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Home My WebLink About95-0054~i q~~co54 This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. AUG t 6 200T Date H/05.1 a3 Rev. 2/87Y TYPEYVNwT IN PERMANETIT nuaL INN a W W U 0 O Z Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLWLNIA'• DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH G02 X88 NAME OF OECEOENTIFirx MioW.La+9 SE% SOCIAL SECURITY NUMBEA GATE OF OEANiMarM.OSy.'al«1 +• a•Female ]. 198 - 30 - 1185 ., r~ltk, ~ /9q'~ AoE(Lare:mayl ,YEAH uNDER,tTIr pAEoFeIrTr,1 BafD1PlAC81'Cayaad PLACCOSOEICNacn.rAmr~an.-w~nrn,tlmnatlnw,«ad.l MoAr I pays Holea = a,YaAea IMOMI OSy.'Awl Stw orFOeglCaneyl Penn Tw HOSPIDNL OTHER: p . 8 Yom. May 12 1907 Irpaliare ^ ERIOu,patlere ^ DoA ^ ,~ R..ie.rlr ^ ~~ ^ 7 , a zCumb.Co.PA COUNTY OF DEATH CfTY,BORO.TWP OF DEATN FACKITV NAME(M nd arRlaon.4M aaM and nulnb«1 VILS DECEDENTOF HISPANIC OfIMaIN7 MCE-Anrrlun ardlerL BYCk,WNN. a,e Y ~Pw ~~ C No ® Ma ^ ayr, apaay COMn, M "°`~" P""°"~"" a" ~') w Cumberland .a. .a / DD~ rn - „ . ' ' ,a White DECEDENT'S USl1AL OCCUPAION IOy1D OF BU3INESSfINDUSTRY WA90ECEDENf EVERN DECEDENT'S EDI1C,QgN MARILLL STRU9-Mamr SURVNIIq SPOUSE (Give lsMd•,ykgrydAno nwM M U.S. ARLffDFORCE3T N lS C NMrM«rNd,WWOwad. Diwad(S •o1 ) IawM OM mrdannarrrel np aN; do nolur raied.l d rlw ~^ NpC7 flwnanWy armd«y a a9a `°'~ "a'S'1 p Y „~ Teacher „o.P 1' ,]. 4 ,a. ,.. Never Marri ,s. oECEOEfarewuwDADORESS(SaaM.CaN~.Sm1e.7JpCOae1 ~ A~ ^ rw aao.aaratlrrm e ,x Di E NT3 4 Todd Circle, Apt. D .p. . . iA CT, i 1h.Sgb ~ d REST ~«+ ,a Carlisle, PA 17013 ~«~ ~ ,>e Cumberland '°"""~' ,Ta®w .ora~dl__ Carl ; cl a dnn«n. fQyIER'S NAME (Frsi. MidOla. Lead MOTHER'S NAME (Aal. Middle. MaidnSrnamel ,.. Holbert A. M ers ,s. INFOMVINT'S NAME (TyprPrap INFOIWANr .Cilylkrrl. Sera. Lp Coda) Doroth ]os. METt100 aFI71SPOSITION QQE OF DISPOSITION ~ PLACE DF , , L Brr~cr«a.loa^ Rarrlwalaara5lW^ (M"""'Diy''""' °Otl"P1vci Centerville ^ °""'°"~ °'h"l's""ay` f,a Jan. 14 1995 ]ta f ]/o. ]1d. sIDNAUREOF ACTI As SUCH LICENSENUMBEH NA1AEANDAO°^E%4OFf~'L"Y Hoffman-Roth Funeral Home ]]s. zx. Coreplra A«r 23ac only wrrrlo«wy«p To ar n..Iamy ano.Mdo.. a.«now.«wat m. wn.. mane pmd. al«w. ucENSE NUMBER stDr~Eo payMrJr 1. nel raarM tll«r of 4elha oartiry ow. afa.rh (Sivlaa+re r IManaI. DeY. Ye«I . aa. w C ]x.~C/~ ~3 /~ Marv 2A,]S rruatNCOrrIplalWM TMIE OF DEAN / DAEiRONOUNCED DEADIMOnm.DW. Ya«I YMS CASE REFERRED /D MEDICAL E%AMI prrn wlb pmnola¢w a..m. A!J°~°~'"tit M ,••^ N.r~ Z N /9 ~ /1 ] ]a s. u .~ , 17. -ART 1: Era«IM OitaaaN.Yyvir«mrrganalvrwaam c«rwrM ram. DO not erd«dr dya10. aramr «r«plralory mrl, alwca«Irart ha«e. ~AppmtinMN MRT D: g11«apiSC«R wnSYwumalhl«gbdaaN. GR LM OraY Orr eauae an eacn fir.. I~a«ee«r nd m«ilYq intln urla«ryYlp rrra da•11 in PMI1T I. ~ TEO ~ (Fxw /~( it a a ~1 ~i1 j 1~. % rrdargndeam)-~ a. l~~"`•a~_~~ /MA71 (^ ~i A~..11 •' /a J DUE 70 (OR CONSFf%IENCE OFyy ~ / 'w I G `~ V SaglrraMay a«ooneaor o ~' a «rµ Medmgrir«rrdiar e«ae.6ew 11TIOEALY1110 CAUSE(Oierrar,ryuy 011ETOIORASAC OUENCEOq: I ~ O awirbMed evade OUE ip (OR ASACONSEOUENCE OF7: rasaarq r deem) LAST I 4 VMS AN AUTOPSY WERE AUNPSY FYyDS!(i3 MANNER OF DEATH DATE OFINJURY TIME OFINIURV INJURY AMORNT DESCRIOE HOWINN1ftY OCCURRED. PEAFORMEDT /M1N.ABLE PRIp, 70 IMOnm, DeY. Mar) COAAPLETgN OFCAUSE F NaN l N iid ^ O DERNi a arn e Y ^ NO Aceidanl ^ Pandrq MvallgallOn ^ r ~/ ^ M N '/a ^ tb LJ 1ba ^ Ne ^ Sdcide CoWdmrtr d««miwd ^ PLACE OFIN.IURV-Al lnOr.h me«.NaOry,oMp LOC/QgN(StreM.Gh1T .Sfde) taril0lrq. «c. ISO«+h1 ]aa. M. ba. 70t. ti11TIF1ER (CMCr odY oral NAU D TIT1E OF C 'CERTIFYWfi PNYSILYAN (Phyvcran c«MYrg Tarr d drm omen andh« d,yedan Ar pronounced Oeain antl etlmpded dem 231 Te me ae« w my Yrorreae, deem oceurree err b era eaerlel and nrnn« r a1eMa............ ......................................... 710. E NUMBER U~NS SgNEO (MOrgl, Dari'~«I '-ROIIOUNCIND AND CERTIFYVNi PHYSICI.AM IPPYxlantdn ponauncvg tleam arW o«tilYUW towused deaml Te tlr tra as my krrwMdge, deem eee«rw M me,rrr•. deb, and Place. and eue b dr eauaNal antl mann« r atatad ......................... ^ / > a L~ 71e. / el ~ ~d"~ ` D ~ _ L- ]14 NAME ANDADORESS OF PE WMO COMR.ETE SE DEAN " 'MEDICAL EXAMINERICOiiONER (Oem 2 71 Type or Print ll G ~a..yp }~j ~/1q ~/1 r / } y ~ -' • On tM GW of eaaminstbR and/or inraatigation, In my opinion, death occlured at the time, dale, and place, and e e to the eause(si and , /, ( ~ 77'A W 1•!