HomeMy WebLinkAbout01-22-08
--.J
15[]5b[]41147
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 2 1 0 7
789
Date of Birth
197 26 4892
08 03 2007
10 24 1934
LANDIS
LOUISE
MI
J
Decedent's Last Name
Suffix
Decedent's First Name
(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
[!J 1. Original Return D 2. Supplemental Return 0 3. Remainder Return (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
[K] 6. Decedent Died Testate D 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
0 9. Litigation Proceeds Received 0 10 Spousal Poverty Credit idate of death 0, 11.Election to tax under Sec. 9113(A)
. between 12-31-91 and -1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
MICHAEL L. BANGS 717 730 7310
Firm Name (If Applicable)
{--
~ ~,
.- -- ....
REGISTER OF WILLS US ec:aN L Y
..... t (
429 SOUTH 18TH STREET
.)
First line of address
: t
-.-J
Second line of address
~~J
DATE FILED
, '-.I
r>J
City or Post Office
CAMP HILL
State
PA
ZIP Code
17011
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.
ATURE OF ON RESPONSIBLE FOR FILING RETURN DATE
Joseph M. Landis
Michael L. Bangs
DATE
:<Jr... ~o\ J
429 South 18th Street, Camp Hill, PA 17011
Side 1
L
:L5[]56[]41147
15[]56[]4:L:L47
~
~0
-1
1505bOlf21lf8
REV-1500 EX
Decedent's Name: Louise J. Landis
Decedent's Social Security Number
197 26 4892
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) D Separate Billing Requested.............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D 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, of
transfers under Sec. 9116
(a)(1.2) X ~
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 1 '4i'aXable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
0.00
15.
197,734.01
16.
0.00
17.
0.00
18.
19. Tax Due....... ....................... .... .............. .......... .............. ......... ....... ......... ............... ..... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
L
Side 2
150560421411
79,074.68
13,625.36
132,492.34
225,192.38
25,523.26
1,935.11
27,458.37
197,734.01
197,734.01
0.00
8,898.03
0.00
0.00
8,898.03
D
150560421...11
---I
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-07-789
DECEDENT'S NAME
Louise J. Landis
STREET ADDRESS
28 Tory Circle
CITY I STATE !ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
8,898.03
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
0.00
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 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.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(58)
8,898.03
8,898.03
Make Check Payable to: REGISTER OF WILLS, AGENT
.~ ~ _ -~_..L r~ _\ _J_l ~....~:....-\.:..~~- ::'i~t ,_~~~, J.. ~,.- ~l ".J T~I t'~_l ..~~ j t. A~ r_ ..,. _I.. r,.~-": :.<;J~!:::..l:r:g.t~~.2:.l1.:'-...;....:: 'rt 'I h~~~lvr"l ~J:rt..,r 4~
_.l:~i
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
B B
o 0
o 0
o 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. 0 D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property Which
contains a beneficiary designation?. .................... ...... .................................... ...................... ............. ............. .... .... 0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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?................... ................... ........................ ............... ........... ...... ...........................
Yes
-- ,- _ - _ -::;:~-: _.~::'4;;~.-:=+d..- ::~_ . '!~-L ~-t --tl-:;i:h~~~,,~~ _ nt~f.:~-.:-=' ~+::.~t~1 f--:-rt~L~~~j~:~.t~:t: ~~-; ;...1 J~:i -. r:+1_'_; t t 1.. 1- ~-.ci$f:tL~t -..I ~rv~ ..~~l~l~ h l -'lit h~l-ffil,k-'j: t -. -!ft.' ':n;<=:~~::.--.~~
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 exemot 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. 99116 (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. 99116 1.2) [72 P.S. 99116 (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. 99116 (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+ (6-98)
*'
SCHEDULE A
REAL ESTATE
COMMONWEAllll Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Landis, Louise J.
FILE NUMBER
21-07-789
ESTATE OF
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 jolntly-owned with right of survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Real Estate - 28 Tory Circle, Enola, Pennsylvania. Property was sold on November
30,2007 (see settlement sheet attached)
79.074.68
TOTAL (Also enter on line 1, Recapitulation)
79.074.68
(If more space is needed, additional pages ofthe same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
Rev-1508 EX+ (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEAl. TH OF PENNSYLVANIA
II'fiERITANCE TAX RETlJRN
RESIDENT DECEDENT
Landis, Louise J.
