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Home My WebLink About05-19-11IN THE COURT OF COMMON PLEAS OF CUMBE BLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of (~ (; Zabd~~ alk/a: - ,Deceased ESTATE NO: 21- - ~'~ ~ ' J -~~ 1 ~ - ~rv4 a/k/a: a/lc/a: ss No: - ~, - 2'22 ~ Petitioner(s) who is/are 18 yrs of age or older, a 1 ies f appllcable: PP Y( ) or. COMPLETE SECTION `A' or `B' AND «C" as L~Probate and Grant of Letters Testamenta or ^Ad and aver that Petitioner(s) is/are entitled to the aforementioned1Letterso Tya~~ or d.b.n.c.t.a. (complete Part Calso) the last Will of the above-named Decedent, dated hnA ~ '~"`' ~"`' ~ ~ ~ Zvv '~' and codicil(s) dated --- under (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 chit instruments offered for probate; was not the victim of a killing, was never ad'udic d born or adopted after e:Kecution of the party to a pending divorce proceeding at the time of death wherein grounds for divor ecapacitated person, and was not a 23 Pa. C.S.A. § 3323(g): had been established as defined in p B. Grant of Letters of Administration (If applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate) C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no following spouse (if any) and heirs (If Administration c.t.a. or d.b.n.c.t.a., enter daWill and was survived by the heirs); was not the victim of a killing; was never adjudicated an incapacitated erso of Will in Section A and complete list of proceeding wherein grounds for divorce had been established as provided in 23 PanC.S s not a party to a pending divorce Name •A• § 3323(g), except as follows: ~ ~,, Address Relationshi to Decedent ""' E' 1J~. ` ~' I U ~Y' 1 ,c J ~ ~ .--- USE ADDITIONAL SHEETS IF NECESSARY ~ ~" ' ~ ~ . ~ _~ THIS SECTION MUST BE COMPLETED: ~` ~ - __ _ Decedent was domiciled at death in Cumberland C un ~ ~ ~ ~` ' At • ,ti, - ~ ~ ~ ~.~ ~ ,~ ~ CAS ,; ~ l~ ~~ ty, Pennsylvania, with his/her last farnil-~ erprinc~i-pal residence (Street address with Post Office and Zip Code, Munici li ~T ~ ~ s _ -- Pa ty ownsh~p, Borough, City) -~-~ _._ . Decedent, then ~ ~ -- - _ i years of age, died ~ ll p 2 p 11 at C~ ~ - ~ ~ ~ ~~ ~ ~ - ~ ~ o Estimated value of decedent's roe (M h, aY. ear of death) ~ ~ -- ~ ~ P p rty at death: (City and State where death occurred) _If domiciled in PA _If not domiciled in PA All personal property , _If not domiciled in PA Personal property in Pennsylvania $ ~ ~~' ~~~ _Value of Real Estate in Pennsylvania Personal property in County $ - Total Estimated Value $ - Location of Real Estate in Pennsylvania: (Provide full address if possible.) $ -~Uf ~' `-'~ ca v Signature(s) -___________ --~~ Name(s) & Mailing Address(es) Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 1 of 2 " ~~ ~~ r OATH OF PERSONAL PRESENTATIVE Commonwealth of Pennsylvania County of Cumberland SS The Petitioner(s) herein named swear or affirm that the statements in correct to the best of the knowledge and belief of Petitioner(s) and tha h as oregoing Petition are true and Decedent, Petitioner(s) will well and truly administer the estate ac Personal representative(s) of the cording to law. Sworn to or affirmed and subscribed . -a before me this f ~ ~ ''-' ~ ~ day of :~ .. 