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HomeMy WebLinkAbout07-23-14 (2) � 1505610105 REV-1500°``�-""�''� oF�cuu.uae oN�r PA DepartmeM of Revenue �� ;o�Code Year File Nwnba Bureau of Indtvtduat Taxes INHERITANCE TAX RETURN ��/ � // /� Po aox s8o6oi HaMsbu�,PA s�i28-o6oi RESIDENT DECEDENT / CO�J � ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date oi Bkth MA�DDYYYY ' 10/24/2013 12/07/1921 DecedenYs Last Name Suffix DecedeM's Fkst Name MI ___ _-_ _ __ _ ' MURTOFF RUTH K (If Applfcabl�)EMer Surviviny 8pouse's Information Below Spouse's Last Name Suifix 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 O 2.Supplemental Retum O 3. Remainder Retum(Date oi Death Priorto 12-13-82) p 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Retum Required deaM atter 12-12-82) � 6.Decedent Died Testate O 7.Decedent MaiMained a Uving Trust 0 8. Total Number of Safe Deposit Boxes (��PY of Will) (Attach Copy of TrustJ O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Sd�edule O) CORRESPONDENT-THIS SECTION IIUST BE COMPLETED.ALL CORRESPONDENCE AND CONFlDENTIAL TAX INFORMATION SFIOULD BE DNlECTED TO: Name Daytime Teleplwne Number Robert G Murtoff (717)258-3768 , , >-:_� _ REGIST �F`�INILLS 113�ONLY �� �.� � �f. `_� rJt7'�j i-° i- -� �-Y-'. . .'l i � � f! � r Firat Line of Address ' � �. �.� , : . ....._....... .._. d. � . r t- PO Box 274 ��`' w � �,,- t - C7 C_.� xa» � , _ Sec�ond Line of Address ��:^ '� - - ?��; _ _ ..,_ _ ,._.. . ._:.r l,p - `�'a ,.. -�-"'_I :. r . . City or Post OIBoe State ZIP Code ����� �'`� ~ � ____. 'Boiling Springs PA 17007 Comspond�M's amail addr�ss:robmurt@aol.com Under penaltisa d perjury.I dedare tliat I have examined thfs retum�kiduding acoortiDe�sd�edubs ard sta�MS.and b the best oT my Imowlstlpe and belief, k ic true.oorrect and comPle�.Dsclarallon ot preparer other tlian the PB►sona�nD►eeenfatlre k bassd on ap kitortnatbn d which preparer has arry krwwledge. SIGNAT O PER� SPONSI � IN� G RET�RN 7^�3 — ?�/� DATE ADDRESS PO Box 274, Boiling Springs PA 17007 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEAEE U8E ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 J � � 1505610205 REV 1500 EX(FI) DecedenYs Social Security Number _ oecedenrs Nair�e: RUTH K MURTOFF RECAPITULATION 1. Real Estate(Schedule A). ............................................ 1. : 2. Stocks and Bonds(Schedule B) ....................................... 2. ' 3. Cbsely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 4. Mortgages and Notes Reoeivable(Schedule D)........................... 4. ; 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. ' 117,243.58 , 6. Jandy Owned Property(Schedule F) O Separate Billing Requested ....... 6. 7. Inter-�vos Transfers 8 Miscellaneous Non-Probate Property - -- - _ __ (Schedule G) O Separate Billing Requested........ 7. 'i 8. Total Gross Assets(total Lines 1 through 7)............................. 8. 117,243.58 ! 9. Funeral Expenses and Adminishative Costs(Schedule H)................... 9. '' 6,045.61 I 10. Debis of Decedent,Mortgage Liabilitles and Liens(Schedule I)............... 10. : 36,624.92 " 11. Total Deductions(total Lines 9 and 10)................................. 1L ' 42,670.53 12. Net Value of Estata(Line 8 minus Une 11).............................. 12. 74,573.05 ; 13. Charitable and Govemmental Bequests/Sec 9113 Tnists for which _ _. _ an election to tax has not been made(Schedule J) ....................•••. 13. ; _ _ _. . 14. Net Valus Subjoct to Tax(line 12 minus Line 13) ........................ 14. ! 74,573.05 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Lir►e 14 taxable at the spousal tax rate,or transfers u�der Sec.9116 (a)(1.2)X.0_ 15. 16. Amount of Line 14 taxable . _ . .. _ _ . _, .__ ,__ _. , .. at uneel rate x.0 45 ' 74,573.05 ! �g, 3,355.79 __ _ _ __ _ __ _ __._ . _._ - -__ 17. Amount of Line 14 taxable at siWing rate X.12 ', 17. 18. Amount of Line 14 taxable _ _ . at oollateral rate X.15 ' 18. 19. TAX DUE ......................................................... 19. 