HomeMy WebLinkAbout04-07-08
.......J
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes' INHERITANCE TAX RETURN
PO BOX 280601
Harrisbu ,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDEN:rl~FORMATION BELOW
Social Security Number Date of Death
15056041125
OFFICIAL USE ONLY
County Code Year
File Number
2 1 0 7
(I 9 2 9
14516 514 1
Date of Birth
o 8 0 6 2 0 0 7
04031916
Decedent's Last Name
S Y L V EST E R
Suffix
Decedent's First Name
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
FRANCES
MI
K
S Y L V EST E R
Spouse's First Name
Spouse's Social Security Number
ARTHUR
MI
F
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 0 11. Election to tax under SetIJ113(A) _ 1
between 12-31-91 and 1-1-95) (Attach Sar. 0 ;=:,;
'. )
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. All CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATlONj'sOULD BE~ECTED jo;)
Name Daytime Telephonecifufiiber :;>:) . I
"ITI I
7 1 7 7. 6 -;3J 1 -31 8
'..' ....-_.5..:'"
FILL IN APPROPRIATE OVALS BELOW
[XJ 1. Original Return
o 4. Limited Estate
[XJ
o
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
o
o
~?
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
SUSAN
H
CONFAIR
REAGER
&
ADLER,
P C
-~'IC) ""'\J
REGISTER Of WiU:-SIUSE QHi Y
:~~ ;'>.)
Firm Name (If Applicable)
First line of address
2 3 3 1
MARKET
STREET
co
Second line of address
City or Post Office
State
ZIP Code
DATE FILED
C AMP
H ILL
P A
17011
Correspondent's e-mail address:SCONFAIR@REAGERADLERPC.COM
Under penalties of pe~ury, 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 re rese tive is based on I information of which preparer has any knowledge
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
c:- S->
SIGNATURE OF PREPARER
CARLISLE
PA 17015
DATE
:;, - (-~ ~)
CHURCH ROAD
ADDRESS ~~
2331 MARKET STREET
CAMP HILL
PLEASE USE ORIGINAL FORM ONLY
PA 17011
L
Side 1
15056041125
15056041125
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Dr)
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15056042126
REV-1500 EX
Decedent's Name FRANCES K. SYLVESTER
RECAPITULATION
Decedent's Social Security Number
145165141
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 1.
2. Stocks and Bonds (Schedule B)
.................................. 2.
116908.35
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) 0 Separate Billing Requested . . . . . " 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
................ 9.
116908.35
1704.00
........................... 8.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
. . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
1 7 0 4.0 0
115204.35
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.
115204.35
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.O _ 1 1 5 2 0 4 . 3 5 15. o . 0 0
16. Amount of Line 14 taxable
at lineal rate X 0 o . 0 0 16. o . 0 0
17. Amount of Line 14 taxable o . 0 0
at sibling rate X .12 17. o . 0 0
18. Amount of Line 14 taxable 0 . 0 0
at collateral rate X .15 18. o . 0 0
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. O. 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Side 2
15056042126
15056042126
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
FRANCES K. SYLVESTER
STREET ADDRESS
120 MCALLISTER CHURCH ROAD
File Number
21 07 0929
CITY
CARLISLE
i STATE
I PA
ZIP
117015
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C) (2)
0.00
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
0.00
0.00
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
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; ...................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
:~or 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. S9116 (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. S9116 (a) (1.1) (ii)]. 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.
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. 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 PS. S9116(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.
REV-1503 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FRANCES K. SYLVESTER
FILE NUMBER
21 07 0929
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
9.
DESCRIPTION
COMCAST - 150 COMMON SHARES - CUSIP #20030N101
VALUE AT DATE
OF DEATH
3,888.00
AVAYA, INC., 18 SHARES - CUSIP #00145005349910
299.70
PRUDENTIAL FINANCIAL INC. - 100 COMMON SHARES - CUSIP #744320102
8,696.00
WACHOVIA CORP. - 1159 COMMON SHARES - CUSIP #337358105
54,751.16
ALCATEL-LUCENT - 42 SHARES - CUSIP #013904305
475.86
AT & T INC. - 929 COMMON SHARES - CUSIP #00206R102
37,401.54
PUBLIC SERVICE ENTERPRISE GROUP INC. - 73 COMMON SHARES _
CUSIP #744573106
6,313.04
MASSACHUSETTS INVESTORS TRUST - 235 SHARES - CUSIP #575736103
5,083.05
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
116908.35
REV-1511 EX + (12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FRANCES K. SYLVESTER
FILE NUMBER
21 07 0929
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRA TIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attomey Fees REAGER & ADLER, PC 1,200.00
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 CUMBERLAND COUNTY REGISTER OF WILLS 290.00
5. Accountant's Fees
6. Tax Retum Preparer's Fees
7. SHORT CERTIFICATES - CUMBERLAND COUNTY REGISTER OF WILLS 60.00
8. ADVERTISEMENT - THE CENTRAL PENN BUSINESS JOURNAL 79.00
9. ADVERTISEMENT - CUMBERLAND LAW JOURNAL 75.00
TOTAL (Also enter on line 9, Recapitulation) $ 1.704.00
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. ARTHUR SYLVESTER Spousal 115,204.35
120 MCALLISTER CHURCH ROAD
CARLISLE, PA 17015
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
e<v,""'.'.
