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HomeMy WebLinkAboutL 12287 P 241 --~ L )(7..';u.j p ~'-fl. ":l o ~ ~ q VI ':::2. C) ~ Q~....... l()OO See 1 2 ) Blk 10" Lot 01 5. <:> 2. . T ..:s-__nlI'IlY...T.u.........Qo6IctIIa..... '... ........I.e____.I......_).II... - /()~- /O-/S A:C0.7 lD()(D<( ~/i>be ,,"-I1e ~~ -..-..._L ....6.-1llb..ne:. --.. CONSULT 'YOUI LAWY.I I.POI.IIGNIN. tMll.INITIU"INT-THII INlftUMINT SHOULD" UII. IT LAWYIU ONLY. THIS INDIN'I1JJU!, mod. the 24th clay of. November, 2003 IErWI!EN CATHERINE SMITH a/k/a CATHERINE E. SMITH and SUSAN SMITH a/k/a SUSAN M. SMITH, as Joint Tenants with Right of Survivorship Both residing at 148 Bayview Avenue, Port Washington, NY 11050 pany of ttie first ~rt, and CATHERINE SMITH a/k/a CATHERINE E. SMITH Residing at 148 Bayview Avenue, Port Washington, NY '1050 pany of the. MCOnd part. WlI"NE'.5IE"IH that the party of the fint part. in consider.uioll of ten dollan paid by the s-rty of lhe lecond pary. doa hereby remile. rdeue and. quitc:laim un.to the party of the I<<~' part. the heir. or l\lCCcsson and --18M of the pany of the aecond pan forever, . ALL that cenaia plot. piece or- pan:cl of Jand. with the buildiIlC.. aDd impt'overnenb thr.reon erected. situate. lying and beinc in the . 56 ATTACHED SCHEDULE A. nee with an Order of the hereto), dated 11/1~/03, sau County Clerkls Office -.... TOGETHER with aU richt. title: and interest. if any. of the party of the fir.t part in and to any street.. and road. abuttin. the above deKl'ibed premise. to the: center lines thrrcof; TOGI:.-rHER with 1he 3ppurtenancu and all the atatc and richts of the party of the first part in and to said premises; TO HAVE AND TO C(i\ uflOL.D.the premises.her.~i!1l',:an"t.!.d unto the patty of the aecond part, the hein or succeuo... and assicns of JI,~.party of the ~~part fore~r. L' , 11' ;':tl' ~. . . ..'h~ AN-D'th'e party of tbe tint p;.rt. in compliance with Section 13 of the Lie~ Law. hereby covenantlthat the panr of the firat pAn vUU'rcceive the conlideratioa. for this conveyance and will hold the richt to rec:c-i,'e .ucIl conaid- eratioa .. . trUlt fund to be applied-lirlt for the purpoIC of payine the cosi: of the improvement 2.nll will -Pr,ly the aame fint to the paymell;lt of the co.! of the improvement before ulin&: any part of the tOCaJ of thl: same for any-~. . The word ..party" shall be construed. .. if it read ....rti... whcacver the acniC of this indenture 80 requires. IN ~ WHII'."OP, the party of the fint part has duly executed tm deed the: day and. year fint abo\"e writtaL bn~"h-" DO, E' L ,,' P'. Catherine Smith a/k/a -: . Catherine E. Smith h",,, Ai' ~'*~~C' I-..~ Susan Smith a/k/s a- .:./e --, 15usaq M. Smith By Catherine E. Smith, as Guardian for the P s & Property of Susan ';f. 'MI.n:h, .IP I. ........c. ow: ,~.l3~ ~rC.ttAA. - -.,..'t~";.~-''''''''~'1::~~...'.. ~ IN '-YORk STAT. eII"- aae..J St.lle of New York, County 01 Nassau ...: On 11/24/03 bef"", me, .... andeniallOd, penonollY_8IM Catherine E. Smith peI'IOI1IIJy known to me or proved 10 me an.. bull of....ilfK'~ rory ev_ 10 be lhe --CI) wbaoe"IIIIIIO(.) is ClIO) _10"'" _ill _,11M! -..owIedpd 10 me lIIII bdobaIIIIey __ "'" ume In hla'herfllleir capoc\Iy(la), _ _by h_ir~I)'" ""'. indi- viduoI(l). or "'" _ _. idua1CI) _ CUClI1ed "'" I , JOHN G. Notary Public ..e No.02 AS Qu.lifiad In :!IS CommISSion Eapir -- S_aI On ........lIy _81M pIDOII8Dy known to me or proved CO me ad rhr: bais of llIIi.. fOCl<lly ..