HomeMy WebLinkAbout01-20-11PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF CUMBERLAND
Estate of ANGELA L. ANGELOZZI
also known as
COUNTY, PENNSYLVANIA
File Number ~ ~ _ ~ ~ - ~~ Q ~
,Deceased Social Security Number 202-16-3749
DONNA M. ANGELOZZI and MARY ANNE ELLMER
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' OR 'B' BELOW:)
Q A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is 1 are the EXECUTRICES named in the
last Will of the Decedent dated 2/22/1993 and codicil(s) dated
AVIO ANGELOZZI, HUSBAND OF DECEDENT, DIED JUNE 3, 1999.
(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 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) aad heirs: (If
Administration, c. t. a. or d. b. n. c. t. a., enter date of Will in Section A above and complete list of heirs.) ~ ~~ :.,~:_ .
Name Relationshi Reside-i~c~~
~
.F~
--
-
,
r°n r , _
- ., _ ~__:
:~ -~
.
J ..) S "j
~~ .. r^.
r
.w ~~
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his /her last principal residence at
3419 Logan Street Cama Hlii PA 17011
(List street address, town/city, township, county, state, zip code)
Decedent, then 86 years of age, died on 1/7/2011 at GOLDEN LIVING REHABILITATION CENTER
CAMP HILL PA 17011
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 120,000.00
(If not domiciled in PA) Personal property in Pennsylvania $ 0.00
(If not domiciled in PA) Personal property in County $ 0.00
Value of real estate in Pennsylvania $ 150,000.00
3419 LOGAN STREET, CAMP HILL, PA 17011
situated as follows:
Wherefore, Petitioners} 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
a'vw~ ~ DONNA M. ANGELOZZI 123 RUTLEDGE AVENUE
FOLSOM PA 19033
~;;
~~vc/ L~~~--w~/ MARY ANNE ELLMER 26 CR~DON ROAD
MAYS LANDING NJ 08330
Form RW-02 rev. 10.13.06 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA ;
SS
COUNTY OF CUMBERLAND
The Petitioner(s) abave-named swears} 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, Petitioners} will well and truly
administer the estate according to law.
Sworn to or affirmed 2nd subscribed
before me the r- day of
.IANLIARY 20'11
-•
For the Register
~~~~ ~
Signature of Personal Representativ/e~ DONNA M ~AN6>L~.OZZI
/ J~,~.
d ~ 1 ~~~ ~
~,.
Signature of Personal Representative MARY ANNE ELLMER
Signature of Personal Representative ~,
,. ~`i
_.A~/
~t `.~ i
_: ,
..~:
_._ ~ ~R~
File Number:
~ i _ {T"7
~•.~ ti~ ...._r.
Estate of ANGELA L. ANGELOZZI , Dec~s~ ~,~,~
:~
Social Security Number: 202-16-3749 Date of Death: 1/7/2011
~j ~~
;.. .-r
a,` .....,,,}
~" ~, i
'1
~-
- ra
.~
::~.~ a
AND NOW, JANUARY vZ.O , 2011 , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT IS DECREED that Letters TESTAMENTARY
are hereby granted to DONNA M. ANGELOZZI and MARY ANNE ELLMER
._ in the above estate
and that the instrument(s) dated 02/22/1993 _
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES ~~~ ~'
~ ~~ ~ gister of Wills '~~ .r~~ ~ ~_ ~~
Letters ............................. $ s-~1 C! - -C ~~ ~,
Short Certificate(s) • • • • • • • • • • • • $ ~~1--) C?~ ~ Attorney Signature: f
Renunciation(s) •••••••••••••••• $
~,L~ ~ ~, ~ .••• $ i <~ _ Gf~~ Attorney Name: Robert E. Diehl, Jr.. Esquire
~ • • ~ ~ $ `~" `~ `~~, Supreme Court LD. No.: 07613
•••. $ Address: 1070 Market Street
"" $ Sunbury. PA 17801
.... $
.... $
.... $
$ Telephone: 570-286-9999
TOTAL ............................. $ c~~ ~ - `i]C
Form RW-02 rev. !0.!3.06 Page 2 of 2
OCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.OQ
This is to certify that the information here given is
correctly copied from arl original Certificate of Death
duly filed with me as Local Registrar. The original
certificate will he ~l~orwarded to the State Vital
Records Office for permanent filing.
