HomeMy WebLinkAbout07-15-05
REV.1500EX (6"()O)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
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FilE NUMBER OS-
21 _.. 0475
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNTY CODE
YEAR
NUMBER
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Cl
W
(,)
W
Cl
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
BYERS, MARY JO
SOCIAL SECURITY NUMBER
177-16-1054
DATE OF DEATH (MM-DD-YEAR)
05/14/2005
DATE OF BIRTH (MM-DD-YEAR)
01/06/1920
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[!] 1. Original Return
o 4. Limited Estate
00 6. Decedent Died Testate (Allach copy of W"')
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12.82)
o 7. Decedent Maintained a Living Tnust (Al1Bch copy omust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (dale of dealh prior 1012-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Allach Sch 0)
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THIS SECTION MUSTBECOMJ:'LETED;Al;I!:;CO~ESPONDEliWe;~
NAME
THOMAS E. FLOWER
FIRM NAME (If Applicable}
SAlOIS, SHUFF, FLOWER & LINDSAY
TELEPHONE NUMBER
(717) 737-3405
CONFiDENTfAI,;lrAA INI'ORMATlON1'SftOl!J 'DaE D1RI:Cletli.rO: "
COMPLETE MAILING ADDRESS
2109 MARKET STREET
CAMP HilL, PA 17011
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
196,581.58
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3 Closely Held Corporation. Partnership or Sole-Proprietorship
(1)
(2)
(3)
(4)
(5)
20,406.99
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4 Mortgages & Notes Receivable (Schedule D)
5. Cash. Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or l)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I)
(9)
(10)
(8)
10,979.28
1,472.52
(11)
(12)
(13)
12,451.80
204,536.77
(6)
CTI
(7)
216,988.57
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Tnusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
204,536.77
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116 (a)(1.2)
xO_ (15)
204,536.77 x.O ~ (16)
9,204.15
16. Amount of Line 14 taxable at lineal rate
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)
9,204.15
20.~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
HENDEL LOOP
CITY CARLISLE
STATEpA
ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
9,204.15
29,250.00
460.21
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C ) (2)
29,710.21
-Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
0.00
20,506.06
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5)
(SA)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
[K]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... D
b. retain the right to designate who shall use the property transferred or its income;................ .......................... D
c. retain a reversionary interest; or... ............................... ................................................................ D
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ...... .................. ................. ........................................ D
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? .............. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................ .... .................. .... ........................ ..... ..... ........................... ........ D
No
[K]
[i]
[i]
[iJ
[K]
[K]
Under penalties of pe~ury. I declare that 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 personal representative is based on all information of which pre parer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
DATE
07/13/05
ADDRESS
SAlOIS, SHUFF. FLOWER & LINDSAY, 2109 MARKET ST., CAMP HILL, PA 17011
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (a) (11) (i)J.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of tran~fers to or for the us 1)..;(
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosu Pci
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 twenty-one years of age or younger at d
or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)].
3,o,c:.:()
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6 (a) (11) (ii)J.
plicable even if
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, eXel
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 PS. 9!
individual who has at least one parent in common with the decedent, whether by blood or adoption.
At>.n
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6(a)(1)].
~n 9102, as an
50.6U
Idoptive parent,
REV-1503 EX+ (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
MARY JO BYERS
FILE NUMBER
21-05-0475
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Sterling Financial Trust Company, investment account # 001612 (see attached itemized valuation)
