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HomeMy WebLinkAbout11-23-10PETITION FOR PROBATE AND GRANT OF FETTERS REGISTER OF WILLS OF ~' (~l~B~~~ ~ COUNTY, PENNSYLVANIA Estate of ~~/'~/fl ~~ / ~ /~~' ~C~/7 l~~ ~ File Number ~~~' ~~ I I ~ ~°' also known as ) C,"/ Deceased Social Security Number J / / N ~ ~- ~~ Petitialer(s), wllo is/are 18 years of age or older, apply(ies) for: (COiti1PLETE 'A' or 'B' BELOtW :) A. Probate and Grant of Letters estam/entary and aver that Petitioner{,g) is //.are the ~1C~eGl/~ named in the last Will of the Decedent dated ~t.~.r~ Z6f ~~ and codicil(s) dated n rq (State relevant circumstances, e.g., rerunciation, 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 ad}udicated an incapacitated person: ^ B. Grant of Letters of Administratio (If applicable, enter: c.t.a.; d. b. n. c. t. a.; pendente life; dw•ante absentia; durante mirtoritate) 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 Admi,ristranon, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) { Name Relationship Residence _~ J ~~ Form RW-0? rev. 10.13.06 --J -~-~ ~? Pale Hof 2 l,L'> (COMPLETE Lti ALL CASES:) Attach additio~tal sheets if necessary. De edent ~ ~- dor icil d at death in -~ ~LEfI ~~ C unty, ennsy v nia with his /her last principal residence at ~~ )~ L. z ~~ ~,~~~ s ~~ ~ ~ ~ ~ ~~ co (L st strec address, town/citQy, t' vn rip, to ~, state, zip code) ~ L ~j I ,¢ Decedent, then ~ D years of age, died on 0 ~.3 at / t~~ °~tri~' ~/Q~~s ~1~1 ~~ S ~1 y 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 sit!tar~d as follows: ~ ~~ w ~'ia~~s, LUm $ ~D~ ~o~ I6 ~'~~ ~~+1 ~L f~- l ~~~ Wherefore, Petitioner(s) respecttitlly 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 ~',> r-.a ~? =~; ,~ ~ , f. ~ s~'_ ~.r N Jr mm.~ S_1 ~) "~~ ~ ~ ~ ~ -- i Oath of Personal Representative `'~ COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF ~;um8~'•~D . The Petitioner(s) above-named swear(s) or affirm(s) that the statements~in the foregoing Petition are title and coned 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. f i ~~= ~~~~ ~ ~~ ~ ~~~ Sworn to or affirmed and subscribed ; - G /G/ • G2 / j,. ~ Signntrrre ojPersonnl Representative day of before me the C!-~ 1 V I V~~ resentative nal Re P ~ Si ~ . V erso p gnature oj N ~' ~ C ~~ C~ -I_.~ ~ ~ 1 ~ For the Register Signature ojPersonal Representative ~ ~ ~ p rn C ~> '" ~~i TJ __} a~ rr 11 ~I~~ ~~~ _ r~l~" == FrieNumber: ~ tD ^ _ ~~ ~- ff'' I n Estate of ~~N~N/ T ry~ ~j~ ' C ! ~ ~~IJS.-T~~W ~~ , Demised F' ~ ~ f ~ Social Security Number: fSI 32-ZS Date of Death: -~ ~ AND NOW, , in consideration of the foregoing Petition, satisfactory proof DECREED that Letters M.P~ ! . ore me, IT IS having been presented b ef rr nn rn are hereby granted to T"K.~~C~S I rte ~ ~~~~Sl~ in the above estate and that the instrument(s) dated (' ! ~ ~~9 described in the Petition be admitted to probate and filed of reco;d~a~the last Will (and Codicil(s)) of~~edent. n ~ FEES Letters ........... $ •,~~ Short Certificate(s) ..'~ . $ Ob ~ $ . GO G.S ... $ ..5th .~}iJ o ... $ .oa ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. $ ~~ Register jWills~ U / Attorney Signature: Attorney Name: e ~~~/-' Supreme Court I.D. No.: ~ / ~~~ Address: Telephone: Fares R6V-0_' rep 10.13.oh Page 2 of 2 ~ ~ L.C~AL, RECIST'RAR~S +~ER`~~IF~IA~'It~N C)1= ~~ ~~' ~ 'I~:~RNlNG: !t is iilegai t0 duplicate this c€si~°y ~~ ~11C~tc~~~~at Or ~~~atc~°- _ ~4. ! 1 t.'+ ~,11q~ ',111`. ,>:l-ttl(t.;ilt . `'~{',,i)(} -P---~ 6_~ 5_ ~ ~ ~ ~> _ C'L'['lt1f~;)(ttl;l "~t,4ait~ti i ~ 5 hr,R,c,i ~ ~Ls2r-~Ci ~.~~ ~s ~ ~~~ ~ /O~ ~~O ~, ,r,,,..;,: .,~i~`~~iN 0~~~~ l`~! ,~ ,. ~~ ~ ao.~ 'Z:!! ~ F `` ~ \.. . ^ ~^~ .. tip.. `i ~~ ~ ; ,~.f`rr ~ `~ ~~,; ,, ; rt. 1~ 11~ a.':~ i 'I'eltlr _lE.• Ili , 9 3 ( > I'. t_~L r. Yt 1. ~ /~ i . ,., i)rittit ~Lti')t1 Fr~'re ~~i~ct1 i~ ,~ 9 ~-1~,, r~. 1 :'l slif~i~,t1e o>i~1)c~at1~1 ~,l I~ `! 1 ~I tlh. ~~ jiC' (t( i'?It)~1~ ~t lt't~, ~1 1( i'c' ll<ilt" ViCt11 , . ,. !~',?! lll~tl!r ~_ ~ ~_~~~~c Z~ >~~ ~__0_ T ~._ _2010. .~~~°~ I ~)L-II 4'~~~i~~,)r<11~ f~~,)1~° 9~~~:L~~l ~~~,:> C~1 ~. O C~,.:.t _ 1~~ ~ M f--` .. _ i , ~•~ " ' -' i> f G. ~ fV f~` - i 1 _y. ~ "r"T - _~ ~ ~ - -f - - _..