HomeMy WebLinkAbout04-29-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
File Number 21 - 11 ~;. t'~ yj
Estate of Wilbur R. W. Hubley - `
also known as Social Security Number 168-14-1054
Deceased ,
Jo Ann Shepp Burns and Lou Ann Shepp Houck -
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE `A' or `13' BELOW:)
QX A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executors ~, named in the
last Will of the Decedent dated 02/0212006 and codicil(s) dated _-__ -~-.
(State relevant circumstances, e.g., renunciation, death of executor, etc.) -~„
After the execution of the documents offered for probate: Decedent did not mar ;was not divorced; was not a party to a ppending divorce proceeding
wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. §73323 (g); did not have a child born or adoptESd;~was not the victir;n of
a killing; and was never adjudicated an incapacitated person, except as follows:
B. Grant of Letters of Administration -
app ica e, en er.• c..a.; .n.c..a.; pe en e i e; uran e a sen ~a; uran a minon a e
Petitioner(s~, after a proper search, has/have ascertained that Decedent left no Will and was survived by the following spouses (if any) and heirs (if
Administrat-on, c. t. a. or d.b.n.c.t.a., enter date of Will on Section A above and complete.list of heirs); was not the victim of a killing; was never
adjudicated an Incapacitated person; and was not a party to a pending divorce proceeding wherein grounds for divorce had been established as
provided in 23 Pa. C.S.A. § 3323 (g), except as follows: -
Dec;aden!, then JQ years of age, died on 01/09/2011 at Holy Spirit Hospital -
Decedent at death owned property with estimated values as follows:
(ifi domiciled in PA) All personal property $ 93,000.00
(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 in the appropriate form to
the undersigned:
Signature Typed or printed name and residence ~
i..-~~ ~`~~ ~ t ~ Jo Ann Shepp Burns 2767 Oakland Drive
Dover, PA 17315
(/
Lou Ann Shepp Houck 29 Beechwooa rcoaa
~` Airville, PA 17302
~ C ~~~ _
Form Rev. 12-26-2010 (interim form, pending action by the Court) Copyright (c) 2010 form software only The Lackner Group, Inc. Page 1 of 2
(COMPLETE IN ALL GASES:) Attacn aaafr-ona- sneers -r nece~sa-y. ,~_:_
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
4905 East Trindle Road, Mechanicsburg, PA 17050 -
(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 corre~ a best of y'°
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well,ai~u ,'
administer the estate according to law. a ~ c•~ T=
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.f.r .. l ~ ~,.&J
Sworn to or affirmed and subscribed ~~, ~~ ~ ,, .. _ . /f „.~ s-~ .~.~ 3 :1~•:rrnfi _ •°~.
before me this ---~_ day of
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~-
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~,-~ ,~ ,-~ ~ _~; ~^~ CSC%Z'~
For the rZegister
of Personal resent Ive .~ ~~ -
Jo Ann Shepp rn~ ~ ;•.,,
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of Person Re resentative Lou Ann
p Houck
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Signature of Personal Representative
File Number: 21 - 11
Estate of Wilbur R. W. Hubley
,Deceased
Social Security INumber: 168-14-1054 Date of Death: 01/09/2011
AND NOW, ~~~~ f 1 l ~ C( i (~ (, , in consideration of the foregoing Petition, satisfacto roof
rY P
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Jo Ann Shepp Burns and LOU Ann Shepp Houck
and that the instruments dated in the above estate
() 02/02/2006
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent
FEES
Letters ...................................... ...... $ ~ ~ ~ 1 • ~' ~~
Short Certificate(s) ................... ..... $ ~ ~ ,
Renunciation(s) ........................ ..... $
$
$
$
$
$
$
TOTAL ................................. ... $ ~~~1.,, . (~ ~ ~ ~~
Form RtN QZ Rev. 10-13-2006
--, ~
Register of Willa-
Attorney Signature: ~~` K ~ ~,t,~C~A~tc~-~-
Attorney Name: Debra K Wallet
Supreme Court I.D. No.: 23989
Law Offices of Debra K. Wallet
Address: 24 North 32nd Street
Camp Hill, PA 17011
Telephone: 717/737-1300
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 2 of 2
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS '~ ~""
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CERTIFICATE OF DEATH
rsno instructions and eYamoles on reverse) ~.,r< <„ ~ .~~ ~..o~o
, _ _. __
t Name d Decedent (Fast. rrvdda, Wst, sums( 2. Sea 7. Soclil Secunty Number 4. Oats d Death IMonm, day. year)
Wilbur R.W. Hubley Male 168 - 14 - 1054 January 9, 2011
5. Age Mast &rmday( Under t ear Under 1 da 6. Oa1e d &rM Monet. de ar 7 B G and state w !oe count 8a Place d Deallt Check ate _
Honors DJYS Howl Mnugs Hospual: Olher.
