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HomeMy WebLinkAbout10-11-11PHONE: (717) 737-1300 law c~f~s of DEBRA K. WALL~;T 24 N. 32nd STREET CAMP HILL, PA 17011-2917 E mail Walletdeb(a~aol.corn October 6, 2011 Glenda F. Strasbaugh, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Dear Ms. Strasbaugh: Re Estate of Willbur R. W. Hubley Will No. 20 1 1-00485 FAX: (717) 761-5319 Enclosed are an original and one copy of the Pennsylvania Inheritance Tax Return, a check in the amount of $4,519.57 representing payment of the inheritance tax due, one copy of an Inventory of the Estate, and one copy of a Status Report Under Rule 6.12 for filing in the above-captioned estate. I have also enclosed a check in the amount of $30.00 representing the filing fees for the tax return and the inventory. I have enclosed a copy of the first page of each to be stamped in and returned to me in the pre-addressed envelope provided. Thank you. Sincerely yours, Debra K. Wallet DKW/mm Enc. cc: Jo Ann Shepp >~urns, Co-Executrix Lou Ann Shepp Houck, Co-Executrix 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. CD 015049 SHEPP HOUCK LOU ANN 29 BEECHWOOD ROAD AIRVILLE, PA 17302 fold ESTATE INFORMATION: ssN: isa-i4-io54 FILE NUMBER: 211 1-0485 DECEDENT NAME: DATE OF PAYMENT: HUBLEY WILBUR R W 10/ 1 1 /201 1 POSTMARK DATE: 10/1 1 /201 1 couNTY: DATE OF DEATH: CUMBERLAND 01 /09/201 1 REMARKS: RECEIPT TO ATTY ACN A~>SESSMENT CONTROL NUMBER REV-1162 EX~11-96) AMOUNT 101 ~ 54,519.57 TOTAL AMOUNT PAID: 54,519.57 CHECK#112 INITIALS: HEA SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH Rf=GISTER OF WILLS REGISTER OF WILLS REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } couNTY of Cumberland } ss File Number 21 - 11 - 00485 Jo Ann Shepp Burns Lou Ann Shepp Houck Personal Representative(s) of the Estate of ($4,000 each) Hubley, Wilbur R. W. deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at 1:he end of this inventory. I verify that the statements made in this Inven- tory are true and correct. I understand that false state- } ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to } authorities. --- --•-rr .......... Attorney -- (Name) Debra K Wallet S ~''f"'- k • l~we ~ .a ___ ( upre (Firm) Law Offices of Debra K. Wallet me Court I.D. No.) 23989 ------------ (Address) 24 North 32nd Street Camp Hill, PA 17011 ele hone p ) 717/737-1300 ------- DATE OF DEATH LAST RESIDENCE 4905 East Trindle Road 1/9/2011 DECEDENT'S SOC. SEC. NO Mechanicsburg, PA 17050 . 168-14-1054 FIGURES MUST BE TOTALED Personal Property 67 Savings Bonds - Series E and EE 14,553.19 222 shares of Principal Financial Group 7,177.26 Wells Fargo (formerly Wachovia) checking account #1000015159262 32,894.60 Wells Fargo (formerly Wachovia) checking account #1010248200680 16,579.45 Wells Fargo (formerly Wachovia) savings account #1010248200664 42,282.78 Personal property in room at Country Meadows (dresser, old TV bookshelves , chair) , .-C~ :_125.00 _~-, ~ Cash in possession of Decedent --, ~ -' " ~1510 ', =ri _~ ~; ~~ - _7 _ _, .. _. .". . J ti_ (Attach additional sheets if necessary) Total Personal Property and Real Est t _ . -l.~ "` _~ y > i-.:.,T. a e $1 ~3,627~3Z~ T-~ --~ REV-1500 Ex(°'-'°' 1505610143 PA Department of Revenue ~ OFFICIAL USE ONLY Pennsylvania Counly Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 11 0 0 4 8 5 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 168 14 1054 O1 09 2011 09 26 1920 Decedent's Last Name Suffix Deicedent's First Name MI HUBLEY WILBUR R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® 1 Original Return ^ 4. Limited Estate ® 6 Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ qa Future Interest Compromise (date of death after 12-12-82) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Return Required 1 ___ 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) ~.vrcrctarurvutrv I -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number DEBRA K WALLET 717 737 1300 First line of address 24 NORTH 32ND STREET Second line of address City or Post Office State ZIP Code CAMP HILL PA 17'011 REGISTER OF WfiL~~j 1SE ONL-Y ' -,-, - - ~,~ __ ~ ;- ~._ . _, _ - ~ _ , ~, - .