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b+�w^'^N.^a: Weilman, Lilian J.
EGAPITULnnoN
1. Real Eatate(Schedule A)....................................................................................... 1.
�. st«�s a�a e�r,as{sd,eau�e s�............................................................................. z. 1,a a o,s as. s 9
�i. Cloaely Held Caryoretion,Partnership or Sok-Proprietonhip(Schedula C)......... 3.
�
�4. Nlortga9��Nates Recaivable{Schedub D)................_......_.............................. d.
p. Caah,Bank Deppsits&Miscallaneous Personal Praperty(SClredule E)............... 5. 214� 744 . 3 6
I
. JoiMly Owrred PropeetY(5cl�duie F} ❑ SeParate Biliin4 Requeated............ 6.
. Inter-Vivos Tranefers&Miecelianeous -Probate Property
(SChedula G) � Separate Billing Requested............ 7. 601�704.$1 �
roar c,roas assaes{rotai�ines�tnrou�n n.............._..............................,......... s. 1,857,033. 8&
. Funerel Expensea and Administrative Costs(Schedule H).................................... 9. 44 , 665 . 84
t . Debts of dacadeM,tuiortg8ge liabilities arM tie�s(Stheduie 1}............................ 10.
1 . Tdtal Deductlons(total Lines 9 and 10)................................................................ N. 44� 665.84
1 . Net Value of Estate ilina 8 minus Li�e 11}.......................................................... 12. 1�$12�367 . 22
1 . Charitable and GavemmeMal Bequests/Sec 9113 Truats for which
an election to tax has not been made(Sthedule J)............................................... 13. 32 r 50Q.00
1 . Net VNue Subjibct to Tax(Line 12 minas Une 13)............................................... 1d. 1��7 9�tf�7 . 2�t
T COMPUTATION-SEE IN8TRUCTION3 F�R APPUCABLE RATES
1 . Amount of litre 14 taxabb
at t�e Spovsai tax rate,or
trensfers under Sec.9116 15 � , d O
(a)(1.2)X.00
1 . Amount of Csrse 14 taxabie
at lineai rete X .4a5 a• a� }$. 8.��
7 . AmountofLine74taxaDle 88�, 718 61 n 10fi 806.23
at sibling rete X.12 r i
� . .amauntottioelat�ab�e 898 148. 61 1s. I34 ?22 .29
at Cailatarei rate X.15 � �
7 . TAX DUE................................................... __.._................................... 19. 240,528. 52
I� 20. FILL IN THE OVAL IF YOU ARE REqUE3TING A REFUND QF AN OVERpAYMENT. �
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1505610243 1505610243 �„�
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REV-150 EX P�ge 3 File Number 21-13-04$0
Dec Ys Camplste Addrsss:
DECEQE SNAME
eilman, Lilian J.
STREET DDRE5S �
3�5 Weslay E7r�ve
�1� STATE ZIP
echenica�rg PA 17p55
Tax Pa t�ds and Credlts:
1. 7ax D e(Page 2, Line 19) (1) 240,52$.62
2. Crod' aymenfs
A. P Payments 22d,841.33
B. Di count 11,833.76
Totai Grediffi{A +B} {Y} y$g,$[.�,�9
3. Intere$t (3)
�
d. if Wne b grooMr thsn Line t +�in,p 3,ertter the tlifierenoe. This is the OVERPAYMENT. {d)
Check box on pape 2,Line 20 to roquest a refuntl
5. K lina +z�ne 3 is greater than Line 2,enter the dHteronce. This is the TAX DUE. {5} $�$�$,��
Make Check Payable ta: RECiISTER QF WIk.LS, ACEN7.
PL�ASE ANSWER THE FQLLOWIN(3 QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
I1. 6id deceder�#make a iransfer and: Yes Na
a. refain the use ar income oE the ProperiY transferred�...............................................................................
b. ret8in the right to designate who shall use the property trensferced or its income:......................._.........
a retain a reversmnary iMerest or..................................._..............._......................................_................. x
d. receive N4e pramise for Iite of ei�er papnerrta,benetits or taro?.........................___.............................
2. If death occumed aftar pec. 12, 1982, did decedant transfer property within one year qf death without
receiving adequate coneideretion7.................................................................................................................... ❑ �
' 3. OM decedant own an"in Wst foP ar paya6ie upon death benk account or security at hi�or her death?....... ❑ Q
I 4. pid decedent ffwn sn individuai retirement acxouM,annuity,ar other non-pro6atd property which
� contains a bdneficiary desqnation?....................................... .......................................................................... � ❑
� IF THE AN WECt TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLEiE SCHEDULE G ANp FILE IT AS PART OF TME RETURN.
For datea o death on or aftet Jury 1,1994 and before Jan.1, 1985,the tax rate imposed pn the net v�lue of transfen to or Ppr the uaa af the surviving
spouae is 3 percent[72 P.S.§9118(a)(1.1)(i)].
Fcr detes c death on or after January t, 1995,the tau rate 6nposed on the net value of transfers to or for the use of the surviving spouae is 0 percant
[72 P.S.§9 SS{a}(1.1){u'}]. The atatute does r�e�m�a transter to a surviving spouse from tax,and tha statutory requiromerrts tor disUOSUre of
assets end ling a tax retum are still applicable even if Me surv'ning spouse fs the ony beneficiary.
