HomeMy WebLinkAbout09-12-05
Estate of
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
No. rA I- OS .~{)<S II
Donald A. Gelbauqh
also known as
, Deceased
Social Security No. 193-12-9024
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A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executor named in the laS~~i11 ofT e
Decedent, dated June 8, 2005 and codicil(s) dated' ~
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State relevant circumstances, e.q., renunciation, death 01 executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution .of tha documeOtS.
probate; was not the victim of a killing and was never adjudicated incompetent; "J
fI) 0 11. ~ (11
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Petitioner(s), who islare 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
\-:...,
EJI B. Grant of Letters of Administration
(c.I.a., d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the followi g spouse (if
and heirs:
Name
Relationshi
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent, thenJ!Q years of age, died September 1 , 2005, at Carol n Croxton Slane Residence
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property ............................................... $
(If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
(If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Value of real estate in Pennsylvania ........................................................... $
Total ........................................................................... $
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of lett rs in the
appropriate form to the undersigned:
Si nature
Isabel C. Gelbaugh
21 Cumberland Road
Lemo ne, PA 17043
Form RW.l Page 1 of 2 (Dauphin County. Rev. 9/92)
II
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing
Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and !that, as
personal representative(s) of the Decedent, Petitioner(s) will well and truly administer ~he estate
according to law. I
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Sworn to and affirmed and subscribed
before me this \ a.+~../ day of
~ i~'t'-Y\ 'cu...'v 2005
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DECREE OF REGISTER
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Estate of Donald A. Gelbaugh
Deceased No.~' -O~) (VII
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also known as
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Social Security No: 193-12-9024 Date of Death: September 1. 2005 .. :.':)
AND NOW, ~V_YY1~ "-- \ ~ ,2005, in consideration of the Petition on me
side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters IKJ Testamentary D of Administration
everse
(c,t.a.: d.b.n,c.t.: pendente lite; durante absentia: durante minoritate)
are hereby granted to
Isabel C. Gelbaugh
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of D cedent.
FEES
Letters............. ..............
$ ",3\ Q .l)\')
,LJ h I ~~~, '" ~'i7~; 71'
RegIster of Wll~'\ l\,~~v>~), ,~
G tu.Q'fU3\
Short Certificate(s) ~)... $ \\..0 00
Renunciation ( )............ $
Affidavit ().................. $
E~nl Pages ( ).~LL $' 5 cO
CodiciL.......................... $
JCP Fee........................ $ \0 .CO
Inventory & Tax Forms... $
OtherC~~"rr.~:~..&."- $ S OD
Attorney:
J.D. No:
Address:
~~:~:EROgerS ~1-1p1~l
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415 Fallowfield Rd. Suite 3011
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Camp Hill. PA 17011 I
717-612-5801 !
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TOTAL............... .
$ 3S~, ,o()
Telephone:
DATE FILED:
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This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
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Local RegIstrar '
No.
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SEP 0 3 20051
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P 11689358
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Rev. 2187
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COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
NA'MEOFSECEDE~~~cjdie~~--'----"---_.'---------"----------- 'S~)( --- SOCIAL SECURITY NUMBER
9024
1.
Donald A. Gelbaugh
2. Male
,.193 -12
AGE 'Last 8irthOay)
UNDER' YEAR
Months Days
UNDER 1 01<<
~"
Hour!! : !.41nutes
BIRTHPLA"CE :c.t'y ar:d PLACE OF DEATH rC"'eclc only I)ne -- ->ee InSlrucl.ons on othel SIde)
3tale rn Fcre~n Counlr") HOSPITAL
:npahent 0 ERJOutpatlenl P
Harris burg, P ...
FACILITY NAME (It nollns.1Llullon. give street and numben
80
v"
..
