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PETITION FOR GRANT OF LETTERS
REGISTER OF WII,LS OF C V���I� COUNTY,PENNSYLVANIA
Petitioner(s) named below, who is/are 18 yeazs of age or alder, apply(ies) for Letters as specified below, and in
support thereof ave�(s)the following and respectfully request(s)the grant of Letteis in the appropriate form:
DecedenNs Informstion �� n' �(' �` l -�,3 - Q�G ��
Name: I /!/, �/ ff'�.S C�i'J File No:
�a� (Asaigoed by Reglater)
�a: �
�a� Socisl Secadty No:
Date of Death: L Z O� Age at deat6: �9 y�G rS
Decedent was domiciled at death}'n C U✓h�i R/�a County, ��_�Srare)with his/her last
principal residence at SS 1 fJ�ol U�tiaiv G{�g� GGV-np/{�l(��-t$J� (76// Gvm bEil4�
Gold en ��n� Centr��U'�s+ S°r°'',p�`°J r".'°�`.w T'p��` / CllY,TonwrYlp or-H7oro�! / �°°y��/
Decedent died at _1 ?U / �!�lQ� GI)U/G� n"a0�, CGtmP l�l l,/"H � /U� � ��J/�7 b fl�un.{`/�
so-«�■aar�,e�omce..a z�cea: cyry,Tow..�+n or eo�o.w co..� sa�
Estimate of value of decaienrs properry at deeth:
/jdo�kBeiAirtPennsylrr�ia............................ AIIP���ProP�3' S SDOOU��p
IJnat dowicl/d tn Pennsy/vanla. ....................... Petsonal property in Penneylvania $
ljnat dawici/din Ptewaylwnia. ....................... Personel P�nY��o�Y S
Vdue ojrca/eawe b PenwsyJranie......................................................... S�t�vU D.UD
SS D� J � _ / TOTAL ESTR1tA7'ED VALU�jE. ... S lUn,o a0,UO �9
xeateareoeinreoosyt�soiasiwaceaec / Gl �C�i�n/ L-A'nE �'Gt�n�/�i`(, ✓/7 t� l7/lD �ui.,��'i/y�
(Attxh addlnonal sheeu,if nece.%*nrl'.) 9heet�ddee�,PM OMtt ud 7Jp Code Clry,Towe�Yip ar Boroqh Cooaty
�A. Petltlon fo�Probste and Grant of Letters Testsmentary �1I��j/�� r,
Petiaoner(s)avei(s)hdahekhey is/are the Ezecutor(s)named in the last Will of the Decedent,dsted 1 0 b ��cil(s)
thereto dated
Shte relevaot drc�mpaoees(y.�w�clda�.dnfb ojececiuor,efcJ
Exceptasfotlows:aRertheacocutionoftheinstrument(s)oB'e2dforprobateDecadentdidnMmerry,wasnMdivom.ed,wasnota Wa
P%«Y P��B
divorce procading w6wein the grounds for divmce had be�esfsblished ae de5ned in 23 Pa.C.S.§3323(B),end did nM have a child bom or
and Decadent was neither the victim of a]dlling nm ever djudicaud en incepacitarod po�son,
NO EXCEPT[ONS Q EXCEP170NS
� B. PeNHon for Grant of Letters of Adminietrallon (�fappucable)
e.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,duranreabsenNn,durnnte minoritnte
If Admintstratlon,c.ta or db.n.c.ta,enter date of WiR in Sect�ton A above and comnkte Iiat,�6elrs.�
Except as followa: Decedmt was not e parry W a pendiag divorce proceeding w6erein the ginunds for��e 6ed be�spb�s de6ned
in 23 Pa.C.S.§3323(g)md was neiffier Me victim of a killing nor ever edjudicaud en incapacimted pe�iti,� C G'� o
Q NO EXCEPTIONS �EXCEPT[ONS ��if�� n Z � �
Petitioner(s),aflerepmperaeazch has/have aseutained thet Decedent leftno Wiltandwas survivedbythe�71oD'�ous�my)�d�rs(nN¢ch
odditional sFeets,if neeessary): Z N 7c O 4�
Z7 '+'7
Name Rel�tlonahi a �� � —
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Oath of Personal Represental3ve °�°"�u�`°°ry
COMMONWEALTH OF PENNSYLVANIA }
/ / / } SS:
COUNTY OF l� �I�v�/I�'✓f }
Petitioner(s)Printed Name Petitionec(s)Printed Addtees
y U G�6�✓ C Gt�6' l�/� ///S6v� 1710
The Pedtioner(s)abovo-uemed swear(s)or effirm(s)the aretemenm in the foregoing Petidon ere uue aud cortect W the best ofthe lmowledge end belief
of Petitlonec(s)and tbe�as Personal Representativels)of U�e Decedent,ffie Petitioner(s)will well md tnily adminieter the esmte acco�ding to lew.
