HomeMy WebLinkAbout01-23-06
Register of Wills of Cumberland County
Estate of .:;r R./1 171
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
~/-Q(y'-lD1
'77 }
~ .<: cJ (:./1 e;e
No.
To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
, Deceased.
Social Security No. / 9.3 - 0 7- G 3 7/
The petition of the undersigned respectfully represents that:
Your petitioner(s), who' lare 18 years of age or older, and the execut_ named in the last will of the
above decedent, dated /'?- G.>- ,20
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in f u >n /3 e ..e L. .4Y7 J"")
Penilsylvania, with hi:?last family or principal residence at
County,
(list street, number and municipality)
Decedent, then~ years of age, died /7/ J/1..-11,20 o~, at ~ 5'S-j4,.J.,J l/'2.4_40 ~ec;?~.JC--'6~
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:
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;
,<s'- 00,,:/
./
$
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented
herewith and the grant of letters
thereon.
~~~~
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
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Residence( s) of Petitismer(s) ,c:;'
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Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYLVANIA
}
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 of petitioner( s) and that as personal representative( s) of the above
decedent petitioner(s) will well and truly administer the estate accord~o law. .
Sworn to or affirmed and sl,tbscribed {'j ./ ~ ~
Before me this <>;l ~ Q\) day of
-S~~\;)..\:)."(~ , 20 ~~ _
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Register N^I, \
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Estate of I"\I~ f(llDvl v \ , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW \J kN (,.Lll1\ \.fl4 20 O~ in consideration of the petition on the reverse side
hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s), dated
.-l0. Lv. 105.- , described therein be admitted to probate filed of record as the last will of
IRA- IYIPrLCOIY) \B LOCl--l PR ; and Letters are hereby granted to ~ cl3E:RT .B LOCH ~
FEES
Probate, Letters, Etc. ............. $
Will ................................. $
Renunciation... . . . . . . . . . . . . . . . . . . . . $
Short Certificates (6) ............ $
J CP . . . .. .. .. . . . . . . . . . . . . . . .. . .. . . . . .. $
Automation Fee.. . .. .. .. .. .. .. . ... $
Bond................................. $
Total 5 $
Filed J"PrtJ. L3.. - 20C(o
toO.DD
ISDO
18:88
6.00
Attorney (Sup. Ct. LD. No.)
Address
1).;1.00
Phone
Register of'\ViUs of Cumberland Counri
OATH OF NON-SUBSCRIBING 'WITNESS
Estate of J/r/1 ~~ <'c>.i-rrr g~c.-74->e No. ~J - DiP -Dlv'l
Also known as
, Deceased
/j e'l {'/\ I~ \Gc. (\e z
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of "~/l YYl 3L,c,.l.Ie-/Z... , testat_ of (one of the
--
subscribing witnesses to) the codicil/will presented herewith and that _ believefbelieves the signature
on the codicil/will is in the handwriting of to the best of
knowledge and belief.
Sworn to or affirmed and subscribed
Before me this c).. ~ ~~ day of
"S~~'-:)."'-'( '-..1. , 20 ~\, "
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eglster . .\
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Deputy .~ \ - \ ---~~
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(Address) \ 1M. \L(^,(WiQJ f~ ~~
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This is fe) certify that the informcltion here given is u,rrectlv [rum '111 original certificate ..if decHh duly filed with me as
Local Regim'ar. The origic:d certificate will be forwarded [() tt~t >rart Vital Records OffiCe for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
..___~_233~_
No.
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-F+~ Date
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HI05.143Rev.2187
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS
CERTIFICATE OF DEATH
MOTlf:;~n(F'! '1lfl1:rSumame}
...
INFORMANT'S MAILING ADDRESS (StrMl. Cilvr!OHO S!at"" ?;" r.".i.~)
200.213 ;;a1nut Cirole Shiremanstown, PA 17011
PLACE OF DISPOSITION. Name 01 Cem8l8fy, Crematory LOCATION -CltyflOwn, SCale, Zip Code
81~~g Green Memorial Park Lower Allen Twp.,
TVPElPRlHT
IN
PERMANENT
BLACK INK
NAME OF DeceDENT (First. Middle, last)
t. Jane
AGE (Las! Birthday) UNDER 1 YEAR
Monttui Days
Blocher
SEX
2Female
E.
UNDER 1 DAV
t-tours ! MlRUt..
BIRTHPlACE (City and
State or ForttignCOllntfy)
echanicsburg
A .
5. 74
COUNTY OF DEATH
v"
. ..Cumberland
DECEDENT'S USUAl. OCCUMlON
~~Uf~~u'::~:f
"Cashier "food chain
DECEDENT'S MAILING ADDRESS (Srael., CityllOwn, &ate, Zip Code) DECEDENT'S
ACTUAL
RESIDENCE
(See inSlruchons
on Olller side}
o
III
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218 Walnut Cirole
Shiremanstown, PA
II.
OOHffi."y~; (Fa'. "Ya'ttte r
...
INf(1"~"SMAME3~cher
....
