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Home My WebLink About02-04-10 (2) 15056051058 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICULL USE ONLY County Code Year Fla Number 21 09 (If Appllcabie) Enter Surviving Spouse's Informatlon Below Spouse's Last Name Spouse's Social Severity Number Date of Birth ovo5i1915 Suffix Decedenrs First Name MI Helen .__...__....__...---._: _ --__._ ? E ._.._._...........----.. L._...._._u Suffix Spouse's First Name MI •I I -~? THIS RETURN MU5T BE FILED IN DUPLICATE WITH THE { REGISTER OF WILLS FILL IN APPROPRUITE OVALS BELOW OID 1. Original Retum O 2. Supplemental Retum t~ 3. Remainder Refum (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Fedarel Estate Tax Retum Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe DeposR Boxes (Attach Copy of wll) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 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 CONflDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Benjamin C Williams (717) 566-333 ° _ Finn Name (If Applicable) __.. _ o ;"-~ ~ ' ~ .I `~ REGISTER SE ORL1 -~1 W I ~} Cam,? ~' c ::~ __CJ Flrst line of address __~__ ~- ~ 7C _ ~ ~7 t-"7 590 South 82nd Street t~ ~ ' ~O-~ _ ~~ ~~ ' ~ _ _ Second line of address -..~ p a .. ~ ~ n-, I ~ },, ~ I City Or POSE Office State ZIP Code ' .............._DATE FILED_.___ . Harrisburg ~ ~ PA ;1711.1 Correspondenrs a-mail address: bcwilliams_61 @yahoo.com Under penalties of perjury, I declare that I have examined this return, induding accompanying schedules and statemems, and to the best of my knowledge and ballet, h is true, correck and complete. Dedaretion oT preparer other than the personal representative is based on all IMormaticn of which preparer has any knowledge. SIGNATU OF PE SON Fi~$ I )LE F FLING RETURN ' 6 A - C/1T K /h ~/~~~0/O ADDRESS 590 South 82nd Street; Harrisburg, PA 17111 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE PATE ADDRESS PLEASE USE ORIGINAL FORM ONLY 15056051058 REV-1500 EX (~5) PA DepaMlent of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0fi01 51de 1 15056051058 ~~ J 15056052059 REV-1500 EX Decederrt's Social Security Number Decedent's Name: Helen E Williams ~ 172-01-7890 RECAPITULATION 1. Real estate (Schedule A) ............................................. 1. 0.00 2. Stocks and Bonds (Schedule B) ....................................... 2. '' 0.00 3. Closely Held Corporation, Partnership or Solo-Proprietorship (Schedule C) ..... 3. 0.00 4. Mortgages 6 Notes Receivable (Schedule D) ............................. 4. 0.00 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. ', 5,654.05 6. Jointly Owned Property (Schedule F) O Separste Billing Requested ....... fi. ~; 0.00 7. Inter-Urvos Transfers & Miscellaneous Non-Piobete Property (Schedule G) Q Separate Billing Requested........ 7. j 0.00 8. Total Grroas Assets (total Lines 1-7) .................................... 8. ', 5,654.05 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 8. ' 766.26 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 2,779.23 11. Total Deductions (total Lines 9 & 10) ................................... 11.. 3,545.49 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 2,108.56 13. Charitable and Governmental Bequests/Sec 9113 Trusffi for which an election to tax has not bean made (Schedule J) ........................ 13. 0,00 14. Net Value Subjsd to Tax (Line 12 minus Line 13) ........................ 14. 2,108.56 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_ 0.00 '' 15. ' 0.00 16. Amount of Line 14 taxable s -" dt lineal rate X.O 45 t 2,108.56 16. I; 94.89 17. Amount of Line 14 taxable ( i at sibling rate X .12 0.00 ' 1 ~ 0.00 18. Amount of Line 14 taxable at collateral rate X .t5 0.00 18 0.00 19. TAX DUE ......................................................... 19. 