Loading...
HomeMy WebLinkAbout09-30-09PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF ~um ~er~[ty~ COUNTY, PENNSYLVANIA Estate of Q C S~ File Number ~~ ~~~~~~~ also known as a /~- , Deceased Social Security Number / 7 7 - aZ 5~ - ~o / S~ 01 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 t?X < < (.(-~ U /'S named in the last Will of the Decedent dated na . 9 , 1 99_~ 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 bom or adopted after execution for probate, was not the victim of a killing and was never adjudicated an incapacitated ^ B. Grant of Letters of (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lire; durante absentia; Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spot Adntittistratiott, c.t.a, or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) -~~„ (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. was domiciled at death i /~0 P7 S GO /' Gt i (List street nddress, tow,dciry, township, coup ,state, zip code) Decedent, then ~ years of age, died on S~Df . G,~t~ at ~° ~ ~j a rja ~t~ ~rD ss ~' ~1c~ S r~a r / r,c ~e f Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $_?/S?- 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: Fa~,u R6V-0? rev. 10.13.06 Page 1 of 2 offeret~. -^' „, r...r.,. ..J i = `~' Cf - ~ ~ n -' ~- ~ ~ -~ any) ai3P>rheirs: ~ fIf a,- N ~. County, Pennsylvania with his /her last principal residence at Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant ofLetters in the appropriate form to the undersigned: Oath of Personal Representative CO~I~IONW"EALTH OF PENNSYLVANLA SS COUNTY OF ~,(~~~ 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 7~ befog me day of Signature ojPersonnl Representative Signntur•e ojP onnl Repr•esentntive Register Signature oJPersonnl Representative ~:} ~ ~ J ~~ . ~7 -*-~ --i File Estate of /"t(.(X. f( - • a~- 9~ Social Securi Nu Aber: / 7~ ~~ ~ ~~~~ Date of AND NOW, f ~~ , in consider having been presented bef e me, IT IS DECREED,,that~„//Letters ~~~ ,~llli are hereby granted to ~ -'«,el~ 51,~ ~` rv o l ~o _~~ _~.~ ~''t 1 ~~ 1 . __; ~ O r~- ''~ x ..7 $ ~~ ;7 ~~ ~.'" l N of the foregoing Petition, satisfactory proof in the above estate and that the instrument(s) dated (,( 'r / yr d; described in the Petition be admitted to probate and filed of record as the last Wi l (and Codi il(s)) of Decedent. FEES , /~~ 3 f > Y e ister o 6Yil i Letters ............... $ Short Certificate(s) ........ $ ~, ~ Attorney Signature: Renunciation(s) ... , ~ .... $___~ ~ $ . $~~~ ... $ ... $ ... $ ... $ ... $ ... _,~~ TOTAL .............. $ C, Attorney Name: Supreme Court I.D. No.: Address: Telephone: Fvrui RW-0? rev. lv.ls.oa Pale 2 of 2 _ _ H)ns Fos ur_~ ro~m-t LOCAL REGISTRAR'S CERTIFICATION OF DEATH ~~ ,~~ WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 15690302 Certification Number 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 Records Office for permanent filing. PI... SEP 10 2~9 Local Registrar Date Issued # ~~ SHOULD READ AS FOLLOWS: d2T ~curr~~-~/7`?~-~~D „~ a ~} - ~ ~ ~ ~; ~ ?` cry (.r; ,~~ _ ~.._ ~ m W =Ti r-~ = ~' C/~ s ~ i,_~~~ C° r_~ r~ C ~_) a- _ ._T:y ' vEV nlzoa COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ~ [ ~ ". :K MK CERTIFICATE OF DEATH N ~ ~ (See instructions and examples on reverse) STATE FILE NUMBER N " t. Name d Osterud (Fen, middle, lest, sulfa) 2. Sea 3. Sadel Secu'dYNulmer 4.Ol,le al heath (MOdh, day, Year) Mae A. Amsbaugh female 177 - 24 s 6142 September 6, 2009 5. Age (Lan &roMey) UntlH t yeu Under 1 day fi. Date of Binh (Month, er) 7. as (Ci and naro orb taunt) 8e. Pup d Desm (Check ody one) r4oalw Ihys 11oa, senses fiospnal: Olhen 86 rrs January 28, 1923 Gardners, PA ^I„~111811,, ^ER/Oulpetunt ^DOA ~N Home ^Residena ^Omer-Specdy. Sb. Couny d Deem Bc. City, Born, Twp. d Deem Bd. Fadiry Name (N rqI mnidAial, give street end number) 9. Wes