HomeMy WebLinkAbout01-25-131 1505610105
~1 REV-1500 °"~-" "~' ~
PA Department of Revenue Pennsylvarda OFFICIAL USE ONLY
Bureau of Individual Taxes File
N
umber
.~~.,.~ INHERITANCE TAX RETURN CourlryCode Year
PD BOX 23D6Di
Harrisburg, PA ].77.28-0601. nn
--
77
RESIDENT DECEDENT
~ 1 - I r~~t - --+' I
ENTER DECEDENT INFORMATION BELOW
05/15/2012 06/04/1923
Decedent's Last Name Suffix Decedent's First Name MI
Williams Harry M
(If Applicable) Eller Survhirlg Spouse'e Informatbn 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
r>b 1. Original Retum O 2. Supplemental Ratum O 3. Remainder Retum (Date of Death
Prior to 12-13.82)
O 4. Limited Estate O 4a. FUlure Interest Compromise (tlate of O 5. Federal Estate Tax Retum Required
death after 12-12-82)
tC 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceetls Receivetl O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec, 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- Tt83 SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFlDENTLLL TAI(NIFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Charles J. Hartwell (71 79 7 5-9446 ' ~ ; ~ m
YPI
First Line of Address
Dethlefs-Pykosh Law Grp
Second Line of Address
2132 Market St.
City or Post Office
Camp Hill
correspondears e-mau addr.ee: chariwell(cDdDlalaw.com
State ZIP Code
Pa 17011
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Under panaltlas orperjury, I Ifedere that I have examined this return, Indutling accomparryirg achedubs 811tl statements, and to ale best of my faxrwietlge and belief,
it is true, correct end complete. Dedereeon of preperer oMer than the personal representatlve ie based on all Information or which preparer has any krawledge.
SIGNATURE OF PERSON RESPONSIB FOR FILING RETURN DATE
515 Harding Street~New Cumberland, PA 17070
SIGNATURE R PARER OTHER THAN REPRESENTATIVE
~iT ~ r Y-I1
2132 Market Street, Camp Hill, PA 17011
PLEASE U3E ORIGINAL FORM ONLY
Side 1
L 1505610105 1505610105 J
REV-1500 EX (FI)
Decedent's Sodaf Security Number
oecedenrs Name: Harry Maxwell Williams
RECAPRULATION
1. Real Estate (Schedule A) .......................................... ... 1. 0.00
2. Stocks and Bonds (Schedule B) .................................... ... 2. 266.00
3. Cbsely Hekl Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 0.00
4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).... ... 5. 5,081.95
6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 7,490.13
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Sepaate Billing Requested..... ... 7. 0.00
8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 12,638.08
9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 9,226.30
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule t) ............. .. 10. 0.00
11. Total Deduetlons (total Lines 9 and 10) ............................... .. 11. 9,226.30
12. Nst Value of Estate (Line 8 minus Line 11) ............................ .. 12. 3,611.78
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 Tax (Line 12 minus Line 13) ...................... .. 14. 3,611.78
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 .0 4~` 3,611.78 18.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 ig.
19. TAX DUE ....................................................... .. 19.
20. FILL IN THE OVAL IF YOU ARE REOUESTINO A REFUND OF AN OVERPAYMENT
Side 2
1505610205 1505610205
1505610205
162.53
152.53
O
REV-1500 f-X IFI) Page 3 Fik Number
I'facedent's Complete Address:
DECEDENTS NAME
Harry Maxwell Williams _, ~i ,_ _
STREET ADDRESS
521 Park Avenue _.__ __
cITY.._------------- ----- ---- STATE _!_ .ZIP -__.
New Cumberland Pa 17070
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. GeditslPayments
A. Prior Payments _
B. Discount
3. lnteresf
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill In oval on Page 2, Line 20 to request a refund. (4)
5. ff Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5J
162.53
(3)
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: Yes No
a. retain the use or income of the property transfened .................................................................................... ...... ^
b. rebin Ole right to designate who shall use the property transferred or its income ...................................... ...... ^
c. retain a reversionary interest ........................................................................................................................ ...... ^
d. receive the promise for life of eittrer payments, benefits or care? ................................................................ ...... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer properly within ono year of death
without receiving adequate consideration? ....................................................................................................... ....... ^
3. Did decedent own an "in trust toP orpayable-upon-death bank account or secudty at his or her death?........ ._... ^
4. Did decedent own an individual retirement aaount, annuity or other non-probate property, which
contains a beneficary designation? ................................................................................................................. ....... ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
For dates of death on m 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 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 statute does not exempt a trarsfer to a surviving spouse from tax, and the statutory requirements for disdosure of assets and
filing a tax return are sOll applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after Jufy 1, 20D0:
• 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 netvalue of transfers to or for the use of the decedent's lineal berrefsiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)].
