HomeMy WebLinkAbout02-05-13PETITION 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:
Cindy L. Radle
Decedent's Information 1~
Name: Jeanne B Spayd File No: 21 - f x "' ~~ / `f ~9
a~/a: (Assigned by Register)
a/k/a:
a/k/a:
Date of Death: 10/11/2012
Decedent was domiciled atdeath in Cumberland
Social Security No:
Age at Death: 84
County, pq
principal residence at 4905 E. Trindle Road, Mechanicsburg 17050 Hampden
Street address, Post Office and Zip Code City, Township or Borough
(State) with his/her last
Cumberland
County
Decedentdied at Holy Spirit Hospital East Pennsboro Cumberland PENNSYLVANIA
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
If not domiciled in Pennsylvania .................. Personal propertyin Pennsylvania
If not domiciled in Pennsylvania .................. Personal propertyin County
Value ofreal estate in Pennsylvania...........
18,000.00
TOTAL ESTIMATED VALUE$ 18,000.00
Real estate in Pennsylvania situated at
(Attach additional sheets, if necessary.)
Street address, Post Office and Zip Code
City, Township or Borough
Q 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
thereto dated
County
11/10/2004 and Codicil(s)
(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 mar ,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(8), and did not have a child born or
adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
^X NO EXCEPTIONS ^ EXCEPTIONS
^ B. Petition for Grant of Letters of Administration (tfapplicable)
c. t. a.; d. b. n.; d. b. n. c. t. a.; pedente liter durante absentia; durante minoritate
If Administration, c.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 pending divorce proceeding wherein the grounds for divorce had been estab
in 23 Pa. C.S. § 3323 (g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. l~ed s defined '~-"~'
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NO EXCEPTIONS ^ EXCEPTIONS W
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Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse
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Form i~IN Q2 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2
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Oath of Personal Representative
~ COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Official Use Only
Petitioner(s) Printed Name Petitioner(s) Printed Address
Cindy L. Radle 107 Roberts Valley Road
Harrisburg, PA 17110
Name as listed in Will: Cindy L. Weikert
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I ne reutloner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are tru and correct to the t o~fihe knowl~d~e and • " ' "
belief of Petitioner(s) and that, as Personal Representative(s) ofthe Decent, Peftioner )will a truly administer estate accoctslt>ng to~~v. y
r t Date ~' ~ /
Sworn to or affirmed and subscribed before
me this y ~ day of, ' ~,' y ~ l f ? , ,, i Date
By:~ s~ .~l ~ ~ ~ t~~~' ~~ 1~,~ ~; ~~ ~ ~ , ~'~ Date
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i-ur the Register % ~ Date
BONDRequired? ~ Yes QX No
FEES
Letters ............................................ , { ( ,
( )' ) ShortCertificate(s)........... ~~~" , ("
( )Renunciation(s) ...............
( )Codicil(s) .........................
( )Affidavit(s) .......................
Bond ...............................................
Commission ...................................
Other
AutomationFee .............................. ~ j . ~ ~~~'
JCS Fee ......................................... .~ ~ c_~~,
TOTAL ........................................... $ 1 ~~ ~. ~(. `
To the Register of Wills:
riease ter my appearance by my signature below:
Attorne nature: !~ ~'r~ (
Pririfed Name: Scott M Dinner Esq
Supreme Court
ID Number: 53353
Firm Name: Law Office of Scott M. Dinner
Address: 3117 Chestnut Street
Camp Hill, PA 17011
Phone: 717/761-5800
Fax: 7171761-5008
E-mail: dinnert~localnet.com
DECREE OF THE REGISTER
Date of Death: 10/11/2012
Social Security No: 201-18-4942
Estate of Jeanne B Spayd File No: 21 -~,~~ •~ ~~ /
a/k/a: ~ ` ~__
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AND NOW, F~ " . ~~~, ~ ~ ~ _~ C - ~ ( I~_.~~ tt + -~-"" 9 9
satisfactoryproofhsving been pre fed before me, IT IS DECREED t Letters esT tamentary
are herebygranted to Cindy L. Radle
in the above estate and (if applicable) that the instrument(s) dated 11/10/2004
described in the Petition be admitted to probate and filed of record as t e last Will (and Codicil(s)) of Decedent.
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Copyright (c) 2011 form softwar~ only The Lac ner Group, Inc.
Page 2 of 2
RECaR~E~ ~~'~ ~c~ OF
REGISTcR OP ''~C.L~-
~~13 ~E8 5 HC~ ~ ~ 5?
