HomeMy WebLinkAbout02-15-1315D561D143
REV-1500 Ex (D2-"'
PA Department of Revenue pannsylvania
Bureau of Individual Taxes °~"9in1ertOF ea~a,a~
Po eox.zaosot INHERITANCE TAX
Harrisburg, PA 1712&-0601 RESIDENT DECE
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
201 Ol 4108 10 02 2012
Decedent's Last Name
ZEDLAR
(lf Applicable) Enter Surviving Spouse's Inforrnatlon Below
Spouse's Last Name
Spouse's Social Security Number
OFFICIAL USE ONLY
County DOde Vear File Number
1 21 12 1106
Date of Birth
02 27 1918
Suffix Decedent's First Name MI
JOSEPH
Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
X~ 1. Original Return
~
2. Supplemental Return _
`~
3 Remainder Return (Date of Death
Prior to 12-13-82)
q, Limited Estate
C- ~ qa Furore mrarest Compromise
(dale of death after 12-12-82) L J 5. Federal Estate Tax Retum Require0
(X 6 Decadent Died Testate
J - (anern copy of wep r-1
LJ ~ ~Atla~e~opY ienf,i~esq living Trust g, Total NUmbef Or Sale Deposit Box85
j ~ g, Litigation Proceeds Received ~ 10. pg°~,i,P~-°~~~e y {°1a~as~ r Death ~ 1 L~A~ h Schedule O) Sec. 9113(A)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION ULD BE DIRECTED TO:
Name Daytl~l TelephonembeyD rn
71$ 0 73rd0 ~
MICHAEL L BANGS ~
First Line of Address
429 SOUTH 18TH STREET
Second Line of Address
City or Post Office
CAMP HILL
Correspondent's a-mail address:
State ZIP Code
PA 17011
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00
DATE FILED
schedules and statements, and to the best of
is based on all information of which preparer
Am G. Yovanovich
ADDRESS
1406 Chatham Road Camp Hill PA 17011
SIG TURE OF PREPARER OTHER iH REPRESENTATIVE DATE
Michael L. Bangs ~ /i
ADDRESS
429 South 18th Stree Camp Hill PA 17011
Side 1
150561D143 15D561D143 J
REV-1500 EX
nacedentb Neme' Zediar, Joseph
Decedent's Social Security Number
RECAPITULATION
1. Real Estate (Schedule A) ....................................................................................... i .
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
3. Closery Hetd Corporation, Partnership or Sole-Proprietorship (Schedule C)........ . 3.
4. Mortgages & 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 & Miscellaneous t~on,•Probate Property
(Schedule G) (J Separate Billing Requested............ 7.
8. Total Gross Assets (total Lines 1 through 7) ....................................................... . 8.
61,262.06
5,274.25
18,338.43
84,874.74
9. Funeral Expenses and Administrative Costs (Schedule H) ................................... . 9.
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I} ........................... . 10.
11. Total Deductions (total Lines 9 and 10) ............................................................... . 11.
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12.
13. Charitable and Governmental Bequests/Sec 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.
i6. Amount of Line 14 taxable 66 , 521 .2 9 ts.
at lineal rate X .045
17. Amount of Line 14 taxable
0
00
17
.
at sibling rate X .12 .
18. Amount of Line 14 taxable
0 • 0 ~
18
at collateral rate X .15 .
19. TAX DUE ............................................................................................................... . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243
1505610243
17,247.11
1,106.34
18,353.45
66,521.29
66,521.29
0.00
2,993.46
0.00
0.00
2,993.46
15056111243
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-12-1106
DECEDENT'S NAME
Zedlar, Joseph
STREET ADDRESS
1707 Sherwood Road
CITY STATE -ZIP
New Cumberland PA 17070
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
0.00
q, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
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.
(t) 2,993.46
Total Credits (A + g) (2) 0.00
(3)
{4)
(5) 2,993.46
Make Check Pa able 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 inwme 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 ................................................._............................................................ L~ C
d, receive the promise for life of either payments, benefits or care? ................._......_.......__........._........... ^ 0
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ~ 0
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 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) {ii)]. The statute does not exempt a transfer to a surviving spouse from taz, 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 alter 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. §9118 (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
[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 [72 P.S. §9116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev4503 EX+(0740)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TA%RfTURN
RESIDENT OECEDEM
ESTATE OF
SCHEDULE A
REAL ESTATE
Zedlar
FILE NUMBER
All real property ovmaN wlely or as a tenant In common must be reported at fair market value. Fair market value is tlefinetl es the price et which property woultl be
exchengetl between a willing buyer and a willing seller, neiNar being cpmpelletl to buy Or sell, both having reasonable knpvAedge pt the relevant fads.
