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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 request(s) the grant of Letters in the appropriate form:
Decedent's Information 1
Name: Doris Ann Wolff File No: Ott J 3 - 037
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 232-52-1420
Date of Death: February 13, 2013 Age at death: 80
Decedent was domiciled at death in Cumberland County, Pennsylvania (state) with his/her last
principal residence at 509 Cocklin Street, Mechanicsburg 17055 Mechanicsburg Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 509 Cocklin Street, Mechanicsburg 17055 Mechanicsburg 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 $ 200,000.00
If not domiciled in Pennsylvania Personal property in Pennsylvania $
If not domiciled in Pennsylvania Personal property in County
$
Value of real estate in Pennsylvania $ '200,00000
TOTAL ESTIMATED VALUE.... $ 400,000.00
Real estate in Pennsylvania situated at: 509 Cocklin Street, Mechanicsburg 17055 Mechanicsburg 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) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated April 28, 2011 and Codicil(s)
thereto dated December 3 2012
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 parry 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.
O NO EXCEPTIONS O EXCEPTIONS
❑ B. Petition for Grant of Letters of Administration (If applicable)
c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante absentia, duranteminoritate
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 a pending divorce proceeding wherein the grounds f~divorce had l~n est A ishft as defined
in 23 Pa. C.S. § 3323(g) and was neither the victim of a killing nor ever adjudicated an incapacitated Xs9 --n G~ Cl)
O NO EXCEPTIONS O EXCEPTIONS M T- 0D
~
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by tfJF16 " spo ss (if are4a eirs (attach
additional sheets, if'necessary): U) ~ -
Name Relationship c"Aflc'Iress ZJ
Form RW-02 rev. 1011112011 Page 1 Of t
~V
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s) Printed Name Petitioner(s) Printed Address
Ma Ka Chambers 44 Hark Lane Moundsville WV 26041
The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the best of the knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the Decedent, the Petitioner(s) will well and truly administer the estate according to law.
SworItor a rmed an subscribed beforeDate thay of RUW#' \ j Date
B Date
For the Register Date
BOND Required: Q YES Q NO To the Register of Wills:
FEES: / Please enter my appearance by my signature below:
Letters Attorney Signature:
Short Certificates
( ) Renunciation(s).........
( )Codicil(s)
( ) Affidavit(s)............ t
Bond Printed Name: Richard L. Placey
Commission Supreme Court ` ' rr1 GM7
Otl;er. ID Number: 07232 X C>
16.0 C0 cj-) =
V
Firm Name: Placey & Wright ao r- r1_1) ~yl rri
I tj .00 Address: 3621 North Front Street ag -r y
5s(~ Harrisburg, PA 17110-1533 j r
7 C 3
rri
y-
Phone: (717)236-9577 CO
Automation Fee Fax: (717)236-0843 C11 Lr~~r~
JCS Fee . Email: z wlaw enix net
TOTAL $
DECREE OF THE REGISTER j /
Estate of Doris Ann Wolff File No: 6437
a/k/a:
AND NOW, in consideration of the foregoing Petition,
satisfactory proof having bee p sented before me, I S DECREED that Letters Testamentary
are hereby granted to Mary Kay Chambers
in the above estate and (if applicable) that
the instrument(s) dated April 28, 2011 and December 3, 2012
described in the Petition be admitted to probate and filed of ecord as the last Will (and Codipil(s)) of Decedent.
t'
Register of Wills ~ Jrtr' "
Form RW-02 rev. 10/1112011 Pag2
ff IUyHOS PFV 190 i I
ORDED OFFICE OF
LOCA~,R$TIR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
2013 FEB 27 91M 8 52
Fee for this certificate, 56.00 11-)(s is to certify that the inform ltion hc(c _i\cn is
CLERK 0 Gr ~c eo(redly copied from an original Certificate o1' Dcath
ORPHANS* 0 i Jule filed ti~ith me as Local Registrar. The ouginal
GllMBERLAN CO a v c at(ficate %~ill be forwarded to the State Vital
Records Office for permanent filing.
