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HomeMy WebLinkAbout06-21-12~ .wova 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 ^~ /I ,^,((~~~~ ~~ Name: Mariorie J. Bonner File No: ~ ~ ~d 6lt/ 1~i a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 199-OS-8454 Date of Death: June 8, 2012 Age at death: 93 Decedent was domiciled at death in Cumberland County, penn,5ylvan;a (stare) with his/her last principal residence at ~ O p ~pti I?T4~ ST. Boilin¢ Sntin¢s. South Middleton Two. Cumberland Street address, Post t'NBce and Zip Code City, Towaship or Borough County Decedent died at 1920 Trolley Road West Manchester Twn York PA Street address, Post Offtce and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: N(/hl If domiciled in Pennsylvania .......................... .. All personal property $ ~0. CSZYJ ,ls~ If not domiciled in Pennsylvania ...................... .. Personal property in Pennsylvania $ If not domiciled in Pennsylvania ...................... .. Personal property in County $ Valve ojreal estate in Pennsylvania .................... ..................................... $ TOTAL ESTIMATED VALUE.... $ Real estate in Pennsylvania situated at: ~ O~Q FbU i2TI~ ST..~Oi ~.(1~~ sp~ 1 l1~ , 5 . U. MBi:JE' ~.1~J~1~ (Attach additional sheets, if necessary.) Street address, Post fHftce and Zip ode City, Township or Borough County ® A. Petition for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated August 1, 2001 and Codicil(s) thereto dated State relevant circumstances (eg. renanciadon, deatk of executor, etc) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3 adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. Q 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 N ed, was a nding did nave m or r.. N ~~•~ If Administration, c.tm or db.n.c.ta., enter date of Will in Section A above and comalete list bftheirs. Except as follows: Decedent 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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. Q NO EXCEPTIONS Q EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (ifany) and heirs (attach additional sheets, if necessary): Name FarmRW-oz .ev.lonvaou Page 1 oft Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland To the Register ojWills: Please eater my appearance by my signature below: } } SS: } Petitioner(s) Printed Name Petitioner(s) Printed Address Karen B. Ro an 27 South Seward Street Yor PA 17404 `~`-`~ ~~ ~ r~ The Petitioner(s) above-named swear(s) or affum(s) the statements in the foregoing Petition are tme and correct to the best of the lmowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Dec dent, the Pe ' 'oner(s~ will well and truly administer the estate according to law. Sworn to ffirmed an subscribed before ~/ Date ~ ~/-/~ me this ,~ Date By: Date _ 1 r Date BOND Required: Q YES Q,j N0 FEES: ers .................. ~'f tt ~~ ~/~ (~ .... $~ ~ (t„~ )Short Certificate(s).. .... C(~~ ( )Renunciation(s)..... ... . ( )Codicil(s) ......... ... . ( )Affidavit(s)........ ... . Bond .................... .... Commission .............. ... . Other Automation Fee ............... /~' JCS Fee ..................... TOTAL ..................... $ Attorney Signature: Printed Nsme: Mark A. Mateya Supreme Court ID Number: 78931 Firm Name: Mateya Law Firm Address: 55 W. Church Avenue Carlisle, PA 17013 Phone: 717-241-6500 Fax: 717-241-3099 Email: mam ,mateyalaw.cnm DECREE OF THE REGISTER Estate of Marjorie J. Bortner File No: pG l f ~ ~ ~ l(~ ~~ a/k/a: AND NOW, ~ ~ ~ ~ l{~ , in const to of the fo •egoing Petition, satisfactory proof havin been presented before me, IT IS DECREED tha~tern are hereby granted to r l'CCl f~ , t'~ 4^~~1 the instrument(s) dated _ described in the Petition be ~pp{~~((~~ ;;FG 1~sFF~n;E QF f1LU~J~~1 ~~i `Q'97.