- 10 be lbc indivklualCI) _ 11lIIIO(1) is ClIO) aabacribed ID the within instrument. and acImowleqed 10 me dloI....lllelllleyc_dle.ameilllri_Ir~Ic.I). ODd ..... by IdaIbedlhcir Upoluft(.)... IIlc inIlnI_~ .... iadi- vlduaI(s}. or "'" _ upm beholf or wbiclt lbc 1ndMdua1(.) _ _ lbc inIIIu_ IIIId _ oudI iadivimal ..- mcb --rr __ before Ibe: underaianed in (...."dI)'-poIIIItwI...........--__~orGllwr",.u~ -- (~.".,oJIb",~..... """1.4-_ 4J ./ (futtdabn ..rilI 1m. Ca""'AIft ACM:1Ift c.,,1mM'a Acra TrrLB NOfi CATHERINE E. SMITH SUSAN M. SMITH TO CATHERINE E. SMITH . f .. I ! i i J. .. ~1h''''UCR_llIwm --E"] sa.a. 01 County of 10..: On pcl'oonolly oppeared before me. Ibe undenipd. die lut.crlbiftl wlUlelI(ell) to Ibe fenloilll IIlIbUmc.nt, wllb w....... I un pcrMmally acqaaiDll<d, wllo. bel.. by me duly lworn. did depoee and say Ib.u. heI&heIlbe,. rakle(l) In tV- ,~ ." ,.~ u I_ . riI7, 1Itcl.. ... ~ fIfttl II'"' _.-Hr. If...", ''--A: Ill.. .....sIleIdley -C.) 10 be me indlvlduolC.) deocribcd In and who eucuMod ..... rare. aoina iDllnlmenl; ..... said oubocnbl.. ..;1nCa(0I) woo C-.o) _'_lOW said. - eaecull: die AIDe; and that aaid wlUll'U(n) at the same lime _ribcd hillberllllcir namc(1) U 0 wllDOll(ca) Ill...,.... ([J U--......,.. Brisw. """"dIy.,,...., ............._ ""~"'__,*"_~. ~ 11..... ADd......8id..Al-..Jbb.. W~OI) made oucb ....--.'" bel'ore lhe a_pod in 1 t.....""..." t/fIIIn -:/".."..'..... _..4 .11 SECTION "1.26 IILOCI< 1 0 LOr 15 00UIn'Y Oil 'I'OWN Suffolk II&'I'UJIJI BY IlAIL TO. John G. Dalton, Jr., Esq. 12 Monfort Road Port Washington, NY 11050 Zip No. .. .... .,. SCHEDULB A ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being at Laurel, in the Town of Southold, county of Suffolk and state of New York, being bounded and described as follows: BEGINNING at a monument set on the northwesterly line of peconic Bay Boulevard which monument is north 42 degrees 01 minutes east 100.00 feet from a monument set at the intersection of the northwesterly line of Peconic Bay Boulevard with the easterly line of the land now or formerly of Dr. Martin and which monument is also north 42 degrees 01 minutes east 220.76 feet from a monument set at the intersection of the northwesterly line of peconic Bay Boulevard with the boundary line between the lands now or formerly of Thomas H. Harper and now or formerly of Charles F. Lewis and running thence from said point of beginning northerly and northeasterly along land of Bllen Hinsch, the following two courses and distances: (1) northerly 18 degrees 54 minutes 10 seconds west 202.29 feet to a monument; (2) northerly 42 degrees 01 minutes easterly 100.00 feet to a monument set in the westerly line of land of S.T. Mackenzie; thence southerly 18 degrees 54 minutes 10 seconds easterly along land of S.T. Mackenzie, 202.29 feet to a monument Bet on the northwesterly land of peconic Bay Boulevard thence southerly 42 degrees 01 minutes west 100.00 feet to the point or place of BEGINNING. TOGBTHER with an easement for passage on foot to be used in common with others entitled to use same, over a certain Right of Way 25 feet in width adjoining other property formerly owned by Jesse E. Kahn at Laurel, Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a