HomeMy WebLinkAbout11-23-111505611185
EX (02-11) (FI)
, IAL USE ONLY
REV-1500
--' OFFIC
mber
N
Fil
PA Department of Revenue
u
e
County Code Year
Bureau of Individual Taxes INHERITANCE TAX RETURN 2 ]~ ]~ 1 9 91
PO BOX 280601
RESIDENT DECEDENT
Harrisburg, PA 17126-0601
ENTER DECEDENT INFORMATION BELOW MMDDYYYY Date of Birth MMDDYYYY
Social Security Number Date of Death
08282011 05261921
166-14-9832 MI
'
s First Name
Suffix Decedent
Decedent's Last Name
MARY RITA
DUNLEVEY
(If Applicable) Enter Surviving Spouse's Informat ion Below Spouse's First Name MI
Suffix
Spouse's Last Name
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW ^ ^ 3, Remainder Return (Date of Death
® 1. Original Return 2. Supplemental Return prior to 12-13-82)
^ ^ ^ 5. Federal Estate Tax Return Required
4. Limited Estate 4a. Future Interest Compromise (date of
death after 12-12-82)
^ ^ 8. Total Number of Safe Deposit Boxes
X 6. Decedent Died Testate 7. Decedent Maintained a Living Trust Q-
(Attach Copy of Will) (Attach Copy of Trust.) ^
^ 11. Election to Tax under Sec. 9113(A)
9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (Date of Death (Attach Schedule O)
Between 12-31-91 and 1-1-95)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIADaytimeFTeleph oe Number BE DIRECTED TO:
Name
717-620-240 R
VICKY ANN TRIMMER _
REGISTER OF Vv~L.L SE ONLY,,,. ~?
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First Line of Address ~ ~ `-- ;_~ r ~~ .-~
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PERSUN & HEIM PC r, ~ "
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Second Line of Address
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P O BOX 6 5 9 DATE FILED
State ZIP Code
City or Post Office
PA 170550659
MECHANICSBURG
correspondent'se-mail address: VATRIMMERa~PERSUNHEIM • COM
it is trues correct andecomplete.cDeclahation of peepare other than the personaa p esentative c basedson allsnformat on of wh ch preparerf has an k owledge belief,
DATE
SI R~ OF PARSON RF~~NSIBLE FOR FILING RETURN ~ ~ _ Z Z - f ~
313 W GREEN STREET
SHIREMANSTOWN, PA 17D11
ne'rc
t I - Z~t- Z-c~ t
ADDRESS MECHANICSBURG, PA 17D55-0659
PERSUN & HEIM, PC PO BOXPLEASE USE ORIGINAL FORM ONLY
Side 1
15 0 5 61118 5 OM4647 3.000
THAN REPRESENTATIVE
1505611185
J
1505611285
REV-1500 EX (FI)
Decedent's Social Security Number
166-14-9832
oecedent'sName DUNLEVE,Y MARY RITA
RECAPITULATION
1. Real Estate (Schedule A) ... 1. $14 9 ,10 0.0 0
2. Stocks and Bonds (Schedule B) . .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3,
4. Mortgages and Notes Receivable (Schedule D) 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5,
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested 7.
8. Total Gross Assets (total Lines 1 through 7) .. g,
.$0.00
$0.00.
$0.00
$7,765.37
$143,408•.07
-$0.00
$300,273.44
9. Funeral Expenses and Administrative Costs (Schedule H). .. 9. $ ]~ 7 , D D 4 . 8 2
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) , 1 p. $ 4 , 3 81.8 6
11. Total Deductions (total Lines 9 and 10) , . 11. $ 21, 3 8 6.6 8
12. Net Value of Estate (Line 8 minus Line 11) 12. $ 27 8 , 8 8 6.7 6
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) , , 13. $ D • D D
14. Net Value Subject to Tax (Line 12 minus Line 13) , i 4. ~ 2 7 8 , 8 8 6.7 6
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
18. Amount of Line 14 t xable
4~
at linealratex.o $278,771.77 1s.
17. Amount of Line 14 taxable
at sibling rate X .12 $ 0 . D D 17.
18. Amount of Line 14 taxable
at collateral rate X .15 $ ], ], 5 . D D 18.
19. TAX DUE 19.
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505611285 15D5611285
OM4848 3.000
$0•DO
$12,544.73
$0.00
$17.25
$12,561.98
File Number
3. Interest
(3) $0 • ~~
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) $ ~ • 0 0
Fill in box on Page 2, Line 20 to request a refund.
(5} $ ~ ' ~
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Make check payable to: REGISTER OF WILLS, AGENT.
OCKS
ATE B
ACING AN "X" IN THE APPROPR
ANSWER THE FOLLOWING (1UESTIONS BY PL I N
PLEASE
Did decedent make a transfer and:
1 X
.
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 reversionaryinterest
d. receive the promise for life of either payments, benefits or care?
within one ear of death
did decedent transfer property Y
1982
X
,
If death occurred after Dec. 12,
2
.
without receiving adequate consideration?
st for" or payable-upon-death bank account or security at his or her death?
t
"i
ru
n
3. Did decedent own an
nt own an individual retirement account, annuity, or other non-probate property, which
d ^
e
4. Did dece
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 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 of16e ath ; ; oii afThe slat to does not exempt aetransfeeto ansuhviving spouse from tax,rand the statutory requirehmentsrfor1disclosute of assets and
[72 P.S.§91 () ( ) ()]
filing a tax return are still applicable even if the surwwng 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 paten , 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(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.
