HomeMy WebLinkAbout10-15-12 (2)J 15D5610143
REV-1500 ~`~°,_,°,
PA Department of Revenue • OFFICIAL USE ONLY
pennsylvanfa Cwrny coae rasr Fib NumEer
8ureau of Individual Taxes ~µ*~a~
ao BOx.zaoaot INHERITANCE TAX RETURN Z 1 12 0152
Hamsbu~, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
198 24 1653 01 13 2012 11 30 1926
DecedenPs Last Name Suffix Decedent's First Nama MI
3HANDELMIER JEAN ~
(If Applicable) Enter Surviving Spouse's Informatlon Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH TME
REGISTER UF WILLS
MI
X^ 1. Orlginal Return ~ 2. Supplemenql Retum ~ 3. Remainder Retum (date of death
pdor to 12-13-82)
~ 4. Limited Estate ~ qa, Futuro Intereat Com~romise
(tlate W deeth after 2-12-821
^ g. Federal Estate Tax Ratum R uired
~
~ g, Decedent Died Teatats
(Attach Copy W 4Vilp ~ ~ p~t Memtg~ned e LivinQ Truet
( opy of 7N6q 1 8. Tot81 Numbef of SBfe De
pOSlt BOXBS
~ 9. Litigation Proceeda Received ~ 10. 'o~ P9~~1~~M~f ~!~~ ~h ^ 17. Electlon M tex under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT • THIS SECTION MUST BE COMPLETED. ALL CORR°SPONDENCE AND CONFIDENTIAL TAX INPORMATION SHOUI.D BE DIRECTED T0:
Name Daytime Telephone Number
EDMUND G MYERS (717) 61 45~
~ ~ ~
Flrst line of address
301 MARF~T STREET
Second line of address
PO B03C 10 9
City or Post OffiCe
I~i0~7E
State ZIP Code
PA 17043
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DATE FILED
CorreapondenYs e-mafl address: e9mG~ldsW.com
Under penalties of perjury, l dedare that I heve examined thfa ratum, including accompanying schedules and statemenffi, and to the beat of my knowledge and belief,
it is hue, correct and complete. DeGaration of preparer other tlian the person8l representatlve is based on all information of which preparer has any knowledge.
SIGNATURE F PERSON RE9PONSIBLE FOR IIING RE7URN DATE
~~'"^~~ ~}~ ~.r.-~-~-~ Susan Ann Lindsey l O~~~ 1/ a.
DRESS
935 Old Quaker Road. Etters, PA 17319
31G RE OF PREPARlE,R OTHER THAN REPRESENTATNE DATE
u ~"/~y,~ EDMUND G. MYERS /~ //1z/r ~/
301 MARKET STREET, Lemoyne, PA
Side 1
~ 150561D143 1505610143 J
~
J 15U5610243
REV-1500 EX
; DecedenPs Social Secufity Number
o°uae^ce Nei^a: SHANDELMIER~ .IEAN O 198 24 1653
RECAPITULATION
1. Real Estate (ScheduleA) ....................................................................................... 1. 119 ~ 6~0 . 00
2. Stodcs and eonds (Schedule B) ............................................................................. 2. 104 , 457 . 57
3. Cloaely Held Coryoration, Partnership or Sofe-Proprietorship (Schedule C)......... 3.
4. Mortgages $ Notes Receivable (Schedu~e D) ........................................................ 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedub E) ............... 5. 60 , 450 . 82
6. Jointly Owned Property (Schedule F) ^ Ssparate Billing Requested............ 6. 9, 2 72 _ 11
7. Inter-Vivos Transfers & Miscetlaneous ly nq Probate Property
(Schedufe G) ~ _~ Separate Billin9 Requeated............ 7. 24 6, 938 . 95
8. Total Groas Assets (total Lines 1-7) ..................................................................... 8. SQO ~ 719 . 45
9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 38 , 248 . 92
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 2~ 4 4 7. 4 9
t t. Total Deduetlons (total Lines 9& 10) ................................................................... 11. 4 0, 6 9 6. 41
12. Nat Value of Estate (Line 8 minus Line 11) .......................................................... 12. $OO , 023 . ~4
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............................................... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. 500 , 023 . 04
TAX COMPUTATIpN - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amou~t of ~ine 14 taxable
atthe spousaltax rate, or
transfers under Sec. 9116
(a)(1.2) X .00
15.
0 . 00
16. Amount of Line 14 ta~cable 4 90 0
at lineal rete x.045 ~ 23 . 04
t6.
