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HomeMy WebLinkAbout04-04-13 (2) REV-1500 Ex (°'_'°' 1505610140 PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 2 1 1 9 5 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 0 9 0 1 2 0 1 2 0 4 2 4 1 9 1 9 Decedent's Last Name Suffix Decedent's First Name MI L a n y i M a g d a (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 ❑X 1.Original Return 2.Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) El 4. Limited Estate 4a. Future Interest Compromise(date of 5. Federal Estate Tax Return Required death after 12-12-82) 6.Decedent Died Testate 7.Decedent Maintained a Living Trust 0 S.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9.Litigation Proceeds Received ❑ 10.Spousal Poverty Credit(date of death ❑ 11.Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number W a y n e F S h a d e E s q u i r e 7 1 7 2 4 3 0 2 2 0 _gEGISTER OF LS First line of address C O Rt-_ =7 -1 y. r- —t' v 5 3 W e s t P o m f r e t S t r e e t 3W •� MM Second line of address Z N O O c� o 0 7 _n oc"� ; City or Post Office State ZIP Code ro_ ____DAILE�_f12 C a r l i s l e P A 1 7 0 1 31 - -a Correspondenrs e-mail address: waynefshadenacomcast.net Under penalties of perjury,I declare 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.Declaration of p rer other than the personal representative is based on all information of which preparer has any knowledge. SI UR ERSON RESPONS R FILING RETURN DATE r ADDRESS 28 Cambridge Court Carlisle PA 17013 SIGNATyR OF PREPAR� AN EPRESENTATIVE DATE �O ADDRESS 53 We* Pomfret Street Carlisle PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 2 1505610140 1505610140 J ) 1505610240 REV-1500 EX RECAPITULATION 1. Real Estate(Schedule A) . . . . . 1 2- Stocks and Bonds(Schedule B) . ... . . . .. . . . . .. . . . .. . . ... .. . .. . .. . . . . . 2, 0 a 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) , . . 3. 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . 4, 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. . .... 5. 5 5 1 7 • 4 3 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested 6, 1 3 1 8 7 4 7. Inter-Vivos Transfers&Miscellaneous N20-Proloate Property (Schedule G) [:] Separate Billing Requested 7. 9 3 2 4 6 4 2 6 8. Total Gross Assets(total Lines 1 through 7) . ... 8. 9 3 9 3 0 0 4 3 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9 1 0 7 6 6 1 7 10. Debts of Decedent,Mortgage Liabilities, and Liens(Schedule 1) .. . . . .. . . . 10. 1 4 8 8 3 . 6 0 11, Total Deductions(total Lines 9 and 10) . . .... ... .... . ... .. .. 11. 2 5 6 4 9 . 7 7 12. Not Value of Estate(Line 8 minus Line 11) . . . .. . . . . . . . . . . . . . . . . . . . .. 12, 9 1 3 6 5 0 . 6 6 11 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . 13. 14. Not Value 34N W to Tax(Line 12 minus Line 13) .. ... 14. 9 1 3 6 5 0 . 6 6 TAX L I LA Qi4-SEE INS MUCTIONS FOR APPLICABLE RATES 15 Mo 3 of Lice 14 taxable at thespou4ii-tax rate or transfers under Sec,0;16 (a)(1.2)X.0 0 0 0 15, 0 . a 0 16. "ount of Line 14 taxable ao Ilne*4 rate X.045 9 1 3 6 5 0 6 6 16, 4 1 1 1 4 . 2 8 17. Anount of Line 14 taxable at sibling rate X.12 0 . 0 0 17, 0 . 0 0 r! 18. Amount of Line 14 taxable afdblliftraf rate X.15 0 . 0 0 18, 0 . 0 0 19. TAX DUE . . . . .... .... . .. .. . ... . . . . . . . . ..... . .. 19, 4 1 1 1 4 . 2 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 - REV-1$00 EX Page 3 File Number Decedent's Complete Address: 21 12 1195 DECEDENTS NAME Mafpda Lanyi STREET ADDRESS 28 Cambridge Court CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 41,114.28 2. Credits/Payments A.Prior Payments 39,000.00 B.Discount 2,052.57 Total Credits(A+B) (2) 41,052.57 3. Interest (3) 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) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 61.71 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 transferred; ...................................................................... ❑ X❑ b, retain the right to designate who shall use the property transferred or its income; ............................... ❑ ❑ c. retain a reversionary interest;or ................................................................................................ ❑ IKI d, receive the promise for life of either payments,benefits or care? ....................................................... ❑ 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ ❑X 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... Q ❑ 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 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 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[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in 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.