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Home My WebLink About12-03-12 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 requests the grant of Letters in the appropriate form: James D. Leggett and Jan L. Hawkes Decedent's Information / Name: Ann W. Ferraiolo File No: 21-12 - a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 169-24-1755 Date of Death: 11/10/2012 Age at Death: 81 Decedent was domiciled at death in Cumberland County, PA (State) with his/her last principal residence at 303 Founders Way, Mechanicsburg 17050 Silver Spring Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Holy Spirit Hospital Camp Hill Cumberland PA Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvania All personal property $ 40,000.00 If not domiciled in Pennsylvania Personal property in Pennsylvania $ If not domiciled in Pennsylvania Personal property in County $ Value of real estate in Pennsylvania $ 250,000.00 TOTAL ESTIMATED VALUE $ 290,000.00 Real estate in Pennsylvania situated at 303 Founders Way, Mechanicsburg 17050 Silver Spring Cumberland (Attach additional sheets, if 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) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated 03/23/2011 and Codicil(s) thereto dated 04/1112011 State relevant circumstances (e.g., renunciation, death 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 ❑ B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., pedente lite, durante absentia. durante minontate If Administration, c.t.a ord.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 pending divorce proceeding wherein the grounds for divorce had been established as defined in 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 ascertained that Decedent left no Will and was survived by tl following spite (if MW)Md heirs (attach additional sheets, if necessary): O t~ CD rr i Name Relationship Address :0 t- - srt y, ~ ~ :ry :z p C7 Cy C fz> °x-t ii Co s","" "YI ~I Ln "y 1 Form RW-02 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } Petitioner(s) Printed Name Petitioner(s) Printed Address James D. Leggett 6411 Glenwood Street Mechanicsburg, PA 17050 rr`' C? %..i R1 Jan L. Hawkes 95 Holly Lane k t_ " Etters, PA 17319 m -U ~ G') =C A W K' Q r" `3 d GJ t t-VI The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the st of the knovAaUge and belief of Petitioner(s) and that, as Personal Representative(s) of the pecedent etitiop, er(s) will well and truly administer the estate accordin to la Sworn to or affirmed an subscribed before Date J j day of 71 } , < ( Date ii me i§ " 1'( Date ~ Date For the Register BOND Required? E] YES NO To the Register of Wills: Please enter my appearance by my signature below: FEES: Letters $ c 0 Attorney Signature: ' ( )Short Certificate(s)......... ( )Renunciation(s) ( )Codicil(s) Affidavits Printed Name: Michael L. Bangs Bond Supreme Court Commission ID Number: 41263 Other -Cc Firm Name: Bangs Law Office, LLC Address: 429 South 18th Street Camp Hill, PA 17011 Phone: 717/730-7310 Automation Fee Fax: 717/730-7374 JCS Fee cl-r r E-mail: mikebangs@verizon.net TOTAL $ 6S`i 1~ • ~C DECREE OF THE REGISTER Date of Death: 11/10/2012 Social Security No: 169-24-1755 Estate of Ann W. Ferraiolo File No: 21-12 a/k/a: AND NOW, 3 C G e in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to James D. Leggett and Jan L. Hawkes in the above estate and (if applicable) that the instrument(s) dated 03/2312011 04/11/2011 described in the Petition be admitted to probate and filed of record as th K I st Will (and Codicil(s)) of De dent. L'nda Register of Wills )DI / / Z j{L Copyright (c) 2011 form software only The Lackner Group, Inc Pag of 2 rJ r JJI 'I RECORDIED G FICE CF ;REGISTER OF V!1 ZG12 DEC 3IRi 8 1 S CLERK 0r P 18 8 0 21(0gQHANS GOO i - NOV 1'11 14 ~7Q12 .,-,CUMBERLAND CO.. i'`,( Type/Print In COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF HEALTH VITAL RECORDS Permanent CERTIFICATE OF DEATH Black Ink State File Number: 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) Ann W. FerralOlO Female 169 - 24 - 1755 November 10, 2012 Sa- Age-Last Birthday (Yrs) 5b. Under 1 Year 5c. Under 1 Da 16. Date of Birth (MO/Day/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Country) Months oavs Hours Minute Allentown PA f 81 August 11, 1 9.51 7b. Birthplace (COpnty)Lehigh 8a. Residence (State or Foreign Country) 86. Residence (Street and Number -Include Apt No.) 8c. Did Decedent Live in a Township? tvp Penns lvania ®Yes, Decedent Iived in Silver Spring 8d. Residence (County) 303 Founders Way Cumberland 8e. Residence (Zip Code) 17050_ Q No, decedent lived within limits of city/boro. 9. Ever in US Armed Forces? 