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HomeMy WebLinkAbout08-01-06 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION PETITION FOR GRANT OF LETTERS Estate of ROY F. MYERS also known as No. <--2/- Olf; - Lv'? S- , Deceased Social Security No. 204-01-3365 Donna Keammerer Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) GJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut ~_ named in the Last Will of the Decedent, dated 3/13/2006 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 documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.t.a., db.n.ct.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence 1 .~ -,..- (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or princi~1 residence at 720 Mountain Street, Enola, East Pennsboro Township, Cumberland County, PA 17025 '. , (list street, number and municipality) r.:; Decedent, then 87 years of age, died July 23 ,2006 ,at MS Hershey Medical Ctr., Hershey, PA 17033 (Location) 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 ........................................................................................ $ To~1 ........ ............................................................................................... $ 300,000.00 100,000.00 400,000.00 Real Estate situated as follows: 720 Mountain Street, Enola, PA 17025 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 x Donna Keammerer 307 Autumn Chase Drive Harrisbur PA 17110 RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitioner(s) above-named swear(s) and 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 esta:~ aCr'iing ~~ ':w. ~/I. 4~' __..-1., ." 1 'I Sworn to and affirmed and subscribed cfr~- K..---rV /) .~'.'It./v/,...> T -" F ,/ /u \ 'Sl D nna Keammerer before me this I day of ~~-t tOe)D\n ~~~~~~ DECREE OF REGISTER Estate of ROY F. MYERS also known as Deceased No. 1J -(,'V -lft7~ Social Security No: 204-01-3365 Date of Death: 7/23/2006 AND NOW, Cl~,~ ~ , 2006 , in consideration o!the Petition on the reverse side hereon, satisfac ry proof having been presented before me, IT IS DECREED that Letters IE) Testamentary 0 of Administration are hereby granted to Donna Keammerer (c,t.a., d.b.n,c.t.; pendente lite; durante absentia; durante minoritate) in the above estate and that the instrument(s), if any, dated March 13, 2006 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters...............,...........,....... . Short Certificate(s) ............... Renunciation......................... . Affidavit ( ) ....................... ~~ ( )W.;.L~. Codicil ................................. JCP Fee ................................. Inventory & Tax Forms............. Other .~~;~~........ $ .~.O() $ 40. CJ0 $ $ $-' 5.()D $ $ ID,OO $ $ 50u J;:\1-~~'~+\~b~, ~....;. ~Gfr Register of Wills ! '~) rrn b/ xl ~Ur\ tv Attorney Attorney: Jill M. Wineka, Esquire 1.0. No: 58802 Address: 1719 North Front Street Harrisbur~, Telephone: (717) 234-4178 DATE FILED: r 1,10 {, PA 17102 TOTAL .............................$ 42:0 .<Y:) RW-7A ~; 1 1" ~i ,:":',-~\ ::\\1\_ , , ..,,- ~ ',.. '-- j ~ 1! ]-h,' l;\ ()ifii. WAF ,'J1i""G. It is Illegal to duplicate tn! s coPy photostat or R 'I. a J,. . ../;.' / .~, /,:", '" "/."/ ,~.' ~:fi.;i!.,L~'., .' 1-"~'''' .;;- 1./ '. "",:~. " ..\ \~~\.'~ JUL 242006 p 12625990 HEM # i l " SHOULD READ AS FOLLOW~): 5T G' ~L. E P. C-c Tic /J ~ '-';'1<') c. vi ,'. N' .... I, '1 ,'iIL',' .,-,,-,--. '/ /e.' ~~. "I" <. (; -) Rev.G1I06 IRINT IN ANENT :1<; JNK 1 Name of Deceder1! (First middle, last) 21- 01o - LPl.$ COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH .; STATe FiLE NUMBER 3 Social Security Number 4 Gale of f)e<lth (Month,rJay, year) Roy F. Myers 204 - 01 -3365 7/23/06 v" 7, DateolBinh Month, da , 8 Binh lace C 5. Age (Lasl birthday) 87 5/18/19 Harrisburg, 8a. Place of Dealh Checkonl olle Hosprtal o In alie~J 0 ER/Oul alient 9 Other o DOA 0 Nursin Home Was Decedef1t of HispanIC Otigin? cKNo 0 Yes (II yes, specify Cuba(1, Mexican. Puerto Rican. elc) o ReSidence 0 Other-S CI 10 Race: American Indian, Black. White. etc (Specify) white 8b, County 01 Oeafh M.S. Hershey Medical Center 720 Mountain St. Enola, Pa 17025 13. Decedent's Educalion S eci on Elementary/Secondary (0-12J U k '" slale---Rennsylvania I7b Couo~~uml:Jerland _.__ hihesl radeco leted College/1-4orS..) 14 Mar~al S\alus Wide,wed,Oivorced Wj_dower 15 Surviving Spouse (11 wife, give maiden name) ~:e~:~edenl 17c. ex Yes,DecedenILivedin_ ___J;;.l?-st PennsQoro Two Township~ iTer Ci No, Decedenl lived wilhin Actual Limits ot City!80ro Charles H. Myers t9 Mother's Name (First, middle, maiden surname) Margaret B. Stambaugh 21a MethodotDisposrtion ~Buriai 0 Cremalion o OIher.Specify I ature of Funeral Service licensee (or person acling as such) . A~ 23a To the best or my knowledge, dealh occurred at the lime, dale and place staled. (Signature and title) 21b, Date of Disposilion (Month. day, year) 20b Inrormant's Mailing Address (Slleel, city"own, stale, Zip code) 307 Autum Chase Dr Hb Pa 1711 21c Place of Disposition (Name ofcemelery, crematory or olher place) 21ci, Locatiof1 (City"'own, stale, zip Code) Donna Keammerer o Removal from Slale o Donation 7/26/06 Stone Church F.D.011897-L 51 Cemetery Sullivan Funeral En 1 Dr., Enol 23b, lb~nseNul1lber Twp,Pa 22b. license Number 22c. Name and Address 01 Facility lIems 24-26 must be compleled by person . who pronouncesdealh 24 Tlmeo(Qeath 25, Date Pronounced Dead (Month, day, year) 26 Wo,s Case Referred 10 a Medical ExaminerlCorone() 5: 381*1 7/23/06 CAUSE OF DEATH (SeE! instrrn:tions and examples) Item 27 Part I: Enter the chain of events ~ diseases, inrurres, orcomplica1ions ~ thai directly caused the dealh, DO NOT enter INminaJ evenls such as cardiac arrest, respiratory arrest, or venlricular fibrillahon without Showing Ihe eliology, DO NOT abbreviate. Enter only one cause on a line IMMEDIATE CAUSE (Finat disease or condition resulting in death) --? a : Approximate interval' : onsel to death DYes ,. No Part It: Enlerothel sianiflcanl condrtions contributina to death. but 001 resulting in the underlying cause given in Part I 28 Old Tobacco Use Contribule (0 Dealh? DYes 0 1j( No 0 Sequenliallylistcondilions.ifany, leading to Ihe cause lisled on line a . Enter lhe UNDERL YfNG CAUSE 30a, Was an Autopsy Performed? d 30b WereAulopsyFindings Available Prior to Completion of Cause ot Death? o Yes 0 No 31 Manner of Dealh " Nalural o Accident o SUicide 32a, Date of tnjury {Monlh,day, year) 32b. Describe how Injury Occurred 29 It Female o Not pregnanl wrthm past year o Pregnant at lime of death o NOlpregnaf1l,butpregnantwithin42days ofdealh o NOlpregnanl, butpregnanl 43 days to 1 yeal beforedealh o Unknownitpregnantwllhinlhepaslyear 32c Fac10ry.Oflice Dueto (or asa consequence 00 o Yes If No o Homicide o Pending Investigation o Could Nol Be Determined 32d, Timeollnlury 321 32g, Localion (Slreet,citY,10wn, slate) M 33a. Certifier (check only one) Certifying physician (Physician cer1I~lng cause of death when another phYSICian has pronounced dealh and completed Ilem 23) To the best of my knowledge, death occurred due 10 the cause{s) and manner as sl.Hed ...... . .. .......... ..':'fl Pronouncing and certifying physician (Physicia~ both pronouncing dealh and certifying 10 cause or death) To the best of my knowledge, death occurred at the time, date, and place, and due to thecause(s) and manner as slated... .0 Medical examiner/coroner On the basis of examination and/or invesligatiof1, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner as stated. ......0 35 Regislr nalure and o~~m~___ L 2.??