HomeMy WebLinkAbout08-17-10PETITION FOR PROBATE AND GRANT OF LETTE;RS
REGISTER OF WILLS OF CUMBERLAND
Estate of Paul E . A . Myers
also known as
Deceased
COUNTY, PENNSYLVANIA
File Number ~ ~ - ~ ~ - ~-~ I`~ ~~ ~ 1
Social Security Number 1 71 - 3 ~0 - 5 0 0 4
Petitioner(s), who islare 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW.)
A. Probate and Grant of Letter Test mentary and aver that Petitioner(s) is e the Executor named in the
last Will of the Decedent dated 2 ~ 21 ~ 0 7 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
(If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente late; durante absentia; durante minoritate)
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Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following s~s~~if any) an`~ieirs: (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.) ~' ~~ `~
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Name Relationshi Residel~c~?'"' ~' ~-
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. '"" _ _~ ~ > ~.__)
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c dent was do iciied at~ieath i Cumber land County, syly his /her last principal residence at
~~ ~ Moun~ai n Road, gs , ~'~' ~~~~~1
(List street address, town/city, township, county, state, zip code)
Decedent, then 71 years of age, died on ~ ~ 1 1 / 2 01 0 at 5 2 4 Mountain Road
of ing prangs,
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 2 5 x 0 0 0. 0 0
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 1 5 0, 0 0 0. 0 0
situated asfoltows: 524 Mountain Road, Boiling Springs, PA 17007
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 T ed or ranted name and residence
~ 314 Heisers Lane ~~~-eiY~ (/v. (M,, ,~ f,S
Carlisle, PA 17015
Form RW-02 rev. 10.13.06 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
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
_,~ Signature of Personal Represen
before me she ( day of .-
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File Number: Cr ~ ~
Estate of Paul E.A. Myers
Social Security Number: 1 71 - 3 0- 5 0 0 4
Deceased
Date of Death: August 1 1 , 2 C)1 0
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AND NOW, ~° ~ ~, ~ r. ~ , in consideration of the foregoing Petition, satisfactory proof
having been presented befo e me, IT IS DECREED that Letters T e s t ame n t a r y
are hereby granted to Darren W . Myer s
_ in the above estate
and that the instrument(s) dated ,:fit ` ~ ~ - ~ l~>C} ~
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
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Short Certificates} ........
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Attorney Signature: ,
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Renunciation(s) .......... $ Anthony DeL,uc'a, Esq`~ii e
(~ , ~~ ~ ~- ~.~ Attorney Name: _
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... $
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TOTAL ........ ~' 0:6d
18067
Supreme Court I.D. No.:
113 Front Street
Address:
P.O. Box 358
Boiling Springs, PA 17007
Telephone: 71 7- 2 5 8- 6 8 4 4
Form RW-02 rev. 10.13.06 Page 2 of 2
.OAL REGISTRAR'S CERTIFIDATION OF DEA'TI~
~11,~I~NING: It is illegal to duplicate this copy by photostat or photograph.
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'phis is to ticrtity tFa~tt the in~fonnation here given is
c(~lrrertly ct1}~ied ~roili o~n original Certificate of DeaCh
dO]v #~iled with ))~e ~~~~. Local Registrar. The original
c ) tificatc w; ll i-1c 4~>rwasded Co the Stat(~ Vital
E~, rortis C~{~f)L~e t~Or ~~sr;-manent filing.
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ,. , . • ~-1
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CERTIFICATE OF DEATH
($@@ II18trUCtIOfl8 8pllj @XBmp(@S OA 1'@V@f8@~ STATE FILE NUMBER
H705-143 REV 112006
TYPE !PRINT iN
PERMANENT
BLACK INK
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1. Name of Decedent (First, middle, IasL ) 2 Sex 3. Soda) Severity Number 4. Date of Death (Month, Bey, year)
Paul E.A.M ers male - - Au.qust 11,2010
5. Age (Leal Birthday) lNdar 1 r Under 1 day 6. Date d Bits (Madh, da , r) 7. BiMplace ( and gale or country) 8a Plea d Death (Check only one)
71 kw~l. ~"" ~' ~"" 1 2 / 7 / 1 9 3 8 Ro i 1 i n g Springs , ~
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Yre. ER / outpetlent
DOA
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pec
y:
Nurs
ng Home
es
fib. County of Death 8c. City, Borcf~T~vp? f Death fid FaWMy Name (tl rat instilulion, give street and rsrmber) 9. Was Decedent of Hispanic Odgin? ~] No ^ Y'es 10. Race: American Irrdan, BWck, White, etc.
