HomeMy WebLinkAbout02-28-12Reset
PETITION 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 request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name: DAVID O. LILLICH, 7r. File No: ~ ~ _ ~ ~ "~ ya
tea: (Assigned by Register)
a/k/a:
a/k/a: Social Securl:ty No:
Date of Death: 02/25/2012 Age at death: 85
Decedent was domiciled at death in CUMBERLAND County, P~, (Stare) with his/her last
principal residence at 225 N. DICKINSON SCHOOL RD. CARLISLE, 17015 - DICKINSON TOWNSHIP, CUMBERLAND
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 225 N. DICKINSON SCHOOL RD, CARLISLE, 17015 - DICKINSON TOWNSHIP. CUMBERLAND. PA
Street addreess, Post Office and Zip Code City, Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania ............................ All personal property $ 100,000.00
If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $
If not domiciled in Penns,~lvania ........................ Personal property in County $
Value of real estate in Pennsylvania ......................................................... $ 371, 5z_ n_nn
TOTAL ESTIMATED VALUE.... $ 471,250.00
Real estate in Pennsylvania situated at: 225 N. DICKINSON SCHOOL RD, CARLISLE 17015• DICKINSON TWP., CUMBERLAND
(Attach additional sheets, if necessary.) Street address, Post Office and Zip Code City, Township or Borough County
A. Petition for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) he/shedthey is/are the Executor(s) named in the last Will of the Decedent, dated JULY 23,1997 and Codicil(s)
thereto dated FEBRUARY 16, 2011
State relevant circumstances (eg. renunciation, death of executor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not divorced, was not a party to a pending
divorce procceding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(g), and did not have a child born or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person..
NO EXCEPTIONS Q EXCEPTIONS
B. Petition for Grant of Letters of Administration (If applicable)
c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante absentia, durance minoritate
If Administration, c.~a, or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.
Except as follows: Decedemt was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined
in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
Q NO EXCEPTIONS ~ EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by tha; following spouse (if any) and heirs (attach
additional sheets, if necessary): ~ ~,
Name Relationshi Address' -'r,~~rT~-~'-,
5~
Q7 ~.-=
ti:
7s m N -
7 ~
_
~~
.,y {~ ..=
'T
t~
u~
r,
-~
r~
7
Form RW-02 rev. 10/!!/20/1 Page 1 of 2
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
O~ticial Use Only
..~li: ~~.Iw:1 :._Jti ~~~ llf
~1.` '~.... .~ f!
~ - ~ ~'~I
=?~=2 FHB 28 Pi# i~~
Petitioner(s) Printed Name Petitioner(s) Printed Ad--~ ..
BARBARA G.B. LILLICH 225 N. DICKINSON SCHOOL ROAD CA ~~~~~r
- ,. .
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 Persional Representative(s) of the Decedent, the Petitioner(s) will well and truly administer the estate according to la~
Sworn to or affirmed and $ubscribed before U ~ ~ ~ '~(`~,.. Date ~ ~'~/, ~-
me thi ~1' ay of ~U1 ~ Date
BY~ Date
For the Register Date
BOND Required: ®YES ~ NO To the Register of Wills:
FEES: Please enter my appearance b;y my signature below:
Letters ...................... $ ~ V
( 10) Short Certificate(s)..... .
( )Renunciation(s)........ .
( 1) Codicil(s) ............. 1 ~_
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other (,.J:ll ,,,,,,,,
Automation Fee ............... _ (jU
JCS Fee . ....................
TOTAL ..................... $ ~~: .~-r^
Attorney Signature:
Printed Name: THOMAS E. FLOWER
Supreme Court
ID Number: 83993
Firm Name: FLOWER LA'W, LLC
Address: ]0 W. HIC;H ST.
CARI.TSi.F_, PA 17013
Phone: (717) 243-551:3
Fax: (7171241-4021
Email: Tnm ;FlnwPr-Law_cnm
DECREE OF THE REGISTER
~,~-- ~a ~ a~~
Estate of DAVID O. LILLICH. Jr. File No•
a/k/a.
