HomeMy WebLinkAbout08-27-09~ REV-1 500 1505607120
F~( (06-05) OFFICIAL USE ONLY
PA Department of Revenue County Cade veer Fib Number
Bureau of Individual7axes INHERITANCE TAX RETURN 2 1 0 9 0 0 9 7
PO BOX.280601
Hanisburg, PA ~7~28-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
182228815 12032008 06021929
Decedent's Last Name Suffix Decedent's First Name MI
BA3EHORE VIOLET R
(N Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Return
^ 4. Limited Estate
® B Decedent Dbd Teetale
(AttaM Copy MWN)
Suffix Spouse's First Name
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
^ 2. Supplemental Relum
^ qa Future Interest Compromlee
(date or death after 12-12-e2)
^ ~ Daeetlent MalMabled a Living Tmat
(Adach Copy of Trull)
MI
^ 3. Remaintler Return (date of death
prior to 12-13-92)
^ 5. Federel Estate Tax Return Requiretl
S. Total Number of Safe Deposit Boxes
^ 9. Litigation Proceetls Received ^ 10, bPoeiw er'tP2ae~credrc{ae85or death ^ 7t.ElecNOn to tax untler Sec. 9113(A)
CC (Attach Sch. O)
NemeESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTULL TAX INFORMATION SNOULD BE DIRECTED TO:
Daytime Telephone Number
STEVEN P. MINER ESQUIRE 7177249821
Finn Name (If Applicable) ro
DALEY ZUCKER MEILTON MINER & REGISTE~FWILLSU~ONLY L.
CO .o -, .
First Ilne of address ~ ~ ~ ~ (~..i
1035 MUMMA ROAD, SUITE 101 ,.- 1,;
y ~~i-i N
37 .,.t
%:cri
Seeond line of address ~~ i- __-~
C~ ~ -
r~ -n =
'iC
Ct or Poat Office ~ S~FILED ~ 'r
ty State ZIP Code _
WORMLEYSBURG PA 17043 cn
correspondent'se-malladdress: Sminer~dzmmglaw.com
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules eM statements, and to the best of my knowledge and belief
It Is true, coned antl complete. Declaration o! preparer other than Me pereonal repreeantatlve Ia Dasetl on ell informatton of which preperer has any knowledge.
NATUnRE OsF PERSON REP NSIBLE FOR FILING RETURN ATE
't'~a~- ~ Tito Aloneo Basorez BIZG~D9
ADDRESS
3605 Darby Road, Harrisburg, PA 17109
SIGNATURE OF PR OTHER THAN REP ESENTATIVE ATE
~~~/ Steven P. Miner Esquire rd ~~ (~ ~G S
1035 Mumma Road, Suite 101, Wormleysburg, PA 17043
Side 1
L 1505607120 1505607120 J
... ~ .. , ~. , . ., . ,N ~.. , ~,u~.~~,c~~:~~ ,.
J 1505507220
REV-1500 EX
Decedent's Social Security Number
oec,d,m~, Name: BASEHORE, VIOLET R 1 8 2 2 2 8 815
RECAPITULATION
1. Real Estate (Schedule A) ........................................................................................ .. 1.
2. Stocks and Bonds (Schedule B) ............................................................................. .. 2.
173,849.42
3. Closet' Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ .. 3.
4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ .. 4.
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) .............. .. 5.
35,364.49
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............ . 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............ . 7.
8. Total Gross Assets (total Lines 1-7) ...................................................................... . g. 2 0 9, 2 1 3. 9 1
9.
Funeral Expenses 8 Administrative Costs (Schedule H) .......................................
.. 9. 25,193.37
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............................. .. 10.
5,263.96
11. Total Deductions (total Lines 9 8 10) .................................................................... ..
11. 3 0, 4 5 7. 3 3
12. Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12. 1 7 8 , 7 5 6 . 5 8
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................................................ . 13,
14. Net Value Sub ( )
feet to Tax Line 12 minus Line 13 ................................................
. 14. 1 7 8, 7 5 6 5 8
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amounl 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 17 8 , 7 5 6 . 5 8
at lineal rate X .045
16.
