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Home My WebLink About09-10-15 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) far Letters as specified below, and in support thereof aver(s)the following and respectfully request(s)the grant of Letters in the appropriate form: Decedent's Information Name: Marqaret Joanne Davis File No: �/ - �,�jl'�9G,.� a/k/a: Marqaret J. Davis (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: August 31, 2015 Age at death: 61 Decedent was domiciled at death in Cumberland County, Pennsylvania (Srare) with his/her last principal residence at 2103 Foxfire Drive Mechanicsburq 17055 Upper Allen Township Cumberland Street address,Post OtTice and Zip Code City,Township or Borough County Decedent died at 2103 Foxfire Drive Mechanicsburq 17055 Upper Allen Township Cumberland PA Street address,Post OfTice and Zip Code City,Township or Boraugh County State Estimate of value of decedent's property at death: If domiciled in Pennsy[vania.. ...... ... ........ ......... All personal property � 475,000.00 If not domiciled in Pennsylvania. .... ............ ....... Personal property in Pennsylvania $ If not domiciled in Pennsylvania. .... ..... ....... ... .... Personal property in County $ Value of real estate in Pennsylvania..... ........ ... .... ............ ...... ..... .............. $ TOTAL ESTIMATED VALUE. .. . $ 475,000.00 Real estate in Pennsylvania situated at: NONE (Attach additional sheets,if necessary.) Street address,Post Offce and Zip Code City,Township or Borough County 0✓ A. Petition for Probate and Grant of Letters Testamentary Petitioner(s)aver(s)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated MaY 14, 2009 and Codicil(s) thereto dated NONE 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. 0 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.,pendente lite,durante absentia,durante minoritate If Administration,c.t.a. or d.b.n.c.t.a.,enter date of Will in Section A above and comqlete 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. ❑NO EXCEPTIONS �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 additional sheets,if necessary): Name Relationshi Address :' �'� fn �� G O +,J) ��.7 C:� ,� `� ��,�� i C_f � , . ' :. -",�,. t" - , , , � _� _..� "=} '. --- � : � a . `;� , C� �� t,� -r1 � Form RW-O2 rev. roiiiiznu Page 1 of 2 ' � ' "�.:/ � Oath of Personal Representative ofs��e�u5e on�y .:> ��--, COMMONWEALTH OF PENNSYLVANIA } �-> � .,�� } SS: � � "�� COUNTY OF Cumberland ,._ "� �� } _�_ r-,-� :: � '�� , :, ._,_, .; • �.�� ,. _... __ .. ,,., Petitioner(s)Printed Name Petitioner(s)Printed Address ; '�` O ' � � Aprille Marie Jordan 1070 Hartford Drive, Boulder, CO 80305 _..�, `.;� Meredith Colleen Hill 2562 Georgetown Blvd., Ann Arbor, MI 48105 "-"; - ,=; . �n � '� The Petitioner(s)above-named swear(s)or affirm(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 Decede t,the Petitioner(s)will well and truly administer the estate according to law. Sworn to r affirmed a ubscribed before -,z �--_ vate � I O 1 me th' �' da�o � � �/',� �'� Date � I c� I' gy: Date or t e egister Date BOND Required:�YES �NO To the Register of Wills: FEES' Please enter my appearance by my signature below: Letters . . . . . . . . . . . . . . . . . . . . . . $ 410.00 Attorney Signature: ( ) Short Certificate(s). . . . . . 40.00 ( )Renunciation(s).. . . . . . . . ( ) Codicil(s). . . . . . . . . . . . . ( )Affidavit(s).. . . . . . . . . . . Bond.. . . . . . . . . . . . . . . . . . . . . . . Printed Name: Mark D. Hipp Esquire Commission. . . . . . . . . . . . . . . . . . Supreme Court Other Will . . . . . . . . 15.00 ID Number: 84493 Inventory . . . . . . . . 15.00 Inheritance Tax Returr. . . . . . . . 15.00 Firm Name: METTE, EVANS&WOODSIDE . . . . . . . . Address: 3401 North Front Street , , . . . . . . PO Box 5950 . . . , . , . Harrisburq PA 17110-0950 . . . . . . . Phone: (717)232-5000 Automation Fee. . . . . . . . . . . . . . . 