90 r~ Sept 26 , 19 20 York PA ~ InDatieM ^ ER t Outpatient ^ DOA ^ Nursng Home ^ Resrdenc. ^ onrr ~ sD.aN:
d0 Caxtry of Deem & Gry. Sao, Twp. tit Deem 8d. Facdrty Name III red ut5ktutlan, qve sweet arW number) 9. Was Decedent d Hispanic Orgn~ ®No ^ Yes 10. Rea. American Irtdiert, Bladt VVItNS, alt.
1Speo4~1
• East In yes, speedy Cuban.
White
Cumberland Pennsboro Holy Spirit Hospital Me~,Pt~rtdRKan.etdl
t t Decedent's Usual Occ wore Kurd of work d one duet most d ate. Do real stag reared t 2. Was Decadent ever in dte 13. Decedents Education ISpectty only nyhest grade corttWeledl i d. Marna) Status Marned, Never Manned. t 5..`~unrvng Spwue (d rode, giro rtwdan runts)
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Social Worker De t. of Health ®Yes ^ No 12 5+ Widowed _
• 16.OecedenYs MarWg Address IStreel, city /town, state, zp code) DecedenYS ~ Decedent ~7~
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PA Live n or 17c ~ Ves Decedent Uved n
4 9 0 5 East T r i red l e Road _
Actual Residence t 7a State
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Mechanicsburg, PA 17050 tve
t7p.coirtty Cumberland
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t8 FamKS Name (First, midde. fast. sumxl t9 Homer's Nanw (Full etudes. mbdpt suman»I
Richard J.H. Hubley Unknown -
20a. kuorntanYS Nartw (Type i Pnnt) 20b Informant's Mading Address IStiaal ary I town, state, tp code)
Ms. JoAnn Burns 2767 Oakland Road Dover PA 17315 _
21 a. MtMad d DisposiUOrt t ®CrernaWrt ^ Oanatwn 21b. DaW d Disposi0drt (Monet. say. rear) 21c. Place d Dcspositan tName d twneMry, aematory o Deter place) ltd. l.ocatiort IC.ry l town. state, aD Dods)
• ^ Burtal ^ Removaltranstate ~ waaCrmlaliortorDOnNIOnAWhorizad 1-14-2011 Cremation Society of PA Harrisburg, PA 17109
^ Omer - ' r ' by Iledkal Esrtminerl Cororwr? ~Yes^ No _
• 22a.SgtaN dFurWral aUCensea ~ tsar assucnl , 22D LrenseNtrttbw 22c NartwandAdtlressolFacikty Alter Cremation Services of Pennsylvania, Inc.
. - FD 138312 4100 Jonestown Road Harrisbur PA 17109
Complete sterns 23a-c oruy ~ utg
physrCiart .s na.availaDle at o1 deem to 23a. To ttw d my knowkidga, deem occurred pw1 dauyan~d place sated (Stgrwbue arN otlel
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Items 24-26 rrwst W CotplaNd by person 24. Time d lXam 25. Deli Pratourtced Dead (Harem, diY• Year) 26 Was Case Relerr o Medical Exarttrwr -Coroner fa a Reason Otlw CremaEOrt or Dptabon?
rota pronounces dean. : 1 ~ ~ M. ~'AjK V~ (~ ~ l ( ^ Yes
CAUSE OF DEATH (Set• instrucrlona and •:amp ~ i Approumata :ntervy
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YAME0IATE CAUSE Fral disease a
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Eruer UNDERLVMIG CAUSE Due t0 ~a ~ a ° ' w y S
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JDs. Was an Autopsy 30D. Were Autopsy FaWatgs 3t Mamar d Dean 32a. Dale d Iryury (Moult, day, year) 32b. Describe Flow injury Occurred 32r, 0~ ~ , ~1StreeL Fatdory.
1 Pertomted? Avadade Pnor td Conpletion
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Acadenl ^ Pertdatg invasigabon 32d. Tirtte d tnpuy 32e Irqury at'NOrli~ 721 If Transpotatgn inlay (Speclyl 32g. Location d iryury ISUeat. City ~ town stale)
^ Yes 131 No
\\ ^ Yes ^ No ^ Yee ^ No ^ DnverlOpwator ^ Paewtger ^ Pedestrwn
^ Sucwe ^ CauM Nd W Detemtawd
^ sucide ^ Ca,a Nor w DNemrwd M.
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To iM t>tst d my knowksdys, loth oawrsd u tM time, daN, and place. and dw to tM cwsaisl and manner as ststed_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^
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lAt 1M Dasu d eaammahon and) n ti0r1, n my opnion, dultt occurred at tM bete, daU, and p4a, and dies to tM crosses) and nlarnlM a sreteeL ^
34 Nomear,tQ",AdJdreu d Person Who Competed Cause of Deam) hem 27( Type P~nl
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