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HomeMy WebLinkAbout95-0113I ~~ ~ v ~ ~~ This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General. Assembly, approved 29 June 1953, P.L. 304. ;~ AUG 16 20aT Date H105.,~3Rw. 2/87 TYPE/PRMT M PBIYANEl1T ~~ Buac .~ v H ? ' ~_ Fran eropoli, ' act Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH ~ ooa ~~ /n c , ,r.a, noise, us) SE% SOCML SE{TIRTTV NIMS7ER _ __ DATE OF DEATH (Mren, Dey, lYer) ,. HsncMl V. Frost :Male s. 199 ..._ 07 _4862 ~ January 17, 1995 ADE M1+n a~+teer) INJDEn' D•re Hrn 'MhWa avEOFTaTm, BI~RT,wLACE ~ Puce DFDFJSHICIMdteM~one-seehwuc~uamaBwr Has) MawTr I ~~`e" "~'~ OTHER 76 Y° a 1918 Grdnsrs, PA xwwraR] ER^DrPetwtr ^ Da ^ . N"~~, ° ^ R~rr~ ^ ~,., ^ CDUtm'OFDEATH CfTY, TNNq,TTNP aF DERH FACBfTY NAMEIB riatYrataon.Ow menand neriDSr) WA~Sa yDE~CEDENT aF FSSFATAC ORKNN7 RACE-Anwken Cumberland Carlisle NI,01 n.^B,«.eP«B,cuWn. 1~.c+~ Mn,TiYee.wnw,eb CarNsle Hospital Metkrt,PUr,oRbrl,NC. yyryl~e '°. as ,a DECEDENT'S UffiIAL OCCUPRION pND OF BUSINESSIINDUSTRY WAS DTSEDEMEVERW DECEDENT'S EDUC.YgN New~Nertte4 WMO,.ad. WnOtl wpkCpuaw.~o mon LLS. ARMED FORCESY SURVMND SPOUSE . _o(korlYraMr.: ao nr ur re&ea.l y~ l,' prae. Wre mresn rem•1 1, LBDOref 11A r 17. N(TJ No ^ ,7~ (t,~) /•. ••~ oECEDENraMAiuNOADDRESS~.r.cMrton.s~r,.zgo,ae, DECEOOrrs +s. PA 1020 Goodyear Road ~sTD~ENCE ,Ta sNb Db n~l Kti e.c•are Bv.a ~ (Sse Mtru Mo•yry P IMNe ,a Pa °"°""'n0y „a Cumberland p4 ,Ta^ ~~a Rar,En's NAME IRrr. MiOda, Lan) Mo7HFA'S W WER~ lidfl•. Mrden fie, e~~• ,~ EM(S Frost 'r'l'ewiw.l. ,R • O~ tNFDnAANr s MATLrq ADDRESS (SD•eL cayrb•n. sw. rp code, 57 Ladnor Lana Carl(Ne PA 17013 METHDOaFaePDerrtoN TJATEOFDiSPOBRgN eurte~ Creme,bn^ RMnarr D•o 9gee^ PA01MA. Dex Ken PucEOFD~ePOSn,oN-w~n.ac.m•Nmc~e.b.Y Loc~DwN-o*rrrD.ns+.aPCee. >OtTrrPTea Drrbn^ ,~ ^ =10. Jatuary 21, 1995 Uriah Chtxch CerrTetsry South MlddkloTT Twp., PA 17324 7,e FUNERAL DR PERSON ACTIND A9aucH NUMBER . Tna NAME ANO ADORESSOFTi1CBITY ~ Fta,Bral Hama, kTC. FS-011589-L ~~~~ ~ 501 N. BaltlmorsAw., ML Hdlg Sgigs, PA 17085 oe.ayYq TbIMDeramybgwNdpa, oxereerBrtlin.. ane PM1/ek1eB bna ertLMe r,hN a dwN b ~• •~~ LtCENBE NUM B ER DQE sq„~ (MOreh. Day, ) eewdAarn. ~,~,~~ ~~ ~ / ~ S ~~ ~ Tlatne242B Her DeoonpedDY oFT)ERH DRE D 9AUen,Ory, Kan NNSCABE REFERREDroMEpCAL E%AMNIEI4(,'CRDNER9 / Preaew,b taorouww he,A. / / 1 K. ^ 21. ~ Y N• M. I S ~ S7. FAIT-I: Enbr,Mdle.re, hJuriwrmngRerbna wDbD CrwedtM OeM.fb narAr„r mrba atwn orrrpiretwy ell•n.nbdt ar lrert,e7va. l acaridear W,eTWYgbdwn lJranly pw oust on serJt eru. APFade b PAITr S: Olhar taA , a~~Mi[~lFetel ~~ ~ janM enddeelA not eeuBYp h,Marrnyhpeauaa Wwnh PART I. ,n~ {p~ I ~ - ~ ' " ~~~~'~~ ' r~atYph Mrhl-- a. - Law ' G ~ T u ~'Y14'N.R-r LiiLS~! .