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HomeMy WebLinkAbout09-11-14 � 150561�1�1 REV-1500 EX�°1_1°, ' PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes �`"p��"�'°`p`°`"°` County Code Year File Number PO BOX�8o6oi INHERITANCE TAX RETURN �,f , Harrisburg,PA i'7128-06oi RESIDENT DECEDENT �u , � ��f� , ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ', Suffix DecedenYs First Name MI : LEHMAN _ CARL __ _ W ; � — __ — _ __ _. _ __ ___ __ _ � (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M� LEHMAN , _ _ _ w__ � ISABEL G � � __W._ . __.,.. . _____� � __ . __ _ . . _ . � ; Spouse's Social Security Number ____ _. ° THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ��i - /8� �r� 3 _ .._ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C� 1. Original Return O 2.Suppiemental Return p 3. Remainder Return(date of death prior to 12-13-82) O 4. Limited Estate p 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required death after 12-12-82) C� 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 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 Sch.O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALl CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SNOULD BE DIRECTED T0: Name Daytime Telephone Number _ _ _.,., Andrew H. Shaw, Esquire (717)243-7135 . _.__ � �.. _ _ _ _ _ _ _ . ,-,,,--.._ .�: REGISTE� 4(L�S USE�LY rn M � � � First line of address � Z c'� "'o � � 200 S. Spring Garden St_ _ __ __ ' ;.� z,, r-- F.,, r*' � �"' w �`r 1 f...,a �'1''� C'J , ..� lt;• ,., :a7 �'7 Second line of address ' ��' _ r", , y •-0 <�J C� Suite 11 � �: .:- � `-� "n <.� � � "i'r ~��, .... Cit of POSt OffICe ,DAfiE FILED � t"" y. _ . State ZIP Code � ' Carlisle ._ _ PA 17013 � � tn o CorrespondenYs e-maii aadress: andrew@ashawlaw.com Under penalties of perjury,I declare that I have examined this return,inciuding accompanying schedules and statements,and to the best of my knowledge 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 knowledge. SIGNATUR,rs�i�ON,l�ESP��FOR FILING RETURN DATE �\ �_ �o _ �y ADDRESS 379 Lo s Gap Road r'sle, PA 17013 SIGNAT OF PRE OT E HAN REPRESENTATIVE DATE ,(,.�,�,,, ... �,_ AD S 200 S. Spring Garden St., Suite 11, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY � Side 1 � � 15�5610101 15056],0101 � J 1505610105 REV-1500 EX Decedent's Social Security Number �ecedent's Name: j �� RECAPITULATION 1. Real Estate(Schedule A). .. . . . .. .. .. .. .. .. .. ... .. . .. .. .. . .. .. .... . .. . 1. ._ 0.00 ! _. �_ � �. . �. P, �.��.F _ . 2. Stocks and Bonds(Schedule B) .. . . ..... .. . .... .. . .. ... .. .. . .. .. . .. .. . 2. 80,916.59 ' 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .. .. . 3. 0.00 4. Mortgages and Notes Receivable(Schedule D) .. .. ... .. .. . . .. .. .. .. .... .. 4. � � 0.00 ' _ . �_,� �„_. . � �_ . .a.� . .�� 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). .. .. .. 5. 0.00 v,a . _.x _ m�� '� . 84 850.00 � 6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. .. . . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property -• --- m.-��-., (Schedule G) O Separate Biliing Requested.. .... .. 7. I 32,546.91 '' a_,e . ... � . ..na _Mm�� ...��v.��� 8. Total Gross Assets(total Lines 1 through 7).. .. .. ... .. .. . .. . .. ..... ..... 8. 198,313.50 9. Funeral Expenses and Administrative Costs(Schedule H).. . .. .. . . ... .. . .... 9. ' 728.50 ' _ � _ _ .... �_ ,� �����..< 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) . . . . .. .. .. . .. . 10. 0.00 . � �� ..n _ ,... . 11. Total Deductions(total Lines 9 and 10). .. .. .. .. . .. .. .. . . . . .. .. .. ..... .. 11. 728.50 � „ a . _ _ ,. y _ ._ '� 12. Net Value of Estate(Line 8 minus Line 11) . . .. . ... .. ... .. . .. ... .. .. .. .. . 12. 197 585.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ` °. ° ° an election to tax has not been made(Schedule J) . .. ... .. .. . ... .. .. .. .. .. 13. ' 0.00 �. � -- ._.�u �. . ,. .s _ �..,_._. .�� 14. Net Value Subject to Tax(Line 12 minus Line 13) .. .. . . . .. . . . ... .. .. .. .. . 14. ' 197,585.00 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 00 197,585.00 15. '' 0.00 i 16. Amount of Line 14 taxable � ' `� `�`" ` ` a e, .�_ . ___ � �.� at lineal rate X.0 45 0.00 ' �g, � 0.00 : 17. Amount of Line 14 taxable � �� � � � "� ���� � ° �° ���� °• � �a ,� _.�. _. �t _ . �. _, at sibling rate X.12 0 00 ' q� � 0.00 18. Amount of Line 14 taxable � �� ' � �� ��" �" � -� � � �.. ._n �F u� . at collateral rate X.15 0.00 ' �g � 0.00 _ � . � __� _ . � r �_.� 19. TAX DUE . ..... .. . .. .. .. .. .. ... . .. .. .. .. .. .. .. . . .. .. .. . .. . .. . . .. .. 19. �.UO ; 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 � 1505610105 1505610105 � REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Carl W. Lehman STREETADDRESS — - 581 Longs Gap Road ciTV - -- Carlisle STATEPA ziP 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments 0.00 B.Discount 0.00 ------...