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HomeMy WebLinkAbout04-05-13 (2) REV-1500 ex(01-1 0) 1505610143 X15 OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number Bureau of Individual Taxes DEEANTNENT r*REVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 12 0771 07 03 2012 09 20 1925 Decedent's Last Name Suffix Decedent's First Name MI LONG FERN M (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ❑ 2. Supplemental Return ❑ 3.Remainder Return(date of death prior to 12-13-82) ❑ 4. Limited Estate ❑ 48.Futufe Interest Comprom ni ❑ 5, Federal Estate Tax Return Required opera 0 death aRer 12-12-82) ® 8 Decedent Died restate ❑ 7, Decedent Maintained a Living Trust 0 8, Total Number of Safe Deposit Boxes (Attach Copy of Wily (Attach Copy of Trost) 0 9. Litigation Proceeds Received ❑ 16.`w�+sal 1o2 Creda(alga cf death 11.Election to tax under Sec.9113(A beWreen 12-31-9]and 1-]-95} ❑ tAttach Sch.O) CORRESPONDENT•THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephon"umber GERALD J BRINSER 71g 838 &340 A 0 FagL WF vlll tl �LY xr y, r- r,T m First line of address 3* U1 o 6 E MAIN STREET n c7 '71 -n -Dt , cam F—' ..` Second line of address C'> IV r' Prl PO BOX 323 o a DATE FI D In City or Post Office State ZIP Code PALMYRA PA 17078 Correspondent's is-mall address: glbrin@aol.COm 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 ail information of which preparer has any knowledge. SIG FOF PERSON RESPAYSIeI.- OR FILI RETURN ATE Joanne Kress ADD SS. 17714 Cricket Hill Drive,Germantown,MD 20874 SIGNATURE PARER OTHER HAN PRESENTATIVE DATE// Gerald i1�� Gerald J Brinser ADOR =—rte vfr 6 E. Main Street, Palmyra, PA 17078 Side 1 1505610143 1505610143 1505610243 REV-1500 EX RECAPITULATION 1. Real Estate(Schedule .........................---...... 2. Stocks and Bonds(Schedule 8). . . ............. -.......... . ... . ......... 2, 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 1 4 Mortgages&Notes Receivable(Schedule D).........-...... ......... .. ....... ................ 4. S. Cash..Bank Deposits&Miscellaneous Personal Prop"(Schedule E)................ 5. 269 , 095 . 26 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested........... 6. T Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested..._........ 7. 65 , 690 . 46 8. Total Gross Assets(total Lines 1-7)........._........ ......... . .. ........-.............. 334 , 785 . 72 9 Funeral Expenses&Administrative Costs(Schedule H).... ........... . ................ 33 , 144 . 09 10. Debts of Decedent,Mortgage Liabilities,&Lions(Schedule]).............-...... 110. 3 , 399 . 94 11 Total Deductions(total Lines 9&10)....-..........._.... ......... ............ . -....... 11, 36 , 544 . 03 12 Not Value of Estate(Line 8 minus Line ........-............. 12. 298 , 241 . 69 13.--Charitable and Governmental Bequests/Sec 9113 Trusts for which ,,an election to tax has not been made(Schedule J)... 13, 14. -ketValuetilubjeetto Tax(Line 12 minus Line 13).-- ......... 14. 298 , 241 . 69 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X x.00— 15 16. Amount of Line 14 taxable at lineal rate X .045 298 , 241 . 69 1& 13 , 420 . 88 17•Amount of Line 14 taxable at sibling rate X 12 17, 18 Amount of Line 14 taxable at collateral rate X 15 18. 19 Tax Due..- .. . ......... . .... . .... ................. ...... .... .. .................. 19. 13 , 420 . 88 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 15056102143 1505610243 REV-1500 EX Page 3 File Number 21 - 12 - 0771 Decedent's Complete Address: DECEDENT'S AM Long, Fern M. STREET ADDRESS 838 Oak Oval CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: i. Tax Due(Page 2,Line 19) (1) 13,420.88 2, Credits/Payments A. Prior Payments 11,000.00 B. Discount 578,95 Total Credits(A +B) (2) 11,578.95 3. Interest (3) 0.00 4. if Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 1,841 .93 Make Check Payable to: REGISTER OF WILLS, AGENT. . .: .