22 ~ 051. 04
17. Amount of Line 14 taxable
at sibling rate X.12 0. 0 0 17. 0. 0 0
18. Amount of Line 14 taxable
atcollateralrateX.15 1~~~~~.0~ 18. l,$~~.0~
~e. rax Due .................................................................................................................. ~s. 23 ~ 551. 04
20. F~LL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ~
x
Side 2
L 1505610243
1505610243 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-12-0152
DECEDENT'S NAME
SHANDELMIER, JEAN O
STREETADDRESS
130 Hummel Avenue
~~N STATE ZIP
Lemoyne PA 17043
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Peyments
B. Discount
3. Interest
i7,000.00
894.T4
4. N Line 2 is greater than Line 1+ Line 3, e~ter the ditfarence. This is ihe OVERPAYMENT.
Check box 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.
Make
to: REGISTER OF
23,551.04
17,894.74
ts) 5,656.30
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCK3
1. Did decedent rpake a transter and: Yes No
a. retain the. uae or income of the property transferred :............................................................................... ^ x
b. retain the right to designate who shall use the property transferred or its income :.................................. z
c. retain a reversionary interest; or ............................................................................................................... x
d. receive the promisa for 1'rfe of either payments, benefits or care7 ............................................................ x
2. If death accurced after December 12, 7982, did decedent transfer property within one yaar of death without
receiving adequate consideratlon? .................................................................................................................... ^ ~
3. Did decedent own an "in trust fo~' or payable upon death bank account or security at his or her death?....... ^ Qx
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ~ ^
contains a beneficiary designation7 ..................................................................................................................
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 vatue of tra~sfers to or for the use of the surviving
apouse is 3 percent ~72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or atter 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
asssts and fl~ing s tax retum are still applicable even if the surviving spouse is the only beneficiary.
For detes of death on or after July t, 2000:
• The tax rate imposed on the net value of trenafers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptrve 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 decedenPs lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1I1•
. The tax rate imposed on the net value of transfers to or for the use of the decedenPs siblings is 12 percent [72 P.S. §9118 (a) (1.3) . A
sibling is defined under Section 9102, as an individual who has at least one parent i~ common with the decedent, whether by blo~ or adoption.
(U
Tofal Credits (A + B) (2)
(3)
(4)
P
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INHERRANCETA%RETURN
RE8IDEM DECEDEM
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
SHANDELMIER, JEAN O 27-12-0152
All ral ProMKY ovmed solsly w a~ a b~~nt fn conmon must W npoAad d fNr mnk~t valus. FaV markN value is defined e~ ths price at whkh properry would be
exdienpetl bshveen a wdlirp buyx wW a wi1Mq ealbr, neithx psirp cpnpellsd to buy ar eel~, bolh hav'mp reesona~b krqwladpe of tM rebaM fade.
. R~Y prop~rty whicA A Jointlyownad wiMNqht M survlvonhlP~at G tlf~elowd on ~cAedula F.
Attwh a eopy o1 th~ Ntdsnant ~he~! Neh~ propMty hu Msn sold
InNuds a copy M th~ tl~sa showinp dscWenY~ InMat H ownaa u MnaM tn com~wn.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate located a~t 130 Hummel Avenue, Lemoyne, Cumberland County, PA - Assessed 119,600.00
Value of Real Estate. Assessment ia attached to this Return.
TOTAL (Also enter on Line 1, Recapitulation) I 119,600.00
pf more apace is neetled, addilional papes ot the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1600 Schedule A(Rev. 11-08)
Rw•1507 EXt (6-98)
I SCHEDULE B
STOCKS ~ BONDS
caauo~~rn oc ~~snvnNu
INMERRANCETA%RETURN
REBIDENT DECEDENT
ESTATE OF FILE NUMBER
SHANDELMIE~2, JEAN O _ 21-12-0152
. All propsrty joindy-ownedwlM rlyht oi wrvivorship must W dlsclo~M on SchMuls F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 17298742a 153 shares of CitiGroup Inc. - Valued using EstateVal 30.44 4.65T.32
Valuation. A copy is attached to this Return.
2 ~59351604 72 shanes of Reinsurance Group of America, Inc - Valued 53.775 3.828.6Q
using EstateVal. A copy of the valuation 1s atfached.
3 89a17E1o9 108 sha~res of Travelers Companies, Inc. - Valued using 59.13 B,386.04
EstateY~i. A copy of the valuatlon is attached.
4 Dreyfua State Municipal Bond Fund - Dreyfus PA Fund-CI A 1B.52 89,A38.44
- Valued using EstateVal. A copy of the valuation is attached
to thia Retum.
Accrued income on Item 4 through date of death 14T.17
TOTAL (Also enter on Line 2. Recapitulation) 104,457.57
p~ nRne spa~z is neaaeo, aoortronai pages or me same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Fortn PA-1500 Schedule B(Rev. 6-98)
- _ _ .
Rsr160o EX+ t6-9!)
SCHEDULE E
CASH, BANK DEPOSITS, 8 MISC.
