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Home My WebLink About10-02-07 (2) --.J REV -1500 EX (06-05) P A Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 15056041158 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year 21 07 File Nu mber 0202 ENTER DECEDENT INFORMATION BELOW Social Security Number 036-01-9164 Date of Death 02232007 Date of Birth 06011918 Decedent's Last Name ERNO Suffix Decedent's First Name EVA MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW [K] 1. Original Return o 4. Limited Estate [K] 6. Decedent Died Testate (Attach Copy of Will) o 9. Litigation Proceeds Received Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required D.- 8. Total Number of Safe Deposit Boxes Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD C. SNELBAKER 717-697-8528 o 2. 04a. 07. 010. Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy of Trust) Firm Name (If Applicable) SNELBAKER & BRENNEMAN, P.C. REGISTER OF WILLS USE ONLY , .~.~... First line of address 44 WEST MAIN STREET C-::J C"',} -....; I r.~; Second line of address ,; p.o. BOX 318 c..:) '11 City or Post Office MECHANICS BURG State PA ZIP Code 17055 C) CO Correspondent's e-mail address: 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 which preparer has any knowledge. Ie, VA ~ MAIN STREET MECHANICSBURG, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041158 6M4647 2,000 15056041158 --.J .-J 15056042159 REV-1500 EX Decedent's Name[ R N 0 RECAPITULATION 1. Real estate (Schedule A) 2. Stocks and Bonds (Schedule B) . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C). 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) 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). 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) Decedent's Social Security Number 036-01-9164 EVA . 1. 125900.00 . 2. 0.00 . 3. 0.00 . 4. 0.00 . 5. 1763.00 . 6. 2749.05 . 7. 0.00 . 8. 130412.05 . 9. 26120.29 10. 24246.72 11. 50367.01 12. 80045.04 13. 0.00 14. 80045.04 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers u:1ger Sec. 9116 (a)(1.2) X .0_ 0 . 00 16. Amount of Line 14 .taxable at lineal rate X .0':U;! 80045 . 04 17. Amount of Line 14 taxable at sibling rate X .12 0 .00 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042159 6M4648 2.000 15. 0.00 16. 3602.03 17. 0.00 18. 0.00 19. 3602.03 []] 15056042159 .-J REV-1500 EX Page 3 File Number 0202 Decedent's Complete Address: DECEDENT'S NAME ERNO EVA STREET ADDRESS MESSIAH VILLAGE, 100 MT. ALLEN DRIVE UPPER ALLEN TWP., CUMBERLAND COUNTY CITY I STATE I ZIP MECHANICSBURG PA 17055- Tax Payments and Credits: 1 . Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3602.03 0.00 0.00 0.00 Total Credits (A + 8 + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.00 TolallnlerestlPenalty (D + E) (3) 4. If line 2 is greater than line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3602.03 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 3602.03 Make Check Payable to: REGISTER OF WILLS, AGENT 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes D o D o D D o No [Xl 00 [K] [X] 00 [K] [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. F or 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 three (3) percent [72 P.S. 99116 (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 zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a survivin9 spouse from tax, and the statutory requirements for disclosure of assets arId filing a tax return are still applicable even if the SUrviving spouse is the only beneficiary. F or 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 use of a natural parent. an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in 72 P.S. 89116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(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. 