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LAW OFFICES OF
ZULLINGER -DAVIS
PROFESSIONAL CORPORATION
JOEL R. ZULLINGER
14 North Main Street
Suite 200
Chambersburg, PA 17201
717-264-6029
Fax:717-264-1.884
zuln rgrlaw~a,earthlink.net
Dale F. Shughart, Jr.
of counsel
February 25, 2009
Register of Wills
Cumberland Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Florence Bessieres
Est. No. 21-08-0999
Dear Sir or Madam:
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Enclosed herewith please find an inheritance tax return, filed in duplicate, and payment in
the amount of Six Hundred Thirty-Nine Dollars and 18/100 ($639.18), as payment for the above
estate.
A check for filing fee in the amount of $15.00 is also enclosed
If there are any questions or concerns, please contact me at the Shippensburg office. Thank
you.
HCD/njk
Enclosures
Sincerely yours,
,~ -- %1.~
~_--;~ ~
Hamilton C. Davis"
for Zullinger -Davis
Professional Corporation
Reply to: Hamilton C. Davis
P.O. Box 40
Shippensburg, PA 17257
HAMILTON C. DAVIS
20 East Burd Street, Suite 6
P.O. Box 40
Shippensburg, PA 17257
717-532-5713
Fax: 717-530-5222
hamiltondavislaw(a~ comcast.net
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J
r 1505607120
-
REV-~
JOO
EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes
County Code Year File Number
Po Box.28oso~ INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 ~ RESIDENT DECEDENT 21 0 8 0 9 9 9
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
215229102 07092008 04141915
Decedent's Last Name Suffix Decedent's First Name MI
BESSIERES FLORENCE
(If Applicable) Enter Surviving Spouse's Inform ation 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 INAPPROPRIATE OVALS BELOW
® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Retum (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ qa, Future Interest Compromise ^ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
® g Decedent Died Testate ^
(Attach Copy of Will) ~ Decedent Maintained a Living Trust 8. Total Number of Safe De osit Boxes
(Attach Copy of Trust) p
^ 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. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name
Daytime Telephone Numbed
HAMILTON C DAVIS 717532c~713 ~~ --:
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Firm Name (If Applicable) "
REGISTER ~ IrZS USE70NLY
~
ZULLINGER DAVIS, PC <
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First line of address ~~ ~ ~ ~ ~ "~ '
;VAC ~t~-~ ;
20 EAST BURD STREET, SUITE 6
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Second line of address
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DATE FILED
City or Post Office State ZIP Code
SHIPPENSBURG PA 17257
Correspondent'se-mail address: hamiltOndaVISIaW@COmCast.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, ect and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNAT OF PER~S~"/~ESPONSIBLE FOR FILING RETURN DATE
~7/.,r. /: !-/L~/ HAMILTON C. DAVIS
20 EAST BURD STREET, SUITE 6, SHIPPENSBURG, PA 17257
SIG~R F PREPARER ~T R THA~~ ESE/ ~ DATE
Hamilton C Davis
20 East Burd Street, Suite 6, Shippensburg, PA 17257
Side 1
1505607120 1505607120- J
1505607220
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: BESSIERES, FLORENCE 215229102
RECAPITULATION
1 . Real Estate (Schedule A) ......................................................................................... . 1.
2 . Stocks and Bonds (Schedule B) .............................................................................. . 2.
3 . Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 1 6 , 0 4 1 . 9 9
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............. 7,
8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 1 6, 0 4 1. 9 9
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 , $ 3 8 . 0 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10.
11. Total Deductions (total Lines 9& 10) ........................................................
..............
11. 1 8 3 8. 0 0
,
12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 1 4 , 2 0 3 . 9 9
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. 1 4 , 2 0 3 . 9 9
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 .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 14 , 2 0 3. 9 9 16. 6 3 9.18
17. Amount of Line '14 taxable
at sibling rate X .12 17
18. Amount of Line '14 taxable
at collateral rate X .15 18.
19. Tax Due ..................................................................................................................... 19. 6 3 9. 1 8
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
L. Side 2
1505607220
1505607220 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 08 - 0999
NAME
BESSIERES, FLORENCE
STREET ADDRESS
GREENRIDGE VILLAGE
210 BIG SPRING ROAD
CITY STATE ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 639.18
Total Credits (A + g + C) (2) 0.00
3. Interest/Penalty if applicable
p. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) 0.0 0
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 639.1 8
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) s 3 9 .
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 :.................................................................................. ^ O
b. retain the right to designate who shall use the property transferred or its income :.................................... ^ ^x
c. retain a reversionary interest; or .................................................................................................................. ^ ^x
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? ....................................................................................................................... ^ 0
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 andt~efore 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)]. 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.
SCHEDULE E
' CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNS`/LVANIA PERSONAL PROPERTY
INHERITANCE TAX RETURN ~~
RESIDENT DECEDENi~
FILE NUMBER
ESTATE OF BESSIERES, FLORENCE 21 - 08 - 0999
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 OPPENHEIMER MUTUAL FUNDS -ACCOUNT NO. A25-0027966 (SEE VALUATION 15,941.99
ATTACHED)
2 I MISCELLANEOUS PERSONAL PROPERTY AND EFFECTS (THE DECEDENT RESIDED IN AI 100.00
NURSING HOME AND HAD ALMOST NO PERSONAL EFFECTS)
TOTAL (Also enter on Line 5, Recapitulation) I 16,041.99
SCHEDULE H pp~ ''
COMMONWEALTH OF PENNSYLVANIA I rvl~ -"
INHERITANCE TAX RETURN ~r~A'~'~e~
RESIDENT DECEDEIJT rr.r~~~ w„v-~
FILE NUMBER
ESTATE OF BESSIERES, FLORENCE 21 - 08 - 0999
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION
NUMBER FUNERAL EXPENSES:
A.
B. ~ ADMINISTRATIVE COSTS:
1. ~ Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission paid
z. Attorney's Fees HAMILTON C. DAVIS, ESQUIRE - ZUL
3. ~ Family Exemption: (If decedent's address is not the same as claimant's
Claimant
Street Address
i City State
Relationship of Claimant to Decedent
4. Probate Fees CUMBERLAND COUNTY REGISTER OF
5. ' Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 CUMBERLAND COUNTY LEGAL JOURNAL -LEGAL AD
TOTAL (Also enter on line 9, Recapitulation) 1,838.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedule H
Funeral F~q~er>ISes &
Administrative Costs continued
ESTATE OF BESSIERES, FLORENCE FILE NUMBER
21 - 08 - 0999
THE NEWS CHRONICLE -LEGAL ADVERTISING
CUMBERLAND COUNTY REGISTER OF WILLS -FILING FEES AND RESERVE
113.00
50.00
Page 2 of Schedule H
REV•1513 EX+ (8-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA ~r-~rr~~~ ~ ~~re~
INHERITANCE TAX RETURN ~~. ~GIYGrIt-1/'11'[IG~7
RESIDENT DECEDL=NT '~
ESTATE OF ~ FILE NUMBER
BESSIERES, FLORENCE
21 - 08 - 0999
NUMBER ' NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO ' SHARE OF ESTATE
DECEDENT (Words) ~ AMOUNT OF ESTATE
($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers ~
under Sec. 9116 (a) (1.2)]
1 i PAUL BESSIERES Son ~ 1/2 OF ESTATE 7,101.99
51 SOTELO AVENUE .,,
SAN FRANCISCO, CA 94116
2 GRACE BESSIERES Daughter 112 OF ESTATE 7,101.99
15 STEVENSON ROAD
HEWLETT, NY 11557
I
I
Enter dollar amounts for distributions shown above on lines 1 i
5 through 18, as appropriate, on Rev 1500 cover sheet
II. INON-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 0.00
PPENHEIME ~~ r O ~ Oppenheimer & Co. Inc.
J ~ 1015 Mumma Road
Wormleysburg, PA 17043
800-722-2294
Member of All Principal Exchanges
Zullinger-.Davis
ATTN: Hamilton C. Davis, Esquire
P.O. Box 40
Shippensburg, PA 17257
RE: Estate of Florence Bessieres
Dear Mr. Davis,
November 4, 2008
As per your request, please find below the Date of Death Valuations as of July 9, 2008
for the Estate of Florence Bessieres:
385.429 shares of AIM Charter Fund A $15.10 =
344.333 shares of Goldman Sachs Structured $24.67 =
US Equity Fund A
1,627.33 Advantage Primary Liquidity $1.00 =
The current value of the account as of November 3, 2008 is $12,961.89.
There will be no fees involved to liquidate and mail a check to you.
$5,819.97
$8,494.69
$1,627.33
Also, we will need the Affidavit of Domicile signed by you as the Administrator of the
Estate, please sign and return.
If you have any other questions, please don't hesitate to call me.
Thank you.
MGC/lo
Sincerely,
c
Mic ael G. se
Fi nciai Advisor
Enclosure
%a~~ ~~y~r~ , ~I. la~~;~,
I, Florencr~ A. Bessieres,
Pennsylvania declare that this is my
215 22 9102.
