HomeMy WebLinkAbout07-10-13 (2) PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF C�.(�w��eY,p�,,,,,r� 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 � f r���G
Name: _� .�'.'1�� �Qf,c„� � Q,t,t �d}� File No: _ 21 " I� r V
a/k/a: (Assigned by Register)
a/k/a: �
a/k/a: Social Security No: ��5�-S�[�- ����
Date of Death: �f J Ol .� i� Age at death: ___7�(
Decedent was domiciled at death in (� U m�t)eY-�,Q h� County, �,� (Srare)with his/her last
principal residence at �i l a. C7L L�nn .S�r�-��- �C� ,� (�Y��_��L},y�,��,--)4=v
Street address,Post Office and Zip Code City,Township or Borough County
Decedent died at 1�1. S 1-��.��, rn P,c1 1 c�t � �.p�-�-r.� �p�rS t� �0�,�tD�l t r� 1"�
Street address,Post Office and Zip C e City,Township or Borough County State
Estimate of value of decedent's property at death:
If domiciled in Pennsylvania............................ All personal property $ .�� ocC.00�
tf not domiciled in Pennsylvania. ....................... Personal property in Pennsylvania $—�
If not domici[ed in Pennsylvania. ....................... Personal property in County $
Value of rea!estate in Pennsylvania...................... ............ $ ��`�
TOTAL ESTIMATED VALUE. ... $ � , }G�,,`
Real estate in Pennsylvania situated at: � � � "�P .S' `�h� �. �'��(e�
(Atrach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Township or orough Coun a'/�
. R�
� Petition for Probate and Grant of Letters Testamentarv
Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of tl�e Decedent,dated and Codicil(s)
thereto dated
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 party 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• nd Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
O EXCEPTIONS ❑EXCEPTIONS n '_ �a �+:r
C � _... f_: < '
❑ B. Petition for Grant of Letters of Administration (If applicable) �3 �=' ��_
�--
c.t.u.,d.b.n., d.b.n.c.t.u.,pendentA7tt'e,-idur�nte abs•entia,du'rahte minoritute
� � `,a�-� i F.�
If Administration,c.t.a. or d.b.n.c.t.a.,enter date of Will in Section A above an�camp�I"'+e�te li�t�of he;rss,:-
� � .
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds t�d�vorce�had beeu est�i7sh'ed as defined
in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated p�sqa`�., _�= � '
❑NO EXCEPTIONS �EXCEPTIONS :-' ``�" �—' �°� __
Petitioner(s),after a proper search has/have ascertained tha:T?ecedent left no Will and was survived by th�ollowing spo�s�(if any,�►xtfieirs(nttach
uclditionul sheets,if'necessury): �' �,p '�`�
Name Relationshi Address
Fo,�»,nw na �-�v.inittizoii Page 1 of 2
Oath of Personal Representative off�;a�us�o��y
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF C C� W��tJ Q`��- v� � }
Petitioner(s)Printed Name Petitioner(s)Printed Address
`C� Q � �D� Cl ���V�h � �l __ L 7 0� `J�
The Petitioner(s)above-named swear(s)or a�rm(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.
Swcrn to or affirmed and subscribed before �I�JLC'Cp� Date � U ����
me ciay f ,o�� _ Date
�Y� Date
For rhe 2e�isrer Date
BOND Required:Q YES �10 To the Register of Wills:
FEES: Please enter my appearanc�y my signatitYe below:�-.:
, 1-� � � ��_� `,,'�
Letters . . . . . . . . . . . . . . . . . . . . . . $ ! ".l Attorney Signature: -� c__ �
G7 =� t t
( � )Short Certificate(s). . . . . . (1. Z. ' — " -"
I � rT, -.,. ,-.,; ,
( )Renunciation(s).. . . . . . . . � .c� ;°� F_, � °
( )Codicii(s). . . . . . . . . . . . . r �, �.,... � ,
•
-7. F�� . ..
-:�- �.-
( )Affidavit(s).. . . . . . . . . . . . �, , ,.
_.:�,
Bond.. . . . . . . . . . . . . . . . . . . . .. . Printed Name: �� r5 ,e�. .r -. ;;
...3 r_
� .: ,.,
Commission. . . . . . . . . . . . . . . .. . Supreme Court G..,� ...� " � y
_ N� .. .