OM4671 2.OD0
Tax Payments and Credits: (1) $12 , 5 61 •9 8
1. Tax Due (Page 2, Line 19)
2. Credits/Payments $11, 9 3 3. 8 8
A. Prior Payments $ 6 2 8 1~
B. Discount $12 , 5 61.9 8
Total Credits (A + B) (2)
REV-1502 EX+(01-~0) SCHEDULE A
pennsylvania
pEPPRTMENiOF REVENUE REAL ESTATE
INHERITANCE TAX RETURN
occR1FNT r)FCEDENT
ESTATE OF:
FILE NUMBER:
21 11 991 1
Mar Rita Dunleve
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is de(ned as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both 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. VALUE AT DATE
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. OF DEATH
DESCRIPTION
NUMBER
~. 3423 Bedford Drive, Camp Hill, PA known as TPN $149,100.00
0121-0275-028
TO7AL (Also enter on Line 1, Recapitulation.) I S $149,100.00
If more space is needed, use additional sheets of paper of the same size.
9W4695 2.000
__- ___
__
REV-1508 EX+,~~-ta, SCHEDULE E
Pennsylvania
DEPARTbENT OF REVENUE CASH, BANK DEPOSITS, 8 MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT FILE NUMBER:
ESTATE OF: 21 11 991 1
Mar Rita Dunleve
Include the proceeds of litigation and the date the proceeds were received by the estate.
All ropert 'ointl owned with ri ht of survivorshi must be disclosed on Schedule F. VALUE AT DATE
ITEM OF DEATH
NUMBER DESCRIPTION
$1,455.00
~. Household Items - specifically devised
See attached appraisal
$456.35
2 Household Items - sold at auction
$5,664.04
3 Susquehanna Bank # 10005947808 $8 gg
Interest accrued to 8/28/2011
$59.25
4 Alert 1 - refund
$33.18
5 Comcast - refund
$88.66
6 Patriot News - refund
TOTAL (Also enter on line 5 Recapitulation) $ I $ 7 , 7 65.37
If more space is needed, use additional sheets of paper of the same size.
owaaAD z.ooo
__ _ _
REV-1509(7(+(01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBEK:
ESTATE OF:
21 11 991 1
Mar Rita Dunleve
If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
ADDRESS RELATIONSHIP TO DECD
SUNNING JOINT TENANT(S) NANE(S)
A Dunlevey, Charles 1313 West Green Street,
Shiremanstown, PA 17011-6522 Son
JOINTLY OWNED PROPERTY:
OF
uerTER DATE
R~ FOR JOINT AItAOE
Nl1NBER TENANT JOINT DESCRIPTION OF PROPERTY
MJOLUDE NAM: CF FMMNOMLINSTRLffK7N ANO BANK AOOg1Nf NUMBER DR SIMIAR
IDENTIFVINDNUMBER.ATTACNDEEDFORJDMITLVNELDREALESTATE. DIATE OF DEATH
VALUE OF ASSET DECEDBQT'S
NT62EST
1 A Mid Penn#18014027 $39,058.46 50.0000
2 IA
3 A
4 A
5 A
6 A
7 A
8 A
Rolled over from prior
account held joint for morE
than 1 year
Mid Penn #309003025
Rolled over from prior
account held joint for mor
than 1 year
8/20/2010 Fulton Bank # 348-0371841
8/20/2010 Fulton Bank # 3624-56609
12/12/2003 Members 1st #238630-00
4/15/2009 Members 1st #238630-91
6/28/2010 Members 1st #238630-46
Members 1st #238630-47
Rolled over from prior
joint account held at
another finacial
institution for more than
year
$59,606.85150.0000
$24,720.98 50.0000
$2,001.83 50.0000
$25.00 50.0000
$16,732.22 50.0000
$17,318.21 50.0000
$10,081.73 50.0000
from continuation schedules ~ ~ _
TOTAL (Also enter on Line 6, Recapitulation) S
If more space is needed, use additional sheets of paper of the same size.
TE OF DEATH
VALUE OF
$19,529.23
$29,803.43
$12,360.49
$1,000.92
$12.50
$8,366.11
$8,659.11
$5,040.87
$58,635.41
$143,408.07
gW46AE 2.000
21 11 991 1
Estate of: Mary Rita Dunlevey
Schedule F Part 2 (Page 2)
DOD Value of Perc DOD Value of
Item Joint
Asset Int. Interest
No. Cot. Date Des cription
4/18/2009 Member s 1st # 238630-48 $7,348.05 50.0000 $3,674.03
g A
$356.99 50.0000 $178.50
10 A 11/25/1986PSECU #S1
136.75
$1 50.0000 $568.38
11 A 11/25/1986PSECU #S4 ,
$685.08 50.0000 $342.54
12 A 11/25/1986PSECU #S7
$12,523.44 50.0000 $6,261.72
13 A 11/25/1986PSECU #S50
023.32
$13 50.0000 $6,511.66
14 A 11/25/1986PSECU #S51 ,
$16,060.11 50.0000 $8,030.06
15 A 11/25/1986PSECU #S53
$60,740.93 50.0000 $30,370.46
16 A 11/25/1986PSECU #S59
$5,396.11 50.0000 $2,698.06
17 A 11/25/1986PSECU #S60
$58,635.41
Total (Carry forward to main schedule)
REV-1511 EX+ (10.09) SCHEDULE - H
pennsylvania FUNERAL EXPENSES AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENiDECEDENT FILE NUMBER
ESTATE OF 21 11 991 1
Mar Rita Dunleve
Decedent's debts must be reported on Schedule I.
