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HomeMy WebLinkAbout09-04-15 pe��syi�a��a 1505614105 J ���,..�.,.�.� ��a; ,<,��� REV-1500 OFFICIAL USE ONLY Bureau of Indlvldual Taxes Coun:yCOJe Year FleNumber ao eox zeoeoi INHERITANCE TAX RETURN � Harrisbury, PA ll128-o6o1 RESIDENT DECEDENT 1� �5 C'�}��� ENTER DECEDENT INFORMATION BELOW Social Sewriy Number Date o�Death A1M�OrvY'Y Dale of Birth MMOOPlYY ��. � 04152015 03259124 Decedenfs Last Name � Suf6x Decetlent5 First Name MI WORK JOHN T (If Applicable�En[er Surviving Spouse's Iniormation Below Spouse's Last Name Sulfix Spouse's Firsl Neme MI THIS RETURN MUST BE fILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS 6ELOW m 1. Otlginal ReWrn O �-Supplementel ReWrn O 3. Remaintler ReNrn(date of dea�h prior to 1213 82) p d.AgricWWre Exemption(tla�e of p 5. FuWre In�erest Compromise(tla�e of � 6. Fetleral Es�ate Tax ReWrn Required tlea�M1 on or aXer]-02012) 4ea1M1 afler 12-0292) � ].Decetlent�ied Teslate O B.�ece�enl Main�ained a Living Tmst _ 9. Total Number of Sale Oeposit Boxes (AVacM1 copy o!will.) (A��ech oopy of(msl.J � 10_Lifigalion Pmceetls Rocclved O 1t Non-Pro�ate Transferea ReWm O 12. De(ertaVEloclion of Spousal Tms�s (Schatlule F and G Asse6 only) O �3 Buslnass Hssets O 14. Spowa Is Sole 9enelidary (No imsl involvetl) CORRESPONDENT- TNIS SECTION MlISi BE COMPlETEO.ALL LORRESPONDENCE AND CONFIOENTIAL iA%MF�RMNTION SHOULO 9E�IRECTE�i0: Name Daytime Telephone Number John M. Eakin �� (717) 7663172 First Gne o(Address 1 .. . ... ... �. Semnu Lme olAddress West Main Street Ciry or Post OHire State ZIP Code Mechanicsburg � PA 17055 � � —� � m . . . . . . c. � ~ �n � _ �� CorrespontlenPsemailaddress: � r^ -- �� c' v REGISTER-0i W0.15U5E ONLY . 'i �"1 _L J � REGISTEROFWILLSVSEONLY . OATEFILEOMMOOYWY -J �1 ... . . � ..- _� . �. . 1—` .- <"J . . . �.... __ � �� o �� OATE FILED STAMP � PLEASE USE ORIGINAL FORM ONLV Side 4 L II��I�����������I��I�����II���4������II�I�������������� y505614105 � ll 56 J15�5614205 REV�1500 EX(FI) oecetlenfs Soclal Sewriry Number oe�ede„�'sName.� JOHN T. WORK RECAPITULATION 1. Real Estate(Schetlule A). ... ... ... ... .. . .. . .. . .. . . ... . .... . . .. . .. . . . . 1. 2. Srocks antl Bonds(scnedule B) . .. . .. . . . . . .. . .... . .. . .... .. 2. .2,572.50 . 3- Closety Heltl Corporetion, Patlnarshlp or Sole-Proprletorship(SchetlWo C) ..__. 3. 4. Mortqaqes and Notes Receivable(Schedule D). . .. . . . .. . ... .... . . . . . . ... . 6. 5. Cash,Bank Deposits and Miscellaneous Personal P�operty(Schetlule E). . . . ... 5. �� ��� � 1 fib�a�4.08 6. Joinlly Ownetl Pmperty(Schetlule F) O Separa[e Billinq Requested . ... . .. 6. ]. Inler-Viws Transfers 8 Miscellaneous Non-Probate Property � (Schedule G) O Separa[e eilling Requested.. . ... . . ]. .. . 1.274.56 8. Total Gress Assets(rotal Lines i (hmugh]�. . . . .... . . .. . . .. . . .... . .. . . .. 8. 17�.721. 14 9. FuneralExpensesandAtlministre[iveCosis(SchetivleH). .. . ..... .... . ... .. 9. $�93�.97 10. �ebls o(Decetlenl,Martgagc Liabilities and Gens(Schedule I). . ... . . .. . . .. . . 14 ' . 50.17 . 11. To[al Oetluctions(total lines 9 and 10). . . . .. . .... . ... . .. . . ..... . ... . . .. fl. . $�988.14.,. .. 12. Net Value of Estate(Line 8 minus Line 11) . . .. . ... . . ... . .. . .......... . .. 12 . 1(1�73$.�0.. '13. Charitable and Governmen�al BequesislSec.9113 Tmsts tor which an election to tax has not been made(Schedule J) ... . . .. . . . . . . .... . ... . . . 13. 16. Ne[Value Subject to Taz(Line 12 minus Line 13) . _ _ . _ . . _ _ __ . ._ _ 1G. 161,733.00 TA%CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amounl of Line 14[axable at tha spousel�ex ra[e.oe [rans(ersunderSec.9116 ��� � �� �.. � (al(12)X.0_ ��.. 15. 16. Amocnt of Line 14 taxable ... . . . . . . . ..... . ... . ....... atiinealrate x.o_ 161�733.00�. 16' . . _ 7�277,99 11. Amount of Line 141axable .. .. .... . �. atsibiing rate X.12 � 1l. 18. Amount o(Line 14 taxable ��� � � � � atcollaceral rate X.15 18. 19. TA%DUE ... . . . . . .... ... . ... . .. ... . . . ... . . . .. . ... 14 . .. . 7.277.99 20. FILL IN THE OVAL IF VOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Under pana16e5 0!Derlury.I dedare I beve examined tM1is reWm. Induding aavmpanying scM1etlules antl slelemen(s,antl�o iM1e Dast ol my knowletlge entl�elle( I�is Vue, correa�end oomple�e. Oeclerellon ofpreparerotM1er(M1an�M1a peRon responslble for Ol:ng I�e reWm Is beseU on eIlln�ormaLon o:w�ic0 preparerM1as any knovAetlge_ SIGN E OF P R ONp��$PgN�SIBLE FOR,5ILING RETURN �ATE .a�-ai,_,.� (: �fz-L<:a roJh.at <'xc-o:u�.�a � /7- .2a �.s' nooaess ['�� . � �J D � r�Pa � f.�R�JL E� � ��e54ct2c 7H, / � SIGNATURE OF PREPAR pTHER T P RSON RESPONSI6LE FOR FlLING THE R RN �ATE �.��Y �� q aooaess �� 1-�/n/��!' .. . �`� f '� �./} <daiS ...�. �r L II��I�III"I�IIIII�I��I��'ll{IIII��p�I�I��II��I�I�III�III Side2 y505614205 J L b1 F[V-0500[X (Rj Page3 Fil¢Numbe/ Decedent's Complete Address: DECE�ENT'S NAA1E JOHNT. WORK srReernooaess � ����� ����� 4603CHESTNUTAVENUE �Cirv . . . ...___. . .... . . SrAre .__�.. CAMP HILL PA �� 17011 Tax Payments and Credits: L Tex Oue(Page 2 Gne 19) (1) 7,277.99 2 Credi�s/Paymenis A. Prior Payments _ B.�ismunt (See Insimc�ions.) ���� ���� To�al Credl�6(A*B) (2) 3. In�erest (3) 4. If Line 27s grea�er than Cine 1 t Llne 3,enter Ihe dlHerence. Thls Is�he OVERPAYMENT. Fill in oval on Page 2,Line 20 ta request a rafund (4) 5- If tine 1 +Gne 3 is greatar ihan Cine 2,enter ihe dlflerence.This is�he TAX DUE (6) 7,277.99 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a Uansferand' �es No a. re�ain�heuseorincameofihepropertytrensferred.......... ................ _._._.. .......... ❑ � h. retainiherighitodesignatewhoshallusethepropertytransferretloritsincome ._.....__._._..__._............. ❑ � c. retainareversionarym�eresl _...._.._ .._.._. ,._...... ...._..... ...._... ❑ � d. receivelhepmmiseforlifeofeitherpaymenis,benefitsorcare� ._......_. .,,_.._ ............ ❑ � 2. If dea�h ocanetl after Dec.12,1982,did dece0en�t2nsfer property within one yearof death wi�hoNreceivingadequa�econsidera�ion? .......... ........._. ..__. ._...... ❑ � 3. Did tlecedent own an"in trus�far"or payable-upoo-death bank accoun�or security a1 his or her tleath?..._......... ❑ � 4. Did deceden�own an individual relirement accounl,annuiry or other non-proba�e pmperty,which containsabeneficiarydesgna�ion? ._._._ ._.._. ....... .............. ................ � ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF TNE RETURN. Por dates of death on or aker July 1,1994,and before Jan. 1, 1995,the lax rate imposed on Ihe net value of Iransfers to or for[he use of ihe surviving spouse Is 3 percent�72 PS.§9N6(a)(1.1)p)]. For da�es of death on or after Jan. 7, 1995, Ihe �ax rate imposed on Ihe net value of bansfers ro or for the use of ihe surviving spouse is 0 percent [/2 P.S.