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HomeMy WebLinkAbout05-21-12Reset 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 avers} the following and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information ~ ~ Name: Louise H. Jacobs File No:~' ~ ,~ O 1 a/k/a: (Assigned by Register) a/k1a: Date of Death: Anril 30, 2012 Age at death: 89 Decedent was domiciled at death in Cumberland County, pennsylvania (state) with his/her last principal residence at 253 Walnut Street Carlisle. Carlisle Boroueh Cumberland Street address, Poet O(tke and Zip Code City, Township or Borough Couuty Decedent died at Carlisle Reeional Medical Center, Alexander Sorine Road. Carlisle Cumberland PA Street address, Post Onice and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: Ijdomiciled in Pennsylvania ........................... . All personal property $ 35,000.00 Ijnat domiciled in Pennsylvania ....................... . Personal property in Pennsylvania $ Ijnot domiciled in Pennsylvania ....................... . Personal property in County $ Yalae ojreal estate in Pennsy/vania ..................... .................................... $ 145~no nn TOTAL ESTIMATED VAL[JE.... $ 180.000 00 Real estate in Pemsylvmia situated at: 253 Walnut Street Carlisle. Carlisle Boroueh Cumberland (Attach additlanai sheets, if necessary.) Street sddresa, Post Ortice 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 M[ay 23, 1978 and Codicil(s) thereto dated none _ - _ - State relevant dreumataucea (e.g, renunciadaq death of executor, eta) 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 apending divorce procceding wherein the grounds for divorce bad been established as defined in 23 Pa. C.S, § 3323(8), and did not have a child bom or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.. ~NO EXCEPTIONS o EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c,t.a., d.b.n., d.b.n.e.t.a., pendente life, durance absentia, durance minoritate If Administration, c.t,a. or d.b.n.c.t.a., enter date of Will in Section A above anti complete list of heirs. Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds firr 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. © NO EXCEPTIONS Q EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spfany) an~'eirs additional sheers, if necessary): ~7 ~ _ 3s T, y :,) ~[ Name Relationshi _i Address ? . ) ~ G~ . a: ~ ~n ,5 z~ Form RW-01 reg. rori/rzo// Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland Official Use Only ^' ^.p. e .~~'.~L.' ..~ .. ~,/ !~~~ n Petitioner(s) Printed Name Petitioners) Printed Address Kirk E. Jacobs 300 Creek Road !, ^~~ . - Newville, Penns Ivania 17241 CUMBERIa4ND CO., PA - Brian L. Jacobs 253 Walnut Street Carlisle, Pennsylvania 17013 The Petitoners) above-named swear(s) or affirm(s) the statements in the foregoing Petifion are true and correct to the best of the knowledge and belief of Petitioner(s) and [hat, as Personal Representative(s) of the Dfec~eny the P ~ 'boner(s) will well and tmly