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Home My WebLink About11-06-09~-~ REV-1500 1505607120 EX (06-05) OFFICIAL USE pNLY PA Department of Revenue Bureau of Individual Taxes county Code Year File Number Po Box.28oso~ INHERITANCE TAX RETURN 2 1 0 9 0 6 8 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social 07172009 09111921 Decedent's Last Name Suffix Decedent's First Name MI WARD HELEN C (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 INAPPROPRIATE OVALS BELOW ® 1. Original Retum ^ 2. Supplemental Retum ^ 4. Limited Estate ^ qa, Future Interest Compromise (date of death after 12-12-82) ® g, Decedent Died Testate ^ ~ Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trusq ^ 9. Litigation Proceeds Received ^ 1p, Spousal Poverty Credit ((date of death between 12-31-91 and f-1-95) DAVID R. MORRI30N Firm Name (If Applicable) DAVID R. MORRISON & ASSOCIATES First line of address 600-A EDEN ROAD Second line of address City or Post Office LANCASTER State ZIP Code PA 17601 Correspondent's e{nail address: Daytime TelepF~othe Number 7175601500 _'-7 -: ~ ~_~ C rz-t r^] r~+ Under penalties of perjury, I dedare that I have examined this return, inducting accompanying schedules and statements, and to the t of my knowledge and belief, it is true, correct and complete. DedareBon of preparer other than the personal representative is based on all information of which pre rer has any knowledge St~TURE OF PERSON RESPONSIBLE FnR FILING RETURN naTc Yl nhl o w (/,~~ p ,,` Marian L. Silveri / 4~ 3 b ~ o ADDRESS C ~' 404 Pawnee Drive, Mechanicsburg, PA 17050 I ~.E~~~'ri/'/~~ ~~ DATE David R. Morrison ~~ 3~ 7i~ 9 nnnwccc 600-A Eden Road, Lancaster, PA 17601 Side 1 1505607120 15056071120 J C ^ 3. Remainder Retum (date of death prior to 12-1J-82) ^ 5. Federal Estate Tax Retum Required 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sc ~ ~ C~ ~ "~ "+ :. DAVE FILED `, J 1505607220 REV-1500 EX RECAPITULATION 1. Real Estate (Schedule A} ..................................................................................... 1. 2. Stocks and Bonds (Schedule B) ................................ ........... 2 2 5 , 7 10.0 0 ............................... . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ....................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Pro e P rtY (Schedule E} .............. 5. 3 3 , 3 0 0.14 6. Jointly Owned Property (Schedule F) Q Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Propert y (Schedule G) p Separate Billing Requested............ 7, 1 6 7 0 0 0. 0 0 8. Total Gross Assets (total Lines 1-71 .................................................................. g, 2 2 6 , 01 0.14 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9. 19.6 3 1 . 7 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................... 10. 1 6 7 . 7 6 11. Total Deductions (total Lines 9 & 10} ................................ ,,,,, ............................ 11 • 1 9 , 7 9 9 . 4 8 12. Net Value of Estate (Line 8 minus Line 11 } ................................ .......................... 12. 2 0 6 , 2 1 0 . 6 6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. 13, 14. Net Value Subject to Tax(Line 12 minus Line 13~ .............................................. 14. 2 0 6 , 2 1 0 . 6 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable 2 0 6, 2 1 0. 6 6 at lineal rate X .045 16. 