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Home My WebLink About05-11-12Reset 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 ~• t ::;_ File No: ~. ~ ~ - ~ ~ - ~-`~ Name: Burton Reisman a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: Mav 1 2012 Age at death: 9 Z- th in Cumberland t d d il i County, Pann ylvania (state) with his/her last ea a e c Decedent was dom principal residence at 4705 GettvsburQ Road Mechanicsbur c PA 17055 Lower Allen Township Cumberland County nt C Street address, Post Office and Zip Code Cdy, Township or Bo rough y ou Decedent died at 503 N 21st Street Camp Hill PA 17011 East Pennsboro Township Cumberland County , Pennsylvania Street address, Post Office and Zip Code Crty, Township or Borough County State Estimate of value of decedent's property at death: $ 000.00 1 If domicifed in Pennsylvania ............................ All personal property i $ , If not domiciled in Pennsylvania ........................ a Personal property in Pennsylvan $ If not domiciled in Pennsylvania ........................ Personal property in County . $ 00 75 000 Value of real estate in Pennsylvania ...................... ................................ TOTAL ESTIMATED VALUE. .. ... $ . 76 000.00 Real estate in Pennsylvania situated at: 4705 Gettysburg Road Mechanicsburg PA 17055 Lower Allen Township Cumberland County (Attach additional sheets, irnecessa.ry.) Street address, Post Office and Zip Code City, Townshrp 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 m the last Will of the Decedent, dated February 23, 2012 and Codicil(s) thereto dated N/A. 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(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.a., d. b. n., d.b.n.c.t.a., pendente lice, 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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. Name --- ~..- "~ _.t:., O ` '~ ~ ..~ ~ . _ _i Ln ~~ ~~ NO EXCEPTIONS ~ EXCEPTIONS ~ Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survivedby the following spQtt~~fany) anda?;rirs (attach~.~ additional sheets, if necessary): ?-;_, is*`~ Relationshi Address ~7 •=, ~._ T! Farm RW-02 rev. l0/11/2011 Page 1 of 2 Oath of Personal Representative - ,~ t iy ~_ •' ..~.' i The Petitioner(s) above-named swear(s) or affirm(s) the statements in the for~gtlfn'g~tition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Deceden~#,~tfie Petitioner(s) will well and truly administer the estate accordingrto law ~ ,XL .. r-`_ Date ' ~ -~p ~ Sworn to or affirmed and s abscribed befor ~ ' `- Date met ! 1 ~ ~ day of 1 ~~~~ ,~~ ~ ~~~ _ ` ~ ~ ~ :1 l -~ ~i 1.~~ ~ ~ Date BY~ ~. Date Forth;: Registzr BOND Required: ~ YES FEES: \. NO To the Register of Wills: Plrace enter my appearance by my signature below: $ -'~ '~~" Letters.. ~••••• •• ~~~ ~ ( ~ ~ )Short Certificate(s).... .. . . ( )Renunciation(s)...... .. . ( )Codicil(s) . ......... .. . ( )Affidavit(s)......... .. . Bond ..................... ... Commission ............... .. . Other •••• ••• ..... Automation Fee ............ ... ... .` ~'~' - JCS Fee . ................. ... ~_~~ $ -~ ~ ~ `~C 9~6 TOTAL .................. ... Attorney Signature: Printed Name: Supreme Court ID Number: Keith O. Brenneman 47077 Firm Name: Snelbaker & Brenneman, P. C. Address: 44 WPCt Main Street -- Mechaniccbilrg PA 17055 717-697-8528 717-697-6781 Phone: Fax: Email: DECREE OF THE REGISTER =,,_~ ~' Estate of Burton Reisman File No: -~ ~ - ~;_,~ `" a/k/a: ' `~ `~~~ j~._, in consideration of the foregoing Petition, AND NOW, i`,. \ ~ i satisfactory proof having bee presented before me, IT IS DECREED that Letters Testamentary are hereby granted to David L. Reisman in the above estate and (if applicable) that the instrument(s) dated Februa 23 2012 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Regtster of Wills ~~ ' Page 2 of 2 Form RW-02 rev. 10/ll/ZOl1 COMMONWEALTH OF PENNSYLVANIA } } ss: COUNTY OF CUMBERLAND } NIIVG: It i_sl il{~ga( to dupli~,at~ th4°~ ~(~~~+ ~av c~A~~'tc~~ts~? cs, x3hs~tc,r~r:~ss>~ GFir'~: ~, , ~: - CUMBtRI~'NU~Cn~ PA ':,,. ~ ~ '. ;,, ~r, ~: ___-. , ~`t ~ ~' I ~_ _~li't, li . 