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Home My WebLink About07-20-101505610143 REV-'1500 ~``°'-'°' PA Department of Revenue Pennsylvania Bureau of Individual Taxes °~"'~TMD"a"~OA1E Po Box.28osD~ INHERITANCE TAX Harrisburg, PA 17128-0601 RESIDENT DECE OFFICIAL USE ONLY County Code Year File Number ~ 21 09 01061 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 198 30 7496 10 27 2009 07 14 1939 I Decedent's Last Name ! MI Suffix Decedent's First Name SHILLINGSFORD JOYCE ' M (if Applicable) Enter Surviving Spouae's Information Below Spouse's Last Name Suffer Spouse's First Name MI SHILLINGSFORD JOHN ~ S Spouse's Social Security Number THIS RETURN MUST BE FItEDiN DUPLICATEI,W~TH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Retum ^ m onder Re~~ 2. Supplemental Retum ^ 3. Re ktlate of death p~ t ^ q, Limited Estate ^ Future Interest Compromi~ ^ 5. Federal Estatel,Ta~ ~. (date of death elver tt ) Retum Required x^ 6 Decedent Died restate ^ ~ Ma' a Living Trust ~ g, Total Number ¢f S ~oay~) ~fe Deposit Boxes (Attach copyotwu) ^ g. Litigation Proceeds Received ^ 10. bbtrreenl~-37 91 a~r~t1<-1-95) death ~ t t,Election t0 t>tuc (Attach Sch. O ~Ind er Sec. 9113(Aj CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMAtI Name Daytime Telepho BE DIRECTED TO: MARCI S MILLER ESQ 717 540',4332 _'~ N First line of address 2000 LINGLESTONN ROAD Second line of address SUITE 202 City or Post Office State ZIP Code HARRISBURG PA 17110 Correspondent's e-mail address: mmurerlwnaienera®naw.cvm R IL LS US~ONLY-~ ;''-~ ... ~~ f 1 ~ ~ f' //~ U! ~, F: ~ •~ r-~ 0 r'1~i ~x; ~ ...-#.l :~ !~ ~ - .~ i 3 BATE FI ED O `'~ t Under penalties of pery'ury, I dac~are that I have examined this return, including acxxxnpMenYl'. schedules and statements, and to the bes of y knowledge and belief, it is true, oortect and complete. Dadaration of preperer other than the persona! representative is based on all information of which p arty knowledge. SIGNATU'~Ff~RSON SPIN! FIL RETURN / L,/ ATE QTiih Lvnda Black '7 f ~T/ ~ ADDRESS SIGNATURE OF REP EPRESENTATNE (DATE - Marci S. Miller, Esq. '~ I ~-[ '~ ADDRESS 'T'ar ~_ 7'~ 2000 Linglestown Road, Harrisburg, PA 17110 Side 1 1505610143 1505610143 1505610243 REV-1500 EX Decedent's Social $iecurity Number D~SNa~,a: Shillingsford, Joyce M 198 30 X496 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. '' I, 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Hekl Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages 8~ Notes Receivable (Schedule D) ........................................................ 4. ~2 , 923.16 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 8. I, 7. Inter-Vivos Transfers 8 Miscellaneous N,nq Probate Property arate Billin Re uested u Se h l S G 7 7 , 953.64 ............ g p q ( c edu e ) . 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. ',1 0 , 87 6.80 4 , 2 4 4.4 0 9. Funeral Expenses & Administrative Costs (Schedule H) ............... ........................ 9. ' 3 , 3 60.7 7 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. ' 7 , 605.17 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. ~~l 3 , 2 71.63 13. Charitable and Governmental BequestslSec 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. ',1 3 , 2 71.63 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or ', transfers under Sec. 9116 0 0 0 15 0. 0 0 . (a)(1.2) X .00 . 16. Amount of Line 14 taxable 123 271.63 ~ 1s. ' 5 , 547.22 at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 ' 0. 0 0 . at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 0. 