~ - - --I `.. DATE FILED i T'` ' _ ..: T:. ~ '.: `-~ --r3 Correspondent'se-mail address: Walletdeb@aOI.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 Q~ PERSON RESPONSIBLE FnR Fu wr. acn Tau o Ann Shepp Burns 2767 Oakland Road, Dover, PA 17315 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS 24 North 32nd Street, Camp Hill, PA 17011 Side 1 1505610143 Debra K Wallet DATE ~0~4 ~ 11 1505610143 1505610243 REV-1500 EX oecedent~s Name: R U B L E Y, W I L B U R R. W. RECAPITULATION 1. Real Estate (Schedule A) ..................................................................................... .... 1. 2. Stocks and Bonds (Schedule B) ............................................................................ ... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)...... .... 3. 4. Mortgages & Notes Receivable (Schedule D) ...................................................... .... 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 & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested .......... ... 7. 8. Total Gross Assets (total Lines 1-7) .................................................................... ... g, 9. Funeral Expenses & Administrative Costs (Schedule H) ..................................... ... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. ... 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... ... t 1. 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... ... 12. 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. 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 0 0, 4 3 4 8 8 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. Decedent's Social Security Number 168 14 1054 21,730.45 91,896.93 10,507.73 124,135.11 17,335.21 6,365.02 23,700.23 100,434.88 100,434.88 4,519.57 4,519.57 Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 11 - 00485 Hubley, Wilbur R. W. STREET ADDRESS 4905 East Trindle Road CITY Mechanicsburg ATE ZIP - - ---_. PA ', 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund'. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Make Check Payable to: REGISTER OF WILLS, AGENT. (3) (4) (5) 0.00 0.00 4,519.57 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 :......................................._........................................ ~ !rx 1. b. retain the right to designate who shall use the property transferred or its income :.................................... ~ ~Lx l 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 transfE~r 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?......... [l ~ x j 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..................................................................................................................... U ~~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Fp r dates ofp eath o~ or afte §July 1 ~ 1) ~ 4) (j]before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving s Ouse is 3 ercent 72 P.S. 9116 a 1.1 i For dates of death on or after Januarryy 1, 1995, the tax rate imposed on the net values of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The stafute 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 years Hof 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 decedents lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. (1) 4,519.57 Total Credits (A + B) (2) • The tax rate imposed on the net value of transfers to or for the use of the decedents 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, wfiether by bloo~ or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Hubley, Wilbur