HomeMy WebLinkAbout01-26-06
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
t')" Beatrice Saussaman
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Social Security No,
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Deceased
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(CO'-'IPLFTI' "A" OR "B" BELOW)
a
.\. f'rub~te ~lIld Grant of Letters ~nd aver th~t PetitIOner is the Executor n~ll1ed in the L~st Will of Decedent, dated
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Except as follmvs, Decedent did not man)', was not divorced, and did not have a child b0111 or adopted after execution of the documents alTered for probate; was not the
victim of a killing and was never adjudicated incompetent: NONE
o
B. Grant of Letters of Administration
(d,b_II_c,La.: pendellte liLe; durautc absclltia~ dur<.llllc minorit.lh:)
Name
Relationship
Residence
Petitioner(s) after a ro er search haslhave ascertained that Decedent left no Will and was survived b
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 205 Third Stre&;:.' Summerdale,
Cumberland County, Pennsylvania,
(list streel. number and muuicipality)
Decedent, then 71 years of age, died January 20,2006 in Holy Spirit Hospital, Cam Hill, Cumberland County, Pennsylvania,
(Location)
Decedent at death owned propCt1y with estimated values as follows:
(If domiciled in P A)
(11'not domiciled in PAl
(11'not domiciled in PAl
Value of real estate in Pennsylvania.
All personal property
Personal property in Pennsylvania.
Personal property in County...
7 ;\ 1\)\ C C
......... s j V \.; ,~~,. ,#
...........soooooouou
... .... ..$000000000
...... $
Total..
7 1'\, ;"'\.' '\ 1'\
..... $ I..... V\-i, l; '-..:
Real Estate situated as tallows:
Wherefore, Petitioner respectfully requests the probate ofthe last Will presented with this Petition and the grant ofletters in the appropriate torm to the undersigned:
Signature
Typed or printed name and residence
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Commonwealth of Pennsylvania
County of Cumberland
The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true and correct to the best of the
knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate
according to law.
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Sworn to and affim1ed and subscribed
'J
before me this ~ day of
~l'I.2006.
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No.
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Estate of Beatrice Saussaman, deceased
Social Security No:'~ I .../
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Date of Death: January 20,2006
AND NOW, I ~ 2 U 2006, in consideration of the Petition on the reverse side hereon,
satisfactory proof having been presented before me,
IT IS DECREED that Letters Testamentary are hereby granted to A} / e n
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estate.
Letters.......................... .
$ 45. [;1)
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FEES
Short Certificates..M... $
Renunciation................ $
Affidavit ( )................. $
Extra Pages ( )............ $
CodiciL....................... $
JCP:J;:.ee........................ $
Itt~~Ory....................... $
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Attorney:
LD. No:
Address:
TOTAL................
$91.uD
Telephone:
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Hi05,~():'i REV 1105
This is to certify that the information here given is conectly 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.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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1222lU314
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Fcc for this certificate, $6.00
Local Registrar
JAN ~ 4 2006
Date
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Rev.01106
IRINTIN
ANENT
:K INI<
1 Name of Decedenl (Firsl, middle, last)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
Beatrice Saussaman
5 Age (LaSl birthday)
7. DateotBirth Month, da , ear
8, Binh lace C" andstaleortof
o Other 5 ci
10. Race: American Indian, Black, Whrte, etc.
(S""ci'YJ
Vbite
3, Social Security Nurrber
Yrs
251-48
7]
]934
Anderson, South Carolina
8d. Facility Name (If nol instrtution, give stree' and number)
l-4ok SPi"'..\- t6p~~\
on h' hest ade co leted
College (1-4 or 5+)
14 Marrtai Status: Married, Never married, 15. Surviving Spouse (\1 wife, give maiden name)
wilC::1 Divorced (Specify)
8b County ot Dealt>
Cunber land
East Pennsboro 1Wp.
11 Decedenl's Usual Occ alion Kind of work done durin most of workin life; do nol slale retired
Kind of Work Kind ot Business/lnduslry
Installment loan Office POC Bank
16 Decedent's Mading Address (Slreet, cityJlown, stale, zip code)
12. Was Decedenl ever in the US
Armed Forces?
o Yes JfJ No
Decedenl's
AclualResidence 17a. Slate
~~e~~~edent 17cYa Yes, Decedenllived in East Pennsboro
Townsh~?
Twp.
205 3rd St.