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FRANCES K SYLVESTER
SCHEDULE J
BENEFICIARIES
1
FILE NUMBER
21 07 0929
(If more space is needed, insert additional sheets of the same size)
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'JAM/WI LLS/sylveslfr. WI L. wpd
Augusl"13, 1999
LAST WILL AND TESTAMENT
OF
CG(Q)O~W
FRANCES K. SYLVESTER
I, FRANCES K. SYLVESTER, of Carlisle, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will
and Testament, hereby revoking any and all prior Wills and Codicils thereto by me at anytime heretofore
made.
1. 1" AMILY.
1.1 Identification of Famil~. I declare that I am married to ARTHUR F. SYLVESTER.
I have one child from a previous marriage whose name is DUANE F. JELINEK.
1.2 Definition of Family Terms. As used in this Will, the term "my Spouse" shall mean
only ARTHUR F. SYLVESTER. As used in this Will, the terms "my Child" or "my
Children" refers to all my natural Children. As used in this Will, the term "issue" refers
to all lineal descendants of the indicated person of all generations, with the relationship
of parent and child at each generation determined by the definition of "Children" set
forth in this paragraph.
2. PA YMENT OF BURIAl, EXPENSES AND DEBTS. I authorize my Executor to pay all the
expenses of (1) a funeral or memorial service; (2) the interment of my remains, including the
costs of a gravesite, if necessary; and (3) the installation and inscription of a suitable marker at,
and perpetual care of, the gravesite. I further direct my Executor to pay all of my debts that my
Executor in his sole discretion may allow as claims against my estate.
3. DISPOSITION OF TANGIBLE PERSONAL PROPERTY.
3.1 Disposition to Spouse. I give all of my tangible personal property of every kind and
description, including, but not limited to, books, pictures, clothing, articles of household
or personal use or adornment, household furnishings and effects, and automotive
vehicles and their accessories, but excluding any money, evidences of indebtedness,
documents of title, and securities and property used in connection with the operation of
any trade or business, to my Spouse.
3.2 Alternative Disposition. If my Spouse does not survive me by more than sixty (60)
days after the date of my death, and my Child survives me, I direct my Executor to
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divide my tangible personal property into two parts. The first pmi shall contain all items
that my Executor determines, to be of no present or future value or use to my Child. The
second part shall contain the balance of the property. My Executor shall dispose of the
first part by sale, abandonment, destruction, or gift to any charity or person. The
proceeds of any sale shall be added to my residuary estate. All property in the second
part I give to my Child who survives me.
4. DISPOSITION OF RESIDUARY ESTATE.
4.1 Disposition to Spouse. All of the rest, residue and remainder of the property that I own
at the time of my death, both real and personal, and of every kind and description,
wherever situated, to which I may be legally or equitably entitled at the time of my
death (my "residuary estate"), I give outright and absolutely to my Spouse, ifhe survives
me.
4.2 In the event my Spouse is not living on the sixtieth (60) day after the date of my death
I leave all the rest, residue and remainder of the property that I own at the time of my
death, both real and personal, and of every kind and description, wherever situate, to
which I may be legally or equitably entitled at the time of my death (my "residuary
estate") to my Child who survives me.
5. POWERS OF ADMINISTRATION.
5.1 Grant of Powel's. My Executor, in the administration of my estate, (my "fiduciaries")
shall have the powers and authorities set f01ih in this Article 5. These powers and
authorities may be exercised by my Executor in their sole and absolute discretion,
without the permission or order of any comi. These powers shall be supplementary to
those conferred by law, including, but not limited to, those set forth in Title 20, Chapter
33, of the Pennsylvania Consolidated Statutes.
5.2 Retention of Assets. My fiduciaries shall have the power to retain any or all property
of my estate, however received and acquired, for so long as they deem appropriate. This
power may be exercised even though the propeliy may not be of the type authorized by
law for investment, and even though the retention may leave a disproportionately large
amount of the value of my estate invested in one type of property.