ITEM AMOUNT
DESCRIPTION
NUMBER
A. FUNERAL EXPENSES: $10,657.52
~ Malpezzi Funeral Home
$975.00
2 Resurrection Cpmetetery
$818.32
Total from continuation schedules
g. ADMINISTRATIVE COSTS:
~. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
State ZIP
City
Year(s) Commission Paid:
$3,000.00
2. Attorney Fees:
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
3.
Claimant
Street Address
State ZIP
City
Relationship of Claimant to Decedent
$323.50
4. Probate Fees:
5. Accountant Fees:
g, Tax Return Preparer Fees:
7. $24.01
1 Copies, postage, etc
$100.00
2 Jason Smith Appraisals
I $1,106.47
Total from continuation schedules
TOTAL (Also enter on Line 9 Recapitulation) I $ $17 , 004.82
If more space is needed, use additional sheets of paper of the same size.
9W46AG 2.000
__
21 11 991 1
Estate of: Mary Rita Dunlevey
Schedule H Part 1 (Page 2)
Item Amount
No. Description
$46.95
3 Pictures, etc for display at funeral
$367.57
4 Funeral meal
$8.80
5 Thank you notes - stamps
$395.00
6 Brachendorf Memorials
$818.32
Total (Carry forward to main schedule)
Estate of: Mary Rita Dunlevey
Schedule H Part 7 (Page 2)
21 11 991 1
3 Mike Biechler $275.00
Home Inspection
4 Susquehanna Bank $21.25
Check fee
5 UPS $13.22
Shipping to return Alert 1 unit
6 House repairs $797.00
Required to list house for sale
$1,106.47
Total (Carry forward to main schedule)
__
__
REV-1512 EX+(12-06) SCHEDULE
pennsylvania
E DEBTS OF DECEDENT,
DEPARTMEM OF REVENU
RETURN MORTGAGE LIABILITIES S LIENS
INHERITANCE TAX
RESIDENT DECEDENT FILE NUMBER
ESTATE OF
21 11 991
1
Mar Rita Dunleve
to death that remained unpaid at the date of death, including unreimbursed
i
Report debts incurred by the decedent pr or VALUE AT DATE
OF DEATH
ITEM DESCRIPTION
NUMBER
1• Janice Baker $2,902.50
Final Payment for in home caregiving services
2 Alert 1 $104.10
Final payment and return of unit
$46.09
3 Verizon
$40.05
4 UGI
$362.00
5 Erie Insurance Group
$45.75
6 Penn Waste
$78.20
7 PA American Water
$66.24
8 Comcast
$304.09
9 PPL
$282.84
10 FM Berkheimer
$150.00
11 Borough of Camp Hill - Sewer
4,381.
TOTAL (Also enter on Line 10 Recapitulation) S $
If more space is needed, insert additional sheets of the same size.
BW46AH 2.000
REV-1513 EX+ (01-10) SCHEDULE J
pennsylvania
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT FILE NUMBER:
ESTATE oF: 21 11 991 1
Ma Rita Dunleve RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
[ TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1_ Charles Dunlevey
313 West Green Street
Shiremanstown, PA 17011-6522
General Bequests: $11,114.00
Son $144,624.21
One Half of Residue: $133,510.21
2 Francis M. Dunlevey, Jr.
11550 Colchester Drive
Chargin Falls, OH 44023-9332
General Bequests: $90.00
Son $133,600.21
0~ of Residue: $133,510.21
I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16 OF REV-1500 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 DISTRIBUTIONS:
1
0.00
TOTAL OF PART II ENTER mOore spaceTsAneeded,tuse add tionaSsDheetsNof papeFof the same sOe ER SHEET. S $
9 W46AI.2.000
Estate of: Mary Rita Dunlevey
Schedule J Part 1 (Page 2)
21 11 991 1
Item Relation Amount
No. Description
3 Elizabeth K. Dunlevey Loomis
14 Ruthford Drive
Pittsburgh, PA 15241
Items of personal property $160.00
Granddaughter
$160.00
4 Joann M. Dunlevey
2676 Rochester Road
Shaker Heights, OH 44122-2165
Items of personal property $15.00
Granddaughter
$15.00
5 Elizabeth AS Dunlevey
301 Prince Street
Harrisburg, PA 17109
Items of personal property $45.00
Granddaughter
$45.00
6 Katherine H. Dunlevey
11550 Colchester Drive
Chargin Falls, OH 44023-9332
Daughter-in-law $170.00
General Bequests: $170.00
7 Maryann Hirsch
11440 Woolington Road
Great Falls, VA 22066
$85.00
General Bequests: $85.00
Niece
8 Elizabeth Rudomanski Howell
20508 Straham Way
Sterling, VA 20165
$30.00
General Bequests: $30.00
Niece
9 Judy K. Souleret
313 West Green Street
Shiremanstown, PA 17011
Daughter-in-law $157.35
General Bequests: $157.35
REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
CERTIFICATE ®F
GRANT OF LETTERS
No . 201 ~ - 00991 PA No
Estate Of: MARYRITA DUNLEVEY
(First Middle, Lastl
a/k/a : MARY R DUNLEVEY
Late Of: CUMBE LAND COUNTY
Deceased
Social Security No : 166-14-9832
21- 11-0999
WHEREAS, on the 19th day of September 2011 an instrument dated
May 18th 1988 was admitted to probate as the last will of
MARY RITA DUNLEVEY
/FHsL Middle, Lastl
a/k/a MARY R DUNLEVEY
late of CAMP H/LL BOROUGH, CUMBERLAND County,
who died on the 28th day of August 2011 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
CHARLES DUNLEVEY
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 19th day of September 201 ~.
eglst of Wills
D ~ ~r~ I /~~ S~'/1')
~--- ~~
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
P--J
Last WiII and Testament
~~
~~ ~.
