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Home My WebLink About08-27-12PETITION FOR GRANT OF LETTERS ~ C> ~T G REGISTER OF WILLS OF ~~~ r; -r. .;~ ~Z ~s~; ~~,~~ COt7N'I'Y, PENNS~ 'MANIA ~= ._.,~ Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as jet ~~,ed bele~y, support thereof aver(s) the following and respectfully request(s) th€: grant of Letters In the approp~ form: Decedent's Information Name -~~i,nn~~ VY~ . a/k/a: m,~ ;,~~.~ Date of lleath: ~ r Decedent was domiciled at death in principal residence at Z~ f~ ~.~^ C~ --,- ._... -~ .. :~~ ;~--, _z., .--. ~, '~ ~ ~_ ,, ., ~'. -_ ~~::~. and~~ ili __:-.~. . - ,= ; =n File No: ,~(.I "lr ' .~~ ~~~ (Assigned by Register) Social Security No: ZC>~ - ~L~ i'-i~c~ ~ Age at death: ~ Z _ County, ~ i1~~~ ~` l V~'~ ~~ 1c~, (Srace) with his/her last Meer.. , (tq ! ~7, ~-ll Street address, Post Office atf~d Zip Code City, Township or Borough County Decedent died at CL°~ s~ ~ sly + ~ '~ ~ ;vr~c~.~ ~dc~,cc:.t ~ e~~vo C~-°= ~ ~Sl~ ~vr"~r~~ Street address, Post O ue and Zip Code City, Township or Borough County State Estimate.o~alue of decedent's property at death: If domiciled in Pennsylvania ............................ All personal property $ „2Q, C-~C:~C.J If not domiciled in Pentssylvania ........................Personal property in Pennsylvania $ If not domiciled in Pennsyh~ania ........................Personal property in County $ Value ojreal estate in Pennsylvania ......................................................... $ ~ / ~~ TOTAL ESTIMATED VALUE.... $ Real estate in Pennsylvania situated at: !~ (Attach additional sheers, il'necessary.) Street address, Post Office and Zip Code 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 ~~..~,/ ~~, ~'~-Wand Codicil(s) thereto dated Cl~~rr, o_,r ~~: ~~~ State relevant circumstances (e.g. renu~eciation, deat/a of executor, etc.) Except as follows: after the execution of the instrument(s) offered for probate Decedent did not marry, was not divorced, 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(g), and did not have a child born or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ~NO EXCEPTIONS ^ EXCEPTIONS ~ P. Petition for Grant of Letters of Administration (If applicable) c. t. u., d.b.,i., d.b.n.c.t.u., pendente lite, durunte absentia, durunte minoritate If Administration, e.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs. Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had been established as defined i~t 23 Pa. C.S. § 3323(g) 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 ascer. ~incd that Decedent left no Will and was survived by the following spouse (if any) 2r. r_' ;.pit:, z ~:rc,~ch udditionul sheets, i~~necessury): Name Relationshi Address J Fo,-,~~ nw nz r•ev. Inilli1n11 Page 1 of 2 ' Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~.~,~-'~~Ir~(~.n~ } } SS: } C7 ~~. t~ Use Only r`` ~ ~,~; ;: 7 -Y-, ~s. rr-~ ~ _ ~ =}..., C ~. , ~; "",~ ~7 ; .. E ;..~: -~ •s" Cdr..:. __ Petitioner(s) Printed Name Petitioner(s) Printed Address --~ :. ~- s' ~~t~,n ~r•~ ~- Wd. ~ ~~ Lh~~ ~ ~ r~l~ N~.wc~r~- flc, ~~ ~v. - The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Pet'tio~ are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of the Deced , tll ' 'o r( ''/`~frll well ~rt'd truly administer the estate according to law. ~.r~. G G/f ~r Sworn to or affirmed an subscribed before Date ~'~~ / 2 me this da of ~ v >~~ ,~~~~~~ ~% Date $ ~ ~ Date F r e Register Date BOND Required:~YES ~NO FEES: Letters ...................... $ a oC~ ( ;~) Short Certificate(s)...... ~ ( ~ )Renunciation(s)......... _ • v 4' ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . _~ Other ....... Automation Fee ............... - JCSFee . .................... •° TOTAL ..................... $ ~~ Attorney Signature: Printed Name: Supreme Court ID Number: Firm Narne: Address: Phone: Fax: Email: To tl:e Register of Wills: Please enter my appearance by my signature below: DECREE OF THE REGISTER i ~~ _ ~ ~~ Estate of i r ni7~ u~ File No: a/k/a: AND NOW, u ~~~ ~ ~~ , .~~`/ Z , in consideration of the foregoing Petition, satisfactory proof having- en presented before me, IT IS DECREED that Letters. t',.5~' ,/)? ~/' ~ ~ ~ are hereby granted to ar ~ ~~ _ ~;~~~ ~ ~ - • in the ove estate and (if applicable) that the instrument(s) dated { ~ ~ ~~ d ~- described in the Petition be admitted to probate and t e of record as the last Wi (and Co~i~il(s)) of Decedent. ~~ ~~ Register of Wills Form RW-OZ rev. !0/! 