HomeMy WebLinkAbout09-29-0915056051058
REV-1500 EX (06-05) OFFICIAL t1SE ONtY
PA Department of Revenue Coon Code Year File Number
Bureau of Individual Taxes ~'
PO Box 280601 INHERITANCE TAX RETURN 2~ ~~~ ~ i .~Li
Harrisburg, PA 17128-0601 RESIDENT DECEDENT l3
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
202-20-0578 07/14/2009 04/02/1914
Decedent's Last Name Suffix Decedent's First Name MI
Kline Ravenda W
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
• 1. Original Return 2. Supplemental Retum
3. Remainder Retum (date of death
prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required
death after 12-12-82)
• 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wrll) (Attach Copy of Trust)
9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
William N. Jamieson (717) 645-3218
Firm Name (If Applicable) c.7
REGISTE~IIILLS US~NLY -, ; : `~~
'rt rf^, ~
J ~ t'a'i
~
First line of address `
~..r, n i
5 Ovis Drive - ~-~ `~
-
Second line of address :~ ,~.,
_' `-_
~_ ---~ N Y , . _-~
City or Post Office State ZiP Code DATE FILED ~
Mechanicsburg Pa 17055
Correspondent's a-mail address: W1amIeSOn_blll p~hOtmall.COm
llnder 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.
RESPONSIBLE FOR FILING RETURN
2
ADDRESS -
5 Ovis rive, Mechanicsburg, Pa. 17055
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
15056052059
REV-1500 EX
Decedent's Name: RaVenda W Kline
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.
6. Jointly Owned Property (Schedule F) Separate Billing Requested .... ... 6.
7. Inter-Vvos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested..... ... 7.
8. Total Gross Assets (total Lines 1-7) ................................. ... 8.
9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9.
10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ............. ... 10.
11. Total Deductions (total Lines 9 & 10) ................................ ... 11.
12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12.
13. Charitable and Govemmentai 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.
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_ 15.
16. Amount of Line 14 taxable
at lineal rate X .0 45 212,549.96 16.
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.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
Decedent's Social Security Number
202-20-0578
1, 209.78
219,787.97
220,997,75
8, 358.03
89.76
8,447.79
212,549.96
212,549.96
9,564.75
9,564.75
15056052059
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER
Ravenda W Kline 202-20-0578
STREET ADDRESS
5225 Wilson Lane Appt. 309
CITY
Mechanicsburg STATE
Pa ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments _
C. Discount
3. InterestlPenalty if applicable
D. Interest
E. Penalty
0.00
0.00
Total Credits (A + B + C) (2)
Totai Interest/Penalty (D + E) (3)
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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5g)
478.24
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? .............. ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ^ 0
9,086.51
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 exemot 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.
(1)
9, 564.75
478.24
0.00
9,086.51
0.00
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCi~lED1~LE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Ravenda W. Kline
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM _____~ I VALUt AI UHIt
__ /1C I1C AT41
Met Life Common Stock - 34 Shares, Price per Share $35.5817, CUSIP 001 928 59156R10. I 1,209.78
TOTAL (Also enter on line 2, Recapitulation) I $ 1,209.78
(If more space is needed, insert additional sheets of the same size)
~t3 •!
please Note: Your Sale Proceeds Check is P'~ ~~hed
BROKER'S Name, Address, 21P Code,
Federal Identification Number and
Telephone Number:
Mellon Investor Services
480 Washington Bivd.
Jersey City, NJ 07310
22-3367522
Telephone: 1-800-649-3593
~~2009
Form 1099-B
COPY B FOR RECIPIENT
"''IMPORTANT TAX INFORMATION'""
This is important tax information and is being
furnished to the Internal Revenue Service. If
you are required to file a return, a negligence
penalty or other sanction may be imposed on
you if this income is taxable xrtd the IRS
determines that ff has not been reported.
TO WHOM PAID
BARBARA J SHUGHART & LOIS J
JAMIESON EX UW RAVENDA W KLINE
5 OVIS DRIVE
MECHANICSBURG PA 17055-4865
Sox ia. -Shoves the trade date of the transaction. For aggregate reporting, no entry will
~e present.
Sox 1 b. -For broker transactions, may show the CUSIP (Committee on Uniform Security
dentification Procedures) number of the item reported.