~
Cumberland
S. Middleton Twp
. 524 Mountain ~itd. (H yes, spedty Cuban,
Mexican,PlraAORicen,etc.) (SVepM
White
11. Decedents Usuel Ilon Kind d work d one d noel d world qle. Do rat state retlred 12. Was Decedent ever kt the 13. Decedent's Edtastbn (Spedty only highest grade compl eted) 14. Mental Status: Married, Never Married, 15. Surviving Spo use (II wile, give maiden name)
Kind d Work
IOnd of Buekless I kdualry U,S. Amred Forces?
Elementary i Secondary (D•12)
College (1-4 or 5+) ~~ Drvoroed (SP~~
Car ender Construction ^Yes [fib 9 widowed
- 18. Decedents Maipnp Address (Street, dty / town, stale, zip code) Decedenfb Did Decadent
$ Mir1~~ Q+-nn ('ice
DecedantLivedin
Slale PennSVlvania uYe~a no.I~Yes
~+~ ,7a
524 Mountain Rd. _
,
.
Township? 17d. ^ No
Decedent Lived withkr
F3oiling Springs, .PA 17007 ,
t~•~+'rtyCT7mhE?rl and Aaaalumtuol CitylBoro
15. Fatlrera Name (First, middle, lest, auRbc) 19. Mother's Name (Brat, midde, maiden aumarta)
nklin M ers Marie Alic c'ol n
20a. Inlorment's Name (Type /PAM) 20b. Inlomrent's Moping Address (Street, dry /form, stale, zip code)
narren W. Myers 314 Heisers Lane Carlisle PA 1701
21e. Method d Disposition
• [~Crematbn ^ Donation 21b. Date d Dispositon (Monty, day, year; 21c. Place of Dispoattbn (Name of cemetery, crenratary or other place) 21d Location (City I town, state, riv cede) 17 0 6 5
^ BuAal ^ Removal from Slate
^ rnher - specny: Was Crametbn w Donadon AutlaAud
br Medbel Ezaminer /coroner? C~'es ^ No
8 ~ 1 3 / 2 01 0 H o 11 i n e r Cremator
g Y t. Ho 11 S r i n s P A
Y P g
~ 22a. S lure of Funeral Se Licensee (or person ad'mg as surh) 22b. License Number 22c. Name and Address of Far~ry
. ~ J 011 589E HollingerFEi&Cremator Inc. Mt.Holl S grin sPA17065
Complete hems 23a•c anty when certifying
physician is not evapeble et tkrre d death 10 . To the beat d knowledge, death occurred Ure time, date and place Baled. (Sigrlattxe orb tltla
~^
1 ~~ \ 23b. License Number
) 23c. Date Signed (Mash, day, Year)
/
A
canary cause of death. :
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tteme 24.26 mast be canrpleled by parser 24. Time of Death 25. Date Dead (Montle, day, year) 26. Was Case Referred ro Medx~l Exandner / Conxar for a Reason Other than Crematlon or Donation?
who prorarxreea death. ~Q M, ~ ` ~ ~ ^ Yes ~ No
CAUSE OF DEATH (SSe Instructions and ) r Appmxkrmle interval: PeA 11: Enter Defter sidni9rbnt corrdltlons nxxitributlne a deatlL 28. Dld Tobacco Use ConmTate to Death?