94.89 j 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: FlN Nu ~ 21 09 10 134 ~~_--~ DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER Helen E Williams 172-01-7890 STREET ADDRESS Cumberland Crossing Nursing Home 1 Longdort Way CITY STATE ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit 0.00 B. Prior Payments 0.00 C. Discount 0.00 3. interest/Penalty ff applipble D. Interest E. Penalty 0.00 0.00 (1) Total Credits (A + B + C ) 94.89 0.00 0.00 94.89 0.00 94.88 (2) Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, order the difference. This is the OVERPAYMENT. fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5g) Make Check Payable to: REGISTER OF IMLLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRU~TE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain the dght 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 a security at his or her death? .............. ^ [x] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................:.................................................................................... ^ IF THE ANSVYER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN or dates of death on or after Juty 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)]. Fordates of death on or after January 1, 1995, the fax 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 statutory requirements for disGosure 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 Juty 1, 2000: The tax rate imposed on the net value of transfers from a deceased child lwenty-0ne 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 w for the use of the decedents siblings is twelve (12) percent 172 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+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scN~ou~ E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER . Helen EWilliams 21-09-1134 Indude the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned wkh riQM of survivorship must be disclosed on Sehaduk F. trt more space is nceoec, Insert atltlitional sheets of the same s¢ei REV-1511 EX+ (10-09) Pennsylvania DEPARTMENT OF REVENUE INNERITANC~ TAX RETURN RESIDENT DE¢DENi SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE•OOSTS ESTATE Of FILE NUMBER Helen E Williams 21-A9-1134 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-OB) SCHEDULE I r :~' pennsylvania ~~ ' DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DEt®ENT ESTATE OF FILE NUMBER Helen E Williams 21-09-1134 Report debts incurred by the decedent prior to death that remained unpaid at the date of deatfi, including unreimbursed medical exper~sea. If more space is needed, Insert additional sheets of the same size. REV-1513 EX+ (11-08) ~ ,~ Pennsylvania SCHEDULE J BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Helen E Williams 21 _pg_~ ~ ~ NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY RELATIONSHIP TO DECEDENT Do Not Ust Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [Indude ouMght spousal distributions and transfers under Sec. 9116 (a) (1.2).j 1. Benjamin Charles ~Iliams Son 100% 590 South 82nd Street Harrisburg, PA 17111 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER BECKON 9113 FOR WHICH AN ELECTION TO TAX [S NOT TAKEN 1. B. CHARRABLE AND GOVERNMENTAL DISTRHIUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ u more space is neetletl, insert adtlttional sheets of the same size. REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA No . 2009- Estate Of, CERTIFICATE OF GRANT OF LETTERS 1134 PA No . 21- 09- 1134 HELEN E W/LLIAMS IFirst MiddM, Gasp Late Of : SOUTH M/DDLETON TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No: 172-01-1890 WHEREAS, on the .8th day of December 2009 an instrument dated October 4th 1991 was admitted to probate as the last will of HELEN E WILLIAMS (First, Mitltlle, LesU late of SOUTH M/DDLETON TOWNSH/P, CUMBERLAND County, who died on the 1st day of December 2009 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi1Is in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: BENJAMIN C WILLIAMS ' who has duly qualified as EXECUTOR(R/XJ and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 8th day of December 2009. LAST WILL AND TESTAMENT OF HELEN E. WILLIAMS I, HELEN E. WILLIAMS, of 447 South 14th Street, Harrisburg, Dauphin County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Wili and Testa- ment, hereby revoking all former Wills by me at any time hereto- fore made. ITEM I. I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property shall be paid by my Executor out of the property passing under ITEM II of this Will, as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement of any such tax so paid, even though on proceeds of insurance or other property not passing under this W111. In the absolute discretion of my Executor, such taxes may be paid immediately, or the Executor may postpone the payment of taxes on future or remainder interests until the time possession thereof accrues to the beneficiaries. Page 1 of 2 pages Helen E. Williams n ~o N o ~ _ ~~ ~, .