§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. REV-108 EX+(11-10) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE INHERITANCE TAX RETURN CASH, BANK DEPOSITS, & MISC. RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Magda Lanyi 21 12 1195 Include the proceeds of litigation and the date the proceeds were received by the estate. All propkrty Jointly owned with right of survivorship must be dbclossd on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Diamond engagement nng 2. Gold wedding ring 320.00 3. Bon-Ton, credit card refund 4.00 4. FEGLI, class action settlement 2.43 5. Internal Revenue Service, income tax refund 4,132.00 6. Pennsylvania Department of Revenue, income tax refund 884.00 TOTAL(Also enter on Line 5,Recapitulation) $ 5,517.43 If more space is needed,insert additional sheets of paper of the same size James Line Jewelers Qwftn'Ynu can&vAw a price)m can 406rd 200 S. Spring Garden St. Carlisle,PA 17013 717-2494888 Appraisal September 14,2012 To whom it may concern: This is to certify that the following articles of jewelry from the estate of Magda Lanyi have current values as indicated: Ladies solitaire diamond ring,consisting of an old mine cut 3.8 mm round diamond weighing.20 carats of G.I.A. color grade G and clarity grade S12,bezel set in a 10 karat white gold setting(as per the attached picture),has a current value of$175.00. One 14 karat white gold 3.6 mm wide plain half round wedding band 1.7 mm thick in size 6.5(as per the attached picture),has a current retail value of$320.00. James Line Jewelers J REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Magda Lanyi 21 12 1195 If an and was made jointly owned within one year of the decedents date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A.Thomas Lanyi 28 Cambridge Court Son Carlisle, PA 17013 B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FORJOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 1/30/09 Orrstown Bank, checking account# 146001485 2,637.47 50. 1,318.74 TOTAL(Also enter on Line 6,Recapitulation) $ 1,318.74 If more space is needed,use additional sheets of paper of the same size. Orrstown Bank 01: Account Transactions Page I of 1 19011� {)��s�o��vBA� A Tradition of Excellerim View Transactions for: 50 Int 0001 Current Balance: 6,223.33 Available Balance,6,223.33 Transactions from 08/22/2012 to 09/06/2012 View Range:Since Last Stat?^?"-'•nt 17 DAYS 115(Days 130 Day I AU ).ace Rol/Check No, Desesiptluft: Debit: Credit: Balance 09/05/2012 INVESTMENT VGI-IT TRSY AD 130.78 6,223.33 PPD 09/05/2012 INVESTMENT VGI-PA LT ADM 222.19 6,092.55 PPD 09/05/2012 INVESTMENT VGI-LT TRSY AD 1,101.78 5,870.36 PPD 09/05/2012 INVESTMENT VGI-HIYD CP AD 1,418.11 4,768.58 PPD 09/04/2012 PENSION MET LIFE-COMER. 713.00 3,350.47 PPD 08/31/2012 XXCIV SERV US TREASURY 312 676.97 PPD i 08/31/2012 XXSOC SEC US TREASURY 303 1,096.00 1,960.501 PPD 08/29/2012 View Image Miscellaneous Debit (10,345.00) 864.501 08/29/2012 509 CHECK PYMT SEARS PAYMENT (1,131.94) 11,209.501 CHECK* 0509 08/27/2012 50 Check 508 (36.08) 12,341.441 08/26/2012 Interest Deposit 0.13 12,377.52 08/24/2012 507 Check 507 (137.39) 12,377.39 08/24/2012 $06 Check 506 (225.48) 12,514.78 08/22/2012 INVESTMENT VGI-PA TE MM 10,000.00 12,740.26 PPD Totals(this page): Transactions 14 066198:(11,8MI119) Credltr:13,358.96 j Print Preview LEIgER https://cm.netteller.com/login200$Niews/Retaii/AccountTransactions.aspx 9/6/2012 RIEW 510 EX-(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Magda Lanyi 21 12 1195 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REALESTATE. VALUE OF ASSET INTEREST (IFAWLICAR.Q VALUE 1 Vanguard Flagship account , TOTAL(Also enter on Line 7,Recapitulation) $ 932 464.26 If more space s needed,use additional sheets of paper of the same size. Vanguard- vanguard Page 1 of 1 Vanguard My Portfoho * ACCOGants &Activity n Holdings Details Find balance by date Historical balances are available online for the past 18 months. If your fund pays a daily dividend,your accrued dividends will be displayed. Enter the date you'd like to view for your account and click Calculate. View Magda Lanyi—Individual Account Data 09/01/2012 M(mm/ddlyyyy) Note: This screen only displays mutual fund accounts.Annuity assets, 529 plans, and brokerage accounts are not included. View Employer Plan balances