HomeMy WebLinkAbout01-12-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Estate of CTFVFN C • BAKER
also known as
File Number ~ ~ -~ ~ - C%~a
Deceased Social Security Number 16 9- 5 2- 3 4 2 8
WILLIAM A• BAK R
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW.)
^X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the E X E C U T 0 R named in the
last Will of the Decedent dated 8 / 5 / 2 010 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, was never adjudicated incapacitated, and was not a party to a pending divorce proceeding at the time
of death wherein grounds for divorce had been established as provided in 23 PA C.S. section 3323 (g):
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.)
Decedent, then 51 years of age, died on 12 / 2 3 / 2 010 at 13 0 E • CUMBERLAND R D
FNOIe PENNSYLVANIA 17025
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 2 8 , U U U • U U
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County . $
Value of real estate in Pennsylvania $ 13 2 , 0 0 0.0 0
130 E• CUMBERLAND RD•, ENOLA, PENNSYLVANIA 17025
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
WILLIAM BAKER 170 LOCUST GROVE ROAD
Form RW-02 rev. 10.13.06 Page 1 of 2
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(COMPLETE INALL CASES:) Attach additional sheets if necessary. --o =---i t~ ~ --- m
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Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his /her last principal residence at ~-
~.ar~ E• CUMBERLAND RD• ENOLA PA 17025 EAST PENNSBORO TOWNSHIP
(List street address, townlcity, township, county, state, zip code)
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.
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Sworn to or affirmed and subscribed (,~J a
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before me the '~ day of Signature of Personal Representative
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For the Register Signature of Personal Representative ~`'r ~, ; ~
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File Number:
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Estate of STEVEN C • BAKER ,Deceased
Social Security Number: 16 9 - 5 2 - 3 4 2 8 Date of Death: 12 / 2 3 / 2 010
AND NOW \ ~ , 2011 , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, T IS DECREED that Letters T E S T A M E N T A R Y
are hereby granted to WILLIAM A • BAKE R
in the above estate
and that the instrument(s) dated AUGUST 5 , 2 010
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Letters ............................. $ ~ 1 ~ ~) LJ~7
Short Certificate(s) • • • • • • • • • • • • $ ~~ ~ - GiC~
Renunciation(s) •••••••••••••••• $
$
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$
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$
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$
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.... $
.... $
TOTAL ............................. $
Attorney Signature:
Attorney Name:
Register of Wil((jjls,; ,{y ~ '-~E r CX ~~ l l/t-E%~X:X~/ "
Supreme Court LD. No.: 7 0 2 41
Address: X331 MARKET STREET
Telephone: 717 - 7 6 3 -13 8 3
Form R W-02 rev. 10.13.06 Page 2 of 2
LOCAL REGISTRAR'S CERTIFICATION OF DEA1~H
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 17046082
Certification Number
1 REV 1112008
/ PRINT IN
IMANENi
ACK INK
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 ft:~rwarded to the State Vital
Kecords Office for perr-lanent filing.
~, EC 2 ~ 2010
Local Registrar ~ Date Issued
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CORONER'S CERTIFICATE OF DEATH
(See inetl'UCtions and exaMples on reverse) STATE FILE NUMBER
1. Name d Decederd IFkaL mktde, last, aulfix) 2. Sex 3. Social SecuMy Number 4. Date of Death (Month, day, year)
Steven C Baker Male 169 -52 ~ 342 December 23 2010
5. Age (Last Birthday) Under 1 r llrxler 1 de B. Date of Birth Month, ) 7. Bi and state « ) 0a. Plea of Death t'~tack txte
Ma/a Days Haan AWxxss Hoapllal: Other:
51 Yre. J anuar 14 19 5 9 ^ Inpatient ^ ER I outpatiertt ^ DOA ^ Nursing Horne ~ Residence ^Other -Specify:
bb. County of Death 8c. Gty, Death 8d. Facdlly Name (N not katidAbrt, gNS sheet end number) 9. Wes Decedent of Hlepenfc Origin? ~ No ^ Yes 10. Race: Antedcert.lndlan, Black, White, etc.
