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HomeMy WebLinkAbout10-04-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ,1 - ,Deceased ESTATE NO: 21- 5 - L'y~ a/k/a: a/k/a: ~ ~ _ _ a/k/a: SS NO: lC~~ 'cX2;/ ~~c~:~ ~}' Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as appjcable: ~. Probate and Grant of Letters Testamentary or ^ Administration c.t. , or d. .n.c.t.: (comp,lete P t 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 codicils 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): ~ ~- ~ ~' Grant of Letters of Administration ~, V ,_ __ (If applicable, enter d.b.., pendent life, durante a sentia, durante minoritate) J ~ ~ ' i r~- `~-~, ,~ ~ 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 (Tf 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), e~:cept as follows:- Name ~ :::.:: ~ _ .~ _,_(: ~ ." ;, t'-: 1 -~ ,=: \1 Address Relationship ttt:DOcedent _r, -- ,. :.. _. _. USE ADDITIONAL SHEETS IF NECESSARY -' "~? ~~ THIS SECTION MUST BE COMPLETED: D = + .: _ ;'-r Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last famlal'y or principal resid`en~ At (Street address with Post Office and Zip Code, Municipality: Township, Borou h, City) J' , _ Decedent, then years of age, died r at ! ~` , ~ I t.~--- (M nth, ay, Year of death) (City and State whe death occurre ~ ,''~ Estimated value of decedent s property at death: ///;;; ,~ ,,, _If domiciled in PA All personal property $ I ,~ ~~ +b`L~ 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 $ ~~'' _~ T Location of Real Estate in Pennsylvania: (Provide full address if possible.) _ ~,----_\ Signature(s) Name(s) & Mailing Address(es) ~~ ` J °~ ~ ~" ~ CD ~^~ ~~I Interim Form RW-02 revised 12.26.10 by Cumberland Cowity pending action by the Court Page l 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, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed -~= before m.e this ~-~ day of -_ ~ i r ,- -- ~ _, _.~ - -~ i~- For the Register - `_ DECREE OF PROBATE AND GRANT OF LETTERS --.i ~ ~:~ ~~ t ~- Estate of i-~ r ((~ (~ ~~a('~ (~(~ ,~ ,Deceased File Number: 21- •-_ ~„ AND NOW, this ~ day of Gt -~(; ~~~ r ~~ ~ ( , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary of Administration are hereby granted to: (If a plicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) - ~~~( _ in the above estate and that instruments(s) dated - ~) ~; ~ ~ described in the petition. be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasbaugh, ,~~ ( 1 ~. ~;`~~~- ~ )G r~ ~.~~ F, Register of Wills FEES: Letters ....................$ 7~ i ~ ~`~~ Will ........................ I ~ Codicil(s) ................. (,~) Short Certificates l ~ C~.' ( )Renunciations....... Bond ............................. Other ............................. ..... Automation FEE......... 5.00 JCS FEE ................... 23.50 TOTAL ................ $ `~J `~ ~-jG Signature of Counsel Required to En1;er Appearance Atty's Signatuy~-~ ~~ ~ ~' ~;.-f rrf ~ PRINTED loam ~ '= ::~;' ,'~`'-o Supreme Co 1(.txt~D No.: ~ ~~ ~''-~ v Address: '~ ~~ ..ie.~` . ~ ~,~.. ~~ r~ ~ ~ .~, r . ~, „~ ,,_ -~ - . - ,-~ ~. ." Phone: ~ ~_ . . -. , i ~ 1 ~ ~ _ Fax: ~ j: ~,. t ~.- _L W --- k~ _~ Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2 OCAL REGISTRAR'S CERTIFICATION OF ®EA•1•I~ WARNING: It is illegal to duplicate this copy by photostat or photograph I'CC. li)f lht~ ka_'(iItIC(U~'. `~C).!)