PERSONAL PROPERTY
coweo~w~n~ or r~NSnv,ww
INHERRANCE TAX RETURN
RESIDENT DECEOEM
ESTATE OF FILE NUMBER
SHANDELMIEIR, JEAN O 21-12-0152
Inelude lM W ~1'patbn arul the dele the proesWs wxe receWedby ths eetMe.
NI proputy ntlyormMwlM M~ AyM o/survWaship mu~t M dbelw~don ~ch~duls F.
~~M
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Members First Checking Account No. 56724-11 - Date of Death Letter from Member's First is 17.74T.00
Attached to this Retum.
2 Members First Investment Account No. 56124-05 637.48
3 Members First Regular Savings Account No. 56124-00 26,834.34
4 2009 Honda Accord - Kelly Blue Book Valuation is Attached to this Retum. 15,588.00
5 Personal Property 3.690.00
6 Intemal Revenue Senrice - 2011 Federal Income Tax Refund 7,953.00
TOTAL (Also enter on Line 5, Recapituladon) I 60,450.82
Qt more space is needetl, addHional pages of the same size)
Copyright (c) 2002 form softwaro only The Lackner Group, Inc. Fortn PA-1500 Schedule E(Rev. 6-98)
Rsvd6Gi EX+ (&9B)
cweMa+waurn oF venr~sv~vnr~u
IMIERITANCE TA%RETURN
REBIDEMOECEDEWT
ESTATE OF
MIBR, JE/
H ~n ~s~st wu
SCHEDULE F
JOINTLY-OWNED PROPERTY
IFILE NUMBER
21-12-0152
n~ w~min on. ysaror tn• d.~.aa~r• aa a d..u~, k must M ropoRW on seh~tlul~ 6.
ADDRESS RELATIONSHIP TO DECEDENT
935 Old Quaker Road Daughter
Etters, PA 17319
SURVIVING JOINT TENANT(S) NAME
A. Susan A Lindsey
B.
C.
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LEITER
FOR JOIN
~~NT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
~NCIUDE NAME OF FINANCIAL INSTRUfION AND BANK ACCOUNf
NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR
JOINTLY-HELO RFAL ESTATE.
DATE OF DEATH
q~UE ~F ASSE °~ OF
DECO'S
INTEREST DATE OF DEATIi
VALUE OF
DECEDENTS INTEREST
7 A Various 31 3eries EE 5100 United states Savings 5,157.76 50.000°h 2,578.88
(1887-1889 Bonds - Valued using Savings Bond
Calculator
2 A 05/30~(1878 Members Firat Federal Credit Union Account 13,386.46 50.000°k 6.693.23
~
t No.56191-00
TOTAL (Also enter on line 8, Recapitulatlon) I 9,272.11
(Ii more spaee is needed, additlonal pagea of the same size)
Copyright (c) 2002 form soflware only The Lackner Group, Inc. Fortn PA-1500 Schedule F(Rev. 6-98)
R~v-7670 EX+ (8-9E)
~
co~o~~n+oF ver+NSV~v~Nw
INHERITANCE TAIf RE7URN
RE810EM OECEOENT
SCHEDULE G
INTER-VIVOS TRANSFERS ~
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
SHANDELMIER, JEAM O 21-12-0152
This schedub must be canpbted entl filetl H the anewer lo any of questiona 1 IFrouph 4 pn Me reverae side of the REV-1500 COVER SHEET is yee,
ITEM
NUMBER cL DESC EIPTION pF PROPERTY
THE DATE 0 TRANSFRERSATTkCF1 A COPV~OF THE DEED F~ORER~i EsTr~nrE. DATE OF DEATH
VALUE OF ASSET % oF oECO~s
~~'~TERE3T ~c~usion
(~F APpLICABLE) TAXABLE
VALUE
1 Members First IRA Certiflcata Account No. 56124-15 - 17,846.43 17,846.43
Beneficiary: Susan L(ndaey, Daughter
2 Members First IRA Certificate Account No. 56124-16 - 229,092.52 229,092.52
Beneflciary: Susan Lindsey
TOTAL (Also enter on I.ine 7, Recapitulationl I 246.938.95
(IP rtare apace is needed, atlditional papes of the same aize)
Copyright (c) 2002 form software only The lackner Group, Inc. Form PA-1800 Schedule G(Rev. 6-98)
REV•11b7 E7(+(70-08)
COMN~~~E~ANIA
II
SCHEDULE H
FUNERAL EXPENSES &
1DMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
SHANDELMIER, JEAN O 21-12-0152
j Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION ~ AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
B. ADMINISTRATIVE C05TS:
1. PersonalRepresentative'sCommissions
Name of Personal Representative(s)
Streat Address ~
~nY State Zio
Year(sl Commission naid
2. Attornev's Fees JOHNSON DUFFIE
3. Family Exemption: (If decedent'a address is not the same as claimanYs, attach explanation)
Claimant
Street Address
~~Y State Zio
Relationshio of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Retum Preparer's Fees
Y
7. Other Administrative Costs
See continuation sahedule(s) attached
~ 7,452.00
7,500.00
319.50
250.00
12,727.42
TOTAL (Also enter on line 9, RecapitulaUon) I 38,248.92
Copyright (c) 2009 form software oniy The Lackner Group, Inc.
