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Home My WebLink About07-10-06 REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ..... z w c w U UJ Cl UJ I- ~ :=fU) u n:~ UJ ~U I n::l U a..al a.. <t DECEDENT'S NAME (LAST FIRST, AND MIDDLE INITIAL) Wirt, Evel n R DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) FILE NUMBER . L- ~b \0_~~--.LL..:l ~TY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 2 04- 0 3 - 0 4 4 6 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS James H. Turner 4415 N. Front St FIRM NAME (If Applicable) z o t.- <C ...J :::::> I- a.. <C U w 0:::: z o I- <C I- :::::> a.. :! o u >< <C I- 04/28/2006 02/03/1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [gJ 1. Original Return D 4. Limited Estale D 6 Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2, Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) DiD. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) PA 17110 70,472.26 10,513.91 80,986- 17 2,347.85 18.49 (11) (12) (13) 2,36634 78,619.83 I- Z UJ o Z o a.. U) UJ n: 0:: o U TELEPHONE NUMBER 717-232-4551 Harrisbur (14) 78,619.83 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 3,537.89 3,53789 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < '\ l 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) (8) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) 78,619.83 X .045 (16) X .12 (17) X .15 (18) (19) 16 Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due Decedent's Complete Address: STRE:::T ADDRESS Bridqes of Bent Creek CITY 1 STATE I ZIP Silver Spring PA Tax Payments and Credits: 1 T ax Due (Page 1 Line 19) 2 Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,53789 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total Interest/Penalty ( 0 + 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5) A. Enter the interest on the tax due, (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 3,53789 3,53789 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................................... ......................... ........... 0 [K] b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [K] c. retain a reversionary interest; or ...................................................................................................... 0 [K] d. receive the promise for life of either payments, benefits or care? ..................... .......... ...................... ........ 0 [K] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.... ............................ ................... ............ ........ ........................ 0 [K] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .... ...... ....... 0 [K] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 [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. Under penalties of perjury, 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 preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE. ~///..7~ //j.;,. .. ') C' /;) ,f t J7 3> ,3 f DATE Ir ;J l: '--' ,~, ADD if 1-11 '-"j AJ. f(eD t Si - I ~ \0.1' {j sb I .t { ~ rt~ /'111 () 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 PS ~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 PS ~9116 (a) (1.1) (il)]. The statute does 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. ~9116(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 ~9116(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. ~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. REV-1503 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Wirt Evelyn R FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Bear Stearns Co. Medium Term Note (18,000) as of 4/28/06 VALUE AT DATE OF DEATH 17,857.55 2 Bear Stearns Co. Medium Term Note (17,000) as of 4/28/06 16,838.50 3 John Hancock Life Insurance Signature Note (5000) as of 4/28/06 4,290.00 4 Capital Income Builder Class A (157.884) as of 4/28/06 8,933.08 5 Income Fund of America Class A (385.213) as of 4/28/06 7,376.83 6 Investment Co. of America (456.43) as of 4/28/06 15,176.30 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 70,472.26 REV-15G8 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Wirt. Evelyn R FILE NUMBER 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Edward Jones Money Market account as of 4/28/06 7,691.86 2 M& T Bank checking account #970699 as of 4/28/06 58.79 3 proceeds from sale of cemetery plots 1,400 00 4 Refund from ROBC Limited Partnership 814.79 5 Refund from Highmark Blue Shield 548.47 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1051391 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wirt Evelyn R SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. W Orville Kimmel Funeral Home, Inc 62500 2 Luncheon 100.00 3 Donation to Bridges Employee fund 100.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name 01 Personal Representative (s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees Turner and O'Connell 1,00000 3. Family Exemption: (II decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship 01 Claimant to Decedent 4. Probate Fees Cumberland County Register of Wills 260.00 5 Accountant's Fees 6. Tax Return Preparer's Fees 7. 8 Advertising (The Sentinel) 187.85 9 Advertising (Cumberland Law Journal) 75.00 TOTAL (Also enter on line 9, Recapitulation) $ 2347.85 (II more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Wirt. Evelyn R FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Alert Pharmacy Services, Inc VALUE AT DATE OF DEATH 18.49 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 18.49 ''''''''>'''w COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF E I R FILE NUMBER Wirt velvn 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. Cynthia D. Miller daughter 14.28% 334 Walton Street Lemoyne, PA 17043 2 Raymond P. Wirt son 14.28% 700 South 80th Street Harrisburg, PA 17111 3 Marvin L. Wirt son 14.28% 6123 Evelyn Street Harrisburg, PA 17111 4 Gary D. Wirt son 14.28% 6 John Myers Circle Glenn Mills, PA 19342 5 Phyllis J. Walker daughter 14.28% 103 Laurel Drive Enola, PA 17025 6 James L. Wirt son 14.28% 2903 Green Street Harrisburg, PA 17110 7 Darlene M. Hillegas daughter 14.28% 749 Collina Drive Lewisberry, PA 17339 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 1 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 1. TOTAL OF PART Il- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ , . (If more space IS needed, Insert additional sheets of the same size) ~.b/18/2..b 15,28 717'332'3452 JAMES H. TURNER 4415 N. FRONT STREET HARRISBURG PA 17110 June 19, 2006 EST A TE OF EVEL YN R. WIRT STOCKS & BONDS, MONEY MARKET Edward Jones BANK DEPOSITS M & T Bank SALE OF CEMETARY PLOTS ROBe LIMITED P ARlNERSHIP refund HIGHMARK BLUE SHIELD refund FUNERAL EXPENSES W. Orville Kimmel Funeral Home, Inc. 725.00 less County Burial Allowance ~100.00 Luncheon-Donation ALERT PHARMACY SERVICES, INC. GIFT TO THE BRIDGES EMPLOYEE FUND ATTORNEY FEES Turner & O'Connell Darlene Hillegas, Executrix 749 Collina Dr Lewisberry, PAl 73 3 9 938-5974 FAX 932-9452 DARLENE HILLEGAS PA~E 01 58.79 1400.00 814.79 548 47 2822.05 + Edward Jones 625.00 100.00 18.49 100.00 05/08/2005 15:15 8883408587 4227 Elmerton Avenue Harrisburg, PA 17109 717-541-5474 www.edwardjones.com David A. Hamilton Investment Representative Jeffrey L. Hoachlander Investment Representative June 8, 2006 Estate of Evelyn Wire. James Win, Exec. 2903 Green Street Harrisburg, PA 17110-1233 Dear Jim: EDWARD JONES PAGE 02/03 EdwardJones Per your request. I am writing to provide valuation for the following securities belonging to Evelyn R. Wirt, now deceased. - Description Money Market Investment Shares Total Value $7,691.86 Qty Description Maturity Date 18,000 17,000 5,000 Bear Stearns Co, Medium Term Note Bear Stearns Co Medium Term Note John Hancock Life Ins. $ignatureNote 12/21/21 1/1 0/22 7/15128 Qty Description Cusip or Symbol 157.884 Capita.l Income Builder Fd. CAIBX Class A 385.213 Income Fund of America AMECX Cla.ss A 456.43 Investment Co. of America AIV$X Rate Total Value Accrued Interest (*muni) $24.50 $60.78 $9.66 7.00% 7.15% 5.35% $17,657.55 $16,838.50 $4,290.00 Value per Item $56.58 Total Value $8,933,08 $19.15 $7,376.83 $33.25 $15,176.30 The values listed are as of April 28, 2006, the day that Evelyn R Win passed away. The values were obtained from an outside historical pricing service and while we believe that they are reliable, we do not guarantee their accuracy. Please let us know if you need any other information or assistance. ickie Snyder Senior Branch Office Administrator ~M&I'Bank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 May 23, 2006 Turner and O'Connell Attorneys At Law 4415 North Front Street Harrisburg, Pennsylvania 17110 Re: Estate of" Evelvn R Wirt Social Securitv: 204-03-0446 Date of Death: Avril 28, 2006 Dear Sir or Madam: Per your inquiry dated May 17,2006, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: I. Type of Account Checking Account Account Number 970699 Ownership (Names oj) Evelyn R Wirt, Principal * Darlene W Hillegas, Rep Payee * Opening Date OS/28/63 Closed 05/17/06 Balance on Date of Death $ 58. 79 Accrued Interest $ 0.00 Total $ 58.79 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the Fairview Office # 717-938-1829. Sincerely, ~vy0~~ Nancy Clagett Records Management CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, P A 17013 June 16,2006 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: James H. Turner, ESQUIRE RE: Evelyn R. Wirt, ESTATE Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. --------------------------------------------------------------------- --------------------------------------------------------------------- Advertisement inserted on following dates: June 2, June 9 and June 16, 2006 Second Proof Request $ 75.00 $ 0.00 $ 0.00 $ 75.00 ------------- Advertising Cost Proof of Publication Payment Received Total Amount Due $ .00 --------- --------- Payment received May 26, 2006 by Becky H. Morgenthal/Executive Director RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Rece~pt Date: Recelpt Time: Rece ipt No.: 5/12/2006 14:25:02 1044347 WIRT EVELYN R Estate File No. : Paid By Remarks: 2006-00414 HILLEGAS DARLENE 06-414 WZ ________________________ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 1080 Total Received......... 210.00 15.00 20.00 10.00 5.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN $260.00 $260.00 en Cl Ck:: o U w Ck:: c::: ~ o ~ Ck:: o LL 2 o i= Ck:: o 0.. en ::I: I- Z c:( I- W c::: N I- oj( co ~ z N 0 06 '<t' ;::: ..........~ 0 oj( ~r--<t ;::: I.!) 0 <toU) N a:: <flO 0.......... ~ N w ~I.!) a..~", I- ~OCl u.. :J U) <t: * H I- 00 I.!) ~ H riI ~ \0 z I.!) 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(J) u ~=o 00 >- '" 0 ::> <t ::> ~ E-i 0: <t <tZ a..('f) ('f) 0 a.. r<\ ~r') 0- ~~g~ \ O::l C~~\ .w Z Ul -5 ro ~ :>.~;; ro 0 'O.w0 'r-! ro Z H Iil :>. N roM tf.l'O ...-1 ~.lJ Oro ~~ :>. 'Otf.lro ~-..-I '0 o tf.l ~ :>. (I) ro~ .. '0 '0 tf.ltf.l(l) .lJ(I)S: ~~ (I) '0 tf.l E (I)-r-! (l)S: tf.l :>. -r-! .~ ro .w . '0 H E-r-! (I) (I)'H ..c: :> ~~ E-i '0 ro '<t' .~ ..c: ~ .lJ ...-l.w0 -..-I ro ro 0 :3: trl Z (I):>' trl ...-lroN ~ 'OM -..-I ~...-I tf.l EH.w!:: -..-I ::l ~ ro 0 .w...-l 0 H 0 tf.l :>.Z (I) t)-r-! ro :> I 'ON '0 !:::>'tf.lM ro -r-! ro (I) 'O;::l.lJ H Htf.lE-iro o 0(1) 4-l 4-l;::l tf.l :>. E-i -r-! ro tf.l '0 (I) .~:>. tf.l s:: . ro H -..-I E'O ;::l ...-l . tf.l..c: '0 ro H E-i ro ;::l (l)M..c:m P M E-i -r-! ~3 ~ ...-l (I) s:: -r-! .lJ !:: (I) Ul Uj Cl <t U) U) UJ ::2 ;::l o :>. ~ s:: ro ..c: E-i ...-l ...-l ro t) (I) m ro (I) ...-l ~ ...-l ...-l -..-I .a ...-l ro trl (I) H H ::l o :>. trl s:: -r-! ('f) '00 HN ro trl.lJ (I)~ H(I) m ~ S::M OM '..-I~ .wN ml (I)('f) ::l'<t' tJ1N :>tH ~(I) ro~ ro (l)E :>Q) roO ..c:..c: CI.l 5:>t :>t~ 4-lro HE-i .w E!:: OQ) C:.a ~t) S::ro -r-! .w ...-l.w Hro (I) ~~ ::l t)OO @lro '0 (1)00 -r-! 00 4-lQ) -r-! H Hm'O (l)m'O ~roro ro...-l EV'O (I) !:: o..ro ..c:m Ul'OQ) roE :>t ro ~a3 !:: roo..-l H E-i4-l::l -..-10 S::OO:>. 000 -..-I ro 01 .lJ...-l!:: ~ O-r-! (I) '0 .w0::l .w.wrl ro u ...-l!:: ~ ro-r-! '<t'trl I.!)(I)H r--...-l (I) ('f) .w IH.w ('f)::lQ) '<t'0r-l N:>t H o H Q) .lJH:> Ul ~ 8 ...-l~ ro ro trlO (l)m'O ...-l...-lS:: roQ) H 00 ;::l~ OroQ) :>tt)oo ro ~::lQ) roOrl 1il~P-i LAST WILL AND TESTAMENT of EVELYN R. WIRT I, EVELYN R. WIRT, of Swatara Township, Dauphin County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last will and Testament, hereby revoking all former wills by me at any time heretofore made. ITEM I. 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 ITEM II of this Will, as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement of any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. In the absolute discretion of my Executor, such taxes may be paid immediately, or the Ex- ecutor may postpone the payment of taxes on future or remaind- er interests until the time possession thereof accrues to the beneficiaries. !:t)~~r~ R, W~:~ Evelyn R. wirt Page 1 of 3 pages ITEM II. I give, devise and bequeath all the rest, residue and remainder of my property, of whatsoever nature and wheresoever situate at the time of my death, to my husband, J. Lester wirt, provided he shall survive me by thirty (30) days. In the event my husband should predecease me or not survive me by thirty (30) days, then all the rest, residue and reemainder of my property shall be distributed in equal shares among my children. If any of my children should predecease me, then the share that he or she would have received shall pass in equal shares to his or her children, being my grandch- ildren, or if none, the share shall be distributed in equal shares among my surviving children. ITEM III. In the event any beneficiary is under the age of eighteen (18) at the time of my death, then his or her share shall be placed into a federally insured restricted account until such beneficiary attains the age of eighteen (18) . ITEM IV. I nominate, consti tute and appoint my husband, J. Lester Wirt, as sole Executor of this, my Last will and Testament. In the event my husband refuses or is C'. i .' I ) , C ~ ~,fY- 1<." l 1,/ hL/ Evelyn R. wirt Page 2 of 3 pages unable to act for any reason, I nominate, consti tute and appoint Darlene W. Hillegas and James Wirt as Co-Executors of this, my Last Will and Testament. In the event Darlene W. Hillegas or James Wirt should predecease me, the survi vor shall act as sole executor hereunder. It is my desire that my Executor shall serve without bond. IN WITNESS WHEREOF, I, Evelyn R. Wirt, have, to this my last Will and Testament, typewritten on this and two (2) other pages, have set my hand and seal this first day of February, 1994. witness: L~~~ c-- // //4, /!-}~,!~ ~'J /) b (... f/(,N? ~ ~ 1? I I/,-J A-~L7- Evelyn R. wirt COMMONWEALTH OF PENNSYLVANIA : : SSe COUNTY OF DAUPHIN . . I, EVELYN R. WIRT, 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 ex- ecuted the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein contained. Sworn or aff irmed to and acknowledged before me, by EVELYN R. WIRT, the testatrix, this first day of February, 1994. COMMONWEALTH OF &,~i?~'-h^- I? l '11.) ;.~ Ev lyn R~ wirt {L G !otary PENNSY:Y/ANIA . . . . ~s,.. COUNTY OF DAUPHIN . . ;. ~."..,. ,.-'. :,... We, James H. Turner and Amy Huber, the Witnesses, respecti vely , 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 the testatrix sign and execute the instrument as her Last will and Testa- ment; that EVELYN R. WIRT 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 was at that time eighteen 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 H. Turner and Amy Huber, the witnesses, this first day of February, 1994. ---7 ,,,...-- . c::::::.. L-