HomeMy WebLinkAbout05-28-13 (2) 1 1505610101
J REV-1500 Ex�°'-'°> �l'
enns lvania OFFICIAL USE ONLV
PA Department of Revenue P Y
Bureau of Individual Taxes `°•"T"`" "` County Code Year File Num6er
INHERITANCE TAX RETURN � �" ' �
PO BOX z8o6oi �
Harrisburg,PA191a8-o6oi RESIDENTDECEDENT � �� ��" ��i "`�� � .3:-.3�9'
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
� 0�.b ��z�: o8b '7' � 2�o� z �:° i � / 140�9�1 9 'f�..i .
DecedenYs Last Name Suffx DecedenYS First Name MI
kp�� R, T'N Em E R�. �., � � J ��!e�t-�F{u F �?�
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffx Spouse's First Name MI
� �
:
`���.. ,. ... _ . , . .. 's � _... , . . . . . � , . . .
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)
p 4. Limited Estate p 4a. Future Interest Compromise(date of O 5. Fetleral Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wilp (Attach Copy of Tmst)
O 9. Litigation Proceeds Received O 10.Spousal Poverry Credit(date of death O it. Election to tax under Sec.9113(A)
between 1231-91 and 1-1-95) (Attach Sch.O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TA7(INFORMATION SHOUL0.8E DIRECTED T0:
Name DayGDne Telephon�mb6q �
C�H �"�Q L ES E oS,�N l E'L DS � / '� i/ � � _'' ��(��'n�� '�,cj;.
�€.� � ,,,,.
�RfC'ISTER QRWILL&{;(SE'•ONLY
r �� r.; � ,•
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First line of address _ _"� �
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6 C L o u � � R �2�D��D ° .
{;. .$ ,� . ' ;
Second line of address -.- '�� �� � ,,; �
�� � � � �t w- K v '�� rl
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City Or POSt OffiCe � � State ZIP Code DATE FILED
iY�;�CH9N / CSBy��Gx o- '�f�' � 7oss9 � 3S
CorrespondenYse-mailaddress: CPS���/r/53� ���!astne�'
Under penalties of perjury,I declare[hat I have examined ihis retum,including accompanying schedules and statemenis,and to the best of my knowledge antl belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is base0 on all information of which preparer has any knowledge.
SIGNATIytEAF PER�PONSIBLE F R�TURN DATE � /f�
X �� ��Y� s 3�
ADDRESS L�N .FT�- 'iI. OHN� (� H;cko.-y Lan�, /Nee{�unicsEiur9, pR 170SS"
SIG�N,ATUj�E F PR ARER Q7{7ER T FP�TATI� DATE Sy�.��3
// �
nooae Cy�Q�� Sy��p,s � 6 C/ouse� Rd., /Yleehan�osbw.-9, P/F /70SS
' PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610101 150561a1�1 �
� 15�561�1�5
REV-1500 EX
DeaedenYs Social Security Number
^T r� ��,,p ?�A g�Y p
Decetlenf'sName: V(�Y�P.+1�E �. ("R!'7f1LfflL'� � ���� ✓@�llt��O �b�7
RECAPITULATION
..: , . ...... .., � ,..
1. RealEstate{SCheduleA). .... . ... .. .. ...... .. ...... . . . ...... ... 1. � �j� ;,G}�`
,. ... ,,�4.
2. Stocks and Bonds(Schedule 8) ... . .. . ... . . . . . . . .. . . . . . . .
2. a�y' 3 /? � � ,
_. ��ti��. ..
3. Cioseiy Heid Corporetion,Partnership or Sole-Proprietorship(Scheduie CJ .. . 3 � - ; '�(���Qi�
, ri::�t.�:E«w�w���
� .� ..
4. Mortgages and Notes Receivable(Schedule D) . . . . .... . . . . . . . ... . .. .. ... 4. � ,� , ?�- a�
,.�..��-;,�^"�„„�"_a�g7w
5. Cash, Bank 6eposits and Mtsceilaneous Personai Properiy(Sohedule E}. .... .. 5. � ��5�g�.' �� b�:"(}i.
n.&�!�xi.�
6. Jointly Owned Property{Schedule P) p Separate Billing Requested ... . . . 6 * � �Q�
7. IntarvVivos Transfers&MisceE4aneovs Non-Probate Property '`"=�"�+'�"?�`�' F .. h �� '��
(Sahedule G} p Separate Biiling Raquested... . . . 7 � � � , �k'J "3#
�++s
" W^�r a
� &. ToWI Gross Asseis{total i.in0s 1 through 7). . . . . . . . ... .. . . . ... ... .. . . .. . $. ��ry.��p� $'.� a� �:
9. Funeral Expenses and Administrative Costs(Schedule H}. . . . . , . . . 9. � � ?t��.b.,$ .1�' 7 �'�,
�., �: e ,
i0. Debts of Decedent,Mortgage LiabiliGes.and Liens{5chedule I). .. ... .. . . . . .. 70. �� � � .�$` p � � q � �
���;::y.. ��ta�.tii„.'
11. Totel Deductions(total Lines 9 and 1U). . . . . . . . . . . . . . . . . . . . . . . . . . . ... . 11 .. �'� ° ' . '� 6� �+�
:x� -
iZ t3et Yaive of Estate(Line B minUS Line 11) . . . . ... .. .. . . . . 12, ,. *'� ; g�+��?2 f��
13. Charitable and Governmental Bequestsl5ec 9193 Trusts for wfiicb �' ��'^`°��^"� -:� .
an election to�tax has not been made(5chedule J) . . . . . . . . . . . . . . . . . . .. . . 13 :� '. � " �[�"
. :�£�:����..��::��� �.,
14. NeY Vatue SubjeCt to Tax(�ine 72 minus lina 13j ...___. ..._ ._....._ 'IA � ��(}" 'f��.$.g ��}';
TAX CAI.CULATION•SEE INSTRUCTIONS FOR APpi.tCABLE RATES � � � �
75. Amount of Line i4 taxable
at the spousal tax rate,or
transfers under Sea 9'116 q<. -b a.". ^�.,e� . .-r.-. .�• �.. .
�
(a)I1.2)X .60 . , . ' ��„ � �6 � e g R,�_� v. .. ' �..j��
�a z �
96. Amount of Line 14 taxable '`'4"���.��g� '�� ��
atll�aalrate X.O� ` � � � `� � . - 96 . � b (y�
'17. AmountofLine.l4taxable *"^�'��'�'""� /. � � � � �.�� 17 � .�
at sibling rate X .'12 �p : � /�� � � R
18. Amount of Line 14 taxable � �"D ` M
atopilafera(rate X.15 � '� . �g,�Z � . n .
�� ar..-e ��b'�<H,_ w-� � v.
19. TAX DUE . . . . . . . . . . . . . . . . . . . .�. , . ` _
,9 �..u.� �.* ��..�.�y `�` � � ��
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OYERpAYMEN7 �
Side 2
� 1505610105 1505610105 J
REV-7500 EX Page 3 Flle Number Z/-//- i339 �
DecedenYs Complete Address:
DECEDENT'S NAME
�ar/ene ff1. Parthem��'
STREETADDRESS ��- �
a�f3 C'ope vr;✓� SoK�
ciTV /yJCC�1Q/J�CS66! STATE P� j Z1P / 7 o SS
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (�) ��j/ �2 9 87
2. CreditslPayments �`Q s.�o0
A.Prior Payments _____1�_- ._'..
