HomeMy WebLinkAbout03-14-14 � 1505610143
REV-1500 Ex�oz_,,, ,v�.
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENTOFREVENUE
PO Box.28osoi INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 �y .���
ENTER DECEDENT INFORMAT�ON BELOW
Social Security Number Date of Death Date of Birth
12 23 2013 02 13 1921
DecedenYs Last Name Suffix DecedenYs First Name MI
DAUBERMAN BERNICE p
(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
� 1. Original Retum � 2. Supplemental Return � 3. Remainder Return(Date of Death
Priorto 12-13-82)
� 4. Limited Estate � 4a.Future incerest Compromise 5. Federal Estate Tax Return Re uired
(date of death after 12-12-82) ❑ 4
� g Decedent Died Testate � Decedent Maintained a Living Trust � 8. Total Number of Safe De OSit BOXeS
(Attach Copy of Will) ❑ (Attach Copy of Trust) p
� 9. Litigation Proceeds Received � �p.Spousal Poverty Credic�(Date of oeath ��,Election to tax under Sec.9113 A
belween 12-31 91 and -1-95) � (Attach Schedule O) � �
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JAMES D BOGAR (717) 737 8761
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�
�
REGISTER O �LS USE�ILY �
.� C�
First Line of Address ���.,� � �`'�;�
r"�C:.' _' , -1:-�"";
ONE WEST MAIN STREET zcr"" '� "`�`��'
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Second Line of Address �"7C� � -i_i
o� Op ��s'�'rt
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City or Post Office DAT�ILED
State ZIP Code
SHIREMANSTOWN PA 17011
CorrespondenYs e-mail address: Jbogar@bogarlaw.com
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.
TURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
Jane F. Neumayer
ADDR
2375 Rt. 17 Liver ool PA 17
SIGN E OF REPAR R HER THAN REPRESENTATIVE DATE
James D. Bogar � � r
ADDRESS
One West Main Str et, Shiremanstown, PA 17011
Side 1
L 1505610143 1505610143 J
� 1505610243
REV-1500 EX DecedenYs Social Security Number
o�edenrSName: Dauberman, Bernice V.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held 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. 1, 675 . 92
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 2 6, 57 7 . 65
7. Inter-Vivos Transfers&Miscellaneous t�n�Probate Property
(Schedule G) U Separate Billing Requested............ 7.
g. Total Gross Assets(total Lines 1 through 7)........................................................ g. 2$ ,253 . 57
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 11 ,53 6 . 53
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 11,53 6. 53
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 16, 717 . 0 4
�3, Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13. 1, 0�0 . 0 0
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 15, 717 . 0 4
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 �5 0 . 0 0
(a)(1.2)X.00
16. Amount of Line 14 taxable 15, 717 . 0 4 16. 7�7 • 2 7
at lineal rate X .045
17. Amount of Line 14 taxable 0 . 0 0 17. 0 . 0 0
at sibling rate X.12
18. Amount of Line 14 taxable 0 . 0 0 18. 0 . 0 0
at collateral rate X.15
19. TAX DUE................................................................................................................ 19. 707 . 27
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 15�5610243 J
REV-1500 EX Page 3 File Number 21
Decedent's Complete Address:
DECEDENT'S NAME
Dauberman, Bernice V.
STREET ADDRESS
1053 B Allendale Road
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 707.27
2. Credits/Payments
A. Prior Payments
B. Discount 35.36
Total Credits(A +B) (2) 35.36
3. Interest �3�
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
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. (5) 67�.9�
Make Check Pa able to: REGISTER OF WILLS, AGENT � � �
� � � � ����� r� �.� �° _ '�.
