HomeMy WebLinkAbout03-05-13
PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND 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: Frances S. Myers File No: rI D-
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 177 - 30 - 9039
Date of Death: February 26, 2013 Age at death: 75
Decedent was domiciled at death in Cumberland County, Pennsylvania (state) with his/her last
principal residence at 1810 Pine Rd., Newville, PA 17241, Penn Township, Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 361 Alexander Spring Rd., Carlisle, PA 17015 South Middleton Township Cumberland Pennsylvania
Street address, Post Office and Zip Code City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania All personal property $ 20000
If not domiciled in Pennsylvania Personal property in Pennsylvania $
If not domiciled in Pennsylvania Personal property in County $
Value of real estate in Pennsylvania $ 100,000
TOTAL ESTIMATED VALUE.... $
Real estate in Pennsylvania situated at: 1810 Pine Rd., Newville, PA 17241, Penn Township, Cumberland
(Attach additional sheets, if necessary.) 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 March 27, 1998 and Codicil(s)
thereto dated Charles G Myers died August 11, 2008. A copy of the death certificate is attar e .
State relevant circumstances (e.g. renunciation, death of executor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, 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.
Q NO EXCEPTIONS O EXCEPTIONS
® B. Petition for Grant of Letters of Administration (If applicable)
c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante absentia, durante minoritate
If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete Hsi of heirs.
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds divorce had~n elRed as defined
in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated =sg +
O NO EXCEPTIONS O EXCEPTIONS rn ^ts Cf' r
g-0 Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by thl i spoon (if any) Kid heirs (attach
additional sheets, if necessary): U~y
CC)
Name Relationshi es4 W c=a
t
cn uy c'>
Form R W-02 rev. 10,71.-2011 Page I d2
vuic~ai vac vuiv
uatn of rersonal xepresentatlve
COMMONWEALTH OF PENNSYLVANIA
} SS:
COUNTY OF }
Petitioner(s) Printed Name Petitioner(s) Printed Address
Brian C. Myers 62 Tevis Circle, Apt. 3, Martinsburg, WV 25404
Michele R. Redding 160 Rake Factory Rd., Biglerville, PA 17307
Dixie L. DeJesus 1626 Coon Rd., Aspers, PA 17304
The Petitioner(s) above-named 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~edent, the Petitioner(s) will well and truly administer the estate according to law.
Date I /_3
Sworn to Qr affirmed and subscribed before L
me is I day o Date
B n Date
-
or the Register Date
BOND Required: O YES (j NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters .VV Attorney Signature:
( i ) Short Certificate(s)......
( )Renunciation(s)..... ,
( ) Codicil(s)
( )Affidavit(s)............ Robert G. Frei
Bond.. • • Printed Name:
`S,7 bi 1
Commission SuPreme Court M
O e ID Number: 46397
Firm Name: Frey&Tiley -C> C>
Address: 5 South Han rst._l
r ~ l~ •IJ~ Q~ v .
Carlisle PA 1-70 3;
. . . Phone: 717 - 243 - 5838
Fax: 717 - 243 - 6441
Automation Fee. . Z;:w
JCS Fee. Email: rfrey@freytiley.com
TOTAL $ 2 .
DECREE OF THE REGISTER
Estate of Frances S. Myers File No: s~` I ^ 1 y1 z
a/k/a:
AND NOW,1 in consideration of the foregoing Petition,
satisfactory proof having bee presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Brian C. Myers, Michele R. Redding, and Dixie L. DeJesus
in the above estate and (if applicable) that
the instrument(s) dated March 27, 1998 _
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
Register of Wills
Forn2 RW-02 rev. 10;112011 Page 2 f 2
OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of FRANCES S. MYERS , Deceased
Robert G. Frey
(each) a subscribing witness to
(Print Name/s)
the 2 Will ® Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he / they was / were present and saw the above Testator / Testatrix sign the same
and that she / he / they signed the same and that she / he / they signed as a witness at the request of
the Testator / Testatrix in her / his presence and in the presence of each other.