P 19179920 \`\q\`--~'. i3~l ~L?y-
--,l~fEtdT
Certification Number
Local Registrar Date ls;ucd
Pe/Print In COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
Black Ink' CERTIFICATE OF DEATH State File Number:
1 Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sea 3. Social Secufly Number 4. Date of Oeath (MO/Day/Y,) (Spell M.)
Doris Ann Wolff female 232-52-1420 February 13, 2013
St. Age-last Birthday (Yrt) 5b. Under l Year 5c. Under 1 Da 6. Date of Birth (MO/Daear
y/Y) (Spell Month) a. aac_e (Clly nd5tato or Foreign Country)
Months Days Hours Minutes ~n,
80 vember 24, 1932 2 ?b. Birthplace (County) Mar$
B., Retitle... (State or Foreign Country) ark. Residence (Street and Number- Include All No.) Bc. Did Decedent Live in a Township?
PA 509 Cocklin Street ❑ Yes. decedent W.of In Twp.
Be. Residence (County)
Cumberland Be. Basic-,(Zip Code] 17055 No,decedentlivedwithinlimitsof Meehanicsb= city/boo.
9. Ever in US AN Forces? 30 Marital Status It Tlme of Death 0 ..,,led Widowed 11. SurvNiI g Spouse's Name (If wife, give name prior to not no Ligei
❑ Yes 2{$ No ❑ Unknown ❑ Olvorced ❑ Never Married 0 Unknown
12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last)
Charles E. Yost Sr. Ewa L. Stewart
14..J fcmuml', Name ]rib. Relationship to Decedent 1dc. Inlormant's Mailing Address III,- and Number, CITY, State, 11, Cod,)
o Kay Chambers sister 44 Hark Lane, Moundsville, WV 26041
_ _ _ _ _ _ _ 15a. Pace ctt. Dea[ Check pn Yone _ _d _ _ _
i If Deeth OccurredIna Nospi&' Inpatient I% Death Occurred Somewhere Other Than a Hospital Hospice Fanllty oe.eEenrS Home
0 EmergencyROOM/Outpatient ❑ Dead on Arrival ❑NUrsing HOme/LOngTerm Care Facility ❑ Other (Specify)
15b. Facility Name (If not Institution, give street and number) 115.. City or Town, State, and Zip Code 15d. County of Death
509 Cocklin Street amcsbuirg, PA
17055 Cumberland
16x. Method of Disposition 0 Burial g] Cremation 16b. Date of Dispauhj,, 161. Place of 1bx-ition (Name of cemetery, crematory, or other place)
0 Removal from 51.1. C Donatlon 2p3
❑'her(Speafy) ebruary 15 Hollinger Crematory
Z 16d. Locatkm of Disposition (City or Tawm, State, and Zip) Ila. Signature of Funeral AMU-... or Person in Charge of Interment 12b. License Number
E Mt. Holly Springs, PAb~ FD 011667 L
o
E 17c. Name and Complete Address of Funeral Facility
Malpezzi Puneral Home, 8 Market Plaza Way, Meohanicb PA 17055
Z 19. Decedent's Education- Check the boa that best describesthe 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. boa that best describes whether the decedent the decedent considered himself or herself to be.
0 Sth grade or less is Spanish/HispamgLatllw. Check line 'No- White 0 Korean
0 No diploma,9th-12th grade boa if decedent is not Spanish/Hispink/Lat:rlo. 0 Black or African American 0 Vietnamese
High school graduate or GED completed No, not Spanish/Hispanic/latino 0 American Indian or Alaska Native ❑ Other ASla.
