HomeMy WebLinkAbout07-03-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF Ctttv-6er(aric( 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 ( C~G~ ~ ~~' ~~~
Name: l,U ~ ((tam jowl STp Yl~ File No:
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: -8
Date of Death: ~Ttt.r,t? r5 . aoi~ Age at death: _ S4
Decedent was domiciled at death in tNi~t'j County, (ware) with his/her last
principal residence at ~ p ~~
Street addreu, Post Ollke and Zip Code Clty, Towrohip or Borough qQf {~ County
Decedent died at ~ t r "'"~7
Street addrns, Pos Oftlce and Zi Code City, Township Borough County State
Estimate of value of decedent's property at death: ~~~
Ijdomk(led in Pennsylwrnia ............................ All personal property $ ~ jdC7.
Ijnot domklled !n Pennsylvania ........................ Personal property in Pennsylvania S
Ijnot damktled in Pennsylvania ........................Personal ro to Coun $
..P PAY ~ ty
Value ojrca/estateln Penttsyfvania .............. ......................... $ o ~ [ I
,~ 1 TOTAL ESTIMATED VALUE.... S ~'~, U ~
Real estate in Pennsylvania siNated at: N~
(Attach additional sheen, ijnecessary.) Street address, Post Onlce and Zip Code City, Township or Borough County
A. Petitioa for Probate and Grant of Letters Testamentary
Petitioner(s) aver(s) he/she/they is/arS utor(s) named in the last Will of the Decedent, dated ~ Z Od and Codicil(s)
thereto dated ))
r-a
State relevant drcamsbnees (eg.renunciation, death ojexecutor, eta)
Except es follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not dive
divorce proceeding wherein the Bounds for divorce had been established es defined in 23 Pa. C.S. § 3323(8),
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
~NO EXCEPTIONS ^ EXCEPTIONS
^ B. Petition for Grant of Letters of Administration (If applicable)
c.r.a., d.b.n., d.b.n.c.t.a., pendente life, durance
N ~~
a patt~a peni~
eve a c~ild bor~
W `.:i 1 CJ
a~
-*+ -r"w
S
duran~i tinori ~y
If Administration, c.ta or db.n.c.Ga, enter date of Will in Section A above and complete list of heirs.
Except u follows: Decedent was not a parry to a pending divorce proceeding wherein the Bounds 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.
NO EXCEPTIONS ^ EXCEPTIONS
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived bythe following spouse (ifany) and heirs (attach
additional sheets, iJ'necessary):
Far,n xw-nz r~~. irultizntr Page 1 of 2
~E~D ~,«F1CE ~
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
I^ ( ~ } SS:
COUNTY OF LJ 1/r•, ~`6-"~ }
1Q11 J!!L -3 PM 3= 2.6
Petitioner(s) Printed Name Petitioner(s) Printed A
The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are we and correct to the best of the knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the Decedent, he Petitioi s ' hw and truly administer the estate according to law.
Sworn to firmed d su scribed before ~~ Dam-~~~!
me th' y ~ Date
Date
For the Reg' er Date
BONDRequired:QYES QNO
FEES:
Letters ...................... s_ Q, ,~
( ~ )Short Certificate(s)......
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commissio .. ........
Other , ...... ,
Automation Fee ..............: _~-
JCS Fee ....................
TOTAL ..................... S t.f~
To the Register ojWllls:
Please enter my appearance by my signature below:
Attorney Signature:
Printed Name•
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate of _ V V c ~ ~ i Q~ ~j y ~ S~1'l~_ File No: ,.~ ~ ~ ~ ~ ' 7~
a t3
a/k/a: ~
AND NOW, ~1~( ~ ,°~ ~ ~ , in considerat'on of the foregoing Petition,
satisfactory proof having een presented before me, IT IS DEC ED that Letters 2l)
are hereby granted to
in the above estate and (if applicable) that
the instrument(s) dated L~ t
described in the Petition be admitted to probate and filed of record as the last W,jll (and Codicil(s)) of Decedent
Re~,lster of Wills /~ ), '
t~V ~
Form RW-(11 ,•ev. ln~tuaoll Page 2 of 2
LOCAL /~ ~~~
,~` CERTIFICATION OF DEATH
WARNING: ,~i ate this copy by photostat or photograph.
