HomeMy WebLinkAbout03-06-12~~
PETITION FOR PROBATE AND GRANT OF LETTE
Register of Wills of Cumberland County, Pennsylvani r-~`r _!~_" 1 `:~; ~'
Petitioner, named below, who is 18 years of age or older, applies for Letters as specified below, and in support thereof,
avers the following and respectfully requests the grant of Letters in the appropriate form:: •, ,y ,, J: €~ 1
DECEDENT'S INFORMATION
~~~~~~~
Estate of NILA J. SUTPHEN File No. °~ ~ - , ~'(~°H~N'GtJi"~T
Deceased Social Security ~ ` ~ ~ $-' 7 7
Date of Death: January 14, 2012 Age at Death: 88
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with her last family or principal residence at
993 West Trindle Road Mechanicsburg Cumberland County PA 17055
(List street, address, townlcity, county, state, zip code)
Decedent died at 993 West Trindle Road Mechanicsburo I Cumberland County PA
List street, address, Post Office and zip code city, township or Borough County State,
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property .....................................................................$_ 11,800.00
(If not domiciled in PA) Personal property in Pennsylvania .....................................$
(If not domiciled in PA) Personal property in County ....................................................$
Value of real estate in Pennsylvania ......................................................................................................................$ 873,700.00
Tota1 ......................................................................................................... $ 885,500.00
Real Estate situated as follows: 993 West Trindle Road Mechanicsburg Cumberland County AND 809 Boiling Springs Road
Monroe Township, Cumberland Countv PA
(attache additions/sheets ifnecessaryJ Street address, Post Office and Zip Code City, Township or Borough County, State
L`'J A. Probate and Grant of Letters. Petitioner avers that decedent, Nila J. Sutphen named MID PENN BANK
Executor of her Will dated December 23, 2002. Mid Penn Bank has renounced its right to serve as Executor Petitioner is
the alternate Executrix under Decedent's Will
Mate relevant circumstances, e.g. renunciation, death of F~cecutor, etc.
Except as follows, After the execution of the instrument offered for probate, Decedent did not marry, was not divorced, and
was not a party to a pending divorce proceeding at the time of death wherein grounds for divorce has been established as
defined in 23 Pa.C.S.A. § 3323(8) and did not have a child born or adopted and the Decedent was neither the victim of a
killing and was never adjudicated an incapacitated person
~ NO EXCEPTIONS ^ EXCEPTIONS
^ B.
Petition for Grant of Letters of Administration (if applicable)
enter: c.t.a.; d.b.n.c.t.a.; pendent elite; durante absentia; durante minoritate
If Administration, c.t.a. or d.b.n.c.t.a.,
Except as follows: Decedent was not a party to a pending divorce proceeding at the time of death wherein grounds for
divorce has been established as defined in 23 Pa.C.S.A. § 3323(8) and was neither a victim of a killing and was never
adjudicated an incapacitated person
^ NO EXCEPTIONS ^ EXCEPTIONS
Petitioner, after a proper search, has ascertained that Decedent left no Will and was survived by the following spouse (if
any) and heirs (attached additional sheets, if necessary)
Name Relationshi Residence
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SEC; i ~= t:;E (~
1 i~a1~11se Only '!--:.,~
Petitioner's Printed Name Petitioner's Printed Addr ~~
Diana Sutphen Shaw
` 46 Walters Lane ~} ~~~ "~ ~~~ -~~'~~,~'~~~
~'-~!
Pt. Pleasant, PA 18950
The Petitioner above-named swears or affirms that the statements in the foregoing Petition are true and correct to the best
of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly
administer the estate according to law. /
Sworn to and affirmed anti subscribed ~ ~' ~C4-~-~-<< ~~~ '~i~~lc~~~
t ~/~
Before me this J _ day of
~~ ~G~ i%;~1 , 2012.
Letters ........................... $ ~ f I ~ ~`'~,
{ )Short Certificate(s ) $_ ~ (~ ~ ~ '
{ }Renunciation ............ .. $ ~ '~ C' C.
