HomeMy WebLinkAbout10-31-11 (2)1505610105
~ ~ REV- ~ 50o EX (o2-u) (FI) 1!1
{{,x.77 OFFICIAL USE ONLY
PA Department of Revenue Penns lvarna
~,>.a,~Ex'~of FE,E~~E County Code Year File Number
Bureau of Individual Taxes 'INHERITANCE TAX RETURN
PO sox zr3o6o~ ~ ! ~ ! f0 /3
Harrisbur~PA i'71z8-ofioi ' RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
128-03-0533 09/17/2011 07/25!1908
Decedent's Last Name ' Suffix Decedent's First Name M{
RYAN ELIZABETH T
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number ', THIS RETURN MUST SE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
F{LL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise {date of
deajth after 12-12-82)
m 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spoiusal Poverty Credit (Date of Death
Between 12-31-91 and 1-1-95)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENT
Name
THOMAS E. FLOWER ~~`
O 5. Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
O 11. Election to Tax under Sec. 9113(A)
(Attach Schedule O)
IAL TAX INFORMATION SHOULD BE DIRECTED T0:
Daytime Telephone Number
(717) 243-5513
First Line of Address
FLOWER LAW, LLC
Second Line of Address
10 W. HIGH ST.
City or Post Office State ZIP Code
CARLISLE PA 17013
REGISTER WILLS USE `QI~LY
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Correspondent's a-mail address: TOm@FIOWef-LBW.COm
Under penalties of perjury, 1 declare that I have examined this return, i eluding accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, corm and complete. OeclBration of preparer other than th~ personal representative is based on all information of which preparer has any knowledge.
SIGNAT F PERSON RESPON LE F,~R FIUNG RETURN DATE
BARBARA FALCONER, ~ STRAYER DRIVE, CARLISLE, PA 17013
TU IOF PREPap~t'O';THAN REPRESENTATIVE ~ DATE
ADDRE
FLOWER LAW, LLC, 101~V. HIGH ST., CARLISLE, PA 17013
PLEASE VISE ORIGINAL FORM ONLY
Side 1
1505610105
_~ _
1505610105
C~
J
1505610205
REV-1500,EX (FI)
Decedent's Social Security Number
Decedent's Name: ELIZABETH T. RYAN ' 128-03-0533
RECAPITULATION
1. Real Estate (Schedule A) .................. ........................ .. 1. 0.00
2. Stocks and Bonds {3chedule B) .............~~ ...... , .............. , .. .. 2. 162,455.90
3. Closely Held Corporation, Partnership or Sole-Prioprietorship (Schedule C) . , . .. 3. 0.00
4. Mortgages and Notes Receivable (Schedule D) .I ............. . .. . ........ .. 4. 0.00
5. Cash, Bank Deposits and Miscellaneous Person~l Property (Schedule E)..... .. 5. 1,700.00
6. Jointly Owned Property (Schedule F) O Sep~rate Billing Requested ..... .. 6. 51,304.16
7. Inter-Vvos Transfers & Miscellaneous Non-Prob~'te Property
84
354
20
(Schedule G) O Sep rate Billing Requested...... .. 7. ,
.
8. Total Gross Assets (total Lines 1 through 7) ... ' . ................... . ...
- -_ ~_ .. 8. 299,814.26
9. T _ _ -
Funeral Expenses anNi Administrative Costs (Sch~dule H) .............
.. , ... 9.
15,173.50
10. Debts of Decedent, Mortgage Liabilities and Lien (Schedule 1) ......... ......10. 1,525.28
11. Total Deductions (total Lines 9 and 10) ...................... . .... ...... 11. 16,698.7$ ,
12. Net Value of Estate (Line 8 minus Line 11) .. , ..' ................... ...... 12. 283,115.48
13. Charitable and Goven~tmental Bequests/Sec 9113Trusts for which
an election to tax has not been made (Schedule J ..... . ...... . ..... ...... 13. ' 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13~ .. . ............... ...... 14. 283,115.4$
TAX CALCULATION - SEA INSTRUCTIONS FOR AP~'LICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_ 15.
