HomeMy WebLinkAbout02-19-08
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15051:.041147
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
INHERITANCE TAX RETURN 2 1 0 7
RESIDENT DECEDENT
File Number
0489
Date of Birth
171346028
01152007
07031943
Decedent's Last Name
SULFARE
Suffix
SR.
Decedent's First Name
JAMES
MI
H
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return 0 2. Supplemental Return D 3. Remainder Return (date of death
prior to 12-13-82)
[J 4. Limited Estate 0 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
~ 6 Decedent Died Testate ;~ 1. Decedent Maintained a Living Trust 0 8, Total Number of Safe Deposit Boxes
. (Attach Copy of Will) (Attach Copy of Trust)
I ' 9. Litigation Proceeds Received 10 Spousal Poverty Credit ~date of death ~1 11. Election to tax under Sec. 9113(A)
. between 12-31-91 and -1-95) LJ (Attach Sch. 0)
.ijORRESPONDENT. THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
BRADFORD D. WAGNER ESQ. 6108386563
Firm Name (If Applicable)
1"--.)
First line of address
662 MAIN STREET
REGISTER jF<!JILLS US~NL Y -:: '
Eo;;P -: ~~',
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DATe FILED
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Second line of address
ry
City or Post Office
HELLERTOWN
State
PA
ZIP Code
18055-1726
Correspondent's e-mail address:
Under pena' 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 tnJ complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knoWledge.
SIG TURE OF PER N RESPONSIBLE FOR FILING RETURN DATE
~ ~ ^-' . James H. Sulfare Jr.
Bradford D. Wagner Esq.
662 Main Street, Hellertown, P A 18055-1726
Side 1
L
15056041147
15056041147
~
~
\
---l
15051:.042148
REV-1500 EX
Oecedent's Name: Jam e s H. Sui far e Sr.
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) n Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous No".Probate Property
(Schedule G) LJ 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 14 taxable
at sibling rate X .12
18. Amount of line 14 taxable
at collateral rate X .15
o . 00
15.
101,897.32
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.
Side 2
L
laSOSb042146
Decedent's Social Security Number
171 34 6028
55,467.89
68,882.64
124,350.53
8 -~-2-j3-~8 1
14,219.40
22,453.21
101,897.32
101,897.32
o . 00
4,585.38
o . 00
0.00
4,585.38
D
15051:.04214&
---l
REV-1S00 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
James H. Sulfare Sr.
___._._ _'"__'_"'_"__.'__"____ _____"_.___.. _______.~.w__
STREET ADDRESS
121 Walnut Bottom Road
File Number 21-07-0489
CITY
STATE
ZIP
Shippensburg
PA
17257
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 4,585.38
0.00
Total Credits (A + B + C)
(2)
0.00
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty (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
S. 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 S + SA. This is the BALANCE DUE.
(3)
(4)
(5)
(SA)
(5B)
4,585.38
4,585.38
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;................................................................................ [J [xJ
b. retain the right to designate who shall use the property transferred or its income;.................................. 0 L~]
c. retain a reversionary interest; or..................................................;............................................................ r1 L~]
d. receive the promise for life of either payments, benefits or care?............................................................ LJ L~J
2. If death occurred after December 12, 1962, did decedent transfer property within one year of death without
receiving adequate consideration?.... ............... ....... ......................................................................................... n l~]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... I_J [!J
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which . .. _
contains a beneficiary designation?.. ........ ...................... ........ .......... ................................. ............................... l)( I LJ
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)).
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero
(0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not 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. ~9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.S) percent,
except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1)].
The tax rate imposed on the net value oftransfers to or for the use of the decedent's siblings is twelve (12) percent[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.
Rev-~ 508 EX+ (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sulfare, James H. Sr.
FILE NUMBER
21-07-0489
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joIntty-owned with the right of lurvlvorshlp mUlt be dllclOled on Ichedule F.
ITEM
NUMBER DESCRIPTION
1 Wachovia Bank - Savings #1010093321756
VALUE AT DATE
OF DEATH
6.528.57
2 Wachovia Bank - Checking #1010110870753
48.939.32
TOTAL (Also enter on Line 5, Recapitulation)
55.467.89
(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
COMMONWEALTH Of' PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sulfare, James H. Sr.
