HomeMy WebLinkAbout08-28-13 � 15�5610�01
REV-15Q0 EX{°1_10> �'
PA Department af Revenue pennsytvenia oFFiC�At usE Ot��Y
Bureau of Individual Taxes OEVANTMENTOFqEVfxUE County Code Year File Number
PO�ox 28g6o1 INHERETANCE TAX RETURN
Harrisburg,PA 1'712$-Q601 RESIDENT DECEDENT l j •� f �Z�S�
ENTER DECEDENT INFORMATIQN BE�OW
Social Security Number Date of Death MMDDYYYY E7ate of Birth MMDDYYYY
/ ! I � tl O � t � y d��. � uY D o� �✓��� / / �` T
RII I�I OppIM��@[ rf ��mas
Decedent's Last Name Suffix DeeedenYs First Name MI
� rw.:
�' l G � u
(If Applicable)Enter Surviving Spouse's Information Below
Spause's�ast Name Su#Fix Spouse's First Name MI
�
l
Spouse's�socia�Security INumber THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
III IIIII �.J�."��'� REGISTER OF WI�LS
��t
FIRL IN APPROPRIATE dVALS BELOW
� 1.Original Retum p 2.Supp{emental F2eturn +p 3. Remainder F2eturn(date of death
prior to 12-13-$2)
(� 4. �imited Estate p 4a.Future Enterest Gompramise{date of Q 5. Federal Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate Q 7.Decedent Maintained a Living Trust � 8. Total Number of Safe deposit Boxes
{Attach Gapy of WiI1} {Attach Copy of Trust}
Q 9. Li#igation Proceeds Received Q 10.Spousal Paverty Credit(date of death O 11. Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach 5ch.O)
CORRESPONDENT- THIS SECTION MUST BE COMPLE7ED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION 5HOULD BE DIRECTED T0:
Name Daytime Telephone Number
ey s � s � r � � 7� ° ° �
REGISTER�;WILI�tsU ONI.Y
�� '� C"7
���y�:� .. �..'.. .� r�—y
Firs#line of address ; k-' � �� '
:�� ,. �
�► "�' �. Q u S D 1� c.;;; `, _�
Second line of address ��; , ' " —�
. �...;
} ���
; > e : ,
City or Ppst Office State ZIP Cade � ��'E PIEEp I�y r
- c < e uR � o �� y � �- �� �
Garrespondent's e-mail address: �e5/j I GlGr,'S��r CQ,�yf'CQS`/•/jGf
Under pe�aities af perjury,i deciare that 1 have examinad this retum,inciuding acoompanyfng schedules and stateme�ts,and to the best of my knowiedge and belief,
it is true,carrect and compiete.Deciaration of preparer other than the personai representative is based on aii informatian of which preparer has any knowiedge.
SIGNATURE ERSON RES SIB E FdR FILING RETURN DATE
f� I
AL7DRES �1L K T Sd] �fJ���I�7MS �VB �e�, /Ylee,h�n�csbccrf /7`DSS"
i
SIGNATUj �PR�PARE OTHE AN RESENTATIVE DATE
i.�l�itl.t.���C��u°�� �— e�ZZ O/�-
ADDRESS liH$I�LE'S �: c51�/,�21�.� f�L � �ou�er' Rc�, /I7P.r.�ia/t�cs�u�. /�i� !?osS-
PLEASE USE ORIGINAL PORM OMLY
Side '1
� �,5�561�],01 �,5D56101a3, �
.
� 1505610105
REV-1500 EX
DecedenYs Social Security Number
� �t � `� � ; �" �.
r� � � �
DecedenYs Name: �(��� m ��^�L(� � ��7 ' � !�� �� ����
� �. ��r ��
RECAPITULATION
.� ,.��,���� a��.��„��„�� a.� �����..
1. Real Estate(Schedule A). ..�.. .. . .. . .. ..�.... .. .. .. .. . .. .. ... .. .. .... . 1 � v a �� �g� ����� "� � �
���u��.i5����,_.�. �
� d ° �� ° �
2. Stocks and Bonds(Schedule B) .. .. . .. .. ........ .. .. . .. . .. .. .. ...... . 2 � � * 7 � � 0'
�""��;„� k ����:
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ... . 3 � �" � � � ��� ` � ��
r.. '�y� �a � �
4. Mortgages and Notes Receivable(Schedule D). .... ... .. .. . .. .. .. .. ..... 4. � � � r� � a�_ �� V ���'�
,� ��� . a
, a
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). .. ... 5 � � � � � 3 7 O O_ 1 `,3
Y�:���� �-, . �.: s
� , a.
6. Jointly Owned Property(Schedule F) p Separate Billing Requested . .. . .. 6. � � � � � �� 1 � z �
7. inter-Vivos Transfers&Miscel�aneous Non-Probate Property �= „ r n -
(Schedule G) p Separate Billing Requested... . . .. . 7. � � � � �� y ~ 7 � '7 =
=r: �
8. Total Gross Assets(total Lines 1 through 7). .. . .. . . ... . . .. . .. .. .... .. . . 8 �` � � ��� g � �, � Q /
- - �
9. Funeral Expenses and Administrative Costs(Schedule H). .. . . . .. .. .. .... . .. 9. � � � � 7
�F� ��.��. �� � ,,
10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) ... .. .. .... ... 10. � � � � l� ,Z
11. Total Deductions(total Lines 9 and 10). .. .. .. .. .. .. ... .. . . . . . . . .. .. . . .. 11. ; � � 6 5 �
12. Net Value of Estate(Line 8 minus Line 11) .. .. .. . .... .. .. . . . .. .. .. .. .. .. 12. " � � � � ��� o �; �
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which . �
an election to tax has not been made(Schedule J) ... .. .. .. . .. . . .. .. .. .. . . 13. � � . 0 0
_ ,
14. Net Value Subject to Tax(Line 12 minus Line 13) . .. .. .. ... .. . . .. .. .. . .. 14 ��� � ����'�� � �� �p � ��
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 ������� ' :�� ���� °°� � ���� �* ��'� � �°���� �F����`
�a)�1.2)X.0(� � � � � � � p', � � 15.`� �� r��Q
16. Amount of Line 14 tax le �°����° � "' � �� �' � ��`�
at lineal rate X.0� � � ��' � � �� ��� � �� 7 � 16.�� � � ��� `
� � '
17. Amount of Line 14 taxable � r = � ��
at sibling rate X.12 � } � � � 0 17. �
18. Amount of Line 14 taxable � �
at cotlateral rate X.15 � ���a�� � �� �0 � 18. � �
19. TAX DUE .... .. .. .. .. .. ..... .. .. ... ....... .. .. .. ..... .. ..... .. .... 19.. � �] �
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
� 1505610105 1505610105 �
CHARLES E. SHIELDS,III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANICSBURC,PA 17055
GEORGE Iv1.HOUCK 1'ELEPHONE (717) 766-0209
(1912-1991) FAX (717) 795-7473
February 25, 2013
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle,PA 17013
Re: Estate of June M.Price
No.21-12-1284
Dear Register of Wills:
Please find enclosed Check No.9603 in the amount of$?,600 and Check No. 1239 in the
amount of$6935.00 for a total estimated Inheritance Tax of$14,535.00 for the Estate of June M.
Price.
Thank you for your kind attention to this matter.
Very truly yours,
. `
C . �
�
Charles E. Shields,III
Attorney-At-Law
CES/mjj
Enclosure
c�a��M�ouGH� 1239
607 Wt�UAMS GROVE�i� eo-tzl3/3ta
MECHANICSBURG,PA 17066 1 �/'^ ��!3 oq�
�/�l� ���ate ...
�1
� /� I
Pay to the �7��f�
Order of
� - �j ,q g� E
��� " ollars L'.I o !
a
t�3.; N�BAN , t
� PNC Beok,t3.A 040 . . , � i
� Ctqtrat PA ' � �
„�i.T�w„� ?u.nc Pric.c �1—lo't_Ix,�t/ �t ""
For�— :`-Vf����'�`�_.._—.
J
�;03i312 ?38�: 5004t50 � 28fk• � 239 '
��.��,e -
r— —..:�-� — �-::�-.:,��.:�..
�'�T_�° s s a�
� JUNE M. PRICE �`'°�
GAE! M. �C}UGNT -�'
� 506 WfLLtAt+1S GROVE RD. 20�
Iv?ECHANICSBU , PA VO55
Pay To • " ��..-.+�.�c^�yt,..i�1..f�#' �
i � '['tie Order Of ,
° q �„�,- �
� . � �Dollars EJ n.n,.�..a. �
�
j TOWER FEDERAL CREpIT UNION 1
8{�X i 23
� ANNAP(3liS Jt3NCTlQN,ML}20707 _
� FoT F�t-� �`•��"��,�P�� a�-��-►2sy_ �� ------""
-�
► �: 2 � 50 � � 3 �o�: 0 2a �o�, �oo ��• ��0 3 �
1.....,..�.�.....�-.�..._..:� , � �
�
REV-1500 EX Page 3 File Number �I—/z �./9 Q�
I� U
Decedent's Complete Address:
DECEDENT'S NAME
,J'�.�,n e M. Pri«
STREET ADDRESS
5�o�e I�J,I�i a�ms G�'o✓p� �,�.
CITY . STATE -i ZIP
Mec.ti�.n��sbur P� l�osS
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) p�0� 7�'�,g�
2. Credits/Payments ��� pp
A.Prior Payments _ _
B.Discount 7(o � , o0
Total Credits(A+B) (2) ¢�S .30D. Dd
3. Interest
�3� D
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in ovai on Page 2,Line 20 to request a refund. (4) 0
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) �� y�'�,Jr�f
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;or.......................................................................................................................... ❑
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ �
2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ �
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. � ❑
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................� ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the suroiving 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 suroiving spouse from tax, and the statutory requirements for disciosure 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 chiid 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs sibiings 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.
REV•1502 EX+(6-98)
SCHEDULE A
GOMMONWEAITH OF PENN5YLVANiR REAL ESTATE �
INNERI3ANCE TAX RE7URN
RESIDENT DECEDENT
ESTATE OF r... , FIIE NUMBER
J kr�e li'1. Pr��e o2 I- /,,�-- /z8�
A#t reat properiy owned sotety or as a ienant In camman mast be reported at talr market value.Fair marlcet ualue is defined as the price at which property wouid be
exchanged between a wiiling buyer and a wiiting seiler,neither be+ng compeiled to buy or seli,both having reasonable knowiedge of the relevant facts.
Real property which is jaintly-owned with right of survivorship must be disclosed on Schedul�F.
ITEM VA�UE AT DA7E
NUMBER DESCRiPTION OF DEATH
�- �I� /J$l l�JQt�'1 T!'�G� 6I la.cd i.�p�yu� .1'ry A /L°SrGi�
�J17a� �t!lGll iJq /�ia6lt� SiT1ta� �r! ,7`ti «�'nu�i e1�
J
,f1'Ic�i�t�i�s�ur�, C�uwb�f`an� .�OUn �./�i�s /va,.r.�.
, , � C1`
�S ,�Nv� �1� c�s�h��C4� �•a �a 1� Ce,�^�rli�r c�e�r..�
�►m �nA/� �: �u�,l� �� f�j% /�1'. ���l�f`
�;S tr1r�� , l� �1fC 1� �r�c c, �!t�tlj �� 1.,�
!`f;t�j'i, 1r�01Y,�P6t� r�'I � L'�TT�CG d��, /�GL"l/rclG!^�
�/�Cl�S !�'7 u�tA ,Tal" �lllJl�iBt"1RXq� Lp f.lh�j �P'...sln`
S /�✓a�:�, � �.cr.q/ l�ook' i�1S, �a '�
y � rmp�.
�ese G Cv�s. >J� .5'�"•� ,A'dG.�r' a�12 clt�►c� ,/Ki'e e o�
{ t
�� t��./ nlo �ZU-��-07�5 IfSf,�
LOl�llffy /+'SSBS� .��uG �070?�7DP.�. oa ¢
�ounf 111kj��/.er — ,/Q ��r3;.7'lL'��
�
�s� }� 6;�I a���,�
TOTAL(Also enfer on line 1,Recapitulation) $ r�ab' 7�,Q� �''
{If more Space is needed,insert additiana!sheets o#the same size}
_ x.� � . . _� �.�r� , � � ...�,...�.��,.,� t=..�� � � ,�, � ,�.. .�,,.��.�a:.�-�,.�.�,..�
-t ^ _' t ,, �, . � °_._ �� � _' ���s 4�`ki ta�.rt_��Yi1'��.��,��. T��,
�.�.,}�,� '� �cfiiL��3+.f ..�a - �. -n, 's� ro'4?a. 3�,
�k,zf ��:''4�Tz .w'as: ic .�+I d: .�b��S:'w.'�`�$��xs�ir:���?d'1iMatdtt'.G���i3�`Nr�"b�.� ,.�� ,✓
_ 2� 3�L
Tax Parcel No. +�O. �-aU-o7�S`/`�p
THIS DEED
Made the /3�j day of �, in the year one[housand nine hundred and
ninety-six(1996).
