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HomeMy WebLinkAbout07-18-12Reset 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, a 1 tes for Letters as specified below, and in support thereof aver(s) the following and respectfully request(s) the granp f Letters in the appropriate form: Decedent's Information Name: MARTHA M. GIBNEY a/k/a: a/k/a: a/k/a: Date of Death: JULY 5 2012 File No• ~ l - - (Assigned by Register) Social Security No: 204-03-7069 Age at death: 91 Decedent was domiciled at death in CUMBERLAND principal residence at 870 OVAL OAK CIRCLE MECH.4lvrreR- ro ounty,~pF.NNSYr yANIA (State) with his/her last Street address, Post Office and Zip Code ~~~ Decedent died at SF.I.FrT en~r~ ~ r T~, ,.,,.,,,..,, . _ _ City, Township or Borough Street address, Post Office and Zip Code ~~...~ ~ii~L 1 /V 1 1 LAMP HILL t Estimate of value of decedent's property at death: City, Township or Borough If domiciled in Pennsylvania ............................ All personal property If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania If not domiciled in Pennsy!vania ....................... . Value of real estate in Pennsylvania ............... Personal property in County TOTAL ESTIMATED VALUE... . Real estate in Pennsylvania situated at: (Attach additional sheets, iJ'necessary.) County County State $ 18 000.00 $_ $- 18 000.00 Street address, Post Ottice and Zip Code City, Township or Borough Count Y A. Petition for Probate and Grant of Letters Testamentar Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated JUNE 22, 201 1 thereto dated and Codicil(s) State relevant circumstances (e.g, renunciation, death of executor, edc.) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not mar divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S Wa3323divorced, was not a party to a pending adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. (g~' and did not have a child born or Q NO EXCEPTIONS O EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c. t. a., d.b.n., d.b.n.c.t.a., pendente lite, 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 com Iete 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. 0 NO EXCEPTIONS ©EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no W ill and was survived by the following spouse (ifany) ap~;heirs (attach additionai sheets, if necessary): Form RW-02 rev. 10/Il/?0/] Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 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 Representative(s) of the Decedent, the Petitioner(s) will well and truly administer the estate act rdi~n~ ~ haw. ,,/~ ~ ~ ~.~~ Date Sworn to or ~~irmed and subscribed before l/ Date Date me this _ day of. ds.! ~-- ~~--- Date By: Fn [ e Re¢ister BOND Required: '~ YES ~ NO FEES: 60.00 Letters ..................... ~ $ 12.00 ( 3) Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) . ........... . ( )Affidavit(s)........... . Bond ........................ Commission........ . Other '~~"'~~ 15.00 WILL ~~••~~~' To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: -,~ 6~~ ROGER~B. IRWIN, ESQUIRE Printed Name: Supreme Court ID Number: 6282 IRWIN & McKNIGHT, P.C. Firm Name: Address: ~~•••••~ Phone: (717)249-2353 5.00 Fax: 717 249-6354 Automation Fee . ............. • 23.50 Email: 7CS Fee . ................. • • • 115.50 TOTAL ..................... $ DECREE OF THE REGISTER File No: ~ ~ ~~~~ ~ ~~~ Estate of MARTHA M. GIBNEY a/k/a: ~'~ ~ ~ , in consideration of the foregoing Petition, AND NOW, ~ IT IS DECREED that Letters TESTAMENTARY satisfactory proof ha ing b ~ presented before me, are hereby granted to ROGER B. IRWIN ES Un he above estate and (if applicable) that the instrument(s) dated JUNE 22 2011 O Decedent. described in the Petition be admitted to probate and filed of re ~ d as the last ~ ill (and Codicil s) ~f- ~ ~ ~ ~~~~ ~ ~ ~ Register of Wills FQrmaw-nz ,-ev. ~n~~~rn~i p~n uJ~~ f ~/ Pa .. ~~~~~-CI ,~M•. ,I..qa ~ ae . - . ~ ~+~ SP,awry- t.~~:. ~Mt !. ~RY bR S'ES `2~6'{1 41 C '%!" i,)I`~ L;CfLf~!Ctst.'