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Home My WebLink About02-07-08 -..J 15056041147 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 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 0538 Date of Birth 178142136 05202007 07111921 Decedent's Last Name Suffix Decedent's First Name MI HENRY E JEANNE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Ml Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return 9. Litigation Proceeds Received ~ D D D 4a. Future Interest Compromise (date of death after 12-12-82) D D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 2. Supplemental Return 4. Limited Estate :jC 6. Decedent Died Testate (Attach Copy of Will) 7 Decedent Maintained a Living Trust . (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) ~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number DIANE G RADCLIFF 7177370100 " .) Firm Name (If Applicable) DIANE G. RADCLIFF, ESQUIRE First line of address REGISTER OF WILLS USE ON4Y ~'C'] ;'~ I ~-J ~,~ '-~ 3448 TRINDLE ROAD Second line of address DA TE FILED UI . , I CAMP HILL State PA ZIP Code 17011 City or Post Office Correspondent's e-mail address: Frances E Kring 17050 DATE Diane G Radcliff 3448 Trindle Road, Camp Hill, PA 17011 Side 1 L 15056041147 15056041147 ~ d0 -.J 15056042148 REV-1500 EX Decedent's Name: E J e ann e Hen ry Decedent's Social Security Number 178142136 RECAPITULA TION 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) D Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 00 Separate Billing Requested............. 7. 8. Total Gross Assets (total Lines 1-7)....................................................................... 8. 6,815.57 387.02 0.00 7,202.59 6,782.39 9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 11. 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. 9,018.76 15,801.15 -8,598.56 -8,598.56 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. 16. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X .00 0.00 15. Amount of Line 14 taxable at lineal rate X .045 0.00 16. Amount of Line 14 taxable at sibling rate X .12 0.00 17. Amount of Line 14 taxable at collateral rate X .15 0.00 18. 17. 18. 19 . Tax Due................................................................................................................... ~. 9. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L Side 2 15056042148 0.00 0.00 0.00 0.00 0.00 D 15056042148 -.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME E Jeanne Henry ---- -------~~-_._------~~- STREET ADDRESS 1400 Bent Creek Blvd File Number 21-07-0538 -----~-~ Apartment 230 ~- -------~- - - _._--._--~-~."--------_.._._~--_.~-~---~- CITY \ STATE PA jZIP 17050 Mechanicsburg 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 of- B of- C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 of- Line 3, enter the difference. This is the OVERPAYMENT. Check box 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 the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) 0.00 0.00 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;.................................................................................O ~ b. retain the right to designate who shall use the property transferred or its income;....................................D [Xl c. retain a reversionary interest; or.... ...... ............ ....... ............... ....... ........ .............. ...................... ....... .........0 ~ d. receive the promise for life of either payments, benefits or care?.............................................................D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.......................... ........ .......................... ........ ....... ..... ......................... ...........0 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D [Xl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.................................................................................................................. 