HomeMy WebLinkAbout03-0289 PETITION
Estate of ~L~ .~ ~_ e4 a ~
also known as
FOR PROBATE and GRANT OF LETTERS
To:
., Deceased.
Social Security No. ] ~4, - ~"~ --
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut
in the last will of the above decedent, dated 14hAO_o_~ I ~ ; ~
and codicil(s) dated
Register of Wills for the
County of O_qmA~pL~mb
Commonwealth of Pennsylvania
in the
named
,19"7,h'"
(state relevant circumstances, e.g. renunciation, death of execulor, etc.)
Decendent was domiciled at death in ~c,tm/5~0_. L,W~.0 County, Pennsylvania, with
h~F__~., last family or principal residence at ~ ~'"? 5 g.~coWO '~T, L~7 g't~l P-U ~t ~g&
(Iisi streel, number and muncipalily)
Decendent, then ~ years of age, died ~O~d ~0 ~oo3,
Excepl'as follows, decedent did'no(~arry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: ~ M~
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ ~ 9~, ~
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters '-?E-%T'h-vnw_,4f0, ttx]
theron. (testamentary; administration c.t.a.; administration d.b.n.c. La.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA q
COUNTY OF (~,lt~Z~_koa-~D j,- se,
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
beforf,, me this ! ,~--~ day of
No.
Estate Of FLORENCE H COMP , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW APRIL 2 ~ 2003 19 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 3-13- q 975
described therein be admitted to probate and filed of record as the last will of
FLORENCE H COMP ;
and Letters
are hereby granted to AUDREY E GATFS AND .qllqAN g HART
FEES
Probate, Letters, Etc .......... $ 40.00
Short Certificates( ) .......... $ qB.Off
g~qme..gat~ extra .pages... $ 3-no
jcp $ 10.00
TOTAL ~ $ 7 ~ - nn
Filed _4-1-200~ .......... ~ .......
'al&Il'rid ex'6d'6h 4-2-200
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITN~8Sc
codicil
(each) a subscribing Witness to the will presented herewith, (each) being duly qualified according to
say(s) that-: present and saw
law,
depose(s)
and
the testat .
request of testat.__
other subscribing witness(es)). .
Sworn to or affirmed and subscribed before
me this day of ........... ..
, sign the same and that signed as a witness at the
in Ix presence and (in the presence of each other) (in the presence of the
Register
(Name)
%~X.%Address)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
LO & .,~_ familiar with the signature of
testat 7~ ~'X of (one of the subscribing witnesses
that [t)~ [C)~ !,'~_xv~' "~the
to the best of Or; [o knowledge and belief.
Sworn to tlr affirmed and subscribed before
me th)- ~ 1~c
~___ I --'__ ~ day of
~ ~/~ _ ~~ -I Reg'C'Jter
codicil
to) the wili"~) presented
C herewith and
........ · codicil
signature on t~is in the handwriting of
(Name)
JAddress)
(Address)
LAW OFFICES
JON F. LAFAVE[R
NEW CUMBERLAND, PA,
LAST WILL AND TESTAMENT
OF
FLORENCE Ho COMP
I, FLORENCE Ho COMP, of West Fairview, Cumberland County, Penn-
sylvania, being of sound mind, memory and understanding, do hereby make, pub-
lish and declare this as and for my Last Will and Testament hereby revoking
and making void any and all other wills by me at any time heretofore made.
I.
I direct that my Executor hereinafter named shall pay all my
just debts and funeral expenses as soon as conveniently may be done after my
decease.
II.
Ail the rest, residue and remainder of my estate, whether real,
personal or mixed, and wheresoever situate, I hereby give, devise and bequeath
unto my husband, FERMAN H. COMP, if he survives me by a period of thirty days.
If my said husband does not survive me by a period of thirty days, then this
gift to him shall be divested, and I then give, devise and bequeath my entire
estate as follows:
A. One-half (1/2) unto my daughter, AUDREY E. GATES.
B. One-half (1/2) unto my daughter, SUSAN K. HART.
III.
I hereby nominate, constitute and appoint my husband, FERMAN
Ho COMP, as Executor of this, my Last Will and Testament. If the said Ferman
H. Comp should predecease me, or otherwise fails to qualify, or ceases to act
as such, then I nominate, constitute and appoint my daughters, AUDREY E. GATES
and SUSAN K. HART, as Coexecutrices.
IV.
No fiduciary acting under this Will shall be required to post
bond in this jurisdiction or in any jurisdiction in which he may act.
Page one of two Pages
LAW OFFICES
JON F, LAI~AVER
3117 TH[RD STREET
NEW CUMBERLAND, PA.
IN WITNESS WHEREOF, I, Florence H. Comp, the Testatrix, have unt(
this, my Last Will and Testament, set my hand and seal this ~-~ day of
March, A. D., 1975.
(SEAL)
SIGNED, SEALED, PUBLISHED and DECLARED by Florence H. Comp, the
above-named Testatrix, as and for her Last Will and Testament in the presence
of us, who have hereunto subscribed our names as witnesses at her request, in
the presence of the said Testatrix and of each other.
Page two of two Pages
0
~f
FLORENCE H. COMP
LAXLY' OFFICES
317 THIRD S~EET
NEW CUMBERL~D, PE~SYLVANIA 17070
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 002592
GATES ROBERT B
412 CASCADE ROAD
MECHANICSBURG, PA
17055
........ fold
ESTATE INFORMATION: SSN: 164-54-0536
FILE NUMBER: 2103-0289
DECEDENT NAME: COMP FLORENCE H
DATE OF PAYMENT: 05/20/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/20/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $52.52
REMARKS:
AUDREY E GATES
C/O ROBERT B GATES
TOTAL AMOUNT PAID:
$52.52
SEAL
CHECK#1009
INITIALS: SK
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX 16-00)
GOMMONWEALTH OF
, PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDEN'PS NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
Comp Florence H.
DATE Of DEATH (MM-DO-YEAR) I DATE OF BIRTH (MM-DO-YEAR)
03/20/2003 11/06/1915
(IFAPPLICABLE)SURVIVINGSPOUSE'SNAME(LAStFIRS~ANDMiDDLEiNiTiAL)
None
r--] 2. Supplemental Return
[--~ 4a. Future Interest Compromise (date of death after 12-12-82)
[~7. Decedent Mainlained a Living Trusl (^,~h copy of Trust)
---]10. Spousal Povedy Credit (date of death between 12-31-91 and f-1-95)
LU
COUNTY CODE YEAR NUMBER
~(--]1. Original Retum
[~4. Limited Estate
~]6. Decedent Died Teslate (A~tach copy et Will)
~-Jg. Litigation Proceeds Received
r- THIS SECTION MUST BE COMPLY: i ~.u,* ALL CORI~ESPONDEN~I~A
NAME
z Robert B Gates
O ·
FIRM NAME (ffApplicable)
n, TELEPHONE NUMBER
O
SOCIAL SECURITY NUMBER
164 - 54
- 0536
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
r---] 3. Remainder Relurn (date of death pdor to 12-13-82)
['~5. Federal Estate Tax Return Required
_Q_ 8. Total Number of Safe Deposit Boxes
~]11. Election to tax under Sec. 9113(A) (^,ach Sch O)
COMPLETE MAILING ADDRESS
412 Cascade Road ~
Hechanicsburg, Pa. 17055
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporalion, Padnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Properly (Schedule F) (6)
J~--J Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
1351.20
None
None
6878.95
None
None
7001.78
None
(8). 8230.15
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to lax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(11) 7001.78
(12) 122R. 37
(13)
(14) 1228.37
15.
16.
17.
18.
19.
20
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable at lhe spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
Amount of Line 14 taxable al lineal rate I 2 2 R. q '7
Amounl of Line 14 taxable al sibling rate
Amount of Line 14 taxable at collateral rate
Tax Due
x .o. (15)
x .o. 45 (16) 55.28
x .12 (17)
x .15 (18)
(19) 55. 28
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK,MATH " " ........ ," ....
Decedent's Complete Address:
ISTREETADDRESS 127 Second Street"
CITY West Fairview (East Pennsboro Township)I, STATE
ZIP
Pa.
17025
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
2.7 6 Total Credits ( A + B + C )
3. Interest/Penalty if applicable
D. Interest
E. Penalty Total Interest/Penalty ( D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 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.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(1) 55.28
(3)
(4)
(5)
(5A)
(5B)
(2) 2.7 6
52.52
52.52
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 properly 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.
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 RESPONSIBLE FOR FILING RETURN DATE
ADDRESS 412 Ca~scade Road 12'7 Second Street
M~r~=n~,,~_q D= ~vO55 West ~rvie,._~ P?__ 17025
DATE
SIGN ATU RE ~~~)N T-AlIVE ~--~/
ADDRESS
412 Cascade Road Mechanicsburg, Pa. 17055
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 3%
[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% [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 0% [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%, 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% [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.
COMMONVVEALTHOFPENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEOENT
ESTATE OF
Comp, Florence
He
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
2 Each United States Series EE Savings Bonds,
Denomination $500, ~D12375577EE and D12375583EE
redeemed April 4, 2003
VALUE AT DATE
OF DEATH
$1351.20
TOTAL (Also enter on line 2, Recapitulation) $ 1 3 5 1.2 0
(If more space is needed, insert addilional sheets of the same size)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
'NNER,T^NC~ T^X RETU.N
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF
Comp, Florence II. FILENUMBER
Include the
ITEM
NUMBER
)roceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with the right of survivorship must be disclosed on Schedule F.