4 , T -~ , ,. 1 / - .~ _._.. , -;~.7 ~.~ For the Register :~ ;. ~; _._.. _:, _- l DECREE OF PROBATE A ~~~ r ,, e F . - _. ND GRANT OF LETTERS ~-~ ~ ~ ~ `~~ . ;~ Estate of ~. ~ ~ ~~ ~ ~ ff'l ~ ~~~ rl ~~ t ° ~ ~ ~-: Deceased File Number: 21- ~ _ ~' ~~ _ ~ ~ AND NOW, this ~~ day of the reverse side hereon, satisfactory proof haul been r , in consideration of the Petition on Testament p esented before me, IT IS DECREED that Letters ary of Administration (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., erc.) are hereby granted t0: the above estate and that instruments(s) dated in admitted to probate and filed of record as the last Wi1 lh y ~~ described in the petition be 1 and Codlc><1(s) of Decedent. lends Farner St ~i ~ ~ rasbaugh, Register of Wills ~". ~-~~~C~(,~~~C ~~ FEES: Letters. , , .. , Will....~:2.~ ..... $ ~ ~~` ....... Codicil(s) .............. . . (~ L) Short Certificates ( )Renunciations..... .. Bond .................... ........ Other ............................ ........................... Automation FEE......... . 5 00 JCS FEE .................. . 23.50 TOTAL ................ $ 5 --_ Signature of Counsel Required to Enter Appearance Atty's Signature PRINTED Name: Supreme Court ID No.: Address: Phone: Fax: Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2 OCAL REGISTRAR'S CERTIFI WARNING: It is illegal to du licate t ~ CATION OF DE.~~,1rH p his copy by photostat or photograph. Fee for this certificate, $(~.Op P ~72975D2 Certification Number This is to certify th)_(t the infor~r-ation here given is correctly copied fr1:,m an ori~~inal Certificate of Ueath duly filed with i71f' as Local Re«~.~ ~IStrar. The original certificate wi11 ht' li)rw.u-ded to the State Vital Records Office Tor permanent filing. ~~ ~~_" ,S f f I' Local Re17 - - ~ .~ -~ ,~istral . ; , _ Uta~~ ;7s~ued ~ -~ _ ...., ` i =i .. _: ,; z~ . ~ ~:. ~ ~ --; , H105-143 REV 11kn06 PERMANENT TYPE /PRINT N4 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH .VITAL RECORDS BLAI~( INK 1. Name d Decederd (Pest middle, lest, suffix) (See i^stEruRCtlon~s a^d a amp~~ on averse) 2 ~ STATE FILE NUMBER Kauffroath 3. social secaMy rkanbar . s. Asa (fast ekmmy> ~„ 1 female 527 36 - 2226 a. Dana d Deem ( m, my, year) Monmc D under, fi.Deced&rm Made, , 5/10/ 81 m Hours tAa,aee +md sfak a Doan Ba. Plea d Death Chsdc on axe 201 1 Yom. 4 / 12/ 1930 Hasp;tal: a,b. Counry a Dann, Point Marion PA shat - ~ sc. Ciry, eao. Twp. of Deem 8d. FaciAry Name (M na inananon, give sheet and ~ ^ Int+t ^ ER / ougpenem ^ ppA CIBTIbeY'land ~~ r""~B`i 9. was Decedent d s Hone ^ Residence ^ Other - spedry ~~~ Hepatic origin? ®No ^ Yes , 0. Rae: Anxerican Indian, • 1,. DecederM's lbual C~mlberland CrossincJS I?l yes, spedry cues„ l~etlt, wnma, ~ Kind of work done mast d Ala. Do not state re' Mexkbn, Puerto Riau, eld.) ( Kind d Work 12. Was Deadsra ever in mB 13. Deadenis E ~~,1., },...