10- Marital Status at Time of Death Q Married Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Yes ® No Q Unknown Q Divorced Q Never Married Q Unknow 12- Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Roy Keiser Wise Frieda Bauman 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code) o James D. Leggett Son 6411 Glenwood St., Mechanicsburg, PA 17050 .15a. Place o Death (Check _ ..o Other Than _ If Death Occurred in a Hospital: Inpatient =1f Death Occurred Somewhere OtM1e Than a Hospital: Hospice Facllity Q Decede ni's Home ° Q Emergency Room/Outpatient Q Dead on Arrival _ ON ".i.g Home/Long-Term Care Facility Q Other (Specify) 15b. Facility Name (If not institution, give street and number; 15c. City or Town, State, and Zip Code 15d. County of Death Hot Spirit: Hospital Cam Hill, PA 17011 Cumberland 16a. Method of Disposition Q Burial Cremation 16b. Data of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) m Q Removal from State Q Donation November 12 , Q Other(Specify) 2012 Evans Crematory 16d. Location of DISpO51Uon (City or Town, State, and Zip) 17a. Signature of F al Servi nsee or Person in Charge of Interment 17b- License Number Scs haefferstown, PA 17088 FD 013 340 L E 17c. Name and Complete Address of Funeral Facility Parthemore FH & CS =nc. P.O. Box 431, New Cumberland, PA 17070 18. Decedent's Education - Check the box that best describes the 19. Decedent of Hispanic Origin - Check the 200 Race - Check ONE OR MORE ra s to indicate what I- 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 b- E3 81h grade or less s Spanish/Hispanic/Latino. Check the "No" White Q Korean Q No dlploma, 9th - 12th grade box if decedent Is not Spanish/Hispanic/Latino. Black or African American Q Vietnamese Q High school graduate or GED completed JM No, not Spanish/Hispanic/Latino Q American Indian or Alaska N-I- Q Other Asian CR 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 Q Bachelor's degree (e.g. BA, AB, BS) O Yes, Cuban Q Filipino Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino Q Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, EdD) or PDrofessional degree (Specify) Q Other (Specify) .MD DDS DVM LLB, I 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 Black or African American Ej Korean Q Other Pacific Islander Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Homemaker Q Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian Q Other (Specify) Q Filipino Q Go ama nian or Chamorro Domestic ITEMS 23a - 23d MUST BE COMPLETED 23a. D Ye Pronounced Dead (MO/Day/Yr) 23 b. Signature of Person Pronouncing Death (Only when applicable) 23<. License Number BY PERSON WHO PRONOUNCES OR ] CERTIFIES DEATH 19 23d. Date Signed (MO/Day/Yr) 24. Tf e f D th Q 25. Was Medical Examiner or Coroner Contacted? 00 Yes Q No CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of a ents--diseases, Injuries, or complications--that directly caused the death- DO NOT enter terminal --s such a card lac arrest Interval: - respiratory arrest, or ventricular fibrlllatlo ith ut showing the tlology DO NOT BREVIATE- ('E~Ln . ter only one cause on a line. Add additional lines if necessary Onset to Death {rte/ w /e~ ,p\$■ J(.t1 IMMEDIATE CAUSE > a- Y <A~~P~e.SS G.