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HomeMy WebLinkAbout09-12-11PETITION FOR PR~O~A,TE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of 1`'1 • Romaine F i shburn also known as Mary R . 1 S Urn File Number ~ ~ '` ~ ~•~ Deceased Social Security Number 19 2 -14 - 6111 pefitinnprlcl „i.,. __i_ -•-• ~~~~ ~~~~ ~~iare i zs years of age or older,. apply(ies) for: (COMPLETE 'A' or 'B' BEL OW.) A. Probate and Grant of Letters Testamentary and aver last ,Ww ill~{of the Decedent da ed 0 3 31 / 19.9 9 that Petitioner(s) is /are the EX e C U t r ]. ~ av~~Q la 1 !1' ~ iA ~~ ~ ,, ~ ,~ . . • _ and codicj~(s) dated - named in the ~ -'v~-vl V'~ ~ ~ ~~ .tale relevant circumstance e. , ren ~s io d th ~ ex utor, etc.) --~ ~-t Exc as follows, Decedent did not ma ~ ' " ~ ~ ~ ~ 2 3 `- ~-~-~ rry, was not divorced and ~ ~ ~. ~ - tot have c d bo or ado ted after ex 1 ~ ~ ~ `~ for probate, was not the victim of a killing and was never adjudicated an inca tated person: p eeution ol~ae~men1 offered: r'~ r- -~ rra B. Grant of Letters of Administration"' `~~ =~'` -.., (If applicable, enter: c. t. a. ; d. b. n. c, t. a.,~ pendente life; durance absentia; dura ' 1 -, Petitioner(s) after a proper search has /have ascertained that Decedent left no ~oritate) .~ , _ ~-- ---a ~._._. ~'~ i Administration, c. t. a. or d. b. n. c. t. a., enter date of Wil! in Section A above and complete list o f heirs. Will and was survived by the following sp~se (if any) arld`heirs:`'~ Name Relationshi Residence (COMPLETE INALL CASES:) Attach additional sheets if necessar . y Decedent was domiciled at death in Cumberland ~~ .ty; Pec dy~v~ 18w1t~ his /~e~ last ~r~f-1pra~ (Lrst street nd~ro~~ ,.,..._~_:~ . - esidence at _...r, .,.,~„~y, ~~u~e, zrp code) Decedent, then 8 7 _ years of age, died on 07/3 0/2 Q 1 1 at Carlisle Regional Medical Decedent at death owned property with estimated values as follows: (If domiciled in PA) (If not domiciled in PA) All personal property (If.not domiciled in PA) Personal property in Pennsylvania Value of real estate in Pennsylvania Personal property in County situated as follows: $ 53,500.00 $ none Wherefore, petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition the undersigned: and the grant of Letters in.the appropriate form to 1 ea or rioted name and residence 1005 S. 49th St. Philadelphia, PA 19143 Form R~{! 02 rev. 10.1.3.06 Page 1 of 2 LOCAL REGISTR ~ ~r ~ ~ ~~ AR S CERTIFICATION OF p WARNING: It is illegal to duplicate this co b EATH pY Y photostat or photograph. Fee for this certificate, $b.pf- F 1777378 Certification Number H105.143 REV 11/1006 TYPE / PRM1T IN PERMANENT BLACK INK 1. Name of Decedent (First, middb, last, suffix) M. s. Aga (Last arthday) 87 v v ~a *; This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with .me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. f~2~~i Local Iceglstrar ' Date Issued n ` , :~: _ _. ~fl _ - __. .... :~~ ~ -.,. ; «~; = ~ G7 ~ C'~3 ..~~ ~~,~ ~: -~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH .VITAL RECORDS CERTIFICATE OF DEATH (See Instructions and examples on reverse) Romaine Fishburn Sax STATE FILE NUMBER 3 r4onma l pays flours Yrs. / 19 / 19 2 4 6a. Plata of Deam Check on one eb. cax,ry of t7eam Wa 1 n u t Bottom p Noapitel: Bc. Ctry, Born, Twp. of Deam Other: Cumber 1 a n d "" If iroti street and nom r ~ I°Pa~°t ^ ER / Outpatient ^ DOA ^ ~~ South Middleton ~~l~~e"~~glona~) Medical 9.wes "~"~ ^Rastdanee C7otit®,-spae~,; Center °~"' ~ "~P~"'° °r~^? • 11. Decadence llwal lion Kind of work (If yes, spedly Cuban, N0 ^ Yes 10. Rye: American Inden, Bode, dome du ' moat of tib. Do not state re' Mezlcarr, Puerto Rican. etc.) (SPegM Whde, etc. 12. Was Decedent ever h tits 13. Decedent's Education Regis e y e d N u r s K''" a I^dpanr U.S. Amred Forces, (speay ony higneat grade whit e Me t~l C a (j rtt~prtt Elemertta / S °°"pb~) 14. Margal Status: Merrbd, Never Marred, 15. Survlvin S ~ 16. Decadence Mailing Address (Street, d1y /town, state, zip code) ^ Yes Ly IVo 1 2 econdary (a12) 4 (1.4 or 5+) Wld°wad, Divoroed (Sped/yj g Pouse (K wife, give maiden name) 770 South Hanover St Daeedenra widowed Car 11. S t e P Aduel Residence 17a. state P A Did Decadent A 17 013 , 7b. Counry Cumberland LNe in a 17c ^ Yas Decedent Lived In 18. Fathefs Name (Ertel, middle. last, suffix) Township? 