IFILE NUMBER
21-07 -0489
ESTATE OF
This schedule must be completed and fded If the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM I Jt-SI IIUN OF, ""'" ...,,1 T 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 Ryan Beck & Co. . Acct. #72H-040619 TOO to 68.882.64 68.882.64
Nathan Sulfare, Trishia M. Fortuner,
and James H. Sulfare, Jr., children of decedent
TOTAL (Also enter on Line 7, Recapitulation) 68.882.64
(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-!151 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sulfare, James H. Sr.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-07 -0489
ESTATE OF
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
James H. Sulfare Jr.
Social Security Number(s) I EIN Number of Personal Representative(s):
160-60-7149
Street Address 14125 Mountain Green Road
City Willow Hill State ~ Zip 17271
Year{s) Commission paid 2007
4,000.00
2.
Attorney's Fees
Bradford D. Wagner Esq.
4,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
233.81
TOTAL (Also enter on line 9, Recapitulation)
8,233.81
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
R.",.1502 EX+ (6-98)
.
SCHEDULE H.B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sulfare, James H. Sr.
FILE NUMBER
21-07-0489
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland Law Journal. Estate Notice
75.00
2
The Sentinel. Estate Notice
158.81
Subtotal
233.81
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE liABiliTIES, & liENS
COMMONWEM.TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sulfare, James H. Sr.
FILE NUMBER
21-07-0489
ESTATE OF
Include unrelmbursed medical .xpen....
ITEM
NUMBER DESCRIPTION
1 Balhara Internal Medicine - Medical
VALUE AT DATE
OF DEATH
785.00
2 Good Shepherd - Medical Balance Due
497.00
3 Health Network Labs - Medical
107.28
4 Life Star - Medical
61.00
5 Millennium Pharmacy - Prescriptions
549.16
6 Millennium Pharmacy - Prescriptions
184.93
7 Shippensburg Area EMS - Medical
626.00
8 State Employers Retirement System - Refund of Pension Overpayment
11.111.82
9 Stifel Nicolaus - Debt of Decedent
117.21
10 UPS Store-Mail Box Rent
180.00
TOTAL (Also enter on Line 10, Recapitulation)
14,219.40
(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 I (Rev. 6-98)
REV-1513 EX+ (9-00)
.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Sulfare, James H. Sr.
NAME AND ADDRESS OF
NUMBER PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal
· Cfistributions, and transfers
under Sec. 9116(a)(1.2))
RELATIONSHIP TO
DECEDENT
Do Not u.t Tru.teet.'
FILE NUMBER
21-07-0489
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
ESTATE OF
Trlshla M. Fortuner
908 Cedar Hurst Drive
Raleigh, NC 27609
Daughter
One-Third (1/3)
of Residue of
Estate
James H. Sulfare, Jr.
14125 Mountain Green Road
Willow Hill, PA 17271
Son
One Third (1/3)
of Residue of
Estate
Nathan Sulfare
3300 Monroe Street
Bethlehem, PA 18020
Son
One Third (1/3)
of Residue
Total
Enter dollar amounts for distributions shown above on lines 5 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)
1Kast 3IlItill altb WC!.ltalltCltt
BE IT REMEMBERED,
THAT I, JAMES H. SULFARE, SR., presently residing at 1059
Easton Road, Hellertown, Northampton County, Pennsylvania, being of
sound mind, memory, and understanding, and considering the
uncertainty of life do hereby make, publish, and declare this my
Last Will and Testament, hereby revoking and making null and void
any and all former Wills or Codicils by me at anytime heretofore
made.
FIRST:
I appoint my daughter, Trishia M. Fortuner,
Executrix of this my Will. If she should predecease me or decline
to serve, I appoint my son, James H. Sulfare, Jr., Executor
of this my Will.
I direct that no bond shall be required of my
Executrix or Executor.
SECOND: I request the payment of my funeral expenses and
expenses of my last illness, as soon as conveniently may be done
after my death. I request that my funeral shall be in keeping with
my station in life.
THIRD: I give and bequeath all of my remaining household
and personal effects, including all clothing, jewelry, furniture,
furnishings, automobiles, silver, books and pictures, together with
any existing insurance policies thereof, to my children, Trishia M.
Fortuner, James H. Sulfare, Jr. and Nathan Sulfare, or their then
living issue, per stirpes.
Said items shall be equally divided
among them, as they may agree, and in the absence of agreement any
disputed items shall be added to the residue of my estate. In the
event ~ny of them predecease me without living issue, then his or
her share shall be divided equally between my children living at
the time of my death, or his or her then living issue, per stirpes.
