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HomeMy WebLinkAbout02-14-12 Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 Cog ~y ~~'3~-l ~;f 1 ~f~o t o o'~o~ ~ ~`~ ~ Decedent's Last Name Suffix Decedent's First Name MI 5 T R ~} S 8 +4 U C~ N +~ ~ R 3-o R 1 ~ ~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 1505610101 ~ REV-1500 ex `°'-'°' PA Department of Revenue pennsylvanta Bureau of Individual Taxes oEP, E~f ~~pjNHERITANCE TAX RETURN PO BOX z8o6o1 RESIDENT DECEDENT Harrisburg PA 1'7128-o6oi ENTER DECEDENT INFORMATION BELOW Spouses Social Security Number FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return First line of address I ~ S~FOEf'~~}K'~R ~~¢N£ Second line of address THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS OFFICIAL USE ONLY , County Code Year File Numher 2 I ' • ~ ~L~~1f ..~d~ ~ 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 O 5. Federal Estate Tax Return Reqwred death after 12-12-82) O 8. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number.... R T~ ~or~-~ S-~~A58~ u ~N ~ t ~ ~G~ I,a t ~ City or Post Office ~1 E c t~ >'4 N ~sgvR~ ~, r t~ -a ~, ti ~-j'': ~' r-r-I State ZIP Code ~ P ~ ( 7 DSD 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. - SIGI~IATUR; OF PEf~ON ~~PON~IBLE FCC FILING RETURN DAT~/~/~ A ~a~ES5~0eMAKer Ln V /"/f'c ~an1cSD~fG 1'~`I' ~`T~.sd - SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 1505610105 REV-1500 EX Decedent's Name: kr(0 P' I e? RECAPITULATION Decedent's Social Security Number 1. Real Estate (ScheduleA) .......................................... ... 1. ' - ~ ~ 9 ~ ~ • ~ ~' 2. Stocks and Bonds (Schedule B) .................................... ... 2. s "/ ~ 3 • ~_~ 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) p Separate Billing Requested .... ... 6. • } 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property ;~ -•° :.~ (Schedule G) p Separate Billing Requested..... ... 7. ~ $ (~ ~ 7 ~ j`~ 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. ..; • -w ..; ~ SpZ S 3 ~ ~ S,j 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. ~ O ~ U ~ i ~ 3 10. Debts of Decedent, Mortgage Liabilities, and liens (Schedule I) ........... ... 10. _.:. ti,. ~ t~ ~ ~ ~~ ~~~->_~g 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. .t z 3 ~ (~ g 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. LI SSA f L f 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which v,.. .. . ~ - ~=' - .... an election to tax has not been made (Schedule J) ...................... .. 13. ~ - 14. Net Value Subject to Taz (Line 12 minus Line 13) ...................... .. 14. :< - : ~: f ~ ~, ~~~~' 1.~ TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0- . 15 16. Amount of Line 14 taxable ~ at lineal rate X .0 ~ ~ ( ~ y . 5 s„ ~ 4 . 16. ~ .. x . , ~,•r,~,~ ~, ~ ;~ -~, ~. ~ S ~ +--~ ~ c{ ~ g 17. Amount of Line 14 taxable ~~3r y~'„' ,nc'•• -a ~ $~r~ ~• at sibling rate X .12 r, 17. t 18. Amount of Line 14 taxable ~~' ~> •.€~^~ •°=~~~~~*~ ~,~ ,~~ at collateral rate X .15 ~ 18 19. TAX DUE ....................................................... .. 