P 17046842___
Certification I~lumber
T;CEM # ,~
SHOULD READ AS FOLLOWS:
~~ar _ ~~~ ~- -~ JANi1 B ~'h'
's ~~~~~ Date Issued
Local Reg), trar
~ ~ ,_
C ~ ~:~ ~'7
._tJ
~
i ...
- ~~` ,`" _t
l..t -.~
hJ
,
' ~ C~ r
-w->
,_ ...
'-.
~~ ~ -~} i t
_) ~~ ....~ -- Ft~1
-. ~~
~
~. -';'~
a3 REV 11/2008 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH a VITAL RECORDS
R/M~ CERTIFICATE OF DEATH
LACK INK (See Instructions and examples on reverse)
CTATC CII F All 1-.RCR
1. Name d Decederd (First. middle, Net, wMx) ~ 2 Sex 3. Sodel Seaeay Number e. Deb d Death (Maltlt, day, Yad
7 2011
An e a elozzi Female 186 - 18,- 8523 Januar
Age (last exutday) Under
5 1 Undo 5 B. Dab d ISrth 7. and eNb a N. PNa d Death Check on one
• .
86 v~ ~ ~ tom. t June 20, 1924 Summit Hill, PA "°'p"°`'
^ InpetbM ^ ER I Oulpetlent ^ DOA Other:
Ntxaing Hone ^ Residence ^ Other - Spedly:
Sr. County d Death 8c. City, Bono, Twp. d Death 9d. Fal#ly Name (N not kletlhebrl, glue street end rxertber) 9. Wes Decederd d FlNperYc Orlgkt? ,~No ^ Yea 10. Race: American Indan, BNck, Whfte, elc.
(
~
(
Cumberland E. Pennsboro 'It~vp. ~~ .a
. •~)
White
Golden Living Center
11. Decedertre Ueud d wale d one mat d rife. Do nd state 12 Wee Deaderd ewr m 11a 13. DecederlPa Edrxbtlon (Specny only ttglmet grade twmpNNd) 14. Marital Sbbm: Mertbd, Never Married, t 8. survking spouse pt wile, give maiden name)
edNI
~o~ (S
wb
d
IOrtddBudneea/Industry
Ir)vent~"'1'~anagnen U.S. Amted Forces? ENrrtentary / Secatdery (a12) Cdlege (1-4 a 5+) D
OWe
'
^ Yea No idowed
- ~rN)
,B.DecedertraMefNngAddresa(stmt
dy/tow,,,aLNN,n~ 'e Penns lvania °~D rq E. Pennsboro
Twp.
Decedent Lived in
17c
t111 Yes
•
y
r
.
7 70 Poplar ll turCl t tut . ,_
,
.
~
?
Aduet Residence 17a. StaN
Cumber land , 7d. ^ No, Decedem t.lved wddtin
Camp Hill , PA 17011 „b. c«mty
Aatwl Limits d C'dy ~ Boro
18. Father's Name (Flrsl rttldda, Nat, sulAx)
Gaetano Carulli 19. Mdtler'a Name (First, middle, maiden eumerrm)
Riparata Martello
20a. IrdortttsnYs Name (Type (Print) 20b. InlameM'a MeiNrtg Address (Sheet, d+Y I town, aNb, zip code)
NJ 08330
s Landin
Ma
don Rd
26 C
g,
y
.,
roy
Mar Anne Ellmer
21e. Method d DNpaitlat r tl0" ^ Donation 21b. Deb d Diepaeltlan (Month, day, year) 21c. Place d tJlepoeitlon (Name d cemNery, aentsbry a otMr place) 21 d. Locaton (City! town, state, zip code)
^ t~ ^ RemovelfiomSNb ~ w ~ oroon.non Y
01-11-2011 Holli er Cremation Service Mt. Holl S tin s PA
^ N
o
..
°tlw ~ ~
22b. Urxrae Nlsr~ber 221: Nam. n,d Addroes d Parity Myers-Hamer Funera Home Inc .
