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Home My WebLink About09-13-05 (2) H I!I_":-:(ic; 1,,:[-\ 1"1. .. t 'ertifv that the information here aiven is correctly copied from an original certificate of death du)r filed with 11S IS 0 C - . b . I I ()f'f'. f' tf I Local Registmr. The original certificate will be forwarded to the State VIta Recore s Ice or permanen I mg. "- \, f- Z W o w U w o ~ ~ z me as WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 rr, . #tL f ' ~r1:~ ,2 ' Local Registrar .\\","(~(1"'Orpl:i'-'___~ ,,,,,$~1'J),\. ~~! - ""~ .. \.~~ ~ ~, ~~ \?~ ~:tEi ,~_, \~% \~I\~~. ~.."-;i!:::J \~-~~' - //~l ...~ ..$S,. .".. ~p ./-\\.'r.... ""'-.!iMEN1 \\\ """., """"///#0#1111/111' r~) ~e r. '..~I-.-1J~~o~';1 ~ Date~'" -.'-; -'l d ~~L t~~ ~l 8 fj :3 ~:J No. (',0 -'TO) c...) W H105.143 Re..... 21BT COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS TYPE/PRINT IN PERMANENT BLACK INK CERTIFICATE OF DEATH STA.TE FILE NUMBER SOCIAL SECURITY NUMBER fa '" " "' "" " "" At; SEX 1 Edward AGE (last Birthday) 2Male 3.201 BIRTHPlACE (Citv and FOnt State or Foreign Country) HOSPITAL: York, Co. P a '0""" S ERIO"~..." D 7. a.. FACILITY NAME (If not institution, gil,'e street and number) 16 - 5. 81 Yrs COUNTY OF DEATH OOAD R.llidenctlD :~) 0 RACE - American Indian. Black, While, el lSpeclfy) 10. W hit e SURVIVING SPOUSE (If WIle, giWl mailMn 1'IaI'M) ab. Cumberl and a.manor Care AS DECEDENT EVER IN u_s. ARMED FORCES? Ye'~ NoD 12. MARITAL STATUS. Married, NSl,'er Marraed, Widowed, o;""ced (Specify) 14. Mar r i e d Iwp 11b, County Dauphin citylboro 17d."R!' ~~~~~:<<:: of Steel ton MOTHER'S NAME (First, Mkldle. Maiden Surname) I.. Mar N i eke 1 INFORMANT'S MAILING ADDRESS (Street. Cityrrown, State, Zip Code) ~~ 176 South 2nd Street Steelton, Pa. 17113 PLACE OF DISPOSITION. Name of Cemetery, Crematory lOCATION. Cilyrrown, Slate. Zip Code or Other Place ~~echanicsburg Cemeter ~~Mechflnicsburg, Pa. NAME AND ADDRESS OF FACILITY 22c.M ers F.H. 37 E Main LICENSE NUMBER 24. 3 St MBG DATE SIGNED (Month, Day, Year) 23b t2t'/ {; Y q s 7 (j L 230 WAS CASE REFERRED TO A MEDICAL EXAMINER ICORONER? 26. Yo. D No 181. . Approximate PART U: Other iStgnificant conditions contribubng to death, but : interval between not resulting in the underlying ceu&8 given in PART I. : onset and death __ J I'/y/)/I* Pa. 17055 27. PART I: Enlw Itl. dl....... InJur", Of compNulkl". whIch ceu..d tn. dultl. Do" LI,1 0"1)1" 0"' ce,," on "ch II".. ~. 0,,,, e... uf( J~ '- i . ! \) DUE T AS A CONSEQUENCE Of): !: DUE TO (OR AS A CONSEQUENCE Of)" CUE TO (OR AS A CONSEOUENCE OF) WERE AUTOPSY FINDINGS MANNER OF DEATH AVAIlABLE PRIOR TO {Z] D COMPlETION OF CAUSE Natural Homicide OF DEATH? D D Accident Pending Inyesligalion Ye.D No Ye.D NoD Suicide D Could not be delennined D DATE OF INJURY (Month, Day, Year, TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED Yo. D No D 30... 30b. PLACE OF INJURY Al home, farm, street, factory, office building. ele (Specify) 30e. 28a. 28b. CERTIFIER (Check onlV one) .~~~:=~~tGor~~~;~~~7I.s~~~c:~'t~i~duJ: I~ t:~.:~:~(:r~~3r.g~~~i~a~. h:t~r~3~~~:~~ .~~~.~. ~~~ ,:?~~~:~~.~ .i.l~~~ .:~~ 29. .PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both prooouncing death and certifying to cause of death) To the beat 0' my knowledge. d.ath occurred al the lime, date. and plac.. and due 10 the cau...(a) and manner as staled,.. ."'EDtcAl EXAMINER/CORONER ~::::'::::I:::::~~ln.t1on and/or InVeallg..tlon.I~.~~.~~I.~~~.~..~~a.~ ~~~~~.d alth. Urn.. date. and plac., and due..t~.~~~.~~~~.~~.(.~~ and 0 318. I REG T Creston C. Herold It.. M.D. 32. DATE FILED (Mon Lcmoyne. PA 17043 5e.l> V1> c.,.. 