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Home My WebLink About03-18-10 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Fee for this certificate, $6.00 P 16244524 This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. ocal Registrar Date Issued Certification Number I H105-t43 REY 1112006 TYPE / PRg4T IN PERMMIFJYT BLACK INK ~ ; 0 Z rv __.. .; _..__ ______ ___ ___-- ---_ _ __ _ _ _ _ ~= o ~ -~ ,'' ~ c-~ - ~ ` - ~ - - I~ ~ ~, -- ~ -; ~~ -. , = ~ =-= - _~ ~T w f-~-, , '~ C :~ ~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) „_..._ _.. _ ......___ i. Name d Decedent (First, midde, last, styfnt) Dr Sabra Calland 2. Sex 3. Sadal Secudy Number 4. Data d Death (Ma1h, day. Year) F l . ema e 420- 21- 2010 Februa 21, 2010 5. Age (Last tlirn,aay) tinder 1 Under 1 6. Data d Bill Month, 7. C' and stets a coon Be. Plea d Death Chaar ate Menea ~s Haxs Afnu~ 74 Yrs November 15,1935 Hospital: Other: Phoenix, Arizona ^ Inpetiary ^ ER /Outpatient ^ DOA Nursing Home ^ Residence ^ Other . $pecily: Bb. County a Death tic. City, Boro, Twp. of Death 8d Faatiy Name (M rat ltstittrtiart, give street end number) 9. Was Decedent a Hispanic Odgin? ~~ ^ Yea to. Race: American In6an, Black, WNte, etc. Dauphin Susquehanna Carolyn Croxton Slain Hospice Residenc ( ~~; ( „ .,~) White 11. Decedents llatxd Kind d wok d one moat d Ids. Do rat state 12 Was Deadery ever in the 13. Dscedera's Education (Spedly ony highest grade comp leted) 14. Marital Statue: Marled Never Married 15 Survivin S o use (If wile ive maid Kind d Wark Physician KltddBtgnecc/Industry Healthcare U.S. Amted Forces? ^ Yea ~~ Elementary I Secondary (412) Collage (1-4 a 5+) 5+ , , Wdosed, Divorced (SpeaYy) Widowed . g p , g en name) 16. Decedents Mailing Address (Street, city /town, state, zip coda) Decadence Did Decedent PA 511 West Main Street Acnr:v Residence t7a. sate Live in a 1?c. ^ Yea. Decedent Lined in Twp. Mechanicsbur PA 17055 9~ ,?b. ~Y Cumberland T°"~"p' 17d. No, DecadentLrvedwithin Mechanicsburg ~ ~~/~ aaualLini~a 18. Fatlter's Name (Fast, middle. last, suffix) Lewis Wetzler PHD 19. Matlter's Name (Fret, rtydde, maiden surnteme) Evelyn Miller 20a InformanCs Name (type /Print) 20b. Informant's Mailkg Address (sred, dly I awn, stets, zip code) Pippa S. Calland 511 West Main Street Mechanicsburg, PA 17055 21a. Method of DispasKbn i Cremation ^ Donation 21 b. Date d Disposition (Modh, day, Yom) 21 c. Place of Dispositon (Name d cemetery, crematory a other place) 21d. Location (City/tam, state, nP code) ^ Btmel ^ Removal born state r was Cramatlon a Donatlon Atdhordzed ^ otlter. t by Madleal Exrdnsr/corortar? Yes^ rlo Februa 23 2 ry 010 Conolite Crematory SchaefferStown, Pa. 17088 22a Signature d Funeral Service l.icensea la person achg as such) 22b. Lianss Ntxnbar 22c. Name and Address d Feciliy - FD-012662-L Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055 Complete items 23at oay wftert artilyirg phyaiden is cal availabb at time d death a d . T d my krawledge. death occurred al time, date and P~ ~ (Sigm aae ~) 23b. Number ~6 73/ 23c. Dale ' (M0n ~, Yom) da.~,. ~~ _ S ~ aZ0 ~o IMnts 24-26 must be oonpbted by Person who Pronounces death 24. a Death 25. Date P Dead ,day, 26. Was Case Referred Medical Examinar I Coroner for Reason than Cremation a Donation? . ~: p M. oZ ~. ~< ^ Yea Ne CAUSE OF DEATH (See Instruetd exa ) , Approximate imsrval: lam 27. Part I: Enter the -diseases, injuries, a cortpCcaOOns • that 6regly caused the tlt. DO NOT abler terminal suede such as car6ac arrest. ~ Onset o Death i n f Part II: Emer oftbr ' txy rat remytirr9 in yte underlying cause given in Part I. 28. Did Tobacco Use Cayri6ule to Daalh? ^ Yes ^ Probedy resp ratory areal a vant ayar ibritiation without shotwg the etiology. I~at any one ease m each fine. WMEDIATE CAUSE ((FvW disease a ~ t t ^ Unkrawn condition restyling in deaM) _~ a ~-~ --1 /~ e ~ ~ il.. ~ ((~ ~ ~,1,~ 1 29. g Female: P ~r Due to (a as a consegraxae ot): ~ ~ Yet oon6tiorts, 0 ant, b. ~ !Tl f" ~, `~ to wins fiseed on firx a. ~ " ~ ~ {~ r (r,.:4~,yc.