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HomeMy WebLinkAbout10-27-11.1505610143 REV-1500 Ex(o,_,~) OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code veer File Number Bureau of Individual Taxes OEFARTMENT OF NEVENOE Po Box.28o601 INHERITANCE TAX RETURN 21 11 0673 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 174 20 7897 03 26 2011 05 20 1927 Decedent's Last Name CHRISTINE Suffix Decedent's First Name WINIFRED (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82} 4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death atfater,2-12-82) 6 Decedent Died Testate ~ ~• (Attach Copy Hof T~usl)a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) 9. Litigation Proceeds Received ~ 10. benveenP2 31 ~~a d~t~(dat~es)f death ~ 11.Election to tax under Sec. 9113(A) (Attach Sch. O) MI A MI CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number BRADLEY L GRIFFIE (717) 243 5551 First line of address 200 NORTH HANOVER ST Second line of address City or Post Office State ZIP Code CARLISLE PA 17013 REGISTER OF W~~USE ONLY ~.~I ~ _-, -}, - ` --, --; ~- _ . `_ ~~1 --~ .+~.. L DATE FILED ~'`-' :a-, ._;~ ~._'. _ :=:.i L.•7 tv ..J 'Tl Correspondent's a-mail address: bgriffle@grlffielaW.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. N URE OF PERSON RESPO IBLE FOR FILING RETURN ~ DAT~ ~ ~ / Jean Lona Q ~ ~ 303 South Filbert Street Mechanicsburg, PA 17055 SIGNATURE OF P I PRESENTATIVE DATE ~%~ Bradley L. Griffie, Esquire i p ~ t a ( I I r~i Fie associates, 200 North Hanover Street, Carlisle, PA 17013 Side 1 1505610143 1505610143 PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF I FILE NUMBER Christine, Winifred A. 21-11-0673 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 #2 Name Address1 Address2 City, State, Zip Date Ronald Hertzler 101 S. Norway Street Mechanicsburg PA 17055 :1505610243 .REV-1500 EX Decedent's Social Security Number DecedenrsName: Christine, Winifred A. 174 20 7897 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sote-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 892 - 69 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 114.7 4 7. Inter-Vivos Transfers & Miscellaneous lyan; Probate Property Requested Separate Billin 7 ............ g (Schedule G) u . 8. Total Gross Assets (total Lines 1 7) ..................................................................... g. 1 , 007.43 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 4 , 835.6 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 12 , 22 0 • 8 6 11. Total. Deductions (total Lines 9 & 10) ................................................................... 11 • 17 , 0 5 6.52 12• Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. -16 , 04 9. 0 9 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. -15 , 04 9. 0 9 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 0 . 0 0 16. at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 18 at collateral rate X .15 . . 19. Tax Due ............................................................ ..................................................... . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L ],505610243 15056:10243 0.00 0.00 0.00 0.00 0.00 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-0673 DECEDENT'S NAME Christine, Winifred A. STREET ADDRESS 1067 Allendale Road, Apt. C CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits (A + g) (2) 0.00 3. Interest (3) 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 a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~.0~ Make Check Payable to: REGfSTER OF WILLS, AGENT. . .._ , .. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 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 :.................................. ^ 0 c. retain a reversionary interest; or .............................................................................................................. d. receive the promise for life of either payments, benefits or care? ............................................................ ^ ^x If death occurred after December 12, 1982, did decedent transfer property within one year of death without ^ ^ receiving adequate consideration? .................................................................................................................... x 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? .................................................................................................................. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS lS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adaptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1508 EX+ (6.98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Christine, Winifred A. 21-11-0673 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Metro Bank Savings Account -Account No. 626406433 (See attached statement) 170.37 2 All State Apartment Insurance -Refund 21.00 3 Comcast Cable -Refund 6.25 4 Verizon -Refund 17.29 5 Security Deposit -Refund 307.78 6 Rent Rebate (2010) 370.00 TOTAL (Also enter on Line 5, Recapitulation) I 892.69 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+t6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Christine, Winifred A. 21-11-0673 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. Jean Louise Long ADDRESS 303 South Filbert Street Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT B. C. IOINTLY OWNED PROPERTY: Daughter ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH DECEDENTS NTEREST 1 A 11/12/2003 Metro Bank Checking Account -Acct No. 140.94 50.000% 70.47 536572308 (See attached statement) 2 A 02/28/1985 Members 1st Federal Credit Union Savings 67.02 50.000% 33.51 Account -Acct. No. 47626-00 3 A 03!0611985 Members 1st Federal Credit Union Checking 21.51 50.000% -10.76 Account -Acct. No. 47626-11 TOTAL (Also enter on Line 6, Recapitulation) 114.74 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV-1151 EX+(10A6) COMMON RITAN~ETFAXRNETURNANIA N RE3SIDEEN DECEDENTT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF I FILE NUMBER Christine, Winifred A. 21-11-0673 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State ZiD Year(sl Commission paid 2, Attorney's Fees Griffie & Associates 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 1,945.00 2,500.00 Street Address City State ZiD Relationship of Claimant to Decedent 4. Probate Fees 115.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 275.16 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 4,835.66 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Christine, Winifred A. 21-11-0673 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Rolling Green Cemetery 1,815.00 2 Aver Cremation Services 130.00 H-A 1,945.00 Other Administrative Costs 3 The Sentinel -advertising 200.16 4 Cumberland Law Journal -advertising 75.00 H-B7 275.16 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 FJ(+ (12-08) SCHEDlJLE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OFPENNSYLVANlA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Christine, Winifred A. 21-11-0673 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbureed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Chase Bank USA, N.A. -Acct. No. xxxx-xxxx-xxxx-9528 8,964.83 2 Visa -Members 1st Federal Credit Union -Acct. No. xxxx-xxxx-xxxx-9871 2,717.99 3 Meadowood - (Partial Rent) 144.00 4 Hospital Telephone and Telecom Services Ltd 28.00 5 Golden Living Center 11.00 6 Pinnacle Health (Medical Services) 93.55 7 Pinnacle Health (Medical Services) 41.15 8 Verizon 4.59 9 MofFitt Heart Vascular Group 2.00 10 Kantor & Tkatch Associates PC 147.40 11 PPL Electric Utilities 23.56 12 PPL Electric Utilities 42.79 TOTAL (Also enter on Line 10, Recapitulation) ( 12,220.86 (If more space is needed, additional pages of the same size) Coovriaht (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-08) COMMONWR AgLT~ ,Fq~PENENSUYLVANIA INH ES~~EN DECEDENTRN S~HED~JLE J BENEFICIARIES ESTATE OF I FILE NUMBER Christine- Winifred A. 21-11-0673 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal ~ distributions, and transfers under Sec. 9116 a 1.2 1 Barbara Beaver Daughter none 911 Wertzville Road $0.00 Enola, PA 17025 *Insolvent E 2 Gerald E. Christine, Jr. Son one-third $0.00 2221 Onaoto Avenue *Insolvent E Dayton, OH 45414 3 Ronald Hertzler Son one-third $0.00 101 S. Norway Street *Insolvent E Mechanicsburg, PA 17055 4 Jean Long Daughter one-third $0.00 303 S. Filbert St *Insolvent E Mechanicsburg, PA 17055 5 Susan Yinger Daughter none $0.00 1604 Main Street *Insolvent E Mechanicsburg, PA 17055 Total Enter dollar amounts for distributions shown above on fines 15 throu h 18 on Rev 150 0 cover sheet, as a r o riate . NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS state state state 'state 'state TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) ~tt~~ ~~II ttn~ C~~~~~uutaenY aF WINTERED ARLENE CHRISTINE I, WINTERED ARLENE CHRISTINE, of 68 North 9th Street, Lemoyne, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my Executor hereinafter named to pay all of my just debts, funeral expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my Executor need not accelerate and pay those ulnnatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. It is 1ny desire that my bodily remains be cremated and not interred, with my ashes being disposed of in a manner deemed appropriate by my Executor, taking into account any written instructions I may leave for such purpose. It is further my specific instruction that there be no memorial service, viewing or wake for me following my death, GRIFFIE & ASSOCIATES ATTORNEYS•AT-LAW 200 NORTH HANOVER STREET NORTH MAIN STREET