0 SOmecollege credit,but no degree 0Yes, Mexican, M,,ican American, Chicano 0Asian Indian ❑N,tye H,waiian
0 Associate degree(e.g. AA, AS) O Yes, Puerto Rican OChinese O Guamanlan or Chamorro
0 Bachelors degree (e.g. BA, AS, BS) 0 Yes, Cuban ❑ Fllipm. 0 Samoan
0 Masters degree (e.g. MA, MS, MEng, MEd, MSW, MBA) 0 Yes, other spa ish/Hupi nlc/1,Hm, ❑ Japanese 0 Other Pacific Islander
❑Doctorate(e.g. PhD, EdD) or Professional degree (Specify) ❑ Other (Specify)
DDS DVM LLB lD
It. Decedent's Singl< Rxe Sell-Designation - Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22x. Decedent's Usual 0...pxien - Indicate type of work
~ White 0lipanese 0 $...an doneduringmpstofworkingllfe. DO NOT USE RETIRED.
0 Black of AfricanAmerican 0 Korean O Other Pacific 'slander administrative assistant
0 American Indian or Alaska Natlve 0 Vietnamese 0 Don't Know/Not Sure
❑ Asian Indian 0 Other Asian 0 Refused 22b. Kind of Business/Industry
0 Chinese 0 Nature Hawaii an 0 Other(SpecIN) naval depot
0 Filipino 0 Guamanian or Chamorm ITEMS 23a -21I MUST BE COMPLETED 23a. Data Pronounced Dead (MO/Day/Yr) 23b. Signature of Person Pronouncing Death (Only when applicable) 23c. License Number
BY PERSON WHO PRONOUNCES OR -y 1
CERTIFIES DEATH O."
23d. Date Slgned (M~YO/~Oay/Vr) 2d. TimeRf Death ,.~f P~`a(~S,vA'•~+. L
13-DK-fir/ t/ QS /1l- 25 Was Medical Examiner Or Comm, Contacted? L1 Yes 0 No
CAUSE OF DEATH I Approximate
26. Part:. Enter the chain of evenU--diseases, inlurles, or complic.0--that directly reused the death. DO NOT enter terminal events such as cardiac arrest, Interval:
respiratory arrest, or ventricular fibrillation without sh,mng the etl,l,gy. DO NOT ABBREVIATE. Enter only co, cause on a line. Add additional linesif necessary. 1 Onset to Death
I
IMMEDIATE CAUSE -------------a a. C Gr-C.~ -k, ` 'L VlM 0 LE ) i.j 1
(Hoop tlise ondltion Due to for as consequence ofl:
resulting In death) 1
b. S -1 r 1 2 L. CJ r Ll 1
Sequentially ust conditions, Due to (or as a consequenle of)
If any, leading to the cause
listed Mine. Fnlerthe
UNDERLYING CAUSE Due to (or as a consequence of.
(disease or Injury that
F Initiated the events resulting d.
In death) LAST. Due to (or as a e .,sequence of),
6 26.Partll. Enter other significant condition, wrHibutine to death but not resulting In the underlying cause given In Part I ZT.Wasan autopsy!2rmed?
❑ Yes No
f 21. We, autopsy Rndings available
[,complete thecaus oftleath?
E ❑ Yes No
d 29. IfJJFemale : 30. Did Tobacco Us, Contribute to Death? 31. Manner o/Death
o ,p.net pregnant within past year 0 Yes 0 Probably ~yatural 0 Homicide
0 Pregnant at time ofdeath 0 No jg<nknown 0 Accident ❑ Pending:nvestigalio.
0 Not pregnant, but pre gnanl within 12 days of death 0 Suicide 0 Could -predetermined
0 Not pregnant, but pregnant 43 days to l Year before death 32. Date of Injury lMo/Day/Yr)(Spell Month)
0 Unknown if pregnant wihin the past year 33. Time of Injury
M. Place of Injury (e.g. home; constructkn site; farm; school) 35. Location of Injury (Street and Number, City, County, State, Zip Code)
36. Injury at Work 111, II Transportation Injury, Specify: 38 . Describe HOw Injury Occurred:
0 Yes 0 Driver/Operator 0 pedestrian
0 No 0 Passenger 0 OMer(Smclfy)
39x.6 rfl r- Physician, certified nurse po-ft Der, medical examiner/coroner(Chxk only one):
ertlfying only - To the best of my knowledge, death occurred due to the cause(s) and manner stated.