(M yes, sP•rdN Cuban, (Spedlyl
Cumberland East Pennsboro 130 East Cumberland Road Mexican,PuedoRlan,et°•) White
11. DeadertYe Uwd KYM of work d one mat of Nfe. Do rat ateN 12. Wea Decedent ever M the 13. DecederrYa Erirxretfon (Specfy ony hiptast grade comp Nted) U. MarMd Stets: Marrkd, Never Martled, 15. Surviving Spo use (M wife, give maiden name)
Kind d Work Kind ~ Buskaaa / Indueby U.S. Amad Forces? ElertteMary / Secortdery (0.12) Colbge (1.4 or 5+) ' ~OBd (SP~M
Pi e Fitter Construction ^Y«iz7-~ 12 Unk Never Married
18. Decedent's Malang Address (Street, rAY I rown, state, zJp code) DecedenYa Dk1 Decedent
AdualReaiderae ,7a.slete Pennsvlvania gi
,7a~ Yee,DeadentUvedin East Pennsboro Twp.
130 E. Cumberland Rd. p?
17d
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Decedent Uved wkMn
E no l a P a 1 7 0 2 5 .
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17b. Court
b~'ti m he r l a 1n r7 Actual lknfls of coy / Boro
16. Father's Noma (Fkst, mkidle, leaf, stAMx)
Baker
Charles W 18. Motlter'a Name (Flat, ntkldN, maiden sumeme)
. Madel n V. Baker
20a. Infortnenys Nana (type / Pdnq 20b. Informant's MelNrtp Address (Street, dy I town, state, zip code)
William A. Baker 170 Locust Grove Rd., Dillsburg, Pa17019
21a. Meaad of Dlepaltbn ~ Cremetlort ^ Donation 21b. Date of Diepoailbn (Month, day, year) 2tc. Place d Diepoaltlon (Name of arttelery, crematory «other place) 21d. Locetbn (City /town, state, zip code)
^ Budel ^ Removal from State I wee Cr«ratlon «Donnwn AuMorllad
^ Ober-sP~n% by rt4alalEwnlrar/corortsr9 Yea^No
Dec 27 2.010
Evans Cremation Service
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z2a. F serv~ (« ectlng ae wdt) 22b. Lkxfae Number 22c. Name and Address a FecNtty S u 11 i va n F un e r a 1 H om e
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Complete M 23ac «rY when artllyktg 23a. To the best of my knowledge, death oocurted et the floe, date end plea stated. (Slgnalure and tltle) 23b. Utanee Number 23c. Date Signed (Month, day, year)
pttyekdert N rat avaNeble et time of death ro
oedMy ease of deaMt.
Mama 24.26 must be completed by person 24. Tma of Death 25. Date Praaunoed Dead (Month, day, year) 26. Was Casa Referted ro Medal Examiner 1 Coroner for a Reason Other than Cremetbn « Donation?
"'l'°p'°"°""~°°`'°'"'~ A rx. 1:00 A. M. December 23, 2010 ~Y°° ^"°
CAUSE OF DEATH (See Mstructbne end ezsmplee) r Approxhnste kaerval: Ped II: Eller otter 26. Did Toberxa flee CaMribute to Death? -
ttem 27. Pad 1: Enter the dint d evaMa - dlaeeees, irqudes, a cemplications - tlat dkecny seed the death. DO NOT enter tertMnel such as ardlec arrest, r Onset ro Death but not resulting in the underying ease given in Part L ^ Yes ^ Probably
rasplretory arrest, «vaMdcular Mbdtistron wMftaul rhowktg the etiology. Ust Doty one ease on eadt Noe. r
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^ No ^ Unkrawn
~ TEC IA~USE Fi ~ dsea+e «
~ a. Pending Investigation ~ zs."Pe"als;
^
Due to (« as a consequence of): i Not pregnant wflhln past year
ga cartdtlora tt ~,y b. r
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r ^ Pregnant at time of aath
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Enkr UNDERLYMKi CAUSE Due to (or as a consequence of): r ^ Not pregnant, but pregnant wMhin 42 days
(deasae~tiat MMiated ba c. i
8bvveenMba death) LAST, of death
Duero (or as a consequerce of): i ^ Pbt pregnant, but pregnant 43 days to 1 year
d. ~ afore death
^ Unknown if pregnant wMhln the past year
30e. Wes en Auropey 30b. Wero Autopsy FNMkge 31. Manner of OeaM 32a. Dare of Injtxy (Momh, day, y«~ 32b. Describe How Injury Ocarred 32c. Plan of Injury: Fbrta, Farm, Street, Factory,
Pedomad? Avetiebb Prbr ro Compbtlat ^ Naturel ^ iloneClde _ OfSce Buildf eta S
n8• (P•~'1
of Cause of Daedt?