3,355.79 i 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 1505610205 J REV-1500 EX(FI) Paye 3 FIM Numb�r Decedent's Complete Address: oeNrs w►r� RUTH K MURTOFF S7REETADDRESS 801 N Hanover St CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 3,355.79 2. CreditslPayments A.Prior Payments 2,700.00 B.Discount 142.10 Total Credits(A+B) (2) 2,842.10 3. Interest (3) 4. If Line 2 is greater than Line 1+Line 3,ent�the diflerence. This�s the OVERPAYMENT. Fill in oval on Pape 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) 513.69 Make check payable to: REGISTER OF WILLS,AGENT. � e^s.'°� ,,.,�G� �`+ s• -ia .��- �ztt' y; e.saa�'a,"� �'+,,� `€ � �-�.r v`�`�:�". %�.�.: �.SS""�'��. ,'�,�x� �`+ „aS"'�w`a*<.'"�, ?,,;Y.. ,�.�., .` .. . .��-��.,-��sa� �..�,�'�:'::>..�n ..,a_.�.. :0 5. ., � ...�:., .w�.��-�- �_-.:�����-=`s' .U��., . ..�':.��'�Ua�'.. �_....'v�°-�� 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�e property transfemed.......................................................................................... ❑ � b. retain the right to designate who shall use the property transferred or its incon�e ............................................ ❑ � c. �etain a reversion�y in�e�est.............................................................................................................................. ❑ � d. reoeive tl�e promise for 1'rfe of either payrtients,benefils or ca�e?...................................................................... ❑ � 2. If death oxurred ai�er Dec.12,1982,did decedent trar�sfer propeAy within or►e year of death without reoeiving adequa�oonsideradon?.............................................................................................................. ❑ � 3. Did decedent own an"in bust ta"or payable-upon�death bank account or securiry at his or her death?.............. ❑ � 4. Did decedent own an individual retiremeM acaount,armuity or other rwn-probate properiy,which contains a benefic�ary designatia�? ........................................................................................................................ ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. �� �� �, � , . � ;��,.� � _� �������- _ � �5� � � � � �� � �����. ��Y��.����r �_�_ �., , ���� �� .� For dates of deaih on a after July 1,1994,and before Jan.1,1995,the tax rate imposed on tl�e net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)j. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to a for the use of the survnring spouse is 0 perceM [72 P.S.§9116(a)(1.1)(ri)].The statute does not exempt a Uansfer to a sun�iving spouse irom tax,and tlie statutay requiremenls for disdosu�of assets and filing a tax retum are still applicable even ff tlie surviving spouse is the ony benefiaary. For dates of death on a after Juhr 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 a a stepparent of tl�e chiid is 0 percent[72 P.S.§9116(a)(1.2)j. . The tax rate imposed on tl�e net value of transfers to a for the use of the deoedenfs 6neal benefiaaries is 4.5 percent,except as no�ed�[l2 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 Sec6on 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-i5o8 EX+(o8-u) �pennsylvania SCI�IEDULE E r�� DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: RUTH K MURTOFF 2013-01163 Include the proceeds of litigafion and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Members 1st Federal Credit Union,5000 Louise Drive,P.O.Box 40,Mechaniscburg,PA 17055 account#271431-00;Regular Savings 5.19 2. Members 1 st FCU(see address above);account#271431-05;Investment Savings 82,241.19 3. Members 1st FCU(see address above);account#271431-11;Checking 2g�ggg,5� 4, Orrstown Bank,Operations Center,2695 Philadelphia Ave.,Chambersburg,PA 17201 account#106003069;Checking 458.32 5, 2005 Hyundai Elantra(selling price) 4,500.00 g, Church of God Home;refund of overpayment 1,039.37 TOTAL(Also enter on Line 5, Recapitulation) $ 117,243.58 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) �� pennsylvania SCHEDULE H ��+���uE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER RUTH K MURTOFF 2013-01163 Deadent's debts mud be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' First Lutheran Church,21 S Bedford St,Carlisle PA 17013;funeral reception 259.56 2. Baughman Memorial,41 S Bedford St,Carlisle PA 17013;grave marker 1,081.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 2,000.00 Name(s)of Personal Representative(s) Robert G. Murtoff Street Address PO Box 274 �;�, Boiling Springs state PA ZIP 17007 Year(s)Commission Paid: 2014 2,000.00 2. Attomey Fees: 3. Family Exemption:(If decedent's address is not the same as claimanYs,attach euplanadon.