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HomeMy WebLinkAbout01-26-11 (2)J 1505610101 REV-1500 ~f°'-'°' PA Department of Revenue ptmnsylvania OFFICUIL USE ONLY Bureau of Indfviduat Taxes "` °` `~'°` County Code Year File Number INHERITANCE TAX RETURN PO BOX 28o6oa, Harrisburg, PA i7i28-0601. RESIDENT DECEDENT ~ ~ ~ ~ O Q~ Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY _. 356-26-4705 10/27/2010 06/11/1924 Decedent's Last Name _ Suffix Decedent's First Name MI _. EDWARDS ' IRENE R (If Applicable) Entsr Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N/A Spouse's Socal Security Number _ _ _ _ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW l]d 1. Odginal Return O 2. Supplemental Retum O 3. Remainder Return (date of death prior to 12.13.82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) rap 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (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 CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ""' ~=-~,~ Andrew H. Shaw, Esquire (717) 243 ~88 ~ ~~ ,.~~ v , :,; Y REGIST SUS NLY ~- ~.. ~;'~ r m n> I ~~~ at 1 "...7 First line of address '-' ~~Ln -C7 ' C~ -r 200 S. Spring Garden St ~ ~ a - c ~ t-n Second line of address ~ N Suite 11 ~ City or Post Office State ZIP Code DATE FILED Carlisle PA 17013 Correspondent's e-mail address: erldrewt~eShawlaw.com antler penames Ot perjury, I tleGare Nat 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Dedaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PE ~ SP I FOR FILING RETURN /r ~/'T~ D ~/ ADDRESS - - 128 Oldtoyyn Road, ~~Ddltgrsl, PA 17324 SIGNATUR PREP TH AN REPRESENTATIVE DATE J/ 200 S. Spring Garden Street, Suite 11, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610101 1505610101 J 1505610105 REV-1500 EX Decedent's Social Security Number Dacedanrs name: Irene R. Edwards 356-26-4705 RECAPITULATION 1. Real Estate (Schedule A) .................................. ........... 1. j 0.00 2. Stocks and Bonds (Schedule B) ............................ ........... 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ~ 0.00 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. ' 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. ! 300.00 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. ' 325.88 ' 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~ ` "` "` ~ - " "" (Schedule G) O Separate Billing Requested........ 7. ', 80,000.00 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 80,625.88 9. Funeral Expenses and Administrative Costs (Schedule H) ........... ........ 9. '" 9,970.82 10. Debts of Decedent, Mort a e Liabilities, and Liens Schedule I gg ( ) ....... ~ .......10.j ' 117.21: 11. Total Deductions (total Lines 9 and 10) .......................... ....... 11. ~ 10,088.03 12. Net Value of Estate (Line 8 minus Line 11) ....................... ....... 12. !: 70,537.85 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~,. .. .. ..,._ ...,_.., ......._w,. ....... .. ..: an election to tax has not been made (Schedule J) ................. ....... 13. ' i..n .... ......... ... .. 0.00 .... ........ .m... ..n.. r .....y 14. Net Value Subject to Tax (Line 12 minus Line 13) ................. ....... 14. ', I 1 70,537.85 TAX CALCULATION -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 0.00 15. ` 0.00 16. Amount of Line 14 taxable at lineal rate X .0 4~` 70,537.85 ; 1s. ! 3,174.20 '' 17. Amount of Line 14 taxable _ at sibling rate X .12 0.00 17 ! 0.00 '' 18. Amount of Line 14 taxable at collateral rate X .15 __ 0.00 _ 18 i .. -... _.. 0.00 - i w 19. TAX DUE ............................ ........................... , .. 19. '° . ,...,.