CARLISLE, PENNSYLVANIA 17013 CHAMBERSBURG, PENNSYLVANIA 17201 ~~ r ti c~ but that there only be a private service after my cremation for three of my children, namely, JEAN LONG, of Mechanicsburg, Pennsylvania; RONALD HERTZLER, of Mechanicsburg, Pennsylvania; and GERALD E. CHRISTINE, 3R., of Dayton, Ohio. s~coNv I give, devise and bequeath my entire estate of whatsoever nature and wheresoever situate, together with all insurance proceeds thereon, in equal shares to three (3) of my five (5) children, namely, JEAN LONG, of Mechanicsburg, Pennsylvania; RONALD HERTZLER, of Mechanicsburg, Pennsylvania; and GERALD E. CHRISTINE, JR., of ~ r Dayton, Ohio; providing they survive me by sixty (60) days, per stirpes. I have specifically ., not provided for any distribution to my daughters, SUSAN I'INGER, of Etters, Pennsylvania, nor BARBARA BEAVER, of Carlisle, Pennsylvania, not out of want of affection, but because I have provided for them as I desire during my lifetime. It is further my desire that my Executor/Executrix, after consultation with any heir or heirs of mine who survive me, and in his, her or its own discretion, choose such articles from my tangible personal property (exclusive of cash, stock certificates, bonds, and all other tangible evidences of intangible personal property) as he, she or it believes will be useful to ~~ such heir or heirs or' desirable for him o1- }per or' them to have, either from a sentimental point of view or otherwise, and to delivel• such articles to such heir or heirs or among such heirs in equal or unequal shares as determined by the further exercise of his, her or its discretion, provided no other heir objects to the distribution. All tangible personal property not so distributed is to be sold, either publicly or privately, by my GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 14 NORTH MAIN STREET SUITE 550 200 NORTH HANOVER STREET CHAMBERSBURG, PA 17201 CARLISLE, PA 17013 Executor/Executrix, adding the proceeds of such sale or sales to my residuary estate and to be disposed of in equal shares among my surviving heirs after payment of my estate debts, taking into account the tangible personal property otherwise provided to them. THIRD Any devise or distribution under this Last Will and Testament which is payable to any beneficiary who may be under 21 years of age or, in the judgment of my Executor/Executrix, mentally disabled, shall be held in a separate trust by my ~~ Executor/Executrix as trustee until such beneficiary reaches 21 years of age or during such period of disability. During the term of any trust created pursuant to this Paragraph, the Trustee is authorized to expend and apply so much of the net income and principal of each such trust as the Trustee shall consider advisable for the health, maintenance, support, and `•.,•`, ~: education (including college education, undergraduate and graduate) of each such ,, ~- beneficiary until he or she attains 2 ] years of age, or until all such amounts are paid out of \` trust. I direct that no Trustee shall be required to give or post bond for the faithful performance of the Trustee's duties in this or any other jurisdiction. FOURTH I grant my Executor/Executrix the following powers in addition to and not in limitation of such powers as my Executor/Executrix shall hold by law: (a) To retain all pl°operty received including the stock of any corporate fiduciary acting hel•eunder, provided such property remains productive. (b) To join in any corporation, partnership, recapitalization, merger, reorgamzat~on or- voting trust plan; to delegate authority with respect thereto; to deposit GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 14 NORTH MAIN STREET SUITE 550 200 NORTH HANOVER STREET ~'HGMRFRSBLJRG. PA 17201 CARLISLE, PA 17013 investments under- ag1•eements and pay assessments; and generally to exercise all rights of investors, including but not Limited to, the voting of shares. (c) To manage, operate, 1•epair, improve, mortgage or lease on any terms any real estate held or owned by my estate. (d) To operate any business that I may own at my death. (e) To invest any funds of my estate in any stocks, bonds, notes or other securities or property, real or personal, without regard to the principle of diversification or any other- statute or general rule of law in his, her or its absolute discretion, it being my intention to give 1ny Executor-/Executrix the broadest investment powers possible, providing such investments do not unnecessarily prevent the prompt settlement of my estate. (f) To sell or otherwise dispose of any property, real or personal, tangible or ilitangible, at any time forming a part of my estate in any manner and on such terms and conditions as 1ny Executor/Executrix shall see fit in his, her- or its absolute discretion. (g) To borrow money for the