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Home My WebLink About11-16-10PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF C U M B E R L A y,,p COUNTY, PENNSYLVANIA r- Estate of GREG 0 R Y A • WHITE File Number ~ ~' ` also known as Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' OR 'B' BELOW.) Deceased Social Security Number ~-S~S ^' ~~' ~ ~ ~l Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the Executrix _ named in the last Will of the Decedent dated 7 / 2 9 / 2 0 0 8 and codicil(s) dated (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 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 sp~se (if any) ap~,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.) ~~ ~ Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his !her last principal residence at 3815 ~~NFSTOGA ROAD CAMP HILL PA 17011 HAMPDEN TOWNSHIP (List street address, town/city, township, county, state, zip code) Decedent, then 59 years of age, died on 9/20/2010 at 7815 ROYAL STREET EAST PARK CITY UTAH Decedent at death owned property with estimated values as follows: (lf domiciled in PA) All personal property $ 7, 900.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 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: Signature Typed or printed name and residence EMILY J• WHITE 3815 CONESTOGA ROAD P Page 1 of 2 Form RW-02 rev. 10.13.06 (COMPLETE INALL CASES:) Attach additional sheets if necessary. 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 l~ t~h be ore e the day of D V~ f~ C~~ ~ of --- Signature of Personal Representative or th Register Signature of Personal Representative - ..... ' ~ ~ ,. ; ~ ~ +- . ~ ` , - 4.>~ t .~ k.....t f -,..} . ~ _... .... _.~ ~~ ~ ~; File Number: a ..... ~ _ ~~ Estate of GREGORY A • WH ITE Deceased .~-- ~ ~ J `~-' _ ,; R~ -~ ~~ ~ ~ l/ (f ` ' / ~ ~ ~ /~ Social Securi Number:. _ t Date of Death: 9 / 2 0 / 2 010 ~~~/~ ~~ ~ AND NOW, - , 2010 , in consideration of th e foregoing Petition, sat isfactory proof having been presented before me, IT I S DECREED that Letters T E S T A M E N T A R Y are hereby granted to EMILY J • WHIT E in the above estate and that the instrument(s) dated JULY 2 9, 2 0 0 8 described in the Petition be admitted to probate and filed of FEES Letters ........................... Short Certificate(s) ...... Renunci 'o (s) ......... l 4 TOTAL ............. $ ~r° c~ .... $ -5- ~~-' .... $ ~~ .... $ .... $ .... $ .... $ .... $ .... $ .... $ , Supreme Court I.D. No.: 7 0 2 41 Address: i?331 MARKET STREET CAMP HILL PA 17011 Telephone: 717 -? 6 3 -13 8 3 Form RW-02 rev. 10.13.06 Page 2 of 2 Attorney Name: SUSAN H • CONFAIR ~I 'III ~ e jf~g~ >S~ , I~ ~ `\ ~ ~~ j@ I I~fi i~ ~~ ~ --- - , - r: L ,~; e ~ ~:, ~ \~\~ ~ f ~ R-J •/ ~4 lLI ~, ~ r~ ~ , ~~ v DECEDENTINFORI Date of Death: City of Death: Age: Place of Birth: Armed Services: Spouse's Name: Industry/Business: Residence: Mother's Name: Facility or Address: I ~~i~pr r,~ ~ ~ I!• - ~ -; ~ ~~ }~ Z i;l}~I, r.'. •R~',?"'- \111 ~ ~i. e: ,I~) t~-~ ` l~f~'~"?~~~ ~~Y\ 15 ~{~ \t~ 1. "-~i ~ M 411111 15l 1i1y IrI, _ ~1~ y. - ,TW of Id 11 1, ~.1~ /!~ ~: Z,~~ S, a ~~ ~~ .^~ -~ « Z~C ~,,,; 5$ I.~ ~~,~~ ~. ri €ir~i - ~ ~ . v"~' ~ r ® F~ s ~~ ~ ~ ,~ 1. ~ ~$ d ~ 1 I ~ ~ `~1 ~'/ - ~` \: '!.', .p ~, I J ~ f ~ i ~/ CERTIFIC~~TE OF DEATH ~ '' ; `~' u~`''~~~ ~~„~`~~.Sh~. ~- ,.,. State f=ile Number: 2010010003 ~ '~ Gregory A White ` ~~~ VIATION September 20, 2010 Park City 59 Chicago, Illinois, No Emily J Flickinger Education Camp Hill, Pennsylvania Norma Shaner 7815 Royal Street East, 210 ,:;.. - ~~;.,~ .,,~~~ Time of Death: 22:38 ,~,,: ~'%- %~ r,,-,, County of Death: Summit '7 Date of Birth: August 1, 1951 _ ;_~""' Sex: Male -; ~ =_; = ~-=: Marital Status: Married ;. ,-~;, Usual Occupation: Consultant \;c~ I~~,~;;. Education: Bachelor's Degree = ~~~~' '! Father's Name: George M White 1;;°,; „-; Facility Type: Hotel ""~ r~-== -; ~; INFORMANT INFORMATION = ~._: Name: Emily J White Relationship: Wife ~„ , ,~,,~,,, „~ ~;, Mailing Address: 3815 Conestoga Road, Camp Hill, Pennsylvania 17011 ~ ~ ~ :;; DISPOSITION INFORMATION - _ ~~~ _ ~ ~ '~~r~i ~ ~"r~' ,' Method of Disposition: Cremation ~~~ .