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HomeMy WebLinkAbout07-22-10' 1505607121 Rir~~~ ~~ ~ (~) Ot!~FICML UaR CMN.Y PA O'~t of ReverNle Bureau d ~ Tatoes INHERITANCE TAX ltfTURN Countf- Ctade Veer Fps Number Po e0x 240601 2 1 0 9 1 0 7 1 PA 1z RESIL~E~VT' Q CEaENT ENTER DECEDENT ~MA'#1ClN 8~E1.O1N Social Securityy Number .Date of Death Date of B#th 2 0 6 3 2 1 3 8 6 1 p 2 2 2 0 0 9 0 4 2 0 1 9 1 4 Dboedent's Last Name Suffer DeoecknCs First Name MI A S H M O R E M A R Y J (1f Applicable) Enter 3unrhring Spouse's Information Below Spouse's Last Name Suffix Spouse's. First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVAtr.S BELOW THIS RETURN MUST FiLE~ IN DUPU~ATE WITH THE R~t~tS"i"`~R t3~ 111~LLS © 1.Original Return ~ 2. Supplemental Return ~ 3. Remairac~ Return (date of death prior to 12-13-82) 4. LhrtiEed Estate [] 4a. Futuro Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate [] 7. Decedent Maintained a Living Trust 2 8. Total Number of Safe Deposit Boxes (Attach Copy of Wet) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) betvreen 12.31-91 and 1-1-95) (Attach. Sd~. O) C - Tt~ SECTION MEJST BE CCRAPLETED.11L1. CORRESPONDENCE AND CONF'ID~EN'T1AL T;i1X N~RMATION SIIDtfLD taE DIRECTED TO: Name Daytime Telephone Number S U S A N H C O N F A I R 7 1 7 ? 6 3 1 3 8 3 F' N ff bl e irm erne ( App6Ca ) R E A L E R & A D L E R P C First line of address 2 3 3 1 M A R K E T Second l~ Of addreas S T R E E T City or Post Office C A M P H I L L State ZIP Code REGiBTER OF YYILL8 USE O~t 1( n ~~ ~ n / ~ ~.ti~'„v'~ ~ ~~y 1 V f. ~~~ ~ ~- DIR~ ~E~ n.~ ~n P A 1 7 0 1 1 Correspondent's e~ma6 addroas: JGR0SS~IREAGERADLERPC • C4M rv -.,- s ; ~, ~:~:~ ~-~ ~~ ~:..~ ,. ~f-, ..,~ .....~ ~;'" 3 f. . ~.,,; ""~ ~ ._, r~n 4.~~ .~ i Under of pe~tny, I dedrre fat 1 have eeanllne~"die mtum, indudi~g acQo~pw~q ~ and , and'b the beet cf n~rknerrled~e and beef, it is . dadenEgn d pnepeaer oih~ tt~eat #Ie pereorlal , is baoed on aN iNriarmedon of wMch proparer has anykr+o~wledge. E PER E F F ETURN ~T~ YICE R . ~ ~ _ / ~. must v~lc~ ~ / 1 /~//~ 213 MARKET STREET HARRISBURG PA 7 SIGNATURE OF P AJtER OTHER THAN REPRESENTATNE i QA' 2331 MARKET STREET __,_C,AMP HILL PA 17011 PLEASE USE ORIGINAL Ft~IA ONLY Bide 1 1505607121 150560?121 ~''~ J 1505607221 REV-1500 EX DecedenCs Social Security Number t+lan~e: MARY J• ASHMORE 2 0 6 3 2 1 3 b 6 RECAPITULATION 1. Rea estate (Schedub A) ........................................ 1. 1 7 0 0 0 0. 0 0 2. Stocks and sonde (Schedule B) .................................. 2. 6 6 1 7 1 ? . 2 3 3. Ckmely Field Corporation, Partnersh~ or Sole-Proprietorship (Schedub C) ..... 3. • 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. • 1 1 b 7 2 D • 4 6 5. Cash, Basic Deposits 8 Misceilar~aa-s Personal Property (Schedub E) ....... 5. 