HomeMy WebLinkAbout12-04-09PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
Estate of Joan C. Butler
also known as
Deceased
COUNTY, PENNSYLVANIA
File Number ~ 1 ' ~C~ ~~' Z Oj
Social Security Number 290-18-3366
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 Co-Executrices
last Will of the Decedent dated October 9, 2008 and codicil(s) dated
named in the
(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.)
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary. f ~~; ~ rte" ~ ~ . ~ f .i
Decedent was domiciled at death in Cumberland 'T
County, Pennsylvania with his /her last principal ~te1SYd~rxCt at - --
325 Wesle Drive A t. 103 Mechanicsbur Lower Allen Tw PA 17055 ~` ~.~t~`7 ~s,. ~`--r,
(List street address, town/city, township, county, state, zip code) y.,`.==- ~ ~:
.. ~ ~ ' ' ~: .Iw~.c`
Decedent, then 87 years of age, died on 12/27/2009 at Select Specialty Hospital -t7 `~ , ,~ t.--->
. _s
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 50,000.00
(If not domiciled in PA) Personal property in Pennsylvania $
(1f not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Form RW-O2 rev. 10. /3.06 Page 1 of 2
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:
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 affirrped and subscribed
before me the c.7~ ~". day of
~~, ~ vo3
For the Register
Signature of Personal Representative
r" ~ .. 1
File Number: 2 ~ - ~C70 j - ~ Z Q ~ `' Q -z
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Estate of Joan C. Butler , Decel~e~ ~ W ~" ~-' ' '
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Social Security Number: 290-18-3366 Date of Death: Z ZOr~ `~ ~. %~::7 ~~ '•
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AND NOW, 0 , in consideration of the foregoing Peti '`~ ~` ~ ~ fir'`
tip;-satisfactd~proo)"' - }
having been presented before me, I IS ECREED that Letters Testamentary b ,~- . ~= ~ ~~ +;: ~.:~
,rt.
are hereby granted to Madeline B. Leslie and Judith N. Butler
in the above estate
and that the instrument(s) dated October 9, 2008
------
described in the Petition be admitted to probate and filed of reco~ as the last Will (and Codicil(s)) of Decedent.
FEES ff~~ f~' ~
Letters ............... $ t/. vo Re 'ster ills
~ r
Short Certificates ........
() $ ~ - `~ ~ Attorney Signature:
Renunciation(s) .......... $
~, ~ .l ~ $ 5 ~ Attorney Name: Lis Marie Coyne
• • • $ ~ 3 -5~ Supreme Court LD. No.: 53788
.~ ~~ ... $
d
$ ~ Address: Coyne & Coyne, P.C.
• • • $ 3901 Market Street
... $
$ Camp Hill, PA 17011-4227
• ~ $ Telephone: (717)737-0464
... $
TOTAL .............. $ . ~~~'
Form RW-02 rev. 10.13.06 Page 2 of 2
ulnc qnc qr.~i ~nr rn-„ ----- -- - - - - - - -.. _ _- _- - -- - -_ - -
21~o`~-lZo3
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 16030375
Certification Number
HIOS~l43 REV 11/2006
TYPE /PRINT IN
PERMANENT
BLACK INK
1. Name d Decedent (Post, rtuddle, bas, sugix)
Joan C. Butler
5 Aye (Last BiMaay) under, under, da
Mo^IAS Days Hours Minuses
87 Yrs.
Bb County of Oealh Bc. City, Boro, Twp. d Death
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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
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See InstructlCtns and examples on reverse)
STATE FILE NUMBER
2. Sex 3. Social Security Nwnber 4. Dab d Dwtt (Msxdh, day, year)
Female 290 -18 - 3366 12/27/2009
6. Date d Bath Madh, da , 7. and SbM a Ba. Rap d Death Chock ate
ROyePIMI~ Otirer.
