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HomeMy WebLinkAbout06-29-11PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Ruth N. Myers also known as COUNTY, PENNSYLVANIA File Number 21-11 •- ]~,~;,' ,Deceased Social Security Number 179-10-3913 Jeffrey L. Cisnev and Charles R. Cisnev 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 Executors named in the last Will of the Decedent, dated 05/29/1986 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc. After the execution of the documents offered for probate: Decedent did not marry; was not divorced; was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323 (g); did not have a child born or adopted; was snot the victim of a killing; and was never adjudicated an incapacitated person, except as follows: B. Grant of Letters of Administration (Ifapplicab/e, enter: c.t.a.; d.b.n.c.t.a.; pedente liter durante absentia; durante minoritate) 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. ord. b. n. c.t.a., enter date of Will on Section A above and complete list of heirs); was not the victim of a killing; was never adjudicated an Incapacitated person; and was not a party to a pending divorce proceeding wherein grounds for divorce had been established as provided In 23 Pa. C.S.A. § 3323 (g), except as follows: Name Relationship Residence ~°~-~ ,...., ._ 0 .~::: ~..-~ ~. ~-~, ~„` ~ ~'? ,:p ~ ~ N .: ~~:. (COMPLETE /N ALL CASES.) Attach additional sheets if necessary. ...o _...~ r;.~ ~."~ t=r, Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last princt~'al residence 2tt"~ `''' ~,, i 121 William Drive, Shippensburq, Shippensburq Township, Cumberland County, PA 17257 (List street address town/city, township, county, state, zip code) Decedent, then ~_ years of age, died on 04/23/2011 at 121 Willow Drive, Shippensburq, PA 17257 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 50 000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 50 000.00 situated as follows: 121 Willow Drive, Shippensburg Township, Shippensburg, Cumberland County, PA 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 Jeffrey L. Cisney ~r ~C.P 717-530-0895 Charles R. Cisney D /y~ (717) 532-9181 or printed name and residence 9287 Muddy Run Road Orrstown, PA 17244 9407 Muddy Run Road Orrstown, PA 17244 Form RW-O2 Rev. 12-26-2010 (interim form, pending action by the Court) Copyright (c) 2006 form software only The Lackner Group, Inc. 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 before me this ~" day of _, j ~ ~ '~~ For the Register L. Cisney Signature of Personal Representative Charles R. Cisney Signature of Personal Representative ~ ~~.: ,, r-- ~~ :_~~ rY-t N , ' ' ~L~ a File Number: 21-11 ~- 7 ~ ~ ~ C~ ~a ~., _ Estate of Ruth N. Myers ~~ed r.~~ ~ ".~: Z~ i.. `~ ~ "i T7 (.. Social Security Number: 179-10-3913 Date of Death: 04/23/2011 AND NOW ~ ~~ ' ~~~~~ ~, ~- ---i--,~-:~ -i ~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Jeffrey L. Cisney and Charles R Cisn y in the above estate and that the instrument(s) dated 05/29/1986 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent FEES Letters .......................................... $ -i~' ~l.i Short Certificate(s) ....................... $ `,y . U ~ j Renunciation(s) ............ ............... $ ~ f~~ ~~ $ ~ J~C7v /' ~1 ~~.~ $ ~ ~, ~,.~~ ~ 4 4 $ $ $ Telephone: $ $ TOTAL ................................... $ ~~->y ~~ (_~ ~~ ~, ~~ .. r' of o Representative Hanover, PA 17331 717-632-4656 I Form RW-02 Rey. ~o-~s-zoos Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 Address: 230 York Street 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 ~~ day of I"~ ~ y Ys d~-~ i ,/ ~ A„ For the Register Signature of Personal Representative Jeffr y ~. ~sney ,i Signature of Personal Representative Charles R. Cisney Signature of Personal Representative `~ ..J~1 . }„~ ~.~ 1~ J ~ ~ ..~ ' -~ .... ~....-J File Number: 21-11 _- ~s> ~ •~i' state of Ruth N. Myers , D~.' Coed -_ Social Security umber: 179-10-3913 Date of Death: 04/23/2011 ~-- AND NOW, , in consideration of the foregoing Petition, satisfactory proof having been presented before me, I DECREED that Letters Testamentary are hereby granted to ai~~.