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HomeMy WebLinkAbout10-30-0915056051058 REV-1500 Ex c~5) OFFICtAL USE ONLY PA Deparbrrent of Reverwre Cq~y Code Year Fde Number Bureau of hrdividual Taxes INHERITANCE TAX RETURN PO eox zeosot 21 09 161 Harrisburg, PA ntzl~osot RESIDENT DECEDENT ENTER DECEDENT MIFORMATN~1 BELOW Social Security Number Date of Death Date of Birth 181-42-8412 02/10/2009 10/13/1916 Decedents Last Name Suffix Decedents First Name MI MCCREA MARY H (If AppNcal~le) Ertter 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 YVITN TIRE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Retum e:~ 2. Supplemental Retum __.. 3. Remainder Retum (date of death prior tD 12-13-8Y) :. 4. Limited Estate t'~ 4a. Future Interest Compromise (date of ;'""7 5. Federal Estate tax Retum Required death after 12-122) '~ 6. Decedent Died Testate CWa 7. Decedent Maintained a Living Tnist 8. Total Number of Safe Deposit Boxes (Attach Copy of III) (Attach Copy of Tnrst) ~r: w:~ 9. Litigation Proceeds Received ;:' ~ 10. Spousal Poverty Credit (date of death r~ 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 CONFDENTUIL TAX INFORMATION SItOULD BE DIRECTED TO: Name Daytime Telephone Number SALLY J. WINDER (717) 776-1245 Finn Name (ff Applicable) REGISTER OF NfILLS USE ONLY C'~ N First line of address ~"= -~ ,w - -~ ~ r ~ { , Second line of address n "r k:.:: P.O. BOX 341 i '- DATE FI(s~$j T°+a. c ~, r,t City or Post Office State ZIP Code ~ _;C _,_ •--,,t NEWVILLE ---i PA 17241 ~ ~~ T7 r ._.. ; 3~T f ~C `~ ~ ADD~RES1S ~~ v PLEASE USE ORIGINAL FORM OIN.Y Side 1 15056051058 15056051058 (~h'1 Conespondent's e-mail address: Un~r penalties d perjury, I dedare that I have examined this return, irx~uding aocorrrperrying sctredules and statemerrts, and to the beet of my krawledge and belief, it is true, correct and . Dedaratlon of preperer other than the personal r~reserMative is based on all information of which preparelr has any laxrwlerige. SI TUt~ OF PEbI.S¢1y E FOR FILING RETURN /~~~/O 15056052059 REV 1500 EX Decedents Social Security Number MARY H MCCREA 181-42-8412 __ _._ Decedents blame: _~___._..~._._____.._. _._._ _..,._. __.~.m_~...--._ _.____..._._. w...__._. _ ___.__ __._.._ _.. ._.._._~_ ___. __ _ RECAPITULATION 1. Real estate (Schedule A) ............................................. 1. 54,500.00 2. Stocks and Bonds (Schedule B) ....................................... 2. 309,714.47 3. Cbsely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. 257,444.70 6. Jointly Owned Property (Schedule F) ;~ ~:~ Separate Billing Requested ....... 6. 9,448.25 7. Inter-V"nros Transfers 8 Miscellaneous Non-Probate Property (Schedule G) " ~~ Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. 631,107.42 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 44,853.63 10. Debts of Decedent, Mortgage Liabiities, 8 Liens (schedule I) ................ 10. 1,658.61 11. Total Deductions (total Lines 9 8 10) ................................... 11. 46,512.24 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 584,595.18 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Sc~-edule J) ........................ 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 584,595.18 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_ 15. 16. Amount of Line 14 taxable at lineal rate x .0 45 584,595.18 16. 26,306.79 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 1s. rAx DUE ......................................................... 1s. 26,306.79 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT __., 15056052059 Slde 2 15056052059 T T REV-1500 EX Page 3 Decedent's Complete Address: Flle Nur~sr . ........................... . 21 09 ! 161 DECEDENTS NAME DECEDENTS SOCIAL SECURrrY NUMBER MARY H MCCREA 181-42-8412 srREETADDRESs 70 MCCREA RD CfrY NEVWII_LE STATE PA ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 26,306.79 2. CreditsfPayments 24,000.00 A. Spousal Poverty Credit B. Prior Payments C. Discount 1,200.00 Total Credits (A+ g + C) (2) 25,200.00 3. InterestlPenatty if applicable D. Interest E. Penalty Total InterestlPenally (D + E) (3) 4. If Lure 2 is greater than Line 1 + Line 3, eater the difference. This is the OVERPAYMENT. Fifl in oval on Page 2, Line 20 fA request a refund. (4) 5. If Line 1 + Lure 3 is greater than Line 2, enter the difffference. This is the TAX DUE. (5) 1,106.79 A Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) 1,106.79 Make Check Payable to: REGISTER OF N/-LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transfemed :.......................................................................................... ^ b. retain the right to designate who shah use the property transferred or its incarre : ......................... . .................. 