,~, ..~
~
~ ~ - ~c
of ,
c, t_
~1~~ ~ ,
`~~~
INTRODUCTORY CLAUSE r`"
,~y~ ~ R `~ ~/ ~-~ 0 U ~ L ~ U E ~ also known as
I, / , / 7 (your full name)
r1'J h-R ~/ /Q ,D un/L E V E y a resident of the
(your name vnth commonly used imualsl
(., D u N T y of C..- urrJ,B F~FC ANI~
(county, parish, borough, etc.) (name of your county, pansh, borough, Hc.)
D ~ ~ u G ~ -of (name of your cdv, town, vdlige etc.)
(city, town, viAage, etc.)
o M m 0 ^1 w EAGTr`l _of /~~NNS y c. V /gN/f~
(state, dtstnct, prowtnce, etc.) Insrne of your state, dutnct, provtce, etc.)
being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and
Testament, thereby revoking and making null and void any and ap other Last Wills and Testaments and/or Codicils to Last
Wills and Testaments heretofore made by me. All references herein to this Will shall be construed as referring to this Will
only.
RESIDENCY CLAUSE
FInRST: Having in mind the possibility that I may reside outside, or be temporarily absent from the
(- 0~'-'1 m o/tJ W E AL TN of PE N/y S y ~ UAN/ /9 my place of domicile at
(state, district, prcvmce, etc.) (name of your state, du;tnct, province, etc.)
the time of my death, I elect and hereby declare that this Will and each and every disposition and provision contained herein
a M »? on/ w Er417/f
shall be construed and regulated by and in accordance with the laws of said (state, autnct, province, nt:.l
of P nJNSYL V/qN//9 -and the validity and effect of this Will
{name of your state, district, province, elc.)
and each and every disposition and provision contained herein shall be governed by the laws of said
(state, district, province, etc.)
It is my desire that this Will be probated in the ~~ m ~ O N 4J fs4 G T f/ of
(state, d'utrict, province, etc.)
/~~' /VrVS y L Ui9iV ~ ~ my place of domicile, and that the principle administration of
(state, district, province, etc.)
PEN N S yL V /9N //`~
my estate had in said Co M ~ G N wf /9 ~ T N of
(state, district, province, etc.) (state, district, province. etc.)
and that none of the assets of my estate which may be found in my place of domicile, be
remitted to any other jurisdiction for administration or distribution.
Page pN ~ of my Will ~~ ~~ ~~~
81983, Alpha Publications Of America, Inc. AW-1 O~
DEBT CLAUSE
SECOND: I direct that all my just debts and obligations, including funeral expenses, and expenses incident to my last illness
be paid as soon after my death as practical, excepting any mortgage indebtedness or other long term contractual
indebtedness secured either by real or personal property, or both which may exist as a part of this my estate, may be
continued and assumed by the beneficiary of said property.
My executor shall pay out my gross estate, as they were my debts, and without proration or apportionment, all estate
and inheritance taxes, by whatever name called, (including any interest due thereon) becoming payable because of my
death in respect to all property comprising my gross estate for death tax purposes, whether or not such property
comprising my gross estate for death tax purposes, whether or not such property passes under this Will.
SURVIVORSHIP CLAUSE
THIRD: If any beneficiary, other than my principal beneficiary, under this my Last Will and Testament shall not survive me,
then that share of my Estate which would be given to such predeceased beneficiary shall 6 E given to
(6e1 snot be)
the CN f ~ p R~~ of such beneficiary.
(child) (children) Ispouse)
In the event, I elect above not to give a share of my Estate to the child, children and/or spouse of said predeceased
beneficiary, then that share of my Estate which would have been given to said predeceased beneficiary shall be given as
provided in Paragraph C of the Distribution Clause.
The words "child" and "children," wherever used in this Will with reference to either children of mine or children of any
beneficiary under this my Will, mean and include, not only children of my blood and children of the blood of any child of mine
but also any children who shall have been legally adopted either by me or by any child of mine.
COMMON DISASTER CLAUSE
FOURTH: (A) In the event my Principal Beneficiary and I shall both die in, or as a result of, a Common Accident or Disaster
or under such circumstances that the order of our deaths cannot be established by proof, then I direct that for the purposes
me.
of this Last Will and Testament, my Principal beneficiary shall be deemed to have ($oM„~) ,r (predeceased)
(B) !n the event that any other Beneficiary under this my Last Will and Testament and I or any other person upon whose
death the rights of such beneficiary depend shall both die in or as a result of a Common Accident or Disaster or under such
circumstances that the order of our deaths cannot be established by proof, then, except as expressly provided in the
immediately preceding Paragraph A, I direct that for the purposes of this Last Will and Testament such beneficiary shall be
deemed to have predeceased me or such other person, as the case may be.
Page Tw ~ of my W ill ~ ~ s~gnat e)
m1983, Alpha Publications Of America, Inc. AW-~ f)2
DISTRIBUTION CLAUSE (continued)
(D) 1 give, devise and bequeas~ this my gross estate, to each of the halo ~ amed ben ~~~ ~ ~ Eoli ws:
~ ~`1 A ° f ~ ~ 7''
1) TO my (title of beneficiaN) (name of beneficary)
if he (she) (it), whichever the case may be, shall survive me, !give:
(check and initial the item(s) applicable): ( / ) of this my gross estate.
