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HomeMy WebLinkAbout11-13-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Nellie E. Miller also known as COUNTY, PENNSYLVANIA File Number 21-08- //;~,~ ,Deceased Social ,3ecurity Number 202-36-8519 Gary L. Miller Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or `B' BELOW) ~X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executor named in the last Wlll of the Decedent, dated 09/11/1971 and codlcll(s) dated Primary Executor, Robert P. Miller, and alternate Executrix, Joan M. Shambauph, renounced their right to serve in favor of their brother, Gary L. Miller. State relevant circumstances, e.g., n=nunciarion, death o/executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after e:Kecution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: B. Grant of Letters of Administration ap rca e, en er c..a.; ..n.c..a.; en e r e; uran e a sen ra; uran a rnrnon a e Petitioner(s~ after a proper search has/have ascertained that Decedent left no Will and was survived by the folllowing spouse (if any) and heirs: (If Administration, c.t.a. ord.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Name Relationship Residence r,,,, C7 0 -::; ~ --~_ .~ _. r-1 _._. _, 1 ~' ~ ~_. __ ? ~.-~ ~~] (COMPLETE /N ALL CASES:) Attach additional sheets if necessary. ` -` - ` r`i --{ Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal reside at ~ , Church of God Nursing Home, Carlisle, Carlisle, Cumberland, PA 17013 (List sheet address, town/city, township, county, state, zip code) Decedent, then 99 years of age, died on 11/01/2008 at Church of God Nursing Home, Carlisle, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) (If not domiciled in PA) (If not domiciled in PA) Value of real estate in Pennsylvania situated as follows: All personal property Personal property in Pennsylvania Personal property in County 144,000.00 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 appropriate form to the undersigned: e Gary or printed name >.780 Blackberry Dover, PA 17315 Form Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 of 2 '. 7 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } 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 of Petitioner(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 before me this f ~) day of c,a - ~J ~~ ~ ~ Signature of Personal Representative L t'_7 - , __- For he Register Signature of Personal Representative ~ ,.~ C `;.r ~ __ ` - . ... e~w File Number: 21-08- ~~~~ Estate of Nellie E. Miller ,Deceased Social Security Number: tf~,,2O2,-f3~6n-8519 Date of Death: 11/01/2008 AND NOW, ~ ~~ ~ ~VV ~~Il~~.fJ t, ~_ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, I IS DECREED that Letters Testamentary are hereby granted to Gary L. Miller in the above estate and that the instrument(s) dated 09/11/1971 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............................................ $ ~ ~ ~~. v Short Certificate(s) ........................ $ ~~. Renunciation(s) ............................. $ / ~ ~ ~~ ~C~' $ t'l~ , da $ TOTAL .................................... r ~ Register of Wills /Y v~ Attorney Signature: ~ ti~,(~ A Inn. _ l Attorney Name: .Jan M Wileyr ~' Supreme Court I. . No.:. `06978 The Wiley Group, PC Address: 130 W. Church Street Dillsburg, P,A 17019 Telephone: 717-432-9666 $ 0.3~ ~ ~ Form RW-OZ Rev. 1413-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 i~Ct~-il~~ LOCAL REGISTRAR'S CERTIFI(;.~~TION IMF DEATH WARNING: It is illegal to duplicate this cc,~py k,}/ photostat or photograph. Fee for this certificate, $6.C0 P 14793347 Certification Number This is to certify that the information here given is correctl~~ copied ti-om an ori~~inal Certificate of Death duly' filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ~~~ ~ ~~~-,, 1 i~ ~ 3 ~ v~ Local Registrar Date Issued rs 0 C~ ~ ; ~ i ~ `J O cn ~ - --i_ ', ' „ ~ ~ _ ,= ~ ~ ~. ,1-,-z _- r ~ , + ~, - ~ , -7-'~ - ; ; ~ __ ; . - ~ = r, ' ` ~ 1 CJ ~ -1 •..! cal Hms~14d REV nr2w6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE ; PRINT do PERMANENT BLACK INK CERTIFICATE OF DEATH (Sae instructions and examples on reverse) sTATF Frl F raiixxAFo .. .......