9, 2 7 9. 4 8 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ............................................................................................................... 19. 9, 279 .48 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505607220 J REV-1500 EX Page 3 File Number 21 - 09 - 0684 Decedent's Complete Address: Ward, Helen Catherine STREET ADDRESS - 404 Pawnee Drive CITY Mechanicsburg STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applipble D. Interest E. Penalty 2,250.00 118.42 Total Credits (A + B + C) Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thtaOVERPAYMENT. Check box 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 theTAX DUE A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE Make Check Payable to: REGISTER OF WILLS, A (1) 9,279.48 (2) 2,368.42 (3) 0.00 -. (4) (5) 6,911.08 (5A) (56> 6, 911.0 6 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APIPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the properly transferred; .................................... x b. retain the right to designate who shall use the property transferred or its income :.............................. a c. retain a reversions interest; or .............. .. ..........:.:.:.:.:..., ..................:...:.:................. x d. receive the romise for life of either a ments, benefits or care? ......................_........... 2. If death occurred after December 12, 1982, did decedent transfer props vuithin one ar of des receiving adequate consideration? ................................. ..........................~................. Ye th without ........... ................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her delath?....... ~x ~] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefiaary designation2 ...................................................................................... x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of tran fors 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 statutedces not exemota transfer to a surviving spouse from tax, and th'e statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only benefiaary. 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 oche-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) p2 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)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. C.OMMONVVEALTN of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS -__ _ ~ ESTATE OF Ward, Helen Catherine FILE NUAiIBER __ _ 21 - 09 - 0684 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 500 shares of Exelon Stock .51.42 25,710.00 TOTAL (Also enter on line 2, RecapitulationD 25,710.00 EXC: Historical Prices for EXELON CORPORATION -Yahoo! Finance Page 1 of 2 Yahoo! My Yahoo! Mail More Get Yahoo! Toolbar New User? Sign Up Siyn In Help ,~++a-+~.J~~, ~f~I~~C•~ ~~ Search ~.. WEB SEARCH __ ... _ .. __ _ _ _ __ ._..._..-----I Dow ~ 0.13% Nasdaq ~ 0.59% Fri, Jul 24, 2009, 1:43PM ET - U.S. Markeb Nwa In 2hrs 19mins GET QUQTI3 t Exelon Corp. (EXC) ~ Tr.,acle,~t~w~ NEW to f~:._;.37:~ $ ,~.. INVESTING? _. _ .