R. W. All property jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM ' DESCRIPTION NUMBER 1 67 Savings Bonds - Series E and EE (see attached list) 2 ', 222 shares of Principal Financial Group FILE NUMBER 21 - 11 - 00485 UNIT VALUE VALUE AT DATE OF DEATH ii 14,553.19 I 32.33 I', 7,177.26 TOTAL (Also enter on line 2, Recapitulation) ~ 21,730.45 i COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Hubley, Wilbur R. W. FILE NUMBER 21 - 11 - 00485 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION NUMBER 1 Wells Fargo (formerly Wachovia) checking account #1 00001 51 59262 2 Wells Fargo (formerly Wachovia) checking account #1010248200680 3 Wells Fargo (formerly Wachovia) savings account #1010248200664 4 Personal property in room at Country Meadows (dresser, old N, bookshelves, chair) 5 Cash in possession of Decedent TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 32,894.60 16, 579.45 42,282.78 125.00 15.10 91,896.93 CHEDULE G COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Hubley, Wilbur R. W. FILE NUMBER 21 - 11 - 00485 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH I % OF EXCWSION NUMBER Include the name of the transferee, their relationship to decedent VALUE: OF ASSET i DECD'S (IF APPLICABLE) ' TAXABLE VALUE and the date of transfer. Attach a copy of the deed for real estate. INTEREST 1 ', Thrivent Financial Annuity ~0,507_~~ ! 100% 10,507.73 i j I I i TOTAL (Also enter on line 7, Recapitulation) ', 10,507.73 SCHEDULE H FUNERAL Ex~ENSES & COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN A r'VIA'NICT~A'1'7~ lC /'~/'~Q'1'C RESIDENT DECEDENT F1LJ1~~ F~7 ~ r~/'\ ~ ~ V C l-W ~ J ESTATE OF Hubley, Wilbur R. W. __ _ Debts of decedent must be reported on Schedule_ I. ITEM NUMBER ',' FUNERAL EXPENSES: DESCRIPTION A. 1 Tri-County Memorial Gardens 2 Delivery of ashes to Ocean City, MD (320 miles x $0.51/mile) 3 Delivery of ashes to Ocean City, MD (overnight accommodations and meals) B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Jo Ann Shepp Burns Lou Ann Shepp Houck ($4,000 each) Street Address 2767 Oakland Road city Dover State PA zip 17315 ' Year(s) Commission paid 2011 2. Attorney's Fees Debra K. Wallet, Esq. 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. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 ,Postage, photocopies, mileage, etc. TOTAL (Also enter on line 9, Recapitulation) 8,000.00 5,000.00 341.50 50.00 17, 335.21 FILE NUMBER 21 - 11 - 00485 AMOUNT 3,290.00 163.20 308.00 C Schedule' H ~ COMMONWEALTH OF PENNSYLVANIA r~'" """" -T°'~" "` INHERITANCE TAX RETURN -~ AdminlslwadVle Costs OOnhnued RESIDENT DECEDENT ESTATE OF Hubley, Wilbur R. W. F LI E NUMBER ___ _ 21 - 11 - 00485 2 Reimbursement of expenses incurred by Co-Executrices (postage, mileage, supplies) _____ - 182.51 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN 7 RESIDENT DECEDENT ~ FILE NUMBER ESTATE OF Hubley, Wilbur R. W. ~ 21 - 11 - 00485 Report debts incurred by the decedent prior to death that remained unpaid at the hate of death, including unreimbursed medical expenses. ITEM DESCRIPTION NUMBER 1 Country Meadows -final bill 2 Darren Barbucci, DPM 3 Verizon 4 Jackson Gastro. 5 Azizkhan Internal 6 West Shore EMS 7 State Employees' Retirement System (repayment of monthly pension for month after death) TOTAL (Also enter on Line 10, Recapitulation) REV•1513 EX+ (11.08) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES H ITANCE TAX RETURN IN ER RESIDENT DECEDENT ESTATE OF Hubley, Wilbur R. W. NUMBER ', NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I~ 'TAXABLE DISTRIBUTIONS[include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Marc Hubley CB 5657 2500 Lisburn Rd., P.O. Box 200 ', Camp Hill, PA 17001-0200 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son FILE NUMBER 21 - 11 - 