~ ... 105-143 REV 11!2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ~ ~.• - - ~ C~; ) PERMANENTIN CERTIFICATE OF DEATH ~ ` t BLACK INK See instructions and exam les on reverse P ~ STATE FILE NUMBER 1. Name of Decedent (First, middle, last, suffix) 2. Sex 3. Social Security Number 4. Dale of Death (Month, day, year) RONALD T . MICHALSKI Male 151 - 32 -2549 October 13, 2010 5. Age (Last Birthday) Under 1 ar Under 1 day 6. Date of Birth (Monet, day, year) 1. Birthplare (City and state ar for eign country) 8a. Place of Death (Check ony one) MwxM Days Figrrs Minutes Hospital: Other. 6 8 Yrs. Augus t 2 7 , 19 4 2 Perth Amboy NJ ^ inpatient ^ ER /Outpatient ^ DOA ~ Nursing Home ^ Residence ^Other - Speciy: Sb. County of Death 6c. Ciry, Boro, Twp. of Deem 8d. FataNly Name (If not institution, give street and number) 9. Was Decedent of Hispanic Origin? [~ No ^ Yes e: American Irrdian, Black, WhNe, etc. 10. R ac Cumberland Carlisle Boro Forest Park Nursin Home g (It yea,aperarycuban, Mexican, Puerto Rican, etc.) 1~ SS ~~ Whl~_e 11. Decedents Usual tkc lion Kind of work do ne dud most of wtxki life. Do not stale refired 12. Was Decedent ever in the 13. Decedents Education (Specify only highest grade compl eted) 14. Marital Status: Married, Never Married, 15. Surviving Spo use (If wife, give maiden name) Kind of Work K'xd of Business /Industry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (SpeCily) . Master Ser cant US Army ~~ ^No ------12---- ------------- Married Frances Kol.esar 16. Deceden's Mailing Address (Street, city /town, state, zip code) 309 Forge Road Decedent's Did Decedent Actual Residence ,7a.Slate . Pennsylvania ownsha? 17c.®Yes,DecedentLivedin South Middleton rwp. Boiling Springs, Pa 17007 1ro.Couny Cumberland ~ 17d.^No,DecedentUvedwilhin Actual Limits of Ctty I Boro 18. Famer's Name (First, middle, last, sulfa) Joseph Michalski 19. Momer's Name First, mkldle ma sumeme) Nary ~o esar 20a. InformaM's Name (Type / Pdnt) 20b. Informant's Mailklg Address (Street, city /town, state, zip code) ' Frances Michalski 309 Forge Rd. Boiling Springs, Pa 17007 21a. Method of Disposition i ^ Cremation ^ Donation 21 b. Date of Disposition (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or Deter place) 21 d. Location (Ciry /town, state, zip case) ° • ~] Burial ^ RemovalfromState ! waeCrematlonorlMnatlonAutltorimd October 19, 2010 Indiantown Gap National Cemetery Anville, Pa w m ^ Omar - Speciy: ) by Madfcal Examlttx /Coronet? ^ Yes ^ No a ~ 22e. Signature neral Service Licett (or pa~ tirg as such) ~ ~__ _ ~ //,~_..s 2'2b. license Number FD-012909-L 22c. Name end Address d Faauy Ronan Funeral Home 255 York Road Carlisle, Pa 17013 ~-. Complete It 3a-c any when Certilyiltg 23a. To the best of my knowledge, death occurred at the bete, dale and place stated. (Signature and fide) 23b. License Number 23c. Date Signed (Monet, day, year) ptvysician is tint available al lima o1 deem to rx+my cause of deem. I ttems 24-26 must be completed by person 24. Time of Deam ~ r 25. Dale Pronounced Dead (Mon day, year) ~ 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other than l:remation or Donation? wta pronounces death. r z s A M, l./G •~ 13 ~ ~ ~ © ^ Yes ~o ,_ ., t~ „•..r...w.,.,.•• •,•., •an•np•v, t ,.yt.,~H„p,e ~„a,.a,. Item 27. PeA I: Enter the tdtain of events -diseases, irquries, or complicadona -that directly caused me deem. DO NOT enter terminal events such as cardiac arrest, t Onset M Deem a„ ,,. ~,,,m ,,,,,~, but not resulting in the urderying cause given in Part I. ,.,,,o ..M,.,W .o ,., „w,,,. ^ Yes Probably respiratory arrest, or ventricular fibddation vrithout showing the etidogy. List ony one cause on each Noe. ~ ^ Na ^ UnKrawn ~ NIMEDIATE CAUSE Fetal disease or ~ cerddbn resulting in ~th) _~ a. ~ ~~ ~2A,~0 ~iL.