- / <' /~Z/.f.';;;~-P.-<./'iJ7.4?_ -~~ (J 1.21/10\1/ I / I :JG 33d Dale S'goed IMoolh day. yea c) ---1 ~~:,,~~~c Z}::kled Ca""IDeal; 11l:!~}Yr"CI2 L{/ :l. OOb _~ M.S. Hershey Medical Ctr. I Hershey, PA 17033 I (See instructions and examples on reverse) LAST WILL AND TESTAMENT OF ROY F. MYERS I, ROY F. MYERS, of East Pennsboro Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, and revoke any and all Wills and Codicils previously made by me. ITEM I: I direct that all my just debts and funerali expenses, including my grave marker and all expenses of my last illness, 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: All federal, state and other death taxes payable because of my death with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid out of the residue of my estate, without apportionment or right of reimbursement. ITEM III: I give, devise and bequeath to my son-in-law, RONALD KEAMMERER of Harrisburg, Pennsylvania, all of my firearms. ITEM IV: I give, devise and bequeath to my granddaughter, EMILY KEAMMERER of Harrisburg, Pennsylvania all of my fishing equipment. ITEM V: I give, devise and bequeath to my granddaughter, KIRBY KEAMMERER of Harrisburg, Pennsylvania all of my sewing and knitting supplies, tools and equipment. ITEM VI: I give, devise and bequeath all the rest, residue and remainder of my Estate of every nature and wheresoever situate to my daughter, DONNA KEAMMERER of Harrisburg, Pennsylvania, provided she survives me by thirty days. In the event my daughter, DONNA KEAMMERER, fails to survive me by thirty days, then I give, devise and bequeath all the rest, residue and remainder of my Estate of every nature and wheresoever situate to be divided equally between my granddaughters, EMILY KEAMMERER and KIRBY KEAMMERER or their issue, ~ stirpes. ITEM VII: I appoint my daughter, DONNA KEAMMERER as Executrix of this my Last Will and Testament. In the event my daughter, DONNA KEAMMERER should fail to qualify or cease to act as Executrix, I then appoint my attorney, JILL M. WINEKA of Harrisburg, Pennsylvania to serve as Executrix of this my Last Will and Testament. ITEM VIII: I direct that no Executrix be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this / '2 >..fl .J day of /f);qIUH ,2006. ~~ 'f Pl~ ROY F. MY S (SEAL) The preceding instrument, consisting of this and one other typewritten page, was, on the date thereof signed, published and declared by Roy F. Myers, the Testator therein named, as and for his Last Will, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. j/(/)(A m &l/f~1'\ residing at ~. P //0 f{;2.. J residing at ;/0 'f / I S/)(j rJ ,;19 / 7// J 2 COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF DAUPHIN WE, Roy F. Myers, JtI./,i!t (!, ~'e.s~ and~77{J (\' ,In l5f ((I '$fe,() the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will, and that he had signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of their knowledge, the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 0\. ~ 't- /fY! k'UM-J ROY F. MY S (7 g~r:~ ness /fAJ(,' /71/!;Mu/},,-v- Witness Subscribed, sworn to and aCknowledge? before me bY, ROY,h MYERS, the Testator, subscribed and sworn to before me by J J, fit c. II e..!>) e.te..... ~ #' 170 (, (Y' 13ft (15 lfl , witnesses, this !3'f.11 day of (Y) JCJe~1-i 2006. and and /t i -- /~ ' A.)Ajv6-1t./u,-- C: I Notary Public / xftLl~j- I "\)T/\H1AL SE'\". (wills\myers\will)