administer the estate according to law. Sworn to or affirmed and subscribed before '/(.G~~ G^--"'^ Date ~~~ 1 I) z- ySk-ts~~y of ~ - ,~~`)- _ Date Y: "1 Date b` 2( l or the Regi Dale BOND Required; AYES /t~~''NO To tke Register of B'i/(s: FEES: / Please eater my appearance by my signature below: Letters ( ~- )Short Certificate(s)...... .',?Gf ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Co mmissjf~a9J ................. . Other W ~~ / / ........ /,~ Automation Fee ............... JCS Fee ..................... _ TOTAL ..................... $ O Attorne ~ natuk: r Printed Name: David A. Boric, ]?squire Supreme Court ID Number: 44853 Firm Name: Boric Scherer LhC Address: 19 Wesf Snath Street Carlisle P~navlvania 17014 Phone: (717)249-6873 Fax: (7171249-5755 Email: dharic harirsrhErEr_rnm DECREE OF THE REGISTER Estate of Louise H. Jacobs File No: 1 ~- I~ J~~ a/k/a: AND NOW, satisfactory proof fire instrument(s) dated May 23, 1978 described in the Petition be admitted to probate and last Wyll (and Codicil(s)) ~ f Decedent. ~~~- ~ t ,r-fi~!".l , in consideration of the foregoing Petition, presented before me, IT IS DECREED that Letters testamentary _ are hereby granted to Kirk E. Jacobs and Brian L. Jacobs in the above estate and (if applicable) that FonaRw-oz reg. ioi(uzoi/ ~ 7 Pa~~JG oft L~L REGISTRAR'S CERTIFICATION ~DF DEATH [ l' . ~I€}(,d~'ifl~"gal to duplicate this copy by photostat or photograph. R6~~ ._ ~!J Fee fur this certificate, $6,pQ~ ~QY ~ ~ Qf~ ~~ .,1 r,., ..,.. ORPNANo ;;~;,iRt P 18 4 8 7 R~'JD co.r ~ Certification Number n This is to certify that the information here given is correctly copied from an original Certificate of Death duly fi]ed with me as Local Registrar. The original certificate will he forwarded to the State Vital ~j~Re~cords Office for permanent filing. C~Cbayt. ~~Fau.~ie~De~e't~RX' M Local Registrar Date Issued Pe/Print In <OMMONWULTX OF PENN3V LVANIA • DEPggTMENT OF XEgLTX VITAL R[CORDS CE RTI FILATF AF nFAT1-1 1<gal N m¢ (Glrst MI ale Last SuMx) 2. Sex 3. 5oc1a15ecurlty Numbm s< • a<n (Ma/°a rl (Spell Mn) I a e ta e Laxq its U Ts eo s t 199-12-LD07 A il 30, 2012 Age-uac BL<na.r rvrx) m. una¢r v res.. sc. una¢. I D. s. Da. ni Blrtn (MO/D.rnea.r (spell Mpnml >a. BInM1PIa (aN.na state or F ncrvl cop I M M ex Sg nom. D.va Hopr Inut Nov_ 13, 1922 >b,Brtn lca (cnpnN) W Amin W ga. Rezm.n¢e estate n, Forelsn cppn<M eb. amn.l met a r- mduae gp<rve.) ec. old ° [eeent u.,. m w nxmp> e 2 a ( P A 53 Walnut St OY¢a e.¢.e<« IL,¢a L , e<. R¢aa.npa (nw coos) n, eec¢aan<u..e wmm~ uml<a ni Carl Tale nlN/born N a Ever m us Armes Fn eza .I natua a nm. ui D .m O M I a wlapwe . wrvwing spup.e ., Name Ui wRe, eNe nem. print to nrss m.rN.Zel r '°oo ~ `ro ¢a ~ryp o nknnwn o oN 1<a DnKntlwn vn 33. EaMai a Nam<(Fnit Mltlale. Lsat 6uHlrrl 13. Mpthels Name P,ler <a FI a (Fart, Mltlale M. 1 g Lest1 Herbert M_ Ph1111 , Lillian Sayre lea. lnh.m.ntl rv.m. b. q<LUpnxhlp to De[ee¢ne n. gaa...a Is[r«t.na rv a. 19 s s[ Kirk E. Jacobs eon 300 Craelc