00485 SHARE OF ESTAT AE MOUNT OF ESTATE (Words) ; ($$$) 100% of residuary Estate 'Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate. II. INON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 @~ ~` i T WILBt.JR R. W. HUBLEY, of Camp Hill, Cumberland County, Pennsylvania, of sound and disposing mind, memory, and understanding, do hereby make, publish, and being declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils that I have made, including the Will dated June 27, 2001. FIRST: I direct that after my death my body be cremated. I have made pre- arrangements through the Cremation Society of Pennsylvania who should be contacted at my death. wherever situate, be liquidated as soon as practical. After the payment of my final expenses and any taxes due, I direct that my Executrix purchase a single premium annuity payable to my ^~~ce ated and ;~.~!~^ is Pxpected to be r' W . W , H UBLE`~', who is cup r~ntly. in:.u. r r son, MAF:~. incarcerated for the foreseeable future. My Executrix sl~.all have absolute discretion to select a reputable company and to determine the terms and conditions of this annuity. This annuity shall be payable to my son until the end of his natural life. Should there be any residual payment due upon my son's death, said payment shall bf: paid to those individuals named in SECOND: Upon my death, I direct that all of my Estate, of whatever nature and Part THIRD herein. THIRD: Should my son fail to survive me by thirty (30) days, then I give, devise, and bequeath all of my Estate, of whatever nature and wherever situate to the following individuals who shall survive me by thirty (30) days: p. Fifty (50%) percent, in two equal shares, to my wife's nieces: JO ANN SHEPP URNS, of York, Pennsylvania, and LOU ANN SHEPP HOUCK, of York, Pennsylvania; B g, Fifty (50%) percent, in two equal shares, cne to my nephew, DENNIS L. ERS of York, Pennsylvania; and one to my half-sister, ROMAINE NALEN, of York, MY , Pennsylvania. I have provided here for these named beneficiaries only and not for any of their issue. Should an of the above-named beneficiaries fail to survive me by thirty (30) days, I direct that y the share given to said beneficiary be distributed to the survivor named within each subpart. FOURTH: All interests of any beneficiary in the income or principal of this Estate, while undis in 'b to ed and in the possession of my Executrix, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligation or liability of any beneficiary and, fi.~rthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. I specifically direct that the bequest to my son shall not be subject to anv fees set by the Commonwealth related to his incarceration. FIFTH: All inheritance, estate, and succession taxes (including interest and any penalties thereon) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate, without apportionment or right of reimbursement from any person. In the event that a substantial portion, as determined in the sole and absolute judgment and discretion of my Executrix, of the non-probate assets are directed to be paid to a beneficiary or beneficiaries, so that the taxes referred to herein would be paid out of the robate residue passing to the beneficiary or beneficiaries of this will (whether or not the same P as the beneficiary or beneficiaries under the non-probate assets), my Executrix, in the ecutrix's sole and absolute judgment and discretion, shall have the right to allocate the full Ex or artial payment of the taxes to the beneficiary or benefit;iaries of the non-probate assets. P SIXTH: In addition to all rights and powers conferred by law, I authorize and m ower my Executrix and her successors, in her absolute: discretion and without necessity of e p obtaining court approval: A, To buy investments at a premium or discount. B, To hold property unregistered or in the name of a nominee. C. To give proxies, both ministerial ar.