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Home My WebLink About12-22-05 Estate of f:. PI '.sA (, also known as PETITION FOR PROBATE and GRANT OF LETTERS 2/--05 -I/Ou S t ('I p~(),.,; No. To: Register of Wills for the , Deceased. County of (Vt1l!1ttL.A~O in the Social Security No. S ~ b - l D - ~- s:- ~ L Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ell in the last will of the above decedent, dated No \.l{~ 6~fl- 10 and codicil(s) dated _ named ,-+9-~~- (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domicikd at death in (v M ~ti(LLI4 N i) County, Pennsylvania, with h ~ t. last family or principal residence at 52. "Z. Sell riot' F~ III f" S ~H. 1 Wb~I"\I.~'f1f?vl2b fA. 17olt) (list street, number and muncipality) Decendent, then -.R!ifl years of age, died at u.,c,(.~ 1.."" s. f)...~ (0 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: D ~((t'" ~e..(L 17- , i9: 200 r-, Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters 1'"1 )-r,A.t\'1f./"'\~.e Y theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) , -' '1 en I~ ~~' V~~;7 cG~ -g.g ro"= 3~ v'- :;0 ~ <:: OJ) Vi i< ) 1-\ I ( ) C) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF ~11j~1 L LA V D J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above dec~~dent petitioner(s) will well and truly administe the estate according to law. ~-~ ~ C;C;. ;:s l:l ..... l:: ~ ~ No. ~. 0 S-ilOlf Estate of Z:DUSI\ Co .$1r"f.5o"; , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW 2-? v\.d, -\) Cl.? f\\.be\{ ~1ti.:f::.", in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated III) 61) i 0 ,. 70)) 5' . . described therein be admitted to probate and filed of record as the last will of ~ 1t1SS (/. (2. D'~iJ~ and Letters are hereby granted to FEES Probate, Letters, Etc. ......... $ J 0 . t D Short Certificates( ~ . . . . . . . . ., $ I d. () D Renunciation .... W .' .l.l. . . . . " $ IS. 0 D J c P t1TJ \1) $ I 5. U"U TOTAL _ $ ~:J. ()0 Filed ... .~. '. J.~ / ~ DD.). . . . . . . . . . . . c~ ~~ ('/~'7) AT~RNEY (Sup. Ct. I.D. No.) ~ 00 FV\t+IL'i'i:f S', f L.{Jl-toY~( fit l7o<() ADDRESS (117) 7b)"- 813'"\ PHONE (.,) L) .' ..' ..9fOS--ljI57"'d I t"l d .'1 Till' is to certify that the information here gIven IS correctly copied trom an ongIl1al ce:~.' 111:,~te oj dc~ LI -'I. I e \V It 1 Loc,tl Registrar. The original certificate will be forwarded to the State Vital Records 011ILC tor permanent fIllI1g. me as WARNING: It is illegal to duplicate this copy by photostat or photograph. jti;liii'-';;;;i;;;;"".. "ll~ ....~,\\ OF pr:;;---. ,,"'o.\.'\.l"' -~C:I(4'-'''' l~Y ~i'~-"'_ l~!-~ 'IJ'- \~\ ~:::!e'! . ;..; ,~~ i ~\ .~~f~~.. ;:s;:~ ... \ . - ' " , '\ ..,1f;...;;,,1 ",-~~/~,,\ ~--!~lMEN1 ti{~:;","" ",.,,,,/,,,//,,,,,/11"'" . -(;2; 1IJ- ~ A . ,rr ....",.? /vvn- Lo'tal 'R~gi~tr;;'" 'f/" ~ Fee for this certificate. $6.00 P 1 1 q ~ 1t -1 t: -7 Ji L "~) L" ,L. ,=' ......0# DEe 1 6 ZOOS No. Dale ( ~) 1 Rev. 2187 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH c.:; STATE FILE NuMBER 7Tucson. AZ ER/Oulpa~jenl 0 DDA 0 DATE OF DEATH (Monlh, Day, Year) 4December 12, 2005 1. AGE (Lasl Birthday) NAME OF DECEDENT (First, Middle, lasl) Edissa C. SEX 2. Female PLACE OF DEAl HOSP1,. Al I'lpatient 0 8., FACILITY NAME (If not institution, give street and number) SOCIAL SECURITY NUMBER 3.526 - 20 - 5592 BIRTHPLACE (City Bnd State or Foreign Counll)l) heck on on ~ see instructionc; Cumberland DECEDENTS USUAL OCCUPATION (~lf:O~~~jre~'ld:teu~rirr:ii::)' 8e. Wormleysburg KIND OF BUSINESS I INDUSTRY WAS DECEDENT OF HISPANIC ORIGIN? r"\o 0 Yes fXllf,yes, specify Cuban, Mexican, pue'ito'Rlcan, "l'lexic.an MARITAL STATUS. Married, Never Married, Widowed, Divorced (Speeiti) 14,Married Residence KJ g~:~ify) 0 RACE ~ American Indian, Black, White, at \Specifyj 10, Hispanic SURVIVING SPOUSE (If wife, give maiden I'lame) . 