\Y \ C~.ll T1 V!l Vl (Final disease o condition Due to (or as a consequence f): res ulting in death) b. IVJ Sequentially list conditions, Due to (or a n nce if any, leading to the cause ` I-d on Iine a. Enter the W UNDERLYING CAUSE c Due to o as a consequen w (disease or inJu ry that (%y~, p~ Initiated the ev nts resulting d. ~+'-x'~ L I. death) LAST.e Due to (o as sequence of): - S 26. Part It. Enter other significant conditions contributing to dear but not resulting I. the underlying cause given In Part I 27- ° Was Q autopsy pero med? Yes No 28. Were autopsy findings available to complete the c of death? a Q Yes aQ No w 29. If Fe le: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death E ot pregnant within past year Q Yes Q Probably ~~N atural Q Homicide S Q Pregnant at time of death Q No rL6.known Q Accident Q Pending Investigation Q Not pregnant, but pregnant within 42 days of death T Q Suicide Q Could not be determined Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Yr) (Spell Month) 4 ; 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) tJ 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Yes Q Driver/Operator 1-3 Pedestrian f. Q No Q Passenger Q Other (Specify) ' 39a. Certifier (Check only one): Certifying physician - To the e t of my knowledge, death occurred due to the cause(s) and manner stated Q Pronouncing 8< Certifying Ph - To t% best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated Q Medical Examiner/Coronery/~r~,~Icc p/' siis of examination, and/or Investigation, in my opinion, death ` rred at the time, date, and place, and due twos the cau/se(s) and er stated Signature of certifier: Title of certlFler: V ` 7 License N.mb~e V- - - 39 Name, Atltlress and Zip Code of Com pleting Cause of Death (Item 26) 1 -0p tA- Gp~ NT 39c. Date fined o/Day/V r) L5EE_ M . 1 M, ( G 0 4 3 10 .,A- C, 1 y 40. Regis rs District Number 41. Registrar's nature y~~ 42- Reglstr r File ate (MO/D,V/Yr, ° 43. Amendments ITEM # -I" s" SHOULD READ ;00~a ti F-- nnc A,T i H105-143 C rn f C> 41> r7_ :20 > r- 2: rTI 6~ riff . cn TT, I, ANN W. FERRAIOLO, of Silver Spring Township, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness shall be paid from my residuary estate as soon as practicable after my death as a part of the expense of the administration of my estate. ITEM II. All estate, inheritance and other death taxes (including interest and penalties) payable by reason of my death shall be apportioned among, charged to and paid by the recipients and beneficiaries of the property or interests included in the measure of the tax in the proportion that the net amount of such property or interest bears to the amount of my net estate. In determining the allocation of the tax, the property or interest included in the measure of a particular tax shall be reduced by any deduction specifically attributable to that property or interest with respect to that tax. The term "net estate" shall mean my gross estate as defined for purposes of a particular tax less any deductions (other than the unified credit) allowable for the purposes of that tax. ITEM III. I hereby make a specific bequest to my son DONALD B. LEGGETT provided he survives my death by thirty (30) days of the property I own and identified as Unit 101, 1525 North Front Street, Harrisburg, Pennsylvania. I currently have a mortgage on this property and my son Donald is required as part of this bequest to pay off that mortgage or otherwise have it refinanced so that it is no longer a debt of my estate. In the event that he 1 cannot pay off or refinance that mortgage, then the property should be sold and he shall be entitled to retain all of the proceeds from the sale. My son, DONALD B. LEGGETT, shall be responsible and required to pay any and all inheritance taxes due or which result from this specific bequest. ITEM IV. I hereby make a specific bequest to my son DONALD B. LEGGETT of my ownership interest in 701 East Locust Street Associates, LLC which essentially is an interest in real estate at 701 East Locust Street, Mechanicsburg. In conjunction with my purchase of the interest in 701 East Locust Street Associates, LLC, I took out a home equity loan with PNC Bank which currently is a lien on my home at 303 Founders Way, Mechanicsburg, Pennsylvania. If the home equity line owed to PNC Bank has not been paid in full as of the time of my death, then my son DONALD B. LEGGETT shall be responsible to pay the outstanding balance of the home