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HomeMy WebLinkAbout03-12-12PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of Eleanor K. Myers also known as COUNTY, PENNSYLVANIA File Number 21 - 12 • C~~`c~` ,Deceased Social Security Number 070-32-9695 Sharon R. Myers Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or B' BELOW:) 0 A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the Executrix named in the last Will of the Decedent dated 03/12J2003 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 mar • 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. §ry3323 (g); did not have a child born or adopted; was not the victim of a killing; and was never adjudicated an incapacitated person, except as follows: B. Grant of Letters of Administration ap rca e, en er. c..a.; ..n.c..a.; e e e; uran e a sen ra; urdn a mr a e 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. or d.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 Relationshi Residence Sharon R. Myers Daughter 320 West Shady Lane, Apt. 2 Enola, PA 17025 ~ r-~ c: -, ... r ...~?-.p .~. t-~ ' ~ C7 ':~. (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. _ L*3 ~ t"~ Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at --' '- t~ ..,.,,, "_i~j ,1 320 West Shady Lane, Apt. 3, Enola, PA 17025_ ~= ~"_~ ~ ~_ (List street address, town/clty, township, county, state, ap code)~J --t , . .~ r.~ Decedent, then 71 years of age, died on 01/20/2012 at 320 West Shady Lane, Apt. 3, Enola, PA 17025 ~= Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 20,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 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 Typed or printed name and residence Sharon R. Myers 320 W. Shady Lane, Apt. 2 Enola, PA 17025 Form Rev. 12-26-2010 (interim tone, pending action by the Court) Copyright (c) 2010 form software only The Lackner Group, Inc. Page 1 of 2 "3:? _ry..i i`y` ~ %; <- _. ; ; `, =~ - c-, -- ~'~ c~ -~z 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. Swom to or affiirrned and subscribed 1~~ i before me this ~~-~ _.___ day of ~~ I` ` ~.L~.~~Cc I,i~ d.~~~~ For the Register File Number: 21 - 12 ~~,U Estate of Eleanor K. Myers ,Deceased Social Seecurity Number: 070-32-9695 Date of Death: 01/20/2012 AND NOW, 1 Y1~,( ,C ~ , ~ 1 ~ ~~ ~~ ' , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Sharon R. Myers in the above estate and that the instrument(s) dated 03/12/2003 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............................................ $ L.4.~,; (` ~~ Short Certificate(s)..... `l) ............. $ ~ ,~ . ~ ~\~ Renunciation(s) ............................. $ L~~ ~~ $ 1~ U~~ $ ~ -~ -~~ ~~.~ ~yc,~ TOTAL .................................... $ ~ I ~~ . ~ [~ Al Supreme Court I.D. No.: 17225 Address: 525 North 12th Street Lemoyne, PA 17043 Telephone: 717/761-5361 r~~C: "~ iC_% _ _ ~ G, ~r~, { _~.,, ~l l~~ Form RW-OY Rev. 1413-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 2 :~ ii "^~ Signature of Personal Representative -z~ --ti . . _' C.°3 -..1 Attorney Name: Samuel L Andes LOC~IL~I~IR'S CERTIFICATION OF DEATH i.-, .. ... .' f7 WARI~~St,~;lt'iis,ille~~~,.fp duplicate this copy by photostat or photograph. Fee foj- thiti certificate. $6.00 This js to certife tea:( the jnformation here given is correctly copied iroh~rj arJ original Certificate of Death ~,~~~~( Q~ (!uly tiled ~~'ith itte „~• x. j-~a1 Registrar. fhe original ~~~'~ ~GURr ce(tlficate will be lurvi,arded to the titate Vital ~s~~MR?`{~~..ia~`~(~~ rn Pa h.ecords Offiice i2)j ~urrnanent filing. ___ P 18226884___ Certification Number Type/Print In Permanent x!7'1_1 D~ i$ Y [Z -~ ~ ~-c~d~t'e~u ~a Local Kegjstrar Date Issued COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH -VITAL RECORDS CERTIFICATE OF DEATH 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sez 3. Social Sacunty Number 4. Data of Death (MO/Day/Yr) (Spell Mo) Eleanor K M era Femal 070-32-9695 Januar 20 2012 Sa. Age-Last Birthday (Vrs) Sb. Under 1 Vear Sc. Under 1 Da 6. Oate of Birth (MO/Day/Vear) (Spell Mpn[h) 7a. Blrthplau (City and State or Foralgn Country) Months Days Hours Mlnut.s N. Ta wn, NY 71 Se tember 15, 1940 76. Birthplace (county) Weatcheeter Ba. Residence (State,pr FOrelgn Country) Bb. Residence (Street and Number -Include Apt No.) Bc. Dld Decedent LIVa In a Townshlp7 A YY 320 West Shady Lane was, decedent uyea In East Penneboro twp. ed. a.aidane~( m~ u rland 8e. Residence (Zip Coda) Q NO, decedent Ilved wlthln limits of city/born. 9. Ever In US Armed ForcesT 10. Marital Status at Tlma of Death Married Q WI owed 11. Surviving Spouu's Nam• (It wife, give name prior to first marriage) Q Ves ~] No Q Unknown ~] Dlvorted Q Never Married Q Unknow 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marrlge (First, Middle, Lazc) George Andereen Eleanor Mlnnerly 14a. Informant's Name 14b. Ralatlonzhlp to Decedent 14c. Informant's Malling Address (Street and Number, Clty, State, 21p Code) ~ Sharon Myere DAUGHTER 320 Wsst Shady Lane Enola, PA '17026 G s ..........................................................wHyt ......................................... It Death Occurred in a Hospltsl: LJ•Inpatient ! a. ate o eat ....