Sunm2rdale, PA 17093
17b. Coun~ Cumber land
17d, 0 No, Decedent Uved wilhin
Aclual limits of
CitylBoro
18. Falher's Name (First middle, Ias!)
19, Molher's Name (First, middle, maiden surname)
Humphrey S lors Sr.
lOa. Inlormant's Name (Type/print)
Lillian lollis
2Ob, Informant's Mailing Address (Slreet, cilyllown, stale, zip code)
Allen W. Saussaman Sr.
78] Lancaster Ave. Enola, PA 17025
21b. Dale of Dispos~ion (Month, day, year)
21c. Place of Disposrtion (Name or cemetery, crematory or other place)
21 d. location (Cityl!own. slale, zip Code)
o Removal from Slale
o Donation
22b. license Nurrber
Paxtang Cerretery
22c. Name and Address of Facility
Paxtang, PA Ill] I
FD 0]2774-L
knowledoe, death occurred althe lime, dale and place sla,ed. (Signalure and litle)
Richardson F.R. Inc. 29 S. Enola Dr. Enola PA ]7025
23b. License Nurrtler 23c, Date Signed (Month, day, year)
: Approximate interval:
: onset to death
26 Was Case RefefTed \0 a Medical ExaminerlCoroner?
DYes YNO
PartH: Enter olher sianificanl condilions contributina to dealt!,
but not resufting in Ihe underlying cause given in Pan I
28. Did Tobacco Use ContritJute 10 Death?
.,d'Ves 0 Probably
o No 0 Unknown
25. Date Pronounced Dead (Month, day, year)
~:45 pM
CAUSE OF DEATH (See Instructions and examtHes)
ftem 27. Pan!: Enter the ~ - diseases, injuries, or cOfTlllications -thai directly caused the death. 00 NOT enter terminal events such as cardiac arrest,
respiratory arrest, or ventricular fibrillation wrthoul showing the etioloQy. 00 NOT abbreviate. Enter only one cause on a line.
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IMMEDIATE CAUSE (Final disease or
cond~(lf1 resutting in death) --7 a.
(2. E S f' I fZ--1't"TOrL 'r
Due to (or as a .E.Q.n~equence o~:
t::-H/'l-.'''-' {(:_ 0 tJS.~vE
Due 10 (orasaconsequenceo~:
;:::1ctt u.;/lE
/t:--./..JV) 'ld1S.
3Oa. Was an Autopsy
Performed?
31. Manner of Death
~aturat 0 Homicide
o Accident 0 Pending Investigation
o Suicide 0 Could Not Be Determined
32b. Describe how Injury Occurred:
29 lfFemale:
..~NOI pregnant within past year
o Pregnan' at time or deeth
o Not pregnam, but pregnant within 42 days
of death
o Not pregnant, but pregnant 43 days to 1 year
before death
o Unknown if pregnant within the past year
32c. Place of InjUry: Home, Farm, Street, Faclory, Office
Building, etc. ($peciM
Sequentially list condttions, if any,
r. leading 10 'he cause ~sled on Una a
Enter the UNDERL Y1NG CAUSE
. (disease or injury that inrtiated the
events resu~ing in death) LAST.
Due 10 (or as a consequence o~:
DYes J/! No
d.
JOb. Were Autopsy Fmdings
Available Prior to Completion
of Cause of Death?
OYes~
32a. Dale 01 Injury (Month, day, year)
32f If Transportation Injury (Specify)
o DriverlOperator 0 Passenger
o Pedestrian 0 Olher - Specify:
33tJ. Signature and Trtle of Certifier
~rl ~.
32g. Location (Street, cityllown, Slate)
32d. Time of Injury
M
33a. Certifier (check only one)
Certifying physician (Physician certifying cause of dealh-when another physician has pronounced death and completed 1Iem 23)
To the best of my knowledge, death occurred due to the cause(s) and manner as staled ......................
Pronouncing and certifying physician (Physician bolh pronouncing death and certifying 10 cause of death)
To the best of my knowledge, death occurred at the time, date, and place, and due 10 the cause(s) and manner as stated.................
Medical examinerlcoroner
On the basis of examination and/or investigation, In my opinion, death occurred at the time, dale, and place, and due 10 the cause(s) and manner as stated ........0
36, Dale Filed (Monlh, day, year)
....,;f-
'7><.