17d. ®Nc~ Decedent Lived within Twp. G• William Hemmin Ac1ualLimdsol Carlisle z0a. Infomrancs Name g e r S r • 19. Mother's Name (Bret, middle, maiden surname) (Type /Print) City/Boro Jo Ann Fishburn Bessie Wolfe 27 a. Merhod of DbposBion 20b11"~` j~ f'ta~' O (Sneet,,clJk ttgyn, sta~ ~P r e e t • ^ ~ Burial ^ Removal nor„ State ; wo^con w Doru^uorr~BAtzed 21b. Date of a u 1. f 1 ~! `J !'1 Phi 1 a d e 1 p h 1' a P A 1914 3 sposltlon (Monet, day, year) 21c. Place of Disposition (Name of cemetery, crematory or Omer place) zza signan~w F - Swy~ (« by Mamw Exarmnar/canna,? ^ Yes ^ Na 8 ~ 2 ~ 2 0 1 1 Pro s 21d. Loptbn (City/town, state, zqt code) acting asauch) pact Hi 11 Cemetery ewvi l le PA 17241 . 22b. License Number 22c. Noma and Address of Feriliry E' Corrtpkte items 23a-c only ~ FD 13 8 9 5 L 15 B i gg e r Funeral Home I n c Pfryac~ar+ is not available at time of des ro ° "'e best of my bax4edge, deem occurred et me time ~ g Spring Ave . N e W V 111 e , P A 17 2 41 oartiry cause d death. ~ place stete~. (Signature and tine) 23b. License Number kerns 24.26 moat he congbled by person 24. Tana of Deam ~ 23c. Date Signed (Monet, day, Year) who Proraurx;es dim. ~O i ~ 25. Date Pronounced Dead (Monet, day, Year) ~' ~ ~ Zv s 7/3~,~ r~ M• ~, i 7~ 26• Was Case Referred to Medical Examiner /Coroner for a Beeson Item 27. Pan is Enter me CAUSE OF DEATH (Sae Inatructlons and examples) 3 • ~ ~ i ( ^ Yes ~ Omar man Cremation or Donation? resptrelory aBIS diseases, injuries, or complications -mat directty caused the de NO rg the etio t ApProxsnate interval: ar fibn9atxn wMout showi am. DO NOT enter terminal events such as cardiac arrest, r i~~ ~uCl A~U$E 1Fsra~ disease or b9Y. list onty one cause on each line. r Onset to Deam m death Part II; Enter other ' 29. Did Tobacco Use Contribute t but cwt resultlng in me und D d i , -~ a. ~:~1Z.K1~D.lf ~ r o o y eam? ng cau~ given in Part I. ^ y~ ~] Probably Due to (or as e ~ SstcorMitiora; k any c°nae9ue°ce of): t0 °ausa listed ion tine a b. - . ~ --~--- E ^ No ^ Unknown / `~ ~ 1 29 If F . nter UNDERLYING CAUSE Due to (or as a consequerxXt of): r (disease or injury that initiated the r event ~ . emale: ~ iJ - , ^ Not pregnam wimin Past ear ~ ~" deem) u~' c. t -~"~- Due to (or as a cons r aqua° f y -- "l'}' -"/"/_~' Li ^ Pregnant at lime of deem ~ ^ oe o /: i d No~eegnanl, but Dragnent within 42 da _--- 30a. Was an A r Perfo r ~' Were r Fxidxgs 31. Manner of Deam ' Available Prior to Com l r -~~ i 32 ys ^ Not r D egnant, but Pregnant 43 days to f year bef p et on a. Date of Injury (Monet, day, year) 32b. Describe Flew I 'u of Cause of Deam? ^ Natwat ^ Homidda M ry Occurred ore deem ^ Unknown it r P e~ant within th rte/ ^ Yes 1lJ No ^ Vas ^ No ^ Accident ^ Pending Inve ~ 32d Time of I ' e past year 32c. Place of Injury: Horrw3, Farm Street Fact stgabon nlury Office Braiding, etc. (SpecllyJ °ry' 32e. Injury at Work? 32f. II Trensponatpn Injury (SPadhl ^ Sukdde ^ could Not be Determined 32g. Location of i 'u Street, 33a. Certifier (dteck onty one) M. ^ Yes ^ No ^ Ddver/Operator ^ Passen r al ry ( ~ / Idwn, state) ^ ~~ - S 9a ^ Pedestdan GK~n9 physkian (Physician pecity.