HomeMy WebLinkAbout10-26-12 (2)~--~ REV-1500 Ex (o1-10) 1505610143
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania county code veer File Number
Bureau of Individual Taxes OEPnR7MENT OF REVENUE
Po Box.2aoso~ INHERITANCE TAX RETURN 21 12 0 0 3 7 9
Harrisburg, PA f7128-0801 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03 03 2012 07 O1 1926
Decedent's Last Name Suffix Decedent's First Name MI
DWIGHT ALICE J
(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
® 1. Original Retum ^ 2. Supplemental Return ^ 3. Remainder Retum (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ qa Future (Merest Compromise ^ 5. Federal Estate Tax Retum Required
(date or death aner 12-12-t32)
® 6 Decedent Died Testate
(Anach copy or wn) ^ ~ Decedent Maintained a Living Trust ~ 8. Total Number of Safe De
(Anach copy of Trust) -.- posit Boxes
^ 9. Litigation Proceeds Received ^ 1 p, Spousal Poverty Credit (date or death 11. Election to tax under Sec. 9113 A
between 12-31-91 and i-1-95) ^ ( )
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name
Daytime Telephone Number
DEBRA R WALLET 717 73~ 1300''
C ~ ~.
'"
_
REGISTER~~k,S US~l NLY':j 7
;;..
3, N ~- ni
First line of address - --
7 ~~~ -:°, p~
x, ~~
24 NORTH 32ND STREET ~c~~~`,~ -~ `~~ `~-,
Second line of address O ~ ~
~: i
~ -.., --
D -n
~:!
~
G~ pp
~ '~
City or Post Office
-..t
DATE FILED
State ZIP Code 7
CAMP HILL PA 17011
Correspondent'se-mail address: walletdeb~aol.com
Under penalties of perjury, I deGare 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. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
1~Q~c 11, ', ~4cc~ . Debra K. Wallet ita~23~~Z
ADDRESS
450 Allenview Drive, Mechanicsburg, PA 17055
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
4,Q~,~,1~. (n~la,t-- ~, Debra K Wallet ~I /23/~t,
ADDRESS
24 North 32nd Street, Camp Hill, PA 17011
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
oeceae~rs Name: DWIGHT , ALICE J
RECAPITULATION
1. Real Estate (Schedule A) .......................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)... ....... 3.
4. Mortgages i~ Notes Receivable (Schedule D) .................................................. ........ 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ......... ....... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ...... ....... 6.
7. Inter-Vivos Transfers i3< Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ...... ....... 7.
8. Total Gross Assets (total Lines 1-7) ................................................................ ....... g.
9. Funeral Expenses & Administrative Costs (Schedule H) .................................. ....... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......................... ....... 10.
11. Total Deductions (total Lines 9 & 10) ............................................................... ....... 11.
12. Net Value of Estate (Line 8 minus Line 11) ...................................................... ....... 12.
13. Charitable and Governmental 13equestslSec 9113 Trusts for which
an election to tax has not been made (Schedule J) ........................................... ...... 13,
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... .. 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 4 0, 0 0 0. 0 0 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 2 9 2, 8 5 0. 0 0 18.
19. Tax Due ................................................................................................................... .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Decedent's Social Security Number
1,087,659.40
1,087,659.40
33,695.56
6,357.15
40,052.71
1,047,606.69
714,756.69
332,850.00
1,800.00
43,927.50
45,727.50
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21 - 1 2 - 00379
Decedent's Complete Address:
Dwight, Alice J
STREET ADDRESS
1705 Chatham Road ____
CITY STATE ZIP
Camp H[II PA 17011
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1)
2. Credits/Payments
A. Prior Payments 38,000.00_
B. Discount 2,000.00
Total Credits (A + B) (2)
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)
45,727.50
40,000.00
0.00
5,727.50
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "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 life of efther payments, benefits or care? ...............................
2. If death occurred after December 12, 1982, did decedent transfer properly within one yE
receiving adequate consideration? .........................................................................................
Yes No
.............................. I^~ ~ XVV~,,
.............................. ^ J
.............................. ^ [x
gar of death without
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~~ [x lI
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary 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) (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) u)]. 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
adoptive parent, or a stepparent of the child is 0 percent p2 P.S. §9116 (a) (9.2)].
