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HomeMy WebLinkAbout03-22-12IN THE COURT OF COMMON PLEASOF CUMBERLAND COUNTY, PENNSYLVANIA ~` REGISTER OF WI LLS PETITION FOR PROBATE AND GRANT OF LETTERS Estate of Lois F. Glennon a/k/a: ~ oaa~sad ESTATE NO: 21- /~ ~ (~~ £j a/k/a: tea' 130-32-5984 SS NO: Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as applicable: ~A. Probateand Grant of Letters Testamentary orpAdministration c.t.a., or d.b.n.c.t.a. and aver that Petitioner(s) is/are entitled to the aforementioned Letters Testamentary (~-~IeiiePart Ca/sn) the last Will of the above-named Decedent, dated May 4 , 2 0 0 5 under and codicil(s) dated June 10 , 2 0 0 9 . -__ _- (State relevant circumstances, e.g. renunciation, death of executor, etc.) xcept as ollows, Decedent did not m instruments offered for probate; was not the vicrim ofla killing~wast ne ~er adjudicated an incapa rtated person Band was n e party to a pending divorce proceeding at thetimeof death wherein groundsfor divorce had been established asdef ned in 23 Pa. C.S~A. §3323(9); N /A ^ B. Grant of Lettersof Administration (IfapplicatN~ enter db.n., pendent iite, durartteabs~ttia, durarrteminoritate) C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived b 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 divoroa proceeding wherein groundsfor divoroehad been established asprovided in 23 Pa. C.S.A. 3323 § ~g), except as follows: Name - uonsti tpfle~ ~, = C'7 sM~ - ~ _ ~ _~= ._ ~ ~ ~ - fV -, C~ -~~ '-r-, ~- r .,d. ~ ,~ _-` r-r-r THISSECTION MUST BE COMPLETED: rv `~" C7 Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her las anvil ~ -r^, At 223 Touchstone Drive, Carlisle, ~,~ 1v~~~r~ Cumberland County, ncipal residence (street address with Post Office and Zip Code, Municipality: Township, Borough, City) Decedent, then 70 years of age, died March 18, 2012 at Hershey, PA Estimated value of decedent's roe (Month, Day, Year of death) (City and State where death occurred) _If domiciled in PA p p m' at death: If nat domiciled in PA Al] personal property ~ 5 0 0 0 . 0 0 Personal roe ' _If not domiciled in PA P P riy in Pennsylvania $ _Va1ue of Real Estate in Pennsylvania Personal properly in County $ Total Estimated Value $ ~ Location of Real Estate in Pennsylvania: (Provide full address ifpossible.) 22 3 Touchstone Drive n ~ n n n • ~ p n a,..,.,...-~_, _ Carlisle, PA 17015 Namejs) & MailingAddress(es) Leah Glennon 60 South Chestnut Street Form RW-02 revised ]2.2(.10 by Cumberland County pendine actin., n„ ,ho New Pa 1 t z New York 1 2 5 61 Page I of OATH OF PERSONAL REPRESENTATIVE Commonwealth of Pennsylvania ~ SS County of Cumberland The Petitioner(s) herein named swear or affirm 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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed n ~ ~.. before me this `~~ day of ah Glen on For the Register r:~ ~'s `> ~? -~~ ~, DECREE OF PROBATE AND GRANT OF LETTER ~-~ Estate of Lois F. Glennon r;a Deceased File Number: 21-~,;~ __-___ G. 3 ~ i ~~ „ ~--, _.; _- _ _: :T ~.~> _~ AND NOW, this day ofMarch, 2012 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters X Testamentary - of Administration are hereby granted to: (If applicablg enter at.a., d.b.n., d.b.n.at.a, eta) Leah Glennon >=ne anove estate ana that mstruments(s) datedMay 4, 2005 & June 1 O,described in the petition be admitted to probate and filed of record as the last Will and Codicil(s) of Decedent. Glenda Farner Strasbaugh, ,~ =' r ,' ;~2/'~,,~~1;' Register of Wills ~.