19. Sa~~-f'O y}~F 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610105 150561D105 O REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME ,~/~ , I Gtt e r \ e f'7 . 5~~ `j ~~v --- - -- 5--- __ - -- --- --~- ----- -_ - - STREETADDRESS ~M- ---------t_-- CITY Y \e C ~Q (~ \ ~ S 9v fZ~ -- _ _ - STATF~~ ' ZIP ~ ~O s~-- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments ___ B. Discount Total Credits (A + B) (2) 3. Interest (3) 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) 5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) j , a ~{(~ , ~-~ 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 .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ 2. 1f death occurred after Dec. 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. '-'+ ~~i,~.°~.c~ +~ yit~~`r~+~'~`: +'-,~ "~f~~.: '.~:":~~'~'~~-. ~.r;"-~f`~`~. ~~. ~~ ~'~ ..F'n~ ~1'h~'` _.. 2.:~ ..... "~'~4R~:s ~. ~~-.(h'. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still app{icable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116{a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHED~ILE A REAL ESTATE ESTATE OF FILE NUMBER 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, both having reasonable knowledge of the relevant facts. (It more space is needed, insert additional sheets of the same size) Cumberland County Tax Reassessment Value Lookup:Details Page 1 of 1 Detailed Results for Parcel 19-23-0567-125. in the 2010 Reassessment Database Municipality: 19 -MECHANICSBURG 4TH WRD Property Type: R School District: 6 -MECHANICSBU RG SD OWner: STRASBAUGH, MAR]ORIE A Parcel ID: 19-23-0567-125. CG StatUS; HOUSe 218 Taxable Status: Taxable Property Number; Street: W ALLEN STREET O!d Assessed -Land: Zoooo New Assessed -Land; 25000 Old Assessed -Buildings: 520~o New Assessed -Buildings; 8a9oo O!d Assessed °° Total: ~ZO~o New Assessed -Total: 109900 O!d CG Assessed -Land: NOT New CG Assessed -Land: NOT OId CG Assessed - NeW CG Assessed - APPLICABLE Buildings: APPLICABLE Buildings: Old CG Assessed -Total: New CG Assessed -Total; http://ccweb.ccpa.net/tax_lookup/Details.aspx?pid=19-23-0567-125. 1/9/2011 REV-1503 EX+ (6-98) SCFIEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. 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' °' r o' ~ W ~i~ co ~ a x _~ a^~ c N ~ ~ ~c3 ro3i~°' OD O N c °_: o ~~ a '~ ~ ~ ~ Q C W C c d ~ G ' Q g 7 ~, 3 d C N n ~' D 'ems n~ ~. p c, 3 ~ ~ (Q fp w? m~ C ".N 9~0~ a S p ? ~, ~ ~ O 3 ~ ~. ~, tp O ~ C a p x o m a Q C D n n C Z -+ x N rn rn Z n r O rn v mi'v A o ~ y~ ._{ ~ m w ~oAO~ ~ ~ ~ tD N ~ O N o N O x x~~ _ . ~~ ~~ m s m m w D ~ D_ CrncDrl~ ° ~ _ ^ Za o° ~ 3 n ~ ~ p 7 Dp ~~Dtn ~ w~a ~O m ~ N~ D f'p0 ~ 2~ ZQ D C °' ~ 3 m N x 0 w O ~ N X ~ ~ v+ ~ v °' o ~ ~~ W N N ; Q ~ ~yo~$,3 3Zt7 ~' m ~ v, g ~ 7m o .. p-~ -I ~~~++{ ~ x ~ y ^'» 7 • D ~ Q ~~o~~?~,>c~~i ~ '~ ~ 7 O O 7 W .Z a g m m d~ ~ 3 a n ~ z O ~~• ~. :z ~`~~~n ~ o ~ ~ ~ v ~ n• " O C N 'G m N ~ ~. ° ~ ~~ ~ tii NW 7p1 ill q Oo O_O 0~~ ~ I ~~ ~ I ~ -I <n to ~ ~ ~ x ~ ~ m 0 w t o m~ g W ~~ ~ x i~ i I ~ c~ p 7 ~ ^^ ` ~ ~~N a ~ !T o ~ ~ A PI d gj ~ m O ~ fl. Z ~. n p O N N ~ N N ~ m ~ n ~ ~ (D ~. /~ 1 N > ~ ? ' a~ ~~ ~ 3. N N ~ Z ~ c~ ~ _ ~ o; n N fC ~ '•~ ~ M ~~; I 3 !