HomeMy WebLinkAbout02-06-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF ~y>»~<-~' ~~n ~ COUNTY, PENNSYLV,aNIA
Petitioner(sj 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: CIL•P~/'? ~~ RD6/~S~C~
a/k/a:
a/k/a:
a/kla:
Date of Death: J 3~~a-o? 2
T ~"
Decedent was domiciled at death in (~ri7~Jt^'"~~~d{ County,
principal residence at a ~ ~• E tt/~~r~ ~T S ,Sh,r~,r,,.,.., s ~>"
Street address, Post Office~J~d Zip Code
Decedent died at ~~lu-f' SiPE-~'4~-~i ~tjsp,~4
Street address, Post Office and Zip Code
File No• (~ I, ~ I ~ "~ I ~-~
(Assigned by Register)
Social Security No: ~Z~ ~~g~ J `~ ~~
Age at death: 7_S
(Stare) with his/her last
City, Township or Borough County
City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled itt Pennsylvania ............................ All personal property $ L/,3 Ol DOD
!f nat domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $
Ijnot domiciled in Pennsyh~ania ........................ Personal property in County $
Value of real estate in Pennsylvania ......................................................... $
~`~' JJ > ) TOTAL ES/TIMATEDVALUE. ... $ l.~tiQ.CD //
Real estate in Pennsylvania situated at: o2I~ ~' WQ{>7 Jr" ~r SI'! lyL••~t~Ls'l,s~h1yt ~~-1 b,ra,Ia.n.~
(Attach additional sheets, ijnecessary.) Street address, Post Office snd Zip Code City, Townslirp or Borough County
A. Petition for Probate and Grant of Letters Testamentary / ~l
Petitioner(s) aver(s) helshe/they is/are the Executor(s) named in the last Will of the Decedent, dated to ~~ ~7 and Codicil(s)
thereto dated
State relevant circumstances (e.g. renurrciatia:, death ojexecrrtor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not divorced, was not a parry to a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(8), 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.u., d.b.,r., d.b.n.c.t.a., pendente life, durunte absentia, durattte minoritute
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 parry to a pending divorce proceeding wherein the grounds for divorce had been established as defined
in 23 Pa. C.S. § 3323(8D and was neither the victim of a killing nor ever adjudicated an incapacitated person.
^NO EXCEPTIONS ^ EXCEPTIONS
Petitioner(s), after a proper search has/ltave ascertained that Decedent left no Will and was survived by the following spouse (ifany) and~htirs (attach
additional sheets, ifnecessury): ~ r~
-'v .
Name Relationshi Address ~ rT1 - :,.'1
em.
f
.
~O~ -v -:
~ `
r_
~
t~
F~,~» ~ Rw nz reg. roilliznll Page 1 of t
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
/ } ss:
COLNTY OF ~b[,/[ }
2~~2 ~ EB _S P~ f ~ 32
r
/111h~
Petitioner(s) Printed Name ~ s
Petitioner(s) P ~ s
. Rnt~ ~ n K 1 61 ~~G c~t.-~~ ~,~{ cam.,- r s . - ~° l ~o lS
The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and a~rrect to the best of the knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the Decedent, the Petitioners will Il nd trd administer the estate according to law.
Sworn to or affirmed ubscribed before~~ ~ G~ Date 7/ / ?/
me thi day o ,~~ D
By.
For the Register
ate
Date
Date
BONDRequired:QYES ~NO
FEES:
Legs ......................
( )Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( ;) Affidavit(s)........... .
Bond ........................
Commis ion...........
Other
$ -(.(~!
~--
Automation Fee ...............
JCS Fee .....................
TOTAL ..................... $
To the Register of Wills:
Please enter my appearance by my signature below:
Attorney Signature:
` f,
%~
Printed Name:
Supreme Court
ID Number:
l .
