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HomeMy WebLinkAbout08-15-12J 1505610105 REV-1500 EX (oz-a) (Fq g ~y( PA Department of Revenue pennsylvanid OFFICIAL USE ONLY Bureau of Individual Taxes ~~"~'~"~~~~INHERITANCETAXRETURN Po e County Code Year FleNumber ox z8o6ot _ Harrisbum, PA t7ta8-0601 RESIDENT DECEDENT 2 ! !2 OdO ~ ENTER DECEDENT INFORMATION BELOW ' Social Security Numher Date of Death MMDDYYYY Date of Birth MMDOYYYY 11/12/2011 01/01/1936 Decedent's Last Name Suffx Decedent's First Name MI FITZPATRICK MARJORIE A (tt 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 APPROPRUITE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death O 4. Limited Estate O Prior to 12-13-82) 4a. Future Interest Compromise (date of O 5. Federel Estate Tax Retum Required tleath after 12-12-82) 1~ 6. Decedent Died Testate O (Attach Copy of Will) 7. Decedent Maintainetl a Living Trust B. Total Number of Sate Deposit Boxes (Attach Copy of Trust.) O 9. Litigation Proceetls 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 Schetlufe O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number THOMAS E. FLOWER (717) 243-5513 First Line o(Address FLOWER LAW, LLC Second Line of Address 10 W. HIGH ST City or Post Office CARLISLE State ZIP Code PA 17013 REGISTER O~ILLS USE ONLY' ~~ r.s `til =R..; }:.. c ~_ - V _ ~ ~ C)O t, - ~~ ©:.- DA p O { :? CJ7 C? ~;~ _a -~ L..; r r.., ;J r;=? f 1 ;...-i `r t 'rt ~_ Correspondent's e-mail address: TOm(DFIDWeM1Law.COm Under penakies 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 coned and complete. Declara[lon of preperer other than the personal representative is based on ail information of which preparer has any knowksdge. S NAT R F P O PON E FOR FILING RETURN GATE ADD s 08/15/2012 J N H. KLIN R, A, 1156 WALNUT BOTTOM ROAD, SUITE #2, CARLISLE, PA 17015-9130 SI A / OF PRE~B,F,$.97y1[R THAN REPRESENTATIVE ~-~( ~ i DATE ~_ rn to ADDR s 08/14/2012 FLOWER LAW, LLC, 10 W. HIGH ST., CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 15D561U105 J ~~~ 1505610205 REV-1500 EX (FI) Decede~t•s Name: MARJORIE A. FITZPATRICK RECAPRULATION 1. Real Estate (Schedule A) ............................................. t 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporatioq Partnership or Sole-Proprietorship (Schedule C) ..... 3, 75,000.00 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) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Pro ert 47,080.31 (Schedule G) P Y O Separate Billing Requested.... .... 7. - - -- _.,... 14,425.31 8. Total Gross Assets (total Lines 1 through 7) ...... 6. 138,505.62 9 Fune l E . ra xpenses and Administrative Costs (Schedule H) ............... .... 9. 37,072.91 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ........... 11. Total Deductions (total Lines 9 and 10) .............................. 12. Net Value of Estate (Line 8 minus Line 11) ...... 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ..................... 14. Net Value SubJect to Tax (Line 12 minus Line 13) .. ......... TAX CALCULATION -SEE INST .... 10. ... 11.. 12 ... 13. 1a 26,009.44 63,082.35 73,423.27 1,500.00 71,923.27 RUCTIONS FOR APPLICABLE RATES 15. Amount of Line i4 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ i6. Amount of Line 14 taxable - 15. at lineal rate X.O_ 17. Amount of Line 14 taxable - - -- - 16. at sibling rate X .12 71,923.27 17 18. Amount of Line 14 taxable - - - at collateral rate X .15 18. 19. TAX DUE ..... .... ................ ~............. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 1505610205 Side 2 O 1505610205 J 8,630.79 8,830.79 REV-1500 EX (FI) Page 3 Decedent's Complete Address: MARJORIE A. FITZPATRICK STREETADDRESS 1017 N. PITT ST. CITY.. CARLISLE Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CredifsrPayments A. Prior Payments B. Dismount 3. Interest 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Flle Number STATE PA ZIP `__ 17013 (1) 8,630.79 Total Credits (A + 8) (2) (3) 0.00 (4) 0.00 (5) 8,630.79 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS .,r .; 1. Did decedent make a transfer and: a. retain the use or income of the property transferred ................................... No b. retain the dght to designate who shall use the ro ~~~~~~~~~~~~~~~~~~~~~~"~~~""~~"'~"'~"" ^ P Party transfened or its inmome ............................................ ^ . c. retain a reversionary interest .............................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death ^ ^ without receiving adequate monsideration? .............................................................................................................. ^ 3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? .............. ^ ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which ^ contains a beneficiary designation? ........................................................................................................................ ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, For dates of death on or after July 1, 1994, and before Jan. i, 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. i, 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)j. 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)j. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)j. • underaSect on 9102a s anhndividual who has at least one parent necommon w th the delcelldentl whetercby blood or adopho(n.)(13)]. Asibling is defined, REV-1502 EX+ (11-08) ~' Pennsylvania SCHEDULE A DEPggTMENT OF REVENUE iNHERRANCE TAx RETURN REAL ESTATE RESIDENT DECEDEM ESTATE OF MARJORIE A. FITZPATRICK FILE NUMBER 21-12-0004 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 pace at which property would he 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. NUMBER Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE DESCRIPTION OF DEATH 1' SMALL DWELLING HOUSE ON 0.18 ACRE, Borough of Carlisle, Cumberland County Tax parcel 06-19-1641-137, CONTRACT SALES PRICE, settlement on or before 10/31/2012 75,000.00 TOTAL (Also enter on Line 1, Recapitulation.) I; 75,000.00 If more space is needed, insert additional sheets of the same size. REV-i5a8 FX+ (n-1D) ~ Pennsylvania DEPARTMENT OF gEVENUE INHERtTANCE TAX RETURN RESIDENT DECEDENT ca~n~c vr: MARJORIE A. FITZPATRICK Include the All orooertr t, SCHEDULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ids of litigation and the date the proceeds were received by the estate. owned with right of survivorship must be disclosed en Schedule F. 1 . SOVEREIGN BANK CHECKING ACCT. N0. 1671000196 of oeA7rl 2. SOVEREIGN BANK SAVINGS CERTIFICATE N0. 1675202517 17,971.12 3. SOVEREIGN BANK SAVINGS CERTIFICATE NO. 1675202616 1,278.68 4. SOVEREIGN BANK SAVINGS CERTIFICATE N0. 1675203077 1,147.03 5. SOVEREIGN BANK SAVINGS CERTIFICATE NO. 1675203481 1,123.88 6. SOVEREIGN BANK SAVINGS CERTIFICATE N0. 1675205163 1,373.21 7. SOVEREIGN BANK SAVINGS CERTIFICATE N0. 1675206501 1 227 57 8. SOVEREIGN BANK SAVINGS CERTIFICATE NO. 1675205619 1,142.78 9. SOVEREIGN BANK SAVINGS CERTIFICATE N0. 1675489510 1,193.63 10. SOVEREIGN BANK SAVINGS CERTIFICATE N0.3385102060 1,133.97 11. HOUSEHOLD FURNITURE, FURNISHINGS AND EFFECTS, AUCTION PROCEEDS 1,492.29 12. INSURANCE SETTLEMENT FOR TOTAL VEHICLE DAMAGES 4,158.50 13. JEWELRY SALE PROCEEDS 10,892.00 14. MISCELLANEOUS REFUNDS 119'24 15. 