HomeMy WebLinkAbout04-15-13 R
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(ics) 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
r _13�04 nio
Name: WAYNE E.RAUDABAUGH File No: ,91 V:��J
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 204-30-8191
Date of Death. APRIL 3,2013 Age at death: 86
Decedent was domiciled at death in CUMBERLAND —County, PENNSYLVANIA (state)with his/her last
principal residence at 15 JEFFERSON DRIVE,CARLISLE 17015 S.MIDDLETON TOWNSHIP CUMBERLAND
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 15 JEFFERSON DRIVE,CARLISLE 17015 S.MIDDLETON TOWNSHIP 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 7,000.00
If not domiciled in Pennsylvania. Personal property in Pennsylvania
If not domiciled in Pennsylvania. . .. Personal property in County $
Value of real estate in Pennsylvania..... ................. ................................. $ 250,000-00
TOTAL ESTIMATED VALUE. ... $ 257,000.00
Real estate in Pennsylvania situated at: 15 JEFFERSON DRIVE,CARLISLE 17015 S.MIDDLETON TOWNSHIP CUMBERLAND
(Attach additional sheets,if necessary.j, Street address,Post Office and Zip Code City,Township or Borough County
0 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 FEBRUARY 7, 1983 and Codicil(s)
thereto dated
-CAROLINE A RAUDARAUGH DIED ON 10/17/2011
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 many,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 0 EXCEPTIONS
0 B. Petition for Grant of Letters of Administration (If applicable)
C-1
me absenib,dug
e.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lit&9 ti9inoritate
cc)
If Administration,c.t.a. or d.b.n.c.t.a.,enter date of Will in Section A above and ci>ana etzlist:ffhei
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for I V:,nz o hW beetatabl"ter n6 defined
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated pers=. VZ
q� C->
0 NO EXCEPTIONS 0 EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the foRWT59 spouse fi,�ny);0'17ir-s(attach
additional sheets,if'necessary):
-0 Cn
it*
Name Relationship Address
Form RW-02 rev. 1011112011 Pagel of
Oath of Personal Representative Official use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s)Printed Name Petitioner(s)Printed Address
DANIEL W.RAUDABAUGH 1171 RHODA BLVD.,MECHANICSBURG PA 17055
3
The Petitioner(s)above-named swear(s)or affirm(s)the statements i foregoing Petition"rue and correct to the best of the knowledge and belief
of Petitioner(s)and that,as Personal Representative(s)of the De the etitio } ell truly administer the estate according to law.
Sworn to or affirmed and subscribed before 'a< Da "
me*F , `'day o �, Date
By Date
Register Date
w M
BOND Required: Q YES (E) NO To the Register of Wills: rn c->
c? CS
FEES: Please enter my appearance by my og ure belts.
Letters . . . . . . . . . . . .. . .. . . . . . . S 310.00 Attorney Signature: '0 >' t— f" ""
( 3 )Short Certificate(s) 15.00 D CD
( )Renunciation(s).. . . . . . . . •`? ;K
( )Codicil(s). . . . . . . . . . . . . (r' C� `+t
( )Affidavit(s).. . . . . . . . . . . 4 N r=
Bond.. . . . . .. . . . . . . . . . . . . . . . . Printed Name: RO R B.IRWIN,'ES41RE r- c�
Commission. . . . . . . . . . .. . . .. . . Supreme Court ys �, In
Other . . . . . . . . ID Number: 6282
WILL . . . . . . . . 15.00
INH TAX RETURN . . . .. . . . 15.00 Firm Name: IRWIN&McKNIGHT,P.C.
INVENTORY . . . . . .. . 15.00 Address: 60 WEST POMFRET STREET
. . . . . . . . CARLISLE„PA 17013
Phone. (717)249-2353
Automation Fee. . . .. . . . . 5.00 Fax: (717)249-6354
JCS Fee. . . . . . . . . . . . . . . . . . . . 23.50 Email:
TOTAL. . . . . . . . . . . . . . . . . .. . $ 398.50
DECREE OF THE REGISTER
Estate of WAYNE E.RAUDABAUGH File No: 02 .- �` D`"t 2�
a/k/a:
AND NOW, ' i i , . ,in consideration of the foregoing Petition,
satisfactory proof having been present 6d before me,IT IS DECREED that Letters TESTAMENTARY
are hereby granted to DANIEL W.RAUDABAUGH
in the above estate and(if applicable)that
the instrument(s)dated FEBRUARY 7, 1983
described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Decedent.
&AdA-., ("TDMI4 &""i
Register of Will -PV 1140A)
Form RW-02 rev. 1(t/!!12(!!! Page 2 of 2
H105.805 REV(9/11)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WAMMD106 iop"JC�e Oslicate this copy by photostat or photograph.
REGISTER OF WILLS
Fee for this certificate, $6.00 m I„I. "°'�--- This is to certify that the information here given is
1013 APR 15 PM 2 41 "%,ptN OF pE'; correctly copied from an original Certificate of Death
toy`� y`r duly filed with me as Local Registrar. The original
CLERK O r certificate will be forwarded to the State Vital
QRPMANS COiJRT If Records Office for permanent filing.
� ,
P 1943527TuMBERLAND CO., P AM 7013
Certification Number """""""' Lo al Registrar Date Issued
Type/Print In COMMONWEALTH OF PENNSYLVANIA.DEPARTMENT OF HEALTH VITAL RECORDS
Permanent OF DEATH
Black Ink CERTIFICATE State File Number:
1.Decedent's Legal Name(First,Middle,Last,Suffix) 2.Sex 3.Social Security Number 4.Data of Death(Mo/Day/Yr)(Spell Mal
Wa e E_ Raudabau h M 204 30 8191 April 3, 2013
5Age-Last Birthday(Yrs) 15c.Under 1 Day 6.Date of Birth(MO/Day/Year)(Spell Month) 7a.Birthplace(City and State or Foreign Country)
86 Montns Days Hour, Minot,, Carlisle, PA
August 28r 1926 7b.Birthplace(County)
Sa.Residence(State or Foreign Country) 86.Residence(Street and Number-Include Apt No. Sc.Did Decedent Live in a Towne ip? gland
PAI a.,decedent I. ed 1n outh Middleton twp
Sd.Residence(County) l 5 Jefferson Dr
CLanberland Be.Residence(Zip Code) 17015 0 No,decedent Ilved within limits of city/born.
9.Ever in US Armed Forces? 10.Marital Status at Tlme of Death 0 Married Widowed 11.Surviving Spouse's Name(If wife,give name prior to first marrlageJ
0 Yes g]{NO 0 Unknown 0 Divorced 0 Never Married 0 Unknow _
12.Father's Name(First,Middle,Last,Suffix) 13.Mother's Name Prior to First Marriage(First,Middle,Last)
Fla Raudabau h Pearl Hair
14a.Informant's Name 14b.Relationship to Decedent 114..Informant's Ma I11ng Address(Street and Number,City,State,Zip Code)
o Daniel W. Raucabau h Son 1171 Rhoda Blvd_ , Mechanicsbur , PA 17055
G ................................................ ......Pa..................................I........15a:P ace o Deat...C ec on Y one
.shah a_..ospital:............w��+tt.....................................x.�vf�.....................................
If Death Occurred in a Hospital: In bent :If Death Occurred Somewhere Other Th Hospital: u Hospice Facility IGI Decedent's Home
° Emergency Room/Outpatient Q Dead on Arrival _ 0 Nursing Home/long-Term Care Facility M Other(Specify)
dd 15b.Facility Nam,(If not institution,give street and number; 15c.City or Town,State,and Zip Code 1Sd.County of Death
15 Jefferson Dr_ Carlisle PA 17015
Cumberland
16 a.Method of Disposition Burial Cremation 16b.Date of Disposition 16<.Place of Disposition(Name of cemetery,crematory,or other place)
a �Removal from State 0 Donation
0 otner(sp,clfy) 4/6/2013 Westminster Memorial Gardens
2 16d.Location of Disposition(City or Town,State,and Zip) 17a.51 Lure o ral Service Ucens r P so n�.charge of Interment 17b.license Number
Carlisle, PA 17013 GlC FD 012633 L
E 17c.Name and Complete Address of Funeral Facility
8 Et vin Brothers Funeral Horne, Tnc_ , 630 S_ Hanover St_ Carlisle, PA 17013
18.Decedent's Education-Check the box that best crib,,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" Korean
JEr No diploma,9th-12th grade box if decedent Is not Spanish/Hispanic/Latino. 0 Black or African American 0 Vietnamese
0 High school graduate or GED completed WN O,not Spanish/Hispanic/Latina 0 American Indian or Alaska Native 0 Other Asian
0 Some college credit,but no degree 0 Yes,Mexican,Mexican American,Chicano 0 Asian Indian 0 Native Hawaiian
0 Associate degree(e.9.AA,AS) 0 Yes,Puerto Rican 0 Chinese 0 Guamanian or Chamorro
0 Bachelor's degree(e.g.BA,AS,BS) 0 Yes,Cuban 0 Filipino 0 Samoan
0 Master's degree(e.g.MA,MS,MEng,MEd,MSW,MBA) 0 Yes,other S Fili 1
panish/Hispanic/Latino 0 Japanese 0 Other Pacific Islander
0 Doctorate(e.g.PhD,Ed D)or Professional degree (Specify) 0 Other(Specify)
.MD,DDS DVM LLD,JO
21.Decedent's Single Race Self-Designation-Check ONLY ONE to In'Icate what the decedent considered himself or herself to be. 22a.Decedent's Usual Occupation-indicate type of work
Black or African American 0 Japanese 0 Samoan done during most of working life. DO NOT USE RETIRED.
0 0 Other Pacific Island,
W 0 America or Alaska Native 0 Vietnamese 0 Don't Know/Not Sure Glass Pac 7kaging
0 Asian Indian 0 Other Asian 0 Refused 22b.Kind of Business/Industry
0 Chinese 0 Native Hawa Ilan 0 Other(Specify)
0 Filipino 0 G.amanian or Chamorro PPG Tndustrias
ITEMS 23,-23d MUST BE COMPLETED 12 3 a.Date Pronounced Dead(MO Day/Yr) 23b.Signature of Person Pronouncing Death(Only when applicable 23c.License Number
CERTIF ES DEATH PRONOUNCES OR p, ri1 3, 2013
23d.Date Signed(Mo/Day/Yr) 24.Time of Death
Ap=: 5:00 a_m_ 125.Was Medical Examiner or Coroner Contacted? $x Yes Q 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 ventricular fibrillll�atiiion withouut showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset to Death
IMMEDIATECAUSE ---------------> a. //-49�RIOGL !n`�oCifyLOr/fZ TAII-¢�G77pye /fjj�lys
(Final dis,as,or condition Due to(or as a conseq uenc,of):
resulting In death)
b.
Sequentially list conditions, Due to(or as a consequence of):
if any,leading to the cause
Ilsted on line a. Enter the
UNDERLYING CAUSE Due to(or as a consequence of):
(disease or Injury that
Finitiated the events resulting d.
in death)IAST. Due to(o as a consequ nce of):
,j 26.Part 11. Enter other significant conditions contributing h but not resulting In the underlying c ; Ven In Part 1 27.-11,y autopsy performed?
7-V RJE .Il ,5�-'TES �IT�C Z_ ��-�e ��/7 Y'�k 2nALS--A- , O Yes Na
/���,�� 28.Were autopsy findings available
yr/.c-LJ NL l G X171/ -3>",i�►' cq cpmpleta me cau,a of death?
O Yes �.No
29.If Female: 30.Did Tobacco Use Contribute to Death? 31.Manner of Death
E 0 Not pregnant within past year Yes 0 Probably (g Natural p Homicide
0 Pregnant at time of death No 0 Unknown E3 Accident
0 Not pregnant,but pregnant within 42 days of dean 0 Pending Investigation
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)
0 Unknown if pregnant within the past year 33.Time of Injury
t 34.Place of Injury(e.g.home;construction site;farm;school) 35.Location of Injury(Street and Number,City,State,Zip Code)
�-t 36.Injury at Work 137.If Transportation Injury,Specify: 38.Describe How Injury Occurred:
0 Yes 0 Driver/Operator 0 Pedestrian
0 No 0 Passenger 0 Other(Specify)
39a.Certifier(Check only one):
ffi.Certifying physician-To the best of my knowledge,death occurred due to the cause(.)and manner stated
0 Pronouncing 8.Certifying physician-To the best of my knowledge,death occurred at the time,date,and place,and due to the cause(.)and manner stated
Q 0 Medical Examiner/Coro er-On the bas s cf a amination,a�'n'd�-/^or investigation,in my opinion,death` urred at the time,date,and place,and due to theL se(s)and m tated
Signature of certifier: .� , A,0 Title of certifier:_ * Jc License Number:rte/DGOZY L�oZa�
39b.Name,Address and Zip Code of Completing Cause of Death(Item 26) 39c.Date Signed(MO/Day/Yr)
tt Fa.�-n wtu�A, r% sF� 7U r!-s� .f3G L L !9�/'O 3-
5 40.Registrar's District Number 41.R IsCrar's Signature 42.Registrar File Date
-a/
43.Amendments
O_
2
Disposition Permit No.
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M
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Bill ao re ita da- ; a C)
nor? m, 7"
I. WAYNE E. RAUDABAUGH, of South. Middleton Towr�sh p , CNbeF tMd
County, Pennsylvania, declare this instrument to be my last'1ill and
testament, hereby expressly revoking all wills and codicils heretofore
made by me.
1. I direct my executrix to pay all of my debts , funeral and
administrative expenses as soon as convenient after my decease .
2. I authorize and empower my executrix to sell any realty owned
by me at my death, at either public or private sale , and to give good
and sufficient deeds therefor, in fee simple , as I could do if living.
My executrix is authorized and empowered to continue to engage in any
business in which I may be engaged at my death, for such period as
seems expedient to said executrix.
3. I devise and bequeath all of my estate of every nature and
wherever situate to my wife, Caroline A. Raudabaugh, providing she shall
survive me by sixty days .
4. Should the gift in Paragraph No. 3 not take effect , I devise
and bequeath all of my estate of every nature and wherever situate to
my children, share and share alike, the child or children of any
deceased child taking the share their parent would have taken if living.
5. I nominate and appoint my wife , Caroline A. Raudabaugh, to be
the executrix of this my last will and testament ; she is to serve as i
such without bond. Should she die before my death, renounce or refuse
Ito serve for any reason, or die leaving and of my estate unadministered,
I nominate and appoint Daniel W. Raudabaugh as substitute executor with
#
the same powers as are given herein to my executrix, and also without
the filing of any bond.
6. I hereby suggest that my personal representative retain the
services of Irwin, Irwin & Irwin as attorneys in the settlement of my
estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7z
day of February, 1983.
(SEAL)
WA.YNE E . RAUDABAUGH
Signed, sealed, published and declared by Wayne E. Raudabaugh, the
testator above named, as and for his last will and testament, in the
presence of us, who, at his request , in his presence and in the present
of each other have subscribed our names as witnesses hereto.
i
-2-
ACKNOWLEDGEMENT AND AFFIDAVIT
We , WAYNE E. RAUDABAUGH , KATHLEEN M. KENNEY ,
and SHARON L. SCHWALM , the testator and the witnesses,
respectively , whose names are signed to the foregoing instrument ,
being first duly sworn, do hereby declare to the undersigned
authority that the testator signed and executed the instrument
as his Last Will and that he had signed willingly, and that he
executed it as his free and voluntary act for the purpose therein
expressed, and that each of the witnesses , in the presence and
hearing of the testator, signed the Will as a witness and that
to the best of their knowledge the testator was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence .
WAYNE E. RAUDABAUGH
KATHLEE M. KEN
(/-)� 00--,L2d--�
SHARON L. SCHWA M
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CU14BERLAND
Subscribed, sworn to and acknowledged before me by WAYNE E .
RAUDABAUGH , the testator, and subscribed
and sworn to before me by KATHLEEN M. KENNEY , and
SHARON L. SCHWALM witnesses, this 7i day of
February 1983 .