HomeMy WebLinkAbout06-05-12IN THE COURT OF COMMON PLEASOF CUMBERLAND COUNTY, PENNSYLVANIA
REGISTER OF WILLS
PETITION FOR PROBATE AND GRANT OF LETTERS
Estate of
a/k/a:
a/k/a:
a/k/a:
Robert B. Goril
Deaeesad ESTATE NO: 21- ~ ~- ~~a /~~
SS N
Petitioner(s) who is/are 18 yrs of age or older, apply(ies) for: COMPLETE SECTION `A' or `B' AND "C" as
applicable:
®A. Probate and Grant of LettersTestamentary or ^Administration c.t.a., or d.b.n.c.t.a. (QOrnlpllete Part Calsn)
and aver that Petitioner(s) is/are entitled to the aforementioned Letters Testamentary under
the last Will of the above-named Decedent, dated March 6 , 2 0 0 8 and codicil(s) dated
(State relevant circumstances e.g. renunciation, death of executor, etc.) r-.a
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted r executio~f the
instruments offered for probate; was not the victim of a killing, was never adjudicated an incapacitated n, and tpt~s not~t C`~
party to a pending divorce proceeding at thetime of death wher~n groundsfor divorce had been fished ~lef in~4 i~
23 Pa. C.S.A. §3323(8): ~ ,~ `~ .''" r'+''
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^ B. Grant of Lettersof Administration n~ ` ~ -i.~ ~.~
(If applicable; enter d.b.n., pendent life; duranteabsentia, Jura , itate) ~ ~' rn
--~
C. Petitioner(s), after a proper search, has/have ascertained that Decedent left no Will and was survived ~ 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 complet mist of
heirs); was not the victim of a killing; was never adjudicated an incapacitated person; and was not a party to a pending divorce
prooeedingwhereyn groundsfor divoroehad been established asprovided in 23 Pa. C.S.A, §3323(8), except as follows:
Name Address Relationship to Decedent
Rose Ann Goril 30 Moon ale Dr. Carlisle PA Wife
1 701 3
USE ADDITIONAL SHEETSIF NECESSARY
THISSECTION MUST BE COMPLETED:
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence
At 30 Moonaale Drive, Carlisle, PA 1701.3____
(Street address with Post Office and Z,ip Code, Municipality: Township, Borough, City)
Decedent, then 84 years of age, died January 26, 201 at Carlisle, PA
(Month, Day, Year of death) (City and State where death occurred)
Estimated value of decedent's property at death
If domiciled in PA All personal property
If not domiciled in PA Personal property in Pennsylvania
_If not domiciled in PA Personal property in County
-Value of Real Estate in Pennsylvania
Total Estimated Value
Location of Real Estate in Pennsylvania: (Provide full address if possible.)
Signature(s)
10,000.00
Name(s) & MailingAddrese~es)
30 Moongale Dr., Carlisle, PA 17013
Interim Form RW-02 revised 12.2(.10 by Cumberland County pending action by the Court Pale I of 2
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OATH OF PERSONAL REPRESENTATIVE
,u
~ ~ ~
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Commonwealth of Pennsylvania ~ SS ~ r ~
County of Cumberland ~ri==- ~ ~_~'~ ~
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The Petitioner(s) herein named swear or affirm that the statements in the foregoing P~(tion are true and ~
correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representati~s) of the
Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
-th
before me this ~ day of
June /"~. 2 01 2
1
~ ;j
~, ~~
Rose Ann Goril
the Register
DECREE OF PROBATE AND GRANT OF LETTERS
Estate of Robert B. Goril
Deceased File Number: 21-~~ _-~~
AND NOW, this ~~ day of J„n ~_ 2012 , in consideration of the Petition on
the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters
_~Testamentary _ of Administration are hereby granted to:
(If applicable enter ct.a., d.b.n., d.b.n.ct.a., etc)
Rose Ann Goril in
the above estate and that instruments(s) dated March 6 , 2 0 0 8 described in the petition be
admitted to probate and filed of record as the last Will and Codicil(s) of Decedent.
Glenda Farner Stras
Register of Wills
FEES:
D t'
Letters ................. $ ~-
Will ........................ G~
C icil(s) .................
(-Short Certificates
( )Renunciations.......
Bond ............................
Other .............................
Slgnatureof Counsel Required to Enter Appearance
Atty's Signature
~X
PRINTED Name: Anthony L. DeLuca, Esq
Supreme Court ID No.: 1 8 0 6 7
Address: 113 Front St.
Automation FEE......... 5.00
JCS FEE ................... 23.50 Phone
~.~~ Fax:
TOTAL ................$ ~ ~-:~...
