HomeMy WebLinkAbout07-31-13 , 1 15�561�1�5
—� y C EX(a2-a1)(FI)
REV�iJOO � OFFICIALUSEONLY
PA Department of Revenue pennsylvania
� Bureau of Individual Taxes `••""`" ��"`"°` County Code Year File Number
Poaoxzao5oi �NHERITANCE TAX RETURN � " ` � jz i � � ?—" �
Harrisburg,PA i�128-o6oi RESIDENT DECEDENT � � � g z
ENTER DECEDENT INFORMATION BELOW J
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYVYY
— i i__ —. _
� � OS/18l2012 ! �0111 4/1 9 2 3 j
—__... _ __ — _—, _� �
DecedenPS Last Name Suffiz DecedenPS First Name MI
Ta� � �� Warren � � G�
(If Applicable)Enter Surviving Spouse's Information ,'elow
Spouse's Last Name SuKx Spouse's First Name MI
.. ...... ..._ ....,.------- ..._ �.� �—_
.. __� .. _._ .
� .-__ _ _ ____--- ---, i __� �-_ _ _ _- ! _�
Spouse's Social Security Number
! - � -- - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
_�_._... ---- __—__( REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1.Originaf Retum O 2.Supplemental Return O 3. Remainder Retum(Date of Death
Priorto 12-13-82)
O 4. limtted Estate p 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Retum Required
tleath after 12-72-82)
� 6.Decedent Died 7estate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy ot Wili) (Attach Copy of Tmst.)
O 9.Lltigation Proceeds Received O 10. Spousal Poverty Credit(Date of Death O il. Election to Tax under Sec.9113(A)
Between 12-31-91 and 7-1-95) (Attach Schetlule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONOENCE AND CONFIDENTIAL SAX INFORMATION SHOULD BE DIRECTED T0:
Name Day[ime Telephone Number
—....— _ ....._— .___ .....--
_ _ --__ _..._
�
Eflen Frownfelter �(717)426 1662 :
_. — _ . __— .�,--_ � �—: '
__ �.�_ _ . �,..—-.. _aa�—
�R�J6ISTER O�WILL�OSE'ANLY
77 � � q
m �° �, • � x'
First Line of Address � � � �
r---_ _.�_._._ � _._.—__._ _ _ __._._. _ _ .. _ r � m � �� a
i 25 Gwen Circle ; � v? � o �,
--_ . ._—__ .._ . �_
____� _. _ .._._ _ ---.__., o � � '� -n -n
Second Line of Address
i .....__._ . .»..__�___..._._—_.__�— _...._...... ....... _._._.� 4 � -r� � � �
! � � r m
fCiry or Post Office... .. ....... ��... . �.....�_.. .... ..---�� ... ...State ZIP Code � � o F�� �
�.__...._.. .._____'_._..__�.. .._._.... ..__....^.__..... _ _._. •__ --e '*7
j Marietta j PA� �17547 �;
CorrespondenYS e-mail address:
Under penalties o(perlury,I tleclare that I have examined this refum,including accompanying schetlules and siatements,and to the best o!my knowledge and belief,
it is true,cortect and complete.Declaration of preparer other than ihe personal representalive is based oo all infwmation of which preparer has any knowledge.
SIGNq7{3(2 � F"PERS � � Off���RET�t �,/ DATE
C � � l4 Gv 2('_ U. � X '7 �2�D/.3
AD ESS
SfGNATURE F REP RER OT E N R ESENTATIVE ATE
C/° l0 2
aooRESs
� >>i�'� �zf � � � PLEASE USE ORIGINAL FORM ONLY
� � ���oe3iate� � �, �
0
�yi��h"�nut Hattom wcC,�e��`
' �' ��x'�►�r5i8a P(4 k701y�, '� { Side 1
� x��/`"�5��6�0'S'f a 1505610105 �
�
. � 1505610205
� REV-1500 EX(FI)