11.. Manager 11\:;. Charles Furriers DECEDENTS MAILING ADDRESS (Stneet, CityfTown, State, Zip Code) DECEDENTS 322 South Front Street ~~~~DA~NCE 16,Wormleysburg, PA 17043 ~~a;~~~rr;:~~)"s 17b. County Cumberland FATHER'S NAME (Fin;t. Middle. Last) 18, INFORMANTS NAME (Type/Print) 20.. METHOD OF DISPOSITION Donabon 0 Surial 0 Cremation ~emoval from State 0 . 21a, Olher (Specify) SIGNATU aJ FU~E~L ~E~YICE,~ OF38ERSO . . 22a ~ - 7:::J Complete items 23a-c only when certi t e best of my knowledge. death occurred at the time, d~te And plar.e stated phYSICian Is net available at time at ae8th to (S' nature and TItle) certify cause of death. 23a, ~:~~:~~~ ;~~~~~c:':'~::~ by TIME OF DEATH, '5 24. q '-( Sr. [lid decedent live In a township? 17C, 0 Yes, decedent lived In twp. 17d, 0 ~~i~.~~~~~\i:;;i~~ 01 Wormleysburg city/bora. MOTHER'S NAME (First, Middle, Malden Surname) 19. Elena Unknown I>':FORMANTS MAiliNG ADDRESS (Slreet, CityfTown, Slate, ZiD Code) wb.322 South Front Street Wormleysburg, PA 17043 PLACE OF DISPOSITION- Name 01 Cemetery, Crematory LOCATION - CityfTown, State, Zip Code orOlherPlaceCremation Soc~ety of 21c. PA Cremator 21d, Harrisbur PA 17109 NAME AND ADDRESS OF FACILITY Auer Memorial Home & Cremation 22e.Services Inc. Harrisbur PA 17109 LICENSE NlJM~ER DATE SIGNED (Month, Day, Year) 26, : Approximate I interval between : onset and death Miguel Cervantes DATE PRONOUNCED DEAD (Monln, Day, Year) M. 25, "]).e C 'f rv~'- /:1. .2cxx5 21, PART I: Enter the dl....... Injuries or complications whieh cau.ed the death. Do not enter the mode of dying, such as cardiac or respiratory arreat, shock or heart failure. ~s~;~I~;~;;~~;(:~~:I'u" on uchllnf AN e..t€C<..- ~ ~ ~ ( ~\~ O~ ' resulting In death) ---+ DUE TO (OR AS A CONSEQUENCE OF) Sequentially list conditions if any. leading to immediate cause. Enter UNDERLYING CAUSE (Disease or injury that initiated events resulting on death) LAST t: DUE TQ (OR AS A CONSEQUENCE OF); aUE TO (OR AS A CONSEQUENCE OF) WAS AN AUTOPSY WERE AUTOPSY FINDiNGS MANNER OF DEATH PERFORMED? AVAILABLE PRIOR TO l8' 0 COMPLETION OF CAUSE Natural Homicide OF DEATH? 0 D Accident Pending Investigation YesO '10$ Yes 0 NoD Suicide 0 Could not be delennined D DATE OF INJURY (Mo(lth, usy. Year) TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. 33. REGISTRAR'S SIGNATURE AND NUMB611 anm- /1J %:~4 I' I~JIPt)I/1 Yes 0 No D 30e, 30d, LOCATION (Street, CityfTown, Slale) 301. RTIFIER 28., 28b. CERTIFIER (Check only one) .~~~~~~';':~tGof::a~~;~~eWgh:'S~~:rh c~~~~crdUj: t~ ~e:1ha~:~{;r~~3rrG~x~~~a~s h:~~~~~t~~~~.~ . ~~~~~_ .~~~ .:~~~~~~~.~. i.t~~ ,:~~ 29, 30a 30b. M. PLACE OF INJURY. At home. farm. street, factory, office building, etc, (SpeCify) 30e, *PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death) To the best of my knowledge. death occurred at the time, date, and place, and due to tha causes(s) and manner as stated."....."".". "MEDICAL EXAMINER/CORONER On the basis of examination and/or Investigation, In my opinion, death occurred at the timet date, and place, snd due to the causes(s) and manner as stated..".,..,.....,........,.. -.....,.,.,..""..,.., ,."".',.,..,.,....,.,..".,..,.................,........,..,., ,..." ,......... -.... ...,.....,.".... ..... 0 31.. 34. /4 ;< tJ cJ .5' ;~~\ - () S- II ~ Y LAST WILL AND TESTAMENT OF EDISSA C. SIMPSON , t--) I, EDISSA C. SIMPSON, of Wormleysburg, County of Cumberland, Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and declaring null and void any and all wills and codicils at any time heretofore made by me. FIRST: I direct my Executor, hereinafter named, to pay my just debts, expenses of my last illness and my funeral expenses as soon as convenient after my death. SECOND: I declare that I am presently married to CHARLES L. SIMPSON, SR., and any and all references in this will to the term "my husband" refers to my beloved husband, CHARLES L. SIMPSON, SR. THIRD: I give, devise and bequeath my +-' enL..ire estate either, real, personal and mixed of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death, to my husband, CHARLES L. SIMPSON, SR., to have and to hold the same for his own use absolutely