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HomeMy WebLinkAbout09-21-09Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOfCE Bill To: InvoiceNo: 2637 DONALD F DAVIS ESQ Invoice Date: 9/10/2009 Estate of THELMA P RICHARDSON PO BOX 205 Estate No: 21-09-0152 SAP NEW KINGSTON, PA 17072- _ Qty Fee Description Fee Total 1 Additional Probate 240.00 $240.00 Total: $240.00 ~.R.~.:e.~:~..Q ~ _-- t N `~ `Le ~/U r ~~ _______ ,~N /1~I~ Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. DONALD F. DAMS, ESQ. Attorney and Counselor at Law P.O. Box 205 New Kingstown, PA 17072 ~ Phone: (717) 909-2339 Fax: (717) 774-1919 September 14, 2009 Re ister of Wills g N n ~Q `" z, cn -- ~' '~ ~~~_-~ r - Cumberland County Court House ~~ r*~ ~~ ~ ~ C~,. -v ~ ~~ TM ~. c.~-a 1 Courthouse Square r ! ~,~ ~ ~ N .. Carlisle, PA 17013-3387 ~~fl µ~ ~,~~:~ ~--~ ~ ~~~, ~r~ Re: Estate of Thelma P. Richardson {r,Q ~ '"'"" ""T' r ~~ File No. 21 09 O l 52 ~ ~ . _~ {° 3 cn Dear Sir: Enclosed find an original and two copies of an amended Inheritance Tax Return for the above referred to estate. The decedent owned two assets that were non-probate property. I included the non- probate property on Schedule "E" which was incorrect. I have removed the non-probate property from Schedule "E" and listed it on Schedule "G". The new return shows that the inheritance tax is the same amount as on the original return. I am filing the amended return to show that the probate fees should be based upon $4,327.25 instead of $130,865.02. If you have any questions, please call me at (717) 909-2479. Sincerely, Nancy L. Anderson, Paralegal to Donald F. Davis, Esq. .~ ,r J 15056071,2], REV-15 0 0 EX (OS-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Po Box 28oso1 County Code Year File Number INHERITANCE TAX RETURN Harrisbu PA 17128-0601 RESIDENT DECEDENT 2 1, 0 9 0 1, 5 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 0 0 9 0 1 7 9 1 2 0 1 1 9 2 0 0 9 0 6 2 7 1 9 2 0 Decedent's Last Name Suffix Decedent's First Name R I C H A R D S O N MI T H E L M A P (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name N O T A P P L I C A B MI L E Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER QF IIUILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return 0 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ prior to 12-13-82) 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required d ^X s. Decedent Died Testate ~ A eath after 12-12-82) 7. Decedent Maintained a Livin Trust g ( ttach Copy of Will) 9 Liti ti P -.--. 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) . ga on roceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec 9113 A b t ( ) . e ween 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED A Name . LL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: D O N A L D F Daytime Telephone Number - D A Firm Name (If Applicable) V I S E S Q 7 1 7 9 0 9 2 3 3 9 r•a REGISTE~F WILLS US LY -~ First line of address ~ -p ~„; ;~ C ,..7 ~ ~ P O B O X 2 0 5 ~ ~, rya- r:. _ r ~-, = ... Second line of address ~ .~Cf?~ .... y j ~ ,, c'". ~ } C7 -`fin 3 .. --,°, -ri City or Post Office ~,p - ~ •• ' ,~ ~--•~, State ZIP Code D ~E FILED Q -. , N E W K I N G S T O W N P A 1, 7 0 7 2 Correspondent's a-mail address: Under penal8es 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. G RE OF PERS R NSIBLE FOR FILING RETURN DATE i ADDRESS _/~ -~ 322 VALLEY ROAD, ETTERS, PA 17319 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY L 1505607121 Side 1 1505607121 J 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: THELMA P• RICHARDSON 0 0 9 0 1 7 9 1 2 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 8~ Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 4 3 2 7 . 2 5 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. 1 2 6 5 3 7, 7 7 8. Total Gross Assets (total Lines 1-7) ........................... g. 1 3 0 8 6 5. 0 2 9. Funeral Expenses 8 Administrative Costs (Schedule H) ................ 9. 2 9 6 9 . 4 7 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ..... ....:.. 10. 11. Total Deductions (total Lines 9 8~ 10) .................... ....... 11. 2 9 6 9 . 4 7 12. Net Value of Estate (Line 8 minus Line 11) .................. ....... 12. 1 2 7 8 9 5. 5 5 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 2 7 8 9 5. 5 5 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. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 1 2 7 8 9 5. 