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HomeMy WebLinkAbout10-17-05REV-1500 -EX (6.00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Z Webb William B ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) U 4/9/2005 1/28/1928 (1) WQ (IF APPLICABLE) SURVNING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Q Margaret L. Webb ®1 Original Retum 0 202-20-6748 y . 2. Supplemental Retum 0 3. Remainder Retum date of death ( rior to 12 1382 ~ av ~ 4. Limited Estate O 4a. Future Interest Com romise date of death aRer 12-12-82 p ( ) p - ) 0 5. Federal Estate Tax Return Re uir d v am ®6. Decedent Died Testate (Attacn copy of Will) 0 7. Decedent Maintained a Livin Trust A q e 1 Q ~ 9. Litigation Proceeds Received g ( ttach copy of Trust) 0 10. Spousal Poverty Credit (care of cream Deeween tz-at•st anc t•r- 8. Total Number of Safe Deposit Boxes es) 0 11. Election to tax under Sec 9113 A z THIS'SEGTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFOR . ( ) (AUachscn of MATfON SHOULD REDIRECTED TO w ° NAME : COMPLETE MAILING ADDRESS z Joanne $. Book, 8s ire PO Box 1146 N FIRM NAME (If Applicable) ~ Rhoads & Sinon, LLP Harrisburg PA 17108-1146 V TELEPHONE NUMBER 717-233-5731 1. Real Estate (Schedule A) Z O QHQ ..7 F- a a w Q' OFFICIPL USE ONLY 21 - 05 0419 --_ COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 162-22-0302 i rtu IttTURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 0. 2. Stocks and Bonds (Schedule B) (2) 1, 3 42 9 5 3. Closely Held Corporation, Partnership w Sde-Proprietorship (3) 0 . 0 0 4. Mortgages 8 Notes Receivable (Schedule D) (4) 0 . 0 0 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) (5) 0 . 0 0 6. Jointly Owned Property (Schedule F) (6) 0 . 0 0 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 18 , 9 3 2 . 9 0 (Schedule G or L) OFFICIPL USE ONLY C. k 8. Total Gross Assets (total Lines 1-7) (8) 2 0, 2 7 5 8 5 9. Funeral Expenses 8 Administrative Costs (Schedule H) (g) 13 , 3 6 6 . 6 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 0 . 0 0 11. Total Deductions (total Lines 9 8 10) (11) 13 3 6 6 . 6 0 12. Net Value of Estate (Line 8 minus Line 11) (12) 6 , 9 0 9 2 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 6 , 9 0 9 2 5 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax zo rate, or transfers under Sec. 9116 (a)(1.2) 4 , 4 0 9 . 2 5 x .0 0 (15) 0 . 0 0 F 16. Amount of Line 14 taxable at lineal rate 2 , 5 0 0 . 0 0 4 5 x .o (16) 112 5 0 _ . ~ 17. Amount of Line 14 taxable at sibling rate 0 . 0 0 x .12 (17) 0 . 0 0 O U 18. Amount of Line 14 taxable at collateral rate 0 . 0 0 x 15 (18) 0 00 X ~ . 1s. Tax Due (19) 112 .50 > > BE SURE`TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH. < < 3 W 4645 1.000 decedent's Complete Address: STREET ADDRESS 1924 Enfield Road Cumberland CITY STATE 7~p Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 112.50 0.00 0.00 0.00 0.00 0.00 Total Credits (A + B + C) (2) 0 .0 0 Total Interest/Penalty (D + E) (3) 0 .00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 112 .50 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 112.50 Make Check Payable to: REG/STEROFWILL~AGENT ,, v __.. t PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" tN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; . 0 b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiarydesignation? . ® Q IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE.G AND FILE.IT AS PART OF THE RETURN. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ~' ~'D~J~ c/o Rhoads & Sinon, LLP For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one yep or a stepparent of the child is 0 % [72 P.S. ~ 9116(a)(1.2)). The tax rate imposed on the nef value of transfers to or for the use of the decedent's line The tax rate imposed on the net value ottransfers to or for the use of the decedent's sibli individual who has at least one parent in common with the decedent, whether by blood 3 W 4646 1.000 nn n..,. ~ ~ A c f~ r~~~ " ~t.r,S l PA 17108 natural parent, an adoptive parent, 9116(1. <) [72 P.S. F 9 t l o^(a)(t )]. defined, under Section 910?, as an For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate impos°~+ nn the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. § 9916 (a) (1.1) (i)j. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of to )% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory i a return are still applicable even if the surviving spouse is the only beneficiary. RF_V-1503 EX + (8.98; SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS 8c BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER William B. Webb 21 05 0419 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION ~ DEATH 1.3 Shares AT&T Corp CUSIP: 001957505 57.39 Dividend accrued on 4/9/2005 0.71 2 5 Shares Comcast Corp Class A CUSIP: 20030N101 3 6 Shares Lucent Technologies, Inc CUSIP: 549463107 4 United States Savings Bonds - Series ES (3) Face: $1,000 DOD: $694.00 Face: $500 DOD: $347.00 Face: $100 DOD: $69.40 Owner: Decedent 159.78 14.67 1,110.40 TOTAL (Also enter on line 2, Recapitulation) I $ 1, 342 95 3wasss i.ooo (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (698) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER William B. Webb 21 05 0419 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBE DESCRIPTION OF PROPERTY INCLLOETFEWIMEOFTFETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND TFEDATEOFTRANSFF.RA7TACIIACOPYOFTHEDEEDFORRE4LESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE ~• Belco IRA acct #11940, Beneficiary is decedents wife, Margaret L. Webb 18,913.47 100.0000 0.00 18,913.47 Interest accrued to 4/9/2005 19.43 100.0000 19.43 TOTAL (Also enter on line 7, Recapitulation) ~ $ 18,932. (If more space is needed, insert additional sheets of the same size) 3W46AF 1.000 ~~V-,5„ ~:-t,z-~, SCHEDULE H ~ COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPEN`SE`S Sc INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER William B. Webb 21 05 0419 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~' Musselman Funeral Home 6,460.00 Total from continuation schedules . B. 1 ADMINISTRATNE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) - - Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 4. 5. 6. 7. 1 2 Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Rhoads & Sinon LLP Reserves for expenses The Bricker House Reception 3,691.00 2,500.00 100.00 615.60 _- TOTAL (Also enter on line 9 Recapitulation) ~ $ 13 , 3 6 6 6 0 3W46AG 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: William B. Webb Schedule H Part 1 (Page 2) Item No. Description 2 Rolling Green Cemetary Cost of headstone and grave site expenses 162-22-0302 Amount 3,691.00 Total (Carry forward to main schedule) 3,691.00 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF William R _ wut,7~, FILE NUMBER L1 U S 0419 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not Llst Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)j 1 Michael E. Ryle 1919 Enfield Road Camp Hill, PA 17011 Specific bequest under ITEM 2 of the Last Will and Testament Grandson 2,500.00 2 Margaret L. Webb 1924 Enfield Road Camp Hill, PA 17011 100 Residue: 4,409.25 Surviving Spouse 4,409.25 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0 . 0 0 SCHEDULE J BENEFICIARIES 3W46AI 1.000 ~u ~nvic aNaa.c is IICCU CU, niscr~ 0a(7111On 81 SrleeiS OT Ine San1e SRG) LAST WILL AND TESTAMENT OF WILLIAM B. WEBB I, WILLIAM B. WEBB, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing. mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made. I am mazried to MARGARET L. WEBB (hereinafter referred to as "My Spouse") and the children born of our marriage are SCOTT W. WEBB and ROBIN B. WEBB. As used herein the term "my children" shall refer to the aforelisted children bom of my mamage with My Spouse. TANGIBLE PERSONAL PROPERTY. I give and bequeath all of my household furniture and furnishings, automobiles, other motor vehicles, books, pictures, jewelry, china, crystal, appliances, silverware, wearing apparel, articles of household or personal use or adornment, collections, artworks, boats and recreational equipment and vehicles, together with all policies of insurance thereon, to My Spouse, if My Spouse survives me. If My Spouse does not survive me, I give and bequeath such tangible personal property which is set forth in a sa~i~o.i Page 1 of 7 Pages ~©p~ Origr~al neid by Rf~e~aCS 8~ Sinon E.LP separate signed and dated memorandum which I shall place with this Will to the persons therein designated. I give and bequeath all of the rest of such articles to my children living at my death in as nearly equal shares as they shall select under the supervision of my Executor. Any cost of packing and shipping said personalty to the beneficiaries, including insurance, shall be paid by my Executor as a general administration cost. If any such articles cannot be fairly divided or distributed in kind in the opinion of my Executor, such articles shall be sold and the proceeds thereof shall pass as a part of my residuary estate. 2. SPECIFIC BEQUESTS. (a) I give and bequeath the sum of Two Thousand Five Hundred Dollars ($2,500) to my step-grandchild, MICHAEL EUGENE KYLE, with the condition that if I have survived My Spouse and Michael Eugene Kyle has already received a bequest in this amount from My Spouse's Estate, this bequest shall be null and void. (b) If I survive My Spouse and own an interest greater than a life estate in my residence at my death, I give, devise and bequeath all of my right, title and interest in my real property known and numbered as 1924 Enfield Street, Camp Hill, Cumberland County, Pennsylvania, to my son, SCOTT W. WEBB, if he survives me. If he does not survive me, this bequest shall become null and void. (c) If I survive My Spouse and own any shares of common stock at my death, I give and bequeath such shares or the proceeds of such shares to my son, ROBIN B. WEBB, if he survives me. If he does not survive me, this bequest shall become null and void. RESIDUE. I give, devise and bequeath all of the rest, residue and remainder of my property, real, personal and mixed, not disposed of in the preceding portions of this Will, including all property over