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HomeMy WebLinkAbout08-10-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Mildred R. Marguart also known as William R. Boldosser COUNTY, PENNSYLVANIA File Number 21 - `~~ ~- f ~c~ ,Deceased Social Security Nurnber 202-01-5108 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or `B' BELOW.) ^X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) last Will of the Decedent, dated p3/18/2~10 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 (!f applicable, enter: c.t.a.; .b.n.c.t.a.; pedente ite; urante absentia; durante minoritate) 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: (/f Administration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) Name Relationship Residence ~, ,_ ___ _ ;_ ,- ~~ ,~,~ _.~. I ~ ~. _- ~_. _ . . _~ _-' ""7 (COMPLETE IN ALL CASES.) Attach additional sheets if necessary. ~~ ~: ~ r~ ; - ~ z= Decedent was domiciled at death in C m rl n County, Pennsylvania with his /her last principal resid~tce at 210 Bia Suring Road. Newville, West Pennsboro Township, PA 17241 ~ _ _ (List street address, town/city, township, county, state, zip code) Decedent, then _~ years of age, died on 08/05/2010 at 210 Big Spring Road, Newville, PA 17241 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 313,000.00 (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: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters m the appropriate form to the undersigned: Signature Typed or printed name and residence William R. Boldosser 36 Mount Rock Road n ,,--~ Newville, PA 17241 named in the is/are the EXeCUtor Form RW-OZ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } 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 before me this ~ ~ day of William R. Boidosser Signature of Personal Representative - l(//`- Signature of Personal Representative C-7 ~=' For the Regi ter ~. ~~ ~; _~ :~'7 ~. , 7 7 ~ ~ • ~' ;`Tl -~.- ~:~J ~,,, . _, Fiie Number: 21 -- ~ U - ~~' - ~ _t -~ -- y , - ..~~ _ Estate of Mildred R. Marquart De6p~;ed .. ~, , Social Security Number: 202-01-5108 Date of Death: 08/05/2010 AND NOW, .~ _ ~ ~ ~ C l LJ , in consideration of the foregoing Petition, satisfactory proof having been presented be ore me, IT IS DECREED that Letters Testamentary are hereby granted to William R. BOIdOSSer in the above estate and that the instruments} dated 03/18/2010 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES L t ~~~ $ 2 ' ~ ~ ~ '~ ters ...................................... e .... U . r jlX ,..-- ~ Register of Wills ~ ~ r^ ~~ I (~L L ` , {~ Short Certificate(s) ................... .... $ ~ ~ ~,~' • (~~; Attorne Si nature: /j 1 t ` ~~ \ Renunciation(s) ....................... ..... $ y g , . ..- ~~ ,,,,. ~1 ,~ ~_` $ '~ (,I ~ 1 Attorney Name: Richard L .Webber, Jr. Esquire ~~ $ ~~'~~ _, Supreme Court I.D. No.: 49634 Weigle ~ Associates, P.C. $ Address: 126 East King Street $ Shippensburg, PA $ Telephone: 717-532-7388 TOTAL ............................... .... $ ~' -1 • ~~-) Form RW-O2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Pape 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF DEATH trlt,q,~NIiVG: It is illegal to duplicate this copy by photostat or photograph. ~_~'1ililr_'.l.`:iflll ~,s!'fl~'~t,'. __ n+"~"' ••• liS Li tU l l~-'t1~ i that l~~e -]]~.1~O1-111at-011 hE're atVell 1S ~ i rrrir ,~ llH~fp,r ~tt,t~y4.,P -,~ ~ ~ `"'.~, c t>rrec ll>~ c(~~~1e~1 t~l-~E-~~ an ~>ri~~-nal Certificate cif Death ~~~~~~; ~ .