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HomeMy WebLinkAbout07-23-08 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisbur , PA 17128-0601 RESIDENT DECEDENT 21-07-01042 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 224-36-6526 05212007 10141931 Decedent's Last Name Suffix Decedent's First Name MI HATCHER BARBARA J (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 Q 2. Supplemental Return Q 3. Remainder Return (date of death Q 4. Limited Estate ~ 4a. Future Interest Compromise (date of prior to 12-13-82) 0 5. Federal Estate Tax Return Required death after 12-12-62) 6. Decedent Died Testate (Attach Copy of Will) 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit (date of death Q 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number STEPHEN D. TILEY 717-243-5838 Firm Name (If Applicable) FREY AND TILEY First line of address ~5 SOUTH HANOVER STREET Second line of address City or Post Office State ZIP Code CARLISLE PA 17013 REGISTER OF WILLS USE O~Y w _ti7 ~ ~ rte'" ~ ::~ ~ ~ rv u~ ~ ~ i_. 7 ~ 7 ._ ~ ti DATE ED ,.~ ~ __, (, ,} -_1 _ r _- f`~7 r-~ -- e '~ Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge SIGNATURE OF PER ON RESPONSIBLE FOR FILING RET~ DATE ADDRESS ROBERT w. HATCHER, 6116 LOCUST STREET, HARRISBURG, PA 17112-1834 SIGNATURE OF PREPAR R OTH THAN ~ RE ~NTA~ ~ 'DATE - ADDRESS ~ ~ ~-'F STEPHEN D. TILEY, FREY & TILEY, 5 SOUTH HANOVER ST., CARLISLE, PA 1701 PLEASE USE ORIGINAL FORM ONLY 15056041114 Side 1 15056041114 15056[)421,1,5 REV-1500 EX Decedent's Social Security Number Decedent's Name: BARBARA J HATCHER 2 2 4- 3 6- 65 2 6 RECAPITULATION 1. Real estate (Schedule A) ........................................... 1. NONE 2. Stocks and Bonds (Schedule B) .. , ........ , .... 2. NONE .................. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages & Notes Receivable (Schedule D) ............................ 4. NONE 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 2 3 62.0 0 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ........ 6. NONE 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) OSeparate Billing Requested ........ ~ NONE 8. Total Gross Assets (total Lines 1-7) .................................. 8. 2 3 6 2 . 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) ................ ... 9. 2 3 62.0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........... .... 10. NONE 11. Total Deductions (total Lines 9 & 10} ............................. .... 11. 2 3 6 2 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ......................... .... 12. 0 . 0 0 1::. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... ... 13. 0 . 0 0 1~i. Net Value Subject to Tax (Line 12 minus Line 13) ................... .... 14. 0 . 0 0 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 .0 0 15. 0. 0 0 1E3. Amount of Line 14 taxable at lineal rate X .0 4 5 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X 12 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X , 15 18. 0 . 0 0 19. TAX DUE ............................................ .......... 19. 20. FILL IN THE OVAL 1F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 0.00 15056(142115 15056Q42115 ...~.~ REV-1500 EX Page 3 224-36-6526 Decedent's Complete Address: File Number DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER BARBARA J HATCHER 224-36-6526 STREET ADDRESS 940 WALNUT BOTTOM ROAD CITY STATE ZIP CARLISLE PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 0.00 Total Credits (A + g + C) (2) 0.00 Total Interest/Penalty (D + E) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 00 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 : ...................................... . b. retain the right to designate who shall use the property transferred or its income; ........... ~..... c. retain a reversionary interest; or ..................................................... . d. receive the promise for life of either payments, benefits or care? ............................ . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................ . 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? ...................................................... 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 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. §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 (4.5) 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 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. 217 REV-1508 EX+ (6-98) SCHEDULE E COMIvIONWEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Hatcher Barbara J. 21-07-01042 Include the proceeds of litigation and the date the proceeds were received by the estate. tlr more space Is neeged, Insert additional sheets of the same size) REV-1511 EX + (10-06) F SCHEDULE H COfvIMONWEALTHOFPENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Hatcher Barbara J. 21-07-1042 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Plaque for gravestone (Remaining funeral expenses pre-paid) 125 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Robert W. Hatcher street Address 6116 Locust Street city Harrisburg state PA zip 17112-1834 Year(s) Commission Paid: 2008 477 2. Attorney Fees Frey and Tiley 1,500 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 4. 5. 6. 7. 8. 9. Street Address City State Zip _ Relationship of Claimant to Decedent Probate Fees Frey and Tiley (Reimburse for Small Estate Petition filing fee) Accountant's Fees Frey and Tiley Tax Return Preparer's Fees Frey and Tiley Register of Wills -certified copy of Petition. (Reimburse Frey and Tiley) Checks cleared after death (see copies of Citizens Bank statements, attached.) Filing fee for Inheritance Tax Return TOTAL (Also enter on line 9 Recapitulation) ~ S (If more space is needed, insert additional sheets of the same size) 30 15 200 15 217 REV-1513 EX+ (g-00) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA 6ENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Hatcher, Barbara J. 21-07-1042 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)] Robert W. Hatcher, 616 Locust St., Harrisburg, PA 17112 son 1/5 ($0.00) James E. Hatcher, Jr., 4871 Spring Rd., Shermansdale, PA 17090 son 1/5 ($0.00) William T. Hatcher, 326 S. Washington St., Mechanicsburg, PA 17055 son 1/5 ($0.00) Mary E. (Hatcher) Mumma, 107 Braodway Ave., Duncannon, PA 1702 daughter 1/5 ($0.00) Shari L. Hatcher, 28 N. High St., Duncannon, PA 17020 daughter-in-law 1/5 ($0.00) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 B 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ 0 (If more space is needed, insert additional sheets of the same size) ~. . `~ ~ Checking Account ~_. Statement 1-888-910-4100 ~ of 2 Call Citizens' PhoneBank anytime for account information, current rates and answers to your questions. Beginning May 10, 2007 through June 11, 2007 US059 BR291 2 1 JAMES E HATCHER SR Contents 6116 LOCUST ST Checking Page 1 HARRISBURG PA 171 12 Overdraft Line of Credit Page 2 Checking SUMMARY Balance Calculation Previous Balance 1, 234.23 Checks 235.68 - Withdrawals .00 - Deposits & Additions .00 + Current Balance 998.55 = TRANSACTION DETAILS - Checks "There is a break in check sequence Check # Amount Date Check # Amount Date 1338 .135.68 05/17 1339 100.00 05/24 Daify Balance Date Balance Date Balance Date Balance 05/17 1,098.55 05/24 998.55 ~ MEMO --Important Notice Regarding Our Funds Availability Policy Our Funds Availability Policy discusses our rules about when we make funds from your cash and check deposits avai table to you. This policy is contained in your Deposit Account Agreement. Our general policy is to make funds from your cash and check deposits available to you on the first business day after we receive your deposit. Our policy includes exceptions that may delay the availability of deposits. In many cases, we have been providing same day availability for check deposits when our policy calls for next business day availability, generally. The purpose of this notice is to inform you that beginning Jdly 23, 2007, for checks not drawn on Citizens Bank or Charter One Bank, we will