~~'7 -~ 1 ot pregnant within past year ^ Pregnant at time d death Due to a as a Enbr UNDERLYNO CAUSE ( oor~gtaero• of): titat k n t d th (Qeease a aMta ~ ~ ? ~ o f ^ Nd pregnant, but pregnant widwn 42 days t a e i~-~ iw t X e e. evens reautiag m death) LAST. t ~ i t d death ^ Due o (a as a consequence d): t Na pregnant, Dut Pregnant 13 days to 1 year b b d. r t re death e ^ lkyvtoam d pregrtery wiClin rice past year 30e. Was an Atyopay Perlonrted? Sob. Were Aubpay Fvtdirgs Aveyable Prig a Campktim 31. blamer d Death 32a. DaU d Irtprny (MOnM, day. Year) 32b. Describe How Injury Ocarted 32c. Place d Injury: Home, Fenn, Street Factory, d Cause d DeaM? ~~ ^ Hornicfde Office Building. etc. (Specly) ^ Yea ~ No ^ Yes ~ ^ Acddem ^ Pendkg Inveatigauort 32d. Tine d Injury 32e. Injury at Work? 32t. M Treneportation Injury (Seedy) 32g. Location d nWY (Street, dry /town. state) ^ Suicide ^ Could Not be Determined M ^ Yea ^ No ^ Driver / Opereor ^ Passenger ^ Pedestrian Other' Specr?y 33a. Certifier (Gtedt orgy one) 33b. Signature Idle d CB ~ ~ • CartNydng phyekWt (Phyeidart artiyyg cause d death wl>on anolMr physktian has pronaaaed death and arnpbted Item 23) ',~i,, ~ ~ t TotMbastdmykrtowisdpa,dsaMoauredduetotMawa(Nrrdmrxrrasstand---------------- -----------------~ - ~ -- • PranouneNtp and cerUlykrp physklan (Physiaan both praatackg tlwth and artlylg b catty d death) To tlta best d my knowNdga, death oaurrod k the Ums, daN, and plea, and dw to Uta awys) and mrutx a sfautl_ _ _ _ _ _ _ _ _ license Ntxrber ` ' ~ `~ 33d. Date (Month, y, Year) • wdcatExamMr/c«aw O U b i d i d _ _ _ _ _ _ _ _ _ v tit~G ~ ~ ~ ~ L 7i Z~ C . n te as s axam na on and! a lrrvaalgalfon, In my opltbn, death occurred k tits 1Nrr, dale, and plea, and dw to Uts awe(s) and ranrrsr as sfatsd_ ^ 34. Name and Address of Person Who Compkhd Cause d Death ( ~7 ~Typ-e //Prim / r ~'. ~~ ~ 35. s SignaNro and District - ICI il~.t ~ iai 38. Dam Filed (Month, day Year) • i r l.~ V~-':~,L. ~~ ~ 1JC, ,` / i ) ~~~4)~ ; ~ ~ < ~~ !~ ~ ~ e ; .,, ; t cS ~ ~" c~~( r) C` ~ V U Disposition Pemet No. ~i-~ y .'i f '-~ LAST WILL AND TESTAMENT n r ' j ~' C7 :-~ .'_~ _~ SABRA W. CALLAND M.D. ' ~ : ~ ; - - ' , , _a.~ ~'r_1 ~ Y 1 ~ _.~.i f._ ,~ f5` •. J t »l .:.... ~ r °-r -. ~ ~ 1 V~ -r'i .. ~ - __ ~; ~ - ' __.{ _ _ > -1:: -- • ~ c~~ I, SABRA W. CALLAND, M.D., now domiciled in Cumberland County , Pennsylvan ia, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. A rti rl P TT All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give and bequeath my tangible personal property in accordance with any memorandum I have handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. To the extent no such memorandum is found, or all of my tangible personal property is not disposed of pursuant thereto, I give and bequeath my tangible personal property in accordance with the terms of Articles IV and V hereof. Article IV I give and bequeath my jewelry to my daughter PIPPA S. CALLAND, if she survives my death by thirty (30) days. If she fails to so survive my death, I give and bequeath my jewelry in accordance with the terms of Article V hereof. Article V I give, devise and bequeath the following items to my daughter, PIPPA S. CALLAND, of Cumberland County, Pennsylvania, and my son, JAMES F. CALLAND, M.D., of Charlottesville, Virginia: A. My real property and its contents located at 511 West Main Street, Mechanicsburg, Cumberland County, Pennsylvania; B. My apartment and its contents located at 355 South End Avenue, Apartment 16B, New York, New York; and C. My art collection and all remaining tangible personal property. If JAMES F. CALLAND, M.D., fails to survive me by thirty (30) days, his share shall be distributed to his descendants, per stirpes. If PIPPA S. CALLAND fails to survive my death by thirty (30) days, her share shall be distributed to my son, JAMES F. CALLAND, M.D., per stirpes. Article VI All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath as follows: 2 A. TWO THIRDS (2/3) to be equally divided and distributed to my daughter, PIPPA S. CALLAND and my son, JAMES F. CALLAND, M.D. If JAMES F. CALLAND, M.D., fails to survive me by thirty (30) days, his share shall be distributed to his descendants, per stirpes. If PIPPA S. CALLAND fails to survive my death by thirty (30) days, her share shall be distributed to my son, JAMES F. CALLAND, M.D., per stirpes; and B. ONE THIRD (1/3) to be equally divided and distributed to my daughters, ROBIN