HomeMy WebLinkAbout06-28-11EX (G1-t 0.
_J REV-1500 1505610143
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania county code Year _ File Number
Bureau of Individual Taxes -=-==r~~F••~ :f RE~E~,~~~
PO 80X.280601 INHERITANCE TAX RETURN 21 0 9 1 0 8 5
Harrisburg.. PA 17128-Q601 RESIDENT DECEDENT _
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
193 12 5951 10 30 2009 06 09 1922
Decedent's Last Name Suffix Decedent's First Name MI
WAGONHURST ARLAND H
(If Applicable) Enter Surviving Spouse's Information Below
Spouses Last Name Suffix Spouse's First Name MI
WAGONHURST D'ARCY
Spouse's Socia! 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 Llmlted Estate
^ 4a. Future Interest Ccmprmise
~
5. Federal Estate Ta>': Return Required
::date of death after 1t-12-821
0
® g Decedent D,ed Testate
•Attacn Gooy or Will) ^ 7 Decedent Maintained a Liwng Trust
~Attacr, copy of Trusc; -__- 8 Total Number of Safe Deposit Boxes
~ 9. Lttlgatien Proceeds Received ~ ~ p Spousal Poverty Cretl4 i date of tleath
between 12-31-91 and ?-^-95
~ ~ ~ Election to tax under S,ec. 9113 A
( )
(Attach SCh. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION ~~HO~ULD BE DIRECTED T0:
Name Daytime Telephone I'Jurnber
RICHARD E CONNELL ESQ 717 232 8731
First line of address
2303 MARKET STREET
Second line of address
City or Post Office State ZIP Code
CAMP HILL PA 17011
Correspondent's a-mail address: C O n n e l l~ b m C- I a W. n e t
,REGISTER OF WILLS USE ON~.Y~
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under penalties of penury, 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. eclaration of preparer other than the personal representahve Is based on aN information of which preparer h.as any knowledge.
SIGN TURE OF PERSON RESPONSI E FOR FLING RETURN LATE
r S'~' • Jeffrey A. Wagonhurst, Sr. (E,,~g~ ~
ADORES
has o airfax tation, VA 22039
SIGNATURE OF PREP ER O E TH REP E IVE DATE
ADDRESS Richard E Connell Esq ~ ~~
~--~
2303 Market Street, Camp Hill, PA 17011
Side 1
L 1505610143 7505610143
J 1505610243
REV-1500 EX
Decedent's Name: W A G O N H U R$ T, A R L A N D H
Decedent's Social ~Sec;urity Number
193 12 .5951
RECAPITULATION
1 214,564.29
1. Real Estate (Schedule A) ..........................................................................................
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 4.
5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............. 7.
8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 2 1 4, 5 6 4. 2 9
9. Funeral Expenses & Administrative Costs (Schedule H} ......................................... 9. 2 0, 9 6 0 7 3
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 2 9 , 6 0 0 0 0
11. Total Deductions (total Lines 9& 10) ...................................................................... 11. 5 0, 5 6 0 7 3
12. Net Value of Estate (Line 8 minus Line 11) ............................................................ . 12. 1 6 4 , 0 0 3 . 5 6
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. 1 6 4 , 0 0 3 5 6
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
at lineal rate X .045 1 6 4, 0 0 3. 5 6 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. Tax Due ................................................................................................................... .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243
7,380.16
7,380.16
J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 09 - 1085
DE EDENT' NAME
Wagonhurst, Arland H
STREET ADDRESS
110 Union Hall Road
CITY
Carlisle STATE
PA .ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 7 , 3 8 0.1 6
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits (A + B) (2) 0.00
3. Interest (3) 0.00
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2 Line 20 to request arefund
5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 1.5) 7 , 3 8 0 . ~ s
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 :................................................................................. ^ ^x
b. retain the right to designate who shall use the property transferred or its income :.................................... [~ ^x
c. retain a reversionary interest; or ................................................................................................................. ^ ^x
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 ~rithout
receiving adequate consideration? ....................................................................................................................... ^
3. Did decedent own an "in trust 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 I'f AS PART OF THE RETURN.
..
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.. ... ..... :v.. ,.
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 retturn 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 ears 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) (y.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, w ethE:r by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
FILE NUMBER;
ESTATE OF Wagonhurst, Arland H 21 - 09 - 108`.1
All real property owned sole)yy or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be excF~anged between a willing buyer and a wilting seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
Attach a copy of the settlement sheet if the property has been sold.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 110 Union Hall Road 214,564.29
Carlisle, PA 17013
Parcel ID #29-17-1576-008 (See attached HUD-1) (Settlement June 1, 2011)
TOTAL (Also enter on Line 1, Recapitulation) ~ 214,564.29
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
/~FU~NE~~R~A~LQDCPENSES &
/"Y./I~A1 ~V 1 ~ v\ 1 1 ~I L V~
FILE NUMBER
ESTATE OF Wagonhurst, Arland H 21 - 09 - 1085
Debts of decedent must be reported on Schedule I. _
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION ~ANIOUNT
A.
