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HomeMy WebLinkAbout01-06-12PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF ~~~ COUNTY, PENNSYLVANIA Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information Name• a/k/a: a/k/a: a/k/a: Date of Death: ~u,~,c,~ / ~ %~ Decedent was domiciled atat death in ~ .,,~, ~__~ County, principal residence at address, Post Office and Zip Code Decedent died at c~' ~ 1 `~~ , ~~~,•t~~~ Street address, Post Office and Zip Code File No• ~ l ~ I ~ ~~J ~ t (Assigned by Register) Social Security No: - 0= 7 a ~' Age at death: 9 PP~~t.~t~~..t..a ~(Srate) with llxs/hex last,- City, Township or 7 D City, Township or Estimate of value of decedent's property at death: If domiciled in Pennsylvania ............................ All personal property $ /lC~ ~(~ Q • ~-tl If not domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $ ~ If not domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsylvania ......................................................... $ ` TOTAL ESTIMATED VALI;E.... $ O, (/`dQ. Real estate in Pennsylvania situated at: /~//~ (Attach additional sheen, il'necessary.) Street address, Post Office and Zip Code City, Township or Borough County © A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated thereto dated 0 Coin County State and Codicil(s) State relevant circumstances (e.g. renunciation, death ojexecutor, etc.) Except as follows: after the execution ofthe instrument(s) offered for probate Decedent did not marry, was not divorced, was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), and did not have a child born or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ^ NO EXCEPTIONS ^ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d. b. n., d. b. n. c. t. a., pendente life, durance absentia, durance mina-itate If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs. Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. ^NO EXCEPTIONS ^ EXCEPTIONS ~ .. Petitioner(s), after a proper search haslhave ascertained that Decedent left no Will and was survived by the following spa~(if any) artd~eirs (aCtac tt,., additional sheets, if'necessary): ! ~ w1v C7 "-' t,, n -:~° Name Relationshi Address ; "~~ `3` ._ . ., c.,. _7 -ii ..~ ~__ ~.,. _i '.. r_._ '~ y r^,~ t..~ l T Form RW-02 rev. roiunoll Page 1 of 2 U'~~ Oath of Personal Representative CO VI~tONW'EALTH OF PENNSYLVANIA } } SS: COUNTY OF ~„_,,, } Petitioner(s) Printed Name Petitioner(s) Printed : s'*-`"'.~' ~ F~r ~ F ~~ a s ' a e ~ ~r ~ ~S u~ T3 7'~~ ~ Ave t ~ i~~4 /~od.~ The Petitioner(s) above-named swear(s) or affirm(s) 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, the Petitioner(s) will well a td truly administer the estate according to law. Sworn to or affirmed an subscribed before '' Date ~ ~-- ( _ /v~ me this day Cf~trs U/2 Date ~ 6-i ~- $y; Date F the Register Date BOND Required: ~ YES ~O To tlae Register of Wills: FEES' Please enter my appearance by my signature below: Lette s ...................... $ ~~ (~) Short Certificate(s)...... ~~ ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission .................. Other ........ ...... Phone: Automation Fee ............... / Fax: .ICS Fee . .................... _ Email: TOTAL ..................... $ ~ DECREE OF THE REGISTER Estate of ~r~>s~~V~`4., ('1-'A,1~U(Y> l,~~p~~~/FileNo: ~ I ~ ~ -'" Q~~~ a/k/a: AND NOW, ~ , ~ ~, in consideration of the fore oing Petition, satisfactory proof having been resent before me, IT IS DEC ED that Letters hereby granted to r ~-- 't ~ in the above estate an (if applicable) that he instntment(s) dated c~ Q ! 9 5 described in the Petition be admitted to probate and filed of record s the la Will (and Codic' )) of Decedent. gister of ills ,, ~ ~~ _ ~ .. ~ ~~ Pa e 2 of 2 Form RW 0_ ; cv. l0/1Ii1011 g Attorney Signature: Printed Name: Supreme Court ID Number: Firm Name: Address: Hins.so~ (zE~' wii n LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. n Fee for,~sc-certifi~e, $6.00_ - - _ , , tT~ ,~ - i;_ ,~ ~ _~K- J '"" {"V -~ `~Eertificat~ Number Z~ -- Type/Print In Permanent Black Ink d 1~! ~y S.J a This is to certify that the information here given is correctay 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. L.~irt ~ ~~~xt~r~t" J A1~1 3 ~ 012 Local Registrar Date Issued . COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS CERTIFICATE OF DEATH 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Vr) (Spoil Mo) Gertrude K. Shoenberger Female 167-40-2298 Janus 1 2012 Sa. Age-Las[ Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Da 6. Dste of Birth (MO/Day/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Country) 92 Months Day: Hogs Minutes Sept . 