� � .� ��-�� ���,��: ..s_ - - ,'�a�'—�M������ .;�:7 � �'-�nsrv��.,;'�. �` �. '� ��. ,
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:........................:...................................................... � �
b. retain the right to designate who shall use the property transferred or its income:.................................. � 0
c. retain a reversionary interest;or................... .. ........................................................................... x
. . ............. ❑
d. receive the promise for life of either payments,benefits or care?............................................................ x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without ❑ ❑
receiving adequate consideration?......................................:............................................................................. z
3. Did decedent own an"in trust fo�' or payable upon death bank account or security at his or her death?....... ❑ 0
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑
contains a beneficiary designation?.................................................................................................................. X
IF THE ANSWER TO ANY OF THE ABOVE QUESTiONS IS 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
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 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 decedenYs 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 decedenYs 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.
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OFREVENUE p E RSONAL P RO P E RTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dauberman, Bernice V. 21
Include the proceeds of litigation and the date the proceeds were received by the estate.
All propeRy jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1993 Buick-per attached appraisal 500.00
2 Personal Property-sold at private sale 500.00
3 Allstate-Apartment insurance refund 2�'S2
4 Comcast-Refund 29.22
5 Erie Insurance -Automobile insurance refund 278.00
6 Meadowood Apartments-Rent refund 319.14
7 Prevention Magazine-refund 19.93
8 Verizon-refund 2.11
TOTAL(Also enter on Line 5, Recapitulation) 1,675.92
(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)
Ai.EXANl)�il
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Mike Reed
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ElIISS30NS INSPECTION REQUIRE�/�IESEL VEHICLE8 EflENPT COUNTY: CUM9ERLAND
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� BERNICE V DAUBERMAN � � � �
" 1053 ALLENDALE RD APT B ' ' � � �
: � � � MECHANICSBURG PA 1'7055 , � � � •
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Rev-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dauberman, Bernice V. 21
If an asset was made joint within one year of the decedenYs date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Jane F. Neumayer 2375 State Rt. 17 Daughter
Liverpool, PA 17045
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY a�a pF DATE OF DEATH
ITEM FOR JOIN MADE INUMBER OR SIMILARNDENTIFYI G�NUM ER.ATT CHK EEDOFOR DATE OF DEATH DECD�S DECEDENT'S INTEREST
NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST
1 A 09/15/2008 Santander-Checking Account No. 3,190.50 50.000% 1,595.25
0481143874. Principal balance at date of
death$3,190.50;accrued interest$0.00
2 A 09/16/2008 Santander-Checking Account No. 39,963.24 50.000% 19,981.62
2107922365. Principal balance at date of
death$39,962.93;accrued interest$0.31.This
account was opened using funds previously
held in Savings Account No. 1684304205 and
Money Market Account No. 1684069858, both
of which were jointly owned by the Decedent
and Jane F. Neumayer. The attached letter
indicates that Jane F. Neumayer was added
to this account on April 8,2013. This addition
was to correct the omission of Jane F.
Neumayer as a co-owner when the account
was opened on March 26,2013.
3 A 08/04/1993 Santander-Certificate of Deposit No. 10,001.56 50.000% 5,000.78
0575138706. Principal balance at date of
death$10,000.00;accrued interest$1.56
TOTAL(Also enter on Line 6, Recapitulation) 26,577.65
(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 F(Rev.01-10)
. . � '
Court Order Processing\Decedents- MA1-MB3-02-10 - P. O.Box 841005 - Boston,MA 02284
January 14, 2014
�
s
� James D. Bogar
� Attorney at Law
� One West Main Street
� Shiremanstown, PA 17011
9
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� RE: Estate of Bernice V. Dauberman
� Date of Death: 12/23/2013
�
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� Dear Sir or Madam:
� Per your request, enclosed please find the account information as of the date of death
� for the above-named decedent. For your information, accrued interest is not included in
� the date of death balance.
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� Please feel free to contact me if I can be of any further assistance.