1010 30 V 12111211121 .' lllant ~ilI Ctltb- 'Q}t!5tmtttnt OF EDWARD G. HARTMAN I, EDWARD G. HARTMAN, of the Borough of Mechanicsburg, County of Cumberland and state of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last will and Testament, hereby revoking and making void any and all prior wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same may be conveniently done. 2. I direct that my entire estate, of whatsoever nature and wheresoever the same may be situate, be converted into cash, and r',' " ') :1 for this purpose I authorize and empower my personal ,.-) -:, ( f) -', ~ ~ representative hereinafter named to sell any and all real ~ta~ w which I may own at the time of my decease, as well as myperso~~l ,'1 - property, at either public or private sale or sales. After myc..j -; - 1 ... C) estate has thus been converted into cash, and upon payment of a~l - 1 - " ') . my obligations, the costs of administration of my estate, and all inheritance and succession taxes, I direct my personal representative to divide the entire balance of my estate then remaining into three (3) equal shares, and to payout and distribute the same in the following manner, to wit: (a) I give and bequeath one (1) such equal share to my good friend, ELIZABETH A. BYRD; (b) I give and bequeath one (1) such equal share to CAROL A. HEISEY, who is the daughter of Elizabeth A. Byrd; and; (c) I give and bequeath one (1) such equal share to TRACY L. HEISEY, who is the granddaughter of Elizabeth A. Byrd. 3. LASTLY, I nominate, constitute and appoint my good friend, ELIZABETH A. BYRD, Executrix of this my Last will and Testament, and in the event that she should predecease me, or should she be unable or unwilling to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint her daughter, CAROL A. HEISEY, Executrix of this my Last will and Testament, in her place and stead, and in either instance, I direct that my said personal representatives be excused from posting any bond or other security for the faithful performance - 2 - of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this II day of March, A. D. 1997. ~.-&.w-~ (SEAL) Edward G. Hartman Signed, sealed, published and declared by the above named, EDWARD G. HARTMAN, as and for his Last will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. xL~/ }' ~L-' - 3 - i COMMONWEALTH OF PENNSYLVANIA) SSe COUNTY OF CUMBERLAND) I, EDWARD G. HARTMAN, the testator 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 Last will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before me by EDWARD G. HARTMAN, the testator, this J/ t~ day of March, 1997. .1 ) 1-/ ~ ./. /'} ( CL-L1./~~ -.(. J (,,,.. [.........- , tary/Public SSe Notarial Seal ~n Kay Eakin, Notary Put)!:,; ; ~.<1Jmbei~andCOLi';Y I ,." ExpiresNov.S,1997! .. ,,'--' n of NOlaric~~ COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND) We, the undersigned, J. ROBERT STAUFFER and SUSAN A. McCOY, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testator, EDWARD G. HARTMAN, sign and execute the instrument as his Last will and Testament; that the said testator, EDWARD G. HARTMAN, executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the testator, signed the will as witnesses; and that to the best of our knowledge, the testator was, at the time, eighteen (18) or;~re years of age, of sound mind, and under no constraint, re~ 0 ndue influence. Sworn and subscribed to before ..,-A. me this ) I / day of March, 1997. /17 (LN~i~rC~~bl[~ NolariaI Seal Ma!IYn Kay Eakin, Notary PttiIC ~ Boro C\JlT1bei1arKl County Mi CQmrrission eXpres Nov. 6, 1997 '~of~ - 4 -