_._
Form PA-1600 Schedule H(Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
SHANDELMIER, JEAN O 21-12-0152
ITEM
NUMBER DESCRIPTION AMOUNT
1 Funeral Ex nses
Gingrich Memoriala
1,955.00
2 Gingrich Memorials 1,955.00
3 Mr. Harry 3tack - Funeral Service Organist 200.00
4 Ma. Marian Baker - Funeral Service Soloist 100.00
5 Musaelman Funeral Moms - Funeral Expenses 11.942.00
6 Reverend Byron Krapf - Funeral Service 200.00
7 Reverend ~ugene Liddick - Funeral Service 200.00
8 Reverend Frank Bergstrom - Funeral Service 200.00
9 St Johns Cemetery - C~rave Opening 700.00
H-A 77.452.00
10 Other Administrative Costs
Cumberland County R~egiater of Wills Office - Additional Short Certificates
16.00
71 Hoapice of Central PA 4,320.00
12 Hospice of Central PA 6.806.32
73 Mutual Benefit - Homeowners Inaurance 430.00
14 Mutual Benefit - Homeawners Insurance ~yg,pp
Copyright (c) 2002 form software only The Lackner Group, Inc. Fortn PA-1600 Schedule H(Rev. 6-98)
SCHEDULE H
~UNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FIIE NUMBER
SHANDELMIEIR, JFAN O 21-12-0152
ITEM
NUMeER DESCRIPTION AMOUNT
15 Reserves; Miscellaneous Administrative Expenses 2~0.00
16 The Cumberland Law Journal - Notice of Estate Administration 75.00
17 The Patriot News • Notlee of Estate Administratlon 151.10
H-67 12,727.42
Copyright (c) 2002 form software only The Lackner Group, Ina Form PA-1500 Schedule H(Rev. &98)
Rsv7614 E7Cr (12-08)
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INNERRANCE TA%RERIRN
REeIDEMOECEDEM
SCHEDULE 1
DEBTS OF DECEDENT,
MC3RTGAGE LIABILITIES, 8 LIENS
ESTATE OF IFILE NUMBER
SHANDELMIEIR, JEAN O _ 21-12-0152
RpoR d~bb Incurivd by tl1~ Wc~Mnt prbr to d~~M Mat nmNn~d unpNd at fh~ tlN~ ot dsnh, Induanp unMmbunW mMicd ~xp~nNS.
~~M VALUE AT DATE
NUMBER ~ DESCRIPTION OP DEATH
1 Checks Clearing After Date of Death 479.37
2 F.A. Nicola, Tax Coliector 1,032.44
3 Members First ~sa A~ccount No. 467208000021964 428.00
4 Metlife 46.34
5 PA American Water 163.10
6 Pennsylvania Power & Light ygg,y,q
TOTAL (Also enter on Line 10, Recapitulation) I 2,447,49
, (N more space is neoded, adtlitional papes of the same size)
Copyright (c) 2009 form soitware only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-7673EX+~11-08) .
SCHEDULE J
coM~~~D`~~~~~""'" BENEFICIARIES
ESTATE OF
FILE NUMBER
.7r7A1VUCLMICK~.JCA1V lJ 21-72-0 152
NUMBER
NAME AND ADDRESS OF RELATIONSHIP TO
DECEDENT
SHARE OF ESTATE
AMOUNT OF ESTATE
PERSONfSI RECEIVING PROPERTY ~p~s) ($~a)
I
' TAXABLE DISTRIBUT ONS [inGude outright spousal
distributions, and transfers
under Sec. 9116 a 1.2
1 Swan Ann ~indssy Daughter Tangible
936 Old Quaker Raad Personal
Etters, PA 17319 Property;
Residue
2 Margaret GL McKee Cousin ;10,000 Specific
117 Rawson Road Bequest
Quincy, MA 02170
Total
Enter dollar amounts for istributions shown above on Iines 1 5 throu h 18 on Rev 150 0 cover sheet aa a ro riate.
