HomeMy WebLinkAbout08-12-10
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF
Estate of Merle E. Miller
also known as
COUNTY, PENNSYLVANIA
File Number 21-10-~ ~~''~
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,Deceased Social Security Number 193-24-0575
Bradley W. Miller and Allan K. Miller
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 Testamentary and aver that Petitioner(s) is/are the named in the
last Will of the Decedent, dated 10/16/2003 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
app ica e, en er.• c..a.; .n.c..a.; pe en e i e; uran e a sen ia; uran a mrnon a e
Petitioner(s~ after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (iif any) and heirs: (If
Administration, c.f.a. or d.b.n.c.f.a., enter date of Will in Section A above and complete list of heirs.)
Name Relationship
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(COMPLETE /N ALL CASES:) Attach additional sheets if necessary. ~~~-=
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
.,, : ,-1
1343 Zimmerman Road, Carlisle, Monroe Township, Cumberland, PA 17015
(List street address, town/city, township, county, state, zip code)
Decedent, then 79 years of age, died on 08/04/2010
Decedent at death owned property with estimated values as follows:
at Carlisle Regional Medical Center, Carlisle, PA
(If domiciled in PA) All personal property $ Over 140,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ Over 160,000.00
situated as follows: 1343 Zimmerman Road, Carlisle, Monroe Township, Cumberland County, PA
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with trns PeUUOn and the grant or Letters In the appropriate rorm to
the undersigned:
Signature Typed or printed name and residence
.~ t Bradley W. Miller 1339 Zimmerman Road
~~,,, ~ ~~~ ~ ~ Carlisle, PA 17015
< I Allan K. Miller
i
366 Whiskey Springs Road
Dillsburg, PA 117019
CUMBERLAND
Form RW-02 Rev. ~o-~s-loos
Copyright (c) 2006 form software only The Lackner Group, Inc.
Page 1 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.
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Sworn to or affirmed and subscribed
Signature of Persona epresentative Bradley W. Miller
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before me this :.~- day of ~~!'y
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a re of Personal Repr entative Allan K. Miller
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For the Regist~ Signature of Personal Representative -' rt
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File Number: 21-10- ~~.~ C~
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Estate of Merle E. Miller ,Deceased
Social Security Number: 193-24-0575 Date of Death: 08/04/201 O
AND NOW, -` ' ~ `C ~" 1r~ ~` i , in consideration of the foregoing Petition, satisfactory proof
having been presented ~ fore me, IT IS DECREED that Letters Testamentary
are hereby granted to Bradley W. Miller and Allan K. Miller
in the above estate
and that the instrument(s) dated 10/16/2003
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ............................................ $ ~3j `~- .~,~ '~ ~."~~ ~ ~ } ~-~-~ t-r ~ G~~~
Register of Wills ,f ..¢ ~ L 21~~ /~,/~':r„~
Short Certificate(s) ........................ $ ~ c~ , ~,i~ > / G- ,/
Attorney Signature: ~-~- C`--'" -~~``~
Renunciation(s) ............................. $ -
~~ ~ $ a ~,,,~ ._,..,_....
',V f ~ ~,~ ~' Attorney Name: n M Wiley
C_~ $ Z~ t7~~'
Supreme Court I. .. 06978
The Wiley Group, PC
$ Address: 130 W. Church Street
$
$ Dillsburg, PA 17019
$ Telephone: 717-432-9666
$
$
TOTAL .................................... $ ~ ' ~~ c`7 . ~-~
Form RW-O2 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) STATE FILE NUMBER
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1. Name of Decedent (Fret, middle, last. suffix) 2. Sex 3. Sodal Security Number 4. Date of Death (Month, day, year)
Merle E. Miller Male 193- 24- 0575 August 4, 2010
5. Age (Last Birthday) Under 1 ar Under, da 6. Date of Berth Momh, da , ear 7. Binh lace Ci and stale or for ei coon Ba. Place of Death Check one
79 zbnths nays Hours z4nutes
October 19, 1930
Harrisburg, Pennsylvania HospitaC
1~t OMer.