.0
33c. license Number
c.s. 06 S- '1 74--L
33d, Dale Signed (Month, day, year)
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d~
(See instructions and examples on reverse)
34 Name and Address 01 Person Who Col'l1'leled Cause of Death (Item 27) TypelPrinl
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8
LAST WILL AND TESTAMENT
OF
B. BEATRICE SAUSSAMAN
I, B. BEATRICE SAUSSAMAN, Widow Woman, of Summerdale,
ast Pennsboro Township, Cumberland County, Pennsylvania,
eing of sound and disposing mind, memory and understanding
o hereby make, publish and declare this to be my, Last Will
nd Testament, hereby revoking any and all Wills and Codicils
reviously made by me at any time heretofore.
FIRST:
I hereby direct my personal representative,
ereinafter named, to pay my just debts, funeral and testa-
entary expenses, including inheritance taxes, as soon after
y demise as may be practicable.
SECOND:
All the rest, residue and remainder of my
state, I hereby give, devise and bequeath to my four (4)
children, equally and per stirpes,:
A. To my son, ALLEN W. SAUSSAMAN, JR.;
B.
To my daughter, DEBORAH (nee:
SAUSSAMAN)
ARTZ;
To my daughter, JOAN L. (nee:
SAUSSAMAN)
C .
EICHELBERGER;
and
D. To my son, JON R. SAUSSAMAN.
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THIRD:
Should my son, JON R. SAUSSAMAN, die without
ssue, his one-fourth (1/4th) share as per Paragraph SECOND
bove, shall be divided equally among his siblings.
FOURTH:
BE IT KNOWN, that on this same date, I am
eeding my residence, known as 205 Third Street, Summerdale,
ast Pennsboro Township, Cumberland County, Pennsylvania, (as
er previously recorded Deed recorded in Deed Book "U", Vol. 19,
age 477), to my four (4) children as "Joint Tenants with the
ight of Survivorship", reserving for myself a "Life Estate".
A. I hereby direct that my son, JON R.
AUSSAMAN, shall have the first opportunity to purchase said
esidence from his brother and two (2) sisters.
1. Using his one-fourth (1/4th) share as
down payment, he shall be required to secure mortgage finan-
ing sufficient to pay his brother and two (2) sisters their
espective one-fourth (1/4th) shares in full.
2. He shall have a maximum of nine (9)
onths to do so following my demise.
FIFTH:
I hereby nominate, constitute and appoint
y son, ALLEN W. SAUSSAMAN, Jr., as Executor of this my, Last
ill and Testament.
SIXTH:
The abovenamed person shall not be required
to post bond or surety in this or any other jurisdiction for
faithful compliance of the office of Executor.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this
and two (2) other typewritten pages, identified by my signature,
to this my, Last Will and Testament, dated on this, the
;}--#- day 0 f,~j-~"-'- , 19 ;i~
A Adu~&~~ (SEAL)
B. BEATRICE SAUSSAMA~Testatri )
The preceding instrument, consisting of this and two (2) other
typewritten pages, identified by the signature of the Testatrix,
B. BEATRICE SAUSSAMAN, as and for her Last Will, who at her
request, in her presence and in the presence of each other,
have subscribed our names as WITNESSES hereto.
RESIDING AT
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COMMONWEALTH OF PENNSYLVANIA
s s.
COUNTY OF CUMBERLAND
C~';J fit 4l.US
, the Testatrix, and the Witnesses,
and
respectively, whose names are signed to the attached and
foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority, that the Testatrix, B. BEATRICE
SAUSSAMAN, signed and executed the instrument as her Last Will;
and that she signed and executed it as her free and voluntary
act for the purposes therein expressed; and that each of the
WITNESSES, in the presence and hearing of the Testatrix,
B. BEATRICE SAUSSAMAN, signed the Will as Witnesses; and that
to the best of our knowledge and sight, the Testatrix, B.
BEATRICE SAUSSAMAN, was at the time eighteen (18) or more years
of age, of sound mind, and under no constraint or undue influence.
4 &;ci1A~~~'/ (SEAL)
B. BEATRICE SAUSSAMAN (Testatrix)
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WITNESS
Subscribed, sworn to
SAUSSAMAN, Test ri
the WITNESSES
on this the
acknowledged before me by
'subscribed and
J;S and
~r
dS )AAefJ g (2
ry Public
B. BEATRICE
fo r(e me by
res:
o I'll! eJ'
Donald B. Ow~n. Notary Fu,:.\i(.. I l .., Ie
ennsboro Township, Clj.l11be~!~I1':J.:~'Ir'!'J 111;Lf( '12---
y CommISSIOn Exr~ov. ':'1. "".0.
er, Pennsylvania A$sQc*.ticn ot Notaries .
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