G!„ : r. <; ;'~! it
Fee for this certificate, $6.00
P 18626296
„IIJJ~""'~ ~ This is to certify that the information here given is
2D11 JUL -3 PM 3~ ~p~TN OFpEy'ys correctly copied from an original Certificate of Death
'~ ~ : duly filed with me as Local Registrar. The original
I
~ - 9~ certificate will be forwazded to the State Vital
~~"~ CQU~. v y sg Records Office for permanent filing.
~` _ ~,t~t
'9lA1ENi OE~~""~~ (.~tv~ Fl~~~),.1n.r~et JUN 15/2Q12
" """"'~~~ Local Registrar
Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
Certification Number
kn
TYPe/Prlnf In
Parmanen!
a
1. peceden! • Leta Name (First, Mlaale, R Su/Rx) ~ - ~ ~ ~ -- - -- - - - - - -~ - SteN FIM Number:
2. Sex !. SOC1e Serodty Number 4. Date oI Deet (MO/D•V r) (SPell Me)
Wi\1Pq
/'
n< /
) 280-64-6599
Jiinc !S
tu(t
,
,
Sa. Ate-Last Blrt tley (Yrf) Sb. n er 1 Ve r Sc. Untl•r 1 D 6. D•N of Birth,.(I}y1p Dry r) 3p•11 MO"~Tfh >f. BlrMplau end St•t• pr Foreitn Country)
MOMha Days HOUrf Mlnut s
!f
/
!_
` ~ / ~S
Sf
eJ L J
~tJ9/J I
~
I
>b. einhvl.o I~otrnty)
Be. Msltlerlce (S!e!e pr Fore to Country) b. Reaitlanee (Street antl Number - Inciutle Apt No.l tc. Dld DecWen2 Lhre In • Township
PA
120 W. Hi1lCrest Dr. IEIYef, aeced•ntuwdln N
Mir9A7J~ art -
_
LV,p
f . .~L lint a7~`~art~ -
te. R.neeno. (mp codel ENO, aeofdene nYa wwmn umw of aty/berp
.
9. Ever In U3 Armetl ROrcef? id. MerRel Status et Tlme p/ Death Martlaa ewe 31. SuMVint SPOYta's Name llf wIN, five name odor t° flow mamlate)
Q~ Yea Q No Q U
k
O
nown
n
pWOrced Q Newr Marrlad D Unknown Ii011 sur6lClc
12. FatM,L Name Irst, Middle, Left, SuMx) id. Mother's Name PHOr t° Clrft Mardate (flrfL MItltlN. Lea!)
Carl atone
Juanita Caa®y
14e. Inlo/man<'f Name 14b. RelatlOnahlp to Decetlen! Sic. In orma.rt'f Mailin A dress lStreN ana Num r, C n[eta, Zlp Cetle7
Holly Stone
it
f
~
w
s 120
w. rail
cremt Dr_ , Car
1
eia, PA 17013
n
1/Death Occurred In • NO•Dlial: ~-InpHl! t If•Death Oe<urretl Somewhere OM~r Than a tlospR•1: t~HOSpic~ F~clllty ~Dtt d N
..ntf em. ~~-~
Eme a Roo Out KIarI[ D•W on ArrWal Nunln MOma/LOn -Term tare Facll Other 5 •clfy
13b. x H Name II not Insthu[lon. •Iya sheet an number; 1St. CYty or Tpwn, State, and ZIP C lStl. county oI Oeet '
lfa. Meth o Difpeelllen a al Cremation 16b. D•N o DlfpealtlOn 16<. PIiCe 01 DlfpOfRlOn (NPme W pmetery, Crematory, pr ether Dlape)
p R.mo
rpm Efate
~^:
p D°n.ll°" June 25 / 201 xndiantown Gap National Cemetery
1 . Leu ono speawlon (CIN or Town, 3LPLe, antl 21p) 1>a. } r• of nerd ryl LI P on In
a I>b. llunfe Number
nvillo, PA 17003
013144E
1>e. Nome ana Compleb Address O1 Funeral Facility
al
rQ 10. Decedent's Etlutet n - Check t e boa t a[ est describes the 19. Oeuden! e/ Hispanic OrlLln -Check the 3D. Deuden['s Rau - C eck ONE OR MORE reaf [e Intllu[e whet
hlBMft aetrea or Iw•1 of school cempletetl at the nm
f d
h
e o
eat
. boa that Wst tlaseNbes whether the tleotlent [ha decedent conslOeretl hlmseH or herfell to ba.