Sox 2. -Shows the proceeds from transactions involving stocks, bonds, other debt
obligations, commodities, or forward contracts. Losses on forvrard contracts are shown
n parentheses. This box does not include proceeds from regulated futures contracts.
2eport this amount on Schedule D (Form 1040), Capital Gains and losses.
OMB NO. 1545-1)715
Proceeds From Broker~artd Barter Exchange Transactions
instructions for Recipient
Brokers and barter exchanges must report proceeds from transactions to
you and to the Internal Revenue Service. This form is used to report
these proceeds.
1a. Date of Sale 1b. CUSIP Number
08/12/2009 59156R10
2. Stocks, Bonds, etc. 4. FEDERAL INCOME TAX WITHHELD
$1,209.78 $0.00
REPORTED ® Grass Proceeds
TO IRS ~ Gross Proceeds less commission and
options premiums
7. Description `- - - -- - -
METLIFE, INC.
Investor ID Recipients Identification Number on File
125035239919 ~ 276136076
Box 4. -Shows backup withholding. Generally, a payer must backup withhold at
a 28% rate if you did not furnish your taxpayer identification number to the payer.
See Form W-9, Request for Taxpayer Identification Number and Certification, for
information on backup withholding. Include this amount on your income tax
return as tax withheld.
Box 7. - Shows a brief description of the item or service for which the proceeds or
bartering income is being reported. For regulated futures contracts and forward
contracts, "RFC" or other appropriate description may be shown.
For inquiries about your account, contact BNY Mellon Shareowner Services, MetLife's Transfer Agent:
Telephone: 1-800-649-3593 U.S. Mail:
E-Mail: metlife~bnymellon.com Metl.ife
Internet: www.bnymellon.com/shareownerlisd clo BNY Mellon Shareowner Services
PO Box 358447
Pittsburgh, PA 15252-8447
YOUR ACCOUNT HAS BEEN CLOSED. THE ATTACHED CHECK REPRESENTS THE FULL VALUE OF YOUR ACCOUNT.
^ IMPORTANT TAX RETURN DOCUMENT ATTACHED ^
.. ,. 'F~1S;erEC'1'~!~ C~II~''E'L ''' I
SHAREHOLDER OF .TRANSACTION DATE ~ DESCRIPTION
METLIFE, INC. i 0811212009 SHARES SOLD
CUSIP INVESTOR ID ACCOUNT KEY I CHECK NUMBER CHECK DATE CHECK AMOUNT
001 928 59156R10 125035239919 KLINE----RAVEWOF00 717281 08/17/2009 $1,209.78
OPENING TRUST INTEREST BALANCE SHARES SOLD PRICE PER SHARE {$) GROSS PROCEEDS
34.0000 34.0000 ~ 35.5817000 $1,209.?8
TAX W ITHHELD NET PROCEEDS 'CLOSING TRUST INTEREST BALANCE
__ _ _--_ $0.00. $1,209.78 00.0000 I
- - - - - - - - - - - PLEASE DETACH BELOW CHECK NUMBER: 717281
uo9a>F~;~c~d i~ us n. Detach stub before cashing JY4.51A.SCRf:(10/04)
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, 8~ MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Ravenda W. Kline 1505605105
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointtyowned wkh right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
E-1 PNC Bank PO Box 609 Pittsburgh, Pa. 15230. Checking Account No. 5070075705 39,946.67
E-2 Bethany Village Rent Refund Deposited to E-1 (above) Sept. 21, 2009 1,788.45
E-3 RiverSource Funds 70100 Ameriprise Financial Ctr.,Minneapolis, MN. 55474 Annuity 93003379551 7 004 160,664.02
E-4 RiverSource Funds 70100 Ameriprise Financial Ctr.,Minneapolis, MN. 55474 Annuity 93007463682 8 004 17,388.83
TOTAL (Also enter on line 5, Recapitulation) E i 219,787.97
(If more space is needed, insert additional sheets of the same size)
vta~ _ king Statement PNCBANK
(~ l;;utl: ~~~
For ttte periori 07/17/2009 to 08/77/2009
Primary account number: 50-7007-5705
('age 1 of 3
Number of enclosures: 0
EST OF RAVENDA W KLINE DECD
BARBARA J SHUGHART EXTRX
L.OIS J JAMIESON EXTRX
5 OVIS DR
MECNANICSBURG PA 17055-4865
I~ For 24-hour banking, and transaction or
r`--' interest rate information, sign on to
"a' PNC Bank Online Banking at pnc.com.