>/f,~i~a~(I•+'~~ - V tik1r1l7W- a/~dWr~ ~ ~ " ~- ~ ~ \/ - , 29. If Female: ^ N t ihi t v+ Due to (or as a consequence ot): t ~ ~ ot pregnan w n pas year ^ PregneM et time of death S Sequentietly bsl condtfons, d any, b. t ~.1.1~ ~ r'rN~l \~CLT~G ~ ~ leading to thhe ceuae fi6led on fine a. t Enter the UNDERLYING CAUSE Due to (or as a consequence off: t ^ Nol pregnant, but pregnant wihin 42 days ~ (d~aease or injury mat Initiated ttre c r t th LAST h lti d ~ L `~N ~ t ~~~~ Q• ~ of deem ng in ea ) . even resu Due to (or as a consequence of): t T ^ Not pregnant, but pregnant 43 days to 1 year ~ . d ' C J before deem ^ Unknown N pnagnant within the past year ~ 30a. Was an Autopsy 30b. Were Autopsy Findings 31. Mannar of Deem 32a. Date of Injury (Month, day, year) 32b. Descdbe How Injury Occurred 32c. Place of Injury: Home, Fann, Street, Factory, Pedomted7 Available Prior to Compledm of Cause of Death? ~Jafural ^ Homicide Office Building, etc. (Speaty) O ~ ^ Yes ~No ^ Yes ~ No ^ Aocrdarrt ^ Pending Irwestigation 32d. Time of 4njury 32e. Injury at Work? 32f. If Transportation Injury (Specify) 32g. Location of Injury (Street, city /town, state) eretor ^ Passen er ^Pedesldan ^ Ddver l O N ^ Suiride ^ Could Nol be Determined M ^ Yes ^ No p g V ^ Other -Specify: 33a. Certifier (aleck Doty one) 33b. Signature and Ttle of Ce ' Q Y CertityMg physkian (Physician cerlilykg cause of deem when artolher physician has pronounced deem and txxnpleled Item 23) io the bast oT my kttowbdga, death occurred due to the cause(s) std mariner as etate4_ _ _ ^ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ _ _ _ _ _ _ _ _ _ _ . _ _ ^ -~ - • Pronatnefng antl txxtltying physklart (Physican both pronourtring death and certlfying to cause of death) ^ 33c. License Number 33d. Date Signed (Month, day, year) t- `~ " _ - ^ - - ^ _ To the beat of my knowbdge, death occurred at the time, date, and pbce, and due to the cause(s) and manner as atated_ _ ^ _ _ _ _ _ _ _ _ Medksl Exami er / C ron r _ ~ ~~ 1 e ~~ V ~ ~ n o e On the basis of examination and ! or irneatigation in my opinion death oceurmd at the time date and place and due to the cause(s) end manner u atated_ ^ \ 0 , , , , , 34 Name and Address d Person Wta Completed Cause of Death (Item 27) Type / Pdnt 0 35. Registrar' ``i~~'lure~ end trict,PlamTet ` ( 36.Oate Fled (Monet, day, year) . /Y~L~1~ s ~ ~ ~~ ~~~"~ `~ ~ ~ N r "-1 Z , I . ~e~r~x~-~ I ( I ~ _~ I ( - L_~~xv~~ ~, r ~\~ ~ Per 1 4 Dispositon Permit No. ~ ~f~IJ U`1 ~J - ~, . _~ ~. LAST WILL ANTD TESTAMENT OF RONALD T. MICHALSKI Dated: March 26, 2009 Prepared by: Carlisle Barracks MAJ Michael J. Gennett 22 Ashburn Drive Room 105 Carlisle, PA 17013 C7 r.~ ca _~ O ~~ 1-p rrt ~- ~ ,~ ~~ ~~ ~~ GM ~ '~ :~> .~" ;:? ~-~ ' __ ... _ 1 -_ LAST WILL AND TESTAMENT OF RONALD T. MICHALSKI I, RONALD T. MICHALSKI, a resident of the Commonwealth of Pennsylvania, make, publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any time heretofore made by me. I am retired from the military service of the United States. FIRST: I direct that the expenses of my last illness and funeral, the expenses of the administration of my estate, and all estate, inheritance and similar taxes payable with respect to property included in my estate, whether or not passing under this will, and any interest or penalties thereon, shall be paid out of my residuary estate, without apportionment and with no right of reimbursement from any recipient of any such property. SECOND: I give all tangible personal property owned by me at the time of my death, including without limitation personal effects, clothing, jewelry, furniture, furnishings, 1lousehold goods, automobiles and other vehicles, and all rights that I have under any related insurance policies, to my wife FRANCES M. MICHALSKI, if she survives me, or if she does not survive me, to those of my children (MAYRA R. MICHALSKI and LUIS R. MICHALSKI and any other children which I hereafter may have) who survive me, in substantially equal shares, to be divided among them as they shall agree, or if they cannot agree, or if any of them shall be under the age of eighteen (18) years, as my Executor shall determine. I specifically disinherit TERESA D. MICHALSKI, RUSSELL E. MICHALSKI, RENEE M. MICHALSKI, MICHAEL E. MICHALSKI and MICHELE L. MICHALSKI. This is not an oversight on my part. If any of said children shall be Linder the age of eighteen (18) years at my death, my Executor may sell any property bedueathed to said child under this Article SECOND, as my Executor may deem