` FEES: Letters ................... 1 .$ , ~). ~~ Will ...................... .. l ~-~' .~ Codicil(s) ................. '> ; Z ((.,F) Short Certificates ( )Renunciations.... ... Bond ........................... . Other ........................... . .............................. ... Automation FEE......... 5.00 JCS FEE .................. . 23.50 ToTAL ................ $ ,3 a. >n Signature d Counsel Required to Enter App~ranoe Atty's Signature PRINTED Name: Anthony L. DeLuca, Esq. Supreme Court ID No.: 1 8 0 6 7 Address: 1 1 3 Front St. , P.O. Box Boiling Springs, PA 17b0 Phone: 717-258-6844 Fax: - - Interim Fonn [2W-02 revised 12.26.10 by Cumberland County pending action by the Court raga 2 of 2 ~AI~f~IG.~~~t,~ ~iilegal to dupfic~~~ t~9s cz~pY b~+ phc~trrs~at ar ~ar«.=,~' ~ - .. :~ ~;:~R 22 ~.f 2• ( ;,, 1, ' ~, (,rJ J G; ,~, I CLERK pF ~~~ ``' `- . l.. ORPHANIS G`0k1R~ ~ ~' ~ ~ of t (t 1. ~ , ~;~ , ~ ,. v, ,.~. ,., [..:~~_~. ~' 201 __ __ C~,~.t-tu~5n.tt \~rJ3nr)c=; Type/Print In COMMONWEALTH OF PEN NSV LVANiA _ DEPARTMENT OF HEALTH ~ VITAL RECORDS Permanent - ~_ o G -- v Cry s 1"t State File Number 1. Decedent's Legal Nam¢ (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4- Dat¢ of Death (MO/Day/Vr) (Spell Mo Lois F_ Glennon emale 130-32-5984 ) sa. A y ( March 18 , 2012 ge-Last Birthda Yrs) Sb. Under 1 Year Sc. Under 1 Da 6- pate of Birth (MO/Oay/Yea r) (Spell Month) 7a. Birth plac¢ (City and State or Foreign Country) 70 Months Days Hours Minutes March 25 , 1941 BrOOIGl NY Sa. Residence (State or Forei Count 7b. Birthplace (County) ):C1n 8 PA Bn ry) 8b. Residence (Street and Number -Include Apt No-) Sc. Did Decedent Live In a Township2 - 223 Touchstone Drive Yes, decedent Ilved in South Middleton gd. Residence (County) ~ twp Cumberland Be. Residence (Zip Code) 17015 ~ No, decedent lived within limits of 9. Ever in US Armed Forces? 10. Marital Status at Time of Death 0 Married Widowed 11. SurvWin 5 city/born. Yes ~ No Q Unknown ~ Divorced ~ Never Married ~ Unknow H Pouse's Name (If wife, give name prior To first marriage) 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior tp First Marria Archibald Mooney ge (First, Middle, Last) Florence Malenbroch 14a- Informant's Name 146. Relat(onshi to Decedent 14c. Informant's Mailing Address (STre¢[ and Number, City, State, Zip Code? Leah Glennon p step-daughter 60 S. Chesnut St_, New Paltz, ........................°.---°•.-----.....---. 1 P a s ...---.... ...... ..-----••-°-..... te ace o Deat C ne ec on )r o yyr ......................... If Death Occurred in a Hospital: In -' ---•••-----•~•..... •----- IA1 ....Patient .............................. cif Death O .. g ccurred Somewhere Other Than aHospital: -~--"-"------•"-"•- l~ Hos Pice Facility .w .....•...•••...•••. •• Q Emergency Room/Outpatient Q Dead on Arrival LJ Decedent' H ~• - s omc 0 Nursing Home/LOn Term Care Facility Other 5 ( pacify) 156. Facility Name (If not Institution, give street and number; SS C. Cit M.S. Hershe Medical Center Yor Town, State, and Zip Code l6d-County fDeath Hershe P 17 a. 033 Dau hin 16a. Method of pisposition W Burial ~ Cremation 16b p t m . a e of Disposltlon 16c. Plac¢ of Disposition (Name of ceme[e ~ Removal from State Q ponatlon r¢ n'• c matory, or other place) !