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HomeMy WebLinkAbout05-31-12n ~, 1505610143 • J REV-1500 Ex(o,_,o, OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 60X.280601 INHERITANCE TAX RETURN 21 12 0020 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 188 12 5212 10 09 2011 05 25 1924 Decedent's Last Name Suffix Decedent's First Name MI MP,CPHERSON ANNA S (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 IN APPROPRIATE OVALS BELOW 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ~ qa. Future Interest Compromise (date of death after 12-12-82) ^ 5. Federal Estate Tax Return Required X g Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 6. Total Number of Safe De osit Boxes P ^ 9. Litigation Proceeds Received ^ 10. Spousal PovertyY Credit (dale of death between 12-31-yt and 1-1-95) ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JERRY A WEIGLE ESQUIRE 717 5~2 7388~~ ~' _ :a~ REGISTEILLS U ONI~Y~ ; ~~< r- ~."' C.~ _ _ First line of address =L' ` _. _ 'r. 12 6 EAST KING STREET c.~ ~~- ~.. Second line of address -`f ~ ~_~ ~.~? Cit or Post Office DATE FILED c'' Y State ZIP Code SHIPPENSBURG PA 17257 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN _DATE // /CL~L.t/ ,,,~'~i.2~./t,Q Mary Seavers ~ ~~ ADDRESS 416 Ma le Hill Avenue Shi a sbur PA 17257 SIG URE OF PREPARER OTHER THAN EPRE NT IVE DATE ~~ ~ ~~ Jerry A. Weigle Esquire ~ - ~ -~ ~. 126 East Kina Street. Shiupensburid. PA Side 1 1505610143 1505610143 J ~ ~~ 1" ~~ 1505610243 REV-1500 EX Decedent's Social Security Number oe~eder,c~SName: MacPherson, Anna S. 188 12 5212 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 63 , 32 9.54 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous coq Probate Property (Schedule G) u Separate Billing Requested............ 7. 8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 63 , 32 9.54 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 7 , 652 .25 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 16 , 3 8 8 . 8 0 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 24 , 041.05 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 3 9 , 2 8 8 . 4 9 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................... 13. 915.43 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. 3 8 , 3 7 3 . 0 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 . 0 0 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 0 0 0 16 0. 0 0 . at lineal rate X .045 . 17. Amount of Line 14 taxable 0 0 0 17 0. 0 0 . at sibling rate X .12 . 18. Amount of Line 14 taxable 3 8 3 7 3. 0 6 18. 5, 7 5 5. 9 6 , at collateral rate X .15 19. Tax Due .................................................................................................................. 19. 5, 7 5 5. 9 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^X Side 2 ],55610243 1505610243 ,REV-1500 EX Page 3 File Number 21-12-0020 Decedent's Complete Address: DECEDENT'S NAME MacPherson, Anna S. STREET ADDRESS Episcopal Home 206 East Burd Street CITY STATE ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 5,500.00 287.80 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund (1) Total Credits (A + B) (2) (3) (4) 5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Make Check Payable to: REGISTER OF WILLS, AGENT. 5,755.96 5,787.80 31.84 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 :............................................................................... ^ ^x 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? ............................................................ ^ ^x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^ ^x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ ^ contains a beneficiary designation? .................................................................................................................. x 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 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 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3)]. A sibling 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-1508 EX+ (6-98) m SCHEDULE E . CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MacPherson, Anna S. 21-12-0020 Include the proceeds of litigation and the date the proceeds were received by the estate . All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Blue Cross/Blue Shield -benefit check 169.02 2 Check on hand at date of death - HMA Physician Management refund 15.60 3 Claremont Nursing & Rehabilitation Center -refund 4,502.12 4 Claremont Nursing & Rehabilitation Center -refund 1,567.29 5 Fogelsanger-Bricker Funeral Home -refund 267,44 6 Highmark Blue Shield -benefit check 1,637.50 7 Highmark Blue Shield -benefit check 1,292.50 8 Highmark Blue Shield -benefit check 5.71 9 Highmark Blue Shield -benefit check 125.44 10 Highmark Blue Shield -benefit check 1,392.50 11 Highmark Blue Shield -benefit check 557.50 12 Highmark Blue Shield -benefit check 14.98 13 U. S. Treasury - 2011 federal income tax refund 1.513.22 14 M & T Bank Certificate of Deposit 14452063 3,731.56 Accrued interest on Item 14 through date of death 8.74 15 M & T Bank Checking Account 97370118 18,111.64 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 63,329.54 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) ~ Rev-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MacPhersoi Anna S. FILE NUMBER 21-12-0020 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY continued Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+(10-06) ~ ;h COM IN~ ERITANCEOT~ RETURN ANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF I FILE NUMBER MacPherson, Anna S. 21-12-0020 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Mary Seavers Street Address 416 Maple Hill Avenue City Shippensburg State PA zip 17257 Year(sl Commission Daid 2012 2, Attorney's Fees Weigle & Associates, P.C. 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 5. Accountant's Fees 6. Tax Return Preparer's Fees 3,166.00 3,916.00 145.50 7. Other Administrative Costs 424.75 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 7,652.25 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER MacPherson, Anna S. 21-12-0020 ITEM NUMBER DESCRIPTION AMOUNT Other Administrative Costs 1 Cumberland Law Journal -advertising Letters Testamentary 75.00 2 Linda K. Klein -notary fee 25.00 3 Ludwig's Jewelers -appraisal of diamond ring 50.00 4 News Chronicle -advertising Letters Testamentary 104,75 5 Register of Wills, Cumberland County -filing PA Inheritance Tax Return 15.00 6 Register of Wills, Cumberland County -filing Family Settlement Agreement 100.00 7 Weigle & Associates, P.C. -reimbursement for postage, xerox copies, and long distance 55.00 telephone calls H-B7 424.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) * Rev~512EX+(12.08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MacPherson, Anna S. 21-12-0020 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Alert Pharmacy Services 138.47 2 Alexander Springs Emergency Physicians 25.34 3 C V Neuro Consultants 30.00 4 Cardiology Diagnostic 2.25 5 Carlisle Regional Medical Center 849.13 6 Chambersburg Hospital 8.19 7 Chambersburg Imaging Associates 17.54 8 Cumberland Goodwill Fire Rescue EMS -insurance payments 3,130.00 9 Cumberland Goodwill Fire Rescue EMS -insurance payments 657.50 10 Cumberland Goodwill Fire Rescue EMS -insurance payments 1,392.50 11 M & T Bank Checking Account 97370118 -check outstanding at date of