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HomeMy WebLinkAbout06-19-12J Lsoselolos REV-1500 Ex `°_-"' (Ft, PA Department of Revenue peMSylvania OFFICIAL USE ONLY Bureau oflndividualTaxes -~~N~~~~~~INHERITANCETAXRETURN CounryCode Year FileNUmber PO BO%28o60t ~' 'L D~39~ Harrisburg, PA t7128-06D3 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Dale of Death MMODYYVV Date of Birth MMODYYVV 3/17/2012 03/14/1993 Decedent's Last Name Suffix Decedent's First Name MI FICKES JR HAROLD C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (ip 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 1213-82) O 4. Limited Estate O qa. Future Interest Com romise date of P ( O 5, Federal Estate Tax Return Required death after 12-12-BZ) OD 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ____ B. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceetls Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 antl 1-1-95) (Attach Schetlule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TA%INFORMATION SHOULD SE DIRECTED T0: Name Daytime Telephone Number THOMAS E. FLOWER (717) 243-5513 REGISTER OF WII~ USE ONLY First Line of Atldress ~y L~ r ~ FLOWER LAW, LLC ~~(rl Second Line of Address fin,... 10 W. HIGH ST c~ =1; ~~ ~,. :a: City or Post Office State ZIP Code L~-. DATE~ED CARLISLE PA 17013 ~ Correspondent's a-mail address: Untler penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements. antl to [he best of my knowledge antl belief, it is true. cortect and complete. Declaration of praparer other than the personal representative is based pn all in/orma[ion of which preparer has any knowledge. SIG ATURE ERSON R OR FILING RE RN O - DA_---~ ADD -- 0.1~ L FICKES LINDA FICKES, 59 DEWALT DR., MECHANICSBURG, PA 17050 SIQRIATC{IYE OF BR/eHaF&R OTHER THAN REPRFFFNTATNF 4//t //Z FLOWER LAW, LLC; 10 W. HIGH ST., CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY j ~~= (.y1 r-' )F47 m;~;:C -^r C.7 i ~ ~.-t _~'i i•= rn Side 1 L, 1505610105 15[15610105 J 1505610205 REV-1500 EX (FI) Decedent's Social Security Number Decedent's Name: HAROLD C. FICKES, JR 204-26-8820 RECAPRULATION 1. Real Estate (Schedule A)...... _ ..................................... 1 2. Stocks and Bonds (Schedule B) .................... .. .. 2. 14,819.95 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . ... 3. 4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 28,207.64 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 7. Inter-Yvos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7, 260,533.18 8. Total Gross Assets (total Lines i through 7) .......................... ... 8. 303,560.77 9. Funeral Expenses and Administrative Costs (Schedule H) .... ........... ... 9. 17,835.06 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule 1) . ........... .. 10. 4,227.11 11. Total Detluctions (total Lines 9 and 10) ............................... .. 11. 22,062.17 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 281,498.60 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... . . 13. 0.00 14. Net Value SubJect to lax (Line 12 minus Line 13) ... ................ .. 14. 281,498.60 TAX CALCULATION -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 .0_ 15. 16. Amount of Line 14 taxable at lineal rate X D ~ 281,498.60 16. 