HomeMy WebLinkAbout08-18-11IN THE COURT OF COMMON PLEAS O~ CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of (~/f~/~~(/ /!7 f.~ ~Q!/~~CtG" ,Deceased ESTATE NO: 21- I 1 - ~ %~S
a/k/a: 1///r!~¢yV />j~app~ D',2Dll~KE'
a/k/a:
a/k/a:
ss No: lg~- zo-~~99'
Petitioner(s) who is/are 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 0 Administration c.t.a., or d.b.n.c.t.a. (complet'e Part Calso)
and aver that Petitioner(~}is/.srtentitled to the aforementioned Letters T~t~t,~y __ under
the last Will of the above-named Decedent, dated _Ta-+.W,utiT/ ~, 2oa3 ~~
tow~c,cicvaJn 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
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated person, ,and was not a
party to a pending divorce proceeding at the time of death wherein grounds for divorce had been established as defined in
23 Pa. C.S.A. § 3323(8): T~rb~-t Dt r2nurke Sure+v;r7q S,.pou5e iSf d.o~v~J..~~' L,« c:.. ~„J
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0 B. Grant of Letters of Administration
~„ upyucatne, enter n.D.n., pendent life, durante absentia, durante minoricate)
C. 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 and complete list of
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a pending divorce
proceeding wherein grounds for divorce had been established as provided in 23 Pa. C.S.A. § 3323(8), except as follows:
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Name Address Relatieli to Decedent =T- ~~
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USE ADDITIONAi. SHF'.F.TC tF NF!`FCCwvv _~ 4.,..
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THIS SECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland
At `f/8 PINE ~~1, /j1T, t/o~~ v S
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Pennsylvania, with l~tler last family or principal residence
(Street address with Post Office and Zip Code, Municipality: Township, Borough, City) --'-
Decedent, then ~~ years of age, died _~j pfr~ /~ ZO/o at _ /yI~ ~o/`y sj,~y'nSS, >~/`!t _
(Month, Day, Yeaz of death) (City d State where death curred)
Estimated value of decedent's property at death:
_If domiciled in PA All personal property $ I y OOD• °~~ eSli~
_If not domiciled in PA Personal property in Pennrylvania $
_If not domiciled in PA Personal property in County $ --
_Value of Real Estate in Pennsylvania $ --
/ Total Estimated Value $ p~ .oO~jyl,)
Location of Real Estate in Pennsylvania: (Provide full address if possible.) / Op~ ~ ESf~d.~ I~,IQS ;n T u sf)
'Signature(s) Name(s) & Mailing Address(es)
Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 1
OATH OF PERSONAL REPRESENTATIVE
Commonwealth of Pennsylvania ~ SS
County of Cumberland :
The Petitioner(s) herein named swear or aff rm 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 represent:ative(s) of the
Decedent, Petitioner(s) will well and truly administer th?e estate according to law.
Sworn to or affirmed and subscribed ~ // „ / ; ~. ~
b~efore1/me this ~ i l~ day of
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For the Register ---=----..... = _
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DECREE OF PROBATE AND GRANT OF LETTERS
D~Rou~Ke
Estate of ~/i /iq~ /yJ, OROUt/~p~ Qi4'¢ li~/iah /~, (/2~e/~ ~ Deceased File Number: 21- / / __~'~?
AND NOW, this ,~~ay of ' ~ - ~ ~ ` , in consideration of the Petition on
the reverse side hereon, satisfactory proof ha ng been presented before me, IT IS DECREEI) that Letters
XTestamentary _ of Administration are hereby granted to:
y ~, (If applicable, eater ct.a., d.b.n., d.b.a.ct.a., etc.)
the above estate and that tnstrttments(s} dated ~Q~,r.~~ ~3 described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
~ _ _
Glenda Farner Strasbaugh ~ ~
Register of Wills ~~'e~ ~~~~ ~L~~' ~I~SC~~'%~ F~?(~ F,
FEES:
Letters ....................$ _ ; ~C; ~
Will............
............ f ~~U~)
Codicil(s) .................
(~) Short Certificates ~~` GTE
(~) Renunciations....... ~ ~~~)
Bond ............................
