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HomeMy WebLinkAbout11-06-08 (4)15056051047 R~~-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue ~ Bureau of Individual Taxes ~ ~,,, County Code Year File Number Po Box zsosol ~~ INHERITANCE TAX RETURN a / o ~ ~ ~ ~ ~ 7" Harrisburg, PA 17128-0601 ~~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth l 7`~ a.o ~~o ~ ~-6Q7 x..008 dP' /~ / q 19 Decedent's Last Name Suffix Decedent's First Name MI ~, ~~~ 5 x~T:H~ y~ ~ (If Applicable) Enter Surviving Spouse's Information Below Spo(use's Last Name Suffix Spouse's First Name MI /N Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH T'HE 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-ES2) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~_ 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: Name Daytime Telephone Number C H~~L FS C SH / ~'L~S: / ~ 1 7~ 7 ~ ~~D 9 Firm Name (If Applicable) -- ~ -, REGISTER ~S US LY r t r i First line of address t,`J~~ ~ -~r, t r' C~ , .,; ' ~ Z r Second line of address ~ ~ ~ r { v C -r ~.:. ~...; ' DATE FILED , City or Post Office State ZIP Code Correspondent's e-mail address: C l° $ ~ ~ e Id s 3 Q Come e st: net Under penalties of perjury, I declare that-I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN R OF ,PERSON, RES $rlt3{_E FAR FILING RETURN DATE ~ ADDRESS ~ u DRr'y, C NGE o U 7l9 h~eCot-im~ck QeLd, ~-1e.chan~csbu,rg, P/1~ 17oSS SIGNATU F PRE~ER OT}~ER TH ~ RE NATIVE DATE ~( cG' ~ /i/ jo ?7 OB ADDRESSt`N,~,~.[~ ~; Sy~t-~bs ~r ESy~- (o C!D[,tSee` ~Oad. i,Yl~rtieai cs~ae~re . ,Pi4~ /To SS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 15056051047 ~~ T ~~ ~ ~° ~i ~_ 1,5056052048 REV-1500 EX ', I Decedent's Social Security N-u7mber Decedent's Name. x/~ LNRy~I ~. !N~« ~S ~ 7 ~ ~ Q ~ / ~ / RECAPITULATION 1. Real estate (Schedule A). ... N ...................................... .. 1. ~ a Q 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. . Q ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. j '~ a~ J 3 . ~ (p 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O S t Billi R / ~ ~ ( ~ ~ / ~ p epara e ng equested...... .. 7. ~ to O 8. Total Gross Assets (total Lines 1-7) .................................. g. ~ T,0 3 ~ "~ ~ ~ 9. Funeral Expenses & Administrative Costs (Schedule H)..... .. ~....::...... 9 ~ ~ 3 ~ ~o ~ S O 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. t7 5 ,! 7 ~. 6 7 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. ' ~ 5 ~ a ~''' ~ 7 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12 (p .~ ,'~ N ~{ 5, $ 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. 0 p 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. > l0 a '1' - ~ ~ S . 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 .00 ©Q 15. O C.1 16. Amount of Line 14 taxable at lineal rate X .0 ~ ~ ~ ~ ~ ~ ~. $ ? 16. ~, D ~ ~ ~ 17. Amount of Line 14 taxable at sibling rate X .12 ~ ~ 17. ~ ~ ~ 18. Amount of Line 14 taxable at collateral rate X .15 ~ p 1 g O Q 19. TAX DUE ....................................................... .. 