~ Other (Specify) Mar 23 / 2012 2ndiantown National Cemetery 16d ~ . Location of Disposltlon (City or Town, State, and Zip) 17a. Sig of Funeral r Person In Char Annville / PA 17003 e ° ge of Interment 176. License Number E 17c- Name and Cpmplefe Address of Funeral Facility 138504 s _ m 18. Decedent's Education -Check the box that best describes the 19. Dece enf of Hispanic Origin -Check th h ' ~ e 20. Decedent ighest degree or level of school completed at the time of death. box that best describes whether th s Race -Check ONE OR MORE races to Indicate what d d e ece ent the decedent considered himself or herself to be. Q 8th grade or less "s Spanish/His a nlc/L ti " " ` p a no. Check the No b ~ No diploma, 9th - 12Th grade b ] White ~ Kor if d ean ox ecedent is not Spanish/Hispanic/Latino. ~ High school graduate or GED completed ~ Black or African American ~ VieTna mere ~ No not S ani h/Hi , p s Some colie spanic/Latino 0 American Indian or Alaska Native ~ Other Asian ~ ge credit, but no degree 0 Ves Mexican Mexi , , can American, Chicano 0 Asian Indian O ~ Associate degree (e-g- AA, q5) Q Ves Puerto Rican Native Hawaiian , Bachelor's degree (e.g. BA, AB, BS) Q V Q Chinese ~ Gua ma C l b es, u n an an or Cha Morro Master's degree (e.g. MA, MS, MEng, MEd, MSW ~ Flliptno ~ Samoan MBA) 0 yes th , , o er Spanish/Hispanic/Latino EdD ~ Japanese Doctorate (e.g PhD or Prof i Q Oth l d . , ess ona er Pacific Islander egree (Specify) . MD, DDS DVM, LLB, ID ~ Other (Specify) 21. Decedent's Single Race Self-Designation -Check ONLY ONE to Indicate what the dec d t e en considered himself or herself to be. 22a. Decedent's Vsual Occupation -Indicate ffi Whit¢ Q Japanese Q Samoan tYPe of work done Burin ~ Black or African American ~ Korean Q Other PaclFlC Islander g most of working life. DO NOT USE RETIRED . 0 American Indian or Alaska Native ~ Vietnamese ~ pon't Know/Not Sure Teacher Asian Indian ~ Other Asian ~ Refused ~ Chinese ~ Native Hawaiian ~ Other 5 22b. Kind of Business/Industry ( Pecify) FIIlpino p Gpamanlan °r champrrp Public School ITEMS 23a - 23d MUST BE COMPLETED 23a- Date Pronounced Dead (MO/Day Vr) 236. Signature of Person Pronou BY PERSON WHO PRONOUNCES OR i n ~ ~ ~/2.Q ~ -~ c ng peach (Only when applicable) 23c. License Number CERTIFIES DEATH 23d- Date Signed (MO/Day/Vr) 24. Time of Death 6 ~ 0 ~ 25 . Was Medical Examiner or Coroner Contacted? ~ Yes ryp CAUSE OF DEATH 26- Part 1. Enter the chain of evens --diseases, Injuries, or com plicaLlons--chat directs Approximate y caused the death DO NOT . s irato enter terminal events such as cardiac arrest. Interval: re p ry arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE Ente l - r on y one cause on a Ilne. Add adtlitlonal lines If necessary Onset to Death IMMEDIATE CAUSE _______________> a, ~~ d ~~~ t7T ~ r ~ r ^l i" I ~ i e.Z~l t c f/s. S,r € (Final disease or condition D ( seq uewee ot). resulting in death) con b. Sequentla lly list contlittons, Due to (or sequence of): if any, leading to the cause as a con listed on line a. Enter the UNDERLYING CAUSE Due to (or sequence of): (disease or Injury that as a con F initiated the events resulting d- in death) LAST. Due to (pr as a consequence of): S 26. Part 11. Enter other signlfica nt diH t ib tl t d th but not resulting in the underlyin cau i • g g se g ven in Part 1 27. Was a auto psy performed? Ves ~ No '° 28. Were autopsy findings available °V' co 29. If Female: to plate the cause of tleath7 E O Yes ~ No ~ Not pregnant within past year 30. Did Tobacco Use Contribute to Death? 