• -. ~.w,,, i„~>,. ~~,~,..~, w>i, >.,iiixr - 2 Sax 3. Social Seca Number '- Nellie E. Miller Female a q DateaoeamlMonm dayyearl 202 _ 36 _ 8519 November 1, 2008 5. Aga (Lass Binhdayl t1Mer I year UnAer I tlay 6 Dale of Birth (Month, da ,year) 7. Binnplace (City and stale a lore) COUnlry) Ba. Place a Dealn (CMck only One) xwnra P.ya wwa Mnures Hos ~ 99 Y,a February 12, 1909 Broadway, Virginia °' doer. m Da, I Deem ^mpauenl ^ ER ro„Ipauea ^ DGA ~Naaing Home ^ Resmaike ^otner sp¢cey. mY o &. Cey. Born, TwP. of Death 8d. Faciary Name III rid institution, give areal ano raxroerl 9. Was Deceds nl of H isPanic Ongin7 ®,No ^ Yes 70. Rare. AmeriWn Yidan, &a:k Wm;e, etc. Cumberland North Middleton Twp. Church of God Nursing Home I"ye$ ePedimaba^ IsPecinl Mexican, Pusno Rican, ac) W h Ice Il. Decedents Usual DCLd non IKlib a waA dxvd Burin most of waltin tile. Do not state retired 12. Was Decadent ever m IDe 13. Decedenl'9 Education (Specify only highest grade cornpl¢led) 14. Martial Status: Married, Never Marred. f 5. Survm Kind d Wod Kmtl of Business I Indus) U. S. Armed Forces? ng Spouse III mle, {yve marten name) ry ~i Elementary / $ecordary (012) Cdlege (1-4 «5.1 'Niadwed, Divorced ISpeciy/ Homemaker Own Home ^Yea plNd 8 Widowed 16 Decedents Mailing Adeaess ($Ireel, city I bwn, slate, zip cotlej D¢cadeas PA Da 13eceeea over 2780 Blackberry Road AcwdResmance na sate low sra tic ~Ya:, DaeaerilD.edm T„~, Dover, PA 17315 vb coney York ~'? I7d ^ Nd, DecetlemD~adwdnm Acldal Carrie a coy , BOm 16 Fdmar's Name IFrtsl mitlde, last. stain) 79. Maher s Name (First, made. maiden 5umame) Thomas Pennington Hannah Williams 20a Intomant's Name IType % Pnm) 2gb. mlormanl'S Mailnq Atldess (Street Cdy /town, smle z ode) Gary L. Miller 2780 Blac~Cberry Road Dover, PA 17315 eta Metnotl OI Dispomuon ^ Cren>aear ^ Donaton 21 b. Dale of Disposigon (Monty, day, year) 21c. Place of Disposition (Name d camel ~Bwial Rerarval Irom Stale ery, crematory or diner INaCe) 21 d. Location (Coy I town. SWe, by Code) ^ Was Cremalron a Donation AuNOrized ^ aMr ,r ' brFbemaExamlrKryc«enera ^yea^N^ November 6, 2008 Chestnut Hill Cemetery Mechanicsburg, Pa. 17055 22a. re a Funera o rs« acYr,Oi su:h 22b. License Number 22c. Nartie and Address a Fatlfry ~~ FD-012662-L Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055 Canplele dams z3a~c Dory when [erDP/mg 23a To the t a my knowle , tlealn occurred al the lime. dale and place slated. (Signature and bile) 23D. license Number 23c Dele &gned IMonN, day, year) pnysinan is trot aradaDle al lime of death to J cedry cause a dean ~_ ,~$ yV ~L~~~~v. (~ _ ~ +(,~,~Kv / z4 Ttme or Dealn ~UU uems 242tl muss De comWaletl byiQorson 25 Dale Pronduncetl Dead (Monty, day, year) 26. Was lase Referred b Medical Examiner I Canner Ia a Reason Other man Cremation a aaMlion? wlp Prrnowtces death. ~~ M. / ' ~ ,~ LY7~1 n ~L / ~ CJ n~' ^vas ~aNo CAUSE OF DEATH (Sea Inatructiona and eaempMs) i Appronmate iderval: Pan II: Enter door rg~tl016tSpNtlGutipQto Ueam 28 Did Tobacco Use Cailnbule b Deem? Item 2/ Pan I Enter ll'.e {JtgI1t41 evt.ls - 0ue:tizs. inlunas, or cornplicabons -mat dreary cau5etl me Beam. DO NOT ed¢r terminal events such as cardiac ar:esl, Onset b D¢atn bW not r¢sullin Ih6 uM¢n respretory arrest, a vearicular libnl4bon wiUiout slwwing tM euoloyy Lisl only one cause on aacn line 9 in yug Cause given in Pan l ^ Yes ^ Piobebty ^ No ^ Unknown IMMEDIATE CAUSE '1Final disease or ~ / caNibon resWang n deaml ~ a l ,`s may-. \ ~ ~ 1 „ _ r~ ~ \ ~ ~ ~ ~ 29. II Female: Due to ( aYiL 4 se<Ilue ce a). NKJ- n Nul {.rup~anl wilnm µ,si yxai Jey Bally Y>I ~axaliur~>, d any D I¢aMi~ Ip uia Ceuw Wtatl ai Lne d I _I Pugianl al linty of dulls Fi la N.e UNDEflLYN/G CAUSE Due IO jar a> a wnwyuunco ulj. I Nnl piegii,u,l. but piuynaid xnlan J: J.n, fdseuse a nyury Ilia) inilidlc-0 Inn evems raswung x. dennl LAST. a death c Due to (a as a wnsequence otj. d. ^ Nut pregnant. but p•,egiwn143 U>ys l0 1 year ~ oelore d¢ain ^ Unxnorvn it piegnent wiean Ina G+sl /oar 30a Was an Autopsy 30b Were Autopsy Findngs 31. Ma car of Deam 32a Dale a Injury (MOnm, tlay, year) 32b. DescriM How Ina Occurred P¢Aanu=d? Available Prgr td Camplaba .. I ry 32c Place d injury Home Farm $lieel. Factory of Cause of DealM ~Imel ^ HomiciUe Odx:e BudOirg. ac Spat,/y) ^'i es QNO ^ Yes ^ No ^ Aceidenl ^ Penang Invesugalion 32tl. Time 01 Injury 32a. Injury al Worx? 721 It TmnspoAdtwn Injury (Speedy) 32y. L«ahm of Iryury ISUee1 city I town ;tale) ^ Suk~Je ^ CoulU Nul he Delermaied M ^ Yus ^ No ^ Unva! Gperala ^ P nga ~]Pedesliiari ^aher - $panly 73a Candler Icnecx Only one) 33b syriawre ~ a Hier n ~ • CeNlying pnye{clan IPhyaluan candying cause OI tlaalh ~~hen en„mer pliysiuen has pronounced Jeam and complelad lien 23) - Jl TO tM Msl of my knowkdge,deam occurred due to the causels)end manner as sated_________________________________ - • Prorwuncmg and eenlrying phy 'C' (Physkia bu h p mg death and ce Icy y I e ul dealt I 33c Licen 33d Data $iynnd ltlunlh yeatl io IM best of my knewladge M th « rred aI tM 1 0 le, art place and due 1 the use(s) a d n Wiled _ _ _ _ _ ~~ T r ~~~,,,yyy • Medal Examiner I Crooner DO I I/ ']. ~ ~ ~ (( / ~ `^ ]~i On tM basis o7 aarmnalion a d / sligal y li moo, death «curred I In \ e.. date, nd place, and due to the cause(s) d manner as stated ^ T 'V U _ :f4 Nem2 aritl Adtlres5 0l Perron Ylnd Co\mVlemd Cause a Dcaln Iltun 27'1 /TyV+ Pn~il 3~ flayull -~ ignalu~ yd C~.sVdit Nw a 36 to F~ (Monet day year) F C I~ fG a ~ ~a `.y N vv' L l n/ <y pl A V1 sL - IWIJ {a`I -r~CI l Ia,.l1 I~,I ~VeK~et-,3 p ca+.r~~SLa,t~- L~tcl~ Diaixsinw Pe,p,n No, v a ~'l l o 7 ~ ~~, t.c ~ ~ ~~ ,~ OF _ ~ -~ , -~ ~ -.,. c=; -~c `- r-rz w. NELLIE E. MILLER ~ ~=~ ~ BE IT REMEMBERED, that I, Nellie E. Miller, of R. D. 2, ~D~~l.sbur ~C,. York County, Pennsylvania, being of sound mind, memory and understanding, ~ make, publish and declare this as and for my Last Will and 'Pestament, hereby revoking and making null and void any and. all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1 : I direct that all my just debts and funeral. expenses be paid. as soon after my d.em:ise as may be convenient. ITEM 2 : All the rest, residue and remainder of may estate, of whatso- ever nature and wheresoever situated, whether it be real, pE~rsonal or mixed, including property over which I have a power of appointment,, I give, devise and - `; ~~ --, r _ c r-. re:-, bequeath unto my issue per stirpes living on the thirty-first day following my death. ITEM 3 : I appoint The Commonwealth National Bank, of Harrisburg, Pennsylvania, guaz•d.ian of any property which passes either under this will or otherwise to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided. that this appoint- ment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college ed.uca- tion, both graduate and. undergraduate) without regard. to his or her parent's ability to provide for such support and. education, or to makes payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM 4 : I nominate, constitute and. appoint my so~7, Robert P. Miller, executor of this my Last Will and. Testament. Should my so~z, Robert P. Miller, WITNESS: '~ \~~~'...~E.Jy ~ 1>>.., ,f~~:,_ (SEAL) NELLIE E. MILLER. fail to qualify or crease to act as executor, I appoint my daughter, Joan M. Shambaugh, executrix of this my Last Will and Testament, ITEM 5 : I direct that my executor, guardian or their successors 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 d.ay of _~; ~,~. / / 1971. /"),~.