_ fyr•} C7.. 1 y 50 IN (1.YMaL.~ r ^ m.n..ra.,t.,.d ............................................................................... °................. c d,a. T]. e1,i,L~~ 4 1 REGISTRAR'S SIGNATUREA NUMBER 4J ~ DAEFILED (MOnm pay. Yearl ~ ~ ]]. ~~ac ><. , i~. 194 PETITION FOR PRORATE and GRANT OF LETTERS Estate of __ OLIVE L . r'YERS No. _ ~ ~ -- 9,~'s` "- ~j `7" also known as To: Register of Cu~in~o~rleand Ae.tastd County of in the Soeial Secaeri8y .P'o. ~ q S _-,~ Q - Z 1'8 5 COmtnonwealth of Pennsylvania The pctidon of the undcrsign~x! respectfully represents that: Your petitioner(s), who is/are 18 ycan of aye or older an the execuc o r. na~~ in the Iast wilt of the above decedent, dated ~731u.3~Y ~ 0 ;19 91 and codidi(a) dot-.-' * enuncia ~.on o ~ oro v Myers, a ac e (cents relevant ctrcumstaaxs, e.s. rwunda-ion, deatlx of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or prindpal residence at ~ Todd C irc i e . Abt . D . _ C ar'I l S~ P~, PA 1 ~n' "~ (lict stroot, number and mundpaitty~ Decendent, then _.$? ._ years of aye, died January ], l , 19_x, at_New_Zodd Home. C riiG; : P nn~ylvania Except as follows, decedent did not marry. was not~divorced and did not have a child born or adopted after executi6n of the will offered for probate; was not the victir~t of a killing and wan never adjudicated incompetent: none Decaadent at death owned property with estimated values as follows: (If domidlcd in Pa.) All personal property S_~00. 000.00 (If not domialed'ia Pa.) Personal property in Pennsylvania S (If not domidled in Pa.) Personal property in County S Value of real estate in Pennsylvania S situated as follows: None ~%I-IEREpO~, petitioner(s) respectfully r~uest(s) the robots of the last will and codidl(s) presented herewith and the grant of letters E6 ~~/i`~-Kv theron. (tectamwtary; adminiatntIon c.t.a.; adminIstrat[on d.b.n.c.t.a.) a ~ H LBERT G. MXERS _L1TPT.nri 1 1 P~ PA 1 7741 ~. 0 h f Y ~ OATH OF PERSONAL REPRESENTATIVE COMIVION~'EALTH OF PENNSYLVAN>rA 1 a~ COUNTY OF CUMBERLAND r The petitioner(s) aiiovt-named swear(s) or affum(a) that statements in the foregoing petition are true and correct to the best of the knowledge and belief boner(s) and peraonal represen- tative(s) of the above decedent pebboner(s) w~}1 ~ y_adn~ste# yse according to law. Sworn to or affirmed bcforc me this _._,L nuar i ._- _. ~~/ MARY C. LEWI ~~~-rl ~~ subscribed day of Regislzr t..~ ~~ f f ~~ _ _ _ _ -, - ~?~~a ?_1'- 95 - 5~ -9 ~~., 3~ r„orsi~txritioa of ~~ p~,a~I~;~, can :.~ ;>~:~: $ ~a~-:.:~~s w,~, ~~~~i~~~~:ay ~~~~:o~" ~°.~~~„ ~ rr~ tr t~ ~dfcaPe z, :~'a"' a~ '.::~~:~~~`.;~~ ~:~r ~S~ ~~~~~ ~r',c~ Januar~r 10 z 1 g91 _ e~c~sk~:,? ~.°.~~T~.a 2±~ ~~x~il!t~d?~ X03 psi x`"s~~ o~ x.~rd ~? xhe I~t ~~ of _ O1 ive Z . i~:x er s ~s~'rzerelay ~sr:~.~ 4,9 HOZBERT , G . MYERS Itegiatar e:f'tit'll!a MARY C. LEWIS 'E.S .psobn:c, E.t~°-a~, ~~tc. , ....... > ;t 2 70.00 Si.aze ~t~~~t.,~:t~ irJ....... , .. ~.o..,..~? ~c;.~k r~s~~~~ .... . ........... ~ 5.00 n-~d'3P_S ~ VU MCP -.-r.~®. '~p°S'AL ~„~,j ~~~ :RPdUARY"?3: 19Q5 • • . .•se. •s. w•• w~ ~,,p~ C t71 ~ C_ •:~; U ~) G2 a"t. a ~ -.~ ~a- ~ ~~ : U~ +m,~ William S. Danielss No. 27735 f) ....._ ~'IwY'DP.2-'~Y (aup. Gt. I.D. Yc.) Une W. High 5t.~ Ste.205 Carlisle i~DDEtESS p _717--243-3.831. PHOAI$ "5 m... xd-r '-~~-r ,,^.N ,~_:. ,..., ,.-. ~ .' ~'~,z~.*tr; .. ..~Y~-~,a.;~..c~.." .-3N'l~~et+'N . ... '' r R.. .. n ~.. ' ~,:.. , ~-• - ~. ~, _ __ ~. - . ~ , __ ~. 21 - 9 5 - 5 4 I ~~G~ST~° R ®F yVI~~.S OF' CUMBERLAND COUNTY OATH ®~' SUBSCRIBING VVTTNFSS I ; WILLIAM S . DANr~:r,S and V7.