~ n ~-~ c=:. O ~ y~ ~•, f'~' . ~'!`y"~I -i .Y•' ~ ~~ ~ ~Ta rp • O n~ VJ ~ ` ITEM II. I give, devise and bequeath all the teat, residue and remainder of my property, of whatsoever nature and wheresoever situate at the time of my death, to my husband, Benjamin C. Williams, provided he shall survive me by thirty (30) days. In the event my husband should predecease me or not survive me by thirty (30) days, I give, devise and bequeath all the rest, residue and remainder of my estate in equal shares to my sons, Benjamin C. Williams and Thomas A. Williams, both of Harrisburg, Pennsylvania, or to the surivovor of them. ITEM III. I nominate, vonstitute and appoint my son, Benjamin C. Williams, as sole Executor of this, my Last Will and Testament. In the event Benjamin C. Williams refuses or is unable to act for any reason, I nominate, constitute and appoint my son, Thomas A. Williams, to act in his stead. It is my desire that my Executor serve without bond. IN WITNE33 WHEi2EOF, I have set my hand and seal tv this, mY Last Will and Testament, typewritten on one (i) other page, this =l-- day o f ~~ / , 19 91 . Witness: ~-'y ~C~S7 ~ ~ ~ Cam( / ~~~ '~ ~1~"-~~/ Helen E. Williams 2 t'.pMt4pNWEALTH DF PENNSYLVANIA. S5 COUNTY OF DAUPHIN I, HELEN E. WILLIAMS, testatrix whose name is signedualified attached or foregoing instrument, having been duly q according to law, do hereby acltnowledge that I signed thatexl ecuted the instrument as my Last Will and Testfreetand volun- signed it willingly; and that I signed it as mY tart' act for the purposes therein contained. Sworn or affirmed to and ac ~owlaa~eQfbefo~r~~V pY n~,.~~. °; WILLIAMS, the testatrix, this 19 91 . //// ~ / •/ n v~ mot" D I ~ L~J iL~L~C.~~/~ Helen E. Williams . N art' Pub]~lc y >+w.. H ~ ~ :.... L M :,iSti- 4~ NfJ S.'~'~ ~ ~~~~ •v~~eeY1i ttisrt~sfiK=ef3, i3a~tt~! L'sra~y COMl~IONflEALTH OF PENNSYLVANIA W a~.S~,tC~kt . S5 COUNTY OF DAUPHIN ~ yte, , the Witnesses, and respectively, whose names are signed to the attached or 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 and Testament; that HELEN E. WILLIAMS signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix was at that time eighteen or more years of age, of sound mind and under no con- straint or undue influence. ~ Sworn or affirmed to and ubscribed to before me by ~.1m,-~'~'` ! ~ ( ' .~i1k~~ and I Txf n , s/ da of , 1991. the witne~ses, this ~~ Y W Witness No~Cary Publ i {~8i4i£431JY1, f-':1`••~±'ittrl ~~r~ ~3 ~ . ti~ ~. 'vas' P' i36 ~+ ' as.aos xsv Io,ro~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. ee for this certificate, ':$6.00 ' „7m~•~~ ..t This is to certify that the information here given is A~~~p~TH OF Pfq~~ _ correctly copied from an original Certificate of Death L ~ = r r duly filed with mesas Local Registrar: The original o , - •;~ z certificate will be forwarded to the State Vital ~ ~ Records Office for anent filing. +' P 15981483 ~°~~ ~ =~ ~~ Certification Number 99T~1fNT OE~wP'~~ Local Registrar Date Issued oraEV ni2Or _. COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VRAL RECORDS - . ~~r" , CERTIFICATE OF DEATH ,.. _ ($!! NIfWCNOM Nd tlI«IIIDM~ on 20YNNI e+.ee a~ a ee vubro , M.«a oe«we IF«t eeeee, u« aew z. sr a seer s.eee7 M«er. .: •.Oral De«, IarM, re 7rO Helen E. Williams Fallale -:.172 -: 01 - 1890 Oecenlber 1, 2009 s.?w M1aa Mabwl,.,: unMrz ur., aorrrnltean. i. Bubb. wmrr YNreaoeeM lubn< aa1 ., a.a. Ow.' HAa U.... l,er«t Onc ,. m. Steelton PA ^barre ^elraaa«.e ^Ba MewgXa« ^w,aai« ^oe.•Brr,: ee.eanbaB.r,; ec.awmo.iw.ao.rn uF.aB2x.