2011 FEDERAL INCOME TAX REFUND 778.41 2,048.00 FILE NUMBER: 21-12-0004 70TAL (Also enter on Line 5, Recapitulation) ~ 47,080.31 If more space is needed, use additional sheets of paper of the same size. Sovereign Court Ordered Processing \ Decedents - MA]-MB3-02-10 - P. O. Box 841005 -Boston, MA 02284 ~ January 18, 2012 3 B a John H. Klinger ~' Klinger & Associates, P.C. 1$ 1156 Walnut Bottom Rd., Suite 2 Carlisle, PA 17015 a RE: Estate of Marjorie A Fitzpatrick Date of Death: 11/12/2011 Dear Mr. Klinger: Per your request, enclosed please find the account information. as of the date of death for the above-named decedent. For your information, accrued: interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance:: ~/ery truly y~lurs, Donna Lead 17-y114-5189 Sovereign Bank ESTATE OF Marjorie A. Fitzpatrick SOCIAL SECURITY #: 022-30-1744 DATE OF DEATH: November 12, 2011 Account #: 1671000196 Type: Checking Open date: 11/21/2000 In the name of: Marjorie A. Fitzpatrick Date of Death Balance: $17,971.07 Int.(PTD) from 1/1/2011 to 11/3/2011 $1.76 Accrued interest to date of death: $0.05 Otherlnfo: Account Closed 01/11/2012 Account #: 1675202517 Type: _ In the f Time Deposit Open date: 2/3/1998 name o : Marjorie A. Fitzpatrick Date of Death Balance: $1,279.65 Int.(YTD) from 1/1/2011 to 10/31/2011 $0 53 Accrued i t . n erest to date of death: $0.03 Otherlnfo: Account Closed 01/11/2012 Account #: 1675202616 Type: In the n f M Time Deposit Open date: 4/3/1998 ame o : arjorie A. Fitzpatrick Date of Death Balance: $1,147.01 Ink(YTD) from 1/1/2011 to 10/31/2011 $0 48 Accrued i t . n erest to date of death: $0.02 Other Info: Account Closed 01/11/2012 Accouut #: 1675203077 Type: _ Time Deposit Open date: 2/16/1999 In the name of: Marjorie A. Fitzpatrick Date of Death Balance: $1,123.86 Int.(YTD) from 1/1/2011 to 10/31/2011 _ $0.46 Accrued interest to date of death: $0.02 Other info: Account Closed 01/11/2012 Account #: 1675203481. Type: _ Time Deposit Open date: 8/17/1999 In the name of: Marjorie A. Fitzpatrick Date of Death Balance: Int.(I'1'D) from 1/1/2011 to Accrued interest to date of death: _ Otherlnfo: Account Closed 01/11/2012 l,3 /3.US 10/31/2011 $0.16 $5.64 Page 1 of 2 Sovereign Bank ESTATE OF Mazjorie A. Fitzpatrick SOCIAL SECURITY #: 022-30-1744 DATE OF DEATH: November 12, 2011 Account #: 1675205163 Type: Time Deposit Open date: 4/4/1995 I n the name of: MarJone A. Fitzpatrick Date of Death Balance: Int.(YT'D) from 1/1/2011 to _ Accrued interest to date of death: _ Otherlnfo: Account Closed 01/11/2012 Account #: 1675205601 Type: Time Deposit Open date: 7/2/1997 In the name of: Marjorie A. Fitzpatrick Date of Death Balance: $1,142.75 Int.(YTD) from 1/1/2011 to 10/31/2011 $0.47 Accrued interest to date of death: $0.03 Otherlnfo: Account Closed 01/11/2012 Account #: 1.675205619 •- Type: Time Deposit Open date: 9/2[1997 In the name of: Marjorie A. Fitzpatrick Date of Death Balance: $1,193.61. Int.(YTD) from 1/1/2011 to 10/31/2011 $0.51 Accrued interest to date of death: $0.02 Otherlnfo: Account Closed 01/11/2012 Account #: 16754895 ] 0 Type: In the name of: Marjorie A. Fitzpatrick Time Deposit Open date: 6/3/2004 Date of Death Balance: $1,133.95 Int.(YTD) from 1/1/2011 to 10/31/2011 $0.47 Accrued interest to date of death: $0.02 Otherlnfo: Account Closed 01/11/2012 Account #: 3385102060 Type: Time Deposit Open date: 8/5/1998 In the name of: Marjorie A. Fitzpatrick Date of Death Balance: $1,492.12 Int.(YT'D) from 1/1/2011 to 10/31/2011 8637 Accrued interest to date of death: $0,17 Otherlnfo: Account Closed 01/11/2012 $0.02 $0.51 1,227.55 10/31/2011 Page 2 of 2 EZGN BANK 6436-CFS 6017 BOX 12fi9fi FADING PA 19612- 2696 FEDERAL ID NUMBER : 23-1237295 DIRECT INQUIRIES TO: B]7-768-2265 1 MARSORIE A FITZ PATRICK YOUR TA% PAYER 1017 N PITT ST CARLISLE PA 1]013-1427 L D. NUMBER: 022-30-17 44 TAX YEAR 2011 FORM 1099-INT SOVEREIGN PREFERRED CHECKING 16]O1000196MBER BRANCH INTEREST BOX 1) 00167 1.92 6-7 MONTH CD ACCOUNT STATUS: ACTIVE 16]520251] 00167 6-7 MONTH CD ACCOUNT STATUS: ACTIVE 0.64 16]5202616 00167 6-7 MONTH