death to Claremont 8,960.00 Nursing & Rehabilitation Center 12 Milton S. Hershey Medical Center -hospital services 350.00 13 Milton S. Hershey Medical Center -hospital services 204.18 14 Milton S. Hershey Medical Center Physician Groups 48.94 15 Mobile X-Ray Imaging, Inc. 484.78 16 Mount Rock Inpatient Services 64.35 17 Quantum Imaging 15.14 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 10, Recapitulation) 16,388.80 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) ~ Rev-1512 EX+ (6-98) ~, SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF (FILE NUMBER MacPherson, Anna S. 21-12-0020 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-7.513 EX+ (11-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MacPherson, Anna S. ~ 21-12-00 20 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not ist Trustee s I TAXABLE DISTRIBUTIONS [include outright spousal . distributions, and transfers under Sec. 9116 a 1.2 1 Adam Barner Grand Nephew Prorated specific 4,569.26 709 Park Avenue bequest Baltimore, MD 21201 2 Susan Barner Niece Residuary 298 Grayland Road Mooresville, NC 28115 3 Zachary Barner Grand Nephew Prorated specific 4,569.26 443 West Baltimore Avenue bequest Media, PA 19063 4 Barbara Bottiglieri Henning Friend Prorated specific 4,569.26 175 Devon Road bequest Williamsburg, VA 23188 5 Jane Motter Niece Prorated specific 1,826.92 446 South Fayette Street bequest Shippensburg, PA 17257 See continuation schedule attached Continuation 22,838.36 Total 38,373.06 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 15 00 cover sheet, as a r o riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Saint Andrews Episcopal Church 915.43 206 East Burd Street Shippensburg, PA 17257 ID # 32-0338551 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETS 915.43 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Anna S. MacPherson 10109/2011 188-12-5212 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Margaret Seavers Sister-in-Law Prorated specific 4,569.26 410 Clifton Road bequest Shippensburg, PA 17257 7 Mary Seavers Sister-in-Law Prorated specific 18,269.10 416 Maple Hill Avenue bequest Shippensburg, PA 17257 Total 22.838.36 LAST WILL AND TES7'~4MENT ~~ ANNA S. MacPHERSON I, ANNA S. MacPHERSON, of Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish and declare this as and for my last will and testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment, owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefore funds from my estate, in such amount as my personal representative shall consider necessary and desirable, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. To mfr fries ids, EETS~ i~IEP and ~GI-11'~ STG1"~EER; 1 rig<e and bequeath my bedroom suite. To the niece of my iate husband, BERTE~A DEITY, 1 give and bequeath the matching drop-leave end tabies which her step-father trade for me. To Saint Andrewr's Episcopal Church, in Shippensburg, F~ennsylvania, 1 give and bequeath the sum of Gne Thousand Doiiars [~~,O~a]. To ADAM SARP~ER [the son of my niece, SUSA~J BARk~ER], 1 give and bequeath the sum of Five Thousand Dollars [~~,Q04]. To ZAGFIARY SAR~ER [the son of my niece, SUSAN BA,RI~EER], i give and bequeath the sum of Five Thousand Dollars ~~5,000]. To my niece, JANE ~fOTTER, i give and bequeath the sum of Tt~~o Thousand Doiiars To my sister-in-ia~ti~, 14~ARY SEAVERS,i give and bequeath the sum of T~~venty Thousand Dollars ~~20,Op~]. To my sister-in-fawn, i!/IARGI-FRET BEAVERS, i give and bequeath the sum of Five Thousand Dollars [$5,x00]. To my friend, I~ARBA,RA i3C3TTiC~i_iEsRi, i give and bequeath the sum of Five Thousand Dollars ~~5,000]. Should any of the foregoing persons not survive me, their gift shall lapse and pass as a park of rr~~< residuary estate as set forth beio~~'. Page 2 of 8 ~:• f `~aE, ~e4rise 3rsr~v' be~~ :nth all `,h~ rest, residue ~nE~' remainder of ~~f e~tat? unto ^s'lt,~ niece, ~~Sf~l`~ f~~~F~f~f=f~, per stirpes, provided she sha!! s!