~
014819 1 1 0 1
Car9NM Nero 2Aat any when artllyirlp 23a. To fM beet d my knowNrige, death oxurred et the rime, deb and pNcs aNbd. (Sigrrhxe end tltb) 23b. Licerlee Nlxnber 23c. Date Signed (Morah, day, year)
ai wne d deelh ro
w d e r/~
„ `~r 1'~ _ p~''` ~
` K N 518 (-~ 5 t `~.o ( I
~
eatli.
y a ~
~
•]_ .-
`
v ,
Item 24.28 moat be aanoNbd by person
who pratorxtcee death. 24. Time d oe.th
~ '. 3 0 qN. 25. Date Deed (Mortth, day, year)
~ r a.~ 1 I tc Medcel Exartriner f Corcatar fa a Reason r then cnmletion a Darretla~?
28. Wes Csea
Rer°~
^ YesLJ No
CAUSE OF DEATH (SM Instructloeu erd mxnreplee) r APProximeN interval:
~.bY9m1- deeesse, kljurlee, a compAatlam - drat drsdy eased the death. DO NOT order bmunal events such as cardac arresl i Or»et b Dea9i
hem 27. Pert I: Fster the SibOh PeA II: Enter otlter
but not reeuMing in the undedyirig cause given in Pert I. 28. Did Tobacco Uee Contribute to Death?
^ Yes ^ Probeby
.
reapYebry eneeL a ventrtadar 11brSeNori wNlaut ehowkq the etbbgy. Llat ady oa carme on each Ilse. r ^ No ^ Unknown
~~9 1
CAU~) dNeaee a ~ ~ r
~lww I1 /+~ ~ /~ ~ /,~ r
r • r
~1
ls/lJ`tiAI~
(
W ~C t ~iY l -
~ r IL n
29. If Female:
nant within
ast
ear
^ Pbt pre
,te
a,
~
_
-~-
a.
,.
y
~ i
Due b~rerxs dl' n `
~ lQ _ ' p
y
g
^ Pregnant at tkne d death
-
/
/
~~'r`~T~ ~~ ~'~P~ /~t1~1~ ~~ - ~
b - ^
.
b orbs ~bd,~ ~ a.
E~UNOEALYRq CAUSE Due b (a es a col gtxintx dl: -a r Not pregnant, but pregnant whhhin 42 days
of death
( a ~ IBd ~ C r - nant 43 da
s to 1
ear
^ N
nt
t
r
t
b
- eveMe rewlYry~ In death) LAST. pa m (a ea a consequence of-: ~ y
pregna
u
p
y
o
,
eg
before rises,
e
-
Unknown tl pregnant within the peat year
• d. r
30a. Wes an AtrNpof 30b. Were Aubpey Flndkgs 31. Heiner d Death 32a. Date d Injury (Month, day, year) 32b. Describe How Injury Oaxlned 32c. Plaee of Injury: Hare, Fenn, Street. Factory,
Omce BuikAng, etc. lSpeary)
Fbrfonried't AveNeble Prbr b CornpNtion
d D
th?
d C lt>'t~. ~ ^
xltetaw
ea
ause ^ Aociderrt ^ PerxNng Irweetlgatlon ~. Time d Injury 32e. htJury et Wok? 321. H Treneporbtlon NhuY (Spedly) 32g. Location d injury (Street, city /town, state)
^ Yea C~,NO ^ Yea ^ No ^ Yes ^ No ^ Driver/Operator ^ Passenger ^ PedeeMen
^ Suil~e ^ Could Not be DetertNned M. OMer - Spsdly: _
33a. CerdNer (dMCk any one) 33b. SipteNre d Tips d CsrtlNer t
• Grylylnp pleyekNn (Ptrirek9en «dy+rw Huse d death when eriotller phyaldan hoe pronasiced death and canPieted Item 23)
^
,
TolhebesldmylowwbdSe,deaMoaewnddwtotlwauee(e)andmannaagaeed---..,----------------------------- ~. Licerwe ~~ 33d. Date Signed {Month, day, year)
Prorquredrq and aeAMyNrg ph,elden (PhyUcNn both prortournirtg death end certlykq b cause d death)
d
~ ~
2
Ibl ~
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
To nle beet or rq IrrowNdge, deatlr ooeureed at ttre sine, rises, erd pboe, and due ~ ttn awe(s) ertd nrnrler • sbb
' !