. __._------
8.Discount _ ,5'pP,oo _ ,�
Total Credits(A+B) (2) /O OOo.�o
3. Interest
(3) 7R 9. 7�F
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�s greater than Line 2,enter the difference.This is the TAX DUE. (5) .3 yj &s7•�O�
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 ihe property transfened or its income;.........._................................ ❑ ��1
c. retain a reversionary interest;or................................................................................................_..........._........... ❑ i.ei
d. receive the promise for life of either payments,benefts 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 sewrity at his or her deaih?.............. ❑ �]
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 ftom tax, and the statutory requirements for disclosure of assets and
fling a tax retum are still applicable even if the surviving spouse is the only benefciary.
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 decedenYs lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116(12) [72 P.S.§9116(a)(1)1.
. The tax rate imposed on the net value of transfers to or for the use of the decedenPs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is def ned, under
Section 9102, as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
COMMONWEPLTH OF PENNSYLVANIA REV-1 i 62 EX�i 1-96)
DEV6FTMENT OFREVENUE
BUREAU OF INOIVIDUAL l'AXE$ �
DEPT.280601 ' �
IipRF15BURG.PA 1]128-0601 �
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 015652
YOHN LANETTE M
6 HICKORY LANE
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
---- ,oa --------- ------
101 � 59,500.00
ESTATE WFORMATION: SSV: 2os-32-086� I
FILE NUMBER: 211 1 -1 339 �
DECEOErvr rvannE: PARTHEMER DARLENE M �
DATEOFPAYMENT: 03/02/2012 I -.
POSTMARK DATE: 03/O2/2012 �
CourvTV: CUMBERLAND �
DATEOFDEATH: 12/02/2011 I
�
TOTAL AMOUNT PAID: 59,500.00
REMARKS: RECEIPT TO ATTY
CHECK/i114
INITIALS: WZ
sen� RECEIVED BY: GLENDA FARNER STRASBAUGH
� REGISTER OF WILLS
TAXPAVER
RF:V-t.502 EX�!!.'.-n�g)
� pennsylvania SCHEDULE A
DEPABiNENTOFHEVENUE �
,N„ER„AN�E r�RF,»RN REAL ESTATE
RESIfJENT�ECEDEM
ESTATE OF FILE NUMBER
Darle.rie M. Pa�fticmcr z/—//—/33`f
All real property owned solely or as a tenant in cnmmon must be reported at fair market value.Fair market value is defined as the price at which proDerty
would be exchanged be[ween a willing buyer and a willing seller,neither beinq rompelled to buy or sell,both having reasonable knowledge of the relevant fac[s.
. Real property that is jointly-owned with right of survivorship must be disclosed on Sc�edule F.
Attach a copy of[he settlemen[sheet if the Droperty has been wld.
ITEM Indude a copy of the deed showing decetlen['s in[erest if owned as tenant in mmmon. VALUE AT DATE
NUMBER � . OF DEATH
DESCRIPTION
1 fll! �tnl- Cer'f't+in �of of yroti,�d µnd t�e. residcn�:a�
homc e►t�t°�d ��oH ti,; fP� "Asti��be �YMs, P
�. D. � I,��pu- Alic+, Twnsl,;p, C�•.,,�•bGrlc�cl C'o�.nfi,
„
�r1h5��Yania , [!s iS Mo2 fu�y v1eSCr�bu� a�' �ar+�� in
�}l�a �ue n-vid C'�rrcL�(- Co�y a� �+e ���rt dee,cd
wh��h '�s Qtha��d.
qS a:d ��rm%scs we�e so/a� 6y �'t Ea}n� �'
T omas iP, ,Ber/or:c, ,T u-ur/ /Jafr;c.¢ .� �'�H�,
�J:s wilrt, o� �pt 1/, Zo/2. See �j� of'
c�e/�/Cm<at �'li�e f a1�aclae.o!
TOTAL(Also enter on Line 1,Recapitulation.) # e�.��o OZ$, ��
i
[f more space is needed,insert additional sheets of[he same size.
Tau Parcel Number: 42-30-2106-075
THIS INDENTURE
MADE THE `UN day of t1�U.y I� Str�{' ,in the yeaz of our
Lord hvo thousand and lwelve(20]2).
BE1'WEEN
LANETTE M.YOHN,as Executri�c of t6e Estate of DARLENE M.
PARTHEMER a.k.a.DARLENE V.PARTHEMER,deceased,late of Upper
Allen Township,Cumberland County,Pennsylvania,Grantor,
and
THOMAS R BERTOVIC,JR.and PATRICIA A.BERTOVIC,husband and
wife,currendy of 60l South Norway Street,Mechanicsburg,Cumbedand County,
Pennsylvania,Grantees.
WHEREAS,the said Dazlene M.Parthemer a,k.a.Dartene V.Par[hemer,was ves[ed in
her Gfetime with title to the pcemises hereinafter described,in the Township of Upper Alleq
County of Cumberland and Commonwealth of Pennsylvania;and
WHEREAS,the said Dazlene M.Parthemer a.k.a.Dazlene V.Parthemer,departed this
earthly life,[estate,on the 2nd day of December,201 l,and Letters Testamentary were duty
issued to the said Lanette M.Yohn,by the Register vf Wills of said Cumberland County,
docke[ed ro No.21-11-1339;and
WHEREAS,the lands herein-menlioned were no[specifically devised:
NOW,TAEREFORE,THIS INDENTURE WITNESSETH,that the said Lanerie M.
Yohn,Executrix,as aforesaid,for and in consideraUOn of Ihe sum of TWO HUNDRED
TWENTY-SIX TAOUSAND AND TWENT'1'-FIVE and No/t00ths($226,025.00)
DOLLARS,and other good and valuable consideralions,to her in hand paid by the said
Grantees,at and before the ensealing and delivery hereof,the receipt whereof is hereby
acknowledged,has granted,bazgained,sold,aliened,released,and co�rmed,and by these
presen[s,by virtue of the power and authority in her vested by the Fiduciaries Act of the
Commonwealth of Pennsyfvania,does grant,bargain,sell,alien,release,and co�rm unto Ihe
said Grantees as tenants by[he entireTy,their heirs and usigns:
ALL THAT CERTAIN lot in the property known,named and identified in the
Declaration referenced below as"Ashcombe Fazms,P.R.D.",a Planned Community,located in
Upper Allen Township,Cumbedand County,Pennsylvania,which has heretofore been submitted
to the provisions of the Pennsylvania Unifortn Planned Community Act,68,Pa.C.S.A.Sections
S l01 et seq.,as amended by the recording in the Office of[he Recorder of Deeds of Cumberland
County,Pennsylvania,the Declazation for Ashcombe Fazms P.R.D.,a Flexible Residential
Planned Community("Declazation"),dated April 6, 1998,recorded April 13, 1998 in Misc.