~ To the best W Cen'h'e19 cause of deem when anomer p onowrcad deem and a9' ImowNd9e, death oceurrsd due to the ca ° ~ r completed Item 23 33b. Signature and Title of Cem' • Pronorarcing and artlyln9 PhYdeisn Ph ~He) end manner sa stated _ _ ) ( Yerdantx>th ------------------ io the bast of my knowbd PronOUnd^9 deem and cemrying to cause of deem) - - - - - - - - - - - - - ^ rvy_ s~ 90. loam eccurred at the Nme, date, and place, and due to the cause(s) and manner ae stated- _ MedkN Examirw/Cororyr 33c. Llexfnae Number On the Dnb of exeminatbn and / or Investigation, In m - - - - -' - - - - - - - - - - 33d. Date Signed (Month, de , Y oPMion, deem occurred at the lima, date, and place, and due to the eau ~ ~ `Z'~~~/ ,6 y y~ar)I Re9istracs amt ~,~.~ se(e) and manner as etated_ ^ 34. Name and Address of Person Who C ( ~ _ ~ V " ~ 1 ~'°""^r~ ~ 4 °mpleted Cause of Deam Item 27) Type / Pdnt ~C11~'•~~ ~j I I d I_-' I ~ I 36. Date Bbd (Monet, da , ~ . Y year) ~ a,s ~ ~a.+.a i`Q.~ , ,~, Disposition Permit No. . em a 1 e Socel saeudry Number 4. Date of Deam (Monet day, year) 3. Date of Birth Month, da , er 19 2 _ 14 _ 6111 J u 1 y 3 ~ , 7. Birth C end state or fare' count 2,011 2 /f RS^~- ~~~t mill ~n~ c3le~t~ment ~f M. ROMAINE FISHBURN ,;~: .; , -. ~. , ~ : ,; f .. ~ `; r~ 1 t~ ~ z ~ ~ J' . r , I, M. Romaine Fishburn a/k/a Ma Road, Newville, Cumberland Count ~ R' Fishburn, of 32 Mt. Rock age, sound mind and memor Y' Pennsylvania, being of lawful this, my Last Will, revoki g alld others no restraint, do publish previously made by me. First: All expenses, fees, costs, and taxes related estate shall be paid from the probate estate assets, and a to this and bequests shall be paid from the net distributable e ll gifts state. Second: I give, devise, and bequeath my entire estate personal, or mixed, of every kind and nature ~ real, situated, which I may own, or hereafter acquire, or•~havnd wherever dispose of at my death, to my beloved daughter, Jo e a right to absolutely. Ann Fishburn, Third: In the event that my daughter does not survi then I give, devise, and bequeath my entire estate ve me, personal, to my Trustees, to hold, to distribute the rinci ea 1 and to pay the net income of said trust, to m p p 1. and Joy Fishburn, as follows: Y grandson, Harry Abinash (a) If Harry Abinash Joy Fishburn is under the a e o twenty-one (21) at the time of my death, to hold the ri g f trust for a trust term to last until Harry attains a e ncipal in (21) or sooner die, and to a g twenty-one frequently so much of the entire P et income in quarterly or more my Trustees, in their absolute discretion, deemhadv portions, as distribution of income on any distribution date shall able. The a pattern for any other distribution date. All net in ometablish paid shall be accumulated and added Lo principal, not so (b) Upon the expiration of subparagraph (a), or upon m the trust term under twenty-one 21 Y death if Harry has attained age ( ), I direct my Trustees to pay to Harry the entir principal of the trust created in this Last. Will. e Fourth: I appoint G. William H Zeigler as Co-Trustees of any trust ~crea~ted~ III and Krista H. event that one of either G. William Hemminger h III ndo r~ In the Zeigler, is unable to act as Trustee, then the individu r Krista H. who is able to act shall remain a al remaining Trustee. In the event that both G ppW lliam H Sole Individual Krista H. Zeigler, are unable to act as Trustees,ethen glr, III and appoint my brother, G. William Hemminger, as successor or any trust created hereunder. alternate Trustee of Fifth: In the event that neither m Fishburn, nor my grandson, Harry Abinash Jo F shb aughter, Jo Ann then I give, devise, and be ueath m Y urn, survives me, personal, in four (4) equal shares to the f Ire estate, real and 1• I give, devise, and bequeath one fou g• estate, real, personal, or mixed, of every kind and °f my entire wherever situated, which I ma nature, and y own, or hereafter acquire, or have a right to dispose of at my death, to m Hemminger III, his heirs and assigns, Y nephew, G. William 2• I give, devise, and bequeath one-fourth of m estate, real, personal, or mixed, of every kind and Y entire wherever situated, which I may own, or hereafter a nature, and a right to dispose