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 trer death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which contains a benefiaary designation? ........................................................................................................................ ^ IF THE ANSYYER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R ~I-S PART OF THE RETURN. For Baths of death on or after Juy 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 exemot a transfer to a surviving spouse from tax, and the stafirtory requirememts for discbsure of assets and filing a tax return are still applicable even if the surviving spouse is the only berrefiaary. 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 benefiaar~s 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. • Last 2ViCCand~~Iestament of Mary ~f. ~I~IcCrea I, MARY H. McCREA, of Lower Mifflin Township, Cumberland County, Pennsylvania, being of sound mind and memory declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I give, devise and bequeath those articles of furniture and personal property as set forth in a separate memorandum, which I shall place with my Will and copies of which I shall provide to the recipiems as set forth in the memorandum prior to my decease. ITEM III: I give, devise, and bequeath all of my M 8c T Bank and Trust Company, or its successors and assigns, bank stock to my grandchildren living on the date of my death in shares of equal value, share and share alike. ITEM 1[V: I give, devise, and bequeath the full sum of Five Thousand ($5,000.00) Dollars to each of my great grandchildren, their heirs and assigns, living on the thirty-first day following my death. ITEM V: I direct that all taxes that may be assessed in consequence of my death,. of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expenses of the administration of my estate. ITEM VI: I appoint ANDREW M. McCREA, guardian and trustee of any property which passes either under this Will or otherwise to a person under the age of twenty-one (2l), or other person entitled to distribution under the tenors of Item III above, and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointment of a guardian and trustee shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the person under the age of twenty-one (21 ~r to another for the person under the age of twenty-one (2l) years' benefit. Such guardian and trustee shall have the power to use principal as well as income from time to time for any person under the age of twenty-one (21) years' support and education {including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility to the person under the age of twenty-one (21) years or to their parent or to any person taking care of the person under the age of twenty-one (21) years. ITEM VII: I give, devise and bequeath the rest, residue and remainder of my estate of every nature and wheresoever situate to my three children, ANDREW M. McCREA, MARY JANE SPENCER, AND LUCY M. BERILLA, their heirs and assigns, in equal shares, share and share alike, provided however, that the calculation of 2 these shares shall take into account the listing of lifetime gifts which I have made to my above-named children and which are set forth on a separate memorandum which I have signed and dated contemporaneously with this Last Will and Testament. Provided, however, that the residuary shares distributable to Lucy M. Berilla and Mary Jane Spencer, as set forth herein, shall be held IN TRUST, by ANDREW M. McCREA, and the income and principal shall be accumulated and distribution from these funds shall be made to each beneficiary at a rate often (10) percent per annum of the net distributable share of each beneficiary until such time as such beneficiary shall have depleted her share or shall have filed for, and begun to receive, Social Security benefits (excluding those received, or entitled to be received by Lucy M. Berilla as death benefits arising out of the death of William C. Berilla, Jr.) . At such time the beneficiary thus qualifying shall receive the balance of her net distributable share as well as any accumulated income accountable to her share. Upon the death of any beneficiary, the net distributable share shall be immediately distributable to the estate of the deceased beneficiary. ITEM ]IX: No interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary before an actual payment to the beneficiary. ITEM X: I appoint ANDREW M. McCREA, Executor of this, my Last Will and Testament. Should he fail to qualify or cease to act as executor, I appoint LUCY M. BERILLA executrix of this, my Last Will and Testament. ITEM VI: I direct that my Executors or their successor shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 3 IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on ~_ ~-~ of paper, dated this ~daY