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Home My WebLink About11-14-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of a/k/a: a/k/a: a/k/a: Jeffrey D. Pollak (11 applicable, enter d.b.n., pendent lite, durante absentia, durance minoritate) Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: OA. Probate and Grant of Letters Testamentary orpAdministration c.t.a., or d.b.n.c.t.a. (cor>~plete Part Galso) and aver that Petitioner(s) is/are entitled to the aforementioned Letters - -" ` -~tlnder~" the last Will of the above-named Decedent, dated _ __ _ _ and codicil(s) dated ti_ ; -- -_-°~- ,_ (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'e~Qcution o~t,~e ~ , instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated pe~on;'and was•riot a ;, ' _' party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as c~'ined ins ~ 23 Pa. C.S.A. § 3323(8): N/A ~ B. Grant of Letters of Administration See attached Waiver of Fiduciary Bonds signed by children 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 follows: N/A Name JoAnne M. Pollak r+uuress 5020 East Trindle Road, Mechanicsburg, PA 17050 Relationshi to Deced~ Wife Ghia (Pollak) Wittlin 1130 Fernwood Avenue, Camp Hill, PA 17011 Daughter Aja Laurie Pollak 920 South 12th Street, Philadelphia, PA 19147 Daughter Jenna Rachael Pollak IJSE AllUI'r10NAl, SFII':1%.-1'S IF NF'.('FSCARV Rnt,h 5020 East Trindle Road, Mechanicsburg, PA 17050 , M..,.~ D..1 ,.1. cn~n r.__. m___ ~ Daughter ent - - --- ~ ---- , ~~~~ ,_,a,r l llllule iCUAU, rviecnamcsourg, YA 17050 Daughter Andrew Charles Pollak, 1919 North Uber Street, Philadelphia, PA 19120 Son THIS SECTION MUST BE COMPLETED: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence At 5020 East Trindle Road Hampden Township Cumberland County Mechanicsbur4 PA 17050 (Street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 64 years of age, died 1/3/2011 (Month, Day, Year of death) Estimated 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 SS NO: 087-36-4142 (City and State where death occurred) All personal property Personal property in Pennsylvania Personal property in County ~.~~ Deceased ESTATE NO: 21- ~~ - Mechanicsburg, PA 17050 $ 2,000.00 $ _ 2,000.00 Total Estimated Value Location of Real Estate in Pennsylvania: (Provide full address if possible.) Signature(s) Lo4~o ~ ( Form RW-02 revised 12.26.10 by Cumbcrlani Name(s) & Mailing Address(es) JoAnne M. Pollak, 5020 E. Trindle Rd., Mechanicsburg, PA 17050 pcndin~ action by the Pagc 1 of t 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 ~ ~~~ d~a~~of _-: -i, 1~ `~,lU it - ~ -' ~~G~~ , -, - For the Register _ __,; ; -; TJ __. t j ,~1 :. _ri L ~ ~ `_ •~ ~ DECREE OF PROBATE AND GRANT OF LETTERS ;- -~~ Estate of j.~ ~YLQ ,'` f ~ ~(~ ((C(t( ,Deceased File Number: 21-~_- AND NOW, this ~~ Fday of ~ ~~ ~ ~ 1 ~ ~ i ~ F~~ , 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 applicable, enter c.t.a., d.b.n., d.b.n.c.t.a., etc.) 1C) l~V1~1 ,P I~~~'~ l~('1.~ 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. n enda Farner Strasbaugh, Register of Wills n~ ( ~; ~'(;~jf~/1~SC FEES: Letters ....................$ ~L Cw Will .... ................ Codicil(s) ................. (~) Short Certificates CXJ (5) Renunciations.(. ~!(k ~ ' ~ c~U Bond ............................ Other ............................. ................................. Automation FEE......... 5.00 JCS FEE ................... 23.50 TOTAL ................$ 50 Signature of Counsel Required to Enter Appearance Atty's Signature Cj„ ~ ~ ~~, PRINTED Name: Craig A. Diehl Esquire Supreme Court ID No.: 52801 Address: 3464 Trindle Road Camp Hill, PA 17011 Phone: (717) 763-7613 FaX: (717)763-8293 Interim Form KW-O2 revised 1226.10 by Cumberland County pending action by the Court Page 2 of 2 i s n 5 Rea a vo-l LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fck~ for this certilicale. $(;.tl(I 'T'his is trl certit~y that the information here given is ~orr'crtly copied iron( an original Certifica(e of Dea(h duly filed with me as Loeal Registrar. The original cer(ilicate ~+ill he i-Ilr~eurded to the State Vital }{ecords Office tax a~ennanent filine. ___ P_ 17029597 C`ertil~iration !~ul?Ihrr Loral Itegl~tralr pate issued C~ _ _. ~--~ .e.. -1~ - ;;;..~ -~ _ S.:I ~ ~' ~ -,-, ,., I-_r ~c -._. _, _' _ °r-~ Htas-tai REV tarzoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE / PRINT IN - PERMANENr CERTIFICATE OF DEATH BLACK INK (See Instructions and examples on reverse) STATE FILE NUMBER 1. Name a Dxarnl (First, mbde, lad. sdfa) 2. Sex 3. Soda Sewny Number a. pee of Deam (MOnm, Jeffrey D. Pollak Male d"'''xe0 087 _ 36 _ 4142 Janua 3, 2011 s. Acs (Last arnbarl user, yrr unrr t my s. Due d earn (Ma,m, . watl 7. amlpesa tCM and err a ~ county) r. Plax or Drm (~ atay one) ry aaenw Ikye wsa IAMr Omer: 64 vrs April 17, 1946 Jamica, N.Y. "°a°'r'' ^ Inpawnl ^ ER / Outpanent ^ DOA ^ Nursng Home ~ecilrw ^Oth« - SpecAy m. cowry d Deem x. city. 9oro. Twp. d orm r. Pacify Noma In rot inatlNnon, give steal am Cumberland Hampden 5020 E. Trind el Road 9 (~Da~ylc ~ °nbor~n? ~ ~ vaa ,D. w~a:Am.,e,n mtla,,, e,.a, y„„a „x. (~+M Maxiwn, Puerto Riven, e(0.) White 71. Derdra's lhual (Kid d wod doro mod d ae. Do rat aas Iz. Wr Deudem aver b the 13. Deprnl's Etlwxnon (SpedN 0.^N NgM91 grtr wnWetetl) 14. Medal 9aNS: Monied. Never Marred 15. Surviving Spouse (a wr. give meirn name) Qplolnatrist ~e~.•al'e U.S. Armed Fumes? Er,~ry/ SeporMary (0.12) Cdlege -a or 5<I W~dow'ed, Divomr (Speayy) ^rr ~f3~ ~+ Married JoAnne Mendelson t& Deatlenra Mstlbg Aaartr (strea. Dry r lows. sate. zio code( PA Dkl Dxedem 5020 E. Trindle Rd. R.atlxn ,7a srr Live in a „a ~ yr , ~ ~ am en rownaNp? Mechanil;sbu PA 17050 Cumberland T"° rge t7b. County nd. ^ No, Decetlem livetl wmm Aauu Limas d ~, / Barn 1& Fatlx/s Name (FnL midae. ra. sulfixl 19. Mrxfs Nona (Fast. middle. rtxieen surname) Stanley Pollak Berenice Newmeyer 2a. hllarmanl'c Name IType /Prim) 206. Inlamanys Mainq Arrtr (Slnst, dtY r town, ear, ~ mee JoAnne Mendelson Pollak _ 5020 E. Trindle ~td. Mechanicsburg, PA 17050 zta. Mande d omPaaiban ~mn,ar„ ^ Dania, ztb. Dar a ^ sand ^ tran asp0°'O0" ( r% war) 2tc. Place d Disprwon (Name a cemetery, aarbry «ama Waw) 21 d. Lowtbn (city /town, srr, :p Dods) • O ,a"'""a, „~° ~'"a"°"°tl ;,;,^~ January 4, 2011 Conolite Crematory Schaefferstown, Pa. 17088 ~ 22a. d F (a r still) 71L. tare Nlmba 22c. Name and Adder d Faddy FD-012662-L Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055 Cmgtea 23ac onN uAN*5 2 o tlx txa d my , deem oaunee a me line. rr ell Wax acrd. I59naoae am title) 23h. Latent