DecedenPs Social Security Number
---......_- ---.. ..----���
oecedere's Name; Wef�erl G TaylOr
RECAPITULATION
_ . ..-.._.__ �-�.1
1. Reat Estate(Schedule A). . ... .. . ... ... ... .. .. .. ... .. ... . .... . 1.
2. Stocks and Bonds(Schedule B) .. .. .. .. ... .. .... .. ... ... ... ... .. . 2. ��� �
3. Closety Held Corporetion, Partnership or Sole-Proprietorship(Schedule C) ., ... 3. {
f�
4. Mortgages and Notes Receivable(Schedule D�. . .. ... ........... ... . ... .. 4. �
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E}. . ... .. 5. � 97,827.31
i
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... ... . 6. ` ,
7. Inter-Yvos Transfers&Miscellaneous Non-Probate Property �
(Schedule G) O Separate Billing Requested.... ... . 7.
- _,_ .�..�.._..
8. Total Gross Assets (total Lines t through 7).. . .. ... . ... ... ... ... .... ... . 8. 9�,827.31 �
9. Funeral Expenses and Administrative Costs(Schedule H)...... ... .... .. . .. . 9. � 12,108.08 )
10. Debts of Decedent,Mortgage Liabilities and Lfens(Schedule I).. .. .. ... . . . ... 10. � 16,901.37 4
1t. Total Deductlons(total�ines 9 and �0).. ... . . . .... ... .. .. .. . .. . ... .. . .. 1t. �� 29,009.45
12. Net Va4ue of Estate(Line 8 minus Line 71) . .. ... ... ... . . .. .. . . .. ... . ... . 12. 68,817.86 i
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which '��� �'�'�
an etection to tax has not been made(Schedule J) . .. . ... . ... .. . ... ... ... . 73. �
74. Net Value SubJect to Tax(Line 12 minus Line 13) . ... . ... ... . . . ... ... .... 14. 68,81�
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxabfe
at the spousal tax rate,or
transfers under Sec.9116 r. __.� . ._..._..-----, ............__ ..._ .._....._.- , .,.__......_ . ..._ ....,. .--
(a)(12)X .0_43 4 68 817 86 �5. ' 3,096.80
16. Amount of Line 14 taxable S
at lineal rate X.0_ � 16.
17. Amount of Line 14 taxabte
at sibling rate X.12 � 17. �
18. Amount of Line�4 taxable
at collateral rate X.15 � � 18.
----. .. ...._
19. 7AX DUE . ... .. .. .. . ... ... .. ... 19. 3�096.80
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
� 1505610205 1505610205 �
REV-7500 EX(FI) Page 3 File Numbet A! _`� — 0 A��
• DecedenYs Complete Address: '( T
DECEDENT'S NAME
Warren G Taylor •
STREETADDRESS
C/O Ellen Frownfelter, Executrix
25 Gwen Circle
cirv STHTE zia
Marietta PA 17547
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) {1) 3,096.80
2. CreditslPayments
A.Prior Payments 2,932.38
B.Discount 154.34
Total Credits(A+g) (y) 3,086.72
3. Interest
(3)
4. if Line 2 is greater than Line 1 +Line 3,enter the difference. 7his is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the diflerence.This is the TAX DUE. (5) 10.08
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 irtcome of the properly transferred .......................................................................................... ❑ �
b. retain the right to designate who shali use the properiy transferred or its income ............................................ ❑ �
c. retain a reversionary interest .............................................................................................................................. ❑ �
d. receive the promise for life o(either payments,benefits or care?......................._............................................. ❑ �
2. If death occurred afler Dec.12,1982,did decedent transfer propedy within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ �
3. Did decedent own an"in trus�for"or payabie-upon-death bank account or security at his or her death?.............. ❑ �
4. Dld decedent own an individual retirement account annuity or other noo-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 7, 1994,and beiore Jan. 1, 1995,the tax rate imposed on ihe net value of transfers to or for the use of the surviving spouse
is 3 percent p2 P.S,§9116(a)(1.1)li)j.
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116{a)(1.1)(ii)].The statute does not exempt a iransfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax retum are still applicable even if the surviving spouse is ihe only beneficiary.
For dates of death on or after July 1,2000:
. The tax rate imposed on the net value of trensfers from a tleceased 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 chitd is 0 percent[72 P.S.§9116(a)(12)].