Q t[h trade or less l
S
i
h
H
"
a
pan
s
/
lspanlc/LeHnp. Check [he
NO" )~ White Q Korean
O N° tliPlOma, 9th - 12th trade box H tlautlent If ne! 3Penlsh/Hlspanl4latlno. O Black orAMUn Ameri
can Q Vletnamefe
Q Hlth school traduate or OED romplKetl ®N°, not 3panlsh/Nlspanl4Latln° Q American Intll•n Or AI•flu N•NVe
Q Seme rolhte credll
but n° de
u
,
f
e Q Yea, Mexican, Mexiun American. Chignp Q 41an Indian Q N taw Hawellen
AffpclaN decree (a.t• M. A57 O Yea, PV•RO Rican ~ CRIn•se
~ Ouamanlan er Chemorro
Bachelor's dgree (e.t- BA. A6, BS) Q Yea, Cuban Q Flli
l
p
no
MasteYf decree la.t. MA, M3, MEnt. MEd, MSW, MBA) Q Yes, Other BPanifNMlsPanl4Latinp Q nemoan
t~ Japanese ~ Other Paclflc Ifl
M
ar
er
O Doctorate (a.t. PhD, EdD) or Pr°Teulonal decree 13pecIN) O
Other (BPecIN)
•. . MO DD OVM ue JD
21. Dautlent's SIniN Raw Self-Deflina[lOn - CMC ONLY ONE tp Intlicata whit LM tleutlenf <pnsidera Imzelf pr hersNf tp be. 22a. Deudent'z Usual Occupation - Indleab tyM Of work
WhRe Q Japanese Q Samoan d
yne tlurln
Bleak or ATnean Amerlun Q Korean O OMer PecH1c Hlander • mort of werkint Ilh. DO NOT VSE REnRED.
Q AmeH<an Intllan or Alaf W N•IhN Q Vlelnemefe Q Don't Know/NOL Sure E.~L1CatOr
Q Aalan Indian Q OMar Asian Q Rehsetl 22b. Klntl of Bualnaz Industry
Q Chinese Q Netlw Hawellen Q Other (sPeclry)
Q Flliplno pGU•m•man or cnamerro Military ACad@my
• - a. Dale r Dea a av r z tnature o rs n roneundn at
BY PERBON YVNO PRONOUNCES OR °nOynce V t tit Grr' w,/.~ n en ePP u • c. ee m er
ctwnn TN t.4 i2 S caY
`~~
(
23a. Deee to ( q Day r za. nm. m po<n tc~AO\ JCM S4Y
y
v
t't/`v/
O S (2 070,5 2n. Wa Medial Ex•mirnr er ceromr contactedT p yes
CAUSE OF DEATH
Approalmate
28. -ar[ 1. Enter the chain oT wenu--tllaaafu, InJprlez, or comPli<a[Ipns-that airec[IY cwfetl the tleath. DO NOT enter terminal ewrm au<h as cardiac arr
t
es
, InpNel:
refPlra[Ory arrest, or ventricular Rbrlllet
N
OUt fh°wln
M
S t
l^~` I<
efiolow. D/OJNOT ABBREVIATE. Enter only One cause on a Iln
e. Adtl atltll[lonal Ilnea N neuuary Onze[ tp Death
/
1
/
J
~
- ~
J
IMMEDIATE GUSE ---------> •, ( !/C- ~ O~/ !/~_ /L
~
~
~
/
n`
~x`L;
( ~, ^~_S
f~
(Final tlNeue er centlitlOn a t° (or az a co s ~u ^ fj
pf)
c
.
reeuhint In death)
b. y
SequentlellY Ilrt COntliilOnf, Due t0 (Or •f a COnseque Ofl:
If anY. le•alnt t0 <h1 apse
> _
~
listed pn Ilne a. Enter the ~ ~ ~'j iJ /_J / ~ n /~~
<
DNO[wLY1N0 CAUfE
DI/e t0 (pr •i • COnfeq Yence °r):
(tllfee{f Or ln)V rY that
Inl<leted the events r•sultlnt tl.