6. Jointly OMnred Property (Sd~edub F) ^ Separate BiNing Requested ....... 6• • 7. Inter-Vivos Transfers 8 Miscellaneous N~Prols~te Property (Sdtedub G) (~ Separate Bring Requested ....... 7. • 8. Total Gross AssNs (total Lines 1-7) ........................... 8. 9 5 0 4 3 ? . 6 9 9. Funeral Expenses 8 Administreti+ve Costs (Schedule H) .......... ...... 9. 5 0 5 5 7 , 2 9 10. Debts of DeoedeM, Mortgage Li"abilities, & Liens (Schedule i) ...... ...... 10. 4 5 4 0 0 • 4 0 11. Total Deductions (total Lines 9 810) ..................... ...... 11. 9 5 9 5 ? . 6 9 12. Nst Value of Estate (Line 8 minus Line 11) ................... ...... 12. b 5 4 4 b 0. 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which b 5 4 4 8 0 0 0 an election to tax has not been made (Schedule J) ............ . . .... 13. . 14. Net Value Subject to Tax (Line 12 minus Line 13) .................. 14. 0 • 0 0 TAX COIyAPUTATION -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 0 0 0 0 0 0 at lineal rate X .0 16. • 17. Amount of Line 14 taxable 0. 0 0 , 7 0. 0 0 at sibling rate X ., 2 , 18, Amount of Line 14 taxable 2 0 0 0 0 0 3 0 0 0 0 . at collateral rate X .15 18. . 19.Tsx Due .......................................... ...... 19. 3 0 0. 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 ]505607221 1505607221 J REV 1500 EX Pape 3 Decedent's Complete Address: File Number 21 09 1071 DECEDENTS NAA~ MARY J• ASHMORE STREET ADDRESS 3011 YALE AVENUE CITY CAMP HILL STATE PA 21P 17011 Tax Payments and Credits: ,. Tax Due (Page 2 tine 19) 2. credits/Paymen~ A. Spousal PeveRy Crept B. Prior Payments C. Discount 3. InteresUP~enalty ~ app~cable D. Interest E. Penalty (1) 300. Do 285.00 15.00 Total Creccfitts (A + B + C) (2) 300.00 Total InhrostiP~lialty (D + E ) 4. lF Line 2 is than tine 1 + tine 3, enter the difference. This is the OVERPAY~NT. Ffil M oral on Psi T, LMe 20 to rogues a rotund. 5. ff tine 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX ~E. A. Errter the ink on the trot due. B. Enter the total of Line 5 + 5A. This is the BAt.Air1CE DUE. (3) 0.00 (4) 0.OD (5) 0.00 (~) (58) 0.OD Make Check Payable to: RE~IST~R OF MV?lLS, A~E~WT PLEASE ANSWER THE FOLLOWING QUESTIQNS BY PLACING AN "X" IN THE APPRbPR1ATE BLOCKS 1. Did decedent make a transfer and: Yea No a. retain the use or irxx~me of the property transfemed : ...................................................................... ^ b. main the ri~# to designate who shall use the property transferred or its income; ............................... c. retain a revers nary interest; or ................................................................................................ d. receive the pr+cxrase for iii of eitl~r payments, benefits or cue? ....................................................... ^ 2. {f occurred after December 12,1982, did decedent transfer property within