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Home My WebLink About02-28-08 , Deceased d\ t.o Cia\'! Social Security Number File Number also kno\\n :j, Petltioner(s). \\ hl> is/em: ! S yecus of age or older, apply(ies) for: (Co.HPLETf: ',J' or 'f]' BEUJIJ:) ~\. I'rubat" :ll1d (;l ~Ilt of Letters :Testamentary and aver that Petitioner(s) is I are the AecOf"70R.J be;; Will ')jtb.:' Dccden\ dated IWl/t!f1f:R1L I{,. ';'oof and codicil(s) dated / named in the (State relevant circulI/stallces. e.g.. rellullciation. death of executor. etc.) Except as tallows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for pl'obate. was not the victim of a killing and was never adjudicated an incapacitated person: D B. Grant of Letters of Administration (1/ applicable. ellter: c.t.a.; d.b.l1.c.t.a.; pelldellte lite; durallte abselltia; durallte milloritate) Pcwioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following'~9\!.se (if anypt}d heirs: (If Administratio/l. c.t.a. or d.b./l.c.t.a. enter date of Will in Section A above and complete list of heirs.) '. , c Name Relationship R'''d~~ ~ :.,> r' '-- . Decedent, then 90 years of age, died on fa. ~ ;J.O':?'i? at Decedent at death owned property with estimated values as follows: (lf domiciled in P A) All personal property (lfnot domiciled in PAl Per: ,mal property in Pennsylvania (If not domiciled in PAl Personal property in County Value of real estate in Pennsylvania $ '130i 00 () ./ $ $. $ 7f;0t10 situated as follows: Whererore, Peltltoner(s) "cspectfll\\Y reqllest(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate fOl"l11 [,' the undersigned: Typed or printed name and residence l)oSd f~ J lOt Fur", R W-!J2 !e! 10 /3 r)G Page I of 2 Oath of Personal Representative COiVIMONWEAL TH OF PENNSYLVANIA SS COUNTY OF The Petitioner(s) above-named swear(s) or affim1(s) that the statements in the foregoing Petition are tme and con'ect 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 tmly administer the estate according to law. Sworn to or affirmed and subscribed before me the d 7 day of Signature of Personal Representative (-_..:: File Number: ~ \ tJ~ tall Estate of CJ-'Cd \e <:.., L S (\. ~)~ -€., r , Decea$~d ~::.; Social S:curity Number: \ )., ~ate of Death: ~ \ c, I u; " AND Now,1 e_\:)(LJ,CUL\ '~1:) ,~tot), iI:_~1sidefation of the \orego3ng petitwtl; satisfac~~ proof having been presented before m~, IT IS ?ECREE~ th~t Letter~ ,,- \ (<-S,:tlr'\'(-::::.r)~\ "-")'" ---.., ~:-, are hereby granted to r \ "(U \L~ ~'--' ~C0...0 '-~\ e.,\ 0 (\ c\. leu '( ~~\c;'-'-~ Q r \ , in the above estate and that the mstrument(s) dated \ \ \ \ la ~ G~ desCrIbed in the PetltlOn be admItted to probate and filbd of record' as the last Will (and Codlcil(s)) of Decedent. en" J1h~ ~~~~{-wb'L'1 ~~cd,,(' ';r.y; (X;:- uGO ReglsterofWtlls ~ Lettel s .,., ~ . , '/' , JV, 5) I Short Certificate(s) . .l.'::;>~ . . . $ (00 Renunciation(s) .'..',.... 5) tJ ill $ ~~L P $ 1Av... -k) $ $ $ $ $ $ $ . 0<' $ ~ 5")0 ' Attomey Signature: 15 ]0 Attomey Name: Supreme Court I.D. No.: 5- Address: Telephone: TOTAL ".....' Fo,.,,, RW.()] rev /0.13.06 Page2of2 !i j~ I, \ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certi Ilcate. "6.00 ~,,""m'//?~ /,,"t'~\.\ \\ OF fil;;---- ;l~" /~-...!!4'.l.--- ~;\\ ~y ..!ilIa... ... ". ::?. \~ '.~~;MI "J!i"'~.. .~- I~::!i/ c_ ~ ' \~i i~ ~\ 'j~~-" ,;h,~1 .... ','. "f' \\~\ ..~.~.'.' ..j:::/ '~~~ /'$>/ ~----~__'/lIMENT i\~ ~~",I" ............... U JI'" ~"/nIn/~ P 14121850 Certification Number This is to certify that the information here given IS correctly copied from an original Certificatc of Death duly filed with me as Local Registrar. The original certificate will be forwarded to The State Vital Records Office lor permanent filing. C~ lJ{ ~- ~ 1 Z fil08 Local RegisTrar DaTe Issued ., , , I 'c..' <:0 y~;;, r . ...._" I REV 1112006 I PRINT IN \.1ANENT .CK INK COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE NUMBER ~ \ C~~ 6L~\1 1. Name of Decedent (First, middle, last, suffix) 6. Dale or Birtn (Month, day, year) 90 9, 1917 West Fairview,P y" Jul. 8b. County 01 Dealh 8d. Facilily Name (If not institution, give street and number) Cumberland Camp Hill Manor Care 11. Decedent's Usual Occu oon Kind of work dOlle duri most of worl<in life. Do not state retired KindolWorl< Kind 01 Business/Industry mechanic elevator CO. 13. Decedent's EducatiOl'1 (Specify only highest grade compieted) Elenr2ry / Secondary (O.12) College (1.4 or 5+) . 