HomeMy WebLinkAbout11-02-05
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Helen Moyer
also known as
, Deceased
No. 21-05- '\ '\ \
Social Security No. X 1:70 -' J. t - ? /~
William M. Long
Petitioner{s), who is/are 18 years of age or older, appl{ies) for:
(COMPLETE 'A' or 'B' BELOW)
00 A. Probate and Grant of Letters Testamentary and aver that Petitioner{s) is/are the
the Decedent, dated 07/11/2003 and codicils dated
Executor
named in the last Will of
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 documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
none
o B. Grant of Letters of Administration
(c.t.a; d.b.n.c.t.a; pedente lite; durante absentia; durante minoritate)
Petitioner{s) after a proper search haslhave ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs:
Name
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with hislher family
or principal residence at 4905 E. Trindle Road, Apt. 98 '
(list street, number, and municipality)
iJ) / '\,,/ " I / (' 1;/ / _~."J{j C, l /",-f-
Decedent, then ~ years of age, died 10/202005 at '^' ,Ai~. ~/ '~y/I~/ 'TJ<,JJIJ1,-);,' i UJfp/I//[.!i/'/d/l.'''-]J
Decedent at death owned property with estimated values as follows: I (Location) Cii41 ~k?.1{.,.,z vO.
(If domiciled in PAl All personal property $ 20,000.00
(If not domiciled in PAl Personal property in Pennsylvania $
(If not domiciled in PAl Personal property in County $
Value of real estate iil'Pe1msylvania $
situated as follows: none
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:
William M. Long
Typed or printed name and residence
. ~ 875 Hawthorn Ave.
Mechanicsburg, PA 17055
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Prepared by the Pennsylvania Bar Association
Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
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 ding to law.
Sworn to or affirmed and subscribed
~
Go. -:~~
before me this ~
day of
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No.
21-05- ~ "\ \
Estate of
Helen Moyer
, Deceased
also known as
\;' . {'j
Social Security No: II, (l - ~ y - G / (q E', Date of Death:
10/20/2005
AND NOW,
~~"\"2.'" ~~ ,<-
-:::,
d....'\::\~s ,in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary D of Administration
(c.I.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate)
are hereby granted to William M. Lona, Executor
in the above estate and that the instrument(s) dated
7/11/2003
described in the Petition be admitted to probate and filled of record as the last Will of Decedent.
Short Certificate(S)\.~~\............ $
12.00
~ ~~ ~~~~\~
~ V _~ Register of 'wms - .,-
-,.,~.. . -..~"\ ~~'~..'
<~,.l... .~ "/T~
Attorney: Robert C. Said is, E~C;:;/ ~
/
~
FEES
Letters....... ...................... ............. $
60.00
Renunciation............................... $
Extra Pages ( )......................$
I.D. No: 21458
Said is, Shuff, Flower & Lindsay
Address: 2109 Market Street
Affidavits ( )...........................$
Codicil.................... ...................... $
JCP Fee...~...~~~...s~~....$
15.00
Camp Hill, PA 17011
Telephone9 (717) 737-3405
Inventory...................................... $
E-Mail:
-,
/
~,....~\~..........................$
15.00
TOTAL............................ $
102.00
Prepared by the Pennsylvania Bar Association Copyright (c) 2004 form software only The Lackner Group, Inc.
Form RW-1(1991)
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Thi '. is to certify that the information here given is correctly copied from an original certificate () death du I) fi led with me as
LOtti Registrar. The original certificate will he forwarded to the State Vital Records Office for PI;) nall,;nt filtl~~.
WARNING: It is illegal to duplicate this copy by photostat or photog'aph.
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No.
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Local Registrar
Fee for this certificate. S6.00
f.../
OCT 2 5 2005
---,-.:'
Date
r~
Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
NAME OF DECEDENT (First. Middle. Last)
1.
AGE (Last Birthday)
Helen Moyer
SEX
2. Female
SOCIAL SECURITY NUMBER
3. 190 - 28 8165
DAT):: OF DEATH(Month. Day. Vear)._
4. ()l+obn-}D).OD~,
5.
COUNTY OF DEATH
69 Vrs.
BIRTHPLACE (City and
Slale or Foreign Country)
Johnstown, PA
Residence D ~;:~ify) 0
RACE - American Indian, Black, White, et .
(Specify)
White
10.
Sb. Cumberland
DECEDENTS USUAL OCCUPATION
MARITAL STATUS. Married.
Never Married, Widowed,
Divorced (Specify)
14.Never Married
SURVIVING SPOUSE
(If wife, give maiden name)
17c, IKl Yes, decedent lived in
Hampden
twp.
17d, D ~~hi~e:~~7~i~i~~ of
cityfboro.
M. Betts
PA 17055
27. PART I: Enter the din...., Injuries or complications which caused the death.
List only one cau.e on each Une.
23b. 23c.
WAS CASE REFERRED TO A MEDICAL EXAMINER ICORONER?
26. Ves 'ffi-'\\9 No D
: Approximate PART II: Other significant conditions contributing to death, but
: ~~:~a~~::~~~ nol resulting in the undertying cause given in PART I.
.,
Items 24-26 musl be completed by
person who pronounces death.
IMMEDIATE CAUSE (Final
disease or condition
resulting In death)---"
Sequentially list conditions [. b.
if any, leading 10 immediate
cause. Enter UNDERLYING
CAUSE (Disease or injury c.
that initiated events
resulting on death) LAST d.
