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HomeMy WebLinkAbout12-12-28 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA Estate of Bernice P.Meyers File Number CX� - �� ` ���� also known as ,Deceased Social Security Number 2�2-20-3069 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 Executrix named in the last Will of the Decedent dated March 24,2004 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: � � ,;;� `- ---- , t_.�� � .,. , l {'�� —Cs � B.Grant of Letters of Administration - = (]fapplicable,enter.• c.t.a.;d.b.n.c.t.a.;pendente lite;durante absentia;durahTe_rr�t�ritate�, . � _ , . N Petitioner(s)after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse,(if anY)a�nd heies (��f`j Administration, c.t.a. or d.b.n.e.t.a., enter date of Will in SectionA above and complete list of heirs.) ;.�-_,'� � ;_ �_�,�� Name Relationshi Residene�-} " ' � 'f Diane M.Howard a/k/a Diane M.Nilsen Niece 16 Nittany Drive,Mechanic , rg,PA 170 Nancy T.Peterman,Deceased Niece 32 E.Green Street,Mechanicsburg,PA 17055 (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County,Pennsylvania with his/her last principal residence at 505 East Marble Street Mechancisbur PA 17055 (List street address,town/ciry,township,counry,state,zip code) g4 ears of a e died on November 29,2008 at Manor Care,Cumberland County,Carlisle PA Decedent,then y g � Decedent at death owned property with estimated values as follows: $ 4,000.00 (If domiciled in PA) All personal property (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: Si nature T ed or rinted name and residence Diane M.Howard a/k/a Diane M.Nilsen 16 Nittany Drive,Mechanicsburg,PA 17055 � :�i' .,,z,� �I�?. Page 1 of 2 Form RW-02 rev. 10.13.06 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA . : SS COLJNTY 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. —�-- �_,i-,��->.� L,7�, 1/f���-� Sworn to or affirmed and subscribed � Signature ofPersonal Representative t before me the 0 z-� day of —'i ;(�.�j Signature of Personal Representative •—�� '���`— �f. - c�� - i� � � Fcr the Register Signature of Personal Representative �� � � J � _ �N�� � ._,. ._ _ � _;_, , ,- -;. _ r- --- �-� .r-- ::- ;_� _ _; FileNumber: �,l -C>��- I2`-I�{ �< , �; t'•� � �_-, , �: Deceased =' �� � Estate of Bernice P.Meyers � -���- -�� r� - ;�-��; Social Security Number:202-20-3069 Date of Death:November 29,2008 '�'� � , , ;-�-. � AND NOW,��.�<'^�`�-�^-- `2- , 2t�.�3 ,in consideration of the foregoing Petition,satisfactory proof having been presented before me,IT IS DECREED that Letters Testamentary are hereby granted to Diane M.Howard a/k/a Diane M.Nilsen in the above estate and that the instrument(s)dated � �'-� c`} �""'-"' described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Decedent. � ,� �4Q �. ��� ' FEES �/""'""`��" ��� egister o s Letters . . . . . . . . . . . . . . . $ 30.00 � � Short Certificate(s) . . . . . . . . $ 20.00 Attorney Signature: �-- lJ Renunciation(s) . . . . . . . . . . $ Attorney Name: Peter J.Russo,Esquire JCP Fee . $ 5.00 Automation Fee $ 10.00 Supreme Court I.D.No.: 72g9� t a�_Xx • • • $ `�'�-� 5006 E.Trindle Road,Suite 100 Address: . . . $ $ Mechanicsburg,PA 17050 . . . $ . . . $ • • • $ Telephone: 717-591-1755 . . . $ TOTAL . . . . . . . . . . . . . . $ 65.00 Page 2 of 2 Form RW-02 rev. 10.13.06 Illii:`..Sii<!L,,�� ir,�;f�.-� LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to cluplicate this copy by photostat or photograph. E�ce for this certil�icate, $6.00 -;,��' �� �-� T1iis i5 t�> certify iha[ the infou�iatiun here �iven is ,r�"' �,�H OF p'-_ ,,� �P�- fy> co��c ctl�� �opied h otn an ou«in�l Cc rUficate of Ueath /`'��� ���s-` dul t�lEd ��ith mc i�� 1 uc��l R�.��str ir. The vriginal ;,,�� � �l` } �ol� ��� «=itihcate will he for��aided to the State Vital �: �a.: ���, y�,- ��a; Rec�irds Oii�ice f<n� perm��nent fili�g. �: *� ,�*,g. ,. , ; o, . .�.��- ,�,1 ,� � � �a � �. J� J / `F `h � _ _ F�q9 ENTO`�,���~`/ - - �' � 0 �' Certifiication ?�Iumher """" Local Re�*istrur� Uatc lssued rv � � _..., C=.;.- � � .. .�.� _._. . ::, _ � ��J :� � _/ ,.._., i-�'i ..._..,'_,....� `�,--• � 'p I� J .. � r �...� � ...- ___, . . ......:';`I ...� ....�.1 :�_,. : _:_7 ,`,`"t .. ./� ,� � _..7 . .�.--- ��'' � -..i� ���'t � �� -a �;� _ .. -�'Tt , y; r� �..., nios�u�aev n;zoos COMMONWEALTH OF PENNSYLVANIA•DEPARTMENT OF HEALTH•VITAL RECORDS � T1PE.PRWTIN PERMANEN� ' ' s�acKiNH CERTIFICATE OF DEATH • (See instructions and examples on reverse) I.Wnx ol Dec¢tknl(Frsl,n.dYe,Wsl,suBn) STATE fILE NUME3EH 2.$ax 3.Social Security NumDer 4 Dp Ie ol Dna1��Alonlh.aay.Yaar) 5.Age�last&Maay) UnEer t year uw��i a,Y 6.Dale of BiM�Mom�,bay,year� �& e m a 1 2 0 2 -2 0 - 3 0 6 9 �✓ov���.,t r :��i ��;t; � �I��v�a staie«�wei cawnl ea riaw a oeam tcneck«dy are� MwMM DaYx Hwrs Muwks - MoSqW: Otlie!'. 8 4 r�s J u n e 1 5 1 9 2 4 MechdrliCsbur PA ❑i�v�uam ❑ea i a,��m ❑oon N��:��� �qes�ae�e par�r-s�h: ' BC.Canty ot DeaN &.Ciry,Bwo,Twp.ot Deam 8d.FxWry Name p1 rwt instilulirm, give Streel ard nump¢f) 9.Waz DeceGen�d Mispank Origln7 �No �Yes 10.liaca:Nnerren kiyyi.g�,yrry�,ek. Cumberland Carlisle wYa�`P�°yc"�", �sar�n Manor Care �,�.P�a r��,��.� Wh i te 11.DeceAeM's Usual Occ i�Kmo d work moe d,� ,�osi a won�a w�e oo�o�:m��er�ed iz.was o�enam eve��u�e 13.Decetlenl's EOucaGon(Specily oniy pighesl graae competed) 1C.MarGal Status:AlairieC,Naver MarneA, 75.Surviving Spouse(II wife,g�va maiGen rianpJ K��W� Kintl d Buslness/InOustry U.S.ArmeC Frnws? E�m���y�,����,(o-12) Cdlege(1 J a 5�) W'�"�•�^'01�(���'I Floor ❑vas 6�N� 12 Divorced • I6.DBCBtleN's MJilYlg Adhe59($U¢BI.city/IOwn.S�dle,zip Ca0¢) �9d9n1's 505 EdSt Mdrble StZ'eet A0^'�pe�"� »a���e- peI1i15vlVania uein�e�`�� ��c.pres,oeceueau�ean Qmberldnd '"D Mechanicsburg, PA 17055 ��o cowro T�'"'' ,�n�I���a��,�„��}�nicsburg 18.Falher's Nama(Fusl,miJJe,Wst,supix) Ciry;Bpc 19.Ab�har's Name(Fwst.rititlde.nwxfen suman�e) David Unger F?mia Susan Letunan 20a Inlwmanfs Narne�Type/Pnnl) 20b.InlomaN's MaiGrg Atlyess I�reet.c0y/bwn.slate.zy code) Nanc Peterrtian 32 E. Green St. Mechanicsbur PA 17055 zla.M�evuba of rnsposium ❑cremaum ❑oonation z�e.oaie o�o�spos�tion