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HomeMy WebLinkAbout11-30-11,r'' - v PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of .~ (~ ~~ File Number 21-11"~ „Z~~ ,Deceased Social Security Number 204-03-9122 Matthew Brundzo Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or 'B' BELOW.) © A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the last Will of the Decedent, dated 04/01/1980 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc. After the execution of the documents offered for probate: Decedent did not marry; was not divorced; was not a party tb'a pending divQCe procee in wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323 (g); did not have a child born o~dopted; was-net the uicti f a killing; and was never adjudicated an incapacitated person, except as follows: = ~ -°m ~ _~ ;_T -I r_.~ B. Grant of Letters of Administration ~' ' - ~ -' (Ifapplicable, enter: c.t.a.; d. b.n.c.t.a.; pedente rite; durance absentia; durance minodtate)~-~ ; , ; -~ Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived by the following3gouse Zif any=end heirs (if.!.;>> Administration, c. t. a. or d.b.n.c.t.a., enter date of Will on Section A above and complete list of heirs); was not the victim otaikilling; w s,never; ? adjudicated an Incapacitated person; and was not a party to a pending divorce proceeding wherein grounds for divorces-yia~fibeen est~tflished as `~`~ provided In 23 Pa. C.S.A. § 3323 (g), except as follows: v ~.~~ ~~ Name Relationship Residence Mat>?hew J. Brundzo Son 30 Briarcliff Drive Shippensburg, PA 17257 Debra C. Rotz Daughter 111 South Washington Street hi n PA 172 7 Victoria A. Smith Daughter 37 Violets Path P 1 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his !her last principal residence at Elmcroft, 129 Walnut Bottom Road, Shippensburq, Shippensburq Township, Cumberland County _ (List street address, town/city, township, county, state, zip code) Decedent, then ~~ years of age, died on 10/15/2011 at Chambersburg Hospital, Chambersburg, PA 17201 Decedent at death owned property with estimated values as follows: (If domiciled in PA) (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania All personal property Personal property in Pennsylvania Personal property in County 18.193.00 $ 65,000.00 Total 83,193.00 situated as follows: 30 South Washington Street, Borough of Shippensburg, Cumberland County respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to Signature Typed or printed name and residence Matthew Bru 30 Briarcliff Drive / -~ // .. ~ .. ~ n~~ ~ ~ Shippensburg, PA 17257 ---~ Form RW-O2 Rev. 12-26-2of0 (interim form, pending action by the Court) Copyright (c) 2006 form software only The Lackner Group, Inc. Pa, 1 of 2 COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland Oath of Personal Representative } SS } The Petitioner(s) above-named swear(s) or affirm(s) 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 +n before me this,f_~__ day of ^ ~O ~ I Signature of Personal Representative Stgnature of Personal Representative ~ 7 z' For the Register , -. -> :;:~ _~ ~+ q - -~ -- File Number: 21-11 - I a~ I ~-'= ' ~ _t~ - , Estate of `~~ (-= Deceased -r, Social Security Number: 204-03-9122 Date of Death: 10/15/2011 AND NOW, i~ ~'. Y~Y1 ~ Y oZ ~a~ 1 , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary ~;,~~ ew are hereby granted to Ma hew Brundzo in the above estate and that the instrument(s) dated 04/01/1980 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent FEES Letters .......................................... $ ~ ~ ~. Short Certificate(s) ....................... $ ~ . G~ Renunciation(s) ............................ $ ~:~, l~ ~~G ~~ c~ Attorney Signatu Register of 1.~~7 ~Sl/L-~ $ ~,~~ ~ UG Attorney Name: gr A. Wei le Es uire $ ~ ~ ~ ~ Supreme Court LD. No.: 1 4 Weigle 8~ Associates, P.C. $ Address: 126 East King Street $ $ Shippensburg, PA 17257 $ Telephone: 717/532-7388 $ $ TOTAL ................................... $ , Form RW-OY Rev. f 0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 c. ~n5 t~, c 9^\.