WAS AN AUTOPSV WERE AUTOPSV FINDINGS
PERFORMED? AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
DATE OF INJURV
(Month. Day, Year)
TIME OF INJURV
INJURY AT WORK? DESCRIBE HOW INJURV OCCURRED.
dent
D
D
Pending Investigation
Could not be determined
D
D
D
30a. 30b. M.
PLACE OF INJURY - At home, farm, street, factory, office
building, etc. (Specify)
30e.
'MEDICAL EXAMINERlCORONER
~:~~:rb::I:::e~~~.~.I.~~t.I.~~. ~~,~~~~ ~~~~~~~~.~~~~~: .I~ .~~. ~~I.~~~.~: .~~~~~ .~~~~~~.~. ~.t. ~~.~. ~I.~~.'. ~.~~'. ~.~~ .~~~.~~.'. ~~~ .~.~~. ~~ .~~~ .~~.~~.~~.(.~~ .~~~., 0
31a.
REGISTRAR'S SIGNA2Z. U. AND NUMBe~~. ~ '
.1;;.'"." /~i) /o.".'L6.,.~.
33. ;,.-.." ./' / ' :r.f
~ 1[.:;0\1 /[ /1
Ves D No D
30e.
Yes 0 No
Ves D
No
2S.. 2Sb.
CERTIFIER (Check only one)
"l~~~:F~~tGor~~~~~~e~~s~~:rh ~~i~%J':JU~: t~ fhe:~a~~:~(:r~~3r~~x~~~a~s h:t~~~~~~~~~.~ .~~~~. ~~~ .~?~~~~~:.~ .i~~~ .:~.~.................
29.
"PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death)
To the best of my knowledge, death occurred at the time, date. and place, and due to the causes{s) and manner as stated......................
34.
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REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
OATH OF NON-SUBSCRIBING WITNESS
Estate of: HELEN MOYER
No. 21-05-
Also known as
, deceased.
Annabel Callaway and William M. Long
Subscribers hereto, being duly qualified according to law,
depose(s) and say(s) that
they
are familiar with the
signature of Helen Moyer
, testatrix of the Will presented
herewith and that
they
believe the signature on the Will is
in the handwriting of Helen Moyer
to the best of
their
knowledge and belief.
Sworn to or affirmed and subscribed
Before me this ~~) day of
~f',~~"'s.)::.~ Q.... , 2005.
x!f:d~J:l:~/
1010 S. Market St.
Mechanicsburg, PA 17055
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Register
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Last Will and Testament
I, HELEN MOYER, of 11 A Hemlock Drive, Mechanicsburg, Cumberland County,
Pennsylvania 17055 do hereby make publish and declare this to be my last will and
testament, hereby revoking all wills heretofore made by me.
1. I direct my personal representative to pay all of my debts, funeral and
administrative expenses as soon as convenient after my decease. I direct that
all inheritance taxes imposed or payable by reason of my death and interest
and penalties thereon with respect to all property, whether or not such
property passes under this Will, shall be paid by my personal representative
out of my estate.
2. I authorize and empower my personal representative to sell any realty and/or
personalty owned by me at my death and not specifically devised or
bequeathed herein, at public or private sale or sales and to give good and
sufficient deeds and/or bills of sale therefore, in fee simple, as I could if
living. My representative is authorized and empowered to engage in any
business in which I may be engaged at my death, for such period of time after
my death as seems expedient to said representative.
3. I give, devise and bequeath all of my estate of whatever nature and wherever
situate as follows:
A. 10% to Mechanicsburg Church of the Brethren, Gale Street,
Mechanicsburg, Pennsylvania, for general purposes;
B. 5% to Robinson Church of the Brethren, Robinson, Pennsylvania, for
general purposes;
C. To Lori Callaway, my Royal Dalton "Bride and "Affection" figurines;
" D. To Barbara Kotches, my Hummel "Spring Dance" figurine;
E. To Patricia McConnell, four items of her choosing of my remaining
Hummel and Royal Dalton collections;
~ F. To Donna Long, everything in the china closet; and all the
G. Rest, residue and remainder to Robert A. Moyer, Ronald N. Moyer,
William M. Long, Barbara Kotches, Randy W. Moyer, Lori Callaway And
Joseph Callaway, share and share alike.
H. If any of my beneficiaries have predeceased me, then their share I give,
devise and bequeath to their children, share and share alike, or if such
deceased beneficiary has no surviving children, then the gift to such
beneficiary shall lapse and become a part of my residuary estate.
.:J.. I nominate and appoint William M. Long to be the personal representative of
my estate, to serve without bond. Ifhe cannot or does not serve. then I appoint
Randy Moyer to be the substitute representative, also without bond.
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IN ~TN15 WHEREo,F, I have hereunto set my hand and seal this lL th day of
LG ,200.).
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'7,)1..-1 ~L
HELEN MOYER
ACKNOWLEDGEMENT
I, HELEN MOYER, the testatrix, whose name is signed to the foregoing instrument, do
hereby declare to the undersigned authority that I signed and executed the instrument as
my last will and I signed willingly, and that I executed it as my free and voluntary act for
the purpose herein expressed.
~
~JJ...J
~MOYER
Commonwealth of Pennsylvania
:ss:
County of Cumberland
Subscribed, il"om to and acknOWn~.1"fore me by HELEN MOYER the testatrix
herein this J..\-.-...-. th day of \'. , 2003.
NOTARIAL SEAL
PAMELA F. HOFFMAN, N01ARY PUBLIC
MONROE TWP., CUMBERLAND COUNTY
MY COMMISSION EXPIRES JUNE 7, 2004