9/22/1922 Tulsa, OK l~Inpawnt ^ERlOutpagent ^DOA ^N
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ane
Resitlerrp
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8d. Facairy Name (q rat atstAlAbn, give ebeel and rrtmber) 9. Was Dacedxa d
Orgin? ~ No ^ Yes 10. Rap: American btdiart, Black
Wtrae
etc
Iq ris, eDeciN GrDen, (~rM
Mertiprt, Ptrrrdo Rican etc ) ,
,
.
11. Decedent Usual tk lion Kind d work dome nest d w ib. 0o rat state refired 12. Wes Depdera ewr in qte 13. Depdera'e EtlrtxYort (Specgy ply highest grade cdntpbkid) 14. Marital $181116: Married Never Married, 1$. Whl to
Kind d work Kind of Busaress/Industry U.S. Armed Papa? Eb~ary / ~~, (0.12 YYltlowe4 Divoreed (S,pecdy) ~~ ~~ Iq wile, give maiden rwrrw)
Cogege (i-4 a 5+)
^ Yes No
tfi Decedent's Mai&tg Address (Street, city! town, state, zip code) pepdan's ~ Decedent
325 Wesley Dr Apt 103 AdualResidertce 17a.Stab Pennsylvania Liveina „c,[y~y!!,Dl~lntUv~b T[xat~ar Al]Pn T,,,p
Township?
Mechanicsbur PA 17055 nb.cow,ry C`Innlwrl an~7 lid. ^ o t~rved,„na,
18. Father's Name (Fall, middle, last, sugix) City /flora
19. Mother's Name (First, rrudde, maiden slxnwrte)
C1 de Watson' bell Mabel Noe
20a Infamanfs Name (Type I Prinq 20b. Inbmwa's Maikrp Address (Sheet, sxry /town, stale, zip coda)
Judith N. Butler 30 Rock Shelter Rd. PO Box 293 Waccabuc NY 10597
21 a Method d Disposition 1 [~ Cremation ^ Donation 21b. Dale d Oisposigon (Month, day, year) 21c. Place d OisPoeaion (Named ae
1 prrrsb7, tttabry a dher place) 21d. Lrxatoon (Coy/town. state, :ip code)
Baral ^ •ll~noval from Slate as Cremation a Donation Autltaiud
^ omer - s ~r : by Mealr:al Ex ilter,corostaz ^ Yet^ No 12/31 /2009 Rolling Green Memorial Park Camp Hill, PA 17011
.a. Signature d Sere' son ) zzb. Lirxmse Number 22c. Name and Address d FartiMy Nei 11 Funeral Home, Inc
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Compels i 23 only when ce aW 23a. To Ure best d my krrowbdge, death occurred at Uw time, dale and
place stated. (Signaure and tale) 23c Oate Signed 1Morret, day. Y~rl
ptYSician is rwt ~ ode at Unto of death to 23b. Licence Number
Gerdy cause death.
tlenis 24.26 must W canpleled by person 24. Time d Death 25. Data Pr d Oe (Mongr, day, year) 28. Was Case Rafe ed b Medical Exarnirlw I Caawr la a Reason Ogre` draft Cremauost a Danatwrr?
tvfw prawa>Les deaN
f:rp ° .3U M. ld? T ~ ^ Yet
CAUSE OF DEATH (Ser InatrucUons arW axe a) r Approximate inbrval: Part U: Enter other 2S. Did Tabasx» Use Contribua b Deem?