Yrs. Inpatient ^ ER /Outpatient ^ DOA
LY ^ Nursing Hone ^ Resioence ^ Other - Speciy.
8b. County d Death Bc. City, eoro, Twp. of Death 6d. Facility Name (If not institution, give street and number) 9. Was Decedent of Hispank Origin? Q, No ^ Yes ,0. Race: American Indian, Black, White, etc.
Cumberland South Middleton Carlisle Re Tonal Medical Center
g ("''~' specify Cuban,
P (specr»
Whit
Mexican,
uerto Rican, etc.) e
,1. Decedent's Usual lion IGnd of work done d odo most of worki life. Do not state retired ,2. Was Decedent ever in the , 3. Decedent's Educetbn (Specify only highest grade comp leted) 14. Marital Status: Married, Never Married. t 5. Sumwng Spo use Qf wife, give maden name)
Kid of Work
Kind of Business / IndusuY U.S. Amted Forces?
Elementary !Secondary (0-, 2}
College (,-4 or 5+) Widowed. Divorced (Spealy)
OwnerlOperator Transportation ^ Yea ~ 12 Widowed
,6. Decedents Mailing Address (SVeet, city! town, state, zip code) Decedent's Dd DeDe~nt Mon roe
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Pa
1343 Zimmerman Road ve
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Actual Residence t7a State
n a „~ Yes, Decedent Lived in __ Twp.
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Carlisle Pa
17015 owns
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,7b.Counry Cumberland 17d. No, Decedent livedvnttzn
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s Actual Limits of City/Boro
18. Father's Name (First, middle, last, suffix) , 9 Mothers Name (First middle, maiden surname)
George Miller Sophia Greenawalt
20a. InfortnanYs Name (Type /Print) 20b. IrdormanYS Mailing Address (Street, pry /faun, state, Tip code)
Bradley Miller 1339 Zimmerman Road Carlisle, Pa. 17015
21 a. Method of Disposition ~ ^ Cremation ^ Donation 21 b. Date or Disposition (Month, day, year) 2, c. Place of Disposhbn (Name of cemetery, crematory ar odter place) 2, d Locator (City /town, state, zip code)
j~, Burial ^ f?enaval from State ~ was cremMwn or Donation Authorized
^ Otlter - s r by ~ Exsminer,Coroner? ^ Yes^ ND Au ust 7, 2010
g Lon sdorf Cemete
g ry New Kin stown Pa. 17072
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22a. Sk,)natu~b rat Service ~ az such) 22b. License Number 22c. Name acct Address of Fadiry
- ,, FD-012662-L Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
whence ' 23a. best knowledge, death ocarred at Ute tine, date and place silted. (SignaNre and title) 23b. Ucense Number 23c. Date Signed (Month, day, year)
physiaan is rat available at line of death a
certify cause of death.
ttems 2426 must be corttpleted by person 24. Time of Death 25. Date Praaurtced Dead (Month, day, year) 26. Waz Case Referted to aminer I (:Droner la a Reason Other than Cremator a Donation
who pronounces death. ~) M / ~ ^ Yes
CAUSE OF DEATH (See instructions and mples) , Approximate interval: Part II: Eller other gjq~ificent conditions contributing a dg~, 28. Oid Tobacco Use Contribute to Death?
hem 27. Part I: Enter the Chain of events -diseases, injuries, or cnrnplicatiorzs -that directty caused the death. DO NOT enter temtinal events such as ixrdiac arrest, r Onset to Death but not resuttitg in the underlying cause gben in part I. ^ vas ^ Probably
respiratory arrest, or ventricular fitxillatlon without stewing the etiology. List Doty one cause on each line. ~
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^ No ^ Unknown
IMMEDIATE CAUSE IFnal disease or / / ~ r
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En UNDERLYING CAUSE Due to (or as a consequence of). r
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~ Not pregnant, but pregnant 43 days to ,year
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Unkrtovm it pregnant within the past year
3~. Was an Autopsy 3rya. Were Autopsy Flndigs 3,. Mann Bath 32a. Date of Injury (Month, day, year) 32b. Describe How Irqury Occurred 32c. Place of Injury: Home, Farm, Street, Factory,
Performed? Available Prior to Completion
of Cause of Death?