~^ ~ g ~q o NC ~ , I ~m 3 ~ ~ IND ~ I ~ ~ ~ N O ~ ~ 3 I I N ~ ~ ~ ~ rn QI ~ I ~ -i _ ~ , ~ $ Ti ~ a i ii ~ O~ H : L (A i O w,~~,_ WII~~'~~I~N~~~~ (~ Ol N lD Z eD 0 c W m m '~ O n m fD a N S m f7 7S' ~' d n m a O Z O REV~1508 EX + (t-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (Yl~' on e ~ . ~ -bras FILE NUMBER ~1- lo- l1~7 Include the procee of litigation and the date the proceeds were ived by the estate. All propeRy jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~~~a? ~11F'/~ole-{' L-4Jq I ~"er Co~~.~ 07 c(~r ~{~/~ yam. ~ ~` PNC h~~~ t~e~~4~r•~ ~CCOunT ~~~~~~~ Q~ L hlir~k Suvc•1~ S QCCa~~n 1 .~ (~ ~f~3. ~ ~~ 3, TOTAL (Also enter on line 5, Recapitulation) I $ ~~ D 7 $ ~ (n (If more space is needed, insert additional sheets of the same size) Total Banking Statement ~a PNCB,AI'~1K For tit. p~rbd lvoai~o,la to ~zrasr~o~a For 24-hour information, sign on to PNC Bank Online Banking EST OF MARJORIE A STRASBAUGH DECD on pnc.com. Primary account number: 50-7008-7204 Account number: 50-7008-7204 -continued Page 3 of 6 SAY~Dg$ A6`COlil~lillt ~ilfi1n111iitty Est Of Marjorie A Strasbaugh Decd Account number: 50-3002-9296 R Timothy Strasbattgh Extr Overdraft Protection Provided By: Contaot PNC to establish awerdraft Protaotion Balance Summary Beginning Deposits and Checks and other Ending balance other additions deductions balance -- 1,4x,3.17 ~- .00 1,453.1.7 .00 Average monthly Charges balance and fees 1,23?.99 .(~ Interest Summary As of 12/06, a total of $.58 in interest was _. paid this year. Annual Percentage Number of days Average collected Interest Paid Yield Earned (APYE) in interest period balahce for APYE this period 0.007. 2 8 1,453.17 .00 ACtl~tlitty Derts11~ -- -- - -- Online and ~ectranic Banking. Deductions There was 1 Online or Electronic Banking Date Amount Description Deduction totaling $1,453.17. 1?/U2 1,453.1.7 TrausferToAcr.ouut (>n(X~05070087204 Other Deductions Date Amount Description ]?/02 .00 Outsta~uding Item Close Daily Balance Detail Date Balance pate Balance 11; t>4 1,4xi3.17 12/0 .00 There was 1 Other Deduction totaling $.oo. DAIf1RA1 Tf1 ~- If1D79700 IAl1 AIAI!\IAIAIAI !1119 r1AAAA4 Tatal Banking Statement For 24-hour information, sign on to PNC Bank Online Banking on pnc.com. Account number: 50-700&fi2ll4 -continued For rite. p.rbd 41/esntioi@ to 1~/06J2A1A EST OF MARJORIE A STRASBAUGH DECD Primary acxoun# numtter: 50-7008-7204 Page2of6 Tir~saalion Samnnaey Checks paid/ Check Card POS Check CaM/Bankcard withdrawals signed transactions POS PIN trensections 13 0 0 Total ATM PNC Bank Other Bank transactions ATM transactions ATM transactions 0 0 0 Mpotil#ls and Olhw Addiligns There were 6 Deposits and Other Additions Date Amount Description totaling ~8,~9.811. 11/19 72.78 Maker Deceased Return Ck 000000000003614 ...,..._-„~_w,~.,,........ .. E,,~'fec.k,tve1.1-18-10 11/30 572.62 Direct Deposit -Annuitant PA Treasury Dept X5519 12/01 884.55 Direct Deposit -Civil. Serv US Treasury 312 F 2231114 W CSF 12/02 1,453.17 Transfer From Sub. Account 0000005030029296 12/02 17.00 Deposit Reference No 522797640 12/03 489.79 Direct Deposit - Paymenk Pruco Life. Of Az E0249191 ti:b~dcs and Substtilh~ts Chawics Check Date Reference Check Date Reference number Amount paid number number Amount paid number 3583 290.00 11/08 5R1x7s15s 3607 15.00 11/24 5ROY75796 3595 * 50.00 11/23 o84<t4seas 3608 111.33 11/10 o8ssX8oRS 3596 20.00 11/04 580599915 9611 * 37.50 11/15 084589868 3601 * 64.00 1,1/08 5R127sxao 3613 * 50.40 11/17 ossRios&t 3603 * 292.00 11/08 oa5sR751s 3614 72.78 it/18 oassloas4 3605 * 42.38 11/09 oss781887 3615 312.67 11/12 58Y&s8854 3606 35.84 11/12 os41o55ss 3616 27.36 12/06 oa5a79s7s " Gap in check sequence There were 14 checks listed totsling ~1,~1 Z~. Qr11b1~- ~d ®sa4teonic Bin11m1g DAduolions There were 4 Online orElectronic:Banking D d di t t I' ~1'608.3l1' Data Amount Description e u OnS o a Ing _.._._.1~~~ _:~.Y_ _.. .~.._~~ _.261.49 PaY-nent,E-Check Check PYn!t_..__..~,._._.__. _._ .__._. _.~..._~.___._.~._ __w__. _.__ . . _... .._ __---__.._.__.__w.~ ___ ._.._ ._ .._ __.___ Fia Cardservices 3610 11/12 17.35 Payment,E-Check Utll Pmt UGI Utllities 3609 11/15 342.00 Payrnent,E-Check Checkpaymt Hsbc Credit Svc2 3604 12/06 884.55 Direct Payment -Reversal US Treasury 312 F 2231114 W CSF ~blf~, ~dNOt'~~s There. was 1 Other Deduction totaling Data Amount Description ~•@0• 12/06 2.00 Check Images In Statement Fee Qa>Iti1,y ~Iltas pitail Date. Balance 11/04 4,32.00 Oate 11/12 Balance 2,604.94 Date 11/19 Balance 2,175.04 Oats 12/01 Balance 3,567.21 11/08 3,386.00 -•~.-11/15 2,225.44 "'~' 11/23 2,125.04 12/02 .5,03.7.38 11/09 x,949.62 11/17 2,175.04 11/24 2,110.04 12/03 5,52'7.17 11/10 , 2,970.80 11/18 2,102.26 11/30 2,682.66 12/06 4,613.26 ~nr~r~~as~~ 2002 Cher=tc~let Cavalier -Private Pnrt}~ Pricing Repot - l~elhey flue Book " belle Blue c THE TRl~STED RESUURCE kbb.ceni adv_~. _~~n~~~~_,.r PROG~t . rta£. UVe hake it easy t+o ~~'', compare rates and save. '~ .~ 2002 Chevrolet Cavalier Coupe 2D BLUE BOOKS PRIVATE PARTY VALUE ri ~~~y,{,;,;,,; .. .... Condition IttpwllAtY •Mlbl~ Nki Value -i'~ Exceller*t + ~}. ~q 'q }~ $4, f l.t ~ •~ Good $4,440 (Selected) Vehicle Highlights Mileage: 15,600 Engine: 4-Cyl, 2.2 Liter Transmission: Automatic Drivetrain: FWD Selected Equipment Standard Air Conc+ C ..rnn~ i 11t Wheel CD (5n ula~ Uist! P-wet ~,~ ir.~ AP41Fh, St reo Dual Ai B-ig<: Blue Book Private Party Value Kelley Blue Book Private Party Vatue is the amount a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than any remaining factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive fair Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings ~xCetl~nt ~4, :J9o a .lu ifi r, r, ~rjy P.U~K 3nC o .. arch tv~ll pa;~ , ;mod a ir, jr~t ~ ,peC~i;c ~. 6 :nt ; clear,. a i cc + i ...~ .. , i ~ - - - x'rvi:-~ nrd~. _r t~4i a!tt,~ ehic `e~lr..~ Page 1 of 2 Send to Printer __ , , Enter ZIP Code _ _ http : //www. kbb. com/used-cars/chevroletfcavalier/2002/private-party-valuelpricing-report?... 