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HomeMy WebLinkAbout09-11-09.~ PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Merle H. Myers File Number 21-- Q~ - ~ 0 ~3 also known as Deceased Social Security Number 168-26-2574 Linda Nk>~1Ayers and Penny E. Myers Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or `8' BELOW) ~X A. Probate and Grant of Letters Testamentaryand aver that Petitioner(s) is/are the named in the last Will of the Decedent, dated 02/04/1988 and codicil(s) dated 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: B. Grant of Letters of Administration apprca e, en er: c..a.; ..n.c..a.; pe en e r e; uran e a sen ra; uran a mrnorr a e 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 C'> `~ _ C`O w _-. `~- ~v cn ,z ~ ~ ti~ >-~ - ~~-~~ -- _.i_ _ ~. ;, (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. _ ~~ ~ . '' '> Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal re~e`n~e at •• ~ ..~, 1.~ 154 Chamberlin Road, Shippensburg, Hopewell Township, Cumberland, PA 17257 O (List street address, town/city, township, county, state, zip code) Decedent, then $1 years of age, died on 08/24/2009 at 58 Deadend Lane, Shippensburg, PA 17257 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 39,000.00 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: Signature Typed or printed name and residence Linda Mt~iVlyers 1612 Sugar Bush Lane ~ n Chambersburg, PA 17202 Penny E. Myers 58 Deadend Lane Shippensburg, PA 17257 Form RW-02 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page t of 2 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. Sworn to or affirmed and subscribed before me this I 1+~ day of I For the Register fi a Ma~IVlyers Personal Penny E. Myers Signature of Personal Representative File Number: 21-- ~~- ~ gS3 Estate of Merle H. Myers Deceased Social Secu++rity Number: 168-26-2574 q Date of Death: 08/24/2009 AND NOW, ~ QIJt. YYl ~ f ~ ~ ~ ~ / , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Linda McyMyers and Penny E. Myers ---r in the above estate and that the instrument(s) dated 02/04/1988 _ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Q Letters .......................................... $ -/ ~ ~ ~~ Short Certificate(s) ........................ $ ~~ LC: Renunciation(s) ............................. $ $ IS ~ ~~ -L,t`'t'G h/\Cl~l GYM $ ~ -. ~~ ~~ $ $ $ $ $ TOTAL .................................. $ I~~ ' U l~ Form RW 02 Rev 10-13-2006 ~~ by ( a Register of Wills ~~ ~ y Copyright (c) 2006 form software only The Lackner Group, Inc. Attorney Signature: ~ Attorney Name: Jerry A. Weigle Esquire Supreme Court I.D. No.: 01624 Weigle 8~ Associates, P.C. Address: 126 East King Street Shippensburg, PA 17257 Telephone: 717/532-7388 Page 2 of 2 OCAL RECaISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fce 1~x this certific;ue. S6.(1O P 15847787 Certification Numhrr ,~x~x~ %~~-~=.,, - Thls Is tct certify that Ihe u~t~x-mation h~lc given is Itll,~~Q~ZH Of pfN~~ eon~uly i opted 1)um an LYri~~)nal Ccltitic lte of Death ,(~~' ~ ~~1~~ duly filed v~ith nn Is '~oe,d Regititrar. The original ~~ ~ celtific,atE will he fur«~arded to the State Vital ``o „ z: ~' ~t , ~- ~a~ Rccord~ Office for pennanen filing. ~~~M~~f~ ~N~ T OF `'_._il/lllllr Loci es*istrar Date I;~ul°d IV n ~ -rx • ~~ ~.tl ..,.y ~a rn ~ :. COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~~ ~ ~_~ ""."1 ~ ~T_.i r') ~ ~:z~ CERTIFICATE OF DEATH _ ~7 ;- lSna Instn,rTlens end examples on reverse) ..r.r«„....,..era-( H10S143 RLY 112006 TYPE /PRINT IN PERMANENT BLACK INK 0 z 1. Name of Decedent (First, natltlle, less, sMiz) 2. Sex 3. Saael Security NunMr 4. Dale of Death (Montlfll~year) ,i Merle H. Myers a 168. 26 - 2574 August 24, f~9 5. Age (Last BiMday) Under 1 r Untler t de 6. Date M Binh Momh, da , ear 7. Girl ce entl state w br n coon 8e. Place of Death Check an one Hospital: Other: Menges ays Noun Minuses Lett~k ~ 81 yrs Januazy 2, 1928 1!'rankl.in ^ Isspalient ^ ER I Oulpelienl ^ DOA ^ Nwsbg Home ®Residence ^ Other SpecBy: • Bb. Carry of Death &. City, Boro, Twp. of Death Bd. Fadlay Name 111 nM inalilNion, gw• alreet end number) 9. Wes Decedent or Hispenk Ongn7 ®No ^ Yes 10. Race: American Irdian, Black, While, mc. (sveaM d CW Qmbetlr]tY3 OdIIity u Ztap, en, (h Yes. see y Dead Ehd Lane, 4rz*~)?