as personal representative(s)
administer the estate according to law. n h l1 -
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rn to or affirmed and subscribed
nar r o 'P sonal Representative ~ Q
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before me the_ .
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~ /~G azure of Personal Representa
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For the Register Signature of Personal Representative i ~
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File Number: .Deceased
Estate of Paulin-p_B~bb
Date of Death: Ma 27 2009
Social Security Number: 201-18-6461 petition, satisfactory proof
',~_, in consideration of the foregoing
AND NOW, Testamentary
having been presented before m , IT IS DECREED that Letters in the above estate
are hereby granted to Jovice A. Rehm and Brenda D. Orr
June 24, 2003 of Decedent.
and that the instrument(s) dated
ed in the Petition be admitted to probate and filed of record as the last Wi 1 and Codicils
dcscny ~' „ r.•~~
(~1 FEES
Letters .. • • • • `U r~~' ' ' $ c~`~b
.. $
Short Certificate(s) .. ~ • • $
Renunciation(s) .. • • • • • • $ 15
t>~~iP ... $ ~
... $
... $
... $
... $
... $
... $
~ 1 p ~ ~ c ~9-99-'-
TOTAL .............. $
RegisteroJ vvuw.~ •,r• ~~~ ~
Attorney Signature:
C~~g A Hatch Esquire
Attorney Name:
Supreme Court I.D. No.: 76361
Gates, Halbruner, Hatch & Guise, P.C.
Address:
1013 Mumma Road, Suite 100
Lemoyne, PA 17043
(717) 00
Telephone:
Page 2 of 2
FormRW-02 reu ~0.~3~06
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LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for [his certificate. `~h.0O
15~.89~59 _
Ccrtitirltion tinmber
This is to certify that the information here given i~
correctly copied =rant an original Certificate of Deatl
duly filed with rim as Local Re«istrar. E'he ori,~ina
certificate wiil he forwarded to the. State Vita
Records Office f~u F~ernrulent film<r.
LGrym-' ~ ~' ~IAY 3 0 2009
Local Red*istr<:; ~ L)ate 15sued
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REV t1/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
PRINT IN
(ANENT CERTIFICATE OF DEATH
;KINK (See instructions and examples on reverse) ...____ _~ ~ /5Ci f'1 ~ ~/,. Q
t. Name of Decedent (First, mitltlle, Issl, sudiz) 2. Sex 3. Serial Semnry Number 4. Date of Death (Month, day, year)
female 201 -18 x-6461 a 27, 2009
5. Age (Last Birthday) Under 1 year Under 1 tlay 8. Data d Birth (Month, day, year) 7. BiMplace (City and state or foreign country) 8a. Place of Death (Check Doty one)
91 M°""'a °ey6 Hwrs MinuUS Aug. 23,1917 Summerdale,PA Hosptal. °"1ef1 Assisted Living
Vrs. ^ Inpatient ^ ER I Outpatient ^ DOA ^ Nursiry Home ^ Residence Other - Specify.
e6. county a beam fk. City, eoro, Twp. of Death fro. Fadltty Name (N not mstttutim, gNe street antl number) 9. Wes Decedent of Hispanic Odgin? No ^Ves 10. Race American Indian, Black, While, etc.
f
d
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C
b
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d
il
yea,ape
y
u6am,
um
er
an
S
ver Spring Bridges at Bent Creek o
(5 ,ror
'
Mezkan, Puerto Rican, etc.) 1
11 L e
11. Decedent's Usual lkcu tlon Kind of work dare dodo most of wadi life. Do not stale retired 12. Was Decedent ever in the 13. Decedent's Educallon (Specify Dory highest grade completed) 14. MarDal Status: MarrieQ Never Married, 15. Surviving Spouse (II wife
give maitlen name)
,
Kind of Work Kind of Business /Industry U.S. Armed Farryces? Elementary /Secondary (012) College (1-4 or 5+) Wroo'^'~• Divorced (Specilyf
food servic Food
^Yee LpNO 8 idowed
16. Decedents Mailing Address (Sheet, city /town, state, zry code) Decedent's Ditl Decadent
935 Gettysburg Pike Adual Residence 17x. Spate 17c. vas, Decedent OveO in
~ve-~-S.P.>ri.iz4~ Twp
A ~°""s";
?
~
Mechanicsbur PA 17055 p
17d.