• The tax rate imposed on The net value oT 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 SecOon 9102, as an individual who has at least one parent in common with the decedent, whetlter by Mood or adoption.
(1)
Total Credits (A + B) (2)
REV-a5o3 E%+ (7a1)
pennsylvarria
UEPPPTMENT OF flEVENUE
INHERITANCE TAX RETURN
RESTDENT DECEDENT
SCMEpULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Harry Maxwell Williams 21-12-0717
All property Jointly owned with right of wrvlwrship must be diadased an Sd~edule F.
it more space is neetletl, insert atltlitionaf sheetr of the same size
NEV-i5o8 Ex+ (u-io)
pennsytvania /.
DEPARTMENT OF pEVENUE `,ASH
iNHERITAN~ TA% RETURN P
RESIDENT DECEDEM
SCNEpULE E
BANK DEPOSIT5 & MISC.
ERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
Harry Maxwell Williams 21-12-0717
Include the proceeds of Ilbgation and the date the proceeds were received by the estate.
AN property f olmty owned with right of wrvivorahip must be distbsed on Schedule F.
ii more space is neeaeD, use aoamonai sheets of paper of Me same size.
REV-T5D9 EX+ (oi-io)
pennsylvania SCi1EpYLE F
ail DEPARTMENT OFftEVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Harry Maxwell Williams 21-12-0717
it an asset became joimly owneA rrkfiin ane year of the decedent's date at! death, k must lx reported on SchedWa G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. Margery L. Hempt 1515 Harding Drive, New Cumberland, PA 17070 I Daughter
B.
C.
IOINTLY OWNED PROPERTY:
REM
NUMBER LETTER
FOR JDnR
TENANT DATE
MADE
]DIM DESCRIPTION OF PROPERTY
INCLUDE NAME OF FlNANC101 n/STITUItON AND BANK AC[DUNT NUMBER OR SIMILAR
IDENRFIING NUMBER. ATTACH DEED FOR xIINTLY HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET ~ of
DKEDENT'S
INTEREST DATE of DEnTH
VALUE OF
DEC®ENr51NiEREST
t. A
. O1I01/05 Sovereign Bank, Account 0571113125 14,980.26 50 .7,490.13
TOTAL (Also enter on Line 6, Recapitulation) I; 7,490.13
If more space is needed, use additional sheetr of paper of the same size.
REV-1511 EX+ (10-U9)
}~'~ Pennsylvania
fil DEPARTMENT OF REVENUE
INHERITANCE Tax RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Harry Maxwell Williams 21-12-0717
Decdent's debts must be reported on Scheduk I.
ITEM DESCRIPTION AMOUNT
NUMOER
A. FUNERAL EXPENSES:
I' Parthemore Funeral Home, PO Box 431, New Cumberland, PA 17070 7,277.07
Crypt Opening -Rolling Green Cemetery 225.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 385.00
Name{s) of Persona4 Representative(s) Margery L. Hempt ~__
street Address 515 Harding Street __ ___
city New Cumberland _ state P'4 _ ztP 17070,
Year(s) Commission Paid: 2013 _.__
860.00
2. Attorney Fees:
3. Family Exemption: (IF decedent's address is no[ the same as daimant's, attach explanation.)
Claimant _ __ __ ~_____
Street Address
a.
5.
6.
7.
City ~_ _ _ _ _- State
Relationship of Claimant to Decedent ._ ,_
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
Tax trill
Medical Bill -Poplar Healthcare -Pathology - 3127!12 -paid 6!19(12
TOTAL (Also enter on Line 9, Recapitulation) I ¢
371.82
10.00
97.41
9,226.30
ZIP
If rtwre space is needed, use addlNonaf sheets M paper of the same size.
REV-1513 EX+ (OS-30)
pennsylvania SCHEDULE ]
DEPARTMENT OF REVENUE BENEFICIARIES
iNHERTfANCE iAX RETURN
RFSIOENT DECEDENT
ESTATE OF: FILE NUMBER:
Har Maxwell Williams 21"12"0717
RELATIONSHIP TO DECEDENT AMOUM OR SNARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Margery L. Hempt, 515 Harding Street, New Cumbedand, PA 17070 Child 50%
2 Thomas A. Williams,130A Diller Road, New Cumbedand, FA 17070 Child 50%
II
1.
