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HomeMy WebLinkAbout07-22-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ~ ~ , o (~~ ~ (' b ~ ~ ~ ,Deceased ESTATE NO: 21- ~~~~ a!k/a: a/k/a: ll 7 .JT a!k/a: SS NO:~ ~' C~ moo? - CP 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 Grant of Letters Testamentary or ^Administration c.t.a.,, or d.b.n.c.t.a. (complete Part C also) and aver that Petitioner(s) is/are entitled to the aforementioned Letters under the last Will of the above-named Decedent, dated _ 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, and 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(g): ~ B. Grant of Letters of Administration (If applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate) C. Petitioners}, after a proper search, haslhave 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. § 332,~(~), except as~ollows:~,„ --- ~n .~.... ~, ;: Name Address sbi t`I~ecedeist- ~: ~'"`j ~-~ 'T ~ - - ---- r'~' f"' ^- ~ ~. Q --, ~~ . ~ ~~;,b .. USE ADDITIONAL SHEETS IF NECESSARY v C.,. f~ :~ ~= •-~ (-~ 1 ^"T ~ ~, _ ~=~ ~' -- :--1.-1 `_... . ~ni Q "i'1 THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Penns lvania, with his/her last family or principal residence At 3 ~~~ S t .~vl ~ , r on~~! ~ ~ i ~ ~~ S (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then ~_ years of age, died at ~t, a 1 c' C.-~ onth, y, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: _If domiciled in PA All personal property $ Q _If not domiciled in PA Personal property in Pennsylvania $ ~~ If not domiciled in PA Personal property in County $ ?. Value of Real Estate in Pennsylvania $ Total Estimated Value $ ~O. ~ ~) -~ Location of Real Estate in Pennsylvania: (Provide full address if possible.) /" Signature(s) Name(s) & Mailing Address(es) ~~nne A '-~a.ss .3 t? S~ C...~(~~cz r. ~~-la ~~ 17c~. ~. tntenm Norm Kw-UZ revised 12.Zb.iU by Cumberland County pending action by the Court Page 1 oft IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ~ Q ~1 1" ,Deceased ESTATE NO: 21- ~g~f1 a/k/a: aikla: ,7 ~., alk/a: SS NO._ ~ () ~' 2~c~ -' CP 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 Grant of Letters Testamentary or ^ Administration c.t.a., or d.b.n.c.t.a. (complete Part C also) and aver that Petitioner(s) is/are entitled to the aforementioned Letters under the last Will of the above-named Decedent, dated and codicil(s) dated V (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, and 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. Grant of Letters of Administration (If applicable, enter d.b.n., pendent lite, durante absentia, durante minoritate) C. Petitioner(s), after a proper search, haslhave ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs (lf 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. § 332,0, except ash©llows: Name Address i t"Decedea~ ~~ ~"'~ T~ -- -~-- r-' ^` ~ ~ f~ ti.~ ~ 4.J ~ ....1 ~7 r,»..b USE ADDITIONAL SHEETS IF NECESSARY C _.~ f::, r= ~~ ':_:~ i -_.i 1 .. _ =~ _~ ~'T" t L~ THI5 SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Penns lvania, with his/her last family or principal residence At 3 I~~? .S7 ,ny~ ~ ~r ~n~~! ~ ~ 1 ~ ~~ S (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then ~_ years of age, died at ___~-n a ~ ~ G~ onth, y, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: If domiciled in PA All personal property $ Q If not domiciled in PA Personal property in Pennsylvania $ ~ ~If not domiciled in PA Personal property in County $ 2'~ Value of Real Estate in Pennsylvania $ b T,oitaf Estimated Value $ t7C~t7. ~ Location of Real Estate in Pennsylvania: (Provide full address ifpossible.) /" ri Signature(s) Name(s) & Mailing Address(es) ~~'nne ~ 'I~oSS ..~ 1 .