5.3 Transfer of Assets. My fiduciaries shall have the power to sell, transfer, and convey
any propeliy, of whatever nature, including real property, and wherever situated, that I
may own at the time of my death, or that may come into my estate or into the trust
corpus at or after my death. The sale, transfer, or conveyance may be by public or
private sale, at such time, on such terms and conditions, including selling price and
credit, in such manner, and for any reason that my fiduciaries deem appropriate,
2
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FRANCES K. SYL VESTIyR
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August, 13, 1999
including, but not limited to, the purpose of obtaining net proceeds to be distributed to
my residuary beneficiaries.
5.4 Investment. My fiduciaries shall have the power to invest and reinvest any property in
my estate in preferred and common stocks, bonds, notes, common trust funds (including
any managed by any corporate fiduciary), interests in investments, tmsts, mutual funds,
leases, mortgages on property wherever located, and, generally, in any property and in
proportions of property as my fiduciaries deem advisable, even though the investments
are not of the character or proportions authorized by applicable law for the investment
of the funds.
5.5 Power to BOHOW. My fiduciaries shall have the power to borrow money for any
purpose, for any periods of time, and on any terms and conditions as they deem
advisable (including the power to borrow from any corporate fiduciary), and to pledge,
mortgage, or otherwise encumber any property in my estate to secure repayment of any
loan, as well as the power to renew existing loans either as maker or endorser.
5.6 Power to Hold Property in Nominee Form. My fiduciaries shall have the power to
hold any property in the name of a nominee or in bearer form.
5.7 Distribution in Cash or in Kind. My fiduciaries shall have the power to make
distributions in cash or in kind, or partly in cash, in divided or undivided interests, as
amended, or other applicable law, and to determine which assets shall be sold and which
shall be distributed in kind, without notice to or consent by any beneficiary.
5.8 Distribution to Minors and Persons Under Disabilit~. My fiduciaries shall have the
power to make distributions or payments to or for the benefit of any beneficiary who is
a minor, an incompetent, or who in the fiduciaries' judgment is incapacitated. The
distributions or payments shall be made in anyone or more of the following ways: (1)
directly to the beneficiary; (2) directly to the creditor in payment of the debts or
expenses of the beneficiary; (3) to the guardian of the person or estate of the beneficiary;
(4) to any custodial parent of a minor beneficiary; (5) to a custodian for the beneficiary
under any law related to gifts to minors, including to my fiduciaries in that capacity; or
(6) to any other person who shall have the care and custody of the person of the
beneficiary. There shall be no duty to see to the application of funds so paid, provided
due care was exercised in the selection of the person to whom the funds were paid, and
the receipt of the person shall be full acquittance of the fiduciaries.
5.9 Employment of Agents. My fiduciaries shall have the power to employ and pay the
compensation of any and all attorneys, agents, custodians, attorneys-in-fact, experts,
investment counsel, accountants, bookkeepers, or other agents or providers of services
as my fiduciaries deem advisable in the administration of my estate.
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August. 13, 1999
5.10 Third Party Reliance. No person or corporation dealing with my Executor shall be
required to see to the application of any property paid or delivered to my Executor, or
to inquire into either the authority of my Executor to enter into any transaction or the
expediency or propriety of any transaction entered into by my Executor.
6. P A YMRNT OF DRA TH TAXES.
6.1 Payment of Estate Taxes. I direct that all federal and Pennsylvania estate taxes
payable as a result of taxes assessed on property passing under this Will shall be paid
from my residuary estate as a part of the expenses of the administration of the estate.
6.2 Inheritance Tax. I direct that the Pennsylvania inheritance taxes payable as a result of
my death, limited to taxes assessed on property passing under this Will, shall be paid
out of my residuary estate and shall not be deducted or collected from any beneficiary
under this Will or other transferee.
7. EXECUTOR.
7.1 Appointment. I name, constitute, and appoint my Spouse as Executor of my estate. If
my Spouse shall not survive me, shall not serve as Executor for any reason, or shall
cease to serve as Executor for any reason after appointment, DUANE F. JELINEK
shall act as Executor in his place.
7.2 Bond Not Required. None ofthe individuals named in Paragraph 7.1 shall be required
to furnish a bond for the faithful performance of his duties as Executor.
8. PRESUMPTION IN CASE OF SIMULTANEOUS DEATH. For the purposes of this
Will, in determining whether a person has survived me or another person, (1) I shall be
deemed to have predeceased my Spouse unless it unmistakably appears by proof that he
survived me; and (2) in all other cases, a person shall not be deemed to have survived
me or another person if he or she dies within sixty (60) days of my death or of the death
of the other person.
