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~ 1505610105
REV-1500 Ex (off-v) (FI) ' ~'
' ~~ OFFICIAL USE ONLY
PA Department of Revenue P~rts7dvRa-Ma County Code Year File Number
Bureau oflndividualTaxes INHERITANCE TAX RETURN n
PD Box 2Bo6ot RESIDENT DECEDENT ~ ~ ~ of ~ ~~
Harrisburg, PA 17128-o6ot
ENTER DECEDENT INFORMATION 6ELUW
Social Security Number Date of Death MMOOYYYY
11129/2012
Decedent's Last Name Suffix
McGuffin
(If Applllable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
Date of Birth MMDDYYYY
02/06/1922
Decedent's First Name MI
Regina R
Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-ffi)
O!D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Tmst.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 72-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED~TO:
Name Daytime Telephone Numb
er
Coleen M. Clineschmidt r
~~t
~1C1;.234-91~ ~ c9.
~ ~ ecrISTERX)F Ve01.~99E ONLY
~ y r- N rri rn
D Z' ~
V N ~1 4
First Line of Address Z : Tc o O
v ~ o ~ -rt ~t
2660 Yost Road o ~ `°~ ~ -:
Second Line of Address ~ <a r- m
P
d DATE FlLED
City or Post Office State ZI
Co
e
Perkiomenville PA 18074
Correspondent's e-mail address
Under penalties of perjury, I declare that I have examined Mis return, induding axompanying schedules and statements, and to the best of my knowledge and belief.
it is true, coned antl wmplete. Dedaretion of preparer other then the personal representative is based on all information of which preparer has any knowledge.
_. _.. __ __ _____.. _ ................ ~.... ~.. ..... .,.T, ,.,., nes i
SIGNATURE OF PARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
1505610105
Side 1
1505610105
~;,
1 1505610205
REV-1500 EX (FI) Decedent's Soaal Security Number
Decedent's Name
RECAPITULATION
1. Real Estate (Schedule A) ........................................... .. 1. 0
2. Stocks and Bonds (Schedule B) ..................................... .. Z. 0
3. Closely Held Corporation, Partnership w Sole•Proprietorship (Schedule C) ... .. 3. 0
4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. p
5. Cash, Bank Deposits and Miscellaneous Personal Property (SCheduie E).... ... 5. 14,999.94
6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. 108,112.26
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested..... ... 7. 0
8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 123112.20
9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 3109.94
t0. Debts of Decedent, Mortgage LiabNities and Liens (Schedule I) ............ ... 10. 2107.36
17. Total Deductions (total Lines 9 and 10) .............................. ... 11. 5217.30
12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12.
117, 894.90
13. Charitable and Governmental Bequests/Sec 9113 Trusfs for which
an election to tax has not been made (Schedule J) ..................... ... 13. 0
14. Net Value Subjeet to Tax (Line 12 minus Lina 13) ..................... ... 14. 117,$94,90
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(ax1.z) x .o_ 1s.
16. Amount of Line 14 taxable
at lineal rate x .Oqr~ 117,894.90 16' 5305.27
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral mte X .15 18.
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
1505610205
Side 2
1505610205
5305.27
O
J
REV-1500 EX (Fn Page 3
Decedent's Complete Address:
File Number
STATE
Tax Payments and Credits:
1. lax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount ___~ .,,~o ~~
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Paga 2, Line 20 to regwst a refund.
Total Credits (A+ B) (2) ~~o ~~
(3)
(4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Fr»r; n~
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred .................................................................................... ...... ^
b. retain the right to designate who shall use the property transferred or its income ...................................... ...... ^
c. retain a reversionary interest ........................................................................................................................ ...... ^
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 considerefian? ........................................................................................................ ...... ^
3. Did decedent own an "in trust for" or payable-upon-death bank account or security al 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 betore 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)J.
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a Vansfer to a surviving spouse from tax, and the statutory requirements for discbsure 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 fax 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 tartrate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiades is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §91i6(aj(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX+ (12-12)
~i Pennsylvania
~ai~ DEPARTMENT OFAEVENUE
INME0.ITANCE TAX RETURN
RESIDENT DECEDENT
w~ %''
SCHEDULE A
REAL ESTATE
ESTATE OF:
FILE NUMBER:
u a tenant in common moat be reported at fair market value. Fair market value is defined as the price at which property
If more spate is needed, use additional sheets of paper of the same size.
REV-i5o3 E%a (8-u)
~~ Pennsylvania
~.~7 OEPARtMFMOFIIEVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
N~~
SCN pYLE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
If more space is needed, insert additional sheetr of the same size
REVn5o0 EX+ (g.r2)
~~ Pennsylvania
C~7 DEPNiTMENTOFREVENUE
iNHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
_~v~~
scN uu~s c
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
FILE
~' -Schedule C-1 or L-2 (including all supporting information) must be attached for each closely-held coryoration/partnership interest of the decedent,
other than asole-proprietorship, See instructions for the supporting information to be submitted for sole-proprietorships.
(If more space is needed, insert additional sheets of the same size)
RED-1505 E%+ (1 L- ll) ~ ~ ,~
Pennsylvania SCHEDULE C-1
~i7 DEPARTMENT OF REVENUE CLOSELY-HELD CORPORATE
INHERITANCE TAX RENRN STOCK INFORMATION REPORT
RESIDENT DECEDENT
ESTATE OF FILE
1. Name of Corporation n~ State of Incorporation
Address Date of Incorporation
City
2. Federal Employer ID Number
3. Type of Business
4.
Product/Service
Business Reporting Year
TYPE TOTAL NUMBER OF FAR VALUE NUMBER OF SNARE9 VALUE OF THE
'
STOCK VotlrrpMoo-VoUnp SHARES OUTSTANDING OWNED BYTHE DECEDENT DECEDENT
S STOCK
Common $
Preferred $
Provide all rights and restrictions pretainirg to each class of stock.
5. Was the decedent employed by the corporation? .................................. ^ Yes ^ No
If yes, Position
State ZIP Code Total Number of Shareholders
Annual Salary $ Time Devoted to Business
6. Was the corporation indebted to the decedent? ................................... ^ Yes ^ No
If yes, provide amount of indebtedness $
7. Was there life insurance payable to the corporation upon the death of the decedent? ..... ^ Yes ~ No
If yes, Cash Surrender Value
Owner of the policy
Net proceeds payable $
8. Did the decedent sell or transfer stock in this company within one year prior to death or within two years
if the date of death was prior to 12.31-82?
^ Yes ^ No
Transferee or Purchaser
If yes, ^ Transfer ^ Sale Number of Shares
Attach a separate sheet for additional transfers and/or sales.
Consideration
Date
9. Was there a written shareholder's agreement in eHed at the time of the decedent's death? ....^ Yes ^ No
If yes, provide a copy of the agreement.
to. Was the decedent's stock sold? ..................................................... ^ Yes ^ No
H yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedent's death? .................... ^ Yes ~ No
If yes, provide a breakdown of disVibutions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other cerporaCions or partnerships? ..... ....... ^ Yes ^ No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
• e •• • ~ ~
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or federal corporate income tax returns (Farm 1120) for the year of death and four preceding years.
C. If the corporation owned real estate, submit a list showing the complete addresses and estimated fair market value/s. If real estate appraisals have
been secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationships to the decedent.
E. List of officers, their salaries, bonuses arrd any other benefits received from the corporation.
F Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
(If more space is needed, insert additional sheets of the same size.)
REV-1506 EX+ (12-11) /
~ 'pennsylvarria
DEVARTMENT OF REVENUE SC EDULE C-2
PARTNERSHIP
INHERRANCE TAX RETURN INFORMATION REPORT
RESIDENr DKEDENT
ESTATE OF FILE NUMBER
.. o r.~..r_ m.,
1. Name of Partnership plgpe Date Business Commenced
Address Business Reportirg Year
City State ZIP Code
2. Federal Employer ID Number
3. Type of Business ProducUService
4. Decedent was a ^ General ^ Limited partner. If decedent was a limited partner, provide ini-al imestmern
5.
PARTNER NAME PERCENT
OF INCOME PERCENT
OF OWNERSHIP BALANCE OF
CAPRAL ACCOUNT
A.
B.
C.
D.
6. Value of the decedent's interest $
7. Was the partnership indebted to the decedent? ................................... ^ Yes ^ No
If yes, provide amount of indebtedness $
8.
Was there life insurance payable to the partnership upon the death of the decedent? ...... ^ Yes
If yes, Cash Surrender Value $ Net proceeds payable $_
Owner of the policy
9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within lwa years it the date of death was
prior to 12-31-82?
