HomeMy WebLinkAbout11-22-11 (3)
• ~ 15056051058
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue Coun Code Year File Number
Bureau of Individual Taxes ry
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 09 0721
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
174-20-2173 05/21 /2009 06/05/1927
Decedent's Last Name Suffix Decedent's First Name MI
Barner Mary _ _ _ C
(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 BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
~ . 1. Original Retum ._, 2. Supplemental Return ~~ 3. Remainder Retum (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ;~ 5. Federal Estate Tax Retum Required
death after 12-12-82)
!- 6. Decedent Died Testate +':.::~~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~_... 10. Spousal Poverty Credit (date of death ~` 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
Lisa Marie Coyne, Esq. (717) 737-0464 ,. ,
Firm Name (If Applicable) n - -=
REGISTER OF"~AItLL~& USE ONLY'
'
Coyne & Coyne, P.C. ~ :` .
i
First line of address ', ~'=' r ; _~ r ;~
3901 Market Street .
_ j -
r. ~
Second line of address ' ::-~'. _~ `~ r --
'.,. ~ C.._._ _ ,
~
_~l
U ~ i `
City or Post Office State ZIP Code ^~
DATE FILED
Camp Hill PA 17011-4227
'X7
- i
~....1
`3
",`
rr
~~~
-~
Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATU OF PER ON ESPONSIBLE F, FILING RETURN DATE
ADDRESS _ ` v -
Park I. Barner, Jr., 471 Frog Hollow Road, Harrisburg, PA 17112
-- - __
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
15056052059
REV-1500 EX
Decedent's Social Security Number
~ecedent•s Name: Mary C Barner
__ _.. _.. , ....... ~...~.__...._. _,...... _.... _..
, 174-20-2173
__ r....
...
RECAPITULATION
~_...~ _..
_.... ,. _. .__ ..... d
1. Real estate (Schedule A) . .......................................... .. 1. 26,000.00
2. Stocks and Bonds (Schedule B) ..................................... .. 2. 144,737.63
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00
4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. 0.00
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 10,648.76
6. Jointly Owned Property (Schedule F) :~ Separate Billing Requested ..... .. 6. 0.00
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ":';::w`~ Separate Billing Requested...... .. 7. 0.00
8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 181,386.39
9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 27,312.96
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 22,174.91
11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 49,487.87
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 131,898.52
13. Charitable and Governmental Bequests/Sec 9113 Trusts 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. 131,898.52
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_ 15.
16. Amount of Line 14 taxable
at lineal rate X .0 45 131,898.52 16. 5,935.43
17. Amount of Line 14 taxable
at sibling rate X .12 17,
18. Amount of Line 14 taxable
at collateral rate X .15 1 g.
19. TAX DUE ....................................................... .. 19. 5,935.43
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ;;~~
15056052059 Side 2
15056052059
REV-1500 EX Page 3 File Number
_., ._
Decedent's Complete Address: 21 09 0721
Mary _ _ C
STREET ADDRESS
127 Wentzville Road
Barner
DECEDENTS SOCIAL SECURITY NUMBER
174-20-2173
clrr
Enola
STATE ZIP
PA 17025
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 5,935.43
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 7,000.00
C. Discount 296.77
- -- Total Credits A + B + C
( ) 2
()
7,296.77
3. InteresUPenalty if applicable
D. Interest
_ _ __
E. Penalty
Total InteresUPenalty (D + E) (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 2, Line 20 to request a refund. (4) 1,361.34
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (5A) 0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 0.00
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 : ............................................ ^
c. retain a reversionary interest; or .......................................................................................................................... ^ Q
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 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 IT AS PART OF THE RETURN
For dates of death on or after July 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)].
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 surviving spouse is zero (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 twenty-one 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)j.
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (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.
REV-1502 EX+ (11-08)
Pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary C. Barner 21-09-0721
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, bath having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
127 Wertzville Road, Enola, PA 17025 -- Settlement Sheet Attached
26, 000.00
TOTAL (Also enter on Line 1, Recapitulation.) ~; 26,000.00
If more space is needed, insert additional sheets of the same size.
~+y
A. ~ett~ement 4J'tatemeni U.S. Department of Housing
L n
"'r
and Urban Development
B: Type of Loan ~ OMB No. 2502-0265 (Page I)
1. ^ FHA :?. ^ FmHA 3. ^Conv. Unins. 6. File Numb'et ZLoan Number
I
4. ^ VA 5. ^Conv. Ins. I 8. Mortgage Insurance Case Number
C. Note: naa mam 1. rnraua,a m p.. ypn .,1.1.m.na.ocln.l..ul.m.nt...1,. Am.,ma p.a m ..a by tn. aetu.m.no.ewe,r. an.wn. it.m. aa.aa.a •tP.o.r )• wa• v,fa o.e.w. m: ao,m • m.
wcormauonal purpoea .aa,re na mdaaea is me mtw. e. r a• mowu ae~.