Firm Name: /~
Address:
Phone:
Fax:
Email: ,
DECREE OF THE REGISTER
Estate of ~ ~ 1~ ~ if ~~S~~.. File No: ~~I ~j - 1 ~ ~'
a/k/a:
AND NOW~S
satisfactory pro f h~ tng been
the instrument(s) dated ~ /a x-1(9 sr y
described in the Petition be admitted to probate and filed
6 ~~~ , in cons' er lion of the foregoing Petition,
before tne, IT I,S DECREED that Letters "
:by granted to ~,~~~ `~p(oi ~ S ~Ci.
in the above estate and (if applicable) that
the ~asf Will (and Codicils
Iti
Form RW-02 rte. roiiliaoii `~ I ~ ~ Page 2 of 2
{7 ~~. Cf~~ art In/I!,
LO~~~~RAR'S CERTIFICATION OF DEATH
V{~11~[~i:''..Ft iL~'~i~egal to duplicai:e this copy by photostat or photograph.
Fee for this certificate, $6.0~~ ~ Z ~~~ ' 6 P~ , ~ 3
CLERK OF
pRPHAN'S COURT
CUMR~R! ~7N~ CO . PA
P 1~1~4341
Certification TJumber
l~
'~
"!
~_
rYpe/PHntM
Nrmxwnt
Bkd Ink
This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will be forwarded to the State Vital
Records Office for permanent filing.
~r~~~~~ ~ i ~ i~~
-cam
Local Registrar Date Issued
COMMONWEALTH OF PlNNSYEVANM • DEPARTMEM OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH Sbb FAe NUmben
L DebdenYS Lapt Narrla (FNat Mlddk, Latinn, Sufllel 2. Sn 3. Sxhl searlty Numbx A. Dab d MHA IMWDHnrI ISpeN Mol
GLVI R Y1P$ RQbIKS~CI I7I - ~gK1ACA.v' °U olDl
Sa. Ne1aO Birthday IYnI Sb.IMMr 1 Yea k. UnM 1 6. DHe
H
R
M
h
(M
O/
Drynaxl (S
WN MrnM) TF. StW w forNFn Cnunbyl
. McMM Mw Noun Mimstn n
y~
L
~~ ~
~
,~
~
~
w~
n
~UCPIIMJGL' -~ ~-7~
LC , ~
7a Nrthpao IEOUntY)
V. Stan w ForHN CaYntly'I Rb. Reskance (Stoat and Number - InclMe Apt Na.l k. Dld De<MarN LM M a 7awrNMp7
^II_ s. l_In~ cL_Ctl
, ^YM dabdmtNvad In lwp.
b. erlee lCauHV1
11 ~'~ JfT
E%%~ APP YY
11
M. ReNdence IZk Cede) ~' No, eecedent IMd wkhln INnlb of .5h IYY_YVYGWYS'~n 1 Lra'1 clly/bwo.
9. Ewr M US AmiM FpcesT 10. Marital SbM n Time W MM ^ MxrNd Wldoead 11. SurNNnF Spow1 Name INrih, 4'n name pNw ro flrH mamkF.)
Q Yes ~ No ^Unknovm ^ Dhurod ^ Newr MarrMd ^ NAuosvn
12. FHMM1 Name IFksL Mbdk, Last SuMkj 13. MoMaYS Name Prkr ro Nnt AlarrkBe IFln4 MNMk, laR)
r
SN. MFormant's Name 110. shk to Decadent ]k M/ormant's Ma AOdreH (SirM aM Num , [ky, StM, 21p Cadal
E
+
S
A€
~
b€b€
N OoN OtnrrM M a MppW: Inpatlenl :
E Roam/ Matl m ANMI
' ............ .......... ...... ...._............_...........
II Math OuurrrM SonNwhan MMr loco s Mbpbl: ~ Nespha faclMry -QMCeMnrs Nome
Nun N •Txm Gn FatlNry Otlsar (
yyy lSb
FatlNry Name IN rut Yutkutlon
pae HtM aM rwmMr' 13C
Cll
w Town
Sbte
aM 2y Ced
f D
lSd
M
.