0 0 . at collateral rate X .15 . 19. Tax Due .................................................................................................................. 19. 5 , 547 .22 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505610243 15056102~4~', J REV-1500 EX Page 3 Decedent's Complete Address: Flle Number 21-09-01061 DECEDENTS NAME Shillingsford, Joyce M STREET ADDRESS 28 Central Blvd. CITY Camp Hill STATE PA 'ZI 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 5,100.00 268.42 3. Interest 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line ZO to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. C1> Total Credits (A + B) (2) (3) ~4) ~5) Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE 1. Did decedent make a transfer and: a. retain the use or income of the property transferred :............................................................................... b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................................................................................................... d. receive the promise for life of either payments, benefds or care? ............................................................ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death with~ul receiving adequate consideration? .................................................................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....',... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................................................... .. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE i~ ~-S For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or fb spouse is 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 suMi p2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requir4i assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the adoptive parent, or a stepparent of the child is 0 percent X72 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 4.5 percent,'e~C~ 72 P.S. §9116 1.2)172 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 12 percent p2 P.S. §911 sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, wheth r 5,547.22 5,368.42 178.80 ATE BLOCKS Yes No ^ a x x x ^x ^ a ^ 'ART OF THE RETURN. e use of the surviving 3 spouse is 0 percent nts for disclosure of of a natural parent, an t as noted in (1.3)]. A blood or adoption. ~~ ~ ~ SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY co~raNwEALTNOFVEw+srwu~aA SeERITANCE TAX RETURN RESIDENT DECEDENT i ESTATE OF FILE NUJ ~R Shillin sfolyd Jo ce M 21-09 1 1 kwfixb the pro~s~ d and the date the prooeede wero nlwuiwd by the estate. AM property Jo) owned right oT survNonMp mwt M dacbaedon aclwdWs F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Refund - Highmark Insurance premiums 403.27 2 Merrill Lynch Acct #872-49854 33,638.43 3 Sovereign Bank Checking Acct #2331034079 3,412.67 4 Soveroign Bank Savings Acct #2334020373 6,473.79 5 2003 Subaru Impreza-0utback - as per attached Kelley Blue Book'Good' valuation 8,995.00 TOTAL (Also enter on Line 5, Recapitulatiorti) 52.923.16 (K more space is needed, additional papas of the same siu) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-h Schedule E (Rev. 6-98) .I e~~c~n eY. jean ~~- ~-~--- ~---~ SCHEDULE 6 ++ INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COI,MONNIEALTN of PENNTrivAN1A aeERITANCE TAX RETURN RETICENT DECEDENT '~, ~~. ESTATE OF FILE NU ER Shillin sford Jo ce M 21-08 1 ~1 This xhedule must be compbted and filed it the answer to any or gwations 1 through 4 