and forever. FOURTH: In the event that my husband should 1 predecease me or fail to survive me by sixty (60) days, I direct that my estate be liquidated and distributed in equal shares to my children, namely my daughter, SANDRA M. LINDUSKA, of Chesterfield, Virginia, my daughter, PAMELA J. SIMPSON, of Wormleysburg, pennsyl vania, my son, CHARLES L. SIMPSON, JR, of Wormleysburg, Pennsylvania, and my son, RUSSELL W. SIMPSON, of San Ramon, California. In the event that anyone of my above named beneficiaries shall predecease me or fail to survive me for a period of sixty (60) days, the share that otherwise would pass to that predeceased heir shall instead pass, per stirpes to the deceased beneficiaries issue. FIFTH: I appoint my husband, CHARLES L. SIMPSON, SR as the Executor of this will. No bond or other security shall be required of any Executor appointed in this will. SIXTH: In addition to all the powers conferred by law upon my Executor and not in limitation thereof, I hereby authorize my Executor to sell any bonds, stocks or other personal property and any and all real estate which I may own at the time of my death, without the order of authori ty of any Court being required, at public or private sale, upon such terms as may in the discretion of my Executor seems to be in the best interest of my estate. In pursuance of his power, my Executor shall execute and deliver all documents of conveyance, including deeds or bills of sale or any other instruments which may effectively transfer title. 2 I further authorize my Executor to settle and compromise any and all claims in connection with the administration of my estate herein and to do any and all things in his sound discretion, which shall be conducive to the best interest of my estate. It is my desire that these powers be given to any successor to my named Executor. It shall not be necessary for any purchaser to see the application of any purchase money, nor shall any person or corporation inquire as to the propriety of any such sale or assignment. SEVENTH: All pronouns referring to an executor and the term "executor" shall be construed to mean any person acting as my executor and the gender shall be construed as either masculine, feminine or neuter. IN WITNESS WHEREOF, I have hereunto set my hand and seal at Cumberland County , Pennsylvania this I 0 day 0 f I-'i).,..I-IC ..It!.. , 2005. /~;~d~d"~ Edissa C. Simpson 3 The foregoing instrument was signed, sealed, published and declared by the above named Testatrix, Edissa C. Simpson, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~ '7 ;:z. .:{ I r~; ~ Jt:-, ./" .P.o,,~~ Pl4- 1 7'070 1/ ~Q:. (,.~;( A dress. 3 ~';-p,< c r (flrttfJ (.1ft i Off"" {""'Nl/ Address 4 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND I, Edissa C. Simpson, 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 Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. P~~j?4 ~~ Edissa c. Simps~ SWORN or affirmed to and acknowledged before me by Edissa c. Simpson, the Testatrix, this ~\ day of t'-.\ ~\J (W'v~~ ( \( , 2005. ~b~___ Nota' Public om&^ NOTARfAL SEAl - . I fV\V Y K KATSHIR, . l~8oro, ~PubIc , My CoInmiaak,., Expha Feb. ~ 5 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND We,Jn)}f}YJ~ #...."5~~h'1. and 01>'- ('+1:1f1'"('" wi tnesses whose names are signed to the attached or foregoing the instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as her Last Will, that she signed willingly and that she executed it as her free and voluntary act for the purpose 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 that time eighteen (18) or more years of age, "~ ' / Address: //;:?.;< -p,~.:/ ,-~T /(~)O<~?' )~~j 111- /7070 and under no constraint or."/lndu.e influence. --e. . J 1-0- /~ Address: ~ f'-/4'J-~V drj-" c~, (frL..... /1), IN" I SWORN or affirmed to and subscribed to before me by -f-otrM'\ ~ ~T~ , and f't-C.6 lL~ltC.. , witnesses, this ~ day of N;A.k~L 2005. ". NOTARIAl SEAL ' =~~PlM: ... MyCotI;"ij '1/1'&pnsFeb.~ 6