CD ACCOUNT STATUS: ACTIVE 0.58 167520307] 00167 0 12 MONTN CD ACCOUNT STATUS: ACTIVE .56 1675203481 00167 fi-7 MONTH CD ACCOUNT STATUS: ACTIVE 6.33 1675205163 OOlfi7 6-7 MONTN CD ACCOUNT STATUS: ACTIVE 0.61 16]5205601 00167 6-7 HONTH CD ACCOUNT STATUS: ACTIVE 0.57 1675205619 00167 6-7 MONTH CO ACCOUNT STATUS: ACTIVE 0.61 16]5989510 0016] 12 MONTH CD ACCOUNT STATUS: ACTIVE 0.56 33B51020fi0 00289 ACCOUNT STATUS: ACTIVE 7.12 TOTAL INTEREST INCOME NOT INCLUDED IN BO X 3 TOTAL INTEREST ON U.S. SAVINGS BONDS ET C )BOX 1) : 19.50 , .., .TOTAL 1099-INT REPORTED TO THE IRS (BOXES 1'AND 3) 0.00 : 19.50 REV-].510 EX+ (08-09) " ~ Pennsylvania SCHEDULE G DEPAPTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERRANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDEM DECEDEM __. _._ ESTATE OF FILE NUMBER MARJORIE A. FITZPATRICK 21-12-004 This schedule must be completed and hied if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY mauoE T1E Nnnf amE mu+srEREE, nrDR anAnoNSRiP To DEaoENr nNo Tr~wn: ar TPM6FFR. aTrroiacnPV OP n1E OLEO wa AEAE ESrarE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION it MRICemE TAXABLE VALUE 1. TIAA annuity No. Y909774.55, payable to decedent's brothers Michael P. 5,516.88 100 0.00 5,516.8! Fitzpatrick and G. Patrick Fitzpatrick (see schedule J far addresses) 2 CREF annuity No. 2909774-3, payable to decedent's brothers Michael P. 8,908.43 100 0.00 8,908.4: Fihpatdck and G. Patrick Fitzpatrick (see schedule J for addresses) TOTAL (Also enter on Line 7, Recapitulation) $ 14,425.31 If more space is needed, use additional sheets of paper of the same size. SUBSTITUTE FORM 712 This statement has been prepared as a substitute for U.S Treasury Department .Form 712 which does not apply to our annuity contracts or certificates since they have no life insurance features. Name of FYrat Annuitant Marjorie Fitzpatrick Date of Birth Dak arDeatn 01/01/1937 11/12/2011 Name of Decedent Marjorie Fitzpatrick Date of Birth Daa of Deatn 01/01/1937 11/12/2011 VALUE OF CONTRACT/CERTIFICATE AT DECEDENT'S DEATH Notes: The Federal Estate Tax Value (Date of Death Value) of an annuity at death is what it would cost the surviving annuitant or beneficiary to replace the continuing benefits. The value is calculated as of the date of death and therefore does not change. The value does not represent the cash entitlement a beneficiary is due and is used solely for estate tax purposes. TIAA-CREF follows accepted industry standards and procedures in determining the value of payout annuities for the estate of a deceased annuitant. The Remaining Investment in the Contract/Certificate represents any remaining after-tax contributions in the Contract or Certificate owned by the annuitant. The Remaining Investment in the Contract/Certificate isnon-taxable to the surviving annuitant or beneficiary when it is paid. THE UNDERSIGNED MANAGER OF TIAA-CREF HEREBY CERTIFIES THAT THIS STATEMENT SETS FORTH CORRECT AND TRUE INFORMATION. 5'QJ~(j(,~Q /~RGft I May 29, 2012 REV-1511 EX+ (iD-09) ~~~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDEM DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MARJORIE A. FITZPATRICK 21-12-0004 Decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: I' Hoffman-Roth Funeral Home & Cremato Inc. -Traditional funeral service acka e ry~ P 9 4,650.OD z. Outer burial container 1,620.00 s. St. Patrick Catholic Church Cemetery 1,000.00 a. Honoraria: Clergy, Cantor, Organist, Altar Servers 535.00 5. Cadisle Memorial 215.00 s. Flowers 159.00 ~. Death Certificates & Obituaries and newspaper display, the Sentinel, the Patriot, Berkshire Eagle 2,060.50 B. ADMWISTRATIVE COSTS: 1. Personal Representative Commissions: 10,750.00 Name(s) of Personal Representative(s) JOhn H. Klinglef, CPA street address _1156 Walnut Bottom