-i C ~ L. S TJUE ro (OR AS A CONSEWENCE oF): Se4tenBrtYer COndlto,r p ~ ~ DUE TO (OR ASACONSEOUENCE Oq: _. , ~ QAtNEID4eabar hjury o. I ~ raltitghtleeN LAST DUE ro(OR ASACONSEOUENCE OF): I d WAB AN AUTOPSY WERE AUTOPSY FlNDING9 MANNER OF DEATH DOPE OFINJURY TIMEOFINJVRY INJURY AT WORK7 DESI:RIBE HOW aUURY OCCURRED. PERFORMEm rut PRIORro IL,onm Day Kar) . . COMgETK)N OFCAUSE ~ OF DEATH? NNwn HombNa ^ ~(/ Ambler ^ Psndkp hrrtlprbn ^ Yr ^ NO^ ^ w Na IC_T~ K. ^ No ^ Suk10. ^ caee nalwaetermhw ^ M" PLACE OFIWURV-N hanr ,rm eD••t ,ectorY olRCa LDC T , . , . A KIN (Street. Cayibat, SN,e) ?m. 39. . Me.lSPeoi~'1 t7HtTtnetla,ecemvane) . ' C61TiYNDPNYSI I SIONR ~ C MITPDYeicisn cerdlyinp crweadeed. wnen anMrphyaicbn tue P,aw,,,wgt d,~q,b w.wMad Hem 23 URE ANTI, OFC IFIER ~ ~ ~'Gd J` nM anenMeBa, daeW omune/ A,r b,M ) \) ee„eNp eM wrtnerrretad ..................................................... ~91b 'LL r ~~! L . 'PRDNDUNC11q AND CF.R7IFYINa PNYSIC,IW LICEi19E NU ER _ ~/~ -~ (PDYanan twin pandawinD tle6lneM rocauntlOeelh /~ ) DATE SgNE 1Mmtl+, DaY, ,~ To YU berary TmewbnpglarD aeeweW rtlb,Iwb, deN, ear pboe, ntn dueb al rWtnwwrrraNd .......................... ^ 7/a.~ G ~/ ~ ~G~T ~~~ 770. NAME AND ADDRESS OF W/q COMPLETED CAUSE OF DEATN •IIIEDICAL EXAMNEp/COpONep (11tH 27)Typa or Print 1~~~ ~~ J On M B i a / • Ba e neen6,etfon anC/or im•atlpatlo,,, in my oplnbn, dsrh oeCWrad at tl,e 14na, dra, II,E ~ `/ enr,ner M •bbd...... PTeo•. and dtr b iM ewna(q rM ...................................... N '951GNATURE AN R ~' /LL ~~~ i(~ ~~C'-~ . DATE FILED (MOnN. oey, v ) aa ~ 77. 7a. ~~~ . i~ . r a ~-- _ ~s' `;; '~Es _ ,soo Ex : (,-~,>` ~~ ,~ 5 0 ~1'7 9 ~ 0 ~` COM~AOPAW ~~•T•pO~F P EN ANIA HARRISRG, F'/~8_p8p~ D E C E D E N T E R O K P S O O R N R D S N - T R E C A P I T U L A T I O N T A X C O M P u T A T I O N /V /J -' INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE 7ECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Frost Hershell V iOC1AL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH 199-07-4862 01/17/1995 09/02/1918 APPLICABLE) SURVIVING SPOUSE'S NAME (LAST,FIRST AND MIDDLE INITIAL) 1. Original Return 4. Limited Estate ^X 6. Decedent Died Testate (Attach copy of wll) ALL CORRESPONDENCE AND NAME Roger B. Irwin 'ELEPHONE NUMBER 717-249-2353 3. ~5. 0 8. CHECK HERE AMOUNT RECEIVED (SEE INSTRUCTIONS) 0.00 Remainder Return (for dates of death prior to 12-13-82) Federal Estate Tax Retum Required Total Number of Safe Deposit Boxes LETE MAILING ADDRESS ('~ ('~ IRWIN, McKNIGHT~_ r_~'HUGHEB 60 West Pomfret-'Street f Carlisle PA 17b1~ -- 1. Reat Estate (Schedule A) 1 5 , 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Hekf Stock/Partnership Interest (Schedule C) (3) Noi3e 4. Mortgages and Notes Receivable (Schedule D) (4) Node 5. Cash, Bank Deposits 8, Miscellaneous Personal Property (Sch. E) (5) 275 , 933 . $ ~ -'_ 6. Jointly Owned Property (Schedule F) (8) _ 5 , 006.09 ` 7. Transfers (Schedule G) (Schedule L) __ (7) None 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous (9) 49 181.71 Expenses (Schedule H) _ , 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 969.87 11. Total Deductions (total Lines 9 r£ 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 