31 Man ner of Death o / ~ Pregnant at time of death ~Qp Yes 0 Probably A Natural ~ Homicide NO ~ Unkn m own ~ Not pregnant, but pregnant within 42 da 1~ Vs of death O Accident 0 Pendln g lnvesti gation ~ ' o ~ Nat pregnant, but Suicide pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Vr) (Spell Month) ~ ~ Could t be determined Q U k n nown if pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g, home; construction site; farm; school) 35 . Location of Injury (Street and Number, CI ty, State, Zip Code) 36. Injury of Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: ~ Yes ~ privet/Operator ~ Pedestrian ~ No ~ passenger ~ Other (Specify) 39a- Certifier (Check only one): ~ Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manne t d r s ate ~$ Pronou nctng J3< Cert Hying physician - To the best of my knowledge, death occurred at the ti d me, ate, and plac¢ and due fo the cause(s) and manner stated Q Medical Examiner/COro - the basis of examination, and/or investigation in m i i r , y op n on, death o red at the time, date, and place, and due to the c se(s) and m ~.~ r stated ¢ Signature of certifier: Title of certifier: i./ License Number:~~[ ~(~ y f ¢ M 39b. Name,.Address d Zip Code of Person Completing Cayffq.o e ~ ~6 ~ J t-I r fl K .- IvV ~I J f'i r fl 39c. pate Signed (MO/Day/Vr) ;/ Medical Center, Hershey Pa 17033 , . 40. Registrar's DistrlcT Number 41- Registrar's 5 re , Z~ Z~ 42- Registrar File Date (Mp Day -~\b 43. Amendments L ~~ Disposition Permit No. lJ `L~-J ~ `flex./ H105-143 REV 07/2011 LAST WILL AND TESTAMENT ~...~ OF ~? .~-~; ?~-~ o . , LOIS F. GLENNON ~ ~ ~ -~. _ D f'~l ~J ~_~ f'•,) r ~ ~ ,'i'•~. "Cn l?C '~ LOIS F. GLENNON, a resident of Gardners, Cumberland County, I J - ~.~ ~' `:~.~ _,,~ c , , .t. Pennsylvania being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ITEM 1: I direct that all my just debts, the expenses of my last illness and funeral expenses be paid as soon after my decease as the same can conveniently be done. ITEM 2: I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the government of the United States, or any state or territory thereof, or by any foreign government or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governments, whether the property passes under this Will or otherwise, excluding, however, any property over which I have a taxable power of appointment, provided, however, that no residuary beneficiary shall by reason of this provision be denied the benefit of any deduction, credit, favorable rate of tax or other benefit which by law enures to such beneficiary. ITEM 3: To the individuals listed below, I bequeath the following: LOIS F. GLENNON LAST WILL AND TESTAMENT OF LOIS F. GLENNON a. To LOIS CARTER, currently of Baltimore, Maryland, if she shall survive me, the sum of Ten Thousand Dollars ($10,000.00); and b. To DECOKES GLENN-LEWIS, currently of Tucson, Arizona, if she shall survive me, the sum of Ten Thousand Dollars ($10,000.00). ITEM 4: I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever kind and nature, and wheresoever situate at the time of my death, in equal shares, unto my step daughters, IVY GLENNON, LEAH GLENNON, HOPE GLENNON, KIM ROBERTS, and CAITLIN CARROLL, provided however, that they survive me and are living sixty (60) days after the date of my death. ITEM 5: If and in the event that a step daughter of mine does not survive me and is not living sixty (60) days after the date of my death, then and in such event, I give, devise and bequeath the interest in my estate, which such deceased step daughter would have received, if living, to the issue of said deceased