IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS222 COURT DIVISIONIN RE: ESTATE OF DECEASED||||| | DOCKET NO. 21| BOND AND SURETY FOR PERSONAL REPRESENTATIVE KNOW ALL BY THERE PRESENTS, that as principal(s) and as surety (sureties) are held and firmly bound unto the COMMONWEALTH OF PENNSYLVANIA in the sum of ($) to be paid to the Commonwealth, for which payment we do bind ourselves, jointly and severally, our heirs, executors, administrators and successors, the condition of this obligation being that if as of the estate of , deceased, or any of them, shall well and truly administer the estate according to law, then this obligation shall be void as to the personal representative or representatives who shall so administer the estate and her or their surety or sureties; but otherwise it shall remain in full force. Signed and sealed this day of , , each intending to be legally bound hereby. Personal Representative Signature (seal) Personal Representative Signature (seal) Personal Representative Signature (seal) Signed and sealed this day of , , each intending to be legally bound hereby. Bondsman/Agency Signature (seal) Bondsman/Agency Name Bondsman/Agency Address Bondsman/Agency Bond Number (Attach POA/Authority to transact in PA) American LegalNet, Inc. www.FormsWorkFlow.com