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HomeMy WebLinkAbout11-26-07 , ---I REV-1500 EX(06-05) P A Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 15056041158 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year 21 07 File Number 0175 ENTER DECEDENT INFORMATION BELOW Social Security Number 204-03-5562 Date of Death 02102007 Date of Birth 08051921 Decedent's Last Name BECKER Suffix Decedent's First Name GILBERT Ml M (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 BOXES BELOW [K] 1. Original Return o 4. Limited Estate [K] 6. Decedent Died Testate (Attach Copy of Will) o 9. Litigation Proceeds Received Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 1....... 8. Total Number of Safe Deposit Boxes Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Day1ime Telephone Number RICHARD C. SNELBAKER 717-697-8528 o 2. 04a. D 7. 010. Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy of Trust) Firm Name (If Applicable) SNELBAKER & BRENNEMAN, P.C. REGISTERaoJNILLS USedNLY ~_'J (''''':; First line of address 44 WEST MAIN STREET 1-1 ~) C.' , Second line of address p.o. BOX 318 - .~ ~I '-'.) City or Post Office MECHANICSBURG State PA ZIP Code 17055 DATE FILED " Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. '7 SIGNATURE OF PERS EXECUTRIX THAN REPRESENTATIVE :t~a<< 1520 FISHER RD., MECHANICSBURG, PA . Df-TE ( \ (j \oty 0 ADDRESS RICHARD C. SNELBAKER, ESQUIRE 44 WEST MAIN ST., MECHANICSBURG,PA PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041158 6M4647 2.000 15056041158 --.J ~ 15056042159 REV-1500 EX Decedent's NameB E eKE R RECAPITULATION 1. Real estate (Schedule A) 2. Stocks and Bonds (Schedule B) . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C). 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E). 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested 8. Total Gross Assets (total lines 1-7). . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H). 10. Debts of Decedent, Mortgage liabilities, & Liens (Schedule I). 11. Total Deductions (total Lines 9 & 10). . . . 12. Net Value of Estate (line 8 minus Line 11) . 13. Charitable and Governmental BequestslSec9113 Trusts for which an election to tax has not been made (Schedule J) . 14. Net Value Subject to Tax (Line 12 minus line 13) GILBERT Decedent's Social Security Number 204-03-5562 M . 1. 170000.00 . 2. 197313.60 . J. 0.00 . 4. 0.00 . . 5. 27838.90 . . 6. 0.00 . 7. 0.00 . 8. 395152.50 . 9. 19408.77 10. 2330.25 11. 21739.02 12. 373413.48 13. 0.00 14. 373413.48 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable al the spousal tax rate, or transfers uJSer Sec. 9116 (a)(1.2)X .0_ 0.00 16. Amount of Line 14Jaxable atlineal rate X .O':U;J 373413 . 4 8 17. Amount of Line 14 taxable at sibling rate X .12 0 . 00 18. Amount of Line 14 taxable at collateral rate X .15 0 . 00 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. FIL.L. IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042159 6M4648 2.000 15. 0.00 16. 16803.61 17. 0.00 1 B. 0.00 19. 16803.61 [K] 15056042159 ~ REV-1500 EX Page 3 . Decedent's Complete Address: File Number 0175 DECEDENTS NAME BECKER GILBERT M SffiEEf ADDRESS 303 SHEPHERDSTOWN ROAD MECHANICSBURG BORO, CUMBERLAND COUNTY CllY IISTATE I ZIP MECHANICSBURG PA 17055- Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 16803.61 0.00 0.00 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.00 TotallnteresllPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT. Fill in box 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) 16803.61 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 16803.61 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 . Did decedent make a transfer and: 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 death 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 own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes o o B o o o No [Xl 00 [Xl [Xl 00 [Xl [K] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE [T 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. 89116 (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 {OJ percent [72 P.S. 39116 (a) (1.1) (iill. 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. F or 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 use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. S9116(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. g9116{1.2) [72 P.S. S9116(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. S9116(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. 