5.00 Fax: (717)236-1816 dCS Fee. . . . . . . . . . . . . . . . . . . . . 35.50 Email: mdhipp _mette.com 'ro'rAL. . . . . . . . . . . . . . . . . . . . . $ 535.50 DECREE OF THE REGISTER Estate of Marqaret Joanne Davis File No: ��"0/!�� a/k/a: Mar aret J. Davis AND NOW, . � , 2015 , in consideration of the foregoing Petition, satisfactory proof having een presented befare me,IT IS DECREED that Letters Testamentarv are hereby granted to Aprille Marie Jordan and Meredith Colleen Hill in the above estate and(if applicable) that the instrument(s) dated May 14 2009 - described in the Petition be admitted to probate and filed of re rd as the last Will (an dicil(s)) of Decedent. r rt� egister of Wills r,� � Farm RW-02 rev. 10/I U201/ -' age �'of 2 � �-� REGISTER OF WILLS CERTIFICATE OF CUMBERLAND COUNTY GRANT OF LETTERS PENNSYLVANIA f�� y �F cuMe - �,� �� ` No. 2015- 00963 PA No. 21- 15- 0963 9 Es ta te Of: MARGARET JOANNE DA VlS O D "� (Fiist,Middle,Last1 V � a/k/a: MARGARET J DAVIS La te Of: UPPER ALLEN TOWNSHIP N � CUMBERLAND COUNTY Deceased 1750 Social Security No: WHEREAS, on the lOth day of September 2015 an instrument dated May 14th 2009 was admitted to probate as the last will of MARGARET JOANNE DA VlS (First,Middle,Lastl a/k/a MARGARET J DAVIS late of UPPER ALLEN TOWNSH/P, CUMBERLAND County, who died on the 31st day of August 2015 and, 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 certify that I have this day granted Letters TESTAMENTARY to: APRILLE MARIE JORDAN and MEREDITH COLLEEN H/LL who have duly qualified as EXECUTOR(R/Xl and have agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal ofs�my oftf�ice on the 10th day of September 2015. c7 .�� C, . !a.� _�`, CJj c '' +--( O�Z/ C.,_ :; .. , (—i Register of i/s � ., �._ ._ �"_..: i Q c-� . . r--i " : _:� ;,; DeP Y a , i � � � :�:.. . � , C � C�� La.� t:.- r'1 � tt i t'!N'• r� -�. .�,.. Lw: � ^-3 � c--> fJ r�` **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) � �� LAST WILL AND TESTAMENT �F MAR�ARET JOANNE DAVIS BE !T KNC�WN TH1S DAY THAT t, Margaret Joanne Davis, of Cumberland County, Pennsyivania, being of tegal age and of sc�und and disposing mind and mem�ry, and not acttn� under duress, menace, #raud, or undue influence o# any person, do make, de.clare and publish this to be my Wiil and hereby revoke any VNill or Codicil I may have made. ARTICLE ONE Marriage and Chitdren: � ;��: -�, � C � :r3 j:�.� � I am sing{e {not matried) and have the following adult children: `; � ,.--, `� �� ; - , _ a_, � ,.a � ' � �� ;��'-; Name: April#e Marie Jordan Date ofi Bir�h: Uctober 2fi, 1975 Name: Meredith Colleen Hifl Date of Birth: Aprii 1fi, 9978 ��3 � -j ca :_ �:� ARTfCLE TWO " '�rv' Debts and Expenses � `' � I direct my Personai Representative t� pay a1t casts and expenses of my last illness and fut�era! expenses. ! further direct my Personal Representative to pay a!! of my jus# debts th�t may be proba#ed, regis#ere�! �nd �11QwQd against my �s#�#e. However, #his provision shall no# extend #he s#atute of limitatior�s for the paymen#s of debfs, or enlarge upon my (egal obtigafion or any statutory duty of my Personat Representative to pay debts. ARTICLE THREE Specific Bequests of Reai andlor Personal Properly I wiil, give and be�ueath unto the persons named beiow, if he or she survives me, a!1 of my Rea! andlor Persanal Property. They are to receive the property, equalty, per stirpes. Name Address Rela#ionship Apriiie Marie Jordan 50� Hartford Drive Daugt�ter Boulder, Colorado Meredith CoHeen Hi{{ 2562 Georgetown Blvd Daughter Ann Art�r, Michigan Signed by TestatoriTestatrix .��,�� .J . l.