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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 Lettcrs 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
Name: Henry L. Albert File No: ���—/� ���
a/k/a: tienrv L.Albert,lr. (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: September 25,2014 Age at death: 97
Decedent was domiciled at death in Cumberland County, pennsylvania (srare) with his/her last
principal residence at 4905 East Trindle Road Mechanicsbure Hampden Townshin Cumberland Countv Pennsvlvania
Street address,Post Oftice and Zip Code City,Township or Borough County
Decedent died at Holv Spirit F-Iospital,Camn��ill Cumberland Countv Pennsvlvania 17011
Street address,Post Otfice and Zip Code City,Tawnship or Borough County State
Estimate of value of decedent's property at death:
Ifdomiciled in Pennsylvania.. .... .... ...... .......... .. All personal property $ 1,000,000.00
/f not domiciled in Pennsy[vania. . ... ..... ....... ..... .. Personal property in Pennsylvania $ ���
If not domiciled in Pennsylvania. . ..... ..... ..... ... .... Personal property in County $ �p�
Value of real estate in Pennsylvania... .. ..... .... .......... ...... .... ....... .. ........ ..... . $ ���
TOTAL ESTIMATED VALUE. ... $ 1.000.000 00
Real estate in Pennsylvania situated at: 4905 East Trindle Road,Mechanicsburg Cumberland County Pennsvlvania
(Attach udditianal sheeis,if necessary.) Street address,Post Otfice and Zip Code City,Township or Borough Caunty
� A. 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 the Decedent,dated November 16,2010 and Codicil(s)
thereto dated N/A
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 bom or
adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
�NO EXCEPTIONS �EXCEPTIONS
0 B. Petition for Grant of Letters of Administration (Ifapplicable)
c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,durante minoritate
If Administration,c.t.a. or d.b.n.c.t.a., enter date of Will in Secfion A above and complete list of heirs.
Except as follows: Decedent 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 was neither the victim of a killing nor ever adjudicated an incapacitated person.
o NO EXCEPTIONS Q EXCEPTIONS
Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse(if any)and heirs(attach
udditional sheets, if necessary): Spouse deceased July 12,2002
Name Relatiooshi Address c—>
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Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF CUMBERLAND }
Petitioner(s)Printed Name Petitioner(s)Printed Address
Helen A. Bickett 909 Ba be Court Williamstown NJ 08094
The Petitioner(s)above-named swear(s)or aftirm(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.
Sworn to or affirmed and subscribed before �o� ��.�./� Date �U�/'�
iTte t � ��' da of Octob r _ , 2Q 14 Helen A.Bickett Date
By Date
or the egisier
Date
BOND Required: Q YES Q NO To the Register of Wills:
FEES: Please enter my appearance by my signature below;
Letters . . . . . . . . . . . . . . . . . . . . . . $ 660.00 Attorney Signature:
( ]2 ) Short Certificate(s). . . . . . 60.00 ^ f
( )Renunciation(s).. . . . . . . . �� / ,�,,
/�( )Codicil(s). . . . . . . . . . . . . ��
( )Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Robert R Church,Esq.
Commission. . . . . . . . . . . . . . . . . . Supreme Court
Other . . . . . . . ID Number: 40z85
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• • • • • � Firm Name: Keefer Wood Allen&Rahal,LLP
V • • • • • • � • •�(3 Address: 417 Walnnt S r t 4th Floor P n Box 1 1963
. . . . . . . . Ha_ rri_sb�g PA 1710R-196
• • - • • • • • Phone: (717)255-8059
Automation Fee. . . . . . . . . . . . . . . 5.00 Fax: (7171255-8050
JCS Fee. . . . . . . . . . . . . . . . . . . . . 35.50 Email: �hurch(u�keeferwn�d rrnn
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Oath of Personal Representative Official Usc Only
COMM WEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF }
Petitioner(s rinted Name Petitiouer(s)Printed Address
The Petitioner(s)above-named swear(s)or affirm(s)the tements in the foregoing Petition are true and correct to the best of the knowiedge and belief
of Petitioner(s)and diat,as Personal Representative(s)of t Decedent,the Petitiouer(s)will well and tnily administer the estate according to law.
