HomeMy WebLinkAbout12-06-13 � REV-1500 E"�02-1' 1505610143
PA De artment of Revenue � OFFICIAL USE ONLY
P pennsylvania County Code Year File Number
Bureau of Individual Taxes �EPARTMENTOFREVENUE
Po aox.2soso� INHERITANCE TAX RETURN 2 1 13 0 9 2 6
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
199 12 3063 08 03 2013 07 O1 1926
DecedenYs Last Name Suffix Decedent's First Name MI
SELECKY HAROLD G
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVA�S BELOW
� 1. Original Return ❑ 2. Supplemental Return � 3.Remainder Return(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � 4a.Future interest Compromise � 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
� g Decedent Died Testate � � Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
� 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � ��,Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION.$HOULD BE DIRECTED TO:
�::_
Name Da�yne Telephone uml�r�
LISA MARIE COYNE ESQ 7bo737 �4 � �
w -�- `�'�' t.n %�
i.,� -�._
R�I�LER"DF WILLS U3��'�LY
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�-,. �,' __:; �., C':
First Line of Address =_-- - �� °�r
3 9 0 1 MARKET STREET C� �� � --� � -`�
c-_> �, ..,-;
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Second Line of Address __� -�1 c.� �,,� c7
'Y1
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DATE FILED
City or Post Office State ZIP Code
CAMP HILL PA 170114227
CorrespondenYs e-mail address: I I S 8@ C O y e a n d C o y n e.c o m
Under penalties of perjury,I are that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and e. laration of preparer other than the personal representahve is based on all information of which preparer has any knowledge.
SIGNAy►1gE OF PER RE NSIB E FO ILING RETURN 1 DATE •
�"Q� Henry F. Coyne `,
�
ADDRESS ��
3901 Market Street, Camp Hill, PA 17011
SIGPd/�URE OF PRE ER OTHER THAN REPRESENTATIVE DATE
i�� - �'� LISA MARIE COYNE Esq r��� Jc- .Z�,�
ADDRE
C ne 8�Coyne, P.C.
39 1 Market Street, Camp Hill, PA 170114227
Side 1
� 1505610143 1505610143 �
;1
1 1505610243
�J
REV-1500 EX
DecedenYs Social Security Number
�e�eee�es rvame: S E L E C K Y� H A R O L D G. 19 9 12 3 0 6 3
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1.
181 , 568 . 21
2. Stocks and Bonds(Schedule B)............................................................................... 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).......................................................... 4.
260 , 201 . 16
5• Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested............. 7.
g. Total Gross Assets(total Lines 1 through 7).......................................................... g, 4 4 1 , 7 6 9 . 3 7
35 , 154 . 67
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9.
6 , 008 . 88
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10.
11. Total Deductions(total Lines 9 and 10).................................................................. ��.
41 , 163 . 55
12• Net Value of Estate(Line 8 minus Line 11)............................................................. 12.
400 , 605 . 82
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14.
400 , 605 . 82
TAX COMPUTATION-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.00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 16.
17. Amount of Line 14 taxable
at sibling rate X .�2 ���
18. Amount of Line 14 taxable 4 0 0 , 6 0 5 . 8 2 �g. 6 0 , 0 9 0 . 8 7
at collateral rate X .15
19. TE►xDUE................................................................................................................... 19. 60 , 090 . 87
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. a
Side 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21 - 13 - 0926
Decedent's Complete Address:
DE EDEN ' AME
SELECKY, Harold G.
STREET ADDRESS
4837 E. Trindle Road
Mechanicsburg, PA 17050
CITY STATE ZIP
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 60,090.87
2. Credits/Payments
A. PriorPayments 58,000.00
B. Discount 3,004.54
Total Credits(A +B) (2) 61,004.54
3. I nterest (3) 0.0 0
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 913.67
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. �5�
Make Check Payable to: REGISTER OF WILLS, AGENT.
