HomeMy WebLinkAbout04-04-08
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF \VILLS OF CUVl'\..b't-'r-la n I
COlTNTY, PENNSYLVANIA
Estate of
r~'o'\l<.-{b'A.<<A- l...
fl1y t:....rt.J
File Number
J J ~ {)<t - (l3x!i
also kno\vn as
, Deceased
Social Security Number
;
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(C01\IPLETE 'A' or 'B' BELOW:)
~i\. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the
last Will of the Decedent dated 'I AVa I, 7" and codicil(s) dated
v A'..,;l (',.J +-(1 ,
named in the
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(State relevant circumstances, e.g., renllncliltion, deaih of executor, ete) c; 9 ~_.
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Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution ofth~F\~mer:tt>io:)ffered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:':~, ~ ~ !
1..</.......
o B. Grant of Letters of Administration
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U) l_.J II
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(If applicable, enter' c,t,a.; d,b.n.c.t.a,; pendente lite; durall/e absentlil, dlirallte}llill~ate)
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Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following SPOt'i?e' (if any) and ii:Irs: (If
Admillistration, c,t,a, or d,hn,c.I.a" enter date of Will in Section A above and complete lisl of heirs)
~-~---b~
Relationship
Residence ~
-t--~~--------~~-~----
Name
(C01'vlPLETE IN ALL CASES:) Attach additiollal sheets ifllecessary.
County, Pennsylvania with his / her last principal residence at ___
~ 170 I ~
Decedent, then
SD
years of age, died on ~ l;J,.s I 0 S
at CAI2.I.'sk !<-t!1Ion#-( {11...,J, le<<.-(
e'en I. y
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
(lfnot domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
OlJC, "0 ,I ~
'lo~, tltr;)~
$
$
$
$
!;too, 'O~!
situated as follows: ->II /'l /)~ r.- v ,,-.,,)J /J N:. . CII-I2.-I..-/-J /~: jJ ri-
/7CiI.,3
Wherefore, Petitioner(s) respectfully request(s) the probate ofthc last Will and Codicil(s) presented with this Petition and the grant of Letters in the approJriate form to
the undersigned:
Signature
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Ty ed or rinted name and residence
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Form RfV.O] rev /0./306
Page 1 of2
Oath of Personal Representative
COMMONWEAL TH OF PENNSYL VANIA
ss
COUNTY OF LV r r--Io n -t
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and conect to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well ar.d truly
administer the estate according to law.
. JIt-/f.-(.. /rt. Yc::.J
Signature oj Personal Representative
Signature oj Personal Representallve
Signature oj Personal Representative
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Date of Death:
.~
, Deceas~
3/15 lor;
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File Number:
cJl- O~ - (X3glj
r5
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Estate of
.-
-
AND NOW,
I
having been presenter! before If ,IJ
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are hereby granted to - 'Cj
(
Q, - , J,lY.)j _ ,iFwn'~orf'hdO"gOing P''''wn, ""'["'0<, pmof
DlcCH I ED thell Letters .JtsJ..i.lD I .tLt_L4__ ...____ ____
fHl()c N\ Rel(~' J.. .____
in the above estate
TOTAL. . .
$ CJt;O. CO
$ LkJ. OD
$ ~jrro
$-1S,Ol)
$ jD ,Cb
$
$
$
$
$
$
$
$
Attomey Signature:
Letters ...
Short Certificate(s) . . .
Renunciation(s) ....
IMlll
jet '_"
r\lXtDYY\(l~~. . .
Attomey Name:
Supreme Court 1.0. No.:
Address:
Telephone:
Fun" RW.()] rev 10.13.06
Page 2 of2
:}/' cP~ ()3,f V
LOCAL REGISTRAR'S CERTIFICATION OF DEt f'H
WARNING' It is illegal to duplicate this copy by photostat or phok'qrap 1
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:11 ()11i2II:iI Certificate oj Death
i ()c,iI l^'ci2i"trar. The orit!illal
"I\\:lI"<k<l Ll the State Vital
lL!Ilen filillt!.
