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Home My WebLink About10-25-13 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 requests the grant of Letters in the appropriate form: Dana L.Smith Decedent's Information Name: William S.Smith,Sr. File No: 21-13-)��Q �Wa� Wiiliam S.Smith ' (Assigned by Register) a/k/a: a/k/a: Social Security No: 165-28-8978 Date of Death: 10/09/2013 Age at Death: 76 Decedent was domiciled at death in Cumberland County, pq (State)with his/her last principal residence at 700 Walnut Bottom Road,Cariisle 17013 Carlisle Cumberland Street address,Post Office and Zip Code Ciry,Township or Borough County Decedent died at 700 Walnut Bottom Road,Carlisle 17013 Carlisle Cumberland PA Street address,Post Office and Zip Code City,Township or Borough County State Estimate of value of decedenYs property at death: If domiciled in Pennsy/vania...................... All personal property $ 25 000.00 Ifnot domiciled in Pennsy/vania................ Personal property in Pennsylvania $ lfnot domiciled in Pennsylvania................ Personal property in County $ Value of real estate in Pennsylvania................................................................... $ TOTAL ESTIMATED VALUE � 25,000.00 Real estate in Pennsylvania situated at (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)that he/she/they islare the Executor(s)named in the Last Will of the Decedent,dated 12/23/2010 and Codicil(s) thereto dated none State relevant circumstances(e.g.,renunciahon,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;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. �NO EXCEPTIONS � EXCEPTIONS ❑ B. Petition for Grant of Letters of Administration (If applicable) c.t.a.,d.b.n.,d.b.n.c.t.a.,pedentelite,durantea _,=_ tia.durant�minoritate If Administration,c.ta or d.b.n.c.t.a.,enter date of Will in Section A above and comnlete list of heirs.0 Q `''' o� 4-mj Except as follows: Decedent was not a party to pending divorce proceeding wherein the grounds for divorce�aa-p�en esta(�fi�hed�d�bned in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated perso rn -�� _� {,� �� NO EXCEPTIONS � EXCEPTIONS � 1> � N €'t �"n Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the fa'#ouy�g��iouse(i anyf�nc�.,l�eirs(attach additional sheets,if necessary): P-�-� - i� .� ,�.� _., "� �..." c"'? _`t a �� -% _.�., �3 Name Relationship Address '" �; � "M rn -a � v� �� y -�� Form RW-02 rev 10-11-2011 Copyright(c)2011 form soflware only The Lackner Group,Inc. Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } Petitioner(s)Printed Name Petitioner(s)Printed Address Dana L.Smith 2443 North 5th Street r-� Harrisburg,PA 17110 � `—�: �p � C �' r'�'t C'�`.) ..,L� '_- ....9 C:i C+�3 '^t;' �_{ (n ^�3 t"'�1 =,,� �": m�.� C:3 � y,M �._, rv ,,_; ;_:r �. �`� � ._' � .��. c�� ... � . --� _.,,. -;, d� c:a �..,. � _� �, � ..,..: ._„� �.7 r--_ ._ .a p ^�} � N �`.� -Y� `� r. � i� � "� The Petitioner(s)above-named swear(s)or affirm(s)the statements in the f oing Petition are true and correct to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s) ec d t titioyC'� \./'will well and truly administer the estate accordin to law. Sworn to or affirmed and subscri ed before Date � � �s a+�f3 me ' '2S�dayof � � , 2-��3 Date ay. � Date � __._ For the Register Date BOND Required? NO To the RegisterofWills: Please enter my appearance by my signature below: FEES: F� Letters.......................................... $ j�J��•l,'(.� Attorney Signatur • ( � )short Certificate(s)......... ,�S.�%Cy � �� _ _ � ( � )Renunciation(s).............. �j,e-(`, ��. ( )Codicil(s)........................ ( )Affidavit(s)...................... Printed Name: Jessica F.Greene Esq. Bond............................................. Supreme Court Commission.................................. ID Number: 310018 Other 1 � 1 ��'�� Firm Name: Keystone Elder Law P.C. �� ' ��'� Address: 555 Gettysburg Pike I,� Lk.l 1�.