HomeMy WebLinkAbout06-08-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF __ COWT`C, PENNSYLVANIA
Petitioner(s) nomad be'.ow. who is%are 18 years of age or older, apply(iesi fer Letters as specified below. and in
st~.ppor[ thereof aver, s) the followins and respectfully renuest(s) the grant of Letters in the appropriate form:
Decedent's Information_
Name: ~i CAL/w L- C>l~jjc /Z ~ ~/Z
-r
alkta:
a/k/a:
a/k/a:
Date of Death: ~ ZZ Zo/Z
Decedent was domiciled at death in ~. UCS t ~!-/f.~-~ County,
principal residence a[ ..2 $~~> L---i~ w ~~~i/) /_i~~~', c~
File N'o: ~> I _ I ~ ~< <-f
(.assigned by Register) / //
Social Security No: ~~ --zT `~37 ~~
Age at death:
(Scare) with his/her last
~2 /7~/~~
Street address, Post Office and Zip Code ~ City, Township or Borough County
Decedent died at ~~c-'c-iy ~1~~~ c-" ~/L 1 i¢ 6 ~= ~'l/~ lt> li/L LE` ~~°«//3c~~~~.19 ~/~
Street address, Post Office and Zip Cade Clty, Township or Borough County Slate
Estimate of value of decedent's property at death:
Ijdomici/ed in Pennsy(vania ............................ All personal property $ ~ ~
If not domici/ed in Pennsy!vania ........................ Personal property in Pennsylvania $
Ijrrot domiciled in Pennsy!vania ........................ Personal property in County $
Vrtlue ojreal estate in Pennsy/vania ............................................ ............. $
TOTAL ESTIMATED VALIJE.... $~ GO
Real estate in Pennsylvania situated at: 1`~/ U /'CJ ~.
(Attach additional sheets, i(necessary.) Street address, Post Office and Zip Code Clty, Township or Borough County
~A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) heJshe/they is/are the Executor(s) named in the last Will of the Decedrnt, dated. / ~60 ~ and Codicil(s)
thereto dated
State relevant circmMlances (eg. renunciation, death afrxecuror, etcJ
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not many, was not divorced, was not a party to spending
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 bom or
ado ed; end 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)
e t.a., d.b.n., d.b.n.aLU., penden!e life, durunte absentia, durunte minoritate
If Administration, c.ta or d.b.n.c.t.o.,
Except as follows: Decedent was not a parry to a pending divorce proceeding wherein the grounds for dive
in 23 Pa. C.S. § 3323(8) 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 WiII and was survived by the follo~
additional sheed~, iJ'necessury):
establ"iS`Red as
G
r Z
N
Forrn RW-01 rev. 10// 1/1011 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COU~7TY OF
}
} SS:
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201;?JUN-8 AMiI~ 25
Petitioner(s) Printed Name Petitioner(s) Prin
cL~ ~ 9 + I S I,h' S T V ~E P-
A
~ss`37
The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are we and co:rreci to the best of the knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the Dec Petit will well and truly aJminister the estate according to law.
Sworn to r affirmed and subscribed before e,~~i ij-~.~,~~,.~.~ Date/ ~~~~j
m i da of JvVt_ ,~2 ~' -"'~ ' ~~-
Da[e
y: ,_~
Date
a the Register Date
BOND Required: Q YES ~NO
FEES:
^O
('
~
Letters ................. ..... $
'
( ~~ )Short Certificate(s). ..... hf ("~
( )Renunciation(s).... .... .
( )Codicil(s) ........ .... .
( )Affidavit(s)....... .... .
Bond ................... .....
Cominissio ........... . . ..
Other ~_,,, ,,,,, I~
Automation Fee.. .
JCS Fee . ...............
..... ~ L
TOTAL ................ ..... $
To the Register of Wills:
Please enter my appearance b;y my signature below:
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate of 1 (~U\',~~,~~,r Gyt~ File No: ~ I IO( - (7 ~~
a/k/a:
AND NOW, 4
satisfactory proof having been presented before me, IT
are hereby granted to
the instrument(s) dated It CJN
described in the Petition be admitted to probate and filed of
ForuiRW-Ol ree !0/11/207/
O in co tiler tion of the foregoing Petition,
that Letters °~
~I C/L: J ~.
in the above estate and if applicable) that
as t e last Wi (and Codicil ) ecede L
'o ils ~ ~
Page 2 of 2
WARNING: IT IS ILLEGAL TO ALTER 1fHIS COPY OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAIPH.
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(~C~~- ~ `~ 1..17fiA1_ REGIS'YFtQ,If w L Ei;~11f=1r; ~ ~13:,~ OF [lE,a7t~f
2012 JUN -8 AH ~ ~ ~ 25 ....,
~~~ ~ _ _-
`~I~ a 9 0,~„ nis ce r roe
tln.. ~'&.. .i. _.-
Name of Decedent__.- _Pauline Umberger
;; ~ ,.
