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IN THE COURT OF COMMON PLEAS OF CUMBERLAND C UNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
PETITION FOR GRANT OF
ETTERS
Estate of DOROTHY M. MYERS
also known as
No..2...J - 05-- 5 S4
, Deceas d
Social Security No. 172-01-7256
Donna Keammerer
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
Gl
named in the Last Will of the
State relevant circumstances, e.g., ren ciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopt d after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
o
B. Grant of Letters of Administration
(c.I.a., d.b.n.c.l.a.: pendente lite, duran absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Wil and was survived by the following spouse
(if any) and heirs:
Name
Relationship
(.. ,,~.;
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
residence at 720 Mountain Street Enola East Pennsboro Townshi Penns Ivani
(list street, number and municipality)
Decedent, then 88 years of age, died April 13 , .!QQL , at Masonic
(,.; ,
sylvania, with his/her last family or principal
17025
Decedent at death owned property with estimated values as follows:
(if domiciled in PAl All personal property ...................... .................. $
(if not domiciled in PAl Personal property in Pennsylvania. .................. $
(If not domiciled in PAl Personal property in County ........... .................. $
Value of real estate in Pennsylvania ..................................................................... .................. $
Total .................................................................................................. .................. $
e Elizabethtown PA
(Location)
.3SlJ. (J()O. () 0
,
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented ith this Petition and the grant of letters in
the appropriate form to the undersigned:
Type or printed name and residence
, Donna Keammerer
615 Mountain Street Enola PA 17025
RW-7
-
Oath of Personal Represent tive
Commonwealth of Pennsylvania
County of Dauphin
The Petitioner(s) above-named swear(s) and affirm(s) that the state ents in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as p rsonal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
before me this c1o'tU day of
DECREE OF REGISTER
Estate of DOROTHY M. MYERS
also known as
Decease
No.~- 05 -55l/
Date 0 Death: 6/13/2005
AND NOW, 2005 , in consideration of the Petition
on the reverse side hereon, tisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary 0 of Administration
are hereby granted to Donna Keammerer
(c.I.a., d.b.n.c .; pendente lite; durante absentia; durante minoritate)
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters.................... ...... ..........
r
Short Certificate(s) ....~........
Renunciation ..........................
Affidavit (
) .......................
t::xtl.!! VB~S (~............
Codicil .................................
JCP Fee .................................
Inventory & Tax Forms.............
r\ * --
Other ~..~~)~......
$c. ~(OO. CO
$o2D.co
$ 5 at)
$
$ 15.~
$
$ 10, DU
$
$ 5.~
PA 17102
TOTAL .............................$ 4h5, CD
RW-7A
DATE FILED:
Thi;, is to certify that the information here given is correctly copied from an original ce~~ificate of death dulr filed with me as
Local Registrar. The original certificate will be forwarded to toe State Vital Rec rds OffICe for permanent ftlmg.
WARNING: It is illegal to duplicate this copy by phot stat or photograph.
Fee for this certificate. $6.00
P
!
,~ ~'~ r::
".,::"" 'ooJ' \"j
-)I
, L..,
~I?~
Local Registrar
APR 1 5 2005
No.
Date
r
105.143 Rev. 2187
I.
COUNTY OF DEATH
Lancaster
8 8 Vrs.
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VIT
CERTIFICATE OF DEATH
c
C'
NAME OF DECEDENT (Firsl, Middle, Last)
,.
AGE (La.,_y)
STATE FILE NUMBER
DATE OF DEATH (Month. Day, Vear)
4.April 13 2005
lb.
I.
CITY, BORO, TWPOF DEATH
Elizabethtown
Ie.
OECEDENT'S USUAL OCCUPATION
(c:rwor~~~.:Jr=f
S t Penn Dot
. 1~ ecre ary 1~
OECEOENT'S MAILING ADDRESS (Street, CilylTown, State, Zip Code)
720 Mountain st.
Enola, PA 17025
KIND OF BUSINESS "NDUSTRV
RealcMnce 0 ~~f)') 0
RACE. American Indian, Black, Wlite. at
(Specify) Wh i t e
10.
II.
FATHER'S NAME (First, Middle, Last)
II.
INFORMANT'S NAME (TypelPrint)
20..
METHOD OF DISPOSITION
Conation 0 !luriel ~ Cremation [1emoval from Slale 0
~ 21.. 0_ (Specify)
SIGNATURE OF FUNERAL SERVI
. 22..
Complete Items 23a-c Only whe ndying
physician i8 not available at tim of death to
certify cause of death.
DECEDENT'S
ACTUAL
RESIDENCE
(See instructions
on other side)
MARITAL STATUS - Married, SURVIVING SPOUSE
N8V&'~~S=ed, (It wife, glvem./den name)
14. Married II. Roy F. Myers
East Pennsboro
Iwp
Ray W.
Alvord
cilylboro
Mary I. Sheetz
Roy F.
17025
LOCATION - CilylTown, Slate, Zip Code
Silver Spring Twp.
