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HomeMy WebLinkAbout06-29-11IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA REGISTER OF WILLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of ROBERT ARTHUR LIDDICK ~h~a: a/~/a: a/1:!a: SS NO: 182-58-0544 Petitioner( ~~~ho is~ 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: ~%A. Probate and Grant of Letters Testamentary or ^ Administration e.t.a., or d.b.n.c.t.a. (complete Part C.' also] and aver that Petitioner( is/entitled to die aforementioned Letters Testamentary _ _ tinder the last Will of die above-named Decedent, dated _March 6,_ 2005. _ and codicil(s) dated none (State relevant circumstances, e.g. renunciation, death of executor, etc.) 1?ticept as tbllows, Decedent did not manti~. was not divorced, and did not have a child born or adopted a[icr execution of the instrtmients oilered for probate; ~~~as not the victim of a killing, was never adjudicated an incapacitated person, and Sias not a party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in 33 Pa. C.S.A. § 3323(8):_ ^ B. Grant of Letters of Administration (If applicable, enter d.b.n., pendent lite, durante absentia, durante minuritate) C. Petitioner(s); after a proper search, has/have ascertained that Decedent left no Will and was surnived by the l~~llowing spouse (if any) and heirs ~If Administration e.t.a. or d.b.n e.t.a., enter date of Will in Section R and ~e7nrplcte list of 7ieirs): was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a ixmding divorce proceeding wherein grounds fur divorce had been established as provided in 23 Pa. C.S.A. § 3323(8). except as l~>llo~rs:__ 0 - _~ } ~ - __ ~'!.~~ `17 rt~ I ~ ...1 CSI ADDI"I'10V':1I. Sltl?~I?'h5 t1' tih;fi1~;S5 ARY "'I .-~~ ~ _ __ ~~ - i.,.Q ~. THIS SECTION MUST BE COMPLETED: ~C~-r-~ '"~ Decedent was domiciled at death in Ctunberland Count, Peunsylval>ia. «~ith his/her last famih~ or j~rit ~ipal res~nc~ Al 940 South 30th Street, Camp Hill, PA 17011 Z' `'~- _ '"s'i (Street address with Post Orrice and Lip Code, Municipality: Township, Borough, City) ~~ Decedent. den 41 ~ cars of age, died June 15 , 2011 at East Pennsboro Township, Cumberland County, PA (Month, Day, Year of death) (Cit~° and State where death occuircd) Pstinurted value of decedents property at death: If domiciled iu PA Il not domiciled in PA Ifnot domiciled in PA Value of Real Estate in Penne~~lvania All personal property Personal properly iu Pennsylvania Personal properh~ in County 'T'otal l,stimated ~'aluc Location of Rcal Estate in Pcnn~ti~~lcania: (Provide full address if possible.)_See attached sheet $ 10, 000.00 __ - - ---- - __ -- y; 378,000.00 5 388, 000.00 Sit;natur (s) ~amc{s) & .Aiailiu~ Address(es) Kathy Jean Irvin, 217 Belle Vista Drive, Marysville, PA 17053 ~ . , r ,,, Deceased ESTATE NO: 21- ~ ~ ~ ti 1. tmme Address Relationshi to llecedent Interim Dorm tt\b~-02 ieviscd 1226.10 by Cmnberlaud Counh pcndine action by the Corot Paec, 1 of Re: Estate of Robert Arthur Liddick, Deceased Continuation of Location of Real Estate in Pennsylvania (Petition for Probate) 940 South 30t" Street, Camp Hill, PA 17011. 2. 350 Huntington Drive, Enola, PA 17025. 216 Belle Vista Drive, Marysville, PA 17053 OATH OF PERSONAL REPRESENTATIVE Commonwealth of Pennsylvania ~ SS County of Cumberland y The Petitioner(s) herein named swear or affirm 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 before me this r'`'~` ~ day of 1June 2011 ~~ Kathy Jean Irvin ,-~ T._ ;= ~ :~ `ii ~ cr For the Register ~ t~~~ `~ <"~ c~ s:~ ->c7 „ :DECREE OF PROBATE AND GRANT OF LETTERS ~7~~,, ~ --~ . . n ~, Estate of ROBERT ARTHUR LIDDICK ,Deceased File I~;umber: 21-~` ~r~~ ~ -_ AND NOW, this day of June, 2011 , in consideration of the Petition on the rep erse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary _ of Administration are hereby_ granted to: (It applicable, enter e.t.a., d.b.n., d.b.n.c.t.a., etc.) Kathy Jean Irvin m the above estate and that instruments(s) dated March 6, 2005 described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. :a~ -ry .