Nwnb« 23c. Date Wyeon r ml evaaabr a rr a ram r carry tax. d arm. ~ .... /~ N sipiea (MOnm, ry, war) Ilema 2x-28 mxt r orrobbd W persm 2a. Tmx of Deem 25. Dar Pnxbinwtl Der Q N 5 7 5 3 ~~ L ~0. n 3 Z O 1 l 1"r""' ry wa) 26. wr Car Referred to Medial Examiner /Coroner br a Reason ghat man Crematbn or Donanon7 ~ tNo pronax¢r drm. 7 t{ 5 ~ M 5'Y~ 3 2C ~ ^res CAUSE OF DEATH ISM InxtrucUonx antl exampNx) , gpprsimar nrrval~ Pan II: Ewer otlxr ' parr 27. Pan I: Eax Me Wit a arena - disrra, apart, «wrtpn aaana _ Itrt NrxlN cawed tlx tlsam. DO NDT errr rrmiW event sucn r artliec artasl. ~ .. 28. Did Tdtatto UaeDontdbute b Deem? rtaPtaotY drab(, «vendwla OOrirnm wAnod stnwg tlx etbbgy Lwt Day ax four an rw ar. Onaa to orm rd nCl resuarg in me'+^rrM^9 war guar b Pan I. ^res r~,by Calatlan mW q~b drm)~ase or ,/. 1 ~ ,s, ~ pn//n//, ~ ~ ^ No ^ Unloarm -~ a. /~ '7 ! ~{~ ~ 7~'(s-rA w"'w/r-/ G%~fr *-•,Y- /~q~~l~ 29. n Femar: S$~aPqaarr~ar/y kat Corlatlwrx, a arry, ~ ^ Nd ae0narlt within Pasf war Madtl b l(a Calla Belt m lax e. G. ^ Prepxnl et rr d deem EdY i6Mx ~ ICAU$E DUa b (« as a corl5e7uarlCO o(f: ^ Nd Pra9~anL dA Dregnanl wilNn 42 days (dart «vpoty mat ear me a dram MMrrWr Due r (« as a wnsepence Dry: G. ^ Not pregnea, but pepxM q7 daYb b t year betas dam 3q. Wr BnAlkpy 300. Warr Ataapy Fiidvrgb 31. Memer d Oaem 1 ^ IAikrbwn it pegnaa wdhb tlx pad yrr _ Pabnra? Aveaaae Prior b Carpbam 32e. ~ d bjwy (avert, ry war) 320. Drcrte How Iryury Ommee d Care d Deem? era 32c. Place d I^IUY Honk, Farm, Strad. Factory. ^ ybnidee atiw . eb. IsAeaM ^ rr [~NO ^ yr ^ No ^ Accksa ^ Penang lrnRbngatlpn 3zd. ter a Injlay Sze. igwy a wok? 3m. n rraroarda, Iny,y IsParyr/ 3zg. Lo Wbn d kwr Istrta, city /town, srr~ ^ saidtle ^ cede Na r Detemiktl ^ rr ^ No ^ orwer / Opsramr ^ Pabeenger pPaarlwian M. ~ - sP+aN~ J3a CertlBer (dick day one) i PNyabW IPNyadan ceM+q wwa d ran wlkn anrw ~ Sig^aare and rata a Cearr To me Ott d my bwwrtlga, deem oaurretl dr r tM Plnwidai hea prorrxanad dell all amaentl Irni 23) Ixtrela)antlmwwrarleL________________________________ ~ , ' To ~ OW d+~ ~WrY Myklr (PlMkdan ban ponoumirg arm sm ceeNNg b war d rant ' signed Mam,. r ~z n0' bka4tlga. datah oatared a me trk, dw, arq War, and eu. r tlk cauMsland mane r wra_ -"--""-- _ -' -' _ ^ 33c. Latent Nwrber 33tl. Dw y, war) b' Yelled EsaMnr/Caonx ~ on Ina Wr d exranatlon arq / «mvaatlgaiar, b mP oWwat. tNam aewmd r w mr, rt., and plat, all dw to tlk wwyq all meow r ebled_ ^ ~ ~ 3A. entl Ademse a Pneron who CaroMr Doan ((tern 27) type / 35. Rep' 8 Sigreturt and Distrid Nu 38. Dar Fiad Mash, .~ ~ ~ 7` O Y ~ I H M S ~ ~ l a l i I ,~ l 1 I ~l J Q . `. c~)i a g ~ z :~ , / /o d i 6~ Dlaporion Pennn No. U'~' G '7 4 7 i BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JEFFREY D. POLLAK ~ "' also known as NO. ,.~ ~ - ~ ~ - ~ 1 ~-{ __. _. Deceased ~~ ., ~~_ _ ~, WAIVER OF FIDUCIARY BOND The undersigned, being the sole (all) residuary legatee(s) or next of kin of the above named decedent who is (are) adult and sui juris, herby waive(s) the posting of any bond by JoAnne M. Pollak who is (are) the petitioner(s) for grant of letters of administration. i' " ~igiiature Typed Name: Ghia (Pollak) Wittlin Address: 1130 Fernwood Avenue Camp Hill, PA 17011 Sworn to or affirmed and subscribed before me this ~ ~ ~ day of ~~ , 2011. Notary Public My Commission Expires: 1~eC . SNARON MAT1Eq SOROlIQi~t, CUMg gtANO CpUNTy ~ Commis~ion Expires Oec 5, 2012 `', aU1a. BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JEFFREY D. POLLAK also known as ~ ~ ~ _-~ -~ C.