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� Very truly yours,
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Sovereign Bank
ESTATE OF Bernice V. Dauberman
SOCIAL SECURITY#: 183-12-3271
DATE OF DEATH: December 23, 2013
Account#: 0481143874 Type: Checking Open date: 9/15/2008
In the name of: Bernice V Dauberman or Jane F Neumayer
Date of Death Balance: $3,190.50
Int.(YTD) from 1/1/2013 to 12/20/2013 $0.46
Accrued interest to date of death: $0.00
Other Info:
Account#: 2107922365 Type: Checking Open date: 3/26/2013
In the name of: Bernice V Dauberman or Jane F Neumayer
Date of Death Balance: $39,962.93
Int.(YTD) from 3/26/2013 to 11/26/2013 $2.69
Accrued interest to date of death: $0.31
Other Info: opening deposit=funds from closed MMA 1684069858 (Jane added 04/08/13)
Account#: 0575138706 Type: Time Deposit Open date: 8/4/1993
In the name of: Bernice V Dauberman or Jane F Neumayer
Date of Death Balance: $10,000.00
Int.(YTD) from 1/1/2013 to 12/5/2013 $36.70
Accrued interest to date of death: $1.56
Other info:
Account#: 0575138698 Type: Time Deposit Open date: 8/4/1993
In the name of: Bernice V Dauberman In Trust For Kasey F Neumayer
Date of Death Bajance: Closed prior to death
Int.(YTD) from to .
Accrued interest to date of death:
Other Info: Acct Closed 08/06/2012 $10,000.00 transferred to DD 0481143874
Account#: 1684304205 Type: Savings Open date: 6/2/2009
In the name of: Bernice V Dauberman or Jane F Neumayer
Date of Death Balance: Closed prior to death
Int.(YTD) from to
Accrued interest to date of death:
Other Info: Acct Closed 02/15/2013 $10,039.10 transferred to MMA 1684069858
Page 1 of 2
Sovereign Bank
ESTATE OF Bernice V. Dauberman
SOCIAL SECURITY#: 183-12-3271
DATE OF DEATH: December 23, 2013
Account#: 1684069858 Type: Money Market Open date: 9/16/2008
In the name of: Bernice V Dauberman or Jane F Neumayer
Date of Death Balance: Closed prior to death
Int.(YTD)from to .
Accrued interest to date of death:
Other info: Acct Closed 03/26/2013 $39,960.24 transferred to DD 2107922365
Page 2 of 2
REV-1511 EX+��O-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE � FUNERl1L EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dauberman, Bernice V. 21
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N MBER
q. FUNERAL EXPENSES:
See continuation schedule(s)attached 5,938.83
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. attornev's Fees Bogar 8� Hipp Law Offices 2,100.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
City State Zip
Relationshio of Claimant to Decedent
4. Probate Fees
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. OtherAdministrative Costs 3,497.70
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 11,536.53
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Dauberman, Bernice V. 2�
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex enses
1 Mt.Olivet United Methodist Church-funeral luncheon 333.76
2 Musselman's Funeral Home-funeral bill 5,435.00
3 Patriot News-Obituary 170.07
H-A 5,938.83
Other Administrative Costs
4 Messiah Lifeways-final bill 21.70
5 RESERVES:-Cost to conclude administration of estate,including payment of outstanding 200.00
medical bills
6 Santander Bank-fee to obtain date of death valuation 20.00
7 Stonebridge Rehab-final bill 3,256.00
H-B7 3,497.70
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BEN EFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dauberman, Bernice V. 21
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT ��/�/ords) ($$$)
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
Jane F. Neumayer Daughter Rest, residue
2375 State Rt. 17 and remainder
Liverpool, PA 17045
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro 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
1 Mt.Olivet United Methodist Church 1,000.00
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 1,000.00
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
LAST WILL AND TESTAMENT
OF
BERNICE V. DAUBERMAN
I, BERNICE V. DAUBERMAN, of Mechanicsburg, 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 . �
�'f
FIRST: � I give and bequeath the sum of One Thousand
Dollars ($1, 000 . 00) to the Mt. Olivet United Methodist Church,
5000 Simpson Ferry Road, Mechanicsburg, Pennsylvania 17055 to be
used for general purposes as the governing body of said church
deems appropriate.
SECOND: I devise and bequeath all the rest, residue
and remainder 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, to
my daughter, JANE F . NEUNIAYER, provided that should she prede-
cease me, then, in equal shares, to her children, KENNETH E.
NEUMAYER, JR. , KEVIN J. NEUMAYER and KASEY F. NEUMAYER. '
y� THIRD: No provision is made in this , my Last Will and
Testament, for my daughter, CHRISTINE M. LOBB, not necessarily
C � because of any lack of affection for her, but because she is
� already well provided for.
FOURTH: Should any of my grandchildren, as specifi-
�`
cally set forth hereinabove, not have attained the age of twenty-
,� two (22) years at the time for distribution to him, I give,
� devise and bequeath the share of each such grandchild to my
�• hereinafter named Trustee or Trustees, IN SEPAR.ATE TRUSTS, to
� hold, manage, invest and reinvest the shares so received, and to
use and apply from time to time such portion of income and
principal for the said grandchild' s education (including college,
,. �..�.�a.,�.e �.�,� .�w..x� ��,.�.,�. �. ,..� ,« �:.� �,..�
trade school or other similar training or education) , as my
Trustee or Trustees, in their sole discretion, deem advisable.
The Trustee or Trustees, in exercising their discretionary
authority with respect to the payment of income or principal of
the within Trust to my grandchildren, shall take into consider-
ation any income or other resources available to my grandchildren
from sources outside this Trust .
Any income or principal not so applied shall be dis-
tributed to each grandchild when he attains the age of twenty-two
(22) years. In the event any of my grandchildren die prior to
the termination of this Trust established herein for their
benefit, the interest of said grandchild in said Trust shall
cease with any income and principal being divided evenly between
or between my other grandchildren or the separate Trusts
established hereunder for their benefit.
FIFTH: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, 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, exchanges or leases, for such prices and upon
� such terms (including credit, with or without security) or
�� conditions as are deemed proper. This includes the power to give
� legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
�
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
,� sion, improvement, zoning or management of real estate and to
(��, impose or extinguish restrictions on real estate.
2
�,��.� ��-�.,.r,�,.�,� � ���.�.,���.��.���;�,�.�-��
� � � _ . .�,.� . �,���.���,�. : �. .. ,..�.
. .
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, 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 income, gift and estate or inheritance tax
laws .
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
� any other rights which they may have under the plan, in whatever
� manner they consider advisable.
� SIXTH: I nominate and appoint my daughter, JANE F.
L.e NEUMAYER, as Trustee of the hereinabove described trusts . In the
� event of the death, resignation or inability to serve for any
� reason whatsoever of the said JANE F. NEUMAYER, I nominate and
� appoint my son-in-law, KENNETH E. NEUNlAYER, as Trustee of the
1
' hereinabove described trusts. I direct that my Trustee or
3
Trustees, as the case may be, shall serve without bond and shall
receive fair and reasonable compensation.
SEVENTH: I direct that all inheritance, estate,
transfer, succession and death taxes, of any kind whatsoever,
which may be payable by reason of my death, whether or not with
respect to property passing under this Will, shall be paid out of
the principal of my residuary estate.
EIGHTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
NINTH: I nominate and appoint my daughter, JANE F.
NEUMAYER, Executrix of this, my Last Will and Testament . In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said JANE F. NEUMAYER, I nominate and
appoint my grandson, KENNETH E. NEUMAYER, JR. , Executor of this,
my Last Will and Testament. I direct that my Executrix or
Executor, as the case may be, and their successors, shall not be
required to post security or a bond for the performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this ,��x'c' day of
� �c�-e�� , 2 0 0 6 .
����,�i���t'� �r �tL!t�����x-�'-"-� (SEAL)
BERNICE V. DAUBERMAN
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�' ` .
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses .
Address
,. �,
Address
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