Decedent of Hispani% Ongm? ®No ^ yes t(). Rain. American Indian. Black. White, etc. Cumberland S. Middleton 1tap. Cumberland Crossings c~IpntuR~ican,nc.t '~`~ white 11. Dacedws's l1sIW ~ ~ d cork doe ~ mon d ~ kro. Do nd elate reared 12. Was Deaedanl ever in IM 13. Decetlenl'c Eduptpn (Specify only hghbl grade canDrorodl 14. Martial 9elus: Marrud, Never Mended 15. Surviving Spouse (II wale, give maiden name) Kent d Wqk Kkd d Buskub / kWnry U.3. Armed Forces? Elementary / 3econdery (Pt2) College (t •d ar B+) Witlowetl, Divorced (Specify) Office Assistant Governmental Law ^vea ®Na 12 2 widowed 'B.°ac'a.m''M'""'°"are"IS`ea"'cly/I°`"r''ro"'~pDpd°) 1038 Rockledge Drive °aDaa""'' AchWRbidena 17e.state Penns lvania D1tlDBCedB11 S. Middleton Y LWelna ,7a.®v,a,DecedentLivedm , ~ Carlisle, PA 17015 t7b.cwnry , Cumberland Town'hW? nd.^No, Deadenllmdwimin Aclwl Limks d City ~ Bono 1B. Famer's Name (First mlOde. Nsl. sueu) 1B. Mdher'9 Name (First, naddro, nuidsn wmeme) George C. Prosser Annie M. R. Fohl 20e. Inbmud's Name (Type / Pmll) 20b. InlMnent's Matlkg Addeo Israel, city /town, state, tlp top) Ro er L. Amsbau h 1038 Rockled a Drive, Carlisle, PA 17015 21a. Medrod d DupaPoan ^ Cremekon ^ Donation 216. Date d DiWOCilbn (MDMh, day, year) 21c. Plea of Disposhbn (NUne d pmetery, crenutory a other des) 47d, Lacatpn (City 1 town, 9ule, tiD coda) ® Braiel ^ Removal frarn Suro Wae CnmMlon a Dorotton AuUortbd ^omer-spay: •bywaptEarNnarfCororur7 ^rb^ttp September 11,2009 Rolling Green Cemetery Lower Allen Twp., PA 17011 22a. 5gre br person adkg as such) 22b. license Neither 22c. Name entl Address al FedWy - FS 012 849 L Parthemore FH & CS, Inc. P.O. Box 431, New Cumberland, PA 17070 CorrpkN INrre artltyhg aD m ~ a d,~ a rme a d~th w 23a. T~°`ben d my knowledge, deem omarad et thej1lea_, dale and place slerotl. ISppture end tltu) C~L~ l~ ~ >~i-~.l- ~• ~ ~ Number _ ~ o~ '~7 7`5 1~-- 23c. Dale Signed (Month, day, Veer) (J' C hxa 21-28 ,nun ba alrwMed W person who pmrplalcea tleelh 2/. race/ol Dsey n ~C ~ C~~ 23. Data Pronounced Dead (MaKh, day, year) ~ ~ Y~` 2fi. Wet Case Rebr~re,Id to Medical EkemNUr f Coroner for a Reason Other then Cremalian or Donatbn? . . F'f M. y .-. -, ~~~( ^Yee Iy1 NO 7s CAUSE OF DEATH (See Inatruetione end enmWee) r Approxirtute interval; hpn 27. Pad 1~. Enter Ik f~101B.~6 - diseases, njunes, a oDmpledlorw -met dredly cawed du deem. DO NOT enter lennhlal suede such as ardec arrest, r Onset to Dealn t a 16d Pan II: Eller other ~ ~ bW rid resddrg n the underlying puce given u Pait L 28. Ditl tdraao Use Contribute to DeaN? ^ yes ^ Prebabty neprs ay anon. a venlna er rolbn wequl ahawtlrg Nu edobgy. tut ony oa suss on eea Ina. eaEDIATE CAUSE /1Fnn rL+b,e a s ` ^ No ^ Unknown cat6kon remetirlg n ~ml _~ B, ~ /ASA7 \ ~ ~ I ~/ v v~ i 29. II Famele. Due to far b a oft: ~ ^ Nd Pregnant wi1Nn pest year In cprldliau, d NY. 6. b pub (Bled a Yrle e. r r Pr egrertt et time d death Pinter tiIroERLyep CAUSE Ow to (or as a arueguenp an: s r Nd pregnant, but Dregnanl walkn 42 days May dot h~Ied tea c. averse raswg m death) LAST. r d death Due to (a as a conaepuence ~: i Not ant. dll ^ pregnen143 aye to t year tl ; ~~ ~ ^ Udmorm it pregnant widen Ina pan year 30e Wes b Adogy Pedamed7 30b. Were Aubpey FeWkgs Avecebu Pdor u Completion 31. Manner d Dom 32a. Dale d Inryry (Mash, day. Veer) 32b. Obcrip How Inhuy Occurred ~ 32c. Pus d mryry. dame, Fmm, Street Factory, d Ceub d Deem? ^ Nabaal ^ Fbrlknda . OIACe BuMdng, etc. (Specfy) ^ Yb td, ~ ~I ^ yb ^ ~ ^ Accitlent ^ PeMkp Imealipelion 32d. Thne d Irl)ury 32e. InWry al Work? 321. ll Treneporletnn IMwY (SpadlYl 32g. Laadon d InluryllStree6 dty /town, state) ^ SukMa ^ Could Nd ha PMermkud ^ ye, ^ No ^ Ddvx! Operate ^ Pedeetrlen M Omer ~ SpxAy: 33e. Gensler (duck tidy oa) • Cwlllyklg phyakfn (Phyauen ararykg auee d deem when erlolMr phyeidan