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Home My WebLink About09-01-05 (3) " c: ~ .. ~ J:: .. .. . 0 :::; ";". .. '" .. u .. 5 .. 1Il .. 5 (; 0 'j ~ J::. .. ii ;; ~ .. '" 1Il " C ~ ~ :l CO ;; (; u. C") .. >- 0 5 ii .c 0 0 ~ "0 J:: I '" 1i 1Il an "" .c: Qi ,.. ~ .C Q. N ,.. d5 E 0 N ~~~i 0 'C 1Il c: i~:! lD ca :!2 ai': ,g 0 ~ :;]:!:'-- I- .2,,~~ ca ~; ,! i ::E -05"':: ; ni E Ci -~.= en _.'!:: 0 G) 0: .. 01_ 0 ~ fii~ ~ E . " ."::i t:: 1:'C' . E '" 0.- ~ ~!~i .. 1Il " C ~ 0; E " c: '" " c:; ta \!l "'-'- )( 0 '" c .~ W '" .~ :i CO .0 2.0 ii I"'- '" f.s u c:o ;;; '6 ~ a... CO 01'" 1Il >< e c: :Jl :IE '" '6 0 " c: :> C r: '" ~ ta lD ;;; = 0 '" "'- 'u d " ",,, 'i '" .c: .. -.c: 5 >0" c.: ;;; .o!!! J: " .. ~ 6 .." >- ~ .. c: .. :!! .~.c .c 'C '5 .." "0 ... 0- ~g GI 0 :!! Qi (,) J .o{ji Q. G) !!! ~'" a: .. .c: .. E r: ~g' 0 itj >- '" a. 0 c: " . :.;: 0 GI - . ~ti :> .c; lD .; " .. 0 - >0 ~ii I- 0 J:: .c: - Q. - '" C c: eft Q;CD c .;::: c: 0 .2 :O.c<..2 ;; c co ,;.; lD ta III ! ~'~ ;. ~ '> oc.......o C o ~ is .~ ; ~~~~ 0 ~2 ~~ ii u x <<:r U. iD '6 .N.Gi .c.S;ca.. 1Il -.c.-e :IE ~~~8 \,\1il.-- .tl~~ :5 State Registrar DHMH 17 Rev 1/2001 .~ VALID ONLY WITH IMPRESSED SEAL I HERI.BY CERTIF\I THAT THE ATTACHED IS A TRUE COpy OF A RECORD ON FiLE IN THE DIVISION O'VlTAL RECORDS. DATE ISSUEDt 011/' I~ OOSrrrm REGISTRAR 0 Amended Item 25 per H.E. 08/19/2005 Carroll County, wjl Please Type or Print in Black Indelible Ink. Ensure All Copies Are Legible. State of Maryland / Department of Health and Mental Hygiene Certificate of Death 3. Time of Death , I.... '--~ "58 pM 75 Usual Residence of Decedent lOa. State 1 Db. County 10e. City, Town or Location 1Od. Inside City Limits 1 DYes 2}Q No PA CUMBERLAND SHIPPENSBURG 1 De. Street and Number 1 Of. Zip Code 1 ag. Citizen of What Country? 510 RIDGE RD. 17257 USA 11. Marital Status 10 Never Married 20 Married 3XJ Widowed 4 0 Divorced 12. Was Decedent Ever in U.S. A'l'led Forces? 113Yes 20No If Yes, Give KOREAN Year or Dates: 14. Race - American Indian, Black, White, etc. 13. Was Decedent of Hispanic Origin? (Spec~y Yes or Na- If Yes, specify Cuban. Mexican. Puerto Rican. etc.) 1 0 Yes 2JO No Specify: Specify: WHITE 15. Decedent's Education (Specify only highesl grade completed) Elementary/Secondary (0-12) College (1-40' 5+) 12 17. Father's Name (Firsl. Middle. LaSI) 16b. Kind of Businessllndustry 16a. Decedent's Usual Occupation (Give kind of worl< done during most 01 worl<ing life. DO NOT use retired) MASON CONSTRUCTION 18. Mother's Name (Firsl, Middle, Maiden Sumame) FERDINAND LEWIS FRICK CLEEDIE VIOLA WILLIAMS 19a. Informant's NamelRelationship (Type. Prim) 19b. Mailing Address (Slreet and Number or Rural Roule Number. City or Town. Slala, Zip Code) BRUCE I. FRICK RIDGE RD.,SHIPPENSBURG.PA. 17257 2Ob. Place of Dispos~ion (Name of Date 20c. Location - City or Town, State cemelery, cremarory or olher place) 8/20/05 SMALLWOOD, MD. 22. Name and Address of Facility FLETCHER FUNERAL HOME 54 E. MAIN ST., WESTMINSTER, MD. 21157 SON 20a. Method of Disposition 1 ~ Burial 2 0 Cremetion 3 ORemovallrom Slete . 