-.... _.._ _ _,., 3,174.20 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENTS NAME Irene R. Edwards -... - STREETADDRESS 128 Oidtown Road CITY Gardners STATE PA ZIP 17324 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 3,174.20 2. Credits/Payments A. Prior Payments ______ _ 0.00 B. Discount 158.71 _ Total Credits (A + g) (2) 158.71 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 1, 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) 3,015.49 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No 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 :............................................ ^ x^ c. retain a reversionary interest; or .......................................................................................................................... ^ ^Q d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ ^x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. x^ ^ 3. Did decedent own an "in trust for" or payable-upon-death bank account or 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? ....................................................................................................... ^ ^ ................. K IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. " ~§{ ~ ~3 '~ e.. '~~h7 ..,-.. , "# ~ ~. ~,-`:a- °2`"~.~E~G`~nYY'"~"" "i{ gi4,xy*` ~~„,:g~~ .n <~~`~d§ ._ _ ~ i#'~Ai .. ~ u:4, ... _ . ,.. :. .~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 for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure 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 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 use of a natural parent, an adoptive parent or a stepparent of the child is 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 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 20 1 1- 00002 PA No . 21- 11- 0002 Estate Of : IRENEREDWARDS (Fiisf, Middle, Lastl Late Of : SOUTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 356-26-4705 WHEREAS, on the 3rd day of January 2011 an instrument dated November 21st 2007 was admitted to probate as the last will of IRENEREDWARDS (First, Middle, LesU late of SOUTHM/DDLETON TOWNSH/P, CUMBERLAND County, who died on the 27th day of November 2010 and WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: MARTIN J EDWARDS who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to law, a1Z of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARL/SLE, PENNSYLVAN/A. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 3rd day of January 2011. eglster oT / s f ., Ott r ~ ~ ,~r~ ~ -~L~lz~~r'y~- **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMENT h,,, OF ~~i ~ ~~~ ~r~ n cry IRENE R. EDWARDS z C'' ^~'.~' ~cn~ C7 =x: c_;7 O~~ ~ .-- I, IRENE R. EDWARDS, residing at 128 Old Town Road, Gardners, F-~n~ylvanf~ ~ `~T' c. being of a sound and disposing mind, over the age of eighteen (18) years, and under no legal disability, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me at any other time. Article I: I direct that my Personal Representatives, hereinafter named, pay all my just debts and funeral expenses as soon after my death as practicable, including all property, state and federal death taxes assessed against me, my estate, or my beneficiaries, without proration among my beneficiaries. However, all property bequeathed or devised hereunder, either outright or in trust, is bequeathed or devised subject to existing mortgages, liens or encumbrances thereon. Article II: I confer on my Personal Representatives and/or any Trustee(s) appointed herein and their successors the right to sell or otherwise convert any real or personal property at public or private sale, at such time or times, in such manner, and for such price or prices, and on such terms and conditions as my Personal Representatives shall determine, and to execute and deliver good and sufficient conveyances, assignments, and transfers of the property, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or personal property, pledge of investments, or otherwise, ^ ~' 1 Irene R. Edwards