HomeMy WebLinkAbout11-20-13 Reset
�'ETITION FOR GRA,NT OF LETTERS
REGISTER OF WILLS OF Cumbertand COUNTY, P�NNSYLVANIA
Petitioner(s} named below, who is/are I8 years of age or older, apply(ies} for Lctters as specified below, and i��
supporE tIlereof aver(s)the following ai�d respectful[y request(s}the grant of Letters in Elze appropriate fonn:
Decedent's Infornaation
�iame: Jav F.Davidson File No: � � ' ��— ���c�
��a= (Assigned by Registcr)
a/k/a:
a/k/a: Social Security No: 17i-28-2217
Date of Death: i�3ovem6er 2,2013 Age at death: 80
Dctedent was domiciled at death in Cinnber[and Co�►nty, penn�ylvania (Sia��) witl�his/l�er last
principai residence at 141[ Lonefeltow Court. I7070 Lower Allen Townshin Cumberland
Street adciress,1'ost Office a�td'Lip Code City,'torrnsf�ip or Borough Counly
Decedent died at 1411 [_onafefla�v Court. 17�70 Lower Allen Townshio Cumbertand PA
Strcet address,Post U€fice and Zip Code City,'I'ownship or 13orougls Couatp Statc
Estimate of value of decedent's property at deatEi:
Ifdm�eiciled ix Pe�rits3�lvmria......... ................... All personal property S 500,000.00
If nu1 rf�nriciled i�i Pe�ixs}�Iva�:ia. .............. ......... Pcrsonal property in Pennsyfvania S
Ifno1 dorxicited i�r Perur���lva�aia. ....................... Personal property in County S
Yalue o.f'real estate rn Perrnsylvartia... ................................... ..... .............. S 200 0,�) Q.00
TOTAL ESTIn9AT�D VALU�. ... S �oa.000.00
Real esiate in Pennsylvania sifuated at: 14l 1 Loft�fellow Court, 17070 Lower AElen Township Cumberland
(Attaclr additio��al slteers.ijnccessaiy.) Streei address,Post Off cc a»d Lip Code City,7'ownsliip or Borough County
0 A. Petition fox•Probate and G�•ant of Letters Testamentary
Petitioner(s)aver(s)he/she/tficy is/are 8te�xecLitor(s)naincd in the last Wilf of ihe Decedent,datcd lanuary 5,201 1 and Codicil(s)
themto dated
Sfafe relevant circumstances(e.g.rerarrrcialiorr,dea!!e uf execn(or,etc:)
��cept as fol lo�vs: afier the execulion oCihe instrument(s)offemd for probaie Decedent did not marry,uras not divorced,«�as not a purty to a�ending
divorce proceeding wherei�t the grouncls for divorcc had been est�Uiished as definec!in 23 Pa_C.S.� 3323(g),ar�d did not have a chiid born or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitaled�erson.
�P[O EXC�PTIpNS Q EXC�PI'IONS
� B. Petition for Grant of Letters of Administration (Ifappl'scabie)
c.t.a.,d.b.n.,d.b.�r.c.t.a.,perrdentelile,dttrante abserrlia,durnnfe minaitate
lf Adminisfration,c.1.a. ar cl.b.n.c.1.a.,enter datc of Wil[ in Section A above and completc list o!'hcirs.
