HomeMy WebLinkAbout05-27-05
Estate of
also known as
OR PROBATE and GRANT OF LETTERS
M RAE JR. No. 2J - 0 5 - <17 C}
To:
Register of Wills for the
, Deceased. County of CUMBERLAND in the
Social Security No. 207-220 26 Commonwealth of Pennsylvania
The petition ofthe unders' ed respectfully represents that:
Your petitioner(s), who is e 18 years of age or older and the execut RIX named
in the last will of the above cedent, dated JANUARY 10 2004
and codicil(s) dated
(s te relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled a death in HAMPDEN TWP. CUMBERLAND County, Peunsylvania, with
h IS last familyorpri cipal residence at 510 SPRINGHOUSE ROAD HAMPDEN TWP.. CAMP
HILL CUMBERLAND CO NTY PENNSYLVANIA
(list street, number and municipality)
years of age, died 5/23/2005
at 510 SPRlN HOUSE R AD HAMPDEN TWP. CAMP HULL PA
Except as follows, decede t did not marry, was not divorced and did not have a child born or adopted
after execution of the will of red for probate; was not the victim of a killing and was never adjudicated
incompetent: NONE
Decedent at death owned pro erty with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Penns lvania
situated as follows:
510 SPRINGHOUSE ROA CAMP HILL PA
$
$
$
$
35.000.00
0.00
0.00
130.000.00
WHEREFORE, petitioner( ) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the g nt ofletters TESTAMENTARY
thereon (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
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1365 BRENTWOOD ROAD
YARDLEY PA 19067
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OA H OF PERSONAL REPRESENTATIVE
COMMONWEALTH FPENNSYLVANIA} ss
COUNTY OF CLIMBER AND
The petitioner(s) above-l,a ed swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to t....e be"i of e knowledge and belief ofpetitioner(s) and that as personal represen-
tative(s) of the above decede petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and sub oribed {~~ /l \ //:-k ,<
b,.\'f2remethls 21 yof _~~!..!f:!... ~C?t
'YlA 1. 5
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No. Z-1-05-<1'1l1
Estate of
M RAE JR.
, Deceased
OF PROBATE AND GRANT OF LETTERS
AND NOW 1'1 20-05 , in consideration ofthe petition on
the reverse side hereof, sa sfactory proof having been presented before me,
IT IS DECREED that the i strument(s) dated 1/10/2004
described therein be admi ed to probate and filed of record as the last will of GEORGE WILLIAM RAE. JR
and Letters TESTAMEN
are hereby granted to
JANICE RAE MITROVIC EXECUTRIX
b L E . . . . $ lliO,U-O
Pro ate, etters, tc....
Short Certificates ( '1 ) . . . . . . $ 7..!l. oV
Ro....noi.tioll . ~'l! l,.L,. .. .... $ I 5. /JO
.:rc..P Ii-- $ 15 . CJl)
TOT L 2- $ 31\?l.TO
Filed. .51.2~.lQ~. . . . . . . . . . . . . . . .
414 BRIDGE STREET
NEW CUMBERLAND PA 17070
ADDRESS
717-774-7435
PHONE
t-c
HIO).H05 REV ]105
This is to certify that the informatio
Local Registrar. The original certific
here given is correctly copied from an original certificate of death duly filed with me as
te will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
t2nm...1? ~..
Local Re~
Fee for this certificate, $6.00
p
MAY 2 5 2005
Date
~, ..,
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;~-~
61.f3Rev.2I81
COMMO EAlTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE Fl.ENUMlIEIl
(.~
73 y~.
.
COUNTY OF DEATH
SEX
:.male
SOCIAL SECURITY NUM8ER
.. 207 22 - 0826
"",0
:::.rJ 0
1nd\8n,Blal:k,WhIlIt,
NAME OF DECEDENT (FIQl, Middle. lift)
t.
AGE (lut BlrNay) 1
Mon~ O-vf
TE OF BIRTH
( Itl,o.y, Yur)
6 14/1931
..
CITY, BORO, TWP OEA.TH
BIRTHPLACE (City ..,d
Stew or Forelgn Countty) tfOSPfTN.:
Harrisburg, p ~IOIIIID
1. ...
FACILITY NAME (If not Inltilulion, give sIre$t III1d nurn/:ler)
ERIOu...-.-D
.
Ih. Cumberland Co.
DECEDENT'S USUAL OCCUPATION
fIf~..;1,"::~
"..engineer 11b.HVAC
DECEDENl'S tN.lLIHGADDRESS (S\re8I, ~QWI'I,~, Zip Code)
510 Spring House Rd.
Camp Hi1l,PA 17011
Hampden T
...
KIND OF BUSINESS
....
DATE OF DISPOSITION
1_. 0.,. v..,)
,,~Ma 25,2005
SUCH LICENSE NUMBER
FD-013163-L
510 Spring House Rd.
...
AS DECEDENT EVER IN OECEDeNrS EDUCATION MARlT~ ST,J.ruS.~,
U.S.~OFORCeS1 (anIy'" _........-1 NlIlIw~~)'d,
v"J6L NoD E 1010-121 411~) widowed
12. 13. ~ 11r.
11'.Sta18 Pennsylvania ~ 11C.)slV...declldentllv.dln Hamoden
17b. Countv Cumberland =.:~? 17d.D ~~':::of
UOTHER'S NAME (Firel, MicIdIe. Maiderl S_)
tt, Ellen He mans
INFORUANrs M.f.IUNGADDRESS (Slre8l, ~own, SCet1t, ZIp Code)
-.1365 Brentwood Rd.,Yardle ,PA19067
PLACE OF DISPOSITION-Nemec/Cemetery, Ctemetory LOCATION-Clly/TQWl, Stac.,,14aCode
woo...","", 11U88
2*on-O-Lite Crematory haefferstown,PA
NAMEAND"""RE"OF'''''''TY Lemovne PA
Musselman FH&CS,324Humme1 AVe.
LICENSE NUMBER DATE SIGNeD
(Monlh. v...)
....
R/COR
No
..
_.
George W. Ra , Sr.
.
,A5 TAil
0lIE TO I AS A CONSEQUE OF):
CoCDl\l
Z1.
:-
.inllllY-'
:Of\$8I.ooduth
..,.RAI ,tS7/"/~L. -
WA,S CASE REfERRED TO A U
Yu
27. PART I: E_...__,lnJurIM..........-..-......,h-..l....
Uot.....,__....__.
PARTII: OlNw"~condilion.Cl:lfIIrbItinglodNlh,but
notreUlingln lheundertying QUS8giyen In PART..
I2.CIN0.mA
l'.
,
.
Qt,lE1O{ORIo.S",COOSEQllE OI'};
DUE TO (OR AS A OF:
DATE Of INJURV
jMon... Oay. V_I
TIME Of INJURV
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
H_
Pendlnglnveslig8l/Qf1
o
D fuDNoD
03GiI. JOb. M.30c.
PLACE Of INJURY -At home, "'nn. strHl., fador)'. aIfIce
lluIkling..k:.(S~1
....
"PRONOUNCING AND CERTlFYINO PHYlNClAH (Phy$ll::lan bolh ncing dOillh ilnd certifying to cause 01 delllh)
To..... bell of I"IIf knowledte. deeth occwred ill .....llme, d..... p1ace, iIIId dull 10 the ce_le) end INnner.. ....l.d..........
30d.
L.OCATION (Streel, CilyfTown. State)
....
SIGNATURE AND TITLE Of CERTIFIER
~h::.~~.~.~~.~~~.~.~~~............ .. 0 31b. ;?, (. .5C ~ /'1, b'
LICENSE NUMBER DATE SIGNED (Uonlh. Pey, Yeer)
.031,. <3'321/<,'122- "d. S/25 OS
MAME,J.HO ADDRESS OF PERSOHWHO COMPlETED c.\USE OF D~'f!'i
(Item21)TypeorPrinl {2, (, SCH WIJf2.-72. />? l~
m.....~.~~~.~.~.~tJm.,dete,WId~..~~.~~.~.~~~(.~~.~~. 0 U. ~??rLoNJ)d j)~~~ / A~
DATE FILED lMonlh, o.y. Yeer)
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Could not be detennined
st Will and Testament
I, George William , Jr., 510 Springhouse Road, Camp Hill, Cumberland County,
Pennsylvania, being of s und mind, memory and understanding, do make, publish and declare this
my Last Will and T es ent, hereby revoking and making void all wills or declarations by me at
any time previous to this writing.
Item I: equeath all of my estate of every nature and wherever situate as follows:
A. One-thir to my daughter, Janice Rae Mitrovich
B. One-third to my daughter, Linda Rae Grant
C. One third to my son, David William Rae
Item II: I appoint m daughter, Janice Rae Mitrovich, Executrix of this my Last Will and
Testament.
Item ill: No fiduciary cting hereunder shall be required to post bond or enter security for the
faithful perfo e of her duties in any jurisdiction.
In witness whereof, I, orge William Rae, Jr., have to this my Last Will and TestaJ11e!lt, so
documented and signed elow.
/ 0 ..;j~/)fy ~e Y .
Date .. :.:1.
f',,)
Signed, sealed, publishe
Will and Testament,
presence of each other,
and declared by George William Rae, Jr., Testator, as and for his Last
in the presence of us, who at his request, in his presence and in the
ve subscribed our names as witnesses.
~
Witness
Notary Public
_00 . -NOTARIAL SEAL
HARlES A. HARBOLD, NotarY Public
Camp Hill Boro, Cumbel\8lId County
Commission Expire8 Dec. 30, 2006
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