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REV-1500 EX(024 1) 1505610143
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania county cone Year File Number
Bureau of Individual Taxes DEFMTtAEW* Ravel°
PO BOx.280601 INHERITANCE TAX RETURN 21 13 0178
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
01 30 2013 01 15 1944
Decedent's Last Name Suffix Decedent's First Name MI
GANNON KATHLEEN M
(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 INAPPROPRIATE OVALS BELOW
❑ 1. Original Return ❑x 2. Supplemental Return ❑ 3. Remainder Return(Date of Death
Prior to 12-13-82)
Limited Estate 4a
4. Future Interest compromise 5. Federal Estate Tax Return Required
❑ ❑ (date of death after 12-12-82)
❑x B Decadent Died Testate T ?a.�e�oMaienf Tfesdt a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) pY c 1 t
❑ 9. Litigation Proceeds Received ❑ 10.Sp=al P?ver� e�1-Dia95M Death ❑ 11.Election l0 tax under See.9113(A)
(Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
SEAN M SHULTZ 717 243 6222
REGISTER OF WILLS USE ONLY
First Line of Address
26 W HIGH STREET
Second Line of Address C-7
z7
DAfE FILED
City or Post Office State ZIP Code
CARLISLE PA 17013 , ;
Correspondent's e-mail address: dhockenberryGDssr-attorneys.com �T
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the beestof my knowl edge;and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative Is based on all information of which preparer has any knoY+ledge.
SIGN RE OF PERSON RESPONSIBLE FOR FILING RETURN D�T� `
a r•„rte. Mark S. Gannon Z J L
ADDRESS
PO Box 458 San Quentin, CA 94964
SIGNATURE OF PREPARER THAN REPRESENTATIVE DATE
` � Sean M. Shultz
ADDRESS
26 W. High Street, Carlisle, PA
L
1505610143 Side 1 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Deoedenfs Name. Gannon , Kathleen M.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... i.
2. Stocks and Bonds(Schedule S).............. .. - . .. .................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 1 , 726. 00
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Nt Probate Property
(Schedule G) u Separate Billing Requested............ 7,
8, Total Gross Assets(total Lines 1 through 7)........................................................ 8. 1 , 726. 00
9. Funeral Expenses and Administrative Costs(Schedule H)............ ....................... 9. 228 . 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 228 . 00
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 1 , 498 . 00
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. 1 , 498 . 00
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15. 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable 1 498 . 00 16. 67 . 41
at lineal rate X .045
17. Amount of Line 14 taxable 0 . 00 17. 0 . 00
at sibling rate X.12
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE............. ..... ............................................................................ ............... 19. 671. 41
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13-0178
Decedent's Complete Address:
DECEDENT'S NAME
Gannon , Kathleen M.
STREET ADDRESS
2024 Lincoln Street
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 67.41
2. Credits/Payments
A. Prior Payments
S. 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. (4)
Check box on Page 2,Line 20 to request a refund
5. If tine 1 +Line 3 is greater than Line 2.enter the difference. This is the TAX DUE. (5) 67.41
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;....................-.................-......................................
b, retain the right to designate who shall use the property transferred or its income;......... ........ L�
c. retain a reversionary interest;or............................____.......................................
................................ z
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?........................................._......................................................................,.. ❑ 0
1 Did decedent own an in trust for' or payable upon death bank account or security at his or her death?....... ❑
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑
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.
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)(IA)(q].
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
172 P.S.§9116(a)(1.1)(ii)j. 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 172 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(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-1508 EX.(11.10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gannon , Kathleen M. 21-13-0178
Inctade dro oraceeds M litigation end the dale the procmds were received by the estelo.
