HomeMy WebLinkAbout01-07-13RECO~o~~ n~:.~~r o~
0013 ~~~`' ? ~'~ ~_~'~H OF St BSCRiBItiG ti~•IT~ESS(ESj
CLEt~,~ 4}`~
ORPHAN ''; ~~~~~,,,~_ R~GISTER OF `FILLS
MBERE,gP~~~~'y' ~-~-°~"'/~'` COUNTY PENNSYLVANL~
CU ,
Estate of Gam/ ~ ~- ~~J~- ~ r ~L ~ ~`S~~ ,Deceased
~1 %~G/w%~j" / ~ ~ ~~Y~~~ , (each) a subscribing witness to
(Print Names)
the Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
says 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.
(Signature)
(Street Address)
(City, Stale, Zip)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this C~ day
of~f~ ~D/.~.
y for Register of ;~'is
~ ~~~
(Signatw e) ~~ / G tj/ N/ ~ ~- /G LS
~ ~liCvJ /^~C~
(Street Address) /~
~~~,~,~~~, ~.~ ~~3 zy
(City, State, Zip)
Executed otet of Register's Office
Sworn to or affirmed and subscribed
before me this ~ day
of
'~o.:r~~ Pubiic
'~1y Cor:~~rissior. Expires:
(Signature and Sea; of Ao:ary or other e fici~' : ~aiitie.: to
adminis:e: oaths. Show date of expiration ei ~+e:ar;'s Commission.)
NOTE: To be taken by Officer atrthorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization.
Fornt RW-03 rev. 10.13.06