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Home My WebLink About08-21-06 .. .' ~ o v Register of Wills of Cumberland County Estate of' '1~f also known as PETITION FOR GRANT OF LETTERS OF ADMINISTRATION e l YVlc}lll1~-t1 No. To: ."J lllr . I! C. c Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania , Deceased. Social 5,'ecurity No. I -s q - '3 '~ .- 5' 7 ') 7 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl_ for letters of administration on the estate of (d,b.n,; pendente lite; durante absentia; durante minoritate) the above decedent. Decedent was domiciled at death in (u.Yl~\1i\11l\ County, Pennsylvania, with hiL.last family or principal residence at i ('; c., C ( f-l1l~1 S;\.-, YYk:.c h IH1 ,(. .\ b i.. .2 J P A . (list street, number and municipality) Decedent, then r; '3 years of age, died () G -Df..o ,200(.,. , at Decedent at death owned property with estimated values as follows: (lfdomiciled in Pa,) All personal property (Ifnot domiciled in Pa.) Personal property in Pennsylvania (lfnot domiciled in Pa,) Personal property in County Value ofreal estate in Pennsylvania situated as follows: $ 1,1,/ I-J :J $ ).' r- $ , $ ^} .1 THEREFORE, petitioner(s) respectfully request(s) the grant ofletters of administration in the appropriate foml to the undersigned. ~' -.., '-.,.... '.~o""" ~ ' Residence( s) of Petitioner( s) 67' ,'-1 r.:..:..z C f-- ~ Ii; (, 1-"'-f~A NJ of Petitioner( s) Register of Wills of Cumberland County OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } SS: COlINTY 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 ofpetitioner(s) and that as personal representative(s) of the above decedent petitioner( s) will well and truly administer the estate accor4ing to law. -----. , ( f ,i-~ -' \ .... _ ..._ ., , ~'- .1 --""_.._---- Sworn to or affirmed and ~bscribed Beforlrme this f! . day of . ( L ( l' I I , 20t 'u l/I ,'.. ,1 J 1/ _ / , II v ,r: I. ii. LA { C/1 riO' ~ " ~ ;. i. , " , \ / 'j , .:: ! li',\ i [,. j (, Ii I' ,Register J I "'I c. '" / , I / No. Estate of j) I(. K. (\'k rY1~tlI1I1 Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW C side hereof, satisfactory IT IS DECREED that is!are entitled to Letters of are hereby granted to in the estate 0[--- 3()-{> \.l.A. ding, Letters of Administration R m( m.IL~ ~~~~bchd"-- . Register ofWiIl~,- ~.~ \j FEES o2c . CIQ . \:i ~ Probate, Letters, Etc. ............. $ 6tlol, Q..9 Will ...........................~... $ ItS _ ~ Renunciation.................. . . \(:) . C)C) Short Certificates ( )............ $ ~ JCP.................................. $ ~~ 1~,0b Address Automation Fee................... $ .S; OW S .ll"O Bond................................. $ ISO:) ...,..-1 Total_ $ \~'T1 I :-<3() Fi)ed~;ll 200\.p q L (.)'1) Attorney (Sup. Ct. I.D. No.) Phone 12624207 tZ1fl2,- -::1 I"I,~ ,.,.~ "' I ./ ~;<<><>".-1.../~~...!-.'" i ~~;,<.x:~ (/ p ., Jl li....' ,~r,r.~. \... L,.; f~ v -.\IJ4J V.Q212{)Q6 HNT)N ~~~T #30-261 1. Name of Decedent (First middle, last, suffix) Joe COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH . VITAL RECORDS CERTIFICATE OF DEATH (CORONER) 58 Sep. 20, 1947 Johnstown, PA 3. Social Security Number 189 38 R McMillan y" 6 Date of Birth Month, da 3r 7 Birth lace Ci 5. Age llaslBirthday) Cumberland 105 E. Allen Street Residence 0 Other - Specify 10. Race: American Indian, Black, White, ele IspeC;~)Black Bb. CounlyofDeath ad. Facifity Name (If not instittJUon. give street and rlumber) 11 Oecedenfs Usual Occupation Kind of worl<. done durin mosl of workin ~le Do not stale retired InvenrgrYW~upplier ~~CI:rarSlf'o\?t 13. Decedent's Educahon (Speedy only nighest gfooe comple\ed) Elemenlaryf~ary(O"12) College (1-4or5+) '4, Marital Status: Matried, Ne,<er Married Widowed, Divofc~11Speci'Y.J ' Never Marned 15. Decedent's Mailing Address (Street city f lawn, state, lip code) 105 E. Allen Street Mechanicsburg, PA 17055 17a, State PA Cumberland Did Decedent Uveina Township? 