HomeMy WebLinkAbout04-02-08 (2)
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
Cumberland
COUNTY, PENNSYLVANIA
Estate of Betty J. Myers
also known as
File Number
:ll-O~; 03&~
, Deceased
Social Security Number
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE ~, or 'B' BELOW:)
III A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the executrix named in the
last Will of the Decedent dated May 20, 1970 and codicil(s) dated n/a
Marlin E. M ers named as the executor of decedent's Will died on Ma 13 200 I. Blake E. M ers named as an alternate executor of decedent's
Will. died on Januarv 15, 2007.
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
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. Grant of Letters of Administration
(Ifapplicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If
Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his / her last principal residence at
Sarah Todd Memorial Home, 1000 West South Street. Carlisle. Carlisle Borough, Pennsvlvania, 17013
(List street address, town/city, township, county, state, zip code)
Decedent, then 84 years of age, died on March II, 2008
Carlisle, Pennsylvania. 17013
at Sarah A. Todd Memorial Home, 1000 West South Street,
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
situatedasfollows:q IOtVLt::,.{] ljTllllEj 't>.....ILfIOf':T7 <;;'()J?/Alf'77<;;;', P/f 1~?t:.L.
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Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appl~ ~ f-l f-;~"
the undersigned: U !:::::' rn ~ 0
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120,196.39
130,000.00
T ed or rinted name and residence
Anita M. Lanious, 296 Heisers Lane, Carlisle, P A 17015
Form RW-02 rev. 10.13.06
Page 1 of2
.
Oath of Personal Representative
COMMONWEAL TH OF PENNSYL VANIA
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 ofPetitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Swom to or affirmed and subscribed
/). L . (
LY~ -/ /J1 k? /J'i'/ ('k;{ S
Signature of Personal Representative
before m.e the
Signature of Personal Representative
Signature of Personal Representative
File Number:
cQl-O~-()3&~
Estate of Betty J. Myers
, Deceased
Soda! S"urity Numbe" 190~ Dale of Dealh, M,~h 11 , 200'
AND NOW, I sf !XLV of, II$, fJ.f'fJ~,;n ,on'idemlion of ,he fo,egoing Peti';on, "';,f""o'Y proof
having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Anita M. Lanious
and that the instrument(s) dated May 20,1970
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
Lott= n:ES $ .310 .)jofldJu 1(j!tl}!.1!"f'9!::kff~~ if "
Short Certificate(s)..l.Q... $ Y6 Attorney Signature: /~ .__-.. t::7~
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Renunciation(s) .......... $
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...JC \) .. . $
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.. . $
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...$3
TOTAL. . . . . . . . . . . . . . $ ... .-e:tl'lT"
in the above estate
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Attorney Name:
Stephanie E. Chertok, Esq.
Supreme Court J.D. No.: 52651
(717) 249- II 77
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Page 2 of2
Address:
61 West Louther Street
Carlisle, P A 17013
Telephone:
Form RW-02 rev. 10.13.06
WILL
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I, AOONIA L. P AITON, of the Borough of Lemoyne, Cumber land COWl f3~"'"
Pennsylvania, declare this to be my last will and revoke any will pr~i6usly
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Item I. I direct that all my just debts and funeral expenses, including
my gravemarker and all expenses of my last illness, and all taxes and
assessments imposed by any governmental body as the result of my death,
whether on property passing under this will or otherwise, 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 give, devise, and bequeath all my possessions and estate
of every nature and wherever situate to such of my issue, per stirpes, as
survive my death by sixty ( 60 ) days.
Item III. I appoint my daughter, JUDITH ANN PATTON, executrix of this
my last will. Should my said daughter, Judith Ann Patton, predecease me or
otherwise fail to qualify or cease to serve as executrix, I appoint my
daughter, MADELYN PATTON WYNNE, executrix of this my last will.
Item IV. I direct that my personal representatives as well as their
successors, shall not be required to give bond for the faithful performance
of their duties in this or any jurisdiction between the parties.
(G;:fQ day of
IN WI1NESS WHEREOF, I hereunto set my hand this
SQ?i.~"'^~v"
1977 .
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Adonia L. Patton
Page 1 of 2 Pages
The preceding instrument, consisting of this and one other typewrittal
page, each identified by the signature of the testatrix, was on ele date
thereof signed, published, and declared by Adonia L. Patton, 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.