Real property Met le jMnNyawmtl with right W survlvarahlp mwt be NlacloseN on schedule F.
(If more space is needed, additional pages of the same size)
Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1 b00 Schedule A (Rev. Ot-10)
Rav-1508 E%e 111101
COMMONNhALTH OF GENNSVLVgN1A
INNFAn~NCE TPX RENRN
RE81pENT OECEOENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Zedlar, Joseph 21-12-1106
InGuCe ma praceetls of litigation eM the tlale the proceatls were receivetl by the estate.
All property foiMlynwned with Me right of survivorship must bs dbcloead on achetlule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Aetna beneFlt -October payment 21.64
2 Aviva Life and Annuity -benefit payment 83.85
3 M&7 Bank • Checking account 1,435.61
4 M&T Bank -Savings Account 2,977,16
5 PSECU -Regular share account 403.71
6 State Employees Retirement System -final benefit 22.02
7 State Employees Retirement System benefit 330.26
TOTAL (Also enter on Line 5, Recapitulation) I 5,274.25
(If more space is needed, additional pages of the same size)
Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 11-10)
Rev-1509 E%+IOL70)
COMMONWEALTH OF PENNSYLVANIA
lNHERlTANCETA%RETWN
RESIDENT DECEDENT
SCHEDULEF
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Zedlar, Joseph 21-12-1106
If an easel was matla )olnl within one yegr of the tlecetlant's tlate of tleath, it must Da reportetl °n gehatlWe G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Amy G. Yovanovich 7406 Chatham Road Daughter
Camp Hill, PA 17011
B.
C.
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOIN
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT
NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR
JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
yALUE OF ASSE %OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1 A 1 2131 /2 0 0 9 MBT Bank -Certificate of Deposit 36.676.86 50.000°/a 18.338.43
TOTAL (Also enter on Line 5, Recapitulation) I 18,338.43
(If more space is needeq additional pages of me same size)
Copyright (c) 2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 01-10)
REV-1151 EX+110-09)
COM71f N~~D~~yt'~SVLVANIA
SCHEDULE H
FUNERAL EXPENSES AND
ESTATE OF FILE NUMBER
Zedlar, Joseph 21-12-1106
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
q, ~ FUNERAL EXPENSES:
See continuation schedule(s) attached
10,507.66
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s) Commission Paid
2. Anornev's Fees Michael L. Bangs 5,000.00
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees 315.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 1,423.95
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 77,247.11
Copyright (c) 2009 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE GOSTS
continued
ESTATE OF FILE NUMBER
Zedlar, Joseph 21-12-1106
ITEM
NUMBER DESCRIPTION AMOUNT
1 Funeral Expenses
An Olde Town Florist
265.00
2 Musselman Funeral Home 8,572.66
3 Rolling Green Cemetery Company 1,670.00
H-A 10,507.66
4 Other Administrative Costs
Brian Porr -clean out of house
1,240.00
5 Cumberland Law Journal -estate advertisement 75.00
6 The Patriot News Co. -Estate advertisement 108.95
H-67 1,423.95
Copyright (c) 2002 form software only The Lackner Group, Inc. Forth PA-1500 Schedule H (Rev. 6-98)
Rev1812 EX~ (12-08)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
LOMMONVUEAITH OF VENNSYLVANIA
INHERITANCE TA%ftETIMN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Zedlar, Joseph 21-12-1106
Report dabta incurred by the dacatlent pnor to tlsath that mmalnetl unpsltl at the tlate of death, Including unreimbuned metlicel ezpenaes.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATR
1 BJ Johnson -payment for services provided to decedent prior to death 50.00
2 Brian Johnson -payment for services provided to decedent prior to tleath 50.00
3 Department of Veterans Affairs 120.00
4 Holy Spirit Hospital 11.72
5 New Cumberland Boro -Sewer/trash 131.94
6 PA American Water Company - 914112 to 1012112 14.96
7 PA American Water Company -1012112 to 1111112 14.03
8 PA American Water Company -12/3112 to 12/79/12 21.51
9 PP&L Electric Company -final bill 10.59
10 PSECU Visa 211.05
11 Quantum Imaging 1.74
12 Susquehanna Valley Tree 100.00
13 UGI -Services to 9/25112 16.42
14 UGI - 9/25112 to 10/24/12 18.40
15 UGI- 10/24/12 to 11!27!12 68.04
16 UGI -11/27/12 to 12/27/12 91.50
17 UGI -final bill (12/27112 to 1/8/13) 46.18
Total of Continuation Schedule See attached page
TOTAL (Also enter on Line 10, Recapitulation) 1,106.34
(If more space is needed, addigonal pages of the same size)
Copyright (c) 2008 form software only The Lackner Group, Inc. Form PA-1500 Schetlule I (Rev. 72-08)
Rev-0b1Y Eke (13-Oe)
WMMONWEALTHOF PENNSYLVANIA
INHERITANCE TA%RETIMN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
continued
ESTATE OF FILE NUMBER
2edlar. Joseph 21-12-1106
Copyright (c) 2008 form software only The Lackner Group, Inc. Form PA•~500 Schedule I (Rev. 12-OB)
REV-151 ] E%* (01-10(
COMMONW I~DEGED~LVANIA
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Zedlar, Joseph 21-12-1106
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
. distribubons, and transfers
under Sec. 9116 a 1.2
1 Jan Marie Leib Daughter One-third of
545 Rt. 47 North Estate
Cape May Court House, NJ 08210
2 Zoe Weglaa Daughter One-third of
15047 Blue Marlin Terrace Estate
Bonita Springs, FL 34135
3 Amy G. Yovanovich Daughter One-Third of
1406 Chatham Road Estate
Camp Hill, PA 17011
Total
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 15 00 cover sheet as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI
Copyright (c) 20t0 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 01-10)