�L STE C-100 Mechanicsburg,PA 17055 Phone: 717-697-3223 Automation Fee............................ �j. �;"� --� Fax: JCS Fee....................................... 3-��`��.' TOTAL......................................... $ �(��-�(; E-mail: Jessica@keystoneelderlaw.com DECREE OF THE REGISTER Date of Death: 10/09/2013 Social Security No: 165-28-8978 Estate of William S.Smith,Sr. File No: 21-13�1+�1"; a/k/a: William S.Smith AND NOW, �� , � , in consideraYi�n of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Dana L.Smith in the above estate and(if applicable)that the instrument(s)dated 12/23/2010 described in the Petition be admitted to probate and filed of record as th,� ast Will(and Codicil(s))of De ent. �� /L(l.�'�--- , � � � Register of Wills �= � }lu'�2--�'' �� Copyright(c)2011 form soflware only The Lackner Group,Inc � / �ge 2 of� j` c 1 H705.805 REV(9/I1) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00��;� u �'�_�f^� ��: ,,,,��°"' This is to cerkify that the information here given is � � , �,��p�,ZH Of pE�;y__ correctly copied from an original Certificate of Death ��?et i V . ��..1 V� 5� ' ; ' 1,1 � - - V-� . `-'-� r�� - G; duly filed with me as Local Registrar. The original °- 9' certificate wiil be forwarded to the State Vital �.��i� �%�i 2� �I``� 2 �� '° � a? Records Office for permanent filing. . ,�� j�- � ;�' .; . P 19 � 12 � 5 7 c= �; � �_ �°�'�q9T� E��,a��,'' i� � ��a �, ��, _ ��c� ��n 3 � --,MENT�U,,,,,, Certification Number �+�� I�ii� Local Registrar Date Issued GU��RL��,� ��0., PA Type/PMnt In COMMONWEALTH OF PENNSYlVAN1A�DEPAftTMENT OF HEALTH�VITAL RECORDS PErmanent Black Ink CERTIFICATE OF �EATH SSate File Number: 1.Deceden['s Lcgal Name(First,Middle,Last,Suffigx) 2.Sex 3.Social Security Number 4.Date of Oeath(MO/D^ay/Vr)(Spell Mo) � Jn oL� ` Sa.Age-last 9lrthday(Yrs) Sb.Under 1 Year Sc.Under 1 Da 6.Date of Birth(MO/Oay/Year)(Spell Monih 7a.Bi�lace(City and Stafe�or For�ign Cou�S �) � � � � . Monihs DayS Hours Minutes � � ' �� 4� �. � 7b.Birthplaro(CO�nty)�(3 Sa.Residenc State or ForBign Country) 8b.ResitlenL�(Street a�Ny�ber-ITC�IUd o.) Sc.Did Decedent Live In a Township? � � � � f _ -,.-vi`�r-{ �`1 'J�-Y�Y1��6�. O ves,aocoaenc iwea i� � cwo. 9d.Residence(GOUnty)� -t - ._{� ��L �-�� /. [� Be.Residence(2Ip Code) ��'`��(Q - ' No,decedeni lived within Ilmits of �AQ i�i/�'!�Q� <fty/boro. 9.Ever in US Armed Forces? 30.Marital Status at Time of Death � Marrled � Widowed il.Surviving.�pp��Name(If wife,give name prior io first marrlage) Ves � No 0 Unknown � Divorced � Never Married �Unkno N 12.F ther's Name(Firs[,Middle,last,S�ffi 13.Mocher's Name Prlor to First Marriage(Fint Midtlle Last) W' �. �s�n.lZ-�F-E- - s�t-1 C.� .�.cs 14a.Informant's Name 14b.Relationship to Decetleni 14c.Informant's Mailing Addr (SCreet and Num� r,City,SiatB,Zip Cotle) � � � -� IY � -a�l- //ar�il� S rH4 !7�� °G � isa. ace o cat c ec on�o�e _ If Death Occurred in a Hosplial: � Inpatient �If Death Occurred Somewhere O[herThan a Hospital [7 Hospice Faeilfly� �[]Decedent's Home � � � Emergency Room/OUtpattent O Oead on Arrival � Nuraing Home/LOng-Term Care Facility Q Other(Specify) �� ad SSb.Facility Name(If not insticution,give street antl n mber) 15c. ity or Town,State,and Zip Code 15d.Couniy of Oeath � o. c,T u �• ta R.c-.� � � ! !03 u r►a J3 C �G.A nl b 16a.M<thod of OlspoSiCion O Burtal Crcmatlon b.Dafe of Disposfilon 16c.Place of Disposliton(Name�of cemetery,crematory,or oSher place) � 0�Ramoval from State 0 Donation � � - o othe��sPe��*�� O Q��u3 PR a I�E's t fv q� G'.R�'�t+4T�R � 16d.Locailon of Disposifton(City o�TOwn,Stafe, ntl Zlp) 17a.Signatu�re of Funeral Service Ltcensee or Person in Cha�ge of IniermenL�S7b.�Lice e N�mbe� � !