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Home My WebLink About08-16-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of Robert E. Brandt a/k/a: a/k/a: a/k/a: Deceased ESTATE NO: 21- ~ SS NO: 182-22-5390 Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: DA. Probate and Grant of Letters Testamentary or ^Administration c.t.a., or d.b.n.c.t.a. (complete Part Calso) and aver that Petitioner(s) is/are entitled to the aforementioned Letters Testamentary under the last Will of the above-named Decedent, dated 9/y2009 _ 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 :i 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 (lt-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 e.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 follows:- -- Huuress lZelationshi to Deced~ _,. ~ _~ r G ... ...t.7 ~,. f-" [?SE AI)DI'IT()~aI. SIII+'F'I'S III NPC'P~iSAiZY ~_~ - ant :~} ~`~ ~-"--_~ r {' __ _f r~ ~' ; . ,. . 1.. ,.,.~ ~ -...t ..' t "'1'T _~ THIS SECTION MUST BE COMPLETED: ` ~ ~ "~`' ~`_' Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family ~ principal a ider~ ~' At 124 South Market Street, Shiremanstown, PA 17011 (Borough of Shiremanstown) ~~~ (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 83 years of age, died 8/8/2011 at Harrisburg Hospital, Dauphin County , PA (Month, Day, Year of death) (City and State where death occurred) Estimated value of decedent's property at death: _If domiciled in PA All personal property $ $00, OQQ ~ QQ _If not domiciled in PA Personal property in Pennsylvania $ _If not domiciled in PA Personal property in County $ -Value of Real Estate in Pennsylvania (Value based upon R/E tax assessment) $ , , Total Estimated Value $ 9~8-., 020 0 Location of Real Estate in Pennsylvania: (Provide full address if possible.) 124 S. Market Street, Shiremanstown, PA 17011 Signature(s) Name(s) & Mailing Address(es) ~ Richard S. Simpson, II 426 South Third Street, Suite 104 Lemoyne, PA 17043 Interim Fo~in RW-02 revised 12.26.10 by Cumberland County pending action by the Covet Page ] of 2 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, Petitioners} will well and truly administer the estate according to law. Swom to or affirmed and subscribed before me this ~ (~~~ day of F-~~~ Richard S. Simpson,~I --- _ August __ 2011 ,- ...._ ---- ' _- 4~~ z~ ~~-.J. ry- ...-. For the Register _-, t"7 ~ . ~' ~ ~ DECREE OF PROBATE AND GRANT OF LETTERS -o -~~' b, r.a. ~~ iM r"i' t .:.~ ,.~:'_ .. ,~:.~ ~ Estate of Robert E. Brandt ,Deceased File Ntunber: 21-_~_ -_~~_ AND NOW, this day of August, 2011 in consideration of the Petition on the r r eve se side hereon, satisfactory proof having been 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.) Richard S. Simpson, II ~ in the above estate and that Instruments(s} dated 9 / 2 / 2009 described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Famer Strasbaugh~.- r. Register of Wills I. L FEES: Letters .................... $ ~G: ~y _~C~ Will ...................... . 1~-~~ Codicil(s) .............. . ( ~(,) Short Certificates ~ , ~(~' ( )Renunciations.... ... Bond ........................... .. Other ............................ ................................. Automation FEE........ 5.00 JCS FEE .................. 23.50 TOTAL ................ $ ?J aignazure of c.