follow our general policy of next business day availability for check deposits that was disclosed to you in your Deposit Account Agreement. Please refer to your Deposit Account Agreement for details on our Funds Availability Policy. If you have misplaced your Agreement, you can obtain another copy by visiting one of our branches or calling 1-888-910-4100. --Did you know you could view your statement through Online Banking? Log into Online Banking at citizensbankonline.com, click on the account you wish to view, and then click on "View Statements" . JAMES E HATCHER SR BARBARAJHATCHER Basic Checking 610071-420-9 Previous Balance 1,234.23 V Total Checks 235.68 Current Balance 998.55 _ ~, .. . _ ~" ~ a .. _.. , 1-888-910-4100 Call Citizens' PhoneBank anytime for account information, current rates and answers to your questions. Checking Account Statement OF 2 Beginning May 10, 2007 through June 11, 2007 Overdraft Line of Credit SUMMARY Balance Calculation Previous Balance Advances & Debits FINANCE CHARGE Payments & Credits Current Balance JAMES E HATCHER SR Balance BARBARA J HATCHER Overdraft Line of Credit 00 Average Daily Balance • 00 610071-420-9 00 + Credit Limit 2, 500.00 00 + Available Credit 2, 500.00 00 - Interest 00 = ANNUAL PERCENTAGE RATE 15.49% Daily Periodic Rate .04244% Days in Billing Cycle 33 Payment Statement Beginning Date 05/10/07 Statement Closing Date 06/11/07 Past Due Amount . 00 Payment Due Date Minimum Payment Due . 00 TRANSACTION DETAILS No activity this statement period Previous Balance 00 Current Balance .00 NEWS FROM CITIZENS --Effective August 6, 2007 we are changing our overdraft/insufficient available funds policy. When you visit any of our branches to request a check, in-person withdrawal, or other debit on your account, and the transaction creates an overdraft on your account, the Overdraft/Insufficient Available funds fees described in your account Fees and features Guide may be charged if we decide to process the transaction. Please refer to your Deposit Account Agreement for more details about our overdraft/insufficient available funds policy. If you have misplaced your Agreement, you can obtain another copy by visiting one of our branches or calling 1-888-910-4100. --Notice to Certificate of Deposit customers. Monthly, Quarterly and Annual Certificate of Deposit (CD) Statements will no longer be mailed as of June 29,2007. Notice to Savings account customers. Monthly statements will be mailed quarterly as of June 29, 2007. You may continue to review the status of your CDs and Savings accounts on your monthly checking statements by linking these accounts. To link your CD, savings, and checking accounts, please call 1-888-910-4100 or visit your local Citizens Bank branch. --When you're traveling on vacation or business take along American Express Travelers Cheques. If they are lost or stolen, you have 24-hour access to worldwide refund services, 7 days a week. American Express Travelers Cheques -the safer, smarter way to carry cash' Available at any Citizens Bank branch. 5. -,. i ~.~~~ ' ~ __ ~ ~ ~ Checking Account _: __.~ i w. ~ ~ Statement , 1-888-910-4100 ~ of 2 Call Citizens' PhoneBank anytime for account information, current rates and answers to your questions. US059 BR291 1 1 JAMES E HATCHER SR 6116 LOCUST ST HARRISBURG PA 17112 Beginning June 12, 2007 through July 11, 2007 Contents Checking Page 1 Overdraft Line of Credit Page 2 Checking SUMMARY JAMES E HATCHER SR Balance Calculation BARBARA J HATCHER Basic Checking Previous Balance 998.55 610071-420-9 Checks 100.00 - Withdrawals .00 - Deposits & Additions . 00 + Current Balance 898.55 = - Previous Balance TRANSACTION DETAILS 998.55 Checks 'There is a break in check sequence Check # Amount Date Check # Amount Date 1340 100.00 06/29 Total Checks 100.00 (-1 Current Balance Daily Balance 898.55 Date Balance Date Balance Date Balance 06/29 898.55 MEMO --Did you know you could view your statement through Online Banking? Log into Online Banking at citizensbankonline.com, click on the account you wish to view, and then click on "View Statements". .