�a-� � - 1 - � �s There are specific items of Property that are heirioom pieces and which are to remain within the f�mily and are not to be sold or o#henrvise given �way t4 anyone no# directty retated to the Meyer famity. These items were ptaced in my possession w�th this understanding and stipulation; and thus, are also placed upon those persons that i bequeath and named abave, the€ollowing property. Property: 1. Dry Sink: This i�em was made by my great-grandfather Meyer. 2. Black Steamer Trunk with wood slats and brown leath�r straps: This item belonged #o my grandmother, Elsie IVlas Peters Mey�.r, It #raveied with her on her#rip to Europe. 3. Two J. C. Meyer Dairy Mi(k Bott(es, one being a pink and one a quart: These items are from the time when my grandfather, Joseph Curtis Meyer, Sr. defivered mi�k by horse an�t bu99Y in and around State Cotlege, Pertnsylvani�. 4, Antique China; These items belonged to the mother and grandmother o#my grandmother, E�sie Mae Peters Meyer. 5. Pale biue glass salad bowl set with six (6} dessert dishes to match: This item beionged to my grandmother, Elsie Mae Peters IUleyer. f>. Walnut dining table with six (�} boards: Th'ss item was given to my parents, Joseph Cur#is and Carolyn Meyer, Jr., by my grandmother, Elsie Mae Peters Meyer. it was purct�ased by her#rom "two ofd iadies going out of housekeeping�, and given to my parents as a wedding preser�t. As a note to Apriite and Meredith, in distributing my reat and personal property equaiiy, there are #wo piec�s o#jewelry which wc�uld have special meaning #o each. These two piec�s of jewelry �re�s#ollows: 1. Aprille, there is a gold necklace with #hree (3) opafs encased in an open t►eart, which your father gave to me when you were born. When distributing my jewetry between you and Meredith, 1 wouid like you to have this necki�ce. 2. �ll�redi#h, there is a gold ne�klace wi#h a diamond encased in an open heart, which your father gave to me when you were born. When distributing my jewelry between you and Aprille, 1 would like you to have this neciciace. In the even# 1 rtame a person in this Article and said person predeceases me, the bequest to such person shali lapse and the property shall pass under #he other provisions of this Wiil. in the event that ! do not possess or own any property listed above on the da#e o#my dea#h, the bequest of#ha# proper#y shall lapse. Signed by TestatorlTestatrix ��-�,�J �� - 2 - ARTIC�E FOUR Hamestead or Primary Residence ! Wi1�, devise and beq�ae�#f� al! my in#sres# in my homes#ead or primary residence, if 1 own a homestead or primary residence on the date of my dea#h that passes through this �ii to my children, �prille Marie Jurdan and Meredith Colleen Hill. if I have and name more#han one child, ttiey are to receive the property equa!!y, per st�rpes. ARTtC�E F�VE Al! Remaining Propert�/ — Residuary Glause 1 wi((, devise, bequeath and give aIi fhe resf and remainder of my properfy and estate of every k'rnd arrd cfiaracter, inciuding, but not limited to, reai and personal property in which i may have an interest at the date af my death and which is not otherwise effectively disposet! of, to My Children, Aprilie Marie Jordan a�d Meredi#h Colleen Hill. If � have and name more tfi�an one child, th�y are to ceceive the property, equaily, per stirpes. ARTtCLE SiX �4ppointment of Personai Representative, Executor ar Executrix i hereby appoini Aprille Marie Jordan and Meredith Colleen Hi!!, as Persona! Represen#atives o# my estate and this Wili. ln the event both Personaf Representatives shal! predecease me, or, for any reason, shali fai! #o quali#y or cease to act as my Personal Representative, then 1 hereby appoint Nancy Marie Smeltzer to serve as successor Personaf Represenfative of my estate and Vllill. in the event #hat both Personal Representatives, Apriile Marie Jordan and Meredith Colleen Hill, shall predecease me, or, for any reason, shall #ail to qualify or eease to ac# as my