7 1919 St _ Thomas , PA I 7b. Birthplace (cq•,na) Frame n 9a. Residence (State or Foreign Country) Sb. Residence (Street and Number -Include Apt No.) 8c. Oid Decedent Llve in a Township? Pp+ 801 N _ Hanover Street Vas, decedent lived In N[]rtl't Mi ddl pt on twp. qu gd. Rg:l( n ~ d G-: 1 8 Be. Residence (Zip Cade) Q No, decadent lived within limits of clty/boro. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death Q Married q[Widowed 11. Surviving Spouse's Name (If wife, gtve name prior to first marriage) Q Yes ~ No Q Unknown Q Divorced Q Never Married Q Unknow 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Hila Frank Ma hu h Alice Avis Mowen 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, Clay, State, Zip Code) g Richard A. Shoenberger Son 327 S_ Baltimore Ave., Mt_ Holly Springs, P i a. awe q eat qn qne s _ ....... If Death Occurred~in a Hos Ital: ~ In [lent : p pa _ _ _ ........ If Death Occurred Somewhere Other Than a Hoz ital: [~ Hos IceFaclli p p ty [~ Decedent's Home ~ Emergency Room/Outpatient Dead on Arrival • Nursin Home/Long-Term Care Facility Other (Specify) a~G lSb. Facility Name (If not Institution, glue street and number; lSC. City or Town, State, and Zip Code lSd. County of Death - 16a. Method of Disposition ~ Burial Q Cremation 16b. Date of Disposition 16c. Place of Disposition (Name o7 cemetery, crematory, or other place) p Removal from state p Donation ,Ian _ 7 , 2012 Cumberland Valley Memorial Gardens Other (SpecHy) 2 16d. Location of Disposition (city or Town, State, and Zip) 17 nature of Funeral Service Licensee or Person In Charge of Interment 17b. License Number Carlisle, PA 17013 013144E 17c. n and Complete Address of Fun al Facility Hoi~man-Roth Funeral Home & Crematory, 219 North Hanover Street, Carlisle, PA 17013 ~ 18. Decedent's Education -Check the box that best describes the 39. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to Indicate what ~ highest degroe or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. Q gth grade or less Is Spsnlsh/Hispanic/Latino. Check the "NO" White Q Korean W No diploma, 9th - 12th grade box If decedent is not Spanish/Hispanic/Latino. Q Black or African American Q Vietnamese Q Hlgh school graduate or GEO completed Q) No, not Spsnlsh/Hispenlc/Latino Q American Indian or Alaska Native Q Other Asian Q Some college credit, but no degree ~] Yes, Mexican, Mexican American, Chicano Q Asian Indian 0 Native Hawaiian Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, AB, BS) Q Ves, Cuban Q Filipino Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino Q Japanese Q Other Pacific Islander ~ Doctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (Specify) . MO DDS DVM LLB JD 21. Decedent's Single Race Self-Designation - Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Vsual Occupation -Indicate type of work White Q Japanese Q Samoan done during most of working Ilfe. 00 NOT VSE RETIRED. Black or African American Q Korean Q Other Paclflc Islander Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Homemaker Q Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian Q Other (Specify) OWn Home ~ Filipino Q Guamanian or Chamorro ITEMS 23a - 23 MV BE COMPLETED 23-{ygate Pronounce Dead Mo Day 23 . S gnature o Person Pronouncing Deat Only when applicab a 23c. License Number BY PERSON WNO PRONOUNCES OR CERTIFIES DEATH / /f O / • L c~^b~Z'~(~C~~ 23d. Da a Sig d (MO Day/Vr) mo .Time of De at h / t 6 (~ / ~ LQ ~ J ~ ~ ~~, 25. Was Medical Examiner or Coroner Contacted Q Ves No CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of events--diseases, injuries, or complications--that directly caused the death. 00 NOT enter terminal events such as cardiac eat Interval: respiratory arrest, or venirlcular fibrillation wlthouY showing the etiology. DO NOT A 66REVI A TE. En ter only one cause on a line. Add additional lines if necessary Onset to Death l / N ( IMMEDIATE CAUSE --------------> a. ~ L "~ ~ ~- tl- ~ ~~ ` ~ ~ 1 ~ Y -~ ) (Final disease or wndition Due to (or nsequence of): resulting in death) Sequentially list conditions, Due to (or as a consequence of): If any, leading to the cause listed on line a. Enter the UNDERLYING CAUSE Due to (or as a consequence on: ( (disease or Injury that F iniilated the events resulting d. In death) LAST. Due to (or as a consequence o7): 26. Part 11. Enter other si niflcan Itl but not resu Ring In the underlying cause given in PaK 1 27. Was an autopsy performed? Ves 3: ~' ~~ ~ C JT' -~c--~ ~ l .i ., iG -~% ~ ~^ `~- ` V ~ 2H. Were autopsy findings available to complete the cause of death? ~ D Yes No S' 29. if Fe^~~^ale: t re nant within ast ear QN 30. Old Tobacco Vse Contrlbule to Death? Q Ves Q Probabl 31. Manner of Death Natural Q Homicide p g p y O Q Pregnant at time of death y Q No ®Tnknown Q Ac<Ident Q Pending investiptlon °~ Q Not pregnant, but pregnant within 42 days of death Q Suicide Q Could not be determined ~ Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Yr) (Spell Month) Q Unknown if pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, Qty, State, 21p Code) 36. Injury at Work 37. If Transportation Injury, Specfy: 38. Describe How Injury Occurred: Q Ves Q Driver/Operator Q Pedestrian ~ No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): g'!