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. probate�ees: 353.50 5. Accountant fees: 6. Tax Retum Preparer Fees: 290.00 �• Certified postage 35.55 s. 2012 and 2013 PA income tax due 26•00 25 TOTAL(Also enter on Line 9, Recapitulation) ; 6,045.61 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) � pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER RUTH K MURTOFF 2013-01163 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,inciuding unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• PA Department of Pubiic Welfare;Reimbursement of inedical assistance 36,570.40 2. Alert Pharmacy,219 N Naltimore Ave,Mt Holly Springs PA 17065;medications 54.52 TOTAL(Also enter on Line 10, Recapitulation) � 36,624.92 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) �pennsylvania SCHEDULE � DE►ARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: RUTH K MURTOFF 2013-01163 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS Of PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under Sec.9116(a)(1.2).J 1. Ruth M.Osbome,9 E.Linden Dr,Carlisle PA 17015 daughter 25% 2. Wiiliam A.Murtoff,9A Worcester Ave,Hudson MA 01749 son 25°� 3. Anne L.Hawbaker,509 N.Walnut St,Mt.Holly Springs PA 17065 daughter 25% 4. Robert G.Murtoff,PO Box 274,Boiling Springs PA 17007 son 25% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A, SPOUSAL DISTRIBUTIONS UNDER SECfION 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. ._ _ _ _ _ __ _ _ . _ � s MEMBERS 1'� ������ REGULAR SAVINGS ACCOUNT: Account Number/Suffix 271431-00 Date Account Established 09/13/2005 Principal Balance at Date of Death $5.19 Accrued Interest to Date of Death $0.00 Totaf Principal and Accrued Interes# �5.19 Name of Joint Owner None INVESTMENT SAVINGS ACCOUNT: Account NumberlSuffix 271431-05 Date Account Established 03/04/2006 Principal Balance at Date of Death �82,22$•2h Accrued Interest t�Date of Death $12.95 Total P�ncipal and Accrued Interest $82,241.19 Name of Joint Owner None CHECKING ACCOUNT: Acx�ount NumbedSuffix 279431-11 Date Account Established 09/13/20U5 Principal 6alance at Date of Death $28,��•s� Aocrued Interest fio Date of Death $0.91 Total Principai and Accrued Interest $28,999.51 Name of Joint Owner None MEMBERS 1sT FEDERAL CREDIT UNION � — Tessa L Klugh Lending Insurance Support Specialist July 10, 2014 Estate of: RUTH K MURTOFF Date of Death: 90124l2013 Sociai SecuMty Number. 182-18-1458 �— Printmail Group ORRSTOWN gqNK Date 11/08/13 Page 1 - � OPERA7'jONS CENTER Primary Account 106003069 2695 PHILADELPHIA AVENU� Enclosures CHAMBERSBURG, PA 17201 Ruth K Murtoff AlbertJ Murtoff�--(�dtcc�.sc� °1��1� ZOaS, PO Box 334 Boiling Springs PA 17007-0334 CHECKING ACCOUNTS Account Title Ruth K Murtoff Albert J Murtoff 50+ Interest Checking Chedc Safekeeping Account Number 106003069 Statement Dates 10/11/13 thru 11/11/13 Previous Balance 458.32 Days In The Statement Period 32 1 Deposits/Credits 363.00 Average Ledger 583.10 Chedcs/Debits .00 Average Collected 583.10 Service Fee .00 Interest Paid .00 Current Balance 821.32 2013 Interest Paid .27 Deposits and Additions Date Description Amount li/Ol XXSOC SEC SSA TREAS 310 363.00 PPD Daily Balance Information Date Balance Date Balance 10/11 458.32 11/O1 821.32 . Interest Rate Summary li/O1 0.010000% THANK YOU FOR BANIQNG WITH ORRSTOWN BANK ' .� BALANCE AS OF DATE OF DEATH 10/24/13 idAS $458•32 (SEE ATrACHdENT) Printed li/8/2013 ' , i0/14 Deposit Iaquiry 15:13:28 ,. K Murtoff Account aumber: 106003069 „losed Messages 1 of 1 Last stmt balance: . 00 Last stmt date: 12/10/13 Curreat balaace: .00 Statemeat cycle: 10 1=View 6=priat T=Tset Control: From To Posted Check No S T/C Debit Credit Salance 8/11/13 151 .01000000� 4,732.26 9/03/13 C 163 363 . 00 5,095.26 9/10/13 160 .04 5,095.30 9/10/13 151 .01000000� 5,095.30 9/25/13 450 P 091 5,000.00 95.30 9/25/13 151 .00000000� 95.30 10/03J13 C 163 363.00 458.30 10/10/13. 