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Home My WebLink About09-23-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Maybelle B. Breighner File Number 21-10- ~, C(~~ also known as ,Deceased Social Security Number 172-01-1590 Connie L. Gruber Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or '8' BELOW ) ~X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the named in the last Will of the Decedent, dated 01/23/2006 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 ( app~ca e, enter c. t. a.; .n.c.t.a.; pe ente ite; uran e a senba; urante mmontate 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.) ~~ ti~ Name Relationship Residence ', ~ 3 ~ ~~~ ~ `-~p , ~ i - w , r-- T , .~. ~ ~ ~ -, c:r; ~ - _ 5, '~ (COMPLETE /N ALL CASES:) Attach additional sheets if necessary. ~~' ~~ _ ~~"~~ ;,_M. Decedent was domiciled at death in Cumberland County, Pennsylvania with his !her last principal residence at ~'' .µ 1700 Market Street, Camp Hill, Camp Hill Borough, Cumberland, PA 17011 (List street address, town/city, township, county, state, zip code) Decedent, then 102 years of age, died on 09/02/2010 at 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 $ situated as follows: 81,000.00 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: Signature Typed or printed name and residence Connie L. Gruber 204 Market Street .~ ,~~ ,, ~' i' Lewisberry, PA 17339 r G' ;, Form RW-OZ Rev. ~o-~s-zoos Copyright (c) 2006 form software only The Lackner Group, Inc. Paga'. oft 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. /~''~ >1 Sworn to or affirmed and subscribed beforF me This °)~~) day of ~. ~~-~ 1 ~ 1r~~ ~.., .~C. t G ~~ For the Re ister Estate of Maybelle B. Breighner ,Deceased Signature of Personal Representative Connie L. Gruber r~.:~ Signature of Personal Representative ~ _....,. ;; _ ~ ~ .~ ~ V3 t - L y ~ ~ ) ~ Signature of Personal Representatwe T~ ~ --- , =~ t~J _ ~ - y ~ ~ _ ~ ~ .. (~J `,~-ra .-- . ; t~ - File Number: 21-10- (~'~ ~~ ~' (~) `~ t.1"9 ~ ~~-~`~ Social Security Number: 172-01-1590 Date of Death: 09/02/2010 AND NOWt i 1 }~.~ 1 =~~~ r~' l ~~' , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Connie L. Gruber and that the instrument(s) dated 01/23/2006 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES ~. ) (, , Letters ............................................ $ ,'~ ~ C ~' ~.; ~ 1 ~ t'~ Short Certificate(s) ....................... $ ~ ~; ~~~ ~ Renunciation(s) ............................. $ Attorney Signature: ~~,' + ~ ~ $ ~ ~~ • ~.'~ ~~ Attorney Name: Supreme Court I.D. No $ Address $ $ $ Telephone: $ $ Register of Wills ~ .- ,? ~ ~ ~~ ~' ~~ m~_ e , ~_7 Michael L. Bangs 41263 _ ______~~-~ 429 South 18th Street Camp Hill, PA 17011 717/730-7310 TOTAL ................................ $ ,=~~ L' CI r EJ~~~ t Form RW O2 Rev. 10-13-2006 Copyright (ci 2006 form software only The Lackner Group, Inc. in the above estate Page ~ of 2 .~,(AL~ RECaI~T~>~,R'~ ER~"~F1~~~'IC~N ~' ~E~#'~aN ~~~~f~l~~: It is illegal to d~Ip9iGat~° tl~i:~ ~(~~1~~' bar ~~h)(:~t(~stat ol" p~otogr~l~~f~i ` r~~ .err. ~~ ~1 ,, •~/ :., v ~ . ~ ~. ..r ~l J • r r .,E.'a. ~ e a i , a .. ~h .`'gam `/ 5, i~ W yid ) ,~i~~ , . ,., !i'~: ,__ ~)1: tlrli~r'n)~tCit~l? 1r it' ~,lr~~t) i~ I'I'!'~ 3 ~ ~ _~11'r- tM 1 I~ ~9, i 6111~_'k11~1~ ( t 4~i1 i i~ ~l(t' '.~ ~ ~_.)t'~li~l ,il~`~ R ~~`C~ Ot,~R2'C ., ~. 1 tt~~Pl ~`~.t'ti`f tj~,~ti~. ~~7t' t7t~)1`.1f~Etl~ ~. j~~941 -t,,, ;~, },. ~ ~~II~„~.°~.i (t (I?a~ `,lttr, b'i(~)9 "v+.`1'1~Io, (,) ~t'• ,. ! y. '' di~ii~. '! ',l~ll~~r 168 __ 0 ~' ~.. 6 ~ _. _~ T~ _ ~ C ~ c~ ~ f ?"7 ~~~~fTi -Wcn~ 43 REV 11/1006 'E I PRINT IN ERMANENT SLACK INK P RTATF FII F NI IL,IRFR ft~~ ~ ~.' r - ~~ --- - _--- -- ____s~-~ r, ------ . } ,,o ~ 1 ,.~' .~t~,,,,,(,.~~II ~.