FILE NUMBER
21-07 -789
ESTATE OF
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 DESCRIPTION
1 2006 Property tax/rent rebate
VALUE AT DATE
OF DEATH
500.00
2 Automobile - Sale of 1995 Plymouth Van (see Bill of Sale)
1,700.00
3 Cash
22.57
4 Jewelry - Diamond Jewelry (see appraisal)
995.00
5 Jewelry - Miscellaneous costume jewelry (see appraisal)
590.00
6 Mutual Service Corporation/Pershing -Individual Account (paid to estate)
4.372.00
7 Refund - cancelation of policy from The Hartford Insurance (automobile insurance)
45.00
8 Commerce Bank - Checking Account
587.97
9 Commerce Bank - Savings Account
4,766.42
10 Refund from Comcast Cable
46.40
TOTAL (Also enter on Line 5, Recapitulation)
13,625.36
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rev-1510 EX+ (6-98)
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEAL lli OF PENNSYLVANIA
ItfiERITANCE TAX RE'TtIRN
RESIDENT DECEDENT
ESTATE OF
Landis, Louise J.
FILE NUMBER
21-07-789
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.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S TAXABLE
EXCLUSION
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDeNT AND VALUE OF ASSET INTEREST IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 Mutual Service Corporation - IRA Account 23.311.00 23.311.00
3VJ-215375. This IRA was comprised of three
assets:
1. Certificate of Deposit valued at $8,991.18
2. 458.159 shares of CSIBX Mutual fund valued at
$15.83 per share for a total of $7,252
3. 775.831 shares of ESAAX valued at $9.24 per
share for a total of $7,168.
The total of all assets in IRA equals $23,311.
2 Prudential Annuity Contract E0187247 109.181.34 109,181.34
TOTAL (Also enter on Line 7, Recapitulation) 132.492.34
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule G (Rev. 6-98)
REV-1151 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Landis, Louise J.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-07 -789
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 5,211.06
B. ADMINISTRA riVE COSTS:
1. Personal Representative's Commissions
Joseph M. Landis
Social Security Number(s) I EIN Number of Personal Representative(s):
158-48-5302
Street Address 12 Eisenhower Blvd.
City Duncannon State PA Zip 17020
-
Year(s) Commission paid 8,500.00
2. Attorney's Fees Michael L. Bangs 8,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 364.00
5. Accountant's Fees
6. Tax Return Preparer's Fees 750.00
7. Other Administrative Costs 2,198.20
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 25,523.26
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEAllM OF PENNSYLVANIA
l'*iERITANCE TAX RETURN
RESIDEHr DECEDENT
Landis, Louise J.
IFILE NUMBER
I 21-07 -789
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 Richardson Funeral Home, Inc.
AMOUNT
5.211.06
Subtotal
5.211.06
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
'*
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMON\I\IEALTH OF P~SYLVANIA
IN-tERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Landis, Louise J.
FILE NUMBER
21-t>7 -789
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Chuck Bricker, Auctioneer - appraisal of miscellaneous personal property of
decedent
90.00
2 Cumberland Law Journal 75.00
3 Joseph M. Landis - reimbursement for carpet cleaning 54.03
4 Joseph M. Landis - Reimbursement for out of pocket expenses associated with 109.58
------:__ L_____ ~__ __I_
S Katherine Barbagallo - Reimbursement for payment of jewelry appraisal 190.46
6 PA American Water - 8/15/07 to 9/17/07 17.79
7 PAWC - 9/17/07 to 10/16/07 18.54
8 PAWC -10/16/07 to 11/15/07 18.74
9 PP&L Electric - 8/21/07 to 9/21/07 23.48
10 PP&L Electric - 9/21/07 to 10/22/07 22.25
11 PP&L Electric - 10/22/07 to 11/20/07 18.39
12 PP&L Electric - Final Bill 5.27
13 Sandra Feigley, Inc. - painting at residence 480.00
14 Sun Trust Mortgage - September and October, 2007 payments plus late fee 923.85
15 The Sentinel 126.70
16 UGI- 7/26/07 to 9/24/07 7.05
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENISYlVANIA
INiERITANCE TAX REl1JRN
RESIDENT DECEDENT
Landis, Louise J.
FILE NUMBER
21-07 -789
ESTATE OF
ITEM
NUMBER DESCRIPTION
17 UGI - 9/24/07 to 10/23/07
AMOUNT
14.55
18 UGI - Final bill
2.52
Subtotal
2.198.20
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1~12 EX+ (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF P9IoISYlVANIA
II*iERITANCE TAX REllJRN
RESIDENT DECEDENT
Landis, Louise J.