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Adonia L. Patton
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Page 2 of 2 Pages
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: 11 is illegal to duplicate this copy by photostat or photograph,
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COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
STATE FILE NUMBER
1. Name of Decedent (First. middle, last, suffhl
Adonia L. Patton
5. Age (Last Birthday)
96 y"
8b. County 01 Death
Ba. Place of Death (Check only one)
Hospital Other
c&'lnpatient 0 ER I Outpatient D DOA 0 Nursing Home C Reside'1ce :JO:her - Specify
9. Was Decedent of Hispanic Origin? J?J No 0 Yes 10 Race: Amencan Indian, Black, White. ete
(If yes, Specify Cuban, (Soecify)
MeXican, Puerto Rican, etc.) Wh i t e
14. Marital Status: Married, Never Married
Widowed, Divorced (Specify)
DIvorced
6 Date of Birth (Month, day, year)
March
Cumberland
11, Decedent's Usual Occu tioo Kind of work done durin most or workin life, [)() 1'101 slate relired
Kind at Work Kind of BusirJess f Industry
Su ervisor A Dept. Revenu
Dy" KJNo
.. 16. Decedent's Mailing Address (Street, city f town, slate zip code"
425 Walnut street
Lemoyne, PA 17043
Decedent's
Aclual Residence 17a. State
PA
Cumberland
19. Mother's Name (First. middle, maiden sumame~
Annie R. CarrOll
17c. D Yes, Decedent Lived in
17d. 5a ~~iu~f~~~~toTiVed wil~lr Lemoyne
17b. County
18 Father'sName(First,middle,lasl,SuHix)
Roy M. Lechthaler
20a. fnformanfs Name (Type I Print)
Judith Ann Patton
4~ Ie ot Death (Month. day, year)
2124 / ec.embei(
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20b. Jilfcu.manl's Mail~g~ddress (~reet, cil'y: f town, state, zip cod~) . b
Ij Mallara Ct., MeCnanlCS urg,
22c. Name and Address of Facility
21c. Place oj Disposition (Name of eemelery, crematory or other place)
Twp
City/Bora
PA
17055
Mt. Olivet Cemetery
21d. Locatior {City ,'town, state, Zip code)
New Cumberland,PA17070
F.R., 408 3rd St.,New Cumberland,PAl7070
CAUSE OF DEATH (See Instructions and examples)
ttem 27. Part I: Enter the ~ - diseases, injuries. Dr complications - that directly caused the death. DO NOT enler tefTl'linal events such as cardiac arrest,
respiratory arresl. or ventricular fibrillalionwithoul showing theeliojogy. Ust only one cause on each line
I poroximaleinterval
: Onset to Death
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~~~Tt~ATe~at~n~~~ J~~1~ll dise:::.-
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Due to (or as a consequence of):
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Due to (or as a consequence 01)
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Sequentiallylisl condillons, If any,
~~t~~~o J~D~~[~II~~~~~~~e a
(disease or injury that initialed the
events resu~lng In death) LAST.
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Due ,0 {OT as a consequence 01)
30a.WasanAutopsy
Pertormed?
3Gb. Were AU10PSY Findings
Available PriOT 10 Completion
of Cause of Dealh?
31 Manner of Dea~h
~ Natural D Homickle
o Accident D Pending Jnvesligahon
o SUICide 0 Could Nol be Determined
32d. Time of In)ury
DYes MNO
Dyes 0"
23b. License Number
/1-,]) C.J./:11..4t.
26. Was Case Referred to Medical Exammer / Coroner for a Reason Q'her than Cremation or Donation?
Dyes DNo
Part II: Enter other sianifieant condhions conlributino to deatb
but not resulling in the underlying cause given in Part I
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33a. Certifier (check only one)
Certifying physician (Physician certifying cause of death when another Dhysician has pronounced death and completed Item 23)
To the best of mv knowledge, death occurred due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ gJ
Pronouncing and certifying physician (Physician both pronouncing dealh and certifying to cause of death)
To the best of my knowledge, death occurred at the time, date, and place, and due 10 the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D
Medical Examiner I Coroner
On the basis of examination and I or investigation, in my opinion, death occurred at the time, dale, and place, and due 10 tile cause(s} and manner as slaled_ 0
321. If Transportalion Injury (Specify)
D Driver f Operator 0 Passenger DPedestrlan
D Other - Specify:
33b Signa1ure and Title oJ Certifier
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33c. License Number
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32g. Location of InjUry (Street. city/town, stale)
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28. Did Tobacc(, Use Cor tribute to Death?
DYes DProbllbly
~ No 0 Ullknown
29. If Ferlate
D Not prf'g'1anrwitlin past year
o PregnC!nt at time of death
D Notprfgnant,bulpregnantw1thin42days
oldeatl
DNotprfgnant,butD1egnan143daystolyear
beJorejealtl
o Unknown Ifpregnanl wilhinthe past year
32c. Place of InJUry: Home, Farm, Street, Factory
Office Building. etc (Specify)
35. Registrlr'sSignat
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34. Name and Address of Person Who Completed Cause of Death (Item 27) Type! Prinl
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OATH OF NON-SUBSCRIBING WITNESS(ES)
REdISTER OF WILLS
CCLl ..... h~ ) ~ COUNTY, PENNSYLVANIA
Estate of
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and
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, Deceased
ketteh) being duly qualified according to law, depose(s) and say(s) that she ;'~y was~ well-
acquainted with -LlJ )p~,-:) L. 'p~.,. t:\<J~ and a~ familiar
with the handwriting and signature of the decedent, and that the signature of I\r\Vr1' < ') L, ';;>-~"l
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of A( J. 'r7')~ l." !~+N,
___ is in~/her own proper handwriting.
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(City, Slale, Zip) (),
(Slreel Address)
(City, Stale, Zip)
Executed ill Register's Office
Sworn to or affirmed and subscribed
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REGISTER OF WILLS
(~'~'I.- b~\~ COUNTY, PENNSYLVANIA
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Estate of
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0' Deceased
S,::24-Y1 ve \ L, 8-... ('\e:-:. , (each) a subscribing witness to
(Print Name/s)
the~ Will 0 Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) a::ld
say(s) that ,stre''/ he / ~ was / wet"e" present and saw the above Testator / Testatrix sign the same
and that_~~l~ / ~' signed the same and that she / he / ,they signed as a witness at the request of
the Testator / Testatrix 111 her / his presence and in the presence of each other.
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(Signature)
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(Street Address)
(Street Address)
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(CIlY, State, Zip) I
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(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
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Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
of (2 p~~ (
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Deputy for Register oflWi1!s
day
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before me this
day
of
Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commis:;ion.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form RW-03 rev, /0./3.06