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HomeMy WebLinkAbout02-19-14 (2) : W ,.>�� �, � .��.��:���- �-��.�� <�. . .�, - � � 15�561�143 REV-15t10 EX`oZ_,,, �; PA De artment of Revenue Y OFFICIAL USE ONLY p penns Ivania County Code Year File Number Bureau of Individual Taxes DEPARTMENTOFREVENUE Po Box.2soso� INHERITANCE TAX RETURN 21 13 0016 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 11 11 2012 07 29 1962 DecedenYs Last Name Suffix DecedenYs First Name MI CALEY—SEIG SHERRIE (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI SEIG SCOTT A 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 Prior to 12-13-82) � 4. Limited Estate � 4a.Future Interesc Compromise � 5. Federal Estate Tax Return Required (date of death after 12-12-82) � s Decedent Died Testate � � (AttacheCopy�of Trust)a Living Trust � 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) � 9. Litigation Proceeds Received � �� betweenP2 31 yCrae dt�(Da95�f Death � ��.Election to tax under Sec.9113(A) (Attach Scheduie O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number GERALD K MORRISON (717) 234 2401 ' REGISTER OF WILLS USE,QNLY n -- First Line of Address `^C} ^ r; '-�'� ��; ,-Tj --� 4431 N FRONT STREET 3RD �' � �- � -i� :�. r ` Second Line of Address ��% � �7 ':�1,.. _ �`,. �...� :�,: \J L_ .> t i �'�FILED ' City or Post Office State ZIP Code -o � .. >-- ,`r� HARRISBURG PA 17110 D � `��-�-ri CorrespondenYs e-mail address: amorrison .sasllp.com Under penalties of perjury,I declare that I have examined this return,including accompanying sche ules 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 b d on all infor tion of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETl1RN DATE Scott A. Seig 'Z /Z �y ADDRESS � ♦. 23 Tiffan Drive Carlisle PA 17015 ��- � �� ����'r J� SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE Gerald K. Morrison ADDRESS 4431 N. Front Street, 3rd Florr, Harrisburg, PA 17110 Side 1 L 150561D143 1505610143 J � s�. ,�,� ,��.a�..� .�.��-�����., �.e,,��� �-s.-�. �-�.-. _�. . _ _ � 150561D243 REV-1500 EX DecedenYs Social Security Number Decedent'sName: C3I@�/�S@Ig, Sherrie 191 56 6550 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 , 4 90 . 70 �, 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. • . 7. Inter-Vivos Transfers&Miscellaneous I�n-Probate Property (Schedule G) �J Separate Billing Requested............ 7. • g. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 1, 4 90 . 70 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 2 , 113 . 50 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 2 , 113 . 50 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. -622 . 8� 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. -622 . 8� TAX COMPUTATION-SEE INSTRUCTIONS FOR APPIICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 0 . 0� 15. � . �� (a)(1.2)X.00 16. Amount of Line 14 taxable 0 . 0 0 16. 0 . 0� at lineal rate X .045 17. Amount of Line 14 taxable � . �� 17. � • �� at sibling rate X.12 1 S. Amount of Line 14 taxable � . Q� 18. � . �� at collateral rate X.15 19. TAX DUE................................................................................................................ 19. � . �� 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 1505610243 1505610243 J _ _ __ � �.- .�..� ���;� � ,� � _ _ ._ REV-1500 EX Page 3 File Number 21-13-0016 Decedent's Complete Address: DECEDENT'S NAME Caley-Seig,Sherrie STREET ADDRESS 23 Tiffany Drive C��, STATE ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 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) 0.�� Make Check Pa able to. REGISTER OF WILLS, AGENT. n ,,: ����-.� ������ �.. � ��� ._ � �,� 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:.................................. ❑ c. retain a reversionary interest;or............................................................................................................... d. receive the promise for life of either payments,benefits or care?............................................................ ❑ 2. if death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without ❑ � receivingadequate consideration?.................................................................................................................... 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ILv 4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ � containsa beneficiary designation?.................................................................................................................