COUNTY OF DEATH
lb.
k.Susquehanna Twp
KINO OF BUSINESSJlNDU$TRY
Residence
Dauphin
DeCEDENT'S USUAL OCCUP~ION
(~iV:Ok:ri~tli;:~d~eu~r~~Wr~
11.. Vice President llb. Byerly Insurance
DECEDENT'S MAILING ADDRESS (Slreet. CllylTo.....n, SIale tip COde) OECEDENT'S
ACTuAL
RESIDENCE
(See InslrucrKmS
on other side}
MARITAL STATUS - Married
N....er MalTied, Widowed,
Divorced (Speclty)
Married
17a. Stale__!:'~____ Old
decedent
live in a
17b.County Cumberland townsr.ip1 17d,KJ ~j,~=~j=Of
MOTHER'S NAME:-: (F,rs\. Middle, Malden Surname)
Florence Peace
17C.O YltS,decedentlivedin
21 Cumberland Road
Lemoyne,Pa 17043
Lemoyne
...
FATHER'S NAME (First. Mioale. Last)
,.. Alexander Gelbaugh
INFORMANT'S NAME (TypelPrintl
2... Isabel Gelbaugh
METHOD OF OISPOSITIQl1.
O Bunal L1- Cremation 0 Removal from Slate 0
DonatIOn Other (SpecJfyL--
. 21..
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9,2005
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INFORMANT'.3 MAILING ADDRESS (Street. Cityfrown. Slale. lip Code)
2Ob. 21 Cumber land Road Lemo ne, Pa 17043
PLACE OF D1SPOSITION. Naf""le 01 Cemelery, CrematOfy LOCATION - CityfTown, State, LIP
or Other Place
21cHarrisburg Cemetery
NAME AND ADDRESS OF FACILITY
ncM ers-Harner Funeral Home
PERSON ACTING AS SUCH
LICENSE NUMBER
LICENSE NUMBEP
22b. 011654-L
To lhe t 01 my knowledge, death occurred at ~he time, date aild pla~':'8 slat~d
(Signalure and Tine)
2:!a.
T'ME OF DEATH , ~RONOUNCED DEAD (Mon"'. Day. Vean
24, . ~ M. 25.
27. PART I: Enter Ihe diseases, injurieS or complications which caused the death, Do not enter the mode 01 dying, such as cardiac or resplralcry arrest, shock C"r heart failure
List onty one cause on eaCl11ine
ttems 24-26 must be completed by
person who pronounces dealh.
IMMEDtATE CAUSE (Final
disease or condition
resulting in dealh)-
il~ [) /lo I'V\ ,;
2..
I Approximate
: intervat berween
I o~ and death
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:
PART II:
C'/.M!. (I/./" 0 Ii)
DUe TO (OR AS A CONSEOUENCE OF).
S8Quentialty list conditions
if any, leading to immediate
cause. Enter UNDERLYING
CAUSE (Disease or ,nfUry
" that irutiated events
resulting in death) LAST
b.
DUE TO (OR AS A CONSEOUENCE OF):
DUE TO (OR AS A CONSEQuENCE OF).
WAS AN AUTOPSY
PERFORMED?
d
WERE AUlOPSV FINDINGS
AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OFDEJIJ"H?
v.. 0 NoD
MANNER OF DEATH
DATE OF INJURY
(M()(lth Day. Year)
T\ME OF INJURY
INJURV AT WORK?
2'.
[]
[]
[J ~'CE OF INJURY. At hOme. tar;,O:~eAI. factory, olflce M.
building, elC, ISpec,t...\
,...
JQc:. 3Od.
LOCATION (Street CitvlTown. Stale)
NatUl'st 0
Accidenl [J
Suicide []
Homicide
Pending Invesligatlon
v.. 0
No 16
v.. 0
NoD
Could nol be del ermined
.2811. :l8b,
CERTIFIER (Cl1eck only one}
.CERTIFYING PHVSICIAN (PMY$IC~n cer!lly'ng cause 01 death whe'" another physloan has pronounced death and completed ilem 23\
To the blest 01 my knowledge, death occurred'due1t1the cause(s) and manner.. stated. .