+ u~a~ uic nwuu~iici~t~a/ ua~au V~7/L`.1/ 1`JaQ described in the Petition be admitted to probate and Letters .................. . Short Certificate(s) Renunciation(s)..... FEES TOTAL ...................... Form RW-02 Rey ~o->s-loos in the above estate of record as the last Will (and Codicil(s)) of Decedent. .,~ $ `o $ Attorney Signature:~~ $ Attorney Name: Supreme Court I.D. No.: of Wills $ ~`'~ Address: 230 York Street~'~~ $ Hanover, PA 17331 $ Telephone: 717-632-4656 mes M Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 ~L REGISTRA,R'S ~ER~"I~~I-~`I ® ~; "fig '~~'~ RNNNG: l~ is illegal t0 duplicate t~i~ ~~;~l~~f ~~~j ~:'rl~i~C~i~r1,~=~~: ~~~ ~~(~ ~ ~~~) ~~_ #.~ ( .`I~' ~1 E~~1' _'t~`C'l~lf+.';ilt ,{-r A°~ rr{~ ~~~ ): II A~~,T~'I~~ ~~ ~7 l r '3 rr," l J'R r ~ ' s r %~. ~ a y` , i ,. , ~~ , ,, ,. ~_i-til~lt_~t!'.~~)P1 ~1'"~i';f1 try , -. e. ~ , C.l ~ s ^~ ~ , ~. 1 ~~ ~ _ ~../y 1 ~~ "'{ r'`'J ~ ~ T'i H705144 REV 1112006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ :.;l ~=7 TYPE /PRINT IN ~ ^- BLACK INKT CORONER'S CERTIFICATE OF DEATH ~i (See instructions and examples on reverse) ~i33-018 STATE FII F NIIMRFR ,l W 0 0 W `_ 1. Name o1 Decedent (First, middle, knsl, suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year) Ruth N Myers Female 179 - 10 -3913 April 23, X111 5. Age (Lest Birthday) Under 1 year Urder 1 day 6. Dale of Binh (Month, day, year) 7. Birthplace (City end slate or faeign country) 8a. Place of Death (Check only one) Months Deya Hours ktinules FbSpnal: Other: 97 Yrs. anuar 12, 1914 Orrstown, PA ^Inpatient ^ER/Outpatient ^DOA ^NursingHOme Residence ^Other-specity: 8b. County of Death 8c. City, Boro Tw of Death ~ Bd. Facility Name Qf n01 institution, give street and number) 9. Was Decedent of Hispanic Origin? ®No ^ Yes 10. Race: American Indian, Blade, While, etc. • Cumberland Shi ensbur 121 Willow Drive (If yes, specity Cuban, Mexican, PuertoRicen,etc.) (SPedM White 11. Decedent's Usual Occu tbn Kmd of work done B urin most of wo life. Do not stale retrced t2. Was Decedent ever m the 13. Decedent's Education (Specify only highest grade com pleted) 14 Mamal Status: Marri d N M i d 15 Kind of Work Kind of Business /Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-0 or 5+) . e , ever arr e , Widowed, Divorced (Specify) . Surviving Spouse (11 wile, give maiden name) Self em to ed Dair farmer ^Yee ®No 12 Widowed 16. Decedent's Mailing Address (Street, city /town, state, zip code) Decedents pe nn s lvania Did Decedent y Shi 121 Willow Drive Adual Residence 17a. Slate ppensburc( Live in a t7~. ®Yea, Decedent u„ed;n TwP Shippensburg PA 17257 Township? 17b.County Cumberland 17d.^No,DecedenlLivedwghin , Actual Limits of Cny / Boro 18. Father's Neme (First, middle, last, suffix) 19. Mother's Name (First, meddle, maiden surname) Charles Ba and Cisne Dais Tressa Parson 20a. Informant's Name (type /Print) 20b. Informant's Mailing Address (Street, city /town, state, zip code) Tressa Thomson 2938 Jefferson Drive Chambersbur PA 17201 21a. Method of Disposgion i ^ Cremation ^ Donation 21b. Date of Dis neon Month, da • pos ( y, year 21c. Place of Dis ) position (Name of cemetery, crematory or other pWce) 21 d. Locatiixr (Cny /town, state, iro code) ® Burial ^ Removal fr St t om e a Was Cremation or Dormtion Arnhorized ^ Other•Specity: ! byMedicalExaminer/Coroner? ^Yea^No Aril 29 2011 S tin Hill Cemeter Shi ensbur PA 17257 • 22a. Signet rat Service Licensee (or person acting as such) 22b. License Number 22c. Name arb Address of Fadlity - ~ . 014831-L -Bricker F.H. Inc. 112 W. St. PA 17257 Corn a Hems 23a-c only wh nifying physician is rat available at time o1 death to 23a. To the best of my knowledge, death occurred al the time, date and place stated. (Signature and title) 23b. License Number 23c. Date Signed (Month, day, year) certgy cause of death. gems 24.26 must be completed by person 24. Time of Death 25. Date Pronouraed Dead (Month, day, year) 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? who pronourxxs death. A rX . 