which I hold a power of appointment (which powers of appointment I hereby exercise in favor of my estate), to My Spouse, if My Spouse survives me. If My Spouse does not survive me, I give, devise and bequeath said residue to my children living at my death in equal shares; provided, however, that if my son, SCOTT W. WEBB, does not Page 2 of 7 Pages survive me and he is marred and not separated from his wife, TERRI L. WEBB, at his death, his share shall pass to his wife, TERRI L. WEBB, if she survives me, but if TERRI L. WEBB does not survive me or is separated or divorced from SCOTT W. WEBB at his death, such share shall pass to my son, ROBIN B. WEBB; and further, provided that if my son, ROBIN B. WEBB, does not survive me and he is married and not separated from his wife, PAMELA DAVIS-WEBB, at his death, his share shall pass to his wife, PAMELA DAVIS-WEBB, if she survives me, but if PAMELA DAVIS-WEBB does not survive me or is separated or divorced from ROBIN B. WEBB at his death, such share shall pass to my son, SCOTT W. WEBB. If both of my sons predecease me and TERRI L. WEBB and PAMELA DAVIS-WEBB do not take hereunder, I give and bequeath said residue to my step-grandchild, MICHAEL EUGENE KYLE, if he survives me. 4. SPENDTHRIFT PROVISION. No interest in income or principal of my estate shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary of my estate prior to the beneficiary's actual receipt thereof. My Executor shall pay over the net income and the principal to the beneficiaries herein designated, as their interests may appear, without regard to any attempted anticipation (except as maybe specifically provided herein), pledging or assignment by any beneficiary of my estate and without regard to any claim thereto or attempted levy, attachment, seizure or other process against said beneficiary. SURVIVAL PRESUMPTIONS. Any person who shall have died at the same time as I or under such circumstances that it is difficult or impossible to determine who shall have died first, shall be deemed to have predeceased me. Page 3 of 7 Pages 6. FIDUCIARY POWERS. In the settlement of my estate, my Executor shall possess, among others, the following powers, exercisable without prior court approval, but in all cases to be exercised for the best interests of the beneficiaries: (a) To retain any investments I may have at my death so long as my Executor may deem it advisable to my estate so to do, including securities owned, issued or underwritten by any corporate Executor or any of its affiliates. (b) To vary investments, when deemed desirable by the Executor, and to invest in every kind of property and type of investment, including securities owned, issued or underwritten by any corporate Executor or any of its affiliates, or as to which such Executor or its affiliate acts as investment advisor, as the Executor shall deem wise. (c) In order to effect a division of the principal of my estate or for any other purpose, including any final distribution of my estate, my Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. If such division or distribution is made in kind, said assets shall be divided or distributed at their respective values on the date or dates of their division or distribution. In making any division or distribution in kind, my Executor shall divide or distribute said assets in a manner which will fairly allocate any unrealized appreciation among the beneficiaries. (d) To sell either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my estate, any or all real or personal estate or interest therein owned by my estate severally or in conjunction with other persons or acquired after my death by my Executor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which maybe necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in this Will. (e) To mortgage real estate and to make leases of real estate for any term. (fl To borrow money from any party, including my Executor, to pay indebtedness of mine or of my estate, expenses of administration, Death Taxes or other taxes. Page 4 of 7 Pages (g) To pay all costs, expenses, legally enforceable debts, funeral expenses and charges in connection with the administration of my estate. (h) To vote any shares of stock which form a part of my estate and to otherwise exercise all the powers incident to the ownership of such stock and to actively manage and operate any incorporated or unincorporated business, including any joint ventures and partnerships, and to incorporate any such unincorporated business, with all the rights and powers of any owner thereof. (i) In the discretion of my Executor, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of my estate. (j) To assign to and hold in my estate an undivided portion of any asset. (k) To hold investments in the name of a nominee. (1) To compromise controversies. (m) To disclaim, in whole or in part, any and all interests in property owned by me at the time of my death, including those passing to me by Will, intestacy, contract, joint ownership, operation of law or otherwise. (n) To designate one or more persons or a corporation to act as ancillary fiduciary in any jurisdiction in which ancillary administration maybe necessary, such ancillary fiduciary to serve without bond or security and to have all powers, authorities and discretions conferred hereunder. (o) To employ and compensate from income or principal, in the discretion of my Executor, investment and legal counsel, accountants, brokers and other specialists, and, whenever there shall be no corporate Executor in office, a corporate custodian, and to delegate to investment counsel discretion with respect to the investment and reinvestment of any or all of the assets held hereunder. 