• 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 p2 P.S. G9116 (a) (1.3)1. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w ether y blood or adoption.
~ SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
DOMMONWEALTH°FPENN3VLVANIA PERSONAL PROPERTY
INHERITANCE TA%RETURN
RE6IDENT DECEDENT
ESTATE OF Dwight, AIICe ~ FILE NUMBER
- 21 - 12 - 00379 ----
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must lie disclosed on schedule F.
_ . ---
----- -
ITEM ---- - ----- _
NUMBER DESCRIPTION
_ _- -
1 Ameriprise Financial Account #000292177094133
2 Schwab Acct. #440016426395
3 Schwab Acct. #50640662
4 Santander Checking Account #181117800
5 Santander Savings Account #354010753
6 2005 Toyota (based on Kelly Blue Book value)
7 Household items
8 SecurChoice (funeral pre-payment trust account)
9 2011 federal income tax refund
10 Gold watch (based on attached appraisal)
11 Costume jewelry
12 Highmark Prescription Drug Plan refund
13 2011 Income Tax Refund
VALUE AT DATE OF
DEATH
143, 821.89
152,057.21
770,170.63
1,541.84
42.87
11,850.00
225.00
1, 768.00
371.00
750.00
25.00
88.40
4, 947.56
I TOTAL (Also enter on Llne 5, Recapitulation) I 1,087,659.40
SCI-EDULE H~~.w
COMMONWEALTH OP PENNSYLVANIA rM~ ~" "r ~+~~
INHERITANCE TAX RETURN ~~y~~~Q~~/~~ /~ /'-~
RESIDENT DECEDENT ~'~L~I~wr~7 1 rV'~ I IYG VW~
ESTATE OF Dwight, Alice J FILE NUMBER
-__-- _____._---_-- 21 - 12 - 00379
------ -----
e is of decedent must be reported on Schedule I.
-----------------
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 j Musselman Funeral Home & Cremation Services, Inc.
1,768.00
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
1
Street Address
2.
3.
4.
Cdy State Zip
Year(s) Commission paid
Attorney's Fees Debra K. Wallet, Esq.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip j
Relationship of Claimant to Decedent
Probate Fees
5. ~ Accountant's Fees Waggoner, Frutiger & Daub, CPA
6. ~ Tax Return Preparer's Fees
7. I Other Administrative Costs
1 ,Postage, photocopies, etc.
30,000.00
817.50
735.00
30.00
TOTAL (Also enter on line 9, Recapitulation) 33 685.56
Sdiedt,re H
COMMONWEALTH OF PENNSYLVANIA w~,, p"~',-.."~~ ~7'~' ^^"' «
INHERITANCE TAX RETURN -- ~ ~ri~' f~...,a~..
RESIDENT DECEDENT ~AI.~
ESTATE OF Dwight, Alice J FILE NUMBER
00379
2 ~ Wire transfer fee T,___---- --
12.00
3 ~~ Cumberland Law Journal (advertisement of grant of letters) 75.00
4 ,The Patriot-News (advertisement of grant of letters)
i 99.66
5 AAA (vehicle transfer) ', 75.90
6 '! Commonwealth of PA (vehicle transfer) '~~ 22.50
7 Munn's (watch appraisal) I 60.00
Page 2 of Schedule H
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA 'i
INHERRANCETAx RETURN LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF Dwight, Alice J
FILE NUMBER
21 - 12 - 00379
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, includi ng unreimbursed medical expenses.
--
ITEM
----------
------------ -----
- - _-- - --
NUMBER DESCRIPTION AMOUNT
1 Citicard credit card (Ascensionpoint Recovery Services) 733.36
2 Bonnie K. Miller, Treasurer (2012 personal taxes) 9 80
3 US Treasury (2010 income tax) 4,935.00
4 PA Department of Revenue (2010 income tax) 426.00
5 PA Department of Revenue (additional 2011 taxes) 111.99
6 I Erie Insurance (auto) I 141.00
_ I TOTAL (Also enter on Line 10, Recapitulation) I 6,357.15
REV-161 ~ EX+ (11.08)
SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
i
ESTATE OF
Dwight, Alice J
NUMBER ~ NAME AND ADDRESS OF PERSON(S)
RECEIVING PROPERTY
I~ TAXABLE DISTRIBUTIONS [include outright spousal
distributions and transfers
under Sec. X116 (a) (1.2)]
1 ':: Kimberly K. Bartlett
1705 Chatham Road
Camp Hill, PA 17011
2 ;Denise Smith
9800 Ferguson Road
Charlotte, NC 28227
3 ~~ Bonnie Price
610 Terraine Avenue
Long Beach, CA 90814
II.
