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HomeMy WebLinkAbout05-03-07 (2),~,,.,~,a.~m, COMMOWYYEALTH OF PENVSyLVAN1A DEPARTMEIIr OF REVEN;IE oEPr. 7aoem FW2RISBURG, PA 17178-0801 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL Alderman, Arlene H Z DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) w 0 W 02/28/2007 06/27/1937 ~ QF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FRST AND MIDDLE INfnAL) 07 00250 SOCIAL SECURfIY NUMBER 202-28-3864 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER Q9 1. Original Return LJ 2. Supplemental Return U 3, rcemamaer rceam taare or seam poor w ~t-is-oq w a y ^ 4. Limited Estate ^ qa, FuWre Interest Compromise (date of death ^ 5. Federal Estate Tax Return Required after 12-12-82) _ ~ ~ v ® 6. Decederd Died Testate (Attach copy ^ 7. Decedent Maintained a Living Trust (Atach 0 8. Total Number of Safe Deposit Boxes a m of W i1Q copy of Trust) a ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death between ^ 11.Election to tax under Sec. 9113(A) (Attach Sch O) 12-31-91 and 1-1- THIS SEC770N MUST BE AME James M Robinson Wz ~ i IRM NAME (If applicable) ~ Turo Law Offices a LEPHONE NUMBER 717/245-9688 z 0 5 a U W 1. RBI Estate (Schedule A) (1) None 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None 4. Mortgages & Notes Receivable (Sc~tedule D) (4} None 5. Cash, Bank Deposits & Miscellaneous Personal Property (5} 9,845.62 (Schedule E) 6. Joirrtly Ovlmed Properly (Schedule F) (6) None ^ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (~ 722,743.43 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 32,207.21 10. Debts of Decedent, Mortgage Liabilitles, & Liens (Schedule I) (10) 359.07 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been roads (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL ldS6 ONLY _; __ _,y _ - I C..:r __ ~_5 r-~ ~._. !'.~ -- .. r ,i .~ (8) 732,589.05 (11) 32,566.28 (12) 700,022.77 (13) (14) 700,022.77 SEE INSTRlDCT10NS ON REVERSE SIDE FOR APPLICABLE RATES 1 g, Amount of Line 14 taxable at the spousal tax rate, x ,00 (15) or transfers under Sec. 9116(a)(1.2) °- 16.Amount of Line 14 taxable at lineal rate 680,022.77 x .045 (16) 30,601.02 a 0 17.AmouM of Line 14 taxable at sibling rate 20,000.00 x ,12 (17) 2,400.00 U 18. Amount of Line 14 taxable at collateral rate x .15 (18) t9. Tax Due (t9) 33,001.02 20. ^ • ~- • . • • •• .. » Brc? au. guESt~NSRE~ase`sroE aNO Rtcl~cK tuu-n~t « Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00} REV-1500 INHERITANCE TAX RETURN FILE NUMBER RESIDENT DECEDENT 21 couNrvc MAILING ADDRESS 28 South Pitt Street Carlisle, PA 17013 TO: Decedent's Complete Address: STREET ADDRESS 1700 N. Market Street CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if appligble D. Interest E. Penalty 1,650.05 (1) Total Credits (A + B + C} (2) 33,001.02 1,650.05 0.00 31,350.97 31,350.97 Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4} Check box on Page 1 Line 20 to request a refund 5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Eller the interest on the tax due. g. Eller the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGEM %w: f'' ~,~~;tir °' ~~ ~ ~ -i ,,spa t -- -._ ~,~a+~.~sswa, ~ti~ ~s+~ -~ ~ * ~, ~.C~~~-... A : ~i~ F . `kr v .- s^,1"a~~~et ., 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 :..................................................................................... b. retain the right to designate who shall use the property transferred or its income :......................................... c. retain a reversionary interest; or ..................................................................................................................... d. receive the promise for life of either payments, benefits or care? .................................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of d~th without ^ receiving adequate consideration? .......................................................................................................................... 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ............... ^ 4. Did decedent awn an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary desigrration? ........................................................................................................................ ® ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, l declare that I have examined this return, including acoomparrying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration d preparer other than the personal repiasentative is based on all information of which preparer has any Imowledge SIGNATURE OF PERSON RESPONSIBLE FOR FIUNG RETURN ADDRESS DATE J d. 1773 North Meadow Drive f >.~~,.,. .L :,z_~-. Mechancisburg, PA 17055 ~~ "~ ~~ ~ SIGNATll PER~SOnN R SIBL FOR FILING RETURN ADDRESS pA~ i ' c~~i' ~ ~ R~~r ~'` W r~ml~ b~, PA 117043 ~",`"- SI ATU OF P THAN REPR AT1VE ADDRESS p~`~ Jtaaes ~ 28 South Pitt Street sf t ~ v~ ' Carlisle, PA 17013 _. 2 For tes of death o 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 3% [72 P.S. §9116 (a) (1.1) (~]. 