FILE NUMBER
21-07-789
ESTATE OF
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 AARP Health Care
VALUE AT DATE
OF DEATH
145.75
2 AT&T
39.26
3 Chase Card Services
92.17
4 Chase Card Services
15.00
5 Chase Card Services
2.14
6 Comcast Cable
49.60
7 PA American Water -7/17/07 to 8/15/07
28.42
8 PP&L Electric -7/23/07 to 8/21/07
66.36
9 Quantum Imaging & Therapeutic Assoc.
243.94
10 SunTrust - Mortgage payments for July and August, 2007
907.24
11 SunTrust - Escrow account shortage due
265.94
12 T. Mobile
24.64
13 UGI - 7/26/07 to 8/23/07
17.17
14 Verizon
37.48
TOTAL (Also enter on Line 10, Recapitulation)
1,935.11
(If more space is needed, additional pages ofthe same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9~)
'*
SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Landis, Louise J.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
aistributions, and transfers
under Sec. 9116(a)(1.2)}
Katharine Barbagallo
31 Washburne Drive
Bertin, NJ 08009
FILE NUMBER
21-07 -789
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not List Trusteelsl
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Daughter
one-third of
residue
Joseph M. Landis
12 Eisenhower Blvd.
Duncannon, PA 17020
Son
one-third of
residue
Louis Landis
79 Nater Street
Ashland, PA 17921-1925
Son
one-third of
residue
Total
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
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
PWVUU6 editiooo al~ t>hwldftt
tOlm HtJD..1 (3186)....f H..ldbook 4305.2
,l\ Settlement Statement
u.s. Department of Housing and Urban Development
~~ of loan OMB ADoroval No. 2502-0265 (expires 11/3012~
1. [,JFHA 2 n, FmHA 3. OConv. Unins.. 16. Rle Number 17. Loao Number 18. foklrtgage Insurance Case Number
4. OVA 5. OCOIW Ins. MSS.1136 601925879
~~ '''1&'0<111 's lumlSll8<llo gl\le VOU a st81ett1ill1, '" ..,WlI1iiill$meIlTcilSIS. _Ill.. palO 10 alll oy VIe SlIl11emlllll age....." """"".
C, Note Il~n'" n...'ktnl ~(fl.O.c.r were paid llUlsiQe lhe clo$ing; lhey are shooM1 here lor IoIomBrran plI'p06e5 alld ale nol i.lCIuded in lhe lotals.
WARNlNG.IIl$ a Cf""" IiJ kna...."gly lI..k.. falsas/alemcnlsto IIlc Uniled Sial.... on lhiso< any OIIle. 5ImIbr roon. Penal"'" upon
._____~"'!.r~~~lUde ....Ii!'.. il/ld Imprisonmen!. For delllilo _: nle 18 U S. Code Section 1001 and Section tala
I TitleExpress Settlement System
Prinled t 113Of2007.ill..Hi:MR..
D. NAME OF BORROWER HEMANT H. AMIN and SIMA H. AMIN
__ADDRESL..
E NAME OF SELLER EST ATE OF LOUISE J. LANDIS,JOSEPH M. LANDIS, EXECUTOR
ADDRESS:
~~-NAME OF LENDER~'--COMMUNITY BANKS
1-_ ADDRESS: 150 MARKET STREET, MILLERBURG, PA 17061
G. PROPERTY ADDRESS: 28 TORY CIRCLE, Enola, PA 17025
1-----__ East Pennsboro Township
H. SETTLEMENT AGENT: Mobile Settlement Services, Inc., Telephone: 610.789.3636 Fax: 610.957.5331
_ ..fLAcg,Qf~f;TTLEMENL_J~~ Township line Rd.. PMB 302, Orexeltllit'pa 1~9~_____~___
I SffiLEMENT DA TE. 11/3012007
~~=----=_ J. SUMMARY OF BORROWER'S TRANSACTION:
..JQ9.:ggQSS ~MOU~T DUE FROM BORROWER
..JQL__Conlract~lespr~____
.....102. Personal PrOD!L~.
t 03 Settlement charQes to borrower (line 14001
.J!M....____.._ .._~___
..JQL.---
--
----..---------------.--
4.997.81
K. SUMMARY OF SELLER'S TRANSACTION:
400. GROSS AMOUNT DUE TO SELLER
401. Contract sales lIIice
402. Personal Prooertv
403.