15. Spousal Transfers (for dates of death after 6-30-94) S I ~, (8) 355, 939.89 (11)__ 50 ,151.58 (12) 305 , 788.31 (13) 300 , 782.22 (14) 5 , 006.09 ee nstructions for Applicable Percentage on page 2. (15) 0.00 X = 0.00 (Include values from Schedule K or Schedule M.) 16. Amount of Line 14 taxable at 6% rate (16) 0.00 X .06 = (Include values from Schedule K or Schedule M.) 0.00 17. Amount of Line 14 taxable at 15% rate (17) 5 , 006.09 X .15 = (Include values from Schedule K or Schedule M.) 750.91 18. Principal tax due (Add tax from Line 15, 16 and 17.) (18) 19. Credits/Sp Poverty Prior Payments Discount 750.91 Interest 0.00 + 0.00 + 0.00 0.00 (19) 0.00 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20) Q ^ ~lo;ck:heie it ; ~iar±s:r :; uwistii7 arofunes(vt ai+r ov:: mint: 0.00 21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) A. Enter the interest on the balance due on Line 21A. 750.91 B. Enter the total of Line 21 and 21A on Line 21 B. This is the BALANCE DUE. (21A) 0.00 Make Check Pa able to: R aster of Wills, A snt (21B) 750.91 - - BE SURE TO ANSWER ALL tiUESTIONS ON PAGE 2 AND TO RECHECK MATH ~ ~ correct and eomplet~e,riudryecjere that all areal estate h s txen reported at true m~ark~etovmal~ue Declaration of ~ta~~' t° t e o preparer other than the ~ now e a e , t s true, which preparer has any knowledge. personal representative Is based on all information of SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Roger B . Irwin 60 West Pomf_r_ et Street DATE ' Carlise, PA 17013 -----"----"-----"--"--'---'-'- RE PRE OTHERT AN REP ESENTATIVE IRWIN, McKNIGHT & HUGHES ~ 60 West Pomfret Street GATE ----------------------------------------------------- ~i~t'%1'ar Carlisle PA 17013 Copyright (e 199 form soft y Systems, inc. Form (Rey; 7_gq) FOR DATES OF DEATH AFTER 12/31/91 IF A SPOUSAL POVERTY CREDIT IS ~M D FILE NUMBER 21-95-113 DENT'S COMPLETE ADDRESS 1020 Goodyear Road Gardners, PA 17324 ty Cumberland SOCIAL SECURITY NUMBER 2. Supplemental Retum 4a. Future Interest Compromise (for dates of death after 12-12-82) ^ 7. Decedent Maintained a Living Trust (Attach a copy of Trust) ~ENTIAL TAX INFORMATION SHOULD BE [ TO: r , Act #48 of 1994 provides for the reduction of the tax rates imposed on the net vaiu~ ~4 transfers to or for the use of the spouse. The rates as prescribed by the statute will be: •3°~6 (.03) will be applicable for estates of decedents dying on or after 711194 and before 1/1196 •2% (.02) will be applicable for estates of decedents dying on or after 111196 and before 1/1197 •1°~ (.01) will be applicable for estates of decedents dying on or after 111/97 and before 111198 .Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS. 1. Did decedent make a transfer and: 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; or . . d. receive the promise for I'rfe of efther payments, benefits or care?. .. .. . 