«Inae«,wtBrabaarr.nr q:zwanoa+awF«bagnT ~N^ ^:r.. ,a mocv.r+nnenrawi+.s (~ Ibt ~Pr1Y Cabn I~d11 SOUttI tetlt~l@tOn eb.bee. Fiin,eROneal WGite n. Deaafe Ua42 ra a.aea r. avba eb. DOM YeaOaN ,z w..owaawawneb ,a Drtaade'eFbdaerlBpra, ae2 bvayeee wnb bael ~~.7b,rl Se,bb WnrO, Mar«rba ,a Ba'^«b Sla w BtaM.b«nae«Mw wbawak Febaadle«elM«IT U$MbbE Farr? Elararyl Bemrryl0-177 Gabge l,las.l 1`fuO+r.ObOiFr I501eF{1 ^"a ~"^ 9 Widowed -` ,a oaa«reaeMiq,~eru lMbet Wlrrn ee..7beeeel 0in°"'~e 1Vania t~,a nc®+w.o.aa.ybwn-SWataza rq: a«rlrmbe. n.aw ~pa9y 590 S. 82nd Street „ap ~a]..e.Mr '; .` C Dauphin i ` PA 17111 w„b, ne aen u. Fran Beeb IF+n~aa7e. bM. baM1 ... ,e.7wbn wr IRY aqi: area, bra«I :... ..:,Steven Vaz Julia Fercak 20i bbraraF Mda01T,p•FaN 700. Yeamax'l Yibbaeam lM!.a bl,lbra.bW.2parl ' W'll' 590 S. 82nd St. Harris PA 1711 1 21 e. t M «Od O~VFa0e0 ~ ^(}aneeen ^Nllle« 710.OW tlOraMa,lleei4 W.1W 21Gne«tlObpOrbn,Nnbdanawy.arnaw,aabrpaN 7,a lafYMiCl7~bal «b.,pmbl r ~ ~ ^ na«wteresb ~ a ""a1° ° +" w i 12/7/2009 Holy Goss Csnetery Harrisburg; PA 17T11 m F,r w ^r«^ ^ aT, a • va. .~... sacra- « 2A.LrrY Meer :.. 72e N0IMw7GMrrafe0lry Nei F~rrleralHOme, SRC / 3501 Derry St. Harris PA 17111 ~qN Frllnb.: am,bpb00e.4Mafaaeerebbee, blb as lbOt MIMe.IS.~leeee 014 WI - 27o. 4cen7e Mena. 27:.144 5gn0010brt r2.lYb : bae.r«Ma MaeelMb ~rlar.a«a,t ;: ~.-~ ~~~\ -~'--- .'-~ ~. aZa -5151 :. ~_ ,~1 .,- , ~ Wr7Ne«rranbbbe MPa«n ~. rwbaBa« 75. Oeb flanwre Orell00rt M. wn 36.W«cn.F.wnO gJMOblEaan.rrtwawbra w0oi o0r Fw tmra,aoa.or ( .ro pawe.aan 1 :OS A «. Decanter 1 , 2009 ^+r 'L7-•' a CAUBe OF BE117M Pee Y,eY„Nb„b n,d nea,lMel. , all~eee«e «evet FnJ[ErrrweyLM xOa Te«®urfarirsO«nr Ode27 Prt Hwllrr{t»~ebl-aelrRebeaawNe«MA-NbaJA'uare,e.OrR WIIDT eIer,IInM„I baa w,ra.«cr«t OYa blleM aemaaMpnnbi«e7equr pnnnMt ^*aOFOM ^ ; mp+raya«a aawbweaMr rra Nie.eb eb abbB~.WMrab<arrM,NM ''' ~ O~ ~r„ ~Rr (( mbt~en ~a«W i .. ~-a-S 1. ~ ,+N•1 OCCr~'GI , `>;7.l4'E-~oh- t P.1 F«Wt ~ , Drb rean.eprwaB: Olrpep«eaM lea l+r ^FegreaYmea O«M ~ 9 g r YO,W wnllae.iab. 0 ~ ... ~b , ~~ eM a - ;-ier6 YlORYB16 COYBEi dbblareaabgwp M::. ~.. ^7blabbrtwaeorre a/m eO eNe . ryry ~aeap~r waaa~' °~ ~ ^ar4 USr darn . 7 . Qabla «aargroal ^Mlpgrlh/pepiretl~ab, ~r i e ,. rb0«,a ^.Ie4bin0rq«eeiinM/„ ePr 70a n««Mrrr:,. ]00. Wae Ma«er Fbbb, TI.Yn«aOxle 7h Deba O~a/IAbnn,ON~MI 1A.DwmrNw qu,OmeM 12c Pbwd ~eb'NeT'.Nw,Faw Ywt Falur, Faavarf MaaM HYbCa,bbn OIbBYe«iatlBDral7 : _ ^n. I~Ne, ^n,.. :^w ^aarr7 ^Mibq b.«IlWlai 72e rm a.epey m:Injryawm1 sx.Fnanw~a!hwlsneM; at taebea0bry lint ory, bat OU,N ,. ^fiew ^Caae Na«OUnrw ^Y« ^b2 ^d..rlOwra ^ QFasun ' Y '. Onr-SIeaF.' 17L Cara pna anl'abl rrielFl eo«aM e oraadM ewanabr aunn aa an Wee a 271 " • rre1 I obr err 0 ]L.Bgben p ~ ry y b . py p b u p o , l M F : 7 Te.M,.,e.paar ba„by.,e..M«c,.vea. rnec~INr,Ewa..bbi""""""""""""-_'_'""'"'"'"" .. ,. ~.. • F,araaYM re arelY,e pbaebnAP,b7ean a«aawaiaq abnaa aivn94«waaae0. - MM w M l s ^ T )% ... 7m. ab59^r~wn b2 N~1 aw.rae ao eaa as l nw OeeMYtlb urNN a aaw «aa.L______________ __ • Wkal6iwbr ~ ~e, /~~ W~ s ` O ~I _ ( : L' ZIG OOIr'OaW aarrnabnaala a/elbbF edr eeca,NaMer,aW. we pe«.rrabbh«eMNrn arrrN M1- ^ >•faib ab aeerwaPrm «bGaaaberradlleM l«a221 rYPeiPm . ".75. Wgw'f r Te Fro 1•' _. ; -- _ . _ ~~, High Performance Money: Market _ ~ + a 01 1010072170944 752 30 ~. 0 18 25,395 ._ - 00006114•._ , . ,. , _;, _ _ _, I~~~IIL~~L~~IL~~II~~~II~I~I~~I~LII~~~~I~LI„1~11~~~~11~,1 _ _ HELEN E :WI LLIANS .. _ _ _' . 580 S 82ND ST - - pg ~~ HARRISBURG PA 't7111"` ,...."" `.' _ - „. _. -~ ~,. _ ~" Hi h Performa nce Money 1Vlarket , y t~l~s~»~~~2~~2aos - g _ _.. _ ~ _ ._ ,..:,. _ ..,. _ _ . __ ..w._._._... ,,:.,. _~. _ . _ _ , Account number 9 01 00721 70944 ~_-~ - _..; ... • Account ovine s . ° . HELEN E-WILL-fAMS ~, ~- _ r' ~~- .~ ,, . ,.. ..:. _ :. .. ... _ .. .. _.. _ - - Account Summary a. - __ _. ~ _._, _.. ... .. _ Opening balarice 11%26 .._::.; z...n_r:.,..._ .::. -':$4,229.35-:-: '_.° .,, -.;~ _ . _,.'' _;_ : ... _ ,__."' ._:~:~ _, ..M.. . , ,,, .. ,.. .. . .: Deposits and other credits ~ -, ~ ~ , .-_ - ~.1.369.D0 + -...-.- _ .., .. _. :. _ _ - - : ,, _. ,. ;Interest Paid _ ,. ._ .:- ,___::,, .... _ .. ~;~ _._0.05: ,.. _. _ .,; _. __.