__ .t Historical Prices SET DATE RANGE Finance Search At 1:26PM ET: 53'L87 • 0.1B (0.31°h) nJ r ~ ~ ~ AMIiR1TRAR-~ , ;,~ , ~~ `~ =~ Tipcks ~- Get Historical Prices for: GO ADVERTISEMENT ;a~ Daily Start Date: Jul 17 2009 Eg. Jan 1, zoo3 ~~ Weekly End Date:: Jul 17 2009 t-)Monthly C~ > Dividends Only Get Prices Trans U nion'_ ...840 '750- ,~ You are here First ~ Prev ~ Next ~ Last 63d '(6+10} PRICES 560 450'.. Date Open High Low Close Volume Adj aao» Close" 17-Jul-09 51.80 52.09 50.66 51.42 3,129,600 51.42 310 Close price adjusted for dividends and splits. Exp~n:$rl .840.:. First ~ Prev ~ Next ~ Last 7so ,~;i: Download To SDreadsheet bso' sso /You've hero. 430 ('' 340`` 310. Equifax. . .....840 730 630 330 ' 430 /You ure`hEre 340 (1111) ` i 310- Click Here To Get Scoret ~ Add to Portfolio '~ t AI ~ Email to a Friend Get Historiwi Prices for Another Symbol: GO Symbol Lookup • Stock Screener Splits http://finance.yahoo.com/q/hp?s=EXC&a=06&b=17&c=2009&d=06&e=17&F=2009&g=d 7/24/2009 CAAMADNN~EALTN OF PENNSYWANIA INHERITANCE TA7C RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Ward, Helen Catherine 21 - 09 - Os84 Include the proceeds of litigation and the date the proceeds were received by the estate9-II property jointly-oVvned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 PNC, Checking Acct. No. 5005211977, established 1/29/07 33,129.82 2 Capital Blue Cross -refund 170.32 ~ TOTAL (Also enter on Line 5, Recapitulation) I 33,300.14 I_l~l~t;~~~~~,~ August 4, 2009 Elder Law Associates David R Morrison Esq 600A Eden Rd Lancaster, PA 17601 RE: Name: Helen C Ward SSN: 183-16-6795 DOD: 07-17-2009 Dear R. Morrison: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Checking Account Account # 6005211977 Established: 01-29-2007 HELEN C WARD DOD balance: $33,129.46 + 0.36 accrued interest Interest paid O 1-01-2009 thru 07-17-2009 $19.40 YTD Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 of 1 COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS ~ RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Ward, Helen Catherine FILE NUMBER 21 - 09 - 0684 This schedule must be completed and filed if the answer to any of questions 1 through 4 on Haas 2 is vas_ ITEM NUMBER DESCRIPTION OF PROPERTY Indude the name of the transferee, their relationship to decedent and the date of transfer. Attach a copy of the deed for real estate. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION OF APP4ICABLE) TAXABLE VALUE 1 M&T Bank, CD No. 31003914618293, ITF Marian 11,000.00 11,000.00 Silveri 2 M&T Bank, CD No. 3100391459293, ITF Judith A. 11,000.00 11,000.00 Meckley 3 Treasury Retail Securities Site, POD Marian L. Silveri 56,000.00 56,000.00 4 Treasury Retail Securities Site, POD Judith A. 89,000.00 89,000.00 i Meckley TOTAL (Also enter on line 7, Recapitulatlorl) I 167,000.00 rU 5177 (Novombar 2005) •r~~ Legac Treasu Direc Y ry www.ueasurydirectgov 1-800-722-2678 1-304-480.6464 (Outside the U.S.) HELEN C WARD POD MARIAN L SILVERI 404 PAWNEE DR MECHANICSBURG PA 17050 '~eP~o~e t~utn~er (717) 737-7169 x sir ide .>4tt~. t[c~1V~.; ~ . Confidential ~~ ~ti~.oIdtu ~ ~t,i~ui~ No withholdin Mailing Number: 021006907 ~+ ,,. , ..... ..... :-. ~ ..~ _: ~. -._e _:~..... .... ..........................:........................................ ..... _.... :~~. 4 a... r .._., ,.. _ .,.,.,.~ ......,_.r .. .~ ~ __.. ~ ~r ~-Y:: TREASURY RETAIL SECURITIES SITE P.O. BOX 567 PITTSBURGH PA 15230-0567 PHONE: (800) 722-2678 Payments made by direct deposit to: PNC BANK Routing Number: 031312738 Name on Account: HELEN C WARD ~- CHECKING Account Number: Confidential ACCOUNT HOLDINGS ~ _ . 