HomeMy WebLinkAbout12-15-06
..
REV . 1100 EX + (1.00) (
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFiCLLc us:: !JIC.
FILE NUMBER
21 06 0964
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
*'
. .
COMMONWEAlTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
I-
Z
W
o
w
U
w
o
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Chronister, Virginia R
200-09-2298
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
10/13/2006
11/08/1919
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
~ 1. Original Return
D
~
D
5. Federal Estate Tax Return Required
D 3. Remainder Return (date of death prior to 12-13-82)
D
o
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
W
I-
:.::!Ul
ua::.::
wlLU
:1:00
ua:.J
lLm
lL
<(
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after
12-12-82)
6. Decedent Died Testate (Attach copy D 7. Decedent Maintained a Living Trust (Attach
of Will) copy oITrust)
9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date of death between
12-31-91 and 1-1.95
THIS SECTION MUST BE COMPLETED~ ALL CORRESPONDENCE ANDCONFIDENTIALTAX INFORMATION SHOULD BE DIRECTED TO:
AME COMPLETE MAILING ADDRESS
Bradley L. Griffie
4. Limited Estate
I-
Z
W
o
z
o
lL
IRM NAME (If applicable)
Griffie & Associates
200 North Hanover Street
Carlisle, PA 17013
(1 ) None
(2) None
(3) None
(4) None
(5) 100.00
(6) 2,567.20
(7) None
(")
~O
'=;:J ;;g
:"'1-'- (")
::0 -I- r-
c:~m
.'0" ~;D
':,7 (f)::::"
:JOO
(.-, 0 ....,
,;-<c
~._j :0
::'O-t
)>
LEPHONE NUMBER
717/243-5551
OFFiCI,d USE f'Wl4,
~
c::;:)
c:II"\
o
,..,
("")
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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)
D 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)
CJ1
-0
:x
N
.-
o
CJl
.~-.
~o/
.. "
(8)
2,667.20
(9)
(10)
9,294.30
852.02
11. Total Deductions (total Lines 9 & 10)
(11 )
insolvent
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 (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
10,146.32
SEE INSTRUCTIONS ON. REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z .045 (16)
0 16.Amount of Line 14 taxable at lineal rate x
~
:;)
lL 17.Amount of Line 14 taxable at sibling rate x .12 (17)
:E
0
U
~ 18. Amount of Line 14 taxable at collateral rate x .15 (18)
I-
19. Tax Due (19)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
20. D
~i"~,Y'lt;;.~:::;';~~li'; .;~~ BE SURE: TO'A'NSWER' ALL QUESTIQNSON REVERSE SIDE AND RECHECK MATH << ..
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
. .
"
Decedent's Complete Address:
STREET ADDRESS
262 Steelstown Road
CITY
-I STATE PA
/ZIP 17241
Newville
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
Total Credits (A + B + C)
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty (D + E)
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
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.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1 )
(2)
0.00
(3) 0.00
(4)
(5) 0.00
(SA)
(58) 0.00
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.................................................................................. ~I ~
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?...................................................................................................................... D C81
D ~
D C81
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?............................... .............................................. ................. .......................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
262 Steelstown Road
Newville, PA 17241
200 North Hanover Street
Carlisle, PA 17013
DATE
/tX-/l!-tb
DATE
tr~fJ1i&"~1I 1II!~~_~~l'~lillti,'1i1ll~~j~t.~I~~~~~~'!lidliH~~~:u8~~~Di*~1t;~st;lti
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) (il)]. The statute does not exemot 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 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 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.
.
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Chronister, Virginia R
FILE NUMBER
21 - 06 - 0964
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 DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Cumberland County VA Widows benefit 100.00
TOTAL (Also enter on Line 5, Recapitulation) 100.00
.
'*
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Chronister, Virginia R
I FILE NUMBER
21 - 06 - 0964
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
Roxann V. Lehman 262 Steelstown Road Daughter
A Newville, PA 17241
JOINTLY OWNED PROPERTY:
LETTER DATE ~~SCR1PT.IO~ ~F PRcmERTY DATE OF DEATH %OF DATE OF DEATH
ITEM Include name 0 manclalms ItU Ion an Dank account number
NUMBER FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET DECD'S VALUE OF
TENANT JOINT INTEREST DECEDENT'S INTEREST
estate.
1 A 12/11/2000 Checking Account # 34-02126 5,134.40 50% 2,567.20
TOTAL (Also enter on line 6, Recapitulation) 2,567.20
.