B. ADMINISTRATIVE COSTS:
~ . Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Ball, Murren & Connell (additional fees above fees 750.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. I Accountant's Fees
6. ~ Tax Return Preparer's Fees
7, Other Administrative Costs
1 Tom Fracker -yard maintenance
2,033.25
TOTAL (Also enter on line 9, Recapitulation) 20,960.73
Schedule H
' Funeral E~er~ses &
COMMON'JVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN AdtY11nIS~'a11Ve Costs COt~nued
RESIDENT DECEDENT
ESTATE OF Wagonhurst, Arland H FILE NUMBER
21 - 09 - 1085
2 K.A. Mullens -mulch 570.00
3 G. Markel -trash removal 225.00
4 Peck's Septic Tank Service 910.00
5 Septic Tank Test Fee and Certificate 110.00
6 Ron Kosner Electrical Services 99.50
7 Armed Forces Insurance Exchange 60.00
8 PP&L 2,475.26
9 Crystal Stubbs Cleaning Service 200.00
10 Russell Shuggart Excavation Service 275.00
11 E. Diffenbaugh Surveying 364.00
12 Assured Land Transfer -settlement charge 435.71
13 Tuckey's Restoration -drainage trench (09/16/10) 505.16
14 Tuckey's Restoration -HVAC repair (10/03/10) 463.20
15 Tuckey's Restoration -piping and drop box (trench 10/03/10) 1,010.30
16 Tuckey's Restoration -roof repair and HVAC service (10/25/10) 788.52
17 Tuckey's Restoration -heat pump 93.00
18 Executor Expense Reimbursement -mileage, postage, etc. 1,123.16
19 Cumberland County Regiser of Wills 200.00
20 R. Sollenberger -real estate taxes (school taxes 07/25/10) 2,318.11
Page 2 of Schedule H
Schedule H
' Funeral E &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ~1~'Y11nISb'atiVle Costs continued
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Wagonhurst, Arland H 21 - 09 - 1085
21 R. Sollenberger -real estate taxes (county/township 04/02/11) 825.13
22 Ball, Murren & Connell -reimbursement for costs advanced 59.07
23 T. Fracker -snow and ice removal 604.00
24 Tuckey's Restoration - 50% down payment for repairs and power washing of house 1,113.92
and roof (01 /08/10)
25 Tuckey's Restoration - 50% final payment for repairs and power washing of house and 1,113.92
roof (05/02/10)
26 Tuckey's Restoration -insulation repairs and power washing of fence (05/15/10) 1,817.24
27 Tuckey's Restoration -roof shingle repairs (06/27/10) 418.28
Page 3 of Schedule H
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LIENS
INHERITANCE TAX RETURN ~
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Wagonhurst, Arland H 21 - 09 - 108Fi
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursecl medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1 D'Arcy Charney Wagonhurst -payment by Estate pursuant to Pre-Nuptial Agreement (copy 29,600.00
enclosed) for share of improvements
TOTAL (Also enter on Line 10, Recapitulation) ~ 29,600.00
OM [3 'Vo. 2502-0265
A. SETTLEMENT STATEMENT (HUD-1) 1. F1iA 2. ' hliMA 3. Ct:)NV. tiN1NS.
4. VA 5. CONY. INS.
I (i I , '
~ 6. FILE NUMBER: 7. LOAN NUMBER
~:
( 11-00004-J U
t 8. MORTGAGE INS. CASE NO.:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent arc shown. Items
marked "(p.o.e.)" were paid outside the closing; they arc shown here for informational pur poses and are not included in the totals.
D. NAME & ADDRESS William S. Kauffman and Laura Lee Kauffman
OF BOKROV.'ER: 51 Graystone Road, Carlisle, PA 17013
E. NAME & ADDRESS Estate of Arland H. Wagonhurst
UE~ SELLER: 1 10 Union Hall Road, Carlisle, PA 17013
F. NAME & ADDRESS Estate Of Arland H. Wagonhurst
OF LENDER:
Ci. PROPERTY LOCATION: 110 Union Hall Road, Carlisle. PA 17013 _
II. Sl["hLEME:N"I' AGENT: Johnson, Duffie, Stewart& Weidner
PLACE OF SE7 TLEME:NT: 301 Market Street. Lemoyne, PA 17043 (717) 761-4540
t. ~F.rT~I l~'.nn(=.?: r -~A~rr-~ ~ml/~nl t
J. Summer of Borrower's Transaction K. Summer of Seller's Transaction
100. Gross Amount Due From Borrower: _
400. Gross Amount Due To Seller:
101. Contract sales price 230 000.00 401. Contract sales price 230.000.00
102. Personal property
103. Settlement charges to borrower-. (line 1400)
'
4 084.00 402. Personal property
403. ___
I
l0~
~
-------- 404. - ---------
-
ttJi 405. '--- -----
j-- ------- - - --
I-- --- -------- ----- -
--._ _
I - - ---------
Adjustments.. F'or Items Paid B Seller In Advan ce: _ Adjustments For Items Paid B Seller In Adv ance:
106. Cite/town taxes __ to
107. County taxes-_ 06/01/11 l0 12/31/1 I
I I OR. Asscssments_ to _
491.35
406. City/town taxes to
407. County taxes 06/01/1 I to 12/31/1 I
408. Assessments to __ {
I
____ 491.35
109. School Taxes 6!01/201 I to 6/30/201 I
h
Ig7,94
409. School Taxes 6/01/201 I to 6/30/2011 __
187.94
~ I I0. -- 410.
w 111.
411. ------
-- -
- 412.
I
113 ---- -- -- - -- _
413. --- -----
I
I la.
15 ------
-------- ---------- ----- 414. _
4 15. - __ __
__ _ _---
II6
1---- - -__- -..._. ----------.
416.
120. Gross Amount Due From Borrower:
234,763.29
420. Gross Amount Due To Seller: ---
230,679.29
2. Amoun P id B r In h f B r w r: 00. Re uc i n Am u o Sel r:
I X01. Deposit or earnest money
-
__ _ 5 000.00
501. Excess deposit (sec instructions) _
~
202. Principal anwwtt of new loan(s)
r-- 215 000.00 502. Settlement charges to seller (line 1400) 16, I I5.(10'i
1203. Existing loan(s) taken subject to
503. Eixisting loan(s) taken subject to __ _
'
J
204_ ______ _ _ _ _- 504. Payoff I st Mtg. Ln. --- -
205. _
505. Payoff 2nd Mtg. Ln. ----
- ^_ ___ -
206. -_ __ _
207.
