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HomeMy WebLinkAbout03-14-08 ....r ''i~ dl+ 4C)C-l " 15- .I COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION FILE NO. 21 -07-0016 FIRST AND FINAL ACCOUNT OF Michael G. Shenk and Nancy S. Cantone, a/k/a Nancy Shenk, Executors of the EST ATE of DOROTHY L. SHENK, Deceased Late of East Pennsboro Township, Cumberland County, Pennsylvania Date of Death: December 10, 2006 ~~ :) Date of Grant of Letters Testamentary to Michael G. Shenk and Nancy S. Cantone, alkla Nancy Shenk "- ..-.- .~': January 5, 2007 " \ ~ ..t.. Date of First Advertisement of Letters: -; ,,--, ...-, Cumberland Law Journal The Sentinel January 26, 2007 January 24, 2007 ,-, c-' Date of Accounting December 10, 2006 to February 26, 2008 PURPOSE OF ACCOUNTING: Michael G. Shenk and Nancy S. Cantone, alkla Nancy Shenk, Executors, offer this Account to acquaint interested parties with the transactions that have occurred during this administration. It is important that the Account be carefully reviewed. Requests for additional information or questions can be discussed with: Michael L. Bangs, Esquire Bangs Law Office Attorney Identification Number 41263 429 South 18th Street, Camp Hill, P A 17011 717) 730-7310 SUMMARY OF ACCOUNT PAGE PRINCIPAL Receipts of Principal 3 $24,409.15 LESS DISBURSEMENTS Debts of Decedent 4 $2,667.16 Administrative Expenses 4 $13,367.52 Attorney's Fees 4 $6,058.50 Administrator's Fee 4 $0.00 Accountant Fees 4 $310.00 $22,403.18 INCOME Receipts of Income 5 $0.00 COMBINED BALANCE ON HAND $2,005.97 PROPOSED SCHEDULE OF DISTRIBUTION 6 VERIFICATION 7 . Page 2 .. RECEIPTS OF PRINCIPAL DATE PRINCIPAL RECEIPTS 1/26/2007 M&T Bank Account 1/26/2007 Wachovia Bank Account 3/6/2007 Refund of unearned automobile insurance premium 3/13/2007 Refund from West Shore Pathology Associates 4/16/2007 Refund of unearned renters insurance 5/25/2007 IRS 2006 income tax refund 9/5/2007 Sale of automobile 10/5/2007 Liquidation of Stock Account with The Investment Center $4,189.02 $16,940.04 $119.20 $22.00 $144.20 $534.00 $2,400.00 $60.69 TOT AL PRINCIPAL RECEIPTS $24,409.15 Page 3 DISBURSEMENTS OF PRINCIPAL DATE DEBTS OF DECEDENT 1/26/2007 PP&L 1/29/2007 Verizon Wireless 1/29/2007 Wachovia Platinum 1/29/2007 Mutual Benefit Insurance Company (car insurance) 3/6/2007 Wachovia Card Services 3/6/2007 John Clements (February Rent) 3/6/2007 Comcast Cable 3/19/2007 Reversal of March Social Security payment 3/26/2007 P A Department of Revenue (2006 income tax due) 4/9/2007 Comcast Cable (final bill) 6/412007 Citibank TOT AL DEBTS OF DECEDENT: $196.22 $71.21 $123.60 $144.20 $30.11 $615.00 $99.18 $543.00 $8.00 $10.03 $826.61 $2,667.16 DATE ADMINISTRATIVE EXPENSES 1/5/2007 Register of Wills (probate fees) 1/16/2007 Cumberland Law Journal (advertising fee) 1/26/2007 Parthemore Funeral Home 1/26/2007 Cantone's (funeral luncheon) 2/1/2007 M&T Bank (check fee) 2/12/2007 The Sentinel (advertising fee) 3/6/2007 Michael Shenk (reimbursement for funeral beverages) 3/6/2007 Karen R. Shenk (reimbursement for funeral expense) 3/6/2007 Judith Shenk (reimbursement for funeral expense) 3/26/2007 Postmaster (mailing of2006 income tax returns) 5/24/2007 Register of Wills (short certificates) 9/4/2007 Register of Wills (inheritance tax due) 9/4/2007 Register of Wills (filing fee for inheritance tax return) 9/19/2007 Register of Wills (additional probate fee) 11/20/2007 Register of Wills (additional inheritance tax due) Register of Wills (filing fee for formal accounting) TOT AL ADMINISTRATIVE EXPENSES: $102.00 $75.00 $10,306.60 $1,662.05 $18.00 $122.51 $158.80 $130.98 $354.03 $6.30 $8.00 $220.65 $30.00 $30.00 $12.60 $130.00 $13,367.52 DATE FEES AND COMMISSIONS 2/12/2007 Frank Baker (stock valuation) 4/26/2007 Boyer & Ritter (accountant fee) Michael L. Bangs, Esquire TOTAL FEES: $75.00 $235.00 $6,058.50 $6.368.50 TOTAL DISBURSEMENTS OF PRINCIPAL: $22,403.18 Page 4 .. RECEIPTS OF INCOME DATE INCOME RECEIPTS TOT AL INCOME RECEIPTS $0.00 Page 5 PROPOSED SCHEDULE OF DISTRIBUTION OF REMAINING PRINCIPAL AND INCOME NAME DISTRIBUTION Kristin Dyan Shenk Michael G. Shenk Nancy Shenk Owen P. Shenk Robert Clayton Shenk, III Richard J . Yost $200.59 $401.19 $401.20 $401.19 $200.60 $401.20 TOT AL DISTRIBUTIONS TO BENEFICIARIES $2,005.97 Page 6 AFFIDA VIT Michael G. Shenk and Nancy S. Cantone, a/k/a Nancy Shenk, Executors of the Estate of Dorothy L. Shenk, deceased, hereby declare under oath that they have fully and faithfully discharged the duties of their office; that the foregoing Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to the best of their knowledge, there are no claims now outstanding against the estate; that all taxes presently due from the estate have been paid; and that more than four months have elapsed since the first complete advertisement of the granting of letters in this estate. This statement is made subject to penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. ' \ ~~.~&~~ NANCY ~TONE Also known as: SUBSCRIBED AND SWORN TO ~mEdtIS -Ulc D~ ro~:. ~}j)~Ub~& COMMONWEALTH OF PENNSYLW\NIA Notarial Seal Wendy K Straub, Notary Public lower Allen Tv.rp., Cumberland (',Qunty My Commission Expires May 10, 2011 Pennsylvania Association of Notaries REQUEST FOR DISTRIBUTION Accountant requests that distribution be determined by the Court in accordance with the Schedule of Proposed Distri bution filed as part of th i s account. /1 c' . '\ "." y. ". ' L/L{.Ui"(u,,..t. r(j;",Ltd t..-- '\r\~n~wn~a~ I ~ ~ Page 7 DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF DOROTHY L. SHENK , DECEASED No. 21-07-0016 ,":-'.."J ....- PETITION FOR ADJUDICATION / ST A TEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 ~ o This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders may be attached. Attach the spouse's election, if any; the papers required under items 8-19 inclusive: and any instrument pertinent to the acijudication. INCLUDE A TTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel: Michael L. Bangs, Esquire Supreme Court 1.0. No.: 41263 Name of Law Firm: Address: 429 South 18th Street, Camp Hill, PA 17011 Telephone: (717) 730-7310 Fax: (7]7)730-7374 Form DC-OJ rev. }(U3.06 Page] of 10 ....:r } Estate of DOROTHY L. SHENK , Deceased I. Name(s) and addressees) ofPetitioner(s): Name: Michael G. Shenk Nancy S. Cantone, a/k/a Nancy Shenk Address: 4 Spartan Circle 6230 Spring Knoll Drive Camp HilL PA 17011 Harrisburg, PA 17111 IdentifY any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: N/A Is this the first accounting by this fiduciary? . . . . . . . . . . . . . . . . . . . .. rzl Yes D No If not, identifY prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on December 10,2006 rzl Letters Testamentary or 0 Letters of Administration were granted to Petitioner(s) on Januarv 5. 2007 Date of Will (if applicable): February 23, 1996 Date(s) ofCodicil(s) (if applicable): N/A Date of probate (if different from date Letters granted): Was a bond required? DYes rzl No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ......... rzl Yes D No Dates of advertising of the grant of Letters: 1/26/07; 2/2/07 and 2/9/07 Cumberland Law Journal and 1/24/07; 1/31/07 and 2/7/07 The Sentinel Form OC-Of rev. /O./3JJ6 Page 2 of 10 J Estate of DOROTHY L. SHENK , Deceased 3. Was decedent survived by a spouse? .. . .. . .. . . .. . .. . . . .. .. . . . . . .. DYes IZl No If yes, name ofthe surviving spouse: 4. Has the surviving spouse filed to take an elective share? ............. DYes IZl No (See Section 2201 et~. of the Probate, Estates and Fiduciaries Code) If yes, date of election: 5. In the case of an intestacy, state the names ofthe decedent's surviving children or surviving issue of deceased children (if none, so state): None 6. Did decedent marry after execution of Will or Codicil(s)? . . . . . . . . . .. DYes IZl No Were any children born to decedent after execution of Will or Codicil(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DYes IZl No If yes, give names and dates of birth: Name: Date of Birth: 7. Ifrequired by the Medical Assistance Estate Recovery Act, 62 P.S. S 1412, was a request for a statement of claim sent to the Department of Public Welfare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. IZlYes D No Form OC-O/ rev. /0./3.06 Page 3 of 10 . Estate of DOROTHY L. SHENK , Deceased 8. Written notice of the Audit as required by Pa. O.c. Rules 6.3,6.7 and 6.8 has been or will be given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants listed in item 10 below. In addition, notice of any questions requiring Adjudication as discussed in item 14 below has been or will be given to all persons affected thereby. A. If Notice has been given, attach a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice. B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice shall be submitted at the Audit together with a statement executed by a Petitioner or counsel certifYing that such notice has been given. C. If any person entitled to Notice is not sui juris (e.g., minors or incapacitated persons), Notice of the Audit has been or will be given to the appropriate representative on such party's behalf as required by Pa. O.c. Rule 5.2. D. If any charitable interest is involved, Notice of the Audit has been or will also be given to the Attorney General as required under Pa. O.c. Rule 5.5. In addition, the Attorney General's clearance certificate (or proof of service of Notice and a copy of such Notice) must be submitted herewith or at the Audit. 9. List all parties (charitable and non-charitable) of whom Petitioner(s) has/have notice or knowledge, having or claiming any interest in the estate as beneficiaries under the Will or Codicil(s) or as intestate heirs if there is a complete or partial intestacy: A. State each party's relationship to the decedent and the nature of each party's interest(s): Name and Address of Each Part',' in Interest Relationship and Comments. if an',' Interest **See attached sheet for listing of beneficiaries Form DC -0 I rev. 10. /3. 06 Page 4 of 10 Estate of DOROTHY L. SHENK , Deceased Name and Address of Each Part]; in Interest Relationshiv and Comments, if anv Interest B, Identify each party who is not sui juris (e,g, minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. Ifno Guardian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each. N/A C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit (see Pa, o.c. Rule 12.4). N/A D, If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. N/A Form OC-Ol rev. f(}.13.06 Page 5 of ] 0 Estate of DOROTHY L. SHENK , Deceased 10. Other than the claim for the family exemption, list the names of all known claimants and the amount of their claims and state whether each claim is admitted. Name and Address of Each Claimant Amount of Claim Claim Will Claim Admitted? Be Paid In Full? N/A DYes DYes DNo DNo DYes DYes DNo DNo DYes DYes DNo DNo DYes DYes DNo DNo If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. S 3392 and the proposed payments. II. Was family exemption claimed? DYes 0No 0No Was family exemption allowed? DYes Family exemption claimant's name and relationship: Name: Relationship: Form OC-OI re\'. 10.13.06 Page 6 of 10 Estate of DOROTHY L. SHENK , Deceased 12. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate Tax paid, the date(s) ofpayment(s), and the interest(s) upon which paid, are as follows: Date Payment Interest 9/6/2007 220.65 0.00 11/26/07 12.37 0.23 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond ofa fiduciary? . . . . .. . . . . . . . . . ... . DYes [l] No If yes, provide the name of the estate, indicate whether an account has been filed and confirmed absolutely and all awards performed, or, in the alternative, how the decedent's estate will be discharged for the decedent's fiduciary administration of the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: N/A B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? .................. DYes D No 15. IfPetitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. Form OC-Of rev. fO 13.06 Page 7 of 10 Estate of DOROTHY L. SHENK , Deceased 16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . D Yes IZJ No If yes, attach a copy of the Order if available; otherwise state the Court, term, number, date, and name of Hearing Judge. 17. A. List or attach a separate list of additional receipts and disbursements since the closing date of the Account. N/A B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. DYes D No 18. If a reserve is requested, state amount and purpose. Amount: PlIIpose: N/ A I f a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest? ........................................ DYes DNo Ifso, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? IZJYes DNo As to real estate only? ........................................ DYes IZJ No Form OC-OI rev. 10.13.06 Page 8 of 10 Estate of DOROTHY L. SHENK , Deceased Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled and suggest(s) that the distributive shares of income and principal (residuary shares being stated in proportions, not amounts) are as follows: A. Income: Proposed Distributee(s) Amount/Proportion B. Principal: Proposed Distributee(s) A mount/Proportion **See attached sheet Submitted By: (All petitioners must sign. Add additional lines ifnecessary): tti<d~4<4.1- Name of Petitioner ichael G henk Form OC-O 1 ret'. 10. 13 06 Page 9 of 10 Estate of DOROTHY L. SHENK , Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that he/she IS title of the above-named name of corporation and] that the facts set forth in the foregoing Petition for Adjudication / Statement of Proposed Distribution which are within the personal knowledge ofthe Petitioner are true, and as to facts based on the information of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false statements herein are made subject to the penalties of 18 Pa. C.S. S 4904 (relating to unsworn falsification to authorities). * Corporate petitioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/ Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. Form DC-OJ rev. JO.13.06 Page 10 of 10 ESTATE OF: Dorothy l. Shenk 204-03-9256 12/10/2006 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Kristin Dyan Shenk Granddaughter one-tenth 763 2nd Avenue Apt. 1 0 New York, NY 10017 2 Michael G. Shenk Son one-fifth 4 Spartan Circle Camp Hill, PA 17011 3 Nancy Shenk Daughter one-fifth 6230 Spring Knoll Drive Harrisburg, PA 17111 4 Owen P. Shenk Son one-fifth 729 Wheatland Road Lewisberry, PA 17339 5 Robert Clayton Shenk III Grandson one-tenth 369 N. 27th Street Camp Hill, PA 17011 6 Richard J. Yost Foster child one-fifth 110 Camp Hill Drive Clarks Summit, PA 18411 Total <t 1 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEAL TH OF PENNSYL VANIA ss. COUNTY OF CUMBERLAND Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, VIZ: January 26, February 2, and February 9, 2007 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. 