hea Proneuraetl Deem ell oanplded nerrl23) 33b. Sipneaae Te tlr hem d my krowkdge deem aaubd dw m the aaub(sl rid mamar p sYbtl ^ - ~ O / , - _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ ~ ' 0 ~ aMIYNt9 phyaldut (PhYeden hdh pmna,lckg deem and pMlyig u puss d dbm) To the Gel d my krwwNdge, daeBl oeerered N the mtra. deb, end lets, ant dtse to dte P awe(s) srd manrw b statatl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. ~ r 33d. ~, • liksdld Examkur l Cooner © ~ ~ _ G ( L („~ ~. On the beau d e,rnNtMkrsend / or mvIlA•tta In my ognbn death occurtetl d do time date arM Mce and d t tM d ^ , , , p , , ue o cauae(e) an manner sa slatxL 3 N ame a n d Address pl Perom Wlp Computed Ca sa d pasam~pre d' m 27) Type /Prim 3fi. Registrar's ~ lure and - ~ I ~I ~I al /I ~I 38. Derv iud ( m, day. Year) y ia~~ao g f 1 . y - ~ 1-~-`~~' 1 ~ ~1 ~ll ,]t w I~I ~ , 'JC; 522 ~. P.++- irec;t ~crlisl~,'i~A 11013 V Disposition Permit No.. ~ ~ ~P l.0 ~ C~ ~~- ~~~ ~ .~ . .~, . LAST WILL AND TESTAMENT ~C~,~ ~ _ -~',~ ~n ~ t, " OF '-n ~~ ' v '~_ > ~ ~rn ~c_~~i W o ' <_,~ _ ~~ ,'_ MAE P . AMSBAUGH ~~~ ` = ~~c .~ ~ ._.. .~ ~ I, MAE P. AMSBAUGH, of Lower Allen Township, aCumber~and;- = ~~~~7 County, Pennsylvania, being of sound mind, memory, and understanding, make, publish, and declare this to be my Last Will, and hereby revoke all wills and codicils previously made by me. ITEM I. I direct my Executor hereinafter named to pay all of my legal debts and funeral expenses, including the cost of my gravemarker, and administration expenses of my estate as soon as practicable after my death. ITEM II. I give and bequeath all of my automobiles, jewelry, wearing apparel, books, pictures, and household furniture and furnishings, and all other articles of household and personal use or adornment, together with any insurance existing thereon, to my husband, GLAIR R. AMSBAUGH, if he survives me; but if he predeceases me, then to my children, RODNEY C. AMSBAUGH and ROGER L. AMSBAUGH, to be divided among them as they shall see fit, but if said children fail to agree upon such division within a period of sixty (60) days after my death, then the items with respect to which there is no agreement shall be sold, and the proceeds therefrom shall be added to, become a part of, and administered with my residuary estate as hereinafter set forth. ITEM III. All the rest, residue, and remainder. of my property and estate of every kind and .nature, and wheresoever situate, including all lapsed legacies and bequests, and including any property over which I may have a power of appointment at the time of my death, I give, devise, and bequeath as follows: A. If my husband, CT~P,IR R. AMSBAUGH, survives me, to him absolutely and forever; B. If my husband, GLAIR R. AMSBAUGH, predeceases me, ONE-HALF (1/2) thereof to my son, RODNEY C. AMSBAUGH, or if he is not then living to his issue per stirpes; and the remaining ONE-HALF (1/2) thereof to my son, ROGER L. AMSBAUGH, or if he is not then living, to his issue per stirpes. In the event that a son of mine shall predecease me without issue him surviving, his share shall be distributed to my other surviving son, or if he is not then living, to his issue per stirpes. ITEM IV. All estate, inheritance, legacy, succession, or transfer taxes, including any interest and penalties thereon, imposed by any domestic or foreign law with respect to all property taxable under such laws by reason of my death, whether or not such property passes under this Will, by operation of law, by contract, or otherwise, shall be paid without any right of reimbursement from any recipient of any such property, without any right of apportionment, and without postponement. ITEM V. Should any person entitled to a share of my estate be a minor, at the time of distribution to him or her, and should the