on the reverse ride of the REV-1500 COVER SHEET is yef. ITEM P ERTY DESCRIPTION OF PRO DATE OF DEATH %OF DECD'S ~~~ ~ TAXABLE NUMBER g ~ T~~ ~F~~ETRraECH n car of THEN GEED ~oii ~~ Esr~n'r°t_. VALUE OF ASSET I~REST ~lF E- VALUE 1 Bankers Life 8 Casualty -Annuity ltt'T843073 - - 17,323.84 100.000% 17,323.94 Beneficiaries are decedents children -Lynda Black and William Black 2 Merrill Lynch IRA Acct. #8T2-78668 - Beneficiaries are 64,433.70 100.000% 64,433.70 decedents children, Lynda Black and William Black 3 US Savings Bond - 6 Series EE - POD to decedents 6,196.00 100.000% 6.186.00 children Lynda Decker {Lynda Black) and William Black; Face value of 52500 to each, as per attached ', savings bond inventory. TOTAL (Also enter on Line 7, Recapitulation) 87,953.64 (If more space is needed, additlonal Pees of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-}I p Schedule G (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES ~ ~ ,~,,,,~ ADMINISTRATIVE COSTS ESTATE OF FILE NUIY~B tZ Shillin #ortl, Jo ce M 21-09-0~ 1 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT q, FUNERAL EXPENSES: See continuation schedule(s) attached ' 2,708.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Repn3sentative(s) Lynda Black Street Address 8523 Rolando Drive ~! -_ city Richmond state VA zip 23228 Year(sl Commission paid 2010 - 2011 2,000.00 2. Attomev's Fees Hazen Elder Law 9,000.00 3, Famiy Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent a. Probate Fees Register of Witls 136.00 5. Accountant's Fees Paul Predmore, CPA -preparation of final tax returns 50.00 6. Tax Retum Preparer's Fees 7. Other Administrative Costs 350.40 See continuation schedule(s) attached TOTAL (Also enter on line 8, Recapitulation) 14,244.40 Copyright (c) 2009 form software only The Lackner Group, Inc. Forrn PA-~ Schedule H (Rev. 10-06) I SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF (FILE NU~IAE}ER Shilliniasford. Jovice M _ 21-081-Q1QQ1~;1 ITEM DESCRIPTION AMOUNT NUMBER Funeral Expenses 1 llAysrs-Hamer Funeral Home 2,708.00 H-A 2,708.00 Other Administrative Costs 2 Commonwealth of PA -Dept. of Transportation -auto title -registration fee 36.00 3 Cumberland Law Journal -Estate advertisement 75.00 4 Sovereign Bank -fee for date of death valuation 20.00 5 The Sentinel -Estate advertisement 219.40 H-B7 350.40 Copyright (c) 2002 form software only The Lackner Group, Inc. Form P/~-1 Schedule H (Rev. 6-98) I ~..•.a..~.r~~~~~ SCHEDULE 1 ! DEBTS OF DECEDENT, ~ ~', MORTGAGE LIABILITIES, & LIENS ~TNOFrENNSnvANu NNIERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NU~IA ~R Shillin sford Jo ce M 21-08 1 1 tt~port d.ea fnelrnd by the dECEd0111 prior to dwt11 MIRT ftlINI1Nd unpdd at MNI dNe «dNfh, indudinp UflTEi1T~WfEd nrdlcM • ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 AAA Visa credit card #4264286024054087 179.01 2 Bank of America credit card #4264520026197186 9~•~ 3 Consumer Cellular -telephone expense 25.46 4 First Communications 7.63 5 Harrisburg Pharmacy -medical 7.00 6 Highmark Insurance -premium 48.10 7 Hospice of Central PA 2.052.09 8 PPSL ElecMc -utility I 106.44 TOTAL (Also enter on Line 10, Recapitulatibr~) 3,380.77 (H more space is needed, additional papas of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA}1 Schedule I (Rev. 12-08) --_ ~_ 1- _~ _ ~ i RFV_1R13 FYa 11~JIS1 ---- ---- . -. SCHEDULE J CO1N~S~~~'~'f~Y^"'^ BENEFICIARIES ESTATE OF FILE NUM ER ShilNn sford, Jo ce M 21-09~ 1 1 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE MOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ~ ($E$) I TAXABLE DISTRIBUTIONS [include outright spousal ~ distnbutwns, and transfers under Sec. 9116 a 1.2 1 Lynda Black Daughter One-half of the 8523 Rolando Dr. residue Richmond, VA 23229 2 William E Black Son One-half of the 3 Columbia Dr. residue Camp Hill, PA 77001 Total Enter dollar amounts for distributions shown above on lines 15 thro h 18 on Rev 150 0 cover sheet as r o isle. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKE 8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 CO R E Copyright (c) 2009 form software ony The Lackner Group, Inc. Forrn PA-y Schedule J (Rev. 11-08} REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CE TIFICATE OF G~iA T OF LETTERS No . 2009- 01061 PA No . 211 09- 1061 Estate Of : JOYCE M SHILLINGSFORD !first, Middle, LesU Late Of : HAMPDEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No: 198-30-7496 WHEREAS, on the 13th day of November 2009 an instrument August 19th 2009 was admitted to probate as the last will pi . m vrF M SHi~ i ini~.cFnRn (Fiisr, Middle, Usr1 late of HAMPDEN TOWNSH/P, CUMBERLAND County, who died on the 27th day of October 2009 and, WHEREAS, a true copy of the will as probated is annexepi THEREFORE, I, GLENDA EARNER STRASBAUGH Register b1 for CUI~ERLAND County, in the Commonwealth of Pennsylvaniay certify that I have this day granted Letters TESTAMENTARY fio: L YNDA BLACK who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to law, ~1 fully appears of record in my office at CUMBERLAND COUNTY lCC CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and ~f of my office on the 13th day of November 2009. dated ereto. Wills in and ereby of which iT HOUSE, fixed the seal NOTE ALL NAMES ABOVE APPEAR (FIRST, MIDDLE S LAST WILL AND TESTAMENT OF JOYCE M. SHILLINGSFORD I, JOYCE M. SHILLINGSFORD, now domiciled in Cum Pennsylvania, declaze this to be my Last Will and Testament. I revoke all other that I may have previously made N Q o ..o ° :~_~ -~,, .., ~ _. rc~7 p -a ``-, -n ~ W ''r ~rl d Coi tfity, ?' ail ~ and codicils Article I My just debts and expenses of my last illness, funeral, and administrati~: shall be paid by my Executor from the principal of my residuary estate as so~o after my death. Article II All inheritance, estate, and succession taxes (including interest and penalt~e not including any generation skipping tax) payable by reason of my death shalll, l; and be charged generally against the principal of my residuary estate without Ire from any person. This provision is not a waiver of any right which my Executer reimbursement for any such taxes which become payable as the result of any I which I have the power of appointment. Article III If my husband, JOHN S. SHILLINGSFORD, survives me, I direct that! sill and furnishings, with the exception of my highback rocking chair, which I may' aw of my death that aze located in a residence used by myself and my husband, may be of my estate practicable thereon, but paid out of to claim over ie furniture at the time >ed by him throughout his lifetime or until such time as he remarries. Upon my hush d's death or remarriage, said furniture and furnishings shall be distributed in accordan e with any memorandum I have handwritten or signed, located with my will or with my vali~a le papers and found within thirty (30) days of the probate of my will. I give, devise and bequeath all other tangible personal property not includ~n the furniture and furnishings referenced in the preceding paragraph in accordance with any 'm morandum I have handwritten or signed, located with my will or with my valuable papers ar~d found within thirty (30) days of the probate of my will. Gifts may only be to persons who survive me or to organizations which e~is 'at my death, and if there is a conflict, the memorandum having the latest date shall govern. 'I~o he extent no such memorandum is found, or all of my tangible personal property is not dispo~e~l of pursuant thereto, my tangible personal property shall be added to my residuary estate Article VI hereof. Article IV It is my intent that all life insurance, annuities, individual retirement 1 pass under and any other assets in which I may designate a beneficiary will pass to the beneficiary than have named and will not be controlled by the provisions of this Will. It is also my intent that'a~n assets I own jointly with another with rights of survivorship or a presumed right to survivors~i which such joint ownership was created before or after this Will, will pass to the surviving j{~i t owner and will not be controlled by the provisions of this Will. Specifically, I property, bonds, bank accounts, mutual funds, and stocks that I own jointly with JOHN S. SHILLINGSFORD, at the time of my death will pass to him by ap~~ any real husband, ion of law, 2 should he survive me, and will become his sole and individual property as the' s~rviving joint owner. Article V If my husband, JOHN S. SHILLINGSFORD, predeceases me and if atlth time of my death, I own that real property located at 29 Central Boulevard, Camp Hill, Penjns lvania, then such real property shall be sold and the net proceeds, after payment of any oiz~s .ding debts, liens, taxes, utilities and/or inheritance tax owed against the property, shall b$ follows: A. The lesser of TWENTY SEVEN THOUSAND ($27,000.00) THIRTEEN AND ONE-HALF PERCENT (13 '/:%) of the net proceeds IN EQUAL SHARES between my children, LYNDA BLACK, of Richr#~~ per stirpes, and WILLIAM BLACK, of Cumberland County, Pennsylvania stributed as LLARS or ~ be divided d, Virginia, per stirpes; B. The lesser of SIXTY THOUSAND ($60,000.00) DOLLAI~.SI r THIRTY PERCENT (30%) of the net proceeds to be divided IN EQUAL SHAR)~S between my husband's two (2) children, JOHN S. SHILLINGSFORD, JR., of C'o mack, New York, per stirpes, and DAVID S. SHILLINGSFORD, of St. Louis, stirpes; C. FIFTY PERCENT (50%) of the balance, if any, of the remaining to be divided IN EQUAL SHARES between my children, LYNDA BLA~CI~ and WILLIAM BLACK, per stirpes; and D. FIFTY PERCENT (50%) of the balance, if any, of the remaining to be divided IN EQUAL SHARES between my husband's two (2) chi~ldr SHILLINGSFORD, JR., per stirpes, and DAVID S. SHILLINGSFORD, ~ssouri, per et proceeds per stirpes, et proceeds ~, JOHN S. 'r stirpes. 3 Article VI All the rest, residue and remainder of my estate, of whatsoever nature aria wheresoever situate, I give, devise and bequeath IN EQUAL SHARES to my children, LY1~1ID BLACK, of Richmond, Virginia, per stirpes, and WILLIAM BLACK, of Cumb~rl d County, Pennsylvania, per stirpes. If a beneficiary fails to survive me by thirty (30) c~a s, but leaves descendants who survive me by thirty (30) days, those descendants shall receive,',p r stirpes, the shaze the beneficiary would have received had he or she survived me by thirty ~3 )days. The shaze of any deceased child who does not have living issue shall be distributed trb y remaining child, per stirpes. Article VII I nominate, constitute and appoint my daughter, LYNDA BLACK, as Elx~ Last Will and Testament. In the