Book 573,Page 407,as amended by Firs[Amendment to Declazation for Ashcombe Faems
P.RD.,a Flexible Residen[ial Planned Community,dated Mazch 13, 1999,recorded Mazch l9,
1999,in Misc.Book 60'7,Page 44Q and by Second Amendment to Declaration for Ashcombe
Farms,P.R.D.,("Second AmendmenP'),a Flexible Residential Planned Community,dated
September 29, 1999,and recorded October l3, 1999,in Misc.Book 627,Page 652,being and
designated in such Declaratioq as amended,as Lot No.30(Identifying Number),described in
Pazagraph 4 of the Sewnd Amendment and shown(and described)I Exhibit B-1 of the Second
Amendment.
LOT NO.30 contains 8,825.45 squaze feey more or less.
BEING Lot No. 3Q Ashcombe Fazms,P.R.D.Final—Phase 2B Plats and Plans,dated
May 7, 1999,recorded in the Office of the Recorder of Deeds of Cumberland Counry in Plan
Book 79,Page 114.
BE[NG Ihe same premises which E.Richazd Parthemer and Dazlece M.Par[hemer by
their deed dated September 16,2004 and recorded October 1,2004 in the Recorder of Deeds
OfPice in and for Cumberland County in Deed Book 265 Page 2649 granted and comeyed un[o
Dazlene M.Parthemer. Her said Estate is the Grentor herein.
UNDER AND SUBJECT ro restrictions and covenants of record,including,bu[not
limited to,Declazation for Ashcombe Farms P.R.D.,a Flexible Residen[ial Planned Communiry,
dated April 6, 1998,recorded in Ihe Office of the Recorder of Deeds of Cumbedand Counry in
Misc.Book 573,Page 407,First Amendme�t to Declazation for Ashcombe Fazms,P.R.D.,a
Flexible Residential Planned Community,dated March 13, 1999 and recorded in the O�ce of
the Recorded of Deeds of Cumberland County in Misc.Book 607 Page 440,and Second
Amendment to Declaration for Ashcombe Farcns,P.R.D.,a Flexible Residential Planned
CommuniTy,dated September 29, 1999,recorded in the Office of[he Recorder of Deeds of
Cumberland County in Misc.Book 627,Page 652,and undet and subject to easements of rights
of way of record and visible by inspec[ion.
TO HAVF.AND TO HOLD the said messuage or tenement and tract of land,
hereditaments and premises hereby granted and reteased,or mentioned and intended so to be,
with the appurtenances,unto[he said Gran[ees,their heirs and assigns,to and for the only proper
use and behoof of the said Grantees,their heirs and assigns,forever.
AND THE SAID GRANTOR,Execuvix,as aforesaid,her successors and assigns does
covenant,promise and agree[o and wilh the said Grantees,[heir heirs and assigns,by[hese
presents,tha[the Grantor has not done,committed any act,mattec or thing whauoever whereby
the premises hereby gran[ed,or any part[hereof,is,are,shall or may be impeached,chazged or
encumbered in title,or otherwise howsoever.
IN WITNESS WHEREOF,the said Execut[ix of the Esta.te of Darlene M. Parthemer,
deceased,Grantor hereiq has hereunto set her hand and seal[he day and yeaz first above written.
Signed,Sealed and Delivered
in the Presence oL
S�Lanelte m• yoy�l (SEAL)
LANE1"fE M.YOHN,Executrix of the
Estate of DARLENE M.PARTHEMER
a.k.a.DARLENE V.PARTHEMER,Deceased
COMMONWEALTH OF PENNSYLVANIA )
. SS:
COUNTY OF CUMBERLAND )
On this,the day o( ,A.D.2012,before me a notazy
public,in and for[he Commonwealth of Pennsylvania,personally appeared LANETTR M.
YOHN,known to me(or satisfactorily proven)to be the person whose name is subscribed as
ExecuVix of the Last Will and Testament of Dazlene M.Parthemer a.k.a.Dazlene V.Par[hemer,
and acknowledged that she executed the same in such capacity.
IN WITNESS WEIEREOF,I hereunto sei my hand an official seal.
Notary Pubtic
My commission exp'ues:
(SEAL)
CERTIF[CATE OF RESIDENCE
I do hereby certify[hat the precise and exact post office address of the within Grantee is:
Attomey for Grantee
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, Bom�w��{sj:73wmsa i2.Bertovic.k.and Palrkie A Seih{a}: Estate of parie�M.P�emx
6eriOVk
601 S.Norwey Slreet 2463 Copg Orive South
Mechanksbwg,PA 17055 Mechanicsburg,PA 17055
S.nbmairt.ey�irt:GUARrWTEEDABSTRACT SERVICES,INC.
{71?)T14$758
Ptus otSdNamxit:GUAILWTEEO ABSTRACT SERVICES,lNC.
3879 MARKET ST,CAMP HILL PA 770i1
s�m�murt Daa:Sapfemher 27,2012
Prep�rty 4ac�tfen:2483 Copa DrIVO SDUth
MeChardcsWt9.PA 17455
Cumber�an0 County,PannsyWania
AddN3ona1 AdJustments Fof Items Patd By Solier IrtAdvance{SOrrowar DaWt}
Oascript{an pmowrc froMThraxdr ProrotedAmouM
HOAFee 150.00 09@t112 tArough12/31/12 41.80
Tot�i Un�709/4C9 d1.80
Sewerfees 1t2.40 4812i1721hrnuph69t30112 12.tT
Totsi ilnt 110i810 t2.t7
Total S O.dO S D.00
Owner's7ltleinsuroncA BORRpWER SELLER
Ownar's Policy Pramium 1,535.00
ko FIRST AMERlCAN FRI.E 3NS.fA.
Total 5 7,636.D0 S 0.00
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t
REV-1503 EX+(6-98) �
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS �
INHERITANCE TAX RETURN
FESIDENT DECEDEfYT
ESTATE OF FILE NUMBER
�arlenc /YI• Pa,-}},emar ,Z/-// —i339
All properry jdntlyrownetl with right ot survlvorship must be dfsclosed on Schedule F.
ITEM . VALUEATDATE
NUMBER DESCRIPTION OF DEATH
, C,'f���cns /��lr Tn✓e,�tmr�rt Ar.�,f. iYn. ��C-o6i�Y3o �Z� 3i/. 35
CSee Yri�!l4�en �ei/fi' a/tucktr/)
TOTAL(Also enter.on line 2, Recapitulation) $ oZ7 3//, 3s
(tl more space is needed,inseR add'Rional sheets of ihe same size)
y� Cit.izens P°B°x°Z°zs
� 711� Investment Services Providence,RI o2940
January 22,2013
l.anette Yohn Ex
E/O Darlene Panhemer
Charles Shields 111
6 Clouser Rd �
Mechanicsburg,PA 17055
RE:Account Number:L7C067830
Registretion:Darlene M Parthemer �
Dear Lanette Yohn:
I am writing with regard to the correspondence recently received in our office regarding the above referenced account.
On behalf of our tirm,pleau exiend our sincerest condolences to the family of Dadene Panhemer.
� In accordance with your request,1 am pmviding a summary of Ms.Parthemers account in the table below as of the
close ot business on December 2,20I t.
Security CUSIP Number Number of price per Share Total
Shares
PimcoRealRe[um pR7'NX 1,178.007 $1224 $14,418.SI
Class A
PimcoTotalRewrn P.�-�.� �,�91.547 $10.82 $12,892.54
Class A
i*� ��k b x �i h '$ 4 SP• A'4� y 5 ' � `-
, � f � �°�. . � � ��r�
?�'�1 . ���,���r �;�, { � s,
��ac����.; � �_�, � t ' :� t;�,' { �,
Ilyou have any questions piease call us at I-R00-942-8300,Option 4,Monday through Friday from 830 a.m.to 5:00
pm.,FT. We will be happy to assist you.
