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Home My WebLink About06-11-13 _ _ _ _ _ _ _,��_ � 1505611185 REV-1500 EX(02-11)(FI) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 28�601 INHERITANCE TAX RETURN 21 11 0634 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number D2te Of DBath MMDDYYYY DBte Of Birth MMDDYYYY 04112011 �3141923 DecedenYs Last Name Suffix Decedent's First Name M V MCCLENACHAN BLAIR (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last tJame Suffix Spouse's First Name M I MCCLENACHAN EILEEN H Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 111-30-2�44 REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW � 1. Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death Priorto 12-13-82) ❑ 4. Limited Estate � 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Required death after 12-12-82) � 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Wiil) (Attach Copy of Trust.) ❑ 9. Litigation Proceeds Received � 10. Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHQULD BE DIRECTED TO: Name Daytime Telephone Nurr}�er � KEITH 0 . BRENNEMAN 717-�9�-852�r' � � � � f�Il R OF WI SE�JL'�tl rn = c� _¢ cr: �7 D r' 4--� 5 r" i�i First line of Address n N � � '�' �� - �c � _;,� 44 WEST MAIN STREET ° � � =� --Yr Second Line of Address ^ � � � '-� � �ti. ;'-_ ;-�1 ,..... P • 0 • B0X 318 r' c:- �� City or Post Office State ZIP Code DATE F1�D MECHANICSBURG PA 17055 CorrespondenYs e-mail address: Under penalties of pery'ury, I declare that I have examined this retum,including accompanyi�g 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 infortnation of which preparer has any knowledge. SIG� E OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS �//G,�`� KEITN 0 . BRENNEMAN ADMINISTRATOR C . T . A • SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505611185 1505611185 J / � OM4647 3.000 � L _ _ _ _ _ _ - - - - - -n-„ - � 1505611285 REV-1500 EX(FI) DecedenYs Social Security Number �ecedent•sName: MCCLENACHAN BLAIR RECAPiTULATION 1. Reai Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . � � ,��, 2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . 2. O • �p'. 3. Closely Held Corporation,Partnership or Sol�Proprietorship(Schedule C), , , , , 3 � •Q 0 4. Mortgages and Notes Receivable(Schedule D) . . _ . . . , . . . . , 4 a. O Q 5. Cash, Bank Deposits and Misce�laneous Personal Property(Schedule E) , , , , , 5. 1 O,8 39 •6 2 6. Jointly Owned Property(Schedule F) � Separate Billing Requested , , , , 6. 0 • �[] , 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (schedu�e G) � Separate Billing Requested . . . . �. 12,0 5 2 • 0 8 ' 8. Total Gross Assets(total lines 1 through 7) , , , , , , , , , , , , , , , , , , $ 2 2,8 91-7 d ' 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . g, � • �0', 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , , , , _ _ . �� •0� 11. Total Deductions(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , >> O • 0 O 12. Net Value of Estate(Line 8 minus Line 11) , , , , , , , , , , , , , , , , , 12 22,891 �70 ' 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J), , , , , , , , , , , , , , , , �3 � • �Q 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . �q 2 2,8 91 •7� TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers un�er Sec.9116 (a)(�.2)x.o_ 22,891-70 �s. 0 •00 16. Amount of Line 14 xable at�inea�rate x.0 4� 0 • 0 0 �s. 0• 0� 17. AmouM of Line 14 taxable at sibling rate X.12 O • 0 D ��. 