event of the renunciation, death, or inability tc reason whatsoever of my Executrix, I nominate, constitute and appoint my sqn, BLACK, as successor Executor of my Last Will and Testament. I direct that rr~y successor Executor be permitted to serve without bond. In addition to those ;utrix of my act, for any WILLIAM :xecutrix or granted by law, I grant them power to distribute in cash or in kind, in like or in unlike shazes,, d to file any qualified disclaimer I could have filed if living. My Executrix or successor ~~ ecutor shall receive reasonable compensation for services rendered to my estate. Article VIII In addition to the powers conferred by law, I authorize my ExecutniX r successor Executor, in her/his absolute discretion: (a) to retain in the form received and to sell either at public or private s estate or personal property except that which I specifically bequeath herein, any real 4 ii (b) to manage real estate, (c) to invest and reinvest in all forms of property without being ca fined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of invest ants, (e) to compromise claims without court approval and without ~o sent of any beneficiary, (f) to file any federal income tax return for any year for which I havl~ of filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to deterrni~n the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed ecessary by I my Executrix or successor Executor; and to pay from my estate reasonable comp~e ation for all their services, (i) to conduct alone or with others, any business in which I am enga~e in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standi~r schedule of fees in effect while their services aze performed. ', IN WITNESS WHEREOF, i, JOYCE M. SHILLINGSFORD, hereby sets; y hand to this my Last Will and Testament, on ~ ~~® , 2009, at Harrisburg Pennsylvania. ~-~" '~7 CE M. SHILLINGSF 5 In our presence, the above-named JOYCE M. SHILLINGSFORD signed this an declared this to be her Last Will and Testament and now at her request, in her presence, and in t e presence of each other, we sign as witnesses. Name Address 2000 Lin~lestown Rd. Suite 2i • ~ 2000 Linglestown Rd Suite 21 I, JOYCE M. SHILLINGSFORD, Testatrix, who signed the foregp~n instrument, having been duly qualified according to law, acknowledge that I signed and xecuted this instrument as my Will, and that I signed it willingly as my free and volun act for the purposes therein expressed. Sworn to or affirmed and Acknowledged before me by JOYCE M. SIIILLINGSFORD, the Testatrix on _ /} ~j ~ ~~ S ~ / ! , 2009. Notary Public ~JO CE M. SHILLINGSFOI ~i~~r~V~~.J~I Frd%-.r~lr..`= a~C1r ~: ~• c~u'• if~t~°~+ P~~~3;7Ei,'i1 S'Ec3i MloitSi,F! 9ui. f\i!!f z, rvOt~y F`Lt~.'iIC Susquehar~r~ 7wp., Uaupt~in County My Commissicri Expires Aug. 11,2010 6 We, the undersigned witnesses who signed the foregoing instrument, being my qualified according to law, depose and say that we were present and saw the Testatrix sig and execute this instrument as her Will; that she signed and executed it willingly as her free ~md voluntary act for the purposes therein expressed; that each of us in her sight and hearing sg$~e the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and Su' sec ~ ,poi before me and Myu,~w ~ P. -P~ witnesses, on ~~t ~ S7- ~ ~ , 2009. t".--~t~-~~.>~ ~1 ~~ ems' Notary Public . Wi COARl~1GNiA1 ~ll3H OF FENNSYlVAN1A No#arlai Seal N?eii.