Eacept as follo«�s: Decedent�vas not a party to a pending divorce proceeding�vherein the gronnds for divorce had bee�i establislied as c�efned
in 23 Pa.C.S, §3323(g)and�vas ncitlier thc victim oP a killi�ig nor ever adjE�dicated an incapacitated person. r.�;
�NO EXCEPT101�'S Q EXCEPTIONS � �' :C7 �
Petitioner(s},after a propersearch has/have ascertained that Decedeat left no Will vid�vas survived by the�to+Q,�rtg spouse�any)6�?dl�irs(atlach
additiortrrlsheels,ifnecessa�y): � _ � � � q
Name Rel:�tionst�ip �s O ;,t7 �3
;� . �, p C..�
[� Cj "'C7 'rl "'�
� 'T'1 �. .�
� � �: �'J�
N i°'° ('Yi
"'� "'� � G� �
Fornr R1V-02 ,•en. 10/I1/201! Page 1 of 2
Oath of Personal Representative off�,�i us�o��Y
COM�riQ1vW�ALTH OF PGNNSYLVANIA }
} SS:
COU�TTY OF �U3nberland �
Petitioner(s)Printed N• Petitioncr(s)Printed Address
Frank Davidson � 362 Pleasant View Road,New Cumber3and,PA 17070
The Petitioner(s)above-namcd s�vcar(s)or affrm(s)the statemenis' tlze foregoing PeEitiort are � and carrect to tUe best of die knowledge and belieP
of Petilioner(s}an�t141i,as Personal Represcnt�ilive(s)oCthe ced tiie P itio er(s viil�� !1 nd truCy`a minisler the cstate according to la�v.
Sworn t or a�firmed an subscribed beforc � �e��Y�.- • Date ll`�"-��
ine `' dav of -�� �1te
B . Date
the Reoisre,- i Dale
EOND Required: ES Q Tu tlre Register nf tYills:
FEES: Please entcr my appcarance by my signature belo�v:
t�� /�, ��
Letters. ..... . . . .. .... . .. ... . S �.J�11- Attorney Signature:
{ �Q ) Short Certificate(s).. .. .. �j(;�.C,'(�— �
( ) ttenunciation(s).. . .. . .. .
( )Codicil(s). ...... .. .. . . �
( }Affdavit(s}..... . . .. . . .
8ond... .. . . . . . . ...... . . . . . . . Printed Name: Anthony J_Ne co,Esquire
Commission. . . . . . . .. .. . .. . . . . Supremc Court
Other . .. ID �umber: 58868
���-u.. . . . ��_
•�•�. l� �� Pinn Na�ne: Nestico Dnzby,P.C.
h .. . . . . . . /� Address: 1]35 F.ast Ctiocolnte Avem�e
� .. . . .. . . ��ite 300
. . . . .. . . ilershev,PA 17033
. . . . . . Plione: 717-533-5406
Automation Fce. .... . . .. .. .. .. -f, ��? Fax: 717-533-5717
3CS Fee. . . . . ... .. . . . . ... .. . . p'��,�•�(j Email: tnesticnnher�g�rn�law.cnnt
TOTAL. . .. . . . . .. , _.. . .. .... 5 Lc33.S7�-(�AA- =
r-.:,
� r_,, •`'�
i�.a %� e'z1
1'r'1
� � � � a
rn = c, � �' a
--�
� y, r rv � �
y�,, � � o �ac�
� � 7� Op
� � � .� �,1 "Ti
O � � � � �
� �7 N 3" r'tl
� � � � �
O
Fonn RlV-01 ,•���.�niit�zo�l Page 2 of 2
Oath of Personal Representative off�;a�us�on�y
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Petitioner(s)Printed Name Petitioner(s)Printed Address
The Petitioner(s)above-named swe r(s)or affirm(s)the statements in the foregoing Petition are true and corre to the best of the knowledge and belief
of Petitioner(s)and that,as Personal epresentative(s)of the Decedci�t,the Petitioner(s)will well aud trul administer the estate according to law.