appropriate, or my Executor may hold such property or any proceeds thereof, without bond, surety or other security, until said child attains said age or such earlier time as my Executor may deem proper to deliver any such property or proceeds to said child, or to said child's guardian or any person with whom said child resides for the use of said child, or, if there is a separate trust for the benefit of said child, to my Trustee to be administered as a part of said trust. All costs incurred by my Executor in connection with obtaining possession, appraising, safeguarding, delivering or selling such property shall be paid as expenses ~of administering my estate. THIRD: I give all the rest, residue and remainder of my property and estate, both real and personal, of whatever kind and wherever located, that I own or to which I shall be in any manner entitled at the time of my death (collectively referred to as my "residuary estate"), as follows: ~° tam ,r?1/~~~~~ (a) If my wife FRANCES M. MICHALSKI survives me, to my wife outright. (b) If my wife does not survive me, then to those of my children who survive me and to the issue who survive me of those of my children who shall not survive me, per stirpes. If, however, any such child then shall be under the age of twenty-three (23) years (each such child being hereinafter referred to as a "Beneficiary"), the share of such Beneficiary shall not be paid or distributed to such Beneficiary but instead shall be given to my Trustee and held by my Trustee, IN TRUST, pursuant to the following provisions: (i) My Trustee shall hold, manage, invest and reinvest each share set aside for each Beneficiary in a separate trust for the benefit of such Beneficiary and may pay all or any part of the net income from each such trust to or for the benefit of the Beneficiary thereof, for the health, education, maintenance and support of the Beneficiary, to such extent and at such time or times and in such manner as may be determined in the absolute discretion of my Trustee. Any net income not so paid shall be accumulated and added to principal at least annually and thereafter shall be held, administered and disposed of as a part thereof. (ii) In addition, my Trustee may pay to or for the benefit of each Beneficiary, for the health, education, maintenance and support of each Beneficiary, from the principal of each Beneficiary's trust, such amounts, including the whole thereof, as determined in the absolute discretion of my Trustee. (iii) When any Beneficiary shall attain the age of twenty-three (23) years, the trust for such Beneficiary shall terminate and any remaining principal and income shall be paid and distributed to such Beneficiary, discharged of trust. If such Beneficiary dies before said age, such principal and income shall be paid and distributed to any then living issue of such Beneficiary, per stirpes, or if such Beneficiary has no issue to my then living issue, stirpes. If any such issue is a beneficiary of a trust under this will, the same may be held in accordance with such trust. If there are no then living issue, the same shall be paid and distributed to the beneficiaries of my residuary estate then in being as provided in this will, or if there are none, to those who would take from me as if I were then to die without a will, unmarried and the absolute owner of the same, and a resident of the Commonwealth of Pennsylvania. (c) If my wife does not survive me and there shall be no issue of mine then living, my residuary estate shall be paid and distributed to DEBORAH DANIEL if she shall survive me. 2 ~~ ,/"'~/`' /~~ t ~~~ l f (d) If none of the beneficiaries described above shall survive me, then I give my residuary estate to those who would take from me as if I were then to die without a will, unmarried and the absolute owner of my residuary estate, and a resident of the Commonwealth of Pennsylvania. FOURTH: If any principal or income of my estate or any trust hereunder volts in absolute ownership (free of trust hereunder) in a minor or incompetent, my Executor or Trustee, at any time and without court authorization, may: distribute the whole or any part of such