RELATIONSHIP TO
DECEDENT
Do Not LIM Truttes~s)
Friend
Stepchild
Stepchild
FILE NUMBER
21 - 12 - 00379
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
$250,000,
automobile,
household items
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate.
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Bethesda Mission
2101 N. Front St., Building 1, Suite 301, Harrisburg, PA 17110 !,
262,075.00
20, 000.00
20,000.00
714,756.69
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
714,
Rl3V-167 S EX+ (8-0ll)
SCHEDULE)
CDMMNHERITANCETAXRETURNANIA BENEFICIARIES continued
RESIDENT DECEDENT
- ----
ESTATE OF Dwight, Alice J
UMBER --
_- -
~ NAME AND ADDRESS OF PERSONS
O
~ ~ RELAI
' DE
RECEIVING PROPERTY _ _
_-- -..- ' Do Not
I
•
TAXABLE DISTRIBUTIONS [include outright s ousal
p
distributions and transfers
i
~ under Sec. X116 (a) (1.2)]
4 ~ Nancy Gilbert 'Grand I
j 1499 Forest Lake Boulevard
Wantagh, NY 11793 ~
I
5 Scott Hilbrandt
Grand I
23 Lincoln Street
Farmingdale, NY 11735
6
' Debra K. Wallet
2
Friend
I 4 North 32nd Street
j Camp Hill, PA 17011
Page 2 of Schedule J
FILE NUMBER
21 - 12 - 00379
®~'
~][e~C]E ~o ~WIG~7[°
I, ALICE J. DWIGHT, of Camp Hill, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory, and understanding, do hereby make, publish, and declare
this to be my Last Will and Testament and hereby revoke all other Wills and Codicils that I
have made, including the Will dated December 27, 2007.
FIRST: It is my wish, and I direct, that after my death my body be cremated and
that my ashes be scattered at the convenience of my Executrix. I further direct that there be no
funeral services held.
SECOND: I direct that all stock I own at the time of my death be sold immediately
after my death and the proceeds be made part of my Estate and distributed in accordance with
paragraphs THIRD through FOURTH below.
THIRD: I give and bequeath to the individuals whose names are set forth in the
Schedule attached to this, my Last Will and Testament, the respective legacies described on the
said Schedule. I have signed this Schedule in the margin for purposes of identification.
Should any of these individuals fail to survive me by thirty (30) days or should said person for
any reason be unable, or otherwise refuse, to accept the gift, then that gift shall become a part
of my residuary estate.
FOURTH: All the rest, residue, and remainder of my Estate, of whatever nature and
wherever situate, I give, devise, and bequeath to THE BETHESDA MISSION, of Harrisburg,
Pennsylvania. I specifically direct that this bequest be used for a capital project related to the
women's shelter or an associated program for women.
FIFTH: All interests of any beneficiary in the income or principal of this Estate,
while undistributed and in the possession of my Executrix, even though vested and
distributable, shall not be subject to attachment, execution or sequestration for any debt,
contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to
pledge, assignment, conveyance, or anticipation.
SIXTH: All inheritance, estate, and succession. taxes (including interest and any
penalties thereon) payable by reason of my death shall be paid out of and be charged generally
against the principal of my residuary estate, without apportionment or right reimbursement
from any person. In the event that a substantial portion, as determined in the sole and absolute
judgment and discretion of my Executrix, of the non-probate assets such as an annuity or
mutual funds are directed to be paid to a beneficiary or beneficiaries, so that the taxes referred
to herein would be paid out of the probate residue passing to the beneficiary or beneficiaries of
this will (whether or not the same as the beneficiary or beneficiaries under the non-probate
assets), my Executrix, in the Executrix's sole and absolute judgment and discretion, shall have
the right to allocate the full or partial payment of the taxes to the beneficiary or beneficiaries of
the non-probate assets.
SEVENTH: In addition to all rights and powers conferred by law, I authorize and
empower my Executrix and her successors, in her absolute discretion and without necessity of
obtaining court approval:
A. To buy investments at a premium or discount.
B. To hold property unregistered or in the name of a nominee.
C. To give proxies, both ministerial and discretionary.
D. To compromise claims.
E. To join any merger, consolidation, reorganization, voting trust
~:
plan, or any other concerted action of security holders and to delegate discretionary duties with
respect thereto.
F. To lend to, and buy from, my estate.
G. To borrow and to pledge real and personal property as security therefor.
H. To sell at public or private sale for cash or credit or partly for each, to
exchange, or to lease for any period of time, any real or personal property, and to give options
for sales, exchanges, or leases.
I. To exercise any option permitted by law which she believes to be
advantageous from the viewpoint of overall tax reductions, including, without limitation of the
foregoing, power and authority to claim administration or other expenses either as income tax
deductions or inheritance or estate tax deductions, without regard to whether they were paid
from principal or income and without requiring adjustments between principal and income for
any resulting effect on income or estate taxes, and a deduction of such expenses for income tax
purposes shall be given effect in computing the respective shares of all persons interested in
my estate set forth herein, even though the effect is to increase the share of one beneficiary or
class of beneficiaries hereunder at the expense of another; and to make such adjustments, if
any, between beneficiaries with respect thereto as she shall deem appropriate in view of the
nature of the transaction and the amounts involved.
J. To distribute in cash or in kind or partly in each.
The powers granted hereunder shall be exercisable with respect to all real and personal
;~~
l
property, including, but not limited to, income and principal held for minors or disabled
beneficiaries at any time, until the actual distribution of all property. All powers, authorities
and discretion granted here shall be in addition to those granted by law and shall be exercisable
without leave of court. However, nothing herein shall be interpreted or construed to
encourage, authorize, empower, or permit the Executrix to act or cause anyone to act in a
manner contrary to or inconsistent with accepted standards of portfolio diversification and risk
management.
EIGHTH: I nominate, constitute, and appoint my friend and attorney, DEBRA K.
WALLET, of Mechanicsburg, Pennsylvania, as Executrix of this, my Last Will and
Testament. I make this appointment primarily because I have no relative who can perform
these duties for me without substantial personal burden. In the event of the renunciation,
death, resignation, or inability of my attorney to act for whatever reason in this capacity, then I
nominate; constitute, and appoint my friend, KIM BARTLETT, of Camp Hill, Pennsylvania,
as Executrix of this, my Last Will and Testament.
I direct that no representative named above shall be required to post security for the
faithful performance of her duties in any jurisdiction insofar as I am able by law to relieve her
of such obligation. It is my wish, and I direct, that DEBRA K. WALLET take three (3 %)
percent of my gross probate Estate or Thirty Thousand ($30,000) Dollars, whichever is less,
for the performance of her duties as my Executrix. I am making this direction in place of
giving her a direct monetary bequest, which I would be otherwise inclined to do.
Any of my other representatives shall be entitled to reasonable compensation for the
performance of the duties set forth here.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 6~"` day of
IJuJu~btr , 2008, on this, the fifth of five typewritten pages. I have also signed the
left-hand margin of the first four of these pages for purposes of identification only.
~ ~~U
ALICE J. DWIG ~
SIGNED, PUBLISHED, and DECLARED by the Testatrix, ALICE J. DWIGHT, as
her Last Will anal Testament, in the presence of us, who at her request, in her presence, and in
the presence of each other, have hereunto subscribed our names as witnesses.
~,i ~'Yyn/ ~L
`zt3 `~ ~' u G b ~ Ro cad'
~a~l otF~~yi 11e i~t~- Zz903
~~
Lf/~/( ~/f( ( ~ j[JY
/n
'DV
SC]H[~I~LTL]E ®~ S~P~CIAL ~]EQIJ~S'I'S T'®
LAST' WILL Al®TI~ T']EST'ANI]E~TT' ®]F
ALICE ~. I~WIG]]FIT'
a. My stepdaughter, DENISE SMITH, of Charlotte, North Carolina: the sum of
twenty thousand ($20,000) dollars;
~ l~ b. My stepdaughter, BONNIE PRICE, of Long Beach, California: the sum of twenty
,~ thousand ($20.000) dollars;
c. My grandniece, NANCY GILBERT, of Wantagh, New York: the sum of fifteen
~ thousand ($15,000) dollars;
-~.
~~ d. My grandnephew, SCOTT HILBRANDT, of Farmingdale, New York: the sum of
fifteen thousand ($15,000) dollars;
~~ e. My friend, KIM BARTLETT, of Camp Hill, Pennsylvania: the sum of two
hundred fifty thousand ($250,000) dollars, any automobile I own at the time of my
death, and all of my furniture and household goods to do with what she wishes;
"' f. My friend, DEBRA K. WALLET, of Mechanicsburg, Pennsylvania: all my
'~ jewelry in my jewelry box, including my gold watch.
~~.
ACKNOWLEDGMENT
Commonwealth of Pennsylvania
County of Cumberland
I, ALICE J. DWIGHT, Testatrix, whose name is signed to the attached instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as
my free and voluntary act for the purposes therein expressed.
t
ALICE J. DWIGHT
Sworn or affirmed to and subscribed before me by ALICE J. DWIGHT, the Testatrix,
this (,,~ da of
Y ~n~JQYYI~9Y' , 2008.
Notary Publ'
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Mary M. I:oPer, Notary PubBc
Camp HII Bao, Ctrriberland Cotxriy
My Camrttiasion E~ires Oct 27, 2011
Member, Pennsylvania Association of Notaries
AFFIDAVIT
Commonwealth of Pennsylvania
County of Cumberland
We, ~)) ~ ~ ~ ~~ nc.a-, and ~~~~ ~.... {'~ ~ ~ ~ ~ ,the
witnesses whose names are signed to the attached instrument, being duly qualified according to
law, depose and say that we were present and saw the Testatrix, ALICE J. DWIGHT, sign and
execute the instrument as her Last Will and Testament; that she executed it as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testatrix signed the Will as witnesses; and that, to the best of our knowledge, the Testatrix
was at that time 18 years of age or older, of sound mind, and under no constraint or undue
influence.
T, t h~r~-
Sworn or affirmed to and subscribed to before me by ~) )~~ '~ }--) y~C~, and
~~1>n L.. !'~~ ~ i ~ ,witnesses, this (~, ~h day of J\~n. ~ yy, i~„ ,,- , 2008.
1 J 1~
Notary Publi
COMMONWEALTH OF PENNSYLVANIA
Notartai Seal
Mary M. Loper, Notary PubBc
Camp HN Bao, Cunbelartd Cotrtty
My Cornrnieslon E~q~irea Oot 27, 2011
Member, Pennsylvania Association of Notaries
= -~_, :~
__
f~ :r MU N I~1'
diamond gallery
EWE LRY AP P RAI SAL
ESTATE~FAIR MARKET VALUE
We estimate the value(s) as listed below for estate purposes only using fair market value guidelines.
The following item(s) have been carefully examined and verified as accurately as possible within normal and reasonable
gemological ranges without the use of gemstone removal or damaging tests. Carat weights are estimated by volumetric
formula unless otherwise noted.
Appraisals Prepared For:
Estate of Alice Dwight
Item Description:
(One) 14k yellow gold lady's watch;
Brand: Geneva
Style: Square case and dial with gold tone chevron and dot style indicators on a white dial.
Bracelet is a flat panther-brick style link with a functioning buckle style clasp and a
safety chain.
Movement: Lunesa mechanica1,17 jewel Swiss.
Mounting: bracelet, case and lid are a1114k yellow gold.
**Fair Market Value of this Item ....................................$750.00
(seven hundred fifty and 00/100 dollars)
Date of Appraisal: July 24, 2012
Completed y; Casey L. Sundell
Munri s Diamond Gallery, Inc.
*When indicated carat weight is estimated by volumetric formula. No stone removal.
**Value calculated per date of March 3, 2012; Gold Market ref: $1,700/oz. (T)
Values excludes sales tax. This is not an offer to purchase or replace articles.
1203 Market Street
Lemoyne, PA 17043
(717)-767-8310.
Fax (717)-761;-8f~32
1-877-DIAMOND
www.munns.net
i nvc~cx -~- `~ X54
~ ~.~