^~---• (fractional amount) F'r~ ST A+~JA f d~ O O b
',~ ~/O,ODD ~%EN "~"kousJ4Nt0 Dolt'_~Q<~ ~o Fn1esT Dollars ($ )~
(dollar amount)
^ Real Property: (Legal Description)
^ Personal Property and/or effects
of this my Gross Estate.
2) To my Sad (~~~kLfS DuNLf~E
(title of beneficiary) ('~~ ~ berrfinerv)
if he (she) (it), whichever the case may be, shall survive me, 1 give:
(check and initia- t e item(s) applicable):
m_~~.. /~'~ ~D N E ` M~pL F~ ~7"/, ~ ~ f ~v111 ~N Of ~2~ ( / / 'j„ ) of this my gross estate.
-/ (iracuona) amount)
Dollars ($ )~
^ (dollar amount)
^ Real Property: (Legal Description)
p Personal Property and/or effects
of this my Gross Estate. G s1 NC f ~f }! TR
(title of beneficiary) (*ame a( 6enerictery)
if he (she) (it), whichever the case may be, shall survive me, I give:
(check an~ iti ~he item(s) applicable):
.~m- 9 x [o~~' f{/QLF'} ~ j1>,f le6/-1MJNQ~Ie, ( ~ / z ) ofthismygrossestate.
(kactronnl amount)
Dollars ($ )~
^ (dollar amount)
^ Real Property: (Legal Description)
"~ ^ Personal Property and/or effects
of this my Gross Estate.
Page /~of my Will m~'h, ~ ~ ~~,~nur ~~• L
(lnsna U
01983, Alpha Publications Of America, Inc. AW-~ ~4 - - --
DISTRIBUTION CLAUSE (continued)
GRAN~AU~NT~k ~ L~ 2A~Q~"rH /'~. DtJNLFtJ~
4) To my (hde of benehcary) (rams of baneliciary)
if he (she) (it), whichever the case may be, shall survive me, I give:
(check and initial the item(s) applicable): ( / ) of this my gross estate.
^ ~~ (fractional amount)
Dollars ($ );
^ (dollar amount)
^ Real Property: (Legal Description)
~J?7~. Personal Property
wEOO~~~
effects ,DiAMO^~D ENGAGE MEN % Rin~G AN ~
/~-
of this my Gross Estate.
5) To my «A/~~/9UC~NTf~ _ ~'
(titk of beneficary)
if he (she) (it), whichever the case may be, shall survive me, I give:
(check and initial the item(s) applicable):
^ lbaetienal amount) (
N~/ M. ~u,t/LEvE y
(twne of txrrficiary)
/ ) of this my gross estate.
Dollars (fit )~
^ (dollar amount)
^ Real Property: (Legal Description)
ALL P~wTEk ~TE/r!S wiTftr THE
~m ~t~. Personal Property and/or effects
F P S ~o ~ o F Tr,~ a N/ G ~~AND L Am PS
of this my Gross Estate. S ~~,~~ ~ v E ~
To my G,QA,t)~AUGN~Ek ~"Li2A6ETlt R• ~
b) (title of beneficiary) (twtte of battaricixv)
if he (she) (it), whichever the case may be, shall survive me, 1 give:
(check and initial the item(s) applicable):
^ ( / ) of this my gross estate.
(hactional amount)
Dollars (~ ):
^ (dollar amount)
^ Real Property: (Legal Description)
Personal Property and/or effects ALL Qf /rl A ~N ~N G TE W f L ~ ~ ; f Ru L RE v E R ~
$fLUEQ fNG~~uID QewL CK eF C ~
of this my Gross Estate.
Page ~o uR of my Will
m1983, Alpha Publications Of America, Inc. AW-105 ~ ~~~.,~~IL ~2Q1?~ /~- - /9 , - /~/~ ~' ~'
EXECUTOR (EXECUTRIX) APPOINTMENT CLAUSE
F• Fri - /n R dr~ /r1 y So ^1 -
1: (A)1 nominate, constitute and appoint (tale of first nominee)
n h ~ R L ~ s ~ u ~ L ~ y £ ~ _ to be the Executor (Executrix), whichever the
(name of FseeendT mmeel
case may tie, of my Estate.
(B) lf, for any reason, my First Nominee Executor (Executrix), whichever the case may be, should fail to qualify or be
unable or unwilling to accept or continue as Executor (Executrix) of my Estate, 1 nominate, constitute and appoint my
M sc N FRAN~rS /-~• Qunl~ E ~E ~, T2
(name of ~Med' nominee)
(title of second ,wmmeel ,5 t c e N Q
to be the Executor (Executrix), whichever the case may be, of my Estate.
(C) If, for any reason, both of the foregoing designated Nominee Executors should fail to qualify or be unable or
unwilling to accept or continue as Executor (Executrix) of my Estate,l nominate, constitute and appoint my
~Jy BRo,-Hf~e _ J'~7r~ES V f~,~esc rl
(title of Hurd nominee) (name of thrcd nominee)
to be the Executor (Executrix), whichever the case may be, of my Estate.
EXECUTORY POWER OF APPOINTMENT
(A) All directions in this Will that use by reference the word "Executor" mean and include any person herein named as
my Executor or Executrix and any person who may be acting in either capacity, at any time. Such person shall have
reasonable discretion under the directions of this my Last Will and Testament with respect to any property, real or personal,
left by or held by me, or acquired by my Executor (Executrix) on behalf of my Estate.