Swom to o affirmed and subscribed before �l 'L� ��Tr1-� nau�- �4' -���
� • Ih daY pl �
By: ,,.Mrw nau
For Ihe Regisrer De[e
BOND Requirod: YES B'NO Ta the Reglsfer ojWf!(.r: p o �
FEES: Ple�ee enter my�ppe�nnee by i�ture 661wv: �7 m
� �
Letters.. . . ..... . . ... . . ..... . $ �LIO�(�O Attorney Signature: �r�.��"O C O
( (n )Short Certificate(s).. . . . . � � a r � � va
( )Renunciation(s).. ..... . . Z y � (D � �
( )Codicil(s). . . . .... . .... • 7c
( )Affidavit(s).. . ... . . .... O T! "�'f
Bond... ... . . ..... . . .... ..... Prioted Name: O C � � '� -'�
Commission. . ... .. . . .. . . ..... Supreme Court � y rv � �
Other ... . . . .. ID Number: n C �� o
�h� �'Yl . ... . . . . �� N '*i
�JPnfi'��`b .... . . .. I-r-� CU Ficm Name: �
J,Uiu .... ... . ICi�6(J Addross:
. . .... Phone:
Automation Fee. . . . .. .. ..... . . 5�()() Fax:
7CS Fee. . . . .. . .. .... . . ..... . �.3� Email:
TOTAL. . . . . ..... . ... .. ..... S ?�I'�.50-&90
DECREE OF THE REGISTER
Estatc of C(�,'(1 � ��Q,n S� File No: � I-I 3 - �Ca��
a/k/a:
AND NOW, I"I�� �,{�(�. .�_,in consideration of the foregoing Petition,
satisfactory proof having been presented before me,Tf IS DECREED that Letters '�P_S+Q,YVI Pa1�'R v N
are hereby grantea to t r i/. ��r'1S T—
in the above estate and(if applicable)that
the instrument(s)dated i 1 14, ��08
deacribed in the Petition be 'tted to probate and filed of record as the last Will(and Codicil(s))of Decedent
Ci'WUWI
Register of ill ��
Fo.mew-oz .�.ionirzorr �%� Page 2 of 2
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LAST WILL AND TESTAMENT OF EARL N JENSEAJ o ° � -,� �'
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I, Eazl N. Jensen, of Cumberland County, Pennsylvania, bei�l'g of sound.�ind an�
memory, do make, publish and declaze this my Last Will and Testament, hereby revoking any and
all Wills by me heretofore made.
FIRST: I direct that my funeral be conducted in a manner corresponding with my estate and
situation in life, and that all my just debts and funeral expenses be paid and satisfied
by my Executor or Executrix hereinafter named, as soon as conveniently may be
after my decease.
SECOND: After payment of debts and funeral expenses set forth in pazagraph FIRST above, I
specifically devise the sum of $30,000.00 to my former daughter-in-law Diane
Jensen.
THIRD: After payment of debts and funeral expenses set forth in pazagraph FIRST and after
payment of the specific devise set forth in paragraph SECOND, I give, devise and
bequeath I) one-half(50%) of the remainder of my estate, both real, personal and
mixed, of whatsoever kind and wherescever situate, to my son, Eric William
Jensen; 2) one-sixth (16.6667%) of the remainder of my estate, both real, personal
and mixed, of whatsoever kind and wheresoever situate, to my daughter-in-law
Nancy K. Jensen; 3) one-sixth (16.6667%) of the remainder of my estate, both real,
personal and mixed, of whatsoever kind and wheresoever situate, to my grandson
Peter Jensen; and 4) one-sixth (16.6667%) of the remainder of my estate, both real,
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personal and mixed, of whatsoever kind and wheresoever situate, to my grandson
Phillip Jensen.
FOURTH: If any one or more of the Beneficiaries set forth in pazagraphs SECOND or THIRD
do not survive me for a period of at least 60 days, then I direct that the deceased
Beneficiary(ies) shaze(s)be divided into as many equal shares as there are surviving
Beneficiazies and then the resulting shaze(s) shall be distributed to the surviving
Beneficiaries.
FIF"TH: Anything herein to the contrary norivithstanding, if any Beneficiary set forth herein
has not at the date of distribution of my esiate, attained 21 yeazs of age, I direct that
the share(s) allocable to such Beneficiary be paid in Trust upon the following terms
and conditions and for the following uses and purposes:
a) The Trustee shall invest and reinvest the Trust assets.
b) A separate Trust shall be maintained for each Beneficiary of mine
whose share is paid to said Trustee.
c) The Trustee may in its sole and uncontrolled discretion pay any amounts
of income and/or principal for the health, support, education, welfare
and maintenance of said Beneficiary(s).
d) All payments by the Trustee relating to a particulaz Beneficiary(s), or
expenses chazged or paid allocable to a particular Trust, shall be paid
out of and from that Trust.
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e) The Trusts shall be managed and the Trust funds invested in accordance
with the provisions of the Pennsylvania "Probate, Estates and
Fiduciazies Code", its supplements and amendmeats, except as
otherwise provided herein.
� Upon a Trust Beneficiary attaining age 21,that Trust shall terminate and
the Trustee shall pay to such Beneficiary, free and cleaz of the Trust, all
remaining assets ofthat Trust.
SIXTH: No interest in principal or income shall be assignable by any Trust beneficiary
hereinunder or available to anyone having a claim against such beneficiary until
actual distribution thereof to such beneficiary.
SEVENTH: I hereby nominate, constitute and appoint Eric William Jensen, to be the Executor
of this my Last Will and Testament. If the said Eric William Jensen is unable or
unwilling to serve as such, I then appoint Diane Jensen to so serve.
EIGHTH: I nominate, constitute and appoint Nancy K. Jensen to be the Trustee of any Trust
established pursuant to this Last Will and Testament.
NINTH: I direct that the Trustee may compensate herself out of any Trust over which they
are Trustee but that such compensation shall not exceed 1%of the net asset value of
the Trust per year.
TENTH: I direct that any fiduciary of mine herein named, be permitted to serve without bond
in any jurisdiction where a bond would be required for the faithful performance of
his or her duties, in the absence of this provision.
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ELEVENTH: I direct that any and all inheritance, estate and transfer ta�ces imposed upon my
estate, passing under my Will or otherwise, shall be paid out of the principal of my
estate before any distributions aze made to any Beneficiaries set forth herein.
I, Eazl N. Jensen, the Testator whose name is signed to the 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.
�� • L��►'`- (Seal)
Earl N. Jensen
Sworn to or affirmed and acknowledged before me by Eazl N. Jensen, the Testator,
this�_day of � 2008.
COMMUNWEALTH OF PENNSYLVtWIA �
No[arial Seal
Jeffrey N. Yofte. Notary Pubiic AR �I.IC
East Pennsboro Tw�_ Cumbedani C�unty
My Commission Expires Oct 23, 2008
Mem6er. Pennsyl�enia Associatian of Notaries My Commission Expires:
We, �G/i5S4 S�Byei and /vU/ma� �, yu�i� the wifiesses, whose
names are signed to the foregoing 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 his Last Will;that
the Testator signed willingly and executed it as his free and voluntary act for the purposes therein
expressed;that each subscribing wifiess in the hearing and sight of the Testator signed the will as a
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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 influ nce.
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Witness
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Witn ss
Sworn to or affirmed and subscribed to before me by /vU/MGn /�- Yoiflt and
/Y![NI S S�1 SB�y�'/ ,wifiesses this�day of // , 2008.
- ,>:MO�'WEALTH pF R�NN.Y(,VANIA
Noimial Swl
JePfrey N_ YoiTe_ No[nry Public .
tinst Pennsboro rUp, Cumberland County TAR PUBLIC
My Commissian L+xpires Oct 23, 2008
Member, PennsyNanie Association of Notaries
My Commission Expires:
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