step daughter, per stirpes. ITEM 6: I hereby nominate, constitute and appoint my step daughter, LEAH GLENNON, Executrix of this my Last Will and Testament, with full power to do any and all things necessary for the complete administration of my estate, and direct that no bond ~~~ LOIS F. GLENNON 2 LAST WILL AND TESTAMENT OF LOIS F. GLENNON or other surety is required of her in this or any other jurisdiction for her performance of this office. If and in the event that my step daughter, LEAH GLENNON, does not survive me and is not living sixty (60) days after the date of my death, or does not complete her duties as Executrix, then and in such event, I hereby nominate, constitute and appoint JAMES GLEASON, the husband of LEAH GLENNON, Executor of this my Last Will and Testament, with full power to do any and all things necessary for the complete administration of my estate, and direct that no bond or other surety is required of him in this or any other jurisdiction for his performance of this office. ITEM 7: If any provision of this Will or of any Codicil hereto is held to be inoperative, invalid or illegal, it is my intention that all the remaining provisions thereof shall continue to be fully operative and effective, so far as is possible and reasonable. IN WITNESS WHEREOF, I, LOIS F. GLENNON, the Testatrix, have to this my Last Will and Testament, typewritten on four (4) consecutively numbered pages, subscribed my name and affixed my seal this ~~~day of May, 2005. ~~-~ ~~ ~~ ~ ~/1~u+~n__ SEAL) LOTS F. GLENNON 3 LAST WILL AND TESTAMENT OF LOIS F. GLENNON Signed, sealed, published and declared by the above named LOIS F. GLENNON, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and of each other. ~~ ~ ~ '~ `~ r iding at ~ ~.~ lQ ~/"~~~p- l/~3 ~ ~~~ ~~:~ `~w~ '' residing at ~ ' ~ / l ~~ ~~ 4 OATH OF StiBSCRIBI~v~G ~VI'I'NESS(ESj c~ - __ . ~.. o ~ ~ r, ; a; REGISTER OF WILLS ~~ , /~-/ / ~'-/?/~_1~ COUNTY, PENNSYLVANL~ ,r~ ~ rrT, r,, -= cr 7 ? h-1 ''c~C' ~~~~-., -"7 _. --i C`J . -. .. ,~.t..~ Estate of ___ C-~'~ / j" ~,- ~.- ~,~: ~,~~ ~ ~ Deceased ~ ~" (each) a subscribing witness to (Print Name/sJ t the fgWill ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they signed the same and that she / he /they signed as a witness at the request of the Testator /Testatrix in her /his presence and in the presence of each other. ~, r _-~,~. r (Signature) ~ -Y' (Street Address) r.-l .- c :.ic ' ~~11~~ (City, State, ZipJ f Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ ~"~ day -~~ of '~ (~ ~~, ~ ~~ ~ ',_ Deputy for Register of ~~"il's ~.~ (Signature) (Street Address) (City, State, Zip) Executed occt of Register's Office Sworn to or affirmed and subscribed before me this day of Nota;-}' Public ?~1~ Com~ri:~ior. Ex: ~-es: (C;pna:ure znd Sea' o` Ne;ary ~~ other of5ci-' . _zi::~e; ~_ administer oaths. Show date o;`e~:pirauon o; ::-~;ary's ~ammissioc NOTE: To be taken by Officer authorized to administer oaths. Please have present ;he original or copy of instrument(s) at time of notarization. Form kW-03 rev. 10.13.06 OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of Lois F. Glennon . ~© a ~ ~ _ -~7 ~ T ~ 2 Z n ._. ~. a;.., ~J - _ ~ __ J ~.J ~ ~ ,. ,_, -- ~_ __ ~ .. L-- _ :'T .