HomeMy WebLinkAbout02-01-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF ~pinr~E.Pt•Irt/d 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 respecttillly request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name: Cs1R/~•r/.yE .8. ~a+~+-d/R6C'R
a/k/a:
a/k/a:
a/k/a:
Date of Death: O/' 23 ' ZO~Z
Decedent was domiciled at death in
principal residence at 33S Wi~f~
Decedent died
/70~
Street addrea:, Poat Office and Zip Code
Estimate of value of decedenPs property at death:
City, Township or Borough
County
a~a FN
County Stste
If domiciled in Pennsylvania ............................ All personal property $ 2'.!'~iODG
Ijnat domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ -~-
Ifnot domiciled in Pennsylvania ........................ Personal property in County $ _Q~-
Value of real estate in Pennsylvania ......................................................... $ ~~
TOTAL ESTIMATED VALUE.... $_ DSO
Real estate in Pennsylvania situated at:
(Attach additional sheets, ifnecessary.)
Street address, Post Office and Zip Code City, Township or Borough
~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 //-/~ -3~~
thereto dated
County
.~ ,.,
State relevant circumstances (eg. renunciation, death ojexecutor, tfa)
t37
Exceptasfollows: aftertheexecutionoftheinsttamen[(s)offeredforprobateDecedentdidnotmarry,wasnotdivorcapa~ioapen
divorce proceeding wherein the grounds for divorce had been established es defined in 23 Pa. C.S. § 3323(8), an aye a'Clttld bo~~
adop d; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ~ 7or C
[+~NOEXCEPTIONS ^EXCEPTIONS ~~~ ~ ~„-rt
^ B. Petition for Grant of Letters of Administration
-s .. .r-n „Ft
(If applicable) $ W
c.t.u., d.b.n., d.b.n.c.t.a., pendentelite, durunteabsentiu, durantPlninoritute
If Administration, c.t.a. or d.b.n.c.da., 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. § 33Z3(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
^NO EXCEPTIONS ^ EXCEPTIONS
Petitioner(s), afters proper search has/have ascertained that Decedent !eft no Will and was survivedby the following spouse (ifany) and heirs (attach
additional sheets, iJ'necessury):
Name Relationshi Address
File No: _~~~ ~~ - a~~b
(Assigned by Register)
Social Security No:
Age at death•
~o County, Pif
e~-~/ie~BaRG PA /7a53
~~,~~ City, Township or Borough
(ware) with his/her last
Fnrm RW-01 rev. /0/(//101[ Page. I Of L
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
}
} SS:
}
~r
~~ r w'~ ;~ ~~'~ ~S
1Q12 FEB - I AM 9= 37
~Onit/ AR/ /?s/rolQrlR~it' I ?d 5. Llwis.+st~.ay .~aID ~'IEGN.F~/IrYl~tG~fdi~f~ll65'
The Petitioner(s) above-named swear(s) or affittn(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 Petitione )will well and truly administer the estate according to law.
Sworn too affirmed an s bscribed beforek/~~....Gy.,~. Date ~-/-2 oiZ
me is da ~~ Date
BY~ Date
F the e ' rer Date
BOND Required: ~ YES
FEES:
Letters ...................... $
(/Q )Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commissi n ..... ............
Other i ~ ....... .
~uraazatief rF e e .............. .
JCS Fie. ...................
To the Register of Wiils:
Please enter my appearance by my signature below:
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate of ~ Y 1 f'I S*I ~~ , ~ tt_M tom. ~(,~Q„~ File No• _ ~'~ ~~ - ~ y d
AND NOW, {-P hYtAfil(1 ~ 076/ , in cons~ti of the f regoing Petition,
satisfactory proof having been pr nted before me, IT IS DE REED th tters ~~
are hereby granted to ,
in the ve estate and (if applicable) that
the instrtunent(s) dated I
descrtbed in the Petition be admitted to probate and filed of cord as the ast Will (an odicil(s)) of De dent.
egister of Wills
r
Form RW-01 rev. 10/11/1011 Page 2 of 2
,,: n5sn~ ttcp r?/::1
~a-~yv
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 18216508
Certification Number
Type/Print In
Permanent
<J
,IpI'"""'"--- This is to certify that the information here given is
I~~~p~SH OF pF;yyf, correctly copied from an original Certificate of Death
=- r=, duly filed with me as Local Registrar. The original
~ 3 =3 certificate will be forwarded to the State Vital
~ - a~ Records Office for permanent filing.