16. Decedent's Mailing Adoress (Street, city / town, state, zip code) Pennsylvania Cumberland 122 Front St. rview PA 17025 18. Father's Name {First, middlll,last, suffix) Lester Saw er 17a.State 17b. County 4 Date of Death (Month, day, year) - 07 -9892 Feb.9 2008 Other o Inpatient 0 ER / Outpatient 0 DOA NurSing Home 0 ReSidence 0 Other. Specify 9. Was Decedentot Hispanic Origin? ~NO 0 Yes 10 Race: AmerlCar'llndian, Black, While, ete (If yes, Specify Cuban, J SPvci!Yl Mexican, Puerto Rican, etc,) W hIt e 14. Marital Status: Married. Never Married, Widowed, Divorced (Specify) widowed Twp Did Decedent live in a Township? 17c.D Yes, Decedent Lived in 17d]8.~~iu~m~~~lo7iV"'W1~in Wes t Fa i rvi ew Cityl Born 19 Mother's Name (Firsl, middle, maiden sumamel Rachel Ensor 20a. Informant's Name (Type I Print) Charley W. Sawyer j 0 Cremation 0 Donation 21b. Date 01 Disposition (Month, day, year} i Was Crernallon or Don.lIonAuthorlzed D D Feb. 15 , 2008 : by Medical Examiner f Coroner? Yes No 20b. Informant's Mailing Address (Street, city f town, state, Zip code) 195 College Hill Rd., Enola, PA 17025 21d Location (City I town, state, zip code) Camp hill, PA 17011 22c, Name and Address of Facility 21c. Place of Disposition (Name ot cemetery, crematory or other place) Rolling Green Cemetery L Musselman FH&CS,324 " mjel j) ~[.G fLJ 2~'~bunc'" De~(~U~D[, 7) CAUSE OF DEATH (See Instructions and examples) Item 27. Part I: Enter Ihe ~~ - diseases, injuries, 01" complications - that directty causaathe death. 00 NOT enter terminal events such as cardiac arrest, respiratory arrest, 01" ventricular fibrillation without showing the etiology. List only one cause on eacn tine. Items 24.26 must be completed by person - who pronounces death. Approximate interval: Onsel to Death =Th~~~nt~~ ~~~~~~ N\e:t-vts:.h,Ji c CA nce..,r Due to (or\~s a consequence 00: I . b. LAli\ F-f'\aI,.,M PI; W""-!3L -;v{ M"" Due to (or as a consequence 00: ( ( d.C\.y =uen~~:=d:=.~:~ a Enle~ UNDERLYING CAUSE (disease or lritJIY that Initiated It'e events resulting In death) LAST. Due to {or as a consequence 00' d. 3Oa, Was an Autopsy Performed? 3Ob. Were Autopsy Findings Available Prior to Complehon c~ Cause 01 Death? 31. Manner 01 Death ~jUral 0 Homicide o Accidenl 0 Pending Investigation o Suicide 0 Could Not be Determined M Dvos ~ Dyos DNo 32d. Time of Injury 333, CertnieJ (check only one) certifying physician IPhysician certifying cause of death wilen another physician has pronounced death and completed Item 23) To the best of my knowledge, death occurred due to Ihecause(s) and manner as stated.. _ _ _ _ _... _ _ _ _ _ _ _ _ _ _...... _... _............ _ _ _ _......... 0 ;::u:~~fa~ ~=~~J::~~~a~~u~:: ~~~i~~~;n~~~a:rt~:iot~c::~~~~aa~~ manner as slsted.. _ _ _ ...... ...... _ ... _ _ _ _... _... _ 0 ~:~;~~~~~;~r:t: and I Of investigation, In my opinion, death occurred at the time, date, and place, and due to the causa(s) and manner 8S staled.., 0 35, Registrar' ~ 1 ~ /1 0l,1 / 1 ;' I Dispositl" P"mil No. () 0 <1 tt 0 3 a.. Hummel Ave.,Lernoyne,PA17043 23b. License Number R.iJ 5 10 ( CJ- ?- L- 26. Was Case Referred 10 Medical Examiner I Coroner for a Reason Other than Cremation or Donation? Dyes '~o 23c. Date Signed (Month, day, year) FEG, q) <:)[)05 Part II: Enter other sianiflCanl conditions contribulino to death, but not resulting in the underlying cause given in Part I. 28. Did Tobacco Use Contribute 10 Death? DYes DProbably o No~nknown 29. !l Female o Not pregnant within past year o Pregnant at hma of death o Not pregnant, but pregnant wilhin 42 days of death o Not pregnant, bul pregnant 43 days to 1 year before death o Unknown if pregnant within the past year 32c. Place of I.niury: Home, Farm, Street, Factory. Office BUIlding, etc. (Specify) r;. i Lv. rf' +v -fhri Ve. >01Cv"a.e ch.CiA b,-+//l " (~ , 01":"11\<1(1 AY-fe.'1.