~ Tl ,Deceased a, Esq. & Marjorie A. DeLuca (each) a subscribing witness to (Print Names) the ~l Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that /they ~Xr~/ were present and saw the above '~ /Testatrix sign the same and that b /they the €~~k /Testatrix (Signature) !f ,~ (Street Address) (City, State, Zip) signed -the same and that in her /his Executed in Register's Office Sworn to or affirmed and subscribed before me this of day Deputy for Register of Wills ~IX~!?4~ /they signed as a witness at the request of and in the presence of each other. 7~~L 2t'.i - C- C = ...C ~~'~ `~ (Signature) 113 Front Street (Street Address) Boiling Springs, PA 17007 ~~ Executed out of Register's Office Sworn to or affirmed and subscribed before me this ~~ day of t'Y1~r-~~ ~Lol<3. ~+~~ ~z~~<~k~: otary Public ~ My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. (City, State, Zip) ~~~i ~3~ g ~'~ ~• >a 33Q~ ~~~ ~~~~ ~~~~ ~~ Fornt RW-03 rev. l0. /3.06 FIRST CODICIL TO LAST WILL AND TESTAMENT OF LOIS F. GLENNON DATED MAY 4 2005 I, LOIS F. GLENNON, widow, of South Middleton Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do make, publish and declare this as and for a First Codicil to my Last Will and Testament, dated May 4, 2005, to be in addition to and supplemental to the provisions contained in said will. 1. To the below-listed organizations, I give and bequeath as follows: a. To the Second Presbyterian Church, Carlisle, Pennsylvania, the sum of $18,000.00; b. To the Smile Train, 44 Madison Avenue, 28`h Floor, New York, New York 10010, the sum of $2,000.00; c. To World Vision, , P. O. Box 70399, Tacoma, Washington 98481, the sum of $5,000.00; d. To Sunshine Acres, 165 Sportsman Road, Napanoch, New York 12458, the sum of $5,000.00; e. To TEAM, P.O. Box 969, Wheaton, IL 60187, the sum of $5,000.00. Except as herein provided, I ratify and confirm the provisions set forth in my said Last Will and Testament dated May 4, 2005. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this First Codicil to my said Will dated May 4, 2005, on this the 10"' day of June, 2009. ~.. ~,S .- ~~%~~ ~.t-~ (SEAL) LOIS F. GLENNON Signed, sealed, published, and declared by LOIS F. GLENNON the Testator above named, as and for his Last Will and Testament, in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. 5 ~ Q~~11 C; ~J\ ~v ~ ~. - u. ~ - ~,,,, ~ _ ~._ C =-- ~~ r ,~ -- - i:' U c ~ . IBS ~0.. ~ `~-~.~J ttis ~..c..t ~ ~ ~- C.~ ~ t_ _ L7 OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA Estate of LOIS F. GLENNON Robert G. Frey and Trisha A. Liess (each) a subsribing witness to Deceased the ~~ Will ~ ]Codicil presented herewith, (each) being duly qualified according to law, depose(s) a say(s) that she / he /they was /were present and saw the above Testator / Tesatrix sign the same and that she / he /they signed as a witness at the request of the estator /Testatrix in her /his presence and in the nce ach other. 7 Ro art G. Frey ~~~ M~i~~ Trisha A. Liess r~"`~ S South Hanover Street S South Hanover Street Carlisle, PA 17013 Executed in Register's Office Sworn to or affirmed and subscribed before me this day of , 20 Deputy for Register of Wills Carlisle, PA 17013 Executed out of Register's Office -- -.--.~., ... ~u,o, vlucal quallttef administer oaths. Show date of expiration of Notary's NOTE: To be taken by Officer authorized to administer oaths. Please have present the o g nal orocopy of instrument(s) at time of notarization. t;i._ r ; __ : ` ~ NOTARIAL SEAL ~ - _ ~ '° r SUSAN R, HENRY NOTARY ' L w , PUBLIC Carlisle Borough C~bsrl ~ - ; = , end County My Commission Explrss Deco mbar 15 20 ~. , 13 ' CJ ~ ;~=- ,_ C_; Sworn to or affirmed and su~iscribed before me this 2 '` day of r...r C , 20 '