1 /23!2011 REV-1510 EX + 11-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTANDTHEDATEOFTRANSFER. ATTACH ACOPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IFAPPLICABLE TAXABLE VALUE ,. ~ ~;~c~ z~J~s~~e ~~- a ~, X67, sa r~1~; ~gi ~ a7,~ TOTAL (Also enter on line 7, Recapitulation) $ oL gf (9 67 S~? (If more space is needed, insert additional sheets of the same size) r Pruco Life insurance Oompany V~ V V V~lT~JaJ V .. A Pruden#iaf company Wachovla Bank National Association ', PrudeMlal Aanufty Services Savannah, GA 31401 64-975 P.O. Box 13888 612 Philadetphla, PA 19176 Strate i c Partners Basic contracttdo, E024 191 Pay: i >F>t>'c&>t>t>F~tiu w - H 0 A D HUNDRED E' DEG 10 2010 ~~~ 2 p].5 I ~~>ti~e~~c~~~~~>e>~~cn~~c>rs~~e~~>ti>e>F~t>•e>F~r>~>r>'c>ti~tgND 52/IDO ~~LLARS To th® PleaSe cash within 180 days Dotlais Cents c?rderot: R48£RT TIMOTHY STRASBAUGH, EX£G~~~~~~k>~*>ti f`XECk1tOR ESTATE OF ESTATE OF MARJORf E 5T ~~"~` 12 SHOEMAKER LANE tF+~~sua~R MECHANiCSBURG PA 17050-1557 corrnat.~E'~ ___..:. ._.._._,__ _._ .___':.__...._..._~.._._. _:::_ "_...~~!uecNFl~YF@~LLi#5@it?GIt:~~R.C~44~~i1~BR_6GQ1S1.. ....."...... ,_.~.~~_:_ _. _._...._.w._ ...:,_____. _. ._.__... _. ._.:_.._. __.... _"_ .._".. ..__._.. ~i'3 7 308 54 3 36i~' ~:06LZ09756i:20?9900087880ii' REV-1511 EX+ (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNED~ILE N FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT _ A. FUNERAL EXPENSES: 1. f~alPe~~t ~~~~~ ~ ~-~e 5'log`~.os ~~r~we~5 i ~e c~D~-;c,.t I e'I'c . j ~ ~7, a~ / B. 1 2. 3. 4. 5. 6. ~. ~~ Q. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City Year(s) Commission Paid: -State Zip ____ __ Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees V2u~~ pS~a`I e r'1G~tcY /1ew'SPaPPr C~..n-~y hc. ~ cue ~+~ Fate I sto ~-i fe PraPe~~~ ~Perz,~-;~, L ~sTf ~T 7. So - Zip it S3~,S0 ~ 50. ~ ~ v~ y~ 75 TOTAL (Also enter on line 9, Recapitulation) I $ ~Q ~~~, (If more space is needed, insert additional sheets of the same size) ~ Y 'f ' ~ { t 1~ T x _ __ rC > P. P. ~ ~ . _. r' ~ l~ ! 30.7 ~' __ .._ ~a I ~ ~7r. r~`i. rat ~ ~. ~ ~ , ~~~ /l' ~' ~J a ,. _. _ . ~. / ~ (~ ~ P _ L ~ ~~ °~ ~ '~` ~' ' 3 ;~ Il3 V~~~-~ ~a~~~- P~4- zip ~ _ _ _ _ ,~ /o.~~- _...__,_- __ ;M'" a~+Y~i "...~ ,~Zl, ~ 71777 _ ~ I ~r~~~ptea:_ 'F :,r~lM __ ~. i l ~~~. ~!.'` 11.5 1~'~r-i-~c-~.. ,~ ~ ~~- j 'R .. . t a E . __ .._ , ~~ . T~_ 5~,~ q~; ~ ~; ~~ 1 ~ -_ _ _. ~... _ _.~. > '' Spa ~. ~~t ~ r~~s ~ ~ 5, _" ~~-~ . __ ~__ . _.. _ ~~1 ~ ~~~`~i ~ ~t~S~ ~~,.~~C.. c~F~J~7~ _ _. .. ~ / P~a'_ _ _ ._ ~.. ~'"'~` __ __ r .i~ r~~-; ~. C~ ; ~~ 3 f ~ t' l~. ~ 3 :._. _ dad f ~_ . _ P, P. ~. H~ a ..... ...__. .. ~3, e~ __ . 9 _,.. _ . - 3 e s~ b -~ ~ 1 1, ~~~ . ;. ~' ^~~i, ~~ ^5 A ~"'~ :tip -,~ ~, y~. ~~` ~~~ ;~ ~~ ~- ~, ~~ ~P~ _ _ ___ __ ,`i, l ,, _. ___ _ __ __ ~pp t ~ rt ~~ ~ z`r _ _ _ ~~ _ _ _._ _ L_~ - ~~ ,,. (. ~- ~, .> ,~', ; ~~ t //'' //,' I ~ ~ ~. tl ^~. ~7~t ..~. ~ ~ I~W-vTM~c~ ,J''~'~4ci~tlag'' ,;~ Z 17~~d1A~~ ~~',f~,G~c~ ~ _ d t~ ~,,o"I ~~'~ ~ ~vn~ ~a ~ ~ ~~ ~ ~~~o ~~ d'~ j ,,trc r ,. _, ~~.. ,, _ __ _ ,~~~ _ _ : . _ __ t ~ _. _ _ _ __ . _ __ __ _ . _. _ _ _ p .. ., _ . _._~~-.. .m ._._- s~h ~~ ~ ~~? D~ °~ ~ ° ~~ s., i ~. '~ 1 ~,; T~-~~ ~: ; ~;' - . , `~ 1 ~, i z ~ -' S..