, . - � ��� �
; - � -
� �.��.��N. � ��. _ �
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:.................................................................................. ❑ �x
b. retain the right to designate who shall use the property transferred or its income:.................................... � �
c. retain a reversionary interest;or.................................................................................................................. ❑ 0
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
receivingadequate consideration?....................................................................................................................... ❑ ❑x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... � �x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
containsa beneficiary designation?...................................................................................................................... ❑ ❑x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
_ .�
�. ;.�r
� =�r
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 January 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 stafute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax re�urn are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
•The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
•The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)].
•The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent(72 P.S.59116(a)(1.3)1. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether by blood or adoption.
REV-1b03 EX+(6-98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
FILE NUMBER
ESTATE OF SELECKY, Harold G. 21 - 13-0926
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF
NUMBER DEATH
1 228.613 Shares Capital World Bond (CWBFX) 20.14 4,604.27
2 107.991 Shares EuroPacific Growth (AEPGX) 44.62 4,818.56
3 206 Shares Windstream Holdings Inc(WIN) 8.64 1,779.84
4 1,497.43 Shares American High Income(AHITX) 11.26 16,861.06
5 118.572 Shares Fundamental Investors(ANCFX) 48.09 5,702.13
6 111 Shares Pfizer Inc(PFE) 29.19 3,240.09
7 692.531 Shares American US Government Securitites (AMUSX) 13.76 9,529.23
8 324.238 Shares Washington Mutual Investors (AWSHX) 37.37 12,116.77
9 582.857 Shares Income Fund ofAmerica (AMECX) 19.75 11,511.43
10 710.967 Shares Intermediate Bond Fund of America (AIBAX) 13.47 9,576.73
11 1,555.776 Shares Bond Fund of America(ABNDX) 12.47 19,400.53
12 287.795 Shares Capital Income Builder(CAIBX) 56.50 16,260.42
13 318.075 Shares Investment Company of America (AIVSX) 35.87 11,409.35
14 463.323 Shares AMCAP (AMCPX) 25.95 12,023.23
15 85 Shares UGI Corp (UGI) 42.49 3,611.65
16 250.251 Shares Capital World Growth and Income (CWGIX) 41.69 10,432.96
TOTAL(Also enter on line 2, Recapitulation) 181,568.21
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN co nti n u ed
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF SELECKY, Harold G. 21 - 13 -0926
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF
NUMBER DEATH
17 1,000 Shares First Trust Global Dividend (30278R151) 10.44690 10,446.90
18 6,000 Shares Select Notes Trust Securites (81619PAd9) 4,914.82
19 390 Shares Goldman Sachs Group Inc(38145X111) 24.0129 9,365.03
20 5,000 Shares Select Notes Trust(81619PAA5) 3,963.21
Page 2 of Schedule B
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Aug 5,2013 20.14 20.14 20.14 20.14 0 20.04
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Aug 5,2013 44.62 44.62 44.62 44.62 0 44.62
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Aug 5,2013 8.54 8.72 8.54 8.64 7,712,200 8.39
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fwg 5,2013 29.30 29.36 29.13 29.19 14,392,700 28.97
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�`°A�'°�S � Edward Jones
201 PROGRPSS PARKN�AY
� ST.IAU[$,M0.630J3-3042 �
7E(.314-SL-2000
TRADE CONFIRMATION ^�. ,
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RETAIN FOR YOUR PERMANENT TAX RECORDS '� � `� � f f�;°`',w..