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REV 11/2006
f PRINT IN
MANENT
\CK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
STATE FILE NUMBER
1, Name 01 Decedent (First. middle, last, suffix)
Cumberland
IBC City, Bom, Twp, of Death
South Middleton
I';:male 13soc'al~c~'rN:b~8 -4034
7.8irthptace(Cilyan<lstateorforeigncounlry) 8a. Place of Death (Check only one)
I I Hospital: I Other'
30. 1927 Carlisle. PA lXl'cpallOCI DER/Oulpali,nl DooA DNu"mgHom, DResldecce DOlh"'Sped~
ad. Facility Name (II nol inslitution, give street and number) 9. Was Decedent of Hispanic Origin? IX! No 0 Yes /'0. RlIce: Ame.jcan Indian, Black. While, ele
(II yes. specify Cuban, (5peclfy)
Carlisle Regional Medical Center Me"c"" Pue" RIO"', ,'e) White
12 Was Decedent ever in the 13. Decedent's Education (Specify only highest grade completed) 114. Manlal Status: Married, Never Married(115, Surviving Spouse (If Wile, givE~ maiden name)
U.S. Armed Forces? rElementary I Secondary (0-12) College (1-4 or 5+) I Widowed, Divorced (Specify)
IlIves DNo 12 3 Widowed
Decedent's Did Decedent
ActualResidence 17a.Stale Pe.nnRylvania ~~;~:h~P?
17bCounty Cnmhprland
!,OateofDeath(Month,day,yea,)
Karch 25. 2008
Barbara
5 Age (Last Birthday)
Lee
Mvers
80
Under 1 yeal Under 1 day 6 Dale of Birth (Month, day, year)
V" I Moo,", I 0." I Hoo" I M,,,,.., I Kay
8b. County of Dealh
11. Decedent's Usual Occupation I<ind of work done durinn most 01 warkin lite. Do not slale retlledl
Kind 01 WoO I V ari~1i8slcM ""!t'lian
Reeistered Nurse . :1~
. 16 Oecedenfs Maiting Address (Street, city.' town. stale, ZiP Code)
210 Dorwood Drive
Carlisle. PA 17013
18. Father's Name (First middle, lasl, suHi~)
George G. Sayers
20a. Inlormant's Name (Type I Print)
17c !Xl Yes, Decedent lived In
17d. 0 No, Decedent Lived wllhin
Aclual Limits of
North Middleton
Twe
19, Mother's Name (Firsl, middle, maiden surname)
Emma Anna Mueller
Cityi Bora
Kr. William J. Myers
21a. Method 01 Disposrtion I IX] Cremation 0 Donation 21b. Date 01 Disposition (Monlh, day, year) 21c. Place of Dispositior1 (Name of cemetery, crematory or other place)
. 0 Burial 0 Removallrom Stale Was Ctemallon or Donation Authorized Ka h
o O'her.Specify by Medical E..miner/Comner' ~vesDNo rc 28. 2008 Cremation Society of PA
. 22a. Signatur'fl F";~' SeIViC8 uc'n.s~e (or person jling as such) f22b.license Number 122c. Name and Addre:s ~f :a~lity Auer Mem~ri~l Home and
. ~ ^~)o-x.... ( ) -Co", I FD 010696 L I I.wn Il~"...
Complete Items 23a-c only when certifying 23a. To the best 01 my knowledge, death occurred at the time, dale and place staled (Signature and tille)
pllysician is not available at lime 01 dealh 10
certify cause of death
201:>. Informant's Mailing Address (Street, city I town, stale, Zip code)
2412 William Street. Augusta. GA
30904
121d. Location (City/lown, stale zip code
I Harrisburg. PA
17109
Cremation Services, Inc.
1>.\ 17101)
23b. License Number
23c. Date Signed (1I'1ont~l, d.:.y, year)
~~~~Te~1tt~~~ ~~~~ dise~
125. Dale Pronounced Dea~ (Month, day, ye~r)
A- M. 3- ,;:. ~" d,OO 2?
CAUSE OF DEATH (See Instructions and examples)
Item 27. Part I: Enter the ~ - diseases injuries, or comphcalions - thal directly caused the death. 00 NOT enter lerminal events such as cardiac arrasl,
respiratory arrest. or ventricular fibnllatlon without showing the etiology. List only one cause on each line
':)
l/<J~"1'\IA
Due to (or as a ces!.~u~nce 01)
b ) I ,e.t' "-eo"
Due 10 (or as a consequence of)
24 Time af Death
I L.. If
26 Was Case Referred to Medical Examiner I Coroner for a Reason Other than Cr(~malion 0' Donation?
o Ves W-No
llems24-26 must be completed by person
. who pronounces death
Approximate inteNal
Onset to Death
Part II: Enler other sianificant conditions contribulino 10 death,
but no! resulting in the under1ying cause given if1 Part I.
28. Did Tobacco U~.e COIltribJte \0 Death?
DYes J:J Probably
U"NO [J Unkn'Jwn
29. If Female:/'-
~'~regnantwilhinpastyear
o Pregnant ,It lime 01 death
D Notpregnllnt, but pregnant within 42 days
at death
o Notpregn<!f1l.bu'pr~gnant43daysl01yeaT
before death
o Unknown i' pregnarl' WIthin the past year
Sequenhallh list conditions, if any,
~~l~~ JJD~~~i~~~r~~ a
(disease or injury that ifIiliated the
. events resulling In death) LAST.
Due to (or as a consequence of)
d.
30a. Was an Autopsy
Performed'
3Qb. Were Autopsy Findings
Availabte Prior to Comoletior1
01 Cause ot Death?
31. Manner 01 Dealh
32a. Dale 0' tr1jury (Month, day, year) f32b. Describe How In;ury Occurred 32c. Place of Injury Home, F3rm, Streel, Factory,
I Office Building elc. (Sp€(:ify)
o Accidenl 0 Pending tnvesligalion 32d. Time 01 Injury l32e. injury al Work? 32/. Ii Transporta. tiO. n Injury (Specify) 7'1" r 32g. Location of Injury {Street, city I town. slate}
o SUicide 0 Could Not be Determined 0 Yes 0 No 0 Dnver I Operntor 0 Passenger Op.. strlan
M DOther-Sp6CIfy
338. Certifier (check only one) 33b Signalure and Title of ge~ter "
Certifying physician (PhysiCIan certifying cause of death when anolher physiCian has pronounced death and completed Item 23) ... ;;':'--:>. ...)..J 02.1! ~\ J\J_"._"'t../l_
To the best of my knowledge, death occurred due to the cause(s) and manner as staled- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0
Pronouncing and certifying physician (Physician both pronouncing death and certifYing to cause of death) , '3~c License Number . 133d Date Signed (Month day, year)
To tile best of my knowledge, death occurred al the lime, dale, and place, and due 10 the cause(s) and manner as slaled_ - - - - - - - - - - - - - - - - _.-EJ c, "'" (?, (Ii!, Z. t(. j __ i 'Nt A'" "')' __~:;-. l (l'(:'~ :;,~
Medical Examiner f Coroner ..;; ~ \ ~_. _;;
On the b,," of ...mlnallon and I 0< '''''''9allon, In my Op;ClOO, death occ",,,d " lhe tlm., d"e, and place, "d duo 10 Ih. causels) and macner" stal.d. D 34 Nam, aod Add"~:3 ~{ftPL'~"~~.t O,,'h (lI.m 271 Typ'i O'lel ~.
35.Registrar'SSi~eandDiSl[iCl~r. ""'--'1'7 136.Date:ited(Mo~th,day,year) C ' 1') I 1/1 If Ie. ,-'
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o Homicide
Dyes .DNo
DVes .DNo
DiSposilion Permit No
0195836
OF
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LAST WILL AND TESTAMENT
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BARBARA LEE MYERS
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I, BAR BAR ALE E MY E R S, ale gal res ide n t 0 F Cum b e r 1 an;d-I
County, Common we a 1 th of Pennsy 1 van i a, be i ng of sound ari'a- ['-,) , ,
disposing mind and memory, do hereby make, publish and declare
this instrument to be my LAST WILL AND TESTAMENT. I hereby
revoke any and all wills and codicils by me heretofore made.
I
IDENTIFICATIONS AND DEFINITIONS
A. I am married to WILLIAM JENNINGS MYERS, JR., hereinaFter
referred to as "my spouse." We have two children, WILLIAM
JENNINGS MYERS, III and ANNE MYERS REID, hereinaFter referred
to as "my children." My husband has one child, PATRICIA
LEE CLOUD, of a previous marriage. I have intentionally
omitted to provide herein for PATRICIA LEE CLOUD and for
any other relatives or For any other person, whether claiming
to be an heir of mine or not.
B. The following definitions obtain in any use of
the terms in this will:
1. "Descendants" means the immediate and remote
lawful, lineal descendants of the person referred to, and
it means those descendants in being at the time they must
be ascertained in order to give effect to the reference
to them, whether they are born before or after my death
or of any other person. The persons who take under this
will as descendants shall take by right of representation,
in accordance with the rule of per stirpes distribution
and not in accordance with the rule of per capita distribution.
Persons legally adopted when under the age of Fourteen years
shall not be differentiated From blood descendants for any
purpose.
2. "Survive me" is to be construed to mean that
the person referred to must survive me by thirty days.
If the person referred to dies within thirty days of my
death, the reFerence to him shall be construed as if he
had failed to survive me.
Page 1 of 4 Pages
3. As used in this will, the words "Executor,"
"he," "him," "his," and the like shall be taken as generic
and applicable to a natural person of either sex or a corporatE!
person of other legal entity.
C. I have served in the Armed Forces of the United
States. ThereFore, I direct my Executor to consult the
legal assistance oFFice at the nearest military installation
to ascertain iF there are any beneFits to which my dependents
are entitled by virtue of my military aFFiliation at the
time of my death. Regardless of my military status at the
time of my death, I direct my Executor to consult with the
nearest Veterans Administration and Social Security Administr'ation
oFFice to ascertain iF there are any beneFits to which my
dependents may be entitled.
II
PAYMENT OF DEBTS AND TAXES
I direct my Executor to pay the Following as soon aFter
my death as may be practicable:
1. All of my just debts and the expenses of my
last illness, Funeral and of the administration of my estate;
but my Executor need not accelerate and pay those unmatured
obligations which, in his opinion, it might be proper and
more advantageous to retain or renew and pay as they become
due and payable.
2. All inheritance, transFer, estate and similar
taxes(including interest and penalties) assessed or payable
by reason of my death, on any property or interest in my
estate For the purpose of computing taxes. My Executor
shall not require any beneFiciary under this will to reimburse
my estate For taxes paid on property passing under the terms
of this Will.
III
RESIDUARY ESTATE
A. I deFine "my Residuary Estate" as all of my property
aFter the payment of debts and taxes under Article II, including
real and personal property, whenever acquired by me, property
as to which eFFective disposition is not otherwise made
in this Will, and property as to which I have an option
to purchase or a reversionary interest.
Page 2 of 4 Pages
B. I give my Residuary Estate to my Spouse iF he survives
me.
C. IF my Spouse does not survive me, I direct my Executor
to divide my Residuary Estate into equal shares and to distribute
those shares as Follows:
1. one share to each of my children, WILLIAM
JENNINGS MYERS, III and ANNE MYERS REID;
2. iF either of my Children, named above, Fails
to survive me, then his or her share shall be distributed
equally among his or her descendants who survive me;
3. iF either of my children Fails to survive
me and leaves no descendants who survive me, then his or
her share shall go to the survivor of them or their descendants
who survive me, as set Forth in subparagraphs 1 and 2 above.
IV
APPOINTMENT AND POWERS OF EXECUTOR
I nominate and appoint my spouse, WILLIAM JENNINGS
MYERS, JR., as Executor of this my LAST WILL AND TESTAMENT.
IF my spouse, WILLIAM JENNINGS MYERS, JR., is unable or
unwilling to serve in this capacity, I appoint WILLIAM JENNINGS
MYERS, III of Port Orange, Florida, and ANNE MYERS REID
of Bethlehem, Pennsylvania, as Co-Executors to serve instead.