16. Amount of Line 14 taxable
at lineal rate X .0,_ ' 1g,
17. Amount of Line 14 taxable
at sibling rate X .12 ~ 17,
18. Amount of Line 14 taxable I
I
283,115.48
at collateral rate X .15
',
18. 42,467.32
1s. .............a
TAX DUE ................... ......................
.. 1s.
42,467.32
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 I~
1505610205
. REV-1500 EX (FI) Page 3
Decedent's Complete Address:
nr~cncurc ~inuc
ELIZABETH T. RYAN
STREET ADDRESS
2100 BENT CREEK BLVD.
File Number
SILVER SPRING TWP.
CITY S :ZIP
MECHANICSBURG I PA 17050
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments
B. Discount
3. Interest
40,344.02
2.123.31
4. If Line 2 is greater than Line 1 + Line 3, enter the difference.
Fill in oval on Page 2, Line 20 to'request a refund.
(1) 42,467.32
Total Credits (A + B) (2) 42,467.32
(3) 0.00
is the OVERPAYMENT.
(4) 0.00
5. If tine 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
I
Make check payabl1e ta: REG{STER OF WILLS, AGENT.
__ 1
PLEASE ANSWER TF~E 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 trans erred .......................................................................................... ^
b. retain the right,to designate who shall use th property transferred or its income ............................................ ^
c. retain a reversionary interest .............................................................................................................................. ^
d. receive the promise for life of either payment, benefits or care? ...................................................................... ^
g q nt transfer property within one year of death
2. without receuv nd ader D to cons'deration?deced.'i ................................................................................................... ^
3. Did decedent own an "in trust for" or payable-up~n-death bank account or security at his or her death? .............. ~ ^
4. Dld decedent own a~mdivg ual rekirement accou ........................... ............ .. _... _ _......... ^ ^
contains a benefici~ desi nation? .,,.,,,ht, annuity or other non-probate property, which
IF THE ANSWER TO ANY OF THE
ABOVE QUESTIONS IS Y~S, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 impos d 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 o 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 he only beneficiary.
For dates of death on or after July 1, 2Q00: ~,
The tax rate imposed on the net value of transfers from a de ased 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}J.
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(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)J. Asibling is defined,
under Section 9102, as an individual who has at least one pare t in common with the decedent, whether by blood or adoption.
' REV-1503 EX+ (6-98}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF ~' FILE NUMBER
ELIZABETH T. RYAN 21-11-1013
All property Jointly-owned w ith right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
~~ 296 SHARES OPPENHEIMER BALANCE FUND CL A @ 9.64 2,853.44
2. BNY MELLON INVESTMENT ACCOUNT ~ DREYFUS MONEY MARKET FUND
10,225.48
3. BNY MELLON INVESTMENT ACCOUNT /I2,026 SHARES EXXON MOBIL COMMON @ 73.73
~I
i 149,376.98
TOTAL (Also enter on line 2, Recapitulation) S 162,455.90
(Ir more space is needed, insert additional sheets of the same size)
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REV-i5o8 EX+ (ii-io)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DKEDENT
SCHEDULE E
CASH, BANK DEPOSITS & MISC.
PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
ELIZABETH T. RYAN 21-11-1013
Include the proceeds of litigation and the date the proceeds were received by the estate.
Ali property jointly owned with right of survivorship must be disclosed on Schedule F.
~~ nivrr space is neeaea, use aoaiuonai sheets of paper of the same size.
REV-iSo9 EX+ (oI-io)
' pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCFIEDVLE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
ELIZABETH T. RYAN 21-11-1013
If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
5URVMNG JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A• BARBARA E. FALCONER 3 STRAYER DRIVE COLLATERAL
CARLISLE, PA 17013
B.
C.