Other ............................
.............................
Automation FEE......... 5.00
JCS FEE ................... 23.50
TOTAL ................$ ~ ~. jC~
Atty's Signature (,~~~~2'~// C Q./~i,G~~'e ~
PRINTED Name: t-~l4~"~e5 F' ~jp~a/s ~
Supreme Court ID No.: 38s/3
Address: _ ~ ~o Ser' ~2~
/~ec{t,~, c 5 6u r,~ , (PA~ l-7dS,
Phone: 7/ 7 766- D,Z,~/_~
Fax: ~/7 - 79t-7S~~3
Interim Form RW-02 revised 12.26.10 by Cumberland County pending action by the Court
Signature of Counsel Required to Enter Appearance
Page 2 of 2
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~G~rAL REGIST'RAR'S CERTIFICATION OF DEA,'T'H
1,N,~RNING: !t is illegal to duplicate this copy by phatastat err photograph.
~'CC )nI' C)l i'. i t l-i ll ICCt[;~ 'i( I -( I
P___~65~57~~
t fta~~~ ~ /p~,• r Ill`` )~ I i't'fl!Tr !iIl.ll the In~OfTTlittlOn ht'fl'. glVCll IS
)IleCtl~ Louie±1 li-Im) an +Yriginat C:ertit(~ ale of Death
~;~" ~ ~=~,, ~ ~11~ file! rtiith ~n~~ ~':•: Loyal Rez;istrar- The original
~ ~ zai ~ tifi~alc ~Y'1}' r ?II;~n~urdcd to [he State Vila(
°•' t,: ~"~ i ccurd~ UtL~~~ t 1t I' no
'~ * 1,11 , ~ rlria;)ent filing
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H105-143 REV 112006
TVPEy PRINr IN
PERMANENT
BLACK INK
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions and examples on reverse) CT4TF F~~ ~ x~~ ~ ao~o
•. ••°••._ ~~ ~~... ~, ~~,~>,. i,i..w, xrec aunixl
Vivizn Mab-del_L O'Ro1ir•°k'~~ 2. Sex
Femal 3. Soqal umper
~~~ 20_9899 4. Del t 1
~°~~('~vf'~r)
5. Age (Last &rmdeYl UMer 7 year UMer 1 day 6. Date of ann (Hoorn, tlay, Year) 7. Birthplace Icily and state a kr
~ntlw 0.n Ham ~ ei cam) 1 B a. Place al Death (Check onl ore)
vwe Hospital: Other:
83 vrs. 2/19/1927 indber,PA
^ Inpatiam ^ ER / Oulpedent ^ DOA ^ Nosing Honx ~] Residence ^gher - Slxsgty:
6b. County of Daath &. City, Born, Tss-p. d Deam Bd. Fedlity Name (II riq inslilution, gNe Mreel aM numbeN
9. Wes Decedent of Hispanic O v
dgln. No ^Ves 10. Race: Amer' ~ Intian, Black, Wide, ek.
11 Cunk~e.rland g, Micj. mres,svaatycaean, (
,1 • dleton 41 8 Pine Rd
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can,
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ken,et°a White
1t. Decedents Uwal Oc tion Kind d work done most of IMe. Do rid dale retiretl 12. Was Decedent ever in dte 13. Decedent's Edlcatlon (Spegry Dory highest grade opmpleled) 14. Marital $UWS: MaOieQ Never Memeq 15. Surviving Spouse (II wife, give maiden name)
Kind a Work Nix) d Business I Industry U. s. Ametl Forces?
Wkf
owad, DA.omed (Speq/)Q
Elementary /Secondary (612) College (13 or 5+)
House ^vea C}}wn 6 M
arried Robert O'Rourke
16. Decetlent'a Medmg Address (Street cdY /town, stale, ziP code) Decedent's
Dq Decedent
418 Pine Rd
Actual Rasitlerme na
Sale Pennsylvania U
.
.
ve ins „°.®Yes, DacedeM LNed ln_ c M;,adletcui Twp.