(I ~~~~~~.,,. r~l~ I~ Ii, 11itI~ 1~ 1~:'L I11~H'1ltti11111 hUr ,t~L'll lti II ~;~ ~~EP frY,yJs-- ~h l~` lif~~~' ~~}i)(I)j;1,1, 1. , ,~ (I jiZ~t O tltur(tlthr ,ni)rinal ~~~' ~ z, ~~~ hljc~tt~ ;i - Ir(11~i1 Iu th:~ State A`ital v ,'' x.'~ li ' I,j:1~ C I A , . I l?', tnL~n[ flltrl~~. _ ~_ ~ ,x P 772671.C~ ~ ~~~ -- l - - \q9r ~`~~I'''t~' L~itvE` ~ . ~'e~~~DteX~ 4f~ 3 ~ 2U 1 l ~ MENTOF _-- - ____ _.__. ------ „~,,,,, I,11'- -- Cert)firation :~umhcr ,-- L~~~.11 IlL~ ~t,.u I);ItL I'.~ucxl C~ ~ C _ ~~ -~ O .,..~ _z_3 7 ~:7_C -t _ >, r> ~ n >__-p 1 ,- c- , r.~ _ :? `. n _ ~~ ~ ' ~~ { g .._.. . ~7 > ~ Htos-t43 REV ttrzo36 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYP P IM IN E I R PERMANENT CERTIFICATE OF DEATH INK BLACK (See instructions and examples on reverse) STATF FII F NI IMRFR I~ ,~ <v V 1. Name of Decedent (Rrst, midde, last, wflix) 2. Sex 3. Sodel Securry Number 4. Dale of Daem (Monts, day, year) Harry Charles Goldby Male 181 - 26 - 2233 September 26, 2011 5. Age (Lest BiMdaY) Under 7 e Under 1 tle 6. Data of Bits Monm, M , e 7. Binh Ci entl state or to count Be. Place of Death Check o p~ 94 "~"'"5 °"' ~'"` """'"~ April 28, 1917 Pittsburgh, PA "a5pnal: tn ar o Yrs. ^ Inpatient ^ ER / Outpatient ^ DOA a l~~ l 1.~ Nursing Home ^ Residence ^ Other - Spedry-. i3b. County of Death Bc. City, Bam, Twp. of Death Bd. Facility Name (II ml insUlWion, give sheet and number) 9. Was Decedent of Hispank Origin? C~"NC ^ "es 10. Race: American Indian, Black, While, etc. Cumberland North Middleton Church of God Home pt yes, 5petiry Cuban Mexkan Paeno Rican, em.) (sPaaM White 11. Decetlenl's Usual Occu anon Kind oI work tlme Mrn most of work' life. Do nd slate redratl 12. Was Dacedenl ever in the 13. Decedent's Etlucet'lon (Speciy qtly highest grade Comp leted) 14. Martel Status: Marred, Never MarreQ 15. S wing Spo use (It wile, give maitlen name) Kintl of Work Kind o78usinassllndustry U.S. Armed Fortes? Elementary I Secontlary (0-12) College (1-4 or 5+) Wxbwed. Forced (Specify) p ~l Yes ^ Np 5+ Nev Ma i d 16. Decedent's Mailing Address (Street, city I sown, sale zip cafe) Decedent's Dltl DBCedenl 801 North Hanover Street ActaalRaSieence nasmle PA uveme np.®Yas,DatadamLmaam_I4. Middleton Twp. Carlisle PA 17013 ry Tpwnamp? nd ^NO,l3xedemu~edw6hin ,7b cpan Cumberland , Actual LimAS of Ciry/ Boro 78. Fathers Name (First, middle, last, Sumx) 19. Mothei s Name (First, midtllB, maiden Surname) Harry Goldby Gertrude Knight 20a. Informants Name (Pype /Print) 20b. IntomRnl's Meiling Atltlress (Street, coy /town. slate, zip code) Lisa Li es 139 Cahille Drive, Winchester, VA 22602 27 a. Method el Disposition ~ Cremation ^ Donation 2tb. Data of Disposition (Month, day, year) 21c. Place of Dispositkn (Name of cemetery, crertalory a Omer place) 2,d. Lrratior (Ciryl town, stele, zip code) ^ Bunal ^ Removal) r WasCrematlonorDOnadonAUmorizM Se 27 2011 t Hoffman-Roth Funeral Home & Calrlisle, PA 17013 ^ Olnq r Dy Medical Examiner/Garner? Yes^ No p , . 22a. Sig al seaka ~ -atang a5 5pth) 22b. LkenSe Namber z2t. Noma and address of Facility Hof fman-Roth Funeral Home & Crematory - 138504 Co plate Item wfien ceniryirg 23a. To Ire be al my knowledge, em oCCUrt al Uce time, dale and place staled. (Signature a title) 23b. License Number _ 23c. Dale Signed (Manm, day, year) physcian is nq able al time of death to ~ ' i ~,~~]_~[ y ~ ~ Z ~ 2 C , certiry ca se of Mam. ~ ( Items 24-26 must be comdelrttl M person 24. Time of beam ~. Z ~ ~ 25. Date P q:etl De Ih, day, year) ' l ( ^ 2fi. W