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Home My WebLink About11-29-06 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Deceased No. 2, \ D l~ Social Security No. \ D -S-\ 195-32-4551 Estate of CECELlA E. JACOBS Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) MELVIN L. JACOBS. JR. o Probate and Grant of Letters and aver that Petitioner is the executor named in the Last Will of the Decedent, dated September 3.2002 and modified on September 17. 2006 Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent: D B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate) I Name I COMPLETE IN ALL CASES;) Attach additional sheets if necessary. Relationship Residence Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 116 Conodoquinet Avenue, Camp Hill, Hampden Township, Cumberland County, Pennsylvania (List street, number and municipality) Decedent, then 76 years of age, died September 28. 2006 at 116 Conodoquinet Ave. Camp Hill. PA (Location) 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 ......................................................................................................................$ T otal......................................................................................................... $ 5.200.00 5.200.00 Real Estate situated as follows: Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: Si nature T ed or rinted name and residence Melvin L. Jacobs, Jr. 116 Conodoquinet Avenue Cam Hill, PA 17011 . J1iU-L~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate according to law. ~~~ V Melvin L. Jae bs, Jr. Sworn to and affirmed and subscribed :-fb Before me this dq day of ~..w.~. . ,2006. ~~ No. ~\ G~ \D-S\ E e of CECILIA E. JACOBS AND NOW, ceased. Date of Death' eration of the Petition on the reverse side hereon, satisfactory proof having been presen IT IS DECREED that Letters Test ary are hereby granted to ent dated Se tember 3 2002 and modified on Se tember the Petitio admitted to probate and filed of record as the last Will of the Decedent. FEES Letters........................... $ Short Certificate(s) $ Renunciation.............. $ Affidavit ().................. $ Extra Pages ()....... $ CodiciL......................... $ JCP Fee....................... $ Inventory...................... $ ,.... Other.............................. $ TOTAL......... $ ') ,~'. .,.i i~~ 006 described in Register of Wills Attorney ~~t;s 1.0. No: 20558 Address: Johnson, Duffie, Stewart & Weidner. 301 Market Street, P.O. Box 109, Lemovne. PA 17043- Telephone: 717-761-4540 Thi'l is to certifv that the ll1i'onnation here given is correctly copied from an uriginal-:ertit'icate ot' [icath dulv tiled with 11 L' ~l' Lll',1I RCghtLd'. The original cCTI,ficate will be forwarded to the State Vital Records Officc L1r per!l1anent tiliniC WARNING: It is illegal to duplicate this copy by photostClt or photograph. ;'i~'~(~H'iftpl}-~~ /,ii'..l.\..~/.-..-,lf4' ~-~'\ /~t ~~/ ~ ",< _~-~\ l~. ' ~~~\~ ,~~. .. 7, i~<::::l: - >>, --~~ \~ t..:J _ _ -t;#j. _. _.:ba~ ,*~y *f)) \~~\,-- ----. - ---~/ '\. ~'-.., .' /.$$:,,~ ~-_'7,fli~-- .(. 't--<':' .\Y '<<~_~!YTENT \,)'."",,!" ~-!.!!L~ /7 ~ '"'" J;. -) U/v/(.-~ :~ .,~ ~:'7~<';'l<1..~.I:"?<?-. (, ll'l fur thi, certificate. Sh.OO I.. ,,';d -; 1 r~l r P 12839534 ocr 0 4 2006 :\ (J. f~) ~l! L' . '.) IV ~\ (:)\..Q \\:)S\ CFt ,REV 0212006 /PRINTIN MANENT \CKINK 1 Name of Decedenl (First. middle, last. suffix) Cecelia E. Jacobs COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH Cumberland Earn[iden Twp. 116 Conodoguinet Ave. STATE FILE NUMBER Yes 4 Dale 01 Death (Month, dClY, year) September 28, 2006 5 Age (Last Birthday) 6 Dale of Birth Month, da ear) 76 July 23, 1930 Harrisburg, PA [2JResldence 0 Other. Specify 10 Race: American Indian, Black, White, ete (Speedy! White Bb County of Death ad Facility Name (lll1Ot institution, grve street and number) 11 Decedenfs Usual Occupation Kind of work done durin most of workin life Do not state retired Kind of Work Kind of Business / Industry Executive to Assnt. PA De'Jt.Laoor&Ind . 16 Decedent's Mailing Address (Street. city / town, state, ZiP code) 116 Conodoguinet Ave. Camp Hill,FA 17011 18, Father's Name (Firs!, middle, last, suffix) Paul Swei ert 12 Was Decedent ever in the U,S Armed Forces? Dy" (JNo Decedent's Actual Residence i 7 a State 13. Decedent's Education (Specify only highest grade completed) Elementary I Secondary (Q.12) College (1-4 or 5+) 2 14 Marital Status: Married, Never Married, Widowed, Divorced (Specify) Married L. Jacobs Jr. 17b County PA Cumberland Did Decedent Uvelna Township? 