E. CALLAND, Ph.D., of Colorado and LAURIE A. CALLAND, of Tucson, Arizona. If either of them fails to survive me by thirty (30) days, her share shall be distributed to the survivor between them. Article VII If a beneficiary under this Will has not attained the age of twenty-eight (28) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the following terms: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the health, education, support and maintenance of the beneficiary until the beneficiary attains the age of twenty-eight (28) years. B. Upon attaining the age of twenty-five (25), one-half (1/2) of the remaining principal and accumulated income of the beneficiary's remaining share shall be distributed outright to the beneficiary. C. Upon attaining the age of twenty-eight (28), the remaining principal and accumulated income of the beneficiary's share shall be distributed outright to the beneficiary. D. If the beneficiary dies before the entire principal of the Trust has been withdrawn, the remaining principal and accumulated income shall be distributed by my Trustee to the 3 beneficiary's then-living descendants, per stirpes. If the beneficiary dies before the entire principal of the Trust has been withdrawn leaving no surviving issue, the remaining principal and accumulated income shall be distributed to the beneficiary's siblings, per stirpes. E. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes of law. F. At the time any distribution or distributive share of Trust assets is to be made by the Trustee, if a beneficiary of this Trust is disabled as defined in Section 1614(a)(3) of the Social Security Act (as determined by the Social Security Administration or by any State-level disability determination agency operating under the auspices of the Social Security Administration), and/or has been determined by a nursing home or State agency to be medically eligible for nursing home care, then said beneficiary shall cease to be a Trustee of this Trust or any Trust share hereunder and, thereafter, the Trustee shall not make any distributions to said beneficiary that might decrease or eliminate that beneficiary's eligibility for any public benefits based on need, such as, but not limited to, Medicaid or Supplemental Security Income. Article VIII In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law, shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: (a) to retain in the form received and/or to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, 4 (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file fiduciary/income tax returns and pay the tax due for any year for which such a return is required, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to the extent any trust hereunder is the beneficiary of a Retirement Account (as hereinafter defined) my Trustee shall draw the benefits from the Retirement Account in amounts sufficient to meet the minimum distribution requirements of IRC Section 401(a)(9) and the regulations thereunder (the "Required Minimum Distribution"). Notwithstanding any provision of the trust to the contrary, the Required Minimum Distribution shall be paid to or applied for the benefit of the income from such trust, or if there is more than one income beneficiary, my Trustee shall make such distribution to such income beneficiaries in the proportion in which they are beneficiaries or if no proportion is designated in equal shares to such beneficiaries. "Retirement Account" means a plan qualified under IRC Section 401, or an individual retirement arrangement under IRC Section 408, or a Roth IRA under IRC Section 408A, or atax-sheltered annuity under IRC Section 403 or any other benefit subject to the distribution rules of the IRC Section 401(a)(9), or the corresponding provisions of any subsequent federal tax law. It is my intention that this trust qualify as a "conduit trust" under IRC Section 401(a)(9) so that the trust beneficiaries shall be considered designated beneficiaries for purposes of the minimum distribution rules, and that 5 distributions may therefore be taken over the trust beneficiary's life expectancy (or the life expectancy of the oldest trust beneficiary). The Retirement Accounts shall not be subject to the claims of any creditor of