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HomeMy WebLinkAbout06-21-13 ' � 1505610143 REV-150Q EX(01-10) �, PA Department of Revenue OFFICIAL USE ONLY pennsylvania County Code Year File Number Bureau of lndividual Taxes DEAARTMENTOFREYENUE PO BOX.280601 INHERITANCE TAX RETURN 21 .-- Harrisburg, PA 17128-0601 RESIDENT DEGEDENT ��` ��t�„� ENTER DECEDENT INFORMATtON BELOW Social Security Number Date of Death Date of Birth 07 O1 2t311 �03 28 1943 DecedsnYs Last Name Suffix Decedent's First Name MI WALLACE RUTH J (If Applicabfe)Enter Survivinq Saouse's Informatinn�glQ�,u Spouse's Last Name Suffix Spouse's First Name M� WALLACE � CHARLES I, Spouse's Social Security Number . THIS RETURN MUST BE FILED{N DUPLICATE WITH THE • REGISTER OF WiLLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return � 2. Supplemental Return � 3. Remainder Return(date of death prior to 12-13-82) � 4. Limited Estate � 4a.Future interest Compromise 5. Federal Estate Tax Return Re uired (date of death after 12-12-82) ❑ q a g Decedent Died Testate � Decedent Maint ined a Living frust 8. Total Number of Safie De osit Boxes (Attach Copy of Wifl) ❑ (Attach Copy of�rust) p � 9. Litigation Proceeds Received � 10.Spousal PovertY Creait tdate of death ��,Election to tax under Sec.9113(A) between 12-31�J1 and T-1-95) � (Attach Sch.O) ' CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Tetephone Number : JERRY A WEIGLE ESQUIRE ?17 532 7388 �ICS3TER OF�1IfLLS��NLY First line of address � -��p � � � � � G'� �tiE 12 6 EAS T KING S TREET � �' � f``� �"� '� �► � � ~ '�` ~ Second line of address � � � C� �' _'L ,,,,T'l `'•�1 � '� � �,.�,,,, '�"t t=? -s- � Q � .�.. t a City or Post Office � DATE�IJ2ED �'"° d'r3 State ZIP Code SHIPPENSBURG PA 17257 > ...�,J � � CorrespondenYs e-mail address: _ 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.Dec{aration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S� RE OF RSON RESPONSIBLE�OR FIUNG DATE - � Charles L.Wallace �j"� '.DDRESS 646 Walnut Bottom Road Shi ensbu PA 17257 �IGNATURE PREPARER OTHER THAN REPRESE �IVE DATE � r Jerry A.Weigle Esquire �—Z�—��'� DDRESS i 26 East Kin Street, Shippensbur A Side 1 _ 15�5610143 1505610143 J � � � . � ' � 1505610243 REV-1500 EX Decedent's Social Security Number DecedenYs Name: Wallace, RUth Jai1e RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. : 2. Stocks and Bonds(Schedule B)............................................................................. 2. 3. Closely Held Corporation,Partnership or So{e-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 5• Cash,Bank Deposits&Miscetlaneous Personai Property(Schedule E)............... 5. 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscelianeous f�q Probate Property (Schedule G) �J Separate Billing Requested............ 7, 8. Total Gross Assets(total Lines 1-7)..................................................................... g_ ; 9. Funeral Expenses&Administratiye Costs(Schedufe H)....................................... 9. 10 , 0 9 0 . 0 0 ; 10. Debts of Decedent,Mortgage Liabilities,8�Liens(Schedule 1).............................. 10. 5, 641 . 60 l 11. Total Deductions{tota{Lines 9&10)................................................................... �1. 1$ , 7 31 . 6 0 12. Net Value of Estate(Line 8 minus Line 11).......................................................... �2. -15 , 7 31 . 6� ! 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. -15, 7 31 . 6 0 TAX COMPU7ATION-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 � . 0 0 15. 0 . �0 16. Amount of Line 14 taxable 0 . 0 0 16. 0 . 0 0 at lineaf rate X .045 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable af collateral rate X.15 0 . 0 0 18. 0 . 0 0 , 19. Tax Due.................................................................................................................. 19. 0 . 