6M4671 1.000 REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FilE NUMBER Eva Erno 21 07 0202 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value ;s defined as the price at which property would be exchanged between a willing buyer and a willing selier, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION NUMBER 1. Property known and numbered as 404 East Coover Street, Borough of Mechanicsburg, Cumberland County, Mechanicsburg, PA 17055, sale value (see attached settlement sheet) VALUE AT DATE OF DEATH 125,900.00 TOTAL (Also enter on line 1, Recapitulation) $ 125,900.00 3W4695 1.000 (If more space is needed, insert additional sheets of the same size) A. S.ettlement. Statement U,S, Department of Housing and Urban Development OMS Approval No. 2502-0265 B. Type of Loan 1. [ ] FHA 2. [ ] FmHA 3.[ X] Conv. Unins. 6. File Number: 4. [ ] VA 5: [ ] Conv. Ins. 400700907-CB 7. Loan Number: 8. Mortgage Insurance Case Number: 0044408813 C. NOTE: This form Is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside of lhe closing: lhey are shown here for infoonational purposes and are not included in the tolals. O. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender DANIEL J. REEDY JOHN W. ERNO, CO-EXECUTOR AND ERA HOME LOANS SUSAN J. ERNO, CO-EXECUTOR OF 3000 LEADEN HALL ROAD, ESTATE OF EVA ERNO MOUNT LAUREL, NJ 08054 907 APPLE DRIVE MECHANICSBURG, PA 17055 4100 CARLENE COURT ENOLA, PA 17025 G. Property Location H. Settlement Agent 404 EAST COOVER STREET, SECURED LAND TRANSFERS - MECHANICS BURG MECHANICSBURG, PA 17055 Place of Settlement I. Settlement Date 06129/2007 COUNTY: CUMBERLAND 19 NORTH BALTIMORE ST Disbursement Date 06129/2007 PARCElID: 17-24-0789-018 DILlSBURG, PA 17019-1354 TOWNSHIP: MECHANICS BURG BOROUGH J. SUMMARY OF BORROWER'S TRANSACTIONS K. SUMMARY OF SELLER'S TRANSACTIONS 100. Gross Amount Due From Borrower 400, Gross Amount Due To Seller 101. Contract Sales Price $125,900.00 401. Contract Sales Price $125,900.00 102. Personal Property 402. Personal Property 103. Settlement Charges to Borrower $5,143.35 403. Adjustments For Items Paid By Seller In Advance Adjustments For Items Paid By Seller In Advance 113. CityfTown Taxes 413. CityfTown Taxes 114. County Taxes 562.18/yr 6/29/2007 to 1/112008 $286.48 414. County Taxes 562.18/yr 6/29/2007 to 1/112008 $286.48 115. School Taxes 1,536.26/yr 6/2912007 to 7/112007 $8.42 415. School Taxes 1,536.26/yr 6/2912007 to 7/112007 $8.42 118. Assessments 418. Assessments 119. 419. 121. Sewer 1 Refuse (April 1 May 1 June) 2007 106.821qtr $2.35 421. Sewer / Refuse (April 1 May / June) 2007 106.821Qtr $2.35 for 6/29/2007 to 7/112007 for 6/29/2007 to 7/112007 120. Gross Amount Due From Borrower I $131,340.60 420. Gross Amount Due To Seller I $126,197.25 . 200. Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seller 201. Deposit or Eamest Money $1,000.00 501. Excess Deposits 202. Principal Loan Amount from ERA Home Loans $80,750.00 502. Settlement Charges to Seller $9,800.20 203. Existing Loan(s) Taken Subject to 503. Existing Loan(s} Taken Subject to Adjustments For Items Unpaid By Seller Adjustments For Items Unpaid By Seller 210. 510. 211. 511. 212. 512. 213. CityfTown Taxes 513. CityfTown Taxes 214. County Taxes 514... County Taxes 218. Assessments 518. Assessments 219. 519. 220. Buyer's Total Credits 300. Cash At Settlement FromlTo Borrower 301. Gross Amount Due From Borrower (line 120) 302. Less Amounts Paid BylFor Borrower (line 220) $81,750.00 520. Seller's Total Charges 600. Cash At Settlement To/From Seller $131,340.60 601. Gross Amount Due To Seller (line 420) $81,750.00 602. Less Deductions In AmI. Due To Seller (line 520) I $9,800.20 I I I I $126,197.25 $9,800.20 303. Cash [ X ] From [ ] To Borrower $49,590.60 603. Cash [X] To [ ] From Seller $116,397.05 \', 400700907 - CB l. Settlement Statement Page 2 700. Total Sale Commission 125900.00 @ 6 % = 7554.00 Division of Commission (line 700) As Follows: Paid From Borrower's Paid From Seller's 701. $3802.00 to ReMax Realty Associates Funds At Settlement