~rvi~fe me by si?.~#y (6~) da~rs, farther provided, ho~F~ever, that ~f she does riot su€v~ve me by s;a~ty (fig) days, the share ~~.~hich that she would have received is bequeathed to her issue. ~ f authorize my Executor to definer such articles to v~hich a minor may be entitled under ~' this testament to the guardian of the minor or to the person having custody of the minor, or to retain such property unfit an age at ~~hich my Executor considers it appropriate to deliver tl-re property to him or to her, provided ir? no event shall such property be retained by my Executor beyond the time the minor .attWins his or her n~a~ority. The receipt of such of the above enumerated persons as may be selacted to receive delivery of such property shall be a full and C~~ complete discharge to rr?y ~:ecutor. fn the evenf ;may Executor at any time decides it is desirable to sell any item or items of tangible personal property held hereunder for a minor, the proceeds of such sale or sales shall be delivered to the guardian of the property of the minor appointed in paragraph SfXT~f hereinafter to be held under the terms and conditions thereof. ~'~~.~ f direct that any and ,all Inheritance, Estate and Transfer Taxes imposed upon my estate passing under my trill or other`,~¢ise, shall be paid out of the principal of ray residuary estate. f='sce 3 of S FIFTH In addition to the powers conferred by law, I authorize my Executor, in his or her absolute discretion: (a) to retain in the form received, and to sell either at public or private sale any real or personal property; (b) to manage real estate; `` (c) to invest and reinvest in all forms of property without being confined to legal e investments, and without regard to the principle of diversification; ~ (d) to exercise any option or rights arising from ownership of investments; (e) to compromise claims without court approval, and without the consent of any beneficiary, and to abandon any property which, in my Executor's opinion, is of little or no value; (f) to file any state or federal income tax return for any year for which I have not filed such return prior to my death. srxTH My Executrix shall have the right to appoint a guardian of any property, including but not limited to all proceeds of insurance on my life, which passes to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so. In addition to the powers given by law, I authorize the guardian of the property: (a) to use such amounts of both income and principal as they in their sole discretion deem proper for the support, education and welfare of such minor without leave of any Court; (b) to invest in any property without leave of any Court; (c) to invest in any property without restriction to legal investments. Page 4 of 8 The guardian shall not be required to give bond orfurnish sureties in anyjurisdiction, and shall hold the property IN TRUST for the minor. I hereby direct majority to be defined as the age of twenty-one [211 and that no funds be turned over to the minor or adult until they attain the age of twenty-one [21j years. if my trustee, in its sole discretion, determines that it is desirable to do so, my trustee may end any trust under this deed. This maybe done by paying the then-remaining principal and income of that trust to the person then eligible to receive the income. If any person is a minor or is, in my trustee's opinion, disabled by illness or other cause and unable to properly manage the funds, my