Rd_, Necrville, PA 17241 S H Deatn Occurree In a Hospital: t~~~lnpatlent ~ Iif °eath Occurretl Somewhere OMer Than a Hpspl<al: ~~~~~~~~~ ~~ "~"~"~"-"" """"""""""""""""""' 1•~• Xnxplce FacIIIN C]'~Oaceaen['z Ho q me ~ Ema enc nom/OUtpaVant Deatl pn ArNVeI ~ Nufsln H me/LOn -Term Ure Faclll O[ner (SpaclN) ~ ISb Faclll a (If net In I[utlon one number SSC. O 5 ate, one 21 C tl 13a. Cou N of h Carl~ale Reg ~onalgNMecslical Center ~ar~~aj e P]P °1 eJ015 ~ ~a . , Cum 3er nd a. M nos of Dlzppalnnn Burls <r<m.[mn lfib. O. f DIx lupn Sfic. Pl. c. ni DNposlclon ( e or cemaery, cram.<n ry, or oener wl.ce) t P N m nnm s cc ce O Dpnanpn o Nay 4, G012 Weatminatar Cgmcetery a^ o ~ o ; o<n, r (sP ) e z lea. L Dlipozltlnn (O[y ar Town, State, en Ipl rat Sarvlc arson In CM1a,ge of Interment 1>b. Llcanse Numbaf Carlisle, PA 17013 013194E X Lt.Amreax ni FUner.IF m[v 1 ~ O 3 HO££man R th Funeral Home & Cremat 219 North Hanover Strgeet Carlisle, PA 17013 ~ 1B Decetlent's Etlucvtlon-CM1eck [M1e box <ha<beat eescrlbaa Me 19. Decedent of Hispanic Orlgln-Ch¢ck Me ceeent'i pace-CM1eck ONE Oq MORE rates olntllce<e wnat t nlBnest aegree nr level of zchpal completetl at the [line ni aeatA. box toes[ best tlescribes wnetner [he aeceaent the aecatlnnt consltlerea M1lmseli or nerseli to be . ~ 8<n graaa pr lases Ia SpanrrM1/Nlspanl4tatlno. Cneck [M1e "N O" Wnlh O Kprevn p Nn elpioma, 9th - um g,.ee [ ls no<SpanlaM1/Hlspanlc/Latlno. ec„ gfricsn American la[nsmese $] Hlgn achnol graduate or GED coin boK li tlaceaen plates N M1 a r ~ P Ir /XI anl4Latlnn ~qma an lnalan prAlazka Natlva DOFherAalan some coll¢g¢crcal<, but no tlegrae ~V eKicen,M angmeNCVn CM1lcano Ogslno.al.n I , pry 0 A nclate eegr¢e (a. M,A3) O V arts can O ch nose ~ G or cM1amnrro ualmanlana I i 0 gacheloi i aegree (e g. gq, qB, Bs ) Q FI plop O 3 ~ C n a ¢ E 0 Maa[ei a tlegrae (<.g. Mq, M3, M ng, MEd, MEW, MBq) ~ yes her spanlaM1 H / Ispanlc/Latino Q Ja anexe 0 OMer Pacinc Islanaar O DaRarate lu.g. pnq Etl0) ar Pmieszlonal tlegrae ppaclry) O oener (sp¢dry) DD3 OVM L ls ` ceeent' De Single Race 3eli Oeslgna[Ipn-Ueck ONLY ONEta inalcah wha[ehe aecetlen[cnnsleer¢a M1lmxell pr heraeli [n be. ceaent'sV aI OCCUpa< Intllcah Npe of wprk bite B ~ cone outing most of working qh^°O NOT VSE RETIRED, o Lek nr grv¢.n Am.n[an p Ke ~.er6e o o.n.. wclnc I:Liner Homemaker ~gmencan lntllan nrglaska Na[IVe ~Vletnamaxe ~DOnR Knnw/Not SUr¢ ~ Aalan L n Q Oeher gslen ~ geiusetl 22b. Kind of Buzlners/Ineurtry O CM1In¢a¢al O Natlva Xawellan O O[ner (speclM o Fiupmw o Guamanln nr cna Olar3 Home z3 s D¢ec S PERBON WNO PONOV NOES OR!° a. Oats Pro unto Dee p °ry r 31gne[ur Only w en app Ice a 3[, licenaa Num er I cetlnp IEg DurX ar f '~- lgn¢ Mn/D.y n .nine pi Deam ~ ~~ O o OJ o!Y¢~z ~ s i ($ 2 0 a soma E mine r co. 3 eez O vas rvp CAUSE OF DEATH z .Enter cna m. n .-.ala..xe:, lnltlaex. p. [ornpncaunnx--toes alreter [.r.am me seam. oo rv nal eyentx xr,[h as eaml[ arras[ ~ 1 I: Apphrva ate ¢epl.anry artext p..en<Nma. nbrlllupn wlmnpe xnpa;ing me <cmmgv. D NOT gBBREVIATE. En .r n ¢ [.pee on a Imo. Aae aemnnnal lleaf n.