-------.------- Total Credits(A+g) �2� 0.00 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �3� 0.00 Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 Make check payable to REGISTER OF WILLS, AGENT k"`k �y��"� _°a � �, ��� �,,�� ,. �'a,� "� .� ..� 6�;.� �. ' ��,wr�a_;�,� ��•,.,a� ��-Yrz�vk ..:u,-� �9i �` i ,.<t ��� ���°�'d��� - �li �y,, ��.�,� �� _ � � . � _ ��'�" �`�a .�,u.R.�r�»��"4,t:� �.r. �,�_ i`����sm .. �sri��-°�'.� 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 shail use the property transferred or its income:............................................ � Q c. retain a reversionary interest;or.......................................................................................................................... ❑ 0 d. receive the promise for life of either payments,benefits or care?...................................................................... � 0 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?.............. ❑ �x 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ 0 ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. �;��` . �,. -s: ��'�r ,- 7� �.„ �, '�a �,^,°_ , . �,. i :� ���#6 ��r-'�r� - � :..� a��r� . � � x�.�� �,�:e_ .�:,�..- �.!�a . s � , � "=. � i..,� , . .i . . . �-� _�� :.- _ ...� _ ��.> ����'. .�F,c 7,s,�� � ���. 7 �„�_.,«�__ �" ��� � .�`s��t ���:� For dates of death on or after July 1, 1994,antl 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 p2 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 oniy 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 notetl 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 tlecedent's siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. � LAST WII,L AND TESTAMENT OF CARL W.LEHMAN I, CARL W.LEHMAN,presently residing at 581 Longs Gap Road, Carlisle, Pennsylvania, being of a sound and disposing mind, over the age of eighteen(18)years, and under no legal disability, and mindfui of the brevity of this life, having placed my faith and confidence in Jesus Christ, my Saviour and Lord, Who redeemed my soul through His shed blood and death upon Calvary's Cross for my sins and Who, by His resurrection, thus assures me of eternal life, and knowing that the life which I now live in this worid is by faith in the Son of God Who gave Himself for me, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all ather Wills and Codicils heretofore made by me at any other time. Artiele I: I direct that my Personal Representative(s), hereinafter named,pay all my just debts and funeral expenses as soon after my death as practicable, including all property, state and federal death taxes assessed against me, my estate, or my beneficiaries, without proration among my beneficiaries. However, all properiy bequeathed or devised hereunder, either outright or in trust, is bequeathed or devised subject to existing mortgages, liens or encumbrances thereon. Article II: I confer on my Personal Representative(s)and/or any Trustee(s) appointed �;= r r ��. � � 1 ��``� �' ���" Carl W. Lehman herein and their successors the right to seli or otherwise convert any real or personal property at public or private sale, at such time or times, in such manner, and for such price or prices, and on such terms and conditions as my Personal Representative(s) shall determine, and to execute and deliver good and sufficient conveyances, assigrunents, and transfers of the property, without liability of any purchaser for the application of any consideration; to borrow money and to secure its payment by mortgage of real or persona�property,pledge of investments, or otherwise, without liability on the part of the lenders to see to the application thereof; ta retain any investments at discretion; to invest and reinvest at discretion, as permitted under Act 28 of 1999, the"Prudent Investor Act"; to make distribution in cash or in kind; to allocate and distribute different kinds or disproportionate shares of property or undivided interests in property among beneficiaries, in cash or in kind, or partly in each; and all other powers given under the statutory and common law of Pennsylvania available at the time of my death and the power to do all acts and things necessary or appropriate in the management, administration and distribution of my estate. Article III: At the time of execution of this Last Will and Testament I am married to ISABEL G.LEHMAN. Article IV: At the time of execution of my Last VVill and Testament I have the following children: A. LIlVDA R.BREHM; � B. CARLA J. HUNT; �'�j�j{�,� t.