point on the southeasterly side of peconic Bay Boulevard where the same is intersected by the westerly side of land now or formerly of Booth; running thence along said land now or formerly of Booth south 19 degrees 42 minutes 40 seconds east 341.05 feet to peconic Bay; thence along the same south 40 degrees 05 minutes 30 seconds west 21.94 feet to land now or formerly of Jesse E. Kahn; thence along said land north 20 degrees 18 minutes west 340.04 feet to the southeasterly side of peconic Bay Boulevard thence along the southeasterly side of peconic Bay Boulevard north 42 degrees 01 minutes east 25.48 feet to the point or place of BEGINNING. Being the same premises conveyed by Andrew L. Reilly to Catherine Smith and Susan Smith, as joint tenants and not as tenants in common with right of survivorship and to the heirs and assigns of the survivor forever, by deed dated September 4, 1970, and recorded on 9/15/1970 at the Suffolk County Clerk's Office in Li~er,6807; and pag~' 126. Said premises also known as 7025 peconic Bay Boulevard, Laurel.. New York. - - L. .t;VI ~ 1 $'tf Yi~1JI iv/ct... f/~.1 'l V'\ H '\ \ ~ 1 . At IA Part 26 of the Supreme Court of the State of New York, held in and for the County of Nassau, at 100 Supreme Court Drive, Mineola, New York, on the I~ day of ~ ,2003 PRE S E N T: H 0 N: Anthony F. Marano Justice -------------------------------------x l[n the Matter of the Application of Catherine E. Smith, ORDER TO TRANSFER ASSETS OF.THE INCAPACITATED PERSON' iLS Guardian for SUSAN M. SMITH, Index No. 269S3-I-2002 An Incapacitated Person. -------------------------------------x . The petition in writing, duly verified the sth day of ()ctober, 2003, by the petitioner therein named, having been presented to this Court wherein it is requested that the assets ()f Susan M. Smith, an Incapacitated Person, pursuant to Mental Hygiene Law Section Sl.21 be transferred to her sister, the Guardian and tbe Petitioner, Catherine E. Smith, and the request being made (i) transfer of the interest of Susan.M. Smith in real property at 7025 peconic Bay Blvd., Laurel, New York, [H) transfer of JO~ Hancock Annuity #BK 1120602, (Hil transfer of 1,634 shares of Merrill Lynch stock and further, it being :requested that 417 shares of Merrill Lynch stock of Susan M. :Smith be transferred to St. Peters Roman Catholic Church, Port I Washington, New York, and the Court, by Order to Show Cause granted October 8, 2003, having required notice of the presentation of said petition to be given to Susan M. Smith, Catherine E. Smith, Michael P. Smith, Jr., Lawrence P. Smith, Thomas R. Smith, Patrick J. Smith, Nanette Smith, Marianne Smith, F:rank smith, Margaret Hutcheson, Patricia S. Rocks, Elizabeth Redding, Katie Gent, Joseph Duffy Smith, and to John Newman, Esq., the Court Examiner, Nassau County Department of Social services, St. peter of Alcantara Roman Catholic Church, and the Hanover Insurance Company (Guardian Bond) and proof of service upon each of the aforesaid respondents having been duly filed, I I ( . i I I and The Court having thereupon considered said petition then and there .presented, and a hearing having been held on the 5'. day of. ,. November, 2003, and John G. Dalton, Jr., Esq., having appeared for Catherine E. Smith, the petitioner, and on the reading and filing the recommendations of John Newman