2ft - ditor Shenk. Dorothy L., dec'd. Late of East Pennsboro Town- ship. Executors: Nancy S. Cantone and Michael G. Shenk c/o Michael L. Bangs, Esquire, 429 South 18th Street, Camp Hill, PA 170 II. Attorney: Michael L. Bangs, Es- quire, 429 South 18th Street, Camp Hill. PA 17011. SWORN TO AND SUBSCRIBED before me this 9 day of February, 2007 NOTAR! L SEAL LO!S E. SNYDER, Notary Public Carlisle Bore, Cumberland County My Commission Expires March 5, 2009 .. PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Tammy Shoemaker, Classified Advertising Manager, of The Sentinet of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following day(s) January 24, 31, February 07, 2007 COPY OF NOTICE OF PUBLICATION .EIIAIE. NQIJg LETTERS TESTAMENTARY on the Estate of DOROTHY L. SHENK, late of East Pennsboro Township, County of Cumberland, Pennsylvania, deceased, were granted to Nancy S. Cantone and Michael G. Shenk on January 5,2007. All persons knowing themselves to be indebted to said Estate are requested to make Immediate payment, and those having claims will present them without delay, to the undersigned. ' Michael L. Bangs, Esquire 429 South 18th Street Camp Hill, PA 17011 Affiant further deposes that he/ she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of 3:~~~~ Sworn to and subscribed before me this 7th. day of February, 2007. Giu;}J:bAt1 ,X UJ~ Notary Publ' My commission expires: q II jOg COMMONWEALTH OF PENNSYLVANIA Notarial Seal Chnstina L Wdfe, Notary Public Cartisle 8010, Cumberland County My CommissiOn Expires Sept. 1, 2008 Member. Pennsylvanif'. Association Of Notaries LAST WILL AND TESTAMENT OF DOROTHY L. SHENK o ~-;O -IJ~ .J~_::p . C.c. "l "':"-~' -,....., ,:.... ".:.~\ ... ,.~... J .'V ..::::-:) C~;J --.. L. ):'11'10 r rn ....., :J::-. (Xl I, DOROTHY L. SHENK, of Lower Allen Township, Cumberlan~County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise and bequeath all of my estate of every nature and wherever situate as follows: A. One-fifth to my son, ROBERT C. SHENK, or to his issue if he does not survive me. B. One-fifth to my daughter, NANCY S. CANTONE, or to her issue if she does not survive me. ~ C. One-fifth to my son, OWEN PHILIP SHENK, or to his issue if he does not survive me. D. One-fifth to my son, MICHAEL G. SHENK, or to his issue if he does not survive me. E. One-fifth to my foster son, RICHARD J. YOST, if he survives me. ITEM II: I appoint two of my children, NANCY S. CANTONE and MICHAEL G. SHENK, Executors of this my last will. ITEM IV: I appoint my Executors and their successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this ap- Page 1 of 4 pointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make paYment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of his/her duties in any jurisdiction. IN WITNESS WHEREOF, I, DOROTHY L. SHENK, have hereunto set my hand and seal this ~).1 day of ~~ ' 1996. M "X-7~);( .~ DOROTH L. SHENK SIGNED, SEALED, PUBLISHED and DECLARED by DOROTHY L. SHENK, the Testatrix above named, as and for her Last Will and Testament, and 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. QQ~N~~ W. i sn..~ ,#-. ... fJI ~/---L ./ /~ d~\ "Witness ' ~~/~' Address r ;??~ ~Lt~ 12 .. Address Page 2 of 4 COMMONWEALTH OF PENNSYLVANIA: :SS: COUNTY OF CUMBERLAND I, DOROTHY L. SHENK, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ~~~~ DORO Y L. SHENK Sworn to or affirmed to and acknowledge by DOROTHY L. SHENK, the Testatrix, this ~3 ~ day of , 1996. lij l~~v X{(~ Notary Publi N(::n:Li,R!AL 8E.<\l CON?F\NCf: L MRU, ~1(\1.3ry PlJ!Jllc ~!r.t" ",'W"",,"'.-~,' [',0, ('" ,,' " i~,;"t:~ q.i~.tin~,r;i J.:::;;ai r'r1 'll~rrV~p'n1n(j Cq My Commission Explms j;P~';;'13,'1999 COMMONWEALTH OF PENNSYLVANIA :SS: COUNTY OF CUMBERLAND We, ~ Q,.iJ.. tv ~.~ ~n~c9~~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed Page 3 of 4 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; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. ~<4Z~~ 4dd~ ltness Sworn to or affirmed to and acknowledged before W~ by and~9~: , 1996. witnesses, this ;:;;.3 ^1 day of ~~1)-;1( ~<<- Notary Pub lC NOTARIAL SEAL CONSTAt',iCE L [(ARLI, t'!otJPf Publlc New Cum!}:Bi!;},1:d, p;~ CUl'i1\!erI3Ild Co. My Commis:;ion Ex[Jire.s ~prB i~. 1999 Page 4 of 4