Between DONALD E. FOUGHT and GAIL M. FOUGHT, his wife, of Mechanicsburg,
Cumberland Counry. Pennsylvania,Grantors,
and
NNE M.PRICE,single woman,currendy of Columbia,Howazd County,Mary�and,the mother
of Gail M.Fought,Grantee,
WI'INESSETH,that in considerarion of the sum of ONE ($1.00)DOL.LAR in hand paid,
the receipt whereof is hereby acknowledged,the said Grantors do hereby gant and convey to the
said Grantee,her heirs and assigns:
ALL THAT CERTAIN tract of land situate in the Borough of
Mechanicsburg,Connty of Cumberland,Commonwealth of Pennsylvania,
, bounded and described as follows,to wic
BEGINNING at a point in the center line of S.R 2011,commonly known
as the Williams Grove Road,said point being at the eastem corner of other
lands of the grantors herein,of which this was focmerly a part;thence along
said other lands of the grantors herein South 55'l5'00"East 200.00 feet to
an iron pin(set);thence along lands now or fom►erly of Elmer N.Adams,et
ux,and of lands now or formerly of Paul S.Konhaus,Jr.,et ux,North 34'
29'00"East 75.00 feet to a steel rebar(fnd)at the southwest corner of
lands now or formerly of Frances E.Coffman,thence along said lands of
said Coffman and along lands of Dorothy S. Conant North 55' 1S' 00"
West 200.00 feet to a point in the centertine of said S.R. 2011,thence
through said centerline South 34'29'00"West 75.00 feec to a point in the
said centerline aforesaid,the poi�t and place of BEGWNING.
BEING Lot No.2 on the PRELIMINARY/FINAL SUBDMSION PLAN
FOR DONALD E. FOUGHT SITUATED IN THE BOROUGA OF
MECHANICSBURG, CUMBERLAND COUNTY, PENNSYLYAIVIA
Dated June 17,1996(revised)and recorded in the Recorder's Office in and
for �Lmberland County, Pennsylvania, in plan book 72, page 128.
Containing 14,984.64 square feet
BEING pazt of the same premises which Fannie B.Miller,widow,by dced
dated August 16th, 1941,and recorded in Deed Book"K",Volume 12,
Page 103.in the Recorder's Officc in and for Climberland County.and all
of the same premises which Fazuue B.Miller,widow,by deed dated Manch
20th,1948 and recorded in Deod Book"U",Volumc 13,Page 129 in the
said Recorder's Office,granted and conveyed unto Wiibur H.Fought and
Elizabeth M.Fought,his wife. And further being the same premise which
are designated as Tract No. 1 which Wilbur H.Fought and Elizabeth M.
Fough4 his wife,by dccd dated Junc 2Ath, 1971,and recorded in Dccd
� book"D°,Volume?A,Page 780,in the said Recmder's Office,gcanted and
conveyed unto Wilbur H.Fought and Elizabeth M.Fought as unanu in
common and not as tenants by the entireties.
aoox 145 PACEi0�4
y �. .-:-'+' '-�::: -�t � -�:�: �� t�:.� _ - t� y`- �'� / .5,::; ?
�� � . . .�� �'� ��. � � _�. -"� t
Yi.` '�\t^' �i�..'�..��ir�. ..t<,.;'�..ri:3cac"�J,."x_�-?.�d�;' r- rs�i.'lr,:r�tw#..e>'s:i�.am.':�`:,•.�_i....._,.<..�.Ls.t.°<:_..tSi..cc`,:..c..�a.t_.�?`3�, �.<, _..;=n�.ti.,�_�.
. �r __�.�w.
� „ �� .__ __
r,�.��.w m�-. �_
t., . . - F� � � �
AI..SO BEING part of the same premises which were awardtd by iwo(2)
decrees,each of an undivided one-half(1!2)intcresi by Judge Harald E.
Sheely from the estates of Wilbur H_For�ght and EI'zzabeth M.Fonght,his
wife,both deceaseci. The respective estates are docketed to Nos.21-83-57?
� and 21-87-238 in the Register of Wills Office in and for Curnberland
Caunry. The decrees are both dated the 6th day of December,19$8 and are
recorded respectivety in Dced Book"S';Volnme 33,Pages?and 9.
. T'he saici UONAI D E.FOUGHT has since married his current wife GAIL.
M.FOUGHT arrd she jains herein to transfer any interest to which sht is
argnabiy cntided by virtue of their rr,a�rriage.
AND the said Granwrs wil2 wanant specially the propexty hereby conveyed.
THIS 'I'RANS�'ER IS REAL ESTATE TAX EXEMPT BECAUS� TT
IS'A TRANS�ER FROM S4N-IN-LAW AND DAUGHTER. Tp �fa7',�1c7t-,ritf�
An/D MD�l�'�'.�•
�
°� W WiTNESS WHEREOF,the said Gxantors have herennto set their hands and seals the
day and year fust above written.
a .
°> Signed,sealed and deliveaai .
.y in the presence of:
�,�.�r.� �' }���.°.��- �' �" ��. csEnr.,
� � ��( DOl�TALD E.FOUGF�Tf
����`����� ts�'�
AIL M F -
a
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- ��oK 1� PA�E�.acS
- � ,-
.... .. .. '�A:.:.. .., . �R.. .a.i...vc.,�, ...:; �. : � a y .:o. 168 ",�.
_ _ a .�,� k '_y
. .. .. .. . . . � - ' - ' . . .. . ... ....xa., x. ..*uee5at:c �
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ti
} COMMOIV'WEALTH OF PENN$YLVANLA:
�. :SS.
� CCiUN7'lt OF C't7MF3ERI.AlVI> .
,� .
?, On this, the _�_day of � , A.D. 1996, befare me tha
nndersigncd o£ficer,persanally appeared DONALD E.FOUGHT and GA3L M.FOUGAT,his
;} wife.known to me,(qr satisfactorily pmven}to be the persans whose names are snbscribed to the
t -
within instrument, and acknowledged that they executed the same for the purpases therein
cantained. '
TN WTFNi•:SS WFIEREQF',I hereunta set my hand and official seal.
�
} _���!��Ls:CG4/ � a�u.e-�.r�.1lt:...;...`_.._...,,
�`,�;3,.�'
� Natary PubIic •( .�,��.",�!;
Natariai Seat � �
j Cxqrles E.Shields ill,Notary Pu��c •= '
K3
Mechanicsburp BorD.CUmbertar�d COUn �_ e
My Gommi55ron E�cpires June 20. .
' 'Y4aF '.• _ '
. . MBiiibCt i211flSjNdnld ASSOCidtiO(i�N4tlfiCS .�+ :.-. ',.
�
��r+ 9.•' � •
� "
I HF.REBY C:ERT`IFY thac the precise residence af the Grasstee is ��° ����'.''-'
�, t�r�wsfu s �'7 jiL/�'.2nr.,�i�°�,e .E'c1.f i�lec',.�rut.,a��, �'A' /7a s
���� ��',��..,�.�-
Auamey for Grantee
�N i'S�
�'�ts:oft'ennsylvania �
=�-:ustty ot Gumbortand�
���" = ded in the dffice for the recording of Deeds
r-r,�i f���C�',linb�.lsnd Count Pa
t�:;c`•t�—?VoL__.Page�
,.rn;r hrynd�/�>szf of offrce� � '�+ '' �'
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TAX PAYER'S COPY- KEEP THtS PORTi�N FOR YOUR RECORDS
i , s , s- i i • � c*-�
Payak�Me To: BARRY L HECKARD SR TAX GCILLECTOR Office Hours: MAR,APR TtiE3�TiiURS 10AMr4PM
605 SOMERSEI`DRIVE MAY-DEC TUES 10AM-4PM
MECMAhiICSBUltt's,PA 17055 - CLOSED ACL Fi4LIDAY3,MAFt 7-8;
JUNE 24-28;EI.ECTiON DAY BiH No: 2347
PWONE(li7)768-6205 BiN Date: 3/1M3
MAP NO:20 244785-d59. Ccarstro!Na: 2000lM61T
Desc:506 YWLllAMS!�ROVE F20t1� Assessed Yalue: L.and:48,080 Imprcrvc�neM:18tF,700 Tofat:228,T00
MILLER ACRES Disccwnt F� Pena
�47 Z PB?2 PG 128
Acres 0.34 Lteeci 0014501084 Coun#y RE Z.i31 S417.6i 5487,38 5536,10
County Li6 0.143 532.05 532.70 ;35.97
��� �� MuniuG RIE 2.58 55T8.25 ;590.05 $649.46
ia�r Payer:
PRiGE,JUNE iW
sos umwaMS G�arvf Ra � TAX AMOUNT DUE 51,087.97 $1,190.11 31.ZZi•�3
MECNANICSBURG PA 17055-d104 tf t3ate 4f Paymer►t is on 311113 thru M3Q/'!3 fit1113 thru 613pl13 '7!1/13 or Later
Ta review the assessment data tor this property,go to:
v+ww.coartt�ouseonfine.com>AssessmerttOffice>Cumberla�d>Pra�RyRecords.
Thew enter Cor�troi# 2000061T and passward CUFJE{tLN
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REV-1503 EX+(6-98)
SCNEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF T.�nG m, Pr,1Ge FILE NUMBER �l_!Z- /Z$U
7
Ali property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
,. �/t//s ��v �ddi,Se� � �/Y. 6�03- 3765�
(i�) /9�. !�/ka�io�, ,i/lC�acl�i4 BDs /Y��tfj /l�,C't id 9�, 9 9•?.Z 6
� p , f/
r,B J !tG'true� lHttirs7�asr,v� 1�1✓�/Cilo�s �G/.o�
�.32G d4�!!R�O�'! �//�Y !�t/i/N /fC/�'I/Z47'�Oit S c�riX�
�'�Cu�Q75os�5 dl�Qc�ilu��
01. �6 oS�i/tr�o a� �OA�1/yION S�oC�C v� /Ylef L.�e
�
h�� i3�.�S /v �3�.�� .c%. = 3�.Sy x 5�b � /, �f99. /4�
( �e l�4��t4�vn 7�'D�7 /a�oo �i7. a7�ac.�fca�)
TOTAL(Also enter on line 2,Recapitulation) $ 1 T .s�a �D
(If more space is needed,insert additionaf sheets of the same size)
Wells Fargo Advisors,LLC
1250 Broadcasting Road
, � � . Suite 100
Wyomissing,PA 19610
Office:610-376-1700
Fa�c:610-478-1352
Toll Free:800-288-2437
December 14, 2012
Charles E. Shields III
6 Clouser Road
Mechanicsburg, PA 17005-4100
RE: Estate of June M. Price
Account#6803-3764
Dear Mr. Shields:
Mrs. Price opened a single name account on March 21, 1994. The date of death values
are summarized on the attachment.
If I can provide additional information,please do not hesitate to call.
Very truly yours,
� � ^,� ;
�..�.'2�.�i.%���L'i'�_/
�._
f
Eleanor S. Collins
Senior Vice President-Investment Officer
Enclosure
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First(Previous�Next�E.ast
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Date C?pen Nigh �ow Ciose Volume Adj Close'
Nov 28,2012 32.37 32.95 32.22 32.94 7,022.400 32.38
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a�v.isoe oc.{i.s7�
SCHEDULE E
COMM6MNEALTHOFPENNSYLVANCA CASH, BANK DEPCtSITS� Q[M�S4i.
`����s;a�o�c�o N�" PERSONAL PRC9PERTY
E37ATE OF , FiLE NUMBER _
J'uune ��. Pr►�G a•l-:z�z8y
indude the proceeds of Mtiga6on and the date the proceeds were received by the estate.AIE property joinUy-owned with the right of survivorship must be disctosed on Schedufe F.
lTEM VALUE AT DATE
NUtJ16ER DESCRIPTION OF DEA i H
,. .�'nYen�►�r a� ��fr.���.n a� ���^sonrrt�, a�'` c��cc�f..