For datms o death on or after July 1,200p:
•The twc p�p�ed 4n the net vaiue M transfers ham a deceased child 21yea rs of age or you�ga�at death to ar tor the use of a naturai pareM,an
sdppkive pare,t or a ateppereM of tha child is 8 pert�t j72 P.S.§9118{a){i.2}j.
. Tha tax te impoaed on th�net value of transfera to or for the use of the decedenPs Ilneal beneflciaries is 4.5 percent,except as noked in
[72 P.S. 9716(a?(�)1�
.The twc impa9ed a�tht net value cf tra�sfers to or for the use of the deoedenPS a�ii�s is 12 perce�rt(72 P.3.§$116{s){1.3). A
s�a8ng is tlefined under Sectwn 91d2,aa an indiWduai vfio hgs at ieaet one pa4ent in c�mmon wlth the dac�dbnt,whether by bi or adoption.
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�' 4850�D41046
,,,,� ftEV-d65 EX(05-�t}
SAFE DEPOSIT
BOXINVENTORY
PADepaRmentotRevenue � PLEASE USE ORIGINA!FOPoM ONLY
S ' i Security or Death CeAiBcate hlumber Dafe of Death Covnty Code Year Fiie Numbsr
o G. mG� 9 5,� SO
pe edenCs Last Name � Su�x First Name M�
c t �••k/q- x! ,L t j1,9-s� �`
ADDRE�OF�CEtiEN7��TRE�TG.. ... .. .... .. . . . ... .. . , ..��... .. . . . . � STATE: ZIPCpDE:
� w+(. �ZN�f H. D �
NAME AND AD6RE63 OF PERSON�RE� ES NG THE QPENINLG 6F TH£9AFE DEPOSIT 9QX
NAME: /Y� •It /,I I /'S/Q-R.I✓�A'#�T -
� �•�Z�• 7y, $IQTE, ZI7 CODE:
' STREETADDRE : 7— ��
t �I
+ NAME,ADDRESS AND RELATtO!lSNIP{iF ANYi TO OECEQENT,OF PERS4N(S}P SENT AT TFiE 84X OPENiNG
� a. NAMEi / . � �. RELATION�iP:c� .
�.
STREETADDRESS. Gt7Y: TATE: ZIPCODE:
�� 5�-!aJ �� � <G ai2.�2 �i4- IG a Z s
b. NAME: RELATION$HIP: . .
• ( STR£ETADDRESS: C�TY: STASE: ZAPC4PE: �-.
�'. c. NAME: RELATIONSHIP: . ..��'...
� ( STREETA6DRESS: CIN: STATE: ZIPCAOE: '
NAM@ AND ADDRE89 OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSR BOX IS LOGATED '
�„�: p �
'� STREETADDRESS: Ci7Y' � STATE: ZIPGODE: '
� e e�c �4 �aw �R- o .�y"'S
tiAME pF PERSON MAK G LAST EN1'RY . � � DATB AlID��IME OF EN7RY
! K �
. DATE OF ONTRACT O RENT BO% • NUMBER OF BOX 1 TIRE UNDER ICH BOX 1$�O FST
Z.- � ~
NAM£ ADDR 95 OF PER80N{5}HAYIN6 ACCESS Tb HOX
a. NAME: �J / b. NAME: .
� !�I A^r✓ � 1'�`C//�19 R /L"� , .
'�� STREETADDRESS: STREETADDRESS:
3� c L�/,. t�/�y D�,:��
.. GiTy: SFAjE: ZIP CODE: CITY: 97ATE: ZEP GQOE:
�✓ /'J T
NAME ANO TRLE OF EMPLOY 7AKING E INVENTQRY �
WAS A WIL tN 7tiE 60X? ❑ YEB. �NO if yei, a. 6ata of wiii:
b. Nsme a�d address of personal representativo,If namad I�n^the wlil J / '
( NAME;,�j'lR�Q� �L�1�Y�I/i—� IYT�/X"H/A'�*f � .
L � /
STREETA�D��ftESS: �C! � I\C� ^ .l CITY: �� IG/ L�
3 _�— � `"/.�t.co�4r¢ .i".
c. Nama and addreaa et attorney,If any - . �
NAME:
STREETADORE55: - GTY: � S7ATE: ZIPCODE�.
� 485C]���+���6 48SC1��41046 �
�
, . . _ _ .
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REV-48 Ex SAFE DEPOSIT BOX INVENTORY Page of
lNSTRUCTIONS
(1� Cash: Reporl to�al only. . �
(2) Stocks: List in detail every common or preferred certifcate,warrant or other rights found in box.Stocks are to be designated by
name of company,certificate number,date o!certiFCate,name in which stock is registered,and number ot shares and class of stock.
(3) Obligations of LLS. Government: Number of items,date of issue, face value, names in which regis[ered and type of ownership, .
i.e.,jointly held,payable on death, eta �
(4) Bonds: Designate by name,amowt,serial number,or other designation.(Bearer Bdnds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number oi book,last date appearing in book, name of bank
and branch,and balance. �
(6) Jewelry, Coins,Stamps,Manuscripts,etc: List and descnbe as fully as possibie.
(7) Deeds,Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible.
(6) All other contents.
9) Return completed fortn to: DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT.280601
HARRISBURG,PA 17128-0601
ITEM �TEM DESCRIPTION
NO.
�� � lc < < o
Z 1� ov .� n1t - -fm - c
R�.J -�'
a � �
nit t.e�t P w rVt
i[ vN 't u it 4
7 L'4✓tT
,4 u� ( �
/
I'�'1 ef 1 �F'
i i� r
��t
t S
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I CERTI Y UNDER PENALtt OF PERJURY THAT THE ABOVE RECORO IS PERSON RECEIVING COPY OF
CORRE T ANO COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSR 80X INVENTORY:
SIGNAN E � SIGN/TURE �
/� ✓ i G�
PRINT NA E PRMT AME ANO CMECKAPPROPRIATE BOX BELOW:
� L�
PRINT TI E OATE CHECK APPROPRIATE 80X:
�/�� �3 �Executarprix� �AaminisVamqtrix) '
G � �Eclele Reprosentetive ❑Joint owner of sefe tleposlt Cox
!V
NOTE: Attach additional 8'/:"x 11"sheet(s) if necessary or use dupiicates of this page of form.
The Depa ent is authonzed by�aw,42 U.S.C.§405(c)(2)(CKi),�o require disclosure of Saial Secunly numbers in conneclion wlth administenng state tax laws.The Depar6nen�uses ihe
Social Se nry number to idenUfy Me decedent and personal representatives of the estate.The Commonwealth may also use the informafion in exchange of tax information agreements
. wiM Fede al and local�zxin authodNes.The state law rohibik Me Commonwealth's ersonnel from disclosin canfdentlai taa inlortnaGon except fa offidal u ses.
_ _ _ _
R�v-7603 ♦�6-88)
� scHE�u« s
STOCKS 8 BONDS
coMwom�Kn'oF voasnv,wu
MlEPRMICETNf IiEMiH
MENOENiOECEDEM
ESTAT OF FILE NUMBER
Heilman Lilian J. y�_13�p
ai prop.ny�aonr<wo.a.wm eaM a.wavo�nin m�.e e.a.uw.a o�son.a�H F.
ITEM CUSIP VALUE AT DATE
NUMBE NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 Stlfel Nicolaua Investment Account-Date of death balance 1,040,583.89
per attached ifst from SUfel Nfcolaus. Please note,the two
(2)Jackson NaBonal AnnulUes are reported on Schedule G
of this Pennsylvania lnherifanaee Tax Retum and are
therefore not included in this toWl.
TOTAL(Also enter on Line 2.RecapitulaUon) 1,040,583.69
pf more apace Is neeCad,atltlitlonal pepea of the same size)
Copyright c)2002 form software onty The Ladcner Group,Inc. Form PA-1500 Schodule B(Rev.698)
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Rav-1608 +�t7-0O) .
SCNEDULE E
nnsylvania CASH, BANK DEPOSITS, & MISC.
EPARTMENT OF REVENUE
1 HERITANCETAXRETURN PERSONAL PROPERTY
ESIDENT DECEDENT
ESTAT OF FILE NUMSER
Heilman Lilian J. 21-13-0480
maua.me woaeCe a�iliw�m.ro m.au u,e aro«.e..+re rec.ivatl bv u»eswe.
NI P�YIa��HownW wHh tlro rlpM of wvlwnhlV�q M dltebm��on�ehW Wa F.
ITEM VALUE AT DATE
NUMBE DESCRIPTION OF DEATH
7 Comwst-partial share 69.03
2 Commonwealth of Pennsylvania-atate retlrement payment 804.75
3 Frontier-partlal share 66.96
4 PNC Bank-Certificate of Deposit No.31300289975. Date of death balance 55,985.94; 5.988.07
accrued interest 52.07
5 PNC Bank-Cerdflwte of Deposit No.31900303603. Date of death balance 511,819.71; 7 7.820.00
accrued inteiest 50.28
6 PNC Bank-Checking Account No.5000978437;date of death balance SE67.B43.02;accrued 67,843.02
interest 50.00
7 PNC Bank-Savings AccouM No.5000862667,date of death balance 511.361.75;accrued 7 7,362.26
interest E0.51
8 PSECU-Savings Accour�t No.83 7 5035201 7 66(S1)•principal balance at dats of death 11,701.35
$77,700.55;acerued IMerest�.80.
9 PSECU-CD No.8315035201786(CD 50)-principal balance at date of�ath E27,752.83; 27,752.93
accrued fnterest aa.za.
10 Wells Fargo•Checking Account No.XXXX4609. Date of death balance 558,529.83;accrued 58,529.88
interest 50.05
11 Wella Fargo-Savings Account No.XXXX4163. Date of death balance 520,945.23;accrued 20,945.29
interest 50.06
12 Coins -per appreisal 197.50
73 Penonal Property-per approisal 1,660.00
Total of Continuation Schedule $�ey'��w�
TOTAL(Also eMer on Line 5, Recapitulatlon) 214,744.36
(tl mae space Is neade0,atltlitlonal papes of the seme size)
Copyright )2010 fortn software only The Lackrrer Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
r
Rw-0b98�r{tt-00}
scH�du�E E
ennsylvania CASH, BANK DEPOSI7S, � MISC.
M'TMENT OF REVEMUE
xERRAN�E„�RE,� PERSONA� PROPERTY
ESI�ENT DECEDENT .
continued
ESTA 4F Fltf NUMBER
Heilman Lilian J. 21-13-0480
NUTM�BME DESCRIPTION VA�F p���
14 Petsonal ProperEy-aold by Allegheny Gaileries Constgnment 7,238.77
15 Asbury-Refund 676.61
1& CaroMark-refund 18.00
17 Penn Treaty-insurance refund 79.80
I
I
TOTAL(Also ente�on Line b,Recapitulation) 214,744.36
CopyrigM }2010 torm sollware onty The tackner Group,Ina Fortrt PA•1SOD ScheQule 8{Rev.11-50} .
_ _ . __
_
May. � . 2013 6:58AM PvC Baok ___ �_ d��� p._
I "
�III
� .
II �.����
i
ay 13,2013
ames D Bogar Esq.
ttomev at Law
ne West Main St
�iremanstown,PA 17011
: Lilian J Heilman
SSN: 206-09-9050
bOD; 04-11-2013
ear Mr. Boger:
response to your request for Date of Dearh (DOD)balances for the customer noted above, our
cords show the following:
�cate of Depos[t
ccount#313002B9975 Estsblished: 04-12-2006
LlI,LAN J HEI[,MAN
OD balana: $ 5,985,94+2.07 accrued znterest
terest paid 01-01-2013 thru 04-11-2013 $ 6.22 Y'T'D
ccount#31900302603 Established: 09-07-2006
LII.IAN J HEII.MAN
OD balance: $ 11,819.71 +0.29 accrued interest
terest paid Ol-01-2013 thru 04-1]-2013 $ 16�8 Y'�D
hecking Accouut
ccpunt�5000978431 Established: 03-Z2-1999
LILIAN J HEILMAN
OD balance: $ 67,843.02 T 0.00 accrued interest
terest paid O 1-O 1-2013 thru 04-1]-2013 T 1.47 Y'I'D
avia�s Account
ccount# 5000962667 Established: 10-29-1999
LTI,LSN ) HEII,MAN
OD balance: $ 11,361.7i+O.S l accnted 'utterest
terest paid Q1-01-2013 thru 04-11-2013 $ 2.52 YTD
Pege 1 of 2
Mz.y 1�. 20�3 F: 54AM _.PNC °ank _ �!e. dFC2 e. 2 _
I
�I
afe Deposit Sox
decedent maintained safe deposit hox #0081 S
LFLIAN 7 HEII,_NL4N
ocated at:
etheny Village Branch
?5 Weslep Dr
echanicsburg, PA 17055
717) 691-4087
lease note$taz this office provides date of death balances for deposit accounts(IRAs, CDs, Checking and
a�ings). We do nor process any Lnauciel trsneactioos or provide statements. If'you need assisrance wi$F
y of these items,please call 1-SSS-PNC-$ANK(1-888-762-2265) or stop by your local PNC Bank btancb
ffice.
iacerely,
ational Financial Senrices Center
NC Bank,Iv A. .
ember FDJC
is message is intended for the use of the iredivia5.u1 or entiry ro which, it is addressed and�nay
ontain infornzation that is privileged, confidentzal and uempt from disclosure under applicable low.
the reader of this message is not the inlended recipient or the employee or asoent responsible for
ln�ering rhis message to the intended recipien[, you are hereby nohfied lhal any disseminadon,
istributian Or copying Of thi,s eommunieations is sirietl��prohibired. If you have received rhts
ommunication in error,please nofify me immediately by reply or by telephOne at 800-%62-177� ond
i mediately destroy this.faxed document.
Page 2 of 2
_ _
II o
�� PSEC�
,
�
09/20/2013
James D. Bogar
Attorney at Law
1 WestMainSt.
Shiremanstown, PA 17011
Re:LILLIAN HEILMAN,Deceased.
PSECU Reference#8315035201186
Deaz Attorney Mr. Bogarr
The above referenced person has an account with PSECU which was opened on 5/12/1964.The Share
accounts were individually held by LII,LIAN HEILMAN.
The following aze the Date of Death Balances for LILLIAN HEILMAN's account with PSECU:
Accoun[ Date of Death Balances Interest—Aprit 1- 1 Ith
Savings (Sl) $ 11,900.55 $0.80
CD50 (CD 50) $ 21,752.93 $8.28
If you have any questions,please contact our deparhnent tol4free at(800)237-7328,press 6,extension
3120 or email accountservices c(�osecu.com.
�cerely,
Sandy Fa
Member Service Representative
PSECU
1 CREDIT UNION PLACE, HARRISBURG, PA 17110-2990 i00.207J34i »pSeCU.COm
THIS CREDIT UNION IS FEDERALLY INSUAED BYTHE NATIONAL(flEDIT UNION ADMINISTRATION.EQUAL OPPONTUNITY LENDER.
� n.ceneov.mu�in
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S�z�3
5 l0/2013 LILIAN HEILMAN ESTATE
C ins Received:
� w
6 .S. Silver pollazs � S 3 �
1922
1922
1922
1882
1882
1882
4 .S. Pennies � ��--
3 .S. Coins(2 mazked .7 with sticker/1 without sticker) yl `'�=—
all with Indian Head on front
3 .S. Nickels 3 s�,
2 -Buffalo Nickels
1 - 1883 (V on Back)
1 .S. HalfDollaz �=
/S
vy
9 iscellaneous Unidentified Foreign Coins �S� �
T�–�.ti-t. V�A-�-�'`'�– � � 1 �
.s��
�,(!�l<<�-�..� G • � ,.--�
__ _ __
� __ _
�
LINDEN HALL ANTIQUES
i 2�4 N.OLD STONE HOUSE ROAD
CARLISLE, RA 77075
I 717-249-1978
o: James D. Bogar, Esquire
Bogar&Hipp
One West Main Street
Shiremanstown,PA 17011
F m: William G. Rowe,Appraiser
211 N.Old Stone House Road
Carlisle, PA 1�015
e: Peraonal Property Appreisal
Lilian J. Heilman Estate '
Date of Death-April 11,2013
D te: May 9,2013
ree-stem floral wall hanging-metal $15.00
P 'nts(2)-floral-gold frames gq0.0p
B ,crystal-heigM B"-not signed $15.00
F gurine,Madonna-porcelain"Llardro"Spain ygp,pp
D r items(2),small ring box&lattice bowl y�0.pp
R np box-smaH glaas owl-small vase,3 items $Zp,pp
ace-1859 PoAugese coin �rp.pp
P n-frame Portugese coin 535.00
S box(2)-cbnteMs small porcelain flowers §�5.pp
R ng-14 caret white gold-brillieM cut diamonds,ceMer diamond.8 carat
2 side diamonds .4 carat each $�,35p,pp
TOTAL $1,860.00
�� l
William G. RaNe
Heilma Appraisal 1 05/09/2013
rz..-,a,u�.{osaa}
scH�ou�E �
nnsylvania lNTER-VlY�S TRANSFERS AND
ARiMENT OF tiEVf,MUE
,T,w�Etr��,,,w+ MISG. NQN-PROBATE PROPERTY
ESIDENT DECEDENT
ESTA OF FILE NUNIBfR
Heilman Lilian J. 21-13-p480
m�s.craa,b�wu w cwrobme.r�aebe�ru,e vwwxm am or a�msn«+:i enrw,�n a o�,pape mraa oraa Rsv.�sao�s roa
�
�pq {�p �(� DESGRIF'1'I6N OF P�R�OPERTpYp� DATE OF DEATH x ov oecvs �G,us�oN TAXABLE
NUMBE j�{�pp�pF 7pµg�q,Sq�EN A COPV pFTTHE DEED FpR REAEESTA'IE. VALUE OF ASSET IMERB$T (�p ppp���pg�) VALUE
1 Jaakson Nadonai Life-Annuihr Policy No. 266.823.87 286.923.87
t002325293. Lisa Nellman-Coaslia,ttre DecedenYs
niece,is the beneflciary of this policy.
2 Jackson Nationa!life-Mnuity Po1Fcy No. 298.976.2T 298,9T6.27
100312Ei500. Charyt Beimhart,the DecedenYs niece,is
the beneffcla�ry of this policy.
3 MetLlfe Annuity-Car�tract Na.Sd8004438.Date oi` 36,504.8T 35,804.87
death value 535,804.87. Charyl BemhaR and Lisa
Hellman-Couslio are the named beneflciaries of thls
accouM.
�
I
TQTAL(Also eMer an Line 7,Recapitulation) 601,704.81
(@ mme sp�e k(reeead,adaitionst pages ottne sanre size}
Copyrlght{ }20Q9 torm softwere onty The Lackner Grovp,Inc. Fortn PA-1606 Schecfule G(Rev.08-09}
1— _ _ _ _ _ _ _
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M ife
P. .Doz 70366 MetLi f eb
D Moines IA 50306-0396 _
I
September 18, 2013
C ERYL H BARNHAR7 � �
331 STEIN RD
C IGORA PA 16025
R : METLIFE INVESTORS INSURANCE COMPANY CONTRACT 940004435
DECEASED LI�IAN J HEILMAN
D r Ms. Barnhart:
Tf ank you for your recent inquiry regarding the co�trad reTerenced abovo, Our recards indicatc thal the
da e ni death and the acoount valuo on[hat date are:
Date of Death:M11/2013
Acwunt Value:$35,804.87
If ou have any queslions, please contact your representative or call our Customer Service Ce�ter
at -800-255-9448(Fixed Line)Mondey lhrough Friday between 8:30 a.m. and 6:30 p.m., ET.
Si cerely,
C urtney Gorden
Sr Annuiry Represenlativo-Post Issue Processing
M tLife Anrtuity Operatians and Servlces .
Hal us atay connectod: Pleaee keep ua updetad wfUi respeot fi all who are aasociated with Ihis contrect inGudi�g the awnar,the
en itnn4 an�f nny beneflclarias. Maka siro Nal wa havo fhQ following irrtarmafion for all persons or entities; name,addr�s.
ph e numbxr,dnte of birlh,and sor.ial cocurlty w tax IdrnUflptlon number. Ch�agae may be eubmiltatl to the addres+pro�dgtl
abo a,6y calling our CusWmef ServiCe Cenlef al Ihe phone roimber prtrvlAqA ahnve,or hy mnlactlng your RepreaonhaHva.
�v.�a�i .t�am�
ennsylvania �HEDULE H
EPARTMENTOFREVENUE FUNERAL EXPENSES AND
° sER�r��iFr'"f`" ADMINISTRATIVE C{�STS
ESTkTE OF FILE NUMBER
Hsilman Ulian J. 21-13-4480
Decederrt's debts must be naported an Schedule i.
ITEM DESCRIPTION AMOUNT
p. FUNERAI EXPENSE3:
(
Sae eon#inuatian schedule{s)attaahad iff,4sg•3�
8. AbMINISTFtAT1VE COSTS:
1. Peraonal Rapresentative'a Commissians
Name of Pereonal Repreeentative(s)
Streat Addreas
City State Zio
Year(s)Commission Paid
p, Attomev's Fees Bogar d�Hlpp Law OffiCBS 24,150.00
g. Famiy Exernption: {if decedent's address is nat the sama as daimant"s,attach explanation}
Claimarit
� StreetAddress
- City Stste Zio
Relationshfo of Claiment to Decedent
4. Probate Fees 588.50
5. AaountaM's Fees
& Tax ReWm Prepanets Feea
�
7. 6ther Adminiatrativa Costs 9,478.03
5ee caMtnuation schedu�(s}attached
TOTAL(Alsa eMer on Ilne 9,Racapitulatlon) 44,665.84
Copyripht{ }2009 fortn software onty The lacknar Group,Inc. Form PA•160Q Scheduk H{Rev. 10-09}
�
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIYE COSTS
continued
ESTA OF FF�E NUMBER
Heiiman Lilian J. 21-13-0480
�
ITEM
NUMBE DESCRIPTION AMOUNT
funenl Exnansas
1 ' Bethany Village -memoria!serviee 248.87
2 8ueehele Funerat Home-funerel bill 10,221.00
H-A 1o,a68.31
3 AMrt Pharmacy 5.44
A Aebury(Bathany Vlllage} 1,438.26
5 AT&T 55.57
6 AT8�T 18.42
7 Bill Rowe-fee for appralsal 65.00
8 � 8uchek Funeral Hane-fee for additlonal dea#�caKifieate�s 90.00
9 Gara Pharmacy 11$.99
I
10 Cumberland Law Jaumal-Executrix's Natlee 76.00
11 PedEac-aost ta mal!items tc i.isa F�iman-Coasiio 95.85
13 FedEx 24.80
�
13 Hampden Physicians-medicai bili 58.01
14 Iit3-eatimabsd 2013 fadenl income taxea 1,391.00
I
I
I
CopYriqM )2Ck72 fwm saRware only The lackner Group,lna. Fnrm PA-t60D Schetlule H iRev.8-98)
(
_
i
I SCHEDULE H
; FUNERAL EXPENSES AND ADMINISTRA7lVE COSTS
; conti�ued
�,
ESTA OF FIIE NUMBER
Heilman Lilian J. 21-13-0480
ITEM
NUM@E DESCRIPTION AMOUNT
15 PNC Bank-transfer fee 15.40
1& Regiater M Wiils-2 8hort Certiflca�s 10.00
17 RE$ERVES:•CoaM to aonclude adminlatration of Eetate including preparation of final 2p13 4,5q0.00
Penonal Incpma Tau Ratum and payment of taxes,Nling fee for Cou�k Accourking,
preparation and fiiing of Fiduciary Incoma Ta�c Retums
18 Stlfel Nicolaus-wirra trensfer fee 15.00
19 The Sendnei-ExecutriXs Notice 15T.68
20 UPS-letter seM to Charyt and HowaM 8arnhaet on May B,2015 28.53
21 U3 Postal Service-certified mail to PNC and Dept of Revenue re Safe Depoak Box Inventory 12.22
22 U8 P�tal Serv3ce-priority mail ta Charyl Bartrhart fara+arding colns 8.80
Z3 Verizon 8.39
24 Ve�Izon 1,296.77
H-87 8.a�8.03
(
�
I
Copyright }2002 farm software anty The Lackner Group,ina. Form FA-ibOD Scheduia H{Rev.B-98}
Rer-�aas t{m.�at
enns ania
EPARTI���N�� SCNLDULE J
� rra+ceTwc�roaH BENEFfC1ARlES
ESl6ENT pECE6EN7
ESTAT OF FILE NUMBER
Heifman Lilian J. 21-13-448Q
REIATIONSHIP TQ
NAME AND ADDRES3 OF SHARE qF ESTATE AMOUNT OF ESTATE
NUM ER pERSON(Sl RECEIVINCr PROPER7Y DECEpENT �o�s� ���)
;i TAXABLE piSTRIBUTIONS [inGutle autright spausal
d�trdru6tms,afu!transfers
under Sec.8116 n 12
� See attaahed scbaduie
Totai
E II� ounts kr utlons shown abave on linas 15 throu h 18 on Rev 1500 cowr shaM as ro riaie,
NON-TAXABIE DISTRfBUTIONS:
1T. A.SPOUSAt 6ISTRIBUTIONS UNC}Eft SECTIQM 4413 FdR WHICM AN ElEGT10N TQ TRX IS NOT 7AKEN
B.GHARITABLE AND GQVERNMENTAI DISTRIBUTIONS
1 Bathany Vliiage Caro A�urance Fund '10.{lOd.�
2 Ameriean Red Cross 7,500.00
3 American Cancer Society 7.500.00
i � Market Square Ptesbyterian Chn�h 7,5d0.00
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4TRL PART II-ENTER TOTAL NON-TAXABIE ptSTR18UTIONS Oti UNE 13 OF REV-150Q COVER StIE 32,f�4i.40
Copyright{ )ZO10 fortn soltware anty Tha Ladcnar GrOUp,Inc. Fartn PA-15q0 Schedute J{Rev.91-i0)
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BENEFIGIARIES
I (Part I,Taxabie Dlstributions)
ESTA OF:
Lillan . Heilman 04/11I2013 206-09-9450
ftem Name and Addresa of Person(s) Share of Es#ate Amount of Estate
Numbe Rsceiving Property Relatlonship (Words) (SSS)
1 Charyi N.Bamt�rt Mlece One-haif of rest,
331 Stein Ruad residue and romainder,
Chlcora, PA 16025 plus 3 diamond dinnrIDr
rfng
2 Lisa Hellman�Coaalio Niece 1847 Portugese coin on
5 Greenway Clrele necklace,Lladra
SacrameMO,CA 95831 figarine and othar
mementos af chaca
3 Guy G.Heilman Brother Ona-half of rest,
cto I.Isa Hsllms��ozzalio re:idus and remainder,
5 t3reenway Circ{e pius 2 portolain
Sacramento,CA 95831 piatures,Onfer
8wedtsh eryatai,2
Herrand cWisc�b�s
and memento of choice
4 � dorls Herre Friend Spec{fic beqt�st of 2
484 GraysWns Orive flarol picWres 8 tuflp
HaMeburg,PA 77112 sculpture
5 I Ka�ryn P3oggia Ftiend Specific beqt�t of 8a#
348$upartown Road Gresk pin
Devon, PA 19333
$ Wemiy SMarer FHend Spetific bequast of
5209 Locwt Lane E15,000.00
HarMaburg,PA 17108
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LAST WILL AND TESTAMENT
OF
LILIAN J. HEILMAN
I, LILIAN J. HEILMAN, of Mechanicsburg, Cumberland
County, Pennsylvania, make, publish and declare this as and for
Last Will and Testament, hereby revoking all other Wills and
C dicils heretofore made by me.
FIRST: I bequeath such of my tangible personal prop-
e ty as is set forth in a separate dated and signed Memorandum,
w ich dated and signed Memorandum shall be placed with or at-
t ched to this, my Last Will and Testament, to the individuals
d signated therein. It is my intent that the last dated and
s ' gned Memorandum shall control . If there is no Memorandum, it
i my intent that all of my tangible personal property shall be
a d become a part of my residuary estate.
SECOND: I give and bequeath my three diamond dinner
r ng to my niece, CHARYL H. BARNHART, provided that should she
p edecease me, then to my niece, LISA H. COZZALIO.
� THIRD: I give and bequeath the sum of fifteen thousand
� (� d llars ($15, 000 . 00) to my friend, WENDY SHEARER, of Locust Lane,
s
�� H rrisburg, Pennsylvania 17019, provided that should she prede-
, � c ase me, I direct that this specific bequest be and become a
�j
p rt of my residuary estate to be distributed as set forth in
� C ause EIGHTH hereinbelow.
'�,\ F TH: I give and bequeath the sum of ten thousand
a ( 10, 000 . 00) to the Bethany Village Care Assurance Fund, of
�' M chanicsburg, Pennsylvania, for general purposes as the
govern-
! C i g body of that organization deems appropriate .
` FIFTHs I give and bequeath the sum of seven thousand
five hundred dollars ($7 , 500 . 00) to the American Red Cross, Pa
C pital Region Chapter, of 1804 North 6th Street, Harrisburg,
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ennsylvania, for general purposes as the governing body of that
rganization deems appropriate.
IXTB: I give and bequeath the sum of seven thousand
ive hundred dollars ($7, 500 . 00) to the American Cancer Society,
f 3211 North Front Street, Suite 100, Harrisburg, Pennsylvania
7110, for general purposes as the governing body of that organi-
ation deems appropriate.
SEVENTH: I give and bequeath the sum of seven thousand
ive hundred dollars ($7, 500 . 00) to the Market Square Presbyterian
hurch, of 20 S . 2nd Street, Harrisburg, PA 17101, to be used for
ission work.
EIQHTH: I devise and bequeath all the rest, residue
a d remainder of my estate of whatever nature and wherever
s ' tuate, including any property over which I hold power of
a pointment and together with any insurance policies thereon, as
f llows :
(A) Fifty percent (50�) thereof to my brother, GUY G.
� H ILMAN, provided that should he predecease me, then to my niece,
L SA H. COZZALIO.
� (B) Fifty percent (50�) thereof to my niece, CHARYL H.
� B HART, provided that should she predecease me, then, in equal
�'� s ares, to her children, JASON BARNHART and TODD BARNHART.
���
\ NINTH: In addition to all powers granted to them by
�, 1 w and by other provisions of this Will, I give the fiduciaries
� ting hereunder the following powers, applicable to all proper-
! t , exercisable without court approval and effective until actual
�
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d stribution of all property:
�1 �' (A) To sell at public or private sale, or to lease,
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f r any period of time, any real or personal property and to give
o tions for sales, exchanges or leases, for such prices and upon
s ch terms (including credit, with or without security) or
c nditions as are deemed proper. This includes the power to give
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legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
a d to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
i pose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
a andon any property which is of little or no value.
(D) To invest in all forms of property, including
s ocks, common trust funds and mortgage investment funds, without
r striction to investments authorized for Pennsylvania fiduci-
a ies, as are deemed proper, without regard to any principle of
d'versification, risk or productivity.
(E) To exercise any option, right or privilege granted
i insurance policies or in other investments .
(F) To exercise any election or privilege given by the
F deral and other tax laws, including, but not necessarily being
1 mited to, personal income, gift and estate or inheritance tax
\�� 1 ws .
(G) To make distributions to my herein named benefici-
��
\� a ies in cash or in kind or partly in each.
`� (H) To borrow money from themselves or others in order
(' t pay debts, taxes, or estate or 'trust administration expenses,
protect or improve any property held under my will; and for
e! i vestment purposes .
J�
�,) (I) To select a mode of payment under any qualified
,;
�� � r tirement plan (pension plan, profit sharing plan, employee
� s ock ownership plan, or any. other type of qualified plan) to the
e tent the plan or the law permits them to do so, and to exercise
a y other rights which they may have under the plan, in whatever
m nner they consider advisable.
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TENTH: I direct that all inheritance, estate, trans-
er, succession and death taxes, of any kind whatsoever, which
ay be payable by reason of my death, whether or not with respect
to property passing under this Will, shall be paid out of the
principal of my residuary estate. Notwithstanding, I specifi-
cally direct that there be no allocation of inheritance, estate,
transfer, succession and death taxes, of any kind, whatsoever, as
t any charitable beneficiary designated by me herein.
ELEVENTH: I nominate and appoint my brother, GUY G.
H ILMAN, Executor of this, my Last Will and Testament . In the
e ent of the death, resignation or inability to serve for any
r ason whatsoever of the said GUY H. HEILMAN, I nominate and
a point my nieces, CHARYL H. BARNHART and LISA H. COZZILIO, or
t e survivor as between them, as Co-Executrixes of this, my Last
W' ll and Testament . I direct that my Executor or Co-Executrixes,
a the case may be, and their successors, shall not be required
t post security or a bond for the performance of their duties in
a y jurisdiction.
IN WITNESS WHEREOF, I have hereunto set mv hand and
{-z'�
s al to this, my Last Will and Testament, this _� day of
� ��C, ,c_'.e.'._7� •�j.i..�/� � 20�7 .
f C / / -�, � �
� l�.(..��� �'��.,,(.•fJ � 1?,t,.�.J,�,,,�\. �r.SF'..a.1a� .
L IAN J. ki,ETLMAN �
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I Signed, sealed, published and declared by the above-
amed Testatrix as and for her Last Will and Testament in our
resence, who, at her request, in her presence and in the
resence of each other, have hereunto subscribed our names as
ttesting witnesses .
/)
r� "' �
ddress
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dress
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MEMORANDUM
In accordance with the provisions of Clause FIRST of my
Last Will and Testament, dated '���.�. . ;;;� , 2007 , I direct that
t e following described personal property be given outright to
t ose individuals so designated:
1 . To my brother, GUY HEILMAN and ARDYS HEILMAN, his wife, of
4700 Brand Way, Sacramento, California 95819 :
2 porcelain pictures (currently in bedroom) ; Onfer Swedish
Crystal; 2 Herend collectibles; and any other object or
memento of their choosing.
� 2 . To my niece, LISA H. COZZALIO, of #5 Greenway Circle,
Sacramento, California 95831 :
� 1847 Portugese coin on chain necklace, Lladro figurine and
�� any other mementos she may choose.
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3 . To my friend, CAROL KEESEE, of Homeland, 1901 N. Sth Street,
�\`.\ Harrisburg, Pennsylvania 17102 :
�, � 2 Herend and 1 Genori collectibles (marked "CK" on bottom) .
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�' 4 . To my friend, DORIS HERRE, of 4043 Graystone Drive,
�} � Harrisburg, Pennsylvania 17112 :
2 large floral pictures and the tulip sculpture which hangs
on the wall between them.
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5 . To my friend, KATHY PIOGGIA (daughter of DORIS HERRE) , of
348 Sugartown Road, Devon, Pennsylvania 19333 :
Flat Greek pin given to my by CAROL KEESE for Christmas 2004
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D te �' _ �� c�- / � t: . � � ci<_r�r_.` �- ,.��.-�_�-c (SEAL)
�
LILIAN J. HEI7„b
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� MEMORANDUM
/ In conjunction with my Last Will and Testament, dated
✓�f-- °�'' � , 2007 , the following information may be of some
elp to my personal representatives in the administration of my
state. This information is in no way intended to be a part of
Wi11 nor to alter in any way anything contained in my said
ill .
1 . I direct that my last remains be interned at the
cemetery located at Brady' s Bend, Armstrong Countx, Pennsylvania.
I addition, I direct that my date of death be placed upon the
rave marker.
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D te: °� ;,<.c.: _. �" 1 , � �}°* �, z�=--
,,(, .,� ,
� ���.� ��� �-- , �sE�>
LILI J. H MAN
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