=exx.rv I Dnx¢t m Deam ' o c my pn IMMEDIATE <nusE ----__-..> a. A[..+g. RGTp)r.F. Fo%lMre 'EI se pr contlltlan ue [o brazes consequan e I m °N` exm g aemp CP ri. :a JIaR.+ ~Fw:la.z i s¢ap.nGea v nm gonmNnnx. o to wr az. pnnxeap<na nn: ) n.v enEme [ i iua<.e en Im< a. n<. a p r < . ~ NOERLYING UU6E Due to (or ax a canseeuence on: 1 (ales Inlurvm.v 1 nlt Lha M~ tz resW<I a. i ng ~ a g ^ °°[nl T. Oue tp (or as a consepuence on: y yes n m[nn 36. PaR IL E ter otM1er en £ cs but np<rexulting In me un erlying cause given In Pert r mea} e ,v p.nn s ib Nn Acx..+~, le:Irxe~, -FRfiwe ,s+.+al ~' ze. f~(Fx~,[ ix'ctyn.%c ./~+-pl..f sV nntlinga avallabl¢ o ~o t ~ ve: cna c.p~oe<.m> li a. Dm 3D T b ~Npt p,egnvn[wleM1ln past year . o acco Uxe <pntrlbu<a to DeaMi 1.M net of eam 3 D g 0 V ~ Pmnably grvo O vnknpwn p Na<u rat 0 H cl ml ae ~' ~ Nnt P<gnant but pregnan[witnln 43 Gaya of tleam g p Accla¢n< ~ Sulcltl¢ ~ C ula no[betl ~erminea ~ Not pregnant but pregnan<63 tlays <0 3 y ar before seem ~ Unknown li re nant withi Me s 33. Oats a In(ury (Mrs/Day r) (3pell Monthl p g n past year 33. Time ni ln/ury . Place a Infury (e. g. M1nme, conisruRlon site, Iarm, zchaan .Location of In)ury IStree<ane Numbers ON. Shh, Zlp Cnae1 . LNrva prk ran a p Inlr.rv <pIN: . .Dearnb<Hpw lnlurv occr.rm. O r p D o.r/opt <o O P O rve O Paaxen er p a eryspeelNl a. 4r<lner (coats only or.el: 39 0 c rtlMn o ones base ni my knowlaege, eeaen ppcprree sue w m. ¢apaepl and m ma a ~P n n ng®c rtlNln Iclan- a pi my k nn Iee ge, aaaM ac teas <M1 e tl e,tl t ce n au e M1 e <i SG s a n t¢ rt n r p e O Mea cal Exe ne /C - me oi e m nestles ones/ Inve tlgaNpn. In m n Inlon, ass urretl at < a a m..~aa . ~a I [ , ear. p a s an [o c e me ae(q .ne mann¢r aa[. [ oIC mn.r IV¢nie rtlner PO eNUmben FJ.SO/YL07 ! e T e 39e rv.m¢ Aee x a z c a. of p<r nn c m L[mg ca.,x¢ y am (nem zsl slg alMn/Dav/vrl L. I l etc ( l J e x p G ` .~ , Sl/9Tf/~ ~p Rrr.,.n/ WL Cp..JFr Y37;z ¢ g ..r am ¢. R¢g om, .r a Q ` -ax~ aoia gm a . ¢n m.n: Dlxppalnpn Parmlt ~R aa~-d E ~D9-IA3 R Dr/SD13 _ _ .~ _ ~~. :., ~-, _.. a "'' ' --_' ~ i,~ LAST MILL ANL? TESTAMENT OF lAUISP•. H. JACOBS I - >:~ cv ~ z T LOUISE H. JA.COBS, of the Borough of Carlisle, Cumberland ~_~'.' .c. -- , ~CO -~L~unty, Pennsylvania, declare lr. this instrumetnt to be my Last i11 Li'-- (:L_ ~t a °"` and Testament, in manner and form following: a_, I hereby expressly revoke all Tdi11s and Codicils hereto- fore made by me. 7_. I hereby direct my Executor. to pay all my just debts, funeral and administrative expenses out of my estate, as soon as nract:ica.ble after my death. 3, Should my husband, Kenneth E. Jacobs, survive me for a ~' period of thirty days following my death, I devise and bequeath j the remainder of my estate to Kenneth E, Jacobs, i 4. Should my husband, Kenneth E. Jacobs, predecease me or I die on or before the thirtieth day following my death, I devise and bequeath the remainder of my estate to my issue living on the thirty-first day following my death, per st:irpes. 