HomeMy WebLinkAbout09-11-12PETTTION 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 spxified below, and in
support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name: CAROL A. DUBLE
a/k/a:
a/k/a:
a/k/a:
Date of Death: 08/30/2012
FYie No: ~ ~ - /o? - ~~~
(Assigned by Register)
Social Security No: 206-32-1836
Age of death• 70
Decedent wss domicIIed at death in CUMBERLAND County, pENNSYLVANIA (Bran) with his/her last
principal residence at 210 BIG SPRING ROAD. NEW VILLE 17241 WEST PENNSBORO TOWNSIIP CUMBERLAND
Street addnra, pmt Olfteo sad Zip Code CHy, TownYlp or DorayY Coaaty
Decedent died at 210 BIG SPRING ROAD. NEWVII.LE 17241 WEST PENNSBORO TOWNSHIP CUMBERLAND PA
Strati addraa, Pmt /titles sad Zip Code Ctty, Tmnetdp or >IoroaSh Coaaty State
Estimate of value of decedent's property at death:
rjao~ri~ ~ P,tom ............................ Alt paraonal property s S, OQ~ • DO
Ijnot aowierw to Parwsylrarria ........................ Personal property in Pennsylvania S '
Ijnot donrklJsd is PLRtstylvanio ........................ Personal property in County S
Yalne of rw~ mMtr lx Pdtwsylvmtia ......................................................... S
TOTAL ESTIMATED VALUE.... S S O O 0.00
J
Rent estate in Pennrylvaaia situated at: NONE
(Atmch additional sheen, if necessary.) Street addrer, Port Ordee asd Zip Cade City, TowaaHp or Horoa~Y Coaaty
~ A. Petition for Probate and Grant of Letters Teatamentarv
Petitioners) aver(s) he/ahe/they idare the Executor(s) named in the last Will of the Decedent dated 1C.[~ ~ Codicil(s)
thereto dated
State rekvaat eUeamslaxa (ej rsnwnc4afoa, JaedY oftxacrbq sec.)
lxrxpt es follows: after the execution ofthe instrument(s) offered for probate Decedent did not Harry, w~ ~t &w
divorce proceeding wherein the grounds for divorce had been eatabliahed es defined in 23 Pa. C.S. § 3323(g~
adopted; and 1lecedent was neither the victim of a killing nor ever adjudicated en incapacitated person.
NO EXCEPTIONS Q EXCEPTIONS
B. Petition for Grant of Letters of Administration (If applicable)
e.t.a., db.n., db.n.c.t.a.,
rv
c_a
~smta~to
mt liavw chI
m
_. ~
_,
If Administration, eta or db.n.ata, enter date of Will in Section A above and comol~ libt of he
Except as follows: Decedent wes mt a party to a pending divorce proceeding wherein the grounds for divorce had bees estabh~dae'defined
in 23 Pa. C.S. § 3323(g) and was neither the victim of s Idling nor ever adjudicated an incapacitated person.
Q NO EXCEPTIONS Q EXCEPTIONS
Petitioner(s), after a proper search las/have ascertained that Deoedmt left no will and was survivedbytbe following spouse (ifany) and heirs (attach.
additional sheets, ijnecersary):
Forn~ RW-01 ,a,~. iat-nou Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
} SS:
}
OtScial Use Only
AF~COAI~EC ~,~FiCE ~
REG,., .~ ~ ~~, e
Petiti s Printed Name Petitioner(s) Printed Address
GERALD C. STAUFFER tl... `,. j~.
111 COWDEN STREET ELIZABETHVILLE PA '~ T
CUMBERLAND CO., PA
The Petitioner(s) ~ovo-narued avuear(s) or affirm(s) the statements in the foregoing Petition ere true and cortect to the beat of the ]mowlodge end belief
of Petitioner(s) and that, u Personal Representstive(s) ofthe t, theme Pet~i 'oner( will well y administer the estate aooording to law.
