HomeMy WebLinkAbout09-02-10 (2)1505610143
REV-1500 Ex(°'-'°'
PA De artment of Revenue OFFICIAL USE ONLY
p Pennsylvania county code Year File Number
Bureau of Individual Taxes uEVUenExr OF nEVEauE
Po Box.28oso~ INHERITANCE TAX RETURN 21 10 0392
Harrisburg, PA 17128-OS01 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
174 20 2832 03 27 2010 02 25 1927
Decedent's Last Name Suffix Decedent's First Name MI
WEIDNER VALERIA M
(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 Return ^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ~ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
g Decedent Died Testate
(Attach Copy of Will)
^ 9. Litigation Proceeds Received
^ T' (Attaohe~Gopy Hof ~~ust)a Living Trust
^ 10. b~tweenl2 31 91 and T1a95~f death
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 TO:
Name Daytime Telephone Number
AARON C JACKSON ESQ 717 23n 4121
_' Ta
REGISTER ~t~,I~S US~1LY , `
- ~ = r-J J
First line of address '."'`' ~ I '
111 NORTH FRONT STREET `-` c~, t: > ---, ~ ~ _
,
Second line of address ~`~
~~ + ,._
PO BOX 889 '~~ r-,
City or Post Office DATE FILED ~~ ' ~ ~
State ZIP Code
HARRISBURG PA 171080889
Correspondent's a-mail address: ajaCkSOn@tuckerlaW.COm
Under penalties of perjury, 1 declare that I have examined this return, inGuding 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.
SIGNATURa OF PERSON RESPONSIBLE FOR FILING RETURN nnrF
D. Lester Weidner Jr.
34'//0
3 Kin swood Drive Mechanicsbur PA 17055
~IGNAIURE PREPARER OTHEfitTHAN REPRESENTATNE
Aaron C. Jackson Esq.
111 North Front Street, Harrisburg, PA
Side 1
1505610143 1505610143 J
REV-1500 EX
Decedents name: Weidner, Valeria M.
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) ........................................................
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...............
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............
7. Inter-Vivos Transfers & Miscellaneous lyoq Probate Property
(Schedule G) LJ Separate Billing Requested............
8. Total Gross Assets (total Lines 1-7) .....................................................................
4.
5.
Decedent's Social Security Number
174 20 2832
355,042.86
6.
7 117,800.69
8 472,843.55
9. Funeral Expenses 8~ Administrative Costs (Schedule H) ...........................
............
9. 18 , 4 81.5 9
10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. 10. 1 , 151.5 3
11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 19 , 633.12
12• Net Value of Estate (Line 8 minus Line 11) .......................................................... 12, 453 , 210.43
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, 453,210.43
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 .00 15.
16. Amount of Line 14 taxable 453 210.43 16.
at lineal rate X .045 ~
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 0 0 17.
18. Amount of Line 14 taxable
at collateral rate X .15 0 , 00 18.
19. Tax Due .................................................................................................................. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
1505610243
0.00
20,394.47
0.00
0.00
20,394.47
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-10-0392
DECEDENT'S NAME
Weidner, Valerie M.
STREET ADDRESS
5225 Wilson Lane, Suite 103
CITY
Mechanicsburg STATE
PA ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
18,000.00
900.00
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box 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.
Make Check Payable to: REGISTER OF WILLS, AGENT.
(5) 1,494.47
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 :.................................. ^
c. retain a reversionary interest; or ............................................................................................................... ^ ^
d. receive the promise for life of either payments, benefits or care? ............................................................ 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 "intrust for" or payable upon death bank account or security at his or her death?....... ^ ^x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary 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.
~~_'~' ~~ , Lis' r'
For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 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 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 21 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 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 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 12 percent [72 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.
(1) 20,394.47
Total Credits (A + B) (2) 18,900.00
(3)
(4)
Rev-1508 EX+(6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDEN7DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, 8t MISC.
PERSONAL PROPERTY
ESTATE OF (FILE NUMBER
Weidner, Valeria M. 21-10-0392
..,,,..V......-....,o,ow,.o...,, ,,.o o,.a,o.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 AARP Health Care -Refund of Premium payment made on 4/5/10 175.25
2 Asbury Communities, Inc. -Refund -Overpayment Resident Account 711.90
3 Asbury Communities, Inc. - 25% Refundable Entrance Fee 29,866.00
4 CNA LTC -Long Term Care Check. 5,130.00
5 County of Cumberland -Burial refund for Veteran 100.00
6 Pennsylvania Department of Revenue - 2009 State Tax Refund 95.00
7 Investment Account -Investment Account #xxxx02324 held solely by Decedent. 252,254.87
8 Members 1st Federal Credit Union -Checking account 179222-0011 held solely by Decedent. 12,478.13
9 Members 1st Federal Credit Union -Savings account 179222-0000 held solely by Decedent. 4,269.17
10 Members 1st Federal Credit Union -Money Management account 179222-0005 held solely by 36,282.45
Decedent.
11 Personal Property -Miscellaneous personal property. 11,910.00
12 Auer Cremation Services -Prepaid death arrangements 695.00
13 IRS - 2009 Tax Refund 1,068.00
14 Ladies' Home Journal -Refund for subscription 7.09
TOTAL (Also enter on Line 5, Recapitulation) I 355,042.86
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1510 EX+(6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
ESTATE OF (FILE NUMBER
Weidner, Valeria M. 21-10-0392
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.
ITEM
NUMBER DESCRIPTION OF PROPERTY
THE DATENOF RANSFERSATfACFiTA COPY OF TIHE DEED FOR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET % OF DECD'S
INTEREST EXCLUSION
(IF APPLICABLE) TAXABLE
VALUE
1 DWS Investments -IRA account #xx9047 held solely 68,380.35 100.000% 0.00 68,380.35
by Decedent. Passes to beneficiaries outside of
Estate.
2 Franklin Templeton Investments -IRA account 49,420.34 100.000% 0.00 49,420.34
#xxxxx25850 held solely by Decedent. Passes to
beneficiaries outside of Estate.
TOTAL (Also enter on Line 7, Recapitulation) I 117,800.69
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98)
REV-1151 EX+(10-06) SCHEDULE H
COMM N T F PENN YLVANw FUNERAL EXPENSES &
~"~~'6~N~o~o~~~R" ADMINISTRATIVE COSTS
ESTATE OF I FILE NUMBER
Weidner, Valeria M. 21-10-0392
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION- AMOUNT
N MB R
A, FUNERAL EXPENSES:
See continuation schedule(s) attached
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
1,353.51
Street Address
City State Zio
Year(sl Commission paid
2. Attorney's Fees Tucker Arensberg, P.C. 16,115.18
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4. Probate Fees 383.50
5. Accountant's Fees 335.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 294.40
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 18,481.59
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Weidner, Valeria M. 21-10-0392
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex ep nses
1 Auer Cremation Services -Fee for cremation. 874.82
2 Funeral Expense -Fee for Obituary Y83,82
3 Funeral Expense -Lunch for funeral service 194.87
H-A 1,353.51
Other Administrative Costs
4 Cumberland Law Journal -Publication of Estate Notice in legal journal 75.00
5 The Sentinel -Publication of Estate Notice in newspaper. 219.40
H-B7 294.40
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX+ (12-0ti)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF (FILE NUMBER
Weidner, Valerie M. 21-10-0392
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbureed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 AARP Health Care -Premium payment 175.25
2 Bonnie K. Miller, Treasurer - 2010 Per Capita Taxes for Cumberland County and Township of 9.80
Lower Allen.
3 Continuing Care RX -Prescription drug charges 621.19
4 Visa -Payment for Visa credit card. 80.86
5 Visa -Payment for Visa credit card. 264.43
TOTAL (Also enter on Line 10, Recapitulation) I 1,151.53
(lf more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08)
Estate of Valeria M. Weidner, deceased
Estate No. 21-10-0392
Re: PA Inheritance Tax Return
List of Exhibits
A. Death Certificate
B. Letters Testamentary issued by Cumberland County Register of Wills on
April 13, 2010, including Last Will & Testament of the Decedent dated
February 25, 2000.