Items 24-26 must be completed by
person who pronounces death.
To the sl cA my knowledge, death occurred at the time. date and place staled
(Signature lI9d\Title) ()
231. ;h IJc;J/l
TIME OF DEATH
PA
!J..OO,S-
24.
27. PART I: Enter Ihe d......, Injuries or oomplationa which caaHd the death. 00 not ........Itt. rnocM of dying, such.. cardile or reapntOf')' .n..t, shod; or h.art f.ilu....
L", ont, on. CMlM on IIKh line.
Other significant conditions contributing to death, bul
not resutting in the underlying cause given in PART L
IMMEDIATE CAUSE (Final
disease or condition
resulting in death) ---+
a.
DUE TO (OR AS A CONSEQUENCE OF):
Sequentia/ty ~5t COfldjtions
if eny, leading to immediate
cause. Enter UNDERL YtNG
CAUSE (Disease or irlury
that initialed events
resutting on death) LAST
WAS AN AUTOPSV WERE AUTOPSV FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
E
TO (OR AS A CONSEQUE E OF);
MANNER OF DEATH
No Oil
Natural
Acddent
Suidde
~
o
o
DATE OF INJURV
(MOMh, Cay, YeM)
TIME OF INJURV
INJURV AT WORK? OESCRIBE HOW INJURV OCCURRED
Ve. 0 No tKI
Ve.O
Homidde
Pending Investigation
Could not be determined
o
o
o
3Oa. 30b.
PLACE OF INJURY - At home, tarm, street. factory.
buiklng,etc. (Specify)
30e.
"MEDICAL EXAMINERlCORONER
~:'::::,b::I::e~X'~ln~'.~n..~n.d'~~ '~~~~.tl~~~~: .'.n .~~ .O~'.~~.n: .~~'.~ .~C.~~d. '.~ t~e. ~',",,'. ~.t~,. ~n~ .PI~.C~,. ~~~ .d~~.t~ .~~ .C'.~~.~.~) .'~~.. 0
31a.
REGISTRAR~GNATURE AND NUMBER
33. ~ ~
~l/l~/vl
30<1.
LOCATION (Street. CilyfTown. Stale)
28a. 28b.
CERTIFIER (Check only one)
.~~~~F:~:Gor~~\I~J~~~~s~:~ ~~~u:: tr:1 &e:~a~=:~~3~^~~a~. h~I:~~.~.~.~~~~ ~~ .~~~~~.~.i.I~~.~~~... ......
2..
"PT':.O~~~:;I~,Gm~~;~:J:;:~:e~t~~~~~ ~:':6:~".~:;r.~~~~,~~~hd~~t~~~u~.~~i~~~ ::~~., as .t.t.d................... . 0
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
RENUNCIATION
Estate of DOROTHY M. MYERS
No.
also known as
, Deceased
The undersigned, Ro F. M ers Husband and Executor
(Relationship)
of
the above Decedent, hereby renounce(s) the right to administer the estate a d respectfully request(s) that
Letters Testamentary be issued to Donna Keamme er
Witness my
hand this
PA 17025
Address)
Signature)
Address)
Signature)
Address)
(".
Sworn to or affirmed and subscribed
before me this :2 () IJ..A day of
~C'~
N6tary Public .
My Commission Expires:
i.....",
c.:'.:
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed tside the Office of Register of Wills are
required in some countie to be notarized.
RW-3
Ii
LAST WILL AND TEST
OF
DOROTHY M. MYERS
I, DOROTHY M. MYERS of East Pennsboro Towpship, cumberlan~fCol.Wty,
I.'.......>
Pennsylvania, declare this to be my Last Wil~ and Testament, h~repy
revoking any will previously made by me.
u,
I - I direct the payment of all my jpst debts and funeral expen-
ses out of my estate as soon as may be pract~cal after my death.
II - I devise and bequeath all of my estate of whatever nature
and wherever situate unto my husband, Roy F. Myers, providing he sur-
vives me by sixty (60) days.
III - Should my said husband fail to be living on the sixty-
first (6Ist) day following my death, then I ~evise and bequeath all of
my estate of whatever nature and wherever si~uate as follows:
A. I bequeath my Remington rif~e to my son-in-law, Ronald
Keammerer.
B. I bequeath any jewelry that I may own to my granddaugh-
ters, Kirby Alicia Keammerer and Emily Lynn ~eammerer.
, 1
;J:It t<-t::./!u/
777 . /Jz,( Lt.1.,~ j
Cl
Page 1
ARNOLD & SLIKE, ATTOR~nS-AT'LAW, 2109 MARKET STRiEET, CA.\IP HILL, PA 1701:
"
I'
C. All the rest, residue and r mainder of my estate shall
be distributed as follows:
1. One-third of said resi ue shall be paid to my son,
Randy L. Myers. Should he predecease me, then his one-third share shall
be paid to my daughter, Donna Keammerer.