^ Yes ^ No If yes, ^ Transfer ^ Sale Percentage transferred/sold
Transferee or Purohaser Consideration $ Date
Attach a separate sheet for additional transfers and/or sales.
10. Was there a written parhrership agreement in effect at the time of the decedent's death? ...... ^ Yes ^ No
If yes, provide a copy of the agreement.
11. Was the decedent's paMership interest sdd? ......................................... ^ Yes ^ No
If yes, provide a copy of the agreement of sale, etc.
12. Was the partnership dissolved or Iquidated after the decedent's death? .................... ^ Yes ^ No
If yes, provide a breakdown of distributions received by the estate, including dates and artaurns received.
13. Was the decedem related to any of the partners? ...................................... ^ Yes ^ No
If yes, explain
14. Did the partnership have an interest in other corporations or partnerships? ............... ^ Yes ONO
If yes, report the necessary information on a separate sheet, including a Schedule C-t or C-2 for each interest.
• • •• • ~ ~
A. Detailed calculatlons used in the valuaton of the decedent's partnrership interest.
B. Complete copies of financial statements or federal panrlership income tax returns (Form 1065) for the year of death and four preceding years.
C. If the partnership owned real estate, submtt a list showing the cempkrte addresses and estimated fair market values. tt real estate appraisals have
been secured, attach copies.
D. Any other information relating to the valuation of the decedent's partnership interest.
^ No
REV-1507 EX+ (6-9a)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
,v~~-
SCN ULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF FlLE NUMBER
Ren~na R Mr-C:uffin
All pmperty bimy~owned xdM Rght of aurvivorahlp must tb dladosetl an Schedule F.
(M more Space is neede4 insert addhional Sheets of the same Size)
REV'-1508 EX+ (D8a2)
Pennsylvania SCHEpULE E
~i7 DEPARTMENiOFREVENUE CASFIr BANK DEPOSITS & MISC.
INHERRANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENr
ESTATE OF: FILE NUMBER:
R<~'n~ R fW +llffl0 -
Indude the proceeds of litigation and the date the proceeds were received by the estate.
If more space is needed, use additional sheets d paper of the same size.
REVaSog EX+ (ol-lo)
~ pennsylvania
~~ DEPARTMENT OF REVENUE
INHERRANCE TAX RETURN
RESIDENT DEl7•DEm
SCNEpULE F
JOINTLY-OWNED PROPERTY
ESTATE OF:
FILE
Rnginn R AAK:i ifFn
If an asset beome jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) I ADDRESS I RELPSIONSHIP TO DECEDENT
A,Coleen M. Clineschmidt
8.
C.
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR IOIM
TENANT DATE
MADE
10TH DESCRIPTION OF PROPERTY
INCLUDE NAME OF FlNANOAL INSTITMDN AND BANK AIIOUM NUMBER OR sIMINR
IDENTIFl7NG NUMBER ARACH DEED FOR ]OINRV HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET %OF
DELT~ENTS
INTEREST DATE OF DEATH
VALUE OF
DECEDENT5 INTEREST
1. A.
9/2008 PNC Checking Acct. 514004-0373 6361.42 50% 3180.71
2. A 10/2008 PNC Money Market Acct. 5005169086 53077.00 50% 26538.50
3. A 8/2009 PNC Investments Acct 50740362 which became Acct. 004-794708 61779.33 50% 30889.67
4. A 10/2008 PNC CD 31400343645 (Funded from Money Market 5005169086) 20701.00 50% 10350.50
5. A 10/2008 PNC CD 31900364075 (Funded from Money Market 5005169086) 68141.00 50% 34070.50
6. A 9/2008 Reimbursements from cancellation of insurances, refunds tram others 6164.73 50% 3082.37
See Supportive Material for Schedule F
2860 Yost Road, Perkiamenville, PA 18074 ~ Daughter
TOTAL (Also enter on Line 6, Recapitulation) I; 108112.26
If more space is needed, use additional sheets of paper of the same size.
REV-ISto ex+ IDa-aeI
,B pennsylvarria
~~ DEPARTMENT OF REVENUE
INHERRANCE TA% RETURN
RESIDENT DKEDENT
w ~,~.
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
This schedule must be completed and filed if the answer to any of questions i Mrough 4 on page three of the REV-1500 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
nxwoE nIE xAhE aF THE TWVSFFAFE, TNDx xRAnoxsmaro oECEOExr AND
THE OAre or TxAxsRal. Anna ACaaT Or rHE Oao waxes ESrATE.
DATE OF DEATH
VALUE DF ASSET
% OF DECD'S
INTEREST
IXCLUSION
Ir AP)UG&E
TAXABLE
VALUE
I No answers were "yes"
TOTAL (Also enter on Line 7, Recapi[ula[lon) ; I 0
If more space is needed, use additional sheets of paper of Me same size.
Rev-rstt Ex+ Ito-oe>
pennsytvania
UEPARTNENT OF RENeNUEDEPARTMENT OF REVENUE
INMERRANCE TAX RENRN
RESIDENr DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Decedent's debt must be reported on Schedule I.
ITEM
dUMBER DESCRIPRON
A. FUNERAL EXPENSES:
t.
Grave marker, openinglclosing ofgrave at Rose HiIlCemetary, Hagerstown, MD
2. Cremation
a.
1
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
2.
3.
Street Address
City State
Year(s) Commission Paid:
Attorney Fees:
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
1199.94
800.00
Street Address
City. State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
S• Accountant Fees:
6. Taz Return Preparer Fees:
~' Trips to and from Mechanicsburg (200 miles each) (D,$0.555Imile X 10 Yips 1110.00
TOTAL (Also enter on Line 9, Recapitulation) ; 3109.9
ZIP
If more space is needed, use additional sheets of paper of the same size
~, REN-1512 EX+ (1Z-12)
Pennsylvania
f~7 DEPAfrTMB1TOFeEVENUE
INHERITANCE TA% RERIRN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Report ebh intoned by the decedent prior to death that remained unpaid at the date of death, hrclodhg unraimbersed medial expenses.
1TEM VALUE AT DATE
NUMBER DESCRIpr10N Of DEATH
1.
Verizon Wireless (Later reimbursed; See Schedule F) 37.16
2. UGI Utilities 69.17
3. Coleen M. Clineschmidt (reimbursement for obituary) 177.37
4. PPL Electric 52.99
5. Discover Card 616.98
6. Verizon Wireless 16.20
7. Comcast Cable (later reimbursed; see Schedule F) 74.68
8. Boscov's (clothes) 7.63
9. Register of Wills 116.50
10. Angels on Call ($704.03 reimbursed; see Schedule F) 713.69
ti. House Calls RX (Michael Lawler, NP) 50.00
12. vsitingNurseAssoaation 90.00
13. Alpha Diagnostics 14.99
14. Mechanicsburg Meals on Wheels 70.00
~\
TOTAL (Also enter on Line 10, Recapitulation) ; 2107.36
If more space is needed, insert additional sheets of the same size
REl~-1513 EX+ (O1-10)
~ : pennsylvania SCHEDULE
DEPA0.TMENT OF REVENUE BENEFICIARIES
INHERRANCE TAX 0.ETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
RELAIIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1~ Coleen M. Clineschmidt Daughter 100°h
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES IS THROUGH IS OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECRON 9113 FOR WHICH AN ELECRON TO TAX IS NOT TAKEN:
1.
l B. CHARITABLE ANO GOVERNMENTAL 0[STRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NONdAXABLE. DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I;
S more space is needed, use additional sheetr of paver of the same size.
nEV-1514 EX~ (4-09)
~ ' pennsylvania
~~
SCf1EQULE K
bEP~aTMENT OF aEVENUE LIFE ESTATE, ANNUITY
aureau o(IndivlduaLTaxes
PO B°z zao6or &TERM CERTAIN
Namsbufg PA t7uSafior (CHECK BOl(q ONREV-tSao COVER SHEET)
ESTATE OF FILE NUMBER
This schedule should be used for all single-life, joint or successive life estate and tens-certain calculattons. For dates of death prior to 5-1-89,
actuarial factors for single-life calculations can be obtained from the Department of Revenue.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99,
.and in Aleph Volume for dates of death from 5-1-99 and thereafter.
Indicate below the type of instrument that created the future interest and attach a rnpy of it to the tax return.