1 Ct : C-C) P . M. A r i 1 2 4 2 011 ~ Yes ^ No CAUSE OF DEATH (See instructions and examples) r Approximate interval: gem 27. Pan I: Enter the chain of events -diseases, injuries, or complications -that directly caused the death. DO NOT enter terminal events such es cardiac amest Pan II: Enter other jgngicant contlilbns contributing to alh, 28. Did Tobacco Use I;ontdbule to Death? , r Onset to Death respiratory arrest, or vemricular fibrillation without slwwing tfte etiology. L'ISt ony one cause on each line. r but not resulting in the undertying cause given in Pan I. ^ Yes ^ Probably r IMMEDIATE CAUSE (Final disease or r ^ No ~ Unkrawn condition resulting in death) ,~ a. Hypertensive Cardiovascular Disease ~ Hypercholesterolemia 29. 11 Female: Due to (or as a cronsequence ol): ~ Sequenliall ksl cerdnions, it any, b r y leading to the cause ksted on line a. r ~ Not pregnant wghin past year ^ Pregnant at time of death Enter the UNDERLYING CAUSE Due to (or as a consequence of): ~ ^ Not pregnant, but pregnant wghin 42 days (disease or injury that ingiated the c r events resuging to death) LAST. r D of death ue to (or es a consequence op: r ^ Nol pregnant, but pregnant 43 days to 1 year d. r r before death ^ Unknown g pregnam within the past year 30a. Was an Autopsy Pedormed? 30b. Were Auiapsy Findings Available Prior to Completion 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred - 32c. Place of Injury: Hrxne, Fann, Street, Factory, 01 Cause of Death? ~ Natural ^ Homicide Office Building, etc. (SpecilyJ ^ Yes ~ No ^ Yes ^ No ^ Accident ^ Pending Investigation 32d. Time of Injury 32e. Injury at Work? 32f. If Transportation Injury (Specify) 32g. Location of Injury (Street, cfly /town, slate) ^ Suicide ^ Could Not be Determined ^ Yes ^ No ^ Driver /Operator ^ Passenger ^Pedestrien M. ^ Other • Specvty: ~ 33a. Certifier (check only one) • Cenlfying phyalclan (Physician certifying cause of death when another physician has pronounced death end completed Item 23) To the b t m k l d d 33b. Signature and Title of Cenil r ~ ~ es my now e ge, eath occurred due to the uuse(s) and manrxr es cteted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ • Pronouncing and cenM in h sicfen (Ph n b ic th d d - ~ C o r o ne r y g p y ys a o pronoun ng eath and certifying to cause of death) To the best of my knowledge, death occurred at the time, date, and place, end due to the cause(s) and manner as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. License Number 33d. Date Signed (Month, day, year) • Medical Exsmirter /Coroner On the basis of ezaminetfon and / or Investigation, in my oplnio ath occurred at the time, data, and place, end due to the cause(s) end manner as atated Apr 11 2 5 , 2 ~ 11 _ ' ` 34. Name and Address of Person Who Completed Cause of Death Qte m 27) Type /Print 35.Regislrer'sSignalurearxl anict er Todd C. Eckenrode, Coroner - - IZItI Z7 I 36. ate Filed (Month, day, year) ., 6375 Basehore Rd. , Suite 4{1. V Disposition Permit No. ~~~8~~ / J ~ ~ • . y LAST WILL AND TESTAMENT Law Offices GLEN ~ GLEN 306 Chambersburg Trust Bldg. Chambersburg, PA 17201 I, RUTH N. MYERS, a resident of Southampton Township, Franklin County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my last will and testament, hereby revoking any anc~ all wills by me heretofore made . ITEM I. I direct my executor or executors, hereinafter named., to pay my funeral expenses as soon after my decease as may be found convenient, and also to pay all estate, inheritance, succession and other death transfer taxes, of whatever nature and by whatever jurisdiction imposed and interest and penalties in respect thereto, assessed against my estate or payable by reason of my death, with respect to any and all property, lifE: insurance and other interests comprising my estate for death tax purposes, whethE~r or not such property or interests pass under this will or any codicil. thereto, without reimbursement as if such taxes were administration expenses . ITEM II. I give, devise and bequeath all my estate, real, per~~onal and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my decease, to my husb~ind, W. BRtJCE MYERS, absolutely, if he is living at the time of my decease. ITEM III. In the event my husband, W. Bruce Myers, is not living at the time of my decease, I dispose of my estate as follows : - (A) I give and bequeath the sum of Five Thousand Dollars ($5 , 000.00 ) to ORRSTOWN UNITED BRETHP.,EN CHURCH. (B) I give and bequeath the sum of Five Thousand Dollars ($5 , 000.00 ) to my nephew, ANDREW C. BRENEMAN, if he is living at the time of my --~ ~` ~ s 1~/~ pa 5-11~y~~~wfl~ ~ ~ ~ ~ ~ ~~ N dip '~,~ ~3~~ n y 7 ~~ ~~~ 6~, ~~ lei ,, ~ r ~v, ~~-~--. , ~~~~~ ~ i ~~~~ `~ r ~ ~Myf iP (,, decease, but in the event the said Andrew C . Breneman has Predeceased me, then this bequest to him shall lapse and form part of my residuary e~;tate. Law Offices GLEN ~ GLEN 306 Chambersburg Trust Bldg. Chambersburg, PA 17201 (C) I give and bequeath the sum of One Thousand Dollars ($l , 0~~0.00) to my friend, SUMMR RUTH MYERS, if she is living at the time of my decease, but in the event the said Summr Ruth Myers has predeceased. me, 1:hen this bequeath to her shall lapse and form part of my residuary estate . (D) All the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my decease, I give, devise and be- queath in equal shares to my nephews, CHARLES R. CISNEY and JEFFREY L. CISNEY, if both are living at the time of my decease, but in the event either of said nephews have predeceased me, then the entire said residue and :re- mainder of my estate to the survivor of said two nephews . ITEM IV. I nominate and appoint CHAMBERSBURG TRUST COMPANY, of Chambersburg , Pennsylvania, guardian of the estate of any person under the age of 18 years and with respect to which I am authorized to appoint: a guardian and have not otherwise done so, to serve until such persoris attain the age of 18 years, and no bond shall be required of said guardi;~.n; said guardian shall have the power to use principal as well as incorr~e frorr~ time to time for the maintenance, education and medical care of suchh benE~ficiar:ies under the age of 18 years . ITEM V. I hereby nominate and appoint my husband, W. BRUCE MYERS, executor of t his my last will and testament, but in the event the said 'W. Bruce Myers is not living at the time of my decease, or fails to qualify, I nominate and appoint my nephews, CHARLES R. CISNEY arlcl JEFFREY L. CISNEY, executors of this my last will and testament, and direct that no bond shall be required of said executor or executors . ~/ 2. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this last will and testament, this `~~~ day of May, A . D . 1986 . ,,..~ _-, ,/ Law Offices GLEN ~ GLEN 306 Chambersburg Trust Bldg. Chambersburg, PA 17201 SIGNED, SEALED, PUBLISHED AND DECLARED by the said Ruth N. Myers to be her last will and testament in our presence, who at her request and in her presence and in the presence of each other, we ~-elieving her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses . ,~ ~ ,; {, ,. ~, n ~, "~ a `.~.-. ~ ~~~....~_ .~ -ern, ~~ - ~ ~.~.:~~.~ `~~ ,--- s .,,s 'G ~, 3. OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Ruth N. Myers Deceased Charles R. Cisney and (Print Name) (Print Name) (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with Ruth N. Myers and am /are familiar with the handwriting and signature of the decedent, and that the signature of Rutn N. Myers to the foregoing instrument purporting to be the Last Will and Testament/Codicil of Ruth N. Myers is in his /her own proper handwriting. :~7 ~ (Signature) Charles R. Cisney 9407 Muddy Run Road (Street Address) Orrstown, PA 17244 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed befor me this-~=~ (~, day o ' ~ ~ , ~~~,L. . r, i ~ ~' ' ~' y 1 uty Tor Register of 1Ni~ls (Signature) (Street Address) (City, State, Zip) co --,-, <~ ~_ -~ ..~ ,. r'rt N r .1. j 1 ~ ~ ; f.1 _ {~ " v ` _..~ ~,.~ i ~J~ r`t ~ ~ - ~.~ Q ~ - ~ rs c r.: Form RW-04 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Ruth N. Myers ,Deceased Jeffrey L. Cisney and (Print Name) (Print Name) (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with Ruth N. Myers and am /are familiar with the handwriting and signature of the decedent, and that the signature of Ruth N. Myers to the foregoing instrument purporting to be the Last Will and Testament/Codicil of Ruth N. Myers is in his /her own proper handwritings. ~r ,, ~~~ (signature) J ey L. Cisney 9287 Muddy Run Road (Street Address) Orrstown, PA 17244 (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me thi~ r _____ d y ~~~ ~ ~ • ~__. , i~ ~ ~ ~ eputy for Register of S/Vills Form RW-04 Rev. f0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. (Signature) (Street Address) (City, State, Zip) ~ '~~ ~.~ r ,r, ..,.... --c~ ; ~-, fS . ~ c...... rr-t ~7 ~ ~ ' ~C 7 _ "r7 ~ ~ f ' Cfa ~ ~~ _ _~ . ~ ~.~ r c..