0 0 � 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 150561�243 1505610243 J _ � E x i REV-1500 EX Page 3 File Number 21 Decedent's Complete Address: DECEDENT'S NAME Wallace, Ruth Jane STREET ADDRESS 635 Walnut Bottom Road C1TY STATE ZiP Shippensburg PA 17257 ai( �ajiii?if�fii`t��154 i.i`�pii�: f E . Tax Due{Page 2, Line 19j (1) 0.00 = E . Credits/Payments � A. Prior Payments - � • • � B. Discount 0.00 f Total Credits(A +B) (2) 0.00 � � � � � F Interest (3} � �. 4 �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 ��) 4 � If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) �.QD � � � � R �' � � [ . {_ � Make Check Pa able to: RE GISTER OF ..,:: � x .v,p;;s...,:.,w..� :�;e x4`.'.xe9><'. . .; ...a�a' ^�x•�fi�"xs :rr�s: ����..,..�r w:�y WILLS, AGENT. :�. �: ��. � .� .�� .,�.��,:�:; .n��. .n..�.,. -.: � �" ..: .z. ..: ... ... ;., � , �: :�>: �H; =z,,. �, _n�..��;.,.Q..� .�.. . y.. , s,;..,..H., . . � r. .,rw .,. .., . ''�'�: :,� < ,.:x,. ..���;.;�z..x ,�.. �r.:;�r:c-,�.ax>:. .a��� �u �� „„�,>,:;F<. `e:;c� °�%Fk., .n,< ^-ay. � .:.< 7 „:, ....;;,...s, .� ;�M , , . . � s. �.,�.�.�:.� ..:. . 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Did decedent make a tra�sfer and: Yes No �_ a. retain the use or income of the property transferred:............................................................................... � 0 � b. retain the right to designate who shalt use the property transferred or its income:.................................. ❑ 0 � . . ❑ ❑ € c. retain a reversionary interest;or........................................................................................ ,, ....................... x s d. receive the promise for life of either payments,benefits or care?............................................................ ❑ 0 X' 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without ❑ � _ receiving adequate consideration?.................................................................................................................... x ; r 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ �x � 4. Did decedenE own an Individual Retirement Account,annuity,or other non-probate property which � contains a bene�cia desi nation x � rY 9 ?.................................................................................................................. ❑ e E ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. z :�: .:.FA '.Y'A ..',�l�R � �' ..'::^..,ttG. ' �� ...�y.�o'7.y:..;:^..ti�n..T..;,..:;.,ny .`.T. ..,�_ g�: e�«x�.;^� ��s. ..cr m..3�:� �� .�!.. �.�n£� .�...«.,Y �c..zs F,+�� a�,. �I �s. �. ,�..,»_. �c. a�>,. �,r.$... ..,5,�",� �.,z «.�`s .re. 'c� £x .H��� as ..�,,..Z� ..a�i��, �t.v ,F�. �s'<Sk',: „k,x.� a s�,.�. --s� s� � a'Y..:.:, 1 y: „,�,� � �.f.9 '"�:x.ro n. �<z:;..,Y y Sr; �.,,K�,,.. � ,, :� 3,�'. :,:� ,. , <s�:.;; ;,. .t..�r;,z u ,�^'"'uR;:,... ,.,..g,.�. . . .�.. �- S;i �> � �5.: ��:�.c� ,.�"x,>E?><>:.� .. .�..�.a.<.E,:w.. ,r�a;,h;:��.,�.�ss�:>:��:s�z+.n��..:��..s �. . �,. �'k^��""�"'��,�,3;�s,.,..a.�.:,.,r�.s.�;..�.:��.�.fi;>�rx:c���r.,..,�s�.s..F.�.�>�''u�s.£,M4ri�;.Z��,� �.•..�."°' „M,. � �{ �.. .�?rK.„s".H �1 :� ��: < � ..p;.,.s. �� >,.,_;, _�.,..,�1�:,..:b.a s,�. �.:,..��._.�..r,:.,.,.,,r�_r��;..., e,.s.,.., ".5�.`�a�?�>,.�:..��:fi,% a� .tes of death on or after July 1, 199�and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving � e is 3 percent[72 P.S.§9116(a)(1.1)(i)]. � � � � tes 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 � �.§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 ° and filing a tax return are still appiicable even if the surviving spouse is the only bene�ciary. ies of death on or after July 1,2000: x tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or far the use of a natural parent,an ` ptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. _# tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in �.S.§9116 1.2)[72 P.S.