~GINIA H. DANIELS codicil (each) a subscribing witncss to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that they were .present and saw OLIVE L. MYERS , the testa[ r ix ,sign the same and that they signed as a witncss at the request of teseat rix in h er presence and (in the presence of Bach other) (' e p esence of the other subscribn$ witness(es)). ~ _ Sworn to or affirm" an subscribed before i i m ante me this ._1_C ~ day of (Name) 7~ -19 1 0 ersto ardners PA 17324 ess ~ MAR. ~ E W I S Re cater ,-, o N T tea. g nia i is r, ,~ ~ L _ ame~ ~=-} ~ 1040 Myerstown Rd . , Gardners, PA 17324 ~. ;~ ~'; '~ ~ (Address) r- -~ _r- :~s O •~ ~ li ~ OC ~ii n~ ~ ~.I;,~G?L~R ~OF 'S'VILLS OF COUNTY Ot~TH OF NON-SUBSCRIBING ~ITNBSS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) aa:d say(s) that familiar with the signature of , ~ lcll festal o e of the subscribing witnesses to) a will presented herewith and COC11Cll that believ a signature on the will is in the handwriting of to the best of l;no dge and Sworn to or affirmed an ubscribed before me this ~ day of 19 Register (Addr~cr) (Name) C:; . i I r i . ~. .` ,. ~~ ,~ ~. r;. ~ ;. (Address) ;~~`~,~.~; . ~rx ; ~: i~~~ _. ''~~;:-. '`;~ :I -~-;x- r.^''_"-z.'~'~-z^'-mow, =:~rs'~*.,~a~- .-.,~~ .~i :: ~ r 4 ?7 ,. ~ , l ~~ in ?e £sttate ®k~___ OLIVE L . MYERS - deceassd. o the Re,~ist~r c+' 1'~i:'s of Cumberland County, Penr:sytvania. The 2~d,ess~~i~` DOROTHY E. M5'ERS of tiie abo~•e dve~edcrt, hereby renoance{s) the right tQ admiaister the estate and resg~e~tfu:l~ ask(s) that Letters '1 estamentary he issu~ci tc ~~OI,BERT G . .'VIPERS 6~1ITNESS ~, mY hand this f~~ day of January ~ 19 9 5 DOROTHY E .(S1~IYEhS 4 Todd Circle, Apt. D, ~_ ~' ~ r1 ~~ Carlisle, PA 17013 ¢' ~ " ~' a_ C. ca U •-- ^-: ~ _^ ~t ~ C , ci ~:, , x ~ ~~ ~ ~ ~ tai.) (Si~twe) (fzddress) (Segaarurc) {`? (Address) ri ~rt;• vr•.~ z rnt ,a,., ~"iN;,Z.c~^+ t~„,„„ -_ '"~~I#~"910 ~_:'"'~ hLSt~~°e~Y~~ra ~ p'x ~h, ~`?~~a ,'~s';rr,~-._+,Cr,s'~'er~+"".~ ^N"~,~.Yo'y~laF;'A~Y..':SE~~~'` ., ~ ~~~ ~ - _ _ .E_ { v' 6 l ~•`i ,' ti . ,~ ',.~^L,. .x ,; 4~ . I, C3 x17'R' L. 2tY~RS, of the Borough of Carlisle, Cumberland Cou.xt;r, ~?enrisylvania, declare this to be my last will and revoke al' 4~i11• awnc? codicils which I leave previously made. I. :~ direct my executrix hereinafter_ named to pay all of m just deb~s, funeral and administrative expenses and all estate, I transfer, inheritance and succession taxes whether payable by reasor_ of property passing under this will of otherwise, as soon niter my decease as may be convenient. IT. I give and bequeath the sum of Five Thousand and no%100 ($5,000.~?0) Dollars to the Dickinson Presbyterian. Church of Cumninsto~rn, Pennsylvania, (12 Church Road, Carlisle, Pannsylvaz~ia 17013} to be used as the Board of Trustees may ~ determib.e. II:.. I give and bequeath to my niece, MARY LR1L Bi3RY, the sum of ile~t~ Thousand and no/100 (55,000.00) Dollars; to my niece, E. J~r'ih~ xsl~;C,ER, the sum of Five Thousand and no/100 (55 , 000 .00 ) Dollars; 'to my nephew, JOHTit K. BIXLER, 3R. , the sure of Five T:~ousanc. anc? n.o/100 ($5,000.00) Dollars; to my nephew, F€OY,BERT O. f ~ivFRC, the s~a.m of Five Thousand and no/100 ($5,000.00) Dollars; !~ u.zd ?~a FA~,~:ICZc'~. SI'bOI~E, the sum of rive Thousand and no/100 r ~ (~S,OCD.'~,) D+oilars, in appreciation of her many kindnesses ~:o ~_ ~. '~ a I ;•~ f i i G (: R r ~_. d .:".,j ! -~ ~' '~ b ~.' z ~. a ~. ~ ~~~ ~r~:~ i iI . !. ~~ .._.~' __ ~ _,. _ ~r , . ~-m -~ , .. ., ,, ,. ~< , .. Ems;, r . i ~,~ . I.F. I give and bequeath to my sister, DOROTHX E. l~6YER8, such ar'cicles of tangible personal property having sentimental, family oz heir'.~om significance. ~'. I give and bequeath the residue of my estate as follows, Z. 33 1/3~ to my sister, DOROTHY E. MYERS; ~ 2. 33 1/3$ to my sister, ELVA lid. BISLER, and if she shall 5~.edecease me, then in equal shares to her two children, JE?:ra3~; ~K. :QI..I.ER, JR. and E. JEAN BIXLER; 3. 