�Rl� /�i l S 6�'2 ¢- oO g 7 9 G, 0 1� d C Addres F 1 Fa II �� 'o�i� � rRSori�l�u�u��ia-7 �foMG- r'1 � �-` �O v/-�ausc�aoe7 �'/�{ m 18.Decedent's Education-Check the box ihat best describes the 19.Decedent of Hispanic Origin-Check the 20.Deccden['s Race-Check ONE OR MORE r o tndtcate what � highest degree or level of school completed at the time of death. box that best describes whettier the decedent the decedeni conslCered himself or herself 2o bes t O Sth grade or less Is Spanish/Hlspanic/latino. Check the"NO" [`�White O Korean � No diploma,9th-12tFi grade boJ�if tlecedeni Is nof Spanish/Hispanic/Laiino. � Black or African American � Vietnamese �'High school gradvate or GEO completed $f No,not Spanish/Hlspanic/Latino � American Intlian or Alaska Native � Other Asian � Some college credit,b�t no degree �Yes,Mexican,Mexlcan American,Chicano �Asian Indlan 0 NaLive Hawailan O Associate degree(e.g.AA,AS) O Ves,P�erto Rican O Chinese O Bacheior's tlegree(e.g.BA,AB,BS) 0 Yes,Cuban � Filipino � Samoan ian or Chamorro � Master's degree(e.g.MA,M5,MEng,MEd,MSW,MBA) � Yes,other Spanish/Hlspanic/l.atino �Japanese 0 O[her Paciflc Islande-r 0 Doctora[e(e.g.PhD,EdD)or Professlonal degree (Specify) � Other(Specify) � .NID pO5 DVM,LLB,JD 21.Decetle�f's Single ftace Self-Designation-Check ONLY ONE to indicate what the decedent considered himseif or herself to be. 22a.Decetlent's Us�al Occ�pation-Indicafe type of work �Whife �Japanese � Samoan tlone tluring most of worktng iffe. DO NOT USE RETIRED. 0 Black o�Af�ican American � Korean � Oiher Pacific Islantler p q �American Indtan or Alaska Native �Vietnamese O �on't Know/NOt Sure : (/( � „� `✓�� rx �Asian Indlan � Othcr ns�an O Ref�satl 22b.K�ntl of B�siness/Intl�s[ry � Chinese O Native Hawailan O Other(Specify) /� �� s � 0 F11lpino O Guama�lan or Chamorro TRu C.L� �l"-��V ITEMS E3a-23d MUST BE COMPLETEU 23a. ate Pronounced�cad(MO Day Yr) 23b.Signature of Person Pronouncing Death(Only wM1en applicable 23c:License Number BY PERSON WHO PRONOVNCES OR �_.}--/ qd'�' � � � G CERTIFIES EATH CXC_iG�-t(/�C.� O� � � �/} / 23 aS�Sig etl(MO/Oay?/Yr) f 24.Tlme of Oeath // �. . ,..� 1��P� pC Q/ � �'y� /1'� 25.Was Medical E aminer or Coron«Contactetl� � Yes No CAUSE OF DEATH � ,y irt,aSe pproz 26.Part 1. Enter the chaln of e ents--diseases,injurles,or complicailons--ihat directly caused che death. DO NOT entar cerminai events such as cardiac arrest, � Interval: respiratory arrest,or ventricular fibrllla^Hon without showing the efiology. DO NOT AB9REVIATE. Enter only one cause on a Iine. Adtl addiHonal Iines if necessary. 1 Onset to Deafh (� , / / IMMEOIATE CAUSE ' _.`O ��rQ (�p yXJE_A(Q� � • _______________' a. (Final disease or condfUOn Due io(o sequance of): � resulting in d¢aTh) ` as a on ' b. �' `V'\O�P Sh.JL. �Af`.C-'T �k-fCA_�,1Lw l�L� V:l��C� Sequen(lally Iist condttions, -�- Oiae to(or as a conscquence of): � �-- If any,leading to the cause � . � � Iisted on Ilne a. Enter the 1 �C�=.��5 UNDERIVING CAUSE Due to(or as a consequence of): . � -7- (disease or InJury that F IniHafed ihe events resulting d. � � tn tleath)LAST. �� Due to(or as a consequence of): � � �j 26.Par[S1�1. Enter other sianificant conditions contr"butlna to d¢ath but not res�lGing in the underlying cause given In Part i. � . 27.Was an a topsy performedT GK 1� ^�K� t�'�) O Yes � N�o �� ] � E-'-^ za.we�e a�aoP:y noa�..gs ..a�iame � plete the ca�se of death? � a io coO Ves O No a 29.If Female: 30.Dtd Tobacco U ContribuSe to Death2 31.Manner of Death Eo � Not pr¢gnant within pasC year � Yes �{[9Probably �fJatural � Homfcide � Pregnant at time of deaih � No p Unknown 0 Not pregnarit,but pregnan�wi2hin 42 da f tleath 0 A�ciCenT � Pentling Investigation � � ys o � Sulcitle � Coultl not be determined � NoS pregnanS,but pr¢gnant 43 tlays io 1 year before death 32.Daie of Injury(MO/�ay/Yr)(Spell Month) � Unknown if pregnant within ihe past year . 