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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: ~ ,:~ ~~ Name Address Re~i hi to D edent ~ '~~''~'-~ ~~~r~ ~ _.. -;ca ._ - ;~ ~` ti ~~ t~- St:~ - ~7 Ln _? C ~ ~ -^~ ~~ Z7 .'-", USE ADDITIONAL SHEETS IF NIECESSARY .. ~~ 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 r i•^~- :- t ::.n ~ -r-i 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 ~~, t ~ ~ F' D ~~Pa i ~~~ ~,/~ h..1. C^ ~~ -v ~ __ °~ ~- o ° =r' 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.) c c°~; ~~ 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. ,~, :~~ ; ~~ ,: - ~ ~~~ - ~ :_~ ~~ p m 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 ~l,~:l~1~lIN~: ~t is ~Ilegai to du~icate~ t"r1~b~; ~:.~F)~ ,.~)~/~ :~l~cyi:c~:~t~:~t ~~ ~'~~,., o- ~. -~~ ~,; '___P .,17.5 5.7.1_.7.2 ~~~~s~til~ici~iiltl~ '~):sr'+~°: ,, ,~., :A ~t ifw a t' ? 7- a . ~.i 7 yl )Z (:r tll)I, i)t Y :xl ~"?i i r r ~lr , " - ~~, Yf l ~fE E: i@3~(I li tlr'~il.l) ?1s ~,`t.`t!(}) ~~ a ~ ,~' ~~ _. i~['~'I~,ki',tl. ~ ~1: t+[I`liia~ , „~ -"`' t ' f ~ :,rlit.~~f (fy CI~L' ~`ii<ifE` q,- ida~ ,~ sue, ~, 4 t l`E€I r'iRiJ?-'~ .... ~'r~-,Y ~', l //JJ 3~li, h ,i5~ . / UNNNNN j2 ~ ~~~ y / ,, _ ~ __ __. __. _ _ _ 6'~ -_. ~ ~: ~-= 7 ; o ~. Xj . C,_.. -ter , r'ra C . 'U C , a~ m ~ rn r-- ~ Cr ~ Uj . x _, i - _~_ f -T, ~ ~, ~; ; ~ C ~ Y ,, -.~ _ ---~ > , v y. w ~-~ O -.,,. f REV 1lnlws 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 ^ ^ ^ ~ 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 an ~ rto ken (spa~i>» I c P ua ,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 i S If if i i 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) r ^ 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? ^ ^ respiratory arrest, or ventricular fibrillation without showing the etiology. List only one cause on each line. i g Yes Probably ^ N ^ U k IMMEDIATE CAUSE (Final disease or ' ~ r ` o n nown ^ condition resuking in death) /~~' ~ ri ~ ~ ~? , u /~ r 29 It Female: ~ ~,~ O , --~- a ff~~JJ V ~~•K,J~-- r . ^ 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) ~9PY ( Y ~Y 9 I Y P P .~ ~ =% ~ 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( ) d f t d ^ 33c. License N 33d. Date Signed (Month, da ear) ~ , , , p , s an manner ae a e e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • Medkel ExamineNCoroner ~.y.~ ~O ~ ~ S ~ t C.~/ ~ / Z ~ (, 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 1 __ _ _ __ _ 003796-00001/March 12, 1993/CRW/24330 > > .. , , /~ . j ~_ µ ~•~.u,.u~ ~ ~ ~ ~x~t til ~ n~ ~~z~xmc~n~ ~ ~ C.... ... . ~ ~^Y' ~ ~ ~{ _ ry 3r RUTH K. COLLINS C...> "~ 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. f ` r, _ E '- - L ~_.C _~ l..~x.. x, ~~ i s~ E..,... I'"t"1 ~~ f _ _ ~ 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. ,.~:' ~ r>~ ~ ~~ (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 i vuv. hereunto subscribed our names as witnesses. r- r - ~_.- ~ . 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 _~ 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. A ., . ~~ . ,,.~ J 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