,
s•
r .
r
,
,
e ~-~s
. my o
p
I
IW. Melhod of
CbmHion 1Bb. OHeHDbpvdtlon 1 Mao Hdsposkbn lNameMbmebry, aertutay,w Mher okeel
° Rat ~rha1 3bb1 Q Mnatkn a 3 ~ al a YYtccl,A,v~rF `(,~b Coma
ItA1. Lontbn M Olspwlikn I[kr w Town. Stab. and 2y1 ]7a. Funanl Saryke Lbansw o Peron t2Mne H IMermem 17b. Ucarne NumMr
mecsharl~cs P/F I ~os-5 H~ a~ FDO >_
}7c. Name a Campl~te Mdnr H iunerH FaUkr 1 _
L. rsE -flecktM bn thtt 6M denrlbestM 19. Oendent Mc OryN-CNM Me 20. DaoMnt's Rob- FOR ravsroindkate what
i° hIBMt dapee w IeeN W wheel campMad at Me tlme a1 Mats. boa thH beNdasctlbM whathx its datadant its deoadml eanaNered NmseN w hxrNto M.
Mh Brade orku IsSpnhh/NlsWnk/latlra. GMtM'NO' WhM ^ Koran
Q Na dlWoma, 9th-12M patle Yea NdacadentbmlSpaMSh/NlspaMC/laHno. ^MadiwAhbnAnuNnn ^VNWmne
HI/i school paduata w GED oompkbd No, not SWMsh/Nbpank/Latlne Q Mixon IMNn wAlasb NHM Q Otlwr Allan
Some bReBe ruedk, but m deBrw Yn, Makan, Mnion MNrkan, fAkaro ^ Askn Inelan ^ NatM Hawalkn
Avotlate dyrw (ey M AS) ^ Yn, Puerto RNan Q CAMap ^ Guamanian w Chttrwro
,® ILMeIw'a e.Bree ley x AB, BSI ^ Yn, CuMn Q FNybu Q sxnnn
MHMS datpw (ay MA, M5, MEN, MEd, MSW, MBA) ^ Yn, oMer SwMSh/Hhpenk/laNno Q legneM ^ DIMr PacMc Iskntler
Q Doetonb Ia.B. PAD. EeDI w M1eInWnH deBrea (SpaeNyl Q tkMr ISparNyl
e.. MD DVM LLB m
21.OecatlanYS Siryle Rob Sek-0aaymtbn -ChM ONLY ONF ro IMIn[e what Me deudant cansMlerae MnaaN w hanall to M. 2h. DeoMnYS Uwal Orsupttbn - IMlcab tyq W wM
)~ Whke ^ kgneN ^ Samwn done duchy oust d workiry Nh. DD NDT USE RETIRED.
Q &atk w AHbn Anwrk n Q Karen ^ Otlwr Pacific Waneer ~ps
Amxkm IMkn w AWka Wthre ^ Vktnamne ^ Don4 Krww/NOt Sun -
C•.~ ar<.'~
^ Ashn IMkn ^ OMer AWn ^ RRlusad 226. MM H Budruss Mustry
Chinese Q NNM NawlMn Q OIMr ISgciN)
N (,'' 11 ~L CI- __ _ (~~ ~ ~ ~ y~ ~ ,y.