~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 18008475 Certification Number This is'to certify that the information here given is correctly copied from an original Certificate of Death I duly filed with me as Local Registrar. The original certificate will be forwarded to the State, Vital Records Office for pe anent filing. 2a o Regtstrar Date Issued . __. ~r ~ ~ ~ .. ~~ 7 ,. ~~ ,.._ _, -.~ __ _ ; M105AM REV 112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS -~ `~ _ - -_ TTpErpmm~w CORONER'S CERTIFICATE OF DEATH ' ,'' PEIVAANENT BLACK INK nom. .,...-.-. ._.,, ~ -- ~ )D m 0 a ~a_ v sva_v ~___ _..__ ___.-..- _..- -._.....~.~.. ~„ .o.a. owl STATE FILE NUk1BER -~ ~ - 1. Yrme d Desadam R'ar, nftlAe, M0. ue.'el 2 Sea 9. Some SaaPrr NumOar d Derh fAlonm, aY• YdiY) I Evel n B BRUNDZO . Female 204-03-9122 october-15, 20`4'1^ 5. Ape flat BiNdfy) Umrr 1 r Uror t deY 6. Dre a Bidh (Mmm, 7. BMhaara Cny rid rW m 1 m. Prr d Orlli (Check m oM) aaeamf o,rs N«" raer Newbur Pa. ~ 01Mr 90r,a. January 19, 1921 9a Ik]byeiem ^Blraepn.n O+x,A ONUrsinplbine ^IWitlanca ponrr•spedly: eb. count' a Deem ec. Cby. 0oro, Twp. a oenh id. F+dM Nrr fn ms euRueon, qse stmt are nuMeO p. w« oapdem a > Nrprc Oripvi. ~x No ~ Ye5 t0. Yrx: Mmirn Ydaq Buck Whlr, rc. Franklin Boro of Chambersburg Chambersbur Hos ital w~a ~~ (~" g p . na ,er:, White 11, Oandre's W W rtl a wrk done '. moq d W. Do na frr 12 W« Osutlem eeer in Ua IS. Deagrdf Edu4tlm (figscMy Day Ifplrel prle cprglfrd) 1L MfriW 8rbr: AWrtl. Nwer kYnifd. I5. Sunxuq Spouse I„ rWe. prve mf4en Nme) KrdaRtrk Keroaaskr«lY•dulry U.S.AmatlFOa«? Ernanrry/Seconhry(P72) Cotlape(1-aaSs) 1 seamstress textile ^Y« prop 12 Widowed e.n.neaems~wrpAmm«~sue,LtlYlwrn.fm.. cede) Elmcroft of Shi ensbur 129 Walnut Bottom Rd aew.mf Penns Ivania °itlDivdeM Shippensburg Twp swe y Urine Aawlwfalrwe v. l] pp g, . Shippensburg„ PA 17257 . na. Y«.ao.areutlm Tip ,Tb.c,,,~, Cumberland T0"'"M0~ nd.0 uredar,r ~ a Aa aryreoro 1a. Ferr's Narta (Fk.t mkge, rft fang) ii. Idonrrs Yrme IRaI. eddtlk, mflen rmm~r) Harry Hayes Watson Minnie Grace Fogelsanger 2a. lmomemr wine (TyPS / Rlnp zro. kdmrreaf Iatnp Atlaas Ri«L ep mown eW, rp ma) Mathew J. Brundzo 30 Briarcliffe Dr. Shippensburg, PA 17257 z,a~aaanaadorpafron ` ©Gemfim ^Bd,Kd, 21b. wraf>I~omm~lMmm, day,yrr) 27c,RrsaBepwl4n tNfeieacenrery.arriraydanr pYOy ___- 21d.lmfm (ayrbrm,fire. npooaa) p a~rrBS~ad~-~ ~'I~~ ~ r°~~Op~In~a~eMrr I"dOwfONe October 21, 2011 Dugan Funeral Home and Crematory, inc. Shippensburg, PA 17257 2L. Sipnarra a F,airal SenAr Id Perim eabp w auay as I.innw Nurrar zz<. err. aro Atlreea a Fariy - Q~ X FD-012884-L Dugan Funeral Home and Crematory Inc. 51 Asper Drive, ShippensbLrg, PA 17257 cargra lrnr Y3as gay ergo ariynp 29a.Tame bKamy rrdeepe, gain ammadrar mr,mr.ropra mxa. tSquWeero rerl zm.lirree Number 23c. Dar ahmry~ r nd a«nade r tkna a drm b spn.a (sromk aY Yerl ceriryc.ua. a arm. name laze mar b aompkrtl M peaen z4. flr a Oeam 26. Bee Pmgerrd Deed tliMh, dN, t..r) zs. Was Cw RelenW b IAeaWI Erumirrr r cdmr to a Beeson Dint mr cmnrfnon «oonabn? `"'opP"°"~tl~h 9:58 P.M. October 15, 2011 l]Y« O~ CALiBE I1F IpE11TN (s.e IrretrssNom rmd..empin) , A{pmamae MrYae PW n: Emroma . ze. ou ra>ecr~ ur cdrbde m orm? Item 27. Pull: Ema me ~ih.d.C706-dgees«.ry.ni«,dmrpfanoia-IN4dfealr agreed tlr tleen.DO NDT erect rrrobul eserds rrdi«oMecamct. r Onelb Daam bul minWrg in tlrurdedtnpnuse piNr, tl Pedl ~ Y« ~PmCaNY Madrelory ems!, or wmdwrr nD'Raion ailgasioesq me a10Ia9Y. Lbt omyone wfe m each ire. ~ INiI TE CAIWE F aaeefa d ~ lr]a No [] lhrizwxn un~"reanMipb~r~r') i a, Complications of t_eft Hip Fracture! Surgery ; as.draa.r: we a to as a fanrar^nr an: ; O Nm pmgrm ergo pen Year sep,rammrM is miwkdm.narry, e. Fall 1 Q Pmp,rm nirddrm ro tour Wetl mine f. E UNBERLYNB CAUSE Dw b for «e oa«eprnce d): ^ Nd paprm, bn prepruM nglin 12 d°n ~.n.