~`~~''`,, dui~,~ 1~ilecl ~~~ith inc a ; 1_~~>cal Re~-stra~. The r)--i« r , _ Final ~~ ~~ ,~ ~~~'I c~~'rt~f~ir.:aic ~~~il~ ~~e fi~lrw:frcl~;d tcy the State Vital ~, `~, ~ }~~:c11 ~l. (..fit#~ice t(,- ~~I~r~-~1ane)~~t filing. ~``\ ~F.a ~~` , ~ . ~~.,,, -~~..,,_,.,, ,,,,e -' ~ ~ :al:el~ ~Zf'i~'I°;1?'~t!' ~_)i~CC ~SSIUIt~~ l -', __... _ ~ ~7~1 ~¢~ - (_) :a' - I r-~ ... __. ,- +-,) ~ C-J - - 1 ~. ,~t ~ ^~ .~~_ - t _ ~.. '~-.~ ... ~~J .._ ....T~i _.~; .. '' C.,.`. H105-143 REV 11/2006 TYPE /PRINT IN PERMANENT BLACK INK COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) .._.r~ ~„ ~ ,,,,,.,,~„ 1. Name of Decedent (Frst, middle, last, suflix) Mildred Ruth Marquart 2. Sex female 3. Social Sewdry Number 202 O1 5108 4. Dal of Death (Month, day, year) _ ~~ 5. Age (Last Birthday) Under 1 ear Under 1 de 6. Date of Birth Month, da , ar 7. Bidh ace Ci end state or feral count fle. Place of Death Check onl one 91 Months Deys Hours Minutes November 1 191 N e wv i 11 e P A HOSpitel: Othef: ~ Yfs. ~ ^ Inpatient ^ ER /Outpatient ^ DOA rT~ L7 Nursing Home ^ Residence ^ Other - Specity: ' fib. County of Death &. Ciry, Boro, Twp. of Death 6d, Facility Name (If not instlhdion, give street and number) 9. Was Decedent of Hispanic Origin? ®No ^Yes 10. Race: Amedcen Indian, Black, White, etc. • Cumberland West Pennsboro ' / (It yes,speciryCuban, whi i ~ ~~1 ~ ~ V t ~ (a~ ~ Mexican, Puerto Rican, etc. ) t e • 1 i. Decedents Usual lion Kind of work done d ud nest of Nfe. Do rat state retired 12. Was Decedent ever in the 13. Decoder Educaflon (Speciry ony ghost grade comp leted) 14. Marital Status: Married Never Marled 15 Surviving Spo use (If wrfe ive maiden name) Kind of Work Laborer Kind of Business/ Industry U.S. Amred ForcesT ~ Elements /Seconds 0-12 ry ry( ) Coll ege(1dor5+) , , Widowed, Divorced (Specify) Never married . , g F r ^ Yea Na 16. Decedents Ma6ing Address (Street, city /town, state, zip code) Decedents p A Did Decedent ~-}~ West P e n n s b o r o Actual Residence 17a State Live in a 2 1 0 B 1 S r i n Road g p g . i 7c. L3 Yes, Decedent Lived in _ T Townshi ? '"p' N e wv i 11 e P A 17 2 41 p 17b. County Cumber 1 a n d 17d. ^ No, Decedent Liven within Actual Limits of Ciry /Boro 18. Father's Name (First, middle, last, sufliz) Franklin W. Marquart 19. Mothefs Name (First, middle, maiden surname) R. Belle McCalister 20a. InfortnanYs Name (Type !Print) William Boldosser 20b. Informant's Mailing Address (Street, city /town, state, zip code) 36 Mt. Rock Road Newville PA 17241 21a. Method of Dispositon r ^ Cremation ^ Donation 21 b. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name of cemetery, crematory or other place) 21d. Location (Ciry/town, state, zip code) ~] Burial ^ Removal from State ~ Was Crematbn a Donation Authorized r 8 / 7 / 2 010 N e wv i 11 e Cemetery N e wv i 11 e P A 17 2 41 by Medical Examiner/Coroner? ^Yes^ No ^ Other - S • 22a. signaturr~une servire Licensee or parson acting as auah) "~ ~ ~ ~ 22b. L.icerue Number FD 13895 22c. Name and Address of Facility Egger F u n e r a 1 Home I n c . ~ ~ _ ; ; ,~ ,~ ~ ~ L 15 Big Spring Ave Newville PA 17241 Complete Hems 23a-c any when cerklyirg physican is not available at time of des o ' 3a. To the best of death occurred at the time, date and lace stated. (Signature a ) ~ 23b. License Number 23c. Date Signed (Month, day, year) ~~~,, cease of wag,. ~ 1~~- f ~ f ~. , , Items 24-26 must be corn feted rson p q' pe • who pronounces death 24. jjTe of Death /'~ n /' C r~ ~ 4 ~~ ~G I ~ 25. Date renounced Dead (Month, day, year ) / ~ 26. Was Case Referred to Medical Examiner / Corcx>er for a Reason Other than Cremation or DonationT . ~ ~ ~ M. ._ . h ~ L~S I V a~D [i ^ No ^Yes CAUSE OF DEATH (See Instructions and mples) r Approximate interval: Item 27. Part I: Enter the drain of events -diseases, injuries, or complications -that directly caused the death. IDO NOT enter temdnal events such as cardiac arrest, ~ Onset to Death Part II: Enter other 3jgnificant conditions contributing tc dean, but not resulting in the underlying cause given in Part I. 26. Did Tobacco Use Contribute to Death? ^Yes ^ Probebry respiratory arrest, or ventricular fibrillation without showing the etiology. List ony one cause on each line. r i IMMEDIATE CAUSE IFn l di ^ No ^ Unkrawn a sease or corxldbn resulfing in death) ~ : ~ ` y2 (~ ~ T_ . 29. It Female: ~ ~~ , ~ J _~ a C ^ ' Due to (or as a cronse nce oQ: i r SequentlelN list conditions, it any, b, r leading to lie cause listed on line a. - Not pregnant w nhin past year ^ Pre rant at fime of death 9 ^ Enter 9re UNDERLYING CAUSE Due to (or as a consequence oi): i - Not pregnant, bd pregnant within 42 days (disease or injury that initiated the r events resulting in death) LAST. c' r of death ^ Due to (or as a consequence oq: ; - Not r rant, brit re y y Peg p grant 43 da s to 1 ear ~ d r before death r - ^ Unknown if pregnant within the past year 30a. Wes an Autopsy Performed? 30b. Were Autopsy Flndings Available Prior to Completion 31. Manner of Death 32a. Dale of Injury (Month, day, year) 32b. Descdbe How Injury Occurred 32c. Place of Injury: Hama, Farm, Street, Factory, Office Buildin eta (S ecil J of Cause of Death? Natural ^ Homicide g, p y ^ Yes ~No ^ Yes ^ No ^ Accident ^ Pending Investigatbn 32d. Time of Injury 32e. Injury al Wak? 32f. I1 Transportation Injury (Speclly) 32g. Locetbn of injury (Street, city /town, state) ^ Suicide ^ Could Not be Determined ^ Ves ^ No ^ Driver/Operator ^ Pa gar ^ Pedestrian M. ^ Other - S ~ti 33a. Certifier (check ony one) 33b. Signature a d ~ " r • Certifying physician (Physician certifying cause of death when another physkian has pronourx~ed death and completed Item 23) 1 ~ .~. '~ ' To the best of m knowledge, death oxurred due to the ceu Y ae(s)endmannerasstated--------------------------------- I. • Pronouncing and certlrying physician (Physidan both prorauncing death and certifying to cause of death) - To the best of my knowledge death otturred at the time date and lace end due to th d ^ 33c. License N ~! ~ 33d. D (Month, day, year) , , , p , e cause(s) an rnenner es stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Madieel Examiner/Coroner y- / ~ -- ~ ©V ~ Q LtL ` ,~ ~~ V On the heals of examinatbn and / or Investigation, in my opinion, death occurred et the tlme, date, end place, and due to the cause(s) and manner as staterL ^ 34. Name and Address of Person Who Completed Cause of Death (Item 27) Type /Print ~ 35. Ragisfrafs ~'\\J],~,a~n~~d ~D~TStp~~\ r ~ p ^ 1 I~ ~ ~ ~ ~ O ~ ~~ ~ ~ 36 Date Fled (Month, day, year) ~ ^, 1.r )% / \1 ...r ° lV7 ~ f 1 ~' ~ 6 .'y.i ~I T: •1 1 rat 1 a?-~' ~yRC ~R ~•C ,1~, Disposition Permit No. ~,~D ~ ~C-t-->~T LAST WILL AND TESTAMENT ....> ~ ~,_..~ I, Mildred R. Marquart, presently residing at 210 Big Spring Road,`.~vville, pest __ Pennsboro Township, Cumberland County, Pennsylvania 17241, .being of sound r~1i~ ma~ory ;; and disposition, do hereby make, publish and declare this my Last Will and Testam~t, hereby revoking and making void all Wills by me at any time heretofore made. - ~ c~' __; -,~ _ _. ~ 1 - FIRST. I order and direct the a ment of all m le all enforceabl~.~ ~ .