I request that my Executor be permitted to serve without
bond or surety thereon. I authorize my Executor to do any
and all things which in his opinion are necessary to complete
the administration and settlement of my estate, including
Full right, power and authority, without the order of any
court and upon such terms and under such conditions as my
Executor shall deem best For the proper settlement of my
estate; to bargain, sell at public or private sale, convey,
transFer, deed, mortgage, lease, exchange, pledge, manage
and deal with any and all property belonging to my estate;
to compromise, settle, adjust, release and discharge any
and all obligations or claims in Favor of or against my
estate; and to borrow money For the payment of inheritance
and estate taxes or For any other purpose. Without in any
way limiting the scope of the powers enumerated herein of
my Executor, I hereby speciFically give to him Full power
to retain any and all securities or property owned by me
at the time of my decease whenever, in his absolute and
uncontrolled discretion, such a course shall seem to him
Page 3 of 4 Pages
to be best, without liability For depreciation or loss,
and Free From investment restrictions incident to executorship,
whether imposed by common law or statute. In the execution
of his duties and powers as Executor he shall have the power
to comply with all legal requirements as to the execution
and delivery of deeds and all other writings, documents
or Formalities without the order of any court; and he shall
Furnish a statement of receipts and disbursements at least
annually to each person then entitled to receive income
or property From my estate.
IN WITNESS WHER.EOF, I have at Carlisle, Pennsylvania,
this + day of //LW<t.--C 1992, set my hand and seal
to this my LAST WILL D TESTAMENT consisting of Four (4)
typewritten pages.
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B'ARBARA LEE MYERS
Testator
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(SEAL)
Signed, sealed, published and declared by the Testator,
BARBARA LEE MYERS, 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 hereunto subscribed
our names as witnesses.
NAME
ADDRESS
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA) SS:
COUNTY OF CUMBERLAND )
I, BARBARA LEE MYERS, Testator, 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,
LEE MYERS, the Testator, thi s' day of / (I, ,~" _
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by BARBARA
1992.
NfJTARIAl SEAl
ROSlf M.I3URTON, Notary Public
C<>.:~\;);<;, Curnt1i:rland County
My CCil;r1is~j,~f' b.pltl;~ M-ty fj, 1~
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BARBARA LEE MYERS, T~stator
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Notar~ Public
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA) SS:
COUNTY OF CUMBERLAND )
'.
, W_8.. ' f.. !,I; !J ' 'I" < < I ' , I , i3 n d
i' ""/ ",' l (Ir f' ; 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 Testator sign
and execute the instrument as his Last Will; that BARBARA LEE MYERS,
signed willingly and that she executed it as her free and volun1:ary
act for the purposes therein expressed; that each of us in the
hearing and sight of the Testator signed the Will as witnesses; and
that to the best of our knowledge the Testator 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
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witnesses , this (I day of " '," /. 1 992. I
me
by ,f(;,TN ,t? ';0,,) (".
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NO r AH1AL SEAL
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~;arl;.;ie, ~;LJmberlano CclNlfy
My COIl1m;S~l(;n Expires Mey 6.1__
2153455857
EASTBURN GRAY
10:35:46 a.m. 03-31-2008
RENUNCIATION
REGISTER OF WlLLS
C1.j.mberland COUNTY, PENNSYLVANIA
~I-()S'~ G3<6Y
Estate of Barbara L _ Myers
I, William J _ Myers
(prliJJ ~)
Co-execllt.or/son
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. in my capacity/relationship as
of the above Decedent, hereby rCDOUDce the risht to
administer the Estate of the Decedent and respectfuDy request that Letters be issued to
Anne M. Reid. Executor
March 31, 2008
(DtIIt)
ExecMtdi" Regi#er's OJJlce
Sworn to or a1linned and subscribed
before me this day
of
Deputy for Register oCWiUa
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ExeClltetllllllllf Register'$ Office
Before the undersigned personally appeared the
party executing this renunciation and certiti-ed
that he the renunciation for the
:t~C~~ i;thin 'on this. .<.~~~/_ ~
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(SipIIure _ Seal ofNoIary or oIIlcr olfital ~ 10
~ oalill. SIIow _ of npDtio. ofNOlIIry'5 Coumiuioa.)
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