payment of taxes or for any other proper purposes in the administl•ation of 1ny estate, and to mortgage or pledge estate assets as security. (h) To compromise claims without court approval including, but not limited to, any controversies with the United States of America or the Commonwealth of Pennsylvania concerning estate and inheritance taxes on any interests that may pass under this my Last Will and Testament. GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 14 NORTH MAIN STREET SUITE 550 200 NORTH HANOVER STREET CHAMBERSBURG, PA 17201 CARLISLE, PA 17013 (i) To distribute in cash or in kind upon any division or distribution of my estate. (j) To undertake any and al] acts deemed necessary and proper by my Executor/Executrix for the proper, advantageous and prompt management of the settlement of my estate. (k) In general, to exercise all powers in the management of my estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as to him, her or it may seem best and to execute and deliver all instl•uments and to do all acts which he, she or it ~ deems necessary or- proper to carry out the purposes of this, my Last Will and Y Testament. FIFTH No interest of any beneficiary of my estate, either in income or in principal, shall be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have the power in any manner to charge or encumber his interest either in income or principal, nor shall the interest of any beneficiary be liable or subject in any manner while in the possession of my Executor/Executrix for the liability of such beneficiary. SIXTH I nomil~ate, constitute and appoint my son, RONALD HERTZLER, and daughter, JEAN LONG, or their- survivor, as Co-Executors of this my Last Will and Testament. I di1•ect that my Executor/Executrix shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 14 NORTH MAIN STREET SUITE 550 200 NORTH HANOVER STREET CHAMBERSBURG, PA 17201 CARLISLE, PA 17013 ~S"EVENTI~ I hereby declal•e it to be my expressed desire that my Executor/Executrix employ the law firm of Griffie & Associates, of Carlisle, Pennsylvania, for legal advice and assistance regarding this my last Will and Testament, they having considerable knowledge of my affairs, views and wishes respecting any matters that may arise at the probate of this instrument, the administration of my estate, and the execution of the powers herein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament this ~ ~~ •~ day of ~ ;•i 4- ~ , 1999. WITNESS: „ 3 WINIF . ~ D ARLENE CHRISTINE GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 14 NORTH MAIN STREET SUITE 550 CHAMBERSBURG, PA 17201 200 NORTH HANOVER STREET CARLISLE, PA 17013 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: SS. COUNTY OF CUMBERLAND I, WINIII'RED ARLENE CHRISTINE, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Wil] and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ,L C~'~-,~' r WINIF . ARLENE CHRISTINE Swo1-n or affil•med and acknowledged before me by WINTERED ARLENE ....~ , CHRISTINE the Testatrix this '~ ~ day of~~j~ , 1999. Notarial Seal Ca~-sle Boro80umberland CounC~y My Commlaelon Expires April 17, 1 Sgg GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 14 NORTH MAIN STREET SUITE 550 200 NORTH HANOVER STREET CHAMBERSBURG, PA 17201 CARLISLE, PA 17013 A.F'r:[DA VIT COMMONWEALTH OF PENNSYLVANIA: SS. COUNTY OF CUMBERLAND and ~ ~lZ~r< .c, ~ ~ ~r~ • > the WE, ~~,~ r~ ~ j ~~m~~s witnesses whose names are attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Last Will and Testament as witnesses and that to the best of our knowledge the Testatrix was at the time 1 ~ or more years of age, of sound mind and under no constraint or undue influence. ~: ,. ~-~ .--- Sworn or affirmed and subscribe e •or me by ~ y o~, ~~rr,-eL_ and `"` ~- 1999. `" ,~. ; ~, ~~ this /~- day of , `~~~J t,.(l. Notary Publk Notarial Seal Robin J. Goshorn, Notary Public tr~rllr;la F~oro, Cumberland Coun My Oammi®®lan Explr~a Aprll 17,1 88 GRIFFIE & ASSOCIATES ATTORNEYS AT LAW 14 NORTH MAIN STREET SUITE 550 200 NORTH HANOVER STREET CHAMBFRSBURG. PA 17201 CARLISLE, PA 17013 METRO BANK June 27, 2011 Griffie & Associates Attn: Bradley Griffie 200 N Hanover St Carlisle PA 17013 3801 Paxton Street 888.937.0004 Harrisburg, PA 17111 mymetrobank.com RE: Estate of: Winifred A. Christine Tax Identification Number: 174-20-7897 Date of Death: March 26, 2011 To Whom it May Concern: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 536572308 Date Opened: 11/12/2003 Primary Owner: Winifred A. Christine Secondary Owner: Jean Louise Long Date of Death Balance: $140.94 Account Type: Savings Account Number: 626406433 Date Opened: 12/11/2003 Primary Owner: Winifred A. Christine Date of Death Balance: $170.37 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, Diana Reynolds Metro Bank Research Associate/Deposit Services