one year of death WIthOUt feCetYrtlg adeQUate OOnal~l? ....................................................................................... ^ 3. Did decedent own an "in trust for' or payable upon deattl bank account or security ~ his or her death? ......... ^ 4. Did decedent own an Individual Retirerrlent Account, annuity, orother nai-probate property v~ich contains a benefiaary 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. The tax rate imposed on the net value ~ transfers to or for the use ~ the decedent's siblings is twelve (12) peroe~t C72 P.S. §9116(aK1.3)). A sibling is defined, under Section s1t32, as an indivi~af woo has at least one parent in common with the decedent, whether by bkxxl or adoption. REV 1502 EX + (8-98) cOMIAONVVEALTM of PEr~NSnv,~Na REAL ESTATE INHERRANCE Ti4X F~TURN RESIDENT QECEOENT E8TATE df F'D.E NtNMOER MARY J• ASHMORE 21 09 ]071 AN nN Ply owned ~l- orae ~ IeraMrt h oearaan rnslR be niporl~d a~ bik rNerlretvelae. Fair merleat glue is deAned as the prbe at whidt properly would be exchanged between a w~inp buyer and a wl~np seMe~, bebg oornpeNed b buy aseN, bode harlnp Ee~orabb latiowr~edpe of ~e nNe+rant mss. R~eM which ie wilh o1 br aNdodad, oa ~ F'. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 3011 YALE AVENUE, CAMP HILL, PENNSYLVANIA 17011 170,000.00 APPRAISED VALUE USED TtyTAI (Also enlsr on pne 1, labion) ~ : 170, 00 . (it more space is needed. iraert additlorral st+eeb of the sane size) REV-1503 EX + (6-96) ~~~~~~~~ ~o~o-TH o~ ~ENN~,~~ANa STOCKS & BONDS II~iERRANCE TAX I~TURN RE8~ENT L1Et-EDEMT ESTATE Of FILE NU#~ER MARY J• ASHMORE ,_ 21 09 1071 M properly joMMhaownad w~h ~t ~:wvhronhip be a~d®ad oa sdMdeie F. {TEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SERIES EE AND SERIES E SAVINGS BONDS 422,293.88 2• US TREASURY NOTE 20,208.36 3• US TREASURY NOTE 16,138.75 4• US TREASURY NOTE 41,875.55 5• US TREASURY NOTE 52,838.32 6• US TREASURY NOTE 20,314.65 7• SUShcUEHANNA TYP• PA SCHOOL DISTRICT - BOND 27,986.97 8• HARStO CORP. - 200 SHARES OF STOCK ?,459.75 9• HEINZ H J CO - 100 SHARES OFSTOCK 4,D83.50 10• HERSHEY CO• - 200 SHARES OF STOCK ?,833•DO 11• DEL MONTE FOODS CO• - 44 SHARES OF STOCK 482.90 12• DREYFUS ST• MUN - 618 UNITS 9,813.84 13• PUTNAM PA TAX EXEMPT - 1,096 UNITS 9,882.32 14• NUVEEN FLAGSHIP MULTISTATE I - 1,975.476 UNITS 20,505.44 TOTAL (A~o enter on lire 2, Rsc~p~la~ian) t 6 1, 717.23 (~ naro space b needed, iroert addilbnal cheek of the same siae) REV-1508 EX + (6-98) SCN~t~~lL~ E CASH, BANK DPOSiTS 8~ MASC. ~ ~ , cc~o A~TH of r~nvnwv - MVHERITANCE TqX ItCTtNtN PERSaNAL RRO~RERTY RESIDENT raE ESTATE OF FR.E j MARY J • ASHMORE ,_,___, , _ 21 09 1[171 _ • incN+ds the Prooeeda of ~alfon artid the dab ~e w~aae r~ec~eiMed bl- the eebb. MI wNh of W diacb»d on F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MEMBERS 1ST FEDERAL CREDIT UNION - SAVINGS ACCOUNT X328252 76.91 5000 LOUISE DRIVE 11ECHANICSBURG, PA 17055 2• M ~ T BANK - CHECKING ACCOUNT •11377321 110,343.7? 