q„
,
• Medbal Esanrlrre-/Coroner
on ttre beeN of aerarnNrtlon and / a Imrwtlpalbre, In my opinion, daMh ooaetted et the tlma, dale, and pNa, and dw to rite ewN(s) and manner a eubrl. ^ 34. Name end Address d Person who Completed Calms d Deed (kem 27) type /Print
ire ~ ~ lz7 l ~ 1 vZ 1 ~ 1 r ~ /~ A°d ~lr day ve.~/
-
DispoeNbrtPermitNo. nrj(~7~57
e . _ ~ ~ ~ ~ ~ ~ ~I,1 t~
- - -~ r _ - _ _ .. .
I, ANGELA L. ANGELOZZI, of 3419 Logan Street, Camp
Hill, Cumberland County, Pennsylvania, declare this to be my Last
Will and Testament and hereby revoke and make void all former
Wills by me at any time heretofore made.
AS to such estate as it has pleased God to entrust to
me, I dispose of the same as follows:
ITEM I: I direct that my just debts, last illness
expenses and funeral expenses be paid as soon as practicable
after my death.
ITEM II: I am leaving a Memorandum which is dated this
day and is in existence at the time of the execution of this Will
and I direct my Executor, or his successors, to deliver and
distribute the articles mentioned therein to the person or
persons designated therein. These items shall be free and clear
of inheritance taxes, transfer taxes and other death taxes which
shall be paid from my residuary estate.
ITEM III: I bequeath to my husband, AVIO ANGELOZZI, if
he survives me, otherwise to such of my children as shall survive
me, in equal shares, my automobiles, household and personal
effects and other tangible personal property of like
nature (not including cash, securities or any item bequeathed by
virtue of the Memorandum referred to in ITEM II:) owned by me at
:~.,~
~j ~,.~, ~y deat~~:A all unearned premiums on policies of insurance insuring
~, ,.~ ~
~....
a - - _~-~ ~.~, ~ ~, ~ ~ (SEAL)
.._
~ ~ -~_
-,.,
.-
t ~.~
C~~r ~,! a fL_
[.~ - U
.. Y
fi. i
r
said articles of personal property against loss by fire, theft,
accident or other casualty, and the net proceeds of any claim or
claims against any insurance company or persons arising out of or
connected with any such loss, destruction or damage of any said
property.
I direct that any expenses incurred in safeguarding or
delivering such property be paid from my estate as an expense of
the administration thereof.
ITEM IV: All the rest, residue and remainder of my
estate of whatever nature and wherever situate, I devise and
bequeath to my friend, ANGELO MARK PAPALIA, and in the event he
fails or ceases to so serve, my nephew, GERARD BOHOVICH,
presently of Allentown, Pennsylvania, IN TRUST, for the following
uses and purposes:
1. During the life of my husband, AVID ANGELOZZI, to pay
or apply the net income therefrom to or for the benefit of
my said husband, in quarterly or more frequent installments.
2. In addition, my Trustee shall have the authority, in
his sole and absolute discretion, to pay to or apply on
behalf of my said husband such amounts of the principal as
he may determine to be necessary and proper for his support,
maintenance and welfare.
~~~---~- ~---" ( SEAL)
- 2 -
3. After the death of my husband, AVID ANGELOZZI, or after
my death if he fails to survive me, Trustee shall first
deduct and pay to the personal representative of my
husband's estate an amount equal to the increase in federal
estate tax or state death tax which his estate will have to
pay because of the inclusion of the assets under this ITEM
IV of my Will in his gross estate (unless he directs
otherwise in his Will) and all then remaining principal of
this trust shall be distributed in equal shares to my
daughters, DONNA M. ANGELOZZI and MARY ANNE ELLMER, per
stirpes. Any accumulated and undistributed income shall be
distributed to my husband's estate.
In the event either of my daughters die before me
leaving no living issue, the share that would have passed to
such a deceased daughter shall pass to my then living issue,
per stirpes, if any, otherwise to my sister, EDITH T.
BOHOVICH, per stirpes.
4. Trustee shall hold each share of principal which shall
vest in a beneficiary during minority (minority shall mean
under twenty-one (21) years of age), IN TRUST, and invest
the same in property authorized by this instrument; apply
income and principal as necessary for the support,
,~..,,,,_ ~.~°,.~,,,,, ,,,~ ~~.,. ~.. ~.,.~ SEAL
( )
- 3 -
education and welfare of such minor; accumulate and invest
the aforesaid income not needed for such purposes; and pay
over and distribute all remaining principal and accumulated
income to such beneficiary, at his or her majority, or to
the estate of such beneficiary, at his or her death, prior
thereto. Should the share of a minor, in the sole opinion
of the Trustee, be or become too small to warrant
continuing such fund in trust, or should its administration
be or become impracticable for any other reason, (including
the fact that the rule against perpetuities may be violated)
Trustee in his sole discretion, may pay such share to a
parent or other person maintaining said minor, or may
deposit such share in the minor's name in a savings account
in a savings institution of his choosing, payable to the
minor at majority.
5. Trustee shall in his sole discretion apply the income
and any amount of principal to which any beneficiary shall
be entitled hereunder for the maintenance and suppart of
said beneficiary should such beneficiary by reason of age,
illness or any other cause, in the opinion of my said
Trustee be incapable of receiving it or judiciously using
it.
"'
''f' ;~
( SEAL )
:.:
- 4 -
6. This Item of my Will is intended to empower my Executor
to qualify this gift or as much thereof as it deems
advantageous for the qualified terminable interest property
provision set forth in Section 2056 (b)(7) of the Internal
Revenue Code, as amended by Section 403 of the Economic
Recovery Tax Act of 1981, and as may be further amended
after the execution of this Will, and my Executor is hereby
authorized to make the election to qualify or not to
qualify. As such I direct that (1) if any provision of my
Will shall result in depriving this Item of the benefits of
IRC Section 2056 (b)(7), if elected, such provision is
hereby revoked and my Will shall be read as if any portion
thereof which would result in such disqualification is null
and void; (2) my Executor is hereby excused from liability
to any person for the decision to elect to have this Item
qualify for the marital deduction or for the decision to
elect not to so qualify it; and (3) no reimbursement or
other adjustment shall be made as among beneficiaries by
reason of the consequences of such election or failure to
elect.
ITEM V: In addition to the rights and powers given to
them by law and elsewhere in this Will, my fiduciaries named
G ^' ~.,. ~ Y ~ ( SEAL)
5
herein whether they be Executor, Trustee or Guardian, and their
successors shall have the following discretionary powers
applicable to all real and personal property held by them,
effective without court order and until actual distribution:
A. To retain any real and personal property which may at
any time form part of my estate including stock of the Corporate
Trustee, if any.
B. To invest and reinvest in any real or personal
property without restriction to investments authorized for
Pennsylvania fiduciaries. I may own several real estate investment
properties at the time of my death and I specifically authorize my
Executor and/or Trustee to retain the same if they in their sole
and absolute discretion deem them to be proper investments.
C. To keep reasonable amounts of cash in bank
uninvested, if deemed advisable for the protection of principal.
D. To subscribe for or to exercise options for stocks,
bonds or other investments; to join in any plan of lease, mortgage,
merger, consolidation, reorganization, foreclosure or voting trust
and to deposit securities thereunder, and generally to exercise
all the rights of security holders or employees of any corporation.
E. To register securities in the name of a nominee or
in such manner that title shall pass by del`i~very.
-/ -~-~~.-- .~i •; ~ ~~--- ` SEAL
-~.- c ~
;,
6
J
F. To repair, alter, improve or lease for any period
of time, any real or personal property and to give options for
leases.
G. To sell at public or private sale, for cash or
credit, with or without security, to exchange or to partition any
real or personal property and to give options for sales or
exchanges.
H. To borrow money from any person, including any
Executor, Trustee, or Guardian and to mortgage or pledge any real
or personal property.
I. To compromise claims.
J. To distribute in cash, in kind, or both, at such
values as they may fix.
K. To conduct any business in which I am engaged or in
which I have an interest at the time of my death, for such periods
as may be deemed advisable and with power to borrow money and
pledge the assets of the business and do all other acts which I, in
my lifetime, could have done or to delegate such powers to any
partner, manager or employee, without liability for any loss
occurring herein, provided, however, that no assets of my estate
which I have not devoted thereto in my lifetime shall be liable for
the debts and contracts of such business.
,~`~ 4
,~ ~ ., ti...~...~;,..-- L ~~ ~~ ,~.~: SEAL
t
;,
7 -
L. To sell at public or private sale any business in
which I am engaged or in which I have an interest at the
time of my death, and the real and personal property thereof.
ITEM VI: No payment received by Trustee and excludable
from my gross estate for federal estate tax purposes under any
section of the I.R.C. in effect when I die shall be used or applied
for the payment of death taxes, estate expenses or claims against
my estate.
ITEM VII: All federal, state and other death taxes
payable because of my death, with respect to the property forming
my gross estate for tax purposes, whether or not passing under this
Will, including any interest or penalty imposed in connection with
such tax, shall be considered a part of the expenses of the
administration of my estate and shall be paid from my residuary
estate without apportionment or right of reimbursement. However,
to the extent possible, no such tax shall be paid out of any share
of my estate passing to my surviving spouse and which qualifies for
the marital deduction.. All such taxes on present or future
interests shall be paid at such time or times as my Executor may
think proper, regardless of whether such taxes are then due.
.,.~_ ,~;,.1 ~ ~ "~ SEAL
g
ITEM VIII: The interest of the beneficiaries herein
shall not be subject to anticipation or to voluntary or involuntary
alienation.
ITEM IX: I appoint my husband, AVID ANGELOZZI, Executor
of this my Last Will and Testament. In the event he fails or
ceases to so serve, I appoint my daughters, DONNA M. ANGELOZZI and
MARY ANNE ELLMER, or the last surviving of them, Substitute
Executors.
I direct that my fiduciaries named herein whether it be
Executor, Trustee or Guardian, shall not be required to post bond
for the faithful performance of their duties in any jurisdiction.
Wherever the words Executor, Trustee or Guardian are used
in this document, they shall include both the singular and plural.
IN WITNESS WHEREOF, I, ANGELA L. ANGELOZZI, the
Testatrix, have to this, my Last Will and Testament, set my hand
and seal this day of February, 1993. }
3
~+~ ~~~ ~..~ ~ EAL)
Ang la L. Angel zzi
Signed, sealed, published and declared by the above named
ANGELA L. ANGELOZZI, as and for her Last Will and Testament, in the
presence of us, who have hereunto subscribed our names at her
request as witnesses thereto, in the presence of the said
Testatrix, and of each other.
r ~3~
~ ~/~/~ r 9
/ i ' ~1 fib. r'aAr t,_:t.~+ ~ ~ -~`- Gl, ,.i.f.,+tJ-~1. /
9
OATH OF SUBSCRIBING WITNESS(ES) ~c
~ 4 =~ -,
_
~:~ ~ _~_ ~
, . ,
_ ,~,
_: ~-~
REGISTER OF WILLS ~
'~ ~' --,
__
,, ,
CUMBERLAND COUNTY
PENNSYLVANIA
~-~
~'~
,
,
;'
~ TM~
~
~~J . ...m "'3" t
~•~
f`a:.
Estate of ANGELA L. ANGELOZZI ,Deceased
ROBERT E. DIEHL JR. and MARIANNE L. WEAVER , (each a subscribing witness to
(Print Name/s)
the 0 Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she 1 he 1 they was /were present and saw the above Testator 1 Testatrix sign the same
and that she 1 he /they signed the same and that she / he /they signed as a witness at the request of
the Testator /Testatrix in her /his presence and in the presence of each other.
(Signat e)
1070 MARKET STREET
(Street Address)
SUNBURY PA 17801
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of
day
Deputy for Register of Wills
w
(Signature)
101 NORTH 11TH STREET
(Street Address)
SUNBURY PA 17801
(City, State, Zip)
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this `~~ day
of ~ ~,c ,t~c Q.J~_ , ~~ .
ary Public
Commission Expires: d i~p~~~zo lZ
(Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instru nt(s) at time oA~aSfcM.
1ANET 1. SNIPE, NOTARY Pt)BLiC
Cf1Y ~ SUMBURx NORTHUMBERLAND CQU}!TY
MY COMMISSION EXPIRES JANUARY 5, 2012
Form RW-03 rev. /0.13.06