~ ham 27. Pan t. Enter Vte GIIdID-LflYE015 -diseases, injwies, or complications ~ ma1 IkrecUy caused the death, DO NOT enter terminal events stlCtl~aS cardiac arrest, r Ortsel ro Death but rrd r
respiratory arrsst, a ventricular ibrilllalion wdtrout showis>g Ina atidugy List ody one cause on each Una. 1 eGUIWtg In ifN atY cause 91t'en h Part I. ^ Yes ^ Prabaply
1MMEpIATE CAUSE Futat dsease a r
' ^ N~ O Unlutown
swrtl4uon resuhag b ~am) ~ N •T, V ~ 1 1 ~~ t
Dye to (a as a consequence ol): -{- t ^ Nos pragnara wWwt pest year
uenuatly list auditions, 4 an I1~ ~/~ CT~.1 ' ~ ~s~ /1 s ~+ ~ ~ ~~ "
wading w Iha cause psted a, r,e' a. a ~~~ ~ v - vv ` , r .~~t (mac. ~', O P~regrrant at tap a aeon
Enter fie UNDERLYING CAUSE Due Io (or as a consequence d t
) r ~~ • . rlgrtertl, b1A pregrsra wigwr 42 dvys
(dsease a ifylxy prat aauated me t af'~•,AVAe• •^ d daatlr
evenib rESUNeIg n deem) LAST, c _ il-J-t
Due b (a as a consequence oQ ~ ~ ~
f ~ c ,~ / -~•~ /~ a. 1 pregnant. bW pregnara 43 days b 1 year
d ,
~~~_1-~ a/ ~7~ L-~ 7 ~ J 11/, v ~ s betas daaln
1 ^ IAtlutovm q pegnant widest pre past year
30a. Was an Autopsy 30b. Were Autopsy Findings 31. Manner of Deem 32a. Dale d ktjury (Month, day, year) 32b. Desabe How Iry'ury Occurred
PEAormed? Available Prior to Completion 32c. Plop d kyury Fionte, Farm, Skeet. Factory,
ICI ' / d Cause of Death? ^ Hatxcide Ogice 8uildirp, etc. (Syx+ary)
^ Yes L,Wa ^ Ytls ^ t,lo ^ Accident ^ Pending Inveslpa4on mod. Tone d Mryry 32e. IrrJwy al Work? 32f. U Transportation IMun' (SG~YI 32g. Loeatgn d' ' Scree
^ SuicWe ^ Could Nol be Determined ^ Yet ^ No ~ ^ Passenger ^ Pedestrian xM~' ( t, Gty I bwn, slate)
^ Driver/ rata
M. Other • SpecAJ'.'
33a Cenaier (Uieck asty ate)
33b. and `Tabw d' ilia`
• Cenifytng phyalcbn (Physkwr cenirying cause d death wtren arrolher physx;ian has pronolrrced death and cortpleted Item 23) Y VV~
To the beat of my Wwwledge, dam occurred dw [o ttte pussl(e) and msnrtsr u sWed _ _ _ _ _ _ _ _ _ _ _ _ _ ^ -
• Prortouncatp and prlilyNp physician (Physiaan bum prorwuncing death acrd candying b cause d deem) - - - - - - - - - - - - - - - - - - - - ICMt Number 33d. Date (Maeh, do ,year)
To ItN best W my knowdedpe, deem otturrW m tM tlrM, date, and place, and ties to tM puee(s) and manner as sW W _ _ _ - _ _ s~/fj ~ ~ 1~ 1,
• MedkalExamkta/Ca'awr ''''''----- , .` 7 ~ A
On qte bob d examMetiolt and / or Invssllgallon, fn my opinion, deem occared Y the time, daU, and place, and title W the `:wa(s) and manner as states!` ^ 34~~ d Person yy~ ~~~ Ceusa d v`
35 R s' is al~lre ask' DEr ~ ~ t0ab Filed (Mash, aey~ ) ~ ~ ~ `~ I ~ `tC. v
Disposaiorl Permit No. ~/ ~ ~ ^~ ~• " v ~ .! ^ ~ I
S:\LINUS\W ills\Butler.Joan. Will.doc
October 9, 2008 c, .t
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LAST WILL AND TESTAMENT --'~'~? ~~' ~ '
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JOAN C
BUTLER ~~ ;?
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I, JOAN C. BUTLER, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will
and Testament, hereby revoking any and all prior Wills and Codicils thereto by me at anytime heretofore
made.
1. IDENTIFICATION OF FAMILY. I declare that I have two (2) children whose names are
JUDITH NOE BUTLER and MADELINE BUTLER LESLIE. As used in this Will, the term
"my children" refers to all my natural children and adopted children. As used in this Will, the
term "issue" refers to all lineal descendants of the indicated person of all generations, with the
relationship of parent and child at each generation determined by the definition of
"child/children" set forth in this paragraph.
2. PAYMENT OF BURIAL EXPENSES AND DEBTS. I authorize my executor to pay all the
expenses of (1) a funeral or memorial service; (2) the interment of my remains, including the
costs of a gravesite, if necessary; and (3) the installation and inscription of a suitable marker at,
and perpetual care of, the gravesite. I further direct my executor to pay all of my debts that my
executor in his or her sole discretion may allow as claims against my estate.
3. DISPOSITION OF TANGIBLE PERSONAL PROPERTY. I give all of my tangible
personal property of every kind and description, including, but not limited to, books, pictures,
clothing, articles of household or personal use or adornment, household furnishings and effects,
and automotive vehicles and their accessories, but excluding any money, evidences of
indebtedness, documents of title, and securities and property used in connection with the
operation of any trade or business, in equal shares, to my children, JUDITH NOE BUTLER
and MADELINE BUTLER LESLIE.
4. DISPOSITION OF RESIDUARY ESTATE. All of the rest, residue and remainder of the
property that I own at the time of my death, both real and personal, and of every kind and
description, wherever situated, to which I may be legally or equitably entitled at the time of my
death (my "residuary estate"), I give outright and absolutely in equal shares to my children,
JUDITH NOE BUTLER and MADELINE BUTLER LESLIE, per stirpes.
5.
POWERS OF ADMINISTRATION.
5.1. Grant of Powers. My executor, in the administration of my estate, (my "fiduciaries")
shall have the powers and authorities set forth in this Article 5. These powers and authorities
may be exercised by my executor and trustee in their sole and absolute discretion, without the
permission or order of any court. These powers shall be supplementary to those conferred by
~' C .
JO N C. BUTLER
S : \L,INUS\W it l s\B utl er. Jo an. W it l . doc
October 9, 2008
law, including, but not limited to, those set forth in Title 20, Chapter 33, of the Pennsylvania
Consolidated Statutes.
5.2. Retention of Assets. My fiduciaries shall have the power to retain any or all property of
my estate, however received and acquired, for so long as they deem appropriate. This power may
be exercised even though the property may not be of the type authorized by law for investment,
and even though the retention may leave a disproportionately large amount of the value of my
estate invested in one type of property.
5.3. Transfer of Assets. My fiduciaries shall have the power to sell, transfer, and convey any
property, of whatever nature, including real property, and wherever situated, that I may own at
the time of my death, or that may come into my estate or after my death. The sale, transfer, or
conveyance may be by public or private sale, at such time, on such terms and conditions,
including selling price and credit, in such manner, and for any reason that my fiduciaries deem
appropriate, including, but not limited to, the purpose of obtaining net proceeds to be distributed
to my residuary beneficiaries.
5.4. Investment. My fiduciaries shall have the power to invest and reinvest any property in
my estate in preferred and common stocks, bonds, notes, common trust funds (including any
managed by any corporate fiduciary), interests in investments, trusts, mutual funds, leases,
mortgages on property wherever located, and, generally, in any property and in proportions of
property as my fiduciaries deem advisable, even though the investments are not of the character
or proportions authorized by applicable law for the investment of the funds.
5.5. Power to Borrow. My fiduciaries shall have the power to borrow money for any
purpose, for any periods of time, and on any terms and conditions as they deem advisable
(including the power to borrow from any corporate fiduciary), and to pledge, mortgage, or
otherwise encumber any property in my estate to secure repayment of any loan, as well as the
power to renew existing loans either as maker or endorser.
5.6. Power to Hold Property in Nominee Form. My fiduciaries shall have the power to
hold any property in the name of a nominee or in bearer form.
5.7. Distribution in Cash or in Kind. My fiduciaries shall have the power to make
distributions in cash or in kind, or partly in cash, in divided or undivided interests, as amended,
or other applicable law, and to determine which assets shall be sold and which shall be
distributed in kind, without notice to or consent by any beneficiary.
5.8. Distribution to Minors and Persons Under Disability. My fiduciaries shall have the
power to make distributions or payments to or for the benefit of any beneficiary who is a minor,
an incompetent, or who in the fiduciaries' judgment is incapacitated. The distributions or
payments shall be made in any one or more of the following ways: (1) directly to the beneficiary;
(2) directly to the creditor in payment of the debts or expenses of the beneficiary; (3) to the
guardian of the person or estate of the beneficiary; (4) to any custodial parent of a minor
beneficiary; (5) to a custodian for the beneficiary under any law related to gifts to minors,
J AN C. BUTLER
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October 9, 2008
including to my fiduciaries in that capacity; or (6) to any other person who shall have the care
and custody of the person of the beneficiary. There shall be no duty to see to the application of
funds so paid, provided due care was exercised in the selection of the person to whom the funds
were paid, and the receipt of the person shall be full acquittance of the fiduciaries.
5.9. Continuation or Liquidation of Business. My fiduciaries shall have the power to
continue or to permit the continuation of any business, incorporated or unincorporated, in which I
may have any interest at the time of my death for any period of time, or to liquidate the business
on any terms as they deem appropriate. This power includes, but is not limited to (1) the power
to invest additional sums in any business, even to the extent that my estate may be invested
largely or entirely in the business, without liability for any loss resulting from lack of
diversification; (2) the power to act as or to select other persons to act as directors, officers, or
employees of any business, to be compensated without regard to being a fiduciary under this
Will; and (3) the power to make any other arrangements in regard to any business as my
fiduciaries shall deem proper.
5.10. Employment of Agents. My fiduciaries shall have the power to employ and pay the
compensation of any and all attorneys, agents, custodians, attorneys-in-fact, experts, investment
counsel, accountants, bookkeepers, or other agents or providers of services as my fiduciaries
deem advisable in the administration of my estate.
5.11. Commissions. My fiduciaries shall have the power to take reasonable commissions on
account at any time during the administration of my estate without the approval of any
beneficiary or of the court, but subject to allowance or disallowance on the settlement of the final
accounts of my fiduciaries.
5.12. Third Party Reliance. No person or corporation dealing with my executor shall be
required to see to the application of any property paid or delivered to my executor, or to inquire
into either the authority of my executor to enter into any transaction or the expediency or
propriety of any transaction entered into by my executor.
5.13. Charitable Donations. In the event that any of my tangible personal property is donated
to a charitable organization(s) then my fiduciary is instructed to use the value of said donation(s)
as an inheritance tax deduction for any inheritance tax return which may be required to be filed as
a consequence of my death.
6. PAYMENT OF DEATH TAXES.
6.1. Payment of Estate Taxes. I direct that all federal and Pennsylvania estate taxes payable
as a result of taxes assessed on property passing under this Will shall be paid from my residuary
estate as a part of the expenses of the administration of the estate.
6.2. Inheritance Tax. I direct that the Pennsylvania inheritance taxes payable as a result of
my death, limited to taxes assessed on property passing under this Will, shall be paid out of my
3
J AN C. BUTLER
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October 9, 2008
residuary estate and shall not be deducted or collected from any beneficiary under this Will or
other transferee.
7. EXECUTOR.
7.1. Appointment. I name, constitute, and appoint my children, JUDITH NOE BUTLER
and MADELINE BUTLER LESLIE, as co-executors of my estate.
7.2. Bond Not Required. None of the individuals named in Section 7.1 shall be required to
furnish a bond for the faithful performance of his or her duties as executor.
8. PRESUMPTION IN CASE OF SIMULTANEOUS DEATH. For the purposes of this Will, in
determining whether a person has survived me or another person, a person shall not be deemed to
have survived me or another person if he or she dies within sixty (60) days of my death or of the
death of the other person.