trustee may pay the funds to his or her guardian or to any person or organization taking care of the person. In the case of a minor, my trustee also may deposit the funds in an interest bearing account in the minor's name payable to the minor at majority, or appoint and pay the funds to a custodian for the minor under the Uniform Gifts to Minors Act of any state. My trustee shall have no further responsibility for funds so paid or deposited. I further direct my trustee distribute his or her share of the corpus and any accumulated earnings to the beneficiary upon the attainment of their majority. SEVENTH Any and all payment or payments of any sum or sums, whether in cash or in kind and whetherfor principal or income, payable to the said beneficiaries or any of them, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. All shares of principal and income herein given shall be free from anticipation, assignment, pledge, or obligations of any beneficiary, and shall not be sub- ject to any execution or attachment. Page 5 of 8 ~~ .~F.~ I i~E~~'nc t~, :frt~c~i~Pµfi° aE;~ru4 =n!nr~int r? F ~cAC ..tr ~rR E -Nt~ ~ ~~..«;r r,Y-~~tt, (E~.F.~~` ~~~~f~S, ~n~C~rl3: v~ EC...rL t ,,..!1C€rl. klE tif~ Ml~'~'€°i ~ ~f[.~ l-r["FE Fr yp. .::{. ( C~ Fed e f E ' ' `~~ s~t.6i~ ~~°~ ~ s~^T~ A bL. E ~Y i.ir E e~ c~i t, '' 4, rCvi.~i~C.c Ee'v r•I tsr ii i~ ~t-+.~eP C6.aei~cy to aot for any reason i~~hatsQe~~er oe m~~ said sister-an-la~r~r, I r~o~;n=te, oonst€t!.cte ano appoeE t n i~lF niece, S1~SAI~ BARI~EI~, Executrix of this my last will a. Ed testament. 6 hereby relieve my executor from the necessity of posting security in connection ~tfith the Executor's duties as such in any jurisdiction in which my ~>cecutor may be called upon to act insofar as I am able by law to do so. IIV ~,~~?I~fi'd~ES~'~~E-Ic~E~lr, i have hereunto set my hand and seal to fhis, my last wi11 and testarrtent, consisting of seven pages, the ~rst i~ve of which bear m}~ signature in the margin for the purpose of ider~tifcation this 19"' day of ~ecernber, 2004. Anna S. MacPherson Signed, sealed, published and declared by the abo~~e Warned Testatrix, Al~~r~ S. I'i>~:~cPC~EPS~I~, as and for her last rr~fili and testament, in the presence of us, who, in her sight and presence, and in the sight and presence. of each other, have hereunto subscribed our rarnes as witnesses. 9 Travis Avenue Shippensburg, PA 17257 Pd Box 51 Spring l~un, Pennsylvania 17262-0051 ,/ ,,. ~ r `Maine L. Sushma f0~ fox 51 Spring dun, Penn~y~(~tania 17262-0051 Page 6 of 6 ~~EtFE~~C~~~`~~`~~~.~_i_-€-i"i €~~ P'El~`~S~'L~~,-~FE~ ~~ ~~. P, ~.E-Ene S. ~~iacPherson, the testatrix ~~t~€ ease ns:rrEe is sigE-aed #a ire a.tec(~ed or foregoing instrurE~ent, having been duly guali~ied according to ia~tiA, do hereby ac~na~r~lledge filet signed end executed the instrumen# as my Lest t~~ili; end that E signed it v4Aillingly and es my free end voiunteny~ act for the purpE;ses therein expressed. Swann to ar affirrned end ackna~~r6edged before rr~e by Anna S. ti~iecPherson, the testatrix, this 19th day of 13ecernber, ~E7~~. ~.nna S~.~h~r-s~i~~~s~atrix ",P~ ~~/.ice/- ~_ ~i ~FE~~L.cl~`u~m"~n, fittarney admitted to the Bar of Pennsylvania ~~36~~1~] ~~-~ti~E~,~C~~V~~~LTFi ~P P~-~~S~L~~6~i~E~ ~~'.t~ITY ~~ FC~ECLIf~ .~S. ale, -=-~i~E L. BASE ~l~lAt~! and -~TH'~ ~,. S~EiTH, the ~~itnesses v~~E~ose names are signed to the attached or foregoing instrument, beEng duly t~ualafsed according to iaw, do depose and say that we were present and saw the testatrix sign and execute the instrument as her Last Vr{ill; that t~Ee testate-ix signed willingly and executed it as her free and voluntary Gct far the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the ~~~ii! as a witness; and that to the hest of eE,€r i~novtfiedge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue infiuence. Page 7 of 8 Sr~rarn to or ef~rr~ed end subscribed to before me by El~.lt~E i_. E~E.I~E~r~r~t~! and E~T'-fY ~z. ~F~~iTH, v~~itnesses, this i ~"' ctey of December, %~~~~. d '~ 6,S~C ~~\ Maine L. ~ushrnen, ~~ i~~.,,,s \ Riche'rd ~: Bushmen, ~,ttarney ~drnitted to the Bar of Pennsylvania ~#36~~~~ ~C7l~ll~~~~~Er~l_TH C)F PEl~ll'~lSl'~.