~ PA 1.7257 Mexican. Puerb liicen, sk.) Vallte 11. DeedeM's Usual tbn Klrb M work tlone Burin rtasl M wake Ne. Do nos state reti 12. Wes Decedent ever b Ihe 13. Deratlenl's Etluetion (Spedly only higMal grade camletetl) 14. Martel Stales: McMed Never Married, 15. Survising Space (II wge, gNe maitlen name) tl (SOeCdY) Klnd of Won Kbtl of Business l IntAatry U.S. Amsed Fumes? Elementery~ ondary (P12) College (1 d or 6:) 1 Dalry F8xmer' Ocun FetDt W C ^ Vas ®No 16. Decedent's Maigng Adtlress (5tree6 city l town, orate, z4 soda) Decedent's PA Did Decedent t7c. ~ Yes, Decetlem Lived in TwD. Actual Resitlence t7a State TN 154 Q~erl i n Road, $hl~el'1Sbl1Y'Cj, PA 17257 . Ownsh®7 Lrved within Cd QIdOerlaTld t7d. ^ ~am /B C of OrO y 17b. ount' Actuel 1 B. Fathers Name (First, mitltlle, IesL sWlix) 19. Mother's Name (First, Mdtlle, maiden surname) F1i Myers Katie H. Hower 20e. IMomnm's Name (Type 1 Print) 20b. Inlormant'a Mating AtlMess (Street dly /town, slate, zip cotle) Linda M• Myers 1612 Sugar Hush Lane, PA 17202 21 a. Method M Dslwsabn ^ Cremation ^ Donation 21 b. Date M Disposabn (Month, day, year) 21c. Place M DisposPoon (Name M cemetery, cremebry or oMer place) 21 d. Locatim (City/town, slate, zip code) ® Burial ^ Removal hwn stale ~ wu cremnlon w Donffibn Aalhwlaea ^ ^ • August 29, 2009 Middle S1x lTg O~letexy Shipper>sbtmg, PA 17257 No Ves ^ Odser- r by MedbM Examiner/Coroners • 22a. S' re of Funeral on ire as such) 22D. Lkerwe Number 22c. Name entl Address M Facility ~ FD 014351-L Fbgelsanger-Bricker Flmeral Hrme Inc• 112 West St. PA 17257 Complete Gems 23at mty when ~wrtiybg M ble et lime of death to ~~ 23a. o best of mylwpxA death oxurted et gse time, dale an place slated. (Signature entl title) - 23b. License Number ~ ,~ y ~ 89 8 L 23c. Dale Signetl (MOnM, day, year) ~ Z. y , ~ Oe~' e of dee ~M , Items 2/-Zfi must M oanpleled by person 24. Time d Death y 25. le Pronounced Deatl (Monty, My, year) G ~ 26. Was Case Relerretl to Medcal Examiner /Coroner for a Reason her then Gemelbn or Daalbn? ® ^ wM pasamces death. d-1 ~ 20 A M. a4 , U 1 Yes No CAUSE OF DEATH (See Inetrucllons end a:amplee) r Approximate Interval: s m O D Pan II'. Eller other 6ian Icant cond'n'ons ConlrAuaOp to death. Nen in Pan L ullb in cause t re in the underl b s 2B. Did Tobacco Use Comribute to Death? ^ y ohad ^ P , nset m ea Item 27. Pan 1: Enter Me drab of evems -diseases, Injuries, or Conplielbns ~ Net directy caused llse tlealh. DO NOT enter terminal events such as ceNiac oriel g g g y u no s r y es respiratory arrest, a veMrKmer lbritlelbn wahoul showing gre etiology. LLS1 ony urea reuse on each Ihe. ~ ~lo ^ Unknown IMMEDIATE CAUSE (Final dsease a /^~/,' ~~s,~ ,, ~ ~ ~ ~ mntldpn resWlsg in death) /w ~~~~r ~~i G ~„~V `tee-Vrw'7~"y 29. B Female: ^ Nos pregrem wghin pest year _~ a. Due to (or es a consequence ol): ^ pregnant et Ilme M death 4 any $epuenliagy bt contli6ass t ithi 42 d ^ , , b. leadinrgg to the cause listed on line a. Due to (a es a con nee of Eller gte UNDERLYING CAUSE r~ )~ (tlisese or bjury Mel initiated the s NM gegnanl, but pregnan w n ays d death s to t year re nant 43 da e nant bm ^ Na c ew:ms resukmg m tleath) IAST. r g y pr g , p Due b (w as a Consequence DI): r Mlore tlealh ^ Unknown g pregnant wahin Ihe past year d 30a. Wes en Autopsy 30b. Were Autopsy Fettlkgs 31. Manner sash 32e. Date M Irqury (Month, day, year) 32b. Describe Mow Injury Oceunetl 32c. Plea of Injury: Home, Farm, Street Factory, Ogice BuiWbg, etc. (Spea'N/ Penamad? Aveiable Prior to Completion f C f D 1M Nelurel ^ Homicbe r-~~ ause o ea o ^ ^ Accitlent ^ Pendbg Inveslge6on ~~ Tme of Injury 32e. Injury el Work? 321.6 7rensponation Brjury (SpealyJ 32g. Location of bjury (Blreel, dty /town, state) ^ Ves IQ No Ves No ^Ves ^ No ^ Driw:rlOperata ^ Passenger ^ Pedeslrien ^ Suidde ^ Caultl Na M Delembed M ONer ~ Spedly' 33a. Ced6ier (check anyone) 33b. Signature 6k of Cenilier • Cenlrying physlclen (Physidan cen6ykg rouse M death when another physician has pranowKetl tleath end completetl Mm 23) ~ _ _ _ _ _ _ _ _ _ _ _ _ tlnth occurred due to the ease(s) entl manner u elated e t of m knowled T th b - ~~- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g , y o e es 33c. Lisa umbel 33d. Date Sipsetl (Month, my, year) • Pronounelrq end cenNying phyalclen (Physldan bah prorwsnxing death and ceniyirg to cause M tleeth) ^ d O1 C- s '7 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ To the Mal of my knowledge, death occurred et the time, date, entl place, snd due b the ease(s) snd manner es ettle ~ D // ~ ~/ D F fJ • MedlelEumlror/Cororser On tM Msls d exeminatlon end I or Imestlgnfon, In my aplnbn, de occune0 el the time, date, end pace, and due to 1M caurx(q entl menrrer es sated. ^ 34. Name end Adtlress ~ers~ WhgCo ~ IDCeuse ai Death Qlem 27) Type / Pnnl V/ ~ tl Registrar's Signature tl r'ct N r ~ I ~ I / I ~ I, I ~ I 3B. Dale F (Month, da ~ e~ ` L D ~ •v ~ ~ ~y J. e w ~ ~ ~ Z ~/ - T- (/ Dispositbn Permit No. O" ' ~ S LAST WILL AND TESTAN~P I, Merle H. Myers, of North Newton Township, Cumberland County, Pennsyl- vania, declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all ~' just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I give, devise and bequeath all of my estate of every nature and wheresoever situate to my wife, A4. Jean Myers, providing she shall survive me by thirty days. ITEM III: Should my wife, M. Jean Myers, predecease me or die on or before the thirtieth day following my death, I give, devise and bequeath all of my estate of every nature and wheresoever situate to my issue per stirpes living on the thirty-first day following my death. ITEM TV: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid frcan my residuary estate as part of the expenses of the administration of my estate. ITEM V: I appoint my wife, M. Jean Myers, executrix of this my Last Will and Testament. Should she fail to qualify or cease to act as executrix, I appoint Linda May Myers and pay E. Myers, co-executors of this my Last Will and Testament. ITEM VI: I direct that my executrix or her successors shall not ~ ~~ O W ..r. required to give bond for the faithful performance of their dames in~y _, _ ? = rte- 'L7 ~'-; _=t.i '>~ ~~~~~ _._ _ c.-~d jurisdiction. _ -;.,;.~ -- ~-_'r::~7 -~t_ 3 ,_' . Tj _ - 1r.J-~~ •• r•fi 1? © ~ IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on two sheets of paper, dated this ~~ day of ~~TGfLi -' , 1988 . -- ~!1LL_`x_`_"-+--- - ----------- (SEAL) Merle H. Myers C~71 The prececling instnmient, consisting of this and one other typewritten page, each identified by the signature of the testator, Merle H. Myers, was on the day and date thereof signed, published and declared by Merle H. Myers, the testator herein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other, have sub- scribed our names as witnesses hereto. ~~ - - ---------------------------residing at---------------------- ~~ _p~-- --- ~--9_~------------residing at- - r COMMOD]WEALTH OF PENNSYLVANIA: COiJN`I'Y OF CLIMSERLAND SS We, Merle H. Myers, J01vY! ~~~~-~ and ~~' ~. hr the testator and the witnesses, respectively, whose names are"signed to the attached or foregoing instr~urent, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and Testament and that he signed willingly (or willingly directed another person to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the will as witnesses and that to the best of our knowledge, the testator was at that time eighteen years or older, of sound mind and under no constraint or undue influence. le ~I. Myers Subscribed, sworn to and acknowledged, by Merle H. Myers, the testator ~ and sworn to before me by <~ti ,~il~-~1~ and ~~-'.~ ~rd,-~ i' ,witnesses , this. L~}-l, daY o~.e~~!'Gut/t~ 1988. Notary lic ^~Y c lion expires April 16, 1990 Shippensburg Township Cumberland County -2-