~d discretionary. D. To compromise claims. E. To join any merger, consolidation, reorganization, voting trust other concerted action of security holders anal to delegate discretionary duties with plan, or any respect thereto. p. To lend to, and buy from, my esta~.e. G. To borrow and to pledge real and personal property as security therefor. H. To sell at public or private sale fol- cash or credit or partly for each, to anae or to lease for any period of time, any real or personal property, and to give options exch b , for sales, exchanges, or leases. I. To exercise any option permitted 'by law which she believes to be aeous from the viewpoint of overall tax reductions, including, without limitation of the advantab foregoing, power and authority to claim administration or other expenses either as income tax deductions or inheritance or estate tax deductions, without regard to whether they were paid rinci al or income and without requiring adjustments between principal and income for from p P an resulting effect on income or estate taxes, and a deduction of such expenses for income tax y ur oses shall be given effect in computing the respective shares of all persons interested in P P my estate set forth herein, even though the effect is to increase the share of one beneficiary or class of beneficiaries hereunder at the expense of another; and to make such adjustments, if any, between beneficiaries with respect thereto as she shall deem appropriate in view of the nature of the transaction and the amounts involved. J. To distribute in cash or in kind or partly in each. The powers granted hereunder shall be exercisablf° with respect to all real and personal roperty, including, but not limited to, income and principal held for minors or disabled P beneficiaries at any time, until the actual distribution of z:ll property. All powers, authorities and discretion granted here shall be in addition to those granted by law and shall be exercisable without leave of court. However, nothing herein shall b~° interpreted. or construed to encourage, authorize, empower, or permit the Executrix to act or cause anyone to act in a ersification and risk manner contrary to or inconsistent with accepted standards of portfolio div management. SEVENTH: I nominate, constitute, and appoint my wife's nieces, JO ANN SHEPP BURNS, an Ld OU ANN SHEPP HOUCK, as Co-Executrices of this, my Last Will and Testament, In the event of the renunciation, death, resignation, or inability of either of my wife's nieces to act for whatever reason in this capacity, then I nominate, constitute, and appoint the other to act as sole Executrix. I direct that no representative named above shall be required to post security for the faithful. performance of her duties in any jurisdiction insofar as I am able by law to relieve her re resentatives shall be entitled to reasonable compensation for of such obligation. Any of my P the performance of the duties set forth here. ~,~, da of WITNESS WHEREOF, I have hereunto set my hand and seal this y IN 2006, on this, the fifth of five type~'ritte;n pages. I have also signed the F~~~ , mar in of the first four of these pages for purposes of identification only. left-hand g ~~ WILB JR R. W . HUBLEY NED PUBLISHED, and DECLARED by the Testator, WILBUR R. W• IG S his Last Will and Testament, in the presence of us, who at his request, in his HUBLEY, as and in the presence of each other, have hereunto subscribed our names as witnesses. presence, _ ~ , ~J.,,w...