HomeMy WebLinkAbout07-15-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of Rutn K. couins ,Deceased ESTATE N 0:21- I ~ - C`> ~7 ~
a/k/a:
a/k/a:
a/k/a:
SS N ~ : 201-16-1893
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
~ A. Probate and G rant of Letters Testamentary or^Administration c.t.a., or d.b.n.c.t.a. (comp/ete Part C also)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters Testamentary under
the last Will of the above-named Decedent, dated -M~,.~ ~-1 ~ I ~`l 3 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
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person, a n d was not a
party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in
23 Pa. C.S.A. § 3323(8):
^ B. G rant 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 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 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(8), except as foKo~ws:
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Name Address Re~i hi to D edent ~ '~~''~'-~
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USE ADDITIONAL SHEETS IF NIECESSARY
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THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence
At ~~~ r~r..i Cam.-,,,,~ ni..... ~.......u.,,..i.......~ nn ~ ~n-~n o.,......,.~.. ..c n~..... ~....,..i...._~__~
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City)
Decedent, then 87 years of age, died fi125~2Q1i at So~-rH ('~"r~-r~U^l ~.,.,~.
(Month, Day, Yeaz of death) (City and State where death occurred)
E St i m ate d value of decedent's property at death:
If domiciled in PA
If not domiciled in PA
_If nOt domiciled in PA
_Value of Real Estate in Pennsylvania
Total Estimated Value
$ -
$ 160.000
$ ~ .c~IC'~~~n
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s) Name(s) & Mailing Addresses}
arbara C. Oyler, 1550 Longs Gap Road, Carlisle, PA 17013
Interim Form RW-02 revised 12.26.10 by Cumberland County nendine action by the Court Paa~~ ~ ~,+'~
All personal property
Personal property in Pennsylvania
Personal property in County
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OATH OF PERSONAL REPRESENTATIVE
Commonwealth of Pennsylvania ~ SS
County of Cumberland =
The Petitioner(s) herein named swear or affirm 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 affirmed and subscribed
before me this _~ , ay of
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For the Register J ~ '~`'
DECREE OF PROBATE AND GRANT OF LETTERS
described in the petition be
Estate of ~j (~~ ~ ~ C ~ ~ ~ ~ ~ ,Deceased File Number: 21- ~ ~ ~ - ~ ~
AND NOW, this .._L day of ~ ` I ` ` ~ , in consideration of the Petition on
the reverse side hereon, satisfactory proof having een presented before me, IT IS DECREED that Letters
X Testamentary - of Administration are hereby granted to:
- (If applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.)
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the above estate and that instruments(s) dated ~~.,
admitted to probate and filed of record as the last Will
FEES:
Letters ....................$ ~ I >w
Will ........................ i'S • .mss
Codicil(s) .................
(~5) Short Certificates I ~ • CMG
( )Renunciations.......
Bond ............................
Other ............................
.................................
Automation FEE......... 5.00
JCS FEE ................... 23.50
Codicil(s) of Decedent.
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Glenda Farner Strasbaugh,~ ~-~~~~ U~; ~~t~ _~,~ 1.
Register of Wills
Signature of Counsel Required to Enter Appearance
Atty's Signa re ~~-~'~~' ~ ate-'
PRINTED Name: Tim^ ---thy--
Supreme Court ID No.:R~~ss~
Address:
Phone:
Fax:
Page 2 of 2
Interim Foml RW-02 revised 12.26.10 by Cumberland County pending action by the Court
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I PRINT IN
tMANENT
ACK INK
COMMONWEALTH OF PENNSYLVANIA a DEPARTMENT OF HEALTH .VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) __.__ _.. _ ......___
1. Name of Decedent (First, middle, last, suffix)
2. Sex _ - --
3. Social Security Number --..
4. Date of Death (Month, day, year)
Ruth K. Collins Female 201 - 16 ,- 1893 June 25, 2011
5. Age (Last Birthday) Under 1 ar Under 1 da 6. Date of Birth Month, da , ear 7. Birth ace Ci and state or (oral count 8a. Place of Death Check on one
Mods Deys Hours Minulas Hospital: Other
87 vrs. January 15, 1924 Harrisburg, PA ^
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Inpatient
ER /Outpatient
DOA Nursing Home ^ Residence
^ Other- Speedy
Bb. County of Death Bc. City, Boro, Twp. of Death 8d. Facility Name (If not instdution, give street and number) 9 Was Decedent of Hispanic Origin? ~ No ^ Yes 10. Race: American Indian, Black, White, etc.