* ' *~
p99rMENT Q~~~Pj11 1 ~~d'-----DcPa75/ / ~26 ~!Z-
H%/N~//II/III ~~7
Local Registrar Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
' P'COTf Cg/•'ATC !1C EICATY
1. D.Gtlen<'f Legal Nama (Flrat, Mldd a, Las[, SVT X) 2. SeX 3. SOCIaI Security Number a ^4. Data of Death (MO/Day/VI) (Spell MO)
Christine B. Rumber er F 185-12-9843 January 23, 2012
Sa. Age-Last glrthtleY IVra) E Un er Ya r Sc. Untler 1 Da 6. Date of girth (Mo Day r) (Spell Montp) >a. Birthplace ICIty and state er Ferelgn Country)
' 8 7 Monthf DaYS Moura Minutes r~rCl-L 7 , 1924 Onc PA
Tb. girthpleu (COUntV) r
ga. Real nce (State or Foreign Country) Bb. Residence (Street and Numher-Include Apt N
~ B<. 1 Dewdan< LWe In a Townships
PA 335 Wesley Drive Apt. 60
q Yea
decaeenaJ wee In Lower Allan
fld. Real enu County ,
pyp,
N. Residence (ilp Gede) QN9, tlacedent Ilwd wlthlnlimlts of city/bero.
9. Ever In US Armed fgrgefT 30. Marttal SLaNS of Tlme Of Death Married WI owed 11. Surviving Spouse's Name (It wife, give name prior to rat merrlegej
Q Yes ~NO Q Unknown Q DlVOrcetl Q Newr Married Q Unknew
12. Fathar'a Name (Firft, Middle, Las[, Su
x 13. MoMer'a Nama PNOr to Flrat Marriage (First, Mldtlle, Laatl
Harr F. Bowser Clara See er
lqa. Informant'f Nam. Iqb. Relations Ip to Decadent Iqc. Informant's Malling Addreca (5lreet and Numpar, <I<y, State, Vp Gode)
20 5. Lewiaberr Road Mechanicsbur PA1705
........................................................ ............................_._......... a. ace q on one
.............................~....... 4.......Y....................... .....................,.............
...........-..........._.....
............. ..
n D.ah Ocwrr.a In . Hoaphal: Inwtl.n< H Death OCCWYbd Semewhera Other Then a Hofpltel: ~t Hosplc! Ficlllty ~ o.uaenrs Homa
Ema an Rgem/Due tlant bead On ArrNal Nurfln Home/LOn -Term Care Fanllty Other s fy)
cl
lEb. Fac11Ry Nama (N ntR IrubtWtien, gNa aSreet a
C
li
l
i SSC. City or Town, Ssate, end 21p Doe SSd. County O Death
ar
s
e Re
onal Medical Center Carlisle PA 17013 Cumberland
~, lEa. Ma[ otl of DlapOaltien Burls Cremation 16b. Date o/ Dlsposltlon 1gc. Place of OlspoalNOn Name of cemeNry, crcmasory, or em<r place)
p Remo«~o55tate p pgnatlen J~j• 27, 2012 Era tlawn C~inetCry
S6tl. Location o DI{pWltlon (City or Town, State. and Zipj 17a. etur of rvlce L e or Parson In harge ollnterment 1>b. License umber
rove PA 16686 00 9641E
ITC. Nam nd Gompleb Addre of Fu rel Facllny
71 lg. Deutlent's Edutatlen -Check the box teat best escN a the 19. Decadent of Hispanic Origin -Check the 20. Oac cot's Race -Check ONE OR MOPE races to IntlluN what
highest degree or Iwel of school com Dieted at the time of death. box that bast tlascrlbes whether the tlecetlent the dacetlent contitleretl M1lmself or herself tar M
.
Q g[h grade or late Is Spanlah/NlsOanl4La[Ino. Gpack the "NO" ~ White Q Korean
Q NO diploma, 9th - 11th grade box If decedent Is not Spanlah/HlspanlylatinO. Q Black qr African Amarlun Q Vletname[a
High sOhoel gratluaH er GED cgm
letad
p
0 Ne, nOf Spanlah/HISPanlc/Latino Q American Indian or Alafka Na[Iye Q O[I,ar Aalan
Q Some college credit, but nP degrees Q Ves, Me:(Can, Mexican American, CRlceno Q Aslen Intllan O NatlV• Hawaiian
Q Associate tlgree (e.g. AA, A3) Q Vea. Puerto Rican Q Chinese Q Guamanian or Chemorro
O gachalor a degree (a.g. gA, Ag, l15) Q Yes
Cuban
,
Q Filipino Q SemOan
Q Master's degree (e.g. MA, M3, MEng, MEtl, MSW, MgA) Q Ves, other Spanlah/HHpsnlc/Latlna Q Japanese Q Other PaciRc Islander
Q Oonorate (e.g. PAO, EAD) or Professional tlegrce (S
eOlry) Q
p
Other (Specfy)
. MD DOS DVM W lD
11. Oecedent'a Single Race SeIT-Oaf {nation - CMck ONLY ONg to indicate what the tlacetlant conslaerctl himself or herself to be. 22a. Decetlen['s Ufusl Occupation -Indicate type of work
S Wlalq Q lapaneae Q Samoan done during most of working Ilfe. DO NOT USE RETIRED.