-°~ z. . _r a. ~, - ~_ 1-888-910-4100 Call Citizens' PhoneBank anytime for account information, current rates and answers to your questions. i Checking Account Statement OF 2 Beginning June 12, 2007 through July 11, 2007 Overdraft Line of Credit SUMMARY Balance Calculation Previous Balance Advances & Debits FINANCE CHARGE Payments & Credits Current Balance Balance 00 Average Daily Balance 00 + Credit Limit 00 + Available Credit 00 - Interest 00 = ANNUAL PERCENTAGE RATE Daily Periodic Rate Days in Billing Cycle Payment Statement Beginning Dare Statement Closing Date Past Due Amount Payment Due Date Minimum Payment Due JAMES E HATCHER SR BARBARAJHATCHER Overdraft Line of Credit .00 610071-420-9 2,500.00 2,500.00 15.49% 04244% 30 06/12/07 07/11/07 .00 00 Previous Balance TRANSACTION DETAILS .OO No activity this statement period n Current Balance .00 NEWS FROM CITIZENS ' --Cover al I of your education-related costs now. Defer payments until later. Apply for a Citizens Bank Student Loan at www.citizensstudentloanl5.com or by calling 1-888-797-9796. --Notice to Certificate of Deposit customers. Monthly, Quarterly and Annual Certificate of Deposit (CD) Statements will no longer be mailed as of June 29,2007. Notice to Savings account customers. Monthly statements will be mailed quarterly as of June 29, 2007. You may continue to review the status of your CDs and Savings accounts on your monthly checking statements by linking these accounts. To link your CD, savings, and checking accounts, please call 1-888-910-4100 or visit your local Citizens Bank branch. ,~;~, K~ '_:i =~a ,~ Phone: (7 ] 7) 9G0-0005 V1~~/ OFFtGE 74 V'/est !'omfret St. Far: (717 960-99?0 ~ ~-" ~ f~E-EELEEz C~B€~tGf~.t~(Tt ~ Carlisle, PA 17013 LAST «'ILL AI~TD TEST 41~'IEI~TT ~} F BARBARA SEAN HATCHER I, Barbara Jean Hatcher, currently residing at 1 ~5 Salem Church Road, Lot 26, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind, do declare this to be my last Will, hereby revoking any and .all Wills and Codicils by me at any time heretofore made. ITEM I. APP©INTMENT OF PERSE~NAL REPRESENTATIVE. I name, constitute, and appoint my son, Robert W. Hatcher, Executor of this my last Will. My Executor shall hereinafter be referred to as my "Personal Representative." ITEM II. PAYI~~ENT ~}F DEBTS AND PTJIITP/RAL EXPENSES. I order and direct my Personal Representative to pay my debts and funeral expenses as soon after my decease as maybe convenient. ITEM III. DfSPaSJTFGN Gp' SPECIFIC PR~?PERTY. I give, devise and bequeath the following property as indicated: shotgun, vice, wheelbarrow, lamps and one pocket knife to my son, James E. Hatcher, Jr.; secretary, digital camera, one pocket knife, reciprocating saw and plumbing tools to my son, Robert W. Hatcher; .22 rifle, tin-cutting scissors, and sledge hammer to my son, William T. Hatcher; and my two remaining cemetery plots at Rolling Green Cemetary to Shari L. Hatcher. ITEM IV. I}ISPEJSITI~IN ~}E RE1VIAINDER GF' ESTATE. ~My Personal Representative shall sell the remaining property in my estate to my surviving children who wish to purchase such items, at a fair price as determined by the Personal Representative, and shall then liquidate the remainder of my estate in any reasonable manner he deems fit. I give, devise and bequeath all of said proceeds of my estate, and all of the remainder of my estate, absolutely unto the followring persons, in equal shares: Robert W. Hatcher, James E. Hatcher, Jr., William T. Hatcher, Mary E. Mumma and Shari L. Hatcher. In the event any of these persons does not survive me, the issue of such deceased person shall take the share of that person, per stirpes. In the event that any of these persons dies Leaving no issue surviving, I then give the share to which such deceased person would have been entitled equally to my surviving beneficiaries. ITEM V. TRUST FGR BENEFICIARIES I:ThTDER THE AGE GF T@VENTY-~3I`~TE. If any of my beneficiaries has not attained the age of twenty-one (21) years, I