8, 0 4 4. 0 5
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. 8, 0 4 4. 0 5
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
L Slde 2
1505607220 1505607220 J
y.:
,_ _... ,ro-.ut F.d,..cs'~3htass... x ,:`€~rk., .e ,a.
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 09 - 0097
Basehore, Violet R
STREET ADDRESS
Country Meadows
4905 East Trindle Road
CITY
Mechanicsburg STATE
PA ZIP
17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. InterestlPenaky if applicable
p, Interest
E. Penalty
7,500.00
394.74
TotalCredits (A+e+C) (2) 7,894.74
(t> 8,044.05
Total InteresVPenalty (D+ E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Llne 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)
A, Enter the interest on the tax due. (5A)
g, Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56)
0.00
148.31
149.31
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: Yea No
a. retain the use or income of the property transferred :..............................~~~~~~~~~-.......................................... xx II
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 cere? .............................................................. x
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 Aaount, annuity, or other non-probate properly which
contains a beneficiary designation? ...................................................................................................................... ^ 0
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 trensfere 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 examot 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 it the surviving spouse is the only beneftciary.
For dates of death on or after Juy 1, 2000:
The tax rata imposed on the net value of transfers from a deceased chikl iwemy-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 (O) percent [72 P.S. §9116 (a) (1.2)].
The lax rata imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is Four and one-haN i4.5) percent,
except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
The tax rato imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent p2 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.
CgAMONWFlLTH OF PENNETLVANIA
rlNE11rtPNCE TA%NETUPN
PE810@ITDEDEDENi
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
ESTATE OF Basehore, Violet R 21 - 09 - 0097
All properly Jolntry-owned with right of survivorship must be dlaclosed on Schedule F.
ITEM
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF
DEATH
1 Edward Jones Account#27004457-1-7, market value of 149,850.00
investments
2 MFIS -Money Market Fund Investment Shares 23,999.42
TOTAL (Also enter on Ilne 2, Recapitulation) 173,849.42
. ... i ,. E .. , . .. ..
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEN,TN OF PENNSriVN11N PERSONAL PROPERTY
MHERR/JICE TN(RETIRN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Basehore, Violet R 21 - 09 - 0097
Include the ~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorsh p must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
DEATH
NUMBER
1 PNC Bank Checking Account No. 5070090315 12,750.15
2 Refund from Country Meadows 4,232.10
3 Refund from Blue Cross for ambulance invoices 870.00
4 Refund from Medco 25.00
5 Refund from Patriot News 8.15
6 Cash 218.46
7 PNC Bank Savings Account No. 5000919618 4,013.97
8 PNC Bank Savings Account No. 5030088878 1,164.42
9 Refund of 2008 Federal Income Tax 2,167.00
10 MelLife TCA Money Market Account No. 4030829606 9,915.24
TOTAL (Also enter on Line 5, Recapitulation) I 35,364.49
SCF'EDI~~E rH~~.