~ ~~ '";:: ~` Place of Disposition: Independent Professional Services, Taylorsville, Utah ~ ~~ , Date of Disposition: September 23, 2010 cn ~; .. ~...~ ~ ~ a ~ ' _~ ~~ FUNERAL HOME INFORMATION c~ ~ ~ ry-' ~ ~ ~ ~ \..~,~ ~, , i ~^ f~ Funeral Home: Independent Funeral Service ~ ~ -- ~~~ :_ ,,,, Address: 2746 South State Street, Salt Lake City, Utah 84115 :u. I ~ . Funeral Director: V Frank Coon -~' "~ r': N w MEDICAL CERTIFICATION M di l P f _:_ ' '~,= ~ e ca ro essional: Pamela S Ulmer DO, Office of the Medical Examiner, 48 North Mario Capecchi Drive Salt Lake :< ,~~ City, Utah 84113 , R',~`~ ~ CAUSE OF DEATH „ ,, ~ %~' „~ Atherosclerotic cardiovascular disease ~ Tobacco Use: Non-user ~~ - Medical Examiner Contacted: Yes Autopsy Performed: No Manner of Death: Natural Date Issued: October 8, 2010 ' This is an exact reproduction of the document registered in the State Office of Vital Statistics. ~ Security features of this official document include: Intaglio Border, V & R images in top Cycloids, ,~••~~~~~~~~~~~~~ul, ultra violet fibers and hologram image of the Utah State Seal, over the words "State of Utah". This ''~F TN's-~'~nq~~~~ document displays the date, seal and signature of the State Registrar and the County/District Health Officer, ~ W ~ `NJW H ~~. kj~ ~~ ~ Isar ~, .s~~ ~ ~~~,. ~i~ 7 N g 6 _d~ i I ~~ ltll. NIII ~~~ ~ ~IIIIIIIIIIIIIIIIIIIHIIIII~~I~~ *061718850~k Barry E. Nangle, State Registrar Office of Vital Statistics Steve n s Directo ealth Officer County/District Health Department ~` r~ ) , ;,1~`a -~ _: ~ .~~1 i ~- a.""**~~'' ~ ~ ....~~. Y~~ ... ~~l~ ~~ ~6r . ~~ /r'~.`, . ~ , s~s l,~•, _ LAST WILL AND TESTAMENT OF GREGORY A. WHITE ~~ ~ ~ ~a~k F ~ a o~~ ~ ~ lil~4'' i'\ ;..% E .~ I, Gregory A. White, of Camp Hill, Hampden Township, Pennsylva~1~ei~g~4' `-'~-~~~ F,~. sound mind, do hereby make, publish and. declare this to be my Last Will and Testament. FIRST. I hereby revoke all of my former wills and codicils. SECOND. I direct that all my just debts and funeral and testamentary expenses shall be paid as soon as practicable after my death, including if applicable the testamentary expense described in the Ninth Paragraph of this Last Will and Testament. THIRD. I give, devise and bequeath all real property and all interests in real property owned by me at my death to my wife, Emily, if she survives me. If my wife Emily should predecease me, then said real property shall become part of the residuary estate and shall be distributed in accordance with the provisions of the Fifth Paragraph of this Last Will and Testament. FOURTH. I give, devise and bequeath all of my personal property, of whatever nature and wherever situated, to my wife Emily, if she survives me. If my wife Emily should predecease me, then I give, devise and bequeath my personal property as follows: 1. To my brother Stuart White: the set of Lenox china and crystal, including all serving dishes, which Emily and I obtained on or about the time of our wedding; Grandfather Raymond White's pocket watch and the Ballou pocket chain located in the golfer jewelry case in the bedroom dresser; the l !~' ~ 7/29/2008 painting of the Oakmont Country Club by Grandfather Raymond White; the William Rogers & Son silver plated teapot with a pineapple finial, bowl and plate which formerly belonged to my mother, Norma Jean White; my oak desk, desk chair and bookcase located in my study; and my Cyma watch. 2. To my sister-in-law Fawn White: the blue Tibetan rug located in my study; and the blue sapphire jewelry formerly belonging to my wife Emily, consisting of a necklace, earrings and a ring. This bequest applies only if, at the time of my death, Fawn has not been divorced from my brother Stuart, nor have divorce proceedings been filed and pending. If Fawn has been divorced from my brother Stuart or if divorce proceedings have been filed and pending, then these items shall be distributed as part of the residuary estate. 