HomeMy WebLinkAbout01-27-12~/ - /I- /3 8~S
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2012 ,IAN 27 ppl 2-• S !
OATH OF SUBSCRIBING WITNESS(ES) DRPRSIC OF
(~1ME3ERI `ANA ~Fi
`~~"~~,, -~~„RF,GISTER OF WILLS
~LLU[W1~Ld~~ COUNTY, PENNSYLVANIA
Estate of_ ~ ~u~~ l.~d~,ut.~ru~ ,Deceased
C o r r ~'~ ~~ Q r~ , (each) a subscribing witness to
-/ (Print Name/sJ
the ltd Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say~,d~ that sh he /they wa were present and saw the above Testator estatrix sign the same
and that sh / he /they signed the same and that sh / he /they signed as a witness at the request of
the Testator Testatrix in er his presence and in the presence of each other.
~~
rgaature) (Signature)
~' /~ ~ ~~-
(S[ree[ Address) (Street Address)
(City, State, iP) (Ciry, Srate. Zrp)
Executed in Register's Office Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
of
day
Sworn to or affirmed and subscribed
before me this 2rj~' day
of .j uo~ry 20t2
Deputy for Register of Wills Public
'tf10F PFPM~YW/Ig1A My Commission Expires:
NOtafIN~4N1 (Signature and Seal of Notary or other official qualified to
administer oaths. Show date of expiration of Notary's Commission.)
~Il~pl DEC, )~
NOTE: To be taken by Offi' sent the original or copy of instrument(s) at time of notarization.
Form RW-03 rev. !0./3.06