5 5 1 s. 5 7 5 5. 3 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 0. 0 0 19. Tax Due ......................................... ....... 19. 5 7 5 5. 3 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505607221 1505607221 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 09 0152 DECEDENTS NAME THELMA P. RICHARDSON STREET ADDRESS 1700 MARKET STREET CITY STATE Zlp CAMP HILL PA 17011 Tax Payments and Credits: ~• Tax Due (Page 2 Line 19) (1) 5,755.30 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 5,271.21 C. Discount 263.56 Total Credits (A + B + C) (2) 5, 534.77 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E ) 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) 0.00 (5) (5A) 220.53 (56) 220.53 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 : ...................................................................... ^ X^ 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? ....................................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... ^ Q ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property 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 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)j. 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. REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RESIDENT DECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER THELMA P. RICHARDSON 21 09 0152 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Integrity Bank checking account #203006659 (see attached letter, marked Exhibit "3" 1,482.25 and incorporated herein by reference) 2. Refund from Manor Care 2,717.00 3. Refund from Pennsylvania Income Tax 128.00 4. Assorted clothing - no value TOTAL (Also enter on line 5, Recapitulation) I $ 4,327 25 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & COM NH RI~ cE AX RETURN ANIA MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER THELMA P. RICHARDSON 21 09 0152 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1, Manning & Napier Fund, Inc. (see attached facsimile dated 48,218.72 100. 48,218.72 February 20, 2009, marked Exhibit "1"and incorporated herein by reference) 2. ABWE Foundation Inc. WGA #1319 (see attached letter 78,319.05 100. dated January 19, 2009, marked Exhibit "2" and incorporated herein by reference TOTAL (Also enter on line 7 (If more space is needed, insert additional sheets of the same size) 78,319.05 126,537.77 REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF THELMA P. RICHARDSON SCHED!!LE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ~1 n4 n~, Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: ~• Pathemore Funeral Home & Cremation Services, Inc. 2• Anair Memorials (grave marker) 3• Lyndon Center, Lydonville, Vermont (internment) AMOUNT 408.17 1,166.00 300.00 B• ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Donald F. Davis, Esq. 3. Family Exemption: (If decedents address is not the same as claimant's, attach explanation) Claimant Street Address Cry State Zip Relationship of Claimant to Decedent 4• Probate Fees Cumberland County Register of Wills 5, Accountants Fees 6• Tax Return Preparer's Fees ~• Cumberland Law Journal 8• The Sentinel 9. Pamela Purrington (reimbursement for flowers for internment) 10. Pamela Purrington (reimburesementfnr pastor and pianist at funeral) 11. Benjamin Barrett - (preparation of DVD of funeral service) 500.00 54.00 75.00 166.30 50.00 200.00 50.00 TOTAL (Also enter on line 9, Recapitulation) ~ s (If more space is needed, insert additional sheets of the same size) 2,969.47 REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER THELMA P. RICHARDSON 21 09 0152 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Pamela R. Purrington Lineal 40,786.93 322 Valley Road Etters, PA 17319 2 Gregory N. Richardson Lineal ~ 40,786.93 5641 Bidwell Pkwy #102 Sarasota, FL 34233 3 Jeffrey L. Richardson Lineal 40 786.93 66757 Reilly Road , Gregory MI 48137 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) ,Feb 20 2009 3:33PM HP LRSERJET FAlt PQ BaX 182454 • COLUMBUS, OH 43218 p. ($OC}j 466-3863 f. (614) 428-3390 FaX p.1 Mann ing & ' r Nap+e nd lnc.