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11,01,2012
Bangs Law Office, LLC
Michael L. Bangs, Attorney
429 S. 18`h St.
Camp Hill, PA 17011
Re: JOSEPH ZEDLAR, Deceased.
PSECU Reference # 9566021644103
Dear Attorney Bangs
The above referenced person has an account with PSECU which was opened on December 7,
1994. The Share accounts were individually held by JOSEPH ZEDLAR. The Visa loan was
individually held.
The following are the Date of Death Balances for JOSEPH ZEDLAR's account with
PSECU:
Account Date of Death Balances Interest -October 1-2
Shares:
(SI) Savings $403.71 $0.00
Loans:
(L9) Visa Loan $0.00
The interest paid on the Savings from 1/1/12 to 9/30/12 is $2.18
On October 7, 2012 a transaction for $211.05 posted to the Visa loan. If the Estate has
sufficient funds to payoff the decedent's Visa, please remit a check, made payable to PSECU
for $211.05. If there are not sufficient funds to payoff these loans, please submit a letter of
insolvency along with supporting documentation such as a final inheritance tax return and
financial accounting.
Please provide us instructions on closing the decedent's account.
If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237-
7328, press 6, extension 3120.
Sincerely,
--- SandyFagley
Member Service Representative
PSECU
Pennsylvania State Employees Credit Union
1 Credit Union Place, P.O. Box 67013, Harrisburg, PA 17106-7013 • 800.237.732& • »pSeCU.[Om
TNIC fRCnIT I INInN IC ccncoel I V INCIIRCO RV TNG NlTIONE I (RFn1T IINION AIINIINICTRETION F01Id I ORPORTIINITV I FNOFR
a~~
499 Mitchell Road, Millsboro. DE 19966 Adjustment Services
Phone 588-502349
F ax 1302) 934-2955
October 22. 2012
Bangs Law Office, LLC
429 South 18th Street
Camp Hill, PA 17011
Re; Estate of Josh Zedler
Social Security: 201-01-4108
Date of Death October 2, 2012
Dear Sir or Madam:
Per your inquiry on October 12 2012, please be advised that at the time of death, [he above-named decedent had
on deposit with this bank the following:
I. TypeofAeeount
Account Nrunber
Ownership (Names ofj
Opening Date
Balance on Date of Death
Accrued Interest
Total
2. TypeafAccount
Account Number
Ownership (Names of)
Opening Dale
Balance on Date of Deady
Current Balance
Checking Account
38340623
Amy G. YovanovichlPOA)
Joseph Zedlar
0128/! 988
$1.435.6()
$ O/
$1,435.61
Installment Loan
12044457798734998
Joseph ZediarlPrimaryy
02242009
$-27.00**Thic amount is trot to be used
for payoff purposes. Far a payoff
balance. please call 7-800-724-2440
$ -27.00** This balance is nor a
payoff balance
3. Ty°peof Account SavingsAccoutu
Account Number 15004205355587
Ownership (Names of) Amy G. Yovanovich(POA)
Joseph Zedlar
Opening Date 03/082004
Balance on Date of Death $2.977.12
Accrued Interest $ .04
Total $2,977. /6
4. Tvpe ofAccount Certificate of Deposit
Account Number 31003920511283
Ownership (Names of) Amy G. Yovannvich
Joseph Zedlar
Opening Date 12/312009
Balance on Date of Death $34, 900.00
Accruedfnrerest $ /,776.86
Total $36.676.86
For any addfdonel informatlon on the above accounts, including ownership and any changes, closures and/or reimbursement of funds,
please ®Il the EGghland Park at 717-777.3322
W e were unable to locate any safe deposit box for the above-mentioned decedent.