Esq., the Court Examiner appointed herein, AND upon the evidence presented at the aforesaid hearing, AND there being no obj~ction, AND it appearing to the satisfaction of this Court, by clear and convincing evidence, that the Petitioner meets the criteria set forth by Section 81.21 of the Mental Hygiene Law regarding transfer of assets and the substituted judgment doctrine regarding transfer of assets is appropriate here, and the Court f'inding that the natural object of Susan's bounty would be her sister, Catherine, who'S been the loving and caring sister that. 2 I , , , " ~as resided with her for the last thirty years; been her friend, cl~mpanion and now health aid with respect to her sister, and upon all the aforementioned papers heretofore filed herein, the e'vidence adduced, and the d.e'ciBion of this Court rendered on the r,ecord on November 5, 2003, and after due deliberation, NOW, on motion of John G. Dalton, Jr., Bsq., Attorney for the petitioner, it is ORDBRED AND ADJUDGBD, that in respect to the real property in Laurel, specifically 7025 peconic Bay Boulevard, Laurel, New York, that the Guardian shall be authorized to transfer Susan M. Smith's fifty (Sot) percent interest in such premises to Catherine B. Smith, and. it is further ORDBRBD AND ADJUDGBD, that in respect to the annuity in John Hancock IBK 1120602, the Guardian is authorized to transfer such annuity from Susan M. Smith to Catberine B. Smith, and it is further ORDBRED AND ADJUDGBD, that in respect to the shares of Merrill Lynch stock, 'the Court is authorizing a transfer of 1,634 shares of Merrill Lynch stock from Susan M. Smith to Catherine B, S,mith, and it is further ORDBRED AND ADJUDGBD, that in respect to the shares of Merrill Lynch stock, the Court is authorizing a transfer of 417 shares of Merrill Lynch stock to St, Peters Roman Catholic Church i,n Port Washington, New York, and it is further, ORDERBD AND ADJUDGBD, that the Court is authorizing the transfers of stock effective immediately, and it is further. ORDERBD AND ADJUDGBD, that the Guardian shall pay from the 3 t , .. . --- ~ E~s of the Incapacitated Person, the following disbursements: To John G. Dalton, Jr., Bsq, the Petitioner's attorney, the sum of $ ~ ~OO ~ , as and for any and all services , :~endered in thi,s proceeding, including for serving as Attorney for the Petitioner through the conclusion of this matter, and the sum c)f $ 4'!.D. kt. for disbursements. BNTBR J.B.C. ENTERED Nal 1 B III 'NASSAU COUNTY COUNTY CLERK'80Fa COUII'I'Y CLl!IUI:'S 07nllB } B'l'ATB or NIlW YORK, B8: C01IlI'l'Y or IIA88AU 1, K.... V. II....... 0Ia'1< 01 UIe CouD\;I' 0111_ ond of UIe BuJINIIIII aDd CouDI7 cou.... CDu... al_, do _, 00I'U1711la1 ha" oomparocl UIe aD_ WlUl Lbo arlClnoI OIlDBII rlLIlID AIID ~D In my oflIl:o, . .. .. .. :t1'4!.. tr, .~'IU .. .... aDd Ulol UIe oomo la 0 IruO ~P' Ulorool. ond of till .bala of ouch artClDoI. In TeoUmanr WIlorool. I hO'l!JlorlU1ISG 01'1111 h&Dd &D4 otlIzed UIe -.::---;7~~~ 4 .-..... ',-. NUlllhL-r or Imgcs TORRENS ~ RECORDED 2003 D~ 01 04:02:28 ?~ Edward P,~~~ai~ CL-"RK OF stF'FOLK COUtfiY L 000012287 P 241 OTl 03-10083 Scriul :# Ct.:rtilicalc" Priur elr. # Deed I Mnrtp:age Instlument I"=eLl I ~lJrtgngc "l"a.1( Slump . FEF.s Reconling I Filing Stamps 2J R.I'.T.S.A. .