33 1/3~$ to my nephe~?, HOLBERT G. MYERS, if living, and if deceased, in equal shares to his two children, A. RYLE A4YERS a nci FILL I SOId E . MYERS . If the beneficiary or beneficiaries of any of the foregoing share or shares shall have predeceased me, said legacy shall lapse and be added to the share or shares of the beneficiaries living at the time of my death. VI. i appoint my sister, DOROTHY E. ~dYERS, as Executrix of this rry last ~=i',.1, and. if for any reason she shall fail to qualify or cease to act as such during the administration of my estate, I appoint my nephew, AOLBERT G. MYERS, as substituted Executor of this my last will. Should both my sister, DO1tOTHY E. MYERS, a:nd my nephew, IiOLBERT G. MYERS, fail to qualify or cease to act as executors, I appoint i~iILLIAd4 S. DAPIIELS as Executor of this my last will. VII. T direct that neither my executrix nor her successors shat= be required to give bond for the faithful performance of r~ `"~ '; -.x ~~ ~, i . r .. .. :l~~i~ r;~.z~~.eil in any jarasdict3.an. ''I~ HI3'~dESS taHEF,EOF, I have hereunto set my hand this j ~;c~ r~ ~~ ' b ~°~~ ol,zvE L. MYEFtS ~?~~ ;preceding instrument, consisting of this and two other tyge~::itt~er ,pages identified by the signature of the testatrix, GLI4'_. L. l3YEES, was on the day and date thereof signed, published any: decia;.red by OLIVE L. AYYE~S, the testatrix therein named, as and for r.f~r last will, in the presence of us, who at her re~~uest, in her presence, and in the presence of each other have subscribed our ames as witnesses hereto. ,,~ ~ ,~ :i ~ i -- 1 _. i .. _ ___ n 1 CR ...~. -.a!.ry~W,+ua ...v3^.'..7,. fiw Rf ~~.' i .~~ i 4"'')T sr .... g ;' ; ;: ~~~ t'~ .''. ~;. ,. a ;,:~ ~1 '~' Y +` ", r'~~. ~~ `1 ~ ,r 7'. i~F ~._• i . G.~. ~'... ; t ~.. - ~~#Cfl fit; ^~ _'i4i'r,'':.' ~i ~ ~. 's rl .~ ~ u £ ,:.., T "'.4~. d~ j r `~ ~„A I' ~1{~tPF '~:. ~ '^~.1.~ l.~ f ._~ ._ O ~Cn.} ~~ J~f~ ~ {- ~ V ^__.~_ ~ U.. _. _~.- ---. ~. . s :~•~ r •~e~C` ~ ..~ L;•T~.T `7 ~: L~ V~y".V i~i~ ~.,e~~t:^i"' _. :. i`~.A4L J;:znur7;'v ? 1, 19°5 ~•, t~ .1 ~~ ~~?-_).}. :oc+; `'si. "'a:~e ~dt~iz.i:stration Pao. 21-~5-~.~ r.~--~_;,~-:~ #-?:al :tatice a~ ben facial interest reguirerl 'may ,u~ _,=.(-; ', ,:~~ ',~:,~ ^rph~a.ns' Cour'~ Rules was sewed on ar m,iled } o tz~e ~ cl ] o~-*ing beneficiariPS of the move-captioned. estate on ii ~ I^ G' ;~ _. Hddr~s.s ~dotice `gas now been givAn to al]. persons entitle thti eto under Rule 5.5(a) exc.epi:: Bone ~ G ~ - Signature name• 4Ti1].iam S. Baniels I~ddzess: One West High Street Carlisle, ?A 17C}_3 (717) 243-3631 `G ?q3 a 1 a ~' Telephone. ~~ Ga.naci ty: Counsel toz personal representative 1. ~`~ ~° ,,, i~' . 4~ ~' , ,; Y }~i qry~ .. ...i ^~! r. ,~ 6 ~4 i 9 ~'~ ~._ _.. _ ..-fi-. ,. ,.~_ _~ _ ~ , , ,_ ~, '~ 4 y 7 i ~ ~R;~,f~'^F:[C,IA~IP:S GF uS^t ATE Or^ OLZ`JE L. M3tERS, i,ECEA5EI? :~.~.:`~ ,.,e+a :dyers Bury a. . 2.!.3 ..a:~isan Avenue i s:^rn.''' :~~'~ '!A 2106$ a '~ ~'e~r. Lixler r. t ' a ~, { Y B,. i' i:;~r~ Springs , PA 17007 ~ ' .,_ , 3. moo:: ?:. Bixler, .:~r. 210 ?a~r'k Drive ^ailinc~ Springs, PA 17007 ~ :. Holb~,:t ~. Myyers ~~ 1.&0~x *~3alnut Bottom Road - ~~ iVe~?ville, PA 17241 f~ 5. Patrirza Snake ' r85 F<~r:~ Road r Ir'et^rzlle, PA 17241 5. Dr,r~~thy ~. Myers 4 '~acic: Circle, Apt. D Cv~~-'_zsle, PA 17013 7. L°•ie~insan Presbyterian Church a umminstown, Pennsylvania ?,; .: 7.2 Church Road _ r~.~r'_' i.~la, PA 17013 `'- ~~'f ;~ i ~ - ~:~'. ~_ r: ~. ~-:~_' ~. ,r r :;;,:~ :~~;~: I , w~= :, . ,'!'. .. ~.tij~„'^•~,`'t =.tl;~+' ;~+i'W~~~ ~iy'~~~~'tN!'A+~ f'° .'tK', w.. .. h ~ .~~ - II!'!~ M ~~ t) ~ ` ~` \ - ~ ~- - ~ .~ ~ .~ ~ -- \. f \ , . ~ ~ ~ - ` . `' . 1 - ; . ~-\ ~ ~ ` \ ~, ' \ - - \ ` .... ~\ w..-.nn..yjC+•y-L:L':~,=.'S..r...,....ew.srv-m..u~vw~rn:. w`W~II'i. ~..t.. ._.a_..y;~.u.v~a.-'+.iic.~S~S iiLtid:6:iLV'~ pp pp~~, A k ~.~ ? yt., ~ ~< r ~J Z :- r ~}yf .ti ~ 't i.V. ~ 6 iy'. 4 ~. REKIIA2 E%~d-Old. 1 VI"Y04r.iliM~~'~ ,y ;.v.. `_u.+. r-H~ t+'rt ~^,~ •BS. ACN ~ ASSESSMENT ; AMOUNT RECEIVED FROM: ® CONTROL NUMBER ,- I'OlD HERE I ~' DANIEL8 WILLIAM $ 1 W Fi I $~-I STREET CARLISi_l~ PR 17013 ! r • 42 /2 4 /9R I ~ TOTAL AMOUNT PAID $~~~~•~ ~ REMARKS tit?LSERT S MYER$ ~ CfQ WILLI6~M S 1bANIEt~$ ESQ - SEAL ~}~$~~~ O~;i RKEIVED BY~~j-~ ~' `~' /~' ! ~~ MARY C. tEWIS .; ,~. ,~',;..:,y~-:f%°,~/' REGISTER OF d1-lLLS l9~6$I87ER OF WEttB V „____, .. ~ f.....t.,.,,r- -~,.._..,.., ~. ~.,,,,..,,.