Sworn to ored su scri d before ~J22e.Ga( C~~~*~®~~~ Date g' -/d^aG/a
me thi~g~ day of~~~~~~" ~„ o~/~ Date
ay:
For tht ReaiaGer
~_~
BOND Required: Q YES ~NO
FEES:
Letters ...................... S 9U.
(~ •6') Short Certificate(s)...... ~r 0~
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commissio . ; .....
Other ~........
Ta the Rsglster ojWitla:
Date
Date
Pieaae enter my/appearance by my tignatnre below:
Printed Name: HAROLD S.
Supreme Court
ID Number: .29920
Firm Name:
Address:
Automation Fee .............. .
JCS Fee .....................
TOTAL ..................... S
Phone:
Fax:
Etnail:
IRWIN LAW OFFICE
717-243-6090
DECREE OF THE REGISTER
Estate of CAROL A. DUBLE Flle No: n~(' ~oZ - ~6
a/k/a:
AND NOW, ~ ` ..X~ ~ , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, TT IS DECREED that Letters Testamentan+
are hereby granted to Gerald C. Stauffer
in the above estate and (if applicable) that
the instnlment(s) sated _ I«N~ 7,00
described in the Petition be admitted to pr6bate and filed of record as the last Will (and Codicil(s)) of Decedent.
FonnRW-01 rrv.1Q/1l/101I
Page 2 of 2
y,~<,4~~ ~~~. ,o~, „
LOCAL_I~IE~~~~'S CERTIFICATION OF DEATH
WARN~ri~C~i, ~t{T ~I I'~ plicate this copy by photostat or photograph.
~CI~CJ I r h ~ ; .1._~L~
Fee for this certificate, $6.00
P 18628022
2012 SEP I I PM I ~ 2!
~~-'. _ J
ORPHAN'S COURT
(~11BERLANO CO.t PA
/7- ~S~
This is [o 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 will be forwarded to the State Vital
~j'~Record~s O/ffi-c~e for permanent filing.
'--fiO°'t''~~• ~~~~ Ati~ 3 1/2012
Local Registrar Date Issued
Certification Number
rype/PNns In
Pefinenent
el..k Ink
J
C
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF NEALTM VRAL RFCORD3
CERTIFICATE OF ~EATN
ar 4 Fne rvem e
1. Osutlent's La{al Nems (FIraL MI s, LaaL 3uMx) ~ 2. 3sx !. Saclal 3scurhy Number 4. pate M Dss Mo Dry r) (3ps11 Mo)
Carol A. Dub1a emai 206-32-1836 AvguE;ft 30, 2012
3e. Ms-Lest Blnhtley (Yral S Untler S Yser 3c. Untlsr 1 Da 6. Da4 of Blnh (Me Day eer)'f3pell Month) )a. Birthplace (City entl 34te Or Forol{n Country)
•
` )p MOntha Deva HOIJra Mmu4a AuguBt 17 r 1942 @ @ PA
)b. Birth lets (County) '
De. Refl nee (34N Or Fofel un[ry • s S<raet d Nu her- Inr.1{1tl Apt No.] 8c. Did Decadent Llva In • TownshlpT
P@nn®yivan~a l~s.~ g ~pr~ng xJ~
Yss, decedsn[Ilwtlln A]@8t Pennaboro tap-
M. Reeldenu (Zip COae) 1 4 1 ~ No, tlecetlent Iiwd wthln limits of cRy/boro.
9. Ever In S Arm forces] 30. Marital 34tua at Tlme of Dseth Married owe Si. Survivln{ 6pOUte'a Nema (11 w1le, {IYa name pAOr4 Rrat meMe{e)
0 Vet ][j NO ~ Unknown Q Divorced ~ Nwer MBMetl n Unknew
" Richard D. Dub1e
11. ~BtrIB F1~, MI tl~~ ~ r
.~C1 13. Methe NS Name prior t0 First Marde{s (First Midtlle, last)
Eleanor S a de
14e. InlormenYs Nema 146. Raa[lonahlp to Dace snt 14c. InformerR a Mellln{ Atltlre4 (3trest entl Num r C 44 Z del
'
°
Gerald C. stauf Per srother 111 coved en st_ Eli
za
e
~iv i'e ~@
-
M uee4 OtcDrredSn a HOa '-- ••. ... ••••••••• ... .. ... .......... ... ..