Mt. Holly Springs,PA 17065 17b.Dounry T°wreMP? ,7d.^Na,Dacamn,u„dw;m;n
~umbe r 1 a rid
Agaal Lknits a ciy / 13om
7B. Father's Nance (First, mitldb, lest, auflix)
19. Moaler's Name (First, mitldle, maidM wmame)
Victor J. Kushto
Janet Helen Cook
20a. Infoiment's Name (Type / PnM)
20b. InlamanYS Meiling Address tarsal, city / rown, slate, z4 catlel
Lori V. O'Rourke
418 Pine Rd Mt
21 a. Methotl a Disposition ~ Cremedon ^ peoetion 21 b. Date a Disposilkn (MOnm, tlay, year) 21c. Place at Disposition (Name M tamer
^ Burial ^ Removal trap stale ! ery, aenmrory a omer place) ztd. locelbn (CM /tam, state, ap ~ 7 O 6 5
was cranallon or Donedon Aatnorh
d
e
A~,
^omer jbYMedkelESaminer/Coroner? [JYas^NP 8/16/10 Hollinger Crematory Mt
~
.. Holly Springs, PA
22a. tore d Furerel5erv' Licensee (or parson agmp as such) 22h. License Nlmdxa 22c. Name end Adtlress of Facility
' ~ 011589E HollingerFH&CrematoryMt.Holly Springs, PA 17065
C
omplete Items 23ac aMy when cerllyiy a. T° die best a my krewbtlge, ath occurree al me time, dale aM s61etl. (Sigreture antl line) 23b. License Number
pltysiden h not avalleae al lime of deem to ' J :?3C. Date Signed (MOnm, daY, year)
Praary cease of Death. ~'• yam, RN 8 / 1 4 / 2 01 0
uema 24-zfi meal Ix ~anplatad py person
wlro prmaaroes seam. 24. rme of Daa
4
5
H 2s. Data mrwtaroed Dead (Hmm, day, year) 26. Was Case Retenad to Metlkal Examiner /Coroner for a Reason Other Than Cremation or Donation?
:
0 M 8/ 1 4/ 2 01 0 ^ vee ~j rm
CAUSE OF DEATH (See InatrucNona erM examples) Appraxknele interval: Pad IL Enter doer ~'f I cordltnrs rord ' - I tla:.
Item 27. Ped I: Enter me chain of eveno - tliseeaea, iryunes, a cornpYcerypn - met tliragly ceuaed the deem. DO NOT enter lennnal events s1A'll as certluc anasl
lh. 28. DM Tocecce Use Cann'bule k Deem?
,
resgrelay anesl, a ventricular NxdWlkat without Showi ate oMy cause pl each Nne. Onset to Deem bN trot resWlkp m me undo
rg edokgy L)sl rtymg cause given n Ps~d I. ~ Yes ^ Pmbebry
INMEDIAIE CAUSE Final disease a ~ ^ No ^ Unkrewn
caltldkn rewning in ~eaml
F
-•>. a. t r4 ur
G y r
29. II Panels:
Due to uenm
Sequanliapy 6l andlidne, rf arty, b. ~ ~ - - ~ Not laeg'bM wiUw1 pest year
Ieatluq ro Ifle ca~Aa dated m cne a
.
Enter the UNDEflLYING CAUSE Due to (or as a coruseguenca oQ: PmgnaM al time of deem
(disease a kllurY mat NlOaled ma ^ Not pregreM, but pregnem within 42 der
` y'
eve Is rewlting m tleaml LAST.
Due to (or as a consequence og: M death
d ^ Noy pregruM, bN pregrem d3 days l0 1 year
~ betas tlealh
OOa. Was an Aulapwy 30b. Were Autopsy Fxxlirgs 37. Manner of Deem - ^ Unknown it pregnant wihin me pall year
Pedormetl? AvaAaNe Prior to Cortpletion 32a. Dale d Iryury (Monet, day, Year) 32b. Describe How Injury Ocevnetl 32c. Place of Injury: Fkme, Faun, Street, Factory,
~N
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a
ura
of Cause of Deam?
Homicide OM a Builairg, etc. (Spealyl
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^ Yes [~ No ^Ves ^ No
^ Acadenl ^ Penhn9 mvesUgation 32d. Tme of Injury 32e. InNry al Work? 32f. II Transporletion Injury (SpagtyJ 32g. LoWlkn of Injury 151rea, city / lavn, slate's
^ Suxire ^ Could Nd re Derertnir d H ^ Yes ^ N° ^ Orrver / Operator ^ Paasanger ^Padestrien
33s. Cedifier (Check only one) Omer - Specify
33b. s neNre antl Tele of CerlAkr
• Tend ~DMTrNen (Phyaxian certifying cause of deem where arelher physician has prawuncad Beam and carripleled Item 231 ~/,
nowbdga, dnlh oaurtetl due to the pu9e(a) end manrer ere Haled
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/
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• Pronourehg arM cartNying phyakien (Physigan poet prarourckg death eM cenaying 1o reuse d deem) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
T° Nte bast of mY knowktlge, deem occurred at the time, date, and place, end due to Ule uus - - ^ 38C. Lx:ense Number 33tl. Dale Signed (M Ih, day, year)
e(a) aM mMref 98 Ble1e0- _ _ - -
• Medkall:x.miner/Damrer ----------- O
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bd. of .xemm.tion and / or maeMlganon, m my opnkn, deem oaaurred et tna fime, d.m, aria dare, aria due to Ina aau..(a) and manner ee ataea_ ^
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36. Regislrer' urp and ~~,[.~~~~'~~pe~r t~ ~ ~ ~ ~~. 3e ° ~ (
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.Date Filetl (Mmth, day. Year)
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Disposition Permit No. - ~~ Z1~Q'j~ ~j /
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RENUNCIATION r~
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In Re Estate of V ~'~~~~ ~ O ~~ou ~k~ ~' ~- ~ `''~
deceased. ,'
To the Register of Wills of _ CGlMBF/ZL~4A/7~ County, Pennsylvania.
The undersigned ~~BE~ 7" (7 ~~DU /ZKC ~INSBA~ ~,t1D CCU T ~
of
the above decedent, hereby renotmce(s) the right to administer the estate and respectfully ask(s) that Letters
(''ESTi¢iyt~NTi~RY
be issued to f1~S ~/0 T~/E l~=C~JE~V%S 1~4GlGyT~ 7~yF ~i,~T ,,~T~,~y~T~.
WITNESS /!lY hand this day of _, X20//,
_._
Ort this ~ day of ,
200~~, personally appeared before tne,
X ~1c d ~c~c
1?OL3t~T (Signature) O~~- ~
a Notary Public i.n and for the Cottamnwealth
of Pennsylvania, i2~6~ (~'Rova.)l~ ,
(who is personally kTtawn to the or has
provided sufficient .identification to rne)
and sworn to and subscribed 1't~/his name
herein.
~-
NOta1y Pub11C
3F+AI, COMMONWEq~~ p~ PENNSYLVANIA
Notarial Seal
Roger B. Irwin, Notary public
Carlisle Boro, Cumberland County
My Commission EX Oct 3 2012
Member, Pennsyivanla AstwriMbn Ot Notaries
y/8 Pi~~ ROAD , /L/T ~fo~s?~/n~s~ p~
{Addy ) /rso6.S
(Siaoature)
(Address) ----
(Signature)
(Address)
r-r'
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LAST WILL AND TESTAMENT ' ; r? -
t~ E ;
• (Pour-Over Will) ~:,,--r-, __
VIVIANM.O'ROURI{E -__ -.;=-~~ _--
~: ~~
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IDENTITY
I, VIVIAN M. O'ROURKE, residing in the County of Cumberland, Convnonwealth of
Pennsylvania, being of sound mind and memory, and not acting under duress or undue influence of any
person whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby revoke all
other former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 194-20-
9899.
All reference made herein to "spouse or my spouse" refers to the person to whom .[ am currently
married, namely, ROBERT O'ROURKE By the ensuing provisions of this Will, it is my intention to
dispose of my interest in our property; I do not intend to dispose of anything belonging to nny husband or
to put him to any election.
I have the following children: Lori V. O'Rourke, born October 26, 1960; Janet M. Feister, born
October 7, 1951; Mickey S. Rankin, born February 26, 1954; and Jack R. O'Rourke, born October 10,
1957.
DEBTS, TAXES AND ADMINISTRATION EXPENSES
• I have provided for the payment of all my debts, expenses of administration of property wherever
situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other
than any tax on ageneration-skipping transfer that is not a liability of my Estate (including; interest and
penalties, if any) that become due by reason of my death, under THE ROBERT O'ROURKE AND
VIVIAN M. O'ROURKE REVOCABLE LIVING TRUST executed on even date herewith (the
"Revocable Trust"), or if my spouse predeceases me, under the Survivor's Trust created by the said
Revocable Trust. If the Revocable Trust assets should be insufficient for these purposes, my Executor
shall pay any unpaid items from the residue of my Estate passing under this Will, without any
apportionment or reimbursement. In the alternative, my Executor may demand in a writing addressed to
the Trustee of the Trust an amount necessary to pay all or part of these items, plus claims, pecuniary
legacies, and family allowances by court order.
PERSONAL AND HOUSEHOLD EFFECTS
It is my intent that all my personal and household effects were transferred to the Revocable Trust
as a result of the Declaration of Intent signed this date. If there are any questions regarding the ownership
or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me
this date in accordance with the provisions of the section titled "Residue of Estate."
RESIDUE OF ESTATE
I give, devise and bequeath all the rest, residue and remainder of my property of every kind and
description (including lapsed legacies and devices), wherever situated and whether acquired before or
after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of
• the execution of this Will. The Trustee shall add the property bequeathed and devised by this, item to the
POUR-OVER WILLS
Page 1
Testatrix
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corpus of the above described Trust and shall hold, administer and distribute said property in accordance
• with the provisions of the said Trust, including any amendments thereto made before my death.
If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a
court of competent jurisdiction shall declare the foregoing testamentary disposition to the 'Trustee under
said Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the
residue and remainder thereof to that person who would have been the Trustee under the Trust, as
Trustee, and to their substitutes and successors under the Trust, described herein above, to be held,
managed, invested, reinvested and distributed by the Trustee upon the terms and conditions pertaining to
the period beginning with the date of my death as are constituted in the Trust as at present constituted
giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such
Trust by reference into this my Will.
EXECUTOR
I hereby nominate and appoint Robert O'Rourke as my Independent Executor of this, my bast
Will and Testament, to serve without bond.
In the event the first named Executor shall predecease me or is unable or unwilling; to act as my
Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint Lori V.
O'Rourke to serve without bond as my Independent Executor.
Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this
my Will, such words and respective pronouns shall be held and taken to include both the singular and the
plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Executor named
• herein and to any successor to substitute Executor acting hereunder, and such successor or substitute
Executor shall possess all the rights, powers, duties, authority, and responsibility confen-ed upon the
Executor originally named herein.
EXECUTOR POWERS
By way of Illustration and not of limitation and in addition to any inherent, implied or statutory
powers granted to executors generally, my Executor is specifically authorized and empowered with
respect to any property, real or personal, at any time held under any provision of this my Will: to allot,
allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract
with respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold,
improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options
with respect to, take possession of, pledge, receive, release, repair, sell, sue for, make distribul:ions in cash
or in kind of partly in each without regard to the income tax basis of such asset and in general, exercise all
of the powers in the management of my Estate which any individual could exercise in the management of
similar property owned in its own right upon such terms and conditions as to my Executor mazy seem best,
and execute and deliver any and all instruments and do all acts which my Executor may deem proper or
necessary to carry out the purpose of this my Will, without being limited in any way by the specific grants
or power made, and without the necessity of a court order.
My Executor shall have absolute discretion, but shall not be required, to make adjustments in the
rights of any Beneficiaries, or among the principal and income accounts to compensate for the
consequences of any tax decision or election, or of any investment or administrative decision, that my
executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of
• Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate, my
Executor shall have discretion to select the valuation date and to determine whether any or all of the
POUR-OVER WILLS
Page 2
~~ V
Testatrix
allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as
• Federal Income Tax deductions and shall have the discretion to file a joint income tax return with my
spouse.
SPECIFIC OMISSIONS
I have intentionally omitted any and all persons and entities from this, my Fast Will and
Testament, except those persons and entities specifically named herein. If any person or entity shall
challenge any term or condition of this Will, or of the Living Trust to which I have made reference in the
sections "Household and Personal Effects" and "Residue of Estate," then, to that person or entity, I give
and bequeath the sum of only one dollar ($1.00) only in lieu and in place of any other benefit, grant,
bequest or interest which that person or interest may have in my Estate or the Living Trust and its Estate.
SIMULTANEOUS DEATH
If my spouse and I should die under circumstances such that the order of our deaths cannot be
determined, then it shall be conclusively presumed for the purpose of this Will that my spouse survived
me.
If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively
presumed for the purpose of this my Will that said Beneficiary predeceased me.
b ~
• VIVIAN M. O'ROURKE
Testatrix
POUR-OVER WILLS
Page 3
This instrument consists of 5 typewritten pages, including the Attestation Clause, Self-Proving
Clause, signature of Witnesses, and acknowledgment of officer. I have signed my name at the bottom of
each of the pr~ding pages. This instrument is being signed by me on this
~'" -~~ day of
0~3..
ATTESTATION CLAUSE
The Testatrix whose name appears above declared to us, the undersigned, that the foregoing
instrument was his Last Will and Testament, and she requested us to act as witnesses to such instrument
and to her signature thereon. The Testatrix thereupon signed such instrument in our presence. At the
Testatrixr's request, the undersigned then subscribed our names to the instrument in our own handwriting
in the presence of the Testatrix. The undersigned hereby declare, in the presence of each of us, that we
believe the Testatrix to be of sound and disposing mind and memory.
Signed by us on the same day and year as this Last Will and Testament was signed by the
Testatrix.
WITNESSES: ADDRESSES:
•
. 8D
(Printed Name of Witness)
a
(Printed Name of Witness)
.~~ a ~°'~ e lie ~~ d
~'~i ohs'
City, State, Zip
~~ o ~iYc.. ~Q~_
City, State, Zip ~`'-`~~~
•
POUR-OVER WILLS
Page 4
--t,[--[LPL.
Testatrix
COMMONWEALTH OF PENNSYLVANIA
• COUNTY OF CUMBERLAND
SELF-PROVING CLAUSE
BEFORE ME, the under igned authority, on this day personally a ,geared VNIAN M.
O'ROURKE, ~ ~/n@ -~ !? and ,known to me
to be the Testatrix and the witnesses, respectively, whose names are subscrib d to the foregoing
instrument in their respective capacities, and all of them being by me duly sworn, VNIAN M.
O'ROURKE, Testatrix, declared to me and to the witnesses, in my presence, that the ins~~trument is her
Will and that she had willingly made and executed it as her free act and deed for the purposes therein
expressed; and the Witnesses, each on his or her oath, stated to me in the presence and hearing of the
Testator, that the Testator had declared to them that the instrument is her Will and that she executed the
same as such and wanted each of them to sign it as a witness; and upon their oaths, each witness stated
further that she did the same as a witness in the presence of the Testatrix, and at her request and that she
was at that time eighteen (18) years of age or over and was of sound mind, and that each of the witnesses
was then at least fourteen (14) years of age.
VIVIAN M. O'ROURKE
Testatrix
• ~
W ~ ' ess
(Printed Name of Witness)
Witness
~~ ~ ~e ~ ,~~ ~' ~
(Printed Name of Witness) -~~~
SUBSCRIBED AND ACKNOWLEDGED before me by VN AN ~ O'ROURKE, Testatrix,
an~su~cribed aid swo to before me by ~Q~~ `-
/'~j /~~~J b-7 Z ~ and
?~N witnesses, this the !`~ day of
Notary Pub nwealth of Pennsylvania
. Noi.aria3."year
C~ruu~ ~:;I,~Sk~ ~vrit~r~ G{rttlic
r'iti ,.ryt~~, ulPyr ~+rr ~,nt-
~-M-y Cnrru.,tssur. ._x[`n'r.< +~.. %ry00~1 ~.
POUR-OVER WILLS
Page 5