AND NOW
satisfactory pros
~1 ~~ , ~_~-;-in consideration of the foregoing Petition,
;served before me, IT IS DECREED that Letters TESTAMENTARY
are hereby granted to BARBARA G. B. LILLICH
in the above estate and (if applicable) that
the instrtunent(s) dated JIJ~ILY 23, 1997 and FEBRUARY 16 2011
described in the Petition be admitted to probate and filed of record as the las W'll (and Codicils of D cedent. J
~J~G,~tJ ~~/
Register of W lls ~ ~!
~/
Form RW-01 rev. 10//1/1011 P ~e 2 of 2
~ ,~. RAR'S CERTIFICATION OF DEATH
,~,'~, ,~;: ~°_I~, a Ito duplicate this cop b hotostat or hot
r~FC•!`u' ; ~ ~ . ~~.1 i,~ Y Y p p ograph.
Fee for this certificatle, $6.00.1 ~ ~ ~- ~~ 2
P~ ~~; ~~ This is to certify that the information here given i~
correctly copied from an original Certificate of Dean
~ duly filed with me as Local Registrar. The original
C~~~ ~~' ~j certificate will be forwarded to the State Vital
QRI~ v~Uflr Records Office for permanent filing.
P 18 2111 ~~~~~,~v~? co . ~ ,
Certification Number
TYPe/Print In
Permanent
David O_ Lillich 3r_
'a. Age-Last Birthday (Yrs) 6b. Under 1 Ve:
$5 Yrs ~ Months [
1
3
~~-~- ~ r ~~~,~ ~ t o~z
~;ocal Registrar Date Issued
COMMONWEALTH OF PEN NSVLVANIA _ DEPARTMENT OF HEALTH ~ VITAL RECORDS
CERTIFICATE OF DEATH
') 2. Sex 3. Social Securi Number5tate File Number:
ty 4. Date of Death (MO/Day/Vr) (Spell Mo)
male 186-26-9712 Februa
5 U d 1 O y 6. Data of Birth (MO/Day/Year) (Spell Month) 7a. Blrthpl ce (City and State or Forei ry 25 J 2012
Hours Minutes November 23, 1926 :kson Z1au.. PA gn co°ntrv)
ea. Residence (State or Forel Count 7b. Birthplace (County) YOrY
Bn ry) 8b. Residence (titre t and Number -Include Ap[ No.) 8c. Did Decedent Llye In a lownihip7
Penns lvania 225 N. Dickinson School
Sd. Residence (County) Road ®Ves, decedent lived in _Dieki nson twp
Cumberland 8e. Residence (21p Code) 17015 ~ No, decedent Ilyed within limits of
9. Ever in US Armed Forces? 1 Marital Status at Time of Death Marrl d ~ Widowed 11. Surviyin 5 o city/bor
~] Yes ~ No ~ Unkno Q Divorced ~ Ney r Married ~ Unkno g p =• N e (If wife, glue name prior tp first marriage)
12. Father's Name (First, Middle, Last, Suffix) " Barbar8 G. B. Barnitz
DaV1d ~< L1111 Ch w13. Mother's Name Prior to First M i I ~ ,
~_
~
~+ 14a. Infprmanrs Name
14b. Relat)onship to Decedent
Barbara Lillich s use
....... Carrie S
14c. Informant'i_ n
225 N. Di
8 ...............•--•--.............................. .............
If Death Occurred in a HosPita l: 'u' •j~ .•...-•-••••---•••
patient lSa.
•-•--••'•-•~•••-~-.. -..ace o eat _ one •-,
:If D
~
~ Emargen Room/Outpatient Dead on Arrival eath Occurretl Somewhere Othe
Thah a
lSb. Facility Name (If not Institution, give street and number; Nursln Home/LOn -Term Care Fec
i6
~
225 N. Dickinson Sc ool Road c. City or Town, State, and 21p Code
~-
16a. Methotl of Disposliion ® Burial Q Cremati Carlisle PA 17015
on
p Rempyal fr°"' stet` p D°nati°"
Other (SpecHy) 16b. Date of Disposition 16c. Place of pl
reh 3 , 2012 Mt _ Hol
16d. Location of Disposition (City or Town, State, and 2i
P)
17a. Sig tuts of Fune 1 Servic
Mt _ Ho11y Springs, PA 17065 e
17c. Name and Complete Address of Funeral Facility
Hofgman-Roth Funeral Home and Cremato =
m
18. Decedent's Education -Check the bbx that best describes the nc_ 219 N_ Han
19
D
I-
highest degree or level of school completed at the time of death .
ecedent of Hispanic Origin -Check the
box th
t b
.