No,oa~adamLi.adwim~
17b. County Cumberland
Actual Umih of
City /Borer
18. Father's Name (First, mkltlle, IasL suffix)
H
M
ht
W
i 19. Mother's Name iFirst, mitltlle, maitlen surname)
arry
.
r
g Elizabeth Shelly
20x. Informant's Name (Type / Pnnq 20b. Infomanl's Mating Address (Street, ctty I town, state, zip cotle)
Joyce A. Rehm 935 Gettysburg Pike Mechanicsburg, PA 17055
21 a. Methotl of Dispositon ^ Cremation ^ Donation 21b. Date of Disposition (Month, tlay, year) 21 c. Place of Disposition (Name of cemetery, crematory a other place) 21 d. Location (City /sown, stale
zip code(
^ ~ Burial ^ Removal from Slate i Was Cremetlon or Donation Arrthonzed
M
di
S
if
l E
i
/
^
^ June 1 , 2009 St. John's Cemetery ,
Camp Hill
PA
r -
pec
y:
e
ca
xam
ner
Caorla?
Yes
No ,
22a. Si lure of FLiceySee (or pe frig as such) 22b. License Number
011248 L 22c. Name aM Address of Fadkry
l
~ usse
man FH&CS Inc. 324 Hummel Ave.Lemoyne,PA
Compiele Marne 23a~c oMy when cerlirying 23x. To me sl of my knowledge, tleem occurretl at the Dole, date and place stated. (SignaNre antl Dtle) 236. License Number 23c
Date Bi
netl (Month
da
physician H na available at time of death to .
g
,
y, year(
cenity cause of Oeath.
Items 2426 must be completed by person
who prorrounces death 24. Tm~e+of Dea/th ~ ~
~
( • 25. Dale Prmouncetl Dead (Month, tlay, year)
lJ1
1~ 1 '1 ~1 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Donation?
. .
•••F M. .
O ~ ~
V• 1 •i ^ yes ®No
CAUSE OF DEATH (See InstrueNOns and examples)
1 Approximate imerval:
Item 27. Pan I: Enter the chain of events -diseases, kryunes, or canplicatbns -mat directly caused the tlealh. DO NOT enter terminal evmLS such as camiac artest, Onset to Death Pan II: Enter other sianifcant cond'aions contdbuBno Io Ih,
but not resultln in the untlen n cause iven in Pan I
g N 9 9 28. Did Tobacco Use Contribute to Death?
Yes Pro6aDl
^ ^ y
respiratory artesl, or ventricular fibnllaDm wmout showing me eliobgy. List only one cause m each Fne. r
r .
IMMEDIATE CAUSE (Final disease a
L /`ham r
n!
^ ^
/~.~~ ,~
1 yQ no ^ Unknown
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condition restating in death) _~ a W L v}TKJJ K4 ,(,~')-~ ~ y t 1 t li/(~~ ~ r _
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29. II Female:
D/u~e,~to (v)ase-atconseque~ncle oQ: /yam [ ~p _ ~
Sequenlialry list condoms, if any, b. y,[y_r~•/ N(1, `7y 1 110'1 (,/vy ~ IS t ,~., r
Dre N , , ~'
leadng ro cause listed m Ime a.
L1
1 1 ^ Not pregnant wahin past year
^ Pregnant at lime of death
Due to a as a cans
Enter the UNDERLYING CAUSE I equence oQ: i
(disease a injury that inttiatetl the o '
~
'^
`l r^ n
I'
- ^ Nol pregnant, bw pregnant within 42 days
of deals
events resulting m death) LAST r ~
m
_
7 r r 1 1
PSI
Due to (or as a consequence op: r ^ Nol pregnant, but pregnant 43 tlays to I year
d, r _
^'T ~ ~ ~ ~Yf r 1 r ~ 1 ~
a~
.{ K before tleath
. ^ Unknown if pregnant within the past year
30a. Was an Autopsy
Performed? 30b. Were Autopsy Fintlmgs
Available Prior Ie Completion 31. Mancer of Death 32x. Date of Injury (Mmm, day, year) 326. Describe How Injury Occurted 32c Place of Injury: Home, Farm, Street, Factory,
of Cause of Death? ~ ",~,,~
y+•=~~~=I ^ Hanicitle ODice Buildin etc S c
g• - f ce rN)
^ Yes Q.MS ^Ves ^ No ^ Aaibenl ^ Pending Investigation 32tl. Time of Injury 32e. Injury at Work? 32f. D Trsnsportation Injury (SpacifyJ 32q. Location of Injury (Street, city I town, slate)
^ Suiatle ^ Could Nol be Detemined ^Ves ^ No ^ Dmer /Operates ^ Passenger ^Pedesmen
M ^Omer - Speciy:
33x. Certifier (check only one)
gn
33b S azure antl Title of Cendier
• CMNying physician (Physican terrifying cause al dearm when another pnysiaan has pronounced deem and completed hem 23)
,
To the best of my knavAedge, death attuned due to the cause(s) and manner as 9tetld_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~
V ~/t~~ 1 x" `~ -
• Prmouncing and cerNtying physiden (Physician both pronouncing Death and certiying to reuse of tlealh)
To dre beat of my knowledge, tleath occurred at the time, date, and place, and due to the cause(s) and manner as stataL _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. Lit Number