6M467\ 1.000 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE REV-1502 EX + (6-98) ESTATE OF FILE NUMBER Gilbert M. Becker 21 07 0175 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. DESCRIPTION VALUE AT DATE OF DEATH 170,000.00 Property known and numbered as 303 Shepherds town Road, Mechanicsburg Borough, Cumberland County, Mechanicsburg, PA. Sale value attached settlement sheet) (see 3W4695 1.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 170,000.00 A. SETTLEMENT STATEMENT U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD-1 OMB No. 2502-0265 B. T e of Loan 1.DFHA 2.0FmHA 3. DConv. Unins. 4. OVA 5. DConv. Ins. 6. File Number: RE07-123 7. Loan Number: 8. Mortgage Insurance Case Number: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational purposes and are not Included in the totals. D. Name and Address of Borrower(s): The Mechanicsburg Presbyterian Church E. Name and Address of Seller(s): The Estate of Gilbert M. Becker c/o Snelbaker & Brenneman F. Name and Address of Lender: David L. McGowan G. Property Location: 303 Shepherdstown Road, Mechanicsburg, Pennsylvania 17055 Mechanicsburg Borough, Cumberland County 17-24-0787-006 130 Clearview Place, Carlisle, PA 17013 Place of Seltiement: 1 Irvine Row, Carlisle, PA 17013 H. Name of Settlement Agent: Duncan & Hartman, P.C. 1. Settlement Date: 7-25-2007 Funding Date: 7-25-2007 7-25-2007 290.77 7-25-2007 to 7-25-2007 to 6-30-2008 9-30-2007 1 725.99 77.79 205. 505. Payoff of second mortgage loan 206. 506. 210. Cit Itown taxes 211. Count taxes 212. Assessments 508. 509. 208. 209. -'-:. ''1 - to to to 510. Cit Itown taxes 511. Count taxes 512. Assessments to to to 214. 215. To Borrower From Seller :-,. Paid From Borrowers Funds at Seltlement Paid From Seller's Funds at Settlement Duncan & Hartman P.C. 125.00 804. 806. 807. 808. 810. 811. 813. 814. 183.47 . ~' ~:i~ "~at.! .;,.;., "~I!1!lfif~.1f~t~,\~~'j~~J~~r~~t~~t; Duncan & Hartman P.C. 135.00 Premium $ Premium 1 208.75 1107. Altorney's fees to includes above item numbers: 1108. Title insurance to Snelbaker & Brenneman POC William A. Duncan, Agent for United General Title 1112. 1113. -!:i~,~~,'-.' '.' ~~.~~~.W!'~-.~~~~~~1 ~_~~~~~&~;J.l 86.50 1 700.00 1 700.00 1302.2007 Count fLocal R.E. Taxes 1303. Tax Certification 1305. 1400. Total Settlement Char es enter on lines 103 Section J and 502 Section K 3598.72 4286.71 CERTIFICATION: I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I r ceived a cqpy of the HUD-1 Settlement Statement. €.,s-f<<.-4.. Of c;; ~..t- "'. Uj e.1c tl r fMc.L rJud7~ el.uW1 'J/~r t? ~U't .blft~'trI- Signature of Borrower Signature of S6rrower Signature of Seller c..~. WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisionment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Gilbert M. Becker 21 07 0175 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPllON VALUE AT DATE OF DEATH 197,313.60 1PNC Financial Services Group 2,640 shares of common stock valued at $74.74 per share TOTAL (Also enter on line 2. Recaritulation) $ 197,313.60 3W46961.000 (If more space is needed, insert additional sheets of the same size) REV-150B EX + (6-98) COMMONVVEAL TH OF PENNSYL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Gilbert M. Becker FILE NUMBER 21 07 0175 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER rESCRIPTION VALUE AT DATE OF DEATH 1 1993 Buick Sedan automobile sale value 2,800.00 2 AT&T refund due the decedent on phone service 3.91 3 Comcast refund due the decedent on cable TV service 78.86 4 379.20 Conseco refund due decedent on long term care policy 5 Household goods retained by family 335.00 6 Household goods sold at public auction 4,103.00 7 59.10 Medicare refund due the decedent 8 Ohio Casualty refund due the decedent on auto and homeowner insurance policies 15.74 9 PNC Bank, N.A. savings account #5030009607 7,094.97 10 PNC Bank, N .A. checking account #5070076791 2,471.45 11 Sale of decedent's membership stock in Toboyne Oaks a Pennsylvania non-profit corporation 8,000.00 12 Service Master refund due the decedent on lawn maintenance services 153.33 13 Susquehanna Club Membership refund due decedent on membership 20.04 14 United States Treasury refund due decedent on 2006 form 1040 1,107.20 Total from continuation schedules . 