(B) As 1 wish my Executor (Executrix) to exercise broad and reasonable discretion in dealing with my estate, so as to be
able to do everything he (she) deems advisable for the best interest of my estate and the beneficiaries thereof, I direct that
my Executor (Executrix) perform all acts, take all such proceedings and exercise all such rights and privileges, although not
specifically mentioned in this Will, with relation to any such property, as if the absolute owner thereof, and in connection
therewith, to make, execute and deliver any instruments and to enter into any covenants or agreements binding my estate
or any portion thereof.
(C) No such person named in, or appointed in connection with this Will in a fiduciary capacity shall be required to file
any bond or other security for the faithful performance of his or her duties as such fiduciary in any jurisdiction; and if, despite
this direction, a bond should lie required, I request that it be accepted without sureties and in a nominal amount.
Page ` ! tl ~ of my Will
X1983, Alpha Publications Ot America, Inc. AW-~ f)7 - --
SAVING CLAUSE
_S t X T N : !n the event any of the separate provisions of this Will should be held invalid, the invalidity of such
provision or provisions shall not affect any of the other provisions hereof, as it is my intention that each of the separate
provisions shall be independent of each o(the others so that all valid provisions shall be strictly enforced irrespective of the
invalidity of any of the others.
IN W[TNESS WHEREOF, 1 hereunto set my name and affixed my seal to this my Last Will and Testament, this
r•X TN day of ~~ `~ 19~-
~,~,, v~ ~;m0,,.-~
(your t e)
ATTESTATION CLAUSE
(/NtttuO~NG ~•R~
THE FOREGOING Last Will and Testament, consisting of SFV f N pageswhich have been individually
the testator
signed by
(testatrix), was on the date last mentioned, sealed, published and declared by the above named testator (testatrix) as his
(her) Last Will and Testament in the presence of each of us, and at the same time, we, at his (her) request, in his (her)
presence and in the presence of each other, hereunto subscribed our names as witnesses thereto; this attestation clause
having been first read aloud; and we hereby certify that at the time of the execution hereof, we believed said testator
(testatrix) to be of sound and disposing mind and memory.
1 ~ i Residing a
(witrxss address)
(vntness atgnatu
Cam,. ~ ~;,~G~/~ l 7'a~ ~
(Gty end state)
2 ~,U ~ Gr%~.~ Residing at 3 ~ v v (. rte)
(witness ai nature)
l(
,/ (a a gyre)
4-~1-JZ~2.~ Residing at ~T °~ ~ ~~C~TO~'C~ ~ r'' y ~
3' (witness :isnat [,~ fn~tnua address)
"r (city and state)
4 Residing at
(witness signature) (wMess address)
(city and state)
5' (witness signature)
Page ~_of my Will
Residing at (~~ addreaa)
(city and scale)
ot983, Alpha Publications 01 America, Inc. AW-1 O9
1-'agY 4-A
IAA 11E TITLE
Francis M. Uunlevey, Jr'. ~01~
i-'ather ine H. Dun 1 CvC:'' i~n"La~wCj
l~le4'C
M ._r'yanlt Hi rs~~h
EI i~aUeth kudomansl'i Pdiece
Judy K.. Souleret Daughter'-in
Law
~vh'~'tr 1 es ~-?ufi 1 et~C`y ~•or~
I TFt~I (S) BEQUEATHED
German Uf'vstal Deca7itcrs ~: glasses
Buddy (wood>; egyptian head (stone)
kama sutra (plastic); c:edar chest;
Geddr GioSet; 1JOUte
dolls
Waterford Crystal Christmas Decora-
tions; Llue stained glass tat~le
1 a m 1?
Green st8.itied =1~.ss taule 1~~iyl=}
Christmas TreevDecorations
Linens? '~I"iii~~; i r•}}stal i iuuli~aar•e4
Serving howls and Trays; Kitchen
Utensils and Implements etc`
All Household furnishings and
furniture; appliances, stained
glass litc}'jen lamp; all remaining
residual items
,n ~ 4-A of my will s~' ~ _
1=- g- (signatu e)
TaxDB Result Details
Page 1 of 1
Detailed Results for Parcel O 1-21-0275-028. in the 2010 Tax Assessment Database
DistrictNo O1
Parcel ID 01-21-0275-028.
MapSuffix
HouseNo 3423
Direction
Street BEDFORD DRIVE
Ownerl DUNLEVEY, MARY R
C/O
PropType R
PropDesc
LivArea 1040
CurLandVal 38800
Cu rImpV al 110300
CurTotVal 149100
CurPrefVal
Acreage • 18
CIGrnStat
TaxEx 1
SaleAmt
SaleMo
SaleDa
SaleCe
SaleYr
DeedBkPage 0018F-00229
YearBlt 1958
HF File Date 10/27/2004
HF_Approval_Status I A
9/15/2011 -
httn://taxdb.ccna.net/details.asn?id=01-21-0275-028:&dbselect=l -
r
APPRAISAL REPORT
OF
PERSONAL PROPERTY
OF
The Estate of Mary R. Dunlevey
3423 Bedford Drive
Camp Hill, PA 17011
FOR
Charles Dunlevey, Executor
313 West Crreen Street
Shireinnstown, PA 17011
AS OF
SEPTEMBER 19, 2011
BY:
JASON M. SMITH
Appraiser of Personal Property
545 Mumper Lane
Dillsburg, PA 17019
717-421-9750
DOLLS
Madame Alexander 18 @ $5.00 ea 90.00
Buyers Choice 5 @ $15.00 ea 75.00'
Souvenir type and misc. 50.00'
JEWELRY
14K Diamond Ring 75.00 ~
14K Wedding Band 85.00
Misc. costume jewelry 40.00 ~
SMALLS
German crystal decanter and glass set 15.00 '~
Pewter collection 15.00'
Waterford Christmas ornaments 9 @ $5.00 45.00
Misc. Christmas ornaments 5.00'
Stained glass lamps 2 @ $20.00 40.00
Pewter bedroom lamps 2 @ $15.00 30.00
Paul Revere silverplate bowl 5.00
Souvenir Buddha, Egyptian head, Karma Sutra 5.00
Stained glass hanging lamp 25.00 ~
FURNITURE
Maple drop-leaf table 125.00
Maple hutch 75.00
00
95
Maple secretary drop-lid desk .