Other . . . .. . ID Number: : ,�, : ,,-
�1 ( . . . . . "�'^ �
��'�'�' ,� cI' �-� c_x
� �. . . . (�.(,?j'l FirmName: � -'+
. . . . . . ��.(��� Address:
. . . . . . . . Phone:
Au+ornation Fee. . . . . .. . . . . . . . . . Fax:
JCS Fee. . . . . . . . . . . . . . . . . . . . . • EmaiL•
TOTAL. . . . . . . . . . . . . . . . . . . . . $ �IQ.�
DECREE OF THE REGISTER
� /�
E:;::�te of � C� �� C�� _ File No: n.l I � �.� ' /J 7�/��
a/k/a:
AND NOW, � �+� eT ��( � ��� , C���� in consideration of the foregoing Petition,
satisfactory proof having been presented before e,IT IS DECREED that Letters Q '1L°
are hereby granted to (', Q,U pV
� in the a e estate and(if a�;plicable)that
the instrument(s)dated
described in the Petition be admitted to probate and filed of record as the last Will�(and Codicil(s)) f ecede t.
� r � � , �
� eg:ster of ills �� �' � ����� ��'
Forui RW-02 rev. 10/!1/201/ � Pa 2 Of 2
�. _� �. �.�. � �, �:,�,., ,�:,�..�.,..,� �,��.,,�,�.�,�.,�,��,�»��
HIG5.805R&V{9ti17 .` . .. ... . . ..... .�... .. . . . .. �
LC3CAL REGISTRAR'S CERTIFICATION t�F aEATH
WARNING: It is illegal ta duplicate this copy by photastat or photograph.
Fee for this certificate, $b.{XJ����i ' � � 3 � ���' ,,,,,,,,,H,,,.�. This is to certify that the information here given is
�'"`�,ZHOFp`
��"��` � .':� ��r `; ,`...!..� �,,n''��,'�p' _ fil',yJ;; carrectIy copied from an original Certificate of Death
�� ' _- �` duly filed with me as Lc�cal Registrar. The originai
���� �(�� �� �� � �� ;o x'�,,,� certifieate���wilt b� forwarded to the State Vital
:� � s*: Records Office for p anent filing.
a * . ., *:
f� � � Gl � � � � - �
�:�i:.��l� i�;• O�`,o _ '�,�o,`
Certification Number ��u��S" C�:���i �'�9l!HEN1jt1�,��;�'�'' ~ 2,>' Z.a/
���g��L.��� �,� ' �� L egistrar Date Issued
��
Type/Prtnc fn CqMMONWEALTH 4F PENNSYLVANIA*pEPARTMEN7 oF HEALTH�VITAL REC(7RD5
PermanenS
Black I�k CERTIFICATE OF DEATH Staz��,i�N�m��:
1,De<ed¢nt`s tegat Name.(First,Mlddte,Last,S�Hix) 2,Sex 3.Sociai Security Number . 4.:pet¢o�Denth{MajDayflr}{Spoil Mo}
Victar Ka Ta lar Ma1� 258-56-4
Sa.Age-Last.Blrthday(Yrsj Sb. tler 1 Veer Sc.Under 1 Da 6.Dafe of Blrtl�(Mo/Day/Yeer)(Spel�Month) '7a.Birthplace(City gn�SAtaie qir Forelgn uncry)
� � MonYhs pays Nours nn,,,,,�e. � � Atlanta �
74 Junt� 5 1 3 �b.s�.cnc���rtcou.,svy N 8
8a.ResitlenG@(SWte pr Fara38n Cauntry) 8b.Resitlerice(Street and Number-�hdude Rpt No.}� $�.6id 6ecedant LWm[n a Township7 � �
Fc.nna lvan3 a 619 Glerm Street o ve�,am��ae.,n�n,,,a�„
8d,Residence(County) TwP_
Cumbt:z lan[1 ae.ngsia���e iz�p coaef �tao,dacedent Iwed w�ch�n 11mlts ofi '�S1�ivp�nsbu.rQ ricyJao.o.