9. LIABILITY OF EXECUTOR. My executor shall not at any time be liable for mistake of law
or of fact, or both law and fact, or errors of judgment, nor for any loss coming to any beneficiary
under this Will, or to any other persons, except through actual fraud or willful misconduct on the
part of the executor or trustee. My executor may, from time to time, consult with counsel with
respect to the meaning, construction, and operation of this Will, particularly with respect to the
appointments, allocations, and disbursements, and may act on the advice of counsel in all matters
without incurring liability on account of his or her actions.
10. INTERPRETATION.
10.1. Successors of Fiduciaries. All pronouns referring to an executor and the term
"executor" shall be construed to mean any person acting as my executor, co-executor, personal
representative, or administrator, as the case may be.
10.2. Number and Gender. If required by the context of this Will, singular language shall be
construed as plural, plural language shall be construed as singular, and the gender of personal
pronouns shall be construed as either masculine, feminine, or neuter.
10.3. Headings. All headings used in this Will to describe the contents of each article,
paragraph, or other division are provided for convenience only and shall not be construed to be a
part of this Will.
10.4 Governing Law. This Will shall be construed in conformity with the law of the
Commonwealth of Pennsylvania.
4 n' ~ ~n
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J ANO~C.BUTLER
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October 9, 2008
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting of five (5) typewritten pes, the first four (4) of which bear my signature in the
margin for the purposc of idcntification, this~_ day of rC~,~ , 200x.
C , -s.-r
J AN C. BUTLER
Signed, sealed, published and declared by the above-named Testatrix, JOAN C. BUTLER, as
and for her Last Will and Testament, in the sight and presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses.
Address: 2331 Market Street
Witness Camp Hill, PA 17011
Address: 2331 Market Street
Camp Hill, PA 17011
5
S :\LINUS\W it l s\B utler. Joan. W it l . doc
October 9, 2008
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
I, JOAN C. BUTLER, THE TESTATRIX WHOSE NAME IS SIGNED TO THE FOREGOING
INSTRUMENT, HAVING BEEN DULY QUALIFIED ACCORDING TO LAW, DO HEREBY
ACKNOWLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT AS MY LAST WILL AND
TESTAMENT; THAT I SIGNED IT WILLINGLY; AND THAT I SIGNED IT AS MY FREE AND
VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED.
SWORN OR MED TO AND ACKNOW_I.E~GED BEFORE ME BY JOAN C. BUTLER, THE
TESTATRLY, THIS ~_ DAY OF DC ro~`s~c zoos.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Deborah L Brenneman, Notary Public
Camp Hill Boro, Cumberland County
My Commission Expires June 18, 2010
Member. Pennsylvania Associatlon of Notaries
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
,~, ~~,~r~r E ~d~c~P A~ ~~t~~i-e ~~d~~~c~c~
THE WITNESSES WHOSE NAMES ARE SIGNED TO THE FOREGOING INSTRUMENT, BEING DULY
QUALIFIED ACCORDING TO LAW, DEPOSE AND SAY THAT WE WERE PRESENT AND SAW THE
AFORESAID TESTATRIX SIGN AND EXECUTE THE INSTRUMENT AS HER LAST WII.L AND
TESTAMENT; THAT SHE SIGNED WILLINGLY AND THAT SHE EXECUTED IT AS HER FREE AND
VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED; THAT EACH OF US IN THE
HEARING AND SIGHT OF THE TESTATRIX SIGNED THE WILL AS WITNESSES; AND THAT TO THE
BEST OF OUR KNOWLEDGE THE TESTATRIX WAS AT THE TIME EIGHTEEN (18) OR MORE YEARS
OF AGE, OF SOUND MIND AND UNDER NO CONSTRAINT OR UNDUE INFLUENCE. ,~/
y'
SWORN R AFFIRMED TO AND SUBSCRIBED TO EFORE ME, THIS DAY OF
/ , 2008. ~ ~~ ~ ~
S
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Deborah L. Brenneman, Notary Public
Camp Hili Boro, Cumberland County
My Commission Expires June 18, 2010
Member; Pennsylvania Asaodatlon of Notaries '
N ARY PUBLIC
6