HomeMy WebLinkAbout01-12-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as specified below, and in support thereof aver(s) the
following and respectfully requests the grant of Letters in the appropriate form:
Robert J. Hollis
Decedent's Information
Name: Lucy C. Hollis
a/k/a:
alk/a:
alk/a:
Date ~ Dea1h: 12/07/2011
File No: 21 - 41-' ) ~ `- ~"~~( ~--
(Assigned by Register)
Social Security No: 190-22,2548
Age at Death:
80
Decedent was domiciled at death in Cumberland County, PA
principal residence at 801 ~. H (state) wi81 his/her last
,artover Street, Carlisle 17013 No Middleton TwP Cumberland
Street address Post Ofice and Zip Cade Cily, Township or Borough Cou
Decedent died at 801 No. Hanover S `~
treat, Carlisle 17013 No. Middleton Tw . Cumberland PA
Street address, Post ORice and Zlp Code 1P Borough CourHy State
City, Townsh or
Estimate of value of decedent's property at death:
N domicr7ed in Penney/vanie ........................ All personal properly
If not domrcr7ed in PennsYl~nia• ................. Personal properly in Pennsylvania
!f not domrcNed m PennsYlvmnla .................. Personal property in Courrty
Value of real estate in Penniy/vania...........
Real estate in Penroyhrania sidiated at
(Ntech additional sheets, if necessary.)
$ 45,000.00
TOTAL ESTIMATED VALUE/
Street address, Pos[ Office and Zip Code City, Township or Borough
CourKy
A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) that he/she/they is/are the Exectrtor(s) named in the Last Will aF the Decederrt, dated 01/25/1999
thereto dated and Codicil(s)
(State relevant cimumstanoes, eq., renurwYetlon, rbe[h of executor, efe.J
6ccept as fdkrvvs: attar the execution of the instrum~t(s) offered for pabate, Decedent did not ma was not divorced, was not a party to a pending
divorce proceeding wherein the grounds for divorq had been eatabl~hed as defined in 23 Pa. C.S.~g'3323(g), and did not have a child bom or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated en incapacitated person.
~X NOEXCEPTIONS ^ EXCEPTIONS
^ B. Petition for Grant of Letters of Administration (r applicable>
c..a.; ,n.; ,n.c..a.; pe a e; ran e a e; r e rru e
ff Administration, c.t:a or dbn.c.La., ember date of Will in Section A above and comoleba list of heirs.
i ~ ~ f~ ~rn was not 8 party to pendir~ divorce proceeding wherein the grou-xia for divorce had been established as defined
§ (g) and was neither the victim ofa killing nor ever adjudicated an incapacitated person.
0 NOEXCEPTIONS Q EXCEI~TiONS
Petitroner(s), after a proper search has/have ascertained that Deoedentleft no Will and was survived by the followin
additional sheets, if necessary); g spouse (iF any) and heirs (attach
Form RW-02,ev, to-t t-tot ~
CoPllright (c) 2011 form software ony The Lackner Group, Inc.
Pape 1 or 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
~~ ~ ~i.' Oficiar"t~t. ~n
-i _, i C
- - ~a
r. '
Petitioner(s) Printed Name Petitioner(s) Printed Address .:'' ' a -J ~ ti e '
Robert J. Hollis 401 Orchard Lane
Mechanicsburg, PA 17055 ~~~~2i{ ~-
S r-~;~II~T
~c~ ° '
~~:J'~
(~ r r} t ~ ~,
\.~1 ~1\h~ _,_
The Petitioner(s) above-named swear(s) or affirm(s) 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 la
t~r~ ~/~~- Date / /~!)
Swom to or affirmed and subscribed before
me this •~~ da of ,~~
By:
Date
Date
Date
BONDRequired? ~ Yes ~ No
FEES
Letters ............................................ $ ~
(~) Short Certficate(s)...........
( ) Renurtaation(s) ...............
( )Codicil(s) .........................
( )Affidavit(s) .......................
Bond ...............................................
Commission ...................................
other ~~ ~~ .
AutomationFee .............................. --- -
JCSFee .........................................
TOTAL ........................................... $ /,$"-~'
To the RegisterofWills:
rrease emer my appeararrce oy my srgrrawre cerow:
Attorney ature:
PrirHed Name: Scott M Dinner Esq
Supreme Court
ID Number: ~~
Firm Name: Law ~~ of Scan M. Dinner
Address: 3117 Chestnut Street
Camp Hill, PA 17011
Phone: 7171761.6800
Fax: 717/761-6008
E-mall: dinner~localnet.com
DECREE OF THE REGISTER
Estate of Lucy C. Hollis File No:
alk/a: ,
AND NOW,
satisfactory proof
are hereby granted to
~-
before me, IT IS DECREED that Letters
21 =~ I a - von ~
~1~ / pZ , , in consideration of the foregoing Petition,
Testamentary
in the above estate and (ff applicable) that the instrument(s) dated
described in the Petition be admitted to probate and filed of record
01/26!1989
Will (afld Codicil(s))
Copyright (c) 2011~n so~vare only The Laclmer Group, Inc. r~~ L'~"~ ~ ~GK ""~ Pape 2 of 2
HI05.805 REV !01/07)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
P 18037527
Certification plumber
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 forwarded to the State Vital
Records Oftice for permanent filing.
~.
Local Registrar Date Issued
-
`p
' i___ r
~ ;L.;..«.
~ ~
_
~
~
'(
ce ~
-
i)
~
`.(
j T'I
,
~
i
. ~
_1
Lj ' ___
(-'1-j
-
J
SS .a-- `-'~~ rJ
H105-1t3 REV 112008
TYPE~~ W
suet pet
l 1. Nenrr
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
(See instructions end examples on reverse)
(Frr, nWds, np, rKW) BTATE FILE NUMBER
2. ~ 3. Saw Sadsiry Num6ar !Deb d
Lucy C_ Hnllic
S Me tier BIrMaY) tkldr 1 lka
eases D•ra Mwaa
80 vrs.
tna ca.ay a own &. sty. mm. T
C~snberland ~:
11.Oeatlere'e UrW Oca soon Wise wwk dsrr dam aardr
Nee d Wak Kra
'1'??nhPr Fi
tfi. Oecebra's Naiy Ad6wa (strw, by / bwn, raa, zip rode)
401 Orchard Lane
20a Idonrprs'a Nrw (7yp / PmQ
21a. A~N,}VgE d Divposi0on~
GI ~+ ^ Remwrkansaa
^ Omr~Serx- r
by. w.r)
1 b 8. Dan d 9tm 7. ' W anN a l1
ae,,,,., Be. Ptaw d Dwm CMdc ar
Dec. 15, 1930 "°'°'~ om.r
~n r PA ^ Irpan^ra ^ ER / Orwprna ^ Ocu $7 Na,~ ~ ^ Rwaerae ^ Dutar - SP•u1Y
d Deem m Fedlly New. to na ~auuDOW Owe weer and Warn,,) a. car D^adsM a ,
isle Church of God Ht~ to rw, we<w cu ` °riyr [~ ra ^ Yea t0. Drdw, BNd<. wrw, r
Nsakan, Purto 91an, re)
Na. Ib m rw ~ ez. wee Decetlera ^wr at ma 1a. Daadre', Eaianw tsP•dIY ay Npnr grab aarynnd) u. NraN sans: sawed, Narer NrrieE, is s
Brwaw/kawsy U.S. AmrE Faar?
~8R1fgary / ~~Y (atzt cdnpe tt < a s•1 w'o'ws Daaraa IsPear/ 1M0n""9 spews (n cab, pw mrtlw Wawa)
^ Yw ®Na + Married Robert J. Hollis
O+ceaerKa DIE Dxebnt
Acar ReelESras ,7a. eau Penns lvania W.Y,a
tn: ®Yw. Deaarq LiveE n ~111UpS A 1 1 pn
tTb. cowry 137m}wrl arv3 Tow.lrap? a nl. ^ No, DeaEra liueE arum Tom'
AcDrl Lirila d _.. ._
Idamar'e Nea'rp Addws (saeeL wY / mrrrti aan, zip rods)
Daiedw 21 D. Dan d Digwiaw (NCreh, Ear. Yep 2f c. Face d DYpalnon (Name d anletery, cmubry a otle
^ Yw^ Na Dec. 13, 2011 Indiantaan C,ap National
22D LrerNe NumDar
cwcnapllrr 23sc war ^alsn 23a. To ma apt d hawnEpe, Ewma:aand r IM ems, ere and rasa.) re am nnl
s mtewabn ,times b
Drily' ear d E^em. ~ Y
P~
. Wn 2428 mw a wnpwE ty W Ww xI. tans d Dwlh ?5. Den Pialaalcatl Detl
jNwm. day. year)
Iaowaaw Erm
.
