HomeMy WebLinkAbout01-24-13PETITION 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: arty U File No: ~~ - 1~ "" ~-~'~iy'
a~a: Larry Ray Ruff (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 1 /12/2013 Age at death: 70
Decedent was domiciled at death in Cumberland County, FA (State) with his/her last
principal residence at 432 Water Street 17070 New Cumberland Borough Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 4_30 Water Street 17070 New Cumberland Borough Cumberland PA
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 $ 2.500.00
Ifnat domiciled in Pennsylvania .............................Personal property in Pennsylvania $
Ijnot domiciled in Pennsylvania .............................Personal property in County $
Value of real estate in Pennsylvania .............................................................. $ 112, 500.00
TOTAL ESTIMATED VALUE.... $ _ 115,000.00
Real estate in Pennsylvania situated a[: '432 Water Street 17070 New Cumberland Boro Cumberland
(Attach addirionat sheers, ifnecescary) 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/ttrey is/are the Executor(s) named in the last Will of the Decedent, dated 12/18/2012 _ and Codicil(s)
thereto dated
State relevant circumstances (e.g. renunciation, death ojexecutor, 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 ^ EXCEPTIONS
^ B. Petition for Grant ~of Letters of Administration (If applicable) _
e.t.a., d. b. n., d. b. n. e.t.a., pendente life, 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 comlalete 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.
^ NO EXCEPTIONS ^ EXCEPTIONS _
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the follog+G~pouse (if any~'and ~rs~ttach
additional sheets, rfnecessarv): ~ ,.t;a e__ ,,-~
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Name Relationship ~ds .r rU ~ ~/'
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Form RW-02 rev. !0'11;'2011 Page 1 Of 2
Oath of Personal Representative
COMMONWEALTl3 OF ~'ENNSYLVANIA }
} SS:
couNTY of Cumberland }
Petitioner(s) Printed Name Petitioner(s) Printed Address
Ter Galla her 103 Pleasant View Terrace '~;~ ~n`ti ~ ;;; j ; ',
New Cumberland PA 17070
_ GLL~~°~, _
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<< ~ ,.
The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and ect to the best of the knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the Decedent, the ner(s) w' ell y administer the estate according to law.
Sworn to or ffirmed an subscribed bef_o~re~ Date ~ y
met >~~ day of c I t~ 3 Date
gy. N G '~~~ f
~ Date _
For the Register Date _ _
BOND Required: ^ YES ®NO
FEES:
~ ~
Letters ....................... $ . CSC
(~ )Short Certificates(s) , ..... _~;,2
( )Renunciation(s) ... ......
( )Codicil(s) ..............
( )Affidavit(s) ............ .
Bond .........................
Commission ................... .
Other - .. ......'-~LZ
~ nU~ rl ~`Y~--_ ........ ~. UZ~
Automation Fee ......... .
JCS Fee ................
TOTAL ...............
......
...... ~~3- 'G
Official Use Only
To the Register of Wills:
riease enter my appearance ny my sigq~ture below:
Attorney Signature:
Printed Name: a I H.
Supreme Court
ID Number: 39785
Firm Name: Stone LaFaver & Shekletski
Address: 414 Bridge Street
P.O. Box E
New Cumberland PA 17070
Phone: 717-774-7435
Fax: 717-774-3869 _
Email: dstone C(/~stonelaw.net
DECREE OF THE REGISTER
Estate of Larry R. Ruff.
