HomeMy WebLinkAbout12-13-05
PETITION FOR PROBATE and G~J OF LETTERS
Estate of ANNA I. BLAUSER No. - n.r:; ,- ()q 0;;;"
also known as To:
Register of Wills for the
, Deceased, County of CUMBERLAND in the
Social Security No. 182-22-8042 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner( s), who is/are 18 years of age or older and the execut OR nam d
in the last will of the above decedent, dated JUNE 16 1999
and codicil(s) dated
WILMER J. BLAUSER - DIED OCTOBER 23 2003
(state relevant circumstances, e.g, renunciation, death of executor, etc.)
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, wit
hER last family or principal residence at 257 OLD CABIN HOLLOW ROAD LOWER ALLEN
TOWNSHIP CUMBERLAND COUNTY PENNSYLVANIA 17019
(list street, number and municipality)
Decedent, then 82 years of age, died 9/22/2005
at MANORCARE HEALTH SERVICES - CAMP HILL CUMBERLAND COUNTY PENNSYLVANI
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: NONE
Decedent at death owned property 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 Pennsylvania
situated as follows:
$
$
$
$
6000. 0
O. 0
O. 0
O. 0
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant ofletters TESTAMENTARY
thereon. ~ I / (-""'Y~~~;~;~:~-;;~::;~;~)
3 .X ~ h~ DILLSBURG PA 17019
g GARY .BLAUSER,EXECUTOR
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYL VANIA } ss
COUNTY OF CUMBERLAND
The petitioner(:s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief ofpetitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will w{ell a~ tru ministetje state according to law. v.,
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No. dJ -05--c::Ao&.-
Estate of ANNA I. BLAUSER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW 0 ~~~\.. l3 (-!J (XD , in consideration of the petition 0
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 6/16/1999
described therein be admitted to probate and filed of record as the last will of ANNA I. BLAUSER
and Letters TESTAMENTARY
are hereby granted to
GARY E. BLAUSER, EXECUTOR
FEES
Probate, Letters, Etc.. . . . . . . . $ gS CD
Short Certificates ( )...... $ 8.co
.a..-.--<' \ . ~ . t. '0 $ \5 CD
_~.All~~. . . . .. ..'_
o...,_-'-*u~p $ iX. 'fB
TOTAL _ $8:3 .C()
Filed. . .\9: -. \.2>: 9$ . . . . . . . . . . . .
ATTORNEY (Sup. Ct. 1.0. No.)
414 BRIDGE STREET
NEW CUMBERLAND PA 17070
ADDRESS
717-774-7435
PHONE
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This is to certify that the information here given is correctly copied from an original ce~'~ific~te of death du~~. f led with me as
Local Registrar. The original certificate will bt~ forwarded to the State Vital Records Othce tor permanent flh g.
WARNING, II is illegal to duplicate this copy by photostat or photograph. I
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Fee for this certificate. $0.00
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No.
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3 Rev. 2187
SEP 2420.0.5
Date
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CERTIFICATE OF DEATH
COMMONWEALTH 01' PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
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STATE F:lE NUMBER
..--.---.- SEX ~OCIALSECURITYIIUMeER
Blauser f.emale 3182 _ 22 __ 80l.2
UNDER -1 DAY Of... TE (1J: BIRTH BIRTHPLACE (City and PLACE 0'= DEATH Check ani one - see instru~lions on ther side
Hours I Minutes {Month, Day, Yuar~ State or F0rE:.lgn Country) HOSPITAL: OTHER:
I .04/30/23) Carep Hill, PA 10,.tI,." 0 EP/.:l",!"" 0 D.:lA 0 I Nm"'9 ~ . 0 0""'. 0
,~, 7.' __ 8a. ~ Residenc (Specify)
CITY BORQ, TWF OF :JFA TH FACILITY N,AME (If 'lot institutior" giv~ stn~et and nunber) WAS DECEDENT OF HISPANIC ORIGI~? RACE: (nerican Indian, Black, Whlte, el .
NOU Yes n If y'es, specify Cuban, (SpeC! ) .
8e. Camp Hill 8dManor Care Mex,can. Pue'rto' Rican. etc. 10. white
K!ND OF BLiS!NE.SS AS lJECECEN j EVER IN I MARlTAL STATUS. Manied, URVIVING SPOUSE
lJ.$. ARMEl) FORCF.:~? Never Marriftd, Widowed, 'twite. giv~ mn'dl'ln 'l'If"'f'~'
C' [Xl DivOfced (Specify,
12.Yes ~ No 13. (0-12111 14.widowed
17a. State Pennsylvania
NAME O. DECEDENT (First. M;odle. Lastl
Anna r "
1.
AGE (Last Birthday)
Cumberland
DECEDwrs USUAL OCCUPATION
\Glve kind ofworll none during n"losl
cf wonting life: do r.ot un retired)
lla. clerk llbpromotion
DECEDENTS MAI:.JNO ADDRESS (Street, CityfTown, State, Zip Code) DECEDENT'S
ACTUAL
RESIDENCE
(See instructions
on other side)
Cumberland
Did
decedent
live In a
township?
257 Old Cabin Hollow RD.
Dillsburg, PA 17019
17b. Countv
Crumlic
Items 24-26 r.1ust be completed by
person wl'1o pronounces death
To the best of my knowledge, death occurred at the tim~, date and place stat.ed.
\Signamrt: snd Title)
Lk/
!? ';10
IMMEDIATE CAUSE (Final
disease or condition
resulting in death)--+
23a.
~-:ME OF DEATH
124.
27. PART I: En~r the dl.e..... InJurl.. or compile_lion. whlcn caused the death. Do not .nter the mode of dy ng, ....ch as cardiac Of re.plrafl'ry arreat, .he.d, or heart failure.
Ust only one cau.. on each IInl.
Sequentially list conditions I b.
if any. leading to immediate
cause. Enter UNDERLYING
CAUSE {Disease or injury c.
thal initiated events
resulting on death) LAST d.
WAS AN AUTOPSY WERE AUTOPSY FINDINGS
PERFORMED? AVAILABLE PRiOR TO
COMPLETION OF CAUSE
OF DE;">TH?
DLJE TO (OR AS A CONSEQUENCE OF)'
MANNER OF DEATH
DATE OF 'NJURY
(Month. Dey, Year)
~-
o
o
Homicide
o
D
D
30.. 30b.
PLACE OF INJURY - At home, farm, street. factory, office
building, elc. (Specify)
30e.
Natural
Accident
Pending Investigation
Could not be determined
N~
Suicide
288. 28b.
CERTIFIER (Check only one)
*l~~J:F~:tGor::'~il~~eW:l.s~~:t},c~g~~~~cl~u~: te:: g,e:~a~~:~(:r~~3rJ~x~~~a~8 h:t~f~~~~~~ ,~~~~~, ~?~ ,:~~~~:,~, i.I~~ .~~),....,., ".",..,
29.
"PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death)
To the beat of my knowledge, death occurred at the time, date, and place, and due to the causes(a) and manner as slated.,....................
"MEDICAL EXAMINERlCORONER
~~~~:rb::I:t;:8~~~~.I.~~.t.I~~, ~~~~~r. ~~~~~~~~.~~~~~: .j~ .~~. ~~i~~O.~: .~~~~~ .~~~~~~~,~. ~~. ~~,~ .~I,~~:, ~.~~~:. ~.~~ .~~~.~~.'. ~~~ .~.~~. ~~ .t.~~. ~~,~~~~.(.~~ .~~~" 0
318.
REGISTRAR~NATURE~U~~'
33. U:/Jvn.... '( /~<Z...'2..(-i7J~A?-' ~i /HI / I" I 34.
15.
He. Ga Yes. decedent lived in
twp.
17d, 0 ~~h~e~~~~7\i~i~ of
city/bora.