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 096 [72 P.S. §9116 (a} (1.1) (i~]_ The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for discbsure 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 0% [72 P.S. §9116 (a} (12)]. The tax rate imposed on the rTet value of transfers to or for the use of the decedent's lineal bertef~iaries is 4.5%, except as rested in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (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. SCHEDULE E CASH, BANK DEPOSITS, 8r, MISC. ~MTMOF~~ PERSONAL PROPERTY INHERfTANCE TA7C RETURN RESIDElIT DECEDENT ESTATE OF FILE NUMBER Alderman, Arlene H 21 - 07 -00250 Include the proceeds of litigation and the date the pproceeds were received by the estate. All property jointly-0wned with the right of survivorship must be disclosed on schedule F. . ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1 Wachovia Securities Investment Account 9,845.62 TOTAL (Also enter on Line 5, Recapitulation) I 9,845.62 SCHEDULE G INTER-VIVOS TRANSFERS ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCETAxREruRN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF Alderman, Arlene H FILE NUMBER 21 - 07 - 00250 This schedule must be tom leted anti filed rt the answer m an or ues><ions ~ rr~rou n a on e c ~s ITEM DESCRIPTION OF PROPERTY weir relationship to decedent and ttie date of transfer. Include ttie name of the transferee DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE VALUE NUMBER , Attach a copy d the deed for real estate. VALUE OF ASSET INTEREST QF APPLICABLE} 1 Merrill Lynch Investment Acct. 872-54002 267,052.90 100% 267,052.90 2 Merrill Lynch CMA for Trust Acct. 872-54012 455,690.53 100% 455,690.53 TOTAL (Also enter on line 7, Recapitulation) 722,743.43 CONMONNIEALTN of reaasr~vnNw INffRRANCE TA7C RETURN RESIDENT DECEDENT 9(~DULE H FUNERALEXPBVSES~ ADN~NSTRATNE CO5°T'S ESTATE OF Alderman, Arlene H FILE NUMBER 21 - 07 - 00250 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: 1 Neill Funeral Home 12,657.55 2 Theo's Bar ~ Grill -Post-funeral meal 1,244.13 3 Boscods -Clothes for burial 60.00 4 Pam's Flowers -Flowers for funeral 1,118.25 5 Richard J. Alderman -Travel Expenses Related to Funeral 120.00 B. ADMINISTRATNE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s}: Street Address City State Zip Year(s) Commission paid 2, Attorney's Foes Turo Law Offices 14,651.78 3. Famiy Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address CihT State Zip Relationship of Claimant to Decederrt 4. Probate Fees Register of Wills 545.00 Cumberland Law Journal 75.00 The Sentinel -Legal 158.81 5. Accountant's Fees 6. Tax Return Preparer's Fees Robert Kautz - 2005 to 2007 Returns 1,500.00 0.00 7. Other Administrative Costs 1 Staples -Files, boxes and Journal 76.69 TOTAL (Also enter on line 9, Recapitulation) 32,207.21 SCHEDULEI DEBTS OF DECEDENT, MORTGAGE C.OMMONWEALIH OF PENiS`lWANU. LIABILITIES, 8c LIENS IIi~RITANCE TAX RERIRN RESIDENT DECEDENT ESTATE OF Alderman, Arlene H I FILE NUMBER 21 - 07 - 00250 Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Neighbor Care Pharmacy 267.30 2 Health Network Laboratories 51.77 3 Heartland Pharmacy 40.00 TOTAL (Also enter on Line 10, Recapitulation) ~ 359.07 I, Arlene Alderman, currently of Cumberland County, Pennsylvania, declare this to be my last will and testament and revoke all prior wills and codicils made by me. 1. Personalty. I bequeath such items of my tangible personal property, as are specifically itemized on the list, if any, in my handwriting, signed and dated by me at the end thereof, and attached to this, my last will and testament, to the persons named thereon to receive such items. I bequeath to my children all of my remaining tangible personal property not used in business or for the production of income, including without limitation furniture, clothing, jewelry, objects of art and decoration, and the like, but not including motor vehicles which I own, together with the insurance thereon. With regard to the property passing hereunder, distribution shall be made among said children on the basis of choices in order determined by lot and rotation, and the values as finally determined for inheritance tax purposes shall be determinative with regard to the values of the property chosen, and any disparity among said children shall be equaled by such payments among them as may be necessary. If any one of said children are not living at the time of my death, the choices to which he or she would have been entitled shall be made by his or her issue in order determined by lot and rotation. 2. Special Bequests. (a) I bequeath one thousand (1,000} shares of Class A common stock of Pennsylvania Manufacturers Corporation to my brother, John W. Springer, if he survives me, and if he does not survive me, to his wife, Caron Springer, if she survives me. If do not hold any such stock at the time of my death, then I give to John W. Springer, if he survives me, the sum of Twenty Thousand Dollars ($20,000.00), and if he does not survive me, then I give such amount to Caron Springer, if she survives me. (b) I bequeath one thousand (1,000) shares of Class A common stock of Pennsylvania Manufacturers Corporation to each of my grandchildren, but not.including Maggie Alderman, David J. Alderman or Thomas Nagle, who received similar bequests under my deceased husband's will. If I do not hold any such stock at the time of my death, then I bequeath to each of my grandchildren the sum of Twenty-five Thousand Dollars ($25,000.00), other than Maggie Alderman, David J. Alderman or Thomas Nagle. 