P.O. Box 358
Boiling Springs, PA 170 7
717-258-6844
Interim Fonn RW-02 revised 12.26.10 by Cumberland County pending action by the Court Page 2 of 2
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LAST WILL AND TESTAMENT r~~-=' ~ G~ _.,~
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OF ~~~~
t7 rj - ~ >;" c;
ROBERT B. GORIL ~" w ~ ~ i
~ ~~
I, ROBERT B. GORIL, a resident of Carlisle, Cumberland County, 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 dzcease as the same can conveniently be done,
ITEM 2: I direct that there shall be paid out of my residuary estate all estate,
irdleritance and like taxes together with any interest or penalty thereon imposed by the
govermment 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: I give, devise and bequeath all of the rest, residue and remainder of my
estate, real, personal and mixed, oi` whatsoever kind and nature, and wheresoever situate
..,
ROBERT B. GORIL
LAST WILL AND TESTAMENT
OF
ROBERT B. GORIL
at the time of my death, unto my wife, ROSE ANN GORIL, provided, however, that she
survives me and is living sixty (60) days after the date of my death.
ITEM 4: If and in the event that my wife, ROSE ANN GORIL, 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 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 children, CHRISTINE A. LASKIN and ROBERT
T. GORIL, 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 child 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 child would have received, if
living, to the issue of said deceased child, per stirpes.
If and in the event that any issue of a said deceased child is a minor at the time of
my death, then, and in such event, I direct that any share of my residuary estate
bequeathed to said minor issue of my deceased child be placed in a restricted savings
account or Certificate of Deposit at Members 1st Federal Credit Union until said minor
ROBERT B. GORIL
2
LAST WILL AND TESTAMENT
OF
ROBERT B. GORIL
child attains the age of twenty-five (25) at which time the proceeds shall be disbursed to
said grandchild. All interest earned until age twenty-five (25) shall be added to the
principal. Invasion of the principal shall only be permitted to maintain such child in the
proper station in life, including proper support, maintenance, medical. care and college or
higher education, including vocational school.
ITEM 6: I hereby nominate, constitute and appoint my wife, ROSE ANN
GORIL, 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 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 wife, ROSE ANN GORIL, 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 my children,
CHRISTII~rF, A. LASKIN and ROBERT T. GORIL, Co-Executors 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 them in
this or any other jurisdiction for their performance of this office.
_,
ROBERT B. GORIL
3
LAST WILL AND TESTAMENT
OF
ROBERT B. GORIL
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, ROBERT B. GORIL, the Testator, have to this my
Last Will and Testament, typewritten on four (4) consecutively numbered pages,
subscribed my name and affixed my seal thi~~~ day of ~L1~~' ~=-~ o , 2008.
~- -~
ROBERT B. GORIL
Signed, sealed, published and declared by the above named ROBERT B. GORIL, as and
for his Last Will and Testament, in the presence of us, who have hereunto subscribed our
names at his request, as witnesses hereto, in the presence of the said Testator, and of
each other.
M _w 1
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This is to cer-tify~tha~ t~is is a tru~copy of the record which is on file in the Pennsylvania Department of Health, in accordance with
the Vital Statistics Lpa~w of 1953, as amended.
~~~I?:,~~,`~'llegal to duplicate this copy by photostat or photograph.
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Marina O'Reilly Matthew
State Registrar
FEB232012
No.
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` Type/Print In
7
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Date
COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
CF RTI FI C'ATF [lF 1']FATH
1. Decedent's Legal ame (First, Middle, Last, Suffix) 2. Sex 3. Social Security Nu mber~ 4. Date of Death (MO/Day/V r) (Spell Mo)
Robert B_ Goril January 26, 2012
6a. Age-Last Birthday (Yrs) 56. Under 1 Year Sc. Under 1 Oa 6. Date of Birth (MO/Day/Near) (Spell Month) 7a. Birthplace (City and State or Foreign Country)
~! 84 Months Davs Hgnrs Minptes A
ril 3
1927
p
, ]b. Birthplace (copnty)
8a. Residence (State or Foreign country) gb. Residence (Street d Number - Inclu•!e Apt No.) gc. Did Decedent Liv a To nship?
l
PA 30 Moongale Drive ln N _ Middleton y,p
(gyes, decedent uyed
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Btl. Residence Cou nt
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C~ber
anv Se- Residence (Zip Code) 1713 ~ No, decedent lived within limits of city/born.
9. Ever in US Armed Forces] 1D. Marital Status at Time of Death [Married Q Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage)
Ves Q No (] Unknown Q Divorced (] Never Married ~ Unknow Rolla Gri££in
other's Name (First, Middle, Last. Suffix)
12 13. Mother's Name Prior [o First Marriage (First, Middle, Last)
Robert A _ Gori1 Anna Pawlah
14a. Informant's Name 19b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Cgtlej
0
Rose Goril wife
30 Moongale Dr_, Carlisle, PA 17013
............................................................... ........_ P ace o Deat c ¢
qn y qne)
...._..1sa.-....__............
.
_
awe
If Death Occurred in a Hospitals Q Inpatient ____________ _ _ _ _ _
_______ _ _ _
-
.
._
If Death Occurred Somewhere Other Than a Hos 1 ~~~ ~~ ~~~~~~ ~ ~~~ ~~ ~~~ ~~ ~~ ~~
pita Hospice Facility ~ Decedent's Home
° Q Emergency Room/OUtpatlent Q Dead on Arrival _ Y~X}[--''
~ry.lursing Home/Long-Term Care Facility Other (Specify)
16b- Facll icy Name (If not' t Lion, give ;tre d ber;
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~aHOm 16c. City r,Tq State d 15d. f p h
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S6a. Method of Disposition 0 Burial ~ Cremation 16b. Dat of Olsposltlon
~ 16c. Place of Disposition eName of cemet matory, or other place)
~
m p Removal from State p Dgnano^ Jan _
30. 201 Ho££man-Rota Funera~
Home & Crematory
- Other (Specify)
16d. Location of Disposition (City or Town, State, and Zip) 1]a. Si of Funeral Service LI or Person in Charge of Interment 17b. License Number
Carlisle PA 17013 - 013144E
E 1]c. Name and Complete Address of Funeral Fa ell ity '
3 Ho££man-Roth Funeral Home & Crematory, 219 North Hanover Street, Carlisle, PA 17013
m 18. Decedent's Education - Chegk [he box that best describes [he 19. Decedent of Hispanic Origin -Check the 2D. Decedent's Race -Check ONE OR MORE r o indicate what
t
~- highest degree or level of school completed at the time of death. bo chat best describes whether the decedent the decedent considered himself or herself to be.
Bth gratle or less s Spanish/Hispanic/Latino. Check the "NO" ~ White 0 Korean
~ No diploma, 9th - 12th grade box if decedent is no( Spanish/Hispanic/Latino. Q Black or African American 0 Vietnamese
~ High school graduate or GED completed No, n t Spanish/Hispanic/Latino ~ American Indian or Alaska Native 0 Other Asian
~ So ollege c edit, bu o degree Yes, Mexican, Mexican American, Chicano ~ Asian Indian ~ Native Hawaiian
Q A e tlegre¢ (e.g. AA, AS)
l ~ Yes, Puerto Rican ~ Chinese Q Guamanian or Chamorrq
~ Bache
lor's degree (e.g. BA, AB, BS) 0 Ves, Cuban p Filipino ~ Samoan
~] Master s degree (e.g. MA, MS, MEng, MEd, MSW, MBA) (] Ves, other Spanish/H lspa rile/Latino Q Japanese
~ Other Pacific Isla ntler
0 Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) ~ Other (Sped Fy)
. MD DOS, OVM, LLB, JD)
21. Decedent's Single Race Self-Designation -Check ONLY ONE io indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work
White Q Japanese ~ Samoan done during m st of working life. DO NOT USE RETIRED.
p
Black or African American 0 Korean O Other Pacific Islantler Administrotor
Q American Indian or Alaska Native ~ Vietnamese Q Don'Y Know/NOS Sure
Asian Indian ~ Other Asian O Refused 22b. Kind of Business/Industry
0 Chinese 0 Native Hawaiian 0 Other (Specify)
p Fuipinn p Guamaniangrchamgrrq Mental Health Clinic
ITEMS 23a - 23d MUST BE COMPLETED
CERTIF E$ DEATH PRONOUNCES OR 23a. Date Pronounced Dead (MO/Day/Vr)
~Qh UQ~"~ a(a r °~U/ ~ 2~ Si na'
~n Pronouncm~p ath (Only when aPPlicablel
~ ~
~ / 23c. License Number
23d. Daf Signetl (MO/Day/Yr)
4. Time of Death
_ ~
~
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9
~/ X /'YJ.~{ -e. Q~~x 25. Was Medical Examin er or Coroner Conta Red? Q Yes No
CAUSE OF DEATH
Approximate
26. Part L Enter the chain of a nts--diseases, injuries, o mplications- that directly c etl the death. DO NOT enter terminal a uch a ardiac a esc Interval:
r
respiratory arrest, or ventricular fi brillahon hour showing the a olggy. DO NOT
wit ti '
ABBREVI Enter only one cause on a line Atld additional lines
if necessary Onset [o Death
1
IMMEDIATE CAUSE ---------> a. ~c]OS ~~~-'~ \~lc~.. t ~~~~'^~-
(F al d ndi[ion p o (o consequence of):
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resul<in
g In tleath)
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Sequentially list contlitlons,
Due <o (or as a consequence of):
if any, leading to the cause A ~ ~ ~ ~<-`
listed on line a. Enter the 1 - ~.'L_ ~ ~ ~ a ~C
C
U NOERLVING CAUSE
i ^ Due to (or as a consequence qf):
(tlis eor 'njury
ha
_ =
i~~ .F ~_ ~~ ~ L/.~Gr(L
"Led the eve s resulting d. \\
l
~n
d¢ath) LAST. Due to (o as a consequence pf):
S 26. Partll. Enter other sienifica nt conditions c ributing to leach but not resulting in the underlying cause given in Part I 27. w topsy performed]
as
~ O Ves No
psy findings available
r
to
mple[e the cause of death?
<q
g 0 v p N o
29. If Female: 30. Did Tobacco Use Contribute to Death/ 31. Manner of Death
~ ~ Not pregnant within pas[ year ~ Ye ~ Probably ~ Natural 0 Hom tide
' (] Pregnant at time of death ~ ~ Unknown ~ Accident Q Pending Investigation
~ 0 No[ pregnant, but pregnant within 42 days of death Q Suicide 0 Could not be deferm fined
(] No[ pregnant, but pregnant 43 days to 1 year before death 32. Daf¢ of Injury (MO/Day/Vr) (Spelt Month)
0 Unknown if pregnant within the past year 33. Time of Injury
34. Place of Injury (e.g. home; co nstructlon site; farm; school) 35. Location of Injury (Street and Number, CICy, Scat, Zip Code)
36. Injury at Work 37. If Transportation Injury, Specify: 3S. Describe How Injury Occurred:
~ Yes ~ Driver/Operator 0 P¢tles[rian
I ~ No ~ Passenger 0 Other (Specify)
39a. C¢ 'r (Check only ono-•):
e rtifying physician - To the best of my knowledge, death occurred due to the cause(s) and manners ted
(] Pronouncing Sa Certifying pphysician - To the best of my knowledge, death occurred at the tune, date, and place, and due to the cause(s) and manner stated
~
f
Medical Examiner/ ~o~e
-- On the ba f e urination, and/or Investigation, in my opinion, death occurred at the Cline, date, and place, and due to She cause(s) and m er ed
/ s~~x~_
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y
Signature of certifier: (7' ~ f/
TiTle of certifier:
License Number: V~ , J~ ~~ ~ ~~
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39b. Name, Address rid Zi de of Perso Compl g Cause f Death ( 26) n
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_ 39c. D e Signe (MO/Day/Yr)
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40. Registrar's District Number 41. Registrar's
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re _ 42. Registrar File Date (MO Day yr)
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43. Amendments
Disposition Permit No. C~ C ~ l lL~ ~ H105-143
REV 0]/2011
OATH OF SUBSCRIBING WITNESS(ES)
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
Estate of Robert B
Deceased
Anthony L. DeLuca, Esquire , (each) a subscribing witness to
(Print Names)
the ~ Will ~ 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.
(Street Address)
., / ,
~'Gz-zF c-c ~ CfCI /
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this ',~ `t /~ day
of ~ -1~~-.- __,
~~~~
for Register of Wills
(Signature)
(Street Address)
(City, State, Zip)
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this
day
of ,
Notary 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.
.,
X ~t
y
(Signature) /
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.7 CJt .x i C..s
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Form RW-03 rev. 10.13.06
~~
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OATH OF SUBSCRIBING WITNESS(ES) c
-~~ `-~'
REGISTER OF WILLS C3~ -
CUMBERLAND COUNTY, PENNSYLVANIA ~~~' ~"~ ~,~ r~
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Estate of Robert B. Goril ,Deceased
Mari orie A. DeLuca , (each) a subscribing witness to
(Print Names)
the ~ Will ~ 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.
L/~ l ~~+J~~ l_2. _ ~ ~ ~C. L. C G~
(Signature)
(Street Address)
(City, State, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this
of
day
(Signature) / /
~~ ~~ t / ~~ ~7-t~ ~.
(Street Address)
(City, State, Zip) ~
Executed out of Register's Office
~~i
~$~
Sworn to or affirmed and subscribed
before me this
of ~~~w~~
,~`'~'
~? c~ /~2
day
y~C~r~--z~ ~ ~ .. ~~,,~~~
Deputy for Register of Wills
I~6tary Public
My Commission Expires: U.3~Z-~Z°i,r-
(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.
~~3Z
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~~=d
33 ?~
~~~
~~~~
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FormRW-03 rev. 10./3.06