a/k/a: Larry Ray Ruf f
File No: :~~ - ~;~ ` ~%~
AND NOW, ~~, ~ ~ , ~_ , in consideration of the foregoing Petition,
satisfactory proof having been prese t d before me, IT IS DECREED that Letters Testamentary _
-_ ar hereby granted to Terry Gallagher ___
--- in the above estate and (if applicable) that
the instrument(s) dated 12'18/2012
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent
Form RW-02 rev. !0 ~11 2011
Register of Wills ~ ~ M~~~t~~~i
1~--~ Page` of 2
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C,c~rtili.~(ti(~(j ~(jn~ij~) -
Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
Permanent CFRTI FI['ATF AF fIFATI-1
Zi
1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number's '•4!•Date Of Death (MO/Day/Vr) (Spell Mo)
Larr Ra Ru££ Male 195-32-1814 Sanuar 12, 2013
Sa. Age-Last Birthday (Vrs) 5b. Under 1 Year SG Under 1 Da 6. Date of Birth (MO/Day/Vear) (Spell Month) 7a. Birthplace (City and State or Fn reign Country)
Months Days Hours Minutes Mechanicsbur PA
70 August 13 , 1942 7b. Birthplace (County)
Sa. Residence (State or Foreign Country) Sb. Residence (Street and Number -Include Apt No.) 8c. DId Decedent Live in a Township?
Penns lvania Q Ves
decedent Iiyed in
,
M,p,
Bd. Residence (cot,nty) 432 Water Street
Cumberland 8e. Residence (Zip Code) ®NO, decedent Ilved within limits of New Cumberland city/boro.
9. Ey<r In US Arm<d Forces? 1D. Marital Status at Time of Death Q Married Q Widowed 11. Su rvlving Spouse's Name (If wife, give name prior to first marriage)
Yes Q No Q Unknown ~ Divorced Q Never Married Q Unknow
12. Father's Nam¢ (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last)
ose h L. Ru££ L dia Romaine wet art
14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, CIN, State, 2Ip Code)
~ Mar aret ££ o an n r e~,~,
G
s ................. ........'.'..--.........~°......°... .........°'-°.-................,.......-....?; ace o Deac c e<_ on y one •
If Death Occurred in a Hos it- I• In ---'•-- -- r •••••••-------•^•••-----------------
p patient :If Death Occu rrGd Somewhere Other Than a Hospital: ~ Hospice Facil-ty ~' • Decedent's H
°
4 ome
Q Em<rgency Room/OUCpatlent Q D¢ad On Arrival Q Nursing HOm</Long-Term Care Fadlity Other (Specify) 8n t Ome,
a
G 156. Facility Name (If not Instetution, gWe street and number; 15c. City or Town, State, and Zip Code 15d. County of Death
•: 4 O Water Street New Cumberland PA 1 070 Cum ,er and
. 16a. Method of Disposition ~ Burial Q Cremation 16b. Date of Dlsposi[tOn 16c. Place of Disposition (Name of cemetery, crematory, or other place)
$ Q Removal from State Q Donation 201 3
othGr(spe<Ify)_ anuar 18, Mt. Olivet Cemeter
~ 16d. Location of Disposition (City or Town, State, and Zip) 17a. Signature f Funer Ire Lice s or Person In Charge of Interment 176. License Number
4 Fairview Townshi PA 17070 ~- FD 013 34 L
E
8
° 17c. Name and Complete Address of Funeral Facility
Parthemore FH&CS inc. PO Box
431 New Cumberland PA 1707 -04 1
~ 18. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -check ONE OR MORE races to indicate what
•- highest degre¢ 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
.
Q 8th grade or less Is Spanish/Hispanic/Latino. Check the "NO" White Q Korean
Q No dl ploma
9th - 12th grade bo
If d
d
I
,
x
ee
ent
s not Spanish/Hispanic/Latino. ~] Black or African American Q Vietnamese
® High school graduate or GED completed ~ No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native Q Other Asian
Q Some college credit, but no degree Q Ves, Mexlea n, Mexican American, Chicano ~ Asian Indian Q Native Hawaiian
Q Associate degree (e.g. AA, AS) Q Ves, Puerto Rican ~ Chinese Q Guamanian or Chamorro
'
Q Bi<helOr
s degree (e.g. BA, AB, BS) Q Yes, Cuban Q Filipino 0 Samoan
'
Q Master
s degree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispanic/Latino ~ Japanese ~ Other Pacific Islander
Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (Specify)
. MD DDS DVM LLB JD
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 Q Japanese Q Samoan done dui n
r g most of working life. DO NOT USE RETIRED.
