HomeMy WebLinkAbout01-20-15 � 1505610105
REV-1500 EX(02-11)(FI)
OFFICIAL USE ONLY
PA De artment of Revenue Pennsylvania Count Code Year File Number
P OEPARTMENT OF REVENUE Y
Bureau of Individual Taxes INHERITANCE TAX RETURN �j i I � ,,/_�(/�
PO BOX 280601 �
Harrisbur9,PA 17128-0601 RESIDENT DECEDENT !�
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
-���� a� ��l-��r� C�� -��- ���.i
DecedenYs Last Name Suffix DecedenYs First Name MI
ANDERSON MARY K
(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 BOXES BELOW
Q 1. Original Return Q 2. Supplemental Return Q 3. Remainder Return(Date of Death
Priorto 12-13-82)
Q 4. Limited Estate Q 4a. Future Interest Compromise(date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 6. Decedent Died Testate Q 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
Q 9. Litigation Proceeds Received Q 10. Spousal Poverty Credit(Date of Death Q 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
ROBERT G. FREY 7175435838
REGISTER OF WILLS USE ONLY
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First Line ofAddress � n � rn
-.. O f'�� C>
5 S . HANOVER ST . �r� �� � J' G
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Second Line ofAddress ;-�:.a b.;� r-�- N --•i �`a
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DA ILED."
City or Post Office State ZIP Code .
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CARLISLE PA 17013 � cr� ,��
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Correspondent's e-mail address: R F R E Y a�F R E Y T I L E Y . �0 M �� � ��
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statement�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.
SI`N U E OF PERSOf�,RE P LE FOR FILING RETURN DATE
�,r��� � G(�% -J�+n i.r �./' � t 4 zc>� 5
ADDRESS
1625 WALNUT BOTTOM ROA NEWVILLE PA 17241
SIGNAT E O REPARER THER A��REP ENT IV DATE
, . �l�:r ��� i4 Zo��
ADDRESS
5 SOUTH HANOVER STREET CARLI E PA 17D13
PLEASE SE ORIGINAL FORM ONLY
Side 1 \
,�
� 1505610105 1505610105 ,�,' �
�
� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
Decedent�s Name: M A R Y K A N D E R S 0 N
RECAPITULATION
1. Real Estate(Schedule A). . . .. . . . .. . . . . . . .. .. . .. . . . .. .. .. . . . .. . .. . . 1. 0 . 0 0
2. Stocks and Bonds(Schedule B).. . . . . . .. . . . . . .. . . . . . . .. . . . .. . . . . .. . . 2. 0 . ��
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C). . . 3. � . ��
4. Mortgages and Notes Receivable(Schedule D). . . . . . . . . .. . .. . . . . . . . . . . . 4. � . ��
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . 5. �3`)2. �3
6. Jointly Owned Property(Schedule F) �Separate Billing Requested. . .. . . . 6. � . 0�
7. inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . .. . .. 7. � . 0 0
8. Total Gross Assets(total Lines 1 throuph 7). . . . . . . ... . . . .. . .. .. . . . .. . . 8. 7 3 9 2. 0 3
9. Funerai Expenses and Administrative Costs(Schedule H).. . . .. . . . .. . . . . . . 9. 9638. 16
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). . . .. . . .. .. . .10. 2 3 4 6 . 19
11. Total Deductions(total Lines 9 and 10).. ... .. .. . .. .. . .. . .. .. . .. . . . .. 11. 119 8 4 . 3 5
12. Net Value of Estate(Line 8 minus Line 11). . . .. .. . .. . ... . .. .. . . . . . . . . . 12. -4 5 9 2 . 3 2
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J). . . . . . .. . . . . . . . . . . . . . . 13. � . 0�
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . .. . . . . . . . . . . . . . . . . 14. -4 5 9 2. 3 2
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable at
the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 � 15. 0 . �0
16. Amount of Line 14 taxable
at lineal rate X.0 4 5 16. 0 . 0�
17. Amount of Line 14
taxable at sibling rate X • �+2 17. �. �❑
18. Amount of Line 14 taxable
at collateral rate X . 15 1 g. � . ��
19. TAX DUE. . .. . . . .. . .. . . . . . . . .. . .. .. . . .. .. .. . .. ... .. . . .. . . . . . . . . . . 19. 0 . 0�
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
L 15056102�5 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 21-14-0588
DECEDENT'S NAME
MARY KANDERSON
STREETADDRESS
801 NORTH HANOVER STREET
CITY STATE ZIP
CARLISLE PA 17013
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+g� �2� 0.00
3. Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in box on Page 2,Line 20 to request a refund. (4) 0.00
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.
_...�...u.,>,��.,.,�'k.�s�`.,'�«5 ,. '��'�+�«�.���_:':��i:a r,�:..*� ''as"�.5'�da '8'= Me f y r�R��; ;y�. � �" ,s, ��� �`��:. ,,..,w,�v�'��:�����,�„��:�t..M.�....z, �t .� ��� ...e�.� # a ., ,. , �.
�)�'r�',.�,,.`tic .rbak.., a.%Fmt�..a .. .,w.�.� .,.�aw.xa u5s,...,.. So-. ,. X .,„..�. ... , . .
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............................................................................................................................. ❑ �
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 receiving adequate consideration?............................................................................................................. ❑ �
3. Did decedent own 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 ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
�e � � .,. . �. . � � , . ,� ,. . , „ .. . �,�� z �� ., ,< ,. `'.... .� '''��:, Y,.. ?�y ,. ,�� . .,,,.�,¢ , . � _.
. . .. _ . _. w�. .
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 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 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)J.
• 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.
/
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B�SID�bi'i�=C�DEI.�T '� �
�.�1"/:.�� OF: -- i�PLC f��U[ik�ER:
f�iiar�� N:�,noerson 21-14--0588 �
Inciude th�proceeds of lifigation and the date the proceeds v��er2 received by the estate.
��.If propei-�ar iointl��ov�med with right of sur��ivor�l�€p must be disclosed on Schedule F.
fTEfU VALUE AT DATE
NUt�IBER DESCPIPTION OF DEATH
1. Balance in resident account after paying final bill to Church of God Home 1,735.41
2. ACNB Irrevocable burial account 4,136.41
3. ACNB checking account 1,520.21
. � ,
TOTaL(Also enter on line 5, Recapitulation) $ 7,392.03
If more space is needed,use additional sheets of pap2r of the same si�e.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENTOF REVENUE FUNERAL EXPENSES AND
R SEDENTDEC DENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Mary KAnderson 21-14-0588
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Egger Funeral Home 8,248.50
B. ADMINISTRATIVE COSTS:
1. Personai Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. AttorneyFees: �,��0.�0
3. Family Exemption:(If decedenYs address is not the same as GaimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 113.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7. Advertising in Cumberland Law Journal 75.00
8. Advertising in the Sentinel 201.16
TOTAL(Also enter on Line 9, Recapitulation) $ 9,638.16
If more space is needed,use additional sheets of paper of the same size.
. REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN DEBTS OF DECEDENT�
RESIDENT DECEDENT MORTGAGE LIABILITIES& LIENS
ESTATE OF FILE NUMBER
Mary K Anderson 21-14-0588
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
1.
Brockie Pharmatech 2gg.�g
2. Church of God Home 2,057.00
TOTAL(Also enter on Line 10,Recapitulation) $ 2,346.19
If more space is needed,insert additional sheets of the same size.
� �3 t� -�� �� �,,��
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CHURCH OF GOD HOME,INC � ��° �°"° &�' "�'� -� ° �" �'
Fortn PB-01
801 N.HANOVER STREET
CARLISLE,PA 17013
RESIDENT# UNIT STMT. DATE
464 H225A 08/31/2014
RESIDENT S
PATRICIA WILHIDE Mary K.Anderson
1625 WALNUT BOTTOM ROAD
NEWVILLE,PA 17241 TOTALAMOUNT DUE $0.00
DETACH AND RETURN THIS PORTION WITH YOUR REMITTANCE $
_. -----------._.. .._.------ --..... ----------------- --- ----- --- ---------- ------AMOUNT REMITT_E..D.._
Days/
DATE DESCRIPTION ���� CHARGES CREDITS BALANCE
Balance Forward -1,735.41
07/31/2014 Refund of credit balance 1 1,735.41 0.00
----_.
Please call the billing office at 717-866-3256 or 717-866-3255 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 TOTAL AMOUNT DUE
464 0.00 0.00 0.00 0.00 0.00 $0.00
RESIDENT NAME Mary K.Anderson FortnPB-01
�
�
ACNB
BANK
June 26,2014
Frey& Tiley
Attorneys at Law
5 S Hanover St
Carlisle PA 17013
RE: Estate of Mary K Anderson
Dear Mr. Frey:
The following information is being provided as per your request:
Acct. Type Account No. Balance at Accrued Ownership Date
D.O.D. Interest to Opened/Joint
D.O.D.
Savings 9000272785 $4,136.41 $.06 Irrevocable Burial 12/17/13
Account
Checking 110221 $1,520.21 $.00 Individual 9/6/84
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. If you need any additional information,please contact me at(717)339-5122.