~:y~ : N. a-~- i
Vern 27. Par) I: Eraw tae CAUSE DEA ~(SN tfl^irreta{prw and saampas)
w d'•dN aieed ms deem. DO NOT aver Mmiral e
rw
aeb
W
n r Appma4ron YYerr
p
re
a ur
w crElec amt,
y ~aorl willgn
me emibpy lit weY ae ,awe w each me.
YIE 7E CAUSE fFaW 6wese a ~ .
owriDw rwAfrq"bra
~
~ Ormr m Dsam
) } a. ~~
j hliyc~l ~ ~~p~~6,,,Lr
t ~ ~.
m ~ m W~ie a D. Cc IrK (,e,a.TJe't J r
(((L
////~~~n ~~~~
Error UeDERLYYI6 CAUSE Due ro la w e ~:
(diww a Ma
nW a
iD ...
y
l
and me
c
eww rsa>tadAip n dsM) LAST. ~
Due n la w e w^w4ueria o/t:
tl.
30a. Wr n Awgey 300. Wen Awlpsy Faidrga 37~N+anr~er d Dwm r
PaEOnrra!
~. Dan d Injury (Mwm. deY, Y~wr) 3Pb. DaeaBs Mow Injay OcaneO
~
~~
ar ^ Ham
ep
lsl
d Cauca d
N
DUm?
(
~
l
^ Yee ~ ^ Yes ^ No `-a Act ^ Peridiq IrnwD~dm ~ 7me d InIuN 32s. Yjuy et Waa? 32t. n 7ryupornapri h
^ sulbea ^ coed Na a Dreaanw ^ vw 11 u„ ^ DEwr/owrrar
PA 17055
21tl. )mien (Daylbwru alts, ny wee)
Arlnville, PA
Way
23b. L,iaonelna Nlanhe1 ~'''] Qom/ 23c. /Dan SgriaE (Naval, ryy. yaa~
2fi. Ww Caw 13elrreE to Ladcr Exenmer / Caw, lw a Reason Omier men Gemsdan w Dweawl
^ Yw ~No
Pan 11:5br dhr ~
da nol raeulDnp n ma uMwlynO cam area n Pen I. 28. Ditl Tabeew Uw Cwnnuts n Dwm?
^ Yw ^ Pwhedy
~ No ^ UNmowa
.a~
~'.~~jr[/.Ga'7.[,~ti 71 ^w PWparR vlidiil par Year
^ Pregwe r Dme d bum
^ Not pre0rlenl, dA pWplra w111an 42 days
d bam
^ Na wavvaa. ME pegrsal e3 bys m t year
ltafwe help
^ llrYuiovm a pre0mra wimp me Per yet
32c. Pnce a Injury: Mane. Farm, sDeeL Faawy,
ONa Bdkarp, sec. (sP•~Y)
r1
Pw••awr ^ I'adeelEen 3au I eceDOn a awwy (sa.et dry /tam, sren)
33s caerw (cats ody err)
.. 33D. SipntuW end Ca '
70~~ PDYsnarr (parew rr oewry:q awe a dwm when vmner Mgrder~ aw aanmcw own era m~rpletad new 23) r Spar -~.
my alswtadDe~Earh aawrM aw to the ceisete)wd manwrs^rred__--___--- ~ ' ~~j ~i ,i J~
To tlr Oar o ~ ~Mro PlrYaldaa (phYelderi Dda Eesth ra arDlyig a awe d deem) 33c. Liam Nwrn^r
mY arownd0s, dwm oa•urrod r W^ I ~pjnd pna, rr dlr n nn esueas) and rlwn^r w cares-- -- --- -- ` si9red INwm, by, ywp
33a. Ore
w • he^ladwraarbn ^nd/am --------- ^ M.D o 3s 8~a~ //
vwlSsOOn, m mY opMan, Ee^tll awler^d r the tmr, deee, cad pea, anddw a tlr - ~ Q.--1 ~` l I 1
~ c~WinO "w'"ar a' wled_ ^ 3r. News ra Aan.w a Pe wro Darpletsd caws d own pnm z'~ Type / Pdm
~ , taste ~ tvrv ~ t~ I ! I a ~ •~ I Ja I 3aD.nFwtNarl,dy,yw MlChd>` I ~d.61~.>;1S,y1ty7
. .,~ .. ~'•~C:17 3~3 ,v /3n1~4-zrvyol~ ~,,re ~Llri- ~l~ ~ 1211) ~S
t
DiaporDwt Pemr No. OF9 ~ S 50
LAST WILL ~
OF y ~ _ ~~ - -~-,
LUCY C. HOLLIS ; ;~~ ~ ~. " ~ ~' %:
. -`r_ ~_ rt ---
'~~ ~ ~ ~ -
~..~ ~- -~
I, LUCY C. HOLLIS, presently of 401 Orchard bane, MechaniESi~>}rg, Cl.i~iberland
_y ~-)
f .