1.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
NON-TAXABIf 0[STR[BURONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WH[CH AN ELECTION TO TAX IS NOT TAKEN:
0
B. CHARITABLE AND GOVERNMENTAL D15TRIBUAONS:
0
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUT10N5 ON ISNE 13 OF REV-1500 COVER SHEET.
]f more space Is needed, use additional sheets of paper of the same size.
Last Will And Testament
Of
HARRY 1~SAXWLLL WILLIAMS
I, HARRY MAXWELL WII.LIAMS, of CUMBERLAND, PENNSYLVANIA,
revdke my former Wills and Codicils and publish and dechu+e this to be my Last Will and
Testament
ARTICLE I
MARRIAGE 8c CHII.DREN
I was married to MARY JEAN WILLIAMS, who is now deceased. I have the following
adult child(ren) fmm that marriage:
N: MARGERY L. HEMPT Bom on APRIL16,1953
N , e: THOMAS A. WILLIAMS Born on APRIL21,1958
ARTICLE II
FUNERAL 8s BURIAL EXPENSES
I authorize the Executor of my Will to pay such sums as the Executor deems proper for
my funeral, cremation or burial and interment, including the disposition of the ashes or the
acgt$isition of any burial site and the erection and engraving of monuments and markers,
regakdless of any limitation fixed by statute or rule of court and without order of any court.
ARTICLE III
PAYMENT OF DEBTS AND EXPENSES
I direct that my just debts, testamentary expenses and expenses of last illness be first paid
out ~f and charged to the capital of my general estate.
All taxes (including income taxes and inheritance taxes) and any interest and penalties
therm owed because of my death shall be paid out of the residue of my estate. The Executor
shah create, out of the residue, a separate fiord for the purpose of paying any inheritance taxes in
the amount necessary to pay said inheritance taxes. The payment of tbe taxes shall be made
regardless of whether the taxes are owed on property passing render this Will or any codicil
here{o, outside of this Will, in connection with any insurance on my life or any gift or benefit
give~m or conferred by me either during my lifetime or by survivorship. The payment of the taxes
steal be made regardless of whether the taxes are owed by my estate or by any beneficiary. The
Executor shall not seek reimbursement from any beneficiary for the payment of the taxes.
Initials: / i4In~/iG~ 1" t'fC. ----- Page 1 of `]
Testator R'ttrtess lf'aness We
This direction shall not extend to or include any such taxes that may be payable by a
ter or transferee in connection with any property transferred to or acquired by such
ter or transferee upon or after my death pursuant to any agreement with respect to such
ARTICLE IV
DISPOSITION OF PROPERTY
Specific Bequests I direct that the following specific bequests be made from my estate.
Drv Sink. Drop Leaf Table. Tools. Cherry Table sad Chairs. Silverware, and my
J shall be distributed to Thomas Williams, my son. If this beneficiary does not survive
me, this bequest shall be distributed with my residuary estate.
Corner Cupboard of her choice. Hammel collection. marble table and boon, chetly
s shall be distributed to Margery Hempt, my daughter. If this beneficiary does not
me, this bequest shall be distributed with my residuary estate.
56,000, Maple: fnrnilare, watch collection, shall be distributed to Stephanie
~orth, my granddaughter. If this beneficiary does not survive me, this bequest shall be
Red with my residuary estate.
Slot Machine shall be distributed to Harry Adam WiQiams, ury grandson. If this
iary does not survive me, this bequest shall be distributed with my residuary estate.
Curio cabinet, shall be distributed to Danielle W~iams, my gnnddanghter. Ifthis
iary does not survive me, this bequest shall be distributed with my residuary estate.
items may be distributcd to the above-mentioned at the discretion of the
Primary Residence All my interest in my primary residence or homestead, if any, shall be
ibuted to my child(ren) NIA (name(s)). If more
one child is named, then the distribution shall be in equal shares per stirpes.
Residuary Fstate I direct that my residuary estate, including any real property and
pal property, be distributed, bequeathed and given to my child(ren) MARGERY L
HE and THOMAS A. WILLIAMS. If more than one child is named, then the distribution
shat be in equal shares per stirpes. If none of the named child(ren) or tbeir descendants, survive
me, direct that my residuary estate be distributed in equal shares per stirpes to:
:-
Texta[or Wincess itrress ._itness .