Sworn to or affirmed and subscri ed before Date
me this day of Date
By: Date
For the Re,;ister Date
BOND Required:�YES �NO To e Register of Wills:
FEES: ease enter my appearance by my signature below:
:-..,
Letters . . . . . . . . . . . . . . . . . . . . . . $ Attorney Signature: �� �
( ) Sliort Certificate(s). . . . . . C `''' � �-�j
( )Renunciation(s).. . . . . . . . 3 � �=-� � �
( )Codicil(s). . . . . . . . . . . . . I� "� C � 't3
( )Affidavit(s).. . . . . . . . . . . ?J y,. r— N t�'t r''�
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed N e: t"' � rT1 O � �=
Coinmission. . . . . . . . . . . . . . . . . . Supreme Co t � - :� � -n
CJ � � -
Other . . . . . . . . ID Number: n O _ ,`t
. . . . . G7 � _.._` C�
. . . Firm Name: 7� L`� ` � ��
. . . Address: "'� C� �
. . . . . . . . Pl�one:
Automation Fee. . . . . . . . . . . . . . . Fax:
JCS Fee. . . . . . . :. . . . . . . . . . . Eulail: �
TOTAL. . . . . . . . . . . . . . . . . . . . . $
DECREE OI+ THE REGISTER
Estate of ,��C�-�� � ����1(��� File No: �� � ° ��—����
a/k/a:
AND NOW, ����� ��C11lr�/�}'� �,�(� „1,�,,-���, in considera ion of fhe foregoing Petition,
satisfactory proof having been presented before me,IT IS DECREED th t Letters �
are hereby granted to r � / i� ,�
in the above estate and(if app icable) inat
Che instrument(s)dated � � {'"j_/ (Q �,�.�/ "�j, c����
described in the Petition be admitted to prob and filed of record as the last Will (and Codicil(s))c��Deccaent.
���'�'7�� ; ��/��-� ;'�-��,� , �
Register of Wills� ����� �p� � �',� `� �
",�- �lJa �k����
F����,aw-n? ,��v. �ni�rizn�� V
ge2of2
H105.805 R6V(9/I I)
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $6.00R EC O R D�D O F F(C E O F This is to certify that the information here given is
,�,,,,,,,,,
R E G I S T E R 0 F W i L L S. ,,,,''°1��p�tH OF pE','t',j�= correctly copied from an original Certificate of Death
`,�`p�` _ L; d u l y f i l e d w i t h m e a s L o c a l R e g i s t r a r. T h e o ri g i n a l
p �y� � _- z; certificate will be forwarded to the State Vital
?�t 3 �0� 2� ( � � ��' ;� y - a� Recor Office far p a nt filing.
� �� � � � � � �? � ,,0�� �'a��
CLERK Oi� 1
� //�I�P�1,
Certification Number P H A N S' C 0 U R T 99lMENT OE� �
"""' oc egistrar Date Issued
Gt1MBERLAND, �0., P�,
Type/Print In COMMONWEALTH OF PENNSYLVANIA�DEPARTMENT OF HEALTH�VITAL ftECOR�S
Permanent State File Number:
e,a�k,,,k CERTIFICATE OF DEATH
1.Decetlent's L¢gal Name(First,Middle,Last,Suffix) 2.Se 3.Soclal SecuriSy Number 4.Daie of Death(MO/Day/Vr)(Spell Mo)
Jay �n.anlz Vav,idaon a-Qe 777-2g-2277 Novemb¢�c 2, 2013
�Sa.Age-Lasf Birthday(Yrs) �Sb.Under 1 Vear Sc.Under 1 Da 6.�ace of Birth(MO/Day/Vea�)(Spell Mon[h) 7a. irshplace(Clfy antl Siate o�Fo�eign Country)
. gQ Months Oays Hours Minutes S� en.abwc P y[ �V[L�(,Q
Sep�embe�c 29� 1933 7b.Hirthplace(co��cy> um n
Ha_Residence�(State or Foreign Country) Hb.Residence(Sireet and Number-Include Apt No.) 8c.Ditl�ecedent live in a Townshtp7
sa Pe a� �va�� 141 1 Long SeX,2.ow Cot.UC� �Yes,decedenUivetl in Low A p Twp c.,,P.