~~R--------- --
-- ------ _ 506. Seller Mort age
507. -- --
508. -- 215.000.00
-----
------ '
2(19.
------ - --- ---- - -
509. -------
F---------- ------ ----------- --
-
Adjustments For Items Unpaid By Seller:
' I (1. City/town taxes to
~=- ~--- - Adjustments For Items Unpaid By Seller:
510. City/town taxes
to
21 I County rues __-_ to _
5I I .county taxes to _ ___
21 2. Asscssments to - 512. Assessments to
213. -- ---- --- 513.
214. -- ---
S l4.
------ ---
1 216 _
-- - ---- - 516. i ----
2 I Z _
- 5 l 7. - ------ ---
I 218.
------
- _-
5 18. ---.
-
i ~ 19
-- - - - --- ----- -
_ -
5 19. --- -~
~
~.. -- - - -- - -----
--t ~-.
-
-
--- ---
220. Total Paid By/For
Borrower:
220'000.00 520. Total Reductions
In Amount Due Seller:
2~ I.1 15'00
300. Cash .4t S lement Fr T B rr wer: 600. C h A 'et n r To Sel er•
301. Gross amount due from borrower (line 120) 234 763.29 601. Gross amount due to seller (line 420) 230,679.29
'__3_(12. Less amount paid by/for borrower (line 220) _____
303. Cash (X FROM) ~ TO) Borrower: 220 000.00
14,763.29 602. Less reductions in amount due seller (line 520)
603. Cash ( TO) (~X FROM) Seller: ~ _
_______231. I 15.00
1135.71
~~
rrevious ratuon is tiosotete SE3-4-3538-000-I
Fonn No. 1581 IiUD-I {3-86)
3186 RESPA, FIk3 4305.2
}~ Page I of 3 }~
X
7U0. Total Sales/E3roker's Commission: Paid From Paid From
Based On Price $ r~+; %= Borrower's Seller`s
i ~ Funds Funds
~ _ At At
Settlement Settlement
7t)7 ~ 7 ISOhO to Rr•/Mav let Arivantaor
703. Commission paid at settlement _____ 250.00 ______I3 800.00
704.
801. Loan Orieination fce
% ^
_
802. Loan Discount _ % _ I
I _
_____~
803. Aonraisal ('ee to: Estate Of Arland Ei. Wagonhurst
_
8 4. Credit renon to: Estate Of Arland FI. Wagonhurst __ ___
___
8(15. Lend is in ection fce _
806. Morigagc insurancc application fee to _ ___
` -
_
807, Asswnption fee ___
808. Tax Service F'ee To: Estate Of Arland H. Wagonhurst _ _
809.Flood Certilication Fee To~ Estate Of Arland H. Wagonhurst _ ___
810. Docum nt Preparation "fo: Estate OfArland I I. Waeonhurst ___
__
81 1. Processin Fec "I'o: Estate Of Arland H. Wagonhurst _ _
812. Underwriting 1=ce I'o: Estate Of Arland H. Waeonhurst ___
813. A lication Fee To: Estate Of Arland H. Wagonhurst __ _
___
814.
--_- - __ ________
----
8 15.
--- -- --
-
816. --- ----
----- ---- ----
818. --- ----
819.
^- -- ---
820.
---- ----------
R~I. ---
y01. interest from 6/0]/201 1_____ to / / ~a~$ __ X9.4521 /day 0 da s
902. M rt a e insurancc oremium for mo. to _______ _ _____
__9~3_ tlzl<ar~ insurance premium for ____._ vrs. to __ -- -
-
- --~
90~. Flood insurancc r°mium for r . to ______ _
_
905.
----- - - -
906. ---
1U
01. } lazard insurancc _ U months jai $
O.OU per month
_
~ '
'
t t u02. Mortaa~e ir~surance 0 months cry $ _ 0.00 oer month __
L 1003. Cit~_~tpertv taxes ___ 0 months r($ 0.00 oer month ___
L 1004_County propertY_taxcs ___ U months r _ 70.16 per month
I
I -_
I I _ _ _
~___
L___
~
__
1005. Annual assessments __ 0 months n $ 0.00 per month
L1006. Flood insurancc __ U months ~a? $ U UO per month I
I I ___ _
I _ _~
1007. School I'ax Reserves 0 months'i> $ 197.12 per month
1 I __ _
__
1008. A r're ate Ad'u tment ___
_t 1 Ql . Settlement or closing fee to __ ~
__
I I02. Abstract or title search to _
__ _
1103. "Title examination to __ _
1 104. Title insurance binder to
_- ___
- ____
_ 1.105. Documant prepat anon to
--- -
-
-
-
1106. Notar ~ fees to _ _
_
__
1 107. Attorney's fees to Pecht & Associates, P.C.
(includes above item Numbers: ) _
750.00 _
1 108. Title insurance to Johnson, Duffle, Stewart & Weidner
(includes above item Numbers: ___
109, Lender's coveraec _ $ 215.000.UO Premium: -$0.00
1 10. Owner's coy-era'e 23U UOO.UU Premium: $U.UO _ ___
_ ___
I 1 I I. Owner's Certificate to Johnson, Duffle, Stewart & Weidner ___
250.00 __ _
_1 112. Sculement Fee to Johnson Duf~ic Stewart & Weidner
400.0 ______ __ _
_I 113. Notar~ce to CASFI -- -
10.00 __
10.00
1 114. -- -----
1201. Recordi_~fees: Deed $ 62A0__- ;Mortgage $ 62.00 __
_ :Releases $ 0.00 124.
_
12U2. Cit /count tas/stamps: Decd $ 0.00 ___ :Mortgage $ 0.00 _ _
_
1203. State tax/Stamps _ Deed $ 4,600.00 :Mortgage $ 0.00 -__
2 300.00 ___
2 300.00
1204.
- ---- --- - --- --- _ ___
l 205. - --- --------
1301. Survcv to __
- -----
1302. Pest inspection to
-1303. Tax Certification Fee to Johnson Duffle Stewart 8i. Weidner _ ___
5.00
1304.
__-_---
--- - -
----- ------
I305.
- - --------- -------- --
----
1306.
---------- --- --
1307. ---
1308. _ -- -
Eater orr line 103 Section J -and -line 502 Section K'
4 084.00 ___
16 115.00
Form Nn. 1582 Page 2 of3 St3-4-3538-OOb-I
X X X
SELLER'S AND/OR BORROWER'S STATEMENT Escrow: 11-00004-JD
I have carefully reviewed the FIUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of a.ll receipts and
dishursements made on my account or by me in this transaction. 1 further certify that I have received a copy of the HUD-I Settlement Stateme;nt.
Borrowers/Purchasers Sellers
_-~ __. __._ _ .______ Esta eland H. Wagonh st
~iam S. Kauf2'man
~~,, ,,~ Y~
Laur+a~Lce~Kauffman ~ ~~ Jeffrey gon rst, Execut .
The HUD-1 Settlement Statement which 1 have prepared is a true and accurate account of this transaction. 1 have caused or wi11 cause the funds to be
disbursed in accordance with this statement.
~~~
Settlement Agent: ~ ;~(:~~ Date: ~ G~f? // Z O
title Of7i • r i r`
~.E, c hnson. Dutfie, Stewart & Weidner
WARNING: It is a crime tci ~nowingly make false statements to the United States on this or any other similar form. Penalties upon conviction ca:n include a
tine or imprisonment. For details see: "Title 18 t1.S. Code Section 1001 and Section 1010.
Page 3 of 3
PRENUPTIAL AGREEMENT
THIS AGREEMENT, made this .~ ~~day of ~~ l 1999 b
Y~ ~ y
and between ARLAND H. WAGONHURST (hereinafter called "Al") and
D'ARCY CHARNEY (herein called "D'Arcy").
WHEREAS, the parties hereto are about to marry and in anticipation
thereof desire to keep their respective estates intact and desire to fix and
determine by this Prenuptial Agreement all present and future rights and
claims that will accrue to each of them in the estate of the other by reason of
the marriage, and all rights of inheritance and rights to act as Executor or
other personal representative arising from the marital relationship, ~~nd to
accept the provisions of this Agreement in lieu of and in full discharge,
settlement and satisfaction of all such rights and claims; and
NOW, THEREFORE, in consideration of the premises and of th.e
marriage, and in further consideration of the mutual promises and
undertakings hereinafter set forth, each intending to be legally bouna~ hereby,
the parties agree as follows:
WHEREAS, Al has had the advice and counsel of Richard E. Connell,
Esq., and D'Arcy has had the advice and counsel of David Stone, Esq., and
through counsel, each of the parties has been fully advised as to his/her
economic rights following their marriage in the absence of an AgreemE~nt
between the parties relative thereto;
~G
1. The parties hereby confirm that each has disclosed to the other the
full extent of their respective present assets, income, expectancies azid
liabilities.
2. Except as otherwise specifically set forth in this Agreement, each
party hereby waives, renounces and releases any and all rights, title, interest,
election and demand which he/she may have acquired by reason of their
relationship, their marriage or otherwise, including but not limited to the right
to:
a) Take against any Will of the other and any conveyance of assets by
the other;
b) to share in the estate of the other under the intestate laws of the
Commonwealth of Pennsylvania;
c) to administer the estate or qualify as an executor of the Will of the
other;
d) to claim the widow's or widower's rights, family exemption or
homestead allowance; '
e) to claim any community, dower or courtesy interest in the pro~pert~-
of the other;
f) to claim any right to equitable distribution or other allocation or
division, upon separation or divorce, of the property of the relationship,
including marriage; and
2
C
g) to make any other claims, inchoate or otherwise, to any property or
right of the other, whether or not arising out of their relationship
including marriage.
3. Nothing herein shall be construed as preventing either of the parties
from giving any of his/her property or estate to the other by deed, gift, ~~Vill or
otherwise.
4. Each of the parties agrees to keep the other indemnified anal saved
harmless from all debts or liabilities incurred by him/her prior to the date of
this Agreement and from all actions, claims and demands whatsoever v~rith
respect thereto, and from all costs, legal or otherwise, and any counsel fees
whatsoever pertaining to such actions, claims and demands. Furthermore,
neither party shall contract or incur any debt or liability for which thE~ other
might be responsible without the knowledge and consent of the other, and each
party shall keep the other indemnified and save the other harmless from all
such debts or liabilities incurred by him/her subsequent to the date of this
Agreement and from all actions, claims and demands whatsoever with. respect
thereto, and from all costs, legal or otherwise, and counsel fees whatsoever
pertaining to such actions, claims and demands.
5. The consideration for this Agreement is the mutual promises and
waivers herein contained in the marriage about to be solemnized. If the
marriage does not take place, this Agreement shall be in all respects anal for
all purposes null and void.