. The t2x 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(a)(1)].
. The tax rale 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 si6ling is defined,
under Secfion 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adopGon.
.
REU-�SO8 EX+(o8-u) �
• �pennsylvania SCNEDULE E
��y�� OEPARTMENTOFqEVENUE CASH, BANK DEPOSITS & MISC. �
INHER(TANCETACRENRN PERSONAL PROPERTY
RESIDEM DECEDENT •
ESTATE OF: , FILE NUMBER:
Warren G Taylor � 21-12-0972
� Include the proceeds of litigation and the date the proceeds were recelved by the estate.
All property jointly owned with right of survivorship must 6e disclused on Schedule F. ' �
ITEM • VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
_— . . —_. .._.-- ----- ---
--- -- ---- ----- ----------- -- - .
1. M&T 8ank checking account No.9850010621 • 95,230.23
2. Insurance reimbursement
. 1,921.00
3, Highmark Insurance Premium Refund �
• � ' ; 620.50
� q, Insurance Refund ' '
� � 55.58
, i
- . I
� ' .
� _ �
_ - . �
� .
� � . . � ;
_ , i
I '
�
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� .
, I ,
• ' I �
, . .
r
' . �
` . I
• ` I
- . �
I
I
• i '
. � .
TOTAL(Also enter on Line 5, Recapitulation) $ ;� 9�,827.31
. � If more space is needed, use additional sheets of paper of the same size. �
� o��
` aecocRrT::Nb 1iCC6uN�r �t^rp� . sM3�fierv�x�r p��axoD S pACE
� 9850010621 ��� MYCHOZCE PREMIUM CHECAING ��� AUG�.11 SEP 12� 2012 I 1 OF 1�
� 00 0 04342M NM 017
�— WARREN G TAYLOR
,.�_ 119 WILLOW YIEW DR �
CARLISLE PA 17013-8478 �
INTEREST EARNED FOR STATEMENT PERTOU � 3.18 PARLISLE PIKE
INTERE52 'PAID YEA,R TO DATE 49.7�
ACCOUNT SUMMARY
7 $�GINI3IIiG II$P(SSI.TS & .� `.�. .:'; OTlIGR.' < CURR�A7T;�: �BNDIfiG
i .'f .� ' � :: ": ' . >
�: .... '����CE � ' .:. 6 EiY Fi1527T7'P 5�.:`: .CF1C KS` PP.'ID . ::. SU9&'RACT��NS � � ::ENTEftEST���PD � ��9XiE,AN E :x
Np, AMOUNT � NO. AMOiJNT NO. AMOUNT
95,230.23 3 2,447.08 7 95,649.38 0 0.00 3.19 2,031.12
ACCOT.3NT ACTSVITI'
;-ROSTIS3G <:�.: ':�::OEP08tTS,:ItY'£ERE6T. .;� CFIECIC6.:�.& QTkESR , DAS�LY
�i6AT � > TRAN ACT ON bEHC���Tf�TZOT� i'���& OTFEER����� TTY I35�"� :�5� - IONS�' �.��CE
OB-11-12 BEdTNNffi� HALANCE $95,2�0.23.
OB-23-12 CHECK A7UMHER 0668 10,492.00 � 94,738.23
OB-2A-12 CHECK Nf7M17HER 0667 7,828.00 76,910.23
OB-29-,12 bEPOSIT 1,921.00
OB-28-12 CHECK�NUNffiER 06b9 � 199.76 78,631.47
OB-31-12 CHECK 1�[JMAER 0670 68.00
08-31-12 CHECK NUNHER 0671 50.00 Tg,503.49
09-04-12 HENEFIT PAYMENTS DEPOSIT 470.50
09'-04-12 CH�C& NUI3BER 0672 1,001.62 77�,972.35
09-05-12 DEPOSIT 55.58 �8,027.43
09-07-12 CHECK NUMBER 6673 76,000.00 2,02T�.93
09-12-Y2 INTEREST PAYh1ENT 3.19 2,031.12
ENDZNG HALANCE 52,031.12
�;G7iECK3 PItiID.S�RY.�
667 08-24-�12 �,'82B.00 b88 OB-23-12 10,492.00 669 08-28-12 199.76
670 OB-31-12 68.00 671 08-31-7.2 �a.00 672 09-04-12 1r001.62
673 �4-07-12 ' 76,OO�.d�
ANDi[JAL P�RCENTAGE YI6LD EARNID � 0.04 $
pID YOU IINOW THAT YOti CAN MANRGE VIRTOALLY ALL YDUR ACCOUNTS IN ON6 9LACE AND
DTSCOVER WAYS TO SAVE MQNEY HY USING FINANCEWORICS RVAILASLE TN MS�T WE8 BANKIN�?