Maple chairs 2 @ $20.00 40.00
00 /
40
Lane waterfall cedar chest .
30.00'~~
Cedar wardrobe
Maple bedroom suite -Dixie 6 pc. consisting of:
Headboard
Chest of Drawers
Dresser w/ mirror
Night stands (2)
00
450
Vanity w. bench .
1,455.00
APPRAISAL CERTIFICATE
I hereby certify that upon request for valuation of the personal property of the
Mary R. Dunlevey Estate, located at 3423 Bedford Drive, Camp Hill, PA 17011,
by Charles Dunlevey, Executor, 313 West Green Street, Shiremanstown, PA 17011,
I have personally inspected the following personal property for the purpose of
appraising and reporting the Fair Market Value as of this 19th day of September,
2011.
The information and values contained in this report are based upon my
experience as an appraiser and other reliable sources. The personal property
was found to be in good condition unless otherwise noted. Values are reported
piece by piece and as a whole.
APPRAISAL SUMMARY
It is my opinion that, as of this 19th day of September, 2011, the Fair Market
Value of the personal property of the Mary R. Dunlevey Estate is:
ONE THOUSAND FOUR HUNDRED FIFTY-FIVE DOLLARS
($1,455.00)
Signed,
~1(.~,
JA N M. SMITH
APPRAISER
SOURCES OF VERIFICATION
Haar's Auction
185 Logan Road
Dillsburg, PA 17019
Hardy's Auction Service
193 Ore Bank Road
Dillsburg, PA 17019
ASSUMI?T'IONS AND LIMITING CONDITIONS
F.dlR MARKET t'ALUE
The term "Fair Market Value" as used in this report is defined as follows: The highest price
estimated in terms of money which the property will bring in a competitive and open market under all
conditions requisite to a fair sate, with the buyer and seller each acting prudently and knowledgeably, and
assuming the price is not affected by undue stimulus.
This appraisal is based upon the following assumptions, limitations and conditions:
I . The information contained in this report is gathered from sources considered reliable and
from personal examination and research of authenticity and that comparable sales and/or
auction prices were available and dependable.
~. No responsibility is assumed for mattes legal in nature, including but not limited to:
representation of others of value, authenticity, condition, origin, or provenance of an item
appraised.
3. The appraiser assumes that a normal and careful examination of the property was
sufficient to determine their quality and condition and that no extraordinary examination
procedures would be utilized unless specifically requested and the expenditure of funds
therefore authorized.
q. Court Attendance-The appraiser's court attendance and giving of expert testimony are not
included as part of this report.
"THE UNDERSIGNED HEREBY CERTIFIES:
I . Appraiser has no interest now. heretofore, or contemplated in the future in the property
covered by this appraisal.
~_ That, to the best of my knowledge and belief all statements and information included in
this appraisal are true and based upon objective findings and that no pertinent information
has been knowinglywithheld or deleted in this report.
3, That neither the employment to make this appraisal nor compensation for doing so is
contingent upon the value of the property.
Even though it is the Frm belief of the appraiser that the information furnished in this appraisal
report and the conclusions drawn from this information are true and correct, they are not
guaranteed.
RESPECTFULLY SUBMITTED
;~
JAS ` N M. SMITH
.AP - ISER
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September 22, 2011
CHARLES Dt_TNLEVEY
313 W GREEN STREET
SHIREMANSTOWN PA 17011
~~sq~~~~~-~
Susquehanna Bancshares, fnc.
26 North Cedar Street
P.O. Box 1000
Lititz, PA 17543-7000
Tel 1.800.311.3182
Fax 717.825.4478
RE: Mary R Dunlevey Estate
DOD: 8/28/2011
SS#: ~"~-XX-9832
Tracking # 243177
To Whom It May .Concern:
In response to your letter of September 20, 201 1, here is the above customer account information
as of August 28, 2011.
Account #1
Account Title: Mary R Dunlevey
Charles Dunlevey POA
Account Type/# CD 10005947808
• Date Opened /Maturity 10/15/08 - 10/15f13
Interest Rate: 4.41%
Account Balance*: $5,664.04
Accrued Interest: $8.89
YTD Interest: $163.58
*Account balance does not inclu de accrued interest.
® There is no safe deposit box in the name of the decedent.
