Loading...
HomeMy WebLinkAbout04-24-07 --.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 21 06 0863 Date of Birth 206-10-9246 08/29/2006 05/04/1918 Decedent's Last Name Suffix Decedent's First Name MI Shank William T (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW . 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 8. Total Number of Safe Deposit Boxes 4. Limited Estate 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT _ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Diane M. Oils, Esquire Firm Name (If Applicable) ",i' '.w, , Oils & Oils First line of address ~ \ 1400 North Second Street L,l.J Second line of address First Floor, Front C? --J City or Post Office State ZIP Code OAl L F:Li'~', Harrisburg PA 17102 Correspondent's e-mail address: Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, ,t i~ue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. (lJi!lv:Ji~'F~R"~NG:TU~_ . /?-t'/,;z #--/:p~/ LGflllL.,df/tt!4/t.T.,iltf&-- OAOE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 ~ L 15056051058 ~ ---I 15056052059 REV-1500 EX Decedent's Name: William T Shank RECAPITULATION 1. Real estate (Schedule A). .................................... . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested. . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10)................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 16,765.02 1 7. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L Decedent's Social Security Number 206-10-9246 0.00 0.00 0.00 0.00 14,556.50 3,834.03 0.00 18,390.53 1,625.51 0.00 1,625.51 16,765.02 0.00 16,765.02 754.43 754.43 15056052059 ---I REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENTS NAME William STREET ADDRESS 208 Senate Avenue, Apartment 819 21 06 0863 T Shank DECEDENTS SOCIAL SECURITY NUMBER 206-10-9246 CITY Camp Hill I STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 754.43 550.00 Total Credits ( A + B + C ) (2) 550.00 3. Interest/Penally if applicable D. Interest E. Penalty --~--~---~---- Total Interest/Penalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 204.43 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) A. Enter the interest on the tax due. 204.43 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 [K] b. retain the right to designate who shall use the property transferred or its income; ........................................... 0 [K] c. retain a reversionary interest; or....................................................................................................................... 0 [Xl d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [Xl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [KJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [KJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [K] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 39116(1.2) [72 P.S. 39116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 39116(a}(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (6-9. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF William T. Shank FILE NUMBER 21-06-0863 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. NONE DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 000 REV-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF William 1. Shank FILE NUMBER 21-06-0863 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH NONE TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-1504 EX+ (6-98) t _9/&~~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF William T. Shank FILE NUMBER 21-06-0863 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent. other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships_ ITEM NUMBER NUMBER 1. NONE DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 0.00 REV-1507 EX+ (6-98) t. '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF William 1. Shank FILE NUMBER 21-06-0863 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH NONE TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0.00 REV-15G8 EX+ (6-98) t. '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISe. PERSONAL PROPERTY ESTATE OF William T. Shank FILE NUMBER 21-06-0863 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION PNC Checking Account #51-4005-6798 - PNC Money Market #50-0190-1671 VALUE AT DATE OF DEATH 12,63405 United Health Care - Reimbursement 527.10 AIMCO Reimbursement 455 00 AIMCO Reimbursement 617 CIGNA Group Insurance - Reimbursement 300.00 T-Mobile Reimbursement 2541 Comcast Reimbursement 46.29 Verizon - Reimbursement 948 Erie Insurance Group - Reimbursement 453.00 Couch, Bed, Dresser, Table with 2 Chairs, Misc. Kitchen Items 100.00 TOTAL (Also enter on line 5, Recapitulation) $ 14,55650 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98) r, '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF William T. Shank FILE NUMBER 21-06-0863 If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Robert G. Shank 609 Magaro Road Enola, PA 17025 Son B c JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH OECOS VALUE Qf NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTL Y.HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 08/29/96 Bank of Landisburg Checking #0622214 7,668.05 50% 3,834.03 TOTAL (Also enter on line 6, Recapitulation) $ 3,834.03 (If more space Is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98) r, '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF William 1. Shank FILE NUMBER 21-06-0863 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUOE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A copy OF THE [)fED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. NONE TOTAL (Also enter on line 7 Recapitulation) $ 000 (If more space is needed, insert additional sheets of the same size) REV.1511 EX+ (12'99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF William T. Shank FILE NUMBER 21-06-0863 Debt. of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: James R. Gingrich Memorials 125.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Waived Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City . State Zip Year(s) Commission Paid: 2. Attorney Fees 1,20000 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant NONE Street Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Cumberland Law Journal Carlisle Sentinel 103.00 7500 122.51 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,62551 REV-1512 EX+ (12-03) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF William 1. Shank FILE NUMBER 21-06-0863 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 000 REV.1513 EX+ (9.00) .9_jl~& ~ SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF William 1. Shank FILE NUMBER 21-06-0863 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Randy G. Shank, 609 Magaro Rd., Enola, PA 17025 Son 331/3 Kathleen Helen King, 831 Humer St., Enola, PA 17025 Daughter 331/3 Jeffrey Lynn Shank, 904 Humer St., Enola, PA 17025 Son 331/3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 00 (If more space is needed, insert additional sheets of the same size) ~ .,--'~~ ~.....:. ~':"" >- ~ -< E-< Z U..l ~ U..l E-< r:/) U..l E-< ~ o r:/) ~ U..l !: U..l .....l :t~ ~ oz< Z ::J::J..... < OOZo :t~t::x::u<u.l r.nOOo>r.n r-:u.l~Z....:l< ~E-<....:l<>-u.l .<:<..........:l....:lr.nu ~::J:I:t::x::~~ ....:l p...u.lu.l d ~~p... ~ <~ u::J U \0 8 N N t::x:: u.l ~ o E-< U o <") \0 00 '=? \0 o I ...... N UJ I If- <..9LL a> ::>0 rJ) <{ '''' ::l a:l ~ 0 t-- Cl)O::f-"€a>co <{L1.j~::lro~ rv-'......O::l ' u.. U 0 () 0-(") f-CI) ~ U >. (j) (; -a>t-- 0:: CI) en 5 rJ) ..- UJ::::JZ,o,,6<( Z-<{'-'.cQ... ~:S:I-g~.i .....LLO-roOrJ) LL 0:: -C () 'E <{ooa>..-ro 00:: E () zUJ ::l UJf- () ....J5Q <..9<..9 UJ 0:: t Q) .- co .- (/) UJ "0 Q) ::l (/) (/) o Z Q) .- co .- (/) UJ " ~ .~ .~,':,~' .. . '. ~.: '. '. '.<J; ;:~tZ~~;!r"; ;;~;~);;il' REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2006-00863 PA No. 21-06-0863 Es ta te Of: WILLIAM T SHANK (First, Middle, Last! Late Of: CAMP HILL BOROUGH CUMBERLAND COUNTY Deceased Social Securi ty No: 206-10-9246 WHEREAS, on the 2nd day of October 2006 an instrument dated March 21st 2000 was admitted to probate as the last will of WILLIAM T SHANK (First, Middle, Last! late of CAMP HILL BOROUGH, CUMBERLAND County, who died on the 29th day of August 2006 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: DIANE M DILS who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 2nd day of October 2006. ~#n~G~J !Jqii)Jk .. **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMENT OF {.f) o WILLIAM T. SHANK 9 ...,. L..--CL. te: --:) 0 :[: LL C1 c_~. r.:::: 0 (-)-, N ~~:waLIAM T. SHANK of the Borough of Lemoyne, Cumberland County, ~ ~iEi: trenn'ij~~, declare this to be my Last Will and revoke any Will previously made by me. S; aS g ITIN\f 1: 1 devise and bequeath all of my estate of every nature and wheresoever situate, C-..J ~' \_,1 (,' I.'..: __ ~-~': .. L;._ .. ;::s ~~~:71 S~1 ;_~--J ,-'1 '.." c:: ~~: c=> -~ ~<. C:L.':J. LJ.,l t_J- p-: together with insurance thereon, in equal shares, to my three (3) children, RANDY G. SHANK of 609 Magaro Road, Enola, Cumberland County, Pennsylvania; KATHLEEN BELEN KING of 831 Humer Street, Enola, Cumberland County, Pennsylvania; and JEFFREY LYNN SHANK of 904 Humer Street, Enola, Cumberland County, Pennsylvania; and 1 direct that issue be made on a per capita basis. ITEM 2: 1 direct that all taxes that may be assessed in consequence of my death, of I ';! ~ ~ whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as ~'\ '" a part of the expense of the administration of my Estate. Bi' ~ ITEM 3: I direct that all my just debts aud funeral expenses be paid as soon as practical ~ ; after my death. ~ H ITEM 4:1 appoint my son, RANDY G. SHANK of 609 Magaro Road, Enola, ~ H ~ ~ Cumberlaud County, Pennsylvania, Executor of this my Last Will. Sbould my SOIl, RANDY G. SHANK, fail to qualify or cease to act as my Executor, 1 appoint my daughter, KATHLEEN ;t ~ t" ~J HELEN KING of 831 Humer Street, Enola, Cumberland County, Pennsylvania, Executrix of 1 ;~ ih ~ ~ ~- ~'" this my Last Will. ; [1 t ~ , :~ ht ITEM 5: I direct that my personal representatives or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM 6: Upon my demise I direct that my body be buried in the Stone Church Cemetery, Wertzville Road, Silver Spring Township, Cumberland County, Pennsylvania. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this M day nf /l1I~' ,2000. w~~~~yfl WILLIAM T. SHANK Signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ?1 ~~1 ~ ~>ks (1~. ;:;11- /70{J , 1/ ~)j ~ JJ./J~ cyt44 ' ~ xkv; fJ~ 17~/( 2 'l .j '" '. $/J:~ . "~~~ .. '7 ".~ ~~.' -~~ '. ,,\:,:,~~:~?~.;) '. :i> ':~f:;~~ ;: I)." . COMMONWEALTH OF PENNSYL V ANlA ) ) ss: COUNTY OF CUMBERLAND ) We, WILLIAM T. SHANK, (!4t-yCIt. St .J....j~<V, and , the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the will as witness and that to the best of his or her knowledge, the Testator was at the time eighteen (18) years of older, of sound mind and under no constraint or undue influence. ~~~~ &~,L~. WItness ~ >;.'J1Ik~ Witness Subscribed, sworn and acknowledged before me R",,-%r. ;1,.fo;,"<---- by ~LIAM T. SHANK, the Testator, and subscribed and sw to be ore me by ~t...Jt... St,~~4"" and , the witnesses, this~S"" day of 111.~ ,2000. Notary Public ~"-:mJ~~-~ OO.;.R1d r~i3;~.:. , H:N~V F. COYNE, i.f'::"~.i7 F<;S~;e Ham,.,don Twp., Cumb,'!'k:oj C':;l'r:y, ?A My Commluion E::pln.:$ .'Jf.;, i ,,/, 2000 i 3 ;\.:~t~ 'l'''' ,(' . ." : ,J' .: ':!"" J::';f)~ . ;..~:<,~ "t,.i; ',i; d',' . " " , '.' ,"" . '~\~~'.';'t,g,~ llJ.~-' . . ~ , '. . l'. ;jjj" 1\' ..~ . < A""1"~,..: """"", ~ . ,.' . J ' L ""~>IO, ~ . ~ j;":~ J . " I ," 'Ct, ~t 1 l'! ~~ '\': ~ \ f; .. ~ ~ i,_ ~ "~"':C,,,f< ,;';., 'i;!'ri.;f ~ ~" ~. ~ ,~:; 'if..