Q 8th grade or less
Q No diploma, 9th - 12th grade a
est describes whether the decedent
is Spanish/Hlspa nic/Latino. Check the "NO"
~ High school graduate or GED completed box if decedent Is no[ Spanish/Hispanic/Latino.
Q Some college credit, but no de
gree (Q No, not Spanish/Hispanic/Latino
O
Associate degree (e.g. AA, q5) 0 Yes, Mexican, Mexican American, Chicano
Bachelor's degree (e.g. BA, AB, BS) ~ Yes, Puerto Rican
~ Master's degree (e.g. MA, M5, MEng, MEd, MS W, MBA) 0 Ves, Cuban
Q Ves
other S
i
h
~ Doctorate (e.g. PhD, Ed D) or Professional degree ,
pan
s
/Hispanic/Latino
e. MD DOS DVM LLB, JD (Specify)
21. Decedent's Single Race Self-Oesignatlon -Check ONLY ONE to Indicate what the decedent considered hi
® Whit
e Q Japanese
~ Blmck or African American (] Ko mself or
Q Samoan
~ A erican Indian or Alaska Native ~ Vietna mesa Q Other PaciFlC Islander
'
Q Asian Indian Q Other ASian 0 Don
t Know/Not Sure
Q Chinese ~ Native Hawallan
Q Flli
i 0 Refused
Other
O (Specify)
p
"° ~ Guamanian r Cham orro
REMS 23a - 23 MUST BE COMPLETED 23a. Date Prono ced Dead Mo Day r) 23 . SI¢natu re of vr,r<r.., o .
BY PERSON WHO PRONOUNCES nw
23d. Date 51
fined (MO/ sy/Yr) ~~
24. Time of Dest L ~ ^vu `Q ~
~L~,~l -_.___.-_...__..
-
~Zi7 Z
- 3 ~ S ~N~ sV lZv.~ 12NZ~~
773L
25. Was Medical Examiner or Coroner Com:actedT Q Yes
26. Part 1. Enter the chain of~e
respirato
arr
t
L;<__
diseases, Injuries, or complica CAUSE OFD
EATH
tions--that directly caused the death
DO NOT N
Appro
l
ate
ry
es
, or Ventricu lar fibrillation without showing th .
enter ter
e etiology. DO NOT ABBREVIATE
Ent
l minal events such as rv
a
cardiac arrest
Inte I:
~
IMMEDIATE CAUSE e ~
S ~' .
er on
y one cause on a Ilne. Add addlN onal Tines If necessa Onset to Death
rv
----________-
(Final disease or conditio" ~ a.
r0 ~~ Q
t e
3 7" '
resulting in death)
~ \ ~
~ L
b o (or as a
`~ ~ ^=equence of):
~ `
1< /
Sequentially Ilst conditions, . v.
.7
if any, leading to the cause
(~ e t
as a can
o (or sequence of):
listed on line a. Enter the +
~{..~ ~I
c, Tt/-~. c_ p. ~-e~,t• ~ ~
^
`
'
UNDERLYING CAVSE ~
(disease or InJ ry that Due to (or
as a consequence of):
F Initiated the events resulting d.
~ in death) LAST.
Due to (or
c
of):
26. Part il. Enter other sianiflca t ^
dit( i t d th but .
~ i
not resulting in the under)
y g cause given In Part I 27
~- . Was an autopsy performed?
O Ves p_N,f
28. Were autopsy findings available
3'
29. If Female: to complete the cause of death?
E
Q Not pregnant wlthln past
e
ar 30. Did Tobacco Use Contribute to Death?