~~C in'4he above estate and (if applicable) that probate and filed of record as the ,Will (and Coil(s)) o~'Decedent. ~~ ~ ~~ Form Rw-oz rev. 10/11/2011 Page 2 of 2 H105.805 RCV 19/11) L RAR'S CERTIFICATION OF DEATH I to duplicate this copy by photostat or photograph. " 'Al~C i ~ t;r (, I tJ Fee for this certificate, $6.0~ ~ ~ ~~~ ~ ~ ~~ ~. 4 OFtrPFiAN'S ~UAr P 18 5 717 Rio ~~/ ~; Certification Number f7 TYp•/PNm In Psrril•MM SI a ~~~~ This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registraz. The original certificate will be forwarded to the State Vital RecQords Office for permanent filing. --P~ni,~.t..QG~e,~.~, Cpl e2 ~~L Local Regllstrar Date Issued COMMONWEALTH OF PENNSYLVANIA. DEPARTMEM OF NGLTH ~ VITAL RECORDS CERTIFICATE OF DEATH { FII N 1 . D•c•tl•nt't Wal Nam• FIrt4 MI •, tAt4 SYRiY) 3. SN f. • S•curky umwr 4. N Ott IMO dV r SN Me) Ju 1'lar~orla J. Bortnar Female 199-OS-8454 S pI9 yynn a. A9•-LaKSrthday rra s c. Undarl 6. •h Slrth M Day ear SN MO ) 7R. ~bi n~dCO N Y ~~Q1 GWKry a Co lt OO Mp1tM Day. HOUr. Mlnuf•F 1 93 January 19 F 1919 Tb. 9lrthplata (Cwnry) ( t• N For•yn Cwrary Sb. Ns Nc• r•K and Numtier - InCUd• Apt Ne. N. D•eatlaK lWa In • MIpT Fan 1Ve a 1920 TSOl IOY Road tEIYN, d•otdark uwaln m.er *+~...-f+~a r~~ ~n..~ twP. d. Msltlans• NY YOTY N. R•sWI1N (Zip Code) DNO, decedent IWed wkhin IImM o/ cltY/born. 9 . Ewr In US Armed Lorpti 30. M9rital itatVf K Tlma o• MarcWd OWa Si. Su1MW na SpeYt•'{ Nam• IN . Shea Ilam• prbr tp 1st ma aq ~Yaf ~ Ne QUnknown Q Dlvorc•d O Nw•r M\rrl•d ~Unknewn 12. FKM •Nam• Rlrf4 •, f4 19. Meth•F• WIr1• Mor to ktt •p (FIn14 MI I•, Lart) Arehur K. Bvitsar 14a. In r111•M F Nam• 14 . R•IKIeNhlp to ant 14c. InlxmanYS MaOlns r9ta (Str•N antl Numb9r, GhY. Stara, 21p Code 14ran B. Ro sn Dau to 27 South 3eTtard Strss I .........r .u...... u ......... ............ ............................. • '...N. } DNM Oeeurrb In • NeNItK: t7-InpatNra 1)' W>,trt-dcc~mC iwn•~ ..}....p..l. .O..M ............ ................ ....... ..... t~~HUplc• FKINN met m• MI•r. DM•r TMn 9 HNpieh •••~•••••••• •.•• .• ArrW1 NurN Mam PP dK1< DNn S n -hNn GNF•CN Other m m: SS •d iW • net w ftr•K Ise. er ewn. Nate, arts p Ced• 1 . Gunty W Cozen ow York FA 17408 1N. dfPefklon NMI matron 16b. OK• M DISpNMen 16C. P N• Dlfpoahbn (Nam• D/ umat•ry, crematory, or otna PI•u) S, p Nmwal hem 9tat• •] DenKlen 4/ /$012 Cremation Boe iety Of FA OtMr K 1 Ip aNen DNpNltbn GIN Or Town, Nata, • P r STa. n FunK N Parfen M M ImarnlKlt 17 . UNnN u Harriebur A 7 09 ~ FD-136753 STC Nama end GIr1pIM Atltlrafs W FVnaral FaGlky Auer Cr ma iD e ~ IS. an s l uutlOn - N tM ! t bet tM 19. Dwtlant HlfNnlt ONpn - Ch O. • aN - MORE rout M IIMNata whN r hISMK daPN or krrN K tcheol complKad N tM tlma of tlseM. beR thK bM datcAMt wMtMr Ma dK•d•r11 Ma dac•daM comMaNd hImMR Or MNaR to M. Q Nh 9ratle or l•N b5pN1Yt/Hlap•nlc/latllq. GNI[eM'Ne° ~WhM Q iW^•n Q NO tllPlOma, 9th - 13th 9rad• beR H tlNadant k not sNONh/MltNnkJlaHno. O Ned or Alrlran Am•dun Q VlNnamNa Hish uho01 EraduNa er OEO comPlKatl ~ No, rot Sp•nbh/Hlapanlc/Latlne Q AmariNn Indian or AlaKa Natal Q OtMr AN•n CM1lune Q Nlan IMI•n Q NKiw HawKlan M•KICan Am•NUn Q Yat MNINn . , , Nrl1a eellaP mtlk, but no dapN ~ Attoelat• daSrN (a.s~ AA, AS) 1] VN, Puerto Rhin Q lTirlata Q GuamaNan or CMmorro Q NEhalp'a tlH<N (1.