912795N64 ~ ~! ~b O1 15,000 02/12/09 99.757333 0.488 0.480 1 26MK BILL 08/13/09 15,000 912828EQ9 a,~~3• 1 2,000 12/15/05 99.733563 4 435 4 3/8 NOTE R 10 . 12/15/09 12/15/10 2,000 /J Intsr~st ~ lO 43.75 912828KE9 Z~j~~ Ol 25,000 03/02/09 99.830481 0 961 0 7/8 NOTE V 11 . 08/31/09 02/28/11 25,000 Int~r~st 109.38 912828L63 Cj1. 01 Q 3,000 07/31/09 99.842137 1 08 1 NOTE AA 11 2 , . 01/31/10 07/31/11 3, 000 ~y ~ _ Intsrsst . \ ~ 15.00 912828FQ8 ~ O1 1 1 11,000 09/15/06 100.499835 4 81 4 7/8 NOTE E 16 . 08/15/09 08/15/16 11,000 Intrar~st 268.13 /~ ~ Q~ IF YOU HAVE t]UESTIONS CONCERNING THIS STATEMENT, PLEASE CONTACT YOUR TREASURY RETAIL SECURITIES SITE AND PROVIDE YOUR ACCOUNT NUMBER ~r TRANSACTION HISTORY For 05/01/2009 to 07/31/2009 :. > I3egtlpnmg Par B~Ianl~+~ on ~ ,. 05/01/2009 ~: ... [~ $89,000 "ate 3 ~ ~.,: ~~ ,~ - ~ ~ ~.~ ~ ` ~ ayrl~e~t A,ipoa4~~ .~{ f,N ~. ~ 4 ~ a x s 05/15/09 912828FE5 4 7/8 NOTES 09 Par and Interest Paynsnt 8,195.00 05/15/09 912828FF5 4 7/8 NOTES 09 Rsdenption -8,000 05/31/09 912828671 4 7/8 NOTE Z 09 Par and Interest Paynsnt 25,609.38 05/31/09 912828671 4 7/8 NOTE Z 09 Redewption -25,000 06/15/09 912828EQ9 4 3/8 NOTE R 10 Interest Paynsnt 43.75 07/31/09 9128286Y0 4 5/8 NOTE AB 09 Interest Paynsnt (Held) 69.38 07/31/09 9128286Y0 4 5/8 NOTE AB 09 Redsnption -3,000 07/31/09 912828L63 1 NOTE AA 11 Reinvestment Purchase Security Price: 2,995.26 +3,000 07/31/09 912828L63 1 NOTE AA it Refund Paynsnt (Held) 4,74 ;. Eudtng Par BalAn~ on ` ? 07/31!2009 $56 000 IMPORTANT MESSAGE IF YOU MOVE PERMANENTLY, CONTACT US TO UPDATE YOUR ADDRESS. IF YOUR ADDRESS CHANGE IS TEMPORARY, LET THE POST OFFICE KNOW AND THEY WILL FORWARD YOUR LEGACY TRE~ISURY DIRECT MAIL. DID YOU KNOW OUR TREASURYDIRECTWEB-BASED SYSTEM NOW PERMITS ACCOI7NTS IN AN ENTITY REGISTRATION? GO TO WWW.TREASURYDIRECT.GOV FOR REGISTRATION OPTIONS AND MORE INFORMATION. IF YOU HAVE QUESTIONS CONCERNING THIS STATEMENT, PLEASE CONTACT YOUR TREASURY RETAIL SECURITIES SITE AND PROVIDE YOUR ACCOUNT NUMBER sm (Mw.mbar Zoos) Legacy Treasury Direct ,w,~,.trea~,,,+aradeor 1-800-722-2878 1.30d.dH0.848i iOUtslAe the U_6.) HELEN C WARD POD JUDITH A MECKLEY 404 PAWNEE.DRIVE MECHANIC5$UR6 PA 17050 www~0 ~~uiniw~. w~vwwv -----------._."------ .-..~_s~ -- - .~~ _ _ TREASURY RfiTAIL SLlC~'JRITIES SITE P.O. BOX 567 ~ PITTSBURGH PA 15230-0567 PHONE: (800) 722-2678 " '" . __ _ _ _ 717) 737-7-169 Payments made by direct deposit to: PNC BANK e.. ~~~~,L~a, ~°. ~~l91#~~ Confidential Name oa Account: HELEN C WARD CHECKING Accouat Ntimbier. Confidential _.,. - =-- -- -- _ No v~nthholdin ACCOUNT HOLDINGS 912795N98 BILL 09/03/09 `~ 8,000 912795Q38 BILL - --- 1-1/12/-09 _ . _.:. ._._~~5~800. 912828H89 4 NOTE AC 09 08/31/09 ~ 3,000 912828EQ9 4 3/8 NOTE R 10 12/15/10 6 2,000 91E828KE9 0 7!8 NOTE V 11 02/28/11 `" 25,000 ~O1 8,000 03/05/09 99.777556 D.447 0.4401 1 26tncl O1 15,000 05/14/09 99.045806' 0.31 0.305 2 26MK 01 3,.000 08/31/07 99.781361 4.115 ~O1 2,000 12/15/05 99.733563 4.435 O1 26,000 03/0?J09 99.$304$1 4.901 08/31/09 Psr end Int~ryst 3,060.00 12/15/09 Intsr~st 43.75 08/31/04 In~~wst 109.38 IF YOU HAVE QUESTIONS CONCERNING THIS STATEMENT, PLEASE CONTACT YOUR TREASURY RE'1'All SECURITIES SRE AND PROVIDE YOUR ACCOUNT NUMBER T'D s~ n INOwme.- zoos ,- . `~ =---: ttr ........ : -.t-:::::::. :.t-.,err::.. ......... t. ........... tt.:::::.t. A~' .....r.. ~' ..... t..:t.:::::.t...._..:::::: . . ~ -rr :::::: •:~.: . :r:;:::::::;`::;2:::;:;~: ~~•. . ~.