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HomeMy WebLinkAbout06-12-08 (2):15056051058 REV-1500 EX (OEi-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes Y ' County Code Year File Number Po Box 28osot INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 -~ RESIDENT DECEDENT 21 0$ 0368 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 'March 27, 2008 February 25, 1908 ', .Decedent's Last Name Suffix Decedent's First Name MI Garman Ernest_ B __ __ ___ _ (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 ~~„ `;:- 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) „ 4. Limited Estate ~~"'°~ 4a. Future Interest Compromise (date of a,-,. 5. Federal Estate Tax Return Required death after 12-12-82) ;l• 6. Decedent Died Testate ~„"„;e 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ ~~ 10. Spousal Poverty Credit (date of death .,:,_ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number :Andrew C. Sheely, Esquire . ' 717-697-7050 .Firm Name (If Applicable) _ _ __ _ _ _ __ . _ r.~ __ ......._ _-_..... __.. .._ ._ .. ... _... _... I REGISTER OF>;?4p.LS USE ON~ `7 .Andrew C. Sheely, Attorney at Law ~ ~-~~ ~ -r i~~~t First line of address i ~ ~ _~,7 ~ ~ :_ ' ; j 127 South Market Street I _~? , ~ ,_ 1- ~,~ _ r ~ fU , ~ Second line of address j ~ ~ ~?(~ -p ~ r-;~ _ I - ~. P O Box 95 ` ='~-- L7 . . __ 1 ~J _ _ ~.: .: f ~'l City or Post Office State...... ZIP Code _ _ ?.. _ _DATE~LED _ _ ~ 'Mechanicsburg _ _ _ _ _ _ PA ' 17055 +.I Correspondent's a-mail address: andreWC.Sheely@verlZOn.net 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. SIGNATURE OF P SQN SP NS BL R FILING RET~ ~P iia~a Ahf)RFSC Michael E. Garman, Executor, 95 Haldeman Avenue, New Cumberland, PA 17070 SIGNA E OF P EPAR OTF~ HA PRESENTATIVE HATE p nRCCc Andrew C. Sheely, Esquire, 127 arket St., P.O. Box 95, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name Garman, Ernest B. w.~ . ~ ~ _ _ _ _ ~.~.~ . _... w... e ...... _ . e , RECAPITULATION 1. Real estate (Schedule A) ........................................... .. 1.' 118,454.10 2. Stocks and Bonds (Schedule B) ..................................... .. 2.' 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. S`S 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. 5. Cash, Bank De osits & Miscellaneous Personal Pro ert Schedule E P P Y( ) ...... 5. ' .. 113,982.41 6. Jointly Owned Property (Schedule F) ~ ~"~ Separate Billing Requested ..... .. 6. 45,445.26' 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~~:. Separate Billing Requested..... ... 7. `: 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. '; 277,881.67 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. ' 12,022.06 10. 9 9 ( ) ............. Debts of Decedent, Mort a e Liabilities, & Liens Schedule I 10, ... 195.97 11. Total Deductions (total Lines 9 & 10) ................................ ... 11. "~ 12,218.03 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 13. Charitable and Governmental Bequests/Sec 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. 265,663.64 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ..~,.. ~ ^~,...~.. 15. Amount of Line 14 taxable at the spousal tax rate, or transfers unc+~~ sec. 9116 00 500 0.00 (a)(1.2) x .o. . 15. 16. Amount of Line 14 +~~~ble at lineal rate X .045 _..... 260,163.64. 16. 11, 707.37 17. Amount of Line 14 taxable at sibling rate X .12 I ., _ 17• _. 18. Amount of Line 14 taxable 000.00' 5 750.00" at collateral rate X .15 _ , _ _ 18. .. . 12,457.37. ..... 19. TAX DUE .................. ........................... ..19. ._ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~J~ ~ 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Ernest B. Garman STREET ADDRESS - -- 1509 Brandt Avenue 0~ 0368 ' DECEDENT'S SOCIAL SECURITY NUMBER 178-05-1368 CITY ~ STATE New Cumberland zIP - PA 17070 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 12,457.37 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 11,834.53 C. Discount 622.85 3. Interest/Penalty if applicable Total Credits (A + B + C) (2) 12,457.37 D. Interest - E. Penalty -- 4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT.tal Interest/Penalty (D + E) (3) 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable fo: 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 :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ 0 c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................. ............................................................ ^ ^X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ n 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)j. The statute does not exemg 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)j. 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. §9116(1.2) [72 P.S. §9116(a)(1)j. 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. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 21 .. ~?EV-1503 ErX+ (6-d38) `'.. '~ .. SCHEDULE B Ct)MMONWEALTH OP PENNSYLVANIA STOCKS & BONDS lNHERITANCL== TAX RETURN RESIDENT DECEDENT ESTATE !7F FILE NUMBER Ernest B. Garman 21-0$-0368 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (It more space is needed, insert additional sheets of the same size) N m ~ ~ e ~ o ~ ~= S N ~r ~ ~ 3 0 ~ , , . ~ > n ~ ..,,~ ~- w m > SID T, iy ~~ ~\ II~ '`~~` ~V ~`` Y ~9 N n ~ m A a A 3 a Z U m~m C H m ~ ~ n ~~~,, ~ ~- c ~~ ~ 1 ~ \` ~ ~ '`~ . D ~ ~ `.~, D C-' `' ~ ~ ~, ~ Z \~ N ~\ D \. 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G .. %+ ;} J.: R ~- r y ~. ~< . ~~~m W W vo ~ Q "'~ z C , i ~ T i ~ S ~i{ ~ , m ~ A = ~ ~ ~ ~p :A < O ~ m ~- Ali ~y "+I ~.. ~, , ~,~: ,, ~~„ j ` ~ ,.r ~ ~ ~,,, z ~ ~"~ ~~ i / t V ^~ { ~ e ~ n c ~ ~ i H 'D r ~~~ ~, .~ ri : ~, ~~,~ .~ ~ ~ >,' O ~ q x N f~EV-1508 ~X+ (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Ernest B. Garman 21-OJ-0368 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 1997 Lincoln Continental, fair condition $3,250.00 2. PNC Bank CD account # 31600323388 - at date of death 20,135.63 3. PNC Bank CD account #31900218481 - at date of death 20,639.47 4. PNC Bank CD account #31900220555 - at date of death 24, 980.16 5. PNC Bank CD account #31600254419 - at date of death 25,161.43 6. PNC Bank checking account #5140022546 - at date of death 19,815.72 113,982.41 TOTAL (Also enter on line 5, Recapitulation) $ ~_ (If more space is needed, insert additional sheets of the same size) . a.er~`.~~~~--~ R~#ureE tt tags ~# f~~~~. e . 2177745204 01:17:47 p.m. 04-15-2008 B PNC Facsimile 1 /2 Phone: Date: t~-/~ _ U From: ~ Phone: Re: ~ _ ~ i v Fa:: Page Including Cover: Fax: This facsimile may contain privileged and confidential information intended only for the use of the addressee(s) named above. if tfie reader of this message is not the intended recipiengs) or the employee or agent responsible for delivering the message to the intended recipirnt(s), please note that any dissemination, distribution or copying of this communication is strictly prohibited Anyone who receives this communication in error should notify us immediately by telephone and destroy the message in its entirety. The P~IC Ftrwdal Servka Grwp www.pnc.com 7177745204 01:17:59 p.m 04-15-2008 2/2 i _ . Name Ernest B Getman (Deceased) SS# 178-OS-1368 DOD 03-27-2008 ACCQUNT NUMBER * X}ATE OF DEATH BALANCE + ACCRUED INTEREST Cda # 31000233277 $ 10,700.04 + $ 5.37 Cda # 31600323388 $ 20,072.21 + $ 63.42 Gda # 31900218481 $ 20,639.47 + $ p.00 Cda#'31900220555 $24,931.45 + $ 49.16 Cda # 31600254419 $ 25,106.20 + $ 55.23 Dda # 5140022546 $19,810,77 + $ 4.95 Sv8 # 5003172468 $ 80,Obb.'~8 + $ 118,39 If you've selected the balances to be sent to the `= Branch " they will only be sent to the regttestor vla Lotus Notes. FiEV-1509 lrXi- (6-9f3j COMMONWEALTH OF PENNSYLVANIA INFiE-RITANCE TAX RETURN RESIDENT DECEDENT scN~ou~E F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Ernest B. Garman 21-0~-0368 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A• Michael E. Garman 95 Haldeman Avenue, New Cumberland, PA 17070 Son B. C. JOINTLY-OWNED PROPERTY: ITEM NUMAER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEAThI VALUE OF ASSET °o OF D[CD'S INTEREST UATF OF DEATH VALUE OF DECEDENTS IMEREST 1. A. 0~'f-2i-2oo3 PNC Bank - CD account #31000233277 $10,705.37 50% $5,352.68 2. A. S-2y-lees PNC Bank money market account #5003172468 $80,185.17 50% $40,092.58 TOTAL (Also enter on line 6, Recapitulation) I $ 45,445.26 (If more space is needed, insert additional sheets of the same size) EV-151? EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Ernest B. Garman 21-0~ 0368 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~~ Parthemore Funeral Home $8,856.37 2. Flowers $ 328.60 3. Funeral services/luncheon $813.56 4. B. 1 2. 