I
~~
(
•
^ F
pko ^ GuMNMM w CMmwn 3/
ZJ
W
~T a71V=
c .]E;.YIUJ
COMMETm
Br RFRFa«wNO rILONOLndas oR 33a. Mb ay r
/ -~-/~ 23b. 51Fnttwe Penan a ble
/:.V
/y//CNELE 3'.V S/ UvrNe N
Kr/5(89y1J~L
'„ f '
2Kne
alMamwnrl :..TNnepEDepp
s/ /17/kA~L/af7 ARdAR.v ~/ RAr
S(o50ggPf}
/
`
"~'CJ3 25.WaMadkal EaamkurwCeranar [amactad7 QYn No
CAUSE OF DEATH Approaknate
26. M1rt1. EmxtM dNln dawnh-disnxs, Mlurks, or complkHbns-MH dNactly nosed Me deaM. DO NOT anbrterminalewnU SUChnuMlacamsl Intaml:
rnpiratory arrest, w wnWwlx RbrNk
bn
e
wkl
uut sAOwby the etl
d
O
N
O
T
AB
BR
EV
IA
TE. Entx oMy wr
n
~se m
a Ilne. Add addkbnal Nrns N ~Nnsaxy j Omet to Deets
. D
aFy
/
~
~
E
~
~
~
,
p
n
~
/
-
~
y
~
~
•
^~
IMMEDIATE CAUSE --.-..._..> a.~lTl"+-11 C~ ~~ S 1'I le-E ' 1 V In / ~L S I
IHnH dlYw w cwdMm Dw to Iw M a wnae9Yence all:
rewmrymaeMl 6.~10R~JN~'2Y (~1Tt.7~12Y ~I S~ CL
seawntwN NH mMmon., we n for n a bnseawnce oF1:
N,m. kaakB ro its wse
Nstad on Noe a. EMx tM
UNDGLrNIG f1111SF Due to jar as • conseawnae oFl:
IHIwaM w Inury tMt
IMtkted Meawnh roukiry d.
C In eeathltA.sT. Dua to lac esacomwuence oq:
16. Pan 11. EnM Hhx Ml notnwMNkIM YMerlyNy base lNe^MPartl 37.Wnmaskapsya 7
~7,"IS
pTIr~ ~27LRY $~j¢tq
Av4rvrno
v
19 LAR rn No
,
.
~
~ 2B.wxe autapW nMNya.raNabe
} AI.'-Fp ~1 r-! ~/~ /1,r~ /~
PV
LA 04~k
~r1
4c t~lU? OX
P to <ompMetM HdnM7
.
! Vy
N
/VIL
.J
/RNIG rn No
29. If Femak: 30. Old Tobatte Use ConWMta to MIM7 31. Manner M MHh
Not palpum wHNn pastwx ^ Yn ^ ProMbN ^ Nttunl ^ slolnklde
Pra9rnn[tttlme ofMM ^ No Q Unknown Q Atrldent ^ PeMNy lmeslyatbn
Q Not presets, but prelMant wnhM 12 dM of aatn Q SukIM Q Cwk not M eetermime
^ NH prgnan4 bN preBwnt 13 caw to /war Mfon even 32. Date H Inury IMO/Daynrl (SpaN ManMl
^ Unknown N pn9nant wNMn the pot yea 33. TMe Mlnlury
3.. Noce of Injury ley Mme; mnstnsMOn ske; krm; school) 35. Lacatlon H Injury l$trM all NumMr, CNy. Sttte, 21p Cove)
36, Injury H WM 37. MTramportaNan Injury, 3pttIN: 31. DeseHbe Now Injury Owunetl:
Q Yn ^ DrMr/Opentw ^ PaMHrkn
^ Na ^ Paexryer ^ aner IANeNrI
39e. IChM oMy anal:
physkbn • Te Ilr beN H mY NnaWMp, daaM acprrW dw to Me ousels) and mentor sttted
^ ProriosaRblB B Cartlrylry physkkn -TO IM Mst H rrw kr~owNdBe, dell otsurred tt tlw tlme, eHe, all pkn, all dw b tln nuxlO all mamer tlned
^ MMkal EeamMx -M Me bash H eeaminaHan, and/or kwxtiptbn, k my aplnbn, Oats occumd at Ma one. Nb, all pko, ant dw to tM ewWsl all mNRrr flatea
sywtwe arnRMar: TIM H canlDer: M ~ Lkerw Numb.r:;M []42~ 3 3 3
I96. Naau, Addrw all PP H N CwnWenM 4uu of Mats Ikam 26) ~
2
~ 39c Dab ( nrl
fJ1 (
AM I9,~1 1"~I'~L71
AR Nl47QV) Ie 1S I~vHRrv 3yn,IY319~I~ 1 0~ 1 .ZQ al.