__~_, er KinddBuekrps/Irldustry U.S. Amiad Faces? ~as0n ( ad' t grade congbtad) 14. Marital Status: Married, Never Married, 15. SurvF wit1te •~~~~13K Elementary /Seconds ) an9 Spouse (If wAe, 16. Decedents Mani ^ tea ~ No ry (tY12 1;o11egg (1-4 or St) WldOe'~• Divorced (Spearyj give maiden name) ns Address (Street dy /town, state. zip code) W].C~OW 1 ~ngsdorf Way ActrResiaertce na. state PA Did Deaden, Carlisle PA 17015 „~. ~,ry ~nberlar~ 17a. ®Yp, Decedent l.~ed ~, _~~ ~~~~ 18. Female f4ertle Brat, T ~ ( middle, last, sulfa) 17d. ^ No, Decedent Uuetl winin T"'D• #+a ro 1 CI 19. MomMa Name F ~ L~ of ~_- 20e. IM°rtna"ra Name B 1 X 1 e r (••t midde mel°""um°"") City/ eoro ~'~/Pnnq Hattie ~'a MeA Grimm 21a Memod d Di "~s A (Street city / bwn, aide, zip node) Kauffro h Mech. ~ ^ o^nwr 9aiel ^ Renaval non sofa ; Wp Crernetion ^ Donation 21b. Dated PA 1 7 0 5 5 r Cnrnallort a Donatlon Aumor~ Dep06E0" (~~~ ~Y. Year) 21c. Place d Dispanion (Name d 2za. F by r.dlal Examy,ar/caro„an ^ rp^ No 5 / 1 1 / 2 0 1 1 (V~„g~g ~ & ry~~y P~Ce) z,d. I.oaanan (city/tawn. state. np cqt,) ~~ (« ~ tia`"a "'"'~' 2zc. Nana and Address d FacAity ""tt~3~~ PA 17¢5 items 23ac when artrryirg 23a. Tome d ~ ~9 ~ & ' pyaidan ro na avaAable at time d loam a r"'` af01M~~~ dBBm t m. tim.. day and plate stated. (si9nawre and Dale) ~ F» Mein St. M~ PA 17055 arYry sup d dpm. ~• Manse Ntxnber . comvleted by parse, q 2 • who 2Pratotatop deem. 24. tans dDeem - / :. ~~ ~~~ Dead 23c. Data signed (Monet, day, year) zs. (Mash, day, Yom) „/ `-' ~ ~ C~.L ~~,j - ~ 1 M•J^ ~ z6. was case Referred w Medial Examiner / Coroner f« a Feasm Outer than U~ / Mere 27. Part 1: F~raer the CAU3E OP DEATH (gas inahualons and examples) ~ ^ Yes .~] No Crernetion « Dawtion7 -diseases, injurip, a ampAations ~ mat ~ ate' ar venbiader fibrfiletion wimout showing me eadogy~~ eased me deem. DO NDT enter terminal evems such as ardac shpt ~ ~~1e ~~: Part II: Emer oma gUSE ,_ 1 d~ease a \ ady are sup on each Ana. ; Onset W Deem but not resuMkg h me urxbdying ease 28. Dld Tobacco Use Corrtilbuk to Deem? CiN,~ ~~ ,/ /' given Y. Part L G Yes ^ P r ^ No ^ ~k„~ Due to (« p a ~. Yet oard(noro, 4 any, -_ cataequerw;e t 29. If Frnale: b. r (dresses a 14DER~VIt4G CAUSE a. Due to a as a consequence ' ^ Not pregtgrd winin past year ~' mat kitieted me ( dJ' r event rssuMin9 n dpm) LAST. c r ~- ^ Pregnarrt at time d deem ~ • Duero a as a ~ d ( oonaequenoe d): r ^ Not Pregrxurt, but pre9nem within 42 days d deem 3~' Po~ A~P6Y 30b. Were i ^ Nd pregnant but pregnant 43 days ld 1 year AvaaebreA ~ Fatdirga 31. Ma of Deem 32a. Data d I . t txjfae deem d Cause d Deemt~ ~ I ^ HaniCide May (Mash. day, Year) 32b. Dpaiee How Injury Ocarred ^ Unknown M pregnam within the pas, Year ^ Yes Na 32c. Prece of Injtxy: Hans, Fame, Saeet Faaory, ^ Yes ^ No ^ Aaadent ^ Pending Irnpti98tio„ 32d. Time d Iryury 32e. I ' Office Building. etc. (Spepy) ryury at Work? 32f. M Transpp,tetion Iryury (sP,p(y) _ ^ Suicide ^ Could Na he Determined 329. Location d . . 