17 c ro Yes. Decedent Lived In 17d, 0 No, Decedent Lived within ActuatLlmltsof Twp City/Born 2Ga, In/ormant's Name (Type I Print) 19 Mother's Name (First, middle, maiden surname) Luella Berlin Melvin 1. Jacobs 21a. Methodo(Disposition . XXaurial 0 Removat from Stale o Other . Specify : by Medical Examiner / Coronet? 22a, Signature of Funeral Servk:e Licensee (or person acting as such) . ~ 014819 L 23a To the best 01 my knowledge, dea 'OCCurred at the time, date and place stated (Signature and title) Harner Funeral Home Hill PA 17011 23b, license Number 23<::. Date Signed (Month, day. year) Complete Items 23a.{: only when certifying phYSICian is not available at lime 01 death to certify cause of death lIems 24.26 must be completed by person . who pronounces death 24 T'meot~ : S5 ,4" CAUSE OF DEA TH (See instructions and examples) Item 27 PART I Enter the c1li!!D.Pl~.~~- diseases, Inlunes, or eompHcations . Ihat directly caused the dealh DO NOT enter terminal events such as cardiac arrest respiratory arrest. or ventricular fibrillalion withoul shoWing the etiology List ooly one cause on each line 2006 26 Was Case Referred to Medical Examiner l Coroner for a Reason Other than Cremation or Donatior'i? Dyes ~o Approximate interval : OnseltoDea\tl Parlll' Enter other slonificantconditions contributina 10 death, 28, Did Tobacco Use Conlribule to Death? but not resulting in the underlying cause given in Part lOVes 0 Probably o No [31Jnknown 29 If Female o Nol pregnant within past year o Pregnantaltlmeofdeath o NOlpregnant.butpregnanlwithm42days of death o Not pregnant, but pregnant 43 days to t year 01 death o Unknown II pregnant W1thll1lhe past year 32c Place of Injury Home, Farm, Street. Factory, Office Building, elc (Specify) =7t~I~~~u~t~~~~ J:~~) disea~ Sequentially Ii.c;t c,?"dihons, if any. ~::a: ~se~(~,.Gn ~~~;'E (disease rx injury that initiated the . events resulting in death) LAST. Due to (or as a consequence of) Due to (or as a consequence of) DYes ~NO D y" D No ~Natural 0 HomICide o Accident 0 Pending Investigation D Suicide 0 Could No! be Determined 32d. Time 01 Injury 329 Location 01 Inlury (Street. cify I lown, slate) 30a Was an Autopsy Performed? 30b Were Autopsy Findings AvailalJje Prior to Completion of Cause of Death? 31 MannerolDeath 321 ff Transportation Injury (SpecIfy) o Driver I Operator 0 Passenger 0 Pedestnan o Other. Specify 33a Certifier (check only 0fIe) )3b. Signature and Title of Cef1if1;(. ' /i Certifying physician (PhYSICIan certifying cause 01 death when another phYSICian has pronounced death and completed Uem 23\ ~ / / . To the best of my knowledge,dealh occurred due lolhe cause(s) and mann erasltate9_________________________________-O ~ t11iL---L /1 '/l1 f1'~vvt-t111 D ~~Ot~:u:~~~,a:; ~:~~~:,h:::~~~~:~rr:~~ ~;hu~~~~;~~n;n~~:::e~a~~r1iZ::9t~Ot~~::uo~e~~~~d manner as stat!d_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 33c License Numbe / 33d, Date Signed (Month. day. year) {)I '600'16 (J1 Se tember 28 ~d::~;:~m~~:~~;.f~~~~ and I or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(5) and manner as sta1td_ _..D 34. Name and Address of Pe~n Who Completed Cause of Death (Item 27) Type I Ponl 36 Dale FiOd (Mo"h. day. "'''I I11dAA_//1 s,~/I1 n1 yVlj../ 1'-1 j) ~9~tfdt. 51/2, Nt6 tf (See instructions and examples on reverse) 2006 35 Reg,~ SignalUle a'~~1 NI!~"'" ~ L0Vn..- /' '( ~~?..1..1~1.-t/lL'(~ Idl/ldl/f ~ \ 0 lu \ D -sl LAST WILL AND TESTAMENT OF CECELIA E. JACOBS r. I \. ',: (j '\' '" I, Cecelia E. Jacobs, of Hampden Township, Cumberland County, P~nnsylv~~'- declare this to be my Last Will and testament and revoke all Wills and CMicils previously:, made by me. ITEM I: I direct that all my legally enforceable debts and funeral expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II: I bequeath any automobiles or motor vehicles I may own at my death, my personal effects, such household goods ifany as may be my individual property and not the property of my husband or owned jointly by me with him, and other tangible personal property of like nature (not including cash or securities), together with any existing insurance thereo~ to my