~c~J~' ~vfa ~r.. ~t~f~t ~c~ 17~. j. lntertm Form KW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 1 of 2 IOS.A05 REV r0U071 f ~~~ ~~~ /~ LOCAL REGISTRAR'S CERTIFICATft~N OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $b.OG r,,,r~r~~~~~~~~~~~-. ~ This is to certify that the information here ~i~ tr~P~SH OF pF~;-: p , ~ ,a'' correctly ~ o icd from an on final Certificate of I a' 1, ~~'ys- : - ~oo~ \ ~~ duly filed wit{t me as Local Registrar. The on ~~ ~ z certificate wit] he forwarded to the State ?° ti~ -~ ~a~ Records Office. Tor permanent filing. 4 \ ~ `~ ,~ ,~ ~Gry~2. JUL 9 1 . P 17 5 5 7 7 6 0 =`~99r ~---~~~~~~'' _ _~ -.. MENT 0~ t - Certification Number Local Reg~strt~r ~ ,_.,,. Date ss~ued r---, . ~ SHOULD MEAD AS FOLLDt~VS: ~ ~`' ~'~' `~~ ~~~ ~~ < <~ y, .~. Cn ~ k~` 1 C7 {~ ~ - -, ~. .~ ,. ~ r ,,, ~ ,,,R,.. ~`~f-~~xr/ A/ Il =~ ~ r ~._ ~ 43 aEV t1l2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS 'E /PRINT IN 'RMANENr CERTIFICATE OF DEATH LUCK INK (See instructions and examples on reverse) STATE FILE NUMBER 1. Name of Dearlent (First, middle, last, sudix) 2. Sex 3. Sodel Securely Number 4. Date of Death (Month, day, year) Al ice M. Brewbaker Female 200 -22 - 6735 July ] 6, 20 1 1 5. Age (Last Birthday) Under 1 ar lhder 1 da 6. Data of Birth MorM da ar 7. Bi C end state a fo 8e. Plan d Death Check one Days hearts Mrsdes Hospital: Other: • 8 4 Yrs. January 23, 1927 east Waterford, PA ^ lrrpedent ^ ER / Outpetbnt ^ DOA ^ Nursing Hans ®Reaidence ^ Odrer . sprrctly: &r. Corary ~ Death 8e. City, Boro, Twp. of Death 6d. Fadldy Name (Ii not irrsddrtbn, give street erxl number) 9. Wes Decedent of Hlepanic Originl ®~ ^ Yes 10. Race: American Indian, Blade, White, etc. • CLmberland t Pennsboro 'lisp. 317 A South Fawla Drive (l+ yes, epaci~ c~6a°' Mexican, Puerto Rican. e~.) (spe~r>7 11~11te 11. Deatbrrt's thwd don Knd of work d are dart moat d elk. ~ not stele red 12. Wee Decedent ever In the 13. Decedent's Educafiar (Speedy Doty hfpheat grade camp bted) 14. Marital Status: Herded, Never Married, 15. Surviving Spo use (If wife give maiden mama) Kind of Wok Kind of Buainessilnduatry U.S. Armed Forces? Elementary /Secondary (0-12) Goikige (1.4 or 5+) Widowed, DNOrced (SpecKy) , Houseduties ^ Y86 ~],~ 12 Widowed 16. Decedents Heeling address (Street, coy t town, state, zip coda) DecedettYs PA Did Decedent t m Decedent owed in East Pennsboro T ' aesidence Ira sla-B 17c ~ yes • 3 l 7 A South Enola Drive ~ ~ ~p? . . , wp CLII]bt2rland 17d ^ No Decedent Lived wthin Enola PA 17025 . , , 7b. ~~, Actual Limds of city t Boro 18. Fathefs Name (Fast, middle, lest, suidx) 19. Mother's Name (Flret, midde, mefden surname) Robert Williamson Mary Colyti>`~, 2De. IMormanYs Name (Type !Print) 20b. InfamenYs Mailing Address (Street, cdy /town, state, zp code) Penney A. Noss 317 A South Enola Drive, Enala PA 17025 21a. Method of Disposition r ®Crertretion ^ Donetlon 216.Oete of DlapalUen (Month, day, year) 21c. Plea M Dbpoeitbn (Name of cemetery, cremetay a other place) 21d. Location (City/town, state, zip code) • ^ eorial ^ Removal tram state ' wa c"m.d°" a Donttlon Authorlad ^ od»r • r by ttkdlal Examiror/Caorrer7 L~ vaa^ No Jul 26 20 ] ] y x Cumberland Crt3nato LLC YY, Carl isle PA 17013 22a. Signature of Ftxrerel Service Licensee (a person actlng es such) 226. Lianee Number 22c. Name and Address d FeciHty • - - FD 012774-L Richardson Funeral Home Inc. 29 South Enola Drive Enola, PA 17025 Complete items 23ec when ceAdying 23a. T nt my knowledge, death occurred et the tlme, date end place stated. (Signaure and title) 23b. Licerrae Number 23c. Date Signed (Month, day, year) phyaiden is not evadable at time of death to - ~ r (~' ~ ~ ~~ / '/ ! ~ ~~ certlly cause d death. + /~ _/ , ( ~/ ~ ~ • • INrtrs 24.26 moat be tbrnpleted by person 24, Time of Death a ~ 25. Date Pronounced {Month, day, year) 28. Was Case Reter~ed to Medical Examiner /Coroner to a Reason er then C motion a Donation? T ' ~ who prorrourrces deadr. : tie U ~.M. ~/ / D 1/ ^ Yea ~ No 4 ° CAUSE OF DEATH (Sea instruetlona end examples) r Approximate interval: Pawl II: Enter other ' 26. Did Tobacco Use Contribute to Death? dam 27. Part I: Enter the Ct18k1 of events -diseases, injuries, or COnIpIlCatlona • that diretdty ceased the death. DO NOT solar terminal events such as cardiac arrest, ~ Onset to Death but not resoling in the underlying cause ghren in Part I. ^ Yes ^ Probabty respiratory arrest, or ventrieular Tilxilletion without showing the etiology, List only are cause on each Ifne. r ~ No ^ Unknown IMMEDIATE CAUSE ((Final disease or ,// / , r i corrditiorr resulting in death) _~ ~l*Z~ ~l vin Q~f' S ~j~ e-0.5 '~ ~ t~ (/QQ`.S a. L 29. It Female: N t hi nt i ~ Due to (a es a r ~ ~ r pregna o w t n pest year ^ Pregnant at time of death list corxAtlats, tl any. 6 r ^ 1-rdet roUNDERLYRMa CAUSE a Due to (a as a consequence ot)'. , Not pregnant, but pregnant within 42 days of death (dress a in drat initlabd the c r ~ ~r deelh) LAST events resuNk ^ • y . ~ DUB 10 (elf 8s 8 COr1eBQUBrICB ~: r Not pregnant, but pregnant 43 days to 1 year before death • d. ~ ^ Unknown if pregnant wthin the past year 30s. Was an Aubpey 30b. Were Autopsy Partings 31. Manner of Deatlr 32a Date of Injury (Month, day, year) 32b. Describe How Injury tDcaned 32c. Place of Injury: blame, Fann, Street, Factory, Pedarrrred? Avrsdeble Pda to Conrpletbn of Cause of Death? ^ Natural ^ Homkide Offke Buikling, etc. (Speci(yJ fff~~~ ^ Y N ^ ~ ^ Y ^ Accident ^ PeMing Investigation 32d. Time of injury 32e. Injury at Work? 32f. d Treneportedon Injury (SpscHy) 32g. Locaton of Inury (Street, city I tovm, state) es yrr o ' \ es ^ Su~ide ^ Could Not be Detemrirred ^ Yea ^ No ^ Driver/Opereta ^ Passenger ^ Pedeetdan M. Other - Sped(y: 33e. Certifier (clrack only are) 33b. Signature and TNIe o} Ce • Csrtltyln9 phytkisrr (Phyak9sn cerdtying cause of death when another physician has prorwurroed death end completed Item 23) To tM bat of my lotowbdgs, lath oceurred ~s to the gues(s) end manner a stmd _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _' _ _ _ _ _ _ _ _ _ _ - , PronoureMy and artifylrg phytielan (Physiden both prorrowrtdxrrg deaM end txindyirp to cause of loth) 33c. Ucense Number 33d. Date S nod Month, day, year) b ( To the bat or my knowledge, loth occurred a< rM lima, data, and plea, sod due to nr. awe(s) and manner a ateted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~,,, ~0 2 ~ ~ ~~~ r ~- • IAsdlal Erwrrmsr/co-orter ~ ~ Zit On the bob of examinslbn end / a Invastigedon, In my opinion, loth oceunsd N the time, deb, end plea, end dos to the ease(s) and manner a sUrtsrL ^ 34. Name and Address o1 Parson Who C anpbted Cause of Death (dam 27) Type /Print D i a ~' ~ ~ ICI ~I °~I ~I ~ ~' ~`~ q~y~~ / r . Bruce Coh clc 2151 Linglestown Rd. Harrisburg PA 171 ]2 l , Disposition Permd No. D G/C~ 3 cS' Y -,. ~'~ 6 , C..w. r.. ~~ C"'~ _ ~•-~ LAST WILL AND TESTAMENT m ,~'' `~' `=' ~ ~ ~ ._, ALICE M. BREWBAKER :~~~ ~~ ~, ~ ~ -=~~ ~0 r~,k~ .._.. -t ~~ 'L7 ~~~ ~ ~ . ~. 1 i'*. I, Alice M. Brewbaker, of Enola, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made. FIRST I direct the payment of my just debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently maybe done. I direct that my body be cremated and disposed of as conveniently as possible at the discretion of my Executor. SECOND I give, devise and bequeath all the rest and residue of my property, real, personal and mixed, in the enumerated shares, per stirpes, as follows: • Charles Brewbaker one-fourth Penney Noss one-fourth Cherie Bucher one-fourth Robert Brewbaker one-fourth; in the event he is receiving governmental benefits, then paid out in allowable monthly installments, or as needed for health, welfare and maintenence. THIRD All shares of principal and income hereby given shall be free from anticipation, assignment, pledge or