coNNOxwExm or vENNSn.vnNU ~~
INNEPRNICE TN(PETUPN ArV~C1flA1f1~/G'/~M1'C
PEEX]ENT DECEDENT I'1LA~~I~I r rW ~ r1/G V W r ~7
FILE NUMBER
ESTATE OF Basehore, Violet R 21 - 09 - 0097
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 Malpezzi Funeral Home 12,292.37
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Tito Alonso Basorez
Social Serwdty Number(s) / EIN Number of Personal Representative(s):
streetnddress 3605 Darby Road
City Harrisburg State PA Zip 17109
Year(s) Commission paid 2009
z. Attorneys Fees Daley Zucker Meilton Miner 8 Gingrich, LLC
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 Register of Wills of Cumberland County
5. ~ Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 The Paxton-Herald, advertise Estate Notice
9,550.00
2,860.00
322.00
38.00
TOTAL (Also enter on Ilne 9, Recapitulation) 25,793.37
SchedirreH
CgMNANWEAI.TR OF PENNSYLVANIA ~ /~y~yy
INNERITANCE TA%RETURN ~~AJ01a
ESTATE OF Basehore, Violet R
2 Dauphin County Reporter, advertise Estate Notice
3 Additional short certificates
4 ~ Filing fee for Petition to Withdraw as Executrix
FILE NUMBER
21 - 09 - 0097
75.00
20.00
36.00
Page 2 of Schedule H
..__
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
°°"",„"Ea ~, E~;~°'E;a,~;""" LIABILITIES, & LIENS
REBIDENTDECEDENT
FILE NUMBER
ESTATE OF Basehore, Violet R 21 - 09 - 0097
Include unrelmbureed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1 Pennsylvania Department of Revenue, 2008 State Tax 69.00
2 Berman & Rabin, P.A., American Home Patient 17.02
3 Azizkhan Internal Medicine 244.01
4 Darren Barbacci DPM 22.56
5 Quantum Imaging 18.49
6 Pinnacle Health 51.93
7 Cardiology Diagnostic LLC 3.63
8 Cardiovascular Surgical Institute 2.15
9 Center for Kidney Disease 173.39
10 Shah Neurology 27 67
11 Country Meadows -Prescriptions 69.65
12 Health South Rehab 100.00
13 Kantor 8 Tkatch Associates, medical bill 155.79
14 Kunkle Surgical Group 6.52
15 Moffitt Heart 8 Vascular 3.46
16 Physicians of Health South Rehab 68.57
TOTAL (Also enter on Llne 10, Recapitulation) I 5,263.86
_, nx ,. .. e~.uk E. .~tt~,±,.x,. e~a.~c. ai, xa. w~° _,
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
DpAM0NWEN.TN aF PENNEYLV0611R LIABILITIES, & LIENS
INNERRMICETN%RENRN
RESIDENT DECEDENT
continued
FILE NUMBER
ESTATE OF Sasehore, Violet R 21 - 09 - 0097
Include unrelmbureed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
17 Pathology Associates 6.15
18 Internists of Central Pennsylvania 132.02
19 PA Gastroenterology Associates 93.82
20 Pinnacle Health Medical Services 113.37
21 Pinnacle Health Hospitals 400.00
22 Pulmonary & Critical Care 55.22
23 Vascular Associates 15.73
24 East Pennsboro Ambulance 46.00
25 Medicine Shoppe 97.94
26 U. S. Treasury - 2007 Tax Adjustment 1,537.00
27 Hampden Township Ambulance Service 870.00
28 Health Network for bloodwork 6.11
29 Pinacle Health Emergency Services 75.19
30 Harrisburg Hospital 285.00
31 Health South Rehab 68.57
32 Department of Revenue, additional State tax for 2007 428.00
Page 2 of Schedule I
REVd61] El(~ (0.W) ! ~,
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF Basehore, Violet R FILE NUMBER
21 - 09 - 0097
NUMBER NAME AND ADDRESS OF PERSONS
() RELATIONSHIP TO
~m uKD
E
n~ SHARE OF ESTATE
(Words) AMOUNT OF ESTATE
($$$)
RECEIVING PROPERTY o,
ir
u
lq
I, TAXABLE DISTRIBUTIONS [include outright s ousel
distributions and transfers
under Sac. X116 (a) (1.2)]
1 Boaz Blough Grandson 1,000.00
355 S. Park Street
Dallastown, PA 17313
2 Cynthia Negley Daughter One Sixth
202 E. Main Street
Mechanicsburg, PA 17055
3 Sandra Basehore Daughter One Sixth
134 Lancaster Boulevard
Mechanicsburg, PA 17055
Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS
NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI 0.00
sr mP .~ Lb t^~~~~lu fY~.~~P.PA S. x;9. o -
REV~767J EX+tf-00) t ~ a
SCHEDULE)
COMMONWEALTH OF RENNSVLVANIA
INHERITANCE iAX RETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF
Basehore, Violet R FILE NUMBER
21 - 09 - 0097
NUMBER NAME AND ADDRESS OF PERSONS
() RELATIONSHIP TO
N a
~a ~„~E SHARE OF ESTATE
(words) AMOUNT OF ESTATE
($$$)
RECEIVING PROPERTY N
st
m
I, TAXABLE DISTRIBUTIONS [include outright spousal
distributions and transfers
under Sec. X116 (a) (1.2)]
4 Tito Alonso Basorez Son One Sixth
3605 Darby Road
Harrisburg, PA 17109
5 Marcella Hubbard Son One Sixth
238 E. Main Street
Shiremanstown, PA 17011
6 Judy Levy-Stutsky Daughter One Sixth
17113 Founders Mill Road
Derwood, MD 20855
7 Teresa Hunt Pennington Daughter One Sixth
29 Forest Drive
Mechanicsburg, PA 17055
Page 2 of Schedule J
.~,.,, a.1~, .w~a~.~- . .,
LAST WILL AddD TESTAIViEIi^t
BE IT REMEMBERED THAT
I, VIOLET R. BASEHORE, a resident of Cumberland County,
Pennsylvania, being of sound mind, memory and understanding, do make,
publish and declare this to be my LAST WILL AND TESTAMENT, hereby
revoking any and all Wills and Codicils previously made by me.