§9116(a)(1)]. ¢ tax rate imposed on the net value of transfefs to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A � ig is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. � � t �: � � ,Rev-1508 EX+(6-98) , �������� � � � �°-�' CASH, �At�K DE�O�SfTS, & �E�C. : �.1:� - PERSC�[��� PE�QPEE��"Y COMMONWEALTH OF PEt3NSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT EST!!TE OF FILE hEUtl�f�EF� 1tVa{lace, Ruth Jane 2� include the proceeds of litigation and the date the proceeds were received by ihe estate. A14 property jointiy-owned with the right of sun�ivorship must be disciosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTfON OF DEATH ALL ASSETS JOINTLY OWNED WlTEi SPOUSE TOTAL(Also enter on Line 5, Recapitulation) 0.00 (If more space is needed,additionat pages of the same size} (c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.6-98) Rev-��s�ex+��o-os� � > , . ;� SCHEDULE H COMMONWEALTH�F PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE AX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Wailace, Ruth Jane 2� Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s)attached • 9,925.00 � � s � . ADMINISTRATIVE COSTS: 1. Persona!Representative's Commissions Name of Personal Representative(s) � Street Address � City State Zin Year(sl Commission naid 2. Attornev's Fees Weigle&Associates, P.C. 150.00 t 3. Family Exemption: ({f decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address � � � City State ZiD Relationshin of C4aimant to Decedent 4. Probate Fees # 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 15.00 See continuation schedule(s)attached � TOTAL(Also enter on line 9, Recapitulation) 10,090.00 ht(c)2009 form software only The Lackner Gcoup,Inc. Form PA-1500 Schedule H(Rev. 10-06) � F � � � SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Wal{ace, Ruth Jane 21 ITEM NUMBER DESCRiPTiON AMOUNT Funeral Expenses 1 Fogelsanger-Bricker Funerai Home 9.925.00 H-A 9,925.00 Other Administrativ Costs � � 3 2 Register of Wiils,Cumberland County-filing Insotvent PA Inheritance Tax Return 15A0 s H-B7 15.00 ht(c)2002 form software onfy The Lackner Group,inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+(12-08) SCHEDULE i y� R DEBTS OF DECEDENT, MORTGAGE LIAB1LITlES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wattace, Ruth Jane 21 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRlPTION f�F pEATH 1 Northiand Group,Inc.-cotiection agent for Capital One Bank credit card 2,382.02 2 Pharmacare Pharmacy 794.58 � 3 Summit Physician Services 2,465.00 � � € � � � f: e i f- i }: � 4 TOTAL(Also enter on Line 10, Recapitulation) 5,641.60 ' (If more space is needed,additional pages of the same size) z (c)2009 form software onfy The Lackner Group,Inc. Form PA-1500 Schedule 1(Rev. 12-08) ; ; ; F R�V-1513 EX+(11-08) ' , . ` SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERiTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER _ Waflace, Ruth Jane 21 RELATIONSHIP TQ NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(Sl RECEIVING PROPERTY (Words) ($$$) D Not List Trustee I TAXABLE DISTRIBUTIONS [inciude outright spousai ' distributions,and transfers under Sec.9116 a 1.2 �at r�ieva�i.t ds es�ate is insolve t. � � Total Enter doffar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. � NON-TAXABLE DISTRIBUTIONS: • A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHlCH AN ELECTION TO TAX 15 NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIlJNS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTlONS 4N LINE 13 OF REV-1500 COVER SHEET c)2009 form software oniy The Lackner Group,Inc. Form PA-15Q0 Schedule J(Rev. 11-08) . �._.,,� . `-� LAST WILL AND TESTAMENT I, RUTH JANE WALLACE, of R. D. 2, Bax %58, LeesbLrg, Southa�pton Township, 5hippensburg, Pennsylvania, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct�the payment of all my just debts and funeral, expenses as soon as may be convenient after my decease. � � � � SECOND. I specifically direct that any and all debt that I may have incurred during & � my lifetime which was secured by a Certificate of Deposit issued by Hill