~~ P Y Y g Y debts as s;~qn as - . ~ .:> may be convenient after my decease. My funeral expenses have been prepaid. e~~,w _ C:~~ SECOND. I hereby give and bequeath the the full sum of Ten Thousand ($10,000.00) Dollars to William R Boldosser and Dorothy Boldosser, on a per, capita distribution basis, this gift to be considered in my name as well as that of my deceased sister, Dorothy C. Marquart: THIRD. I give, devise and bequeath all of the rest, residue, remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, as follows, with said gifts being considered in my name as well as that of my deceased sister, Dorothy C. Marquart: A. Fifty (50%) percent to my church, First Church of God of Newville, Pennsylvania; B. Twenty-five (25%) percent to the Newville Historical Society of Newville, Pennsylvania; and C. Twenty-five (25%) percent to the John Graham Public Library of ~,~ Newville, Pennsylvania. FOURTH. I nominate, constitute and appoint William R. Boldosser to be the Executor of this my Last Will and Testament. In the event that he be unable to fulfill the duties of Ia:~ecutor, I then nominate, constitute and appoint Richard L. Webber, Jr., to be the Executor of this my Last Will and Testament. ,, FIFTH. To the greatest extent permitted by law, before actual payment to a _ beneficiary or to his or her account, no interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary. ~_ SIXTH. I direct that my personal representative(s) shall not be required to give bond for the faithful performance of their duties in any jurisdiction. f SEVENTH. I hereby direct that all federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such taxes, WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 shall be considered a part of the expense of administration of my estate and that such be paid out of the rest and residue of my estate. IN WITNESS WHEREOF, I, Mildred R. Marquart, have hereunto set my hand an ~~eal to this my Last Will and Testament, the first page signed for identification only, this ~~ _ day of ~-''G~~ , 2010. r a ~~ ~-~~ _ _____ _ (SEAL) I~~TLL~u En ~? . ~[~.R_(~iJART WEIGLE & ASSOCIATES, P.C. - ATTORNEYS AT LAW - 12.6 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to be her Last Will and 'Testament, in our presence, who at her request and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. u,d±t~ a GveEE~_ -~ - COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, Mildred R. Marquart, the person whose name is signed to the 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 I signed it as my free and voluntary act for the purposes therein expressed. MILDRED R. UAR Sworn or affirmed to and acknowledged before me by Mildred R. Marquart, the Testatrix, this (~ ~ day of /L''~ ~~ ~ ,~ , 2010. ~~w~ Notarial SCI Rhcxtda R. Wolford, Notary Pt~lic Sii~penstwrg Soro, t~cs~riand County .~M.~..Cc~'t~ r , ~ .. < < _ F, ~? _2013 WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-11397 COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, ~~CJI ~ ~~ ~ I ~ ~ `"~ e ~ and / ~ ~lr~ ~ ~~~,~!- ~J ~_r-~ the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Mildred IZ. Marquart, 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 purposes thereL*~ Pxpressed; 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 the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. ~u d~ GI, G~eG-Fi e~ Sworn or affirmed to and subscribed before me ~--~ by J Lt ~ ~ ~~ ~ ~~6 P~ .. and !~ ~ G ~ ~ ~_, ~/~~ y ~-,i- ~ ,- , l witnesses, this „ ~~~ ~.~of /~~~ c:~ ih 2010. otary Public ' ~--- `-'~ `" N P~~ R, Wotford, No~'Y ShK~~~ ~~' C~rla ~_ ~~ WEIGLE & ASSOCIATES, P.C. -ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397