•_w ._. _ _; Ofherwitfidi'avirals'andservice"fees .'~':'"... .::":__._ __":5.598.40"''= '; :. ~. °'; _ ,~.: ,.,. ~ d _ Closing balance 12/29 `"`~ :' $0 00 ' _...: ....:: .._._ .. .. ~ _. - ._ _. _._ ___ _._ ; .._. _; ..,a .. .. .. _... __.. .. .. -_ ... r.. _ .. :. _ .._ ...... '=Deposits and Otherr,Credts r,_ , ~ - - - _ ;- -..- .- .. ,- .., _ ._ - __ _ _. _ ,. ...- .~ _r.. ~. .. .. . ;: . Date : .. .n. Amount - ,: Description _ „-: _, ~_~._ T .. .:::.... . . .. --,-.., :: .. _ .. ;.. . '., . 12/03 ~ 1,3fi8 00 ° AUTOMATED CREDIT US TREASURY 303 SOC SEC - -- ~ ~~ -- ••- - - ~ - ': .., _ .. _ : -_ . _ _ ....,.. .. - CO. ID.:303j03603Q°d99:203 PPD".< -_ .. N 1.2/08 005 'INTEREST FROMII%26/2009THFIOUGH~12%08%2009- --•••- •--•-.--- __.-. .._ > - ..~ otal _._ _ 1;369:05 - .,.. _ ,. .. ,_ . , -. , . _ .:.". ... .. , ... _~_ _ ... .. i~ Interest.:.: .._.. ~:_.,_. ~ -.: .:; - a Number of da s this statement penod 12 _ .. Aririual ercenta e yield eamed ; :_ 0 03 : -_ ~ tl~V ~M1 • ~~ - m .. p g _ . _,., m... ~. ,'a , ,., . . % : ,.:: _. _ - .Interest earned this-statement penod . _ -- -_ -• $0 05 - ~ , ., - . - ; _ __ '_.. .. -. .. ~ _ ,..-.'._. - z .:Interest paid-this sfateinent period _.___:: _. ,_...•._ ~ ';":$005 : ,`, . ,_::_ ,,.., : - - -• ~ z Interest paid_this year°,_ _ ._.__ $1 21 - -w~_. ._. ___.:..... _..:: _ ..~ „" ' . .:_ _ .: ::....,_ ..: ' ... _ ? • _ __ . ,. ... _ . ..: ., .,.. ~_ ,_. Other W;<thdrawals and Service Fees z , _ .: ~: _. _ __ ..:.Date _ .. ~,_ ~. _._ _ _ . ,:;-Amount.':.Description ..,..~- ' ~ __ _,._ v ~ ~_ :: ... , .,,- _ _ . ; _ .:. ,_ _. ... Z z ~r° 12/08 - ~5T59840 vDE81TTOCL~SE-ACCOUNT ~,~'~~1~ =; ,~ ;""~ ~ ; z a . ^ Total :5 40. _.~--, ,- _ _ _ ... ~ ., .:" .:R - AS YOU REQUESTED YOUR ACCOUNT IS NOW CLOSED; AND THIS IS THE ~~~ - •° -- - - • FINAL STATEMENT (F YOU HAVE ANY'QUESTIONS OR` WISH-TO REOPEN - , - • - _ - ~ - THIS_ACCOUNT CALLUS AT 800-WACHOVIA (80P-922 4684), OR CONTACT _ .- ,.. ~.. . , .-T,-~...., , -- ~~~ - .YOUR LOCAL FINANCIAL CENTER, rWEAPPRECIATE YOUR BUS/NESS n_ _ .... . _ . , ., - Free Business Checking w~HCi~T7A 01 2000039476234 752 130 0 136 111,562 00039925 ~ui~~~u~~n~~~n~~~u~~~~~~~n~~~~~~uu~~~~~n~~~~u~i~~u~ ~ ESTATE OF HELEN E WILLIAMS BENJAMIN CHARLES WILLIAMS EXECUTOR CB ~ 580 S 82ND STREET HARRISBURG PA 17111 ' Free Business Checking ~a/osrtaos thtu ~2i3v2oos Account number: 2000039478234 Acxount owner(s): ESTATE OF HELEN E WILLIAMS BENJAMIN CHARLES WILLIAMS EXECUTOR Account Summa Opening balance 12/08 $0.00 Deposits and other credits 5654.05 + Checks 2 764.23 - Closing balance 12/31 $2,889.82 Deposits and Other Credits Date Amount Description 12/08 5,598.40 DEPOSIT 12/14 55.65 DEPOSIT Checks Number Amount oos~d 0992 1,395.23 12/16 Daily Balance Summary Dates Amount 12/08 5,598.40 12114 5,654.05 Number Amount oosteo 0993 1,369.00 12/28 Dates Amount 12/16 4,258.82 12/28 2,889.82 ~_ ~_ ~_ aa~ Number Amount posted Ota Dates Amount WACHOVIA BANK, NA. , HARRISBURG MALL page 1 of 2 weca~A ~ 00036724 ~n~~~~u~~u~~~n~~~n~~~~~~~n~~~~~~uu~~~~~~~n~~nn~~~~~ ESTATE OF HELEN E WILLIAMS i BENJAMIN CHARLES WILLIAMS EXECUTOR CB ~ 580 S 82ND STREET ~ HARRISBURG PA 17111 Free Business Checking ~ ~ro~rzo~otnn, ~r~sr~o~o Account number. 2000039476234 Account owner(s): ESTATE OF HELEN E WILLIAMS BENJAMIN CHARLES WILLIAMS EXECUTOR Account Summary Opening balance 1/01 $2 889 82 Checks 250 90 - Closing balance 1/29 $2,638.92 Checks Number Amount oas~e~ Number Amount oosfed 0994 140.90 1/08 0995 110.00 1/25 Free Business Checking 01 2000039476234 752 130 0 -136 104,185 _~ _~ s i ae. Number Amount oos~etd Total ates 25 . ~. N 0 0 Amount a A 0 OV/A ~ NG 8 N w z IL z z z z z z z z z z z z z z z z z z z Daily Balance Summary Dates Amount Dates Amount 1/08 2,748.92 1/25 2,638.92 IF YOU ISSUE CHECKS TO PAYEES WHO CASH 7HE/R CHECKS /N WACH FINANCIAL CEN72=RS, THEY MAY BE ASKED TO PAY A FEE WHEN CASHI CHECKS, INCLUDING PAYROLL, lF THEY DONT HAVE AN ACCOUNT RELATIONSHIP WITH WACHOVIA. 7H1S FEE WELL BE INTRODUCED /N NV, AND AZ ON 3/16/10 AND /N CA, CO, AND KS ON 4/6/10.. WACHOVIA BANK, 17A. , HARRISBURG MALL page 1 of 2 ~~~~~~.