^ Will ^ Intervivos Deed of Trust ^ Other
NAME OF LIFE TENANT
DATE OF BIRTFI •
NGREST AGE AT
DATE OF DGTN
TERM OF YGRS
LIFE ESTATE IS PAYABLE
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Tenn of Years
^ Life or ^ Tenn of Years
1. Vaiue of fund from which life estate is payable .........................................$
2. Actuarial factor per appropriate table ............................................... .
Interest table rate - ^ 3.5% ^ 6% ^ 10% ^ Variable Rate %
3. Value of INe estate (Line 1 multiplied by Line 2) ....................................$
s
NAME OF ISFE ANNUITANT DATE OF BIRTH NEAREST AGE AT
DATE OF DGTN
TERM OF YFI1R9
ANNUITY IS PAYABLE
None ^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Life or ^ Term of Years
^ Ufe or ^ Term of Years
1. Value of fund from which annuity is payable ...........................................$
2. Check appropriate block below and enter corresponding number ................ .
Frequency of payout - ^ Weekly (62) ^ Bi-weekly (26) ^ Monthly (f 2)
^ Quarterly (q) ^Serni-annually (2) ^ Annually (1) ^ ether ( )
3. Amount of payout per period ........................................................$
4. Aggregate annual payment, Line 2 multiplied by Line 3 .................................. .
5. Annuity Factor (see instructions)
Interest table rate - ^ 3.5% ^ 6% ^ 10°/a ^ Variable Rate °f°
6. Adjustment Factor (See instructions.) ....................................... .
7. Value of annuity - If using 3.5, 6, or 10°k, or if variable rate and period
payout is at end of period, calculation is Line 4 x Line 5 x Llne 6 .............. . ... .
.......$
If using variable rate and period payout is at beginning of period, calculation is
(Line 4 x Line 5 x line 6) + Line 3 ...............................................$
NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G of the
tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return.
If more space is needed, use additional sheets of the same size.
RLW-1644 EX+ (O1-10)
~':~,' pennsylvania INHERITANCE TAX
SCHEDULE L ~~
OEPp0.TNENT OF PEVENUE
INHERITANCE TAX FlETIIHN REMAINDER PREPAYMENT
RESIDENT DECEDENT OR INVASION OF TRUST CORPUS
I. ESTATE OF FILE NUMBER
R ina R. McGutfin
This schedule is appropriate only for estates of decedents dying on or before Dec. 12, 1982.
This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of
Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust corpus (principal).
II. REMAINDER PREPAYMENT:
A. Election to Prepay Filed with the Register of Wills on
(Date)
B. Name(s) of Life Tenant(s) Date of Birth Age on Date Term of Years Income
or Annuitant(s) of Election or Annuity is Payable
C. Assets: Complete Schedule L-1
1. Real Estate ...........................$
2. Stocks and Bonds . . ....................$
3. Closely Held Stock/Partnership .............$
4. Mortgages and Notes .......... . .........$
5. Cash/Misc. Personal Property ..............$
6. Total from Schedule L-1 ..............................................$
D. Credits: Complete Schedule L-2
1. Unpaid Liabilities .......................$
2. Unpaid Bequests .......................$
3. Value of Non Includable Assets .............$
4. Total from Schedule L-2 ..............................................$
E. Total Value of Trust Assets (Line C-6 minus Line D-4) ...........................$
F. Remainder Factor ....................................................
G. Taxable Remainder Value (Multiply Line E by Line F) ............ . ...............$
(Also enter on Line 7, Recapitulation)
[II. INVASION OF CORPUS:
A. Invasion of Corpus
(Month, Day, Year)
B. Name(s) of Life Tenant(s) Date of Birth Age on Date Term of Years Income
or Annuitant(s) Corpus or Annuity is Payable
Consumed
C. Corpus Consumed ....................................................$ --- --
D. Remainder Factor .................................................... __ __ __
E. Taxable Value of Corpus Consumed (Multiply Line C by Line D) ....................$ ___ ____ __
(Also enter on Line 7, Recapitulation)
REV-1645 EX+ (11-09)
~ pennsylvania
DEVAgTMENl OF REVENUE
tNHERITANCETAXRETURN
RESIDENT DECEDENT INHERITANCE TAX
SCHEDULE L-1
REMAINDER PREPAYMENT ELECTION
-ASSETS'
~ ~-
I. ESTATE OF l FILE NUMBER
e »~ ~. rntbcc~/~i~J
II. ITE O. DESCRIPTION VALUE
A. Real Estate (Please describe.)
Total Value of Real Estate
(Include on Section II, Line C-1 on Schedule L.) $
B. Stocks and Bonds (Please list.)
Total Value of Stocks and Bonds
(Include on Section II, Line C-2 on Schedule L.) $
C. Closely Held Stock/Partnership -Please list. (Attach Schedule C-1 and/or C-2.)
Total Value of Closely Held{Partnership
(Include on Section II, Line C-3 on Schedule L.) $
D. Mortgages and Notes (Please list.)
Total Value of Mortgages and Notes
(Include on Section II, Line C-4 an Schedule L.) $
E. Cash and Miscellaneous Personal Property (Please list.)
Total Value of Cash/Miscellaneous Personal Property
(Include on Section II, Line C-5 on Schedule L.) $
[II. TOTAL (Also enter on Section II, Line C-6 on Schedule L.) $
If more space is needed, attach additional sheets of paper of the same size.
REW-1646 EX+ (11-09)
~ pennsylvania INHERITANCE TAX
SCHEDULE L-2 i j
/~
/U
OEP~pTMENT OF flEVENVE r
INHERITANCE TAX RETURN REMAINDER PREPAYMENT ELECTION
RESIDENT DECEDENT -CREDITS-
I. FILE NUMBER
ESTATE OF
p \\
Q Yf ~ R. y17 <<7Gr: i~1
II. ITEM DESCRIPTION AMOUNT
A. Unpaid Liabilities Claimed against Original Estate and Payable from Assets
Reported on Schedule L-1 (please list)
Total Unpaid Liabilities $
(include on Section II, Line D-1 on Schedule L)
B. Unpaid Bequests Payable from Assets Reported on Schedule L-1 (please list)
Total Unpaid Bequests $
(include on Section II, Line D-2 on Schedule L)
C. Value of Assets Reported on Schedule L-1 (other than unpaid bequests listed
under "B" above) that are Not Included for Tax Purposes or that Do Not Form
a Part of the Trust.
Calculation as follows:
Total Non Includable Assets $
(include on Section II, Line D-3 on Schedule L)
III. TOTAL (Also enter on Section II, Line D-4 on Schedule L) $
If more space is needed, attach additional sheets of paper of the same size.
REV X1647 EX+ (02-10)
Pennsylvania
!~7 DEPARTMENT OE REVENUE
INHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
-~ f2 c f~~ Aj
This hedule is appropriate only for estates of decedeMS who died aRer Dec. 12, 1982.
This schedule is to be used for all future interests where the rate of tax that will be applicable when the future interest vests in
possession and enjoyment cannot be established with certainty.
Indicate below the type of instrument that created the future interest and attach a copy to the tax return.
^ Will ^ Trust ^ Other
I. Beneftciaries
NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO
NEAREST BIRTHDAY
1.
2.
3.
4.
5.
II. For decedents who died on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within
nine months of the decedent's death, check the appropriate box below and attach a copy of the document in which the surviving spouse
exercises such withdrawal right.
^ Unlimited right of withdrawal ^ Limited right of withdrawal
III. Explanation of Compromise Offer:
IV. Summary of Compromise Offer:
1. Amount of future interest .............. . ... . ... . ................................ $
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(Also include as part of total shown on Line 13 of REV-1500.) ........ $
3. Value of Line 1 passing to spouse at appropriate tax rate
Check one. ^ 6%, ^ 3%, ^ 0% .................... $
(Also include as part of total shown on Line 15 of REV-1500.)
4. Value of Line 1 taxable at lineal rate
Check one. ^ 6%, ^ 4.5% .. . ....... . ............... $
(Also include as part of total shown on Line 16 of REV-1500.)
5. Value of Line 1 taxable at sibling rate (12°h)
(Also include as part of total shown on Line 17 of REV-1500.) ........ $
6. Value of Line 1 taxable at collateral rate (15%)
(Also include as part of total shown on Line 18 of REV-1500.) ........ $
7. Total value of future interest (sum of Lines 2 thru 6 must equal Line 1) ....................... $
SCHEDULE M
FUTURE INTEREST COMPROMISE
(Check Box qa on REV-15oo)
~/~
tf more space is needed, use additional sheets of paper of the same size.
rs<var>4e ex toz-es) SCHEDULE N
~ ? Pennsylvania ~ J~
• ~OEMpTMEMrafpEVEXUE SPOUSAL POVERTY CREDIT r
Bureau of Individual Taxes
a08ox a8o6ox _ FOR DATES OF DEATH 01/01/92 TO 12/31/94
ESTATE OF D I FILE NUMBER
schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet.