by date Portfolio of Magda Lanyi—Individual Account Magda Lany"ndividual Account Fund& Accrued Name Symbol Account Shares Price Value Dividends Total Value Vanguard High-Yield 0029- Account had no shares on this Corporate Fund investor VWEHX 09877892928 0.000 $5.98 date. Shares Vanguard Pennsylvania Tax- VPTXX 0063- 5,000.260 $1.00 $5,000.26 $0.00 $5,000.26 Exempt Money Market Fund 09977892928 Vanguard High-Yield Corporate Fund Admiral VWEAX 0529 65 512.168 $5.98 $391,762.76 $66.22 $391,828.98 Shares 09977892928 Vanguard intermediate-Term VFIUX 0535- 10,000.001 $11.85 $118,500.01 $4.45 $118,504.46 Treasury Fund Admiral Shares 09977892928 Vanguard Pennsylvania Long- Term Tax-Exempt Fund VPALX 0577- 6,135.547 $11.71 $71,847.26 $7.17 $71,854.43 Admiral Shares 09977892928 Vanguard Long-Term VUSUX 0583 25,000.000 $13.81 $345,250.00 $26.13 $345,276.13 Treasury Fund Admiral Shares 09977892928 Subtotal $932,464.26 0 1995-2012 The Vanguard Group, Inc.All rights reserved.Vanguard Marketing Corp.,Distrib.Terms&conditions of use I Security Center I Obtain prospectus I Careers I Mobile services I A Feedback I Enhanced Support https.//personal.vanguard.com/us/TPView AccotmtBalanceByDate?SelectedAccountFromT... 9/6/2012 REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Magda Lanyi 21 12 1195 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home, funeral expenses 5,198.17 2. Saint Patrick Church, funeral services 500.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2, AttomeyFees: Wayne F. Shade,Esquire 1,500.00 3. Family Exemption:(If decedents address is not the same as claimants,attach explanation.) 3,500.00 Claimant Thomas Lanyi Street Address 28 Cambridge Court city Carlisle state PA ZIP 17013 Relationship of Claimant to Decedent Son 4. Probate Fees: 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Register of Wills, filing Pennsylvania inheritance tax return 15.00 8. James Line Jewelers,jewelry appraisal 53.00 TOTAL(Also enter on Line 9,Recapitulation) $ 10 766.17 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-08) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES,&LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Magda Lanyi 21 12 1195 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,induding unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Sears Gold MasterCard,account#xxxxxxxxxxxx2358 341.50 2. Anna Smith, home care 45.00 3. Cumberland Goodwill EMS, ambulance service 83.33 4. FC&A, garden book 39.95 5. Cumberland Crossing, laundry service 9.04 6. Jitterbug,cell phone termination 14.78 7. Saint Patrick Church, cemetery plot 500.00 8. Internal Revenue Service, federal income tax 11,250.00 9. Pennsylvania Department of Revenue, state income tax 2,600.00 TOTAL(Also enter on Line 10,Recapitulation) $ 14,883.60 If more space is needed,insert additional sheets of the same size. REV-1513 EX.(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Magda Lan i 21 12 1195 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outn'ght usal distributions and transfers under Sec.91 , (aa (1.2).] 1. Thomas Lanyi Lineal 913,650.66 28 Cambridge Court Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: --_---_-39,000.00 Discount: 2,052.57 Interest Table Year Days Delinquent Balance Due Interest this time period this year this period - Before 1981 _1982 1983 1984 1985 1986 -- 1987 —- 1988 through 1991 _ 1992 1993 through 1994 1985 through 1998 1_999 2000 -_--- 2001 - -- - - - - --- - -- 2002 - -r - - ---- j- .2003 2004_ - - --- -- -- 2006 2007 -- - 2008 2009 - 2010 2011 through 2012 I TOTALS - - -- - Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: ____--_-- Penalty: LAST WILL AND TESTAMENT I, MAGDA LANYI, of the Borough of Carlisle,County of Cumberland, Commonwealth of Pennsylvania, being of sound and disposing mind,memory and understanding, do make,publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills,codicils and trusts by me at anytime heretofore made. FIRST. I order and direct that all my just debts,funeral expenses and expenses in q , connection with administration of my Estate be paid by my personal representative or 61 representatives, hereinafter named,as soon as conveniently may be done after my decease. I further authorize my personal representative to expend funds from my Estate in such amounts as my personal representative shall consider appropriate, for the disposition and memorial of my remains. SECOND. All the rest,residue and remainder of my Estate, real,personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath unto my son, THOMAS LANYI, if he survives me. THIRD. For the purposes of this my Last Will and Testament,a person shall not be deemed to have survived me unless he or she shall have survived me by more than ninety (90)days. wAnon F. Law awns= Attontey at L FOURTH. If my son,THOMAS LANYI, should fail to survive me,I give,devise 53 West Parn iel Street Carlisle.Pennsylvania 17613 and bequeath the said residue of my Estate,as follows: (a) Ninety(90%)percent thereof unto the Association of Graduates of the U.S. Military Academy for its West Point Fund;and (b) Ten(10%)percent thereof unto the Association of Graduates of the U.S. Military Academy for its Class of 1967 Fund. FIFTH. I order and direct that any estate, inheritance or similar tax due as a result of my death with respect to any property passing as a result of my death,shall be paid from the residue of my Estate before its division into shares and prior to distribution as an 1 expense of administration and that no q , pe part of the taxes should be prorated or apportioned 1�5 among the persons or beneficiaries receiving the taxable property. It is my express intention that all inheritance taxes imposed as a result of my death be paid from the residue of my Estate whether or not the property passes under my Last Will and Testament. My personal representative shall have full power and authority to pay, compromise or settle any such taxes at anytime whether with respect to present or future interests. SIXTH. Any and all decisions, determinations or actions made or taken by a personal representative hereunder, if made in good faith, shall be final and conclusive on all persons who are or may become interested in my Estate. No fiduciary acting under this my Last Will and Testament shall be liable for any error in judgment or for any WAYNE F.SHADE Attorney at Law 53 West Pomfret Street Culisle,Pemisylsania 17013 -2- depreciation or reduction in value of any Estate assets at anytime, in the absence of willful default. SEVENTH. I order and direct that my body be cremated in lieu of burial and that disposition of my ashes be with those of my late husband,THOMAS LANYI,at the Gate of Heaven Cemetery in Silver Spring,Maryland. LASTLY. I nominate,constitute and appoint my son,THOMAS LANYI,to be the Executor of this my Last Will and Testament,but if, for any reason,he should fail to qualify as such Executor or decline or cease so to serve, I nominate, constitute and appoint my legal counsel, WAYNE F. SHADE,ESQUIRE,to be the Executor hereof, each to serve without bond. IN WITNESS WHEREOF,I, MAGDA LANYI, have hereunto set my hand and seal to this my Last Will and Testament which consists of five(5)typewritten pages to each of which I have affixed my signature,this 18th day of December , A.D. Two Thousand Eight(2008). (SEAL) Magda LVnyi The preceding instrument, consisting of this and four(4) other typewritten pages, WAYNL F.SHADE each identified by the signature of the Testatrix,was on the date thereof signed,sealed, Attorney at Law 53 West Pomfret Street Carlisle.PenarA ama 17013 -3- published and declared by MAGDA LANYI,the Testatrix therein named, as her Last Will and Testament,and we, at her request, in the presence of each other,have subscribed our names as witnesses hereto. L--j Acknowledgment COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF CUMBERLAND ) I, MAGDA LANYI, the person whose name is signed to the foregoing instrument, having been duly qualified according to law,do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by MAGDA LANYI,this 18th day of December ,2008. r Magda Lanyi d. a—7-'L� Notary F16blic WAYN Attorney at Law CCWW40"VJff^L-TH0FP8NPdMVAMA �. 33 West Pomfret Street NOTA ML$y-�N.IL,,, Carlisle,Pennsylvania COME Nft J.7WT. P Ubk 17013 -4- L1C=de*n8*n0do1w5,2)j2 Affidavit COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF CUMBERLAND ) We, Leonard W. Tritt and Helen H. Shade the witnesses whose names are signed hereto,being duly qualified according to law,do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Wilt and Testament;that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed;that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that, to the best of our knowledge,the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by Leonard W. Tritt and Helen H. Shade ,witnesses, this 18th day of December 2008. K2, Notary Pub c oowroMwsw"4WPW*4MVAW NOT"ANAL SEA. Ic � Connrabn OGobat 5,i0t? WAYNE F.SHADE Atiomey v Law 53 W,:a Pomfret Strw Carlisle.Pemisylvania 17013 -5-