33.Time of InJury 34.Place of InJury(e.g.home;con5truction site;farm;schoolj 35.Lo<ation of Injury(Street and Number,City,Couniy,State,Zip Cotle) r Z � 36.InJury at Wo�k 37.If Transportation InJury,Specify: 38.Describe How InJury Occurred: ' . � Ves � Driver/Operator Q PedesSrian _� � No � Passenger � Other(Specify) \) 39a.Certifier-physician,certiFied nurse prac�itioner,medical examiner/coroner(Check only one): rtifying only-To the best of my knowledge,death occurred due to the cause(s)and man r stated. P onouncing 8.Certifying-To the best of my knowledge,tleath occurred at the time,dace,and p�ace,antl due So She cause(s)and m r sfaced. 0 Medical Examiner/COroner- e basis aHon and/or I�vestigation,in my opinlon,death occurred at the time,date,and plare,a�tl due co the cause(s)and m stated. Signature of certifier: Title of certlfier: - License Number:(��.D 7_� 39b.Name,Address and Zip ode of Perso mpl Ing Ca�se of DeatM1(Item 26) 39c.Date igne. (MO/Oay/Vr) � � S �..� �' `1 � `� LQ � � . � 40.Rcgis tri 41.Regis . 42�.Ragist�ar Fil@ D te� O/� y/Y�) m �� 43.Amendments � Q-1D}� � 7 � H105-143 Dispositlon Permit No� ` �� . REV O7/2oi2 - � n <_._; =� r'n �Y � r-;i � __> �:' ca � : - , •= �a c-? �,� , ._, �, . _ C__, , ...� �L�� l�J1Jl ��1�1'JL��"- '' c.=i �`,; '`� f�, . r_� E> . . -,� - .� ,. ? —�3 'i �� : Y � � 0'i f "' . ....y ,� Cl3 �� o ��9 ��v I, WILLIAM S. SMITH, SR.., having my legal residence at 600 D Street, Carlisle, Pennsylvania, 17013, do hereby declare this to be my Last Will and Testament, revoking all other Wills and Codicils heretofore made by me. I declare that I am widowed and that I have the following two (2) children born to me; Dana L. Smith and William S. Smith, Jr. ITEM ONE: I direct that all my valid debts and the expenses of my last illness and funeral be paid from my estate as soon as practicable after my death. ITEM TWO: I give and bequeath all of my tangible personal property to my residuary heirs under Item Four, below as follows: A. All items of tangible personal property shall be inventoried and valued at a fair market value. B. I may leave a Memorandum listing some of the items of my tangible personal property which I wish certain persons to have and request that my wishes as set forth in the memorandum be observed by my Personal Representative. Any items of tangible personal property not so designated shall be divided and distributed among my residuary heirs as follows: 1. Each of my heirs may select one item, in rotation, in order determined by lot, until such time at which the items chosen by each heir reach such heir's proportionate share of the total value of my estate, or until such time as each heir wishes to make no further selections. 1 2. Any items not selected shall be sold and the net proceeds added to the residue of my estate. 3. To the extent my heirs are unable to agree, the decision as to what may constitute "one item" for purposes of this selection shall be made by my Personal Representative(s). 4. Any disputes concerning this method of allocation shall be resolved by my Personal Representative(s) in my Personal Representative's sole discretion. 5. To the extent my Personal Representative is unable to resolve a dispute among two or more of my heirs concerning the in-kind distribution of any of my personal property, I direct my Personal Representative to sell the disputed property and the net proceeds there from be added to the residue of my estate. ITEM THREE: I give and devise any interest I may own in any real property together with the insurance thereon to my residuary heirs under Item Four, below. My Personal Representative may either distribute any real property at its then fair market value to one or more of my residuary heirs under and in accordance with Item Four below, or may sell any such real property and the net proceeds there from be added to the residue of my estate. ITEM FOUR: I give, bequeath and devise all the residue of my estate, of whatsoever nature S.