Cumberland S. Middleton Twp. Cumberland Crossings (
dexi
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rto ken (spa~i>»
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P
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,etc.) White
11. Decedents Usual Occu bon Kind of work done d unn oast of worki life. Do not state retired 12. Was Decedent ever in the 13. Decedents Educatbn (Spedly only highest grade comp leted) 14
Medtal Status: Married
Never Married 15 S
rvi
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S If
if
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Kind of Work
Kind of Business/ Industry
U.S. Armed Forcesl
Elementary /Secondary (0-12)
College (1-4 or 5+) .
,
,
Widowed, Divorced (Specify) u
v
ng
pouse (
w
e, g
ve ma
den name)
Secretar Education ^ Yea ®Ne 12 Widowed
16. Decedents Mailing Address (Street, city /town, state, zip code) Decedents Did Decedent
Penns
lvania
7 5 7 Caro 1 Street y
Ac1ualResidence 17a.State
Liveina 17C. Twp
^ Yes, Decedent Lived in
New Cumberland
PA 17070 .
Township?
17b.Counry Cumberland 17d.®No,DecedentLivedw@hin New Cumberland
, Actual Limits of City I Boro
18. Father's Name (Prat, middle, last, suffix) 19. Mother's Name (First, middle, maiden surname)
Frederick Kohle Leora Brenisoltz
20a. Informant's Name (Type /Print) 20b. Informant's Mailing Address (Street, city /town, state, zip code)
James J. Collins, II 21 Holly Street, Mt. Holly Springs, PA 17065
21 a. Method of Disposition r ^ Cremation ^ Donation 21 b. Date of DisposRlon (Month, day, year) 21c. Place of Disposkion (Name of cemetery, crematory or other place) 21 d. Location (City l town, state, zip code)
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^ Burial ^ Removal from State r WaaCremetbnorponeUonArdhonzed ^
® other - s entombment I by Medical ExaminerfComner? ^ Yes No
June 30 2011
s
Rolling Green Cemetery
Lower Allen Twp. , PA 17011
22a. S' re of neral S icensee (o n acting as such) 22b. License Number 22c. Name and Address of Facifiry
- FD 013 340 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070
Complete items 23a-c Doty when certitying 23a. best my knowledge, death occurred at ime, date and place stated. (Signature and title) 23b. License Number 23c. Date Sign d (Month, day, year)
physician is not available et time of death to
certity cause of death. ~~ ~ ~~/
Items 24-26 must be completed by person 24. Time of Death
^
' 26. Date unced Dead (Month, day, year) 26. Wes Case Re erred Medical Examiner I Coroner for a Reason Other than Cremation or Donation?
who pronounces death. /
^
/
) M. 5 ! ^ Yes No
CAUSE OF DEATH (See inatructlon d examples) , Approximate interval:
Item 27. Pan I: Enter the chain of events -diseases, injuries, or complications -that directly caused the th. DO NOT enter terminal events such as cardiac arrest, i Onset to Death Pan 11: Enter other sigp'rficant conditions contribu6nq to death
but not resulting in the underlying cause
iven in Pan I 28. Did Tobacco Use Contdbute to Death?
^
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respiratory arrest, or ventricular fibrillation without showing the etiology. List only one cause on each line. i g Yes
Probably
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IMMEDIATE CAUSE (Final disease or ' ~
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condition resuking in death) /~~' ~
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29
It Female:
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Due to (or as a consequence oQ: i Not pregnant within past year
Sequentiallyy list cenditlons, H any, h ~
leading to the cause listed on line a. ^ Pregnant at time of death
i
Enter the UNDERLYING CAUSE Due to (or as a consequence oQ: i ^ Not pregnant, but pregnant within 42 days
(disease or injury that inPoeted the i of death
events resulting in death) LAST. °' r ^
Due to (or as a consequence of), r
r Not
pregnant, but pregnant 43 days to t year
d. i before death
^ Unknown if pregnant wtthin the past year
30a. Wes an Autopsy
Penormed? 30b. Were Autopsy Findings
Available Prior to Completion 31. Manner of Deets
I~7~ 32a. Date of Injury (Month, day, year) 32b Describe How Injury Occurred 32c. Place of Injury: Home, Farm, Street, Factory,
of Cause o1 Death?
uu Natural ^ Homicide Office Building, etc. (Specify)
^ Yes No ^ Ves ^ No
^ Accident ^ Pending Investigation
32d. Time of Injury
32e. Injury at Work?