Financial Savings Association, 49 West King Street, Shippensburg, Pennsylvania dated June, � � 1988, (Cert. �� 31-69002304) and drawn in the amount of Fifty Thousand ($50,000) Dollars, or any renewal thereof issued by the said Hill Financial Savings Assocation ` or any other f inancial institution, be paid in full out of other assets of my estate as soon as may be feasible and practical after my death. Furthermore, I give and bequeath the above referred to Certificate of Deposit Number 31-69(J02304, including any and all interest credited to said Certificate of Deposit or any renewal of the said Certificate of Deposit (Number 31-6900234) issued by Hill Financial Savings Association or any other financial institution to my children, DOUGLAS R. SHOTTS and BRIAN K. SHOTTS on a per stirpes distribution basis. � THIRD. I give, devise and bequeath all of the rest and residue of my estate, real, personal and mixed, whatsoever and wheresoever situate to my beloved husband, CHARLES L. WALLACE, absolutely. FOURTH. In the event that the said Charles L. Wallcce predeceases me or is not -�'�1 ; ,� .�� R �� ',� `�- ,,r; '�i �t��y--�,.-� (SEAL) 4��,�_ \..; �''.�z.�:.� � � %�� � %`� MARK, WE16LE A►VD PERKINS - ATTORNEYS AT LAW - 115 EAST KIN6 STREET - SHIPPENSBURG, PA. 17257 € ; t, F living on the sixtieth (60th) day following my death, I then give, devise and ` � bequeath all of the rest an�. residue of my estate on a per stzrpes distribution basis � ; as follows: � � �' A. ONE SHARE to my son, DOUGLAS R. 5HOTTS; � � B. fJNE SHAR.E to my son, BRIAN K. SHOTTS; �: C. ONE SHARE to my stepson, MATTHEW WALLACE. � t . � . � � FIFTH. In the event that any beneficiary of this my Last Will and Testament is ` � under the age of eighteen (18) years, I then give and bequeath said beneficiary's share to and appoint as Guardian of any property which passes under this Will or � � � otherwise, GERALDINE WALLACE, AS GUARDIAN, NEVERTHELESS, to invest and re-invest the � � same until the said beneficiary reaches the age of eighteen (18) years, with the � following powers in addition to those presently given by law: � A. The power to expend the income towards the health, support and maintenance, € and education, including a college (both undergraduate and graduate), � trade, business or technical school education, of the said beneficiary; � � B. The power to expend the principal, within the discretion of the said = f: Guardian, if the income is insufficient, towards the health, support and maintenance, and education, including a college (both undergraduate and graduate), trade, business or technical school education, of the said ' - beneficiary; C. The power to sell any and all real estate, within the discretion of the said Guardian; � D. The power and obligation to distribute the balance of principal and. interest, if any remaining, when the said benef iciary reaches the age of ; eighteen (18) years, without the necessity of a formal adjudication of the Guardian's account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release; f � � E. The principal of the Guardianship and the income therefrom shall be free � from the debts, liabilities, and engagements of those beneficially � interested therein, and shall not be subject to assignment by him or her, � nor to attachment or e�,ecution under any legal, equitable or other process ; � . rt r ��, � ; l%`� ?� _ '���_ ,, ,,.