499 MITCHELL ROAD MILLSBORO, DE 19966 3• PA TREASUREY - PENISON 1,511.93 4• UNLASHED CHECK - HJ HEINZ 42.00 5• REFUND OF CANCELLATION - VERIZON 5.33 b• REFUND ON HOMEOWNERS POLICY - PENN NATIONAL 319.00 ?• US TREASUREY - FEDERAL INCOME TAX REFUND 500.00 8• PROCEEDS OF SALE OF HOUSEHOLD EFFECTS - HOBBIE AUCTIONS 4,071.5D 9• REFUND OF VA BURIAL ALLOWANCE 100.00 10• SALE OF MISC• COINS 1,640.00 11• REFUND FROM COMCAST 106.94 12• CASH IN HOME 3.08 TOTAL. (Also ertt~x on ~e 5, R~ecspi~laaoH) ~ i 118 , 720 • _.~. (ti move speroe b Headed, inert addidonb aheeb cf >he name aims) r REV-1511 EX + (10-08) CONMAONVIIEALTH OF PENNSYLVAh{A MHERITANCE TAX RETURN ~~~~~~ FUNERAL E~CRENSES 8~ ADNNNISTRATIVE COSTS ESTATE OF FN.E NUif~ER MARY J• ASHMORE 21 09 1071 t of deesdent mist ba npoeled on Schedule it. ITEM NUMBER DESCRtPTtON AMOUNT A. FUNERAL EXPENSES: 1. W• ORVILLE KIMMEL FUNERAL HOME, INC• 7,641.00 2• BAUGHMA:N MEMORIAL WORKS, INC• 2,338.00 3• BURIAL CLOTHING 117.2°! B. ADMINISTRATIVE COSTS: 1. Personal R~eq+esert~atlve's Cortsrrnssions Platne of Pe~aonai Representative (s) MAN_, OF A C TUR E~„RS AND TRADERS TRUST C OMP A Street Address 213 MAi~K E T STREE T City HARRISBURG State P~_____ Zip 1?101 Year(s) Commission Paid: 2 010 33,013.00 2, AtbmeyFees REAGER 8 ADLER, PC 6,800.00 3. Famiy Exemption: (If decedents address is not the same as aaimanrs, attach ~) cent stre~ Address ~ state zip R~ ot` Clamant to Decedent 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 4b0.00 5. ~ Aooountar-Cs Fees 6. Tax Retum Pnsparat's Fees 7. LEGAL ADVERTISEMENT -CUMBERLAND LAW JOURNAL ?5.00 b• LEGAL ADVERTISEMENT - JOURNAL PUBLICATION 85.00 9• SNORT CERTIFICATE - CUMBERLAND COUNTY REGISTER OF WILLS b•00 TOTAL tAbo enter on ~ 9, Recapiit~al~on) i S (If more space is nestled, insert adt~ional st~eela of ~e same sib RE1/-1512 EX ~ (12-03} co~oNw~u.TF+ ~ ~~nv INHERITANCE T/1X R~v~+ RE8~IDENT OE f~lT ~~~~~~~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FM.E MARY J• ASHMORE _ 21 09 1071 R~epott ~ the t1~d~ttt prbr bo ds>rtlI wl~ch roma>~Sli unpidd as of the dale c[ dNllh, inclu~ unroimbws~d nle~l exPen:a:. VALUE AT DATE DESCRIPTICIN NUI~ER OF DEATH 1. ELECTRIC - PPL ELECTRIC 1,545.0? 223.89 2. WATER - PA AMERICAN WATER 18.13 3. PHONE - VERIZON 234.64 4. TV - COMCAST 25.00 5. SAFE DEPOSIT BOX FEE {,. COUNTY/80ROUGH REAL ESTATE TAXES - JANET MILLER 945.12 ?. FLOORING EXPENSE - WHITCO HOME FURNISHINGS ?,643.32 8. MEDICAL EXPENSE - MICHAEL J• LAWLER SP 15.00 9. LOCKS - DUDY'S LOCK, SAFE ~ SECURITY, INC• 134.68 10. SEWER - BOROUGH OF CAMP HILL 207.50 LIABILITYlPROPERTY INSURANCE - SES INSURANCE BROKERAGE SERV• INC• 11- 1,422.00 12• APPRAISAL