00 D 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 exemOB 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-1508 EX+ (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONVllEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henry, E Jeanne FILE NUMBER 21-07 -0538 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 1 New York Life Annuity - Payable to Estate - Policy No. 58089722 VALUE AT DATE OF DEATH 2.882.52 2 New York Life Annuity - Payable to Estate - Policy No. 58089368 3.933.05 TOTAL (Also enter on Line 5, Recapitulation) 6.815.57 (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 E (Rev. 6-98) Rev-1509 EX+ (6-98) . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henry, E Jeanne FILE NUMBER 21-07 -0538 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 A. Frances E Kring ADDRESS RELATIONSHIP TO DECEDENT 1400 Bent Creek Blvd, Apt. 230 Mechanicsburg, PA 17050 Daughter B. 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 DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE. 1 A 7/25/2005 PSECU Bank Account 774.03 50.000% 387.02 TOTAL (Also enter on Line 6, Recapitulation) 387.02 (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. 6-98) Rev-1510 EX+ (6-98) . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMON~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Henry, E Jeanne FILE NUMBER 21-07 -0538 ESTATE OF This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1 New York Life Insurance Annuity - paid directly 0.00 0.00 to beneficiary - Policy No. 58089368 - $11,070.60 Payee: Frances E. Kring Address: 1400 Bent Creek Blvd. Apt. 230 Mechanicsburg, PA 17050 Policy No. 58089722 - $8,234.12 Payee: Frances E. Kring Address: 1400 Bent Creek Blvd. Apt. 230 Mechanicsburg, PA 17050 TOTAL (Also enter on Line 7, Recapitulation) 0.00 (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 G (Rev. 6-98) REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Henry, E Jeanne Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07 -0538 ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 2,941.39 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 Diane G Radcliff 250.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 66.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 25.00 See continuation schedule(s) attached TOTAL (Also enter on line 9. Recapitulation) 6,782.39 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henry, E Jeanne FILE NUMBER 21-07-0538 ITEM NUMBER DESCRIPTION AMOUNT 1 Citizen's Cemetery Association - Cremation Internment 450.00 2 Haven Lounge - Funeral Meals 127.00 3 Parthemore Funeral Home &Cremation Services - Cremations/Death Notices/Death Certificates 2.364.39 Subtotal 2.941.39 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6-98) '* SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMON~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Henry, E Jeanne FILE NUMBER 21-07 -0538 ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills - Filing fee - Inheritance Tax Return/Inventory 25.00 Subtotal 25.00 Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTA TE OF Henry, E Jeanne FILE NUMBER 21-07 -0538 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Chase Visa VALUE AT DATE OF DEATH 6.663.67 2 New York Life Visa 2.355.09 TOTAL (Also enter on Line 10, Recapitulation) 9,018.76 (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 I (Rev. 6-98) illast lIill ann (llpslamrnt of EMILY JEANNE HENRY BE IT REMEMBERED, that I, EMILY JEANNE HENRY of 657 Revere Circle, Lewlsberry, Pennsylvania 17339, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me, at anytime heretofore made. ITEM 1. BURIAL INSTRUCTIONS: I direct that no autopsy be performed on my body. I further direct that I be cremated by a reputable firm and that my ashes be placed next to my husband, BOYD M. HENRY, at the Grandview Cemetery, Johnstown, Pa. I last direct that prayers be said for me. ITEM 2. DEBTS AND FUNERAL EXPENSES: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 3. TANGIBLE PERSONAL PROPERTY: I give and bequeath all tangible personal property owned by me at my death and all insurance policies on such property as follows: a. To those individuals who survive me and who are designated on a list or memorandum signed by me which refers to this Will or is found with a copy thereof, I give and bequeath the items listed beside their names. b. The balance (including any items under subparagraph (a) above the bequest of which has lapsed) shall be included in my residuary estate, and shall by distribution by my hereafter named Personal Representative to the beneficiaries thereof as herein provided. My Personal Representative shall have the WITNESS: \ vJ 1 right to dispose of said remaining items of personalty to become part of my residuary estate, either in kind or in cash as a result of liquidation thereof as my Personal Representative, in my Personal Representative's sole discretion, deems appropriate under the circumstances. It is my intent, however, that should any beneficiary of my residuary estate desire to receive a particular item in kind which was not specifically bequeathed to that beneficiary, to the extent reasonably possible, my Personal Representative shall attempt, but not be obligated, to follow that beneficiary's request. c. If any beneficiary of any item of tangible personal property aforesaid has not yet attained the age of 18 at the time of my death, I order and direct that my Personal Representative, hereinafter named, to hold said items in safekeeping for that beneficiary and to deliver the same to that beneficiary upon he or she reaching age 18. For these purposes my Personal Representative shall be entitled to use or set aside from my estate sufficient funds to provide for that safekeeping. ITEM 4. SPECIAL BEQUEST: I give and bequeath my two New York Life Insurance Annuity Corporation annuity policies, designated as Policy No. 58089722 and Policy No. 58089368, or the proceeds to be payable thereunder, unto my Co-Trustees, FRANCES KRING and FREDERICK C. RAFFETTO, (hereafter appointed and referred to as "Trustee"), to be held for the benefit of my grandchildren, JOSHUA A.. PIRO and JUSTIN S. PIRO, IN TWO SEPARATE AND EQUAL TRUSTS, under and subject to the following terms and conditions: a. Trustee may accumulate the income from each beneficiary's trust or so much thereof from time to time as they considers advisable; and Trustee may expend and apply so much of the net income including accumulated income and so much of the principal of that share as Trustee may consider necessary for the support, maintenance, medical and dental expenses and education of that beneficiary, including college education, both graduate and undergraduate, or post-secondary vocational or technical training, in accordance with that beneficiary's talents, abilities and needs; and Trustee may pay all expenses which it deems necessary and desirable in connection therewith, including, by way of illustration, room and board, clothing, travel expenses, tuition, books and supplies, and reasonable sums for personal and living expenses. The amount to be paid WITNESS: // I), l SJtv'~1S ,,? 2 for the benefit of that beneficiary shall be determined from time to time based on that beneficiary's needs, considering that beneficiary's other income and assets, including any income payable for the benefit of that beneficiary from other sources as other trusts or social security or other governmental benefits, with the further direction that the funds shall be liberally disbursed. The said payments may be made as my Trustee deems appropriate directly to that beneficiary if that beneficiary is, in the sole opinion of my Trustee, of an age and ability to handle the funds so paid; or directly to the person having custody and care of that beneficiary; or directly to any institution entitled to such payment by reason of services rendered or to be rendered to that beneficiary: b. The Trustee for the purposes of carrying out my intentions stated above shall have the following powers, in addition to all other powers granted by law or other provisions of this Will: 1. To retain any property, ,< real, personal or mixed, and to manage the same for the benefit of this Trust; 2. To sell at public or private period of time, any real or prices and upon such terms appropriate; sale, or to lease for any personal property for such and conditions as may be 3. To compromise any claim or controversy and to abandon an}' property which is of inconsequential value; 4, To make distribution to my herein-named beneficiaries, on their behalf, in cash or in kind; and 5. To carryon any business owned or controlled by me at my death, for whatever period of time is deemed proper, and to do all things necessary and appropriate to manage, supervise and operate the business and to close out, liquidate or sell the business at such time and upon such terms as are deemed proper. C. Trustee shall invest all trust funds received by my Trustee including, but not limited to, income received from the retention of property in kind and cash received from the liquidation and sale of property, in any minimal risk investments including, but not limited to: checking accounts, savings accounts, money market accounts, certificates of deposit, mutual fund accounts or other minimal risk investments, or any combination thereof. Distribution from the Trust shall be made solely for the benefit of the beneficiary of the Trust in accordance with my instructions set forth in subparagraph (a); provided, however, that my Trustee shall be entitled to pay WITNESS: ~ EMILY EJ E HE~ . 3 i .j I I for any taxes, professional services or other fees arising out of the administration of the Trust and shall be entitled to periodic, reasonable compensation for services rendered hereunder, which may be equitably apportioned between principal and income. d. Any and all payment or payments of any sum or sums, whether in cash or in kind or whether for principal or income, payable to the beneficiary, shall be made upon the sole receipt of the respective individual to whom the payment is made, free from anticipation, alienation, assignment, attachment, and pledge, free from control by the creditors of any such beneficiary and shall not be subject to any execution or attachment. e. when each beneficiary reaches age thirty (30), the then remaining assets, principal and any accumulated or undistributed income of that beneficiary's Trust shall be distributed to that beneficiary, absolutely. f. In the event a beneficiary hereunder dies before reaching age thirty (30) the remaining principal and any accumulated income of his Trust shall be distributed at his or her death to the other beneficiary set forth in this item, or in the event the other beneficiary is not then living, that share shall be distributed to my then living residuary beneficiaries set forth in Item as set forth 5 or in the event of lapse, Item 6 herein, in the proportions provided for therein. g ,. Should the principal of the Trust herein provided for be or become too small in the Trustee's discretion so as to make establishment or continuance of the trust inadvisable, my Trustee or Personal Representative may make immediate distribution of the then-remaining assets, principal and any accumulated or undistributed income outright to the Guardian of the Person of any minor beneficiary herein appointed or to the person or persons and in the proportions they are entitled. ITEM 5. RESIDUARY ESTATE: All the rest, residue and remainder of my Estate of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including any insurance policies therefor, property over which I have power of appointment, and proceeds from any insurance policies payable to my estate, I give, devise and bequeath to my children, FRANCES KRING, HENRY M. BOYD, JR. And PATRICIA J. PIRO, in equal shares per capita. WITNESS: / 4 ITEM 6. ALTERNATE RESIDUARY ESTATE: In the event all of my children, FRANCES KRING, BOYD M. HENRY, JR. And PATRICIA J. PIRO, have failed to survive me, I then give, devise and bequeath my entire residuary estate to the issue of my children, FRANCES KRING, BOYD M. HENRY, JR. and PATRICIA J. PIRO, in equal shares, per capita. ITEM 7. APPOINTMENT OF TRUSTEE: I appoint FRANCES KRING and FREDERICK C. RAFFETTO, or the survivor of them, as Trustee of any Trust created by this my Last Will and Testament. ITEM 8. APPOINTMENT OF GUARDIAN OF PROPERTY: I appoint FRANCES KRING and FREDERICK C. RAFFETTO as Guardian over any property which passes either under this Will or otherwise to any beneficiary who is then a minor. ITEM 9. APPOINTMENT OF PERSONAL REPRESENTATIVE: I appoint FRANCES KRING as my Personal Representative of this my Last Will and Testament. Should FRANCES KRING predecease me, fail to qualify, cease to act or renounce probate, I then appoint BOYD M. HENRY, JR. as Alternate Personal Representative of this my Last Will and Testament. ITEM 10. PAYMENT OF TAXES: I direct my Personal Representative to pay all inheritance, estate, succession and legacy taxes of whatsoever nature and kind, to which my Estate or the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes WITNES~ ~ ~ ~.r.~(., _ EMILY' E= . S" ) ~('rd.J. l~ ! 5 against my residuary estate, it being my intention that none of the aforesaId taxes, either federal or state, or any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interest in my Estate to whom such property is or may be transferred to whom any benefit accrues. ITEM 11. POWERS OF PERSONAL REPRESENTATIVE: In addition to the powers conferred by law, I authorize my Personal Representative in my Personal Representative's absolute discretion: a. To retain in the form receive; and to sell either at public or private sale any real or personal propertYi b. To manage real estatei c. To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principle of diversificationi d. To exercise any option or rights arising from ownership of investmentsi e. To compromise claims without court approval and without the consent of any beneficiarYi f. To disclaim any interest in propertYi g. To claim an elective share of the estate of any deceased Spousei h. To join with any spouse I may have upon my death in the filing of any federal income tax return for any year for which I have not filed such return prior to my death, and to consent to the treatment of any gifts made by my spouse as being made one-half by me for gift tax purposes notwithstanding the fact that such action may result in additional liabilities for my estate. Any income or gift taxes due on such returns and any deficiencies, interest, penal ties, or refunds thereon, shall be allocated between my estate and my spouse and my spouse's estate, or all to any of them, in such manner as my Personal Representative and my said spouse may agree. WITNESS: ~lJ \ ,1'1" ll~ 'V~,,,,-- . /... I '-.) I ~.~:l:EA~ EMILY E HE~ 6 i. To disburse my estate in kind or by way of liquidation thereof in whole or in part as my Personal Representative in my Personal Representative's sole discretion may deem appropriate under the circumstances. ITEM 12. NO BONDING REQUIREMENT: I direct that my Personal Representative, Guardian and Trustee or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM 13. SURVIVAL: Any person or organization herein named or referred to shall be deemed to have survived me only of such per~on or organization shall in fact survive me for a period of at least thirty (30) days. Any person or organization named or referred to herein who shall not survive me by a period of thirty (30) days shall be deemed to have died before I do. ITEM 14. GENDER AND NUMBER: Where appropriate to the context, pronouns or other terms expressed in one number or gender shall be deemed to include the other number or gender, as the case may be. ITEM 15. EXCLUSION: It is not my intention to make provision in this, my Last Will and Testament, for any relative or any other person not expressly provided for herein, except for children born to or legally adopted by me after the date of this instrument, and if any such person has not been expressly mentioned herein, he or she has been omitted by me intentionally and with full knowledge of his or her relationship and existence, and not by any oversight or neglect. WITNESS: L) ~~ i I'" 7 IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~~day of. -::1.l\.----...\- ,1 ~ f:~~ ./ 8 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND We, EMILY JEANNE HENRY, r~~e- ~. ~LV~ and Diane G. RadclifC Esquire, the TESTATRIX and the witnesses respectively, whose names 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 the instrument as Last will and that TESTATRIX had signed willingly (or willingly directed another to sign for the TESTATRIX, and that TESTATRIX executed it as TESTATRIX 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 witnesses and that to the best of their knowledge the TESTATRIX was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed to before me this ~ day / ,19~. ~of! dffl~ NOTARY PUBLIC My Commission Expires: Notarial Seal Debor~h L. Donley. Notary Public Camp HIli 80ro, Cumberland County My CommiSSion Expires Sept. 23, 1999 Member Pennsvivanla r~~soclati(ln of Notaries 9 NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION 51 MADISON AVENUE NEW YORK, NEW YORK 10010 II 1...111...111"1.1.1.11......111..1..11...1111.1.1..1.1..11..1 THE ESTATE OF E. JEANNE HENRY, FRANCES E. KRING AS EXECUTOR 1400 BENT CREEK BLVD APT 230 MECHANICSBURG PA 17050-1866 POLICY NUMBER 58089368 CLAIM NUMBER 981550 DECEASED HENRY, E. JEANNE DATE 06/08/2007 PAYEE THE ESTATE OF E. JEANNE HENRY, TOTAL AMOUNT FRANCES E. KRING AS EXECUTOR DUE PAYEE 1400 BENT CREEK BLVD 3,933.05 TAXABLE GAIN 2,428.44 FEDERAL TAX WITHHELD STATE TAX WITHHELD PAYMENT AMOUNT 0.00 o .00 3,933.05 IF YOU HAVE ANY QUESTIONS OR REQUIRE FURTHER ASSISTANCE, PLEASE CONTACT OUR VARIABLE PRODUCT SERVICE CENTER AT 1-800-598-2019 NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION 51 MADISON AVENUE NEW YORK, NEW YORK 10010 11 11..111...111....1.1.11'1....111..1'1111..11...1.11.1.1..11..1 THE ESTATE OF E JEANNE HENRY, FRANCES E. KRING AS EXECUTOR 1400 BENT CREEK BLVD APT 230 MECHANICSBURG PA 17050-1866 POLICY NUMBER 58089722 CLAIM NUMBER 981550 DECEASED HENRY, E. JEANNE DATE 06/08/2007 PAYEE THE ESTATE OF E JEANNE HENRY, FRANCES E. KRING AS EXECUTOR 1400 BENT CREEK BLVD TOTAL AMOUNT DUE PAYEE 2,882.52 TAXABLE GAIN 1,378.14 FEDERAL TAX WITHHELD STATE TAX WITHHELD PAYMENT AMOUNT 0.00 0.00 2,882.52 IF YOU HAVE ANY QUESTIONS OR REQUIRE FURTHER ASSISTANCE, PLEASE CONTACT OUR VARIABLE PRODUCT SERVICE CENTER AT 1-800-598-2019 PSE(~ December 14,2007 Account # 8203XXXXXX DIANE G. RADCLIFF 3448 TRINDLE RD CAMP HILL, PA 17011 Dear MS. RADCLIFF: The following is the status ofE. JEANNE HENRY's account with PSECU as of the date of death. J oint Owner's Name Date of Death Date of Birth FRANCES E. KRING- ADDED 07.25.2005 AS JOINT TENANT W/ROS 05.20.2007 07.11.1921 Share SOl S 04 Description Regular Shares Checking Open date 07.25.2005 07.26.2005 Balance $ 11.69 762.34 Accrued Dividend $1.23 0.06 The dividend earned from January 1, 2007 through the date of death was $11.51. The decedent had no loans with us. We do not have safe deposit boxes for our members. This account was closed May 31, 2007 by authorization of joint owner. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, 'lJdd.4 Me%:::;U~ Member Service Representative Finance Support Unit Pennsylvania State Employees Credit Union Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 . 7172348484 .800237.7328 . Mailing Address: PO. Box 67013, Harrisburg, PA 17106-7013 . 717.777.2100 (TOO) . 800.472.1967 (TOO) This credit union is federally Insured by the Notional Credit Union Administration Equal Opporiunity Lender www.psecu.com . "\ \ \ I, / ~/ ~~/ ~r~ ~:2 _\ ~ ~~~ PARTHEMORE Funeral Home & Cremation Services, Inc. A Family Tradition Of CaringE Mrs. Fran E. Kring 1400 Bent Wood Creek Blvd. Apt. 230 Mechanicsburg, P A 17050 5/23/2007 1303 Bridge Street P.O. Box 431 New Cumberland, PA 17070 (717) 774-7721 (Fax) 774-5546 www.parthemore.com We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. The following is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected when making the funeral arrangements. f Terms Net 30 Due Date 6/22/2007 Account # 2007048.1 Description Amount SERVICES & MERCHANDISE Direct Cremation 1,875.00 Total Services and Merchandise 1,875.00 Gilbert W. Parthen1Ore. Founder Professional Memberships: NFDA · PFDA DCFDA.CCFDA CASH ADVANCE ITEMS Death Notice, Harrisburg Patriot /\ Death Notice, Punxsutawney Spirit ~O \ Death Notice, Johnstown Tribune q; 20 Certified Copies of Death Certificates \~ Cumberland County Coroner Fee, Cremation Authorization \/\ ~~~\b~ ~ . 'f'( ,<\~{yJlC yq v I \ t "~) " 1{11/~ u / ) ~.../'" 526.89 Stephen K. Pat1hemore, CFSP Total Cash Advances 205.15 40.00 136.74 120.00 25.00 Gilbert J. Parthemore. Supervisor Bruce R. Parthemore, Pre-Need Coordinator, epc Immediate Pay Discount - Thank you! -37.50 G~~DL'i5EN RQg/ The Rille }'I/{ /,'1/(1", The f'('()fJ/e }il/{ [{'nIl _Jk ~"" ~. ~1~~:1. t;;;'~~r~~31 Total Payments/Credits Balance Due $2,364.39 $-645.00 $1,719.39 . /~~""=~.~ I-U/lIt:/1 4/ ~f? ~~~ \03 ~ ~~ ~ \ ~\~~V;1 z o ~ U It) o ~'C 8l ~S<<lT"" G) 0 Ea:<( >G)~a. a:O~- W~...Z to- G)g3: w'-'-O ==~::Et- We.... (I) o !!!oZ cn~CX):I: - 0 Z ..., ~ i= U AMT. PAID BALANCE DUE 006562