HomeMy WebLinkAbout02-04-09 5056051058
REV-1500 EX (06-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po Box 28oso1 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 08 1219
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
11 /08/2008
Decedent's Last Name Suffix
EVENS
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
'.EVENS ' 'IIIJR
Spouse's Social Security Number
Date of Birth
02/03/1934
Decedent's First Name..
CAROLYN
Spouse's First Name
CLIFFORD
MI
J
MI
H
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
?;.~; 1. Original Return ~;"°t 2. Supplemental Return ~°~`;~ 3. Remainder Return (date of death
prior to 12-13-82)
_,",.~ 4. Limited Estate '°:-,~ 4a. Future Interest Compromise (date of ,,~„„, 5. Federal Estate Tax Return Required
death after 12-12-82)
°:.l~ 6. Decedent Died Testate C°~."> 7. Decedent Maintained a Living Trust __._..._ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
C~„:~ 9. Litigation Proceeds Received ".~.~ 10. Spousal Poverty Credit (date of death 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
THOMAS E. FLOWER ' (717) 737-3405
Firm Name (If Applicable)
-
REGISTER OF WILLS USE Ot~
SAIDIS, FLOWER, LINDSAY C w
~
First line of address ~
~ w
2109 MARKET STREET ~
t
" ~~ .C
Second line of address ~
C' Q ss
~j ~ s
City or Post Office State ZIP Code -- DAT~"F~ --N
CAMP HILL PA 17011 ~ t~
Correspondent's a-mail address: tflDwer@sfl-IaW.CDm
Under penalties of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correc and complete. Declaration of preparer other than the personal representative is based on all in which preparer has any knowledge.
SIGNATUR F HERSOfThR1~PONSIBLE FOR FILING RETURN ~ Dl~TE ~
ADDRESS
C ' rd H. Evens, III, 8 Vicksburg _Ct., Mechani_c_sburg, PA 17050
(GNAT RE OF PREB11ftt'~ THAN REPRESENTATIVE
r/y
DATE
it
--
Saidis, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17011
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
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_J 15056052059
REV-1500 EX
D
ecedent's Name: CAROLYN J EVENS Decedent's Social Security Number
_
_
RECAPITULATION~~~~~"~"~'""""""~'""` a .~ ,-...a
1. Real estate (Schedule A) .............. _
........................... .... 1.
2. Stocks and Bonds (Schedule B) .......... _
......................... .... 2. 262,436.74
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) ~.;~ Separate Billing Requested
6 .. ...
....
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
Schedule G)
" ...
.
.
_....
C;,,~
~ Separate Billing Requested.... 7
. ...
.
54, 987.90
8. Total Gross Assets (total Lines 1-7)...... .
...........
~,..~,~ .
...............
m,,.~,.~.,~,.~,~,~,,~„~.,,~„~~„~,.,, ~„~, ... 8.
317,404.64
Funeral Expenses & Administrative Costs (Schedule H) .
................. ... 9.
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I)
............. ... 10.
11. Total Deductions (total Lines 9 8 10) .......
......................... ... 11.
12. Net Value of Estate (Line 8 minus Line 11
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12 317,404.64
an election to tax has not been made (Schedule J) ..
.................... . .
13.
15,000.00
Net Value Subject to Tax (Line 12 minus Line 13) .
.....................
_..__..__.._.._...m..._..~~.~....__._,.__..._.~ ~_..._~ ~...__.~.__.~_....._.____._._...._._..._..___...
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES .. 14
...._._ _._._,
_._._._.__.__.. _._......_._... 302,404.64
°"'
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 - -- __._
(a)(1.2) X .0 00 302,404.64: 15
16. Amount of Line 14 taxable .
0.00
at lineal rate X .0 -
17. Amount of Line 14 taxable - 16.
_
at sibling rate X .12 - __ _ _
_ _. .
18. Amount of Line 14 taxable _ 17.
at collateral rate X .15
_ _... _. _ 18.
19. TAX DUE ...........
............................................. .19.!
0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
~rv~~
I.- 15056052059 Side 2
15056052059
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 08 1219
_,~..
DECEDENT'S NAME DECEDENTS SOCIAL SECURITY
- _---
STREET ADDRESS --
230 N. 19th Street
_- _ _- -
CITY STATE ' Zjp
Camp Hill PA ' 17011
i
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 0.00
2. CreditslPayments
A. Spousal Poverty Credit ___ ____ __
B. Prior Payments
C. Discount ---
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
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.