value of such property be more than the amount which may be paid or delivered to him or her or in his or her behalf without the appointment of a guardian or other fiduciary or the delivery of security, such share shall be paid and distributed to my Trustee hereinafter named to be held IN TRUST and managed, invested, and reinvested, together with the accumulation of income thereon, if any, and the Trustee shall use and apply from time to time such portion of the income and principal thereof as it deems necessary or desirable for the minor's reasonable maintenance, support, and complete education, including preparatory, college, post-graduate, or professional training, or to make such payment for such purposes to the guardian or person with whom such minor resides. or directly to or for the benefit of the minor without further responsibility to such minor or any person taking care of such minor, and when such minor attains the age of twenty-one (21) years, any principal or income not so paid or applied shall be distributed to such minor, or if he or she dies prior thereto, to his or her personal representative. -2- .. .. • A ~ r , r ITEM VI. In addition to the powers granted by law, my personal representative shall have the following powers: A. To sell at public or private sale, to exchange, to lease, to pledge, to mortgage, to transfer, or convert or otherwise dispose of, or grant options with respect to any and all property, real or personal, at the time forming a part of my probate or trust estate, in such manner, at such time or times, for such purposes, for such price or prices, and upon such terms, credits, and conditions as shall be deemed advisable or necessary under the circumstances. B. To compromise any claim or controversy. C. To invest in all forms of property without being limited to legal investment. ITEM VII.. I nominate and appoint my husband, GLAIR R. AMSBAUGH, or if he predeceases me, fails to qualify, or ceases to act, I nominate and appoint my sons, RODNEY C. AMSBAUGH and ROGER L. AMSBAUGH, or the survivor of them, but if they predecease me, fail to qualify, or cease to act, I nominate and appoint DAUPHIN DEPOSIT BANK & TRUST COMPANY as the sole Executor of this my Last Will, to serve without bond for the faithful performance of duties in any jurisdiction, and I nominate and appoint the said DAUPHIN DEPOSIT BANK & TRUST COMPANY as the sole Trustee of any trusts created by this my Last Will. IN WITNESS WHEREOF, I have hereunto set my hand this ~~ day of , 1993. ` t MAE P. AMSBAUGH The preceding instrument, consisting of this and two (2j other typewritten pages, was on the date thereof signed, pu~lished,~and declared by MAE F. AMSBAUGH, the Testatrix. named thezkexn, 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. Witn ses: ~-~ , ~~ ~ ~ ~~ ~e Address r Name ddress -3- •~ ~ ~ ~ Commonwealth of Pennsylvania County of .!~%u%.~'`~ ss I, 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 free and voluntary act for the purposes therein expressed. R.Q ~ ~~ ~; MAE P. AMSBAUGH SWORN to or affirmed to and acknowledg d before me by the above named Testatrix this N day of , 1993. Nota Public My Commission Expires: (SEAL) NOTARIAt.,SEAI JO ANN ALLEWIAN, Notary Punic Dauphin County Commonwealth of Pennsylvania MyCOtt'ImiSSionExpiresMarch8,1997 County of ,~f}-u~°h~"~ ss We, the undersigned 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 she 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 Testatr' was at the time eighteen (18) or more years of age, of sound dad under no constraint or undue influence. ~iK~ SWORN or affirmed to and acknowled ed before me by the above named witnesses this l'T-t day of ~ , 1993. No ry Public My Commission Expire: (SEAL) NOTARIAL,S~P-l. JO ANN ALLEMAN, Notary PubAc Dauphin County My Commission Expues~March 8,1997 -4-