��Qnce_(Qun�iy� ge.Residence(Zip Code) �No,deceden[Iivetl wiihin Ilmiis of ciiy/boro.
b PJLCli. �A
9.E��er in US Armetl Force57 10.R�arita!Status af Time of Oea�h �Married � N/idowed 11.Surviving Spouse's Name(If v�ife,8�`-'e name prior to firsT marriage)
�Yes O N`a �llnknnwn � Divorced � Never Marrled �Unknow
12.iather's Name(Fir i,MidS11e Lasi,Suffix) 13.Mother's Name Prior to Firsf Marriage(Firsi,Middle,Last)
�nanlz C. �ccv,cd6on G.ea.dye R,Lbe.
14a.Infor� ni's Name � 146.Relationship to Decedeni 14c.Infarmant's Mailing Address(Streec and Number,�ity,Staxe,Zlp Code)
� ��cank Wccyne Da.v.i daan Son 362 ALeaea.n� V,i.ew Rd.,New Cumbeh.ea.nd,PA 1707
C, � i a.P are o oeac c ec on Yone
If Death Occurred in a HospiYal: e} Inpatlent �If Death Occurretl Somewhere OYherThan a Hospital ❑Hospice Facility . �Oecedent's Home
� Emergency Roam(OUtpatienY O Oead on Arrival � Nursing Hom¢/Long-Term Care Facllity �Other(Specify)
a i5b.Fecility Name(If not ins[ituiion give stree[antl�umbe�) 115c.City "lown,Siate, �id ZI Gotle 15tl.C u ty of Death
� 7477 Long{�Q.Caw C;auh� New Cumbeh,Q.anc� PA 17070 umbe�and
�� m� S6a.M¢ihotl of Di�sposl<lon � Burial � C�emation 16b.DaTe of Disposition I6c.Place of Disposition(Nama of cefnetery,crematory,or other place)
o ee..,o„a�.�o,.,s�a�e o oo„a��o„ 1 1_7_2013 OZte�cbe�n C e�eh.
- o Other(Specify)_ , eT y
� .� 16tl.L«ation of Oisposition(t_ity o�'Town,:itate,antl 2i{�) .7a.Signa e of fu eral e Lic or P r�n In Char�e of Incerment 17b.license Number
� Newbwcg, PA 17240 FD074351-L
Nam tl Complete Addrv�ss f Fune� Fac{liiy
s �oge.�-eange�e-8�ce�ze�c �une�ca,C. I-lome 112 Ule-ex K.Ln S�. Sh.i. en.abwc PA 17257
�' 18.Decedeni's Etlucation-Check ihe box thaf best tlescribes ihe 19.Oecedenf of Hispanic Origin-Check the 20.Decetlent's Race-Check ONE OR MOftE�aces to indicate what
�- highest tlegree or level of school comple[etl a[the time of death. box that best tlescribes whefher the tlecetlent xhe tlecedent consitleretl himself o�herself fo be.
� 8[ti grade or less s Spanlsh/Hispanic/Latino. Check the"NO" �Whiie � Ko�ean
� No tliploma,9[h-12th grade box if tlecetlent Is not Spanish/Nispanic/Lafino. O 61ack or African American � Vietnamese
O High school graduate or GED completed �J No,not Spanish/Hlspanlc/Latino �Ame�ican Intlian or Alaska Native � Other Asian
� Some college credit,but no tlegree O Yes,Mexican,Mexican American,Chicano Q Asian Intlian O Native Hawalian
O %ssnciate d¢gree(e.g.AA,AS) O Ves,Puerto Rican O Chinese O Guamanlan or Chamorro
0 Bachelor's tlegree(e.g.BA,AB,BS) � Yes,Cuban O Fllipino O Samaan
� Master's degree(e.g.MA,M5,MEng,MEtl,MSW,MBA) 0 Ves,oiher Spanish/Hispanic/Latino �lapanese � OCher Pacific Islande�
� Doctorate(e.g.PhD,Ed�)or Professional degree (Specify) Q Other(Speci
fY)
.MD DOS DVM,LLB JD
21.Decetlent'S Single Race Self-Designation-Check ONLV ONE to Intlicate what the decedent consitleretl himself or herself to be. 22a.Oecedent's Usual Occupation-Indicaie type of work
�Wh{ie �Japanese � Samoan tlone during most of working life. DO NOT USE RETIRED.