{ )Codicil(s) $
{ )Affidavit(s) .................. $_
Bond $
Commission $_
Other
~ $
,
~[ $ i_
$_
$_
$_
$_
Automation $ ,- ~ ~
JCP Fee ....................... $ '-:,,,, ; ; ~-
TOTAL......... $-- ---~! ~~~~, t~C:
DIANA SUTPHEN SHAWA/K/A D/ANA L. SHAW
To The Register of Wi/ls
Please enter my appearance by my signature below:
Attorney Signatur
~------
ri d Name: JERRY R. DUFFIE
Supreme Court
I.D. No: 09601
Firm Name: Johnson. Duffie, Stewart & Weidner
Address: 301 Market Street. P.O. Box
Lemoyne PA 17043
Phone: 717-761-4540
Fax: 717-761-3015
Email: 'rdCciidsw.com
DECREE TO THE REGISTER
Estate of NILA J. SUTPHEN Deceased. File No. ~ 1 i ~ ~= `~ '~\~~
Social Security No: 149-18-3777 Date of Death: January 14, 2012
AND NOW, T~..~(~ ~4 ( ~ 1 ~ ~ 1 t } , 2012, in consideration of the foregoing Petition, satisfactory proof having
been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Diana Sutphen
Shaw a/k/a Diana L. Shaw in the above estate and .that the instrument dated December 23. 2002 described in the
Petition be admitted to probate and filed of record as the Last Will of the Decedent.
Register of Wills
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BOND Required ^ YES ~ NO
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1V TYPe/PElnt In
Permanent COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
Black ink CERTIFICATE OF DEATH
1. Decedent's Legal Name (First, Middle, Last, Suffix)
2. Sex 3. Social Secu rirv v..... t,,,_State File Number:
Ni la J _ ~, , r,-,~,o,-. _
G
Z
s
~$ --.- r~vurs mutes - '-'"-" '"""' r plrtnpla ce (City and State or Foreign Cou n[ry)
ga. Residence (State or Foreign Country) 86. Residence (Street and Numbe Zb. Birthplace (County)
p
r -Incl
d
a
Sd. Residence (Co u
e Apt No.) 8c. Did pecede nt Live in a Township?
unty) ~IVes, decedent lived in
- I~
3. Ever in US Armed Forces? Be. Residence (Zip
10. Marital Status at Time o
~ Yes ~~TT
~~ww Fkr92 _ wP
Code) QNO, decedent lived within limits of ~ t
f p
h
''o
..
.--~y- 0 Unknown Q pivorced )~ N eat
a ed uy/bore-
~--yam-- idowed 11. Su rvlving Spa>u se's N
ever M
rr
L2. Father's Name (First, Middle, Last
Suffix) auled
ame (If wlt~,
~ Unkno give name prior to first marriage)
,
NelSOP J . Schoen 13. Mother's Name Prior to Firs[ M
Loa. Informant s Nam
e arriage (First, Middle, Last)
14b. Relationshi
W1111am Sl.lt hen Jr P to Decedent 14c. Informant's M
ili
....................'---'--
............... a
ng Address (Street and N
on er
a p
993 W '
T~'i
1
f Deatn o«nmed ~
In a HPSpital: . ........ .....................
......-`--'
tY"'inpatient . n
Roa
..... isa. P ace o Deat
. .........
:._.. o~
y
ri ~o
r
p
es
Q Emergency Room/Outpatient 0 Dead on ArriYal
5
ms
-
. _
If Deat
ccu~~ed son,PrvF,e
.......... .
re Other Th
an a Hos
tal
~~ - --
H
~~ ~~~~~--~~--'""-"'"
~
Facility Name (If not' 'tu glue trees and n nber;
993 W
"`
ti _
os Pice Fa cil its
Q Nursing Home/L
Deceeeni~s rio.,,e'--~'~~'
ong-Term Care Facility Q Other (Specify)
~lsc
cu
T
_ Trindle
Road .
y Pr
pwn, state, and ZiP cnde -
6a. Method of Dis
osition ~] Burial Meeha 15d. County of Death
m
Q Removal fro State ~ Don atip p~' Cremation ~~
166. pate of Disposition 1 c. Place of pis
i
i
Other (Specify) pos
t
on (Name of cemFte ry, r ory, °r other place
remar )
6d. Location of Disposition (City or Town, State, and Zip) Janu 1
Mt HOll
S rin s Pa Ignatu re f Funeral Service or Person in Charge of Interment I b License Number
Ce"~
7 Name and plate Add of Funer 1 Facility
1Elyers-Darner `~liner
~
a
Home
B. Decedent's Education -Check tl,e boz that b
nC 1903
Haricot Strl?et ~~aflt
esT descrlbe
Ighest degree or level of school co s the
m pleted at the ti 19. Decedent of Hispanic Origin _ Check the
me of death.
