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PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland 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: Liebrum, Glenda S File No: __ ~~ ~ - ~~- L `~-{ ~ ~i
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: Apri15, 2012 Age at death: 76
Decedent was domiciled at death in Cumberland County, pennsylvania (Stare) with his/her last
principal residence at 671 Easv Rd Carlisle. North Middleton Township Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 671 Easv Rd Carlisle North Middleton Township Cumberland Pa
Street address, Post Office and Zip Code City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania ............................ All personal property $ 60,000.00
If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $
If not domiciled in Pennsylvania ........................ Personal property in County $
Value of real estate in Pennsylvania ......................................................... $ 189.000.00
TOTAL ESTIMATED VALUE.... $ 249,000.00
Real estate in Pennsylvania situated at: 671 Easv Rd Carlisle, North Middleton Township Cumberland
(Attach additional sheets, if 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 June 9, 2004 and Codicil(s)
thereto dated
State relevant circumstances (e.g. renunciation, death of executor, etc.)
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 born or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
Q 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, durante absentia, durante minoritate
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 has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs (attach
additional sheets, if necessary):
Name Relationshi
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Address
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Form RW-02 rev. 10/11/2011 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
To the Register of Wills:
Please enter my appearance by my signature below:
Petitioner(s) Printed Name Petitioner(s) Printed Address
A 1 L. Liebrum ?~. ~~
506 Belle Rd. Boalsbur Pa. 16827 s~c~ r`~~~}~ r~~r
CUM(~F~~! ~~~~![~~~ ~;~ ~pa
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 kepresentative(s) of the Dece ent, the Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirnled and subscribed before Date ~-{ -I 1 - t Z
me this ~ 1 __ day of ~ i ~~ '1 _, ~~~ Date
,-
sy: _( 1 ~, ~_i_l {. ~1~ ~ Date
For the ?tegister Date
BOND Required: Q YES ~ NO
FEES:
_, ~
Letters ...................... $ ~~~~ ~.~~'
( ~~ )Short Certificate(s)...... _'~ (_.~( ~~
( )Renunciation(s)........ .
( )Codicil(s) . ........... .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other .......
;~ ~ T ........ ~. ~,; . 0
Attorney Signature:
Printed Name: Fredrick Farber
Supreme Court
ID Number: 17043
Firm Name
Address:
State College, Pa. 16801
Automation Fee . ..............
--
JCS Fee . .................... L.
=~. ~ ~ `->
TOTAL ..................... $~-~ ~ ~~ ~ O.Ofl'
Phone:
Fax:
Email:
Fredrick Farber
814-238-0760
814-234-6013
ffarher ffarher_cnm __
.. _ _ ..'J
DECREE OF THE REGISTER
Estate of Liebrum, Glenda S File No: . "%~~ - ~(_ I ~~ `:
a/k/a:
AND NOW, ~~~. '~' .ir _-=' ~ ,~ ~' I~~ , in consideration of the foregoing Petition,
satisfactory proof having, en presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Apryl L. Liebrum
the instrument(s) dated June 9, 2004 O(.j~('~
,~ i.
described in the Petition be admitted to probate and
in the above estate and (if applicable) that
of record as the last Will (and Codicil(s)) of Decedent.
W111s T~, _
Form RW-02 rev. 121 U20/1
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Page 2 of 2~,~~
LOC~~;~G'1~c°~`F~p4R'S CERTIFICATION OF DEATI-I
WAR112~'1t is:illej~~I Qo duplicate this copy by photostat or photograph,
Fee loi this certificate. $6.00 ~~~ I ~ ~~~ t
P 18329501
r„~ dnly fled ~~ith nu as ~.111~L~1 RcgjsU~ar. the orj~*)n~{1
CLERK ~l
i cc•rtji'irate ).~~~ill ~)~ h)rr~arded to the State Vitul
ORPHAf~I c '.,OUR?
~E,l~R~p~. AJ'(1~1 ~,~ . ~~ K«ords (?(fire f(Ir (urn) t)~ent filing.
Certification Number
o\
Type/Print In
Permanent x/33-223
Black Ink
J(
~_
~~j , a ~ ~
rYl ~ ~~ I-f~is is to c~rtity that The intixmation here hia~en is
correctly copied iron; an original Certificate ul~ De~ub
~_~~_eu_.c1~~~.ti~C~1Q1~.~.9~d12
C .)r(I Reg(sirnr 17atc Issued
COMMONWEALTH OF PEN NSVLVANIA DEPARTMENT OF HEALTH VITAL RECORDS
C'F RTIFI['ATF AF f)FATI-1
1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Secu riTy Number 4. Dale of Death (MO/Day/Vr) (Spell Mo)
Glenda S Liebrum Female 210-26-5699 April 5. 2012
Sa. Age-Last Birthday (Vrs) 56. Under l Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Year) (Spell Month) 7a. Birthplace (City antl Stai<or Foreign Country)
~` Months Days Hours Minutes -
76 Januar 25 , 1936 7b. Birthplace (COUn[y)
8a. Residence (S[afe or Foreign Country) Bb. Residence (Street and Number -Include Apt No.) Sc. Ditl Decedent Live In a Township?