5, I nominate and appoint Commonwealth National Bank, Carlisle, Pennsylvania, Trustee of the shaz^e of any beneficiary who m<3y be under the age of twenty-one years. The income and/or principal of said trust may be accumulated or expended for the maintenance, education and support of such beneficiary as my Trustee in its sole discretion may determine; and my Trustee, in the expenditure of income and/or principal for such purposes, may, at its discretion, apply the same directly without the interv¢ntion df a `guardian or pay'the'same to any person having i the care or control of said beneficiary or with whom the bene- ficiary r~sides,,without~duty on the part of the Trustee to supervise or inquire into the application of the funds by any person to whom,'ariy payment is so made. The balance of such ~ income and/or principal shall be paid to such beneficiary upon - 1 - . .. ~.... ., A........ 1 s reaching the age of twenty-one years or to such beneficiary's estate in the event of death prior thereto. 6, I nominate and appoint my husband, Kenneth E, Jacobs, as Executor of this my Last Taill and Testament; and as substitute' Ewecutors I nominate and appoint my sons, R;irk E, Jacobs and Brian L, Jacobs. 7. I direct that my personal representative and Trustee, as well as their successors, shall not be required to f.i1e bond or security in any jurisdiction. ~ IN WITNESS k~ EOF, I have hereunto sea my hand and seal ~ ~, this Z3'~ aay of ~ ~ , 2978, i~ `' ~'~~c~ ~~ • ~ CSEAL) --~ouiae coUs WITNESS r - 2 - ,~ COrIItONFTF.ALTH OF PF.NNSYLUANIA SS. COUNTY OF CUMBEnLAND I, Louise H. Jacobs, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrianent as my Last [dill;. that I si,;n.ed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed, Sworn or affirmed to and ack owledged b fore me, by Louise H. Jacobs, Testatrix, this '~ 3 Y~ day of ~I~ , 1978. ~~ ~~ ~~ estatr c JANICE E. NERTZLER, NOTARY PUBLIC ~~`"''~'- ~ '`~~ ~~, I Cumberland county Carlisle, Pa. My Commission Expires January 27, 1979 CON>i~"ONGIEFLTH OF ??ENNSYLVADTIA ; SS. COt]NTY OF CUMBEP.LAND [1e, Tom H. Rietsch and Roger M. Morgerithal, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present .and saw Testatrix, Louise H. .ifacobs, sign attd execute the".instrument as her Last Will;. that she signed willingl and that sloe ere aitesd it as her free and voluntary act for the purposes therein expressed; that both of us in the hearing and sight of the.,Testatrix signed the wi11 as witnesses; and that to the best of our knowlE dge the Testatrix wae~ at that time 18 or more yeaz~ of age, of sound mind and under no constraint or undue influence. Swc{rn or affirmed to and subscribed to before me by Tom H. Bietsch attd Roger M. Morgenthal, witnesses, this ~_3 ,_ day of (y ~„p , 1978. ANICE E. NERTZLER, NOTARY PUBLIC ~ Cumberland County Carlisle, Pa. I~ y Commission Expires January 27, 1979 -~Titne s s I'~ wl ~~~ ittiess ~ ~ 3'-