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HomeMy WebLinkAbout10-28-08PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Alice L. Kohler also known as Deceased FileNumber ~ ~ "QO ~ ~Q~~ Social Security Number Petitioners, who are 18 years of age or older, apply for: (COMPLETE `A' OR `B' BELOW:) ® A. Probate and Grant of Letters Testamentary and avers that Petitioners are the Executrix named in the last Will of the Decedent dated March 8, 2001 and a Codicil dated November 12, 2004 (State relevant circumstances, e.g. renunciation, death of executor, etc.) Except 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 of Letters of Administration (If applicable, enter: c.t.a; d.b.n.c.t.a.; pendente liter durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Name Relationshi Residence ~-..? (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with her last principal (List street address, town/city, township, county, state, zip code) Decedent, then 87 years of age, died on October 16, 2008 at Decedent 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 TOTAL C7 ~ 1 C~ © t~ -- - ".,~ ~ ~ ce~t~outh~ trd , `~ C ?'a ~enw~tie,'Ctumber~rtd - -~. _ , ~ ~ ?~ . ~ $ 8,000.00 $ 90,000.00 $ 98.000.00 situated as follows: 7420 Spring Road, New Bloomfield, Carrol Township, Perry County, PA Wherefore, Petitioners respectively request the probate of the last Will and Codicil presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Si nature T d or rimed name and residence G/`~~~~ Marlin Edward Kohler 441 South Third Street, Lemoyne, PA 17043 Keith Drinkwater Kohler 7420 Spring Road, New Bloomfield, PA 17068 3~.ti Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF SS 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirm and subscribed _~~~jf/~/~~~•// ~l/ ~~ Before me the a ~%j day of Sign re off P rsonal Representative !, p~~d Q ~ - ignature of Personal Representative /o"('( or the ester ,...~, Signature of Personal Representative C ~ -~. Q ~ _ ~ n , ~~ ~L~ '""'~ `: :; c- r~" N ; i - - .p GO File Number: 2,~ - ~ ~ i(~lov~ - ~~ Estate of P~.~~e L Kc~ h i e r ,Deceased `--~ ~~ ~ = Social Security Number Date of Death: o - t ~ -o ` "7 =~ AND NOW, ~\- ~ ~ , ~oo~- in consideration of the fore ~ ing Petiti satisfactory proof having been ~ented before me, IT IS DECREED that Letters ~e~ are hereby grlanted tto~' ` ' ~' - ~ s) ~(IAQ.Ia--~ ~C~.UJO.r~. 1(sJh\{~r tl. ~~ 1~,~`~r~lcwc.~-ker kCUh~2/ 1~.~~ -1C`Ol~e~ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of 3-~-o t Decedent. Coc\~c~ - ~w}ec~ FEES ~Qs,Y CA.~._vln.~ 11- \ Z -may Register of Wills •`)'~9a,9 ~~ Letters .......................~lo -c~u Short Certificate........... $ ~g • a-u Renunciation(s)............ $ .. Ce~c.\ ~ c • ...... $ t 5 . uU C~ ..... $_~ o. vy .... $ .... $ .... $ .... $ .. .... $ TOTAL ................ $~3 . cN Attorney Signature: .~• _ Attorney Name: Joshua B. Beisker Supreme Court I.D. No.: 94545 Address: c/o Rhoads & Sinon LLP P.O. Box 1146 Harrisburg, PA 17108-1146 Telephone: 717-233-5731 105_Rp5 RFV /Dr(n7~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 14808351 Certification Number REV 11/2006 PRINT IN AANENT CK INK 1. Name d Decetlant (Fwl, middle. 1881, 9dna) Alice L. Kol 5. Ape (Last Birmdey) Under 1 ~ kiantlw 8 7 Yra. 6D. Coumy d Death Cumberland This is to certify that the information here given is correctly 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. Local Registrar ~ ~ Date Issued c_~ ~' ~ ca "~~ _[ t ~ _ ;!i ;~~ - ,.._ -_ - C iC.J _ ; .., 1 ]=* ; _`~,J q y -~ ~ , .~" COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE NUMBER 2. Sea 3. Social Security NunMr 4. Dale of Death (Mmm, day, Year', female 188 - 12'= 3124 n~+ 1~ Anna 8 Date d tvnn ree,wm nw wa Ilawe zevnea _ ~.. _~... ...,..~. ..~A..,. M. ~.nr Sept.4, 1921 Harrisburg, PA ~P~ 01~" &. Ciry, Born, Twp. of Deam ^ Irpaoent ^ ER / OutpeDent ^ DOA ^ Nureirp Hans 6d. FadlXy Narw (K nd inatnwm, ghw ebeal ant number) 9. Wes Decedent d HmpeMC Origin? ^ Ves Lemoyne 441 S. 3rd St. ,L~moyne (nr.s, apsciy cuDen, Mexlcen, Pwno Rlran, etc.) .•~ ,. mm w was acne dun moat d we. Do not stare .. ,._..,,.,,, • V Ki 12. Wee OeMMnI ever M LM 13. DecedenYe Educetbn (SLrocly my NpMM Wade aortpletedl nd d Wodc Kkd d t7wYresa I kWwtry U.S. Armed Forces? Emmenmry ! Secontmry (0.12) Cdrege (td or 5+) su ervisor sure commissi n ^Yea '~l0 12 2 16. DeceMnt'a Mawng Addrow ISMi, dry /lam, amle, zp Mtle) D,~e11,y 4 41 S. Third S t. Aawl RruiMnM na. score P a n n e ~, l v a n i a w l T,~mnvnc . PA 1 7nd'2 t7b,Couny Cumberland T°m"h'0? 18. Fami1 Name (FireL mitlde, lest, eulfia) Edward D k t' Manietl, widowed d 17c. ^ Yes, Decedent Lived in _ 17d. f ~} No. Deeetlent I~ved wmn, Actual Umim d _. 20e. InlmrenYS Name (Type /Print) rin wa ..r Pea Hare Marlin E. Kohler 20b. InlamenYs Maw Atltlres6 Street, re ( ay/lawn, smm, zip MM) 1 441 S. Third St.,Lemoyne ,PA 17043 2 a. Methotl of DiepMnion ~. Buni ^ Renpval from Stela ~ ^ Cremalim ^ Doatbn W 21b. Date d Diapoawm (Month, MY Year) 21c. Place d Diapoeigon (Name of Mmel cry, crematory a other place) 21d. Locatbn (City! town stele zi cod l ^ Other " SOecdY': as CrsmNbn a Donstbn Autlpr ~ srMwk:.lEZininilcoronerY izsd ^yea^,~ Oct. 22,2008 Rolling Green Cemetery , , p e amp Hill, PA 17011 bite o~ IYIBfd Service see (a perm scarp as such) 220. License Number 22c. Nana ant Address of Fedliy ~ 23 tl e "~ Gc-t FD-013163-L Musselman FH&CS,Inc.,324 Hummel Ave.,Lemoyne,PA17043 ec a y w brl Mrwying pryeiden d not avellede et time d dMM to 23e. To IM Mat of rty IowiMdge, deem rted at dw tlrtw, dew and °~'~~~ (SlWeaxe erd ~) 23b. tiMnce Number 23c. Dare Signed (Maxh day year( c•rdN cause d Meth. , , wM 2Apmqurw du1tM ~ oereon za. nme d Deem j c' ,~/ 25. Date Pranunceo Dwtl (Mmm, My. Year) CAUSE OF DEATH (See InetrueNOne end exampke) r APProzinem rerer item 27. PaR I: Enter the gbgjB,~y - deeases, eyuMe, a oomdiatloM -that direrdy cawed dte Mih. DO NOT mlar lemial events such m Mrdec arrest, r nedrotay erred, a veMricVmr nMYelbn vritlloid showirp the etlology. L'pt my ale awe m etch nne. r Onset ro Deam IMYEIxATECA~SE 1Flna1) tloeeae a r Ccmmddldlomn in death r --- a. ~, r r Ow to (a ae a oq: r Np Mrldlians, d arty, D, i En~iryuy~RLYM~~OayCalAaUd6»E a~ Due to (a ea a ooneegwna of): ~u~r everxe reawlmg n~datem) LAST' a ~ Dw m (a es a MnaeRUence dl: r r d. i 3a. Wu en Adapry 30b. Waro Aumpry F Im 81. Meurer of Daem 32a. Dale d Injury (Monet, day year) 32D. pasadDa How Iryury paurteo PeRametl? Available Prbr to d Comae d Deam7 emrel ^ Ii01nlLlde ^ Yea ^ Acdtlenl ^ Peawq Irn ~ don 320 Tkne d I Relemetl to MerAMI Ezamiwr 1 Coroner la a Reesan Other man Cremanon or ^ No _Twp. /Born Pan II: Emi ami ' ~ 26. D'd T M Use Cmtribue to Deelh7 bd not readlkp In me untledtirp Muse given m Pen I. ~i ^ Prebaby ~//' ~~/~/~ ^ No ^ lAamawn i;/1/t:~~~ ;.7i/L"e"'~~ ~ ~t 29. II Female: ~' ~'Aot propeM within pall year ^ PregMnt et time d Meth ^ Nd maptem, but pregnant wilMn 42 days a deem ^ Not pre9nenl out pregnant 13 Mys re 1 year Morro Math ^ tMmawn if pregnant wihin we peal year 32c. Plea of Injury: Home, Fam, 9red, Factory, ONM Bd kp, etc. (Speo'NI ^ Yea ^ No aeoga ~ rytxy Sze. Irryury at Work? 32f. II Trenepamlpn Injuy (SpacMy/ 32g. Lacalian at Injury (Street, city /town, smte) ^ Suickm ^ Codtl Na a Demmpwd M ^ Yes ^ No ^ D'Ner / Opereta ^ Paeaenger ^Pedeatrien 33a. CeMner (sack afy one) Omer " speaN: 33b. Signature and rde d Cenwer ' C«nying phytlcmn (Phyeeien Mnityng caws d deem when armmi phyeiaan nee IxonoariMd Maur and cmlpleted item 23) l~ilf// To 1M Daet d my krrowmdge, dWh ooMrretl tlw to IM Mues(q ird mwrr d slamd_ _ -' _ -"' _ -' _ ~ '~/ v' /L/ • Pranautldng 1md citifying physielan (Physkden bosh pronoundip death ant MRitymg to awe ddeem) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~. License Hunter ,/ To dta beat d my krrowMtlgs, seem oaumea i tM time, Mm, entl plow, antl aua to tl1e Muse(s) eM manner m staled_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ ^ CY G 33d. Date Signed IMmm, My, yeerl • Matlleal Exeminer /Coroner /N Av ~~ [ ~ .~ (•" ~' G~f" ~!'~ /6 On iM MNa of azaminNmn antl I a imytpslbn, in my opmim, tlsslh occumM et IM lime, Mte, end place, ant dw m Ilro Mu U / 1~7~~U se(a) antl manner a e8etetl_ ^ gn. Name and AMreas d Person Who Co~ysaNd CnuM d peam p~~ Type 1 Pant 35. Registrar's ~ re and /j 36. Dam Fned (Mash, My, Year) /l.1 aY vt ,a°. i*y A+1 i,' DisPMinoh Permit No. ~~ 67~ CJ / Q R f 7. Rant: Amiican Inden, Slam, White, ea. w~idite e III wile, give meitlen name) LAST WILL AND TESTAMENT OF ALICE L. KOHLER I, ALICE L. KOHLER, of Lemoyne, Cumberland County, ~ i Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made . c7 '~==_ ~(~ c~ , My husband, Marlin E. Kohler, predeceased me'~~ tk~~ ~~ -=~ m _ children born of our marriage are Marlin Edward Kohler". ~iud Kith - - -,, _, ~ _ . _:.,1 s Drinkwater Kohler. ~ ~` 7 --i ~] ~~> . 1. TANGIBLE PERSONAL PROPERTY. I give and beque,`~..h all of my household furniture and furnishings, automobiles, books, pictures, jewelry, china, crystal, appliances, silverware, wearing apparel, articles of household or personal use or adornment, collections, artworks, boats and recreational equipment and vehicles, together with all policies of insurance thereon, to my sons, MARLIN EDWARD KOHLER and KEITH DRINKWATER KOHLER, if living at my death in as nearly equal shares as they shall select under the supervision of my Executor. Any cost of packing and shipping said personalty to the beneficiaries, including insurance, shall be paid by my Executor as a general administration cost. If any Page 1 of 7 Pages 378290.1 1 ~ I t ~ ~~ such articles cannot be fairly divided or distributed in kind in the opinion of my Executor, such articles shall be sold and the proceeds thereof shall pass as a part of my residuary estate. 2. BEQUEST OF RESIDENCE. I give, devise and bequeath all of my right, title and interest in my real property known and numbered as 441 South Third Street, Lemoyne, Cumberland County, Pennsylvania, to my son, MARLIN EDWARD KOHLER, if he survives me. If he does not survive me, this bequest shall become null and void. 3. RESIDUE. I give, devise and bequeath all the rest and residue of my property, real, personal and mixed, not disposed of in the preceding portions of this Will, including all property over which I hold a power of appointment (which powers of appointment I hereby exercise in favor of my estate), to the then Trustee of "The Alice L. Kohler Revocable Living Trust" created by my declaration of trust dated the same date as this Will. 4. SPENDTHRIFT PROVISION. No interest in income or principal of my estate shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary of my estate prior to the beneficiary's actual receipt thereof. My Executor shall pay over the net income and the principal to the beneficiaries herein designated, as their interests may appear, without regard to any Page 2 of 7 Pages ~ 1 y 1 1 attempted anticipation (except as may be specifically provided herein), pledging or assignment by any beneficiary of my estate and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. 5. SURVIVAL PRESUMPTIONS. Any person who shall have died at the same time as I or under such circumstances that it is difficult or impossible to determine who shall have died first, shall be deemed to have predeceased me. 6. FIDUCIARY POWERS. In the settlement of my estate, my Executor shall possess, among others, the following powers, exercisable without prior court approval, but in all cases to be exercised for the best interests of the beneficiaries: (a) To retain any investments I may have at my death so long as my Executor may deem it advisable to my estate so to do, including securities owned, issued or underwritten by any corporate Executor or any of its affiliates. (b) To vary investments, when deemed desirable by the Trustee, and to invest in every kind of property and type of investment, including securities owned, issued or underwritten by any corporate Trustee or any of its affiliates, or as to which such Trustee or its affiliate acts as investment advisor, as the Trustee shall deem wise. (c) In order to effect a division of the principal of my estate or for any other purpose, including any final distribution of my estate, my Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. If such division or distribution is made in kind, said assets shall be divided or distributed at their Page 3 of 7 Pages respective values on the date or dates of their division or distribution. In making any division or distribution in kind, my Executor shall divide or distribute said assets in a manner which will fairly allocate any unrealized appreciation among the beneficiaries. (d) To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my estate, any or all real or personal estate or interest therein owned by my estate severally or in conjunction with other persons or acquired after my death by my Executor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in this Will. (e) To mortgage real estate and to make leases of real estate for any term. (f) To borrow money from any party, including my Executor, to pay indebtedness of mine or of my estate, expenses of administration, Death Taxes or other taxes. (g) To pay all costs, expenses, legally enforceable debts, funeral expenses and charges in connection with the administration of my estate. (h) To vote any shares of stock which form a part of my estate or trust and to otherwise exercise all the powers incident to the ownership of such stock and to actively manage and operate any incorporated or unincorporated business, including any joint ventures and partnerships, and to incorporate any such unincorporated business, with all the rights and powers of any owner thereof. (i) In the discretion of my Executor to unite with Page 4 of 7 Pages any other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of my estate. (j) To assign to and hold in my estate an undivided portion of any asset. (k) To hold investments in the name of a nominee. (1) To compromise controversies. (m) To disclaim, in whole or in part, any and all interests in property owned by me at the time of my death, including those passing to me by Will, intestacy, contract, joint ownership, operation of law or otherwise. (n) To employ and compensate from income or principal, in the discretion of my Executor, investment and legal counsel, accountants, brokers and other specialists, and, whenever there shall be no corporate Executor in office, a corporate custodian, and to delegate to investment counsel discretion with respect to the investment and reinvestment of any or all of the assets held hereunder. 7. EXCULPATORY CLAUSES. In the settlement of my estate: (a) My Executor shall not be personally liable for any loss to my estate or to any beneficiary of my estate resulting from an election made in good faith to claim a deduction as an income tax deduction or as an estate tax deduction. (b) In valuing property in my gross estate for the purposes of any Death Tax, my Executor shall not be personally liable for any loss to my estate or to any beneficiary of my estate resulting from my Executor's decision made in good faith to use a particular valuation date. 8. TAX CLAUSE. Except to the extent paid by the Trust Page 5 of 7 Pages __ _ :, described in ITEM 3 hereof, all inheritance, estate and similar taxes becoming due by reason of my death, except any taxes relating to generation skipping transfers imposed under Chapter 13 of Subtitle B of the Internal Revenue Code, as amended ("Death Taxes"), whether such Death Taxes shall be payable by my estate or by any recipient of any property, shall be paid by my Executor out of the property passing under ITEM 3 of this Will as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any Death Taxes paid by my Executor, even though paid with respect to proceeds of insurance or other property not passing under this Will. 9. EXECUTOR APPOINTMENT. I hereby appoint my son, MARLIN EDWARD KOHLER, and THE PRUDENTIAL SAVINGS BANK, F.S.B., or its designee, as Co-Executors. If for any reason either should fail or cease to act, the other shall act or continue to act with all the powers granted to the two of them. All references in this Will to my "Executor" shall refer to my originally named Co- Executors, or to my successor Executor, as the case may be. 10. WAIVER OF BOND; FIDUCIARY FEES. The Custodian and my Executor shall qualify and serve without the duty or obligation of filing any bond or other security. Any corporate fiduciary Page 6 of 7 Pages 1 shall be entitled to compensation for services in accordance with the standard schedule of fees in effect when the services are rendered. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding six (6) pages, this ~ day of ~ G~ _, 2001. ___s~~~C.e' ~' J6~~`7~ht;{~(J ( SEAL ) Alice L. Kohler We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound and disposing \_ (SEAL) Residing at d"!J j Residing at : ~-i1 ki dden wood Dr. ~ Hg; r r is b ~ r~i , r"~~4 (SEAL) Page 7 of 7 Pages r COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF ~-i`'""`Q~"~ We, ALICE L. KOHLER, ~-~_~~~ °Jw.;t~ and ~ - 1. r~~~ct ~~4~ the Testatrix and the Witnesses, respectively, whose names are signed to the foregoing instrument, having been sworn, do hereby declare to the undersigned officer that the Testatrix, in the presence of the Witnesses, signed said instrument as her Last Will and Testament, that she signed voluntarily, that each of the witnesses, in the presence of the Testatrix and of each other, signed said Will as a witness and that to the best of the knowledge of each witness, the Testatrix was at the time of sound mind and under no constraint or undue influence. Subscribed and acknowledged before me by ALICE L. KOHLER, the Testatrix, and subscribed and sworn to before me by ~-~~~-v.~ A.S~~'~C.._ and ~_~. ~~c.v-d~.1~I~~_ the witnesses, on this ~~"~ day of 1`fll.~-xc-fti__ 2001. Notary blic My Commission Expires: (SEAL) Notarial Seal Cindy L. Leitzel, Notary Public Harrisburg, Dauphin County z a a ~ ~ a i My Commission Expires Dec. 2, 2002 *Jier~ihar. ~~ennsylvania Association of PJotaries i CODICIL TO THE LAST WILL AND TESTAMENT OF ~ `~' o ~' -, ~ ~, ALICE L. KOHLER _ n ~ -, ~ ~ , -.~ -~ ~ rv rr% ~~ co . ~- . ; __, --. ,~ Y'1 ~ .. I, ALICE L. KOHLER of Lemo ~ J" ~ . yne, Cumberland County, Pennsylva~Zi~+ being ~ ~ _ .~- sound and disposing mind and memory, do make, publish and declare this to be a Codicil to my Last Will and Testament dated March 8, 2001. 1. I hereby add a new ITEM 2A (between existing ITEMS 2 and 3) to my Last Will and Testament, as follows: 2A. BEQUEST OF PROPERTY. I give, devise and bequeath all of my right, title and interest in my real property located in New Bloomfield, Perry County, Pennsylvania, to my son, KEITH DRINKWATER KOHLER, if he survives me, free and clear of all mortgage encumbrances, any such mortgages to be paid by my Executor as a debt of my Estate. If Keith does not survive me, this bequest shall become null and void. 2. I hereby revoke ITEM 9 of my Last Will and Testament and in lieu thereof provide the following new ITEM 9. 9. EXECUTOR APPOINTMENT. I hereby appoint my sons, MARLIN EDWARD KOHLER and KEITH DRINKWATER KOHLER as Co-Executors. If for Page 1 of 2 Pages 537825.1 any reason either of them should fail or cease to act, the other shall act or continue to act with the powers granted to the two of them. All references in this Will to my "Executor" shall refer to my originally named Co-Executors, or to my sole surviving Executor, as the case maybe. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this Codicil to my Last Will and Testament, consisting of this page and the preceding one (1) page, thisf~ day of 2004. L~.t~ ~L - ~~BVIEAL) Alice L. Kohler We, the undersigned, hereby certify that the foregoing Codicil was signed, sealed, published and declared by the above-named Testatrix as and for a Codicil to her Last Will and Testament, in the presence of us, who at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time ecutio thereof, the said Testatrix was of sound and disposing mind and memory. (SEAL) Residing at: ~ ~~ (SEAL) ~s~~ a~ Residing at: /vZ/ ~,~Qi Page 2 of 2 Pages COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS: We, ALICE L. KOHLER, Testatrix, ,c\~ ,~ _ ,~,~--and ~`~ ~ cl ~. Kru~ the Testatrix and the Witnesses, respectively, whose names are signed to the foregoing instrument, having been sworn, do hereby declare to the undersigned officer that the Testatrix, in the presence of the Witnesses, signed said instrument as a Codicil to her Last Will and Testament, that she signed voluntarily, that each of the witnesses, in the presence of the Testatrix and of each other, signed said Codicil as a witness and that to the best of the lrnowledge of each witness, the Testatrix was at the time of sound mind and under no constraint or undue influence. fitness Subscribed and acla~owledged before me by ALICE L. KOHLER, the Testatrix, and subscribed and sworn to before me by ~.n ~c..i ~ 5 ~-t ~- and ~G~t ~ c( ~~~ ~~~~~, the witnesses, on this I~..day of ti(o`le ~-~ tam---- , 2004. Notary Publi My Commission Expires: (SEAL) COMMO WEALTH OF PENNSYLVANIA y Notarial Seal City of Harrisburg, Daup ih n County My Commission Expires Dec. 2, 2006 Member, Pennsylvania Ass::cia+ipn cf Notaries