as Case Referreo Medical Examiner /Coroner for a Reason Other than Cremation or Dglation? who pronounces deem. . M. ~ I L .r `( J ^ Vas No CAUSE OF DEATH (See Instfucllons end exemp es) r Approximate inlervel. PaM1 II'. Enter other elodlkant condNOm contrbut'ne la tleam, 2fl. Ditl Tobacco Use Cantnbule to Death? Item 27. Par I'. Enter the Clain of events - diseases, mjudes, or c4mplicatials - that directly rausetl Ibe death. DO NOT enter terminal events such as camiac arrest, Onset to Deam but rpl resuUklg In the unMdyiry reuse given in Pan I. ^ yes ^ Probeoly respiratory artest, or vemncukr fibrillation wUtloul showing me et'Iraogy. List my one rouse on each line. `~ No ^ Unknown IMMEDIATE CAUSE (IFinal disease or contlnwn resu6irg m deem) ~ a n. ~y'Qe• (h I i ` (~~~` 29. It Female'. ^ N ! t imi l Due to (cr as a co(n5~e uence ot): ~ 1 - o pregnan w n pal year ^ Pregnant et Hme of death SeguantiallY 45t conditions, II any, b ~ S bl ~ L7r1 ~ le di m th lu N t d - ^ a nngg on e reuse s e te a. Due to (or as a Corse Enlerthe UNDERLYING CAUSE guenca oD: Np; pregnant, but pregnant within 42 days e~sease q injury that Inhaled the h resulting in Math) LAST C of death ^ . Due to (or as a consepuence o0' - pregnan pregnan y year Not I, but 143 tla s l0 1 before tleath o. - ^ Unkn wn it pregnan) within the past year 30a. Was an Autopsy 30b. Were Autopsy Findings . Mannar of Death 3 1 32a. Dale el Injury (Manm, My, year) 32b. Descrbe How Injury Occurred 32c. Place pt Injury: Hare, Farm, Street, Fanory, Pedamed? Available Pdor to Completion x ~ ^ Office Building, etc. (5pecl/y) of Cause of Death? DtNalurel Homicide rrte~,,.. ^ Y N ^ Y ^ N ^ Accident ^ Pending IrneStigaUal 320. Time of Injury 32e. Injury at WoM? 32t 11 Transporation Injury (SpecityJ 32g, Locatkn of injury (Street., tint I town, stale) es L9 O es o ^ S i b ^ C k N r be D i ^ Yes ^ No ^ DrVerl Operator ^ Passenger ^ Pedestrian u c e ou elarm ned o M. ^ Omer ~ Specify: 33e. Cefifier (tltttk arty arts) 33b. Signalu~and Ttlle of CerUtier • LMllying phynlcian (Physician cenilying cause of deem when another physician has pronounced Beam art completed Item 23) - ~V'( y' p ~ h - _ _ To the best of my knowledge, deem occurted due to lha ceuee(a)and manner as stated______________________________ ~ ~~' " • Pronouncing entl rxnltymg phyalcran (Physician both proraundrg tleath and cerHty4rtg to cause of deem) 33c. lxe nse umber N 33d. Dale Sigrred (Month day year) To lire best of my krowledge, Math occurred at the Ilme, date, and place, and due to the cauaNs) arts manner ae stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~ -L ~ ," ` ~` .•~ , .~,y d I V Z. ~ I ~ ~ ~j ~(ra s•f /,~ 0 7 ~t ( • M•dkal Examiner/Coroner , • On lbe baste of examinadon entl I or investigation, in my opinion, death otturratl •1lhe time, dale, end place, and due Ia the ceuse(e) entl manner as slated- ^ 34. Name entl Atltlress of Person Who C lelad Cause of Deelh (Item 2]) Type I Print ~ ~. S w tn P ~ ~ ~ ~~~ Registrars a art Dls ' Dale Filed (Month 36 da ear) • so/~,~ • 1 ~ J '~"'--' I • I ` ~ I I I O ~. ~ . ~~Y.~KC<,t~~ ~ l . , y, y ` ~ N~•~ ~v„ "~ r ~vt, G~,~ y~ w 1~ z ~ 1 o IJ Disppsitlon Permit No. ~ G ~O 5 ' ~1 r' c ~\wp5 I \wi II s\goldby. wil lr) '~ ~; ` i 1 r~ `fir l~T7 ~. - ~i LAST WILL AND TESTAMENT ~ -''~r ~ R :_ , _~ r -~, HARRY C. GOLDBY I, HARRY C. GOLDBY, of 825 North Hanover Street, Apartment 110, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executor, hereinafter Warned, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I direct that all of my furniture, furnishings and other personal property be divided equally between my niece, KATHLEEN S. NERANGIS, of ~n;,~ 7eslCr, 4cr ~„ „a, are,. my ..