Funds At Settlement 702. $3752.00 to ERA-NRT. Inc. 703. Commission paid at settlement $7.554.00 708. Transaction Fee to ReMax Realty Associates $150.00 709. Broker Administrative Fee to ERA-NRT, Inc. $165.00 800. Items Payable In Connection With loan 801. loan Origination Fee 1.00000% to ERA Home loans $807.50 802. loan Discount 803. Appraisal Fee 804. Credit Report to FNMA CBC (PaC 19.95 by Lender) 805. lender Inspection Fee 810. Document Preparation to ERA Home Loans (PaC 85.00 by Lender) 812. Flood Cert. Fee to Stars (PaC 19.50 by Lender) 815. Application Fee to ERA Home Loans (PaC 500.00 by lender) 900. Items Required By lender To Be Paid In Advance 901 . Interest from 6/29/2007 to 711/2007 @14.4200/day $28.84 902 . Mortgage Insurance Premium 903 . Hazard Ins. Premium to Erie Insurance Company (PaC 378.0000 by Buyer) 904 . Flood Ins. Premium 1000. Reserves DeposIted With lender 1001. Hazard Ins. Reserve 3 mo @ 31.50/ mo ERA Home Loans $94.50 1002. Mortgage Ins. Reserve 1003. City Property Taxes 1004. County Property Taxes 5 mo @ 46.85/ mo ERA Home loans $234.25 1005. School Taxes 12 mo @ 128.02/ mo ERA Home Loans $1.536.24 1010. Aggregate Accounting Adjustment from ERA Home loans -$328.73 1100. TItle Charges 1101. SettlemenVClosing Fee 1102. Abstract or Title Search 1103. Title examination 1104. Title Insurance Binder 1105. Document preparation Deed Preparation to ReMax Realty Associates $125.00 1106. Notary fee to Cash $20.00 . $10.00 1107. Attorney Fee 1108. Title Ins. Tolalto Secured Land Transfers - Mechanicsburg $988.75 1109. Lender's Coverage $80750.00 ($) 1110. Owner's Coverage $125900.00 ($988.75) 1111. Endorsements-100/300/900 ($150.00) to Secured Land Transfers - Mechanicsburg $150.00 1119. Wire Transfer Fee to Secured Land Transfers - Mechanicsburg $35.00 1127. Electronic Delivery & Handling Fee to Secured Land Transfers - Mechanicsburg $50.00 1138. Processing/Tax Cert. to Secured Land Transfers - Mechanicsburg $10.00 1200. Government Recording And Transfer Charges 1201. Recording Fees for Deed 38.50; Recording Fees for Mortgage 64.50 $103.00 1202. City/County Tax/Stamps 1259.00 $1,259.00 1203. State Deed Tax 1259.00 $1.259.00 1300. Additional Settlement Charges 1305. 2007 CountylTownship Taxes to Barry L. Heckerd. TC $618.40 1306. Tax Receipts to ReMax Realty Associates $5.00 1307. Overnight Mail Fee to Becky Yost $24.00 1308. Sewer Overages (April/ May / June) 2007 10 Mechanicsburg Borough Office $44.80 1400. Total Settlement Charges $5.143.35 $9.800.20 I have carefully reviewed the HUD-1 Seltlement Statement and to the best of my knowledge and behef It is.true and accurate statement of all receipts and dIsbursements made on my account or by me in this transaction. I further certify that J have received a copy of the HUD-1 Settlement Statement. BUY~S DanielJ.Lv ~ SELLERS The HUD-1 Settlement Statemenl which I have prepared is a true and accurate a accordance with this statement. _"-Agent C ' t:M. I" tf)..P k' Y 0--/1. . ,.: tu.~, L SECURED LAND TRANSFERS - MECHANICSBURG J: E:ev,J : Susan J. Erno, Co-Executa nt of this transaction. I have caused or will cause the funds to be disbursed in Date 06/29/2007 REV-1508 EX + (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Eva Erno FILE NUMBER 21 07 0202 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 NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Household goods retained by family (see attached sheet) 960.00 2 Internal Revenue Service refund on 2006 Income Tax Return 803.00 3W46AD 1.000 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,763.00 Est.4t& of Ev~ &rrlo ~ / 'C).co j.j/JILJ IJtl)/j~ I ~~. bD ~ '<bb 15t>.oo Pl~ L - '/J.c: ?If. /) D .-J / .. .. R EV-1509 EX + (6-98) COWMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDeJT ESTATE OF SCHEDULE F JOINTL V-OWNED PROPERTY FILE NUMBER Eva Erno 21 07 0202 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 RELA TIONSHIP TO DECEDENT A Erno, Paul J 5004 Virginia Avenue, Harrisburg, PA 17109 Son iHP,l- Additional note - Th ~ funds from the j oint accounts liste( below were used to pay e:tate obligations. JOINTL Y.QWNED PROPERTY: LETTER DATE DESCRIPTION OF PROA:RTY %OF DA TE OF DEA TH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DA TE OF DEA TH DECO'S VALUE OF NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENl'S INTEREST 1 A 2/1/2001 Members First Federal Credit Union 2,001.21 50.0000 1,000.61 life savings, account #5860-04 2 A 9/7/1998 Members First Federal Credit Union 128.00 50.0000 64.00 checking account, #5860-11 3 A 9/7 /1998 Members First Federal Credit Union 25.67 50.0200 12.84 savings account, #5860-00 4 A 2/16/1999 Sovereign Bank 3,343.20 50.0000 1,671.60 checking account, #1681723905 TOTAL (Also enter on line 6 Recapitulation) $ 2,749.05 (ff ITOre space is needed, insert add~ional sheets of the sarre size) 3W46AE 1.000 REV-1511 EX.+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Eva Erno ITEM NUMBER A. 8. 1. 1. 2. 3. 4. Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: Funeral Expense luncheon and flowers for funeral Total from continuation schedules ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Snel baker & Brenneman, P. C 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 Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 3W46AG 1.000 7. 1 2 Borough of Mechanicsburg sewer/refuse service Cumberland Law Journal advertising Executors' Notice Total from continuation schedules FILE NUMBER 21 07 0202 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ AMOUNT 673.11 9,568.00 2,775.00 252.00 17 4.02 75.00 12,603.16 26 120.29 Estate of: Eva Erno Item No. 2 3 4 Description Gingrich Memorials memorial engraving Myers Funeral Home, Inc. funeral services Rolling Green Cemetery grave opening 036-01-9164 Schedule H Part 1 (Page 2) Amount 35.00 8,338.00 1,195.00 Total (Carry forward to main schedule) 9,568.00 Estate of: Eva Erno 036-01-9164 Schedule H Part 7 (Page 2) 3 Derrsha Hauling removal of trash from property 85.00 4 Patriot News advertising Executors' Notice 154.62 5 PPL Electric electric service 443.16 6 Register of Wills filing fee for Inheritance Tax Return 15.00 7 Settlement charges associated with the sale of real estate a. Realtors Commission - $7,554.00 b. ReMax transaction fee - $150.00 c. ReMax deed preparation - $125.00 d. Notary fees - $10.00 e. Tax Certification - $10.00 f. Transfer tax - $1,259.00 g. County/Township taxes - $618.40 h. ReMax tax receipt fee - $5.00 i. FedEx fee - $24.00 j. Borough of Mechancsburg sewer- $44.80 9,800.20 8 UGI repair and gas service 893.09 9 United Water Pennsylvania water service 212.09 10 Reserve for filing fees, accounting fees and miscellaneous costs associated with the administration of Decedent's estate 1,000.00 Total (Carry forward to main schedule) 12,603.16 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Eva Erno SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 07 0202 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. AARP Chase Bank credit card debt VALUE AT DATE OF DEATH 1,693.28 2 America Online, Inc. internet service 62.16 3 Bank of America credit card debt 2,426.50 4 Borough of Mechanicsburg sewer/refuse services 191.42 5 Capi tal One credit card debt 8,665.00 6 Comcast Cable cable TV service 152.35 7 Discover Card credit card debt 1,126.00 8 MCI phone service 40.08 9 Messiah Village resident care 9,515.11 10 Mobile X-Ray Imaging, Inc. medical expense 17.84 11 Patriot News newpaper subscription 29.65 12 PPL Electric electric service 150.90 13 UGI gas service 114.00 14 United Water Pennsylvania water service 48.46 15 Urology of Central PA medical expenses 13.97 3W46AH 2.000 TOTAL (Also enter on line 10. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 24 246.72 REV-1513 E:X+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Eva Erno NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Morrow 824 Lisburn Road 1 Carolyn M. The Woods, Suite 106 Camp Hill, PA 17011-7110 One Sixth of Residue: 13,340.84 2 John W. Erno 4100 Caissons Court Enola, PA 17025 One Sixth of Residue: 13,340.84 3 Susan J. Erno 1360 Auburn Drive Charlottesville, VA 2290~ One Sixth of Residue: 13,340.84 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21 07 0202 AMOUNT OR SHARE OF ESTATE Daughter Son Daughter 13,340.84 13,340.84 13,340.84 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 3W46AI 1.000 TOTAL OF PART 11- 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) $ 0.00 Estate of: Eva Erno Item No. Description 4 Thomas R. Erno 2338 Kensington Harrisburg, PA Street 17104 Schedule J Part 1 (Page 2) One Sixth of Residue: 13,340.84 5 Steven H. Erno a/k/a Melyssa Morgan 404 East Coover Street Mechanicsburg, PA 17055 Son One Sixth of Residue: 13,340.84 6 Paul J. Erno 5004 Virginia Avenue Harrisburg, PA 17109 Son One Sixth of Residue: 13,340.84 Son 036-01-9164 Relation Amount 13,340.84 13,340.84 13,340.84 ~ t'-' ~ "~""\ , , f'o rJ \~\~'. \ , I LAW OFFICES SNELBAKER. ;ALEB Be ELICKER LAST WILL AND TESTAMENT OF EVA ERNO I, EVA ERNO, of the Borough of Hechanicsburg, Cumberland County, Pennsyl- vania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will aud Testament, hereby revoking and making void any and all wills by me at any time heretofore made. 1. I direct that all my debts and funeral expenses be paid as soon as practicable after my death by my Executors hereinafter named. 2. I give and bequeath any jewelry owned by me at the time of my death equally to my daughter SUSAN J. ERNO and my daughter CAROLYN M. MORROW. 3. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to my children, their heirs and assigns. I am the mother of six (6) children whose names and dates of birth are as follows: CAROLYN M. MORROW, born June 12, 1942 JOHN W. ERNO, born February 3, 1946 SUSAN J. ERNO, born May 1, 1952 THOMAS R. ERNO, born June 30, 1953 STEVEN H. ERNO, born April 9, 1955 PAUL J. ERNO, born October 26, 195] Should any child of mine predecease me, I direct the share such deceased child would have received shall pass to his or her issue surviving me per stirpes and if there be no such issue then such share shall lapse. 4. I hereby nominate, constitute and appoint my son, JOHN W. ERNO, and my daughter, SUSAN J. ERNO, as Co-Executors of this my Last Will and Testament, and if either of my Co-Executors predecease me or is unab~e to serve, I direct that the other Co-Executor can act as if he or she had been solely appointed. Ii: I further direct that no person serving as Executor or Executrix shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on two (2) pages this 02.:L day of ~' 1983. ~.... ~ ~A. ~ ~~ Eva Erno (SEAL) Signed, sealed, published and declared by EVA ERNO, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. C..' r, V' W OFFICES !ELBAKER, EB ll: ELICKER -2- COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND ) We, EVA ERNO, E. ROBERT ELICKER, II and SUSAN A. McCOY,. the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoin instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last ~il and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his or her knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. () CJ ~';'A&: ~-~ Testatrix (~~ (. . . I' ~ Witness L,,~{ d. '2>1<- '7- . Witness Subscribed, sworn to and acknowledged before me by EVA ERNO, the Testatrix, an subscribed and sworn to before me by E. ROBERT ELICKER, II and SUSAN A. McCOY witnesses, this.;.? ;;{.4t.y day of ~ L:l '-/~uut'7 , 1983. ~." 42.) ~,<t.-u....~J; (!, . ~ Notary Public ~. CATH:~Rirt;; f. flOllS:HJ. MbTI\Ri' PU13UC M[C~-~':ltf.::C::,.2,ijfr.G FiJY<:), CU~i\B[nlf~ND COUfiTV r~fi {;n~\.Hi:ISJiO~~ (}:fLiE~;~ FE~t 27, 198$ Mel\\~;. f")l\nsytvOinia A:;sociation of Notaries ,W OFFICES IELBAKER. Ea & EL.ICKER