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YOUR FiNANQAL ADVISOR: ��-�� �iJ�� f�•��i
Af f,f�,�
ESTATE OF HAROLD G SELECKY JEFF ZAVODA �,,...s�
HENRY F COYNE EXECUTOR 4400 DERRY ST �
3901 MARKET STREET HARRISBURG, PA 17111 k�
CAM P H I LL PA 1 701 1-4227
BxANCH rrUMSEx: 26165
FINANCIAL ADVISOR#: 425408
ANY QUESTIONS CALL (717)561-2480
_ WE ARE PLEASED TO CONFIRM TI�FOLLOWING TRANSACTION SUBJBCT TO THE INFORMATION,
DISCLOSURES, AND TERMS ON TI�FRONT AND REVERSE SIDES OF THIS DOCUMENT: �
ar Yovx c.�AccouNZ� 616-210 6 9-1-5
ON TRADE DATE 0 9/10/2 013 FOR SETTLEA�N'I'DATE Q 9�1��2 O Z�
YOU SOLD 1,0 00 PiucE 10.446 9 0
DESCRIPTION:
FIRST TRUST GLOBAL DIVIDEND rRU.rc�ai,.aMOUh�r $ 10,446.90
MONTHLY CASH
SERIES 27
MONTHLY PAYMENT
UNSOLICITED
ToTaL $ 10,446.90
ORDER 616969549 PROCESSEDON 09/10/2013@ 16:52:35 cus�P 30278R151
WE EXECUTED THI&TRANSACTION AS YOUR AGENT.
• If the phrase "we make a mkt in this security" appears on this confirmation,we have acted as principal functioning as a secondary
market maker.
• If the phrase "unsolicited"appears on this confirmation,the transaction was conducted pursuant to an unsolicited order to buy or sell �-
placed by the client. �
' For debt securities transactions,call features may exist which could affect yield; additional information available upon request. �
• For zero coupon transactions, no periodic payment and callable below maturity value, without notice by mail to holder unless registered. �
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PAGE 1 OF 2
��y�J�� Edward J o n e s
20�PROGRFSS PARKWAY
� S1�.LAU[S,MO.63043-3042
TEL314515-2000 TRADE CONFIRMATION
U ��
RETAIN FOR YOUR PERMANENT TAX RECORDS � ���) ��
sFP /� ,�
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YOUR FINANQAL ADVISOR:
ESTATE OF HAROLD G SELECKY JEFF ZAVODA �����
HENRY F COYNE EXECUTOR 4400 DERRY ST '`�-.t"4
3901 MARKET STREET HARRISBURG, PA 17111
CAMP HILL PA 17011-4227 ��
BRANCH NUMBER: 2 E>1 C 5 z
FINANCIAL ADVISOR#: 425408
�QUESTTOrrsc.�, (717)561-2480
WE ARE PLBASED TO CONFIRM THE FOLLOWING TRANSACI'ION SUBJECI'TO THE INFORMATION, _
� DISCLOSURPS, AND TERMS ON THE FRONT AND REVERSE SIDBS OF THIS DOCUMENT:
uv YouR casx Accovrrr 616-210 6 9-1-5
ON TRADE DATE 0 9/10/2 013 FOR SETl'LEMENT DATE 0 9/13 i 2 013
You soLn 6,000 Px�cE 89.46000
DESCRIPTION:
SELECT NOTES TRUST SECURITIES PRINCII'ALA1�40UIv"P $ 4,895. 17
LONG TERM CTF 2003-4 AccxuEn��sr 24.60
CURRENT FACTOR = .911984
5.78z DUE ON 06/15/33
PAYS MONTHLY ON 15th Txatvsacrioxr� 4.95
BOOK ENTRY ONLY
YIELD TO MATURITY: 6.747X
UNSOLICITED
CURR FACTOR 91198400 TOTAL $ 4,914.82
CURR PRIN BAL 5,471.90
ORDER 616969548 PROCESSED ON 09/10/2013 � 13:35: 16 cusip 81619PAD9
WE EXECUTED THIS TRANSACTION AS PRINCIPAL SELLING TO YOU OR BUYING FROM YOU AND A PAYMENT TO EDWARD
JONES MAY HAVE BEEN DEDUCTED FROM OR INCORPORATED INTO THE PRICE YOU RECEIVED.
. If the phrase "we make a mkt in this security" appears on this confirmation,we have acted as principal functioning as a secondary
market maker.