�,_ ,��;��1:::�%�--�-,-�_..., (S EAL) ;: -2� '� `�f� � ;�,: :, �: MARK, WEIGLE AND PERKMS - ATTORNEYS AT LAW - 1 15 EAST KING STREET - SHIPPENSBURG, PA. i 7257 � 1 � � ; for th� enforcement of judgme�ts 6r claims of any sort against them, either individually or collectively; F. In the Event the abov�-mention�d Guardian is unable to accept �he Guardianship, I then name, constitute and appoint ORRSTOWN BANK, of East King Street, Shippensburg, Pennsylvania, as Guardian, witih the same powers hereinbefore stated. SIXTH. I nominate, constitute and appoint my husband, CHA�LES L. WALLACE, to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute and appoint DOUG R. SHOTTS to be the f Executor of this my Last Will and Testament. � � SEVENTH. I direct that my personal representative shall not be required to give bond for the faithful performance of duties in any jurisdiction. EIGHTH. I hereby direct that all federal, state and other death taxes payable �ecause of my death, with respect to the property forming my gross estate for tax ; �urposes, whether or not passing under this Will, including any interest or penalty �posed in connection with such taxes, shall be considered a part of the expense of �ministration of my estate and that such be paid out of the rest and residue of my tate. IN WITNESS WHEREOF, I, RUTH JANE WALLACE, have hereunto set my hand and seal to s my Last Will and Testament, written on hree pages, the first two signed for ..- ntification only, this ' ay of , , 1989. �� ,, � �` ' ;�`�-�.�::._..... �,�''t� ����E�`-�-� (S.EAL) ��� J/I t( // Lf r S� ri I MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - i i 5 EAST KING STREET - SHIPPENSBURG, PA. i 7257 This instrument was by th� Test�trik, RUTH JAI�?E GIALLACE, on the date hereof, signed, published and aecla�ed by her to be her Last Wi11 and Testament, in our f presence, who at her �eguest and in her presence and in the presence of each ath�r, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. �;; . i/ r, -•f: r; .�- f 1 � : ���€�..f �.,/� >C.�•� ,.-;T�. �� ��� ,v :' • ,�,. !f, � � � � ,� �„? ,,� f";:✓���'���� i�Cf���'f � t---- f" ..��� r. � � � } � OMMQNWEALTH OF PENNSYLVANIA : : SS. �UNTY �F CUMBERLAND : I, RUTH JANE WALLACE, the Testatrix whose name is signed to the foregoing �trument, having been duly qual.if ied according to Iaw, do hereby acknowledge that I �ed and executed the instrument as my Last Will; that I signed it willingly; and I signed it as my free and voluntary act for the purposes therein expressed. � , ���`� _, �� � /( j,,.,; �.-,� �,� C.��h�'� , rr ,' :� or affirmed to and acknowledged m by RUTH JAI�E W LLACE, the Testatrix, � 1989 i aY of j�/�` � �r f� { r { � WOTRR��iI.5��� JstryA.lAleiBle.N�ta Fubiic ' . S�ppet�sbt�t�,PA Cumbert�nd�vurz�y ; M Commis�ion ires Jut�31, 199� ; -4- � RK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 1 15 EAST KtNG STREET - SHIPPENSBURG, PA. i 7Z57 � { CQI�'II.+'I011�n�EALTH QF PENNSYLVANIA : ; SS. C4UNTY OF CU�IBERLAND : '"_J . i .» F .-Jj .�*- ' ,i , - , ,. �� / �'� � � � . �. f ... �`� ,. �• : r � -� ,/ i i �` , _..-- F c f`� F,. We, ���r i,�.�,�����.� �. '�,��; �. -�.�-ti...� and � � �r:��,�,�, �,� ��(. f ,,,���,��,. — _ ,�.. 1 r �y.a �r ✓' C�✓WC 4" G• ' {r"'r, � the witnesses whose names are sigi� d to the foregoing instrument, being duly �ualified according to 1.aw, da depose and say that we were present and saw RUTH JANE 'ALLACE, Testatrix, sign and execute the instrument as her Last Will; that she �_gned willingly and that she executed it as her free and voluntary act for the rposes therein expressed; that each of us in the hearing and sight of the � � � � tatri� signed the will as witnesses; and that to the best of our knowledge the � � � t was at the time eighteen (I$) or more years of age and of sound mind and under no ' =raint or undue inf luence. � '�� ����� .� ��� _�. .� ���.y � � � ��� , �� ,.�- - � �,��.�� � ; � � ,�. affirmec� to and subscri�e -:� by �.....�� ,���"��� ��,✓�'�Z�'" �f:� ' � � ,� , this ��` � ay of � , 198�. r � y � , �i � V illi'�i�.i� � d „MaryA.1A18i�le�,Na�aryt £ � �ensbtng,PA t�umbrat't+iMt�d � `ommisss"Q�Er:�r�res J�ly 31�!$9�4 � � � : � ; � i � � _5_ � � � F f �LE AND PERKINS — ATTORNEYS AT LAW — 1 i5 EAST KING STREET — SHIPPENSBURG, PA. 17257 � N � �' � �° a m�' � � � � � � . � � � `Q `Q o � � � � � �' � � c� N � y� � � v � ». _,__�.�_ � w__� - _._.___ - _. � - .. ___.� __ _ , _ _ .�,.,..,_,,��-�-- ____. .a r. �. ...._. .._.__,,,,,___,-�. __._.._-..�.,....-