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Home My WebLink About11-14-07 ~ 15056051047 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFACIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth Decedent's Last Name Suffix Decedent's First Name (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW C:) 1. Original Return <::) 2. Supplemental Return Cj 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required <:::) 4. Limited Estate <:::) 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) c:> o 8. Total Number of Safe Deposit Boxes ~ 6. Decedent Died Testate c:> (Attach Copy of Will) <:::) 9. Litigation Proceeds Received <:::) C) 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Da time Telephone Number REGISTER OF WILLS USE ONLY ~ = = -.J :z: o ....:; (") Co 3::0 ml(") :0 r c; 93 ZCD;l': a8~ <J_ ~ FILED Correspondent's e-mail address: he amer-cS ~ e;p~,)C. (let Under penalties of perjury, I declare that I have examined this return, including accompanying it is true, correct and complete. Declaration of preparer other than the personal representa!" MI MI +" -0 :x 0:> statements, and to the best of my knowledge and belief, ati f which preparer has any knowledge. DATE SttrANAI€ 1'1f1f!7Jle/JtO~b 170S~ J2'1 ':'1/1, Ave. ~ uJ e,,4IH},er/~ R4l707o DATE Side 1 L 15056051047 15056051047 -...J -I 15056052048 REV-1500 EX Decedent's Name: 7SA~E"{., S. HA/lIJER RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::> Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1:7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. Decedent's Social Security Number o B. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 1'1. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .. . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .O~ . () 0 15. 16. Amount of Line 14 taxable at lineal rate X .O~ 10 I J,. 7 . 7 ~ 16. 17. Amount of Line 14 taxable at sibling rate X .12 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 . () 0 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 'ldf-j()j 15056052048 7 I.{.l/ 7./f9 10 r;{1~7:l. /0 . c::> 15056052048 -I ,-15f1O EX Page 3 File Number )../- (), - If {)ft? Decedent's Complete Address: DECEDENT'S NAME :I.sAfjEl. S. /lII-IUJET< STREET ADDRESS 3/CJ ~,flnN ST CITY LE!HOYN/F "'", ZIP /7 () 'It.3 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 4SS.75"' f!) o - ----..-" -"-- ---0---- Total Credits (A + B + C ) (2) o 3. Interest/Penalty if applicable D. Interest E. Penally f) _____....___" ___n_ ___ ______.___ e (3) 0 (4) 0 (5) I Lf~ fi". 1~ (5A) fao,'1'1 (5B) ~SI".1'" ---.- -- ..-------- Total Interest/Penally ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, 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 thl~ interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. 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: 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 income; ............................................ 0 181 c. retain a reversionary interest; or.......................................................................................................................... 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? .............................................................................................................. 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-probate property which contains a beneficiary designation? ........................................................................................................................ 