HomeMy WebLinkAbout03-05-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF C'.LW\l"fJ ~
Iv\~. C-. M.t"~
also known as \ I. r; ~ ~ .' _
~'1m> ~~ ~ ~~
COUNTY, PENNSYL VANIA
Estate of
File Number
07\
()G
t, '0'-10
, Deceased
Social Security Number
~
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COl'v/PLETE 'A' or 'B' BELOW:)
% A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is! are the
last Will of the Decedent dated "I. - :,), \ -a. coo and codicil(s) dated
~~ ~<:'I.l..-\'" ~ ')( ~ .........
named in the
(State relevant circumstances. e,g., renunciation, death of executor, ete.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
o B. Grallt of Letters of Administration
(if applicable, enler: C.I.a.: d.b.n.c.t.a.. pendente lite: durante absen/ia: durante.,lllinonlate)
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following Spotl?]:if any) ari:d~heirs: (If
Admillistratioll, c.t.a. or d.bll.c.t.a.. enter date of Will in Section A above and complete /ist of heirs.)
Name
Relationship
Residence.
cr.
: .~
( :-"
(List street address, towlllcity, township. county, stale, tip code)
Decedent, then
<Z:1;
years of age, died on
\=;..~ ~ ~""'4 ~? ,~<OO-y;
,
\~\J I\,M..
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PAl Persona] property in Pennsylvania
(lfnot domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$ 33, 300
$
$
$ l.-O ,00"-
sitLlated as follows:
O\l\..~
~~~
}
-\-v.;.o ~-2t.II\.~:::W C'''~i.. k
Wherefore, Petltloner(s) respectfully request(s) the probate of the last Will and Codlcil(s) presented with thiS Petition and the grant of Lett orm to
lhe undersigned:
(701')
-A.. l'lCl3
Form R W-IJ] rel'! O.! 3.06
Page 1 of2
Oath of Personal Representative
COMMONWEALTH OF PENNSYL VANIA
COUNTY OFC)U.VV\'ot...\\ ~vJ
The Petitioner(s) above-named swear(s) or affinn(s) that the statements in the foregoing Petition are tme and conect to the best of
SS
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and tmly
administer the estate according to law.
Sworn to or affirmed and subscribed
-~
before I1le the
r::,-
-:J
day of
ignatllre of Personal Representative
~ 'V
jJ (; i ~/~-'(! ',,/~1A)tA~
Signature of Personal Representative
"
mfU c h , ~(jxL
~tiL ~0Y:>"--
j9r the RegIster
Signature oj Personal Representative
c-,
File Number:
.J. \ bE) (~().~~~
j\t\ i ~UL C .Kl~c-~~
')
, Deceased
Estate of
Social Security Number:
Date of Death:
~"L~ i-v...:a.,\ :;)1) d. 00'0
AND NOW, " in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters., .~ '''\ C11\"ef'\b C\I.. \
are hereby granted to J)a.c ~"'e. '\\0..'--\ \\u c\t--e., \Jf' (" (" ~ (.'--1\ c~ CDO-.d,01\~ C ",- 's \. n c_ \-(02,(''-
in the above estate
and that the instrument(s) dated \'\l.' (j~'\ Ql, dOt:. L:>
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) ofDecedenL
FEES ~hl\cb. ~\....NL'--- J\t\,(;'-....~\XLLU.~~ .J
~ 6 d\D RegisterojWills-,_) p-- ,~,._,J-''--i I~
Letters ....,.. .,~ . DC). . $
Short Certificate(s) . , . :~. . . $ \ lo
Renunciation(s) .......... $
\...0\\\ $
,jC? $
(~.'-\O $
$
$
$
$
$
$
TOTAL __ __'" __ __ __' $ ~5u
Attomey Signature:
Supreme Court LD. No.:
\S
,0
Attomey Name:
S'
Address:
Telephone:
Forlll RW-1!2 rev 10./3.06
Page 2 of2
11 RL,\
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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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 wili be forwarded to the State Vital
Records Office ! (lr permanent fi ling.
Fee for this certificate. 56.00
P 14126018
~UtNt t:\. ~~~~-b. . .FE~ 2 8/ 2008
Local Registrar 9f- - Date Issued
Certification Number
( :"
If
H'i05-'i43RE\l1112OClO
TYPE I PRINT IN
PERMANENT
BlACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
IklFaclilyNamo(''''''_giw.........'''''''"'l
Tw .854 Lindsey Rd.