This klter does not include any amwtnts N which the deceased may havx been tilted as Power of Attorney, Custodian of Uniform T'aasters,
Repre~fa6re Payee, or Trustee user a Written Agreement
Sincerely,
Vatarie Mercer
Adjustment Services
~~
~`,
~.
~?~-.acs,
I, JOSEPH ZEDLAR, ~>fthe'3oroug - ' `• ~,•~ + t~ rLu i. C imberland County,
Pennsylvania, declare this to be my la~•t t~ il? acx! r, . ~' ~ ~ ,ll ! cvi irsly made by me.
ITEM I. I direct that aii my jtst det,ts .rn' ~ ai z „ rF~er~ ~ ii :;lc~iding my gravemarker
and all expenses of my last illness, an+l an} .n i+i + : t~ ~ .. .: ; ss ° ~~ne +ts imposed by any
govet7unental body as a result of my rreath, a 1, _ ',. ~ c ~ -; : + t} i _si under this will or
otherwise, shall be paid from my resi¢luar} e' -a:::- : , _a . . ab e ,after my death as a part
of the expense of the administration of my c~t:u.:
ITEM IL I give and bequeath all ..f ~i~ ' r. _ 1 ~ ~ o-i ~u~ +mobiles, jewelry, and all
other articles of household and personal usa, «::+ ~~in r ~l try c;r together with all
insurance thereon and relating theretr,+, in +zyuu l ~' m •e - , . , ~ ~~y ;sue per stirpes who
survive my death by thirty (30) days,
ITEM III. I give, devise, and bequeath :~_ tl~~ . - rs:~a_~, ~ id. remainder of my
possessions and estate of every nature anca v h. ~_ . ~,~,r _ ~ + ~ n:.l °.ares to those of my issue,
per stirpes, as survive my death by tlrliny (3U: ~±cr, .,
ITEM IV. All of the interes~s of Ar< h::.:1 is +: A-. re a ier ~ hall not be subject to
anticipation or to voluntary or involunte¢y aG~n< ti» , ~ .r..[1 J ` .r :subject to any execution or
attachment.
ITEM V. I appoint my daughter ri vt ` (`. "; ~)` ' ':H: :~ecutrix of this my last
will. Should my daughter predecease me o- c~ 1+. ; ;~ ; i ~ ~ i lifj or cease to serve as
executrix of this my last will, I appoint my daughter JAN MARIE LEIB executrix of this my last
will.
ITEM VI. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regazd to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this ~ day of
JLtau , 2012.
" / ~--
JOSEPH ZEDL
The preceding instrument, consisting of this and TW O other typewritten pages, each
identified by the signature of the testator was on the date thereof signed, published, and declazed
by JOSEPH ZEDLAR, the testator therein named, as and for his last will, 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 hereto.
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
The undezsigned. being the testator whose trams is silgt-ed to We armrbod or taeaai~ inA~oeK,
having been duly qualified according to law, does hereby aclmowledgc ~ I si~oed and a=called the
foregoing instrument as my last will, that 1 signed if willingly; and that I signed it as my See aed
voluntary act for the purposes therein expressed. /
JOSEPH ZEDLAR '
Swom or affirmed to and acknowledged
before by the to tator amed above
this ~~ dey0 , 2OI2. COMMONWEALTH OF PENNSYWANIA
NOTARIAL SEAL
~" Wently K. Straub. Notary Public
lower Allen Township, Cumoerlend County
otary Public My Commisslon Expires May 10, 2015
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
wE, M, ~{~:~. ~ ~ L ~a~ d ~ ana ~a n ,~I ct r i e Le ~ b ,the
wimesses whose names~aze signesigned to ' e attached or foregoing instrument, being duly qualified according
to law, do depose and say that we were present and saw the testator sign and execute the instrument as his
last will; that he signed it willingly and that he executed it as his free and voluntary act for the purposes
therein expressed; that each of us in the hearing and sight of the testator signed the will as wimesses; and
that to the best of our knowledge, the testator was at that time 18 or more yeazs of age, of sound mind,
and under no constraint or undue influence.
Swom r affirmed d acknowledged
before ~ thi~1 ~ day of
~J 11 , 2012.
COM MONW EAITH OF PENNSYLVANIA
NOTARIAL SEAL
Wendy K. Straub, Notary Public
Lower Allen Township, Cumberlen0 County
My Commisslon Expires MoY 10, 201b