1,217.10 3W46AD 1.000 TOTAL IAlso enter on line 5. Recanilulalionl $ (If more space is needed, insert additional sheets of the same size) 27,838.90 Estate of: Gilbert M. Becker Item No. 15 204-03-5562 Schedule E (Page 2) Description Value at Date of Death United States Treasury social security due the decedent from January 2007 1,217.10 Total (Carry forward to main schedule) 1,217.10 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gilbert M. Becker SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 07 0175 ITEM NUMBER A. B. 1. FUNERAL EXPENSES: Hollinger Funeral Home funeral services Debts of decedent must be reported on Schedule I. DESCRIPTION Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Claimant Street Address City Relationship of Claimant to Decedent 4. Probate Fees 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions State Zip Street Address City Year(s) Commission Paid: SNELBAKER & BRENNEMAN, P.C. 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3W46AG 1.000 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Borough of Mechanicsburg sewer/refuse service State Zip Total from continuation schedules TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ AMOUNT 5,388.38 5,550.00 360.00 213.64 7,896.75 19,408.77 Estate of: Gilbert M. Becker 204-03-5562 Schedule H Part 7 (Page 2) 2 Bricker's Auction commission and expenses associated with the sale of household goods 929.00 3 Cumberland Law Journal advertising Executrix Notice 75.00 4 Lester Hess & Co. basement and chimney repointing 725.00 5 Patriot News advertising Executrix Notice 147.90 6 PPL Electric electric service 95.22 7 Register of Wills filing fee for Inheritance Tax Return 15.00 8 RSR Appraisers & Analysts appraisal fee property located in Mechanicsburg 350.00 9 Settlement charges on sale of property in Mechanicsburg a. Transfer taxes - $1,700.00 b. School Taxes - $1,847.47 c. County Taxes - $734.24 d. Tax Certification - $5.00 4,286.71 10 UGI gas service 146.78 11 United Water Pennsylvania water service 65.18 12 Verizon internet service 60.96 13 Reserve for filing fees, accounting fees and other miscellaneous costs associated with the administration of decedent's estate 1,000.00 Total (Carry forward to main schedule) 7,896.75 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gilbert M. Becker SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 07 0175 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses_ ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Barry Heckard, Sr. 2007 personal tax 10.00 2 Cardio Surgical Institute medical services 6.49 3 Community Life Team ambulance service 40.45 4 Foot Care Center medical expense 25.16 5 Harrisburg Gastroenterology medical expense 159.81 6 Hershey Kidney medical expense 170.11 7 Internists of Central PA medical expense 333.26 8 Kilmore Eye medical expense 134.63 9 Lewis & Nada medical expense 3.22 10 Mechanicsburg Meals on Wheels check number 9102 written by decedent prior to death from PNC Bank checking account 72.00 11 Orthopedic Institute of PA medical expense 207.88 12 Pulmonary Critical Care medical expense 210.49 13 Penn Health Emergency medical expense 32.17 14 Pinnacle Health Hospital medical expense 38.24 Total from continuation schedules 886.34 3W46AH 2.000 2,330.25 TOTAL (Also enter on line 10, Recapilulation) $ (If more space is needed. insert additional sheets of the same size) Estate of: Gilbert M. Becker 204-03-5562 Schedule 1 (Page 2) Item No. Description Amount 15 Pinnacle Health Medical Services medical expense 297.54 16 PPL Electric electric service 62.46 17 Quantum Imaging medical expense 1. 68 18 Riverside Anesthesia medical expense 30.22 19 UGI gas service 457.90 20 United Water Pennsylvania water service 22.34 21 Vascular Associates medical expense 14.20 Total (Carry forward to main schedule) 886.34 REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gilbert M. Becker NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Tonya B. Mowery 1520 Fisher Road Mechanicsburg, PA 17055 1 All of Residue: 373,413.48 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter FILE NUMBER 21 07 0175 AMOUNT OR SHARE OF ESTATE 373,413.48 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 3W46AI 1.000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. 