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an 'intrust for' bank account at his or her death? .. . YES NO X X X X X X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Copyright (c)1994 form software only CPSystems, Inc. Form 1500 (Rev.7-941 REV - 1502 EX + (12-85) ~M~N~~~q~$~~/ANIA I SCHEDULE A ~~ff''^" REAL ESTATE ESTATE OF _ FILE NUMBER Hershell V. Frost SS~~ 199-07-4862 01/17/1995 21 95 113 (Property jointy owned with Right of Survivorship must bs dlselosed on Schedule F) All real estate should bs roported at fair market value which is defined as the price at which property would bs exchanged between a willing buyer and a willing seller, neither being compelled to bu or sell, both havin reasonable knowled • of the rokvant facts. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 1020 Goodyear Road, - Gardners, Dickinson Township, Cumberland County, more particularly described in Deed Book"M", Vol. 12, Page 347. Property sold 06/23/95 to Rodney L. and Delores J. Shields (settlement sheet attached). TOTAL (Also enter on line 1, Reca itulation) (If more space is needed, insert additional sheets of same size.) Gopyrlght (e)1994 form software only CPSystems, Inc. 75,000.0 s 7 000.00 Form 1500 Schedule A (Rev. i2-es) REV - 1508 EX + (2-87) COM ~~~A~T}{~~gy~yANIA SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS Hershell V. Frost SS~~ 199-07-4862 01/17/1995 II roe 'oi owned with Ri ht of Survivorshi must be diselos~d'on Sdr ITEM NUMBER DESCRIPTION 1 Adams County National Bank, ;.- checking account ~~141-806-8 (confirmation attached) 2 Adams County National Bank, Certificate of Deposit ~~44-0000049 (confirmation attached) 3 Adams County National Bank, Certificate of Deposit ~p44-0004643 (confirmation attached) 4 Aetna car insurance cancellation refund 5 Costume Jewelry sold 6 Donegal Companies, refund homeowners policy cancellation 7 1990 Lincoln Continental sedan, VIN42502524801FR sold 05/13/95 to Charles O. and Phyllis L. Marks 8 Meridian Bank, Certificate of Deposit ~~3034010060 (confirmation attached) 9 PNC Bank, N.A., Certificate of Deposit ~p1713160114271 (confirmation attached) 10 PNC Bank, N.A., refund of; credit balance on credii»~'~ card 11 Proceeds of public sale held 05/13/95 by Charles Spahr (see continuation schedule attached) Total of Continuation Schedule(s) TOTAL (Also enter on line 5 Reca itulat' ) 21-95-113 VALUE AT DATE OF DEATH 27,104.15 15,036.68 wn s (Attach additional 8 1/2" x 11" sheets if more space is needed.) Copyright (e) 1994 form software ony CPSystems, Inc. Form 1500 10,024.45 53.00 603.00 22.00 14,500.00 15,010.59 50,141.03 18.00 12,933.00 130 ,,4$7 , 90 2 933.80 edule E (Rev. 2-87) Estate of: Hershell V. Frost SS~~ 199-07-4862 01/17/1995 CONTINUATION SCHEDULE Continuation of Schedule E ITEM DESCRIPTION VALUE AT DATE ~~ OF DEATH 12 TV Cable of Carlisle, 10.34 cancellation refund 13 Waddell & Reed Financial 6.71 130 477.56 Services, United , Accumulative Fund (confirmation attached) 130,487.90 f ,:^ REV - 1509IX + (t2-gg) coM~~gH41'fb1~r>Y "' ANIa SCHEDULE F ___ _ __ ~~b""~~ r~Y'" JOINTLY-OWNED PRI