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COMBINED VERIFICATION. OATH ANO DESIGNATION
STATE OF NEW YORK 3 It u~! wnen a pet honer ut or euD~•~ntM
County Of . !¦eculo. •1 not ~ Danr Or oust companrl
I. the undersigned . being duly. sworn, say .
111 VERIFICATION: I have read the foregoing petition subscribed by me and know the contents thereof, and
the same Is true of my own knowledge, except as to the matters therein stated to tie alleged upon Information and
belief, and as to those matters I believe it to be true.
(21 OATH OF EXECUTOR: 1 am over eighteen (18) years of age and a citizen of the United States: I am the
executor named in the Will described in the foregoing petition and will well, faithfully and honestly discharge the
duties of the office and the trust reposed in me and duly account for all moneys or other properly which may
come into my hands. I am not ineligible to receive letters.
131 DESIGNATION OF CLERK FOR SERVICES OF PROCESS: I do hereby designate the Clerk of the
Surrogate-s Court of Suffolk County, and his successor in office, as a person on whom service of any proces
tssulnq from such Surrogate's Court may be made, in like manner and with like effect as it tt were served
p~rsonatly upon me whenever 1 cannot be lound and served within the State of New York after due dltlgencr± used
My domicile Is . . . . . .
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On . 19 ...before me personally came
to me known to be the person described In and who executed the foregoing Instrument
Surh person duly swore to such Instrument before me and duly acknowledged that
e;ecutert the same.
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