give such beneficiary's share to the Trustee, hereinafter named, IN TRUST, for the use of such beneficiary until he or she attains the ale of twenty-one (21) years. During the continuance of the trust, I authorize the said Trustee to use all of the income and so much of the principal as he deems advisable for the proper maintenance, support and education of such beneficiary. If any beneficiary dies before receiving the full principal of his or her trust, any accrued but undistributed income shall be distributed unto his or her issue, per stirpes, and if he or she has none then unto my issue, per stirpes, subject to the provisions of this section. ITEM VI. POWERS C}F PEIZSE}NAL REPRESENTATIVE AI~I3 TRUSTEE. My Personal Representative and Trustee shall have, in addition to and not in limitation of the powers given by law or by other provisions of this Wili, the power to invest the estate or trust assets in stocks, shares and obligations of corporations, of unincorporated associations or trusts and of investment companies or in any other kind of personal or real property, notwithstanding the fact that any or all of the investments made are of a character or size which but for this expressed authority would not be considered proper. ITEM VII. PA~'l~~FENT Q>~ DEATF~ TAXES. I direct that all estate, inheritance and other taxes in the nature thereof, together with any interest or penalties thereon becoming payable because of my death, with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid from the residue of my estate; and no legatee or devisee or any person having a beneficial interest in such property, whether under this Will or any Codicil thereto or otherwise, shall at any time be required to refund any part of such taxes. Taxes on future interests may be prepaid. ITEM VIII. TRFTSTEE. I appoint Robert W. Hatcher as Trustee of any trusts created hereunder. ITEM IX. WAIVER CIE B~l\TD. I direct that none of the fiduciaries appointed under this instrument be required to give bond. ITEM X. SAVINGS PR~3V~SIQ~N. If any provision of this Will or any Codicil thereto is held to be inoperative, invalid or illegal, it is my intention that all of the remaining provisions thereof shall continue to be fully operative and effective so far as possible and reasonable. ~~~,~ IN W..~ITNESS WHEREQF, I have hereunto set my hand and seal this ~" ~ -~ day of -=~ ~-,~, „ , 2005. I: T f ~~ ~~-u.~.1-~.~-eu, Jam- ~~ C/1~4,~ f ~ (SEAL) Barbara Jean Hatcher i, THIS INSTRUMENT, consisting of tt~o (2) typewritten pages, was by the above-named Testator, on the date hereof, signed, sealed, published and declared to be her last Will and Testament, in the presence of the undersigned, who, at her request, in her presence and in the pre ce of each other, have hereunto subscribed their names as witnesses. E-• ~ ~ ~= ,~,%~ ~ .,.~'`- residing at < .S" ~~'~ ~~ ; ~ ~~ ~-~;r. ~~, ~ ~ ~ .~ - ~~' ~ ~- ~-~ ~:~ ~ E f ~, 'residing at _ ~°,~ f~<< -r, ~f~::-~~-; .~E ~, f-'~` ~~~. ~F`~` f i~'~~ r~-• _7_ COI~~II~~ION~~~EALTH Or PE~?I~TSY"LVAI~TIA COUNT' OF CUIt~IBERLAND SS: ~~Je, Barbara Jean Hatcher, Philip C. Briganti, and Debra K. Briganti, the Testator acid the witnesses, respectively, whose names are signed to the attached or foregoing inshument, being first duly affirmed, do hereby declare to the undersigned authority, a Notary Public, that the Testator signed and executed the instrument as her last will and that she had signed willingly, and that she executed it as her 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 his or her knowledge the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ,r r i~ ,,: ,/ S Cz.-~l-[.,~~~='.'`~ ~~ .~~ .~a ,~ ~`=~~T'estator v~; '``' r~,m / Witness r'~. ~~!~` ~~'~,-~',.~ ~~~ ~i,.,~-~.% Witness v' Subscribed, affirmed to and acknowledged before me, a Notary Public, by Barbara Jean Hatcher, the Testator, and subscribed and affirmed before me by Philip C. Briganti and Debra K. Briganti, witnesses, this f ~~ °"` day of `r~'~r'u ~z-.t.,;~ 200. ` J `~ ~ ~ Y' ,~ Notary Pubkl~i~c ~E .;~