9. LIABILITY OF EXECUTOR. My Executor shall not at any time be liable for mistake oflaw
or of fact, or both law and fact, or errors of judgment, nor for any loss coming to any beneficiary
under this Will, or to any other persons, except through actual fraud or willful misconduct on
the part of the Executor. My Executor may, from time to time, consult with counsel with respect
to the meaning, construction, and operation of this Will, particularly with respect to the
appointments, allocations, and disbursements, and may act on the advice of counsel in all
matters without incurring liability on account of his actions.
4
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FRANCES K. SYLVESTE f
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Augus~13, 1999
10. INTERPRETATION.
10.1 Will Not Contractual. My Spouse and I are executing Wills at approximately the same
time, in which each of us is the primary beneficiary of the Will of the other. These
Wills are not being executed pursuant to any contract to make a Will or any contract not
to revoke a Will. The Will of each of us is revocable at any time, whether before or
after the death of the other Spouse, at the sole discretion of the Spouse making the Will.
10.2 Successors of Fiduciaries. All pronouns referring to an Executor or trustee and the
terms "Executor" and "trustee" shall be construed to mean any person acting as my
Executor, co-Executor, co-trustee, trustee, or administrator, as the case may be
10.3 Number and Gender. Ifrequired by the context of this Will, singular language shall
be construed as plural, plural language shall be construed as singular, and the gender of
personal pronouns shall be construed as either masculine, feminine, or neuter.
lOA Headings. All headings used in this Will to describe the contents of each article,
paragraph, or other division are provided for convenience only and shall not be
construed to be a pmi of this Will.
10.5 Governine Law. This Will shall be construed in confomlity with the law of the
Commonwealth of Pennsylvania.
IN WITNESS \VHEREOF, I have hereunto set my hand and seal to this, my Last Will and
Testament, consisting of five (5) typewritten pages, the first four (4) of which bear my signature in the
margin for the purpose of identification, this j 0 day of Uc l_ ":i v<-<l/'-C , 1999.
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Signed, sealed, published and declared by the above-named testatrix, FRANCES K. SYLVESTER,
as and for her Last Will and Testament, in the sight and presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses.
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· 'JAMNvILlS/sylvestfr.wIL.wpd
August 13, 1999
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
I, FRANCES K. SYLVESTER, THE TESTATRIX, WHOSE NAME IS SIGNED TO THE
FOREGOING INSTRUMENT, HAVING BEEN DULY QUALIFIED ACCORDING TO LAW, DO
HEREBY ACKNOWLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT AS MY
LAST WILL AND TESTAMENT; THAT I SIGNED IT WILLINGLY; AND THAT I SIGNED IT AS
MY FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED.
SWORN OR AFFIRMED TO AND ACKNOWLEDGED BEFORE ME BY FRANCES K.
SYL VESTER, DIE TESTATRIX TIIIS I h DA: OF (" '/ 1 q/L .' 1999i_
/"/-)f./,L> I/C<'/) ff.\f,i.-j .t'I/U'-<I' p'L
FRANCES K. SYLVESTER, TESTATRIX
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NOTARY PUBLIC
COMMONWEAL TH OF PENNSYL VANIA ) Deborah L. B~~~~~;~,a~otary Public
: S S . Camp Hili Bora, Cumber1and County
CO UNTY 0 F CUMBERLAND ) My Commission Expires June 18, 2002
Member, Pennsylvaniu Association 01 Notaries
WE, ~ \A..t.-C.- f\. l.t('~ AND //~;-c c:. /L:,::- .:':/'/7L/1~<J {/ / /~z.,
THE WITNESSES WHOSE NAMES ARE SIG~D TO THE FOREGOING INSTRUMENT, BEING
DUL Y QUALIFIED ACCORDING TO LAW, DEPOSE AND SA Y THAT WE WERE PRESENT
AND SAW THE AFORESAID TESTATRIX SIGN AND EXECUTE THE INSTRUMENT AS HER
LAST WILL AND TEST AMENT; THAT SHE SIGNED WILLINGL Y 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
THE TIME EIGHTEEN (18) OR MORE YEARS OF AGE, OF SOUND MIND AND UNDER NO
CONSTRAINT OR UNDUE INFLUENCE.
~W~(N OR AFFIRMED TO AND SUBSCRIBED TO BEFORE ME, TIIIS \ LtrlA Y OF
~~ ,1999. @7~-'-' (~_ /
WITNESS ~ ~
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WITNESS .,' . /.
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NOTAy r IKI
Notarial Seal
Deborah L. Brenneman, Notary Public
Camp HIli Bora, Cumber1and County
My Commission Expires June 18, 2002
Member, Pennsylvania Association of Notaries