II NON-TAXABLE DISTRIB TIONS:
• A. SPOUSAL UISTRIBUTIONS UNDER SECTION 8113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART Ii - ENTER TC~TAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
Copyright (c) 2009 fortn so(tware only The Leckner Group, Inc. Form PA-1500 Schedule J(Rev. 11-08)
E~'TATE OF JEAN O. SHANDELM~ER
SCH~DUZE OF EXHIBI_TS
EXHIBIT A Last Will and Testament for Jean O. Shandelmier signed and dated
June 16, 2012 ~
EXHIBIT B Receipt of Prepayment of $17, 000. 00 made on Aprid 10, 2012.
EXHIBIT C CumBerland County Real Estate Assessment for Real Estate
located at 130 Hummel Avenue, Lemoyne, Cumberland Counry,
PA
EXHIBIT D EstateYal Yaluation for stocks/Municipal Bond Fund
EXHIBIT E Members First Federal Credit Union Date of Death Yaluation of
. Account Letter
EXHIBIT F 2009 Honda Accord - Kelly Blue Book Yaluation
EXHIBIT G U. S. Savings Bond Calcudator for Joint Bonds Owned.
519619
Last Will and Testament
OF
JEAN O. SH'ANDELMIER
I, JEAN O. SHANDELNII~R, of Lemoyne, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and declaze this
as and for my Last Will and Testament, hereby revoking and making void any and a11 V~ills or
Codicils at any time heretofore made by me.
ARTICLE I
DEBTS
I direct the paymer~t of a11 my legal debts, and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done.
ARTICLE II
SPECIFIC BEQUEST
I give and bequea4h the sum of Ten Thousand ($10,000.00) Dollazs unto my cousin,
MARGARET Q. McKEE, Boston, Massachusetts, provided she survives me.
ARTICLE III
TANGIBLE PERSONAL PROPERTY
I give and bequeath my motor vehicle(s) and my household goods and personat effects and
other tangible personalty of like nature (not including cash or securities}, together with any existing
insurance thereon unto my daughter, SUSAN ANN LINDSEY, Collegeville, Pennsylvania
provided she survives me.
ExHiBrr A
1
ARTICLE IV
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue and remainder of my estate, of whatever
nature and wherever situate unto my daughter, SUSAN ANN LINDSEY, CollegeviTle,
Pennsylvania provided she survives me. Should my daughter, SUSAN ANN LINDSEY,
predecease me, I give, devise and bequeath the same unto my cousin, MARGARET Q. McKEE,
Boston, Massachusetts.
ARTICLE V
POWERS OF FIDUCIARIES
My fiduciaries shall have the following powers in addition to those vested by law and by
other provisions of my V4~i11 applicable to all property, whether principal or income, including
property held for minors, exercisable without court approval and effective until actual
distribution of a11 property:
A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in
such manner as they may deem appropriate.
B. To retain a~y or a11 of the assets of my estate, real or pexsonal, without restriction to
investments authorized for Pennsylvania fiduciaries, as my fiduciaries deem proper,
without regard to any principle of diversification or risk.
C. To invest in all forms of properiy without reshiction to investments authorized for
Pennsylvania fiduciaries, as my fiduciaires deem proper, without regazd to any
principle of diversification or risk.
D. To sell at public or private sale, to exchange, or to lease for any period of time any
rea1 or personal property and to give oprions for sales, exchanges or leases, for such
2
prices and upon such terms or conditions as deemed proper.
E. To allocate receipts and e~enses to principal or income or partly to each as from
time to tirn~e considered appmpriate.
F. To coinpromise any claim or coniroversy.
G. To make such elections, decisions, concessions and settlernents in connection with
all income, estate, inheritance, gift, generation skipping or other tax refunds and the
payment of such taxes as my fiduciaries shall deem appropriate, without obligation
to adjust the distributive share of any person thereby affected.
ARTTCLE VI
TAXES
I direct that all estate, inheritance, transfer and other taxes of similar nature payable by
reason of my death, toge~her with any interest or penalties thereon, and imposed with respect to
any property, whether or not disposed by tlus Will, shall be paid out of the residue of my Estate
and shall be considered a part of the expense of the administration of my esta.te. I further direct
that my Personal Representative shall have the absolute power in her or his discretion to pay the
same at once whether or not the law under which they are imposed pernuts the postponement of all
or part to a later date.
ARTICLE VII
APPOINTMENT OF PERSONAL REPRESENTATNE
I name, constitute and appoint my daughter, SUSAN ANN LIlVDSEY, Executrix of this
my Last Will and Testament. Should she fail to qualify or cease to so act, I name, constitute and
appoint my grandniece, HEATHER E. O'HARA, Altemate Executrix to complete the
administration of my estat~e. I direct that no fiduciary appointed herein shall be required to post
bond for the faithful admin,istr~ation of the duties required in any jurisdiction.
3
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, this ~G~ day of ~. 201 l.
