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Home My WebLink About07-13-09 15056051058 REV-'I 5OO EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number IN PO BOX 280601 HERITANCE TAX RETURN ~`~ 21 ~ C>_ ~ _(;~'~ Hanisburg, PA 17128-0601 _ RESIDENT DECEDENT 6659- ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 203-10-9307 03/15/2009 06/25/1921 Decedent's Last Name Suffix Decedent's First Name MI Brubaker Frances L (If Applicable} Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Retum 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) 6. Decedent Died Testate ;' 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9713(A) between 12-31-91 and 1-1-95) (Attach 5ch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD 8E DIRECTED T0: Name Daytime Telephone Number Marvin Beshore, Esquire (717) 236-0781 Firm Name {If Applicable) Law O~ces M. Beshore First line of address 130 State Street Second line of address P.O. Box 946 City or Post Office State Harrisburg PA f7 REGISTER OF WILLS US~ON[~ - '_.~ ~'7 _. -1 ' - "'7 ~: • ' ; . . .. ) ( - ~rl r -~ _ .y DATE FILED ~'' ZIP Code 17108-0946 Correspondent's a-mail address: MBeshore@beshorelaw.COm 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, corre d complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATUR F ER ON PO 5}B4E FOR FILI G RETURN D qTE ADDRE ~ / 2 ~/O~ 669 Gatyl~er Road, New Cumberland PA 1 130 State Street, P.O. Box 946, Harrisburg, PA 17108-0946 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 ~, r -: C.J ~ :' - 15056052059 REV-1500 EX FfanCeS Decedent's Social Security Number Decedent's Name. L Brubaker 203-10-9307 RECAPITULATION - 1. Real estate (Schedule A) . ............ ................................ 1. 2. Stocks and Bonds (Schedule B) .......... ............................. 2, 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3, 4. Mortgages & Notes Receivable (Schedule D) ...... ...................... . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5 ....... . 53,133.28 6. Jointly Owned Property (Schedule F) Separate Billing Requested 6 ....... . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7) ........ ............. . ..... ....: ' 8. 53,133.28 9. Funeral Expenses & Administrative Costs (Schedule H). .... . ~~~~ '~'~~ 9. 5,915.50 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. 10 . . . 11. Total Deductions (total Lines 9 & 10) . 6,267.75 .................................. 11. 12,183.25 12. Net Value of Estate (Line 8 minus Line 11) ......... . 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12 40,950.03 an election to tax has not been made (Schedule J) ....................... . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .. ............... . . TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES • . • .. 14. 40,950.03 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable 15. at lineal rate X .0 45 17. Amount of Line 14 taxable 16. 1,842.75 at sibling rate X .12 18. Amount of Line 14 taxable 17. at collateral rate X .15 18. 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 1,842.75 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 0699 DECEDENT'S NAME Frances L Brubaker DECEDENT'S SOCIAL SECURITY NUMBER STREETADDRESS 203-10-9307 Mallard Run, APt. 508 cITY Camp Hill STATE zIP P'q 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments (1) 1,842.74 A. Spousal Poverty Credit B. Prior Payments 1,700.00 C. Discount 89.47 3. Interest/Penalty if applicable Total Credits (A + B + C) (2) D. Interest 1,789.47 E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.tal Interest/Penalty (D + E) (3) Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (4) (5) 53.28 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 53.28 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 a. retain the use or income of the property transferred :............... No 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? ........................................................................................................................ ^ a 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 survivin sous is three (3) percent [72 P.S. §9116 (a) (1.1) (i)], g p e 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 n_ of 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, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY wink yr Frances L. Brubaker FILE NUMBER 21-09-0509 Include the proceeds of litigation and the date the proceeds were received by the estate. All orooartv inin+Iv_n~,..,.d ..,:.~ _._~. _~ . . EV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT CJIHIt Ut' Frances L. Brubaker SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-09-0509 Debts of decedent must be reported on Schedule I. ITEM DUMBER DESCRIPTION A• FUNERAL EXPENSES: AMOUNT t' VFW Post 7415 (funeral food) 2• Richard V. Brubaker (funeral food) 450.00 3. Bonnie Brubaker (pastor fee) 50.00 60.00 B. ~ ADMINISTRATIVE COSTS t • Personal Representative's Commissions Name of Personal Representative(s) Richard V. Brubaker 2,500.00 Social Security Number(s)/EIN Number of Personal Representative(s) street address 669 Gaumer Road city New Cumberland state PA Zip 17070 Year(s) Commission Paid: 2. Attorney Fees Marvin Beshore, Esquire -Law Office of Marvin Beshore 2,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees $128; Inheritance Tax Return $15; Inventory 158.00 5• Accountant's Fees $15.0 0 6. Tax Retum Preparer's Fees ~• Patriot News -Publication of Estate -Notice 92.50 Cumberland Law Journal -Publication of Estate -Notice 75.00 M. Beshore -expenses (photocopies, fax, mail, etc.) 30.00 TOTAL (Also enter on line 9, Recapitulation) $ 5,915.50 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ___... _ ..... ... ........ ..~ .~~c oauic a:cej ESTATE OF Frances L. Brubaker FILE NUMBER 21-09-0509 Report debts incurred by the decedent orinr r~ do~tti ,.,ti,.ti ...__:__~ ..__ _. , ... REV-1513 EX+ (9-00) SCNEDIJLE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Frances L. Brubaker 21-09-0509 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 ~ Richard V. Brubaker, 669 Gaumer Road, New Cumberland PA 17070 Son 30% 2~ Kenneth A. Brubaker, 55 School Street, Mayfield, NY 12117 Son o 30 /o 3• Charles F. Brubaker, 594 Old York Rd, Lot 32, Etters, PA 17319 Son 30% 4• Tina M. Bruner, 150 Fecco Street, Cocoa, FL 32927 Grandchild o 10 /o ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space Is needed, insert additional sheets of the same size) ,~ Poor Richard's Ruto Sales 717-774-1485 ,nmerce Bank 0184021NY1N00005423 Commerce Bank/Harrisburg N.A. P.O BOX 4999 Harrisburg, Pennsylvania 17111-0999 1-688-937-0004 FRANCESLBRUBAKER BONNIE E BRUBAKER 669 GAUMER RD NEW CUMBERLAND PA 17070 p.3 •:~--~ rl i! . .,~_.~ ., // ; _.. - CGLii - .. % -1 r -t- ~G6..-71 ~ - 8 i _ -_,_ ..~ `` - .. ` We're here 7 days a week, 24 hours a day at 1-888-937-0004. - ' PERSONAL ULTRA MONEY MARKET 0538095506 Statement Balance as of 03110/09 Plus 2 Deposits and Other Credits Less 4 Checks and Other Debits Less Cycle Service Charges Statement Balance as of 04/13!09 ~~- Transactions By Date 513,764.03 $330,40 $6,078.99 $ t2,00 $8,003.44 Date Description Debit Credit Balance 03/16/09 CHECK#511 $50.00 $13,714.03 03!19109 SUBSTITUTE CHECK # 513 $5,845.36 $7,868.67 03/31!09 CHECK # 515 $80.00 $7,788.67 04101!09 DEPOSIT $324.59 $8,113.26 04!01/09 CHECK # 514 5103.63 $8,009.63 04!13109 INTEREST PAYMENT 55.81 $8,015.44 041131D9 CYCLE SERVICE CHARGE $12.00 $8,003.44 ---- - ----- -- -------- Tf~ ~,... ~ /~ -?M~ "~-~C<U-.cr --- ~Check Transactions Number Date Amount Number Date Amount Number Date Amount 511 03!16 $50.00 514 04101 $103.63 513' 03119 $5,845.36 515 03/31 $80.00 Items denoted with an "E" are electronic entries and wi{I not have a check image. Interest Summary Beginning Interest Rate 1.qg°/, Number of Days in this Statement Period 34 Interest Earned this Statement Period $5,g1 Annual Percentage Yield Earned this Statement Period (APY) 0.67% Interest Paid Year to Date $83.22 ,~~ i~ ~~ ~: ,;,,, , . 4 ',. 003 Cycle 2 Page 1 of 2 NOTES SEE REVERSE SIDE FOR IMPORTANT INFORMATION Member FDiC ~mmerce Bank 0184021NY7N00009571 BONNIE E BRUBAKER 669 GAUMER RD NEW CUMBERLAND PA 17070 Commerce BanklHarrisburg N.A. P.O BOX 4999 Harrisburg, Pennsylvania 17111-0999 1-88 B-937-0004 / / ! 4JL~v We're here 7 days a week, 24 hours a day a1 1-888-937-0004. TOTALLY FREE CHECKING 0538098492 Statement Balance as of 02/25109 $35,563.65 Plus D Deposits and Other Credits $0.00 Less 10 Checks and Other Debits 51,045.94 Statement Balance as of 03!25!09 $34,517.71 Transactions By Date Debit Credit Batanee Date Description $26.50 / 535,537.15 02(26!09 CHECK # 158 00 ~ $85 535,452.15 03102109 GHECK # 160 . $246.00 ~ 535,206.15 03/04/09 CHECK # 154 44 ~ $16 $35,189.71 03119109 CHECK # 164 . ~ 540.17 535,149.54 03.'19'09 CHECK # 163 $75.00 '~ S35,D74,54 03119109 CHECK# 162 19 ^~ $16 535,058.35 03120109 CHECK # 167 . 