Irno�m.aay.rea�� zic.viace oi[Hsposnion Ir�ame a cemeiery.crema� omer �p Burul �Pemoval Irpn$late aY a P�a) 21E.Laalion(CRy/bwn,sleta.ip wtle) ❑Ol�er� Waa trmialien a Donalion AuMorizeE ��a. , W►kak e. �c«�a�v ❑ve�Or+�; 12/5/08 Mechanicsburg Ce�netery Mechanicsburg, PA 17055 _ P2a.Sgreture a� pe 1 22G.Lknnse Nu�Mer 22c.Name antl AOMess ol FactlNy ` � � - F'D 013239 L �ill Funeral Hane, Inc /� f•arpleie tlems 2 c Wy when - 23a.To Ihe besi of mY kr w1eGg¢.CeaM oc�urrea el me time.dale anG place s�aad.(SgnaWre ard Nq) � 29c.Date Siqrwd(MonN.Eay.year) p�Ysican is� mlade at time d GeaN l0 23b.Llr,s,n/sa Nwber � �y�� a�am ._�6t11..�<.1� � .�21 r e lr_ee�.L�� �� R/� � L /L u��„n,��iz� ;�y ��o�� ��ema za.zs mus�Ee cwn e,ea o 2a.r o�oeam zs.was casa rie�e�rea�o MBbcal Examiner�c«oner ror a aeaso�ar�e�mar�cremauon or oww�ion? pl y person 25.Oa�e PrmqpMetl p¢a0�MonN,tlay,year) wrw w«wunces deaN t. I 1 '.�l:� M ./�GI,�n�VI��.Q.l ��y '�00`� ❑v� ❑ow . CAUSE OF DEATH(See Instructions antl ezamplee) � Approi mate incerval: Pan I��.Enter otl� 2B.Od 7o0acco Usa Corr��rrR.qe I�p¢aN? It¢m 27.P2iI I.Enler Ne j{yyp�jeytlplS-rys2as'es,nrynes,a cpnylira�im5-Na�drxlty caused Rg p¢alh.DO NOT mler larnunal eve�ils such as cartiac anesl, Co �e�p�ai«y erre:i,«��v�r nemww�wnnan snowe�y me erobqy�si oNy o�e�a��e o�nam roe. o�«i a oeam wi oa�e.wn:w��o me�.,mM.y w�se qV�n Pan�i ❑ra: �v�maay �� i�g�Ta�a�usN��N a�ease w ��[ A ❑rw []un�m .. ` -� a O.-E.�S 11G`�Q f 2�Q���-O�V-Sc-.��C,r' �;�cc�G�v-�" � zs.n F��. oua ro�or as a cnnsequeMe op: � � 4 SeWe�inliy�St conO�W�s.a any. p. ❑Na vregneni wmm�pxsi reai kah�q b tli2 cause i5I9A pri 1�9 a. ❑PregrNnl a14me o14aU1 ' Entei 9�e UNDEflLYING C�USE Due ro(or es a conseyirence ol�. � ❑nw piegium,oa � IQsea5a w Injury tlul ilnilidlB0lAy I P��IwM wNWi Cllbya 4 arens rewllrg n CeaN)IAST. b�a� c. Ow lo(a as a consequence op. � ' tl ❑NW p'e9nanl.bN qeynan143 days W 1 yeu � Celue OeaN ❑Unkrwwn A prep�t wMm n�p;�st yea� 3Da.Waz an Aulopsy 30p.Were AWopsy F�ngs 31.Mannei ul DeaN 32a.Dale ol Iryury(Month.Cay.Year) 326.p¢uriDe How Injury Occuned yc.Place d I PeAormeO? Availade Pnor 10 Ccrrpleucxi � ryury:Home Furm.SY�ael.Fxbry, �� o�CauSB o1 DeaN7 ❑NaWr,ll ❑Haiucile �Ke B�dQuiy,k(Spenly) " �Yes �Na �Yes [�No ❑A.ciaenl []Penan�g InresegaAwi �0.T�e ol Irywy 32e.Injury at Work? 321.I�Tra�i�nelbn Iryu7 I��NI 32g.locatiai W Inlury�9�ee1,ci1Y/bwn.Stele) S ❑SuwiJe []Cp�ltl Nol pe fklarmined M ❑Yes ❑No ❑���vdi I OpBin�m Q Passeiger QPeaesbian ]011xr�Spn'ily. Q 33a.C¢N�i¢r�MCCk aMy MB) 3�p.Syy�aluie a e eNtier �� • CMi�ying pllysieian(Pliys[ian ceNfyiig csuse ol tlealh rvhen anclher phy�ic�ian hes p�uni.vric�v)JeaN an��cmpkletl Ilem 23� � � � TO IM 6e5�01 my k�wwledpe.tl8a1�acarred Cue lo Ne fause�s)end nwnn¢!n slale�__"__'_"_"""""""'_"'__� � W g ry 9 pAysician�Physician 0.�m prorour�cing aealn aM..eniryug b cnu�e ol aealh) 33c.License 33tl.Date Sg d(Monm,day ear) rwwuncin anE ceN in • To Ihe bes�ol my Mnowkdge,Aeath occurreE al tM lime,Aale,antl place,an0 Aue to Ne cause�s)anE mannn as slale0__________________❑ n • Neacal exzminer�cwoner �O(O �-l S�- L � 1 1 �30(O� oOn 111e basie M eaamin lion end/oe hvesligation,in my opmion,0eath ocwireC al lhe time,aate,antl platt,enG Gue to Ne cau98(e)an0 manner a9 slaleG_❑ YI.Nazne and AGtlress ol Persm Who Completetl Cause ol DeaN�ilem 27)Type�Prinl C, �1 . 0 95R � � aWre t umhxr � �lQ�►l�U� S� Date FdeO(MonN,day,eai _ ► t�� � �� � � �� ��e�.,��er� a� Dr_ D O. Ca r l isle; R . Dis{wsni�n Pennit No. ��� 1�� � � i t 'f � � � �' � I LAST WILL A1�rD TESTAMENT OF BERNICE P. MEYERS I, BERNICE P. MEYERS, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all former Wills by me at any time heretofore made. 1. � I direct the payment of all my just debts and funeral expenses as soon aft�i�y � -,-, -�, �-, - � �.:� ,�: .% � .�f; decease as the same can be conveniently done. ` ;; -- ; :.,�;� rv ,-�,, _ , � �_ 2. _ ;; -�� r_; �;�.; =, � �----� , .^,;�-� I give, devise and bequeath all the rest, residue and remainder of my estate, real, ,."'�, personal and mixed, whatsoever and wheresoever the same may be situate, to my two (2) nieces, to wit, NANCY P. PETERMAN and DIANE M. NILSEN, share and share alike. 3. LASTLY, I nominate, constitute and appoint my two (2) nieces, the aforesaid NANCY P. PETERMAN and DIANE M. NILSEN, Co-Executrices of this my Last Will and Testament and direct that they be excused from posting bond or other security for the - 1 - .�. � . . � � ` .. �. .. . faithful performance of their duties, in any jurisdiction. IN WITNESS W��REOF, I have hereunto set my hand and seal this � � day of March, A.D., 2004. ../�a�-�-�.- �' �"l�;Z�,�� �SEAL) � � Bernice P. Meyers' - 2 - , F ?, � � v P' i , COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF CUIVIBERLAND ) I, BERNICE P. MEYERS, the testatri�, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the same instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act and deed, for the purposes therein expressed. �A;�,���c �.:� �� ����� u� (sEAi,) Bernice P. Meyers Sworn and subscribed to before me this �'y�h day of March, 2��4. �pMMONW�ALTH OF PENNSLVANIA Notarial Seal Heidi M.Nelson,NotaN P�►�ic 1 ' `-t'�� . ����.��� �anicstwr9 Bor°,Cumberland County Notary Public My Commission Exp�res June 27.zoo� �v2n'sa Ass+�ation C�No�zries n�r�ber,Penns A COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF CUMBERLAND ) We, the undersigned, J. ROBERT STAUFFER and JOHN M. EAKIN, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix, BERNICE F. MEYERS, sign and execute the instrument as her Last Will and Testament; that the said testatrix 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 the time, eighteen (18) or more years of age, of sound mind, a�nder no constraint, duress or undue influence. , t � ` �, ``j f L%'r ,� y�,� ��'l ' ' -1✓�rl.•� Sworn and subscribed to before me this �`�� day of March, 2004. COMMONWEALTH OF PE�ViVSI.VANIA Noharial Seal ((�-( ``�'n, � ,l C Heidi M.Nelson,Nohary Public 1 J(� Med�anicsburg Boro,Cumbedand County Notary Public MY C.anrnissan E�ires June 27,zoo� Member,Permsylvania Assaiation Of Notaries - 3 -