_ ~)
AN O. S ELNIIER
Signed, sealed, published and declazed by the above-nazned Testatrix, as and for her Last
Will and Testament, in th~e presence of us, who at her request, in her presence and in the presence
of each other, have hereunto subscribed our names as witnesses.
~a~,~~. F~ ~ ~~ ~
4
AFFIDAVI'I' AND ACKNOWLEDGMENT
COMMONWEALTH QF PENNSYLVANIA :
: SS
COUNTY OF CUMBEI~I,AND :
We, JEAN .O. SHANDELMIER, ~~~_M(,~v~S and
~ j~([,~~ .~ , the Testatrix and the'vv~tnesses, respectively,
whose na.mes are signed to the attached or foregoing instrument, being first duly swom, do hereby
declare to the undersigned authority that the Testatrix signed and executed the inshwnent as her
Last Will and that she had signed willingly and that she executed it as her free and voluntary act for
the purposes therein expr~ssed, and that each of the witriesses, in the presence and hearing of the
Testatrix, signed the Will ss witness and that to the best of his/her knowledge the Testa.trix was at
that time eighteen years of age or older, of sound mind and under n4 constraint ox undue influence.
SHANDELMIER
Witness U
~~ ~ ~~~
Witness ~
Subseribed, sworn to and acknowledged before me by JEAN q. SHANDELMIER,
Testatrix, and subscribed and sworn to before me by ~~1L._(,I, ~'. ~.~. rn~~ and
~~A.Y (l,I~l ~ . ,~_, witnesses, this ~,~ day of ~,~,L(,IILQ. , 2011.
~ ~~~
Notary Public
:443933v2
~pNyyEpLTH OF PENNSYIVANV-
~~ ~ Pub~k
l~~-~'~ndC•ow1Y .
~~~ ~~1 ~ '~
~yar, Pen
5
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OFREVENUE
BUREAU OF INDIVIDVAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0801
RECEIVED FROM:
REV-1182 EX(11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 015823
UNDSEY SUSAN ANN
935 OLD QUAKER ROAD
ETTERS,PA 17319
-------- ,a~d
ESTATE INFORMATION: sStv: 19E-24-~653
FfLE NUMBER: 2112-0152
~ECEDENr NAME: SHANDELMIER JEAN O
DATEOFPAYMENT: 04/11/2012
POSTMARK DATE: 04/10/2012
COUNTY: CUMSERLAND
DATE OF DEATH: 01 / 13/2012
REMARKS: RECEIPT TO ATTY
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ S 10,000.00
~
~
~
~
~
.~
~
~
TOTAL AMOUNT PAID:
S 10,000.00
CHECK#108
INITIALS: HEA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
RECEIVED
REGISTER OF WILLS
APR 12 2012
JOHNSON D FFIE
TAXPAYER
ExHiBiT B
_ _
_ __ _
.
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(7 7-96)
DEPARTMENT OFREVENUE
BUfiEAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG. PA 17128•0801
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 015822
LINDSEY SUSAN ANN
935 OLD QUAKER ROAD
ETTERS, PA 17319
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- ,o~d
ESTATE INFORMATION: SsN: ts8-24-1653
F1LE NUMBER: 2112-0152
~ECEDENT NAME: SHANDELMIER JEAN O
DATE OF PAYMENT: 04/ 1 1/2012
POSTMARK DATE: 04/1 O/2012
COUNTY: CUMBERLAND
DATE OF DEATH: O1 / 13/2012
101 ~ $7,000.00
~
~
~
~
~
~
~
~
TOTAL AMOUNT PAID:
REMARKS: RECEIPT TO ATTY
57,000.00
CHECK# 703
INITIALS: HEA
sEA~ RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
T~DB Result Details
Page 1 of 1
Detailed Results for Parcel 12-21-0265-393. in the 2010 Tax Assessment Database
I ~~I II ~~ 12 ~~
12-21-0265-393.._._ ... .............._......_..~
130
HUMMEL AVENUE
SHANDELMIER, JEAN O
R
1313
22900
96700mm
119600
.06
(1
22320
~O1
i ~._~
'21
_._...__...__...._ ............ . . .
19
r81 -il
0029G-00979
1897 _ ~^
10/19/2004
A ~
EXHIBIT C
http://taacdb.ccpa.nebdetails.asp?id=12 21-0265-393:&dbselect=l
_ _ _ _ 1/2612012 .