All property)ointlyowerod with the right of suMvonohlp must be disclosed an schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 2012 Income Tax Refund 1,726.00
TOTAL(Also enter on Line 5, Recapitulation) 1,726.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 forth software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
REV-1511 EX.(10-0B)
Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE
DECEDENT SRN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Gannon ,Kathleen M. 21-13-0178
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
_ Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zio
Relationshio of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
T Other Administrative Costs 228.00
See continuation schedule(s)attached
TOTAL(Also enter on line 9,Recapitulation) 228.00
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1600 Schedule H(Rev. 10.09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Gannon , Kathleen M. 21-13-0178
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 Hixon and Simko,LLC-Income tax preparation 228.00
H-B7 228.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1600 Schedule H(Rev. 6.98)
S f • r
LAST WILL AND TESTAMENT
KNOW ALL MEN BY THESE PRESENTS,that I,KATHLEEN M. GANNON,
currently residing in Camp Hill,Cumberland County, Commonwealth of Pennsylvania, being in
good health and of sound and disposing memory do hereby make, declare and publish this as my
Last Will and Testament,hereby revoking all former Wills and Codicils heretofore made by me.
FIRST: I direct that all of my debts not barred by the statute of limitations,
expenses of my last illness,funeral expenses,costs of administration and claims allowed in the
administration of my estate shall be paid by my Executor hereinafter named, from my estate as
soon after my decease as shall be found convenient.
SECOND: I bequeath my automobiles,household and personal effects and other
tangible personalty of like nature(not including cash or securities),together with any existing
insurance thereon,to my sons MARK S. GANNON and BRIAN J. GANNON,in equal shares. If
they are unable to agree,then by making alternate selections of items in turn until each has
selected an equal dollar amount,provided that the share of anyone who predeceases me or dies
before the complete distribution of his share shall be distributed to.his issue per stirpes.
TH RD: I give, devise and bequeath the rest,residue and remainder of my estate,
whether real,personal or mixed, and of any nature whatsoever and wherever situate,to my sons
MARK S. GANNON and BRIAN J. GANNON,in equal shares,per stirpes.
FOURTH: I hereby nominate, constitute, and appoint MARK S. GANNON as
Executor of this,my Last Will and Testament. In the event that MARK S. GANNON shall
predecease me, or be unwilling or unable to act as my Executor, as aforesaid,then I nominate,
constitute and appoint BRIAN J. GANNON without necessity for posting security regardless of
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state of residence,.as Executor of this, my Last Will and Testament. All references to the
j Executor herein shall be applicable to said substitute Executor.
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FIFTH: My Executor shall have, in addition to the powers and authority conferred
upon him by law,the following additional powers and authority:
1. To sell at public or private sale,exchange,transfer,partition, give options upon,
lease,mortgage,pledge or otherwise dispose of any property,real or personal, at any time
constituting a portion of my estate, and upon such terms and conditions as the Executor shall
deem wise.
2. To invest any money at any time in such bonds, stocks,notes,real estate,
mortgages, life insurance, annuities or other securities, or such property, real or personal, as the
Executor shall deem wise,without being limited by any statutes or rule of law regarding
investments by the Executor.
3. To retain, without incurring any liability, as investments, any property owned by
me at the time of my death, as long as my Executor may deem it wise, and even though such
property is not the kind of property an Executor would purchase as an investment; and even
though to retain such property might violate sound diversification principles.
4. To cause any security or other property which may constitute a portion of my
estate to be issued,held or registered in the Executor's own name,or in the name of a nominee,
or in such form that-title will pass by delivery.
5. To consent to the reorganization,consolidation,readjustment of the financial
structure, or sale of the assets of any corporation or other organization, the securities of which
constitute a portion of my estate, and to take any action with reference to such securities which,
in the opinion of the Executor is necessary to obtain the benefit of any such reorganization,
consolidation,readjustment or sale; to exercise any conversion privilege or subscription right
given to my Executor as owner of any securities constituting a portion of my estate resulting
from any reorganization, consolidation,readjustment, sale,conversion or subscription.
6. To pay all costs,taxes, charges and expenses in connection with the
administration of my estate, including such compensation to the Executor which shall.be in
accordance with established fees throughout the period of administration of my estate.