• If the phrase "unsolicited" appears on this confirmation,the transaction was conducted pursuant to an unsolicited order to buy or sell a
placed by the client. �
� For debt securities transactions, cali features may exist which could affect yield; additional information available upon request. �
• For zero coupon transactions, no periodic payment and callable below maturity value,without notice by mail to holder unless registered. �
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PAGE 1 OF 2
�"�°'°`� Edward J o n e s
- �201 PFOGRFSS PAP.ICWAY
��� ST.I;OU[S,MO.63(kt3-3042
� TEL314-515-2000
TRADE CONFIRMATION
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RETAIN FOR YOUR PERMANENT TAX RECORDS !l�If�' f��---�
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YOUR FiNANQAL ADVISOR:
00000046 04 MB 1.337 04 TR 00004 EJCN8901 000000 ; u �.�j'�` �s�?��
ESTATE OF HAROLD G SELECKY JEFF ZAVODA ��F �`� ��j'��
����`"�� HENRY F COYNE EXECUTOR 4400 DERRY ST �"`�..,�'°`��,�a�� <. �
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�:��: 3901 MARKET STREET HARRISBURG, PA 17111 �m�_, �
CAMP HILL PA 17011-4227 �.-°«...� .�.R �
BxA1vCH 1vuMBER: 26165 ����
FINANCIAL ADVISOR#: �+25408
A1vY QuES'r�ONS C�,L (717)5 61-2 4 8 0
_ WE ARE PLEASED TO CONFIRM THE FOLIAWING TRANSACTION SUBJECT TO THE INFORMATION,
DISCLOSURES, AND TERMS ON TI�FRONT AND REVERSE SIDES OF THIS DOCUMENT: '
IN YOUR CASH ACCOUNT 616-2106 9-1-5
ON TRADE DATE 0 9/10/2 G 13 FOR SETTLEA4ENT DATE 0 9/13/2 013
YoU soi.n 3 9 0 P1ucB 2 4.012 9
DE3CRIPTION:
GOLDMAN SACHS GROUP INC PRINQPALAMOUNP $ 9,365.03
6.125� PREFERRED NOTES
UNSOLI C I TED COMMISSION 217.30
CALLABLE EQUITY SECURITY.
ADDITIONAL INFORMATION TRarrsacrioxr-� 4.95
CONCERNING THIS SECURITY
IS AVAILABLE UPON REQUEST.
TOTAL $ g� I.�F 2.7 H
ORDER 616969533 PROCESSEDON 09/10/2013 � 13:28:22 cusir 38145X111 i
WE EXECUTED THIS TRANSACTION AS YOUR AGENT.
■ If the phrase "we rnake a mkt in this security" appears on this confirmation,we have acted as principal functioning as a secondary
market maker.
• If the phrase "unsolicited" appears on this confirmation,the transaction was conducted pursuant to an unsolicited order to buy or sell �
placed by the client. ��
' For debt securities transactions, call features may exist which could affect yield; additional information available upon request. o
• For zero coupon transactions,no periodic payment and callable below maturity value, without notice by mail to holder unless registered, o
• If the phrase "average price" appears on this confirmation, details regarding the actual execution prices are available on request. m
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PAGE i OF 2 �
ID�,�,°�s Edward�ones
201 PROGRPSS PARRWAY
• ST.`LO[DS,M0.6304 3-304 2
7EL 31A-515-2000
TRADE CONFIRMATION
�
���.
� q�� ,.;`�,-�,
f�r�- ;�..``'�..
RETAIN FOR YOUR PERMANENT TAX RECORDS �� 8�` �'" 'R� ,..