Q 8th grade or less box that best describes whether the decedent
~ No diploma, 9th - 12th grade is Spanish/Hispanic/Latino. Check the "NO"
High school graduate or GED com Pleted box if decedent is not Spa nls h/Hispanic/Latino
Some college credit, but no degree
Q A .
~ No, not Spanish/Hispanic/Latino
Y
ssociate degree (e.g. Aq, q5) es, Mexican, Mexican American, Chicano
Bachelor's degree (e.g. 6A, Ag gS1 0 Yes, Puerto Rican
~ Master's degree (e.g. MA, MS, MEng, MEd, MSW
MBA) ~ Yes, Cuban
,
~ Doctorate (e. g. PhD, Ed U) or Professional de
r ~ Yes, other Spanish/Hispanic/La Tino
g
ee
. MD DDS DV M, LLB, Jp (Specif
Y) --
.. Decedent's Single Race Self-Designation _ Check ONLY ONE to
hate __
Indicate what the decedent co
i
0 Ja Panese
Black or African American ns
dered himself or
~ S
moan
~ Kp
~ American Indian or Alaska Native ~ Vietna C
~ O her Pacific Islander
mese
Q Asian Indian 0 Other Asia ~ Don'[ Know/Not Sure
n
0 Chinese 0 Native Haw
ii 0 Refused
a
a
~ Filipino 0 Guamania ~ Other (Specify)
__
n or Chamorro
.MS 23a - 23d MUST BE COMPLETED 23a
D
.
ate Pronounced
PERSON WHO PRONOUNCES OR Dead (MO/Day/Vr) : 36. Sion ~.~..e ,.s .,____._ _
20. Decedent's Race -Check ONE: OR MORE r s [o Indira to what
he decedent considered hi
m
l~ White self of herself to be.
Q Black or African American ~ Korean
0 Vietn
Q Arn erican Indian or Alaska amese
Native ~ Other Asi
Asian Indian an
Q Native H
ii
Q Chinese
Filipino awa
an
~ Guamanian or Chamorro
p Japanese O Samoan
0 O
h Other Pacific Islander
t
er (Specify) __ -,__
;elf to be. 22a. Decedent's U sual Occu
Potion -Indicate type of
done Burin ost
g m wor
of working life. DO NOT USE RETIftF_D.
~
23d. Date Signed (MO/ Z -° --'-„ <~-• r when appncable~ 23c. L se Number
n
24. Time of De th ~ ~N
/
'
26
P
/
J ~
?-~ ~ ~ 25. Was Medical Exam ner or Co ner Contacted?
CAUSE O
~ ~~e ~ 2~-
~"~
n Ve
.
R
a i
a
art 1. Enter the c of _ts--diseases, injuries, or mplica[io
respiratory arrest
or F DEATH
o
ns--tha
t directl
,
ventricular fibrillation without showing the y caused the death. DO NOT e rte rininal a nts s ch as to APProximare
etiolo
me ve u - rdiac ar
gY. DO NOT ABBREVIAT
IMMEDIATE CAUSE ----__
_-____-_~ a.
(Final disease or condition rest
E. Enter only one cause nn a line. Add additional lines if necessa ~ Interval:
~ rv ~ ry i Onsi-t to Death
~ I T~ O t~
resulting in death) _
Due to (o as a r_onsequen ce of): _-._.-__ _
b.
SequentiallY list conditions -
,
if any, leading to the cause _
Due to (or as a conseq ue cn e of)
_-..-_
listed on Ilne a_ Enter thn
c ---. ___ ____
:
----~ -
UNDERLYING CAUSE
w (disease o 'njury [hat
Initiated the Due to (or as a conseque nee of): '----- _ ___ -
-
even s resulting d
in death)LAST. -'----
___
V Due to (or as a consequence of) -- -- --~--._-__
0 26. Part 11. Enter other si¢n'f'ca nt .onditions co ntributin to death but not resultin
i
h
~
`
_
~!~ ~h<- ~ `-„_u
C6 ~I ~, z' C-,.tau ~e_'z-:
m g
n t
e under)
ving rase gwen in Pan I
Lz¢
4 F ~J
z~>. was at,to
s
v n,c---
Gtn (-t'\.+ zl.~ C" 1r-, c=-C.:., 4! p
v Pe~rt~~o~rr ed?
0 Yes ~`No
'
°' 29. If Female: -- ze. were a opsv findings ayaaame
t° co
plate the c t
a
~~
o Not pregnant within past year
30. pid Tobacco Use Contribute to Death? death?