c>
c~ rYtrs
_ A _4'-')
m
(Signature) (Signature) s""i t`t 7
Za i Cn ~
5 South Hanover St. = C. ~
(Street Address) (Street Address) C7 i -ri
N rTj
Carlisle, PA 17013 - r-
-.tip
.tip
(City, State, Zip) (City, State, Zip) -C
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed Sworn to or affirmed and subscribed
before me this day before me this day
of of ,
Deputy for Register f Als Notary Public
My Commission Expires:
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
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
OATH OF NON-SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of FRANCES S. MYERS , Deceased
Aot--'-~ WM, ~""C j and
(each) being duly qualified according to law, depose(s) and say(s) that she / he / they was / were well-
acquainted with Frances S. Myers and am/are familiar
with the handwriting and signature of the decedent, and that the signature of Frances S. Myers
to the foregoing instrument purporting to be the Last Will and Testament/Codicil of
Frances S. Myers is in his/her own proper handwriting.
(Signature) (Signature)
5 South Hanover Street
(Street Address) (Street Address)
Carlisle, PA 17013
(City, State, Zip) (City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
rn ra r.')
before me this day s' m r E°t~
of.mo-rch V-U C:)
3Y c J t f19 O
Deputy for Register of
Farm RW--04 rev. 10. 13.06
IIIo5.g(L REV (9/1IJ
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
RECORDED ,fFF r
OF
Fee for this certificate. 56.00 ~t ~~F
'I hi, i, to .:elfin that the information here -ieen is
REGISTER O dll FY~ - P1(j/ C(iIICCCI~ copicd flOm an original Certificate OI Death
dL11% fil d with me as Local Registrar. The original
M13W ~C Gr1 ~j~i ce I~Ilelt; Iclil 11c 1,01-A nded to the State Vital
1 I I yi3: Rc-cordw Ottlcc k permanent filing.
CLERK 01
P19434545
F 0 2 7/ 2 013
ORPHANS' COURT
Certification Number." Le)cnl Registrar Date Issued
CUMBERLAND CO., PA
Type/Print In COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS
Permanent
Black7nk CERTIFICATE OF DEATH State File Numbe r.
1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. SF ex - 3. Social Security Number
a n 4. Date of Death (MO/Day/Yr) (Spell M,)
Frces S _ 177-30-9039 Feb_ 26 2013
5a. Age-Last Birthday (Vrs) Sb. Under 1 Year Sc. Under 1 Da 6. Date of Birth (Mo/Day/Year) (Spell Month) ]a. Birthplace (City antl State or Foreign Country)
Months Days Hours Minutes Gardners PA
-75 r s_ Dee _ 2 5, 1937 ]b. Birthplace (c„nty) Adams
9a. Residence (State or Foreign Country) 8bt. Re Jdenc,Jgeet and Number - Include Apt No.) 8c. Did Decedent Live In a Township?
PA 8 3. ne Road ~Yes,decetlentlivedin
8d. Residence (County) Newvi 112 PA Swp
Cumber land Be. Residence (Zip Code) 1 7 2 4 1 0 No, decedent lived within limits of city/boro.
9. Ever in US Armed Forces? 10. Marital Status at Time of Death 0 Married EN Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage)
0 Yes CR No 0 Unknown 0 Divorced El Never Married 0 Unknown 12. Father's Name (First, Middle, Last, Suffix) L14!21 . Mother's Name Prior to First Marriage (First, Middle, Last)
Llo d M_ Brandt ff1
14a. Informant's Name 14b. Relationship to Decedent formantling Address (Street ad Number, City, State, Zip Code) C- My I-_. 37 1159 2 Zevis Circles A t 3 Martinsbur
G 15.. Place o Deat c ec o e
If Deatn Occu reedin a Hospital _ _ _ ~npa _ _ _ _ _ _ _
t;ent I If Death Occurred somewhere Other Than a Hospital d Hospice Facility Decedent's Home
0 Emergency Room/Outpatient 0 Dead on Arrival I 0 Nursing Home/Long-Term Care Facility 0 Other (Specify)
~d 15b. Facility Name (If nIt Institution, give street and number) SSC. City or Town, State, and Zip Cotle 1Sd. County of Death
Carlisle Res Tonal Med Ctr Carli 1 P Cumberland
16a. Method of Dlsposate Burial 0 Cremation 16b. Date of Disposition 16c. Place of Dls position (Name of cemetery, crematory, or other place)
°O 0 Removal from State El Donation
o Other(Specify) 3 2 201 3 Mt _ Ho11 rin s C2meter
16d. Location of Disposition (City or Town, State, and Zip) 17a. Si n of Fun~al Se Ice yltCprge o ers Charg Inierm nt 1]b. License Number ur, Mt_Ho11y Sprincjs,PA 17065 ~4T_! FD-011932-L
o 17c. Name and Complete Address of Funeral Fa ci iity a 1m V2
~3
13 Mt_Holl S rin s PA 17065
O m 18. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin - Check the 20. Decedent's Race - Check ONE OR MORE r -s to Indicate what
F- highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be.