404.
405.
13~~
133.500.00
--
__ Adjustments for items paid by seiter In advance
100. Citvllown taxes 11/30/07 to 12/31107
_.!QL..~ounty taxes__
108 Assessments
~~tiOOL
110. WATERlSWR
,,,JJL____ ____.
~__:L1L____
1--120. GROSS AMOUNT DUE FROM BORROWER
I-JOO...AM.Q~~I~P'_'lQ BY"OR _~" 8EH"ALF QF BORROWER
201. Oeoosil or eamest money
202 Principal amounl of new loans
~. ExistinQ Ioan( 5) laken subject to
_fM___ ______,_" _______._____
30.77
406
407-
408.
409.
410.
41t
412.
420. GROSS AMOUNT DUE TO SElLER
500. REDUCTIONS IN AMOUNT DUE TO SELLER
501. Excess Deoosit (see instructionsl
502 Se"lement cha-oes to seller lIine 14001
503. Existinn loan( 5 \ taken sumact to
504. Pavolf:0201452893
SUNTRUST MORTGAGE
Adjustments for items paid by seller in adyance
Cilvltown laxes 11/301071012/31/07
County taxes
Assessments
SCHOOL
WA TERlSWR
30.77
-------_.._--
11/30/07 to 06/30/08
11/30/071012/31/07
726.52
38.75
11130/07 to 06130108
11/30107 to 12/31/07
726.52
38.75
139 293.85
--
. 13~J.~&4.
3 000.00
100125.00
~5.00_
____.AM~:~~
1-----------..- .__,,______..________
JQL----
~-
. 207. ______
208.
~~--_.--
_________.___Ml!:latmentafor itema unpaid bv seller
210. Cltyltown taxes
211. GolH1!Y taxes
212. Assessmenls
~!L
_.~J!...._____
215.
216.
217.
~_..
219.
120. TOTAL P~lQJ!'(/FOR BORROWER
300. CASH AT SETTLEMENT FROM OR TO BORROWER
30 1. G;~;~~lnt due from borrower Woo 120\
~~oi' - Less af!1ounts paid bylfor borrower mne 2201
505.
506.
507.
508.
509.
--
Adiuatmenta for items un'paI~_!?y'sell~~____
Citv/town taxes
Gounlv laxes
Assessments
103125.00
510.
511.
512.
513.
514.
515.
516.
517.
518.
519.
520. TOTAL REDUCTION AMOUNT DUE SELLER 1.-....___ 55,221 :31
600. CASH AT SETTLEMENT TO OR FROM SELLER
601. Gross amounl due to seller (line 420)
602. Less reduction amount due seller (line 5201
--------
--
._-
139 293.85
103125.00
13~296.<!4.
55,2~1J!.
L 303. CASH _fROM BORROWER
I
36 188.85 603. CASH TO SELLER
I
79m:t6~_
SUBSllTUlE FORM '1099 SEUER STAlaAENT: The inf"""..U03n oonIeined herein i6 ~"'"' lax inf<>mBIlon and is being rumlshed to lhalnlernal Rowe""" Same... II YOUHfernquimd kJ role a .<Jlum.
~::,,~::,::,,~~:~:Sht-::;' ~;::'':~b=~'''' item is IllqUinld 10 be mpccled and ltle IRS dele..........1haI ~ has nd bee" reported. The ConIng Sales P1U described ""
You Ill" ",quirtld bv !.lwlu p'ovld~!he ....."''''''111 agent (Fed Tax 10 No: ____ _ " " _.. , )1,"''' your coned laxpayer idenlilicalion numIler.llyou do no! ",ovlde you1ComICI IaxpayelldenliflCallOn
numbo.. you Ill"Y 00 subl""C 103 civij or Cltminal penaNies 1mpo6ed by Iaw_ ~ ~.I retliy IIra\ !\,~r ll/lOHIl on Ihis ~emenl ~ '...payel idenlirlCalion numbe(
TIN. ______.._ "__.___ '_'_ - _ "__ SE\.LER(S)SIGNATlRE(S _ Y V{.~ ~ ._____
SElLERIS) NEWWUllNG AOORESS _U_'i 'S" i "?t A ~. t 1/;>><:' A /'A ". to ~ _____
SElLER(S) I'tOE NUMBERS: (H) (7/)\) :] O' "..] I e
Previous editions are obsolete
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
File Number: MSs..1136
form HLO-1 (3/86) no! Handbook 4305.2
PAGE 2
TilleExoress Settlement System Printed 1113012007 at 16:38 PR
L. SETTLEMENT CHARGES PAID FROM PAID FROM
700. TOTAl SALES/BROKER'S COMMISSION based on price $133500.00 fil5.000 = 6.675.00 BORROWER'S SELLER'S
Division of commission lIine 700\ as follows: FUNDS AT FUNDS AT
701 $ 3312.50 10 THE HOMESTEAD GROUP INC. SETTLEMENT SETTLEMENT
702. $ 3 362.50 to LAWYERSREALTY.LLC
703. Commission paid at Settlement ---1.675J)~
BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN --
801. LOiIl Ori!lination Fee %
802. Loan Discoont %
803. Appraisal Fee 10 DIVERSIFIED APPRAISAL SERVICES LR 300.00
804. Credit ~ to EQUIFAX LR 32.16
805. mers fee 10 COMMUNITY BANKS LR 9.90
806. PROCESSING FEE to COMMUNITY BANKS LR 345.00
807. COURIER FEE to COMMUNITY BANKS LR 20.00
808. DOC PREP to COMMUNITY BANKS LR 200.00
809. UNDERWRITING FEE to COMMUNITY BANKS LR 320.00
810. FLOOD TRACKING LIFE OF LOAN LSI LR 4.00
811. FLOOD CERT 10 LSI LR 8.00 .-
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
001 Interest From 11/3012007 to 12/0112007 @$ 17.1305 Id:w 1 Days LR 17 .73
902. Mortoaae Insurance Premium for to
903. Hazard Insura1Ce Premium for 1 to LIBERTY MUTUAL (P.O.C.) 295.00 Buyer
904. INVESTOR FEE to COMMUNITY BANKS LR 150.00
005. TAX SER FEE to COMMUNITY BANKS LR 85.00
1000. RESERVES DEPOSITED WITH lENDER FOR
1001. Hazard InsuralCe 3 mo. em. $ 24.58 lmo LR 73.74
1002. MortQaOe Insurcn;e mo.@$ lmo
1003. Cilv Prooertv Tax 10 mo. (Q) $ 9.45 lmo LR 94.50
1004. Counlv ProoerJyJax 10 mo. @. $ 21.36 lmo LR 213.60
1005. Amual Assessments mo. @. $ 1100
1006. SCHOOL 6 mo. tal $ 136.96 lmo LR 821.76
1009. AQ!J8Qate Ancivsis Adjustment to COMMUNITY BANKS LR .3<<.46 0,91
1100. TITLE CHARGES
1101. Settlement or closina fee
1102. Abstract or title seach
1103. Tifte el\ilnination
1104. Tide insurCllCe binder l
1105. Document Preoaralion
1106. NotiIV Fees 10 Mobile Settlement Servic:es. Ine. 25.00 I
1107. Attorney's fees
c----- ~udes OOove items No: I
1108. Tide InsurlllCe 10 Mobile Settlement Services, Inc. 925.88
(includes lilove items No: I
1109. Lender's Policv 100.125.00 .
1110. Owner's Policv 133.500.00 . 925.88 --
1111. 100 No Viol-'.-300 SUMlv. 900 E to Mobile Settlement Services. Inc. 150.00
1112. OVERNIGHTIWIRE to Mobile Settlement Services tne. 40.00 20.00
1113. ClosinaSvcltr 10 Mobile Settlement ServIces Inc. 35.00
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
..J~1. Recordina Fees Deed $ 38.50 . MJrtQaQe $ 72.50 . Releac;e S 111.00
1202. CilvlCountv taxfstamDs Deed $1.335.00 . Mlrl.ai:KJe $ 1 335.00
1203. Stale T axlstamos Deed $1.335.00 . Mlrtaaae $ 1 335.00
1204.
--.1405.
1300. ADDITIONAL SETllEMENT CHARGES
1301. SUIV9V --
1 ~ Pesllnsoection --
1303. HOME WARRANTY 10 AHS 355.00
~_ 'MJ7 twpIcountyfSCHOOL to DEBORAH A. LUPOlD COLLECTOR POC $2013.25
1305. SEWER SANITATION to EAST PENNSBORO TOWNSHIP 25.00
1400. TOTAL SETTlEMENT CHARGES Center on lines 103 Section J and 502 Section Kl 4997.81 8.385.00
HUD CERTlFlCAllON OF BUYER AND SEI.1.ER
r have ....e/ully ""'_ the. HUO-1 Sell_I Stalemenl and 10 the best ri rnr ~ and belief, . Is e true and BCCllI1Ile s1a18m8nl or 81 mcaipls and di5bu"""""",,, mad" on my ..aXIl",t
or by me in Ihis lransadioo. Ilurt...... c:e<1ily WI have _ed 8 copy 01100 HlJD.1 SeUIenw1I Sl9lemenl.