~ Fu Tor Parn Farrington Fromm lCmberiy M. Woof! Eruct 717-774-1919 ~lil~ ~ p Dotb: 0~l20109 RrM: Accout:t VaN.ie Verification ~~ ^ tJr~snt D por Roview D PMrao Contt~nt ^ Pl~wso R.oply D Plartros R~ycfa Ms. Farrington. Please let this fax serve as cvr:firmation of Thelma Richardson's TOD account vale as of her date of death on 1N 9109. The avcamt vedue as of 1!19/09 was $48,218.72. The price per share was $10.04. Please let me know if you have any questions or need anyth~g ®Isa. Thenk you. Best Regards, ~~~ ~~ C? Kimberly M. Wood Fund Servkes Assacia~e Distributed by Manning 8~ Napier Inaes~r Services, Inc. ne ASSOCIATION OF BAPTISTS FOR WORLD EVANGELISM January 19, 2009 To Whom It May Concern: This letter is to confirm that on this day of January 19, 2009, the date of death of Thelma P. Richardson, there was an account balance of $78,319.05 with the ABWE Foundation, Inc. Sinc ly, tit ' Larry D. Inskeep Director of Accounting ABWE Foundation, Inc. P.O. Box 8585 Harrisburg, PA 17105-8585 Phone: 717-909-2335 MAIL P.O.Box 8585, Harrisburg, PA 17105-8585 PHONE 717-7747000 FAX 717-7741919 WEB www.abwe.org DELIVERIES 522 Lewisberry Road, New Cumberland, PA 17070 CANADA OFFICE 980 Adelaide Street South, Suite 34, London, Ontario, CANADA N6E 1 R3 PHONE 519-690-1009 (~ ((r ~~ ft !- 1 WITHDRAWABLE GIFT AGREEMENT # 1319 , _~ , ~ THIS AGREEMENT, prepared in duplicate, entered into this 16th day of August, 2007 between THELMA P. RICHARDSON (Donor), now residing at 322 Valley Road, Etters, PA 17319 and the ABWE FOUNDATION, INC., a Pennsylvania nonprofit corporation ("FOUNDATION"), provides as follows: The FOUNDATION acknowledges receipt of SEVENTY-FIVE THOUSAND DOLLARS ($75,000.00) as the initial withdrawable gift made by Donor for the purpose of establishing this Withdrawable Gift Agreement. This amount and any further additions which the FOUNDATION shall accept from the Donor shall be held under the conditions set forth in this agreement. 1. DEPOSITS AND WITHDRAWALS. Donor reserves the right from time to time, to make withdrawals from, and deposits to this Withdrawable Gift Agreement in amounts not less than five hundred dollars ($500.00), except that reinvestments of income may be made in any amount. The FOUNDATION agrees to make payment of withdrawal within ten (10) days of receipt of a written request. 2. INTEREST. The FOUNDATION agrees to pay interest on balances credited to this account from the date received until the date of withdrawal payment. Interest will be paid or credited to on the last day of each calendar quarter this agreement is in effect. The rate of interest shall be set by the Board of Directors of FOUNDATION annually. The current rate is four and two-tenths percent (4.20%) per annum. 3. TERMINATION. Upon the death of Donor, the remaining balance, less interest accrued from the last interest payment date preceding the Donor's death, shall be distributed, in equal shares, to Pamela R. Purrington, Jeffrey L. Richardson, Gregory N. Richardson, children of Donor. 4. RIGHT TO CANCEL. The Donor reserves the right to terminate this agreement or request withdrawal of the entire balance upon thirty (30) days of receipt of written notice to the FOUNDATION by registered mail. The FOUNDATION reserves the right to cancel this agreement at any time by paying the balance to the Donor together with any unpaid accrued interest. 5 OTHER CONDITIONS. This agreement shall be binding on and inure to the benefit of the parties, their heirs, executors, administrators, legal representatives, successors and assigns. /yF ., ^ 4 7 ~.. THELMA P. RICHARDS fi~1(Donor) ABWE FOUNDATION, INC. By: William on, President ~, Attest: ce . Jac s ,Director Planned Giving Minis 'es EXHIBIT "3" 03/ l l f 2005 14:34 7179015501 INTEGRITY BANK ~rregxiry B I1 N K On the day of January 19~' 2009, Thelma R.ichardson's checking account number 203006659, had an account balance of $X482.25. This balance reflects any and all transactions and interest payments up to that date. PAGE 02f 82 Si»cere~y, ~ ~ Toseph Ritter Customer Service Rep. Integrity Bad ~' •~;.' ~~?~' 'mss "~ : r .~~ ~,~• •~w 6 3345 Man~rt Scnx4 C+~mj+ X;ll, ,F~ ,f7Cltl - ~i'rbs~: 7X7-91x0-490.87?- I-fIA1rF..F!'' • FRx: 7.17 ?10-~f7~ • wweu ~r~te~rrr,}~bwrt~r4xe.~o~x URiGiNAL AT LRW OFFfCE OF LEAHY & DEFAULT, LLP 178 BROAQ ST.; P.O. BOX 829 GLARE~iGNT, NH 03743-0829 (603a 543-3185 ~Lagt t~C and ~C¢sfamettt r~_~ t . of ~~jeCma ~. ~i~jarb~ott . I, Thelma P. Richardson, of Claremont, in the County of Sullivan and State of New Hampshire, do make this my last will, hereby revoking alI earlier ones,. and I dispose of my estate in the following manner: 1. I direct the payment of all my just debts, funeral expenses and expenses of administration of my estate. 