H BG D 8:115130-1 025956-145902
r
EXHIBIT A
{105.805 REV (01/07)
' LQCAL R~(~~STRAR'S CERTi I~~CATi !~N ~~ ®~A~`H
WARNING: It is illegal to duplicate this copy by photostat or photograph.
wee for this certificate, $6.00 ;,,,,~<~~~ -- This is to certify that the information here Given
,t,,~~P~1N OF pfyy correctly copied from an original Certificate of Dea
~,~~`o'~ '- `~G: duly filed with me :as Local Registrar: The origin
~,g • ` - ~ certificate will be forwarded to :-the State Vii
s ., a~ ' Records Office fore ermanent filing...
Tr ` * a
P 164~7~~3 =~=• ?
Certification Number q~j~1ENT OE,~~P~t11 ~ - ~ J~~
oca egistr Date Issued
s.,~s acv n2oos COMMONWEALTH OF PENNSYLV'ANIA+ DEPARTMENT OF HEALTH • VITAL RECORDS
;.. ...,
YPE . PRWT W i . - .... ..,:
PERwWENT " CERTIFICATE OF DEATH
tuACtc trL (See Instructions and examples on reverse)
STATE FILE NUMBER
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C,.
REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
No.
Estate Of:
Late Of:
CERTIFICATE OF
GRANT OF LETTERS
PA No . 2 ~ - 10- 0392
VALERIA M WEIDNER
(First Middle, Last)
LOWER ALLEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No : ~ 74-20-2832
WHEREAS, on the 13th day of April 2010 an instrument dated
February 25th 2000 was admitted to probate as the last will of
VALERIA M WEIDNER
(First, Middle, Lastl
late of LOWER ALLEN TOWNSH/P, CUMBERLAND County,
who died on the 27th day of March 2010 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
D LESTER WEIDNER JR
who has duly qualified as EXECUTOR(R/XJ
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 13th day of April 2010.
~~
egister of Wil
Deput
* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
1 V F+
~,,- - ~ i ~~ f ,:: i t;
20f0 ~~R 13 ~I~ 8~ 4~7 ,
CLERK ~~
C~.a``F'~`nl ~~'~"~ ~~`~' ~ALAST WILL AND TESTAMENT
OF
VALERIA M. WEIDNER
ORiC3th7AL ~]~i TF1E TsAr-~
OF ROBEZT E; pAYEr:S, ESQUI E
100 YO;;K ROAD
Nom/ CWV-BERI.ANp, PA. ]7070
I, VALERIA M. WEIDNER, of 19 Southmont Drive, Enola,
Pennsylvania, being. of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking all other Wi'_ls and
Codicils previously made by me.
ITEM I: I direct that payment oT all my just debts,
expenses of my last illness, funeral expenses, and the costs of
administering my estate from my estate as soon after my death as
conveniently may be done. It is my will that my body be cremated.
ITEM II: T_ give, devise and bequeath all of the rest,
residue and remainder of my estate, of every Nature and wherever
situate, together with all insurance oclicies thereon, ~.~nto my
three children, namely DEBORAH L. AUSTIN, DENISE L. DOUGHERTY and
D. LESTER WEIDNER, JR., absolutely, share and share alike. In the
event any of my children predeceases me or dies within ninety (90)
days of my death, then his or her shire to go equally to his or her
children then living, per stirpes and not per capita, othe raise to
the survivor o` them.
ITEM III: I direct that any and all taxes that may be
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assessed in consequence of my death, including. all inheritance,
estate-and transfer taxes imposed upon my estate passing under my
Will or otherwise, shall be paid out of the principal of my
residuary estate. as a part of the expense of the administration of
my estate.