19. ~ ~ ` ! D ~ ~ © ~O 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056052048 1,5056052048 COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX~11-961 NO. C® 010200 LYNCH EDWARD R 220 WOOD STREET CAMP HILL, PA 17011 -------- fold ESTATE INFORMATION: SSN: t74-20-0707 FILE NUMBER: 2108-0647 DECEDENT NAME: WILLIS KATHRYN M DATE OF PAYMENT: 08/28/2008 POSTMARK DATE: 08/28/2008 couNTY: CUMBERLAND DATE OF DEATH: 06/07/2008 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 58,550.00 .I TOTAL AMOUNT PAID: 58,550.00 CHECK#1001 INITIALS: AJW SEAL RECEIVED BY: GLENDA EARNER STR,ASBAUGH REGISTER OF WILLS TAXPAYER ~ COMMQNWEALTH OE PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT COLANGELO AUDREY 719 MCCORMICK ROAD MECHANICSBURG, PA 1705'5 REV-1162 EX111-961 N0. C~ 010201 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- foltl ESTATE INFORMATION: sSN: t74-2o-0707 FILE NUMBER: 2108-0647 DECEDENT NAME: WILLIS KATHRYN M DATE OF PAYMENT: 08/28/2008 POSTMARK DATE: 08/28/2008 COUNTY: CUMBERLAND DATE OF DEATH: 06/07/2008 101 ~ 58,550.00 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 2405 INITIALS: AJW RECEIVED BY: 58,550.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX~11-961 NO. CD 010202 LYNCH LAWRENCE L 35703 MAGNOLIA ROAD REHOBOTH, DE 19971 ------- fold ACN ASSESSMENT ,AMOUNT CONTROL NUMBER ESTATE INFORMATION: ., SSN: 174-20-0707 FILE NUMBER: 2108-0647 DECEDENT NAME: WILLIS KATHRYN M DATE OF PAYMENT: 08/28/2008 POSTMARK DATE: 08/28/2008 couNTY: CUMBERLAND DATE OF DEATH: 06/07/2008 REMARKS: 101 ~ ;8,550.00 .I TOTAL AMOUNT PAID: ;8,550.00 CHECK#946 INITIALS: AJW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME STREETADDRESS K~ iH.KY/d /lt, Gv/~L /S __ _ __ CITY M ,, / y~ f~- /~ - _ S~ /'IL~CIy/~/V~CSiJK~G STATE n ZIP ~7CS Tax Payments and Credits: ~-, 1. Tax Due (Page 2 Line 19) 2. Credits/Payments D - A. Spousal Poverty Credit B. Prior Payments ~ 5~ ~ SO , ov C. Discount 1 3 5'D ~ o 0 i- 3. InterestlPenalty if applicable (1) _ ~ app. oho Total Credits (A + g + C) (2) ~ ~ ]. D 00, as D. Interest ~ ~ _ -_ E. Penalty _ _ ~` Total Interest/Penalty (D + E) (3) Q 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 requesrt a refund. ~ (4) ~ 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ I ~ J©p , Q(p A. Enter the interest on the tax due. (5A) ~? B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~ ~~ j ©p, 0(~ 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: `(es 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? ........................................................................................................................ ~~ ^ 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 o~ for the use of the surviving spous 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) percer [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 any 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, al adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(x)(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-hz~lf (4.5) percent, except as noted it 72 P.S. §9116(1.2) [72 P.S. §9116(x)(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(x)(1.3)]. Asibling is defined, uncle Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. File Number ~ I . b & D~(f • ~REVd5o8 E%+.U~97) Y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEE CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER GILL/5~ ~~~H~r~ ~'1. ~?J-D~-D~5~7 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. FUCTD,III ,f3~4NK C hcck,nq ~, ,n/p, 0005- ~77~`~ ~- Partia( ~etund ~rn Ver'-zch ~-rele~.s ~ay.36 3, Pdrf;a~ ~etund firow- eot~.n~'ry 111eadows /~580G5, ~~6 $. a!o +~. Part~a,l V?end ~n~ >Noly Sp~r--} ~-los~-f41 ~ ~ ~ ~, 00 5. Partial 'f~e~u.n d ~ro r,1 '- Gt.e Pa~'r~o~ -News ' f) o . 