HomeMy WebLinkAbout10-12-06
PETITION FOR PROBATE and GRANT OF LETTERS
K aker No. gl -()tu--D~~
To:
Register of Wills for the I d
Deceased. County of Ulmber-_an_ in the
Social Security No. i Cl3 - Z 4. I tb4 2- 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 O( named
in the last will of the above decedent, dated Oc..+o hpv- 2 , 19~
and codicil(s) dated
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(state relevant circllmstances. e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in (~U mbe.y\o...v\d County, Pennsylvania, with
last family or principal residence at !)C) ~~ Spr-i~ Ave I NeWV llle. I
Estate of
also known as
(list street, number and muncipality)
, 19
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 Pps>'Ji'ania . . . r. ' $
situated as follows: -0 0 ~; ~ SfY' n (} Q v4.. N'eN VI II 1.." P k
9,500
.
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rl 1
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron,
on c.t.a.; administration d.b.n.c.La.)
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OATH OF-PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF C.l Jmb~r \IJ.J-\cl
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 represen-
tative(s) of the above decedent petitioner(s) will wen U adm~e estat~!ding to law.
Sworn to or affir. me<il~d snbscn.'b, ed { i Lc ~ ~
before lje thit:< .;- .f9~ ~
jjt ;~~ n ~ r7I Sins ~t.- ~
(h ~ ~ ~:;;er ~
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No. d (- () (0-- 0 'T93
Estate of [Ii za b..&1 K Br-p_Wbo ~e.r , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ()~ lil_~_..___~{)b, in consideration c " :It: !';('::t:cw on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated octnbf"r 2. ,q)? I
described therein be admitted to probate and filed of record as the last will of -EJ;ZQ tJeth
K E)Y-e~
and Letters ~;-a.r~
are hereby granted to
FEES
Probate, Letters, Etc. ......... $ 10)
Short Certificates( I)) . . .. . . . . .. $ ~O
R~nunciation ................ $ I ()
W: II $ I C;
JGO.} frVro TOTAL _ $ is
Filed ..............,......... J.q . S. ~ .0).
~ {() ( (21.1 0 lJ
Re~ist of ills ~
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ATTORNEY (Sup. Ct. J.D. No.)
I () S1 no V tr S'f..
A.-- J l.:s Ie- ,;DDRESS Fit I 7 /) I 3
7 J -}- ~4-:3 - 14-3 ~7
PHONE
68 :6
[105.805 REV 1105
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.
p
11331471
No.
~~.~..~~~..~
Local Registrar
Fee for this certificate, $6.00
MAY 6 2005
Date
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H105.143 Rev. 2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
~\
BIRTHPlACE (City and
Slate or F~ COUntry)
TYPElPRlNT
IN
PERMANENT
BLACK INK
twp.
dlyiboro.
26.
: Approximate
,lntsl'V8l
: onset and death
01'):
t....
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,-.
s::.
--
ll)
SequentiaIy n,l condIlIons b.
if 16ffy, IeadIl1g to_
. ........ Enter UNDERlYING I
CAUSE (1JlseMe or irjufy e.
lIIaItnlUated_
mUting on _)lAST d.
WAS AN AUTOPSY _RE AUTOPSY FINOINGS
PERFORMED? AVAILABLE PRIOR TO
COlolP~ETION OF CAUSE
OF DEATH?
DUE TO
ON
TOt ASA
MANNER OF DEATH
NoturaI
DATE OF INJURY
(Mon81. o.y, v..)
TIME OF INJURY
INJURY AT w:>RK? OESCfUBE HOW INJURY OCCURRED.
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YosO NOW YOSO No~
26s. 2111.
CERTIFIER (CheCk only one)
:~~"=J~=~g:~=:r=.r.=.~~.~~~.~.~p1~.~.2~}.,........... 31b.
LICE
.P:.,o~=:,am~':~~PHY~~~~~,:d~:::Z~~:"=1..r.._...................... 0 31c. 31d.
'MEDICAL EXAIIINERICORONER ~~~~~~A,5f~~~~~~TB,o .
on tile _. or W1m1n_ onellor InYftllgIlllon. In my OplnlOll, _ oc:c:umd st tile time, dots. olld pis.., ond due to tho couHS(.) ..d I f}.71J;H I./UI..ff Go ''7'7On''- I!J) .
31~"ot_............................................................................................................................................................ 0 32. ':r. . .i3v~ n 57
REGISTRAR'll SlGNAruru; AMIl NUMBER C':- DATE FILED (Month. Day, Yeer)
t;\.~bJ..~ bl\ 1~1I101 34.
Suicide
5>
o
o
Homldds
Pending I.....tigallon
Could not be dot_nod
o
o ~O~O
O 300. 3Gb. M. 300.
PLACE OF INJURY - At home, farm. ,treet. l8etofy, o1IIce
.............C_l
308.
Aedd8nl
29.
1105.805 REV 1/05
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Lncal 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.
No.
21.;....~. ~~
Local Registrar
Fee for this certificate, $6.00
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12726435
JUL 2 4 200B
Date
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H105.143 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
1YPEIPftJNT
IN
PERMANENT
BlACK INK
;..>1' ~
SEX
STATE file NUMBER
SOCIAL SECURITY NUMBER
2.female 3.193
BIRTHPlACE (CIIy Irld
StlIl8orFOtIigiICCMtry)
Newville ~:El
7. ...
FACILITY NAME (~not 1nolIbiIon, gIw IIlftt ond nurrtMlr)
MARITAL STATUS. M_.
N~.:=a\="'"
14. Widowed
11c. 0 Ves. _"'led In
~)O
RACE - American Indian. Black, VI/tllte, 8t .
(~hi te
10. .
SURVIVING SPOUSE
(I' wife, gtv. fMIdw\ n.me)
Iwp
17b. Countv Cumberland 17d.D.~=1=0I Newville
MOTHER'S NAME (First, Mlddlo, Moldon Sumsmo)
11. Rachael
INFORMANT'S MAILING ADORESS (Su.ot. Clt\'lTown. StaIo, Zip Code)
~51 Middle Road Newville PA 17241
PLACE OF DISPOSITION. Nome 01 Comotory, cnmotory lOCATION. CllylTown. Stole, Zip c-
or Othor Ploco
~~wville Cemetery
NAME AND ADDRESS OF FACILITY
2
CltylborO.
Gwville, Pa 17241
15 Bi9' Spring
LICENSE NUMBER
231>.
21.
: Appmxlmolo
, interval b8tw
: onset and death
Othor slgnlficant condtionl cootributing to dooth, bul
not resulting in the undOf1ying caul. given in PART I
..
~"y Ult condtionl
, Kony.loodingto-.o1o
. cause. E_ UNDERL VlNG
CAUSE (Dlse8lO or irjury
Ihal inItIotod_
retUtIng on _ I LAST
WAS AN AUTOPSY \/\'ERE AUTOPSV FINDfNGS
PERFORMED? AVAIlABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
E
NlllUr81
Accldont
Homicide
Pending Investlgatlon
DATE OF INJURY
_,llay.v..,)
o
o -D~D
O 300. :lOb. M. SO<:.
PLACE OF INJLlRV . Al home. 1000. Itreet. factory, oftIco
iaMnO,.... tlpedfy)
300.
INJURV AT WORK? DESCRIBE HOW INJURV OCCURRED
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2Ia. 2lIb.
CERTlFIER (Chock only one)
.~~~":i~c:==:mr~"A~.~.~.~.~~~.i.I<l~.2~}.................
Suicide
COuld not be determined
21.
~lIlalllol
34.
__ __<__-.<U ",0.,0 r-^1.
Reg...... of Wills of Cu \'Y'Ibe.r-I OfId County, Pennsylvania
RENUNCIATION
~ofB2()bdf\ Ii.. ..erf'lNbCAl?"'~ No ~l-'blCODq?;
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~n ~er ShughOfi" CO' :(!cu;;: :;
Tlte~, fY1111~.. ............r~ JIJA'f- ('!n." <;h ~ti (lrl. F~
(Relattonlhip) apadty)
the _ ()e<ledeftI, hen>bY ~.l \he light to ~ the es\8Ie end ~ reque&t($) \l>at lel\eI$ be
losue<I to ~I/U'1 ~ zra..13rt!'~ h:> v.... ,.-
allO known at
(;=...~..._....~~
\c(~~S- C\bN ~ LT. c..,t\\~5>8U~SJ'0
(AddreSS)' d-OR"'=l-1
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SwOrn . to Of afft..J1!1f 8UbICII*I
r:1)t'70'f:.f .,.;Jrd., dr/
. l^rlJ'A/O.~&
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My' comt1\iSSlon expire.: I\pR 4 I 1l6r
(SIgnature and sM' of Not_tV 01 othef offieial
qualified to admin'" 0IIlhS- ShOW date 01
expiration of NoUrl" QUlI.miUion.)
