Loading...
HomeMy WebLinkAbout02-27-12Reset - ~r PETITION FOR GRANT OF LETTERS REGISTER OF WII.,LS OF CUMBERLAND COUNTY, PENNSYLVANIA Petitioner(s) named below, who islare 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 f a - ~~ ~~ File No: Name: Barbara A. Brozack (Assigned by Register) a/k/a: a/k/a: a/k/a. Social Security No: 176-34-8629 Date of Death: December 29 2011 Age at death: 68 Cozen Mania (stare) with his/her last Decedent was domiciled at death in Cumberland h' P.~nn.~.v principal residence at 914 Wentzville Road Enola, Pennsylvania 17025 East Pennsboro Township Cumberland County Street address, Post Ottke and Zip Code City, Township or Borough Decedent died at 361 Alexander Burins Road Cazlisle PA 17015 SoCuty Msdodsle~tOO Borough tp Cumberland s~PA Street address, Post Office snd Zip Code County Estimate of value of decedent's property at death: $ 1,000.00 Ijdomiciled in Pennsylvania ............................ All personal Property If not domiciled in Pennsylmnia ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylmnia ........................ Personal property in County .. $ 75,000.00 ........................ Value of real estate in Pennsylvania ................ • • • • • ' ' ' • • TOTAL ESTIMATED VALUE..... $ 76.000.00 Real estate in Pennsylvania situated at: 914 Wertzville Road Enola, PA 17025 East Pennsboro Township Cumberland Ci Townahi or Boro h County (Attach additional sheets, ijnecessary.) Street address, Post Office and Z[p Code tY+ P ~ ® A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/are the Executor(s) named m the last Will of the Decedent, dated Mazch 18, 2010 and Codicil(s) thereto dated N/A Decedent's husband John G Brozack Jr predeceased Barbara A. Brozack State relevant circumstances (ug. renanciabon, death ojexecator, etu) Except as follows: after the execution of the 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 bom or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. O NO EXCEPTIONS Q EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If appticable) c.t.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, durante minoritate If Administration, Gta. or db.n.c.ta, 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 divon;e 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 Q EXCEPTIONS ° ' Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following ~(if any) andheirs (g~t~ additional sheets, if necessary): rp -~ f'r'y '='-.r Name Relationahi Address ~ tTt (V ti~ ~ - ~~ O -.~ Form RW-02 rev. 10/71/2011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } COUNTY OF CUMBERLAND } SS: } Official Use Only Date BOND Required: ~ yEg ~O FEES: ~" _ Letters ...................... ( S )Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ........... . . ( )Affidavit(s)........... . Bond ........................ Commis ion... . .............. Other ` a ~~ To the Register of Wills: Ptease enter my appearance by my signature below: Attorney Signature: Printed Name: Keith O. Brenneman Supreme Court ID Number: 47077 ' ' ' ' ' ' Firm Name: Snelbakex & Brenneman, P.C. ..... • Address: 44 Wect Main Street Mechan_ i~chn,~pp 17055 " " " " Phone: 717-697-8528 Automation Fee ............ . . . ~ JCS Fee. Fax: 717-697-7681 TOTAL ..................... $ Email: ---B:ffft' ate. ~ DECREE OF THE REGISTER Estate of Barbara A. Brozack ~ ~~ a/k/a: File No: ~- AND NOW satisfactory pr ving be d before me, IT IS DECREED that Letters T~t~rnation of the foregoing Petition, are hereby granted to Roxanne Rse Kuvkendall the instrument(s) dated March 18 2010 in the above; estate and (if applicable) that described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) p f Decedent. I l\n , aster of Wills ~-1 Form RW-02 rev. 10/]1/2011 Page 2 of 2 ---- ----~°~ ~w•~-.,a.,.~ swcarts) or strum(s) the statements in the foregoing Petition are true and correct to the best ofthe Imowledge and belief of Petitioner(s) and that, as personal Representative(s) of the Decedent, the Petitioner(s) will well and trul + Sworn to or affirmed and ubscribed before }administer the estate according to law me sy of ~ ~--~ `~ -rG, ~-^nr~ .-_ Date 2 - 2 7 _ ~ ~ BY~ Date r Register Date :105.805 REV f911U LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or plhotograph. Fee for this certificate, $b.00 P 18118205 _ Certification Number This is to certify that the information here given ,s correctly copied from an original Certificate of Ueath duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ~~Si~.-`~~~c~.~a J N 2_~_ 2012 Local Registrar Date Issued ~} ~~ , r, '~ i C7 z ~ tz~ ~ -:.:a~~ ~ tv t ; *-; ; r , --J r - ~ ~ T~ ~-. , ~ -~ - ~ z1 - ~ REV l,nooB COjM1AONWEALTH OF PENNSYLVANIA • DEPARTMENT OF NEALTH • YRAL RECORDS ~ I PRIM fN CERTIFICATE OF DEATH ~ (See Instructions and exampbs On reverse) '•tTATE FILE NUMSER 2. Sea 3. Sadsl Sewdty Number 4. Oeb d Death (Mora, day, 1. Name d Deudem IFasL midde, ~• ~) Female 176 _ 34 __ 8629 Dec . 29 2C Barbara A. Brozack _ _ • •-- , -- _-° s. Age (Leal eiM~ay) ~a 68 Memha Yrs. M. Canty d DtlYi Cimi~erland Hw'a ~ I June 14, 1943 Carlisle , PA ~ rp.Mm ^ ER I ougrenem ^ DDA ^ Naming tame ^ Raeitlenoa ^ Otlnr - seedy Bc. Cny, Mro, Twp. d Deane S. Middleton 1tap. Kadd WOrk Mobf194HdRIE„'~. Sales ,B 9 4aWertzville /Rd.~.~p~1 Enolay PA 17025 tB. FaMela Nacre (Flm4rdddla, laaL wiNa) Alvin Killinger 2oa Iniamads Name (Type I PrIM) Roxanne Kuykendal 21a Method d OBpositlon r ~ Cremenon Donedon ^ 9urid ^ Rernovd from Stale r wtl Cramatlar a Defrdbfl Autlprltld . r by eledlcd EaamNrar,Coroner7 ^ ghat - 22a. Siauhae d Fuierd Service Lroe~eee~(a parson emirs es such) 9. was pxedem d HkyeMC Origin? ~] No ^ Vas 10. Race: Amencen Hldrn, Black, WIMe, ea. M. Fapnly Name In not Irnnlutfon, give aired end number) (n ytl, seedy CMai, (SpeaYy( White Carlisle Regional Medical .Center Maven, Puerto Rken, aro.) 12. Wtl Decedent ever In Itre 13. DxeaM'e Education (Seedy any fNglrtlt gads cdnDb~) 11. Mantel :IrNa: MernM, Never Married. 