17c 0 Yes, Decedent lived in 17d_}ir ~~iu~f~~~~~ived within Twp 17b, County City/Born 18, Falher's Name (Fi~l. midd~, lasl, suffix) John McMillan Sr. 19 Mother's Name (First, middle, maiden surname) Carrie Bell 20a, Inlormanl's Name IT ype I Pnnt) Adreece F Taylor 20b 1"'oonanl'sMallm9Add'essIS"""'g2'g15~mPr~~e Ct Belle Mead, NJ 08502 21c Place of Disposition (Name of cemetery, crematory or other place) Benshoff Hill Cemetery 21d, l..ocation (City flown. state, Zip code) Johnstown, PA 15906 22c Name and Address of Facility Wallace Funeral Directors, Inc. 106 Agnes Street Harrisburg, PA 17104 23b_ License Number 23c Date Signed (Month, dav year) 25, Date Pronounced [kad (Month, day, year) June 6, 2006 26, Was Case Referred to Medical Examiner! Coroner for a Reason Other than Cremallon or Donatlon? ltl Yes D No CAUSE OF DEATH (See instructions and examples) Item 71. PART I Enter the ~QI~.fll~- diseases, inruries, or complications - that direclly caused the death, DO NOT enter termirlal events such as cardiac arrest, respiratory arrest, or ventricular ~bril1abon without showing the etiology _ list only one cause on each hne : Approximate inleNal' OnseltoDeath Part II, Enler other sianiftcanl COIldilions contribu~na 10 death.. but not resulting in the underlying cause given in Part I ~~~gl~~Jtt~~; J:~~j disea~ Hypertensive Cardiovascular Disease Due \0 \01 as a oonsequence of) Hepatic Cirrhosis 28 Did Tobacco Use Contribute to Death? DYes DProbably o No UnknQwn 29,lfFemale o Nol pregnant Within pas! year o Pregnanl al lime of death o Not pregnant but pregnant within 42 days oldealh o Not pregnant. but pr~nanl43 days 10 1 year oldealh o Unknown d pregnant WIthin the pas! year 32c Place 0\ ',njUl)I HOTTl€, farm, Street. Factory Office BUilding, elC, (Specify) SequentiaHy lisl conditions, if any, ~~:~~ ~O~~L~NGn ~AtSE (disease or injury thaI initiated the events resulting In death) LAST, Due to tor as a consequence of) Due 10 (or as a consequence of) D Yes )(No Dyes DNo 31. MannerofDealh ~Natural 0 Homicide o Accident 0 Perding 1r.'ffiStigation o Suicide 0 Could Not be Determined 32d, Time ollniul"j 32g. Location of InjUry (Street, cily I lown, state) 30a Was an Aulopsy Performed? 30b Were Autopsy Findings Available Prior 10 CompletIOn ot Cause of Death? 321, If 1ransportation Injury (Specify) o Driver I Operator 0 Passenger M DO~",Speclfy 33a Certifier (check only one) 33b Signature and Till or e ~~~~:i~s~~~c~aknn~;~~:~ ~:~i~Y~c~~~= ~fu~eta~~:e~~ua:eo(~~:~~Y~:~e~~:~~:~~ ~e~l~ ~~ :~e~_"~ 2~)_ _ .. _ _ _ _ _ _ _ _ _ _ _ _ _ .. _ LJ .. Cor 0 n e r ~~Ot~:U~~~~~fa~ ~~:::~~.h~;~~~a~~::;r:~~~ ~~ht~:~:~i,rl~n~::~:;da~~rtld~:gt~at~~u~:u~e~~~~d manner as stat!d_ _.. _ _ _ _.. _ _ _ _ _ _ _ _.. _..D 33c License Number 33d Dale Signed (Month, day, year) Medical Examiner I Coroner 'hr( J un e 7, 2006 On the basis of examination "nd I or inv"tigation, in my opinion, death occurred at the time. date, and place, and due to the cause(s) and manner.s stat!l!. _ -F\ 34 Name afKI Address 01 Person Who Completed Cause of Death (l1em 27) Type I Print Michael L. Norris, Coroner 36 Dale~"'1 ';h.d~"~ 6375 Basehore Roadj Suite IiI 1.o2i/ I.;?I /.v I / /v Mechanicsburg, PA .70::>u (See instructions and examples on reverse) Register of Wills of Cumberland County RENUNCIATION Estate of Joe Robert McMillan No. Also known as Joe Robert McMillan , deceased To the Register of Wills of Cumberland County, Pennsylvania The undersigned David McMillan Brother (Name) (Relationship) (Capacity) of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to Adreece Frank Taylor Witness my/our hand(s) this day of August ,2006. Affirmed and subscribed before me this 10!, _day of ~-'M;t ,to r:-C, , Di' kVl r1 t/.~M4rc);) Notary Public iJ~~~ /~Cf)O "8CX.tJ ~~I Gr FL.D~L roSA AJ T UrJ &.