0 Pronouncing&Certlfying - TO the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated.
0 Medical Examiner/COr -On the basis of eaamina nvestigatiln, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and manner stated.
Signature of certifier. mile of certifier: License Number: US0 oa^ 1`0 3_L
396. Name, Address and Zip Code on Completing Cause of DeHh (Item 26) 39t. De Slgned ( o/Day/..)
J- NAr~ y
Q. Registrar' District Number dl. e Signature o d,.0. gistrar File late
(MO Day r)
12 ~/)oL ~rrH~,
43. Amendments
0819571 5.143
Dlioasihon Permit No Fill Vn 11m,
A.
70 M
C">
G O _T1 4a G?
3: ;:0 r1ri ;ar3
Co ^i;7 133
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FIRST CODICIL TO THE
LAST WILL AND TESTAMENT OF
y rv
DORIS ANN WOLFF
I, DORIS ANN WOLFF, now of Mechanicsburg, Cumberland County,
Pennsylvania, do hereby make, publish and declare this to be the First Codicil to my Last Will
and Testament dated April 28, 2011.
ITEM L Item IV of my said Last Will and Testament is deleted in its entirety
and, in lieu thereof, the following is inserted:
"ITEM IV. I give to my brother, THOMAS D. YOST, SR., the sum of Five
Thousand ($5,000.00) Dollars. I give the rest, residue and remainder of my estate of
every nature and wherever situate in equal shares to my sister, MARY KAY
CHAMBERS, and my sister-in-law, SANDRA JO YOST. In the event either of them
predeceases me, I give the share of such deceased residuary beneficiary to the remaining
residuary beneficiary."
ITEM II. In all other respects, I hereby confirm and republish my Last Will and
Testament dated April 28, 2011.
IN WITNESS WHEREOF, I hereby set my hand to this First Codicil to my Last
Will and Testament dated April 28, 2011 on this 3rd day of December, 2012, at Mechanicsburg,
Pennsylvania.
D ris Ann Wolff
The preceding instrument, consisting of this typewritten page and an acknowledgment page,
identified by the signature of the testatrix, was on the day and date thereof signed, published and
declared by Dorothy E. Hamilton, the testatrix therein named, as and for her First Codicil to her
Last Will d Testament, in the presence of us, who, at her request, in her presence and in the
presence o each other, s scrib o~ir names as witnesses hereto.
i
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA:
. SS.
COUNTY OF DAUPHIN
I, DORIS ANN WOLFF, testatrix 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 First Codicil to my Last Will and Testament, that I
signed it willingly, and that I signed it as my free and voluntary act for the purposes therein
expressed.
L'
oris Ann Wolff
Sworn or affirmed to and acknowledged before me, by Doris Ann Wolff, testatrix,
this 3rd day of December, 2012.
Hwt'~j , Z. i -
Notary Public
My Commission ONWEALTH OF PENNSYLVANIA
Notarial Seal
Holly S. Kirk, Notary Public
AFFIDAVIT Susquehanna TWp., Dauphin County
My CommiSSlon ras Aug. 14, 2016
MEMBER, PENNSYLVANIA ASSMAr CIN OF NOTARIES
COMMONWEALTH OF PENNSYLVANIA:
SS.
COUNTY OF DAUPHIN Q
We, , `I ' ij 11c! M-1 I, t ec/witnesses
whose names are sign to the attached or foregoi g instrument, being duly qualified according
to law, do depose and say that we were present and saw testatrix sign and execute the instrument
as her First Codicil to 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 of us in the
hearing and sight of the testatrix signed the Will as witnesses; d b t of our
knowledge the testatrix was at that time 18 or more years of age, un )min nd'Junder no
constraint or undue influence.
a
Sworn to and subscribed before me this 3rd day o D cembe, 2012.