~ ~'l.lt~ ~~~;n~ 3 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and exam les on reverse) r•~ 4~ its cn ma- W ~~ ~~ ~. r-I-~I ~~~ G.J'? - __.I. ~.,._~ ; ~z~ c_: ~: _ ~-, Cry C 1. Name of Decedent (First, mddle, lest, suffix) 2. Sex 3. Sodal Security Number 4. Date of Death (Month, day, year) Maybelle B. Breighner Female 172 - Ol, - 1590 September 2, 2010 5. Age (Last Birthday) Urder 1 ar Under 1 de 6. Date o1 Birth Month 7. Bi and state a fie. Place of Death Check on one Months Deyc Hours Mklulee Hospkel: Other. 102 Yrs May 5 , 1908 Harrisburg, PA ^,,,panent ^ ER l Outpatient ^ DOA ®Nureing Home ^ Residence ^ C)ther - Spealy: 8b. County of Death 8c. City, Born, Twp. of Death ed. Facility Name (N not institution, give street end number) 9. Was Decedent of Hispanic Odgin? ~] No ^ Yes 10. Roca: American Indian, Black, Whtte, etc. Cumberland Cam Hill P Manor Care (n yea, specHy Cuban, Mexican, Puerto R'x~n, etc.) (SpexSly) whit e 11. Decedents Usual tlat Kind of work d one dud most of life. Do not state retir 12. Was Decedent ever ro the 13. Decedents Education (SpecNy only highest grade comp leted) 14. Martial Status: Marded, Never Marred, 15. Surviving Spo use (If wife give maiden name) Kind of Work Kind of Business/Ir>~try U.S. Armed Forces? Elementary I Secondary (0-12) Cdlege (1-4 or 5+) Widowed, DNOrced (SpedryJ , Stenographer State Government ^Yes ®No 12 Widowed 16. Decedents Mailing Address (Street, dty /town, state, rip code) DeaedeM~e A t l R id 17 S Penns lvani a Did Decedent y Live in a ^ 1700 Market Street c ua es ence a. tate 17c. Yes, Decedent Lived in _ Tw Township? P Cam Hill PA 17011 17b.county Cumberland 17d.®No,DecedentLivedwithin Cam Hill p p , Actual Limits of City I Boro ifi. Fathers Name (First, middle, last, suffix) 19. Mother's Name (Fret, middle, maiden armame) Harry W. Bradigan Anna Elizabeth Gise 20a. Informants Name (Type /Print) 20b. Intomlants Mailirp Address (Street, dry I town, state, zip code) Connie L. Gruber 204 Market Street, Lewisberry, PA 17339 21 a. Method of Dispositon I [~ Cremation ^ Donation 21 b. Date of Disposition (Month, day, year) 21c. Place of Disposition (Name o1 cemetery, crematory or oMer place) 21 d. Locetbn (City /town, state, ;7p code) ^ Budel ^ RemovaltromState ~ wwcrematlortorportetlonAtllhoAZed September 4,2010 Evans Crematory St::haefferstowri PA 17088 ^ Otlter - I try kledlcel Examiner/COronx7 Yes^ No , 22a. Sign of Funeral Service (or ~9 as 22b. License Number 22c. Name and Address of Facility ~ FD 012 848 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 Compote ibms 23ec only when ceAHykg 23a. To the best of my knowledge, death occurred at the Hme, date end place stated. (Signature end tole) 23b. Lirxmse Number 23c. Date Signed (Month, day, year) physician re rat available at time of death to certNy cause of death. Items 24.26 must be conglebd b/ person 24. Time of Death 25. Date Proraunced Dead (Month, day, year) 26. Was Case Referted ro Medical Examiner !Coroner for a Reason Other than Cremation or Donation? who pronotxtcas death. o OO M. 9 Z ~~,0 i ^ Yes ^ No CAUSE OF DEATH (See Inetructlone end exsmpbs) t Appmximete interval: Pert II: Enter other sianHk?nt txxxtitlone contribc~*nm L death. 26. Did Tot>ecco Usa Conhibute to Dealh7 - Item 27, Part I: Enter the chain of events -diseases, injuries, or compticatbns -that directly caused the death. DO NOT enter tartninel events such as cardiac artest, ~ Onset to Death respiratory anent or ventricular tlbdAa without showi the etbbgy List any one cause on each tine but not resulting in the underlying cause given in Part I. ^ Yes ^ 'ro , . . ~ ' ^ No nkrawn IMMEDIATE CAUSE (Float disease or - ,, 1 A , _ ~ J,^ A condition restdting In death) _~ a N/,,~(1n (J~ v ~, ~ ~ I 29. If Fe N t t i i Due to or as a ( consequence op: , o pregnan w th n past year Seaw^+;,M, Ifet conditlons B any p le~dkq ro cause Hated on Iine a ~ Pregnant at time of death ^ . Due to or as a con o Eller 