( dAlt>.-:x (:.f" 329. location of Injury (Street, city I town. state) fhYIICfC1'l 33d Date Signed (Month, day, year) .'!, 2../(2. ~/()g 34, Name and Addrass of Person Wlio Completed Cause of Death (Item 27) Type I Print Ckri.sb~ ~("che~ Do /3::>c) MarW,S't; , I 'I V LAST WILL AND TEST AMENT (Pour-Over Will) OF CHARLES E. SAWYER 'j i, IDENTITY I, CHARLES E. SAWYER, residing in the County of Cumberland, Commonwealth of Pennsylvania, being of sound mind and memory, and not acting under duress or undue influence of any person whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby revoke all other former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 197-07- 9892. I have the following children: Charley W. Sawyer, born September 21, 1942, and Larry L. Sawyer, born December 10, 1947. DEBTS, TAXES AND ADMINISTRATION EXPENSES I have provided for the payment of all my debts, expenses of administration of property wherever situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other than any tax on a generation-skipping transfer that is not a liability of my Estate (including interest and penalties, if any) that become due by reason of my death, under THE CHARLES E. SAWYER REVOCABLE LIVING TRUST executed on even date herewith (the "Revocable Trust"). If the Revocable Trust assets should be insufficient for these purposes, my Executor shall pay any unpaid items from the residue of my Estate passing under this Will, without any apportionment or reimbursement. In the alternative, my Executor may demand in a writing addressed to the Trustee of the Trust an amount necessary to pay all or part of these items, plus claims, pecuniary legacies, and family allowances by court order. PERSONAL AND HOUSEHOLD EFFECTS It is my intent that all my personal and household effects were transferred to the Revocable Trust as a result ofthe Declaration of Intent signed this date. If there are any questions regarding the ownership or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me this date in accordance with the provisions ofthe section titled "Residue of Estate." RESIDUE OF ESTATE I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description (including lapsed legacies and devices), wherever situated and whether acquired before or after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the corpus of the above described Trust and shall hold, administer and distribute said property in accordance with the provisions of the said Trust, including any amendments thereto made before my death. POUR-OVER WILL Page 1 IL1/ ./ Testator If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under said Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the residue and remainder thereof to that person who would have been the Trustee under the Trust, as Trustee, and to their substitutes and successors under the Trust, described herein above, to be held, managed, invested, reinvested and distributed by the Trustee upon the terms and conditions pertaining to the period beginning with the date of my death as are constituted in the Trust as at present constituted giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such Trust by reference into this my Will. EXECUTOR I hereby nominate and appoint Charley W. Sawyer and Larry L. Sawyer to serve without bond as my Joint Executors. In the event that one of the Joint Executors shall predecease me, or is unable or unwilling to act as my Executor for any reason whatsoever, then and in the event I hereby nominate and appoint the remaining Executor to serve without bond as my Independent Executor. Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this my Will, such words and respective pronouns shall be held and taken to include both the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Executor named herein and to any successor to substitute Executor acting hereunder, and such successor or substitute Executor shall possess all the rights, powers, duties, authority, and responsibility conferred upon the Executor originally named herein. EXECUTOR POWERS By way of Illustration and not of limitation and in addition to any inherent, implied or statutory powers granted to executors generally, my Executor is specifically authorized and empowered with respect to any property, real or personal, at any time held under any provision of this my Will: to allot, allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract with respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold, :improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect to, take possession of, pledge, receive, release, repair, sell, sue for, make distributions in cash or in kind of partly in each without regard to the income tax basis of such asset and in general, exercise all of the powers in the management of my Estate which any individual could exercise in the management of similar property owned in its own right upon such terms and conditions as to my Executor may seem best, and execute and deliver any and all instruments and do all acts which my Executor may deem proper or n.ecessary to carry out the purpose of this my Will, without being limited in any way by the specific grants or power made, and without the necessity of a court order. My Executor shall have absolute discretion, but shall not be required, to make adjustments in the rights of any Beneficiaries, or among the principal and income accounts to compensate for the consequences of any tax decision or election, or of any investment or administrative decision, that my executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the POUR-OVER WILL Page 2 CJJ} Testator allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as Federal Income Tax deductions. CONTESTS AND SPECIFIC OMISSIONS If any beneficiary under this will, singly or in conjunction with any other person or persons, directly or indirectly: 1. contests in any court the validity of this will or, in any manner, attacks or seeks to impair or invalidate any of its provisions; 2. contests in any court the validity of the Testator's/Testatrix's Will or, in any manner, attacks or seeks to impair or invalidate any of its provisions; 3. seeks to obtain an adjudication in any proceeding in any court that this trust or any of its provisions or that Testator's/Testatrix's Will or any of its provisions is void; 4. claims entitlement by way of any written or oral contract to any portion of the Testator's/Testatrix's estate, whether in probate or under this instrument; 5. unsuccessfully challenges the appointment of any person named as Executor or successor Executor ofthe Testator's/Testatrix's Will; 6. objects in any manner to any action taken or proposed to be taken in good faith by the Executor of the Testator' s/Testatrix' s Will; 7. objects to any construction or interpretation of this Will, or any provision of it, that is adopted or is proposed in good faith by the Executor; 8. unsuccessfully seeks the removal of any person acting as the Executor of the Testator'slTestatrix's Will; 9. files any creditor's claim in Testator's/Testatrix's estate (without regard to its validity), whether the claim arose before or after the date of this instrument, but excepting claims for cash advanced or paid for expenses of the Testator's/Testatrix's last illness or funeral paid by said claimant; 10. attacks or seeks to invalidate any designation of beneficiaries for any life insurance policy on Testator's/Testatrix's life; 11. attacks or seeks to invalidate any designation of beneficiaries for any pension or IRA or other form of qualified or non-qualified asset or deferred compensation account, agreement or arrangement; 12. attacks or seeks to invalidate any will which Testator/Testatrix has created or may create during Testator's/Testatrix's lifetime, or any provision thereof, as well as any gift which Testator/Testatrix has made or will made during Testator's/Testatrix's lifetime, whether before or after the date of this instrument; 13. attacks or seeks to invalidate any transaction by which Testator/Testatrix sold any assets (whether to a relative of Testator's/Testatrix's