4 ODona' SOOther (SpBCify) D ervice Licensee isease, or complicalions that caused the death. Do not enter the mode of dying, such as cardiac or respiratory arrest. i1ure. List only one cause on each line. Approximate Interval Between Onset and Death 2. 01. &, Sequentiaily list conditions, ~ any. leading to immediate cause. Enter Underlying Cause (Disease or injury that in~laled events resulting in death) Last a. vJ{.( b. c. Due to (or as a consequence of): d. -y -,1 23<1:..o:.te of deliV~ri?, r.~nth . day-,; c.n . ~'l IF FEMALE: 23b. Was decedent pregnant in the past 12 months? 10Yes 20No 9 0 Unknown 23c. If yes, outcome of pregnancy 1 OLive birth 2 o Fetal death 40Pregnent al time of death 90 Unknown 30Ectopic pregnancy 50 Other (specify) Year Part II. Other significant conditions contributing to death but not resulling in the underlying cause given in Part I. 23e. Did tobacco use contribute to the cause of death? 1 0 Yes 20 No 3D Probably 4)q0nknown 25. Was case referred 10 medical examiner? - 11][Yes 27. M~r. of Death l~~tural 201\ecident 3 0 Suicide 4 0 Homicide 24b. ~~ret~~~~~~ti~~i~~sc:~~~a~te death? 1 DYes 20 No 28b. Time of Injury 50 Residence 6 OOther (Specify) Describe how injury occurred 5 0 Pending investigation 60 Could not be determined M 20No 28e. ~~~:;::n~,I~I~~s:.:c?~)e, farm, street, factory, office 281. Location (Slreel and Number or Rural Roule Number, City or Town, State) 29a. Cert~ier (Chock only one) Cartlfylng Phylliclan: To the best of my knowledge. death occurred at the time, date and piace, and due to the cause(s) and manner as stated. 20 Medical Examiner: ~dt~ea~~:~Ssi~l~~minatiOn andlor investigation, in my opinion, death occurred at the time, date and place, and due 10 the cause(s) 29c.~cense number Ir Coo:;; ()(J 0 ,tV 117b"l ~5' L 10:>; 5" 29d. Date signed (Month, Day. Year) -P I nlMc,{-t MD 'l.-I2,..ol Fe I. 31. S f'y-b- t ./; ORIGINAL I I DONALD E. FRICK, of Carroll County, in the State of Maryland, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all former . ills and codicils by me heretofore made, in manner following, that is to say: After the payment of all my just debts and funeral expenses, includ- in g the erection of a monument at my grave, in the event one is not erected during my lifetime, I hereby give, devise and bequeath my entire estate to my wife, RUTH L. FRICK, should she survive me. In the event my said wife predeceases me, then I give, devise and bequeath my entire estate unto our son, BRUCE 1. FRICK, absolutely. And I hereby nominate, constitute and appoint my said wife, RUTH L. FRICK, to be the personal representative of this my Last Will and Testa- ment, with full power to sell and convey any and all of my property that may be necessary in the proper administration of my estate, without the necessity r-.) f ....... . of obtaining an order of any court, and I request that she be excused from the " necessity of giving bond. In the event my said wife predeceases me, or fgiJs ) said Ruth L. Frick. Witness my hand and seal this I) day of t~ 1981. ~c.72~ Donald E. Frick (SEAL) Signed, sealed, published and declared by the above named testator, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~?-k-. ~L;eL C I /1 IJ AAl~u j) ~~,;