equity loan or otherwise have it paid so that it is not a debt to my estate. The debt may be repaid from any share that he is to receive from my estate. However, should Donald B. Leggett not receive sufficient funds from my estate to pay this debt or is unable to otherwise refinance the debt, then my interest in 701 East Locust Street Associates, LLC, must be sold and the home equity loan with PNC Bank must be paid in full. All proceeds in excess of the outstanding balance of the home equity loan shall be given to Donald B. Leggett. ITEM V. I give and bequeath one (I%) percent of my estate or Ten Thousand and 00/100 ($10,000.00) Dollars, whichever is less, to each of my grandchildren and step- grandchildren who survive my death by thirty (30) days. 1 2 ~~s ITEM VI. I give and bequeath all my household goods, automobiles, jewelry and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, in equal shares to my children JAMES D. LEGGETT, DONALD B. LEGGETT, ERNEST W. LEGGETT and JAN M. HAWKES who survive my death by thirty (30) days. In the event that any of my children fail to survive my death by thirty (30) days, then their share shall go to their issue. ITEM VII. I give, devise and bequeath all the rest, residue and remainder of my possessions and estate of every nature and wherever situate in equal shares to my natural children JAMES D. LEGGETT, DONALD B. LEGGETT, ERNEST W. LEGGETT and JAN M. HAWKES and my stepchildren MARK FERRAIOLO, JOSEPH FERRAIOLO, DAVID FERRAIOLO, BRIAN FERRAIOLO and KENNETH FERRAIOLO. In the event that any of my natural children or stepchildren fail to survive my death by thirty (30) days, then their share shall go to their issue per stirpes. Should they not have any issue, then their share shall be divided evenly among those beneficiaries designated in this paragraph who do survive my death by thirty (30) days. ITEM VIII. Should any beneficiary entitled to a share of my estate not have attained the age of twenty-one (21) years at the time for distribution to him or her, I devise and bequeath the share of such beneficiary to my hereinafter named trustee, IN SEPARATE TRUSTS, to hold, manage, invest, and re-invest, the shares so received, and the accumulation of income thereon, and to use and apply from time to time such portion of income and principal thereof as my trustee thinks proper for the comfortable support, maintenance, health, welfare, and education of the beneficiary or to make payment for such purposes, without further responsibility, directly to n 3 such beneficiary, or directly to any person taking care of such beneficiary. Any principal or income not so applied shall be distributed to such beneficiary when he or she attains the age of twenty-one (21) years, or if he or she dies prior thereto, to his or her personal representative. ITEM IX. I appoint my son DONALD B. LEGGETT trustee of the trust or trusts created by this my last will. Should my son Donald predecease me or otherwise fail to qualify or cease to serve as trustee, I appoint my son JAMES D. LEGGETT trustee. In addition to the other powers and authorities granted to my trustee by Pennsylvania Law and by the preceding paragraph of this my last will, I hereby give my trustee the following special powers and authorities: A. To retain any or all of the assets of my estate, real or personal (including any stock or securities of any corporate fiduciaries), without any regard to any principle of diversification, risk, or productivity; B. To invest and re-invest in all forms of property without restriction to investments authorized for Pennsylvania Fiduciaries, as my trustee deems proper, without regard to any principle of diversification, risk or productivity; C. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my trustee deems proper and in the best interest of the beneficiary or beneficiaries of said trusts; D. To allocate receipts and expenses to principal or income or partly to each as my trustee from time to time deems proper in its sole discretion; E. To compromise any claim or controversy; 4 F. To exercise any option, right, or privilege granted in insurance policies or in any other investments; G. My trustee may accumulate the income from this trust during the term thereof but may, from time to time, distribute from current income or from accumulated income or from principal such amounts as my trustee, in its sole discretion, deems advisable for the education, welfare, and comfort of the trust beneficiary. ITEM X. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM XI. I appoint my son DONALD B. LEGGETT executor of this my last will. Should he predecease me or otherwise fail to qualify or cease to serve as executor of this my last will, I appoint my son JAMES D. LEGGETT executor of this my last will. ITEM XII. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; 5 to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM XIII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ' r2 6ay of , 2011. ANN W. FERRAIOLO 6 The preceding instrument, consisting of this and SIX other typewritten pages, each identified by the signature of the testatrix was on the date thereof signed, published, and declared by ANN W. FERRAIOLO, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. 7 COMMONWEALTH OF PENNSYLVANIA ) (SS: COUNTY OF CUMBERLAND ) The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ANN W. FERRAIOLO Sworn or affirmed to and acknowledged before me by the testatrix na ed above t~~4t~tONW`j 1-T H of P sm this day of I c , 2011. Vft: cty K Sh b, MAMN t'ubk -m- r AII&I TW G COX* My Cwerniss!w EA*w May 1o, 2011 1~'otary Public pon;Wswa Associaton of Notaries COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) WE, M , av. e I L & and L y lzy 617kFIV ic--Ew , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more ears of age, of sound mind, and under no constraint or undue influence. J Sworn or affirmed to and acknowledged before m ji sday of 2011. T otary Public Notarai Seat Wardq K Straub, Notary Pubec t.aAw ripen 1V4p., C wterfaM 0W* W CowNsslw E*hw May 10, 2011 ponnVvenia Association of Notaries 8 M c-' ;0 r : rm w the C -Wo C CC) 1 '1 c) c~1il~• /~i: ~/dl ~li~~ 1, ANN W. FERRAlOLO, of Silver Spring Township, Cumberland County, Pennsylvania, declare this to be my sole codicil to my last will dated March 23, 2011. ITEM I. 1 hereby revoke ITEM XI of my will and in lieu thereof provide as follows: IrI'EM XI. I appoint my son JAMES D. LEGGETT and my daughter JAN M. HAWKES Co-Executors of this my last will. Should either or both of them predecease me or otherwise fail to qualify or cease to serve as Co-Executors of this my last will. I appoint my son ERNEST W. LEGGETT Executor of this my last will. ITEM II. In all other respects, I hereby ratify, confirm and republish my last will dated March 23, 2011, together with this sole codicil as and for my last will. IN WITNESS WHEREOF. I have hereunto set my hand and seal this day of , 201 1. i ANN W. FERRAIOLO 1 Signed, published, and declared on the date hereof by the above-named testatrix as and for the sole codicil to her last will dated March 23, 2011, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. 2 COMMONWEALTH Of' 1 1 NNSYLVANIA ) (SS.: COUNTY OF CUMBERLAND ) The undersigned. being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my sole codicil to my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. d", Lo ANN W. FERRAIOLO Sworn er affirmed to and acknowledged beibre me by le test rix named above this day o ' It test 201 1. COA!>r10N1NEALTH OF P NA.SYLVANiA 1 1 Wendy K Straub, Notary pub t - - Lo*wmlen Twp. cwte mid C(xaziy i 4t~ MY COmrnls on Exphw May 10, 2011 Notary Publ Pennsylvanis Association of Notaries COMMONWEALTH OF 111:NNSYLVANIA ) ( SS.: COUNTY OF~CUMBI?I LAND ) WE, and Z y/vny E :AD'FEZ,D , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her sole codicil to her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the codicil as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed to and a A nowl ged before me this day of V22 011. gotary Pu f~TH Mow F NN'113`1-VA NtA P-L-Aesiat Sad We* K Straub, Mary R M 3 Low v Ai w Twa., r..un. be Wid Cau+t'j EomMrj a1y tars n~ Gaon 10, 2D11 Fon*vania knociation of Notaries