1/101 ! Page 2 of 2 +' / _ J .. '- - _~T~-..e. ~ ! s ,, i ~ I , ~. _ ., .. -___- __ Cry ~tit~i: _)tic.~; '~(.)r~?`r~~. ~o Type/Print In Permanent C. BI k k .~_. Q `~~~ ~ ~ ~U~ 27 ~ ~ ~ 46 .~ ~.: , . .. ~~M~o ~o., Pa .R . ~ ~~ ' ~ ~ ,~~- M a~~ 1 ~ r a_, , COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS ~`roT~C~!'ATC !lC t'lFAT4.1 ac In 1 . Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (Mo/Day/V r) (Spell Mo) rn _ Kv~Z. ~ 202-30-1481 try ~~ ~ S a. Age-Last Birthday (Yrs) 56. Under 1 Year Sc. Under 1 Da 6. Date of Birth (Mo/D ay/Near) (Spel l Month) 7a. Birthplace (City and S tate or reign Country) 72 Months Days Hours Minutes NOV _ 8 i 1939 ~` 7b. Birthplace (County) a k11 Ha. Residence (State or Foreign Country) 86. Residence (Street and Number - Include Apt No.) Hc. Did Decedent Live in a Township? pp, 210 B1g Spring Rd. Yes, decedent lived in W2St Pennsboro twp. 8d. Residence (County) Cumberland 8e. Residence (Zip Code) 1"724]-, Q No, decedent lived within limits of city/born. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death Q Married Widowed il. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Ves $] No Q Unknown Q Divorced Q Never Married Q Unknown 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Joseph Jay Mowery Naomi Grace Locke Informant's Name 14b. Relationship [o Decedent 14a 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code) s . Karen Weyl daughter 7 Charles Pointe, Newark, DE 19702 . ....... ................................................. ..........................................: atient ~ c ~] In it l H d 15a. Place of Deat Check on one .. _ ........ . . .... ... ... .. ... . .. ..... ....... -.............. -.............---.Y............................ -......... if Death Occurred Somewhere Other Than a Hospital: ~] Hospice Facility ~ Decedent's Home ° p : in a osp a If Death Occurre Q Emergency Room/Outpatient Q Dead on Arrival _ Q Nursing Home/Long-Term Care Facility Q Other (Specify) z 15 b. Facility Name (If not institution, give street and number; 15c. City or Town, State, and Zip Code SSd. County of Death Z Carlisle Re Tonal Medical Center Carlisle, PA 17013 Cumberland -- 16a. Method of Disposition Burial Q Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) theran Church l L li p Removal from state Q Donation May 21 , 2012 ca u St _ Peters Evange Q Other (Specify) ~ 16d. Location of Disposition (City or Town, State, and Zip) g at of Funeral Se ce censee f Interment 17a. Si n 17b. License Num er ~ Newville, PA 17241 138504 E 0 u 17 c. Name and Complete Address of Funeral Facility m - 18. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to Indicate what ~ highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. Q 8th grade or less is Spanish/Hispanic/Latino. Check the "N O" ~ White Q Korean African American Q Vietnamese Bl k i ac or no. ~ No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Lat A i Oth s an er Q High school graduate or GED completed ~ No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native Q Q Some college credit, but no degree Q Yes, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawaiian Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Q Guamanian or Chamorro Bachelor's degree (e. g. BA, AB, BS) Q Yes, Cuban Q Filipino Q Samoan ifi I l d h er s an er Pac c Q Master's degree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispanic/Latino Q Japanese Q Ot Q Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) Q Other (Specify) (e. MD, DDS, DVM, LLB, JD 21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a_ Decedent's Usual Occupation -Indicate type of work White Q Japanese Q Samoan done during most of working life. DO NOT USE RETIRED. Q Black or African American Q Korean Q Other Pacific Islander Registered Nurse Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Q Asian Indian ~ Other Asian Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian ~ Other (Specify) Hospital Q Filipino Q Guamanian or Chamorro ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead (Mo/Day/V r) 23b. Signature of Person Pronouncing Death (Only when applicable) 23c. License Number BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH 5 ~~ ~/iC ,QO O~ 01 23d. Date Signed (MO/Day/Yr) 24. Time f Death 25. Was Medical Examiner or Coroner Contacted? ~ Yes $~ No CAUSE OF DEATH Approximate Enter the chain of events--diseases, injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest, Interval: Part 1 26 . . respiratory arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset to Death IMMEDIATE CAUSE ~ a (Final disease o ndition Due to (or as a consequence of): resulting in death) b_ Sequentially list conditions, Due to (or as a consequence of): if any, leading to the cause listed on line a. Enter the c. UNDERLYING CAUSE Due to (or as a consequence of): cc . (disease or injury that _ initiated the events resulting d. w V In death) LAST. Due to (or as a consequence of): _ S 26. Part 11. Enter other <ionifica nt conditions contributing to death but not resulting in the underlying cause given in Part 1 27. Was an autopsy performed? Q Ves ~~ No a \1 _ \ , ~ 28. Were autopsy findings available ~ v F~ C~~x V q.J, to complete the cause of death? Q Yes Q No a If Female: 29 30. Did Tobacco Use Contribute to Death? 31. Manner of Death ~ . i'0 Not pregnant within past year Q Yes Q Probably ~}B Natural Q Homicide v nantat time of death Q Pre Q No ,~ Unknown Q Accident Q Pending Investigation m g but pregnant within 42 days of death nant re N t Q Suicide Q Could not be determined i_°_ , g o p Q Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (Mo/Day/Yr) (Spell Month) Q Unknown 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, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Ves Q Driver/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): Q Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated }~~ Pronouncing g~ Certifying physician - To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated the cause(s) and manner stated d d t l d ue o ace, an p of examination, and/or investigation, in my opinion, death occurred at the time, date, an sis th e ba er O n ron Q Medical Examiner/Co rr '' // ~ ~ ~ / Signature of certifier: `~~ 7~C~ ~n Title of certifier. License Number: ~ ~~~j._Z.~ 7 39b. Name, Address and Zip Code of Person Completing Cause of Death (Item 26j _ 39c. Date Signed (Mo/Day/V r) : 40. Registrar's District Number 41. Registrar's S'~ 42. Rem fg ids ar File Date (Mo/Day/Yr) ~ ~-r i f~ ~~ - lJ C~ \a- ~ ~e a 0 i 43. Amendments Disposition Permit No.~')~J~ OU O REV 07/2011 t _ ~-.~' RENU~ICIATIC~N ~ ~ - ` rv i ~ _'-- _ _ !, , . 'r REGISTER DF WILLS ~~ ~~ ~' `=-. ~~ ~ °~ ~ !-~ /~; . °,~/ C4UNTY, PENNSYLVANIA ~~' ~- ~" ~; (~ ~~ Estate of ~E~ o, ~,:~~ l ' ~ ,~<~~ ;/'Print Name) ~!~ /~% t Deceased in my capacity/relationship as of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to ~ ~ ~~~r c __ (Dace} Executed in Register's Office Sworn to ar affirmed and subscribed before me this day of , Deputy for Register of Vijills ../ . ~~ / `_. . , (Signature) ., ~ / _.7 (Street Address) f / ,, ] ,c.~ _ ,. (City, State. Zip) ~xecute~ o ut of R_e~isfer's (~. flee Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciatiop for the purposes stated within on this _~ ~h_--- da.y t% , ^l~c-t-, Notary Public My Commission Expires: (Signature and Seai of Notary or other o~ciai qua~ifie~ to adminisl~c.oaths. Show date of expiration of Notary's Commis,ion. j CiOIY'1fTiOflW@~~10~ f1~8 Susan C. Bn3wster -Notary Public Commission No. 127637 My Commission Exp~es 11/3012013 Form RW-06 rev. 10.13, 06 p.,., 4:'<_;~ LAST WILL AND TESTAMENT ~~ ~~ -s, ,_~. ~ -. OF ~. .~~ _ ,:. , JANNA LOCKS MOWERY KURTZ J~ ~. ~: -~ ` - ~ ' V+/ S+..~.._ J. { ...+ j.._.. ~ . _- .~ ~. _ . .-.~ ~'.." ~.. ~...... . '-k 1..~7 I, JANNA LOCKS MOWERY KURTZ, of Carlisle, Cumberland County c~~ '' Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my personal representative hereinafter named to pay all expenses of my last illness, just debts, funeral expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my personal representative need not accelerate and pay those urllnatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay ~' as they become due and payable. If I do not own a burial plot or a grave marker at the time of my death, I authorize my personal representative, in his, her or its sole discretion, to r ~ purchase a burial plot and to erect a suitable grave marker at my grave, and to expend sums from my estate for this purpose. ~ SECOND I give, devise and bequeath my entire estate, of whatever nature and wheresoever ;: ;~ ti situated to my beloved children, CRAIG DAVID KURTZ, and KAREN KURTZ ~~; WEYL. 1 of 9 THIRD To my husband, ROBERT LEE KURTZ, I give, devise and bequeath the sum of $1,000.00 cash. Such is intended to constitute a token gift. My intent is based on the fact that throughout our marriage, my husband and I maintained entirely separate estates. We each supported ourselves and accrued assets separately