A ONWEALTH OF PENNSYLVANIA
IMrial Seal
Nota y Pub4ly S.
lark, Notary Public
Susquehanna Twp., Dauphin County
My Commission Ex ' Commission
Expires Aug. ASSOCIATION O~F2i OTARIES
C> W M
M C">
A r G*")_
M C?
A r rv r r1l
LAST WILL AND TESTAMENT
r:)
.7,
car , --I :.r
OF
C:7
:z3 CO r- M
DORIS ANN WOLFF a> C''
I, DORIS ANN WOLFF, now of Mechanicsburg, Cumberland County,
Pennsylvania, do hereby declare this to be my Last Will and Testament and hereby revoke all
prior Wills and Codicils made by me.
ITEM I. I direct that all of my just debts and funeral expenses, including the cost
of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my
decease as a part of the administrative expenses of my estate.
ITEM II. By separate document attached to this Will, signed and dated by me, I
have set forth gifts of specific items of personal property to certain individuals. I incorporate the
gifts set forth thereon as part of my Will and direct that the items listed thereon be distributed by
my personal representative to the persons indicated.
ITEM III. I direct that the remainder of my household goods and personal
effects be sold at public auction and the proceeds thereof be distributed as part of my residuary
estate.
ITEM IV. I give and devise all of the rest, residue and remainder of my estate of
every nature and wherever situate in equal shares to my sister, MARY KAY CHAMBERS, my
brother, THOMAS D. YOST, SR., and my sister-in-law, SANDRA JO YOST. In the event any
of them predecease me, I give the share of such deceased residuary beneficiary to the remaining
residuary beneficiary(ies).
ITEM V. If any income or principal shall be payable to any person who shall be
under the age of twenty-five (25) or who shall be incapacitated for any reason, my personal
representative, as trustee, shall such income and principal for such beneficiary until the age of
g 9
0
Doris Ann Wolff
twenty-five (25) or during incapacity (whichever event occurs first) and shall be entitled to
apply such income and principal to the health, maintenance, support and education of such
person after considering other resources available to such person for those needs without the
appointment of any guardian or committee or any authority of court, and shall be entitled to
make direct application hereunder or to make application by payment thereof to the parent or
other person in charge of such person, or to his or her guardian or to a custodian under the
Uniform Transfers to Minors Act. Any remaining income and principal to which such person
shall be entitled shall be paid and distributed to such person upon attaining the age of twenty-five
(25) or upon the termination of incapacity.
ITEM VI. I appoint my sister, MARY KAY CHAMBERS, Executrix of this my
Last Will and Testament. Should she fail to qualify or cease to act in such capacity, I then
appoint my niece, DIANA CARPENTER, Contingent Executrix of this my Last Will and
Testament. No bond shall be required by my personal representative in any jurisdiction.
ITEM VII. In addition to the powers given by law to my personal
representative(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of
any trust(s) created herein, they shall have the following discretionary powers applicable to all
real and personal property held by them, including property held for minors, effective without
court order until actual distribution.
A. To retain any property owned by me at my death and to invest any funds held
by them in any stocks, bonds, notes or other securities or property, real or personal, including
common trust funds, mutual funds and money market deposit accounts operated or offered by
my corporate trustee, if any, or any affiliate of it.
B. To sell or otherwise dispose of any property, real or personal, at any time
forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on
such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the
application of any monies paid.
Dor' Ann Wolff
2
C. To manage, operate, repair, improve, mortgage or lease for any term [even if
beyond the duration of the trust(s)] any real estate at any time held or owned by them as
fiduciaries.
D. To hold investments in the name of a nominee and exercise and dispose of
warrants.
