HomeMy WebLinkAbout10-24-13 � f s
� 15056107,05
REV�1500 EX(o2-ii)(FI)�� �
OFFICIAI USE ONLY
PA Department of Revenue pennsylvarria Coun Code Year File Number
DEVARTMENTOFNEVENUE {�/
Bureau of Individuat Taxes INHERITANCE TAX RETURN ��
PO BOX 28o6oi
�� Harrisbur ,PA 1 �28-o6os RESIDENT DECEDENT �1 ' �3 ' �'��7J
, ENTER DECEDENT INFORMATION BELOW
- Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
; �/' ' 05/18/2013 _ 05/30/1912.
_ _ . _ ._ _ .. .
_ _ _
DecedenYs Last Name Suffix Decedent's First Name M�
_ __. ...._ _ , ; _._ _..... _ _.
_._... ___........
;Robie Steve M
;� (If Applicable)Enter Surviving Spouse's information Below _ __ .._ _ _ _ __ ____ _ _ _
F:
��• Spouse's Last Name Suffix Spouse's First Name M�
; . ___
__ __ _ . _ _. _ ..._ _. _; __. . ;
_. _ . .... _ _ _ ;
__
Spouse's Social Security Number
` " " ' THiS RETURN MUST BE FILED IN DUPUCATE WITH THE
� ___ ' REGISTER OF WILLS
FILL IN APP120PRIATE OVALS BELOW
� 1.Original Return p 2.Supplemental Retum Q 3. Remainder Return(Date of Death
Prior to 12-13-82}
O 4.Limited Estate Q 4a.Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
� 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 Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax upc�gr Sec.9113(A)
Between 12-31-91 and 1-1-95) (,�ach Schedul�� �3
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX IWFOR O�HOULD B�D REC� �- -
Name Daytim4'�e��hone Nt,I�i�er �
. _. _.... __. _...
_.._. _.. _. _........ _... ___.._.... .
Andrew C. Sheel Es uire � � �'' � �-� �
� Y� q 717-69'T-��5fl- ��; ►~� ;
_....... _ _........_ ` C`"" �,.` N '
_
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,��,
REGlSTER OF WI�S US�I�
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... �, � ��^- _�
;„ First L�ne ofAddress • �� � -°�
: _._. _. _.. . . ...._ __. . _.._
....
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; ,M.�i p� �„�,i
� ___...__ _...
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;127 South Market Street ' �,s �-� W � �,
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__ _ �
_. ;
_. _. �' •
_ __ _ __. _ __ _ _ ..
Second Line of Address
.S' P.O. Box 95
City„or Post Office State ZIP Code DATE FI�E�
, __.. _....... __. _..... __....__._ ;. _ ......... ., _ _.. .. ..._...........
Mechanicsburg PA 17055 ;
_.._ _ ___ __ _ _: _ _..
Correspondent's e-mail address:andrewc.sheely@verizon.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 preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG E OF P fSON RESPONSIBLE FOR FILING RETURN rnTc
' � .2 � /3
pnnRFCc
� Patri ' M. Middendo ec ' , 8 Glencarr Court, Dillsburg, PA 17019
SIG RE OF ER HAN EPRESENTATIVE {� F �
1Q l3
.
nn I�CCC •
Andrew C. Sheely, Esquire, South Market Street, P.O. Box 95, Mechanicsburg, PA 17055
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PLEASE USE ORIGINAL FORM ONLY
� Side 1
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� 1505610105 ],505610105 J�
;,:
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7 •
�SDS6�D�05
� R�v-��oo�x{�i�
• Decedent's Sacial Security Num�er
DecedenYs Nai�e: RObl2, steve M.
RECa��TU�.A-riarv
1. Real Estate(Schedule A). . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
2. Stocksand Bonds(Schedule B) .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Ciosely Held Corporation, Partnership or Sale-Proprietarship(Schedule Cj . . . . . 3.