If any such beneficiary does not survive me, my residuary estate shall be distributed to
my ieus-at-law, their identities and respective shares to be determined under the laws of the
Star of PENNSYLVANIA, then in effect, as if I had died intestate at the time fixed for
di 'bution under this provision.
any
or v
the
Except as may be specifically otherwise provided herein or directed otherwise by Iaw, if
son should become emifled to any share in my estate before a Alning the age of majority
under any other disability, I authorize the Executor to nevertheless make any
tion for any such person directly to the beneficiary or to a parent, guardian, conservator,
tee of such person, trustee of such person, person with whom the beneficiary resides at
of the distribution or to any other person the Executor may consider to be a proper
it thereof. Receipt of any such distribution shall be a sufficient discharge to the Executor.
ARTICLE V
NOMINATION OF EXECUTOR
I appoint MARGERY L. HEMPT, ("Executor") as the Executor of this my Will. If
suc person or entity cannot, does not or is unable to serve or continue to serve as Executor for
any reason, I appoint THOMAS A. WII.LIAMS, to be the Executor of this my Will in the place
and stead of the first aforementioned Executor.
References to "Executor" in this my Will shall include each Executor, Executrix, and
mal Representatives of my Will, my estate or any portion thereof who may be ailing as
from time to time whether original or substituted and whether one or more.
To the extent permitted by law, the Executor shall have tbe right to administer my estate
adjudication, order or direction of the court having jurisdiction over my estate, using
ial", "unsupervised", or "independe~" probate or equivalent legislation designed to
without unnecessary intervention by the probate court.
No bond, security or surety shall be required of any Executor serving herermder.
ARTICLE VI
POWERS OF EXECUTOR
In addition to the existing authority of the Executor and in addition to other powers and
ty granted by law or necessary or appropriate for proper administration of my estate, the
x shall have the right and power to:
1. Lease, sell, grant options, partition, exchange, mortgage, or otherwise encumber or
dispose of all or part of any real or personal property that may be included in my estate in
such manner and for such purposes, for such prices, and upon such terms, credits and
conditions as maybe deemed advisable, without order of court and without notice to
TTY)11C MTG ~~-- -'='=-"' Page 3 of
renew w;a,es, wurre.,5 Wurress
anyone. I also give to the Executor power to execute and deliver such deeds, mortgages,
leases or other instrnnents and documents as may be necessary to effect such a sale,
mortgage, lease or other disposition. The power of sate herein is discretionary and not
mandatory.
2. Take charge of any real property as part of the probate administration of my estate
for such period as the Executor stall determine; collect any income therefrom; and pay
the taxes and expenses thereof, including the cost of keeping such property in adequate
condition and repair, in the manner and to the extent that the Executor shall deem
advisable.
3. To accept surrenders of leases and tenancies, to expend money in repairs, alterations,
rebuilding and improvements and generally to manage any such property. The Executor
shall also have the right to renew and keep renewed any mortgage or mortgages upon any
real estate forming part of my estate or any part thereof, to borrow money on any such
real estate upon the security of any mortgage, or mortgages and to pay off any mortgage
or mortgages which may be in existence at aay time forming part of my estate.
4. Make any division of my real or personal estate or set aside or pay any share or
interest therein either wholly or in part in the assets forming my estate at the time of my
death or at the time of such division, setting aside or payment, and I expressly will and
declare that the Executor shall in their absolute discretion fix the value of my estate or
any part thereof for the purpose of making any such division, setting aside or payment
and the decision of the Executor shall be final and binding upon all persons concerned,
notwithstanding any fluctuation in market value and notwitbstanding that one or more of
the Executor may be beneficially interested in the property or any part thereof so valued.
5. Sell, call in and convert into money any part of my estate rat consisting of money at
such time or times, in such manner and upon such terms, and either for cash or credit or
for part cash and part credit as they may in their absolute discretion decide upon, or to
postpone such conversion of my estate or any part or parts thereof for such length of time
as they may think best. Make any division ordistribution of my residuary estate in money
or in other property or partly in both upon the psis of fair market value and cause any
share to be composed of money, property or undivided fractional share in property.
6. Retain any of my investments or assets in the form existing at tbe date of my death at
Executor's absolute discretion without responsibility for loss to the intent that
investments or assets so retained shall be deemed to be authorized investments for all
purposes of my Will. No reversionary or future interest shall be sold prior to falling into
possession and no such interest not actually producing income shall be treated as
producing income.