husband, Melvin L. Jacobs, Jr., providing he survives me by thirty (30) days. Should my said husband predecease me or die on or before the thirtieth day following my death, I bequeath such tangible personal property and insurance thereon to my sister-in-law, Sylvia Y. Gore. I direct that any ofthe foregoing articles not selected by my said sister-in-law shall be sold at public or private sale by my personal representative(s), and I further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate to my said husband, providing he survives me by thirty (30) days. ITEM IV: Should my said husband predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate of every nature and wherever situate to my sister-in-law, Sylvia Y. Gore and brother-in-law, King W. Gore, or to the survivor. Should both of them predecease me, I devise and bequeath the residue of my estate of every nature and wherever situate equally to their sons, Michael '1 ~-~__ T..,._n..hco nnrp / ..z ITEM S: All Federal, State and other death taxes payable because of death, with respect to the property forming my gross estate for tax purposes, whether passing under this Will or otherwise, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my residuary estate without apportionment or right of reimbursement. '-:71 JL..4- ITEM.DR: I appoint my said husband Executor ofthis my last will. Should my said husband fail to qualifY or cease to act as Executor, I appoint my brother-in-law, King W. Gore, Executor of this my last Will. Should my said brother-in-law fail to qualifY or cease to act as Executor, I appoint my sister-in-law, Sylvia Y. Gore, Executrix ofthis my last Will. Should my said sister-in-law fail to qualify or cease to act as Executrix, I appoint Michael King Gore, Executor of this my last Will. ITEM ~: I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this 3rd day of September, 2002. /7, t; L~lv // > h--'~ (Seal) (/ The preceding instrument, consisting of this and the two other typewritten pages, each identified by the signature of the Testatrix, was on the date thereof, signed, published and declared by Cecelia E. Jacobs, the Testatrix therein named, as and for her last Will, in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses hereto. (~ (i ' , J" ~{G-, "~'v\ Lrl Of [...'<2- -n~ k;~ Wv.A 1l11.<;~{ ~'Y1 " ' Ii ~; . , " I-: ~ ~ ' C z.c-.:..i.L/ {;...;i (~ ~ u " (l-rh~ / /L, . d '.. ~",~//-x.""".,..,.,.i ", ~{+1<II. 1u(JAd. /' , ' ",.. <-~F 1 ;>.--- (' .. ,'. /'" / ,,/ f , / / ~. .-/ fJ.A ~ ~ i/V} 7-/7-00 l ;W ~I /U-vz ~~A- r~~ll~ ~fI_ ~<./0~'~:I I or- ~ ->t ~ ~-c ~. fY-c~.~ ~ ~ ~ fl~G~ 3 tL~ 9"1J- " ~ ~ -?> 4 ~ t(. ~ ~~ ~ 4-<-v-U-t~ sA-v} ~ Jl~-~'- 6-r:-~-L $', mL ~~ ft~ ~ ..-" (!;Lt~~~ iJ:~~,C~ Register of Wills of Cumberland Countyl Pennsylvania OATH OF SUBSCRIBING WITNESS Estate of CECELlA E. JACOBS No. d.\ bG, \tlS \ Also know as , Deceased RAUCHELLE SMIRAGLlA a subscribing witness to the will presented herewith, being duly qualified according to law, deposes and says that she was present and saw the above Testatrix sign the same and that she signed as a witness at the request of Testatrix in her presence and in the presence of the other witness. ~ 0'" L~ti... 0 /~....lvv) UL.G.9 (~(L RAUCHELLE SMIRAGLlA 124 Conodoguinet Avenue Camp Hill, PA 17011 Sworn to or affirmed and subscribed before me this K day of f\-I~\.J~~ ,2006. Dt~l~Q Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of Instrument(s) at time of notarization. ~, NOTARIAL SEAL CHARLES A HARBOLD, Notary Public Camp Hili Bora, Cumberland County My Commission Expires Dec. 30, 2006 ,...., "-1 ) ',-) Register of Wills of Cumberland County, Pennsylvania OATH OF SUBSCRIBING WITNESS Estate of CECELlA E. JACOBS No. a\ Gl2\OS\ Also know as I Deceased ANTHONY). SMIRAGLlA a subscribing witness to the will presented herewith, being duly qualified according to law, deposes and says that he was present and saw the above Testatrix sign the same and that he signed as a witness at the request of Testatrix in her presence and in the presence of the other witness. Sworn to or affirmed and subscribed before me this ~ day of ~1").f?,,"\_ ,2006. C!~.,..Q\.~ Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of Instrument(s) at time of notarization. NOTARIAL 9EAL CHARLES A. HARBOLD, Notary Public Camp Hill Bora, Cumberland County My Commission Expires Dec. 30, 2006 ;....,i J SO : 1