^ Yee ~ No ^ Yes ^ No ^ Accident ~ Pendkg Inveetlgatiart 32d. Time d Injury 32e. Injury et Wodc? 32t. M Treraportatbn Injury (Spedly) of Injtsy (Street, city /town, stet
^ Sukade ^ Could Not be Determined ^ Yes ^ No ^ Driver I Operet« ^ Peswrtger ^ Pedestrian
M OMer • Speci/Jr
33e. CedlAer (check oMy once) 33b. Spneture
• Certllylrp phyebart (Physlden certllying cease of death when another phydden has praaunced death and completed ttem 23)
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Todal»etMmyluawMdpe,deetltoayxrwdwtoMaauae(.)r+dmamar«ataEad-----,.--------------------------- ^ er
• PronorncMg and artllying pttyekian (Phyakdert both pratouncktg desfh end artlfylrq ro auw of death)
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^ 33c. Lbenae Number 33d. Date Signed (Manor, say, year)
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On tM bah of examrkatton and I «Imeedgatlon, M my oplnbn, daatlt occurred N the tlme, data. and plea, ma dw to tM cauw(e) end manner w e1Med_~ December 2 7 , 2 010
Compbted d (ttem 27) T !Print
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36. Registrar's and DbMd Number
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6375 Basehore Rd. , Suite 461
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Dlspaltbn Permit No. f;.J~J ~~7(~
Y:\Clients\Baker, Steven C\Will.doc
August 5, 2010
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LAST WILL AND TESTAMENT ~ ~-~ c..._ ~ ~ `~ ~
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STEVEN C. BAKER c--~ ~ -4-, ..~~. ~f
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I, STEVEN C. BAKER, of Enola, 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. IDENTIIFCATION OF FAMILY. I am not married and declare that I have no children.
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. SPECIFIC BEQUESTS. I hereby devise and bequeath the following items of personal
property, specifically the handcrafted items made by my mother, Madelyn Baker, to be divided
substantially equal among my siblings, JUDITH A. RHINEHART, VIRGINIA K. BITNER, and
WILLIAM A. BAKER. In the event of a dispute or disagreement with regard to the distribution, the
decision of my executor shall be conclusive and binding on all persons interested in my estate.
4. DISPOSITION OF TANGIBLE PERSONAL PROPERTY. 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, and not otherwise disposed
of herein, I give to DALE BARBER, SHELLY WATSON, and JESSICA MAGGIORINI, to be
divided substantially equally among them.
I direct my Executor to divide my tangible personal property into two parts. The first part
shall contain all items that my Executor determines, after consulting with DALE BARBER, SHELLY
WATSON, and JESSICA MAGGIORINI (my beneficiaries} to be of no present or future value or use
to my beneficiaries. The second part shall contain the balance of the property. My Executor shall
dispose of the first part by sale, abandonment, destruction, or gift to any charity or person. The proceeds
of any sale shall be added to my residuary estate. All property in the second part I give, in substantially
equal shares to DALE BARBER, SHELLY WATSON, and JESSICA MAGGIORINI. In the event
~~~~~~~
STEVEN C. BAKER
Y:\Clients\Baker, Steven C\Will.doc
August 5, 2010
of any dispute or disagreement with regard to the distribution, the decision of my executor shall be
conclusive and binding on all persons interested in my estate.
5. 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 DALE BARBER, SHELLY WATSON, and
JESSICA MAGGIORINI; PROVIDED THAT, if any of my beneficiaries shall predecease me leaving
issue, then I leave the share of that beneficiary to his or her issue, per stirpes; PROVIDED FURTHER
THAT if any of my beneficiaries shall predecease me and do not leave issue, then I leave the remainder
of that beneficiary's share to be divided equally among my then living beneficiaries named in this Article
5, per stirpes.
6. POWERS OF ADMINISTRATION.
6.1. Grant of Powers. My executor, in the administration of my estate, (my "fiduciaries")
shall have the powers and authorities set forth in this Article 6. 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
law, including, but not limited to, those set forth in Title 20, Chapter 33, of the Pennsylvania
Consolidated Statutes.
6.2. 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.
6.3. 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.
6.4. 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.
6.5. Power to Sorrow. 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
2 ~~ ~, S~
STEVEN C. BAKER
Y:AClients\Baker, Steven C\Will.doc
August 5, 2010
(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.
6.6. 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.
6.7. 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.
6.8. 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,
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
fiends 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.
6.9. 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.
6.10. 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.
6.1.1. 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.
STEVEN C. BAKER
Y:AClients~Baker, Steven C\Will.doc
August 5, 2010
6.12. 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.
6.13 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 maybe required to be filed as
a consequence of my death.
7. PAYMENT OF DEATH TAXES.
7.1. 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.
7.2. 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
residuary estate and shall not be deducted or collected from any beneficiary under this Will or
other transferee.
8. EXECUTOR.
8.1. Appointment. I name, constitute, and appoint my brother, WILLIAM A. BAKER, of
Dillsburg, York County, Pennsylvania, as executor of my estate. If my brother, WILLIAM A.
BAKER, shall not survive me, shall not serve as executor for any reason, or shall cease to serve
as executor for any reason after appointment, I appoint my sister, JUDITH A. RHINEHART, of
Enola, Cumberland County, Pennsylvania, as successor executor.
8.2. Bond Not Required. None of the individuals named in Section 8.1 shall be required to
furnish a bond for the faithful performance of his duties as executor.
9. 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.
10. 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.
STEVEN C. BAKER
1 L INTERPRETATION.
11.1 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 maybe.
11.2 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.
11.3 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.
11.4 Governing Law. This Will shall be construed in conformity with the law of the
Commonwealth of Pennsylvania.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting of five (5) typewritten pages, the first four (4) of which bear my signature in the
margin for the purpose of identification, this ~_ day of _, 2010.
~~
STEVEN C. BAKER, Testator
Signed, sealed, published and declared by the above-named Testator, STEVEN C. BAKER, as
and for his Last Will and Testament, in the sight and presence of us, who, at his request, in his sight and
presence and in the sight nd presence of each other, have hereunto subscribed our names as witnesses.
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Y:AClients~Baker, Steven C\Will.doc
August 5, 2010
COMMONWEALTH OF PENNSYLVANIA )
SS:
COUNTY OF CUMBERLAND )
I, STEVEN C. BAKER, THE TESTATOR WHOSE NAME IS SIGNED TO T:HE 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 FIRMED T AND ACK OWLEDGED BEFORE ME BY STEVEN C. BAKER, THE
TESTATOR THIS DAY OF ~ ~ , 2010.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
~~
STEVEN C. BA R, TESTATOR
NOTAR PU IC COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Jennifer Gross, Notary Public
Camp Hill Boro, Cumberland County
S S ; My Commission Expires Sept. 11, 2012
~ Mernbsr, Pennsylvania Association of Notaries
/-
WE, o..~-?!J ~~.... ~t" ~ ~.~~'~ ~c:~..~r AND C Z O ~
THE WITNESSES WHOSE NAMES ARE SIGNED TO THE FOREGOINC~NSTRUMENT, BEING DULY
QUALIFIED ACCORDING TO LAW, DEPOSE AND SAY THAT WE WERE PRESENT AND SAW THE
AFORESAID TESTATOR SIGN AND EXECUTE THE INSTRUMENT AS HIS LAST WILL AND
TESTAMENT; THAT HE SIGNED WILLINGLY AND THAT HE EXECUTED IT AS HIS FREE AND
VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED; THAT EACH OF US IN THE
HEARING AND SIGHT OF THE TESTATOR SIGNED THE WILL AS WITNESSES; AND THAT TO THE
BEST OF OUR KNOWLEDGE THE TESTATOR WAS AT THE TIME EIGHTEEN (18) OR MORE YEARS
OF AGE, OF SOUND MIND AND UNDER NO CONSTRAINT OR UNDUE INFLUENCE. ~
t~
SWO OR AFFIRMED
OF~, 2010.
~~
TO AND SUBSCRIBED TO BEFORE ME, TH:[S J DAY
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Jennifer Gross, Notary Public
Camp Hill Boro, Cumberland County
My Commission Expires Sept. 11, 2012
Member, Pennsylvania Association of Notaries
,~
WIT SS
W NESS
NOTA P LIC
COMMONWEA TH OF NNSYLVANfA
otari Seal
6 lennif s, Notary Public
Cumberland County
e~ Sepi ~ o, 2012
association of Notaries