§9116(a)(1-1)(ii��.The statute tloes not exempt a transfer to a surviving spouse from tax,and the s�aNtory requirements for tlisclosure of assets and fling a tax reNrn are s�ill applicable even if Ihe surviving spouse is�he only benefciary. For dales of death on or afler Juty 1,2000�. . The tax rate imposed on Ihe net value of Uansfers from a deceased child 21 years of age or younger at death to or for Ihe use of a naNral parent, an adop�ive parent or a s�ep-paren�of the child is 0 percent[72 P.S. §9116(a)(12)]. . Thetaxra�eimposedonthenetvalueofVansferstoorfortheuseofthedecedenfslinealbeneficiariesi54.5percent,ezceptasnotedin[72P5.§9116�aJ(1��. • The�ax rete imposetl on the net value of transfers�o or for lhe use of ihe decedenPs siblings is 12 percent[72 PS. §9116(a)(1.3)J.A sibling is defned, under Section 9102. as an individual who has at leas�one pareN in common with the decedent,whether by blood oi adop�ion. RN v u5 E%�(Bnx) � pennsylvania SCNEDULE B ��Paa.ME�,o.NE�E��F ���ER�rA��E�AxaEnAN STOCKS & BONDS aes�oENr oE�EoeNr ESTATE OF FILE NUMBER JOHN T. WORK 2015-00490 All proper[y lo�^��Y owned wifh tight of survivorship must be disclosed on Schedule F. ITEM VA W E AT DATE NUMBER �ESCRIPTION OF DEATM 1' 300 Shares- Rlte Aid Corp.@ B]5 2,57250 I TOTAL(Also enter on Line 2, Recapitulation) ; 2,572.50 If more space is neede�, insert a0tlitional shee[s of the same size FEV-�SoB EX+(a8-a) � pennsylvania SCREDULE E oePaarnervroFr+evcNue CASH� BANK DEPOSITS & MISC. ;��Ea��^��F*^"a�T""" PERSONALPROPERTY '� aesmervr oecv�wr � ESTATE OF: FILE NUMBER: JOHN T. WORK 2015-00490 Inclutle[he proceeds of litlgattor.ana[he tlate[he pmceeds were receNed bV[he estate. All property Iointly owned wi[h right at survivorship must be disdosed on Schetlule F. ITEM VAWE AT DATE rvuniaea oesca�rr�oN o�oenrn �, Members'isi F.C.U. �Savings Accoun[N4663-00-(See Attachetl) 113,887.19 p Members'ist F,C.U,-Life Savings Account#4663-04-(See Altachetl) 2,000.00 3. Members'isl F.C.U.-Imestment Savings Accounl A4fi63-05�(See Attached) 5,902.39 q, Members' lst F.C.U.-Checking Account q4663�11 � (See Attached) 45,084.50 TOTAL (Also enter on Line 5, Recapitulation) $ 166,874.08 If more space is needed,use adEitional shee[s of paper of!he same siEe. st MEMBERS 1"� 1FI]['RSLCRCUIT V\IOF REGULAR SAVINGS ACCOUNT: Account Number/Suffix 4fi63-00 Date Account Established 02/03/1959 . Principal Balance at Date of Death $113,882.82 Accrued Interest lo Date of Death 54.37 Total Principal and Accrued Interest $113,887.19 Name of Joint Owner None LIFE SAVINGS ACCOUNT: Accounl NumbedSuffix 4663-04 Date Account Established 02/�3l1959 Principal Balance at Date of Death $2,000.00 Accrued Interest to Date of Death $0.08 Total Principal and Accrued Interest $2,000.08 Name of Joint Owner None INVESTMENT SAVINGS ACCOUNT: Account NumbedSuffix 4663-OS Date Account Established 10/01/1985 Principal Balance at Date of Death 55,902.16 Accrued Interest to Date of Death $023 Total Principal and Accrued Interest $5,90239 Name of Joint Owner None CHECKING ACCOUNT: Account NumbedSuffx 4661-11 Date Account Established 02/29/1980 Principal ealance at Date of Death $45,083.18 Accrued Interest to Date of Death $1.32 Total Principal and Accrued Interest $45,084.50 Name of Joint Owner None MEMBERS 15T FEDERAL CREDIT UNION Tess�lug�� Lending Insurance Support Specialist May 4, 2015 Estate of: JOHN T WORK Date of Death: 0 4/1 512 01 5 Social Security Number: 204-033238 5000 Lonisc Drive • PO.Box 40 • 1lechanicsb�eg, Pennsylvania 1705� • (800) 283-2328 • �evnumembcrslscorg dEV-I510 EX+ (OB-09j � pennsylvania SCHEDULE G o=anarneNrc.r+evervue INTER—VIVOS TRANSFERS AND �n�F�'*^�«�a*SE,�a�� MISC. NON—PROBATE PROPERTY aes:oervroeceo_nr ESTATE OF FILE NUMBER JOHN T. WORK 2015-00490 Thls sd�edule mus[be completee and fled if!he answer to any of quest'm�s i Nroug�6 on page three of Ge REV-I500 is yes. OESCRIPTION Oi PROGERTY REM ;�;aooerxews+eormeraaxsexs,TMnvuu.iansxi>iooEceo�mm� DATEOF�EAiH %OFDECD'SI EXCLUSION TF%ABLF N�MBER ��Ecnrormrare�. �neartmwormeor�owxr.n��snre. VAWEOFASSET IfVTEREA ' +e�l VALUE �� MemUers' 15t F.C-LL-Account#156654-00�Owner John Work and 6i27 60% 3264 Joint Owner Honora Ezbiansky-(See A[tached) Z Members'ist EC.U.-Account#156654-05-Owner John Work and 2q83.e3 50% L24t.92 Ja'm[Owner Honora Ezblansky-(See Attachetl) � I � I TOTAI(Also enter on Line 7, RecapiNlatian) 5 �,Z74.56 I(more space B needed, use a0dl6ona�sheets ofpaper of�he same slu. REV'-b116i. fJ!,! 'u� � pennsylvania SCHEDULE H oecna�n�mroFaevemue FUNERAL EXPENSES AND ;vnea�rnr�c:exa=_:uarv ADMINISTRATIVECOSTS a�_smervr oseoENr ESTATE OF FILE NUMBER JOHN T. WORK 2015-00490 DecedenPs Oebts must be reportetl on ScheEule 1. ITEM ' NU?IBER DESCRIPT[ON AMOUNT A. RINERAL EXPENSES: ` Ncill Funeral Home 206.65 FuncralLuncheon 360.82 e. AD+IINISTRATIVE COSTS 1. �ersonaiAepresentaticecommisslons: 4,000.00 Name�s)af Permnal Representative(s) HOnofa Leedy Ezbi2�5ky .. 4reec address 103 Fairway Drive p�y _Mechanicsburg ___ _ scaec PA Z�P 17055 � vear(s)Commisslan aaid- 2015 4,OWA0 2. Atlom�y FfPi: :. Family ExeRqtlan�. Qf aecedenYs address Is not the sarne as clalman['s,attach�plana6en.) Clalman[ Street Address Gry_ ____ Sta[e__. . ZIP.. ... .. . _.___ Relationship of Qaiman[[o De�eden[ 4. Pmbate Fees: 37Q50 5. Accounfant Fees�. 6. Tax RaNrn Pre�arer Fees: J. II TOTAL(Also enter on ��ne 9, RecapiNlatlon)� S 8�937�97 R more space is needeC, use addi6onal soeets of papu of Me same slze st MEMBERS 1"e FF➢FBALC6EUIT UV ION PRIMARY OWNER: Kelsea Ezbiansky REGULAR SAVINGS ACCOUNT: Account Numbed5uffix 156654-00 Date Account Establishetl 02/08/1996 Principal Balance at Date of Death $6527 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $6527 Name of Joint Owner Honora Ezbiansky John Work DateJointAdded 02/08/1996 09/01/1999 INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix 15664-OS Date Account Established 04/17/2001 Principal Balance at Date of Death $2,48378 Accrued Interest to Date of Death $0.05 Total Principal and Accrued Interest $2,483.83 Name of Joint Owner Honora Ezbiansky John Work Date Joint Added 04/17/2001 04/17/2001 MEMBERS 15T FEDERAL C/REDIT U/NION T�a L K�L�i l� Lending Insurance Support Specialist May 4, 2015 Estate of: JOHN T WORK Da[e of Death: 04/15/2015 Social Security Numher: 204-OS3238 5000 i,ouise Diice • P.O. Box 4U • R[echanicsburg, Pennsy�lvania 1705� • (800) 283-2328 • w�c��:membcrsls[.oig ae�as�z ex+ �taaq � pennsylvania SCHEDULE I ��� oEvnaTwcrv-oraEVErvu� DEBTS OF DECEDENT, ���E���T^�==TF�a'Tua" MORTGAGE LIABILITIES & LIENS aesmem os=oenr ESTATE OF FILE NUMBER JOHN T. WORK 2015-00490 Report Cebts incurred by the Oecedent prior to deaN thal remained unpaiE at the Oa[e at death,inclu0ing unreimbursed medical expenses. ITEM VAW E AT�ATE NIIMBER �ESCRIPTION OF DFNTH 1� BrickiePharmacy 50.17 TOTAL (Also enter on Line 1�, Recapitulation) S 50.17 � If more space is needed, Insert atlaitianal shee:s of lne same size. aEv-si3 �.fm-io; �� pennsylvania SCHEDULE ] yi' oE�.�.ME�,��aE�E���� �rvnea�.nrvceraxae.uarv BENEFICIARIES aesioervr oeceoEr�* ESTATE OF: FILE NUMBER: JOHN T. WORK 2015-00490 REUTIONSNIPTOOECEOENT Ahi00NTOR5HARE NUMBER NAME AND ADDRE55 OF PERSON(S)RECENING GROPERTY Da Not List Trustee(s) OF ESTATE I TAMABLE D6TRIBUTIONS[Indude outrightspousal Gistributions andtranslers un7er Sec 9116(a)(L2).] i. Honora Leedy Ezbiansky, 103 Fairway Dr., Mechanicsburg, PA 17055 Step-Daughter $10,000.00 Bequest 2. R. Donald Leedy, 16267 Diamond Bay Dc,Wimauha,FL 33598 Step-Son $10,000.00 Bequest 3. �onald 1 Ez6iansky,100 Bridge St,New Cumbedand,PA 17070 Step-Grandson One-Fifth of Residue 4. Christopher A. Leedy,2807 Ormandy Crt,Tampa,FL 33618 Step-Grandson One-Fifth of Residue 5. Jennifer L Leedy Hinshillwood, 344 Windsor Dr., Cherry Hill,NJ 08002 Slep-Grandaughter One-Fifth of Residue 6. Karin A Ezbiansky Pavese,4 Verendah Place, Bmoklyn, NY 11201 Step-Grandaughler One-Fifth of Residue 7. Marcia L Ezbiansky Arnwine, 2416 Rolling Hill Dr., Mech,PA 17055 Step-Grandaughter One-Fikh of Residue ENTER�OLLAR AMOUNTS FOR�15TRIBUTIONS SHOWN ABOVE ON LINES 15 THROIIGH 18 OF REV-1500 COVER SHEET,0.5 APPFOPRIATE. I� NON-TA%A9LE�ISTRI9UTIONS A, SPOUSAL�15TRIBUTfONS UN�ER SEQION 9113 FOR WHICH AN ELERION TO TA%IS NOT TAKEN: 1. B. CHARITABLE AN�GOVERNMENTAL�ISTRIBUTIONS: l. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEf S - I(more space is needed,use aGGitianal shee[s of pa0er o!the same size. ��r�# `�fl�i�I M�t� `C� ����trttez�� OF JOHN T. WORK I, JOHN T. WORK, of the Township of Hampden, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon afrer my decease as the same can be conveniently done. 2. I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United States, or any state or territory thereof, or by any foreign govemment or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like taac purposes - 1 - by any of such governments, whether the property passes under this will or otherwise. 3. All the rest, residue and remainder of my estate, real, personal and mixed, I give, devise and bequeath to my wife, HONORA M. WORK, absolutely and unconditionally if she survives me. 4. In the event my wife should predecease me, I give, devise and bequeath my entire estate as follows: A.) I give and bequeath the following items of personal property to my wife's grandson, DONALD JOAN EZBIANSKY: all fumiture including the entertainment center in the living room and all furniture in the basement except my drop leaf table, my bell collection, all books in the living room and basement, all records, tapes, cassettes and videos in the basement and living room. B.) 1 give and bequeath the following items of personal property to my wife's grandson, CHRISTOPHER AINSWORTH LEEDY: all furniture, lamps, television and television stand in the master bedroom. C.) I give and bequeath the following iYems of personal -2 - property to my wiFe's granddaughter, MARCIA LYNN EZBIANSKY: all dining room furniture including wall hangings, emerald and diamond etemity ring, step-stool/ironing board and baker's rack. D.) I give and bequeath the following items of personal property to my wife's granddaughter, KARiN ANN EZBIANSKY: all furniture, wall ha�gings, books and miscellaneous contents in the third bedroom except the roll-top desk, the contents of the built-in cupboazd in the dining room, all contents of the sun room and my ring with five diamonds. E.) I give and bequeath the following items of personal property to my wife's granddaughter, JENNIFER LYNN HINSHILLWOOD: all furniture in the second bedroom, the drop- leaf table in the basement, all patio fumiture, sewing machine and supplies, all craft material and supplies and my wife's three ring diamond. F.) I give and bequeath the following items of personal property to my wife's son, R. DONALD LEEDY, the roll top desk and pitchers on top of hutch. G.) I give and bequeath the following items of persona] -3 - property to my wife's daughter, HONORA LEEDY EZBIANSKY: all chattels not specifically bequeathed, including but not limited to furniture, fixtures, equipment, clothing,jewelry, utensils and dishes, my wife's wedding and engagement ring, my wife's Irish ring, all movies, photographs and pig cookiejar. H.) I give and bequeath the sum of$10,000.00 to my wife's daughter, HONORA LEEDY EZBIANSKY. I.) I give and bequeath the sum of$10,000.00 to my wife's son, R. DONALD LEEDY. J.) All the rest, residue and remainder of my estate, real, personal and mixed, 1 give in equal shazes to my wife's five (5) grandchildren, DONALD JOHN EZBIANSKY, CHRISTOPHER AINSWORTH LEEDY, JENNIFER LYNN HINSHILLWOOD, KAl2IN ANN EZBIANSKY and MARCIA LYNN EZBIANSKY, absolutely and in fee simple. 5. Lastly, I nominate, constitute and appoint my wife, HONORA M. WORK, to be Execu[rix of this my Last Will and Testament, and in the event she should predecease me, or should she be unable or unwilling to serve in this capacity for any reason, then I nominate, constitute and appoint my wife's daughter, HONORA -4 - LEEDY EZBIANSKY, Executrix of this my Last Will and Testament, in hcr place and stead. I further direct that no bond or other security be required of my personal representative to guarantee faithful performance of her duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ti� day of May, 2001. i �'�'l l � '�/�' (SEAL) John T. Work Signed, sealed, published and declared by the above named JOHN T. WORK as and for his Last Will and Testament, in the presence of us who have subscribed our names hereto as wiMesses, at his request, in his presence and the presence of each other. U-2i+� � ^-�i - � , �„� _ �� �,./�:� _� - � - JOHN M . EAKIN ATT�RNEY AT LHW MECHANIC59U0.G,uPA.�19055 Septembcr 1,20]5 Register of Wills Cumberla�id Counri Cour[house One Courthouse Square CazlisLe, PA UO13 RE: John T. Work Estate File No. 2075-00490 Deur Register of Wills: Enclosed for filing is the Inherita�ee Tax Retum in the above estate together with a check in the amoimt of$7,377.99,the amount of tax due. Very truly you�s, �, I ^ � ����� John M. Eakin IMEAbet Enclosums c� �,, a � m c o ~ rn c� ti � m � o c� � � � � r- .` .-� ;.� s � � � -.i 3 _,i � c� �� [- n N G� � CD � � � o` `� " � � v � � z � N a � � a � r w� � � ' � � mf. D S. c V � O � N FS R ;' � �YU- �� r,a; M" _ �yt �. _ , �y. = .:i:e� ...� — ,:�,.;, ��, . - �`:� ti� . _ ��. q (. ,� r _ G � � F ��" r': _ �c 5 T c� .. jyy.;. . N � R lC C �-Oj �� �. �.l . � .Z �' V :J Y. � . � � d y C ('1 _ ' j � � � � � r p _ � � J C n � � �� � � � 6 r1 �� � R � �� E � N C � �C �'y� � �:i; . � `� � , ,�,e� � � »r�, , /