'*
SCHEDULE H
RJNERAL EXPENSES &
ADMINISTRATIVE COSlS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Chronister, Virginia R
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 - 06 - 0964
ITEM AMOUNT
NUMBER FUNERAL EXPENSES: DESCRIPTION
A. 1 I Ewing Brothers Funeral Home, Inc. 6,546.30
2 West Minister Cemetary 1,150.00
(opening / closing)
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Griffie & Associates 1,500.00
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 98.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1
TOTAL (Also enter on line 9, Recapitulation)
9,294.30
. .
'*
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Chronister, Virginia R
FILE NUMBER
21 - 06 - 0964
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Final Billing - Green Ridge Village 852.02
TOTAL (Also enter on Line 10, Recapitulation) 852.02
~
. ,
Attachment for Schedule F
.".
L..
(l)
Ui
'c
0
L..
<3
Ii <0
0
--
.!!1 C")
c .,-
--
'OJ 0
L.. .,-
:>
Q) ..c
E ~
(/) ('C!
c ('C! Q)
0 20
:;:; '- -
('C! Q) 0
::l E Q)
('C! 0 ~
> ...... ('C!
(/) 0
..c ::l
~ U
('C!
Q)
0
-
0
<D
~
('C!
0
1:':
(l)
c
$
0
C .....
::J (l)
0 ~ c
C,) <'il
C,) C ,-
<.( o c
.....~
~ 0)
O....l
0::>
<'il c
:S ~
CT.\X
.!::: 0
>0:
(l) 0
C,) -.::t
c ..,f
<'il
ro C")
..-
co liJ-
ro
"0
I- ~
C C")
~
"0 .,-
0)
::J
U
U
<.( CA-
r-
0) 00
U N
C C")
<'il .,-
(ij liJ
co
~
(l)
m
0 c
(l) 0)
rJ'J 0..
~ 0
u~
rJ'J
0)0
......0
<'il--
O~
cN
0).,-
0..
0
L..
0)
...0
E <.0
::IN
Z"-
N
-0
c ,
::J.q-
OC")
U
U
<.(
Q) OJ
o..c
>- '-
I-.Y.
U
- 0)
U..c
~U
I
I
I
I
I
I
I
I
I
I
I
i
I
\ I
. I
i,- I
, )- : ) I
,\1-; (i
i\'t! I
~ ," i
\ ' i
r\' {
\ r
/~ I
\: ' i
~~~-.~
~ 1
I'"'
~,.
1Ea5t )IiI! anb illt,la11ttttt
OF
VffiGINIA R. CHRONISTER
o (p - c, (p L/
C]
I, VffiGINIA R. CHRONISTER of 262 Steelstown Road, Newville,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this to be my Last Will and Testament,
hereby revoking and making void all previous Wills and Codicils heretofore made by me.
I order and direct my Executor hereinafter named to pay all of my just debts,
this purpose.
G:RIFFIE 8: ASSOCIATES
A~RNlls6f*AW
200 NORTH HANOVER STREET g
CARLISLE, PENNSYLVANIA 17013 CHAMBERSBURG PENNSYLVANIA
funeral expenses and expenses involved or connected with the administration of my estate
as soon after my death as is reasonably possible. However, my Executor need not
f."
'\ ; accelerate and pay those unmatured obligations which, in his, her or its opinion, it might
FIRST
be proper and more advantageous to retain or renew and pay as they become due and
payable. If I do not own a buriai plot or a grave marker at the time of my death, I
authorize my Executor/Executrix, in his, her or its sole discretion, to purchase a burial plot
and to erect a suitable grave marker at my grave, and to expend sums from my estate for
(..~)
0"
SECOND
I give, devise and bequeath my entire estate of whatever nature and wheresoever
situate, together with all insurance proceeds thereon, to my beloved daughter, ROXANN
v. LEHMAN, providing that she survives me by sixty (60) days.
THIRD
Should my daughter predecease me or die on or before the six'tieth (60) day
following my death, then I give, devise and bequeath my entire estate of whatsoever
nature and wheresoever situate, together with all insurance proceeds thereon, in equal
,-..., I;
',,:
~, j
'.0- 1
'J.\ i
t~.
shares to my granddaughters, KARISA J. LEHMAN and STACY E. LEHMAN, who
f
~
sUIvive me by sixty (60) days, per stirpes. I direct my ExecutorlExecutrix to divide
r-
(,
;;.
....
among such beneficiaries all personal property of a sentimental or family nature (excluding
~
. '-"
cash, stocks, bonds and the like), including but not limited to jewelry, household goods,
\ \,
~ antiques, furniture and memorabilia, in accordance with a separate memorandum which I
-'
~C'
r"
::'J
.....
".
\
<-..'
F>"..
" '
may place with my Will or deposit with my attorney. In the absence of such disposition by
memorandum, I direct that the said tangible personal property be divided between my
residual beneficiaries with due regard for their personal preferences in as nearly equal
shares as practical, with the value of such dispositions being credited to the share of each
respective recipient. If the said beneficiaries do not agiee to the division of the personal
property provided for hereunder, the decision of my Executor/Executrix, including the
decision to sell the property at public or private sale and distribute the proceeds therefrom
as provided hereinafter, shall be final and conclusive on all parties.
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 2 of8
38 N. Main Street
Chamhersburg, PA 17201
FOURTH
I grant my Executor/Executrix the following powers in addition to and not in
limitation of such powers as my Executor/Executrix shall hold by law:
(a) To retain all property received including the stock of any corporate fiduciary
acting hereunder, provided such property remains productive.
(b) To join in any corporation, partnership, recapitalization, merger, reorganization
or voting trust plan; to delegate authority with respect thereto; to deposit
r .
investments under agreements and pay assessments; and generally to exercise
h
'(1
'I'
f"
\
--'
all rights of investors, including but not limited to, the voting of shares.
(c) To manage, operate, repair, improve, mortgage or lease on any terms any real
r-..
~.
...
estate held or owned by my estate.
?":).
'. ,,>
(d) To operate any business that I may own at my death.
~~.
~. -
".
'...j
( e) To invest any funds of my estate in any stocks, bonds, notes or other securities
-,
1'<
!'. .
K
~,,,,-t
..;\
or property, real or personal, without regard to the principle of diversification
or any other statute or general rule of law in his, her or its absolute discretion,
it being my intention to give my ExecutorlExecutrix the broadest investment
powers possible, providing such investments do not unnecessarily prevent the
prompt settlement of my estate.
(f) To sell or otherwise dispose of any property, real or personal, tangible or
intangible, at any time forming a part of my estate in any manner and on such
terms and conditions as my ExecutorlExecutrix shall see fit in his, her or its
absolute discretion.
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 3 of8
38 N. Main Street
Chambersburg, PA 17201
(g) To borrow money for the payment of taxes or for any other proper purposes in
the administration of my estate, and to mortgage or pledge estate assets as
security.
(h) To compromise claims without court approval including, but not limited to,
any controversies with the United States of America or the Commonwealth of
Pennsylvania concerning estate and inheritance taxes on any interests that may
J
pass under this my Last Will and Testament.
\
\'"
. \l ,
--;.'
\'-
S
'"
;.....
~~
(i) To distribute in cash or in kind upon any division or distribution of my estate.
G) To undertake any and all acts deemed necessary and proper by my
:;r-'4.
--'
Executor/Executrix for the proper, advantageous and prompt management of
h
I
1 '.~
the settlement of my estate.
~ --
,~
(\i
""
~
I~
~
~
~
\.'
(k) In general, to exercise all powers in the management of my estate which any
individual could exercise in the management of similar property owned in his
own right, upon such terms and conditions as to him, her or it may seem best
and to execute and deliver all instruments and to do all acts which he, she or it
deems necessary or proper to carry out the purposes of this, my Last Will and
Testament.
FIFTJI
No interest of any beneficiary of my estate, either in income or in principal, shall be
subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any
beneficiary have the power in any manner to charge or encumber his interest either in
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 4 of8
38 N. Main Street
Chambersburg, PA 17201
income or principal, nor shall the interest of any beneficiary be liable or subject in any
manner while in the possession of my Executor/Executrix for the liability of such
beneficiary .
SIXTH
I nominate, constitute and appoint my daughter, ROXANN V. LEHMAN, as
Executrix of this my Last Will and Testament. In the event my daughter is deceased,
unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I
nominate, constitute and appoint KARISA J. LEHTvlAN and STACY E. LEHMAN as
Co-Executrices of this my Last Will and Testament.
I direct that my Co-
(',- \
f!:
Executrices/Executrix shall not be required to give or post bond for the faithful
-" h..
'r~
\
'-l
performance of his, her or its duties in this or any other jurisdiction.
:'\
~~'
SEVENTH
..........
---
I hereby declare it to be my expressed desire that my Executor/Executrix employ
~-
~.
t....
~
.......
~9
~
the law firm of Griffie & Associates, of Carlisle, Pennsylvania, for legal advice and
assistance regarding this my last Will and Testament, they having considerable knowledge
~
~.", ]"
~
of my affairs, views and wishes respecting any matters that may arise at the probate of this
instrument, the administration of my estate, and the execution of the powers herein
mentioned.
No interest of any beneficiary of my estate, either in income or in principal, shall be
subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any
beneficiary have the power in any manner to charge or encumber his interest either in
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 5 of8
38 N. Main Street
Chambersburg, PA 17201
income or principal, nor shall the interest of any beneficiary. be liable or subject in any
manner while in the possession of my Executor/Executrix for the liability of such
beneficiary ,
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last
Will and Testament, consisting of eight (8) typewritten pages, the first five (5) of which
,..- . .;t..
bear my signature on the side margin, for purpose of identification, this t:) I .
,/ "i '-f-
da\l of I /.. ..... .
J l~-...',,~ '(d.:.. ,)..:. ,'/.1..,- u~../
.J
, 2001.
WITNESS:
~----: ~-,:---;;
/;.--)( ,,:,':':-',?-;~~!
~..:-:~;~>~;/ ~;'~:' ./
L
r-, .' I -.....'
. ,-- '_.."" ~:'.-Y"rpt. "~~'/~.J ,,~.__~, Ie" .'.It ,1~.: <:. . ....r" ~c..,.-.,~ .i:' .--;,,-
VIRGINIA R CHRONISTER
~- /' /)
T' ('
. r k:. ir.:..!\ 'u )~
C. Y
.~ /~. -.(_.. c',
n (~ ~,..~l
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 6 of8
38 N. Main Street
Chambersburg, P A 17201
ACKNO'''LEDGMENT
COMMDNWEAL TH OF PENNS\'L VANIA:
: SS.
COUNTY OF CUMBERLAND
I, VIRGINIA R CHRONISTER, the 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 and Testament;
that I signed it willingly, and that I signed it as my free and voluntary act for the purposes
therein expressed.
~ : i'~' J, ( 'l>
< -""'~~""-CA:'-- fl /Jjjz/r'h_.""-<!.:/< ' I
viRGlNIA R. CHROl\1JSTER
Sworn or affirmed and acknowledged before me by VIRGINIA R.
CHRONISTER the Testatrix this
'J, ..../.:
i.:,_i./ ..;.~~
day of
".,f-'" '.
,.-' ./ l
(i /i~i ~f,~>,~/.^-j,;1""
~ - /j
,.--",/
2001.
/----1
00 /
!,,/ !
l~,; !,,"{L -,-?
I'
2 ;.
. ,/\-1 -,' I
- , ./ i .', ! ~.c;'
-' ~{-.!.- 'l-...-. V'-,(
/} -
/ I
1../
f-~----;'7;ria;SeEl' --I
~ RODin J. Goshom. !-Jotary Public
t . Carlisle Boro, Gumberland County
L~~!~~~:~i:~i~::~~::::.~s Apr 17, 2003
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 7 of8
38 N. Main Street
Chambersburg, P A 17201
AFFIDA VIT
COMMONWEAL TH OF PENNS\TL VANIA:
: SS.
COUNTY OF CUMBERLAND
\VB,
'7 '
~t) :.' ~._...-:~r1 {.c_
',.....;:.~. .,:;: ~
and
!' ! I
I' .\1. r.. ,
,,, L. ! ,I I L, \
(
I~l ,L ,
11.11,,, '(",-,
the witnesses whose names are attached to the foregoing document, 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 Testament; that she signed willingly and that
she executed it as her free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the Testatrix signed the Last Will and
Testament as witnesses and that to the best of our knowledge the Testatrix was at the time
18 or more years of age, of sound mind and under no constraint or undue influence.
and
l/, P ,./ , h
f )10'::12:" ! HiL" i 'j
~
~/r~~~
,/ ' /<;;7~e :;::>:_::~~::,(:f/ ,,/
? ~'.~. /~ j1.
W~l// .;.. ,(/J',/I. j, r.
!. _~' i. Itl/t'-..,. elL I of i,f ."e-c.]
-- I 1..-) l /'
"-, ~- /' (" ,
Sworn or affirmed and subscribed before me by '-,r:.:rri' ::-!r(~A' l. t<:-1' 114~.,;
.->r <<.{.- '/}J j
this ~. '5. ...u- day of Ll ti ?;i;>J" .-
,J
, 2001.
,/--j ,,'" eo- L(
.-l:'~..hj..:, ;,./ .i.."~.~;,.;ji_ (7....j .j
Notafy Public) ,
r-----=--.., ,
! ' .". Notariai Seal
! ?fiO~1rr J. Goshorn, '''oiary Public
r . ~,~riISle ~oro, q,umberland CountY
f M~ .:::ommlSStorl EXplf',9S Apr 17, 2003
. .y._---..,........,...~..-........,..._.............<:~-
200 N. Hanover Street
Carlisle, PA 17013
GRIFFIE & ASSOCIATES
Attorneys At Law
Page 8 of8
38 N. Main Street
Chambersburg, PA 17201