HomeMy WebLinkAbout12-07-10' 1505610140
REV-1500 EX (01-10)
PA Department of Revenue
Bureau of individual Taxes County Code Year i=ilg Number
Po Box 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 9 8 1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
2 0 2 2 0 1 9 7 3 0 7 2 9 2 0 1 0 0 9 0 3 1 9 2 7
Decedent's Last Name Suffix Deceder+Ys First Name MI
C E K O V I C E L I
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M(
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUP1_1CATE W{TH THE
REGISTER OF WILLS
F{LL {N 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 (date of ~ 5. Federal Estat+: 'Tax Return Required
death after 12-12-82)
0 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust fl 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wiii) (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}
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Name Daytime Telephone Number
C H A R L E S E P E T R i E 7 1 7 5 6 1 1 9 3 9
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City or Post Office State ZIP Code ATE: FILED ,_,.. --; ,
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H A R R I S B U R G P A 1 7 '1 1 1
Correspondent's a-mail address: PetrieLaw AOL.COm
Under 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.
SIGNATURE OF PERSON RESPON$,IBLE FOR FILING RETURN DATE
~'..~'~,~ ~, ~?'1 ~,~ ~,.rs-uc.~ , 11 ! 1$/2010
ADDRESS 1..
6050 WERTZVILLE ROAD HARRISBURG PA 17111
SIG E PRE RER OTH H REPRESENTATIVE DATE:
f~~ M~ ,~ _ __ _ _11!18/2010
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ADDRESS
3528 BRiSBAN STREET HARRISBURG PA 17111
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056],D1,4D
Lsos61a14a J
1505610240
REV-1500 EX Decedent's Social ,>ecurity Number
2 0 2 2 ~p 1 9 7 3
Decedent's Name: E~! CEK4VIC
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 and Notes Receivable (Schedule D) ............... ........ .. 4. •
~ 0 0 ~0 C) 0 ' 0 0
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5.
6. Jointly Owned Property {Schedule F) ^ Separate Billing Requested ..... .. 6. 1 0 0 0 C} 0 0 0
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G} ^ Separate Billing Requested ..... .. 7, •
8. Total Gross Assets (total Lines 1 through 7} ....................... ... g. 4 0 0 0 0 0 0 0
9. Funeral Expenses and Administrative Costs (Schedule H) ............... 9. •
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ......... 10.
11. Total Deductions (total Lines 9 and 10) ................. ............ 11. •
12. Net Value of Estate (Line 8 minus Line 11 } ............................ 12. 4 0 0 U 0 0 0 0
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................. . .... 13. •
................14.
14. Net Value Subject to Tax (Line 12 minus Line 13} ...... 4 0 0 C) 0 0 0 0
TAX CALCULATION -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 15.
16. Amount of Line 14 taxable
at lineal rate X •Q 0 0 0 16.
17. Amount of Line 14 taxable
0 0
0
17
at sibling rate X .12 .
18. Amount of Line 14 taxable
0 0
0
18
at collateral rate X .15 .
19. TAX DUE ......................... ..................... ..... .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1,505610240 1,50567,0240
0.0 0
0. 0 0
0.0 0
0.0 0
0 • 0 0
D
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REV-1500 EX Page 3 File Number
Decedent's Complete Address: 0 0
DECEDENT'S NAME
ELI CEKOVIC
STREET ADDRESS
6050 WERTZVILLE ROAD
CITY. _ _ _ - ~ STATE I ZIP
,HARRISBURG PA 17111
Tax Payments and Credits:
~ ~ Tax Due (Page 2, Line 19} (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits (A + 8) (2) 0.00
3. Interest
(3}
4, if Line 2 is greater than Line 1 + Line 3, eater the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
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; .......................... ..... ^
c. retain a reversionary interest; or ........................................................................................... ..... ^ 0
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? ............................................................................................. ..... ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS lS 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for 1:he use of the surviving spouse
3 percent [72 P.S. §9116 (a) (1.1) (i)).
For dates of death on or after Jan. 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)]. Asibling is defined, undE
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.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELI CEKOVIC 21 09 0981
Include the proceeds of lifigation 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. PROCEEDS FROM WRONGFUL DEATH LAWSUIT 300,000.00
TOTAL (Also enter on line 5, Recapitulation) I $ 300, 000.00
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (0 i -10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELI CEKOVIC 21 09 0981
SCHEDULE F
JOINTLY-OWNED PROPERTY
If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S)
A. ELLEN CEKOVIC
ADDRESS
6050 WERTZVILLE ROAD
ENOLA, PA 17025
RELATIONSHIP TO DECEDENT
B
c
JOINTLY-OWNED PROPERTY:
SPOUSE
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET ~/o OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1. A. REAL ESTATE AT 6050 WERTZVILLE ROAD 200,000.00 50. 100,000.00
ENOLA, PA
TOTAL (Also enter on Line 6, Recapitulation) ~ ~~ 100, 000.00
If more space is needed, use additional sheets of paper of the same size.
REV-1513 EX+ (01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Fi i r_~Knvir_ ~1 n9 n9R1
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. ELLEN CEKOVIC 400,000.00
6050 WERTZVILLE ROAD
ENOLR, PA 17025
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS 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.
It more space is needed, use additional sheets of paper of the same size.
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LAST WILL AND TESTAMENT ~±~ ~`
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ELI CEKOVIC
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I, Eli Cekovic, presently of 6050 Wentzville Roacl, Enola,
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~~ Cumberland County, Pennsylvania, declare this to be my Last Wi11 and I
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~;; Testament hereby revoking all wills and codicils previously made by me.
I declare that I am married to Ellen Mary Messinger Cekovic
!I and that all references in this Will to my Wife are references to her.
~;' I have three (3) children, now living, whose name=sand dates ~,
~~~
I', of birth are as follows: ~
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Michael Jay Cekovic October 12, 1962
~~
I~! Elias Junior Cekovic September 7, 1965 ~
~~ Frank James Cekovic November 13, 1967
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!,j All references in this Will to my children include only the
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children named above.
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'~~ ARTICLE I ~~
I direct the payment from my estate of the expenses of my I'
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j last illness and funeral as soon after my death as convenient]_y may be j
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done.
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ARTICLE II
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Ij I give all of my household furnishings and tangible personal
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~` property to my Wife provided she survives me by thirty (30) days. If
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~' my Wife fails to survive me by thirty (30) days, then I give all of my I
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!j household furnishings and tangible personal property to my children to
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be divided among them as they are able to agree; if they are unable to
agree, then said property and furnishings shall pass with t:he residue
of my estate.
~ ARTICLE III i
i I give the rest, residue and remainder of my estate to my
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i! Wife provided she survives me by thirty (30) days. Should my Wife fail
'! to survive me by thirty (30} days then I give the rest, residue and
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', remainder of my estate in equal shares to my children who survive me by
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'! thirty (30) days. If my Wife and all of my children fail to survive me
by thirty (30) days, then I give the rest, residue and remainder of my
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Ij estate in equal shares to my grandchildren who survive me by thirty
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{', (30) days. ~~
ARTICLE IV
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A, I appoint my Wife as the Executrix of this Will. In the
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!i event of her death, resignation, renunciation or inability to act in
~~ that ca acit then I a
~, p y, ppoint my son Michael Jay Cekovic as the
Executor of this Will in her place and stead. ~,
'' B. No bond or other security shall be required of_ a.ny ~~
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Executor/Executrix appointed in this Will.
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C. The Executor/Executrix shall receive reasonable
compensation for his or her services performed as determined by the
'~ Court in which this Will is admitted to probate.
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(,~ D, I give my Wife in addition to and not in limitation of
I~ the powers given by law or by other provisions of this Will, the
following powers with respect to settlement of my estate, to be
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Page 2 of 7
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exercised from time to time in the discretion of my Executor/Executrix
without further order or license of the Register of Wills or of any
court:
1. To borrow money from any person including any
fiduciary acting hereunder, and to mortgage or p1_ed.ge
any real or personal property;
2. To hold shares of stock or other securities in
nominee registration form, including that of a clearing
corporation or depository, or in book entry form or
unregistered or in such other form as will pass by
delivery;
3. To engage in litigation and compromise,
arbitrate or abandon claims;
4. To make distributions in cash, or in kind at
current values, or partly in each, allocating specific
assets to particular distributees on a non-prorata
basis, and for such purposes to make reasonable
determinations of current values;
5. To make elections, decisions, concessions and
settlements in connection with all income, estate,
inheritance, gift or other tax returns and the payment
of such taxes, without obligation to adjust the
distributive share of income or principal of any person
affected thereby;
6. To retain any property, pending distribution
hereunder, to invest in or purchase any property without
restriction to legal investments for fiduciaries, to
distribute property in kind, to compromise claims, and
to sell any property at public or private sale;
7. To manage, control, repair and improve all
estate property;
8. To procure and carry at the expense of the
estate, insurance of the kinds, forms and amounts deemed
advisable by the Executor/Executrix to protect the
estate and the Executor/Executrix against any hazard;
9. To employ any attorney, investment advis~sr,
accountant, broker, tax specialist or any other agent
deemed necessary in the discretion of the Trustee; and
to pay from the Trust estate reasonable compensation for
all services performed by any of them;
Page 3 of 7
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10. To conduct alone or with others any business ~
;; in which I am engaged or in which I have an inte:rest at f
;i my death, with all the powers of any owner with :respect
ji thereto, including the power to delegate discretionary ~
duties to others, to invest other property held
'~ hereunder in such business and to organize a partnership
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or corporation to carry on such business; !
ARTICLE V `
~, ~ ~
My Wife and I are executing Wills at approximately the same ~,
time in which each of us is the primary beneficiary of the Will of the
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!i other. These Wills are not executed because of any agreement. between
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'' my Wife and myself. Either Will may be revoked at any time at the sole ~'
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+' discretion of the maker thereof .
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ARTICLE VI
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;; If any beneficiary or remainderman under this Wi1.1_ in any
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~,, manner, directly or indirectly, contests or attacks this Wil_1 or any of
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~! its provisions, any share or interest in my estate given to that
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contesting beneficiary or remainderman under this Will is revoked and
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shall be disposed of in the same manner provided herein as if that
'~' contesting beneficiary or remainderman had predeceased me without
~~ issue.
ARTICLE VII
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~' If any provision of this Will or of any codicil thereto is
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it held to be inoperative, invalid or illegal, it is my intention that all
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of the remaining provisions thereof shall continue to be fully ',
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'~j operative and effective so far as it is possible and reasonabl'.e. '~
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Page 4 of 7 `
ARTICLE VIII
All estate, inheritance and succession taxes, together with
any interest and penalties thereon, payable as a result of my death and
imposed with respect to any property, whether or not disposeci of by
'~ this Will, shall be paid out of the residue of my estate. '
;~,
~,
IN WITNESS WHEREOF, I have hereunto set my hand and seal and
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~: caused this my Last Will and Testament, consisting of 7 typewritten
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'~~ pages, including this attestation clause, to be executed, declared and'
~~~ published this / day of .,.:,~.,..~:~,~- ~ 1 989, at ~~
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ELI CEKOVIC
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Page 5 of 7
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA: j
SS.
COUNTY OF DAUPHIN
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~, I, Eli Cekovic, Testator, whose name is signed to the
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1! attached or foregoing instrument, having been duly qualifiE~d according
to law, do hereby acknowledge that I signed and executed the instrument
~~ as my Last Will; that I signed it willingly; and that I signed it as my
free and voluntary act for the purposes therein expressed.
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ELI CEKOVIC
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Sworn or affirmed to and acknowledged before me, by Eli
ii Cekovic, Testator, this '~ day of 1989.
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COMMONWEALTH OF PENNSYLVANIA : ~Y ~ y t-~, f;~,~.~~;u, . ; ~~;..., ,,:.~~
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COUNTY OF DAUPHIN
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ij and ~c ~~,~ ~~ the witnesses whose names ar_e signed to j
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the attached or foregoing instrument, being duly qualified according to '~
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Page 6 of 7
law, do depose and say that we were present and saw Eli Cekovic sign
and execute the instrument as his Last Will and Testament, that he
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signed willingly and that he executed it as his free and voluntary act ',
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for the purposes therein expressed, that each of us in hearing and
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sight of the Testator signed the Will as witnesses and that t:o the best
of our knowledge, the Testator was at the time eighteen or more years
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of age, of sound mind and under no constraint or undue inf]_uence,
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Sworn or affirmed to and acknowledged before me, by
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~ ~.2, f~R.w s ~} this ~1~"' day o f .___ ~,,,~,~ ~, ,
1 989 .
Notary P lic
My Commission Expires:
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Page 7 of 7