6ET STARTEI) TODAY FOR ONLY $0.99 PER MONT'A. LOG ON 'PO M&T W$B IIANKING AN� SELECT
"FINANCGWORYCS" UNOER THE ACCOUNf6 �TA➢". Li:ARN MORE FsT MTB.COM/FINA2�iCGWORiCS.
FINANCEWORK3 IS A ftF.GISTERSD TItADEMARK OF INT[STT�TNC.
MEMBSR PDiC.
REU4511 EX+(10-09) -
. �Jpennsylvania SCHEDULE H
���ti. DEFARTMENTOFREVENVE FUNERAL EXPENSES AND
INMERITPN(ETq%RENAN ADMINISTRATIVE COSTS
•0.ESIDEM DECEDENT
ESTATE OF FILE NUMBER
Warren G Taylor 2�_�2_pg72
� DecedenPs debts must be reported on Schedule I. �
REM
NUMBER � DESCRIPRON �
AMOUM
A. FUNERAL EXPENSES:_
1' Hollin er Funeral Home ---`-
L 9 _--- ---- .� 10,492_00 i
� Young's United Methodist Church �� �� -� _jg9.76 J
� �_ � - �� I' ��- �.-�
i� �— � 1 �-=�
CJ 1�� - .�__ -- _____I ��--.- .�1--a_
❑ - ^ _� �,� _ _ �, .
❑ �_____--- — � _._ � -- _ - ,.
B. ADMINISTRATiVE COSTS:
1. Personal Representative Commissions: . � . �—���
� Name(s)of Personal Representative(s) ' � --
� Street Address � � �
- ��h State,ZIP ,
� � Year(s)Commission Paid: '
� Z• AttomeyFees: _ � � . - I ------ - -�:
' 3. . , Family Ezemption: (If decedent's address is�not the same as daimanPs,attach explanation.) � � (
��
� � Claimant � � '
-, ' Street Address ' � �
. City Stdte 21P � .
. . , � . Relationship ofClaimant to Decedent -
� � �`-� - "�I
. 4. Probate fees: � - ' �- " k
�--- --_ —�..J
5. Accountani Fees: - - � . � .
i �f
-6. Tax Retum Preparer fees: - , . , �—����9 pp�
—i
1• . Filing Fees - ' 265.50
❑ ' . ----�-____—.� ��,
Advertising' , �� 200.82]
❑(�'� � � � �z�__���i
4J � -- ��
�� -
� -- � - � �__ -- --�
� n . ~� _____� ����
TOTAL(Also enter on Line 9, Recapitulation) $E� 12,108.08�5,
� � � If more space is needed,use additional shee[s of paDer of the same size. -
, HoIlinger Funeral Home & Crematory, Inc.
Eric L. Hollinger, Supervisor
Soi North Ba(timore Ave. • Mount Hol1y Springs, Pennsylvania i�ob5
. �717) 486-3433
STATEMENT OF FUNERAI.GOODS AND SERVICES SELECTED
Chazges are only for thase items that you seletted or that are required.ff we aze required by law or by a cemetery or crematory ro use any items,we a'ill
erzplain the reuon in writing below.
If you selected a Funerzl that may require embalming,such u a funeal viewing,you may have to pay for embalming.You do not have ro pay For embalm-
ing you did not approve if you selected artange�J ents,�yich as d'uea cremadon or'unmediate buriaL If we charged for embalming,we m�enp�why below.
