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Home My WebLink About02-19-13PETITION 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 requests the grant of Letters in the appropriate form: Decedent's Information Name: Audrey M. Hobbs a/k/a: a/k/a: a/k/a: Date of Death: 02/07/2013 File No: 21 -13 - (~ / (Assigned by Regis er) Social Security No: Age at Death: 86 Decedent was domiciled at death in Cumberland County, pA principal residence at 100 Mt. Allen Drive, Mechanicsburg 17055 U peer Allen Twp. Street address, Post Office and Zp Code City, Township or Borough (State) with his/her last Cumberland County Decedent died at Holy Spirit Hospital, 503 N. 21st Street Camp Hill 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 $ If not domiciled in Pennsylvania ................. Personal property in Pennsylvania $ If not domiciled in Pennsylvania ................. Personal property in County $ Value of real estate in Pennsylvania........... $ Real estate in Pennsylvania situated at NONE (Attach additional sheets, 'rf necessary.) 15,000.00 0.00 TOTAL ESTIMATED VALUES 15,000.00 Street address, Post Office and Zip Code City, Township or Borough Q A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated County 06/O7/Z011 and Codicil(s) Husband, William T. Hobbs, predeceased Decedent on June 12, 201 Z. (State relevant arcumstances, e.g., n:nunaation, death of executor, etc.) Except as follows: after the execution of the instrument(s) offered for probate, Decedent did not ma ,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 bom or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ^X NO EXCEPTIONS ^ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.. a.; .. n.; .. n. c.. a.; pe en e / e; uran e a sen la; uran a m/no a e If Administration, c.t.a or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs. Except as follows: Decedent was not a party to 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. ^X NO EXCEPTIONS ^ EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Deoedetrt left no Will and was survived by the following spq~ (if any) and h rr (atta~h._ ~ additional sheets, if necessary): ~, ~~'7 rn ~t`1 >~ ~ ~0 r~ ,,,,, G7 Name Relationship Address z ~ ...,; ~ A~~ ~ ~` ~ ~ ~; C3~ ~~ ~~ ~n C~ C-, c:::s ~. ~,,,~..} ~,~, 'mo't f..._..~ . `~ '~ ~ ~. _ ..~ rf ~- c~ 3,- w ~ Form RW-OZ n3v. 10-11-011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } COUNTY OF Cumberland } ss: } Petitioner(s) Printed Name Petitioner(s) Printed Address Karen J. Durbin 21 Laurel Drive Mechanicsburg, PA 17055 ~ ~~- ~ ~; ft~ C ~ ~ W~ ~.~~ rn ~ ~ if---~ ~ ~ k ~., ~~ f,....i flj ..~ The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foreg ing Petition are true correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Deced t t e e l loner(s) ill n `r d ruly administer th e estate according to law. . Sworn to r affirmed and~ubscribed before ,. ` thi ~~~ ~ d Date ^t' me s ay,of , - Of-,~ ~ Date By. ; /~ ~ (-'e- ~ ! ~ i~ ~--`E ' , , _ F pr he Re i t Date ~ g s er ~~ / ~: Date BOND Required? ~ Yes ~ No To the Register of Wills: FEES Letters .......................................... ( ~) Short Certificate(s)........ .. $ T !? ~ ~' .. . G; ( )Renunciation(s) ............. .. ; )Codicil(s) ............... i )Affidavit(s) ...................... . Bond ............................................. . Commission .................................. . Other ~' ~ ~'~' , l Automation Fee ............................. ~ 44 << JCS Fee ........................................ . - TOTAL ........................................... "' $ `~' .~_ L.~ ranee py my signature below: Attorney Signature: r ~~ ~ - ~ ' ,. Printed Name: Gerald J Brinser DECREE OF THE REGISTER Estate of Audrey M. Hobbs arrva: AND NOW, ~"'~ ~ e' r U frV ~ satisfactory proof having been pre ented before me, IT IS DECREED that Letters are hereby granted to Karen J. Durbin %~~~~ ~,~ , in consideration of the foregoing Petition, Testamentary _~.,~._ in the above estate and (if applicable) that the instrument(s) dated 06/07/2011 described in the Petition be admitted to probate and filed of record as th,~ I~t Will (and C dicil(s)) of Dece nt. /= ~ ~ ~~ Register of Wills ~ "~'~ Form RW-02 rev. 10-11-2011 ~.,,~' ~ c-~' ~ r Copyright (c) 2011 form software only The Lackner Group, Inc. Page 2 of 2 ~ Date of Death: Social Security No: File No: 02/07/2013 21 - 13 ~~-(1 ~ ~ ~r' f L~_ H105.805 REV (9/11) 1 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 19398317 RECOR~3E~ ~~~'~~E OF ,~~~~~"""~--, This is to certify that the information here given is REG ~ ~ T ~ ~ 0 F ~~ ~ ~. ~ S ~,,~~p~TH OF pE~;y :_ correctly copied from an original Certificate of Death ~,.