I declare that I am not married, my beloved husband having predeceased
me and that I have six (6) children, CYNTHIA NEGLEY, SANDRA. BASEHORE,
TITO A. BASOREZ, MARCELLA HUBBARD, JUDY LEVY-STUTSKY and TERESA
HUNT.
II
I direct that all my just debts and funeral expenses shall be paid from my
residuary estate as soon as practicable after my decease.
III
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 a part of the expense of the administration of my estate.
IV ~
co
17
I give and bequeath ONE THOUSAND DOLLARS ($1,000.06)'t8~y eat
.,
_fZ~ co
Grandson, BOAZ SLOUGH, per stirpes. ~="D^ c~
JC>-~ ~.
V ro=i C~
A _
I have made loans to my daughter, SANDRA BASEHORE and my dau~Ater,
MARCELLA HUBBARD. Any bequest to SANDRA BASEHORE or MARCELLA
HUBBARD, shall be offset against the balance of the riebt that each still owes to
me.
VI
I give, devise and bequeath all of the rest, residue and remainder of my
property, whether real or gersonal, wherever situate, including any property over
which I may have a power of appointment to my children, CYNTHIA NEGLEY,
SANDRA BASEHORE, TITO A. BASOREZ, MARCELLA HUBBARD, JUDY LEVY-
STUTSKY and TERESA HUNT, in equal shares, per stirpes.
VII
I nominate, constitute and appoint my daughter, TERESA HUNT, as
Executrix of this LAST WILL, to serve without bond. If my daughter is unable or
unwilling to act in that capacity, then I nominate, constitute and appoint my son,
TITO A. BASOREZ, as Executor of this LAST WILL, to serve without bond.
IN WITNESS WHEREOF, I, VIOLET R. BASEHORE set my hand to this
LAST WILL this ~3 J51- day of I~4¢.~~~. , 2005.
(~~~ K, ~7' Ih
VIOLET R, BASEHORE
Signed, sealed, published and declazed b3' the above-named VIOLET R.
BASEHORE, as and for her Last Will and Testament, in the presence of us, who,
at her request and in her presence, and in the presence of each other, have
hereunto subscribed our names as witnesses.
,,
/,
fL..<<>~_ /fit. ~:j,:r
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
I, VIOLET' R. BASEHORE, Testatrix, whose name is signed to the attached
or foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my LAST WILL; that I
signed it as my free and voluntary act for the purposes therein expressed.
~J ~~~ ~~ s(r_..,..-~
VIOLET R. BASEHORE
Sworn or affirmed to and acknowledged before me by VIOLET R. BASEHORE,
Testatrix, this :-j/j{- day of ,.~~r-c~1.` , 2005.
AFFIDAVIT
/ ._._
Sworn or affirmed to and acknowledged before me
this 3/Sf day of t /41ieteE` , 2005.
~ _ (( /J
Notary Public ~` dd~~
Qli(
Y
. ~: '.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Notary Public
w tu. ~ ~ ,
~r ~ ,
ss.
