HomeMy WebLinkAbout12-18-12R1~:C.ORI)ED OFFICE OF
KI~;(;1517:R O1~ ~~(/1],1,5
2012 DEC 18
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(_)RPI I:U~IS C~)~tR'1'
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O_~TH OF SLBSCRiBI~G ~ti"IZ'tiESS(ES)
//--~~ REG STER OE WILLS
~-' G'"`'~' ~'''" ~~'" ~ COLNTY, PENi`ISYLVANL~
Estate of G~~- L%l`_~._~- ~, ,~~l~ ~S S ~n
L C._ i ,~ ~ -~ ~ ~~-/t/~~~
Deceased
(each) a subscribing witness to
(Print Name/S)
the ill ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say() that she / he /they was /were present and saw the above Testator /Testatrix sign the same
and that she / he /they signed the same and that she / he /they signed as a witness at the request of
the Testator /Testatrix in her /his presence and in the presence of each other.
r` ~ ~~
(Signature) (Signature) !,, _r ~ ~~ ~ ~, /~/ < L~~
`iv
(Street Address)
(Street Address)
(city, state. zip)
(City, State, Zip)
Execa~ted in Register's Office
Sworn to or affirmed~a/nd subscribed
before me this _,~0 day
Execcrted oc~t of Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Deput}- for Register of `,'~`i,1s
'~o-_~' Pubiic
'~1~~ Cor,~rissior. Expires:
(Signature and Sea'. of Notary or other e:*ri;: c.,ai~t~e,: to
administe: oaths. Sho« date of expiration o`No:ary's Commission.)
NOTE: To be taken by Officer authorized m administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Form RW-03 rev. ! 0. i 3.06