- ,_. _. ,... . -._ REV•1500 EX+ (7.94) z W D W 0 W Mari, Y W d V =oo ~a~.m o. a vs ~ W Z ~ W D: ~ oz ~d Jv10NWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 >ECEDENT'S NAME (LAST, FIRST, AND MIDDII MYERS, OLIVE L. / INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) ....ii+~ xwKn r rvVmntK ~ DATE OF ATH DATE OF BIRTH 198-30-1185 1/ 1/95 5/12/07 ca~~r AVPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL( SOCIAL SECURITY NUMBER f 1. Original Return ^ 2. Supplemental Return ^ 4. Limited Estate ^ 4a. Future Interest Compromise ~, (for dates of death aher 12-12-82) ~) a. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust (Attach copy of Will} (Attach copy of Trust) William S. Daniels, EsgJ 717 1 243-3831 FOR DATES OF DEATH AFTER 12/31191 CHECK HERE IF A SPOUSAL POVERTY CREDIT IS CLAIMED ^ FILE NUMBER 21 95 0054 COUNTY CODE YEAR NUMBER 4 Todd Circle, Apt. D Carlisle, PA 17013 Cumberland r ^ 3. Remainder Return (for dates of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes Suite 205, One West High St. Carlisle, PA 17013 z 0 ~- a v z 0 o_ f 0 U a 1, Real Estate (Schedule A) ....-:_. _ °~ (1 } ~ -._. 2. Stocks and Bonds (Schedule B) ` _ 2 1 9 1,? 6 4 8 5 s.: ( ) - 3. Closely Held Stock/Partnership Interest (Schedule C) (3 ) 4. Mortgages and Notes Receivable (Schedule D) (4) _--~ ~;-°-~ 5. Cash, Bank Deposits 8. Miscellaneous Personal Property (5 )362, 885.5 (Schedule E) - 6. Jointly Owned Property (Schedule F) ,,,,,.~.,._,,:n...,..,,,. b 42 + 619.94 '' 7. Transfers (Schedule G) (Schedule L) (7) . Total Gross Assets (total Lines 1-7) - -'""' ~ ,%°-~-~~-• _ 9. Funeral Expenses, Administrative Cosis, Miscellaneous (9) \ 53 , 398.90 '°' Expenses (Schedule H) _~_._.. 10. Debts, Mortgage Liabilities, Liens (Schedule I) (lo) 3.350.56 11. Total Deductions (total lines 9 & 10) 12. Net Value of Estate (Line B minus Line 11) 13. Charitable and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8 - _ -S~Fi", 77;1. 36 56,749.46 (t2) _ 540, 020 . ~Q_ (13) _ 5, 000.00 .--°" 1141 535020", 9p 15. Spousal Transfers (for dates of death after b-30-94) See Instructions for Applicable Percenta e on Re 15 g verse ( ) Side. (Include values from Schedule K or Schedule M ) x.-= . 16. Amount of Line 14 taxable at b% rate (16) (Include values from Schedule K or Schedule M.) x .Ob 17. Amount of Line 14 taxable at 15% rote (17) 535.020.90 (Include values from Schedule K or Schedule M.) x .ts 80, 253 . l'4 18. Principal tax due (Add tax from Lines 15, 16 and 17.) (18) 8 6 , 2 53 .14 19. Credits Spousal Poverty Credit Prior Payments Discount Interest 78, 778+3, 947. 7 _ (t9) _ 82, 674 i35 20. If Line 1 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20) 2 , 421.71 21. If ~~ Lie is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) A. Enter the interest on the balance due on Line 21A. (21A) B. Enter the total of Line 21 and 21A on Line 21B. This is the BALANCE DUE. (21B) Make Cheek Payable to: Register of Willsr Agent Under penalties of perjury, I declare that I it is true, correct and complete. I declare the based on all informs ion of which preparer SIGNAT OF P 5 ES*ONSIBLE FOR FI f SIGNATURE OF PREPARER OTHER T REPRESE William S. Daniels ~„~ad ~hra rororn, mcluamg accompanying schedules and statements, and to the best of my knowledge and belief, estate has been reported at true market value. Declaration of preparer other than the personal representative is nowledge. ADDRESS ~ t /Z- DATE ~yI ADDRESS Ste. 205, 1 W. High St.Carlisle, PA 17013 ' Act #48 of 1994 provides for the reduction of tk~ tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by `the statute will be: • 3% (.03) will be cpplicable for estates of decedents dying on or after 7/1/94 and before 1./1/96 • 2% (;02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 1% (.O1) will be applicable fot-e~tates of decedents dying on or after 1/.1/97 and before 1/1/98 • Spousal transfers occurring on or after l/1/98: will be exempt from inheritance tax. PLEASE:ANSWER THE FOLLOWING.QUESTIONS -- BY PLACING'A CHECK MARK {~) IN THE APPROPRIATE BLOCKS: Did decedent make a transfer and: - - .- ~ - . a. retain the use or income of the property transferred, .......... -- b. retain the right to designate who.. shall use the property transferred or its income, .::............ c. retain a reversionary interest; or .............................:.......:. d. receive the promise-for life of either payments,-benefits or care$ ...:........,... 2. If death occurred on or before December .12, .1982, did .decedent: within two' years. preceding death transfer property without receiving adequate .consideration$ If death :occurred:: after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration$ .............: 3. Did decedent own an 'intrust for' bank"account athis or her death..:......... IF THE ANSWER"TO` ANY OF~~THE ABOVE QUESTIONS 1S YES, YOU MUST COMPiETE:;SCHED.ULE,`G AND:.FL~E:-JT, AS .PART OF THE RETURN: ~tt~~ ~i11 ~crc~ C~TP~t~zrrcPrt~ I, OLIVE L. MYERS, of the Borough of Carlisle, Cumklerland County, Pennsylvania, declare this to be my last will and revoke all wills and codicils which I have previously made. I. I direct my executrix hereinafter named to pay all of m just debts, funeral and administrative expenses and all estate, transfer, inheritance and succession taxes whether payable by reason of property passing under this will of otherwise, as soon after my decease as may be convenient. II. I give and bequeath the sum of Five Thousand and no/100 ($5,000.00) Dollars to the Dickinson Presbyterian Church of Cumminstown, Pennsylvania, (12 Church Road, Carlisle, Pennsylvania 17013) to be used as the Board of Trustees may determine. III. I give and bequeath to my niece, MARY LEE BIIRY, the sum of Five Thousand and no/100 ($5,000.00) Dollars; to my niece, E. JEAN BIXLER, the sum of Five Thousand and no/100 ($5,000.00) Dollars; to my nephew, JOHN R. BIXLER, JR., the sum of Five Thousand and no/100 ($5,000.00) Dollars; to my nephew, HOLBERT G. ' MYERS, the sum of Five Thousand and no/100 ($5,000.00) Dollars; and to PATRICIA SNORE, the sum of Five Thou sand and no/100 (55,000.00) Dollars, in appreciation of her many kindnesses to me. I~• I give and bequeath to my sister, DOROTHY E. MYERS, such articles of tangible personal property having sentimental, family or heirloom significance. V. I give and bequeath the residue of my estate as follows: 1. 33 1/3$ to my sister, DOROTHY E. MYERS; 2. 33 1/3$ to my sister, ELVA M. BIXLER, and if she shall predecease me, then in equal shares to her two children, JOHN R. BIXLER, JR. and E. JEAN BIXLER; 3. 33 1/3~ to my nephew, HOLBERT G. MYERS, if living, and if deceased, in equal shares to his two children, A. KYLE MYERS and ALLISON E. MYERS. If the beneficiary or beneficiaries of any of the foregoing share or shares shall have predeceased me, said legacy shall lapse and be added to the share or shares of the beneficiaries living at the time of my death. VI. I appoint my sister, DOROTHY E. MYERS., as Executrix of this my last will, and if for any reason she shall fail to qualify or cease to act as such during the administration of my estate, I appoint my nephew, HOLBERT G. MYERS, as substituted Executor of this my last will. Should both my sister, DOROTHY E. MYERS, and my nephew, HOLBERT G. MYERS, fail to qualify or cease to act as executors, I appoint WILLIAM~S. DANIELS as Executor of this my last will. VII. I direct that neither my executrix nor her successors shall be required to give bond for the faithful performance of ~: '~ their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~~~, day of 1991. OLIVE L. MYERS The preceding instrument, consisting of this and two other typewritten pages identified by the signature of the testatrix, OLIVE L. MYERS, was on the day and date thereof signed, published and declared by OLIVE L. MYERS, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other have subscribed our ames as witnesses hereto. C~~2~~~j-~ cam,.-~_ i _ C ~ ` `~ ~, r _ ~ o D ~- ,~ ~j REV-1503 EX+ (4-86) r COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS AND BONDS MYERS, OLIVE L. (All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.) ITEM NUMBER DESCRIPTION r. AT&T, 288 shs 2. Bell Atlantic, 760 shs 3. Consolidated Edison, 10"shs 4 • ~"~e`S"~`a"i:cs- Financial Corp. , 24.0 shs 5 • ~SJC~`~~Cl,~~,s:" E Commo 24 shs •- 6 . r ? G ~ shs _~ ~.~` - ~57~<Y~~f'-.. 7 . F ~T_, ..~~r'~~1? r 52 8 shs 8. Gr1, 400 shs :9. GM Hughes, 6 shs 10. :Kimberly Clark, 176-shs- 11. Nnr~oik.-Southern, 1.80 shs 12. Y~"-~n~. Mimic., 35 shs ~ 982.67 13 . PA ~~~'~.~ -Mun=c . , 15 shs ~ 998 .93 14. _ PP&L, 400 s, 15. Series, H", $50D0_2/77 16. Se~~' s~,.~ $5y00"-:6/78 18. Series E, 1000 2/77 FILE NUMBER 2195-0054 TOTAL Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of same size.) VALUE AT DATE OF DEATH 13,917.60 37,145.00 265.00 6,300.00 924.00 15,925.80 18,348.00 16,800.00 207.75 8,668.00 11,295.00 24,566.75 14,983.95 7,900.00 5,000.00 5,000.00 1,110.40 2,907.60 $ 19~, 264.85 REV~1500 EX + (2-87) COMMONWEALTH OP PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 'SCHEbULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY MYERS, OLIVE L. Please Print or T 2195-0054 (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F) ITEM DESCRIPTION VALUE AT NUMBER DATE OF DEATH 1. Cash in pocketbook 199.19 2. Cash at home 500.00 3. Cash in safe deposit box 140.00 Farmers Trust Company 4. C A # 6-64804 6,429.51 5. CD # 73331 20,042.74 6. CD # 94565 83,798.96 7. CD # 103771 12,589.30 8. CD # 104958 3,001.75 PNC Bank 9. C A # 5140188853 3,820.97 Meridian Bank 10. S/A # 8338119101 - 6,406.68 11. CD # 4000992158 4,941.83 12. CD # 4001973652 26,475.44 Mellon Bank 13. MM # 1800706127 33,272.25 14. CA # 1326626234 5,410.81 15. IC``#-00016907 SQ,094'.60 16 . CD # 18.~~'8-707 51 , 000:00 17 . CD # l°8A63f 39 5O, OOfl-. 00 18. Belvedere Medical Corp., refund 67.77 19. United Security Assurance, refund 402.84 20. Coin collection, by appraisal 473.00 21. Tangible personal property/HHE, by appraisal 1,935.00 22. Jewelry, by appraisal 1,290.00 23. Sarah Todd Home, maintenance fund refun¢~ 9.00 24. Thompson Eye Assoc., refund ~ 9.00 25. Carlisle Imaging Assoc., refund 11.69 26. Professional Ins. Svcs., Inc. Refund Medicare Supp. 414.05 Refund. PA Blue Shield 101.84 27. RWC refund 16.80 28. AARP Group Health refund 2.00 29. Thompson Eye Assoc., refund 28.55 TOTAL (Also enter on line 5, Recapitulation) I $ 362 ,f885 . 57 (Attach additional 815" x 11" sheets if more space is neoded.) REV-1509 E%+ r14.8BI COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MYERS, OLIVE L. Joint tenant(s): NAME A. Dorothy E. Myers B. C. ADDRESS Todd Home, Apt. D Carlisle, PA .17013 °ILE N~IMBER 2195-0054 RELATIONSHIP TO DECEDENT sister _~ / -7 /b Jointly -owned pro perty: LETTER NUMBE JOINT MADE JOINT DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF TENANT OF ASSET 96 INT. DECEDENT'S INTEREST ~ • Money Market Acct. 37,747.27 1/2 18 873.64 2• Certificate of Deposit 12,000.00 1/2 , 6 000.00 3 • Tangible personal- proper , 4 (by appraisal) - 2,795.00 1/2 1,.397.50 • 5 Sarah Todd Apt. 23,385.00 1/2 11,692.50 • Savings Bonds r~, - rG,~ ~~- (Series E,, 1000 .X 2.-~, ~ 44 Series E', 500 X 1 ~ ~~1 . Series HH, 1000 X 2 }~•~ 9, 312 .60 ', 1/2 4, 656 .30 ~~ . (!f more space is needed insert. additional sheets of same size) SCHEDULE F JOINTLY-OWNED PROPERTY TOTAL (Also enter on line 6; Recapitulation) I $ 4 2 , 19 , 94 REV-1511 EX+ (7.881 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT OF MYERS, OLIVE L. SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or FILE NUMBER ~ 2195-0054 ITEM NUMBER DESCRIPTION ~-• Funeral. Expenses: ~• Hoffman~Roth Funeral Home 2. Georges Flowers, floral arrangements AMOUNT 7, 321 .00'` 169.60 .> B• 1 Administrative Costs: 1• Personal Representative Commissions Holbert G . Myer s_ _ Social Security Number of Personal Representative: 231 62 1789 20, 879.00 f Year Commissions paid 2. Attorney Fees Humer & Daniels 21, 629 . 00 / 3. Family Exemption Claimant _Dnrnthy F Myers Relationship Sister 2, 000.00 ~^"" Address of Claimant at decedent's death Street Address 4 Tndc~ i t 1 P Apt D Ciry r a r 1 i s 1 P State PA Zip Code 17 013 4. Probate Fees Register of Wills, Cumberland Coufity 286.00.- C• Miscellaneous Expenses: I• Cumberland Law. Journal, Adv. Ltrs. Testamentary 40.00° 2. The Sentinel, Adv. Ltrs. Testamentary 72.20 3. Register, Short Certs. (30) 90.00 4. Gerald Lackey, coins appraisal 15.00' 5. W.H. Newbold's Son, securities transfer fees 210.00- b. Register of wills, filing inventory & inh. tax return 25.OOr 7. Register of Wills, additional probate fee 140.00" 8. Reserve for settling estate 350.00 continued on pg 2 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additioncl sheets of same size.) Continuation of Schedule H, Page 2 MYERS, OLIVE L. 2195-0054 9. Mountz Jewelers, appraisal $ 53.00 10. Robert T. Rowe, appraisal personalty 75.00 11. FTC, safe deposit box rental 26.10 12. Hoffman-Roth, death certificates (6) 18.00 Total $53,; 98.90 i~ 5 REV~1512 EX ~ (10.86 COMMONWEALTH OF PEN NSYWANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MYERS, OLIVE L. E NUMBER 2195-0054 ITEM NUMBER DESCRIPTION AMOUNT 1• 2. 3. 4. 5. 6. 7. 8. 9. 10. Belvedere Medical Cor p. ,deductible Professional Insurance Services Co., premium Jeffrey S. Cohick & Assoc., tax preparation Edward V. Dailey, tax preparation IRS, personal income tax PA Dept, Revenue, personal income tax IRS, personal `income tax 1994 PA Dept. Revenue, 1994 tax Dickinson Presbyterian Church, annual pledge Dickinson Presbyterian Church, bldg. fund pledge 100.00 441.00 43.50 200.00 39.78 7.28 352.00 197.00 1,250.00 720.00 SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABLITIES AND LIENS TOTAL (Also enter on line 10, Recapitulation) $ 3, 3 0 56 (/f more spots is needed insert additional sheets of some size) E ' REV-113 EX+ (8.86) v e, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE "' ITEM NUMBER 2. 3. 4. 5. 6. 7. SCHEDULE J BENEFICIARIES MYERS, OLIVE L. NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: Mary Lee Bury 213 Madison Ave. Hamilton, VA 22068 E. Jean Bixler Box 45 Boiling Springs, PA 17007 John K. Bixler, Jr. * 210 Park Dr. Boiling Springs, PA 17007 Holbert G. Myers ~~~~ 1804 Walnut Bottom Rd. ~ ~ '~ Newville,.PA 17241 Patricia Snoke 485 Farm Rd. Newville, PA 17241 Dorothy E. Myers 4 Todd Circle, Apt. D Carlisle, PA 17013 Elva M. Bixler (Deceased 6/28/94, survived by two issue *) FILE NUMBER 2195-0054 RELATIQNSHIP niece niece nephew nephew sister sister ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: I• Dickinson Presbyterian Church of Cumminstown, PA 12 Church Road, Carlisle, PA 17013 TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) (If more space I: needod, insert additional sheets of same size) AMOUNT OR SHARE OF ESTATE 5,000.00 5,000.00 and 1/6 residue 5,000.00 and 1/6 residue 5,000.00 and 1/3 residue 5,000.00 personalty and 1/3 residue (1/3 residue) AMOUNT OR SHARE OF ESTATE 5 , 000.00,,.-•'" S 5, OQr6.00 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '"':('(",n"\::T' n~[~~' [""ITANCE TAX "",,,1 '1, )1'""'.. )' .\-,J \J. ,.L.NnCK. '[':I~:~~"c~::~ ~A"EMENT OF ACCOUNT \ ~;t\.....~:u' -...... j...}' '! 1'~ .-..~~ *' REV-1607 EX AFP (03-05) ZOOn OCT - 2 pf'\ \2.: 34 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-18-2006 MYERS 01-11-1995 21 95-0054 CUMBERLAND 101 Amount R_i Ued OLIVE L WILLIAM S DANIELS STE 205 1 W HIGH ST CARLISLE CI ERK OF ORPHAN'S COURT EslCUMtEPL,".~:D CO. PA PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 NOTE: To insure proper credit to your eccountl subIIlt the upper portion of this for. with your tex payllent. CUT ALONG THIS LINE -------------------------------------------------.-------------------------- --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF MYERS OLIVE L FILE NO. 21 95-0054 ACN 101 DATE 09-18-2006 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE MAttED ESTATE. SHOWN BELOW IS A SUlltARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAY"ENTSI THE CURRENT BALANCE I ANDI IF APPLICABLE I A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-10-1996 PRINCIPAL TAX DUE: 801253.14 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-07-1995 AA023017 31947.37 751000.00 05-12-1995 AA047756 .00 900.00 05-12-1995 AA047757 .00 21827.48 TOTAL TAX CREDIT 821674.85 BALANCE OF TAX DUE 21421.71CR INTEREST AND PEN. .00 . IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE 21421.71CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PA~ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIr' (CRll YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FO~ FOR INSTRUCTIONS. l ci