Q Black or Afrlean American Q Korean (] Other Pacific Isla
d
n
er
O American Indian or Alaska Native Q Vietnamese Q Don't Know/NOT Sure ualit ('On"tr01 1nS OCCOr
Q Asian Indian Q Other Asian Q Refused 226. Ktnd of Business/Industry
Q Chinese Q Na[ixe Hawaiian Q Other (Specify)
Q FIIIPinO O Guamanlanorchamnrrp Manu£acturin
ITEMS 23a - 23d MVST BE COMPLETED 23 Date Pronounced Dead (MV Day r) 23 b. 51JSnatu re of Pers Pronouncing Deat On1Y when a plicable) 23c Ucenx Number
BY PERSON WHO PRONOVN(:ES OR 1d'1 ~ _
~
// ,t ~ ' ~
//
CERTIFIES DEATH
`~
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23 Date Signed (Mv/~Vr) _ 24. Time of O at ~~
t
!
7 /
V
I
?
25. Was Medi al Examiner or Coroner contacted? Q Ves ~ No
CAUSE OF DEATH
Approximate
26. Part 1. Enter the chain of events--diseases, injuries, or compllca[lOns--Shat directly Caused the death. DO NOT enter terminal events such as cardiac a rest Interval:
r
respiratory arrest, or ventricular fibrillation without showing The etiology- DO NOT ABBREVIATE. Enter only one cause on a Ilne. Add additional lines
if necessary Onset to Death
IMMEDIATE CAUSE ->
F'1C:1~~; /ail L 8- A~oyS Cf Lt_ ~r~/C~2
(Final disease or condition Due to (o as a c ns<qu n e of):
r
res Ulting in death) l~xj C
/~
b. ` T I'Z d ~ lJ i'~I ~ ~/ ~ G_ ~ .~/ 1 !2 G /"1F~-!Z
-
~ _ _
Sequentially list conditions, Due [o (or as a Consequence of): -
If any, leading to the cause -
Iisted on line a Enter the
V NDERLYING CAUSE Due to (or as a consequence of): -
(disease or injurythat
F initiated the events resulting d.
in death) LAST. Oue to (or as a conseq uence of):
26- Part 11. Enter other si¢nifica nt conditions contributing to death but not resulting in the undG rlying cause given in Part 1 27
Wa
B .
s a utopsy pertormed?
O Ye, No
_ 28. Were autopsy findings available
$ to c pl¢te the c of death?
G
p
3+
29. If Female: O Yes
No
F6 30. DId Tobacco Use Con[Nbute to Death? 31. Manner of Death
Q NOS pregnant within past year Q Yes Q Probably ~] NatU ral Q Homicide
Q Pregnant at Lime of death
Q No ~ Unknown Q
Q Nat pregnant, but pregnant within 42 days of deatF Accident Q Pending Investigation
r Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In Mo Day/Yr 5 Q Suicide Q Could not be determined
jury ( / ) ( pelt Month)
Q 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, Clty, State, Zip Code)
36. Injury at Work 37. If Tr'ansportatlOn Injury, Specify: 38. Describe How Injury Occurred:
Q yes Q Ortver/Operator Q Pedestrian
Q No Q Passenger Q Ocher (Specify)
39a. titer (Check only one):
lr7 Certifying physician - To th¢ best of my knowledge, death occurred due to The cause(s) and m nner stated
Q Pronouncing 8< Certifying physician - To fhe best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and mann
r
t
t
d
e
s
a
e
~ Medical Examiner/Coroner - On _ basis Of examination, and/or investigation, In my opinion, death occurred at the time, date, and place, and due to the cause(s) and mann
t
d
s
ate
Signature of cerYifier:_ Title of certifier:- r1 n License Num ber:
Z Z ~ ~<</
~ ~
39b. Name, Address and 2Ip Code of Person Com piecing Cause of Death (Item 26) __
7
Y
Ra eah ra e i 39c. Dat¢ Signed Mo/Day/Yr)
n
40
Registrar's District Numb
' 1 ~ 2013
.
er 41. Registrar
s atUro
/ -~ / ' 42. Registrar FFIe pate (MO/Day r)
43. Amendments
/'s C~ 1 C4 !1 9 H1D5-143
Disposition Permit No. [ 1 T~ `, `7 REV 07/2011
Z:\EP\WILLS\Ruff.Larry 12-2012.wpd
LAST WILL AND TESTAMENT
OF
LARRY R. RUFF
- - i
e
I, LARRY R. RUFF, of the Borough of New Cumberland,
Cumberland County, Pennsylvania, declare this to be my last will
ai!d rF~~oke ally iti~il prCV.~OliSiy !iiC;:d~: by iTl.::,
I'EM I: I direct that my Executor hereinafter named shall
pay al~ my just debts and funeral expenses as soon as conveniently
may be done after my decease from the residue of my estate. As of
the date of this will, I owe TERRY GALLAGHER Eleven Thousand
($11,000.00) Dollars.
I~i'EM II: I devise and bequeath all the rest, residue and
remainder of my estate, of every nature and wherever situate, in
equal shares to MARGARET E. RUFF, SHERRY SUNDBERG and MICHAEL
SUNDBEi~'.G, or the survivor of them.
ITEM III: I appoint TERRY GALLAGHER, Executor of this my
last w_ 11.
I',:'EM IV: No fiduciary acting hereunder shall be required to
c~ _=~ ~
post b,~nd or enter security f.or the faithful e~5forma~icer~~' his
_,, ~-- ~~
G"7 -i7
duties in any jurisdiction. ~"" -~~- ~-~ -- `~' ~.~w
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Page 1 of 4
ii _
IN WITNESS WHEREOF, I, LARRY R. RUFF, have hereunto set my
hand and seal this ~~ day of ~~C~i~r+-.~c~,. 2012.
} J
~~ `~ ~~`
LARRY R. RUFF
SIGNED, SEALED, PUBLISHED and DECLARED by LARRY R. RUFF,. the
Testator above named, as and for his Last Will and Testament, and
in the presence of us, who at his request, in his presence and in
the presence of each other, have subscribed our names as
r
witness>es .
~,~
`° _ 414 BRIDGE ST., NEW CUMBERLAND PA
Witn ss_ ~ .~,~ Address
414 BRIDGE ST., NEW CUMBERLAND PA
Witness Address
Page 2 of 4
11 ,-
COMMONWEALTH OF PENNSYLVANIA:
. SS.
COUNTY OF CUMBERLAND .
I, LARRY R. RUFF, the Testator 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
this 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 contained.
~j/
'/ Fh~ r7t ~CfiJ
!' f
LARRY R. RUFF
S~~,orn to or affirmed to and acknowledged before me by LARRY
o ~'~
R. RUFF', the Testator, this rr~ day of ~~=~r'^.~~,~ 2012.
,~~:/
%~ -~~ "
~~-~'~ Notary Public
CdMMONW~AL7H (7F F~~FJN3YLV~NIA
NOTARIAL SEAL
JENNIFER A. MEARKLE, Notary Public
New Cumberland Boro.Cumberland Co.
My Commission Expires July 7, 2016
Page 3 of 4
COMMONWEALTH OF PENNSYLVANIA
. SS.
COUNTY OF CUMBERLAND
W e , ~ 'J- J °i~1r, and
the witnesses whose names are signed to the attached o:r foregoing.
inst:rument, being duly qualified according to law, depose and say.
that; we were present and saw Testator sign and execute the
inst:rurnent as his last will; that Testator signed willingly and
that: he executed it as his free and voluntary act for the purposes
thereir_ expressed; that each of us in the hearing and sight of the
Testator signed the will as witnesses; that to the best of our
knowledge, the Testator was at that time eighteen or more years of
age, off" sound mind and under no con
Witness
5~~~%orn to or affirmed to and ackn ledged before me by
-~' Cam`/ , ~ ~- ~~'~-~ and ~~ ~~~~.~~`~
t~'~ T-
witnes:es, this ~~ day of
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
JENNIFER A. MEARKLE, Notary Public
New Cumberland Boro.Cumberland Co.
My Commission Expires July 7, 2016
Page 4 of 4