� and wheresoever situate, to my children as follows: � ��p� i�ll� � ` 1. To my daughter, DANA L. SMITH, I give•frfCy�ercent �56°�'0) of the residue of my estate. In the event my daughter fails to survive me, this gift shall lapse and I give her share to my remaining beneficiaries under this.Lt�m Four, pe�i es. S r 2. To my son, WILLIAM S. SMITH, JR., I give ��rcent �"s�i o j of the residue of my estate. In the event my son fails to survive me, this gift shall lapse and I give his share to my remaining beneficiaries under this Item Four, per stirpes. ITEM FIVE: I appoint, my brother, JOHN H. SMITH, Personal Representative of this my Will. In the event my brother is unable or unwilling to act or continue to act as my Personal Representative, I appoint my daughter, DANA L. SMITH, as Personal Representative of this my Will. 2 ITEM SIX: I appoint my duly appointed Personal Representative(s) Trustee(s) of the Trust(s) created pursuant to Item Five, above. ITEM SEVEN: No bond shall be required of any fiduciary hereunder in any jurisdiction. No fiduciary hereunder shall have any liability for any mistake or errar of judgment made in good faith. ITEM EIGHT: I authorize my Personal Representative(s) and Trustee(s) to exercise the following powers in addition to those given by law,to be exercised in their sole discretion: A. To retain any or all of the assets of my estate, without regard to any principle of diversification, risk or productivity; B. To invest in all forms of property without restriction to investments authorized for any type of fiduciary; C. To compromise any claim or controversy; D. To loan money to or buy property from my estate; E. To borrow money from any person, including any Executor or Trustee, and to mortgage or pledge any real or personal property; F. To sell at public or private sale, to exchange or to lease for any period of time, any real or personal property, and to give options for sales, exchanges or leases, all for such prices and upon such terms and conditions as they deem proper; G. To allocate receipts and expenses to principal or income or partly to each as they deem proper; H. To repair, alter ar improve any real or personal property; I. To distribute in cash or in kind or partly in each at valuations fixed by them; J. To keep reasonable amounts of cash in a bank uninvested if deemed advisable for the protection of the principal; K. To subscribe for or to exercise options for stocks,bonds or other investments;to join in any plan of lease, mortgage, merger, consolidation, reorganization, foreclosure or voting trust and to deposit securities thereunder, and to generally exercise all the rights of security holders or employees of any corporation; L. To register securities in the name of a nominee or in such manner that title shall pass by delivery; M. To add to the principal of any trust created by this instrument any real or personal property received from any person by Deed, Will or in any other manner; N. To exercise all power, authority and discretion given by this instrument after the termination of any trust created herein until the same is fully distributed; O. To use their sole discretion in deciding whether stock dividends on stock they hold in trust should be apportioned to principal or income, except stock dividends of regulated investment companies which shall be added to principal; P. To commingle the assets of any trust estate created by this Will in any one or more common funds for greater convenience and flexibility; 3 Q. To employ agents, accountants, engineers and such other persons, professional or otherwise, as may