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Home My WebLink About07-29-05 (2) Hl05112 RFV 1,05 (FEE cOR T ,IS CERTIFICATE 5600) WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS LOCAL REGISTRAR'S CERTIFICATION OF DEATH CERT. NO. T 5915991 ,Iul y 06, 2005 Date of Issue of This CI~r'hfication Name of Decedent_. P.leaIlQL F'b! _____..EL.....___ ---.-1Qp~ I ?~j Sex F'PTTB1p Social Security No. _ .....47.0-01-7403 ____ Date of Death --->lUly.~.L 2005 Date of Birth SPpt. 04. 1919 Birthplace Duluth. MN Place of Death _..2l9 s......l.1t.h....st......._ ~'1::ij,jy "Jarnf' r.1J!nber land C'-"IH'j', r.aIl\l? ~ill Bora 'ow, .~nr,:I(II- 'A Pennsylvania Race . Whi h, .. Occupation Nurse/Medical__ _ Armed Forces? (Yes or No)_. No Decedent's Marital Status wi <'I()wed _ Mailing Address _ 219 S. 17th St. Cam~ Hill PA r;'L.,W";1 C,'((e01 (;,j',,.- or . ,:"~'r Staje Intormant Julia .Ji........banka._ Name and Address of Funeral Establishment_....Rohland Funeral HameL IllC.L 508 Cumberland St, Lebanon , Funeral Director Peter N. PyleQ.___~ Part I: Immediate Cause Pfl.~042 Interval Between Onset and Death (rt) r.ongesti ve Heart Fail ure (c) . r......J '.-) j c:-" . --:C) ::-.Ji - i-~ ;=: -+-9- :~,._- _'J 1.':-1 i i.. ) "} (~-) (~ --Renal.. Fa i lure (d)_____ Part II: Other Significant Conditions . .~.;- ) ::~ "j Manner of Death .' ~--1 Describe how injury occurred: ;::3 , ~"~ 'J ..'.1 , '\ -;-l :..." Natural ~] Homicide Pendin9 Investigation Could not be Determined -.j Accident II Suicide u [-'1 Name and Title of Certifier_---St.even Prophet, MD (MD., DO., Coroner, ME) Address ElSS Poplar Chur~d, Camp Hill.L....2A__.__._____ This is to certify that the intormation here given is correctly copied from an original certiticate of death duly tiled with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. .~~-ef.--~ 38-3~ 1.Q.85 ~i~;";~:'~:'~anon, PA, 17042" July 06..L..2QQ~__ Oa'"., 1',\.'.\.'.U\",fj fl','" ;:L:.1'~1':;r ',':rectt..cI'1'L"" TC''Nr:-I'l ~ CODICIL OF ELEANOR M. LOPEZ I, Eleanor M. Lopez, of Mechanicsburg, Cumberland County, Pennsylvania, hereby declare this to be the first Codicil to my Will dated February 21, 1997: 1. I direct the following changes be made to my last Will: ARTICLE III reads: I hereby nominate and appoint my son, JAMES T. WOOD, as Personal Representative of this, my Last Will and Testament. If he has predeceased me or if he fails or refuses to qualify as such Personal Representative, then I nominate and appoint my son, G. GRIER WOOD, as Alternate Personal Representative of this, my Last Will and Testament. I direct that none of my Personal Representatives be required to post any bond or other security for the faithful performance of the duties of this office. I ___,: ARTICLE III shall be altered as follows: I hereby nominate and appoint my daughter, JULIA K. HANKS, as Personal Representative of this, my Last Will and Testament. If she has predeceased me or if she fails or refuses to qualify as such Personal Representative, then I nominate and appoint my son, G. GRIER WOOD, as Alternate Personal Representative of this, my Last Will and Testament. I direct that none of my Personal Representatives be required to post any bond or other security for the faithful performance of the duties of this office. _.'.j, LAW OFFICES OF STEPHEN J. HOGG L",' ' ':! ::::: 19 s. HANOVER STREET SUITE 101 CARLISLE, PA 17013 -.,) .. 2. In all other respects, I hereby make, publish and declare my Will dated February 21, 1997. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this odicil consisting of two pages this ;-./ day of ,2004. nJ~. '/7; ~ Eleanor M. Lopez ~ LAW OFFICES Of STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and two other pages was on the day and date hereof signed, published and declared by Eleanor M. Lopez, to be the first Codicil to her Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. ~~ (_A')~)'b' A- Q Cwftness ~ )e /JtLJL itness LAW OFFICES or STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLlSLE, PA 17013 .. ACKNOWLEDGMENT State of Pennsylvania ss County of Cumberland I, Eleanor M. Lopez, the testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my first Codicil to my Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Md'-yt#V m ~~ Eleanor M. Lopez ----. NOTARIAL SEAL STEPHEN J. HOGG, NOTARY PUBLIC CARLISLE BORO. CUMBERLA Y COMM'SS:ON EXPIRES SE~~B~~':':OO5 AFFIDAVIT State of Pennsylvania ss County of Cumberland We~bSl CPt- G(A/sr;and L/.S.CA k. bl lL+, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her first Codicil to her Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Codicil as a witness; and that to the best of our knowledge the testatrix was at that time 18 or more years of -?ge, of sound ~under no oons!raint or undue influence ~,. ~. -LJ~ /< ,sL~ -'- Sworn to or this 2.