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Home My WebLink About04-08-08 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Estate of Ruby J. Myers also known as CUMBERLAND COUNTY, PENNSYLVANIA File Number 21-- I) ~ IJY/\<{ , Deceased Social Security Number 181-32-4446 Angela M. Myers Petitioner(i>), who is/are 18 years of age or older, apply(ies) for: (COMPLETE :4' or 'B' BELOW) o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the last Will of the Decedent, dated and codicil(s) dated named in the 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: 00 13. Grant of Letters of Administration ~ & app ~ca e, en ef: c. .8.; . .n.e. .8.; en e f e; uran e a sen la; uran e romon a e,' ~':' :J:J ,[ I Petiti.o~er(s.) after a proper search has/have ascertained that. Decedent left no Will and "Yas surxived by the following sp~~Qf-Jny) a~heirs:.c (If Admlnlstra/"/On, c.t.a. or d.b.n.c.t.a., enter date of Will In Section A above and complete Itst of heirs.),} '1;; r- ::::0 -,"c.: .~ !~~:;: 59 ' , ' , Name Sherry J. Cline Relationship Daughter Residence , C) ~-) ., ''''. 'q s-:;> Ruby L. Fleming Daughter 4 N. Second Street:'::;' ~ Lemoyne, PA 170~---; 20 N. Second Street Lemo ne PA 17043 724 North Front Street Lemo ne PA 17043 ::.r: "P Angela M. Myers Daughter (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his / her last principal residence at 9 N. Second Street, Lemoyne, Lemoyne, Cumberland, PA 17043 (List street aefdress, town/city, township, county, state, zip code) Decedent, then 68 years of age, died on 02/06/2008 at East Pennsboro Township, Cumberland County, Pennsylvania Decedent at death owned property with estimated values as follows: (If domiciled in PAl 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 situated as follows: 700.00 $ $ $ $ Wherefore, P,etitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Signature , oJ ~U:VJJ (J fi!t/]~~ C Angela M. Myers Typed or printed name and residence 724 North Front Street Lemoyne, PA 17043 I Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group. Inc. Page 1 of 2 Oath of Personal Representative } SS } COMMONWEALTH OF PENNSYLVANIA 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 of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. before me this t Sworn to or affirmed and subscribed ~\ ~~ Signature of Personal Representative 21-- 01, 10"o~ (] Co --. :u J-n :':C:O '-"",r- ,;; FI, "~'~f-':~;~ 00 c.J-n C :u ..,-.-; .)I f'-.;) """" = 0:> ;n.. -0 ::::0 , CX> :u ~~[: f3 ( , ,~) :~.,lJ ,-_~:~~.J \.__.i ,_ ",-n j ~':':J Signature of Personal Representative :J:o. :x 1..0 -. C') ---f, or; i!~: r~ . .., (=;:? File Number: Estate of Ruby J. Myers NKJA , Deceased AND NOW, Social Security Number: 181-324446 \\\1{\\~ Date of Death: 02106/2008 'h,()\)ct , in consideration of the foregoing Petition, satisfactory proof of Administration having been presented before me, IT IS DECREED that Letters are hereby granted to Angela M. Myers in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filled of record as the last Will (and Codicil(s)) of Decedent. FEES /:) () (, Letters..... ....................1.0............ $ Short Certificate(S).............~....... $ Renunciation(S)..................:'h:..... $ 7-0 I~ to -1~~(;. ~ ~J~ ~,,>gI~r AttomeyS;goat"~ o~;i;f Attorney Name: _ B. Hlpp jC~ ~k> $ $ $ $ $ $ $ $ $ [0 --- S Supreme Court I.D. No.: 86556 Bogar and Hipp Law Offices Address: 1 West Main Street Shiremanstown, PA 17011 Telephone: 717-737-8761 l.9{Ob TOT AL....................... ... .......... $ Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group. Inc. Page 2 of 2 HtO).XO) REV dll/()7) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6.00 P 14121699 Certification Number n So . :::0 U .-LO )--"j=; :2;:b en^ ()O (_)-'T1 C ::0 ::p-l -- REV 1112006 PRINT IN lANENT :K INK COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) ~~Q , I1~_ T L.-.:;r-,' V LUUU Date Issued I'.) c:::> <:::::) 0::> )> -0 :;0 I CO HI] J i-I .. -) ~~ ~~-~~ ;:::-) (-" r--" ''7l -n C') [Tl :x:- :It I..D .. STATE FILE NUMBER 1... \ oS b'"bq'b -32 -4446 6. Dale of Birth (Month, day, year) 14. Manlal Status: Married, Never Married. Widowed, D<vorced (Specify) divorced Did Decedent live in a Township? 