Estate Valuation
Date of Death: O1j13J2012 Estate of: Shandelmier, Jean 0. Estate
Valuation DaCe: O1/13/2012 Account: 016820-1
Processing Date: 06/21/2012 Report Type: Date of Death
Number of Securities: 9
File ID: Shandelmier
Shares Security Mean and/or Div and Int Security
or Par Description High/ASk Low/Bid Adjustments Accsuals Value
1) 5913.999 DREYFfIS ST MUN BD FD (26202D529) ~ '
PA SER CL Z
Mutual Fund (as quoted by NASDAQ)
O1/13/2012 16.52000 Mkt
16.520000
2) 153 CITIGROUP INC (172967924)
COM NEW
New York Stock Exchange
O1l13l2D12 31.00000 29.88000 H/L
30.440000
3) 72 REINSURANCE GROOP AMER INC (759351609)
COM NEW
New York Stock Exchange ~
O1/13l2~12 53.98000 52.87000 H/L
53.175000
9) 108 TRAVELERS COMPANIES INC (89917E109)
COM
New York Stock Exchanqe
O1/13/2012 59.96000 58.80000 H/L
59.130000
Total Value:
Total Accrual:
Total: $104,310.90
69,438.99
9,657.32
3,828.60
6,386.04
$109,310.40
50.00
ExHiBir D
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricinq Systems, Inc. If you have questiona,
please contact evP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.1)
St
.
MEMBERS 1~
E~HDHRALCRHDiT NVION
PRIMARY OWNER: Susan Lindsey
R~G I~LAR__3.4VING3 ACCOUNT
Account Number/Suffix 56124-00 56197-00
Date AccOUnt Eatabliahed 04/07/1978 05/30/1978
Principal Balance at Date of Death $26,832.35 $13,385.45
Atx.~uedlntevestto Da~e of Death $1.99 $1.07
Total Prlncipal and Accrued Intenest $26,834.34 $13,386.46
Name of Joint O~nmer None Jean Shandefmier
Date Joint Ownership Established 05/30l1878
CHECKING ACCOUNT:
Account Number/Suffix 66124-11
Date Account Established 02/21J2009
Princlpal Balance at Dete of Death $11,746.65
Accrued Interest to Date of Death $.35
Total Principaf and Accrued Interest $11,747.00
Name of Joint Owner None
INVE8TMENT SAY IJ~GSJ-CCOUNT:
Account NumbedSuffuc 58124-05
Date Account Established 02/21/2009
Principal Balance at Date oT Death $637.46
Accrued Interest to Date of Death $.02
Total Principal and Accrued Intereat $637.48
Name of Joint Owner None
IRA CERTIFICATE:
Account NumbedSuffix 66124-15
Date Acxount Established 04l13l2002
Principal Balance at Dete of Death $17,820.92
Axrued Interest to Date of Death $25.51
Total Principal and Accrued Interest $17,846.43
Name ef Baneficiary Susan Lindsey
IRA CERTIFICATE:
Account NumbedSuffix 58124-16
Date Account Established 05/08/2009
Prfncipal Balance at Date of Death $228,874.56
Accrued Interest to Date of Death $217,g6
Total Principal and Accrued I~terest $229,092.52
Name of Beneficiary Susan Lindsey
VISA ACCOUNT:
Account NumberiSuffix 467209000021864"
Date Account Established 02/24/2009
Principal Balance at Date of Death $428.00
Joint Cardholder None
•Contracwal Piedge of Shares
Estate of: JEAN SHANDELMIER
Date of Death: 01h2/2012
Soeial SecuNty Number.198-24-1953
M M RS t ST FEDERAL C EDIT U
n~~ ~- ~u-~.
Danie A. Kline
Lending Insurance SuppoR Specialist
February 24, 2012
EXHIBIT E
5000 Louise Dxive • P.O. Bo$ 40 • Mechanicsburg, Pennsplvania 17055 •(800) 283-2328 • wwwmembetslstorg
_ .
2009 Honda Accord LX Sedan 4D Trade In Values - Kelley Blue Book Page 1 of 2
~~I ~i~U13 ~O~Cr~eetrumnana~~e'
_.. , _ _ _ _ _ .
Used Car Privafie Party Values
Tiade-In/SeN Values
~
~ ~~ 2009 Honda Acxord
.."~E~'~ .,~ StyN . x >:,cfr~n 4t::
Private Party Value Vehide Highligh~s
i Excellent ~i,
, $16,539
_. ;
~ Very Good ~
$16,039 ~
_ . ... . ,
Good ~
~15,589 ;
___ . ... ~
Fair
~14,189
MPG: Clty 21/Hwy 30 Max Searing: 5
Doors: 4 Engine: 4-Gyl, VTEC, 2.4 Litar
Drivetrafn: FWD Transmissipn: Aubomadq 5-Spd w/pverdrhre
EPA Class: Mldsfre Cara Body Style: Sedan
Country of Origin: 7apan Country of Assembly: Unihd 9taM
Your Cvnfigured Options
~ Our pre-fdetted optlons, 6ased on typkal equipment tor MIS [ar.
/ Optlons that you adAeO whik conHguring this Csr.