be necessary for the proper administration of this estate or trust and to pay their compensation from such funds; and R. To disclaim all or any interest in a property passing to me or my estate. ITEM NINE: I realize that Personal Representatives are given discretion by law to make various elections which affect the income and estate t�es payable by estates and beneficiaries, as well as the relative shares of beneficiaries, such as taking administration expenses as deductions for either estate or income taa� purposes, selecting options for the payment of employee death benefits, electing to take a qualified terminable interest as part of the marital deduction, selecting alternate valuation dates, postponing the payment of taxes, filing joint income tax or gift t� returns and redeeming corporate stock. The decisions made by my fiduciaries in any of these matters shall be binding upon, and not subject to question by, any affected persons. I rely upon my fiduciaries to take into consideration the total income and estate taxes payable by reason of their decisions including those payable by my survivors, and they are authorized in their discretion, but not required, to make adjustments between income and principal as a result thereof. ITEM TEN: I direct that all estate, inheritance and other taxes in the nature thereof, together with any interest and penalties thereon, becoming payable because of my death with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this my Last Will and Testament, shall be paid from the principal of my residuary estate, and no person receiving or having a beneficial interest in any such property, whether under this my Last Will and Testament or otherwise, shall at any time be required to contribute to or refund any part thereof; PROVIDED, however, that this direction shall not apply to the taxes on any property included in my estate solely because of a power of appointment thereover which I possess but have not exercised or on any qualified terminable interest or to any generation- skipping transfer ta�ces. ITEM ELEVEN: If any beneficiary, person or entity in any manner, directly or indirectly, contests or attacks this Will or any of its provisions, or objects to the accounts or actions of my fiduciaries, without probable cause, such beneficiary, person or entity shall pay all costs, including but not limited to attorneys fees, arising in connection with such contest, attack or objection incurred by my estate, such trust 4 or such fiduciary personally. In the event that such beneficiary, person or entity does not prevail in such action, any share or interest in my estate or such trust which would otherwise pass to such beneficiary, person, entity or remainderman under this Will shall be revoked and the property consisting of such share shall be disposed of in the manner provided herein as if that contesting person or entity had predeceased be without surviving issue. ITEM TWELVE: Should any of the provisions of my Will be for any reason declared invalid, such invalidity shall not affect any of the other provisions of this Will and all invalid provisions shall be wholly disregarded in interpreting this Will. ITEM THIRTEEN: This Will shall be construed, regulated and governed by and in accordance with the laws of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, I have at Carlisle, Pennsylvania, on December 23, 2010, set my hand and seal to this my Last Will and Testament consisting of six (5)pages plus any acknowledgement, affidavit and certification pages. ��'.�� r (SEAL) WILLIAM S. SMITH, SR. 5 SIGNED, SEALED, PUBLISHED AND DECLARED BY WILLIAM S. SMITH, SR., the above named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. � ' ness Witn s 555 Gettvsburg Pike,Mechanicsbur�, PA 17055 555 Gettvsbur�Pike,Mechanicsburg,PA 17055 6 ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA : . SS: COUNTY OF CUMBERLAND : I, WILLIAM S. SMITH, SR., the Testator whose name is signed to the attached ar 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. .