3. Residue. I bequeath, devise, and appoint all the rest of my property, of whatever nature and wherever situated, including property over which I hold a power of appointment, to my issue per stirpes, provided, however, that if any such issue other than a child of mine is then under the age of thirty-five (35} years, his or her share shall be held for him in a separate trust hereunder under the terms of paragraph 5 below, or, if no issue of mine are then living, the same shall be subject to the terms of paragraph 4 below. 4. Alternate Distribution. Any property held hereunder when no issue of mine are living which is not effectively disposed of elsewhere herein shall be distributed outright one-half per stirpes to the issue of my parents and one-half per stirpes to the issue of my husband's parents. 5. Separate.Trusts. The income and principal of a separate trust in which a share is held for a beneficiary pursuant to the terms of Article 3 above shall be distributed as follows: (a) Income. The income shall be distributed at least quarterly to or for the benefit of the beneficiary. No payment shall be made under this subparagraph (a) which would discharge to any extent the legal obligation of any person for the support of the beneficiary. (b) Principal. The trustees shall pay from the principal such sums to or for any or a!I of the beneficiary and his or her issue as in the discretion of the Trustees seems proper for their support, maintenance, health care, and education, and such sums to or for the benefit of the beneficiary as in the discretion of the Trustees seem proper to help establish him of her in a business or profession or to acquire or furnish a home for him or her, taking into account the other sources of income, support and estate that are available to the distributee, the reasonably anticipated needs and resources of the beneficiary and his or her issue, their income and estate tax brackets, the desirability of the transaction (if any), and the possible application of any generation- skipping tax. No payment shall be made under this subparagraph (b) which would discharge to any extent the legal obligation of any person for the support of the distributee. (c) Distribution of Separate Trust. li) When such beneficiary shall have attained the age of twenty- ve (25} years, the Trustees shall distribute to him or her at written request one-third (1/3) of the remaining principal balance then held in his or her separate trust; when such beneficiary shall have attained the age of thirty (30) years, the Trustees shall distribute to him or her at written request one-half (1/2) of the remaining principal balance; and when such beneficiary shall have attained the age of thirty-five (35) years, the Trustees shall distribute to him or her at written request the entire balance held in his or her separate trust. (ii) If such beneficiary should die before making proper request for the entire balance in his or her separate trust, then the entire balance in his or her separate trust shall at his or her death be distributed, outright or in trust, I such sums or proportions as such benef+ciary may direct in his or her last will, expressly referring to his or her separate trust hereunder, but only among my issue and their spouses or ~~ ` ;'~ former spouses and persons gifts to whom are then allowable as deductions under Section 2055 of the Internal Revenue Code (or any successor provision); and to the extent that such beneficiary shall fail to exercise effectively his or her limited power of appointment hereunder, the aforementioned balance in his or her separate trust shall then be distributed per stirpes to his or her issue, or, if no such issue survive him or her, per stirpes to the issue of his or her parent who was a child or more remote descendant of mine, or, if no such issue survive him or her, per stirpes to my issue, with the share of any of such issue for whom property is then held in or payable to a separate trust under this paragraph 5 being added to such separate trust, or, if no issue of mine are then living, said balance shall be subject to the provisions of paragraph 4 above. (d) Disposition Upon Application of Rule Against Perpetuities. If during the lifetime of a person for whom a separate trust under this paragraph 5 was established the interest of such person therein becomes void under the applicable rule against perpetuities, then the balance in such separate trust shall then be distributed outright to such person. 6. Survival Clause. If any beneficiary hereunder should die within sixty (60) days after me or within sixty (60) days after any other person the survival of whom determines his or her rights hereunder, then such beneficiary shall be deemed to have predeceased me or such person for all purposes hereunder. 7. Powers. In addition to such other powers and duties as may be granted elsewhere herein or which may be granted by law, the fiduciaries hereunder shall have the following powers and duties, without the necessity of notice to or consent by any Court: (a) To retain all or any part of my property, real or personal, in the form in which it may be held at the time of its receipt, including any closely held business in which I have an interest and any stock of any corporate fiduciary hereunder, as long as in the exercise of their discretion it may be advisable so to do, notwithstanding that said property may not be of a character authorized by law, provided, however, that upon written request by my husband, they shall within a reasonable time make productive of income any interest in property (however and whenever acquired) held in Trust A hereunder. (b) To invest and reinvest any funds held hereunder in any property, real or personal, including, but not by way of limitation, bonds, preferred stocks, common stocks, and other securities of domestic or foreign corporations or investment trusts, mortgages or mortgage participations, and common trust funds, even though such property would not be considered appropriate or legal for a fiduciary apart from this provision. (c) To sell, convey, exchange, partition, give options to buy or lease upon, or otherwise dispose of any property, real or personal, at any time held by them, with or without order of court at their option, at public or private sale or otherwise, for cash or other consideration or for such credit terms as they think proper, and upon such terms and for such prices as they may determine, and to convey such property free of all trusts. -~~~~ ~,, ., ;~ _~ (d) To borrow money from any person, including any fiduciary hereunder, for any purpose in connection with the administration hereof, to execute promissory notes or other obligations for amount so borrowed, and to secure the payments of such amounts by mortgages or pledges of any property, real or personal, which may be held hereunder. (e) To make loans, secured or unsecured, in such amounts, upon such terms, at such rates of interest, and to such persons, firms or corporation as they may deem advisable. (f) To renew or extend the time for payment of any obligation, secured or unsecured, payable to or by them, for as long a period of time and on such terms, as they may determine, and to adjust, settle and arbitrate claims or demands in favor of or against them. (g) In dividing or distributing any property, real or personal, included herein, to divide or distribute in cash, in kind, or partly in cash and partly in kind. (h) To hold, manage, and develop any real estate which may be held by them at any time, to mortgage any such property in such amounts and on such terms as they may deem advisable, to lease any such property for such term or terms, and upon such conditions and rentals as they may deem advisable, whether or not the term of any such (ease shall exceed the period permitted by law or the probable period of retention under this instrument; to make repairs, replacements and improvements, structural and otherwise, in connection with any such property, to abandon any such property which they may deem to be worthless or not of sufficient value to warrant keeping or protecting, and to permit any such property to be lost by tax sale or any other proceedings. (i) To employ such brokers, banks, custodians, investment counsel, attorneys, and other agents, and to delegate to them such duties, rights and powers as they may determine, and for such periods as they think fit. (j) To register any securities at any time in their names as fiduciary, or in the names of nominees, with or without indicating the trust character of the securities so registered. (k) With respect to any securities held hereunder, to -vote upon any proposition or election at any meeting of the person or entity issuing such securities, and to grant proxies, discretionary or otherwise, to vote at any such meeting; to join or become a party to any reorganization, readjustment, merger, voting trust, consolidation or exchange, and to deposit any such securities with any committee, depository, trustee or otherwise, and to pay out of the trust created herein, any fees, expenses, and assessments incurred in connection therewith; to exercise any new securities issued as a result of any such reorganization, readjustment, merger, voting trust, consolidation, exchange or exercise of conversion, subscription or other rights and generally to take all action with respect to any such securities as could be taken by the absolute owner thereof. (I) To engage in sales, leases, loans, and other transaction with my estate, the estate of my husband, or any trust established by either of us, even if they are also fiduciaries or beneficiaries thereof. (m) To make all necessary proofs of death under the insurance policies of which they are the beneficiary, to execute any receipts for the proceedsatad t~ institute ~~~~ ~ ~ ~ ~_ .. any action to collect said proceeds and to make adjustments of any claim thereunder, provided, however, that they need not institute any action unless they shall have been indemnified against all expenses and liabilities to which they may become subject as a result thereof. If, however, they desire to institute such action without