-_. _ r- _ ~ r ~ _ ~~ ~~ .,., f , __. ~~„ ~ • . a' f .. •,. .. ,~+~ ;; ~ r'P~% ~~ f't.r~tnt ~~~ r~ // ~- °~ ~, >. , i ,_ 1. f -- hl: ., ~,. / } . _... ,~ r , a ;~ t' a~ ~~ l t= ~" 5 r ', ... _ ~ ~ ~.. ,, I t~~ ~ . ~- • a ~~~~~ _ a: ,~, ~' Tin L- z`tT._.._~~ ~,~_, ,~ ;~ ~~_ /H1 eE r~~ r~.wa~t: ,~l "~ ~ ~ .y'~ ,.r ~~~ ~~~~~ r i.' ~~~ !, n,. ,~ c, _. _.. ~. ., 1'~~, ~' ~'.F r ,, /,,~~~ :~'r ~' ~ ~ „. r t ~, , . ,~c?fit -..., ~J'i~~ I~ r (l. ~~ 1 __ _____.. __ _ .. ___ _ ~o~'~ _._~_ `~ __ ~ I ~ ~b ~~! ,~3, a ~o~, &~~ e ~"~ ~~, ~ ,i~ ~, '~ ,1 „r~ e ~ fi> REV-1512 EX+ (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN DEBTS OF DECEDENT] MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH t. AA ~} ,F~n~h~,~,l IS3. 00 ,~ . ,F3ar~~e (~ free 5~,-,r;~e 5 3~ D . as 3: Co~,~ to s~- Ca ~Ie ~'t'o, 5'6 ~. V~ t~u~ene X(; ~-M~ret S,T t ~_D.~ (? C. °Z4`~.CsO ~~ P;~nkcle N-eAl~-t. ~ted~`cal Ser~~'~es >U~~ ?, ~ P. C , E (~ c ~r-; c (~~--~ C : +; e 5 Corp o ~ ~- ~ cM !p G, ~ ~ ~. S~'R~'e Ev+~tP(or+~e~f RfJ'~t'f~wt,eh"~ Sy S1reM I 3Gi~~fO ~. r-I~sP,~~i ~~ 1y SP; ~-.°~ ~a..so l1. I~QSP n1c~,~ C. L radon ~ ~ - D, / D. DO 1,~. U , C--. ,i. /~{. ~ 3 r 3. M.1,~ ~ ~ n P (~ 5 ~~e ~ ~ ,~' ~u t~~ 179 ~ v0 I~. f}t4A ~'~~~cikl Se r'~tice S ~~$'aa, ~l r l~ ~516L ~a~SeC'viceS ~'~Gya3 ~ '~. ~ r ~ n a r ~ ~ F~e ~ ~-~-~ ~td ~^c<< ~ Se r~i `ce S ~ ~. ~ TOTAL (Also enter on line 10, Recapitulation) $ I ~~~~~. -> (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCI~IEDt~LE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 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) (1.2)] 1. 1 R ,~a1u~r~~, STraS~a./~^ S~ ,1 ~.~°~o lo? S1,~e,,~c~ke~Ln. r"le ~~a/~:c5~v ~ ~ Pro 17f75U ,?, i'1; c~.ec,l R. rrle I o~ $o,~ o?SIb Q~ I'7f75U t~ec~wn~c5j.it-~ 3. ' Rv~j;n F~e~rY Da~~>,•er o2.Sy~ X4'1 ~4~-v?C evt~ Cr'y', 2k Pl~rFa f ~~ a6k~!(o ~f. Lo tq ~ e f~laYarc ~Jc~rlk k-!~'er o7S~~ SI ycf L i mewc^o~ Sfi, ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) - l0-//~7 ~..ast mill and Testament 2o~a Nov 24 P~ 2= o~ ~~ ORR~ S ~OURT MARJUR~E A. STRASBAUGH CUMR~R~ ~t,Jn Cp , pq I, Marjorie A. Strasbaugh, of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this to be my Last Will and Testament and hereby revoke all other Wills and Codicils; if any, that I have made. FIRST.• I direct that all my just debts and the expenses of my last illness and funeral shall be paid from the assets of mp estate as soon as practicable after my decease. I authorize my personal representative to expend funds from my estate, in such amounts, as my personal representative shall consider necessary and desirable, for the disposition of my rem~inc in accordance with the instructions I have provided to my Executor/Executrix. SECOND: I give, devise, and bequeath till of my residence at 218 W. Allen Street, Mechanicsburg, Pennsylvania to my son, R TIMOTHY STRASBAUGH, of Silver Springs Township, Cumberland County, Pennsylvania. THIRD: All of the remainder of my Estate, of whatever nature and wherever situate, I give, devise, and bequeath to my son, R TIMOTHY STRASBAUGH, so long as he shall survive me by thirty (30) days. Should my son predecease me or should he for any reason fail to take under this, my Last Will and Testament, then I give, devise, and bequeath all the rest, residue, and remainder of my Estate, of whatever nature and wherever situate, to mp daughter-in-law, GLENDA FARMER-STRASBAUGH. m;,;,~ M 0.s FOURThT.