phd: t~ Inpeaent If Death O[wrretl Somaw ere Other Thin a Hosphal: [] 1JOaplu Fedll<y '~ Decedent's Home
Ems en. Room Ou. dent Deed on Arnwl Nuraln Home/LOn -Term Cera Facility Other (3peclfy
13{}, r ®Hy n m 1 ~~natllvtlPrr. Wast~riRt~tl numbsN
Ci @ B V 111 y 15~~[~T~u~n~~s, ~~Ylp ~ot~k2 4 1 13d. County o Death
Cumberland
~, lSa. Method of Dlapoaltlon BuHal <rsmatlon 166. Da4 of Dlspeeltlon i6c. Pleee of DlapealtlOn (Nama o csmatary, crematory, or other p ace)
~ RsmwH from 3t14 Q Donation
er Cre
8/31/2012 Hollin
t
Otbr a g
ma
ory
16 . l.odtlon of D spoalt on City or Town, 344, entl Zlp) 1)e. Slime ra o Funeral 3ervica Llcsnsee or person In Char{e Of In4rtnent 1)b. Llums Number
Mt. Ho11y Springs PA 17065 FD 13895 L
1)c. Name and ComPls<a Addrsas of Funara11ac11
E er Fu
l H
~
15 Bi
i
-
y nera
om@
nc
g Spr
ng Ave
ewviiie, PA 17241
SB. Decedent s E ueetlen - Chec eha box that aa< dsacrlbsa the 19. Den ant Of Hispanic Orl{in -Check the 20. Decadence Reu - C eek ONE OR MORE rows to In Ica4 whet
hlBhsat ds{rse or level of school comple4tl e[ the Ume oT tlseth. hex that best daacrlbsv whether the tlecstlent the tlautlant conalderad himaalf or hsreell to be
~ 8th {4tle or lase Is 3penlah/Hispenle/Le[in0. Check the "NO" Whha 0 Korean
NO diploma, 9th - 124 {rode box If ds<edent Is not 3penlah/HHpenlt/lafine. Q Black or A/dean Amerlwn Q Vletnamees
NI{h school {raauete or OED completed Ne, nef 3penlah/HlePanlc/Launo Q Amerleen Intllen or Alaalu Natlw ~ Ocher AsNn
30ma eell
e wtlR
b
t
tl
y
,
no
u
a{rss Yas. Mexican, Mexleen Amedun, <h14no ~ Pulan Intllen 0 Natlva Hawaiian
Q Aeeoclete dyroe (e.{. AA, A3) 0 Yaa
Puerto Rlcen
,
<hlnaaa
BFMaor'a tls{roe (s.{. BA, AB, B3) Q Vey Cuban ~ Q Ouamanlan or CMmorro
O FIIIPlnO
Q 3emoan
~ Maa4r'a tle{roe (e.{. MA, M3, MEn{, MEtl, MSW, MBA) ~ Yas, other 30anish/NlsPanlt/Latino ~ la Panasa Q Dthsr PeclRc Island
er
Dowreb (a.{. PhD, Etl D) or Pro4vlonel de{rea (Specify] Q Other 13psclTy)
e. . MD DOS DVM LLB JO
Z3. Dece ent'a sin{le R{CO Self-Deal{nKlen - Cha<k ONLY ONE to Indice4 whet the aacadent conslderea him4H Or hsrxeH to bs. 22y Dewden['s Usuei Otxupetbn - Indl4ta type p work
W
hha Q Jepanue 0 Samoan tlons duFln{ mosiof workln{ Ilh. DO NOT USE RFTRED.
Sleek OrAMUn American QKOraan OOeher P.clnc lalantlar~ Secretary
Q Amerlun Intllen or Aleake Natlva Q Vistnamue D Don't Know/Net Sure
gelen Intllen 0 Other AFlen Q Refuaatl ~ 22b. Klna of Bu~t~tInca Indurtry
~ chinete Q Natlva Hawaiian Q Other (3Peclfy) i
t
i S
J3
o r 1 o a
O C i@ t
0 Filipino Q Buimanlan er Chemerro y
I - M e. •<e pounce ee MO OY r 2 1{nHUre o n r nouncin{ Death On Y w en iPP o c. L cen4 Num a
r
BY P{RBON WNO PRONOUNCES OR
Od LSo .4oi 2
CB
T
-
.
R
I I
~
~4/.R'-/4s/
23tl. Oa Ellms Mo Dey r) 24. Time Death
•~~ .y - ~~ 23. Was Mstll xemlMr or Coroner Can4ctstlT
O Yee Ne
CAUSE OF DEATH
Approxlmm
26. Pan L Enter the than m avant _ISOaey Injuries, or compllutlpna-the[ tlirac<ly ceuaetl the tluth. DO NOT sn4r terminal events such a eerdlec arras[ In4rnl:
raapl4tory erree<, or wntnculer flbrllletlon wl[heu<ahe
w
lnt the atlolo{y. DO NOT ABB`NIATE. Enter only one cauaa on • Ilns. Add addltlenal Ilnef N netauery Onaat LO Oseth
(
~
IMMEDIATE GU3E -----> e. _ Y'C-~ ~ ~ ~~ S' Ck. -S
(Final dlpeaa or condition Dus [o (or as a consequence of):
resuhln{in tlseth)
b.
segWntlally Bat contlitlona• DW to for ea • cervaquanca of):
If anY. leadin{ co the uuae -
Ila4d en IMe a. Enter tbs
c
UNOBRLYINO GU{E
Dua to (or ase consequence ef):
(tllasaes or lnJurythe[
InRIB4a Ma wants resultlna d.
In death) LAST. Due to for as a cense0usnce ef):
26. P{R 11. Enter eMar alanlRcan[ cendl<I t Ib 1 S th bqi not resultin{ In She untlsrlyln{ cause {Ivan In PaR I 2). Was en autopsy performed]
Yes No
- 2{. WKe eu[eDq• findlnp wallah s
[O wrdple[a the uuas oI deathT
~(
~t Yea Ne
19. IT Female: 30. Dld Tobeceo Usa Con[ribu4 [O Ose[hT 31. Manner OT Deetn
9 Q Not pre{nan[wlthln past year Q Ves Q Probably Natural
Q ~ Momicitle
~ ~ Pro{pant et time of tlaafh
~ Not PrsfnanL but Pra{pant wlthln 42 tlen of death Q No Q Unknown Q Aocltlent Q Pantlin{ Inwal{etlon
1= Q 3ulcltls Q COUItl not DO tlaNNRlnaa
Q NM bra{neut. but pre{pent 43 tleya to 1 year before death 31. Date of InJury IMe/Day/Yr) (3pel Month)
Q Unknown If Pre{pent wlthln the Pe+t Year 93. Tlma o InJury
34. P ace o1 InJury (a.{- hams; construction aHe; 4rm: scheeH 95. Location of InJury (3treet entl Number, City, 34te, Zip Cede)
3p. InJury et Werk 3). If Tranaponatlon Injury, Spaclfy: 36. DeacHbe How InJury Occurratl:
0 Yas 0 DrWer/Opan[or Q Patlestnen
Q No Q Paafan{ar Q OMar (SPacl/y) _ '
39e. Check only one):
snHyln{ phyaclsn • To the beet of my knovReafe. tluth oeeurrstl aua In [hw esuae(a) end manner s[s4d
O PronounelnB `Gniryln{ Physician -TO tM beat e/ my knewlad{e, death occunatl a[ the tiny tlete, entl plea, entl due to <M1a uuM(al end manner a4[ea
Q Matllcal Ewaminsr/Coroner - O sis Of axaminenen, one/Or Inws[I{aeon, In my opinion, tleeth occurre
d
et Me nme, tla<s, end vlau, and due tp the uuae(a) ana m nsr s44tl
n
/
i
3lfnature of unlRsr: TItN of csr[ITar: Ff/) - L / Licsnsa Number. ~~~ 0 ~/S
~~
396. Nems, A rNa and SAp Code non mOle[In{ Ceuae o} Ossth (Item 26) 39c: Data 31{netl (MO ey/yr)
~ 3 / Z~
. Re{ Kr ct um ar 91. Re{ offer lure
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43.Amantlmenta
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LAST WILL ~ ~ - ~"~= -n
D ~" N ~~
~ ~
tt`
CAROL A. RUBLE
I, CAROL A. RUBLE, of the Twp. of Lower Mifflin, County of Cumberland,
Commonwealth of Pennsylvania, being of sound and disposing mirxi, memory and
understanding, do hereby make, publish and declare this my Last Will and
Testament, hereby revoking any and all wills and corriicils thereto by me at
any time heretofore made.