--.~:_~~... ~ ------"~
------:~ "
...----"
--'
~..~.::c::..:':':::'::':
.~~
Ml:.MAN I N. AMN
b..... n. IWIIN
..:;,;......'-'.
t~-f2~,~
WARNNG: IT IS ACRIr.E TOI<NClIMNGLYMN<E FAlSE STA11:MENlS TO THE
VNIn:D STAn:S ct/ THIS OR AHY SMlIAR FORM. PENAL liES UPON CON\IICflON
CAN INClUDE A ANE AHO _SONIoIENT. FCI'l DETAILS SEE lIltf 18:
U.S. CODE SECllON 1001 AND SEClIct/ 1010.
The HlJO.-l Seltlelnonl SIaIemenI which I hev" preplIRld Is a Irue and """"""" """""01 ollhls
- '_c:sused or" 0lUe lhefundolobe ~ In~"'" with ',.....lemD1l1. 0
__ " ~- ---- . .... 1/ / J)
SElllEMENTAGENT .c:- -- - DATE ----1.L.l)'C 01
~ Prudential
......
The Prudential Insurance Company of
America Annuity Services
PO Box 7960
Philadelphia. PA 19176
(888) 778-2888
BANGS LAW OFFICE
A TIN MICHAEL L BANGS
429 SOUTH 18TH ST
CAMP HILL PA 17011
Re: Louise J Landis
Contract: EO 187247
August 29, 2007
Dear Mr. Bangs:
We are writing in response to your recent letter concerning the contract shown above.
The value of the contract as of the date of death, August 3,2007, is $109,181.34.
Under the terms of the contract, at the death of Louise J Landis, the death claim proceeds are to be
paid to Katherine Barbagallo, Joseph M Landis and Louis Landis, daughter and sons.
I would appreciate your help in providing the following information:
· Claim forms completed by each of the named beneficiaries
Reply envelopes are provided for your convenience.
If you have any questions, please call the Prudential Annuity Service Center at (888) 77&-2888.
The Service Center is open Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern time.
If you are using a telecommunications device for the hearing impaired, you may call (800) 654-
7637,Monday through Friday between 8:00 a.m. and 8:00 p.m. Eastern time.
Sincerely,
.)
''-~rl,Q-C ,L /-:Jcv\../t~,L/~;l-
Nell Bailey U
Annuity Service Center
A Prudential business
Corporate Office: 751 Broad Street, Newark NJ 07102-37n
Page 1 of 1
Bangs Law
From: Tina Magill [tina.magill@contebrowne.com]
Sent: Wednesday, October 17,20074:43 PM
To: mikebangs@verizon.net
Subject: Louise Landis
Dear Wendy.
I apologize for not getting back to you today regarding the death claim for Mrs. Landis. She had three accounts with our
firm, one of which has already been paid out to the beneficiaries. The other two accounts are an individual account and
an IRA account both with Mutual Service Corporation (MSC)/Pershing.
I thought it might be easier to give you the figures and let you know what is needed to move the accounts out of louise's
name; we can then properly produce the paperwork for signatures.
The funds in the individual account at the time of death were $4,372. The current balance is $4,777.23. In order for the
funds to be distributed we will need to establish an Estate account. We will need to know the name of the Estate, the tax
to number, address being used for the Estate. We need to know the Executor's name and address, phone number,
annual income, net worth, liquid assets, their driver's license number, date of issue, date of expiration and state of issue.
The account can be set up for check writing, let us know if this is needed as additional paperwork will be required.
As for the IRA account MSC is not able to pin point the amount on the date of death as mutual fund prices fluctuate. I am
forwarding you a statement on the account as of 9/30/07 and the closing price on the mutual funds as of August 3, 2007
were $15.83 on CSIBX and $9.24 on ESAAX. The current balance in the account is $23,699.07. The three children are
listed as beneficiaries and the funds are split equally between the three. The money will need to be transferred into three
individual beneficiary IRA accounts in the name of the children. We need the following on each of the children: names,
social security number, address, phone number, marital status, resident state, date of birth, employer name and address,
business phone, annual income, net worth, driver's license number, date of issue, date of expiration and state of issue.
As soon as we receive this information we can produce the paperwork and deliver to your office for signatures. If you
have any questions, please let me know.
5ina e~ ~
Marketing Assistant to Frank A. Conte, CLU, ChFC, CL TC
2009 Market Street
Camp Hill, PA 17011
(717) 975-8800
(717) 975-0646 Fax
tina.magill@contebrowne.com
Securities offered through Mutual Service Corporation, Member FINRA/SIPC. Advisory Services offered through The Conte-Browne
Group. LLC, a Registered Investment Advisor. The Conte-Browne Group, LLC is not affiliated with Mutual Service Corporation.
This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized
to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in
the message. If you have received the message in error, please advise the sender by reply e-mail, and delete or destroy
the message
10/18/2007
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August 28,2007
Commerce
eSank
Bangs Law Office
429 South 18th Street
Camp Hill, PA 17011
RE: Estate of: Louise J Landis
Tax Identification Number: 197-26-4892
Date of Death: August 3,2007
Dear Sirs:
This letter is in reference to decedent account information you requested for the
individual listed above.
We are able to provide the following:
Account Type: Checking
Account Number: 512087859
Date Opened: 7/24/95
Primary Owner: Louise J Landis
Date of Death Balance: $587.97
Accrued Interest: $0.07
Principal Balance: $587.90
Account Type: Savings
Account Number: 410150943
Date Opened: 8/16/95
Primary Owner: Louise J Landis
Date of Death Balance: $4766.42
Accrued Interest: $0.15
Principal Balance: $4766.27
Please feel free to contact me at (717) 412-6134 if I may be of further assistance.
Sincerely, ,
~~OjltUl;) . \LtUl L~
Marcia L. Ka~man I~
Levy Specialist/Deposit Services
Commerce Bank
Commerce Bank / Harrisburg, N.A.
PO Box 4999
3801 Paxton Street
Harrisburg, PA 17111-0999
commercepc.com
BILL OF SALE
I, JOSEPH M. LANDIS, Executor of the Estate of Louise J. Landis. have sold the
Decedent's 1995 Plymouth vehicle to Donald E. and Maryann Nutter for the sunl of One
Thousand Seven Hundred and 00/100 ($1,700.00) Dollars.
Date: October 4, 2007
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.~ COlllment.: ESTATEOFl..Ol.Jf~Ei~A;NDtsi' V"LUE': .. r\M.. 5.. 0~ ~~'..~.W:_,\\,.,
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~~ The foregoing Appraisal is made with the understandin - at the Appraiser assumes no liability with M
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?"~ APPRAISER t-/ f DATE '\~~
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H & M ENTERPRISES
q"td mine J/eeve!eu
902 North Route 73
MARL TON, NEW JERSEY 08053
(856) 983-9569
TO WHOM IT MAY CONCERN:
This is to certify that we are engaged in the jewelry business, appraising diamonds, watches. jewelry and
precious stones of all descriptions.
We herewith certify that we have this day carefully examined the following listed and descrihed
articles, the property of:
LOUISE LANDIS
NAME
ADDRESS
28 TOREY CIRCLE C/O KATHY BARBAGALLO E~QLA~_LL0e5
We estimate the value as listed for insurance or other purposes at the current retail value. excluding
Federal and other taxes. In making this Appraisal. we DO NOT agree to purchase or n~place the
articles.
DESCRIPTION
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One.....14.. KT...White....tioId............. tc\die~f llIAMONDENGAGEMENT SE
weighing~ppro)(jllatelY.3.70DWr
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(A) . ONE .NATURALDIBMO~P(CENTe:R)
Shape.. & Cut =RDUND&'~.RI~L.IA~~
Measurement s(Appro)(.:>: 4.tr8X4. BMM
Weight (Appl'''ox,; ):.. 40CT . (;0 ~ or . Gt'''ad e: H- I
Glari.t y Gl'''ade: 511
995.00
(B) .. SIX NATURAL#;R",()f\U)B(~!B)
Shape .' &...Cut:Rnl.JND'~~R,lLL~;fl~T.
Mea $l.\re"'ents;tAppro)(;....~.:. 3~0X~3;. 0M~
We i ght<Approx.):,;60CT OnI?r . G~ade: H- I
01 rl\l'''i t yGrad e: SI 1
COlllbined.Esti ~~t.ed .' ~~ight i . 00CrrW
Graded as Mounti ng.Pet"mtts
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TOTAL.E:STi~,tr'ATEB.~ETAIL>R~t'LACEMENT VALUE: ~9{){) -~;.~
The foregoing Appraisal is made with the understanding that tJfe Appraiser assumes no liability with ~ $'
respect to any action that may be taken on the basis of thiS~isal. ; :;;;:
Harvey AreChavala~ (4!- 7flldi>/o7 10/0 '. ' :;;,:.'
APPRAISER (./~) " f/I,A 8 DATE "~ 57\
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H & M ENTERPRISES
geM "Inine ;kweteu
902 North Route 73
MARL TON, NEW JERSEY 08053
(856) 983.9569
TO WHOM IT MAY CONCERN:
This is to certify that we are engaged in the jewelry business, appraising diamonds, watches. jewelry and
precious stones of all descriptions.
We herewith certify that we have this day carefully examined the following listed and described
articles. the property of:
LOUISE LANDIS
N Atv1E
ADDREf)S
28 TOREY CIRCLE C/O KATHY BARBAGALLO ENOLA, PA 17025
We estimate the value as listed for insurance or other purposes at the current retail value. excluding
Federal and other taxes. In making this Appraisal. we DO NOT agree to purchase or replace the
articles.
D~~CRIP'flON
APPRAISED VALUE
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ONE JEWELRY BoxtON'T.(.\INlNGrHlRTY NINE MISe PIECES OF .
$
590.00
COSTUME JEWLERY'.:--~ e..'.. .,o..:.'.':'..,';"w~.'jj',~:',iI Ii .. it.,.. .-,. .,a . .',-. .. . . . -Ii . . . . . .. .
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TEN RINGS~ 100.00.....,.Hr~,.tENMlSE<~()STUME.BROACHES 130. /lU .
ONE STERLING .SI~VE~SrtRB~> B~AqLE~.G~~.000NEENAMEL COS U
BRACLET 10.00,THRE:ESEMI.PREFI09S.BERDEDNECKLACES 10~.
TH REELAD I ES> COSTUMENE:S~LACE:Bt:;tlI.<00,'FIIJEGOLD PLATED .
CHAINS 75. 00.. ONE>.~NUF'ti[q)X~iONE:.stERLINGSILVERCAMEO..
BROACH 100.00,&..... ONE STERLING SILVER COSTUME NECKLACE. I .
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I, LOUISE J. LANDS, of East Pennsboro Township, Cumberland County, Pennsylvania,
declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, and all other
articles of household and personal use, equipment and ornament, together with all insurance
thereon and relating thereto, in equal shares, to those of my children who survive my death by
thirty (30) days.
ITEM III. I give, devise, and bequeath aU the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate, in equal shares to those of Iny
children as survive my death by thirty (30) days.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
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ITEM V. I appoint my son JOSEPH M. LANDIS executor of this my last will. Should
he predecease me or otherwise fail to qualify or cease to serve as executor of this my last will, I
appoint my son LOUIS LANDIS executor of this my last will.
ITEM VI. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as Iny
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
"_ diversification; to sell at public or private sale, to exchange, or to lease for any period of tinle,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
2
IN WITNESS WHEREOF, I have hereunto set my hand this
I 9 day of
:r~~ 7-
,2006.
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"WUISEJ. LAND
Jolt/Joe. P/dlf:ief {lI6itE
:r-hf/// ~ IlII i!Jr mCj
1,4 14 r /'YI c; .DJ9 LrJ J. reA..
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The preceding instrument, consisting of this and THREE other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by LOUISE 1. LANDIS, the testatrix therein named, as and for her last will, in the presence of
us, who at her request, in her presence, and in the presence of each other, have subscribed our
names as witnesses hereto.
M~2~
~~~~~
4
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed~9 ~
LWISE J. LANDIS -4
, NOTARIAl SEAL
S.CHE=~
Men T"1)., ~.:::,.
My ~ ~res Mev 10. 2007
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTI OF CUMBERLAND )
WE, -l'1 ,J,.,JI L A p<f';,6s, and ~~~ \..l?-.~,s. , the
witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according
to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as
her last will; that she signed it willingly and that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as
witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of
sound mind, and under no constraint or undue influence.
a d acknowledged
day of
, 2006.
o
SEAl
WENDY S. , = PubIc
lower Allen 't'wp., Cumbee Ccutt
My ComrnIs8Ion Expns May 10, 200~
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