Personal Representative; and if then subsequently to this Nancy Marie Smeftzer predeceases me, Aprilte Marie Jardan and Meredith Cofieen Hitf, or, for any reason, sha11 fai! to quali#y or cease #o act as my Personal Represen#ative, then 1 l�ereby appoin# Joseph Dennis Meyer as suc,t:essor Personal Represente#ive of my estate ar�d Will. The term "Personal Representative", as used in this Wrt1, shatt be deemed to mean and include"Personai Representative�, ��acecuto�' or�Executri�. ARTICLE SEVEN Waiver o#' Bond, inventory, �ccoun#ang, Reporting and Approvai My Personal Represen#a#ives and successor Personal Representative shall serve without any bond, and I hereby waive the necessity of preparing or fiting any inventary, accounting, appraisal, reporting, approvals or finaf appraisement of my estate. Signed by TestatorTTestatrix � (��<�� , -�. �� - 3 - ARTICLE EtGHT Powers o# Rersonaf Representat�ve, E�cecutor and Executrix i dire�c# tha# my Persona# Represen#�tives sl�ai# #�ave br4ad discretion in #he administration of my Estate, without the necessity of Cour# approvat. t grar�t unto my Person�l Representatives, afl powers that are allowed to be exercised by Personai Representat�ves by #t�e iaws of #he State of Pennsylvania and #o the exter�t not prohibiied by the )aws af Pennsylvania, fhe following additionai powers: 1. To exercise ali the powers, rights and discretions granted by virtue of any °Uniform Trustees' P�vers Law,n andlor�Probate Coc(eA adopted by the State of Per�nsy�vania. 2. To Compromise claims and to abandon property which, in my Execu#�r�s)'s opinion is of littie or no value. 3. Ta purchase or otherwise acguire and ta retain any �nd att stocks, bonds, notes or other securities, or shares of in#erests in investmen# trusts and common trust ft�nds, or in any other property, real, personai or mixed, as my Personal Representatives may deem ad�isable, whe#her or not such investments or property be of the chara�ter permissible by fiduciaries, without being liabie to any person for such retention or investment. 4. To settfe, adjust, dissoive, windup or continue any partnership or other entity in which I may own a partnership or equity interest at #he #ime of my death, subject, however to the terms of any partnership or other agreement to which i am a party at ti�e time of my deafh. 1 authorize my Personai Representatives#t�c�on#inue in any parts��rship t�r oth�r�n#ity#or such periods and upon such terms as they shall determine. My Personal Representative shall no# be disqualified by reason o# being a partner, equity owner or title holder sn such firm from participa#ing on behalf of my estate in any dealings herein authorized to be carr'red on between my Personaf Representatives and the partners�r�qu�ty owners o#any such partner�hip or other ent�#y. 5. To lease, sell, or offer on a lease purchase, any rea! or persona! prope�ty for such time and upon such terms and condiiions in sucn manner as may be deemed advisable by my Personat Representatives, att without court approvai. fi. To sefi, excl�ange, assign, transfer and convey any security or property, real or personal, held in my estate, or in any trust, a# public or private sale, at such time and price and upon such terms and cond'+tions �including credit) as my Personal Representatives may d+eem advisable and for the best irrterest of my astate, or any trust, i hereby waive any requirement of issuing summons, giving nvt�ce flf any hearing, �nducting or h4lding any such hearing, fiiing bor�d or other seciari#y, ar in any way obiair�ir�g cou�t authori�ty or approval #or Signed by Testatorfl'estatrix ,� �,��° � ��`� � G. c��=.` �- - 4 - any such sale, exchange, assignment, transfer or conveyance of any rea! or per�Qn�! prQper�y. 7. To pay all necessary expenses ofi administering the estate and any trvst including #a�css, trustees' #ees, fees for the services vf accountants, agents and attomeys, and to reimburse said parties #or expenses incurred on behal# o#the es#a#e or any trust hereundsr. 