't '~.. ~ ~l, ~ 1 " .AI~. i,_,. Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS P<rmanent CERTIFICATE OF DEATH State Flle Number: J/ a~_z Y (lack In k SufFlx) 2. sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo Middle Last i t ' , , rs , s Legal Name (F 1. DecetlenC 144-12-2910 Ma 1 2012 6a. Ag<-Last Birthday (Yrs) Sb. Under 1 Yaar Sc. Under 1 Da 6. Dat¢ of Birth (MO/Day/Ye>r) (Spell Month) 7a. g~thplac Ity and 5 or Foreign Country) tSroo~c~yn, 92 Months Days Hours Minutes April 13, 1920 7b. Birthplace (County) 8a. Residence (State or Foreign Country) Sb. Residence (Street and Number -Include Apt No.) Bc. Did Decedent live In a Township] Lower A11en c 4705 Gettysburg Rd. wp. Caves, de«den[Il..ea in Sd Residence (~ount~ CumJ7r°r 8n Code) 17055 ONO, decedent lived within limits of city/boro. sidence (Zi S R 9. Ever in US Arm¢d Forces? 10. Mari p e. e tal Status aS Time o4 Death Q Married ® Widowed 31. Surviving Spouse's Name (If wife, give name prior to fi rsf marriage) QYes Q No Q Unknown Q DN Orc¢d Q Never M>rrietl Q Unknown 12. Father's Name (First, Mldtlie, Last, SufFlx) 13. Mother's Nam¢ Prior to FIrsL Marriage (First, Mitldle, Last) Morris Reisman han~ah Newir h 14a. Informant's Namc 14b. R<lationship to Decedent 14c. Informant's M cling Address (Street and Number, City, State, 21p Code) G acs q eat ec on gnu ... ... - ....°.• --- --. .... .....-'-- ... ....... ........ ........ >tient elf Death Occurred Somewhere Other Than a Hospital: ~] Hospice Facility ~ Decedent's Home ~~In H it l $ p osp a : If Death Occurred in a Q Em¢rgency Room/Outpatient Q Dead on Arrival Q Nursing Home/Long-Term Care Facility Other (Specify) • 16c. CI[y or Town, State, and Zip Code SSd. County of Death SSb. Facility Name (If not InstiSUtion, glv¢ street and number; 16a. Method o Disposition Burial Q Cromatlon ifib. Date of Dispos Ion 16c. Place of DlsposlCion (Namc of cemetery, crematory, or other place) p R.mq.ralfrgmsc>t< p Dpnatign 5/3/2012 Temple Beth Shalom $ . other (specify) € Locatlpn of Disposition (City or Town, stet, antl Zlp) 16d 17 sl of Funeral service Licensee or Person in Charge of Interment ~ 1Tb. License Number . Mechanicsburg, PA - ~- FD-013592-L a' Namc and Complete Addr<ss of Funeral Facility 17c . Hetrick-Bitner Funeral Home 3125 Walnut St. Harrisbur PA 17109 .~ Decedent's Education - Ch<ck the boz the[ best describes the 19. Decadent of Hispa nlc Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to Indicate what 18 ~ . highest dagre¢ or level of school com plot<tl at the time of death. box that best describes whether the decedent th¢ decedent consider<tl himself or herself to be. Q Bth grade or less Is Spanish/Hlsp•nit/Latino. Check the "NO" White Q Korean ican American Q Vletna mesa Af ~ Bl k r ac or Q No diploma, 9th - 12th grade box if deced<nt is not Spanish/Hispanic/Latino. A ian N i Oth at er s ve Q Q High school graduate or GED completed No, no[ spanish/Hispanic/Latino Q American Indian or Alaska Chicano Q Asian Indian Q Native Hawaiian Mexican American M i ~ Y , can, ex es, Q some college credit, but no degree Q Asaoclate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Q