? 1
M ~ V 0 N
o y
Q Pregnant
tlme of death
~ Yes ~ Probab .
anner of D
~ eath
.~ a^
Q Not pregn t, but pregnant
wlthln 42 days of death Wyt
~ 0 Unkno ~
al
~ Accid
t (] Homicide
I-
~ Not pregnant, but pregnant
43 days to 1 year before death en
Q Suicide ~ Pending Investigation
C
ld
Q Unknown if pregnant within
the past year 32. Date of I
nJury (Mo/Day/Vr) (Spell Month) Q
ou
not be determined
-- -- ---~- c.rcac:pn Imury, Specify: 38. Describe How Injury Occurred:
O Yes O Passern Op`ratOr Q Petlestrian
NO ~ fiat Q Other (Specify)
rtifl ^Ch k ly )
IQ CeKifyl g physician - To the best of'my knowledge, death occurred tlue to the cause(s) and manner stated
'~ Pronouncing 8. Certifying physician '~ To the best of mV knowledge, death occurred at the time, tlate, and place, and due to She causes
~ Medical Examiner/C,gr9sRr= pn~lsys~ ex (nation, and/or Inyesfigatl°n, In m )and manner statetl
~~~- / ~ y opinion, death occyL ed at the time, dates, and place, and due to the a se() nd manner stated
Signature of certlRer: Title of certifier: IY1 l /~~ ~ 0 Z`~. 7G J
b. Narrte~ A ~a Zip Cod f Pers n Complete/p Cause o/~peath (Item 26) I ` C e /~_ / - License Number:
a/ J~.+~T' -~ ~ Ill ~ //'1Q~lt\ Z Z(~ ~,/ ~ ~ cJa1'\ J~~ ~-C/ I cJ l0 ~~ 39c. Date Sig d (MO/ Y/Vr)
. Registrar's District Number ' 7ut~ O ~- L T Zo~'~
41. Re¢i ~r's S_gnature 42. Regis r File Date (Mo Day
~[./ -z!v si-cc:c~, - ~Z~-CP - Fcba 2"7. ~o l~
Amend manta
Disposition Permit No. ~ / ~ C~J y / / HSOS-143
REV 07/2011
5
Springs Cemetery
138504
to Indicate what
the deceden! considered hi self or h
O
lf
® White ers
e
to be,
~ Black or African American ~ Korean
Q Vietnamese
~ American Indian or Alaska Native 0 Other Asian
Q Asian Indian ~ Native Hawallan
Chinese
Q Flli
i ~ Guamanian or Chamorro
p
"° Q Samoan
Q Japanese ~ Other Pacific Islander
Other (!ipecify) -
(done during most of workin life. DO NOT USE RETIREOR I
Independent ~igent
P
M
CODICIL
OF
DAVID O. LILLICH, JR.
I, DAVID O. LILLICH, JR, the within named Testator, do hereby make and publish
this Codicil of my Last Will and Testament dated Apri127, 2005.
FIRST
I hereby amend ARTICLE SEVENTH, Paragraph I. of my said Will to provide as
follows: I appoint my son, David O. Lillich, III, to serve as sole trustee of the foregoing trust.
SECOND
I hereby further amend ARTICLE SEVENTH of my said will by adding thereto the
following Paragraph J.: I direct my trustee that it is my desire .and intention that no interest in
any farm which may form a part of this trust shall be sold during the lifetime of my surviving
spouse, except in a case of strictest necessity.
THIRD
In all other respects I hereby ratify, confirm and republish my Last Will dated July 23,
1997, together with this sole Codicil as and for my Last Will and Testament.
IN WITNESS WHEREOF, I, DAVID O. LILLICH, JR, have hereunto set my hand
and seal to this Codicil to my Last Will and Testament this ~~ day of ~ ~c ~-- 2011.
~ -_~,
~~
DAVID O:~IL ICII',~fiR
~ ,-..~
.~, -~-, ~ ~ c-
cam' ~-~
~~ °3 -' `v
~ r ..,
~~ ~
~ . °1 t r.. ;'t'1
~-' ~ t~
~:~~~~~
ADDRESS / p ~,c.J ,
ADDRESS -~~~~
~~~o ~ ~~~'/3
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
CUMBERLAND
ss,.