12,667.44 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 L 1505610205 12,667.44 O 1505610205 REV-1500 EX (FI) Page 3 Fil• Number Decedent's Complete Address: DECEDENT'S NAME HAROLD C, FICKES, JR STREET ADDRESS 7 W. MAIN ST CITY STATE ZIP NEWVILLE PA 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 12, 034.81 B. Discount 633.39 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill fn oval 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. (1) 12,667.44 Total Credits (A+ g) (2) 12,668.20 (3) (4) (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 0.00 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred ......................_................................................_.......... ...... ~ ^ b. retain the right to designate who shall use the property transferred or its income ...................................... ...... ^ c. retain a reversionary interest ........................................................................................................................ ...... ^ d. receive the promise far life of either payments, benefts or care? ................................................................ ...... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ 3. Did decedent own an "intrust for" or payable-upon-death bank account or security at his or her death? ........ ...... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate properly which , contains a beneFciary designation? ...................................._..................,......................................................... ...._ ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN 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) CO1 For dates of death on or after Jan. 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 statwte 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 benefciary. 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 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 decedent's lineal beneficiaries is 4.5 percent, except as noted in [/2 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)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by trlood or adoption. REVa503 EXi (pu) ~' Pennsylvania SCHEDULE B OEFAPiMENT OF PEVENOE INHERITANCETAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER HAROLD C. FICKES 21-12-0394 ,~ ~~,~~ ~ ,N,~e n neeoea, insert aoo¢ionai sheets of the same size AxounYHolder(s) Harold C Fickes Axount Number 851-09752-1.9 ~ tit Axount Type Single 6 Financial Advisor Peter B. Arnold, 717-731-1672 3780 Trindle Road, Camp Hill, PA 17011 ~•~ Statement Date Jan 1-Mar 30, 2012 Page 1 of 4 f~I " ~," T 00039362 01 ~4T 0.374 01 TR 00176 EJADD022 100000 ® HAROLD C FICKES 7WMAINST NEWVILLE PA 17241-1003 IIIII~IIII'llll~lll'llllll~llllll~llll'~I~~1~~11~1'lllllllll.~.ll $14,819.95 1 Month Ago i Year Ago $14,673.75 E13,442.66 Important Tax Information All 2011 Consolidated 1099 Tax Statements have been sent to clients. Everyone, including clients who previously received a "Figures Not Final" 1099 for CMOs, REMICs, unit investment grantor trusts, HOLDR trusts or royalty trust securities, should have received a final 1099 by now. Visit us at www.edwardjones.com/taxcenter for more information about securities taxation and the new cost basis regulations. This Period Thh Year Beginning value ;13,810.39 ;13,810.39 Assets added to account 0.00 0.00 Income gg.7g gg_78 Assets withdrawn from account 0.00 0.00 Change in value .910.78 910.78 Ending Value. 