~`~~o~ _ _ - - _ `r~'_ duly filed with me as Local Registrar. The original ~~~~ ~~~ 19 ~ ~ ~ s _ ~ _ _ =: z certificate will be forwarded to the State Vital Yom; a Records Office for ermanent filin . p g * ~ _, * ,~ ~LE~~ ~' - ~'~ a 0~~9 ~~~+,`~' FEB 1 2 3 --_ 9l ~ (~ ~`~'yyL 0!RPNANS CQURT -.. MENTOF ' ~"""""""''~~+++ll Local Registrar Date Issued --~~+IBERLA--#~II-~ fit}., ~'~- ----_ _ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH VITAL RECORDS IC'FRTIFII~'~TF AF nFAT1-1 Certification Number -- . Type/Print In Permanent 1'~ 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (Mo/Day/Yr) (Spell Mo) Audrey M. Hobbs F_ February 7, 2013 Sa. Age-Last Birthday (Yrs) 56. Under 1 Year Sc. Under 1 Da 6. Date of Birth (Mo/D ay/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Country) Months Days Hours Minutes DLlrllil0 e 86 Se tember 13 1926 7b. Birthplace (County) Lac wanna 8a. Residence late or Foreign Country) Sb. Residence (Street and Number -Include Apt No.) 8c. Did Decedent Live in a Township? Penns vania ves, decedent lived in U~~ner Allen twp. 8d. Residence (County) 100 Mt . Allen Dr . Cumberland Se. Residence (Zip Code) QNO, decedent lived within limits of city/boro. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death Q Married [~ Widowed 11. Surviving Spouse's Name (If wFfe, give name prior to first marriage) Q Ves [~No Q Unknown Q Divorced Q Never Married Q Unknown 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Harold MacY~.ler Mabel Je sen 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Stree[ and Number, City, State, Zip Code) g Karen Durbin Dau liter 21 Laurel Dr. MecYianicsbur PA 17055 G .......................................................... lSa. ace o Deat C ec on one ........................................ ....................................................Y............................ • _c _ _ . ----- .................................... ........................----------• --- If Death Occurred in a Hospital: ~ Inpatient :If Death Occurred Somewhere Other Than a Hospital: ~( Hospice Facility ~ Decedent's Home ° Q Emergency Room/Outpatient Q Dead on Arrival _ Q Nursing Home%Long-Term Care Facility Other (Specify) 15 b. Facility Name (If not Institution, give street and number; SSc. City or Town, State, and Zip Code 15d. County of Oeath LL Hol S irit Hos ital Hill PA 17011 Cumberland m S6a. Method of Dlspositlon Burial Q Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) ~ Q Removal from State Q Donation Other (Specify) 02/12/2013 Dunmore Cemeter ~ 16d. Location of Disposition (City or Town, State, and Zip) 17a nature of Funeral Servi on in C e of Int ment 17b. License Number ~ Dunmore, PA -- 014819 E 1 Name and Complete Address of Funeral Facility ~~ s ers-Harper Funeral Home Inc. 1903 Market St. Hi ll PA 17011 m 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 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_ Q 8th grade or less is Spanish/Hispanic/Latino. Check the "NO" hire Q Korean Q No diploma, 9th - 12th grade box If decedent is not Spanish/Hispanic/Latino. Black or African American Q Vietnamese ~~igh 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, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawaiian Q Associate degree (e.g. AA, AS) Q Ves, Puerto Rican Q Chinese Q Guamanian or Chamorro ~'j,Bachelor'S degree (e.g. BA, AB, BS) Q Yes, Cuban Q Filipino Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino Q Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (Specify) e. 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 during most of working life. 00 NOT USE RETIRED. Q Black or African American Q Korean Q Other Pacific Islander Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Homemaker Q Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian Q Other (Specify) Q Filipino Q Guamanian or Chamorro ITEMS 23e - 29d MUST BE COMPLETED 23a. Date Pronounced Dead (Mo/Day r) 23 b. Signature of Person Pronouncing Death (Only when applicable) 23c. License Number BY PERSON WHO PRONOUNCES OR CERTIFt S DEATH O ~ /O ~'/a7 O ~,3 ~ ~ ~ ~ n f l ~ / Q ~~~ 23d. Date Signed (MO/D y/Yr) ~ 24. Time of D eath - ~'~` -_ (~/ ~ 1!~ ca 0 ~~ o?d / ~ y /~ a , ~ r/~ 25. Was Medical Examiner or Coroner Contacted? Q Yes No 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 ventNcular fibrillation with out showing the etiology. DO N OT B B~REVIATE. Entervnly one cause on a line. Add additional lines If necessary Onset to Death •A nn ll - T ~ IMMEDIATE CAUSE --------------~ a. /-1 ~i(.t~X. ~G1JC.a~/ A (Final disease or condition Due (or as a copse ence of): resulting in death) f~ b. __ ~" Sequentially list conditions, Due to (or as a consequence of): if any, leading to the cause listed on Ilne a. Enter the c. UNDERLYING CAUSE Due to (or as a consequence of): ~ (disease or Injury that ~ initiated the events resulting d. In death) LAST. Due to (or as a consequence of): 26. Part 11. Enter o her sign ifl cant conditions contributing to death but n ot r esulting in the underlying cause given In Part 1 27. Was an autopsy performed? ~ t ' r' r Q yes ~ No ^~ pp ~ e ~) r!