Sex -F~e __.___ Social Security No. _____ -174 - 24 -348$ _ __ _ Date of Death __05-22-2012
Date of E'~irth __QZ-~=1919-. - _-- Birthplace__-. Windber,__Pa. -____ __ - __ _._ _ _
F'tace of .Death _~EetLRidQP V; llaoa __ ~~rlg~
N ' 1 e Pennsylvarna
_, ~,;,~ ,;;,; ~ ~,~Un. , .~,~
Race i~h1Le_ _- __ Occupation Hmm~maker_ __ - Arrned Forces? (Yes or No) No _
Decedent's
Marital Status _ Wi dowed _ _____ Mailing Address__ 2$~._Re~S~?4od .LBriQ~-Sdr11S1~~_~ 1701_
~,~~~~ <~,.~,~ ,_~~ r,rv., sa _...
Informant -..-Pdu1.._.P141!1311__.------ __ Funeral Uirecfa-_ 0•_-$~Lll1_~C€rS_.___.-__- _._. .-.
Name and Address of
Funeral E[stablishment_ _Akers._Funeral I-brtte 294_.$3y_3Y4I4[1-I~ad.~.F.1?~L2tta_.P~._1~$~7 ____ ____
Interval Between
Part I: Immediate Cause Onset and Death.
(a~
(b)
_- Cnngec ,v Heart-_Eailure-_
(d) -- - - - - _-- _
Part II: Other Significant Conditions
Manner of Death
Natural X; Homicide i I
Accident Pending Investigation ,_,
Suicide Could not be Determined f I
Name and Title of Certifier. _ - _ Tlarr '
(M.D.. p.CL; Coroner, M.E.)
Address ___ -- _ -- -.,_ f0 Ri$ S~rigg Rnad _PIESZSSZlllfl.~__P3~.
~~_- - --
This is to certify that the information here given is correctly copied from an original certificate
of death duly filed with me as local Registrar. The original certificate wi'J be torwarded to the
ata're Vitai Record> Oftice tor' permanent filing._~ /~ /
~, ~~.,~ ,,,w~~~,,-
Describe how injury occurred:
Be it remembered that I, Pauline Umberger, of 286 Redwood Lane, Cazlisle,
Pennsylvania 17013, being of sound mind, memory and understanding, do make, publish and
declaze this as and for my last Will and Testament, hereby revoking and making null and void
any and all wills and testaments or writings in the nature thereof by me at any time heretofore
made.
First: I order and direct the payment of all my just debts and funeral expenses as soon
as conveniently may be done after my decease.
Second: All the rest, residue and remainder of my estate, of whatcsoever nature and
wheresoever situate, be the same real, personal or mixed, I give., devise and bequeath to my four
children, Paul Plovish, Barry C. Umberger, Sandi K. Sherba and Allen J. Umberger, share
and share alike.
Third: In the event that any of my children shall fail to survive me, I direct that his or
her shaze shall go to those of my children who shall survive me, share and share alike.
Fourth: I name, constitute and appoint my son, Paul Plovish, as the Executor of this,
my Will. In the event that my said son should, for any reason, fail to qualify as Executor, I then
name, constitute and appoint my daughter, Sandi K. Sherba, as the Executrix of my Will and
direct that neither of the above-named fiduciaries shall be required to post bond.
IN WITNESS WHEREOF, I, Pauline Umberger, the Testatrix, have to this, my Will,
written on one sheet of paper, set my hand and seal this_ 24`" day of November, 2004.
Pauline U g --~-.
Signed, sealed, published and declared by the above-named Pauline Umberger as and
for her last Will and Testament in the presence of us who have hereunto subscribed our names
in the presence of the said Testatrix an~f each o~r.
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Commonwealth of Pennsylvania
County of Bedford, ss:
I, Pauline Umberger, 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 instrument as my Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by Pauline Umberger, the Testatrix,
this 24"' day of November, 2004.
Commonwealth of Pennsylvania
County of Bedford, ss:
LORI R. PRflCE, NOTARY PUBLIC
BEDFORD BOROUGH., BEDFG~RD CO.
IAY COMMISSION EXPIRES JAN.24, 2006.
We, John B. Koontz, Esquire, and Debra J. Brough, the witnesses whose names aze
signed to the attached or foregoing instrument, being dul qualified according to law, do depose
and say that we were present and saw Testatrix sign andyexecute the instrument as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was
at the time 18 or more years of age, of sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed before me by John B. Koontz, Esquire, and Debra
J. Brough, witnesses, this 24"' day of November, 2004
LORI R. Pn R OAE, INOTggY PUBLIC
BEDFORD 80ROUGH., BEDFORD ~
MY COMWIISSIDN EXPIRES JAN. 24, 2006,