HomeMy WebLinkAbout11-13-06
REV-1500 EX + (6-00)
.
I OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 260601
HARRISBURG, PA 17126-0601
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
II 06
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
0245
NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Eager, Gayle R.
DATE OF DEATH (MM-DD-YEAR)
133-28-8608
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
o 8. Total Number of Safe Deposit Boxes
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[!J 1. Original Return
D 4. Limited Estate
[!J 6. Decedent Died Testate (Attach
copy of Will)
D 9. Litigation Proceeds Received
4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Pove~ Credit (date of death between
. 12-31-91 and 1-1-95)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to ta~ 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, 0 .010
or transfers under Sec. 9116(a)(1.2)
Copyright 2002 form software only The Lackner Group, Inc.
DATE OF BIRTH (MM-DD-YEAR)
02-08-2006
02-25-1936
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
2. Supplemental Return
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NAME
James G. Morgan, Jr.
FIRM NAME (If applicable)
Tucker Arensberg, P.C.
I TELEPHONE NUMBER
I (717) 234-4121
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
,
111 Nori' h Front St.
POB 88
Harrisb. rg, PA 17108-0889
(1 )
(2)
(3)
(4)
(5)
(6)
(7)
1 $4,200.00
None (")
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None s:
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None:);?
1,950.00
11,002.02
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None
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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)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) D Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
OFFICIAL USE ONLY
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11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
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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
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157,152.02
(9)
(10)
16,475.16
1 ~6,935.22
I
0.010
0.010
0.00
(11 ) 173,410.38
(12) insolvent
(13) 0.00
(14) 0.00
x .00 (15) 0.00
x .045 (16) 0.00
x .12 (17) 0.00
x .15 (18) 0.00
(19) 0.00
Form REV-1500 EX (Rev. 6-00;
,
Decedent's Complete Address:
STREET ADDRESS
216 Glenn Road
CITY Camp Hill I STATE PA I ZIP 1 7011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
0.00
Total <Credits (A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Totallnte~st/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPA YM~Nt
Check box on Page 1 Line 20 to request a refund I
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.
(3)
(4)
(5) 0.00
(5A)
(58) 0.00
Make Check Payable to: . REGISTER OF WILLS, GENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;............................................................................. 0 [!]
b. retain the right to designate who shall use the property transferred or its incpme;................................ 0 [!]
c. retain a reversionary interest; or.............................__...................................I........................................ 0 [!]
d. receive the promise for life of either payments, benefits or care?..................,......................................... 0 [!]
2. If death occurred after December 12, 1982, did decedent transfer property within! one year of death without
receiving adequate consideration?....................................................................... .,................ n..................... 0 [!]
3. Did decedent own an "in trust for" or payable upon death bank account or securitY at his or her death?......... 0 [!]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probat, property which
contains a beneficiary designation?............... .................... .............. ..... ..................1....... .................. ......... ...... 0 [!]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDUL G AND FILE IT AS PART OF THE RETURN.
Under penalties of p8!jury, I declare that I have examined this return, including accompanying schedules and statements, and t the best of my knowledge and belief, it is true, correct and
complete. Declaration of preparer other than the personal resentative is based on all information of which preparer has any owledge.
SIGNATURE OF PERSON RESPONSIB F FliNG RETURN ADDRESS
Robert J. Eage
SIGNATURE OF PREP
James G. Mo
l
DATE
1453 Ryland Driv,
Mechanlcsburg, 'A 17050
/O-J3-(JC:O
DATE
I~/ Iq~ i
.. DATE
ADDRESS
TATNE
ADDRESS
111 North Front St
Harrisburg, PA 1-'108-0889
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on he 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 transfer to or for the use of the surviving spouse is 0%
[72 P.S. ~9116 (a) (1.1) (ii)]. The statutedoes not exemot a transfer to a surviving spouse from t x, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only benefi iary.
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 a e 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 bene Iciaries is 4.5%, except as noted in 72 P.S.
~9116 1.2) [72 P.S. ~9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 2% [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 d cedent, whether by blood or adoption.
..
Rev-1502 EX+ (6-98)
*
SCHEDIILE A
REAL ESTATE
COMMON\/\/EALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Eager, Gayle R.
FILE NUMBER
21-06-0245
.
!
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market vs ue is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which Is jolntly-owned with right of survivorship must be dlsclOl,ed on schedule F.
ITEM
NUMBER DESCRIPTION
1 216 Glenn Road, Camp Hill, PA 17011
VALUE AT DATE
OF DEATH
154,200.0
TOTAL (Also enter on Line 1, Recapitulation)
154,200.0 I
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 fonn software only The Lackner Group, Inc.
Fonn PA-1500 Schedule A (Rev. 6-9~
I
II
Rev.15G8 EX+ (6-98)
*' SCHEDULE E
CASH, BANK DEPOSITS, & MI~ ;C.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESiDeNT DECEDeNT I
ESTATE OF FILE NUMBER I
Eager, Gayle R. 21-06-0245
!
Include the proceeds of litigation and the date the proceeds were receit by the estate.
All property jolntty-owned with the right of survivorship must be disci sed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1994 Dodge Caravan 1,950.0l
II
II
I,
I;
;
,
,
.
!
I'
11
TOTAL (Also enter on Line 5, Recapitulation) 1,950.0(
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleE (Rev. 6-9 ~
- -
II
Rev.1509 EX+ (6-98)
*
SCHEDULE F
JOINTLY-OWNED PROPERn
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Eager, Gayle R. 21-06-0245
If an anet was made joint within one year of the decedent's date of death, It n ust be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT I.
I.
A.
-:
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH I j
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT D~ TE OF DEATH DECO'S VALUE OF ~l
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR V LUE OF ASSET INTEREST DECEDENT'S INTERE T
JOINTLY-HELD REAL ESTATE.
1 Members 1st Federal Credit Union - 1.425.05 50.000% 712.5j
Checking Acct. No. 139308-11
2 Members 1st Federal Credit Union - 25.00 50.000% 12.5~11
Savings Acct. No. 139308-00 i
3 Members 1st Federal Credit Union - 553.88 50.000% 276.9.4
Savings Acct. No. 155404-00
I
4 Members 1st Federal Credit Union- 0.10 50.000% O.O!
Savings Acct. No. 155404-00 - accrued
interest
,
!
TOTAL (Also enter on Line 6, Recapitulation)
1.002.0 ~
I
(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 F (Rev. 6-Sa)
REV 1151 EX+ (1299)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Eager, Gayle R.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
FUNERAL EXPENSES:
See continuation schedule(s) attached
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
1.
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City
Year(s} Commission paid
State _ Zip
2.
Attorney's Fees
I
!
See continuation schedule(s) attached
3. Family Exemption: (If decedent's address is not the same as claimant's, attach eX~lanatiOn)
Claimant :
Street Address
City
Relationship of Claimant to Decedent
State
4.
Probate Fees
See continuation schedule(s) attached
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
Zip
FILE NUMBER
21-06-0245
TOTAL (Also enter on line 9, Re~apitulation)
Copyright (c) 2002 form software only The Lackner Group, Inc.
II
,
:
AMOUNT
10,197.13 "
,
6,000.00 '
62.00
216.03
16,475.16
Form PA-1500 ScheduleH (Rev. 6-9f)
II
Rev-1502 EX+ (6.H)
'* SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Eager, Gayle R. 21-06-0245
I
ITEM I
NUMBER DESCRIPTION AMOUNT
i
1 Malpezzi Funeral Home 10,197.1~
Subtotal 10,197.1~
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-A (Rev. 6-91)
---------..- ------- ----..- I ------ -
II
Rev 1502 EX+ (698)
W SCHEDULE H.B2
ATTORNEY'S FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Eager, Gayle R. ! 21-06-0245
I
ITEM
NUMBER DESCRIPTION AMOUNT
1 Tucker Arensberg, P .C. - attorney fees 6.000.0(l.
Subtotal 6.000.0(
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-B2 (Rev. 6-9 )
II
Rev-1502 EX+ (6-98)
* SCHEDULE H.B4
PROBATE FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Eager, Gayle R. 21-06-0245
ITEM
NUMBER DESCRIPTION AMOUNT
1 Register of Wills - probate fees 62.0C
I
Subtotal 62.0~
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-9 )
II
Rev 1502 EX+ (6-98)
*' SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
COMMONWEAlTH OF PENNSYLVANIA continued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Eager, Gayle R. I 21-06-0245
:
ITEM AMOUNT
NUMBER DESCRIPTION
1 Cumberland Law Journal - proof of publication 75.0(1
2 Register of Wills - short certificate 4.0(
3 The Sentinel - Legal - proof of publication 137.0:
Subtotal 216.0:
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-B7 (Rev. 6-9!3)
----
Rev-1512 EX+ (6-98)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIE NS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
21-06-0245
Eager, Gayle R.
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
216 Glenn Road, Camp Hill, PA 17011 - mortgage payoff I
Capital One - Acct. No. 4121741361162436 - credit card debt I
Discover Financial Services - Acct. No. 6011002450689518 - cre~it card debt
Members 1st Federal Credit Union - Visa Credit Card No. 412149991393088
1
2
3
4
TOTAL (Also enter on Line 10, Recapitulation)
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
II
VALUE AT DATE
OF DEATH
145.475.7'
2.286.7:
3.086.7!-
6.085.9!
156,935.2:
Form PA-1500 Schedule I (Rev. 6-9B)
-"-
---~---- -~---,-
REV 1513 EX+ (9-00)
*
SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Eager, Gayle R.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
C1istributions,l and transfers
under Sec. ~116(a)(1.2)J
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
I.
Mary Lynn Bushman
216 Glenn Road
Camp Hill, PA 17011
Daughter
John F. Kennedy Eager
1077-2 Lancaster Blvd.
Mechanicsburg, PA 17055
Robert J. Eager
1453 Ryland Drive
Mechanicsburg, PA 17050
Son
Son
JoAnne D. Hinkes
8918 Gary Place
Indianapolis, IN 46256
Kathleen Elizabeth Woska
947 Allendale Dr.
Mechanicsburg, PA 17055
Daughter
Daughter
jr---
FILE NUMBER
21-06-0245
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
Total
Enter dollar amounts for distributions shown above on lines 5 through 18, as appro pnate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTI:>N 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 O.O(
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ (Rev. 6-9 )
II
FILE COpy
WILL
OF
GAYLE R. EAGER
me.
I, GAYLE R. EAGER, of Camp Hill, Cumberland County, p~nnSYIVania, do make this my
Last Will and Testament, hereby revoking all Wills and Codicils at ,ny time heretofore made by
I
I
I
I
FIRST:
Tangible Personal Property.
A. Distribution. I give my tangible per onal property to my spouse,
JOSEPH R. EAGER, if my spouse survives me. If my spouse doe not survive me, then I direct
that specified items of my tangible personal property be distributed I in accordance with the
I . '
provisions of a signed memorandum or letter of instruction which i" be found with my copy of
this Will or with my other valuable papers. I give the balance of SUfh property, or all of such
. property in the event the memorandum or letter of instruction is notl.found, to my children who
I
survive me, to be divided among them as they may agree, or in th~ absence of such agreement,
I
as my executor shall determine, in such executor's discretion, mak~ng such distribution in as
I
nearly equal shares as may be practical.
SECOND: Residue If Spouse or Children Survive. I $ive the residue of my estate
to my spouse, GAYLE R. EAGER, if my spouse survives me. If m~ spouse does not survive
I
me, then I give the residue of my estate, as follows: I
!
1) I give our home at 216 Glenn Road to our daughter, MARY LYNN BUSHMAN,
provided we still own the home at the time. Said rig t to the home is subject to
MARY LYNN BUSHMAN being responsible for any utstanding mortgage and
Page 1 of 5
"
making a determination to take the home within 12 days of my death. Should
she not determine to take the home, said home is t be sold and added to the
residuary estate hereinafter set forth.
2) The remainder of my estate shall be divided, in equ I shares, to my children,
MARY LYNN BUSHMAN, KATHLEEN ELIZABETH WOSKA, JOANNE DEBR
HINKES, ROBERT JOSEPH EAGER and JOHN F. KENNEDY EAGER, share
and share alike, per stirpes and not per capita.
THIRD:
Spendthrift Provision. While in the hands t my executor, and until
actually paid over or delivered to the persons entitled thereto, the i terest of beneficiaries in the
income or principal of my estate shall not be subject to assignmen , pledge, attachment, or the
\
claims of creditors.
FOURTH:
Powers of Fiduciaries. In addition to the p wers conferred by law, my
executor shall have the following powers to be exercised in such e ecutor's absolute discretion:
to retain for distribution !n kind, without duty of diversification, all pr perty owned by me at my
death, or to sell all or any part of such property, upon such terms a my executor deems
advisable; to hold any proceeds and other cash uninvested or to in est in all forms of property,
without restriction to so-called "authorized" or "legal" investments and without regard to
I
diversification; to exchange or lease for any period of time any real or personal property and to
give options for sales, exchanges, and leases; to exercise all right of security holders; to
compromise any claim or controversy without court approval; to de egate discretionary powers;
to employ investment counsel,custodians of trust property, broker I agents, accountants and
attorneys and to act without independent investigation upon their r commendations; and to
make distributions in cash or in kind at current values, in undivided interests or non-pro rata
shares.
Page 2 of 5
II
FIFTH: Payment of Taxes. All estate, inheritance, nd succession taxes,
including interest and penalties, payable with respect to property i c1uded in my gross estate,
including any property not forming part of my testamentary estate, shall be paid from the
principal of my residuary estate, at such times and in. such manne as my executor deems
advisable, without apportionment or right of reimbursement.
SIXTH: Appointment of Executor.
A. Appointment. I appoint my son, ROBERT OSEPH EAGER, as the
executor of this my Will. If my son does not survive me, or if he is nwilling or unable to act or
continue as my executor, then I appoint my daughter, MARY L YN BUSHMAN as my executor.
B. Executor's Compensation. Any individual xecutor serving hereunder
shall be entitled to compensation which is commensurate with his r her services to my estate.
Any corporate executor serving hereunder shall be entitled to shall be entitled to compensation
for its services hereunder in accordance with its schedule of charg s in effect from time to time
during the period in which its services are performed.
C. No Bond Required. Under no circumstanc s shall any personal
representative appointed hereunder or otherwise be required to po t bond in any jurisdiction.
SEVENTH: Provisions for Minors. I authorize my exe utor to give any property,
whether principal or income, which vests in a minor by reason of y death, to such person
(including to my executor), as my executor may determine, as Cus odian under the applicable
state's Uniform Transfers (or Gifts) to Minors Act, as the case may be. For purposes of this
Article, a minor shall be any person under the age of 21.
EIGHTH: Headings. The bold headings used throug out this Will are for
convenience only. I do not intend such headings to be used in the construction and
interpretation of this Will.
Page 3 of 5
- ___._------p-__n__
WITNESS my hand this
60n
day of
,2005.
f~(
GAYLE R. EAGER
(SEAL)
Signed, published and declared by the above named testa or, GAYLE R. EAGER, as the
testator's last Will in the presence of us who at the testator's reque t, in the testator's presence
::hCV'~
Name
(;r, HD({}f'0j;J (
and in the presence of each other have hereunto subscribed our n mes as witnesses.
'AMY ~. ~
Name'
Page 4 of 5
AFFIDAVIT OF WITNESSE
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF DAUPHIN )
We, GAYLE R. EAGER, :JOrn ~ (}~ HoT ( , anc;t
AlY''f t;:_ r;v,r ' testator and witnesses, respectiv Iy, whose names are signed
to the attached or foregoing instrument, being first duly sworn, do ereby declare to the
undersigned authority that the testator signed and executed the in trument as the testator's last
Will and that the testator signed willingly, and that the testator exe uted it as the testator's free
and voluntary act for the purposes therein expressed, and that eac of the witnesses, in the
presence and hearing of the testator, signed the Will as witnesses nd that to the best of his or
her knowledge the testator was at that time eighteen years of age r older, of sound mind, and
under no constraint or undue influence.
GAYLE R. EAGER
is (
TESTATOR
WITNESSES
IS'
Is
Subscribed, sworn and acknowledged
before me by GAYLE R. EAGER, the
testator ~ subscrib d and sworn to ~re
me by ~6
and
this
, witnesses,
,2005.
,,~i~~~t6
o ary Public
MY COMMISSION EXPIRES:
81194
Page 5 of 5
Notarial Seal
PaUine Patti Thomas. Notary Pubnc
OtyOt~~ ~ County
My Commission Expires Mar. 24, 2007
, Pennsylvania Association Of Notaries
1\