~~~ •1 ~~
^ 33tl. Date Signetl (Month, tlay, year)
• Medical Ezaminer I Coroner ~
~ ~~ O~
On Me basla of examinatim and / a investlgatim, in my opinim, death awned at the time, date, and place, and due to the cause(s) and manner as spled_ ^ 34 Neme and
Ad
dress
el Persm Who Ca
npleted Cause 1
Death
Qte m 27)
Typ
/ P
ri
m
Regislrefs Si ore antl Dist ~ ~ I
X i / i ~ I / i / i
36 Dale latl ( ,day, Year
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v Disposdion Permit Na. _ Q ~ J •~ v r~ ' I
LAST' WILL AND TESTAMENT
OF
T'A I~LINE F. BOBS
I, PAULINE F. BOBB, of the Township of Lower Allen, County of Cumberland and
State of Pennsylvania, being of sound and disposing mind, memory and understanding, do
make, publish and declare this my Last Will and Testament, hereby revoking and making
void any and all former Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my
decease as the same can be conveniently done, including the payment out of the principal of
my general estate, of all inheritance, estate and succession taxes which may be assessed i~~
-__o
~~
consequence of my death. ~ ~? ` V
. ti ~ `7~ •
In the event that I have not already done so during my lifetime, I make ~e~ollow~i'g -~
c~
c~
bequests, to wit:
a) I give and bequeath my Marble Top Stand to my daughter, BRENDA D.
ORR.
(b) I give and bequeath my Bookcase to my daughter, JOYCE A. REHM.
c) I give and bequeath my Desk to my daughter, BRENDA D. ORR
-1-
3.
I give, devise and bequeath all the rest, residue and remainder of my estate, of
whatsoever nature and wheresoever the same my be situate, to my five (5) children, to wit,
GLENN I. BOBB, JR., DENNIS E. BOBB, BARRY W. BOBB, JOYCE A. REHM AND
BRENDA D. ORR, share and share alike, per stirpes.
4.
For the purpose of facilitating the settlement and distribution of my estate, I authorize
and empower my executrices, hereinafter named, to sell any and all real estate which I may
own at the time of my decease, as well as my personal property, at either public or private
sale or sales.
LASTLY, I nominate, constitute and appoint my daughters, the aforementioned,
JOYCE A. REHM and BRENDA D. ORR, Co-Executrices of this my Last Will and
Testament and direct that they be excused from posting bond or other security for the
faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~° i~ ~ day of
June, A. D. 2003.
~~ ~~.yrr~ ~ t~~,.~~ (SEAL)
Pauline F. Bobb
-2-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
1,
PAULIIvTE I' . ROB
whose name is signed to the attached
been duly qualified according to law
signed and executed the instrument a
that I signed it willingly; and that
tary act and deed, for the purposes
SS.
B the testat_P_].X
or foregoing instrument, having
do hereby acknowledge that I
s my Last Will and Testament;
I signed it as my free and volun-
therein contained.
Sworn and affirmed to a
PAUL: ivE I~ . BOBB ,
day of ~L1d~'~ A. D.,
nd acknowledged before me by
the testat I'.1X this ~ ~~'
2003.
/ Pauli F,. B b
( ..
~ q'Eary Public
C%
NOTARIAL SEAL
COMMONWEALTH OF PENNSYLVANIA ) MAURA A, JENKINS, Notary Public
SS. Mechanlesbur~ Born, Cumberland County
COUNTY OF CUMBERLAND ) My Commissia~~ Expires November 10, 2003
We, the undersigned, J. POB~T STAUFFEF~
and ~iEIDI NI. NELSON the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the
testatri PATJLTI~:E r. BOBB sign and exe-
cute the instrument as 14~WC/her Last Will and Testament; that the
said testat~'i.: PAULIT~ ~ F. BOBP executed it as
Sher free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testatS'1X signed
the Will as witnesses; and that to the best of our knowledge, the
testatT'iX was, at the time, eighteen (18) or more years of age,
of sound mind, and under no constraint, duress or undue influence.
Sworn and sub ribed to befo~~e '
me~xhis ~ ~~~' day of
~,,~1111! 2003.
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NOTARIAL SEAL
MAURA A. JENKINS, Notary Public
Mechanicsburg Borc, Cumberland County
My Commissi;~r~ Expires Ncvembes 10, 2003