HomeMy WebLinkAbout06-03-11PETITLON FOR PROBATE AND GRANT OF LETTEl~.S
REGISTER OF WILLS OF Cumberland
Estate of Mary Catherine Coble
also known as
_ Deceased
COUNTY, PENNSYLVANIA
File Number ~ I `' ~ !V~ ~~~
Social Security Number 293-22-7605
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 eXeCUtOr - named in the
last Will of the Decedent dated 3/4/2002 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, was never adjudicated incapacitated, and was not a party to a pending divorce proceeding at the time
of death wherein grounds for divorce had been established as provided in 23 PA C.S. section 3323 (g):
B. Grant of Letters of Administration
(If applicable, enter: c. t. a.; d. b.n~.c.t.a.; pendente life; durante absentia; durante mr,noritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if a.ny) and heirs: (lf
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Decedent, then 86 years of age, died on 5/24/2011 at Golden Living, West Shore
770 Polar Church 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
207 N 17th Street, Camp Hill, PA 17011
situated as follows:
$ - 550,000.00
$ -
$ -
$ - 125,000.00
TOTAL: $675,000.gO
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 undersiened:
igna_t re Typed or printed name and residence
David H. Stone 414 Bridge Street
New Cumberland - PA 17070
Page 1 of 2
Form RW-02 rev. 10.13.06
(COMPLETE INALL CASES:) Attach additional sheets if necessary. ~ .,~ ~ `
Decedent was domiciled at death in Cumberland Count ,Pennsylvania, with his /her last principal residence at
207 N 17th Street Camp Hill PA 17011 Borough of Carrp Hill
(List street address, town/city, township, county, state, =ip code)
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) oft e Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or a-ffi!-med dnd subscribed
before me the `~~._ day of
For the Register
Signature~f~-'exsarlal Represtive
Signature of Personal Representative
Signature of Personal Representative
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File Number: --~ ~ - ~ ~ - L~ -~ ~ ~- ~ ~~ ___.
Mar Catherine Coble ,Deceased `~
Estate of
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Social Security Number: 293-22-7605 Date of Death: 5/24/2011 -
AND NOW, ~ ~C.t ~ ~ U ~ ~ ~ ~ ,~.==, in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters TeStamentar~/ -
are hereby granted to David H. Stone -
in. the above estate
and that the instrument(s) dated March 4 2002 - - --
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES al ~K,~t `--~ "" , .~ - ~, ,. ~. .v~W -- - -
`~ ~ Register of Will '~r ~~` j ~~~'~~) CSC-~,~
~~ tti
Letters ............................. $ -
Short Certificate(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ , ~ Attorney Signature: -- -
`-
Renunciation(s) ~~~~~~~~~~~~~~~~ $
~~ ` ~) $ l ~ ~ Attorney Name: DaVld H. Ston , EvGuire
CS ~~~~ $ 1~ Supreme Court I.D. No.: 39785 -
$ Address: 414 Bridge Street -
~~~~ $ New Cumberland -
.... ~
$ PA - 17070
$ 717-774-7435
$ Telephone: -
TOTAL ............................. $
Form RW-02 rev. 10.13.06 Page 2 Of 2
C)C:AL REGISTRAR'S CERTIFIC:ATIC~N C)F C)!~A'~~!~
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I PRINT IN
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) eTeTe cu ~ nu woo
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1. Name of Decedent (First, middle, last, suffix) 2. Sex 3. Social Seculty Number 4, Date of Death (Month, day, year)
Mary Catherine Coble Female 293 - 22 - 7605 May 14, 2011
5. Age (Last Birthday) Under 1 ear Under 1 da 6. Date of Birth Month, da , ear 7. Birth lace C' and state or for e) count 8a. Place of Death Check onl one
Mogths
Days
Hours
Minutes
Hospital: _
Other:
86 Yrs. March 8, 1925 Camp Hill, PA
^ Inpatient ^ ER i Outpatient ^ DOA
®Nursing Home ^ Residence ^ Other -Specify:
8b. County of Death 8c. City, Boro, Twp of Death Bd. Facility Name (If not irtgtittfion, give street and number) 9. Wes Decedent of Hispanic Origin? ~] No ^ Yes 10. Race: American Indian, Black, White, etc.
Cumberland E. Pennsboro ~-+~.,~,
y ^
• Golden Livin West Shore
g (It yes,specityCtfian, (Specify)
Y s Mexkan, Puerto Rican, etc.) Whit e
11. Decedents Usual atbn Kind of work d one d ud most of world IRe. Do rat state retired 12. Was Decedent ever in the 13. Decedents Education (Specfy only highest grede corttp leted) 14. Marital Status: Marled, Never Monied, 15. Surviving Spo use (If wHe
give maiden name)
Kind of Work Kind of Business /Industry U.S. Armed Forces? Elementary /Secondary (a12) College (1.4 or 5+) Widowed, Divorced (Speci/y) ,
Dietician State Government ^Yea ®No 12 4 Never Married
16. Decedents Melling Address (Street, ~i /town, arses, Zip rode) Decedents Penns lean i a Did Decedent
Y Live in a
Actual Residence 17
St
t
^
2 0 7 North 17th Street a.
a
e
17c.