{lrf"/ Mongogc Allll. J. BlLo;ir.: Tax 2. AddiLiollal Tax Sub Total Spec.l Assit. IIr Spec. I Add. TOT. MTG. TAX Dual Town _._ Duul Counly _ Held fur Appoinlment Trnn.lC" Tax - a-- Mansiun T:IX P:I~C I FilinEl Fee Ihmdling 5.~ TIJ.5K4 NI)llIliOII r::/"\-52 17 (Cuunly)__ E.'\-.5217 (Slute) Sub l'i.ltul CClIIIIII. nrEd. __~ .!'!L Amd:1Vit <"':crlifiL~ COIl1Y NYS SIIn:lulIrgc Olher 15. J!\L 'suhl'ul:l.J '111e proJ'Crty cuvcred by thi~ mortgagc is or will be 'iml)mved by u oue or two fumily dwclliug unl)'. YES ur NO Or:llul Total Ir NO, ~,,"'e appropriale lax clause on p-dgc # ur thi:.; in.~trumcnt ~. 4 Section 03048826 1000 12500 1000 015000 ~~ 61 S;lti~riU:li(ln!V1)i"cllD.-g~~lRclcu~s List Property Owncn; M~ilillg.^ddres."" IUtCOIU) & RETURN TO: Rt'al (lmpclty Ta~ Scrv ic:.." Agency VI...riIiL'ntitJn Consideration Atnount $ 5 Community Preservation Fuud 0- CPF Tax Que 5 Inlpn)VOO Vacum LancJ SOy\-{") G. ~ \-\tn ,-:Sf. I ES'1s . I' 2.. l-1on~+ fC.ood PO"i+-tJQSh.vz.:rhn, W " /)!V TO TD TD Thil\ page fUrl11N pm1 uf Ihe aU.achccJ _ Suffolk County Recording & Endorsement Page (JPA'"J _ (SPECIFY TYPE or INSTRUMENT) ('"(1-h..~~ i ..., ~ t:.-' The premise... herein is ,.iUlRh,"d in SUFFOLK COUNTY, NEW YORK. 7 ~I mauc by: Ca.n..hi\ne S"".:fh .../yu. ~~ .s1uran ~)f..(,~ TO In lhe "filwn.hip of __ Stll...H..i61d .Ca.ftv?;"/",e S,..,,'.h. '" IAI, In the VILl.AGE ('I'l'fw,nr.p E;. <).-l-h-, urliAMLETur IJOXI3S Ii THI~U K MlIST 1113 TYPED OR I'RINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FlLlNG. 1111111111111111111111111111111111111111111111111111111 1111111111111111111111111 SUFFOLK COUNTY CLBRK RBCORDS OFFICB RECORDING PAGE Type elf InBtrument: DBEDS/DDD N'umbe]~ of PageB' 8 TRANSFBR TAX NUMBER: 03-18083 Recorded: At. LIBER: PAGB: 12/01/2003 04.02.28 PM D00012287 241 SUSAN SKITH CATHERINE SMITH Distdct: 1000 Deed AIIIount. Section. Block: 126.00 10.00 BXAMINBD ANI) CHARGED AS FOLLOWS $0.00 Lot. 015.000 Received the Pollowing Pees por Above InBtrl.llll8Dt Exempt lZY'""Ipt Page/Piling $24.00 NO Handling $5.00 NO COB $5.00 NO IfYS SRCRG $15.00 NO BA-CTY $5.00 NO SA-STATB $50.00 NO TP-584 $5.00 NO Cert.Copies $0.00 NO RPT . $30.00 NO SCTM $0.00 NO Transfer tax $0.00 NO COIIIII.Pres $0.00 NO PeeB Paid $139.00 TRANSFBR TAX NUMBBR. 03-18083 THIS PAGB IS A PART OP TEB INSTRtJMBNT THIS IS NOT A BILL Bdward P.Romaine County Clerk, Suffolk County PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473-7222 FOR COUIIJTY USE QN:..Y I~ ?~, ~ g '1; I / c>(! I ! f) ..21 Month DBV V....., g, 11 CU... I <<,'-t, (, Hp_5217 RevJl97 REAL PROPERTY TRANSFER REPORT C1. SWIS CDde * C2. Datl~ Deed Recorded STATE OF NEW YORK STATE BOARD OF REAL PROPERTY SERVICES RP - 5217 C3. Book 1 /: q', q:: PROPERTY INFORMATION 1.r=:i:~1 70 'd-S STRHTNUMeER t-A-uR\:;L rE.LCl/...; i CD.P<. \j STREET NAME _I IlciWI ZIP CODE 2. Buyer Name sm J T/-i L^STNAMcl';OMPANY --AII<-/A c,uu Li:O\J!'IRD L ___""~" I (ATHErZlfc.J(= SrYln H ,c.tJ." \-\~Im~."t. I C'TYOR TOwrJ L.AST NAMi: I COMPANY ARSTNAME 3. Tax :nd;cate wnere future Tax Bills are to be serll Billing 'f other than bUYln address I"tbottom offorml Addr_ L-- LAST NAME I COMPANV FIRST NAME I S;I\LL1NUMal"AI',D$TREHNAME CITV OR TOWN SlAN' 71PCODE 4 Indicate tl..... numb.. of AM_ment Roll JNIrce,lstransferrlld on thll dlllKl 100 4A. Planning Board with Subdivision Authorrty Exists I It of PlIrceh; OR D Part of a Parcel {Only if Part of a Par"lIl1 CheGk as they apply: \rj e", -.J X I r"i5N~JfEh ACRES . D D 4C.ParceIApprovedforSubdivisionwithMlIpP'ovided 0 (',flTHEr<-lrUE A/KIA, 5:011 t~kr.