Cumberland
204 - 03 - 0995
Sa. Place 01 Death (Check only one)
Hospilal: Other:
o Inpatient 0 ER IOutpallenl 0 DCA 0 Nursing Home [!l Residence
9. Was Decedent 01 Hispanic Origin? []. No 0 Yes
('yes,opeclfyC"""n.
Mexican, Puerto Rican, etc,)
6. Date of Birth (Month, da , year)
Nov. 7. 1919
Om", Spoolly'
10.='~t~ck,White,elc.
. 16. Decedenfs MaiI~Address (Streel, city floWn.. state, zip code)
116 Elm St.
Carlisle. PA 17013
17b. Coun~
PA
Cumberland
Did Decedent
live in a
Township?
17c. 0 Yes, Decedent lived in
17d.1!] No, _nt lNed wllhin
Aclua/UrTilsol
r~ er
CarlIsle
TWO.
most of world life. Do not state reiii'
tfirl ~ 'il'19'me
'12. Was Decedent ever in the
U,S. Armed Forces?
Dves ~No
_.
ActUBIResidence 17aSlate
13. Decedanrs Education (SpecIfy only highest grade completed)
Elementary'Secor'ldary (Q-.12) CoI\ege (1-4 or 5+)
12
14. Marital Slalus: Married, Never Married,
Wodowed, Divo_ (_
Widowed
City/Born
18. Falhefs Name (First middIe,last. suffix)
Zoura M. Baum
19. Mother's Nama ~FlfSt.lWddIe, melDen SUIl'\an'Ie-)
2OaInlonnanl'.Nam.{TypeIPrlnll Darlene Hockenberry
2I)b4~~f:yngrct.'~""t~'IT'S're~'1IA 17015
- ~
21b. Dale of DIsposition (Month, day, year) 21c. Place of DIsposition (Name of cemetery, cremaklfy or other p1aq) 21d. Location (City ftown, state, zip code)
Feb. 29. 2008 Cuberland Valley Memorial Garde Carlisle, PA 17013
22c. Name and Address of F"'1Iy Hoffman !lotch FuneI;all Hglf~ & Crematory, nc.
219 N. Hanover 5~.. CgrlYsle. YA 7u
=:=s:=~thea.:;
~tT~~'\L"....J;L Ack....ol.t1..C.,.,.b...........
Due to (or as a consequence of):
s
Cola...
I Approxinatelnterval:
: Onset to 0ea1h
.
,
: /2 ~6'''1J.~
,
,
,
,
,
,
,
,
,
,
28. Did Tobacco Use Contribute to Death?
DVes Dl'robabfy
~ Na 0 Unknown
29. ~ Female,
~NotpreQnanlwilhinpaslyear
o PnIgnanI"time~",.'h
o Notpregnanl buI pnllPlant within 42 days
ofdealh
o Not pregnant but p~ant 43 days to 1 year
beforodealh
o Unknown ij pregnant within the past year
32C.~:: ~~=~ :7s=i Street, Factory,
"L008
Part II: Enter other
00\ not resuI\lng ln1heundeltylng cause given InPartl
=~~'~~~a
Enter !he UNDERLYING CAUSe
~~~mU:a~~ST~
b,
Due to (or as a consequence o~:
Due to (Of as a consequence o~;
3Oa. Was an Autopsy
Pertormed?
d,
308. WereAulopsyFincli1gs
Available PIior 10 Completion
of Cause of Death?