For customer service call 1-888-PNC-BANK
between the hours of G AM and Midnight ET.
Para servicio en esparSol, 1-8GG-HOLA-PNC
Movinga Please contact us at 1-888-PNC-BANK
® Write to: Customer Service
PO Box G09
Pittsburgh PA 15230-9738
~ Visit us at pnc.com
TDD terminal: 1-800-531 1G48
1'or hc.~r ino imp.~iav! ~licnr~ onlc
alationship Overview
nk Deposit Accounts
;rvption Account Numt~Ar Deposit Balance
c= (.hccf~_IttK U- lO1)l--, (I) i ;i~,i3'?.fil
al llcfiusils ;48.5:12.64
I(' (h'crlcral 1)cl~rrcit Insur.rnce ('otcra};e) incresurd co~era4!c bas been eztentletl frnm 1 2/31/20119 10 1)ecemher3l, 2(113. On \tav
Zt)fttt the FDIC announced an extension oClhe incr.ascd covcra~c through 1)cremhcr i 1. 2011. lleposits held at FDIC' insuttct inslihrGons
nr,~~ )nsurrd up to al Icasl `y2~f1.00(1 icr d~ positor. Clrt tanuary 1.201-! !hr standard insurance amount i~~ill r~iunt to 5100,000 per depositor
all account cate~orics ezccpf !or Ilt:1s and other cc-lain r~liremcnt accounts ~~hich ~~ ill remain at 52~(1,(Itl(1 per depositor. Y\C' is a
mhcr of 1~ 1)I('.
ee Checking Account Summary F st Of Ravenda W Kline Decd
Barbara J Shughart Extrx
ount number: 50-7007-.;701 Lois J Jamieson Extrx
~rclratt Protection Provided By: Contact PNC to establish Overdrak Protection _
~tanee Summary Please see the Activity Detail section for
additional information.
~eainnira n=_po<,its and Ch.erks and other End!nq
balance other additions dedi.rchons balance
.ir) <) li~~.l~i7 .(111 l.~l 1 (.,(r'~ ~3~.?:~:~.lt t
Avenge rnonti•,!y Charges
balance and fees
anSdCtlOn ~Jtlmmc'tl'y
Cher: t spaid/ Check. Card POS Chec4 Card/Banff r.ard
:withdrawals signed transactions POS PIN transactions
)
-
Iota! t'~TM O
PNC S:inh 1
Other Flank
transactions ATM transactions ATM transactions
U O (1
terest Summary As of 08/17, a total of $3.84 in interest was
paid this year.
Ftnnu:rl Pcrreniage Number of days Average coller~ ~F'd Interest Paid
Vield Earned (APYE) in interest period balance for t;PYE this perood
O.(I(1% O .OO .OO
,~- t- 3
,~- y
WiHiBm J StuberfCorp/AMPF- To Susan H Fulginiti/Field/AMPF@AMPF
07/i 7!2009 12:06 RM cc
bcc
Subject 15968489 3 001
RAVENDA W KLINE - DEATH SETTLEMENT
REQUIREMENTS -PLEASE DO NOT DELETE
RiverSource Life Insurance Company
RiverSource Funds
Ameriprise Certificate Company
Ameriprise Brokerage
70100 Ameriprise Financial Center
Minneapolis, MN 55474
July 17, 2009
SUSAN HORNER FULGINITI
214 SENATE AVE STE 604
CAMP HILL, PA 17011-2382
Dear SUSAN HORNER FULGINITI:
We have received notification of RAVENDA W KLINE's death. The deceased's name appears on the following
accounts. Account values as of 07/14/2009 are listed below. At the end of this letter, you will find a list of
beneficiaries shown in our initial review of the accounts
Account Information
Annuities -Post 1985
Account Number Ownership
93003379551 7 004 Individual
93007463682 8 004 Individual
Annuities -Post 1985
Account Number Total Value
93003379551 7 004 $160664.02
93007463682 8 004 $17388.83
The date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be
subject to market fluctuation as governed by each product. Please note that the values indicated for any Life
Insurance products with the insured deceased reflect the gross death benefit at date of death and not the cash value.
Values indicated for Life Insurance products with only the owner deceased reflect the cash value as of the date of
death. Values for any proprietary mutual funds include accrued dividends as applicable. Values provided for
brokerage products are manually calculated, and should be used as estimates only. The prices used to provide values
are estimates obtained from outside sources believed to be reliable. Ameriprise Financial provides these values as a
service to its clients. Actual values used in preparation of tax returns or for planning purposes should be verified by
REV-1511 EX+ (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8c
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ravenda W. Kline
Debts of deceder>t must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 ~ Musselman Funera! Home !nc -Services of Mortician/Funeral Director 6,750.00
Royer's Flowers -Funeral Flowers 163.22
Sophia's on Market -Funeral Refreshments 333.90
Hospice -Religious Services 100.00
Patriot News & Sentinel -Obituary 335.91
Rolling Green Cemetery Company -Headstone 255.00
Bricker House -Funeral Luncheon Room 260.00
B. ADMINISTRATIVE COSTS:
1. Personal Representatve(s Commissions
Name of Personal Representative(s) William N. JamleSOn
Social Security Number(s)/EIN Number of Personal Representative(s) 199-34-7906
Street Address 5 ~VIS DrIVe
city Mechanicsburg .state Pa zip 17055
Year(s) Commission Paid: 0
2. Attorney Fees 0.00
3. Family Exemption: {If decedent's address is not the same as claimant's, attach explanation) 0.00
Claimant
Street Address
City State .Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) I $
(If more space is needed, insert additional sheets of the same size)
.REV-1512 EX+ ;12-08j
~ Pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ravenda W. Kline
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
I ~ Continuing Care Rx -Medicine 59.90
2. Continuing Care Rx -Medicine 29,86
TOTAL (Also enter on Line 10, Recapitulation} ~ $ 89.76
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (11-08)
Pennsylvania SCHEDULE ~
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ravenda W. Kline
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).J
1. Lois J. Jamieson 5 Ovis Dr., Mechanicsburg, Pa. 17055 Daughter 50%
2. Barbara J. Shuhgart 100 Westgate Dr., Mount Holly Springs, Pa. 17065 Daughter 50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed, insert additional sheets of the same size,
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
estate of RA VENDA W KL/NE
SHORT CERTIFICATE
I, GLENDA EARNER STRASBAUGH
Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 21st day of July, Two Thousand and Nine,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
late of LOWER ALLEN TOWNSH/P
/First, Middle, Last)
in said county, deceased, to BARBARA J SHUGHART
LOTS J JAMIESON
and
(first, Middle, Lastl
(First, Middle, Last)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 21st day of July
Two Thousand and Nine.
Fi 1 e No . 2009- 00674
PA Fi 1 e No . 21- 09- 0674
Date of Death 7/14/2009
S . S . # 202-20-0578
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SRAr,
LAST WILL AND'1'I~S"I'AMEN'[' Oh RAVENDA W. KLINE
I, RAVENDA W. KLINE, unre~7larr-ied widow, of the Upper Allen Township,
Cuulherland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this my Last Will and Testament, hereby revoking
and making void any and all prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts aJld funeral expenses as soon after my decease as
the same can conveniently be done.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever anc!
wheresoever situate, I give, devise and bequeath to illy beloved daughters, BARBARA J.
SHUGHAP.T, and LOIS J. JAMIESON, in equal shares, per stirpes.
3.
I nominate, constitute and appoint r,iy daughters, BARBARA J. SHUGHART and LOTS J.
JA~~I.F.SON to be the r,c?-I=xecturic;es of this my Last Vvill and Testament. I further direct that they
sha11_ not be required to file bond or other security in the Office of the Register of Wills for the
purpose of administering my Lstate.
IN WITNESS WI-II?P~EOF, I have hereunto set my hand and seal this 1 7'!~ day of~
A.D. 1996.
%~ ~
F;A ~ _-~-t'.-~ (SEAL)
VENDA W. KLINE
Signed, sealed, published and declared by the above-named RAVENDA W. KLINL-' as and
for her Last Will and Testament, in the presence. of us, who at her request and in her presence, quid
in the presence of each other-, have hereunto subscribed our names as witnesses.
~~~ ~ 1 c S-.y -- l~i~>
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