��.�-s�� s� WILLIAM S. SMITH, SR. Sworn to or affirmed and acknowledged before me, by WILLIAM S. SMITH, SR., the Testator on December 23, 2010. , -- ; � PA Att rney 7 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : . SS: COUNTY OF CUMBERLAND : I, Robert P. Grubb, a witness whose name is signed to the attached or foregoing instrument, being duly sworn and qualified according to law, do depose and say that I was present and saw the Testator sign and execute the instrument as his Last Will; that he had signed willingly and executed it as his 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 Witness; and that to the best of my knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraints or undue influence. Witness Sworn to or affirmed and acknowledged before me, by Robert P. Grubb, a Witness on December 23, 2010. _ � - ' or PA Attorney s AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : I, Jessica L. Fisher, a witness whose name is signed to the attached or foregoing instrument, being duly sworn and qualified according to law, do depose and say that I was present and saw the Testator sign and execute the instrument as his Last Will; that he had signed willingly and executed it as his 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 Witness; and that to the best of my knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraints or undue influence. . , u�� - ,L�-�, Wi ess , • , , • �tzn��ttb�ie- CERTIFICATION COMMONWEALTH OF PENNSYLVANIA : . SS: COUNTY OF CUMBERLAND . On December 23, 2010, before me the undersigned officer, personally appeared Jessica L. Fisher, Esquire (Pennsylvania Supreme Court ID No. 310018), known to me or satisfactorily proven to be a member of the bar of the highest court of Pennsylvania and certified that she was personally present when the foregoing acknowledgement and affidavit(s) were signed by the Testator and witnesses. IN WITNESS HEREOF, I hereunto set me hand and official seal. %'�� n ��--�- Notary Public NOTARIAL SEAL MARCIA M NESBIT Nohry PuDlic UPPER AIIEN TWP.,CUMBERLAND COt1�ITY 9 M�►ComrMssion Expka Jun�.201! �� 1� � �lJ� �� o ��9 ��o This informal letter of instruction to my family and Personal Representative serves to convey my personal wishes concerning distribution of selected personal effects. In any situation where the provisions of this letter may be deemed to be inconsistent with or contrary to the terms of my Will, or other formal Estate Planning Documents, it is my desire and intent that the provisions of my Will and other formal Estate Planning instruments shall govern and be controlling since I do not intend that this letter shall serve in any respect as a Will nor shall the terms of this letter override the provisions of a Will or a Trust executed by me whether it was signed prior or subsequent to the date of this letter. Distribution of Personal Property Description of Property Beneficiary 1. 1. 2. 2. 3. 3. 4. 4. 5. 5. 6. 6. 7. 7. 8. 8. 9. 9. 10. 10. 11. 11. 12. 12. 10 Descrintion of Pronerty Beneficiary 13. 13. 14. 14. 15. 15. 16. 16. 17. 17. 18. 18. 19. 19. 20. 20. 21. 21. 22. 22. 23. 23. 24. 24. 25. 25. Other Directions To My Family: 11 RENUNCIATION REGISTER OF WiILS OF CUMBERLAN� COUNTY, PENNSYLVANIA -- � � Estafie of Wiitiam S.Smith,Sr. c A-, `�''; D� l��•� wg Y'1 -'°- ��r `-�' [�;,s `� � �'ti1 _.fi: --'s i'"} q'7 {"� � C"J .....� � ;��. r— r�� k:,, �;y r' �-,� s°�', u� �:� �:w� c� �-; �w,, � � «-� e�� ..;� _:.:: �� C� . . i' �� ,_... !