~ ~.~ c~ER~a~. ~~~ /~ ._ OCT152012
ORPHANS' CaURT i~
'%~/~' C-U1~ B ER L~~~QEA~~o. PE(SNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS
~' Type/Print In
Permanent CERTIFICATE C!F I~FATH _ _-. -. -
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1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo)
Jeanne B_ Spayd Fama1 October 11, 201
Sa. Age-Last Birthday (Yrs) Sb. Under 1 Vear Sc. Under 1 Day 6. Date of Birth (Mo/D ay/Year) (Spell Month) 7a. Birthplace (City and S tate or Foreign Country)
Months Days Hours Minutes 1
2 Harrisburg , PA
8 4 Ma 2
9
8
y ~ 7b. Birthplace (County) Daup 1 n
Sa. Residence (State or Foreign Country) 8b. Residence (Street and Number -Include Apt No.) 8c. Did Decedent Live in a Town nip?
Penns lvania 4905 E_ Trindla Road I~ampdan
®Yes, decedent lived in twp.
8d. Residence (County)
Cumber 1 and 8e. Residence (Zip Code) 1 7 0 5 0 ~ No, decedent lived within limits of city/born
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)
Yes $] No ~ Unknown ~ Divorced ~ Never Married Q Unknown
12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last)
Edward Kautz Haza1 Row
14a. Informant's Name 14b. Relatio sH"p to Decedent
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1 07 Roberts Va
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.. _..............._ 15a. Place of Death (Check on y one)
......... _.. _..__. _
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If Death Occurred in a Hospital: Q In atient ....... ..... ... ___..... Pi...
=1f Death Occurred Somewhere Other Than a Hos tai: ~ Hospice Facility ~ Decedent's Home
° Emer enc Room Out atient
g Y / P ~ Dead on Arrival
.
~ Nursing Home/Long-Term Care Facility ~ Other (Specify)
w 15b. Facility Name (If not institution, give street and number, 15c. City or Town, State, and Zip Code 15d. Coun of De h
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Hot Spirit Hospital and
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Camp Hi11, PA 17011 Cum
m 16a. Method of Disposition ® Burial ~ Cremation 16 b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place)
v pRemovalfromState pDonation OCt16,2012 Rolling Green Cemetery
0 Other (Specify)
16d. Location of Disposition (City or Town, State, and Zip) 17 Si ature of Fun I Service Licensee or Person in Charge of Inter ent 17b. Licens Numb r
~1 242
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Camp Hi11, PA 1 701 1 -
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~, 17c. Name and Com lete Address of Funeral Facility
Stone ~ Murray Funeral Hom 408 3rd•Streat, New um erland, PA 17070
°' 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
F°- highest degree or level of scn Doi completed at the time of death. box that best describes whether the decedent the decedent considered Himself or herself to be.
0 Stn grade or less is Spanish/Hispanic/Latino. Check the "N O" ~ White 0 Korean
0 No diploma, 9tH - 12th grade box if decedent is not Spanish/Hispanic/Latino. Q Black or African American Q Vietnamese
® High school graduate or GED completed No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native [~ Other Asian
Some college credit, but no degree ~ Yes, Mexican, Mexican American, Chicano 0 Asian Indian Q Native Hawaiian
Associate degree (e.g. AA, AS) 0 Yes, Puerto Rican ~ Chinese ~ Guamanian or Chamorro
~ Bachelor's degree (e.g. BA, AB, BS) ~ Yes, Cuban ~ Filipino Q Samoan
Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) ~ Ves, other Spanish/Hispanic/Latino Q Japanese ~ Other Pacific Islander
Doctorate (e.g. PhD, EdD) or Professional degree (Specify) ~ 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. 22 a. Decedent's Usual Occupation -Indicate type of work
$] White ~ Japanese 0 Samoan done during most of working life. DO NOT USE RETIRED.
0 Black or African American ~ Korean ~ Other Pacific Islander Adm i n i s t r a t i va
Q American Indian or Alaska Native ~ Vietnamese ~ Don't Know/Not Sure
Asian Indian ~ Other Asian ~ Refused 226. Kind of Business/Industry
0 Chinese Q Native Hawaiian ~ Other (Specify)
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~ Filipino Q Guamanian or Chamorro Consumer Lif
2
ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead (Mo/Day/Yr) 23b. Signature of Person Pronouncing Death (Only when applicable) 23c. License Number
CERTIF EOS DEATH PRONOUNCES OR /-1 ~ t ~~ ~ ~'' ~n'~
23d. Date Signed (Mo/Day/Vr) 24. Time of Death
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25. Was Medical Examiner or Coroner Contacted? ~ Yes
Q No
CAUSE OF DEATH Approximate
26. Part 1. Enter the chain of events--diseases, injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval:
respiratory arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE Enter only one cause on line. Add additional lines if necessary Onset to Deatfi
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IMMEDIATE CAUSE ---------------> a. ~L! ~V ~~ % / / / ~~ / ~~/
(Final disease or condition Du to (or as a cssnsequgyce of}
resulting in death)
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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):
(disease or injury that
initiated the events resulting d.