70INTLY OWNED PROPERTY:'
ITEM
NUMBER LEITER
FOR JOINT
TENANT DATE
MADE
]DINT DESCRIPTION OF PROPERTY
INICLUDE NAME OF RNANCUIL [NSTRUTIOW AND BANK ACCOUNT NUMBER OR SIMILAR
IOENTIFYlNG NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
1. A. 01/07/10 ORFtSTOWN BANK ACCT. N0. 106800664 13,703.16 50 6,851.85
2. A. 06!01/06 ORRSTOWN BANK ACCT. N0. 106004108 20,379.71 50 10,189.86
3. A. 08/13!09 CITIZENS BANK CERTIFICATE OF DEPOSIT #1172531128 34,470.35 50 17,235.18
4. A. 10/25/08 CITIZENS BANK CERTIFICATE OF DEPOSIT #1173092535 34,054.54 50 17,027.27
TOTAL (Also enter on Line 6, Recapitulation) ~ $ 61,304.16
If more space is needed, use additional sheets of paper of the same size.
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~ PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES FILE N0. 21
PO BOX 280601 enns lVania AND
HARRISBURG pA 17128-0601 ~ ~ ACN 11165722
DEPARTMENT OF REVENUE TAXPAYER RESPONSE DATE 1 0- 0 4- 2 0 1 1
REV •1563 EX AFP (OS-11)
BARBARA E F~ILCONER
3 STRAYER DR
CARLISLE PA 17013-4403
EST. OF ELIZABETH T RYAN
SSN 128-03-0533
DATE OF DEATH 09-17-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
0 RRST OWN BANK provided the department with the information below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a joint owner7benefiiciary of this account. If yoU are the SpoUSe of the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of yoi~r_relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe the information i9 incorrect, please obtain written correction from the financial institution, attach a copy to this form and return
it to the above address. Please .call 717-787-8327 with questions.
COMPLETE PART 1 F~ELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 106800664 Date 01-07-2010 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance
$ 13 703
16 payment i:o the Register of Wills. Make check
"
.
, payable f:o
Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to TaX
$
6
851
58 NOTES If tax payments are made within three
,
. .months of the decedent's date of death,
Tax Rate ~( , lrj deduct a 5 percent discount on the tax due.
Potential TaX Due
$
1,027.74 Any inheritance tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
AtLU~' .T~'1; R£S~*~: -~1'It.[,; itEStti.~'.-:214 Ati ttFF~~1Ai. TAX <J1s5£SS#~IENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or return this notice to the Register of Wills and
ONE
~ an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~ lfhe above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
0 N L Y filed by the estate revresentative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
~"omplete PART ~2 and/or PART 3~ below.
PART If indicating a d fferent tax rate, please state ,-j~'~j~,~1„ ~^y~ ONLY
~~`
relationship to d@cedent: ~„
'
'
'
i
A' DEP~TitEfi
, OF. REVENUC
i
TAX RE TURN - CALCULAtION OF TAX ON JOINT/TRUST ACCOUNTS PAD `_ f'=
LINE 1. Date Established 1
2. Account Balance 2 $ ~
3. Percent Taxable 3 X ~
4.
Amount Subject to 'T ax 4
$ .s _;
,4 -
5. Debts and Deductioins 5 - 5
6. Amount Taxable 6 ~ ~ ~____ t ~'
7. Tax Rate 7 X ;-7 '""~Yt^ ~
8. Tax Due 8 $ ~. '=~
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PgYEE DESCRIPTION
AMOUNT PAID
Under penalties of perj'iury, I declare that the facts I reported above are true, correct and
complete to the best of', my knowledge and belief. HOME C )
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
.F ~
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 Pennsylvania
HARRISBURG PA 17128-0601 DEPARTMENT OF REVENUE
~• REV-1543 EX AFP (OS -11)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE NO. 21
AND ACN 11165721
TAXPAYER RESPONSE DATE 10-04-2011
BARBARA E FALCONER
3 STRAYER DR
CARLISLE ~ PA 17013-4403
EST. OF ELIZABETH T RYAN
SSN 128-03-0533
DATE OF DEATH 09-17-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 1'7013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
ORRSTOWN BANK provided the department with the information below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a joint owner/benefiiciary of this account. If you are the SpoUSe of the
deceased and any amount otherthan zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of yourl,relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return
it to the above address. Please c~11 717-787-8327 with questions.