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�`7 DC�
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TOTAL{Also enter on line 5,Recapitelatian} S �3 '7�p, �3
(II rnore space is needed,insert additianal sheeks of the same size)
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999046180JUtVEMPRICE 290865 U2/21tt3
583 No[th 31st Street
C�Hill,PA 17011 2258 P�ge 01 Of 01
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_.-:.-,...NSFYCl1�E�1N�F$�I�:.:'.
NSG-42�74-3515 02/19/13 688.31 0.00 �•�1
Refand of averpayment-Any
questions,please call Sophia at
(7I�972-4785
Date af service: �,������
TOTAL $sgg,31
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As you requested,we I�ave adjusiect y�ur accvunt.
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�,ve tK���be of further assist�nce,please don'i k�esitate ta.
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COMCAST
1555 3UZY STREET �
ATTN: LBBANONI SUPPORT S13RVICBS
LEBANON, PA 17046
�omcast=
JUNE PRICS 21108 0998-26-46-3DG
506 h*ILLIAMS GRV RD
I�i.HANICSBURG, PA 17055-4100
Ilt�i��b��ll�l��ll��dll�"��11'llll'��I'��'11��61��1'���II'I'1
PAYMENT SU1I�VIARY
CHECK Na Q010254807
accouNrNO: 09547-24003201 CHECKDATE: QLI21/13
Dear JUNFi PRICE, .
The attached check represents a refund for account number 09547-24003201 in the amnunt of
$82.03.
If you are a Comcast %FINITY customer and have questions regarding your refund check, you
can write us at the address above, call Comcast's toll free custom+er service number at
1-888-COI�CAST (1-888-26.6-2278), or chat with us at www.comcast.com/chat. Our
representatives are available to assist you 24 hours a dap, ? daps a week.
If �ou are a Comcast Spotliqht client or agency, please contact your local Spotliqht
office.
oErncH u�to REraN n�is srnre�Exr
� - THE ATTACHED CHECK IS IN PAYt�ti OF ITEM.S DESCRIBm ABOVE •
. - . tF NOT CARRECf,PLEASE NOTIFY US PROA�TLY NO RECHFi DESIRm.
................................°----°--.............---°°--°•-:.....:.....-°-----•--...........--`°....._. tachHere •••-........_......_..__....•••.:.....-°•••......-°--.._._....._.......__.......-••_•-•-•-•••-•---•-•--•-•----°
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; ;`A C011!1�AST'_�AB1.E COMMUI�IGATlON�.GROUP C4M��1+� 6t� 150f433 :
ACCOVNT;NUMBER , CHECK DATE EkiECK�1YJJN8EFt
D9'�lT 24003201 Ol/21J2013= 00102548U7
1 I l i
; . ' ' VALID T�OIt 180 DAYS
' so , _ JUNE PitiCE ; $��*****�s2.o3
; THE 5�6 WI�.LIAMS �RV RD
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THE BANK OIl 1�SFT'YbRR MLLIAN
''. PITTSBURGH; PENNSYLVANIA
S . ; � '
�►'00 LO 2 S 480 7��' �:0 4 3 30 L 60 L�: L L 3���?8 3 4��'
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� C�'�RDIC�VA.S�ULAR
E�.: � = Assoc�TEs
HOLY SPIRIT CARDIOVASCULr�R INSTITUTE
101 Erford Road
Camp Hill, PA 17011
Telephone: (717) 724-6450
Fax: (717) 724-6461 �
January 16, 2013
Dear Patient:
We are sending the enclosed check to you because we recently identified an overpayment on
your account.
Based on your health insurance plan's determination,the patient balance due for the services
you received was less than the amount you paid to us. We are therefore issuing this refund
check to you at this time.
If you have questions, please feel free to call our Billing Department at(717) 724-6462,
Monday through Friday,from 8:00 a.m.to 4:30 p.m.
Sincerely,
Julie H.
Billing Department
Telephone: (717) 724-6450, ext., 1228
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; 205 Grandview Ave.Suite 210
Camp NiU, PA. 17011 P�J@ 01 Of 01
IN�JOICE NUNIBEFi QATE iNYOiiCE"AN[OUPfT DiS�4UNT:iRMQ�fI�t'f ::N��';AtV1�3UNi':;
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Inventory-506 Williams Grove Rd., Mechanicsburg, PA 17055
Estate of Mrs. June M. Hoiland Blackmore Price
DOD: 11/28/12 Total: $4022.25
page 1 of 6
Location Item Condition Value
Front Porch Choir Bench, wood poor 12
Rocking Chair, wood poor 5
Foyer Entry Table, wood half-round good 35
Wall Mirror, wood frame 2x3 oval good 20
Runner Carpet, 8 ft. good 5
Crucifix, wood poor 2
Stained Glass Window good 60
Sailing Model, half-hull good 15
Den / Library TV, portable, non-HD fair 2
DVD/Video Player good 15
Entertainment Cabinet, wood good 75
Small # Entertainment media
Video, Audio Cassette good 1
Armchair,
wood frame,naugahide fair 5
Painted Trunk poor 3
2 Recliners,
upholstered motorized good 600
Side Table, chrome & glass poor 2
Assorted knick-knacks 20
2 Figurines good 45
Pictures
1 painting fair 30
1 print good 30
3 Floor Lamps poor 12
Books, approx 150 :75@.75;75@.25 26.25
Living Room
Sofa,upholstered, 4 throw pillows good 80
Armchair with Ottoman, leather fair/poor 40
Armchair, upholstered stained poor 5
Side Chair, upholstered good/fair 15
Coffee Table good 15
2 End Tables, wood 1 good, 1 fair 15
2 Curio Cabinets, 5 shelf, wood/glass 1 good, 1 fair 60
Cut Glass Pieces 6 good, assorted fair 50
Electric Organ & Bench, working good 75
Plant Stand, wood good 10
2 Table lamps fair 1
Sofa Painting good 25
Inventory -506 Williams Grove Rd., Mechanicsburg, PA 17055
Estate of Mrs. June M. Holland Blackmore Price
DOD: 11/28l12 Total: $4022.25
page 2 of 6
Location Item Condition Value
Living Room, conYd.
1 Framed Poster 2
8 Mirrors: 2 med, 6 Sm good 12
3 Ornaments (1 metai, 2 ceramic) good 12
Dining Room
Round Dining Table good/fair 75
6 Side Chairs, upholstered good 60
Electric Wall Clock good 10
14 Decorative Plates good 28
20 Throw Pillows fair 20
Microwave Oven fair 30
Microwave oven Stand, wood good 15
Paper Shredder fair 5
1 TV Tray fair 2
Rolling Stand, 3 shelf poor 2
1 Set Stainless flatware good 15
Assorted Glassware 15
Numerous Brass Candlesticks fair 30
Assorted Table Linens fair 15
1 Framed Picture good 2
Kitchen
2 Sets China, white everyday fair 20
1 Partial Set Stainless Flatware fair 5
Stained Glass Piece good 30
Wind Up Wall Clock fair 15
Under-cupboard Radio/CD Player good 15
Rolling Service Cart, 3 shelf good 10
Assorted unmatched
cooking & serving pieces
glassware & china 40
Inventory -506 Wiiliams Grove Rd., Mechanicsburg, PA 17055
Estate of Mrs. June M. Holland Biackmore Price
DOD: 11/28/12 Totai: $ 4022.25
page 3 of 6
Location Item Condition Value
Master Bedroom �
Double E2d fair 15
Brass Bed Frame poor 50
Arm Chair, wicker poor 25
Round Table, wicker& glass good 60
Side Table, wicker & glass good 40
Wall Mirror, wicker good 20
Magazine Basket, wicker good 10
Flower Stand good 5
Floor Mirror poor 1
Table Lamp fair 2
Area Rug, 4X6 good 20
Entertainment Cabinet good 85
TV, non-HD, portable 1
Master Bath & Dressing Area
2 Chests, 6 drawer poor 20
Wicker Ottoman fair 20
Plant Stand, metal fair 2
Wheelch�ir fair 40
Bedside Commode fair 2
Assorted Clothing fair 40
Assorted Costume Jewelry fair 20
Mirror, plastic frame poor 2
Screened Porch adjacent to Master BR
Glider, cushions good /fair 75
Table, wrought iron (wi) good 60
4 Side Chairs, wi poor 40
2 Armchairs, wi good 40
1 Double Seat, wi good 20
Cushions for wi seating poor 5
Plant Stand, wi fair 10
Side Table, wi poor 5
Inventory-506 Williams Grove Rd., Mechanicsburg, PA 17055
Estate of Mrs. June M. Holland Biackmore Price
DOD: 11/28/12 Total: $ 4022.25
page 4 of 6
Location Item Condition Value
Stairs, Upper Haliway and Foyer
Wali Mirror poor 10
Small Mirror good 5
Stand, 4 shelf wood 1 X2X3 good 10
Throw Rug 2X3 good 10
Ornamental Hanging good 5
1 Framed Poster good 2
Bedroom #1
Bedroom Set:
Double Bed with Headboard fair 45
Bureau, 6 Drawer good 75
Bureau Mirror good 40
Night Table good 20
Low Chest, 4 drawer poor 30
Wicker Chair fair 15
Electric Clock fair 20
Luggage Stand good 10
Throw Rug, 3X5 fair 10
Set of 12 Horticulture Prints good 20
1 Table Lamp good 10
Bedroom #2
Twin Bed,
metal head & footboard good 40
2 Chests, 8 Drawer poor 20
Wall Mirror good 30
Fotding Chair aaod 7
Fold-out Foam Chair good 5
2 Floor Lamps fair 15
Numerous Stuffed Toys good 10
2 Throw Rugs, 2X3 fair 5
Bedroom #3
Twin Bed w. Headboard fair 25
Electric Typewriter with Stand fair 20
Low Entertainment Cabinet fair 15
Large Ottoman, Upholstered good 18
Bureau, 4 drawer good 50
Plastic Garden Armchair good 2
Inventory - 506 Williams Grove Rd., Mechanicsburg, PA 17055
Estate of Mrs. June M. Holland Blackmore Price
DOD: 11/28/12 Total: $4022.25
page 5 of 6
Location Item Condition Value
Bedroom #3, conYd.
2 Throw Rugs, 2X3 fair 5
Dolls &Toys $fair 20
2 Table Lamp fair 8
Hanging Lamp fair 4
Basement (there is no Attic)
4 Steel & Particle Board
5 Shelf Storage Units good 80
1 Lightwt. 5 Shelf Metal unit poor 2
Round Card Table fair 5
2 Ladder-Back Side Chairs poor 30
Wicker Armchair poor 10
3 Wicker Side Chairs fair 45
Drop-Leaf Table fair 20
2 Side Chairs fair/poor 10
1 double Chair fair 10
Secretary poor 15
Metal Cabinet poor 2
2 Folding Tray Tables & stand good 5
2 Metal 8� Glass Etageres incomplete 2
2 Metal & Glass End Tables poor 4
1 Metal & Glass Side Table poor 15
Dehumidifier good 25
Portable TV, non HD 1
8 Trk.& Radio Unit good 2
Wicker Stool good 2
1 Table Lamp poor 2
2 Floor Lamps poor 4
1 Mirror fair 15
1 Wind Up Clock not working 15
Assorted Cds good 5
Assorted Picture Frames fair/poor 15
Assorted Kitchenware fair 20
Assorted Christmas Decorations fair 30
Assorted Stocking Gifts poor 10
Assorted Memorabilia 100
Inventory - 506 Wiiliams Grove Rd., Mechanicsburg, PA 17055
Estate of Mrs. June M. Holland Blackmore Price
DOD: 11/28/12 Totai: $ 4022.25
page 6 of 6
Location Item Condition Value
Garage
Snow-Thrower; 8HP, 24" good 60
2 Expandable Wheelchair Ramps good 30
' Transport Chair good 30
2 Walkers poor 10
Heated Birdbath good 15
Metal Birdbath poor 5
Lawn Spreader good 2
Electric Hedge Trimmer good 10
7 Shelf Storage Rack poor 1
6 shelf Storage Rack poor 2
Wood Workbench poor 5
2 Garbage Barrels fair 4
Garden Cart fair 20
Step Stoof fair 5
Wicker Armchair poor 10
2 plastic Lawn Chairs fair 4
2 Plastic Folding Side Tables fair 4
1 Juvenile Plastic Chair fair 1
1 Vacuum Cleaner poor 10
1 Ironing Board fair 2
1 ClothES �r�r fair 2
Assorted Lawn Ornaments fair 15
Assorted Gardening Hand Tools fair 30
Various Cleaning Hand Tools poor 10
Inventory- 506 Williams Grove Rd., Mechanicsburg, PA 17055
Estate of Mrs. June M. Holland Biackmore Price
DOD: 11/28/12 Total: $ 4022.25
pa� I a f Z
� 48500041046
REW485 EX(05-04)
SAFE DEPOSIT
BOX INVENTORY
PADepartrnenlotRevenue PLEASE USE ORIGINAL FORM ONLY
Social Security or Death Certificate Number Date of Death County Code Year File Number
_
F z �_� � z oo �� ,� I?�] �o�-L= �� , � �a � �
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DecedenYs Last Name Su�x First Name Mf
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-- ���_____._ _ _.�.__�,�
�—__.ADD��OF DE�r�I/�/!�SET�ftO Y� ��. �e CITY:, S r STAT�: ,Z�OCOD�r
.____�__�_--___...._.._.._..__.._�__.__.,_-------- __.._ _
lD � rr
NAME AND ADDRE53 OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSR BOX
"`�,,E:G a; I m. K� ��,,�{,t
STREETADDRESS: � CITY: STATE: ZIPCODE:
Sb7 G✓,%h�rmS �ro✓e j'Y)c�chan�esl�ur-e P�4 170S,S� ;
. NAME,ADDRESS AND RELATIONSHIP�1F ANI�TO DECEDENT,OF PERSON�S)PRESENT AT THE 80 PENING
a. NAME: RELATIONSHIP:
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STREETADDRESS���/ ����C�! �� STATE: ZIPCODE:
�'QifJC AS LY�10ve
b. NAME: RELATION HIP:
ar/PS � �i��e,��/5 �� ��v` f� �=s f•
STREETADDR S : �7 / CI ' ST TE: ZIPCODE: ;
D ��OGfser !/foaA' ��°�6ii7iCS��fy'9 �,�- / 7dS-.S ';
c. NAME: RELATIONSHI .
STREET ADDRESS: CITY: STATE: ZIP CODE:
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS�OCATED
NAME: �
/ NC /.3R�n,�,_%V/-�.-- ---- ---------- '
-- ----- ------- : ------ ----- --_ -------
STREETADDRESS: CIN: STg�E• ZIPCODE:
oZ F. /17!/i/7 Sf �PC�I�/n�CS�iHt /`�� /7GLiS�'
. NAME OF PERSON MAKING LA T ENTRY DATE AND TIME OF LAST ENTRY
4; , �'an.9,2 0�3
: DATE OF CONTRACT TO I2ENT BOX • NUMBER OF BOX � 1 TITLE UNDER WNICH BOX IS REQUESTED ',
San. 28�/�`j7 �1573 ae ►^ o ' r-
NAME AND ADDRESS OF PERSON(S)HAVING ACCESS TO BOX
a. NAME: b. NAME:
lr�r.'J /f1. �oati�t J"'tine h'. ���-� :
STREETADDRESS: STREETADDRESS :
.�'am� as u�or� s4.���r l:Sf'e� adora
CITY: STATE: ZIP CODE: CITY: STATE: ZIP CODE: `
NAM AND TITLE OF EMPLOYEE TAKING THE INVENTORY
tirt-/rS � Sh��,/�/S �L-. c/�'f- �r r-s�t _
WAS A WILL IN THE BOX? ❑ YES NO M yes, a. Date of wfll:
b. Name and addresa of penonal representaWe,If named In the will
NAME:
STREET ADDRESS: CITY: STATE: ZIP COOE:
c. Name and address of attorney,if any
NAME:
STREETADDRESS: CITY: STATE: ZIPCODE:
i _ _ . ___ _ __:_ _ __ __ _. ___. . ........... _ _ __
L 48500041046 485�0041D46 �
REV-485 EX
SAFE DEPOSIT BOX INVENTORY Page 2_of a _
INSTRUCTIONS
(1) Cash:Report total only.
(2) Stocks:List in detail every common or preferred certificate,wartant�;other rights fou�d in box.Stocks are to be designated by
name of company,certificate number,date of certificate,name in which stock is registered,and number ot shares and dass of stock.
(3) Obligations of U_S.Govemment:Number of items,date of issue,face value,names in which registered and type of ownership,
i.e.,jointly heid,payable on death,etc.
(4) Bonds:Designate by name,amount,serial number,or other designation.(Bearer Bonds)
(5) Bank and Savings and Loan Passbooks:State name of depositor,number of book,last date appearing in book,name of bank
and branch,and balance.
(6) Jeweiry,Cofns,Stamps,Manuscripts,etc:List and describe as fully as possible.
(7) Deeds,Mortgages,Current Insurance Policies or other evidences of indebtedness:List and describe as fulty as possible.
(8) All other contents.
(9) Return completed form to: DEPARTMENT OF REVENUE
INHERITANCE TAX DMSION
DEPT.280601
HARRISBURG,PA 17128-0601
REM ITEM DESCRIPTION
NO.
� ,(aal�eS ' .f�r Ue�i wi}� ,Sa�i/'e _ _
� �ad:eS ' �;n �t 'n wifl d .Sn�s�/ q�: arto/
3. l,�d�e ' 9•�
1 CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERS N RECEIYING COPY OF
CORRECT AND COMPLETE TO T E BEST OF MY KNOWLEDGE AND BELIEF. SAFE POSIT BOX INVENTORY_
SIG SIG
PRltdz E PR T NAME AND PR RIA7 BOX BELOW:
L �c��S � c�iP��S �/Il./�us!f
PRINT TfTLE DATE CHEqC APPROPRIA� - �
,� �;�-L.�ul �S(� �8s�3 � Z�1,3 �����.> �.�M�����
�EsWa Representa4ve e Jol�t owne�d sate deposil bmc
NOTE:Attach additional 8'Iz"x 11"sheet(s)if nacessary or use duplicates of this page of form.
The Department is auUarized by law,42 U.S.C.§405(c)(2KC)n,to require disdosure of Sociai Security numbers in comection wi�administerirg sfate tax laws.Tix DepaMient uses Ihe
Sodat Security rwmDer to iden6P�ihe decedent and personal represenfatives of ttie esfate.The Commonwealth may also use the infom?atien in exchange of fax informa5on agreements
wilh Federal and local taxi authorities.The stat?law bits the Commonwealth's rsonne!from disdos' confidential tax intortnation ex t for otficial
- -- _ -� -
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. W.� E .,L E' R :S � ;
_
:: � _ . . . • : .- -. _ ]`. E
- TivstYour 5pedal MomentsTo Mountz: � - -
- � January3l,20I3
- -`� IJon and Gail Fought; .. -
� 50'�Williams Grov�:Road -
- ':" ;Mecbantcsbiir�,�'A:"1?11�� -=
': Dear:�on aucl fiail Eaught, �
- At�our reqvest I exaniined ih�1evvclry yon submitxed for v_aluation and fiave provided an apimon of 3he
_ -; ., , ..
.
-Appro�mate�atc:Market Valne for the estate of 3aae Marie Holland Blacknioxe Price,Norretnbex�8;2@13.
dafe_oftleath: � - -
- 'Thi"s ieport is val�d Qnly in�its ent�ety,and t�e final-figure exctucles.az►y+ePplieabie taxes Yoar may v�t�sh�to -
�_ �ake th�s u�tQ consicieration�hen tisitr�the report. The�+alue concl�is�ons are sabject tc�1�mif�ng condifiens.-
. `: .th�t�re set forfh m_the bc�dy of�e:repoFt. 'To die best of my l�ov�leci�e�nd expenence,I�Eimate t�e� -
_ - jewejry has a total Approycimate Fair:Ivtazket Value of$2,�85.UO
. Photographs are mcluded with the origina�i�ep�rt far your reference:I suggest that y�u geep yc�utcopy of _
_.- this report�a safe pNace. - - _
�� This reporC was prepared�acc+ordance with'the Uniform Standards`of�ofes�onal Appr�sat Practiee
{iJSP�) - - -- - -
If I i�an f>e of any�further assistance;,piease�call. _
- -- Since�e - -
" �
- ����.:�., _
r.x' _ - -
; ` . .
: . . e�ynn.Gmve:: -.:�: .. . :
�:' " Cerhfied'Gemolog''�Appraiser>AGS '� _ `: �-
; Enclqsucgs - � -
-- _37sb�ncue xoad •:ca�n.p�,rA iza2i.� �i�.�63.i�99 �.(�n.�.763$953- moune�e�ve�ers e�m;
. Page 2 of 9 -
-.A M E R��C��A K t'i�E lf
.'-. . .�.- ...- - � -' - " - - `.��. �
.-_ . - .: ..._ :. �_ ..�_ -•:• . �-..-_. : .S�b"C I�E-.T Y_��- -��� -
- � - - �`'. i - --
� Talile bf Contents � - =
' . "•_ .1,etter ofT ` ` ` - -
_ .
_, .
; , _
tans�uttal�,__.
,; _ _ , - -
�_ • -:Table af Co�ents ` =: ` - - - ' -� - _ _ -
•...:_p�npose :. - - - - -
- • �.;Intended"Use� . - -
• >De�tion of Fa�r141arket Yatue .
; .. . - -
_
. � _::
� _ : - - `
- • .APproach Eo Yalue . ::' - - "
- • 1Narket - - _
• ::Limifing C�nqdiqons �- -
-- � 'S�bscr�ptions Retained for Value Consult�ng.-;� -
• � 'Metal 1Vlarkefs:�. ' - -- - "-
• , Cer.Eificataan _- - _ -
•" -�,,ist af Labocator�Tnstniments:' _ � -
• rtem Descflptions . -- � - - - -
- • 'Photngcapih�s} - ; -
. _ _ ,,
�... Biogrdp�ca�.Ii�formation,- _ - � _
,This'repott�s val�d o�nly m its entirety and�or its stated�urpose and intended use a�d was prepared�in
- aecordance w�#h the_Uz"tif'orm Standards of Professional Appraisai�Practice(LtSBAPj.
:- r; - -, ' : . . �` ; '.S�ate�rients and Limitaing`Couditi�ns ` � -
'.. rur�,ose_ .: : � - , = � - _ - - - -
The putpose.afttusreport,is:fo desenbe�and:doc�ent tlie quality ofi5e jeweky listed and to estimate rt's .:
'F'airMarketV�alue;=;' - - _ -
. Intended i7se ' -- - -
Definrtioa Qf Fair-]Vlsirltet�Value� ,'. .
- - TL�;faq ma�lcet t+aluers�ie�pnce a#,whielt fhe pioperly wauid ehange.i�ands:hetween a willixg buye�and -
_ _.
. : - -- : : .
_ _w�liagseller,neitlierbemg�md�any compulsion to buy o�'.setl-and.bQth�fiavingrea,sonable�cnovvledg�of::
- - iele�+ant fa�ts The_f�r�a�Ieet vaiue of a:paiticular iteni�.of proPerE3'; �s:not to iie deteiminei�by a forced = _
s�le pnce Nor is tliefa�r market Value of au itsin of propercy ta be determinied 1�y ihe-sale�ce of f�ie ite�:- -
in a'market:o��r=tt�n�iin wluch such item is uiost commonty sold'�o,tbe pnblic,taking�to account , �.
. . .: , _.:. _ .:.
; - '- . � -}osstion of the ttem:�vherevet:apprppnate: Taken from Txeasury Regulatiorr 202Q31 1(b) "
� . . Approa�t:to V.alne. : � _ -
, . , -- -
< • _:-. _
' Theie au�#hi�ee h`a�iit►o�al appro�ches to_r�alue thac ai�e a§foliows ' -
• "Iiicome-appinach l�ppues.t�mcome Praducing Pro�rties and is�sed onty if an�ncome situat{on = -
� _ __ . - - -
ar renffiT. ra �;ean be identifie� . `�, -
� : . ,- _ p,.p�'ty ._ - : - -
Marlcet Data appioach.Compaies.the qualihies gfthe subject item#a an azti�le with similar os -
� -. :
_ idenhcai qi�ahtie�.and
researcfies and�records ciIIreniverifiable sa�tes ofsuch�merc�andise:::
�osc app�roach.�stablishes the total.walue'of an item-�eonsidsring�fie value of its couapon�t . _
_ . - . . .- ... . ,
_ : . - - : -
. .- - parts-precious m�etal cozrte�gemstone weights and quali#ies,:Iabor,a�d'�riy nther�aes�togeti�� �
_ ;. . . ,,,
�vifh the appm�zet�i m�k!�p;according to the nozms of the,ewelers nn 4he loca[e,suPP�Y�?d � -
. .. � , _ _ -
� : _c�emand,anid the-cur�en�.state.ofthe maricetplace. - - :�
�� Page�of 9 : . . -
- -: Pre�►ared For _ D�n and�Gra�Eought - ° -Date:1/3I12013 �
•: . . _ ; ,$OZ willianis�ye Road - -
- ;. .,
, ,. _ . _
. . .-_ . �. -
-, � - lylechanics
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._ , ..burg,PA-17055 . - ;
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- Ifem 1 - _
, lting � ' " ; - � �. . -. ": � -
_ •- , .. One.lady's k8I�white gold�bjack opal d�amond ring.'There is pne=apprt�?ci�teIY 11.�&3 x 10�39mm avai -
,.. . . < , . .
- cabochon b�ack�opal'set w�L foirr piongs in tl�e eenter of the rmg _Thene ai�e:two siarounc�ing halos:bf
�� "� . - � round briltiant eut�iamonds. The�er halo has 20;aPProx�ate�y.:U2�t round bn•Iliant eut-d�amonds set '
. � . __. . . , , _
_ : . vsrith:8vee;5hared piongs-. The.o�t balb is�e[Iawer with 20:a�Prtnumat+ely;0�'s;t round briUiant tut ;'- -
: _.. ; . . , �
- diamonds each set�w�th two prongs;.The ring has an open.wire gallet�+and sfiank_�he rmg.mgasdt`es
20,52mm wide ai.the top,5�06mm wide atthe high golish�ire slioulders,aud 3 84mm wide-at the-i�a,se of �.-
- the ring. �Tlie rmg is=stamped"1$K",weighs 5.5dwt,-and�►eas�u�es finger size 6 5 :'' - -
- `: Opal�ttributes ` -- - - -
Shap��deut:; _ Oval cabochon - _ -
- `iVieasureu�ents:_ �1_$3 x 1 Q:19 x 7_4+6 mm�(apProximafe) ` -
.
. - -
Weigh� ` : 3.;39_Cts_(estimated�: - -
'Base color:, Biack _ - -
'_Color mtensity; �vloderate to High. - -
Fire pattern_ <:: : Harlequin - _
_ - Diamonit Melee�lttribnies - - � -
:�Shape and'cut Round#uil'.cut . _
- <:1fAeasuremerits. : 2 mm - - -
.. - _, _ , _ .
, �I�umtief of�iainonds: , . ._20 '; _ ' _
. . .. � : � � ,_ � 'Tota1 Weig6t -: ; ' -.40 cfs.Eestimated)
Clari�y: , 1-1 ° -
- . Cotcsr.. ;. - - , t-J', - _ - _ -
__ ...: , . .- .
- . Di�mond_Meiee A#Eribntes - -- - =
• , : - _.
.
. ..Sh�pe and cttt �-. Round full cut'- . - _ - -
, : . -. . , -
``_ - � -
::,:MeasuremeFlts: - - 2_mm" _ -
- .Numtie"r of.diar�►onds;: ; ` � 20 : _ _ -
_ Tot�i 1�yeigh�`" .fi0�c�s_.(esfama�d� -
',Ctarity::,-. . 11 _
- - Color _ � ` I;J - - -
- - Propordons :'' _ FaiF . - - -
._ . -
'Comr�en#s_ "�wo ichipped =
- Total Approanmafe Yalas Eifcludu'tg'T'a�c _ =�1;964,4(?; -
.: �
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_ Page 6 of 9, _ - _- _ :
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, ; - ;Item 2 . -- .: �
Ring _ _ -
- On�lady's;18K yellow g41d:diam+�nd as��earl ring.-:The.ring has o�e 3�mm white pearl set v�h'six �
Iirong,s,:with on+�ap�tto�mately.23cE Qiil Mmer's-cut.diama�ds�wrth six_piongs in a butSercup style - _
- � sstting u�a idiagQna� Tfiere are fQ�-approximately:Ot-.fl4c�Old Mine�s cut;and miind,smgIe c�t :� - _
��_diamonds bead set in I�TC�v}ute gold m a]eaf pattern on either side of the center in a by+pass�manner: The :_� -
`:. - ring measp�es 13 81inm�v►�ide at top;224mm�wide at the high polish shonld�r,and 1,:66min wide at the =
; , - -: .
-: :`ba,ce;of the ting `�'he�ng'y►�eighs"�.4d�vt,measw�es fmger size 6 5„and is °18I�". .;' -
."` : - . . ; . - __. - . . -
:, stamPed..
' "'Pearl Attribntes ?` . � .- - - -
Number: t.:?.-. - - -�
_ ... ,. _ .
._ . _ _
.. :_:
;S�e � ,_ �_
: : : . : _ 3-Tf2 mm to.�mm� .
• . ..� _
.. - _ -
, ",:_:;Color._' . . ; . . '::. ; White. - -• -
,: .. - : - _
� : Sh�pe:- . ':: _ .:,; Baroque _ -
- --
..,
'; - „- _ -I-i�ter. . -.. � �-: : Lov►',. _ ` - '- -
�;, ' ,'` :: _ Blemisfies =' . - ` Very slightly blemished
- ` D�amond 1.Vlelee 'butes -
: ��
. ::Staape'and au� -- f3hi;Miners.Cut - - -
..; ; _: Meas�rements - 4:U mm . . . -
.. - . ; . _.
; � . _: ;Numbe�vf diarnonds: 2 _ __
- -TotatVNe�gFit-, ..4.6 cts_{estimated) _
Clarity:: . . - � �f�-2� _
. ,. _ , ,. _
_
:. , -Golor.:::: :; .:: - � ." _ :. - - -
- G=H .
"I?iamond'Melee;A�ttribntes; � -
�hape':anc6 cu� . Otd:Miner`s.cut anci s,ingie cuf. - _ -
. __. . : � . ,. ,
.- . •
_ _ ""-_Meas�remeitits. ` ` 1:5-2.2 mm _ -
- �1Neight_ - � 4_01 to 0_O�t cts. each - _
- =Numberof diarnot�ds:� .8 �. - -
- ;TotallNeight : � _2d_cts.(estimatecf)_ _ _ " _
Clarity: - VS" -_ -
Golor:' . ' G-H - ° -
� Total Approximate:Value Excluding-Tax. � -$246.00
. _ , _ . -
., __ _ _ �: -
'-Paga?of 9: • -
_
Item 3 - __ _ - _
>. . ; -� ..
' - Pin, - - ,.. - - -
- t�n lad�'s I4IC yeltow gold pierced filigree;bar sxpphire bar p�n. Ttiere���e approzas�ely 4mm.round -_ -
��, � • hire�3.set m.a beaded�d he on: The in m
.;.
_ �FP. _ .� �g. P easnies2 1!2"I�ng,3l8,"widw,weighs 2 8dwt,and `
- is stamped"14K". -
- . _Sapphire Me1ce Atki-ibutes' - -
- ::Shape�and cut - Round fat��ed � - - -
_ ` Measu�ements _. '�3_5 mm -
: . Nur;�ber _-. '1. .-; -
- =�otat V11e�gh�,' :24`cts (eshmated) _ .;.
_ :Glarity: - - �.Type�i#,mo-rieratelj�mcluded -
: Color : � _ Medium;sii�h�y-gray�sh;:very slightty-greenish>,Biue ::_
. 'Propairtions_ . '_ F�ir ° � -
`Finish:. . Poor�: = --
_ Tota�Approiumate Value�xclusim,g�ai�; $78 C0=
. .. : -- _
- Total Approic�aiate Value foi-Ail Tbems Eicclud�ng:Tax: , $2�85.0(? ,
: _ .. . . _ _ .. � ,
- - Twothoosand two. . r 'eighty:five dollars and=no�nts .
: _ �-- • ' -
: Signature of Appraiser. -i��. � �
- -` : �tieiie L�Grove- " _ - -
- -.Certified:Gemologcs-�APP��':A�S � ' -
-: Page 8 of 9�_ ,
_ _ $�ogra�hscal B�:ckground�and Qualificati�ns� �' _
- .. ;- .-,: :, : � . . - - _
_ - . :i�p�raaser`s�7sine • :
:; .,:. _ ` . -, � �:.: •:Ch - -
. . , . _ . . __ .. er�e I.ynn_Grove,G.G,C.G.EL , : '
Ediir:at�on Bacheior of Science,tt�e ShiPPe�sburg T3niversity,2(100: - _ -
, _ _
� - °.:Graduate�'iemoTo . � _
_ . g�st,�'iemological.Tnstitute�of A�enca,2006 -:
- ' , ` " -• Regi§tei�d 3ewPler,l�n�rican�G,em Society,2�7 -
:"-Pearl�ra+dmg,FemologicaI��i►stitufe of;Amer�ca,2005: - =
- Pe�rl Gr�+di�g Lab�ratoiy,Gemologicat:Institute vf.�en�a,2�Q7 -
_ - -Identi�ying S�+nthetic.Diamonds,;Gemologicai'Institute:Q�A�merica,2QQ7 . '
- :;Eertifieii Gemologist,>.4mericau:_Gem Society,.200$. :_ - -
, _ „ .
, - _ : - -. . :Identi�ying,Diamond Tieahnents,Gemologic�l.Institute:ofAmerica;�048 - - _
�Tdentifying Ruby and Sapphire i;abnratory,Gemalogical Insti�ute of f4meiica;20@8 - -
� :., . ,
_ : Identif,}!ing Emeralds,Gemological InstiUrte of tluierica,2008.::-;
' Cer4fied C'temologbst'AppmiseF,America�em�S�ety,,20�0� , : -
;7dentif}±mg Rulry aud 5apphire I.aboratory,Gemologic�Institut��of Amenca,2fllA.
. _ - .'�Cbioied Stone�'ieaffients,`Gemological�snstitiite of Amenca;2012_ . _�
- _ :Undershanci�g Ciarit}±Ghatacteiistics and Clariiy G,rading,C�e�Qibgical.
- _ - . Institute of America,2012: - - -
„ _ , - -
. ' ': Busmess: =;In the;jewelry ti�ade smce 2000: . . ' __ - =
1Viember.AIIieric�n Gem Society � _
� =::American Ge�Societ�+Conelawe 2007.-j—D�ver,CQ `' -
1lmerican Ge�Soeiety Conctave 200$-�-Seaule,WA.,.
� -,Ameiican Gem Snciety`Conelave 2�10=$ost4n,1�+�A. �
• :: - ... .
: Ameiican{'iezri Soc�iery-Conclave 2412-Miami,FL.
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Don ��d Gai[ Fought
.lanuary, 2013
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Sanuary, 2013
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� �� � AMICA MU�`UAI. INSURAP�t:�. �..c.nvir�.�� _ y �� , �,;. _.
INUfL:P O.80X 6�8i PROVtDENCE,ttt 42940�8ope , '
��-,' , :1vYr, t ; . . �"'. , �a � . ..
PHILADELFHtA FtEGi4NAL OFEiCE �`.r F - .
'CHi.EPiiO1�tE TdLL FREE.i-$71-572-64�2
DMDEND PDR: JUNE M. PRICE . ACCOUNT MUMBER: N2�T3OZ4
ct�cK r�U��rt: 17270763
TYPE OF INSURANCE POLICY NUMBER } AMOIINT.
HOMEOWNERS � � 63t?337-2otJ�t $2ao.2s
MARt�i 27, 2Q�3 NET DIVII?END PAXMENT $2d0.25
�mica offers you tEie ability to apply your dividenH check to your *_-enewal pol.icy.
A7.sa, if yau are cuzrent3p on our autonaL� pa�aent plan, we can deposit your dividend
directly i.nto yaur bank account. If you would like to Lake advantage of either of t.i�ese
ngtions, please contact us at the nu�ber abotte.
DZVIDEND RATES
While no conpany car► guarantee future�dividends, our latest divi:dend rates
in �ennsy3.va�zia a�e--as fallows: ; _, _ . _.._ ,
TXPE OF INSURANCE RATE
�.utomobile Liabi3ity 20X
�utomabile Physical Damagie 2d�
Fire 25X
Homeawners 25x
Ho�eawners(Inland Marine), 25X
Homeowners(Earthquake} 25x
u Persanal ttmbre3la LiabiZi�ty 20z
Boat�Xacht �p�
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�:�� �.�y.����� ..;'; AMICA MUTUI�L INSURANCE COMPANY soverceagn Banlc
Auro Noexe �aFe i:ORi�ORAT'E OFFIGE—Ut1COLM,FttNJDE tSLAND
E�tVlDEND AGCOUNT �7�7v��3
accoutn MU��a_ N273024 MARCH 2T, 20"!3
PAY *ZOO�Ba�s �►rm zs c�rt�s
$2ao.25
Td THE ���i�tu�!{II��"IIIt1Iu�I�������iF11�!'��lf�'f��l'���'�uj(lini
atu�tt JUNE !i. PRICE
°F 506 WILLiAMS GROYT RD �y�� p� t f�,�
MECHANICSBURG PA 17055-410U Yl���k' !iG' �`2.�'r'Z�
coNraou�t
x"L7 �C?Cl?�3a• �:Oii375c'45�: ?5860DO�S979u•
WELLS FARGO ADV{SORS, LLC D�� .�;=° ' `����
One North�efterson 0 8/0 6/13 00235 9 9 8 2
St Loufs,MO 63103
;�ESCRIPTIOf�._. ; DATE ; AMOUNT
' 3311-4018-1 A 08/06/13 002359962
EST OF JUNE M PRICE
CHECK ISSUED �y 5,000.00
TOTAL 5,000.00
�\�.
�
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AMICA MUTUAL INSURANCE COMPANY
n�cCOUtrr Nuwsat: N273024
POLICY NUMBEI2 640337-20VR CHECK NO. 796396? 37 85 5
UNEARNID PREMIUM ON CANCELLATION $592.00
DIVIDEND ON CANCELLATION $78.50
TOTAL � $670.50
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R�v.,��x,n-sn
SCHEDULE F
co,�,��,�,.�o��N��Y�VAN� JQINTLY-OWNED PRQPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Fl1.E NUMBER
T'wn� �'i. �r;�G �t- iz —1z,�y
N an asset was made jalrrt wtthin one year of#he decedenYs date of death,it must be reported an Schedole G.
S(1F2VIVING JOlN3 TENANT(5)NAME ADDRESS REtAT14NSNIP TO t"�ECEDENT
A. ('��rt m. �ottGh/T so7 ,6ia:/l;�'r�s �o✓� Gla�.d
Jl'It�an�csbur�, PA t7osS �Jau�h�"tr
B.
C.
JQINTLY-0WNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
iTfM �dR JOINT hAaDE I€�ctt�de n�of fina�al irms6kuErort�x3 b�tk aceount mfmber a sirr�lar identilySng number.Attach DA"FE OF DEATH DECO'S VAIUE OF
NUMBER 1'ENANT JOINT deed(pr jointly-hekl reai estate. VALUE OF ASSET tNTEREST aECEDENTS INTEREST
,. A. ���.� p�r r��n�, ���aci� ��. ��
.S"ovo 6 y4�7i� ��`f 38 �57a7� �37:/9
(�.SGG YQ J!t a�on le�l`�r <i�l�`A�i�'ut�
�. J�. ��,�rfro ?:.�u- kra/xral �i'r,r�.� Gtnrnrt f?r;•r t
.�I�are ,�-�. ,N'o. a8�o y-,�p �'9, 6$c2�/ :� ��i�,,c�'S�D.4�l
`�. /�. 5����r 1b1d8rr' �CI'.t� ('J"BC��f l.t�'l�nu1 �C�u�af
Checkin ,�: ,No, a€�o y-�z �/3, a75 22 ,5-'df �`6, G�37.b/
�S+�G Ya!'J t{R�art ��P,X" 4'�LftCa7 AS tuG�!
tts jharK@�/ t•tp Nor, Zv1,� rsftxfzme.rf`
VGrify:rl �%/ /�1'. �'a�hfs ��'r�s Qs
tt r,�1T aluntr,,�,
�
TOTAL(Also enter on line 6,Recapitulation) S f �, J'`�1 S, x�
{!#mae spa�;e is raeeded,insert additiona�sheets of the same size}
Jan. 22. IU13 8:h4AM PNC Baok No, 5633 I'. 1
� r,;,9.:,,`',� d"
,
. . _
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�������
3anuary Z2,20I3
Charles E Shields II1 Esq.
6 Clouser Rd
Mechanicsburg,PA 27055
RE: . June M Price
SSN: 217-12-00 l 6
DOD: 1 I-28�2012
Dear Mr. Shields:
In response to your request for Date of Death(DOD)balances for the customer noted abo�'e, our
recprds show the following�
Cbecking Account
Account# 5000644714 Established: 06-26-1996
JUNE M PRICE
.. GAIL M FOUGHT
AOD balance: $7438 non interest bearing
Please note that this office provides date of deatb balances for deposit accounts(TRAs,CDs,Checlnng and
SaviAgs). We do not pro�ess any financial transactions or provide statements. If you need assista.nce with
any of tt�ese items,please calI 1-888-PNC-BANK(1-888-762-2265}or stop by your local PNC Bank branch
office.
Sincerely,
National Pinancial Services Center
pNC Bank,N.A.
Member FDIC
This message is inrended for the use of the individual or entity to whech it is addressed and may
contain information that is privileged, confidential and exempc from disclosure under applicable law.
1'f 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 ure hereby notifred that arry dissemination,
distribution or copying of this communications is strictly prohibited if you have received this
communication in error,please notify�ne immediately by reply or by telephone at 800-76Z-1775 and
immediately destroy rhis jazed document. �
Page 1 of 1
'1'o��srer k�d�e�l C:re�t�t L���n
.a�,k s,mcEv�{vit,�y K:�:af�L,u,r�c::iixr,�,sct�i"43�•:s��
28704 11/O1/12 11/30/12 �� 1 �?�2
[�ernbcr Numkec '�ncia�k Se�cur€tY�u3mtrec Skiiemrrtt Start�ie Theou�:0ails
Transfer high-rate credit
card balances to a 7ower
credit card between
Dec. l, 2012 and Apr. 30, 2013
and receive a special balance
transfer rate of only 4.9996
APR for 12 months from date
of transfer. No transfer fee
saves you more. After that,
the rate becomes our everyday,
7UNE M PRICE low 10.9% APR. See Forms at
506 WILLIAMS GROVE RD towerfcu.org.
MECHANICSBURG PA 17055-4100 _
1!os7tt�. FFFfcfiliE
� � �,� � rnANS���or�s�a�ra sur�r��►���s � ,��o�u�r � eA��� :
SHARE SUFFIX: 00 PRIME SHARE BEGINNING BAL. � 29680.81 �
110712 TwaNSFER TO SHARES 28704-02 -10000.00 € 19680.81
112112 TRA,NSFER TO SHARES 28704-02 -10000.00 � 9680.8Z :
1130 120312 DIRECf DEPOSIT 3572.82 € 13253.63 :
ACH CREDIT FROM: US TREASURY 312 XXCN SERV �
DEPOSIT ALLOCATION TO 28704-02 FOR 3472.82 ` '
1130 120312 DIRECr DEPOSIT -3472.82 f 9780.81
ACH CREDIT FROM: US TREASURY 312 XXCIV SERV E `
113012 .�.?�1t.�B��1D _,,_ 3.01 ; 9783.82
�� 70INT OWNERS: FOUGHT/GAIL M
..: G:�..�,.,.., APYE�": .20%
Y�APYE�`� IS THE ANNUAL PERCENTAGE YIE�D EARNED
FOR THE PERIOD COVERED BY THIS STATEMENT `:
DIVIDENDS PAID: 3.01 YTD DIVIDENDS: 78.03
---- ------ ------------------------------------------------------- -------- -------
�
SHARE SUFFIX: 02 REGULAR CHECKING
CHECKING SUMMARY:
DEPOSITS 25517.77 MAINT/SERVICE CHGS .00 €
CHECKS 12583.76 MISC DEBITS .00
BEGINNING BALANCE � 4469.41 :
1101 110212 DIRECT DEPOSIT 1022.00 � 5491.41 :
ACH CREDIT FROM: US TREASURY 303 XXSOC SEC
110712 TRANSFER FROM SHARES 28704-00 10000.00 ' 15491.41
110912 CHKK # 9548 099500137 -50.00 € 15441.41 `:
110912 CHECK # 9554 099500623 -571.69 i14869_72 `
110912 CHECK # 9550 099500624 -90.00 `•. 14779.72 �
111312 CHECK # 9549 099200109 -70.84 � 14708.88 �
111412 cHECK # 9556 099300017 -51.81 i14657.07 ;
11141Z CHECK # 9555 099300352 -840.00 : 13817.07 >
111512 CH KK # 9547 099401399 -840.00 : 12977.07 �
111512 CHECK # 9557 099401399 -840.00 � 12137.07 '
111612 CHECK # 9562 099500458 -121.55 E12015.52 ;
111612 CHECK # 9560 099500732 -1299.92 : 10715.60 �
111912 CHECK # 9559 �99100300 -42.87 : 10672.73
111912 CHECK # 9558 099100537 -47.12 ; 10625.61 �
111912 CHECK # 9561 099100760 -68.00 : 10557.61
112012 CHKK # 9565 099200032 -60.OQ : 10497.61
112012 CHECK # 9568 099200389 -50.75 ; 10446.86
112012 CHECK # 9566 099200786 -5000.00 : 5446.86 :
112112 TRAHSFER FROM SHARES 28704-00 10000.00 : 15446.86 :
112112 CHECK # 9563 099300777 -9.65 ; 15437.21
CONT NUED ON NEXT PAGE
Please direct ban bitling inquiries ro the atter�tion of Loan Setvicing and all other statement�quiries to Deposit Services.
Mail to TowerFederal Credk Union,PO Box 123,Mnapolis Junction MD 20701-0123
Phone 301-497-7000,800-787-8328•TDD 301-497-7054•Web sRe www.lowerfcu.org
I�f�Fl�ri�sber �58ci,�ity-fdiuti�+tsr 51�tama�t'SiarF t3nke '�+rott�ts Gafa
zs�oa li/oi/x2 �,�./3o/�z ��� z � z
��� �� ,
a,e,� � cas� � �,►��AC�1C?N'�.�TVQ�f#�t1Vt�1Rt�S � f�R+#t�Ut�[7 B�tLAiVC�.. :
r�� nx�dx�r
I12312 CHECK # 95b4 0995C}0956 -45.93 15391.2$ :
1IZ612 CNECK # 9576 0�'n100344 -301.06 1509Q.22
112812 CHECK # 9575 099300314 -50.0� 15040.22
332812 ct�t�ctc # 9569 0993Q0491 -25.OQ 25015.22 :
112812 CHECK # 9578 099301404 -940.fl0 1413.5.�2 :
112812 CHECK # 9567 099301004 -840.00 13275.22 �
112912 CHECK # 9574 099400464 -35.00 13240_22 `
�.130 z2o33.2� c��POSr�r ALLC}CATICIN �aoa� 28704-00 3472.82 �6713.O�t
ACH CitEDIT FROM: US TREASURY 312 XXCIV SEF2V
1130 120312 DIRcCT DE?CSSIT 1022.00 17735.04 �
AC3i CREI)IT FROM: .US TREASURY 3{}3 XXSt►C SEC
113Q12 POSTEQ SFfiARE DRAFT -49.61 27685.43 :
�OR: VERIZON FINANCIA 9573 PAYMEN7S
113012 �HE�K # 9S71 C}99500219 -52.61 17633.82
113012 CHECK # 9577 0995#30470 -231.35 27402_47
113Q12 DIVIDEND .95 174Q3.42 �
� � � � � � � � � � � � � � � � � � � � � � � * � � � � � � � � � � � � � � � � � �
CLEARED CHECK SCIMMARY:
NO. AMOl1NT NO. AMOUNT NO. AMOUNT
9547 840.00 9559 42.87 9568 50.75
9548 50.(}0 9560 1299.92 9569 25.40
9549 70.84 9561 68.04 '�9571 51.61
9550 90.00 9562 . 121.55 �`9573 49.61
'�9554 571.59 9563 9.65 9574 35_OQ
9555 844.00 9564 �t5.93 9575 Sp_00
9556 51.81 9565 6Q.00 9576 301.06
9557 844.dQ 9566 50t30.4U 9577 z3Z.3S
9558 47.�2 9567 840.f�Q 957$ 900.OQ `
�OZNT OWt+tE12S: GAIL M F4UGHT
DIVIDEND RATE: C}.10009b **APYE��': .14%
DIVIDENDS PMID; .95 YTD DIVIDENDS: 7.97
---� ------ -----------------------°------------------------------_-- ___---°--- --------
StfARE St1FFIX: 51 TtiftEE YEAR ItZA BEGIPtNING BAI.. 311._00
1126 112512 DTVIDEND .55 311.55 `
BENEFICIARIES: GAIL M FOUGHT
CERTIFICATE #; 13177 FORFEITURES: .00
ISSIlE DATE. o�.lzsllo MATURITY a,�T�: �1125I13
DIVIDEI�tD RATE: 2.0$Ol°.6 ��'APYE:�`� 2.10%
DIVIDENDS PAID: .55 YfD DI1/IDENDS: 6_18
__ _ _ --- ----------------- ---------- --------
YEAR Td DATE SUMMARY TOTALS:
IRA DIYIDEI'VDS 6_1$ WITHHffLQING .44 �
OTC-tER C►IVIDENDS $6.{3O FORFE2TURES .(}O �
TOTAL DIVIDENDS 92.18
�
�
�
�
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i�2 - � --�.,. r�ccet vn uc.
Tower Federal
� � Credit Union
January 16, 2013
Charles E. Shields, III
Attomey At Law
6 Clouser Road
Mechanicsburg, PA 17055
RE: June M. Price
Primary Account#28704
Dear Mr. Shields,
As requested by you, on behalf of the Personal Representative Gait M. Fought, the
following information is provided regarding the above referenced account. The chart
below (ists the balances on each account as of the date of death,November 28,2012.
Account Type Account# Date Balance at Death
O ened
Prime Share #28704-00 12/31/1970 $ 9,680.81
Re ular Checkin #28704-02 05/23/1977 $13,275.22
IRA #2870451 01/25/2010 $ 311.55
I have enclosed an Account Statement for the month that the member passed away.
I am afso retuming your originaf documents in case you need them in the future.
If I can be of further assistance please don't hesitate to contact to me.
Sincerely, '
r� - ,
c;
Cindy Spurlin
Member Case Settlement Specialist
(301)497-7000 x7348
(800) Z87-8328 x7348
7901 Sandy Spring Road ! Laurel,Maryland 207073589 � 301-497-7000 � 800-787-832g � fax 301-497-8933 ( towerfcu.org
SCHEDULE G
INTER-VIVOS TRANSFERS�
COMNOEW�FANCE�TAX RETURNAN� MISC.NON-PROBATE PROPERTY
RESIOENT DECEDEM
ESTATE OF n FILE NUMBER /�
�K.11G M• 1'C'iGG oZ/-//'� -l2�''7
This schedule must be completed and filed'rf the answer to any of quesdons 1 through 4 on the ceverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM �NCIUDE TF1E NAME OF THE TRANSFEREE,TNEIR REUTIONSHIPTO DECEDEMANOTHE DATE OF TRANoFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH A COPY OF THE DEE�FOR RFAL ESTATE.
VALUE OF ASSET INTEREST 1FAPPLICABLE
�. 7ow�r /�a�eral L�r�d,t Un�oh .ZR.A �
A�-� �uo. a�7o�j-sl �.{
,�GtB�'7G[try : C94/� �• /rDK'l1t�, �4l.lj/y/' � ¢
e�' v�' dt�e�¢n f. l/ 3��ss �o a fo -a — 3 ii,ss
(SP,t° YRIKd�ion �B�Cr 4�a��ea��
�?. .T�i a�'soiy �a�aoad/ L.� f�i�nu;f'y
�' Oo96/6 /3��f
,���wa y: �.i � ���f, ���� �,
e�- a� �2�ea�enf �7�f, 9�'0�o /oo� � -' 75; 9Po 60
(See l/k�ic a/�i oh �i.°//s �r�� ��er
��a����
�- �.uf�tra� �ro�-hood �ndw T r�ru�t
�nnui� �n¢i-a�f 8S8 a,�03z, jS, l6S.,z �oopo --o — �75, I�S./z
CSeE �'k,�f9�}1a��r n7- ��tN�57�r r�qi'�t.riledt
/
�t�'acl�ea� u'`i�ch Qorcr,cl�s �•o•�
!'4/ue)
TOTAL(Also eMer on line 7,Recapitulation) a � 5 D, �51 oZ7
(!f more space is needed,insert additional sheets of the same size)
1'[G; �w�A.v� �ro�iLv�ien� ��h�"iv<.I3f� a� � �3.
DEFERRED INCOME SETTLEMENT OPTION
AGREEMENT SUMMARY
ORIGINQTING CONTRACT OWNER JUNE PRICE
AGREEMENT HOLDER GAIL M FOUGHT
ISSUE DATE NOVEMBER 28, 2012
SUPPLEMENTARY AGREEI�FNT NUMBER 9262953
INITIAL AMOUNT $75, 165. 12
COST BASIS $50,000.00
GUARANTEED INTEREST RATE 3.5%
INCOME OPTION CASH
DEFERRAL PERIOD 05 YEARS
MATURITY DATE NOVEMBER 28, 2017
ORIGINAL CONTRACT(S) OF 00B5829032
MEMBERSHIP AND ANNUITY NUMBER(S)
THIS AGREEMENT WAS ISSUED FROM DEATH PROCEEDS DUE TO THE DEATH OF
THE ORIGINATING CONTRACT OWNER.
TNIS IS A FIVE YEAR DEFERRAL. BY THE ABOVE MATURITY DATE
THE ENTIRE VALUE WILL BE DISTRIBUTED.
YOU CAN MAKE A WITHDRAWAL FROM THIS AGREEMENT AT ANY TIME PRIOR TO
THE ABOVE MATURITY DATE BY SENDING A WRITTEN REQUEST TO THE HOME
OFFICE . (THE MINIMUM WITHDRAWAL AMOUNT IS $200. �
REV-1511 EX+(10-06)
SCNEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
��.�.n� /71• �r��G 21- /Z -l2��1
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
a. FUNERAL EXPENSES:
t. Pt,,,��,d
.�. �UYG�IQSG B� (.irn {-�^o,,+n �$u�r��- dd1� �� �o/nc �'!„30.Oo
B. ADMINISTRATIVE COSTS:
1. Personai Representative's Commissions
Name of Personal Representative(s) �a�I m• �tA4�t
Street Address �� �v���/Q�j'f s (9/'r7!/G (/�'� �I
City �Qf(''�j1j��'J/(" .�Gt rti State�Zip /7 O S� �a-t VGq
Year(s)Commission Paid:
2. Attomey Fees Charle.s �• (�►/!�'G�`+S T �7 SDO���
3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation)
Ciaimant A/D ONE �L/6/.QGE N�NE
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate fees �jy/q� OfY9i/JQ/ /S3L(e Oj�' �S�o/"f �'L/'1•T7 GLt-!C S �/S3 .�7p
c/ n J,, U
5. AccountanYs Fees Gret,na�4.1� 9t Co• r'C' ��`'a' �� �a T� �'�' 1�n.�' �a7s.00
6. Tax Retum Preparer's Fees C��'�►QU�a-�'f �•�C' 1o4t � �a 41� �-QSn m• 7� j"� s�.DO
�. Fi/:hy � f ��i,fu` o� Lt/i�/s f/S•OD
O
8• l�ddifi�ina/ l�i�vbafe Fee f �e�:,s�r o�' 6v.%/s ��70.oD
�• /�dre�fi si nq f�N l��t,�►1�1. ���r/ .T�i�l.
t
7�.DO
l�. A'drerf�sin� �h �ar/s/� �uifi�e/ �/
�f T. d�
�SE2 Co�lfi�7. 5�1� q�aC��)
TOTAL(Also enter on line 9,Recapitulation) $ I 3� 0,2 S, 7 9
(if more space is needed,insert additional sheets of the same size)
i
�a se�i�. �.
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_ _ _ 3,� � _ l�pp�t!.�.__�u __�-v__1'_Y_l.oca�afiz_ .�t�•�1�n-s_ _ __ _ __ _. ¢16__S_d�__
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__ _ _ _ � _ _ _ _ __ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _____ _ _
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h1VERS-BUHRIG �Ut�IERAL
H�h1E AtJD CREhIAtORV
37 EAST h�IN STREE7
i'IECHI�MICSBURG�PA 17455
iERMINAL ID.; 8429
�JGp��j
DISCOVER )/
�����$044 EkP:�l�� SI�IPED �
SALE
BAiCH� 98@1B6 IFIU: �i4�001
tJo� Z8� 12 16:19
AUTH: 0284�P
pUTHl1KI 82846P ._� .-__.
i�i- � , s
GpIL FDU6HT '
_,:..
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N.._ ---- -- - - ------------
I PAV B�UE 10TA1 �h�UNT
� aCCORDIN6 iu Caa ISSUEk A6REEI�Ht
NERCHPHi R6REEMEHT IF CREDIi UO�CHER
- �- = , ;,_ �,
—�, , _ , ,
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717-766-34Z1 "' � `
,., , ,
�. .
MERCNRNT COPY
Walking with Those in Grief
Robert`Bob"L.Buhrig�JL�FD,Supervisor•William`Bill"L.Christopher,F�
Phone: ��i1)766.3421 • Fax: (7t7)795.7291 • 37 East Main Street • Mechanicsburg,PA]7055 • www.Myers-Buhrig.com • Directors@Myers-Buhrig.com
��
�
J E W E L E R S
Fough;Don And Gail ' Fought,Don Md Ga7
507 Williacns Grove Rd 507 Wiliiams Grove Rd
Mechanicsburg,PA 17055-4129 MechanicsbtQg,PA 17055�129
Phone:717-691-8560 Phone:717-691-8560
Feb 4,2013 263796 Immediate TE AR
1.0 875Q788-081 $165.00 $165.(
estate appraisai for tax
June Marie Holland Biadcmore Price
nov 28th 2012
MasterCard""""""'3742 Approved: (Sf65.0
05444P1163758481::
� --' _ Signature: 4---- _ _______—.._.._- -
Sub Total: St65.o
Shipping: So.o
3780 Trindle Baad�Camp Hill,PA 17011 �7I7-763-1199 T� �'�
1160 Walnut Bottom Road•Carlisie,PA 17015•717-243-4936 Total: 5165_0
4520 Jonescown Boad•Hazrisburg,PA 17109•717-545-7508 paymen� (5165.0(
Balance: �o.o
•___.._.-..
:::., ,. �.�+1�111—i�..R
_ ������Il_..I�TA���...1I.�1��R. -
�� �A.��C�;��T�S
H!(�LY SPIRIT CA�'tDItJV� `�' ULAR INSTITUTE
1Q1 Erford Road
Camp HiN, PA 17011
v. _. _ . . . _ Telephone: {717}724-6450
:F�x: (717)724-6462 '
lanuary�.6,2013
Dear Patient:
We are sending the enciased check to you because we recently iden#ified an overpayment on
your account.
8ased on your heatth insurance pian's determinats'on,the patie»t balance due for the services
� you received was tess than the amount yau paid ta us. We are therefore°issuing tt�is refi�nd
check to you at this time.
If you have questians,please#ee!free to calt our Biliing Department at{717)72�-6462,
Monday thrvugh Friciay,from 8:00 a.m.to 4:30 p.m.
Sincerely,
Julie H.
B€iling�epartment
Telephone: {717�724645Q,e�ct.,1228
r `�
��
COM�--
1555 SuZY STREET
ATTN: LEBANON SUPPORT SBRVICES
I.EBANON, PA 37046 �
�omcds��
JUNE PRICE 21108 0998-26-46-3DG
506 WILLIAMS GRV RD
MECHANICSBURG, PA 1Td55-4100
Ill�l��lu�li��l���ll'�11�����161111'��I'����I�rh6�t'���II'1'I
PAYMENT S�Y
CHECKNa 00102548Q7
ACCOUMNO: 09547-24003201 CHECKDATE: Ql/21/13
IJeaz' JUNE PRICE�
The attached check represents a refund for account number 09547-240d3201 in the amount of
$82.03.
If you are a Comcast ZFINITY customer and hane questions regarding your refund check, pou
can write us at the address above, call Co�cast's toll free customer sernice number at
1-888-COMCAST (1-888-266-2278), or chat with us at www_cofficast.coa/chat. Our
representatives are _available to assist you 24 hours a day, 7 daps a �.reek_
If you are a co�ast Spotlight client or agencp, please contact your local Spotliqht
ofticc.
r .��
�
. DElACHANDRE�AINTFBSSiATEMENT� - �
- - THE ATTACHm CH�K IS IN PAYMEM OF fTE#AS DESCRIBED ABOVE �
. � . IF NOT CORRECT,PlEASE NOTIFY-US PROMRTLY.NO RECBFT DESliim.
.................�-----��---.................._...------........._.....:_..----�--._......---......_............----- (�eeacnHere� .......................:........................._........------�--......._._................--�--........
-��►�o � AcxouM Number 095d7 240032-01-4
8i�ing Date 1212�t12
Totai Amamt[�ae -$82.d3
Paymer�Due by No Pa�t Due,
Page 1 of 2
Cortt�Ct us: + www.COrnc�st.com 1-800-XF1NfT1(
,��,�.. .,.�.�.,��.�:�..�,<„��,���� ,���,.,>�,. .<.,��u,�� ,,�.. ..���.�,�,.�.��..-,m.,,� ,�_Y.��,.�_�.a..,��,�.�,,.�ri,.�..�,,,�t x_,.z,��.
JUNE PRlCE ,
P�vKws Balenr�; 5U.T5.
For service a� Payment- '[2/20112-thank ycw -�0.75
.�i06 WlCi_IAMS CRV R[}
MECNANICSBURG PA 47055�4�1 W New Charges-se+e b�elow -82:03:
:T+ata1 A�c>wnt De.:e . ` ��!.43
News fi om Camcast : P�; , ,
_ yrnent Que.by -No�'ayrne�t[3ue;
Yau have a c�rsdit balanoe of-�.2_03. Make na payrtHant! :�
t3ur r�s irid'�ate that y+�u have a cred�bala�e.A!! �- PartiaE Nlarrth Chat�8�Credits -87.65
dt�i'�t balances of$9.00 or more vvili automatic�lly be -_. _�-` Ch es were made ia yaur ac�ount�is►nonth:,
�efur�d m you. If yo�'Crecl�baiarxx3 is iess then$1.00 See��t`otlou+ing.�agecs fvrmnre details_ �
�
and ynu wrwid�iice us ta send you a r�und,P�e Taxes,Surcc�ttarges�Fees =0.38 0
o�s�#oc�o�e by m�!cyr pt�one wwi�y�-fcxrw�a� -
a��irnss.Hcmrever,�f you a�s�l1 a a.�tt�rr�r,this Tota!New Chacges �82.03
balar�ce will be transfemed ba your neuv acaou�rt. _
HearinSlSPeed►1m�lred Cait 71i ,,E , -, �
^�� . � ., �
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A �
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�����sfi+ Account Number Q9�7 240032-0i-4
���� Payment Due by No Payment Due
�o�eox� Tofial Amaunt Due �82.83
TOLEDO qH 43697-0885
AV 01 013135 45032E 3T A*'Sl)GT Ai110tMt EItC�83'8� �
���Rlij'rr�������11rf�����!!��l�II�11it�i�li�/I'��il":�IIlif�ti� Ma�ke c.hdCks
.3UNE PRIGE PaYabie to Comt:ast
506 WILLIAMS 6RY Rp
n�c�nK�csauR� �n i7ass-�,oc� ' iI�II�I11ri���fi�ii��rtr�l��r1���n11•t�N•�ii�p�•������lli{�����
cancns� c,ue�
P 0 BOX 3005
SOUTffEASTERN PA 15398-3005
�'i54? 240tI32 t�� 4 2 tl��2t13
.... ..... . ..
;:: ;,��C�l�1�. �I���. c.�;u���st�
Hofy Spirit H�sp'ttat - >: _ .. .,:_ .. ,
303 North 21s#Stc�eet 9990d618Lt 3UIUE M PRIGE 24{38&5 0212tPt3
Camp Hi11,PA 17011-2"188 Pa�e 01 Of 01
-
1f�V#91GL:���: . :: ; _<. . "tJaR� :.>:.. IItFYOC�€.?�"Mt3l1N'[ R[S�t}C1i1i�::�kNK�lN't",
' ;:.1Si�T 1i�1E3!�1I�#` >.` <:
HSG-42055574-3516 02/19/i3 688_3i Q.00 688.31
Refund of overpayment.Any
questions,please cali Sophia aY
(71'7)9?2-4785
pate pfservice: 3.'��,��
_�-____-- -
TOTAL $688.31
CONIVERGE,iNC.
539a ��x��r� p�cwA�
S�IITE 30t3
NORCROSS, �A 30092
r�s ,7ur� rxrc� 5021 o�ss-i�-as-sz��
505 WILLIAI�S GROVE RD
MECHANTCSBUR6, PA 17055-4100
��h��tt�ll���i�1nqE�1lI�,�,�iM�lr�l�l�illt���rn����lttl�•r�
P.AY1t2�1�NT SU1l�I1��3�
�p��, U0004PPLQT29738
��Np: 42Q00.42782 ���p�-� IIlO7l22
!� + �
P3ease see enclased letter regarding your 8-pawer Peak Saver incentive
_--------------�--•- _-..,,..... ..._.._......,....__.. (C)etach Here} ..._...,......,.......................... .,....,_........_..._.._....._...---..._....�_._.. ...._......_
' REV-1512 EX+(12•03)
SCHEDUCE 1
COMMONWEAITH 4F PENNSYLVANIA DEBTS C1F DECEDEN'T�
iNHERE-��ce�r��E�ruaN N10RTGAGE �.IAB1kIT1E5, & LIENS
RESIDEN7 DECEpENT
F .�'�c.nG 1n. Q '
FiLE NUMBER
�-�� �t - i� -ia,�
Report debts incurred by the decedent prior to death+�hich remained unpaid es of the date of death,ir�ciuding unreimbursed medica!expenses.
ITEM VALUE AT DATE
NUMBER pESCRIPTION OF DEATH
'. (3�� � J a7:37
s�• �}n�fcc� 6il�f�' �3.�:9�
3. Co.,��a.sf' '�Sd.�S
'� 1��. f�� !�` . . ' rl 2 r o0
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�r. ;��i,l"!L017' �•�� �r�
�. �D/tre p�fu fior�s ,� .Su�rT�ijes �+$`7.lD
� 4Sas� ,G�e�os•f �� ���a/ �35.o0
�' L!�'I �1Q7 7.5"
/a. %w�r ��! �i�r;f lfi�ian [��f �ar� ���•/,�r� '����8'3
/�. �I?�/''�P�1�lG /`"/ed�i"Gs /a L'�'.�oSE Dt.tT C'lc�C'J14�4r�/���"
�y.'rt� �r aa/z �d.a.d. ��j:�f,��
/J�; o�i rn�vss,s� 1�1s l.� ��d+r�t�r �,�D,Do
� �`a/�a,�'on Army fsS aa
C. I'�Kman� so�;u�y � us�,�;s6�rr� �p,ob
�_ SPC� 'so.o�
�,�, Orf�ip�ed;c. �rsf vf �e�nq. �16.l�
I3. uo��e �o/u�iohs � su p p�►es f,.?Z 9(�
��. �'� I� �,.a,rtdsc.q„�:+�y� �t,wrt s ��►ru.� �}a�t►�`z�ta,rt�e �3 o�a. "�`Q
,
�5. �ctt�ec� ��� �'�'sSacU.s. ` �`11.o�F
1�. C�+ut�ro,1 'tt�ed��f..� �q�t,�.� p�G`. '�'x y�t 9
TQTAL(Also enter on line 10,Recapitulation) E '7, 8�x,7�
{!t more space is needed,inserE additio�a!sheets of ihe same size}
� RF_V-1513 EX+(9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESlDENT DECEDENT
ESTATE OF FILE NUMBER
�I�n� M� 4�ric�- �Z1- Ix.-►a85E
RELATIONSHiP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERN Do Not Ltst Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS�include outright spousal distributions,and transfers under
Sec.9116(a)(12)J
1. ��;� l?�- �a�ht c�QU��ter /oo qo
S'o7 6v://i Q�'Is G'rv�� S�d-
/�c°C�ia/1 r'cs��tr�, �!f /70SS
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV-1500 COVER SHEET
n NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LiNE 13 OF REV-1500 COVER SHEET $
(If more space is needed,insert additional sheets of the same size)
., �.e.,, ,M.,,,��..�,.�,x.� - . ,���� �,.�, �,n...� �,..,�.�,� � ,
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I.AS1'Wii,T,A�TA�"OF J lf,�,HC?LL��B��KM0�2E Ffti CE
I,JCTNE H(3LLAND BL.ACKMORE PRICE,of khe Bomug}►of Mechamicsburg,
Curnbedand County,Pennsyivania,being of saund and disposing mind,memory and
understanding,do make,pubiish and declare t2sis my Last Wili and Testament,hereby revoking
and making void any and all priar Wills by me at any rime heretofore made.
L
I direct the payment of all my just debts and funerai expenses as soon after my cleoease as
the same can conveniently be done.
2.
AI!the rest,residue and remainder oI my Fstate,reaI,personai and mixed,whatsaever and
wheresoever situate,I give,devise and bc�queatlr W my beloved danghter,Gail M.Blackmore
I)anieison Fought,per,t�s'r�se ,of the Borough af Mechanicsburg,Cumberland County,
Pennsylvania
3.
I nominate,cxmstitute and appoint my said daaghter,Gaii M.Blackmare Danielscm
FoUght, to be the�ecutrix ot this my Last Will and Testament� in the event that she shtn2ld
predecease me or for any reason be unwilling or unable to act as snch Facecutrix,T nonninate,
constitute and appc>int rny son-in-law,l7onald E,Fought,to be Eac�tor in her place at►d stead. In
[he event that t�sl�ould predeeease me cx'for any tEascx�be vnwilling or unable to act as such
Eacecutar,I nominate,constitute amd appoint my granddaughter,Briana G.Danielson,cwrently of
Columbia,Maryland,to be�ecutrix in his plac�and stead, I fwther direct that they shall not be
requircd to file band or ather security in the Of�ce of khe Registet of Wills for the purpose of
administering my Estate.
IN WITN]FSS Wk�REC7F,I have l�reunto set my hand and seal this •'�� day od'
r ,A.D. 1998. 1����
��:}
JUNE HOLLA B1A ORE PRICE
Signed,se�led,p�ubtished and declared by the above-narned JU2�1E HOI.L,AND
BI:ACKMO�2E PRICE as and for h�Last Will and Testament,in the pcesence of us,who at her
request and in her presence,and in the presence of each other,have hereunw subscribed our names
as wimesses.
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��Sf WILL AND TFSTAMEN'P OF JiJNE HOLLAND BLAC�O_RE PRICE
I,NNE HOLLAND BLACKMORE PRICE,of the Borough of'Mechanicsburg,
Cumberiand County,Pennsylvania,being of saund and disposing mind,memory and
understanding,do make,publish and declaze this my I.asc Wili and Testament,hereby revoking
and making void any and all prior Wills by me at any time heretofore made.
l.
1 direct the payment of all my just debts and funeral expenses as soon after my decease as
the same can conveniendy be done.
2.
All the test,msidue and remainder of my Fstate,real,personai and mixed,whatsoever and
wherescever situate,I give,devise and bequeath to my beloved daughter,Gail M.Blackmore
Danielson Fought,per stiroes,of the Bomugh of Mechanicsburg,Cumberland County,
Pennsylvania.
3.
I nominate,constitute and appoint my said daughter,Gail M.Blacl�nore Danielson
Fought, to be the Executrix of this my L.ast Will and Testament In the event that she shouid
predeoease me or for any reason be unwiliing or unable to act as such Executrix,I nominate,
constitute and appoint my son-in-law,Donald E.Fought,to be Fxecutor in her place and stead. In
the event that he should predecease me or for any reason be unwilling or unable to act as svch
Facecutor,I nominate,consritute and appoint my granddaughter,Briana G.Danielson,currendy of
Columbia,Maryland,to be�xecutrix in his ptace and stead. I further direct that they sha11 not be
required to file bond or other security in the Off ice of the Register of Wills for the puc�pose of
administering my Fstate.
IN WITNESS WHIIZEOF,I have hereunto set my hand and seal this a�!`1day of
,A.D. 1998. � "
y �.,�
v���
NNE H� BIA ORE PRICE
Sigoed,sealed,published and declared by the above-nazned JLTNE HOLI.AND
B1.ACKMORE PRICE as and for her Last Will and Testament,in the p�sence of us,who at her
reqUest and in her presence,and in the prese�e of each other,have hereunto subscribed our names
as wimesses. ,
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CHARLES E. �HIELI}S, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANI�SBURG,PA 17055
GEC)RGE M.HOUCK TELEPHONE (71?} 766-02Q9
(19L-1991� FAX {717} 795-7473
August 27, 2013
Register of Wills
Cumberiand County Court ��ouse
1 Caurthouse Sc�uare
Carlisle, PA 17Q 13
Re: Estate of June 1YI.Price
No.21-12-1284
Dear Register of Wi11s:
Please find er�closed for filing 2 capies af the Inheritance Tax Return for the June M.
+ Price Estatc as well as Check No. 002 i�1 the amount of$15.OQ for the filing fee, Check Na. 003
� in the amaunt of$270.00 far additianal Probate and Check Na. 1329 in t1�e amaunt af$5,447.54
• for the Inheritance Tax due.
Th�nk you for your kind attention ta this matter.
Very truly yours,
�������
Charles E. Shields, III
Attorney-At-Law
CES/mjj
E;nclosures �
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