160 .02 '�' 458.32 11/O1/13 C 163 363.00 821.32 11/O1/13 151 .01000000� 821.32 11/il/13 151 .01000000� 821.32 12/02/13 N 135 363.00 458.32 12/02/13 N 053 458.32 .00 12/02/13 151 .00000000� .00 Bottom �'4=Redsply F6=Bal Iaq F7=Scan iPwd F8=Scan Bkwd F11=Prior bal F15=$FT F'16=Sort E'17=Top F18=Bottom F19=EDI F20=IInfold F22=T/C F23=Checks �� . .: �� � �' 244 CHRISTOPHER WARNER AUTOMOTIVE P.O.BOX 220 8 FRONT STHEET F&AA TRUST BOIUNG SPRWGS,PA 17007 � p»j 2sa-s�a2 7/14/2014 PAY TO THE OADER OF RUTH K MURTOFF ESTATE • � $*4,�00.00 r n fiv Hund and 00/900 ouAc RUTH K MURTOFF ESTATE PD BOX 334 BOIUNG SPRINGS, PA 17007 � MEt�o 2005 HYUfdDAi SDN KMHDN46D55U953903 �_ "'�� �������� ���' - -------�------ � .� ,� _ �� _ r. CH OF GOD HOME, INC - 801 N.HANOVER STREET ����-o, CARLISLE, PA 17013 RESIDENT# UNIT STMT. DATE 2125 H213A 03l31/2014 RESIDENT S r - ROBERT MURTOFF ��`' � � Ruth K. Murtoff .J u PO BOX 274 �G�,-�� �1-� , BOILING SPRGS, PA 17007 TOTALAMOUNT DUE -$1 039.37 DETACH AND RETURN TH1S PORTION WI TH YOUR REMITTANCE $ �� ��`� � AMOUNT REMITTED DATE DESCRIPTION �a�� CHARGES CREDITS BALANCE Units Balance Forward 7,249.43 06/20/2012 Shampoo &Blow Dry 1 166.80 7,082.63 Ol/31/2013 Security Deposit-Nursin� 1 8,122.00 -1,039.37 Please call the billing office at 717-8b6-3256 with any statement questions. All checks should be made payable to Church of God Home. Please use the enclosed envelope to mail your payment. RESIDENT# CURRENT OVER 30 OVER 60 OVER 90 OVER 120 T OUNT D 2125 -1,039.3? 0.00 0.00 0.00 0.00 -$1,039.37 RESIDENT NAME Ruth K. Murtoff �°""�'01 � -1 T ,� -��\1 „°.�.. ” ,��:?° � :-,: (�, # ., oa,�.Z `Y t .. ��I,! ;.T �+t�t2.e..� L:t_.`�'�C�" . ---- fit��i�i rt�ud St.ere qr.1 t:? ���rt�� - � .. �, �'��ri '' ti�•� �i�•: ; �< :: _/L -� _ G.��•d�•n 'it��ref �'' . �F-i. i..3°lisle. Pfl 17i�13 �� °- '���� � : �;!urEr '+'��!el•hunr. f 1 I i ) i. "� �dr,�`$"1� I'li.u•v��-�:.� � ,�)e��l�une � � i9-2373 7,7 � 7�l9 8$3G , � ' �C!��#fIK 7i�1 � '��_ ;��� �_� � •��3i30 1 9 1 4807 ? i� ;;•; - t'f:111 il�.•;��; !'I ii7C CII lal � t 1 I i u�.�C ' �8 T ' t� �. . � i �3� T r�rrir� , ,���; �u, ;�� � ,, .� �,•� �; .ss r --- - .i i!i !: !�i'i ! i:iril,. - � �> �? �.;o �' '� +�� ���' r ' G�an t Faod S ture 161�2 S(: iitlNl!S �!I:' SFIi�:NG 255 5. Srr•iny Garcler. Sir�aet F'�•i�:�. fu,• 3 t I .��� :i 00-F Cai•lisle. PA 17�13 ��i � P�!< � i � �ir1Y'o _ , �. �� � o.i ;. 39 F ;1'�-?323 t �t:�', i: td ,i � � Store 1'elePhone: (7i�.� 4�'�-�83Cy �l � 3� " � � ! �•i ii Pht�r�acy 1'e leNhone� SC iit)h!U$ 4iUY �' �r q$Ui)19i4807 .�►� tN�; Pr i c,> f c�r- � 9 Ot) ' 34-B THAN��: YAU :� �� ��.� q' 99 F >:� ;i NFlii r: i��l;1�i Pt1RTY Tf'f1Y ; i.> F �► t! ��•i '� �R T PREMItIM t:Ki) IIIIM 3.7C F t:„!li ii'lz!1 t p ::,; SW1SS Ckll"ESf� i, 9:i F '� !i..l�l�� ►�t i:;•:ti?!i � ���; f BISTRO :;TYI E TUk 3r, ge f `�:• Ci f.�if t' I(l !f � `'� � FRUIT TRfiY t.G 2� 9�) F F�irrli l, ;�I i.i:ir- l�IP � '�� � RC•.LISH �;f:AY t G qQ 9'1 F S:� I+t, i:� :l;t i I! ` ''' r Fu�� SHr�f�T cc►hc c��r rt��r � i:i c►�Mrr -' '�`� r 6@ 3.5`� 21 5•i F CI' !`i11):i[=!1 �,t pF� �, yy f . PQTATQ i'fIU.S i .00-F � .,�1;; �XENPT i Oh' 1 00-b CP PRODUCf: �1 OFF 1 .00-F 2.06- CP kIYO ANY IIM-31 0� t .00-F �i�!��� ��rr��Ri ;�:i,ltii,�. `�, �;•1 CP UYO AN'.' 17M 3t 0 .:,;�.�. ;n;��i � ;., •.i11VINL-5 18� 2i; ':;ii�;jv( TO'i�l nFrnFC. _�,ir,�t �lr �i R ���1��1Nr.�: � i� YOIIN 70TAt. SAU�iNG�� > 00 'r#:; i''�T D ' %�? TQ iil AfTfk Si��'INGS �8�� ?li '•t+-�"ilTitl. t c►r.cr �Fr:[:IVRH!_F' YAti: PAID 186.26 (:NriNli£ 73 30 *�r�+�TOYFlL �gb.26 00 AC::T RGCFT1tA6t.1: �u�:�; �,u:1 �i !r' �1� ' 11 ;�•. •.:�• „ CHt1N6E i�� . �; , � . . .. �,..')in�2S/t3, ���� �.. � . . TUT11l NIIMRf�R?�� AMjlM,� 'SO�3�Q0o; 3!�02 ��� : .�1 .��,,: t A/.'.9I13 �: ''r �'.'. •i !,,., . .,, �,.�� '.�� ,,.,. �•d I�err I od:��i '•tl�.ii ; I'A 31:�d e�uu ::h,uP�� Rt�GEI f► .. .. .. � ►.1ii'r�E�:. �i �. Yuur Ca::hler - ,il�.t _,nt�Etll:�; ',UI! i ir ; . .�. .�:x= BnHrr��' p ._ . . ,�.*:�.. no�►usi:n��n snv:ia�s stinr�r�itY ��• ,r� �ti-ur�ri�i;��i►urt�c,s 3.00 ClTiti. SpV1tl�3S -`i.34 r .uo E:tTRA R�Y��RDS SA111NG� � pp 6.3q TOTAL SAV�M65 ° ^ , . '�r ;.j:i;t��� f'ili►17.. , , � � , •.� ,�z ';i,pfn�;:. � .��•r� f���:trP�� -i ,: 1 .R i r,• �x�■x�rx RrWARD°� PGI��":: $111'NRjI<�l C N:re E"<srn Ru�leew . _ F_t, .,r:�•u.0 �!•, - -- l� .Ci9 i 1 :3 �3 c� 'r,� � � , 3i� [.;tr�Rewar ds �RE , :,yr�xs•. ;k:ix:,.FY�'�• - • _....... ,. „ _ '�'�'�{�./� . . . . (``� � �5�'. S� / . . d � �Price � � ���'�. , '' �T, -�, ..�� � �,'''�?` ��`�, ° 1 �� �� ��.� � _.. �81�20y"'ZCII�O�'k.f�Inc. °�sz:� -�"� '�.�i.C���.> r € , ��, � 23-25 South Main Street � 10 First Avenue �G%�j� ���'� Dover, PA 17315 Red Lion, PA 17356 Telephone (717) 292-2621 Telephone (717j 244-i 828 Fax (717}292-7936 Fax (71� 417-5263 E-mail in#oC�baughmanmemorials.com E-mail lori@baughmanmemorials.com Totat rice { �t° �} �- ��' ,. p � Date x .f �% �`� � . �� : - �° For ' s � ° '� — -,;, _r Address �' � ;`" , ;,f� ��L�- . r;'�.�:� ;! x � b e Y fP�..��: �` Design No. Material ,r;� _..,...j y;�, ,,.� �� Die Base Markers � `'^ � ��`�° � ';'� Posts Vases , �. �_ Price j `' '` �,;� ' Tax ,�..�..�..�. Deposit Balance Due Style of Letters _ �� Foundation to be furnished by ��`'`a ;`�>����`�y�'� Material to be best selected monumental grade and to be free from imperfections and first class in every way.Work to be finished in a workmanlike manner. ° �:' This memorial to be erected in �.-'�'�"`f ��'%+#�` '� ��'�� Cemetery in or near during the month of ��.- 3�°���`'' �'.�y°�'"��'+ '�''�� unless unavoidably delayed by labor troubles and other contingencies beyond our control and then as soon as possible.Additional lettering and other work on this memorial in the future is not included in the Contract Price. Title and right of possession and removal of said stone,monument or appurtenances shall remain for all purposes in Baughman Memoria!Works, Inc.until work and materials ordered are fully paid by purchaser or purchasers.ln consideration of the acceptance by Baughman Memorial Works,Inc. of this order,the undersigned(hereinafter known as tne purchaser)agrees to pay Baughman Memorial Works,Inc. f 'a '4 / ;,` �' � . u�' :„=• Dollars on or before the 15th day following the billing of the work or job upon compleiion thereof by Baughman Memorial Works,Inc.Thirty(30)days from date of invoice a 1-1/2%finance charge will be added to the unpaid balance. Said billing to be notice of completion thereof,this order shall become a contract between the purchaser and Baughman Memorial Works,Inc.upon acceptance thereof in the space below by a duly authorized representative of said Baughman Memorial Worlcs, Inc.It being understood that this instrument upon such acceptance covers all of the agreement between the purchaser and Baughman Memorial Worics, Inc. and that no agent or representative of Baughman Memorial Works, Inc. has rUade any statements or agreements,verbal or written, modified or adding to the terms and conditions herein set forth. It is further understaod that upon the acceptance of this order the contract so made cannot be cancelled,altered,or modified by the purchaser or by any agent of Baughman Memorial Works,Inc.in any manner except by agreement in writing between the purchaser and Baughman Memorial Works, Inc.and it is hereby understood and agreed by all parties involved that in case of default by purchaser or purchasers,twenry-five per cent of the total original cost of the work or work and materials ordered,as the case may be,shall be a specified correct sum as liquidated damages which purchaser shatl owe Baughman Memorial Works,Inc.less any payment on account made prior to such defauli,this specification of damages to be due regardless of removal and taking possession of stone,monument or materials from purchaser or purch�sejs by Bau�hman I�mo��o s, Inc.upon following such defauk. t:� '� ,'��'�,��.�_.--'� i�l�`s�''` t �...�_� (SEAL) � _.. ,�f: .. T�: v 20� � (SEAL) , ;� r a: . o,...,.�....,,., �e,...,,,.,,.i�ni...�� i..� n...,..,.,�i [2�� :�"'''.. . . � a#; e�=,`c= :d.:,a (SEAL) 4 ' � RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date: 11/O1/2013 Cumberland County - Register Of Wills Receipt Time: 13 : 10 :27 One Courthouse S uare Receipt No. : 1076099 Carlisle, PA 17�13 MURTOFF RUTH K �� �� Estate File No. : 2013-01163 Paid By Remarks : ROBERT MURTOFF DBl ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee �ame PETITION LTRS TEST 90 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 20 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 .50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN INVENTORY 15 . 00 CUMBERLAND COUNTY GENER.AL FUN INH TAX RETURN . - CUMBERLAND COUNTY GENERAL FUN ---- ----------- Check# 2644 $183 .50 Total Received. . . . . . . . . $183 . 50 . t R�CEIP� ��R PAYIKENT LISA M. GR.AYSON, ESQ. Receipt Date: 7/21/2014 Cumberland County - Register Of Wills Keceipt Time : 09:38 :47 One Courthouse S quare Receipt No. : 1078595 Carlisle, PA 176Z3 MURTOFF RUTH K Estate File Na. : 2013-01163 Paid By Rema�ks : ROBERT MURTOFF DMB ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name AF3D PROBATE' FEE 1"7 0 . 0 Q eL7MBERL,�l'�TD et3fi.T1�TT� GEhTER.P;L FUN ---------------- Cheek# 004Q933750 $170.04 Total Received. . . . . . . . . $170 . 00 � ,� , �;--- ! .,�E� ��IoP�.�' z� zr l� No. � _ �_, DATE� �� RECEIVED F M "� �"' � __� _ _ DOLLARS QFOR RENT Z� .� �� �C.7�I � ��� ��- �i�L ACGOUNT O CASH �L� � � PRYMENT �CHECK FROM TO �O MONEY �ORDER BAL DUE OCREDIT CARD � 8Y , . �L 1 ! �� SWOPE TAX SERVICE 182 FAITH CIR CARLISLE, PA 17013-8870 (717) 24Q-0823 swopetaxservice@comcast.net June 24, 2014 RUTH K. MURTOFF P.O.BOX 334 BOILINGS SPRINGS,PA 17007 Statement of Charges for Services Rendered: Per Form Charges: See forms listed below-Federal 110.00 Miscellaneous Fees and Adjustments: PRICE INCLUDES COPYING AND ACCOUNTING FEES 0.00 Total fee $ 110.00 Summary of Federal Form Charges: Description Charge per Form Count Charge Form 1040 Individual Income Tax 80.00 1 80.00 Medical Expenses Worksheet 5.00 1 S.OQ Schedule D Capital Gains&Losses 15.00 1 15.00 Form 8949 Sales/Disp of Cap Assets 10.00 1 10.00 _ _ _ _ - �,��-- ��� ��;� Z �� �fn . �,.,..,.�-. �'�" �f,.` SWOPE TAX SERVICE 182 FAITH CIR CARLISLE, PA 17013-8870 (717) 240-0823 swopetaxservice@comcast.net June 24, 2014 RUTH K. MURTOFF P.O.BOX 334 BOILINGS SPRINGS, PA 17007 Statement of Charges for Services Rendered: Per Form Charges: See forms listed below-Federal 90.00 Miscellaneous Fees and Adjustments: PRICE INCLUDES COPYING AND ACCOUNTING FEES 0.00 Total fee $ 90.00 Summary of Federal Form Charges: Description Charge per Form Count Charge Form 1040 Individual Income Tax 80.00 1 80.00 Medical Expenses Worksheet 5.00 1 5.00 Schedule D Capital Gains &Losses 5.00 1 5.00 ,�,�� y.,..�.. �.. ..�„�"° . �� - _ . , � �.� -�.. . . ��.... . ����w . _�_.� , �.. . _ ._ , � : ��i� SWOPE TAX SERV 1�,� 182 FAITH CIR CARLISLE, PA 17013-8870 (717) 240-0823 swopetaxservice@comcast.net June 24, 2014 RUTH K. MURTOFF P.O.BOX 334 BOILINGS SPRINGS, PA 17007 Statement of Charges for Services Rendered: Per Form Charges: See forms listed below-Federal 90.00 Miscellaneous Fees and Adjustments: PRICE INCLUDES COPYING AND ACCOUNTING FEES 0.00 Total fee $ 90.00 Summary of Federal Form Charges: Description Charge per Form Count Charge Form 1040 Individual Income Tax 80.00 1 80.00 Medical Expenses Worksheet 5.00 1 5.00 Schedule D Capital Gains &Losses 5.00 1 5.00 _ .� twtun� rnl� CARLISLE MPO . BOILIi� SPRING , ernsyivania �"" , � 17���8 GARLISLE, Pennsylvania 4134870U07 -0097 170139998 12/10/2013 t717)258-6668 03:46:02 PM 4134870013 -0098 07/21/2014 (800?275-8777 10:01:32 lU4 Sales Receipt �— Product Sale Unirt Final Sales Receipt Description Qty Frice Price Product Sale Unit Finat Description Rty Price Price HARRISBURG PA 17105 Zone-1 $0.46 First-Ctass Mail Letter HARRISBURG PA 17105-8486 Zone-1 $0.49 0.30 oz. First-Class Nait Letter Scheduled Oelivery Day: Wed 12/11/13 0.40 oz. Return Rcpt (Green Card) $2.55 Expected Delivery: Tue 07/22/14 2-70 99 CerYified $3.10 Return Rcpt (Green Card) �3.30 Labei #: 70123050000�28434054 (+p Certified _______= USPS Certified Mnil #: Issue PUI: � - 70140510000237510512 � _____�_� � Issue Posta9e: $6'49 , .� Total: � $6.� � Paid by: Total: �6.49 Cash $�•� Change D�: -$13.89 paid by: Gash $10.00 Q9 For tracking or inquiries go to Change Due: -53.51 USPS.com or call 1-800-222-1811. Orde►^ st�s at usps.com/shop or call t+0 Por tracking or inquiries 9a to USPS.coN or call 1-800-222-1811. 1-�0-St�24. GO t0 USpS.CO�I/Ci1dCnSFtIP *+eww+r*,r.a►***r.w*,M.*,r�►*+.*w*eww**«***,+***fi* to pri nt shi ppi rig 1�el s wi th postage. F� „*,�,�,�**,�****..«**..+.********************** other inforn►ation cail 1-800-ASK-USPS. � BRIf,HTEN SOMEONE'S MAILBOX. Greeting cards *"x"""""""""*"""�""`�""""`**"*'�*�`*'�**�"�*�`�` a�ai 1 abl e for purehase at sel ect Post *�rx*xrcxaxt�r�xx,.xxx*x*xrcrcxxxxxxxs�rx*xxxxx Offi CeS. . Get yo� nai 1 when and r�ere ya� want i t *..****,�►,.,,***«..,tw+.**********************'` wi th a sec�e Post Offi ce Box. Si gn up fa, ,+a,�**w**,w,w*ww+�*wi.r.w,►*,►,r*,r**,r,�w****w***+.* a box online at usps.com/poboxes. rcrcxrctx*xxxxx**xx*xxz*xxx*rrx�rx*:a*xxxzxx* xxzxxz*xxx*xx*x*x*xxxx*xx**:zx*xxsxxxxx* � Order sta�ps at usps.coa/shop or ca 1-800-Sta�p24. Go to usps.co�/cticknship Bill#: 1000�3228117 to print shipping tabels vith postage. For ���: � other infor�ation calt 1-800-ASK-USPS. **w*w********r*«w,►*aw*«w+*ww«*«w*******« �1�1 Sd�BS flfl8� dl St811p5 dfld POS'C�JB *,k*,irr.+ni.wwirwr�as.aw�rw,r.rrww,irw,nw*n.*,twwr.+.,+�w*,ir,t.w Reftands for guaranteed services onty Get your �ail ahen and Wt►ere You aant it Thar�c you for your business rith a secure Post Office Box. Sign up for xx**sx*xx**xxx*x**zxx�cxxxx*fcxxxxxxx***xx 8 bOX oniine 8t USpS.COM/Poboxes. xxxx:xxxfrxsxxxxxxaxx*xxsxxxxxxsxxxx�tx�xx airw**+rw*+errww.t,rw+r*a,r**w*rn+**w*+*w**,+*+.*aw HELP US SERVE YOU BETTER ****»*»««*«**�**+►«*******************'*** Go to: https://postalexperience.com/Pos Bill#: 1000205990301 TELI US ABOUT YOUR RECENT Cierk: 07 POSTAL EXPERIENCE Al1 sales final on staa�ps and postase yOUR OPIWION COUNTS Refunds for guaranteed services only xxxxxx*xx*zxxxxxxxxx*xx:xxx:*x*x**:*xxr* Thank you for your business xxxxxx*u*xz**xxx*�c:xxxxxx*x��r�c*xxx*xxx*x ****,k,k*r,kwwww+►**w******+►*wwws*war«*.e*+.*..* *+►**wir,�rw**rr***www*ww,t*wre*w*ww*,r,�,v x*a,+*w+. HELP US SERYE YOU BETTER Custa�er Copy Go to: https://POStalexperience.coaJPos TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE �/L�'(F/� � ���/�'j,�J �iE(�!P T YOUR OPINION COUNTS w******«*w**rr*****ww**x***«.►�*,+**,r**w*** �d�r,��.� -- �7�vV **************.*�**********.*�*********� �Custorer CopY / � ��es� -�Oy �c.,�•,c•�,.:�' o �'- aw�o v�,�' d�� 6•!I Z f� y►,u�-�' o t' a�v�►� d v Q � �O. Lf � � o�- _ _ __ _ , , m.� .. �. _ BOILIWG SPRINGS PO ,�— BOILING SPRIN�S, PennsYlvania 170079998 4134870007 -�99 07/07/2014 (717)258-6668 02:54:57 PM � Sales Receipt Product Sale Unit Finai Description Qty Price Price HARRISBURG PA 17129-0�02 Zone-1 $0.49 First-Class Mail Letter 1.00 oz. Expected Delivery: Tue 07/08/14 � Certified $3.30 USPS Certified Mail #: ��JJ�) ��� �O S'�} <r �! 70123050�00028445197 `_ ________ �,.., Issue PVI: $3.79 KANSAS CITY MO 64999 Zone-5 $0.70 /�61 ��x ��fjQ,�,i S - First-Class Mail Letter � l Expected Delivery: Thu 07/10/14 Q� Certifled $3.30 �'ed. �- �R Z.o��, �2� �3 �oi���445'�#_ Issue PVI: $4.00 KANSAS CITV MO 64999 Zaie-5 $0.49 First-Ciass Mail letter 1.00 oz. Expected Delivery: Thu 07/10/14 Q�I Certifiied $3.30 USPS Certified Mail #: • 7012�028445210 _r___� Issue PVI: $3 79 , KANSAS CITY ht0 64999 Zone-5 $0.49 First-Class Mail Letter 0.90 oz. Expected Delivery: Thu 07/10/14 �i Certified $3.30 t1SPS Certified Mail #: 7012305000002&145227 '�^�-- � Issue PVI: $3.79 HAf�2ISBUR� PA 17129-0001 Zone-1 �0.49 First-Class Maii Letter 0.90 oz. Expected Deliv�y: Tue 07/08l14 /� Certified $3.30 USPS Certified Mail �: � 70123050000028445234 ^—/ Issue PVI: r $3 79 • HARRISBURG PA 17129-0001 Zene-1 $0.49 F1rst-Class Mail Letter 0.90 oz. Expected Delivery: Tue 07/08/14 �G1 Certified $3.30 USPS C�tified Mail #: 76123050000028445241 ` Is�sue PYI: . --$3.79 � Total: $22.95 Paid by: Personal Chedc $22.95 N For tradci� or inquiries go to U�S.cao or call 1-800-222-1811. Order staieps at usps.caa/shop or cail 1-800-Stan�p24. Go to usps.con/clidcnship to print shipping label�.with postage. For other infornation call 1-800-ASK-USPS. xx*:x:�::���:*x�,�,�,�,�,�**�*�.���,.,���w.,..�..,. r -� 182-18-1458 MU 120091U055 PAYMENT AMOUNT MURTOFF RUTH K 717-258-3768 9 .00 PO BOX 334 B O I L I N G S P R G S Mske d�k°r"'°'�ey°�de� P A DE P A RTMENT US E ONLY �b�e to ti►e F+e�osy�+ran�a 17 U�7 � �e�M°f Revenue L _J � PRIMARY SSN CHECK DIGIT SPOUSE'S SSN � 1 8 2 1 8 1 4 5 8 M U 13D0910D54 u►sr r�e �asr ruMe MI PAYMENT AMOUNT URTOFF RUTH K SPOUSE' UST NA E RST NAME MI PIRST LINE OF ADDRESS 1 7 O � 0 BOX 334 SECOND LINE OF ADDRESS CITY STATE ZIP PHONE NUMBER Make check or money orde� OILING SPRIN PA 17�D7 7b?-258-3768 PaYabietothePennsylvania Department of Revenue DEPARTMENT USE ONLY � � , � � � COMMONWEALTH OF PENNSYLVANIA � BUREAU OF PROGRAM INTEGRITY DIVISION OF THIRD PARTY LL461LITY ' RECOVERY SECTION - PO BOX 8486 HARRISBURG,PA 17105-8486 December 18,2013 STATEMENT OF CLAIM SUMMARY NAME Estate of MURTOFF,RUTH ID 930 310 183 MEDICAL CLASS 3 CLASS 5.1 TOTAL INPATIENT .00 .00 .00 OUTPATIENT _00 _00 .00 LONG TERM CARE _00 36,570.40 36,570.40 DRUG .00 .00 .00 REIMBURSEMENT TO DPW .00 36,570.40 36,570.40 _ _ _ __ COMMONWEAITH OF PENNSYLVANlA DEPARTMENT OF PUBLIC WELFARE E!N- 23-6003113 _ ___.. - �����"�':�'�1,:_.�2�°��1�" �`f��4�[_:_��'�'t�d�`� ��. -'�'--��i3t�`���5-;-"��,-�i$`b�- --- --- -------- , . . . . '' , ; . . . �* ACTIVITY FOR MURTOFF, RUTH K -MURTR3 - -803056 10/04/13 9035932 45 dS-CAL SUO+D CHEW O1 * 4 :55- - --- - - ,-pp �;59_ 10/04/13 9035932 60 OS-CAL 500+D CHEW O1 * 8.35 .00 8.35 10/13/13 9125128 5 ATROPINE 1% EYE 5 01 30.42 .00 30.42 t��� �� �- o��-, ��-�51� DUE . o0 30.42 3 . 80 i LEGEND NON-LEGEND F ToTA�Tax ! FOR MONTH FOR MONTH �evious Balance Charges this month Finance Cha e Tom�rayme�e s creatts AMOUNT 1 20.30 +; 38 . 77 + . 00 = 59. 07 - 4 . 55 - 54 . 52 'OR ALL PHARMACY RELATED INQUiRES PLEASE CALL Alert Pharmacy Services, Inc at 1-800-266-9954 Statement Terminology on reverse ----�. �NWEALTH OF PENNSYLVANIA i�EV-1 762 EX{11-96) DEPARTMEP(T OP REVENUE . BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRI58URG,PA 17128-0601 � PENNSYLVANIA �ECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018690 MURTOFF ROBERT G PO BOX 274 BOILING SPRINGS, PA 17007 ACN ASSESSMENT AMOUNT CONTROL NUMBER --'—" (old """_"_ """"_ 101 � S 2,700.00 ESTATE INFORMATION: ssrv: � F��E tvunnBER: 2113-1 163 ( DECEDENT NAME: MURTOFF RUTH K I DATE OF PAYMENT: 01/23/2014 � POSTMARK DATE: 01/23/2014 � couNTY: CUMBERLAND � DATE OF DEATH: 10/24/2013 � � TOTAL AMOUNT PAID: 52,700.00 REMARKS: CHECK# 53 INITIALS: CJ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS TAXPAYER I�. U LAa?' WILL AND TESTAN�EN'T OF RUTH K. 1VIURTOFF I, RUTH K. MURTOFF, of the Borough of Carlisie, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I give to my niece, MIMI ANN DEVENNEY, of East Street, Carlisle, Pennsylvania, the sum of One Thousand ($1,000.00) Dollars. THIRD: I give, devise and bequeath my residuary estate to my husband, ALBERT J. MURTOFF, provided he survives me by thirty (30) days. . FOURTH: A. Should my husband, ALBERT J. MURTOFF, predecease me, I give, devise and bequeath our tall case clock to my son, ROBERT G. MURTOFF. B. I reserve the right to leave a list of personal property which I may wish various of my children to have with this Will, and request that my Executor honor that list of personal property, and distribute the property in accordance with that list. C. I give, devise and bequeath ail the rest, residue and rernainder of my estate, real, personal or mixed, whatsoever and wheresoever situate, to my children, RUTH A. OSBORNE, of Carlisle, Pennsylvania, ANNE L. HAWBAKER, of Mt. Holly Springs, Pennsylvania, ROBERT G. MURTOFF, of Boiling Springs, Pennsylvania, and WILLIAM A. MURTOFF, of Boston, Massachusetts, per stirpes. In dividing said equal shares, my Executor shall take into account the value of the personal property distributed above, except for our tall case clock, which I have left to my son, ROBERT G. MURTOFF, on the understanding that he will not sell the clock, but pass it down to another member of the family. I direct that his residuary share not be reduced by the value of said tall case clock. LASTLY: I nominate, constitute and appoint my son, ROBERT G. MURTOFF, to be the Executor of this my Last Will and Testament. Should ROBERT G. MURTOFF be my Executor, he shall receive as his compensation the sum of Two Thousand ($2,000.00) Dollars. No Executor shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ;�- �'�fay of , 2005. � ��, , Ruth K. Murtoff. SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: � � 2 . COMMONWEALTH OF PENNSYLVANIA : : ss COUNTY OF CUMBERLAND : I, RUTH K. MURTOFF, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged efore me, by RUTH K. MURTOFF, the Testatrix, this o1.L���-- day of 0 , 2005. �L�'�i� � Ruth K. Murto , Testatrix N ry Public NOTARIAL SEAL MERLENE J.MARHEVKA,NOTARY PUBUC CARLISLE,CUMBERLAND COUNTY,PA MY COMMISSION EXPIRES JUNE B,20� � � Y COMMONWEALTH OF PENNSYLVANIA : : ss COUNTY OF CUMBERLAND : We, �3�..e� nd ' the witness whose names are signed t he attached or regoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me b ��� � .. and � = L�L.( this ���" day of � 2005. U-� � . , Witness � n i • itness _ C��._._ No Public - NOTARIAL SEAL MERLENE J.MARHEVKA,NOTARY PUBLIC CARLISLE,CUMBERLAND COUNTY,PA MY COMMISSIOM EXPIRES JUNE 8,2008 4