33a Certifier (dbdt «,ry ~) M. ^ Yes ^ No ^ Driver/Operates ^ aWry (Street pN / ldwn, state) ^ Pedestrian ~~n~ PhYsklan (Phyeipan Over - ~'~'• io the bps of my krgwisd9s, dp,ry ~~ dw to the a ~~ ~~n hea prona,xw;ed loam arW axnplated Item 23) 33b. Signa,ure ,a _ PfOnOtatN^9 and aertHyln9 PhYUctart (PhYsioian tom pN4 erW marxwr p elated _ _ _ - - To fhe beat d m k Pranunckg dpm and - -~ - - ^ Y nowMda.dsMnoaurredatm.tm,e,eate,ara a'~"'9wauaeddpm ------------------------ -,~ - Medial Examk»r/Coroner plan. and dos to the ease(s) and manner p statsd_ _ _ - ~ 33c. On me bst4 d examination and / a In -'' - - - /lF'1 ~ O ~ ~ ~ ,~ C 33d. Date Signed (Maim. day, year] vn9•tbn, M my opinion, dpm occurred at the nrrta, date, and - - - - - - - - C./~,~ ~ l 35. R Place, and due to the a ~ ~~ ~ ( is Signature and Drebict~lum r tree(s) and manraK p ahted_ ^ 34. Name and Address d Person Who Como1~fed Cause of Dpm (Meet 27) 7 /Print ) ( day, Year) ~S'Yt.~~ ~ l..a_~ J~ t,`] -,~-~ YPe - l ~.-, I ` Ice ~ / I ~ I .Date Filed Mmm, Q it :~cl ! i ~J(, ~ ~tc~~ Y -'I ., . Disposition PennM No. _ ~_~ `J / Form A235 Last W111 and Testament C~ ^~.~ ._..~ -, ._ __ ~ , LAST WILL AND TESTAMENT ..' ~ ~ _ - ~ ~ /~ .s -~. ,, _ f_; BE IT KNOWN, that I, betty J. Kauffroath a , ,.. ;., reside of p a y s o n ,County of G i l a , in t~ S{tate of ` J ~~ AR I NA ,being of sound mind, do make and declare this to be my Last Will r and Testament expressly revoking all my prior Wills and Codocils at any time r.~ade. __~__ ,~_ 1• PERSONAL REPRESENTATIVE: I appoint itr~ L~~P(~u~~ ~ a h t P e n n ~ . , as Personal Representative of this my~st ~il~and Testament and pr vide if this Personal Representative is unable or unwilling to serve then I appoint. "~ ~.'a~l u o a ~~ , as alternate Personal Representative. My Personal Representative shall be authorize to carry out all provisions of this Will and pay my just debts, obligations and funeral expenses. I further provide my Personal Representative shall not be required to post surety bond i:n this or any other jurisdiction, and direct that no expert appraisal be made of my estate unless required by law. 11. GUARDIAN: In the event I shall die as the sole parent of minor children, then I appoint as Guardian of said minor children. If this named Guardian is unable or unwilling to serve, then I appoint as alternate Guardian. 111. BEQUESTS: I direct that after payment of all my just debts, my property be bequeathed in the manner following: `~J ~ ~.~!?~!/~1 ~`~' ` ~ "'~o ,n?,,.rrl ~ S~ ~j''~`1 S ~}l'_-C?