Sincerel
�—_—__—.___ .
Jasmine ivera
CCO Operations Specialist
Securi[ies, Insurance and Investment Advisory Services oHered Ihrough CCO Investment Services Corp.Member FINRA,SIPC. 770 Legacy Place,
MLP240,Dedham,MA 02026.(800)942-8300-CCO Investmen[Services Corp.is an affilia[e of RBS Citizens,N.A.and Citlrens Bank of
PennsyNania �
�RBS
Securities and Insurence Products are:�NOT FDIC MSURED•NOT BANK GUARANTEED•MAY LOSE VALUE
•NOT A DEPOSIT•NOT INSURED BYANY FEDERAL GOVERNMENT AGENCY I
�
RtY-tSOBEX�f»t
SCHEDl1LE E
ea:�u�r+o��NNSYiV� CASH, BANft DEPOSIT3, $� MESC.
INHE�WSIDfNT D�DENT� PERSONAL PROPERTY
ESTATEOF .�Y�� m� AL1,Y'i7tGt?1Gf' FILENUMBER
��-It- r33g
In�lude Ne{�eds of litigation arM the d21e ihe pmceetlR were receivetl by the es1a�.All proparty JoinGy-ovmetl witl�the rigM of surv'norship must be mulosed an SeMedule F.
�7�M VALUE AT DATE
NUM6ER � DESGEt�PT40N OFDEATN
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1 48500041�46
J aEV-ass ex�os-oa�
SAFE DEPOSIT
BOXINVENTORY
PA DeqartneMOf R�e�e PLEASE USE ORIGINAL FORM ONLY �
Social Se�ririry m Death Certibcate Number Date of DeaM Counry Code Vear File Number
.._. _. . ... ..... _.. ____ _____ .
ao� -' .�2- o�rG� i /a -oa - ao// a/ ' : /l j l 339
DecedenPS Last Name .... .... Sufiz Firs[Name ... -......... MI
� _ ___ , — ._... _.__ _ _
� ��4 R TN�lyfE/? 1�A�RL E�VE _ :I3��
— ----— ---- --- -— --------=--- -- — ' __.
�ADORE53 OF DECEDENT STREEt qTY: STA ' ZIP CODE: ��._
av 63 �p� DR ��,,X //lEC'H�¢iLlCS�NiPG �:� ��oss
�NAME AND ADDRESS OF PERSON REWESTING THE OPENING OP THE SAFE DEP0.4R BOX
�,ME: ey�i��ES E sH,�zos� r-s�e.
srrzEeraooaESS: � CGOClSE-i2 .Ql�_ an: srnS€�" nvcooe:
/LlE'CyqN/CSBu/c'G Fsy /7oS.S' :
�Q NAME,ADDRE33 ANU REUITONSNIP(IF ANY)TO DECEDEM,OF PERSON(S)PRESENT AT THE BO%OPENIN6
', a. NAME: � RELATONSHIP.
, L.�N� �iE ii1. yofi'rt� ��rEeuT,e�ix
'�, STREETAODRESS: QTV: STATE: ZIPCOOE: �'��..
' G H/C,Co,ey G.f.t� /yJ�c�.s�.f,r�lCSB�t PA i9os ',
���. b. NAME: RELAT7IXJSHIP. '��.
STREETAD�RESS: CITV: STATE: ZIPCODE: '
���. e. NAME REUTIONSHIP:
��� STREEiAODRESS: GN: STATE: LPCODE: �
NAME AND ADDRESS OF FINANCULL MSTRVTION WHERE 7HE SAFE DEPOSIT BOX IS LOCATED
: �E cer�z�.✓s i9.��,e
�'.. STRE ADD GTY: STy�� ZIP CODE ��.
� Lt�. i31A/N cST_ /17�CH�V! S�B/4/PG f�1 OsS I
. NAME OF PERSON MAKIN N7RY DA7E ANO TME OF LAST ENfRV ;
' �t� /� O Ov �
: DA7E OF CONINACT TO RENT BOX • NUNBER OF BO% 1 TRLE UNDER WH N BOX IS REWESiED
o zZ 9 Z- ��a9 �kua..l�r r R f� Es�
NAME AND ADDRE88 OF PERSON(S)HRVMl6 ACCESS M BO%
'� s. NAME: D. NAME:
"DI}RLENE M. PA�Q.7HEME�2
�� 57REETADDRE55: STREEfADDRESS:
aya3 coPE vQ. sou-na
- qN: $T ZIPCODE CITY: STATE: LPCODE .�'
mECHAM�SB R4 � i7os�
NAr��AND7TREOPENPLOYEETAKW67HEINVE �
Lhe.�-le5 �. �h�e,lcls III Y � �nr ES,�it-fi
WAS A WILL IN THE BOX1 ❑ YES�NO yss, e.Dsb M wlll:
� D. Name end WErua M paiwnsl npnssnbtiva,H nama0 In Ma wlll
NAME
��. STREETADDRESS: � CfTY: STATE: LPCODE:
�.��. c N�me aM�ddnu W sLLCnroY.ff�Y
NAME:
. STREETADDRESS: CITV: STA7E: LPCODE: '
. ...._ .__ ..._. .__ _.._. ..__ ..._. _._ ..._ i:
L 48500041046 48500041046 �
�sT or- D�a��E m. r��rz-n�r��c-� �� _- - .,., ,
REV-0BS EX
SAFE DEPOSIT BOX INVENTORY Page �of �-
INSTRUCTIONS
(t) Cash;Report lotai only.
(2) Stocks:List in detail every common or preferred certifica[e,wartant or other rights found in box.Stocks are ro be desgnated by
name of compa�ry,certificate numDer,date of certifirate,neme in which s[ock is regfstered,and number of shares and Gass ot stock.
(3) Obltgatlons of LLS.Govemment Number o(Hems,tlate o(ssue,face value,names in which registered and rype of ownersAip,
i.e„jointly held,payaDle on tleaM,etc.
(4) Bonds:Designate by name,amount,serial number,or oMer designation.(Bearer Bonds)
(5) Bank and Sadnga and Loan Passbooks:State name of depos(tor,number o(book,last date appearing in Dook,name of bank
and branch,and balance.
(6i Jewelry,Cotns,Stampa,Manuscripts,etc:List and describe es fully as possible.
(� Deeds,Mortgages,Curtent Insura�we Policfes or other eWdences of Indebted�ss:List and describe as tuly as possible.
(B) All 081Gf COMMb. � .
(9) Retum ComD�eted farm to: DEPARTMEM OF REVENUE
INHERRANCE TA%DINSION
DEPT.P80G07
HARRISBURG,PA7]12d9601
�M ITEM DESCRIPTON
NO.
E T � ----
1 CERfIFV UNDER PENALTV OF PERJURY THAT T7E ABOVE RECORD IS PERSON RECEIVING COPY OF
CORRECT ANO COMPLEfE TO iHE BEST OF NY KNOWLEDGE AND eEL1EF. SAFE DEPOSR BOX INVEHTORY:
SIGtUTURE ^ � E �
r
PPoNT NPME NPMENID CMECK ROPRIATE BOX BELOW.