®- '~' ,C -- ~,, ./ ~- ~ ~„~ ~ ~~:'~ -- ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland I, WILBUR R. W. HUBLEY, Testator, whose narrie is signed to the attached nt having been duly qualified according to law, cio hereby acknowledge that I signed mstrume b d executed the instrument as my Last Will and Testament; that I signed it willingly; and that an I signed it as my free and voluntary act for the purposes therein expressed. r WIL~3UR R. W. HUBLEY Sworn or affirmed to and subscribed before me by WILBUR R. W . HUBLEY, the ,.~ _, 2006. Testator, this ~ _ day of }-~ ' ~,. ~/ ,_ ~1- .. _ Notary Publi COMMONWEAL i H OF PENNSYLVANIA Notarial Seal Mary M. Loper, Notary Public Camp HiA Boro, Cumberland2Cout~7 My commission Expires Oct. Member. Pennsylvani? Association Of Notaries AFFIDAVIT Commonwealth of Pennsylvania County of Cumberland We, Debra K. Wallet and C~~,»t ~ ~' ~°~` ~~ ~`~ ~ the witnesses whose names are signed to the attached instrument, being duly quaiii~ied according to law, depose and say that we were present and saw the Testator, WILBUR R. W. HUBLEY, sign and execute the instrument as his Last Will and Testament; 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 Testator signed the Will as witnesses; and that, to the best of our knowledge, the Testator was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence. _~ ~ A_ d c ~J~~~ ~ / ~~ ~/ ~~ _~ S~~~orn or affirmed to and subscribed to before me by 1J.i.1~1''r"~._ ~'= ~ ,; 4-~ i i ~~ ~ and ~'~ 2006 . ~.C~~'} n'~~ ~- ~1 ~1'1f 1L, witnesses, this ~ day of ~rz b, ~~ ~~~ ~ ~ ~ . ~ Notary Publi COMMONWEALTH OF PENNSYLVANIA Notarial Seal Mary M. Loper, Notary Public Camp Hiu Boro, Cumberland County My Commission Expires Od. 27, 2007 Member. Pennsylvania Pssociation Of Notaries tl REV-485 EX (1-07) SAFE DEPOSIT ,-- BOX INVENTORY PA Department of Revenue 48500D4],046 CITY: STATE: ZIP CODE: CA~+? !~l~u.. ~R 1~u11 DATE AND TIME OF LAST ENTRY SA~r ~ i ao i i *i 1 TITLE UNDER WHICH BOX IS REGISTERED w1151.~ ~. Int.... ~~ Cie. {~G/et w.GA~~w/0. Social Security or Death Certificate Number Date of Death County Code Year File Number 1 L Y t y 1 b5~( ~ I D$ ~ 0 1 i 2 1 t'I t7 O'~p' S Decedent's Last Name Suffix First Name MI ADDRESS OF DECEDENT STREET: ' CITY: STATE: ZIP CODE: a,,,vD~E ~.o a~ y9 0~ t; ~sr T ~,~c-~ q,~~cs b~~ ~Q- ti~uSo NAME AND ADDRESSVOF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX NAME: D lra~a rti. ~ RL1.~ l~ k$ Q , ' STREETADDRESS: ~~1 N. ~~.c ~Sr~c~~r CITY: Cer+>~ N ~« STATE: ~~. ZIP CODE: ' too i t NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. NAME: 3o Atirr'.s Stt`?>~ Bu.~t~s RELATIONSHIP: N~&~t: q,~D Go - E~rsc. STREETADDRESS ~,}c,`} bs~,.aa~ ~I~~ CITY: _ ~oy~ STATE: ~A ZIP CODE: 1~3t5 b. NAME: L~t~ AN~J Stt g?~ !ao w.c.k. RELATIONSHIP: _ NI b C L ~sl~ ~~ " G y ~~. . STREETADDRESS: ~g l~ccahwvo~ ~~. CITY: d~t>2v«~~ STATE: ~~4 ZIP CODE: t~3oZ c. NAME: RELATIONSHIP: l STREETADDRESS: CITY: STATE: ZIP CODE: NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED NAME: ~ NG ~paK STREETADDRESS: 11 OH CAa.~IS 1.t KoAD NAME OF PERSON MAKING LAST ENTRY ?oRrNU SCtL7J ~4Ra,lS DATE OF CONTRACT TO RENT BOX NUMBER OF BOX. NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. NAME: W 11 y t,1,r 2• W-u. 6 c c.., STREETADDR S: eSGC. Lctg qa'G } CITY: STATE: ZIP CODE: b. NAME: PLEASE USE ORIGIPIAL FORK! O~iILY loco STREET ADDRESS: CITY: STATE: ZIP CODE: NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY ~iCBRa Id. I.,~Atl.f.T. Q~rrotnaify FoE tkE.GuTR~GIES WAS A WILL IN THE BOX? ^ YES ~ NO If yes, a. Date of will: b. Name and address of personal representative, if named in the will NAME: STREETADDRESS: CITY: STATE: ZIP CODE: c. Name and address of attorney, if any NAME: STREET ADDRESS: 4850004],046 - i CITY: STATE: ZIP CODE: 48500041046 x o ? m o h ~W 0 0~ za oz `° _ p v t z . -s1 .. w ~ ~ ~ ~w s ~ '~ ~ ~ 3 ~ ~ ~ w ~ ~ c r o ~ ~ m ~ ' ~ 9 ~ ~ ~ z ~. ~ z ~ ° U 3 ~ Z ~ j W Q Q ~ i OW W ff] W ~ ~ W ~ J W F- Z Q ~ (n ~ m F w U V1 '"' ~ ` O cn -~ O F- W Li. 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