u in death) LAST. Due to (or as a consequence of):
_
26. Part I1. Enter other sienifica nt conditions contributine to death but not resulting in the underlying cause given in Part I 27. Was an autopsy performed?
a
~ Yes No
~ 28. Were autopsy findings available
to complete the cause of death?
v ~ Yes o-TC~-
o 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of DeatH
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~ Not pregnant within past year
Q Ves ~ Probably
[}TQ3fu ral 0 Homicide
~ Q Pregnant at time of death g.Glo 0 Unknown ~ Accident ~ Pending Investigation
m ~ Not pregnant, but pregnant within 42 days of death
~ Suicide ~ Could not be determined
I-° ~ Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In"u
~ ry (Mo/Day/Yr) (Spell Month)
0 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:
~ Yes ~ Driver/Operator Q Pedestrian
0 No ~ Passenger 0 Other (Specify)
39a. Certifier (GHeck only one):
er ifying physician -To the best of my knowledge, death occurred due to the cause(s) and manner stated
~ Pronouncing 8~ Certifying physician - To the best of m knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated
Q Medical Examiner/Coroner f e that n, and/or inv stigation, in my opinion, death occurred at the time, date, and place, and due to the
caus
e(s) and m her stated
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Signature of certifi Title of certifier:__ License Numbg///~/
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d dress and Zip de of Pers ~~p1/,~r~~Cause of De m 26)
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40. Registrar's Distric[ Number 41. Registrar's Signa a 42. Registrar File Date (Mo/Day/Yr)
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43. Amendments
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Disposition Permit No. c~~ (,,!' p RFV 07!?flt t
LAST WILL AND TESTAMENT
OF
J EAN N E B. SPAYD
I, Jeanne B. Spayd, of Mechanicsburg, Cumberland County, Pennsylvania,
being of sound and disposing mind and memory, do make, publish and declaresthis to be
my Last Will and Testament, hereby revoking all Wills and Codicils ~ ~e at a~ tine ~
~~ rn ~~
previously made. ~ ~ ~ ~ ~ ~
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Provision for Taxes ~' ~` +~~'~~ `~ ~" ~~
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ITEM I: I direct that all inheritance and estate taxes booming d~ byv ~°n
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reason of my death, whether such taxes may be payable by my Estate or by any recipient
of any property, shall be paid by my Executor out of the property passing under this Will
that is not specifically devised or bequeathed as an expense and cost of administration of
my Estate. My Executor shall have no duty or obligation to obtain reimbursement for any
such tax paid by my Executor even though on proceeds of insurance or other property not
passing under this Will.
Dispositive Provisions
ITEM II: I give and bequeath all my household furniture and furnishings,
automobiles, books, pictures, jewelry, china, linen, silverware, wearing apparel and all
other like articles of household or personal use and adornment to my children, Deborah L.
Knowles of Rochester, New York; Cindy L. Weikert of Dauphin, Pennsylvania; and Cheryl
A. Dunn of Clover, South Carolina (herein, my "Children"), per stirpes, to be distributed
among them in as equal shares as practicable, as they may agree. If they are unable to
agree, my Executor shall make such decision as to distribution.
Page 1 of 7
ITEM III: I give, devise and bequeath all of the rest, residue and remainder
of my property, real, personal and mixed, to my Children, per stirpes, in equal shares.
Appointment of Fiduciaries
ITEM IV: I nominate, constitute and appoint my daughter, Cindy L. Weikert,
to be my Executor. In the event of the death, resignation, refusal or inability of Cindy L.
Weikert to serve as my Executor, I nominate, constitute and appoint my daughter,
Deborah L. Knowles, to serve as Executor in her place.
ITEM V: If at any time any minor child or legally incompetent person shall be
entitled to receive any assets hereunder, I hereby nominate, constitute and appoint my
Executor to act as Guardian of the assets payable to such person. Said Guardian may
receive and administer all assets authorized by law and shall have full authority to use
such assets, both principal and income, in any manner said Guardian shall deem
advisable for the best interest of such person, including college, university, post-graduate
or other education, without securing court order. Said Guardian shall have all the rights
and privileges as to the Guardianship and the assets thereof as are herein granted to my
Executor as to my Estate and the assets therein.
ITEM VI: My Executor and Guardian are specifically relieved from the duty or
obligation of filing any bond or bonds.
Page 2 of 7
Powers of Fiduciaries
ITEM VII: In the settlement of my Estate, my Executor shall possess,
among others, the following powers to be executed for the best interest of the
beneficiaries;
(a) To sell either at public or private sale and upon such terms and
conditions as my Executor may deem advantageous to my Estate,
any or all real or personal estate or interest therein, whether owned
by me severally or in conjunction with other persons or acquired after
my death by my Executor, and to consummate said sale or sales by
sufficient deeds or other instruments to the purchaser or purchasers,
conveying a fee simple title, free and clear of all trust and without
obligation or liability of the purchaser or purchasers to see to the
application of the purchase money or to make inquiry into the validity
of said sale or sales; also, to make, execute, acknowledge and
deliver any and alt deeds, assignments, options or other writings that
may be necessary or desirable in carrying out any of the powers
conferred upon my Executor in this Item VII(a) or elsewhere in my
Will.