6isr/ E. �I�;G�i�s � lan aftt oy.�
PRRrtTrtLE DATE �/ piEIXMPROPPoATEHO%:
/�+rn y� �rir �S�ati �f>!�T- �E.swcrcw.l ❑�e�.x.a.anwl
�
�EStYeReprwMSiM ❑JdMaxrorr(aYSMpaYIL�
NOTE:Attach additlonal B'/:'x 71°sheet(s)If necessary or use duplicates of Mis page of fortn.
n,e o�e�a�cy iex,az u.s.c.5+�(�X�(�1G).��wre a�:do�,re ots«sa�sew�r��,cas in m.�xno�w�m eeMn�s�,y smm m gws.me oepa�unxnuses ne
Sorlal Seamry rumMf m idmtiry tlm OazdaY aM v���roR���s d the atak.The CammaroeaXh maY ako use Ihe nbrmefion in archenge d Iaz in(amafion ag�aemenh
xitl�Fetlr�ai and hd ' aW1uil0a.ltn 5a�� ' tM Cmmuroealtlts fian d' ' aonfi0mtiel 1nx nfomwGm for oRind
��t����n� �3����
Account Number 6216313375
Account Tide DARLENE M PARTHEMER
Date ened 4/3/2007
Account T Checkin
Princi al Balance as of DOD $27401.74
Interest from Last Postin to DOD $1.16
Account Balance as of DOD $27402.90
YTD Interest to DOD $14.89
� :�������� ����.�
Account Num reb �
ticcount Title 624gi 17q r�
Date ea — nARLENE M PARTHEMER �
Account T — —______ 3/20/2006
Pnnci al$alance as of D(}D T�m��srts�—
Interest from I,ast Fostin to DOLl � $27�d�g3
Account Balance as of DOD `— $3.fi8
Y7'D Interest io DOU --�— $27974.bi
-- ______, $149.81 —
` ����`i���������°�
Account Nurnber
Account Tit1e G2S8743593
Date ened — �ARLENE M PARTHEMg,R
Account Type — — � 5l20l2411 —'
Princi al Balance as of L?OD Time D sits
Interest from Last Pastin to DOD $20101.03
Account Balance as of DOD �$'26
YTD Interest to DOU � �z41Q9.29
----- $I Ol.d3 �
_ _ _ _ .
M'U M M�S
��wEGty Jeo�E
34 WEST MAIN STREEf
MECHANICSBURG,PA 17055
APPRAISAL Phone:7V-76b94T2 APPRAISAL
Appraisal for:
Estate of Darlene Parthemer
May 8. 2012
I. Lady's iwo-tone 8mm wedding band wiTh a yellow and white gold pattern.
Btate value: $100.00
2. Lady's 14 karat yellow gold wedding band with six diamonds of.04 points each for a total weight of 24
points.
Estate value: $150.00
3. Man's 14 karaT yellow gold wedding band with six diamonds of .04 points each
Estate value: $175.00
4. Lady's diamond engagement ring with a round-brilliant-cut diamond of.16 poinTs set in a 14 karat yellow
gold mounting.
Estate volue: $200.00
5. Lady's diamond 14 karat yellow gold fink bracelet with two lion heads in ihe center.
Estate value: �210.00
6. Lady's 10 karat yellow gold bracelet with 25 single-cut diamonds set on eoch side of ihe bracelet for a
total of 50 diamonds,of fair coior and quality.
BtaTe value: $150.00
7. Lady's 14 karaT yellow gold bracelet with seven marquise-shaped colored siones.The bracelet also has
a gold bead between each link.
Estate value: $110.00
8. lady's cameo pin in14 karat yellow gold.The pin measures 30mm by 24mm and has a pin back and a
bail so it can also be wom as a necklace.
Estate value: $100.00
9. Lady's 14 karaT yellow gold seven inch herringbone-design bracelet.
Estate value: $40.00
This appraiwl constitutes our carefully sfudied opinion of
❑the retal replacement cost through our taciltNes
� �the dishess sales nature value
of The articie�s)describetl above inwFar as ihe rcrouniing(s)have
permitted observation.we ossume no BadliN wim respect to any
ocf'�on th t mw be f �(o�n t,{he basis of ihis aoaaisal.
u ' " I b�.��--'�—_'...
AqPraiser
M�UM M�5
���EGty Jto�E
34 WEST MAM$TREET
MECHANICSBURG.PA17055
APPRAISAL Phone:717-766-9422 APPRAISAL �
Appraisal for:
Btate of Darlene Parthemer
May 8,2012
10. Lady's 18 inch 14 karaT yellow gold herringbone-design necklace.The necklace is 1 mm in width.
Estate value: $70.00
11. Lady's 18 inch 14 karat yellow add-o-bead style chain with five hollow 7mm beads.
Estate value: $90.00
12. Lady's 14 karat yellow gold bracelei with X and heart design, and both satin and brighT finish.
Estate value: $60.00
13. Lady's 14 karat yellow gold bracelet with an X design and heavy weight.
Btate value: $150.00
14. Lady's three-stone diamond necklace.The necklace is 14 karat white gold on a rope chain and has
ihree round-brilliant-cut diamonds measuring .OS poinis, .08 points and 20 points.
Estate value: $250.00
15. Lady's 14 karat white gold oval diamond locket necklace on a rope chain.The locket opens and has
eighty diamonds on ihe fro�t of the locket with a solid back.
Estate volue: $350.00
This appraisal constltutes our carefuly stutlied opinion of
❑fhe retal replacement cost ihrough our facilities
�fhe tli5hei5 Sdes nature valVe
ot me article�s�descnbed above inwfar as tne mounttng�s)hwe
pertnitied observation.We assume no liabiliry with respeci to any
action � af mw �tanken^on fhe basis of this aoaofsal.
I 1 ul�-n"`-tii..^-�—�
Appraiser
APPRAISAL
PersonalPropertyof D�}�tL�'�r� /"� (�A-�iN�/-�Eia 2� 8� c�Pe �R,s , M��H89 /°/�,
Appraised by Chuck E. Bricker AU094L Date � -�,x-12
ITEM VALUE ITEM VALUE
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� � + � -� $ +��- � � � � ts � � -� � � � f � r- t �- � Etfi �+ � tt � � t �
D31:c3 : 121/-t-3�-�'43_i.'r-' .=..�:ti?';':S� . �
Rawe' s i-��.iction 5er�vice
� . �505 Ftitner� Hwy ,
Car�lisle, PR 17Q�15 .
717-�49-�E77, �49-i9?8, 697-4794
www. rowesa�_ict ionservice. com
SettleBent Lanette Yohn ;17-790-9463 pa�e : i
Seller: S
6 Hickory Lane � '
Mechanicsburq PR 17@55
Item Description F�r-ice Qty 7nta1
- ----------------------- -------
-� HL - aluminum set 1 �. O�D.
- BL �- vases i tr. QiQ� �
- RL - silvcr� Y,r�ee 1 ie�. a0
- RL - Hamilton Beach roaster 1 1c. 5�
- RL - vases 1 l. OQ�
-- BL - househald lot 1 i� �iD
- RL_ - stemware +t�t�t Not sc,ld ***
� -- RL. - x-�mas lot � � - 1 1. 0iD
- BL - kiv�.isel-�old ?ot � � �r�* Not sold *-�+�� .