property to the beneficiary; or use the whole or any part for the health, education, maintenance and support of the beneficiary; or distribute the whole or any part to a guardian, committee or other legal representative of the beneficiary, or to a custodian for the beneficiary (including a custodian appointed by my Executor or Trustee without court order) under any gifts L _ to minors or transfers to minors act, or to the person or persons with whom the beneficiary resides. Evidence of any such distribution or the receipt therefor executed by the person to whom the distribution is made shall be a full discharge of my Executor and Trustee from any liability with respect thereto, even though my Executor or Trustee may be such person. If such beneficiary is a minor, my Executor or Trustee may defer the distribution of the whole or a.ny ...~ part of such property until the beneficiary attains the age of twenty-three (23) years, and may hold the same as a separate fund for the beneficiary with all of the powers described in Article SIXTH hereof. If the beneficiary dies before attaining said age, any balance shall be paid and distributed to the estate of the beneficiary. FIFTH: I appoint my wife FRANCES M. MICHALSKI to be my Executor. If my wife does not survive me, or shall fail to qualify for any reason as my Executor, or having qualified shall die, resign or cease to act for any reason as my Executor, I appoint DEBORAH DANIEL, as my Executor. I appoint DEBORAH DANIEL to be my Trustee. I direct that no Executor or Trustee shall be required to file or furnish any bond, surety or other security in any jurisdiction. SIXTH: I grant to my Executor and Trustee all powers conferred on executors and trustees under the Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and all powers conferred upon executors and trustees wherever my Executor or Trustee may act. I also grant to my Executor and Trustee power to retain, sell at public or private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit; to borrow money and encumber or pledge any property to secure loans; to hold property in bearer form or in the name of a nominee; to render liquid my estate or any trust in whole or in part, at any time and from time to time, and to hold cash or readily marketable securities of little or no yield for such periods as my Executor or Trustee shall deem advisable; to exercise all powers of an absolute owner of property; to incorporate any business and form limited liability companies and hold any interests in corporations and limited liability companies; to vote stock or securities, in person or by proxy; to exercise subscription and conversion rights, and to participate or refuse to participate in any reorganization, recapitalization, merger, consolidation, liquidation, dissolution or other action with respect to any corporation; to transfer any business or property to a partnership and to be a general or limited partner; to compromise and release claims with or without consideration; to execute and deliver instruments, including releases; to change the situs or governing law of any trust hereunder to any state my Exec~.rtor or Trustee from time to time may deem desirable; and to employ attorneys, accountants and other persons for services or advice. The term "Executor" wherever used herein shall mean the executors, executor, executrix or administrator in office from time to time. The term "Trustee" wherever used herein shall mean the trustees or trustee in office from time to tinge. Each Executor and Trustee shall have the salve rights, powers, duties, authority and privileges, whether or not discretionary, as if originally appointed hereunder. The determination of my Trustee as to the amount or advisability of any discretionary payment of income or principal from any trust hereunder shall be final and conclusive on all persons, whether or not then in being, having or claiming any interest in such trust. Upon making any such payment, my Trustee shall be released fully from all further liability therefor. SEVENTH: I direct that for purposes of this will a beneficiary shall be deemed to predecease me (or any other