and individually via our individual incomes. As it was our mutual desire to each provide for our own maintenance and support and to invest our own money as we saw fit, independence from any influence from the ~ ~ other, it is my desire to dispose of my own separate estate in the same manner, that being in my sole discretion and free of any influence from my husband, ROBERT LEE KURTZ. FOURTH I give, devise, bequeath the rest, residue and remainder of my estate of whatsoever nature and wheresoever situate in equal shares to my children, CRAIG DAVID KURTZ, and KAREN KURTZ WEYL, per stirpes. ~ FIFTH r Any item that is not distributed under the terms of the prior paragraphs shall be w distributed according to the discretion of my personal representative, after consultation with `~ any heir or heirs of mine who survive me, and my personal representative shall choose such articles from my tangible personal property (exclusive of cash, stock certificates, bonds, and all other tangible evidence of intangible personal property) as he, she or it believes will be useful to such heir or heirs or desirable for him or her or them to have, either from a 2 of 9 sentimental point of view or otherwise, and to deliver such articles to such heir or heirs or among such heirs in equal or unequal shares as determined by the further exercise of his, her or its discretion, provided no other heir objects to the distribution. All tangible personal property not so distributed is to be sold, either publicly or privately, by my personal representative, adding the proceeds of such sale or sales to my residuary estate and to be disposed of in equal shares among my surviving heirs after payment of my estate debts, taking into account the tangible personal property otherwise provided to them. ~~,~ SIXTH Any devise or distribution under this Last Will and Testament which is payable to any beneficiary who may be under 25 years of age, or, in the judgment of my personal representative, mentally disabled, shall be held in separate trusts, by my son, CRAIG ~J ~` DAVID KURTZ, or my daughter, KAREN KURTZ WEYL. In the event that bot r ~.~ KAREN and CRAIG are unwilling or unable to act as Trustee, then in the alternative, I v ~ shall appoint my granddaughter, CABBIE MARIE KURTZ, to act as Trustee until such beneficiary(s) reaches 25 years of age or during such period of disability. J S So long as any beneficiary is under the age of 25 years of age, or mentally disabled, C the net income of his or her Trust shall be paid to, or applied for the benefit of said beneficiary(s) at such times and in such amounts that the Trustee shall in his or her discretion deem necessary for the health, maintenance, support, and education of each such beneficiary(s). Education shall be defined broadly to include not only that available in college, but also trade school and other similar training. In the event that the income 3 of 9 shall be insufficient to provide said beneficiary with adequate health, maintenance, education and support, the Trustee may invade the principal of this Trust for this purpose. SEVENTH I grant my personal representative the following powers in addition to and not in limitation of such powers as my personal representative shall hold by law: (a) To retain all property received including the stock of any corporate fiduciary acting hereunder, provided such property remains productive. ~~ N (b) To join in any corporation, partnership, recapitalization, merger, reorganization or voting trust plan; to delegate authority with respect thereto; to deposit investments under agreements and pay assessments; and generally to exercise all rights of investors, including but not limited to, the voting of shares. (c) To manage, operate, repair, improve, mortgage or lease on any terms any real estate held or owned by my estate. (d) To operate any business that I may own at my death. (e) To invest any funds of my estate in any stocks, bonds, notes or other securities or property, real or personal, without regard to the principle of diversification or any other statute or general rule of law in his, her or its absolute discretion, it being my intention to give my personal representative the broadest investment powers possible, providing such investments do not unnecessarily prevent the prompt settlement of my estate. 