We, DAVID O. LILLICH, JR, JawcC ~, ~/ewcr 5,,, and TJgwvt L. rl.wE,e, the
Testator and witnesses, respectively whose names are signed to the foregoing or attached
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
Testator signed and executed the instrument as his Codicil and that he signed willingly and
that he executed as his free and voluntary act for the purposes therein expressed, and that each
of the witnesses, in the presence and hearing of the Testator signed the Codicil as witness and
that to the best of their knowledge the Testator was at the tune 18 or more years of age, of
sound mind and under no constraint or undue influence.
-~~ ~ '~
DAVID O. LILLICH, JR
~'`u~-~~-cJ
Witness
r~ ~.
rtness
Subscribed, sworn to and acknowledged before me by DAVID O. LILLICH, JR, the
Testator, and subscribed to and sworn or affirmed to before me iby ~~w,.~ ~ F~dwn-~ ,and
D~~ ~ •~(s •~Y- ,witnesses, this ! '`' day of F~ LrK4 r.J 2011.
-~ `~.
Notary Pub]'.ic
COMMONVI/EALTH OF PENNSYLVANIA
NOTARIAL SEAL
THOMA.S~ E. FLOWER, Notary public
Carlisle Boro., Cumberland County
My Commission Expires October 26, 2014
Signed, sealed, published and declared by the above-named 'T'estator, as and for a Codicil to
his Last Will and Testament in the presence of us, who have hereunto subscribed our names at
his request as witnesses, thereto, in the presence of said Testator and of each other.
c: \wp511Wills\Lillich. DO
~`ittst 3i~ill ~n~ C~TPStttm~nt
~...~
~.~,
OF ,~
:;.:-
DAVID O. LILLICH, JR. ~ ~ ~,
~`
~,
I, DAVID O. LILLICH, JR., Dickinson Township, Cumherland County, Pennsylvania,
declare this instrument to be my Last Will and Testament, in mainner and form following:
FIRST: I hereby expressly revoke all Wills and Codicils heretofore made by me.
SECOND: I hereby direct my Executrix to pay all my just debts, funeral and
administrative expenses out of my estate,' as soon as practicahle after my death.
THIRD; I direct that all taxes which may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid out of my
estate as a part ~of the administration of my estate.
FOURTH: I give to my son, DAVID O. LILLICH, III, the sum of Fifty Thousand
($50,000.00) Dollars.
FIFTH: I give to my granddaughter, LINDSAY ALEXANDER LILLICH, the
sum of Twenty Thousand ($20,000.00) Dollars but should she not have attained the age of
28, her parents shall hold the same In Tnlst for her until she reaches the age of 2$ years.
SIXTH: I give to JOAN ALEXANDER LILLICH the sum of $10,000.00.
SEVENT Provided my wife, BARBARA G. B. LILLICH, survives me, I give to the
Trustees hereinafter named, an amount equal to the Federal Tax Exemption Equivalent in
~.
~`'- _.
fA,,~~,
-,;
~~
~,
__ itials
c: \wp51 \W ills\Lillich. DO
.
force and applicable to my estate at the time of my death, In Trust, nevertheless, upon the
following terms and conditions:
A. The Trustee shall invest and reinvest the principal and pay the net
income wising from the principal of this Trust in a monthly or quarterly installments
to my wife, BARBARA G. B. LILLICH, during her life;
B. If in any year my wife, BARBARA G. B. LILLICH, makes request of
the Trustee, there shall be distributed to her from the principal of this Trust in such
year such amount as she may in writing request, provided, however, that the total of
said sum so distributed in any calendar year shall not exceed the greater of five
percent (5%) of the value of the Trust principal (determined'. at the beginning of such
trust year) or Five Thousand ($5,000.00) Dollars annually. This right shall be
exercisable only by my wife personally and shall be nonaccumulative;
C. Upon the death of my wife, the Trust shall terminate and the Trustee
shall distl'ibute the principal and accumulated income to my son, DAVID O.
LILLICH, III;
D. Should my son, DAVID O. LILLICH, III pre-decease my wife, I direct
that distribution be made to his issue, in equal shares. Should any such issue be
under the age of 28 at the date of the life beneficiary, then the Trustee shall hold the
interest of such issue in Trust until he or she attains the age of 28 at which time such
issue shall be entitled to receive his or her appropriate share of principal and
interest;
E. Trustees shall have the power:
~..