{. SA. M, K) Q Va, Cuban Q Flllplne Lmwn Q Maftar'a dasra• (a.9. MA, MS, MEns, MEd, MSW, MM) Q yaL OMK Spanhh/Hkpanlc/latlno Q lapanaf• OtMr PaMC Iflandar O DoctorKa (a.9. phD, !dD) er -roMabnal dyrr• (spNHy) O o<Mr (sp•dN) . M M JO Zl. Dacadan s Slns • MN slSnKlon - GNk ONLY ON[ to IntlINN wMt tM aadant uNid•r ITN or MrNI(to lN. 22\. W K's Ufual OECYpKIOn - Ind1uN HN wo Whka Q JS9awN Q Samwn tlena tlurlrls moft of workins 111•. DO NOT USE RETIRED. Q Slad er AhICM AmariNn O Korean O Other PaeHle Islandaf HOY9lMlfe Amarign IndIN or AINIU Natlw Q VlKmmaN Q Dent Knew/Not SUN Q Aa1an Indian Q OtMr Aa4n Q R•/usad 33b. Kln Sus111a 1 uttry Q OLInaN Q Na[M Haw14n Q Other (SNPM/) DOme9 t iC Q fIRpN10 O 6wmOn19n Or Ch9mOR0 • b IeneYnc• W r 1. OrfOn uM M •n •p G NN• Ym r r MOON YYfTM ~ Su-v1e B r 80 1 7L ^~.^ R N Rhl (e26913 1[ ,yl L 1~ . . . . .. MaDay r s.nm• DN LAnG 8 Z o 1.Z. 6 % 4 LI n , as. Was h+.dm• Esm1nK er Groner Glltaetatli O v« No CAUSE OF DEATH MPrmNmm tote the ch.r.. e/ w,•ntr-dIN.Nt, INurNt, er cemPlleatlonf-Kh.[ directly NYFM tM d•Kh. DO NOT enter t•rmin.l •vnL .uch \. NMI•C •rrMt Inurvel: 36 MR 1 . . ~ar enly oM Nuw en . Nn•. Add Mdkbn.l Iin.t N ngwry ~ n~y O•Eth WA Nplr•tory arroK, er wntHeular flbnll\tlOn YAtI!oVt thowlnE M• Klo DO NOT AG E \ " ~ C ~ = r` A~ TZ Jtr1r~ 4/ ~l ~ ~ ~A IMMEDIATE UUSE -----> a. ' pOnNquNN et): lFlnal tlINNa Or ewtlkbn Due to (er N a rawkins In daKh) b. $.gwntlsNY Iltt C011dIt1onF DY• tO IOI if . CenNOV•np D~: If arW. kNdlnE to Ma uufa IIf[M M INN a. [Ikar tM UNDERLW Na GUR Dua to for a a untpu•nc• of). (dIN•N er INury Mat Inklatatl eM wenb rotukins d. n In dNth) LAST. Dw to (era . unNqua u or): 3d. pat 1 . Em•r Ot . PYL not raYMnR In M• Yn • y1nE GYM E1V•n In p.1< 1 3~1. W9f En FVtOpty rln Y N 6: WaroSWWy n InP N•il• 1• t0 NmPI•b tM uuN o1 d••Ml Me m•1•: NK pre{nant wlthin Pat war ! -o acco UN GMdbuta tO O•aMT ~ YN Q Probably l~.nNr D•K NKUnI Q Homicide 71' pr•Snant •t time of dNth NK prMn•n4 but Pr•SMnt wlthin a2 dap et MaM ~NO Q L1nWewn Q ACCitlant Q Pandlns Imrat<1Satbn Q Sukltla Q GYItl nK Nd•Nrminad 1 naM 43 Dap t0 1 yNr bNON death b t ro ~ N M S W W o/ Injury (MO Day r) (Spa 1 Monts r u p ot pr•Sn• , 9 Q UnkMWn i/ pNSnant wkhin tM p•K Year m• K INury S4. Plau INury 1•.9. Mm•; wnrtruKlon Her rrn, tc o0 95. Leutbn e/ InluN (EtrNt arts NumMr, Cky, Hta, ilp Code) SS. IrYVryKwork 17.1 TNnfportatlon Inlury, Sp•cIN: S9. DaunW HOw Inlury Occurred: Q Ws Q ONV•r/ONr+tor Q Pedestrian p No O PNf•npr O OtMr (SPadN> 9~GrtIMr IChak Pn PN): tlaKh OKUnatl tlua to tM uuN(t) and manner ttK•d T M DM W m knewlatl a k l h N l O a y 9 , n9 p yt : •n - Grt y O ProneunNns L GrtlNlns phplclan - TY M• bNt a/ my knowlMSa, tl•Kh occumtl at tM time, tlata, and plan, and due to the uuN(s) and manwr ttataa Q Madlul E••min•r/feron•r - On <M MW \NminKion, and/or InvKIPtIOn, In mY opinion, dath occurr•tl K tM time, dK•, pnd pIW, •M dw to M9 CiYNIf) end manner it9t•0 ~GLG~. Cr ~~O N W ~~ ` r: LINnN Um I•eFNrtM.r: TR Sisnaur•WUrlI A c ~ 3 ama,GS • PanKanG P `~fCt ~t~s S~ ~ PFl „ (] n ~ OCp t\ ~.tr+1 { I` m r Krar• 9MlW . O' - a2 ~ a/.2 ~ • .Amen Inat14 O[ Dltposkion Parmk No.~ ~ ~ ~ O~ ~~ M106-U/ RCV 0)/2011 ~~-~~~: RF(,'ORUtD.t~~F~E OF RE~iSicn ~~~ ,"1~1.S • LAST WII.L AND TESTAMENT (Pour-Over wiu) 1Q 11 JUN 21 PM 2~ 4 v OF MARJORIE S. BORTNER '~.:r `. ORPFiRN'S (;I;URr IDENTITY ~~~ ~.