~ G Cz) ~s ~~ t~HOV~A BAS r Nfl A ~ I I s Fars Catns?ae~ l~isiCf~i Dep~it Har r isburs DEPCI{sIT TO RCCT! 2xxxxxzxx6i34 A~#0l1HT $55.65 12,'14!03 ^o5$ftt ~eQ # D60Q153 lime ~ 10 ~ Z3 Ahi Calendar Date; IZ~'12j05 DePasit Effective Dat2~ i2it4.'04 ~iMi3Cd7l'.LA~AAJ' ~.+ZtyS1~~r?S .Se.h~E,U' UG ~ ~ (~~ WACHO~IA $APIK> Nfl A Wells Fargo Company Harrisburs ~talI Harrisburg DEPOSIT TO ACCTS 2xxxxxxxx6~34 flMOIAJT 55:598.90 12f08~119 85403 0035 # DOD0141 lime; flZ~45 PM Calendar fja#e~ iL.tlBi'G4 Deposit Effective Dater IZiD8~09 Thank You For Your $usiness Wachovia T~t~:r 4'ou Itvr 5'air &lsiz2ss ~acl :aria Neill Funeral Home, Inc. ~ ,~ (~,r<1 ~~'d~~OL +C 3501 Derry Street .~ . Harrisburg, PA 171111817 (717).564-2633 Supervisor: Stephen J. Wilsbach The following is a detailed bill for the professionatservk~as and/or merchandise arranged for Helen Williams Dam of Service :December 07, 2009 BenJamin Williams Statement Date December 30, 2009 590 S. 82nd Street Contract Number 741200200553 Harrisburg, PA 17111 Ananger Name Daniel C Huff Jr. Initial Selection Final Seledton Difference Funerel Director and StaA SeMces Basic Professional Service Fee $2,680.00 $2,680.00 - Total Funeral Director and Staff Services $2,680.00 $2,680.00 - Care and Preparetion of Remains Embalming $795.00 $795.00 - Dressing and Casketing of Deceased $395.00 $395.00 - Total Care and Preparetlon of Remains $1,190.00 $1,190.00 - Use of Fadiitles and Related Servk~es Visitation $495.00 $495.00 Religious Fadlity Funeral Ceremony $495.00 $495.00 - .Total Use of Fadlities and Related Services $990.00 $990.00 - Trensportatbn TransfeMng Remains to Funeral Home Funeral Vehicle/Hearse Service Vehicle Total Transportation Other Goods and Services Memorial Package Cemetery Equipment Rental Fee Total Other Goods and Services $495.00 $495.00 - $395.00 $395.00 - $395.00 $395.00 - $1,285.00 $1,285.00 - $195.00 $195.00 - $159.OD $159.00 - $354.00 $354.00 - .S~~FOVc~~ ~! C A. ~~ Initial SelecXlon Final Selection Difference Merchandise Concrete Grave Liner . EARTHTONE Cash Advance Cemetery Clergy /Religious Facility Musidans or Singers Certified Copies Newspaper Notice Total Merchandise $995.00 $795.00 $1,790.00 $950.00 $125.00 $100.00 $60.00 $265.62 Total Cash Advance Total Services, Merchandise and Cash Advance Allowanoes Insurance Allowance $1,500.62 $9,789.62 ($1,133.93) Total Allowances ($1,133.93) Total Charges (Total Services +!-Allowances + Taxes) $8,655.69 Less Cash Received Unpaid Balance Due $995.00 $795.00 $1,790.00 $950.00 $125.00 $100.00 $60.00 $265.62 $1,500.62 $9,789.62 ($1,133.93) ($1,133.93) $8,655.69 ($8,514.79) $140.90 Page 2 of 2 SQNcaDucr6 1-+~ C A. t ) 7412 No.0000972 DATE ~_~~ ACCT/CONTR. NAME RECEIVED FROM jIN~ ~D/I~~V~IDUAL CASH RECEIPT ACCOUNT NO. ~~/~OI.CY( J[~CS~~S ACCT/CONTR. NO. S # /~.C. APPROVAL # C~ ~~ C.C. TYPE .,,,,DESCRIPTION ;~ TRUST NO. $ ,. G/L nAff CI: S ~' CHECB.CASH BY ~ CREDT CARD ~ DEBTT TAI' 0 . GEN 8001 (3/08) Wy;a _ Cuatottter Copy Yellow - COIIQflCL File ~ Pink -Control Copy TgANK YOU NEILL FUNERAL HOME °' 3501 DERRY STREET HRRR{SBURY, PA 17111 717-564-2633 Online Services -Online Image Page 1 of 1 w~icxovrA ONLINE IMAGE Account Number: 2000039476234 Check Number ~ Amount Date Posted 994 $140.90. 01 /08/2010 How To Save This Image 7~ i9M8f01t1~< ~. K i'' ~. ' ~~} ~ ~~t PC US@rS Intemet Explorer. Right-dick on the check image, and choose "Save Picture As..." Others: Right-dick on the check image, and choose "Save Image As..." MAC users Intemet Explorer: Click & hold on the check image, and choose "Download Image to Disk." Others: Click 8 hold on the check image, and choose "Save this Image as..." Hide Instructions ~~ ~21aC3 ~. Vt~ .~1 ~A.3) ~t?OMI3ERGER MEMORIALS GRANITE ~ 2395 State Street, Penbrook, PA 17103 MARBLE Specializing in PHONE BRONZE Lettering and Cleaning Monuments 232-1147 Monuments, Markers, Mausoleums, Honor Ralls, Vases, Ums, 800-340-6744 Sandblasting Glass -Signs-Windows -'~f. r~ N Order No .......................................... Terms.................:..:........... Da ...:.,.....~..~.j.:~:; ~ ...:_:.f r. ~ } ~ f # ~ _, _., TO..... !.:..~.~...~.i.?.~....i..j:..~.t ~..1..y1.3.......,,,3...