D: Name and Address of Borrower
Michael J
Chervanick E. Name, Address, andTaxpayer identification N of Seller F. Name and Address of Lender
.
I Estate of Mary C..Baznar, Deceased
By: Park 7. Barrier, Jr.; Ext..
G. Property Location
127 Wettzvitle Road
Enola, PA 17015
100. Gross Amount Due From Borrower
]01 Contract sale
H. Settlement Agent Name, Addressar
COYNE & COYNE; P.C.';
3401 Market Sheet
.Camp $ill, PA 17011
Place of Settlement
3901 Mazke[ Street, Camp Hill,
I{, Summary of Seller's Transati
400.. Gross Amount nun m.a ceu
s prrce 26,000.00 401. Contract sales price
102.
Personal Rroperty
402.
Personal Property 26,000.00
103. Settlement chazges to borrower (line 1400) 652.00 403.
104, .
404:
105.
405.
Adjustments for items paid by seller' in advance Adjustments for items paid by seller in advance
106. City/town taxes 11/19/11 to 12/31/11 406: City/town taxes 11/19/11 to 12/31/11
107.
108. County taxes I1/19/Ilto 12/31/11
Assessments 65.13 407. Coantytaxes 11/19/llto12/31/II
65.13
109. to
School Tax 1 ]/19/11 to 06/30/12
1,085.02 408.
409. Assessments to
School Tax 11/19/1.1 to 06/30/12
110. Sewer and Trash
63.52
410
Sewer and T
sh 1,085.02
111. , ra 63.52
112. 411.
412.
120. Gross Amount Due From Borrower 27,865.67 420. Gross Amount Due To Seller
mn ~__.._._,._.~..- 27,213.67
...,a uwauwer 500. Rednohin c io: e....:::w~ n.... _ c_r.
cvr:
202. ,.,eposus or earnest money ~
Principal amount of new loan s
O 1.,000.00 'SOl. Excess deposit (see inshuctions) 1,000.00
203.
Existing loan(s) taken subject to 502. Settlement charges o seller (line 1400) '
204. 503. Existing loan(s)taken subjecfto
205. 504. Payoff of first mortgage loan
206. 505. Payoff of second mortgage loan
20Z 506.
208.
_ 507.
209. 508:
Adjustments for items unpaid by seller 509.
Adjustments for items unpaid by seller
210. . City/town taxes to 510. City/town taxes to
21 L
212. County taxes to
Assessments ~ 511. County taxes tp
213. to
School Tax
to 512. Assessments
to
214. 513. School Tax to
215. 514.
216. 515.
217. 516.
218. 517.
219. 518.
_ 519.
220. Total Paid By/For Borrower 1,000.00 _ 520. Total Reduction Amount Due Seller
1,000.00
300. Cash At Settlement From/To Borrower ~ 600. Cash Af Settlement Tti/From Seller
301.
302. Gross Amount due from borrower (lmo 120)
Less amounts paid by/for borrower line 220
( ) 27,865.67
( 1
0
0 601. Gross Amount due to seller line 420
( )
27;213.67
,
0
.00 602. Less reductions in am[. due seller (line 520) (. 1
000.00)
303. Cash X~ From ^ To Borrower ~ $ 26,865.67 603. Cash X~ To ^ From Seller ,
T bw. ~s..a,l ::: ....:....., .t_ ....... ,: $ 26,213.67
_ -____., ._.._.._ .. ........... . s.uo~~cm oawmem aaa m me best ofmy lwowledge and belief, it is a true slid accurate stafiment of all receipts and disburaemeota nude on my
. accom t or by me m [his oansacfioa I further certify that I have mceived a completed copy of pages 1 and 2 of tpa (d t S merit.
