HomeMy WebLinkAbout11-09-0915056041125
~' REV-1500 ~ (x-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO Box 28oso1 a l ~ ~' ~ ~ ~~
Hanisbum, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
1 6 2 2 2 6 3 6 5 0 6 0 4 2 0 0 9 0 3 0 2 1 9 2 8
Decedent's Last Name
D EA V 0 R
Suffix Decedent's First Name
H A Z E L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
1. Original Retum
4. Limited Estate
Q 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Retum
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
MI
C
MI
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Retum Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
W I L L I A M A D U N C A N 7 1 7 2 4 9 ,,,~ 7 8 0
Firm Name (If Applicable)
D U N C A N & H A R T M A N P C
First line of address
1 I R V I N E R O W
Second line of address
City or Post Office
C A R L I S L E
State ZIP Code
P A 1 7 0 1 3
•.A.
REGIS•
:liFF~F WILLS U~ ' '
ONL~..:~ . ,,
:
~. .
i t
"~"'
~ 1
`~ , ~
• t a
..
yy
~l - '
r
T.F~
.... ;..
~ ~ ~ ~,~j ~' ~. .I
1i .
{/~ p~~
~
"
~ ~ ~1
r j
~ ~ L_./ ~
,.t
',
:~ W
DATE FILED trJ
Correspondent's a-mail address: bIIldUncant~pallet
Under penalties of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, coned and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
TURE OF PERSON RESPONSIBL~FOR FILING RETURN ~ DATE
10 WESTMINISTER DRIVE CARLISLE PA 17013
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125 15056041125 J
J
15056042126
REV-1500 EX Decedent's Social Security Number
Decedents Name: HAZEL C. DEAVOR 1 6 2 2 2 6 3 6 5
RECAPITULATION
1. Real estate (Schedule A) ........................................ 1 • •
2. Stocks and Bonds (Schedule B) ................................. .
2
6
3
5
5
4.
1
8
3. Closely 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. 3 2 7 2 9 • 6 3
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) ........................... 8. 9 6 2 8 3, 8 1
9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 7 9 6 0 • 1 7
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............ 10. 1 9 0 9 • 7 9
11. Total Deductions (total Lines 9 8~ 10) ........................... 11. 9 8 6 9. 9 6
12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 8 6 4 1 3 • 8 5
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) ..................
.................. 13.
14.
8
6
4
1
3 •
8
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
0
0
0
16. 0 . 0 0
17. Amount of Line 14 taxable 8 6 4 1 3 8 5 1 0 3 6 9 6 6
at sibling rate X .12 17. .
18. Amount of Line 14 taxable 0 0 0
at collateral rate X .15
.
18 0 • 0 0
19. Tax Due ............................ ........... .. ....... 19.
1
0
3
6
9.
6
6
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042126 15056042126
F~EV-1500 PJ( Page 3
Decedent's Complete Address:
(1) 10, 369.66
DECEDENTS NAME
HAZEL C. DEAVOR
STREET ADDRESS
75 E. NORTH STREET
CITY
CARLISLE STATE
PA ZIP
17013
Tax Payments and Credits:
~ • Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Penalty
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 ZO 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.