0 8th grade or less Is Spanish/Hispanic/Latino. Check the "NO" a{, White 0 Korean
0 No diploma, 9th - 12th grade b x if decedent is not Spanish/Hispanic/Latino. 0 Black or African America O Vietnamese
Pg High school graduate or GED completed No, not Spanish/Hispanic/Latino 0 American Indian or Alaska Native 0 Other Asian
0 Some college credit, but no degree 0 Yes, Mexican, Mexican American, Chicano ~ Asian Indian 0 Native Hawes I Ian
0 Associate degree (e.g. AA, AS) 0 Yes, Puerto Rican 0 Chinese Guamanian or Chamorro
0 Bachelor's degree (e.g. BA, AB, BS) 0 Yes, Cuban ED Filipino 0 Samoan
0 Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) 0 Yes, other Spanish/Hispanic/Latino 0 Japanese 0 Other Pacific Islander
Cl Doctorate (e.g. PhD, EdD) or Professional degree (Specify) E3 Other (Specify)
. MD DDS DVM, LLB, JD
21. Decedent's Single Race Self-Designation - Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupatio - Indicate type of work
White 0 Japanese D Samoan done during most of working life nDO NOT USE RETIRED.
0 Black or African American O Korean 0 Other Pacific Islander
0 American Indian or Alaska Native 0 Vietnamese 0 Don't Know/Not Sure Hou E3 e w± f 2
0 Asian Indian 0 Other Asian 0 Refused 22b. Kind of Business/Industry
0 Chinese 0 Native Hawaiian 0 Other (Specify)
a 0 Filipino Cl Guamanian or Chamorro Domestic s
ITEMS 23a - 23tl MUST BE COMPLETED 23a. Date Pronounced Dead
PERSON WHO PRONOUNCES (Mo Day/Vr) 23b. Signature of Person Pronouncing Death (Drily when applicable) 23c. License Number
IT OR / n
CERTIFIES DEATH
23d. Date Signed (MO/Day/Yr)
24. Time of Death _ /`~Q074 2 Z L
-9
Z Z ZG I Z S S. Was Medical Examiner or Coroner Contacted? 0 Ves ~~No
CAUSE OF DEATH
I Approximate
26. Part 1. Enter to, chain of events--diseases, injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest, nterval:
respiratory arree st, orventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on aline. Add additional lines if necessary I
. 1 Onset to Death
IMMEDIATE CAUSE a.
(Final disease or condition Doe to (or as c.-quence of):
e= Icing In death)
b.
Sequentially lilt conditions, Due <o (or as a consequence of):
if any, leading g t the ca use rf-~ ~
Ilstetl on line a. . EnterIhe ,-5'-
G
UNDERLYING CAUSE I
c Due to (or as a c,nsequence of):
(disease injury that /I`f / L li ~Z I
F Initiated the events resulting d.
in death) LAST. Due to (or as a consequence of): 1
1
.j 26. Part II. Enter other significant conditions c nt Ib ti t death but not resulting in the underlying cause given in Part t. F7W,,a s ut py perfomed?