Borrower Michael J. Chervanick Seller Paz c 7. Bazner, Jr., Executor
'.. Borrower Seller
SETTLEMENT AGENT CERTIFICATION Seller's Taxpayer Identirieation Number Solicitation and Certification
caua IND-1 Setdemenl Slalemw whi h i have prcpat<d u a ow wd actuate xcount of this aauacaon. I have .You mq red by 1 to No delve S ttl 1 A
da m be diabuned ~ cadence w W tlua a emenc mbc . n do of pm d N Setllangpt p~ ta°p~,nyaorad borel¢w~ipW~yy~a,j coq fiot ly`peY Id p6udon
. be s bJ a tq 1 r {m al penalLev mpose3 by law. U d p~a~etlb'ea i puj~uryn, I a~aovpry tbazbethan unya
" a hown on Ihte alalemenln my cortect mapaya idenldiwb nu ba.
osettlement Agent ~ - Dat I -
' WARNllJG I t kris gly ake fats slat n II o the Unaal Slams th y om 'riot- form.
j Penal[ po aiouon cen include a One wd tmpnaovmed Pa daala a<e: Tole la V.S. Code sec ton 1001 and
~. Sauoa 1010.
Seller's Si nature Date.
HUD - 13/91
I2ESPA, HB 4305.2
f
L Settl
1
,.aN
701. $
702. $
703. Ca
704.
800. "Ire
BO1
in
Hosea on S ~ @ %_
as follows:
to
to
Page 2
Paid Prout Paid From
Borrowers Sellers
Funds at Funds at
Settlement Settlement
Loan Origination Fee
802. Loan Discount
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee
806. Mortgage Insurance Application Fee to
807. Assumption Fee
808. Flood Certification Fee to:
809. ,
810. ,
811.
900. Items Required By Lender To Be Paid In Advance
901. Interest from to @ $ /day
902. Mortgage Insurance Premium for months to
903. Hazard Insurance Premium for yeazs to
904,
905.
100E Hazard Insurance months @ $ per month
1002. Mortgage Insurance months @ $ per month
1003. City property taxes months @ $ per month
1004. County property taxes months Q $ per month
1005. Annual assessments months @ $ per month
1006. School Taxes months @ $ per month
1007. months @ $ per month
1008. Ag , agate Reserve Adjustment.
a. gca
1101. Settlement or closing fee to
1102. Abstract or title search to Coyne & Coyne, P.C. 50:00
1 I03. Title examinafion to
1104. Title insurance binder to
1105. Document prepazation to
1106. Notary's fees to
1107. Attorney's fees to
(includes above itemsnumbers: ~
1108. Title insurance to
(includes above-items numbers:
1109. Lender's~coverage $
1110. Owner's coverage $
111 E
1112.
1113.
1200. Government Recording and Transfer Cltarges
1201. Recording fees: Deed $ 82.00; Mortgage $ ;Releases $ 82.00
1202. City/county tax/stamps: Deed $ ;Mortgage $ 520.00
1203. State tax/stampsi Deed $ ;Mortgage $
1204.
1205,
'~. 13UU. Adtlitional Settlement Charges
'~. 13U1. Survey to:
'~. 1302. Pest Inspection to:
1303..
I 1304.
1305.
1400.. Total Settlement Char es enter oh lines 103, Sectitin J And 502, Section I 652. 0
Initial Escrow Account Statement Required by Section 10 (c) (1) of the~Real Estate Settlement Procedures Act (RESPA) •
' If checked ~] the terms of your loan requse you to have an esc~nw account to assure [hat the certain obligations relating to the,mor[gaged property, such as taxes; insurance
premiums and otlrer charges are paid. The amount specified below will be collected, along wide your mortgage principal and interest payments; during. the first 12 months after
' your account is openedto pay ntese anticipated expenses: FsvowAccautt
~. Beginning Date: Your escrow account payment will be S per
~, Payee Purpose Anticipated Due Date Estimated Amounf
IIOD - 1 3/91 12ESPA, HB 4305.2
REV-1503 EX+ (6-98)
' SCNEDt~LE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary C. Barner 21-09-0721
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
(It more space is needed, insert additional sheets of the same size)
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REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Mary C. Barner 21-09-0721
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
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STATEMENT OF RECOUNTS
Statement Period05114109 T0~06N4/09
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SOVEREIGN FREE
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• REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary C. Barner
ITEM
NUMBER
A. FUNERAL EXPENSES:
t ~ Funeral
2. Gingrich Memorials
s. Memorial Service and Reception
a. Honorarium
e. Rolling Green Cemetery
g. ~ ADMINISTRATIVE COSTS
SCI~IEDI~LE N
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-09-0721
Debts of decedent must be reported on Schedule I.