Yes, Decedent Lived in _ Twp,
Township?
Cam Hill, PA 17011 17b. Coun Cumberland 17d.~ No, Decedent Lived within
ty Actual Limits of Lamp Hill Ciry/Boro
18. Father's Name (First, middle, last, suffix) 19. Mother's Name (First, middle, maiden surname)
Ra mood David Coble Mar Catherine Foltz
20a. IMortnants Name (Type / Plnt) _
20b. Informant's Mailing Address (Street, city / rown, state, zip code)
Katherine A. Hilton 420 Paige Hill Road, Landisburg, :PA 17040
21 a. Method of Disposition t ~ Cremation ^ Donation 21 b. Dale of Disposition (Month, day, year) 21 c. Place of DlsposNion (Name of cemetery, crematory or other place) 21 d. Location (City /town, state, zip code)
^ Buhl ^ Removal horn State i Wes Crematon or Donation Aulhorfrad
^ tDtMr. r by Medcal ExaminerlCoroner? ~Yes^ No May 2 7 , 2 011 Evans Crematory S c ha a i= f e r 5 t own PA 17 0 8 8
s
22a. Signature of Funerel Service Licensee rson acti as such)
~ 22b. License Number 22c. Name and Address of Fadlity
~ FD 013 340 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
Complete Rams 23ec only 'ng 23a. To the best of my knowledge, death occurred at the time, date and place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day
year)
physician is not available at time of death to ,
certlly cause of death.
Rams 24.28 must be completed by person 24. Time of Death 25. Date Pronounced Dead (Month, day, year) 26. Was Case Refered to Medical Examiner /Coroner for a Reason Other than Cremation or Donation?
who pronounces death. l ; ~'Z P M. a 2y 2p i ~ ^ Yes
No
CAUSE OF DEATH (See inatructlona and exampba) r Approximate interval: Pal II: Enter other gjnnlflcant condRlons contdbttinc to death 28. Did Tobaceo Use Contlbute to Death?
Item 27. Pert I: Enter the chain of evems -diseases, injules, or complications -Net dlredty catued the death. DO NOT enter terminal events such as cardiac artest, ~ Onset to Death but not resuMng in the undelying cause given in Pal I ^ Yes ^ Probably
respiratory arrest, or ventlcular fiblfiation wflhout showing the etioagy. List only one cause on each line. r
r ^ No .{Unknown
IMMEDIATE CAUSE (Final disease or
condition res m death ~ '/ ~+ /~ r
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Due to (or as a cortsequertce of): r
,,rJ rvot pregnant wimin past year
Sequentially list conditions, l any, b ~
badng to the cause Noted on Nne a ^ Pregnant at time of death
^
.
Enter Rte UNDERLYING CAUSE Due to (or as a consequence oQ: i
Not pregnant, but pregnant within 42 days
(disease a inj that inRialed tM r
events resulting ut death) LAST' c i of death
^
Due to (or as a consequence ofJ: Not pregnant, but pregnant 43 days to 1 year
r
d. r before death
^
r Unknown R pregnant wihin the past year
30e. Was en Autopsy 30b. Were Autopsy Findings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. DescrR>a How Injury Occurred 32c. Place of Injury: Home, Fann, Street, Fadory,
Pelamted? AveNable Prat to Completion
Natural ^ H
midde Office Buildng, etc. (Specify)
of Cause of Death? o
^ Yes ~ No ^ Yes ^ No
^ Accident ^ Pending Investigation
32d. Time of Injury
32e. Injury at Work?
32f. R Transportation Injury (Specify)
32g. location of Injury (Street city /town, state)
^ Suicide ^ Could Not be Determined ^ Yes ^ No ^ Driver/Operator ^ Passenger ^ Pedestdan
M ^ Other - Spedfy
33e. Certtfler (check onN ~) 33b. SI atu a Title of Certi r
9rt
• CMtiying physician (Physkxtiaan certifying cause of death when another physidan has pronounced death and completed Item 23) , ~. %~
To the Neat of my knowledge, death occurred due to tM cause(s) and manner u elated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Pronouncl and CMt h Clan Ph kaan bolo onound death and cart
Ilg Ifying p yal ( ys pr ng ifyng to cause Of death)
33c. Laenae Number _
33d. Date Signed (Month, ley, year)
To tM beat of my knowledge, death occurred M the time, date, end pbce, end due to tM cause(s) and manner ea eteted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ !~ y-
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• Medcal ExaminerlCoroner I~
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On tM basis of examination and / or Inveatlgetlon, in my opinion, death accuned at tM time, date, and piece, end due to tM cause(s) end manner es atekd_ ^ 34. Name and Ad`~tess Person d of Death Item 27) T ce I P174t
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35. Registrar's Si re and Digtrat r A/ 7 / ~ ! ~
~ 36. Date Flied (Month, day, Y~) '
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Disposition PertnR No. l y.x I ~ Zl.?