COMPLETE PART 1 BLOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1060041 108 Date 06-01-2006 To ensure proper credit to the account, two
Established copies of this notice oust accompany
Account Balance 20
379
71
~ payment to the Register of Wills. Make check
"
.
,
+ payable to
Register of Wills, Agent".
Percent Taxable X 50.000
Amount Sub ect to Tax $
j 10
189
86 NOTE: If tax payments are ^ade within three
~
. months of t:he decedent's date of death,
TaX Rate ~( , lj deduct a 5 percent discount on the tax due.
Potential Tax Due ' $
1 ~ 5 28.4 8 Any inheritance tax due will become delinquent
nine months after the date of death.
P
T ~, TAXPAYER RESPONSE
~
~
Axi.#U~,~,''~1J RESt'IOMD:itIL#::-.lt Si3LT=..It~~,~i-"Et~~. #CIAI.-7AX XSSESSIIEH
A. ~ TF~e above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
C H E~ K a discount or avoid interest, or return this notic e to the Register of Wills and
ONE
~ an official assessment will be issued by the PA De partment of Revenue.
BLOCK B. ~ Th above asset has been or will be reported and tax p aid with the Pennsylvania inheritance tax return
0 N L Y fi~ed by the estate representative.
i
C. ~ Thj~ above informs ion is incorrect and/ar debts and de ductions were paid.
Co~plete PART ~2 and/or PART 3^ below.
PART If indicating a different tax rate, please state ~~~~ ~~~~~~~ OILY ~ ~~
relationship to decl,edent: ~
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS ¢Afl,;, .-- - -
LINE i. Date Established 1
2. Account Balance 2 $ ~- ~ ~-~
3. Percent Taxable 3 X 3 ^s ~ ~~ 3 :f
...
)
4. Amount Subject to T$x 4 $ '.~ rfi~
~ 'r
.`'3~'
5. Debts and Deduction$ 5 s, '~
6. Amount Taxable 6 $ ~ ~~ ~,~.~ ~'
.+
7. Tax Rate 7 X `7 ~?:~` '~
e. Tax Due 8 $ g
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PA~fEE DESCRIPTION AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) S
Under penalties of perjury, I declare that the facts I reported above are true, correct and
complete to the best of fiy knowledge and belief.
HOME C )
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
- -
-REV-1737-8 EX + (8-08)
~~~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
INTER-VI OS TRANSFERS & ~ use schedule G, Part 2, ONLY for
MISC. NON-PROBATE PROPERTY proportionate method of tax computation.
ESTATE OF FILE NUMBER
ELIZABETH T. RYAN 21-11-1013
Part 1 must imclude all transfers of real estate and tangible personal property located in Pennsylvania.
Complejte Part 2 ONLY when the proportionate method of tax computation is elected.
Include in the description of ~roperty the date the transfer was made and the name and relationship of the transferee. This schedule
must be completed and tied if the answer to questions 1 through 4 on the reverse side of the REV-1737 cover sheet is yes.
DES RIPTION OF PROPERTY
ITEM Include the name of the transfe ,the relationship to Decedent and the date of transfer. DATE OF DEATH % OF' DECD'S EXCLUSION
NUMBER Attach a py of the deed for real estate. VALUE OF ASSET INTEREST (IF APPLICABLE) TAXABLE VALUE
1.
PART 1 TOTAL
• $ $ $ O.Oi
DESC IPTION OF PROPERTY
ITEM Include the name of the transferee, relationship to Decedent and the date of transfer. DATE OF DEATH % OF DECD'S EXCLUSION
NUMBER Attach a y of the deed for real estate. VALUE OF ASSET INTEREST (IF APPLICABLE) TAXABLE VALUE
~' BARBARA E. FALCONEFR, 3 STRAYER DR., CARLISLE, PA
1.A US TREASURY NOTE; 5K8 NOTE AG 13, CUSIP 912828PR5 30,000.00 100 30,000.0(
1.6 US TREASURY NOTE, 3~4 NOTE AJ 13, CUSIP 912828QL7 30,000.00 100 30,000.0(
1.C 1,972 SHARES VANGUAf~D WINDSOR FUND @ 12.35 24,354.20 100 24,354.2(
ALL OF THE ABOVE WERE REGISTERED "POD" OR "TOD"
PART Z TOTAL $ $ $ 84,354.2C
TOTAL (Also enter on Line 7, Recapitulation.) l $ 84,354.20
~n, mvre space is neeoea, use aaatuonat sheets of paper of the same size)
I
07/31/11
Intarast
93.75
ELIZABETH T R~fAN POD BARBARA E
FALCONER
3 STRAYER DR
CARLISLE PA 17013
- "" " -" -~ ice;: (717) 249 2733
- - _ - - - - Confidential
_ . _ -: _ _. -__-.'= ' No withholding
91282aPR5
0 5/S NOTE AC 13
01/31/13 30,000
91282aQ1.7
0 3/4 NDTE AJ 13
03/31/13 30,
TRANSACTION HISTORY
For 12/30/2010 to 04!01/2011
09/30/11
Intarast
112.50
~Ol/31/11 912S28JY7 0 '~/8 NOTE U 11 Intarast Payrant
131.25
zoo)
Legacy Treasury Direct
www.tr0asurydirectgov
1-800-722-2678
1-304-480-6464 (Outsid0 the U.S.)
IF YOU HAVE QUESTIONS CONCERNING THIS STATEMENT, PLEASE CONTACT YOUR TREASURY RETAIL
i -
' TREASURY RETAIL SECURITIES SITE
P.O. BOX 567
PITTSBURGH PA 15230-0567
PHONE: (800) 722-2678
Payments made by direct deposit to:
~ FLEET
Routing Number: 011000138
Name on Account: E RYAN/B FALCONER.
CHECKING Account Number: Confidential
ACCOUNT HOLDINGS
h 31, 2011, quarter-to-date statement
>1of1
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Vanguard'
Client Services > B00-662-2739
www.vanguard.com
ELIZABETH T RYAN
3 STRAYER DR
CARLISLE PA 17013-4403
s
s
Windsor Fund Investor, 0022-00974887760
Date Transaction Amount Share Price Shares Transacted Total Shares Owned Value
Beginning balance on 12/31/2010 $13.51 1,972.540 x26,649.02
Ending balance on 13/31/2011 x14.36 1,972.540 528,325.67
1,246 shares held as certificates
Fund /Account No. 00$2 /00974887760
Vanguard Windsor Fund
Investor Shares
Make checks payable to: The Vanguard Group - 0022
List each check ^. ^ ^ ^, ^ ^ ^ ^ ^
separately. Z
s~.~~i^^,^^^.^^
Do notattsror S^,^^^,^^^-^~
~hotoco~ytkis ^.^~^ ^,^ ^ ^.^ ^
iavestw~t sli'. s
___- TotalAmount S^,^I~,^ ^,^ ^ ^.^
00220 0097418x7760 3D0 70
Elizabeth T. Ryan
7HE VANGUARD GROUP
PO BOX 13750
PHILADELPHIA PA 19101-9897
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•REV-1737-6 EX + (8-08)
REVERSE
. ~ Pennsylvania
DEPARTMENT OF REVENUE
fNNFRttANfF TAX RFTl1RN
scNEDULE x
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Use Schedule H ONLY for proportionate
method of tax computation.
ESTATE OF FILE NUMBER
ELIZABETH T. RYAN 21-11-1013
Debts of decedent must be reported on Schedule i.
ITEM NUMBER DESCRIPTION AMOUNT
q• FUNERALEXPENS~S:
~~ HOFFMAN-RG~TH FUNERAL HOME AND CREMATORY, INC.
PROFESSIOWAL SERVICES, CREMATION, DEATH CERTIFICATES 2,005.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commission(s)
Name(s) of Personal Representative{s) ____ _.__ _ _ _ - _. __ _ __ __
KSubmit requested information for additional personal representative's on additional sheets)
Social Security Number(s) or EIN Number(s) of Personal Representative(s)
Street Addressles)
City(ies) State(s) ZIP(S)
Year(s) Commission Paid
2. Attorney Fees 12,735.00
3. Probate Fees 343.50
4• I Accountant's Fees
5. Tax Return Preparer'~ Fees
6. Miscellaneous Expen$es
PUBLISH EST~4TE NOTICE, CUMBERLAND LAW JOURNAL
PUBLISH ESTk1TE NOTICE, THE SENTINEL
TAX RETURN 1=ICING FEE
75.00
15.00
TOTAL I 15,173.50
(A so enter on Llne 9, RecapltulaUon.) $
(If more space is needed, use additional sheets of paper of the same size)
- -- --
- -- -
-REV-1737-7 EX + (6-06)
SCFIEDULE 1
~i pennsylvania Use Schedule I, Part 2, ONLY for
DEPARTMENT DF REVENUE DEBTS OF DECEDENT, proportionate method of tax computation.
MORTGAGE LIABILITIES, & LIENS
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELIZABETH T. RYAN 21-11-1013
Part 1 must include mortgage liabilities, liens and taxes against the Pennsylvania realty that were due and
owed as of the date of decedent's death.
Comple'~e Part 2 ONLY when the proportionate method of tax computation is elected.
ITEM
NUMBER
1.
DESCRIPTION
AMOUNT
TOTAL PART ~ I $ o.oo
ITEM
NUMBER DESCRIPTION AMOUNT
~• ALERT PHARMACY 80 28
2. ROSA LUCIDON Sk TEAM, 24-HR. NURSING SERVICES 1,445.00
TOTAL PARTS $ 1,525.28
TOTAL (Also enter on Line 10, Recapitulation.) $ 1,525.28
!If more space is needed, use additional sheets of paper of the same size)
_.
.REV-1737.7 EX + (6.08)
REVERSE
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
ELIZABETH T. RYAN 21-11-1013
When flat rate method is elected, list the beneficiaries of the Pennsylvania property.
When proportionate method is elected, list ail beneficiaries.
RELATIONSHIP TO
ITEM DECEDENT AMOUNT OR SHARE
NUMBER NAM AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (~nclude outright spousal distributions and transfers under Sec. 2116 (a)(1.2)J
L
BARBARA E. FALICONER, 3 STRAYER DR., CARLISLE, PA 17013 COLLATERAL 283,115.48
ENTER DOLLAR AMOUNTS ~OR DISTRIBUTIONS SHOWN ABOVE ON REV-1737 COVER SHEET OR THE PROPORTIONATE METHOD WORKSHEET ON THE REVERSE SIDE
OF REV 1737 COVER SHEE , AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTI NS:
A. SPOUSAL DISTRIBUTIO SUNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVgRNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II
(Enter total non-taxable distributions on Line 13 of REV-1737 cover sheet.)
(If more space is needed, use additional sheets of paper of the same size)
$283,115.48
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COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF ',CUMBERLAND
On this; the 14~` day of May, 2007, before me, the undersigned officer, personally
appeared THO~VIAS E. FLOWER, ESQUIRE, known to me to be a member of the bar of
the highest co~rt of said state, Supreme Court attorney license no. 83993, and a
subscribing witness to the within instrument, and certified that he was personally present
when ELIZAB TH T. RYAN, whose name is subscribed to the within Last Will and
Testament, exe uted the same, and that ELIZABETH T. RYAN has acknowledged that
she executed the same for the purposes therein contained.
IN WTTl~TESS WHEREOF, I hereunto set my hand and official. seal
c~oMMONw n~ of r~r~snwwln
Metariei seal
srad ~ rger, NolaryPubYc
c~rdl. cunberyHdcour~y
My oct.t~,2oa
Member, is Assoclftlon d Notaries
~ k (SEAL)