-- RL. - x-mas 7 ot 1 1 . rAV�
-- BI.,. - 3. ittl.e vases �-*�- I�!ot sold ��-�
-- P� -- x�-mas/chopper 1 :i. 00
� - BL. - x-mas lat � . 1 1. Qt0
-- PL �- picnic basketix-mas 1 4. �D0
- RL - fish bawl i 6. 0Qi
-- BL - zinc lidslGor�elle lids ; �.., 14. 00 �
- HL - misc. items � *�* Not sold *** `��
- RL_ - x-mas light=_ 1 5. 00
- BL - aet of dishes 1 1�V1. @P1
- BL - kitchen lat ' 1 i. 00
- BL - Princess Housefplrtes 3 6, 0Q�
-- PL - {iouseh.old items . *�r* IVOt sold +**�
- HL -- cooler i l. �d�
- BI_ - ho�asehold lot i 1. 00
- BL - Fenton. plates � - � i r7. 50
- 2L - lin�ns - �** Not sold +��� �
- BL_ - toilet seatJbread hox 1 1. 00
- c RL. - r•eco�rds **�t Not soid **-�-
- BL - VCR � i 1. 00
- PL - glassware lot 1 1. �0
- BL - kitchen lot/muys 1 1. 00
� -- RL - misc. items 1 10. 0a�
- BL - records ia��r Not sold *** ��
- BL - recards �r*it Not sold +�-**�
- PL. - x-mas lot � �-*� Not sold ***
- HL - tinslmisc 1 3. s0
- BL - Cvke tr•ay 1 6. 00
- � PL - x-mas lot �t�* No�t sold ***
- SL_ - caffee m�_igs 1 4. ¢�0
_ _. _ � __ :
__ _ :_ BL . .£ool joE__ _ o. 1 1:1. 00
- L�L - m i 1 kcan � 1 7.:'. 0Q
UdtY ' ��ILi .i�[� ��YII.G C..�:Y�G:J:i .
�iQW29 5 pll0} lOrl SBT'V lCB
25�5 RitnierI'a Hwy
Garlisl.e� 1^1ry j.7�1J /
717-249-267?, 249-1978, E47-47'34
www. rowesatictionser•vice. com � �
Sattlement �anette Yohn 7i/-790-9463 Page: �
Sellet�: 5
E Hickory Lane ��
Mechanicsbur�g F�R 17St55
Item Description F'rice Oty Total
---- ---------------------------'--------
— PL - pict�tres **� Not sold �*�- �
- BI_ -- ha+asehold lot �*� Not sold �*�
- HL - misc. itemslhousehold � 1 2. 04�
- BL - x-mas/Easter *** Nut sol.d **�-
- BL - silverplate lot 1 �. k'�Q+
- BL - dress books 1 7. 0a
- PL - school bench/cat i 5. 0iD
- RL �- video lot 1 i. 00
- SL - frames . 1 3. 0�b
- P!_ - wi,..e!misc x..xv. ^..I�t ��,) d +*��
- AL_ - golfball disp:ay '1 - 5, 00 �
- E�. - toaster• �** Not sol.d �#��
- PL_ - linens 1 1. �0
- BL - 2 dolls 1 10. 00
- RL - set of scales i 3@. 00
- RL - motor 1 M E.. �DO
- Mahogany card table _ 1 ` 8Q1. �0
- Oak cabinet 1 �. a0
- Oriental light *�� Not sold ***
- Pine desk 1 �0. 0t�
- Gine shelf R rack unit 1 S.c. O�
- Maple end table i 5. �0
- Gi.ne bookshelf , 1 iQ�. 00
- @r•een curio-2 pc i 8�d.�SAO
- French coffee ta6ie - I i 18. @0
- Gr•. ehild' s chair,s 1 c:,:,. 00
- Folding screen 1 18. 0�
- Redr-aom suite a!r•ails I i8i7J. @0
- Child' s rocker 1 �. 00
- Foot �stool ice chest 1 2. 00
- � Lamp �r*� Not sold ***
- Rattan bar 1 6@. 00
- Pr,_ chairs � 1 1�D. 00
- Bedroom si.iite 1 �Qi. 00
- � 6ray �_�pholstered chair 1 18. .:t0
-� Hanging console t,s pc) 1 2,°�. 00
- 2--dr, radio c�binet bar 1 14. Q�0
- TV 1 i. 00
- Desk 1 16, Q�0
_ _ Fr�: ta61e lamps � _ i �5.0�
- F'ine chest 1 4,:,. Qis
o�t�: aa -a�-�m�� ��:m�:s3 ,
� � � Rowe' s R�_tction Service � .� �
25�5 ftitner Hwy
� � CaF-lisle� PR 17015�
7i7-24'3-cE77, �49-7978, E97-/+794
� www. rowesa�.ictianserv�ice. com �, �
5ettlement Lanette Yohn 717-790-9463 Page: � 3
Seller: 5
6 Hickary L_ane
Mechanicsburg PA 17Qt5S
Item Descr-iption Price Qty Total
� -------------------------------------°-----
- Fir�eplace screenlutensils 1 1.:�. �0 � �
- Dr�esser - French-style 1 75. 00
- Sill-life print 1 1. 0@
- Foiding £able fGH) � 3. Pi0 2 E�. 00
- 3 foldir�g tahles 1 g. ¢i�
- WaTker 1 1. @0
- Rocker , 1 3, t�Q�
-- ?"able R r_hair< ... 3Qi. �0
- C�_irio brass/ylass 1 :'¢�. aa
- Twig table 1 EVF. 00
- Ir-aning board 1 i, mm �
Items: 93 Amount : 1, 297. SQi
K
Commission at 35. �Q�0X 454. 12 `
Less adj�.istments : -454�. L2
� Net due to seiler: 843. s8
Thank you f�r� your business Rowes Ructian ! �
i
,
Q
sEV-isio ex+{os-os)
� pennsykvania SCHEDULE G
oEOAnT^+��TOFAE�E��E INTER-VIVOS TRANSFERS AND
'""ERTT""cET"X�" MISC, NON-PR08ATE FROPERTY
RE516ENr0ECEDENT
ESTATE OF FILE NUMSER
Z>arlcnc /YI. /�,c�fl�eirltr .2//!-/33g
� This schedule must he mmpleted and filed if the answer to any of questions 1[hrough 4 on page three of the REVd500 is yes.
JTEM �^ DESCRIGfION OF PRqPERTY pqh OF DEATH %OF DECD'S EXCLUSION TAXABLE
wcwce me ruxe oF TMe,anNSV�nr�,r�a aeunoxsxiP ro o�oeur n�uo
NUMBER m�enhornwnsre+ annasACarc�r�offnr�e�u�.su�. VALUEOfASSET 1N7EREST {�Fr�atcna� VALUE
' Sus fwehann< F�i1.7acra( /�d✓'%SOrS, LLG
lR,� ,��; � FFCOO/3x5
Tfa! //�r/ue �/z/� 8/5. 93 y
�rsee !'a/ua:so�?I S/ree� Q�rclep'J L� t �
/,n�`S Q'���l117- .(./�C..� Gl/l�iF�JLIJ �H4f�y �JC7H"'
Lcy, decu�r.r��s` f�'o tzJ s:s�crr ��+r rz,?e t 2t,8rs� Jm� —r— Jat, 8�5 93
a� la� r.a�,):
yz LR/IB�G �.yo,�n , s,sf�,-
fu2 .Aoro�ly �3iiller; s;sfe/'
r
<.