PA 671 Easy Road ~ Ves, Decedent lived In North Middleton twp
Sd. Residence (County) .
Cumberland Se. Residence (21p Code) 1.7Q13 ~ No, decedent Ilved within limits of city/boro.
9. Ever in US Armed Forces? 30. Marital Status at Time of Death Q Married ~ Widowed 31. Surviving Spouse's Name (If wife, glue name prior to flat marriage)
Q Yes ® No Q Unknown ~[] Divorced Q Never Married Q Unknow
12. Father's Name (First, Mitldle, Last, Suffix) 13. Mother's Name Prior to Firs[ Marriage (First, Middle, Last)
Lester Hurley Pauline Fisher
14a. Informant's Name 14b. Relationship io Decedent 14c. Informant's Mailing Address (Street and Number, Clty, State, Zip Code)
0
Rory Liebrtam son
423 E. Lisburn Rd_, Mechanicsburg, PA 1705
s If Death Occurred in a Hos Ital:
In
atient ............. .......................... ................... ......... ..... ....... ....... .....
...
f
h
~ ~~
p
p
; I
Deat
Occurred Somewhere Other Than a Hos I[al:
p ~ Hospice Facility ~Dec¢dent's Home
Q Emergency Room/OUtpa[lent Q Dead u n Arrival
• Q Nursing Home/Long-Term Care Fa<IllTy Other (Specify)
lSb. Facility Name (If not InstltuHOn, give street and n tuber; lSC. City or Town, State, and Zip Code 15d. County of Death
671 Eas Road Carlisle PA 17015 Cumberland
16a. Method of Disposition Q Burial Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) -
p Remqyal frgm state p DgnaHgn Apr _ 10 , 201 Hof fman-Roth Funeral Home & Crematory
`€ ocher (specify)
? i6d. Location of Disposition (CI[y or Town, Stare, and Zip) 17a. Slgna o Funeral Servic ge of Interment i7b. License Number
Carlisle, PA 17013 138504
S7c. Name and Complete Address of Funeral Facility '
8
' Hoffman-Roth Funeral Home & Cremato 291 North Hanover Street, Carlisle, PA 17013
~ 18. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check [he 20. Decedent's Race -Check ONE OR MORE races to indicate what
~ highest degree or level of school completed at the time of death. box Shat best describes whether the decedent She decetl<nt considered himself or herself to be.
Q 8th grade or less is Spanish/Hispanic/Latino. Check [he "NO" Q9 White Q Korean
Q No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. )~ Black or African American Q Vietnamese
® High school graduate or GEO completed ®No, not Spanish/Hispanic/Latino 0 American Indian or Alaska Native Q Other ASian
Q Some colleg<credii, but no tlegree Q Ves, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawaiian
Q Associate degree (e.g. AA, AS) Q Ves, Puerto Rican Chinese
Q Q Guamanian or Ghamorro
'
Q Bachelor
s degree (e.g. BA, AB, 85) Q Ves, Cuban Q Filipino ~ Samoan
'
Q Master
s degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispa nlc/Latino Q Japanese Q Other Pacific Islander
Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) ~ Other (Specify)
. MD, DDS OVM LLB JD
21. Decedent's Single Race Self-Oesigna[lon -Check ONLY ONE to indicate what the decedent consideretl himself or herself to be. 22a. Decedent's Usual Occupation - Intlicate type of work
® While Q Japanese Q Samoan done during most of working Ilfe. DO NOT USE RETIRED.
Q Black or AfNCan American ~ Korean Q Other PaclFlc Islander Administrator
~ American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure
Q Asian Indian Q Other Asian Q Refused 22b: Kind of Business/Industry
0 Chinese ~ Native Hawaiian Q Other (Specify) Hos
ital
p
Q Filipino O Gua manlan or Cha morro
ITEMS 3a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead Mo Day r) 236. Signature o Person Pronouncing Death (Only when applica le) 23c. License Number
BV PERSON WHO PRONOUNCES OR
CERTIFIES DEATH A ri1 5 2012
23d. Date Signetl (MO/Oay/Vr) 24. Time of Death
A rox. 2:00 P.M. 25_Was Medical Examiner or Coroner Contacted? Ves Q No
CAUSE OF DEATH
Apprpximate
26. Par[ I. Enter the chain of events--diseases, injuries, or complications--[hat directly caused the death. DO NOT enter terminal events such as cardiac arrest
Interval:
.
respiratory arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines If necessary Onset to Death
IMMEDIATE CAV SE > Hypertensive Cardiovascular Disease
(Final disease or condition Due to (or as a consequence of):
resulting In death)
b.