`ertlfying physician - To the best of my knowledge, death occurred due to the cause(s) and m r stated Q Pronouncing a3i CertlHing physlcl n -TO the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated Q Medical Examiner/COrone - th ba minatlo a d/or Investigation, In my opinion, death d at the time, date, and place, and due to the cause(s) and man r stated fJJT}}f x cc / Q y /~ M t~~ Z '~Za g~~ ~ ~ - license number: Signature of certifier: W retie of certiner: I 39b. Name, Address and 21p Code of Person ComS~leting Cause of Dea (Ito 26) ~ v`~ -TI 3 O ~ ~ '730 ~ I f ~ 39c. Date Signed (MO Day/Yr) ~- .~ . ~.--J : r - v ~ 2 G e - r ¢.~ sf V.~4 / t7 A v «( L _ W a .,.,• - , / V 1 - O 3 - 1 Z 40. Registrar's District Number 41. Registrar turc 42. Registrar FI a Date Mo Day 43. Amendments Disposition Permit No. y ~~ I~'lq H105-143 REV 07/2011 LAST WILL AND TESTAMENT c7 .- OF ~ O - -r. ~~ --~ ;'~j ;L C? :~ - GERTRUDE R. SHOENBERGER .`-m ,- .~ cc, _ ., ., ._,~ -_ ; c-~ _ ,, ...r~ - I, GERTRUDE R. SHOENBERGER, Social Security Number 1~7~40-2~.~8,:-of~~ the Commonwealth of Pennsylvania, declare that this is my LAST W~LL ~~ TESTAMENT and I revoke all other wills and codicils previously made by me. FIRST: I appoint my sons, WALTER E. SHOENBERGER and RICHARD A. SHOENBERGER as my Personal Representatives concerning this Will. a. I request that my Personal Representatives be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representatives act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where my Personal Representatives are unable or do not desire to qualify as ancillary legal representatives, I appoint as such ancillary legal representative such individual or corporation as my Personal Representatives shall designate, in writing. b. I direct my Personal Representatives to pay the expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including a suitable monument or marker for my grave), and written charitable pledges which I have made. I grant my Personal Representatives the power to extend or renew any debt for such time as my Personal Representatives shall deem appropriate. c. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representatives may pay such taxes at any time deemed advisable, whether or not then due and payable. d. My Personal Representatives are requested to settle my estate as soon after my death as may be practicable, and to pay or deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. PAGE 1 ~~~~ ~~'~o i ~ ~~ 1~~-~'/~ l,~i OF 5 PAGES e. I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representatives concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representatives honor my wishes therein expressed. SECOND: I give, devise and bequeath, absolutely and forever, all of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to my children, WALTER E. SHOENBERGER, FRANKLIN P. SHOENHERGER, JR., GLORIA J. THUMMA, DWIGHT W. SHOENBERGER, RUTH A. ADAMS, and RICHARD A. SHOENBERGER, in shares of substantially equal value to be divided as they may agree. a. If any of my children shall not survive me, then the share of that deceased child shall go to the descendants of that child, who are to take per stirpes and not per capita. If any of my children shall not survive me and shall not be survived by any descendants, then the share of that deceased child shall be distributed to my surviving children and the descendants of any of my other children who fail to survive me, in the manner set forth above. b. If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shall be made by my Personal Representatives, in those persons' sole and absolute discretion. I empower my Personal Representatives to sell any or all of such property, if such property is not distributed in kind hereunder, and to distribute the proceeds among my said children in substantially equal shares. Any determination of my Personal Representatives as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should be sold shall be conclusive. THIRD: If there is a complete failure of takers under the preceding paragraphs, the property undisposed of shall go to my heirs determined at the time of my death, pursuant to the Statutes of Descent ~ and Distribution in effect, in the state of my domicile, at the time of my death. FOURTH: If any beneficiary to any share of my estate which is not subject to the provisions of any trust which may be created by this will is at the time of distribution of his or her share, a minor under the laws of his or her domicile, I direct that the minor's share be converted into qualifying property and delivered to the minor's Guardian as Custodian for the minor under the Uniform Gifts to Minors Act or the Uniform Transfers to Minors Act as may then be in effect in either the state in which the beneficiary or the Custodian resides, or any other state of competent jurisdiction. PAGE 2 _J~ _~~~ ~' y l~ OF 5 PAGES a. The Uniform Gifts to Minors Act or The Uniform Transfers to Minors Act, as may then be in effect in the state concerned, is hereby incorporated by reference. The property affected by the Act shall be managed, held, and distributed in accordance with the provisions of the Act. b. The financial custodian will serve without bond or surety and without intervention of any court, except as required by law. c. The receipt by the Custodian, for the minor, of any principal or income transferred pursuant to this paragraph shall be a full acquittance and discharge of my Personal Representatives or Trustee, as applicable, from liability with respect to such transfer and from further accountability for the principal or income so transferred. FIFTH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. SIXTH: Any beneficiary who fails to survive until thirty (30) days after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. SEVENTH: Definitions: a. The term "children" as used in this Will includes adopted and afterborn persons. The term "children" as used in this Will shall not include step-children, the natural born or adopted children of a person's spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. b. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. c. The term "Personal Representative" as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. PAGE 3 .. .. J OF 5 PAGES d. The term "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed shall be divided into as many shares as there are (1) living children of the person, and (2) deceased children, who left descendants who are then living, of the person. Each living child (if any) shall take one share and the share of each deceased child shall be divided among his then living descendants in the same manner. EIGHTH: In addition to any powers granted by the laws of the state in which this Will is probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. NINTH: If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representatives may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this 10th day of February, 1995, set my hand and seal to this my LAST WILL AND TESTAMENT, consisting of 5 typewritten pages, each page bearing my handwritten signature. -~J ~ X ~,Q~.y-Q~~~ ( SEAL ) GERTRUDE R. SHOENBERGER PAGE 4 OF 5 PAGES The foregoing instrument was, at Carlisle Barracks, Pennsylvania, this 10th day of February, 1995, signed, sealed, published and declared by GERTRUDE R. SHOENBERGER, the testatrix, to be her LAST WILL AND TESTAMENT in the presence of all of us at one time, and at the same time we, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testatrix is of sound and disposing mind and memory at the date hereof. OF ~-f~LCi ~L '~ / ?0/3 OF / %~7.~fi~.~it.U / ~a/~ I, of p~ /7b~~ PAGE 5 ___ ~~1 F 5 PAGES ~~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ACKNOWLEDGMENT I, GERTRUDE K. SHOENBERGER, testatrix, 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. x..t,~,r~ ~ ~~w.p • ~~~ Ox.~ (SEAL) GERTRUDE K. SHOENBERGER AFFIDAVIT we , ~ S ~C LT'C O~ Gc , ~.'r I.Q,YIJZ_, ~ l ~ S and J 0~~ 11~~~e~ , the witnesses, sign our names to this instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her Last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the will as a witness; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind MMand under constraint or undue influence ~ /y -~,~ Witness fitness Wit ess Subscribed, sworn to and acknowledged before me by GERTRUDE K. SHOENBERGER, the testatrix, and subscribed and sworn to before me by ~S7~c ~ GEZ~~~~ , ~'( 1~.Y1~ ~1~ and Ohn ,"If''~~` the witnesses, this 10th day of February, 1995. NOTARY PUBIC My Commission Notarial Seal Kim C. Guyer, Notary Public Carlisle Boro, Cumberland County My Commission Expires Nov. 10, 1997 Me'. :,;~r, f-'~nnsylvsnia Association of Notaries