HomeMy WebLinkAbout08-11-08PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF ~~+.~-~~~ -\c,.~~~ COUNTY, PENNSYLVANIA
Estate of C~-~~~~„\~~~~C ~. (~rrc~
also known as
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(CO:YIPLETE A' or 'B' BELOW:)
~A. Probate and Grant of Letters Testam
last Will of the Decedent dated i\ ". ~ >>-
v
r /~
File Number ~~ ~ - ~~~;~ JC-'.~~~-/I
Social Security Number ~ ~ ~ ~ ~ ` -~
and aver that Petitioner(s) is /are the ~~~ j ~ r~ named in the
_ and codicil(s) dated
(State relevant circumstances, e.g., renunciation, death of executor, etc.) - - _,
Excep[ as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person: :~~- , ~ -~ -~
^ B. Grant o1' Letters of Administration
(lfnpplicable, eruer: c. t. a.; d.b.n.c.t.a.; peadente /ire; durante nbsentia; durnrrte,»iiii'oriutte)
:_- f:~
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) ac~ieirs: (If
Adtninistratiat, c. t. a. or d.b n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Name Relationship Residence
(CO;LIPLETE LN ALL CASES:) Attach additional\s/:eets if necessary.
Decedent was domiciled at death in ~Sc v \~` k~~. ~ ~- County, Pennsylvania with his /her last principal residence at ~-- ~IL'~ ~l ".i~~ ~ 1r ~ t -'
f ~=~~ t~~ P' ~~ ~ ~ .'l 1 L ~C`L -- ~ ~ '~ I 7 U ~~~
(L1st street nddr~~s, town/aty, township, eounh~, state, zrp Vie/
Decedent, then ~ ,., years of age, died on ~ ~ ~ ~h' `~ ~ ~1 `~ ~ ' r'r \
i
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(lf no[ domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personai 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 with this Petition and the grant of Letters in the appropriate form to
the undersigned:
far,r, Rtv-o~ r~,-. lo.r3.o6 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COliNTYOF ~~~~(~~ ~~~~~~: .
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and con'ect to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law. _
Sworn to or affir imed and subscribed
before me the _ I (~ ~ ~ day of
F
'ice-~~,, lc ~~ _ ~~ ~1~ ~~ -
~,
For the Register
i~ .
SiJnature ojPersonal Represe
Si~nnfure ojPersonal Representntive
C ~ _, M
Signature ojPersonal Representntive
(( ~~ i
File Number: __ ~~' _ ~) _ ; -~ ~ ,
~ --
Estate of ~_! 11Ct~' I~; ~ i~~.~~Cf ,Deceased ~==
Social Security Number: ~ ?~ ~ ~ ~~ , ~~~ ~ ~ ~ '`~ ~ ik
Date of Death: ~ ~ ~ ~ xi r!, ~ '
AND NOW, ~ ~ ~~~ L ~~ ~ (~ ( ~~" ,_~ ~~ in consideration of the foregoing Petition, satisfactory proof
having been presented be~re ~ ; IT ' DEtC ED that Letters ~{~ ~`}~~`'j~-~'(~~ ~~,~
are hereby granted to (~ ~ I ~ f~. , ~,, ~ ~ i ~' (/`
J
_ _ in the above estate
and that the instrument(s) dated ~ ~ ~ ~} `;
described in the Petition be admitted to probate and filed of reco as the last Will (and C icil(s)) of Decede~a. r
,.
(, r
FEES ! ~~t~ ~~~
r ~
Letter's ~ ' ~z' Register ojWills / , r C ~ /
Short Certificate(s) ........ $~_
Renunciation(s) .......... $
f ~ ... $ i t~. . L-'
... $ ( ~~
l ~_ .,1~~ Ci~ ~_... $ ~~- ~~-.
... $
... $
... $
... $
... $
... $
TOTAL .............. $ ~ "~}
Form RW-pZ rev. 1Q 13.06
~ ,~ ~~- .
Attorney Signature: II /
Attorney Name: ,~ ~~,~' /l7 !'G{ ('~ c-~c- C
Supreme Court LD. No.: ,~ S ~ ~ ~r
Address: _ ~ l y /~~. ~<-, c (% S c ,., ~"~'c
Telephone: _TCI~ S GAS - C/ ~C' /
Page 2 of 2
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L~3CAL RECiST'RAR' ~ERT'IF~tJAT'IOiV t~F EY ~~
W~iRNIf~~: It is illegal to duplicate this cca~ay h±~ plea{tastat t1r c'I~ataga~t~-~(~
Fee tirr this certificate. `~f~.(Rl
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iYrE PRINTIN
Ft Rf.tANEN(
BLACK INK
I. name of De<edem IFrsi middle. last ,unir)
S Age ILast
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse)
STAIE FILE NUh18EH
Charlotte P. Reed 2 sea ' ~'^'$eCUf1ryNwndar
_ Female 183 _ 12 _ 3977 4 Da'aaDealnlM°~u~~is~t 5, 2008
.. _.._ Under 1 OaY 6 Dale of Binh IMonlh. day, year) 7. BiM lace CB
Monins oa,s r>Wro Mnuies P ( y and stale or loreign country( 8a. Place of Death (Check onl
86 Y ones
ws March 28, 1922 Mechanicsburg, Pa. "O5Q11~~ Other.
Bb Count} of Deam &. Qly &uo, Tw 7 ^Inpatienl ^ ER; Oulpahem ^ DOA
p °Deam Bd Facility Name (II not inslilulan. give street and niarmer) ~~~ Nursing tsume Residents ^Olner - S{;ecily.
Cumberland Silver Spring g was DetedenlaHrapanK orgrn+ ~ N° ^ Ye: ,o Rate Ame can r>aan Bldck
6 Blue Mountain Vista olYea.weeiycaL,an, wit..e ek
11 Dacedenl's Uswl Ottu IWn (Kira W woM done Burin moss of world Ille. Ib rot slate reared Mexcan. Puen° Rican. etc-) ISpeoly) W h Ire
NW of Work I 12. Was Decedent ever in me 13. Decedent's Ed
Kind of Business' Industry U. S. Arn d Forces? aralron (Sp¢city only highest grade completed) I4. Manlal Status.. Marned, Never Married, 15 Sunni
Homemaker Own Home IISrOO'~'~ Elementary/Secondary (0.12) College (14or 6r) wYk,wed Dmnrted lspacr rg Spouse 0t wde. qve maden name)
I6 DecNenl s Marling Address IAreel, wly /town, stale. rip c°tlel ^ Ves 40no 1 ~ W Idowee~
Decedent's
6 Blue Mountain Vista Anual Residenre va Stale PA Did o~adenl ~-,/
l,ve m e 17c Ilp yes, DecSdenl Lned m
Mechanicsbur , PA 17050 I7b couplY Cumberland r°w°snrp' r+ r„F
le Formers Norma cF~rsl middle lass. sercxl vd ^ Nn oecedern ti.aa wdnm
AtI W l Lams a
Charles Carroll Rhoads Ig MomersNarne(Faaimiddle,maidenaumame) coy/~r°
20a lotormanlsName(iyperPnnl) Retha Morrow
Pat Myers zoo.mmrmarn'aManingAtldresalSlreel wl /town stale r,p Dore)
zla MenexlolDiap°silan 310 ~IAonroe Street Mechanicsburg, PA 17055
Bunel ~ %remalron ^ Donalron 21b Dale of Disposili°n IMOnIn, da ,
^ ^ Ren~o~al Irom Slate I Was Cramalion or Donation Autflor¢ed yr Y Yaar) 21c PWre of Disposition (Name of cemetery. crematory or other place)
l7omar- ,-,y byMeditalEaamirKrycoronela xi'~IYex^NO August 7, 2006 2mL°Celgdicily7lownalal9ape°dal
zza s eolFw,er Conolite Crematory Schaefferstown, Pa. 17088
a son actirg as sutn 22G. Lcense Number 22c Name arW Adtlress of Facility
~ FD-012662-L Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, PA 17055
c°nYhele tie s z3a-c nrvy wnen cemlyin z3a Tom „nI my knowledge, loam ocw,nad at pre mite, ddla ens W staled Isgnawra and hllel
pnrsx:wr is not avaaaae aI mite of d:am to /
..nity muse of Beam ~ dC, z3b. License Number z3c. Dal s ned
~.J a g IM°nm, say. Yeap
hums 2/-26 nual De c'°mpleletl by parson 24 rm,e of Deam R N 5 17 S 3 ~ t_ A ~ Z ~U
wlro prarou e: Je' In 2 Dale Prorwuriced Dead (Monln day. year)
14J 1 M ~ ~ Z O,•,p 26 Was Case Relenetl to Medical Exam ner /Coroner lo, a Reas pher marl Cremation nr Dw,atia!?
CAUSE OF DEATH (See InslfuctlOn d x ~~O ^ Yns ^ ryo
/^~ le n 27 Parl I E u 5)~ y(g 4.ll5 J ea- , w an, kcal q s nal dreCll amp , Approx,nale nlerval. Pan II.. Enter omer y~g~d
J sD t Y I i - 1 bona Ir u, sno ng the el obgy. L sI onl used the Oa m. DO NO7 Amer lermi el events srp`i as cardiac arrest rd~IglyVIn1NlIg14 f>~, 28 Did Tobago use ConlubUla to Deam?
a r o~ cores n w,e. onset m Doan bm nor rehunag ~ me andenr,y caosa
WMEDNTE CAUSE IF I d,,,a e or c gven in Part I ^ Yes ^ propepry
r i cmdawn rerun ng r. dean/ ~A I, ~l,~ 1 ( ({ 1~ ~,( i~,~
-'~ a /'lA~ 4'•('t~-~T1C "~~( tcJ2. ~(c-NfeV~~ -~'"c ^urAruw
t'ti ° l ( y fl 29 It Female: n
SEquenhaYy hSl:.ondlrM5. it any b ~L~
kabn99 to me cause ksletl an line a l°"~I pregnant wulun past year
Enter tt~e UNDFflLY1NG LAUSE Due la for as a conseyuen,:e o1J.
A (6se sa or in,ury mat inil,aieo the ^ P,egnanl al lim¢ of Basin
(~ tints ruzulhng ai Meth) UST. ° ^ Nut aegnaril Lul pregnant wilnui 42 days
Due Ic 1ur as a consr~yuense oil of Jb Ih
d ~ ^ N°I Vregwnl, WI pre 143 days lu I year
balsa dean ynan
30a Was an Autopsy 30G Wara Autopsy Findings 31 Manner of Death '
Prna« rsd? Avaibble Pnor m Cun,piai 32a Dale of Inryry (Month, day, Year) 32b Describe Haw I ^ UrMnown n prsgwnl within Ine pest yea
J ul Cause of Death? ~rlalural ^ Homic,M
,~v~~' nlury Orly ~ 32c Place cl Injury. Hwre Farm Street Fagtry,
J onite twYarg. etc (spec,ryj
~ ^ yes ~ N° [~ ~,~, [] No ^ A„xiMm ^ Pending bweangatar, 32d rme pl m n
Swcide ^ ! ry 32e. Injury al Work4 321. II iiansponabon Injury (SpecrNl 32g Laabm d Injury (Street oty /sown slalel
cows Nnl nor oalemieretl M ^ res ^ Nn ^ Dn.er r operawr ~ Paasanger ^petleslriar,
T 33a cem,~ei Imccx only °rral ]Diner-specyy:
V CoenllYing pnysinan IPnys¢ien cendYiny cause of Deam when another h w,r 33b Sig a dil
r
T Ina best of my knowledge, deem occurred due to the cause(s) p Ysnan has Aron rcetl death end cwilpleteU Ilene 23l
• Pronouncing and cenity g phy 'clan IPny purr d r as slated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ F _ _ - /~ .
To the best of my know) dge, de to occu ed at the I [ o q d Ir d can ly ly to cause of Maai^.I - - -' ~J x,J
• Medical EYam ner / Cor 'dale d Dl nd due to Ine cause(s) d manner as slated_ _ _ _ _ _ _ _ _ _ _ _ ~~ 33c License Nu be 33d. Dale Signed M-nln. tla
on me oasis of e.am nal ,n - -- - 1 ~ Z ~ e yeah
d / r ve I gallon,'n my op ,'on, dean occurred al the Yme sale and place and sue to the cause([) and manrrer ac sWled_ ^ '~ o ~3'' + ~ 8 ~° a ~
2 , 9s1 isu.r/g S'yrygurt a ~D~11c1 Ww: ~o~~ _ .'+4 Name and Atldr~s of Perm Who CgliplateU Cause yl,Dgeri Illem 271 Tvce i P ir;i
Dispcsho:t PSnmt NO ~~.~,1 ~/ (X~
`~t~f i~~ ~n~ r~~menf ._.
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CHARLOTTE P . REED r ~
`~
^_ .',
`_ _~
`,y
`~ ~ ~a~
i, ::F~r'~~.LC`?'T~ P. rtEE-, c-;r ;~9ec.r!anicsburq, Cumberlar~ Coun t,
~~r,.~.s_.r ~ --~,~,;_- , revoke all r m~; fc~r.me~r Wi.1 1 s and Codi ails and `~
\ .,
1~C{.i u vL ~ 1
t ~~.'i'EN~EIQ':C ,~:r ~~T~`tI'IILY
I a:,~ r,,t. married. My r_hildr.ert are PATRICIA A. ?"IYERS o.f
=F~ ~r~,_.._.c._;burc; . F~ennsy.lvania, ~~-IRGINL~ L. SHAMBURGER of Fairfield
'r.~~~°, ~>.: k:ansas, and LI:NDP_ ?. D[JFFY r_)f Sa.n Diego, California. M•,r
:?t_e[~-~~hildren are DIANN M. MATHENY of Wilmington, Delacaare, and
i,~ ~. F:. REED, Jr. of Etters, Pennsyl~rani_a.
:-ARTICLE II
PAYM~'N'!' CiF L,EDTS AitiD EXPENSES
!~
...l
_.,
. ~ ~- ..>>ay..leilt: ~~f 1 i debts i ~~gally r-l.f_o.r_cea?;:1e against m.y°
-:, ;, f: r,- presenrE, ~a~ -:! r ~~~;e y, it~a~tr,~:r dur'i.t<<~ _tle
~; -~ , L~:%:,. :._ i?l'v ~:S`. ,'~ , .iE' F_nSy:~ _ _.atiL .11~ne~G,
~ .. _ ! ~1'lr' a.'~~r "1.,. .. .. _ ~_....i ~wi ~~.lJ .7 ~_ _. ~Vi~l 1J1 1'i.'.\~ 77L.)L Qy, ~i. ~. ~ C.
.- F .,,. ..~ _ .: F ~3 '~..'n~_~11 '~t~ :lt .~.~~- t_`1 my E.:v Ld 1. r:', ~~_~~V it.l 4'~. `.~. .. tlri! , li aY117
1.?('~ T (':Ci: v ,.i~i~) Lt<X1Ilg 1 ~LF .:!s .~ari,~?; , :'i"v~'11Fd ~"Jy Ii1G ~ ,:_r2~1V C~__
i_ ,clivi,~l?~dl., y an~~i passi.r.cJ ,Ar.:~er this ~ti--ill :,r otherwise, shah. be
E.;7CllIll~~~rt?C.i, `~'!~ irlde~Jt2d11~~.SS ,eC'Ure;x by S11Cr'i encumbrarxr,e sr~:~ll
~:c:~t be paid. by ray estate a?ld sucl~l property shall pass sabject to
all GrlCUrilbrar_ces exist inq ;:~t~ t:~y death.
SPEc~I~'I:; C;IF'T;= ~; ~r.''~.P~dGIh.C~?~,, Pr F~~~r]AI~ PR~)FEF.I_
- .~
L _.eave no spe~~'~. Li.~ i.:~'..> ,-1?..::i ~~I.,_ zl~y y~):~~;t,F;.r..t_•~ s.r.!.. ~ _ e
ir~~:-luded ire +.he residue pc~~`_:iori of t=r,is Will.
ARTI~~LE Iv
RESIDUE
I direr_t ghat the residue of_ my estate, being all my
pr~~perty not effecti~~ely disp~~sed of above, both real and
personal, be given to my children and step-children in equal
ehare.:, per stirpes.
~.~ . _ . r',E ~,'
Tl;XE:~
All estate, inheritance and other death taxes (except
c~~~~~eration-skipping taxes and taxes attributable to any power of
ar~pointment that I may havei, including any interest or penalties
thereon, which become payar:le by reasot~~ of my death, -whether in
rr~spe:-t to property passir. under: t.lis wi]_1 or otherwise, shall
be: paid as an administration expense without apportionment.
ARTICLE III
.';UR ~TIVGRS~~I P
Anyone named in the Will who dies within 30 day, after m~~
death !cr who dies under c i rcumstarices su:-h that it ~~annot be
E.-tablished whether such .indiv~duai died ~,~.ithin 30 days after my
t?F_~athi shall be deemed foY E~~l_irposes ~~~t~ this will, to have
o=de ~~-aced me .
~~R`I'~ ~L1~ "~I~.I
APPOIN'1'P~[ENT ,"?F ~ IDUCIARIES
I ap~pc>int my daughter, t'A~IKi,:"I.~ A. M`i'ER.S, as Personal
Rep resentat.ive of my estat:_>. It PA"I'RI~"I~ A. Mi'ERS i~ unwilling
~. ~ anal:le to act for any reason, ax,~~~~~;_nt my grandson, KIRK M.
Pi~ ERS, of '.hippensburg, r F_~Iii1s ;; l v~,_n ia, as Personal Representative
c~ my estate.
f,,~ ~r i ~:, ~~~. ~~~ I I I
PGWERS C~ FIUTJCIARIES
I confer upon my persc>nai representative the following
powers:
a) the right to sell ~r otherwise convert any real or
~~~~=rsonal. property at public or private sale, at such time or
times, in such manner, and f_or such price or prices, and upon
such terms and conditions as my personal representative shall
cletermll7ei
b) to execute and deliver good and sufficient conveyances,
a:.-signments and transfers thereof, without .liability of any
p°~~archaser for the app.licaticn of any consideration;
cJ t~ borroN~ money ~~,~ ~ t c; s~~c,izre 1-t;; payTent by mortgage of
r~-al or personal property, p) E;lg~, ~± investments or otherwise,
~~~~i_r_hout liability on tY~ie part of the lenders to see to the
application thereof;
d) to retain any investments at discretion;
e) to invest and reinvest at discrE=.ti.on, without restriction
to so-called "legal investments";
f) to make distribution in cash or in kind; and
g) to do all other acts and things necessary or appropriate
~~~ the management, admini_-~tration and distribution of my estate.
In addition to the powers listed above, my personal
r<~presentative shall nave ~~11 of the powers conferred upon
it.dependent personal repre,~,entative under the Pennsylvania
Probate rode, as amended, or any similar successor provision, to
t}1t~ exte_~t they are not in conflict with the provisions of this
articl~_~.
A~~1 such powers may ~~~~> exc~rci ;ed ~~ithout application to any
.~~.urt a.~d shall be ex_ercl,~ab7_e b~,~ an~y,~ alternate, survivor or
su:~cessor personal repress>r~tati_ve.
I direct that my personal representative shall not be
required to furnish securi;- in ar~y jurisdiction.
~~_R.TICLE I~:
NC) CUNi'EST
Every heir, iegate~., ~.+~~vis~-~e, or beneficiary under this will
(and any trusts created ir, this will. or intended to be created),
ti•~h~-~ contests in any court ~~~nv K;rovision of this instrument, will
n~:~t be entitled to any devises, legacies, or benefits under this
will or any codicil to th=is will or any trust created by this
will, and any and all devises, legacies, and portions of the
income or corpus of my estate, otherwise provi-ded to be given to
su:~h person, will lapse and is to be given, distributed, and
x,assed in accordance with .r~i:title I~ of this will or. as though
the person had died prior t-.o my death leaving no living lawful
~-~~scendants, my Personal Representative ( and trustee, if
~~pp1i-cable) zlamed in Article VII is specifically authorized to
de tend at the expense of m~~~ estate any contest or attack of any
1~~`ure on this will or any of its codicils, or on any of its
p~aragr_aphs or provisions.
IN WITNESS WHEREOF', I hive signed this will on this
~~~ day of ;~'-,
~ - --,.
~ ~ ~'
CHARI vTTE P . REEL
On this _~ -~_a~ _day o f ' t,:'_ ~f
iiC~~, we each witnessed testator's signing of this will,
te~~tator's acknowledgment >f this will. We believe this testator
~.-~ be of sound mind and meru~rv.
~1 ~-~- c Q
t;intat,irP,~,
,~
~~_~ress
~ -,r ,.
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~_ ~ _-~ 1 cy- 7--------------
- ---,-
r .:~ - - _- -- - -------
ature}
r:
ACKNOWLEDGMENT OF TESTATOR
Commonwealth of Pennsylvania )
ss.
County of Dauphin }
I, Charlotte P. Reed, the testator whose name is signed to
the attached or foregoing instrument, having been qualified
according to law, do hereby acknowledge that I signed the
instrument as my will; and that I signed it willingly and as my
tree and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Charlotte
P'. Reed, the testator, this ~~ ~ day of
r.
~ic~'n~h:;;1 2000.
ci
(Signature o
azure of Testator}
~~
(State of
ttorney)
sslon of Attorney}
AFFIDAVIT OF WITNESSES
Commonwealth of Pennsylvania )
ss.
County of Dauphin )
We, ~ h r ,2f' ~ ~l~a~~ and
- te a a-~,,a ~~-~=_~___- ~c~~~ the w i t n e s s e s
w.,ose names are signed to t-he attached or foregoing instrument,
being duly qualified according to law, do depose and say that we
were present and saw Charl,._,tte P. Reed, the testator, sign and
execute the instrument as her last will; that the testator 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 testator signed the will as a witness;
anc~ that to the best of our knowledge the testator was at that
time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn toi or affirmed and subscribed
(Witness
(Witness) 1 ~~'°
-__ '~~1 ~~ ~' _
{Signature of ttorney}
(State of Adm ssion of Attorney)
to before me by
witness (es) , this
> 2000.
ATTORNEY'S CERTIFICATION TO SELF-PROVING AFFIDAVIT
Co?runonwealth of Pennsylvania )
ss.
~'ounty of Dauphin )
On this, the ~ /
~~_i00, before me, %` - / _ the
=%~
undersigned officer, personally appeared~cott Alan Bly, of P.O.
Box_ 341, Hershey, Pennsylvania 17036, known to me or
satisfactorily proven t,o k_~e a member of the bar of the highest
court of Pennsylvania, and c..ertified that he was personally
present when the foregoing acknowledgment and affidavit were
,signed by the testator and witnesses.
I have signed my name and affixed my seal.
~ ~.~~ %
(Si_gnature, sea aiZd officia capacity
c%f officer)
NOTARIgt. S~Ai,
SHERRY A. MAY, N Pubic
Oerty TwP•. Dauphin
MY 00 ~~ ~+h-12, 2004
.. _ _ _ _.
STATE OF PENNSYLVANIA )
ss.
COUNTY OF DAUPHIN )
On this, the _ ~ ~~ ~~~ ~, ~
-- daY of ~~ ~; ~=
2;=.00, before me, the undersigned officer, personally appeared
Charlotte P. Reed, known to me (or satisfactorily proven) to be
the person whose name is subscribed to the within instrument, and
acknowledged that she executed tree same for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal..
(Signature) G
(Title of Offi~er)
My Commission expires:
~~~~~
~jy t2, zoo~a