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7. To determine what is"income"and what is"principal"hereunder, and my
Executor's decision thereon shall be final; and to purchase securities at a premium or discount,
and to apply or charge said premium or discount against income or principal as the Executor may
determine.
8. The Executor may make.payments to or on behalf of any person who is the
beneficiary hereunder but in no event,however, shall payments be made to any creditor or other
such person because of anticipation of payment by the beneficiary, and any such claim made by
way of anticipation by the beneficiary shall be of no validity or legal effect.
9. To borrow money from any person,firm or corporation,including any
corporation acting as an Executor hereunder,for the purpose of protecting and preserving or
improving my estate hereunder;to execute promissory notes or other obligations for amounts so
borrowed.
10. To employ legal counsel, accountants,brokers, investment advisors, custodians,
managers and other agents and employees and to pay reasonable compensation out of my estate
or any funds held hereunder to which said compensation is attributable.
11. To carry on any business owned or controlled by me at my death for whatever
period of time my Executor shall think proper, and my Executor shall have the power to do any
and all things my Executor deems necessary or appropriate,including the power to close out,
liquidate or sell the business at such time and upon such terms as my Executor shall deem best.
12. To do all other acts in my Executor's judgment necessary or desirable for the
proper and advantageous management,investment and distribution of my estate.
SIXTH: I direct that all transfer and inheritance taxes,state or federal, assessed
ibecause of my death,whether the funds,property or insurance proceeds to which such taxes are
attributable pass under this Will or not, shall be paid,out of my residuary estate;that my Executor
pay, or provide for payment of all such taxes at such time,or times, and in such manner as my
Executor deems best.
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IN WITNESS WHEREOF,I,KATHLEEN M. GANNON,the Testator to this,my Last
Will and Testament,typewritten on four sheets of paper which I have identified at the bottom of
eAh page by my initials,hereunto set my hand and seal the day of
2003.
KATHLEEN M. GANNON
The preceding instrument consisting of this and three other typewritten pages,each identified by
the signature of the Testator,KATHLEEN M. GANNON,this day and date thereof signed,
pubiishe6and declared by KATHLEEN M. GANNON,the Testator therein named, as and for
her Last Will, in the presence of us who, at her request,in her presence,and in the presence of
each other have subscribed our names as witnesses.
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d.
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COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
I,KATHLEEN M. GANNON,Testator,whose name is signed to the attached or foregoing
instrument,having been duly qualified according to law, do hereby acknowledge that I signed and 1
executed the instrument as my Last Will;that I signed it willingly;and that I signed it as my free and
voluntary act for the purposes therein expressed.
THLEEN M. GANNON
Sworn or affirmed to and acknowledged before me by KATHLEEN M. GANNON,Testator,
the day of�f �� ,2003.
(SEAL) Notary Public 4f 11�7
NOTARIAL SEAL
Roberta L Radcliff,Notary Public
Wormleysburg 8orough,Coumy of Cum 2
My Commission Expires Jan.20, 005
COMMONWEALTH OF PENNSYLVANIA
: SS
COUNTY OF CUMBERLAND
. �We �o..MeS Q. 012. and A� �D op nc� �� ,the
witnesses whose names are signed to the attached or foregoing instrument,being duly qualified according
to law,do depose and say that we were present and saw Testator sign and execute the instrument as her
Last Will;that she signed willingly and that she executed it as her free and voluntary act for the purposes
therein expressed;that each of us in the hearing and sight of the Testator signed the Will as witnesses;and
that to the best of our knowledge the Testator was at that time eighteen or more years of age,of sound
mind and under no constraint or undue influence.
Sworn or ffirmed to and subscribed to before me by J/�/yJES f and
witnesses;this 1 %' day of 42��.2 2003.
(SEAL) Notary Public
NOTARIAL SEAL
Roberta L.Radcliff,Notary Public
5 Wormleysburg Borough,County of Cumberland
My Commission Expires Jan.20,2005