8. Unisss otherwise specificaHy provided, to make distributians (incfuding the sa#isfactit�n of any pecurtiary bequest} in �ase or in specifc property, real or personal, or in an undivided in#erest #herein, or partly in cash and partly in oth�r properiy, and #o do so with or witt�out regar�i to #he income tax basis of specific property af(ocated to any beneficiary and without making pro rata distributions of specific assets. 9, To determine what is principa! and wha# is incr�me with respect to all receipts and disbt�rsements; to estabGsh and maintain resenres for depr�ciation, depletion, obsolescence, taxes, insurance premiums, and any other purpose deemed necessary and proper by them and �o pari�te and to distribute prvperty ofi the estate or trust in kind ar in undivided inte�ests, and to determine #h� value o#such property. 14.To participa#e in any plan of reorganiza#9on, consoiidat�on, dissolution, redemption, or similar proceedings involving assets comprising my estate or any trust ereated hereunder, and to deposit or withdraw securities under any such proceedings. 11.To perform such acts, #o participate in such proceeclir�gs and to exercise such other rights and privileges in respect #o any proper#y, as if she or he were fhe absotute owrter thereof, and in connection therewith to eRter into and execute any and ail agreemen#s binding my estate and any trust�reated hereunder. 12.To compromise, settle or adjus# any claim or demand by or against my estate, or any trust, to fitigate any such claims, inctuding, wi#hout limitation, any claims retating to estate or income taxes, or agree to rescind or modify any contract vr agreemen#. 13.To borrow mor�ey #rom such source or sources and upon such terms and conditions as my Persona! Representatives shal! de#ermine, and to give sucl� security therefore as my personat Representatives may determine. A!I au#horities and powers herainabove granted unto my Persanal Representatives shal! be exercised from time #o #ime in her or his sote and absolute discretion and wi#�ou# prior au#hority or approvai of ar�y Co�rt, and 1 in#end #hat suci� powers be construed in the broadest possible extent. Signed by TestatorlTestatmc ��,r �� . ��a � � - 5 - ARTICLE NlNE Construction lntentions !# is my in#ent#1�at thi� 1Ni!! be in#erpret�d according #Q#�e following prQvisions: 9. The masculine gender shall be deemed to include the feminine as well as the neu#er, and vice ver�a, as to each of them; the singutar sha(( be deemed to include#he plursl, and vice versa. 2. The term "testator" as used herein is deemed to include me as Tesfator or Testatrix. 3. This wil! is not a result of a contract between myself and any beneficiary, fidu�ary or third party and i may revoke this Wil! at any time. 4. Ifi any part of this Will shall be declar�d invatid, ilfegaf, or inoperative for any reasvn, i# is my expressed intent that the remaining p�rts shatl be effective and fully operative and it is my intent #hat any �c�urt so interpreting same construct this Will and any provisio� in favor of survivaL Ai�TtCLE TEN Miscettaneous Provisions t direct that this Will and the construction fhereof shafl be governed by the Laws of#he S#ate of Pennsylvania, (� have placed my initiats next to the provisions below that 1 desire to adop#. Unmarked provisions are not adopted by me and are not a part of this Wiil.