my estate and they shall not be applied to the payment of my debts, taxes or other claims or charges against my estate unless and until all other assets available for such purposes have been exhausted, and even then only to the minimum extent that would be required under applicable law in the absence of any specific provision on this subject in this my Will, (i) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; to pay from my estate reasonable compensation for all their services, (j) to conduct alone or with others, any business in which I am engaged in or have an interest in at the time of my death, and (k) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. Article IX I hereby appoint my daughter-in-law, EVANGELINE CALLAND, as Trustee of any Trust(s) created in this Will. In the event of the renunciation, death, or inability to act, for any reason whatsoever of EVANGELINE CALLAND, I nominate, constitute and appoint my daughter, PIPPA S. CALLAND, successor Trustee of any Trust(s) created in this Will. O rti n~ A Y I nominate, constitute and appoint my daughter, PIPPA S. CALLAND and my son, JAMES F. CALLAND, M.D., as Co-Executors of my Last Will and Testament. I direct that my Co-Executors be permitted to serve without bond. In addition to those powers granted by law, I grant them power to distribute in cash or in kind, in like or in unlike shares, and to file any 6 qualified disclaimer I could have filed if living. My Co-Executors shall receive reasonable compensation for services rendered to my estate. Article XI In addition to the powers conferred by law, I authorize my Co-Executors, in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (fJ to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Co-Executors; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard. schedule of fees in effect while their services are performed. 7 IN WITNESS WHEREOF, I, SABRA W. CALLAND, M.D., hereby set my hand to this my Last Will and Testament, on /0 ~ 2 Z ~0 ~_, 2009, at Harrisburg, Pennsylvania. SABRA W. CALLAND, M.D. In our presence, the above-named SABRA W. CALLAND, M.D. signed this and declared this to be her Last Will and Testament and now at her request, in her presence, and in the presence of each other, we sign as witnesses. l~T~,~, o Address ~( x ~ . 8 I, SABRA W. CALLAND, M.D., Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and Acknowledged before me by SABRA W. CALLAND, M.D., the Testatrix on ~ ~G~ ~ ~ , 2009. of ubhc SABRA W. CALLAND, M.D. ~# QF l~E1~iN9V`I,t~AI~A Notarial Seal Marielle R Hazen, Notary Public Susquehanna 'It~vp., Dauphin Coup My Commission Expires Sept. 23, 210 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and Subscribed to before me and witnesse , on ~-~1~,~- a ~ , 2009. Notary ublic COMMONWEALTH OF PENNSYLVANIA Notarial Seal Marielle R Hazen, Notary Public Susquehanna Twp., Dauphin County My Commission Expires Sept. 23, ZQIO 9 Witness It SS H~~~zEly ELDER ~W An Estate Planning, Elder Laces and Special Needs Planning Law Firm 2000 Linglestown Road, Suite 202 Harrisburg, PA 17110 ~.: (71'~ 540-4332 F.~x: (717) 540-4313 March 16, 2010 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Sabra W. Calland, M.D. Social Security #420-21-2010 Date of Death: February 21, 2010 To: The Register of Wills: www.HazenElderLaw.com Marielle F. Hazen, CEI.A* Marti S. Miller, Associate Kindly prepare a Commission to Take Oath for the Co-Executor of the above- referenced estate who lives in Charlottesville, VA. We have provided apre-paid envelope for you to mail the Commission to Take Oath to the following address: Debbie Shipp, Clerk of Circuit Court of Albemarle County, VA Attn: Pam Melampy, Probate Department 501 East Jefferson St. Charlottesville, VA 22901 Telephone No. 434-972-4083 The co-executor of the estate is James F. Calland, M.D. His telephone in Charlottesville, VA is 434-982-4278. Thank you for your assistance. Please let me know when the paperwork has been sent to Virginia. If you have any questions, please feel free to contact me. Sincerely, cc: Pippa Calland and James Calland ~Q ~~d~~io~c A ~~ Corinne Eggers Woodhouse Paralegal *Certified Elder Law Attorney by the National Elder Lain Foundation as authorized by the Pennsylvania Supreme Court