Q Slack er African Amerran Q Koroan O OMer PecIRC lalender
O American Indian qr Alsske NatlVe QVIa[nameae QDon't Knew/NOL SUre Homemaker
Q Aalan Indlen Q Other Aalan Q Rafuaaa 12b. Kind Of Buslnaas/InduatrY
Q Chinese
N
l
H
Q
et
w
awaiian O Other (speclM
Q FRIPInO ~ GVYmanlan Or Chameme Home
1 e. a a oun Das aY ure o '~ 9gnr n` •.[ on v w en app ca 30. Ic- V ~rYJ~~
1V PlIIEON WNO PRONOUNCES OR
,]
~"-'
^LC
cegnstga IpewTN 1 Cpl
r
/
` ^;
-'
1aa. t. 1 0 1q. nm. of .ate
t
r `_
)
f 15. atlical miner or Coroner ContactedT Yes
Ka
o
CAUSE OF DEATH
gV
A
26. Part 1. Enter the cAaln e1 avenW-tllseasea, Injuries, or complicatlens--that alrcctlV caused the death. DO NOT enter terminal eyentf such as s rest a
respiratory arras[, or Ventricular fibrlllatlon without showing the etloloN~ DO N
OT AggREVIATE. Enter only one cauze oNa Ilne. Add atlditl arif neceasPr~y On [p
r
IMMEDIATE CAUSE _______________y a. ~ CJ vLL / i-" ~~ frrl-•, '/
\M
(Final dlceaaa or COndltlPn Due to (or ac a cpnfequanCe Of):
]
resulting In tlseth) t
-~°i
_
i
i
b. i f
Yi
sequentially Ilsf conditions, Due t0 (or as s consequence o1): ` ~ ~s-xr-S.
IT env, leading to the cause
nataa qn une a. Enter th. t~ E {~
O
6 -
UND[RLYINO UUSE Due to for as a consequence Of): y
(dlaaasa or lnfury [pat
G 7 J
r
Initlatetl [he events resulting a.
In death) LAET
as a wn .^
. Dua to (or sequence qf):
W
28. Part 11. Enter other I 1 ut not resulting In the untlerlying cause given In Part 1 3>. Was an au V P<
Ve NO '
~. 2g. Were au~~•a:.~y Rndings ayal a a
$ to f:ompleif tide Ci YSe O( tl!a[hT
$
_ Vaa No
29. If Female: 30
Dld T
y~¢.
qt Prognant wlMln Past Yesr .
o a o Usa Contribute to DeathT
Q Yea cc 0 Probably 31. Manner o Deatl,
aural Q Homicide
t
~ Q Pregnant at time of tleath
Q Not pregnant, bY[ pregnant wltl,ln q2 east of daatM1 ~,~[.}N Q Unknown Q Accident Q Pending Inyestlgatlen
Q Sulclpe Q COUId not ba aeterminea
Q Not pregnant, but pregnant 43 tlayc t01 year before tlaeM
Q UnknOWn If pregnant within the
t 32. Date of Injury (MO Day/Vr) (Spell Month)
pas
year
33. Time Of Inlury
3q. Place Ot Injury (e.g. home; cOnatructlen alts; farm; sc oo) 3g. LOCatIOn of Injury (Street and Number, Clty, State, 21p Gotle)
3g. In)Yry at Werk 3>. IT Trenaportatlon Injury Specify: 3g. D.scrlba How lnfury Occurred:
0 Ves Q pNVar/Opereter p veaeatNan
p Nn p vaaa.ngar p otner (swats)
39e. Ge Check only one
ertllying phYSlnan - TO the bast of my knowledge, death occurred due to the CiVae(a) Intl manner rteted
O Preneuncing ®Cartlfying phyylcl the pes<of my knowledge, tlea[p occurred at the time, date, and place, antl due to tM1e caufe(s) and Mannar stated
~ Medical EXSminfr/CerOner - On aH of examinatlon, end/or Inyestlga[tOn, In my Oplnlon. tleeth oc
c
urced a
l
t
l,e Hme, dale, and p1aCe, antl tlUe to fM1e Oeusela) antl
mann~r ita<etl
y
~
/
a
~
'2
3lgnatura Ot cartlller: Title OT Certl/ler: / l .- ( J Llcanae Number: d ~ r O T f -~
a
39 .Name, Address and Zlp Cetle COmplating Uusa of pea[ (Item 2g)
39c. Date SlRned {Me ay YN
Dr
G
i
er
.
u
atwit
56 Ashton Street Carlisle PA 17013 (/'z sfr/ z
q0. Regla rar f str ct Num a q1. Reglatrar
r~ {nature ~
q2. Raglrtrar FI eDate q Oay. r
u ~ ~
93. Amendments
~.