~ounsel K~ired to Enter Appearance Att_y's Signature ~~ PRINTED Name: Richard C. Snelbaker '~ Supreme Court ID No.: Snelbaker & Brenneman, P.C Address: 44 We G t- Main S r A t Mechanicsburg, PA 17055 Phone: (717) 697-.8528 Fax: - Interim Frn-m RW-U2 revised 12.26. ].0 by Cumberland County pending action by the Court Yage 2 of 2 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat ol• photograph. Fee for this certificate, $6.00 ,runn~~~~~~~-. This i<, to certify that the information here given is ,,frrr'' ~,ZH OF p''- ~~~t,t~~,P Eyy~ _ correctly copied from an original Certificate of Death "off ~~ duly filed with me as Local Registrar. The original . ~ ~.-'_ o _ i certificate will be forwarded to the State Vital ~ .;~ ~ a~ l~ecorcls Office for permanent filing. P 17~2~423 Certification Number ---.~ ;a~~~~''~ ~~~ ~ LG A G 1 1 2011 ~ rtrttt ~NT pE r ~rz.~ ~ vinnrr~pr'' Local l[~eg)strar ~ .-- ;;:~ Date Issued ~ 7 ~„ ~~ ; ~ J M,r./ : ? ~ F:~: -.. . . r s•t44 REV »~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~~~ T~ CORONER'S CERTIFICATE OF DEATH BLACK INK ...-- ---.- _-• _ ~--- ~ ~ v v awa~~~,IRa VII ICrtlffe,~ JIAIC r'ILt NUMkStH 1. Name d Decsdem (Fkrt, nedds, lest, ~) 2. Sex 3. Social Security Nurrtrer 4. Date Of Death (Monts, day, year) Robert E. Brandt Male 182 - 22 - 5390 August 8, 2011 5. Age (Lest Birthday) Under 1 Under 1 6. Date of Birth (Morrpr, ) 7. D arts slab a 6a. Place of Death Check on one sbnre Drys Han eirutw Fb6p0aG Other. ' 83 yrs. s January 19, 1928 Mechanicsburg, PA ®Inpatiem ^ER/outpatlen, ^DDA ^Nurs Home ^r~eieer,~ m9 ^Other • Spedfy: Ob. Courpy d Death llc. Cis, Boo, Twp. of Death fld. FrdNly Name tTf not irtetlddiorr, pve roast and rrrrrtber) 9. Wa Dsoedertt of Hispartic Origin? ®No ^ Yes 10. Race: Amerkbn trrdan, Black White alc , , . Dauphin Harrisburg Harrisburg Hospital (" yeB' °P°'~' D`rba"' (saec"t4 • Mexican, Puerto Rkzn, etc.) Whit e N. Derx+dem's Urusl IGrtd d wok dab moat d tie. Do not state retlr 12. Was Decedsm ever In the 13. Depdenra Edupporr (Seedy only highest spade compbted) 14. Martial Status: Married, Never Marred, t6. $UMWn 9 Spouse (If wife, give maiden name) Cus t omeiE~ 4~r~!'V i c e KIM d Business I Industry U.S. Armed Foroes? El Widowed oworced (s ecif t / S , p y) emen ary ecatdary (0-12) Colege (1.4 or s+) Su ervisor Telecommunications ®Ya ^rlo 12 1 Widowed 16. Decedenys Malting Address (Street, Cdy /town, slate, zip code) Derxxtem's Did Decedent Penns 1Vani8 A lR y 12 4 Market Street ctue esiderrce t7a.state caw to e f 7c. ]yea, Decedent Lhee in ' Shiremanstown, PA 17011 Twp t7b.caunry Cumberland T"P' tad.®~aI1dLNedwphh Shiremanstown City ~ Boo 18. Father's Name (First, nYdde, eat, supbc) 19. Molhsr'e Name (Prat, mklde, meklen rumrme) Ray M. Brandt Mary E. Whitcomb 20a. Intorrner>Cs Nam. (Type / PrMt) 20b. Infornrerd's MaAng Address (street, cis / bwn, stab, zIp code) David E. Brandt 124 S. Market Street, Shiremanstown, PA 17011 21 a. Metlad of DispotMbn ^ Crertlaticn ^ Donation 21 b. Date of Dlepotlport (Month, day, seer) 21 c. Place of Deprteplon (Name of cemetery, crematory a other place) 21d. Laatbn (Clry I town, sbte, zip code) w ® Burial ^ Rertavsl from State ! Wa Crrmrtlon a Donation Authalard ^ other-SpsaYy:~• IryMrdkalExamkrer/Coroner- ^Ya^~ August 13, 2011 St. John's Cemetery