1708&
.,)J, c:( () (1'::'~
TIME OF INJURY
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ep\wills\blauser.ann\6-99
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LAST WILL AND TESTAMENT
OF
ANNA I. BLAUSER
I, ANNA I. BLAUSER, of Lower Allen Township, Cumberland
+unty,
III
Pennsylvania, declare this to be my last will and revoke any
previously made by me.
ITEM I:
I devise and bequeath all of my estate, of every nature
and wherever situate, to my husband, WILMER J. BLAUSER, if he survives
me. Should my husband, WILMER J. BLAUSER, predecease me, I d vise and
bequeath all of my estate, of every nature and wherever situa
Should my son, GARY IE.
to my
son, GARY E. BLAUSER, if he survives me.
BLAUSER, predecease me, I devise and bequeath all of my estat~, of
every nature and wherever situate, to my issue, per stirpes.
ITEM II:
I appoint my husband, WILMER J. BLAUSER, Execu or, of
this my last will.
Should my husband, WILMER J. BLAUSER, fai to
qualify or cease to act as Executor, I appoint my son, GARY E
BLAUSER, Executor of this my last will.
post :::: ::r ~nt:: ::::::::y f::t::: ::::::::r p:::::m::c~e:":F~' ::tie~
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in any jurisdiction.
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Page 1 of 4
or ,
IN WITNESS WHEREOF, I, ANNA I. BLAUSER, have hereunto set my hand
and seal this I (,,:~ day of
}iU~
L/
, 1999.
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G~ (/'Z/7?~A /;~ ~2~~~ e --
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SIGNED, SEALED, PUBLISHED and DECLARED by ANNA I. BLAUSER, the
Testatrix above named, as and for her Last Will and Testament,' and in
the presence of us, who at her request, In her presenc~ and ij the
presence of each other, have subscribed our names as wltnesse .
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Wltness(
'fly 6>4/,Y ,A~>k/ ~~ ~~ ~
Addres~- I /7070
~n/yL-d.- Yh. Fh-n-h<-"/ tfj
Wltness
'11././..(/ tU)-n('-<-_-L-U-~ /'4
Address
COMMONWEALTH OF PENNSYLVANIA:
SS:
COUNTY OF CUMBERLAND
Page 2 of 4
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tal the at-
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accprding
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I, ANNA I. BLAUSER, the Testatrix whose name is signed
tached or foregoing instrument, having been duly qualified
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BLAUSER, the Testatrix, this
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to law do hereby acknowledge that I signed and executed this tnstru-
ment as my last will; that I signed it willingly and that I stgned it
as my free and voluntary act for the purposes therein containld.
" . /00,'1 I <{fA~SER" + '- -
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Sworn to or affirmed to and acknowledged before me by ANNA I.
/'-;; c, day. of ()~ , 1999.
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NOTARIAL SEAL
PATRICHIA L YOTER, Notary Public
New Cumberland Bora. Cumberland Co.
My Commission expires Nov. 18. 2002
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
we,4~
f':
and /(ir1ViLtL 'ns H.1 .:I-.-LiL-?lJ'
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law,
depose and Isay that
the instrumrnt as
that she ex~cuted
I
we were present and saw Testatrix sign and execute
her last will; that Testatrix signed willingly and
it as her free and voluntary act for the purposes therein expr~ssed;
Page 3 of 4
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that each of us in the hearing and sight of the Testatrix
Sig~ed
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the
will as witnesses; that to the best of our knowledge, the Tes atrix
was at that time eighteen or more years of age, of sound mind and
under no constraint or undue influence.
~ rn. /cIo'-/zLR-/~.Cff..
Witness
Sworn to or affirmed to and
me by
~/ A I~ /
. O. (2 J)i!eT~' and
o ~
wi tnesses, this / ~ -J/A day of [
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PATRICH~OTAR'ALSEAL
New Cumber~lg~~'c Notary PUblic
My CommissIon &Plres ~JtOeJl'land CO.
I,OV. 8, 2002
Page 4 of 4