-- day of before me by witnesses, ,2004. /. -f; LAW OFFICES or STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 NOTARIAL SEAL STEPHEN J.. HOGG NOTARY PUBLIC CARLISLE BORO C . MY COMM/SSION EXP/~:'sB;:~~B~<:i:':OO5 1E&st mill &ub mest&meut ~-r') OF "oj ELEANOR M. LOPEZ ,.. - --I ':;",;j I, ELEANOR M. LOPEZ, a resident of Hillsborough County~ Florida, being of sound and disposing mind and memory and desirous of making a testamentary disposition of my worldly estate, do hereby make, publish and declare this to be my Last Will and Testament in manner and form following: ARTICLE I I direct my Personal Representative hereinafter named to pay all of my funeral expenses, costs of administration, costs of safeguarding and delivery of devises and just debts (excluding secured debts), including expenses incident to my last illness and death, if any, legally imposed upon my estate or any part of it. ARTICLE 11 All the rest, residue and remainder of my estate, including all lapsed and void gifts, I give, in trust, to the Trustees of that certain inter vivos Trust Agreement known as The Lopez Trust dated November 15, 1995, which gift is to be added to the property then held in trust by the Trustee, and to be held, managed and distributed in accordance with the terms of the Trust as now existing and as from time to time hereafter amended. If the above-described Trust shall not be in existence at the time of my death, or if for any reason a Court of competent jurisdiction shall declare the Trust to be ineffective for disposition of the assets of my estate, I give the residue of my estate to the Trustees named in the trust instrument, to be held, managed and distributed in the manner described in the trust instrument for the period beginning with the date of my death, giving effect to all then existing amendments of the trust that fi shall be valid, and in any event giving effect to all terms of the trust now in effect; and for those purposes I incorporate by reference the trust instrument as it now exists into this will. ARTICLE III I hereby nominate and appoint my son, JAMES T. WOOD, as Personal Representative of this, my Last will and Testament. If he has predeceased me or if he fails or refuses to qualify as such Personal Representative, then I nominate and appoint my son, G. GRIER WOOD, as Alternate Personal Representative of this, my Last will and Testament. I direct that none of my Personal Representatives be required to post any bond or other security for the faithful performance of the duties of this office. ARTICLE IV In order to more conveniently effectuate the disposition of my estate as above provided, I authorize and empower my Personal Representative to sell at public or private sale, partition, exchange or otherwise dispose of the whole or any part of my property, real, personal and mixed, as he or she in his or her sole discretion may deem best; and he or she shall have the power to execute and deliver such deeds, mortgages, leases or other instruments as are necessary to effectuate sale, mortgage or other disposition and accept purchase money mortgages. ARTICLE V I hereby revoke all wills and testaments heretobefore by me made at any time and all codicils thereto. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 21st day of February , 1997. (=~p~ Signed, sealed, published and declared as and for her Last Will and Testament by ELEANOR M. LOPEZ, the Testatrix named herein in the presence of us, who, at her request and in her 2 presence and in the presence of each other, have hereunto signed our names as subscribing witnesses. Brandon. Florida Brandon. Florida STATE OF FLORIDA COUNTY OF HILLSBOROUGH We, ELEANOR M. LOPEZ, DOUGLAS W. HAMPTON and PAMELA J. FATTORE, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, having been sworn, declared to the undersigned officer that the Testatrix in the presence of witnesses, signed the instrument as her Last Will and that she signed, and that each of the witnesses, in the presence of the Testatrix and in the presence of each other, signed the will as a witness. Subscribed and sworn to before me by ELEANOR M. LOPEZ, the Testatrix, who produced a Florida Driver's License as identification, and by DOUGLAS W. HAMPTON, a witness, who is personally known to me, and by PAMELA J. FATTORE, a witness, who is personally known to me, on this 21st day of February , 1997. My commission expires: I" pOWEl.L JOO . te otflor1de lIotalY public. StIl 24 2000 Exp. Oct. . My Comm. II cc !ill€>€>13 comm. o. 3