� �J
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YOUR FINANCIAL ADVISOR: ��� t���f� �
, ��
ESTATE OF HAROLD G SELECKY JEFF ZAVODA �` �
HENRY F COYNE EXECUTOR 4400 DERRY ST ��,�,
3901 MARKET STREET HARRISBURG, PA 17111 "�`:;--�.� �
CAMP HILL PA 17011-4227 `"'`•�`�
-�"v
BRANCH NUMBER: 26165
FINANCIAL ADVISOR#: 425408
ANY QUESTION5 CALL (717)561-2480
WE ARE PLEASED TO CONFIRM TI�FOLLOWING TRANSACTION SUBJECT TO THE INFORMATION, _
� DISCLOSURES, AND TERMS ON THE FRONT AND REVERSE SIDES OF THIS DOCUMENT:
IN YOUR CASH ACCOUNP 616-210 6 9-1-5
CN TP.A,^.E DATE �9�1��2��3 FOR SLTTL.�MEri'T DATE 0 9/13/2 013
YOU SOLD 5,OOO PRICE 87.29000
DESCRIPTION:
SELECT NOTES TRUST rxnvcmar.nMOUrrr $ 3,947. 16
LUNG TERM CERTIFICATES 2003-1 ACCRUEDINTEREST 21.00
5.97% DUE ON 02/22/33
PAY5 MONTHLY ON 15th
BOOK ENTRY ONLY TxnxsactzoNr� 4.95
YIELD TO MATURITY: 7.185X
UNSOLICITED
CURR FACTOR .90437900
CURR PRIN BAL 4,521.89 ToT� $ 3,963.21
ORDER 616969547 PROCPSSEDON 09110/2013 � 15:07:40 cus1P 81619PAA5
WE EXECUTED THIS TRANSACTION AS PRINCIPAL SELLING TO YOU OR BUYING FROM YOU AND A PAYMENT TO EDWARD
JONES MAY HAVE BEEN DEDUCTED FROM OR INCORPORATED INTO TIiE PRICE YOU RECEIVED.
. If the phrase "we make a mkt in this security" appears on this confirmation,we have acted as principal functioning as a secondary
market maker.
• If the phrase "unsolicited" appears on this confirmation, the transaction was conducted pursuant to an unsolicited order to buy or sell C
placed by the client. �
■ For debt securities transactions, call features may exist which could affect yieid; additional information available upon request. �
• For zero coupon transactions, no periodic payment and callable below maturity value, without notice by mail to holder unless registered. �
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PAGE 1 OF 2
pennsylvania SCHEDULE E
�
DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC.
INHERITANCE TAX RETURN �
RESIDENTDECEDENT PERSONAL PROPERTY
FILE NUMBER
ESTATE OF SELECKY, Harold G. 21 - 13 -0926
Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION DEATH
1 Metro Bank 29,654.30
Checking Acct. No. XXX)OCX0868
2 Metro Bank 224,542.03
Savings Acct No. XXXXXXX7589
3 Sale of 2005 Buick Lacross-private sale, poor condition, Body damage 3,500.00
4 Jewelry Box-per Mumma Appraisal 540.00
5 Edward Jones Cash Acct#xxx-xx725-1-7 1,964.83
TOTAL(Also enter on Line 5, Recapitulation) 260,201.16
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ETRO
BA N K 3801 Paxton Street 888.937.0004
Harrisburg, PA 17111 mymetrobank.com
8/28/13
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Lisa Marie Coyne �. "� �
Coyne & Coyne P.0 �
Attorneys at Law l
3901 Market St.
Camp Hill, PA 17011
RE: Estate of: Harold G. Selecky
Tax Identification Number: 199-12-3063
Date of Death: August 3, 2013
To Whom It May Concern:
This letter is in reference to decedent account information you requested fior the
individual listed above.
We are able to provide the following:
Account Type; CK
Account Number: 512100686
Date Opened: 03/04/1997
Primary Owner: Harold Selecky
Secondary Owner: Jean B. Selecky, until Date of Death 04/25/2013
Date of Death Balance: $29,654.30
Account Type: SV
Account Number: 616297589
Date Opened: 02/04/2002
Primary Owner: Harold Selecky
Secondary Owner: Jean B. Selecky, until Date of Death 04/25/2013
Date of Death Balance: $ 224,542.03
Please feel free to contact us at 1-888-937-0004 if we may be of further assistance.