17c. 0 Yes, Decedent Uved in 17d,~,DecedenllMKlwilhin Wormleysburg Actual Umilsol City/Born 19. Mother's Name (Arsl, middle, maiden surname) Hattie Bell 201:1. Informanl's Mailing Address (Street, city I town, state, zip code) 20 N. Second St.,Wormleysburg,PA 17043 21c. Place of Disposition (Name 01 cemetery, crematory or other place) Tri-County Mem. Gardens Twp. 21d. Location (City flown, state, zip code) ewisberry,PA17339 23b. license Number 22c. Name and Address of Facility L Musselman FH&CS,Inc.,324 Hummel Ave.,Lemoyne,PA 17043 23<:. Date Signed (Month. day, year) 24. Time of Death Part II: Enter other sioniflC'Ant conditions contributina to death, but not resulting in the undertying cause given in Part !. 2e. Was Case Referred 10 Medical Examiner I Coroner far a Reason Other than Cremation or Donation? DYes il!.jNO CAUSE OF DEATH (See Instructions and examples) lIem 27. Part J: Enter lhe kbail~ - diseases, injuries, ar complications that direcUy caused !he death. 00 NOT enter terminal eve respiratory arr,m, or venlricular fibriUation wiIhouI showing the etiology. list only one cause on each tine. Approximate interval: Onset 10 Death ~~~~ATe~Jtt~Si ~~\ dise~ /I1V((."(I/'((;' fJ't..611-N f>>H.Wt.r..': Due ta (or as a consequence on: /" b. /c-~II c "iff) C f( c. DueIO(OiH~~~jylfrl'; /f:tc,it:3-J' d. Due 10 (or as?;;?:tv M A I c,.(;t-(. r,qH..1A (..c ~ l/fIf..o HI 1-1 C."JaI( NIA- he. ~VI Sequentiahy tisl conditions, if any, ~~~Jt:D~~:~~~ a (disease or injuy that iniliatedlhe events resulting In death) LAST. 30a Was an Autopsy Performed? 3Ob, Were Autopsy Rndings Available Prior to CompletIon of Cause of Death? 31. MallOBl'ofDeath o Naluoat 0 Hom_ O Accident 0 P,""nglrwestigalioo o Suicide 0 Could Not be Delermined 32d. Time 01 Injury 32g. Location of Injury (Street, city! lown, state) Dyes 0 No Dyes ONo M. 33a. Certifier (check only one) ;~::'::r~~~=:n~~~::::~ ~~:c~u=~~~:~:r~: =-~_ ~~h _a~ ~~~ ~e~ ~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 .. ;::u~n~fa~~ ~:~:~hJ:.~~O::u~i: :~I==n:n::::C:~~~rt~~;~ot~~a~:~~:a~~ manner as stated.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 ~~:I~::n~~::~;~~:::~ and I or investigation, In my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as slated.. 0 28. Did Tobacco Use Contribute to Death? DYes OP'ol>ably o No 0 Uoknown 29.IrFemale o Not pregnanl wrthin past year o Pregnant alUme of death o Not pregnant, but pregnant within 42 days 01 death o Not pregnant. but pregnant 43 days to 1 year before death o Unknown if pregnant within the past year 32c. Place of Injury: Home, Fann, Slreet, Factary, Office Building, etc. (Specify) Idl 11011/' ," Iu. -c-;; / -H1t ~ ~ .14 '1 ;. t, ! It- /::n {) 2... 35. Registrar's ~ Disoosifion Permit No ~ \ () <t, () ?!'<{ RENUNCIATION REGISTER OF WilLS CUMBERLAND COUNTY, PENNSYLVANIA o Go '----: :::D -'-0 :-'[0 ~~ 1:> 1- -/~.rn ,c,:~ X! .'.':::::^... ?-=5 ~ ':5 ;9. --l Estate of Ruby 1. Myers I, Ruby L. Fleming (PrInt Name) daU2hter . in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to .Angela M. Myers _ 4- 4- o? (L'1ate) /;::(;.t. :i/J ~:/ . 20 N. Second Street (Street Address) Wormleysburg, PA 17043 (City, Sfl1te, Zip) Executed in Register's Office Sworn to or affirmed and subscnoed before me this day of Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified ilia. t he or she executed the renun~~ for the p~s stated within on this day of IY\J...J . ,;ZOO~ . 7JJ.; d...1 J,.. 1.. ~0 Notary Public . My Commission Expires: - Deputy for Register of Wills (Siguature IlIId Seal of Notary or oIhIlr official qualified to administer oaths. Show dale of expiration ofNOlary's Com:1Dssion.) };'orm RW-D6 rev. 10.13.06 COMMONWEALTH OF PENNS iLl/ANIl, Notarial Sea! ~ Michele L Moyer, Notary Public Camp Hill Borc.':, ..t-!:'~rl2!nd County " ~7 Cc~m~j~s~c.~' E> "3::,''"_,!. ~":~~\ :2:.YJ.3 r r---;) c:::> = = ~ -0 :::0 I CO .-. . Deoee.sed ::0- ::E: \.0 .. ,0 '" .-') .c_::, l~ ',__J ( ~-:, (~~) " 'Tl . .. "'i'] :.,:~-: .~ ". 'r'T' J 1.' 0 '6 (.)~ ~~ o -n =u ..~~ <:'/)7' ,~~<o ; ,~,# --r1 )c ..... :D ~--1 f"--) = = 0::> ):Do -0 A) I co > ::I: ~ RENUNCIATION REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA (') ":'~1 ,: ~L3 1Hr1 Estate of Ruby J. Myers , Deceased I, Sherry 1. Cline (Print Name) dauWiter ,in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~~gela M. Myers - (Dale) '1/ i./ 0 J> '""\ 1/1 ::l , ~~ /) (C 'U-Z 4 N. Second Street (Street Address) W ormleysburg, P A 17043 (City. State. Zip) Bxecuted in Register's Office Sworn to or affirmed and subscribed before me this day of Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunci tion for the p~ses.stated within on this .,.-L day of P/~ ~ , - Deputy for Register of Wills Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's CouunissIoll.) Form RW-06 rev. 10.13.06 pOMMQ.~~EAL TfLQL PEl\JNS{i~j!.:0L ~ Notarial Seal I Mic~!e Mol"sr. Not.a:j' Public , i I"C~.:~~?,f:~!J ''';~~''-''':'.~~;~'''.~~:::':'-