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HomeMy WebLinkAbout04-15-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of WILLIAM F. COOMBE also known as Deceased 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 EXECUTRIX last Will of the Decedent dated MARCH 23, 2007 and codicil(s) dated N/A named in the (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: NONE B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durante absentia; durante minoritate) ,:'; 3 '` ~ .7 = r3 ~: r ~~°t `~~ (COMPLETE INALL CASES:) Attach additional sheets if necessary. t_."3 t ~ ~ "'p ~ :` {~~k Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal reside at _~_ ~-r 2117 MAYFRED LANE CAMP HILL BOROUGH CUMBERLAND COUNTY PA 17011 ~ ;;:.~ ~ (List street address, town city, township, county, state, zip code) '"T3 Decedent, then 83 years of age, died on FEBRUARY 20, 2010 at 2117 MAYFRED LANE, CAMP HILL BOROUGH CUMBERLAND COUNTY, PA 17011 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 25,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 150,000.00 situated as follows: 2117 MAYFRED LANE, CAMP HILL BOROUGH, CUMBERLAND COUNTY, PA 17011 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 ature T d or rinted name and residence ~ ~ C. CHRISTINE COOMBE, 1507 CHARLTON AVE, ANN ARBOR, MI 48103-4167 i COUNTY, PENNSYLVANIA File Number ~ ` - ~, ~ -- d Cn -< < L.-_ Social Security Number 196-14-2864 Form RW-02 rev. 10.13.06 Page 1 of 2 Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (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 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND , T'he 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 lrnowledge 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. ~~ r Sworn to or affirmed and subscribed o Signature of Personal Representative before me the ~~_ day of ~~ Signature of Personal Representative fi*.~ For the Regi Signature of Personal Representative ~~ r~-• ~ ti:, =~7 `` .., r, t_...ati.__ ~ r_ i~i File Number: ~ :.. ~~ ~,,, .. ~r <,,,,~ ~:.r.~ Estate of WILLIAM F. COOMBE ,Deceased ~- Social Security Number: 196-14-2864 Date of Death: February 20, 2010 AND NOW, , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to C. CHRISTINE COOMBE in the above estate and that the instrument(s) dated MARCH 23, 2007 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES i'1 Letters ............... $ ~ lY O •~Q er of wills r, ~~ r '~.~ 1r` C Y Short Certificate(s) ........ $ L ( 0 •C~U Attorney Signature: Renunciation(s) .......... $ l ~ . ~U 11 $ 1 5 O!\ Attorney Name: THOMAS E. FLOWER t ~ CS • • • $-~U Supreme Court LD. No.: 83993 _ Address: SAIDIS, FLOWER & LINDSAY ... $ • • • $ 2109 MARKET ST ... $ $ CAMP HILL, PA 17011 ' $ Telephone: 717-737-3405 ... $ TOTAL .............. $~'~UC.~ b~9-ee Form RW-02 rev. 10.13.06 Page 2 of 2 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 15935817 Certification Number REV 112008 PRINT IN U1NENi ~K INK dFZ~_~ t ~ 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 ~Farwarded to the State Vital #~ecords Office for permanent filing. FEB Z 4 10 Local Registrar Date Issued r.,~ C~ ~ ~ :~ ~ ~ ; ~ ~ . ~ t -p ~ rn . ; ..,.. r_ _ ~ mow ~ r # ~ • •~•/ r . © t ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CORONER'S CERTIFICATE OF DEATH (See instructions and exsmnles on revar>aal - - - - n, c r,~c nVmoCn 1. Name q Deoedad (RreL middle, last, aullbc) 2. Sex 3. Sogel Searity Number 4. Date of Dam,(Monfh, day, year) William F Coombe Mal e 196 - 14 '- 2864 February 20, 2010 5. Ape (Lest BirMtdsy) Under 1 Under 1 8. Date of 13hth HoMdt, da , 7. end stab a ) ee. Place of Dam Check on one rw~0,e ~" ~e April 19, 1926 "°°D"~` °tl1ef ' 83 Yre ^ l~tlad ^ ER / OulpetleM ^ DOA ^ Nrmafng Hans ~ Raklence ^Ottter • Spegfy: • Bb. County of Death 8c. Boro . of Death ~. F . edMy Name (R not ltetlbllon, give etrsa and number) 8. Wee Decedent d Hhpanio Odgln7 ~ No ^ Yea 10. Race: American Indian, Black, tattle, etc. Cumberland Camp Hill 2117 Mayfred Lane ("'~'•°Def~''0iba'' ( Mexican, Puerto Rkart, ekc.) White 11. DecedenYe I~ KlM of work' done moat q Ile. Do not ebb 12 Wee Dscedem ever In the 13. DeoedertPe Edrwvtlon (Speclly oMy hiptrat prede conpNtad) 14. Marlbl Sbtue: Married, Never Herded, 15. Surviving Spouse (d wife, eve maiden name) U.S. Anted Portal Kind of Wank IOrW of &uYteea / Irtdul Wid d p ry owe , lvarced (Spedlyl Elerrbrtbry /Secondary (0.12) Colegs (1.4 a 5~) . Letter Carrier US Post Office ~]Ya ^No 12 ~ e ~ 18. Deoedenya Meilrtp Addrea (Street, city I town, state, zip code) Decedent's Did Decedent ~ Pa A~ Ram 17e' smb Twp. 2117 Mayf red Lane ~'n,~, „~" 17b. CounA' Q][i1bPY'1 nd 17d. (~ A t.ived waMn ' - Camp Hi 11 ce, c„y / Boro 18. Father's Name (Flat, midde, kat aulPol) 1g. Homers Name (Flat, ntidrfe, rtrekdert surname) William W Coombe . Elsie Ott 20e. Infommnt'a Name (type / Phd) Cher 1 C Coombe 20b. trdonnertYa MelArtp Address (Street, qty /town. slats, z~ Dods) . 1507 Charlton Avenue Ann Arbor Mi. 48103 21e. Medtod of Diepodtlon ^ Cranatbn ^ Datatlat 21b. Deb d Dlapodtlon (Martin, day, year) ~ Burid ^ Removal hoot State 21c. Pkce of Dkpoeltlm (Name q ambtery, crametay a otlter place) 21d. Locetlon (City I town, state, zip code) ^ C Autlarlxed ^ Yea ^ No Slgnetrne q ng as such) 226. Barra Number 22c. Nems and Ad~ea q Fadlly - 011654-L , ers-Horner Funeral Home Inc 1903 Market Street Hill Pa 17011 Canplela Memo 23ec sty when cerAfyhrp 23a To the best of my krawledpe, dam ocaured et the time, dab and Dlece anted. (Signettre end tltle) 23b. Licertae Number 23c. Date S phyeldat is net eveibble at tlme q dam to igrted (Month, day, year) artlly case q death. _~ llama 24.25 rrsat be carrpleted by person whepraaurtcsodeal,. 24. Time of Death Ap rx . 2s. I>eb Prona,rtced Dead (Mordlt, day, year) 28. Wee Coe Referred to Medkrel F.xaminer / Coroner for a Reason Other then Cremation a Donetbn4 8:00 A. M• February 20, 2010 ~Ya ^No CAUSE OF DEATH (Beer Instrupllone and ~zampba) r Approtdmeb interval; Part II: Eller other 28. Did Tobacco Use Comribub to Deem4 hem 27. Pert I: beer me mYo q evens - dbeeea, r~xlsa, a cattplatlone -that dtrectly ceased the seam. Do Nor enter brtdrtel everde nxdt as rxrclac enaL r Onset to Death but not reepiretory area, a vemdwkr 1~rlbtlon wldtoW eftov4np ttw etk>logy, l.bt only are ease an each Ins. 1 realtln9 in the underlykr9 cause given In Pert L ^ Yes ^ Probably ~'r~u g„ ~" a Pending Investigation ~ ^ ~ ^ U , . r 29. d Fes: Due to (a a e crorteequence of): ^ Not pregnant wahm pest year Mt cortdilons, I arty, 6 ~ ^ Pregnant a tkne of deem E ~ a Due to (a as a consequence of): ~ a pEmetNYptkp~CeA~MmEe ( (d~lseaa Pr~M, txd pregnant wimin 42 days . Avenb rren deem) LAST c' ^ f d . ~ o ee ~ Due to (a a a oataquence of): r ^ Not pregnant, bW pregnant 43 days to 1 year • d. 1 1 before deem ^ Unkn0W1 tl Pr~teM wlWrt the past yea 30e. Wes an Aubpay . 