Rd,_Suite 2 city Carlisle state PA ztP 17015 _ Year(s) Commission Paid: t0 be paid In 2012 Z Attorney Fees: 7,500.00 ;• Family Exemption: ([f decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP _ _. Relationship of Claimantto Decedent 4. Probate Fees: 323.50 5• Accountant Frees: B. Tax Retum Preparer Fees: 350.00 ~• PUBLISH ESTATE NOTICES, THE SENTINEL (189.54), CUMB. LAW JOURNAL (75) 264.50 8. SHORT CERTIFICATES 16.00 s. TAX RETURN FILING FEE 15.00 ~D. MICHAEL & REBECCA KLINE COSTS FOR WAKE , 500.00 >> ROWE'S AUCTION, COMMISSION AND TRANSPORT COSTS SALE OF PERSONAL PROPERTY , 1,490.47 ~2. CONTINUATION SHEET TOTAL 5,623.94 TOTAL (Also enter on Line 9, Recapitulation) $ 37,072.91 If more space is needed, use additional sheets of paper of the same size SCHEDULE H ADMINISTRATION EXPENSES, CONTINUED ESTATE OF FILE NUMBER MARJORIE A. FITZPATRICK 21-12-0004 12.a. UPS, shipping costs b. House Cleaning Service c. Sovereign Bank, d.o.d. statement fee d. Classic Cleaners, Laundry expense e. Lawn Service f. Water, Sewer & Electric utilities g. Heating fuel h. CenturyLink i. Home Owner's Insurance premiums J. Wells Fargo Home Mortgage, interest payments k. County/Local Real Estate Tax 12. Continuation Sheet Total: 667.50 80.00 20.00 863.15 245.00 336.99 575.85 72.90 1,016.39 1,291.58 454.58 5,623.94 FUNERAL HOME 6t CREMATORY, INC. 219 North twnover Sheet Caitsle, PenmlMarda 17013 717.243.4511 toll free 1.866.451.4511 fax 117.243.3723 vv,wahdfirivroth.mrm hk>~trnaYOm.oom February 18, 2012 Michael Fitzpatrick John H. Klinger, CPA 1156 Walnut Bottom Road, Suite 2 Carlisle, PA 17015 Statement of Funeral Expenses for: Marjorie A. Fitzpatrick Date of Death: November 12, 2011 Account Id: 16380-241 PACKAGE: Traditional Funeral Service TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,650.00 Sub Total: S 4,650.00 MERCHANDISE: Outer Container: Monticello $ 1,620.00 Sub Total: $ 1,820.00 TOTAL FUNERAL HOME CHARGES: S 6,270.00 CASH ADVANCES: St. Patrick Catholic Church Cemetery $ 1,000.00 15 Certified Death Certificates at $ 6.00 each $ 90.00 Newspaper Notice -Sentinel $ 486.70 Newspaper Notice -Patriot $ 165.52 Clergy $ 250.00 Flowers $ 159.00 Berkshire Eagle $ 462.00 Patriot Display $ 826,28 Cantor $ 75.00 Organist $ 150.00 Altar Servers $ 80.00 Add'1 DC's $ 30.00 Carlisle Memorial $ 215.00 Sub Total: $ 3,989 50 Total Payments Made: $ 2,981.72 Payments Made: FDLIC Check 181398 Feb 18, 2012 2,981.72 Balance: S 7.257.78 Please return this potion with your Remittance. $ Amount Enclosed Marlorle A. Fttzpatrick SERVING OUR COMMUNITY $ I N C E 1 9 0 7 REV-1512 E%+ (12-0&) ~ pennsylvania DEVARTMENT OF REVENUE INHERRANCE TA% RETURN RESIDEM DECEDEM SCHEDULE I DEBTS OP DECEDENT, MORTGAGE LIABILITIES 8E LIENS ESTATE OF FILE NUMBER MARJORIE A. FITZPATRICK 21-12-0004 °-•- -.••~• ~_ ~~====w ~~~>_~~ nuwuona~ sneers or me same size. REV-1513 EX+ (Ol-SO) ~ ' Pennsylvania DEPARTMENT OF gEVENUE INHERRANCE TAX RETURN RESIDEM DKEDFNT SCHEDULE 7 BENEFICIARIES ESTATE OF: FILE NUMBER: MARJORIE A. FITZPATRICK 21-12-0004 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 G. Patrick Fitzpatrick, 2 Bernard Gibbons Dr. #108, Great Barrington, MA brother 1/2 2. Michael P. Fitzpatrick, 123 East Street, Great Barrington, MA 01230 brother 1 /2 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER BECKON 9113 FOR WHICH AN ELECRON TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. St. Patdck Catholic Church, 152 E. Pomfret St., Carlisle, PA 17013 2. Project S.H.A.R.E., 5 N. Orange St., Carlisle, PA 17013 3. College of Our Lady of the Elms, 291 Springfield St., Chicopee, MA 01013 TOTAL OFPART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~ ]f more space is needed, use additional sheets of paper of the same size. 500. 