O B�ack or African AmeNCan � Korean 0 Other Paciflc Islantler g,�o.eog y }�1L�S Q.a.d 01L
�American Indian or Alaska Naiive O Vietnamese O Don't Know/NOt Su�e
� �Asian Indian �Other Asian O Refused 22b.Kind of Business/Industry
..� � Chinese� � Native Hawallan � Other(Specify)
� �O Filipino o �..ama��a.,o��na.,,o��o • Sh.f.ppev�ebwcg Ur�,i_ve�c.e,ixy
ITEMS 23a-23d MUST BE COMPLETED 23a.Date Pronounced Dead(MO Oay/Y�) 23b.5 nature of Pers cing Death Only when applicable) 23c.License Number
BV PERSON WHO PRONOUNCES OR Novembe�c Z� ZO�'�
CERTIFIES DEATH `
23d.Date Sign.ed(MO/Day/Vr) � 24.Time of Deaih /�f�Q
APPRX. S:OOa.m. is. s nn -�ai o�caro�e�co�ce�ceaz � ves 8.1 no
CAUS�/ DEA "H T1ner qpproximate
26.Part 1. En[e [he 4hain of events--diseases,injuries,or complicaxions--that tlir¢Ctl usetl the deatF�. DO NOT enfer ierminal events such as cardiac arrest, Interval:
r<Spirdtory drre5i,Or ventricular fibrillafion withou[showing the e[iology. Oy N A6BREVIATt. cnter only one cause on a Ilne. Add additional Iines If necessary. Onset fo Deafh
/� / / � �/ 1
IMMEDIATECAUSE ---------------> a. L�/�G(._�(R+'H-r��`�//�l. �/-�g/_'_ ./''�. � (_��T��'/�t�'-A ,
(Flnal disease o ondition � Due to�or as a copsequence of): �
resulting in'aeatM1)
b. �
Sequeniially Iist contlitlons, Dua to(or as a consequence of): �
1f any,1eatling co the cause �
Ilstetl on Ilne a. Enter the
UNOERLYtNG CAUSE Due[o(or as a consequence of): �
(disease or injury that
_ 'niti�aied the evencs resulting d.
,? In tleatM1)LAST. Due to(o�as a consequence of):
a
s�- 26.Pari 11. Enter other anf conCiiio ri but n0<resulting In the untlerlying tause giv¢n in Part 1. 27.Waa a opsy pertormed?
Yes O No
� � � 2B..WCre autopsy fintlings avallable
�''1 � � [a mplefe fhe cauye of death7
. mY�' � - coO Ves No
29.If Female: 30.Did Tobacco Use Contribute io Death? 31.Manner of Death
E Q Not pregnani wifhin past year O �'es O P�obably �Natural O Homlcide
� � Pregnant at time of death �No � Unknown � Accitleni � Pending Investlgailon
$ � Not pregnant,but pregnant wlthin 42 days of deaih 0 Sulcltle � Coultl not be Aetermined
� [] Not pregnant,buT pregnant 43 tlays to 1 year before tleath 32.Date of Injury(MO/Day/V�)(Spell Month)
� Unknown if pregnant wfGhin the past yea� 33.Time of Injury
34_Plaa:e of Injury(e.g.home;consiructfon site;farm;school) 35.Loca[ion of Injury(Street and Number,City,County,Sxate,Zip Code)
�
� 36.Injury ai Work 3].If Transportatlon Injury,Speclfy: 3B.Describe How tn�ury Occurred:
� Yes � D�iver/Operaior � Pedesiriain
� � No n Passenger � Other�5pecify)
39a.Certifier-physiclan,certifietl nurse practitioner,medical examiner/coroner(Check only one):
�`Certifying only-To the besi of my knowletlge,tleath occurred tlue to the cause(s)and mann r siafetl.
. � Pronouncing 8.Certlrying-To the besi of my knowletlge,tleath occurred at the time,tlate,antl place,and due to the cause(s)antl manner statetl.