30D. Were Auropey Findrtps 31. Mauer q Deem 32s. Dale d Inhay (Month, day, year) 32b. Deaxibe How Injury Occurred Perbrtrted9 Avakeble Prior to Corrtpbtbn 32c. Place q Injury. Home, Fan, Street Factory , , of Cause q Deem? ^ Neural ^ Flondcide Once Building, etc. (Speclly) ^ Yee ~ ^ .Yea ^ No ^ Acdderd ~,pertdrp Irnallpetlon 32d. Tirne q Injury 32e. Injury et Work? 321. M Trerteporbtlon Injury (Speq/y) 32g. Locadort q I r ~ (~~ ~ ~, state) ^ yes ^ ~ ^ Ddver /Operator ^ Peeeatger ^Pedatdan ^ Sukide ^ Could Nq be DebrmMed M OINr ~~~ 33a. CsNAer (gtedc Doty one) 33b. Slpteture std Title q _~ • C•~Y PM~bn (~y~an aua of death when ertoBterphyekbrt has prartoutced dadt end aarrtpl.t.d ibm 2a) ' To 1MbeMofmygaaaedpa,deNhaeaunaddwmtheeewe(e-andmamereeahMd-----=--------------------------- ^ ' D ~ adlA'Mr0 PM'~~ (fin bon prortoutblrig deem'ahd ceNyirt f q d th - Drone r g o aura ea ) To 1M beet of m IawwMd e dam ooo d t d fl d 33c. License Number 33d Date Si ned (M et d y p , um e N oe, ale, end pbce, end dIN ~ the cause(s) end merwter a sbbd_ _ _ _ _ _ _ _ _ _ _ _ ^ . g on , ay, year) ' ltweatE>urnww/001°'"' on the hale of aamiradorrend / a Imatlpetlon, M mY ophtlort, deem oecunad et tln time, dab, and pba, end due b tin caus(e) end rnettrter a ebted ~ February 22, 2010 _ 34. ~/Print r " Pe ' N~o " ed ' 35 Slprtaturo clCl li . L' c LtellrOQe, (;o ronEi . - I ~I ~ I a I ~ I ~ I ~•~~(~p!~ deYry.ar> ~ r ~ ~ 6375 Basehore Rd. , Suite 4~1 O/ . . Mechanicsbur Pa. 17050 Dispositbn PennM No. ~~ J J561 l 1Q5.9Q5 REV.!3/Q9) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of i-lealth, in accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. 5491211 No. 1105.1x4 TYPE/ PEfiMIW BLACK INK ~F2~_O1 7 a~~ ~. ~~ Linda A. C;aniglia State Registrar APR 0 2 2010 N ~ -`- ~ ',: .. _. ~ ? = x• ~ -, ~ -© -gyp ~:, °; _' COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~^ ~ `-~ ~ r 1 CORONER'S CERTIFICATE OF DEATH - ~~ rv ~== ~„ (See instructions and examples on reverse) ~T.r~ <„ ~ ,,,,,,,,,.,, ~ ~•,., ,...-„ 1. Name d Deceded (First, midde, last, sdfoc) 2. Sex 3. Sodel Segwtiy Number -- _ ,~, ~. 4. Date d Death (Month, day, year) William F Coombe Male 196 ' 14 - 2864 February 20, 2010 5. Age (Last BiMday) Under t year lkrda t day 6. Date d ado (Month, ,year) ?. BYVplace (City and stele a foreign ceretlry) 8a Place d Death (Check any one) 8 3 Y Mons ~ ~ ram Ap r i 1 19 , 19 2 6 PA ~P Hill dal: Otiwrr: rs , ^ Inpatient ^ ER / ou~atient ^ DOA ^ Nursing Hane Residerrre ^odw3r -Specify; 8b. County d Death 8c. Ci , Boro, . d DeatA • 8d. FaaTily Name (M rat irrstirotion, give street and number) 9. Was Decedent d Hispanic Origin? ~ No ^ Yes 10. fiats: Americen hxtian, Black WIMe, ero. Cumberland Cam Hill p 2117 Ma fred Lane (lryes,spedtycuban, (~~ Y M exican, Puerto fiica, etc.) White 11. Decedents lbrral ~ Knd d wok none ~ most d 6b. Do nd ells 12 Wa Decedent ever in the 13. Decedent's Education (Speaty only highest grade oompbted) 14. Marital Status: Monied, Never Married, 15. Surviving Spouse (ti wde, give maiden nazne) Kwd d Work Knd d Business / kMusUy U.S. Amred Faces? Elementary /Secondary (0.12) Cdlege (1 ~ a 5+) VYxlowed, Divaced (Spedry) Letter Carrier US Post Office ~Ya ^~ 12 - 16. Decedents Mairng Address (Brest, qty /town, slate, zip code) 2117 Mayf red Lane Decederd's Did Deaedem Actual Residence 1?a Bate Pennsylvania Live in a t?c, ^ ya Decedent t~ m T Camp Hill, PA 17011 . wp. TaHnship? tm. Cq,nty lmhe 1 aTKI ,?d. No, Decedent Lived wtihin Cam Hi 11 p Aavaf Ixdls d _ City / eom 18. Father's Name (Fwst, nwddle, ~s4 sulfoc) William W. Coombe 19. Mother's Name (Fast, midde, maiden surname) Elsie Ott ~~~ lobe ~~ "r~or ~~i ev nue~ inn Arbor, MI 48103 • 21a Method d DLspceAbn i ^ Cnmetion ^ Donation ~I ^ `~"'°"~'h°'"~'e lib. Date d Dispceition (kladh, day, year) 21c. Place d Ditiar (Name d camelery, aemetay a other place) 21d. Lacefion (City I town, state, zp code) ~ ""e`1onaDon~°"'~''°'~ed • ^ ; 1>y Medlatl Exeathwrr 1 Caaww9 ^ Ya ^ No Februar 26 201 Y f Rollin Green Cemeter g Y Cam Hill PA P 1e d a "~') • - 22b. `'°~eN1"iba X0 ~• "~1ea'd"d~d Fa~ty Myers-Hamer Funeral Home Inc. 11654 - L 1903 Market St. 