In tl••th) LAST. DVQ [o (or a3 a cpm•gVente Ot):
26. hrt 11. Enter other b,at not refulilnt In eha unded
ln
wuz
l
I
p
y
t
yen
n
e t
ert I 2>. Was an aVtoPry perbnnetl>
Y N°
26. Were autePaY flntlinp awllab
t0 CDmP1eN the cwfe O/ deethT
Vet N°
36.1 FemaN: 3D
Did T
Q No<pretnant wlthln Past Yaer .
°becco Use Cpmribu<e [o Death? ni. Manner of Death
'
Q Pr•inaM at Tlme °/ death Q Yes Q ProbeblY
O NO
Q Unknown Natural
Q Q HOTIGIde
~ NO<
~ pretnant, but Pr•tnan<wwhm 42 tlwa et aeeth
N Q Attitlen[ Pendln
suicide Q Could ne
b
tl
t
Q ~
Q
et pretnent, but pretnant 4B dew tp 1 War before tles[h
~ Unknown I/ Prefnent wlthln the Pert War
32. Dace o/Inlury (MO Day r) (Bpell Month t
e
e
termin.d
33. Time of Injury
S4. Piece of Inlury le.t• home; cenafructlon site; a m, school) 33. LouNOn o/ Inlury (Street antl Number, City, State, IP cotle)
3f. Injury at Work 3>. I/Tranfpprutlon Injury, Speciry: 36. Describe How Inlury Occurred:
Q Yes Q Driver/Operator Q PetleKrlan ~
Q No ~ Peffenfer Q OlM1er (3PKMyI
99e. Cart er (Chet °n y one):
Q CeKlfylnt Physlalan - To the hart °T my knowled death ptturretl sue to the oase(s) antl manner sb[ed
Q P<OnpunNnt 0 Certllyln hwiclan - Te LM b my knOwletlp, death oc<umad at the time, date, sna plea, end due t0 the oase(s) antl manner stated
Q Medleal Examine
/C
O
M
b
r
° -
n
e
ash o Inenon, antl/°r InwfYltetl°n, In my opinion, death otturretl ai tM time, sate, end plea, end tlue to the eaue(a) end m r stated
3ltnatYre O/ CartlMr: Tltl! °f Certlfler:
Llunse Number:
39b. Name, Atltlretl antl Zlp C e o/ P son Completint b Death (Item 207
Ht f ~ Ir'n' 39c. Date Sltned (Mp ay r)
-
et ftra f • um er 2i
4 et stray Lure ~
,O ~ • stray a Mo Y r
43. AmentlmenH
- L~tie~ 0 t~
C7173 O ~ ~ 5i H1DS-tan
Dlspofltl°n Permit No. REV O>/2D11
LAST WILL AND TESTAMENT
OF
WILLIAM L. STONE
is -~.3~v
I, WILLIAM L. STONE, a resident of the Commonwealth of Pennsylvania,
make, publish and declare this to be my Last Will and Testament, revoking all wills and codicils
at any time heretofore made by me. I am retired from the military service of the United States.
FIRST: I direct that the expenses of my last illness and funeral, the expenses of
the administration of my estate, and all estate, inheritance and similar taxes payable with respect
to property included in my estate, whether or not passing under this will, and any interest or
penalties thereon, shall be paid out of my residuary estate, without apportionment and with no
right of reimbursement from any recipient of any such property (including reimbursement under
Section 2207B of the Internal Revenue Code).
SECOND: I give all the rest, residue and remainder of my property and estate,
both real and personal, of whatever kind and wherever located, that I own or to which I shall be
in any manner entitled at the time of my death (collectively referred to as my "residuary estate"),
as follows:
(a) If my wife HOLLY A. STONE survives me, to my wife outright.