~nr"r:ule~m'dwnij~£°s~1e ~. Feet Tangled when Transferring from Bed to Wheelchair ~ adrm eve b tar«e mre.a»na. ar,: ^ Narapmpnrd sent t Y«r a r bMredWA p uw.noeniaevrmenennrpazyw SDa. an Aubpfy Spb. Were Aaooay Flndnps pt.wmaaorm IIa. Oakalntey titomY, day. Year) BPo Durre NOw lquy0murred 9tc.~ablery~ .Farm Street FacWy, P'^01n1ed? Avi°'b1e P1brioeoni^11Dn October 14, 2011 Fall, Feet Tan led when Transfenin from Bed to Wheelchair ~~99 ray a caul. a Urr? ~ Nab"n ^ Nmnatle 9 9 Personal Care Home ^ Yef ©No ^ Y« ^ No ~ Aca°"^ ^ ~Y hnefigenm aTa. Tlm a tnMay eta iPeY n wodc? pzl. M TareporW ion hpry tsp.ay) szp.leanm a IgwYt9uea, eMyrram, oar) ~&auae ^CaW Na be Derrnurtl Apgozhnnlely Dy« ~~ ^OdwtrOprror ^Pataager ~PeduaYn Elmuotl ol5hippensburg, 129 Walnut, SMppansburg Twp, PA 33e. Cstilrr lcheok piny ~) __ xb.sgnalue eronkac.m3er • arBMnpphf+rwrlPnnwenwug;~o~seawm.ArnenanerpnYKrnnespronounedde.n,neoomprralrn,za TomeeeelamrrreeAedpe,eemefr.s.eea.wmao~.ye).edmrK.r.wrt--------------------------------Q -~. ar /~~.s,7suo ~.OfOfl@f • ~e~~Ire~d~MrePM+~tav~mnpmnwdinpawmrdw~RYw~iraa«eaaem) ------- ~w.ucRS.wm.r avd,urespre(rmr.aer,w+n To tM eeerarey knoeMYpa,arm«fumdrur+mr,ar.andpru,end euerom.eeuagf)eea.u~.w«maa_---------- ~ ' i"~IE"'""rJ001en" October 21, 201 i On me bas aermhrtlonerol«i+reallptlfn,Mryoplmm,AtlA«reraartre tlme.4r,ero pra,eM ~Uebaefrrtal endsernrra4bd_ O & Nam aroAtld«sd PeaerWnoCrrpla«Cree dDsahlean 27f TYPe IPriM s6.R.prmrfsrpnws.rrd NuIMr -- 56gr ,dfy,yr,) Mr. Jeffrey R Conner - `- -- I .2.1 ~ (~ i / I S I ~~ 2 c_ ~! 1497 Loudon Road, Chambersburg, PA 17202 '. ~ IMfporam Perna Na 0608630 D01 ~. r~ _~_ '_~ -i C . LAST WILL AND TESTAMENT ' c _ ~_. , ~. _,' y - :--; ` _ I, D. EVELYN BRUNDZO, being of sound mind, memory and unders.~i~ding,~d~ ~~~~ make, publish and declare this my Last Will and Testament, hereby revoking all prior wills and codicils made at any time before by me. FIRST. I direct that all my funeral expenses be paid as soon as practicable after my death. SECOND. I give, devise, and bequeath all my property, be it real, mixed or personal in equal shares to my children, per stirpes, with the provision that they may take in kind, according to value. THIRD. I nominate and appoint my son, MATTHEW BRUNDZO, as the executor of this, my Last Will and Testament, and as such to serve without bond of any nature or kind. IN WITNESS WHEREOF, I, D. EVELYN BRUNDZO, to this, my Last Will and Testament. set my hand and seal this ~~ day of ~ Q~;t 1980. ~.,' ~ , Sworn to and subscribed, declared and published by D. EVELYN BRUNDZO, as her Last Will and Testament, and so done in the presence of we the witnesses, who sign at her request, and in her presence and in the presence of each other. OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of D. Evelyn Brundzo ,Deceased H. Anthony Adams ~n -~ _ ; ;, Sharon Coleman Adams ' (each) a subscr~tit-~~itnes~to ; ~ ~ the ^ Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, ~eps;~ei}s) aim say(s) that she / he /they was /were present and saw the above Testator / T~st~trix s`i~n the sa e __ ,-, and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in his /her presence and in the presence of each other. -~k- ~~ (Signature) H. Anthony dams (Signature) Sharon Coleman Adams 49 West Orange Street (Street Address) 49 West Orange Street (Street Address) Shippensburg, PA 17257 (City, State, Zip) Executed in Register's OfiFice Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills Shippensburg, PA 17257 (City, State, Zip) Executed out of Register's Office Sworn to or affirmed and subscribed before me this z 3- day of ~1 2. v l 1 ~, ~~ /~~. Notary Public My Commission Expires: (Signature and seal of Notary or other official ualified to administer oaths. Sho SSAlnmi~' n.) Linda K. Klein, Notary Public Shippensburg, PA Cumberland County My Commission Expires AR.°e~<~st 15, 2012 NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-O3 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.