~' ~'-v~ ~S' :~ /~/~~ ~~~~~7f?7~!'C%~~~j" . ,~,- ~,~ ;n Y .~ g • ~"7"' ~-l~uh~ ~rD ~~' ~J~.~ ,~-,4,~ i~i/ , S 11~F'~i ~.,~ ~~ rs ,~,~-~ ~ ~;~ c~ ~2~ ~~-r ,~ y lv~~ r/ ~ tits ~~ ~/, ~ 1 ~~ N~ ~ .~ ; ~~ Tie, l N ~"~,y ~ ~:y.,~~~'` ~#-,~..~a ~ f~~.,.~ ,.~' > ,~",~tc,'..~J ~./~ ~~.,~~;~;: ~t,~'~/G?~.5~~',~ ~,~/.~`...~ ~•R /-' /„/ ~ L.-~ ~ 1 V m' Y'C'~ ~ 1/ ~i'~ C7~ f / / EJ ~- `(~/' C'' (~~ /'~ : '~`~/ / • i ~r~~ ..' j ~L ~~~ ~ ~ V^ ~' ~(. (`I~aF'~- is ~ ~5 `~~'~'~.,'4 ~, ~ ~ S' ,~ ~` ,~% ~ ~~J i r/~~ r'.J ~~ ~~' ~ .~ ~ ^'', ~'~ :~,~' t".,~:" ,` cry `'r~ `"' _.r ~ C~ ~ ~G~ , -r-~ ^ 1 ~ ; rJ Y {~7 F~~f?~/v L _~.. _ ~.. ~- , z ~.__ __ In r~ ,~ j ~ ~ , G, ~-~n ~ :?~ rG'~ - `~, ~ ~~ C•f} [J. h ~,,91V ;rs~~ ~? , fir, f ~' ~~' t1 ,-~ ~- ~ j N- °: d W r~?,,, ~ r'9' .l/~ ! A~ ~ ,~C' ~ `-~ _ -- G'` ,~.G ~.~'N1`f e"~. ~ `t.r5e' ~'~4j~ ~ f~J ~- ~., n~~ui~lKaii~i~, ~~ '~ t~~~~0~ ~~1~~Y' O~ ~ ~ ~ ~"h~ S~r~~~inc~ ~~1a1~~"s #~ u~r S ~C~C9~fltt~~~; ~~~ _ ~. ,- ..: . a- - -~ __T_! ,.~ p}y~yq ' -= ,.~,~~,-~~ r ., . ~ ~a.,~C.: -ARIZONA w~~ L:;OUNTY ;; ,~[ssion Expires ' 'Y ~ ~ ~ ,;anu~r 11, 2009 f ~~ IN WITNESS WHEREOF, I have hereunto set my hand this '1 of day of ~ ~ ~ M,~, y- , ~ ~~ °~ to this my Last Will and Testament. ^~"~ 1 ignatur 1V. WITNESSED: This Last Will and Testament of w a s signed and declared to be his/her Last Will and Testament in our presence and at his/her request and in his/her presence and in the presence of each other, we do hereby witness same on this ~ i 3 S ~~-lam-~~ ~ ~~ Ste-. , ~ z ~ s s~~i ~c~j sc~ ~ ~ Z ~ Ss mot/ ,~~ ~ _ 5 ~~~ .~ 1 L~ ~~tlE-~. ~ `~ ~~/ c. E-Z Legal Forms Witness Signature Form A235 Last Wtll and Testament LAST WILL BE IT KNOWN, that I, B e t t residentpf PAYSON Y (Elizabeth) J. Kauffroath, a ,County of G I LA , in the State of ARIZONA ,being of sound mind, do make and declare this to be my Last Will and Testament expressly revoking all my prior Wills and Codocils at any time made. 1• PERSONAL REPRESENTATIVE: ~~-, -~; ;--i ,.., --~, ..,; , - .=-, =; ,_ ~.. ~ c~~~ T; Iappoint Timothy L. Kauffroath ~ - PENNA. , as Personal Representative of this my )~st~i~ andthtown, Testament and provide if this Personal Representative is unable or unwilling to serve then I appoint M i c h a e l K a u f f r o a t h~ as alternate Personal Representative. l~tv Pe nasal RPnr ,shall be authorized to carry out all provisions of this Will and a m --~~ esentative P y y just debts, obligations and funeral C expenses. I fu~~h„~,*ovide my Personal Representative shall not be r uired to '~ any otfiei` jurisdiction, airid direct that no ex rt a ~ post surety bond in this or -~.._~ pe ppraisal be made of my estate unless required by law. 11. GUARDIAN: ~~ In the event I shall die as the sole parent of minor children, then I appoint Guardian is unable or unwilling to serve, then I appoint s Guardian of said minor children. If this named as alternate Guardian. 