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HomeMy WebLinkAbout09-08-0815056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Countv Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 0 $ D ~ 2 ~ a PO BOX 280601 RESIDENT DECEDENT ~ Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Date of Birth Social Security Number Date of Death ~ r o~~3~.008 / Boa ~ 9~~ MI Decedents I ,ast Nam? Suffix Decedenfs First Name ~EE~~~ /h/ LD~E~ ~~ (If Applicable) Enter Surviving Spouse's Information Below MI Sp~o/use's Last Name Suffix Spouse's First Name N l /4 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 O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate ~ 6. Decedent Died Testate (Attach Copy of Will) O' 9. Litigation Proceeds Received CORRESPONDENT - THIS SECTION N Name O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) IUST BE COMPLETED. ALL CORRESPONDENCE AND CONF ~ fl l E L 1~ S I r i O 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) DENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Daytime Telephone Number ~ ~-~ 7b6 02,09 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY r3 _.~ NSA' First line of address C7 `~_' ~' -. --j ; a 7 ~- I'T-I t f ; ., J Second line of address "r~ r ~ C7 - - 3 ~ •-s n `_~'"7~ ~'L_7 -s-1 bATf=~IL~D ~"` _~ State ZIP Code City or Post Office 597 - ~i tV ~ +`~ r ~7 Yi 3~ n1~CN~ N1 ~ seuRG P~ / 70 5 ~ ~:~Sh ~ ~ Id s 3 ®ComCaSf n~ f ' s a-mail address: Correspondent including accompanying schedules and statements, and to the best of my knowledge and belief, d this return i , ne Under penalties of perjury, I declare that I have exam Declaration of preparer o than the personal representative is based on all information of whi t and complete ge. wl ch prepay a . it is true, correc ETURN R PONSI E FOR FI ER SfGNATU F P ~ DATE g ~wB / ,~ ^, ADDRESSL'~.J~QL WIOLUVIC!-,I ~B ~• SCh06~$f~C ~r ~7~S S 4 f~ . i rnp~~ -cs ura _ E S IV SIGNAT OF P EPAR OTHE DATE ~ D ~+~~ ~ ADDRESS CN/FlZLES E. ~' ~~LDS ~M~~l-.~/O~~ bf ~~t•~ ~~ (7oS•S PLEASE USE ORIGINAL FORIVI~ONLY 15056051047 Side 1 15056051047 J 15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 0~ o v z~ a Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth ~ 4z~3a°°8 ~~oa i9~7 De~adenCs Last Name Suffix Decedent's First Name MI ~{ EE_N~ N /jf / LD~ED K, (If Applicable) Enter Surviving Spouse's Information Below SpAo/us/e's Lddast Name Suffix Spouse's First Name MI „' ! r'f Spouse's Social Se~;urity Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Regwred death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust D 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Daytime Telephone Number Name C y~¢~~ ~S F ~k / EL1~S I ~ J 7 ~7 766 02.09 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY ~/~ t3 _~ __,_~. - First line of address r~ -~ c; ~ _ ~ .} ~ Second line of address ~_< <,-, - y- ~ t t ~ ~ ~ - ''-J ~- -_,_t b.4Tf~IL~D f^ - ~ T State ZIP Code City or Post Office a~ ! N ~CN~ n/~ ~ seuR~- ~'~ 170 5597 I~1 3~ ~ ~~<_ , L C:GS r' ~ ~ 1 d S 3 ®ComCa Est n@ t ' s a-mail address: Correspondent Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my kn tive is based on all information of which preparer has t l owledge and belief, any knowledge. represen a it is true, correct and complete. Declaration of preparer o than the persona SIGNATU F PER R PONSI E FOR FI ETURN DATE 1I-!_ ~~ b~~¢ ADDRESSL'~.JQ,()L wto~ov~cN ~ ~• SCh06J tC~C ~r ~ u.ra, f~i4 J7osS h1p~l~anic5 _ SIGNATI~~OF P~EPARE~OTH~~N RF~~SJrA4T/aZIVE DATE „/~~/~A ADDRESS C y14I2LE5 E. .Silk//EGDS ~ (o Clo uS tr Rd b u ~i~ /7osS PLEASE USE ORIGINAL FOR ONLY Side 1 15056051047 15056051047 J 15056052048 REV-1500 EX p /~,, Decedpent's Social Securi7ty Num/b/er Decedent's Name: HEEN~N, M ~(.DR~.D >~. RECAPITULATION 1. Real estate (Schedule A) . .......................................... .. 1. ~ t~D $ ~ ~ 7 oZt O 2. Stocks and Bonds (Schedule B) 2. ~ 3. Closely Held Corporation, Partnership or Sole-Propretorship (Schedule C) ... .. 3. D O 4. 9 9 ( ) ........................... Mort a es & Notes Receivable Schedule D .. 