•^wry.�+I N",701", r' " ,00"014 . 00,0118µ ..".01 1- PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................ ...... ................. x b. retain the right to designate who shall use the property transferred or its income;...__............................. x c, retain a reversionary interest;or......___--...............---...............................-------._...._...._....___......._._.._ x d. receive the promise for life of either payments,benefits or care?..._................... .................................... x 2. If death occurred after December 12, 1962, 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?......... C] ❑ 4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which contains a beneficiary designation?....... ...................................................... ................................ LX] ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. wv k .` o`: .Stiff ..1 5 _r» .., FORMER ` x4�..r1r't , 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 Janus rY 1,1995,the tax rate imposed on the net vaiue of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)iii)]. 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 yyeears of age or younger at death to or£or 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 11)[72 P.S.§9116(a)(1)]. •The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§§9116((a)(1.3). A sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by bloo�or adoption. SCHEDULE E CASH, BANK DEPOSITS, & MISC. COhMONWEAITH°EPENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Lang, Fern M. v _ _ 21 - 12 -0771 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 PNC Bank-Certificate of Deposit#31700314795 10,022.22 (Includes accrued interest of$1.26) 2 PNC Bank-Certificate of Deposit#31200316458 30,010.54 (Includes accrued interest of$0.33) 3 PNC Bank-Certificate of Deposit#31000314873 10,005.49 (includes accrued interest of$0.22) 4 PNC Bank-Certificate of Deposit#31900316258 10,006.37 (includes accrued interest of$1.27) 5 PNC Bank-Certificate of Deposit#31200346262 10,005.27 (includes accrued interest of$0.22) 6 PNC Bank-Certificate of Deposit#31600349233 10,102.77 (includes accrued interest of$2.20) 7 PNC Bank-Certificate of Deposit#31200351144 20,182.39 (Includes accrued interest of$14.84) 8 PNC Bank-Checking Account#5070102806 21,196.43 9 Allstate- Refund of Renter's Insurance 83.01 10 Allstate- Refund of Car Insurance 14.44 11 2005 Buick Century- KBB Value 5,525.00 12 Beico Community Credit Union -Savings Account#0001 1.00 TOTAL(Also enter on Line 5,Recapitulation) 269,095.26 SCHEDULE E CASH, BANK DEPOSITS, & MISC. CCNWNWEALTH DE PENNSYLVANIA PERSONAL PROPERTY INHERITANCE T"RETURN RESIDENT DECEDENT continued ESTATE OF Long, Fern M. FILE NUMBER 21 - 12 -0771 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM I VALUE AT DATE OF NUMBER DESCRIPTION DEATH 13 Belco Community Credit Union -Certificate of Deposit#1003 10,170.28 (Includes accrued dividends of$7.63) 14 Belco Community Credit Union -Certificate of Deposit#1004 20,15313 (Includes accrued dividends of$6.30) 15 Belco Community Credit Union -Certificate of Deposit#1005 10,068.87 (Includes accrued dividends of$11.03) 16 Citizen's Bank -Checking Account#XXXX298-0 50.43 17 Citizen's Bank- Certificate of Deposit#XXXX9386 60,242.61 (Includes accrued interest of$22.80) 18 Final Pension Check 865.98 19 John Hancock- Long-Term Care Ins. 1,038.62 20 Gerber Supplemental Insurance- Refund of Annual Premium 2,432.82 ✓ 21 Messiah Village- Refund of Apartment Equity 36,529.25 22 PA Department of Revenue- Income Tax Refund 213.16 23 Refund of Newspaper Subscription 127.02 24 Cash on Hand 48.16 i i i Page 2 of Schedule E COMMONWEALTH OF PENNSYLVANIA SCHEDULE G INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS & RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Long, Fern M. FILE NUMBER 21 - 12-0771 This schedule must be completed and filed If the answer to any of questions 1 through 4 on page 2 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % EXCLUSION NUMBER Include the name of the transferee,their relationship to decedent VALUE OF ASSET DECOS (IF APPLICABLE) TAXABLE VALUE and the date of transfer. Attach scopyofthe deed forreal estate. INTEREST 1 PNC- IRA Account #75100037751,with children, 41,706.97 100% 41,706.87 Joanne Kress, Susanne Robinson, Robin Long and Randall Long, named as beneficiaries. (Includes accrued interest of$42.74) 2 MetLife-Total Control Account#4053798252,with 23,983.59 100% 23,983.59 two children, Joanne Kress and Randall Long, named as beneficiaries. (Includes accrued interest of$2.91) TOTAL(Also enter on line 7, Recapitulation) 65,690.46 SCHIMMEH FUNERALEXPENSES& CQMM0I CF PENNSYLVANIA INHERITANCE TAX RETIJRN RESIDENT DECE05N I ADMMM7WC0M FILE NUMBER ESTATE OF Long, Fern M. 21 - 12-0771 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. 1 Malpezzi Funeral Home 11,707.07 2 Messiah Lifeways- Use of Room for Service 150,00 3 Trindle Spring Lutheran- Funeral Luncheon 162.32 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personaf Representative(s) Joanne Kress 10,500.00 Street Address 17714 Cricket Hill Drive City Germantown State MID zip 20874 Years)Commission paid 2012 2, Attorney's Fees Brinser, Wagner& Zimmerman --Gerald J. Brinser 10,000.00 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 Register of Wills (Ctrs. Pd. $360.00 = $300,000-$400,000) 419.50 5. Accountant's Fees & Tax Return Preparer's Fees T Other Administrative Costs 1 Register of Wills-Filing Fees(REV-1500) 15.00 TOTAL(Also enter on line 9,Recapitulation) 33,144.09 Sched*H I �y�p�F�u�neyral�E�ms�y��y& ��.� COMMONWEALTH 1AX PENNSYLVANIA P0.01NIi"IYOYYC\osis\�mikiwidl INHERITANCE TAX RETURN FfYaYYC _ RESIDENT DECEDENT _ FILE NUMBER ESTATE OF Long, M. ESTATE 21 - 12 -0771 2 The Sentinel-Legal Advertising 115.24 3 Cumberland Law Journal-Legal Advertising 75.44 I I I Page 2 of Schedule H SCHEDULEI tt: DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH Of PENNSYLVANIA LIABILITIES LIENS INHERITANCE TAX RETURN f RESIDENY DECEDENT FILE NUMBER ESTATE OF Long, Fern M. - -_ 21 - 12-0771 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION _ AMOUNT NUMBER 1 Alert Pharmacy 49.84 V 2 AT&T- Long-Distance Phone 45.88 3 AT &T- Fee to Close Credit Card 1.00 4 PP& L- Electric 47.21 5 Messiah Lifeways 2,558.92 6 Messiah Homecare 667.07 7 Verizon-Phone 30.02 TOTAL(Also enter on Line 16,Recapitulation) 3,399.94 REV-1513 E%+(11�9) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Long, Fern M. 21 -12-0771 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do NW List Trustee(sl I TAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Joanne Kress Daughter 1/4 Schedule G,#1; 138,694.14 17714 Cricket Hill Drive 1/2 Schedule G,#2; Germantown, MD 20874 1/2 Residue 2 Susanne Robinson Daughter 1/4 Schedule G,#1 10,426.72 6817 Wesley Drive Harrisburg, PA 17112 3 Robin Long Daughter 1/4 Schedule G,#1 10,426.72 623 S. Poplar Street Winston-Salem, NC 27101 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. Q. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 REV-1 513 EX-(9-00) �. SCHEDULE J COMMONWEALTH TAX RFSriVA,^t1A BENEFICIARIES continued INHERITANCE TAX PENNSYLVANIA RESIDENT DECEDENT ESTATE OF Long, Fern M. FILE NUMBER 21 - 12-0771 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Na us+Trusme(s) ;. TAXABLE DISTRIBUTIONS(include outright spousal distributions,and transfers under Sec.9116(a)(1.2)) 4 Randall Long Son 114 Schedule G,#1; 138,694.14 1016 Culver Lane 1/2 Schedule G,#2; Virginia Beach,VA 23454 1/2 Residue Page 2 of Schedule J WILL OF FERNM. LONG I, FERN M. LONG, currently of Upper Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. I. I direct that all my just debts and funeral expenses be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate and inheritance taxes that may be assessed in consequence of my death, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath equally unto my daughter, Joanne Kress, and my son, Randall Long. If either of them predeceases me his or her share shall pass unto his or her spouse. If either of them is not survived by a spouse said share shall pass unto my other child named herein or his or her surviving spouse. I am intentionally omitting any reference to my daughters, Susanne and Robin. IV. I appoint my daughter, Joanne Kress, Executrix of this my Will. In the event that she fails to qualify or ceases to act as Executrix, I appoint my son-in-law, Donald Kress, Executor of this my Will. V. I direct that no bond be required of my fiduciaries for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, FERN M. LONG, herewith set my hand to this my Last Will, typewritten on two (2) sheets of paper including the attestation clause and signatures of witnesses, this / w 4k day of r„,v r 2008. c o J (SEAL) ;, -I- FERN M. LONG Signed by FERN M. LONG, by her declared to be her Will in our presence, who have hereunto subscribed our names as witnesses in her presence and at her request, this loNay of Tv,✓i , 2008. residing at �� residing at KAI"U,%, 2L -2- COMMONWEALTH OF PENNSYLVANIA COUNTY OF LEBANON WE, FERN M. LONG, GERALD J. BRBJSER and kwn4y .A. iOc—TCR$ the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she signed willingly (or willingly directed another to sign for her), 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 witnesses and that to the best of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. FERN M. LONG TNESS WANES$ Subscribed, sworn or affirmed and acknowledged before me by FERN M. LONG, the testatrix, GERALD J. BRINSER and 11RTHy R. f�T�3S witnesses, this Ieday of Ju-,n — , 2008. L EAL) otary Publi COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL WENDY L.CRAWFORD,Notary Public Palmyra Boro.,Lebanon County M Commission Ex ires Se tember 10,2009 -3- 3a.n'R PC August 8, 2012 Gerald $rinser Esq, Brinser Wagner & Zimmerman P.C. 6 E Main St 2"d Fl P 0 Box 323 Palmyra, PA 17078 RE: Fern M Long SSN: 208-18-7693 DOD: 07-03-2012 Dear Mr. Brinser: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Certificate of Deposit Account # 3 17003 14795 Established: 07-11-2007 FERN M LONG DOD balance: $ 10,020.96 + 1.26 accrued interest Interest paid 01-01-2012 thru 07-03-2012 $ 13.38 YTD Account# 31200316458 Established: 08-02-2007 FERN M LONG DOD balance: $ 30,010.21 + 0.33 accrued interest Interest paid 01-01-2012 thru 07-03-2012 $ 47.52 YTD Account# 31000314873 Established: 08-28-2007 FERN M LONG DOD balance: $ 10;005.05 + 0.22 accrued interest Interest paid 01-01-2012 thru 07-03-2012 $ 30.62 YTD Account # 31900316258 Established: 07-11-2007 FERN M LONG DOD balance: $ 10,005.1.0 + 1.27 accrued interest Interest paid 01-01-2012 thru 07-03-2012 $ 8.87 YTD Account# 31200346262 Established: 01-28-2010 FERN M LONG DOD balance: $ 10,005.05 +0.22 accrued interest Interest paid 01-01-2012 thru 07-03-2012 $ 30.62 'YTD Page 1 of 2 A o. °. 2^, ', 2 `� , SAM a, .o. X722 2/2 Account# 3160034923') Established: 05-26-2010 FERN M LONG DOD balance: $ 10,100.57 -r 2.20 accrued interest Interest paid 01-01-2012 thru 07-03-2012 $ 5021 YTD Account# 3 12003 51144 Established: 07-07-2010 FERN M LONG DOD balance: $ 20,167.55 + 14.84 accrued interest Interest paid 01-01-2012 thm 07-03-2012 $ 100.28 YTD Checking Account Account# 5070102806 Established: 04-03-1990 FERN M LONG DOD balance: $ 21,196.34 + 0.09 accrued interest Interest paid 01-01-2012 ihru 07-03-2012 $ 1.19 YTD IRA Account Account# 75100037751 Established: 07-25-2008 FERN M LONG DOD balance: $ 41,664.13 +42.74 accrued interest _ Interest paid 01-01-2012 thru 07-03-2012 $ 858.71 YTD lC a� _ /ra pt vie /p For beneficiary information, please call 1-888-762-4727. , ,S'�1n.e�,b/0 : .!� p�. W�y �� Please note that this office provides date of death balances for deposit accounts (IRAs; CDs,Checldng and Savings). We do not process any financial transactions or provide statements. If you Deed assistance with any of these items; please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank N-A. Member FDIC This message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable 1mv. If the reader of this message is not the intended recipient or the employee or agent responsible_for delivering this message to the intended recipient, you are hereby notif2ed that any dissemination, distribution or copying of this communications is strictly prohibited. Ifyou have received this communication in error, please notify me immediately by reply or by telephone at 800-762-1775 and immediately destroy this faxed document. Page 2 of 2 =r > n > r) z > n Z O o I ox Z ; 5" M M Zmz _n F CL :r 0 0 Z 00 V1 CL 0 M. 00 7— > (D. PNCBANK 041 GERMANTOWN (576) I 74 MIIIIIIIIII ROAD 0 loom,.. GE M ANTOWN MD 20874 0 ashbox 02 AM z X 0 Deposit Check > 16:53 AUG 23 2012 > Account Number XXXXXX5544 f M a I- Tran Amount $83.01 0 -4 p N W/S ID WWS00995 Sequence Number 00102 0 Batch 402 This deposit or Payment is accepted subJect to verification and to the rules and regulations of this bank. Deposits may not be available for immediate withdrawal. Receipt should be held 1' - _ n i rt p ) C) - ' _' :r h - a z _ 3 — , � - v c C, m ° � CI n 0. r Q PNIC ,A. I fie; 041 GERMANTO P (° 6) 13074 MIDDLEEF7(F ;(., I _ GERMANTOWN 1111 )X37, o l Q T V Cashbox D.'. 0 D C * Deposit Check N 1 x 9 16:51 AUG 23 2012 d Account Number kC !XXia�,I Tran Amount MISSION W/S ID WW900995 Sequ=nc(, d,nrbi DO ))s o ' Batch 402 Lrt This deposit or ;,ub:a. to verification and to the rules snt 'i!iu a:— s o' _ this bank. Deposits may not be eaa at,le it immediate withdrawal. Aecaivt ;hou ['. to -A BELCO COMMUNITY CREDIT UNION DECEDENT ESTATE INFORMATION(On Date of Death) 1. Name(s) in which the account was held: FERN M. LONG 2. Account number: 861174 3. Balance as of date of death: $40,368.32 Balance Accrued Dividends YTD Dividends Opened Regular Saving: S1 $1.00 $0.00 $0.00 4/25/2007 Holiday Club S2 Money Market: S6 Checking: S4 IRA: S5 Certificates: Balance Accrued Dividends Certficate Number YTD Dividends 3/2/12 clsd $0.00 $0.00 S1002 $14.31 7/24 clsd $10,162.65 $7.63 S1003 $6777 7/24 clsd $20,146.83 $6.30 51004 $81.51 7/24 clsd $10,057.84 $11.03 S1005 $68.87 4. Date the account was initiated: 5. Name(s)in which Safe Deposit Box was held: NONE 6. Date the box was initially rented: NONE 7. Branch address at which the box is located: 8. Loan Information: Balance Accrued Interest Per Diem Int A. Unsecured Loans: NONE L14 Classic Visa Card NONE B. Secured Loans: NONE C. Mortgage Loans: NONE $ $ 9. Miscellaneous: 7/24/12 CHECK#8869 disbursed for$40,393.28 to close Certificates and the Savings , payable to the Estate of Fern Long. 1-80e-773-7373 Circle Gold PO Box -460 0 please tall us anytime for answers to your Account Statement Prowl nc questions,account information,current rates Prime RI 02040 or to update your address I.proms numter. _ O OF 3 Beginning May 04,2012 through June 05, 2012 AV O1 021886 864348 82 A"5DGT 11,11111.1111111,11'�r1'RIl1'llHlllllrllll�id�116rhllllidll Contents FERN M LONG Summary Page 1 838 OAK OVAL MECHANICSBURG PA 17055-8409 Checking Page 2 CDs Page 3 Circle Gold Summary 115002 Account Account Number Balance Balance FERN M LONG Last statement This statement Circle Gold Checking w/Interest DEPOSIT BALANCE XXXXXXX298-0 Checking g Circle Gold Checking w/Interest XXXXXXX298-0 50.43 50.43 CDs 18 Month CD XXXXXXX9386 60,165.49 60,192.61 Total Deposn Satan" 60,243.04 Total Netatfoushtp Balance —_ 60,243.04 la as -- -------- r r E 0 aa ra a N z z �--- m in m I' s s m — — — o m v) c> � -- ----- a tam a a a 0 v m v o It —.__— ;a z O D -n M m C n� N °m ° c ax c z a —�- a cam a z u n - ---- m c ac m o a -- n to z -n r — n, m c o -z z to co — ao oa 041 N GERMANTOWN 13074 MIDDLE ROOK6ROAD — GER 20874 Cashbox N 01 Cashbox O1 AM - Deposit Check 5 2012 count Number an Amount XXXXXX5544 $1,038.62 > - — 'D WWS00138 Sequence Number 00032 — 0 401 �- z = N rr p � — O n — Payment is accepted subject to C to the rules and regulations of o — a--- its may not be available for c � _ __ cu Receipt should be held \ — N C Your statement, ,./ w C F _ - .Y 7-70 --� -- -jr 7- 7- y - -- -- - uly 10, 2012 oanne L. Kress — 7714 Cricket Hill Drive iermantown,NID 20874 Chis is the final statement for the funeral services of Fern M.Long Ve sincerely appreciate the confidence you have placed in us and will continue to assist you in every way.— PROFESSIONAL SERVICES: Services of Funeral Director/Staff $5,475.00 FUNERAL HOME SERVICE CHARGES $5,475.00 SELECTED MERCHANDISE: Poplar Casket $2,125.00 12 ga.Galvanized $1,925,00 — Maroon Register Package $75.00 THE COST OF OUR SERVICES,EQUIPMENT,AND MERCHANDISE THAT YOU HAVE SELECTED $9,600.00 — CASH ADVANCES: At the time funeral arrangements were made, we advanced certain payments to others as an accomodation- The following is an accounting of those charges. Opening Grave $900.00 Cemetery Equipment $180.00 Certified Death Certificates $30.00 Newspaper Notices-Patriot $170.07 — Newspaper Notices-Reading $150.00 Clergy/Mass Offering $200.00 Organist $100.00 Flowers $212.00 Monument Engraving $165.00 -- TOTAI<CASH ADVANCES AND SPECIAL CHARGES $2,107.07 SUS-TOTAL $11,707.07 _ INITIAL PAYMENT/DISCOUNT/CREDITS $0.00 TOTAL AMOUNT DUE BY August 4,2012 $11,707.07 a — If you have any questions or concerns regarding this bill,please call our office at(717)69 1-4696. — I — V � l o 0 O m ; z 7 —. C C m r�Tl A o N S N f - Vi W p m zi too Q N y n; m p Z ^`Vr, Z p -i A m (n o p tlf � T T .+ I � Z N �- _ m m s RECEIPT FOR PAYMENT ------------------- GLENDA EARNER STRASBAUGH Receipt Date : 7/2.3/2012 Cumberland County - Register Of Wills Receipt Time : 14 : 00 : 28 One Courthouse Square Receipt No. : 1070619 Carlisle, PA 17G13 LONG FERN M Estate File No. : 2012-00771 Paid By Remarks : BRINSER WAGNER & ZIMMERMAN DMR Receipt Distribution ----- - - - --- ---------- -- - Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 360 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 16 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN ----- ----- Check4 3495 419 . 50 Total Received. . . . . . . . �419 . 50 § ff4 � Z \ / § � � ■ J k - S ■ ) ■ I § 2 § 222\ w ) \ / ) \ , i § § w / co ( - mr § -j 2 K « 22 ai a 2 § { § 2 2 © - \ k� § \/\ 22 = 2 rrU § � -\E Z � m /_ 6 ■ Z99 � � ( ( wgo� _ $ ; \ - �8 \ k§})§ w - b M-r i ( 4)\ ) /\ ! PON % ) \ k % ! f § 2 § \ � « ( / IL PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Jackie Cox, Sales Director, of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid,was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County,and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following day(s): July 23, 30&August 6, 2012 COPY OF NOTICE OF PUBLICATION N a ,yy en Met LgweTy ICE oon the„E1etacopryM Affiant further deposes that he/she is not ton® pgpaesed,lateof upper AllenToern interested in the subject matter of the LONG,Doses have been granted to the ullcleiet9hed�ceeuldx All persona Yh @reMre Indebted+u®i cielrne estates +"leencm same d�yte aforesaid notice or advertisement, and that pa meat,end thgsd yy allegations in the foregoing statement as auiherdldata for seMe.MD without x Gerald J.8rinse n orney, to time, place and character of publication Hill Drivel Germantown, are tril . .'t Sworn to and subscribed befor me this � 3*dG h �701Z �A Notary Public My commission expires: NOTARIAL SE4L _.... ....._ BAMBI ANN HECKENOORN Notary Public CARLISLE BOROUGH,CUMBERUND CNTY ' My Commission Expires.!;m 't.. n1 d e��`1ND �RASSOC1Pt�� CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tale: (717)249-3166 Fax:(717)249-2663 August 17, 2012 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Gerald J. Brinser, Esquire RE: Fern M. Long Estate Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on the following dates: August 3, August 10, and August 17, 2012 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 0 .00 Total Amount Due $ Payment received by � PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: August 3, August 10, and August 17, 2012 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Li Marie Coyne, Edi r SWORN TO AND SUBSCRIBED before me this 17 day of August, 2012 Notary Long,Fem M.,deed. Late of Upper Allen Township. Executrix: Joanne Kress, 17714 Cricket Hill Drive, Germantown, NOTARIAL SEAL MD 20874. Attorney: Gerald J. Hrinser, Es- DEBORAH A COLLINS quire. Notary Public CARLISLE BOROUGH,CUMBERLAND COUNT' My Commission Expires Apr 28,2014 0 m C a K m a0 I A ° � o � n -j 69 a M w o `+ .. . C3 ? P p - ..- a ° m W O F Ln Er r » o C3 A O O Ll b2 a �K C3 ro o m C3 o m C) 'o I o O g C3 a b L � m oi � 0 0 a r a 2 d o 4 a z 9 u z C3 z G) _ C3 z Ln L K r Y a- C a - J Cl O C3 T - o _ Cl r - LM � ❑ ! ■ BE i Z, ozz C) X m M z I rim M A CD o > C3 -Z (D (D -a CD < r,u a 0 O C3 CD C3 -4 ru ° La 44 C)l C3 z x rm- C3 4 M > > 0 M -j (0 -04 Ln 7 * cm E. Z-04 22 f ca S: MM rn z z 46q V is `j—r {I N UJ —� us — O `� I x � 0W - �- - — –j O D -- --- a F w - Z � — - - *� o ° Z h y F --- Q — — z W K O —� LU I � I O a W < N LU tn A E LIJ x z ::E - - -- < , c� H 1� T I 3 ►'3n � y o C t, N m ti V 2 000 Z Cn D Z rn i p � m w fJ -i N c. o � oomumi o m 00 � ZZ M r o Om c — m cn � cr � oWZ M 00 -zi U) s, vi o v 0 c N Tr N J N m m T ---- --- ---- ---of MHE— i w oS'a`5 £a-i = n� a° P� _— 5 x c tP a m m�' ((F''J m N y j uepm cn so 7 g io -�--- 5 ° m a °: u d � K BL aL R m _ C O LAW OFFICES BRINSER,WAGNER&ZIMMERMAN 6 EAST MAIN STREET-SECOND FLOOR (EAST MAIN&SOUTH RAILROAD STREETS) P.O. BOX 323 PALMYRA,PA 17078 PHONE:(717)838-6348 FAX:(717)838-6912 MECHANICSBURG OFFICE MESSIAH VILLAGE GERALD J. BRINSER 100 MT.ALLEN DRIVE KIAFI1 D.WAGNER MECHANICSBURG.PA 17055 JOIIN M.ZIMMERMAN PHONE/FAX(717)6974666 CALFR J.ZIMMERMAN April 4, 2013 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 In Re: Fern M. Long Estate File No. 21-12-0771 Dear Register of Wills, Enclosed you will find two (2) copies of the PA Inheritance Tax Return for the above- captioned estate. Also enclosed are two (2) checks: one in the amount of$1,841.93 in payment of the balance of inheritance tax due, and one in the amount of$15.00 in payment of the filing fee. If you have any questions, please feel free to contact me. Thank you. Very truly yours, BRINSER, WAGNER& ZIMMERMAN ca w m M Gerald J. Brinser w r c M GJB/Wlc z w = u1 o Enclosures o e) c> '^ -n n C..) *1 3 g q Frn c: file W r ca -rt a �: . . . . _ . __ . . \ � � f � CWIS � \ \ [ < � ( - { \ \ \ k � � \ \�k < 3 \: »- - - CD C-0 Cd � \ 0, \\