500 500 1, 500 07/15/08 LAST WILL AND TESTAMENT OF MARJORIE A. FITZPATRICK C~Oo P~7 I, MARJORIE A. FITZPATRICK, of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I am to be buried in the cemetery easement I have purchased at ST. PATRICK'S new cemetery in North Middletown Township, Cumberland County, Pennsylvania, Lot No. 331: My^stone monument has already been erected and needs only the date of death to be inscribed. THIRD: I hereby make the following specific bequests: A. I give the sum of Five Hundred ($500.00) Dollars to ST. PATRICK'S CATHOLIC CHURCH, of 152 East Pomfret Street, Carlisle, Pennsylvania. B. I give the sum of Five Hundred ($500.00) Dollars to PROJECT S.H.A.R.E., of 5 North Orange Street, Carlisle, Pennsylvania. C. I give the sum of Five Hundred ($500.00) Dollars to the CLASS OF 'S7 MEMORIAL SCHOLARSHIP, COLLEGE OF OUR LADY OF THE ELMS, of 291 Springfield Street, Chicopee, Massachusetts 01013. D. I give the sum of Five Hundred ($500.00) Dollars to MICHAEL B. KLINE and REBECCA R. KLINE, of 121 Conway Street, Carlisle, Pennsylvania, to help them pay for hosting a traditional "Irish Wake" in my memory, preferably within one month after my death, as I have discussed with them. If they no longer live in the greater Carlisle area at that time, or are otherwise unwilling or unable to conduct such a Wake, this bequest shall lapse. FOURTH: I have prepared and provided to my attorney, a list of certain items of personal property which I wish to be given to certain friends. I request that my Executor honor this list as though it were a part of my Will. I reserve the right to amend that list at any time, and should I have prepared a later list of personal property to go to certain friends, the later list shall supersede the list I have earlier provided to my attorney, as well as any intervening lists. FIFTH: I wish my sister-in-law, ELAINE A. FITZPATRICK, to have any clothing that she wishes and to dispose of my `Arizona Parks" sweatshirt in accordance with my list of personal property. All of my remaining clothing and all bed linens in good condition are to be offered to PROJECT S.H.A.R.E. or to the CARLISLE SALVATION ARMY, or some to each. SIXTH: I wish my brothers, G. PATRICK FITZPATRICK and MICHAEL P. FITZPATRICK and MICHAEL'S wife, ELAINE A. FITZPATRICK, to be permitted to go through my home and remove any items of personal property which any 2 of them desires, with the exception of the items in my list of personal property gifts or items otherwise disposed of in this Will. I would particularly like them to remove and preserve the slides arranged in many carousels and all of the scrapbooks in my basement, any personal photos found any where in the house, and all contents of the small metal rack beside the chest of drawers just inside my bedroom door. (These consist mostly of published articles written by me or papers I delivered at professional meetings, and the Jerusalem Bible given to me for Christmas by my Father shortly after my Mother's death.) My brothers may wish, but need not feel obligated, to offer a few of my better slides to GEORGE P. KIRTLEY, brother of BETSY, my deceased friend and constant traveling companion for almost fifty years. There are other items of personal but no great monetary value among my possessions, some of which are souvenirs of my many travels and others are items of sentimental value given to me or bought by me, many of which are assigned to friends and relatives in accordance with my list of personal property gifts. Contact information for the intended recipients of said personal properly may be found in my address book, a small black and calf covered book to be found on the top shelf of the wooden bookcase in the southwest corner of the dining nook in the extension off my kitchen. SEVENTH: I have several items of property of financial value which I would like to be sold, the proceeds to be added to my estate. I direct that my house and land at 1017 North Pitt Street, Carlisle, Pennsylvania, be sold, and the net proceeds added to my estate. 