. ~~-'.,t il? JU` ~ V ~~ ~V' 44~ ' 1 ~~ .. t . : 6. L .ri_L.' _ ('~p tJ[ll~ l H'dV J v~/ V ~ T (~1N16ERLAND CO.. PA~ ~I~ t'~ _ ~~ `I ~ .~ ! , _ ___.. -___ ( Lltlili L r1I1 ~tilt'714~~?- __ A • DEPA0.TMENT OF HEALTH • VITAL RECORDS COMMONWEALTH OF PENNSYLVANI pe/Print In CERTIFICATE OF DEATH state FileNDmner. em Black Ink sgRlxl t L 2. Sex l 3. Social S<curiN Number 4. Date of Death (M2o/O,a2 r)!Spell Mo! July 5 , aa 1. Deceden's Legal Name lFVss,Mmdle, Martha M. Gibney Date of Birth IM°/D 6 fema ay/Year116pe1 204 1 Month) -03-7069 tY ,a. eirthplac s , Country) h . Ba. Age~tast Birthday IYrsl Sb. Under 1 Year Sc. Untler 1 Da Hours Minutes 17 1920 t fl ld l Towns , Months DaYS ]b. Birthplace ICounN! 91 Allgus n a Towns~p~r Al1Pl1 -t`s'p~ Residence I6treet and Number -Include Apt ND.1 8c. Ditl ) 8b nt C . ou ry 8a. Residence (State ar Foreign decedent Ilved 870 Oval Oak Circle /bDrD i . ty mna Df t ^NO, decedent ('wed within li ga. Reamena!cDgnrvl Be. Residence (Zip Coael Cumberland Widowed 11 6urvivin8 Sp°use's Name Ilf wife, give name poor to first marriage) 9. Ever in USArmed Forces, SO MaritalCeatus at Tim^eNCDea~h 1P^Marrie^d Unknown ^ V<s N" ^ Unknown ^ Div°r 13. Mother's Name Prior to First Marriage (Firs[, Mledle, Lastl 12. Gather's Name (First, Middle, Last, Suffix) F]111i1a Jane Rltner Cla on Findle Informant's Mailing Address IStreet and Number CIN, sta[e,jip CDtlel PA 1705 14c 14b. Relationship to Decedent ma"'''Name f a l . anic , 4600 Cree•Aview Rd., Met b n pr 1 a. niece a Mary Jane Blazer' Ssa. Place D Deat ................ o lt .....u..De .................... ........... w c ec om Dne I _ ceaem. Home .................X......1.............................. c v u Cy~iio~ci~e Fa ......................... ~5t .. ............ed . ~ ...................... ;e Deam oahmm somewhere other Than a HDaDitat. G ..._ Inpatient D[ner (SDeciN) i l Qa : vq ta ¢_ II D lh Occu a Hosp NurSin Home/LOng~Term Care Facility ^ nt ^ Dead on Arrival ^ g lsd. COVn 10 h ti ` ~ e ^Emergency ROOm/OVtpa a dZi Cotle ISC. CIN or Town, State, P CVm f9er~and Facility Name (lf not Instltu[len, give street and number; PA 17011 156 Hill C . , amp Select Specialty Hospital Place o(Oisposi[ion (Name of cemetery, crematory, or other place) 16c 16a. Method of Disposition ~ Burial ^ Cremation 16b. Date of Disposition 2 . lling Green Cemetery R ~ ^RemDyalo-pmstate ^oDnati°" July 9, 201 o ^ Other !speclNl and Zlpl l,a. Signature of Funerals t S erment ce licensee or Person In Char 12b. License Numbe. 011667 L e, la 16d. location °f Disposition IEIN or Town, d Camp Hill, PA 17011 ~ g „° NameanecgmDletenaareuprFUneralFacultv 8 Market Plaza way, ehani sburg, PA 17055 e mm<ate w at ft ezzi Funeral Home, MDe ~ ~ l M e n p a Ofe nitnuu p e decedent c°nameree m ' e e a m t ~y etner me dereaenl w lg. Deceae e at boa des<. , Ea l e me rime p~eeam. box r,cnpokcomplerea a "N l h " Wh11e ^ ° p e eve nlghest degree or is 60anish/Hispanic/Latino. Check t III Vietnamese fHCan American ^ /lalino ^Black or i l s H n es c ispan ^8th grade °r bor if decedent is not 6panish/ Other ASlan hn° ^ Ame i Indian or Alaska Native ^ 9th 12th grade /L l oma, a ^ No dip ryp opt SDanish/Hlspamc ®Nigh school gratlua[eor GED COmDleted CHlcano ^Asian Indian ^Na[Ne Hawaiian xican American, manian or Chamorro . Mexic ^ o ^ v l ^ Chinese ^ 6om college credit, but no degree o Ri an Bam ^ oan ^ Cuban ^ Filipino Associate degree !e.g. AA, Asl , ^ Other Pacific Islantler ^ Ye s ^ Bachelor's degree (e.g BA, AB, BSI M9W, MBA( ^ Ye Omer spanish/Nlspanic/LdlmD ^ Japanese MEd MEn M '- , g, 6 ^ Master's tlegree le.g. MA, ISpeci ^ Other IspeciNl - _-- --' -- ree N) l de g _- - ^Doctorate (e.g. PhD, Edo) or Professiona Decedent's Usual Occupat -Indicate Npe o 23a . .. M0, 005 DVM Lle, IDI Race sell~0esl -Check ONLY ONE to'mdicate what the decedent considered himself or horse)) to be done during most of working Ilk^ DO NOT USF R gnation l l ' e n s S g 21 Decedent Samoan ratO hairdresser/owner ope ^,apaneae ^ p wrote ome, Pacific l,la~~eer ^ ^ Black