[] Medical Examine -On ihe basis of ez �irtation and/or investigation,In my opinion,death occurretl ai the time,date,and place,and due fo[he cause(s)and manner stated.
� Signe<ure of certifier. Title of certiFler: License Numb¢r:�����.S��o�
�/ 39b.Name,Adtlress and n Completing Cause of�eatp(Item 26) d�eG� OM�SON 39c.Date SiQn (MO/Day/Yr)
� b C S e Nl ' A OSS // a�l o�
40.Ragist�e�3 DIStY cT mber 41.Re 5 Signa[u�e 42. glsi�3� Ile Da�p( iY
� 02/- o� � c� �.� �
43.AmPntlments
O
� " /� (/^_�� P1 /" v-L I /V'V Y�` „ V�i y�'+�/
� Disposition Permif No. O 9 7 O$9 4 H305-343
REV 07/2012
�ti
��
c `"' rn rn
�
� °� � �? c�
�:�
rn � c-� c � �
� z,. r rv ��, r�y
r ,� rn � � �s
DU? � o �-a
LAST WILL AND TESTAMENT �'
n p � �1 -�j
� c3 -r � •,r- ..._
�- 3 "�� �.:�
UF . � N C'_ �'ri
'L7 �� C!'" "T,�
JAY FRANK DAVIDSON - a
I, JAY FRANK DAVIDSON,now domiciled in Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may
have previously made.
ARTICLE I
The expenses of my last illness,burial, and administration of my estate may be paid by
my Personal Representative from the principal of my residuary estate as soon as practicable after
my death. If I do not own a burial plot at the time of my death, I direct that my Personal
Representative purchase one,together with a suitable headstone, and a contract for the perpetual
care of both the plot and headstone, using funds from my estate.
ARTICLE II
All inheritance, estate, and succession taxes (including interest and penalties thereon,but
not including any generation skipping tax)payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person.
ARTICLE III
I give, devise, and bequeath all the rest and residue of my property, real,personal, and
mixed in equal shares to my children, FRANK W. DAVIDSON,DEBORAH J. ROTZ,
JEFFREY C. DAVIDSON,AND JENNIFER E. YOUNG(hereinafter referred to as the
1
t
"Primary Beneficiaries") in accordance with the instructions set forth herein. If any Primary
Beneficiary should predecease me or fail to survive me by 30 days, then each such predeceasing
Primary Beneficiary's share of my estate, including any specific bequests made herein, shall pass
to such deceased Primary Beneficiary's surviving issue,per stirpes. If any Primary Beneficiary
predeceases me leaving no surviving issue, then I give, devise, and bequeath such predeceasing
Primary Beneficiary's share of my estate to the other Primary Beneficiaries in accordance with
� the instructions set forth herein.
ARTICLE IV
If any person,who, as the issue of any deceased Primary Beneficiary, is entitled to take a
share of my estate, then I direct that each such person's share of my estate be held in trust until
that individual has reached the age of TWENTY-FNE (25) years of age, at which point the
entire share of such person shall be distributed to them. If any such individuals have reached the
age of 25 yeazs at the time of my death, then I direct my Personal Representative to distribute to
such individual his or her share of my estate at the time of my death. Any share of my estate
placed into trust under this Article IV shall be held in trust for that individual's health,
maintenance, education, and welfare, and shall be administered by that individual's parent or
legal guardian and distributed completely to that individual on his or her TWENTY-FIFTH (25`n)
birthday.
ARTICLE V
In addition to the powers conferred by law, I authorize my Personal Representative in his
or her absolute discretion:
2
1. To retain in the form received and to sell either in public or private sale, any real
estate or personal property except that which I specifically bequeath herein and
pursuant to my directions set forth in this Will.
2. To manage real estate;
3. To invest and reinvest in all forms of property without being confined to legal
investments and without regard to principal of diversification;
4. To exercise any option or right arising from the ownership of investments;
5. To compromise claims without court approval and without the consent of any
beneficiary;
6. To file any federal income tax return for any year for which I have not filed such
return prior to my death;
7. To make distributions in cash or in kind, or in both, and to determine the value of any
such property;
8. To employ any attorney, accountant, investment advisor, or other agent deemed
necessary by my Personal Representative and to pay from my estate reasonable
compensation for all of their services; and
9. To conduct, along with or without others, any business in which I am engaged in or
have an interest in at the time of my death.
ARTICLE VI
I nominate, constitute, and appoint FRANK W. DAVIDSON to act as the Personal
Representative of my Last Will. In the event of his renunciation, death, resignation, or inability
to act for any reason whatsoever as my Personal Representative, I nominate, constitute and
3
appoint DEBORAH J. ROTZ to act as the Personal Representative of my Last Will. I hereby
relieve my Personal Representative,whether original, substitute, or successor, from the necessity
of posting security in connection with those duties as such in any jurisdiction in which my
Personal Representative may be called upon to act, so far as I am able by law to do so. My
Personal Representative shall receive reasonable compensation for services rendered to my
estate.
IN WITNESS WHEREOF, I, JAY FRANK DAVIDSON,hereby set my hand to this
( /
my Last Will, on this ��� day of January, 2011, at �.G i.i���( ��� I� � �G V�`+�I����i� ,
�(,t��_������Y�� County, Pennsylvania.
� � ,
JA DAVIDSON
In our presence, the above-named Testator signed this and declared this to be his Last
Will and now at his request, in his presence, and in the presence of each other we sign as
witnesses.
Name Address
� ' t� ��- � �?� � ��, ��.
� � �
,� � ' � �o s �'�..�v -���
� �
I, JAY FRANK DAVIDSON,Testator, who signed the foregoing instrument,having
been duly qualified according to law, acknowledge that I signed and executed this instrument as
my Last Will, and that I signed it willingly as my free and voluntary act for the purposes herein
expressed.
. , ,
�--
V^
J F DAVIDSON
4 �
COMMONWEALTH OF PENNSYLVANIA )
' ) ss:
COUNTY OF �� (,��-���� ��� )
On this,the�day of January, 2011,before me, a Notary Public, the undersigned
officer,personally appeared JAY FRANK DAVIDSON, known to me(or satisfactorily proven)
to be the person whose name is subscribed to the within instrument and acknowledged that he
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
COMMONW�L7H OF PENNSYLVANIA , � �, �j , , ^��
Notarial Seal �, �yr�
Staci Lynne Morgan,Notary Public
Lower Allen Twp.,Cumberland County OTARY PUB IC
My Commission Expires Oct.24,2012
Member Pennsylvania Association of Notaries
We, the undersigned witnesses who signed the foregoing instrument,being duly qualified
according to law, depose and say that the Testator executed this instrument as his Last Will; that
he signed and executed it willingly as his free and voluntary act for the purposes herein
expressed; that each of us in his sight and hearing signed the Last Will as witnesses; and that to
the best of our knowledge,he was at the time eighteen(18) years or more of age, of sound mind,
and under no constraint or undue influence.
� � �
�
COMMONWEALTH OF PENNSYLVANIA )
�� ) ss:
COUNTY OF l.���������'I l��G� �
On this, the �,�� day of Janupry, 2011,before me, , otary,P lic,the undersigned
officer,personally appeared ��I i�- ��til,-��l , and i l��t�.�D� I U vYl i��✓� known
to me(or satisfactorily proven)to be the persons whose names are subscrib to the within
instrument and acknowledged that this document was executed for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal. �
,, ,
COMMONWEALTH OF PENNSYLVANIA � �') `1 ` ', ��'�/(�C� '�
Notarial Seal �y�
Staci Lynne Morgan,Notary Public NO �y pjJg IC
Lower Allen Twp.,Cumberland County
My Commission Expires Oct.24,2012
Member Pennsylvania Association of Notaries