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HomeMy WebLinkAbout09-20-12Reaet~ 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 , i. ~ Z -~ O Z Name: Julia Haas File No: a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: Au ust 31 2012 _ Age at death: 99 Decedent was domiciled at death in Cumberland County, Penn. ylvania (State) with his/her last principal residence at 4 mandv Court Camp Hill Pennsylvania Cumberland County Street address, Post Oftice and Zip Code City, Township or Borough County Decedent died at Holy Spirit Hospital Camp Hill Cumberland PA Street address, Post Ottice 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 $ 60.00 If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsylvania ......................................................... $ TOTAL ESTIMATED VALUE.... $ 60.00 Real estate in Pennsylvania situated at: (Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough 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 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. •® NO EXCEPTIONS Q 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 c~b.n.c.ta., 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. Q NO EXCEPTIONS Q 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): r•..~ Name Relationshi Addr "~ ; T't . ~ C3 f~'1 '~ ~::~ -~ F. r"'" t"tl ~ ~ ~ =~ ~ ~ _ -r-ti ---~ :. G March 7, 1999 County and Codicil(s) Form RW-02 rev. 10/! 1/201 / Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland ~ SEP 20 PM 1 ~ O1 } } SS: } Petitioner(s) Printed Name Petitioner(s) Printed Address Deborah Po leton 4 Mand Court Cam Hill PA 17011 }~l~J L~U~j The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Dece t, the P itioner(s) ill w it and truly administer the estate according to law. Sworn to or affirmed sub cribed before Date S'-o~G' -a ~ ~~ met day o ~ Date By Date For the Register Date BOND Required: Q YES Q NO FEES: Letters ...................... $ 2[~ •Qd (3) Short Certificate(s)...... ~ 2 C~ ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ....•••• To the Register of Wills: Please enter my appearance by my signature below: Attorney Signatur Printed N e: Gregory J Katshir, Esquire Supreme Court ID Number: 61967 Firm Name: Address: Automation Fee ............... ~J -~V JCS Fee ..................... TOTAL ..................... $ ~5• J~ X0'60 Phone: (717)763-8133 Fax: ,L717)763-9425 Email: xat and cnm DECREE OF THE REGISTER Estate of Julia Haas a/k/a: AND NOW, ~~0d~h.' ,(b n 20 20 f2 , in consideration of the foregoing Petition, satisfactory proof havi g been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Deborah Poppleton in the above estate and (if applicable) that the instrument(s) dated March 7 1999 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. P Register of Wills Form RW-02 rev. 10/!1/2011 ~f ~ Page 2 of 2 File No • 2 ~- l 2- ~ U 2 Q L~~it>~C~'RAR'S CERTIFICATION OF DEATH ~~~:~h'~t~lgal to duplicate this copy by photostat or photograph. X12 SEP 20 PM I ~ 08 - - Fix I~.n thi. certrt'~cate, `~6. 1'!u~ js t(, ckrrhiti' i",~t th)^ Informatjon here sjven js alrre~tl~ c~',)(~i:~.! 1~ro~I~ „)) original Certit~icate of Death ~_~ ;P' ~ Ilul~= ~ilcc! I~i?h ~I-fir ~;~, 1_ocal F2e~istr.(r. Thee origins! ~~1~ ~~~T a(t:fic~~)tp~ ;+~ili (I trur~~asded to the State Vital ~~ ~,r ~1 fl.c.or(Is Otlilc k~la,~)~rj~~i (n)it fili(~g. P 18 8 0 0 315 ~~~J~ ~ _`_s ~ ~ o~ Certification N):mber E_I)cal del=ilrtu• Date L;sued Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS P°r"""°"` CERTIFICATE OF DEATH Black Ink State Flpe Number: ~~ 1. Decedent's Legal Name (First, Middle, Last, 6ufFlx) 2. Sex 3. Social Security Number 4. Data of Death (MO/Day/Yr) (Spell Mo) Julia Haas Female 178-12-0477 August, 31, 2012 Se. Age-Last Birthday (Yrs) 6b. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO/Day/Year) (Spell Month) 7a. Birthplac4 (City a d State or Foreign Country) Months Days Hours Minutes P1tts~ur PA 99 March 26 1913 7b. Birthplace (coffin ) 8a. Residence (State or Foreign Country) Sb. Residence (Street and Number -Include Apt No.) Bc. Did Decedent Live In a Townsh i~p7 Penns 1Van1$ ' l~ ~y'es, decedent lived In tiaiilpLlen fwp. u gd. R.ai (('C~ [y~ ~ 4 Maud Ct . t T C+~) rya`^-' Be. Residence (Zip Code) ONO, decedent lived within Ilmits of city/born. 9. Ever in US yy~~f ed F rtes] 30. Marital Status at Tlme of Death 0 Married Widowed 11. Surviving Spouse's Name (If wif<, give name prior to Frst marriage) Q Yes ~CNO O Unknown ~ Divorced Q Never Married ~ Unknow 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name PAOr to First Marriage (First, Middle, Lart) Michael Kra ak Annie Li hick 14a. Informant's Name 14b. RelaNOnship to Decedent 14c. Informant's Melling Address (Street and N tuber, City, State, Zip Cod<) Deborah leton Da ter 4 Ct. Hi'l PA 17011 a .................................................... .................. .............. If Death Occurred In a Hos Ital: In dent p pa - ,...'...."...•.:....e..~....a.t.... e< on y one " ..'. :If Deafh Occurred Some h<re Other Th°n a Hos Ital: ~ Nos Ice Fa<III ~~-~~ ~-~~~ ~- ~-~~-~~~ ~~ w p p ty ~ ~]` Oeced<n['s Home J Emer en Room/Outpatient Dead on Arrival Nursing Home/Long-Term Care Fa<III[y Other (Specify) ' x 41 15 b. Facility Nama (If no[ Institutlgn, give stre°t and number) 15c. City or Town, State, d 21p Code 15d. County of Death . ~ Hol irit Hos ital Hill PA 17011 Cumberland 16a. Method of Disposition Burial Cremation 16 b. Dale of Disposition 16c. Place of Disposition (Name of cemetery. crematory, or other place) ' Q Removal from State ~ Donatlan other(spe~lfy) 09/04/2012 , Holly er Cremator 16d. Location of Disposition (City or Town, State, and 21p) 17a. Signature of Fun ral SaMCe Licensee or n in Charge of Interment 17b. Ucense Number Mt. Holly Springs, PA ` 014819 17c. Name and Compleq Address of Funeral Facility era-Horner Funeral Home nc. 1903 Market St. Hill PA 7011 ~' 18. Decedent's Education -Cheek the box the[ best descHbes the 19. Decedent of Hispanic Origin - Gheck the 20. Decedent's Race - C eck ONE O0. MORE races to indicate what highest degree or level of school completed at the time of death. box that best deserlbas whether the decedent the decedent considered himself or harulf to be. w Bth grade or less Is Spanish/Hispanic/Latino. Check the "NO" White ~ Korean Q No diploma, 9th - 12th grade box if decedent Is no[ Spanish/Hispanic/Latino. 0 Black or African AmeYlcan ~ Vietnamese ~ High school graduate or GED completed not Spanish/Hispanic/Latino ~ American Indian or Alaska Native ~ Other Asian ~ Soma collage credit, but no degree Q Yes, Mexlea n, Mexican American, Chicano ~ Asian Indian ~ Native Hawaiian ~ Associate degree (e.g. AA, AS) ~ Ves, Puerto Rican 0 Chinese ~ Guamanian or Chamorro ~ Bachelor's degree (e.g. BA, AB, B6) 0 Ves, Cuban Q Flliplno Q Samoan Q Master's degree (e.g. MA, M6, MEng, MEd, MSW, MBA) Q Ves, other Spanlzh/Hispanic/Latino ~ Japanese ~ Other Paclflc Islander Q Doctorate (e.g. Ph O, EdD) or Profeaslonal degre< (Specify) ~ Other 5 1 ( pet fy) . MD DDS OVM LLB JD 21. Decedent's Single Race Self-Dezignatlon -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation - Indicate type of work hits ~ Japanese ~ Samoan done during most of working Ilfe. DO NOT USE RETIRED. Black or African American ~ Korean Q Other Pacific Islander ~ American Indian or Alaska Nstlve Q Vietnamese ~ Don't Know/Not Sure Hom LCer ~ Asian Indian 0 Other Asian ~ Refused 22b. Kind of uslness/Industry ~ Chinese Q Native Hawallan Q Other (Specify) Q Flliplno Q Guamanian or Chamorro OWI1 HOR)e ITEMS 7ga - 2 M ST BE MPL D 23a. Date Pro-pto..unced Dea Mo Day r 23b. Signature o Person Pronouncing Deat On y when applicab e) 13c. License Num er BY PERSON WHO PRONOUNCES OR AU VS\ 3 ` p~,~ ~ ~Z (~ ~ ` CERTIFIES DEATH _ ~ tt.V Rt.- 51R ~ a~ _ 23d. Date Signed (MO/Day/Yr) 24. Time of Death ~~1 , V V5~ ~ ~ ~ ~ -- ~ ~ 1- \ 2S. Waa Medical Ezeminer Or Coroner Gontacted7 ~ Yes NO CAUSE OF DEATH Approximate 26. PaR 1. Enter the chain of events--diseases, InJurles, or complications-that directly caused the death. DO NOT enter terminal events such az cardiac arrest Interval respiratory arrest, or ventricular flbrlllatlon wlihout showin the etiology. DO NOT ABBREVIATE. Enter only one cause on a Ilne. Add addltlonal Ilnes If necessary Onset to Death ~ ~/.9-sou--l•~r ~ ~+'~f^L'tZt/~'7 ~- IMMEDIATE CAUSE ----------> L >-°rcb~ (Flnal disease or condition Due to (or as a consequence of): ~yy resulting In death) ~ /- ]1 s L , b. Sequentially Ilst conditions, ~ c D ( r as~a eq ~~e ooofffJ~~ y~ If any, leading to the cause '171i` j~j )1 ~ / t~~ / ~ ~< ~ ~ / Ilsted on line a. Enter the ` / / f UNDERLYING CAUSE Due to (or as a consequence of): (disease or Injury [hat F initiated the events resulting d. in death) LAST, Due to (o as a consequence of): 26. Part 11. Enter other i i but not resulting In the underlying ea use given in Part 1 27. Was an autopsy perfor ed] ~ ~.. Yes 28. Were autopsy findings available ~ to complete the cause of death] O Yes o 29. If....F.[[em~~ale: 30. Did Tobacco Usa Contribute to Death? 31. Manner df Death ~,.ot pregnant within past year ~ Yes p Probably ~ Natural ~ Homicide t4 ° 0 Pregnant at time of death No known ~ j~iCR O Accident ~ Pentling Investigation ati ~ Nat pregnant, but pregnant within 42 days of death ~ Suicide ~ Could no[ be determined ~ 0 Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Yr) (Spell Month) ~ Unknown If pregnant within the past year 33. Time of IrlJury 34. Place of Injury (e.g. home: construction site; farm; school) 35. Location of Injury (Street and Number, Gity, State, Zilp Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: ~ Yes 0 Driver/Operator 0 Pedestrian $~po 0 Passenger 0 Other (Specfy) 39a. Certifier (Check only one): $G<rtifying physician - To the best of my knowledge, death occurred due to the cause(s) end manner stated ncing St C rtifying physician -TO the best of my knowled e, death occurred st the time, data, and place, and due to the cause(s) and manner scat<d ~ TO~e i cal Examin ~~1~(COr n - On the basis of axsmina Investigation, in my opinion, death occurred at the time, dale, and place, and due to th e ca u s e(s ) d m a nner stated / ~t r~ / y ~ s ~ a ~ ) Signature of certi•(Er,~ Title of certlfle ~ Ucense Number:' - ~'a °~~~IY~ 396 e, Address erytZlpfoda of Person Cos/~pla`Ing Cause of~~ih (Ite ~ ~_ j ~ ~ 1 / /~ / 39c. Date ~n d jpQO/Da ; rl ~ ~u 1._. mot `~~ ..J -'C ~f T /` l _- 40. Reg stray s Dlstrlc[ NUUmber 41. Registrar Slgna ture '. 42. R<gistrir FI a O ate o Da y r / // ~ /~/ / 43. Amendments Disposition Permit No. O7S68O7 H306-143 REV 0]/2011 LAST WILL AND TESTAMENT OF JULIA HAAS I, JULIA HAAS, of the County of Allegheny, Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and declaring null and void any and all wills and codicils at any time heretofore made by me. FIRST: I direct my Executor, hereinafter named, to pay my just debts, expenses of my last illness an y fun8~al r*t , .--; expenses as soon as convenient after my death. cn ~r~ SECOND: I declare that I am presentl ~'iec~to°. `'-1 O -"' _ -,1 ROBERT HAAS, and any and all references in this will the ~grm=<= •~ "my husband" refers to my beloved husband, ROBERT HAAS. ~ THIRD: I give, devise and bequeath my entire estate of my property, real, personal and mixed of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death, to my husband, ROBERT HAAS, to have and to hold the same for his own use absolutely and forever. FOURTH: In the event that my husband should predecease me or fail to survive me by sixty (60) days, I direct that my estate be distributed as follows: (a) I give and bequeath the sum of One 1 Thousand ($1,000.00) Dollars to my daughter, DOROTHY ENRIGHT of Pittsburgh, Pennsylvania; (b) I give and bequeath the sum of One Thousand ($1,000.00) Dollars to my son, ALBERT RUMPLER of Ft. Lauderdale, Florida; In the event that any of the above named pecuniary legatees do not survive me, the gift made above to such deceased beneficiary shall lapse and be of no force or effect, and the amount of such gift shall pass as part of my residuary estate hereunder. (c) All the rest, residue and remainder of my estate and property, real, personal and mixed wheresoever situate, I hereby give, bequeath and devise to my daughter, DEBORAH POPPLETON of Hampden Township, Pennsylvania. In the event that my daughter, DEBORAH POPPLETON shall predecease me or fail to survive me for a period of sixty (60) days, the share that otherwise would pass to her shall instead pass, per stirpes and not per capita, to her natural 2 issue then living. FIFTH: I appoint my husband, ROBERT HAAS as the Executor of this will. In the event of his death, resignation, renunciation or inability to act, I appoint my daughter, DEBORAH POPPLETON in his place and stead. No bond or other security shall be required of any Executor appointed in this will. SIXTH: In addition to all the powers conferred by law upon my Executor and not in limitation thereof, I hereby authorize my Executor to sell any bonds, stocks or other personal property and any and all real estate which I may own at the time of my death, without the order of authority of any Court being required, at public or private sale, upon such terms as may in the discretion of my Executor seems to be in the best interest of my estate. In pursuance of his power, my Executor shall execute and deliver all documents of conveyance, including deeds or bills of sale or any other instruments which may effectively transfer title. I further authorize my Executor to settle and compromise any and all claims in connection with the administration of my estate herein and to do any and all things in his sound discretion, which shall be conducive to the best interest of my estate. It is my desire that these powers be given to any successor to my named Executor. It shall not be necessary for any purchaser to see the application of any purchase money, nor shall any person or 3 r corporation inquire as to the propriety of any such sale or assignment. SEVENTH: All pronouns referring to an executor and the term "executor" shall be construed to mean any person acting as my executor and the gender shall be construed as either masculine, feminine or neuter. IN WITNESS WHEREOF, I have hereunto set my hand and seal at Cumberland County, Pennsylvania this day of ~~~? ~„~ rL.- 1999. J is Haas i 4 The foregoing instrument was signed, sealed, published and declared by the above named Testatrix Julia Haas, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~_ ~ l ~ ~- Name '~ ~'` ~-U +I C ~~~~ ~c ~ ~~~ ~ ~~ ~ ~~ Address ~:~-- Address 5 +~:r co N ~ OATH OF SUBSCRIBING WITNESS(ES) -o __ ~ N ~ ~ ~ : REGISTER OF WILLS - ~ C - s <_~~ -T, CUMBERLAND COUNTY, PENNSYLVANIA g ~ .. ~ ~' ~ o `n ~ cia Estate of JULIA HAAS Deceased ~~ ~r~eg~erp-I~atsirir and Tracy Katshir , (each) a subscribing witness to (Print Name/s) the ~ Will ~ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in her /his presence and in the presence o£ each other. (Signature) 3 Mandy Court (Street Address) Camp Hill PA 17011 (City, Sate, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this of day Deputy for Register of Wills (si 3 Mandy Court (Street Address) Camp Hill PA 17011 (City, State, Zip) Executed out of Register's Office Sworn to or affirmed and subscribed before me this a0 ~ day of ~o~em ~r o~tU/~- ~~~ otary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. /0.13.06 ~~TM~ Y~~ ~~~ ~~~ .~,, r~ ~ ~ ,~~ ~ ~ t OATH OF SUBSCRIBING WITNESS(ES) o~`- ° ~,r "' (~ x 7 REGISTER OF WILLS ~ ~- s ~~><~~w~ COUNTY, PENNSYLVANIA © = ?~' ;_ ;_ ~' ~ o `" ~ ca Estate of _ S~ Z(-`t ~I~"S ,Deceased c.U,f~4~ f~Y [~(S tf r(Z , (each) a subscribing witness to - / (Print Names) the Q Will O Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in her /his presence and in the presence of each other. (Signature) 3 I~/F*roY c~ (Street Address) ~~P N-~c` PA- t`Jolr (City, State, ZipJ Executed in Register's Office Sworn to or affirmed and subscribed before me this oct~ day P _ eputy for Register of Wills (Signature) (Street Address) (City, State, Zip) Executed out of Register's Office Sworn to or affirmed and subscribed before me this day of Notary Public My Commission Expires: (signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. 10.!3.06