Loading...
HomeMy WebLinkAbout09-15-104 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Jean E. Lupold also known as Deceased COUNTY, PENNSYLVANIA File Number ~ ~" ~1..•~ ' ~~' `-1 ~~ Social Security Number 210-16-7413 Kaye A Warble and Corrine L Lupold, 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 Executrixes ast Will of the Decedent dated April 14, 1998 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; 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: (If Administration, c. t. a. ord. b.n.c.t.a., enter date of Will in Section A above and complete list ofheirs.) n~ Decedent, then 84 years of age, died on July 21, 2010 at Golden Living West, 46 Erford Road Camp Hill PA 17011 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 $ 150,000.00 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 in the appropriate form to the undersigned: or printed name and residence 5 South 16th Street, Camp Hill, PA 17011-4801 1' 1' (~ ~/ O ~ ~ 2021 Lincoln Street, Camp Hill, PA 17011-3842 named in the Form RW-O2 rev. 10.13.06 Page 1 of 2 t .. _;, ~ - ,- ~. r-- (COMPLETE INALL CASES:) Attach additional sheets if necessary. ~ ~ ~ ~ - ' Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal~fiidence at '• '_ _ 2021 Lincoln Street, Camp Hill PA 17011-3842 3 (List street address, town/city, township, county, state, zip code) Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS 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 ai~f~rmed and subscribed before mc; the i ~ .> day of ~ ~P ' ~' .. For the Regi er Signature of Personal Representative rya Signatu're`lf Personal Representative ~ O __ _ ~~ T C'? -fin ~, ;~~ Signature of Personal Representative ~ _ ~ ~. " CI? ,,;~ "'~ ~ File Number: ~ ~ ` ~.~~ ~~~ ~ 0'~~- Estate of Jean E. Lupold ,Deceased Social Security Number: 210-16-7413 CTt ~° :. Date of Death: July 21, 2010 L ..~ ~ ., .. _..a ._.J ~`. _ ;; _..T..F t ' i ~~-..... J 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 Kaye A. Warble and Corrine L. Lupold in the above estate and that the instrument(s) dated April 14, 1998 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. 1 FEES ~ ~ ~ ~ L ` ~ Y r Letters ............... $-~~`~~ ~,' lam' Register Wills 1~ ~' ~'"~ l/ C;~' 1 Short Certificate(s) ........ $ ~ ._ ~ ~.~ Attorney Signature: O Renunciation(s) .......... $ ~ ... $ r7~~ - ~~ .. $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. ~~ ~ . J~ 0.00 Attorney Name: R. Mark Thomas, Esquire Supreme Court I.D. No.: 41301 Address: 101 South Market Street Mechanicsburg, PA 17055 Telephone: 717-796-2100 Form RW-02 rev. 10.13.06 Page 2 of 2 ~,,.v,. ~~ i~;:~~`,~fl•*~~.., ~~ r m 'I~`~i~~ $i°s E.)~~193'c~~~° (~"{f>• ";~^ s:"~t ~`~~~;it~);~~.:1,' ~°;it ~?r~1~)'~C7'i:~3c;~~~. ,. ~ ,x , r`P 1 t r" ;• . ? ~, 'I' ±' ; ^. ! )il' ilsil~)',1)~l('c111 i)Cl`t_' f'lV~ll IS ~~ .~~ ~ . f~, I .1ri iO)I ('~=rliti~~)1~ r~i [7tiath ( ,. ~ , wc'~~'~~ ' ,,I - _ C'r_' 1;~ 4 ~1C-. ~ 11t tit l','_.li;ll ~ : `r'' , 9 c _ ~)1 1~ 77 ~ a ~. , ~ n ~~~~-+... A ~•.. n- ~ y ~ v v .. , I ~ 1" ~ ~ /~ t i ~~ 1 f ,~ ,r~~ _ ___-. _ __ _ _ __-- ____~_ _ __ c7 : - ~~ c~ r,, _ :. f~ n ~ 1~ ~ ~ ~ : .~ . ,___ ~ _. ~, f ~:r ~ ~ --r--; r --~ ~ ~~ 4 y ~ ~_... ''. , _I © ' r ~. _ 1..... ~ ~ J t ` , F Hit>5.143 REV 11f2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS PER/MANENTN CERTIFICATE OF DEATH BLACK INK (See instructions and examples on reverse) CTlTG Cil C III IxIRCG 0 a ~I s~ i .Name of Decedent (Pest, midde. IesL sldfiz) 2. Sex 3. Sodal Security Number 4. Date of Death (Matdt, day, year) Jean E . Lu old Female 210 - 16 -7413 7f 21 /2010 6. Age (Last Birthday) Under 1 under 1 da 6. Date of Birth Month, da , ar 7. Bi ~ and state a forei coon 8a. Place of Death Check one ~~ paW Flours ~~ Hospital: Other • 84 Yrs. 10 12 1925 Shamokin PA ^ Inpatient ^ ER /Outpatient ^ OOA ®Nursing Home ^ Residence ^ Other - spl>cily: County of Death 8b 8c. City. Boro, Twp. of Death 8d. FacRGy Name IM na institution, give street and number) 9. Was Decedent of Hispanic Origin? I~ No ^ Yes 10. Race: American Indian, 81eck, White, etc. `~ . (tl yes, speary Cuban, (SP~M a ~amberland East Pennsboro Golden Livin West "~"'~"• `'`~'° Rya"~ etl:.) White 11. Decedent's Usual tion Knd of work d one du nwat of Rte. Do not state r 12. Was Decedent ever ~ the 13. Decedent's Education (Spedry only hghest grade completed) 14. Marital Status: Married, Never Me 15. Surviving Spouse (K wile, give maiden name) Oivaced (J Wxlowad Kind of Work Kid of Business/Industry U.S. Am>ed forces? Elementary /Secondary (0-12) College (1-4 a Ss) , i LPN Healthcare ^ Yes ~ Ne 1 W ts ~ 1 d o G • 16. Decedenys Mailing Address (Street, city /town, state, zip code) a d ~ ~ ~ 1 ! ~ s ~ Decedents Dd Decedent Actual Residence 17a. State P e n n s v l v a n i a Live in a tlc. ^ Yes. Decedent Lived in Twp. Township? .V O ( Lrved within ~ ~. /~ DecedeSt C L m b e r 1 a n d nil. ~ f~ 1>b C n • - ~ / 70 / o ~ . ou ty city 18. Father's N (First, midde, last suffix) 19. Molhefs Name (First, middle, maiden surname) 20a.1nformanys Name (Type /Print) 20b. InlormanYs Mailing Address (Street dry /town, state, >uD code) [ / 21 a. Method of Dtsposrtlon I ^ Crematiar ^ Donatbn 21 b. Date d Disposition (Month, day. Year) 21 c. Place of Dispositon (Name of cemetery, crematory a other place) 21 d. Localbn (City /town, state, zip code) • I _ ^ Burial ^ Removal horn State ~ ~ Medical ExatMnarllCorater ^ Yes^ No ~ Z 7 / ~ «i/ L ~' / ~ '~ J • afore Ftuterel S (a ) 22b. License Number 22c. Name and Address of Facility 7oi N 1 ~ Y ~- ~ = • Diot2Zlz-~ l ( ~~// ~- 4 ~er~ ~2 3 ~ ~~ Complete items 23a-c when rxirtilyirg best of my knowledge, death °~Red ar the time. date and place stated. (SignaNre and title) 23b. License Number Signed (Abndi, day. Year) 23c. to .. a not available at time of death to J _ /, /~ , J ' Y ~N ~ ~ ( L / ~G / 2 j 7 f ! Q certity cause d death. Y f G~~ /iti p/ (IJj~C ! ~ ,~ . ~ y j • tterrls 24.26 must be completed b1' Person 24. Time of Death j 0 26. Date Pronounced Dead (Month, day, year) 26. Was Case Referted to Medical Examine !Coroner fa a Re Other than oration a Dortetim? ^ • who pranourrces death. ~ t/Jy rn M. ~ ~ ~' ~ J u D/ G Yes o CAUSE OF DEATH (See (natructtons and atcamples) r Approximate interval: Pan N: Enter other s~^niflca t condrtxms c~?ntdbutira to death. 28. Did Tobacco U rebate b Death? Item 27. Part I: F~iter the chain of events -diseases, injuries, or campkcatkxrs -that dlredly caused ate death. DO NOT enter terminal evltnts such as carl5ac arrest, r Onset b Death twt not resulting in the underlying cause given m Pan L ^ Yes Probably respiratory arrest, a ventticuWr tibrillatbn wdhoul showing ate etiology. List or>fy one cause on each Gne. ~ Unknown 1 IMMEDIATE CASE (Final 6sease a O ~ 1 ~ /f L ~ / i cordition rasa in death ~/' aJ /(G(i-n C- ~/ I ~ a F~ d ~ ~~C ~ ~~ j'(~ ! l 29. If F Not Pregnart'rdNn Past Year - . Due to (a as a consequence of): ~ -mi ^ Pregnant ar time of death $egtkntiaNy kst candtiorre. d any, b i t 42 d b t ilhi N . b to the cause ksted on Rne a. Erder 9ie UNDERLYING CAUSE Due to (a as a axtsequence oQ: 1 ays ot pregrws, u pregnan w n of death (disease a kqury that initiated the c ^ Not pregnant but Pregnant 43 days to 1 year events resulting In death) LAST. I • Due to (a as a consequence of): r before death r ^ Unknovm it pregnant within the past year • d. r 30a. Was an Au[opsy .Were Autopsy Rndngs 31. Man th 32a. Date of Injury (MOnm, day, year) 32b. Describe How Irqury IDccurced 32c. Place of Injury: Flare, Farm, Street, Factory, OfRce BuiWing,etc.