'_ � TOTAi.{Aisa enter an Une 7,Recapitulation} $ j 2 t� ��S, g,�
If more space is needed,use addittonal sheets ot paper of[he same size.
Holdinqs by Investor �_,,_ _ _ _ _
Dadene M Parthemer �tlward P Gormtey CPR,CFP� Combined rttolio
24g3 Cape Qrive CFA.CFP Date: Y2t021241t
�Mechanirsburg,PA 17055 Susquehanna Financiai Advisors LLC Createtl: 11
4999 LQUISE DRIVE
SUITE 101
- MECHANICS6URG,AA 47655
777-506-21{t0
Dariene M Parthemer
Acct Name:NF5/FM7C IRA FBO DARLENE M PAftTHEMER 24$3 COPE OR MECHANICSBURG PA 17055
Acct No:FFC001325 AcatType:IRA Regular
Rep.No:�6fi
e-«.-as. .,,r.; . . ..,�...� .
�AMERICAN FUNDS EUROPqCIFIG AEGFX INTERNATIONAL �AMERICAN 299.tl0 38.98 � 10,871.75
GRF � � � � EQUITY FlJNDS
AFAERICAN FUt3DS GR FNQ 4F GFAFX IARGE Gft4Wf N AMERICAN 67.87 29.10 i.975.08
AMERF � PoNDS
DAVIS NEW YORK VENTURE FUNp A NYVTX US ST4CKS DAVIS FUNDS 75.07 32.54 2,442.68
FkOELITYAt7JGLQHfiC FFC�AX NON-USSTOCKS FIDEIiTY 473.54 f4.60 S,9t3.65
C4t�rS�AOQITY STOCK FUNOS
FIDELITYADVNEWINSIGFfTSA FNWC USSTOCKS FIDELITY 547.45 . 19.96 10,927.001
FUNOS
FtOELt7YAGV STRATEGIC iNC-A FSTAX FiXED tNCOME FIDELITY 2,018.41 12.32 24,863.55
FUNDS
HARBOR INTERNA710NAL�NV HIINX NON-US STOCKS HARBOR 96.73 54.D3 5;231.96
FUNOS
HARTFORDCAPIFAIAPPRECA ITHAX USSTOCKS HARTFpRD 309A2 28.ST 9.168.70
hiUTUAI
FUNOS
MAINSTAY ICAP SELECT E�UITY� ICSRX US STpCKS MAINSTAV 305.62 3927 � 10,168.06
PUND A
MFSVHIUEFUNRA � ME3AX USSTOGKS MFS 89.9G 2225 2.000.� �
OPPENHEIMERDEVELOPING�MKTS ODMAX NON-USSTOCKS OPPENMEIMER 771.49 31A2 � � 5,37925
A � � � FUNDS � . �
PIMCO7pTAL RETURN 0 PTTDx tNTERMEDIRTE- PIMCO FUNDS 7,734.10 10.82 18.T63.Qt
7ERM BOND -RETAit
PRIMEFUNDCAPITALRESEft�IES FPRXX CASH EIDELITY 4,650.'76 1.00 4,870.78
CLA55 � FUNDS�
PRINCIpAL INVESTpRS MID CAP PEMGX US STOCKS PRINCIPAL 605.85 14.13 8,58U.59
BiEND FUND CUSS A FUN4$
Acr.ountTOfat: $i23,815.93
Investor7otal: 5121,815.93
� �['y �Ya W
�y�b�- {/'
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REV-1511 EXa{�0'OB� .
SCHEDULE N
COMMONWEALiH OF PENNSVIVANIA FUNERl�L EXPENSES &
INHFRITANCETA%REfURN ADMINISTRATNE COSTS �
RESIDENT DECEDEM �
ESTATE OF n FILE NUMBER
�h�P.�L rn. !"lLr�{t0]1Cf ai-��-�339
Debis ot Aecedent must be reported on Schedule L �
ITEM
NUM6ER DESCRIPTION AMOUNT
A. FUNERAIEXPENSES:
' Ma��cti� Fknu�a.l N��nc sF /y��un��sbu*�� P�4 �/o, /Yo.7�
Csa sl�zlrerut +�l`��•a!)
�. /Qei.n6. f Lane�e/oln Jsr �//.%�, 6�c+, Cunatiy -To+�mmua(' �!, 395.00
3. fne%��i � �4nc� john r»r Fsn�ra/ L.Nncbvn �32S.o0
f /roUi�t9 6zul CIJ�.h�'y �r- Alarkv Fe� �/� 66� o0
B. ADMINISTRATIVE COSTS:
7. Personal Represenlatives Commissions
Name of Personal Representative(s) Lane� � !s/J/7 .. _ . ��3�, (�l(�,OD
SlreetAddress b HiC��(O/y [,�/JG �
J
c�ry /y/CC aiNCSdsr�s s�a�e�av /7oSS_
Year(s�Commission Paid:
2. nttomeyFees Char/es F d�ti��as � �l3� TQ�.pO
3. Family Ezemption:(If tlecetlenfs adtlress is not the same as Gaimanl's,attach ezplarq[ion)
c�a�mam /3�D O/YE EL/6/�3GE' NONE'
SlreetAddress ______
City___ Stete ZD _______
Relationship of qaimant to Decedent
4. � Probate Fees [tnd ori�i r� issuc o� �Shor1' Cwrfi�+�a-+'�.s f !53.SD
5. AccountanCSFees � on mG�n,r�,�CS6N�M T°r / -��, D0
�1rk Fi�nnncia� �Ttw- r n. ,
/
�os//s P/t �/s n.ra/ c/to�:n ap T-�es ;ssnes �
6. 7ax ReNrn Preparer's Fees � �� �o� p� �0
$y,Sa/�.�.n. /�i'iSo�7��� i �SO. 00
7. �i�1�7q !� " /cp�i3fG1� B� Lt/i��5 �.5�. �
� �
� .4-�c�/.i�i'>n�+/ �rn�laz/e {te �O /le�.sfu'o� W%/s '�270. o0
9. /t</✓crf�;sin� :a C�us�,6�rJaxd Lau/ ,THrna l -�is,c+o
/O. �c/v?.r'�s iil9 :n �4/'/s�e �lsl.fiiie/ /3�GN/.�Oit�ou� �/�7 D6
d
//. /�dd�l�iand/ �Sfiorf �e/`f.�{-�cafe�s fl,T. ov
�Se� L�oil�i� clfJeef)
TOTAL(Also enter on line 9,Recapitula5on) $ L� 6 8 7.3
(H more space is needed,insert additionel shee[s of the same size)
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MalpeZZi Fatneral Home
rx.
8 Mazket Plaza Way (717)697-4696
Mechanicsburg,PA 1'7055 www.malpezzifuneralhome.com
Jeremy J.Sharizer,FD Michael J.Malpeui,Owner,FD Kyle C.Knipe,FD
December 13,2011
Lanette M. Yohn
6 Hickory Lane
Mechanicsburg,PA 17055
This is the final statement for the funeral services of Darlene M.Parthemer
�Ye sincersly appreciateihe con£dence you have placed in us and wi11 continue to assist you in every way.