E. To engage in litigation and compromise, arbitrate or abandon claims and
property.
F. To conduct any business in which I am engaged or in which I have an interest
at the time of my death for such period as the fiduciaries deem advisable, with the power to
borrow money and to pledge the assets of the business and to do all other acts which I, in my
lifetime, could have done, or to delegate such powers to a partner, manager or employee without
liability for any loss occurring therein.
G. To allocate items of receipt or disbursement between principal and income as
the fiduciaries deem equitable regardless of the character given such items by law; to distribute
in cash or kind or partly in each at valuations fixed by the fiduciaries
H. To borrow money, including the right to borrow from any corporate trustee, if
any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee.
1. To join in any merger, reorganization, voting trust plan or other concerted
action of security holders, and to delegate discretionary duties with respect thereto.
J. Should the principal of any trust herein provided for be or become too small in
trustee's opinion so as to make establishment or continuance of the trust inadvisable, my
trustee(s) may make immediate distribution of the then remaining principal and any accumulated
or undistributed income outright to the person or persons and in the proportion they are then
entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise
have an interest as succeeding income beneficiary(ies) or in remainder shall cease.
D is Ann Wolff
3
K. In general, to exercise all powers in the management of the assets of my estate
or the trust estate which any individual could exercise in the management of similar property
owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to
execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary
or proper to carry out the purposes of this will or any trust(s) created herein.
L. To apply income or principal to which any beneficiary is entitled, directly for
his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary
incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the
same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a
complete acquittance therefore without the intervention of any guardian.
M. To assume continuance of the status of any beneficiary with reference to
death, marriage, divorce, illness, incapacity or other change in the absence of information
deemed reliable without liability for disbursements made on such assumptions.
N. All principal and income shall, until actual distribution to any beneficiary, be
free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may
not be liable for any levy, attachment, execution or sequestration while in the hands of any
fiduciaries. Provided, however, any beneficiary may assign any part or all of the beneficiary's
interest in my estate or the trust(s) to any one or more of the beneficiaries or my descendants. ,
IN WITNESS WHEREOF, I have hereunto set my hand and seal this day
of 14) /L t '2011.
Doris Ann Wolff
The preceding instrument, consisting of this and three other pages, identified by the signature of
the testatrix, was on the day and date thereof signed, published and declared by Doris Ann
Wolff, the testatrix therein named, as and for her last Will, in the presence of us, who, at her
request, in 7h, resence, and in the presence of each other, subscribed our names as witnesses
hereto _I
axy
4
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF DAUPHIN
I, DORIS ANN WOLFF, testatrix 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, that I signed it willingly, and that I signed it as my free and
voluntary act for the purposes therein expressed.
Z26~~'
D is Ann Wolff
Sworn or rmed to and acknowledged before me, by Doris Ann Wolff, testatrix,
this Zsj"N day of n 52011.
Not ry Public
My Commission . NWEALTH OF PENNSYLVANIA
Nolnri~
Holly S. Kir: ,!;::.v Pluiir,
AFFIDAVIT Susquehanna -rw . county
My Commission ~ xpi!c': , 4, 2012
Member, Pennsylvania Association of Notaries
COMMONWEALTH OF PENNSYLVANIA :
SS.
COUNTY OF DAUPHIN
We, Y f C ir~ - I Ct ce-y 4 d ~J e b
the witnesses whose na es are signed to the attached or for going instrument, 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; that she signed 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 kn le ge thestatrix was at that
time 18 or more years of age, of sound mind and under no constrai a ue nce.
Sworn to and subscribed before me this Z~ day of 2011.
~L-THQF PENNSYLVANIA
Notarial Seal
IN 0a Y-Two-
Holly S. Kirk, Notary Public
Susquehanna Twp., Dauphin County
My Commission Ex iremy commission expires Aug. 14, 2012
`,AA.rn - QPnnsvlvanle Association of Notaries