HomeMy WebLinkAbout03-11-15 pennsytvanfa 1505614105
M-7-EnTc rW" W EX(03-14)(FI)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
INHERITANCE TAX RETURN
PO BOX 250601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 15t
I
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
12282014 08211921
Decedent's Last Name Suffix Decedent's First Name MI
Curnes Anna
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q>Q 1.Original Return p 2.Supplemental Return Q 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemption(date of C=) 5. Future Interest Compromise(date of C=:) 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
QID 7. Decedent Died Testate O 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 10. Litigation Proceeds Received C=) 11. Non-Probate Transferee Return C=) 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
Q 13. Business Assets CD 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Joann or Earl Henry (717)697-5021
First Line of Address
924 Macoun Dr
Second Line of Address
City or Post Office State ZIP Code
Mechanicsburg Pa 17055
Correspondent's email address: henry15051 @gmail.com._______..._
REGISTER OF WILLS USE,,9NLY
C=
REGISTER OF WILLS USE ONLY C r1
C9
DATE FILED MMDDYYYY._.._ C= C> C'3
IJ (J
cj
DATE FILED-STAMP,
^r
CD rn
r C
PLEASE USE ORIGINAL FORM ONLY CT) -�
Side 1
IIIli11111111118111111111i1llllllil11111111111111111111
15 56 4105 1505614105
1505614205
REV-1500 EX(FI) Decedent's Social Security Number
Decedent's Name: Anna Curnes
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 and Notes Receivable(Schedule D) ... . . . .. .... . .. .. . .. ... .... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). ..... . 5. 33,527.13
6. Jointly Owned Property(Schedule F) C=:> Separate Billing Requested .... 6. 16,096.01
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) C=:) Separate Billing Requested.. .. .. . . 7.
8. Total Gross Assets(total Lines 1 through 7).. . ... .. . . . . . . .. . . .. . . . .. .. .. 8. 49,623.14
9. Funeral Expenses and Administrative Costs(Schedule H).. ... ... .. ... . .. .. . 9. 230.50
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). ....... 10.
11, Total Deductions(total Lines 9 and 10). . ..... .... .... ........ ..... 11.
12. Net Value of Estate(Line 8 minus Line 11) . .. . . . . . .. .. . .. . . .. .. . . . . . . . . . 12.
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. 49,392.64
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.
16. Amount of Line 14 taxable
at lineal rate x o 45, 49,392,64 16. 2,222.67
17. Amount of Line 14 taxable
at sibling rate X.12 17. :
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19, TAX DUE .. .... .. . . . . . . . . . . . . . . . . . .. . . . ..... .. . . ... . .. . .. .. .. . . . 19.1 2,222.67
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C:)
Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIMATURE OF PSON RESPONSIBLE KOR FILING RETURN DATE
L.10 A VW SpC -OLAy Jaap� nzz/5
ADD ESS tA V V f
M(s_L00 n_
SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE
ADDRESS
Side 2
15 56 4205 1505614205
nsV-1amsx (R) Page a File Number
Decedent's Complete Address:
DECEDENTS NAME
Anna Curnes
STREETADDRESS
924 Macoun Dr
I STATE ZIP
Mechanicsburg Pa 17055
Tax Payments and Credits:
1. Tax Due(Page 2.Line 18) (1) 2,222,67
2. Credits/Payments
&Prior Payments 0.00
B.Discount 111.13
(See instructions.) Total Credits(A+B) CD 111.13
3. Interest
CD 0.00
4. |fLine 2iugreater than Line 1 +Line 3.enter the difference, This iothe OVERPAYMENT.
Fill inoval onPage 2.Line 20hwrequest urefund. (4)
S. If Line 11 +Line 3 is greater than Line 2,enter the difference,This is the TAX DUE. (S) 2.111.54
Make check payable to: REGISTER [lFWILLS, AGENT.
'
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN ,.X" !NTHE APPROPRIATE BLOCKS
1. Did decedent make otransfer and: Yes No
a. mtainthaumaminonmom[thepmportykaoofennd------------------------------ El 0
b. retain the right to designate who shall use the property transferred or its income ............................................ F1 N
c, retain oreversionary interest ------------------------------------------ [l E
dreceive the promise for life ofeither payments,benefits mrcare?....................................................................
�l
2. If death occurred after Dec. 12. 1982.did decedent transfer property within one year of death
without receiving adequate consideration?......................................................................................--.............. Fl 0
3. Did decedent own an"in trust for"orpay ble*po*doathbankoccmuntoraamrity athionrherdoath?----' |l 0
4, Did decedent own anindividual retirement ommunt.onnuitymnthe non-probate property,which
contains obeneficiary designation? ---------------------------------------- EJ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE GAND FILE|TAS PART OFTHE RETURN.
'
For dates ofdeath unmafter July 1 1994,and before Jan, 1. 1995,the tax rate imposed onthe net value oftransfers tomfor the use ofthe surviving spouse
is3percent R2PS.G0nG(a)(11)(i)].
For dates of death on or after Jan. 1, 1995, the bm rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
P.S.§911O(a)(i1)(ii)].The statute does not exempt otransfer b a surviving 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:
w 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 orostep-parent ofthe child ioOpercent[72RS.§0i1G(o)(1.2)l.
m Yho&yxndoimposedonthenetva|uuofhonofemtoorhothouuooythnd000danCu}inaa|bonnfioiahauis4.5panmnt.owmpiosnotedinR2P.G.80116(a)(1�
* The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12percent 72PG. 88i18(a)(i3)l,Asibling iodefined,
under Section 9102.as an individual who has etleast one parent in common with the decedent,whether byblood or adoption.
REV-i5o8 EX+(o8-12)
t--r-4 — SCHEDULE E
it- i� pennsytvania
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Anna Curnes 0049
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with eight of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Cash in purse 10.37
2. Arnerichoice FCU,Savings Account#47602-0001 with balance and interest 654.06
3, Arnerichoice FCU,Draft Account#47602-0013 2,597.15
4. Americhoice FCu,Money Market Account#47602-0018 29,339.37
5. Highmark-refund of Medicare Part B premuirn 712.30
6. Highmark-refund of Medicare Part D premuirn 164.88
7. Ede Insurance-refund for apartment insurance 49.00
TOTAL(Also enter on Line 5, Recapitulation) $ 33,527,13
If more space is needed,use additional sheets of paper of the same size.
REV-15oq EX+(oi-io)
pennsytvania SCHEDULE F
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Anna Curnes 0049
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A.Joann Henry 924 Macoun Dr,Mechanicsburg, Pa. 17055 Daughter
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT's VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET -INTEREST DECEDENT'S INTEREST
1. A. 03/03/08 M&T Bank,Account#25035088 32,19210 50% 16,096,01
TOTAL(Also enter on Line 6, Recapitulation) $ 16,096.01
If more space is needed,use additional sheets of paper of the same size.
SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
AnmaCurnes 0049
Decedent's debts must uoreported uoSchedule z.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
Year�s)Commission Paid:
2. Attorney Fees:
3. Family Exemption: (if decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 195.50
5. Accountant Fees:
6. Tax Return Preparer Fees: 35.00
7.
TOTAL(Also enter on Line 9, Recapitulation)1$ 230.50
]fmore space isneeded,use additional sheets v(paper ofthe same size.
Statement of Accounts
AmeriChoice X175 Bumble Bcc Hoilow Road Dec 01; 2014 thru Dec 31, 2014
Mechanicsburg,PA 17055
FEDERAL CREDIT UNION www.americhoice.org
Building Relationships For Life Account Number: xxxxxxx602
Address Service Requested Account Balances at a Glance
Share Drafts: 2,597.15
Savings: 29,993.43
00332
1111111111111n1111t1111111111111n111111111111111!11111111111111
ANNA CURNES
y' 924 MACOUN DR.
MECHANICSBURG PA 17055-7037 New Relationship Reward Level is: Freedom
Page 1 of 4
Please note that your IRS tax forms(1098& 1099-INT)for 2014 are contained in
your December statement for those that meet the IRS minimum reporting standards
Spent too much this holiday season?Get a discounted rate when you transfer a
— - - —- balance-to an'AmeriChoice VISA credit card. It's t15at easy,arid-there s-dever a
balance transfer fee!
REGULAR SHARE - 0001
Date Transaction Description Additions Subtractions Balance
12-01 Balance Forward 654.00
12-31 Deposit Dividend 0.100% 0.06 ��
Annual Percentage Yield Earned 0.110%from 12/01/2014 through 12/31/2014
12-31 Ending Balance 654.06
Dividends Paid Year to Date 0.72
SHARE DRAFT - 0013
Date Transaction Description Additions Subtractions Balance
12-01 Balance Forward 3,049.65
12-13 Deposit Transfer From Share 0018 10,000.00 13,049.65
12-19 Draft 000117 `t -10,452.80 2,596.85
12-23 Deposit by Check 0.30 2,597.15
12-31 Ending Balance
Dividends Paid Year to Date 0.00
Cleared Check Summary
Number Date Amount Number Date Amount Number Date Amount
000117 12-19 10,452.80
('indicates skip in check number sequence.)
Deposits and Other Credits
DateAmount Description Date Amount Description
12-13 10,000.00 Deposit Transfer 12-23 0.30 Deposit by Check
2 Deposits and Other Credits for 10,000.30
PREMIER MONEY MARKET - 0018
Date Transaction Description Additions Subtractions Balance
12-01 Balance Forward 14,594.37
12-13 Deposit by Check 24,745.00 39,339.37
12-13 Withdrawal Transfer To Share 0013 -10,000.00 29,339.37
12-31 Ending Balance
Dividends Paid Year to Date 28.39
(717) r Q7-';474 • Tell Free: (800) 240-4364 • Fax Number: (7 17) 697-3713
AmeriChoice Dec 01, 2014 thru Dec 31, 2014
FEDERAL CREDIT UNION
Building Relationships For Life
Page2of4
Account Number: XXXXXXX602
YTD SUMMARIES
TOTAL DIVIDENDS PAID
REGULAR SHARE 0.72
SHARE DRAFT 0.00
PREMIER MONEY MARKET 28.39
Total Dividends Paid Year to Date 29.11
FOR INQUIRIES CALL: (800)724-2440 ACCOUNT TYPE
M&T SELECT WITH INTEREST
00 0 06113M NM 117
ACCOUNT NUMBER STATEMENT PERIOD
000001766 FIDS154IG70101271501 01 000000
P 25035088 DEC.27-JAN.27,2015
ANNA CURNES BEGINNING BALANCE $32,344.00
O JO ANN HENRY DEPOSITS&CREDITS 2,304.90
924 MACOUN DR LESS CHECKS&DEBITS 12,163.60
MECHANICSBURG PA 17055 INTEREST 0.27
LESS SERVICE CHARGES 0.00
;ENDING BALANCE $22,485.57
INTEREST EARNED FOR STATEMENT PERIOD $0.26 HIGHLAND PARK
INTEREST PAID YEAR TO DATE $0.27
ACCOUNT SUMMARY
BEGINNING DEPOSITS&OTHER CURRENT ENDING
BALANCE CREDITS + CHECKS PAID OTHER DEBITS() INTEREST PD BALANCE
NO. AMOUNT NO. AMOUNT NO. AMOUNT
$32,344.00 3 $2,304.90 4 $9,858.70 3 $2,304.90 $0.27 $22,485.57
ACCOUNT ACTIVITY
POSTING DEPOSITS&OTHER WITHDRAWALS& DAILY
_
DATE TRANSACTION DESCRIPTION CREDITS W OTHER DEBITS BALANCE
12/27/2014 BEGINNING BALANCE $32,344.00
12/30/2014 CHECK NUMBER 1938 $151.80 32,192.20
1 01/02/2015 US TREASURY 312 XXCIV SERV $962.00 -
i
01/02/2015 SSA TREAS 310 XXSOC SEC 874.80
01/02/2015 AETNA INC BENFT PYMT 468.10 _ 34,497.10
01/09/2015 REVERSE DIRECT DEPOSIT 962.00
3 01/09/2015 REVERSE DIRECT DEPOSIT l 874.80 - 32,660.30
01/16/2015 CHECK NUMBER 1940 84.60 - 32,575.70
01/21/2015 CHECK NUMBER 1941 �� 9,422.30 23,153.40
01/22/2015 CHECK NUMBER 1939 200.00 22,953.40
01/23/2015 AETNA INC RECLAIM 468.10 22,485.30
01/27/2015 INTEREST PAYMENT 0.27 22,485.57
ENDING BALANCE $22,485.57
CHECKS PAID SUMMARY
CHECK NO. DATE AMOUNT CHECK NO. DATE AMOUNT CHECK NO. DATE AMOUNT
1938 12/30/14 151.80 - 1939 01/22/15 200.00 1940 01/16/15 84.60
1941 01/21/15 9,422.30
ANNUAL PERCENTAGE YIELD EARNED=0.00%
PAGE 1 OF 2
L008ACS(6/12)
COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE
COUNTY OF CUMBERLAND
of glue
I, LISA M. GRAYSON, ESQ.