(b) To pay all costs, taxes, expenses and charges in connection with the
administration of my Estate. My Executor shall pay expenses of my
last illness and funeral expenses.
(c) To distribute my Estate in kind or in money. If any assets are
distributed in kind, they shall be distributed at their respective
value(s) on the date(s) of their distribution.
(d) To retain any investments I may have at my death so long as my
Executor may deem it advisable to my Estate so to do.
(e) To vary investments, when deemed desirable by my Executor and to
invest in such bonds, stocks, notes, money markets, real estate
mortgages or other securities or in such other property, real or
personal, as my Executor shall deem wise, without being restricted
to so-called "legal investments."
(f) To mortgage real estate and to make leases of real estate.
(g) To borrow money from any party to pay indebtedness of mine or of
my Estate, expenses of administration or inheritance, legacy, estate
and other taxes.
Page 3 of 7
(h) To vote any shares of stock that form a part of the Estate and to
otherwise exercise all the powers incident to the ownership of such
stock.
(i) In the discretion of my Executor, to unite with other owners of similar
property in carrying out any plans for the reorganization of any
corporation or company whose securities form a part of the Estate.
(j) To distribute my personal property directly to the Guardian of the
person of any minor beneficiaries hereunder.
(k) To elect such settlement options as deemed most appropriate by my
Executor with respect to any pension, profit sharing or other
retirement plan in which I am a participant.
(I) To do all other acts that, in the judgment of my Executor, are
necessary or desirable for the proper and advantageous
management, investment and distribution of my Estate.
Miscellaneous Provisions
ITEM VIII: I hereby exercise all powers of appointment that I may have at the
time of my death in favor of my Executor, and all property subject to all such powers shall
be included in my Estate.
ITEM IX: Any person who shall have died at the same time as me, or in a
common disaster with me, or who shall fail to survive me by ninety (90) days, shall be
deemed to have predeceased me.
ITEM X: I am aware that I have not provided any bequests in this Will to
my husband. This omission is not because of any lack of love and affection, but
because his financial needs are adequately provided for by other means and because it
is my desire and intent to distribute my assets to my children.
Page 4 of 7
IN WITNESS WHEREOF, I have set my hand and seal to this my Last Will
and Testament, consisting of this page, the next two pages, and the preceding four pages
~~`
this ~ day of
~; ,
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~' °" / Cam.
Jeanne B. Spayd
SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Testator, Jeanne B. Spayd, as and for her Will, in the presence of us, who, at her
request, in her presence and in the presence of each other, have hereunto subscribed
our names as witnesses in attestation thereof.
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Page 5 of 7
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
: SS.
COUNTY OF DAUPHIN :
I, Jeanne B. Spayd, the Testator whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; and that I signed
it willingly and as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Jeanne B. Spayd, the
Testator this 1~```'da of ; ~ '~'~`~ ! ~"~ v~:
~„~ Y ~ ~ ~ : '' , 2004.
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Jea ne B. Spayd, Testat r
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Notary Public
My Commission Expires: ;'~!;~r~~~
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Harva Owings Baughman, Notary Public
City of Harrisburg, i?auphin County
My Commission Expires July 12, 2008
Member, Pennsylvania Association of Notaries
Page 6 of 7
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF DAUPHIN
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and ~ ~- ,' - -- t ,the witnesses whose names are srgned to the
attached or fo going instrument, being duly qualified according to law, do depose and
say that we were present and saw the Testator sign and execute the instrument as her
Last Will; that the Testator signed willingly and executed it as her free and voluntary act
for the purposes therein expressed; that each subscribing witness, in the hearing and
sight of the Testator, signed the Will as a witness; and that to the best of our knowledge,
the Testator was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
worn t r affirmed and ,subscribed to before me by _ ~ ~ ,
~ ~~~~LC~. ~ ~-~~1~~-~~-`= ~ ,and ;~~ ~~~.; ~~~ ~ ~~~~~~_1~ ~~ ,witnesses, this !:- day of
„ ; ~ ~ ~, _ 2004. ,,
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My Commission Expires: ~` ~ ,~,%`~~ 1
r : \dbw\wills\Spayd\Jeanne - U]ill . doc COMMONWEAL'T'H OF PT?NNSYLVANTA
Notarial Seal
Harva Owings Baughman, Notary Public
City of Harrisburg, Dauphin County
My Commission Expires July 12, 200$
Page 7 of 7 Member, Rennsylvania Association of Notaries