~,%, ~~%~,/~-~,. (SEAL) NELLIE E. MILLER The preceding instrument, consisting of this and. one (1) other typewritten page, was on the day and. date thereof signed., sealed., published and declared by NELLIE E. MILLER, the testatrix herein named., as and for her Last Will and. Testament, in the presence of us, who, at her request, in Iier presence and in the presence of each other, have subscribed our names as witn~°sses hereto. OF ~ '~ ~ ~~ ~2t-c~~-11~-3 OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF ~,~,m,~~~~+ ~, _ _ _ COUNTY, PENNSYLVANIA Estate of Nellie E. Miller tV De~ased -~ -, o ~ x ~= c7 ~+c ~~ ~ -~ ~,.j~` = ^~ ~~~ ~~' -:-, Jan M. Wiley ~ Joan W. Wiley (each) a subscntin~vitness'7A ~-~ (Pont Names) y C.fl +.1 the Q Will ^ Codicil(s) presented herewith, (each) being duly qualified according tc~ law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in his /her presence and in the presence of eacFt other. i Jan M. WIIey (Signature) o yt-, Wiley 1~3A-IN. Church St. Ste 101 15 Kensington Sq. (Street Address) Dillsburg, PA 17019 (City, State, Zip) (Street Address) Mechanicsburg, PA 17050 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Executed out of Register's Office Sworn to or affirmed and subscribed before me thiG ~~~fi -day of f~,'C!~ern L7P~Y' zL2L~ ~~~ Notary Pub c My Commission Expires: vfi.~a~arx to mmission.) ~5:31tc~ ~• . ~ PiI~IC BOro,'York Ctxrri±( +uy corrrttiselon Expires t+nay ~~„ 2oos Member, Pennsylvania Association of Notaries 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-O$ Rev. 10.13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. ~' y ~ ` l ~' REGISTER OF WILLS OF ~~±~~~ Estate of Nellie E. Miller RENUNCIATION ,Deceased Robert P. Miller in my capacity/relationship as (Print Name) Son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Gary L. Miller ~~,~/ 'Z-~ U~ (Dare) ~.~. tl~ Q __ ; f-- ;i ~.t ; - n- > --, , , _ r_ -~ M ~ r i- - ~a t/, ~t- ; _ ~ --- m ~~i ,_ G ~ cv Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , Deputy for Register of Wills Z~~~ `~ '`~""'~ (Signature) Robert P. Miller (Street Address) T ~w~\~,~1 ~~~~~ (City, State, Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this day of !a ~ ~J V .~U~ Notary Public , My Commission Expires: Form RW-06 Rev. fo-ts-loos (Signature and seal of Notary or other offiraal qualified to administer oaths. Show date of expiration of Notary's commission.) ~ ~,~,,,- hr-~! ,;~°;9'~'rFJ~~I• i ; i j' I,at~i\iSYLV NIA I 4a3ar1a! Seal a, Dawn ~latift~tar, Notary Public i Dillsburg ~!-o,1'ork Courriy ~Y Commission Expires May 17, 2009 Mem6ar, Pennsylvania Association of Notaries Copyright (c) 2006 form software only The Lackner Group, Inc. COUNTY, PENNSYLVANIA ~I~(~~~-~I~`3 REGISTER OF WILLS OF 1~1~~~ Estate of Nellie E. Miller RENUNCIATION Deceased Joan M. Shambaugh in my capacity/relationship as (Print Name) Daughter of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Gary L. Miller /l-(2-G~ (Dare) r•-- - - !n •• ~-.- - - ~ ~ - _ -~ L.E._ ~_'~ _ ~ --- . ~~ t. _~ ~ U_1 :. : m Q '_`' --- ~ U tV Executed in Register's Office Sworn to or affirmed and subscribed before me this day of Deputy for Register of Wills ( at~re) oan M. Shambaugh /~31P f~I~ ~~/~ ~o-~ '7 (Street Address) (City, Sta , ZipJ Executed out of Regrster's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within oin day 'w~ s l1`~ Q~ i, o f IV vy~ z ~d~ _. n ~~ i Notary Public My Commission Expires: (Signature and seal of Notary or other offi~~ial qualified to administer oaths. Show dale ~~Q;~~~ i~NftiSYLV II-..~._...o,___. NC~Of2158a~ ~ ~. ~~7awn GladfeRer, Notary Public Dlllsburg I3oro, York Courriy MY Gxmrtission Expires May 17, 2009 MAmbar, ~Pennaylvanla Association of Notaries COUNTY, PENNSYLVANIA Form RW-OS Rev. 90-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc.