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Home My WebLink About07-27-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF W1LLS OF Cumberland Estate of E. Robert Keller also known as late of East Pennsboro Township ,Deceased COUNTY, PENNSYLVANIA File Number Social Security Number 194-28-8141 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the executrix last Will of the Decedent dated September 24, 2008 and codicil(s) dated (State relevant circumstances, e. g., renanciation, 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 (/f applicable, enter: c. t. a.; d. b. n. c. t. a.; pendente life; durante absentia; durance minoritate) (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. ~ _% Cumberland ~ '~ ``~ .~.. Decedent was domiciled at death in _ County, Pennsylvania with his /her last principal reSI3~ence at -- = =} ~~ ~~mo~-~ j_,r.~ 1059 Country Club Road, Camp Hill, PA 17011 (List street address, town/city, township, county, state, zip code) - -~" ~L ~ r~ Decedent, then 71 years of age, died on July 13, 2010 at M. S. Hershey Medical Center Hershey, PA 17033 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (lf 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: $ 60,000.00 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: Si nature Typed or printed name and residence J l ~~ `~_ n _ f~ J~~~~~ ~„ ,~ Michele R. Keller 1059 Country Club Road Camp Hill, PA 17011 named in the Fornr RW-OZ rev. 10.13.06 Page 1 Of 2 Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and hears: (!f Administration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) 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, P etitioner(s) will well and truly administer the estate according to law. ~/~ ~. ~.. ~ Sworn to or affirmed and subscribed _~ ! before me the _ ~~ day of Signature ojPersonal Representative i-^~~ i ~ < l,~ L ~- } Signature of Personal Representative ~"' Q '~ f ~ ~ ' ~ ~ G.~.. C 1 a ~ , i n 5..~." .. I For the Re Ster Signature of Personal Representative ~ ' ,_°' ~ ._ ; ,; -, ~ ~ .:_ : , ' ~' . _ ; ~~-~ --r-t -mr - ms= : File Number: I~ ~}• ~ ! ~ ~% - ~ y %'7 ~ ~~ =.~ ~ ....._ s + .. ~ .~~ {'~') .tr" ;-~ N Estate of E. Robert Keller ,Deceased Social Security Number: 194-28-8141 Date of Death: July 13, 2010 AND NOW ~ `~ ~ ~ ~ ~ ~ -r i , ~ ~I~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT 1S DECREED that Letters Testamentary are hereby granted to Michele R. Keller in the above estate and that the instrument(s) dated September 24, 2008 described in the Petition be admitted to probate and fi led of record as the last Will (and Codicil(s)) of Decedent. FEES ~ , ~ ~~ '~~~ ~ J~ ~'~YL~~`" ~!~ ~C~~. J ~~~~•(`_ (/; ~ Letters . . ............. $ ~~~ ~ L-~ e star of Wills -7 a^~ •' n C~t~~ f--~ C l ~"~~_L.L Short Certificate(s) ........ $ ~ (.~~ • %..'~ ~ Attorney Signature: ~' .a ,.~ Renunciation(s) .......... $ ~ ~..~1 ~ ... $ 1 ~ - C ~ ~:} aroma J. McDonald Attorne Name: y ~~ ~- ~~ • • • $ ~~~ - ~? ~} Supreme Court I.D. No.: 44697 ~- t f ~~+ 6'Yl (,.~ _ r 1('(1 $ ~ Lj ~ $ 439 Walton Avenue Address: • .. $ Hummelstown. PA 17036 ... $ ... $ $ Telephone: 717-566-2127 ... $ TOTAL .............. $ ~ Cl ~ ~ t~~~" Form RNA-02 rev. 10.13.06 Page 2 of 2 .AL REC;ISTRA~'S ERTii~=iATiN +~i= ~E•"i V1!A,I~NING: It isr illegal to duplicate this ~:ap4' ley phctaast~t ~~ ~ahctt~~l:~~~~~`. I ~•t~ti' ~~ tl ths~ ,: t'€'tit~%katt'. wr1 (?t) • P 165~~~~C) C+s,'[i)tlt_il!11r11 ~'11',71E>'` ~J 43 REV 1112006 E /PRINT IN ERMANENT SLACK INK r,r ~~{~,;' [3 1 '.ilk '~ li.'- i'1(11'~ £ !l' tli,.~Cl)illlltr. :Ir:.l' _ •'+l`I'- 1,1 TS {~ ; Ir'q. f' 1~ U>~ l`F ... .~~ ~ 1 Irl ~~,~' ,~ '~` Li1t~l~ti;l~ t~ I I ~_, " l t'~f; ! ttt~ ~ , I?Il)' ~tl tf1 ~) .i:l) 1 ~ -~ !,d~r~'~/ :~" ii`tl\ ~ !c'+.~ `! `E: ~. r~.'J tic"') IT•;il. i !'r.'. +•t! ~IIeIEA .`. ` ^, ~ \ `~'. :-_ ~ ': )if 1!. .,,:. of 'r.. , ,~:lt [!:'i_~ (is kid:.. ~31.t)(l_ 1~Ii. ~~, ^w: ~ . ~?: I~tJ j''; _t+.ti 1`~~."::1)iL7i /l)~~=~.t' ~I q.- R,l~i11';ll` ~11il.ir ,, ~ , i '~ ~ JUL 1 5 2010 ~T ~,~ ,, ~.` ~.Jl t 1 y$ ~.,.? .~ ~ ~ -~ ~~ ~ _. T ~~ _~^.... . - _r.~ .J ~::-.... _.....~ -r-, _ - ,.:..::.. _. ,:..rt .. •r _ ~~ t ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FII F Nl1MRFR 1. Name of Decedent (First, middle, last, suffix) 2. Sex 3. Soclel Security Number 4. Date of Death (Month, day, year) 5. Age (Last Birdxlay) Urxtar 1 r Under 1 da 6. Date of Birth Month, de , r 7. Birth ace C and state ar fa rei coon 8a. Place of Death Check on one Months Days Haurs Minutes Hospital: Other: 71 Yrs. ~I Inpatient ^ ER /Outpatient ^ DOA ^ Nursing Home ^ Residence ^ Other • Specity: 8b. County of Death 8c. City, Bao, Twp. of Death 8d. Fedlfry Name (If not instlardon, give street number) 9. Wes Decedent of Hispanic Odgin? ~ No ^ Yes 10. Race. American Indian, Bladc, White, etc. (If yes, spectly Cuban, (Specrly~ Mexican, Puerto Rican, etc.) Wt11te 11. Decedent's Usual Kind of work data d u most of world Irfe. Do not state red 12. Wes Decedent ever In the 13. Decedents Educafbn (Speciry only highest grede comp leted) 14. Marital Sletus: Martied, Never Marrted, 15. Surviving Spo use (I1 wAe, give maiden name) Kind of Work Kind of Businessllndustry U.S. Armed Forces? Elementary /Secondary (0.12) College (1.4 or 5+) Widowed, Divorced (Speciry) Porches in ^ Yes Ne 16. Decedents Melling Address (Street, city I town, state, zip axle) Decedents Pa Did Decedent rv r Live in a id A R F P k 1059 oun try Club Road C ctual es ence 17a. State 17c. I~Yes, Decedent Lived in , ,a,S t enns xlro TWp. Township? ^ r ~ [L.l 1 a 17d. No, Decedent Lived wdhin 17b. Coon (~ t _ ty '~~r ~~~ Actual Limits rN City / Boro 18. Father's Name (Prat, middle, last, suffix) 19. Mod>er's Name (First, middle, maiden surname) Elwood A. Keller iota 20a. Infaments Name (Type /Print) 20b. InlamanYs Meiling Address (Street, city /town, state, zip code) Michele Keller 21 a. Method of Disposition ' ®Cremation ^ Donation 21 b. Date o} Disposition (Month, day, year) 21 c. Place of Dlspositiat (Name of cemetery, crematory or other place) 21 d. Location (City I town, state, zi o code) r ^ Bunel ^ Removal fran State r Was Crometior or Donation Autlarind ^ ' by Medal ExsminsrlCorolxr'1 ~'1'es^ No t] 22a. posture of acd as such) 22b. License Number 22c. Name and Address of Facility - 011b54-L era-Ratner F~uie 1 ome n e he 23a-e Doty n ce 23a. To fire best of my knowledge, death oaurred at the time, date and place stated. (Signature end title) 236. license Number 23c. Date Signed (Month, day, year) physidan re not avatlable at time of death to certify cause of death. hems 24.28 must be completed by person 24. Time of Death 25. D to Prarounced Dead (Month, day, year) 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? who prawunces death. 6 Z 4 M. 1 ~ 7 ~ 0 ` 0 ^ Yes ^ No CAUSE OF DEATH ( instructions and xampka) ~ Approzfinete interval: Part II: Enter other sienificant cond'Nore contrtbutinq to death 28. Did Tobacco Use Contribute to Death? , Item 27. Part I: Enter the chain of events -diseases, injuries, or complications • that directly caused the death. DO NOT enter terminal events such as cardiac arrest, ~, Onset to Death but not resuhing in the undertying cause given in Part ! ^ Yes ^ F robabty respiratory arrest, or venlrk~ular hbdllatlon without showing the etkNogy. List Doty one cause on each line. ~ i ^ No ~ Unknown IMMEDIATE CAUSE tFinal disease a ' in r]e8tl1) axtditiat resultin tf.- ~ Gd CM-•{(~4•'t/`st~~ ~~~ - - - ~0. 29. If Female: g ~ . _~ a u ~ a~ • i7 ^ N t t ithi Due to (or as a consequence op: ~ ~ pregnan o w n past year ^ Pregnant at time of death uentlally list conditions, h arty, b r ^ lea r to the cause listed on fine a. r Eller fife UNDERLYING CAUSE Due to (a as a consequence of): i Not pregnant, but pregnant within 42 days of death (disease a Injury that initiated the r rrffi r ltin M death) LAST c' ^ g . eve esu ~ Due to (a as a consequence of): Not pregnant, but pregnant 43 days to 1 year i d. i before deatFi ^ Unknown i1 re nant within the ast ear p g p y 30a. Was an Autopsy 30b. Were Autopsy Fntings 31. Manner of Death 32e. Date of Injury (Month, day, year) 32b. Descdbe How Injury Oaured 32c. Place of Injury: Home, Farm, Street, Factory, Performed? Available Prior to Completbn of Cause of Death? ~ Natural ^ Homiade Office Building, etc. (SpecityJ ^ Y ® N ^ Y ^ N ^ Accident ^ Pending Investigatbn 32d. Time of Injury 32e. Injury et Work? 32f. If Transportation Injury (SpecNyJ 32g. Location of injury (Street, city /town, state) es o es o ^ Suicide ^ Could Not be Determined ^ Yes ^ Na ^ Dmrer/Operator ^ Passenger ^ Pedestdan M ^ Other - Spec!ly: 33a. CertiAer (check Dory one) 33b. Signature and Ttlle of er • Csrtllying physktan (Physician certifying cause of deaN when another physiaan has pronounced death and completed Item 23) To tfu beat of my Inwadedge, death oxurred due to the cause(s) end manner ss stated _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ - • Pronouncing and xrtNying physlc4n (Phyafdan born pronoundng death and certifying to cause of death) To the best of my laww4edge, death oecumd M the time, data, and place, and dw to the cause(s) and rtwnnar as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ 33c. Lk:ense Number M ~~, 3 9 $ ~~ 33d. Date Signed (Month, day, year) b '~ / ~ ~ I 1 d L • Msdkal Exambter/Coroner / L On the basis of sxsminallon and ! or InvsetpMfon, In my opinion, death oaurred et the rims, date, and place, and due to the cause(s) and manner a stated_ ^ 34. Name end Address of Person Who Compl ted Cause of Death (Item 27) Type / Pdnt j Regiatrate Sgnature [tistdct NU r „~ I ~I ~ I ~ ~ I ~ I ~~!~ %~ ~ ~p ~ 1 r Q ~ ~~ ~ ~~`~ ~ M.S. Hershey Medical Ctr. ~ p 2 1 a Dispositon Pertnh No. •/~~~~~/~ 1 ~ LAST WILL AND TESTAMENT f I, E. ROBERT KELLER, having my legal residence at 1059 Country Club Road, Camp Hill, PA, 17011, do hereby declare this to be my Last Will and Testament, revoking all other Wills and Codicils heretofore made by me. ~--~ ~~ ~ ~ -; ITEM ONE: I direct that all my valid expenses of my last illness -~funl be~ a ~~ ~~ _..3 ,= , r t~" ,. .,,. ~ r^~,? , ;-a ~ ~ , -, paid from my Estate as soon as maybe practicable after my death. ~•`~ ~ ' ._,,,. ITEM TWO: I give, devise and bequeath my Edward Jones:~count ~~896- = ~, 07879-1-2 to my issue, TRACY A HARMER and SUZANNE L. HEBERLIG, in equal mares, y + per stirpes. ITEM THREE: I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatsoever nature and wheresoever situate, to my spouse, MICHELE R. KELLER. ITEM FOUR: In the event my spouse predeceases me, I give devise and bequeath all the rest, residue and remainder of my Estate, of whatsoever nature and wheresoever situate, to my issue, in equal shares, per stirpes. ITEM FIVE: Any share of the residue of my Estate which becomes distributable to a beneficiary under the age of twenty-three (23) years, shall be distributed to my Trustee, hereinafter named, IN TRUST, in accordance to and subject to the following provisions: A. My Trustee shall divide the principal and net income (hereinafter "Income") accumulated, if any, of my Trust Estate into equal shares among my beneficiaries, or his or her issue. B. My Trustee shall hold the assets received, if any, or property passing outside of this my Last Will and Testament, if any (hereinafter collectively the ~~~ "Trust Estate"), invest and reinvest the Trust Estate and distribute Income and principal as follows: (1) My Trustee shall accumulate all Income earned on the principal of each beneficiary's Trust until each beneficiary attains the age of twenty-three (23), and thereafter be distributed directly to each beneficiary. (2) My Trustee shall pay or apply the Income and any or all principal for the support, welfare, education and. maintenance of the beneficiary, as my Trustee, in his/her sole discretion, deems appropriate. (3) Upon each beneficiary attaining the age of twenty- three (23) years, my Trustee shall distribute one-fourth (114) of the principal of each such beneficiary's share of the Trust Estate to such beneficiary. (4) Upon each beneficiary attaining the age of twenty- five (25) years, my Trustee shall distribute one-fourth (1/4) of the principal of each such beneficiary's share of the Trust Estate to such beneficiary. (5) Upon each beneficiary attaining the age of twenty- eight (28) years, my Trustee shall distribute the balance of the remaining principal of each beneficiary's share of the Trust Estate to such beneficiary. C. Payments on behalf of each beneficiary may be applied directly or may be paid to the person with whom the beneficiary resides or who has care or control of said beneficiary without the intervention of a guardian. D. Should the principal of the Trust Estate, in the sole opinion of my Trustee, be or become too small to warrant placing or continuing of such fund in Trust or should its administration be or become impractical for any other reason, my Trustee, in the ~~ z r P exercise of the Trustee's sole discretion, may then divide such principal remaining into proportionate shares for each beneficiary surviving at that time, and pay such shares absolutely to the person maintaining each beneficiary or may place such shares in the beneficiary's name in an interest-bearing deposit in any bank, bank and trust company, or national banking association of his or her choosing, payable to the beneficiary at majority or, if said beneficiary has reached his or her majority, then to him or her directly. E. All shares of principal and Income hereby given shall be free from anticipation, assignment, pledge, or obligation of the beneficiaries, and shall not be subject to any execution or attachment. ITEM SIX: I appoint my spouse, MICHELE R. KELLER, as Executrix of this my Last Will and Testament. In the event she is unable or unwilling to serve as Executrix., I appoint my daughter, TRACY A. HARMER, as Executrix under this my Last Will and Testament. In the event she is unable or unwilling to serve as Executrix, I appoint my daughter, SUZANNE L. HEBERLIG, as Executrix under this my Last Will and Testament. No bond shall be required of any fiduciary hereunder in any jurisdiction. No fiduciary hereunder shall have any liability for any mistake or error of judgment made in good faith. ITEM SEVEN: I appoint my spouse, MICHELE R. KELLER, as Trustee for any Trust established under this my Last Will and Testament. In the event she is unable or unwilling to serve as Trustee, I appoint my daughter, TRACY A. HARMER, as Trustee under this my Last Will and Testament. In the event she is unable or unwilling to