PROFESSIONAL SERVICES:
Services of Funerel Dircctor/Staff $4,625.00
FUNERAL HOME SERVICE CHARGES 54,625.00
SELECTED MERCHANDISE:
Poplaz Veneer Casket 53,200.00
Sentinel Vault $1,425.00
Natures Tranquility Register Package 595.00
TE�COST OF OUR SERVICES,EQUIPMENT,AND MERCIIANDISE
'fAAT YOU HAVE SELECTED S9,345.00
CASH ADVANCES:
At the trme funern!arrangemenLS were made,we advanced certain payments to orhers as an acromodation.
The follawing is an accoundng of'thase chmges.
Certified Death Certificates $90.00
Newspaper Notices-Patriot $393.74
Cler�/MessOfferinB . SI00.00
Flowers 5212.00
TOTAL CASA ADYANCES AND SPECIAL CHARGES 5795.74
SUB-TOTAL 510,140.74
. . _. -_ .__.. _ . . _- IL71T7AI.PAYM£NTi�f3lSCfll3NP/CREDITS , .pQ .
TOTAL AMOUNT DUE BYJanoary 4,7�(��2 — _- - 510,140.74��
� 9�'�
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DATE���'t- I`�til.c I/
PAY �.� J� � /`�/ // Q
ORDER O��/" �C �Li/ L.r-iL-�n-�l_, -�-F'LTY7'j-t� �.��__,`�_.-- I �V IO / j„' /t?a
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.�L-�rt. G/�( 2c�2G-weL'� OY[F /VUl�t.e-sGi 7�d:iLi+a .ct��^vL �c' ,s-----_____-�-- D O L L A R S a .n.
� Citizens Bank
re��:yi�,�w
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FOR-�'�I��_`_� �G9LR'2e��-�-i °CG2'vCt..c� Z7'u-�"`' �•\��—.7'ft v �w
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n•p00994n• i:p36076i50�: 6 2 3 398 708 7n'
REV-1512 EXt(4-03)
SCHEDULE 1
COMM�MNEFLTH Oi PENNSY�VANIA DEBTS OF DECEDENT,
INHERITANCETAXRETURN MORTGAGE LIABIUTIES, & LIENS
RESIDENT OECEDENT
ESTATE OF Darlene M. r2y'TYqN(.i� FILE NUMBER
2!- II-i339
Report debts incurted Dy the decedent prior to tleath which remained unpaitl as of Ihe date of death,including unreimbursed medical ezpensea.
ITEM VAIUE AT DATE
NUMBER DESCRIPTION � OF DEATH
1. Ci�1�7-G]5 OMY. �LLkiq� / '�'�. C�IL� t��7 G�CGKR�aY �iZ S�// Q�fEr
d.o.� -AtroCar� OYyye�- / / f 3'f, 72
�. GtGZ Rf:/:h'es �io/. i2
3. R/��� lt'aft.- e� P•4 �d.?.8.7
� /�n� '`s�8y
-' �%nnac% �%orasc��tr •�sxs. fS.00
6, 3u/tson. S%e�e/6aam Gasfroutlrin/n�� �„Sp.00
7. 1�'u�;roh G✓Crf' f399•YS
TOTAL(Also enter on line 10,Recapitulation) E 8 7oZ. �`s
(If mwe space is neede0,insert a0di�ional sheets of the same size)
REV-SSL'EX+ (11-081 .
. pennsylvania SCHEDULE )
iNHEaRANCE TAX R�RN BENEFICIARIES
0.ESIDEM DKEDEM
ESTATE OF FILE NUMBER
1�arlcn� M. Pa�r�'l,erner a/-//- �339
REIATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBE0. NAME AND ADDRESS OF PERSON(5)RECENMG PROPERiY Do Not List Trustee(s) OF ESTA7E �
[ TAXABIE DISTRIBUIIONS[Indude ou[right spousal distributions and trdnsfers under
Sec 2116(a)(1.2).]
1. �s.o)� n1:�leY SiSf'e�-
7asz Wu-i-i�;rle Rd. `�� po
Carl�Slc, P/F 17o1S
� Lan�1f'a Yohn
5 i5f'4^ �D Pe
6 H:ckor� La,ne
Atechan�csbN��, PA� /�osS
3. swzanr� �he�eman stcp dau��ile�- /a�o
c�0 $S ft3�iNr�r .17Y:
Narrisbi,u^� � P/} /'j/12
�'. AlarK Partheriltr' S�.son /O/o
�fDO� !.�• Ham:/fi�.� kr�.
Weat QaL�, ,8uc1, , F[. .�5���
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUT[ONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECiION 2113 FOR WHICH AN ELEQION TO TAX IS NOT TAKEN -
1.
B. CHARRABLE AND GOVERNMENTAI DISTWBUTIONS �
1.
TOTAL OF PART II— ENTER TOTAL NON-TAIIABLE DISTR[BUTIONS ON LiNE 13 OF REV-I500 COVER SHEEf. �
If more space is needeG,insert additional shee[s of the same size.
LAST WILL AND TESTAMENT OF DARLENE'M.PARTHEMER
I,DARLENE M.PARTHEMER,an unremarried widow,currently of 2483 Cope Drive,
Mechanicsburg,Upper Allen Township,Cumberland County,Pennsylvania,being of sowd and
disposing mind,memory and understanding,do make,publish and declare this my Last Will and
Testament,hereby revoking and making void any and all prior Wills by me at any time heretofore
made.
1.
I direc[the payment of all my legally enforceable debts and funerel expenses as soon afrer my
decease as the same can conveniently be done.
2.
All[he rest,residue and remainder of my Estate,aRer peyment of all death ta�ces,real,
personal and mixed,whatscever and wheresoever situate,I give,devise,and bequeath to be
� distributed es foilows:
A) Forty(40%)percent to my sis[er,DOROTHY MILLER,per stiroes.
B) Foriy(40%)percent to my sis[er,LANETTE M.YOHN,ner stiroes.
� C) Ten(10%)percent ro my step-daughter,SU7.ANNE SHELEMAN,ner stiroes.
D) Ten(10%)percent to my step-son,iNARK PAR7T�MER,ver stiroes.
3.
I nominate,constiNte and appoint my sister,LANETTE M.YOH1Y,to be the Executrix of
this my Last Will and Testament. In the event[hat she is unable or unwilling to act es Executrix,I
appoint my niece,MARY E.WETZEI„to be Executrix in her place and s[ead. I further direct that
� they shall not be required to file bond or other securiTy in the Office of the Register of Wills for ihe
pwpose of administering my Estece.
IlYVV17'NESS WHEREOF,1 have hereunto set my hand and seal this �day of
� i�E% A.D.2007.
� f `}�J, (SEAL)
ENE M.PARTHEMER
Signed,sealed,published and declared by the above-named DARLEI`IE M.
� PARTHEMER,as and for her Las[Will and Tes[ement,in the presence of us,who at her request
and in her presence,and in the presence of each other,have hereunto subscribed our names as
wimesses. n �i,
C%�y�G C j�S�:�G�A4�
���/