4. Mortgages anci Notes Receivable{Scheduie D) . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Cash, Bank De{�osits and Miscellaneous Persana( Property{Schedule E). . . . . . . 5. 5,084.42
6. Jointiy O�nrr,eci Property(Schedule F) O Separate Billing Requested . . . . . . . 6.
7. lnter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � 0 Separate Biliing Requested.. . . . . . . 7.
$. Tata4 Grc�ss Assets(totaE Lines 1 through 7). . . . . . , . . �, 5,084.42
3. Funera! ExpEns�s and Administrative Costs(Srhedufe H). . . . . . . . . . . . . . . . . . . 9. 1,868.54
10. Debts of Decedent, Mortgage Li�bilities anci Liens(Schedule I}. . . . . . . . . . . . . . . 10. ' 94,935.33
11. Tatai Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . 11. $96,803.87
12. Net Value af Est�te(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. �.0�
�3. Charitable and Governmental Be:�uestslSec 9113 Trusts for v��ich
an electior�to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Valus Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. 0.00
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
95. Amount of Line 14 taxable
at the spousai tax rate,ar
transfers unr+�'r�ec. 9116
(a}('{.2)X.0 15.
16. Amount of Line 14+�Y�bie
afi lineai raYe X.b45 0.00 ��. 0.00
17. Amoi�nt of Lin� 14 taxable
at sibling rate X.12 17.
_
18. Amount af Line 14 taxable •
at callateral rate X .15 18.
19. TAXDUE . . . . . . .. . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19.
0.00
2Q. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Slde 2
� 1,505�1,�205 15056�,Q205 �
� �t �� Y.. . .. . . . . .
REV-1500 EX(FI) Page 3 File Number
Decedent's Compiete Address: � �' ��J" — o��'�
DECEDENT'S NAME
Steve M. Robie
_�, STRFFT A�nRFSS �
�; 940 Walnut Bottom Road
,�
,P... _—_.._._.__'__'_______--.._____ ____—__—._______
�,�.ry ---- ---- - STATE �� ----Z pj 17015 ---------
Carlisle
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) $0.00
2. Credits/Payments
A.Prior Payments __
B.Discount
� Total Credits(A+B) (2)
3. Interest -
�3)
� 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. -
, Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) $0.00
�: ' � Make check payable to: REGISTER OF WILLS,AGENT.
,
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§
2.
�� . PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOGKS
�_
k:
�
1. Did decedent make a transfer and: Yes No
` a. retain the use or income of the property transferred.......................................................................................... ❑ �
b. retain the right to designate wha shal!use the property transferred or its income ............................................ ❑ �
�c. retain a reversionary interest.............................................................................................................................. ❑ �
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ �
� 2. If death occurred after Dec.12,1982,did decedent transfer properry within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ �
_ 3. Did decedent awn an"in trust 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 AI�SWER TO ANY OF THE ABOVE QUESTIONS 1S YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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. . . . .. :.� : '�".. �-.. .. . .�� .
. 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 spo�se
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 retum are still applicable even if the surviving spouse is the only beneficiary.
�: For dates of death on or after July 1,2000:
;` • The tax ra#e 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(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 91�02,as an individuai who has at least one parent in common with the decedent,whether by blood or adoption.
s ._ �
REV-15o8 EX+(li-1o)
:�� � pennsyLvan�a � SCI�IEDVLE E �
� DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC•
f.
INHERITANCE TAX RETURN PERSONAL PROPER� i
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Steve M. Robie ' 21-13-0775
----�----------------�-�--------
� Inciude the proceeds of litigation and the date the proceeds were received by the estate.
• Ali property jointly owned with right of survivorship must be disclosed on Sthedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Members 1 st Savings Account#294144-00-$55.53 principal,$0.00 accrued interest $55.53
2. Members 1 st Checking Account#294144-11 -$5,028.77 principal,$.12 accrued interest $5,028.89
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. $
TOTAL(Also enter on Line 5, Recapitulation) $ 5,084.42 �
� If more space is needed,use additional sheets of paper of the same size.
r ._ , .