7. Permit any beneficiaries of my estate to use any tangible personal property or real
property, without paying any tent, without giving any bond or security and without
liability for any loss or damage. The Executor shall not be liable or responsible for any
injury to, consumption of or loss of any such property so used.
"~~ . ` P- .
~i/.CC.' .~ `~ _ _T~ ----_ Page 4 of 7
Testa[or {fitness fitness ipress
8. Make or refrain from making, in Executor's absolute discretion, any elections,
determinations, and designations permitted by any statute or regulation enacted by the
federal government of the United States of America, by the legislature or government of
any state, or by any other legislative or governmental body of any other country, state or
territory, and such exercise of discretion by the Executor shall be conclusive and binding
upon all the beneficiaries hereof. The Executor shall not be liable to any person, whether
beneficiary or otherwise, by reason of any loss, claim, tax or other cost experienced by
any such person or by my estate resulting from any election, determination, designation
or exercise of discretion, entered into by the Executor in good faith.
9. Windup, dissolve, settle or continue any partnership or business in which I may have
an irnerest at tbe time of my death.
10. Compromise, settle, waive or pay any claim or claims at any time owing by my
estate or which my estate may have against others for such consideration or no
consideration and upon such terms and conditions as the Executor may deem advisable
and to refer to arbitration all such claims if the Executor deem same advisable.
I I . Pay all necessary and reasonable expenses and costs incurred in connection with
administering my estate, including but not limited to attorney, accountant, agent, broker
and other professional fees.
The Executor shad be fully protected in exercising any discretion granted to them in my
Wi and shall not be liable to the beneficiaries or their heirs or personal representatives by
n of the exercise of such discretion. The Executor shall exercise the powers, authority and
di 'on granted herein in what Executor deems to be the best interest, whether monetary or
oth 'se, of the beneficiaries, whether or not such exercise may have the effect of conferring an
ad tage on any one or more of the beneficiaries or would otherwise, but for the foregoing, be
co idered as being other than an impartial exercise of their duties hereunder or as not being
tenance of an even-hand among tbe beneficiaries and all such exercise of their powers,
a city and discretion shall be binding upon all of the beneficiaries and shall not be subject to
any uestion or review, by any person, official, authority, court or tribunal whatsoever or
ARTICLE VII
MISCELLANEOUS PROVISIONS
provisions in this Will for the distribution of my estate shall be supplemented by the
1. Paragraph Titles and Gender. The titles given to the paragraphs of this Will are
inserted for reference purposes only and are not to be considered as forming a part of this
Will in interpreting its provisions. Throughout this Will the use of any gender shall be
''~G' A.tTL ~ J~-_ ~ 5 of_~
resraro. wrnress wrn~ wuness
deemed to include all genders, and the use of the singular the plural, and vice versa. and
any pronouns shall betaken to refer to the person or persons inienbed regardless of
gender or number The terms "child" and "descendant" shall include an adopted person
and such adopted person's descendants, if, but only if, the adopted person is not more
than twelve years of age on the date of the court order granting such adoption.
2. Thirty Dav Survival Requirement. For the purposes of determining the appropriate
distributions under this Will, Each beneficiary shall be deemed not to have survived me
unless the beneficiary is living on the thirtieth day after the date of my death.
3. Liabiliri of Fiduciary. No fiduciary who is a natural person shall, in the absence of
fraudulent conduct or bad faith, be liable individually to any beneficiary of my estate, and
my estate shall indemnify such natural person from any and all claims or expenses in
connection with or arising out of that fiduciary's good faith actions or non-actions as the
fiduciary, except for such actions or non-actions which constitute fraudulent conduct or
bad faith.
4. Beneficiary Disputes. If any bequest requires that the bequest be distributed between
or among two or more beneficiaries, the specific items of property comprising the
respective shares shall be determined by such beneficiaries if they can agree, and if not,
by my Executor.
5. Matrimonial Ri ts. No gift, or the i~ome therefrom, under this Will shall be
assigned or anticipated, or fall into any community of property, partnership or other form
of sharing or division of property which may exist between any beneficiary and his or her
spouse, and every gift together with the income therefrom shall remain the separate
property of a beneficiary hereunder, fi+ee from all matrimonial rights or controls by his or
her spouse.
6. Severabiliri. ff any provision of this Will is declared invalid, illegal or
unenforceable, any invalidity, illegality or unenforceability should affect only that
provision and all other provision should remain effective.