61e UNDERLYING CAUSE ( s•~~ n I I - Not pregnant, but pregnant within 42 days (disease or fnju that ktitlated the events resultlng In death) UST. c' i i of death ^ Due to (or as a carlaequence ot): ' Not pregnant, but pregnant 43 days to 1 year f b d th d. ' i e ore ea ^ Unknown if pregnant within the pest year 30a. Was an Autopsy 30b. Were Autopsy Flndklgs 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Descdbe How Injury Otxurted 32c. Place of Injury: Home, Farm, Street, Factory, Pertomted? Available Prior to Completion f~'~~ ryatural ^ Homidde Office Building, etc. (SpecbyJ of Cause of Death? yQ ^ Yes ~ ^ Yes ^ No ^ Accident ^ PerxJfng Investigetbn 32d. Time of Injury 32e. Injury et Work? 32f. M Trensportatbn Inury (SpecilyJ 32g. Location of injury (Street, city /town, state) • ^ Suiade ^ Could Not be Determined ^ Vas ^ No ^ Ddverl Operator ^ Passenger ^ Pedestrian M ^ Otiler - Speclly 33e. Certl6er (check only one) 33b. Signature and Title of r Grtlh4ng physlden (Physician certHyirg cause of death when anodter physiden has pronounced death end completed Item 23) To tM txat o} my knowedge, death occurred dw to tM ause(s) and manner se sbbd _ _ _ _ _ _ _ _ -------- ----------------- • Pronouncing and csrtilYing physicbn (Physican both prortourlpng death and certilyirtg ro cause of daetn) 33c. License Number Date Signed (Mon day, veer) To the beet of my knowledge, dwth occurred el the Ume, date, end place, end dw to the sow(s) and Inanrxr u stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~ ~ a, • MadkelExaminarlCoroner ~ O _ d ~ Ot On the twab of examination end / or invwtlgetbn, In my opinion, dwNt occurnd at the time, deb, atW place, and dw to the arse(s) end manner w atata<L ^ 34. Name and A ddre~s of Person Who Completed Cause of Death (Item 27) / Pdnt Registrar' nature and I - l 1 / ~ ~ ~ ~ ~ ' L 4X ~ 3~ ~ ~ (Month, day, Year) ~ ` ^ ,f~-~/,s ~` \ 4 < ~ ~ ,~ ~ l~C t.'rl J JJ Disposition Permit No. ~_ ~'`"l' ~ Z (~t~ ~ J ~ ~ ~ ~~ ~~ ~~ ~ <~ ~ C/7 ~ ~ ^ ~JCJ . CJCJ ~~ ~ ~ f - - ' ~; I, MAYBELL B. BREIGHNER, of the Borough of Camp Hill, Cumberlan~~u~ity, .. ~- /_~ ~ ~~ ~,., Pennsylvania, declare this to be my last will and revoke any will previously made b ~'y'me. ~ `~ '~ ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with. all insurance thereon and relating thereto, to CONNIE L. GRUBER provided she survives my death by thirty (30) days. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate to CONNIE L. GRUBER provided she survives my death by thirty (30) days. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint CONNIE L. GRUBER executrix of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ;, ~ ,~-~ day of ,. ~,., ;r ~..a- , 2006. ~~ MA L B. BREIGHNE 2 The preceding instrument, consisting of this and TWO other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by MAYBELL B. BREIGHNER, the testatrix therein named, 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. ~..~.~. ~:~ 3 COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing 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. , , ~°- ~ ~ MA ELL B. BREIGHN R Sworn or affirmed to and acknowledged befog. e by the t i~ named above this-~~ ; day ~~~~ ~.~-006. Notary Public ~'l / INEltBt3Y" S~~E ~ ~~' ~~ l~ lc141~ Tip., ~;~~?.~. ~~~I ~~ C~~ti1 i ~la° i ~, ~~~7 COMMONWEA ~~!~-~-~ ) ( SS: COUNTY OF CUMBERLAND ) WE ~ ~ ~ ~, ~~ w. ~c. i ~ /J r~,' ~ ~, and ~ ~C ~ ~~ ~y' nf.~ ~ ~~1 ~. ~ ~~ ,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 the testatrix sign and execute the instrument as her last will; that she signed it 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 that time 18 or more years of age, of sound mind, and under no constraint or undue influence. S ~°o-rn or ffirmed o and acknowledged }~~efc~re me~this day of :~;~' it,.' , 2006. /~ ~~ Notat-y Publ ~ r'~ •7, V~Tf~p ~~e ___ y , 4