L' •'
County, Pennsylvania, declare this to be my Last Will hereby revoking all Willsyand Codiels
previously made by me.
I declare that I am married to Robert J. Hollis and ghat all references in this Will to
~ my Husband are references to him.
I declare I have one child now living: my son, Alan E. Gloger, presently of
~ Waldorf, Maryland.
ARTICLE I
Payment of DebtslEzpenses: I direct the payment of my legally enforceable debts
and the expenses of my last illness and funeral, from my estate as soon after my death as may be
convenient, without regard to any statutory limitation thereon.
ARTICLE II
Personal Proaerty and Household Effects: I give certain items of my household
SCOEf NI. dinner
Afforney et Law
3 Kecey Court - Site 201
Mec6anto.bu,s, PA 17055
pb. (717) 691-731
furnishings and tangible personal property to my friends and family in accordance with the terms of
a written memorandum which I have prepared. I bequeath any such property not disposed of by
such memorandum, or all of such property if the memorandum is not located or received by my
Personal Representative, to my Husband. Further, should my Husband fail to survive me and no
such memorandum is found, then my successor Personal Representative shall distribute my
personal and household effects to my son, Alan E. Gloger.
-2-
Ifthe written memorandum referred to in this ARTICLE II is not located or received
by my Personal Representative within sixty (60) days after taking; office as such, after and upon the
conducting of a reasonable search for such memorandum, the Personal Representative shall be held
harmless for distributing such property as hereinbefore provided.
ARTICLE III
Establishment of Credit Shelter Trust: I give to my Husband and to Alan E.
Gloger, as Co-Trustees, in Trust, in addition to all assets received directly by the Co-Trustees that
are excludalble from my gross taxable estate for federal estate tax purposes, assets of a total value
equal to the largest amount, if any, that can pass free of federal estate tax by reason of the unified
credit and any other credits available for federal estate purposes except (1) the state death tax
credit to the extent that use would require an increase in the amount of state death taxes paid and
(2) the credit for tax on prior transfers to the extent that credit arises from transfers to me from
individuals who die after me. Such latter amount shall be reduced by the value for federal estate
tax purposes of any gifts which do not qualify for the marital or charitable deduction made by me
under this Will or otherwise, and further reduced by an amount equal to the sum of all charges to
principal, except death taxes (since I direct hereafter that such death taxes be paid from this Credit
Shelter Trust), that are not deducted in computing my federal estate tax.
I recognize that depending upon the amount of bequests under my Will, my
non-testamentary dispositions, the amount of state death taxes and administration expenses, and
SCOEE ~. inner
t>ftorney nt l.nw
3 Ke~Yy co~rt _ su.~ 201 other factors, this Credit Shelter Trust might be non-existent or mi,F,ht consume all estate assets, so
Mecbmicobura, PA 17055
pb. (717) 691-731,1 that no assets may remain to pass outright to my Husband pursuant to the residuary gift under the
provisions of ARTICLE V hereafter.
Distribution of the Credit Shelter Trust:
A. The assets of the Credit Shelter Trust shall be held and distributed on the
following terms during the lifetime of my Husband:
1. Income and Principal Distributions: 'Che Trustees shall pay and
distribute to my Husband or for his benefit the entire income therefrom,
which payments shall be made to him periodically, but not less frequently than
quarterly. In addition, the Trustees shall from time to time pay to my
Husband, or shall apply directly for his benefit, as much of the principal of
this Credit Shelter Trust as the Trustees may consider necessary or advisable
for his health, education, support or maintenance (or any combination of
them).
2. Power of Withdrawal: In any taxable year of the trust, my Husband
shall have the right to withdraw the greater of $5,000 or 5% of the principal
of this Credit Shelter Trust valued as of the date such request for withdrawal
is received by the Trustees. The value of the principal is to be conclusively
determined by the Co-Trustee other than my Husband. The right of
withdrawal shall be exercised only in writing and delivered to the Trustees
and the right. of withdrawal Shall not be cumulative.