1 . Taxable assetr total from Line 8 (cover sheet) .... . ......................................... 1
2. Insu2nce proceeds on life of decedent ................................................... 2.
3. Retirementbenefitr ................................................................. 3.
4. Joint assets with spouse .............................................................. 4.
5. PA Lottery winnings ................................................................. 5.
6a. Other nontaxable assets: List and attach schedule if necessary .. 6a.
66.
6c.
6d.
6. SUBTOTAL (Lines 6a, b, c, d) .......................................................... 6.
7. Total gross assets (Add Lines 1 thru 6) ................................................... 7.
8. Total actual liabilities ........................... . ........ . ........................... 8.
9. Net value of estate (Subtract Line 8 from Line 7) ............................................ 9.
If Llne 9 is greater tltan 5200,000 -STOP. fie estate 15 not eligible to Gaim the credit If not, mndnue to Dart 11.
... . ~ ~ • f • ~ r ~
~ ~
Income: 1. TAX YEAR: 19 2. TAX YEAR: 19 3. TAX YEAR: 19
a. Spouse ............. Ia. 2a. 3a.
b. Decedent ........... 1b. 2b. 3b.
c. Joint .............. 1c. 2c. 3d
d. Tax-exempt income .. Id. 2d. 3d.
e Other income not
listed above ......... le. 2e. 3e.
f. Total .............. If. 0 2f. 0 3f. 0
4. Average joint exemption income plculation
4a. Add joint exemption income from above:
(lf) n + (2f) n + (3f) n = n
(+ 3)
4b.AVeragejointexemptionincome ........................................................ _
ff line 4/b) is arrester than 540.000 - STOV. The estate is not ellaible m daim the credit If no[- continue m Part III-
1. Insert amount of taxable transfers to spouse or §100,000, whichever is less
2. Multlply by credit percentage (see instruRions)
3. This Is the amount of the Resident Spousal Poverty Credit. Include this figure
in the wltulation of total credits on Une 18 of the cover sheet . ................................ .
4. For nonresidentr, enter the ratio of the decedent's gross estate in PA to the value of the
decedent's gross estate ......................... . .......................... .
5. Multiply Line 3 by Line 4 and enter the total here. This is the amount of the Nonresident Spousal
Poverty Credit. Include this figure in the calculation of total credits an Line 18 of the cover sheet.......... .
1.
2.
3.
a.
5.
JlE'V-1649 EX+ (09-12)
f~J Pennsylvania
tiT ~AFIMFNTOF REVENUE
INHERRANCE TAXES RETURN
RESIDENT DECEDENT
SCHEDULE O
ELECTION UNDER SEC. gii3(A)
(SPOUSAL TRUSTS)
~h-
PA T A -DEFERRING STATEMENT
For all trust assets reportable for Pennsylvania inheritance tax purposes for which a deferral of tax is being elected under
Section 9113(a), the personal representative responsible for filing the retum and the trustee(s) of the trust in question hereby
acknowledge the department's Statement of Policy set forth at 61 Pa. Code § 94.3 concerning any potential termination of the
trust under 20 Pa.C.S. § 7710.1 that occurs after the return was filed. Specifically, the signatories recognize each individual's
assumption of liability for inheritance tax consequences that result from any termination of the trust under 20 Pa.C.S. § 7710.1
that occurs after a return has been filed.
Signature of Person Responsible for Fling Return
Signature(s) of Trustee(s)
PART B -ELECTION TO TAX AMOUNTS
Complete this section only if making the election to tax available under Section 9113(a) of the Inheritance >!i
Estate Tax Act.
If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election
applies to the Trust (marital, residual A, B, by pass, unified credit, etc.).
Enter the description and value of all interests for which the Section 9113(a) election is made.
DESCRIPTION VALUE
If more space is needed, insert additional sheets of the same size.
Supportive Material for Schedule F
1. 5130040373 - PNC Checking
a. Copy of statement dated 1 year prior to death
b. Copy of statement where Coleen Clineschmidt first appears
c. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
2. 5005169086 -PNC Money Market
a. Copy of statement dated 1 year prior to death
b. Copy of statement where Coleen Clineschmidt first appears
c. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
3. 004-794708 -PNC Investment Account
a. Copy of statement dated 11/1/12-11 J30 j12 listing ba]ance as of date
of death
b. Copy of statement dated 1 year prior to death
c. Copy of statement where Coleen Clineschmidt first appears
4. 31400343645 -PNC CD -Funds from Money Market account 5005169086
a. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
5. 31900364075 -PNC CD
a. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
b. Because this CD was purchased in }une 2012, joint ownership of
greater than 1 year was questioned on the above form. However, as
shown on the Account Verification from PNC, funds used to purchase
this CD came from Money Market account number 5005169086
(Number 2 above), which was established jointly in October, 2008.
Therefore, the Percent Taxable should be 50 not 100.
6. List of deposits from refunds and reimbursements
Regina R. McGuffin
Supportive Material for Schedule F
1. 5130040373 - PNC Checking
a. Copy of statement dated 1 year prior to death
b. Copy of statement where Coleen Clineschmidt first appears
c. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
PNC
sw trite pNtrlstl s
ootoas
REBINA R MC~UFFIN
' COCEEN~G[21~RlIY!
205 DAISY DR
MECHANICSBURO PA 17050-3724
'~~ PNCBANK
Primary account number. ST-40040373'
Page 1 of 5
Number of erwlosures: 0
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Inl~eos! Cht~eldng Aoetow~! ~sary
Acooum number. 51.4004.0373
OverdroR Protedbn Provkled By: X10000(9086
Bi~1aM ~9aWaaalr
BaplnMtq Dapoalla arM ChaoW and otMr EMing
balenoa otMradditlona daduUlona balanp
1,684.05 4,297.00 4,046.82 1,874.23
Avaraga ttanthy Chatgaa
lalaxa and lees
1,429.51 .00
Reglna R Met"aut6n
Cohen ClfrteechmMt
1fan.atttli~eFlt~In..ary
Chacka pa1N Chaek Gnt PISS Chaek GnLBankeard
wNMnwala algnad trantaUlona POB PIN tranaadlona
12 0 0
Tofal ATM PNC Bank nthar Bank
tranaaetkma ATM tOnaaGiona ATM tgnsadlons
0 0 0
/~Ci~~ll~ awl
Da> ftwsits and OIIaM Add~f7olas Thsro wero 2 Depwlb std Other Addkbna
Date Amount Daaerlptton totaling ~.297.~~.
11/41 1,000.00 Onape Transfer Frorn 0000005005169086
12/02 1,437.00 Direct Deposit - Xxsoc Sec
US Treasury 903 XXXXX1897A
r•
punter rn~ I/lC/171n0 IAn \I\I\I\,\I\, n„7 nnenn+ .
Total' Banking Statement ; ~" PNCBANK
PNC Lank
For tho period 08/08/2008 m 10/00/4008
REGINA R MCGIIFFIN
COLEEN CLINESCNMID7
1305 APPLE DR
MECHANICSBURG PA 17055-3928
Primary account number. 5t-MIdFg373-
Page 1 of 5
Number of enclosures: 0
For 24-hour banking, and transaction or
interest rate information, sign onto
'a PNC Bank Online Banking at pnc.com.
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between the hours of 6 AM and Midnight ET.
Para servicio en espaAol, 7-866-HOLA-PNC
Mordtrpt Please contact us at 1-@88-PNC-HANK
~ Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-973@
Visit us at pnc.com
1DD terminal: 1-@00-537-1648
For hearing unpa6ed clients oNr
ptalationship Overview
Bank Deposit Accounts
Description Account Number Deposit Balance
Interest Checking 51-4004-0373 16,956.41
Certificate(s) Of Deposit Total of 1 10,989-03
Total Deposits 27,845.44
Performance Checking Regina R McGuffin
interest Checking Acco7tl7t S7anmary Coleen Clineschmidt
Account number. 57-4004-0373
Balance Summary Please see the Activity Detail section For
addkional information.
Beginning Deposits and Checks and other Entling
balance other additions deduct{ons balanra
1 ri,433.fi3 12,668.86 11,246.08 16,356.41
Average monthly Charges
balance and fees
15,280.34 . W
Transaction Sumn7ary
Cheeks paidf ChecY. Card P04 Check Ca: d.T,ankwrd
withdrawals signed Ironsact/ons POS PIN transactions
13 0 0
Total ATM PNC Bank Other Bank
ironsacttons ATM transactlons ATM transadlons
0 0 0
Interest Summary As of t0/06, a total of $70.73 in interest was
Paid this year.
Annual Percentage Number o! days Average collected Interest Paid
Vleltl Earned (APYE) in interest penal balance for APVE this period
0.29% 31 14,560.0!i 3.62
iOgM953q-1005
BUREAU OF INDIV IDWL TAXES
PD BDX 2806U1
HARRISBURG PA 17128-0601
COLEEN M CLIMESCHMIDT
205 UAISV DR
MECHANICSBURG PA 17050-3724
/C
c .Y.vrE-~
Type of Account
Savings
Checking
Trust
Certificate
PNC BANK NA provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No. 51311040373
Date Established 09.19.2006
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
With 5% Discount (Tax x 0.95)
$ 6,361.00
X 50
$ 3,180.50
Estate of REGINA R MCGUFFIN
SSN 219-12-1837
Date of Death 11-29-2012
County CUMBERLAND
Remit Payment and Formato:
REGISTER OF WILLS
tCOURTHOUSESOUARE
CARLISLE PA 17013
X 0.045
$ 143 12 NOTE': If tax payments are made within three months of the
decedent's date of death, deduct a 5 percent discount on the tax
$ (see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART StPjp 1: Please check the appropriate boxes below.
1
A ~ No tax is due.
g ~ The information is
correct.
C ~ The tax rate is incorect.
(Select correct tax rate at
right, and complete Part
3 on reverse.)
I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tar Due.
The above information is cored, no deductions are being taken, and payment will be seM
with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
d4.5~° I am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased.
12q° I am a sibling of the deceased.
15% All other relationships (including none).
D ~ Changes or deductions
listed.
E Asset will be reported on
inheritance tax form
REV-1500.
The information above is incorect and/or debts and deductions were paid.
Complete Part 2 and part 3 as appropriate on the back of this form.
The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
Return filed by the estate representative.
Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
`r pennsyLvania
DEPAfl7MENr OF REVENUE
1fY-156 EZ OaGEYE[ (EE-IL
FILE N0.2112-1301
ACN 12170532
DATE 12-31-2012
Supportive Material for Schedule F
2. 5005164086 - PNC Money Market
a. Copy of statement dated 1 year prior to death
b. Copy of statement where Coleen Clineschmidt first appears
c. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
1'NC Bank
ror/M pOriod 10!28!3017 to 71/23/2077
001045
REGINA R MCGUFFIN
. COLEEN CLINESCHMIDT
205 DAISY DR
MECHANICSBURG PA 17050-3724
O< ~ ,~ fl l~ Glti/ /~C lrC°l !.lilt. f'
~ PNCBANK
Primary account number: 50-0516-9086
Page 1 of 3
Numberof enclosures: 0
For 24hour banking, and transaction or
interest rate information, sign on to
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a For customer service call l-888-PNC-BANK
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Saturday & Sunday: 8 AM - 5 PM ET
Para servicio en espaRol, 1-866-HOLA-PNC
Obrbg7 Pbase contact us at 1-888-PNC-BANK
..~ !~A ~i"~ ®Wrke to: Customer Service
__ _ ~ ,~l.1l~ _ Po. Box X09 - _
/ Pittsburgh PA 75230.9738
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® TDD terminal: l-800-537-1648
For hearing impaired <tienu wily
Prannil~n Money Market Account Sueul~ary tna R McGutRn
Account number: 50-0516-9086 t:olesn Clineschmidt
Vo~ur aaouM is currently Opted-Out of Overdraft Coverage.
To team more, visit usonline at pnc.wm/overdraf[solutions
Bal~Ce Sn1lNnary
Beyinninq Deposits and Checks and other EtMlrp
halana other additions datluctlons balance
19,413.11 228.40 1,000.00 18,641.51
Avemye ngmhy Charges
balance and fees
19,480.68 .00
IIIltefeat Snawlnary
Annual Parnmage Number o/ days Average collected Interest Pald
Yield Eames (APYE) In Imsnst penal balance for APYE [Ns period
0.207. 29 19,480.68 3.10
As of 11/23, a total of ¢{0.32 in interest was
paid this year.
Acfi7dtr Detail
Deposits and Other /(bdlhOns There were 2 Deposits and Other Additions
Date Amoum Description totalirg 53271JN.
11j 02 225.30 D'u-ect Deposit -EFT
Natl Fin Svc Llc XXXXXX70811bs1f
11%23 3.10 Interest Payment
Online and ~esbonis Banloaag Dtrdutetions
Date Amount Destdpllon
11/21 1,000.00 Online T[ansFer To 0000005140040973
There was 1 Online or Electronic Banking
Oedtution totaling 57,7100A0.
Daily Balance Detail
Date Balance Date
10/26 19,413.11 11/02
Balariu Date Bslana bah Balarca
19,638.41 11/21 18,638.41 11 /23 18,641.51
PNDMLT01-.1OR10iJD-N4t1_VNNNNN.nn9-omens
_. _ _.. _.
~Premiuxn Money Market Account Statement !?~ PNCBANK
PNC Bank
For tNo period 10/24!2008 to 7 tl20l2099
REGINA R MCGUFFIN
COLEEN CLINESCNMIDT
205 DAISV DR
MECHANICSBURG PA 17050-3724
Primary account number. 50-0576-9086
Page i of 7
Number of enclosures: 0
For 24-hour banking, and transaction or
interest rate information, sign onto
Sr PNC Bank Online Banking at pnc.com.
For customer service call i-B88-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para servicio en esparTol, 1-866-HOLA-PNC
+~ /~~
~~~ ~ ~" `~ ~"~ ~~ ~~~ 8
PNC
BANK
'
! 88-
-
t Please comact us at 1-
Mor~y
IL C CC LC %( >`
®Write to: Customer Service
PO Box 609
Pittsburgh PA 15230.9738
Visit us at pnc.com
- - - --- -- - --- -'- TDD terminal: 1-800-531-1646
'
vnpnaM climb only
For hearmg
Important information on FDIC Deposit Insurance Coverage:
The FpIC announced a temporary deposit insurance coverage Increase from 5100,000 to $250,000, per depositor, t)troagh 12/31/09.
Also, any person, charity or eon-profit may be named as a hene0ciary on a payable on death or In~ng trust accoant. This is a
permanent change. To learn motx stop by env branch or >;o to pnacnm or wwLC.fdic.Rov
Premium Money Market Account Summary Reggina R McGUffin
Coleen Clineschmidt
Account number. 50.0516-9086
balance Summary
Beginning Deposits and Checks and other Ending
balance other atltlltions deductions balance
00 190,989.39 .00 190,489.39
Please see the Activity Detail section for
additional information.
Average momhly Charges
balance and fees
Iti2,874.ti2 .t)D
IMeraat Summary As of t 1120, a total of 5489.38 in interest
Annual Percentage Number of tlays Average cnnected interest Paid 'r'r~ Paid this year.
Yield Earned (APYE) in interest peno0 balance for APYE this period
9-00% 28 _ ._.. 1C,2.87~.62 189.39. _ _-
Activity Detail
-Depeeits-allrfllfElroF Adr6tiens- - - - - -- - - There were 2 Deposits and Uther Additions
Date Amount Description totaling 5190,x99.38.
]023 t9Q,00A0~ t?nGwr74awdesi'io.rf~~= r
11/20 489.39 Interest Payment ~ ~~~ ~ ~Q~,~ ,B,~LL ~yf ,~/~(iV!(~t. "~~ ~+y7t~
Daily Balance Detai G~/ttcK~ u<estt.c/~
Data Balance Date Balance Date Balance
10/24 .00 10/28 190,000.00 11/20 190,48.9,39
OVERDRAFT PROTECTION foryour PNC Bank checking account
If you haven t already done so, stop into your local PNC Bank branch today to open and enroll your PNC Bank Select Rewards Visa Platinum
Cana. Whst could be better than the saFety and comfort of knowing you're protected?
Foatdssatt-tons
BUREAU OF INGIV78U0.1 TAXES
Pe BOX 280601
HARRISBURG PA 1]128-0601
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
Pennsylvania
OEPAR7MEN70F REVENUE
PFY-I5y F1 pae[IIC IFC-li]
FILE N0.2112-1301
ACN 12170533
DATE 12-31-2012
COLEEN M LLINESCMMIDT
205 DAISY DR
MECNANICSBURG PA 17050-3724
Estate of REGINA R MCGUFFIN
SSN 219-12-1837
Date of Death 11-2&2012
County CUMBERLAND
Type of Account
Savings
Checking
Trust
Certificate
PNC BANK NA provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No. 5005169086 - 717 vxt..-.t- 711 cu ,E'i f R emit Payment and Forms to: I
Date Established 10-242006 0 REGISTER OF WILLS
Account Balance $ 53,077.D0 1 COURTHOUSE SQUARE
Percent Taxable X50 CARLISLE PA 17013
Amount Subject to Tax $ 26
538
50
,
.
Tax Rate X 0.045 i
h
h
f
h
'
t
NOTE
: If tax payments are made w
t
in three mont
s o
e
Potential Tax Due $1,194.23 decedents date of death, deduct a 5 percent discount on the tax
With 5% Discount (Tax x 0.95) $ (see NOTE`) due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1: Please check the appropriate boxes below.
1
A ~ No tax is due.
g ~ The information is
CORQCt.
C ~ The tax rate is incorrect.
(Select correct tax rate at
right, and complete Part
3 on reverse.)
D ~ Changes or deductions
listed.
E Asset will be reported on
mlTedtance tax form
REV-1500.
I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
The above information is correct, no deductions are being taken, and payment will be sent
with my response.
Proceed to Step 2 on reverse. Do not check any other boxes,
~4.5°~ I am a lineal beneficiary (parent, child, grandchild, e[c.) of the deceased.
12% I am a sibling of the deceased.
15% All other relationships (including none).
The information above is incorrect andlor debts and deductions were paid.
Complete Part 2 and part 3 as appropriate on the back of this /orm.
The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
Aetum filed by the estate representative.
Proceed to Step 2 al reverse. Do not check any other boxes,
Please sign and date the back of the form when finished.
Supportive Material for Schedule F
3. 004-794708 - PNC Investment Account
a. Copy of statement dated 11/1/12-11/30/121isting balance as of date
of death
b. Copy of statement dated 1 year prior to death
c. Copy of statement where Coleen Clineschmidt first appears
_,. _~,
__ .
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Supportive Material for Schedule F
4. 31400343645 - PNC CD -Funds from Money Market account 5005169086
a. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
BUREAU DF INDIVIDWL TAXES
PO BO% 280601
HARRISBURG PA 17128-0601
COLEEN M CLINESCHMIDT
205 DAISY DR
MECNANICSBURG PA 17050-3724
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
~ pennsylvania
DEPARTMENT OF REVENUE
FEY-tSU FY pnFYK tM.)b
FILE N0.2112-1301
ACN 12170531
DATE 12-31-2012
Estate of REGINA R MCGUFFIN
SSN 219-12-1837
Date of Death 11-29-2012
County CUMBERLAND
provided the department with the information below it
decedent you were a joint owner or beneficiary of the
Account No. 31400343645
Date Established 118-31-2009
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Ra[e
Potential Tax Due
With 5~° Discount (Tax x 0.95)
Type of Account
Savings
Checking
Trust
Certificate
tg that at the death of the
nt identified.
A/G - L' 17 I Remft Payment and Forma to:
REGISTER OF WILLS
$ 20
701.00 1 COURTHOUSE SQUARE
, CARLISLE PA 17013
X 50
50
50
$10,3
.
X 0.045 NOTE': H tax payments are made within three months of the
$ 465.77 decedent's date of death, deduct a 5 percent discount on the tax
$ (see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1: Please check the appropriate boxes below.
1
A ~ No tax is due.
g ~ The information is
correct.
C ~ The tax rate is inconect.
(Select correct tax rate at
right, and complete Part
3 on reverse.)
D ~ Changes or deductions
listed.
E dAsset will be reported on
inheritance tax form
REV-1500.
1 am the spouse of the deceased or 1 am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
The above information is correct, no deductions aze being taken, and payment will be sent
with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
~' 4.5% I am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased.
12~ I am a sibling of the deceased.
15% All other relationships (including none).
The information above is incorrect and/or debts and deductions were paid.
Complete Part 2 and paR 3 as appropriate on the back o/this torn.
The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
Retum filed by the estate representative.
Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
Supportive Material for Schedule F
5. 31900364075 -PNC CD
a. Pennsylvania Inheritance Tax Information Notice and Taxpayer
Response form listing balance on date of death
b. Because this CD was purchased in June 2012, joint ownership of
greater than 1 year was questioned on the above form. However, as
shown on the attached Account Verification from PNC, funds used to
purchase this CD came from Money Market account number
5005169086 (Number 2 above), which was established jointly in
October, 2008. Therefore, the Percent Taxable should be 50 not 100.
`-BUREAU OF INDIVIDWIL TAXES
PD BOX 2SObU1
HARRISBURG PA 17128-0681
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
`F~`~ Pennsylvania
1F DEPARTMENT OF REVENUE
-- REY-IS4! F% Ye.FR[ IOE.121
FILE NO. 2112-1301
ACN 13100005
DATE 01-02-2013
COLEEN M CLINESCHMIDT
2860 VOST RD
PERKIOMENVLLLE PA 18074-9341
Estate of REGINA R MCGUFFIN
SSN 219-12-1837
Date of Death 11-29-2012
County CUMBERLAND
Type of Account
Savings
Checking
Trust
X Certificate
PNC BANK NA provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
rD~C Remfl Payment and Forms to:
Account No. 31900364075
~ ~
Date Esfabllahed 06-22-2012 REGISTER OF WILLS
Account Balance $ 68,141.00 1 COURTHOUSE SQUARE
Percent Taxable X 100
CARLISLE PA 17013
Amount Subject to Tax $ 68,141.00
Tax Rate X 0.045
Potential Tax Due $ 3
066
35 NOTE: If tax payments are made within three months of the
'
,
. decedent
s date of death, deduct a 5 percent discount on the tax
With 5q° Discount (Tax x 0.95) $ (see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1: Please cheCK the appropriate boxes below.
1
A ~ No tax is due.
g The information is
correct.
C ~ The tax rate is incorrect.
(Select coned tax rate at
right, and complete Part
3 on reverse.)
D O Changes or deductions
listed.
E ~ Asset will be reported on
inheritance tax tone
REV-1500.
I am the spouse of the deceased or I am the parent of a decedent who was
21 years ofd or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
The above information is correct, no deductions are being taken, and payment will be sent
with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
(~~4.5% I am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased.
12q° I am a sibling of the deceased.
15% All other relationships (including none).
The information above is incorrect andlor debts and deductions were paid.
Complete Part 2 and part 3 as appropriate on the back of this form.
The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
Retum filed by the estate representative.
Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
~Pi'1'ificate of Deposit Pegs ~ of z ~ PNCBANK
Account Verification
PNC Bank National Association
REGINA R MCGUFFIN
COLEEN CLINESCHMIDT
205 DAISY DR
MECHANICSBURG PA 17050
Certificate Number Reference Number
31900364075 3400144328
Patehess9ate Purchase Amount
06/22/2012 571.000.00
07%22 2013 T13 MONTHS
Annual Percentage Yield
0.4520
Renewal Type
AUTOMATIC
FIXED eRA
e
C
I
D
E
For Information, Call
1-877-BANK-PNC
Account used to purchase this certificate:
PNC Bank 5005169086
Base Interest Rate Package Points Interest Rate Effective
Until
0.4020
0.0500
452 07/22/2013
044 Please review the Account A~eement on reverse side for important information about this account. CMember
EFORM000055~0505 `D'~
_ _
`y~~n /
V'LC./~-~~/KC'~' ~~/ Privacy Security
Last Slgn On: Monday February 1 t Slgn On
. 2013 a14'.Id pm
Email: 5aymares~ comcaelnet Etlil
My ACaounts .-_ - ,d; ~ , i. i, ,.~ ~... ,,.. , ... _.
Summary Aaount AcHWty
Account Activity
Interest Checking XXXXXX0373 Available Balance: 59,567.92 O
Account AeHviry j Aetlvate Online 9btamenb Primer FderMly Pege
'ensf ~r~Tranaaalonr, .-'ounr Summ.vY Accou nt Alerts
Oam Deacnpyion VYlmdnweb Daposib
Avalbbb Babncr.0
39,561.92
7nis account nee no Pending Transecaorb Lsdger Balance: 0 $9,567.92
Pending WlfMnwab: 50.00
rc Psntling Dspoelb: 50.00
,r.
,_.
Inbmt Pald b Dab:
50.16
', Inbreat PaW Laet Yaar. 50.27
List by Dats List by Typs Search Fitter: DsPoebs Export Laet DepoeltAmount: 5781.77
02/05/2013
' Deposits and Other Atlditlona WiStabmant Balance: 58,589.02
OZO6/2013
Oab Amount Deacdption
O?/0912Ut3 Additlonal Infartnatlon
' 01/0&2013 3187.11 DEPOSIT XXXXX7618 ~ Nckname: None Edlt
07/07/2073
~.
'. Type: Inbred Chedring
07/03/2013 5493.40 DEPOSIT X%XXX8006 ~ Text Bankkp Not Enrolled Eatt
72/17/2072 5704.03 DEPOSIT XXXXX4461 ~9. Nickname:
Addrap: 2990 YOST RD E61t
11/132012 54,816.78 DEPOSIT %XX%%1714 [~9. PERKIOMENVILLE, PA 18074
G /G ~f. y3 -834'
Interactive Damo ~ Onltne Banking 8 Sill Pay Guarantee ~ Serviu Agreement ) Privacy Policy I Online Seo,idly
® Copyright 2013. The PNC Finangel Services Group, Inc. All Rights Reserved.
Need Help? Call us at 1-888-PNC-BANK Q824265) Hours
Versmn 01 00 at
~~; ,ll~L! ~.L.~/Yy~ C~GI~ .G'~4.uizC~>rcc,
~"_ / fop r/,~ ~ ~~~ ~~U ~ a3
J
Supportive Material for Schedule H
1. Pre-payment receipt for grave marker and opening/closing of
grave at Rose Hill cemetery in Hagerstown, MD
2. Email noting price paid in 1995 for cremation
Regina R. McGuffin
~~)3~, ~
Date
r .
ROSE h1Ll. CEMETERY Account #
SALES AGREEMENT [nvoiee #
BUYER(S) Re ~,,,~a
DAME:
~S ~t
.nnncnn
Sal - 73 y - -3io .~o
OFFICE USE ONLY
r: ve
.y
~-, v
PrlonE:
V
SECTIOn: ~ RANGE: LOT# SPAC>rS: _
.,y Yfr
' ~ LOtB:
' Opening 8t Closing:
Vault(sI: n s ~, ue..,+/i ,/, jra,.:o_
Monuments ~at~-outal~,T ~,,~I,~.Q_~J ..vr>,.~..~
.~
~~ Subtotal
~I~, ~ ~~• State Adm1n. Pee . '~
1 ~ tony applkable U wa f250AO)
~~ ~ Tax
/ • Total
Down Payment
• ~ Balance Due
5
S
5
5 ~ . on
5 .3~I~ • d J
5
~,~ ~ ~ 9 a ~
b
5/i49g~
S_~_
5
'Buyer(s) are entitled to a copy of this agreement at the time of purci-ase
'Cemetery has a rfght to cancel I( non-payment occurs, 3 consecutive months
'Aii prepaid services and goods are price guaranteed
'Buyer(s) are entitled to ~a copy•of Cemetery Rules 'and Regulations
'Buyer(s) has right to cancel within 3 business. days from date of this agreement
'Prepayment of grave site Openhig and Closing is Monday -Friday buria- only
`Death dates are an additional cost at t{me of death
`Buyer(s) agree to make a payment every Month
Buyer Signature Date
Buyer Signature Date
Tuesday, January 8, 2013 2:26 PM
Subject: Re: Regina McGuffin
Date: Tuesday, January 8, 2013 12:58 PM
From: Auer Funeral Home <auerhome@comcast.net>
To: Coleen Clineschmidt <baymares@comcast.net>
Mrs. Clineschmidt,
I am sorry this took long to get back to you. I was able to look up the
amount paid in for the cremation was, $800.00 on July 15, 1995.
Thank you,
Michelle
Page 1 of 1
Supportive Material for Schedule I
1. PNC Checking account statement listing payments made
2. Copies of checks listed on statement when the payee is not listed.
Handwritten numbers on the copies correspond to the number of
the obligation listed on Schedule I.
Regina R. McGuffin
Privacy Security Slgn 011
Last 31gn On: Wednestlay. February 13 2013 at 650 pm
Emall~. baymsres@cpmcesl ne! Etlil
My Actoun[s ~ ~ ~..
Summary Account Activity
Account Activity
Interest Checking XXXXXX0373 Available Balance: j9,581.92 O
Account ACBvity ~ Activate Onlfne Shtementa Punter F dentlly Page
~. 1~1m:>-vr: ....~~, Account Alerts
Dare Dexcripfi0n IYrthdrawals Depoaid
Available Balancr.0
59,581.92
This account has no Pend'ng Transactions Lstlpsr Balance o $9,581.92
Pantllnp V9lfhdrawalr. 50.00
Pendln9 Daposib: $0.00
Interasl Pald to Darr. $0.18
Intarnt Paid Laat Yaar. 50.27
List by Date List by Type Search EKpott
Last Dspwk Amount: $181.11
' OZOS/P073
hansacfion tlare Check Number gmounr WtSLLment BtLnee: 59,598.02
From: From: From: 02/06/2073
11/30/2012 ~ Sear[h
Additlonal Information
To: To: To:
Nkknams: None EGt
01/10/2013 ~
Type: Interest Checkmq
Tsxt BanNing Not Enrolled Eau
Search Reauks Nickname:
Dare Dastripnon Wifhtlrawa/a DepoaiN 9abnce AtldMS: 2880 YOST RD Eait
~ PERKIOMENVILLE
PA 1 8074
07/10@073 CHECK 7437084075744 G4.
~~ $50.00 $9,884.08 ,
- 9341
01/08/2013 CHECK 7433085819066 C4 ~~~, E90.110 $9,914.08
01!0712013 INTEREST PAYMENT 50.00 $70,004.08 Account Services
01/07/2013 CHECK ]439084869145 ~ ~/'~ $70.00 $7D,D04.00 This Account IS OverdnR Pro4cted ey: Edit
07/03/2073 CHECK 7443 086574953 la4 ~"J. 5177.37 $10,074.00 Premium Money Market SXXX.XX
Uae this Account for Overtlreh Protection
01/03/2073 DEPOSIT XXXXX9006 f~ $483.40 570,251.37
#
01/02/2013 CHECK 7438520019980 ~3.
.(,~ 114.89 $9,787.87
12/31/2012 ACH VYEBSINGLE CKFXXXXX8520POS COMCAST ONLINE $74.68 $9,782.98
PMT
12/28/2012 ACH WE&SINGLE 8852380 CARMELLA CONDO A 1HOA 5150.00 $9,857.04
12/272012 ACH WEBSINGLE CKFXXXXX8520POSuNITED WATER $17.89 $70,007.04
ONLINE PMT
-
. ~~
12/212012 CHECK 7434084428554 ~~-9 $7.83 $70,025.53
72/20/2072 ACH WEBSINGLE DKFXXXXXa52OPG$ VERIZON 518.20 570,033.10
VNRELESS ONLINE PMT
12/2W2072 ACH WEBSINGLE CKFXXXXX8520POS DISCOVER CARD 5618.98 510,040.42
ONLINE PMT
72/77/2012 ACH WEBSINGLE CKFXXXXX8520POS VERIZON ONLINE $71.83 510,888.40
PMT
12/17/2012 DEPOSIT XXXXX4461 ~ $704.03 510,738.23
12/102012 CHECK 2724083500613 L-'-_9-. ~ $718.50 $10,034.20
12/73@072 DEPOSIT XXXXX 7714 [f9. $1,818.79 $70,150.70
y..
72/72/2012 CHECK 7429088124839 ~. y ~Q $713.89 55,336.51
1 217 2 2 01 2 ACH WEBSINGLE CKFXXXX%8520POS PPL ELECTRIC 552.98 $8,048.20
ONLINE PMT
12/12/2012 ACH WEBSINGLE CKFXXXXXa52OPDS UGI U1ILITIES 569.17 $8,707.19
ONLINE PMT
72/07/2072 ACH WEBSINGLE CKFXXXXX8520POS VERIZON $37.18 58,170.38
WIRELESS ONLINE PMT
Imeracvve Demo Online Banking 8 BIII Pay Guarantee Service Agreement I Prvacy PBhq I Online Security
7 Copyrigh12013. IDs PNC Flnanual Services Group. Inc. All R~gMS Reservetl.
Neetl Helps Cali us al ~-886-PNGBANK p5222651 HOUra
VersrOn 410001 r'
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Date Description Amount Account
Ot/03I2013 Check 7443 $177.37 5140040373
This is an image of a check, substitute check, or deposit ticket. Refer to your posted transactions to verify
the status of the item. For more information about image delivery click here or to speak with a
representative call: 1-888-PNC-BANK (1-888-782-2285) Monday - Friday: 7 a.m. - 10 p.m. ET, Saturday &
Sunday: 8 a.m. - 5 p.m. ET.