(5)
(5A)
(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 :........................................................................................ .. ^ 0
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? .................................................................... .. ^ ^x
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? ............. . ^ ^x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................................... . ~ ^
0.00
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. §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 assess 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, as an individual who has of least one parent in common with the decedent, whether by blood or adoption.
REV-1 S03 EX+ (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CAROLYN J. EVENS FILE NUMBER
21-08-1219
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REV-1510 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OI
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
--- - ~~--- ..,..,.....,...~„~~a~ ~iiccw ~~ uie same s¢e~
CAROLYN J. EVENS FILE NUMBER
21-08-1219
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REV-!513 EX+ (11-08)
:j ~ Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE
BENEFICIARIES
ESTATE OF FILE NUMBER
CAROLYN J. EVENS 21-08-1219
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, 2116 (a) (1.2).]
1. CLIFFORD H. EVENS, JR., spouse 100% of residue
C/0 CLIFFORD H. EVENS, III, 8 Vicksburg Ct. Mechanicsburg, PA
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. Harrisburg Chapter, American Guild of Organists 5000
2. St. Stephen's Episcopal Cathedral, Harrisburg 5000
3. Salvation Army, Harrisburg Chapter 2000
4. Volunteers of America, Harrisburg Chapter 2000
5. Bethesda Mission, Harrisburg 1000
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ 15,000
If more space is needed, insert additional sheets of the same size.
LAST V~%ILL AND TESTAMENT
or
CAR®LYN J. E'1~ENS
I, CAROLYN J. EVENS, of the Borough of Camp L-Iill, C~unberland, County,
Pennsylv~ulia, declare this to be my Last Will and Testament, hereby revolting any will
previously made by me.
I - I direct that a]] m}~ just debts, including expenses of my funeral and last
ti
.~
:. '
'~,
illness, be paid from my general estate as a part of the cost of administration as soon after
m}~ death as practical.
II - I make the following specific bequests:
1. The sum of $5,000 to the Han•isburg Chapter, American Guild
of Organists.
2. The sum of X5,000 to St. Stephen's Episcopal Cathedral,
Harrisburg, Pemnsylvania for use in its music program.
3. The sum of $2,000 to the Salvation Army, Harrisburg Chapter.
4. The sum of $2,000 to the Volunteers of America, Harrisburg
Chapter.
5. The sum of $1,000 to the Bethesda Mission, Harrisburg,
Pennsylvania.
III - If my husband, Clifford H. Eve~ZS, .Ir. survives mP >,~, si~,ty X60; d~;'e, I
SAIDIS,
I~OW~R ~
LINDSAY
ATIt71tNGl;ti•ARIAN'
Z l09 Marker Stcee~
Came Hill, PA
devise and bequeath the residue of my estate of whatever nature and wherever situate unto
the trustee of the Clifford H. Evens, Jr. Revocable Living Trust.
IV - Should my said husband fail to survive me by sixty (60) days, then I give,
devise and bequeath all the rest, residue and remainder of my estate unto my sons, Clifford
H. Evens, III and Charles D. Evens, in equal shares, the share of a deceased son io be paid
to 1>is issue, per stiipes.
V - All principal and income shall, until actual distribution to the ~benefciary,
be free of debts, contracts, alienations and anticipations of any benelieiary, and the same
shall not be liable to any levy, attachments, execution or sequestration while in the
possession of my executor.
VI - I hereby direct that all estate, inherit~u~ce, succession and other death taxes
imposed or payable by reason of my death, with interest and penalties thereon, if any, with
respect to all property comprising my gross estate for death tax purposes, shall be paid out
of my estate and can be considered a cost of the administration of my estate.
VII - My executor may join with my husband or his personal representative or
trustee in a joint income tax return covering any period of time for which an income tax
return has not been filed up to the time of my death, or in a gift tax return on gifts made by
m}~ husband prior to my death, for which a gift tax return has not been filed, and in
connection therewith to determine what taxes, interest and penalties are proper and to pay
the same even though such payment may result in additional liability to my estate.
VIII - I appoint my sons, Clifford H. Evens, III and Charles D. Evens, as Co-
Executors of this, my Last Will and Testament. Neither of my personal representatives
shall be required to post bond in this or any jurisdiction.
1N WITNESS WHEREOF, I have hereunto set m}~ hand and sea] on this, the
CIS,
>WER ~
NDSA1'
rnwrf s•n~an~r
Markey Suee~
mh Hill, PA
')~ iv,,
~ ~ ~ day of ~ ~ -~ , 2008.
~ /-) ~ ~~-
~ ,
/ ~ FL,t~ ~;~ ;~--~-~~,~. (SEAL)
CAIZpL~'N,O. EVENS
// ';~
`_
Signed, sealed, published and declared by Carolyn .I. Evens, Testatrix therein named, -as
and for her Last Will and Testament in our presence, who, in her presence, at her rectuest,
and in the presence of each other, have hereunto subscribed our names as attesting
witnesses.
Name: ~-i~~+Ji~1s ~. d=~,~t1C-.iL
~~..- ~.L/Z~ ~f-~c--~LC~
Nall7e: /~i~r/~ IC ftGc:.~~~
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND
Address
Address
SS.
WE, the undersigned, the testatrix and the witnesses, respectively, whose names are
signed to the foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the testatrix signed and executed the instrument as her Last Will
and that she signed willingly (or willingly directed another to sign for her) and that she
executed it as her free will 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.
CA`120LP1x ~. EVE'S, Testatrix
1, ~ ~~ ~, f
Witness
!,
Witness
hIDIS,
EWER bz
NDSAY
rnnrvevs•,n•ia~c
Markel Street
unp Hill, 1'A
Subscribed, sworn to and acknowledged before me by the testatrix, and subscribed and
sworni to before me by both witnesses, this '~ ~' ~'~` day of ~ ~ ~. ,
2008.
Notary Public
COMMONWEALTH OF PENNSI'LVANIA
Notarial Seal
Yvonne Sersch, Notary Public
Camp Hill Boro, Cumberland Gounty
My Commission F~cpires Feb. 1, 2012
Member, Pennsylvania Association of Noiaries
CLII'I+ORD H. EVENS, JR. REVOCABLE LIVING TRUST
THIS TRUST AGREEMENT, made the ~~ ~~ day of N~ ~ ~ 2008,
between CLIFFORD H. EVENS, JR ("Settlor") and WACHOVIA BANK, N.A. ("Trustee"),
~VITNESSETH:
FIRST: Settlor hereby transfers to Trustee the assets listed in schedule A, which Trustee
shall hold, together with any other property which may be added, upon the following terms and
conditions:
SECOND: During the lifetimes of Settlor and his wife, CAROLYN W. EVENS, Trustee
shall ray and distribute to Settlo?~ and/or his wife, or shall apply directly for their benefit, as
much of the principal and income of the trust as Trustee may consider desirable to properly
provide for their health, maintenance, support and comfort;
THIRD: Upon the death of Settlor, or upon the death of Settlor's wife if she survives him,
A. Tnistee shall pay the decedent's just debts and funeral and burial expenses;
B. Trustee shall pay any and all estate and inheritance taxes, together with interest and
penalties, which shall be payable by reason of the decedent's death upon the property passing
under the decedent's will or this agreement of trust to the extent that the same shall not be paid
by the decedent's executor. For such purposes, trustee may advance to the executor of the
decedent's will such amount as may be required by the executor of the decedent's will for the
payment of such taxes.
C. Trustee shall distribute the following charitable gifts, but only to the extent that the same
have not been paid as bequests from Settlor's estate:
1. The sum of $5,000 to the Levi Lamb Fund, Pemisylvania State University,
State College, Pennsylvania.
2. The sum of $5,000 to the Camp Hill Presbyterian Church, Camp Hill,
Pennsylvania:
D. Trustee shall distribute the balance of the principal and income of the Trust, in equal
shares to Settlor's sons, Clifford H. Evens, III and Charles D. Evens, per stirpes.
FOURTH: Tnistee is fiu-ther authorized in its discretion, to make such loans, advances or
expenditures out of the principal of the trust, as trustee may consider desirable in order to
facilitate the settlement of Settlor's estate. In exercising such authority, Trustee may pay in
whole or in part the expenses of Settlor's last ilhless and burial, debts, income taxes, estate or
inheritance taxes, legacies, conullissions, counsel fees and other administration expenses, owing
by Settlor or by reason of his death, which pay?rents may be made directly by Trustee or to the
executor of Settlor's will and neither executor nor any beneficiary shall be required to reimburse
the Trustee for any funds so loaned, advanced or expended.
FIFTH: If any income or principal shall be payable to any person who shall be a minor or
who shall be incapacitated for any reason, trustee shall hold such income and principal during
minority or incapacity and shall be entitled to apply such income and principal to the health,
maintenance, education and support of such person during minority or incapacity without the
appointment of any guardian or committee or any authority of court. Trustees shall be entitled to
make direct application or to make application by payment of income and principal to the parent
or other person in charge of such minor or incapacitated person, or to his or her guardian or to a
custodian under the Unifoi~n Transfers to Minors Act. Any remaining income and principal to
which such person shall be entitled shall be paid and distributed to such person upon the
termination of minority or incapacity.
SIXTH: No income or principal shall be assignable by a beneficiary or available to anyone
having a claim against a beneficiary before actual payment to the beneficiary.
SEVENTH: Trustee and its successors shall have the following powers in addition to those
given by law to be exercised by it in its absolute discretion, which powers shall be applicable to
all property held by it, including property held for minors or incapacitated persons, effective
without the order of any court and until actual distribution of all such property.
A. To retain any investments at discretion including stock of any corporate fiduciary or of a
holding company controlling it;
B. To invest and reinvest in the trustee's discretion as permitted under Act 28 of 1999, the
Prudent Investor Act," with the specific right to invest in stocks, bonds and real estate,
including non-income producing residential real estate for the occupancy of any present income
beneficiary or beneficiaries, and in such diversified, money market and mutual funds, including a
corporate fiduciary's proprietary mutual funds, as the trustee deems appropriate, including any
such funds of any corporate fiduciary hereunder or any successor or affiliated corporation or a
holding company controlling it;
C. To sell, to grant options for the sale of, or otherwise to convert any real or personal property
or interest, at public or private sale, for such prices, at such times, in such manner and on~ such
terms as trustee may think proper, and to execute and deliver good and sufficient conveyances,
assignments and transfers without liability of any purchaser to see to the application of the
purcl~ase money..
D. To bor•ow money and to secure its repa}~nent by mortgage of real or personal property,
pledge of investments or otherwise, without liability on the part of the lenders to see to its
application;
E. To compromise claims by or against Settlor's estate or any tillst created hereunder;
F. To allocate and distribute different kinds or disproportionate shares of property or undivided
interests in property among beneficiaries or trusts, in cash or in kind, or partly in each; partly in
each;
G. To register investments in the name of a nominee or to hold the same unregistered in such
form that they will pass by delivery;
H. To join in any recapitalization, merger, reorganization, or voting trust plan affecting
investments; to deposit securities under agreement; to subscribe for stock and bond privileges;
and generally to exercise all rights of security holders;
L T'o manage, operate, repair, alter, or improve real estate or other property, and to lease real
estate and other property on such ternls and for such period as trustee deems advisable even for
more than five years and beyond the duration of any trust;
J. To receive from Settlor or from any other source any real or personal property as additions to
this trust by deed, will or in any other maru-zer;
K. To combine, without prior court approval, any mist herein with any other tnzst with
substantially similar provisions, although such other trust may have been created by separate
instruments and by different persons.
L. In the sole discretion of the Trustee, to divide any trust created under this agreement, without
court order, into one or more separate trusts for the benefit of one or more of the beneficiaries of
the trust (to the exclusion of the other beneficiaries) so divided, as the trustee determines, and to
allocate to such divided trust some or all of the assets of the mist estate for airy reason;
M. To permit any present beneficiary to occupy any real estate forming part of any trust without
rent or on such other terms and conditions as the trustee shall determine;
N. To do all other- acts and things necessary anal appropriate in the management, administration
and distribution of~this trust.
EIGHTH: The law Finn of Saidis, Flower & Lindsay shall serve as Tnrst Protector. In the
event that the size of the mist corpus should become so diminished that the expenses of trust
administration by corporate trustee should become impractical, the said Trust Protector shall
have the right to remove the corporate trustee by written notice to such corporate trustee of such
removal and the designation of a successor trustee. Any such removal shall not be effective until
the successor so designated has qualified to serve. In the event of such removal of corporate
tnistee, I designate my sons, Clifford H. Evens, III and Charles D. Evens, to serve as successor
co-trustees.