person upon whose death the interest of such beneficiary depends} unless such beneficiary survives me (or such other person) by snore than thirty days. The terms "child," "children" and "issue" as used in this will include children and issue hereafter born. EIGHTH: No disposition, charge or encumbrance on any income or principal of any trust hereunder or my estate by any beneficiary thereof shall be valid or binding upon my Executor or Trustee. No beneficiary shall have the right to assign, transfer, sell, pledge, encumber, anticipate or otherwise dispose of any such income or principal until the same shall be paid to such beneficiary by my Executor or Trustee. No such income or principal shall be subject in any manner to any claim of any voluntary or involwltary creditor of any beneficiary or liable to attachment, garnishment, execution or other legal or equitable process prior to its actual receipt by the beneficiary. NINTH: If my wife shall not survive me or is adjudged to be incapacitated., I appoint DEBORAH DANIEL to be the Guardian of the person and property of any children of mine who have not attained the age of majority. No Guardian shall be required to file or furnish any bond, surety or other security in any jurisdiction. If my Trustee or any trust hereunder is the beneficiary of any life insurance policy, my Trustee shall be entitled to the insurance proceeds rather than the Guardian. TENTH: I have served in the Armed Forces of the United States. I therefore request that my Executor make appropriate inquiries to ascertain whether there are any benefits to which I, my dependents or my heirs may be entitled by virtue of any military affiliation. I specifically request that my Executor consult with a retired affairs officer at the nearest military installation, the Department of Veterans Affairs, and the Social Security Administration. ~!µ M ~ a IN WITNESS ~%HERE~F, I, RONALD T. MICHALSKI, sign my name .and publish and declare this instrument as my last will and testament this 26th day of March, 2009. '' .~~ ~.~ V RONA D ICHALSKI The foregoing instrument was signed, published and declared by RONALD T. MICHALSKI, the above-named Testator, to be his last will and testament in our presence, all being present at the same time, and we, at his request and in his presence and in the presence of each other, have subscribed our names as witnesses on the date above written. having an address at ~/~ ~7~i ~ having an address at C~ ~~~ ~ ~7Di 3 5 ACKN~VVLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND, ss. We, the Testator and the witnesses, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority i:hat the Testator, :RONALD T. MICHALSKI, signed and executed said instrument as his last will and testament in the presence and hearing of the witnesses, and that he stated that said instrument was leis last will and testament, and that he had signed willingly, and that he executed it as his free and voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the request of the Testator, in the presence and hearing of the Testator and each other, signed the will as witness, and that to the best of his or her knowledge the Testator was at the time at least eighteen years of age or emancipated, of sound mind and under no constraint, duress, fraud or undue influence. ,T~,~ RONALD T. MICHALSKI Tes for print: ~i~ ~ `t'Zt~G ~ Witness ~` print: oS~/~, ~~ Z Witness Subscribed, sworn to and acknowledged before me by the said RONALD T. MICHALSKI. Testator, and subscribed and sworn to before me by the above-named witnesses, this 26th day of March, 2009. I, the undersigned officer, do hereby certify that I am, on the date of this certificate, a person with the power described in Title 10 U.S.C. 1044a of the grade, branch of service, and organization stated below in the active service of the United States Armed Forces, or an authorized civilian attorney under Title 10 U.S.C. 1044a, and that by statute no seal is required on this certificate, under authorit granted to me by Title 10 U.S.C. 1044a. Name of Officer and Position: MAJ MICHAE ETT Grade and Branch of Service: O-4, USAR Command or Organization: 153RD LSO