of at my death, to my niece, ~isquire, or have her heirs and assigns. to H. Zeigler, 3• I give, devise, and bequeath one-fourth of m estate, real, personal, or mixed, of every kind and Y entire wherever situated, which I may own, or hereafter a nature, and a right to dispose of at my death, to the Zion Lutheuire, or have Ne~vville, Pennsylvania. ran Church of 4• I give, devise, and bequeath one-fourth of m estate, real, personal, or mixed, of every kind and Y entire wherever situated, which I may own, or hereafter a nature, and a right to dispose of at my death, one-half of tquire, or have share of my estate to my dear friend, Sharon Thue his one-fourth and assigns, and one-half of this one-fourth share f her heirs my dear friend, Debra Behnke. mY estate to Sixth: The Trustees hereunder shall have the folio in addition to, and not in limitation of, those wing powers 1• Management of Trust Pro ert granted by law: with respect to any and all property whpch ma the Trustees shall by them in trust, have the power, exercisable any time be held discretion at any time and from time to time on at the Trustees' such manner as the Trustees may deem advisable touch terms and in (a) sell, convey, exchange, convert, improve r manage, operate and control such property. epair, (b) lease for terms within or beyond the term o trust and for any purpose, including the ex to f said removal of gas, oil and other minerals; and epteraintn for covenants and agreements relating to the property so leas any any improvements which may then or hereafter be er ed or such property. ected on (c) encumber or hypothecate real or personal ro er any trust purpose by mort a e p p tY for (d) carry insurance of suc p k ~ ds ar otherwise. the expense of the trust as the Trustees man dee h amounts at Y m advisable. (e) commence or defend at the expense of the litigation with respect to such trust or an trust such trust estate as the Trustees may deem advisabpeoperty of the (f) invest and reinvest the trust estate fun property as the Trustees may deem advisable, whethe ds in such the character permitted by law for investment o °r not of (g) vote any securities having voting rightsthest funds. Trustee in trust, in person or b ld by the against mana ement Y proxy, in favor of or g proposals. (h) PaY any assessment or other charges levie stock or other security held by the Trustees in t d on any (i) exercise any subscri tion rust. rights or options which may at any times attarsion, or other given to the holders of any stocks, bonds, securi belong or be instruments held by the Trustees in trust, tees or other (~) participate in any plans or proceedin s foreclosure, reorganization g for the liquidation of any corporation or orga~izationnt merger or securities held by the Trustees in trust, and inciderias issued participation to deposit securities to an t to such committee established to further or def aPranec su e or other proceeding. Y ch plan or (k) enforce any mortgage or pledge held b the in trust, and at any sale under any such mort a y Trustees bid and purchase for the trust created hereig ge or pledge to of the trust, any pro ert ~ at the expense instrument. p Y subject to such security (1) compromise, submit to arbitration, release without consideration, and otherwise adjust an c with or of or against the trust. Y laim in favor (m) subject to any limitations expressly set for and the faithful performance of her fiduciar obl. th herein do all such acts, take all such proceedin s yan lgations, to such rights and privileges as could be dod eexercise all exercised by an absolute owner of trust propert .