Sworn to or affirmed and subscribed before Date
me this day of , Date
By' Date
For the Re�ister D1te
BOND Required:Q YES �NO To tke Registe of Wi/ls:
FEES: Please enter my pearance by my signature below:
Letters . . . . . . . . . . . . . . . . . . . . . . $ Attorney Signature:
( )Short Certificate(s). . . . . .
( ) Renunciation(s).. . . . . . . .
( )Codicil(s). . . . . . . . . . . . .
( )Affidavit(s).. . . . . . . . . . .
Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name:
Commission. . . . . . . . . . . . . . . . . . Supreme Court
Other . . . . . . . . ID Number:
• � • • • • • • FirmName:
• • • • • • • • Address:
• • � • • • • • Phove:
Automation Fee. . . . . . . . . . . . . . . Fax:
JCS Fee. . . . . . . . . . . . . . . . . . . . Etnail:
TOTAL. . . . . . . . . . . . . . . . . . . . . $
DECREE OF THE REGISTER �=;
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Estate of e e/- File No: ��`;�'���D�:a � c-��
a/k/a: L- r �;� -� ,� .—{ ,-,
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AND NOW, , , in consideration'bf t�ie forego ng Petit}�rn,
satisfactory proof having been presented before me,IT IS ECREED t Letters �T��}-Q�'j���',�/�/ a -��
are hereby granted to ��e/7 � �I C�C.0 f" " �
in the above estatie and(if ap�cab��j ttt�t
the instrument(s)dated � � p
described in the Petition be admitted to probate and filed of cord as the last Will Zd Codicil�s)) of Deced�t.
�
ister of Wills
Form RG�-0_7 rev. 10/11/2011 ���a� �
Page 2 of 2
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA ' '
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� ('��� e�� No. 2014- 00986 PA No. 21- 14- 0986
�1� 9 Es ta te Of: HENRY L ALBERT
f, D v lFirst,Middle,LasU
v a/k/a: HENRY L ALBERT JR
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La te Of: HAMPDEN TOWNSHIP
" " „ CUMBERLAND COUNTY
Deceased
1750 Soci al Securi ty No:
WHEREAS, on the 17th day of October 2014 an instrument dated
November 16th 2010 was admitted to probate as the last will of
HENRY L ALBERT
lFi�s�,Middle,LasU
a/k/a HENRY L ALBERT JR
late of HAMPDEN TOWNSH/P, CUMBERLAND County,
who died on the 25th day of September 2014 an
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, L/SA M. GRAYSON, ESQ. , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certi fy tha t I have thi s day gran ted Le t ters TESTAMENTARY to:
, HELEN A BICKETT
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, all of which
ful l y appears of record in my offi ce a t CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 17th day of October 2014.
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HENRY L. ALBERT � � '�
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I, HENR`I L. ALBERT, of Hampden Township, Cumberland County, Pennsylvania, do
make,publish and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils by me heretofore made.
ITEM L• Family Information. I am married to Josephine D. Albert, and all
references to my wife in this Will are to her. I have one child: Helen A. Bickett. Any person
born to or adopted by my daughter, Helen A. Bickett, shall be included in this Will as my issue.
Provided, however, no adopted person shall benefit under this Will unless the order or decree of
adoption is entered before the adopted person attains the age of twenty-one (21)years.
ITEM IL Death Taxes. I direct that all inheritance and estate taxes becoming due by
reason of my death, whether payable by my estate or by any recipient of any property, shall be
paid by the Executor out of the residue of m�y estate, as an expense and cost of administration of
my estate, except that no taxes shall be charged against any gift qualifying for the marital or
charitable deduction in my estate. The Executor shall have no duty ar obligation to obtain
reimbursement for any such tax so paid, even though on proceeds of insurance or other property
not passing under this Will.
ITEM III: Debts and Final Expenses. I direct the Executor to pay the expenses of my
last illness, my legally enforceable debts, and my funeral expenses from the residue of my estate
as an expense and cost of administration of my estate.
Page 1 �
ITEM IV: Tangible Personal Pro,�erty. I give my tangible personal property and all
casualty insurance that I am carrying on said tangible personal property to my wife, Josephine D.
Albert, or, if she does not survive me, I give said property to my daughter, Helen A. Bickett, or if
she does not survive me, then to her then-surviving issue, per stirpes. I have complete
confidence that my wife, my daughter or the Executor will honor any written instructions that I
may leave with regard to said tangible personal property. Any such property not so distributed
shall be sold, and the proceeds added to my residuary estate to pass as hereafter described.
ITEM V: Residue. I give the residue of my estate, not disposed of in the preceding
portions of this Will, to my wife, Josephine D. Albert, if she survives me. If my wife or her
authorized agent disclaims any property or interest in property to which she would be entitled
under the provisions of this Item, the disclaimed property shall be held by the Trustee, IN
TRUST, and shall be administered and distributed as provided in ITEM VI. If my wife does not
survive me, the residue shall be distributed as provided in ITEM VI, paragraph (c) et se�c.
ITEM VI: Disclaimer Trust. The following provisions shall apply to any property
payable to the Trustee described in ITEM V as a result of the disclaimer of any such property by
my wife:
(a) Income to Spouse. The Trustee shall pay to or for the benefit of my wife,
Josephine D. Albert, all of the net income of this Trust in convenient installments, but not less
frequently than annually.
(b) Principal to Spouse. The Trustee shall pay to my wife so much of the
principal of this Trust as may be necessary in the discretion of the Trustee for the reasonable
support, mainter�ance and health care of my wife. I direct the Trustee to be generous in
exercising the discretion granted by this paragraph, considering that my wife is the primary
object of my bounty.
Page 2
(c) Upon Death of Spouse. Upon the death of my wife, the Trustee shall
distribute the then-remaining income and principal of this Trust to my daughter, Helen A.
Bickett, outright and free of trust, if she is then living. If for any reason my daughter does not
survive to such distribution date, the principal and undistributed income of the Trust shall be
divided and distributed in equal shares, per stirpes, to her then-surviving issue, subject, however,
to the custodial protections set forth in Item X(c) below for underage beneficiaries.
(d) Trust Without Beneficiaries. If before final distribution of the assets of
any Trust established herein, there is no living beneficiary of that Trust, it shall terminate. The
assets of such Trust shall be paid to the then living issue, on a per stirpital basis, of the nearest
deceased ancestor(with issue living at the time of distribution) of the beneficiary who is me or
my issue. However, if there is then in existence any Trust ar custodial account created under this
Will for the benefit of that issue, the share which would have been distributed to that issue shall
be added to the principal of his or her Trust or custodial account, to be administered and
distributed as prcvided in this Will.
(e) Failure of Issue. In the event I am not survived by my wife nor by any
issue, or if there are no issue of mine surviving upon the termination of any Trust, the remaining
residue (or principal) thereof shall be divided and distributed one-half('/2) to my intestate heirs,
under the laws of the Commonwealth of Pennsylvania, and one-half('/2) to the intestate heirs of
my wife, under the laws of the Commonwealth of Pennsylvania, as if we had each died intestate
on the date of such distribution.
ITEM VI�: S,pendthrift Clause. No part of the income or principal of any Trust
created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse,
assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt of
income or principal distributed. The Trustee shall pay the net income and the principal to the
beneficiaries specified by me, as their interests may appear, without regard to any attempted,
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Page 3 1
anticipation, pledging or assignment, and without regard to any claim or attempted levy,
attachment, seizure or other process against the beneficiary.
ITEM VItI: Administrative Powers. In addition to the powers granted at law, the
Executor and the Trustee shall each possess the following powers, each of which shall be
construed broadly and may be exercised without court approval, but in a fiduciary capacity only:
(a) To retain any investments I have at my death, including specifically those
consisting of stock of any bank even if I have named that bank as the Executor or Trustee.
