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Home My WebLink About04-04-06 PETITION FOR PROBATE and GRANT OF LETTERS No. 2-000 --02Q I To: Register of Wills fgr the I Deceased. County of Cum er .land in the Social Security No. 1 q 1 - 1 R -1 g 20 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ors in the last will of the above decedent, dated March 6 and codicil(s) dated None Estate of CATHARINE E. BOUSUM also known as named 1973 , - (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in h A r last family or principal residence at 801)+-11.]VIj t1c11l?t-nn rr()wn~'hip (list street, number and muncipality) rllMnprl.4l1n County, Pennsylvania, with Manor Care, Walnut Bottom Road, Decendent, then --B2__ years of age, died . . March 14. 2006 f{P9 , at Manor care, Carlisle (South Middleton Township) 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 Decendent 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: $ 3.500.00 $ $ $ None WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters te stamen tary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. . Bousum Hq4 Flagl~r Road Ga it hersb1)X'C}, 'Mn ? 0 H 7 H 'Yn1lJU..a.t:. 'f3~ .J~ ~ Marie E.Bousum-Forbes . 740 ~llpn 'Pn;qn rRrlisl~: PA 17013 OATH OF- PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF CTTMEEPLAND J The petitioner(s) above-named swear(s) or affirm(s) that the state nts in the foregoing petition are true and correct to the best of the knowledge and belief of etiti n (s) and that as perso represen- tative(s) of the above decedent petitioner(s) will and y inist tate according 0 law. CI:l ~. :::s ~ ~,p. !-~~~sum-F~ Q..h...te. _ ~ ~ A ~,I '9'JI1 -:--.. swor. n. . to or affirme~ and subscrib { before me this . ~fi day of -jjJj ~; dA I..ftl~_. --'JA. jJiAlY~ ~ Re ."ler No. Estate of CATHARINE E. BOUSU~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW a.ori) ,)j.-Ih )aJj?OOfl, 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 March 6, 1973 described therein be admitted to probate and filed of record as the last will of Catharine E. Bousum and Letters Testamentary are hereby granted to Richard M. Bousum and Marie E. Bousum-Forbes FEES P b ,~O.oo ro ate, Letters, Etc. ......... $ d.._ Short Certificates( 4) . . . . . . . . .. $ i(P, 00 n .. WJ't1 $ J5.oC! <<enunelatton ................ yep 'If tlu.Jo $ ,6.00 TOTAL _ $ 7(0.00 Filed . rA;.r.I. ~ .1,. !: 9.l!~. . . . . . . . . . . . . . . . . ~ --Iavu/f ~adlcLa C. Register of Wills'~ ~~ SNE A E , .ENNEMAN, P. C.C~~ (717) 697-8528 PHONE (; 1 I . .- ~r'lj" is to certify that the information here given is correctly copied from an original certificate of death d~ly filed with me as LIKal Regi,strar. 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. No. lIJt U~. ~ Fee for this certificate, $6.00 Local Registrar p 12337771 Jja~eh Hi j foo," Date Hl05143 Rev 01106 TYPElPRIHT IN PERU ANENT BLACK INK 1 Name 01 Decedent (First moddle, IaSI) COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMBER 5 Age (last b.,lhday) 82 Jan 24,1924 3 Social SecUlil't Null'ber .. Dale 01 Dealll (Month, day, yeal) Catharine E . Bousum 191 - 18 14 2006 Yrs 7. Dale 01 BiI1h Monlh, da . Cumberland South Middleton Care OIhe. o ERiOuI alieni 0 DOA Nurs Home 9. Was DllCedent 01 Hispanic OIigin? J! No 0 Ves (~yes, specify Cuban, MeXICan, Puer\o Rican, elc.) o Residence 0 OIher. 10 Race' American indian, Blac~, Wh4e. ele (Spec,ryj White Bb County 01 Death 11 Deeedenl's Usual Occ lion Kind of work done durin mosl 01 workin ~fe; do nol state relited Kind 01 Wor~ Kond 01 BusinesSllnduslry Legal Secretar Law ~ 16 Dececlenl's Mailing Address (Slreel. cil'tllown, slale, zip coOe) 740 Allen Road Carlisle PA 17013 17a Slate 13. Decedenl's EducallOn eel ElemenlarylSecondary (0.12) 12 -~A Cumberland hi sl ade c Ieled College (H Of 5+) 1. Malllal SlaWS. Matried, Never married, 15 Survivlllg Spouse (If 'NIle, gr;e maiden name) W~, DNorced (Sped)1 Did Deeedent live in a T01llnsh~? 17c ~ Ves,DecedenllNedin -s.outn--Mi.do le ton _ Twp 17b. County 17d 0 No, Decedenllived ....hln Acluallirrils of __ __________ Cfylfuo 18 Father's Name (F.sI, tOOdle, Ias!) 19. Molher's Name (FitSI, moddle, maiden surname) Raymond W . Boyer Gertrure Ly te r 201. Informant's Name (Typelpnnl) 20b Informant's Mailing Address (SI.eel, c~yllown, slale, zip coOe) Marie Bousum-Forbes 740 Allen Road Carlisle PA 17013 I o w (/) ::> (/) <C ~ 21b. Date of Dispos~lOn (Monlh, day, year) 21 c. Place of Dispos~on (Name 01 cemel6l'f, clema\oly or Olhlll place) St John's Cemetery 22c. Name and Address 0' Facil1ly 21d location (Cilyllown, slale, zip code) Camp Hill PA 17011 Fd-012662-L MYERS FUNERAL HOME MECHANICSBURG PA 17055 ~ " hJo7XJ335L 23b. license NUn1le1 -j . A tJo (p o Ves 'No ',J o Ves [it. No d JOb Were Aulopsy Fll1dings Ava.lable Prollo Cotr4>lelJon 01 Cause of Death? o Ves 0 No 31 Mannlll 01 Death Jil.. Naluraf 0 Horncide o Accidenl . 0 Pendjn~ Invesligahon o SUICide 0 Could Nol EIe Determined 32a. Dale ollniwy (Month, day. year) 32b Desclt>e how inJUry OccUlled: 28 Did TobaccO Use ConlrlbUle 10 Deall1? DYes 0 Probably ~o 0 Unknown 29 ~ Female. jiI Not plegnanl ...<<hill past Yeal o Pr.~nt alllme of death o Not pregnanl. but pl'g/IIn' wllnn.2 days 01 dealh o Nol plegnant, bul ptegnanl43 <lays 10 I yeal belot. dealll o UnMown d pregnant watwn the paSI yeal 32c. Place ollnjuty Home, Farm. Slteet, FaclOly, OIflce Building, ele (Spectfyj Approximate inlerval Part II: Enlel othlll sianificanl condlllOl\s conlllbulino 10 dealh, onset 10 dealh bul not resuKlIlQ in the underlying cause given in Part I .......:. '. . ~: St.quenllally ~I condillons. " any leadtng 10 Ihe caus. IIsled on l ine a. - Enlet the UNOERl YING CAUSE . (dISease or injury that ",alated lhe events rasul\Jng In deolh) LAST Due \0 (or as a consequence oQ: Due \0 (or as a consequence oQ (' 30a Was an Autopsy Performed? I- Z UJ o UJ (.) UJ o u. o ~ z 331. Certifier (Check only one) Certilylng physicyn (PhysIClln cerlllylllg cause 01 death when another physician has pronounced dealh and cofr4Jleted hem 23) To llle besl 01 my knowledge, dealh occurred due 10 lhe cause(s) and manner as staled ......................... Pronouncing and certllylng physic~n (Phvsiclan bolh pronouncing death and cerlily"'1l \0 cause ot tleath) To lhe besl 01 my knowledge, dealh occ ed" lhe lime. lUll!, and place. and due 10 lhe cause(s) and manner as staled........ . Uedical elllmine.lcoroner On the basis 01 examiNllon andl Inv II 32d T ,"18 olllljury 32e 11I1ury at Work? DYes 0 No 32i. 32g. localion (Sltee.. c~yIlo1lln, stale) , ~- ....x o ;w~(;fvned ( ~I~, y~r) 35 Ie: It I 2-11 {~J (See instructions and examples on reverse) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Florence B. Loscher ~&1l~P{ KxOOX a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she was present and saw Catharine E. Bousum the testat r ix , sign the same and that she signed as a witness at the request of testat.1:.i.x.- in h 'hpr presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). " ~ . ;J ~ Sworn to or affirmed and subscribed before ~ & me this ~h , day of Florenc(~me)LOscher ~ ~ ~~, 401 East Marble Street, Mechanicsburg, r. · ~~ (Address) PA 17055 Register COMMONWEALTH OF PENNSYLVANIA (Name) Notarial Seal Su~n L. Matrazi, Notary Public (A ddress 1 Med1am~ Bore, Cumberland County / My Comml6SlOt1 Expires Nov. 24, 2007 '-. ~ Member, Pennsylvania Association Of Notaries REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS \',J (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil testat_ of (one of the subscribing witnesses to) the will presented herewith and codicil that believes the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF rTTM'RFRT,ANn COUNTY OA TH OF SUBSCRIBING WITNESS Richard c. Sne1baker XEd:i:mx ~~ a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that he was present and saw Catharine E. Bousum the testat r ix , sign the same and that he signed as a witness at the request of testat..r.ix..... in h er presence and (in the pr nce of each other) (in the presence of the other subscribing witness(es)), ~ ard (~am~nelbaker West Main Street, Mechanicsburg, PA 17055 (Address) Sworn to or affirmed and subscribed before h' ;. rJ.., d f me t IS / ay 0 af?( i I ~2006 44 ,):f)JAdA '-I~ ~~~ r-{:)eA fj;1~; Register (~ (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of codicil testat_ of (one of the subscribing witnesses to) the will presented herewith and codicil that believes the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) LAW OFFICES MARTSON AND SNELBAKER II LAST WILL AND TESTAMENT I, CATHARINE E. BOUSUM, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executor or Executrix, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath unto my husband, CHARLES M. BOUSUM, JR., absolutely and in fee simple. If, however, my husband, CHARLES M. BOUSUM, JR., does not survive me, then, and in that event, I give devise and bequeath my entire said Estate unto my children, RICHARD M. BOUSUM and MARIE E. BOUSUM, in equal shares. THIRD. I nominate, constitute and appoint my husband, CHARLES M. BOUSUM, JR., to be the Executor of this, my Last Will and Testament, and if for any reason he shall fail to qualify as such Executor, or cease so to serve, then I nominate, constitute and appoint my children, RICHARD M. BOUSUM and MARIE E. BOUSUM, or the survivor thereof to serve in his place, each to serve without bond. IN WITNESS WHEREOF, I, CATHARINE E. BOUSUM, have hereunto LAW OFFICES MARTSON AND SNELBAKER set my hand and seal to this, my Last and Will and Testament which consists of two (2) typewritten pages to each of which I have affixed my siganture this ~ """ day of ;;;;;;?,ancL A. D. , One Thousand Nine Hundred Seventy-three (1973). ~.. '. "-';;~:r7:;r->., _ ,: ~ _ ~ - .#~ - (C~~,",,~_ (o.~ (8 EAL) The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testator, was on the date thereof signed, sealed, published and declared by CATHARINE E. BOUSUM, the Testatrix therein named, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names a~es hereto. ~.~J ~/U:?L~ ~ ~~J /