DESCRIPTION
VALUE AT DATE
Of DEATH
73.26
Cash
Checking account, Citizens Bank, 4101 Carlisle Pike,
Camp Hill, Pa, Account ~610078-480-0 Balance at
date of death '
Health Insurance premium refund, Highmark Blue Shi
P.O. Box 898248, Camp Hill, Pa. 17089,
ID ~ ZAL 164-54-0536B
Pre-need, Pre-paid funeral expense
Arrangement/Insurance, Myers Funeral Home/Liberty
Life Insurance Company, 37 E. Main Street,
Mechanicsburg, Pa. 17055
Various jewelry items, mostly costume and other
inexpensive items-watch, wedding band earrings,
necklaces, etc. '
3553.22
287.47
2765.00
200.00
TOTAL (Also enter on line 5, Recapitulation) $ 6 8 7 8.9 5
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~STATE OF
Comp, Florence H.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
5.
6.
7.
8.
9.
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION
A.
1.
FUNERALEXPENSES:
Following paid to Myers Funeral Home, Mechanicsburg,
Services, use of facilities and automotive equipment,
cremation $1995, Register book $55, Urn $385, Open
grave $225, Cemetary Equipment $140, Newspaper notice
$55, Clergy.S75, Death Certificates $20, Flowers $55,
Total $3005. Myers accepted prepaid funeral arrangemen
insurance proceeds in amount of $2765 as full payment.
2. Reimbursement to Audrey Gates for flowers, reception
food and pictorial tribute
3. Ginqrich Memorials, Mechanicsburg-update grave marker
ADMI~STRATIVE COSTS:
Pemonal Representative's Commissions None
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Represenlative(s)
Street Address
City
Year(s) Commission Paid:
2. Attorney Fees No n e
3.
State ~ Zip
Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation)
Claimant Susan K. Hart
Street Address 127 Second Street
City West Fairview
State Pa. Zip
Relationship of Claimant to Decedeht Da ughter
17025
Pr0bateFees Cumberland County Register of Wills
Accountant's Fees N o n e
Tax Return Preparer's Fees None
Vital records, Commonwealth of Pa., copies of deceased
spouses death certificates
Cumberland Law Journal, Carlisle, Pa. Advertisement
Patriot News, Harrisburg, Pa. Advertisement
Audrey E. Gates-Postage and registration Insurance
policies '
Susan K. Hart-Postage and insurance, Insurance Policy
AMOUNT
2765.00
273.00
90.00
3500.00
71.00
12.00
75.00
193.87
13.36
8.55
TOTAL (Also enter on line 9, Recapitulation) $ 7 0 01.7 8
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Comp, Florence
SCHEDULE J
BENEFICIARIES
FILE NUMBER
NUMBER
!
1.
11
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116(a)(1.2)]
Audrey E. Gates
412 Cascade Road
Mechanicsburg, Pa. 17055
Susan K. Hart
127 Second Street
West Fairview, Pa.
17025
AMOUNT OR SHARE
OF ESTATE
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
Daughter
614.18
614.19
$1228.37
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
Bi CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
(If more space is needed, insert additional sheets of the same size)
TOTAL OF PART !I - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE '13 OF REV-1500 COVER SHEET
LAST WILL AND TESTAMENT
OF
FLORENCE Ho COMP
I, FLORENCE Ho COMP, of West Fairview, Cumberland County, Penn-
sylvania, being of sound mind, memory and understanding, do hereby make, pub-
lish and declare this as and for my Last Will and Testament hereby revoking
and making void any and all other wills by me at any time heretofore made.
I.
I direct that my Executor hereinafter named shall pay all my
just debts and funeral expenses as soon as conveniently may be done after my
decease.
II.
Ail the rest, residue and remainder of my estate, whether real,
personal or mixed, and wheresoever situate, I hereby give, devise and bequeath
unto my husband, FERMAN H. COMP, if he survives me by a period of thirty days~
If my said husband does not survive me by a period of thirty days, then this
gift to him shall be divested, and I then give, devise and bequeath my entire
estate as follows:
A. One-half (1/2) unto my daughter, AUDREY E. GATES.
B. One-half (1/2) unto my daughter, SUSAN K. HART.
III.
I hereby nominate, constitute and appoint my husband, FERMAN
Ho COMP, as Executor of this, my Last Will and Testament. If the said Ferman
H. Comp should predecease me, or otherwise fails to qualify, or ceases to act
as such, then I nominate, constitute and appoint my daughters, AUDREY E. GATES
and SUSAN K. HART, as Coexecutrices.
IV.
No fiduciary acting under this Will shall be required to post
bond in this jurisdiction or in any jurisdiction in which he may act.
Page one of two Pages
IN WITNESS WHEREOF, I, Florence H. Comp, the Testatrix, have unto
this, my Last Will and Testament, set my hand and seal this /~.~x~ day of
March, A. D., 1975.
(SEAL)
SIGNED, SEALED, PUBLISHED and DECLARED by Florence H. Comp, the
above-named Testatrix, as and for her Last Will and Testament in the presence
of us, who have hereunto subscribed our names as witnesses at her request, in
the presence of the said Testatrix and of each other.
BELCO .E.co coMMu.,T c. Eo. u.,o.
co,,,m..u~ c~m~ u.~o. MAIN OFFICE
403 N. 2nd Street · P.O. Box 82 · Harrisburg, PA 17108
irHF ESl'AlE ObR~~ ('OMP
~r~ ~ ~ S~20 - P.O. Box 10e8 · Lan~sle~, PA 1780~
r~J~e ~' ~i~ PA 17011
N E [: i-I~ mo~m~e~t · P~O~ox~fo~ ~ ~arrisbu~g, PA ~7~0~
"~;~ ~ ~re" 5785 Allentown Boulevard · Harrisburg, PA 17112
39 moMh Washington Street · Gettysburg, PA 17325
201 Good Drive · Lancasler, PA 17602
HARRISBURG SERVICE TELEPHONE NO: ...... 1-717-23-BELCO
LANCASTER SERVICE TELEPHONE NO: ....... 1-717-393-1116
CAMP HILL SERVICE TELEPHONE NO: ........ 1-717-720-6290
PINNACLE HEALTH SERVICE TELEPHONE NO:. 1-717-231-8301
GETTYSBURG SERVICE TELEPHONE NO: ..... 1-717-337-3474
TOLL FREE TELEPHONE NUMBERS:
e~ ~m~ ~e~.. ri ..... ~ '~ '~ ~' *' i' ~-~-Z5-B~E
We~...~').~ ~ ~N. ~,..w.~.. ~.......'... m
ON 0~0403 EFFECTIVE 040403
x ILR:3 73 k[IM B- ]0:39:50
TRANSFER BOND REDEMPTiOH 10 SHARE: S 4
&C:CT [)E S[:!~ I F' 1 ] ON TRAN-AMOUNI
S 4 S4-CHECKING
REDEMPTION VALUE $ J,35].20
iNIEREST EARNED $ 85~.20
TOTAL BONDS REDEEMED 2
* NOTE: INTEREST EARNED MAY BE REPORTED TO THE IRS
NEW-BALANCE
1,351.20
,/
SHARE ID LEGEND S1 - SAVINGS S2 - CHRISTMAS CLUB S3 - WHATEVER CLUB, SAFARi CLUB, TEEN CLUB
S4 - CHECKING S5 - IRA S6 - MONEY MARKET GROWTH FUND
CITIZENS [~ANK
Cai{ Citizens' PhoneBank anytime fo~ account informaUon,
cunent rates and answers to your questions.
US059 BR291 4 1
FLORENCE H COMP
127 2ND ST
WEST FAIRVIEW PA :7025-3204
Checking Account
Statement
o[ 1
Beginning Febiua~y 21, 2003
through Ma~ch 19, 2003
Checking
SUMMARY
Balance Calcu[aUon
Previous Balance
Checks
Witttdrawals
Deposits & Additions
Current Balance
3,178.89
422.90
37.77
835.00
3,553.22
": 543 6.00 02/27 Y545
.-, 544 12.00 03/04 o, 546
Amount
400. O0
4.90
Withdrawals
Other Withdrawals
Date Amount Descdptlo.
03/03 v 31.71 Libe~tg Pre-Need Insurance 022803 0040004479
03/19 ~ 6.00 i'4o,lLh[y ~.~a;.~Le.a.ce Fee
Deposits & Additions
Date Amount DescdpUon
03/03 835.00 US Treasmy 303 Soc Sec 030303 172018392d SSA
Date
03/04
03/13
Daily Balance
Date Balance Date Balance Date Balance
02/27 3,172.89 03/04 3,564.12 03/19 3,553.22
03/03 3,976.12 03/),3 3,559.22
FLORENCE H COMP
Citizens Basic Checking
6]00/8-~80-0
3,178.89
Total Checks
422.90
Tutal Withdrawals
37.77
Total Deposits & Ad.lions
835.00
Cunent Balance
3,553.22
COMMONWEALTH OF PENNSYLVANIA i.
COUNTY OF CUMBERLAND .i ss:
Estate of Florence H. Comp
No. 2003-00289 PA No. 21-03-0289
Audrey E. Gates and Susan K. Hart
being duly sworn according fo law, deposes and says fhaf ~ ..... the_y__aLe
Co-Executrixes of the Estate of . Florence H. Comp
late of ---Eas_t__~Pennsboro .Township ....... , Cumberla.d Cou.ty, Pa., deceased a.d that the
w;fhln is an inventory ma. de by -Audrey E~a3~es--&~Susan K~J~arJ~___., the said. Pn-z~r~r~-r~rr~.~
of the entire estate of sa~d d~cedenf, consisting of all the ~ersonal -ro-=-*-. --~ ---, - - .- - J- -' --~--
r r M~--y a.u reel estate, exce t real ·
the Commonwealth of Pennsylvania, end that the figures o~eosife each '-- -z .c_ , ...... P .~?f~.oufs,,de
as of the date of decedenf's death. ~ ~f ......... ,-*.n.ory represen~ n s ~mr value
//' ' ~~ ~ -'~ ~ ~12 Cascade Road 127 Second S _
Date of Death 20th March 2003
Day Month Year
2.
3.
4.
INSTRUCTIONS
An inventory must be filed w;fhln three months after appointment of personal representative.
A supplement inventory must be filed within th;try days of discovery of add;fional assets.
Additional sheets may be attached as fo personalty or realty ~J('";
See Art;cie IV, Fiduciaries Act of 1949. .~ ~'
LU
LLI
0
0
Inventory of tile real and personal estate of
Florence H. Comp
deceased
Cash
Checking account, Citizens Bank, 4101 Carlisle Pike, Camp Hill,
Account ~610078-480-0, Balance on date of death
United States Savings Bonds, 2 each, face value $500 each,
~D12375583EE, D12375577EE, Redeemed April 4, 2003, total value
Health Insurance premium refund, Highmark/Blue Shield, P.O. Box
898248, Camp Hill, Pa. 17089, ID ~ZAL 164-54-0536B
Pre-need, pre-paid funeral expense arrangement/insurance, Myers
Funeral Home/Liberty Life Insurance Company, 37 E. Main Street,
Mechanicsburg, Pa. 17055
Various jewelry items, mostly costume jewelry and other inexpensi'
items-watch, wedding band, earrings, necklaces, etc.
Life Insurance proceeds, Prudential Insurance Company of America,
P.O. Box 9579, Jacksonville, Florida 32231-0038, Policy ~09615791(
Claim ~766555
Life Insurance proceeds, Jefferson Pilot Life America Insurance
Company, P.O. Box 21008, Greensboro, North Carolina 27420,
Policy ~0305140287, Claim ~0419795
Life Insurance proceeds, Jefferson Pilot Life America Insurance
Company, P.O. Box 21008, Greensboro, North Carolina 27420,
Policy ~0200082778, Claim ~0419795
Total Estate
73 26
3553' 22
1351 20
287 47
2765 00
je
J 200 00
2733 25
I! 500 00
1006: 44
$12,469.84
BUREAU OF INDIVZDUAL TAXES
TNHERTTANCE TAX DZYTSTON
DEPT. 280601
HARR/SBURG, PA 17118-0601
ROBERT B GATES
qlZ CASCADE RD
MECHAN[CSBURG
COMMONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
NOTICE OF TNHER/TANCE TAX
APPRAZSEMENT, ALLO#ANCE OR D/SALLONANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
'03 JUL-7
PA 17055 '"~
D~TE
ESTATE OF
DATE OF DEATH
07-07-2005
COMP
03-20-2005
21 05-0289
CUMBERLAND
101
ItEV-15~i7 EX AFP [01-05)
FLORENCE H
ACN
t... Amount Rea i'l"l:ad
MAKE CHECK PAYAIILE AND REMZT PAYMENT TO:
REGTSTER OF NTLLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLONANCE OR
ESTATE OF COMP
DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
FLORENCE H FZLE NO. 21 05-0289 ACM 101
DATE 07-07-Z00~
TAX RETURN NAS: (X) ACCEPTED AS F/LED
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERS.e
CHANGED
APPRATSED VALUE OF RETURN eASED ON:
1. Real Estate (Schedule A)
2.
$.
fi.
5.
6.
7.
8.
ORZGZNAL RETURN
Stocks and Bonds (Schedule B) (2)
Closely Held Stock/Partnership Znterast (Schedule C) ($)
Mortgages/Notes Receivable (Schedule D) (q)
Cash/Bank Deposits/Misc. Personal Property (Schedule E)
Jointly Owned Property (Schedule F) (6)
Transfers (Schedule G) (7)
Total Assets
APPROVED DEDUCTZONS AND EXEMPTZONS:
9. Funeral Expanses/Ado. Costs/Misc. Expanses (ScheduZa H)
10. Debts/Mortgage Liabilities/Liens (Schedule 1)
11. Total Deduct ions
12. Nat Value of Tax Return
13.
lq.
(9)
(10)
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Net Value of Estate Sub,act to Tax
lz$51 .ZO
.00
6~878.95
.00
.00 NOTE: To insure proper
credit to your account/
scd~ait the upper portion
.00 of this fora with your
tax payment.