yZ Register for the Probate of Wills and Granting
DLetters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 15th day of January, Two Thousand and
1750 Fifteen,
Letters TESTAMENTARY
t in common form were granted by the Register of
e
said County, on the
estate of ANNA CURNES late of UPPER ALLEN TOWNSHIP
(First,Middle,Last)
a/k/a ANNIE CURNES ANN CURNES
in said county, deceased, to JOANN HENRY and
(First,Middle,Last)
EARL HENRY
(First,Middle,Last)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 15th day of January
Two Thousand and Fifteen.
File No. 2015- 00049
PA Fi 1 e No. 21- 15- 0049
Date of Death 1212812014
S. S. #
J
Regi
`
L% 'V,�j 9
Deputy
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
LAST WILL AND TESTAMENT
OFM
ANNA CURNES
Cr I
I , ANNA CURNES, of Camp Hill, County of Cumbetl-�nd'-::hand--
Commonwealth of Pennsylvania, being of sound and disposing mind,)and; m
memory, and not acting under undue influence of ony p ;son-) rD
whomsoever, do make, publish and declare this instrument to my
Last Will and Testament, in manner and form following:
FIRST: I hereby expressly revoke all Wills, Codicils and
testamentary writings of whatsoever kind and nature heretofore made
by me .
SECOND: I hereby direct my Executor, or his successor,
hereinafter named, to pay all my just debts , expenses of
administration and funeral expenses out of my estate as soon as is
practicable after my decease.
THIRD: All the rest, residue and remainder of my property,
real, personal and mixed, of which I may die seized or possessed,
or over which I may have the power of testamentary disposition of
whatsoever kind and wheresoever situate, I give, devise and
bequeath unto my husband, EDWARD I . CURNES .
FOURTH: Should my husband, EDWARD I . CURNES, predecease me,
or should we die at the same time as a result of the same accident
or disaster, or during a joint last illness, or under circumstances
that are such that the order of our deaths cannot be ascertained
with reasonable certainty, then and in any of such events, I hereby
direct that my residuary estate be distributed to my daughter and
her husband, JO ANN HENRY and EARL M. HENRY, who presently reside
at 1505 Grandview Road, Mechanicsburg, Pennsylvania 17055 , jointly
or to the survivor thereof, in the event either my daughter or her
husband shall predecease me.
In the event, however, that both my daughter and her husband
shall predecease me, or should die simultaneously with me, I direct
that my residuary estate be distributed to the TRUSTEES OF THE
SHIREMANSTOWN UNITED METHODIST CHURCH, Shiremanstown, Pennsylvania,
In Trust, Nevertheless , to be invested and reinvested and the
interest and principal thereof shall be used, in the judgment of
said Trustees , for benevolent purposes only.
FIFTH: I direct that all estate, inheritance, transfer,
legacy or succession taxes, or death duties, which may be assessed
or imposed of, wheresoever situate, whether or not passing under
this my Last Will and Testament, including the taxable value of all
policies of insurance on my life and all transfers , powers , rights
or interests includible in my estate for the purpose of such taxes
and duties, shall be paid out of my general estate as an expense of
administration, and without apportionment, and shall not be
prorated or charged against any of the gifts in this Will or
against any property not passing under this Will . in the absolute
discretion of my Executor, hereinafter named, he may pay such taxes
immediately or may postpone the payment of the taxes on future or
remainder interests until the time possession accrues to the
beneficiary or beneficiaries named herein. My Executor may, in his
discretion, arrange for extension of time for the payment of said
estate and inheritance taxes, and any interest and/or penalty
incurred on any such taxes , whether or not resulting from such
extensions or postponements, shall be borne by my estate as an
expense of administration.
SIXTH: The rights, titles, benefits, interests and estates of
any beneficiary hereunder shall not be subject to the rights or
claims of his or her creditors nor subject nor liable to any
process of law or court, and all of the income, principal or other
benefits from or under any trust herein created, shall be payable,
and deliverable only, wholly, exclusively and personally to the
designated beneficiaries hereunder at the time the designated
beneficiaries are entitled to take the same under the terms of this
instrument.
SEVENTH: I hereby direct that my Executor, or his successor,
shall not be required to give bond or other security required by
law or otherwise, for the faithful performance of their duties,
whether as Executor or as successor Executor.
EIGHTH: I hereby give unto my Executor, or his successor,
hereinafter named, the fullest power and authority in all matters
or questions pertaining to the administration of my estate and
trust, executing the provisions of this my Last Will and Testament,
including, but not by way of limitation, the power and authority to
determine all doubtful questions which may arise in the
construction of this my Last Will and Testament; I further hereby
authorize and empower my Executor, or his successor, pending
settlement of my estate, to sell, convey, mortgage, lease, ex-
change, encumber or otherwise dispose of any and all of the prop-
erty, real, personal or mixed at any time belonging to my estate,
either at public or private sale, without prior approval of any
court, and at such times and for such price or prices and in any
such case upon such terms as he may think best in his discretion,
and I authorize and empower my said Executor to execute,
acknowledge and deliver to the purchasers, grantees, mortgagees,
vendees, assignees or other persons, such contracts, deeds, mort-
gages, bills of sale, and all other instruments of writing neces-
-2-
sar-y or proper without obligation upon the latter to see to the
proper application of the proceeds . He shall also have the power
to compromise or otherwise settle or adjust any and all claims ,
charges, debts and demands whatsoever against, or in favor of my
estate as fully as I could do if living. He shall further be
empowered to carry on and conduct any business enterprise which I
may be engaged' in at my death, to retain any assets, including
stocks or securities which I may own at the time of my death,
pending settlement of my estate, without regard as to whether or
not such assets or securities are legal investments for fiduciar-
ies. Pending settlement of my estate, he shall also have the
authority in his discretion to convert, sell , exchange or dispose
of such assets and securities either for cash or for terms
satisfactory to him and to acquire other assets without limitation
to securities or investments as may be declared legal for
investment of trust funds . He shall further be empowered to borrow
money, and to pledge assets of my estate as security therefor, for
the purpose of paying taxes which may be levied upon or payable by
my estate in accordance with this Will and in the event that funds
in the hands of my Executor, or his successor, shall be
insufficient to pay such taxes, and if, in the opinion of my
Executor, or his successor, it appears that conversion of
securities and other assets , real and personal, would then be made
at a sacrifice.
NINTH: I hereby nominate, constitute and appoint my husband,
EDWARD I . CURNES, to be Executor of this my Last Will and
Testament. In the event the said EDWARD I . CURNES renounces this
office, refuses this appointment, predeceases me, or for any other
reason is unable to serve, then and in that event, I do hereby
nominate, constitute and appoint my daughter and her husband, JO
ANN HENRY and EARL M. HENRY, or the survivor thereof, as the
successor Executors of this my Last Will and Testament and to have
all the rights, privileges and duties conferred and created by
reason of said appointment .
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
20th day of March, 1994 .
(SEAL)
Anna Curnes
-3-
COMMONWEALTH OF PENNSYLVANIA )
ss :
COUNTY OF DAUPHIN )
We, ANNA CURNES, William D. Boswell and
Patricia A. Reber , the Testatrix and the witnesses,
respectively, 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 and Testament and that she signed
willingly (or willingly directed another to sign for her) , and that
she executed it as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence
and hearing of the Testatrix, signed the Will as witness and to the
best of our knowledge the Testatrix was at that time 18 years of
age or older, of sound mind, and under no constraint or undue
influence.
Anna Curnes
,,.-Witness
Witness
Subscribed, sworn to, and acknowledged before me by ANNA
CURNES, the Testatrix and subscribed and sworn to before me by
William D. Boswell and Patricia A. Reber ,
witnesses, this 20th day of March 1994 .
Notary P lic '
My commission expires : 12/13/94
FM�V, CGGSi❑::