'. ~~
~~
f4. E
~~~~
September 16, 201 l
Charles Dunlevey
313 W Green St.
Shiremanstown PA 17011
Re: Mary R Dunlevey
Date of Death: 08/28/2011
SSN: XXX-XX-9832
Dear Mr. Dunlevey:
In response to your recent inquiry requesting information on the accounts of Mary R
Dunlevey, I have accumulated the necessary data below:
Account Name: Mary R Dunlevey or Charles Dunlevey
Account #: 18014027 -Checking Account
Date Opened: 03/29/2011
Balance DOD: $39,020.29
Balance Accrued interest DOD: $38.17
Total DOD Balance: $39,05$.46
Account Name: Mary R Dunlevey or Charles Dunlevey
Account #: 309003025- Certificate of Deposit
Date Opened: it/12/2010
Balance DOD: $59,245.92
Balance Accrued Interest DOD: $360.93
Total DOD Balance: 559,606.85
If you have any questions, please contact me at (717) 896-5383.
Sincerely,
/t
Sarah Holtzman
Deposit Services Team Leader
349 Union Street, Millersburg, PA 17061 ' 1- Member FDiC • 1-$~7-9HAPPEN • www.midpennbank.com
~ISTENlNG IS JUST THE EEGINNING.''
September 22, 2011
Charles Dunlevey
313 W Green St
Shiremanstown, PA i 70 i 1
Dear Ivir. Dunlevey,
RE: Mary R. Dunievey, deceased August 28, 2011
In response to your recent inquiry concerning the accounts .maintained in the name of
the decedent that were held joint with you, please be advised that the following accounts were
open at the date of death:
Checking #3624-56609
Date of death balance $2,001.83, opened 8/20/10,
joint with Charles DLmlevey
DATE OF DEATH ACC
CD# BALANCE INT RATE OPEN ROLL OVER MAT 8/20!13
348-0371841 $24,720.98 X16.04 2.96% 8/20/10
* Joint with Charles Di,-nlevey
If you have any other questions, please feel free to contact me at (717) 327-2497.
Sincerely,
~~~
,.
Joshua A. Groff
Credit Confirmation Processor
1.$(}O.FiJLT4N.4 fultonbank.com
FuEtor~ Sank CJA. A3ember FDK. Me~nt>zr cf the Fukon Financial Family.
SAVINGS ACCOUNT:
Account NumberlSuffix
Date Account Established
Principal Balance at Date of Death
Accrued interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
CERTIFICATES OF DEPOSIT: 238636-41
Account Number/Suffix 04/15/2009
Date Account Established
Principal Balance at Date of Death $16,716.89
Accrued interest to Date of Death $15.33
732.22
$16
Total Principal and Accrued interest ,
Charles Dunievey
Name of Joint Owner
Date Joint Ownership Established
04115(2009
CERTIFICATES OF DEPOSIT:
Account Nun-ber(Suffix
Date Account Established
principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
238636-66
12(1212003
$25.Ofl
$.00
$25.00
Charles Dunievey
12/12!2003
238630-4fi
06!2812010
$17,297.86
$20.35
$17.318.21
Charles Dunievey
06/28/2010
CER'f1FICATES OF DEPOSIT: 238630-47
Account Number/Suffix 02/22/2011
Date Account Established
prinapaf Balance at t?ate of Death $10,069.89
Accrued interest to Date of Death $11 84
081.73
$10
Total Principal and Accrued Interest ,
Charles Dunievey
Name of Joint Owner
Date Joint Ownership Established py22(2011
GERTtFICATES OF DEPOSIT:
Account Number/Suffix
Date Account Established
principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
07(1912010`
$7,339.42
$8.83
$7,348.05
Charles Dunievey
04!18/2009
*Rollover from Certificate of deposit 238630-42, original4y established 04118/2009.
MEMBERS 1ST FEDERALCR/E~DITUNION
~"'"
LeigVJ e StallingC~~
Lending Insurance Support. Specialist
September 19, 2011
Estate of: Mary R. Dunievey
Date of Death: 68128(2011
Social Security Number: 166-149832
5000 Louise Drive P.O. Box ~0 I~iect~anicsl~ur~, PeFirls~-lvania 1 1055 • (800) 2$3-2328 u-u=u:memberslstorg
PSEC~
Mr. Charles Dunlevey
313 W. Green St
Shiremanstown, PA 170 1 1-6522
Re: Mary R. Dunlevey, Deceased.
Account-# 0156149832
Dear Mr. Dunlevey:
October 4, 2011
The account was opened on November 25, 1986. The Share accounts were held jointly by Marv R. and
Charles Dunlevey.
The Visa loan was he{d jointly by Mary R. and Charles Dunlevey.
The following are the Date of Death Balances for Ms. Dunlevey's account with PSECU:
Account Date of Death Balances Interest -August l -28
Savin (S1) $ 356.99 $
$ 0.11
31
0
Check n
g (S4) $ 1,136.75 $ .
24
0
Money Market (S7) $ 68.08 $ .
23
4
Certificate S50
( ) $ 12,523.44
$ .
44
96
Certificate (S51) $ 13,023.32 $ .
44
55
Certificate S~3
( ) $ 16,060.11 $ .
68
209
Certificate (S59) $ 60,740.93
$ .
28
8
Certificate S60
( ) $ 5,396.11 .
Loans:
Visa Loan (L9) $ 0.00
The Certificates were moved to the joint account held by Charles Dunlevey and Judy Souleret per your
instructions. unleven~Social Security deposit of September Iy2011k n the amount of $ ]s,183 22 weas
to Charles D y
returned.
The account is closed.
If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237-7328, then
press 6, extension 3120.
S' cerely,
Rox$nn Myers r
Service Advisor
Pennsylvania State Employees Credit Union
1 Credit Union Place, P.O. Box 67013, Harrisburg, PA 17106-7D13 - 800,237.7328 • »pSeCU.com
THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION. EQUAL OPPORTUNITY LENDER.