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PETITION FOR11 GRANT OF LETTERS
REGISTER OF WILLS OF ~,te_rv~ be r I d ~ ~ COUNTY, PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in
support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name: ~! / ~1/~ V ~dY~ i -I~~tt',..5
a/k/a:
a/k/a: ~~2, i V v .~ a l e r 5
a/k/a:
Date of Death• f -- ~- / '
Decedent was domiciled at death in ~ r ~ d n L County
principal residence at~rZ$'~; a ~ ~~~ jaa e. ~ D,
Street address, Post Of/flee
Decedent died at ~ `L SS ~ d ~` V j ~! d- t G
Street address, Post Office and Co e
File No: ~ ~ - S a - cJ C) 3~j
(Assigned by Register)
Social Security No• I ~ ,~ .- ~ ~ ~~~ d ~
Age at death• q~
City, Township or Borough
f~i~crt l~r- 1(V~~ec~g~l~
City, Township or Boroag
(crate) with his/her last
Fj u e ~' County
Couuty State
Estimate of value of decedent's property at death: ~ ~, ~~ ~
If domiciled in Pennsylvania ............................ All personal Property $
If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $
If not domiciled in Pennsylvania ........................Personal property in County $
Value of real estate in Pennsylvania ......................................................... $
TOTAL ESTIMATED VALUE.... $ 0.00
Real estate in Pennsylvania situated at:
(Anach additionat sheets, ifnecessary.)
Street address, Post Office and Zip Code City, Township or Borough County
A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated ~ ~ () ~ pC 0 Codicil(s)
thereto dated
State relevant circumstances deg. renunciotiox, death of executor, ttc.J
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not many, was not divorced, was not a party to a pending
divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), and did not have a child born or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
® NO EXCEPTIONS Q EXCEPTIONS
B. Petition for Grant of Letters of Administration (If applicable)
e.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante absentia, durante minoritate
If Administration, Goa. or d b.n.c.~a., enter date of Will in Section A above and complete list of heirs.
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined
in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
® NO EXCEPTIONS Q EXCEPTIONS
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 (attach
additional sheets, if necessary):
,,.'~
Name
Relationshi r-
Address ~° ~z7
,;>:.~~ ,
-
._
? c:
~ __ -
't> is
C:`,
-e ~
Forn Rw-oa rev. ~oi»ao» Page 1 of 2
Oath of Personal Representative
COMiVtONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF
i __ .'
`Official Usc Only . ~ ''-
_~,
4- ,.i I
Petitioner(s) Printed Name Petitioners Printed A 'i ' `' " ~ '•~jv•~ ~ ~
O ie . n~-
~ IS ~cdsd~y' r
D -SCE
t~
The Petitioners} above-^amed swear(s) or affirm(s) 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, the Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed a d subscribed before Date
me this ~,~~ ppday o~ .: ' Date /"' - ~[/1 - / ~2.
By: ~I-L~ ('~ (~' ~~~.( ~~r ~'1 ~ Date
Por the Re~isrer Date
BOND Required:~YES ~NO
FEES:
Letters ..................... .
( ~) Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other
$ `~I 5 • o~
R CSC
1 -OG
Automation Fee ............... (j
JCS Fee . .................... ,
TOTAL ..................... $
To the Register ojWi!!s:
Please enter my appearance by my signature below:
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate of
a/k/a:
S
File No• ~ ~ ' ~ ;~ - UQ ,3
AND NOW, _ J~X1~l)CA.12 J (() (n Q ~ , in consideration of the foregoing Petition,
satisfactory proof having been pre ented before me, IT IS DECREED that Letters T-P~~ (~ VVt.k,vl k~; rt_,i
are hereby granted to ~,! ~~-' O ~ i-~ (Q ,
~~ in the above estate and (if applicable) that
the instrument(s) dated ~~~ U ~ ~O(l ~
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
_ ~ - ~ ,~
Register of Wills V ~ ~ (~ ~""'U'
~ a~~ ):~
Form RW-n2 ,~~~. milt~zntt gage 2 of 2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00 ems is ru ccrury E,lill ulc 1111VE1]dQfl.,/1 ]ll.ll. ~........,
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
certificate wilt be forwarded to the State Vital
Records Office for permanent filing.
P 18 0 3 7 217 ~ ~- ~~~_ - a~/ ~'/ ~~
Certification Number Local Registrar Date Issued
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LAST WILL AND TESTAMENT n --='
, :.
_~
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_
JJ
1 ~ ~ ...
OF ~ ' --T
7`7
_:_~
-
-
...
_~
MYERS
OLIVE G ~~ ~ ~`'
---
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I, OLIVE G. MYERS, of 725 Hogestown Road, Mechanicsburg, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking any and all prior
Wills and any and all Codicils thereto, by me at anytime heretofore made.
ITEM I: It is my will and direction that my Executrix hereinafter named, pay or cause
to be paid and satisfied, all of my just debts and the expenses of my last illness and funeral in such
amounts as she may deem to be proper, as soon after my death as may be practicable. My said
Executrix is authorized, empowered, and directed to incur such bills and expenses for my funeral as
in his discretion are proper, without regard to any limitations imposed by law or rule of Court in
force at my legal domicile at the time of my death.
ITEM II: I direct that all inheritance, estate, transfer, succession and death taxes, of any
kind whatsoever (including any interest and penalties thereon), other than any generation-skipping
taxes which may be payable by reason of my death, whether or not with respect to property passing
under this will, shall be paid out of the principal of my residuary estate.
ITEM III: I will, devise and bequeath unto IMMANUELOHURCH-CHRISTIAN &
MISSIONARY ALLIANCE, the sum of $2,000.00.
Page 1 of 6 Pages ~~ . U ~
O.G.M.
ITEM IV: I will, devise and bequeath unto YOUTH FOR CHRIST, Harrisburg,
Pennsylvania, the sum of $1,000.00.
ITEM V: I will, devise and bequeath unto FREEDOM VILLAGE, of Lake Mont, New
York, the sum of $1,000.00.
ITEM VI: All the rest, residue and remainder of my estate, real, personal, or mixed,
including any powers of appointment of which I may be the donee, I will, devise, and bequeath unto
the aforementioned residue of my estate shall be divided equally between my children, PEGGIE
A. HOPPLE, KAREN M. FOX, and RICHARD W. WERTZ.
ITEM VII: In the event that, at the time of my death, I am joint owner, co-owner, or
owner of any real estate, bank account, government bond, or any security or instrument of
indebtedness (whether issued by private corporation, a government, governmental agency, or an
individual), which is registered or issued in my name and that of another person or persons as tenants
by the entirety or as joint tenants with right of survivorship, or which is shown in writing to be
payable to either the co-owner or named survivor on my death, I give, bequeath, and devise,
absolutely and forever, all my right, title and interest in any such property to the surviving joint
owner or co-owner thereof or to the other survivor apparently entitled thereto upon my death. It is
my understanding that my right, title, and interest in any such property will, by operation of law
upon my death, vest or pass to such surviving joint owner or co-owner thereof or to the other
survivor apparently entitled thereto upon my death. Nevertheless, I make these provisions in order
to eliminate any doubt or question as to the right of any such surviving joint owner or co-owner or
other person apparently entitled thereto to succeed to the full possession and ownership of such
property upon my death, and to provide for the possible contingency of an ineffective attempt to
create a joint tenancy or estate by the entirety.
Page 2 of 6 Pages , ,~ C~. -~
O.G.M.
ITEM VIII: Not in derogation of or in limitation upon the powers, authority, and discretion
conferred upon my Executrix by law, I do hereby give my Executrix the following authority, powers
and discretion:
1. To invest and reinvest the assets of my Estate in accordance with his judgment not
being limited by any present or future investment law; to vote in person or proxy with respect to any
and all stocks; to retain all property in the form in which the same shall be received without liability
for any loss that may be incurred thereby, to sell real estate or personal property, either for cash or
part cash and part deferred payments; to exchange, lease, partition, improve, repair, abandon, or
otherwise deal with or dispose of all or any part of the assets of my Estate at such time or times in
such manner, either public or private, and upon such terms as in the absolute and uncontrolled
discretion of my Executrix deem expedient and proper; to borrow money on the general credit of my
Estate as security for the repayment thereof, and to renew from time to time any indebtedness
incurred by me, by my Executrix for my Estate, to pay, settle, compromise, or submit to arbitration
without Court order any and all rights, demands, or claims, either in favor of or against my Estate,
upon such terms as in his uncontrolled discretion she shall deem proper; to make, execute and deliver
any and all instruments in writing as shall be necessary or advisable to carry out the administration
of my Estate or disposition of property in my Estate.
2. In any case in which my Executrix may be required, pursuant to any provision of this
Will, to divide the principal of my entire Estate into shares or to distribute such shares, she is
authorized and empowered in his sole discretion to make such division or distribution in kind or in
money, or partly in kind and partly in money; and for the purpose of such allotment, the judgment
of my Executrix concerning the propriety thereof and the relative value for the purpose of division
or distribution of the asset or assets allotted shall be binding and conclusive on all persons and
Page 3 of 6 Pages c~ ~ }~
O.G.M.
corporations interested therein.
ITEM IX: I hereby nominate, constitute and appoint PEGGIE A. HOPPLE, as
Executrix of this my Last Will and Testament.
ITEM X: I direct that all legacies and devises and all share and interests in my estate,
whether principal or income, while in the hands of my Executrix, shall not be anticipated, alienated,
or in any other manner assigned or transferred by the legatee, devisee, or beneficiary, and such
interests shall be for the sole and separate use of the legatees, devisees, and beneficiaries and shall
be free and exempt from anticipation, execution, assignment, pledge attachment, distress for rent,
and other legal or equitable process which may be instituted by and on behalf of any creditor or
assignee of such legatee, devisee, or beneficiary, or his or her spouse.
ITEM XI: I direct that my Executrix shall not be required to file any bond in any
jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any
order or approval of any court for the exercise of any power or discretion set forth in this Will.
ITEM XII: All powers and discretions conferred by my Will upon or lodged in my
Executrix shall be construed to be appurtenant to the fiduciary office and shall pass to and be
exercised by any surviving or alternate Executrix, Fiduciary, or by any other successors, whether or
not named herein.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of
~ (Y1 ~ , 2003.
'~ ~_::~.,~ ~'-~. ~'Y~ (SEAL)
OLIVE G. MYERS
Page 4 of 6 Pages ~% ~~- ~
O.G.M.
Signed, sealed, published and declazed as and for the Last Will and Testament of OLIVE
G. MYERS, the Testatrix, consisting of this and five (5) other typewritten pages, in our presence,
who, in her presence, and in the presence of each other, and at her request, have hereunto set our
hands as subscribing witnesses hereto.
~~~J ~ ,
Name R
Address
N ~ Address
arr- Address
Sworn and affirmed~ko and acknowledged before me, by OLIVE G ERS, the Testatrix,
this .`~~~ day of ~~ tYl~ ,--~ , 2~~\
NO IA ~ "
Notary
NOTARIAL SEAi_
Carrie E. Cook, Notary Public
City of Harrisburg, Dauphin County
My Commission Expires Aug. $. 2006
Page 5 of 6 Pages ~ -~ G. M
O.G.M.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
We, OLIVE G. MYERS, L ~ ~ ~ M - OR~c~ a r~- ,~~ `~~ S ~ `,tn~ and
~~r~ ~, `,t~o~ ,the Testatrix and the 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 Testatrix signed and executed the instrument as her Last Will and that she had
signed willingly (or willingly directed another to sign for her), and that she executed it as her free
and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence
and hearing of the Testatrix signed the Will as witness and that to the best of their knowledge, the
Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint
or undue influence.
~'~ .-rte y~`7 cZ.;t~
TESTATRIX, OLIVE G. MYE
rn . ~h~~,~
Witness
~. \,
Witn s ,~ / , )
W
Witn ss
Subscribed, sworn to and acknowledged before me, by OLIVE G. MYERS, the Testatrix,
and subscribed and sworn to before me by , D ~ ~ ,a _ " 0.c` ; ~
and ~~~k-t ~ . ~ t,'F witnesses, this< ay , 2 3.
NOTARIAL SEAL Notary Public
Carrie E. Cook, Notary Public
City of Harrisburg, Dauphin County
My Commission Expires Aug. 8, 2Qi76
Page 6 of 6 Pages ~=- ~ G-~ -'`-(
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