Dv" jiClNa
0"'" DNa
31. Manner of Death
~ Natural D HOOIIcide
DAccldent DpBI1lffn!lI_
o SulcicIe 0 Could Not be Determined
321:1. TI/l'leoflnjt.rry
ffi
~
:5
w
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32I,nr_tion In!"", r_J
Di>MI<IOpe- Dp.....'" Dp-
""'"',-
33a.Certifler(checkoolyooo) ~.~TltIeofCertifl8f
~~:-~==:e~~w:u::=~~~_~~_~_~~~~~~___..___..______..__ ~ ~ \ L--cJ
~~=a==~~~::Il=~~=tok1.:-~:a:lIlInnerasstaled..______ ___ __ __ __ __ 0 33c.lkenseNumber
Modi lEx I ,Carone< e, S - 0 I 07 <-(, L
en;: baS~:ofne~amlnat1on andJorlnvestigatkln, in my oplnlon, death occuned at the lime, date, and plac', and due to the caute(s) and manrntI'.. stated.. 0 34. Name end Address of Person Who Completed Cause of Death (Item 27) Type I Print
3S,~~ ..... t.~ ';, . _(MonA'''Y'yea~ \2.\ <:.h..,,,,\ L<c C"PPdk' -;:'0
~ . ___dl'\~ 180.1\ 1<3, II 10 I - ,0 f \ Ie le<" Cour.J ('..~I;.I< p"
M,
<;)7
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17o'S
Disposition Permit No.
(irQ?,4J++
u
K
0-
LAST WILL AND TESTAMENT
OF
-'
MYRTLE C. MYERS
I, MYRTLE C. MYERS, of Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby revoking all other wills and
codicils heretofore made by me.
FIRST
I direct the payment of my debts and the expenses of my last illness and
funeral from my estate as soon after my death as conveniently may be done.
SECOND
.)
I give, devise and bequeath one funeral plot to my daughter Barbara. The
remaining plot shall be disposed of as my Executrix directs.
THIRD
All the rest, residue and remainder of my estate, real, personal or mixed
wherever situate, I give, devise and bequeath unto my children, Darlene and Barbara,
per stirpes. I have not included my daughter Charlotte in this disposition because I
have made prior arrangements to see she receives the home and furnishings in which
she and I reside.
FOURTH
I nominate, constitute and appoint my children, Darlene Hockenberry and
Charlotte Koser, as Co- Executrixes of this my Last Will and Testament. I relieve my
personal representatives from the necessity of posting security in connection with their
duties as such in any jurisdiction in which they may be called upon to act insofar as I
am able by law to do so.
FIFTH
In addition to the powers conferred by law, I authorize my Co-Executrixes
in their absolute discretion:
A. To retain in the form received, and to sell either at public or private
sale any real or personal property.
B. To manage real estate.
C. To invest and reinvest in all forms of property without being confined
~ ~to legal investments, and without regard to the principal of diversification.
~
r D. To exercise any option or rights arising from ownership of
investments.
E. To compromise claims without court approval, and without the consent
of any beneficiary.
SIXTH
This Will shall be interpreted pursuant to the laws of the Commonwealth
of Pennsylvania where it was prepared and executed.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this,
my Last Will and Testament, consisting of three (3) typewritten pages, the two pages of
which bear my signature in the margin for the purpose of identification, this the .;2 / JI
day of f!u9u5 -f: I 2000,
~M~TLfc,~fRS-d--
(SEAL)
Signed, sealed, published and declared by the above named testatrix
MYRTLE C. MYERS, as and for her Last Will and Testament, in the presence of us,
who, at her request, in her sight and presence, and in the sight and presence of each
other, have hereunto subscribed our names as witnesses.
t') Q,
'<l (, I I,(t'.
-,' .1- ,,-)::..A...-
ADDRESS Il <. C.(J:""Jl7~ ,J {'y: G.,..., (
. 1,'
t(f'rUU\i/Y.....:~' 1fSf'U:iADDRESs517 N ",0CC/!'1LU jr, (r7t. HC/ly'
,
I ..) _jo~
~'J.,. (-1; ,
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f"'F iL:(?'
t ~ __---'
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We, MYRTLE C. MYERS, K~ Ol cJ~
t2nt~ ~ r~~
and
, the testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do
hereby declare to the undersigned authority that the testatrix signed and executed the
instrument of her Last Will, and that she signed willingly and that she executed as her
free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the testatrix, signed the Will as witnesses,
and that to the best of their knowledge, the testatrix was at the time eighteen (18) years
of age or older, of sound mind and under no constraint or undue influence.
Jr /Jilad
Sworn to and subscribed before me thig.)/-day of -7--- - ,2000.
~~~
Notarial Seal
Angela F. Unger. Notary Public
Carlisle Bora, Cumberland County
My Commi!sion Expires Oct. 7, 2000
Member, PenllSylwmia Association of Notaries
rob/willslmcmyers. her