0 - 0 0 18. Amount of Line 14 taxable at collateral rate X.15 � • �� 1 g. � •a� 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. � • �� ' 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT X❑ Side 2 � 1505611285 1505611285 J OM4648 3.000 . _._. . . . _ . _ . . . _ _ _ . . .. .. _ . _ .. . .. . . .. . . _. _ - - -.. - . _ . _ .. . . ... _. .. . ��..�I._. . _ ,n�� REV-1500 EX(F{) Page 3 File Number DecedenYs Complete Address: 2 7, 11 0 6 3 4 DECEDENI"S NAME M C ENACHAN BLAIR STREETADDRESS - MIDDLETON TOWNSHIP UM RLAN COU TY CITY STATE ZIP C RLISLE PA 17013- Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1 j � •�� 2. Credits/Payments A. Prior Payments 0 • �� B. Discount � •�0 Total Credits(A+B) (2) 0 •�� ' 3. Interest (3) fl •�� 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2,Line 20 to request a refund. (4) 0 • 0 0 ' 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0 • �� 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ a 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.§9118(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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.g9116(a)('I)�. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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 blood or adoption. OM4671 2.000 . .. _ . _ . . _ . . . . . . . _ . _ _ _ . . . . . . . . . . . . . . . . . . _ . . . . . .��i..,�.. . . _ _�_„ REV-1506 EX+(11_10) pennsylvania SCHEDULE E DEPARTMENTOF REVENUE CASH, BANK DEPOSITS, 8�MISC. R SEDENTDECE ENTTURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Blair McClenachan 21 11 0634 Include the proceeds of litigation and the date the proceeds were received by the estate. All ro rt 'ointl owned with ri ht of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIP110N OF DEATH �. Orrstown Bank 10,839.62' Certificate of Deposit #4000034462 TOTAL(Also enter on line 5,Recapitulation) $ 10,839.62 oWasnD 2.00o If more space is needed,use additional sheets of paper of the same size. . . . . . _ _ . . .. . .. _ . _ _rIT� . . REV-1509 IX+(01-10) pennsylvania SCHEDULE F DEPARrMENTOFREVENUE INHERITANCE TAX RETURN JOINTLY OWNED PROPERIY RESIDENT DECEDENT ESTATE OF: FILE NUM BER: Blair McClenachan 21 11 0634 If an asset became janUy owned within one year of the decedent's date of death,it must be reported on Schedule G SUF2VNING JOINT TBVANf(S)NANE(S) ACIDRESS RaAT10N5MPT0 DEC,�B�fi A McClenachan, Eileen H 1880 Douglas Drive, Carlisle, PA 17Q13 Surviving Spouse JOINTLY OWNED PROPERTY: � �,TER aarE oESC�noN oF�or�1v %oF a4rE oF�,ani FQR JqNT MADE INCLUDE N41.E OF FINRNCIAI INSTI�UTION AND BANK qCCWNT NUM1BER OR S�MV�R ��,`T� DEC�NTS VALUE OF �� YB� TENANT ,Ja(�(� IDENTIFYINGNUA6ER.ATT�CMDEEDFORJdNTLVHELDRE�LESTATE. VAL�OFASSET INT�EST DEC�B�IrSWIFREST 1 Orrstown Bank 0.00 0 0.00 decedent jointly held a safe deposit box with surviving spouse. Box information as follows: Orrstown Bank 2250 Spring Road Carlisle, PA 17013 Box #111 2 A Orrstown Bank 53,396.84 0 0.00 checking account #143000617. Jointly owned with surviving spouse. This is listed for informational purposes only. TOTAL (Also e�ter on Line 6, Recapitulation) 5 0.00 swasne z.000 �f more sQace is needed,use additional sheets of paper of the same size. _ �.u. _ _ ��-+- REV-151�EX t(08-09) SCHEDULE G pennsylvania DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMSER Blair McClenachan 21 il 0634 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. DESCRIPTION OF PROPERTY ITEM INCLIDETFEW+6IEOFTFETRANSFEREE,THEIRRELATIONSHPTODECEDEMAPD DATEOFDEATH %OFDECD'S EXCLUSION TAXABLE NUMBE T1 E Q47E OF 7RMSFER ATfl�GHACAPY OF TFf�EEO FOR REAL ESTA7E. VALUE OF ASSET INTEREST IF PPPUCABLE VALUE �• Orrstown Bank 12,052.08 100.0000 0.00 12,052.0�9 IRA account #4000025274. Surviving spouse is listed beneficary. TOTAL(Also enter on line 7,Recapitulation)$ 12 052.08 If more space is needed,use additional sheets of paper of the same size. swasnF z.000 _n - REV-1513EX+(Ot-10) SCHEDULE J pennsylvania DEPARTMENT OF REVENUE BENEFI CIARI ES lNHER{TANCE TAX ftETURN RESIDEPlT DECEDENT ESTATE OF: F1LE NUMBER: Blair McClenachan 21 11 0634 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE � TAXABLE DISTRIBUTIONS�Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] �. Eileen H. McClenachan 1880 Douglas Drive Carlisle, PA 17013 100�k of Residue All of Residue: 767.60 Surviving Spouse 22,891.70' 2 Scott Whittington 1106 Sage Brush Court Burlington, KS 66839 None 0.0� 3 5arah M. Mortimer 56 Ryder Road North Attleboro, MA 02760 Daughter 0.00 EMER DOLLAR AMOUNTS FOR DISTRIBU710NS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. {� NO�TAXABLE DISTRIBUTIONS A.SPOUSAL DIS7RIBUiIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 6.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: L TOTAL OF PART II-ENlER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00 swasni z.000 If more space is needed, use additional sheets of paper of the same size. . a �� Estate of: Blair McClenachan 21 11 0634 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 4 Anne McClenachan 7 Dublin Road Ext. Orford, NH 03777 Daughter ' 0.0p' - �d _ , .:: ,: _ , ,. . , , . � ,,, ,. ,:.. ; . , . , Tn v. �� . . i , .. � ,..� . : � ��. . �.. ' '_ . . , . ., ..> � , .. � . . � .i�e . .. . ,. -. . -.�. : . , ,�i. .. ' .:.� � �� °'+� .. , . � . . .. . r _ . , ;. .� . , .� �.�, r . . , . _� ,� � � � - �. :: � . .._ .. , ..... , ,_. ., ��i � . . . . ._ _.. :� LAST WILL AND TESTAMENT iI OF �i BLAIR McCLENACHAN �� I,BLAIR McCLENACHAN, a legal resident of North Middleton Townshi , Cumber ;! County,Peruisylvania, being of sound and disposing mind,memory, and understanding, do hereb�' make, publish, and declare this as and for my Last Will and Testament, hereby revokin all oth �' J; wills and codicils heretofore made b m g e� y e. ��T� I direct that all my just debts and funeral expenses, includin n1 marlcer, shall be paid from the assets of my estate as soon as practicable after my decease.y �ave' � ' SE�'OND: I direct that all taxes that may be assessed in consequence of my death, of' i� whatever nature and by whatever jurisdiction imposed, shall be paid from my residua es part of the expense of the administration of my estate. rY tate as a ' , , ' THIRD: I devise and bequeath the suin of Five Hundred Dollars($500.00)to SCOTT ' ' WHITTINGTON. FOURTH: I malce the following specific bequests to tlle persons indicated; A• I devise and bequeath all ofinycameras,binoculars and telescopes,to include all lens ' accessories, to DAVID MORTIMER. B• I devise and bequeath 200 shares ofExelon Corporation,or any successor com an ' to my daughter, ANNE McCLENACHAN. p y' � C. I devise and bequeath 200 shares of Exelon Coiporation,or an suc ' ; to my daughter, SAR.Ag McCLENACHAN MORTIMER. y cessor company, If any of the above persons shall predecease me or refuse to accept l�is or her spec?fi c be uest h - I direct t}�ai sucn�equest shalllapse and saici item oi�items sha11�c co»siciered a part o�t��e�csid�P„ of my estate. FIFTH: I devise and bequeath the residue of my estate, of every nature and whereve �i' situate, fo my wife, EILEEN H. McCLENACHAN, provided my wife shall survive nle by one hundred twenty(120)days. Should my wife,EILEEN H. McCLENACHAN, redecea on or before the one hundred twentieth day following my death, I devise and bequeath the esidue ;; of my estate, of every nature and wherever situate, to my daughter,ANNE McCLENACH � my daughter, SARAH McCLENACHAN MORTIMER, e uall �� and daughter who predeceases me or dies on or before the one hundred t entie h day follow n�m de Ily ' g y ath initials . _ � � , ��..