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 10, 369.66
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 : ...................................................................... ^ 0
b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q
c. retain a reversionary interest; or ................................................................................................ ^
d. receive the promise for life of either payments, benefits or care? ................:...................................... ^ 0
2. If death oax~rred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ^ Q
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? .................................................................................................. Q ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Total Credits (A + B + C) (2)
0.00
Total Interest/Penalty (D + E) (3) 0.00
File Number
0 0
(4)
0.00
(5) 10, 369.66
REV-1503 EX + (6-98)
scHEOV~E s
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERrfANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HAZEL C. DEAVOR 0 0
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. SCUDDER DESTINATION VARIABLE ANNUITY 63,554.18
jSEE DOD LETTER ATTACHED]
TOTAL (Also enter on line 2, Recapitulation) I ~ 63, 554.18
REV-1508 EX + (6-98)
scHEOV,LE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MASC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HAZEL C. DEAVOR 0 0
Indude the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be discbsed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. M8~T BANK ACCOUNT # 27755878 30,262.10
[DOD LETTER ATTACHED]
2. KEMPER INVESTORS REFUND 500.00
3. REFUND 141.42
4. COMCAST REFUND 268.36
5. PPL REFUND 48.28
6. PROCEEDS OF SALE OF PERSONAL PROPERTY - ROTZ'S AUCTION 1,475.66
7. REFUND FROM WELLSPAN HEALTH 33.81
TOTAL (Also enter on line 5, Recapitulation) I ~ 32.729.63
REV-1511 EX + (12-99)
SCHED!/LE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES 8~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HAZEL C. DEAVOR 0 0
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOFFMAN-ROTH FUNERAL HOME 2,245.06
2. CORRECTED DEATH CERTIFICATES 62.00
B. ADMINISTRATIVE COSTS:
1, Personal Representative's Commissions
Name of Personal Representative (s)
Soaal Security Number(s~EIN Number of Personal Repn~entative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Atbomey Fees DUNCAN & HARTMAN, PC 4,814.19
3, Family Exemption: (If deoedenYs 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 -FILING FEE 272.00
5 Accountant's Fees
6. Tax Retum Preparers Fees
7. CUMBERLAND LAW JOURNAL 75.00
8. THE SENTINEL -LEGAL AD 176.92
9. REGISTER OF WILLS -FILING FEE 15.00
10. HELD IN RESERVE 300.00
TOTAL (Also enter on line 9, Recapitulation) I ~ 7, 960.17
REV-1512 EX + (12-03)
SCHEDULE /
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERrrANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HAZEL C. DEAVOR 0 0
Report debts incun~ed by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ROGER HEFFELFINGER LANDLORD -RENT DUE 575.00
2. EMBARQ REFUND 1.94
3. PPL 26.29
4. WHITE ROSE AMBULANCE 238.75
5. WELLSPAN HEALTH 33.81
6. HANOVER FIRE COMPANY 1 -AMBULANCE 684.00
7. ROGER HEFFLEFINGER -LANDLORD -CLEAN APARTMENT 350.00
8.
TOTAL (Also enter on line 10, Recapitulation) I $ 1,909.79
(If more space ~s needed, insert additional sheets of the same size)
REV-1513 EX'f (9-00)
SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
un~~i ~ n~evnQ 0 0
~~~~ v ~" ` v ~ ` 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 [ndude outright spousal distributions, and transfers under
Sec. 9116 (a) {1. )2
1. JANET L. SMITH Sibling
10 WESTMINISTER DRIVE 50% SHARE
CARLISLE, PA 17013
2. LILLIAN WALTERS Sibling
34 E. PENN STREET 50% SHARE
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~
flf mnra cnar~? i¢ naatari incest arlrtitinnal chaatc of the cams ci~al
M&TBarik
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
June 18, 2009
Estate of Hazel C. Deavor
C/O William A. Duncan, Esquire
Duncan & Hartman, P.C.
One Irvine Row
Carlisle, PA 17013
Re: Estate of Hazel C. Deavor
Social Security: 202-20-3068
Date of Death: June 04, 2009
Dear Sir or Madam:
Per your inquiry dated June 10, 2009, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1. Type ofAccount
Account Number
Ownership (Names o~
Opening Date
Balance on Date of Death
Accrued Interest
Total
Checking Account
27755878
Hazel C Deavor
8/28/64 Closed 6/16/09
$ 30,262.10
~ 0.00
$ 30,262.10 _....__ ............._.._._..._ .
Please be advised, there was no safe deposit box found for the above decedent.
* If upon reviewing the information above, you believe there are additional accounts not referenced, please provide
us with an account number and/or name of any possible joint account holder. For any additional information on the
above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact
our Carlisle West Office # 717-240-6717.
Sincerely, f
n
Tracie Hare
Adjustment Services
- : t ...
.., ,
.: ¢ _~.
_~~ ~ ~ ~_~l.1 t;l:.~~.ti
_,
t ._ :_ . _. r ._. _ ._ ..
_~,
~"~.(,~~: a~ ~:~a':'.3~i~:Y;"~;,~~~L>:.iii X`~;lt i'~'?tatl~~i~;~~ ii"l ~~{)tip' ~e~terCi~^.~~U.~titi~ G~,.~,~~,~~.
~4t;~~f~ 1:~~.°~~~c~3~':~ ~~~tc~d~~' 1:~e~tin~.tio.n~ ~'~riable ~.n.n~t~v
l~~~t;:~ t~'t ~.~~tti~ ~'s~sh ~i~a~ut ~~3,~54.18
~nsi.~~~.rr!ce 't~~.l~t~ -t-~~i~3~~.~b
~.3~~th ~3eir~e~~~ .E~ai~ ~~9~'~10.~~
:I:.merest ~ ~' 1.0~
~?1e,:~s~:> tees fi~e;e tcf ~:.~t~t~ic:~ t~iv~ c~tf~i~:e ~,~~th any furt'laer gLtesYion~. ~~`h~~rt~: yui.>..
~it~c~erciy,
.~ ~~
r
I7~.n i~;1 ~V. ~;tc~tt
,:,~~.~~.~ri't:>.:.~, ofl'~:1'6t! 'pia?;?€Igis F:(:i:>. ~<'esx i,avrsstrr!caii Si;rvice~,``~",
~a %ti;i l••~7:i"i!~. StB}.7S! 11iii.Jr til~~';~+~eiis ~'Lli'}~tl t~: ~•i)CS1F7i]l4 y, ^!jtCi'!i`+~: i': ~:Si~'t: r
s
t}3,S?F eat'JE"~il,`RtIECi'6[l,I1\4'ily +i3~~ G'C~I.tY'Li'a t'nlJiji'
~':•s'i+l c;, : i:~!E5$ (`~(i.~3S, E`i-i~ 1 y,, f5~i'.~ti}~,)fiil
The .cast Will And Testament
Of
Mazel C. Deavar
I, Hazel C. Deavor, of Cumberland County, Commonwealth of Pennsylvania,
presently residing at 75 East North Street, Carlisle; Pennsylvania, 17013, being of sound
w
and disposing mind and memory, do hereby make, publish and declare this to be my.
Mast 111li!! and Testament and hereby revoke any prior wills or codicils heretofore made
by me.
First
give and bequest the following specific gifts:
To my sisters, Janet L. Smith and Lillian Walters, I give and bequest all of my
jewelry in equal shares provided each survives me by thirty (30) days. In the event that
either. 'of my sisters predeceasz ~-ne .or fail .to survive me by' 3J days, I then give the'sr
interest in all of my jewelry to my surviving sister.
second
give ~ all of my remaining tangible personal property wherever situated including
but not limited to automobiles, furniture, works of art, cash, bank. accounts, mutual funds,
stocks, bonds, interests in partnerships or sole proprietorships and any~other investment
vehicles to my sisters, Janet ~. Smith aril Lillian vllalters, in equal shares, provided that
each survives me by thirty (30) days.
Third
In the event that either of my sisters predecease me or fail to survive me by 30
days, I then give their interest in all of my remaining tangible personal property wherever
situated including. but not limited to automobiles, furniture, works of art, cash, bank
accounts; mutual funds, stocks, bonds, interests in partnerships or sole proprietorships
and any other investment vehicles to my surviving sister. In the event that both of my
sisters predecease me, I then give all of my remaining tangible personal property
wherever situated including but not limited to automobiles, furniture, works of art, cash,
bank accounts, mutual funds, 's#ocks, bonds, interests in partnerships or sole
proprietorships and any other investment vehicles to my niece, Barbara Parrish of Bethel
Park, Pennsylvania.
Fourth
give the residue of my estate, to my sisters, Lillian Walters .and Janet L. Smith, in
equal shares, provided that each survives me by thirty (30) days.
Fifth
In the .event tha# either of my sisters predecease me or fail to survive me by 30
days, I then give their interest in the residue of r-iy estate to my surviving sister. In the
event that both of my sisters predecease me, I then give all of my interest in the residue
of my estate to my niece Barbara Parrish of Be#hel Park, Pennsylvania.
Sixth
appoint Janet L. Smith as Executrix of~rr~y estate. In the event, she predeceases
me or. is unwilling or unable to act as my Executrix, I appoint .Lillian. Walters to act in her
stead. In the event,. she predeceases me or is unwilling or unable to. act as my: Executrix,
appoint Peter J. Russo, Esquire, to act in her stead.
Seventh
My Executor/Executrix shall not be required to file a bond in this or~ ariy Qther
jurisdiction. .
Eight
In addition to powers given them by law, my Executor .and any ,successor.
Executor shall have the following powers, applicable to all property held by .them,
effective without court order .anal until actual distribution:
(a) To retain. any property received by them, including the stock of any
corporate fiduciary acting hereunder;
(b) To sell real estate for any purpose, publicly. or privately, for such
prices and on such terms as they deem proper, without liabili#y. to the .purchasers to see
to application of the purchase monies;
(c) To compromise controversies;
{d) To distribute in cash or kind or both at such valuations as they may
fix;
(e) To distribute property passing to a minor under this will either to the
minor or to any person to hold for a minor;
(f) To sell articles passing to a minor under this will if the Executrix, in
his/her sole discretion considers such articles unsuitable for a minor and to use the
proceeds of such sale to equalize the shares of the other beneficiaries of this will; and
(g) To hold investments in the name of a nominee.
Ninth
All federal, s#ate, and other death taxes payable because of my dea#h. an the
property forming my gross estate for tax pur..poses, shall be paid out of the principal of
my probate estate so that the burden thereof falls on my estate anal none of those taxes
shall be charged against any beneficiary, or any outside fund. ~ .
Tenth
My Executrix is directed #o have my remains by placed in my plot at Westminster
Cemetery in Carlisle next to my husband, Raymond N. Deavor. As my funeral has been
pre-paid, ~my final wishes have been communicated and set forth as~ a part of the funeral
arrangements I have made.
In Witness Whereof, I have hereunder set my hand and seal this ~
day of , 1998.
M a2el eavor
The preceding instrument, consisting of this and 3 other typewritten pages, was
on the date thereof signed,. by the .above-named Testatrix as her Lash Will, in the
presence of us, who at her request, in her presence .and in presence of each other, have
subscribed our names as wi#nesses hereto.
Peter ~. Russo
Residing at: ~ 61~ West Louther street
Carlisle. PA 17013
r
Shirley A. Lee
Residing at: 651 Lines Road
-~-~_
DillsburQ; PA 17019
COIIAMQNIN~AL,TH OF PENNSYLVANIA
SS.
COUNTY Q~ CUMBERLAND
. I, Hazel . C. Deavor, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowiedge that
signed and executed this instrument as my Last Will; that I signed i~t willingly, and that
signed it. as my free an voluntary act for the purposes therein expressed.
Haz C. Deavor
Sworn to and subscribed
before r~ne this 29th day
of June, 1998. ~ ~ ~ .
-~~
w~T~R~~. ~~~.
ROGER C: ~pITZ, NOTARY PUBLIC
CAR~l~LE ~p~Ll~H, CUAIIBERLAt~ID CO., PA
AA~C Iv:CMAA..~RES AAAY Z6, 2002
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
' SS.
CUUNTY OF~ CUMBERLAND •
We, .Peter J. Russo. and _ Shirley A: Lee ,the witnesses whose names .are
signed to the attached or foregoing instrument,. being duly. qualified according to law, do
depose and say that we were present and saw Hanel C. Deavar, Testatrix, sign and
execute the instrument as her Last Will; and that she executed it as her free and
voluntary act' for the purposes therein expressed; Ghat each of us in the hearing. and $i~ht
of the Testatrix signed the Will. as witnesses; and that to the best of our knowledge the
Testatrix was at the time 18 or more years of age, ofi sound mind and under na
.constraint or undue influence.
------~ ~ Residing at: C~ West .Lowther Street
Peter J: Russo _ Car. lisle PA 17013 ~ ~~
Shirley A. Lee
Residing at. 6b1 Lvnes Fload
. Dillsburq PA~1701 g
Sworn to and subscribed
before me this 9th day
of June, 1998.
pp,~p~~~ pper., cc: ~:: pp pp
'~.M~OP66Y~la~ , ..~.... y7,.~~®Yj.f1~i11® V~d1p ~W
„____M1P C~MNIi~~I~~~IF1~S AAA~P 2~. 2A62