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMP�ETE SCHEDUIE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent(72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1,1995,the tax rate imposed on the net value of lransfers 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 rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for 1he 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)(1.3j]. 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+(17-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE pERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cale -Sei ,Sherrie 21-13-0016 ' Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Jewelry-value per appraisal 1,490.70 TOTAL(Also enter on�ine 5,Recapitulation) 1,490.70 (If more space is needed,additionai pages of the same size) Copyright(c)2010 form software only The Lackner Group,inc. Form PA-1500 Schedule E(Rev. 11-10) . . � r_ � � ��� �-� � -�-�- -� .�. _ ., - . REV-1511 EX+(10-09� pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN � ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Caley-Seig, Sherrie 21-13-0016 DecedenYs debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N MB R q, FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) . Street Address . City State Zio Year(s)Commission Paid 2. Attorney's Fees Smigel,Anderson 8�Sacks, LLP 2,000.00 3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zio Relationshi�of Claimant to Decedent 4. Probate Fees Register of Wills 113.50 5. AccountanYs Fees ' 6. Tax Retum Preparer's Fees 7. Other Administrative Costs TOTAL(Also enter on line 9, Recapitulation) 2,113.50 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) .�. r .,,��.., ..,� ����-�.�-� . ��-��-o,�,,�� .���� .. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Cale -Sei , Sherrie 21-13-0016 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (words) ($$$) Not ' t T tee s TAXABLE DISTRIBUTIONS [include outright spousal I. distributions,and transfers under Sec.9116 a 1.2 Dani-Marie Seig Daughter Jewelry 23 Tiffany Drive Carlisle, PA 17015 Scott A.Seig Spouse Remainder 23 Tiffany Drive Carlisle, PA 17015 Scott A.Seig Trustee Spouse Remainder 23 Tiffany Drive Carlisle, PA 17015 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 SECT�ON 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) �' � n u.� � r� r�'t � � �-- �� � � �� �_ �.;�, °�:.� �.: � .._, �-� LAST WILL AND TESTAMENT � �:, �., �`� �"'� c;� •;� O F �, ;,�, ;:�� '`� � �;;� �:::,f ;-"� �.' `.., �� � :...� SHERRIE CALEY-SEIG , � :��� . ; . C.. -•, ;'k; ±'. , .:a �;7 I, SHERRIE CALEY-SEIG, of Middlesex Township, Cumberland County, Penr��ylvania; make this Will, hereby revoking all my former Wills and Codicils. I am presently married to SCOTT A. SEIG ("My Husband") and have one (1) child, DANI-MARIE SEIG ("My Child"). ARTICLE ONE TANGIBLE PERSONAL PROPERTY § 1.1 I bequeath any and all jewelry that I own at the time of my death to My Child, if she survives me. § 1.2 I bequeath all my remaining tangible personal property, including by way of illustration but not by way of limitation, my household furniture and furnishings, paintings, books, automobiles, jewelry (if not disposed of pursuant to § 1.1 hereof)and personal effects, exclusive of any such property used in a trade or business, in accordance with the terms of a signed and dated memorandum I may prepare. If no such memorandum is located or received by my Executor within sixty (60) days of being appointed as such, after a reasonable search for such memorandum, my Executor shall be held harmless for distributing such assets as hereafter provided. I bequeath any property not disposed of by such memorandum, or all of such property if no such memorandum is so located or received, to My Husband, if he survives me. If My Husband does not survive me, I bequeath all such prope�ty to My Child. § 1.3 To the extent practicable in the Executor's sole discretion, I bequeath any policies of insurance on such property to the beneficiay entitled to such property. § 1.4 I direct that the expenses of storing, packing, shipping, insuring and delivering any such property to the beneficiary entitled theretc shall be paid by the Executor as an administrative expense of my estate. ARTICLE TWO RESIDUE § 2.1 I devise and bequeath all the rest, residue and remainder of my estate to the then serving trustee of"The Sherrie Caley-Seig Revocable Trust" created under Agreement dated as of even date herewith, by myself, as Settlor, and myself, as Trustee, as the same may {A1871918:1} �._.� ... ., e�,.�:��.�� �, �a,��:-- �.���; .��.����.