2. One-third of said resi ue shall be paid to my
daughter, Donna Keammerer. Should she prede ease me, her one-third
share shall be paid to her daughters, Kirby licia Keammerer and Emily
Lynn Keammerer, subject to the trust provisi ns set forth in the para-
graph immediately following.
3. One-third of said resi ue shall be paid to CCNB
Bank, N.A., IN TRUST, nevertheless, for the enefit of Kirby Alicia
Keammerer and Emily Lynn Keammerer, my daugh er's two natural children.
My trustee shall hold one share as a separate trust for each of my said
grandchildren then living. Out of
derived by the trustee,
trustee shall pay all the necessary costs an expenses of the trust,
including the reasonable compensation of trustee, and the trustee,
at its sole and absolute discretion, may expenditures from the
income or principal of the trust as it may d ern necessary for the sup.
l])Mt-'t t Y. 77? 7)~~~
Page 2
ARNOLD & SLIKE, ,\TTORNEYS.AT-L.\W. 2109 MARKET STREIET. CAMP HILL, FA I i(JII
II
port, maintenance and education of each bene iciary. As each of my
st shall terminate and the
granddaughters attains the age of 22, her
balance shall be paid to her absolutely.
h rights of withdrawal may
be exercised from time to time as the right ccrues. No interest in
income or principal shall be assignable by 0 available to anyone having
a claim against a beneficiary before actual payment to the beneficiary.
IV - My trustee herein named shall h ve the following powers and
duties, in addition to those vested in it by law and other provisions of
this Will:
A. To retain any or all of the assets of this trust, real
or personal, including its own stock, wi thou regard to any principle of
diversification or risk.
B. To invest in all forms of p
common trust funds and mortgage investment f
or others, without restriction to investment
vania fiduciaries, as it deems proper, witho
of diversification or risk.
operty, including stock,
nds whether operated by it
authorized for Pennsyl-
t regard to any principle
c. To sell at public or privat
lease for any period of time, any real or pe
options for sales, exchanges or leases, for
terms or conditions as it deems proper.
sale, to exchange, or to
sonal property and to give
uch prices and upon such
D. To allocate receipts and ex enses to principal or
income or partly to each as it from time to ime thinks proper in its
sole discretion.
E. To make payment to the pare ts or guardians of any
minor or incompetent beneficiary.
F. To hold property in my name or in its name, or in the
name of a nominee or unregistered.
G. To lend to, or purchase fro , my executor even though
trustee may also be such executor.
I
ARNOLD & SLI ", '\nORr\EYS-AT-l.AW. 2109 '1ARKf"T srRE~:T. LA'1P H1LL, PA 17011
Page 3
I'
Ii
v - I have intentionally made no pro ision for my daughter's
adopted son.
VI - I appoint my husband, Roy F. My rs, Executor of this, my
Last will and Testament. Should my said hus and fail to qualify or
cease to act as such, then I appoint my chil~ren Randy L. Myers and
Donna Keammerer, to act in this capacity. S ould both of them fail to
qualify or cease to act as such, then I appo nt CCNB Bank, N.A. to act
in this capacity. None of my personal repre entatives shall be required
to post bond in this or any jurisdiction.
the
IN WITNESS WHEREOF, I have hereunto set m
! -4J- day of -Yl ~
989.
hand and seal on this
1 /)) . 71L<.
M. Myers
(SEAL)
Signed, sealed, published and declared by DO~OTHY M. MYERS, Testatrix
therein named, on this and three (3) other s eets of paper as and for
her Last will and Testament, in our presence, who, in her presence, at
her request, and in the presence of each oth ,have hereunto subscribed
our names as attesting witnesses.
*.. {} ;J~
Name
~ f fly~/
.. Name _
A.
#:;
Address
ARNOLD & SLIKE, ATTORC\JEYS.AT.I.AW. 210'J \lARKET STREdT. CAMP HILL. PA 171111
CO~~10m~EALTH OF PENNSYLVANIA)
SS.
COUNTY
OF
CUMBERLAND)
WE, the undersigned, the testatrix and he witnesses, respectively,
whose names are signed to the foregoing inst ument, being first duly
sworn, do hereby declare to the undersigned uthority that the testatrix
signed and executed the instrument as her Last Will and Testament and
that she signed willingly (or willingly dire ted another to sign for
her), and that she executed it as her free w 11 and voluntary act for
the purposes therein expressed, and that eac of the witnesses, in the
presence and hearing of the testatrix signed the will as witnesses and
that to the best of their knowledge the test trix was at that time
eighteen years of age or older, of sound min , and under no constraint
or undue influence.
and
day
Subscribed, sworn to and acknowledged b
subsc~~ed a~d ~orn to before me by bot
of t/~ , 198~.
fore me by the test~ix,
wi tnesses, this I.....
NOTARIAL SEAL
THEU1A S. McCAIJ.3L1N, Notary Public
eam Hill, PA Cumberland County
..LAy C I11mission Expires July 3, 1992
ARNOLD & SLIKE, ATTORNEYS.AT.LAW. 2109 MARKET STRJ'jET. CAMP HII.I.. PA 17011