<,-o~.y one .... ... .... .......... ... ... --- .. ..----.. ............ ....... ..... ssw~~r .... .. .. ... If Oaath Occ ~~~~ ~~~~~~~ ~-~~~~ ~~~~ y red Somewhere Other Than a Hospltsl: 1-1 Mosplte Faclllt Decedent's Nome S Q Emergency Room/OUtpatlent Q Dead on Arrival ~ Nursing Home/Long-Term Care Faculty Other (Specify) lSb. Faculty Nama (If not Instltutlon, glue street and number; 13c. City or Town, State, and Zlp Coda 15d. County of Death n A 1 2 Cumber and 16a. Method o7 Dlsposltlon Q Burial Cremation 16b. Date of Dlsposltlon 16c. Plate o7 Disposition (Name o1 umetery, crematory, or other place) p Removal rrom seC to Q Donation other (sp Iry) Jan 23, 20'12 Evans Cremation Service 16d. Location of Dlsposltlon (City or Town, State, and 21p) 17a. Signature of Funar 1 Service Licensee or Person In Charge of Interment 176. License Number Lsola, PA '17640 4- FD-'13845-L aa.no A. aglow 17c. Name and Complete Address of Funeral Faculty 8ullhran Fungal Horne 61 N. Enola Dr. Enola, PA '17026 16. Deceden['s Education - Check the box [hat bez[ describes the 19. Decedent of Hlspanlc OrlEln -Check [he 20. Decedent's Race -Check ONE OR MORE races to indicate what highest degree or level of school completed at the Hme of death. box that best describes whether the decedent the decedent considered hlmseH or hersel/ to be. Q Bth grade or less Is Spanish/Nlspanlc/Latino. Cheek the "NO" Whl[e Q Korean Q No diploma, 9th - 12th grade box If decedent Is not Spanish/Hlspanlc/Latino. Q Black or African Amarlcan Q Vietnamese Q Hlgh school graduate or GED completed No, not spanlsh/Hlspanlc/Latino Q Amarlcan Indian or Alaska Native Q Other Asian p Some college credit, bu< no degree Q Ves, Mexican, Mexican Amarlcan, Chicano Q Asian Indian Q Native Hawaiian {~ Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chlnesa Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, AB, BS) Q Ves, Cuban Q FIIIpIno Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Nlspanlc/La[Ino Q lapanese Q Other Paclflc Islander Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) Q Other (Specify) . MD DDS OVM LLB JO 21. Decedent's Single Rate Se17-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to ba. 22a. Decedent's Usual Otcu potion - Indicate type of work White Q lapanese Q Samoan done during most of working Ilse. DO NOT USE RETIRED. Q Black or African American Q Korean Q Other Pacltlc Islander LlCenfed PraetlGil Nurse Q American Intllsn or Alaska Native Q Vietnamese Q Oon't Know/Not Sure Q Asian Indian Q Other Asian Q Refused 22b. Klntl of Business/Industry Q Chinese Q Native Hawaiian Q Other (Specify) Q FIIIpIno Q Guamanian or Chamorro Healthcare ITEMS 23e - 23 MUST E COMPLETED 23a. Date Pronounced Dead (MO Day rJ 2 Signature o Person Pronouncing Death Only when appllca le 23c. License Num er BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH Januar 20 2012 23d. Data Signed (MO/Day/Yr) 24. Time of Death A rox. 8:00 A.M. 25. Was Medical Examiner or Coroner COntactedT Yes Q No CAUSE OF DEATH Approximate 26. PaK 1. Enter the chain of events--diseases, Injuries, or complications--chat directly Caused the death. DO NOT enter terminal events such as cardiac arrest. Interval: respiratory arrest, or ventricular flbrlllatlon without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a Ilne. Add addltlonal Ilnes If necessary Onset to Death IMMEDIATE CAUSE ~ Chronic Obstructive Pulmonary Disease _ (Final dlseaze or condition Due to (or as a consequence of): resulting In tleath) b. _ Sequentially Ilsi conditions, Due to (or as a consequence of): If any, leading to the cause listed on Ilne •. Enter the UNDERLVINp CAUSE Due to (or as a consequence of): (dlseaze or Injury that F Inltleted the events resulting tl. ~ In death) LAST. Due to (or as a consequence of): 26. Part 11. Enter other I 1 but not resulting In the untlerlying cause given In Part I 27. Was an autopsy p rformad7 Ves No ~ 2g. Were autopsyfln In savallable ~' xo mplate the cauaa of deathT to Q Ves No 29. If Female: 30. Dld Tobacco Use Contribute to DeathT 31. Mannar of Death Q Noi pregnant wlthln past year Q Yes Q Probably Natural ~ Homicide Q Pregnant at time of death Q No Q Unknown Accident Q Pending Inwstlgatlon ~' Q Not pregnant, but pregnant wl[nln 42 tlays of death Q Sulcltle Q Could not be determined Q Not pregnant, but pregnant 43 days to 1 year before tleath 32. Oate of InJury (MO/Day/V r) (Spell Month) Q Unknown If pregnant wlthln the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zlp Code) 36. InJury at Work 37. If Transportation InJury, Specify: 3H. Oescrlba How Injury Occurred: Q Yes Q Driver/Operator Q Pedestrian Q No Q Passenger Q Oth r eclfy) 39a. Certifier (Chock only one): Q Certifying physician - To the b sth occurred due to the cause(s) and manner stated Pronoun t bas my knowletlge death occurred at the time, data, and place, and due to the cause(s) and manner stated Medical Examiner/CO - t o1 mina on, and/o wstlgatlpn, In mV opinion, death occurred at the time, date, and place, antl due to the cause(s) and manner staxetl r Slgnatu re of certifler~ ~ Title of certl/ler: COronOr License Number: 39b. Name, Address and Zlp Code of Person ompleting Cause of Death (Item 26) 6375 B882hOre Road , $ui to ~~ 1 39c. Date Signed (MO/Day/Yr) Todd C. Eclcenrode, Coroner MeckLanicsbur PA 17050 Januar 20, 2012 40. Registrar's District Number 41. Registrar's Slgnat t - 42. Registrar FI a Date Mo Day r - oZ - 3 - d0 t Z 43. Amendments n ~t L.' ~ I~ ~ H105-143 D)Sposlt)on Permit NO. IL I REV 07/2011 c$ - ~ WILL ~' ~~ cn OF >>_o -Tl s-~ (~' :~ ELEANOR K. MYERS - ~7 t-r, I, ELEANOR K. MYERS, of East Pennsboro Township, Cumberland Cast; - - Pennsylvania, declare this to be my last will and revoke any will previously ~l de by Vie. ITEM I. I direct that all my just debts and funeral expenses, including my ~~ gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give, devise, and bequeath all of my possessions and estate of every nature and wherever situate to my daughter, SHARON R. MYERS, provided she survives -„ ;~ ~,;c` ~'` -, c.n my death by sixty (60) days. Should my said daughter predecease me or be deceased on the sixty-first day after my death, I give, devise, and bequeath all of my possessions and estate of every nature and wherever situate to my sister, JOANNE E. ADDOTTA, provided she survives my death by sixty (60) days. Should my said sister predecease me or be deceased on the sixty-first day after my death, I give, devise, and bequeath all of my possessions and estate of every nature and wherever situate to such of the issue, per stirpes, of my sister, JOANNE E. ADDOTTA, who survive my death by sixty (60) days. ITEM III. I appoint my daughter, SHARON R. MYERS, executrix of this my last will. Should my said daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my sister, JOANNE E. ADDOTTA, executrix of this my last will. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. In addition to the other powers and authorities granted to my personal representative by Pennsylvania Law and by the other terms and provisions of this will, I Page 1 of 4 hereby give to my personal representative the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representative may determine and at valuations fina-ly to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representative deems proper, without regard to any principle of risk or diversification; to retain any or ali assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representative deems proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM V1. I direct that my personal representatives and fiduciaries 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 this /a ~' day of 2003. ELEANOR K. MYERS Page 2 of 4 The preceding instrument, consisting of this and two other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by ELEANOR K. MYERS, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. a uel L. Andes a Amy H kins Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA ~ ( SS.. COUNTY OF CUMBERLAND ~ The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by the testatrix named above this I z ~ day of Ma~.cl. , 2003. ELEANOR K. MYERS Notary'Public LYNN EHRENFELD, NOTARY PUBLIC LEMOYNE BORO. CUMBERLAND CO. MY COMMISSION EXPIRES AUG. 17, 20( COMMONWEALTH OF PENNSYLVANIA ~ ( SS.. COUNTY OF CUMBERLAND ~ WE, SAMUEL L. ANDES and AMY HARKINS, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and acknowledged before me this 12~'` day of fvto„~~.1, , 2003. amuel L. Andes l~ Amy rkins __ L ~ --- NOS pRIAL SEAL PJotar Public LYNN ENRENfELD, NOTARY PUBLIC LEMOYNE BORO., CUMBERLAND CO. MY COMMISSION EXPIRES AUG. 17 2004 Page 4 of 4