[]
. PRONOUNCING AND CERTIFYING PHYSICIAN (PhySICian balh p,onounc>ng deatn and certifYing 10 cause 01 dealhl
To the best of my knowledgf!, death occurred at Ihe lime, date, and plllce, and dUfr to the cause(a) and manner II. stated..
[]
"MEDICAL EXAMINER/CORONER
On the baals of examination and/or Investigation, in my opinion, death occurred althe time, date, and place, and due to the C8use{s) and
manner a. staled.. . . . . . . . . . .. ..,........ ................ .. ..,..".,................ ...... .,..,..... ........
3'11.
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'2.
DATE FILED (Month Day, Year)
REGISTRA 'S
JURE AND ~MBER
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RACE. Ame can Indian, Black. White. ate
(Speclly)
10.
White
SUR IVtNG SPOUSE
{II WIle, lve mclloen namel
15. Isabel Carpenter
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cifylboro
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Last Will and Testament
OF
DONALD A. GELBAUGH
I, DONALD A. GELBAUGH, of the Borough of Lemoyne, Cumberland
County, Pennsylvania, do make, publish and declare this to be my Last Will ana;~
Testament, hereby revoking all Wills and Codicils by me at any time made. G~,
ITEM 1: I direct that all inheritance and estate
taxes becoming due by reason of my death, whether payable by my estate or by aq.y
recipient of any property, shall be paid by the Executor out of the residue of my
estate, as an expense and cost of administration of my estate. The Executor shall
have no duty or obligation to obtain reimbursement for any such tax so paid, evenl
though on proceeds of insurance or other property not passing under this Will.
ITEM II: I direct the Executor to pay the expense~
of my last illness and funeral expenses from the residue of my estate as an expens~
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and cost of administration of my estate.
ITEM III: I may leave a writteu'statement or list in
my safe deposit box disposing of certain items of my tangible personal property not
otherwise specifically disposed of herein. Any such statement or list in existence at
the time of my death shall be determinative with respect to all items devised
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therein. If no written statement or list is found in my safe deposit box or elsewhe~e
and properly identified by the Executor within thirty (30) days after the probate o(
my Will, it shall be presumed that there is no such statement or list; any
subsequently discovered statement or list shall be ignored.
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ITEM IV: If I predecease my wife, ISABEL C.
GELBAUGH, a/k/a ISABEL C. MASLAND, I give and bequeath to her absolutely
and in fee simple all of my household furniture and furnishings, books, pictures,
jewelry, silverware, automobiles, wearing apparel and all other articles of
household or personal use or adornment and all policies of insurance thereon not
disposed of pursuant to the written list referenced in ITEM III. If I do not
predecease my said wife, I make said be;~uest to the children of my wife living at the
time of my death, to be divided among them as they shall agree. Should there be no
agreement, such property shall be divided among them by the Executor in as neaJly
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equal portions as is deemed practical in the sole discretion of the Executor, havin~
due regard to the personal preferences of such children. i
ITEM V: I give my cemetery lots located at the
Zion Cemetery on Route 22, Harrisburg, Pennsylvania (adjacent to the Zion
Lutheran Church) to my former sister-in-law, MARION PECK, if she survives me;
ITEM VI: I give, devise and bequeath all the rest, i
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residue and remainder of my estate, not disposed of in the preceding portions of t*s
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Will, and after the payment of all taxes specified in ITEM I, as follows: '
(a) FIFTEEN PERCENT (15%) to my sister, NAOMI
BAUGHMAN, if she survives me. If she does not survive me I make
this gift to my niece, DONNA JEAN FARNHAM;
(b) FOUR PERCENT (4%) to MARION PECK, if she
survives me. If she does not survive me I make this gift to my wife,
ISABEL C. GELBAUGH a/k/a ISABEL C. MASLAND;
Page 2
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(c) TWO PERCENT (2%) to JEANNINE MAY, if she
survives me. If she does not survive me I make this gift to her
children, GREGORY and CHRISTINA MAY, to be divided equally
between them;
(d) SEVEN PERCENT (7%) to my niece, DONNA JEAN
FARNHAM, if she survives me. If she does not survive me I make
gift to her daughters, KIMBERLY PETRIDES and KRISTIN NICKEL,
to be divided equally between them;
(e) SEVEN PERCENT (7%) to my step-daughter, CAROL
M. GLEESON, if she survives me. If she does not survive me I make
this gift to her children, KATHRYN GLEESON and CHRISTOPHER
GLEESON, to be divided equally between them; and
(f) The balance to my wife, ISABEL C. GELBAUGH a/k/a
ISABEL C. MASLAND, if she survives me. If she does not survive,
this SIXTY-FIVE PERCENT (65%) shall be distributed as follows:
(i) TWENTY-FIVE PERCENT (25%) to the
J. DONALD CARPENTER FOUNDATION, created under
an Agreement of Trust dated January 31, 1997;
(ii) TWENTY PERCENT (20%) to the CLEVE
J. FREDERICKSEN LIBRARY, Camp Hill, Pennsylvania; and
(iii) TWENTY PERCENT (20%) to the AMERICAN
CANCER SOCIETY, Harrisburg, Pennsylvania.
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ITEM VII: In the settlement of my estate, the
Executor shall possess, among others, the following powers:
(a) To retain any investments I may have at my death,
including specifically those consisting of stock of any bank even if I
have named such bank as the Executor herein, as long as the Executor
may deem it advisable to my estate so to do.
(b) To vary investments, when deemed desirable by the
Executor, and to invest in such bonds, stocks, notes, real estate
mortgages or other securities or in such other property, real or
personal, as the Executor shall deem wise, without being restricted to
so-called "legal investments", and without being limited by any statute
or rule of law regarding investments by fiduciaries.
(c) In order to effect a division of the principal of my estate or
for any other purpose, including any final distribution, the Executor is
authorized to make said divisions or distributions of the personalty
and realty partly or wholly in kind, and to allocate specific assets
among beneficiaries hereunder so long as the total market value of any
share is not affected by such division, distribution or allocation in kind.
Should it appear desirable to partition any real estate, the Executor is
authorized to make, join in and consummate partitions of lands,
voluntarily or involuntarily, including giving of mutual deeds,
recognizances or other obligations, with as wide powers as an
individual owner in fee simple.
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(d) To sell either at public or private sale and upon such
terms and conditions as the Executor may deem advantageous to the
estate, any or all real or personal estate or interest therein owned by
the estate severally or in conjunction with other persons or acquired
after my death by the Executor, and to consummate said sale or sales
by sufficient deeds or other instruments to the purchaser or
purchasers, conveying a fee simple title, free and clear of all trust and
without obligation or liability of the purchaser or purchasers to see to
the application of the purchase money or to make inquiry into the
validity of said sale or sales; also, to make, execute, acknowledge and
deliver any and all deeds, assignments, options or other writings which
may be necessary or desirable in carrying out any of the powers
conferred upon the Executor in this paragraph or elsewhere in my
Will.
(e) To mortgage real estate, and to make leases of real estate.
(f) To borrow money from any party, including the Executor,
to pay indebtedness of mine or of my estate, expenses of
administration or inheritance, legacy, estate and other taxes, and to
assign and pledge assets of my estate therefor.
(g) To pay all costs, taxes, expenses and charges in
connection with the administration of my estate.
(h) To vote any shares of stock which form a part of the
estate, and otherwise to exercise all the powers incident to the
ownership of such stock.
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(i) In the discretion of the Executor, to unite with other
owners of similar property in carrying out any plans for the
reorganization of any corporation or company whose securities form a
part of the estate.
(j) To disclaim any interest in property which would devolve
to me or my estate by whatever means, including but not limited to the
following means: as beneficiary under a will, as an appointee under
the exercise of a power of appointment, as a person entitled to take by
intestacy, as a donee of an inter vivos transfer, and as a donee under a
third-party beneficiary contract.
(k) To do all other acts in the Executor's judgment deemed
necessary or desirable for the proper and advantageous management,
investment and distribution of the estate.
ITEM VIII: Any person who shall have died at the same time as I
shall have, or in a common disaster with me, or under such circumstances that
the order of our deaths cannot be established by proof, or within thirty (30) days
of my death, shall be deemed to have predeceased me.
ITEM IX: If at any time any beneficiary under
the age of twenty-five (25) shall be entitled to receive any assets hereunder, the
parent of such child who is related to me by blood, or who is the issue of my wife,
ISABEL C. MASLAND, shall act as Custodian of the assets payable to such child
under the Pennsylvania Uniform Transfers to Minors Act. If such person is
unable to act, the other parent of such beneficiary shall serve as Custodian. Such
Custodian may receive and administer all assets authorized by law, and shall
Page 6
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have full authority as provided in the Pennsylvania Uniform Transfers to Minors
Act to use such funds in the manner it deems advisable for the best interests of
such beneficiary. In addition, said Custodian shall have all the rights and
privileges as to the Custodianship and its assets as are herein granted to the
Executor as to my estate and the assets therein. I also designate said Custodian
as successor Custodian of any property for which I am custodian under any
Uniform Transfers to Minors Act or Uniform Gifts to Minors Act.
ITEM X:
I hereby nominate, constitute and
appoint my wife, ISABEL C. GELBAUGH, to be the Executrix, herein referred to
as "Executor". In the event of her death or her inability or refusal to serve, I
nominate, constitute and appoint DONNA JEAN FARNHAM to be the Executor.
In the event of the death, inability or refusal of both ISABEL C. GELBAUGH
and DONNA JEAN FARNHAM to serve, I nominate, constitute and appoint
JOHN C. MAS LAND to be the Executor. The Executor and Custodian are
specifically relieved from the duty or obligation of filing any bond or other
security.
IN WITNESS WHEREOF, I have set my hand and seal to this, my
Last Will and Testament, consisting of this and the preceding six (6) pages, at
the end of each page of which I have also set my initials for greater security and
better identification this g- day ofb , 200C
~~cr./~/ (SEAL)
DONALD A. GELBA:U'OH
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We, the undersigned, hereby certify that the foregoing Will was
signed, sealed, published and declared by the above-named Testator as and for
his Last Will and Testament, in the presence of us, who, at his request and in his
presence and in the presence of each other, have hereunto set our hands and
seals the day and year first above written, and we certify that at the time of the
execution thereof, the said Testator was of sound and disposing mind and
memory.
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kSEAL)
Residing at$/);;f~ ~!
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF )
I, DONALD A. GELBAUGH, Testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified according to law, do i
hereby acknowledge that I signed and executed the instrument as my Last Will
and Testament; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
~~A:~
DONALD A. GE~ AUGH
(SEAL)
Sworn to and subscri~ ~~f~re
me this ~k. day of ~
,20DS.
~~
Notary Pu lic
My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
NOT ARIAL SEAL
CYNTHIA J RULE, Notary Public
Camp Hill 80ro., Cumberland County
My Commission Expires Febru 3. 2008
II
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF )
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We, J;1t~ J. db-II and 2)'(Jcf p~(\ ,the
Witnesses whose names are signed to the attached or foregoing instrument, being
duly qualified according to law, do depose and say that we were present and saw
Testator, DONALD A. GELBAUGH, sign and execute the instrument as his Last
Will and Testament; that Testator signed willingly and that he executed said
Will as his free and voluntary act for the purposes therein expressed; that each
us in the hearing and sight of the Testator signed the Will as Witnesses; and that
to the best of our knowledge the Testator was at that time eighteen (18) or more
~
years of age, of sound mind and under no constraint or undue influence.
a;~[~~
Witn s
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d~
Witness
Sworn to and subscri~ before
me this ~~ day of ~
, 20D-S.
~~rLL
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My Commission Expires:
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
C NOTARIAL SEAL
YNTHIA J RULE N
Camp Hill 8 . ,olary Public
M ora, Cumberland C
Y Commission Expires Februa ~~
87772 1
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