� i , 1 r :,f , ! shall be distributed to her issue,per stirpes, living on the one hundred twenty-first day follo death, and in default of any such then-living issue, such share shall be added �'ing lny � for my other daughter. to the share or shares SIXTH: I nominate, constitute and appoint EDWARD L. SCHORPp this, my Last Will and Testament. In the event of the renunciation, death, resi ationExecutor, o�' to act for any reason whatsoever of the said EDWAIZD L. SCHORPp, I nominate ° or inability' appoint my daughters,ANNE McCLENACHAN and S , constitute, and '' the survivor, co-Executrices,of this,my Last Will and Te�ament I he eby el eiv m�RTIMER,or ' his successors from the necessity of posting security in connection with their duties as suc cutor or ' jurisdiction in which they may be called upon to act, insofar as I am able by law so to do. h ln any ' ��T-��v1TNESS VvI?ER.E(�F� 1 have hereunto set my hand and se�i io this, my Last Will and ' Testament, consisting of two (2) typewritten pages, each of wliich bears my initials, this ,.?yT i ' day of /��v.�,'- ��• � - _ _',� � 7 Blair Clenachan, Testator (SEAL) Signed, sealed, published, and declared by the above-named Testator, Blair McClenachan as and for his Last Will and Testament, in t11e presence of us, who, at his request, in his si ght and presence, and in the sight and presence of each other, have heretulto subscribed our names as witnesses. '-�,) .��ti�.� � �� ' , , (�, ACK.i�ipWLEDGMENT COMMONWEALTH OF PEI�'NSyLVANIA � COUNTY OP CUMBERLAND ' �'U• ) I, Blair McClenachan, Testator, whose name is signed to the attach instiument, having been duly qualified according to law, do hereby aclalowled e that r f�oregoing executed the instruinent as m y L a s t W i l l; t h a t I s i g n e d i t wi l lingly; and that I si g I s i b n e d a n d vo luntary act for the purposes therein expressed. �ed it as my free and �Sworn or affi ed to and acknowledged before me by Blair McClenac •��/'� _ day of ,�,� �,S�- � han,the Testator,this , �� :- ��\ � !� `�. � Testa or, ir McClenacha.r�- � ��1.�.c� 7 �`y Notary Public �k"%�� (SEAL) VICTORIA L�.�OTTO iNOTARY PUBttG CARUSLE BORO. CUMBERLAND COl1�IT1' � - - - - _ - - - . . . W Ma�t��loMn� rvn�nro nrn n nnn� , ; . _ _ _ _n ,, _ ' . AFFIDAVIT COMMONWEALTH OF PENNSYLVAN.IA ) COUNTY OF CUMBERLAND SS. ) We, Edward L. SchorpP anci .�/ra.o-�.��. 4� Co�.,r�,-�- whose names are signed to the attached or foregomg mstrument,bein dul � the witnesses law, do depose and say that we were present and saw Testator sign and exec te thel nstru.mentasg is Last Will; that Blair McClenachan signed willingly and that Testator executed it as 11is free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the VViII as�.�itnesses; and th��tt to the best of our knowledge the Testator was at that time eighteen or more years of age, of sound mind, and under no constraint or undue influence. Sworn or affirmed and subscribed to before me by Edward L. Schorpp and �'�G�.,i'"c.i�=�._ �r": �"�,.,�,.n 7 c,�-.. ' ,d � _ `R�,r . ,witnesses, this ,,<� / day of . ;r, ;�r�� , �, . Witness, Edward L. chorpp (SEAL) ' ��c'��:� � �.. � � �z-7�'� (SEAL) Wrt s�' _, , fC C:�� '�r. .�/ �"�..��'� ° �,_' Notaiy Public (SEAL) NOTARIAL SEAL VICTbRtR L. OTTO, NOTARY PlJBLiC CARLlSLE BORQ., CUMBERLAND COUNTY MY COPJIMlSSiON EXPIRES DEC. 2 2006 ' �