11 LAST WILL AND TESTAMENT I, GILBERT M. BECKER, of the Borough of Mechanicsburg, County of Cumberland, d Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at anytime heretofore made. FIRST. I order and direct that all my just debts and funeral expenses be paid by my Executrix or Executor, as the case may be, hereinafter named, as soon as conveniently may be done after my decease. SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, unto my daughter, namely, TONYA B. MOWERY, absolutely and in fee simple, if she survives me. THIRD. Ifmy said daughter, TONYA B. MOWERY, does not survive me, then and in that event, I give, devise and bequeath my said residuary estate unto my daughter's then living issue per stirpes by representation and not per capita, subject, however, to the protective trust provision as contained in Item Fourth hereinbelow with respect to any beneficiary who has not attained the age of twenty-five (25) years at the time of my death. FOURTH. If any beneficiary has not attained the age of twenty-five (25) years at the time of distribution, I order and direct that the foregoing shares attributable to such beneficiary shall be paid over anddelivered unto my Trustee, hereinafter named, as my testamentary tmstee, IN TRUST, NEVERTHELESS, to hold, manage, invest, accumulate income and reinvest for the benefit of said beneficiary and until said beneficiary attains the age of twenty-five (25) years, at which time said trust shall be temlinated and the net proceeds thereof shall be paid over to the beneficiary absolutely. I authorize and empower my said Trustee to invest the assets of said trust in any reasonable manner and not be limited or restricted to so-called "legal" or statutory investments for fiduciaries. I designate any trust hereunder to be a spend-thrift trust. The beneficiary shall have no right to invade, pledge, assign or otherwise dispose of the assets of said trust (including income) LAW OFFICES SNELBAKER & RENNEMAN. P.C. II lor shall any creditor of a beneficiary have any right to seize, levy or execute upon said assets by eason of any pledge, assignment or other transfer, voluntarily or involuntarily, made by said beneficiary. I further authorize and empower my said trustee to use, consume, expend, and apply from ime to time such amounts of income and principal of and from said trust which in the exercise of the Trustee's sole discretion shall be determined to be reasonable and necessary for the beneficiary's education. The term "education" shall be construed and interpreted to mean college or other post-high school training which is intended to improve the beneficiary's productivity as an adult or enhance the quality of his or her life. In considering 'what is reasonable and necessary, my said Trustee will take into consideration the primary responsibility of the beneficiary's parents or surviving parent to provide such education. It is my will and intention that the foregoing discretionary provision for education shall be supplementary to the parent's primary responsibility. LASTL Y. I nominate, constitute and appoint my daughter, namely, TONY A B. MOWERY, to be the Executrix ofthis, my Last Will and Testament, but if for any reason she sho.uld not qualify as such Executrix or cease so to serve, then and in that event, I nominate, constitute and appoint my son-in-law, namely, STEVEN E. MOWERY to be the Executor hereof and the Trustee of any trust created under Item.Fourth hereinabove, each and both of said persons to serve without bond or other security as a condition of qualification hereunder. IN WITNESS WHEREOF, I, GILBERT M. BECKER, have hereunto set my hand and seal to this my Last Will and Testament, which consists of two (2) typewritten pages to each of which I have affixed my signature this 14th day of September, A.D. Two Thousand Six (2006). ~~E~~""') (SEAL) The preceding instrument, consisting of this and one (1) other typewritten pages, each identifIed by the signature of the Testator, was on the date thereof signed, sealed, published and declared by GILBERT M. BECKER, the Testator therein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other, have sobscribed our names as witnesses berelD~ ~ J=~'~ ~2- . ~ .' .. LAW OFFICES SNEL8AKER & BRENNEMAN, P.C. OMMONWEAL TH OF PENNSYLVANIA) SS. OUNTY OF CUMBERLAND ) We, GILBERT M. BECKER, RICHARD C. SNELBAKER and JANE J. COONEY, the estato!' and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly swom, do hereby declare to the undersigned authority that the estator signed and executed the instrument as his Last Will and Testament and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of his or her knowledge, the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. b~'~ . WI ess Subscribed, sworn to and acknowledged before me by GILBERT M. BECKER, the Testator, and subscribed and swom to before me by RICHARD C. SNELBAKER and JANE J. COONEY, the witnesses, this 14th day of September, 2006. )~~oi 1~ Notary Public COMMONWEALTH OF PENNSYLVANIA Nolarial Seal SUsan L Malrazi, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Nov. 24, 2007 Member, Pennsylvania Assoclalion Of Notaries