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Home My WebLink About11-28-12Reset 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 aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information Name: Alice Irene Garbri~ht File No: ;~ ~' ~ ~ " ~ ~~=~ a>'k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: January 6, 2012 Age at death: 96 Decedent was domiciled at death in Cumberland County, Ply v nia (state) with his/her last principal residence at Forest Park Health Center 700 Walnut Bottom Road, Carlisle PA 17013 Cumberland County Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Forest Park Health Center 700 Walnut Bottom Road Carlisle PA 17013 Cumberland County Street address, Post Office 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 $ 20,000.00 If not domiciled in Pennsylvania ........................Personal property in Pennsylvania $ 0.00 If not domiciled in Pennsylvania ........................Personal property in County $ 0.00 Value of real estate in Pennsylvania ......................................................... $ 0.00 TOTAL ESTIMATED VALUE.... $ 2Q,000.00 Real estate in Pennsylvania situated at: NA (Attach additional sheets, if necessary.) Street address, Post Office 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 Wili of the Decedent, dated 30 November 2005 and Codicil(s) thereto dated State relevant circumstances (eg. renunciation, death of executor, etG) 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. ,~ 110 EXCEPTIONS Q EXCEPTIONS Q 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 u~b.n.c.~a., 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.5. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. O 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,w,,.A I°.. 1 Name Relationshi r s -~- ~' " ~ - ~.,.~. j•"~~ V'im' I y ~~.~ ~ ~ ~ ~w.~ ~ ~°,.d r,.J .~i. ~,~~/ • r~a' M ~~ "~r Iy . w ,..'~d . u { P -'i . ~ ~y++ 1 R` 111i Form RW-02 rev. 10/11/2011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland Official Use Only ter: ~, .~..~ =~' ~ r~ ~ ~ ~_ ~_1 Petitioner(s) Printed Name Petitioner(s) Printed Addr ~~ -~~~ =~~ James P. O'Grad ~ ~,,,~ ~. u. 35 Bella Vista Drive Mechanicsbur PA 17050-185 ~ c~ ~ ~' ~,~~` e:~ ~,..,_,_ .~ . ,:.~. ~.- ~-.,..a Y ,... ~ k «yt ~ ~ ~C~ k.:.~ V The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoin etiti are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the D cedent, the t'ti ne (s) 'll well and truly administer the estate acc rding o law. Sworn to or affirmed an subscribed before ~~ Date ~( ~~ ~~ t G__-- me this- ~ ~ day of Utz ~'/' , ~~~ f~-- Date BY: ' 1 ~1~1 __` Date Register Date BOND Required: Q YES Q NO FEES: Lette ..................... ( ~) Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ....... 1~~~~ ....... Automation Fee .............. . JCS Fee . ................... . TOTAL ..................... $ (~![i ~• ` ~ ~~.°`' `T ~~ ~:~ ,,~ S, ~- a $ --8-98- To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: Printed Name: Supreme Court ID Number: Firm Name: Address: Phone: ~~ ~/~~'~ DECREE OF THE REGISTER Estate of Alice Irene Garbri~ht a/k/a: satisfactory proof having been presented before me, IT IS DECREF~ th t L tters ,~1 ~. /~ are hereby granted to .~ P- /~ in th above estate and (if applicable) that the instrument(s) dated ~"/I7 ~ .