~~F~ sei^., ... ~Ar,";, ~ ~,O~v:~-~ ~uTLEr~, of I~hippsburg Maine. THIRD: I give to each of my following relatives the sum of Two Thousand ($2,000.00) Dollars: A. LISA NERANGIS LIMOGES, mygreat-niece; B. NICK NERANGIS, mygreat-nephew; C. STEPHEN NERANGIS, mygreat-nephew; c:~wp51 \wills`,gcldby w'il D. WENDY BUTLER CURTIS, mygreat-niece; E. TODD BUTLER, mygreat-nephew; FOURTH: I give to the CUMBERLAND COUNTY HNSTORICAL SOCIETY, the sum of Two Thousand Five Hundred ($2,500.00) Dollars. FIFTH: I give to the MUSICAL ARTS SOCIETY OF CARLISLE, the sum of Two Thousand Five Hundred ($2,500.00) Dollars. SIXTH: I give to the J. HERMAN BOSLER MEMORIAL LIBRARY, the sum of Five Thousand ($5,000.00) Dollars. SEVENTH: I give the sum of Ten Thousand ($10,000.00) Dollars to my niece, KATHLEEN S. NERANGIS and NICK NERANGIS, her husband, jointly, and the sum of Ten Thousand ($10,000.00) Dollars to my nephew, CHARLES THOMAS BUTLER and ROBYN BUTLER, his wife, jointly. Each couple is to receive the sum of Ten Thousand ($10,000.00) Dollars, not each individual. EIGHTH: All the rest, residue and remainder of my estate, I Dive, devise and bequeath in equal shares, to the following Pittsburgh institutions: A. CARNEGIE INSTITUTE OF PITTSBURGH. B. THE WESTERN PENNSYLVANIA SCHOOL FOR THE BLIND, located on Bellefield Avenue, Pittsburgh, Pennsylvania. C. PHIPPS CONSERVATORY, specifically for the proposed "Hillside Project" behind the present buildings, in memory of my sister, Dorothy Goldby. 2 c:~wp51 \wil (s\goldby.wi I D. PITTSBURGH HISTORY AND LANDMARKS FOUNDATION SCHOLARSHIP FUND, of Pittsburgh, Pennsylvania, for scholarships or its general purposes. LASTLY: I hereby nominate, constitute and appoint PATRICIA ROSENDALE, C.P.A. as Executor of this my Last Will and Testament. Should she be unwilling or unable to serve in such capacity for any reason, I nominate, constitute and appoint the ORRSTOWN BANK, of Carlisle, Pennsylvania, or its successors, as the Executor of my Last Will and Testament. No Executor shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this a ~.~ day of ~ , 2008. ~- _ ~ H rry C. G by SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: 3 c:\wp5 I \wills\goldby.wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I, HARRY C. GOLDBY, 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; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledg before me, by HARRY C. GOLDBY, the Testator, this [~-1C~ day of , 2008. H ry C. G dby, Test or MERLENE J. M~ATRHE VKA NOTARY PUBLIC MY COMMISSt~ON EXPIRES JUNE 8~~1Q 4 c Awp51\wills\~oldby.wil COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We`-O'CldAQ1~~ ~ , ~ and ~m •~. the witnesses whose names are signed to the a a ed or foregoing instrumenf~eing duly qualified according to law, do depose and y that we were present and saw Testator sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing anr~ sight of the T?statr,r signed tho ~,~; i!I as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me b,,~g,dg~~~~ and this aid day of ~4 ~~ 4~,..,.Irw-, 200 . Witness Witness NOTARIAL SEAL MERLENE J. MARHEVKA, NOTARY PUBLIC CARLISLE, CUMBERLAND COUNTI; PA MY COMMISSION EXPIRES JUNE 8, 2010