O Yes
O No
~ )~ Pregnant at time of death
m 0 Not pregnant
b Q Yes 0 Probably
~ 31. Ma of peac
N
r h
'L
~ ,
ut pregnant within 42 days of Beast
n [
b
t
~ O
p
g O ~ Unknown
~ atur
al [] Homicide
O
,
u
n ;f
p regnant 43 daYS to 1 year before Beats
Unkn
o w
~ pre
n
32
Date
f I t C~ fending Investiga
u°~
Suicid
-
~
~ g
an within the past year .
o
nju rY (MO/paY/Vr 5
( Pell Month) e
, Could n
[
of be determined
~~ 34. Place of Injury (e.g, home; construcb°n sl e; farm; school) 33. Time of Injury
35. Location of Injury (Street and Number, City, State, Zip code)
`v
\
- 36. Injury at Work
~ Ye porxatio ll In
37. If Trans jury, Specify:
38
D
~{
s
~ No
~ Driver/Operator ~ Pedestrian r
.
escribe How Injury Occu red:
~ Passenger
Q Other (specify)
39~ C}}ttlfler (Check o
L~C
i nly one): -
~
ert
o ing physician - To the best of my knowledg
, death occurr
d d
n
~a e
e
uet the c
n ing ~ Certifying physician - To the best f ° seC ') and ted
Medical Examiner/Coroner - On the basis of exa minati~ nnowd/ ge, death occurred a he tin ea date Sa nd place, and due to the eau
o n s
ti
ati
e
\
/ /
Signature of certifier: j/L_.pt,y[~_.~,rt, wi
g
anner st
n ccu rr
o n, i my opinip n, death o ed a[ the time, date, and
placc~
and due r
h
t
39 b. Name, Address and Zip Cpde
f P
V ,
o t
e c
oase(s) and moon stateC
Title of certifier:- fVt~
Pr
_
o
erson Completing Cause o
Ucense Number: YVl () ¢Z~eZ ~:-y
f peach (Item Z6)
N /a-yYt GZ A-'r dt I') /k 1
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40. Registrar's District Number L-a Stu T N ~ Lam. {L~ C_F;Yrr ~> `_;_,~LL- ~lJ~ 1.~ i I
l~ 39c. DatA Signed (MO/Day/V r)
o
~f _
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41. Registra
re J~
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42
Re
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Fil
a3. Amenaments C .
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Disposition Permit No.~1 ~ O O0~ H105-143
- _ _.. -_ __ _ - _. _- _.. _. REV OZ/2011
005359-00011 /12.23.02/JRD/LAR/163780.1
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•~71
OF ~;
NILA .I. SUTPHEN ~ ?~ % ~~
-
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-.., -;
~~
I, NILA J. SUTPHEN, of Borough of Camp Hill, Cumberland County, Pennsylvania, declare
this to be my last will and revoke any will previously made by me.
I.
I direct that all my legal debts and funeral expenses, including my gravemarker and all expenses
of my last illness, shall be paid, unless otherwise provided, from my residuary estate as soon as
practicable after my decease as a part of the expense of the administration of my estate.
II.
I bequeath my automobile or automobiles, household goods and personal effects and other
tangible personalty of a like nature (not including cash or securities), together with any existing insurance
thereon, to my children, BARBARA LEE BARONOWSKI, WILLIAM F. SUTPHEN, JR. and
DIANA SUTPHEN SHAW, to be divided among them by my Executor with due regard for their
personal preferences in as nearly equal shares as practical. In the event that any of my children,
BARBARA LEE BARONOWSKI, WILLIAM F. SUTPHEN, JR. or DIANA SUTPHEN SHAW,
shall predecease me, then I bequeath the deceased child's share of such tangible personalty and the
insurance thereon to my surviving child or children.
III.