Sin
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Jennifer Jacobs
Research Associate
Metro Bank
�''��U�1 T'1�5
E�t�rE�j� �fo�E
34 WEST MAIN STREEf
MECHANICSBURG,PA 17055 �
APPRAISAL Phone:717-76b-9422 f��PR� AISAL
f
`f�p ar sal for.
�' Harofd G.Selecky;} July 24,2013
�•------,_,-..---�-�"`
1. One State Police retirement badge in 10�Carat gold. ...........................................Valuation:$220.00
2. Man's 10 karat synthetic red stone ring in yellow gold..........................................Valuation:$210.00
3. Man's 14 karat wedding band in yellow gold.........................................................Valuatian:$100.00
4. Lady's sterling silver bracelet......................................................................................Valuation:$10.00
5. 18 pairs of costume jewelry earrings. ........................................................................Valuation: No value
6. Five strands of synthetic pearfs...................................................................................Valuation: No vaiue
7.26 pins rnade of white and gold-filled metals.........................................................Valuation: No value
8. Lady's Timex wristwatch...............................................................................................Vaivafiion: No value
9. Lady's Ecciissi wristwatch.............................................................................................Valuation: No vaiue
10. Man's Acqua wristwatch...........................................................................................Valuation: No value
11. Six flag lapei pins and other types of i4pel pins....................................................Valuation: No value
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This appraisal constitutes our carefutly studied opinion of
❑the retail replacement cost through our facifities
�the distress sales nature value
ot the article(s)described above insofar as the mounting(s) have
permitted observation.We assume no liability with respect to any
action that mav be taken on the basis of this anoraisal.
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Appraiser
REV-1517 EX+(10-09)
; pennsylvania ���H
" FUf�L DCPENSES AND
"�� ����'� DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN �ry��
RESIDENT DECEDENT ��uN����
FILE NUMBER
ESTATE OF SELECKY, Harold G. 21 - 13 -0926
Decedent's debts must be reported on Schedule I.
ITEM AMOUNT
NUMBER FUNERAL EXPENSES: DESCRIPTION
A. 1 Auer Cremation Services, Inc. 128.52
B. ADMINISTRATIVE COSTS:
�, Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
2. Attorney's Fees Coyne&Coyne, P.C. 25,000.00
3. Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 148.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees 1,���.00
7. Other Administrative Costs
1 Patriot News- Legal Advertisement 123.38
TOTAL(Also enter on line 9, Recapitulation) 35,154.67
Schedule H
Funeral Exper�ses&
COMMONWEALTH OF PENNSYLVANIA q,�nish�ativ�e Cas1s cor�tinued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF SELECKY, Harold G. FILE NUMBER
21 - 13-0926
2 Cumberland Law Journal- Legal Advertisement 75.00
3 Postage 50.00
4 Estate Checks 50.00
5 Reserves 5,000.00
6 Inheritance Tax Return Filing Fee 15.00
7 Appraisal Fee-Mumma Jewelers 100.00
8 Broker's Commision and Fees 456.87
9 Income Tax due 2,000.00
10 Edward Jones-- Estate Service Fee 100.00
11 Pink Hands of Hope--Cleaning and Clearing of Room at Country Meadows 250.00
12 Lower Allen Ambulance Service (7/18/13) 657.40
Page 2 of Schedule H
�,� ,�� pennsylvania SCHEDULE I
':� DEPARTMENTOFREVENUE DEBTS OF DECEDENT, MORTGAGE
INHERITANCE TAX RETURN
RESIDENTDECEDENT LIABILITIES & LIENS
FILE NUMBER
ESTATE OF SELECKY, Harold G. 21 - 13-0926
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Coyne&Coyne, P.C. - POA Invoice 4,856.25
2 Diamond Pharmacy 7.00
3 Verizon 5_97
4 Country Meadows 339.66
5 Uncleared Checks 800.00
TOTAL(Also enter on Line 10, Recapitulation) 6,008.88
REV-1513 EX+�01-10)
�� pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SELECKY, Harold G.
21 - 13-0926
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not L(st Trustee(s)
I� TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Mark H. Kaprive Nephew 48% of Residual
12167 Alder Lane
Wellington, Florida 33414
2 Barbara Ann Kable Niece 22% of Residual
21690 Kearsarge Place ;
Lexington, Maryland 20653 ;
3 Taylor M. Kaprive Grand Nephew 22%of Residual
12167 Alder Lane
Wellington, Florida 33414
�
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II� NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
REV-1613 EX+(p�-�0)
� pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN BENEFICIARIES continued
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SELECKY, Harold G.
21 - 13-0926
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List Tn�stee(s)
I� TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
4 Christopher Kable i Grand Nephew 4% of Residual
536 Ferdinand Avenue I
Delton, FL 32738
5 Barney Kable Grand Nephew 4% of Residual
11001 Kinship Court#104
Manassas, VA 20109
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Page 2 of Schedule J
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
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No. 2013- 00926 PA No. 21- �3- 0926
Es ta te Of: HAROLD G SELECKY
(First,Midd/e,LasU
La te Of: HAMPDEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No: �99-�2-3063
WHEREAS, on the 23rd day of August 2013 an instrument dated
January 18th 2007 was admitted to prohate as the Iast will of
HAROLD G SELECKY
(Fi�st,Middle,Last1
late of HAMPDEN TOWNSH/P, CUMBERLAND County,
who died on the 3rd day of August 2013 and,
WHEREAS, a true copy of the wi11 as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Reg.ister of Wills in and
for CUMBERLAND County, in. the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
HENRV F COYNE
� who has duly qualified as EXECUTOR(R/XJ
and has agreed to administer the estate according to law, aIl of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal . .
of my office on the 23rd day of August 20�3.
egister of �ls
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D puty
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
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I, HAROLD G. SELECKY, of the Townshi� �f East .Pennsbora, Cumberlar�d Cou.r�ty,
Pennsylvania, declare this to be my Last Will and revoke any�vill or codicil previously made by me. �
ITEM l: T direct that my body be cremated by the Cremation Soci.ety of 4100 Jonestouvn
Road, Harrisburg, Pennsylvania 17100. The cremation service has been pre-arranged and has been paid
in full. I direct that my remains be inurned to the columbariurn at Tnnity Evangelical Lutherasi Church,
2000 Chestnrzt Street, Camp Hill,Pennsylvania. � '
�� U ITEIVI 2: I direct that all my just debts and funeral expenses be paid as soon as practical
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� � ITEM 3: I direct that all taxes and interest and penalties thereon that may be assessed in
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� consequence of rny death, of whatever nature and by whatever jurisdiction imposed, shall be paid from
�' x m residuary estate as a part of the expense of the administration of my Estate. �
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�4 `, ITEM 4: I give, devise and bequeath all of my estate of every nature and wheresoever
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��"",`� :�tua�togeth�,.r•v�l`th insurance thereon, to my wife, JEAN B. SELECKY, providing she survives me by
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ITEM 5: Should my wife, JEAN B. SELECKY, predecease me or die on or before the �
{
irty-first (31 st) day following my death, I give, devise and bequeath the residue of my estate of every �
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nature and wheresoever situate,together with insurance thereon as follows:
, �
A. 48% to my wife's nephew, Mark H. Kaprive of 12167 Alder Lane, Wellington, �
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Florida 33414; �
B. 22% to my wife's great nephew, Taylor M. Kaprive oi 12167 Aider Lane, �
6
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� Wellington, Florida 33414; �
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C. 22% to my niece, Barbara Ann Kable of 21690 Kearsarge Place, Lexington, �
Maryland 20653;
D. �% to my great nephew, Christopher Kable of 21690 I�earsarge Place,
Lexington,Ivlaryland 20653; and `
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E. 4% to my great nephew, Barney Kable of 21690 Kearsarae Place, Lexington, �
� 1VIas-S�land 2Q�53.