~C
3
6. The failure of either party to insist upon strict performance of any of
the provisions of this Agreement shall not affect the right of such party
thereafter to enforce same, nor shall the waiver of any breach of any of the
provisions be construed as a waiver of any subsequent default of same or
similar nature, nor shall it be construed as a waiver of strict performance of.
any other provisions.
7. This Agreement may be modified by the parties at any time after
marriage, but such modification shall only be valid if in writing and executed
with the same formality as this Agreement.
8. This Agreement contains the entire understanding of the parties.
There are no representations, warranties, promises or undertakings, oral or
otherwise, other than those expressly set forth herein.
9. This Agreement shall be binding upon and shall inure to the benefit
of the parties hereto and their respective heirs, executors, administrators,
successors and assigns.
10. This Agreement is entered into in the Commonwealth of
Pennsylvania and shall be construed under and in accordance with the laws of
the Commonwealth of Pennsylvania and this shall in no way be affected by
any change in domicile by either of the parties.
11. For purposes of contract interpretation and for the purpose of
resolving any ambiguity herein, the parties agree that this Agreement ~uas
prepared jointly by their respective attorneys.
4 ~/,~f
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12. Each of the parties has carefully read and fully considered t11is
Agreement and all of the statements, terms, conditions and provisions thereof
prior to signing below.
IN WITNESS WHEREOF, the parties hereto have set their hands and
seals the day in here first above written.
~~
ARLAND H. WAGO URST
D'AR Y CHARNEY
5 ~~c
`~ rr m ~ Try cy cY _
D'AR CY CHARNEY
Name/Type Approximate ti'alue (July, 1999
1. Roth IRA $ 2, ~>96.00
2. "B Account" (WheatFirst) 408,956.00
3. "Managed Account" (WheatFirst) 15E~, 563.00
4. IRA 120, 716.00
5. Annuity 46, 000.00
6. 1991 Mercedes ~ (lien: 4, 000.00)
7. Real Estate
a) 4079 Rufus~ing Court, Enola
b) Colorado Time Share
c) New Mexico land
8. Bank Account (PSECU)
9. Personal Jewelry (rings, necklaces, pins)
appraised
10. Oil Paintings
11. Antique Family Furniture
58,000.00 equity ~
5, 000.00
2,000.00
4.,000.00 -est. avg.
20, 000.00
20, 000.00 -est.
100,000.00 -est.
`~,/
Schedule "A"
Financial Disclosures
ARLAND H. WAGONHURST
Name/Type Approximate Value July, 1999)
1. Hershey Foods (common stock) $35,000.00
2. Eaton Vance Utilities Fund (mutual fund) 7:x,()00.00
3. USAA Tax Exempt Intermediate Term Fund '7,()00.00
4. Municipal Bonds (15 varieties) 5(),000.00
5. IRAs (2) 23, 500.00
6. Annuity w/PFL Life Insurance Co. 30,000.00
7. U.S. Savings Bonds (series EE) 3,000.00
8. Harris Savings (savings account) 82,000.00
9. Life Insurance (~; MSLI; Ac~ia; United 7~i,C)00.00
of Omaha)
10. Real Estate
a) 110 Union Hall Rd., Carlisle 30CI,000.00 (est.)
(mortgage free)
b) 1038 Northfield, Carlisle 90,000.00 (est)
(mortgage free)
11. Stamp Collection 30,000.00
12. Bank Accounts (checking) avg/mo = 8,000.00
(Armed Forces Bank)
avg/mo = 2, 000.00
(Commerce Bank)
13. Numerous family antique furniture pieces unknov~Tn value
14. Five (5) Oil Paintings 2,000.00 (est.)
15. Chevrolet Tahoe - 1999 35,000.00
(lien 18,000)
i
AMENDMENT TO
PRE-NUPTIAL AGREEMENT
This is an amendment to that Prenuptial Agreement dated July 30, 1999 by and between
Arland H. Wagonhurst (hereinafter "Al") and D'Arcy Charney (now, Wagonhurst) (hereinafter
"D' Arcy")
WHEREAS Al and D'Arcy are married and reside in Al's real property at 110 Union Hall
Road; and
WHEREAS Al and D'Arcy have mutually agreed to construct an addition ("project") to
Al's real property for which the cost will be borne equally; and
WHEREAS, Al and D'Arcy wish to assure if Al dies first and his estate sells the real
property referred to, that D'Arcy will receive a portion of the sale proceeds to compensa~.te her for
the increased value to the real property which will occur as a result of the contributior.~ s:he is
making to the addition; and
WHEREAS, AI and D'Arcy wish to assure, if D'Arcy is the first of them to die, that her
estate receives from Al an amount which represents her relative contribution to the value of Al's
real property; and
WHEREAS, Al and D'Arcy understand that the matter addressed in this Amendment
could be precise and more detailed and could account for increases or decreases in value. or
interest rates and could factor in other variables, costs and expenses, Al and D'Arcy wis:h to keep
the plan simple and direct; and
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4f
LAST WILL AND TESTAMENT
OF
ARLAND H. WAGONHURST
KNOW ALL MEN BY THESE PRESENTS, that I, ARLAND H. WAGONHURST,
presently residing in Carlisle, Cumberland County, Pennsylvania, do hereby make, declare, and
publish this as my Last Will and Testament, hereby revoking all former Wills and Codicils
heretofore made by ine at any time.
PAYMENT OF EXPENSES
I. Payment of Expenses. I direct that my Co-Executors, hereinafter named, shall have the
power, but not the duty, to pay all my just debts, expenses of my last illness, and funeral
expenses from my estate as soon after my decease as shall be found convenient.
GIFTS
II. A. Real Estate -Personal Residence.
My wife, D'ARCY CHARNEY and I have been residing in my home at 110
Union Hall Road, Carlisle, Pennsylvania. If I die before her, I want to assure that
D'ARCY has a reasonable amount of time to purchase my 110 Union Hall Road.
property from my estate if she exercises the option provided for herein.
During the six (6) month period following my death, D'ARCY may, at her
option, notify my Co-Executors in writing that she wishes to purchase the 110
Union Hall Road property. If she exercises this option within the time allotted, ;;hf;
will purchase the premises "AS IS" without contingencies, for fair market value as
that value is determined by a certified real estate appraiser doing business in cen~tra.l
Pennsylvania (the appraisal cost to be split equally between D'Arcy and my estate)
but less the value added, by her, to the property when the first floor master bedroom
addition to my property was made (the total cost of that addition when made being
$74,000 in 2002) and with that reduction calculated as described in a separate
Amendment to Pre-Nuptial Agreement executed on March 15, 2003. If she
exercises the option, settlement must occur no later than seven (7) months after my
death unless my Co-Executors consent, in writing, to an extension.
Transfer taxes are to be equally shared between D'ARCY and my estate and.
normal pro-rations for real estate taxes and utilities shall apply.
-1-
The option to purchase above-granted is personal to D'ARCY. Should shf;
exercise the option but pass away before settlement, the purchase shall not be
assignable or transferable to her estate, her heirs or any third person.
If D'ARCY fails to provide written notice to timely exercise the above-granted
option, fails to settle within the time provided above, or provides a written waiver
of the option to my Co-Executors, then, under those circumstances, my Co-
Executors shall be empowered to sell the property to a third party subject however
to the following:
D'ARCY shall have up to twelve (12) months following the date of my
death to use the premises at 110 Union Hall Road, Carlisle, Pennsylvania, as
her principal residence. If D'ARCY wishes to reside in the said premises
beyond the seven (7) month anniversary of my death, she shall, at least one
month prior to the said anniversary, contact the Co-Executors of my estate
or the successor thereof, to advise them that she shall extend her residency
to a date not more than one (1) year after my death.
My Co-Executors shall, during any tenancy period following my death
and while D'ARCY remains in residence as a tenant (including the time
until she completes purchase of the property if she exercises the option), pay
the expenses of maintaining my Union Hall Road property as an expense of
the estate. The expenses of maintaining the residence shall include payment
of property taxes, municipal assessments, hazard and liability insurance for
the premises (but not for D'ARCY's personal property), ordinary repairs,
snow and ice removal, grass cutting, garden maintenance and other
expenses. During the tenancy, the payment of utilities or the purchase of
appliances shall be D'ARCY's responsibility.
Nothing in this Paragraph is intended, in any way, to limit the authority of nny
Co-Executors to take possession of and dispose of my personal and household
effects as provided in paragraph II. C., of my Will, even if such possession and
disposition includes items owned by me but routinely used by D'ARCY and me
while we shared my real property. Not to be included as items which the Co-
Executors take are any items jointly purchased by D'ARCY and me, especially the
furnishings in the first floor master bedroom.
B. Specific Bequests.
1. I give to my wife, D'ARCY, the sum of Ten Thousand ($10,000.00) Dollars if'
she survives me.
2. I give to Allison United Methodist Church (99 Mooreland Avenue, Carlisle
(Cumberland County) Pennsylvania) for deposit to the Karen Layman Memorial
Fund the sum of Ten Thousand ($10,000.00) Dollars.
-2-
3. I give to the Greater Harrisburg Foundation (200 North Third Street,
Harrisburg (Dauphin County) Pennsylvania) for deposit into the "Peggy
Wagonhurst Character Recognition Fund" the sum of Ten Thousand ($10,000.00)
Dollars.
4. I give to The Army Heritage Center Foundation, 950 Soldiers' Drive, P.O. ~Bc-x
839, Carlisle, PA 17013, the sum of Five Thousand ($5,000.00) Dollars.
5. I give to each of my grandchildren who survive me, JEFFREY
WAGONHURST, JR., NICHOLAS WAGONHURST, AND GRETCHEN
WAGONHURST HINTZ, the sum of Five Thousand ($5,000.00) Dollars.
C. Personal and Household Effects.
I bequeath my automobiles, household and personal effects (some of which I
have identified in a separate inventory which can be referred to by my Co-
Executors) and other tangible personalty of like nature (not including cash or
securities), together with 'any exist'ing' insurance thereon, to such of my children as
are living on the thirty-first day after my death, to be divided among them in as
nearly equal shares as practical.
I may leave a separate memorandum listing certain items of personal property
and expressing my wishes for disposition of those items. While not binding upon
my Co-Executors, I ask that, to the extent practical, my wishes be honored.
III. Residuary Estate. I give, devise and b~egtteath the rest, residue and remainder of m;y
estate, whether real, personal or mixed, any of any nature whatsoever and wherever situated to
my children, in equal shares. If any of my children should predecease me or die prior to the
distribution of his/her share, said child's share shall be paid to his/her then living issue, if any,
per stirpes. As to my children, JEFFREY WAGONHURST, or CAROLE R. WAGONfIU~RST,
if they leave no issue who would inherit as set forth above, such share, should they predc;cc;ase
me or die prior to the distribution of the property, shall be added to the shares of my othc;r
children. As to my daughter, DIANNE K. MONZA, if she leaves no issue, then her shale is to
be divided with one-half to her husband, VINCENT MONZA, if at the date of her death they
were married and living together as husband and wife, and one-half to my other surviving
children, per stirpes. If, at my daughter, (DIANNE's) death, she is not still married to and living
with VINCENT MONZA, then her share, if she has predeceased me, is to be added to the shares
of my other children.
I have made no provision other than in Paragraph II.B.l . for my wife, D'ARCY, as she
and I executed a Prenuptial Agreement on July 30, 1999 and thereafter amended on March 15,
2003.
IV. Powers of Appointment. No provision of this Will shall exercise any power of
appointment I may have.
-3-
FIDUCIARIES
V. Co-Executors. I hereby nominate, constitute and appoint my children, JEFFRF;Y
WAGONHURST, DIANNE K. MONZA, and CAROLE R. WAGONHURST, as Co-Executors
of this my Last Will and Testament. In the event that any of them should predecease me., or
decline the appointment, the others shall serve as Co-Executors, and if two are unable or
unwilling to serve, the remaining child shall serve alone.
VI. Bond. No Executor (Co-Executor) appointed in this Will shall be required to gave bond
or enter security for the performance of their duties.
ADMINISTRATIVE PROVISIONS
VII. Management Provisions. My Co-Executors shall have, in addition to the powers and
authority conferred upon them by law, the following additional powers and authority:
A. Sell/Lease: To sell at public or private sale, exchange, lease, mortgage or
pledge any property, real or personal, at any time constituting a portion of my
estate, and upon such terms and conditions as they shall deem wise subject,
however, to the restrictions set forth in Paragraph II. A. hereof.
B. Invest: To invest any money at any time in such bonds, stocks, notes, real
estate, mortgages, life insurance, annuities or other securities, or such property, .real
or personal, as my Co-Executors shall deem wise, without being limited by any
statute or rule of law regarding investments by a Fiduciary.
C. Retain: To retain, without incurring any liability, as investments, any properly
owned by me at the time of my death, as long as they deem it wise, and even thc-u~;h
such property is not the kind of property an Executor would purchase as an
investment; and even though to retain such property might violate sound
diversification principles.
D. Title to Property: To cause any security or other property which may at any
time constitute a portion of my estate to, be issued, held or registered in the Co-
Executors' names, or in the names of a nominee, or in such form that title will pass
by delivery.
E. Expenses of Estate: To pay all costs, taxes, charges and expenses in
connection with the administration of my estate.
F. Allocate: To determine what is "Income" and what is "Principal" hereunder,
and their decision thereon shall be final; and to purchase securities at a premium or•
discount, and to apply or charge said premium or discount against income or
principal as the Co-Executors may determine.
G. Borrow: To borrow money from'any person,-firm or corporation, for the
purpose of protecting and preserving or improving my estate hereunder; to execute
promissory notes or other obligations for amounts so borrowed.
-4-
H. Employ: To employ legal counsel, accountants, brokers, investment adviac-rs,
custodians, managers and other agents and employees and to pay them reasonable
compensation out of the funds held hereunder to which said compensation is
attributable.
I. Other: To do all other acts in the Co-Executors' judgment necessary or
desirable for the proper and advantageous management, investment and distribution
of my estate created.
VIII. Protective Provision. To the greatest extent permitted by law, before actual payment to a
beneficiary no interest in income or principal shall be (i) assignable to a beneficiary or (ii)
available to anyone having a claim against a beneficiary.
IX. Death Taxes. I direct that all transfer and inheritance taxes, state or federal, assessed
because of my death, whether the funds, property or insurance proceeds to which such taxes are
attributable pass under this will or not, shall be paid out of my residuary estate; that my C'o-
Executors pay, or provide for payment of all such taxes at such time, or times, and in such
manner as my Co-Executors deem best.
X. Tax O bons. I authorize my Co-Executors to exercise any options available in
determining and paying death taxes in my estate.
IN WITNESS WHEREOF, I, ARLAND H. WAGONHURST, the Testator to this., my Last
Will and Testament, typewritten on five (5) sheets of paper which I have identified at th.e bottom
of each page by my signature, hereunto set my hand and seal the ~...,~..day of ,~ ~,~~
2005. ~'
111~~~h1~ 4d~~ (SEAL)
A ND W ONHURST
The preceding instrument consisting of five (5) typewritten pages, each identified by the
signature of the Testator, ARLAND H. WAGONHURST, was on this day and date thereof
signed, published and declared by ARLAND H. WAGONHURST, the Testator therein named,
as and for his Last Will, in the presence of us, who at his request, in his presence, and in the
presence of each other have subscribed our names as witnesses.
-5-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
We, Jams J. ~Ia ~'s~l ,and ,~ncP;lee L ~oYcl
and % ~hGr '
~ ~. o~~ell ,the witnesses whose names are signed to the
attached or foregoing instrument, being duly qualified according to law, do deposE; and
say that we were present and saw ARLAND H. WAGONHURST sign and execute the
instrument as his Last Will; that he signed willingly and that he executed it as his fires; and
voluntary act for the purposes therein expressed; that each of us, in the hearing anal sight
of the Testator signed the Will as witnesses; and that to the best of our knowledge:, the
Testator was at that time eighteen or more years of age, of sound mind and undE;r no
constraint or undue influence.
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Sworn or affirmed to and subscribed to before me by ,./amen ~ /~f o~'sE~
and ~? anal ~ (ee L l~ ~l '
Y ,and ~.c/ar~l ~, ~o~,r e ~ l ,witnesses
this ~a ~ day of ~~~ ~~- , 2005 .
~~ . n /%
Pub
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
I, ARLAND H. WAGONHURST, Testator, whose name is signed to the attached
or foregoing instrument, having been duly qualified according to law, do lle;reby
acknowledge that I signed and executed the instrument as my Last Will; that I si~;nc~d it
willingly; and that I signed it as my free and voluntary act for the purposes therein
expressed.
ARLAND H. A HU~:S T
Sworn or affirmed to and acknowledged be , re me, by ARLANJD H.
WAGONHURST, the Testator, this a~K-'~ day of ~ ~ , 2005.
Notarv~Iic
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CODICIL
TO THE WILL OF
ARLAND H.WAGONHURST
I, ARLAND H. WAGONHURST, having made my Last Will and Testament dated
September 22, 2005, do hereby make, publish and declare this to be a Codicil to my said Last
Will and Testament. r
1. I hereby amend Paragraph III. of my Last Will and Testament dated
September 22, 2005 by deleting the language set forth therein and substituting; in its
place the following:
a. During my lifetime, I advanced the sum of Forty-Five
Thousand ($45,000.00) Dollars to my daughter, CAROLS R.
WAGONHURST, as an advancement against her inheritance under
my Last Will and Testament. Therefore, before any other division
of my residuary estate as set forth below, I hereby direct that the
first Ninety Thousand ($90,000.00) Dollars of my residuary estate
shall be divided equally between my other children, JEFFREY and
DIANNE and shall be paid at the earliest practicable date after the
formal appointment of the Co-Executors. If JEFFREY has
predeceased me, the $45,000 share allotted to him shall be divided
equally among his wife, SUSAN, and his children, GRETCHEN,
JEFFREY, JR., and NICHOLAS. If DIANNE has predeceased
me, her share shall be divided equally among her living issue, per
stirpes. If DIANNE leaves no issue, one-half of the Forty-Five
Thousand ($45,000.00) Dollars, which would have been payable to
her, shall be paid to her husband, VINCENT MON7,A, if, at the
date of her death they were married and living together as husband
and wife, and the other one-half shall be disposed of as part of the
residue under Paragraph III. b. of my Will as set forth below.
b. I give, devise and bequeath the rest, residue and remainder of
my estate, whether real, personal or mixed, any of any nature
whatsoever and wherever situated to my children, in equal shares.
If my son, JEFFREY, should predecease me, his share shall be
divided equally among his wife, SUSAN, and his children,
GRETCHEN, JEFFREY, JR., and NICHOLAS. If my daughter,
CAROLS, should predecease me, her share shall be paid to her
~~?~~ ~~
-1-
then living issue, if any, per stirpes but, in default thereof, the share
shall be added to the shares of my other children. If my daughter,
DIANNE K. MONZA, predeceases me, her share shall be paid to
her issue, per stirpes but, in default thereof her share is to be
divided with one-half to her husband, VINCENT MONZA, if at
the date of her death they were married and living together as
husband and wife, and one-half equally to my other surviving
children, per stirpes.
c. If, at my daughter, (DIANNE's) death, she is not still married
to and living with VINCENT MONZA, then her entire share, if she
has predeceased me, is to be added to the shares of my other
children.
I have made no provision other than in Paragraph II.B.1. for my wife,
D'ARCY, as she and I executed a Prenuptial Agreement on July 30, 1999 and
thereafter amended on March 15, 2003.
2. In all other respects, I hereby ratify, confirm and republish my Last ~%Ui:ll and
Testament dated September 22, 2005 together with this Codicil as and for my Last
Will and Testament.
IN WITNESS WHEREOF, I, ARLAND H. WAGONHURST, the Testator to this
Codicil to my Last Will and Testament, typewritten on two (2) sheets of paper which [ have
identified at the bottom of each page by my signature, hereunto set my hand and seal
this ~ ~~- day of ~~~-,p,~~r- , 2006.
'~(SEAL)
ARLAND H. AG HURS
The preceding instrument consisting of this and one (1) other typewritten page, each
identified by the signature of the Testator, ARLAND H. WAGONHURST, was on thi:> day and
date thereof signed, published and declared by ARLAND H. WAGONHLTRST, tJhe Testator
therein named, as and for the Codicil to his Last Will and Testament, in the presence o:f us, who
at his request, in his presence, and in the presence of each other have subscribed our :names as
witnesses.
~i0 n,a ,
z.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
. SS:
I, ARLAND H. WAGONHURST, Testator, whose name is signed to the atl:ached
or foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as the Codicil to my Last `N;ill and
Testament; that I signed it willingly; and that I signed it as my free and voluntary act for
the purposes therein expressed.
~, Q 4 0 ~r P~ ~~. ,
ARLA I. WA HURST
Sworn or affirmed to and acknowledged before me, by ARLA~[vD H.
WAGONHURST, the Testator, this j~~`-'- day of ~~~~ , 2.006.
No Public
C e~ v ~' iii ~ & ~~
C 4s~C~[ ~yj ~{y~H ~sar~ U,~~~:.L -i~'.; a' :~~~-32J {i
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COMMONWEALTH OF PENNSYLVANIA
. SS:
COUNTY OF CUMBERLAND
We, James ./. /~a~e/ ,and G~•'cLia~/ ~ ~~.~~~ .
the witnesses whose names are signed to the attached or foregoing instrument, beiinl; duly
qualified according to law, do depose and say that we were present and saw ARLAND H.
WAGONHURST sign and execute the instrument as the Codicil to his Last Will and
Testament; that he signed willingly and that he executed it as his free and voluntary act
for the purposes therein expressed; that each of us, in the hearing and sight of the 'Te:stator
signed the Codicil as witnesses; and that to the best of our knowledge, the Testator ~~vas at
that time eighteen or more years of age, of sound mind and under no constraint o~r undue
influence.
~~
._._.---
<---,.
~~
Sworn or affi ed to and subscribed to before me by Ja~~s T. /1'fU ~-`~;(
and
~'chQ~~ ~ ~ a~nPi/ witnesses this fo ~= day of ~.~,~er , 2006.
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