Hershell V. Frost SS~p 199-07-4862 Ol 17 1995 r~~t nuttAeER 21-95-113 Joint tenant(s): NAME A. Arietta Orris B. C. Jointly-owned property: ITEM L FOR R DATE NUMBER JOINT MADE TENANT JOINT 1 A 02/198 ADDRESS 57 Ladnor Lane Carlisle, PA 17013 RELATIONSHIP TO DECEI iend DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF OF ASSET °~, INT. ECEDENT INTEREST Farmers Trust Company, 10,012.18 50.00% 5,006.09 Certificate of Deposit ~~32164 (confirmation attached) TOTAL (Also enter on line 6, Reca Rulation) 5 , 006.09 (If more space is needed, insert additional sheets of same size.) Copyright (c) 1994 form software only CPSystems, Inc. Form 1500 s~nedule F (Rev, ti-se) REV - 1511 EX r (7-88) COM ~I~~gl,jj{,a~,gy~vANIA SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND C, SATE OF Hershell V. Frost SS~p 199-07-4862 O1 17 1995 ITEM NUMBER DESCRIPTION A• FuneralExpsnses: 1 Gibson-Hollinger Funeral Home B• Administrative Costs: 1. Personal Representative Commissions Roger B. Irwin Social Security Number of Personal Representative: 193 - 24 -1402 Year Commissions paid 1995 2. Attorney Fees Irwin , McKnight & Hughe s 3. ~ Family Exemption Claimant none Address of Claimant at decedent's death Street Address Cky 4. ~ Probate Fees C• Miscellaneous Expenses: 1 Advertising costs for sale of costume jewelry 2 Cumberland Law Journal - estate notice publication 3 Charles Spahr, lr commission on sale of real estate at public sale 4 Charles Spahr, l0y commission on sale of car and household items at public sale State Zip Code (see continuation schedule attached) Total of Continuation Schedule(s) TOTAL (Also enter on line 9. Recaeitularlnnl ~n moro space ~s neeaea, insert additional sheets of same size.) i Copyright (e)1994 form software only CPSystems, inc. Form Relationship oror Ty~~ ILE NUMBER 21-95-113 AMOUNT 7,311.20 ~ ,.. 17,300.00, 17,300.00 0:00 302.00 26.40 40.00 750.00 2,743.30 3 , 40$ :'$1 s' -'181.71 u1e H (Rev. 7-88) Estate of: Hershell V. Frost SS~~ 199-07-4862 01/17/1995 CONTINUATION SCHEDULE Continuation of Schedule H-C ITEM DESCRIPTION ~~ AMOUNT 5 Settlement charges on real estate at 1020 Goodyear Road, Gardners, PA 6 Patricia A. Rosendale, CPA, preparation of 1994 personal income tax returns 7 Patricia A. Rosendale, CPA, fiduciary income tax return preparation 8 Register of Wills, filing fees 9 Advertising, tent and toilet rental fees at public sale 10 Public Sale preparation help - 375 hours 11 The Sentinel - estate notice publication 785.00 80.00 75.00 25.00 870.97 1,504.00 68.84 3,408.81 °' REV - 1512 EX + (1-93) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCETAX RETURN _-_ - RESIDENT DECEDENT MORTGAGE LIABILITIES MID Hershell V. Frost SS~~ 199-07-4862 01/17/1995 21-95-113 ITEM NUMBER DESCRIPTION AMOUNT 1 Aetna Casualt I y ns., automobile policy ~p233 SY 94.00 2936245 2 Adams County National Bank, check wrote 01/14/95 cleared 76.13 bank 01/20/95 3 Adams County National Bank, check wrote 01/13/95 cleared 90.52 bank on 01/18/95 4 Irwin, McKnight & Hughes, 01/13/95 Power of Attorney 36.00 preparation 5 Met-Ed, acct. ~~6643 17 452517 154.47 6 R & A Bender, Inc., acct. ~~BC2350 260.00 7 RWC Emergency Physicians, acct. ~~8531717 62.36 8 Carolyn R. McQuillen, county real estate taxes for acct. 142.85 ~~08423279014 9 United Telephone, account ~~ 717-486-3938 (258) 53.54 TOTAL (Also enter on line 10, Reca itulation) S {If more space is needed, insert additional sheets of same size.) Copyright (e) 1994 form software only CPSystems, Inc. Form 1500 a6~9.87 I (Rev. 1-93) REV - 1513 EX + (2-87) CDMIMN~NT~NT ANIA SCHEDULE J ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: 1 Uriah United Methodist Church 925 Goodyear Road Gardners, PA 17324 TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitula (If more space is needed, insert additional sheets of same size.) Copyright (c) 1994 form software only CPSystems, Inc. AMOUNT OR SHARE OF ESTATE 300,782.22 300,782.22 Form 1~ Schedule .I (Rev. 2-B7) ~, .. -- - ~, _ o~ , , ~~x~~ i11 ~n~ ~~~t ~~en~ I, HERSCHELL V. FROST, o f Dickinson Township, Cumberland County, Pennsylvania, declare this instrument to b~e my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. 1. I direct my executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2• I authorize and empower my executors to sell any realty owned by me at my death and not specifically devised or bequeathed herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I give, devise and bequeath .all-of my estate, of every nature and-wherever situate to Uriah United Methodist Church. 4. I nominate and a ....` ppoint Roger B. Irwin and. Harold S. Irwin, _..... a.,.~:.. Jr., to be the executors of this my last will and testament; they are to serve as such without bond. 5. I hereby suggest that my personal representative retain _. , _ . the services of Irwin, Irwin & Irwin, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~,_. da .~ .....~ ___..._ .. . y of February, 1980. . ~~ ~~ ~`~~~ ~ "-Iz~~'~ ( SEAL ) HERSCHELL V. FROST Signed, sealed, published and declared by Herschell V. Frost, the testator above named, as and for his last will and testament, in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses zereto. '\ "" ~ Ili c~ a ~l1 ACKNOWLEDGEMENT AND AFFIDAVIT We, HERSCHELL V. FROST ~ BETZI A. MORRISON , and J. MARIE JONES , the testator and the witnesses, respectively, whose names are signed to the 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 that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator , signed the Will as a witness and that to the best of their knowledge the testat or was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~~~~ ~L~~ J~~ HERSCHELL V. FROST BETZI A. MORRISON J. MARIE JO S COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by HERSCHELL V. FROST , the testator , and subscribed and sworn to before me by BETZI A. MORRISON and J. MARIE JONES , witnesses, this Sr day of February 19 80 c„ :~e ~~ ray, ~~~;: ~, c_~ :,_ .,~.:,3 couhrr