(b) If my wife does not survive me, then to those of my children (THOMAS
WILLIAM STONE and JACOB ELLIOT STONE and any other children which I
hereafter may have) who survive me and to the issue who survive me of those of
my children who shall not survive me, per stirpes. If, however, any such child
then shall be under the age of twenty-five (25) years (each such child being
hereinafter referred to as a "Beneficiary"), the share of such Beneficiary shall not
be paid or distributed to such Beneficiary but instead shall be given to my Trustee
and held by my Trustee, IN TRUST, pursuant to the following provisions
(i) My Trustee shall hold, manage, invest and reinvest each sh ~r -;
set aside for each Beneficiary in a separate trust for the benefit z~'Ff,
such Beneficiary and shall pay so much or all of the net inco "' ~;~
from each such trust to or for the benefit of the Beneficiary therec~~ '^
for the health, education, maintenance and support of t~ie~
Beneficiary, to such extent and at such time or times and in su
manner as may be determined in the absolute discretion of my
Trustee. Any net income not so paid shall be accumulated and
added to principal at least annually and thereafter shall be held,
administered and disposed of as a part thereof.
~
~ ~
`'
~~ ~
, .,
~ CY7
,~ ,..
N ~"~:.
rn
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(ii) In addition, my Trustee may pay to or for the benefit of each
Beneficiary, for the health, education, maintenance and support of
each Beneficiary, from the principal of each Beneficiary's trust,
such amounts, including the whole thereof, as determined in the
absolute discretion of my Trustee.
(iii) When any Beneficiary shall attain the age of twenty-five (25)
yeazs, the trust for such Beneficiary shall terminate and any re-
maining principal and income shall be paid and distributed to such
Beneficiary, discharged of trust. If such Beneficiary dies before
said age, such principal and income shall be paid and distributed to
any then living issue of such Beneficiary, per stirpes, or if such
Beneficiary has no issue to my then living issue, per stirpes. If any
such issue is a beneficiary of a trust under this will, the same may
be held in accordance with such trust. If there are no then living
issue, the same shall be paid and distributed to the beneficiaries of
my residuary estate then in being as provided in this will, or if
there are none, to those who would take from me as if I were then
to die without a will, unmarried and the absolute owner of the
same, and a resident of the Commonwealth of Pennsylvania.
(c) If my wife does not survive me and there shall be no issue of mine then
living, I give my residuary estate to those who would take from me as if I were
then to die without a will, unmarried and the absolute owner of my residuary
estate, and a resident of the Commonwealth of Pennsylvania.
THIRD: I appoint my wife HOLLY A. STONE to be my Executor. If my wife
does not survive me, or shall fail to qualify for any reason as my Executor, or having qualified
shall die, resign or cease to act for any reason as my Executor, I appoint KATHLEEN SULOFF
as my Executor. If KATHLEEN SULOFF shall fail to qualify for any reason as my Executor, or
having qualified shall die, resign or cease to act for any reason as my Executor, I appoint
EDWARD SULOFF as my Executor. I appoint KATHLEEN SULOFF to be my Trustee. If
KATHLEEN SULOFF shall fail to qualify for any reason as my Trustee, or having qualified
shall die, resign or cease to act for any reason as my Trustee, I appoint EDWARD SULOFF as
my Trustee. I direct that no Executor or Trustee shall be required to file or furnish any bond,
surety or other security in any jurisdiction.
FOURTH: I grant to my Executor and Trustee all powers conferred on executors
and trustees under the Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any
successor thereto, and all powers conferred upon executors and trustees wherever my Executor
or Trustee may act. I also grant to my Executor and Trustee power to retain, sell at public or
private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any kind of
property, real or personal, for cash or on credit; to borrow money and encumber or pledge any
property to secure loans; to hold property in bearer form or in the name of a nominee; to divide
and distribute property in cash or in kind; to render liquid my estate or any trust in whole or in
part, at any time and from time to time, and to hold cash or readily marketable securities of little
91`~- ~~}.~-s
or no yield for such periods as my Executor or Trustee shall deem advisable; to exercise all
powers of an absolute owner of property; to incorporate any business and hold any interests in
corporations; to vote stock or securities, in person or by proxy; to exercise subscription and
conversion rights, and to participate or refuse to participate in any reorganization,
recapitalization, merger, consolidation, liquidation, dissolution or other action with respect to
any corporation; to transfer any business or property to a partnership and to be a general or
limited partner; to compromise and release claims with or without consideration; to execute and
deliver instruments, including releases; and to employ attorneys, accountants and other persons
for services or advice.