15. Surviving Spouse III wile. give maiden name) WidoweA, Dboroed (Speay) U.B. Amnd Faces? Elementary I Secondary (0-12) College (1-4 or Sr) ^ Yes ®No 9 W1dOWed oeteaenra °" °eCBdeM E Pennsb~ro_ -Twp. PA Live In a 17c. I~ Vas, Decedent LNed in Actual Residence 17a. Slate Twmship4 ('.l,mhPrl anA 17d. ^ No, Decedent Lives within C'dyl0ao 17b. County Acluel Umns d 19. Monona Name (Floe, mlddr, maiden aumame) CYdce Betty Fulton 20D. Inarrtlds McMg Addeo (SYred, dy / awn, side, xip ~•) 1 1348 Zimmerman Rd., Carlisle, PA 17015 21b. Date d Dlspoainon (Momh, day, ytlr) 21c. Place m DeposNbn (Name d cemdery, tremarory a otlvx pace) 21d. Loranon (Clrylawn, dare, dD coda) Jan. 3, 2012 Hoffman-Roth Funeral HOme & Car~~s~e PA 1'7013 Ytl^ No 22b. Cicalae Number 22c. Name ant AdMae d FadNy Hoffman-Roth Funeral Home & Crematory, Inc. 23c. Dare Slgred IManm, drY• Peer) z3e< aNy wince ceddYn9 z3e. To the beat d my lgrw ea. dtltli occurred d Yn nme, are end prce Isignlure end (roe) 219 N . Hanover St . y 2~ ~ PA 17013 prysiden rna.vatlNedTatlmdadsro M a ~0 3 q o S a L , 2• Z 9- ~/ ceddY cause d haNi. 26, was Case Referred to Fxemkler / Caner rot a Beeson Other than Cremeton a Donatlan7 24.lime m Deals 25. Dale Pralaaaed Dead (Month, day, year) frrtl z4-2s roust ne tendered M pemon 1 0 9 P ! Z- 2 9- 1 1 ^ vas o -- wM prmaarctl dreYi. O . - M. ~ Approdmere hlervd: CAUSE OF OEA1H (See Imtruellona end s:ampNS, r ~~ a DeeHt Ilsrn 27. Pan L Emer Yee rluir d awnls- datlatl, ajuras, a coaVlkaYMS - that drecd% a•utld ro• deaM. W NCT enter terminal events ach tl ardre erred, r respkflbry meet, or ventriader fibriNation witlaad showing the afiologY. L'el onNyosn^•;~aauae m each tyre. r h CA dueese a r ' \ ' ~reaAeng~j ,~ a ; Due a (a u e cornequeuce o1): i Y6l coriallone, N ant, h. i E IINy~DaEy~N.YM~B CItlIUS a Due ro la as a canse9uance dt: i Beerlls rasullrM~ In d•eMT~. o~ r Us ro for es a consequence o0: a. 30a. was en Autopsy 30b. Ware Auropay Fnags 31. Manner d Dtlih 32e. Date d Ir~ury (, ay, year) 326. Deecnbe Haw Injury Occurred Penannad4 Avarhle Pria ro Con4letid' ~ ^ a aA nd reeuroilg in the aridedYian cause ghen ro Pan I. ml Fiorrxn -- d cause d Dedh4 32d. Time d Injury 32e. Injury al Wod4 32f. If Trenepaletbn IMarY ISP•~i', ~9' Loa r-,~ ^ Accaent ^ paidrig lnvtlligatbn ^ DnverlOpentor ^ Passenger ^ Peasirlen ^ Yes LK No ^ Yes ^ No ^ Sum ^ Cadd Nd he Ddermkwd M. ^ Vas ^ Nc ^ Other - Specify. 33b. Signarre ana Troe d 33a. CeMner Idnck say are) cad dean, end eanpdad Item 23) CwIMYiM PhYaf•rn (Phyaldan awMying ease d deelh when ierrotlnr phyeicrn hen getout' - --- - - - ----------- 33c. Lkentl Number Te tlM haddep lewwrd9a,dwtll Oaterr•d do totM Cnltl(y od marnartl _______________ • PronelanMrY and aa1MYM- PhYaidan (~Yaden bmh Prartoirwiig drdn end terNNne b cause d dtlar) ~ -l ~ ~ l To tM bad d my rrosriadY•• deaM axmrW d lM Xan, ant, ana pre, ana din M fin wtl(q ana manner a aMad- - - - - - - - - - - - - - -- -- ^ • Yadleal EarrNrrwlCaanr On tM hula d aueAndion and I a prvMigatlon, a raY opNnlon, dtltll axumd d1M Jana, dent, ant Pfaea• ant dtl r tM aaaaNa) andmanner tl anted- 3•. Name and Adkess d Person WM Garotted C~ Dale Rlad (Madh, aY, Year) ~ .I /~ , / ~. ei•r~ ~ +$ sow "'a D1~ "~i°°^ t a l l l al 1 1 10 1 3 l K /" Dlspositlan Parmil No. injury (strtlt, ^ Yas ^ Probaby ^ No ^ Urdnown 2B. N Female: ^ Nd pregrrent wNhr pad year ^ PregnM at time d death ^ Na pregnam, bu[ pragam wilhm 42 days d death ^ Nd pregiem, lad praJneM u days a l year Mare sent ^ lJraaaavn Y pregnm within Yn pad year 32c. Place d Infury: Home, Farm, Sh'9e1. Factory. OIRce Bunag, att. (Spedfy, :iN I awn, stale) rM (Ma 7)g Type /Print Q ry- f- I ~ ZOO LAST WILL AND TESTAMENT ,~ ~' ° - °= I {"l f~ ~ J~ _? Y, BROZACK ~ `' A BARBARA ~~ . =~ -- ~ ~ I, BARBARA A. BROZACK, of East Pennsboro Township, Cumbei~nd Coung,, ~'~ Pennsylvania, 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 void any and all wills by me at any time heretofore made. 1. I order and direct that all my just debts and funeral expenses be paid by my Executor or Executrix, whatever the case may be, hereinafter named as soon as practicable after my death. I direct that all taxes that may be assessed as a consequence of my death shall be paid from my residuary estate as part of the expenses of the administration of my estate. 2. All the rest, residue and remainder of my Estate, real., personal and mixed and wheresoever the same may be situate, I give, devise and bequeath to my husband, JOHN G. BROZACK, JR., provided he shall survive me for a period of sixty (60) days. 3. In the event my said husband, JOHN G. BROZACK, JR., should predecease me or fail to survive me by the aforesaid period of sixty (60) days, I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed and wheresoever the same may be situate, to my daughter, ROXANNA RAE KUYKENDALL, absolutely. In the event my daughter, ROXANNA RAE KUYKENDALL, should predecease me, I give, devise and bequeath all the rest, residue and remainder of my Estate, real, :personal and mixed and wheresoever the same may be situate, to my grandson, JEREMY LEE KUYKENDALL. 4. I hereby nominate, constitute and appoint my husband, JOHN G. BROZACK, JR., LAW OFFICES SNEI'BAKER 8L BRENNEMAN, P.C. as Executor of this my Last Will and Testament. In the event he should predecease me, fail to qualify or fail to serve as Executor of this my Last Will and Testament, I nominate, constitute and appoint my daughter, ROXANNA RAE KUYKENDALL, as Executrix of this my Last Will and Testament. I further direct that no person serving as Fsxecutor or Executrix '~ hereunder shall be required to post any bond to secure the faithfiul performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on two (2) pages this 18~' day of March, 2010. ..---- ~~~ ~ SEAL) Barbara A. Brozack: Signed, sealed, published and declared by BARBARA A. BROZACK, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. i ~ i (SEAL) ~' (SEAL) LAW OFFICES SNELBAKER 8C BRENNEMAN, F.C. -2- COMMONWEALTH OF PENNSYLVANIA) . SS. COUNTY OF CUMBERLAND ) We, BARBARA A. BROZACK, KEITH O. BRENNEMAN and SUSAN L. MATRAZI, the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Wiill and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. i Testatrix i wv~--, Witness Witness Subscribed, sworn to and acknowledged before me by BARBARA A. BROZACK, Testatrix, and subscribed and sworn to before me by KEITH O. BRENNEMAN and SUSAN L. MATRAZI, witnesses, this 18~' day of March, 2010. ~~s~~ Notary Public LAW Oh-F'ICES SNELBAKER 8C BRENNEMAN, F.C. COMMONWEALTH OF PENNSYLVANIA Notarial Seal Sandra K Showers, Notary PubNc Mefixg Born, Cumberland Courtly My Commission E~ires Nov. 22, 2011 AAesttber, Penns~Avania Association of Notaries