FEE - CIAUSER REAL ESTATE APPRAISALS, LLC 350.00 13• APPRAISAL FEE - RSR APPRAISERS 350.00 14• REFUND PENSION - STATE EMPLOYEES RETIREMENT 1,915.11 15• HOME CARE EXPENSE - TERRI BARR'S HOME CARE FOR SENIORS 22,944.00 TATS (AI~n meter txti Ntte 10. R;eC8g11~8bOt1~ ~ S (1f n1018 ~Q80B iS 19e9~9d, if 1s81t 8dd~tai sh994s Cf tl1~ ~i1f8- ~~ Continwation of REV-1500 Inheritance Tax Return Resident Decedent 1WM1RY J. ASHMQRE OwesieM"s Name Page 3 21 09 1071 File Number Schedule l - Debts of Ge~aedent, Mortgage Liabilities, ~ Liens ITEM NUMBER DESCRIPTION AMOUNT 16• SNOW REMOVAL - D•J• MAINTENANCE 495.00 1?• COPY OF PHARMACY RECORDS - CVS PHARMACY 50.00 18• CLEANING AND REPAIRS EXPENSE - K•M• DAUGHERTY 4,654.21 19• COMMISSION ON SALE OF HOUSEHOLD EFFECTS - H088IE AUCTIONS 1,?30.92 20• LAWN CARE -MARSHALL QUARTMON 410.00 21• STATE INCOME TAX - PA• DEPARTMENT OF REVENUE 86.61 SU8'TOTA1. SCHEDULE 1 7 , 4 26 • ? 4 t~RANO TOTAL SClISf~Ui.E 1 ~ 45,404.40 REV-1513 EX + (9.00) co~uloNwEA~TH of PENNSYLVANIA INFIERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J eE~EFiciar~~s VARY J • ASHMORE 21 °i 1 D71 RELATKSHiP TO DECEDENT AMOUNT OR SHARE NUMBER NAME Aim ADDRESS OF PERSONtS) RECEIVING PROPERTY Do Mot Lbt Tlvsl~(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include c~ibutlo~s, and hane~s under . Sec. 9116 (a (1. jj 1. RALPH AND MILDRED BOESHOREtSPECIFIC BEQUEST) Collateral 1,000.00 5225 WILSON LANE, APT. *2108 MECHANICSBURG, PA 17055 2• JACK R• YINGERtSPECIFIC BEQUEST) Collateral 1,000.00 2155 BANBURY DRIVE ENOLA, PA 17025 ENTER DOI.IAR AMOttNTS Ft~t t~t,STRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPRt)PRiATE, ON REV-15Q0 COYER SHEET II. N~f-TAXA~I.E D't'RI8U1'IONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARI"fABLE AND GOVERi+~AENTAI DISTRIBUTIONS 1. HOSPICE OF CENTRAL PENNSYLVANIA 213,620.00 1320 LINGLESTOYN ROAD HARRISBURG., PA 17110 2• AMERICAN CANCER SOCIETY 213,620.00 8400 SILVER CROSSING OKLAHOMA CITY,` OK 73132 3• AMERICAN HEART ASSOCIATION 213,620.00 PO BOX 22249 ST• PETERSBURG, FL 33742 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DiSTRi8UTI0NS ON LMtE 13 OF REV-15p0 CQVER S'NEET S b 54 , 4 60.00 (~ mare space ~ treaded, insect adc#~onai streets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent MARY J. ASHMORE 21 09 1071 Deoecbnt's Name Page 4 Fib Number 3Chedule J - Ber~flciairifiits - 2B B. CHARITABLE AND GOVEF~4MENTAI DISTRIBUTIONS 4. HELEN 0. KRAUSE ANIMAL FOUNDATION, INC. ~ 213,620.00 PO 80X 311 MECHANICSBURG, PA 17055 SUBTOTAL iCHEDli1.E J•~B ' • ~ « ~~~ t ` .~ •~' . ' ~~~ . ~ ~ ~ `~~ • ~.,.., 1, MARY J,AI~E ASHII~ORE, ~i resident of CAMP HILL BOROUGH, . CUMBERLAND COUNTY, Pennsylvania, being of sound aACI dispasin,g mind and, tnelnory, do hereby maka, publish ar~d declare this as and for my L~tsst WI#I and Te~nte~t, hereby revoking any and all Wills by meat any time heretofore made. f~~'•r ~ C~* ~i. ~t i ,.A 1 1,_ s-~~`~ ITEM [. i direct my Executor hereinafl!cr named to pay alt my debts, funeral anal burial axpa~s as soon after my decease as nrac~icabte, as well as ail inheritance taxes, w State or F®deral, which may be asset again4t my Estate, a~S ~rt of tha coats - of administration. ~ ' I'T'EM [[. I direrx that my fu~teral and burial ar~lgements shalt be in charge of the . Kimmel. Funeral .Home, app l Market Street, Harrisburg, !'w~nsylvana, and' that my place of burial sltatl he in tfie Mount Nulty Springs Cemetery, Mount He~lty Springs, Pennsylvania, in . thcMlller-Donnelly plot, Lots No. t 82 - l 83. ITEM Ill. l direct that my l~ereinaf~er Warned Executor, shall pay the Mount Hvlly Springs Cemetery Associatiorrfor pe~petuat c.~ire i"nr tt~ foitowi~-g Lats: ~ •• t . Lot No.. l 77, Section C (Calvin and Mary F. DonneNy) 2. Lot No. 181, Section C (Bertha and Nellie Donnelly) ITEM 1V. i further direct my said Executor, tin nlac:e r;~y itarne, cue of birth (Apri120, t 9l4) and the date of my death on d2e cemetery marker,'opposite that of my late ,huab~el, Alvin D. Ashmore. 1"I`El-.4 V. 1 f~isthci~:iif:~c; ~~~y i:x;.cutuc tv purc.~iee a s~xustl da~se, to be planed on the: graves or A~rha Donnelly ~ 1873-1 ~; ;), %Vallie Donnelly t t 88~-1972), Lot No. 181, Section "E;"and Emma Don:~elly.(' 877-1960, uu Lot No. I77, Section "C". ITEM VI. 1 direct my hereinafter named Executor to xll and convert all the property - ~ in my Estate, r+eat, personal and mixed, including my coin.eollection in Safe DeQosit BoxNo. 1755 in the Dauphin Deposit Trust Company now known as Allfirst Bank and my home at 3011 Yale Ave., Campl-tilf, Curtrbe~~lant! Ccwi~ly, !'ennsylvania. If t shall stilt own. it, into cash and to dtstribute the net proceeds derived therefrom, as Ilereinafler provided. ra to ..... 1'TEMI VII. 1f my Siamese Cat, Missy, is living at my death, she shall be euthanized ax the Camp Hill Animal Hcital and then buried in the peg section of Rolling Clr~eert Cem©tery. if tlu~t is not avai able, then such burial shad be lit Golden Lake Kennels, Mexihanicsburg, Pennsylvania. There sha[I be no cremation. ~ • . ITE1M1 VIIL Tha Hause shall be sold by private sale and the G~nttg shall be sold at an auction lie. There shall be no auction at the residentx. 1T'~M [X. if living at my death the following amounts sha#1 be paid 1. X5,000.00 to Ernest M. Clay at 306 N. 17~' St., Csmp• Hill, Pennsylvania. 2. $1,000.00 to Ralph and Mikir~ed I~eshere at 3015 Yale Avenue, Camp Hill. . ~ Pennsylvania or the other survivor. 3. '~1,000.p0 to Jack R. Yinger at 2155 Banbury Drive, Enola, Pennsylvania. ITEM X. Any ranaining balance shall be distributed equally among: 1. Elospica of Central Pennsylvania P.4. Box 266 Enola, Pennsylvania 1 ?025 . 