�,��,,�K� �-. . ,. . . have been or may be further amended or restated prior to my death ("My Revocable TrusY'), to be distributed in accordance with the terms of said trust agreement, or if said trust agreement is not in effect at the time of my death, in accordance with the terms specified therein on the date of this Will or of its last publication by Codicil or otherwise. ARTICLE THREE APPOINTMENT OF FIDUCIARIES § 3.1 I appoint SCOTT A. SEIG as Executor of this Will. If SCOTT A. SEIG is unable or unwilling to act or continue to act, for any reason whatsoever, I appoint DONALD DUPES and LEE CADWALLADER as successor co-Executors. In the event either of them is unable or unwilling to act or continue to act, for any reason whatsoever, the remaining of them shall act solely as my Executor. All references herein to the "Executor" shall mean my originally appointed Executor or the successor Executor(s), as the case may be. ARTICLE FOUR POWERS OF FIDUCIARIES § 4.1 No fiduciary under this Will shall be required to give bond or other security for the faithful performance of the fiduciary's duties. § 4.2 Any such fiduciary shall have, without restriction or qualification, all powers given by law, including without limitation those under the Pennsylvania Probate, Estates and Fiduciaries Code, in addition to the following powers: § 4.2.1 To invest in, accept and retain any real or personal property, including stock of a corporate fiduciary or its holding company, without restriction to legal investments. § 4.2.2 To sell, exchange, partition or lease for any period of time any real or personal property and to give options therefor for cash or credit, with or without security. § 4.2.3 To borrow money from any person including any fiduciary acting hereunder, and to mortgage or pledge any real or personal property. § 4.2.4 To hold shares of stock or other securities in nominee registration form, including that of a clearing corporation or depository, or in book entry form or unregistered or in such other#orm as will pass by delivery. § 4.2.5 To engage in litigation and compromise, arbitrate or abandon claims. {A1871918:1} - 2 ' __ , , _. .. „ .� ��.�� � � �.�a,��, �:;� �,��. �-� �����_;- _ � _�., � § 4.2.6 To determine the appo�tionment of receipts and expenses, including extraordinary cash dividends, stock dividends, capitai-gain dividends of regulated investment companies and proceeds and expenses of the sale of unproductive real estate, befinreen income and principal, such apportionment to be made so as to balance fairly the interests of any income beneficiary and the remaindermen. § 4.2.7 To join with My Husband or his personal representative in the filing of a joint income tax return for any period for which such a return may be permitted, without requiring him or his estate to indemnify my estate against liability for the tax attributable to his income, and to consent, for federal gift tax purposes, to having gifts made by My Husband during my lifetime treated as having been made half by me. § 4.2.8 To make distributions in cash, or in kind at current vafues, or partly in each, allocating specific assets to particular distributees on a non-pro rata basis, and for such purposes to make reasonable determinafions of current values. § 4.2.9 To make elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift or other tax returns and the payment of such taxes, without obligation to adjust the distributive share of income or principal of any person affected thereby. § 4.2.10 To allocate, in the Executor's sole and absolute discretion, any portion of my exemption under Section 2631(a) of the Internal Revenue Code, to any property as to which I am the transferor, including any property transferred by me during my lifetime as to which I did not make an allocation prior to my death. § 4.2.11 To disclaim any interest I may have in any estate if the Executor deems such disclaimer to be in the best interests of my estate and the beneficiaries thereof. ARTICLE FIVE PROVISION FOR TAXES § 5.1 All estate taxes, inheritance taxes, transfer taxes and other taxes of a similar nature payable by reason of my death to any government or subdivision thereof upon or with respect to any property subject to any such tax, and any penalties thereon, shall be paid by the Executor out of the principal of that portion of my estate disposed of by Article Two of this Will and allocated among beneficiaries in accordance with the provisions of My Revocable Trust. All interest with respect to any such taxes shall be paid by the Executor out of the income or principal or partly out of the income and partly out of the principal of such portion of my estate, in the absolute discretion of the Executor. My Executor shall not make apportionment among or seek reimbursement from the beneficiaries, recipients or owners of such property for any such (A1871918:1} - 3 - _: �_ _ �,-� �: �., �� �.,:�. �.�. �� �,�,� -���.�. _ -� _� taxes, penalties or interest, except as provided in My Revocable Trust. Notwithstanding any provision of this Article Five to the contrary, the Executor shall not pay any such taxes, penalties or interest attributable to any property inciuded in my estate solely because of a power of appointment thereover that I possess but have not exercised or any qualified terminable interest property. ARTICLE SIX PROVISION FOR DEBTS AND EXPENSES § 6.1 I direct that any of my legally enferceable debts, any expenses of my last illness, funeral and burial, and any of the administrative expenses of my estate, shall be paid from the principal of that portion of my estate disposed of by Article Two of this Will. ARTICLE SEVEN BUSINESS INTERESTS § 7.1 In the event any business interest should be an asset of my estate, whether the same involves a proprietary interest, a partnership interest, a membership interest in a limited liability company or stock in a closely held corporation, whether wholly owned, controlled by me or owned in substantial part by me, 1 authorize the Executor, subject to the terms of any agreement I may have made for the sale of my interests, to continue said business until such time as the Executor shall deem it advisable to sell, to liquidate or to distribute the same in kind. With respect to any sale or exchange of the stock of any such business interest and in the absence of any such agreement entered into by me prior to my death, I direct the Executor to consider and to determine the appropriateness of a sale or redemption of such stock in accordance with Section 303 of the Internal Revenue Code to the business entity and a possible deferral of federal estate tax payments under Section 6166 of the Internal Revenue Code. It is my desire that to the extent possible any business interest that I may own at the time of my death be continued or disposed of only in an orderly manner so as to maximize the proceeds of any disposition. If an election under the foregoing provisions will effect such desire, the Executor is encouraged to pursue such election if the Executor deems such election also to be in the best interests of my estate and the beneficiaries thereof. The Executor shall have all rights and powers in connection with such business as I had when living, including specifically the power at any time and from time to time to operate or to join in the operation of the same as a going concern, to form or to reform a general or limited partnership or limited {A1871918:1? -4- � .. �. �x . .� � ,..--�,:��� -, . � � __ �. . . � . liability company, to incorporate or to reincorporate and to liquidate or to sell the same or any part thereof as the Executor deems it advisable for the best interests of my estate and of the beneficiaries thereof without the necessity of any order of court and without any liability for loss resulting from the operation of said business except when such loss is the result of gross negligence or fraud on the part of the Executor. ARTICLE EIGHT MISCELLANEOUS PROVISIONS § 8.1 As used in this Will, the term "Internal Revenue Code" shall mean the Internal Revenue Code of 1986, as amended from time to time, or the corresponding provision of subsequent law. § 8.2 If My Husband and I die under such circumstances that it is impossible to determine which of us survived, it shall be conclusively presumed and this Will shall be construed as if My Husband had predeceased me. If any person, other than My Husband, and I die under such circumstances that it is impossible to determine which of us survived, it shall be conclusively presumed and this Will shall be construed as if such person had predeceased me. § 8.3 Whenever a fiduciary is directed to distribute property to or for the benefit of any beneficiary who is under(a)twenty-five (25)years of age, or(b) a legal disability or otherwise suffers from an illness or mental or physical disability that would make distribution directly to such beneficiary inappropriate (as determined in such fiduciary's sole discretion exercised in good faith), the fiduciary may distribute such property to the person who has custody of such beneficiary, may apply such property for the benefit of such beneficiary, may distribute such property to a custodian for such beneficiary, whether then serving or selected and appointed by the fiduciary (including the fiduciary), under any applicable Uniform Transfers to Minors Act or Uniform Gifts to Minors Act to be held until such beneficiary reaches twenty-five (25)years of age, may distribute such property to the guardian of such beneficiary's estate, may distribute such property directly to such beneficiary's estate, or may distribute such property directly to such beneficiary (except if any of the conditions hereinbefore described in (b) apply), without liability on the part of the fiduciary to see to the application of such property. This provision shall not in any way operate to suspend such beneficiary's absolute ownership of such property or to prevent the absolute vesting thereof in such beneficiary. {A1871918:1} ' 5 - - - <- -� w ,,� � ;� a _._: . � ��:��.�� � .� § 8.4 An individual fiduciary shall receive compensation in accordance with the law of Pennsylvania in effect at the time of payment, unless the fiduciary waives compensation. A corporate fiduciary shall be compensated by agreement with the indiyidual fiduciary, or, in the absence of such agreement, in accordance with its fee schedule as in effect at the time of payment. I authorize a corporate fiduciary to charge additional fees for services it provides to my estate or a trust hereunder that are not comprised within its duties as fiduciary, for example, a fee charged by a mutual fund it administers in which my estate or a trust hereunder invests, or a fee for providing an appraisal, or a fee for providing corporate finance or investment banking services. I also recognize that a corporate fiduciary may charge separatety for some services comprised within its duties as such fiduciary, for example a separate fee for investing cash balances or preparing tax returns. Such separate charges shall not be treated as improper or excessive merely because they are added on to a basic fee in calculating total compensation for service as fiduciary. IN WITNESS WHEREOF, I have hereunto set my hand and seal this I'�� day of ���� , 2010. ' EAL) SHERRIE CALEY-S IG Signed, sealed, published and decfared by the above named SHERRI ALEY-SEIG, as and for her Last Will, in the presence of us and each of us, who, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto the day and year last above written. �_ ��-r�nsb�� PA 1 ,, �'+ , r� ., .,,, �C��'r'� � ���-k-x-- Residing at :�1i�.�,'�.�:.�,-: r�,�`�-�i;ru_;�t ��� f,_�i � a {A1871918:1} - 6 - ,,N_..: : , .�., . ,. , ._...,m .__� � COMMONWEALTH OF PENNSYLVANIA : COUNTY OF �P�1� : ss. We, SNERRIE CALEY-SEIG, the testatrix, �r��� l�, ��h�s�n and J ca^ �, i�*'�`'�'�- , the witnesses, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will; 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 his or her knowledge the testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. /' �j � V' V SHERRIE CALE -SE itness �� �,�����-�,.�� T �L�����--- Wjtn ss ; Subscribed, sworn to and acknowledged before me by SHERRIE CALEY=SEIG, the testatrix, and subscribed and sworn to before me by G-�*at�- �{� �'�.�K,i�� and � �'�^ �• `��+-�-Lc._ , the witnesses, this I f� day of�/1�h-�� , 2010. �• �r�4; Notary Public (SEAL) CUIVIi�t��t�vL:��.T's�iiF PENiVS�FLVAIVIA �lo7arlal Seal Mariaryne ii.Acrl,Notary Public Ci�of PiarrDsbcarg,Dauphin County l+Ay orn�+a�ission Expires June 10,2010 {A1871918:1} - 7 - _ __ .. z�.. � av,� : � ,� -���.�,��,,�,, �� ��w�J�����! ,j E Vtj E: L E R S 'liust Your 5pecial Maments'1'o Mour�u. November 7;24 t 3 : : Scott Seig 23'I'iffany Drive : Carlisle,l'A 17013 _ : Dear Scott Seig, : , -Af:your request I examined the jewelry you submitted for valuation and have provided an opinion of the ` � Approximate Fair Market Value for the estate of Sherrie Seig,Novernber t l,2013. : Tliis report is valid only in its entirety and the final figure excludes any,applicable"taxes. You may wish to , take'this info consideration:when using the report. The value conclusions are subject to lisniting conditions that are set forth in the body of the report: To the best of my knowtedge and experience, I estimate the jewelry has a total Approximate Fair Market Value of$1,490.70. ' Photagi�aphs are included with the originai report for your reference. I suggest that you.keep your copy of - � this report in a.safe piace. This report was:prepared in accordance with the U�iform Standards of Professionai Appraisal Pracfice (USPAP). , , , IfI can be of any further assistance,please calt. , � Sincerely, ..: : Cherte L.Grove Certified Gemologist Appraiser,AGS :Enelosures _ 3780 Trindle Road • Camp Hil�, PA 17011 ; 717.763,1199 • {F} 717.763.8)53 • rnountz�ewelers:corn Page 1.of 10 ��.,.� , .. . .. � ... � . . ., . . . � -:A M E R�1�N G'E M � . .. � � . , �. . . -. . . . .................S..0 C I �.T,.Y..y-__.,..,.. , . . .. .. . - .