� 9-Ev¢�!ri U$Armad Fot'casT 10.Maritat Status at Time of Death Ms�rl¢d � Widowed 11.$urvivirig Sppusds Name{i#wlta,giv¢name prior to firs[maYflage}
Yas 0 Na C�tJnknown 1�t7ivorccd C�Never Marrled O Vnknown S 012 �`..�.ee �
12.Fatlie�`s Name(Fl�st,Mitltlle,Last,SuFflu) 13.Mather's Nq�ma Prlo�io First Mm��lage(F��s},Mldqle,Last) .
Gu Ta lor Bernica Hawlcins
14a.fnformant's Nam 146 Retationshtp to D¢c�ed¢nY 2 I far �'s Malii Addt ( t antl N pc�,City g;
Carole Ta l.or PPens�urg, �� �.����'!
o Y Spousa �`i� ��.�nn �`t. ��
� _ .. � � � isa_ eceo n„eae �on�y_o�. � ��
_ If peath O cuYr d in H4spital:� ^�InpaYlent ' � - -��y peath Oceurred Somewh C}tFier Thar�A�Hospltal: ['�I Nosplce FaciliLy�T �.Deced911t's Hortip�
0 Em r wncy Room/Outpaticnt O Destl pn Ar�ival � �Nu�Sing HomB/long T@Ym Gare FYCillty Q Othe�(Speci j
�. 15b.FatFiety Name{If not tnstltuTkot�,Y»+e stt'eet and num6er} 15c.City or Town,-Stoke,and Zip Cada � 15d.Cou ty of Daath
wwrr�� M.5_ Hersh+e? MedEca#Center Hersfie Pa. 17033 Dau hin
�� LL 16a�..Meihod of D{spaa�Ylon Burial Crematlon �16b.Oate�ol OIS � P �
a positlon 16c.Plare of pisposition jName Gf Cemat4ry,c matory,o oth�ar lace
[,] Removal from S#8te O bt�na[lon
� o aene��sPe�;y� .7une 2 201 Park]awns Memo�isl Garderxs r
� ��j. 15d.totatian of bispositian(Gity or Town,Stata,and Zip} 17a.Si�nS'tur f Funara�5¢rvtce ticensg �r Persari rg8 of tntermant. 17b.�fcense Number
tk ����sUu.rg, PA I72CiI ��. FD-012050 L
"6
E 17c,Name and Complate Addresa af Funerel Facility
s Kc�lso-Cornc.lius F.H_ 725 Norland Ave. Cl�.ambersbur PA 17201
�' i$.DecadanYs Educatbn-Ghack thc box that best descH6es tha i9_Decetlanf of Hispanie Origin-Gheck the 20.OecatlenYS Racc-Ghg<k ONE OR MORE races ta Intlicate what
higFest de�ree or ievek of xAoot compietetl at ttia xime of death. box tFiat bast dmscr{bcs whethar tho ciec¢tlant th¢tlewd¢nt cons{dcrad tiimsaiP ar hersaif to ba.
(� Sth gratle or iesv fs Spenish/H�spqnic/Lati�o. Check kfie"NO" [�,White - � Korean
O No aip�oma,9th-12ch Qratle box If tlecetlant is not Spgnish/Hlspanic/laiino. � Black o�Af�ican Amer�[an
d High scM1pol graduaie or GED Complbted o not Spanish/Hispanic/Latlno 0 Vietnamese
�Somc catleg¢cretlit,but no de � �Ameri<an Indian or Alaska Nstiva � pther Asirn
g�ee �Yca,MexiCen,M¢xican American,Ghicano 0 Rsian indfan � NatFVa HawaAan
(� Rssociate Cegrqw(e.g.pp,ASj �Ycs,Pucrta ftican Q Cfrinese
Cj Bacheipr's daQreo(e.¢_6A,AB,BS} [�ygs,Cuban O Filipino n C+uamanian or ChamO�ro
(� Master's degrea(e.g.MA,MS,MEnµ,MEtl,MSW,MBA) O Yes,othe�Spanish/Hlspanlc/latino �O Japanese O Samoan �
� DoctoratN(e.g.Php,EtlO)a�Professivnal degrq'a. (Specl ) 0 6the�Pacific Islander
.MO OD5 pVM LL8 JO � 0 pYher(Speclfy)
Zl.p¢cadenYs Singio Raee Seif-Designatian-Check ON�Y 6NE to indiwte wha2 thm dacedeM consitleretl tNmself or h�rs¢If to be. 22a.OecedenYs Usuai 4<c�pation-lntliGate tVP�af wark
Whita O lapanesa �Samaan tlane during most of Wprking fife, Oo NOT USE RET1REO.
Black p�AfHCary American A Korean � Oiha�paclfic lalantler
� �J'Ame�icun Indian or Alaska Nativa �Viefnamese (� Don't Know/NOt Sure �..5. ,�,'C([]y'
[]Aslan Intlian Q Othe�ASIa� Q qefugld 22b.Kind qf B�sine5s/Industry
� Q ChineS4 � �Naiive Hawailan � Othet'(5pec1£yj � � .. � � . .�.
ct Fit�p�no o�.,aR,,,,�a„aEcna�„o«a - De£enselL7.8. Gnverint�ent
ITEMS 23a-.23d MUST 6E COMP ETEO �,3a.Date Pronoun Dead(MO Oay r 23b.Signatu�e o Person Pronouncing Deaih Qnly whmn.appllca e)� 23c,lJCensa N4m e
BY PERSON WHO PRONqUNCE56R 'T�Y 'G�{�, 26 �3 . . . .
CBikTIF1E5 O@p.7H�� J � � �
23d.Oato Sign¢d(MOJOay(Yr} 2q.Tim¢of O¢ath � � �� � �
��'�� 25.Was M¢dicat Examinmr or Coror�gr Corttacted? � Yes Na
CAUSE OF 6EATH �
26.PaR 1. Enter tha Ghaln of events--disea5es,In uYles,or tdm Iicationt--thai direccl � Approxim8te
1 P y causetl the de,gth. DO NOT enier tmrminal 6vmnis such as cardlaC arrest, � Intervpl:
respiratOry a�rest,or ventrlcular fl6rlllation withaut showing the etlology. DGY NOT A89REVIATE. Entar only o�e cauma on a ti�re.ACtl atltliUOnai ii�as if r�eceaxary. pefset ta Owath
�r� �
iMMEUiATE CAVSE a. V G P Si S �
_____'__'_"""'> i
(Final dfseasa or contlition. D�e.to.(o a consequence of):
reSUl[Ing In death) r as � . .
b. P�,.v�..�..;,.,,.;a
Scqaaanciaily tist cnnditb�s, Oue Eo{o.r as a c�onseq�¢nce ofj:
if gny,teadfng ta the cauae { � � � � � �
{tatetl on ilne a Enter tha �AiQ�/\ � � .
UNDERLYING CAUSB Due to(cvr a�s a c�quence oF): �
(dis�ase or InJury ihat � � ' ' �
� Init�atad 4ha events resulting �. � � � . ;
M a°atl`�tA'i't' p�e m{or as a wnsaquence of): � . . .
� 1
24.PaR 11.� ncer other sianifica tllti Ib I g eath but no[tesulklnQ in ihe untlerlying cause glven in Part 1.� �2 .Was autopsy p�r{ormad7
� . . . . .�O�'ras l�l No
' � � 29,:.W¢�b.b4kopsyflndlrtQSavailabia
�� � to com{tiete tha cause at deathT
29.!f iamale: O Yes rya
� (] Not pl'egnant Wlthin past year 30.6id Tobacco Vse ContNb�te to Deaih7 31.Manner o1 DeaYh
� s � Pregnani at iime of tlea%h � �'es p Prapgbly � Natursl p Homlcitl!
a�' Q Not pregrtant,but pregmm�t wlthln 42 da � No � Unknown O Accident
preQnanf,6ut Ys afcleath � C] PentlinglnvesrigrNOn
� Not pregnaM 43 days to 1 yaar before d¢ath 32.OaXe of in)ury jMOlOayJYr){Speil Monih} SU���e � ��id not be detarmtned
t�+ � Unknown if pregnaM witt�in Me past year
�� 39.Tlme of lnjury
34.place of Injury(e.Q.home;construcHOn sice;farm;school) 35.LocaHOn of InJury(Street antl Number,Clty,County,SYate,2ip Cod¢)
� 36.tn}ury at Wark 37.tf Tranaportation Injury,Spccify: 3S.DaSCriba Hpw In)�ry CJCCUrred:
�' O ves Gry or��er/c+perator O PedestYlan'
� p No p va::enaer O ocner(sPe�iHl
39a.Certifler-physician,Certifisd nune practlitoner,medlcai eKamtne�/coronar{Check oMy one}:
�Cerpfying only-Ta the bast of my knawied�e,tlesth occitrred due to the se(s}and mann¢r sxaSmtl.