514,819.9fi ~ , Ending Cash 8 Money Market - Balance Cash $0.14 Amount Amount Inrested WHhdrawn Stocks Price Quantity Since Inception Since Inception 4alue Penn National Gaming Inc 42.98 96 2,993.99 - 4,126.08 Amount Amount Invested Withdrawn Mufusl Funds Price Quantity Since Inception Simb Inception Value Capital Income Builder Fund A 51.34 127.287 4,717.45 - 6,534.91 Income Fund of America Fund A 17.49 237.783 2,893.53 - 4,158.82 Total AxourH Value 514,819.95 REV-i5o8 EX+ (u-io) ~1 pennsylvania SCHEDULE E DEPARTMENT Of REVENDE CASH, BANK DEPOSITS & MISC. INNERtrarvcE Tax RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: HAROLD C. FICKES, JR 21-12-0394 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. _~ ,~~~~< oyc~e s neeoeD, use aamaonai sneers or paper of the same size. ACNB BANK "~""""'""'"'AUTO""3-DIGIT 172 1824 0.8300 AB 0.374 101 35 I~I~rl~ld~ll~l~.Llih~~l~lll~'I"I'~~I~~'I~"Illgl6~~1~g1111 HAROLD C FICKES JR 7WMAINST NEWVILLE PA 1 7241-1 003 Date 03/06/12 03/07/12 03/20/ 2 03/22/12 03/22/12 03/23/12 0326/12 0327/12 0329/12 o4rovlz 04ro2/12 Account # Statement Date Page ACNE iPad° GNEAWAyI Enter'to win your own iPad 2. Stop by anyACNB Bank Office to enter. bne iPad will be given away each month through May 2012. Ask abodlt the loan that will make you feel better. Vsit acnb.com/betterloan. ~o purchase or account necessary to win. Must be 18 years of age or older. Some restrictions may appty, IPad is a registered tredemark of Apple Inc, w Account Account Summary # Beginning Balance on 03/06/12 + Deposits 8',Other Credits $21 307 64 - Withdrawal$ 8 Other Debits $0;00 -Service Ch$rges $21,308.33 + Interest Paid $0.00 Ending Balance on 04/03/12 $0.69. Days in Statement Period $0.00 28 Account Activity Description Deposits/C BEGIN G redits Checks/Debiffi NIN BALANCE CHECK #2438 CHECK #2 1 $100.00 CHECK #2449 CHECK #2450 CeMuryLink' BILL PYMT SERIAL NUw16ER: 2448 OOOp00000g000314153570 DIRECTV CHECKPYMT SERIAL NUIIABER: 2447 068101613 CHECK #2451 CHECK #24¢4 CLOSING TRANSACTION INTEREST F~AYMENT $87.40 $10'1.77 $34.27 $77'.37 $1,124.80 $16,981.22 $0.69 223972 04/03/12 1 of 3 Balahce $21,307.64 $21,207.64 19,065.64 $18,978.24 $18,876.47 $18,842.20 $18,764.83 $17,640.03 $16,980.53 -$0.69 $0.00 acnb.com • acnbbusiness.com;~ P.O. Box 3129. Gemicburn eu t~a~c _ or,,,.,,, „-, ~„ .,,,. _ „ _ REV-15t0 Ek+!OA-09, '~ Pennsylvania SCHEDULE G DEVARTMENT OF NEVeNDE INTER-VIVOS TRANSFERS AND ~,:NRER;TANCE Tnx RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER HAROLD C. FICKES, JR. 21-12-0394 ___ This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY irvauce T"E wF~EamE rnwsre~,TRETR aEUnuNSwerooECEOErn n"o n+E wTEaTRaasrEa. nrraaacocv or mE OE®roa aEac ESrnTE. DATE Of DEATH VALUE OF ASSET Mo OF DECD'S INTEREST EXCLUSION ;rncwcoa~E TAXABLE VALUE 1. HOUSE & LOT AT 7 W MAIN ST NEWVILLE BOROUGH CUMBERLAND . ., , COUNTY -CONVEYED BY DEED 1999 BUT RETAINED USE UNTIL DEATH 122,500.00 100 122,500.01 2 HOUSE 8 LOT AT 51 BROAD ST., NEWVILLE BOROUGH, CUMBERLAND COUNTY, CONVEYEd IN 1999 BUT RETAINED RENTS UNTIL DEATH 130,400.00 100 130,400.0( 3 ADAMS COUNTY NATIONAL BANK, INDIVIDUAL RETIREMENT ACCOUNT, PAYABLE'TO THREE DAUGHTERS (SEE SCHEDULE J) 7,633.18 100 7,633.1E TOTAL (Also enter on Line 7, Recapitulation) ; 260,533.18 If more space is needed, use additional sheets of paper of the same size. Detailed Results for Parce128-21-0361-043. in the 2010 Tax Assessment Database 2s 28-21-0361-043. 51 BROAD STREET FICICES, LESLIE J C/O HAROLD FICKES RA 2173 15500 114900 130400 .08 1 1 07 06 19 99 1890 lz/3o/zoos D i ~ _ __~ Detailed Results for Parce127-20-1754-155. in the 2010 Tax Assessment Dataha~e z7 27-20-1754-155. 