serve as Trustee, I appoint my daughter, SUZANNE L. HEBERLIG, as Trustee under this my Last Will and Testament. ITEM EIGHT: I direct that all estate, inheritance, and other taxes in nature thereof, together with any interest and penalties thereon, becoming payable because of my death with ~~ 3 7 respect to the property constituting my gross estate for death tax purposes, whether or not sL~ch property passes under this my Last Will and Testament, shall be paid from the principal of any residuary estate, and no person receiving or having a beneficial interest in any such property, whether under this my Last Will and Testament or otherwise, shall at any time be required to contribute to or refund any part thereof; PROVIDED, HOWEVER, that this direction shall Trot apply to the taxes on any property included in my Estate solely because of a power of appointment thereover which I possess but have not exercised or on any qualified terminable interest or to any generation-skipping transfer taxes. ITEM NINE: I realize that Executors and Trustees are given discretion by law to make various elections which affect the income and estate taxes payable by estates, trusts and beneficiaries, as well as the relative shares of beneficiaries, such as taking administration expenses as deductions for either estate or income tax purposes, selecting options for the payment of employee death benefits, electing to take qualified terminable interest as part of the marital deduction, selecting alternate valuation dates, postponing the payment of taxes, filing joint income tax or gift tax returns and redeeming corporate sock. The decisions made by my fiduciaries in any of these matters shall be binding upon, and not be subject to questions by, any affected persons; PROVIDED, HOWEVER, that if a corporate fiduciary is serving, its decision shall also be binding upon any individual. co-fiduciary. I rely upon my fiduciaries to take into consideration the total income and estate taxes payable by reason of their decisions including those payable by my survivors, and they are authorized in their discretion, but not required, to make adjustments between income and principal as a result thereof. ~~ 4 ~--, IN WITNESS WHEREOF, I have on this ~ day of ~ v~iv,-+08, set my hand and seal to this my Last Will and Testament. a E. ROBE LLER SIGNED, SEALED, PUBLISHED AND DECLARED BY E. ROBERT KELLER, the above- named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. e 439 Walton Avenue Address Hummelstown, PA 17036 Address ;- ~,_. .:~ G~ Na e 439 Walton Avenue Address Hummelstown, PA 17036 Address 5 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF DAUPHIN We, E. ROBERT KELLER, JEROME J. McDONALD and JEFFRY L. McGUIRE, Testator and witnesses respectively, whose names are signed to the attached or foregoing instrument, 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 he signed willingly (or willingly directed another 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 their knowledge, the Testator was at that time eighteen years of age or older, of sound mind, and under no constraints or undue influence. r E. RO ER KELLER, TE TATOR J ~ ME J. DONALD, W NESS ~ ; ~~ ~ _ ` ~- JEFF cGUIRE, WITNESS Subscribed, sworn to, and acknowledged before me by E. ROBERT KELLER, the Testator, and subscribed and sworn to before me by JEROME J. McDONALD, and JEFFRY L. McGUIRE, witnesses, this ~~~` day of ,~ee~-f.~~~,L , 2008. r~~~ ~ NOTA~Y'I'UBLIC COMMONWIe~LTI-i ~~r= PFNN: YLVANIA Notarial Seal Karen Tomol, Notary Public South Hanover Twp., Dauphin County My Commission E~ires June 14, 2011 Member, Pennsylvania Association of Notaries 6