4 of 9 (f) To sell or otherwise dispose of any property, real or personal, tangible or intangible, at any time forming a part of my estate in any manner and on such terms and conditions as my personal representative shall see fit in his, her or its absolute discretion. (g) To borrow money for the payment of taxes or for any other proper purposes in the administration of my estate, and to mortgage or pledge estate assets as security. (h) To compromise claims without court approval including, but not limited to, 1 any controversies with the United States of America or the Commonwealth of Pennsylvania concerning estate and inheritance taxes on any interests that may pass under this my Last Will and Testament. (i) To distribute in cash or in kind upon any division or distribution of my T7 estate. (j) To undertake any and all acts deemed necessary and proper by my personal representative for the proper, advantageous and prompt management of the settlement of my estate. veers in the mana ement of my estate which any (k) In general, to exercise all po g individual could exercise in the management of similar property owned in ~~ his own right, upon such terms and conditions as to him, her or it may seem best and to execute and deliver all instruments and to do all acts which he, she or it deems necessary or proper to carry out the purposes of this, my Last Will and Testament. 5 of 9 EIGHTH All property under this Will shall pass as though my husband predeceased me. If any other beneficiary should die within sixty (60) days after my death, he or she shall be deemed to have predeceased me for all purposes hereunder. NINTH No interest of any beneficiary of my estate, either in income or in principal, shall be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have the power in any manner to charge or encumber his interest either in ~° income or principal, nor shall the interest of any beneficiary, while in the possession of my ~ personal representative, be subject to liability for such beneficiary. TENTH I direct that my executor or executrix, trustee, or guardian herein named shall not be required to give or post bond for the faithful performance of their duties in any jurisdiction. ELEVENTH ~> I nominate, constitute and appoint my beloved children, CRAIG DAVID KURTZ, ,;~ and KAREN KURTZ WEYL, as personal representatives of this my Last Will and Testament. In the event that either of them is deceased, unable or unwilling to serve or shall cease to serve for any reason whatever, then the other one shall act alone. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. 6 of 9 TWELFTH I hereby declare it to be my expressed desire that my personal representative(s) i,~~ 1 y r ,~,.:\ employ the law firm of Stephanie E. Chertok, Esquire, of Cumberland County, Pennsylvania, for legal advice and assistance regarding this my Last Will and Testament, they having considerable knowledge of my affairs, views and wishes respecting any matters that may arise at the probate of this instrument, the administration of my estate, and the execution of the powers herein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and 7~f da of ~ , 2008. Testament this y WITNESS: ~' JANNA LOCKS MOW Y KURT 7 of 9 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND I, JANNA LOCKS MOWERY KURTZ, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby m Last Will and Testament; that instrument as acknowledge that I signed and executed the y ~`~: ~ I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein ~ expressed. ~~ /JANNA LOCKS MOWERY KURTZ t~ Sworn or affirmed and acknowledged before me by JANNA LOCKS MOWERY ~ ~ KURTZ, the testatrix, this a~ day of • ~~,..: , 2008. ~ ,< t~ ~'~ - ~ :~. a ~:'~"i?•':N.1'^S/'NkY¢:.SC`9Urw'.,~ytTl:em62'~9~' l'.4~T.z~iY'i~EeT.^~. ~k~.. ~a=.nn 8 of 9 AFFIDAVIT t ~1 ~~ ~s ~~ Y ~~ ~~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS ~~ - d~ r ~ ~ the witnesses whose names are We ~1 ~ nd C~ attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the 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 subscribing witness in the hearing and sight of the testatrix signed the Last Will and Testament as witnesses and that to the best of our knowledge, the testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. or affirmed and subscribed before me b /VQn!?8~•~f~ _and y ~, ~, . ~ b ~ this ~~ day of ~)6~.~.~ , 2008. .~- ,~ ~ ~ ;~ j y,~..!.~'~.`S':~3AI.,r4 ;1:^~.~R': au. at T.~:K.4~±3~'82.F+'.fi5ltifJCF w:i~,Kati;N+~.'".,ifs$.tiAMd•Y,~f-~.,t ~ n ! :7 c~ :{ ~ r '~5z E $ _. L. 4 ~ t~ r ~ ~... a, a~. ~E ~:..;.G':P`X St.<.1... a6. ~:5tu"'C~'tC^':T msAY ..._cx.. .._.~y. !C +.....~.'.~ 9 of 9