1. Personal RepresentaUve's Commissions
Name of Personal Representative(s)
Social Security Number(s)IEIN Number of Personal Representative(s)
Street Address
State
City
Year(s) Commission Paid:
2_ Attorney Fees
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
State
City
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
g. Tax Return Preparer's Fees
~. Legal Advertisement -- Patriot News
s. Legal Advertisement --Cumberland Law Journal
s. Inheritance Tax Filing Fee
10. Woof Appraisal -- appraisal of real estate .
11. Commission for sale of stock
t 2. Total from Page 2 of Schedule H
Zip
Zip
TOTAL (Also enter on line 9, Recapitulation) I $
4,070.00
170.00
339.96
200.00
500.00
12, 000.00
306.00
800.00
137.24
75.00
15.00
300.00
70.00
8,329.76
27, 312.96
(If more space is needed, insert additional sheets of the same size)
A B C D E
1
2 ESTATE OF MARY C. BARNER
- ---- r- --- -
4 FILE N0.21-09-0721
5
--
-- -
6 SCHEDi1LE H:
7 ~ FUNERAL AND ADNIIIVISTRATIVE COSTS. PAGE 2
8
9
Item No.
_ _ ___
Description _
Amount
10 13 _____
Repairs to real estate for sale _
- $2,400.00
11 14
----- ~-.East Pennsboro Ambulance Co.
-
--- $341.76
12
15 T
- --
!Reserves ___
$5,000.00
13 16 iMileage for Executor: 500 miles at $0.50/mile $500.00
14 17
- _ _ Postage
- - ---
-- $88.00
--
15
16 I TOTAL: $8,329.76
17
18
REV-1512 EX+ (12-08)
~ i'~ Pennsylvania
DEPARTMENT OF REVENUE
iNHFRiTANCE TAX RETURN
SCHEDULE I
DEBTS OF DECEDENT,
MinRTGOGE LiABiLITIES & LIENS
ESTATE OF FILE NUMBER
Mary C. Barner 21-09-0721
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
VALUE AT DATE
ITEM OF DEATH
NUMBER DESCRIPTION
1• Golden Living Center 2,304.00
2. Holy Spirit Hospital 1,067.45
56.00
3. Pharmerica
4. Nationwide Mutual Insurance Co. 610.67
5. PA Gastroenterology 30.00
6. West Shore EMS 99'80
7. East Pennsboro Township -- sewer 1,236.00
8. Pinnacle Health 950.00
484.80
9. Verizon
10 Nationwide Mutual Insurance Co. 64.22
11. East Pennsboro Ambulance Service 417.39
12. Quantum Imaging 66.00
13. Women 2 Women Breast Cancer Foundation 15.00
14. Sububan Propane 955.33
15. PP& L 702.35
16. Real Estate taxes 5,874.54
17. Donegallnsurance 576.00
18. Lackawanna Mobile Xray 39.83
19. Carst Fuel Product, Inc. 2,270.67
20. Tuscarora Wayne Insurance Co. --homeowner's insurance 4,354.86
TOTAL (Also enter on Line 10, Recapitulation) I # 22,174.91
If mare space is needed, insert additional sheets of the same size.
REV-1513 EX+ (11-08)
i'~ Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE
BENEFICIARIES
ESTATE OF FILE NUMBER
Mary C. Barner 21-09-0721
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1Z).]
1. Park I. Barner, Jr. Son 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE,
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $
If more space is needed, insert additional sheets of the same size.
1.
yy$..,,
~~
~ ~.
No . 2009- 00721 rti ivo
Estate Of : MARY CATHERINE BARNER
(first, Middle, Lasil
21- 09- 0721
.Late Of : CUMBE LAN OCOUNTW NSHIP '
Deceased
Soci aI Security No : 174-20-2173
WHEREAS, on the 4th day of August: 2009 an instrument dated
December 16th 1992 was admitted to probate as the last .will of
MARY CATHERINE BARNER
(first Middle, Lasil
late of EAST PENNSBORO TOWNSH/P, CUMBERLAND County,
who died on the 21st day of May 2009 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi11s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
PARK /BARNER JR
who has duly qualified as EXECUTOR(R/XJ
and has agreed to administer the estate according to law, alI of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VAN/A.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 4th day of August 20C^
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
LAST WILL
OF
MARY C. BARNER
r
. ~ i
~~ ~I~ I, MARY C. BARNER, of 127 Wentzville Road, Enola,
!~ Pennsylvania,
Township oP East Pennaboro, Cumberland County,
Last Will and revoke any Will previously
deolare this to be my
,I made by me.
I
II Item 1: I devise and bequeath all of my estate of every
II nature and wheresoever situate, together with insurance
thereon, to my son, PARK I. BARNER, JR.
Item 2: Should my Son, PARK I. BARNER, JR., predecease
f
me or die on or before the thirtieth (30th) day following mY
I! estate of every nature
death, I devise and bequeath all of mY
i to ether with insurance thereon, to
and wheresoever situate, g
` ~ my Daughter-in-law, Wife of PARK I. BARNER, JR., who is GAIL
,• ~ ~ ~ R . BARNER .