or African American yletnamese ^ Don't Know/No[ s°re 32b. Kind Of Business/Industry rican Indian or Alaska Native ^ Ame 0 Other Asian ^ Refused beauty shop ian Indian if A a ^ s ^ Native Hawaian ^ omer Ispec ^ Chinese ^ Guamanian or Chamorro ^ Fnlpmo appllcablel nature Pers Pron°uncin De Ih( Si 23 3 License an~ea76ij er ITEM523a-23d MUST BE COMPLETED 23a. Date Pronounced Dead IMO/Day/Yr) RSON WHO PRONOUNCES OR -/I~ 1'Z ~ g . Cl~l~'~~~ a>J y76851 gY PE ERTIFIES DEATH ~ ~ C 2d. Time of Death 23d. Date Signed IMO/Day/Yr) Z~ ~ No 5 a etlical Examiner or Coroner Contacted, ^ Yes C! ~ CAUSE ADDroximate OF DEATH Intervar. or complications-that directly tau d [he death DO NOT enter terminal events such as cardiac arrest Aea aedaional Imo: a n«eaary ~i onset tD Deam Injuries on a Imo diseases t , . , s-- oo Nor ABBR6VIATE. Emer only one caDae 26. part I. Enter [he chain of even ithout showing the etiology f ~_ w respiratoryarrest, or ven[ncularfibrllla /}(pn I . . ' IMMEDIATE CAUSE ~~- ~----' Due to Dr asaconsequence of): (Final disease or condition {~/ In death) ~~~ ~~'~ -r ltin ~\ C'Y « _ - resu g b. Due to IDr asaconsequence of)-. ondltlons ll Il t , y s c Sequentia If any, leading tD the cause ~ r / / - Ilstetl on line a. Enter the ~ pve t° 1°r as a co seq <e °f)'. UNDERLYING CAUSE _ lalaease primDry mat - d nitlatetl the events resulting -~ DuemlDrasacDn quence oft' - t _ in tleath! LAST. 2,. Was an autopsy performed? t to death but not resulting in the underlying cause given in Part I ^ YeS ^ No 3fi. Part II. Enter other ' If t dl I t b 2g. Were auropsY Rndings available _ to tom Dlete the cause o! death, 4 ^ Yes ^ NP lf Oeatn ^ Hpmiciee 30. Dld Tobacco Use Contribute to OeathP 31. Ma atura u 19. If Female'. ^ Yes O ^ Accident ^ Pending lnvestlgallon a y n Unknow o ^ NDl OreBnant within past ye r ^ No ^ Suicide ^ Could not be tletermined h ^ Pregnant at time of deat ^ Not Dregnant, but pregnant within 42 days of death Date of Inlury IMO/Day/Yrl )Spell Monlhl 32 . 33. Time of Inlury ^ Not Dregnant, but pre8nan[ 43 days to 1 year bel°re death ^ Unknown If pregnant within the Oast year 35 Location of Inlury IStreet and Number, Clty, Stale, Zp Code) 34. Place o(Inlury (e.g. home: construction site: farm, school) 38. Describe Haw Inlury occurred 36.Inluryat Work 3]. If Transportation Injury, 5peciN ^ Ves ^ Driver/Operator ^ Pedestrian ^ No ^ Passenger ^ Other l6Peci Nl . -- 39a Certifier (Check only oriel. death occurred due to [he causelsl and manner stated [r]'E rtiNlnB Dhysician - T° the best °f my knowledge, d [ me useli) and manner stated cu tl t h h d pl h t r l c ° d U / a h o oc t'e ca to and due and place date ^ Pronou g & C rt N n phy io me. b y f yo^ owledge deat me t d at tne 0 th b I xj - rid/or rives[ Bat on P _ - n ~ e• l E /~rFa r ~ b ' ~s ^ Med ca / / yG( ///, i i I f rtfer.~ Lcen Signature f fl e se Num 39<. Date Signed IMO/DaY/yr) Address and Zip Code of erson Co pleting Cause n each (Item 26) ~ 39b. Name, n/ "k ' l ~ / ~ 1! rl ~ / / ~ -y. ~ ~ / ~^ 42. Registrar F Date IMO/Day 1 00. Registrar s DlitrlR Number 41. Regls[r is Signature t i' ~ ~ O ('I~ L J ~. ! ? ~ z W 2. c~ ~> H1Dh-143 B ~ L l L~ / ~' 0.EV 0,/3011 Dispoahon Permit No. / r.~ :~ _~ i--' r~ f _i. ~~ 4 ~ + YM1 ILL AND TESTAMENT ©~;.~- ~ ` =' LAST W fir- ~ - _ `'' CR`i •~i I, MARTHA M. GIBNEY, of Upper Allen Township, Cumberland Cody, do hereby make, Pennsylvania, being of sound mind, disposing memory and full legal age, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. 1. I direct my Executor or Substitute Executor, as the case maybe, to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Executor or Substitute Executor from my estate, and that none of the aforesaid taxes shall be prorated among those persons named herein or are otherwise beneficiaries hereunder. 