~,1'tIJ A/KIA S',11/I'11,Scl.SttV) ill. I 5, Deed Property Size 48. Subdivision Approvlll WlIB ReQui'ed for Trnnsler lOR L ~~1~:J 6. Seller Name 2>m I T H lAST ~AMEICOMPANY SrfllTtt lAST I;AME t COMPANY FIRST NAME FI~ST NAME S lA <,.'110 7. Chec:k the box below whic:h most ac:curat8ly describes the usa of th. prop.rty at the time of sele: Check tha box... billow 1111 they apply: 8. Ownership Type is Condominium 9. New Construction on Vacant Land TOA. Property I oealed withi~ an Agricultural District tOB. BUYllr roceiVilda disclo/;urtl noticeindiClltin\J that the property is in an Agricultural D'~t,ict D D D D ~onerSmilYReSidenlial R 2{,r3 Fam'ly Re~id"nLiul C Re,idenliaIVacanll"nd D\lon.ResrdentiaIVacant Land E~AgriCultural F Commercial G Apartment H Entertainment! Amusement ~~ CommllnilyServ:Ce Industriel Public Service Foresl SALE INFORMATION 15. Chfldt one or more of the.. conditions as applicable to transfer: 11. Sale Contrac:t Date ~ MOOlh Year A B C D E F G H I J Sarti BIltw81ln R81atives or Formal' Ralatives Sale BtItween Related Companies or Partners 'n !:lu5iness One ofth" Buyers is also II Sellel Buyer or Soller is Government Allency ur Lcnding Institution Dead Type not Warranty or Bargain and Sale (Specify Below) Sale of Fractional or less than Fae Inlerll51 (Specify Below) Significant Change in Property Between Taxable Status and Sale Dates Sale of BIJ"in..~ is Included in Sale PriclI Othllr Unusual Factors Affecting Sale Price ISpecify Below) None 0., 12. Date of ~Oale ! Transfer Ii 24- 103 -" 0., Yesr 1 l._-----'-------'--------P.~. 0 I , , . (t-~II Sale Prioo is tne toTal amollnt paid for the propenyincluding personal propelly. This paym,mt may be in the form of cash, other propeny or goods. or The assumption of mortgages Or OTher obligatio.",.1 PI""!!,, round to (he nearest whole dollar amount. 13 Full Sale Price &\-\ITr Li\/,'-'I D<:JO:i) ,-{)-:-o, 0 I , . ASSESSMENT INFORMATION. Data should reflect the latest Final Assessment Roll and Tax Bill 14.lndleate the value of pat'sonel propeTty in&luded In the sele 16. :~~::~n~':=t~;.n:a~:~, from ~ 17. Tota' As8essed Value (of all pa.-celli in transferl I '-C57 '11 , 18. Property Class J 10 0\ lE~J-[._J 19. School OilltrlctNam. I l,-"ure\ 20. Tax Map Identifier(sll ROllldentifier(sl IIf mo.. than four, aUsch sheet with addition81 id.ntifi.r{.ll IO.CO-IOlGc,-- ID - is- ~ 1:~ ],_ L-- ICERTIFICAllON I certify dllt~ all of the Items of Inronnation entered on tlU!i form are true lU1d correct (to the best of my knowledgo. and heUeO :and I understand that the making lOr an}' willfull false s....l..m'ml of material fact herein wiD subject me to the Ilrovt~lon~ of the penal law relative to the milking and filing of false instruments. BUYER'S ATTORNEY / BUYER f 4 lj?"" ~ k~_<-<--- Z- .A, ~it:V~n(. srl1lrVl AI/</A Cb..tWYWle. o,SrVII ISI\;(\ l) tul IDYl , , ]P, ~iLV1Vl h FIRBTNAMf LAS'" NAME 70;;JS llP(i)'h1I{ DC1..':,j. STRfnNIJMBEA S~.f TNAI.IE(AFTERSA,lfl '5IG AI1EACOOE Pl';~-(o,-/o/) _ Tnf~~oNE NUMBER .r:;.{' I "-,~ ~ .;$" ~~~ ~",f[I' h} t> f _Laur-fl I. 2' ORHlWN /"u.,:k-..:-.JL, ~ 11/2 /63 NEW YORK STATE L-:"~;r'j.,srnl ~.. ., t~- a... C&~COPY sJ.~o.;r~r\MITH, AI4A SIASM0..-\!..$'{\'mlT f>.(~~ '6l.,l.!U<dldX\ C(' _I