3. 4. 5. 6. ~. s. 9. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Michael E. Garman, EXeCUtOr Social Security Number(s)/EIN Number of Personal Representative(s) street Address 95 Haldeman Avenue city New Cumberland _ state FA .Zip 17070 Year(s) Commission Paid: Attorney Fees 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 Probate Fees Accountant's Fees Tax Return Preparer's Fees Misc. postage and registered mail costs Filing Fees for Inheritance tax return Reserves for first and final accounting, advertising and other Estate administration activities $1, 025.00 $ 360.00 $ 23.53 $ 15.00 600.00 TOTAL (Also enter on line 9, Recapitulation) I $ 12,022.06 (If more space is needed, insert additional sheets of the same size) Parthemore Funeral Home & Cremation Servic s, Inc. p,p. Box 431 1303 Bridge Street New Cumberland, PA 17070-0431 (717) 774-7721 Mr. Michael E. Garman 95 Haldeman Avenue New Cumberland, PA 17070 Fos the service of Emest B. Garman TRANSACTION DATE 03/27/2008 Balance forward Due 04/27/2008. INV #1438 03/28/2008 04/01/2008 . PMT #373. Michael Garman 04/08/2008 PMT #001. Estate Statement AMOUNT DUE 50.00 AMOUNT 8,856.37 -877.00 -7,979.37 ~~~ 1-30 DAYS PAST 31-~ DDUE PAST 61-90 DDAUE PAST O PA T DUE CURRENT DUE 0.00 0.00 0.00 0.00 0.00 Please don't hesitate to call our office if we may be of assistance. AMOUNT ENC. BALANCE 0.00 8,856.37 7,979.37 0.00 AMOUNT you. DATE REFERENCE ITEM ,131/08 000047590 ARRANGEMENT, GENERAL Occasion:. Sympathy ERNEST GARMAN f/31/08 000047591 FUNERAL ARRANGEMENT, CASKET SPRAY Occasion: Sympathy ERNEST GARMAN $20.00 ~ $0.00 ~ $1.20 $21.20 ~ $21.20 $290.00 ~ $0.00 ~ $17.40 I ~ $307.40 I $307.40 ACCOUNT NUMBER CURRENT 30+ DAYS 60+ DAYS 90+ DAYS 120+ DAYS TOTAL DUE 000000 1 1 1 1 $328.60 $0.00 $0.00 $0.00 $ .00 $328.60 _ -- - - .-_ .. _ _ - _ ,~.c Olds 7ewsc ~leslot ~ 'hre. ~ (71 ~ 774-1260 I page 1 of ~~ . _ 1 MAY SPECIAL -BASKET OF AFRICAN VIOLETS - $25.00 - CASH &~, ~~ ,. DELIVERY EXTRA ' VISIT US AT OUR WEBSITE -www.oldetowneflorist.com µ~ . }~ r R^ REV-1512 EX.+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCI~IEDt~LE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FSTOTF f)F Ernest B. Garman FII F NIIMRFR 21-OQj-0368 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) REV-1513 EX~ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ernest B. Garman NUMBER 1 1 2 3 4 5 6 II NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Mari Jo Garman, 508 Harding St., New Cumberland, PA 17070 Abigail C. Garman, 95 Haldeman Ave.,New Cumberland, PA 17070 Kathryn J. Garman, 12 Fisher Ave., Pittsburgh, PA 17070 Kelli A. Recher, 508 Harding St., New Cumberland, PA 17070 Frances Gruber, 700 Elkwood Drive, New Cumberland, PA 17070 Michael E. Garman, 95 Haldeman Ave.,New Cumberland, PA 17070 FILE NUMBER 21-0$-0368 RELATIONSHIP TO DECEDENT ( AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE great granddaughter granddaughter granddaughter granddaughter friend son ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS St. Theresa's Parish, 1300 Bridge Street, New Cumberland, PA 17070 $ 500.00 $10,000.00 $10.000.00 $10,000.00 $10,000.00 $5,000.00 Rest, residue &remainder - --- TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 500.00 (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF ERNEST B. GARMAN I, ERNEST B. GARMAN, now of 1509 Brandt Avenue, New Cumberland, Cumberland, County, Pennsylvania, i~o~o, declare this to be my last Will and Testament and revoke any Will or Codicil previously made by me. Item I: I direct that all expenses of my last illness and funeral, including my gravemai•lcer and perpetual care, 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, devise and bequeath to the St. Theresa's Church of New Cumberland, Pennsylvania, or its successor, Five Hundred ($500.00) Dollars for Masses in memory of Josephine M. Garman. Masses to be said on her birthday, November ~~n. The money should be divided to provide ten (io) Masses over a period of ten (io) years. Item III: I give, devise and bequeath to Frances Gruber of New Cumberland, Cumberland County, Pennsylvania, the sum of One Thousand (.