obligation of the beneficiaries and any of them, and shall not be subject to any execution, attachment, levy or sequestration or other claims of the creditors of said beneficiaries or any of them. FOURTH Any person who shall have died at the same time as I or under such circumstances that it is difficult or impossible to determine who shall have died first, shall be deemed to have predeceased me. Pa e 1 of 5 a es. g Pg FIFTH All death taxes (and interest and penalties thereon) imposed as a result of my death upon the property passing under my Will, and upon assets held in any qualified or non-qualified deferred compensation plan or IRA, and proceeds of insurance on my life, but not otherwise, shall be paid out of my residuary estate, each share thereof, to bear a pro rata portion of such taxes. I authorize my Executor, in my Executor's sole discretion, to :make an election, in whole or in part, to cause a Pennsylvania Inheritance Tax to be payable by my estate on property passing to or for the benefit of my spouse or to defer the Pennsylvania Inheritance "Cax on such property. My Executor shall be without liability to anyone for making or failing to make such election. SIXTH My Executor shall have the following powers in addition to those conferred by law until all property is distributed: {a) To retain any real or personal property in the form in which it is received. (b) To sell at public or private sales for cash and/or credit, to exchange, and to lease for any period of time, any real or personal property and to give options for such sales, exchanges, or leases. (c) To purchase all forms of property, including but not limited to stocks, bonds, notes and other securities, common trust funds, life insurance policies and real estate, or any vanety of real or personal property, without being confined to so-called legal investments and without regard for the principle of diversification. (d) To purchase securities at a premium or discount and to charge such premium or credit such discount to principal or income. (e) To exercise any option arising from the ownership of any investment; to join in any recapitalization, merger, reorganization, liquidation, dissolution, consolidation or voting trust plan affecting any investment; to delegate powers with respect thereto; to deposit securities under agreements and pay assessments; to subscribe for stock and bond privileges; and generally to exercise all rights of security holders. {f) To hold property unregistered or in the name of a nominee. {g) To mortgage, divide, alter, repair and improve real property and generally to exercise all rights of real estate ownership. (h) To distribute in cash, in kind, or partly in each, and to cause any share to be composed of cash, property, or undivided fractional shares in property different in kind from any other share. • Pa e 2 of 5 a es. g P g (i} To compromise claims by or against my estate including but not limited to tax issues i and disputes, without order of court or consent of any party in interest and without regard for the effect of such compromise on any interest hereunder. (j) To borrow money and to pledge any real or personal property as security for the repayment thereof. (k} To apply income for the benefit of any incapacitated individual to whom income may or must be distributed for any reason during the period of incapacity. Income not so applied maybe distributed to a custodian or accumulated, invested and if not sooner applied, paid to such individual upon gaining capacity. (1) To join with my spouse or my said spouse's personal representative in filing any joint income tax return, and to join in any gifts made by my said spouse for gift tax purposes even if this may result in additional liabilities for my estate. Any income or gift taxes due on such returns and any deficiencies, interest, penalties