Por ihe Servlce o^f 4�^���"'� v' � �l t��` Date of Death�p
ct�argew, Y,•�••�u W • F1.�.1....als 12L F.��olsko„io �}e.. '�\:s4 , tk. �70�5 --
Name Address Ciry Sfare�
A CfIARGB FOR 9HRNCES SEI.EGTCD: � Other clahing
1. PROFESSIONAL SEIMCES
Services of Funrnl Uirectod5taff..... . S Crcmatlon um ................... S
�Embalming .....................5 / (DeutlptloN
O[her preqnuon of body
07H2R 5
S
..............................S / TOL1L MENCHANDSE SELECIED .........
SIl&TOT�I.OF PROFESSIONAL SERVICES..........A1 S � ........B S�F9
2. FACf1,17'IPS AND SERVICES C. SPECJAL CFiARGFS: .
Forvnrding of rcrtuins to
Use of fazilities and servicta for s
viewing(V'�sitatioM7ake) ........, 1 � (FUnrnl Hrnne)
Use of hciliuu a�urvi<es Receiving ot rcmalns Bom
for funenVi ceremony ............ 3_� S
Use af hcilitia and xrvices fo� (FUnenl Home} .
Memocul Savia ...............S Immed'ace Burhl .................S
ltae af equipmrnt and servires Dirca Cremation ................. S
for gravaide servi<e ............. S� . S
other use of facitiriu SOB-TOTAL OP SPEQAG QiARGPS .........'.......0 S
D.GSA ADVAN�
.............................. 5
Opening Gnve .................. S�Qf? .
SUB-70'CAI.OF PAGQTfIFS/EQUIPAIBN7 ...........A2 S � Cemttery Equipment ..............S.�SL
3. AUI'OMOT[VE EQUfPMENf i.o[and Deed ........ .......... ST. �—
Newspaper Nouttslonl ...........S�= �T°+T•••+Rrh
�'ehick[o hans(a cemalns to Funeml kLome Newrspaper Notires-0�to6rown ...... S�_65Ti^^''�'�
�� "��""�""�"""""' s � Telephone&Teleg�xms 5
Hearse(Casket CoactO ............
tirfarc ........................ 5
I.owl ......................... S ✓ Lle /Mass Otfetln
LimonsNe BY 6 .............. 3 l ZS
Pa06euen .............�........3^��
Local ......................... S Certified Copies of�he DaN (OK�.�.. S_..I2�±
Family rar Ceniflam
...................... 5
inral .......... ...............5
Flower car or flonl d'a sitbn Politt Escort .................... S
P° Flawe�s........................ S lL
Lonl .........................S � Vault Servlce Cha
iead ar/cl<rgy tar Be............... S
t
taal ....... .................. S ✓ ? p s
Cu for pallbnrers e,.,� s
Wcal ......................... S s _
Out oi towm m�tportadon .......... S S
SU�TOTAL OF AiTi'OMOTIVB SQUIPMPNT.........A3 S � SU&TOTN.OF ADVANCFS .......................D S�U�I R
We cluige}rou for our services m obtaining:
7'OTAI.OF PROFBSSIONAL SERVICPS� CspeNfy wb aduxrrces tbot are markedapl
FACIIIIIES AND AUIOMOTIVS
Q P.�-.r+�e. A S 51So
E UIPMENT .........................
B. CMRGE POR DiEBCHANpISE SELECTED: . SUMMARY OF CHARGFS �
Culcet.........................3'ZO
A.Professional Servica,Padtities and
0quipmmt,and Autanotive
(�escriPtion) �-.�rtsi Equipmmt ........ ........ 3 / 0
....
�..�vsJ.\�a. B.MemFundise ....................S
Other Raepncle ................. S G SP�aI Chafges .................. 5
CDeuripticm) D.Cash Advances .................. S U�l
Outer burial mnyynet .... . .... S 00 707'�1L OP AIL SEC170N5 ...................... . 5 U O�J2
(p���y�) (y........�w+ YAID AT TQ�IIS�F OR PR[OA TO
ARRANGEMPM'3 .............................. j
Acknowlcdganent a . BAI.ANCE DiIE ................................ 5�r
Registtr book(s)..... a���a� REASON FOR EMBAI.\1PIG (Si i P.�wS Do
Memory foldcrs . �°� S �O 9.�
Pnyer nrds ...... ............. S If any law,cemttery,or aemarory rcquicemeius have required Uu purchase�
Temponry gnve marker............ S of nny of�hc LLems LLsted�bove,the law.or iequ'vemrnt Ls uplaincd below.