9 0 TOTAL (Also enler on line 5, Recapitulation) I $ /~ ~ a.33, ~6 FY~1taa~Bank LISTENING. August 15, 2008 Audrey L. Colangelo 719 McCormick Road Mechanicsburg, Pennsylvania 17055 Dear Ms. Colangelo: RE: Kathryn M. Willis, deceased June 7, 2008 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking # 0004-47714, open 1/8/1981, date of death balance $15,805.64 (any accrued interest ($1.99) would not have been payable had the ac;count been closed on the date of death) in her name only. If you should have any further questions, please do not hesitate to contact me at (717) 291-2437. Very truly yours, ~`~ ~~ Karen D. Hillegas Credit Inquiry Processor This ~Rir~r~? jter_,~ ir`, s!_ 3Ii 8~$!}tl??f tC° t~ti;fr r!r;r_ y f (i3` !f!~af~'7G55 COart4Jy C ~ ,~F ~ i~ X111 '..( ~ 1, iff~ . ~;tl'y' i;j~ti !ofi ~`. 1. C;L;k' K ~~~~ .4 ,~ _ ')~ r ! fj~ Gt'C2fS. P O Box 4887 ~ Lancaster, PA 17604 fultonbank.com 1 800-FULTON-4 ' ~ ~~ VEY%~OAwi-eless P.O. BOX 17120 TUCSON, AZ 85731-7120 Manage Your Account Account Number I Date Due Invoice Number 1462552642 ~ 10011960 01 AT 0.346 "AUTO T7 01907 17055-596419 23 E PHIL0704 Quick Bill Summary 11~~111~~~111~~~~1~1~~1~1~~1~1~1~1~~~11~~~1~~1~~~111~1~~1~~1~1 KATHRYN WILLIS 719 MCCORMICK RD Previous Balance (see back for details) MECHANICSBURG, PA 17055-5964 pwmcnt Rcvcreori Aug 08 -Sep 07 Balance Forward Save time and Money It's never been easier to enroll in Auto Bill Pay. See back of Payment Coupon below for details. Taxes, Governmental Surcharges & Fees $.00 Total Current Charges Total Amount Pay from Wireless Pay on the Web • ~ ~ ~ ~eri I~onwireless Bil{ Date Account Number Invoice Number KATHRYN WILLIS Courtesy Bill 719 MCCORMICK RD DO NOT PAY MECHANICSBURG, PA 17055-5964 P.O. BOX 25505 LEHIGH VALLEY, PA 18002-5505 1~~~!!l~~l,li~~~lL~~~J1L1~I~~l~LII~~~~i„~~l~~ll Check here and fill out the back of this slip if your billing address has changed or you are adding or changing your email address. I.LII.~~G~L.4~Ill.flS~f1~r144~L.flrlflrll.rlrlflrlflflflflllnflflrlrlflllrlll~ J '~ Questions: :~ ~~~. ~ VE September 07, 2008 520304456-00001 1462552642 $.00 $.00 ~.~~ G - _-~ ~i~ d CHECY.ING DEPOSIT FU! TON BANK + ' r ~--2q-~ Date ~~~~ CASHlCURRENCY ~ Name ~ f'1 ~ ~ (4 t S E~'¢Z.{'-f>`-- .~ Mpg ~- ~o DEPOSITS MAY NO7 Bt'ArVAILABLE FOR IMMEDIATE WRHDRAWAL I ~( /-~ THIS DEPOSIT IS ACCEPTED SURJEOT TO VERIFICATION AND UNDER THE I ~ 2T D V PROVISIONS OF THE UNIFORM COMMERCIAL CODE AND THE RULES AND PEGULATIUNS OF THIS BANK. I ® ® /~ LESS CASH ~ 1 _1 lJ RECEIVED Number ~: 5 m 5 7t~1 540 bi: ~' ~~~ Couritra! Meadows Associates Wacnovla&anE. N:A 146420 .530 ChetTyDriue _, ' _ s-5a ` .. : aio Heishey,;PA 1?033 - DATECHEGK NO. AMOUNT !, O6/26/?~08 1.464.20 $268.26*""` Pay TWO HUNDRED`.SIXTY-EIGHT~:AND 26/100 DOLLARS ''oRDEIZ AUDREY COLANGELO of 719,MCGURMIGK.RD _ iv1EGHAN~~SBURG:~'A.470~5 ~, a ~ ~,~i-I:Q .~ ,C, ~ `K~, ~"BORDER GONCAINS:WCROPRINTING i` - ~ 6 SECURITY FEATURES INCLUDED. DETAILS ON BACK IJ n°0 X464 2011° ~:031D00503~: 2D i4 20 L 24088511° 503 North list Street Camp Hil{, PA 17011-226E PAY One hundred twenty four and 00/100 Dollars TOTHE ORDER OF' KATHRYN M WILLIS 719 MCCORMICK ROAD MECHANICSBURG PA 17055 PNC SANK sa~~ .