�`) Pronouncing 8�Certtfying-To the bast of my knowied ,deqth occUYretl at the time q tta and plac�,antl duar to tha cause(s)and mann�r akaced.
[� Medlcal Examiner/COr`on�e�v-On ihe basi5 of exa(m�inai or Investigatlon,In my pi i n,d th,�+o�ccurretl at the tlme,date,sntl place,antl due ta t`he. S'a`( )�Lnd+� ner stated.
5Ig a4ure Of GeRifler: �V QI�MA �}(� y1,� � TitlG�of ccttlfl r._ �V - li<artse N.umbe�'7y���"T'-f G��n�Q
39b��.NamC,Atltl�es5 and Zip Gotlg of Pefsan Compic2ittg Ca�p�(' �{aLa� �yy�EV FCf�I�e('�'CeT� f-tershey� Pa.1,7(}33� 39C.DHM�SIgnsA(MO/Day/Yr}
� i�-1 i3 I'! ��--� CT 3 c T
� 40.Registrars Dlstrlct�NUmber �u�'" �q�`' ZC''/..3 �
41.Reg 5tr gn ��e ��4 egi¢kfar Ff e pte(MO�bey^. r)/
� �� �� /� ..�� �-�'C.�+�i .':
.� 33_Aman6mer�ts
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CSISPOStt(on Permit No. Cl d 6/��� oc 1a5-I^3'
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LAST WILL AND TESTAMENT
OF
VICTOR KAY TAYLOR
Dated: November 9, 2012
Prepared by:
Office of the Post Judge Advocate
Captain Joseph S. Steere
22 Ashburn Drive, RM 105
Carlisle, Pennsylvania 17013
(717) 245-4940
LAST WILL AND TESTAMENT
OF
VICTOR KAY TAYLOR
I, Victor Kay Taylor, a resident of the Commonwealth of Pennsylvania, make,
publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any
time heretofore made by me. I am retired from the military service of the United States.
FIRST: I direct that the expenses of my last illness and funeral, the expenses of
the administration of my estate, and all estate, inheritance and similar taxes payable with respect
to property included in my estate, whether or not passing under this will, and any interest or
penalties thereon, shall be paid out of my residuary estate, without apportionment and with no
right of reimbursement from any recipient of any such property (including reimbursement under
Section 2207B of the Internal Revenue Code).
SECOND: It is my desire that, upon my death, I be buried at Parklawn
Cemetery in Chambersburg, Pennsylvania alongside my wife.
THIRD: I give all the rest, residue and remainder of my property and estate,
both real and personal, of whatever kind and wherever located, that I own or to which I shall be
in any manner entitled at the time of my death (collectively referred to as my "residuary estate"),
as follows:
(a) If my wife Carole May Taylor survives me, to my wife Carole May Taylor.
(b) If my wife Carole May Taylor does not survive me, my residuary estate shall
be paid and distributed to Victor K. Taylor if he shall survive me.
(c) If none of the beneficiaries described in clauses (a) and (b) above shall
survive me, then I give my residuary estate to those who would take from me as if
I were then to die without a will, unmarried and the absolute owner of my
residuary estate, and a resident of the Commonwealth of Pennsylvania.
FOURTH: If any property of my estate vests in absolute ownership in a minor
or incompetent, my Executor, at any time and without court authorization, may: distribute the
whole or any part of such property to the beneficiary; or use the whole or any part for the health,
education, maintenance and support of the beneficiary; or distribute the whole or any part to a
guardian, committee or other legal representative of the beneficiary, or to a custodian for the
beneficiary under any gifts to minors or transfers to minors act, or to the person or persons with
whom the beneficiary resides. Evidence of any such distribution or the receipt therefor executed
by the person to whom the distribution is made shall be a full discharge of my Executor from any
c��� i
liability with respect thereto, even though my Executor may be such person. If such beneficiary
is a minor, my Executor may defer the distribution of the whole or any part of such property until
the beneficiary attains the age of eighteen (18) years, and may hold the same as a separate fund
for the beneficiary with all of the powers described in Article SIXTH hereof. If the beneficiary
dies before attaining said age, any balance shall be paid and distributed to the estate of the
beneficiary.
FIFTH: I appoint my wife Carole May Taylor to be my Executor. If my wife
does not survive me, or shall fail to qualify for any reason as my Executor, or having qualified
shall die, resign or cease to act for any reason as my Executor, I appoint Victor K. Taylor as my
Executor. I direct that no Executor shall be required to file or furnish any bond, surety or other
security in any jurisdiction.
SIXTH: I grant to my Executor all powers conferred on executors under the
Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and
all powers conferred upon executors wherever my Executor may act. I also grant to my
Executor power to retain, sell at public or private sale, exchange, grant options on, invest and
reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit; to
borrow money and encumber or pledge any property to secure loans; to pay any legacy or
distribute, divide or partition property in cash or in kind, or partly in kind, and to allocate
different kinds of property, disproportionate amounts of property and undivided interests in
property among any parts, funds or shares; to determine the fair valuation of property, with or
without regard to tax basis; to exercise all powers of an absolute owner of property; to
compromise and release claims with or without consideration; and to employ attorneys,
accountants and other persons for services or advice. The term "Executor" wherever used
herein shall mean the executors, executor, executrix or administrator in office from time to time.
SEVENTH: I direct that for purposes of this will a beneficiary shall be deemed
to predecease me unless such beneficiary survives me by more than thirty days. The terms
"child" and "children" as used in this will include not only the child and children of the person
designated, but also the legally adopted child and children of such person. The term "issue"
includes not only the children and other issue of the person designated, but also the legally
adopted children and issue of such person.
EIGHTH: I have served in the Armed Forces of the United States. I therefore
request that my Executor make appropriate inquiries to ascertain whether there are any benefits
to which I, my dependents or my heirs may be entitled by virtue of any military affiliation. I
specifically request that my Executor consult with a retired affairs officer at the nearest military
installation, the Department of Veterans Affairs, and the Social Security Administration.
2 � ��c i
IN WITNESS WHEREOF, I, Victar Kay Taylor, sign my name and publish and
declare this instrument as my last will and testament this 9th day of November, 2012.
� r •�__ ���
��
Victor Kay Taylor
The foregoing instrument was signed, published and declared by Victor Kay
Taylor, the above-named Testator, to be his last will and testament in our presence, all being
present at the same time, and we, at his request and in his presence and in the presence of each
other, have subscribed our names as witnesses on the date above written.
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having an address at
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ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CGc�,�-���9 N� , ss.
We, the Testator and the witnesses, whose names are signed to the attached or
foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that
the Testator, Victor Kay Taylor, signed and executed said instrument as his last will and
testament in the presence and hearing of the witnesses, and that he stated that said instrument
was his last will and testament, and that he had signed willingly, and that he executed it as his
free and voluntary act and deed for the purposes therein expressed, and that each of the witnesses
at the request of the Testator, in the presence and hearing of the Testator and each other, signed
the will as witness, and that to the best of his or her knowledge the Testator was at the time at
least eighteen years of age or emancipated, of sound mind and under no constraint, duress, fraud
or undue influence.
" � �: �
___ Victor Kay Taylor
.-.Test tor
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print: �Z o��e;�t- �• Sc.�sG<<`e ,
Witness
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Witness
Subscribed, sworn to and acknowledged before me by the said Victor Kay Taylor,
Testator, and subscribed and sworn to before me by the above-named witnesses, this 9th day of
November, 2012.
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Notary Public �
My commission expires on
CdMMO� 6F PEPINSYLVANIA
Notarial Seal
Ester George,Notary Public
North Middleton Twp.,Cumberland County
My Commis5lon Expires Dec.10,2014
MEMBER,pEryrySy�VANIA qS$pCIq'RON OF NOTARIES