~.sa R4. i~in, Notary Public Susquash27~~'0-M~~-. DaaphinCaunty MY Cc~itmi.sion lr x~ires Aug.11,2010 7 ____ _ __ _ _ _ _ - Sovereign Bank ESTATE OF Joyce M. Shillingsford SOCIAL SECURITY #: 198-30-7496 DATE OF DEATH: October 27, 2009 Account #: 2331034079 Type: _ Checking Open date:' 8/5/1995 In the name of: Jo ce M Shillin sford Date of Death Balance: $3,412.67 Int.(YTD) from 1/1/2009 to 10/6/2009 '$b. 7 Accrued interest to date of death: $0.01 Other Info: Account cinse~ nn 1 ~/~~m4 _ ~z ~cn cc Account #: 2334020373 Type: _ Savings Open date: 18/5/1995 In the name of: Joyce M Shillingsford ~- Date of Death Balance: Int.(YTD) from 1/1/2009 to _ Accrued interest to date of death: Other info: Account closed nn 12/~~/nq _ ~ $6,473.79 9/30/2009 $0.71 73.79. Account #: 4529922790 Type: In the name of: John S Shillingsford or J Balance due at death: Other Info: Account #: 0179023772 Type: Line of Credit Open date: 11/22/1989 In the name of: John S Shillin sford or Joyce M Shillin sford Balance due at death: Account closed rior to death Other Info: Account clnsect nn nS/~Q/nR Line of Credit M Shillingsfo~ ~~~ n~< « Open date: /27/2008 Page 1 of 1 ~~~µ~ i~ '~ • ~ ti ~ M f OM O pppappp~ MM^ r ~N ~ n ~oe1 J `` R µ ~ p • ~ ~ ~~~ pfox w F ~, ~o~ra ~w a :~~~ ~~~ 6~g~ ~~~~ ~~ O ~ ~ Y E ~ J aF ~ `~g~•f ~ ICF~• o ~~ 5 ~ ~ n ~~~~ ~~~ ~~"~ ~~.~ M~1Oy • ~ i :~QM ~R ~~~6 g gak: ° 5'a~~ ~i1p M • R g h .:g ~~~ 1~ S M er ~ a ~ 1~ R"~~ Y p• w 1~1+ ~ M p ~. g o ~~ ~~ ~ '~°_.,~ ~~ ._,~~ ~ ~~ _.., 1 M r .~,. 1 ~~'~. 1 b b 1 M O 1tlp b 1 W ~~ ~1 e n i a'. w e e i O • 1 ~ ' 1 ~ ; ~~ ~' ~ i u i [ey~a W 1 O \ 1 ~~11 1 e~ 4 1 1 i of ~ i CK 1 Ta ys 1 ''~ ~i 1 1 '''~ 1 ~ i~ 1 M 1 M 1 M 1 1 i 1 1 1 1 1 I O O 1'~ J J 1 {w~ 1 1 ~' 1 I 1 1 1 1 1 i 1 I 1 N N 1 O oip S o~ 1 1 ~~ 1 S of 8 0 ~ ~i 1 01 OI 1 A 1 ~ ~I • ~ ; ~ ; W W 1 O W 1 O O 1 IU+ b I '. ~d ~~~ ~~ 1 1 o l 1 ~ e o~ ~''' 1 1 1 1 1 N J m 11 p C ~p~ M ~qyN 1 L N M~ H ~p r ~~ i 1 ~~ -~ -~ - Q Y L W pO O W ~ ~ ~ ~ v N; v, v ~ ~ ~ ~ ~ ~~ ~ '- ~ ~», ~~~ V V a++ a .~{ ~. ~ n N 1 ~ ~,~ ~~ m ~ ~ ~ ~ ~ ~ ~ c ° ,, , ~ ~ Ic cc z ~n y v ~ ~. _~ ~ ~~~ ~'n ~ ~ ~ v ~ a _ r- ... N A v1 n r c ~ l m ~ Z a 3 ~~ ~ ~ ° ~' o ~~ v D v , ,~ a ~ ~ ~' C N ~ ~ ~ ~ . ~ m y m v 4W tJ V 7 A --~ ~ ~ m N r..r ', Sp ~ O ~~ D ~. ', ~. D ~ Q S wG y ~ d 't/1 n to m. 2 0 ~. d ~ rt m ep ~ ~ ~ v m C ~~ R r. _ ~ _: __~ . , __ .. _ Calculated Value of Your Pa er Savin s Bond s P g ~) Pagelofl Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 10/2009 Total Price Total Value Total Interest YTD I~htetest _ 2,500.00 $6,196 00 $3,696 00 $Z4b 00 Bonds: 1-6 of 6 Serial # Series Denom Issue Next Final Date Accrual Maturity Issue Price Interest Interte~t Ratei Value Note M459051 M45905128EE, 27EE EE $1s000; 1 0 lOf 1992, 04J2010 1 10/2022'; $500 00 __ $739 20 a, 4 00 0' ~1~239 20 D30905075EE EE EE $ ,00 $500 0/1992 042010 - 10/1992 04/2010 10/2022; 10/2022 $500 OOe $250 00 $739.20 $369 60 _ ' ~' , 4 OQ o~1~239 20 4 00 619 6 _D3090507tiEE EE _$500 10/1992„ 04/2010; 10%2022: . $250.00 . $369.60 „ , !0 X 0 4 Op~o X619 60 D30905076EE EE $1,000; 10/1992 04/2010 10/2022 „ $500.00 ,~ $739.20 , 4 0~°yo ~1 239 20 M45905129EE EE _. . 1 000: ,. $ . '. 10 1992 04 2010. ~../__. _~ ~~ 10 2022 'a 00 00; ~5 $739.20 ~ 4 Op~'o; ~1~239 20~ Tnt ~ s~~ a ::ate t ~ ~ ~ . .... , Notes NI !Not Issued ... ........... ........... . __ _ __ NE Not eligible for payment P5 Includes 3 month interest penalty __ MA Matured and not earnin interest http://www.treasurydirect.govBC/SBCPrice 56.196.00 1/13/2010 ~ ~~ ~~ ~" SERIES EE `. INTC~R~iT C[Ai[i iQ~YKARi IROM IfiU[ DATC 1`~f3 Sit 749r~ , 10 7992 '~ ; ~~ To JOYGE ~+~5 St~I l1.ItV~5Ft.3R`D = ~ . •>:~i7~~ 29 Cc~iT23L ~lV~. ~ -; __ CAMS ~-1II.L PA 17021 '~IfB PHT1N ~... FI~S~C dG~: ,US~, ~Y usuaaAt~itNrf NOIV 16~ ',~.99,~; OATIMO fTAMI ~~~0~ LYi~iLd 0£C"KKK ~~: ;, ,;~,-_, -0 43d, ,. ~ rv 075-~F ,,` /' t 84231 B~0061 2 04.1 ~ vb27, ---- RA ~, ~ r ~ .. D30~~509SEE x:00009000 7:06 ''' 900 3090 SO 7 5~~' __.._ _ - ----._ 111" .. ~ ~ -. INTER[iT C[A~tfs 70 Y[ARi .T 1 .~ L) ~ ~ 7 ~,~~'!. '+ A ~ /ROM lit{UL DATi 1 :.;;r b ..-- ~~. - zi _ 1 V 1 7 72 ~~'' %:. J{)YC ~! ~:'-lILLIhG:iFuRt? _ ~ C~a#~ MIL ~.4 171311 s=iZB Pi-iii. ~. FISC AGT U~. If 6UIN0 AG[N T'8 V ~' N0W ];S 199 ' OAi1N0 fTAM1 - _. -- ~+ear,cga~, t~~?:3 '~ ~, , . M~ n`•`~~-~-90~-128-,~'E ---- .. ~- Z .. ~. 0 u ~t ,.,1 c1 u 1 L 6 ~ ~:. ~ ~ :.~ Rd1c s ~ , -M~ ~ ,~~ ~ ~_,: ~ M45905128EE x.0000 9000 7~.0 1 ~ 0 I.,.e,.,sAf. .ry 1004 590 5 1 28ni __ _. _ __ _ _ .: . 2003 Subaru Impreza -Private Party Pricing Report -Kelley Blue Book ri•iE rR ~Q lt~oullci= iilli-a~ Page 1 of 2 Send to Printer ~daimer> ZQ"E () ~ib8tl{ Ifn f~gzse The 2Q'Ea SubBiu IfRlir~ez8's impnssisiv9e periof-rtiatl0a aixf t'aftge Of Sfy18l~ ittBkB it 81t apPeaiir~ amaN car c~ioioe. 9AA"2 C..L....... T.Y.-~_-_ w__..__ _ ____ _......... +..,F,. ~~~. vuauac.R ~pvrz wagor! 4U BIDE 6Q4K~ PRIYAI~ PARtY YAIUE Condition Value Excellent $9,595 ~ Good $8,995 (Selected) Fair $8,245 Vehicle Highlights , . _ - _ _. i-/ileage: 46,347 l<nyine: 4-Cyl. 2.5 Liter Transmission: Automatic '4rivatrsin: AWD .v~ '4...x ~. '. .~ - 'Selected Equipment Standard Air Conditioning Tilt Wheel Dual Front Air Bags ;Rower Steering Cruise Control ABS (4-Wheel) .Power Windows AM/FM Stereo Roof Rack Power Door Locks _ Single Compact Oisc _ _ Alloy Wheels . ..._ .. advertisement Subaru Impreza Special Offers Find a Dealer Build your Take a Test Impreza Drive Request a Quote _ Presented by: av~- Blue Book Private Party Value Kelley Blue Book Private Party Value is the amount a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than any remaining factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes... VehiNe Condition Ratings ~t ,~, Close Wi http://www.kbb.com/kbb/UsedCars/PricingReport.aspx?Yearld=2003&Mileage=46347&.,. 1 /13/2010 _ _ _ _ , ._ _ -- - __ r,,._, 2003 Subaru Impreza -Private Party Pricing Report -Kelley Blue Book Page 2 of 2 Excellent ~ $9,595 • Looks new, is in excellent mechanical condition and needs no reconditioning. • Never had any paint or body work and is free of rust. • Clean title history and will pass a smog and safety inspection. • Engine compartment is clean, with no fluid leaks and is free of any wear or visible defects. • Complete and verifiable service records. Less than 5% of all used vehicles fall into this category. ~/" GOOd (Selected) $8,995 • Free of any major defects. • Clean title history, the paints, body, and interior have only minor (if any} blemishes, and there are no major mechanical problems. • Little or no rust on this vehicle. • Tires match and have substantial tread wear left. • A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Fair i~L7~° . , $8,245 • Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professional. • Tires may need to be replaced. • There may be some repairable rust damage. Poor - NSA • Severe mechanical and/or cosmetic defects and is in poor running condition. • May have problems that cannot be readily fixed such as a damaged frame or crusted-through body. • Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. * Pennsylvania 1/13/2010 http://www.kbb.com/kbb/L7sedCars/PricingReport.aspx?Yearld=2003&Mileage=4b3~4~7&... 1 /13/2010 __ __