'll A 17011 physiaan is nd avaiable at time d d~ b ~°' To the bat bt ny lopwledge, deatlr M the kme, date and place sued. (Signalue and Ike) 23b. License Number 23c. Oats Signed (Month, day, year) cerWy cause d death. • Items 24.28 must lxr a>fnpleled by person 24. Time d Death Aprx . ~ 25. Date Pnxrouxad Dad , day, year) 28. Was Case Referred to Medicel Examiner / Coraww to a fieason 07rer tlran Cremation a Donation? ""'°P'°"°'"'~a~"` 8:00 A. M. + Februar 20, 2010 Yes ^No CAUSE OF DEATH (See Item 27. Part I: Ender the ~~ - diaaa, injurbs, a campicedaa - that dwectly res rc b t and examples) r Approxirtrate interval: tine death. DO NOT area temwnal sverds such a qudiac arrest, r Onset ro DeaM Part II: Erwa atlww . but rwt resuNrg in the urndenfying galSe giver n Part I. 28. Did Tdxaoce lies Corwn~de b Deadr? [] Ya ^ Probady p ry arres a , a veMricda I~nlabon widaut showing the etiology. Lot anty e a cause on each fine. i ? ^ No ^ lhibawn r ca ~b ) .~ a. Hypertensive Cardiovascular Disease r ^ ~•"F~~ Due b (a a a consegxrnce an: i ^ Nd pregnard witm pest year ba6np~~ ' 4 al'' b. b A S a ~ ^ Pregnard at time d dalh Due b (a a a consequence oQ: Eller Yre UNDERLYMKi C U E " ~ ^ Nd pregnant, bW pregnant wi1M 42 days ( i}vade ~ -tAST~ c. - • _ r ~ r --"' d death Due ro a as a ( ~ of): e ^ Nd pregrwnt, but pregnant 43 days ro t year • d. ~ tiebre decor ^ lkriarown ti pregnant within the ~ ~ 30e. Wa an Ardapay Pedamed? 30b. Were Aubpsy Firdrrgs Aveiable Pdor b Canpblion 31. Mamer d Death ~./ 32&. Date d MheY (Month, dal, year) 32b. Dacrbe lbw ~ Ocgwred 32c. Place d k(ray. (tome, Farm, Breel, Facbry, d Cause d Dalh1 ^ ~ ( ~labaal Oltioe ~~ ~ (mil ^ Ya ~No ^ Ya ^ No ^ Acciderrl ^ lnvestigodon 32d Tone d bMer 32e. kyray al Wok? 321. ti Transportation ~AeY (Specrry) 32g, Location d (Breel, dy I bwn, stale) ^ Suidde ^ Could Delarrwred ^ Ya ^ No ^ Drner / Operabr ^ Passenger ^ M Otlra • SpegTy: 33a CedTier (dredr ardy one) 33b. Sigrrtiwe and ' CerdfyNg phyekpn (Physiden certifying cause d dalh when anotlw phyeidan lwn dalh and awnplebd Item Tof1>lbeetatnrylarowMdge,aetlhoaurndduebmeaaaga)andmennra IeO and ~ e~ b b ------------- ~ ~ ___-- ^ - - - - - - - - - - - - - ~-.. Coroner g PM ( o pig loth and To tlM bat Of ny IolorrNdpe, death OCCtered M the fhlM, deN, and Pie, end b ease d deelh) the awe(el and ewna a eteln~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. Cicero Number 33d D~ (MonM4 day, year) "ea~elerlca'°"or On tlr twaN d awahatlon awl I a hwelfpetlon, fn my apNriorr, deelh the Into, dde, end plea, end dw b tlr eave(s) end owner a sfded_ ~ March 22, 2010 ~. u,,,,..,,,, d per, A~dp~ WhpCon~p~dC~a Dori d (Ibm 2n Type I Pdnl „'."'~" ~ Qd C E K Il Cl l; o c e ro e, oroner .~~ - ~. ~ d / ~ Red d'y~y°"~ (d D~0 6375 Basehore Rd. , Suite ~~1 Mechanicsbur Pa. 170 0 0 y a 0 0 Z Ofepoeition Parrrd No. ~(s 5342 RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of WILLIAM F. COOMBE c~ -- -- ~. o ~, f. , r---;., `-, ~ K~ ..+~_.+~ V /~'~ ~,,, ~ ~s~,W,yy A„J f ~ ~. r ~ ~= :~ _.._ tart ~ ,--. ~.~~:: ~:~ ~' i ' . w~ ~..