of July, 2008. ~' ~'/ J"~~ (SEAL) ARY McCREA of this and ~_ other typewritten page(s), each idernified by the The preceding instrument, consisting Y ~ ublished and declared by signature of the testatrix, MARY H. McCREA, was on the da and date thereof s ed, p MARY lEl. McCREA, the d the h~ nce of each otherf have subscribed w names as~~ow~ hoereto~er request, in her presence, an pr r residing at ~1 ~ U Ll ~ ~~~ residing at ~ ~ L~ sM ~ J~t ~~ 4 REV-1502 EX+ (11-08) Pennsylvania SCHEDULE A DEOARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT e~ rw ~ t vF FILE NUMBER MARY H. MCCREA 21-09-161 Ail real Property owned solely or as a tenant in comrnorr must be reported at hir 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 that is jointly-owned with right of survivorship must be disclosed on Sdreduk F. Attach a copy of the settkvnent sheet if the property has been sold. NUM ER Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE DESCRIPTION OF DEATH 1' REAL ESTATE LOCATED IN NORTH NEYYfON TWP, CUMBERLAND CTY, PA BEING TAX PARCEL SO-07-0483-006 SOLD 8/14!09 SETTLEMENT SHEET AND DEED ATTACHED 54,500.00 TOTAL (Also enter on Line 1, Recapitulation.) I; 54,500.00 If ngre space is needed, insert additional sheets of the same Sze. l~0114 w0~b a~.~HUO-, ~eo„w,w.mo~.sosz a Settlement Statement „~ ..__- - _...j,,_y___,..~_ _ SUBSi1MEPOF114 tOBB8HIER BTA7EaEM: Tlrbluatlonwnbbp Mbbbqu,wbxwambbnaM4E,N04mY1rObCr Mrtitpa,au 9eMO~. r~euw AP~tlbMawbm. tnelDT ~o~opryYwMl~Pi00eads~harrcl~bn~~b~~b6s ~ponM ~n01M WSAbm~iM~M~hs~al6an tepoMd Ths CpWyA.5WRb4~a!!dm Yoyw10pi1ld 6ybwbpoMdl /1s MWN1rr Tu D4b: 1wM yaur0411lgb~1er ldedidtion n~npa. ^40udot nol ombsr,7u+~O'Os+iq~clbciMaa4iiWP~Nw~o~G A'Isr.u.~aer0+~daapw}ry.laNy MYbdwM WOw~m M~ehbwMb~ ~ayerH~pn nm T1N: ._. / _ 4EW A411IL.14R' AODpFB£ ~ ~T~~: /-- SHLBI(S) 8104E 411Y~ .... q..b~.a~.~m.o.,, EaYla dMYy K AbC~ea WARNWCC RBACJIEE701OgWNR1.YiW~ FMBE STATBIBJTg 70 THE 1lRIED SMi~p1Tli60RANY8~MF~IW.PBULTEB UFgH CONVICfIOH Ma~w~Uaitlw Mnb~bM~wa~i~p Haomp p ~~y~py,'0~~~~~~ U CODE S[CTgH f001 AND ffiC710N 1~OETAa88EE TIRE tR N tliY tranp~ion I~h.~ ~ MA~t BMtlemwrt 841,nwrtanQb IMOrtof mr bwiy0pap~iµ i is nus rtl aavYes1 a~tll woepii rN ~bus~lwib edam my aameil aly m~ ~rY iMl 1 hne ~ao~iyea •aopy al Uq HIA-19atllmM TAX PARCEL NO. 30-07-0483-006 THIS DEED, MADE this day of , 2009, BETWEEN Andrew M. McCrea, as Executor of the Estate of Mary H. McCrea, late of Lower Mifflin Township, Cumberland County, Pennsylvania - - - - - - - - - - - - - - - - - - - ----------------------------------------GRANTOR AND Eugene Keeney and Terri Keeney, husband and wife, of 1010 Cranes Gap Road, Carlisle, Cumberland County, Pennsylvania, as tenants by the entireties - - - - - - - - - - - ------------------------------- GRANTEES WHEREAS, Mary H. McCrea died February 10, 2009, testate, a domiciliary of Lower Mifflin Township, Cumberland County, Pennsylvania, seized of the real estate hereinafter described, and WHEREAS, decedent's last will and testament, dated July 2, 2008, was duly probated by the Register of Wills for Cumberland County, Pennsylvania, and is recorded at the Office of the Register of Wills for Cumberland County, Pennsylvania, as Estate No. 21-09-0161, wherein decedent appointed Andrew M. McCrea as Executor of her estate, and WHEREAS, Andrew M. McCrea duly qualified as Executor of decedent's estate and Letters Testamentary were granted on February 18, 2009, and WHEREAS, all federal and state inheritance and estate taxes have been or will be paid and will not be permitted to become liens upon the real estate herein conveyed; neither shall Grantor permit any lien to exist or remain upon the real estate herein conveyed as a result of the Pennsylvania Department of Welfare Estate Recovery Program, and WHEREAS, the real estate herein conveyed was not specifically devised by said will. NOW, THEREFORE, WITNESSETH, that for and in consideration of Fifty-Four Thousand Five Hundred ($54,500) Dollars, in hand paid, the receipt when~of is hereby acknowledged, the said Grantor, as Executor as aforesaid, does hereby grant and convey in fee simple unto said Grantees: ALL the following real estate lying and being situate in the Township of North Newton, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a point on the State Road (now State Highway Roulte No. 233); thence by land now or formerly of B. ]. Strohm, (formerly the Estate of Dr. John Geddes, Deceased), South 81 ~/s degrees West 37 perches to a posh thence by land now or formerly of Lee Lehman (formerly Daniel V. Ahl) North 2 ~/2 degrees East 75.2 perches to the State Highway Route aforesaid; thence by the said State Highway Route, South 25 degrees East 76.8 perches to the place of BEGINNING. Containing eight acres and seventy-three perches, more