3. To my sister Karen White: all of my pewter, including but not limited to plates, candlesticks, goblets, trays and pieces made of both pewter and glass, but excluding the pewter spoons bequeathed to my sister-in-law Susan Ray and excluding the four (4) pewter Crown and Rose wine goblets bequeathed to my niece Christine Lawson; Grandmother Hila White's silverware place settings, including the wooden box in which they are kept, and her silver tray with feet; all David Yurman jewelry formerly belonging to my wife Emily, consisting of necklace, slider, bracelet, 2 sets of earrings and ring; and the "Great Blue Rising" print by Ray Ellis located in the living room. 2 ~ 7/29/2008 4. To my brothex-in-law Russell N. Flickinger, Jr.: the antique oak barrister bookcase located in the spare bedroom; the original oil painting entitled "Weather Vane" by Jim Palmer located in the hallway between the kitchen and the family room; and the oil lamp with the shade etched with the image of an owl located in the spare bedroom. 5. To my sister-in-law Michele Flickinger: the following jewelry formerly belonging to my wife Emily: the silver Native American bracelet with the single earth-tone stone set in the middle, the steel and titanium Dau earrings, and the John Hardy jewelry; and all pink depressionware. This bequest applies only if, at the time of my death, Michele has not been divorced from my brother-in-law Russell, nor have divorce proceedings been filed and pending. If Michele has been divorced from my brother-in- law Russell or if divorce proceedings have been filed and pending, then these items shall be distributed as part of the residuary estate. 6. To my sister-in-law Susan Ray: the cherry drop-leaf table located in the dining room; the Noritake hand-painted celery dish and salts bordered in gold leaf, with the pewter serving spoons kept with the dish and salts, located in the dining room; the following jewelry which formerly belonged to my wife Emily: her wedding ring with the engagement diamond, the white gold earrings with the diamond and pearl jacket inserts, the silver ring with pearl, and the silver and black Movado watch; all pieces of ironstone china which formerly belonged to the Watts family; 3 /J/Ph/ 7/29/2008 the black quilt with the quilt top made by Great-Grandmother Mary Carwell; and the two blue oriental carpets located in the living room.. 7. To my brother-in-law Patrick S. Ray: the "Roarke's Drift" print; the Robert E. Lee framed print; the bookcase located in the living room; and all history and military books that he should desire to have. This bequest applies only if, at the time of my death, Patrick has not been divorced from my sister-in-law Susan, nor have divorce proceedings been filed and pending. If Patrick has been divorced from my sister-in-law Susan or if divorce proceedings have been filed and pending, then these items shall be distributed as part of the residuary estate. 8. To my niece Kelley White: the following jewelry which formerly belonged to my wife Emily: the amethyst jewelry, consisting of earrings, necklace and ring, the silver necklace with pearl in the Higashi box, and the gold bracelet with three seed pearls; and the Hitchcock table and four (4) chairs located in the living and dining rooms. 9. To my nephew Nathan White: my gold bracelet and matching ring; my Seiko gold watch; my Skagen watches; all of my rings; the framed golf print entitled "Muir"; and the Hitchcock bench located in the dining room. 10. To my niece Samantha White: the following jewelry which formerly belonged to my wife Emily: the gold earrings and bracelet in a woven pattern in the Angelo Marraccin box, the black and gold Movado watch, the satin silver jewelry with gold accent in the Morrow Diamonds box, 4 ,,~CJi~ 7/29/2008 consisting of a necklace and earrings, and the satin silver ring with a gold heart accent; and the jewelry armoire located in the master bedroom. 