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New Cars You Might Like
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Harrist
http:/lwww,kbb.com/honda/accord/2009-honda-accord/lx-sedan-4d/?vehicleid=226620&itt... 3/23/2012
Calculated Value of Your Paper Savings Bond(s)
Page 1 of 1
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redempt+on Date 01/2012
Bonds: i-31 of 31
C189336503EE EE ,$100 01(1989 -07/2012 O1f2019 ,. $50.00 ; $107.16 4 00% `~157.16
C189334802EE EE $100 12/1988 06/2012 12/2018
50 00
$
.
$107.16 0
4,00
/q
;157.16
C189333308EE EE $100 11/1988 05/2012 11/2018 .,.
,,,
$50.00 . $107.16 ,
4.00% .
$157.16
C187967538EE EE $1Q0 1Qf1988 '04/2012 1Oj2018 $50.00 $107.16 4.00% ~f 157.16
C187965412EE EE $10D 09/1988 03/2012 09/2018 $50.00 $107.16 4.00°!0 ~157.16
C176239684EE EE $100. 08/1988 02/2012 .08/2018_ .. $50.00 $107.16 4.00% #157.16
C176237513EE EE $lOQ 07f1988 ,07%2012 07/2018 $50.00 $110.32 4.00% ,
$160.32
C176235461EE
_ EE $100 06/1988 06/2012 06/2018 $50.00 $i1Q.32 4.00°fo ~160.32
C171358168EE.
EE
$100
05/1988
05/2012
05/2018
$50.00
$110.32
4.00% _ ....
$160.32
C171356881EE EE $lOQ 04/1988 04~2012 04/2018 .$50.00 $110.32 4 00%0, ~160.32
C1713.54656EE. EE $100 03/1988 03/2012 03/2018 ,
$50.00 .
$110.32 .
4.00% $160.32
C170068301EE EE $100 02/1988. 02/2012, 02/2018 $50.00 $110.32 4.00% , ~160.32
C170066321EE EE
~
l
~
~50.00
113.52
%
4 OO $163.52
C135766030EE EE $100 l
12
1986 06/2012 ~
1
2`2016 '
$50 00 .
~120.12 o
,
4 00 /o ~170.12
4C135765118EE, EE $100 11/1986 05/2012 11/2016 $50.00 $120.12,; 4.00% $170.12
C11974411,OEE EE $100 10/1986; 04/2012 10/2016 , $50.
00 $139.20 4.00% ~ ~189
20
~C119743159EE EE $100 -09/1986 03/2012. 09/2016 .
$50.OQ. $139.20 4A0% .
,
$189.20
C119742271EE EE $100 OS/1986 02/2012, 08/2016 $50.00 $139.20 4.00% ~189.20
C119741405EE EE $1~4 07/1986 07/2012 07j2016 . $50,00. $143.00 a.00% ~193.00
C161712107EE EE $100, 12/1987 06/2012. 12/2017 $50.Q0 $113.52 4.00°!0 $
163.52
C161710234EE EE $100 11/1987 05/2012 11/2017' . $50.00 ~113.52 ,
/~.00% _
~163
.52
C157132313EE.. EE $100, 1OJ1987 04J2012 1Oj2017; $50.00 .._
$
113.52 4.00% ,
~163.52
C146321916EE. EE $100, 09/1987 03/2012 09/2017 „$50.00 ,
$113.52 ,
A.00°Jo .
. ~163.52
C146320671EE EE $100 08/198T 02%2012; 08/2017 $50.00; $113.52 4.00% _
$163.52
C138604724EE EE $100 07/1987 07j2012 07/2017 $50.~0 .$116.80,_ 4.00% $166.80
C138602956EE EE $100 06/1987, 06/2012 06[2017 $50.00 $116.80, 4.00% ..
$166.80
C138601597EE
_. : EE $100 O5/1987 05/2012 05/2017 „ $50.00, $116.80 4.00% : .
„ ~166.80
C135769975EE' EE $100 04j1987 04/2012 04/2017 $50.00 $116.80. 4.00% ' $166.80
C135768973EE EE $100 03/1987 03(2012 03(2017 $50.00 $116.80 4.00°fo $166.80
C135767998EE, EE $100 02/1987 02/2012 02%2017 $50.00 $116.80. 4.00% ~166.80
C135767046EE_ EE $100 OSJ1987 07j2012 O1/z017, ., $50.00 $120.12; 4.00% $170.12
Totals_for3 1_Bonds ~1,550.00: 33,607J6 55,157J6
NI Not Issued
_ __
NE Not eligible for payment
_ ...._.__..___...... .
P5 Includes 3 month interest penalty
MA Matured and not earnin interest
EXHIBIT G
http://www.treasurydirect.govBC/SBCPrice 4J3/2012