I devise to my son, WILLIAM F. SUTPHEN, JR., all that certain 4.743 acre tract, more or
less, situate on Monroe Township, Cumberland County, Pennsylvania, being Lot No. 1, Plan of Lots of
Paul R. Souder, recorded in the Office of the Recorder of Deeds of Cumberland County in Plan Book 22,
Page 185, being more particularly bounded and described in Deed, dated June 29, 1988, recorded in the
Office of the Recorder of Deeds of Cumberland County in Deed Book L, Volume 33, Page 273, and I
devise to my son, WILLIAM F. SUTPHEN, JR., all that certain .775 acre tract, more or less, situate in
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005359-00011 /12.23.02/) RD/LAR/163780.1
Monroe Township, Cumberland County, Pennsylvania, being more particularly described in Deed, dated
June 29, 1988, which said Deed is recorded in the Office of the Recorder of Deeds of Cumberland
County in Deed Book L, Volume 33, Page 270. In the event that my son, WILLIAM F. SUTPHEN,
JR., shall predecease me then I devise both parcels of real estate, as described in this Paragraph III, to my
daughter-in-law, KAREN L. SUTPHEN, provided she shall survive me. In the event that my daughter-
in-law, KAREN L. SUTPHEN, shall predecease me, then I direct that the devise of both parcels of real
estate, as described in this Paragraph III, shall lapse and said real estate shall be added to and distributed
as part of my residuary estate. I direct that any Pennsylvania inheritance tax and Pennsylvania estate tax
due and payable in connection with the devise of both parcels of real estate, as described in this Paragraph
III, shall be paid by my son, WILLIAM F. SUTPHEN, and if my son shall predecease me, by my
daughter-in-law, KAREN L. SUTPHEN. I further direct that all other death taxes (including, if
applicable, federal estate tax) with respect to the devise of said real estate shall be paid from my residuary
estate as part of the administration of my estate.
IV.
I bequeath to my son, WILLIAM F. SUTPHEN, JR., all shares of common stock of Lawns
Unlimited, Inc., owned by me. In the event that my son, WILLIAM F. SUTPHEN, JR., shall
predecease me, then I bequeath said shares of common stock to my daughter-in-law, KAREN L.
SUTPHEN, provided she shall survive me. Should my daughter-in-law, KAREN L. SUTPHEN,
predecease me, then I direct that this bequest shall lapse and said share shall be added to and distributed as
part of my residuary estate. I direct that any Pennsylvania inheritance tax and Pennsylvania estate tax due
and payable in connection with the bequest of the common stock of Lawn Unlimited, Inc., as described in
this Paragraph IV, shall be paid by my son, WILLIAM F. SUTPHEN, and if my son shall predecease
mc, by my daughter-in-law, KAREN L. SUTPHEN. I further direct that all other death taxes (including,
if applicable, federal estate tax) with respect to the bequest of said shares of common stock shall be paid
from my residuary estate as part of the administration of my estate.
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~ 005359-00011/12.23.02/JRD/LAR/163780.1
V.
I devise and bequeath the residue of my estate of every nature and wherever situate as follows:
A. One-third (1/3) to my daughter, BARBARA LEE BARONOWSKI.
B. One-third (1/3) to my son, WILLIAM F. SUTPHEN, JR.
C. One-third (1/3) to my daughter, DIANA SUTPHEN SHAW. In the event that my
daughter, DIANA SUTPHEN SHAW, shall predecease me, I devise and bequeath her share of the
residuary estate to her husband, PETER D. SHAW, provided he shall survive me. In the event that my
daughter's husband, PETER D. SHAW, shall predecease me, then, in that event, this residuary bequest
shall lapse and my daughter's one-third (1/3) share shall be distributed, in equal shares, to my daughter,
BARBARA LEE BARONOWSKI, and my son, WILLIAM F. SUTPHEN, JR., or his or her then
living issue, per stirpes, as applicable.
VI.
Should any of my issue entitled to a share of my estate shall not attained the age of twenty-five
(25) years at the time of distribution to him or her, I devise and bequeath the share of each such issue to
MID PENN BANK, of Harrisburg, Pennsylvania, IN SEPARATE TRUST, to hold, manage, invest and
reinvest the share or shares so received and the accumulation of income thereon, and to use and apply the
income or principal, or so much thereof as, in Trustee's sole and absolute discretion, may be necessary
and appropriate fr~r such issue's support and education (including trade school and college education, both
graduate and undergraduate) without regard to his or her parent's ability to provide for such support and
educatior. and to ;Hake payments for these purposes, without further responsibility, to such issue or to such
issue's parent or any person taking care of such issue. Any income not so used or applied shall be
accumulated and added to and thereafter treated as part of the principal. After each such issue shall attain
the age of twenty-three (23), Trustee shall distribute to each such issue the net annual income from his or
her separate Trust at least as often as quarter-annually. When such issue shall attain the age of twenty-five
(25), the separate Trust shall terminate and the then-remaining principal, together with any accrued and
undistributed income, shall be distributed to said issue. If said issue shall die prior to the age of twenry-
five (25), the separate Trust for such issue shall terminate and the then-remaining principal, together with
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005359-00011 /12.23.02/) RD/LAR/163780.1
any accumulated and undistributed income, shall be distributed to said deceased issue's personal
representative.
VII.
No interest in income or principal shall be assignable by a beneficiary available to anyone having
a claim against a beneficiary before actual payment to the beneficiary.
VIII.
Except as provided in Paragraph III and Paragraph IV, my Executor shall pay all estate,
inheritance and other death taxes, together with any interest and penalties, which shall be payable with
respect to property or interests subject to taxation by reason of my death and whether passing under my
Will or otherwise. My Executor shall pay the same out of my residuary estate as part the expenses of the
administration of my estate.
IX.
I appoint MID PENN BANK, Executor of this, my last Will. If MID PENN BANK fails to
qualify or cease to act as Executor, I appoint my daughter, DIANA SUTPHEN SHAW, Executrix of
this, my last Will.
X.
I direct that my Corporate Executor shall be entitled to compensation based on its regular
schedule of fees for such services in effect from time to time during the period over which its services are
performed.
XI.
I direct that my Executor, and its successor, shall not be required to post bond for the faithful
performance of its duties in any jurisdiction.
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005359-00011 / 12.23.02/) RD/LAR/163780.1
..
IN WITNESS WHEREOF, I have hereunto set my hand and seal this .~ ?~ day of
..a.,,, , 2002.
~-~ ~~~ ~
NILA J. SU'bPHEN ~ ~ (SEAL
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will
and Testament, in the presence of us, who, at her request, in her presence and in the presence of each
other have hereunto subscribed our names as witnesses.
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005359-00011 / 12.23.02/) RD/LAR/163780.1
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND .
I, NILA J. SUTPHEN, Testatrix, whose name is signed to the foregoing instrument, having been
duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my
Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
~~~~~' ~~
NILA J. SU'~HEN O
Sworn or affirmed to and acknowledged before me, by NILA J. SUTPHEN, the Testatrix, this
_~ day of i~~ mG ~J~f , 2002.
~ ~ ~~~_
Notary Public
Notarial Seal
Lori A. Richard, Notary Pubib
Lemoyne eoro, Cumberland County
MY Comrrrssion F_xpires Nov. 12, 2006
itAerrrber. Perxrsyhrania AssflcieGon !J! fYAterf®r
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005359-00011 /12.23.02/) RD/LAR/163780.1
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AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
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We, N _ ?-'~ N r and ~- ~ / Jc:' ~.~ ,~- '~~r'/~ - ~ the witnesses whose
names are signed to the foregoing instrument, being duly qualified according to law, do depose and say
that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will and
Testament; that she signed willingly and that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as
witnesses; and that to the best of our knowledge, the Testatrix was at that time at least 18 years of age, of
sound mind and under no constraint or undue influence.
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Sworn or affirmed to and subscribed to before me by _ J iQ n L Mo+~ fGan1 e~
and
, witnesses, this ~~ day of p[f ~ x/" , 2002.
`t~~%~:/LGl/l
Notary Public
Notarial Seal
Lori A. Richard, Notary public
L~Y-~ Boro, Cumberland County
MY Cortxnission Expires Nov. 12.2006
Member. Pennsylvania Association Of Notaries
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RENUNCIATION
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of NILA .l. SUTPHEN
Deceased
I, ALICE, CAMERINI as TRUST OFFICER for MID PENN BANK named Executor
pursuant to Paragraph IX, Last Will and Testament of Nila J. Sutphen, dated December 23, 2002, hereby
renounce the right to administer the Estate of Nila J. Sutphen, Deceased and respectfully request that Letters
Testamentary be issued to DIANA SUTPHEN SHAW, decedent's daughter, the Alternate Executor under
the Will.
WITNESS my hand this
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`~" , ; L Millersburg, PA 17061
Executed in Register's Office
SWORN to and subscribed before me
this day of __, 2012
Deputy for Register of Wills
Executed out of Register's Office
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF DAUPHIN:
Before the undersigned personally appeared the
party executing this Renunciation and certified
that he/she executed the Renunciation for the
purposes stated within on this ~ ~ day of
~~, 2012.
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Notary Public ----
My Commission Expires:
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Susan M. Novinger, Notary Public
Millersburg Boro, Dauphin County
My Commission Expires Aug. 28, 2012
Member, Pennsyivania Association of Notaries