111. BEQUESTS: I direct that after payment of all my just debts, my property be bequeathed in the manner following: The Checking and M.M.Savings accounts at Bank of America, and mfr IRA at Edward Jones Investment are in Tim's name. He is Executor of my will,and will need these monies to pay my funeral expenses. The investment accounts at Edward Jones Investments can be .divided equally between my sons, Michael and Timothy Kauffroath, after any other and all debts are paid. The car belongs to Tim, the Title is in the safety deposit box at Bank of America. There is a seperate list suf sti g dispersing some individual items in the safety deposit box. I know you boys will handle this with love and respect for each other and pleasing to the Lord. I have chosen to amend my former will because I do not want any hurt feelings. You can each decide if you want to give your share to a ministry in memory of your Dad if you choose. I wish I had left amore Spiritual Inheritance, as well as more material inheritance. Your Dad and I have been very proud of you both, and I love you both equally. IN WITNESS WHEREOF, I have hereunto signed this, m~y Last Will and Testament, this~~-~''~day of , ~3U7 in the Town of Payson, State of Arizona ~: ~, ~~ ' ~/ Testator STATE 0'F ARIZONA COUNTY OF, ~,~~ ~~ The ~oregt~in~r ~1-~,~.+r;;,~~nt was ackno~led~ed ,.. ,., ~f YULE ft~~e C ~ ~ c~ . ~! c; 2~ ~\ CL~I Notary Public ,--- ~+ `~ My Commission ~ 1!-0 ~.,.. ~...._.~.. '----~ ~~~_--~.~.~emov l~v 1~1L~.QN ~vr ... ~=~"..i~; -ARIZONA ~7t~NTY 0 5 926 2 8 3 ~' y~ ri~r°~,. ~,~on ~xPires ~~~:~~~ 11 2009 IN WITNESS WHEREOF,1 have hereunto set my hand this day of 1~,2aorJ', to this my Last Will and Testament. Signature 1V. WITNESSED: This Last Will and Testament of w a s signed and declared to be his/her Last Will and Testament in our presence and at his/her request and in his/her esence and in the presence of each other, we do hereby witness same on this y of ~ , ~ ae~ 7 ~___.__.~--1 ..~. Signature _i' ~GVitness ' ~/ '~ Witness Signature > ~ir~~~ ~~ ~• c. E-Z Legal Forms OF NON-SUBSCRIBING WITNESS(ES) OATH REGISTER OF WILLS ~~ 1 ~~~~(~~~ COUNTY, PENNSYLVANIA _ L ~ ~ ~ ~- Estate of J,. Deceased _ ~ ~ C ~ ~ ~P I ~l~~i~r~ ~ IVl cu~ C~ ~~~v~c ~ and "' a _ ! r.~ that she / he / ey was were well- . o law de ose(s) and say(s) ~~ . (each) being duly qualified according t ~ p ~ ~ and am/are familiar p~a.v J'O acquainted with '" ~ Z~ ~~ ~, 1~ with the handwriting and signature of the decedent, and that the signature of _ ` ~ ~ ~~ z ~ re oin instrument purporting to be the Last Will and Testament/Codicil of to the fo g g . ~ ~ .~`rc; ~ .}-~, is in his/her own proper handwriting. (Signature) ~ v 3g ~ ~ (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ "l ~ day of ~-. ~~_______ ~'f I -; 1 n ~ r ~' ~~ ~ P ~~ ~~ Deputy for Register of Wills •,_ ~.~~ (Signature) ~~~ ~~ ~ .t~rL. (Street Address) (City, State, 7,,p) Form RW-04 rev. I0. X3.06