/~ ~ ~''f~l y~ ~~ ~ 28. Were autopsy findings available m ` v e - i~ to complete the cause of death? Q Ves No 29. If Female: 30. Did Tobacco Use CoPtribute to Death? 31. Manner of Death E g ~ Not pregnant within past year Q Yes Q Probably B Natural Q Homicide c c~ Pregnant at time of death Q Not pregnant, but pregnant within 42 days of death ~ No Q Unknown Q Accident Q Pending Investigation Q Suicide Q Could not be determined Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (Mo/Day/Vr) (Spell 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, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 3S. Describe How Injury Occurred: Q Ves Q OrWer/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): Certifying physician = To the best of my knowledge, death occurred due to the cause(s) and manner stated Q Pronouncing g• 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 Q Medical Examiner/Coroner - On the basis of e~ m lon j~ , and/or investigation, in my opinion, death occurred at t he time, date, and place, and due to the cause(s) and manner stated ( J er ~ / \ ` - ~t N~ ~ ~ Signature of certifier. _ - __ _ ~1 ~ , , Title of certifier: / ~ License Number- ~~ 39b.~e, Addres and Zip Code of~erson Com leting Cause of Death (Item 26) 39c. Date Signed (Mo/Day/Vr) 40. Regist ar's District um er 41. Registrar's Signature 42. Registrar File Date Mo Day r) 7 7 43. Amendments 08 C 7001 H 105-143 Dlspositlon Permit No. J _. REV 07/2011 r-.r ~ w ~ ~ rn ~w~° ~, ~° WILL ~, ~ ~ ~, co ~ ~'"cn~ a ~ ~ ~~~ ~ A UDREY M. HOBBS ~ ~ F._.~ +- `~' ~ ~ ~ cta ~ I, AUDREY M. HOBBS, currently of Upper Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. I. I direct that all my just debts and funeral expenses be paid from the assets of my estate as soon. as practicable after my demise. II. I direct that all estate and inheritance taxes that may be assessed in consequence of my death, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. I bequeath unto my husband, William T. Hobbs, all tangible personal property which I own at my death. IV. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath unto my husband, William. V. In the event that my husband, William, does not survive me, I devise and bequeath my estate that would have otherwise passed under Paragraphs III and IV above as follows: A. I bequeath equally unto my children, namely, Karen J. Durbin, David `~V. Hobbs and William D. Hobbs, ai't iangibte personal property they can agree upon. Any items not chosen shall pass as part of my residuary estate below. B. The residue of my estate shall be divided as follows: 1. Five percent (5%} unto Child Evangelism Fellowship, Dunmore, Pennsylvania, to be used as it determines best; \/ _ Y~YYYYY ~.. -1- .,~; 2. Five percent (5%) unto Messiah Village, Mechanicsburg, Pennsylvania, to be used for its Endowment Fund for Benevolent Care; 3. Ninety percent (90%) to be divided equally among my children, Karen, David and William. If any child predeceases me, his or her share shall pass unto his or her issue per stirpes. VI. I appoint my husband, William T. Hobbs, Executor of this my Will. In the event that he fails to qualify or ceases to act as Executor, I appoint my daughter, Karen J. Durbin, Executrix of this my Will. In the event that she fails to qualify or ceases to act as Executrix, I appoint my son, David W .Hobbs, Executor of this my Will. In the event that he fails to qualify or ceases to act as Executor, I appoint my son, William D. Hobbs, Executor of this my Will. VII. I direct that no bond be required of my fiduciaries for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, AUDREY M. HOBBS, herewith set my hand to this my Last Will, typewritten on two (2) sheets o paper including the attestation clause ~ .~_ and signatures of witnesses, this, day of , 2011. ~ ~` ~„~-~,,; , ~,~m ;, _ (SEAL) AUDREY M. HOBBS Signed by AUDREY M. HOBBS, by her declared to be her Will in our presence, who haves ereunto subscribed our names as witnesses in her presence and at her request, this `7 day of , 2011. residing at ~-~...Q.-~ c residing at ~. 1 -2- COMMONWEALTH OF PENNSYLVANIA COUNTY OF LEBANON WE, AUDREY M. HOBB S, GERALD J. BRINSER and K p-c ~ ~. ~vT~`~ , the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witnesses and that to the best of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~,'.'~ ~~ ~1~ ~~~~ Subscribed, sworn or affirmed and acknowledged before me by AUDREY M. HOBBS the testatrix, GERALD J. BRINSER and Kp,c~} ~ ~~~b~ ^ ,witnesses, this '79-~ day of , 201 1. r ~/ _ (SEAL) Notary Publi COMMONVIIEALTH OF P!~NNSYLVANtA NQTARIAL SEAL WENDY !.. CRAWFQRp, Notary Public Palmyra soro., Lebanon County My Commission Expires September -3-