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Home My WebLink About06-26-09~- PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND Estate of JEROME J. RIVERS also known as ,Deceased Social Security Number 201-26-9119 File Number ~ I ~ ^ ~ ~J -1 A Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the EXECUTOR last Will of the Decedent dated 9/10/1999 and codicil(s) dated 4/18/2009 ~: `. C °~ ' mimed to-.thrr ; r r,-,~ ~ , C~~ ~ ;: (State relevant circumstances, e.g., renunciation, death of executor, etc.).~t) '""~ ~ a ... .~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrumet~Fs) 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.) (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. COUNTY, PENNSYLVANIA Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his /her last principal residence at 624 Colonial View Road (Upper Allen Township) Mechanicsburg PA 17055 (List street address, town/city, township, county, state, zip code) Decedent, then 74 years of age, died on JUNE 8, 2009 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 situated as follows: 624 Colonial View Road, Mechanicsburg, PA 17055 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: or printed name and residence ~ ~ Mark Stephen Rivers, 20507 Quarterpath Trace Circle, Potomac Falls, VA 20165 Form R W-02 rev. 10.13.06 $ 10,000.00 $ 100,000.00 at HOLY SPIRIT HOSPITAL Page 1 of 2 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of JEROME J. RIVERS File Number ~I ~- a also known as ,Deceased Social Security Number 201-26-9119 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) ~ , A. Probate and Grant of Letters Testamentar and aver that P EXECUTOR ~ titi i / h ~ °~'_ ~ `"-- - ~`~ y e oner(s) s are t e • ed m-thee - ; last Will of the Decedent dated 9/10/1999 and codicil(s) dated 4/18/2009 ,,,, ~ _ . ~ f,m__, :-1 r~ t~ c; ~ ~' ., -;; (State relevant circumstances, e.g., renunciation, death of executor, etc.) -~ ""~ . C1 'i ~ , Except as follows, Decedent did not ma '~" rry, was not divorced, and did not have a child born or adopted after execution of the instrumet~(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 life; 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 his /her last principal residence at 624 Colonial View Road, (Upper Allen Township) Mechanicsburg PA 17055 (L~st street address, town/city, township, county, state, zip code) Decedent, then 74 years of age, died on JUNE 8, 2009 at HOLY SPIRIT HOSPITAL Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 10,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 100,000.00 situated as follows: 624 Colonial View Road, Mechanicsburg, PA 17055 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: o~rinted name and residence /i~~"t~,/ ~/~/i, ^ I Mark Ste hen Rivers 20507 rp - p Quarte ath Trace Circle, Potomac Falls, VA 20165 Form RW-02 rev. 10.13.06 Page 1 of 2 ~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND 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 affirmed and subscribed before me the ll~ day of q ^~I ~ For the Register Signature of Personal Representative Signature of Personal Representative File Number: ~~ - a R - !~ ~~ D Estate of JEROME J. RIVERS Deceased Social Security Number: 201-26-9119 Date of Death:JUNE 8, 2009 AND NOW, ~~O _~~~~, in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to MARK STEPHEN RIVERS in the above estate and that the instrument(s) dated September 10, 1999 and Codicil dated April 18, 2009 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil~j~of Deceder~ . n A n FEES Letters ............... $ ( •W Short Certificate(s) ........ $ ~ • (~ Renunciation(s) .......... $ ~ ... $ I S, 01~ $ ... $ ... $ ... $ ... ... $ TOTAL .............. $ ~3'-IS•UD ~ b/ Register of Wills ~ V ,~ Attorney Signature: ~_ Attorney Name: L Marie Coyne, Esq. Supreme Court I.D. No.: 53788 Address: 3901 Market Street Camp Hill, PA 17011-4227 Telephone: 717-737-0464 Form RW-O2 rev. 10.13.06 P1ge 2 Of 2 +n~ qn5 ?cV in.~n~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P X5494063 Certification Number H105.143 REV 112006 COMMONWEALTH OF PENNSYLVANIA a DEPARTMENT OF HEALTH • VITAL RECORDS TYPE ~ PRM1T M4 PeucAic"IEw"cT CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE 0 N ~ • i• l)) t~) ~~~ `~ ti ~ r~s 4~ om ~ r- .. ~:::~:: t ~ {_ ~, - rn tie ~ /~ r ._. - ~ ~ -~ - , .r a~ Q ~ ..,: ~ „~, -' y 1 fVante d Receded (First, ntidde, last, suffix) 2. Sex 3. Sodut Seventy Ntmher V 4. DsM d Dhm IMa~, day, Y••rl Jerome J . Rivers Male 2 1 - 26 - 9119 June 8 2009 s. Aye (Last eMdtday) under 1 under 1 da s.13ea a Birtlt , da , y. ' and awe « re. Plea a Daam Check ary AbnMa Daya 11axe tJi'rxtw Hospitut: Omar: 74 Yra. Nov. 18, 1934 Swoyersville, PA '~] l„pe~ ^ ER J outp.ti.m ^ DOA ^ 11oma ^ Reaaena ^ oMyr . sp.dry f)b. Cotxtry d Deem 8c. Cly, 8oro, Twp. a Deem 8d. FacMiry Noma (q not irytMutiort, yroe stns arld rarrMyr) y. Ws Deeded a Hispanic Orlyin7 ®No Yes 10. Race Anyriart MIQan, &adl. Whin, alc. Clunberland East Pennsboro Twp Holy Spirit Hospital ~ Ayrta ~~ ~- White 11. Deadad's Usual Oa Don Kind of work dory moat d We Do red elute 12. Was Decedent ever h My 13. DecedKM's Educal'an (SpecMy qtly highest grade conplsMd) 14 MerMal Stutw: Ma i d N M i d 1 S Kind d work Kind d BwMtessl En ineer EngineerirxJ U.S. Armed ForaeY ^ vea [$ No ~ / Se~rldery 10.12) college ~~•{ «s,> . rr e . ever arr e , Widowed, Divorced WidOiWed ~ 5. lxNvirp Spouw lM vents, give maiden nary) 16 Decedent's Mailing Address (Street, Gry /town, state, zip code) 624 Colonial View Road ,°~~"' , 7a. stau lvania ~ i°i: °B1t i 1,..,.~r Al fen 17c. ~ Yes Decedent Lived in "~'~ T -~+ Mechanicsbur PA 17055 , wp Toarclsfwp4 nD. cotrdy Cumberland red ^ No, Decadara Lived wMIMn Adual Limits d ~, J Boro 1 B. Father's Name (First, midde, last, suffix) tg. Momar'a Name (First, middle, nyiden sumarty) John Zoolkoski Martha Malikawski 20a Mbrmad's Name (type / PrinQ ZOb. MMormarM's MaiYrly Address ($DBef, dly / bwn, stye, rip code) Mark Rivers 20507 Quarts th Trace Circle, Sterling, VA 20165 21a Method d Disposition 1 ^ Cremalkn ^ Dararion 1 a ~ ^ Renaval rran style c 21b. Day d Dispositon (Month, day, rear) 21c. Place a DisposMiat (Name d txny4ry, crematory «adyr plea) 21d. Location (City! bwn, slay, zp Iwtle) ~ ~ ~ ^ ~r r. ~ a ^ Yaa^ N~ s June 10 2009 Gate of Heaven Cemete Mechanicsburcl, PA 22a. Signature of Service Licenses parson actiy as tuck) ~~ 22b. Lianas Ntmbar 22c. Name and Address a Facwy - ~ f~ FD-138630 Mal zzi F1~neral Home Mechanicsb PA 17055 Compkta ' 23ac only when a 23a. To the best my knowledge, death ocarred at the time, date and plea stated. (SipnaWre and title) 23D. L.kerye Number 23c DeN ~~ ( Oa •arl physici red avasaWe at tkrte am w . , Y, Y shay Asa a deem. Items 24-26 must be corrpleled Dy person 24. Time d Deam 25. Daq Prortotrtad Dead (Monet, day, year) 26. Was Case Referred Medical Examirer !Coroner tar a Reason OIMr Yyn Grematiart « Daytiort7 wAO woes deem. ~ , 3 o A.. M. ~Te1 N~ 8 3 0 0 ^ Yee CAUSE OF DEATH (See Irytruotbns and examples) 1 Approxknale interval: Item 27 Pan I: Enyr the f~d10.