~ taken or 2. The Trustees shall have the power to bor Y any person, firm or corporation, for any trust ur ow money from terms and cor~ditior.s as the Trustees p p°Se~ on such the trust to repay such borrowed money~y deem proper and obligate 3• Except as otherwise specifically provide Trustees shall have full d herein, the power and authority to determine, in the Trustees' discretion, what shall constitute ri estate, gross income of the trust estate, andn nlpal of the trust trust estate, et income of the 4• All property taxes, assessments, fees, char expenses incurred by the Trustees in the admigis~ and other protection of the trust shall be a charge on the tr stration or shall be paid by the Trustees prior to final d~ ust estate and trust estate in full out of the principal or i stribution of the income of the trust estate, or partiall ou n full out of the Y t of principal and partially out of income of the trust estate i proportions as the Trustees may deem advisable, n such manner and 5• On any final or partial distribution of th trust estate, the Trustees may distribute such a e assets of the distribute an undivided interest in such assets ssets in kind, may part of such assets and make distribution in cash or ay sell all or and partly in kind, partly in cash 6• In the event that a beneficiary of a trust dies before final distribution, the trust shall created herein Trustees shall distribute the principal and an germinate, and the thereof pursuant to the terms of Y ..cumulated income ~• No interest in income orrpginpi alfth of this Last Will. herein shall be assi nable b p of any trust created claim a ainst a g Y~ or available to <~ny one having a g beneficiary before actual payment to beneficiary, said Seventh: I nominate and appoint my daughter Jo to be the Executrix of my Last Will Ann Fishburn, sell and convey any or all of m granting to :her authority to mixed, upon such terms and prices aseshe shalleal a.nd personal, or obtaining any prior order of the court therefo deem proper, without full power and authority in the settlement of m .I also grant her mise, adjust, and settle any and all debts and estate, to compro- or from my estate, for such sums, and upon such It bilities due to tions as she shall deem best. In the event that erms and condi- reason decline to serve, or fail to qualify fork an hall for any having qualified and been a Y reason, or administration of my estate, theppl1nomidn fail to complete the Hemminger to be the Alternate or SuccessortExecubrot:her, G. William no bond or surety shall be required of any admin ~r~ I direct that executor or fiduciary named herein, trator, trustee, IN WITNESS WHEREOF, I have hereunto subscribed acknowledge and publish this instrument as m my name, and presence of the undersigned witnesses, on March 31st19111 in the 99. ~~~ ~~~~ I"1• Romaine Fishburn ~~~~~~ _ rY R • Fishburn f SIGNED, sealed, published and declared by M. Romaine Mary R. Fishburn, the above-named Testatrix, as an Fishburn a/k/a Will, in the presence of us, who, at her request i d for her Last and in the presence of each other, have hereunto Sher presence, names as witnesses. ubscribed our i r ~ l COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS We, M. Romaine Fishburn a/k/a Mary R. Fi ~G'©.~'.~ and ~ shburn, Testatrix and the witnesses whose names are subsc the attached Will, being duly qualified according to law rdibed to the say that we were present and saw the Testatrix si n ando depose and instrument as her Last Will; that she signed it g 1 execute the she executed it as her free and voluntary act foringly and that therein expressed; that each of us in the hearin a the purposes Romaine Fishburn a/k/a Mar R• g nd sight of M. witnesses; and that to the best of our bkn n signed the Will as time 18 or more years of age, of sound mindoanddugnd~ he was at that or undue influence. -r no constraint Testatrix : ~'~~~~.~Y,-.~~.~ 4 ~G .r - ~r-- Sworn an~/d subscribed to before me, this ~ ~~ ~J~ 19 9 9 . ~~ Witnesses: `~ ., ,~? f ~ day of Notarial Seal 1 i C Edgar R. Luhn III, Notary Public Harrisburg, Dauphin County My Commission Expires April 24, 2000 ember, Pennsylvania Association of Notaries