32f. It Transportation Injury (Specify)
32g. Location of injury (Street, city /town, state)
^ Suicide ^ Could Not be Determined ^ Yes ^ No ^ Driver/Operator ^ Pa r ^ PedesMan
M ^ Other -Specify:
33a. Certifier (check only one) 33b. Signature an r
• Cart n h sicisn Ph siclan ce ' m cause of death when anomer rh sician has ronounced death and corn feted Item 23)
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To the beat o} my knowledge, death occurred due to the cause(s) and manner es stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~
• Pronouncin and cart In h aician Ph sician both onouncin death and cart
9 nY 9 P Y ( Y Pr g Ifying to cause of death)
To the beat of my knowledge
death oeeurted et the time
date
and
lace
end due to the cause(
)
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^ 33c. License N
33d. Date Signed (Month, da ear)
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_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
• Medkel ExamineNCoroner ~.y.~ ~O ~ ~ S ~ t
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On the basis of examinatbn and / or Investigation, In my oplnlon, death occurred et the time, date, and place, and due to the cause(s) and manner as atated_ ^ 34. Name and Address of Person Who Completed Cause of Death (Item 27) Type /Print
Registrar's Sig and District I ~ ~ ~' ~ I ~I 36. Date Fit (Month, ay, Year) C~'C'g~\ ~~ l_~l°J}-L~~ ~ ~~ ~' ~~ '
Disposition Permit No. ~~ ~ ~ U J"t
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003796-00001/March 12, 1993/CRW/24330
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RUTH K. COLLINS C...>
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I, RUTH K. COLLINS, of the Borough of New Cumberland, County of Cumberland, and
'ommonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby
lake, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills
eretofore made by me.
ARTICLE I
I direct the payment of my legal debts and the expenses of my last illness and disposition of my °
remains from my estate as soon after my death as conveniently may be done. All of the foregoing shall be
considered expenses of the administration of my estate.
ARTICLE II
I bequeath all of my tangible personal property (excluding cash or securities), together with any
existing insurance thereon, to my husband, ROBERT L. COLLINS, if he survives me for a period of thirty
°
(30) days. If he does not so survive me, I bequeath said tangible personal property to my children, JAMES
~I. COLLINS, II and BARBARA C. OYLER, to be divided between them in as nearly equal shares as
possible by my Executrix after giving due regard for their personal preferences.
i
ARTICLE III
I devise and bequeath all of the residue of my estate to my husband, ROBERT L. COLLINS, if
he survives me for a period of thirty (30) days. If he does not so survive me, I devise and bequeath all of
the residue of my estate in equal shares to my children, JAMES J. COLLINS, II and BARBARA C.
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003796-00001/March ]'~2, 1993/CRW/24330
OYLER. Should any of my children have predeceased me, the share of such deceased child shall be
distributed to his or her issue, per stirpes. In the event that a child of mine has predeceased me without
leaving issue to survive, the share of such deceased child shall be distributed to my surviving child or the
issue of any child who has predeceased me leaving issue to survive, per stirpes.
ARTICLE IV
I appoint my husband, ROBERT L. COLLINS, Executor of this my last Will. In the event of his
inability or unwillingness to act or continue to act as Executor, I appoint my daughter, BARBARA C.
OYLER, Executrix.
ARTICLE V
I direct that my Executor, or his successors, shall not be required to give bond for the faithful
performance of their duties in any jurisdiction in which they may be called upon to act, insofar as I am able
by law to do so.
IN WITNESS WHEREOF, I hereunto set my hand and seal this '~`~ ~Zlay of May, 1993.
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(SEAL)
Ruth K. Collins
Signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and
Testa:n~nz i.~ :he presence of us, ~:~h:, ut her .eyuc;;t, i:s ";:- prose cc u~ d ii, tl:, presence a~ °"^~'1 other have
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hereunto subscribed our names as witnesses.
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003796-00001/March 12, 1993/CRW/24330
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
I, Ruth K. Collins, Testatrix, whose name is signed to the foregoing instrument, having been duly
qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will
and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes
therein expressed.
Ruth K. Collins
'~ _
Sworn or affirmed to and acknowledged before me, by Ruth K. Collins, the Testatrix, this j ~ J
day of May, 1993.
Notary Public
NOTARIAL SEAL
SHARON L. PREBLE~ NOTARY PUBLIC
LEMOYNE BORO. CUMBERLAND COUNTY
MY COMMISSION EXPIRES MAR. C4. 1994
003796-00001/March 12, 1993/CRW/24330
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
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W e, ~~ ~ ~ ~ ..l..?..,,~„_~.~1I ~Y ~ C_ ~X'". and ~~~~~ l ~.~~t'_.x ~ f ~ ~~ ~ _~`~i_{./ ~ ~` the witnesses
whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and
say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will
and Testament; that she 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 least 18 years of age, of sound mind
and under no constraint or undue influence.
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Sworn to or affirmed to and subscribed to before me by ?~ ~' ~~C_~ rf ~~" and
1 ~ ~ `a '~._.~(~ ,witnesses, this w~`~~ day of May, 1993.
Notary Public '~
SHARON L. PREBLEL NOTARY PUBLIC
LEMOYNE BORO. CUMBERLAND COUNTY
MY COMMISSION EXPIRES MAR, P4, 1994