Dlspoaltlen Permit Nn_ ~ ~ ~ / '-~J !~ ' REV O>/2p11
,..
LAST WILL AND TESTAMENT ~tit2 fE8 - t AM 9~ 38
I, CHRISTINE B. RUMBERGER, of 1067 Logan Avenue, Tyr
16686, being of sound and disposing mind, memory and understanding, do
hereby make, publish and declare this, as and for my Last Will and Testament,
hereby revoking and making null and void any and all Wills and wrFtir~gs in the
nature thereof by me at any time heretofore made.
I. I direct that all my just debts and funeral expenses, including my
gravemarker, shall be paid from my residuary estate as soon as practicable after
my decease as part of the expenses of the administration of my estate.
II. All Federal, State and other death taxes payable because of my death
with respect to the property forming my gross estate for tax purposes whether or
not passing under this Will, including any interest or penalty imposed in
connection with such tax, shall be considered a part of the expense of the
administration of my estate and shall be paid out of the principal of my estate
without apportionment or right of reimbursement. '~ ~
III. All the rest, residue and remainder of my estate, both real and
personal, of whatsoever kind and wheresoever situate, I hereby give, devise and
bequeath to my husband, Zilian D. Rumberger, if he survives me by sixty (60)
days.
IV. If my husband, Zilian D. Rumberger, should fail to survive me by
sixty (60) days, then and in that event, I hereby give, devise and bequeath all the
rest, residue and remainder of my estate, both real and personal, of whatsoever
kind and wheresoever situate, to my issue, equally, per stirpes
V. I do nominate, constitute and appoint as Executor of this my Last
Will and Testament, john W. Rumberger. In the event an alternate or successor
Executor be required, I do nominate, constitute and appoint as such, Harry A.
Rumberger. My Executor and alternate or successor Executor are hereby
excused from furnishing bond for the faithful performance of their duties in any
jurisdiction and are hereby authorized and empowered to sell my real and
personal property, at public or private sale, at such a time and in such a manner
,.
as may be deemed wise, and to make, execute, acknowledge and deliver good
and sufficient deed or deeds therefore to the purchaser or purchasers thereof.
IN WITNESS WHEREOF, I, CHRISTINE B. RUMBERGER, the above named
Testatrix,,,h//ave to this my Last Will and Testament, set my hand and seal this ~`'
day of 1~,~~ii , 2004.
~~
CHRIST B. RUMS ERGE~ ~
Signed, sealed, published and declared by the said CHRISTINE B.
RUMBERGER, the above named Testatrix, as and for her Last Will and Testament
in the presence of us, who, in her presence and at her request and in the
presence of each other, have hereunto subscribed our names as witnesses.
Address: 1543 Dry Run Road
Address: 1700 Adams Avenue
Duncansville. PA 16635
Tvrone. PA 16686
STATE OF PENNSYLVANIA
COUNTY OF BLAIR ;
SS
We, CHRISTINE B. RUMBERGER, Lorena A. Baughman and Judy W. Houser,
the Testatrix and the witnesses, respectively, whose names are signed to the
foregoing Will, being first duly sworn according to law, do depose and say that
the Testatrix signed and executed the foregoing instrument as her Will, that she
signed willingly, that she executed it as her free and voluntary act for the
purposes therein expressed, that each of the witnesses, in the presence and
hearing of the Testatrix, signed the Will as witnesses and that to the best of the
knowledge of each of them the Testatrix was at that time eighteen years of age or
older, of sound mind and under no constraint or undue influence.
CHRISTINE B. MBERGER
o~`A2Dirtl~ ~ _,.a.~.,.,.. ...
Witness
L L ~.~~
Witness
Subscribed, sworn to and acknowledged before me by CHRISTINE B.
RUMBERGER, the Testatrix, and subscribed and sworn to before me by Lorena A.
Baughman and Judy W. Houser, witnesses, this l~ day of /(/~dP.m6~
2004.
~~~~i~~ ~~~~ G
Notary Public
My Commission Expires:
C,ararfonweelUr of ari
NOTARIAL. SE4L
Edward S. NeiMt~, Notary Public
Tyrone Borough, Glourrty of Blair
My Commissbn Fires Sept 29, 2008