• All interests of any beneficiary in the income or principal of this Estate, while undistributed and in the possession of my Executor, even though vested and distributable, shall not be subject to attachment, execution or sequestration £or any debt, contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. FIFTH.• All inheritance, estate, and succession taxes (including interest and any penalties thereon) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. SIXTH.• I nominate, constitute, and appoint nay son, R 'TIlvIOTHY SIRASBAUGH, as Executor of this, my Last Will and Testament In the event of the renunciation, death, resignation, or inability of. my son, R TIMOTHY STRASBAUGH, to act for whatever reason in this capacity, then I nominate, constitute, and appoint my daughter-in-law, GLENDA FARNER- STRASBAUGH, as Executrix of this, my Last Will and Testament I direct that no representative named above shall be requited to post security for the faithful performance of his/her duties in any jurisdiction insofar as I am able by law to relieve him/her of such obligation. Any of my representatives shall be entitled to reasonable compensation for the performance of the duties set forth here. IN `WITNESS ilP1YEREOF, I have hereunto set my hand and seal this ~ *~' day of h eyemb~.< , 2010, on this, the second of two typewritten pages. . MAR A. STRASBAUGH COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I,. MARJORIE A. STRASBAUGH, Testatrix, whose name is signed to the attached instrument, having been duly qualified according to law, do hereby aclmowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ., MARJO A. STRASBAUGH Sworn or affirmed to and subscribed before me by MARJORIE A. STRASBAUGH, the Testatrix, this day of,~~~~, 2010. NOTARY NGTAF:':. SEAL Marjorie ~. WE~ai=~ ~ N~tar~ Public Carlfs-e.Boro., ~um,,erfand County IMS' COMI4fISS10N E~CAIRES A; ri, 05, 2014 SIGNED, PUBLISHED, and DECLAREDby the Testatrix, ~~~~-ec~~ A• JyT0~1~~'1 J as her Last Will and Testament, in the presence of us, who at her request, in her presence, and is the presence of each other, have hereunto subscribed our names as witnesses. C©~N~~ m~C~~},Qo f~/Y~~T~J•9- LE NG z > S `~~ 2Qh i ~ (-~ ~n r ~ ~ ~- Pa-~-ux~h~ ~~ ~ a P (a ~--a tt~c ~ Zo~4~ AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We C°~/YiE" m~~~~-R~ and ~pb i n ~J - the witnesses whose names are signed to the attached instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that MARJORIE A. STRASBAUGH executed it as her free and vohmtary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that, to the best of our knowledge, the Testatrix was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence. Co !~ ~" ~ U Sworn or affirmed to and subscribed before me by ~ and _ tai ~~ ,witnesses, this ~ day of ~ 2010. NOT PUBLiC COMMONWE= . •~ OF ., ~-k:YLVANIA NOTARIAL EAL Marjorie A. Wevodau - Notary Public Carlisle Bao., ~umberl.nd County Mr COMMISSION EI(PIR~: „: n. 05, 2014