(b) To vary investments, to make loans, and to invest in bonds, stocks, notes,
real estate mortgages or other securities or in other property, real or personal, without being
restricted to so-called "legal investments", and without being limited by any statute or rule of law
regarding investments by fiduciaries.
(c j In order to divide the principal of a Trust or for any other purpose,
including final distributions, the Executor and Trustee are authorized to divide and distribute
personal property and real property, partly or wholly in kind, and to allocate specific assets
among beneficiaries and Trusts so long as the total market value of each share is not affected by
the division, distribution or allocation in kind. The Executor and Trustee are each authorized to
make,join in and consummate partitions of lands, voluntarily or involuntarily, including giving
of mutual deeds, or other obligations, with as wide powers as an individual owner in fee simple.
(d) To sell either at public or private sale real and personal property severally
or in conjunction with other persons, and to consummate sale(s) by deed(s) ar other instrument(s)
to the purchaser(s), conveying a fee simple title. No purchaser shall be obligated to see to the
application of the purchase money or to make inquiry into the validity of any sale(s). The
Executor and Trustee are authorized to execute, acknowledge and deliver deeds, assignme ts, _
�1
Page 4
options or other writings as necessary or convenient to any of the power conferred upon the
Executor and Trustee.
(e) To mortgage real estate, and to make leases of real estate.
(fl To borrow money from any person, including the Executor or Trustee, to
pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy,
estate and other t�xes, and to assign and pledge assets of my estate or any Trust established by
this Will.
(g) To pay all costs, taxes, expenses and charges in connection with the
administration of my estate or any Trust established under this Will.
(h) To make distributions of income and of principal to the proper
beneficiaries, during the administration of my estate, with or without court order, in such manner
and in such amounts as the Executor deems prudent and appropriate.
(i) To vote shares of stock or other business interests which form a part of my
estate or any Trust established under this Will, and to exercise all the powers incident to the
ownership of the same.
(j) To unite with other owners of property similar to property in my estate to
carry out plans for the reorganization of any company or entity whose securities form a part of
my estate.
(k) To disclaim any interest in property which would devolve to me, to my
estate, or to any Trust created hereunder, with such disclaimer to be made by whatever means,
including but not limited to the following: as beneficiary under a will, as an appointee under the
Page 5 �"
exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an
inter vivos transfer, and as a donee under a third-party beneficiary contract.
(1) To prepare, execute and file tax returns of any type required by applicable
law, including but not limited to filing a joint tax return with my surviving spouse, and to make
all tax elections authorized by law.
(m) To employ custodians of property, investment or business advisors,
accountants and attorneys as the Executor or Trustee deems appropriate, and to compensate these
persons from assets of my estate or trust, without affecting the compensation to which the
Executor and Trustee are entitled.
(n) To divide any Trust created in this Will into two or more separate Trusts
so that inclusion ratio for purposes of the generation-skipping transfer tax shall be either zero or
one, in order that an election under Section 2652(a)(3) of the Internal Revenue Code of 1986, as
amended, may be made with respect to one of the separate Trusts, or for any other reason.
(o) To allocate administrative expenses to income or to principal, as the
Executor or Trustee deems appropriate. However, no allocation to income shall be made if the
effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or
estate tax charitable deduction.
(p) To make any adjustment to basis authorized by law, including, but not
limited to increasing the basis of any property included in my estate, whether or not passing
under this Will, by allocating any amount by which the bases of assets may be increased. The
Executor shall be under no duty and shall not be required to allocate basis increase exclusively,
primarily, or at all to assets which pass as part of my probate estate as opposed to other property
for which a basis adjustment is allowable. The Executor shall allocate basis increase equitab y
Pa e 6 � �'��'.
g
among those beneficiaries receiving property as a result of my death, but shall not be liable to any
person, nor subject to removal or surcharge, for any reasonable allocation of basis increase.
(q) To compromise claims.
(r) To terminate any Trust, if in the opinion of the Trustee, the expense of
administration of the Trust is not justified. Upon termination, the Trustee shall distribute the
trust property to the person(s) then entitled to receive or have the benefit of the income
therefrom. If there is more than one current income beneficiary, the Trustee shall distribute trust
assets to the income beneficiaries in the proportion in which they receive income, or if no
proportion is desi.gnated, in equal shares to the income beneficiaries. This power may only be
exercised by a Trustee who is an independent Trustee, and this power shall be ineffective to the
extent that the effect of the power is to vest in any Trustee or beneficiary a general power of
appointment.
(s) To do all other acts in his or her judgment necessary or desirable for the
proper and advantageous management, investment and distribution of the estate and Trusts
established under this Will.
ITEM IX: Accountin�. The Trustee, on an annual basis, shall provide each income
beneficiary who has attained the age of eighteen (18) years, and the Guardian of the person of any
income beneficiary who has not attained the age of eighteen(18) years, statements showing
transactions of each Trust established for the benefit of that beneficiary. The beneficiary, or the
Guardian of the person of such beneficiary, may waive this right to receive an annual accounting.
The Trustee may. at any time, settle any account, or questions concerning the administration of
any Trust established under this Will, by agreement with the then current income beneficiaries of
the Trust, if legally competent, or if not legally competent, with the Guardian of the person of the - r
beneficiary, the legally competent spouse of the beneficiary, or the oldest legally competent
Page 7
relative of the beneficiary who would take a portion of the estate of the beneficiary were the
beneficiary to die at that time intestate under the laws of the Commonwealth of Pennsylvania.
Any settlement rriade in accordance with this Item shall bind all persons who have an interest in
the Trust, and sh�ll constitute a release and discharge of the Trustee with respect to transactions
specified in the settlement.
ITEM X: Distributions to or for Beneficiaries. The Trustee is authorized to
distribute principal and/or income in any one or more of the following ways if the Trustee, in the
discretion of the Trustee, considers the beneficiary unable to apply distributions to the
beneficiary's own best interests, or if the beneficiary is under a legal disability:
(a) Directly to the beneficiary;
(b) To the authorized agent(under a Power of Attorney), legal guardian or
conservator of such beneficiary;
(c) To the Trustee, or to another person selected by the Trustee, as custodian
under the Pennsylvania Uniform Transfers to Minors Act as to a beneficiary under the age of
twenty-five (25)years;
(d.) To a relative of the beneficiary, to be expended by that relative for the
benefit of the beneficiary; or
(e) By directly applying distributions for the benefit of the beneficiary.
ITEM XI: Survival. Any person (other than my wife) who has died within thirty(30)
days of my death, or under such circumstances that the order of our deaths cannot be established
by proof, shall be deemed to have predeceased me. Any person (other than my wife) who has _
____�
Pa e 8 /�-"
g
died at the same time as any beneficiary under this Will, or in a common disaster with that
beneficiary, or under such circumstances that the order of deaths cannot be established by proof,
shall be deemed to have predeceased that beneficiary. My wife shall be presumed to have
survived me if we should die simultaneously or if the order of our deaths cannot be established
by proof.
ITEM XII: Merger of Trusts. Should my wife, by Will or Agreement of Trust,
establish Trusts similar to the Trusts I have established for the benefit of my issue, the Trustee of
each Trust created in this Will shall have the right to merge it with the similar Trust created by
my wife for the same beneficiaries. If inerged, the Trustee shall operate the merged Trusts as a
single Trust.
ITEM XIYI: Trust Situs. The initial situs of each Trust created under this Will shall be
the county of my domicile at my death. The Trustee may determine, from time to time, to change
the situs of any Trust established under this Will. However, no change in situs shall be effective
until written not:ce is provided to the living beneficiaries of the Trust.
ITEM XIV: Executors and Trustees.
(aj I appoint my daughter, Helen A. Bickett, to be the Executor and the
Trustee. If she is unable or unwilling to serve, for any reason, then her son, Thomas C. Bickett,
shall serve as the alternate Executor and as the alternate Trustee. All references herein to the
Executor and/or�he Trustee shall include their designated alternates, successors and substitutes.
('�) Any person(s) serving as the Trustee shall have the power to appoint
additional Co-Trustee(s) at any time.
Page 9
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(c) Any Co-Trustee appointed hereunder may be removed by the person who
appointed such Co-Trustee. Each appointment or removal of a Trustee shall be in writing and
shall be filed with the court in the jurisdiction which is the situs of the Trust. The written
instrument shall be signed by the person having the power to make the appointment or removal.
(d) The Trustee shall have the power to designate a temporary Trustee by an
instrument in writing delivered to such temporary Trustee. The temporary Trustee shall serve as
such only during the legal incapacity of the appointing Trustee, or, during such period of time as
the appointing Trustee in writing designates, and upon the expiration of that time, or at such time
as the legal incapacity of the appointing Trustee ceases, the appointing Trustee shall once again
become the Trustee.
(e) Any Co-Trustee may delegate investment and related management
functions to another Co-Trustee, provided the other Co-Trustee accepts the delegation in writing.
To the extent accepted, the delegating Co-Trustee shall be relieved of responsibility for the
investment decisions of the Co-Trustee to whom investment and related management functions
were delegated.
(f� No Co-Trustee shall be responsible for the acts or omissions of any other
Co-Trustee.
(g) In the absence of actual knowledge of a breach of trust, or information
concerning a possible breach of trust that would cause a reasonable person to inquire, a successor
Trustee is under no duty to examine the accounts and records of any predecessor Trustee, or to
inquire into the acts or omissions of such predecessor, is not liable for any failure to seek redress
for any act or omission of such predecessor, shall have responsibility only for property which is
actually delivered to the Trustee by such predecessor and shall have all of the powers conferred
upon a Trustee h�reunder.
Page 10
(h) The Executor and the Trustee shall have the right to receive reasonable
compensation for services rendered and reimbursement for reasonable expenses.
(i) No Executor or Trustee shall be liable or accountable for any loss that may
result from the good faith exercise of the authority granted in this Will.
(j) The Executor and Trustee are specifically relieved from the duty of filing
bond or entering security in any jurisdiction.
IN WITNESS WHEREOF, I have set my hand and seal on this my Last Will and
Testament this�day of � a- , 2010.
� ''� `-
'�-~" (SEAL)
HENR L. ALBERT
� � F�
SIGNED, SEALED, PUBLISHED, and l
DECLARED by HENRY L. ALBERT as and �' � �6
for his Last Will and Testament, on the day and
year last above written, in the presence of us,
who, at his request, in his presence, and in the
presence of each other, all being present at the
same time, have hereunto subscribed our
names as witnesses:
Page 11
SELF-PROVING AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
: SS.
COUNTY OF CUMBERLAND :
WE, HENRY L. ALBERT, and�p�p�� , C�}� , and
�����, ���Q�_, the Testator and the witnesses, respectively, whose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the instrument as his Last Will and
that he had signed willingly (willingly directed another to sign for him), and that he executed it as
his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testator, signed the Will as witness and to the best of his or her
knowledge the Testator was at that time eighteen(18)years of age or older, of sound mind, and
under no constraint or undue influence.
,� `� � � A�
�
;
�_��C.
HENRY L. ALBERT, Testator
�%�,�",�,�C<
Witnes
(
.
Witness
Subscribed, sworn to, and acknowledged before me by HENRY L. ALBERT, the Testator, and
subscribed and stivorn to before me by�j���- �, �l�,�C� , and
� �qm�� ���� , witnesses, this��� day of �OVe�'(��� , 2010.
Notary Public
C:C�I�►IO�LTM OF�NMl�.VANIA
.........
NOTARUI SFJII
KRISTI P.FOSTER,Not�ry P�I'ic
City o�HamsE�urg,Dat�phin CouMy
Commissan Expires 8,2012
Page 12