-LEYa015 -diseases, kyuries, or conplicaDOns • mat dkectly caused the deem. DO NOT erMar yrminal events such es cardaC arrest, ~ Onset m Deem PaA U: Eder other but ryl resulting in tly undenjrtq cause ykr«t n Pan I ~. Did TaDecco Use ~ peam9 ^ Y ^ P respaatory arrest ar ventikular librieation without showing me etiobgy. LW Dreg area ease an each tine. 1 1 WMEDIATE A USE F C d % . es . ^ 14o tMtMrtown p t ~) II sease or ^ /~^ ~ _ _ ,,, / / ~, _ ~ / ^ I ~ ~ _ i arldDrort res n des y y1 (~Y/ ( (/~ 2g. tl FamW: ~ ` 1 am' l ~ _~ a. ~ `(,(~( ~l~/ l ~(I ~ 1 ^ N Dw q (Of 8a B cancegtrerta On' 1 uenkaeyy fist conditions. d any, D. j k b tAe cause Mated on tiry a d pregnant wWurt Past year ^ PregnarM ut Drry d aam ^ Due to (« es e Eder lN4DERLYING CAUSE consequence dl: ~ Na pregrtartt, bw prsynarM wytin 42 dsya ldiseaee or rr~~ryry mat MMuakd me 1 evade resuarq k+ dean) UST. c. 1 d deem ^ Due b (a as a consequence d): ~ Nd pregrtad, D+M pregruuM 13 days a t year d ~ buton deem ^ tMMe,oan M pregrwM wilten ry pact year 30a. Wes an Autolyy Pedormed7 30b. Were Aubpsy FMtdMpa Available Prior W Completion 31. d Deem 32a. DaM d Mary (Monet, day, Year) 32D. Deaatbe How kijury Occurred 32c. Plan a Irtjtry: Home, Farm. SMeut, factory, ~ Ollie Buildr (~ 1 / d Cause d Deem? ~tlrrut ^ Homicide , p Y ^ Yes CJ No ^ Yes ^ No ^ Accident ^ Pending Investgation 32d. Time d Mtjtry 32e. Mtjury ut Work? 321. II Transportation MMWY /SpscrYyJ 32y Locution d Mtjury (SInaL dy J town, atw) ^ Suicide ^ Could Not be DeWmtMyd M ^ Yes ^ No ^ Ddtrer/Operator ^ Passenger ^ PsdasDiart Omer - SpacAy.• 33a. Certifier (dyck sty one) 3;{b Signature and TNN f,~ • CertMyMly phyeklarl (Physidart anilyirp catty d death when anoater pAysiciart has poratrtced deem and anpleted Ibm 23) ~ ~, Te tly fxfst a m yMnowNdye,OeatlloalunddtylolMcauea(s)andmarlrwaututad--------------------------------- Pr«touncMq and canpYlny phydelaa (Phyaiciart bom pronartdny deem era certYyMp to ease a seam) 33c. Lkxaye Numbw 330. DaN Sig+yd (Mlrttit ear) d ay , • Tut ExawaiYmi YwIC«orler , dWh oallrred ut fly tMy, dau, and place, and dw M fly eauee(e) end manner a wted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Q ~~ / _ L~ y / l p O~ IV Q On fly baa4 of aamkytion and J « Invutigatbn, in my opidan, deem occurred ri tM data, dau, and place, and dw to tM cause(s) and mwyr w ataMd. ^ 3<. Name end Address a Person Wla Caws d Ream (Kam 27) Type / Pmt ar's Sigryture and District ~ ~ ( ~ ~ 1 ~ ~ ~ ~ " 3B. DW FiW (MAMA, OaY~ Y•~) ~ Sl~~i~~ a - G ~ Q ~ %V ~l f- .r / o P ` U ~ DispoailionPemYtNo. 0~18670 -. 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. 6 ocal Registrar Date Issued a< ` ry r ,. ~~~ ~ ~ ~ r ~~ 1 ~~~ ~ ~, _ ~~~~ ~ ,. ..~~ ~~ ~,,; ,f... X~ ~~ ~ ~~ ~ ~~. ~ . Y . ~ ~~ ' ~-~ ~ ~~ ~ ., ~L ~~ ` G 7 !~ ~', < ~~~~ ~~ ~/%La ~~ -~ Z~~ C. //'~' ~ / ~ r f ~ -~ ~~' ~ ;y~-tom-- ~--9~. ~ ---~2~-~~L ~' ' -~- ~.~ ~--~~, d ~~ ~ ~~ ~ ~'2'._.~-1 ~ 9 ~~ J ' ? ~ ! r ~ ~~~~ ~~ `~~ ~. ~ r l ~' ' ~~ ~~ ~ ~~. . ,~ ~ ~ -~ ~~z~~~ ~ ~~~~ c ~~ -- '~(~ 7 ~ .. =~ ~~, ~ ~~ ~~' ,~ ~ ,~ F k 1 ~; J l J ~"~ ~~ ~~ ' ~ .~~~ ~s _ ,, ~f ~ ~~ r r a LQ~~~- ~j„ ~r` ~~ ~ ,/~ c~ ~J ~ ~ ~, ~ O ~~.~ s. ~~ ~~ ~~.~~.~~ K ~- ~~ ~~ °z ~~c ~~ ~e w~,-7- i-e, /l-~r ~ ~~ ~~ i ~ ~~ ~E~ .