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LAST WILL AND TESTPiMENT ~~+~ ~ ;--~ ~
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MP,RY CATHERINE COBLE ~~- ~ ~ c,~ "~ ~=="
f._lS~~ _
MARY CATHERINE COBLE, of the Borough of Camp Hill: Counter of `-'~
I,
Cumberland, and Commonwealth of Pennsylvania, declare this to be my
last will and revoke any will previously made by me.
ITEM I: I bequeath my automobiles, household and personal
effects and other tangible personalty of like nature (not including
cash or securities) together with any existing insurance thereon, to
my sister, SUZANNE ELIZABETH COBLE HILTON, and my niece, KATHERINE
ANNE HILTON, or to the survivor of them.
ITEM II: I devise and bequeath the residue of my e:~tate, of
every nature and wherever situate, including any property over which I
shall have any power of appointment, to the then acting Trustee under
that certain trust created by me on July 21, 1972, as amE?r~ded, in
which I am the Settlor to have and to hold, IN TRUST, for the uses and
purposes and subject to the terms and provisions thereof, including
any alterations or amendments thereto, or any other trust which may
hereafter be substituted therefor.
ITEM III: 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 tr.i,s will,
together with any interest or penalty imposed in connection with such
Page 1 of 4
tax, shall be considered a part of the expense of the administration
of my estate and shall be paid from my residuary estate without
apportionment or right of reimbursement, provided that any taxes on
the trust created by me on July 21, 1972, as amended, may k~e paid from
the assets of that trust as provided therein.
ITEM IV : I direct tnat in L~~~ dU1LLllll~ ~-i Q ~-~-~il `-'~ ~"1' "•" ""' ` _ , _ 1
Executor not sell my real estate at public auction.
ITEM V: I appoint DAVID H. STONE, Executor of this my last will.
Should DAVID H. STONE, fail to qualify or cease to act a~~ Executor, I
appoint CHARLES H. STONE, Executor of this my last will.
ITEM VI: I direct that my Executor and Trustee shall not be
required to give bond for the faithful performance of his duties in
any jurisdiction.
IN WITNESS WHEREOF, I, MARY CATHERINE COBLE, have hereunto set my
hand and seal this ~`~ day of ~ r-~-, _, 2002.
`~-* „~,,
MAR CATHERINE COBLE
SIGNED, SEALED, PUBLISHED and DECLARED by MARY CATHERINE COBLE,
the Testatrix above named, as and for her Last Will and Testament, and
Page 2 of 4
in the presence of us, who at her request, in her presence and in the
e of each other, have subscribed our names as witne~>ses.
presenc
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Witness ~
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Witness
COMMONWEALTH OF PENNSYLVANIA)
SS .
COUNTY OF CUMBERLAND )
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Address
I, MARY CATHERINE COBLE, the Testatrix whose name i:~ signed to
the attached or foregoing instrument, having been duly qualified
according to law do hereby acknowledge that I signed and executed thi~~
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
contained.
MA CATHERINE COBLE
Sworn to or affirmed to and acknowledged before me by MARY
CATHERINE COBLE, the Testatrix, this -~ day of __~~~~ 2002.
No ary Pu is
......... _~.,.s..~~..~.,...~..~~~____----
~~~ ~~F~1~ SEAL
Page 3 o f 4 k - ;~~ ~~ ~.~C'b(~'d, NotBty PubI1C
~~~~ ~~~i~.~~~i~ id I~~. Cumb~'~td Co.
~, C~~~ ~~~s~~~ I:,~ir~s t 27, 2006
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND )
~ ~,~ and ~. A. ~ ~~_~
We,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, depose and say that
we were present and saw Testatrix sign and execute the ins-~rument as
her last will; that Testatrix signed ~f~illingly 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; that to the best of our knowledge, the Testatrix
was at that time eighteen or more years of age, of sound mind and
under no constraint or undue influence.
~f ,~ss
Witness ~°
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a -'
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Witness
,,. Sworn to or ,affirmed to d acknowledged before me by
r~ and ~~ -
this ___~___ day o f ;~'t [(T. _ , 2 0 0 2 .
witnesses,
~_~
tary Pu lic C
-- ..,~
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