without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; to invest and reinvest at discretion, as permitted under Act 28 of 1999, the "Prudent Investor Act"; to make distribution in cash or in kind; to allocate and distribute different kinds or disproportionate shares of property or undivided interests in property among beneficiaries, in cash or in kind, or partly in each; and all other powers given under the statutory and common law of Pennsylvania available at the time of my death and the power to do all acts and things necessary or appropriate in the management, administration and distribution of my estate. Article III: At the time of execution of this Last Will and Testament I am single. Article IV: At the time of execution of my Last Will and Testament I have the following children: A. DONNA JEAN JUDD; B. MARTIN J. EDWARDS; C. KATHARINE J. MOODY. Article V: I hereby nominate and appoint my son, MARTIN J. EDWARDS, as my Personal Representative of this my Last Will and Testament. If MARTIN J. EDWARDS shall predecease me or be unable to serve, I nominate and appoint my daughter, DONNA JEAN JUDD, as my personal representative. If DONNA JEAN JUDD shall predecease me or be unable to serve, I hereby nominate and appoint my daughter, KATHARINE J. MOODY, as Personal Representative. My individual Personal Representatives shall not be required to furnish 2 Irene R. Edwards bond or surety. Article VI: I give, devise and bequeath all of my jewelry, clothing, household furniture and furnishings, chinaware, silver, pictures, works of art, books, personal automobiles and other similar tangible articles of a personal nature, not otherwise bequeathed or devised herein, not including cash or securities, together with any existing insurance thereon, to my children to be divided among themselves as they deem appropriate and such as to be reasonably equal among them. In the event my children are unable to so divide such tangible personal property and any insurance thereon, then my Personal Representatives shall divide such property among my children who survive me with due regard for their personal preferences on as nearly an equal basis as practical. My Personal Representatives, may, as they think advisable and without further responsibility deliver any such article allotted to a minor, to said minor, or to any guardian of said minor who shall hold the same for said minor. If my daughter, DONNA JEAN JUDD, shall predecease me, then her share shall be equally divided among her children, per stirpes. If my son, MARTIN J. EDWARDS, shall predecease me, then his share shall be distributed to his wife, DEBRA EDWARDS, for her support and for the support of Martin's children. If my daughter, KATHARINE J. MOODY, shall predecease me, then her share shall be distributed to her husband JONATHAN MOODY. Article VII: I give, devise and bequeath all the rest and residue of my estate of whatever kind and description wherever situate, to my children in equal shares. If my daughter, DONNA JEAN JUDD, shall predecease me, then her share shall be ,~ 3 Irene R. Edwards equally divided among her children, per stirpes. If my son, MARTIN J. EDWARDS, shall predecease me, then his share shall be distributed to his wife, DEBRA EDWARDS, for her support and for the support of Martin's children. If my daughter, KATHARINE J. MOODY, shall predecease me, then her share shall be equally divided among her children, per stirpes. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of ~~-~. ~~ 9 ~ ~~~~~v~.:~.~t`~., (SEAL) Irene R. Edwards Signed, sealed, published and declared by the foregoing Testatrix as and for her Last Will and Testament, consisting of four (4) pages, in the presence of us, who at her request, and in her presence, and in the presence of each other, have hereunto set ou~r7hands as witnesses thereto. / `rr, ~ 4 / ~ ~` COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND '` :GY~2c7z C~ ~°~,~~ . I, IRENE R EDWARDS, Testatrix, whose name is signed to the attached or foregoing instrument, being duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and. that I signed it as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and ackj-owledged before me by IRENE R EDWARDS, the Testatrix, this ~/ sT day of ~~' i;"l.i ~•"Z11,~v 2007. ~- ~; Irene R. Edwards , s ~ ~ ` Notary Public My Commission expires: coMrrton+w ~rH ~ PEtrNS wuua COMMONWEALTH OF PENNSYLVANIA ~sa~raar~ia, MY Camrt~sslon E~ke6 Nov. 9, Z(li 1 COUNTY OF CUMBERLAND na,,,,~, p,.,w„yti,~, ,~~„~ a Nouns .- We, h"iL E'b2 ~n c<~ ~~-~d u ~ J ~~:~ and ~ ~j ~ BFI L'~G~.z~~i ft,'~i the witnesses 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 Testatrix sign and ~',~ execute the instrument 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 the time 18 or more years of age, of sound mind and under no constraint or undue influence. .Sworn t~ or affirmed and subscribed before me b ~ rl ~'Y/r9 /"'i'~~~u J '~' and ~'~ (-5bz~~)1-l/L~6 ,witnesses, this ~ S day of ~ ~ ~" ~ , 2007. ,~ Notary Public ~~ • ~^syN•M. Assod~tlon o/ Nctarks My Commission Expires: ~ , Nomdd Seel Cone Elzabelh $ Cale Bono -~o~v Pub1c NN ~+~don F~q~Fee Nov. 9~~ 1 REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEp~ILE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Irene R. Edwards 21-11-0002 Inckfde the proceeds of Ntigatlon and the date the proceeds were received by the estate. All property Jolmiyowrled with right of survlvonhlp moat be dladoaed on ticheduk F. to more space nt neeae0, Insen aaanl0nal sheets of the same size) REV-1509 EX+ (o1-io) pennsylvania ~iT DEPARTMENT OF REVENDE INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEpYLE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Irene R. Edwards 21_11_0002 If an asset became ~olntly owned wkhln one year of the decedent's date of death, R must be roported on Schedule G. SURVMNG JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• Martin J. Edwards Debra L. Edwards B. C. JOINTLY OWNED PROPERTY: 128 Oldtown Road, Gardners, PA 17324 I Son and daughter-in-law ITEN NUMBER LETTER FOR JOINT TENANT DATE MADE ]DINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANOAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYINIi NUMBER. ATTACH DEED fOR JOINTLY HELD REAL CSTATE. DATE OF DEATH VALUE OF ASSET % DF DECEDENTS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST I. A. M&T checking akxrount, #1171214 977.63 33 325.88 TOTAL (Also enter on Line 6, Recapitulation) I # 325.88 If more space is needed, use additional sheets of paper of the same size. ~~~~~ n ' &'I' ]~anlc ACCOUNT N0. AGGOUNT TYPE 1177214 M8T SELECT HITH INTEREST 00 MARTIN J EDWARDS DEBRA L EDWARDS IRENE R. EDWARDS 128 OLDTOWN RD GARDNERS PA 17324-9084 INTEREST EARNED FOR STATEMENT PERIOD 0.01 INTEREST PAID YEAR TO DATE 1.66 0 04331M NM 017 47233 ACCOl1NT SIIMMeRV STATEMENT !PERI04 '' PARE OCT.14-tgV.12,2010 1 OF 2 o~~ MT HOLLY SPRINGS B C xNG 9Al;ANCE D I & OTHER :ADDITIONS. CHECKS .PAID OTN :: SUBTRACTIONS CU R INTEREST PD DING BALANCE N0. AMOUNT N0. AMOUNT N0. AMOUNT 2,656.07 2 2,011.50 10 1,318.64 11 917.92 0.02 2,431.03 ACCf111NT A!`TTVTTV PO NO DATE -----... T ANSACTION DESCRIPTION DEPOS , N:EREST 8 OTHER ADDITIONS GHECKS DTHER S CT30NS DAILY BACANC 10-14-10 BEGINNING BALANCE 42,656.07 10-14-10 WAL-MART M2574 CARLISLE ~,ya 30-14-10 GIANT FUEL 11112 CARLISLE '"tea 2,568.38 10-15-10 CHECK NUMBER 2659 ®BY..YO 2,368.38 10-19-10 CHECK NUMBER 2662 `~00 10-19-10 CHECK NUMBER 2660 '~i~io~0 1,992.98 10-21-10 NFI~WWW.NETFLIX.COM CCNETFLIX.COM -}-5i_, 10-21-10 CHECK NUMBER 2661 _,_~- 10-21-10 AES LOAN PAYMT 000000000002664 ~-'r10-@0-- 1,790.65 1D-22-10 GIANT FUEL N269 CAMP HILL 10-22-10 CHECK NUMBER 2665 9- 1,584.85 10-25-10 WM SUPERCENTER CARLISLE 10-25-10 M8T ATM GASH WITHDRAWAL ON 10/23 MT HOLLY SZ,420 N BALTIMORE AV,MT HLY SPRNGS,PA 10-25-10 SMOKEHOUSE TAVERN EAST BERLIN 10-25-10 CHECK NUMBER 2663 r--*~y~ 10-25-10 CHECK NUMBER 2666 '~T5rY4. 