~~ ~Ga„x~„~~~ ~ ~~ ;~- ~~~ ~ ~~~-e -Z . c3~ , ~. ~~~ tip- ~ -~ ~ ~~ ~~~~~~~ ~~ ~ ~ ca,u -~ c4) ~~, ~. r ~L~~~~ `' -t~ ~ ~, -~~-~- ~~ --~ ~~ ~- -~- a r ~~ ~~~~' ~'~~~ i ~,. ~ ~./ } ®,~a"~~G j'am`- `~ M '" I `~~ r'7v . ~ V - ~ ~~ a~g ~~ ~~~ ~ ~~~.wa~~ ~~~~.. SS#~2o/-~~-gii9 ~d , d~~. ~~~ ~ OATH OF NON-SUBSCRIBING WITNESS(ES~ REGISTER OF WILLS "~ ~ CUMBERLAND COUNTY, PENNSYLVANIA ~ ~ ~ ~~~~ ~~-~, -c~.. ~. Estate of JEROME J. RIVERS Arr. 9..1 I cr `-- _:+ c~ - , ,_~ Deceased ~ MS~~~~ ~ and D sC ~R ~ , l"I ~l /jC S (each) being duly qualified according to law, depose(s) and say(s) that acquainted with JEROME J. RIVERS she / he /they was /were well- and am/are familiar with the handwriting and signature of the decedent, and that the signature of JEROME J. RIVERS to the foregoing instrument purporting to be the Last Will and Testament/Codicil of JEROME J. RIVERS is in his/her own proper handwriting. (Signa re) .. C~3o CoLo~v«L (~l ~c~ ~v ~~ (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~D~ day of , ~~_. ep ty fo Regist of Wills Form RW-04 rev. 10.13.06 ESTATE OF: JEROME J. RIVERS, DECEASED BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA NO 21-2009-0598 DECREE OF TIIE REGISTER OF WII,LS AND NOW, this 26th day of June, 2009, upon consideration of the Petition for Grant of Letters filed by Mark Stephen Rivers, for the above decedent and the instrument offered for probate as the Last Will and Testament which is dated September 10, 1999, and containing certain alterations and interlineations thereon, the Register of Wills having given consideration thereto, has made an official determination regarding those alterations and interlineations and renders the following decision: IT IS DECREED that the instrument be admitted to probate as The Last Will and Testament of Jerome J. Rivers, including the obliteration of the name Jerome Bradley Rivers on Page 5 of 5 and the addition of the name Mark Stephen Rivers to the same page and paragraph. IT IS FURTHER DECREED that upon posting of a surety bond in the amount of $20,000, Letters Testamentary shall be issued to Mark Stephen Rivers. Mark Stephen Rivers shall have all the rights and duties of a fiduciary under the laws of Pennsylvania and shall proceed with the administration of this estate according to law. ,~ -- a.. -- ~-- ~ ~ ~~ ~:~:~ ~ , ~ c ~~ i t_i : (~ _ .-.' J E .l .~ ~ ~ .Z U `~ ~ :- Q, ~ ~. c c~ U r~ Glenda Farner Strasbaugh, Register ills f ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: JEROME J. RIVERS CUMBERLAND COUNTY PENNSYLVANIA N0.21-09-0598 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 06-26-09 JUDGE'S INITIALS: GFS TIME STAMP DATE: 06-26-09 ~ ~: DECREE OF THE REGISTER SERVICE TO: MARK STEPHEN RIVERS METHOD OF MAILING: ENVELOPES PROVIDED BY• ^ USPS ^ PETITIONER ^ RRR ^ JUDGE ® HAND DELIVERED ^ CLERK OF ORPHANS COURT ^ OTHER MAILED: 06-26-09 SERVICE TO: METHOD OF MAILING: ^ USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT -,^ D Clerk of Orphans' Court "" POWER OF ATTORNEY ,N.~,"N~~ STATE FARM FIRE AND CASUALTY COMPANY KNOW ALL PERSONS BY THESE PRESENTS: That STATE FARM FIRE AND CASUALTY COMPANY, an Illinois corporation, with its principal office in Bloomington, Illinois, does hereby constitute and appoint: Robert May of Camp Hill, Pa and deliver for, and on its behalf as surety, an and all bonds, undertakin s or otherr writin snobli ato Attorney(s)-in-Fact, to make, execute, seal Y g 9 9 ry in the nature of a bond as follows: $ 2,500 -License, Permit or Indemnity -Financial Guarantee $25,000 -License & Permit- Code Compliance $25,000 -Public Official +v?nC~4~uz~ THIS POWER OF ATTORNEY IS NOT VALID FOR THE EXECUTION OF ANY CONTRACT (CONSTRUCTION OR SUPPLY) BOND -BID, PERFORMANCE OR PAYMENT. This appointment is made under and by the authority of a resolution which was passed by the Executive Committee of the Board of Directors of State Farm Fire and Casualty Company on the 24th day of July, 1974, as is duly authorized by the Board of Directors in Article II, Section 6 of the By-Laws of the Company, which resolution is: Resolved, that the Executive Vice-President or aVice-President of the Company is hereby authorized to appoint and empower any representative of the Company or other person or persons as Attorney-in-Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other writings obligatory in the nature of a bond, which the Company might execute through its duly elected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney-in-Fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any Attorney-in-Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of Attorney. Resolved, that the signature of the Executive Vice-President or any Vice-President and the seal of the Company maybe affixed by facsimile on any power of attorney granted, and the signature of the Secretary, Vice-President or Assistant Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal 1~all be valid and binding on the Company. Any such power so executed and sealed and certifcate so executed and sealed shall, wit s ect to a and or undertaking to which it is attached, continue to be valid and binding on the Company. ~ ; , ` - L. ~_.,~.., ,~ 1 IN WITNESS THEREOF, STATE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be sign r,,._ice-P.~ecsiden~;~nd'~y? its Corporate Seal to be affixed this 14th day of September 2004. This APPOINTMENT SHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2011, UNLESS ~ EVOKED AS ~~-~~ PROVIDED. ~ ;==: ~~~ ~ ~~~•.~. ~, STATE FARM FIRE AND CASUALTY C0~ ~ wroe i W ~ G~ , jf ~ ii ~' ~.:'~..:'.:.. ..,. r '~ if: ..... :~i ~ •• i '~: :~- y STATE OF ILLINOIS Vice-President COUNTY OF McLEAN On this 14th day of September 2004, before me personally came William K. King to me known, who being duly sworn, did depose and say that he is Vice-President of STATE FARM FIRE AND CASUALTY COMPANY, the corporation described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to said instrument is such Corporate Seal; and that he executed said instrument on behalf of the corporation by authority of his office under the By-Laws of said corporation_ °OFFICIAL SEAL" Christine M. Chenoweth Notary Public, State of Illinois My Commission Expires April 20, 2011 $100,000 -Administrator, Executor, or Trustee of a decendent's estate $50,000 -Guardian, Conservator, or Committee $25,000 -Receiver $ 2,500 -Judicial Notary Public My commission expires April Z0, 2(111 CERTIFICATE I, the undersigned Vice-President of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and sealed at Bloomington, Illinois. Dated this ~ day of ~tt.~.~- • ~~i ~~ ,> rat: •-. ~ ; i r • E _ ~ i i `: ~ ~~ . a - ~~= s~ .•`~_~ Vice resident 124061.3 12-27-2007 Bond No. fTATf fAtff INfYlAN~~ BOND OF EXECUTOR, ADMINISTRATOR OR GUARDIAN STATE FARM FIRE AND CASUALTY COMPANY BLOOMINGTON, ILLINOIS COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~urr,eeriand ss i~ Estate IN THE MATTER OF THE ^ Guardianship O F lermme 1 Ri~eer~ ~ Deceased ^ Incompetent ^ Minor KNOW ALL PERSONS BY THESE PRESENTS: Th at we, COURT OF COMMON PLEAS i~ Execut Bond of ^ Administrat ^ Guardian Mark S Rivers as Principal, and State Farm Fire and Casualty Company, a corporation of Illinois, as surety, are held firmly bound unto the Commonwealth of Pennsylvania, in the penal sum of twenty thousand Dollars ($ _ 20000 ),for which payment of which we jointly and severally bind ourselves, our heirs, executors, administrators, successors, and assigns. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, that if the above bound principal shall faithfully discharge the duties of his, her, their trust as Executor (EXECUTOR, ADMINISTRATOR, GUARDIAN, ETC.) , of the estate of Jerome J Rivers according to law, then the above obligation is to be void, else to remain in full force. Dated, signed and sealed with our seals this 2s day of June 2009 PQ~ AND CgSG °" . 9~ ~~Q,~'o a P O R g T `~ P' cipal `~ ~ -•- ~'~ STATE FARM FIRE D CA A MPANY N: ~a~~ :'~ ~' B `00~~' ... ' ~O~y y: M~NGTON,~~~'~~ ome -in-fact Approved this day of Attest: f'' L S ' COMMONWEALTH OF PENNSYLVANIA .~ I swear that I will faithfully discharge the duties of my trust as ~ ~ ~ r' IEXECUTOR, ADMINISTRATOR, GUARDIAN, ETC.) of the person and estate of ac~rding to law; so help me God. Principal 120679 03-25-2004 Page 1 of 2 ACKNOWLEDGMENT OF SURETY Commonwealth of Pennsylvania County of ctunber'land ss 1, Lisa Marie Coyne , in and for said county in the state aforesaid, do hereby certify that Robert May , Attorney-in-fact of STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois, a corporation duly organized and existing under the laws of the State of Illinois, personally known to me to be the same person whose name is subscribed to the foregoing instrument as Attorney-in-Fact of STATE FARM FIRE AND CASUALTY COMPANY, appeared before me this day in person and acknowledged that he signed and delivered the said instrument as his and State Farm Fire and Casualty Company's free and voluntary act for the uses and purposes therein set forth. Given under my hand and official seal this 2 6 day of ~- ~ d of Lam...-~. '~-,~~ ~ otary Public ^ County Clerk e~1=A-, My Commission Expires U ~.~. I D 20 I ~- i.~...-- Month and Day Year ~ Notary Signature ACKNOWLEDGMENT OF PRINCIPAL COMMONa11f6A1.TN OF 1i.ENN Yly4N1A COMMONWEALTH OF PENNSYLVANIA NoTaa~AL SEAL Lisa Marie Coyne.; Notary Public ss Hsm~den Townshro. Cumbl~tiaad County County of ~ vv~. .._, t~-Co~nis ' ir~nn,le»o ~~1~3~@)2 ~'~ S ~`' ~'~ ~ ~ ~ ~,~ tJ~ ~IVotary Public ^ County Clerk in and for said County, do hereby certify that ~~~.~..~ /49. ~-~~ personally known to me to be the same persons) whose name subscribed to the foregoing instrument as Principal, appeared before me this day in person and acknowledged that signed, sealed and delivered said instrument as ~~~. ~ ~ free and voluntary act, for the uses and purposes therein set forth. Given under my hand and official seal this My Commission Expires ~~,.~t_ t O 20 t'L Month an ay ~ Year aQ 5+• ~O+ i V ac W J W Q H Q y ~a y v O Q W O 0 V L.L. O I- O v 0 Z c 0 U to .~ cu a y C c m a. 4~ N N c 0 E 0 v C iM~AONMfEALTM OF OIENNSY NOTAF~IAL SEAL Liaa Marie Coyne., Notary mpden Township, Cumberl~ y Catttmiasiprr g.apites< JL~111 ^ ^ ^ ^ ^ ^ 0 W X ~ O w Z O J m OC OC ~ oo- Q Q ~ O ~ t)t /~ OQ~ Z Z = O W c~ U ~ Cn ~y Q Z Q Q W (.D U JLnr~ Loo q 'ublic d County ill. Z41 ~ 0 cv .a r.r I 'a ^ ~ 0 "_- ~ a -~ ~ m ~ C O ~ ~ m L 0 a~ m C ~ ~ ~ m a'=-' Q Q ~I ~ ~ ~ O fl. Q L.L. N co oL L U .-~ ca ,~ W c -a m -a L ~..~ 'd O tD Z 120679 03-25-2004 Page 2 of 2 :~} i f (~ i.F Mi t ° C ~ ': 1'~ ~ !Syr r :i ; : t1t~ f' 2 i .. } 1~~I~V~~J /~~i~;.l'~~'~:dif J'.a. N t. ~i r '.. ~I VRI ~y 1• .~.~ R ~t,~l1 t ' {r~ ,:~ _~ra ,.~ r t