~/ Dec eased I, SHIRLEY M. COOMBE, by and through her agent under p.o.a. , in my capacity/relationship as (Print Name) SPOUSE of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to C. CHRISTINE COOMBE 02/25/10 (Date) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Form RW-06 rev. 10.13.06 ~ ~ (Signature) Messiah Village, 100 Mt. Allen Drive (Street Address) Mechanicsburg, PA 17055 (City, State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this '<= day N nary Public Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) C,OMUAONWFJILTH OF PENNSYW Notarial Seal A Yvonne Senich. Notary Public Damp Hill Boro. Cumberland County `My Commbsdon Expiros Feb. 1.2012 Mendax~ P~enruhAveMa Assooletion NblaAes ,,. RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA ~7 ~~ C7 Y J ;.~ f'T"I - -; ~, ~~ ,.,, ~~ _:~ :~ -~ ~ `~ Estate of WILLIAM F. COOMBE SON I, DAVID M. COOMBE (Print Name) rs CJl ti~ .~~+ c~ t•? ~e. ? ~', ~~;_~ ~~ .: .~ L. r+~t J Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to C. CHRISTINE COOMBE 02/25/10 (Date) c s?// (Si ature) 1415 RHODE ISLAND AVE, N.W. #520 (Street Address) WASHINGTON, D.C. 20005 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this s L'~-~ day of ~~`~cva I v~ ~~ C7\ y Public ommission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06 C4ANIAONWEALTH OF PENN3YL1/ Notarlaf Seal Yvonne sen;ch, tvotary Public Camp Hill 8oro, Cumberland My Commission Expires Feb.1~2012 MembeK, Assodellon RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA ~7 ~~ ~ct _` -1;~ C ? ... ~~:~ m ~~._ r~ ,: ;~ --~ l -LU- 4a- ~ Estate of WILLIAM F. COOMBE SON I, JEFFREY L. COOMBE (Print Name) r*.~ ~_ :~ + ~ ,... F~ ~..,,, , .,~..t t-_'ti.i 3 _ ~"-? ~~-; tv ~ _ ~ t .. ..._ .~-~ `'~' ., Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to C. CHRISTINE COOMBE 02/25/10 (Date) 343 BLACK RIVER DRIVE (Street Address) MADISONVILLE, LA 70447 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Form RW-06 rev. 10.13.06 Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he e~~ executed the renunciation for the purposes stated within on this ~a S~~ day of ~ ~ r ota Public C mission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) COMMONWEALTH OF PEI~ISYLV Nota~lal Seed Yvorxie Sersch, Notary Publ~ Camp H1118oro. CumbeAand t~ounty My Ccmrt>laalon Fib. 1.2012 Member. Asaodatlon ~• ~~p LAST WILL AND TESTAMENT OF WILLIAM F. COOMBE I, WILLIAM F. COOMBE, of Camp Hill, Cumberland County, Pennsylvania being of sound and disposing mind, memory and understanding, do hereby make publish and declare this as and for my Last Will and Testament, hereby revoking al other Wills and Codicils heretofore made by me. FIRST I direct the payment of my just debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefor funds from my estate in such amount as she shall consider necessary and desirable, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, I authorize my personal representative to expend funds from my estate, SAIDIS, TAWER Si LINDSAY ,~vw~rs~nT:uw 2109 Marker Street Camp Hill, PA in such amount as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. SECOND I bequeath my tangible personal property, including furniture, furnishings, vehicles, jewelry and personal effects to my children, C. CHRISTINE COOMBE, JEFFREY L. COOMBE and DAVID M. COOMBE. THIRD To my beloved wife, SHIRLEY M. COOMBE, if she survives me by thirty (30) days, I give, devise and bequeath one third (1/3) of the residue of my estate. FOURTH I give, devise and bequeath all the rest, residue and remainder of my estate in equal shares unto my children, C. CHRISTINE COOMBE, JEFFREY L. COOMBE and DAVID M. COOMBE, per stirpes. FIFTH I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary estate. SIXTH ti~ In addition to the powers conferred by law, I authorize any personal representative acting under this instrument, in her absolute discretion: A. To retain in the form received, or to sell either at public or private sale any real or personal property; B. To exercise any options to subscribe for stocks, bonds, or other investments; C. To join in any plan of lease, mortgage, consolidation, exchange, SAIDIS, 7AWER ~ LINDSAY A770RNEY5•AT lAW 2109 Market Street Camp Hill, PA reorganization or foreclosure of any corporation in which my estate or any trust may hold stocks, bonds or other securities; D. To sell, transfer, convey, mortgage, pledge, lease or exchange any property, real or personal, which at any time may form part of my estate, for the payment of debts or taxes, or for any purpose of administration or distribution, for 2 such prices and upon such terms as my personal representative, in her sole discretion, may deem wise, and to execute and deliver deeds of conveyance or transfer thereof; E. To make settlements and compromises on such terms as my personal representative in her sole discretion may deem wise without the necessity of obtaining any court approval thereof; F. To make distribution hereunder either in cash or kind, as my personal representative in her discretion may deem wise. SEVENTH I do hereby nominate, constitute and appoint my daughter C. Christine Coombe, to act as Executrix of this my Last Will and Testament. Provided, however, that if she is unwilling or unable to act as Executrix, I direct the duties of Executor to be performed by my son, Jeffrey L. Coombe. EIGHTH I direct that no personal representative, guardian, trustee or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, WILLIAM F. COOMBE, have hereunto set my hand SAIDIS, LINDS,~ A7'IORNEYS•AT•lAW 2109 Market Street Camp Hill, PA and seal to this my Last Will and Testament, consisting of three (3) typewritten pages, the first two (2) of which bear my signature in the margin for identification, this ~3~day of _l`~.. , 2007. fLLIAM F. COOMBE ~~'~ 3 Signed, sealed, published and declared by the above-named WILLIAM F. COOMBE, Testator, as and for his Last Will and Testament in the presence of us, who have hereunto subscribed our names at his request as witnesses thereto, in the presence of said Testator and of each other. ~-~- ADDRESS ~ ~ v ~ d~ ~~ ~- ADDRESS ~\dq '~a~-~ ~~. ~ ~~\ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, WILLIAM F. COOMBE, ~~tfts ~ ~ Fc.c~c:J~~- and 'tvc~~ r-t ~-e~~t.~, the Testator and witnesses, respectively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he signed willingly and that executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Will as witnesses and that to the best of their knowledge the Testator was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ~- ~ ,, ~. WI LIAM . C OMBE (/L~,~.~ Witness SAIDIS, SOWER ~ LINDSAY AT7DWVt'YS•AT•IAW 2109 Market Street Camp Hill, PA ~, .~ Wit ass Subscribed, sworn to and acknowledged before me by WILLIAM F. COOMBE, th Testato~~n~d subscribed to and orn~ or affirmed to before e by Z~ d" o and ~ ~~Jc ,witnesses this ay of 2007. COMMONWEALTH OF PENNSYLVANIA Notarial Seal to ry P I I C Sara J, Ensinger, Notary public Carlisle Boro, Cumberland County My Commission Expires Oct 17, 2009 Member, Pennsylvania Association of Notaries 4