7 W MAIN STREET FICICES,'LESLIE J C/O HAIbOLD FICKES RA 2256 15600 106900 ]22500 .13 1 i 1 07 06 ' 19 99 __ 00203-0032 1875 01/09/200 D ,~ ACNB BANK May 2, 2012 HAROLD C FICK~S ESTATE 7 W MAIN ST NEWVILLE PA 17!241 RE: Hazold C Fickes Jr. IRA Plan ~~ k~~ o~n Dear Ms. Leslie Fiches and Ms. Linda Hockman; As the representativas of the Hazold C Fickes Jr. Estate, we are notifying you of undistributed. IRA. funds so that you rr~ay contact the beneficiaries listed below to make an appointment with a Retail Office Manager and discuss their options regarding the proceeds of this plan. Leslie Fickes Linda Hockman Lorrie Mixell Please contact our dustomer Contact Center by calling (888) 334-2262 at your eazliest convenience and ask to speak witlh Douglas Lindsay, Retail Office Manager of the Newville Office, to schedule an appointment. Sincerely, ~~ Stacey Schuch I Deposit Services Specialist SS/haj acnb.com • acnbbusiness.corrl • P.O. Box 3129, Gettysburg, PA 17325 • Phone 717.334.31611 • Toll Free 1.888.334.ACN6 (2262) G.~ ACNB BANK RETIREMENT ACCOUNT STATEMENT TRADITIONAL IRA HAROLD C FICKES JR 7 W MAIN ST NEWVILLE PA 17241 6-30-11 PAGE 1 * - - - - - - - - - - - -SUMMARY OF YOUR INVESTMENT- - - - - - - - - - - - - - ACCOUNT NBR TYPE OT~' ACCOUNT TYPE RATE MATURES VALUE 9 000192 CERTIF]:CATE OF DEPOSIT VARIABLE .500 1-2~i-12 8,210.75 * EARNI GS NOT YET CREDITED M 3.37 -RETIRE ENT ACCOUNTS TOTAL- 8,214.12 * - - - - - - - - -RE7~'IREMENT CONTRIBUTION/WITHDRAWAL SUMMARY-~ - - - - - - - - BALANCE'~~,AS OF 12-31-10 g~689.gg +DEPOSI7~'S/CREDITS .00 +INTERE~T CREDITED 20,77 -u?T THD~'. WP_TS /.T_1T STRIBTT270D?S 500.00 -SERVICE CHARGES - -00 ENDING FICCOUNT BALANCE 8,210.75 EARNINGS NOT YET CREDITED TO YOUR ACCOUNT 3.37 TOTAL AC~'COUNT VALUE ~ - 8,214-12 TAXES WITHHEI}D _ .00 CON'PRIBUTION5 MADE IN 2011 FORTAX YEAR 2011 .00 * - - - - - - - - - - - - -ACTIVITY ON YOUR ACCOUNT- - - - - - - - - - - - _ _ * DATE ACCOUN'P TYPE OF ACTIVITY AMOUfifT 1-01-11 9000192', INTEREST ADDED 3.69 1-18-11 9000192! DISTRIBUTION 500.00- 2-01-11 90001921 INTEREST ADDED 3-60 3-01-11 9000192!INTEREST ADDED ~ 3.14 4-01-11 9000192 ',INTEREST ADDED 3,4g 5-01-11 9000192~'.INTEREST ADDED 3-37 6-01-11 90001921 INTEREST ADDED 3.48 ~~, ~~c~33 ,Ig acnb.com • acnbbusiness.cor,`~ • P.O. Box 3129, Gettysburg, PA 17325 • Phone 777.334.3161 • Toll free 1.888.334.ACNB (2262) REV-1511 F.X+ (1Q-04) Pennsylvania SCHEDULE H DERARTMENT DEREVENDE FUNERAL EXPENSES AND I'.NHERITANCE iP%RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER HAROLD C. FICKES, JR 21-12-0394 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENS~S: t' EGGER FUNERWL HOME, INC 2,142.00 e. ADMINISTRATIVE Q OSTS: 1. I I Personal Represerytative Commissions: Name(s) of Personal Representative(s) Street Addrkss City ', State ZIP Year(s) Commission Paid: Z AttomeyFees: ~ 11,589.02 3. Family Exemptionii (If decedent's address is not the same as claimant's, attach explanation.) 3,500.00 Claimant 41NDA FICKES Street Addryss 7 W. MAIN STREET City NE~NVILLE State PA z1P 1'7241 Relationship of Claimant to Decedent DAUGHTER 4. Probate Fees: 324.50 5. Accountant Fees: ' 6. Tax Return Prepar~r Fees: ~ PUBLISH ESTAT~ NOTICES, CUMBERLAND LAW JRNL (75), THE SENTINEL (189.54) 264.54 a. REGISTER, TAX ~2ETURN FILING FEE ( 15.00 TOTAL (Also enter on Line 9, Recapitulation) I § 17,835.06 If more space is needed, use additional sheets of paper of the same size. REV-1512 Ex+ (12-08) ~ "' Pennsylvania DEPAPTMENT OF REVENUE IINHERRANCE TA% RETURN I2EStDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS eaEwit ur FILE NUMBER HAROLD C. FICKES, JR. 21-12-0394 ,~ ~~~,,,_ ,Ray= ., IICCIICU, nlse¢ aaolnonal sneers or [nE same size. REV-1513 EX+ (O1-10) ,_ ~ 1,=Pennsylvania