~- 198472 _:CHECKDATE PAY'THISAMQUNT I 07/17/08 """'$124.00 VOID AFTEF2 9i1 DAY5 ^_ ~'~1~ /Plrr•ckaA+It~ ~~' L SECURIT'.' FEATURES INCLUDED. DETAILS ON BACK LJ 11`9847211° t:0313~2738t: 5140D2995911° . ~bIEtPATi121o1 ~Nr,ti's ~r~ttx~ren cHAS~ s,~~iK,?~.~.. - ao 937 ~ '0900025693 ~`' .,~.ttn_;Controller Sti,racuse,I31' ' -.; -` ~ ~.. 21i _ PU F3oa 2265 e Harzisbur~ PP°1710- ~ - ~- - - .llate~06/19Z(~II8' - ~~7a}A~mnunt $*-"x70.90"°* °"TBN-,v~ID 90 afi0 T~OLL:?.h~" ""• - - ~~ ^P,/3I' K~A IlIP1'~ ° ~ ~~~I~,LIS - ~O TH:E AL1Di:E~ CC~l ,I~GELC> ., ,,:., .~r?wt.v~> ~ /[~~ ~"~ ,;aORDER-.QF ' ~~ `I.1`'I000~V[I,cK`RD ~ ~~ nB ~~cn s,g°atBrc I ,h ~ ~ we ~'' NtF.CHF,h[ICSBURG,~FA '1705 ~~ 4~ !i"~/~ ~~ _ ~ ~ ~ - AVthorized Signotun .' ,: M P •4~ ! LISTENING . `'~-,_.___.__.~,,.~....--~~----"' x ^ Savings ^ Loans !%j Checking / ~/ ~~, ~• ~~,,~-° ~.~~ a ~ ~ . f'~f, f• JIJ'*~ .;vim- . ~:.-v~ -u -r ~ , ice' ~.~"' (1 _(i ~i 'UV 1v.%'~I( ~vl,.1J VL' LLi .. ®f'9` •J I ~ *yM' ~..e.++""•"'•~~ vewss „ours I o2-si-ias 0107! DEPOSITS MAY~NOT BE; VAILABLE FOR IMMEDIATE WITHDRAWAL s ...-,LO i _. ,, _,. ; -so I ~ ~tio ' - DATE CHECKNO. AMOUNT 06,126/2008 1464.20 $268.26"" Pay NVO HUNDR SIXTY-EIGHT-A'ND 26/.100 DOLLARS ~\ _ i -TO'THE -~ ~ i ,;o~ROSR AUDREY` GUL:ANG"FLp~, 'mil 7:1G t>/IGGORMIr'!-~ RD MECHANJGSBUPG, `!'A 1'7°Y5 ,~ - ~ ,,. ~,~ ~. ~ ~; ~ Alt./ CURRY FEATURES INCLUDED. DETAILS~ON BACK ~B ~ Bt>AUFA'WNCAN&NICROPPINTNG II°0 146 4 20lI° ,1:0 3 000 50 3t: 20 i>~ 20 1 2 40g~ 5il° _ - PNC BANK . CHECKIIVURABER" ' Hmly ~:piri# H®spita9 sD.~ 503 Notth 21stStceet 198472 Camp Hill, PA 17011-2288 r r CHECK DATE 'PA~'THIS''AMOUIttT' J / 07/17/08 ^••-'•$124.00 VOtD AFTER 90 DAYS ~ ^ PAY One hundred twenty four and OG/100 Dollars JJ TO THE ORDER ~~ OF: ~~ KATHRYN M WILLIS 719 MCCORMICK ROAD /~ MECHANICSBURG PA 17055 Osrwaa.nf<~ ~CL ~,s Q r' SECURfT'.' FEATURES INCLUDED. DETAILS ON BACK. I +~ II°~96472i1° o:0~L312738t: 51.00299591 - ' - - --- THE:YATiR]OT NE~1't 1}~l~at~2cn~ CHns>i BiIN~, ~.~_ so 93> 0-90.00256.93 ,. ~ttn-,Contro'71e1 <'-S~raause,71~~ - °19. -~~ z .PO:B;o~ ?26S _. ~Harz~bifrg; FA"'77.1~~ - -. llnte 06119,=068 ~PayAmounL.,$^"':]0.90*'T* P.S~S" Ii <1TH7:~ ~ "u 1~'IL~l'S - ~"Cl THE A7JDTtE~ COLANGELO ~~ ~J~~~ ORDER-OF ' l~~-Iv1C~ uR7v1ICI: ~D AU nuC Signnturc ~1EGHF NI;:'SB.URG, YA 7705 - ~. ~ - Authorized Signature N? Country Meadows West Shore 4905 East Trindle Road Mechanicsburg, PA 17050 Telephone: (717) 761-8880 Resident Statement Date: 07/01/2008 Audrey Colangelo 719 Mc COrmick Road Mechancisburg, Pa 17055 Re: Kathryn Willis Account#: 78895 Balance Due: Amount Enclosed 00 PLEASE .INCLUDE THIS TOP PORTION OF YOUR BILL WITH YOUR'PAYMENT. ADDRESS .BELOW MUST SHOW THRU WINDOW ON ENVELOPE ENCLOSED, GEORGE M. LEADER FAMILY CORP. P.O. BOX 3060 I-IERSHEY, PA 17033-3060 REV-1510 EX+li~97) ~i. . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF ~ / L L rs., ~~ ///~ VN ~ FILE NUMBER ~/ -O ~ O~ y 7 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 NUMBER DESCRIPTION OF PROPERTY WCLUDETHENAMEOfTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTANOTHEDATEOFTRANBFER ATTACH A COPY OF 7HE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE e4.~ r?c,~~,'f . o~ Def. # ~ 33 5S~ /9 Z Z /N TRUST ~~ ~ ~kD~~ Y L . Cv G.~NG~za ~ ~ 3D 873. IDD 1ea~o -o~ Ioo,b'73,3c ¢ DECEDENTS .~i¢Gf (~HT~Z , ~•) ~f. ~ccr. ~ d.o,Q! oh ,~4. ¢$~: &y /oo~o -o - ~`8y. ~ C.) Ce~t;~ ~ Dip. #~ ~ 33 5SN 19 30 /N Tir,r~s7 f~~' L D!/~~,h'Q ~Y~'CH~ ~/DO, ~73.3D /OD 7e -o - ~/D0, 873.3 ~~ e ~ DEn/Ts soN 17.) ~n't ~CC~'_ ~ cl.a.d. o~ C o// ~ ~5, awl ~Oo~o -O ^ ~&S.~ ,~•) C'e rf.~. o><' lJep. # .Z 3 3 SS`s 1 R ~f ~ .L N 7i~sT' ~,~ ~ s~ w RE~r/CF LYNCH, ~ /o o, f~73. ~' /DD~n - Q -- /00, X73. 3! ,,0~'CFDEr~TS soN ~) l~ t. ~-eer, to d. o, d on E: ¢ F1s: ~~/ /c-ofo - o - ~&S, 8~ S ee l~q/ua~o~r ~e ~' ~M ~o,rCrG~'q,~ ,~~lk 4'ffaclaE~J ~. r~•~~To~/ ,,t3.,~y.NX A.) C'erf,f o~ ~ # 328-oa95~D~jg /N 7~ST ~D,eC ,,~lfD/Z~7/ C'OGe~~GFLO 1E .Sy 09/. 59 /oo~ -a - ~ S~ .s9, 09/, ~ EC~~/ ~ ~.~4-u ~//T~R , ,(a.~ ~nf-. ~-C'C.-'', to cl•d.d, ort ~• ~ ~9.I9 /oa~o -o-- 79.19 ~.) C~hf~-F. o~ Dep. ~ 3zg- o ~9 4 I o ~ ~ //y ?Rl(5 ~ Fo,a ~!~/i¢/ZD L Yil/C/-/ .¢N~ ~D, DOO• oo /o o~ - o - a©O, DOa. ~ L.f~N~2~NCC-- [.YivC<l, DFC.~E~ri S saws. 17.)%n t • ,/-1-cCr: }a d . o, d . o n C • '` a 6 8, o I ~ oo ~v - o -- ~°2 ~ &, o J (See valua~on /e~!`er ~{msX ~/fns//dark a/fttahec~)• t L°o,ry~i~uec/~ 0 TOTAL (Also enter on line i, Recapitulation} ~ ~ a ~ /3 ~ , ~~ SCN~.D, ~., font d . ~. a) Sovereign Bank Court Ordered Processing \ Decedents - MA1-MB3-02-10 - P. O. Box 841005 -Boston., MA 02284 July 21, 2008 Audry Colangelo 719 McCormick Rd Mechanicsburg, PA 17055 RE: Estate of Kathryn M Willis Date of Death: 06/07/2008 Dear Audry Colangelo: Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. Very truly yours, ~ ~' Donna Pe Lead Specialist 617-533-1789 Sovereign Bank ESTATE OF Kathryn M Willis SOCIAL SECURITY #: 174-20-0707 DATE OF DEATH: June 7, 2008 Account #: 2335541922 Type CD Open date: _2/29/2008 In the name of: Kathryn MWillis /itf Audrey L Colangelo Date of Death Balance: $100,873.30 Int.(YTD) from 1/1/2008 Accrued interest to date of death: Otherlnfo: Closed 6/18/08 to 5/31 /2008 $84.84 $873.31 Account #: 2335541930 Type: CD Open date _2/29/2008 In the name of: Kathryn M Willis/itf Edward Lynch Date of Death Balance: $100,873.30 Int.(YTD) from 1 /1 /2008 to 5/31 /2008 $873.31 Accrued interest to date of death: $85.84 Other Info: Closed 6/18/08 Account #: 2335541948 Type: CD Open date: _2/29/2008 In the name of: Kathryn MWillis /itf Lawrence Lynch Balance due on death $100,873.30 Int.(YTD) from 1/1/2008 to 5/31/2008 $873.31 Accrued interest to date of death: $85.84 Other Info: Closed 6/23/08 Page 1 of 1 Pl~tanBank LISTENING. June 27, 2008 Audrey Colangelo 719 McCormick Road Mechanicsburg, Pennsylvania 1.7055 Dear Ms. Colangelo: RE: Katlu-yn M. Willis, decease June 7, 2008 As requested I am writing to provide you with date of death values for CD # 328-0294102 and 328-0294102, maintained by the above referenced decedent: CD # 328-0294098, open 5/12/2008, matures 2/12/2009, date of death balance $59,091.54 plus accrued interest $79.19; paying 1.88%, titled Katln-yn M. Willis in Trust for Audrey 1. Colangelo. CD # 328-0294102, open 5/12/2008, matures 2/12/2009, date of death balance $200,000.00 plus accrued interest $268.01; paying 1.88%, titled Kathryn M. Willis in Tntst for Edward R. Lynch and Lawrence L. Lynch. If you should have any fiirther questions, please do not hesitate to contact me at (717) 291-2437. Very truly yours, Karen D. Hille as Credit Iliquiry Processor' _~~ This R'IiGP -.~; Cf a isi fie. lar ~ -~t• ~ 3 is ()i~ ~C ~til riQ j,~ ". h fY 4 C t t ~ Fa Y ~ ~f' r4,jc~ ~~ 7:~ ~ i. ,... ~ ~~'~i'~l, f"'I ~,. ~~ F~iltonBank ~~s vrsxs nno si~u LISTENING. P O Box 4887 ~ Lancaster, PA 17604 fultonbank.com ~ 1-800-FULTON-4 June 24, 2008 Audrey L. Colangelo 719 McCormick Rd Mechanicsburg, PA 17055 RE: Estate of: Kathryn M. Willis Tax Identification Number: 174-20-0707 Date of Death: June 7, 2008 To Whom It May Concern: Commerce Bank This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: CD Account Number: 1701338 Date Opened: February 29, 2008 Primary Owner: Kathryn M. Willis Primary Beneficiary: Audrey L. Colangelo Date of Death Balance: $61,821.72 Accrued Interest: $63.97 Principal Balance: $61,757.75 YTD Interest: $584.91 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, ~? " Cindy Shultz Support Associate/Deposit Services Commerce Bank Commerce Bank /Harrisburg, N.A. PO Box 4999 3801 Paxton Street Harrisburg, PA 17111-0999 commercepc.com BEAUER URICH FUNERAL HOME 35 GOTHAM PLACE REn LION, PA 1735G 717-244-6991 C O P Y 06i11i2008 10:56:49 Sale= Transaction # S - 1 Card Type: UISA Acc: *~**~~~#**~*798G Entry: Manual Invoice # 55 Total : ~~ - 5d Reference No.: 0001 Auth.Code: 02112B Response: AF' AUS Response : Y Address & fi~e_dic~it ZIP code match. CUU2 Code: M CUU2iCUC2 matches with system data. CUSTOMER COPY REV-1511 EX+ (12-99) ,~.~~~, SCFIE®U@E N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER W /GL/S, ~/~ 7N~y~ ~I. ~/_o~_ 6Gy~ Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' heaver Ldr;cl~ funeral Honne, Tnc. , o{ Lew;sh~rr~ ~t I. boo, o0 ~. 13ausG~man IYlemorial tNO,rkt ¢ ~ 8s.oo 3, ~)awl?r--s, ~ure;,rr~l Spro~.. ~74,sv B. I ADMINISTRATIVE COSTS 1. Personal Representative's Commissions Name of Personal Representative(s) ,~ G! Q,I~E y rr'OL,~N 6EL O GU ~~ ~~ D Social Security Number(s)lEIN Number of Personal Representative(s) Street Address, I.7/9 6L1c C'orm~ ck Olt c~ City ~~ C~10 h i C S o u NQ State ~~_ Zip ~ 7 D SS Year(s) Commission Paid: 2. Attorney Fees CVlCL1'I~$ ~, ~hre~dS 1y (8S~1M.) ~~~Q~17,OD 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant ,1~1~/V~ ~'L/G//3L~' /UaNE Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees ~p+ DY'I~rna.l 1SSUe, D'~ Shoat Cerf'i~~CQ.Ie.S f ~Z,QD 5. Accountant's Fees HtK /3toe.k •{ MP,C~tanicsbkr-5 ~ Pk ~i,r clost-owf /a'yof?~ ~ 11S,dO 6. Tax Return Preparer's Fees 7. F.1~n~ of -~ retnv~nc~q,~,'oyt ~vrms ~¢ g~ ~~/~~ l o.oo ,Fre ~ ~'eq ~ s {fir o~ Lv i ir5 5~~ S. o v ~~}D. 00 TOTAL (Also enter on line 9, Recapitulation) ~ f ~ ,3(Ql,, SQ i flt more space is needed, insert additional sheets of the same sizel RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 6/13/2008 Cumberland County - Register Of Wills Receipt Time: 15:34:14 One Courthouse Sgware Receipt No.: 1053038 Carlisle, PA 17613 WILLIS KATHRYN M Estate File No.: 2008-00647 Paid By Remarks: ATTY CHARLES SHIELDS III WZ ------------------- Fee/Tax Description PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 1170 Total Received......... Receipt Distribution --~---- ------- -------- --- Payment Amount Payee Name 20.00 CUMBERLAND COUNTY GENERAL FUN 15.00 CUMBERLAND COUNTY GENERAL FUN 12.00 CUMBERLAND COUNTY GENERAL FUN 10.00 BUREAU OF RECEIPTS & CNTR M.D 5.00 CUMBERLAND COUNTY GENERAL FUN ---------------- $62.00 $62.00 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Sgcare Carlisle, PA 17613 WILLIS KATHRYN M Estate File No.: 2008-00647 Paid By Remarks: AUDREY COLANGELO WZ Receipt Distribution Receipt Date: 6/16/2008 Receipt Time: 11:07:33 Receipt No.: 1053043 Fee/Tax Description Payment Amount Payee Name RENUNCIATION 10.00 CUMBERLAND COUNTY GENERAL FUN ---------------- Cash $10.00 Total Received......... $10.00 ~=~ c~ ~ i~, ~ ~ (~ ~ o S BEAVER URICH PHONE 717-938-6172 Funeral Home, Inc. FAX 717-938-5732 John P. Katora, Supervisor PENNSYLVANIA AFFILIATES RED LION Olewiler & Heffner June 11, 2008 EAST YORK Everhart-Jackson-Neff ner JACOBUS Heffner Mrs. Audrey L. Colangelo YoRrc 719 McCormick Road Heffner Mechanicsburg, PA 17055 TROY Vickery RENOVO; M XW li Dear Mrs. Colangelo a e , ',LOCK`.HAVEN Helt On behalf of everyone at Beaver Urich Funeral Home, we appreciate your ~wu,rAMSPOxT; confidence in allowing us the privilege of handling the final arrangements for ' - A°er,'& Redmond - your mother: Enclosed you will find a copy of the receipted statement for your ~m~,TON records. Ranck ro7-rs~~ILE We sincerel ho e"that our service was in accordance with our washes and Schlitaer=Allen-.Pugh----~--- ~~-------- - y that pit anticipated your every desire. It is our purpose to give thoughtful n:vocA service, and if in so Join we have hel ed to li hten 'our burden, our. aim has Kniffen OOMalley g p g wli;I~s-BAR1tE been accomplished. Kriiffen:0'Malley _, Mrs. Colangelo, we trust loving memories of your mother will comfort and NI';w YOIiKSTATE sustain you and your family in the days ahead. Please consider us a friend you AFFLAIATES can count on and do not hesitate to contact us if we can be of further assistance. WELLSBURG " . Roberts- Sincerely, ~// ~~' Nath~I~~Ray Funeral Director NJR/lfs Enclosure Mailing Address: Box 322, Lewisberry, PA 17339 Street Address: 305 West Front Street, Lewisberry, PA 17339 1 PHONE 717-938-6172 FAX 717-938-5732 John P. Katora, Supervisor BEAVER URICH ~~~e.~~ Hoer. ~~~. FUNERAL SERVICES FOR: Kat TO: Mrs. Audrey L. Colangelo 719 McCormick Road Mechanicsburg, PA 17055 M. Willis )3ox 322, 305 W. Front St. Lewisberry, PA 17339 Account= No:BEA-208011 Date of Seririce: 06/10/08 AMOUNT FUNERAL GOODS AND SERVICES SELECTED 2,895.00 Basic Services of Funeral Director & Staff 375.00 Transfer of Deceased to Funeral Home 895.00 Embalming 585.00 Other Preparation of Deceased 820.00 Staff and Facilities for Service 395.00 Staff for Graveside Service & Accessories 395.00 Hearse to Final Disposition 185.00 Service Van - Disposition of Flowers 45.00 Guest Register 85.00 Memorial Folders or Prayer Cards - 1-5.00 Acknowledgment Cards 45.00 Hairdresser 2,295.00 Casket Selected - Autumn Oak 1,495.00 Vault Selected - Continental 60.00 Death Certificates 215.00 Out-of-Town Newspapers 125.00 Cemetery Equipment (Tent, Greens,Lowering Device) 875.00 Cemetery Charges 100.00 Clergy Gratuity 11,900.00 TOTAL BILLED 11,900.00 CASH RECEIVED 0.00 BALANCE DUE TERMS: Finance charge of 18.00$ per annum (1.50% per month) on the unpaid valance for each month or fraction thereof commencing on the 1st day after Date of Service. Heffner's Received From The Sum of ~_ uneral Expenses of ^ Heffner Funeral Chapel & Cremator}~, lnc. ^ Life Tributes by Olewiler & Heffner Funeral Chapel & Crematory, Inc. / ^ Everhart-Jackson-Heffner Funeral Home, Inc. ,' Beaver- Date . ~ / / t; f Ub' Urich Funeral Home, Inc. -- l ~' ! u-~ . I i , 'coca , ~~ -~~ hh v ~ ] Cash Amount ofAccount $ C q~v, ~~~ Check #_~ Amount Paid Credit Card ~ ~ ~' ~~ ` ~ Balance Due ~ ~ . ~~ ThuJ1k ~'ou, REV-1512 EX+ (12-03) '~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ~ /LL/S ~e¢T/~Ry/1/ ,/f/. FILE NUMBER ~ ai-o~- D~y7 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. 't .~ 1 x r~ t~ -- [~] E-7 LTJ ~ xcnrf ~nnm O I n C tf] ~] >C n x N~ ~ rfo ~ ` ~• t~~n n w m x I •• ~z zx~ H rt n ~ ~o l7J n C `' c~ m w t~Cmrotoz znzt~ I nrz~d~~ro I ~H ~• a a~ ~~ x x o a~ I rs ~. 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O cn I I (n LT] I I \ N d I I I ~-3 d -- --- ----- I d 'TJ ~ I H '~ ~ ~ I d rt C~ C~ I ~ H H rd I G • • • • (~ I [TJ Lam] r I (D o I .. .. rn r I •• c I \ H c~ I ~, z I O (/1 C I \ ~3 I I-~ o (J7 ` ~ I N ~J I N ~ \ ~ ;tiJ I W ~q I • • \ O O ~.'' ~ I \•• I U~ O co o y Z I o I cn cn H ~3 I co I •• \ x0 I I cno ZJ ~J I I W co 1 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT s~N~~u~E J BENEFICIARIES ESTATE OF W / L G !S, ,~,~ Tiy,~y/1~ /j9. FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1' L /~-u1I2ENCF L. L YiUCH So ry y3 3 5 70 3 ./{?a~noli'a Read '}~ehobo}I~, pE 1991 ,~. Ef~l.~/A~20 R LYNC~1 5o v~ y3 a( a~~ (~J00~ S}'rCet Camp ~'~ i I , Pfl• I ~ 011 3. ~U~nEY CpLi¢NGEGD ~ a.t,u~hfu- y3 7i 9 !'G(C Cor~~c,~! ~t oa cl n`IecharliCS~u,r~ PA~ Doss 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 $ LAST WILL AND TESTAMENT OF KATHRYN M. WILLIS I, KATHRYN M. WILLIS, of the City of York, York 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. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my beloved three (3) children, Lawrence L. Lynch, Edward R. Lynch and Audrey Colangelo, in equal shares, per stirpes, to their own use and benefit absolutely. 3 I nominate, constitute and appoint my said three (3) children, LAWRENCE L.. LYNCH, EDWARD R. LYNCH and AUDREY COLANGELO, to be the Co-Executors of this my Last Will and Testament. I further 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 ~~~- day of ~I a°~'~--~ , A.D. 1999. - , ~~ ~-S' (SEAL) KA YN . WII.LIS Signed, sealed, published and declared by the above-named KATHRYN M. WILLIS 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 here~unto~subscri~bed our _ s~as witne`s~s~~e's'~ r CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M.HOUCK (1912-1991) November 4, 2008 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Kathryn M. Willis No. 21-08-0647 Dear Register of Wills: TELEPHONE (717) 766-0209 FAX (?17) 795-7473 Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Kathryn M. Willis Estate as well as Check No. 2459 in the amount of $15.00 for the filing fee, Check No. - 2460 in the amount of $40.00 for additional Probate, Check No. 2458 in the amount of $366.68 and Check Nos. 871 and 984 in the amount of 366.69 each for the Inheritance Tax due. Thank you for your kind attention to this matter. Very truly yours, Charles E. Shields, III Attorney-At-Law c7 '..> ~~ m x -` - .:~ ~ ._~ Enclosures ~ ~ ~ `~, ' ~ t_. ~C'~ ~ f__,_ -, N _ -:_; .'qr~ . , N W ~ ~ Q ° ~i F r N O W cn ~ ~ ° ON ° J p a ~ f~- w~ _ cn ~~ ~ ° ~ ~ w ~ ~ -~- - - ~ oC ~ ~ ~~ ~ ~~- ~ O _ U r ~_ ~ ~ U ~ Q ~ M _ N ~ E ~ ~ z ~ M ~ U ~ J ~ Cn r p > U Cn r ii cr1 M ~ ~ o - .U ~ ~ ~ LL ~ ~ Q ~° ~ ZO ~ - a~ ~A ~ ~QOa o w J ~ ~ r ~ m ~ J ~ w ~ c~ a ~ ~ ~ OC U r U °_ - a Wow =gym .. ~ cno~v O w J ~ Q Q v~~ ~ F- :' Li ~' t ~ i ~ S 4 ~~ ~ \, S t ~i ( IU ~ - b r'~~lf~ y..a ? f 4 4 •i ~' ~ ~ t ~` ~ ~-:~~ ~ 4 _ ~, ~~ _fy,~. y x1 ~y , i F -~ ' l k a1 C '~ 1 1 ~ ~{J M`~ "!~ Y r~ r I t '~ ~ ~~ 1 ; }~i e ~` 1 ~ - ~ ~ r ,~ ~ ~ r x F~ ~. Y - '. ! k ~ 4~