Sincerely,
� �� � � ��'
Lois Kime
ACNB Bank
Deposit Services Supervisor
acnb.com•acnbbusiness.com• P.O.Box 3129,Gettysburg,PA 17325 •Phone 717.334.3161 •Toll Free 1.888.334.ACN6(2262)
C�G?G��� � ii�!,�c:;�lP ��'LC'.
15 Big Spring Avenue
NEWVILLE, PENNSYLVANIA 17241
F. CHARLES EGGER, Supervisor 717-776-3414 FRANK C. EGGER, Funeral Director
July 21, 2014
Funeral Bill for Mary Anderson
Date of Death June 11, 2014
Professional Ser��ices $4,375.00
12 Death Certificates $6.00 a piece $72.00
Blue Sterling 18 gauge casket $2,185.00
Sentinel obituary $330.50
Valley Times Star obituary $50.00
Cemetery opening . $1,086.00
Register Book $150.00
Total $8,248.50
Paid by Burial Account $4,136.50
Paid by Monumental Life 7/2/14 $2,06434
Remaining Balance $2072.16
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BROCKIE PHARMATECH A FINANCE CHARGE OF 1.50 � PER MONTH
PO BOX 2807 (AN ANNUAL PERCENTAGE RATE OF 18.0%) WILL BE
YORK PA 174 O 5 CHARGED ON ALL AMOUNTS 3 0 DAYS OR MORE PAST
DUE
STAr�'EMENT OF ACCOUNT
PLEASE PAY BEFORE THE 25TH OF THE MONTH. "C"
BEHIND ITEM TOTAL MEANS CO-PAY. 800-864-1744
STATEMENT DATE: 0 9/0 2/2 014
- - 8
ANDERSON, MARY K ANDEMF
C/0 ATTORNEY ROBERT F FREY GRP-CG
60 DAYS . 272 . 72 5 SOUTH HANOVER STREET PAGE
90 DAYS . 16 .47 CARLISLE PA 17013 ' � � ' '
PLEASE DETACH HERE AND RETURN TOP PORTION 1h'ITH YOUR PAYMENT
BROCKIE PHARMATECH PO BOX 2807 YORK PA 17405 717-854-9028
.• �
�. � . . . � . . •
I� **** PREV OUS BALANCE 289•19
o ** T IS AMOUN PAS DUE **
�
0
6
. ��
2453 . 09 16 . 38
. , .
DEDUCTION CHARGE
. . . .
. �
289 . 19 + . 00 + . 00 - 289 . 19- . 00 - 289 . 19
50_250521 Form 501312
CHURCH OF GOD HOME,INC -
Form PB-Ot
801 N. HANOVER STREET
CARLISLE, PA 17013
RESIDENT# UNIT STMT. DATE
464 H225A 11/30/2014
RESIDENT S
PATRICIA WILHIDE Mary K.Anderson
1625 WALNUT BOTTOM ROAD
NEWVILLE, PA 17241 TOTAL AMOUNT DUE $2 057.07
DETACH AND RETURN THIS PORTION WITH YOUR REMITTANCE $
_....----------.._._._.—_._.. ----___._..--- ---..._....------------------.._._..---....-----------................-----.._.......__..__.._._....-----...._.....-----...._..----.._....._...._._._..__..----...._...._._..-----...._....-----.._...._....._..-----....__.._....._..__._._AMOUNT_REMITT..E...D...
DATE DESCRIPTION �a�� CHARGES CREDITS BALANCE
Units
Balance Forward 2,057.07
Please call the billing office at 717-866-3255 or 717-866-3256 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 TOTAL AMOUNT DUE
464 0.00 0.00 0.00 1,735.41 321.66 $2,057.07
RESIDENT NAME Mary K.Anderson FormPB-Ot
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I, ��A�.4'%'. ����Du�SQ�T; �f thw�?or��?����c�.ton Ta�7ar�s�i�, ���zmbe�Ia�� �c�u�t}�,
Pe�nsS��vania, deciar�this to �e�y Las���'ili, r��ru�y revo�.ng a11 ��ior�-,�i1ls w�d cadaci�s.
FU�TE��,��E��+hTS��
FIRS'F': I direct th� p�.yment of my fi4�era1 ���penses, ��cl��i�g my gra��e:nwrl�er, ;�s s�on
as rnay be ca�v�ni�n: ��er my de�t��.
�'�.Yh�?`T'�' 4F I���T� '�'�`�'.��
����kI�TD^: I direct `r.Gt all ��.�:�s thGt may be ass�ssed �n co�:se�uen�� ��f��ty �eath, of
`��h�.tes�e; natu:e �d'�y v,�?��.e��er;ar:sdict��n���posed, s�i�l?be pwi� �'ram�y residu�:y esta�e as a
part o�*he expense a�administr�tio.1 oi�.y esia�e.
£}��S'�'��J'F��I�T �F�.SID��IE
'�'HII�: I gi��e the �est of�y estate in equ�l shares to my frve c��ildre:i, n�.rri�ly, Flo�enc�
B. F�'.eiley�, I-�er��rt 7. ��o�tt, �?��,rles I�. �,n�.�rson, �r., Patricia E. �ilhide and Robert 3. I��effi�t,
de�e�sed, o;their issue,per stirp?s, ���ho s'�all survive r�e �or a period �f�h�r�5��30) da��s.�' is �
understood that the share of my deceased'son, R��ert J. le�o�tt is to go in equa3 sr.ares t�=fris =-` ��_
c�ldrea, �a..mely, Tami Appelbaurn, �.obin�ich�cs a.nd: Ancrew I�ia�tt, ar�heit-:s:�ue, p� =�; �'�J
stirpes, ��ha sha�l sun�ive me for a period o�thirt�J (JO) d���s. , _ � ` -
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�RC��'�CT��hT E.��BE��F�C�.��ES __ ;;: _..
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(Spendthra�'t l�r€���zsae�s�) � c --:-, _ .�.":
c_ �,
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�`c��,�''r�.��': �O lfl�eres�in income a�YI'IIYCt�di';Tlwi; i,�.aSSi�22uD18�j7 a�fiZ�:,infj��.b :>� �
available to anyone having a claim against a beneficiary before actual payment to the bene�ia�y. �
Provided, however, a�y be�eficia.ry may assign any�4rt ar ali af the�eneficiary's interest in my
estate to any one ar more of my d�scen�an�s or to a.ny one or more of the beneficiary's
descendants.
,�1�1 tt'
initials
T�����o�.s 4�� ���c_�r-:�cL����� ����T�rLcL��s
�LT�'T'I�6 If any i��c��.�� ar��i:�cip�,( s��w�I �e�a���b�e�o �rr����rsai� �T��I�o s���,�I��� r�inar�r
�J�ha ��,att ��ir�ca�ac��at�d for ar�y re�san, �y�hecut�r �s tr�stee 5hz�1 ha�� s�c� inca�� ar��
princap�� �caring�r�arity or incapacity ana �hat1 be e�t�tlee�to zpply sLch income �nd p;�ncipal ta
the heaft�, ��inten�nce, support and educ�tian af such person dur�ng�ir�ar�ty or�r�cap�ei�5�
��ptho�t the�ppointme�t af any gu�.r�ian ar com�nittee ar any �utl���itSj af caurt. I��y �xecutar�s
tru��ee ��a�1I be entitled to make direct appiication hereunder or ta ma�e at��Ia�ation by pa.yr��nt a�
gncor�e and praneipal to the parent or oth�r persan i� c�arge of suc�n�nor or incapacit�.ted
persan, or to his or�er gu�rdian or to a custadia�.under t�e Unifo�n'�'ra�sfers to R�inors �.ct.
�y rem�anin�income a.nd pri�cipal to which s�,�ch person shall be enti�led s1�all b�e distributed to
sucfi person upo��he termina.tion of r��ority ar inc�pa,city. I��y execu�or as t�-ustee shapl have t�e
s�.me po��ers �s Fny executor.
�'EI�W�� ��E�'EELT�'EI°L�
ST�'.'F�: I confer upon my executor the right ta sell or other;�ise ean���rt any reat or
personal property at public or pri��ate sale, at such tim� ar times, in such ma.rbner, and far svch
price or p�ices, and on such terms and conditions �s my exeeutor sh�1 determine, an�to e�ecute
�nd c�eli��er goad and suff'icient con��eyances, assi�ents �d transfers of th�propertl�, `��itho�.�t
• �iability of an�purchaser for the applicatian of an5�consideration; �o borr�w money and�o secure
its pay,nent by mortgage of real or personal property, �Iedge of in��estments, or ather-��ise,
�uitho�at Iiability on�he part of the lenders to se��a the application thereof; to a et$FII ^�El��
inves�rnea�ts at discretion; to invest and reim�est at discretion, v✓ith�ut restriction to so-c�.iled `
"1egal in`�es�ments"; to ma.l;e distribution in cas� or i�l�.ind; to �I1oc��e anci distribute di�erent
kinds ar disproportionate shares of property or undivided interests in properiy a.mang
beneficiaries, in cash or in kind, or pa.rtly in each; and to do all other acts and things necessary or
apprapriate in the management, administration and distribution of my estate.
�PP�II�T�fi'�1�TT Q���U�.R�It�i.N ��EST��'E� �F� l�!�II�iTfJ��
S��'��rT�'�i: I appoint my execuior as guardian af ihe estates oi minors��ith pov��er to
hold all property payable by 1aw to a guardian appointed by my��11 and to use it for t�e minor's
health, maintenance, support and education, either directly or by payment to any person selected
by my executor to disburse it whose receipt shall �,e a camplete acquittance. Guardian may, in
discharge of alI the guardian's duties, pay any minor's share deemed ianpractical of�drrainistratian
to the parent or other person in cnarge of the minor or to his or her guardian or to a custodian for
the minor unc�er the Uniforrn Transfers to Minors Act. ivly executor as guardian sha11 have the
same powers as my executor.
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i.��.a�s
���Pi�O���Z���r�;i OI� L,iL,Ct�TGR����
�',IGff1�: I �t�ro���t -_��r a�u��� ��, :� __.�_.. �. �7r':Ih?�e a.�� P�o�vricw� �:�:IjuS�, c-`�rle
SwiNi�TC:�?', ����,S:�CL��:f��S vf�iTi)��7��11�.
�?��4��I�. Q� B O I�rIZ,
h�II'�T�H: I direct tha.t no nd�c��ry hereu�Qer �hail t�e requ�r�d ta f��r.is��i b�nd in ���,
�r�.��dictian, ��� ii a�:���a_�d �s nec�ssar�T, �a su�e�y �kall be re�ui�ed.
�hT�'EI�.C�I�'�-E�.�ff,�T�' ��'�.Ah?�LT�.GE
'�'��T'F�: �3��ords v5ed :n the si;�gul�r�ay be r��d �o inciva�t�e�I�ral or the�lur�.l rnay
�e read �s the sin���r. Si?r�ilar?�, the masculi�e fa-n hnay�e read �o ��clude�he ee_ni.�ne �.nd
�euter; the ie�rr�ne ma�ve re�d to ir�c�ude the��scu�i�e �� neuter; z�-�d �he neuter ma5�ba Fead
ia �ncit.�de the mzsc�Iine and fe�ninine.
g�AD���'-S
��E�'�I�TTH: T�e headings used an th�va�iaus p�.ragra.phs ofthis«�i�t are inclT?d�d �o:
ca���e�ience a�y �.nd shzll :���Te na �e�at significance.
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I ha`�e sign�d��.is�,�ii�this_�day �f �,� �'� �",� ` '�p0;. �
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���%�.�-'('� r�. /'�,�,'(�y',��.�.w�
ivlary I�.`'An�erson, Testatrix
��"itness "
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ti�'�ness ��
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���...��LI\'U �,�\���i":�L��1\�LL.-1\��T �r�LQ. %'Ll�L�1 it � ��L��,
COI����Ql��st��_LTIs OF PE���l����'Z�jl�I��I� )
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�O��JI�'��:'�� CIJ���E�,AI�� �
«1e, R�ary I�. �nders�n, tY�e '�estatr�x in �n�the undersig�e�. ���tnesses to tY�e v��il�, t�e
�tt�c�ed or foregoing in5t�rr�ent, ��ho �ave signed fhe instrument, �a��ing�een a,uaiified
�ccarding td Pa��c�o c�epQse �.nd say:
�a} that I, the Testatrix, do hereby acltnov�ledge that I signed t�e instr�r�rent as
Fny��iil, thut I signed Ft`�iltingly a,nd as my free �nd voluntz,r�� ac�for the purposes the:�in
e�pre�sed; �.nd
(b) that we, the witnesses, were prese�t and saw the Testatrix sign and execute
the instr�rnent as her�rill, tha.t she signed it�,�illingly and executed it as�er�ee and
voluntary act for the purposes thereir� expressed; that each af us in the hearing and sig�t af
the T'estatrix signed the��ill as a witness and that�o the best of our l:no�h�ledge the
T'est�trix��as �t that tipne eighteen or more ye�rs of age, of sound mind �nd ur�der na
constraint or u7due influence.
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�'%'�Gv�,f� /'�,�` /.�`���,.+',��c<���
h�ary K. Arrderson
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Notary Public
Norar;al seal
Rot�rt R. Black,Notary Publir i
Carlisle Boro, Cumberland Cotnsy ;
Nfy Commission Expires Sept l.�, '��r:t' '
���.., .,_.. ;J
No•,ari,al Seal
RE'�rt R.Sla^.k,TJo:ary Pubfic
C�lisie �ro, Cumt�,rland County
IiFy �ommission Ezpires 5ept. 10, 2�5