Sequentially Ilst conditions, Due to (or as a consequence of):
if any, leading to the cause
Ilstetl on line a. Enter The
UNDERLYING CAUSE Due Co (or as a consequence of):
(disease or Injury that
F In i[lated the events resui[Ing d.
In death) LAST. Due to (or as a consequence of):
26. Part 11. Enter other sl nif nt n 1 1 n n[rib I th but not resulting in the and<rlying cause given In Part i 2J. Was an autopsy performed?
c
g D yes No
CAD, CHF. Remote MI
28. Were autopsy findings available
to c plate the c of death?
a
o
Q No
Q Ves
29. If F<mal¢: 30. Did Tobacco Use Contribute to Deaths 31. Manner of Death
E Q Not pregnant within past year Q Yes ~ Probably Natural 0 Homicide
Q Pregnant at time of tleath Q N
k
~'
m o Q Un
nown [
AccldenT Q Pending Investigation
Q Not pregnant, but pregnant within 42 days of deaTh
Q Sulcltle Q Could not be determined
ti Q Not pregnant, but pr¢gna nt 43 days to 1 year before death 32. Date of In
Jury (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. LocaTlon of Injury (Street and Number, City, State, Zip Code)
36. Injury at Work 37. If Tra nsportaHgn Injury, Specify: 38. Describe How Injury Occurred:
Q Ves Q priver/Operator Q Pedestrian
Q No Q Passenger 0 Other (SpeclTy)
39a. Certifier (Check only one):
Q Certifying physician - To the best of my knowledge, ath occurred due to the cause(s) antl manner stated
~Pronou ncing ga Certifying physician - To the be y knowledge, death occurretl at the time, date, and place, and due to the cause(s) and manner stated
Medical Examiner/COron
(jO~ b is o minatlon, and/or Investigation, In my opinion, death occurretl at Hie time, date, and place, and due to the cause(s) and m r stated
anne
<
~
Signature of certifier:
/// Ti
~hie£ Deputy L'Or One ?
l
f
t
e o
certifier
License Number:
39b. Nam¢, Address and 21p Code of Person Completing Cause of Death (Item 26) 6375 BH9 ehOrE! Road ~ Suite ]. 39c. Date Signed (MO/Day/Vr)
Matthew S_ Stoner Chie£ Deputy Coroner M hani bur PA 17050 A ril 5 2012
40. Registrar's District Number 41. Registrar's ygna~
~
y 42. Registrar Flle Date (MO Day
~
L r
43. Amendments
Disposition Permit No. ~ ~ 3 6~~1 lJ H105-143
REV 07/2011
F:\FILES\DATAFILE\Estate Planning\I 1182-Lwi11.2004
LAST WILL AND TESTAMENT
I, GLENDA S. LIEBRUM, of North Middleton Township, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and
declare this to be my Last Will and Testament, hereby revoking any and all former Wills or
Codicils made by me.
1.
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses
and all death taxes (whether such taxes may be payable by my estate or by any recipient of
any property) shall be paid from my residuary estate as soon as practicable after my decease
and as part of the administration of my estate. My Executor shall have no duty or obligation~_ ,
~ ~._,
to obtain reimbursement for any such tax so paid, even though on proceeds of in~~nce or ' ~ ~~
-~,
other property not passing under this Will. r= ~~ =~ I
- ,
-~ C~'~ ~ ~_ __
_
2. _~~ ~;~
_ 1
hA
~~J"il
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-:^I
I give such items of personalty as are itemized in a certain list, if any, attac~he~ hereto= -_ ;T;
a
to the ersons named thereon which list is si `~'
p gned and dated by me at the end thereof. r..:, ~~ ~
3.
I give, devise and bequeath all the rest, residue and remainder of my estate, both real
and personal property, m e ual shares as follows:
a. One share shall be divided in the following manner:
(1) (~%~thereof to ~ each of the children of my daughter,
APRYL L. LIEBRUM, living at the time of my death, and the balance of said share
to my daughter, APRYL L. LIEBRUM.
b. One share shall be divided in the following manner:
(I) ~~ (~°~/o,) thereof to each of the children of my son, AARON
J5 a ~
L. LIEBRUM, living at the time of my death, and the b once of said share to my son, ~~
`~
~~
[Initials]
Page 1 of 5 Pages
c. One share shall be divided in the following manner:
(1) T•e~er~e~t (1~~ ereof to each of the children of my son, RORY S.
LIEBRUM, living at the time of my death, and the balance of said share to my son,
RORY S. LIEBRUM.
d. In the event any of my children shall predecease or fail to survive me and not
be survived by issue, then his or her share shall be added to the shares of my remaining
children in accordance with the terms of this Item 3. ~ ~ I `~'°fo a~.~ ~(L .~,
I direct that the share of any beneficiary under the age off t~wen~-one (2~j1 years shall
be held in trust by my Trustee for the following purposes: ~' 3~
a. I direct that my Trustee shall hold, invest and reinvest the same, collect the
income arising therefrom, and after paying all expenses incident to the management of the
trust, to use and apply as much of the income and principal as maybe necessary in the sole
discretion of my Trustee for the support, well-being and education of such beneficiary.
b. I direct that such beneficiary shall have the right of withdrawal of the principal
of said trust as he or she attains the age of twenty-e~e~~years.
c. In the event any such beneficiary shall fail to attain the age for distribution of
any part of his or her share and shall be survived by issue, then his or her share shall be held
by my Trustee for said issue and distributed to them equally as each shall attain the age of
twenty-one (2~) years.
d. ~ P"r~ r to the distribution of the principal, my said Trustee shall have the sole
discretion to invade the principal of said trust for the support, maintenance and education of
such beneficiary or issue of such deceased beneficiary, regardless of age.
e. To the extent that the same is permitted by law, none of the beneficiaries
hereunder shall have any power to dispose of or to charge by way of anticipation any interest
given to such beneficiary; and all sums payable to such beneficiaries hereunder shall be free
.~~~-
[Initials]
Page 2 of 5 Pages
and clear of the debts, contracts, alienations and anticipations of the beneficiaries, and all
liabilities for levies and attachments and proceedin s of wh tswoey.~r kind, at lbw o inequity.
f. I nominate, constitute and appoint KK ~
as Trustee under the terms of this Last Will and Testament.
5.
I nominate, constitute and appoint my daughter, APRYL L. LIEBRUM, as Executrix
of my estate. In the event she shall be unable or unwilling to serve in such capacity, then I
appoint my son, RORY S. LIEBRUM, to actin such capacity. In the event he shall be unable
or unwilling to serve in such capacity, then I appoint my other son, AARON L LIEBRUM,
to act in such capacity.
6.
I direct that neither my Executrix nor my Trustee, or their successors, shall be required
to file a bond to secure the faithful performance of their duties in any jurisdiction.
7.
I authorize and empower my Executrix and Trustee, or their successors, in their sole
and absolute discretion, to purchase or otherwise acquire and retain any investments of which
I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage,
transfer, exchange, dispose of or grant options in regard to any or all property of any kind
forming a part of my estate for such terms and such prices as they may deem advisable; to
borrow money for any purposes connected with the protection and preservation of my estate;
to mortgage or pledge any real or personal property forming a part of my estate or to join in
or secure the partition of same; to compromise any claims or demands of my estate against
others or of others against my estate; to make distribution in kind and to cause any share to
be composed of cash, property or undivided fractional shares in property different in kind
from any other share; to employ agents, attorneys and proxies and to delegate to them such
power as my Executrix and Trustee, or their successors, consider desirable and to pay
~~
[Initials]
Page 3 of 5 Pages
reasonable compensation for such services as may be rendered by such agents, attorneys and
proxies; and to execute and deliver such instruments as maybe necessary to carry out any of
these powers. In addition, I direct that my Executrix, or her successor, shall have the power
to conduct an inventory of any safe deposit box necessary to the administration of my estate.
IN WITNESS WHEREOF I have hereunto set my hand and seal this ~?f da of
Y
J"v~- .2oa t/
~• ~~ _ _ (SEAL)
Glenda S. Liebrum
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix,
as and for her Last Will and Testament, in the presence of us, who at her request, have
hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and
of each other.
_.
,~~ ~ilfc
Page 4 of 5 Pages
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We, Glenda S. Liebrum, Edward L. Schorpp, and C~ !'r, ter., ~,~ I~ y t y~e,f-S ,
the Testatrix and the witnesses, respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed
willingly, and that the Testatrix 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 a witness and that to the best ofhis/her knowledge the Testatrix was at that
time eighteen years of age or older, of sound mind and under no constraint or undue
influence.
Glenda S. Liebrum Testatrix
~~
Witness
Witness
Subscribed, sworn to and acknowledged before me by Glenda S. Liebrum, the
Testatrix, and subscribed and sworn to before me by Edward L. Schorpp and
CJ~rm~ 1-.• /~~/ ~,rS ,the witnesses, this ~~day of %~~~ ,2c~~j!
/~- /'~-t cam' _ ~ //.~ c ~-'
C~
Notary Public
NOTARIAL SEAL
rICTORIA 1. OTTO, NOTARY PUBLIC
CARLISLE BORO. CUMBERLAND COUNTY
MN COMMISSI01~ EXPIRES DEC. 2 20~~
Page 5 of 5 Pages