The term "Executor" wherever used herein shall mean the executors, executor,
executrix or administrator in office from time to time. The term "Trustee" wherever used herein
shall mean the trustees or trustee in office from time to time. Each Executor and Trustee shall
have the same rights, powers, duties, authority and privileges, whether or not discretionary, as if
originally appointed hereunder.
The determination of my Trustee as to the amount or advisability of any
discretionary payment of income or principal from any trust hereunder shall be final and
conclusive on all persons, whether or not then in being, having or claiming any interest in such
trust. Upon making any such payment, my Trustee shall be released fully from all further
liability therefor.
FIFTH: I direct that for purposes of this will a beneficiary shall be deemed to
predecease me (or any other person upon whose death the interest of such beneficiary depends)
unless such beneficiary survives me (or such other person) by more than thirty days. The terms
"child" and "children", as used in this will, include not only the child and children (whether now
or hereafter born) of the person designated, but also the legally adopted child and children of
such person. The term "issue" includes not only the children and other issue (whether now or
hereafter born) of the person designated, but also the legally adopted children and issue of such
person. The terms "child", "children" and "issue" of the Testator shall not include any stepchild
of the Testator.
SIXTH: No disposition, charge or encumbrance on any income or principal of
any trust hereunder by any beneficiary thereof shall be valid or binding upon my Trustee. No
beneficiary shall have the right to assign, transfer, encumber or otherwise dispose of any such
income or principal until the same shall be paid to such beneficiary by my Trustee. No such
income or principal shall be subject in any manner to any claim of any creditor of any
beneficiary.
SEVENTH: If my wife shall not survive me, I appoint KATHLEEN SULOFF to
be the Guardian of the person and property of any children of mine who have not attained the age
of majority. If KATHLEEN SULOFF shall fail or cease to act as Guardian, I appoint EDWARD
SULOFF as Guardian. No Guardian shall be required to file or furnish any bond, surety or other
security in any jurisdiction. If my Trustee or any trust hereunder is the beneficiary of any life
insurance policy, my Trustee shall be entitled to the insurance proceeds rather than my Guardian.
3
EIGHTH: I have served in the Armed Forces of the United States. I therefore
request that my Executor make appropriate inquiries to ascertain whether there are any benefits
to which I, my dependents or my heirs may be entitled by virtue of any military affiliation. I
specifically request that my Executor consult with a retired affairs officer at the nearest military
installation, the Department of Veterans Affairs, and the Social Security Administration.
IN WITNESS WHEREOF, I, WILLIAM L. STONE, sign my name and publish
and declare this instrument as my last will and testament this ~ day of ~~ 2001.
I also have affixed my signature on the bottom of each of the preceding pages h eof.
~~J'~
WILLIAM L. STONE
4
The foregoing instrument was signed, published and declared by WILLIAM L.
STONE, the above-named Testator, to be his last will and testament in our presence, all being
present at the same time, and we, at his request and in his presence and in the presence of each
other, have subscribed our names as witnesses on the date above written.
having an address at ~
~~-~.f'`~.3-le ~i9-
~?~i3
having an address at
~aZ ~~. NT
fl~~3o
5
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND, ss.
We, WILLIAM L. STONE and E S i~ ~ (T ~ a Q G<-
---------- ---------
--------
__~+-_____I'~%c_Y/_~~ _________________~theTestatorandthe
witnesses respectively, whose names are signed to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that the Testator, WILLIAM L.
STONE, signed and executed said instrument as his last will and testament in the presence and
hearing of the witnesses, and that he had signed willingly, and that he executed it as his free and
voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the
request of the Testator, in the presence and hearing of the Testator and each other, signed the will
as witness, and that to the best of his or her knowledge the Testator was at the time at least
eighteen yeazs of age, of sound mind and under no constraint, duress, fraud or undue influence.
Subscribed, sworn to and acknowledged before me by the said WILLIAM L.
ST~NE, Testa r~anud~~su-b-scribed and sworn to before me by the above-named witnesses, this
day of _~~"~_, 2001.
No ublic
My co fission expires on
tetanal Seai Public
R. Standrid9e, Notary
~t-ryy untY
Cprlisle Bork ExP~s M Y~ 2005
pAy Comm~ssl ~~,~
~rrbar, Pen~~"Ia Assad~la'
~~ J•~
WILLIAM L. STONE
Testator