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WITEM 6: Should any of the beneficiaries listed in Item 5 of this Will,predecease me or axe 15�
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c� � not living on the thirry first(31S`)day following my death,I direct that share be distributed in equal shares
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� to my then remaining living beneficiaries listed in Item 5 of this Will. �
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x ITEM 7: Until distributed, no gift or beneficial interest shall be subject to anticipation or �
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voluntary or involuntary alienation. �
ITEM 8: I appoint my wife, JEAN B. SELECKY, Executrix of this my Last Will. Should
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my wife, JEAN B. SELECKY, fail to qualify or ceases to act for any reason as my Executrix, I appoint '
HENRY F. COYNE, ESQUIIZE, alternate Executor of this my Last Will.
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ITEM 9: I direct that my personal representative or their successors shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and F
Testament, this j�� day of .�'��.0 , 2007. ,
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HAROLD G. SELECKY � ,
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Sigried, sealed, published and declaxed by the above-named Testator as and for his Last Will and
Testament in our presence, who, at his request, in his presence and in the presence of each other, have �
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hereunto subscribed our names as attesting witnesses.
_ O�'i It�� residing at �y �/'�
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COMMONWEALTH OF PENNSYLVANiA ) ;
) ss: I
COUNTY OF CUMBERLAND ) i
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We, HAROLD G. SELECKY, �N��, n.� , �(ao cZ+.-�c�2 , and
. �-�n--�.�E.,,..� S��c���s— , the Testator and the witnesses respectively, whose nasnes are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
dersigned authority that the Testator signed and executed the instrument as his Last Will and that he �
ad signed willingly, and that he executed it as his free and voluntary act for the purpose therein
expressed, and that each of the witnesses, in the presence and hea.ring of the Testator, signed the will as
witness and that to the best of his or her l�owledge, the Testator was at the time eighteen (18) years of
older, of sound mind and under no constraint or undue influence. .
`,��.�.,,� i
HAROLD G. SELECKY �
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Witness
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Witness
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Subscribed, sworn and aclrnowledged before me f--E��a-�t � C�K�E- by HAROLD G.
SELECKY, the Testator, and subscribed and swom to before me by �
�-� � �--� . t�o2��c� and J. �A-�-n-�c—� �«��-T the witnesses, this j
► ;-ti.a day of J���1�--c ,2007. I
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Notary Public (SE ) !
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t���oi�t�+oF��snv�r�t ;
lIOIARIAL SEAL j
HENRY f.CaYNE,NQTARS"PtlBC�G I
NAh1PDEN TWP.,GUMBERIAND COUIt� �
MY COMMtSSfON EXPIRES 1UNE r7,2003 �
�
COYNE & COYNE, P.C.
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
Henry F. Coyne 3901 Market Street (717)737-0464
Lisa Marie Coyne Camp Hill,Pennsylvania Facsimile(717) 737-5161
Bradley C. Baird 1 70 1 1-422 7 www.coyneandcoyne.com
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December�;2013
Register of Wills =' �;,
Cumberland County Courthouse c o `'' � �
One Courthouse Square Q � ,`---�•, �-' �'
Carlisle,PA 17013 � �7 c"� �' �$ �
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Re: Estate ojHarold G. Seleck��ec�ase� a _"�
No. 21-13-0926 � � �? � _ _;�-?
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Dear Sir or Madam: : � c� �`�` rdi
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We represent the Estate of the Late Harold G. Selecky.
Enclosed are an original and two (2) copies of the Inheritance Tax Return for this Estate. Kindly docket
the original Return and return a"clocked-in"copy with the enclosed stamped envelope.
Also enclosed is check no. 105 in the amount of$15.00 which represents the filing for this Return. Please
issue a receipt for this payment.
Thank you for your assistance. If you have any questions,please contact me.
Very truly yours,
COYNE&C YNE, P.C.
���.�,�. �
Lisa arie Co ne �
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LMC/bcb
Encl.
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