Hampden Twp. , PA 17011 ~•• Licensee ( actlrg ~ ~) ?2b. License Number 22C. Name end Address of FecAKy ~ FD 012 848 L Parthemore FH & CS Inc. P.O. Box 431 New Cumberland PA 1.7070 Carpels N 23a oertlyktg 23e. To pre best of my ImaMedpe, death oaxxred at pre tkne, date end pace ataed. (Slgnenxe and 1KIe) 23b. License Number 23c. Date Signed (Monk, day, year) ptrysiaen a rat ewaleDle at Ems d death to axes cause of dark. ~ Mems 21.26 neat be oompletrb by person ~~~ 24. Time of Death oa:2o A M 25. Dab Pronounced Dead (Month, day, year) Augusta 2011 26. Was Case Referred to MeriMal F~rarttiner / Coroner fa a Reason Other ptart Cremation or DonatlonT . , ®Ya ^No CAUBE OF DEATH (See Instructions and examples) r Appraxknete fnbrvY: Part 11: F1IIer r>Iher 26. Did Totxacco Use Conlrlbute to Dealh7 Item 27. Pert I: Fitter the )~,g ~ - disases, iryures, a oanpAcadona -prat dreoly caused the death. DO t40T sorer temrlnad rverks such as aadaC arrest r , Onset b Dppr but not resuping m the uMedyitg cause respiratory arrest, a wxdrkxlar ffbrtlatbn wlprout showrrrg the ettobgy. List oMy one cause on each line. r gven a Part L ^ Yea ^ Probably . ^IMt~IATE CAUSE (Fhal geese a i ~ No ^ Unknown dti lth i wrr cnreer g n th) -~ a. Complications From A Subdural Hematoma ~ 2g.nFernae: Due b (a as a conaegtrerxre oft i ^ Not pregnant wpNn peat year list oorrdifions, p r ^ Pregnant at time of death ~~ s' b D t ue o (a es a e ~ ~ of): r , txA pregnant within 42 days lA C• r ^ d r d ea r Due to or e, e r ( ~e off' r ^ Not Pregnant. but pregnam 43 days to 1 year • d. r r before dark ^ Unknown p pregnant wphin the pest year 30e, Was rn Autopsy 30b. Were Aubpty Frrdr>As 31. Marxter d Death 32a. Date of Initxy (Mash, day, year) 32b. Dacrthe How In)ury Occurred 32c. Piece of I acmry, r>jury: Hans. Farm, street, F P"f010°~' Avalade Pi1or tOcOf"aet10n Au cast 6 2011 F ll 9 DEp ~ , a ~ eoe. (speak! or Cause w corn? ^ Neturd ^ Hanidde Home ^ yes ®No ^ Yes ^ No ®Aocident ^ Pendhg Inveatlsptnon 32d. Time of In(uy 32s. tiwry at Work? 321. p Trenrporbtlon Initxy (Sped7y) 32g. location of frMurY (street, city I town, stab) ^suiclde ^CouldNabeDeenrt-red Apx 12:10 AM ^Yes ®No ^Dr"r'/operea ^Petrtngrr ^P 24 S. Market St. Shiremanstown PA 17011 , . otno< • spears: 33a Certlfer (rireac a,y one) ~Ying Phy'~en (PfNdeen rxirtifying cause of death when anoprrr physldtn hea pronounced death eM completed Item 23) 33b. sispretae and T To the bat of my knowltdOe, rtarth courted due to thr poo(r) ~ myrar a rbe4 ' _ _ _ _ _ _ _ _ _ _ _ ^ _ _ _ _ _ ~ _ ~ ' ' " _ _ _ _ _ _ _ _ ~ Prarorsrgny elk ~YM9 P~ (Ph slcsan both rorrorx i d th d if i ~ Graham S. Hetrick, Coroner p a rrg ea y en cert y ng to catus d death) To tM bat a< my browltdgs, loth oa:urrsd tl pre tYne, data, end place, and drw to the pure(r) rrM marrbr a rbte~ _ _ .. _ _ _ _ _ _ _ _ . _ ^ '"- 33c. lksnse Nun~er 33d, Date Signed (Month, day, year) • YMIalExamlrw/Coranr August 11, 2011 On 1M beab of exaMnepon rnd / a kwatiprtion, In my oplMon, loth occurred et tlw pma, dste, rnd pep, and dw b tM aura(s) end manner a etred_ ® ~. NsRle ~ Arldrett of Person Who CanPeted Cause of Death (Ite m 27J Type I Print 3s Reglttrara ant Graham S. Hetrick . ~ ~ ~ ~ ~ ~ ~ ~ ~ / I ~ ~e , ( ~'~ may. r"'~ ~ / ~l~ 1271 South 28th Street . _ V Harrisbur , PA 17111