ITEM IV: I authorize and empower my personaY~-
representative to compromise, adjust, release and discharge ir.such
manner as my personal representative may deem proper, all debts and
claims owed by or to me or my Estate; to sell, lease or exchange at
public or private sale or in such manr_er, at such prices; and upcr_
such terms of credit or otherwise, as my personal representative
may deem proper, all or any part of my property; real or personal;
to exec ute, acknowledge and deliver instruments of conveyance,
including deeds in fee simple; tc borrow money for *he purpose of
paying estate, inheritance or other taL es which are reaui red to be
paid and to secure any such loar_s by oledge cr mortgage of all or
any part of my property and to execute the necessary instruments to
carry out such powers; Lo distribute my estate ~ r. kind or partly ~ r_
money or partly in kind, and to determine the fair value at-which
any property so distributed in kind shall be received by the
distributees; to conduct any business ir. which I have ar_ interest
at the t,~me of my death, for such period as my personal
representative may deem proper, power to borrow money and pledge
assets of the business and the power tc do all other acts that I,
in my lifetime, could have done, to delegate such power to any
partner, manager or employee without liability for any loss
occurring therein and to organize a corporation to carry on said
business as capital to such corporation and accept stock in the
corporation in lieu thereof and hold such stock for the uses of
this my Will, and to vote said stock or sell .the same as to my
personal representative may seem best; to retain all stocks;
assets, bonds and investments owned by me without being confined to
what is known as legal investments; to execute ary options to
purchase, to apply for stocks, bonds or other investments, to
purchase or otherwise acquire real estate and to execute the same
powers thereover as hereinbefore provided, to retain ir_defirit~ly
any part of my assets, real or personal, which is or may become
unproductive or to make sale thereof; ~o pay carrying charges and
expenses of the property out of other principal or income of rty
estate; to invest and reinvest ir. all forms of property without
restriction to investments authorized Tor Pennsylvania fiduciaries,
as my personal representative deems proper, without regard to the
principle of diversification or risk; to exercise any law-given
option to treat administrative expenses either as income tax or as
estate deductions, without regard to whether the expenses were paid
from principal or income. The. powers herein conferred shall be to
my named personal representative and all successors thereto and
shall be in addition and not in limitatior. of other powers
conferred on said fiduciary.
Any and all payment or payments oT any sum or sums, whether in
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cash or in kind and whether for principal or income payable to any
beneficiary shall be made upon the sole receipt of the respective
beneficiary to whom the payment is made and free from anticipation,
alienation, assignment, attachment, and pledge end free. from
control by the creditors of any such beneficiary.
ITEM V: All shares of principal and income hereby give:.
shall be free from anticipation, assignment, pledge or obligation
of the beneficiaries and any of ahem and shall not be subject to
any execution or attachment, levy or sequestratior_ or other claims
of the creditors of said beneficia=ies or any of therm.
ITEM VI: I nominate, constitute and appoint my
children, DEBORAH L. AUSTIN, DENISE L. DOLTGHERTv and D. LESTER
WEIDNER, JR. as the sole Executers of this my Last Will and
Testament, to serve without bond.
IN WITNESS WHEREOF, I, VALERIA M. WEIDNER; have, to t is my
Last Will and Testament, set my hand this .~s ~ day of
, Ada
` ~u' ~~ i'~ / ~ LV~~9C..GQJ ( SEAL
' VALERIA M. WEIDNER
Signed, sealed, published and declared bv_ VALERI,A M. WEIDNER,
th above named Testatrix on the ~.~~-}- day of
~, as for her Last Will and Testament,
in the pres ce of us, w o, in her presence, and ir_ the presence
of each other; have, at her request, subscribed our names as
witnesses hereto. '
~.
residing at 703 ~ f~
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residing at ,3 ~ c~
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a
CONII~fONWEALTH OF PENNSYLVANIA
COUNTY OF 'i~ SS
WE, the undersigned,- the Testatrix and the witnesses,
respectively, whose names are signed to the foregoing instrument,
being first duly sworn and qualified according to law, do hereby
declare to the undersigned authority that we were present and saw
the Testatrix sign and execute the instrument as her.Will, and that
she had signed willingly and that she executed it as her free and_.=
voluntary act for the purposes therein expressed, and that each of
the witnesses, in the presence and 'nearing of the Testatrix, signed
the Will as witnesses and that tc the best of their knowledge, the
Testatrix was at that time eighteer_ years of age .or older, of
sound mind and under no cor_straint or undue ir_fluence, and. I, the
said Testatrix, do hereby acknowledge that T signed and executed
the instrument as my Last Will and Testament, that I signed it
willingly, and that I signed it as my free and voluntary act for
the purposes therein expressed. ` 1~~,
Testatrix - VALERIA M. WEIDNER
Sworn to and subscribed before
me this ,~~ ~- day of ,
~- a~
Notary Pubfic
My Commission Expires:
NOTARIAL SEAL
MARY D. VER RAGE, Notary Publk
Fairview Twp., York County
M Commission Ex fires Ma 7, 2002