ttem 27. Pan I: Enter the glab~l& - dreeases, krjuriec, a complkstkxm - tlrat rDredly cased the deatll. DO solar terminral events such as sandlot sneer, r Onset b Deets but not rasWUnrg in tla undaAykrg cause gNen h Part 1. ^ Yes ^ Probably
respiratory anew, or ventricrlar fibA9atlon wftlaW ahaxkg the etblog). List Doty one twee on each 9ne. ~ No ^ Unknown
;
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IIAMEDIATE~ ~ E (Fna~disaese or J~ ~ ° /~ ~ 3 ~7~(
corrdpiorr n tlr _~ a. I~T/(1" ( l) 1...-IVY ~~'~-~- r 29. N Female:
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Due b (a as a wnsequence o1): ~
' - year
ot pregnant w
th
n pas
^ Pregnant a15me of death
Segrxnlialry pal cardtbns. H any. b,
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kae6rrg b IFw twee paled on Gne a
EMer The UNDERLYWG CAUSE Due to (or as a consequence oQ: '
r ^ Not pregnant, but pregnant wilhb 42 days
(disease or Injury Ihat kdliated the c r
events resultin
m death) LAST
'
- d Beaty
g
.
Due to (or as a consequence ot): ^ Not pregnant, put pregnant 43 days to 1 year
~
• d, r before ~~
^ Unknovm H pregnant within the past year
30a. Was an Autopsy
P
7 30b. Were Autopsy Fkrdngs
i 31. Manner d Death 32a. bale d Injury (Month, day, year) 3ffi. Descnbe How Injury Ocaned 32c. Place d Injury: Home, Farm, S1reaL Fadory,
OBae Bulbfng
etc
(SpecityJ
eAomred Ava
lable Prior to Completion
d Cause d Death? r.7'
uak ~turel ^ Haria9de ,
.
^ Yes ~ No ^ Yes ^ No ^ Aasdent ^ Pending hwestgation 32d. Time d Injury 32e. trrWY a1 WoAc? 321. tl Tnuisportatbn Injury (Soeciry) 32g. Location of Injury (Street. city 1 town, state)
^ Sulfide ^ Could Not be DelemYned M ^ Ycs ^ t4o ^ Driver /Operator ^ Passenger ^PedeslAan
Other - Spersry•
33e. CeAiller (check enN one)
• Cerdfying phyekhn (Physldan eenpying cause d death when another physklen Iran prorauraed death and cortgleled Item 23) 33b. SlpnaWre Tpb d CeNOer
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TotMlbdolmyknowkdge,dathoeeunaddwtolMuuas(a)andmennarastaNd_.----"-------------------------1~ .
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• Pronouncing and certgying phyalydan (Physkaan both pronourakg Beaty and certifying to cause of death)
^ 33c. lkense 1Junrber 33d. Ds.le Signed (Month, day, year)
To tln beat of my knowledge, d~ih occurred el Ore Ome, date, end place, end due to the eauaa(s) and manner as slater!. _ _ _ . _ _ .... _ _ . _ -' - -
• MedkalExaminer/coroner M.D 0354'1 ~E ~ l.Z.l.L9lO
On the basis of examination and / or lnvesOgation, in my opinion, death occurred at the Ome, date, and pkce, and due to the uuea(s) and n sonar as stated. ^ e !Print
leted Cause of Death (Item 27) T
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OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
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Estate of Paul E.A. .Myers
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Deceased
Anthony L. DeLuca, Esq. & Marjorie A. DeLuca (each) a subscribing witness to
(Print Namels)
the ®Will ®Codicil(s) presented herewith, (each) being duly qualified according to law, deposf;(s) and
say(s) that she / he /they was /were present and saw the above Testator /~eiat sign the same
and that he / ~C signed the same and that ~b~l he / signed as a witness at thf; request of
the Testator / T~~~t in ~~r~ his presence and in the presence of each other.