Guamanian or Cha mono Bachelor's degree (e.g. BA, AB, Bs) Q Yas, Cuban Q Filipino Q Samoan anish/Hispanic/Latino Q Japanese Q Other Pacific Islander other S Q Vas MBA ' , p ) s degree (e.g. MA, M5, MEng, MEd, MSW, Master Q Doctorate (e.g. PhD, Edo) or Professional degree (Specify) ~ Other (Specify) . MD DOS DVM LLB JO 21. Dec<dent's Single Race Self-D<signaflon -Check ONLY ONE to Indicate what the tlecetlent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work during most of working Ilfe. DO NOT USE RETIRED. n e [~ Whl[e Q Japanese Q samoan do ( ~ ~ Q Black or African American Q Korean Q Other Pacific Island<r V W nar Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Q Asian Indian Q Other Asian ~ Refused 22 b. Kind of Business/Industry Q Chin¢se Q Native Hawaiian Q Ocher (Specify) ' Bar and Grill M ' oe s Q Filipino O Guamanian orchamgrrq ITEMS 2 - 23 MUST BE COMPLETED 23a. Date Pronounced Dead (MO Day r) 23b. Signature of Person Prgnouncing Death (Only when applica blei 23c. License Number BY PERSON WHO PRONOVNCES OR r1C, d~ `^ ~~ ~ I ` ~~ S ~g' `~~rJ- GERTIFIES DEATH ~~Jl ` /V 23d. Date sign<tl (MO/Day/Yr) 24. Tim< of Death OC' ~) i2 3 ~ ~ TJ fY1 25. Was Medical Examiner or Coroner Contacted? Q Ves No CAUSE OF DEATH Approximate 26. PaK 1. Enter the chain of events--diseases, Injuries, or complications--Shat directly caused the death. OO NOT enter terminal events such a artliac 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 CAUSE ---------------> a. (S GI--t ~-t'~t G C3o W ~~L (Final disease o ondiUOn Due io (or as a consequence of): resulting in death) b. t~ ~ ~ s l~ 2c A - S¢quentlally list conditions, Due to (or as a consequence of): if any, leading to the cause 1 JLT £ ` 1 c~ - i7 YS FL~t . usted qn un. a. Enter cn. S£V £tZ£ LEFT VF-N Tf~IC L UNDERLYING CAUSE Due to (or •s a consequence of): (disease or injury that - IniSiated the events resulting d. cc rn death) LAST. Due to (or as a consequen of): Enter other i Ifl t ditl t Ib tl d th buC not resulting In the underlying cause given In Part I 27. Was an autopsy performed? 26 Part II . . Q Yea No G 4-i Ro N ~ c. 1C < p ,•~ E Y 'fit S E A s~ , ~--1 y P E R,-{-' E-,.~ S (o N _ D I A P3 ~ T £S 28. Were autopsy findings available to mplete the cause of tl¢ath? co O yes No 3y+ 29. If Female: 30. Did Tobacco Use Contribute to Death? l 33. MJ her of Death ~-Natural Q Homlcitle 0 Not pr<gnan[ within past year f d h Q Yes Q Probab y ~ No Q Unknown Q Accident Q Pending Investigation $' Q Pregnant at time o eat 0 Not pregnsnS, but pregnant within 42 days of death Q Suicide Q Could not be tletermined but pregnant 43 days to 1 year before death nant r¢ Q Not 32. Date of Injury (MO/Day/Yr) (Spell Month) ,. , p g Q Unknown If pregnant within the past year 33. Tim< of Injury 34. Place of Injury (e.g. home; construction sit<; farm; school) 35. Location of Injury (S[re<t and Nu mbar, Clty, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurr<d: 0 Ves Q Dri er/Operator Q P<destrien Q No Q Passeng<r Q Other (Sp<cify) 39a.~erc Ifler (Check only one): ~qc<rtlfying physician - To the best of my knowledge, death occurred due io the cause(s) and man nar staled Q Pronouncing 8. Certifying physician - To the best of my knowledge, death occurred at the time, dat<, and place, and due to the cause(s) and manner statetl statetl Q Medical Examiner/Coroner - On the basis of ¢xamination, and/or Inves[IgaUOn, In my opinion, death occurretl at the time, tlate, and place, and due to the cause(s) and m ~f Signature of c¢rtifi<r: Title of c<rtifl¢r ~~ 6~~)TA U S T~ License Number: ~~ 4 4O 4 ~~ 39b. Name, Atldr¢ss >nd 21p Code of Pers n Completing Cause of Death (Item 26) Q Y'Q.l.. 39c. Date Signed (MO/Day/Yr) C Yl W 1~ . ~ 5 40. Ragistrar'9 Ois[rict Number 41. Regist IgnaCUrc 42. R¢gistrar Flle ate Mo Day 43. Amendments J DlsposiSiOn Permit No. O ~ ~ ~~ H305-143 REV 07/2011 LAST WILL AND TESTAMENT I, BURTON REISMAN, of the Township of Lower Allen, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expa~es be pa~~by ,-~ t :, -ti my Executor or Executrix, as the case may be, hereinafter named, as soon as c`d~''v~nientl~~nay r--.. --_ be done after my decease. ~ ~ _ _ ~. ~,, SECOND. I give, devise and bequeath all the r 'st, residue and rema~ der of m}z: ',., D .._ Estate, real, personal and mixed, whatsoever and wheresoever situated unto my .son, name~y DAVID L. REISMAN, absolutely and in fee simple, if he survives me. THIRD. If my son, namely, DAVID L. REISMAN, does not survive me, then and ~` in that event, I order and direct that my said residuary estate be distributed and disposed of as follows: A. I give and devise my real estate situated in Lower Allen Township, Cumberland County, Pennsylvania, know and numbered as 4705 Old Gettysburg Road, unto my daughter-in-law, namely, ANITA D. REISMAN, in fee simple, if she survives me. B. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated in equal shares unto my four (4) grandchildren, namely, DANIEL L. REISMAN, SABRA L. REISMAN, SHAINA E. REISMAN and MARY P. REISMAN, share and share alike, absolutely and in fee simple. If any of the foregoing named persons should predecease me and leave lawful issue to survive me, I order and direct that the foregoing share of my residuary estate shall be distributed unto said issue per LAW OFFICES SNELBAKER SC BRENNEMAN. P.C. stirpes by representation and not per capita. LASTLY. I nominate, constitute and appoint my son, namely, DAVID L. REISMAN, to be the Executor of this, my Last Will and Testament, but if for any reason he should fail to qualify as my personal representative or cease so to serve, then and in that event, I nominate, constitute and appoint my granddaughter, namely, SABRA L. REISMAN, to be the Executrix hereof, each and both to serve without bond or other security as a condition of qualification as my personal representative. IN \vITNESS WHEREOF, I, BURTON REISMAN, have hereunto set my hand and seal to this, my Last Will and Testament which consists of two (2) typewritten pages to each of which I have affixed my signature this 23rd day of February, Two Thousand Twelve (2012). ~.ti~ (SEAL) Burton Reisman The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by BURTON REISMAN, the Testator therein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. ~rn~~~ LAW OFFICES SNELBAKER SC BRENNEMAN, F.C. -2- COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND SS. We., BURTON REISMAN, RICHARD C. SNELBAKER and SANDRA K. SHOWERS, the Testator 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 Testator signed and executed the instrument as his Last Will and Testament and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of his or her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~h Testator Witness Witness 7 ~ ~ ~` r Notary Public K/~ '~~' COMMONWEALTH OF PENNSYLVANIA LAW OFFICES SNELBAKER EC BRENNEMAN, P.C. Subscribed, sworn to and acknowledged before me by BURTON REISMAN, the Testator, and subscribed and sworn to before me by RICHARD C. SNELBAKER and SANDRA K. SHOWERS, witnesses this 23rd day of February, 2012. Notarial Sent Susan L Mabazi, Notary Public Mxg Bono, Cumberland County My Comrnlssion Expkes Nov. 24, 2015 MEMBER, PENNSYr VANL? ASSOCfATlON OF NOTARIES