Aeeounx PAYMEPIT ~ rosT THIS PAVYerT roe oae N11fUAL eesroYta E1TI.37
r
jflssaa Dlroct ANY OrraaNwu 11473rJ13 ;
CO-fEN M CuNE4CHYrt)T do ONIINa 9111 PayrnaM Pracaaaing Caller ~~~74~
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111a C.OIEEN tX.INESCHMIDT $igDeiWB 00 FUB
kder 2860 t03T RD Thfa chade~ dapeNtor Ized
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Dare Description Amount Account
12/21/2012 Check 7434 $7.63 5140040373
This is an image of a check, substitute check, or deposit ticket. Refer to your posted transactions to verify
the status of the item. For more information about image delivery click here or to speak with a
representative calf: ~-888-PNC-BANK (1-888-762-2265) Monday - Friday: 7 a.m. -10 p.m. ET, Saturday &
Sunday: 8 a.m. - 5 p.m. ET.
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• o~ a~irT RCrn°nuE. -n oor~w,l ~ ,., - ; uton ~sae~ , - , D ~ ber 1l. 2012
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0 Copyri8ht 2010. The PNC Finendel Services Grcup, Inc. All Righb Reserve0.
la PNC Online Banking
Date
12/14/2012
pescription
Check 2724
Amount Account
$116.50 5140040373
This is an image of a check, substitute check, or deposit ticket. Refer to your posted transactions to verify
the status of the item. For more information about image delivery click here or to speak with a
representative call: 1-888-PNC-BANK (1-888-762-2265) Monday - Friday: 7 a.m. -10 p.m. ET, Saturday &
Sunday: 8 a.m. - 5 p.m. ET.
NEOINA R. McGNFFIN j ~~
coue~ cu~escrar~oT
206 OAI6Y ORNE
A6?CFiANIt~EitA1Q PA 17060
rsr TO tt1!
2724
~ ae.trry~ta
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Orratotm Bank
Shippeasburg, Pl1 17257
Phone: 717-532-6119
Bna Date: 12/1!/2012
Branch/Teller 0008/0122
12!1!/2012 10:!!:49
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®Copyright 2010. The PNC Finandal Services Group, Inc. All Rights Reserved.
(~ PNC Online Banking
Date Description Amount Account
12/12/2012 Check 7429 $713.69 51.40040373
This is an image of a check, substitute check, or deposit ticket. Refer to your posted transactions to verify
the status of the item. For more information about image delivery click here or to speak with a
representative call: 1-888-PNC-BANK (1-888-762-2265) Monday - Friday: 7 a.m. - 10 p.m. ET, Saturday &
Sunday: 8 a.m. - 5 p.m. ET.
Please Direct any Ousselons
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Date Description Amount Account
01/10/2013 Check 7437 $50.00 5140040373
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the status of the item. For more information about image delivery click hers or to speak with a
representative call: 1-888-PNC-BANK (1-888-762-2265) Monday - Friday: 7 a.m. - 10 p.m. ET, Saturday &
Sunday: 8 a.m. - 5 p.m. ET.
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MICHAEL J LAwLER N?
me MEDK:AL BILLING SERVICES INC
Order 275 CUM9ERlANp PKNrtr
01 MECHANICSEtURG. PA 17055.5677
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Oate Description Amount Account
01/08/2013 Check 7433 $90.00 5140040373
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the status of the item. For more information about image delivery Gick here or to speak with a
representative call: 1-888-PNC-BANK (1-888-762-2265) Monday - Friday: 7 a.m. - 10 p.m. ET, Saturday &
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Date Description
01/02/2013 Check 7438
Amount Account
$14.99 5140040373
This is an image of a check, substitute check, or deposit ticket. Refer to your posted transactions to verify
the status of the item. For more information about image delivery click here or to speak with a
representative call: 1-888-PNC-BANK (1-888-762-2265) Monday - Friday: 7 a.m. - 10 p.m. ET, Saturday &
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Date Description Amount Account
01/07/2013 Check 7439 $70.00 5140040373
This is an image of a check, substitute check, or deposit ticket. Refer to your posted transactions to verify
the status of the item. For more information about image delivery click here or to speak with a
representative call: 1-888-PNC-BANK (1-888-762-2265) Monday - Friday: 7 a.m. - 10 p.m. ET, Saturday &
Sunday: B a.m. - 5 p.m. ET.
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' LAST WILL AND TESTAMENT
OF
REGINA R. MCGUFFIN
I, REGINA R. MCGUFFIN, of Mechanicsburg, 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 and making void any and all wills
by me at any time heretofore made.
,,,+
1. I direct that all my debts and funeral expenses be paid as soon as practical after my
death by my Executor or Executrix, whichever the case may be, hereinafter named.
I direct that all taxes that may be assessed as a consequence oi' my death shall be paid
from my residuary estate as part of the expenses of the administration of my estate.
2. All [he rest, residue and remainder of my estate, real, personal and mixed, and
wheresoever the same may be situate, I give, devise and bequeath to my lutshand, MARTIN H.
MCGUFFIN, provided he shall survive me by a period of sixty (60) days.
3. In the event my said husband, MARTIN H. MCGUFFIN, shall predecease me or fail
to survive me by the aforesaid period of sixty (60) days, then in such event, I give, devise and
bequeath my Estate to my daughter, COLEEN M. CLINESCIIMIDT.
4. In the event my said daughter, COLEEN M. CLINESCHMIDT, shall predecease me, I
give all the rest, residue and remainder of my Estate, real, personal and mixed and wheresoever
the same may be situate to ST. JOSEPH'S CATHOLIC CFIURCFI of Mechanicsburg,
Pennsylvania.
5. I hereby nominate, constitute and appoint my husband, MARTIN FI. MCGUFFIN, as
Executor under this my Last Will and Testament. In the event he should predecease me or fail to
qualify, [nominate, constitute and appoint my daughter, COLEEN M. CLINGSC'HMIDT, as
UW OFFlCES
sNELRANER.
Executrix under this my Last Will and Testament. I hereby direct that no person serving as
BRENNEMAN
$ SPARE
Executor or Executrix hereunder shall be required to post bond to secure the laithfi~l performance
his or her duties in the Commonwealth of Pennsylvania or in any otherjurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Wiil and
Testament written on two (2) pages this 11`h day of March, 2002.
_ ~
~ ~~ r fl _1 <<, ~ (SEAL)
Re ' ~ R. McGuffin
~j
Signed, sealed, published and declared by REGINA R. MCGUFFIId the estatrix above
named, as and for her Last Will and Testament, in our presence, who, in her presence, at her
request, and in the presence of each other, have hereunto subscribed our names as attesting
witnesses.
_(SEAL)
i1 ,~ ..
t E t ~ . (!~a-~ ~«. (SEAL)
`/ ~l
~,~
COUN"CY OF CUMBERLAND
We, REGINA R. MCGUFFIN, PHILIP H. SPARE, ESQUIRE and .LANE J.
GOONEY, the Testatrix and the witnesses, respectively, whose names are signed to the
attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testatrix signed and executed the instrument as her Last
Will and Testament and that she had signed willingly, and that she executed it as her free
and voluntary act for the purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the Testatrix, signed the Will as witness and that to the best of his
or her knowledge the Testatrix was at that time eighteen years of age or older, o ' tti
mind and under no constraint or undue influence.
SS.
' ,~i ~ , ,,
~~a~atr~x
LAW OFFICES
SNELBAKER.
BRENNEMAN
& SPARE
Wt Hess
r_r.-~ .~ _, _
~-- Witness
Subscribed, swom to and acknowledged before me by REGINA R. MCGUFPIN,
Testatrix, and subscribed and swom to before me by PHILIP H. SPARE, ESQUIRE and
JANE J. GOONEY, witnesses, this 11'h day of March, 2002.
i ~
I ~
Notary Publi~~~~
Nweriar s«i
6usen LggZych, NWery Pudic
fon Ex~~~~4.2009
mbar, ennsyMenia Associalton of N