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~ti'NEREFORE your petitioner(s) pray(s) (a) that process be'issued ta all nccessary parties tu show cause •
why the Last Wi11 he~ewith presented should not be admitted to robate; (b) that an order be granted directing the
srrvice of proccss pursuant to the provisions of a~ticie 3 or tht gcPa, upon the persons named in paragraph (6)
t hr~eof who art non-clomiciliaries, or whose namas or whereabouts are unknown a~d cannot be ascertained; and (c)
~ that such l.ast Will be admitted to probate as a will of real and personal property and that letters issue thereon as >
follows:
lCheck and complete approprinte request.) _
O l.etters Testamentary to....J EE2i2Y CERVEIVKA and ; CiGENE S Tt1CK
O LettersofTrusteeshiQto
Dated: ...x~~Xi..I~~fl...4.....19 7 7.... ~
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• ~ (Petitane~).
I+II CHIG?~N ~
STATE OF COMBINED VERIFICAT[ON, OATH
Coun~y of SHIA~TASS~E ~ AND D£SIGNATION
~Fa ~a~ .,hen . peci~ione. eo be .ppoin~ed
txecutor is aol a b~ntc or tnnt eaaPM7)
I.theundersigned .....J~RRY„ Cr.i2~I~I~.~ i
° being duly sworn, say: ,
(1) VERIF[CATION: I have read the foregoing petition suburibed by me and know the contents thereof,
and the same is true of my own knowledge, except as to the matters therein stated to be alleged upon information
and betief, and as to those matters I believe it to be true. -
(2) OATH OF EXECUTOR: t am over twenty-one (21) ycars of age and a citizen of the United States;
l am not ineligible to rec~ive letters. 1 am the executor(trix) named in the Last Wiil described irt the foreKoing
petition and will well. faithCully and honestly discharge the dut~es of such executor(trix). and 1 shall duly account for
all moneys or other property which may come into my hands.
(3) DESIGNATION OF CLERK FOR SERVICE5 OF PROCESS: I do hereby inevocably designate
the Clerk of the Surrogate's Court of New York County, and his or her successors in office, as a peirson on whom
service of any process ~ssuing trom such Surcogate's Court may be made, in like manner and with like effect as if it
were served personally upon me whenevt~ 1 cannot be found and served within the State of New York afler due
diligence used. ' -
Mydomicileis ..O:~:OSSO, I•lICHIG~1 48867
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5
/ wre eat~oncr
~ On ~CH .4.........19. betore me personailycame . JEt'..RY. CE2VEIVICA
to me known to be t he person described in and
whn Pxect~tPd rhr f~rPOninv ~nctrurr~ent C~r~h ners~n dnlv swore to ~uCh in~trumenc iieiore me a~iu .~ui~
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acknowledge that •
~1i' executedthesame.
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...Nir_L-~.'~:-%t'.. L~~C~
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Helen M. Sisco (~1O1ry Publ~c?
Notary Public, Shiawass`ee County, Michigan
My coramission expires February 3, 1981
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