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(4) Thcre is no other wip or codia7 of the deadant on fde in the oftice ot the oouct, and upon information
and belKf. there exists no will. codicil or ot}xr testamentuy insuument of the decedent later in dace to any of the , ~
?r~,~roments mentioned i~ paragraph (3) hereof. except ~ ~
~5) The daedent left wrnving:
1 I~ Spouse (husbandl~f~1•.
(b) ~Id Child oi ch~!dren; or desandants o[ pcedeaased ch~7d or chiidrea.
l xl F~~r/mocher.
(d) ( xj Brothen or sister:. eithet of the whde or half-blood; or descendents of auh predeaased brothen or
saters. , . ~ ~ - . • . •
(e) ( xj Gnndfather/6nndmothet.
ln l xl Uncles or aunts.
(S) [ Xj pescendants of predeaa~ed uncla or aunts. ~
DO NOT STRIKE OUT ANY PAitT OF THE ABOVE PARAGRAPH.
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Ilnformauon is req~ueA oay? n to tAcss cfaass o! arrvi?in~ Matira who wouW Wce tAe property of
daedem d thcre wero ta ~riLL The tsnn "child or childiea" includes sdopad u rdl at nat~ual '
cMidien. State number of ~utrwors iu eaeh wch dasi Irosrt "X" ia ~Ii ~ub~quent clas~ss. lns~rt
"NO" in alt prat classes.)
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I~ {6) The nama. relationships and addte~ ot all distributees. of each penon desi~nsted in the l~st Wil1 herew~th j~~
prcxnted u ptimary executor. of all persons advecsely affected by the purported exercise by wch Will ot any power ot ~
appwntmen~ of aU persons adv~ersely atfected by any codici) and of all pcrsons havina an intaat undc-r any pnor will
I~j ` o! tAc deccdent on fde in the Surro~,ste's offia. ue heceinafter set ~orth in wt+divu,ons (a) and (b):
i: Dactiption of Legacy, Devise ur
` Other Interest, or Natu.-e of
i~ .
tv~me and Address . - - - . . . . . . . Retationship. . . - . . . Fiduc~ary Stuus -
! (~)-JW pecsons and parties so interested who are of ful) age and sound m~nd. or which are corpuratiom ur
~ aswcutiuns. ue u foUows:
~ ` .
~ Lorenz Beck - - Exeeutor nanned in
, 110 Webster St. Last Will and Teatament
~ Malverne, N.Y. Husband and residuary legatee ~
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i oRe~i~Rn~F~~`A+~~, N.y. .
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