~ Z 0 ~ c.f, (Address) My Commission Expires: ,. iJi , /J .) ',,{, f/!/, Z,HY-- 4- ~C~t;;/-YL (Signature) ~})61 JoL-. , ( Or (Address) Affirmed and subscribed before me this m_dayof~_. (Signature) Register of Wills (Address) Deputy (Signature and seal of Notary or other official qualitied to administer oaths. Show date of expiration of Notary's commission) DIANNE G. MiLTON Notary Public. Notmy Seal State of M\SSOlHi St louis County My Commissiofl Expires Mar 9. 2007 ~ . Register of Wills of Cumberland County RE NUNC IA TION Estate of (lM/~'~~'1- r y;; ~ ~.J!-,!dr~ Also known as ~}..vRdq.tz.l:_ Yl1t"7'J-l,AJ1La.-1< f , deceased No_ To the Register ofWiils of Cumberland County, Pennsylvania The undersigned 9~~. . >>; ~ 7l7.J?J' __-L~ ~ (lfn "..f-f,! 'L.2 (Name) (Rclatio ip) ( apacity) of the above decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to H/{' t} J.! (~ (. p -X;;;jlL~'l- \? day of ~r----i' '" 2' .<0 ~I ".og I c~ Witness my/our hand(s) this s:: 13 .~,~!:' 'J)} :J .] if) J t.' ?;l ~~.~:; ,5 '!il c. is ~ I '" 0... m~~'t: ~1-5 :'~l ~ 2: /~ E"~ ,g Eli i~ ~. i 81: ..J 0 (;) ~,.' '"': ' - ~12 ;E g; ~ 11 UJ, ..' s:::: Zit >, ~' .2. ,:;.=..: OJ -. I ,~ -:: 1=/ C .? .... -: ~~ Qi ~ C58E o~ ~I .~ _' 2{ u~/_;;; 8/ ~ ~ ---.J ~ Affumed and SUbSy~be~ before me this _~&;~ of F ) ;-.r (JliC1Vi tr:14Lt}1C,t"-- No ary Public 0 My Commission Expires: loflS/LTt Or Affirmed and subscribed before me this u_ day of~u~_ Register of Wills Deputy (Signature and seal of Notary or other official qualified to administer oaths, Show date of expiration of Notary's commission) 1'11,:9 ,20 c~j / ) C " ;,L? . (/ 1-<-..' . (Signature) ,/ I;~" ~);~(// 2,5~ ." \-#7:.,-(it~'L--;;~ /hJ/L) YL' 7 .(Address) / (Signature) (Address) (Signature) (Address) Register of Wills of Cumberland County BOND AND SURETY FOR PERSONAL REPRESENTATIVE Estate of Joe Robert McMillan No. 58 318880 Also known as Joe Robert McMi 11 an , Deceased KNOW ALL BY THESE PRESENTS, that Adreece Taylor Asprincipal(s)and Pennsylvania National Mutua 1 Casualty I r,surance Companys surety (sureties) are held and firmly bound unto the Commonwealth of Pennsylvania in the sum of OneHundredFi fteenThousand dollars ($ 115 ,000)'to be paid to the Commonwealth, for which payment we do bind ourselves, jointly and severally, our heirs, executors, administrators and successors, the condition of this obligation being that if Adreece Taylor fiduciary capacity) proba t i ng Joe Robert McMillen as (state of the estate of , deceased, or any of them, shall well and truly administer the estate according to law, then this obligation shall be void as to the personal representative or representatives who shall so administer the estate and his or their surety or sureties; but otherwise it shall remain in full force. Signed and sealed this be legaliy bound hereby. 15th day of August , 20~, each intending to / ---:-:;.. Signature of Personal Representative Signature of Personal Representative (Seal) '::....-..-..-.~. ~ '. C-:" ...... .. Signature ;rnondmg Agency "'S ,,<. \~ (>",-{.'\. c. PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPAN Harrisburg, Pennsylvania POWER OF ATTORNEY Know All Men By these Presents, That PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, corporation of the Commonwealth of Pennsylvania, does hereby make, constitute and appoint SUSAN PETRI, OF MILL TOWN, NEW JERSEY (EACH) its true and lawful Attorney(s)-in-Fact to make, execute, seal and deliver for and on its behalf as surety as its act and deed: ANY AND ALL BONDS AND UNDERTAKINGS PROVIDED THE AMOUNT OF NO ONE BOND OR UNDERTAKING EXCEEDS THE SUM OF ONE MILLION FOUR HUNDRED THOUSAND DOLLARS ($1,400,000.00)-------------------------- ALL POWER AND AUTHORITY HEREBY CONFERRED SHALL HEREBY EXPIRE AND TERMINATE WITHOUT NO ICE A T MIDNIGHT OF THE 31 ST DAY OF AUGUST 2010, AS RESPECTS EXECUTION SUBSEQUENT THERETO. And the execution of such bonds in