1,248.49 10-26-10 CHECK NUMBER 2669 ._.~~ 10-26-10 DISH NETWORK DZSH NTWRK --~rr~~ 'mot 1,037.58 10-27-10 CHECK NUMBER 2668 ' 977.63 10-28-10 M8T ATM CASH kITHDRAMAL ON 10/27 ---, MOUNT HOLLY,631 HOLLY PK,MT HOLLY SPRINGS,PA 10-28-30 CHECK NUMBER 2667 -~.vm. 714 03 11-O1-10 Statue of Ill Dir Dip ,324.37 . 11-O1-10 INRF IMRF BFTS 87.13 11-01-10 M 8 T MORTGAGE MTG PYT 0008238255 ~--~L94,iZ_ 2,431.01 11-12-10 INTEREST PAYMENT 2,431.03 ENDING BALANCE 62,431.03 1A06A (6/07) REV-1510 EX+ (OS-09) "~ i~ pennsylvarria SCHEDULE G ~ DERARTMENTOPREVENIIE INTER-VIVOS TRANSFERS AND INHERfTANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUM6ER Irene R. Edwards 21-11-0002 This schedule must be Completed and filed If the answer to any of questions 1 through 4 on page three of the REV-1500 is ves. TEEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSR:REE, THEIR REUTIONSHIP TD DECEDENT AND iHEDATEOFTRl1N5Rat.ATTACHACOPYDFTHEDffDRMREALE5rATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IrAPPUCABIE TAXABLE VALUE 1• Certificate of Deposit, M&T Bank, Aat # 31003922575948 60,000,00 100 0.00 60,000.0( 2 Certificate of Deposit, M&T Bank, Acct # 31003920291679 20,000.00 100 0.00 20,000.0( TOTAL (Also enter on Line 7, Recapitulation) $ I 80,000.00 If more space is needed, use additional sheets of paper of the same size. ~ M&T Banlc 631 Holly Pike, Mt Holly Springs, PA 17065 717486 3038 rnx 717 486 7269 MANUFACTURERS AND TRADERS TRUST COMPANY *** CERTIFICATE OF DEPOSIT *** DATE: 08/27/2010 OFFICE: Mt. Holly Springs Office MARTIN J EDWARDS DEBRA L EDWARDS 128 OLDTOWN RD GARDNERS PA 173249084 ACCOUNT NUMBER: 31003922575948 OPENING DEPOSIT: $60,000.00 ACCOUNT TERM: 12 Months INTEREST RATE: 0.85 ANNUAL PERCENTAGE YIELD: 0.85 MATURITY DATE: 8/27/2011 Thank you for choosing M&T Bank. *" NOT TRANSFERABLE (AS DEFINED IN 12 CFR 204) **" "** NON-NEGOTIABLE "` Member FDIC ~ M&T Banlc 631 Holly Pike, Mt Holly Springs, PA 17065 717486 3038 F~ 717486 7269 MANUFACTURERS AND TRADERS TRUST COMPANY **" CERTIFICATE OF DEPOSIT •*` DATE: 01/08/2010 OFFICE: Mt. Holly Springs Office MARTIN J EDWARDS DEBRA L EDWARDS IRENE R EDWARDS 128 OLDTOWN RD GARDNERS PA 173249084 ACCOUNT NUMBER: 31003920291679 OPENING DEPOSIT: $20,000.00 ACCOUNT TERM: 18 Months INTEREST RATE: 1,24'/, ANNUAL PERCENTAGE YIELD: 1.25 °/a MATURITY DATE: 7/8/2011 Thank. you for choosing M&T Bank. ""' NOT TRANSFERABLE (AS DEFINED IN 12 CFR 204) "* "' NON-NEGOTIABLE "" Member FDIC REV-1511 EX+ (10-09) pennsytvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Irene R. Edwards 21-11-0002 Decedent's debts must ba reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Hollinger Funeral Home ~ Crematory, Inc. 2,711.32 2. Grave lot 100.00 3. Grave stone 500.00 a. Memorial Service Fee 450.00 e. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Martin J. Edwards street Address 128 Oldtown Road City Gardners state PA ztP 17324 Year(s) Commission Paid: 2011 2. 3. 4. 5. 6. 7. Attorney Fees: Family Exemption: (If decedent's address is not the same as Claimant's, attach explanation.) Claimant Martin J. Edwards street address 128 Oldtown Road city Gardners state PA zIP 17324 Relationship of Claimant to Decedent son Probate Fees: Accountant Fees: Tax Return Preparer Fees: 750.00 750.00 4,500.00 209.50 TOTAL (Also enter on Line 9, Recapitulation) I # 9,970.82 If more space is needed, use additional sheets of paper of the same size. w .. .• ^~r .. Holliri`ger Funeral Home. & Crematory, Inc. Eric i.. HoI[inger. Supervisor November 3,2010 Martin 1. Edwards 128 Oldtown Load Gardners, PA 17324 The Funeral Service for Irene R. Edwards: We sincerely appreciate the confidence you have :placed in us and wip continue t© assist you in every way we can. Please feel free to contact us if you have any questkms in regard to this statement. THE FOLIQWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACitiTiES, AUTCIMQTIVE EQUIPNFENT, AND MERCHANDISE THAT YQU SELECTEfl WHEN MAKING THE FUNERAL ARRANGEMENTS. Professicilt~ Service Cremation Package -Direct Cremation $1750.00 Merchandise Cremation Insert 345.00 Holy Cards, Thank You Cards 70.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, Wf ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCCiMMODATION. THE Fi4LLOWtNG IS AN ACCOUNTING. FOR THQSE CHANGES. Cash Advances Newspaper Notices -Sentinel $158.32 Newspaper No#ices -Downers Grove Sun 239.00 Newspaper Notices -Observer News 34.00 Certified Copies of Death Certificate (15 ~ $tJ 90.00 Cumberland County Coroner's Authorization 25:00 Total Charles $ 7 -32 Less: Received 10j28j2010 VISA 00 Currerrt eatance: 53.711.12 501 NORTH BALTIMORE AVENUE • MOllNT HOLLY SPRINGS. PENNSYLVANIA 17065 • (717) 486-3433 • I'AX (717) 486-3Q 15 ~.holii rfu~,aTi~/~' RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17613 EDWARDS IRENE R Receipt Date: 1/03/2011 Receipt Time: 09:09:04 Receipt No.: 1063868 Estate File No.: 2011-00002 Paid By Remarks: MARTIN EDWARDS DB ------------------------ Receipt Distribution ----- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 135.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 16.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL . FUN --- Check# 2672 ------------- $194.50 Total Received......... $194.50 REV-1512 EX+ (12-08) ~pennsytvania SCHEDULE I ~~++~~-- DEPARTMENT OF REVENUE DEBTS OF DECEDENT, 1NHERRANCE TAX RETURN MORTGAGE LIABILITIES 81 LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Irene R. Edwards 21-11-0002 Report debts incurrod by the decadent pNo~ to death that romained unpaid at the date of death, Including unrolmbuixed medkal exsansas. Ir more space is needed, insert atltlitfonal sheets of the same size. N N j [. b C N i~ a ` f u at P n ~ ~ .. m ~ ~ ,.a ~~ ~ ~ k ~ _. _ 2 N F ~ O .. .. a O et _ ~_ h W 01 N 3 i 0 0 0 m N M O O O N N {O N ri m ei 01 N r-1 Nq~N C~ ~! 3 ~ CUMBERLAND COUNTY AGING & COMMUNITY SERVICES 1100 CI.A1tEMONT Roes, Cex~sr.~, PA 17015 ~ (117) 240-6110 OR i-888-697-0371 Exr 6110 aex: (717) 240-6118 One Team ...O>re Mirrwn IlWOICE FOR SERVICES Irene R Edwards 128 Old Town Rd Gardners, PA 17324 Invoice Number: September-10-31 Invoice Date: November 2, 2010 SERVICE PROVIDED: Home Support ~y~ Ric6rd L Rave~o no. cf..ir.ea ~ee.~ B. ee.., Terry L Bvky MONTH OF SERVICE: September, 2010. ACTUAL COST PER Hour (-- 17.20 YOUR REDUCED SLIDING FEE SCALE RATE PER Hour 7.14 TOTAL Hour(s) OF SERVICE YOU RECEIVED (--16.00 PLEASE PAY THIS AMOUNT 114.24 Payment Dne Upon Receipt of Invoice. Payment Ts Delinquent if not paid by December 28, 2010. Contact CCOA if any issues. Make Checks Payable To: CUMBERLAND COUNTY OFFICE OF AGING ~`\\ ~\ \n C~ ~©~~(~ ~~ r REV-1513 EX+ (O1-10) ''~pennsylvania SCHEDULE 7 ~~ INHERRANCETAXRETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Irene R. Edwards 21-11-0002 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llat Trustee(f) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Martin J. Edwards, 128 Oldtown Road, Gardners, PA 17324 child 2. Donna Judd, 40035 South Walden Street, Aurora, CO 80013 child 3. Katherine Moody,104 Hamson Hill Rd, RD1, Palmerston North 4471 New child ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-LSDO COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUT10N5: 1. 35,840.78 15,840.79 15,840.79 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON IINE 13 OF REV-1500 COVER SHEET. I ~ If more space is needed, use additional sheets of paper of the same size.