ITEM 1: I direct that my Executor hereinafter named pay and discharge
all my just debts and the expenses of my last illness from the assets of my
estate.
ITEM 2: I give, devise and bequeath any and all vehicles, household
effects arri other tangible personal property, including cash or securities,
owned by me at my death, together with all policies of insurance thereon, to
my son, Raymond P. Kasprowicz, Jr., or the survivor or survivors of him, in
as nearly equal portions as is practicable.
ITEM 3: I give, devise and bequeath the residue of my estate, of every
nature and whetever situate, to my son, Raymond P. Kasprowicz, Jr., or the
survivor or survivors of him, in as nearly equal portions as is practicable.
ITEM ~: I hereby appoint my brother, Gerald C. Stauffer, Sr, of
Berrysburg, Pennsylvania, as Executor of this my Last Will and Testament.
ITEM 5: I direct that my Executor shall not be required to post security
in any jurisdiction.
ITEM 6: I further direct that said, Gerald C. Stauffer, Sr., shall be
paid an Executors fee of five percent (5~) of my gross estate.
IN WITNESS WHEREOF, I have hereunto set my hand to this, my Last Will
and Testament consisting of o2- typewritten pages, this 777~~day of
2004.
Lpi,
O~ CAROL A. RUBLE
Signed, published and declared by the above-named Testatrix, Carol A. Ruble,
as ark. for her Last Will and Testament, in the sight and presence of us, who at
her request, in her sight aryl. presence, and in the presence of each other, have
hereunto subscribed our names as witnesses.
Address
y
Address ~~~g ~
~0.~„v~ 1 ~t RQ- law/
Commonwe of Pennsyl 'a SS.
County of Cumberland
i
I, Garol A. Duble, Testatrix whose name is signed to the foregoing instrument,
having been duly qualified according to law, hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly;
and that I signed it as my free and voluntary act ~for~the purposes therein stated.
/~~~'~_
Tes atrix
Sworn to or affirmed aryl acknowledged before me, by Carol A. Duble, the
Testatrix, this day of ~ ~~- , 2004.
irv ~ y ultc
Commonwealth of Pennsylvania SS . Ruch D. Cotderrii , No~ty Pul7lla
County of Cumberland Newvitle Boro, CumhsAend Cou~i~i -
MyCommission Expkes July a4, ZN+
~ er, Penns~v~ ~~~
We , aryl t)u G IAS K~~a y
the witnes s whose names are signed to the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the aforesaid Testatrix
sign and execute the instrument as her Last Will and Testament; that she signed it
willingly and that she executed it as her free and voluntary act for the purposes
therein expressed; that each of us in the hearing aryl sight of the Testatrix signed
the Will as witnesses; arxi that to the best of our knowledge the Testatrix was at
the time eighteen (18) or more years of age; of sound mind aryl. urrier no constraint
or undo influence.
Sworn to or affirmed and subscribed b.,_„~„ .,.., .,,
Witnesses, this ~ day of , 2004.
~~ ~ _.
f~oterlal Seal
Ruth D. Coldyrnith, Notary Pd7M0
Nevwifle Boro, Curn4elentl Co
iNy Commission Expires July 2b,
- _.,,,~,,,.,~rNntarie.