2. My Executor or Substitute Executor may, at his discretion, compromise claims, borrow money, retain property for such length of time as he may deem proper; lease and sell roperty for such prices, on such terms, at public or private sales, as he may deem proper; and p invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor or Substitute Executor to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My Executor or Substitute Executor is authorized and em owered to engage in any business in which I may be engaged at my death, for such p period of time after my death as seems expedient to said Executor or Substitute Executor. /~3~ 3. I give and bequeath certain items of personal property according to a list left with my Executor or Substitute Executor. 4. I give, devise and bequeath ah_ the rest, residue and remainder of my estate of whatever nature and wherever situate as follows: a. Ten Percent (10%) to MESSIAH VILLAGE, Mechanicsburg, Pennsylvania; and b. Ninety Percent (90%) to be divided in four equal shares as follows: (1) One-Fourth (1/4) to GARRY HOSLER, and if he is not living at the time of my death, his share shall go to his wife, NANCY HOSLER; (2) One-Fourth (1/4) to CURTIS HOSLER, and if he is not living at the time of my death, his share shall go to his wife, DELORES HOSLER; (3) One-Fourth (1/4) to MARY JANE WEAVER BLAZER, and if she is not living at the time of my death, her share shall be divided in equal shares among the surviving beneficiaries named in Paragraph 4(b) herein; and (4) One-Fourth (1/4) to JACK DENNIS, and if he is not living at the time of my death, his share shall go to his wife, EMMA DENNIS. 2 5. I nominate and appoint ROGER B. IRWIN to be the Executor of this my Last Will and Testament. In the event he has predeceased me, failed to qualify or is not able or does not serve for whatever reason, I then appoint DOUGLAS G. MILLER as Substitute Executor of this my Last Will and Testament with the same powers as are given to the original Executor hereunder. 6. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. '7. No Executor or Substitute Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 8. No beneficiary may assign, anticipate or pledge his or her interest in any income or rind al held or distributable hereunder, and no beneficiary's creditors may levy, attach or P p otherwise reach any such interest. 9. If any person entitled to share in any distribution under the terms of this my Last Will and Testament becomes an adverse party in any proceeding to contest the probate of this Last Will and Testament, such person shall forfeit his or her entire interest inherited hereunder and all rovisions in favor of such person shall be declared void and of no effect. The share of such P son so forfeited shall be distributed as part of the residue pursuant to Paragraph No. 4 hereof, per 3 except that if such person is entitled to share in the said residue, that interest shall be distributed proportionately to the other residuary beneficiaries. 10. I hereby suggest that my personal representative retain the services of Irwin & McKnight, P.C. as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 22°d day of June 2011. .,._ , ~ ~ ~ ~ ~'I ~..•~._~r,_(SEAL) 1 "~j~% t ~~- F MARTHA M. GIBNEY Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other have hereunto set our names as subscribing witnesses. /~ G( {. 4 ACKNOWLEDGMENT AND AFFIDAVIT WE, MARTHA M. GIBNEY, KAREN S. NOEL and SHARON L. SCHWALM, the Testatrix and 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 she had signed willingly, and that she executed it as her free and volunt~:ry act for the purpose herein ~:xpressed, 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 of their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. MARTHA .GIBNEY ! KAREN S. NOE , ,~ ' ' . SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged bef me b eKARMENRT NOEL• an7d HARON Testatrix herein, and subscribed and sworn to before y L. SCHWALM, witnesses, this 22°d day of June 2011. ;'~, otary Public COMMC3NWF~~-`~M ~'~ ~'~NNaY~.VANIA Notarial Seal Roger B. Inuin, Notary Public Carlisle Boro, Cumberland County My Commission Expires Qot. 3, 2012 Member, Pennsylvania Association of Notaries