or less. LESS AND EXCEPT that portion of the above-described property previously conveyed by John McCrea and Rebecca S. McCrea, his wife and William Henry McCrea, Jr. and Mary H. McCrea, his wife, by their Deed dated April Z7, 1965 and recorded May 17, 1965 in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania, in Deed Book O, Volume 21, Page 1124, to Fickes Silo Company, Inc., and more particularly bounded and described as follows: BEGINNING at a point on the State Road (now State Highway Routte No. 233); thence by land now or formerly of B. ]. Strohm, {formerly the Estate of Dr. John Geddes, Deceased), South 81 ~/z degrees West 37 perches to a post; thence by land now or formerly of Lee Lehman (formerly Daniel V. Ahl) North 2 ~/z degrees East 30 feet to an iron pin; thence by land now or formerly of John McCrea and Rebecca S. McCrea, his wife and William Henry McCrea, Jr. and Mary H. McCrea, his wife, North 81 ~/2 degrees East 37 perches to an iron pin in the center of the aforesaid public road; thence along the foresaid public road, South 25 degrees -2- East 30 feet to the place of BEGINNING THIS CONVEYANCE BEING AND INTENDING TO BE all of theremaining real properly of Grantor contained in that certain Deed from John McCrea and Iris W. McCrea, his wife, dated November 27, 1970, recorded October 6, 1971, in the Office of the Recorder of Deeds for Cumberland County, Pennsylvania, in Deed Book I, Volume 24, Page 9, to W. H. McCrea, Jr. and Mary H. McCrea, his wife. W. H. McCrea, Jr., died September 12, 1976, thereby vesting full fee simple title by operation of law in Mary H. McCrea, the decedent herein. TOGETHER WITH all and singular the rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging or in any wise appertaining, and the reversions, remainders, rents, issues and profits thereof, and all of the estate, right, title, interest, property claim and demand whatsoever of the said decedent at and immediately before the time of her decease, in law or equity, of, in, to or out of the same. TO HAVE AND TO HOLD the said granted premises by the said Grantees, their heirs and assigns, forever. AND the said Andrew M. McCrea, as Executor as aforesaid, for himself, his heirs, executors, and administrators, does covenant, promise and agree to and with the said Grantees, their heirs and assigns, by these presents that he, the said Executor as aforesaid, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, or shall or may be impeached, charged or encumbered in title, charge, estate or otherwise howsoever. Grantees by accepting and recording this deed waive any claims or any liability that might be made against the Grantor as a result of any environmental actions. -3- IN WITNESS WHEREOF, the Grantor has caused this instrument to be duly executed the day and year above written. Witness: (SEAL) Andrew M. McCrea, as Executer of the Estate of Mary H. McCrea -4- STATE OF PENNSYLVANIA : SS COUNTY OF CUMBERLAND On this day of , 2009, before me, the undersigned officer, personally appeared Andrew M. McCrea, known to me to be the person vwhose name is subscribed to the within instrument and acknowledged that he executed the same in the capacity therein stated and for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. Notary Public G E R T I l X77 Cr 4 T E O F R ESI D E N CE I hereby certify that the precise residence of the within Grantees is: Witness my hand on this day of .2009. -5- REV-1503 EX+ (8-98) scNEOU~ s COMMONWEALTH of PENNSYLVANIA STOCKS ~ BONDS INF~RITANCE TAX RETURN RESIDENT DECEDENT ESTATE vF F~ NUMBER MARY H. MCCREA 21-09-161 ~ PraPa1Y ~~Y'~bd +~ ~ of survivorship rtwst be dleclosed on Schedule F. ITEM VALUE AT DAVE NUMBER DESCRIPTION OF DEATH ~' SYSCO, 521.143 SHARES OF COMMON STOCK DATE OF DEATH VALUE $23.36/SHARE 11,910.30 2. MST BANK,1080 SHARES OF COMMON STOCK, DATE OF DEATH VALUE $33.52/SHARE 36,201.60 3. WACHOVIA SECURITIES, AGE DTC X10201 INVESTMENT ACCOUNT, DOD VALUE 23,503.94 4. F&M TRUST, ACCT 30555800, INVESTMENT TRUST,DATE OF DEATH HOLDINGS/ACCRUAL 238,098.63 TOTAL (Also ever on Nne 2, Recapitulation) I $ 309,714.47 (If more space is needed, insert additional sheets of the same side) ~$ W .~ ~ N c p~ N ~~ O W Q L 00 7 O L ro d • u C O u v Q 8 m n a x o~t W In O W S ~ ~ u OF v N ~~ s = O c ~k Q H J z a ~ ~ . o = v i a ch O W 1.7 a S N N Q d o~ N w" a ~ • O O oc W Z i r m L ~ ro -. ~ , ;^y j ro C V ~' • Q ro o ~ u v ~ b A ~ `- E ~ d 3 o } G = d . !v0 ~ ~ ~` O ?so~~ .a Q ~, ~ 3 c eo 3 c 0 ~n ~'i ~ q E .E c 3 v '~ .° -p .n ~ W C d C r ~ E ~ o a+ ro c Q::~ c m e o N ~ " c F - o~ua c E ."o a i A U N a+ ~~ ~ c ro S-°~cn d ~E C a~+ ~ C N C m u+'i b d a ~ Z ~ ~ UI ro ~ a- O u '" n ~ ~ c o ~ N ro ~ ~ ~ t ~ .~ u c ~/1 ~ m Q ~ ~'j~ u~i o .3 ' ~ u a oi ~ is . 