HomeMy WebLinkAbout03-06-1315D56101D5
REV-1500 EX (02-i1) (Fi)
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes ~..P.R~.E„o`w~~`~°` County Code Year File Number
Po Box 28o6oi INHERITANCE TAX RETURN oZ I ~ ~ 102 ~ 7
Harrisburg, PA 1'7128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
~ ~ _ ct ~ _ 3 ~ 3 ~ 10/31 /2012 01 /28/1931
Decedent's Last Name Suffix Decedent's First Name MI
Wydick Edna A
(I# Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
(~ 1. Original Return 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 i2-12-82)
~ 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 Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A}
Between 12-31-91 and 1-1-95} (Attach Schedule O)
~urcrit~f'UNDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Andrew C. Sheely, Esquire 717-697050 ~ as
r w ~ rrt
First Line of Address
127 South Market Street
Second Line of Address
P.O. Box 95
City or Post Office
Mechanicsburg
State ZIP Code
17055
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Correspondent's a-mail address:andrewc.sheely@verizon.net
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SI~~TG RE D~ER~S~ONo ~RnESPONSIBLE~F-OR FILING RETURN ? /~~r~
pnnRF~c
Ellen M. Berringer//, Execu~~tri~~x,//400 Hillside Road, New Cumberland, PA 17070
51GN~E OF PREPAcREi3~rHE rAAN ~GniTeTivr
ngrr`oc CC - ~ -~
Andrew C. Sheely, Esquire, 127
101arket Street, P.O. Box 95, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
I -
/ ~f~
~.p~
1505620205
REV-1500 EX (FI)
Decedent's Social Security Number
Decedent's Name: VU)/dlCk, Edna A. 07~ ~_ t~~ _ ~, ~ 3 ~
RECAPITULATION
1. Real Estate (Schedule A) ........................................... .. 1.
2. Stocks and Bonds (Schedule B) ..................................... .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3.
4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4,
5. Cash; Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. $5,470.08
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. $9,093.31
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested...... .. 7. $303,209.42
8. Total Gross Assets (total Lines 1 through 7) .......... . ................ .. 8. $317,772.81
9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. $5,379.57
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. $2,501.28
11. Total Deductions (total Lines 9 and 10) ............................... .. 11. $7,880.85
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. $309,891.96
13. Charitable and Governmental 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. $309,891.96
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers unc+A~ sec. 9116
(a)(1.2} X .0 15.
16. Amount of Line 14 +=vable
at lineal rate X .045 $309,891.96
1B
$13,945.13
17. Amount of Line 14 taxable
at sibling rate X .12 17,
18. Amount of Line 14 taxable
_,,. _.
at collateral rate X .15 1 g.
19. TAX DUE .........................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
$13,945.13'.
O
Side 2
],505610205 7,5D5610205
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address: ~ ~ ~~ - /~ 7 7
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1} $13,945.13
2. Credits/Payments -
A. Prior Payments $13,100.00
B. Discount $689.45_
Total Credits (A+ B) (2) $13,789.45
3. Interest _
(3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. -
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5} $155.68
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 consideration? .............................................................................................................. ~ ^
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? .......................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 017063
BERRINGER ELLEN M
400 HILLSIDE ROAD
NEW CUMBERLAND, PA 17070
---- fold
ESTATE INFORMATION: ssN: 262-4o-as3i
FILE NUMBER: 21 12-1277
DECEDENT NAME: WYDICK EDNA A
DATE OF PAYMENT: 01 / 1 6/201 3
POSTMARK DATE: 01 /1 6/201 3
couNTY: CUMBERLAND
DATE OF DEATH: 1 0/31 /201 2
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ $13,100.00
TOTAL AMOUNT PAID: $13,100.00
REMARKS: RECEIPT TO ATTY
CHECK#1124
INITIALS: HMW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
REV-1508 EX+ (u-io)
Pennsylvania
: DEPARTMENT OP REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
Edna A. VVydick
SCHEDULE E
CASH, BANK DEPOSITS & MISC.
PERSONAL PROPERTY
FILE NUMBER:
21-12-1277
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. Decedent's 2002 Pontiac Grand Am
2. Verizon refund
3. Comcast refund
4. Morgan Properties refund
5. Country Meadows refund
6. Highmark refund
7. Traveler's Insurance refund
8. ADT Security Services, Inc. refund
9. Manor Care refund
10. Decedent's personal property
11. Decedent's 2012 Federal Income Tax refund
TOTAL (Also enter on Line 5, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size.
VALUE AT DATE
OF DEATH
$2, 500.00
$21.81
$19.71
$68.20
$750.00
$167.00
$10.00
$26.36
$356.00
$500.00
$1,051.00
5,470.08
o :~~a a - y ~?-'~-e^F!i~~a~L® fi~ ti9~e;:-a.s ;;3e- r r~
:_z. :e _ ~z' ~*..._....: _....: "'_. _'i .uB_10si i~ a1" 1 p4:i'L6r.w~9~: ^`:`~1'r'"
P~D'1' S~ ~ u rih S~rr u_ es, Inc.
1~2(~0 F,~isrt Exp~isition A~ enuc
~ A,urnra. CO 801112-2'+12
PAY...TWENTY SIX OOLARS 36 CENTS
To EDNA, W'>'D[CK
rHE 400 H I L!_S I DE RD
ORDER NEW CUM3EZLAND, PA 17070-1862
OF:
THE BANK OF NEW YORK MELLON
PITTSBURGH, PENNSYLVANIA
11'0001 L87921i+' x:04330 L60 L~: ~00~114 265~i'
60-160/433
CHECK DATE CHECK tJUMBER
12/06/2012 0001187921
VALID FOR 120 DAYS
$********26.36
ONE TOWER SQUARE - 0000 PBPZA ~ ~u~'u.._, "s2-2o
HARTFORD, CT 06183 311
TRAVELERS.! 883 ~ 26480 i os
CITIBANK DELAWARE
NEW CASTLE DELAWARE 19720
DATE: OFFICE: AGENT: ~ ACCOUNT: 980572604 PAY
12/ 14/ 12 670 OMB553 5 3 . 0 0 * ~E
THREE 8 00/100 DOLLARS ********xxs************z********ss**a***s**:********ss***********s*x***x
PAY EDNA A WYDICK
TO THE 4 0 0 HILLSIDE R D / iG~' IGvLL/I ~~~~
ORDER OF NEW CUMBERLAND PA 17070
AUTHORIZED SIGNATURE
PLEASE CASH WITHIN 60 DAY
++' 26480 L06~~' 1:03 L L00 2091: 386 L5676~+'
. , ,°'-r _
r:z
>.,
:'
ONE TOWER SQUARE - 0000 PBPZA ~ sz-2o
HARTFORD, CT 06183 TRAVELERS .1 37
CITIBANK DELAWARE 8 8 3 ~ 2 6 5 9 0 2 4 8
NEW CASTLE DELAWARE 19720
DATE: OFFICE: AGENT: ACCOUNT: 980572882
t2/ts/t2 s7o oMea32 PAY 57.00*~~
SEVEN & 00/100 DOLLARS sx**~**********************m*x******:*******************s*xs*:**x*******
PAY EDNA A WYDICK ~~ ~
TO THE 115 MAY DRIVE APT 2 //~~'IGvLGiI ~~,~~
ORDER OF CHAMP HILL PA 17011
AUTHORIZED SIGNATURE
PLEASE CASH WITHIN 60 DAY=
+~' 26590 2481+' ~:0 3 L L00 209; 386 L 56 76++'
Morgan Properties Citi~~rs Bank of Pennsylvania 281976
160 Clubhouse Rd Philadelphia, Pennsylvania
King of Prussia, PA 19406
I **** SIXTY EIGHT AND 20/100 DOLLARS
1
PAY
TO THE
ORDER OF
Edna Wydick
400 Hillside Road
c/o Ellen Berringer
New Cumberland, PA - 17070 - --
3-7615/360
11/07/2012
$68.20******
VOID AFTER 90 DAYS
11'0289?6u' 1:0360?6L50~: 6209?39397u^
COMCAST'FINANCIALRGENCY CORPORATION
:.
A GONICAST CABLE COMMUNICATIQNS GROUP COMPANY, 60;160/.433'
ACCOUNT NUMBER CHECK DRTE CHECK NUMBER
09547-18505010 11/21/2012 0009952910
11
' VALID FOR 180 DAYS
To EDNA WYDICK ********
rHE 4:Q0 HI':LLSIDE RD S 19.71
ORDER <NEW` CUMBERLAND, 'PA 17070-1$62
OF:
----~'
THE :BANK_'OF NEW°;YORK MELLON
PITTSBURGH; PENNSYLVANIA
11'00099529L011' ~:04330L601~: LL3~~~?83411' '
TH{SCOCLMENTC.*','V~.::PIS:LIULTIPL F,~Uiu~T'cRP=~i; StCLri1TY>=aTL'~E=. - --------- --- --
VERIZON .CRG ' - s~= ~~'~=~sF crlECK rlo.
VERIZON PA DATE 1 1 / 15/ 12 voio AFTER 000600199
180DAYS
66-I56/532
" PAY TWENTY-ONE and 81/100 DOLLARS
TO THE EDNA A WYDICK ~~~~~~~'*21 .81
ORDER OF
~_/_~~_r~~~p~p_p_~p ~~rq_~s~l~~~_~l//Ap~~Q n
WELLS FARGO BANK, N.A. ~ ~Y ~~vy L y ~ ~7 `I ~T/i7A
n'000 600 1 9 9 111' ~:053 10 156 i~: 20?9900550 26511'
Country Meadows West Shore 3
4905 East Trindle Road
Mechaniaburg, PA 17050
Telephone: (717) 975-3434
Ellen Barringer
400 Hillside Road
New Cumberland, PA 17070
Please detach and return top portion with payment.
STATEMENT
Statement Date: 01/01/2013
Amount Enclosed $
Amount Due: $ -750.00
Account #: 94765
RE: Edna Wydick
..Date tion _ Days
12/31/12 SECTRANS ua~ ~~ Cha P Balances
750.00 -750.00
Current 31-60 Da s
Y 61-90 Days Over 90 Days Amount Due
-750.00 .00 .00 .00
Thank you for choosing Country Meadows of West Shore 3! -750.00
Please indude the top portion of this bill with your payment by the
15th using the endosed envelope. Make your check payable to Country
Meadows Assodates. Statement Date: 01/01/2013
Edna Wydick -Account #: 94765
Country Meadows West Shore 3
4905 East Trindle Road
Mechanicsburg, PA 17050
Telephone: (717) 975-3434
Country .Meadows Associates.
Pay to: ELLEN BERRINGER
Date: 01/03/2013
MEMO INV. DATE INV. NUMBER
INV. AMOUNT
RESIDENT REFUND 11/01/2012 WYDICK, E
EDNA WYDICK 750.00
9043/94765
-=__
Amt: $750.=7820
DISCOUNT NET AMOUNT
750.00
ELLEN BERRINGER
400 HILLSIDE ROAD
NEW CUMBERLAND, PA 17070
I- G MARK.
Date: 11/13/2012
This Month
Gross payment amount 167.00
Net payment amount 167.:_00 _
0406659
9' ~ 0• ~ ': '• 9 f 0 •y: ~' tl
~~-~~,:.~~~.~~: .0406659
t I H :. ~_~6.;
G t~~K~ 3~.
DASE AMOUM1IT
Premium Refund 11/13/2012 167.00.
Voidif nor castaeC within 1 Year
*ONE HUNDRED SIXTY-SEVEN AND °00/100 D(1LLARS*
PAV THE ESTATE OF EDNA WYDICK
to nie
oR~eR of 4-00 HILLSIDE RD ~[t~.~PI~~rl~
NEW CUMBERLAND PA 17070 ~A~~
~~'0406659~~' ~:036076L50~: 6 20 54 5 2 58~ii'
REV-i5og EX+ (oi-io)
,~ ~ Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
Edna A. Wydick
If an asset became i
SCHEDt~LE F
JOINTLY-OWNED PROPERTY
FILE NUMBER:
21-12-1277
owned within one year of the decedent's date of death it must be r
eported on Schedule G.
SURVIVING JOINT TENA
NT(S) NAME(S)
A•Ellen M. Berringer
B.
C.
JOINTLY OWNED PROPERTY:
ADDRESS
400 Hillside Drive, New Cumberland, PA 17070
RELATIONSHIP TO DECEDENT
Daughter
Sov~ereig~i
To: Attorney Andrew C Sheely
127 S Market St
Mechanicsburg Pa
From: Sovereign $ank
1 b8 S 32°d SC
Camp Hill Pa
Mike Nixon Branch Manager
Date: January 15th 2013
Ref: Edna A Wydick
115 May Dr A.pt 2
Camp Hill Pa
Please be advised that account 1791053459 was opened on 3/7(2012 with a balance of
$9,093.31 ou 10/31/2012. Account 7673009196 was opened on 3l07120I2 with a balance
of $24,124.45 on 10/31/2012.
Mike Nixon
Branch Manager
l •d L60~ •~N
IAlkfl(l:l I 01117 'CI •upr
REV-1510 EX+ (OS-09j
~~. i Pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE
INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
Edna A. Wydick FILE NUMBER
21-12-1277
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY
NUMBER INCLUDE THE NAME OF THE TRANSFEREE, i HEfR RELATI0NSH7P TO DECEDENT AND DATE OF DEATH
THE DATE Of TRANSFER. ATTACH A CDPY OF THE DEED FOR REAL ESTATE.
VALUE OF ASSET % OF DECD'S EXCLUSION TAXABLE
I. Western National Llfe Insurance Company Annuity -Policy VV242358 INTEREST ,IF APPLICABLE? VALUE
$5,525.82 0
100 /o
$5,525.82
2~ Western National Llfe Insurance CompanyAnnuity -Policy VV238715 $8
036
22 0
,
. 100 /o $8,036.22
3• Sun Llfe Financial Annuity -Policy KA12985634-1
$5,241.12 0
100 /o
$5,241.12
4. Axa Equitable IRA -Contract #302 650 793
$193,842.0 100% $193,842.03
5~ American General IRA- Contract #HEA015995F
$69,439.7 100% $69,439.78
6. Sovereign Money Market Acct. #7673009196 (account made joint on March 7
$24
124
45 0
,
,
.
2012, within one year of death) 50 /o $3,000.00 $21,124.45
TOTAL (Also enter on Line 7, Recapitulation) $ I 303 209.42
If more space is needed, use additional sheets of paper of the same size.
Date of death Values as provided from the companies listed below:
Jackson National Life-trust
AXA Equitable-
Sunlife
Western National Life VV238715
American General
$211,285.74 (letter enciosed~
$193,842.03 (per Mohan at AXA}
$5,241.12 (letter enclosed}
$8,035.22 (letter should be at your house)
$69,439.78 (letter enclosed}
This statement has been prepared by Nick Diranian far informationalpurposes only and does not replace the
statement(s). This report has been prepared from data believed to be reliable, but no representation is being made
as to its accuracy or completeness. The information provided should be used only as a general guide to portfolio
value. The frgures presented should not be relied upon for tax purposes.
11-2?-'12 08:21 FROM-AIG LIFE.
1~mericatt ~ener~l
Lift Ccsm~ani~s
November 27, 2012
ELLEN BERRtNGER
Contract Number: HEA015995F
insured; Et3NA A W1'OICK
Dear ELLEN BERR-NGER:
T-960 P000110001 F-007
Insurance Service Center fc-r.~
AmeNcan General Life
insurance Company
As requested, we are providing you with the Oea#h Benefit amount as of 1013112012.
APPROXIMATE DEATH BENEFIT $69,439.78
We appreciate the opportuniEy to be of service to you, If we may be of further assistance, please contact our office.
Sincerely,
INOEVlDUAL CLAIMS DEPARTMENT
cc: 8AV81 /FLEET STAR FINANCIAL L
SAV90 / NICHOLAS M DIRANlAN
1J40P1t~D
P.O. Box 44 3m Houseton, TX 7?2 ii 4-d4a3 •ng gpp~~ ~~5 ; Fax y13.831.3028
Western National Life Insurance Company
P.O. Box 871, Amarillo, TX 79105-0871
CHECK# 16034463
INTERNAL REFERENCE# 2200898030
NAME:
POLICY:
TRANSACTION:
OWNER:
TRANSACTION STATEMENT
EDNA WYDiCK November 23, 2012
VV242358
DEATH CLAIM PROCEEDS
EDNA WYDICK
FEDERAL WITHHOLDING TAX
STATE WITHHOLDING TAX
AMOUNT OF CHECK
TAXABLE INCOME
$ 69.97
$ 10.49
$ 5,445.36
349.$3
~ ~~~~
l~,- 3-1a-
PLFASB DET'AC'H AN"~i F;E'E;P 'Pf-i? S S?'L~ FOR YOUR RECORDS
REV-1511 EX+ f 1C-09j
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~~iAit OF
Edna A. Wydick
ITEM
NUMBER
a FUNERAL EXPENSES:
1. Parthemore Funeral Home
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
FILE NUMBER
21-12-1277
Decedent's debts must be reported on Schedule I.
$2,670.07
B• ~ ADMINISTRATIVE COSTS:
1• Personal Representative Commissions:
Name(s) of Personal Representative(s) Ellen M. Berringer
street address .400 Hillside Road
cty _New Cumberland _ state PA zIP 17070
Year(s) Commission Paid:
Z. Attorney Fees: r~` ~cl~~ uJ ~' , 5 di~GlY ~ Es dui ~-e,
3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City _
__ State ZIP
Relationship of Claimant to Decedent
4• Probate Fees:
5• Accountant Fees:
6• Tax Return Preparer Fees:
~• Postage
$~ Filing Fee
s. Reserves to conclude Estate administration, final accountings
TOTAL (Also enter on Line 9, Recapitulation) ~ $
If more space is needed, use additional sheets of paper of the same size.
$0.00
$1.650.00
$100.50
$335.00
$9.00
$15.00
$600.00
5, 379.57
RECEIPT F`OR PAYMENT
CumbDrland CountyASBRegiister Of Wills
One Courthouse Square
Carlisle, PA 17613
WYDICK EDNA A
Estate File No.: 2012-01277
Paid By Remarks: ELLEN M BERRINGER
HMW
Receipt Distribution
Receipt Date: 12/06/2012
Receipt Time: 13:40:54
Receipt No.: 1072309
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST
WILL 20.00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 15.00
12
00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE
AUTOMATION FEE .
23.50 CUMBERLAND COUNTY
BUREAU OF RECEIPTS GENERAL
& CNTR FUN
M
D
5.00
------- CUMBERLAND COUNTY GENERAL .
FUN
C eck# 1122
Total Received......... ---------
75.50
75.50
~~-~5_"3;'x:02 ;
~.1~/
`~ ~/~
/`
~;`~ ~
_~ .~s'~
o~x ervlces, Inc.
Mrs. Ellen M. B _
400.Hillside Road I t/1/2012
New Cumberland, PA 1 U7U
For the,Seroice of Edna . Wydick
We sincerely apprxiatc a confidence you have placa3 in us and will continue to assist u in ev
we can. Please feel.free o contact us if u hays an ~ erY way .
Yo y questions iti regard to this statement. Thc following
is ati itemized statement Erne servit;p, faci6tics, automotive equipment.and merchandise that you selected
when •making the funera arrangements.
PARTHEMORE Fui~si P ~ rrP,Y,~*;,,,, eo~,,.~.. T~..
130 Biid~e Street
P,O. F3ox 431
New Cumberland, PA 17070
(717) 774-7721
(Fax) 774-554b
www_parthcinorc.com
t;ilhert W. Patxhemore,
Founder
Gilbert J. Parthetnore,
Supervisor
Stephen K'Parthemorc,
CFSP
Brur:c R. Parthemore,
Pre-Need Coordinator, CPC
Professional Mcmb~rships:.
NFDA•PFDA
DCFDA•CCFnA
.,,d„Ne,
U~EE
The Rule You Knoxi
The n~,f,k r.,~. r,...i
SERVICES & ME
Direct Cremation
Total Sirrviccs and
CASH ADVANCE I'I'EI~I5
9'71769?7065 ;
A Family Tradition Of Caring®
ms Due Date
30' 12/!/2012
Description
Account #
2012084.1
Amount
2,320.00
i,3zo.oo
# 1/ 2
Death Notice, Hartisb ~ Patriot
Dcaitt Notice, Worc '1'etegram ~. Gazette
l2 Ccrrified Copies of ath Certificate
Ctimtierlarid County Co ner I"ee, Cremation Authvrirativn
Tvta1 Caen Aidvanccs
Immediate Pay Diswuntl-Thank you!
'~~
~~
1 15.47
184.00
72.00
2s.oo
396.47
-46.44
Total Sz,e~o.n~
Payments/Credits a-z,67o.07
Balance Due so,oo.
01-15-"3;15;02 ;
Parthemore Funeral
New
Mrs. L'llcn M. Bcmngcr
4UU Hillside Read
Ncw Cumberland, PA i 7070
For the Service afEdna A. Wydtck
917176977065 ;
~ me & CrematYOn Services, Znc.
P.O. Bux 431
1 03 Bridge Street
~ herland, PA 17070-0431
(717) 774-7721
Statement
DATE
I /8/2013
# 2/ 2
AMOUNT DUE AMOUNT ENC.
50.00 ~-
DATE TRANSA C~fION AMOUNT BALANCE
1 0/3 1120 1 2 Balance forward ~
11/01/2012
11/0R/2012
1NV X2802. Due 12/01/2012_
PMT#1109. lilen M. Rerringer
~
'
j
2,670.07
-2,670.07 0.00
2,670.07
0.00
CURRENT 1-30 DAYS PAST 31-60 DAY$ PAST 61-90 DAYS PAST OVER 9U DAYS
DUE DUEI DUE, PAST DUE AMOUNT DUE
0.00 0.00 0.00 ' O.OU 0.00 50.00
Please don't hesitate to call our office if we may be of assistance. Thank you.
REV-1512 EX+ (12-08)
Pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
~alE-~~ ur
Edna A. Wydick FILE NUMBER
21-12-1277
Report debts incurred by the decedent prior to death that remaina~l ~~„~~~.~ ~* *tie a~.., ,.~ a__« :__~....:_-
-----, ..._... ,...,.,.,,,~~,.~ o~iccw ~~ uie carne size.
REV-1513 EX+ (01-10)
~~ Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF:
Edna A. Wydick
SCHEDULE ~
BENEFICIARIES
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and trensfers under
Sec. 9116 (a) (1.2).]
1, Ellen Berringer, 400 Hillside Road, New Cumberland, PA 17070
KtLAl1UNSHIY IU Ut(;tUtNl
Do Not List Trustee(sl
Daughter
FILE NUMBER: -
21-12-1277
NMUUIV I UK JHHKt
OF ESTATE
100% rest, residue &
rPmainriar ~f aStatP
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
If more space Is needed, use addltlonal sheets of paper of the same size. $
The Law Offices of Adam J. Tobin
Telephone: 978-725-9083
LAST WILL AND TESTAMENT
OF
EDNA A. WYDICK
I, Edna A. Wydick, a resident of and domiciled in the Commonwealth of Massachusetts, make,
publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any time heretofore
made by me.
FIRST: I direct that the expenses of my last illness and funeral, the expenses of the
administration of my estate, and all estate, inheritance and similar taxes payable with respect to property included in
my estate, whether or not passing under this will, and any interest or penalties thereon, shall be paid out of my
residuary estate, without appontionment and with no right of reimbursement from any recipient of any such property.
SECOND: I give all tangible personal property owned by me at the time of my death, including
without limitation personal effects, clothing, jewelry, furniture, furnishings, household goods, automobiles and other
vehicles, together with all insurance policies relating thereto, to my daughter Ellen M. Berringer, if she survives me.
THIRD: I give all the rest, residue and remainder of my property and estate, both real and
personal, of whatever kind and wherever located, that I own or to which I shall be in any manner entitled at the time
of my death (collectively referred to as my "residuary- estate"), as follows:
(a) If my daughter survives me, to my daughter, or if she does not sur~zve me to David Berringer
if he shall survive me. If neither of the aforesaid beneficiaries of my residuary estate shall survive
me, my residuary estate shall be paid and distributed to Elizabeth Stromberg if she shall survive
me.
(b) If none of the beneficiaries described in clause (a) above shall survive me, then I give my
residuary estate to those who would take from me as if I were then to die without a will, unmarried
and the absolute owner of my residuary estate, and a resident of the Commonwealth of
Massachusetts.
FOURTH: If any property of my estate vests in absolute ownership in a minor or incompetent,
m_y Executor, at any time and without court authorization, may: distribute the whole or any part of such property to
the beneficiary; or use the whole or any part for the health, education, maintenance and support of the beneficiary; or
distribute the whole or any part to a guardian, committee or other legal representative of the beneficiary, or to a
custodian for the beneficiary under any gifts to minors or transfers to minors act, or to the person or persons with
whom the beneficiary resides. Evidence of any such distribution or the receipt therefor executed by the person to
whom the distribution is made shall be a full discharge of my Executor from any liability with respect thereto, even
though my Executor may be such person. If such beneficiary is a minor, my Executor may defer the distribution of
the whole or any part of such property until the beneficiary attains the age of eighteen (18) years, and may hold the
same as a separate fund for the beneficiary with all of the powers described in Article SIXTH hereof If the benefi-
ciary dies before attaining said age, any balance shall be paid and distributed to the estate of the beneficiary.
If any occasion shall arise during the administration of my estate, or in connection with any matter
or proceeding relating to my estate, calling for the appointment of a person to represent the interests of persons
unborn or unascertained or the interests of any other person, I direct that such appointment shall be dispensed with,
if pernutted under applicable law.
~a~a.~/~
FIFTH: I appoint my daughter Ellen M. Berringer to be my Executor. If my daughter Ellen M.
Berringer shall fail to qualify for any reason as my Executor, or having qualified shall die, resign or cease to act for
any reason as my Executor, I appoint my son-in-law David Bemnger as my Executor. If my son-in-law David
Berringer shall fail to qualify for any reason as my Executor, or having qualified shall die, resign or cease to act for
any reason as my Executor, I appoint Elizabeth Stromberg as my Executor. I request that my Executor be appointed
as Temporary Executor upon application therefor. I direct that no Executor shall be required to file or fiuvish any
bond, surety or other security in any jurisdiction.
SIXTH: I grant to my Executor all powers conferred upon executors wherever my Executor may
act, including the Statutory Optional Fiduciary Powers, Statutory Disability Discretionary Powers and Statutory
Principal Discretionary Powers enumerated in Massachusetts General Laws Chapter 184B or any successor thereto.
I also grant to my Executor power to retain, sell at public or private sale, exchange, grant options on, invest and
reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit; to borrow money and
encumber or pledge any property to secure loans; to exercise all powers of an absolute owner of property; to
compromise and release claims with or without consideration; and. to employ attorneys, accountants and other
persons for services or advice. The term "Executor" wherever used herein shall mean the executors, executor,
executrix or administrator in office from time to time.
SEVENTH: If any beneficiary under this will and I die in a common accident or under
circumstances in which it is difficult or impractical to determine who survived the other, such beneficiary shall be
deemed to have predeceased me.
Except as provided in this will, I intentionally, and not as a result of mistake or inadvertence, omit
to provide for any issue of mine.
IN WITNESS WHEREOF, I, Edna A. Wydick, sign, seal, publish and declare this instrument as
my last will and testament this 21st day of September, 2005.
/~' ~~
The foregoing instrument was signed, sealed, published and declared by Edna A. Wydick, the
above-named Testatrix, to be her last will and testament in our presence, all being present at the same time, and we,
at her request and in her presence and in the presence of each other, have subscribed our names as witnesses on the
date a written.
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AFFIDAVIT
COMMONWEALTH OF MASSACHUSETTS, COUNTY OF WORCESTER, ss.
Before me, the undersigned authority, on this day personally appeared Edna A. Wydick and
CilIC~Ec ia~yc~~ and Rn y Lcnncr5 qnd /lrcholas ~i ranrun , known to me to be the Testatrix and the witnesses,
respectively, whose names aze subscribed to the annexed or foregoing instrument in their respective capacities, and,
all of said persons being by me duly sworn, the said Edna A. Wydick, Testatrix, declared to me and to the said wit-
nesses in my presence that said instrument is her last will and testament, and that she had willingly made and
executed it as her free and voluntary act and deed for the purposes therein expressed; and the said witnesses, each on
their own oath stated to me, in the presence and hearing of the said Testatrix, that the said Testatrix had declared to
them that said instrument is her last will and testament, and that she executed same as such in their presence, and she
wanted each of them to sign it as a witness; and upon their oaths each witness stated further that they did sign the
same as witnesses in the presence of the said Testatrix and at her request; that the said Testatrix was at the time at
least eighteen years of age, and was of sound mind and under no constraint, duress, fraud or undue influence; and
that each of said witnesses was then at least eighteen years of age.
,~
estatrix
/u~
Witness
~,, ~ .
W' ess
~~-
Witness
On the 21st day of September, 2005, before me, the undersigned notary public, personally
appeared Edna A. Wydick, the Testatrix, proved to me through satisfactory evidence of identification, which were
~.ir~ d, ~venSj tcEr~Se, and C~neE~T +-9~~~ proved to me through satisfactory evidence of identification, which were
wl~d dr~veR Icc~n~, a rd Arley Canners proved to me through satisfactory evidence of identification, which were
~/~.4~ddrrver~licEnsa and J~icfrc(aS ~; rc:n;an proved to me through satisfactory evidence of identification, which were
+'Q~,d d avers I ree~~ ~ witnesses, all proved to be the persons whose names are signed on the preceding affidavit, and who swore or
affirmed to me that the contents of the affidavit are truthful and accurate to the best of each of their knowledge and
belief.
- ._---~
Notary Pu 'z<'"
My commission expires on
~;cU~ ~. To'~in
I~iotary Public
i4ty Commission Expirea
Septrember 17, 2010