Burial dorhing .... .. ............. 5
1 apee that 1 have czamined rhe items of gaods and servica selected above and found them ro 6e mrtect and a<cording m the amngemrncs 1 have requested.I acknowledge
rcceip�oF a mpy of thu Sntement of Fu�nl Goods and iC�$�G�y��,-.r�ed. I rcpresent th�[1 h�ve suffident Pomis avallable fm paymen[of the cash pdce for Ihe goods
and�rrv��x enlwvcA 1 alan e...e rn....b......,...e�r..!t �Y l L ...nh:.. �C n e..... r.._�_._�,.,._._.�..�� _�._..��.�..��__... ._'__ _�__i_
. . �
' REV-1512 EX+ (12-OB) ' - �
� ' � pennsylvania SCHEDULE I . , �
�� DEPANTMENTOFPEVENUE DEBTS OF DECEDENT,
. I[JHERRqNCE'TAXRENRN MORTGAGE LIABILITIES & LIENS • � •
0.ESIDEM DECEDEM ' •
� ESTATE OF FILE NUMBER
� Warren G Taylor 21-12-0972 �
, Report debts incurred by the decedent prior to death that remained unpa(d at the date 6f death,fncluding unreimbursed medical expenses. ' �
ITEM
'NUMBER � � DESCRIPTION �� . � VALUE AT DATE
OF DEATH
, • .1. �Rosa Lucidon Private Nurse ��
:� i � 7,828.00
, �—
2. �Ambulance Fee • ' 68.00
, 3. �Am� bulance Fee 60.00
4. Ambulance Fee . ' ' 1,001.62
- � 5. iHolySpiritHospital ' ' �. 607.75 ' '
' 6. ;Rosa Lucidon Pnvate Nurse - ' 7,242.00
7. � ;West Shore Ambulance ' , �94.00 •
� � . , • , .
I � ' � ��
! •
� —
� • 1 . . �. .. ..�L.. �.� . � r._ � ' ' . '
. ��
. • 1 .
- �, • � . . • .� �
� �� . ' j.
� .
. � � .
- � �� �
, .. „ .
� . ;
. ' . . ��
' • �� �
� � � ^ : �� .
� �
� � �
i ;
� . � ' ��
� � .
; . . . .
L� ' • . _ —� ,�o
. • � � • � � TOTAL(Also enter on Line 10, Recapitulation) $ ., 16,901.37
. � � � - . If more�space is needed,Insert additional sheets of the same size. � -
, ' � �
. .. , . '. .' . ,
REV-1513 EX+ (01-10) ' . ti � ' � �+ ' r
� �pennsylvania � � SCHEDULE J , .' '' � �'";� '
pEPARTMENTpf REVEttUE C , * 't� � �
INME0.ISAN[ETA%RENRN - BENGFICIARIES � ' �. � �
•RESIDENT UECFREM � � ' �•
ESTATE OF: ti , FILE NUMBER: , '
_ Warre� G Ta for � � � " 21-12-0972 .
� - RELAIIONSHIP TO DECEDENT AMOUM'OR SHARE �
. NUMBER NAME ANO ADDRESS OF PERSON(5)RECEIVING PROPERTY • Do Not List Trustee(s) , �OF ESTATE
I TAW�BLE DISiR18UTI0N5[Indude outright spousal distributions and t2nsfers under . � ' -
Sec.9116(a)(1.2),] . �
y 1. Ellen L Frownfelter,25 Gwen Drive,Marietta,PA 17547 Daughter �� � ' 20.00% .�
�--� --; �--r_
, 1 2.1 Diane Highlands, 126 Fieldstone Dr, Cadisle, PA 17075 , Daughter . • � ,- 20.00°/a •• ` '
�_! .
�3. Debra M Ruth,22 Fieldcrest Drive,Mechanicsburg,PA 17050 � Daughter - � r 20.00°l0 '
, r--�
� U4. Lynan M Pastore,680 Gregs Drive,Apt 57,Hamsburg,PA 17111 Daughter � . 2�.0�°fo -,
{-7 � � �„
_ ;I 5.1 �David W Taylor,320 Reeser Rd,Camp Hill,PA 17011', Son � 20.00% ,
t�J �
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� ENTER DO�LAR AMOUNiS FOR�DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18 OF REV•1500 COVER SHEE7 AS APPROPRIATE. ' �
II . NQN-TAXABIE DISTRIBUTION$ - • . . " �* ' � � '
A. SPOUSAL DISTRIBUflONS UNOER SECTION 9113 FOR WHICH AN ELECi10N TO TN(SS NOT TAKEN: '� . � � �'
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�R . ' 1 � � ' �. t ' ; � � . ' _ , : _ :�' •`-,
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. �
• � ' . ' � ♦
� � ' �. � - : .. . , r • � .
. �.B, •LHARRABLE AND GOVERNMENTAL DISTRIBUTIQNS: , - „ . � � . r , •. - -�� • � . � • .
1. t : � � ' * , �� .
J` , , . . . . .. • • �� ' .
u
C� . . � �...__.._`r'�
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L� � e a � ' . ' � ! �� ow�r.:nr� ' —
� ' TOTAL OF PART II -ENTfR 70TAL NON•TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. � • '
� . - If mare space is needed,use additional sheets of paper af the same size. . ' , r° .
�
-� -
REGfSTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
No. 2012- 00972 PA No. 21- 12- 0972
Estate Of: WARRFN GILMORE TAYLOR
fFirst,Middle,LesO
Late Of: MlODLESEX TOWNSHIP
CUMBERLAND COUNTY
Deceased
5ocial 5ecurity No:
WHEREAS, on the ' 7th day of September 2012 an instrument dated
March 31st 1980 was admitted to probaCe as the last will of
WARREN GfLMORE TAYLOR
(Fi�st,Midd(e,Cast!
late of M/DDLESEX 70WNSH/P, CUMBERLAND County,
who died on the 18th day o£ August 2012 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and
for CUMBERLAND County, in the CommonwealCh of Pennsylvania, hereby
certify that I have this day granted LetCers TESTAMENTARYto:
ELLEN L FROWNFELTER
who has duly qualified as EXECUTOR(R1X)
and has agreed to adm�nister the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY CDURT HOUSE,
CARLISLE, PENNSYLVAIVIA.
IN TESTIMONY [^TEIEREOF, I have hereunto set my hand and affixed the seal
of my office on the 7th day of Septembe� 2012. �
, �l�J
� f � egtsre�(o i�s
'� S��r\ �
eputy
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
. ; . _ � . ..._ ,
• � LAST WILL AND TESTAMENT OF
� WARREN G. TAYLOR
• ' . I, WARREN G. TAYLOR, oF Middlesez TownsMp ti17 k�illow View �
Drive, Carli5le) Cumberland County,-Pennsylvania,.betng of 9o��a aha
dispoeing mtnd, memory a�d understanding, do hereby make, publish and
declare this as and for my f,ast K'ill and Test2ment heCeby revbkittg ahd
making vold any and all Wills by me at anytime heretofore made. �
1. I diiect my hereinafter hamed Executrlx to pay all oP iny juat de6ks
� arid Funeral expenses as soon after my death as may be found convenietit tb da
so.
2. All the rest, re8idae and remainder of my Estate, real,�peraohal
and mixed, and wheresoever the same may be situate, I gtve; devi9e and '
bequeath to my wiFe, Elizabeth B, Taylor, her heLrs and assigns, to the ez-
� clusion oF my childre�, born and unborn, provided my said wiFe shall survive
. me by a period of Ninety (90) days. �
3. Sho�ld my said wife, Elizabeth B. Taylor, pre-decease me or fail
w �\�� to survive me by the aforesaid period oF Ninety (90) days, then in such event
�� �
� . ��` `�-�-, all the rest, residue and remainder o£my Estate, real, personal and mixed,
� � and wheresoever the same may be situate, I give, devise and bequeath in
`���� equal shares to my five (5)�children, their heirs and assigns, provided each
�
� person aharing in my Estate shall survive me 6y a period of Ninety (90) days,
�
• �J
the ehare any deceased peraon would have received to paas to his or her is�ue
� �� per etirpes, and if there 6e no issue such share shall lapse and be added to
\
� �" the remaining shares per stirpes. My five (5) childra, are: Ellen L. Fron-
� f^7*er, Debra M. Ruth, Diane W. Rretz, L,ynan M. DQeseimer,�qnd David
c�
- Warren Taylor. � :s r�, i; ��=':�
in�.._ -� _
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. - �_,� -- �._- .,;.
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Page 1 of 2 Pages
• 4. Should any person less than 21 years oF age be entitled to distributi n �
from my Estate, in such event I nominate, constitute and appolnt Dauphin I
� ' Deposit Bank & Trust Company, and its succeseors, 2 R�est High Street, �
I
Carlisle, Pennsylvania, as Guardfan of the Estate of each �uch pePson and- '�
avthorize and direct it to receive and to invest the 9aiiie,:and:to pay t,he Incom• I
IaTising bherefrom, togethet with so much of the prihcipal thereof, �as (a itn' �
i
opinioh is necesaary or desirable to be expendedfor the proper xnaintenance, ��
i
support, and education of such person, to or for the b2nefit�of ehch persoK, i
I
� and upon auch person attaining 21 ye9rs of age to pay to hixez or her thz then . �
. remaining principal together with any undistributed.income. . .
5. I hex'eby �ominate, ctlnstitu}e and appoint my said wiFe, Elizabeth
' B. Taylor, as Executrix of thi6 my Laet Will�and Testament but should�ahe
pre-decease me or Fail to qualiFy, then in such eveM I nominate, conskitute
- � and appoint my daughter, Ellen L. Fronfelter, as alternate or�successor �
. Executrix, and i further direct that neitfier of them shall be required to post
any bond to sec�re the fatthful performance of her duties in the Commonwealt
of Pennsylvania or in any other jurtsdiction.
• IN WITNESS 4VHEREOF I have hereunto set my hand and seal to this
my Last Will and Testament written on two pages this 31st day oF March, '�
1980.
i .-T-.
.. I/ir7 P R1ZZ•L %,�,�/ di'LT!>
. �rren G. Taylor- ✓ �
. Signed, sealed, published, and declared by WARREN G. TAYLOR, the
Testator above named, as and for hia Last Will and Testament, in our
' presence, who, in his presence, at his request, and in the presence of each
other, have hereunto subscribed our names as attesting witnesses.
. /4.R....i �C.. T.,...'
3
wmmurvw[ALiH OF PENNSYIVANIA REV�1162 EX�11-96)
DEPARTMENT Of PEVENUE
BLREAU OP INOIVI�Ua�TnxES
❑EPT.280601
• H4qp159URG,Pq !]i 28-0E01
PENNSYLVANIA
RECEIVED FROM: , INHERITANCE AND ESTATE TAX
� OFFICIAI RECEIPT
NO. CD 016789
FROWNFELTER ELLEN L
25 GWEN CIRCLE
MAR�ETTA, PA 17547 '
ACN
ASSESSMENT AMOUNT
CONTROL
------- �o�e
NUMBER
...------ ..-
101 � $2,932.38
ESTATE INFORMATION: ssN: I
FILE NUMBER: 2112-0972 �
DECEDENT NaME: TAYLOR WARREN GILMORE �
DATEOFPAYMENT: 11/16/2012 I
POSTMARK DATE: 11/16/2012 I
COUNTY: CUMBERLAND �
DATEOFDEATH: 08/18/2012 �
i
TOTAL AMOUNT PAID: 52,932.38
REMARKS:
CHECK# 102 /
INITIALS: DMB
seA� RECEIVED BY: GLENDA FARNER STRASBAUGH
REGIS7ER OF WILLS
TAXPAYER