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 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 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 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. 99116(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. REV.I503 El<' (1.91) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I-IAIl/JI:7e, /5A~tL 5. FILE NUMBER 21-0~ -9/)~ All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 4:Jf. ~hA.t~S d CDMW\Ol1 stoc.k Souf),AJt~t (;.a,S Cbrp. (.5W-X) hi ~s.r>4 10 ,1Lf.S1> o..ve. qJric.~ ":LV.77 )( i.f3f&, =- (S&J. i;.51r>r/c4! valuo:h'DfJ do.fa. atta.Ghed) VALUE AT DATE OF DEATH 'I J D, 7'1'1. 7J.. TOTAL (Also enter on line 2, Recapitulation) $ I D, 7 q 9.. 7:!- (If morA sn;lC":A is nAArlP.li insArt ::lrlrlitinn::ll "hoot" nf tho ""mo ";70\ SWX: Historical Prices for SOUTHWEST GAS CP - Yahoo! Finance 10/30/200704:06 PM Yallool IN:evvatJaer? lSlrghUl)1lcStgn In Help Make Yl your home page .. .....-,.- - - - ..{~.., I, ~ t\., Web Search 1:. 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All information provided "as is" for informational purposes only, not intended for 1ttp: Ilfinance.yahoo.com / q/ h p?s=SWX&a=04&b=2&c= 2 005&d =04&e= 2&f= 2005&g =d Page 2 of 3 SWX: Historical Prices for SOUTHWEST GAS CP - Yahoo! Finance 10130/2007 04:06 PM trading purposes or advice. Neither Yahoo! nor any of independent providers is liable for any informational errors, incompleteness, or delays, or for any actions taken in reliance on information contained herein. By accessing the Yahoo! site, you agree not to redistribute the information found therein. 1ttp:llfinance.yahoo.com/q/hp?s=SWX&a=04&b=2&c=2 OOS&d =04&e= 2&f= 200 5&g=d Page 3 of 3 REV-l50B EX' (1-97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I-Ilfll /J I::7eJ 1S,1-/Ja s. FILE NUMBER 2. / - /)/s, - ~.?, 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 1. DESCRIPTION VALUE AT DATE OF DEATH 11, 3'17. ()f) I/l/YG'N71)/2Y {)j: /JE/fSIJ/l/lJiry Jet; /7Ehllz.A. 7/~N A- TrA-t!HE.IJ. ~. fJre... fJt:t;tI /JUN' IZ/ Hlnt( "I lIew h.t Ad aI' tUlHkr/q~u/ /lz;fAel1!prt!5 ~ne1"41 .". 5, 3 7 r, ~9 f ::Tit#> hOlt.: De.ceoltni ...)It 50 e.lchrly A-t\cI no1e ; r'I CDn }.,.ol o-P her own thone.y a1- t<<t. -I;M~ f)t h!,... dea.tt. 4.nd he,]d .,,, CCt ~h , TOTAL (Also enter on line 5, Recapitulation) $ ~ I 775.1/'1 (If more space is needed, insert additional sheets of the same size) I i I I I Rs,?: O~ kA-~/Jc~/ /S'46EL S, i I I ..( 17t/Jj/ZEf) IIfJj/tFNl7;/t.Y If)/=. /!€?ft$/)/I,J&7X. /.1 oil b~" 19/rCc/Jhc&'IJ(;J1 ..<'-.1 ia""".ehtl/I'J,,Cllrrelf' 1t/~()qI JIlt2k.$',/ o/lA/)/slt:[e~Je4;J- -l d41'JUt-1" .~c,rXl/J1/c ..r:5Izn~/()/'lJlJ1tlM/1:!tP1en.kt: er4d~ M1d clllmt!c9~e:I... t /J1QI'j,/~ ~~I'~ SS cfft'Vw, el'//.~aI ~ tJ/'di'uJ H/'AIlI( .5:., /?lrlu~jJMi....~ ..liks~~ ...fJtp/!er.. ,. shl411 ,,.~.~/f!A.{ i4~fe./dJPf.n4~t' .~~~~ ltlPkI /J/tL./l!tui!t!J" (2"/ tl/JJp... . 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I Yen~~rS/.!-f1-,)._._._ /3.: II~sf)!:t~sfr!jlJt}~5' .sk~Lthul.;f'/lrh~JJ.~tf:l1~I/.r IL/. 51111111 t?ltlb~~t:~4JIe 7P 0/1 ..n)f~ni.~.(;un'l<va!u~) IS: /&Ir'fert!/Dr , ( ~t1h", u.~) ~J dl 1-06 - !jt:;6 ~ 7LJ- ~t:J ~ ..s-LJt:),4~ ~ 7 s: Of) F;? s: f)() ~IJ. 00 1". ~_O{) 'l.((). o~_ </. /35, 00 I ~..s, Db ~O.D() ~/ ~S, ()O ~ 00.51) ~ ..s; 0-0 ,. /. ,,"0 J'.s-p ,0-0 ~ :z. Sf: or fI~lttJ ee I /S4-/.3l:L s. I I i , I J', I I /7.1 I I It I . /9. I 17~/J1IZE1) /IVIIEN7P~Y OE.I!t!f/f~{)I!!I!? TY C( s.$~l'f~tI lJ1/s~. cI/:.>lJ.~~/;:1bg I ~tf1/15 ~lcl Jf'4~/J~;.JU[t:-hIjSLd aJ- l:uu;n~~ o(d'cle.sk :r tha;", 1-, N ~, I' Small dresser.l. ./'~krfJ/Qsh'c. IVA5te ('fl,n$ ~b, .2/, I . .....\. .; .I~ (e . . ...;~. . .... ....... ...... ... . k:..... . .... .... ...i23. fllti.NPf!t/e~!(4/!I{~t..p.I(!tg . ~1(,... p/,,fl!_~/;i./l~t_ I ~j Sllll/ll{lt'l'l!,a~tR..frt1Ullr:/ .... ~6,.1...t!/~~.1'1!~&'oJ ..rM4/!:'..---... '--....." 21.\.. ...... (b!$.C....~411tlf;,t!lr.._.. . I n~fi;.i....S6P1':f4~. r!J<'~.... ._........ ........ . ~~.(I!II /.1f!t'f",!ttl~I'.... i ! Slhall .d~~5$~':.~.~htll/(IJ1/rrf)rle.~J'ptJel1/A Ilu-rl dl 1 i I I I I .. ...... ..................... . ....1.. ... I ..-... ...... ... ... i'. I .1 I I . 'T I I I I i I I ~/-o6:, -~b ~ ~" Of) ~..~{) 'I () , b{) ~(),()() 'l,C)f) ? ~, I?{/ l' /. IYb ? /.40 ~,,,o ,2, p-o I- :l. Sf) " 2, DO f/ ';,S/) ~"o REV-l509 EX . (1-97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 1 I 0 -.a fifi-fl E'l, / S II- RJ l::'l. s. FILE NUMBER 2. 1- D(;, - 'I~6 If an asset was made joint within one year 01 the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. C h t' i ~ ri tie E. LfJ.Gk.ey 31 ~ WfL(-Ivn Sf. Lerno~nt', Plf 17 ott ~ d 4..4.jhre-r 8. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF UMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST F"r , GN\d 'r tl {"rma-tiJl1t11 plJ.rpD~S 1. A. cpnven I ~ alhu.,hed ar-e ~ d .'reel b; IlIJ1J tM1d nctllt ~r ~rnulf r€.tja.rd : rlj ~ j,o:r1t ~e...e.cw at h\ €.lMibus ~t Feu. TOTAL (Also enter on line 6, Recapitulation) $ flf mnrp c:.n~"'o ic nco.rla,; inro"r+ ........1...1:..:........_1 _L.__J._ ~L AI COMMONWEALTH OF PENNSYLVANIA DEP ARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LACKEY CHRISTINE E 319 WALTON ST LEMOYNE, PA 17043 ______u fold ESTATE INFORMATION: SSN: 206-10-8210 FILE NUMBER: 2106-0406 DECEDENT NAME: HARDER ISABEL S DATE OF PAYMENT: 05/09/2006 POSTMARK DATE: 05/08/2006 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2005 NO. CD 006675 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05136817 I $280.89 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 2002 SEAL INITIALS: MG RECEIVED BY: TAXPAYER $280.89 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF INDIVIOUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 05136817 08-05-2005 REV-154S EX ~FP ,U'-UUl EST. OF ISABEL S HARDER S.S. NO. 206-10-8210 DATE OF DEATH 05-02-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT lXJ SAVINGS o CHECKING o TRUST o CERTIF . CHRISTINE E LACKEY 319 WALTON ST LEMOYNE PA 17043 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of ~ennsyivi:lnia. QUtisiiuhS iliCiY be an:iwEic;::! b~' c;::!.lina (117) 787-B~27 COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 243570-05 Date 04-15-2004 Established x 12,265.29 50.000 6,132.65 .045 275.97 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART ill A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. x PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: OF TAX ON JOINT/TRUST ACCOUNTS L!~!E 1- D~t!! f.S"t~bl i'She--:I 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 6. Tax Due 8 PART @] DATE PAID PAYEE x DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( ) WORK ( ) REV-1511 EX+ (12-99) . ,.1~\~_ ~- SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF H .,....., 1+ /t,O t: "'-/ I SA t3E'L FILE NUMBER :<"1 - 0' - ({-Ore, s~ Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION 1 FUNERAL EXPENSES: Pltrthe.mDY"e Fu.n~ral HofMe of New ~u.J1ttbet--lwnd ~o.IClJ1a du.e OV'\ J:~ No.' (st.t sfrJ-entmt ClIkcJr.u1) Rom ~er l11emer;a.l'6 reo'. Holy Cn6..s c.e.m~:~ry Enjn~r..~?f (see s.Jaiime,nt 4/fA.,C;hul) &.st tJ ;od W re,trt.shrvlenT, ~~ Lfhr &.nt-ra.1 tru.al 2.. .3. J/J 1. B. ADMINISTRATIVE COSTS: 2. Personal Representative's Commissions Name of Personal Representative(s) Kcdila,V1 m . mal' on ~ SUZt:c.~~ ~riiuMDre Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: Attorney Fees C 11 c.c..r-leS e. S h: e.-lc:ls !if' 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 4. Claimant Street Address City State _ Zip Relationship of Claimant to Decedent d t1 ~'h.l ProbateFees tMJ Orl~'lnaJ ',SSLt.l Bf short c.uf;fic.D..TtS 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. ,. F; lin~ fu 10 R~~~ter '* A-'''; f,'tJl1pl fJI'YJbak ~t. , lollls AMOUNT <;l s: "37t. lf9 ~ 71/;,bO ~ / 'fo ,60 r .;z.t> t') i " P wA-IIJ~.D f900.oo .p &3.00 fI I S,OO , /5,00 TOTAL (Also enter on line 9, Recapitulation) $ 7, 'i '17. If '1 (If more space is needed, insert additional sheets of the same size) JO NOT USE FOR REORDERING PURPOSES )rote~~ur Duplicate Checks Store your duplicate checks in your check box '} IHTrack your expenses... D Clothing D Food D Transportation )' D TAX.OEOUCTIBLE ITEM D Credit Card D Utilities D Mortgage ' i ' D Entertainment D Insurance D Other A' 11/,>{:v;t' . " / ,','. ,,/;7 f- " , / /, '// I,.,,' c<.hI'2'[;""~'f-- ' '/ ylZ- ," ~>);1-r~t'~~ ' J ,. . ,,".' / . ~- ,.Y_t_:,JBAL^~'GE .. ~j { ~ t /, -' ~ - ~_ ~_jIo\f'" ~/./ // '"' ',/~ ~J,/ /,'~j.- j // ~;; ..- "-;rj' tx~~ '-'7.k .;uL).:....p~~:/. ,y-/..- - ..'",Y-~ /(' -~ f,t' - ~-- ". For e~~-anCed$~curity;yo~~ name and account mfmber do not'~.~~r on this copy. ~. I / .~5 .f~/:-' , c.>;:'J BALANCE FORWARD .J.tJ!S ITEM // .c+f/) / 1',.... ,I" "7* DEPOSIT OTHER NOT NEGOTIABLE ~; . , ':I ] -=-:.:..=-~::.::=.:.::::=-:.-:-..:::::::~--::==:::---- "":'':--::::::::::::::.:;:::---='=-:-':::::::=:::'':::=:::~-:::-;~=~-=--_7~ "~::::-:-:-:::-..::::--:~-:=..--=, ""-'::'-::-~:"-"""- _=~'-.:~ . GRANITE "--.-MARBI:E--' BRONZE ROMBERGER M.EM.ORIALS 2395 State Street, Penbrook, PA 17103 t -: Specializing in Lettering and Cleaning Monuments PHONE 232-1147 ..-, 800-340-6744 Monuments, Markers, Mausoleums, Honor Rolls, Vases,Urns, Sandblasting Glass-SignS:-Windows Order No. ......................:.....;........:::: . Terms ......:....::~.................. Dale ;;...4...?4?p,=- To ~ZA'V'"'g:.....~~"'~.............~...Z7Y..~...(!'l.Jf.9....... ..~k.':I...........6Er?:r........:...T.~.........d...~~.,.......I!l.........!.~.2Q..... DETAILED DESCRIPTION OF WORK ..- The following ...:..P4.~.;... ..,.... "':~'".''' ............ ..........to be ...-!.I..l>..I>-!;;"t:>.:....................;;:... ..IN..........~.y...:~SS....~;C;&.f;:7P?r........:E~............................... , ROMBERGER MEMORIALS 2395 STATE STREET HARRISBURG PA. 17103 717.232-1147 -. -- - - - - - - - - - - - - - - - - - - - .- - - - - .- .- .- .- .- .- .- - .- - - .- - - .- - .- .- .- .- .- .- .- .- .- .- .- .- .- - - - - - .- - ..-. .- -- .- .- - - - -- May 9, 2006 Suzanne Parthemore 324 Fifth St. New Cumberland, PA 17070 Dear Suzanne Parthemore, Enclosed is an order for the inscription to be added in Holy Cross Cemetery for Isabel Harder. If everything is satisfactory, white copy of the order with payment. your records. sign and return the The pink copy is for Please call me with any question you may have. Thank you. Sincerely, b~~~dNY Steve Bomgardner Romberger Memorials PHONE: 800-340-6744 FAX: 717-232-1046 E-MAIL: ROMBERGERMEMORIALS@COMCAST.NET ~~\\I//~/ ~. ~" ~ ~ &. ~ --:::::::::-. ~ - PARTHEMORE A Family Tradition Of Caring Funeral Home & Cremation Services, Inc. June 9, 2005 1303 Bridge Street P.O. Box 431 New Cumberland, P A 17070 (717) 774-7721 (Fax) 774-5546 www.parthemore.com Mrs. Christine E. Lackey 319 Walton Street Lemoyne, PA 17043 Dear Mrs. Lackey; The following items were either not funded or not guaranteed in the pre- arrangements for Isabel Sarah Harder: Actual Cost As Funded Gilbert W. Parthemore, Death Notice, Harrisburg $ 136.00 $ -o- Founder Certified Death Certificates 60.00 10.00 Gilbert 1. Parthemore, Hairdresser 40.00 25.00 Supervisor Clergy Honorarium 1 50.00 75.00 Organist 100.00 60.00 Stephen K. Parthemore, Soloist 75.00 -0- CFSP Altar Boys 15.00 15.00 Grave Opening 750.00 450.00 Bruce R. Parthemore, Flowers, Casket Spray 1 50.00 125.00 Pre-Need Coordinator, CPC Subtotals: $ 1476.00 $ 760.00 Difference: $ 716.00 ~- Professional Memberships: NFDA . PFDA DCFDA . CCFDA Total Due: $716.00 lntemstionnl Ortkr Qfthe G~~~LDEN ~ Please call if you have any questions. Thank you. fJ~ tf 11h( t {) & I The Rule You KilO"', The People You Trust klc ~{ A~./'" . \r/ I /\'" 1 . .~ \ G/ REV-1513 EX+ (9-00*, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF .-/1 H It 1U) t: ,~ I FILE NUMBER LI -I/{, - <.J.o 0 "IS A-t3 EL 5_ RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY . Do Not List Trustee(s) I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Chf;sf/I/e E. L..ad<e.y 41L'<1htf!.,r 3/1 walfp" SI: / L.entbYAt,,tJA /71Jq 3 1 klo /V,,/i: IP /3 ~.' 61,11,( 4. ec.ou,rl-fs wll.5 ;nt:Jpenthye P.5 fk~ aJt.-re. no e. b.s d eI. D.&!. wnd .ba'1.t A~/{l'Jt hul otef1/Jt4de. jl;int w,'ff, oIlttl'lh1er, CAr/s hize E: ~, per Sch..tI..e; ~ . SUZ4ntle ~(v+heMO~ 3lt./ F,'ffh Sf., New CLttrlbt.rla.'MJ, Pit 17070 (bee (!gllf/IIIlI/II,'} shee,f) d~hter AMOUNT OR SHARE OF ESTATE fP L - DId buI '70.110 If ~ - /win cha..i rJ $SlYJ,1'f) Ml1r-ble. ~p fable '/ ~S:bf) IP 7- d I'Of' leal kh/t!.. "3S.Ob fPlo-j//c/rola '/35.00 tP 12-lYlo-,.b/t.. ~f eloeJc '10.00 bDoK Ct1se ~11.S.f)O (f flf - Ys- e? 1-eS; d Lte. IP'f dlLtnt er 0InI/ '7S.oo m~lI"blt. f. hrtlS$ s.ta.nd ~~s.tJO fPllf - Y.> of res,d ~e 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. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets ot the same size) J?.s7: of /1/1 /Mac., /s,4/3€L S. seH Ef).;r; (!In!;; I........ .. .3, LtJ. UJ rtl1. ce:. /);.t!4jr@l" !S-/'f L.eltl,tvfl.!,llJ I?d/ .~. ~lt.Ld/ 7~11 J/..l Ge.~~!rI fJ. !f.q,rder i tfo9' .-.---.-----t..---.~. ...___n__ .--___~ I I I i I - -t----- j /?qfc./t;/< .~I!,~t.H/Jle'l, A-Zf5~~" "Z 1- t!Jt-~ S6~ 1?.s-l~/JV.J1.~.~ jl'!t /ap$U/ gf ~Q.$ tflH::n tu.Jay nw~ /4,n;. I Y UlrOe/z,; e{. (). 1'/. IP~- C%h';') ~ JIlt ./it/lJ'.ealaftdU r?V~11 tU.u/fY /J1.[)rt! ~ / y~r be/D~I{.o.d fPl,! . Ys- ,rf ~.$/d/,(t!. ~ on. 1f '-p/~tt4.r~pI4 M- h/tssu! hU&r ~/().()O fP /1 - $111.1/ 'nfl' ..k41 . kb/~?'fr;;If() - Y5Lt!J.lres,'du.e .5:.~.. .ffath few.... H :.. mAt.h/!. d4Ujhter ;PfJ - y,p.bp./S.fpa/ ~Jzf. '_AI I ' b. VI Chrt/r or s/r;o/ srI/C. DO .j.. /z~~ KtIldniL. iJ.r.,./J1c:c11411!t..f.H.t:j,tJ 17tJSS' I I T L- 1 f I ! /1>/ f - Y.s- ~I ~ s/dtle LAST WTT,l, AND TESTAMENT ill: ISABEl, S. HARnER I, ISABEL S. HARDER, residing at 319 Walton Street, Lemoyne, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this instrument to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills or Codicils by me at any time heretofore made. FIRST: I direct my hereinafter named Co-Executrices to pay all of my just debts, funeral expenses, administration expenses and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. SECOND: I give and bequeath the antique bed in the front room to my beloved daughter, CHRISTINEE. LACKEY. However, in the event she fails to survive me, then this specific bequest shall revert to the estate. THIRD: I give and bequeath the twin chairs and marble top table to my beloved daughter, CHRISTINE E. LACKEY. However, in the event she fails to survive me, then this specific bequest shall revert to the estate. FOURTH: I give and bequeath the jarneer and marble and brass stand in the dining room to my beloved daughter, SUZANNE PARTHMORE. However, in the event she fails to survive me, then this specific bequest shall revert to the estate. / 11 /'" ~I /.1 /" ~-rt: ./t~ (~:-rjQ~~r'A/V(SEAL) ISABEL S. HARDER ~-; :.: - : Page 1 of 5 FIFTH: I give and bequeath the Lawn Boy lawnmower to my beloved son, LAWRENCE M. HARDER. However, in the event he fails to survive me, then this specific bequest shall revert to the estate. SIXTH: I give and bequeath the picture plate located in the kitchen to my beloved son, GERALD P. HARDER. However, in the event he fails to survive me, then this specific bequest shall revert to the estate. SEVENTH: I give and bequeath the drop leaf table on the outside porch to my beloved daughter, CHRISTINE E. LACKEY. However, in the event she fails to survive me, then this specific bequest shall revert to the estate. EIGHTH: I give and bequeath the Colonial Desk standing in the living room unto my beloved son, LAWRENCE M. HARDER. However, in the event he fails to survive me, then this specific bequest shall revert to the estate. NINTH: I give and bequeath the rocking chair unto my beloved daughter, daughter, KATHLEEN M. MARTIN. However, in the event she fails to survive me, then this specific bequest shall revert to the estate. TENTH: I give and bequeath the Victrola located in the basement unto my beloved daughter, CHRISTINE E. LACKEY. However, in the event she fails to survive me, then this specific bequest shall revert to the estate. ELEVENTH: I give and bequeath the three-leaf table in the living room unto my beloved son, GERALD P. HARDER. However, in the event he fails to survive me, then this specific bequest shall revert to the estate. / . ~~/t~:..( .j/~:~~-^-C~~SEAL) ISABEL S. HARDER Page 2 of 5 TWELFTH: I give and bequeath the marble top clock and book case unto my beloved daughter, CHRISTINE E. LACKEY. However, in the event she fails to survive me, then this specific bequest shall revert to the estate. THIRTEENTH: I direct that all ofthe monies held in my Savings Account and Certificate of Deposits at the time of my death shall be liquidated and the proceeds thereof shall be divided among my five (5) beloved children, share and share alike, per stirpes, as follows: GERALD P. HARDER, LAWRENCE M. HARDER, SUZANNE P ARTHMORE, CHRISTINE E. LACKEY and KATHLEEN M. MARTIN. FOURTEENTH: All the rest, residue and remainder of my estate, consisting of personal property, of whatever nature and wherever situate which I may own or have the right to dispose of at the time of my decease, I give devise and bequeath in equal shares, per stirpes, as follows: GERALD P. HARDER, LAWRENCE M. HARDER, SUZANNE PARTHMORE, CHRISTINE E. LACKEY and KATHLEEN M. MARTIN. FIFTEENTH: I hereby nominate, constitute and appoint my three (3) beloved daughters, SUZANNE P ARTHMORE, CHRISTINE E. LACKEY and KATHLEEN M. MARTIN, Co-Executrices of this my LAST WILL AND TESTAMENT. I hereby give unto my Co-Executrices the fullest power, in their sole discretion to do any and all things necessary for the complete and proper administration of my estate, with full power to sell at public or private sale or sale and without Order of Court, any real or personal property belonging to my estate, and to compound, compromise or otherwise settle or adjust any and all claims charges, debts and demands whatsoever against or in favor of my estate, as fully as I could if //: J/ " i.':':' /.", <' ~\~d //k::,~ {: "/ (1:"~~~~ (SEAL) ISABEL S. HARDER Page 3 of 5 living. In the event that any of my Co-Executrices predeceases me or otherwise fails to act, or charges, debts and demands whatsoever against or in favor of my estate, as fully as I could if living. In the event that any of my Co-Executrices predeceases me or otherwise fails to act, or continue to act, or qualify, or is not able or willing to serve in said capacity, then my remaining daughters shall continue with all powers and authority in place. SIXTEENTH: I hereby waive any requirement which may have been otherwise imposed upon the Co-Executrices of this, my estate, to post bond in connection with the administration of said estate, in this or any other jurisdiction, where permitted by law. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal this JS.Jh q day of June, 2001. ~L' <':.., /.- ,f/ ,/ ,/ d ", / , ," ~ t-G ~jc~~/~/z- ISABEL S. HARDER, TESTATRIX (SEAL ) SIGNED, SEALED, PUBLISHED AND DECLARED BY THE ABOVE-NAMED TESTATRIX, AS AND FOR HER LAST WILL AND TESTAMENT, IN THE PRESENCE OF US, WHO HAVE HEREUNTO AT HER REQUEST SUBSCRIBED OUR NAMES IN HER PRESENCE AND IN THE PRESENCE OF EACH OTHER AS WITNESSED HERETO. U~~ddresS7/? ,4/ 02",d Sfitt"'('~ 1 .A- ~. PtL. /7/0: Vl VI - Address ',' f\J '2..--1 flv ~ ~ Ht \ /J f) { I (')2 0/ Page 4 of 5 ) ) WE, ISABEL S. HARDER, C? ~/ A ed)f~ and (V\u....h{ '\/'" ~ t.J I tf~-/v f)~ , the Testatrix and the witnesses resp ctively, whose names COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed this instrument as her Last Will and Testament and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, in that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and to the best oftheir knowledge, the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. SEAL) (SEAL) Sworn to and Subscribed ..., r-rJ:!-- before me this).......) day of June, 2001. - ;V ~ . /0 OvL"--~ a.C.. ~ NOTARY PUBLIC My Commission Expires: ...__.__ .---- - . ---'1 I\!OT ARIAL SEAL ! O;'.\'!D A. CHU8B, Notary Public I Harnsbutg, Da'Jphin County l:A;:~.~~:Si~n~XPireS~ay 21_,200.2_ Page 5 of 5 GEORGE M. HOUCK (1912-1991) Register of Wills Cumberland County Court House 1 Court Square Carlisle, PAl 7013 Dear Register of Wills: CHARLES E. SHIELDS, III A TTORNEY-A T-LA W 6 CLOUSER ROAD Corner ofTrindle and Clouser Roads MECHANICSBURG, PA 17055 TELEPHONE (717) 766-0209 FAX (717) 795-7473 November 12,2007 Re: Estate of Isabel S. Harder No. 21-06-0406 Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Isabel S. Harder Estate as well as Check No. 7044, in the amount of$15.00 for the filing fee, Check No. 7045, in the amount of $15.00 for additional Probate and Check No. 7046 in the amount of $516.74 for the Inheritance Tax due. Thank you for your kind attention to this matter. CES/mjj Enclosures Very truly yours, , &uda f:~ cP Charles E. Shields, III Attorney-At-Law g sg OJ~ r'f'l (") iB fTi ~u5~ ~~~ p~ ~ ,..., <=:) c:::l' -.J % (:) -< .&'" -0 :x N .. c~) c:> -'''1 --rl .-' -'.'1 ~~: <:-=-:> r"'-- r-r'l r'" ,:>., \D