b. RaFNtr s Dbtrkt N /1. SlBnttun 12. ReFh Ma
w '
dl- ~ 4. i~
a
13. AmeMmenU
plapasitbn Permn No. `-' ~~ (l~O~__
NIDS-113
Rev aT/2Du
OATH OF NON-SUBSCRIBING WITNESS(ES)
Estate of
REGISTER OF WILLS
~~'~:-~ ~4-j~-n a~ COUNTY, PENNSYLVANIA
~~~u-~ ~ ~ ~d~1~nS~)
Deceased
1~1~ ~ , R d/3~n .~ Iz l and ~'~~n ~ ' ~ ~ ~j ns k, ~ ,
(each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well-
acquainted with ~ I L.P.e~ ~ ~ 1013 ~ ~Sk) and am/are familiar
with the handwriting and signature of the decedent, and that the signature of ,EiL~L/~ !7~ , l~~Bin,f~~
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~ll-~'? A • Rai ~ns~ k )
is in his/her own proper handwriting.
~~~~,~
(Sigrruture)
y6 I Sfanr LrGitfz~~ ~~
(Street Address)
Cz,~;~~Y ~~ I~d~~
(City, Stare, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
befor me this ~ day
o > , ~_~./
ter of Wills
~s~ •
(Signature)
(Street Addres/s) /
(City, State, Zips
C'? n,.+
:.":
Q N
- ,~
~
;3.7
(7'q
~
r'~ r
,
ii ~ ____
i ~I=:t C-~
~ .R
-
C7 C7 -r~
oc
~ ~
•
:~~' ~_
__x
-
~ --,
D ..
W n
i-= s
C°~
N
Fonu RW-OA rev. 10.I3.Oh
LAST WILL OF EILEEN A. RCBINSKI
I, EILEEN A. ROBIN~KI, of the Borough of Shiremanstown, County of
Cumberland, State of Permsylvania, being in good bodily health and of sound
'~,! and disposing mind and memory and not acting under duress, menace, fraud or
'i
ii undue influence of any person whomsoever, merely calling to mind the frailty
of human life, and being desirous of disposing of ~tY worldly goods while I
have the strength and capacity so to do, I do make, publish, and declare this
my LAST WILL and TESTAMENT, I hereby revoke, cancel, and annal, ashy and
all Wills and Testaments, by me at any time made heretofore, including
codicils thereto, and declare this alone to be my LAST WILL and TESTAMENT.
AS TO SIICH ESTATE AS IT HAS PLEASED GOD TO ENTRIIST ME WITH IN
THIS LIFE, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM ~,. I direct that my executors hereinafter named pay and
discharge all of ~Y just debts and funeral and testamentary expenses.
ITEM 2. All the rest, residue and remainder of my estate, where-
soever situate and whatsoever it ~Y consist of, I give, devise, and bequeath,
absolutely and in fee to my dearly beloved children, DONALD J. ROBINSK~,
DAVID S. ROBINSKI, and MARK E. ROBINSKI, share and share alike, per stirpes.
ITEM 3• I nominate and appoint David S. Robinski as Executa~r of
this my LAST WILL. Should the Executor named fail to qualify or cease to
aat as Executor, then I appoint Mark E. Robinski as Executor in his stead.
ITEM I direct that mlY personal representatives, as well as
JA3rEB M. BACA
ATTORNEY AND
COUNSELOR AT LAW
107 ST. JOHN~3
CHURCH RD.
SUITE ~ 2
CAMP HILL. PA. 17011
TEL. (7I7) 737-2033
their successors, shall not be required to give bond for the faithful
performance of their duties in any jurisdiction.