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,
�
� MEMBERS 1�
, FEDERAL CREDIT iJl�TION
� REGULAR SAVINGS ACCOUNT:
�° Account Number/Suffix 294144-00 .
Date Account Established 10/12/2006
` Principal Balance at Date of Death $55.53
�'� Accrued interest to Date of Death $.00
Total Principal and Accrued Interest $55.53
Name of.Ic�int 4wner None
REGULAR CHECKING ACCOUNT:
Acc�unt Number/Suffix 294144-11
Date Account Established 10/12/2006 �
Principal Balance at Date of Death $5,028.77
Accrued Interest to Date of Death $.12
Total Principal and Accrued Interest $5,028.89
Name of Joint Owner None
�. •
� .
�� - - - M M ERS 1 ST FEDERAL CREDIT ON �
���� �
� Danielle A. Kline
Lending Insurance Support Specialist
July 26, 2013
� Estate of: STEVE ROBIE
Date of Death: 05/18/2013 `
,
Social Security Number: 195-01-4024 '
5000 Louise Drive � P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • {800)283-2328 • wwwmemberslst.org
. .
� REV-f511 EX+(1Q-09}
� pennsylvania SC H E D U LE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT '
ESTATE OF FILE NUMBER
.�, Steve M. Robie • 21-13-0775 �
�: � —
Decedent's debts must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1� Funeral Luncheon/meaf $330.84
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: $500.00
Name{s)of Persanal Representative(s)PatriCia M. Middendorf
street Address_8 Glencarron Court
. City_Dillsburg ----State PA zIP 17019
� Year(s)Commission Paid:_
�
' $495.00
x. • 2. Attorney Fees: ���d�Cc� C . fj��e%,�� �S�'U�!'`�
t�
3
3. Family Exemption: (If decedent's address is not the same as ciaimant's,attach explanation.)
. Claimant
Street Address_
City__ ___State ZIP
Relationship of Ciaimant to Decedent_
4. Probate Fees:
$133.50
,
' S. Accountant Fees.
` 6. Tax Return Preparer Fees:
.�
�. Misc.Postage $9.20
$• Reserves to conclude estate administration $400.00
TOTAL(Also enter on Line 9, Recapitulation) $
1,868.54
If more space is needed,use additional sheets of paper of the same size.
. .
REV-1512 EX+(12-4$}
�� � SCHEDULE I
� � pennsylvania
�:
t DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCE TAX REfURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE QF FILE NUMBER
Steve M. Robie 21-13-0775
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 DESCRIPTION OF DEATH
i. IRS tax obligation $675.00
. 2. Department of Public Welfare claim $94,260.33
�
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f.?
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4
, •
�p •
. TOTAL(Also enter on Line 10, Recapitulation) $ 94,935.33
If more space is needed,insert additional sheets of the same size.
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�t
COMMONWEALTH OF PENNSYLVANIA
BUREAU OF PROGRAM INTEGRITY �
DNISION OF THIRD PARTY UABIUTY �
RECOVERY SECTION
' PO BOX 8486
HARRISBURG,PA 17105-8486
July 19,2013
� STATEMENT OF CLAIM SUMMARY
NAME Estate of ROBIE,STEVE
1D ' 260 294 030
MEDICAL: CLASS 3 CLASS 5.1 TOTAL •
INPATIENT .00 .00 .00
OUTPATI ENT .00 74.56 T4.56 �:
LONG TERM CARE 22,612.11 71,444.47 94,056.58 ' 4
;i
��°
DRUG 54.24 74.95 129.19 t�
,�,
REIMBURSEMENT TO`DPW ` 22,666.35 71,593.98 94,260.33
Ct?MMONWEALTH•OF PENI�ISYLVANIA �
DEPARTMENT�F PUBLIC WELFARE
. EtN- 23-6003113
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. Page 1 of i l
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.................................................................................................................... _
Department of Treasury Notice CP2044 �
....................................................................................................................
lnternai Revenue Service Tax Year 201 t �
........._._......................................................_._.................../.......................