indemnification, they are hereby authorized to be reimbursed for all expenses and liabilities incurred as a result thereof from any amount which may be held in trust. hereunder then or thereafter. (n} To exercise all elections which they may have with respect to income, gift, estate, inheritance or other taxes, including without limitation execution of joint income tax returns, election to deduct expenses in computing one tax or another, election to split gifts, and election to pay or to defer payment of any tax, in all events without their being bound to require contribution from any other person. (o) To operate, own, or develop any business or property held hereunder in any form, including without limitation sole proprietorship, limited or general partnership, corporation, association, tenancy in common, condominium, or any other, whether or not they have restricted or no management rights, as they in their discretion think best. 8. Spendthrift Clause. No interest (whether in income or principal, whether or not a remainder interest, and whether vested or contingent) of any beneficiary hereunder shall be subject to anticipation, pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have power in any manner to charge or encumber his or her said interest, nor shall the said interest of any beneficiary be liable or subject in any manner while in the possession of the fiduciaries for any liability of .such beneficiary, whether such liability arises from his or her debts, contracts, torts, or other engagements of any type. 9. Facility of Payments for Minors or Incompetents. Any amounts or property which are payable or distributable hereunder to a minor or incompetent may, at the discretion of the fiduciaries, be paid to the parent or guardian of such minor or incompetent, to the person with whom such minor or incompetent resides, or directly to such minor or incompetent, or may be applied for the use or benefit of such minor or incompetent. 10. Taxes. I direct that all estate, inheritance, and succession taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, other than generation-skipping taxes, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration, except that any such additional taxes (and interest and penalties thereon) imposed on account of my interest in or power over any trust established by my husband shall be paid out of the property held in such trust, and all other property includable in my taxable estate for federal or state tax purposes, whether or not passing under this will, shall be free and clear thereof; provided, however, that my executors may in the discretion of the executors request that any portion or all of said taxes (to be paid our of the principal of my general estate) shall instead be paid out of the principal of any trust established by me in this will or otherwise, to the extent expressly authorized under the terms of said trust. ~~ ~.~ V"' 11. Fiduciaries. I appoint as executors my sons, James J. Alderman, currently of Mechanicsburg, Pennsylvania, and Michael J. Alderman, currently of Camp Hill, Pennsylvania. If either James or Michael is unable or unwilling to serve as executor, then my son, Daniel J. Alderman, shall service in his place. I appoint as Trustee hereunder (if necessary) my son, James J. Alderman. If he should be unable or unwilling to serve or to complete the administration of any trust hereunder, then Michael J. Alderman shall serve as Trustee, and if Michael J. Alderman is unable or unwilling to serve as Trustee, then Daniel J. Alderman shall serve as Trustee. No individual fiduciary shall be liable for the acts, omissions or defaults of any agent appointed and retained with due care or of any co-fiduciary. No fiduciary shall be required to furnish bond or other security for the proper performance of duties hereunder. IN WITNESS V1(HEREOF, I have hereunto set my hand to this my Last Will and Testament this _~' ~' `' day of -a;;~~' _, 2004. / ~~ ,~. Wit ` s ~ ~ ~ ..,~ , r.-.., . t Arlene Alderman ~' ~,~~ Witness ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA :SS COUNTY OF CUMBERLAND !, Arlene Alderman, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to the law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. .~ ~ ~~ Arlene Alderman Sworn or aff~med and acknowledged before me by Arlene Alderman, the Testatrix, this ~ day of ~ ~'~, , 2004. rrorarw. sfiu .wars tVobn- R,bYc eona~,couNnroFCU. My ccn+tnWlore Expk~.kn ?, 2o0a ~/(~~. Notary Pu ~` is ~ .-i AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA :SS COUNTY OF-CUMBERLAND ,• ,. ,. We, ~ ~`C ~(_~'i~.e.~a and the witnesses whose nam, are attached to the foregoing document, being duly q lifted according to the law, do depose and say that we were present and saw Testat sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Last Will and Testament as witnesses and that to the best of our knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. f /,< ,~ ~- '`r /y.. V ~ ~' r, ~ ,-(~~~ e , Sworn or affirmed and subscribed before,~e by ~rh-~v.- ~~L'~= and " s t::rt ~-~~ r7~ r~,~.~<r~~,~ this 1 ~''"j~ day of ~ 1'~~..c.~~--~ , 2004. - , ~r s ~ttt~,uw ~Y Ribac oa~rtvoF My CpM11MIb1- Explr~ .lun 7.2004 Notary!Publi