MHHODOF LHSPOSlfI~ --_.
. Burial t:.J Cremillion 0
Donation 0 Other (Specll)o\
21..
SIGNAl
17b. Count
17011
Cumberland
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'0
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DUE TO (OA AS A CONSEOUENCE Of):
.:J
, I)
---
WERE AUlOPSY FINDINGS
AVAILABLE PAIOA TO
COMPLETION OF CAUSE
OF DEATH?
MANNER OF DEATH
DATE OF INJURY
(Monlh, Day, Year)
cY'"
o
o
aWE FtLE NUMBER
SOCIAl SECURITY NUMBER
.. 183 -12 -3122
DATE OF DEATH (Month, Day, Year)
.)laroh 19. 1994
='lyiO
MARITAl SW . Matried
NeverMlIf'rilId,~,
Dlvo<ced_
,'-'arried
RACE . American Indian, Black, White, etc.
(Specify)
,.l'hite
SURVI\ItNG SPOUSE
(II wife. give maiden name)
M Blooher
.....
1110 =~~=Ol Shiremanstown
cil)'/boro
Camp
. .
NAME AND ADDRESS OF FACIU
2~7 E. Main St.. Meohanicsburg. rA 17055
LICENSE HUMBER
ORE SIGNED
~,Oay,'l'eaf)
2:Jb. OS 00 ~I <,3t;'L
W'.S CASE REFERRED TO MEDfCAL EXAMINE
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PART II: Olhef s\gnltkanI conditions contribI.lting to death, but
not rnuIling In the undertying taUM given in PART I.
TIME OF INJURY
INJURY /il WORK?
OEscmBE HOW INJURV OCCURRED.
'y
c-
Accident
Pending Inllesligatioo
o
o
o ~EOFINJURV.Athome,farm~~Mt,faclOl'Y'Oflice M.
building, .Ie. (SpeCify)
....
Ye, 0 NoD
Nalurat
Homicide
<:::$
NoD
Suicide
Could not b8 determined
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H105143 Re~ 01'06
TYPElPRINT IN
PERMANENT
BLACK INK
1 Namt!01 Oecedenl (fIfSI.rr<<ldle,last)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
Ira Malcolm
Blocher
195-07-
IB
2006
3. Social Security Nurrbef
;~ l' Decedenfs Usual Oc,: ahon Kind 01 work done dUlin IT'(lsl 01 workin Ille; do not slale rshred
Car R e ffA ",.1'11" man R a Kl'f' ~"o'a"a,"SI~
Cumberland
Upper Allen
Other
o ERIOu lienl 0 DCA Nursin Home 0 Residence 0 OIhe.
9 Was Deceden 01 Hispanc Origin? 10. Race Ameri:an Indian, Black, Wh.e, ele
;(:J No 0 Yes (II yes. specify Cuban. jSpeciIy)
MexICan, Pu8I1o Rican, ele.) W hit e
12
n h /lest radeco Ieled
CoIIe\18 (1.4 0' S..J
2
14 Mantal Stalus Married, Never roamed. 15 SUNftillli Spouse (il Wile. gMI maiden name)
Widowed. Df\IOI'ced ($pscitrl
Wi ow
16 Decedent's Mailing AddlllSS (Slree!. clfyAown, stale, zip code)
213 Walnut Street
Shiremanstown PA 17011
17b. COO"~_Cll~be r_l~~~_
Did Decedent
live in a 17e 0
Township?
Yes. Decedenllived in
__ Twp
l1d )Q
No, Decedentlivedwilhin
Actuallirhts of
Shiremanstown
._____._._____~__CllylElofo
18. Falhei's Name (First, mddle, last)
19. Mother's Name (First. middle, maiden surname)
IRA CLARENCE BLOCHER
EMMA CECELIA STONESIFER
20a Inlormanl's Name (Type/print)
Robert M. Blocher
2Ob. fntormanl's Mailing Mdress (Slreel, cityllown, state, zip code)
2197 Brunswick Avenue Mechanicsburg PA 17055
o
w
en
::J
en
..
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21b Date 01 Disposition (Mon1h, day, year)
21C Place of DISposition (Name 01 cemetery, clemalOfy or ollier place)
2td. location (Cityllown, stale, zip code)
22b. licenseNurrtler
Fd-012662-L
Rolling Green Memorial
22c. Name and Mdress of Facility
yers Funeral Home 37
Par Camp Hill PA 17011
East main St. Mechanicsbur
23b licenseNUITil81
DYes 0 No
(~
Ilem2? Part I El1t8flhe~-dlSea~es. inju/IEl~,orwnrpIicaIiOfls -that dlrlilClly caused Ihe death DO NOT entertemlnal events such as cardIaC alfesl.
resplfatory anes!. Of ventricular fiblillalion w~hout showing the etoogy DO NOT abbreviate Enler only one cause on a line
IIIMEDIATE CAUSE (Flflaldisease Of
cOl'ldfunresullingindealh) ----3l>
ApprOlnmateintBrval
onsel10 dealh
Patlll. Enter other sianiftcanl conditIOns contribulina 10 dealh,
but nollesuling in !he underlying cause given in Patll
Due 10 {or as a consequenceoQ
_fi.<2.!::.:J__n_ _ u __
~':!_&,2Li.__/'~~~~
28 Did Tobacco Use Contribute 10 Dealh1
DYes 0 Probably
o No }iCUnknown
29 If Female
o No! pregnant within past Yilal
o PreQf\lntatllmeofdealh
o Not pregnant, bul pregnanl wllllin 42 days
~dealtl
o Not pregnant, bul pregnant 43 days 10 I yeal
betM'edwlh
o Unknowfl if pregnant WIthin Ihe pa~1 year
32c Place oflnPJry: Home, Filfm. $Ireet, Faclofy, ()fig
Building,eIc(SpedIyj
Sequenlialty ksI coodl\.:1os, if ilny,
leading 10 the cause listed or, lioea
- Enterlhe UNDERl ytNG CAUSE
(disease Of inlU'Y that irl4ia~ed the
illltlnlsrB$ulllngindealh) lAST
;--~~~:d.!1"iJ. Q{~~~-10:~~(Y
Due 10 {Ol ilS a cOflsequenceoQ
...::,r?' /L-' /7"'~_.!:_:~ _
DYes ji"NO
d
JOb Were Aulopsy FindlllQS
MililabloPJioIloCO"lllelion
01 Cause of Deillh?
DYes 0 No
31 Manner 01 Death
~Nalural 0 HOllw:ide
o kcidenl 0 PandinglnvestiQation
o SUICide 0 Couk! Nol Be Determined
32a. Dale 01 InJury (Month, day, year)
32b Describe how Injury Occurred
30a Was an hllopsy
Perlormed?
32d Timeollnjury
32efnJuryalWOfk?
DYes 0 No
321 lITranspotlation Injury{Specit>>
o D/iverlOperalOf 0 Passenger
o Pedestrian 0 Other - Specify
33b. Signature and Title 01 Certifier
.~ ,}:,--; J.!/.r 4~
32g. localion (Streel,c.yllown, slalej
M
33a Certifier (clleck only one)
Certifying phy"lc~n {PhysICloln certifying cause 01 dealh when anolher phYSICian has pronounced death and co~leled lIem 23)
To the best of my knowledge, ()e~th occurred due to lhe cause(sl ~nd manner ~s sUited on .
Pronouncing and certifying physlc~n (PhvslCloln boltl pronouflClng dealh and Cllflifylflg 10 cause of dealh)
To lhe besl of my know~oe, death occurred al the lime, dale, and place, and due 10 Ihe cause(s) and manner ~I slaled...
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33c license Nunt>el 33d Date SlgIled (Month, day. year)
O~O(/uYC(5"L: 08)>40
34 Name and Addr~.()t Person Who Co~leted Cause 01 De,l1h (Uerti 27) T ype/Pllnl
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"edic~t uamine,lcoroner
On the basis of euml~tion andlor invesligalion, in my opinion. de.lth occurred..t lhe time, date, and pl.lce, and due 10 the cause(s).nd manner as sl4lted.. 0
J5i'~'~':d:':'~N""~~ lc-v,.;. Jgl,-LL~~ =ti10~~"7~""'~'~Y:~
. ~ (See Instrucllons and examples on reverse)
1KCl1Jt DUI Club Qr~1JtClttWut
I, IRA MALCOLM BLOCHER, of the Township of Hampden, County of
Cumberland and State of Pennsylvania, make, publish and declare
this to be my Last Will and Testament, hereby revoking and making
void any and all former Wills by me at any time heretofore made.
1. I direct the payment of my just debts and funeral expenses
as soon after my death as may be convenient to my Executrix herein-
after named.
2. I give and bequeath my entire estate, re~l, personal and
mixed, unto my wife, Jane B. Blocher, provided she survives me by
a period of thirty (30) days.
3. In the event my wife, Jane R. Blocher, does not survive
me, or if by reason of a common disaster we ~oth receive injuries
resulting in death of both of us within thirty (30) days of each
other, I give, devise and bequeath my entire estate, real, personal
and mixed, in equal shares, to my sons, Robert, Thomas and Steven.
4. I appoint the Dauphin Deposit Trust Company to be the
guardian of the estate of any of my sons who may be minors at the
time of my death.
5. I nominate and appoint my wife, Jane E. Blocher, to be the
Executrix of this, my Will if she survives me. If my wife does not
survive me or is unwilling or unable to act in this capacity, I
nominate and appoint my son, Robert Blocher, to be the Bxecutor of
this, my Will.
IN WITNESS WHEREnF, I hereunto set my hand and seal this
I ttz ;(' ~
iJ', - day of (j..i!.A.-U.'<.. 1... 1 9 6 5 .
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_~ Signed, sealed, published and declared by the above named
~estator as his Last will and Testament in the presence of us, who,
8.:1: hisreqL1est, in his oresence and in the presence of each other,
n~ve hereunto subscribed our names as witnesses.
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