• ~ I, MARJORIE S. BORTNER, residing in the County of Cumberland, Commonwealth of Pennsylvania, being of sound mind and memory, and not acting under duress or undue influence of any person whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby revoke all other former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 199-OS-8454. All reference made herein to "spouse or my spouse" refers to the person to whom I am currently married, namely, NAN A. BORTNER By the ensuing provisions of this Will, it is my intention to dispose of my interest in our property; I do not intend to dispose of anything belonging to my husband or to put him to any election. I have the following children: KAREN B. ROGAN born March 3, 1941 and currently residing in Ardmore, PA; and CYNTHIA A. SWARTZ born July 9, 1943 and currently residing in York, PA. DEBTS, TAXES AND ADMII~TISTRATION EXPENSES • I have provided for the payment of all my debts, expenses of administration of property wherever situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other than any tax on ageneration-skipping transfer that is not a liability of my Estate (including interest and penalties, if any) that become due by reason of my death, under THE NAN A. BORTNER AND MARJORIE S. BORTNER REV OCABLE LNING TRUST executed on even date herewith (the "Revocable Trust"), or if my spouse predeceases me, under the Survivor's Trust created by the said Revocable Trust. If the Revocable Trust assets should be insufficient for these purposes, my Executor shall pay any unpaid items from the residue of my Estate passing under this Will, without any apportionment or reimbursement. In the alternative, my Executor may demand in a writing addressed to the Trustee of the Trust an amount necessary to pay all or part of these items, plus claims, pecuniary legacies, and family allowafices by court order. PERSONAL AND HOUSEHOLD EFFECTS It is my intent that all my personal and household effects were transferred to the Revocable Trust as a result of the Declaration of Intent signed this date. If there are any questions regarding the ownership or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me this date in accordance with the provisions of the section titled "Residue of Estate." • POUR-OVER WILLS Page 1 (Testator/Testatrix) RESIDUE OF ESTATE I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description (including lapsed legacies and devices), wherever situated and whether acquired before or after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the corpus of the above described Trust and shall hold, administer and distribute said property in accordance with the provisions of the said Trust, including any amendments thereto made before my death. If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under said Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the residue and remainder thereof to that person who would have been the Trustee under the Trust, as Trustee, and to their substitutes and successors under the Trust, described herein above, to be held, managed, invested, reinvested and distributed by the Trustee upon the terms and conditions pertaining to the period beginning with the date of my death as are constituted in the Trust as at present constituted giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such Trust by reference into this my