pursuance ofthese presents shall be as binding upon said Company as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its office in Harrisburg Pennsylvania, in their own proper persons. This appointment is made by and under the authorization of a resolution adopted by the Board of Directors of the Company on October 24, 1973 at Harrisburg, Pennsylvania, which resolution is shown on the reverse side hereof and is now in full force and fect. In Witness Whereof: PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY has caused these presents to be signed and its corporate seal to be affixed on AUGUST 22, 2005 PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COM /~~:;:~~ / ...;....... .,~ I r!.i" -..... ~ S'f' '0:: 0 \! :!. d. ,~\ ,'~l " '..-: '~~..~ -.-,,~;// '.,~=:. .' ~~':/ ~a? Kenneth R. Shutts, Executive Vice-President, Secretary & General C nsel Commonwealth of Pennsylvania, County of Dauphin - ss: On AUGUST 22,2005, before me appeared Kenneth R. Shutts to me personally known, who being by me duly sworn, did say t the resides in the Commonwealth of Pennsylvania, that he is Executive Vice-President, Secretary & General Counsel ofPENNSYL V Nl~ NA TIONAL MUTUAL CASUALTY INSURANCE COMPANY, That he is the individual described in and who executed the preceding instrument, and that the seal affixed on said instrument is the corporate seal of said Company, and that said instrument as signed and sealed on behalf of said Company by authority and direction of said Company, and the said office acknowledged said instrument to be the free act and deed of said Company. !,~., /t",,~""(.Jy ~ F('~ . ~"'.;: J ~.""" .~ ; ......,..\.,~".'".(::,....c.. .' ":'It~"';".'L:/ ......,..................... ~~~Q. c o Notary Public Commonwealth of Pennsylvania, County of Dauphin - ss: Notarial Seal Jacqueline A Ellis, Notary Public City Of Harrisburg, Dauphin County My Commission Expires Dec. 19,2005 Member, Pennsylvania Association of :--Iotaries I, Michael F. Greer, Vice President, Surety & Fidelity of the PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURA E COMPANY, a corporation of the Commonwealth of Pennsylvania, do hereby certify that the above and foregoing is a true and co ect copy ofa Power of Attorney, executed by the said Company, which is still in full force and effect. on IMPORTA~i r NOTICE: This border must be RED in color. If it is not y. Telephone us at Area Code 717-255-6870. ~ 78-190 (Rev 05/02) PENNSYL VANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, PENN NATIONAL SECURITY INSURANCE COMPANY AND FOUNDERS INSURANCE COMPANY 2005 ANNUAL REPORT CONSOLIDATED STATUTORY BALAN'CE ~HEET DECEJ\1BER 31, 2005 ADMITTED ASSETS 1nvestment~: Bonds........................ ... ... ...... ............... ............... .~...............: ............ .................,............... ............... ............ ....... Stoclcs. ........... ......... ......... ...... ...... ............ ...... .................. ......... ......... ...... ......... ......... ......... .................. ....... .......... Real Estate........................... .,. .................. ............ ...... ............... .....:......... ............ ............ ..................... ............ ... Loans to afliliatcs... ...... ......... "............. ......... ............ ......... ....., ............... ......... ................................. ........... .......... Other assets......... .....:................................. ......... ............... ......... ............ .... ,;'.... ......... .................. ............ ........... .... Cash and cash equivalents............... ...... ......... ...... .............................................:,;............................... ............,........ ..... Total casll and invesbnents...... ............ ......... ...... ..............,........................ .......:...., ..."