~ '"~' • NO. ~ ~ - ..._ Deceased - WAIVER OF FIDUCIARY BOND ` i s., The undersigned, being the sole (all) residuary legatee(s) or next of kin of the above named decedent who is (are) adult and sui juris, herby waive(s) the posting of any bond by JoAnne M. Pollak who is (are) the petitioner(s) for grant of letters of administration. Sign ure Typ Name: Aja Laurie Pollak Address: 920 South 12th Street Philadelphia, PA 19147 Sworn to or affirmed and subscribed before me this l ~~~ day ~~ of atyPr[blic ~/ Commission Expires: 2011. co~onlw~a~rH of ~awrsnvatvra Wota~tat seat t.o~rwr AI7ycum~ b County _n..; 2015 -_, r~ ~"„l 'T7 BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JEFFREY D. POLLAK also known as Deceased WAIVER OF FIDUCIARY BOND The undersigned, being the sole (all) residuary legatee(s) or next of kin of the above named decedent who is (are) adult and sui juris, herby waive(s) the posting of any bond by JoAnne M. Pollak who is (are) the petitioner(s) for grant of letters of administration. Si mkt Jenna Rachael Pollak 5020 East Trindle Road Mechanicsburg, PA 17050 Sworn to or affirmed and subscribed before me this ~ day of a , 2011. Public ~.- y Commission Expires: car~oNw~a~Ttr of ~v~ Notarial Seal Joel Xavier Zeiger, Notary Pubik Lower Allen Twp., Cumberland County Commission E~ires )an. 5 2015 pENN9YkVANt!! -z, ~.~ ._ ~- BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA - ESTATE OF JEFFREY D. POLLAK also known as NO. ~ i -- j ~ - "j 1 - { -~ Deceased ~ ~' =~ ~ c WAIVER OF FIDUCIARY BOND The undersigned, being the sole (all) residuary legatee(s) or next of kin of the above named decedent who is (are) adult and sui juris, herby waive(s) the posting of any bond by JoAnne M. Pollak who is (are) the petitioner(s) for grant of letters of administration. ,- ,l,_ ~_--------_ Signature Typed Name: Robbi Olivia Pollak Address: 5020 East Trindle Road Mechanicsburg, PA 17050 Sworn to or affirmed and subscribed before me this ~/T,~ day of~/,~~„~ ~,ie. 2011. Not lic My mmission Expires: S/-/S-/a2 COMMONWEALTH Of= PENNSYLVANIA Notarial Seal Judy Hoover, Notary public Hampden Tvfp., Cumberland County My Commission lnspi=es Aprif 15, 2012 Member, Pennsylvarfc ?,rs rc~rf~,tion of Notaries BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JEFFREY D. POLLAK . also known as NO. ~ I . ~ I , ~ ~ Deceased , WAIVER OF FIDUCIARY BOND .--, ~' r, -; ,_ 'I~he undersigned, being the sole (all) residuary legatee(s) or next of kin of the above named decedent who is (are) adult and sui juris, herby waive(s) the posting of any bond by JoAnne M. Pollak who is (are) the petitioner(s) for grant of letters of administration. ,,' ~... Signature Typed Name: Andrew Charles Pollak Address: 1919 North Uber Street Philadelphia, PA 19120 Sworn to or affirmed and subscribed before me this 2 ~ day of ~~ ~}~/ , 2011. ~ ~~ ~ (._.~~~e; ~ ~ o t ~> Notary Public My Commission Expires: ~J~ Z.ZJ l ,~' NOTARIAL CATHERINE S RIYERA Notary Public PHILADELPHIA CITY, PHILADELPHIA COUNTY My Commfaalon Expire: M:r 22, 2015