NaNral ^ Homicide Office Buildng, etc. (Specify)
^ Ves No
^ Y
^ N ^ Accident ^ Pending IrwesOgation 32d. Time of Injury 32e. Injury at Work? 32f. If Transportation Injury (Specify) 32g. Location of injury (Street, ciy /town, state)
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^ Suicide ^ Could Not be Determined
^ Yes ^ No ^ Driven Operator ^ Passenger ^ PedasVian
M ^ Other -Specify:
33a. Certfier (check Doty Doe) 33b. Signatprpl and Title of Certifier
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• Certllying physician (Physician certfying cause of death when another physidan has prarauraed deaN and completed Item 23)
To the bed of my knowledge, death occurred due to the auaa(s) and manner as sWed _ _ _ _ _ _ _ _ _
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• Pronouncing and esrthykmg physician (Physician both pronourxarmg deaN and certifying to cause of death)
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^ 33c. License Number 33d. Date Signed (Month, day, Year)
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On the bash of ezaminatlon and / or investigation, in my opinion, death aa:uned at the time, date, and pleee, and due to the auss(s) and manner as stated_ ^ 34.~ and Addreaz ofP}erson Wow Corypleted Cause of Death (Item 27) Type I Print
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` 36. Date Filed (Month, day. year) I
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MERLE E. MILLER
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BE IT REMEMBERED, that I, MERLE E. MILLER, of 1370 Zimmerman"'
Road, Carlisle, Monroe Township, Cumberland County, Pennsylvania, being of sound
mind, memory and understanding, do make, publish and declare this as and for my Last
Will and Testament, hereby revoking and making null and void any and all `Wills and
Testaments and writings in the nature thereof made by me at any time heretofore.
ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after
my demise as may be convenient.
ITEM 2: All the rest, residue and remainder of my estate, of whatsoever nature
and wheresoever situate, whether it be real, personal or mixed, including property over
which I have a power of appointment, I give, devise and bequeath unto my five children,
VICKI A. BEAR, WENDY I~. BELT, BRADLEY W. MILLER, JEFFREY L.
MILLER and ALLAN K. MILLER, in equal shares, per stirpes.
ITEM 3: I direct my hereinafter named Co-Executors to pay all inheritanc;e, estate,
succession and legacy taxes of whatsoever nature and kind, to which my estate or the
transfer of any property passing hereunder or otherwise passing by reason of my demise,
may be subject and to charge such taxes against my residuary estate, it being my :intention
that none of the aforesaid taxes, either federal or state, on any property required to be
included in my gross estate, under the provisions of any state or federal law now in force
or hereafter enacted, shall be prorated among the persons interested in my estate to whom
such property is or may be transferred or to whom any benefit accrues.
/" `- " ` (SEAL)
MERL E. MILLER
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ITEM 4: I appoint my son, BRADLEY W. MILLER, and my son, ALLAN K.
MILLER, as Co-Executors of this my Last Will and Testament.
ITEM 5: I direct that my Co-Executors or their successor 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 ~~ day of
~G~-• , 2003.
TNESS:
,\
G - ~~~AL)
MERL ~ E. MILLER
-2-
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF YORK
We, MERLE E. MILLER, JAN M. WILEY, ESQUIRE and SHERIE A.
MINICH, the Testator and the witnesses respectively, whose names are signed to the
attached or foregoing instrument, being f rst 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 had 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 tl-~e presence and hearing of the
Testator, signed this Last Will and Testament as witness and that to the best of their
knowledge the Testator was at the time eighteen (18) years of age or older, of sound
mind and under no constraint or undue influence.
~i~~. v-
E. MILLER
dESS
ITNESS
Sworn to and subscribed
before me this ~ ~Of~ day of
c~ ~_ , 2003.
NOTARY PUBLIC
MY COMMISSION EMPIRES:
Notarial Seal '
S. Dawn Giad~elter, P~otary public
Digsbu~ Boro, York County
My Commtss~on Expires May 17, 2005
Member, Pennsylvania Association of Notaries