7. EXCULPATORY CLAUSES. In the settlement of my estate: (a) My Executor shall not be personally liable for any loss to my estate or to any beneficiary of my estate resulting from an election made in good faith to claim a deduction as an income tax deduction or as an estate tax deduction. (b) In valuing property in my gross estate for the purposes of any Death Tax, my Executor shall not be personally liable for any loss to my estate or to any beneficiary of my estate resulting from my Executor's decision made in good faith to use a particular valuation date. Page 5 of 7 Pages CUSTODIAN OF ESTATES. If at any time any individual under the age of twenty-one shall be entitled to receive any assets free of trust by reason of my death, whether payable hereunder, by operation of law, contract or otherwise, I appoint my Executor named herein as Custodian for such individual under the Pennsylvania Uniform Transfers to Minors Act. 9. TAX CLAUSE. All inheritance, estate and similaz taxes becoming due by reason of my death ("Death Taxes"), whether such Death Taxes shall be payable by my estate or by any recipient of any property, shall be paid by my Executor out of the property passing under ITEM 3 of this Will as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any Death Taxes paid by my Executor, even though paid with respect to proceeds of insurance or other property not passing under this Will. 10. EXECUTOR POWERS REGARDING BASIS ADJUSTMENT. I hereby authorize my Executor in my Executor's sole and absolute discretion to allocate any adjustments to the income tax basis of assets of my estate to such assets as my Executor deems to be appropriate. I recognize that this power gives my Executor broad latitude which I wish my Executor to exercise while taking into account such factors as my Executor deems beneficial to all of the beneficiaries of my estate. My Executor shall not be liable for any loss to my estate or to any beneficiary of my estate resulting from such allocation made in good faith. 11. EXECUTOR APPOINTMENT. I hereby appoint My Spouse, MARGARET L. WEBB, as Executrix of this Will. If for any reason My Spouse should fail or cease to act, I appoint my sons, SCOTT W. WEBB and ROBIN B. WEBB, as Co-Executors. If Page 6 of 7 Pages ~,:,~: for any reason either of them should fail or cease to act, the other shall act or continue to act with all of the powers granted to the two of them. All references in this Will to my "Executor" shall refer to my originally named Executrix, to my successor Co-Executors or to my sole successor Executor, as the case maybe. 12. WAIVER OF BOND; FIDUCIARY FEES. My Executor shall qualify and serve without the duty or obligation of filing any bond or other security. Any corporate fiduciary shall be entitled to compensation for services in accordance with the standard schedule of fees in effect when the services are rendered. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding six (6) pages, this -~~ ~ay of ~ .- !~1/~~ ~. , 2005. n William B. Webb We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. (SEAL) ,~ ~ SEAL ( ) i Residing at: l~~ 1 V~O ej'~'-C rt ~-+ ~- I-1 ~{ Residing at: 3 71 t' /~! ~.~=.z.,~ S-~_ ~~~~J~3u2G ~ / ~ IrJ Page 7 of 7 Pages w ~ "" v-~ ~:... COMMONWEALTH OF PENNSYLVANIA SS: r COUNTY OF b ~-- We, WILLIAM B. WEBB (testator), '/~E'j~ ~. ~r~~ and ~__~/~ ~,~~~ ,the Testator and the Witnesses, respectively, whose names are signed to the foregoing instrument, having been sworn, do hereby declare to the undersigned officer that the Testator, in the presence of the Witnesses, signed said instrument as his Last Will and Testament, that he signed voluntarily, that each of the witnesses, in the presence of the Testator and of each other, signed said Will as a witness and that to the best of the lrnowledge of each witness, the Testator was at the time of sound mind and under no constraint or undue influence. Subscribed and aclalowledged before me by WILLIAM B. WEBB, the Testator, and subscribed and sworn to before me by /?/~E' ~. ~~k and V~~~I~SI7 ~n ,the witnesses, on this day of ~~~/~ , 2005. Notary. lic My Commission Expires: (SEAL) COMMONWEALTH OF PENNSYLVANIA Notarial Seal Jo Ann Seker, Notary Public City Of Hamburg, Dauphin County My Commission E~ires June 30, ZOa7 Member, Permsyivania Assodation of Notaries William B. Webb ~. .~. o ~ w ~ o ~ ~ 00 ~ 3 b~ G r r ~ ~° m ~ ~~ ax R e Z Cl1 -a o aw y ~ ~ = m ~ „~ r~ y ~ P rNf S ~ i.,.~ F[Cb-~3 F-~ z H