} if any person n�meci h�r+ein i$ ir�deb#ed to me a#the time o#my tlea#h and such indebtedness be evidenced by a vaiid Promissory Note payable to me, then such person's portion of my estate shall be diminished by the amounf of such debt_ Signed if Setected: � Any and all debts of my estate shai) first be paid frort� my residuary estate. Any debts or any real property left herein shali be assumed by the person to receive such rea! property and no# paid by my Persona! Representa#ive. Signed if Selected: � ,�. > � �`� �; -� t tlesire to be bt�ried in the Boalsburg �emetery in Cer�tre County, Boalsburg, Pennsylvania. My paren#s, Joe an�i Carolyn Meyer, have alrea�y made such provisions#or me. SignedifSetected: ��.�_k,��,,,� J, % �-�-�� Signed by TestatorlTestatmc �,t.�� J- � ��-- ' - 6 - I, Margaret Joanne Davis, having signed this Will in the presence of Brenda S. Bishop and Eric A. Failing who attested it at my request on this the � day of May, 2009 at 2103 Foxfire Drive, Mechanicsburg, Pennsylvania 17055, declare this to be my Last Will and Testament. Jv�l ' ' ��.�f 4,� J �`��:�� < � Margaret Joanne Davis Testator/Testatrix Signed by Testator/Testatrix ,�� >,- � .,, lr,Jc;er-2— - 7 - . � NOTARIZATION Commonwealth of Pennsylvania County of Dauphin -��'1 On this�_day of � , 2009,before me, Amy R. Wise, a notary public, the undersigned officer,personally appeared Margaret J. Davis, 2103 Foxfire Drive, Mechanicsburg, PA 17055, known to me (ar satisfactorily proven)to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. � �" 1 �� Amy R. Wise tary Public COMMONWEALTH OF PENNSYLVANIA Natarial Seal Amy R,Wise,Notary Public City of Harcisburg,Dauphin County My Commission Expirea Nov.30,2010 Member,Pennsylvania Association of Notaries ,� The above and foregoing Will of Margaret Joanne Davis was declared by - RIlargaret Joanne Davis in aur view and presence to be her Vllill and was signed and subscribed by the said Margaret 3oanne Davis in our view and presence and at her request and in #he view and presence ofi each other, we, the undersigned, witnessed . and at��sted the �iue �xecution of the V1lil1 Qf Margaret Joanne Davis on this the 1'�/�` day o#May, 2009. ,�'`, � �� --� �, Brer�da S. Bishop Eric A. Fai(i�g �� ....- 29 fl1 Fo�re Drive 2101 Fo�re Drive Nlect�anicsburg, PA 17�55 Nlecha�i�sburg, PA 17�55 Signed by TestatorTTestatrix rr' �z.�--.[ti�''J: �u�' �� - 8 - NOTARIZATION Commonwealth of Pennsylvania County of Dauphin th On this_�day of �C , 2009,before me, Amy R. Wise, a notary public, the undersigned officer,personally appeared Brenda S. Bishop and Eric A. Failing, 2101 Foxfire Drive, Mechanicsburg, PA 17055, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they are witnesses for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. � o Amy R. Wi e, tary Public COMMONWEAL�'H OF PENNSYLVANIA Notarial Seal Amy R.Wse,Notary public City of Harcisburg,Dauphin County My Commission Expirea Nov.30,2010 Member,Pennsylvani�Aasseiati�r� �ri�� OATH OF NON-SUBSCRIBING WITNESS(ES) �1 REGISTER OF WILLS l un.��r Ic.n�Q COUNTY, PENNSYLVANIA Estate of OV t rar��,f,� ,��.�J� 11��'�� , Deceased ��Pr' l I�-- �t/�'c_��/'�c..,� and /"'Gre.�F�'�, (,o l�a.c..n � �( , (each)being duly qualified according to law, depose(s) and say(s)that she/he/they was/were well- acquainted with 4 Vl�e ��.i- �� I�.v�f and am/are familiar ,�n � with the handwriting and signature of the decedent, and that the signature of /V��.-,;� ��_ �E'✓�� / � to the foregoing instrument purporting to be the Last Will and Testament/Codicil of /�t�J a.:�- ��H�,.< <�w� _ .,�/ is in his/her own proper handwriting. r � �� C�5�1. � 1 / D t� i? ig �r � � (gnature) l o�� 1+w-��.� 7,,-:��. 2 �'� 2 �-� �o,�� a.�,�► rS1��P (Street Address) (Street Address) o.�!��r , �� g °3� � �"� �l b� �y � fs�l��' (City,State,Zip) ( ity,State,Zip) ( ,..� Executed in Register's Office c � .� � Sworn to or affirmed and subscribed �'� � �=;,s �� r�a' �T' 'Z7 � `..::�7 / �i L! '1 a �'� C.� before this 10 day ? r-,� o r�-,7 of f�m,� �� . _ - > � i� _.,_! �:; �"7 � � � �� d f.'a't i — eput for Register of Wills � � � �� Form RW-04 rev. 10.13.06