� PO BOX 9038 Notice date September 23 2013 '
............................................................................_....._..................._..........: �
IRS ANDOVER MA 01810-4544 Social Security number 195-01-4024 �:
................................................................................................................: .
AUR control number 550390379 {
.._......................_....................-----._........_.........................._.......................
To contact us Phone 1-8Q0-829-3009
Fax 1-877-471-9485
....................................................................................................................
�021465.372537.0153.004 2 AB 0.384 1�04 Pagelof8
i��iililliil�lii����u�l�llli�„���i��i��iii�i������ll�li�i„�i�� . . . . . . .
� STEVE M ROBIE (��� �� �� �;���� '
,�_. 8 GLENCARRON Ci * * ..
� �
DILLSBURG PA 17019-8957 1950140Z42a11 i
21465
�
��
.. . . Proposed��hanges t:o yc��.r..2�1_���r�cr�-1 C�.40A - -- - , -. . - . . .. . �
Ar�ao�nt due: $675 � _
_,
The incom��and payment inform�tion we have on Summary of proposed changes
�:
file from s�urces such as employers or financial ,
k; .. ....................................................................................................... ....$645 .
institutian�wdoesn't ma#ch the information you Tax.you owe . ........................................................ ................... ..... .... ....... "
reported oe,your tax return.If our information is Payments .........................................................................................:.......:. ... . .....:�� '�
correct,you.wiN owe$675{including interest), lnterest $30
whichyou''.rieed to pay by October 23,2013. ............................:......:.........:....................................................................�..�,:�.�.H,�..,�,,,,�,.;,,�,�,,.�.M
: Amount due by October 23. 2013 $675
� ,..�...,��.: .
;:
What you need to do immediately Review this notice,and compare our changes to the information on your 2011 tax
return.
If you agree with the changes we made � �.
� Complete,sign and date the Respor�se form on Page 5,and mail it to us along
with your payment of$675 so we receive it by October 23,2013.
: • If you can't pay the amount due,pay as much as you can now,and make payment
arrangements that allow you to pay off the rest over time. If you want to apply for
� an installment plan,send in your Response form AND a completed Instaltment
Agreement Request(Farm 9465). Download Form 9465 from www.irs.gov,or call
1-800-829-3676 to request a copy. You can also save time and money by applying
online if you qualify. Visit www.irs.gov.and search for keyword: "tax payment
options"for more information about: '
-- Installment and payment agreements
— Payroll deductions �'X:
�.
� — Credit card payments � :
�. If you don't agree with the changes
Complete the Response form on Page 5,and send it to us along with a signed �
�: h orts our claim so we receive it b ��`
. statement and any documentation t at supp y Y
. October 23,2413.
.:� '
If we db�'t hear from you �f we dbr�'t receive your response by October 23,2013,we will send you a Statutory
Notice of Deficiency followed by a final bill for the proposed amount due. During this
time,interest will inaease and penalties may apply.
. � Continued on back...
• •
REV-2513 EX+(01-10)
� ,� pennsylvan�a SCHEDULE �
DEPARTMENT pFREVENUE
' ' BENEFICIARIES
' INHERITANCE TAX REfURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Steve M. Robie 21-13-0775
KtLAl1UN5Fi1N IU Ut(,tUtlVl HIhUUIVI UK�h1HKt
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under .
� Sec.9116(a)(1.2).]
i 1. Patricia M.Middendorf,8 Glencarron Court,Dillsburg,PA 17019 Daughter 50% Rest, residue&
$
r
� rPmainrfPr
;� 2. Phyllis L.Smith,7027 Ravencrest Drive,Charlotte,NC 28269 Daughter 50% Rest, residue&
remainder
�
.�, ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
�: II NON-TAXABLE DISTRIBUTIONS
f 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.
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f! ' � '
� 4 �
LAST WILL AND TESTAMENT
OF
STEVE M. ROBIE
� I, STEVE M. ROBIE, of 4905 East Trindle Road, �
Mechanicsburg, (Hampden Township), Cumberland County,
Pennsylvania, make, publish and declare this as and for my Last Will and
Testament, hereby revoking all other Wills and Codicils heretofore made
by me.
FIRST: I direct that all inheritance, estate, transfer, succession
and death taaces, as well as my just debts and funeral expenses, of any lcind
whatsoever, which may be payable by reason of my death, shall be paid
out of the principal of my estate as t,he same can conveniently be done.
SECOND: I give, devise and bequeath all the rest, residue and
relnainder of my estate of whatever nature and wherever situate, including
any property over which I hold power of appointment and together with
any insurance policies thereon, as follows:
(a) Fifty percent (5 0%) thereof unto my daughter, PATR.IC IA
M. MIDDENDORF, of Dillsburg, Pennsylvania, provided that should
- PATRICIA M. MIDDENDORF predecease me, I give and bequeath her
share unto her issue, MICHAEL F. MIDDENDORF, I��IA.RY COLLEEN
��, MCCANN, II�IARI�W. MIDDENDORF and PATRICI.A.A.
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�y MIDDENDORF, share and share alike; an
(b) Fifty percent (50%) thereof unto my daughter, PHYLLIS
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L. SMITH, of Charlotte, North Carolina, provided that should PHYLLIS
L. SMITH predecease me, I give and bequeath her share unto her issue,
JACQUELINE DECORTE, JEFFREY SMITH, I�EVIN SMITH and
I�IMBERLY SMITH, share and share alike.
THIRD: In addition to all powers granted to them by law and
by other provisions of this Will, I give the fiduciaries acting hereunder t11e
following powers, applicable to all property, exercisable without court
approval and effective until actual distribution of all property:
(A) To sell at public or private sale, or to lease, for any period
of time, any real or personal property and to give�options for sales, ex-
changes or leases, for such prices and upon such terms (including credit,
with or without security) or conditions as are deemed proper. This
includes th.e power to give legally sufficient instruments for transfer of tlle
�roperty and to receive the proceeds of any disposition.
(B) To partition, subdivide, or improve real estate and to
enter into agreements concerning the partition, subdi.vision, improvement,
zoning or management of real estate and to impose or extinguish restric-
tions on real estate.
(C) To compromise any claim or controversy and to abandon
_ any property which is of little or no value.
(D) To invest in a11 forms of property, including stocks,
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. ` coznznon trust funds and mortgage investment funds, without restnct�on to
C� investments authorized for Penns lvania fiduciaries as are deemed ro er
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without regard to any principle of diversification, risk or productivity.
(E) To exercise any option, right or privilege granted in
insurance policies or in other investments.
(F) To exercise any election or privilege given by the Federal
and other tax laws, including, but not necessarily being limited to, personal
incoine, gift and estate or inheritance t.ax laws.
(G) To make distributions to my herein named beneficiaries
in cash or in lcind or partly in each.
(H) To borrow money from themselves or others in order to
pay debts, taxes, or estate or trust administration e�enses, to protect or
improve any property held under my will, and for investment purposes. �
(I) To select a mode of payment under any qualified retire-
ment plan (pension plan, profit sharing plan, employee stocic ownership
plan, or any other type of qualified plan) to the extent provided for by the
plan or the law.
FOURTH: I nominate and appoint PATRICLA M.
MIDDENDORF, Fxecutrix, of this, my Last Will and Testament. In the
event of the death, resignation or inability to serve for any reason whatso-
ever of, PATRICLA. M. MIDDENDORF, I nominate and appoint
PHYLLIS L. SMITH as Executrix, of this, my Last Will and 1'estament.
� I direct that m Executrix and her successor, shall not be required to post
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. securit or a bond for the performance of their duties in any jurisdiction.
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IN WITNESS WHEREOF, I have hereunto set m hand and seal to
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tllis, my Last Will and Testament, this � da of No
y vember, 2006.
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� � SEAL
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STEVE M. ROBIE
Signed, sealed, published and declared by the above-named Testator
as and for his Last Will and Testament in our presence, who, at his
request, in his presence and in the presence of each other, have hereunto
subscribed our names as attesting witnesses.
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