MYes gTJo
vailable
mPlete the se of death?
oo Yes .O-No
29.1 f Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death
S Notpregnantwithinpastyear 0 Yes 0 Probably
.Natural 0 Homicide
5 2 0 Pregnant to me of death D No .j!r_ Unknown
[3 Pending Investigation
Q Not pregnant, but pregnant within 42 days of death 0 Accident
0 Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury 0 Suicide 0 Could not be determined
0 Unknown if pregnant within the past year (MO/Day/V r) (Spell Month)
33. Time of Injury
34. Place of Injury (e.g. home; construct),, site; farm; school) 35. Location of Injury (Street and Number, City, County, State, Zip Code)
36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred:
0 Yes D Driver/Operator 0 Pedestr)an
C3 No D Passenger 0 Other ISpecify)
39a. Certifier- physician, certified n e practitioner, medical examiner/co r (Check only one):
E rtl(yi ng only - To the best of my knowledge, death occurred due to the case(s) and manner stated.
Pr,=ncing 8. Certifying - To the best of my knowledge, death occurred at the time, date, and place, and due to the c se(s) and manner stated.
-13 0 Medical Examiner/Coroner - On the basis of exam inati and/or investigation, In my opinion, death occurred at the time, date, and place, and due to the cause(s) andd manner stated.
Signature of certifier: Title of certifier: lT7D License Number: /~/V- -L-
74 3 ZZ
39b. Name, Address and Zip Code of Person Completing Cause of Death (Item 26) 139c. Date Signed (MO/Da Y/Yr)
3~/~LEXav1'n SYAZ/NG ee) ~voz~rSLr ~,~J7ors 2 2~1io~3
40. Registrar's District Number 41. Registrar's Si~gnatu~tre 42. Re istrar File Date (MO/Day Yr)
.°g 43. Amendments
0
nqA `3, -7- Z H7 5
Disposition Permit No. J_ REV 07/-2012
3
LAST WILL AND TESTAMENT
OF
FRANCES S. MYERS
I, FRANCES S. MYERS, of Penn Township (mailing address: 1810 Pine Road,
Newville, Pennsylvania 17241), 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 and making void any and all Wills by me at any
time heretofore made.
1. I direct my hereinafter named Executor or Executors to pay all of my just debts and
funeral expenses as soon after my death as may be found convenient to do so. I direct that my
funeral services be conducted by Gibson-Hollinger Funeral Home in Mount Holly Springs,
Pennsylvania, and that my body be interred on my burial lot located in Cumberland Valley
Memorial Gardens near the Borough of Carlisle, Pennsylvania.
2. All the rest, residue, and remainder of my estate, real, personal, or mixed, and
wheresoever the same may be situate, I give, devise, and bequeath to my husband, Charles G.
Myers, his heirs and assigns, to the exclusion of my children, born or unborn, provided my said
husband, Charles G. Myers, shall survive me by a period of ninety (90) days. Should my said
husband, Charles G. Myers, predecease me or fail to survive me by the aforesaid period of ninety
(90) days, then in such event all the rest, residue and remainder of my estate, real, personal and
mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to
such of my children as shall survive me by a period of ninety (90) days, the share any deceased
child would have received shall pass to such of his or her issue as shall survive me by a period of
ninety (90) days, per stirpes, and if there be no such issue the same shall lapse and be added to the
other share or shares, per stirpes. At the present time I have three (3) children, Brian C. Myers,
Michele R. Redding, and Dixie L. DeJesus.
3. I hereby nominate, constitute, and appoint my husband, Charles G. Myers, as
Executor of this my Last Will and Testament, but should he predecease me or fail to qualify, then
in such event I nominate, constitute, and appoint my three (3) children, Brian C. Myers, Michele
R. Redding, and Dixie L. DeJesus, or any of them, as Co-Executors, and I further direct that none
of them shall be required to post any bond to secure the faithful performance of his or her duties in
the Commonwealth of Pennsylvania or in any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament written on one (1) page this 27th day of March, 1998.
SEAL
Frances S. Myers
Signed, sealed, published and declared, by FRANCES S. MYERS, the Testatrix above
named, as and for her Last Will and Testament, in our presence, who, in her presence, at her
request, and in the presence of each other, have hereunto subscribed our names as attesting
witnesses.
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