~,46~1r~ ~C~E~IF~ETI' ®r FP.~1t~1~L1l~ ~~. r~ ~n this, the ~ day of December, 2ai74, before me, the undersigned officer, p~:rs~an_°~I~y appeared Pl~F~~RD ~. ~~Sl•-lPr~~:~, kr~a~n to me ar satisfactorily pro~ren to be a rrrerr~her ~f the bar of the highest court of Pennsylvania, end certified that he ~~ses personally present v,!hen the faregoing acl~novrledgrnent and affidavit E~fere signed by the testatrix end lr4J~tnesses. 6n v~~itrtess whereof, 1 hereto set m}~ hand and official seal. ~~ ~ I~CJT~iE~aL S~Fr4L ~eri~~l~. ~. E~~terson, Notary Public t~atary ~ubliC ~~rrn~t~'ro~n~hip, Franklin Counfiy (~;~ Col~trt~l~~fon Expires October 11, 2007 Page & or' 8 ©M&T~~~nk 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302) 934-2955 January 17, 2012 Weigle and Associates PC 126 East King Street Shippensburg, PA 17257 Re: Estate of Anna S MacPherson Social Security: 188-12-5212 Date of Death: October 9, 2011 Dear Sir or Madam: Per your inquiry on January 6, 2012, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 97370118 Ownership (Names o~ Anna S MacPherson Susan Bamer (POA) Elizabeth M Reip (POA) Mary E Seavers (POA) Opening Date 0128/08 Balance on Date of Death $18,111.64 Accrued Interest $ .02 Total ------------------------------------- $18,111.66 2. Type of Account Savings Account Account Number 15004214183664 Ownership (Names o, fl Anna S MacPherson Elizabeth M Reip (POA) Opening Date 01/11/07 Balance on Date of Death $28,166.70 Accrued Interest $ .06 Total --------------------------------------- $28,166.76 N r 3. Type of Account Certificate of Deposit Account Number 31003914452063 Ownership (Names ofl Anna S MacPherson Susan Barnet (POA) Elizabeth M Reip (POA) Mary E Seavers (POA) Opening Date 11/09/93 Balance on Date of Death $3, 731.56 Accrued Interest $ 8.74 Total $3,740.30 For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the Walnut Bottom Office at #717-532-2414. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement Sincerely, C~ Tammy Spencer Adjustment Services PRIGINATJ GCOSTCENTER „_,EMPLOYEENUMBER ,.'~ .- ~'"AUTHORIL ~ ~ 4`,_p ~` 'mil ~ ,7 G- ~ ~ I :~~ ~~ ~'q ~1i ~,. r_-t~ ~'c-.-. `--~ _ ,000UNI #(' + ? ~ f_ ) Y V' .'~ ` ',. ~. CUSTOMEf~jyIAME!(PRINT) iESCRIPTION: ~ PARTIAL WITHDRAWAL `r CLOSING WITHDRAWAL ` ~~~ :~~.~ 's )riginal -Processing Work - .._ ;opy -Branch CUSTOMER SIGNATURE: • ~,.~ ,,,.~ ,..` SEQ. NO. ..< y'~ ,-!, r^~.. fir. ~ 2 1 9 0 7 8 s ~~ w , , :~ ~ ,r ~ ~~r - - . r ~_ M&TBanlc GF-269(6/10) WIP TRANSACTION DEBT ORIGINATING COST CENTER EMPLOYEE NUMBER ~.., n •AUTHORIZATION DATE ~- r t CCC ~~ "' ~`f /a ^E' ~~ _ ti _ CCOUNT # -°°~ / F d. C TOM~Rq,NAME{PRINT) r-~-, y''\E"'1 ~ 5 ~- f~ ^y -+-3 }'-' Y~ ~ ^~~ i ~i / i ~i f~ it' ) ~ E ~~ I ;f'1 I I I I P~ ~ I F ~ ~~~._.. '-^'" ~ 1 4 S ,...1 i t r! ~` d fSCRIPTION: ~ PARTIAL WITHDRAWAL ~ CLOSING WITHDRAWAL USTOMER Ip~ ~ fi f'= 1.~._~...li tii~ ,-~, C C~*'^ `t ~;1C 7 4 .~` ~ '" ~.. )riginal -Processing Work E ' r' ;-; ~ , "~` f , , ,-. : ;opy -Branch CUSTOMER SIGNATUR ,` r .~ ~ ~. SEQ. NO. . , . . i .~,r..,,.m._.,.....r.-,. .~....~.. ..~-...,.m. R~,~._._-....~,..,~..-.,~. ~_ M&TBanlc GF-269(6/10) WIP TRANSACTION DEBIT OAIGINATING COST CENTER EMPLOYEE NUMBER AUTHORIZATdON DATE ,_ ~~ 'r -~ `~. s t. CCOUNT _.. .