$:i.ro -~~ Dollars for her kindness and understandin for man ears. ~t"'~' a_ g YY ~- ,-~;~ V,,,.,r-,,.., I Item IV: I give, devise and bequeath to my great granddaughter, Mari Jo ~~i~n1 )j (~/ r of New Cumberland, Pennsylvania the sum of Ten Thousand ($io,ooo.oo) /~l ~ !'~ Dollars to be placed in an interest bearing account to be maintained for her by her mother for college or distribution to her after she reaches the age of majority. Item V: I give, devise and bequeath to my granddaughters, Kelli Ann Garman Recher, Kathryn Jo Garman and Abgail C. Garman, a trust fund for each in the sum of Ten Thousand ($io,ooo.oo) Dollars. The funds shall be held in trust jointly by Michael E. Garman and his wife, Frances Garman, or the survivor of the two for educational purposes and, any remainder to be turned over to the named beneficiary on her Twenty First (2i5t) birthday. Item VIII: I direct that the rest, residue and remainder of my estate be distributed to my son, Michael E. Garman, and if he fails to survive me, to my daughter- in-law, Frances J. Garman. Item VII: I direct that all taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed shall be paid from my residuary estate as part of the expense of the administration of my estate. Item VIII: I hereby authorize and empower my executrix or executor, named herein, to sell any of the real or personal property which I may own at the time of my death, as he or she shall, in his or her sole discretion, deem appropriate, for the best interest of my estate and my beneficiaries, upon whatever terms or conditions he or she deems to be appropriate and to execute, acknowledge, and deliver all proper writings, deeds of conveyance and transfer thereof. Item IX: I appoint my son, Michael E. Garman, as Exe,}cutor of this Estate, , /~ shall not be required to give bond for the faithful performance beer duties in any%' jurisdiction. In the event that my son, Michael E. Garman, in unable or unwilling to stand as Executor, I appoint my daughte~n-law, Frances J. Garman, as Executrix. ERNEST B. GARMAN The preceding instrument, consisting of this and four (4) other typewritten pages, identified by the signature of the Testator ERNEST B. GARMAN, was on the day and date thereof signed, published and declared by ERNEST B. GARMAN ,the Testator herein named, as and for his Last Will, in the presence of us, who, at his request and in his presence and in the presence of each other, have subscribed our names as witnesses hereto. of G' ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF ~~~,~,'n I, ERNEST B. GARMAN, the Testator 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 the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by ERNEST B. GARMAN, Testator this = day of ~~ ~,1~f1.~. ° 2004' ERNEST B. GARMAN No ary ublic NOTARIAL SEAL Public MICHELE A. RENEKER, Not County City of Hamsburg, DauptN M Comm~ssion';cp~res March 17,2007 s COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN ' WE, the undersigned witnesses whose names are signed o°e to d say thadt we foregoing instrument, being duly qualified according to law, do dep were resent and saw the Testator, sign and execute the instrumenn a~ tnesse n the p that each subscribe g voluntary act for the purposes therein expressed; hearing and sight of the Testator signed the Will as a witness; and thaf soundbmind and knowledge, the Testator was at that time i8 or more years of age, o under no constraint or undue influence. the undersigned witnesses, Sworn to or affirmed and subscribed before me by A~~~ , 2004. this ~-day of ~~- Witness ~ .'--- NDT~EAL public ` ~ ~' _ ~ MICHELE A. RENEKER, Notary CiC/ of Hamsburg, Dauphin County Witness ~ Tres March 17, 207 ~~dy C~~;imia,on ExP ____- i Notary Public