The URL can be used to link to this page

Home My WebLink About09-27-05 (2) REV-1S00EX+(S-oO) COMMONWEALTH OF REV-1500! OFFICIAL USE ONLY .~. DEPA:~~~;~~A~~~ENUE INHERITANCE TAX RETURN !FILENUUri;E1R--- ~ HARRIS~~~~. ~~610;128_0601 ..J.~_ RE:SIDENT DECE:DENT__.L _UllJl'!~<::ODE Y~: .~-f~c:~:~~~N,A~~~~7s~~:~~: ~I~O~~;ITIAL)- ---- ---- ------~l. .- ~;I~l-S;~U-R;; ;U;BER ~ IO:TE OF DEATH (MM-DD-YEAR) -.. .! DATE OF BIRTH (MM-DD-YEAR) --I~THIS 'RETuRNMUST BE FILED IN DUPLICATE WITH THE ~ 101-02-2005 I 07-07-1943 'REGISTER OF WILLS ~ 1(11" APPLICABLE) SURVWING SPOUSE'S NAME( LAST: FIRST AND MIDDLE INITIAL) -- -- --. I SOCIALSECU-RI1.y-NUMBER I -L- I Ix] 1. Original Retum [] 4. Limited Estate Ixl6. ... z w c z ~ FIRM NAME (If applicable) 1429 South 18th Street ~ .~_. .--- Camp Hill PA 17011 8 TELEPHONE NUMBER ' 717/730 -731 O~____n_._~____~----L.__.. - -=r-t~~~I-Esta7e (S~h;dUle A)-'~'------~- .-----<Du----____~~N~-n!_ I 2. Stocks and Bonds (Schedule B) (2) Non e I I I I .. W 0- )!:S;U) 0"''' wo.o xOO 0"'''' o.lD 0. " . 0204 NUMBER Decedent Died Testate (AIlach copy of Will) 9. Litigation Proceeds Received [] II I I [l 3. Remainder Return (date of death rriof 10 12-13-82) 2. Supplemental Retum I I 5. 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10 Spousal Poverty Credit (dale of death between I I . 12-31-91 and 1-1-95) THIS SECTION MUST BE COMPLETED. ALL CORRESPONOENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE D.!R...E.fTED TO: . NAME .. . COMPLETE MAILING ADDRESS JIIIichael L. B.an~_~_ Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11.Election to tax under Sec. 9113(A) (Attach Sch 0) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None 4. Mortgages & Notes Receivable (Schedule D) (4) None z o i= <( ...J :J ~ a: <( u w a: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) r"1 Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 11,829.35 .------_._----_._.."~_.~-- 12,668.94 (5) 50,855.83 l ;~! (6) None (!.'J (7) None c..) (8) 50,855.83 (9) (10) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11) 24,498.29 26,357.54 0.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 26,357.54 z o i= <( I- :J lL :::;; o u >< ~ I SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES . 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 I or transfers under Sec. 9116(a)(1.2) I 16.Amount of Line 14 taxable at lineal rate I , [I 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate [19. Tax Due i 20_ 0 (19) x .00 (15) 0.00 x .045 (16) 1,186.09 26,357.54 x .12 (17) 0.00 0.00 0.00 x .15 (18) 0.00 1,186.09 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. >> BE SURE TO ~_N~~~ AuLL.. QUeSTIONS ON- REVERSE~SIDE AND-RECHECKMATH << u_u Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00: ~J:. \'.\ .. Decedent's Complete Address: STREET ADDRESS 3614 Dwayne Avenue CITY Mechanicsburg STATE P A Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 Total Credits (A + B + C) 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPA YMENT Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE Make Check Payable to: REGISTER OF WILLS, AGENT ZIP 17050 (1) 1,186.09 (2) 0.00 (3) (4) (5) 1,186.09 (5A) (5B) 1,186.09 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; ....................................... b. retain the right to designate who shall use the property transferred or its income;.................... c. retain a reversionary interest; or .................._.............................._.... ......................................... d. receive the promise for life of either payments, benefits or care?................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................... ............................. .............. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.............................~__.... ... ................................ .............m.._................. i i 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. Under pena"ies of pe~ury. I declare that I have examined this ratum, including accompanying sc~edules ~nd statements, and 10 the best of my knowledge and belief. it is true, correct and complete. Declaration of p~E!pa_rer olher_t~an the personal representative is ba~ed on all info~atlo_~_?_~ which P!eparer has a~y kn~ledg_~. _______ SIGNATUREOF PERSON RESPONSIBLE FOR FILING RETURN ADORESS DATE Fred HI" Bas. k~.. /'. .... 312 Lamp Post Lane () ~'7'7 / D)/' s&uflo!kr!s~~E FOR FILING RETURN ADDREss--~am~_HiIl, PA_~!O_12_ -\ .. ~TE V ~Z ;;.~ STG~RE OF PREPARER O-THE~EPRESENTATIVE --- ---"ADDRESS Michael L. Bangs 429 South 18th Street Camp Hill, PA 17011 Yes No i xJ i.x_! I x I I x I x i x I l./ 1X/ e-( D^TF 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. ~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% [72 P.S. ~9116 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. !j9116 (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%, except as noted in 72 PS. ~9116 1.2) [72 PS. !j9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. !j9116 (a) (13)] 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. . Rev-1S0B EX_ (6-9B) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONVVEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Baskin, Doris Davenport FILE NUMBER 21-05-0204 ESTATE OF 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 NUMBER DESCRIPTION OF DEATH 1 KS Management Services LLP - Refund 4.30 2 Certificate of Deposit - PNC Certificate of Deposit #31100245499 6.043.10 3 Certificate of Deposit - PNC Certificate of Deposit #31300241638 16.000.00 4 Refund - Refund of 2004 U.S. Income Taxes 2.962.00 5 Refund - Refund from State Farm Insurance 50.00 6 Savings Account - PNC Savings Account #5003566301 2.063.11 7 Automobile - Sale of 1999 Honda Civic 6.850.00 8 Shell Benefits Service Center - Death benefit 16.883.32 TOTAL (Also enter on Line 5, Recapitulation) 50.855.83 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev 6-98) H~~-1~-2005 20:09 PNCBANK 412 768 3458 P.01 o PNCBAN< April 19, 2005 Michael L Bangs 429 S 18th St. Camp Hill, PA 17011 scp RE: Estate of Doris Davenport Baskin (Deceased) SSN: 335-36-2735 DOD: 01-02-2005 Dear Mr, Bangs: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account #31100245499 Established 08-12-2004 DORIS DAVENPORT BASKIN DOD balance: $6,043.10 + $6.69 accrued interest Account #31300241638 Established 06-07-2004 DORIS DAVENPORT BASKIN DOD balance: $16,000.00 + $163.85 accrued interest Checking Account Account #5004586566 Established06-07 -2004 DORlS DAVENPORT BASKIN DOD balance: $0.00 + $0,00 accrued interest This account was at zero balance on the date of death (01-02-2005). Savings Account Account #500356630 1 Established 06-07 -2004 DORIS DAVENPORT BASKIN DOD. balance: $2,063,11 + $0,20 accrued interest Page I of2 ~ Please note that this office only provides date of death balances for deposit accounts (!RAs, CDs, Checking and Savings accounts). We do not process any financial transactions OJ' provide st.temenb. If you need assistance with any of these items, please call1-88B-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~ ';J. ~ Erica L Schlegel 1-800-762-1775 P7-PFSC-Q4-F 500 First Ave. Pittsburgh P ^ 15219 Member FDIC Page 2 of2 TOTAL P.02 ~~";;:a BILL OF SALE I, FRED H. BASKIN, Executor of the Estate of Doris D. Baskin, do hereby sell decedent's 1999 Honda Civil automobile to Gregory and Margaret Dunlap for the sum of Six Thousand Eight Hundred Fifty and 00/100 ($6,850.00) Dollars. Date: April 4, 2005 FRE:t:A~ J -t-,- I~-: -Ili~~nsions I I....IJ-.--f" I Your futur.. YDur cholc.. I l_ August 17,2005 THE ESTATE OF DORIS D BASKIN C/O FRED BASKIN 312 LAMP POST LANE CAMP HILL, PA 17011 DORIS D BASKIN Dear Fred Baskin: We are sorry to learn of the death of Doris D Baskin. As a beneficiary, the estate is eligible to receive a single sum survivor benefit of $16,883.32. You may choose whether or not you want us to withhold federal and/or state income tax from the payment. Please complete the enclosed Withholding Form and return it in the enclosed envelope. Ifwe do not receive this form within 45 days of the date of this letter, 20% of the taxable portion will be withheld as required for federal income taxes. Any required state income tax will also be withheld. Your payment will be made in the month after all materials are received in good order. Your payment will reflect benefits from the first of the month after Doris D Baskin's death. If you have questions about your benefit or about the requested forms and information, please call the Shell Benefits Service Center at 1-800-30 SHELL (1-800-307-4355). Service Center Representatives are available to help you any business day, 7:30 a.m. to 11 :00 p.m. Central time. To ensure you receive all future mailings regarding your benefit, please contact the Shell Benefits Service Center any time your mailing address changes. Shell Benefits Service Center Enclosures: · Important Tax Notice . Form . Return Envelope 63036.001 BC.SH-DB-506g-0898 REV-1151 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Baskin, Doris Davenport Debts of decedent must be reported on Schedule I. FILE NUMBER 21-05-0204 ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,893.62 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Michael L. Bangs 5,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 110.00 See continuation schedule(s) attached 5. Accountant's Fees 650.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 175.73 TOTAL (Also enter on line 9, Recapitulation) 11,829.35 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule H (Rev. 6-98) . Rev-1502 EX+ (6.98) *' SCHEDULE H-A FUNERAL EXPENSES continued COMMONV\IEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Baskin, Doris Davenport FILE NUMBER 21-05-0204 ITEM NUMBER DESCRIPTION AMOUNT 1 Neill Funeral Home, Inc. 3.300.00 2 Neill Funeral Home, Inc. - Additional funeral charges 929.00 3 Settegast & Kopf Funeral Home 1.664.62 Subtotal 5.893.62 Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule H-A (Rev. 6-98) . Rev-1502 EX+ (6-98l . SCHEDULE H-B4 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Baskin, Doris Davenport FILE NUMBER 21-05-0204 ITEM NUMBER DESCRIPTION AMOUNT 1 Probate - Register of Wills 110.00 Subtotal 110.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-B4 (Rev. 6-98) Rev-1502 EX- (6-98) . SCHEDULE H-B7 OTHER ADMINISTRA TIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Baskin, Doris Davenport FILE NUMBER 21-05-0204 ITEM NUMBER DESCRIPTION AMOUNT 1 Advertising - Cumberland Law Journal 75_00 2 Advertising - The Sentinel 100.73 Subtotal 175.73 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) . Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMON'NEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Baskin, Doris Davenport FILE NUMBER 21-05-0204 Include un reimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Asset Acceptance LLC - Marshall Fields Account VALUE AT DATE OF DEATH 4.955.77 2 Cardiology of Houston 113.65 3 Enhanced Recovery Corporation - Montgomery Ward Account 2.711.40 4 ER Solutions, Inc. - Washington Mutual Account #3544269 313.27 5 Express Scripts - Account #0101079213 78.00 6 Hartzell Eye 52.29 7 L.L. Bean - Account #FT00811039 195.90 8 NCO Financial Systems, Inc. - Memorial Hermann Southwest Hospital Bill 1.046.50 9 Omega Medical Laboratories - Account #A4266370-0 87.38 10 Omega Medical Laboratories - Account #A431 0286-0 9.90 11 Omega Medical Laboratories - Account #A4322276-0 16.76 12 Omnium Worldwide, Inc. - Household Bank Account 508.32 13 Orthopaedic Institute of PA - Service of 9/16/04 124.26 14 Powell, Rogers & Speaks, Inc. - Orthopaedic Surgeons of Central PA 92.36 15 Reading Hospital and Medical Center - Account #011129520088-0 14.17 16 Reading Hospital and Medical Center - Account #011129520011-2 22.12 17 Reading Hospital and Medical Center - Account #011129520061 14.68 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 10. Recapitulation) 12,668.94 (If more space IS needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc, Form PA-1500 Schedule I (Rev. 6-98) Rev-1512 EX+ (8~98) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Baskin, Doris Davenport FILE NUMBER 21-05-0204 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 18 Reading Hospital and Medical Center - Account #011129520045 37.70 19 Reading Hospital and Medical Center - Account#011129520037-7 27.57 20 Reading Hospital and Medical Center - Account #011129520029-4 12.73 21 Shell Employees Federal Credit Union - Ready Cash Loan #161 285.94 22 St. Luke's Episcopal Health Sys. 753.99 23 Texas Pain Consultants, Inc. - Account #075269*1 15.00 24 Tristan Associates - Account #557874 458.15 25 United Healthcare-Houston 521.13 26 West Asset Management, Inc. - Texas Orthopedic Hospital Bill 200.00 TOTAL (Also enter on Line 10, Recapitulation) 12,668.94 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) . REV 1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 21-05-0204 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT $ Do Not List Trusteelsl (Words) ($$ ) Baskin, Doris Davenport NAME AND ADDRESS OF NUMBER PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal . distributions, and transfers under Sec. 9116(a)(1.2)] Fred H. Baskin 312 Lamp Post Lane Camp Hill, PA 17011 Bonny A. Battles 12407 Mullins Drive Houston, TX 77035-5539 Son One-Half Daughter One-Half Total Enter dollar amounts for distributions shown above on lines 5 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 Copyrrght (c) 2002 form software only The Lackner Group, Inc. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Form PA-1500 SCheduleJ (Rev 6-98) ~&$f JUill &nb illr$famenf of DORIS DAVENPORT BASKIN I, DORIS DAVENPORT BASKIN, a resident of the County of Maricopa, State of Arizona, being of sound mind and memory and not acting under any duress, menace, fraud or the undue influence of any person, do make, publish and declare this to be my Last will and Testament, hereby revoking any and all Wills and Codicils thereto heretofore made by me. FIRST: (a) I direct that all my just debts, funeral expenses and expenses of administration of my estate be paid as soon after my death as practicable; (b) I further direct that all estate, in- heritance, legacy, successor or transfer taxes (including any interest or penalties thereon) imposed by any federal or state laws now or hereafter in force with respect to all prop- erty taxable under such laws by reason of my death, whether or not such property passes under this Will or whether such tax be payable by any recipient of any such property, shall be paid by my personal representative out of my general estate as part of the expenses of administration thereof with no right of reimbursement from any recipient of any such property. SECOND: I declare that I am a divorced woman; that two children have been born as an issue of my former marriage, namely a daughter, BONNY ALICE BASKIN, born July 18, 1968; and a son, FRED HENRY BASKIN, born May 4, 1967. THIRD: I give, devise and bequeath all of my estate, real, personal and mixed, whatsoever and wheresoever situated, to my children, share and share alike. FOURTH: I hereby nominate and appoint my son, FRED HENRY BASKIN of Scottsdale, Arizona personal repre- sentative of this, my Last will and Testament. In the event my said son dies, resigns or fails to qualify as my personal representative, I appoint my daughter, BONNY ALICE BASKIN as successor personal representative. I direct that neither my personal representative nor my successor personal representa- tive be required to give any bond or security for the proper discharge of his or her duties. I hereby give and grant unto my said personal representative or successor personal repre- sentative full power and authority to sell, lease, encumber by mortgage or deed of trust or exchange, any or all of the real or personal property of my estate, with or without notice, but subject to such confirmation as may be provided by law. FIFTH: No person shall be deemed to have survived me who shall have died at the same time as I or in a common disaster with me or under circumstances which make it dif- ficult or impossible to determine who died first, and I direct that all of the provisions of this Will be construed in accordance with that assumption and upon that basis. -2- . IN WITNESS WHEREOF, I have hereunto set my hand to this, my Last Will and Testament, this ~ day of ~~ 1987. f0~~~~ DORIS DAV NPORT BA IN The foregoing instrument, consisting of four pages including the page signed by the Testatrix, was on the date hereof by DORIS DAVENPORT BASKIN subscribed, published and declared to be her Last Will and Testament, in the presence of us, and each of us, who, at her request and in her pre- sence and in the presence of each other, have signed the SffiGC ~z witnesses thereto. 1YIeuuu.r, e.~ ~ ~ ffl-lAA/ STATE OF ARIZONA Residing at 17// S.&t;...'-:....~ 6..p~/lr~/ ~{. Residing atS//t? A/ 3.2 U..;?~ ,42 &'5IJ/Y ss. County of Maricopa 1i'Je, DORIS DAVENPORT BASKIN, 'J11~ C!.. ~and ~ ~ ~~ , the Testatrix and th \1itnesses, re- pectively, w ose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed this instru- ment as her Last will and Testament, that she signed willingly, that she executed it as her free and voluntary act for the pur- poses therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as wit- nesses and that, to the best of their knowledge, the Testatrix was at that time eighteen (18) years of age or more, of sound mind and under no constraint or undue influence. ~fj ~ TESTATRI~ m~ (t.~ WITNESS ~/2~ W NESS by DORIS Subscribed, sworn to and acknowledged before me DAVENPORT BASKIN, the Testatrix, 'm~ Q.. ~ -3- .. . and ~ /f!? ~~VJitnesses, this tlL- day of 'fl<.~ 1987. ~~ ~,1c ~A~ I My Commission Expires: ?Jr IS; /78'Cf -4-