~:r ' '~~:~.~: ... .• . . .: •:.:• . . : ,.r: r r .... •:. ~: ::,..: . ....:. :•::: :. ' ~..~w •:.. . {'$y •• r: . . .............. ......... ::..: .... ........... ...........:.............. ;. ; :t ,..::,.:...:.:....... . :r.: :: .. . :::...t :::•:::;:;,:. • r: rrrt•.... .......................... .:..:.v.:xv::.-r.~ :w::: :v:4: ::ti:?.. vrwr+r.w.:.::. ~::: .:{L::iti{ iii}: w:::,....... •: :•rr:ti•} :%i 't . .tit}:: {: 7: •Y... -\ .tvtvr. ~. . :ti~ •: v~n . . 912828LG3 Ol 25,000 07/31/09 99.842137 1.08 01/31/10 1 NOTE M 11 Interest 07/31/11 •25,000 125.00 -- _ 11,000 09/15/06 100.499835 4.81 08/15/09 4 7/8 NOTE E 16 -- ~ oa/15nc ll,oo0 _-__ 268:13 TRANSACTION HISTORY For 05/01/2009 to 07/31/2009 05/14/09 912795L82 BILL 05/14/09 05/14/09 912795Q38 BILL 11/12/09 Security Price: OS/14/A9 912795Q38 BILL 11/12/09 Oc/15/09 912828EQ9 4 3/8 NOTE R 10 07/31/09 9128286Y0 4 5/8 NOTE AB 09 07/31/09 912828GY0 4 5/8 NOTE 0 07/31/09 912828L63 1 NOTE AA 11 • security Price: 07/31/09 912828L63 1 NOTE AA 11 Redemption Rsinvestnant Purchase 14,976.87 Refund Peyesnt 23.13 Interest Payaant 43.75 Interest Peyeent (Hold) 578.13 ~ eno _._~._.. Reinvestaent Purchase 24,960.b3 Refund Payoant (Held) 39.47 -15,000 +15,000 r +25,000 IF YOU HAVE QUESTIONS CONCERNWC3 THIS STATEMENT, PLEASE CONTACT YOUR TREASURY RETAIL SECURITIES SITE AND PROVIDE YOUR ACCOUNT NUMBER COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCF®ULE H /RJNERAL DDS & /'7.~IrAr~71 rV'1~ ~.IW 1 ~7 ESTATE OF Ward, Helen Catherine FILE NUMBER - _ 21 - 09 - 0684 uedts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Tom McGoldrick, Funeral Director 6,615.00 2 Puchard Florists 295.00 3 TJ Fridays -funeral meal 68.07 4 Fr. Huron -honorarium 50.00 5 Patriot News -obituary 61.92 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zlp Year(s) Commission paid 2. Attorney's Fees David R. Morrison & Assoc. 2,500.00 3. Family Exemption: (If decedents address is not the same as Gaimant's, attach explanation) Claimant Marian Silveri 3,500.00 Street Address 404 Pawnee Drive i city Mechanicsburg state PA zip 17050 Relationship of Claimant to Decedent Daughter 4. Probate Fees Register of Wills -Letters 197.00 Addt'I Funeral Expense: Hillside Cemetery 1 465.00 Addt'I Funeral Expense: DeChristopher Bros. -headstone 4,241.00 5. i Accountant's Fees Addt'I Funeral Expense: Fox's Jenkintown -flowers 299,83 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal -estate notice 75.00 TOTAL (Also enter on line 9, Recapitulation) 19,631.72 G ~Sched~~le H COMMONWEALTH OF PENNSYLVANIA ~y ru ~y~ ~.,.~,I INHERITANCE TAX RETURN /"V ~ryS~iy~ C+~ ~X~ RESIDENT DECEDENT ESTATE OF Ward, Helen Catherine FILE NUMBER 21 - 09 - 0684 2 The Sentinel -estate notice 60.10 3 Marian Silveri -reimb. for 3 flower sprays, mileage 47.70 4 Marian Silveri -reimb. for mileage to funeral 124.00 5 Judith Meckley -reimb. for addt'I death certificates 32.00 Page 2 of Schedule H IN THE COURT OF COMMON PLEAS OF LANCASTER COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In the Estate of ; HELEN C. WARD, No. 21-09-0684 Deceased FAMILY EXEMPTION CLAIM Marian L. Silveri, daughter of the decedent, Helen C. Ward, hereby elects to take the Family Exemption of $3,500.00, by reason of her relationship to the decedent and their sharing a common household at death, 404 Pawnee Drive, Mechanicsburg, PA 17050. 