or otherwise); or 14. refuses a request of Testator's/Testatrix's, Executor or other fiduciary to assist in the defense against any of the foregoing acts or proceedings, then that person's right to take any interest given to him or her by this trust shall be determined as it would have been determined if the person had predeceased the execution of this will instrument without issue survlvmg. The provisions of the foregoing paragraph shall not apply to any disclaimer by any person of any benefit under this will. In the event that any of this provision is held to be invalid, void or illegal, the same shall POUR-OVER WILL Page 3 CtV Testator be deemed severable from the remainder of this provision and shall in no way affect, impair or invalidate any other provision in this will; and if such provision shall be deemed invalid due to its scope or breadth, such provision shall be deemed to exist to the extent of the scope or breadth permitted by law. SIMULTANEOUS DEATH If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively presumed for the purpose of this my Will that said Beneficiary predeceased me. ~' ~ I /-' /-t'vJ!f;pc' . /<7.02/ CHARLES E. SAWYER Testator This instrument consists of 6 typewritten pages, including the Attestation Clause, Self-Provjpg Clause, signature of Witnesses, and acknowledgment of officer. I have signed my name at the by!i6ti( of each of th~rece~~es. This instrument is being signed by me on this ~ day of ')/(/ j~ " J-#/ . , r POUR-OVER WILL Page 4 ATTESTATION CLAUSE The Testator whose name appears above declared to us, the undersigned, that the foregoing instrument was hislher Last Will and Testament, and he or she requested us to act as witnesses to such instrument and to hislher signature thereon. The Testator thereupon signed such instrument in our presence. At the Testator's request, the undersigned then subscribed our names to the instrument in our own handwriting in the presence of the Testator. The undersigned hereby declare, in the presence of each of us, that we believe the Testator to be of sound and disposing mind and memory. Signed by us on the same day and year as this Last Will and Testament was signed by the Testator. WITNESSES: ADDRESSES: #~~~ / d. (; ;::: f--e tJ T _'S~r t?lJ1.R){ C, ST6uJ/JR'T (Printed Name of Witness) WR.<; -r f:: CL i;- VI:e ~ p /I City, State, Zip ~~y~ ,L / tJ dcA-if S I- e. t<../ 0.. I--' f- (Printed Name of Witness) II II City, State, Zip POUR-OVER WILL Page 5 (:Jd/ Testator COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SELF-PROVING CLAUSE BEFQRE ME, the ~~d~.thority, on this qay Bersonally zed CHARLES E. SAWYER, .tI1 iN~ 0<. err and A/rJ)/I /it . ~ A ,-jf1t7{ , known to me to be the Testator and the witnesses, respectively, whose names are subscribed to the foregoing instrument in their respective capacities, and all of them being by me duly sworn, CHARLES E. SAWYER, Testator, declared to me and to the witnesses, in my presence, that the instrument is hislher Will and that he or she had willingly made and executed it as hislher free act and deed for the purposes therein expressed; and the Witnesses, each on his or her oath, stated to me in the presence and hearing of the Testator, that the Testator had declared to them that the instrument is his Will and that he or she executed the same as such and wanted each of them to sign it as a witness; and upon their oaths, each witness stated further that he or she did the same as a witness in the presence of the Testator, and at his request and that he or she was at that time eighteen (18) years of age or over and was of sound mind, and that each of the witnesses was then at least fourteen (14) years of age. &K' () ~ () ? adf:.b c.~._ .'6-tU?]-e/L-- CHARLES E. SAWYER .. Testator j~L<;~ -- Withess /7/;9;(1: ~, S .teaJA-.eT (Printed Name of Witness) ~~~ W(tn ss /-/~d cA- M ~- f-e. ~c'- ;-+- (Printed Name of Witness) ~. ( ~ Notary1'>ublic, Commonwealth of Pennsylvania OF P-NNSYLVANIA COMMONWEALTH C NOTARIAL SEAL . TODD B. GARRY, Notary Public B c\<s County Newtown Boro., u 2008 'on Expires Mae J I.. POU - Page 6