14• 564 $34,994.21 03/23109 CHECK# 166 . 00 .~ $450 $34,544.21 03/23109 CHECK # 168 . _ 1 $26.50 ~ 534,517.71 ~ 03125/09 CHECK # 16 ~.._ -- ~ iCheck Transactions Number Date Amount Number Date Amount Number Date Amount 154 03!04 $246.00 162 03119 575.00 .167 03120 $16.19 158' 02/26 $26.50 163 03119 $40.17 168 03123 $450,00 160' 03102 S85.00 164 03119 $16.44 161 03125 $26.50 166' 03123 564.14 Items denoted with an "E" are electronic entries and will not have a check image. k.~_~- ~, ~ ~ ~,,,,~ i Page 1 of 2 009 Cycle 2 Member FDIC NOTE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION ----- - - May 26 09 03:16p Poor Richard's Ruto Sales 717-774-1485 .~ ;~ ~ p~' rv 5'~ ~ iit i ~.. L~u..i r r R.r c 0 S/ ti C T. m G O T it : • f_ c r ~ O m ~ G r ~~r ;F ,::} O~S--1 'rimm0 z ~ , y I ~~ ~ a f ~ ~ d c ~ ~ a m ~ ~ ~ ~ c ~ ?a~D a ~ ~ v ~ m D ~ a v > o z o m N r L~ Z "~, ~Z m ~~. mG D .~ Z D '~ n ~ °' ~' D 3 ~r -a r r _~~ = C ~ Do Z d Q v I O I J i 'A ~ N J i I R (7 ~ A ~ N A • ~ v 0 d N n 4 m ~ N N ~ v Z Nm v ~ o O O :~J _~/ p.3 ~`~„ ~ v;~~; D ~ '~ - = z ;' ~ ' ~om~ m ,..~~ L, - O 2 i O ~ N O ! ~p m~rvmi N O~D ~- •:~` l ~ ~~oOD D Z=Z t' C'} G7 A "'~ Z Z r ~ y''."' m o ~~D ~• o, a c n Z ~~~ ~ Oc7 3 2 0 ~,,.~ N D e--1- ~ mmDm Z ocfl~ -Z ~; D 70 ~ N N .' Z O m D ~ op C. ~C7GC~ Z Op ~ _.: `~ sz d O oa m m (~ N ti. '~ v ~ -~, r ~ D ~ ~ -. IL ,~ T~ ~ ~ ~ "'~ IT J * Z ~ ~ ' IV 1 n ~ ~ v * ~ r ~.y V ~ ,y~ ;~k ~J.i ; O dp 11 I ~ D p ~ n m m~ 3 - r ~ aso~ ~ o ;~ma S w 0 ,C = A 1 a c ~ s ~ ~~. W ~ ~ °' _ - \ .Ft '. o > \ ~ i. o ~ N ~'; `p a m _. < z _~. i He 0 O ,- o _: -'~ * D ~ „~ _ ~ o - W m - ~' m -~ ~ .- w ~ ~ r ~ -- C ~ v Q~ - . tJ'l ~ ~ :,::; 00 N ~ la,.?p', LAST WILL AND TESTAMENT of FRANCES L. BRUBAKER I, FRANCES L. BRUBAKER, of the Township of East Pennsboro, County of Cumberland, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void all former wills and codicils by me at any time heretofore made. 1. I direct that the expenses of my burial and all my debts be paid as soon after my death as may be convenient to my Executor or Executrix hereinafter named. 2. I nominate, constitute and appoint my husband KENNETH V. BRUBAKER to be the Executor of this, my Last Will and Testament. If my husband does not survive me, or is unable or unwilling to serve for any reason, I nominate, constitute and appoint my son, RICHARD V. BRUBAKER to be Executor hereof. 3. I give all of my property, real personal and mixed to my husband, KENNETH V. BRUBAKER, if he survives me by more than thirty (30) days. 4. If my husband does not survive me by more than thirty (30) days, I give all of my property, real, personal and mixed as follows: (1) to my son RICHARD V. BRUBAKER, I give 30% of my estate, if he survives me; (2) to my son KENNETH A. BRUBAKER, I give 30% of my estate, if he survives me; (3) to my son CHARLES F. BRUBAKER, I give 30% of my estate, if he survives me; and (4) to my granddaughter, TINA M. BRUNER, I give 10% of my estate. If any of my sons do not survive me, I direct that such son's share be divided among those sons Jl, 2 ~3 who do survive me. 5. I give to my Executor the following powers which are to be construed in the broadest manner consistent with validity and their duties as fiduciaries. I give the powers stated herein, in addition to those granted by law, and I give them to Administrators and Trustees who succeed the fiduciaries I have appointed. a. To retain any or all of the assets of my estate, real or personal, without regard to any principle of diversification or risk. b. To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, as they deem proper without regard to any principle of diversification or risk. c. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sale, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. d. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. e. To borrow money from any person or institution, and to mortgage or pledge any or all real or personal properly as my Executors or Trustees, in their sole discretion shall choose, without regard for the diapositive provisions of this instrument. £ To register securities in street name or in the name of a nominee or in such manner that title shall pass by delivery and to vote, in person or by proxy, securities held hereunder and in such connection to delegate discretionary powers. g. To compromise any claim or controversy. - 2 - ~ ~ /3 h. To choose the optional valuation date for federal estate tax purposes. i. To exercise any law-given option to treat administrative expenses either as income or as estate tax deductions, without regard to whether the expenses were paid from principal or income. To exercise any law-given option to pay death taxes in installments, the payment of interest due on such installments to be a charge against principal. k. To make distribution in cash or in kind, or partly in cash and in kind, and in such manner as they may determine, and at valuation finally to be fixed by them. 6. Death taxes: All federal, state and other death taxes payable on the property forming my gross estate for those purposes, whether or not it passes under this Will, shall be paid out of the principal of my probate estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. This provision shall not apply to any property over which I have a general power of appointment for federal estate tax purposes. 7. To the extent that such requirements can be 1_egally waived, I direct that my Executor shall not be required to post bond or give any security in connection with their duties hereunder, whether in the Commonwealth of Pennsylvania or any other jurisdiction. IN WITNESS WHEREOF, I, FRANCES L. BRUBAKER, have hereunto set my hand and seal to this, my Last Will and Testament which consists of ~ typewritten pages, this ~~ day of , 2006. - 3 - ., ,~ ~ FRANCES L. BRUBAKER ~~8~ Signed, sealed, published and declared by the above-named, Frances L. Brubaker, as her Last Will and Testament in the presence of us, who at her request, in her presence and in the presence of each other have hereunto subscribed our names as witnesses. of `T6 ~7~y~ W tness `/ ~ ~~/ ~7~~ b ~~ ~i'~ of ~, ~~~lYaei2 17~rr~ Witne 1~t~~-~, P~ ~1 ~~ - 4 - ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ss. COUNTY OF C~~~~-~ ) I, FRANCES L. BRUBAKER, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed this instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. FRANCES L. BRUBA R Sworn or affirmed to and acknowledged before me, by Frances L. Brubaker, this°~~ day of , 2006. Notary Public COMMONWEALTH__OF PENNSYLVANIA Notarial Seal Anne Marie Beshore, Notary Public City of Harrisburg, Dauphin County My Commission Expires Apr. 5, 2008 Member, Pennsylvania Association of Notaries - 5 - AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ss. COUNTY OF ~~~~-~~ ) We, `7yj~1//~/ .~~5}t~' and ~/~~G~~-,~"~ ~~~~/, the witnesses whose names are signed to the attached and foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by these witnesses, this~~P day of 2006. COMMONWEALTH OF PENNSYLVANIA Notarial Seal Anne Marie Beshore, Notary Public City of Harrisburg, Dauphin County My Commission Expires Apr. 5, 2008 Member, Pennsylvania Association of Notaries - 6 - Notary Public MARVIN BESHORE Attorney at Law 130 State Street, P.O. Box 946 Harrisburg, PA 17108-0946 Email: MBeshore cr,beshorelaw.com Telephone: (717) 236-0781 Facsimile: (717) 236-0791 Glenda Farner Strasbaugh Cumberland County Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 July 10, 2009 Re: Estate of Frances L. Brubaker File No.: 2009-00509 Dear Ms. Strasbaugh: Admitted in Pennsylvania and New York EIN:03-038654? Enclosed please find an original and one copy of the Inheritance Tax Return for the Estate of Frances L. Brubaker. I have enclosed a check in the amount of $15.00 to cover the cost of filing. If you have any questions, please feel free to contact me. MB/tlm Enclosures cc: Richard V. Brubaker (w/encl.) Very truly yours, .~ 1(l~ ~ t~ v.:J Marvin Beshore ~ ?~ - -~ , ._ ~ --_ - - - ~ .J ,a ... _ ._ ~ . =~ ..._ OOOloll2.WPD; vl ui ' :m A .. ,~ f9'4''~~ ~~ ~ ~;r ~F m ~~ } ;a1J i ~;. ._.. Q~~~~~It `. ~f 0 w '~ ~ Q O 3 ~ z 2~ w~o> J W Q cn ~ N } x z m w ~ 0 z Z z Q m a j o~n0 ~ ~ F- ~ a ~ Q Q ~ m' ~ N a ~O 3 ~ ~ o ~. ~ _y O .~ .r ~ ~~CU ~c•~ v, ~ J, ~ M ~ ~ ~ ~ M ~ p p N O ~ U U ~ ~ 0 ~ ~ ~ ~ a ~ a ~ o ~ ~ -~ .~ U C7 U U O Cj