11. To my niece Susan Chalupnik: the following jewelry which formerly belonged to my wife Emily: opal jewelry consisting of two sets of earrings, bracelet and ring, and the silver Cyma watch; and the crystal salt and pepper shakers which formerly belonged to my grandmother Lucille Shaner. 12. To my niece Christine Lawson: the following jewelry which formerly belonged to my wife Emily: blue topaz jewelry, consisting of earrings, bracelet and ring, and the gold Cyma watch; and the four (4) pewter Crown and Rose wine goblets located in the dining room. 13. To my nephew Justin Flickinger: my pewter and gold Seiko watch; the ID bracelet and ruby-like ring which formerly belonged to my father-in-law, Russell N. Flickinger, Sr.; the antique children's rocking chair from the Watts family; and the silver plated cocktail shaker located in the dining room. 14. To my niece Kristin Flickinger: the following jewelry which formerly belonged to my wife Emily: all Native American and in-laid jewelry, including earrings, bracelets, rings and pendants, excluding only the silver bracelet with the earth-tone stone bequeathed to Michele Flickinger; the Watts family cradle located in the basement; and the matching crystal and silver sugar and creamer located in the living room. 5 ~ 7/29/2008 15. To my friend Paul Wentzel: the "Oakmont Golf Course" print by Linda Hartough and the "Harbor Town" print by Barry Honowitz located in the master bedroom. 16. To my friend Kathy Vranicar Wentzel: the "Windswept Dunes" print by Barry Honowitz located in the master bedroom. 17. To my friend Michael Catarino: all framed golf prints except for specified prints or other artwork bequeathed to other named individuals. 18. To my friend Jeannie Bilunas: the large peridot and diamond ring formerly belonging to my wife Emily. 19. To my friend Randy Arnold: the "Royal County Down" print by Linda Hartough and the "University of Pittsburgh Basketball" print. 20. To my friend David Feczko: the framed "Long Cove Club" photograph located in the family room. 21. To my friend Lucinda Feczko: the "Beach Shadows" print by Barry Honowitz located in the master bedroom. The remainder of my personal property shall become part of the residuary estate and shall be distributed in accordance with the provisions of the Fifth Paragraph of this Last Will and Testament. Should any of the individuals named above predecease me, then the specific items bequeathed to said individual or individuals shall become part of 6 x1A~i.~ 7/29/2008 the residuary estate and shall be distributed in accordance with the Fifth Paragraph of this Last Will and Testament. FIFTH. In the event my wife Emily has predeceased me, I hereby direct my Executor to liquidate such personal property and real property as may become part of my residuary estate by the terms of this Last Will and Testament, as well as the rest and residue of my estate, of whatever kind and wherever situate, of which I shall die seized or possessed, and that, after payment of debts, taxes and testamentary expenses, the residue of the estate shall be distributed as follows: 1. The sum of Twenty-Five Thousand Dollars ($25,000.00) shall be paid to Berachah Church, 2815 Sage Road, Houston Texas 77056. 2. The sum of Twenty-Five Thousand Dollars ($25,000.00) shall be paid to R. B. Thieme, Jr. Bible Ministries, Post Office Box 460829, Houston, Texas 77056-8829 3. The sum of Five Thousand Dollars ($5,000.00} shall be paid to my friend and fellow member of the Harrisburg Tape Group, Mary Sharretts. 4. The sum of Five Thousand Dollars ($5,000.00) shall be paid to my friend and fellow member of the Harrisburg Tape Group, Matta Miller. 