.0o
(8)
7,001.78
8,250.15
TAX CREDZTS:
PAYMENT
DATE
05-20-2005
RECETPT
NUHBER
CD002592
DZ$COUNT
ZNTEREST/PEN PA~D (-)
2.76
ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
52.52
TOTAL TAX CREDZT
aALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
AMOUNT PAID
(19)~ 55.28
55.28
.00
.00
.00
( I'F TOTAL DUE TS LESS THAN $1, NO PAYMENT 1'S RE(;IUTRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDZT' (CA), YOU MAY BE DUE
A REFUND. SEE REVERSE SZDE OF TH/S FORH FOR ZNSTRUCTZONS.)
NOTE: Zf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect flgures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Aaount of Line Zfi at Spousal rata (15) .00 X O0 = .00
16. Amount of Line lq taxabZa at Lineal/Class A rata (16) 1,228.57 X Oq5 = 55.28
17. Amount of Line lfi at Sibling rata (17) .00 x 12 = .00
18. Amount of Line lq taxabZa at Collateral/Class B rata (18) .00 X 15 = .00
19. PrincipaZ Tax Due
.00
(11) 7.001.78
(12) 1,228.:57
(13) . O0
(Zq) 1,228.37
REsERvATION:
Estates of decedents dying on or before December 12, 1981 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of tho decedent after the expiration of any estate for
life or for years, the Comaoneaalth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes
at the laeful Class B (collateral) rate on any such futura interest.
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 of tho Inheritance and Estate Tax Act, Act 13 of ZOO0. (7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit eith your payment to the Register of Hills printed an tho reverse side.
--Hake check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, ehich ems not requested on the Tax Return, may bo requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-131S). Applications are available at the Office
of the Register of Hills, any cf the 23 Revenue District Offices, or by calling the special 24-hour
ansearing service for fores ordering: 1-800-362-Z050; services for taxpayers ~]th special hearing and /
speaking needs: 1-800-q~7-50Z0 (TT
Any party in interest not satisfied ~ith the appraisement, allo~anca~ or di~llo~ance of deductions~ or asses~ent
of tax (including discount or interest) as sho~n on this Notice must object ~ithin sixty (60) days of receipt of
this Notice
--~ritten protest to ~e PA Depar~ent of Revenue~ Board o~ Appeals~ Dept. ZS[OZI~ Harrisburg~ PA 17128-1021~ OR
--election to have ~e setter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors di~overed on this assessment should be addressed in ~riting to: PA Depar~ant of Revenue~
Bureau a~ Individual Taxes, ATTN: Post Assessment Revie~ Unit~ Dept. 280601~ Harrisburg~ PA 17128-0601
Phone [717) 767-6505. See page 5 o~ the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" [REV-IS01) ~or an explanation o~ administratively correctable errors.
If any ~x due is paid ~ithin three (~) calendar months after the decedent's death, a five percent [52) discount of
the tax paid is allo~ed.
The 15X tax asnesty non-participation penalty is computed on ~e total of the tax and interest assessed~ and not
paid before January 18~ 1996~ the first day after the end of ~e tax amnesty period. This non-participation
penalty is appealable in the ~=e manner and in the the same rise period as you ~ould appeal the tax and interest
that has been assessed as indicated on ~is notice.
Interest is charged beginning ~ith first day of delinquancy~ or nine (9) months and one (1) day from the date of
death, to the date of payaeqt. Taxes ~hich became delinquent before January 1, 1982 bear interest at the rata of
six (62) percent per annum calculated at a daily rate of .00016~. All taxes ahich became delinquent on and after
January l, 1982 mill bear interest at a rate ~hich ~111 vary from calendar year to calendar year ~ith that rata
announced by the PA Depar~ent of Revenue. The appl~cable ~nterest rates for 1982 through 2005 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Yea~ Rate Factor Yea~ Rate Factor
1982 ZO~ . 0005~8 1987 9~ . O00ZR7 1999 7~ . 000192
198~ 16~ .OOD~8 1986-1991 11~ .000~01 ZOO0 8~ .000119
198~ 111 . 000~01 1992 91 . O001~7 ZOO1 91 . 0001~7
1985 ZSZ .000~56 199~-199~ 71 .000191 2001 6X .00016~
1986 101 .00027~ 1995-1998 9X .0001~7 ZOOS 51 .0001~7
--Interest is calculated as ~ollo~s=
INTEREST = BALANCE OF TAX UNPAID X NURBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice isled a~tar the tax becomes delinquent ~ill ce~lect an interest calculation to ~iftaen [15) days
beyond ~e date of the assessment. Z~ paym~t is made a~tar ~ interest coapu~tion data sho~n on the
Notice, additional interest must be calculated.
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Florence H. Comp
Date of Death: Mar~h ?O, 200.3
Will No. 21-03-289 Admin. No.
To the Register:
1 certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on May !6, 2003 :
Name Address
Audrey E. Gates 41~ ~md~ ~na~ Me~h~n~osb~rg~ Pa~ 17055
Susan K. Hart 127 Second Street West Fairview, Pa. 17025
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date: May 16, 2003
S i gna t ur e Signature
Name ~-d~a/ ~ .,.~ Name
Address 412 Cascade Road Address
Mechanicsburq, PA. 17055
Telephone (717) 6q7-] 477
.o =
Capacity: __
127 Second Street
West Fairview, Pa. 17025
Telephone (71~' 732-3382
X Personal Representative
Counsel for personal representative
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE.
Whether you will receive any money or property will be deter-
mined wholly or partly by the decedent's will. If the decedent
died without a will, whether you will receive any money or prop-
erty will be determined by the intestacy laws of Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA
In re Estate of Florence H. Comp ,deceased, March
Estate No. 2003-00289 PA 21-03-0289
(Name and Address)
20,
2003
TO:
Audroy ~. Gates 412 C~scade
Susan K. Hart 127 S~nnd ~r~t. West. Fairvie%~; Pa_ 17025
P~easet~en~tice~fthedeath~fdecedentandthegrant~f~etterst~thepers~na~representative(s)namedbe~w.
Audrey E. Gates 412 Cascade Road Mechanicsburq, Pa. 17055
Susan K. Hart 127 Second Street West Fairview, Pa. 17025
Florence H. Comp ,diedonthe ?0th
' 2003 ,at Dauphin County,
The Decedent
day of March
Pennsylvania.
The Decedent died testate (with a Will); o~x
The personal representative of the Decedent is
(name, address and telephone number).
Audrey E. Gates 412 Cascade Road MechanSc~qbnrg: Pa. ~7055
Susan K. Hart 127 Second Street West Fairview, Pa. 17025
If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1
Courthouse Square, Carlisle, Pa. 17013. Phone No. 7 i 7-240-6345
If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the
Register of Wills of Cumberland County, I Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345
A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication.
Date: May 16, 2003 Signature:t?~ /</. ~
Signature: /.~-C<~_a.</ ~. 9~/--d~J Name (print) .q~,.~n g_ la, rt.
G~-~s--_v_" Address 127 Second Street
Name:
Audrey
E.
West Fairview, Pa. 17025
Address: 412 Cascade Road
Mechanicsburq, Pa. 17055
Telephone (717) 697-1477
Capacity:
Telephone ( 7 1 ~/ 7 3
Personal Representative
Name of Decedent:
Date of Death:
Will No.:
Status Report Under Rule 6.12
Florence H. Comp
March 20,2003
__21-03-289 Admin. No.: 2003-00289
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ~ No []
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
Did the personal representative file a final account with the Court?
Yes ~ No []
-First and final account submitted with this report.
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes'~ No []
Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date:
S~gnature
Susan K. Hart
127 Second Street
West Fairview, Pa. 17025
(717) 732-3382
Capacity:
~ Personal Representatives
[] Counsel for personal representative
January 2,2004
Register of Wills, Cumberland County, Pennsylvania:
Clerk of the Orphans Court:
This is the first and final accounting related to the estate of Florence H. Comp, deceased
March 20, 2003. Her will was submitted for probate on April 1,2003, file #2003-00289, Pa.
File #21-03-0289, resulting in granting of Letters of Testamentary and Short Certificates on
April 2, 2003 to Audrey E. Gates and Susan K. Hart, Co-Executrixes.
Legal advertisement occurred in the Cumberland Law Journal, Carlisle, Pa. on April 18, 25 and
May 2, 2003. Also, legal advertisement occurred in the Patriot News, Harrisburg, Pa. on April
10, 17 and 24, 2003.
An inventory of Personal Property and Real Estate was submitted to the Register of Wills on
May 20, 2003.
Notice of Estate Administration and Certification of Notice under Rule 5.6 (a) were prepared
and distributed on May 16, 2003 with copies provided to the Register of Wills on May 20, 2003.
Inheritance Tax Return Resident Decedent REV-1500 was submitted to the Register of Wills
on May 20, 2003 and the tax due was paid. The Commonwealth of Pennsylvania, Department
of Revenue, Inheritance Tax Division provided a Report of Acceptance to the preparer, Robert
B. Gates, dated July 7, 2003.
Estate Assets:
a. Cash $73.26
b. Checking account, Citizens Bank, 4101 Carlisle Pike, Camp Hill, Pa.,
account #610078-480-0 $3553.22
c. United States Savings Bonds, 2 each, face value $500 each, serial
numbers D12375583EE and D12375577EE, redeemed April 4, 2003,
total value $1351.20
d. Health Insurance premium refund, Highmark/Blue Shield, P.O. Box
898248, Camp Hill, Pa. 17089, ID #ZAL164-54-0536B $287.47
e. Pre-need,' prepaid funeral expense arrangement/insurance, Myers
Funeral Home/Liberty Life Insurance Company, 37 E. Main Street,
Mechanicsburg, Pa. 17055 $2765.00
f. Various jewelry items, mostly costume jewelry and other inexpensive
items-watch, wedding band, earrings, necklaces, etc. $200.00
g. Life insurance proceeds, Prudential Insurance Company of America,
P.O. Box 9579, Jacksonville, FI. 32231-0038, policy #096157916, claim
#766555 $2733.25
h. Life Insurance Proceeds, Jefferson Pilot Life America Insurance
Company, P.O. Box 21008, Greensboro, N.C. 27420, policy
#0305140287, claim #0419795 $500.00
i. Life insurance proceeds, Jefferson Pilot Life American Insurance
Company, P.O. Box 21008, Greensboro, N.C. 27420, policy
#0200082778, claim #0419795
j. Dividend derived from Estate Checking Account, Belco Community
Credit Union, P.O. Box 82, Harrisburg, Pa. 17108, account #838558
Total Estate Assets-
$1006.44
$0.26
$12470.10
1
o
Expenses:
a. Paid by life insurance assignment to Myers
Funeral Home, Mechanicsburg, Pa.17055:
i. Services, facilities, automotive and cremation $1995.00
ii. Register book $55.00
iii. Urn $385.00
iv. Open grave $225.00
v. Cemetery equipment $140.00
vi. Newspaper notice $55.00
vii. Clergy $75.00
viii. Death Certificates $20.00
ix. Flowers ,$55.00
Total Funeral Home Expenses:
$3005.00
Myers Funeral Home accepted prepaid funeral arrangement/insurance
proceeds in the amount of $2765.00 as full payment.
Reimbursement to Audrey E. Gates for expenditures
from personal funds prior to opening Estate Checking
Account as follows:
Commonwealth of Pa., Vital Records
Register of Wills, probate fees
Cumberland Law Journal, Advertisement
Funeral Expenses-reception food, pictorial
Tribute and flowers
Postage and insurance related to insurance
claim
Total reimbursement to Audrey Gates, Belco
Community Credit Union check #1002
$12.00
$71.00
$75.00
$273.00
~;13.36
c. Gingrich Memorials, Mechanicsburg, Pa. to update
grave marker, Belco Community Credit Union
check #1005
d. Advertisement, Patriot News, Harrisburg, Pa., Belco
Community Credit Union check # 1006
e. Susan K. Hart, postage and insurance for life
Insurance claim, Belco Community Credit Union
check #1001
f. Inheritance Tax, Register of Wills-Agent, Belco
Community Credit Union check #1009
g. Inheritance Tax Return and Inventory Fee,
Reimbursement to Robert Gates, paid in cash to
Register of Wills, Belco Community Credit Union
Check #1010
Total Estate Expenses:
$2765.00
$444.36
$90.00
$193.87
$8.55
$52.52
$25.00
$3579.30
2
h. All known debts and expenses have been paid
8. Asset/Expense Summary:
a. Total Assets
b. Total Expenses
Total Available for Distribution
9. Distribution:
$12470.10
-3579.30
$8890.80
Date Distribution Audrey E. Gates Susan K. Hart _Totals
4/03 Cash $36.63 $36.63 $73.26
4/03 Jewelry $100.00 $100.00 $200.00
4/29/03 Belco ck. #1003 $1366.63 $1366.63
4/29/03 Belco ck. #1004 $1366.62 $1366.62
5/5/03 Belco ck. #1007 $753.22 $753.22
5/5/03 Belco ck. #1008 $753.22 $753.22
5/29/03 Belco ck. #1012 $2000.00 $2000.00
5/29/03 Belco ck. #1011 $2000.00 $2000.00
12/3/03 Belco ck. #1013 $188.93 $188.93
12/3/03 Belco ck. #1014 $183.92 $183.92
12/16/03 Belco account closinq $5.00 $5.00
Totals:
$4445.39 $4445.41
$8890.80
Distribution as indicated above has been completed and the Estate Checking Account has
been closed.
10. We, the Co-Executrixes and heirs, hereby certify the accounting stated above to be true and
correct. Estate closing and discharge of the Personal Representatives is requested.
(seal)
Sworn to and subscribed before me this
~ day of ....J/~M/~/')~Y , 200_~__
Notary Public " ~ '
~L ~, ~p~
. , ~~~J~,~
Sworn to and subscribed before me t,h,i/s
Notary Public- ~ ' ~, 7
(seal)
.. 1in~ L Leitzell, No~..y p~ ~
-- Expires July 25, 2006 ~
Co-Execq~ "
412 Cascade Road
Mechanicsburg, Pa. 17055
Co-Executrix
127 Second Street
West Fairview, Pa. 17025