4. D D 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. ~ ~ ~ 4 O 7 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. / 6 ~ 3 D • J~ 8 - 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 7 ~ ~ (Schedule G) O Separate Billing Requested...... .. . 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. -1 // ~ ~ l~ co 5 (o ~ f 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. , ~; ~ ~{ y .~ 7 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. ..10. a 5 6 J D ~D 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. a 3 ~ Q 7 (~ 0 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. ~ a 3 ~p ~• O r 6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 13 Q an election to tax has not been made (Schedule J) ...................... .. . 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. a ,~ 3 tQ ~ ~ . 6 q 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 .0~ ~ O 15. . O D 16. Amount of Line 14 taxable / Q at lineal rate X .0 ~ ~ a 3 ~ ~ ~ 6 / 16. ' ~ ~ 6 ~ . ~ 9 17. Amount of Line 14 taxable at sibling rate X .12 ~ ~ 17. ~ O 18. Amount of Line 14 taxable ~ ~ • ~ O at collateral rate X .15 • 18. 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1 o t~~~.19 C~ Side 2 15056052048 15056052048 RFV-'i500 EX Page 3 File Number Z / . Q 8' ._ ~ [~Z Decedent's Complete Address: DECEDENT'S NAME h1 ! LDt2E1~ R. ~{~E N ff /Il -_ STREETADDRE:iS ~ r., ~' CHOOLSI D~ ~~. __ __ __-_ _ ___ CITY mceK~~y~cs~au~~ __ STATE ~ A ZIP / 70 ~S Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) ~/O, D L ~}, /Q 2. Credits/Payments A. Spousal Poverty Credit D B. Prior Payments ~/D~ ~~ p, pp C. Discount f ~,s-tfp, d0 __ - _ _ Total Credits (A + B + C) (2) /Oj 800, ~ 3. Interest/Penalty if applicable D. Interest D E. Penalty _ _ ~ - Total InterestlPenalty (D + E) (3) ~ 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. ~c Fill in oval on Page 2, Line 20 to request a refund. (4) r ~ 3 5~ 8~ 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Q A. Enter the interest on the tax due. (5A) ~ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 :.................................................................................... ...... ^ 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? .................................................................................................................. ...... ^ ~vr Ibl IF THE ANS{MER 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. §9116 (a) {1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (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. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, a:> an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (6-98) SCHEDULE A COM~AONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE l7F FILE NUMBER Hcc/Uf~N, /Y!!LD/ZtD R., al-a8-a~z All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~ O~vhers,~~p ;rrter4sf' oj~ 100 in res-'%nf;Ql ~ eSta~e a~ t(o t' . Se-4~oo~s icle ~-i ve, (M }~, ~" oro-,t~ ~- ~ Cl'lec.~tan ~ es bur C°..u.~.bcrl and Lo., f en1~d. h1,o-'e PICt,rrr'cw)arty ~ ~SCr~ bcd ;n ~Q,~' C erfa. ~ n deed Ti^o n~ (,~ • D . C . ~ Tn c . 70 1 lt®n~ a s .T. Heenan amtl -n; Idred R• l-~eenavl, hi S wa ~e . ~ ,sa.a~ 7lzoatas~T i`/ee~an ~~~%cerlse./ L,s ~'Q/c/ 6v~le, /Ke c~~Cea~~°,r1t tier~in , lti~~.o~r ~ ~°L~~1e re ~ /~ ~tq~ adro/u7`e d wl~r` a~ 7`~ ®CJ/C'/yli~s', (d• c•al. Tho/rtdt - ~O%3 I/ 9f,3, C'ccr,~ f~er/any/ Cotcn~ Assessment = 13~, ,z(~o• no Co ccnYy rx ~//.ov/~'er = /• 2Z mid c+/eCa~ %s reeor4'ea~ !mot ~ee4~ ,~a,~ ~~$~'' veL ~6, of ~-z9ce. 75~Y ~/~~ r<?7, zp TOTAL (Also enter on line 1, Recapitulation) $ /~ ~~ 6'77, ,ZQ (If more space is needed, insert additional sheets of the same size) 2]I1ST-Dyed isaaa Cor~ontlc~ to tedhidural ar One7~.. Aaonq'a Arh H.nrs Heil. Im.. Indlean, Ya. r 1~ADE THE ~ "~ ~ day o f of our Lord one thousand nine hundred SEVENTY FIVE (19 7S~ __ ~ in the year BETWEEN W, D, C,, INC., a Pennsylvania Corporation, hag its principal placd of business at R, D. ~1 Carlin'-herein- after called GRANTOR and PARTY OF THE FIRST PART' A N D W L. i ' N,_ I`' THOMAS J, HEFNAN and MILDRED R, HEENAII, hire wife, of Philadelphia, ow~.r ~ Pennsylvania, hereinafter