5. The remainder of the residuary estate shall be paid in six (6) equal shares to the following individuals, in the manner specified: 7 _~~ 7/29/2008 a. To Rose M. White, my step-mother. If Rose should predecease me, her share of the residuary estate shall be divided equally among those named persons in this paragraph who survive me. b. To Winifred W. Flickinger, my mother-in-law. If Winifred should predecease me, her share of the residuary estate shall be divided equally among those named persons in this paragraph who survive me. c. To Karen White, my sister. If Karen should predecease me, her share of the residuary estate shall be divided equally among her two daughters, Susan Chalupnik and Christine Lawson. d. To Stuart White, my brother. If Stuart should predecease me, his share of the residuary estate shall be given to Fawn White, his wife. If Fawn should predecease me or should have been divorced from Stuart prior to his death, then his share shall be divided equally among his children, Kelley White, Nathan White and Samantha White. e. To Russell N. Flickinger, Jr., my brother-in-law. If Russell should predecease me, his share of the residuary estate shall be given to Michele Flickinger, his wife. If Michele should predecease me or should have been divorced from Russell prior to his death, then his share shall be divided equally among his children, Justin Flickinger and Kristin Flickinger. 8 ~~ 7/29/2008 f. To Susan Ray, my sister-in-law. If Susan should predecease me, her share of the residuary estate shall be given to Patrick Ray, her husband. If Patrick should predecease me or should have been divorced from Susan prior to her death, then her share shall be divided equally among those persons named in this paragraph who survive me. SIXTH. The money payable upon my death to a named beneficiary or beneficiaries pursuant to policies of insurance and investments, including but not limited to life insurance policies, individual retirement accounts, deferred compensation accounts or annuities, will belong absolutely to the beneficiary or beneficiaries named therein and shall not be considered to be part of my estate or to be disposed of by this Last Will and Testament. However, in the event that both the named primary and contingent beneficiary or beneficiaries on any policy of insurance or investment have predeceased me, then the proceeds payable under said policy or investment shall be paid to my estate and shall be distributed as part of the residuary estate in accordance with the provisions of the Fifth Paragraph of this Last Will and Testament. SEVENTH I appoint my wife Emily as executrix of this Last Will and Testament, without bond, if she survives me. If my wife Emily should predecease me, I appoint my brother Stuart White as executor of this Last Will and Testament, without bond. I authorize and empower my executrix or executor without order of court to sell, convey, mortgage, invest, reinvest, exchange, manage, control or otherwise deal with any and all property, real or personal, comprising my estate. If Stuart White serves as 9 ~ 7129/2008 executor of my estate, he shall receive the sum of Ten Thousand Dollars ($10,000.00) as a testamentary expense for serving as executor. EIGHTH. In the event that my wife Emily and I shall die in a common accident or disaster or under circumstances such that it is difficult or impracticable to determine who survived the other, then I direct that for the purpose of this Last Will and Testament that my wife Emily shall be deemed to have predeceased me. However, for the purposes of payment of money upon the death of my wife Emily to a named beneficiary or beneficiaries pursuant to policies of insurance and investments held solely in her name, including but not limited to life insurance policies, individual retirement accounts, deferred compensation accounts or annuities, if I was named as the primary beneficiary on such policies of insurance or investments, then, and in that case only, I will be deemed to have predeceased my wife Emily and payment under said policies of insurance or investments shall be made to the contingent beneficiary or beneficiaries named therein. [The remainder of this page is purposely left blank.] 10 ~ 7/29/2008 NINTH. In the event that my wife, Emily, and I shall die in a common accident or disaster, and at the time of our death we possess one or more pets, I direct that the pet or pets should be given to my sister-in-law, Susan Ray, and that she be provided with a sum of money in the amount of Five Thousand Dollars ($5,000.00) to provide for the care of said pet or pets. This sum shall be considered a testamentary expense of my estate. In witness whereof, I, Gregory A. White, have hereunto set my hand and seal and have signed my initials on each of the proceeding pages this o7 ~ day of wl 2008. `- regory A. ite fitness 11 ,,~LJ 7129/2008 ~ ~~- c~ rtCO -.. ~•. ~ ~~ ~, _, .4_ t a ~°~ tJATI-I CAF SUBSCRIBING ~VITNESS(E~'i} L„~ ~ F ~ ~ s ~ rn ~~ ~..r i -'1 _ ~..;'- := l.._i f ~ _...~ ~ _ ~ REGISTER OF WILLS .~ .. CLIMBE~,d,~„~„ COUNTY, PENNSYLVANIA ~' ~~~ ,.,, , ~' _:- ,~,.~- ~~ ~ ~~ Estate o f ,~.~.E.G9By A • ~ ~ ~ T E ,Deceased ,t o Yc l` i _ Ig a a r r nl , (each a subscribing witness to (i'rint Name.'s} the [X~ Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, deposes} and says} that ~she~~ he I they ~.~ wa:~ /were present and saw the above ~~ ~..~estat; /Testatrix sign the same ~.... _. and that ~ ~she~ie /they signed the same and that ~~~ she ~E he /they signed as a witness at the request of ..__._ the:~ ; ., 'Testator 7~ Testatrix in hey,/ ,lais presence and in the presence of each other, ~~~, azure) 5[156 LANCASTER STREET #4 _ (Street Address) liARRI,~, uR~ Q~ 1?~._ (City, State, Zip) ,Executed in Register's C)ffice Sworn to or affirmed and subscribed before me this of day (City, State, Zip} Executed out of Register's Office Sworn to or affirl<an.ed and subscribed before me this ~ ~~ day of I~0 0~ ~Q~ , ~- . ~~~~ Deputy for Register of Wills No Public My Commission Expires: (Siptature and Seal ~RD4~N~v~e~Idt><iE'i~1B1~dJ1bNIA administer oath iow e o ~ ~Q s omm~sst .) Robert L. Srownawel{ II, Notary Publit: NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy inst~lii~+egf(~~ttCstted~,r~@ufioUnty My Commission Expires Dec. 13, 2012 (Signature} (Street Address) Form RW-t13 rev. I (1.13.aG /~~//~G~ a ~~ ~ ~ ma :~ r= ~ ,,.. OATH OF SUBSCRIBING WITNESS(ES) ~~ ~ ~~,~ ,_; _. ~. ~:- 1, ~ ~ ./ \ ~ `~ _ ~, 1.....1 REGISTER OF WILLS ~'~ ~~,fM13ERLANI? COUNTY, PENNSYLVANI,F1 -_- ~ z? -_. ~ j _ ~ . { Estate of ,Deceased ~A j~,D A K S N G , (each a subscribing witness to (Print Name/s) the ~ Will ^ Codicil(s} presented herewith, (each} being duly qualified according to law, depose(s) and say(s) that she he /they ~as~ were present and saw the above estator Testatrix sign the same and that sh / he /they signed the same and that ~she~lhe /they signed as a witness at the request of the ~Testator;.1 Testatrix in heri`his presence and in the presence of each other. ... .° (Signature) ~~~3 ~ O Y f E L A ~___, {Street Address} (Signature} (Street tlddress) ~,~EL.S'~0~~ PA 17136 {City, Stare, Zip} Executed in Register's Dffice Sworn to or affirmed and subscribed ~~ before me this ~ .day of ~ L , c~,C~ I ~ Deputy fox Register of Wills (City, State, Ztp} F...xecuted out of Register's Office Sworn tv or affirmed and subscribed before me this ~ day r . l-t1.~~ Nota Public My Commission Expires: ~~1uar~ ~~ l ~ C~ ~ (Signature and Seal of Notary ar other official qualified to administer oaths. Show date of expiration of Notary's Commission.} NOTE: To be taken by officer authorized to adrinister oaths. Please have present the original or copy of instrument(s) at time of notarization. of PENNSYI.vi~rnn Forr~t RFY-03 rev. 1(1.13.06 NOTARIAL SEAL MIIVDY I HOPSASS, NOTARY PUBIIC FAST HANQVER TWP, DAUPHII~1 COUNTY MY COIr[MLSSION ExPiRES JAN 27.2013