SCHEDULE ] DEPARTMENT Of REVENUE 7NRERRANCE TAX RETURN BENEFICIARIES 13ESIDENr DECEDENT , ESTATE OF: FILE NUMBER: HAROLD C. FICKES, JR 21-12-0394 RELATIONSHIP TO DECEDENT AMOUNT OR SNARE NUMBER NAME AN ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTI NS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. LORRIE MIXELL, 121 STEELSTOWN RD, NEWVILLE, PA 17241 DAUGHTER ONE THIRD 2. LINDA FICKES, 7 Wl. MAIN ST., NEWVILLE, PA 17241 DAUGHTER ONE THIRD 3. LESLIE FICKES, 5~ DEWALT DR., MECHANICSBURG, PA 17050 DAUGHTER ONE THIRD ENTER DOLLAR AMOU TS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRI UTIONS A. SPOUSAL DISTRIB TONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. I TOTAL OF PART I> -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ; I, If more space is needed, use additional sheets of paper of the same size. I LAST WILL AND TESTAMENT I, Harold C. Fickes, Jr., of Newville Borough, Cumberland County, 'I Pennsylvania, declare this to be my Last Will and Testament and revoke any (will or cpdicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemgrker and all expenses of my last illness, shall be paid from my residuary', estate as soon as practicable after my decease as a part of the administration of my estate. ITEM~iII: I give, devise and bequeath all of my estate of every nature and wheresoever situate to my daughters, Linda Ann Helm, Lorrie Jayne Mixell and Leslie Jean Fickes, in equal shares, share and share alike, ITEMIII: I appoint Linda Ann Helm, Lorrie Jayne Mixell and Leslie Jean Fickes Co+executors of this my Last Will and Testament. ITEMIV: I direct that my executors or their successors shall not be required tko give bond for the faithful performance of: their duties in.any jurisdiction. IN W#TNESS WHEREOF, I hereunto set my hand and :seal to t((h~~is my Last Will and Testament, written on 0 sheets of paper, dated this d~ day of 1~ ~-Qi~ 1990. v ~ ~^ ~ (SEAL) Harold C. Ficl~:es, Jr. '. The preceding instrument, consisting of this and one other typewritten page, eac-~{t identified by the signature of the testator, Harold C. Fickes, Jr „ was do the day and date thereof signed, published and declared by Harold C. Fickes,', Jr., the testator herein named, as and for his Last Will, in the presence q'f us, who, at his request, in his presence, and in the presence of each other., have subscribed our names as witnesses hereto, ~ ~~"-` ' " ~'L ~ sa --~ residing at ~ ~X.~r~ '~-yL~ I ~ v ~} p~j >i, ~6~t-~ residing at I~P.GJ"~LY-~ COMMONWEALTH OF PENNSYLVANIA: SS COUNTY OF CUMBERLAND , We, Harold C. Fickes, Jr, ,p~Q,~,i (l~ pCf~QTtLand ~'a~tl~ ~/ (~j /(~~f- the testator and the witnesses, respectively, whose names ar signed to the attached pr foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and Testament and that he signed willingly (or willingly directed 8nother person to sign for him), and that he executed it as his free and volunirery act for the purposes therein expressed, and that each of the witnesses in the presence and hearing of the testator, signed the will as witnessesland that to the best of our knowledge, the testator was at that time eighteen ears or older, of sound mind and under no ~=onstraint or undue influence Harold C. Fickes, Jr, ~ G 1~~~ Subscribe, sworn to and acknowledged, by Harold,C. Fickes, Jr., the testator and sworn 'to before me by ~p~ /N ACrfCx ~ ap~ ~t,( !((~iRt(~r witnesses, this p day f r`~b~ 1990. NQTARIAL SEAL PAULA REED, Notary public Shippensburg~i'wp., Cumberland Co., pa, My Commissi n Expire, Dec. 13, 1993 ~'_-.