B. Upon the death or remarriage of my Husband or at my death if he shall have
.Scott 1~. dinner
Attorney et Law
3 Korey Court -Suite 201
Mecboniwburg, PA 17055
yb. (717) 691-731a
predeceased me, then the Trustees shall distribute the balance of the Credit Shelter Trust to Alan
E. Gloger, per stirpes. If at any time any beneficiary entitled to receive principal from the Credit
Shelter Trust estate pursuant to this subparagraph B. is a minor ol• an incompetent or a person
whom the Trustee(s) deem unable to handle the funds properly or wisely if paid directly to the
beneficiary, the Trustee(s) in his or their discretion may make payments in any one or more of the
following whys:
1. To the natural guardian or legally appointed guardian of the person or
estate of the beneficiary;
2. By making expenditures directly for the care, support, maintenance, or
education of the beneficiary: or
-4-
3. To any person or organization furnishing care, support, maintenance, or
education for. the beneficiary.
The "Trustee(s) shall not be required to see the application of any funds paid or applied in any
of the aforementioned ways and the receipt of the payee shall be full acquittance to the
Co-Trustees.
C. In the event of the death, resignation, renunciation or inability to act of either my
Husband or Alan E. Gloger, as a Co-Trustee of this Credit Shelter Trust, then I appoint my
daughter-in-law, Valeri Gloger, in their place and stead with the same powers, rights, discretions,
obligations and immunities. In the event Valeri Gloger should die, resign, become disabled, or for
any other reason cease to act as a successor co-Trustee, then I appoint PNC Bank and its
~ successors,. to serve as her successor.
ARTICLE V
Residuary Estate: If my Husband survives me, then I give the rest, residue and
.ScotE ~. dinner
E>ttorney nt 1.aw
3 Knay Court - SoiEe 201
MecLnn:c,bn.g, PA 17055
p6. (717) 69fl-7314
remainder cif my estate outright to my Husband free of all trusts. In the event my Husband does
not survive me, the assets shall be added to and be held and distributed in accordance with the
terms of my~ Credit Shelter Trust pursuant to ARTICLE IV. Furthermore, if my Husband
disclaims all or any part of his interest in this residuary gift, such disclaimed property shall be
added to and be held and distributed in accordance with the terms of the Credit Shelter Trust. If
for any reason the Credit Shelter Trust shall not have been created or shall have been exhausted,
such properly shall be held and distributed on the same terms set forth for the Credit Shelter Trust
pursuant to 'ARTICLE V.
-5-
ARTICLE VI
Survivorship Presumption: If my Husband and I should die under circumstances
which render the order of our deaths uncertain, for the purposes of the residuary marital gift under
ARTICLE V, it shall be conclusively presumed that I survived my Husband.
ARTICLE VII
Protection from Improvidence: No interest of any beneficiary under this Will or
any codicil hereto shall be subject to anticipation or voluntary or involuntary alienation.
ARTICLE VIII
Personal Representative: I nominate and appoint my Husband to serve as my
Personal Representative of this Will. In the event of the death, resignation, renunciation or
inability to act of my Husband, then I appoint my son, Alan E. Gloger, as my successor Personal
Representative of this Will in his place and stead.
ARTICLE IX
Fiduciary's Performance and Powers: No fiduciary under this Will shall be
required to give bond or other security for the faithful performance of the fiduciary's duties.
Any such fiduciary shall have the following powers,. in addition to those given by
.SCOEf ~. ~inncr
Attorney st Law
3 Kecey Court -Suite 201
Mec6mic.bur6, PA 17055
pb. (717) 691-7314
law:
1. To retain any property, pending distribution hereunder, to invest in
or purchase any property without restriction to legal investments for
fiduciaries, to distribute property in kind, to compromise claims, and to
sell any property at public or private sale;
-6-
2. To hold shares of stock or other securities in nominee registration
form, including that of a clearing corporation or depository, or in book
entry form or unregistered or in such other form as will pass by delivery;
3. To engage in litigation and compromise, arbitrate or abandon claims;
4. To make distributions in cash, or in kind at current values, or partly
in each, allocating specific assets to particular distributee on a
non-prorata basis, and. for such purposes to make reasonable
determinations of current values;
5. To make elections, decisions, concessions and settlements in
connection with all income, estate, inheritance, gift or other tax returns
and the payment of such taxes, without obllgatlfln to adjust the
distributive share of income or principal of a any person affected thereby;
6. To borrow money from any person including any fiduciary acting
hereunder, and to mortgage or pledge any real or personal property;
7. To manage, control, repair and improve all estate property;
8. To procure and carry at the expense of the Estate, insurance of the
kinds, forms and amounts deemed advisable; by my Personal
Representative to protect the Estate against: any hazard;
9. To employ any attorney, investment adviser, accountant, broker, tax
specialist or any other agent deemed necessary in the discretion of my
Personal Representative; and to pay from the Estate reasonable
compensation for all services performed by any of them.