3 EIGHTH: I own a Wurlitzer piano and bench, which is in my living room. I direct that this piano and bench be sold, probably most profitably to a piano dealer, such as Reisinger's or Menchey's Music, and that the proceeds be added to my estate. NINTH: I have a number of items of silver, including eleven complete place settings of Towle sterling silver in the "Chippendale Pattern'; some additional sterling silver "Chippendale" pieces and a number of other sterling or sliver plate pieces. I have a silver plate napkin ring engraved "Mary'; which was part of a set of napkin rings made and engraved in our childhood for myself and each of my siblings. `Mary" was our sister, deceased in infancy. This napkin ring should go to either of my brothers to keep in the family. I direct that the remaining silver be sold, perhaps to a reputable Carlisle Antique deafer, with the proceeds to be added to my estate. I direct that any automobile which I own as of my death be sold and the proceeds become part of my estate. TENTH: All the rest, residue and remainder of my estate shall be paid to my brother, G. PATRICK FITZPATRICK, of 2 Bernard Gibbons Drive, Apartment 108, Great Barrington, Massachusetts 01230, and my brother, MICHAEL P. FITZPATRICK, of 123 East Street, Great Barrington, Massachusetts 01230, in equal shares. If my brother, ` MICHAEL P: FITZPATRICK, predeceases me;i direct that his share of my estate be paid to his wife, ELAINE A. FITZPATRICK. If both MICHAEL P. FITZPATRICK and ELAINE A. FITZPATRICK predecease me, I direct that the share intended for my brother, MICHAEL P. FITZPATRICK, be paid to his children, MICHAEL P. FITZPATRICK, JR. and MATTHEW J. FITZPATRICK, in equal shares, per stirpes. If my brother, G. PATRICK FITZPATRICK, predeceases me, I direct that his share of my estate be paid to 4 his children, KEVIN J. FITZPATRICK and AMY (FITZPATRICK) McMEEKIN, in equal shares, per stripes. LASTLY: I nominate, constitute and appoint JOHN H. KLINGLER, C.P.A., of 550 Harvest Lane, Mechanicsburg, Pennsylvania 17055, to be the Executor of this my Last Will and Testament. Should JOHN H. KLINGLER be unable or unwilling to serve as such, I appoint as my Executor, JOHN S. HENDERSON, of Drummore Acres, 555 Main Road, Phippsburg, Maine 04562-0044, to serve as Executor. No Executor shall be required to file bond in this or any otherjurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ a N.~ day of , 2008. rt} .u,,, i+~N. L ~'P. ; 1.z~'.`po h~t;r;COI , Marjorie A. Fitz, Patrick SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: 5 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I, MARJORIE A. FITZPATRICK, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged be ore me, by MARJORIE A. FITZPATRICK, the Testatrix, this aa~ day of , 2008. h' ~.~ r-au~y> `k, ' ~ war-~E, Marjorie A. Fitzpa rick, Testatrix 6 NOTARUIL SEAL MERLEIr~ J. MARHEYKA, NOTARY PUBLIC CARLISLE, CUMBERLAND COUNTY, PA MY COMMISSION EXPIRES JUNE 8, 2010 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We, ~,~ and ~ (~(khl , the witnes s whose names are sig to the attached foregoing instrument, being duly qual' red according to law, do depose and say th t we were present and saw Testatrix sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary 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 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by ~m,o p..~c,~,~„ _ and this d3 day of , 2008. ~,.. ~, ~- Witness Nota blic NOTARIAL SEAL MERLENE J. MARNEVKA, NOTARY PUBLIC CARLISLE, CUMBERLAND COUNIY, PA MY COMMISSION EXPIRES JUNE 8, 2010