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Home My WebLink About1-12-10' ' 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN n, ~y PO BOX 280601 ~ V ~ ~ ~ („ ~ D Harrisburg, PA 1128-0601 RESIDENT DECEDENT ~sC ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 192-12-4189 05232009 09271920 Decedent's Last Name Suffix Decedent's First Name MI HARKLEROAD MARY H. (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N/A Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return 0 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 0 9. Litigation Proceeds Received 0 2. Supplemental Return 0 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 0 3. Remainder Return (date of death prior to 12-13-82) 0 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 0 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number PENNIE L. CAVANAUGH, EXECUTRIX 610-777-8769 Firm Name (If Applicable) First line of address 228 BRIAN DRIVE Second line of address City or Post Office State ZIP Code ENOLA PA 17025 REGISTER OF L S USE ONE' ~~ (,r ) j: ~ ~ ~ r ~.:~ [V , ~i.:~ ...~ ~ ~-- w.._ .. _ ?Y'] ' 1 ~ t '_i` l1 ~_ ~ r ., +,~.r ._ _.7 ''' t -; , . _ ;, _~.... ;-; ~.. I C~ J r'i \.._. A -.::`..t Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and com lete. Declaration of re r other than the ersonal r resentative is based on all information of which re arer has an knowled e. A RE PERSON R S SIB F R FILING RETURN DATE ADDRESS 228 BRIAN DRIVE, ENOLA, PA. 17025 NATURE OF PREPARER HER THAN REPRESENTATIVE DATE ~~ / ~ ~ JO 401 DORCHESTER AVE., WEST LAWN, PA. 19609 610-777-8769 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041114 1.5056041],14 J REV-1500 EX Decedent's Name: MARY H . HARKLEROAD 15056042115 Decedent's Social Security Number .192-12-4189 RECAPITULATION 1. Real estate (Schedule A) ........................................... 1. NONE 2. Stocks and Bonds (Schedule B) ...................................... 2. NONE 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages 8~ Notes Receivable (Schedule D) ............................ 4. NONE 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ........ 5. 17 3 3 2 . 0 0 6. Jointly Owned Property (Schedule F) Separate Billing Requested ........ 6. 3 5 3 9 5 . 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ........ 7 19 9 5 8 . 0 0 8. Total Gross Assets (total Lines 1-7) .................................. 8. 7 2 6 8 5. 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) ................... . 9. 4 0 0 2 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. . 10. 5 O 7 . 0 0 11. Total Deductions (total Lines 9 & 10) ................................. 11. 4 5 0 9 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................ . 12. - 6 8 17 6 . 0 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) 14 6 817 6 0 0 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 0 15. 0. 0 0 16. Amount of Line 14 taxable at linealratex.o 45 68176.00 16. 3068.00 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 0 0 18. Amount of Line 14 taxable . at collateral rate X , 15 18. 0 . O 0 19. TAX DUE ....................................................... 19. 3068.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 L 15056042115 15056042115 J COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND estate of MARY H HARKLFRC),4/~ (First, Midd/e, Last/ in said county, deceased, to PENNIEL CAVANAUGH SHORT CERTIFICATE I , GLENDA EARNER STRA SBA UGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 29th day of June, Two Thousand and Nine, Letters TESTAMENTARY in common form were granted by the Register of said County, on the late of EAST PENNSBORO TOWNSH/P (First, Midd/e, Last1 and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office a t CARLISLE, PENNSYLVANIA, this 29th day of June Two Thousand and Nine . Fi 1 e No . 2009- 00608 PA Fi 1 e No . 21- 09- 0608 Date of Death 5/23/2009 S . S . # 192-12-4189 Oml G? NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL LAST WILL AND TESTAMENT tJF h~3 ~~ ~4~. ~. ~.'' ~:, ~~ f._ 'i ~s I, ~~~ ~• HAI2K.LEItt)A,1), of the Borough of Westmont, County of Cambria, and State of Pennsylvania, being of sound mind and body, do make, publish and declare this as and far my Last Will and. Testament, hereby revoking all, former Wills by me at any time heretofore made. ~B-ST;, I direct that my debts and funeral expenses be paid by my Executor as soon after my death ~ conveniently may be done. ,~ As to my worldly Estate, and all the ro e p P rty, real, personal or mixed, of which I shall die seized and possessed, I give, devise and bequeath unto m Y children ZENAS EDWA,R.U HAR.I~LERO.AD ~~ p,E~,~ JIE LYNN CAVANAUUH to be divided equally share and share like. Should one of my children predecease me, then his or her share in my estate shall pass to his or her children, per stirpes. FD-~'~~ I nominate, constitute and appoint my daughter, PENNIE L 'Y'NN CAVA.NAUGH, as Executrix of this my Last Will anal Testament to serve without bond. ' '.~; Should my daughtex, PF~3I~TIE L'4'NN CAVA.NAUGH, predecease me or be unable to act as Executrix, then i nominate, constitute anal appoint, my son, ZENAS EDWARD 1^iARt~.I,ERQAD, to act as Executor of this my Last Will anal Testament to serve without band. y, ' " W1i:T~1~S5 ~jT~E _ o~, I.ha.~re i~~~ .x, 30th day of I~Tovember, 1995. `~ ~~.~== Signed, sealed, published and declared by the above named Testatrix 11~ARy H ~~K-I-ERO'AD, as and for leer Last Will and Testament, in the presence of us w ho at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. I,11~IARY H. I:CA.RI~I.EROAD, Testatrix, whose name is signed to the attae lied or foregoing hrsent, haying been duly qualified according to lava, do hereb acknowledge that I signed and executed the instrument as m Last Will y that I signed it will' 1 • and that I si ed it as rn free and olun and ~'estament; ~ y' ~ y tart' act for the therein expressed. Purposes _ 'Sro~orn or armed to and acknowledged before me by 11~y H. HAl'2KLE~~~, #lae 'f`esta#r~,, this 30t1~ day of November, .1995. :..~-. j x .~ ~,; ~ .. ,. f ~ ~ b Sri' y. - ~ .. , ~r~ ~~\ ~~~~~~ w .. . STATE OF PENNSYI.V"AhTIA: COUNTY OF CAM$I~, SS: We, D•C. NOKES, JR. and. LYNN are signed to the attached or foregoing ins do depose and say that we were present an as her Last Will and 't'estament; that h!IA.R that MARY H. HA.R;,Kt,EROAD executed i therein expressed; that each of us in the h at that time 18 or more years of age, of sot influence. .: ~~~ S>~~ or. a~e~ to and s~bscxibec ter. A~.N1~T ~~IS~.~, witnessesr this. 3 ~ day of N i £ ~• c No blic Notarial Seal 14irriberiy A. Mitten, Notary Public Johnstown, Cambria County My Commission Expires Sep#. 13, 1999 r,~~. ~~ No Publi Notarial seal Kimberly A. iUtiller, Notary Public Johnstown, Umbria County ~Y Commission Expires Sept. 13, 1999 ANN GEISEL, the witnesses whose names trument, being duly qualified according to law, d saw testatrix sign and execute the instrument Y H. ~:~~:RKLEROAD signed willingly and t as her free and voluntary act for the purposes earing and sight of the testatrix signed the Will uid mind and under no constraint or undue to before the I3.~. l~C?I~ES; JR. and L'Y'NN' ove~nber, 1995. ~ rt i ~. it. r. ,F ?.w~. ~~l } ~:i