~, 2 -
~ EILEEN A. ROBINSKI
rya
^r; ~ ,
1'r7 f-
('~^ f' °fi
f ~r
~.Ii.7 `~
~/.~
- 1
LAST WILL OF EILEEN A. ROBINSKI
I, EILEEDT A. ROBINNKI, of the Borough of Shiremanstown, County of
State of Pennsylvania, being in good bodily health and of sound
Cumberlaind,
and disposing mind and memory and not acting under duress, menace, fraud or
undue im.fluence of any person whomsoever, merely calling to mind the frailty
of humam life, and being desirous of disposing of my worldly goods while I
have the strength and capacity so to do, I do make, publish, and declare this
my LAST' WILL and TESTAMENT, I hereby revoke, cancel, and anna.l, any and
all Wills and Testaments, by me at any time made heretofore, including
codicils thereto, and declare this alone to be my LAST WILL and TESTAMENT.
AS TO SUCH ESTATE AS IT HAS PLEASED GOD TO ENTRUST ME WITH IN
THIS LIFE, I DISPOSE OF THE SAME AS FOLLOWS, VIZ:
ITEM ~,. I direct that my executors hereinafter named pay and
discharge all of my just debts and funeral and testamentary expenses.
ITEM 2. All the rest, residue and remainder of my estate, where-
~-
soever''situate and whatsoever it ~Y consist of, I give, devise, and bequeath,
absolutely and in fee to my dearly beloved children, DONALD J. ROBINSK3,
DAVID IS. ROBINSKI, and MARK E_. ROBINSKI, share and share alike, per stirpes.
ITEM I nominate and appoint David S. Robinski as Executor of
this n?y LAST WILL. Should the Executor named fail to qu~,l.ify or cease to
act a~ Executor, then I appoint Mark E. Robinski as Executor in his stead.
ITEM I direct that my personal representatives, as well as
their successors, shall not be required to give bond for the faithful
performance of their duties in an<y jurisdiction.
{,
JAMES M. Bac7i
ATTORNEY AND
COUNSELOR AT LAIN
107 ST. JOHNS
CHURCH RD.
S UI7E ~ 2
CAMP HILL, PA. 17011
TEL. (717) 787-20:13
EILELN A. ROBINSKI
i
r,a
~~
~ ~
-n ~,
rn
~.
~
~ ~ ,...1... f ~ .
-
!'
~ Y
/~
~ y..~
1
.
W ~7
• V
COMMONWEALTH OF p~SyLVANIA
ss
C OUNTY OF CUMBERLAND
I, EILEEN A. ROBINSKI, Testatrix, whose name is signed to the
attached or foregoing instument, being duly qualified according to law, do
hereby ac}fnowledge 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 purpose therein expressed.
Sworn or affirmed to and acl~owledged before me, by 1984•
EILEEN Q. ROBINSKI, the Testatrix, this ~~ day of ~
EILEEN B. COYNE ~~~
NOTARY PUQLIC Notary Publi
3901 Market St. (~°ampc4~re °``'~•~ M Co~tission Expires: ot~~~i
CAMP ~;i'~~., ~'.~. ; d'i~ i o. y
My Commissir.n Frui~~~K ~»ne 26, 19:~
The ~l~eceding instrument, consisting of this and one (1) other
typewritten page, identified by the signature of the Testatrix was on the
date thereof signed, published and declared by EILEEI~ A. ROBINS&I, the
Testatrix therein named as and for her LAST WILL and TESTAM~JT, in our
presence of each other, have hereunto subscribed our names as witness.
wf
Residing at 10 St. John's Church Road
Suite
i Camp Hill, PA 17011
L
Residing at 10 St. John's Church Road
Suite
Camp Hill, PA 17011
JAME6 M. BACA.
ATTORNEY AND
COUNSELOR AT LAND
107 ST. JOHNS
CHURCH RD.
SUITE ~ 2
CAMP HILL. PA. 17011
TEL. !7171 797-2033
-2-