or refunds thereon shall be allocated between my estate and my said spouse or my said spouse's estate, or all to any of them, in such manner as my Executor and my said spouse or my said spouse's personal representative may agree. (m) To apply expenses of my estate permitted as income tax or real estate tax deductions and to value my estate for estate tax purposes by any method permitted.. (n} To employ accountants, agents, attorneys, investment counsel, brokers, bank or trust company to perform services for and at the expense of my estate and to carry or register investments in the name of the nominee of such agent, broker, bank or trust company. The expenses and charges for such services shall be charged against principal or income. My Executor is expressly relieved of any liability or responsibility whatsoever for any act or failure to act by, or for following the advice of, such accountants, agents, attorneys, investment counsel, brokers, bank or trust company, so long as my Executor exercises due care in their selection. The fact that an Executor may be a member, shareholder or employee of any accounting, investment, legal or brokerage firm, agent or bank or trust company so employed shall not be deemed a conflict of interest. Any compensation paid pursuant to this subparagraph shall not affect in any manner the amount of or the right of my Executor to receive commissions as a fiduciary. (o) To invest any part of my residuary estate in, or lend money to, any closely-held business in which I may have an interest at my death for any purposes incident thereto, including but not limited to expansion and entry into new fields of business provided that only assets actually invested in such business shall be liable for the debts incurred in its operation. (p} To disclaim any interest in property without court approval. SEVENTH (a) I appoint Penney Noss, as Executor of this my Last will and Testament. In the event she is unable or unwilling to act, then I appoint Cherie Bucher as Executor in her place. Page 3 of 5 pages. (b) My Executor shall not be required to post security in any jurisdiction. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, this `~ day of ~-- , 2009. ~'-~ "~'~-mow"' (SEAL) Alice M. Brewb ker Signed, sealed, published and declared by the above-named Testator, as and for her Last Will and Testament in the presence of us, who have hereunto subscribed our names at her request as witnesses thereto, in the presence of said Testator and of each other. WITNESSED BY: I, Alice M. Brewbaker, testator whose name is signed to the attached or 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; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. r Alice M. Brewbaker COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND On this day of ~~1,.._ ,2009, before me, the undersigned officer, personally appeared Alice M. Brewbaker, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing Last Will and Testament, who acknowledged that he executed the same as her Last Will and Testament. ~~ Notary Pu lic • Ca~nmonwraNh of hnr~IMOrwo Page 4 of 5 pages. ~~ ERIC C LlK,AII NobrY PtrbMC CI1Y Of PRTI>/tlRtiH. ALLEGHENY CNT1 Comn~hMon E~apkrK Moy 30. 3012 We, ~~`"~~ ~ ~~~~and :~~ ~}~J ~.~ IO~d~t-~J~ ,the witnesses • whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will and Testament; that the testator signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator s at that time 18 or more years of age, of sound mind and under no constraint or undue influence. fi ~- ~~' (SEAL) Residing at: ~~~ S .- ~~ ~~ ~ (SEAL) Residing at: ~ +~f~ `-~- Subscribed and sworn to before me by both witnesses, this ~~ day of ~~_ , 2009. Notary Public CCmR10Aw~IM1 of PellrnyivC~ltiO NOTAR41l SAL [~C C 4UCAS No1Gry IR~Nc CITtt OF MTT~URGH, ALLE6HENy CNTb Cpnmlltlon May 20, 2012 • Page 5 of S pages.