Form #RW-4
NOt SEAL
D:JYS.SMmi.NOTARY~
C8disle aoro,ClJnbadP ~
Uvr,oarnisStOn Expie6April t-
NOTe~ Renunei&fiOn$ executed ouWide the otftQe of Register of
Wills in some C()U'Ities are required to be nat,8riZed.
page
SEP 25,2006 07:59A
LAST WILL AND TESTAMENT OF ELIZABETH K. BREWBAKER
I, ELIZABETH K. BREWBAKER, of the Borough of Newville,
Cumberland County, Pennsylvania, declare this instrument to be my
Last will and Testament, in manner and form following:
1. I hereby expressly revoke all wills and Codicils
heretofore made by me.
2. I hereby direct my Executor to pay all my just debts,
funeral and administrative expenses out of my estate, as soon as
practicable after my death.
3. Should my husband, Elmer S. Brewbaker, survive me for
a period of thirty days following my death, I devise and bequeath
the remainder of my estate to Elmer S. Brewbaker.
4. Should my husband, Elmer S. Brewbaker, predecease me or
die on or before the thirtieth day following my death, I devise
and bequeath the remainder of my estate as follows:
A. I give and bequeath the sum of One Dollar
($1.00) to my stepdaughter, Linda Darlene Brewbaker,
absolutely.
B. I devise and bequeath the remainder of my estate
to my children, Nolan Ezra Brewbaker, Norman Elmer
Shughart and Judy Mae Shughart, in equal shares, share
and share alike~ and to the issue, per stirpes, of any
child who shall predecease me.
5. I nominate and appoint Farmers Trust Company, Carlisle,
Pennsylvania, Trustee of the share of any beneficiary who may be
a minor. The income and/or principal of said trust may be
accumulated or expended for the maintenance, education and
support of such beneficiary as my Trustee in its sole discretion
may determine~ and my Trustee, in the expenditure of income and/
or principal for such purposes, may, at its discretion, apply the
same directly without the intervention of a guardian or pay the
same to anYJPerson having the care or control of said beneficiary
{ : - - " , - '-~ ;~)
or:\Yitl1)lhom the beneficiary resides, without duty on the part of
:~~~i TfP~1fTnnr~0 supervise or inquire into the application of the
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of such income and/or principal shall be paid to such beneficiary
upon reaching majority, or to such beneficiary's estate in the
event of death prior thereto.
6. I nominate and appoint my husband, Elmer S. Brewbaker, as
Executor of this my Last will and Testament: and as substitute
Executors I nominate and appoint my children, Nolan Ezra Brewbaker
Norman Elmer Shughart and Judy Mae Shughart.
7. I direct that my personal representative and Trustee, as
well as their successors, shall not be required to file bond or
security in any jurisdiction.
IN WITNESS ~rnEREOF, I have hereunto set my hand and seal
this 2 k.J. day of October, 1981.
>/L ~ ~r~ ~ (SEALl
;Y~~zabE"th K. . Brewbaker
WITNESS:
~(t1' tllJq~
~\J.~
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
I, Elizabeth K. Brewbaker, Testatrix, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will, that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
Sworn or affirmed to and acknowledged before me, by Elizabeth
K. Brewbaker, Testatrix, this Zv~ day of October, 1981.
~c~~~hLJ
~ statrix .
ca~..u.:--(. ~~
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'" ~"rr. r. urpT7LFR, NOTA.RY PIJBLlC
,- ".,~!" .,~':-;r:d Cmmty Carlisle, PA
N\y C0n~Tlissjon Expires January 27, 19.83
- 2 -
CO~...MONt"lEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
We, Roger r.1. Morgenthal and Tom H. Bietsch, 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 Testatrix, Elizabeth K. Brewbaker, sign and
execute the instrument as her Last will; that she signed will-
ingly and that she executed it as her free and voluntary act for
the purposes therein expressed; that both of us in the hearing and
sight of the Testatrix signed the Will as witnesses; and that to
the best of our knowledge the Testatrix was at that time 18 or
more years of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed to and subscribed to before me by Roger 1L
Morgenthal and Tom H. Bietsch, witnesses, this L~ day of
October, 1981.
~IA 11111~
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Witness
~Cl~.~.~ ~~I
1 ." ~lIrt': r- L'r:"DT7'LER, INOT ARY PllPl Ie
Cu.~~~Y\dr()unty Carlisle. P II
I,', . ;~":~ion Expires January 27, 19[:3
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