r
(Signature)
113 Front Street
(Street Address)
Boiling Springs, PA 17007
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this ~ day
of A•ag~.st 2010
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Deputy for Register of Wills ,f
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(Signature)
113 Front Street
(Street Address)
Boiling Springs, PA 17007
(City, State, Zip)
Executed out of Register's Office ~ ~ o 0
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Sworn to or affirmed and subscribed ~~ ~' a ~ z
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before me this ~ ~ da ~ ~ ~ ~ m
Y ~~- b~ S ~ ~:~ ~
of August 201 0 ~~ ~,~
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otary Public J ~, ~ ~
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~Vty Commission Expires: ~ ~ " z
(Signature and Seal of Notary or other official qualified to t ~ Z,
administer oaths. Show date of expiration of Notary's Commission.'y
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-03 rev. 10.13.06
LAST WILL AND TESTAMENT
OF
~~~.~
PAUL E. A. MYERS :w: ,~-, ~=.~
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I, PAUL E. A. MYERS, a resident of Boiling Springs, Cumberland County ' ~ '
Pennsylvania being of sound mind, memory and understanding, do hereby make, p~lhi~sh , , .,
c.^ w _~
and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils heretofore made by me.
ITEM 1: I direct that all my just debts, the expenses of my last illness and
funeral expenses be paid as soon after my decease as the same can conveniently be done.
ITEM 2: I direct that there shall be paid out of my residuary estate all estate,
inheritance and like taxes together v~~ith any interest or penalty thereon imposed by the
government of the United States, or any state or territory thereof, or by any foreign
government or political subdivision thereof, in respect to all property required to be
included in my gross estate for estate, inheritance or like tax purposes by any of such
governments, whether the property passes under this Will or otherwise, excluding,
however, any property over which I have a taxable power of appointment, provided,
however, that no residuary beneficiary shall by reason of this provision be denied the
benefit of any deduction, credit, favorable rate of tax or other benefit which by law
enures to such beneficiary.
ITEM 3: I give, devise and bequeath all of the rest, residue and remainder ~of my
estate, real, personal and mixed, of whatsoever kind and nature, and wheresoever situate
PAUL E. A. MYERS
1
LAST WILL AND TESTAMENT
OF
PAUL E. A. MYERS
at the time of my death, in equal shares, unto my children, PAUL D. MYERS, DEAN A.
MYERS, TAVVNYA L. BUCHER and DARKEN W. MYERS, provided, however, that
they survive me and are living sixty (60) days after the date of my death.
ITEM 4: If and in the event that a child of mine does not survive me and is; not
living sixty (60) days after the date of my death, then and in such event, I give, devise
and bequeath the interest in my estate, which such deceased child would have received, if
living, to the issue of said deceased child, per stirpes.
ITEM 5: I hereby nominate, constitute and appoint my son, DARKEN W.
MYERS, Executor of this my Last Will and Testament, with full power to do any and all
things necessary for the complete administration of my estate, and direct that no bc-nd or
other surety is required of him in this or any other jurisdiction for his performance of this
office.
If and in the event that my son, DARKEN W. MYERS, does not survive me and
is not living sixty (60) days after the date of my death, or does not complete his duties as
Executor, then and in such event, I hereby nominate, constitute and appoint my sore,
DEAN A. MYERS, Executor of this my Last Will and Testament, with full power to do
any and all things necessary for the complete administration of my estate, and direct that
y
PAUL E. A. MYERS ~
2
LAST WILL AND TESTAMENT
OF
PAUL E. A. MYERS
no bond or other surety is required of him in this or any other jurisdiction for his
performance of this office.
ITEM 6: If any provision of this Will or of any Codicil hereto is held to be
inoperative, invalid or illegal, it is my intention that all the remaining provisions thereof
shall continue to be fully operative and effective, so far as is possible and reasonable.
IN WITNESS WHEREOF, I, PAUL E. A. MYERS, the Testator, have to this my
Last Will and Testament, typewritten on three (3) consecutively numbered pages,
subscribed my name and affixed my seal this ~~ - 5'~"day of February, 2007.
_~.~
-a~~ ~ SEAL)
PAUL E. A. MYERS
Signed, sealed, published and declared by the above named PAUL E. A. MYERS, as and
for his Last Will and Testament, in the presence of us, who have hereunto subscribed our
names at his request, as witnesses hereto, in the presence of the said Testator, and of each
other.
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