NINTH: No fiduciary serving hereunder shall be required to furnish bond in any jurisdiction, and
if any bond is necessary, no surety shall be required.
TENTH: Trustee shall be compensated in accordance with its standard charges for such
trust services in effect from time to time during which such services are performed.
IN WITNESS WHEREOF, the parties have hereunto set their hands and seals on the day and
year first above written:
1
.~.~--~-
Witness CLIF H. EVENS, JR.
SETTLOR
Attest:
5Ta'} ~ ~ 0 F IW1 SSo ui2
C-@~Pd~'~i' OF C
C~rK ~. Gauts~
WACHOVIA BANK, N.A.
TRUSTEE
~~ ~1.
By:
On this, the ~ day of S ~ „ ! i- r,~, ,e r 2008, before me, the undersigned officer,
personally ap eared j~ 5 a z p who acknowledged him herself to be
y; ~ ~ - ~ ~ Q, ; ~~ „-} of WACHOVI BANK, N.A., a corporation, and that he/she as such
being authorized to do so, executed the foregoing instrument by signing
the name of the corporation by him/herself as T~Ma 5 5~-4 ~ ~ U
IN VVIT'NESS WHEREOF, Ihave hereunto
~~~:~ Jl ~J~ ~~ ~'~~ ~ ~
Notary Publi~
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND)
public,
me (or
and act
Notary FuLlir, r+at . ~ , . ~~~.~!
StGte of Misso~.~ri. Je`tecson County
off, i;J3 02,010
~ICOmrn~~,',.. - ...
~~n jl,
r~-~. ~ ...,~....,,~...,~,,...~,.,~^
On this, the ~O~ fi~ day of ~~ , 2008, before me, a notary
the undersigned officer, personally ann::ared fhe Sett_ r, Clifford H. E~.~ers, Ir., known to
satisfactorily proven) to be the person ~.vhose name is suUscribed to the within instrument,
~nowledged that he executed the same for the purpose therein contained.
IN WITNESS WHEREOF, Ihave hereunto set my hand and official seal.
4\ \
tary Pub11C
1VIy commission expires: OOINMdtJWcALI`H of PENNSYLVANIA
Notarial Seal
'Yvonne Sersch, Notary Public
Gamp Hill Boro, Cumberland County
My Commission Expires Feb. 1, 2012
Member, Pennsylvania Association of Notaries
LAW OFFICES
SAIDIS, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
2109 MARKET STREET
JOHN E. SLIKE CAMP HILL, PENNSYLVANIA 17011 CARLISLE OFFICE:
ROBERT C. SAIDIS TELEPHONE: (717) 737-3405 -FACSIMILE: (717) 737-3407 26 WEST HIGH STREET
JAMES D. FLOWER, JR EMAIL: tflower@sfl-law.com CARLISLE, PA 17013
CAROL J. LINDSAY www.sfl-law.com TELEPHONE: (717)243-6222
JOHN B. LAMPI FACSIMILE (717)243-6486
DANIEL L. SULLIVAN
DEAN E. REYNOSA
THOMAS E. FLOWER
MARYLOU MATAS REPLY TO CAMP HILL
JASON E. KELSO
February 3, 2009
Office of the Register of Wills
Cumberland County Courthouse ~ ~ ~
Room 102 .,~~,~ ~ `'
One Courthouse Square ~~~ ~ ~ ~
}
Carlisle, PA 17013 _^_, ~,
~_ ;. ,
-,
Jn
~ a ~
...,... 'Ft_;
Re: Estate of Carolyn J. Evens ~~ ; '~~` ~"~~
File No. 21-08-1219 _,,,~
~ ,
tv '' `-
Dear Sir or Madam:
Enclosed are the original and two copies of the Inheritance Tax Return for the above-
referenced decedent along with a check in the amount of $15.00 in payment of the filing fee.
Please return atime-stamped copy in the enclosed self-addressed stamped envelope.
Please contact me if you have any questions regarding this matter.
Very truly yours,
SAIDIS, FLOWER & LINDSAY
Karen Riccardo, Assistant to
Thomas E. Flower, Esq.
TEF/kar
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