Item 3: I direct that all my just debts be paid as soon
I as practical after my decease.
~I Item 4: I direct that all taxes that may be assessed in
' I death, of whatever nature and by whatever
consequence of my
i juriadiotion impoeed, shall be paid Prom my residuary estate
as a part of the expense of the administration of mY e'state.
• ~ Item 5: Upon my demise, I direct that my body be buried
in the Rolling Green Memorial Cemetery, Lower Allen Township,
' a I Cumberland County, Pennsylvania, where I have a burial lot
~ W
(~~ next to my Late Husband, PARK I. BARNER.
• ~J ~ Son, PARK I. BARNER, JR., Executor
Item 6: I appoint my
v Son, PARK I. BARNER, JR.,
of this my Last Will. Should my
'\ a i oint my
fail to qualify or cease to act as Executor, I app
`~ ~ Daughter-in-law, GAIL R. BARNER, Executrix of this my Last
Will.
II
iI
~ Item 7: I direct that my personal representative, or
their aucoessors, shall not be required to give bond for the
faithful performance oP their duties in any jurisdiction.
TN WI/TnNESS WHEREOF, I have hereunto set my hand this ~~
day oP /1~1~~? 1992.
'r:
ti
~, -
~I ~~ /LC C~. ,~JG"i?~n-~~
MAR ARNER
The preceding instrument consisting of this and one (1)
other typewritten page, each identified by the signature of
the Testatrix,-was on the day and date thereof signed,
published and declared by MARY C. HARNER, the Testatrix
therein named, as and for her Last Will, in the presence of
each other, have subscribed our names as witnesses hereto.
s~ /J 3 4 o i ~wba~v~lr.L`sy`
=gyp residing at ~_~ ~ 7 n ~
~i'~-~ nJ-- residing at l"a.~.~, ~ P/~1?emu
:~
ti
~.
'~,~
I
.it°`~
COUNTY OF CUMBERLAND ) sa:
i
We, MARY C. BARNER, /11~ F- ~~u rit and
LIS/4 /6tWK~~ („U.;~,•C-. the Teatatrix and the
witnesses respectively, whose names are signed to the attached II
i
or foregoing instrument, being first duly sworn, do hereby
declare to .the undersigned authority that the Testatrix signed
and executed the instrument as her Last Will and that she had
signed willingly, and that she executed it as her free and
voluntary act Por the purpose therein expressed, and that each
oP the witnesses, in the presence and hearing of the
Teatatrix, signed the Will as witness and that to the beat of
I his or her knowledge, the Testatrix was at the time eighteen
(18) years of age or older, of sound mind and under no
~ constraint or undue influence.
Sub~c/1r,ibed/, sworn and acknowledged before me
II ~~ ~~e r1J ~ , C~ OY/I/~ by MARY C. BARNER, the
Testatrix, and subscribed and sworn to before me by
~I~ENIYy !~ ~c?~.n~i and ~/Srl fri`+,C'rE l;.j,i~,6= ,
the witnesses, this ~ day of h/.C~ce„ hc°-%G_. , 1g~~•
~ ,
otary Public (SEAL)
~r-NOl'ARIMI SEAL
E•:ILci~Pt B. C0`dPdt, N()TAI3Y PUBLIC j
MY C;ittlf;llS_')Pt iXPIFIES JiJD:=`'.6, t9S'6 , i
I
I
Henry F. Coyne
Lisa Marie Coyne
Jaime L. High
CoYNE & Co1'IVE, p, C,
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
3901 Market Street
Camp Hill, Pennsylvania
1 701 1-422 7
Facsimile (717) 73750161
November 21, 2011
Office of the Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P.q 17013
Dear Madam:
Re: Estate of Mary Catherine B
No. 21-09-0721 arner„ Deceased
Enclosed are an original and three (3) copies of the Inheritan
docket the original Return and return two 2 `~ ce Tax Return for this Estate.
envelope. () clocked-in copies to this office with the enclosed s Klndly
amped
Also enclosed is Estate Check No. 184 in the amount of $15.
this Estate. Kindly issue a receipt for a 00 which representl~#
P Yment of the filing fee.
,- ~ filmg~e for
Thank you for your assistance. = l ! ~ N~ `?
- ,-~ r..
z~ ~,
_; `_ _~
Very trul ~ ; ,:,; , ~~ , ;
Y Yours, ~.u -' -'
COYNE & CO A •~ ~n ~~
~--
isa ~e Coyne
LMC/amd
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