FOURTH: I order and direct the following distribution of
the residue of my estate:
A. One (1) share to my daughter, Trishia M.
Fortuner, presently residing at 456 Freehall
Street, Mertztown, Pennsylvania, or her then
living issue, per stirpes.
B. One (1) share to my son, James H. Sulfare, Jr.,
presently residing at 3674 Pampas Circle,
Chambersburg, Pennsylvania, or his then living
issue, per stirpes.
-2-
c. One (1) share to my son, Nathan SuIfare,
presently residing at 301 W. Wilkes Barre
Street, Easton, Pennsylvania, or his then
living issue, per stirpes.
In the event any of them predecease me without living
issue, then his or her share shall be divided equally between my
children living at the time of my death, or his or her then living
issue, per stirpes.
FIFTH:
In the event there is no named beneficiary
included in any non-probate assets which I may own at the time of
my death, including but not limited to life insurance policies,
retirement benefits or annuities, I give, devise and bequeath the
proceeds of said non-probate assets in equal shares to my children,
Trishia M. Fortuner, James H. Sulfare, Jr. and Nathan Sulfare, as
provided for in Paragraph Fourth above.
SIXTH:
In the event any party entitled to share under
the terms of this my Last Will and Testament is a minor at the time
of my decease and no trust has been established for said minor
under this my Will, then I nominate, constitute and appoint my
daughter, Trishia M. FOltuner, to be Trustee of the Estate of said
-3-
minor with full power in said Trustee in her absolute and
uncontrolled discretion, to pay, use or apply all or so much of the
principal and income from time to time as my said Trustee shall
deem necessary or advisable for the use, benefit, education and
general welfare of said minor and to make distribution of any
principal and. income then in her hands unto any minor when said
minor arrives at the age of twenty-one (21) years. I direct that
for purposes of this clause of my Will, the word "Minor" shall be
construed to mean a person under the age of twenty-one (21) years,
regardless of any state or federal law to the contrary. Anything
herein to the contrary, however, if the property passing to such
minor shall not amount to more than $5,000.00 or shall be tangible
property of such nature that it may be used and enjoyed by such
minor although exceeding $5,000.00 in value, said Trustee in her
absolute and uncontrolled discretion, is authorized to distribute
the property to such minor directly. If she should predecease me
or be unable to serve, I appoint my son, James H. Sulfare, Jr.,
Trustee as provided for above.
SEVENTH: If any person or persons entitled to share in
distribution under the terms of this my Will shall in any court of
-4-
law or equity or otherwise contest the same or dispute or call into
question the validity of this my Will, such person or persons shall
forfeit his or her entire interest hereunder and all provisions in
favor of such person or persons shall be void and of no effect.
The share of such person or persons so forfeited shall be
distributed as a part of the residue as provided for herein except
that if such person or persons are entitled to share in the residue
that interest shall be distributed proportionately to the other
residuary distributees provided he, she or they shall not contest
or dispute the validity of this my will.
EIGHTH:
I give to my Executrix, Executor and Trustee
herein named, the following fiduciary powers, in addition to all
fiduciary powers granted by law, and direct that such powers shall
be exercisable by her or him without leave of court and until final
distribution of my estate has actually been made:
A. To retain any or all real or personal property
owned by me at my death, and to invest in all
forms of property, regardless of any
limitations imposed by law on investments by
fiduciaries.
B. To sell at public or private sale for cash or
credit or partly for each, to exchange or to
lease for any period of time any real or
-5-
personal property and to give options for
sales, exchanges or leases.
c. To compromise or submit to arbitration any
claim which may be asserted against my estate
or any asset of my estate.
D. To borrow money (even if the lender is also a
fiduciary herein named), and to pledge or
mortgage any asset or assets of my estate for
. the payment of taxes, debts, legacies,
administration expenses or any other purpose
which in the opinion of my Executrix or
Executor will facilitate the administration of
my estate.
)~ . To abandon, disclaim and dispose of any
property which in the opinion of my Executrix
or Executor shall be worthless to my estate.
]~. To pay general legacies and any residuary share
in kind or in cash, or partly in each, or by
way of undivided interests, even if shares of
residue shall be composed of different assets
and the valuations placed on assets by my
Executrix or Executor for purposes of
distribution in kind shall be conclusive.
G. To retain and pay agents, employees,
accountants, and counsel (including but not
limited to legal and investment counsel) for
advice and other professional services; no
fiduciary acting hereunder, shall be obligated
to follow any such advice.
H. To expend reasonable sums for the shipment of
personal property to beneficiaries with said
payment being considered an administration
expense.
-6-
I. Whenever the Trustee determines that the size
of any trust does not warrant the cost of
continuing it, or that its administration would
be impractical for any other reason, my Trustee
shall have the right to place said funds in a
Certificate of Deposit or like investment to be
paid to the beneficiary in accordance with this
Will.
J. To pool the assets of all separate trusts as
provided for in this my Will for investment
purposes, allocating to each such trust an
undivided proportionate interest in the pooled
assets.
K. To merge any trust hereunder with any other
trust held by Trustee whether created by me or
by any other person by Will or Deed, if the
trusts are for the primary benefit of the same
persons and contain substantially similar
terms.
NINTH:
No interest in income or principal shall be
assignable by, or available to anyone having a claim against, a
beneficiary before actual payment to the beneficiary.
TENTH:
Any and all state inheritance taxes, estate
taxes, and federal estate taxes for property passing under this my
Will, including interest and penalties, shall be paid from my
residuary estate without charge or set-off to any beneficiary
-7-
herein named and without apportionment in any accounting or tax
schedule.
IN WITNESS WHEREOF, I, JAMES H. SULFARE, SR., have to
this my Last will and Testament subscribed my name and affixed my
/ {;: 'tA, day of April, 2004 at Hellertown, Pennsylvania.
seal this
~'?d ~
J ES H. SUL ili: SR:
(SEAL)
SIGNED, SEALED, PUBLISHED, and DECLARED by the above
named Testator, JAMES H. SULFARE, SR., as and for his Will, in the
presence of us, who at his request, in his presence, and in the
presence of each other, have hereunto subscribed our names as
witnesses in attestation thereof.
---Jr.. Addres s
(~~
)
. · , Ju'" J
fJ (I.-JU.I'tL ."..j@ L (/ "(J~
Address (3ft>ol fW(J/ndL-Ifd' K3j:~tl[o}~,4.~.....'\ 0
. ). .,.V "I ';4
J
-8-
l..
.. i-
:~.,;
!'"' ; ,.".-- ".
COMMONWEALTH OF PENNSYLVANIA
SS. :
COUNTY OF NORTHAMPTON
We, JAMES H. SULFARE, SR., Bradford D. Wagner, fton; ~Q. C"-~Ie
~ \11 e \-
, the Testator and the witnesses, respectively,
whose names are signed to the foregoing instrument, being first
duly sworn,~do hereby declare to the undersigned authority that the
I
Testator signed and executed the instrument as his Last Will and
that he 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 witness and that to the best of their knowledge the
Testator was at the time eighteen (18) years of age or older, of
sound mind and under no constraint or undue influence.
~)
'\
Yr;~...J-jDP., U/~?1~ '
Witness {
(SEAL)
-9-
SUBSCRIBED, SWORN TO and acknowledged before me by JAMES
H. SULFARJ!:, SR., the Testator, and subscribed and sworn to before
me by Bradford D. Wagner and MCtli C:..b- G-Qle ~)o..3 bee ' witnesses,
this
I G.- l-A.
day of April, 2004.
~az~
Notarial Seal
Shirtev A. Frey, Notary ~ic
HeIettowri Boro. Norta.lpbl CotI1ty
My Co...,..,.. &p1'lS Dee. 29. 2006
Member, PennsyIvaria AssoaaIIon 01 Notaries
-10-
'''~~1::'~:;:,[,~ ~)_, 1'::"1!:i,,--,",~
-. ,..-. '-", -:-....
-
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~,C>,-;~... _' I ","
2f:OB FEB 19 P ~'112: 52
CLERK OF
QRPHbN'S C?~RT ~.
CU"J:--"":'P ,', L.JJ~
1\::[;__ i
BRADFORD D. WAGNER
ATTORNEY-AT-LAW
662 MAIN STREET
HELLERTOWN, PA 18055-1726
TO
REGISTER OF WILLS OFFICE
CUMBERLAND CO. COURTHOUSE
ONE COURTHOUSE SQUARE
CARLISLE, PA 17013-3387
~s POS?:
..} ~
* * * @((~ I
152 ~"~8768867
7272$01.990 FEB 13 08
5 3 5 1 HELLERTOWN PA 1 805 5
hhlll'II'l',lhhllhUIJIIIII,IH 1'111' lit ",1111 t 'II