°'r, 1 r ! ..7 ~_ '~ c~ ~, ---~ t ,. s --r_ ~~, Glenda Famer Strasbai~h, ~~~ ~ ' ~ ~ r ~ ' ~ _ t- ~ i - Register of Wi11s ~ ' FEES Letters ... ... ... ...........5 ~ -_ Codicil(s) .. ............ _ ({ i) Short Certificates _=._~ `~ C C ( )Renunciations.......__ Bond ............................. Other ............................. ... ... ... ... ... ... ... ... ... ... ... Automation FEE......... _ 5.00 JCS FEE ................... 23.50 . r~ `~ TOTAL.. ~ ~~ Signature of Counsel Re 'red to 1:nter .Appearance Atty's Signature PRINTED Narile: Richard C. Snelbaker Supreme Court ID No.: 06355 _ Address: Snelbaker & Brenneman, P.C. 44 es ain ree Mechanicsburg, PA 17055 Phone: (717) 697-8528 Fax: (717)697-7681 [nteiim Form F. W-02 revised 12.26.1.0 by Cumberland County pending action by the Court Page 2 of 2 ,>rl~;~-a ~ 04 i~: i~3€~,.aa r..' dial:, _, .. ~ , w i I^. `c.~ ;l' P 17668485 _ K ~~ C`tc~~C~.~~, Z~ ch ~~t ~_~ ~~ :~, ~v~~ ~C ,.:; = ~ C^ -= T, a „ ., ~•~ p --rt Ht05.Y44 REV 11/2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TPeRMnNENT" CORONER'S CERTIFICATE OF DEATH aLACK INIC (See instructions and examples on reverse) srATE FILE NUMBER 1. Namerof Decedent (Flrsl, middle, last, suffix) 2. Sex 3. Social Security Number 4. Date of Death (Month, day, year) Robert A Liddick Male 182- 58- 0544 June 15, 2011 5. Age (Last Birthday) UiMer 1 year Under 1 day 6. Date of Bidh (Month, day. year) 7. Birthplace (City and slate or foreign country) Ba. Place of Death (Check only one) uonms Days bars ravwks Hospital: Other: 41 wa October 9, 1969 Harrisburg, Pa ^Inpatienl ^ER/Outpatient ^DOA ^Nursng Home ^Resitlence Other Speciy County of Death &. City, Bor Twp. 1 Death 6D Bd. FacAiry Name Qf not institution, give street aril number) 9. Was Decedent of Hispanic Origin? ®No ^Ves 10. Race. American Intlian, Black, White, etc. . (If yes, specity Cuban, (Specilh Cumberland East Pennsboro West Fairview Point Park Mezican,PuertoRican,etc.) White DeretlenYS Usual Occu Lion Kind of work done Burin most of work' IAe. Do not stile retired 11 12. Was Decedent ever in the 13. Decedent's Educatbn (Specify oMy highest grade completed) 14. Marital Status: Married, Never Married, 15. Surviving Spouse (II wife, give maiden name) . Kind of Work Nintl of Business I IMUStry U.S. Armed Forces? Elementary /Secondary (0-12) College (1-4 or 5+) Widowed, Divorced (Specity) Clerk State Government W~a ^Np 12 Never Married 16. Decedent's Mailing Atltlress (Slreel, city I town, s191e, zip code) Decedent's Did Decedent Yes Decedem Lived in Twp ^ Y 7c St l PA 94O S. 3Oth St. I~ . . , a e Actual Residence 17a. Township? wedwilhin Camp Hiil Cumberland 17d.ICIKlo rib c t emt a Camp HiII, PA 17011 oan y jp cdylBom lL sol t6. Father's Name (Flrsl. middle, last, suffix) Arthur Liddick 19. Mother's Name (First. middle, maiden surname) Barbara Miller 20a. Informant's Name iType /Print) 20b. Informant's Mailing Adtlress (Street, city /town, state, zp code) Kathy Irvin 217 Belle Vista Marysville, PA 17053 21 a. Methotl of Dsposihon ~ ~ematien ^ Donalron 216. Date of Disposition (Month, tlay, year) 21 c. Place of Disposition (Name of cemetery, crematory m other place) 21tl. Location (City I town, stale, zip code) ^ Burial ^ Removal from State i WasCremationorDOnetionAuNOdred ~ ^ 2011 June 19 Hoffman Crematory Carlisle, PA 17013 No Yes ^ Other - Specify; by Medical Examirer 1 DOrerIM? , . Sgnature of Funeral Service Licensee or rson 22b. Lkense Number 22c. Name aril Address of Facility 13845-L FD Sullivan Funeral Home 51 N. Enola Dr. Enola, PA 17025 ~ - Complete Items 23ac only when cenirying 23a. To the bell of my kipwletlge, tleath occurred al the lime, date and place slated. (Signature and title) 23h. License Number 23c. Date Signed (Month, day. year) physician ~ not available al time of death to cedify cause of death. Time of Death 24 25. Date Pronounced Deatl (Month, day, year) 26. Was Case Referred to Medical Examiner /Coroner for a Reason Other than Cremation or Donation? Items 2426 must be compleletl by person who Dmnounces deem . A rX. 10:00 A.M~ June 15, 2011 Yes ^No CAUSE OF DEATH (See Instructions and examples) ~ Approximate interval: Part 11: Enter of er s militant conditbns conlnbuting to death, 26. Ditl Tobacco Use Contribute to Death? Item 27. Pan f. Enter the cha n of events -diseases, Injuries, or complkalions -that directly roused Ne death. DO NOT enter terminal events such as cardiac arrest, r Onset to Death but not resulting in the undedymg cause given in Pan f. ^Ves ^ °roDaDly respirator arrest, or uenlncular librillalron without showing the etidogy List only one cause on each line. r ^ No ^ Unknown IMMEDNTE CAUSE (Foal disease or condition resuning in death) _~ a Glln 5110 t t O Head 29. If Female-. ^ N ilAl t t t Due to (or as a consequence oq: Sequentially list cmtlilions, if any, b t w year o pregnan n pas ^ Pregnant et erne of death . leadi to the cause listed on line a. rg Duero (or as a consequence ofg ^ Nol pregnant, but pregnam within 42 days Enter the UNDERLYING CAUSE (disease or injury That Initialed the c of death events resulting in death) LAST. ^ Nol pregnant, but pregnant 43 days to 1 year Due to (or as a consequence of): before death tl ^ Unknown if pregnant within the past year . 30a. Was an Autopsy Sob. Were Autopsy Flydings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occurred In t efLt Iona 1 S e 1 f - 32c OUke Bulildin , eicm S F~'m, Slreel Factory, g ' I D hl Pedomred? Available Prior to Completion of cause of Death ^Natural ^Hanidde June 15 2011 Inflicted Gunshot- Lon Gun Woods ^ Accdent ^ Pendng Inveslgation 32d. Time of Iryury 32e. Irpury at Work? 321. If Tmnspalation Injury (Specify) 32g. Location of Injury (Slreel, city /town, state) ^ yes ~NO ^Ves ^ No (y1 APM X ^Ves ~ No ^ Dmer /Operator ^ Passenger ^Pedestrian Suicide ^ Coultl Not be Determine0 y"l 10.00 A • ^omar-speCy.- Front Street West Fairview PA 33a. Cenifler Icheck onW one) 33b. Signature and Tllle • CMitying physician (Physioan certifying cause of tleath when amlher physician has Dronounced tleaN and canpleletl Item 23) death occurred due to the cause(s)and manner es staled_________________________________ ^ knowled To the best of m e ~ ~ Coroner g y . • Prorwuncing and <editylnq physician (Physician bosh pronouncing death antl certiying la cause o/ OeaN) ^ 33c. License Number 33tl. Dale Signed (Month, day, year) To the beat of my knowledge, death occurretl at the time, dale, antl place, and due to the cause(s) and manner as s[ated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • MedicalExaminerlCOroner June 16 2011 On the basis of examination antl I or investigaUOn, in my opinion, death occurtetl at the time, tlste, antl place, and due to the cause(s) aM manner as slated_ 34. Name and Address of Person Who CAmlxeled Cause of Death Qlem 27) type! Print Coroner Eckenrode T dd C 35. Re islrars lure and 'triory~ b-arn ` 9 9 I alal~I~I~J l% ~ 36. ate Filed (M Ih, da ,year) . 17 ~ ~' , o . 6375 Basehore Rd., Suite AIL (.. l..~ e~,~ p O~.O ~~V ~.,y Disposition Permit No. t / ~ • O .... ~. ~_V ~T1 ~ ~ ~~ ..w~ l.'« 1 } S"'J~ f r..> c ~ ~ , ~_u5~ , _, ,._, ~ • ~n C ~T y . " i LAST WILL AND TESTAMENT OF ROBERT ARTHUR LIDDICK Dated: March 6, 2005 Prepared by: 193rd Special Operations Legal Office Lisa M. treason, Esquire, Captain PA Air National Guard, 81 Constellation Court Middletown, PA 17057 (717) 948-2207 ,~--t~~- ( ~` l MILITARY TESTAMENTARY PREAMBLE: This is a MILITARY TESTAMENTARY INSTRUMENT prepared pursuant to Title 10 United States Code, Section 1044d, and executed by a person authorized to receive legal assistance from the military services. Federal law exempts this document from any requirement of form, formality, or recording that is prescribed for testamentary instruments under the laws of a state, the District of Columbia, or a territory, commonwealth or possession of the United States. Federal law specifies that this document shall be given the same legal effect as a testamentary instrument prepared and executed in accordance with the laws of the jurisdiction in which it is presented for probate. It shall remain valid unless and until the Testator revokes it. LAST WILL AND TESTAMENT OF ROBERT ARTHUR LIDDICK I, ROBERT ARTHUR LIDDICK, 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 in 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, funiishings, household goods, automobiles and other vehicles, together with all insurance policies relating thereto, to my son BRANDON V. LIDDICK, if he survives me. If my son shall be under the age of twenty-one (21) years at my death, my Executor may sell any property bequeathed to my son 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 my son attains said age or such earlier time as my Executor may deem proper to deliver any such property or proceeds to my son, or to my son's guardian or any person with whom my son resides for the use of my son, or, if there is a separate trust for the benefit of my son, 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 `f_ / l manner entitled at the time of my death (collectively referred to as my "residuary estate"), as follows: (a) If my son survives me, to my son, or if he does not survive me to any then living issue of my son, per stitpes. If, however, my son then shall be under the age of twenty-one (21) years (my son being hereinafter referred to as the "Beneficiary"), the bequest to 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 this bequest and may pay all or any part of the net income to or for the benefit of the Beneficiary, 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 the Beneficiary, for the health, education, maintenance and support of the Beneficiary, from the principal of the Beneficiary's trust, such amounts, including the whole thereof, as determined in the absolute discretion of my Trustee. (iii) When the Beneficiary shall attain the age of twenty-one (21) years, the trust for the Beneficiary shall terminate and any re- maining principal and income shall be paid and distributed to the Beneficiary, discharged of trust If the Beneficiary dies before said age, such principal and income shall be paid and distributed to any then living issue of the Beneficiary, per stirpes, or if the Beneficiary has no issue to my then living issue, per 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. (b) If no issue of mine survives me, my residuary estate shall be paid and distributed to JOSHUA SCOTT IRVIN if he shall survive me. (c) If none of the beneficiaries described in clauses (a) and (b) above shall survive me, then I give my residuary estate to those who would take from me as if / ~ ~. 2 _. -_, _. f _......... l 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 vests m 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 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 any part of such property until the beneficiary attains the age of twenty-one (21) 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 sister, KATHY JEAN IRVIN to be my Executor. I appoint my sister, KATHY JEAN IRVIN to be my Trustee. If my sister, KATHY JEAN IRVIN shall fail to qualify for any reason as my Trustee, or having qualified shall die, resign or cease to act for any reason as my Trustee, I appoint CONNIE L. ROYER as 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 Executor or Trustee from time to time may deem desirable; and to employ attorneys, accountants and other persons for services or advice. _... r~~_ ~ 3 ~. 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 time. Each Executor and Trustee shall have the same 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 more than thirty days. The terms "child" and "children" as used in this will include only the child and children of the person designated, but not any adopted child and children of such person. The term "issue" includes only the children and other issue of the person designated, but not any adopted children or issue of such person. The terms "child," "children" and "issue" of the Testator shall not include any stepchild of the Testator. 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, 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 involuntary creditor of any beneficiary or liable to attachment, execution or other legal or equitable process prior to its actual receipt by the beneficiary. NINTH: I appoint CONNIE L. ROYER to be the Guardian of the person and property of any child of mine who has not attained the age of majority. If CONNIE L. ROYER shall fail or cease to act as Guardian of the person, I appoint KATHY JEAN IRVIN as Guardian of the person. No Guardian of the person 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 of the person. ~r' 4 r r, 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. IN WITNESS WHEREOF, I, ROBERT ARTHUR LIDDICK, sign my name and publish and declare this instrument as my last will and testament this 6th day of March, 2005. _. _i ~ ~ ~ ~ ~__. ~~ ROBERT AR UR LIDDICK The foregoing instrument was signed, published and declared by ROBERT ARTHUR LIDDICK, 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. ,• -, Print: r~ ~ i~'_ j _ 'j ,,ti; ;r 1•.l- .~''~` r~ ~~~~, ~ G~.1~ Print: ~~~~. N~A~_~ l L having an address at 193rd Special Operations Wing Middletown, PA 17-057 having an address at 193rd Special Operations Wing Middletown, PA 17057 5 MILITARY TESTAMENTARY INSTRUMENT SELF-PROVING AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA, COUNTY OF DAUPHIN, 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 that in the presence of the military legal counsel and the witnesses the Testator, ROBERT ARTHUR LIDDICK, signed and executed the instrument as his military testamentary instrument, that he had signed willingly, and that he executed it as his free and voluntary act and deed for the purposes therein expressed. It is further declared that each of the witnesses, at the request of the Testator, in the presence and hearing of the Testator, the military legal assistance counsel and each other, signed the military testamentary instrument 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. ___ ROBERT ARTH LIDDICK Testator ~ .~/ti ~ l , print: ~r;iL J .~:~ ~;~ Witness print: ~'pi.~~.V p~~tk~~-~.C Witness Subscribed, sworn to and acknowledged before me by the said ROBERT ARTHUR LIDDICK, Testator, and subscribed and sworn to before me by the above-named witnesses, this 6th day of March, 2005 ~.._._._.n.- -=' trt'ary Public My commission expires on ._~ ,, r P,o'S, ,.r. ~.~._ 'G, ,~ C ., "_ e ~, .. ,..~ .. .. "} - .:......