~ .-.
initials
f
c:1wp51\Wills\Lillich.DO
(1) To lend to and buy property from my estate or the estate of my
wi',fe, for the purpose of facilitating settlement of my estate by advancing funds
for payment of taxes or administration expenses or fc;~r any other reason which
may seem advantageous to my estate;
(2) To apply income to which the heneficiary is entitled directly for
heir comfort, maintenance and support should she deem such beneficiary
incapable of receiving the same. by reason of age, illness or any infirmity or
incapacity;
(3) To do all other acts in its judgment deemed necessary or
desirable for the proper and advantageous management, investment and
dis'~tribution of a Trust;
F. Any realized capital gain received by the Trustees in any one year, as
well as any stock dividends of ten percent (10%) or less, may be considered by the
Trustees to be income, in the sole discretion of the corporate Trustee.
G. This Trust may be funded by property from the estate in kind or in
cash.
H. If at any time any minor child shall be entitled to receive any funds
pursuant tin the foregoing subsection D.
I. I appoint FINANCIAL TRUST SERVICES (:OMPANY, of Carlisle,
Pennsylvania, and my son, DAVID LILLICH, III, to be Co-Trustees of the foregoing
Trust.
r-..._
3 ~ ~a,g
c:\wp51\Wills\L;Ilich.UO
EIGHTH: All the rest, residue and remainder of my estate, I give, devise and
bequeath to my'wife, BARBARA G. B. LILLICH.
NINTH: In the event my wife, BARBARA G. B. LILLICH, fails to survive me,
I give my entire estate to my son, DAVID O. LILLICH, III, or tc;~ his issue, subject to the
bequests to my granddaughter and daughter-in-law.
TENTH: I nominate, constitute and appoint my wife, BARBARA G. B. LILLICH,
to be the Executrix of this my Last Will and Testament. Should my wife he unable to act
as such Executrix for any reason, I appoint my son, DAVID O. LILLICH, III to act as
Executor in her place and stead. Should neither my wife nor son he ahle to so act, I
appoint FINANCIAL TRUST SERVICES COMPANY of Carlisle, Cumherland County,
Pennsylvania to ~e the Executor.
IN WITNESS WHEREOF, I hereunto set my hand and seal this ZJ-~-~
~.
day of .~' ~ ~ 1997.
~_...-
--~.~. ..
r ~ ~.~
---~~AVID O. LILLICH, JR. L
,- ~..,
4 is
~_ ~
SIGNED, SEALED, PUBLISHED and
DECLARED irk the presence of:
~.-~
c:1wp511Wi11s11_illich. DO
COMMONWEALTH OF PENNSYLVANIA .
COUNTY OF Ck1MBERLAND
ss.
I, DAVID O. LILLICH, JR., Testator, whose name is signed to the attached or
foregoing instn>nhent, having been duly dualified according to law, do hereby acknowledge
that I signed and executed the instn~ment as my Last Will; that I signed it willingly; and that
I signed it as my free and voluntary-act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by DAVID O. LILLICH, JR., the
Testator, this ~ day of 1997.
.._.._
~. 1
~ ;' .~.,y.,....,~
--,--
DAVIU O. LILLI(:H, JR.,
Testator
Notary Public
NOTARIAL 8EAL
;r1 aAN M. RAMSEY, Notary Public
Carole: Gunberlend Carr, Pa. , _--
......_r.~~.-- ~--,_-
5
c:IwpSl\Wills\Lillich.UO ~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C~JMBERLAND
ss.
We, games D. Flower and Carol J. Lindsay ,the witnesses
whose names at•e signed to the attached or foregoing instrument, being duly qualified
according to lavw, do depose and say that we are present and saw Testator, DAVID O.
LILLICH, JR., sign and execute the instrument as his Last Will, that he signed willingly and
that he executed it as his free and voluntary act for the purposes therein expressed; that
each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to
the best of our knowledge the Testator was at that time 18 or more years of age, of sound
mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by _
and Carol J. Lindsay ,witnesses this
July 1997.
23rd day of
~) .
Witness
Wi ness
NOTARIAL SEAL ~
~(JB~W M, RAMSEY, Notary Public
~ ~ Se ~ 8,1999
James D. Flower