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HomeMy WebLinkAbout09-25-15 pennsylvania 1505618403 DEPARTMENT OF REVENU€X(03-14) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOx.280601 INHERITANCE TAX RETURN � 15 0056 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 12 25 2014 08 06 1917 Decedent's Last Name Suffix Decedent's First Name MI MCKECHNIE JR. ALEXANDER J (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 ® 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(date of death prior to 12-13-82) ❑ 4. Agricultural Exemption(date of ❑ 5. Future Interest Compromise(date of ❑ 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) ® 7. Decedent Died Testate ❑ 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) ❑ 10. Litigation Proceeds Received ❑ 11 Non-Probate Transferee Return ❑ 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) ❑ 13. Business Assets ❑ 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT-TFUS SECTION MUST BE COMPLETED.ALL CORRESPONDENCEAND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number THOMAS S BECKLEY 717 233 7691 First Line of Address PO BOX 11998 Second Line of Address City or Post Office State ZIP Code HARRISBURG PA 17108 Correspondent's email address: becks@pa.net E REGISTERq fF WILLS USEPNLY r-n n REGISTER OF WILLS USE ONLY DATE FILED MMDDYYYY r—D 171r`J r`r7 I-TI _T T1 ¢I r z l _T1 DATE'FILED STAMP Side 1 I IIIIII I II �III IIII IIIII IIIII IIIII IIII I III IIIII III III 1505618403 1505618403 j >J 1505618411 REV-1500 EX Decedent's Social Security Number Dec:edeM'sName. MCKECHNIE, ALEXANDER J JR. 198 05 6263 _ RECAPITULATION 1. Real Estate(Schedule A).......................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................... 2. 258,877.33 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. 272,367.76 5. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested_......... 6. 703,813.13 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7. 8. Total Gross Assets(total Lines 1 through 7)...........:.............................................. 8. 1,235,068.22 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9, 26,891.46 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 10,386.62 11. Total Deductions(total Lines 9 and 10).........................._...................................... 11. 36,278.08 12. Net Value of Estate(Line 8 minus Line 11)........................_................................... 12. 1,198,780.14 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. 1,198,780.14 ...... ........_................... . .. ..... ..... _ - 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.00 15. 16. Amount of Line 14 taxable at lineal rate X,045 1,198,780.14 16. 53,945.11 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. 53,945.11 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT a 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 any4Kowledge. SIGN RE OF S N R ISLE F FILING RETURN Jon McKechnieDATE c i ADDRESS 232 Marker Drive,Somerset,PA 15501 SIGN_A ER OTHER.HAN REP E&ENTATIVE Thomas S Beckley DATE ADDREss Beckley&Madden- P.O.Box 11998,Harrisburg,PA 17108 111111111111111111111111111111111111111111111111111111111 Side 2 1505618411 1505618411 .�.,. 5% REV-1500 EX Page 3 File Number 22 - 15 - 0056 Decedent's Complete Address: DECEDENT'S NAME McKechnie, Alexander J Jr. STREET ADDRESS 3.25 Wesley Drive, Apartment 3316 CITYSTATE � ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 53,945.11 2. Credits/Payments A. Prior Payments 55,000.00 B. Discount 2,69746 Total Credits(A +B) (2) 57,697.26 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 3,752.15 Check box on Page 2,Line 20.to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) Make Check Payable to: REGISTER OF WILLS, AGENT,. i PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No f a. retain the use or income of the property transferred;.................................................................................. ❑ x❑ 6. retain the right to designate who shall use the property transferred or its income;.................................... ❑ x❑ c. retain a reversionary interest;or.................................................................................................................. ❑ x❑ d.-receive-the,promise for life of either payments,benefits or care?................................................a............. ❑ ❑x " 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?....................................................................................................................... ❑ x❑ I 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... ❑ x❑ 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains.a beneficiary designation?...................................................................................................................... ❑ x❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan.1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spo is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after.January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent Q 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 filing a tax return are still applicable even if the surviving spouse is the only beneficiary. Y } 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 ears of age or younger at death to or for the use of a natural parent,an adoptive parent,ora step-parent of the child is 0 percent[72 P.S.§9.116(a),�1.2)]. •The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(' -The tax rate imposed on the net value of transfers to or for the use of the decedent's 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. f pennsylvania SCHEDULE E DEPARTMENT OFCASH BANK DEPOSITS AND MISC. INHERITANCE TAXAXRETURN � RESIDENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF McKechnie, Alexander J Jr. 22 - 15 -0056 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 Genworth Long Term Care Insurance - refund 7,717.01 2 Kiplinger-refund 78.21 3 Capital Blue Cross- refund 191.90 4 Bethany Retirement Village-refund 258,179.64 5 Miscellaneous personal property 1,000.00 6 2014 Federal Income Tax Refund 5,201.00 TOTAL(Also enter on Line 5, Recapitulation) 272,367.76 REV-1609 EX+(01-10) pennsylvania DEPARTMENT OF REVENUE SCHEDULE F INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER McKechnie, Alexander J Jr. 22 - 15 -0056 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT Joan McKechnie Furniss 118 Morningside Drive Daughter A Brevard, NC 28712 James Foster McKechnie 3110 Dickson Street NE Son B Brookhaven, GA 30319 Jon Alexander McKechnie 232 Marker Drive Son C Somerset, PA 15501 JOINTLY OWNED PROPERTY: see continuation LETTER DATE C F�SCRlPTlO J PROdIERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name o Inanclal Ins I u Ion an bank account numbe DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT or similar identifying number.Attach deed for jointly-held real VALUE OF ASSET estate. INTEREST DECEDENT'S INTEREST 1 A February, PNC Checking Account 23,587.00 50% 11,793.50 2009 2 A February, PNC Checking Account 412.00 50% 206.00 2009 3 A February, PNC Money Market Account 108,083.00 50% 54,041.50 2009 4 B March, 2000 Metro Joint Account 39,553.48 50% 19,776.74 5 C March, 2000 Metro Joint Account 39,553.48 50% 19,776.74 6 A March, 2000 Metro Joint Account 39,553.48 50% 19,776.74 7 D March, 2000 Metro Joint Account 39,553.48 50% 19,776.74 8 A February, Morgan Stanley Account 279,224.22 50% 139,612.11 1993 9 B February, Morgan Stanley Account 279,224.22 50% 139,612.11 1993 TOTAL(Also enter on line 6, Recapitulation) 703,813.13 REV-1509 EX+(01.10) Pennsylvania SCHEDULE F DEPARTMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER McKechnie, Alexander J Jr. 22- 15 -0056 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE In dude name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT or similar identifying number.Attach deed for jointly-held real VALUE OF ASSET estate. INTEREST DECEDENT'S INTEREST 10 C February, Morgan Stanley Account 279,657.68 50% 139,828.84 1993 11 D February, Morgan Stanley Account 279,224.22 50% 139,612.11 1993 Page 2 of Schedule F pennsylvania SCHEWLE F DEPARTMENT OF REVENUE "IY I OMERS INHERITANCE TAX RETURN 1�1 1 �JyyryGft RESIDENT DECEDENT ESTATE OF FILE NUMBER McKechnie, Alexander J Jr. 22- 15 -0056 SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT D Jeffrey Reed McKechnie 11 Main Street Son Stowe, VT 05672 REV-1511 EX+(08-13) pennsylvania WHEDULEH DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENT DECEDENT URN ADMINISTRATIVE COSTS FYJIY� �IV1 R ESTATE OF McKechnie, Alexander J Jr. FILE NUMBER 22 - 15 -0056 E Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. 1 Neill Funeral Home, Inc. 12,350.32 3401 Market Street, Camp Hill, PA 17011 2 Funeral Luncheon - Bethany Village 710.64 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees Beckley&Madden 9,500.00 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 Cumberland County Register of Wills 370.50 Cumberland County Legal Journal (advertising) 75.00 The Patriot-News (advertising) 250.00 5. Accountant's Fees Bill Wire, CPA 1,535.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Photocopying 50.00 See attached 1,050.00 TOTAL(Also enter on line 9, Recapitulation) 25,891.46 REV-1511 EX+(08.13) Pennsylvania ScheduleH DEPARTMENT OF REVENUE INHERITANCE TAX RETURN Funeral E)qetlSes& RESIDENT DECEDENT Administrative Costs continued ESTATE OF McKechnie, Alexander J Jr. FILE NUMBER �22 - 15 -0056 2 Mailing 50.00 3 Estimated closing costs 1,000.00 Page 2 of Schedule H pennsylvania SCHEDULE I DEPARTMENT OFDEBTS OF DECEDENT MORTGAGE INHERITANCE TAXAX RETURN f RESIDENT DECEDENT LIABILITIES & LIENS FILE NUMBER ESTATE OF McKechnie, Alexander J Jr. 22 - 15 -0056 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Medicine Shoppe 306.02 2 Holy Spirit EMS 75.00 3 Pennsylvania income tax(2014 income taxes) 343.00 4 Federal income tax 1,400.00 5 Jackson Siegelbaum Gastroentology 25.00 6 GE/Genworth - refund of overpayment 6,237.60 7 MONY-refund of overpayment 2,000.00 TOTAL(Also enter on Line 10, Recapitulation) 10,386.62 REV-1513 EX+(01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF McKechnie, Alexander J Jr. FILE NUMBER 22 - 15-0056 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I, TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 James Foster McKechnie Son 1/4 personalty; 1/4 3110 Dickson Street NE residue Brookhaven, GA 30319 2 Jeffrey Reed McKechnie Son 1/4 personalty; 1/4 11 Main Street residue Stowe, VT 05672 3 Joan McKechnie Furniss Daughter 1/4 personalty; 1/4 118 Morningside Drive residue Brevard, NC 28712 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 REV•1513 EX+(01.10) pennsylvania DEPARTMENT OF REVENUE SCHEDULE J INHERITANCE TAX RETURN BENEFICIARIES continued RESIDENT DECEDENT ESTATE OF FILE NUMBER McKechnie, Alexander J Jr. 22- 15 -0056 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) ITAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)I 4 Jon Alexander McKechnie Son 1/4 personalty; 1/4 232 Marker Drive residue Somerset, PA 15501 5 Karen McKechnie Southworth Granddaughter 5,000.00 2611 Garland Way Duluth, GA 30096 6 Kalene McKechnie Martin Granddaughter 5,000.00 365 Plantation Way Roswell, GA 30075 7 Tyson R. McKechnie Grandson 5,000.00 111 10th Street, #216 Des Moines, IA 50309 8 Natalie McKechnie Mannherz Granddaughter 5,000.00 2195 Norwood Avenue Boulder, CO 80304 9 Jamie Furniss Kilian Granddaughter 5,000.00 828 Blackburn Court Charlotte, NC 28209 10 Dorsey Furniss Beckham Granddaughter 5,000.00 616 2nd Street, #2 Golden, CO 80403 11 Emma Elizabeth Martin Great Granddaughter 1,000.00 365 Plantation Way Roswell, GA 30075 12 Claire Louise Martin Great Granddaughter 1,000.00 365 Plantation Way Roswell, GA 30075 13 Madeline Anne Martin Great Granddaughter 1,000.00 365 Plantation Way Roswell, GA 30075 Page 2 of Schedule J RECORDED OFFICE OF REGI'STE'R. CF le`ILLS LAST WILL AND TESTAMENT ?015 ,1RN 16 nM 12 56 OF CLEI`K OF ALEXANDER JAMES MCKECIINIE,JR. O R P H A H S' C O U RRT CUMBERI_,�"D PA I, Alexander James McKechnie, Jr., a resident of Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM I: TAXES. I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my Estate or by any recipient of any property, shall be paid by my Executor out of the property passing under this Will, which is not specifically bequeathed or devised, as an expense and cost of administration of my Estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax paid by my Executor, even though on proceeds of insurance or other property not passing under this Will. ITEM II: POWERS OF APPOINTMENT. I hereby exercise all powers of appoint- ment which I may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall be included in my Estate. ITEM III. PERSONAL POSSESSIONS. I hereby give and bequeath all of my house- hold furniture and furnishings, automobiles, books, pictures, jewelry, china, linen, silverware, wearing apparel and all other articles of household or personal use and adornment to my children, James Foster McKechnie, Jeffrey Reed McKechnie, Joan Elizabeth McKechnie Furniss, and Jon Alexander McKechnie, or their issue if any one of them predeceases me, per stirpes. I may prepare a personal property memorandum listing specific items of my personal possessions to be given to particular individuals, or I may leave notes on particular items designating the person that is to receive that particular item. My executor is directed to honor such requests, and to distribute my remaining personal possessions as aforesaid, on an equal basis. ITEM IV. SPECIFIC BEQUESTS: (a) I hereby give each of my grandchildren, Karen Southworth, Kalene Martin, Natalie McKechnie, Tyson McKechnie, Dorsey Furniss and Jaime Furniss, and any grandchildren born after the date of this Will,the sum of FIVE THOUSAND DOLLARS ($5,000,00). (b) I hereby give each of my great-grandchildren, including any born after the date of this Will,the sum of ONE THOUSAND DOLLARS ($1,000.00). ITEM V: RESIDUAL ESTATE. I give, devise and bequeath all of the rest, residue and remainder of my property, real, personal and mixed, to my children, James Foster McKechnic, Jeffrey Reed McKechnie, Joan Elizabeth McKechnie Furniss, and Jon Alexander McKechnie, or their issue if any one of them predeceases me,per stirpes. ITEM VI: EXECUTOR'S POWERS. In the settlement of my Estate, my Executor shall possess, among others, the following powers: (a) To sell, either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my Estate, any or all real or personal estate or interest therein, whether owned by me separately or in conjunction with other persons or acquired after my death by my Executor and to consummate said sale or sales by sufficient deeds or other instru- ments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the valid- 4 i,%.,e_ j< ity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in my Will. (b) To pay all costs, taxes, expenses and charges in connection with the ad- ministration of my Estate. (c) To distribute my Estate in kind or in money. In the event assets are dis- tributed in kind, such assets shall be distributed at their value(s) on the re- spective date(s) of their distribution. (d) To do all other acts in the judgment of my Executor necessary or desirable for the proper and advantageous management, investment and distribution of my Estate. ITEM VII: GUARDIANSHIP OF ASSETS. If at any time any minor child shall be entitled to receive any assets hereunder, the minor's parents, shall act as Guardian of the assets payable to such child. Said Guardian may receive and administer all assets authorized by law and shall have full authority to use such assets, both principal and income, in any manner said Guardian shall deem advisable for the best interests of such child, including college, university, post-graduate or other education, without securing court order. Said Guardian shall have all the rights and privileges as to the Guardianship(s) and the assets thereof as are herein granted to my Executor as to my Estate and the assets therein. ITEM VIII: SIMULTANEOUS DEATH. Any person who shall have died at the same time as me or in a common disaster with me or under such circumstances that it is difficult or 11.' ti yr' impossible to determine who died first, shall be deemed to have predeceased me, ITEM IX: EXECUTOR. I hereby nominate, constitute and appoint my son, Jon Alexander McKechriie, to be my Executor. In the event of the death, disqualification, resignation, refusal or inability of Jon Alexander McKechnie to serve as my Executor, I appoint my daughter, Joan Elizabeth McKechnie Furniss, to be my Executor, My Executor and Guardian specifically are relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last Will and Testament, consisting of this and the preceding three (3) pages, at the end of each page of which I have also set my initials for greater security and better identification this I I th day of July, 2012. Page 4 of 4 Pages j,, _(SEAL) Alexander James—McKechnie, Jr. We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator, Alexander James McKechnie, Jr., as and for his Last Will and Testament, in the presence of us who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. (SEAL) Residing atA-t4 • 'M v� C' 1 `7,a ti-5- AL) Residing a t JS e. ........ ... (SEAL) Residing at. s x 4 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA . SS: COUNTY OF CUMBERLAND We, the undersigned Testator, Alexander James McKechnie, Jr., and Witnesses, respectively, whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and declare to the undersigned authority that: 1. The Testator signed and executed the instrument as the Testator's Last Will and Testament. 2. The Testator signed and executed the Will willingly as the Testator's free and voluntary act for the purposes therein expressed. 3. Each of the Witnesses, in the presence and hearing of the Testator, signed the Will as a witness. 4. To the best of the knowledge of each of the undersigned, the Testator was at the time 18 years of age or older, of sound mind and under no constraint or undue influence. 1N��IrG� 9�J1;6Co� ' � Alexander fames McKechnie, Jr. ("Witness") "Witn� ("Witness") Sworn or affirmed and subscribed to before me by the above-named Testator and Witnesses, this 1 lth day of July, 2012. J�Z�_ a Notary Public COMMONNOE$ yLUANIA (SEAL) NOTARIALSEAL ANN M.CARPER,Notary Public ' City of Harrisburg,Dauphin County My Commission Expires June?3,2016 BECKLEY & MADDEN US POSTAG= ATTORNEYS AT LAW $03.18 S CRANBERRY COURT 212 NORTH TmRn STREET Mailed From 17101 POST OFFICE BOX 11998 09/22/2015 HARRISBURG, PENNSYLVANIA 17108-1998 032A 0061835675 First Class Mail LISA M GRAYSON, ESQUIRE RJEGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE ONE COURTHOUSE SQUARE CARLISLE, PA 1.7013