(Spedty) Penormed? Available Prbrto Cortlpletb f Ca se of Death? NaWrel ^ Homicide u o ^ Accident ^ Pending Investigation 32d. rime of Injury 32e. Injury al Wak? 32f. tt Trensportaiion Inury (Splrcily) 32g. Locat'wn of injury (Street city /town, state) ^ Yes No ^ Yes No ^ Yes ^ No ^ Driver/Operator ^ Passenger ^ Pedestrian ^ Suicide ^ Could Not be Detertnkwd M Othe - Syecily ~ Certifier ( ~, ~) ignature and rrtb of • Certllyfng physkbn (Physician certifying cause of death when another physician has pronolxx:ed death and cortpbted Item 23) d d t t - ~,~/ ~ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _' _ _ ^ _ _ - e manner as s a To the best of my q+owl•dg•, death occurred due to the cauae(a) an ~. License Number 33d. ate Signed (Month, day, year) • Pronouncing and cartMykg physcian (Physician both pronourkirtg death and Ixxdryktg to cause of death) To the best of my krroarbdge, death occurred at the Nme, date, and pbce, end due to the ease(s) and manner asstated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ .Art O G 3 O c.(~ /'~~ ^ ~ Z l - ~ V • Medical Examiner/Coroner On the basis of sxsminatlon and i or invelNigaClon, in my opinion, death occurred ar the time, dab, and place, and due to the cause(s) and manner ea stated. ^ 34. Name and Address of Person W/ho Completed ease of DeaM (Item 27) TType /Print ~ ~ ~ ~ ~ r J 36. R " ' s re and ~ trio ~ j ~ ~? I ~ I . ~ I I e. I J 36. ate (Month daY. earl ~ • ~ ~ ~ a ~ ~! / ` . 6 ~ /L ~ ~ ~ /~~ l ~•U C 7 ~ I ,: j 1 v ~. G~ ~ ~ r~, Disposrtbn Permit No. / .. s t- .: c: ~ ~ ~ ~_ CJ'7 LAST WILL AND TESTAMENTS ~ ~~ '`' ~ =' ~.-~ ~ t""' ~~~ ; ;. -~-~ BE IT REMEMBERED THAT ~.^ -,yrn ~ ~ -~ •~ ~':' ~ ~' {y. . i --~ ~- :~ ~ "C3 --~ ~--~ -,-t I, JEAN LUPOLD, a resident of Cumber~~~ County.,; _- .~.. Pennsylvania, being of sound and disposing mind,? memos and ' understanding, do make, publish and declare this to be my LAST WILL and TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I I declare that I am not married, my husband LAMAR L. LUPOLD, having predeceased me, and that I have eight (8) children, JOY ANDERSON, NANCY. DEIMLER, MARY VAUGHN, REYNOLD LUPOLD, KAYE WARBLE, CORINNE LUPOLD, LAWRENCE LUPOLD and RANDALL LUPOLD. II I direct that all my just debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath all my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment to my children, JOY ANDERSON, NANCY DEIMLER, MARY VAUGHN, REYNOLD LUPOLD, KAYE WARBLE, CORINNE LUPOLD, LAWRENCE LUPOLD and RANDALL LUPOLD, in equal shares, per stirpes. V I nominate, constitute and appoint my daughters, KAYE WARBLE and CORRINE LUPOLD as Co-Executrixes of this LAST WILL, to serve without bond. If either daughter is unable or unwilling to act in that capacity, then the other alone may serve as Executrix. ~ ~ IN WITNESS WHEREOF, I, JEAN LUPOLD, C have set my hand to this LAST WILL this ~~ day of 1998. ~ o JEAN L OLD Signed, sealed, published and declared by the above-named JEAN LUPOLD, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ,~ .--- f . j ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. I, JEAN LUPOLD, 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 LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. JEAN POLD Sworn or affirmed to, and acknowledged before me by JEAN LUPOLD, Testatrix, this ! j/`~~-- day of ~ f.-~ ~ 1998. ~; 1~C,~~-~:.._ .~..,~.,~ Notary Public COMMONWEALTH OF PENNSYLVANTA COUNTY OF CUMBERLAND AFFIDAVIT ss. Notarial Seal Mne Carmody, Notary Public Mechanksburg Bo% Cumberland County My Commission Expires Mar. 11, 2002 We, and , the 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 JEAN LUPOLD 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 Testatrix was at the time 18 years of age or more, of sound mind and under no constraint or undue influence. ~, ~/-_ Sworn orfirmed to end acknowledged before me this j L/ day of ~ ~ ~t_ J? 1998 . ~~ ~ ~ , f ,f Notary Public l Notarial Seal Anne Carmody, Notary Public Mechanicsburg Bo% Cumberland County My Commission Expires Mar. 11, 2002