2. American Cancer Society 1 S00 North Second Street Harrisburg, Pennsylvania 3. American Heart Association 1019 Mumma Road Wormleysburg, Pennsylvania 4. Helen O. K~~ause Animal Foundatiai, lnc. P.O. Box 31 Mechanicsburg Pennsylvania (lf this foundation is no longer active, such amouat email lhen be paid to the West Shore Humane Society) • ITEM XI. I nominate, constitute and appoint the Allftrst Bank'at 213 Mark Street, Harrisburg, Pennsylvania, as Executor of this my Last VYig sad Tweet, with fu!! . power in their discretion to do any and all things necessary for the complete administretion of my .estate, with full power to sell at public or private sale and without order of court, any rest or personal property belonging to my estate, and to compound, compromise or otherwise to settle or adjust any or ail claims, charges, debts and demands whatsoever against or in favor of my estate as fully as I could do if living. ~: i' i~ }i :~ ~~ .~ ~; .: ~i ~ ~. i~ :; r~ ', ~' ~'t ~' ;; ,. ~. . ,~ ;~ .; F. ~. •;{ i~ i~ i~ ~ •: r~; i~ r' t; 1. ~; i~ IN WITNESS WHEREOF,1. a herau~~t~o M HAi~ID end SEAL to this, my L~at Will aad 'Fes~ment, this '~ C7~`'~ da of A.D., 1999. y ' esnxY a s Sigsnd, seekal, pt~lished and declared #ha abow~-named MARY JANE ASHM4RE ,as aszd for HSR i.ast Wgl saati Teaduaeat in tha 'ca of us, wino, at HER request, in HER presmteae and ~ proaenae of each otl~aar, wa, believing HER #o ba~of sound and dispasiu~g mind and memory, have Ito subsccibod Our names 85 wi thi ~+ day. of A.D., 1999. vvrrr~ESS~s: ~~ ~ . ~ ., ' i• ' CtMONWEAL'~'8 OF E'giYNSYLVANIA ) .~ ~, ~ ,, , ' . c~cnv~cY OF .~ ~.c,,,1..' ~ ~. ~`"~' ' :. 1, MARY JANE ASHMORE, ~u~t a.F.~ ~ ~~C~ ~' ~" S _~ .t . ~.. ~, Q a1 tl~e TESTATRIX and the witnesses, respectively, :_ ;. '~ whose names arc signed to the forcpoing instrument, being first duly sworn, do 'Y declare ~: ~ ~ ~ . to be die undersigned audYa-rity that the TESTATRIX signed and execubod the instrument as HER I~t VYt~t and 'Teateraeet and that SHE lied signed willingly and that SHE executod i# as' ~~ HER free and voluntary act for the purposes therein expressed, and that each of the witnossas, in .. the pt+a~aice aad hearing of the TESTATRIX signed the Wilt as witness and that to the best of ~~ rs '; tlx3ir knowledge the TESTATRIX was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~ . 4 '. TLSTA~~IX: ~~ i; ~: w~rN~sS ~: i~ .. t c • • ~ ..-_ is ! Subscribed, sworn to and acknowledged ,before me by.MARY JAl3E ASHMfJRF~, i= the Ti~'~?'R~tX, and subscribed sw `: to before me ~i ~ r~' A- Qr.R and ~ l d+i6t.. r+~ the . wbtrease$, the y of ~. A.D.,1999. ~~~~~ NOTARY PUBIIC COMM783ION EXPIItFJS: :; ;~ ,: tc ~i ~~ ;~ ~: .~ ~f :; ., ;s ~~ .: ,: t ,: ,' ;: .; ~: ;: •T t: jY ~~ i~ tS ./ %; ~; ;: ~: .i lj '.: :~ ;: _• ~~ ~~ ~~ coR~r ~,~, .,~. s~, ~ ~Mamhar. M ~~