7 } ~ F ~ ~ . d a~i r Q u°Ca V 1°. Z F° ~n ~~~ dI~ o ~ ~~ ~~ a ga = W ~ ~ von ac m~t=!fS ~ $ ~ tO ~ v r~r ~S a o c a O O z ~ ~ ~ N W °a «'". N ° ~ a w ai ao Q Y ~/ C m N(~ y iR C 8 8 8 ~ ~ a. O O g ~ d ~ a 8 g $ ~~ ~ E ' ^ moo ~ ~" ro v N ~ .+_o' ~ e 0 o 1O a ~ i a ~ -o ' -4 L E 3 ~ C 7 ~ fl. (p ~ O p O w ~ ~ g rov_ OI S OI a. ~ C ~p M OD ~ o tlf m g a t O ~~ ~ ~ a~ H C O y~ .~,. ar U ~ ro ~ A. O N .... D m Y O c a.~ ~ ro C1 ~ v w W N ~ ° C dl a rot ar o ~v '~ E P ~ ~°s m m~ otf a 3 c ~ d ~ = c ~ > o ro ~i - c ~ ~ a p O ~ v T y v ~ ro~ c C "D ro t 11~~ _ ~~L y U W ~ ~ Q~ u W u z a J 4 d O_ J Q z O a REV-1508 EX+ (698) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEpt~LE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER MARY H. MCCRE:A 21-09-161 Include the proceeds of litigation and the date the proceeds were received by the estate. All property JoiMlyowned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. CASH ON HAND, IN POSSESSION OF DECEDENT 725.95 2. FRM BANK, CHECKING ACCOUNT 33-06305 25,466.14 3. F&M BANK, CD 015-2986150 25,000.00 4. F&M BANK CD 015-2990235 10,000.00 5. F8M TRUST CD 015-2991715 30,000.00 6. M8T BANK, CD 31003915939127 25,000.00 7. SOVEREIGN BANK, CD2895384044 25,000.00 8. SOVEREIGN BANK, CD 3385156553 15,000.00 9. PNC BANK, CD 31100254845 10,446.35 10. PNC BANK, CD 31400265436 25,005.11 11. PNC BANK, CHECKING ACCOUNT 5140409804 8,350.75 12. PROCEEDS FROM SALE OF PERSONAL PROPERTY AUGUST 7 2009 , , 34,256.40 13. PERSONAL PROPERTY RETAINED IN KIND 23,194.00 TOTAL (Also enter on line 5, RecapituNation) s 257,444.70 (If more space is needed, insert additional sheets of the same size) COMMUNITY OFFICES IN STATEMENT OF ACCOUNT FRANKLIN, CUMBERLAND, 33-06305 FULTON AND HUNTINGDON ~~ ~ COUNTIES STATEMENT PERIOD `~ www.fmtrustonline.~m FROM THROUGH _ 01-14-09 02-16-09 `""""`''"''"AUTO"`5-DIGIT 17241 3913 1.0330 AV 0.449 14 1 88 PAGE 2 of 5 ~~ MARY H MCCREA 70 MCCREA RD NEWVILLE PA 172419755 ENCLOSURES 20 5 DATE DESCRIPI"ION 02-03 CHECK 2935 00300001090 02-04 CHECK 2945 00400002074 02-04 CHECK 2949 00400002107 02-05 CHECK 2944 00600003292 02-06 CHECK 2947 00600001730 02-06 CHECK 2948 00600002301 02-09 TIME'DEPOSIT CREDIT 00077900000 015-2991715 02-10 CHECK 2950 00300001112 J2-13 IP.`TEi~EST~ CREDIT' 02-16 ENDING BALANCE ACTIVITY CREDITS DEBITS BALANCE 50.00 26,324.40 45.13 400.00 25,879.27 105.00 330.24 73.76 25,370.27 110.90 25,481.17 17.44 25,463.73 2.41 2 5 , 41;+6.14 25,466.14 CHECKS -denotes missing check number in seq uence R -denotes returned check CHECK NO AMOUNT CHECK NO AMOUNT CHECK NO AMOUNT 2923 75.00 2936 23.95 2944 105 00 2927 ` ` 1,300.00 2937 13.01 2945 . 45 13 2930 32.58 2938 11.99 2947 ` . 330 24 2931 400.00 2939 343.35 2948 . 73 76 2932 156.00 2940 15.00 2949 . 400 00 2933 19.94 2941 605.25 2950 . 17 44 2934 20.00 2942 14.94 . 2935 50.00 2943 200.00 TOTAL NUMBER OF CHECKS 22 TOTAL AMOUNT OF CHECKS 4,252.58 "` ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 1-1409 THROUGH. 2-16-09 `** ANNUAL PERCENTAGE YIELD EARNED .10 AVERAGE DAILY COLLECTED BALANCE 25,834.21 INTEREST EARNED 2.41 SERVICE FEE BALANCE INFORMATION FROM 1-14-09 THROUGH 2-16-09 AVERAGE LEDGER BALANCE 25,834.21 AVERAGE COLLECTED BALANCE 25,83421 DIRECT F&M TRUST - NEWVILLE OFFICE INQUIRIES TO: 9 W BIG SPRING AVE NEWVILLE, PA 17241-1301 TELEPHONE: 717-776-2242 rEn. ~~}. LUVY 1-~Vrm rrot, Dn1Vn 41CIV7-Ll4t ~~f -~ stNaw~ur February 24, 2009 Sally wiackr Attorney At Law 22l Doubling Gap Rd Ncwville PA 17241 RE: Mary H McCrea SSN: 181-42-8412 . DOD: 02-10-2049 ,tia. otst3 r. ~ Dear Ms. Winder: ~ . In response to your request for Date of Death (DOD) balances for the customer natod above, our rrcords show the following: Csrtffcate of Deposit Account # 210010531 fib Established: 02-07-1995 MARX H MCCREA CHRISTOPHER D BE,RILLA. DOD balancx: S 8,819.21 + 2.g0 accnu~d merest Interest paid 01-01-2009 thru OZ-10-2009 551.36 YTD Account # 3l 100254845 MARY H MCCREA DOD balance: S 10,428.38 + 17.97 accrued itnecest I~rterest paid Ol -Ol -2009 thru 02-10-2009 $34.68 YID Account # 31400265436 MARY H MCCREA DOD balance; $ 25,000:00 + 5.11 accrued interest Interestpaid Ol-Ol-2(X19 thru 02-10-20(?9 $158.28 YTD L'bcchiag Account Account # 5140409804 MARY H MCCREA DOD balance: $8,350.64 + 0. l4 accrued interest Lrterestpaid 01-01-2009 thru 02-10-2009 $1.38 YTD page I of 2 Established: 0I -25-2005 Established: Ob-08-2005 Estatdisited: 03-01-1984 t i L i 1 ....~ E i f 1099-INT (OMIB I'b. 7545.0112] 10®B-A (OM81'io. 75115-OBttt ( 7099-DN (OIdB-No. 1545-0110} 101.8 No. t343~Q71S] A ] 1099-OID (OI~AB No. 734S-017T] 7099-C No. 1545-1124} ,~L~J~ 1099 7rtISC (04A8 No. 1515A1t5] 10995 AAB No. 7545097!7] Ms~Wrctrnn ara TaNa Tart coryny 0 0 6 2 2 0 3 5 L t0~ B No. 7545°907 } P.O. Box TB7, Buffalo, NY 14240.0767 E.I.N. 16-0538020 1-800-724-2440 PAGE 1 OF 1 MARY H MCCREA b22035 70 MC CREA RD 4344 NEWVILLE PA 17241-9755 2008 - lfl 99-INT, INTEREST INCOME ACCOUNT NUMBER. CERT OF DEPOSIT 031003915939127 BOX 1 INTEREST INCOME .TOTAL INTEREST ~~r5- ~-~. ,N FOR TAX YEAR 2008 TAXPAYERIO NBMYER 181-42-8412 852.29 852.29 j,,~,=~z,~,Q S ~`~..~ ~ 5 •Foi~n 1089.OID: Thb nab/ not fia the correct tlpun to report, on ~~ 6roeme t4uc ratutn. Sao in~trt~tbne on bock. caaa fttw~ ~.1t~INT +wsoa t41l~B 14it-A 'NM~C oAOE idFDN 1t~ibSC TIr itlsrttrtlsr rkt ypNS 1 t,'rM 9 [s ir~pihrtfp~ idsr TAir Y irpthatattit~etrrtlatrreis NrlgtrtridWto nrNsrrri is tAripYnW Anir~tr)+der- •rte ~. s.......e.artit iuferwrtirllM/ is rinE ttrnidtMto ttrl tln pMrarnN R»rrrrr Srtvkr.# ran trpitrdlr Ru a N yor trr ngrbMts ~* mm~l, to w1~E~r~pr~K ~1rs .. -° __ ~1°~-..-~.•~••••••• •• ..~M`.w h irroMMoryer iftlr testlwnrAita[Urcw Sovereign Bank Certificate of Deposit Renewal Notice SEPTEMBER 3, 2009 002900 002900-0001 090909 MARY H MCCREA TTEE ANDREW M MCCREA BENEF 70 MC CREA RD NEWVILLE PA 17241-9755 Dear Valued Customer, Account Number. 2895xi84044 Renewal Notice: 48-59 MONTH CD IYs a great flora to continue to save with Sovereign. Now that we are a part of the Santander Group, we are stronger and more secure than ever before. You can rest easy knowing your money is now backed by one of the world's safest banks.t And if you are a Sovereign Premier Customer you will always receive our best CD rates. Princpal Value $25,000.00 Issue Date NOVEMBER 1, 2004 Grace Days 7 Maturity Date OCTOBER 1, 2009 Renewal Maturity Date (if CD rolls over to same term)...........SEPTEMBER 1, 2014 Renewal Instructions: Renew Principal Only, interest Paid Monthly Your Sovereign CD is set to renew on the date noted above. It will automatically renew on OCTOBER 1, 2009 for an additional term of 59 months. To renew this CD automatically, you do not need to take any action. The interest rate and annual percentage yield (APY) for the new term have not yet been determined. Rate and APY information will be available on the day after the maturity date of your acxount and can be obtained by stopping by your local branch or calling us at the number below. If no changes are made, the value of your account at renewal will be $25,000.00. Withdrawal Instructions If you wish to withdraw funds from this CD without penalty, you must do so within the 7-calendar-d8y grace period that starts the day after the maturity date. Funds withdrawn do not eam interest past the maturity date (within! the grace period). if you wish to withdraw your CD funds, please call us or stop by the nearest branch. You can deposit your funds into a new CD with a new term; transfer your CD funds to your Sovereign d~ecidng, savings, or money market savings amount; or receive your funds via check. If you wish to dose your CD via mail, please send a notarized letter indicating your request to the address below. We must receive this letter (accompanied by a copy of this renewal notice) BEFORE the end of the grace period so you do not incur a penalty. If the CD is a passbook CD, nlea~a include the naach.Mk aln.~ ~::th tha n.^teri~-' lettr~ as it Is required in order to dose by mail. If you no longer have the passbook available, please contact us at 1-877-768-2285 so that we may provide you with a lost passbook affidavit. For Trust Accounts, a copy of the Trust Agreement is required. If you have questions regarding this notice or would like information on other products and services we offer, stop by your local branch, contact us at the address listed below or visit sovereignbank.com. Additionally, you may call 1-877-SOV-BANK, 7 a.m. to 8 p.m. EST, 7 days a week. For customers with hearing impairments, please call 1-800-428-9121 (TTYITDD). Thank you for banking with Sovereign. sinoetelyr, ~~~ ~~ s~v~n Mail inquiries to: Sovereign Bank, Mail Code: RI1-EPV-0218, P.O. Box 831001, Boston, MA 02283-1101. ~~. PLEASE 3EE REVERSE 31DE FOR IMPORTANT INFORMATION Sovereign Bank is a member FDIC and a wholly owned subsidiary of Banco Santander, S.A. ®2009 a~arereign Banks Sovereign and Its ~BovereignBank SEPTEMBER 3, 2009 002909 • 002909-0001 090909 MARY H MCCREA 70 MC CREA RD NEWVILLE PA 17241-9755 Dear Valued Customer, Certificate of Deposit Renewal Notice Account Number: 3388'156553 Renewal Notice: 48-59 MONTH CD It's a great time to continue to save with Sovereign. Now that we are a part of the Santander Group, we are stronger and more secure than ever before. You can rest easy knowing your money is now backed by one of the' world's safest banks.t And if you are a Sovereign Premier Customer you will always receive our best CD rates. Principal Value $15,000.00 Issue Date NOWEMBER 2, 2004 Grace Days 7 Maturity Date OCTOBER 2, 2009 Renewal Maturity Date (if CD rolls over to same term)...........SEPTEMBER 2, 2014 Renewal Instructions: Renew Principal Only, Interest Paid Monthly Your Sovereign CD is set to renew on the date noted above. It will automatically renew on OCTOBER 2, 2009 for an additional term of 59 months. To renew tlttis CD automatJcaity, you do not need to take any action. The interest rate and annual percentage yield (APY) for the new term have not yet been determined. Rate and APY information will be available on the day after the maturity date of your account and can be obtained by stopping by your local branch or calling us at the number below. if no changes are made, the value of your account at renewal will be $15,000.00. Withdrawal Instructions If you wish to withdraw funds from this CD without penalty, you must do so within the 7-calendar-day grace period that starts the day after the maturity date. Funds withdrawn do not eam interest past the maturity date (within the grace period). If you wish to withdraw your CD funds, please call us or stop by the nearest branch. You can deposit your funds into a new CD with a new term; transfer your CD funds to your Sovereign checking, savings, or money market savings arx;ount; or receive your funds via check. If you wish to close your CD via mail, please send a notarized letter indicating your request to the address below. We must receive this letter (accompanied by a copy of this renewal notice) BEFORE the end of the grace period so you do not incur a penalty. If the CD is a passbook CD, nleace inr•~ude the ~Aaehnnk alon® with the nntari>'s+ri iPffP: as it is required in order to close by mail. If you no longer have the passbook available, please contact us at 1-877-768-2265 so that we may provide you with a lost passbook affidavit. For Trust Accounts, a copy of the Trust Agreement is required. if you have questions regarding this notice or would like information on other products and servir~s we offer, stop by your local branch, contact us at the address listed below or visit sovereignbank.com. Additionally, you may caili 1-877-SOV-BANK, 7 a.m. to 8 p.m. EST, 7 days a week. For customers with hearing impairments, please call 1-800-428-9121 (TTY/TDD}. Thank you for banking with Sovereign. sinoerey, s~,~v~e Direchor, Deposit Products Mail inquiries to: Sovereign Bank, Mail Code: RI1-EPV-0218, P.O. Box 831001, Boston, MA 02283-1101. +'y~5 PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION Sovereign Bank is a member FDIC and a wholly owned subsidiary of Banco Santander, S.A. ®2009 Sarereign Bankl Sovereign and its LINDEN HALL ANTIQUES 211 N. OLD STONE HOUSE ROAD CARLISLE, PA 17015 717 248-1878 To: Sally J. Winder, Attorney 9974 Molly Pitk~rer Highway North Shippensburg, PA 17257 From: W'fGam G. Rowe, Appriaser 211 N. Old Stone House Road. Carlisle, PA 17015 Re: Personal Property Appraisal Mary H. McCrea Estate 70 McCrea Road NewviNe, PA Date: March 17, 2009 Beoueaq~ed Personal Property 1. Chest of drawers - Wi1Ps room $1,gOp00 2. Rocking chair - haU $100;00 3. Spencer mirrors (2) -dining room J living room $110;00 4. Sideboard -dining room $1 ~p0»00 5. Dutch cupboani -dining room $2,500.00 6. Blanket chest -Mary McCrea's bedroom $1,000:00 7. Desk -garage -not available -estimate $15000 8. Desk -slant lid -hallway $250»00 9. Blanket chest - WiIPs room $1,200x00 10. Armoire - Merry McCrea's bedroom $1,200:00 11. Mirrors (2) -Queen Anne & Chippendale $25000 12. Mirror - {wing room -Laura Beret (as is) $40.100 13. Collection of pressed & panel glass $115.100 14. Washstand, marble top - Lucy's old bedroom $'150.100 RE~'1509 Ex+ (rrsa) COMMONWEALTH OF PENNSYLVANW INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY H. MCCREA FILE NUMBER 21-09-161 ff an asset was made joint witlrM one year of the decedents dabs of dsalh, it must be reported on Schedule G. SURVMNG JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A• CHRISTOPHER D. BERILLA 31 WEST MAIN STREET, NEWVILLE, PA 17241 GRANDSON B. C. JOINTLY-OWNED PROPERTY: ITEM NUMBER FORJOIN TENANT DATE r MADE JOINT DESCRIPTION OF PROPERTY INCUIDE NAME OF FlNANCWLeSTIlU110NAlOBANKACWUNTnUA~920RSMWt IOENIIFYMG NIJNBER, ATTACH DEED FOR,pINTLYa~.D REAL ESTATE. DATE OFOEATH WIDE OF ASSET ~ ~ DE(~'S ST ~~ ~ DEA7H VNIEOF DECEDENTS INtEREST ~' A. OZp7/95 PNC BANK, ACCT 21001053166 8,821.71 50 4,410.86 2• A. 02/01/99 F8M TRUST COMPANY ACCT 71-29416 , 10,074.77 50 5,037.39 scNEOU~ F JOINTLY-OWNED PROPERTY TOTAL (Also enter on line 6, Recapitulation) I = 9,448.25 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) scNEOU~ N coMMONwEaLTH of PENNSYLVANIA FUNERAL EXPENSES Se INHERITANCE TAX RETURN ADM~NISTRATNE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARY H. MCCRE:A 21-09-161 Debts of deoederrt muta be reported on Schedule L frEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' EGGER FUNERAL HOME, FUNERAL ACCOUNT 8,402.53 FELLOWSHIP FOLLOWING FUNERAL, FOOD 96 15 CARLISLE MEMORIAL SERVICES, GRAVEMARKER 3,470.