VALUE AT DATE
OF DEATH
196,581.58
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
196,581.58
Processing Date, 06/02/2005
Estate Valuation
portfolio of, Mary Jo Byers
Account: 001622
Report Type, Cost Basis
Number of Securities: 11
File ID: estateval
Shares
or Par
Security
Description
security
Value
Price
1)
882.51 NORTHERN INSTL FDS (665278107)
DIVERS ASSETS
NASDAQ
No close information
,.0
N/A
2)
481.59 NORTHERN INSTL FDS (665278107)
DIVERS ASSETS
NASDAQ
No close information
N/A
1.0
3)
9078.584 VANGUARD FIXED INCOME SECS FD (922031307)
GNMA PORTFOLIO
NASDAQ
06/01/2005
10.46000
94,961. 99
4 )
1157.975 VANGUARD FIXED INCOME SECS FD (922031208)
HI YLD CP PTFL
NASDAQ
06/01/2005
6.25000
7,237.34
5)
2852.217 VANGUARD ED INDEX FD INC (921937108)
COM
NASDAQ
06/01/2005
10.32000
29,434.88
6)
114.046 FIDELITY SECS FD (316389204)
GRWTH & INCM PRT
NASDAQ
06/01/2005
37.82000
4,313.22
7)
100.255 LEGG MASON VALUE TR INC (524659208)
NAV VALUE TR
NASDAQ
06/01/2005
359.057 VANGUARD INDEX TR (9229081081
500 PORTFOLIO
NASDAQ
06/01/2005
108.496 VANGUARD/PRIMECAP FD INC (921936100)
COM
NASDAQ
06/01/2005
61.68000
6,692.03
69.15000
6,932.63
8)
111.12000
39,898.41
9)
101
151.515 VANGUARD WORLD FD (921910105)
U S GROWTH PTF
NASDAQ
06/01/2005
16.14000
2,445.45
11)
151.334 VANGUARD GROWTH & INCOME FD (921913109)
COM
NASDAQ
06/01/2005
30.83000
4,665.63
Total Value:
$196,581.58
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This report was produced with CostBasis, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 6.4.3)
Page 1
STERLING FINANCIAL
TRUST COMPANY
CREATING MANAGING PRESERVING WEALTH
June 24 2005
Thomas E. Flower, Esquire
Saidis, Shuff, Flower & Lindsay
2109 Market Street
Camp Hill, PA 17011
Re: Estate of Mary Jo Byers
Dear Mr. Flower:
The enclosed statement is an Estate Valuation for the assets held by Mary Jo Byers at
her death, which were being held at Sterling Financial Trust Company. Mrs. Byer's
date of death, May 14, 2005, was entered into the valuation system and the system
automatically calculates the average of Friday and Monday's averages.
Please note items 1) and 2) are the money market funds and these were not valued
because they are dollar for dollar funds. You will need to include the $882.51 income
cash money market and $481.59 principal cash money market into the total valuation.
The last interest income will post to the account on July 6th or ih. After credit is
received from the income a check will be sent to you for the balance of the account.
As of June 30th I will be retired from the bank and Stephanie Covahey will be the new
relationship manager for the account. Should you need to contact her number is 633-
4416 and she is located at the same address.
Very truly yours,
RUNG FINANCIAL TRUST COMPANY
'p trid. K ~
Assistant Vice President
Enclosure
25 CARLISLE STREET. HANOVER. PA 17331-9934
TELEPHONE ~ 717.637.2201 fACSIMILE ~ 717-633-4439 TOLL fREE ~ 1-800'788,220 I
BANK OF LANCASHR COUNTY . BANK OF LEBANON COUNTY BANK OF HANOVFR FIRST NATIONAL BANK OF NORTH EAST
REV-15G8 EX+ (6-98) *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
BYERS, MARY JO
FILE NUMBER
21-05-0475
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property Jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1 COMMERCE BANK, CHECKING ACCT. #0513034801
7,054.86
558.23
2 PSECU ACCT. #819623467 - PRINCIPAL $557.40 plus $0.83 accrued interest
3 Cash.n account at STERLING FINANCIAL TRUST CO., ACCT. #001622
1,364.10
3,220.80
1,395.00
6,500.00
314.00
4 HOUSEHOLD GOODS, AUCTION PROCEEDS
5 JEWELRY & WATCHES, per attached appraisal
6 1995 GMC VAN, sale proceeds
7 UNCASHED PA INCOME TAX REFUND CHECK
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
20,406.99
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Commerce
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MARY JO BYElR.S
23 HENDEL LOOP
CARLI~LE FA 17013
::ITI\"'~MI!N'r tlATI!
05/1.8/05
051303~ 801
t: ~_9 _'.'
... CHECKING w.. SO PLUS CLUB BEGINNINC RATE
ACCOUNT NUMBER 0513034801
PREVIOUS STATE~ ~CB AS OF 04/20/05 ........................
PLUS :> DEPOSITS AND OTHER CRE~ITS ...................
LESS 8 C}ffiCIG AND OTHER DEBITS ..... .................
CURRaNT STATEMENT BALANCE AS OF 05/18/05 .........................
NUMBER OF DAYS IN THIS STATEMENT PERIon 28
ACCtlUNT Ntl.
0.15000
9,038.63
1,854.16
3.836.85
7.055.94
--------~-----------------------------_._-------------------------_._-~~-----------
.." CHECK TRANSACTIONS .*.
SERIAL DATE
17510 05/02
1791 04./27
1793" 05/04
AMOUN'l'
30.00
74.46
1.5.93
SERIAL
1796.
"l.7 97
17!)!l
DATE
05/09
05/10
05/13
AMOUNT
24.03
15.00
3,555.00
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..* CHECKINO ACCOUNT TRANSACTIONS .**
~ATE DESCRIPTION
04/29 Ae-?A TREASURY DEFT-ANNUITANT
05/03 AC-US TREASURY 303 -SOC SEC
05/03 AC-CM CARD 2 -CHECKPAYMT
CK-00001794
OS/04 AC~AT&T Consumer -CHECKPAYMT
CK-00001795
05/18 INTEREST PAYMENT
DEBITS
CREDITS
1.284.08
569.00
85.27
37 .16
1.08
--------------------~._--------------------------------------------------------~---
*.* BALANCE BY DATB ..*
04/20 9,038.63 04/27
05/03 10,701.98 05/04
05/13 7,054.96 05/19
8,964.17
10.649.89
7.055.94
04/~9
05/09
10,248.25
10,G24.B6
05/02
05/10
10,:a8.2S
10,609.86
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PAYER FBDBRAL ID NUMBER
INTEREST PAID YEAR TO DATE
23-2324730
~.24
-.. INTEREST EARNED THIS STATEMENT PERrOD
DAYS IN PERIOD .........................
I!\lTERES'l' El.l\RNEO ........................
.Ml'il1JAL PERCENTACE YIELD ElAJWED CAPY)....
....
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MARY JO DYERS
23 HENDEL LOOP
CARLISLE PA 17013
"'l'I\'J'I!Ml:!NT DATil
OG/22/05
0513034801
1IC::C::OUN'l" NO.
.,
*** amCKING *** 50 PLUS CLUB BEGINNING RATE
ACCOUNT ~ER 0513034801
~REVIOUS STATEMENT BALANCE AS OF 05/18/05 ....,.'.................
PLUS 3 DEPOSITS AND OTHER CREOITS ...................
LESS 2 CHECKS AND OTHER OEBITS ......................
CURRENT STATEMENT BALANCE AS OF 06/22/05 ........................,
NUMBER OF DAYS IN THIS STATEMENT PERIOD 35
0.15000
7.055.94
1.284.78
8,340.37
.35
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*** CHECK TRANSACTIONS ..~
SERIAL DATE! AMOUNT
1792 05/19 15.00
SERIAL
DATE
AMOUNT
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DATE DESCRIPTION
05/31 AC-PA l~URY DElPT-ANNUITANT
OS/31 DEBIT MEMO
OG/22 CORRECT CLOSING
06/22 INTEREST PAYMENT
DEBITS
8.325.37
CREDITS
1,284.08
.35
.35
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*.. BALANC8 BY DATE ...
05/18 7,055.94 05/19
'II
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7.040.9~ 05/31
.35- OG/:J.2
23-2324730
4.59
.35
PAYER FEDERAL ID NUMBER
INTEREST PAID YEAR TO DATE
JS
.35
0.15'ir
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..... INTEREST E:ARNEC THIS STATEMENT PERIOD
DAYS IN PERIOD .........................
INTEREST EARNED ........................
Al\.'NUAL PERCENTAGE YIELD EARNED {APY)....
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the financiallinkTM
June 1,2005
Account # 8106234647
THOMAS E FLOWER
2109 MARKET ST
CAMP HILL, P A 17011
Dear MR FLOWER:
The following is the status of MARY JO BYERS's account with PSECU as of the date of death.
Joint Owner's Name
Date of Death
Date of Birth
NONE
05.14.2005
01.06.1920
Sharc
SOl
S 51
Description
Regular Shares
60 Month Certificate
Open date
10.30.2002
02.05.2003
Balance
$ 5.02
552.38
Accrued Dividend
$0.00
0.83
The dividend earned from January 1, 2005 through the date of death was $8.43. The decedent had no loans with us.
We do not have safe deposit boxes for our members. A check for the proceeds will be sent under separate cover.
If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu
prompt, enter 6 and then extension 2227.
Sincerely,
~i'f
Member Service Representative
Finance Support Unit
Pennsylvania State Employees Credit Union
Main Address: 1 Credit Union Place. Harrisburg, PA 17110.2990 . (717) 234-8484 . (800) 237.7328
. Mailing Address: P.().Box 6701 Harrisburg, PA 171 06.7013. (717)777;2100(TDO) . (800)472-1967(TDO) I
",/ Savings federally insured up to $1 OO,QOO by the National Credit Union Administration www.psecu.com
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ROSE MARIE'S ANTIQUES
Jewelry, Estate Liquidations, Appraisals
2136 Market Street
CAMP Hill, PENNSYLVANIA 17011
(717) 763.8998
TO WHOM IT MAY CONCERN:
This is to certify that we are engaged in the jewelry business. appraising diamonds. watches. jewelry and
precious stones of all descriptions.
We herewith cp-rlify lhHt we have this day carefully examined the following listed Hnd described
articles. the property of:
NAME~~~-' I~
~
ADDRESS Lf !:> 0 fJ. &, 7 ':,i .
~r pa-
17111
We eSlimHle the value as listed for insurance or other purposes at the current wtHiI value. excluding
Federal and other taxes. In making this Appraisal. we DO NOT agree to purchase or replace the
articles.
APPRAISED VALUE
DESCRIPTION
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~ t..;~~ ~-#- (:.>l1'I1/.""-LV ,J 3'$:00
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The foregoing Appraisal is made with the understanding that the Appraiser assumes no liability with
respec~ any action that may be taken on the basis of this Appraisal.
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REV.1511 EX+ (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
BYERS,MARYJO
FILE NUMBER
21-05-0475
Debts 01 decedent must be reported on Schedule J.
ITEM
NUMBER
A. FUNERAL EXPENSES:
1.
DESCRIPTION
AMOUNT
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees 9,424.65
3. Family Exemption: (If decedent's address is not the same as claimant's, attach expianation)
Ciaimant
Street Address
City State .Zip
Relationship of Claimant to Decedent
4, Probate Fees 319.00
5. Accountant's Fees
6. Tax Retum Pre parer's Fees
7. Mentzer's Auto Sales, lot space rent ($100) and sales commission ($640) 740.00
8. Publish Estate Notices, Cumbo Law Jrnl. ($75) and Sentinel ($180.59) 255.59
9. Allstate Insurance, insurance on GMC van pending sale 211.96
10. PNC Bank, check printing fee, estate checks 28.08
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
10,979.28
REV-1512 EX+ (12-03)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BYERS, MARY JO
FILE NUMBER
21-05-0475
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
3.
AT&T 8.59
SPRINT 3.98
ENGLISH GARDEN 277.82
GM CREDIT 62.45
CUMBERLAND CROSSINGS 960.46
UGI 79.85
MET ED 67.10
CRMC ANESTHESIA 12.27
2.
4.
5.
6.
7.
8.
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,472.52
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BYERS,MARYJO
FILE NUMBER
21-05-0475
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. NANCY ANN HESS, 430 N. 67th St., Harrisburg, PA 17111 step-daughter 100.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheels of the same size)
LAST WILL AND TESTAMENT
OF
MARY JO BYERS
I, MARY JO BYERS, of 23 Hendel Loop, Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do make,
publish and declare this as and for my Last Will and Testament, hereby revoking and
making void any and all former Wills, Codicils, or writings in the nature thereof, by me at
any time heretofore made.
FIRST: I hereby order and direct my Executrix or Executor,
hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses
and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be
conveniently done after my death, out of my residuary estate.
SECOND: I give my entire estate to my step-daughter, NANCY ANN
HESS, of 430 North 6ih Street, Harrisburg, Pennsylvania 17111.
LASTLY: I nominate, constitute and appoint JAMES D. FLOWER, JR.,
to be the Executor of this my Last Will and Testament. In the event that the said JAMES
D. FLOWER, JR., shall be unable to serve as Executor for any reason, 1 appoint,
THOMAS E. FLOWER, as Executor. In the event that the said THOMAS E. FLOWER,
shall be unable to serve as Executor for any reason, I appoint any attorney of the law firm
of SAIDIS, SHUFF, FLOWER & LINDSAY, or its successor. No Executor shall be
required to file bond in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
;1 +4
day of
f~-
~yE"J~
, 2003.
SIGNED, SEALED, PUBLISHED and
DECLARED in the presence of:
~ K- ~j~
~t071' / ./ v;/~~
v
2
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
I, MARY JO BYERS, Testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act for the purposes therein
expressed.
Sworn or affirmed to and acknowle ged before me, by MARY JO BYERS,
the Testatrix, this I / t:::f.- day of
2003.
Y1/ ~ ~eJv.V
~~ry J6- yers, Testatrix
NOTARIAl SEAl
MERLENE J. MARHEVKA, NOTARY PUBLIC
CARUSLE. CUMBERLAND COUNTY, PA
MY COMMISSION EXPIRES JUNE B, 2006
3
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
We, James D. Flower. Jr. and Dawn L. Flower
the witnesses whose names are signed to the attached or foregoing instrument, being
duly qualified according to law, do depose and say that we were present and saw
Testatrix sign and execute the instrument as her Last Will; that she signed willingly and
that she executed it as her free and voluntary act for the purposes therein expressed; that
each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that
to the best of our knowledge the Testatrix was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by James D. Flower, Jr.
and Di'lwn To Flowp.r
this
l~~
dayo! ~A!ltr
2003,
cd ~ /
. /~'?'/ ~.. . c~ ~~-1-/
Witness
NOTARIAl SEAL f',',
MERlENE J. MARHEVKA. NOTARY PUBLIC
CARUSLE, CUMBERLAND COUNTY, PA
MY COMMISSION EXPIRES JUNE e, 2006
4