called GRANTEES and PARTIES OF THE W ;~~ ``- ~ ,SECOND PART v ~ v .R N LL o o a ~ O K N ~~~ J ooiz W~4,z oo©~ r O W =' '~~ " W S O Q OC ~"~ . WITNESSETH, that the s¢id PARTY OF THE FIRST PART for and in consideraf^on of the sum o/ THIRTY NINE THOUSAND NINE HUNDRED and 00100 Dollars ~$39,9~•QO) lawful money of the United States of America, unto It well and truly paid by the said PARTIES CE THE SECOND PART ¢t ¢nd before the seali~Ig and deliveru of these presents, the receipt whereof is hereby acknowledged, h¢s granted, b¢rgained, sold, aliened, enfeoffed, re- le¢sed and confirmed, and by these presents dues grant, bargain, sell, alien, enfeo,8`, release and confirm unto the said PARTIES OF THE SECOND PART, their heirs ana n~sinr~. .FILL liiFi'i` CER'I`A1N lot or ,tract of lane situate in Mechanicsburg, Cumberland County, Peruisylania,nore particularly boundedand described as follows: BEGINNING at a point on the Southerly line of_ Schoolside Drive, at the line dividing Lots rlos. 6 and 7 on the hereinafter mentioned. Plan of Lots; thence along the Southern line of Schoolside Drive by an arc cuurving to the right, having a radius of 200 feet, an arc distance of 88 feet, to the line of Lot No, 8 on the said plan; thence along the line of Lot No. 8, South 36 degrees 10 minutes 14 seconds West 138.94 feet to the Easterly line of Lot No. 4; thence along the same North 25 degrees 51 minutes West 43.41 feet to the Eastern line of Lot No. 6; thence along the same North 10 degrees 57 minutes 37 seconds East 110 feet to the point of BEGINNING, ' BEING Lot No. 7, Block P'I on the Final Plan of Wynnewood Park, as recorded in the Cumberland Co. Recorder's Office in Plan Book 23, Fage 175. UNDER AND SUBJECT to a 25 feet building set-back line from the Southern line of Schoolside Drive. BEING THE SAME PREMISES P?HICH Cumberland-T^Tilson Estates, Inc.by Deed dated May 24, 1.973 and recorded in the aferesaid Recorder's Office it ~e.`u eoc:~ ;~;, `vGilL'•~te .3~ . }'a~" y , grani:.ed and con~%ayed •,nto Gv', D. C. , Inc. the Grantor herein, ;,~ .` _~ 9ereugh e~ ........... ...e.~a School Dis+. Cumb. Co., Pa. Cumb. Co., Pa. ' L Rael Esf sfa Transfer Te: ~ -i Raal Esfals Transfer Fett Q' / q v. ~17 a~^75 ~9f~s ~i Uafa-5.^a/. .' ry Aml. ( / Dais ~ ... Amt. / .. ~• •~• Cumb. Co. Dis}. Col. L G+mhi. Co. Ui~f. Ce , Aq1. ~ ~JOK ~ ~6 PAGE r~4~ i ,, ~a~ ,.: ~, TOGETHER with aU and singular -~ ~-:° ways, waters, water-courses, rights, liberties, ~~'' epea, hereditamente and appurtenances whatsoever thereunto belonging, or in anywise appertairtinp, and the reversions and remainders, rents, issues and profits thereof; and all the estate, right, title, in- terest, praperty, claim and demand whatsoever, of - _ ~~ in la1u, equity, or otherw>!ae howsoever, of, in and to the same and every part thereof, ~-' TO HAVE ANI) TO HOLD the said dIC7L~=.i:ic:':ti^^F.L~ ~romiccc hereditamenta ana preniisea hereby pranteai oY mentioned and intended so to be, with the appurtenances, unto the said PARTIES OF THE SECOND PART, their heirs proper use and behooj of the said their heirs and assigns forever. and assigns, to and for the only PARTIES OF THE SECOND PART, And the Said praetor hereby covenants atul agrees that it will warrant generally the property hereby conveyed. `" COMMONWEALTH OF PENNSYLVANI~'~ ~" DEPARTMENT OF REVENUE ,~ REALTY ~' ~~ ryry i~2A~5FER NA1'29'TS ~~/~ 3 9 9. l: '- TAX _ ° ~ P.B.I1162 _ The PI. U. C. ~ INC. doth hereby constitute and appoint RUSSELL R. PIILSO*? to be its attorney for it, and in tts name and as and for its corporate act anal deed to acknowledge this Deed before any person having authority by the laws of the Commonwealth of Penn.~ylvania to take such acknotuledgment, to the intent that the same may be duly recorded. IN WITNESS IVHEREOF, the said PARTY OF THE FIRST PART has caused thts Indenture to be signed in its corporate name by its President, and has caused to be afic:ced hereunto the common and cor- porate seal of the said corporation, attested by its Secretary, the d~~y and year first above written:.,, r J • _. _._ - ~;T, D. C.r INC. ~-- ~,. ~' ,.,,~ . t------•-• -- --- `-c-- --~ ~, i -. - ~~ ' •. (1/ \ 1. _ . Pre~i~1~tC'..•' Attest: Secretary. RUSSELL R. PTILSON, II BJOl~,~'.26 r~~~ '~~~ ,~ Received the day of the date of the-above Indenture of the above named + State of PENNSYLVANIA sa. County of CUP'IBERLAND On this, the ~~ ~ day of , i9 75, before mt, A NOTARX FUBLIC IN AND FOFt SAIL' COT_TA:TY ~rC~} Syh1E the undersigned officer, personally appeared, RUSSELL R. T+~ILSON known to me (or satisfactorily proven) to be the person who is the attorney named in the foregoing Deed, and acknowledged that he executed the Same as the act of his principal for ,the•~purposea therein contained. ; ;': -.i - ~ , ,; ~~ , ~ . In witness whereo f, i hereunto set my hand o,~icial aea1.. _ ~ ~ , .. , - ,. / ' "' ~ ~ ~ .,i ~ ., ._._ ~. i_..ll--/1~J1 ~. ~ ___._-____.-L_____ _________ __ __ .--/_... __~ ._ .-.... _-.y___. _ ~ Title -of ©~cc~r.~ CERTIFICATE OF RESIDENCE .__________________________~.___ do hereby certify th.a the~,~Teciae residence pnd complete post office address of the within named grantee is G ~,~-~~~~--~ ~ u~ 19 / ~...'~,~a, /~/f ,..~'y Attorney for -_`~__- '.."----:~_-- /''''~...: ~~ a A ~ ~ c(l ~ V V A v-. •,~ a ~i ~~ i~-i ya A ~ ~ ~~ ~ ~ U pa ,..{ as o n a°d ~ ~ ~ U M +~ +.y v ~ ~ F. rnF..% ~ '~ L ~ Yy _~% ~~ '`~ c~ ci .-~ ~ W o ~ -~ :~ '~' ~ ~ ~ ~ ~ ~ r -S'tate 4f _y.11~~1!J_'~~~ t~G ~ ,c...._°• -_-~•--° - v :~ ., .: .. .. ~l ~ ~ a3. County Of _ _ _ _---_ ........:.........-. RECORDED on this -------_-2___•~~__~-- day of ----------~~ . A. D. i9..~~/in the Recorder's Office of said County, in Deed Book Vol. ----•~-~!_..----•--._, Page ..----~~~------• Given under my hand and the a ~aiyd o~.QBce, the date above written. .__~'.~~._----~-•'~-- --`=-- --- --.'~_._., Recorder. $JOK,(~`~Ei ~dGE 74d 1 4i ~£ .. , REVd508 EX+)L97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~, ~ ~ ~~~vK, c~~,~~ ,~ ~vo. ~~~ 7 sz '~3 ~~ ~, ~ Q~. ~~ ~' .¢CC r, i/~t'~ ~ d. o, a! obi Z{nnr No See v4l~Q~oh ~2~/" a~ac~iea~J --O . ~. /~rdd.tisfiaenf' ~ a,l~e~e Cc ~c bu,~ f ~nr ~:lo~.L/~ chua,~e ~Sy ~~' y !/erg zoo - p>att: ~.l re rru n d ~ S. 1. ~1^D ~ /"ILTi D t~ ~ IOCGI. ~ any d C 0 ~1 n ~y r p~.~ e,~ l Q,~, ~G'S ~d. ~' 1 (pai(~ ,~,y Caro) ~Molov;chi, S~ec~~;c ~Cvrse6 ~63~ rv3 6' l~/1~-i"a~ierl ~~ SCLroo ~ 4~~~S~~it~ ~E4.) CSta~E '~-xes ~ ~atid ~y Ca.ral lYlof avic.l~ , S~BC~~-c devise, ~ 2 ~ 3tf . Z 7 p I 11 PQr~i4,l rP~~unG /~-~T S~Clari~ S S7cmS y y ~~~. ~a .L,nrenfory o~,~~~o~a~,y ~~See ift°n?izacf %Sl` Q~i`a~ea~J ~D/, sZ> 9• ~CCOAontic oSfi/~lbG~ilS /"~ Epp. BO TOTAL (Also enter on line 5, Recapitulation) I $ 7/~ D ~ $', 7 ~ !If mnra cnaro is neerleri ineerf ~~Ir1rt~.,.,~1 ohoo+~ ,.a ~ti ........... .......~ ~~~~ ~ ~~i ©'"-"` ~~ 499 Mitchell Street Millsboro DE 19966 March 10, 2008 Charles Shields, III Attorney At Law 6 Clouser Road Mechanicsburg, PA 17055 RE: Estate of Mildred Heenan Date of Death: February 23, 2008 Social Security Number: 196-20-3741 Dear Mr. Shields: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. Account Type ........................... Checking Account Account Number ....................... 41975243 Ownership (Names oj~ .............. Mildred Heenan Opening Date ...........................05 / 28 / 75 Balance on Date of Death ......... X68,198.77 Accrued Interest ~ 0.00 Total .......................................$68,198.77 The above named decedent did not have a safe deposit box. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or the name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please contact our West Shore Plaza branch at 1200 Market Street, Lemoyne, PA 17043, or # 717-255- 2271. Sincerely, Charlene Warrington, Records Management 1-888-502-4349 CHECK ADJUSTMENT SERVICES CUSTOMER ADJUSTMENT NOTIFICATION-ITEM PAID TWICE THOMAS J HEENAN OR MILDRED R HEENAN 6 E SCHOOLSIDE DR MECHANICSBURG, PA 170552741 Mar 06, 2008 Case Number: 001 01 84651 00236 Dear Customer: On this date we have credited your account 41975243 in the amount of $59.88 for the following reason. Error: ITEM POSTED TWICE Date of error: 2/14/2008 Store number (if applicable): Our records indicate that this item was previously posted to your account. We apologize for any inconvenience this may have caused. Please retain this copy for your records for no advice will be enclosed with your statement. For questions regarding this adjustment please contact our Telephone Banking Department at 1- 800-724-2440 or your Commercial Customer Service Representative. Respectfully, Adjustment Services Enclosures: Checkldeposit copy cstRegPT Page 2 of 2 =o3loaao4a= •--- 02/14/20Ub ~ 64157bfi360 ~ ~ MlLDAED HEEtiA y1° ~ ~ Z 2 This I s a LEGAL COPY o f your check. You can use i am wa w uid th o r u ~~ t mr a-n R. N B E SCF100LSi0E DPoVE r 1+ECt1AttlG584.1AG PA S7C55 tXr75 oAi6 ~ ~~-<f~ y,y es e u o use the arig~nal check. ~..a ~ ~~ f~ G ~ ~ 7ATYD li1fi.~. QLiaAF • ! ~ ~ ~' ~~' C t r .D~ "x ~ '~ ` O .9 :~' ,r ~ f -- ~" DOLLARS 8 ~ . N O .f ~ ~1~ 1 O q O O t~ ~ _+:Q3L30Z955+: i. 19752+,3n'Ss,12 4+:03132955+: 4i9752431~•54I2 r~'00000059BB.~' r w __ v ,.o t , 0 0 0 '~~ O ~ O t t W W r t ~ N 1 2 ~ ~^, Y k' Ie~ 6'~ ~ N .. :~y ~ ' i O Q O c >~~ ~ a o 0 { T ~~ ~~' ~ qo :off ! °m o o a S W N 3 g .F3S~ 3 .. •..sro ... ` t '~~esj~~ LY W .t -+a v ~--. t - - iDtr nd ~ndarsa or tr+b 3rh+r tl~Y ina.1 Posting Date 2008 Feb 14 Bank # 096 Research Seq # 5128692443 Account# 41975243 Dollar Amount $59.88 ChecWStore 5412 DB/CR DB Entry Number 6350 RTABA 03130295 http://pc-ncrweb 1.mandtbank.com/inquiry/servlet/inquiry 3/6/2008 Page 1 of 2 =031000040.• 02/p7/2008 0 631044-0110 a ru This i s a LEGAL COPY o f ~.Rl your check. YOU can use i t -e -a youwould the sameway CtU , use theoriginai check ~ \ r u Q ..e O O t~ Q" D rl do 00 flo 00 oa ru N a u MlLDRED R. HEENAN o~75~",~"a 5 412 _ 8 E SCt100L5lOE OPoVE ,c, LtE.CFlhtaGSBIlRG, PA 17055 1 ~;, ~~ own _/ ~~-~~ 3 tnt~ccoe'~ ,1d?f;' "u~''.~2~'Jt/L'~c~,u~.~ f ~+, .5~%. SrS~ - r, ~ ., ~' ......~~..... 5 ~. fit:: r~.... l"v".'" ~ ~Y DgLLARS 8 2~ -±= gnu ' ©31'i~i' t ~- r~~ ..~ cl ,~ -~:0 3 130 29 55i: 419Z5243u•5412 41:0 3 130 29 5 51: 419 7 5 243i~• 54 12 .i'000000 5988.' -~ S -- .~, ~ ~~ . M ~ N ,~ t FN ~.. ~' i~ ~T 1 .~00 ~ - - ~ !~~ ~ - n :-oo .~~ _ 7gaS ga ~ 4+• ~d J tt i~ , ~ b p fh~~~ { 9 ? ~ .., ~. QO O c ,~,~ ~ aP~~333 Y ~ "tur ' ;E _~ O C •~ s 6 '{ PROt~SSED-NtT ~i T g } J m~ g .< ~ ~,t %s 'I 8?.872898 &`~ 4 ~ s . l~1 . $ ~ ~ . 3 ~_ e _ A 0 0 0 w W r r• r r 0 0 0 a o 0 0 0 .o P.oo-ono Wra.. ra.. k. k.. o ~.. O ~,. r Oik'~N r .! J ~ C~o~iUN r, ru ,= ru J r. V~o~r4 O~N~Vv V N t N N N o 0 0 0 0 o a o- o- loo net raadora~ or rrth~ b~ior Ctit ittal Posting Date 2008 Feb 07 Bank # 096 Research Seq # 5127669722 Account# 41975243 Dollar Amount $59.88 Check/Store 5412 DB/CR DB Entry Number 7895 RTABA 03130295 ~http://pc-ncrweb l .mandtbank.com/inquiry/servlet/inquiry 3/6/2008 ACCOUNT N0. ACCOUNT TYPE 41975243 CLASSIC CHECKING 00 0 06123M NM I17 26523 THOMAS J HEENAN OR MILDRED R HEENAN 6 E SCHOOLSIDE DR MECHANICSBUR6 PA 17055-2741 ACCOUNT SUMMARY STATEMENT PERIOD PAGE JAN.16-FEB.15,2008 1 OF 3 NEST SHORE PLAZA BEGINNING BALANCE DEPOSITS 8 DTHER ADDITIONS CHECKS PAID OTHER SUBTRACTIONS CURRENT INTEREST PD ENDING BALANCE N0. AMOUNT N0. AMOUNT N0. AMOUNT 66,917.45 1 2,322.44 9 564.88 3 378.99 0,00 68,296.02 ACf'C1llNT ACTTVTTY POSTING DATE TRANSACTION DESCRIPTION DEPOSI7S,ZNTEREST & OTHER ADDITIONS CHECKS 8 DTHER SUBTRACTIONS DAILY BALANCE 01-16-08 BEGINNING BALANCE 566,917.45 01-28-08 CHECK NUMBER 5408 34.45 66,878.00 01-29-OS CHECK NUMBER 5409 147.56 66,730.44 01-31-OS CHECK NUMBER 5407 159.52 01-31-08 CHECK NUMBER 5410 18.00 01-31-08 CHECK NUMBER 5411 12.99 66,539.93 02-01-08 US TREASURY 312 CIVIL SERV 2,322.44 68,862.37 02-07- CHECK PYMT 000000000005415 65.14 02-07-OS CHECK NUMBER 5412 59.88 68,737.35 02-08-08 UGI UTILITIES UTIL PMT 000000000005414 174.00 OZ-OS-08 ADT SECURITY SER CHECKPYMNT 000000000005413 134.85 68,423.50 02-11-08 CHECK NUMBER 5416 55.60 68,367.90 - 4- BER 5 59.88 02-14-08 CHECK NUMBER 5417 12.00 68,296.02 ENDING BALANCE 568,296.02 CHECKS PAID SUMMARY 5407 01-31-08 159.52 5408 01-28-OS 39.45 5409 01-29-08 147.56 5410 01-31-08 18.00 5411 01-31-08 12.49 5412 02-07-08 59.88 5412 02-14-OS 59.88 5416* 02-11-08 55.60 5417 02-14-08 12.00 LOOSA (6(a7J APT Securit~~ Services, Itu. ® I'.O. I3o~ 31)122 I~~ College Station, A'X 77li42 ADT Ah~ ~~rvs There" I{.II...{IL~III~~{IIII..{II~~IIII....IN..{IH~I~ILII~~I~11~IN~1~11~1 HEENAN MILDRED 3320 0003-13-22-MAAD - 6 E SCHOOLSIDE DR - MECHANICSBURG, PA 17055-2741 - l~r~ill~~~lll~~~~f~l~~l~i~„I~il~~~l~{~~f~~~flll~~~~ll~„~I~If PA~.~VIENT S U~V~1VfAR ~' cHECK No: 0000075335 ACCOUNT NO: 5 92 3 913 CHECK DATE Your ADT account number: 5923913 Dear Valued Customer: 04/04/08 Your ADT account was cancelled effective 02I28I2008. Our records indicate a credit. remains on your account for $91.40. A refund check for this credit amount is enclosed. If you have any questions regarding this refund, please contact ADT at 1-800-ADT-BILL. ADT Secui-it~• Sel~~ices, Inc. 14200 East Exposition Avenue ~ ! lulrora, CO 8001.2-2?12 ADT Ahe~avs There"' 1 I i 1 To HEENAN MILDRED THE 6 E SCHOOLSIDE DR ORDER ME:CHANICSBURG, PA 17055-2741 OF: MELLON BANK N.A. PITTSBURGH, PENNSYLVANIA 60-160/433 ~:~GFiECK DATE CHECK NUMBEA€ 04/04/2008 0000075335 VALID FOR 120 DAYS $********91.40 ~vY~'/Y ~ o~y ©~ ~~soti.~-c Ty ~3T Off' /l1/L ~/2E~ h~~N f}-/!1 _-- -- - ' -- -_ _ ____ - - - _ ~`tc r~1-- ~tZolav,'~l, {~ ~'/~c~~ ~~_~et%s ee. __ -_~1.~ - / l/awi~ ~- f~,~s -_wr~ - -- ~ - ___ _-- _ >> / - -D_Grin~ ~ay__~15._-_1z~C//R/l !yl- ~!„-.DGU/I _/'/~~f.' - - -- - C - - _ - _ _- - ~, -_ _ -- _ 3 _-_ -- - --_ C_~sf -of Dr~s~a~s-- __ _- -- - ~~D.DG - - -- -_ -- _ _-- --------- - -- - - / _- ,8~ _ !~_/i~o~tZt - -~I_CCt9~,~JDQ!"R~ - _ %O, 00 - // _ _ -- -- - - -- -- ---~--- - - ----~~Za_ll r~ .:a~lrlp~ - ---- - _ _- - -- -- -- - - __ _ _ - _ ~ Sze ~ -- _ --- 7 -~ f?ii1q-- aa~/ __ /.~ .d / -_~c/ s~X_~?oDc~cr~__ _C_~a~rr~S_ - --- h~i __- __ - - ~, _ _- _ _ - 2mD. er _ -~'-- -- /~ ---1~i1lf_2~--_~vS~L__------- _ _--_-__ -- - ~/bD. oo - _ __ ___---~-- _~i1~c/'/~stq_LrCi~_/-j?u/~i,~/c_a// ~ir~is~itcs - - - -_ a5z~.a~ _ _ ___ ~ _-- -_ I - ~ - -_ _- ---- ___- __ _ _ __ - _ -_ - _-- _ __ - - REV-1509 EX 111-917 SCHEDULEF COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY .INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER f~E~/r//~il/, ,~l/L D~2ED ~ .2/ D~-- ~ S~z 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. ~~t n2aLD~ieN ADDRESS .E; S~ od/s•de .Dr. l~'1 eehu n ~ c sd f~/1~, Pfd l7osS RELATIONSHIP TO DECEDENT dau~hfer B C. JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. DATE OF DEATH VALUE OF ASSET °/ OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST ,. A, ~/~0/94 m~mQEns ~sT F~~~ G2.FD1T t~.~1O~ ' ~ 13 8~/. /6 .~'~~ ~ 6 930 sB y9so -QO (R lar ~%n~s Ate'. ~o• ~r , , . X13, ~S2.~i3 P~-~nc;~al ba-!• i4-car. ~ ~ clo.c( ~8..?3 (see ,Ya/uu/ioh ~e~t!r a ffttche~l TOTAL {Also enter on line 6, Recapitulation) , $ ~~ 13~i ,~ /lf mnro mono is n~n.~l.,rl ~nn.,.i n.~.A:H......~ ..~... _a_ _~.~_ ___-- - - -~ St 0 MEMBERS 15I FEDERALGREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number! Suffix Date Account Established Principal Balance at Date of Death ,Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner (Date Joint Ownership Established VISA CREDIT CARD ACCOUNT: Account Number Date Account Established Balance at Date of Death Name of Joint Cardholder Estate of: Mildred R. Heenan Date of Death: February 23, 2008 Social Security Number: 196-20-3741 84980-00 01(06!1988 $13,852.93 $8.23 $13,861.16 Carol Molovich 04/10/1996 4121449998849801 10/18/1994 $35.31 None MEMBERS 1ST FEDERAL CREDIT UN10N .G~~ .~~~~~~~ Leig -Anne Stallings Insurance Services Assistant March 19, 2008 5000 Louise Drive P.O. Boa 40 Mechanicsburg, Pelu7sylvania 17055 (800) 283-2328 ~~ww.memberslst.org REV-1511 EX+ (10-06) _ ` COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE N FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITENd NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 9~ rriyExS FGf/VE~A~ f/D/YIF , vF /.Llechan%~s~ury s 73s, ~0 -~ Ai yE~i S Fu,~VE~2Ay h~0/!!E t3 ~ poo, eo ,~. CE/XET~Y F~~, Fem. '`/l /OD •na ~. C~ TEx/.vG, LU,NCHE~oN ~>> SSbr, S!O B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) _ ~QhQ~_ IY]D~OV/G~ __ __ L,J,f}(V~D Street Adtlress ~o ~• /~~O~S % e Dr: _!__ _ City /_~~a/1lGS+Llul'4' State ~~ Zip ~7~_s~ __ Year(s) Commission Paitl: 2. Attorney Fees C h arks E: ~ShI e%s/s 3. Family Exemption: (If decedent's addrhes,,s is not the same as claimant's, attach explanation) Claimant _~~,t-~1__ /rt ~01// G --- ,,,-- - _ ., Street Add~rnes~s.,,,'~~ _~. __ ~C~DOIs,c~~r - - - _____ City !t'It'~(:i1dY1 /GS~LL hit State /'-~ Zip ~ 70 S~_ Relationship of Claimant to Decedent t1Q _ ~tCG>'''_ --- /+ 1 4. Probate Fees ~ pj-j~~nQ,l jSSLIe oT' S~O~'~ C~,^7"i,~7Cq,~'~S 5. Accountant's Fees 6. Tax Return Preparer's Fees ~~ ~dde~f,~sin..~ in ~e C'arl.'s/e ~fi~~e~ ~d~e~t: s:nf %~ ire ~urnbcr/ana/ lain .Turns I 9. !}ddr/i"ohal ~roba,t F~~ f~ Rey. of w:/tr lo. F-1~n~ Fee ~ iQe9. of 6vi//s /~, Re%~r6ursesyfPHf ~ ~r/rs E: S~i•'e~~s ~C /ar p~,Oh~opi~s, /.bss7c~, e ~ • (PS h~+•) r~i 9sD~ ~ ~~SoO,op ~l/D.OD ~lla.7~f p`-7g ; 00 ~a So.oa 1~ 1 S . f,~o ~ 38, ~ TOTAL (Also enter on line 9, Recapitulation} $ ,2, 0 ~ y y ~ . 7 rlf mnrc enara is nao.larl incoN .,aaa,...,..i ,.ti,....,. _<.~- --~_ _`__, Myers Funereal Home, Inc. Boyd L. Myers Jr., Supervisor 37 East Main Street Meci~anicsburg, Pennsylvania 17055 (717) 766-3421 Fax (717) 795-7291 A standard of excellence in Central Pennsylvania since 1910 Monday, February 25, 2008 Ms. Carol Molovich 6 East Schoolside Drive Mechanicsburg, PA 17055 Dear Ms. Molovich, Thank you for selecting our funeral home to provide services for your family during your bereavement. { hope that you found our services to be of the highest standards and that they met your needs and those of your family and friends. The fol{owing is a summary of the service charges as previously explained and provided in written form on the services for: Mildred R. Heenan SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED $10,230.40 LESS: Credits granted 1,495:00 LESS: Total Payments 3,000.00 CURRENT BALANCE $5,735.40 Credits Granted: $1,495.00 Package Price Discount Interest at the rate of 1.5 % per month (18 % perannum) will be added to ba{ance after 30 days. If there are any questions or concerns that remain unanswered, please ca{{ me. Sincerely, L ESTgTE OF MILDRED C:aROL MOLOVICH- R HEENAN EXECUTRIX Par _~ r0 THE ORp~ 80-8224 - 2373 107 ~ , / Date a. I U ---- f~-:"t,p 1! i~~ "~--' emb- '~ 5735,E ~ ~-: Q P~DERAL CREDi2~ i:[j7N ~. - - /100 DOLLARS P. D. Sox 40 ~sic Meehanicshur9, PA 17055 1J~nn~'E.a`'sci eo -, t~ __ _..:.._ ____._ _-. ~_' _.__ ..__. ,~ Pfaia _ . _. , 7G1EIv101~'ifi~y~ __ ._ ~~ • 218324Bi33u~ ~. "• ~~ 0 L 0 ~ °~ Myers Funeral Home, Inc. Boyd L. Myers Jr., Supervisor 37 East Main Street Mechanicsburg, Pennsylvania 17055 (717) 766-3421 A standard of excellence in Central Pennsylvania since 19l 0 Friday, March 21, 2008 Ms. Caro! Molovich 6 East Schoo{side Drive Mechanicsburg, PA 17055 Gear ivis. IViolovich, Fax (7l 7) 795-7291 Thank you for selecting our funeral home to provide services for your family during your bereavement. i hope that you found our services to be of the highest standards and that they met your needs and those of your family and friends. The following is a summary of the service charges as previously explained and provided in written form on the services for: Mildred R. Heenan SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED $10,230.40 LESS: Credits granted 1,495.00 LESS: Total Payments 8,735.40 Cl1RRENT BALANCE $0.00 Credits Granted: $1,495.00 Package Price Discount Interest at the rate of 1.5 % per month (18 % per annum) will be added to balance after 30 days. 1f there are any questions or concerns that remain unanswered, please call me. Sincerely, / ~~' i ~9"' a REV-1512 E:X+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER ~/EEN~N, /YI/c D,~~1~ ~ ~/ _ o ~ ~ y z 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 VALUE AT DATE OF DEATH lY1F,Iv-D[-~ZS 1s7 1~FDE~f~L C.-2~-DlT ~t,~U/o N, ,I//S.~ C/~ ~7~IT ,~L-~T. Na. `f/Zl ~~{9r1' cj'~~({ ~JBoI 3s 3/ ) Sec di,Rlua~c>',n ~~c a~iccltu~ ~ S'~a! ~J 0'1. P . ~jp~ ~ ~GYGf1kG, .ba~ OT ~~"SdflBil 7uXGS ¢~. OD .~ `{..5. 'T!'Cl1SNry~ ~jQ/ Ol' ~'Sd/J~ TwkGS ~~, BIo.S.OO / /y@C/Ca r~, lGya L'O l~ ~Rri~ ~/D ~, 85 S tgar~r //~r~'ard~ layC in0/~ ~/otr ~piJ~~ ~ ~. ~O G . /e ri zbr~ ~ l-aac se+-Yi ~~ ¢ 6 S 9z 7. U G Z Gas ~r~%c e 4 8. t~vvtt ~'~ W caber /79.00 y5~. sy ~/~/7 5~ lo. ~,PL . Rio ~ ~~. , d& TOTAL (Also enter on line 10, Recapitulation) $ ~, S 6 S. ~~o (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCHEDULE J CODAMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE O F ~(EE nl,~~l, rn /` ~~~~ FILE NUMBER ~/-oP- a y2 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] '~ CA~o~ /v~o~a/reN 6 fpst sctioa1si o)e Dr, CIS;1cl s ec;f~i~ cJev~se l~lechan-cs6ur , PA- 17oSS af~ real estate vy %8 Yps i c/ua/ . ~. FR,~ N~ ~S ~EEN,~~ ~ ti : ~ d ~25z ~C3every ~A! y~ hesidc(,e ~tlAr/yiinStCr~ ,/Ji4 /~ 97~f .~. d u oy E'~~~3 ,l Dl ~"~" ; ~' 322 o/a/ Sfane House ,Rd. cl ue, 8 /~s poi/in~ ~S~r~r~ys, P~4 /7007 /)lectian~esbu~, PA i7osS (' ee rLt d ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 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 of the same size) s ~~/~ ,T, c~vt"~ - _ --~ ~ - ih ~,~ y CY,e~K - - - - - 3 3 2 9--- ~~GI19~.5`t.~0 sf - ' -- __ C~'/A~-_ _ __ _ _Y8 __ _/~sc%ce -- _ - - - -- _ /D-Y SG_ __/l~I~l,~/can ~Pd _ - --- ___ _- __ C~i,%/-- __ - y8' t~s ~a~u e - _ - - -- - I -- -- _ -- ~~.-~f-~_ ~r1G{`C- !/L'e._-_ - ----- Chi,'/~/ __ y'~ _ frsia~ice - -- - _ _ ~~~1~ __ Y~ t~s~~/ue -_ ---- ----__ _- -- --~~.n oar -r--«_ _ 3~ai6 _ _ -- -- -_ ---- - - -------- _ -- -- - - _- -- - -- ---- - _ --- --- ---- --- a ----- ----- ---- i I _ _ - _ _ - _ _ _ _- - _ ___ ~ _ __ _ _ ___ -- - - - _ -- _ _ -- _ __ 4 -.____ _ - - - - -_ _ - - __ - - -_ _ - -- -- _ _- _- -- - - - -- _ - - - - _ -_ -- -_ _ r__3 ,~ -- -.:, _7 4_~ -~~ _, ~ c,-, l_51 LAST WILL AND TESTAMENT OF MILDRED R. HEENAN - - -~-sa ~..,. :_ __;_~ `. j ::3 I, MILDRED R. HEENAN, unremarried widow, of the Borough of Mechanicsburg, ~-~"i Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and fi~neral expenses as soon after my decease as the same can conveniently be done. l.a. I give and devise my residential property situate at 6 East Schoolside Drive, Mechanicsburg, Cumberland County, Pennsylvania, to my daughter, CAROL MOLOVICH. I understand that this specific devise will be free of death taxes and that any fees or charges typically assessed against the value of it during the estate settlement process will be paid from the residue of my estate provided it is sufficiently large to carry the same. I make this statement of my understanding so that my children will understand that such is my confirmed wish. In the event that my said daughter predeceases me, and is survived by her spouse by at least thirty (30) days, then this specific devise shall go to her children. If they are minors at the time, then my son-in-law shall act as tnistee for them and shall take title for their benefit in such capacity. In the event that my said daughter predeceases me and is not survived by her spouse, by at least thirty (30} days, then this gift shall lapse and shall be come part of the residue of my estate and shall be divided and distributed as is therein provided. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath in equal shares, per stirpes, amongst my children, to wit: MARY CYBAK, PATRICIA LOCKARD, THOMAS HEENAN, FRANCIS HEENAN, JUDY EAMF,S, JAMES HEENAN, PATRICK HEENAN and CAROL MOLOVICH 3. I nominate, constihrte and appoint my daughter, CAROL NIOLOVICH, to be the Executrix of this my Last Will and Testament. In the event that she should predecease me or for any reason be unwilling or unable to act as such Executrix, I nominate, constitute and appoint my daughter, MARY CYBAK, to be Executrix in her place and stead. In the event that she should predecease me or for any reason be unwilling or unable to act as such Executrix, I nominate, constitute and appoint my daughter, JUDY EAMES, to be Executrix in her place and stead. I fi-rther direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this .27 day of c A.D. 2002. (SEAL) ILDRED R HEENAN Signed, sealed, published and declared by the above-named MILDRED R. HEENAN as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses.