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Home My WebLink About01-08-15 Reset PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY,PENNSYb�'�'ANIA � � � -,� o M Petitioner(s) named below, who is/are 18 years of age or older, apply(ies) for Letters as � i��,d belo�and�n� support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropr�i�a�te�`�o�n3: � r`� '� ._..� �:� Decedent'sInformation `�. ' r`' oo B'' ``' , � -�, �� Name: Doris A.Rover File No• 2,�-J��C, ` � � _� � r� �a� . Assi ned b R es�e� � � `1 � � Y ��. . �r - � a/k/a: . . _ •� �.., � c'� �a� Social Security No: � f- r� Date of Death: October 23,2014 Age at death: 95 y' �� t--� `� Decedent was domiciled at death in Cumberland County,p�,�,lvania (seare)with his/her last principal residence at 100 Mount Allen Drive 17055 Upper Allen Township Cumberland Screat addreee,Past Ottice and Zip Coda City,Township or Borough County Decedent died at Mgssiah Lifewavs.100 Mount Allen Dr 17055 Upper Allen Township Cumberland PA Street addre�a,Poat Office and Zip Code C1ty,Townahip or Borough County State Esdmate of value of decedenPs property at death: Ifdonrklled!n Pennsylvanta............................ All personal property $ 250,000.00 If not doiniclled in Pe�nsylvania. ..................... .. Personal property in Pennsylvania $ n_nn If not domiciled in Pennsylvania. ... .................... Personal property in County $ n_nn Value of real estate in Pennsylvania.. ....................................................... S 0_00 TOTAL ESTIMATED VALUE. ... $ 250,000.00 Real estate ia Pennsylvanis aituated at;n/a (Attach addiNonal sheets,ff necessary.J Street address,Post Office and Zip Code Ctty,Township or Borough County �Petition for Probate and Grant of Letters Testamentary Petitioner(s)aver(s)helshe/they is/are the Executor(s)named in the iast Will of the Decedent,dated Septembeil6,1993 and Codicil(s) thereto dated n/a State relevant circumstances(eg.renuncla[ton,deaeh of eacecutor,eta) Except as follows:after the execution ofthe instrument(s)offered for probate Decedent did not macry,was not divorced,was not a party to apending divorce ptnceeding wherein the grounds for divorce had been established as defined in 23 Pa.C.S.§3323(g),ar.d did net have a child born or adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. Q NO EXCEPTIONS �EXCEPTIONS � B. Petition for Grant of Letters of Administration (Ifapplicable)C.t.a c.t.a.,d.b.n„d.b.n.c.ta.,pendentelite,duranteabsentia,duranteminoritate If Administration,c.�� or db.n.�La.,enter date of Will in Section A above and complete tist of heirs. Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce hed 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. Q NO ERCEPTIONS Q EXCEPTIONS Petirioner(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 additional sheets,ifnecessary): Name Relationshi Address Declazarion of Trust Trust Paul Hoffman,Trustee, 6349 Benniagton Road Mechanicsbur PA 17050 Paul R.Hoffinan Son 6349 Bennington Road D.Charles HofTman Son 5167 Elmwood Avenue Newar CA 94 60 Roger Hoffman Son 533 CR 2119 Rusk TX 75785 Fo�ewoi r�.roi�rno�t ' Page 1 of 2 Reset 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 request(s)the grant of Letters in the appropriate form: Ilecedent's Inforffiation Name: Dorls A.Rover F�le Na: ��"�.�ra �a: (Assigned by Register) a/k/a: ��a: Social Securtty No: Date of Death: October 23.2014 Age at death: 95 Decedent was domiciled at death in Cumberland County, penn.�ylvania (Srate)with his/her last principal residence at 100 Mount Allen Drive 17055 Unuer Allen Township Cumberland Street addreas,Poat Oftice and Zip Code City,Township or Borough County Decedent died at Messiah Lifeways.100 Mount Allen Dr. 17055 Upper Allen Township Cumberland PA Street address,Poet Ofliee and Zip Code City,Townshlp or Borough County State Estimate of value of decedent's property at death: If domiciled in Pennsylvanla............................ All personal property $ 250,000.00 If not domrciled in Pennsylvania. ..................... .. Personal property in Pennsylvania $ n.nn If nvt domiciled in Pennsylvan�a. ....................... Personal property in County $ n.on Value of rea!estate in Pennsylvani4......................................................... $ n_on TOTAL ESTIMATED VALUE.... $ 250,000.00 Real estate in Pennsylvania situated et: n/a (Attach addittonal sheets,iJ'necessary.) Stccet address,Post Ofl1ce and 7Jp Code City,Township or Borough County � A. Petition for Probate and Grant of Letters Testamentarv c-� � �' � Pedtioner(s)avcr(s)helshdd:ey is/are the Executor(s)named in the last Will of the Decedent,dated Septem�[l�1993 �d Co�il� thcrew dated da � ��+ G... « � 7�—,,.�—.�'—L� Stete relevant circumstances(a.g,nnr�nciatlnn,death of execuror,etc) >.� ,:y �"' � e�-� ,,.. r— � _ �� , �.� �..,r� Except as foUows:after the execution ofthe instrument(s)offered for probate Decedent did not marry,was not divar�`ed�,�ras t�ot a par�y to a}iei�d� divorce proceeding wherein the gnounds for divorce had been established as defined in 23 Pa.GS.§3323(g) ar;d did not hav��childs�mrttt>r adopted;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. c ' ^��J � "'`� � _,y Q NO EXCEPTIONS Q EXCEPTTONS ,-� �� ...y {..� . � B. Petition for Grant of Letters of Administration (If applicable) c.t.a t—+ cn �a c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,d rante minoriC e If Administration,c.t.a.or db.n.c.�a.,enter date of Will in Section A above and complete list of heirs. Except as follows: Dccedent 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. Q NO EXCEPTIONS Q EXCEPTIONS Petitioner(s),after a pmpa search has/have ascertaincd that Decedent left no Will andwas survived by the following spouse(if any)and heirs(attach additional sheeu,ifnecessary): Name Relationshi Address PART II Lanny Royer Stepson Lyle Royer Stepson 3435 Ocean Park Bivd.Ste 7 3anta Monica CA 0405 Fo�Rw oa rev.10�71/2011 Page 1 of 2 Oath of Personal Representative Official Use Only e COMMONWEALTH OF PENNSYLVANIA } J,,,�-�- } S S: ,,.�''�--��'� COUNTY OF BERLAND } �/, Petitioner(s)Printed Na ,.,, ,,./ Petitioner(s)Printed Address Paul R.Hoffman 49 Benni on Rd.,Mechanicsbur ,PA 17050 �..','T4.. �'� `�� "''��.... The Petitioner(s)abov -named swear(s)or affirm(s)the statements in e foregoing Petition are true and correct tdt�h@,best of the knowledge and belief of Petitioner(s)a that,as Personal Representative(s)of the Dec e t,the Pe itioner wil e nd truly administer tN'cestate according to law. Sworn to firmed ubscribed b for�_ � Da e�I�� aU�J� me th' � da o ,� Date By� Date �� or the egister Date BOND Required: Q YES Q NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters . . . . . . . . . . . . . . . . . . . . . . $ Attorney Signature: , 7 ( ) Short Certificate(s). . . . . . ,,_y� -�� °'�� ( )Renunciation(s).. . . . . . . . ( )Codicil(s). . . . . . . . . . . . . ' ( j Affidavit(s).. . . . . . . . . . . Bond.. . . . . . . . . . . . . . . . . . . . . . . Print d Name: Craig A.Hatch,Esq. Commission. . . . . . . . . . . . . . . . . . Su�'reme Court Other . . . . . . . . ID Number: 76361 • • � � � � • . Firm Name: Halbruner,Hatch&Guise,LLP • • • • • • • • Address: 2109 Market Street . . . . . . . . �amn Hill_PA 17�1 1 � � � • . . . . Phone: 717-731-9600 �utomation Fee. . . . . . . . . . . . . . . Fax: 717-731-9627 JCS Fee. . . . . . . . . . . . . . . . . . . . . Email: GHatchC�HHC'ri.i.P. .nm TOTAL. . . . . . . . . . . . . . . . . . . . . $ 0.00 ,--., � 'U DECREE OF THE REGISTER � �, � � � �=,� -'-�'� � .�� tate of Doris A.Rover File No: � ' �+;-= �' �� r' .��, i'�" .� rn aJk/a: � _ y. r.�.a oa ,, +�:� �-•.. '. , =w..� � _� ,'' -� AND NOW, �"_, , , in consideration of,tlftatifor.�"gbmgEet�ion, satisfactory proof having bee��resented before me, IT IS DECREED that Letters Testamentarv F=,,�., r-= r-�n a�re hereby granted to Paul R.Hoffman :,_a ~-� i , '� � in the above es�a�te and(if atp�licable)th the instrument(s) dated September 16, 1993 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Register of Wills Form RW-O2 rev. 10/11/2011 Page 2 of 2 Oath of Personal Representative Offic:al Use Only COMMONWEALTH OF PENNSYLVANIA } � � } SS: COUNTY OF CUMBERLAND } :� � � � � � r't c7 t�^� Petidoner(s)Printed Name PeHrioner(s)Printed Address `"<'" ='� ' � Paui R.Ho�'inan 6349 Bennln on Ad. Mechanicsbur PA 17050 y ``�' `� �� . > �;:'> "Ta ,.'� ^�-� �- � � ,� , � .: r� � a:� � ,� , ,. F--� cn The Pedtioner(s)above-named swear(s)or affirm(s)the statements in regoing PeNtion are true and correct to the best of:he knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of the Dec ,e Peti' ner(s 1 we trul dminister the estate according to law, Sworn to irmed su s ' ed bf re r . Date �� me this da Date � BY' '� Date the R�ter Date BOND Required: Q YES () NO To the Registtr of Wills: FEES: Please enter my appearence by my aignAture below: Letters.. .. .... ....... .. ... .. $� A.torney Signature: ( ,�" )Short Certificate(s)... .. . ( �j)Renunciation(s).. . . ... .. )•��' ` ( )Codicil(s). . . . . . . . . . .. . ( )Affidavit(s).. . .. . . ... . . Bond,,, , ,, ,, ,, ,,,, , ,,, ,,,, , , Printed ame: Craig A.Hatch,Esq. Commission. . .. .. . ... .. . . ... . Supr e Court Ot�er . ,.... ID umber: 76361 . .. ... � Firm Name: Halbruner,Hatch&Guise,i.LP 1�� V • •• ••• ��' Address: 2109 Market Streef . .• ••• Camn Hill Pa 17011 • •�• •• Phone: 717-731-9fi00 Autor.iation Fee. ..:.: : .: . .::: : • �'�' Fax: 717-731-9627 JCS Fee. . . .,.... . �i• � Email: C_HatchCa�HHGi.i.P_rnm TOTAL. .... .. .... .. . � , � . ... . . , . s 4� �-�3 O DECREE OF THE REGISTER Estate of_DorIs A.Rover File No: 2/"' ��'" �Q�� a/k/a: ��N��'� � ,U�� ,in consideration of the foregoing Petition, satisfactory proo ving been pres nte before me,IT IS DECREED that Letters Testamentarv are ereby granted to Paul R Hoffman in the above estate and(if applicable)that the instrument(s)dated Se tember 16 1993 described in the Petition be admitted to probate and filed of ec d as the last Will (and Codi ( )of Decedent, ister of Wills Form RW-01 rev.1 D/11/20I1 ge , , �-..� � � � � �, �o � �;� p � r'�� C7 � f7,1 � ""_f ',�... � `'� Cj "�--�'� il> :&7 � r... ._..� C", ... '- � ➢•� T'i—� . �?l (1p '7 C�7 RENUNCIATION � _.�. ...� � ..__ �, d,::, �T7 ,7 -,-s c-> __�{ —r 1 G,-. � REGISTER OF WILLS ' "; �`' �' �T CUMBERLAND COUNTY, PENNSYLVANIt�" t-�-► C" Q 2 f- /�� 6Z � Estate of_ Doris A. Royer , Deceased I, D. Charles Hoffman , in my capacity/relationship as (Print Name) Son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Paul R. Hoffman /�� (� � �� ,��_ (Date) � (Signature) S �f� �-7 ��1��=�✓ �j�� (Street Address) � � � � s�� (City,State,Zip) Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executing this renunciation and certified of , that he-e�-ske executed the renunciation for the purposes stated within on this��day of �P,(', � , Zu � � Deputy for Register of Wills otary ublic My Commission Expires: r�-`�Z��` (Signature and Seal ofNotary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) %--"�"�'�u�'�4 •:.�^___ .r<�''�n -._. � � � STEPHE�a PARFIhJ50(� � �� Com �:�s�ion �2048224 F> 7;��=a�< . Nctary Pui�iic-California ;� Form RW-06 rev. 10.13.06 Z 'r�"° Aiameda Counfy '-:� � My Comm. Ex�ires Dec 2 2017�`, f�.� �-m..��°��.-: � (15 unread)-jylyry42-Yahoo Mail Mtps://us-mg4.mail.yahoo.com/�o/launch?.rand=0jbqu59i2d85m am�ro.�m��,��o��_ �d, �-v C'7 � � c.n �7 � � Q P�"1 � � � � C7 1'�T J C� � fi'� �C7 :°7 r.,, ��. � t� a _.,, �,� �;-y r��7 RENUNCIATION ` "� - �° . �,; . , w<:� r:.;� . . , , wa r.� REGISTER OF WILLS ` � 7"i "fl ��ti� CUMBERLAND COUNTY,PENNSYLVANIA -r 7 � �� '�' i ___ � Zi-l� �OOZ� . , � �-- :� ��. m . , � � � . � -� Estate of Doii5 A.Royer ,Deceased I, L01111y ROyer ,in my capacityhelationship as (PnmY me) Step-Son of the above Decedent,hereby renounce the right to administer the Fstate of d�e Decedent and respectfully request that L.etters be issued to Paul R.Hoffman �/�� (I)atei I�gwwrel ya�1'��' ��r�a��?`" (Street Address) r'';n/ 4�""�_�'.��f7 Executed in Register's Off+ce Executed out of Register's Ofj"�ce Swom to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executi�g this renunciation and certified of , that hc or she executed thc�nunciation for the pu es stated within on this �{�h day of i , I�I _. Deputy for Reaster of Wills Notary Pu c «� My Commission Expires:�"�y J��tj� �� 7� l iSignan¢e and Seal of Notvy or othQ offi�ial quali5ed m admimneroatNs.Showdateofexpiration�Notazy'sCommission.) FormRW-GK ,�..,o.,�.� 04�NE s,,Tf Derik L Dalby = °��,�°�_ � Notary Public � y Wd �'� _} Maricopa County,Arizona , . � 'e`2 e My Comm.Expires 05-31-17 1 of 1 12/3/2014 4:25 PM ,�.,, c-� � co u, � � �- � r�t � tz� � :� G'7 � �'� =1'= G"> � rn .�7 RENUNCIATION � '� � $ �� I . C""T � 6�1 ��l ' �� ._ � 7 C� y . .. y �:? ' — _ c-" ;::.> T] .:,:.� _;"! REGISTER OF WILLS ' �'� � :: --"—�' c� s:��: c' CUMBERLAND COUNTY, PENNSYLVANIA rv , � H � � z�-i��2� N �, Estate of Doris A. Royer Deceased , I, Roger Hoffman , in my capacity/relationship as (Print NameJ Son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Paul R. Hoffman i �{ � c � ' � �_f � ___ � (Date) (Signatu ) � a 3� �. R '1,,I I '�� (streer Address) 'i��l� 1� ��7�� (crry,srare,zrn) Executed in Register's Office Executed out of Register's Office Sworn to or affirmed and subscribed Before the undersigned personally appeared the before me this day party executing this renunciation and certified of , that he or she executed the renunciation for the purposes stated within on this�_day of_�l t'�,Ll�.��t/ , ,�I�f � Deputy for Register of Wills No ary Publi My Commi sion Expires: (Signature and Seal ofNotary or other official qualified to administer oaths. Show date of expiration of No 's Commission.) . t, AMY BETH SUMMERS e*; 1 ?` MV CQMMISSION EXPIRES :�h��'� November 3,2015 Form RW-06 rev. 10.13.06 � -. ;� c � ='3 r�n , � o r=� � za � c:aQ RENUNCIATION `�' �� `- "' �' __._, ;.a_ � __.� c�_a r. r�_ .- „ �-f� � �..�,.� �.�-y..� �,._.�, � ....,, :��:":J .:...7 .��.. �.'�� .. ... .. ,..<; ,..,� C:.;7 REGISTER OF WILLS ' , ' _:�, -n .,1 -�" f : ..,.s � _ —rt CUMBERLAND COUNTY, PENNSYLVANIA v :-, W � � . _.:a ,_ 2� - /J�" ��:Z,� - � � "' `�' Estate of Doris A. Royer , Deceased I, _ Lyie Ro er , in my capacity/relationship as (Print NameJ Step-Son of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to Paul R. Hoffman P c_ � I �01�.-/ (Date) (Signature �Y �s- 0��. �,�� i�� (Sdreet Address) ��- i��,,ed �}� �` Y � _ r� �' (City,State,Zip) Executed in Register's �ffice Executed out of Register's Office Sworn to or affirmed and�ubscribed Before the undersigned personally appeared the before e this �14�r day party executing this renunciation and certified of �✓ ,J O�`� that he or she executed the renunciation for the purpo s stated within on this�day of ,� D,�e�+-��'� , ��i� C � Deputy for Register of Wills N tary Public My Commission Expires: �3�y��.f �� (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) tiV'°" wf.vnv.qr..�, � '=�-.� YVUNfVE BUCHANAtV � e�;;.i- � COMM.#1930G91 � o ``�'�� NGTP,RY PUBLIC•CAL!FORNik n � t:�-'.�a n LOSANG[LFSCOUN�TY Form RW-06 rev. l0.13.06 �� Commission Ex ires Mac 27,zG':5� �.9.5.1'S:•,Y:.LY.'L'Y:.".'.'4"�.'.a.S 1SYeL111'L"16•�.pa s h� C . State of Ca 'fo a County ofi _ On �Z`'Z�� before me,I 0/U alc� ��%��1�9� ,v o� ',r�-4G . � (Insert Name of Notary Pu�lic and Title) personaily appeared �L� �/��i , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. . �M1'�Y.'LW1'/L'.'Nh ,:° YVUNtVL E�U�kiAfVAN � -�, °�� COMM.#9S3�io91 � �� NOTF,RYPUSLiC•;;All'^RNIA D • LOSANGEt_ESCO'��NTy WITNESS y hand and offici I S@aI. �. c' °• Commi;sion ExFir,:;�,�,,.z�,zo,s LYh•.SY.•;„V.VL'.11.5'L'„'.'L,,S mS�Yo":LM1..". Signature �l%-l�l.�i'irt.�/ (Seal) ACK PARA w(POP(Rev O6(OB) - r`J . C� � � ' , "� C.f"1 .� � � O � � w `� � . C'�a � � �� rT� � � ..._' C,;.� LAST WILL AND TESTAMENT r - .�. �� , �.� r i P� �..� ..- , C?a .�, w.7 __ E./�r ..-_l C] OF _, . ` _� `.,, �., < > <-.� � -,; � �°� c_: c5 DORIS A. ROYER _:.�; W �-�-- M , r, U, o cv I, Doris A. Royer, of Riverside County, California, declare that this is my will. I revoke all prior wills and codicils. Article I Preliminary Dedarations A. I am married to Clarence J. Royer, and all references in this will to "my spouse" are to him. We have no mutual children. I have four children from a previous marriage, namely, D. Charles Hoffman, Paul Hoffman, David Hoffman and Roger Hoffman. Clarence J. Royer has two children from a previous marriage, namely, Lanny Royer and Lyle Royer. B. I have deliberately made provision for all of my heirs only in and through the revocable trust referred to in Article II of this will. C. I intend by this will to dispose only of my interests in properry that may be in my probate estate at my death. Any reference in this will to the residue of my estate shall not refer to any property or interests held in Royer Family Trust. I do not exercise any power of appointment I may hold. Article II Pour-Over to Trust A. I leave all of my estate, whether real, personal or mixed, and wheresoever located to the Trustees of the Royer Family Trust, executed prior to the execution of this will, to perform the following. To add the residue of my estate to that trust, as a 1 part thereof and not as a separate testamentary trust, and held, administered and distributed according to the terms of that trust and any amendments properly prepared and executed prior to my death. B. If the above disposition is inoperative in whole or in part, whether because Royer Family Trust fails or has been revoked, or for any other reason, I incorporate by reference the terms of that trust and any amendments properly prepared and executed prior to my death, and I leave the residue of my estate to the Trustee of that trust, to be held, administered and distributed according to its terms. Artide III Executor and Executor's Powers A. I appoint my spouse as my executor. If my spouse fails to qualify or ceases to act then I appoint the following persons to serve as co-executors of this will: (1) D. Charles Hoffman; and, (2) Lanny Royer. B. Bonds shall not be required of any executor nominated in this will. References in this will to my executor include any personal representative of my estate. C. In addition to any powers and elective rights conferred by statute or federal law or by other provisions of this will, I grant my executor the authority to administer my estate under any procedure for informal or unsupervised administration, or any other available procedure for avoidance of administration or reduction of its burdens. 2 � i C ' Artide IV �eneral Provisions A. If any person or persons shall contest my will or in any manner attempt to have it or any trust or bene�cial interest created by it declared invalid, the person or persons shall receive no benefits from or interests under my will, and my will shall be carried out as if the person or persons had predeceased me without issue. Provided, however, nothing in this paragraph shall apply to my spouse. B. If any part of my will is held to be void, invalid or inoperative, I direct that the remainder of my will shall be carried into effect as though the part was never in my will. On _ 1� , 19 l�at Riverside County, California, I hereby sign this document and declare it to be my will. cwc..o /I (.,c Doris A. Royer This document was signed and declared to be her will by Doris A. Royer in our joint presence. At her request, in her presence, and in the presence of each other, we hereby sign as witnesses to the execution of this will, believing that she is of sound mind and under no constraint or undue influence. We declare under penalty of perjury under the laws of the state of California tha the bove is true and correct. Executed on this � day of �� ,�� , ��, at Riversid County C if �. ,�'` , � ,� � ��' C �� , residin at �G �� 9 �'y�.� / -��.�C� --' , California.i�`�' �,� `. ;� . , residing at ��2S � i� �G-- ; California. �� 3 2�� (� l�j . o� O�TH OF �Oti-SL�BSCRIBI\G `� IT\ESS(ES) REGISTER OF �L'ILLS COLJNTY, PENNSYLVANIA Estate of__��n�-1 S � ,� �P f� , Deceased �� O/�_/� ��/��9�1 and_ U �ll� //d �� , (each) being duly qualified according to law, depose(s) and say(s)that she/he the was/ ere well- acquainted with�� d S/_P�� and am/ re familiar � with the handwriting and signature of the decedent, and that the signature of _��O�/S �.p y � to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ,�a /_( �- is in his er own proper handwriting. / / r;;�ic u•e) (Signature) � ��3`� ��r�`n � ,�+� , � > �� , (S[ree�AddressJ treet A ress ��-h An l �— / �� G ' � /,��`'� (City,S(ale,Zip) ( 1Y. lnte.Zip �, Execcrted iii Register's Office � � � � � Sworn to or affirmed and subscribed � � c.._. � �' before e this th day � � C' � --�i '�' � := �p Ew � t��3 of C . �:, � , �;� _ ` '. . °> ��' ; _� ;y -n ' '~ :�✓ —r7 � ., � � � _;� : __ � � � W �"` Pt'1 --� i "" p puty or Register of«' Is _ � U' -� . � For�n RW-04 rev. l0.13.0(