ARTICLE X
Death Tazes: My Personal Representative and Trustees shall pay all estate,
SCOEE ~. dinner
Attorney et Lew
3 Kecey Conn - Sn~te 201
Mecbenicabura, PA 17055
pb. (717) 691-7314
inheritanceE and other death taxes (including the supplemental estate tax on certain qualified plan
benefits b>.~t not including any generation skipping tax imposed on a direct skip), together with
interest an{3 penalties, which shall be payable with respect to property or interests subject to
taxation b~+ reason of my death and whether passing under my Will or any codicil, or otherwise,
including jpintly held and other non-testamentary property. My Personal Representative and
-~-
Only to the extent the Credit Shelter Trust is insufficient or unless my Husband predeceases me
shall any such payments be made from my residuary estate.
ARTICLE XI
Exemat Proaerty: No property received by my Personal Representative and
Trustees vu~hieh is exempt from federal estate tax that maybe assessed against my estate shall be
available for the payment of debt, inheritance and estate taxes or penalties and interest, or
administration expenses in the settlement of my estate.
ARTICLE XII
Concurrent Wills: My Husband and I are executing wills at approximately the
same time in which each of us is the primary beneficiary of the will of the other. These wills are
not executed because of any agreement between my Husband and myself. Either will may be
'revoked at any time at the sole discretion of the maker thereof.
ARTICLE XIII
Invalidi If any provision of this Will or of any codicil hereto is held to be
.Scoff ~. inner
AEtoraey nt Law
3 Kacey Court -Suite 201
Mec6n.uccbura, PA 17055
pL.(717)691-731
inoperative, invalid or illegal, it is my intention that all of the remaining hereof shall continue to be
fully operative and effective so far as it is possible and reasonable.
end of page--
-8-
IN WITNESS WHEREOF, I have hereunto set my hand and seal and caused this
my Will , gonsisting of nine (9) typewritten pages, including this attestation clause, to be executed,
declared at~d published this~~day of January, 1999, at Mechanicsburg, Pennsylvania.
LU C. HOLLIS
~cotf ~. inner
Attorney st Lew
3 Kncey rt -Suite 201
Mecbenicaburg, PA 17055
P6. (717)691-731
WITNESSES:
k~w,
Residing at ~r' S~-o~l`'~ " r~JB
Mec~,r~~csb+,N'~ ~ ~A I~o~S
Residin at .3.5"~.~,~~~,~~,
J T
® / o~J
Residing at ~~ s~o~~ ~rIVG
Me~~~~~1~~ ~ ~~os~
T
-9-
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA:
COUNTS OF CUMBERLAND
SS
We, ut,C ~,, 1a011ts ,-'ia~~~a ~ ~1~+rcY ,
~bSQ.~~ . Sti~~,./c~n ,and ,5~~ ~ .~-~ne~' ,the Testatrix and the
witnesses, respectively, whose names are signed to the foregoing; instrument, being duly qualified
according Ito law, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her Last Will, that she had signed willingly, and that she executed it as
her free amid voluntary act for the purposes therein expressed, that each of the witnesses, in the
presence aiod hearing of the Testatrix signed the Will as witnesses and that to the best of the
witnesses' (knowledge, the Testatrix was at the time eighteen or more years of age, of sound mind
and under ~,no constraint or undue influence.
WITNESSES:
~,vl "1
~,c ,
LUCY . HOLLIS
On this, the~b day of January, 1999, before me, Dawn M. Boyer, the undersigned
.7COEE ~. inner
E~Horney al l.aw
3 I{acey CouR -Suite 201
Mec6w.uc.6nr6, PA 17055
y6.(717169i-731a
officer, personally appeared Scott M. Dinner, Esquire, known to me to be a member of the Bar of
the Suprerle Court of Pennsylvania, and certified that he was personally present when the
foregoing Acknowledgment and Affidavit was signed by the Testatrix and witnesses.
Notarial Seal
NOt PUb11C Dawn M. Boyer, Notary Public
~ Lower Allen Twp., Cumberland County
My Commission Expires Dec. 15, 2001
- Member, Pennsylvania Association of Notaries