Will. EXECUTOR I hereby nominate and appoint NAN A. BORTNER as my Independent Executor of this, my Last Will and Testament, to serve without bond. • In the event the first named Executor shall predecease me or is unable or unwilling to act as my Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint KAREN B. ROGAN to serve without bond as my Independent Executor. In the event the second named Executor shall predecease me or is unable or unwilling to act as my Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint CYNTHIA A. SWARTZ to serve without bond as my Independent Executor. In the event the third named Executor shall predecease me or is unable or unwilling to act as my Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint MAUREEN PEER to serve without bond as my Independent Executor. Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this my Will, such words and respective pronouns shall be held and taken to include both the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Executor named herein and to any successor to substitute Executor acting hereunder, and such successor or substitute Executor shall possess all the rights, powers, duties, authority, and responsibility conferred upon the Executor originally named herein. EXECUTOR POWERS By way of Illustration and not of limitation and in addition to any inherent, implied or statutory powers granted to executors generally, my Executor is specifically authorized and empowered with respect • to any property, real or personal, at any time held under any provision of this my Will: to allot, allocate POUR-OVER WILLS Page 2 (Testator/Testatrix) between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract with respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold, improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect to, take possession of, pledge, receive, release, repair, sell, sue for, make distributions in cash or in kind of partly in each without regard to the income tax basis of such asset and in general, exercise all of the powers in the management of my Estate which any individual could exercise in the management of similar property owned in its own right upon such terms and conditions as to my Executor may seem best, and execute and deliver any and all instruments and do all acts which my Executor may deem proper or necessary to carry out the purpose of this my Will, without being limited in any way by the specific grants or power made, and without the necessity of a court order. My Executor shall have absolute discretion, but shall not be required, to make adjustments in the rights of any Beneficiaries, or among the principal and income accounts to compensate for the consequences of any tax decision or election, or of any investment or administrative decision, that my Executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate, my Executor shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as Federal Income Tax deductions and shall have the discretion to file a joint income tax return with my spouse. SPECIFIC OMISSIONS I have intentionally omitted any and all persons and entities from this, my Last Will and Testament, • except those persons and entities specifically named herein. If any person or entity shall challenge any term or condition of this Will, or of the Living Trust to which I have made reference in the sections "Household and Personal Effects" and "Residue of Estate," then, to that person