_� lohn H.SmIEh ic�m Iatior} as;- -z� ,s �» ° 3> - C�J � Persos�at ReQresentative of the at�ove Deaedent,he�by renounce the right io adminisber�Esffi#e of the D�t and resP�fu�Y request that Let�ers be��o Dana L.Sm�th /D _�/-�z��3 �� Jahn H,Smiifi • 13888 Marven Drfirs �� Morth HuMingdan,PA,15842 r�,:sa�z� EXeCU�sd iR RegiSi+esr'S Of�"ice EXeCUt�ed Oti�t Of R@JiSt@/'S Off/C6 Sw�om ta or affirmed and sut�ibed Bafio�the undersi9r�d�sOnafty aPPea�ed tbe p�fy exeatting this�wnaabor�ar�d� �for�e me thic daY ��d��' �� #tu tbe t� : � � � � r)ept,ty fiar Regi�er of wil4 Puauc • ,n/� � mission ' I� �� I��C�I�.- �� b a�n�raaUx. srowaMeaeapic.�ond � `��P�+�',�NW�.TH Or#�E'W�f5Yi.1+ANU! , _.,__�.�otariai 5eai � :�i�ci�z�J.�erichak,No�ary Publ�r } irw,in&>ro,VVestmoreland t;�untv ! %�y Ccamms:,�ion Ex�ir�s May:a,20�:.� s C ?;SI�;!�C:NN�i�Tz- " r ,� `.)?�: _ FO►�R�RsY.30-15�0�95 CaPY�B�k(�}200B10nn sailwro oNy The iatltt�et Group.ir� OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUN�f, PENNS�=LV�1� - � ��.� s_� � ' ca � ,.,..s �.-> r:,� r a �.:a :_ c.-� ...� „� --� :_�a r's'a _ c_°� ...,q t�:s �� :�:x.. r.�. � + �.,4� t'– _ t"' c� ;:� _.:s r�' U 4 ' �. ,r,v? Estate of William S.Smith,Sr. =% � t ;. .�ecease�l c> �-.: : .__ �a �w ._:, ::.~ <;-> �u rv .,.. r.;,� � ��.� .. �� } �� ..4� Rabert p.Grubb (each)a subscribing witness to (Print Nama�s) the � Wi�) ❑ Codicil(s) presented herewith, (each)being duly qualified according to law, depose(s)and say(s)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 his/her presence and in the presence of each other. (Signatu�e) (Signarure) ROb . �7C b �lw�(�!'G l'rf L�'�S�'C&��G- �I� (Street Address) (Sf�eet Address) ,�, 0}G !Q�'�� C Gfi"G fi3TZ�-- � !�lvll s—0.�7 (City,Sfate,Zip) (Cky,Sfate,Zip) Executed in Register's Office Execufed out of Regisfer's Office Sworn to or affirmed and subscribed Sworn to or affirmed and subscribed before me this- day bef�or�e��me this�day of , • of-�'��, ��1LC1. . Deputy for Register of Wills Notary Public �G/� My Commission Expires:��U""F yi � (Siqnature end seel af Nolary or other official qualifed to NOTARIAL SEAL admfnisteroaths. ShowdateofexpiretionofNOtaryscommission.) MARCIA M NESBIT Notary Public UPPER ALLEN TWP.,CUMBERLAND COUNIY My Commission Expires Jun 4,2014 NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s)at time of notarization. Form RW-03 Rev.1W iJ-2006 Copyright(c)2006 form soitware only Tha Lackner Group,Inc. OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA ,..-=' �a C7 �; -� ih"i � c� , Y°' C.'a '�r -�-., C..J t:e'� �y Estate of William S. Smith, Sr. � ��ec�s°�� :� rr� r.:, , ;:�1 =�.,,v �._ f�� y.m_ �.,..,..� �-- � �`i-� C1� . . ":s � +:;> j � ��-� .� ✓"°�, � _�q .,,.� C:i r..,� �..�, � ._�i C"7 C.,,, � , : 4:"7 � f°. —� h� �..... �„"i"i _ $_._ Jessica L. Fisher(Greene) (each) a su�c bing wit�ss to � (Print Name/s) the � Will ❑ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she/ he/they was/were present and saw the above Testator/Testatrix sign the same and that she/ he/they signed the same and that she / he/they signed as a witness at the request of the Testator/Testatrix in his/ her presence and in the presence of each other. o�2�e.cA- ,�"��.�� .Q,��.s� (Signature) (Signature) �essica L�Fisher(Greene) 555 Gettvsburg Pike Ste C100 (St2ef Address) (Street Address) Mechanicsburg, Pa 17055 (City,State,Zip) (City,State,Zip) Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Sworn to or affirmed and�ubscribed � i � before me this day bef ine t � day . of , . of �� , �. Deputy for Register of Wills Nota P c My Commission Expires: �/oZq�l7 (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) 1�� AEtECCA L STMR NMay Public tIPrER ALLEN TMIP.,CUM6ENlANO CNTY My CoaMIN�Non EzWrea M�r 2Y,2017 NOTE: To be taken by Officer authorized to administer oaths. Please have presen e ongina or copy o ins rumen s)at time of notarization. Form RW-0$Rev 10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc.