HomeMy WebLinkAbout12-05-13 1505610101
REV-1500 IX{az.za)
Pennsylvania
OFFICIAL USE ONLY
enn
PA Department of Revenue P� County Code Year File Number
Bureau of Individuat Taxes >INHERITANCE TAX RETURN r
PO BOX 28o6oi Y ,
Harrisburg PA 17128-0601.. RESIDENT DECEDENT F I, �Y , , ,
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
Decedent's Last Name Suffix Decedents First Name Mf
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last N�ammef ( ( Suffix Spouse's First Name MI
Spouse's Social Security Number
( THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
1 � REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Ii�llllii 1.Original Return Q 2.Supplemental Return O 3. Remainder Return(date of death
prior to 12-13.62)
p 4.Limited Estate 4a.Future Interest Compromise(date of O S. Federal Estate Tax Return Required
death after 12.12.82)
Illliiiip 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8, Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
C=) 9.Litigation Proceeds Received p 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Soh.O) :
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL.TAX INFORMATION SHOULD BE DIRECTED TO:
Name _ _ Daytime Teleirhone Number_
IL
REGIS7E Fe0FXLLSugE ONLY;
7 m f
CO C1"1
O O
First line of address
•,••.•.,�_- rs —_-^.+�;aa:.x+.cr.�.�'sri-crax^ a.-r•-=-�nnccve^a• eq o
O �
Second line of address "'f to r m
�N`r l" ,. _ r 'a'a-s,-.vat-•=•_--,c�na.^�- -T[' ��^.an�G r�� �. CJ C() (D
Yt
City or Post Office State ZIP Code DATE FILED
s. ..fix-+�• sw.� r
91 L
Correspondent's a-mall address: I Arm
Under penalties of perjury,I declare that I have examined this return,Including accompanying schedules and statements,and to the best of my knowledge and belief,
It ls.qqe,correct and complete.Declaration of preparer other than the personal representativo Is based on all Irdonnafion of which preparer has any knowledge.
Si RE OF RS PONSIBLE FOR FILING RETURN TE
AD R
SIGNATURE OF PREPARER OTHER THAN REPRESERTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101 �;,�
-I 1505610105
REV-1500 EX
Decedent's Social Security Number
RECAPITULATION
1. Real Estate(Schedule A). ...... ....:................................. 1: r �. •.
2. Stocks and Bonds(Schedule B) ....................................... 2
(_ -
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .. ... 3. f ) r r�f
4. Mortgages and Notes Receivable(Schedule D)......... ..... ¢
S. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E ....... S.
6. .Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. r- ` L
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule
8. Tota Gross Assets(total Lines 1 through 7)Separate Billing Requested.. ... ... 9 >
F E --.- �
9. Funeral Expenses and Administrative Costs(Schedule H)...... .. 9. . i S
11. Total Deductions(total total L nes 9 and 10 and Liens Schedule I 11. �[- r,
. .
12. Net Value of Estate(Line 8 minus Line 11) ...................... ...... .. 12
13. Charitable and Governmental made e (Schedule Sec J)rusts for which �
14. Net Value Subtject to Tax been ne 2 i us Line 13) 14. ; }�F' t i'
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec.9116
(a)(1.2)X.0_ ( ( '' "JC Ji 15 i e F
16. Amount of Line 14 ble
at lineal rate X .0 E 1 r, �' 16
� _ , t
17. Amount of Line 14 taxable ['� '4 `k-t � "'�=� � 'i„-
at sibling rate X.12 )' 17
��
18. Amount of Line 14 taxable "x
at collateral rate X.15 ,_
19. TAX DUE .... ..... ..... ............ . ..... ly . ............
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610105 1505610105 J
t
REV-1500 EX Page 3 File Number oo Sq 1
Decedent's Complete Address:
DECEDENT'S N E
STREETADDRE S
e
a51
CITY STATE ZIP
Tax Payments and Credits: q 1�
1. Tax Due(Page 2,Line 19) (1)
2. Credits/Payments
A.Prior Payments
B.Discount
Total Credits(A+B) (2)
3. Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) J,C
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 �NNo,S5
a. retain the use or income of the property transferred;.......................................................................................... ❑ pi
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 refirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
.[72 P.S. §9116(a) (1.1) (ii)].The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even If the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000;
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent F2 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 decedent's siblings is 12 percent 172 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-15o8 EX+(ii-io)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INNERRANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: ,l V1,04 A, Y'n Yr FILE J013 NUMBER:001
NI fl1 1lll Include the proceeds of litigation and the date the proceeds were received by the estate. J
All property jointly owned with right of survivorship must be disclosed on schedule F.
REM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
00L)me Jewelry ul� wil� no read value ,
belt&� oohed a far or read proper+y.
AVa� I"ve'd W14k dau �1,er, Ij do, add had
rw �Urniture or belnn ins 0 volue.
CIb�l1i has �,eIL worn value-,
TOTAL(Also enter on Line 5, Recapitulation) $
If more space is needed,use additional sheets of paper of the same size.
REW15o9 EX+(o1-io)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: 'AIv'oA A, ZQrr FILE1 NUMBER:00 µ1
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. i h Q : ZQrr 3D1 , OJ(a UMmEr �, PA bjhW
1103
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF
NUMBER TENANT J INT IDENTIFYING NUMBER.ATFACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 20Dq N Wu
►Jew hm6laxd Weral Credal llWA
PO. lox W
NP10 bm6lud, Pa
Aeeouhl k smi
S (SAVING) a102ge05 50°b 1,01 ,03
S4 UekiNG) 31817.53 5010 I,Wll%
Ilk-
TOTAL(Also enter on Line 6, Recapitulation) $ a q 3a, 1`1
If more space is needed, use additional sheets of paper of the same size.
New Cumberland Federal Credit Union
Your Community Credit Union
P.O. Box 658,New Cumberland,PA 17070-0658
Phone: (717)774-7706. 1-800-716-2328 •Fax: (717)774-7996•Web: www.nefcuonline.org
November 06, 2013
Donna J. Sullivan
319 Hillcrest Drive
New Cumberland, PA 17070
RE: Estate of Mivian Zarr
Date of Death: March 6, 2013
To Whom it May Concern,
Pursuant to your telephone call of today,November 6, 2013, in regards to Estate
of Mivian Zarr the information is as follows:
.Account Number: 82907
Owner(s)-on Account: Mivian Zarr
Linda Zarr
Date acct opened: 05/15/2004
Date of Death Balances: S 1 (Savings) $ 2,028.05
S4 (Checking)$ 3,817.53
Dividends $ .72
If you need anything additional in regards to this information,please feel free to
contact me directly.
Si ,y,
Barbra Wright
Branch Manager
Enclosure
P.O.BOx658 ACCOUNT NUMBER: STATEMENT PERIOD:
Ncw cuwermANO nm�w.cnmR Umov NEW CUMBERLAND,PA 17070 xxxxxxx907 Mar 1, 2013- Mar 31,2013
Tour Community Credit Vnion 8OD-70-NCFCU 1717-774-5731
ADDRESS SERVICEREOUESTED MM.NCFCUONLINE.ORG SUMMARY AT A GLANCE
Total Shares: 5,926.99
Total Loans: 0.00
Total Certificates: 0.00
ii
301 High St
Po Box 251 -
Summerdale Pa 17093-8038
ipa xti�vu PIDWIrlAWRAMMUSRACETNI
Page 1 of 1
Joint Owners: Linda F. Zarr
0
Trans Eff Date Transaction Deposit Withdrawal Balance
Previous Balance 1,928.05
Mar Ot Automated Deposit 114 Dfas-Cleveland/ar Ann Pa........................ 100.00 2,028.05
Mar 31 Dividend........................................................................................... 0.26 ` 2,028.31
The Annual Percentage Yield Earned Is 0.15.
New Balance 2,028.31
o •
Trans Eff Date Transaction Deposit Withdrawal Balance
Previous Balance 2,072.55
Mar 01 Ach Deposit 1221211670 Pru Annty Pymt...................................... 368.31 2,440.86
Mar 01 Automated Deposit 106 Ssa Trees 310/xxsoc Sec........................ 930.00 3,370.86
Mar Ot Automated Deposit 114 Dfas-Cleveland/ar Ann Pa........................ 492.00 3,862.86
Maro6 Ach Withdrawal 2231628836 Colonial Penncpl Ins. Prem. ............. - 45.33 3,817.53
Mar14 Deposit Check................................................................................. 80.82 3,898.35 '
Mar31 Dividend........................................................................................... 0.33 3,898.68
The Annual Percentage Yield Earned Is 0.10.
New Balance 3,898.68
!
1111141f _
Trans Eff Date Transaction Deposit Withdrawal Balance
Previous Balance 0.00
New Balance 0.00
Other Year-to-Date Amounts
Prior Year-to-Date Dividends:4.14
TOTAL DIVIDEND YEAR-TO-DATE 1.31
TOTAL FINANCE CHARGE YEAR-TO-DATE for all loans. 0.00
VISA rates as low as 6.90% . • Free i alance Transfer ...Apply Today!
REV11511 EX+(10-06)
a SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF j FILE NUMBER
Zarr �UI3-00841
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
Iroo s Funeral I1ome Q Oremali" Services Wo3?
+ ain 51re4
WOLIS6n4b ) PA 171`1�
ToTwL �u eral III X8 "170,52
Qi dly Li Ins. b �6eP _8
Reid rom rej�4 ban (10 11 1A3g
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid:
2. Attorney Fees _UrbOr umple-Sulllvlu, fs%.
3. Family Exemption:(If decedent's ad'dless is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparers Fees
7.
TOTAL(Also enter on line 9, Recapitulation)
(If more space is needed,insert additional sheets of the same size)
Brooks Funeral Home & Cremation Services
207 Broadway Street/P.0. Box 41 124 Main Street
Turbotville, PA 17772 Watsontown, PA 17777
570-649-5837 570-538-1675
Fax: 570-649-5675 Fax: 570-649-5675
E1N. 23-2982870
DATE: September 5, 2013
SERVICES FOR: Mivian A. Zarr
TO: Mrs. Linda Zarr
301 High Street, P.O. Box 251
Summerdale, PA 17093
Personal and Staff Service
Professional Care
Facilities and Equipment
(A) Services, including merchandise: Visitors Registor $4,540.00
Acknowledgment Cards/Memory Folders
Funeral Car and/or Sedan
Casket Coach
20 guage Mathews Monarch Casket $2,195.00
Wilburt Monticello Vault $1,245.00
TOTAL (A) $ 7,980.00
(B) Cash Advanced Items:
We have advanced the following Delaware Run Cemetery $400.00
funds for your convenience— Certified Death Certificates(2 @$6.00) $12.00
Milton Obituary $15.00
Vault Installation&Services $198.00
Stone Lettering $100.00
TOTAL(B) $725.00
Additional Laminated Obituaries(11 @$5) $55.00
(C)Additional Items ordered later: Patriot News $10.82
TOTAL(C) $65.82
COMPLETE TOTAL $8,770.82
Colonial Penn ($3,045.44)
-money reed �rom I�r(QjnS.folrfheck, Linda Zarr ($5,000.00)
Credit Un on heck, Linda Zarr ($725.38)
PAID IN FULL Sept.5, 2013 BALANCE DUE ?=z $0 00
Julie A.Brooks, F.D., Owner Steven D. Tetreault, Supervisor
BARBARA SUMPLE-SULLIVAN, ESQUIRE
549 Bridge Street
New Cumberland PA 17070
Invoice submitted to:
Estate of Mivian Zarr
c/o Donna J. Sullivan
319 Hillcrest Drive
New . Cumberland, PA 17070
June 16, 2013
Invoice # 81310
Professional services
Hours
Barbara
3/21/13- Conversation with client 0 . 80
6/4/13- Review of email 0 . 10
Amount
SUBTOTAL: [ 0 . 90 225 . 00]
For professional services rendered 0 . 90 $225 . 00
Balance due n $225 . 00
PATRICK J.SULLIV 'N`!4 `91310 60-7269/2313 7 311
DONNA J.SULLIVAN
319 HILLCREST DR. Shield°
NEW CUMBE ND, PA 17070 DI
a
PREMIER
it r P OCTeigIBank A
RV UP -FA 0�8
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7 1: 2313 07�03075473 c
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RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH Receipt Date : 8/02/2013
Cumberland County - Register Of Wills Receipt Time: 13 : 58 : 14
One Courthouse Square Receipt No. : 1075105
Carlisle, PA . 17013
ZARR MIVIANI A
Estate File No. : 2013-00841
Paid By Remarks : DONNA SULLIVAN
BAJ
------------------------ Receipt Distribution ------- -----------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 45 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Cash $123 . 50
Total Received. . . . . . . . . $123 . 50
REV-1512 EX+ (12-08)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Nlwi 7�rr (�13-0"C1841
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 V 15a NAgr6d r era re�i l Von)
Toy m0, li hi address is,
P 61 lox 4511
krol 51r9a, IL Wlg7 -q{ al
eh.kh, 8058
TOTAL(Also enter on Line 10, Recapitulation) $ 051,40
If more space is needed, insert additional sheets of the same size.
NEW CUN[B Ffn .r
ra .Camrr UNloN VISA
MIVIAN A ZARR
Account Number: #I{#k####8658 Statement Closing Date:
February 13, 2013
A Summary of Account'AoiVlty Payment Information
Previous Balance - $1,837.95 New Balance $1,767.40
Payments - 100.00
Other Credits 0,00 Total Minimum Payment Due $53.OD
Other Debits ♦ 0.00 Payment Due Date 03/10113
Purchases • 0.00
Cash Advances ♦ 0.00 Late Payment Warning: IF WE DO NOT RECEIVE YOUR
Fees Charged • 0.00 MINIMUM PAYMENT BY THE DATE LISTED ABOVE,YOU MAY
Interest Charged ♦ 19.45 HAVE TO PAY A LATE FEE UP TO$15.
NEW BALANCE $1,757.40
Minimum Payment Warning:If you make only the minimum payment
Credit Limit $3,000.00 each period,you will pay more in Interest and it will take you longer to
Available Credit 1,242.00 pay off your balance.For example:
Available Cash 1.242.00 ,.-W you make nd,, - u vnll pay off the. - ':rind you wdI end'vp ',
b
Amount Disputed 0.00 additional charges., ''b-stlaatnecme e snht oirwin:atoon utWs +r'; i 0213/13 usl9 itls'crd anStatement Closing Date ng an estirnated:.
total of.;.' , f-Q y
Days in Billing Cycle 28 eacl%moritlt you:pay...; 'vtY.,�+w?;_; a,
Only the minimum 9 year(s) $2,582.00
payment
rrr}�{ ' ContaCt'Information 59.OD 3years $2,128.00
(Savings $454.00)
.� Customer Service:(800)299-9842
�p Report Lost or Stolen Card:(727)570.4861 If you would like information about credit counseling services,
After Hours:(866)604-0381 call(800)716-2328.
Please send Billing Inquiries and Correspondence to:
CUSTOMER SERVICE PO BOX 30495 TAMPA,FL 33630
c1� Visit us on the web at:
'v www.ncfcuonfine.org
Please Mail Your Payments to:
VISA PO BOX 4521 CAROL STREAM IL 60197-4521
Mews` tx,?..sI ii
a P. a :s 3 .r.. t k, E..t.:�.?.aS
..........«...»..........................................................
•THE TOTAL FINANCE CHARGE PAID ON YOUR ACCOUNT DURING THE PAST YEAR
'WAS...$307.45
NOTICE:CONTINUED ON PAGE 3
_ Page 1 of 6
PLEASE DETACH COUPON AND RETURN PAYMENT USING THE ENCLOSED ENVELOPE-ALLOWS DAYS FOR MAIL DELIVERY
NEW CUMBERLAND FEDERAL CREDIT UN � -
Accou nt�Number';.,,;
PO BOX 658 ##########"8658
NEW CUMBERLND PA 17070-0658 Check box rp indiote ❑
name/address change
on back of this=upon
?g� ' '•- Total Miniintim ""'1+1+4""-`:`?"��"� AMOUNT OF PAYMENT ENCLOSED
Closing:Date; New balance. PayrrlentLbGt:Date _. ... . . ..
! Payment:Due_„ t�sa.�.•
02/13/13 $1,757.40 $53.00 03/10/13
PMIVIAN
BOX 251 R MAKE CHECK PAYABLE TO:
SUMMERDALE PA 17093-0251 =_ IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII oil IIIIIIIIIIIIIIIII
VISA
PO BOX 4521
III If IIIIIIIIIIII 11111111 dill IIII 1111911111 IIIII I IIII I fill,If CAROL STREAM IL 60197-4521
21 4820 9955 0004 8658 00005300 00175740 7
3
IMPORTANT INFORMATION r e
Interest Charge Calculation Methods(ICM)and Computation of Balance Subject to Interest Rate.The Interest Charge Calculation Method applicable to your account for
Cash Advances and Credit Purchases of goods and services Rat you obtain through the use of your card is specified on Me front side of this statement and explained below.
Method A-Average Daily Balance(including new transactions).The Interest Charge on purchases begins from the date the transaction is posted to your account,and the
Interest Charge on cash advances begins from the date you obtained the cash advance,or Me first day of the billing cycle in which it is posted to your account,whichever is later.
There is no grace period.The Interest Charges for a billing cycle are computed by applying the Periodic Rate to the"average daily balance"of your account To get the average
daily balance,we take the beginning balance of your account each day,add any new purchases or cash advances,and submct any payments,credits,non-accruing fees,and
unpaid interest charges.This gives us Me daily balance.Then we add up all the daily balances for the billing cycle and divide Me Val by fie number of days in Me billing cycle.
Method E-Average Daily Balance(excluding new transactions).To amid incumng an additional Interest Charge on Me balance of purchases(and cash advances g Method E is
specified as applicable to cash advances)regected on your monthly statement,you must pay Me entire New Balance"in full,shown on your monthly statement on or beore the
Payment Due Data The Interest Charges tar a billing cycle are computed by applying Me Periodic Rate to the"avenge daily balance"of purchases(and if applicable,cash
advances).To get the average daily balance,we take the beginning balance of your account each day(excluding new transactions)and subtract any payments,credits,
non-accruing fees,and unpaid interest charges.This gives us Me daily balance.Then we add up all the daily balances for the billing cycle and divide Me bbl by Me number of
days in Me billing cycle.
Method F-Avenge Daily Balance(including new transactions),To amid incurring additional Interest Charges on the beginning balance of cash advances(and purchases,if
Method F is specified as applicable to purchases)reflected on your monthly statement you must pay Me Beginning Balance shown on your monthly statement on or before the
Payment Due Date.No grace period is provided tar current cycle transactions.The Interest Charges for a billing cycle are computed by applying Me Periodic Rate to Me"avenge
daily balance"of cash advances(and p applicable purchases).To get the avenge daily balance,we take the beginning balance of your account each day,add any new purchases
or cash advances and subtract any payments,credits,non-accruing fees,and unpaid interest charges.This gives us the daily balance.Then we add up all Me daily balances for
Me billing cycle and divide the total by Me number of days in the billing cycle.
Method G-Average Daily Balance(including new transactions).To avoid incurring additional Interest Charges on Me balance of purchases(and cash advances,If Method G is
specified as applicable to cash advances)reflected on your monthly statement and,on any new purchases(and if applicable,cash advances)appearing on your next monthly
statement,you must pay the entire"New Balance",in full,shown on your monthly statement on or before the Payment Due Date.The Interest Charges for a billing cycle are
computed by applying the Periodic Rata to Me"average daily balance'of purchases(and if applicable,cash advances).To get Me average daily balance,we take Me beginning
balance of your account each day,add any new purchases or cash advances,and subtract any payments,credits,non-acoming fees,and unpaid interest charges.This gives us
the daily balance.Than we add up all the daily balances for the billing cycle and divide Me Val by Me number of days in Me billing cycle.This gives us Me average daily balance.
Payment Crediting and Credit Balance.Payments received by 5PM at Me location specified on Me front of Me statement after Me phrase"Please Mail Your Payments b":will
be credited as of Me data of receipt to Me amount specified on Me payment coupon.Payments made in person during normal business hours at branch locations where such
payments are accepted will be treated as received on Me same day.Payments that do not conform to the requirements set bM on or with the perodc statement(e.g.missing
payment sub,payment envelope other than as provided with your statement multiple checks or multiple coupons in the same envelope)may be subject to delay in crediting,but
shall be credited within five days of receipt If there is a credit balance due on your amount,you may request in writing,a full refund.Submit your request to the address indicated
on Me front of this statement after Me phrase"Please send Billing Inquiries and Correspondence to".-
By sending your check,you are authorizing Me use of the inbnnahon on your check to make a one-time electronic debit from the amount on which Me check is drawn.This
electronic debit which may be posted to your account as early as Me data your check is received,will be only for Me amount of your check The original check will be destroyed
and we will retain Me image in our records.R you have questions please call Me customer service number on the front of this billing statement
Closing Date.The closing data is the last day of Me billing cycle;all transactions received after the closing data will appear on your next statement
Annual Fee.If your account has been assessed an annual fee,you may avoid paying this annual fee by sending written notification of termination within 30 days following Me
mailing date of this bill,to Me address listed on the front of this statement after Me phrase`Please send Billing Inquiries and Correspondence to:".You may use your card(s)
during this 30 day period but immediately thereafter must send your cant(s),which you have cut in half,to this same address.
Negative Credit Reports.You are hereby notified that a negative credit report reflecting on your credit record may be submitted to a credit reporting agency if you fail to fulfill the
terms of your credit obligations.
BILLING RIGHTS SUMMARY
What To Do If You Think You Find A Mistake On Your Statement
H you think there is an error on your statement,write to us at the address shown on Me front of this billing statement after Me phrase"Please send Billing Inquiries...IW:In your
letter,give us Me following information:
Account Information: Your name and account number.
• Dollar Amount The dollar amount of Me suspected error.
• Description of Problem: If you think there is an error on your bill,describe what you believe is wrong and why you believe it is a mistake.
You must contact us within 60 days after Me error appeared on your statement You must notify us of any potential errors in writing(or electronically).You may call us,but if you .
do,we are not required to investigate any potential errors and you may have to pay Me amount in question.While we investigate whether or not there has been an error,the
following are We:
We cannot by to collect the amount in question,or report you as delinquent on that amount
• The charge in question may remain on your statement,and we may continue to charge you interest on Mat amount But d we determine Mat we made a mistake,
you will not have to pay the amount in question or any interest or other fees related to Mat amount
While you do not have to pay Me amount in question,you are responsible for the remainder of your balance.
We can apply any unpaid amount against your credit limit
Your Rights If You Are Dissatisfied With Your Credit Card Purchases
If you are dissatisfied with Me goods or services Mat you have purchased with your credit card,and you have tried in good faith to coned Me problem with Me merchant you may
have Me right not to pay Me remaining amount due on the purchase.To use this right all of Me following must be true:
1. The purchase must have been made in your home state or within 100 miles of your current mailing address,and Me purchase price must have been more Man$50.
(Note:Neither of Men are necessary if your purchase was based on an advertisement we mailed to you,or if we own the company Mat sold you Me goods or services.)
2. You must have used your credit cab for Me purchase.Purchases made with cash advances from an ATM or with a check Mat accesses your credit card account do not
quality.
3. You must not yet have fully paid for the purchase.
If all of the criteria above are met and you are still dissatisfied with Me purchase,mntad us in writing(or electronically)at Me address shown on Me front of this billing statement
following the phase"Please send Billing lnquines...W: While we investigate,Me same rules apply to Me disputed amount as discussed above.After we finish our investigation,
we W it tell You our decision.At that point,if we think you owe an amount and you do not pay,we may report you as delinquent.
(Rev 02-12)
Please use blue or black ink to complete form
NAME CHANGE Last
First Middle
ADDRESS CHANGE Street
city
State Code
Home Phone ( _ Business Phone
SIGNATURE REQUIRED I
TO AUTHORIZE CHANGES Signature
REV-1513.EX+ (01-10)
pennsytvania SCHEDULE 7
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT.
ESTATE OF: FILE NUMBER:
A, larr J013-6601
NUMBER NAME AND ADDRESS OF PERSON RELATIONSHIP TO DECEDENT AMOUNT OR SHARE S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. bonny T Sull,'vaw �au9h�er a5�b
31q N�Ileres � v�
r ew hhWIj N I'1D7o
` eborah A. Na.rdma
1401 Adw Aue. �au�hler a5°fo
NarrAuq, PA 17111
Linda r zu l7 der �5%
ox 151, 301
Su 8fdale,1A 17093
A Gearlipr Kroad- RP3 lu gg3A
Nl 4, W 17751
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
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, use additional sheets of paper of the same size. - j
LAST WILL AND TESTAMENT
I, MIVIAN 0. ZARB, a legal resident of the city of Watsontown, State
of Pennsylvania, being of lawful age and of sound and disposing mind and
memory, do hereby make, publish and declare this my LAST WILL AND TESTAMENT,
to wit:
FIRST: I declare that:
A. I am married to JOHN W. ZARB.
B. I am the mother of DONNA J. SULLIVAN, DEBORAH A. HARDMAN, _
LINDA F. ZARR, and JOANNE K. ZARR.
SECOND: I hereby revoke all other wills and codicils heretofore
made by me.
THIRD: I direct that the expenses of my last illness, funeral and
burial be paid out of my estate as soon after my death as may be practicable
In such amount as my EXECUTOR may deem proper and without regard to any
limitation in the applicable local law as to the amount of such expenses.
FOURTH: I direct that all estate, death and inheritance taxes
attributable to my testamentary estate and to my nontestamentary property
shall be paid from the residue of my testamentary estate and shall not
be charged against any beneficiary or transferee.
FIFTH: I give, devise and bequeath all the rest, residue and
remainder of my estate and property of which I may be seized or possessed
or to which I may be entitled at the time of my death, wherever situated
or of whatever nature, be it real, personal or mixed, including lapsed
legacies and any property over which I may have a power of appointment,
to my husband, JOHN W. ZARR, presently residing at Watsontowu, State of
Pennsylvania, as his sole and absolute property if he shall survive me.
SIXTH: In the event my said husband shall predecease me or not
survive me by at least thirty (30) days, I give, devise and bequeath all
of the said rest, residue and remainder of my estate and property,
absolutely and forever, share and share alike, to my children, DONNA J.
SULLIVAN, DEBORAH A. HARDMAN, LINDA F. ZARR, and JOANNE K. ZARR and any
child or children that may be born to or adopted by me hereafter who
shall survive me; but if any of my children or adopted children shall
not survive me, then to the descendants of such child or children who
may be living at the time of my death, such descendants to take per
stirpes and not per capita.; in the event that any of my children or
adopted children shall not survive me and also shall not be survived by
descendants, then the share of any such child or children shall be
divided among my surviving children and adopted children and the surviving
descendants of any- of my children who have not survived me, such descendants
to take per stirpes and not per capita.
SEVENTH: In the event. that I and' any beneficiary under this LAST
WILL AND TESTAMENT should die In a common disaster or accident in such a
way that it is not possible to determine which of us survived the other,
so that my said Beneficiary shall not,receive the full possession and
enjoyment of my gifts, devise, and Bequeath it shall be conclusively
presumed that I was the last of the two of us to die. Further, no
beneficiary shall be deemed to survive me if he or she shall die within
thirty- (30), days after my death.
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EIGHTH: Except as otherwise provided in this my LAST WILL AND
TESTAMENT, I have intentionally omitted to provide herein for any other
relatives or for any other person, whether claiming to be an heir of
mine or not.
NINTH: I hereby nominate and appoint my husband, JOHN W. 2ARR of
Watsontown, Pennsylvania as EXECUTOR of this my LAST WILL AND TESTAMENT,
and I request that he be permitted to serve without band or surety
thereon and without the intervention of any court or courts, except as
required by law; I hereby authorize and empower my said EXECUTOR, in his
absolute discretion, to sell, exchange, convey, transfer, assign, mortgage,
pledge, lease, or rent the whole or any part of my real or personal
estate, to invest, reinvest, or retain investments of my said estate, to
perform all acts and to execute all documents which my said EXECUTOR may
deem necessary, convenient or proper in regard to my property; in the
event that he shall predecease me or shall for any reason refuse or be
unable to serve or to continue serving as EXECUTOR hereof, then I hereby
appoint my daughter, DONNA J. SULLIVAN of Bowie, Maryland as EXECUTRIX in
his stead, to serve without bond or surety and with the same powers and
authority.
TENTH: I direct the attention of my Executor or Executrix, as the
case may be, to such burial allowances and related benefits that my
family and estate may be entitled to by reason of my husband's service
in the Armed Forces of the United States.
IN WITNESS WHEREOF, I have at Watsontown, PA, Northumberland COUn
this 4th day of October 19 00, set my hand and seal to
this my LAST WILL AND TESTAMENT consisting of two (2) typewritten pages,
this included, the preceding page hereof bearing my signature.,
• (SEAL)
Signed, se led, published and eclared by the above named MrVIAN 0. XARR,
TESTATRIX, as her LAST WILL AND TESTAMENT, in the presence of all of us
at one time, and at the same time, we, at her request and in her presence
and in the presence of each other, have hereunto subscribed our names as
witnesses, and we do hereby attest to the sound and disposing mind and
memory of said TESTATRIX, at the date hereof, and to the performance of
the aforesaid acts of execution at Watsontovm, PA Northumberland Count
this 4th day of October 19_
samu£lR. Klapp residing at 1037 Elm St. , Watsontown, PA
Ai+akah K. Starr residing at 603A I.1ain St. , WatsontOWn, PA
STATE OF PENNSYLVANIA)
COUNTY olNorthumberiand
Before me, the undersigned authority, on this day personally appeared
MIVIAN 0. ZARR, known to me to be the TESTATRIX
to me to be the w R. K-J p
and Rebekah K. Starr
whose names are subscr lbed to the annexed or foregoing instrument in
their respective capacities, and all of the said persons being by me
duly sworn, the said, MIVIAN 0. ZARR, TESTATRIX, declared to me and to
the said witnesses in my presence that said instrument is her LAST WILL
AND TESTAMENT, and she had willingly made and executed it as her free
and voluntary act and deed for purposes therein expressed; and that the
said witnesses, each on his oath stated to me in the presence and hearing
of the said TESTATRIX that the said TESTATRIX had declared to them that
said instrument is her LAST WILL AND TESTAMENT and that she executed
same as such and wanted each of them to sign same as a witness; and upon
their oaths each witness stated further that they did sign the same as
witnesses in the presence of the said TESTATRIX and at her request; that
she was at that time 18 years of age and was of sound mind; and that
each of said witnesses was then is years of age.
/ � D
TE T RIX
W NESS
WITNESS
Sworn to, subscribed and acknowledged before me by the said MIVIAN 0. ZARR,
TESTATRIX and subscribed, sworn to and acknowledged before me by said
Samuel R. Kla and Rebekah K. Starr
witnesses, this th day of October 1H8. . 1988
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