or entity, I give and bequeath the sum of only one dollar ($1.00) only in lieu and in place of any other benefit, grant, bequest or interest which that person or interest may have in my Estate or the Living Trust and its Estate. SIMULTANEOUS DEATH If my spouse and I should die under circumstances such that the order of our deaths cannot be determined, then it shall be conclusively presumed for the purpose of this Will that my spouse survived me. If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively presumed for the purpose of this my Will that said Beneficiary predeceased me. MARJ S. BORTNER Testatrix • POUR-OVER WILLS Page 3 (Testator/Testatrix) • This instrument consists of 5 typewritten pages, including the Attestation Clause, Self-Proving Clause, signature of W itnesses, and acknowledgment of officer. I have signed my name at the m of each of O~G J~~"'/ pages.~~s instrument is being signed by me on this day of ATTESTATION CLAUSE The Testatrix whose name appears above declared to us, the undersigned, that the foregoing instrument was her Last Will and Testament, and she requested us to act as witnesses to such instrument and to her signature thereon. The Testatrix thereupon signed such instrument in our presence. At the Testatrix's request, the undersigned then subscribed our names to the instrument in our own handwriting in the presence of the Testatrix. The undersigned hereby declare, in the presence of each of us, that we believe the Testatrix to be of sound and disposing mind and memory. Signed by us on the same day and year as this Last Will and Testament was signed by the Testatrix. WITNESSES: • (Printed Name of Witness) ADDRESSES: /d5/ ~,~~ /ay ~u27'# S?• S • S . /~1~6 Bo, ~„~~ S~e~~r6s . ~ ~7yo7 (Printe Name of Witness) • POUR-OVER WILLS Page 4 (Testator/Testatrix) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SELF-PROVING CLAUSE BEF ME, ,-rJsli~~ed authority, on this day son ly apps _MARJORIE S. BORTNE)/~~~ ~iU~l ~ and eye ac , known to me to be the Testatrix and the witnesses, respectively, wh eso n~arnes are subscribed to the foregoing instrument in their respective capacities, and all of them being by me duly sworn, MARJORIE S. BORTNER, Testatrix, declared to me and to the Witnesses, in my presence, that the instrument is her Will and that she had willingly made and executed it as her free act and deed for the purposes therein expressed; and the Witnesses, each on his or her oath, stated to me in the presence and hearing of the Testatrix, that the Testatrix had declared to them that the instrument is her Will and that she executed the same as such and wanted each of them to sign it as a witness; and upon their oaths, each witness stated further that he did the same as a witness in the presence of the Testatrix, and at her request and that she was at that time eighteen (18) years of age or over and was of sound mind, and that each of the witnesses was then at least fourteen (14) years of age. ~ t~ MARJO S. BORTNER Testatrix • ` `~~ W' ess (Printed Name of Witness) 5. Witn n~i (Printed Name of Witness) SUBSCRIBED AND ACKNOWLEDGED before me ~~ BORR„Testatrix, and b~" /f~ a d savor l~to before me by __G______~_ !G ---- and ~ ~ ~ witnesses, this the day of ~FI®T'~1~IlAL SEf~L TODD 8. GARFINKLE, Notary Public ~~ Lower Southampron Twp.. Bucks County No Pu is Commonwealth of Penns lvania Commission ~x Ma 3, 2004 ~'Y ~ Y ~1 J POUR-OVER WILLS Page 5 (Testator/Testatrix)