~. • .:.. ~ . ~ ;, i ::;^ _- -,"_ - ;' CUSTOMER NAMEJPRWT) '.. ~~ :.. _. i :. __ . _ ~ ... ` .. ESCRIPTION: ~ PARTIAL WITHDRAWAL ~3CLOSING WITHDRAWAL -_, - , -- -- ~ - - . ~.' . I,aTOMcR ID: P ~ r \v -'-'~ .t.., t41,, - j.. `,~~~'~ ~ ~. -ii .. `tea:..... (riginal -Processing Work - :opy -Branch CUSTOMER SIGNATURE: SEQ. NO. _ f ; _ 2 1 9 0 7 8 7 ~`},_ ~:. ', F;;i '~'~ ~ ~i ;~ `~ j t ~ ` '" f'`• r ~ "~`` i 121 South Main Street UD~~IIG JEWELERS S I N C E 1 8 7 7 Phone (717)264-7693 Chambersburg, PA 17201 Member, American Gem Society Ann Ludwig Wagner, Registered Jeweler Jane Ludwig Mentzer FAIR MARKET VALUE APPRAISAL The fair market value is an estimation of a price arrived at willingly by a buyer and a seller and not under duress. Because jewelry appraisal and evaluation is not a pure science and is therefore subjective, estimations of fair market value may vary from one appraiser to another and such a variance does not necessarily constitute error on the part of the appraiser. Mountings prohibit the full and accurate observation and grading of Diamonds. Therefore only a provisional grade will be given. The weights are estimations determined by formula based on available dimensions. If a Diamond is regraded or weighed unmounted the grades or weights may vary. ESTATE OF ANNA S. MAC PHERSON May 9, 2012 1. One lady's 14 karat yellow gold Diamond solitaire ring contains: 1- .36ct. Brilliant-cut Diamond Dia.- 4.5- 4.72mm. Depth- 2.8mm. Estimated Cutting- fair Color- I Provisional GIA Clarity- SI1 " The Diamond is set in a white gold round illusion head. The yellow gold shank is 2.Smm. wide. ESTIMATED FAIR MARKET VALUE-$250.00 ~.,,-~:: ~~:..:_ ~ ,.._ .,_ ., .. _. _~ _....._ ~:-_ . ~ 42492 ~c~INI ~EkREi~iONT fi9(1RSING & REHkB@ISkTI®N ~ENFER TRUST 1000 CLAREMONT ROAD 60-430/313 1 1/30/201 1 - CARLISLE, PA 17013-8820 PAY TO THE The Estate of Anna MacPherson **4,502.12 ~ ORDER OF $ Four Thousand Five Hundred Two and 12/100**************************************************** DOLLARS The Estate of Anna MacPherson ~ d~ VOID AF~E~O DAYS C/O Mary Seavers 416 Maple Hill Avenue Shippensburg, PA 17257 MEMO 5656 close PCA ^~ CLAREMONT NURSING & REHABILITATION CENTER The Estate of Anna MacPherson Date Type Reference 11/30/2011 Bill Anna MacPherson 5656 11/30/2011 Original Amt. Balance Due Discount 4,502.12 4,502.12 Check Amount .__. ~_ yP ~JP~O SFrG9~ ~~ .___ ~_ ~9FCL `JP ~0 5~ 42492 Payment 4,502.12 4,502.12 Checking 5656 close PCA 4,502.12 t -`~ '~ ~__LL_ 4 2 8 7 0 CLAREMONT NURSING & REHABILITATION CENTER 1000 CLAREMONT ROAD CARLISLE, PA 17013-8820 i=f~IV1 TRUST 60-430/313 3/20/2012 PAY TO THE The Estate of Anna MacPherson **1,567.29 ORDER OF One Thousand Five Hundred Sixty-Seven and 29/100*********************************************** DOLLARS The Estate of Anna MacPherson volD AFTER so DAYS ~ C/O Mary Seavers /~ ~f 416 Maple Hill Avenue `~~~,,,/~.~. ~'?~' -~ Q __~~~'~~--~.~ _ ~- ~° sE P~~ S Shippensburg, PA 17257 _ `'JP r f __ - Cw-_. ~~Z-~ ~ Er'G C . - - N MEMO C~ -~o,; L add'1 funds due to close PCA after final adj. _ F 11'04 28 7011' ~:0 3 L 30 ~+ 306e: L L~~~ ~8 ~,~ 511° CLAREMONT NURSING & REHABILITATION CENTER The Estate of Anna MacPherson Date Type Reference 3/20/2012 Bill Anna MacPherson Checking Original Amt. 1,567.29 add'1 funds due to close PCA after final adj. 42870 3/20/2012 Balance Due Discount Payment 1,567.29 1,567.29 Check Amount 1,567.29 1,567.29 ,~ Cry (.D ~~ . ~ ~ ~~ '~ H • ~; ti rn ~' (U ~. ~ O Cry tI; !~ ;~ ~' ~ t C F~ ~ I-, . ~ ~~ is~ - ~~ - t/. ~t F~ h ~] ( D N CD - C~ c't J I pt O p f~C ~+ ~ ~ w ~ n ~ ~ N ~ H ~ ~ M ~ e:s ~ , O C r ~ W ~U r ~ - j ~ W ib r ~ ~ .. r-~ fD -: ~~~ ~ ~ -° ~ ~ ~- ~ a D p ~ ' a:: 0 rt 300 ° N U N r ~ ~ `S'J~ t s T ~ :tl ... , ~ ON T