~ resident of Cumberland County,
will. My Social Security Number is
FIRST: I revoke all wills and codicils that I have previously made.
SECOND: I have the following children now living: Paul Bessieres and
Grace Bessieres.
THIRD: I give gifts as listed in my Bequest List to Paul Bessieres.
However, if the beneficiary named in this paragraph ~ to receive this
property fails to survive me, that beneficiary's living children shall take
the property. If the beneficiary named in this paragraph; to receive this
property fails to survive me and leaves no living children of his or her
own, the prop erty shall go to my residuary estate.
FOURTH : I give gifts as listed in my Bequest List to Sandra C.
Bessieres., However, if the beneficiary named in this paragraph to receive
this property fails to survive me, that beneficiary's living children shall
take the property. If the beneficiary named in this paragraph to receive
this property fails to survive me and leaves no living children of his or her
own, the ,property shall go to my residuary estate.
FIFTH: I give gifts as listed in my Bequest List to Christianne M.
Bessieres. However, if the beneficiary named in this paragraph to receive
this property fails to survive me, that beneficiary's living children shall
take the property. If the beneficiary named in this paragraph to receive
this property fails to survive me and leaves no living children of his or her
own, the property shall go to my residuary estate.
Page 1 of 7 Initials: _~ ~KN ~,~-D Date: ~' S~ y~
Will of Florence A. Bessieres
SIXTH: I give gifts as listed in my Bequest List to Marshall M.
Bessieres. However, if the beneficiary named in this paragraph to receive
this property fails to survive me, that beneficiary's living children shall
take the property. If the beneficiary named in this paragraph to receive
this property fails to survive me and leaves no living children of his or her
own, the property shall go to my residuary estate.
SEVENTH: I give gifts as listed in my Bequest List to Stuart J.
Bessieres. However, if the beneficiary named in this paragraph to receive
this property fails to survive me, that beneficiary's living children shall
take the property. If the beneficiary named in this paragraph to receive
this property fails to survive me and leaves no living children of his or her
own, the property shall go to my residuary .,estate.
EIGHTH: I give gifts as listed in my Bequest List to ';Grace Bessieres.
However, if the beneficiary named in this paragraph ~ to receive this
property fails to survive me, that beneficiary's living children shall take
the property. If the beneficiary named in this paragraph to receive this
property fails to survive me and leaves no living children of his or her
own, the property shall go to my residuary estate.
NINTH: I give gifts as listed in my Bequest List to Reyna Batista.
However, if the beneficiary named in this paragraph to receive this
property fails to survive me, that beneficiary's living children shall take
the property. If the beneficiary named in this paragraph' to receive this
property fails to survive me and leaves no living children of his or her
own, the property shall go to my residuary estate.
TENTH: I give gifts as listed in my Bequest List to 1st Presbyterian
Church of Newville PA.
Page 2 of 7 Initials: ~ ~'f~N ~-'~-~ Iaate: ~ ~~ - 9s
Will of Florence A. Bessieres
ELEVENTH: As used in this will, the term "specific bequest" refers to
all specifically identified property, both real and personal; that I give to
one or more beneficiaries in this will. The term "residuary' estate" refers to
the rest of my property not otherwise specifically disposed' of by this will
or in any other manner. The term "residuary bequest" refers to my
residuary estate that I give to one or more beneficiaries in this will.
TWELFTH: All personal property I give in this will through a specific
or residuary bequest is given subject to any purchase-money security
interest, and all real property I give in this will through a specific or
residuary bequest is given subject to any deed of trust, mortgage, lien,
assessment, or real property tax owed on the property. ;As used in this
will, "purchase-money security interest" means any debt secured by
collateral that was incurred for the purpose of purchasing that collateral.
As used in this will, "non-purchase-money security interest" means any
debt that is secured by collateral but which was not incurred for the
purpose of purchasing that collateral.
THIRTEENTH: When this will states that a beneficiary must survive
me for the purpose of receiving a specific bequest or residuary bequest, he
or she must survive me by 45 days.
FOURTEENTH: I hereby leave $1.00 to each of the following persons:
Paul Bessieres and Grace Bessieres. These bequests are in, addition to and
not instead of any other specific bequest that this will 'makes to these
persons.
FIFTEENTH: I give my residuary estate to Paul Bessieres and Grace
Bessieres. However, if any beneficiary named in this paragraph to receive
my residuary estate fails to survive me, that beneficiary's living children
shall take that beneficiary's share. If a beneficiary named in this
Page 3 of 7 Initials: _ ~ ~K ~ F.1~U Date: 1- 5 - ys
Will of Florence A. Bessieres
paragraph to receive my residuary estate fails to survive me and leaves no
living children of his or her own, the other surviving beneficiaries named
in this paragraph to receive the residuary estate shall take the deceased
beneficiary's share.
SIXTEENTH: Any specific bequest or residuary bequest made in this
will to two or more beneficiaries shall be shared equally among them,
unless unequal shares are specifically indicated.
SEVENTEENTH: I name Paul Bessieres as my personal representative
(executor), to serve without bond. If this person or institution shall for
any reason fail to qualify or cease to act as personal representative, I name
Grace Bessieres as personal representative (also to serve without bond),
instead.
EIGHTEENTH: I direct my personal .representative to take all actions
legally permissible to have the probate of any will done as simply and as
free of court supervision as possible under' the laws of ;;the state having
jurisdiction over this will, including filing a petition in the appropriate
court for the independent administration of my estate.
NINETIETH: I hereby grant to my personal representative the
following powers, to be exercised as he or she deems to' be in the best
interests of my estate: I~
1) To retain property without liability for ;loss or depreciation
resulting from such retention.
2) To dispose of property by public or private sale,; or exchange, or
otherwise, and receive and administer the proceeds as a part of my estate.
3) To vote stack, to exercise any option or privilege ~o convert bonds,
notes, stocks or other securities belonging to my estate into other bonds,
notes, stocks or other securities, and to exercise all Qther rights and
privileges of a person owning similar property.
~~
Page 4 of 7 Initials: K~ Date: /-s- y~
Will of Florence A. Bessi~res
4) To lease any real property that may at any time dorm part of my
estate.
5) To abandon, adjust, arbitrate, compromise, sue on or defend and
otherwise deal with and settle claims in favor of or against 'my estate.
6) To continue or participate in any business which is apart of my
estate, and to effect incorporation, dissolution or other change in the form
of organization of the business.
7) To do all other acts which in his or Ixer judgment may be
necessary or appropriate for the proper and advantageo',us management,
investment and distribution of my estate.
i~
The foregoing powers, authority and discretion granted to my
personal representative are intended to be in addition 'to the powers,
authority and discretion vested in him or her by operation pf law by virtue
of his or her office, and may be exercised as often as is deemed necessary
or advisable, without application to or approval by any court in any
jurisdiction.
TWENTIETH: Except for purchase-money security interests on
personal property passed in this will, and deeds of trust, mortgages, liens,
taxes and assessments on real property passed in this will, I instruct my
personal representative to pay all debts and expenses,', including non-
purchase-money secured debts on personal.: property, owed by my estate
using my residuary estate.
TWENTY-FIRST: I instruct my personal representative to pay all
estate and inheritance taxes assessed against property iii my estate or
against my beneficiaries using my residuary estate.
TWENTY-SECOND: If any beneficiary under this will:,. in any manner,
directly or indirectly, contests or attacks this will or any pf its provisions,
any share or interest in my estate given to the contesting beneficiary
Page 5 of 7 Initials: ~ f~ , .~p _, Date: ~' S " ~'~
Will of Florence A. Bessieres
under this will is revoked and shall be disposed of in the .same manner as
if that contesting beneficiary had failed to survive me and left no living
children.
I, Florence A. Bessieres, the testator, sign my name to this
instrument., this _ _
~ ___ day of __~ __~^__, ~~,~~ I
hereby declare th I sign nd execute th is instrument as my last will, that
I sign it willingly, and that I execute it as my free and voluntary act for
the purposes therein expressed. I declare that I am of the; age of majority
or otherwise legally empowered to make a will, and under no constraint or
undue influence.
~~,~-~ ~.
(Signed)
Page 6 of 7 Initials: _~'~ ~;J Kl~ ~~- Q Iaate: ~ " s " ~~
Will of Florence A. Bessi~res, Page 7 of 7
We, the witnesses, sign our names to this instrument, and do hereby
declare that the testator willingly signed and executed this instrument as
the testator's last will.
Each of us, in the presence of the testator, and in ; the presence of
each other, hereby sign this will as witness to the testator's : signing.
To the best of our knowledge, the testator is of the age of majority or
otherwise legally empowered to make a will, is mentally', competent, and
under no constraint or undue influence.
We declare under penalty of perju y, that the foregoing is true and
correct, this _ ~ ~ day of ~ /9~~'.
II
~ , /1
Witness #1: ~~ ~~
Residing at:
Witness #2:
Residing at:
Witness #3:
Residing at:
i
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~~ ~~ .~~
Ica av ~ ~
~~ ~ ~ ~~
~ ~~~