2. I direct that any legacy and succession tax, inheritance, estate, transfer, or similar tax, whether state or federal or foreign, which shall be imposed on my taxable estate, whether or not passing under this will, or upon any beneficiary or other recipient thereof as a result of my death, shall he paid out of the residue of my estate as an expense of adrnin.istration without proration. 3 . Mindful of any children and issue of deceased children of mine who may survive me who are not named or referred to in this will, I make no specific provision for any one of them other than as herein provided. 4. I may leave a memorandum stating my wishes with respect to the disposition of certain articles of my tangible personal property, but such memorandum will be simply an expression of my 1 LEAHY 6t D.ENALfLT. LLP • ATTORNEYS AT LAW • 178 BROAD STREET • P.O. 80X 929 • CLAREMOIVT. tVH 03743-0829 • C503} 543-3185 I~ i wishes and shall not create any trust or obligation, nor shall it be offered for probate as a part of this will. 5. Ali the rest, residue and remainder of my estate, whether real or personal and wherever situate, I give, devise and bequeath to my husband, C. Ross Richardson. _In the event that my said husband should predecease me, or in the event that our deaths should occur simultaneously, or approximately so, or in the same common~accident or calamity, or under any circumstances causing doubt as to which of us survived the other, then I give, devise and . bequeath all the rest, residue and remainder of my estate, whether real or personal and wherever situate, to my children, Jeffrey Richardson, Pamela Farrington; and -Gregory Richardson, all in t .~ equal shares share and share alike. If any of my said children shall have predeceased me said .. deceased child's share shall pass to his or her issue, per s~irpes; and for lack of such issue tv my children then living: . b. An adapted ~ child in any generation and his issue, including adopted issue, shall have the same rights under this instxwment as if born to the adopting parent and of the same blood. . 7. I naminate and appoint my daughter, Pamela Puritagton, as Executrix of this my last will and testament. If she shall not be living at the tune of my decease, or if, for any reason, she shall be unable or unwilling to accept this trust and act as Executrix of this my last will and testament, I nominate and appoint my son, Gregory Richardson, as the. Executor hereof. Except as otherwise specifically herein limited, my Executrix and her successors shall have all of the powers conferred on trustees by New Hampshire RSA 564-A, the Uniform Trustees Powers Act, as it exists at the date of this execution of this Will, which Statute is hereby incorporated by reference. 2 I~ IN WITNESS WHEREOF I have hereunto set my hand and seal this 27`h day of May 2005. ...-. /~h ~l ! i' f ~~ Thelma P. Signed, sealed, published and declared by the ~ above=named Thelma P. ~tichardson as her Iast. will and testament in our presence who at her request ~n her presence ~ and in the presence of each other have hereunto set our names as witnesses the year and date above written. ~1~- f `'~~, ~ ~~ 3 L' STATE OF NEW HAMPSHIRE COUNTY OF SULLIVAN We, Thelma P. Richardson, Denise B .~ Saucier; and Debra Johnson-IVlelchex, the testatrix ,~ and.the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned, authority that the testatrix signed and executed the instrument as her Iast will and that she had signed willingly or directed another to sign for her, and that she executed it as her free and voluntary act for the purposes therein expressed; and that each of the witnesses, at the request of the testatrix, in her presence, and in the presence of each other, signed the will as witness and that to the best of their knowledge, the testatrix was at that time IS or more years of age, of sound nand and under no constraint or undue influence. . Thelma P. Richar on Testatrix .. t Wi e s ' Witness Subscribed, sworn to and acknowledged before me by Thelma P. Richardson, the testatrix and subscribed and sworn to before me by Denise B. Saucier and Debra Johnson-Melcher, the witnesses, this 27`~ day of May 205. ~''~~~~,~~~.3.r{~ //fir! •` .~~~ ~i = ~;• COMMtSStCr, EXPtR~a = i ;.y .`. ~ .r .. ~ .. ,'- __ L ~ ~~ ., G-~. Notary blic / '