....... ...... ...... ........:.." ......... ...... Agents' balances and uncollected premiums...................h...................................................................... ...........,.... ............ . Investment income due and accrued......... ......... ........, ......... ......... ".... ...... ......... ........................ ............ ......... ............... .... Amounts due ;from reinsurers... ...... ........................... ......................... ...... ......... ............... .............................. ...... ............ Deferred Ulcome taxes...:..... ......... ...... ...... ............ ............... .................. .......... ......... .................. ............ ...... ....... ...... ...... Other assets... ......... ......... ............ ............... ...... ............... ............... ......... ...... ............ ............... ......... ............ 0.....0.. h.... Total admitted assets............ ......... .................. ..................... .......:................ ...... ............ ...... ......... ......... .........:........... LlABlllTIES Reserves for losses and loss adjusbnent expenses...... ..................... ............... ...... ......... ......... ...... ............ .:. ...... ...... ......... ...- Uneamed premiums... .:. ............... ........... .... ......... ........, ......... ............ ...... ......... ...... ............... ............... ............ ............ ... Premium taxes and other expenses... ..................... ..........;. ...... ......... ...... ......... ................... .................. :........ ................... ..., Drafts outst8llding... ......... ...... .............................. ......... ......... .......0....... ......... ..........:................ ...... ..'m... ............ ........... Other liabilities.................. ............ ............ ............... ............... ..................... ...... .;....... ............... ....... ......... ............. ......... Totallinbilitics........................... ...... ...... ......... ...... ...... ............... ............... ........................ ............ .....:... .......... ...... ...... POLICYHOLDERS' SURPLUS. Surplus Notes......;.. ............ ...... ......... ...... ...... ...............:.. ......... ...... ......... ......... ......... ...... ......... ......... ......... ...... ...... ...... Unassigned SUl}llus............ ...... ................................. ...... ......... ...... ............ ...... ................... ...... .................. ......... ......... .;.... Totnl policyholders' surplus............................................................ ...:..... ........:... ......... .................. ................ ......... ........ Total liabilities and policyholders' surplus..................... ..............:.....:............,......... ......... ........................ ........................ COllllllonwealth ofPelUlsylvania l J.58 County ofDaupbin $ 841,017,982 112,003,028 2,112,129 26,396,618 484,882 12.263.488 994,278,127 150,10i,461 10,810,554 12,346,631 23,718,560 12.492376 $1 203 747709 $ 556,383,680 236,580,893 28,547.827 9,258,401 36226.911 866.997 712 50,000,000 286 749.997 336 74;JLZ2 $1203747709 We, Christine Sears, Treasurer, and Kenneth R .Shutts, Secretary, respectively of PENNSYLVANIA NATIONAL MUTUAL CASUALTY JNSURANCE COMPANY, PENN NATIONAL SECURITY IN"SURANCE COMPANY AND FOUNDE lNSURANCE COMPANY, do hereby' certify that the foregoing is a true statement ofthe financial condition of said Companies as of cce her 3 .2. - ~(J~ Secretary Subscribed and sworn to before me COMMONWEALTH OF PBNNSYLv. Notarial SeB! Dawn L 8eckar, NotalY Public City of Harrisburg, Dauphin County My Commission ExpIres Nov. B, '2009 Mamber, Pennsylvania Association of Notarlas - - 1Se..c1u-v