7. No Spouse. I am not currently married to anyone.
IN WTI'NESS WHEREOF, I have signed my name below to this Will, this 6th day of
OM her, 2007. at NEW CUMBERLAND, PENNSYLVANIA that I declare this to be my Last
Wi and Testament, that I am of legal age and sound mind, that I make this under no constraint
or due influence and ask the Witnesses named below to witness my signature.
Signature: ~~1L ..tom-~^ TG~/`~L~.ft >aa.~
Name: Y MAXWELL WILLIAMS
hG`~24'!~ T L C~ r- '~ __ _. Page 6 of
Testator Witness fitness Witmss
(No1 lice to Wibiesses: Three (3) adults must sign as witnesses. Each witness must read the
following clause before signing. The witnesses should not receive assets under this !I rll )
We, the undersigned, hereby certify and declare under penalty of perjury under the laws
of tt~e State of PENNSYLVANIA that the above instrumem, which consists of 7 pages,
incldiding the page(s) which contain the witness signatures, was signed in our sight and presence
by LARRY MAXWELL WILLIAMS (the "Testator"), who declared this inshvment to be his
Lard Will and Testament and we, at the Testator's request and in the Testators sight and presence
and at Testator's request, and in the sight and presence of each other, do hereby subscribe our
names as witnesses on the date shown above.
We understand this is the Testator's Will; We believe the maker is of sound mind and
y; We believe that this Will was not procured by duress, menace, fraud or undue
ce; The maker is age 18 or older. Each of us is now age 18 or older, is a competent
.. and resides at the address set forth after his or her name.
Dated: October 6.2007
I Testator
W1tne55 SlgnatUre: _ / ,
~.. P(i'l. u..k:i ~ ~ ~ t ~ U.- '`-'"~
Name: Donald R Fuller. Jr.
Address: 515 Hardine Sired
City: New Cumberland
State: Pennsylvania
Witness Signature:
Name:
Address: 5 Hardinu Street
City: New Cumberland
State: Pennsylvania
Witness Signature: ~ ~~
Name: Mic I Colson
Address: 518 Harding Sweet
City: New Cumberland
State: Pem~sylvania
M rc. ~-
Witness Rness A•ttness
Page 7 of~
Self-Proved Will Affidavit
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, the undersigned, an officer authorized to administer oaths, certify that HARRY MAXWELL
WI~.LIAMS, the testator and Donald R Faller, dr., and Lindsey Cobon, and Michael Colson,
the +.vtnesses, whose names are signed to the attached or foregoing inshvment and whose
signatures appear below, having appeared before me and having been first been duly sworn, each
then declared to me that: 1) the attached or foregoing instnmtent is the last will of the testator, 2)
the ~estator willingly and voluntarily declared, signed, and executed the will in the presence of
the tresses; 3) the witnesses signed the will upon the request of the testator, in the presence
and gearing of the testator and in the presence of each other, 4) to the best knowledge of each
wi ess, the testator was, at the time of signing, of the age of majority (or otherwise legally
competent to make a will), of sound mind and memory, and under no constraint or undue
infl>kence; and 5) each witness was and is competent and of proper age to witness a will.
.u <'c '7 ~ ~~ `/~1:=~ 16a ti~ ' Z< .~' C C, Ct -, ~ ' T (Testator)
(Witness)
PrinMt Name: Donald R Faller. dr.
Address: 515 Hardin¢ Street New Camberhtnd, PA
(Witness)
' Nam • o on
ddress: 518 HsrdinQ.Strcet New Cnmberhtnd. PA
518 Hardin¢ Street New Camberhmd. PA
(Witness)
Su 'bed and sworn to before me by HARRY MAXWELL WILLtAMS, the testator, who is
pens Wally known to me or who has produced PENNSYLVANIA DRIVER'S LICENSE as
id 'cation, and by Donald R Fnikr. Jr., a witness, who is personally known to me or who
has aced PENNSYLVANIA DRIVER'S LICENSE as identification, and by Lindaav
Coo a witness, who is personally known to me or who has produced PENNSYLVANIA
DRI R'S LICENSE as identification, and by Michael Colson, a witness, who is personally
kno to me or who has produced PENNSYLVANIA DRIVER'S LICENSE as identification,
this th day of October, 2007.
1S~F,FYT•1 ~_
COMMONWEALTH OF PENNSYLVANIA ~_
NOTARIAL SEAL
GEORGIWN E. KECiG, Notary Public
Ss,ror ~9 Twp., t'lnnber~nd
My camieelon E,rplre. r-ee. 29, xooe