~,~.~.(1....~..:-'...~..~ ..l...t ............................. t-. DETAILED DESCRIPTION ~F WORK The lolbwin t ~ ~ - ~ r..'s C ari -. r ~ r"", i ~ , ~ ,~ U ~~:~` f:r ~_. (~~ . ~ - ~..t.... Total Cost 5..........i..L.~. ..:.......................... '~ Above order ahal tie Iigad ae crated therein unlesa unavddady delayed by labor oondhiona or other contngentlea beyond our contrd, and Ilan as noon u practicable thareatter 809ngs shag be aubierx ro dra above parted tarrr¢ and eondnem . .. f, :... , .._ . +._:.. ,.., ]~ l.. g.. ...rte" ~Fllled t~ ~ Purchaser's SiggaYure Online Services -Online Image. WA(:HOVIA 5~ ~ ~ ur/~ . N t~..~l Page 1 of 1 ONLINE IMAGE Account. Number: 2000039476234 i Check Number Amount Date Posted 995 $110.D0 01/25/2010 _ _ .„ t ~! t F 'Ri R - 4.. .. y S i ' ~ F ' A How To Save This Image H' k ~~ „ ~~l.~Ja aaoor aAl: -+ ~ ~~` e ,v iv .-« r .,y, ! t . Z +~ „g; .. y h. L.! ~ 9 f ~ n Rt ,. .a ~ , F sr.: . ~_:,,_ _. {,. PC users Intemet Explorer: Right-dick on the check image, and choose "Save Picture As..." Others: Right-dick on the check image, and choose "Save Image As..." -MAC users Intemet Explorer. Click & hold on the check image, and choose "Download Image to Disk." Others: Click 8 hold on the check image, and choose "Save this Image as..." Hide Instructions THAN YOU FOR VISITING HERSHEY'S CHOCOLATE WORLD 0015 93 12/07/09 4:07pm 323 ~' .JAR QOLD LABEL M 536. T:~. '~ L,L 2 M T K . .95 6PK TAKE 5 $3.95. .~.~T,~ L 39+ ~. ~ 2 FOR $5.00 $2.90- ITEM SUBTOTAL $44.85 PROMO TOTAL TOTAL .$2.90- SUBTOTAL $41.95 PA TAx $2.22 TOTAL $44.17 DISCOVER CARD $44.17 APPROVED 12/07/09 16:10 N ~ fL5/nJ AUTH # 007023 ~ ~~""z~ INV # 00000026 -rt'6t- 5E0 # 9731 CHANGE $0.00 # OF ITEMS: 3 VISIT US AT HERSHEYSCHOGOLATEWORLD,COM .Sct~csov~t~ `~ C,a,~z Leed's Restaurant & Lounge 750 Eisenhower Blvd, Harrisburg, PA 17111 717.564.4654 Date: Dec07'09 01:52PM Card Type: Discover Acct #: XXXXXXXXXXXX4418 Card Entry: SWIPED Trans Type: PURCHASE.. Exp Date r 08/14 Auth Code: 007010 Check: 3451 Table: 8/1 Server: 120 Banquet BEN WILLIAMS Subtotal: 3 7 8 .6 9 Tip: Total: 37 ~'r ~ Signature I agree to pay above total according to my card issuer agreement. ~ ~ * ~ Customer Copy * ~ ' RECEIPT FOR PAYMENT - ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 12 08/2009 Cumberland County - Register Of .Wills Receipt Time: 30:20:40 One Courthouse Square Receipt No.: 1059193 Carlisle, PA 17613 WILLIAMS HELEN E Estate File No.: 2009- 01134 Paid By Remarks: BENJAMIN WILLIAMS WZ ---------------=-------- Receipt Distribution ------ ------- -------- --- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 30.00 CUMBERLAND COUNTY GENERAL FUN WILL - 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 24.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5..00 CUMBERLAND COUNTY GENERAL FUN Check# 1307 $97.50 Total Received......... $97.50 Online Services -Online Image wtvcxovrA C~9 Page 1 of 1 ONLINE IMAGE Account Number: 2000039476234 Check Number Amount Date Posted ~ 992 $1,395.23 12/16/2009 i ,,. ,. ,,: .. _ ~ ,: ,. ~ _ " ..._ ..~• ~ _. - .-.. ._ - - d m ~. .. .~ u - - _ - '~ _. ,~ -< .. El1T AY` + t :. r. ~~~~~ T~II i, ` ~'~:. ,f R . 3 . '~ , ,may,. *- ~~. ~.: ~:... ~. ~~ 3 ~'.. ' f; ;~ i How To Save This Image PC users Intemet F~cplorer: Right-click on the check image, and choose "Save Picture As..." Others: Right-click on the check image, and choose "Save Image As..." MAC users Intemet F_xplorer: Click & hold on the check image, and choose "Download Image to Disk." Others: Click & hold on the check image, and choose "Save this Image as..." Hlde Instructions ' " ~`' VYachovia Corporation ACH Department 401 Linden Street ~e~~~L~ D4004-024 WinstonSalem, NC 27101 12/ I 1 /2009 PERSONAL REPRESENTATIVE FOR HELEN VJILLIAMS 580 S 82ND ST HARRISBURG PA' 17111 RE: HELEN WILLIAMS `~, WA~HOVIA ACCOUNT: 1010072170944 AMOUNT: $1369.00 SSA Payment Dated 12/3/2009 The Government has notified Wachovia of a death for the above-mentioned customer. Sufficient funds are not available in the account to return the direct deposit payments posted after the date of death. Therefore we have placed a hold on