We, $l C .'+' dt..? ~,' !Zc ~ X57 1 and ../~~.u>4 !''1 . `I ~ :'~~-
the witnesses whose names are signed to the attached or foregoing mstrument,
being duly qualified according to law, do depose and say that we were present
and saw Testatrix sign and execute the instrument as her LAST WILL, that
VIOLET R. BASEHORE signed willingly 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 18 yeazs of e or more, of sound. mind
and under no constraint or undue influence. / / ~' ~'
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Aug. 17. 2099 1:SOPM PNC BANK 412-705-2747
~~~
1.8A(1lNG 7NEYtAY
August 17, 200>
DAMG Attorneys at Law
Susan Hudson
1035 Mumma Rd Suite 101
Wormleysburg, PA 17043
RE: Name: Violet R Basehore
SSN: 182-22-8815
DOD: 12-03-2008
Dear Ms. Hudson:
No, 7916 P. 1
1n response to your request for Date of Death 'DOD) balances for the customer noted above, our
records show the following:
Checking Aecount
Account# 5070090315
VIOLET R BASEHORE
DOD balance: $12,749.08 + 1.07 accrued interest
Savings Account
Account # 5000919618
VIOLET R BASEHORE
DOD balance: $4,013.01 + 0.96 accrued interest
Account # 5030088878
VIOLET R BASEIiURE
DOD balance: $1,164.31 + 0.11 accrued interest
EstablisheQ: 11-27-1981
Established: 02-26-1997
Established: 07-12-1990
Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and
5avings). We do not process any lSnancial transactions or provide statements. If you need assistance with
any of these items, please call .1-888-PNC-BANIG (1.888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank, N.A.
Member FDIC
Page 1 of 1
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PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1429), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Cazlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
February 13. February 20 and February 27, 2009
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and chazacter of publication are true.
Isa aria Coyne, Ed' or
5W0 TO AND SUBSCRIBED before me this
27 day of February, 2009 ~ ~ /J
Haaehore, Violet R, deed. - ~/
Lau of Cumberland County. NOtary
Executrix: Teresa L. Pennington.
Attorneys: Steven P. Miner, Es-
quire, Daley Zucker Menton Min-
er & Gingrich, LLC, 1035 Mumma
Road, Suite 101, Wormleysburg,
PA 17043. NOTARIAL SEAL
DEBORAH A COLLINS
Nofary Public
CARLISLE BORO, CUMBERLAND COUNTY
My Commission Expires Apr 28, 2070
Fa.Y
(717) 857-3523
STATE OF PENNSYLVANL4
COUNTY OF DAUPHIN
Eeat Shore
Office & Plant - (PO Box 6310) 101 Lincoln Street (717) sas-s540
Harrisburg, PA 17112 (717) 545"8762
Before me, the subscriber, a Notary Public in and for the said County,
personally came Llsa M. Carnes who, being duly sworn, doth depose
and say that she is ~I,$$j{ of THE PAXTON HERALD, a
newspaper oT general circulation published in Harrisburg, Pennsylvania;
That THE PAXTON HERALD was established on the 28th day of
June, 1960, and has been published continuously since that date;
That the advertisement, of which a copy is attached hereto, was
published in the advertising columns of THE PAXTON HERALD in
all respects as ordered in the issue(s) of~'~) ~-j$~ aj ~5 ~b7J~.
Affiant further deposes that she is not interested in the subject matter of
the aforesaid notice or advertisement, and that the allegations in the
foregoing statement as to the time, place and character of publication
are true.
~_
( a[ure of the pant)
NOTARIAL SEAL
CARRIE JEAN SINGER, NOTARY PUBLIC
LOWER PAXTON TWP., DAUPHIN COUNTY
MY COMMISSION EXPIRES SEPT. 7, 2010
THE PAXTOH HERALD
TI. fltlw IYnW 1110 Ferl Orln.N~rlWy W 1T, 11 • M2W
Steven P. Mlr~~~ae~~ reu
DALEY ZUCKER IIAElL70N
'MINER&GINGRICN,iLC
1035 Mumma Road, SWIe 101
VYorrnleyebu PA 17043
~~n, z-taz-zs
Sworn and subscribed before me this day of