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Sortial Security Number(s)/EIN Number of Personal Representative(s) Street Address ~` .State dip Year(s) Conxnission Paid: 2. Atiomey Fees 30,740.15 3. Family Exemption: (IF decedent's address is not the same as rAaimant's, attach exPlarralion) Claimant Street Address ~' State .Zp ReNationship of Claimant to Decedent 4. Probate Fees 1,069.00 5. Accamfant's fees 6. Tax Retum Prepaner's Fees 250.00 7. FPM TRUST ,ESTATE ACCOUNT CHECK FEE 26.75 $- JOSEPH JAMES JEWELERS JEWELRY APPRAISAL , 84 80 s. NEWS CHRONICLE, ADVERTISE LETTERS TESTAMENTARY 55.25 10- CUMBERLAND COUNTY LAW JOURNAL, ADVERTISE LETTERS TESTAMENTARY 75.00 t i. PA DEPT OF REVENUE 2008 INCGME TAX DUE , I 499.00 12. LINDEN HALL ANTIQUES, APPRAISAL OF PERSONAL PROPERTY ' , 85.00 TOTAL (Also enter on line 9, Recapitulation) ~ 44,853.63 (If more space is needed, insert additional sheets of the same size) CONTINUATION OF SCHEDULE H, FUNERAL EXPENSES AND ADMINISTRATIVE COSTS MARY H. MCCREA FILE N0.21-09-161 13. GEORGE L. EBENER & ASSOCIATES, REAL ESTATE APPRAISAL 14. F&M TRUST COMPANY, TRUST ACCT VALUATION FEE 15. F&M TRUST COMPANY, ADDITIONAL ESTATE CHECKS 16. CARL OCKER, AUCTIONEER, FEE 17. JS HARDSCAPE, LABOR AND WAULING 18. RECORDER OF DEEDS, TRANSFER TAX 19. SHELBY WINTER, TAX COLLECTOR 09-10 SCHOOL TAX 225.00 93.00 26.75 100.00 489.06 545.00 11.39 REV-1512 EX+ {12-08) pennsytvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INNERrrANCE TAX RETURN RESIDENT MORTGAGE LIABILITIES ~ LIENS DEaDENT ESTATE OF FILE NUM®ER MARY H. MCCREA 21-09-161 Report debts marred by the dexdent prior to death that remained unpaid at the date of loth, indudirg unreimbursed medial expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 ~ FIC CARD SERVICES, AOL ACCOUNT 11.99 2. GRAHAM MEDICAL CLINIC, OUTSTANDING ACCOUNT 77 23 3. STOKEN OPTHAMOLOGY, OUTSTANDING ACCOUNT 35.75 4. DARLENE PITTMAN, REAL ESTATE TAXES 16.62 5. GRAHAM MEDICAL CLINIC, OUTSTANDING ACCOUNT 22 02 6. CARLISLE MEMORIAL SERVICES, BALANCE OF ACCOUNT RE: WILLIAM MCCREA 1,495.00 TOTAL (Also enter on Line 10, Recapitulation) I # 1,658.61 If more space is needed, insert addidon~ streets of the same size. REV-1513 EXt (11-OS) Pennsylvania SCHEDULE ~ ~EPANTME[A' OF REVENUE 1N1~'r""~ T"x REnRH BENEFICIgR2ES RESroerrr o ~~.~.. -- _...... ~ .,r MARY H. MCCREA FILE NUMBER Nt>MBE i R TAXABLE D NAME AND ADDR~ ~ PERSOdI(S) RECEIVING PROPERTY ISTRIBUTiONS [tndud t ~ Nat ~P ro ruabee(sj 21-09-1fi1 AMOUNT OR SHARE e ou right spousal d~ aiM transfers under Sec 9116 (ay (1.2j.j OF STATE 1. MARY JANE SPENCER, 203 LOG CABIN RD., NEWVILLE, PA 17241 DAUGHTER 2- LUCY M. JANSEMA, 3f W. MAIN ST., NEWVILLE PA 17241 SEEWILL , DAUGHTER SEEIMLL 3. ANDREW M. MCCREA,150 GYPSY RUN RD., NEWVILLE, PA 17241 SON 4. ANDREW J. SPENCER, 203 LOG CABIN RD., NEWVILLE, PA 17241 GRANDSON SEEWILL 5. B. CHRiSTIE KATORA, 226 PINE RD., MT. HOLLY SPGS PA 17065 M&TSTOCK , GRANDAUGHTER M&TSTOCK 6. K. MICHAEL SPENCER, 930 FOREST CT., CARLISLE PA 17(}13 , GRANDAUGHTER M&YSTOCK 7. ANDREW E' MCCREA, 70 MCCREA Rp,, NEWVILLE, PA 17241 GRANDSON MBTSTOCK 8• ANNE M. DA1lIDSON,148 REGATTA LN, STANSBURY PK, UT 84074 GRANDAUGHTER 9. EMMA C. MCCREA,150 GYPSY RUN RD., NEWVILLE, PA 17241 GRANDAUGHTER M&TSTOCK 10. KATHRYN BERILl,A, 31 S. PITT ST CARUSLE PA 170 M&TSTOCK ., , 13 GRANDAUGHTER M~TSTOCK II ENTER ~~ AMOUNrs ~ DISTRIBUTio~ sHOwN ABOVE ON LINES 15 THROUGH 18 OFREV--1500 COVHt SHEE NON-TAXABLE DIS17tIBliTI0N5: T, AS AP PROPRIATE. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARITABLE AND GbVHtNMENTAI DL,TRIBUIIp~ i. TOTAL OF PART II -ENTER TOTAL NON 7AXABI.E DISTRIBUTIONS ON LINE 13 OF REV-ISfNI rnvco cuerr If ngre space is needed, insert additlonal sheets ~ the same size. -- -----.. REV-1513 EX+ (11-08) ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ~ BENEFICIARIES CJIAIC Ur MARY H. MCCREA NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 11. CHRISTOPHER D. BERILLA, 31 W. MAIN ST., NEWVILLE, PA 17241 12. ISABELLA MCCREA, 70 MCCREA RD., NEWVILLE, PA 17241 13. COURTNEY DAVIDSON,149 REGATTA LN, STANSBURY PK, UT 14. MERRICK DAVIDSON,149 REGATTA LN, STANSBURY PK, UT 15. DANIEL J. KATORA, 226 PINE RD, MT HOLLY SPGS, PA 17065 16. DYLAN M. MADORSKY,133 S. PITT ST, CARLISLE, PA 17013 IZ 1. 1. FILE NUMBER 21-09-161 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(sl nF ccreTx GRANDSON GT-GRANDAUGHTER GT-GRANDAUGHTER GT-GRANDSON GT-GRANDSON GT-GRANDSON M&TSTOCK $5000.00 $5000.00 $5000.00 $5000.00 $5000.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS ARPROPRIATE. NON TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 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,