this account until such time funds are available to return all erroneous payments received a8er date of death. Piease visit your nearest Wachovia office to return these payments, or submit an Official check made payable to .Wachovia Bank so that we may return these funds to the government. Please mail the Official Check to Wachovia Bank: 401 LINDEN STREET ACH Operations - NC 6024 Winston-Salem, NC 27101 If prior payment has been made and proof can be provided or if you believe this information is incorrect, please contact us at 1-800-841-8893 Option 5. Direct Deposit Associate ACH Operations . v WACHOVIA OFFICIAL CHECK -' ~~.~^~,r "IrJ~~l2C7n?~ WA+[,xQYIA - - : a Pay To The i,3.~ c i~ si v i d ~ t, !'c F.' $ 3 3 Ez ~ ; tt.s~ V Order Of .. _ ~ K : , ~ ~ I e'Ch3~ i HDt.1~ ~~~ 7li?ir i. i-ii,; v£'!~L C7 SIX 1"Y Fd "Pdr T}1:3i_j .41~ _i =1t+;~ ±ff C?=ty ;`~ ~ w~ct,ovta 9enK Neuonel Asaoelanon Dollars ~ y ~ V 'S'i iF ~ ~ .t. ~ ~. ~--i t5 jCl'S ?X C i ~ ". L ~ E.} ~.7 ~ r t ~ L ~ ~ ' 7 ~+ ' ~ ~ ;., + z 7;; ~? ~ t 5 - ~~NON NEGOTIABLE r ~ . " . -. { ~ Retafn'~}is ', eopy 'uS~riel?No, requi~r6tl for srry~u~i}re Inquiry Remitter `,N . .. "CUSTOMER COPY Online Services -Online Image Page 1 of 1 ~AG'HC?~'I~1 SC pa ~A JLC~ ~ ~. ~ ONLINE IMAGE Account Number: 2000039476234 Check Number ~ Amount Date Posted ~ 993 $1,369.00 12/28/2009 , . z B rt ~~ ~~ _ 1. ... ~ _ ~ ~. ` F ~' g /: 4 . n= ~~ ^'w .. A i. How To Save This Image PC users Intemet F~cplorer. Right-click on the check image, and choose "Save Picture As..." Others: Right-dick on the check image, and choose "Save Image As..." MAC users Intemet F~cplorer: Click & hold on the check image, and choose "Download Image to Disk." Others: Click 8 hold on the check image, and choose "Save this Image as..:" Hide Instructions Rev 1501 Ex 04/06 NOTE: (1) File Inheritance Tax Returns in the Register of Wills Office (2) Must be filed in Duplicate (3) $15 Filing Fee (4) A link to these forms may be found at www.ccpa.net/row (can be completed on-line and. printed for filing) INSTRUCTIONS FOR FORM REV-1500 PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT A MESSAGE FROM THE SECRETARY Se.Nc~ovc:c~ I C~) This comprehensive instruction booklet is designed to provide the information necessary to complete the Pennsylvania Inheritance Tax Return for the estates of most resident decedents. Our . new format is designed to assist you in finding the appropriate information quickly. A "- glossary of terms used throughout the booklet has been added. You will note that the REV--1500 l Inheritance Tax Return cover sheet has been redesigned. The use of original forms. is recommende,~l. .. . ~•. As we move toward increasing the use of electronic technology, we will be able to provide better service through the development of new programs that will allow for faster processing.. The Inheritance Tax Division is committed to providing courteous, timely, and accurate service to the estate representatives and the survivors of Pennsylvania decedents. Internet address: www.revenuestate.pa.us You may also telephone (717) 787-8327, or send a fax to (717) 772-0412. VJachovia Online Services ~ Account Activity Page 1 of 1 ~~~~~ A WId1e Fm+go Ca~-sub- ACCOUNT ACTIVTTY want to... View Recent A i i Transfer Funds 'lls Account. FREE BUS CHK'6234 ~ Action View Paoer Statements Order Checks Check Search Yew Rewards Go to Customer Service Page Find Transactions Date Last 60 days _-_J - OR - G ~ ' to Range: Sort By: All Transaction Types ~ (MM/DD/YYYY) (MM/DD/YYYY) Note: You have up to 90 days of account history available. To view up to 7 years, go to ~l~ew Paoer Statements • Includes transactions that have cleared your account as of the dose of the previous business day. See help with this page for more details. "Transactions that have been authorized but not yet posted an: included. See help with this page for more details. CustomerAa emenf Privacy Security Leaa1 ®2010 Wachovia Corporation. All rights reserved. Posted Balance as of 02101 /2 0 1 0: $2,638.92' .Available Balance as of 02/02/2010 :12,838.92'"' a- Check Cana Holds :View Details Transactions tor: FREE BUS CHIC •6234