1 Y 1 ~ l~~ .f.~ ~ ~ MARIAN L. SILVERI c: \work\wp\Wardcath. exm SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMIBER Ward, Helen Catherine 21 - os - os84 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 West Shore EMS-BLS 74.41 2 Country Meadows 22 68 3 West Shore EMS -BLS 70.67 ~ TOTAL (Also enter on Line 10, Recapitulation) ~ 167.76 REV-1513 EX+ (9-00) a ~ - SCHEDULE J COM NHER AANCETAXRETURNAN~ BENEFICIARIES RESIDENT DECEDENT ESTATE OF Ward, Helen Catherine FILE NUMIBER -- 21 - 09 - 0684 NUMBER ~ NAME AND ADDRESS OF PERSON(S) RECEI RELATIONSHIP TO DECEDENT SHARE OF E?STATE (Words) AMOUNT OF ESTATE ($$$) ~ __ VING PROPERTY Do NotLbt7rusUe(s) I I~ TAXABLE DISTRIBUTIONS[inGude outright s ousai distributions and transfers under Sec. X116 (a) (1.2)] 1 Marian L. Silveri Daughter fifty percent 404 Pawnee Drive Mechanicsburg, PA 17050 2 Judith W. Meckley Daughter fifty percent 32 Derry Street Merrimack, NH 03054 I i Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropriate, on i Rev 1500 coverisheet 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 SFHEE 0.00 ~~ r~ ~~~Y 3~ill ~n~ C~IP~t~zmPnt OF HELEN CATHERINE WARD I, Helen Catherine Ward, of the County of Lancaster and Commonwealth of Pennsylvania, being of sound mind and memory, do hereby declare this to be my Last Will and Testament, hereby revoking all wills and codicils heretofore made by me. ARTICLE I I devise and bequeath all of my estate of every nature and wherever situate to my two daughters as follows: 1) Fifty Percent (50a) to Judith Ward Meckley, born February 15, 1945, and 2) Fifty Percent (50%) to Marian L. Silveri, born February 23, 1950. In the event either Judith or Marian predecease me, I give their share to their children in equal shares, per stirpes. My son, Robert Bruce Ward, died in 1970 leaving a son, James P. Ward. I leave nothing to my grandson, James P, Ward, as I have provided for him in the past. ARTICLE II No fiduciary under this Will shall be required to give bond or other security for the faithful performance of the fiduciary's duties. ARTICLE III I hereby nominate and appoint Marian L. Silveri, personal representative of this, my Last Will and Testament. In the event that Marian L. Silveri predeceases me, or is unable to serve, I hereby appoint Judith Ward Meckley, alternative personal representative. It is my preference that David R. Morrison & Associates be retained as counsel for the estate. IN WITNESS WHEREOF, I, Helen Catherine Ward, have hereunto subscribed my name grid affixed my seal this 12th day of November, 1997. U~~~rtJ •( ~~.~1~1.,.~.~J ~G~1.~1:~.~ (SEAL) HELEN CATHERINE WARD Signed, sealed, published and declared by Helen Catherine Ward as and for that person's Last Will and Testament in the presence of us and each of us, who, at the request of Helen Catherine Ward, and in the presence of Helen Catherine Ward, and in the presence of each other, have hereunto subscribed our names as witnesses thereto the day and year last above written. residing at: 3091 Harrisburg Pike Landisville', PA 17538 residing at: 9 Wolf Circle Ephrata, PA 17522 ,r _ . ,~ R, ~~ ~ ~ 1 ~~+M ~ .: :~~ ~ ~ +~ ~ ' ~, `~ ; -~ t ~~ ~~ ~~~ _~ 4 ~ ~yS~. ~ ` ~N +i ,r, ~ ~ ~i;. ~~; ~~ #~ ~~ ~~~~ 'y ` w ~ ',~ ~~~il i' ~ ~ ±~ ~,~ ~ ~~ ~. ~ ~ ~, ~a ~ i j~,a~. ~, ~, ~ ,1~,~ ~ ~ s~ ~'~ ~~~~ ~ ~ ~~~ ~~ ~, ~t i~ ~~~ ~~