~,,;_. ~~ described in the Petition be admitted to probate and filed of record a the last Will and Codicil(s)) of Decedent. ~ ~ ~ ~ l~ ~ Register of Wills File No: ~ ~ ~ J ~ J ~ ~ ~ ~-~- ' ,~v i ~ AND NOW, Q r1~ /}~ ,~}~ /'-" ~ ~ , in considera` o of the foregoing Petition, ~~~ Form RW-02 rev. loilli2ol~ ~ Page 2 of 2 „~yy ; RECORp~C ~~-~~,~. ~,~. .. ,, ~ ~(~a9i,:l::. REGfS ~ ~R ~:E ~~ t s ~ ry a.. - .L j s,. ~WH' ~~ . "4 Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS Permanent ['FRTIFIC'~TF C7F I7FAT1-.1 0 Q Q~ v W O O Q Z 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security NumberJ, 4, Date of Death (MO/Day/V r) (Spell Mo) Alice Irene Garbright Female 141-10-1447 January 6, 2012 Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO/D ay/Year) (Spell Month) 7a. Birthplace (City and S tate or Foreign Country) ~ ~ 96 Months Days Hours Minutes West N2W York, New Jerse , Sept . ~- ~ 1915 7b. Birthplace (county) UriknoWn 8a. Residence (State or Foreign Country) 8b. Residence (Street and Number -Include Apt No.) 8c. Did Decedent Live in a Township? Pd DYes, decedent lived in tw 8d. Re nce (County) 700 Walnut BOttOm Rd. p. Cumberland Se. Residence (Zip Code) ~No, decedent lived within limits of Carlisle city/born. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death 0 Married (,$ Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) ~ Yes [~ No ~ Unknown ~ Divorced ~ Never Married ~ Unknown 12. Father's Name (First, Middle, last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, last) Peter Robert Devery Margaret Smith 14a. Informant's Name 14b- Relationship to Decedent ' 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code) o Jim O Grady grandson 35 Be11a Vista Drive, Mechanicsburg, PA 170 ~ .......................................................... .... -..................-...-............ i...-..-. lSa: Place o Death Check only one).......................... . oc 0 P If Death Occurred in a Hospital: In atient ... .... .... .....- .. :If Death Occurred Somewhere Other Than a Hospital: u Hospice Facility ~J Decedent's Home ~ Emergency Room/Outpatient 0 Dead on Arrival _ ~] Nursing Home/Long-Term Care Facility ~ Other (Specify) w lSb. Facility Name (If not institution, give street and number; iSc. City or Town, State, and Zip Code 15d. County of Death ~ Fo - - m 16a. Method of Disposition ~ Burial $] Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemetery crematory, or other place) p Removal from State ~ Donation Ja 9 2012 Hof fman-Roth Funeral Home & Crematory w Other (Specify) , 16d. Location of Disposition (City or Town, State, and Zip) 17a. i ture f Funeral Service Lice a or Pers n in Charge of Interment 17b. License Number v arlisle, PA 17013 _ 013144E E 17c. Name and Complete Address of Funeral Facility Hoffman-Roth Funeral Home & C ma 2 9 N H m 18. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin - Gheckthe 20. Decedent's Race -Check ONE OR MORE races to indicate what ~ highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. ~ 8th grade or less is Spanish/Hispanic/Latino. Check the "NO" ~ White ~ Korean 0 No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. 0 Black or African American ~ Vietnamese ~' High school graduate or GED completed (~~l o, not Spanish/Hispanic/Latino 0 American Indian or Alaska Native ~ Other Asian Q Some college credit, but no degree ~ Yes, Mexican, Mexican American, Chicano ~ Asian Indian 0 Native Hawaiian ~ Associate degree (e.g. AA, AS) ~ Yes, Puerto Rican 0 Chinese ~ Guamanian or Chamorro ~ Bachelor's degree (e.g. BA, AB, BS) 0 Yes, Cuban ~ Filipino ~ Samoan ~ Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) ~ Yes, other Spanish/Hispanic/Latino 0 Japanese ~ Other Pacific Islander ~ Doctorate (e.g. PhD, EdD) or Professional degree (Specify) ~ Other (Specify) (e. MD, DDS, DVM, LLB, JO 21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work White ~ Japanese ~ Samoan done during most of working life. 00 NOT USE RETIRED. ~ Black or African American ~ Korean ~ Other Pacific Islander ~ American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Ch1ef Of Security Q Asian Indian Q Other Asian ~ Refused 22b. Kind of Business/Industry ~ Chinese 0 Native Hawaiian ~ Other (Specify) Q Filipino ~ Guamanian or Chamorro Insurance Company ITEMS 23a - 23d MUST BE COMPLETED BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH 23a. Date Pronounced Dead (MO/Day/Yr) ~~_ Yl (.t U- f-" C ~ ` ~ O / .2 23b. Sig~of Person Pronouncing Death (Only when applicable) 23c. license Number ~ d. Date Signed (Mo/Day/Yr) 24. Time of Death F-"~' -~ O G s~ ~ _L /'_ ~ CO ~-~ J off- Q ~ ~ O 25. Was Medical Exa finer or Coroner Contacted? Q Ves CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of events--diseases, injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval: respiratory arrest, or ventricular fibrillation out showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset to Death ~J i ( /Al / ~ n C~ , ] ~ ( IMMEDIATE CAUSE ---------------> a. ~}~ ~~ y4 X ~~-~_~ Jam( X .( ~liY~ (Final disease or condition Due to (or as a onseq uence of): resulting in death) b. ~~ Sequentially list conditions, Due to (or as a consequence of): if any, leading to the cause 1 ~ ,, ~s listed on line a. Enter the c. ,Q 7~_Q/y L~~{ ~~, UNOERLVING CAUSE Due to (or as a consequence of): (disease or injury that initiated the events resulting d. ~ V in death) LAST. Due to (or as a consequence of): u 0 26. Part 11. Enter other significant conditions contributive to death but not resulting in the underlying cause given in Part I 27. Was an autopsy performed? Q Yes 28. Were autopsy findings available m ~ to complete the cause o eath? O Ves No v a 29. If Fem 30. Did Tobacco Use Contribute to Death? 31. Manner of Death E of pregnant within past year ~ Yes ~ Prob bly tural ~ Homicide ~° ~ Pregnant at time of death ~ No nown ~ Accident ~ Pending Investigation m ~ Not pregnant, but pregnant within 42 days of death ~ Suicide ~ Could not be determined ~ ~ 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 Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36, Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: ~ Yes 0 Driver/Operator ~ Pedestrian Q No 0 Passenger ~ Other (Specify) 39a. C iffier (Check only one): ertifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated ~ Pronouncing 23< Certifying physician - To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated ~ Medical Examiner/Cor er - On the basis of exam tion, and/or investi~a ti , in my opinion, deat h occurred at the time, date, and place, and due to th e ca use(s) and m a n n er stated ~{ T ~ j } / ^ ~ 7 y ~ Signature of certifier: / V ~Ttle of certifier: 1 J O license Number: ( J.S OOS / I [J ~ 3 .Name, Ad ess and Zip Code of Person Com pletin Cause of Death (Item 26) /~ 39c. Date Si ned (Mo Day/Vr) 1 S- ~~- ~W ~ L~ r 7 t- f~c~ ~I / (.o / Z 40. Registrar's D' trict Number 41. Registrar' re ~ 42. Registrar File D to (MO Day r) - ~ 9 0 ~ 43. Amendments / H105-143 Disposition Permit No. ~to ~ ~ ~O ~ ~ REV 07/2011 ~x-~ ._~° %_~~.. y~~yy~ ~! C.x+-. ~ ~ ...~, ~ ~_ ~ Lh ~~ ~~ c~7 .-t T_, c~ W CV c_:.~ r~ t..i .-. :..~ ~.., 4A-- r,' • ~~ ~~~~ °^o^* J '°~ ~ U ~ W ~ trf LAST WILL AND TESTAMENT OF ALICE GARBRIGHT I, ALICE GARBRIGHT, residing at 39-30 52nd Street, Apt. #3F, Woodside, NY 11377, County of Queens, City and State of New York, being of sound mind and memory, do hereby revoke all former Wills, Codicils and instruments of a testamentary nature by me heretofore made, and I do hereby make, publish and declare this to be my Last Will and Testament in manner and form following: FIRST: I order and direct that all my just debts, funeral and administration expenses be paid as soon after my death as may be practicable. SECOND: All the rest, residue and remainder of my property, both real and personal, of every kind and nature, and wheresoever situated of which I may die seized or possessed or over which I may have testamentary power (collectively referred to as my "residuary estate"), I give, bequeath and devise as follows: a) 50% to my daughter, ALICE O'GRADY, residing at 12 Lily Lane, Levittown, NY 11756; or if she does not survive me, then equally among her children, JAMES O'GRADY, EiLEEN O'GRADY and EDWARD O'GRADIr', or the survivor or survivors; and b) 50% to my friend, MARY OLA WOOLSEY, also residing at 39-30 52nd Street - #3F, Woodside, NY 11377. THIRD: I nominate and appoint my grandson, JAMES O'GRADY, residing in Pennsylvania, to be the Executor of this my Last Will and Testament; or if he does not survive me or fails to qualify hereunder or, having qualified, ceases to serve, or alternatively in any event, I nominate and appoint my daughter, ALICE O'GRADY, to be my Executrix, and I direct that no bond or other security shall be required of either of them for the faithful performance of their duties hereunder. FOURTH: Should any individual mentioned herein die together with me or as a result of a common accident or disaster or under such circumstances as to render time and sequence of death uncertain, then and in that event or in any of those events, it shall be deemed that said individual did not survive me. FIFTH: If at the time of my death there should be no surviving legatee or surviving alternate legatee for any bequest set forth in this will, said bequest shall lapse and become part of my residuary estate and be divided among my surviving residuary legatees in the proportions designated. IN WITNESS WHEREOF, I have hereunto subscribed and signed my name at the end hereof this 30th day of November, 2005. ,~ .~ ALICE GARBRIGHT WITNESSES: SIGNED, SEALED, PUBLISHED and DECLARED by ALICE GARBRIGHT, the Testatrix above named, to be her Last Will and Testament, consisting of this page and two other typewritten pages, in our presence, and we, at her request, and in her presence, and in the presence of each other, have hereunto subscribed our names as attesting witnesses this 30th day of November, 2005 Residing at 39-75 46th Street Sunnyside, NY 11104 Residing at 45-29 47th Street Woodside. NY 11377 STATE OF NEW YORK) COUNTY OF QUEENS ) -S.S.: Each of the undersigned, being individually and severally sworn, deposes and says: That they witnessed the execution of the within Last Will and Testament of ALICE GARBRIGHT on the 30th day of November, 2005 at 45-29 47th Street, Woodside, NY 11377; that each of the undersigned were acquainted with the Testatrix and make this affidavit at her request; that said Testatrix in their presence, subscribed her name to said Will at the end thereof and at the time of making such subscription declared the within instrument so subscribed by her to be her Last Will and Testament; that each of the undersigned, at the request of said Testatrix and in her presence and sight of each other, thereupon witnessed the execution of said Will by said Testatrix by subscribing our names as attesting witnesses thereto. That the Will was executed as a single original instrument and was not executed in counterparts; and that the Will was executed by the Testatrix and witnessed by each of the undersigned under the supervision of MARL CRAWFORD LEAVITT, an attorney-at-law. That said Testatrix at the time of the execution was upwards of eighteen years of age and in the opinion of each of the undersigned was of sound mind, memory and understanding and was not under any restraint or in any respect incompetent to make a Will and could read, write and converse in the English language and was not suffering from any defect of sight, hearing or speech or from any physical or mental impairment which would affect her capacity to make a valid Will. That this affidavit was made and executed simultaneously with the execution of the aforesaid Will. Severally sworn and subscribeu ~~ before, i'ne t is th ay of November, ~.- IORNA NtJGH S Commissioner of Deeds (;thy pf New York,' No 4-39345 ~~Ftificate Filed ~n Queens C~un ~p~~~ss~on Expires April 1, 2 2005