�''.,��'�� 2 Carl W. Lehman C. STEVEN R LEHMAN,SR Article V: I hereby nominate and appoint my daughter, LINDA R BREHM, my daughter, CARLA J.HUNT,and my son, STEVEN R LEIiMAN, SR,as Co-Personal Representatives of this my Last Will and Testament. My individual Personal Representatives shall nat be required to furnish bond or surety. Article VI: I give, devise and bequeath my entire estate, inctuding all the rest and residue of my estate of whatever kind and description where�er situate, to my spouse, ISABEL G.LEHMAN, absolutely and in fee simple. Article VII: In the event that my said spouse, ISABEL G.LEHMAN, has predeceased me, fails to survive me by thirty(30) days, I giVe, devise and bequeath all of my jewelry, clothing, household furniture and furnishings, chinaware, silver, pictures, works of art, books, personal automobiles, and other tangible articles of a personal nature, not otherwise specifically disposed of by this Will, to my Personal Representative(s}; and it is my wish that my Personal Representative(s) dispose of said property in accordance with a memorandum or list I shall leave with my Will at the time of my death as a guide in disposing of the tangible articles hereinabove bequeathed to my Personal Representative(s). Any item of personal property not set forth on said list shall be disposed of as a part of my residuary estate. Article VIII: In the event that my said spouse, ISABEL G.LEHMAN, has predeceased me, fails to survive me by thirty(30) days, or if we should perish in, or as the result of, a common disaster, I give, devise and bequeath my residuary estate to my children in equal shares, ,, 3 �f �j°�� ( i E ���-'��►�,,� Carl W. Lehman per stirpes. Articte IX: In the event I and my spouse, ISABEL G. LEHMAlV, are killed in a cammon disaster or she fails to survive me by at least thirty(30) days, it shall be presumed that she predeceased me. Article X: My spouse is executing a similar Will; however, there is no intention that either of us shall be prohibited from making a different testamentary disposition either before or after the death of one of us. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ,��day of � '�'� , 2011. � r�'�c,�ul'��(..��.+w-�iw''. J (SEAL) Carl W. Lehman Signed, sealed,published and declared by the foregoing Testator as and for his Last Will and Testament, consisting of four(04)pages, in the presence of us, who at his request, and in his presence, and in the presence of each other,have hereunto set our hands as witne�`s 1 thereto. �� � f� , � �,,.....--..�_� �, �. �� 4 _ _. COMMp1�IWEAI,Tg pF PENNSYLVANIA , COUNTy OF CUMBER.I,AND ' I� CARL w• I.EHMAN, Testator, whose name is signed to the attached or foregoing instrument, being duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn to or affirrned and ac owledged before me by CARL W,I,EHMArJ, the Testator, this %�"" day of - ° ' � ^ , 2011. , � ��'�/-�1 f Carl W. Lehman COMMQE���,qi�,���.pENt�SYd.VANIR �in�aNa!�eaf Sarah t7.t�ieckrRan,Notary Pubtic Cariisie€3orc,Cum�eriand Coumy � -,.�"� _'---.� �Y COmtrsiSSi6R Eupfres NOV.$,Z013 :_ Member.Penras�tvania As�ariakion c�f NotaHeS ��'Y Public My Commission expires: CaMMONWEALTH 4F PENNSYLVAIVIA . COUNTy OF CUMBERI,AND � r �� � i VVe��,���--�'✓� �`f . �� a s�. .,;� d i,� �` ;� an c?t t�Z G� I . ���C�.�. �-�� , 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 his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. — �worn to or,affirmed and subscribed before me by � ,.,t ' ` � �. �2�. �- : / �;���r�����.+J and � �' r ��v , witnesses, this � �>�`" da of Y �' c� 2011. ` � f'� � -� � (f� ,4 `� f .�u,a ' !�r�,�.�_� , � ``-��" � � ; c...._ �= ----" -- .�----�.� Notary Public My Commission Expires: ct�r��t�r�v�-F-���������yAy�� t��barial[ea6 Sarah D.t}�e�kkman,NoLary PubtiC CarllsPe Bora,Cumberland Gounty S �1Y Commission Expires Nov.S,2043 Member.Pennsvfvanla Assocratiori of Notarl�s REV-1503 EX+(6-98) � SCNEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carl W. Lehman 21-13-1317 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH �� Pamassus Funds,Account#08924600 80,916.59 TOTAL(Also enter on line 2,Recapitulation) $ 80,916.59 (If more space is needed,insert additional sheets of the same size) �' � � I'� ASSI.� S FUND► S ° "I MarCcet Street � Suite 160() � San Frartcisco, CA 94105 � (415) 778-02Q0 www.parnassus.com CARL W. LEHMAN Account Transaction Summary 641 LONGS GAP ROAD Your Account Representative: CARLISLE PA 17013 PROEQUITIES INC Timothy G.Long (800�23-2838 Your Portfolio SummaryAs Of Sunday,June 30,2013: Account#: 08924600 Cost Basis Details Portfolio Value Detaiis Fund Non-Covered Non-Covered Covered Covered Cost Shares Shares Cost Basis Shares Basis Owned Last Price Market Value %Port. Parnassus Fund 1,615.838 $53,738.47 15�.514 (PARNX) $5,795.30 1,766.352 $45.81 $80,916.59100.00°/a Totats: $80,916.59 Oividends and Capital Gains paid Year to Date Deciared Dividends Short Term Capitai Gains Long Term Capital Gains Parnassus Fund(PARNX) $0.00 $0.00 $0.00 Parnassus Fund(PARNX) Trade Date Trade Type Amount Shares Transacted Price/Share Balance 4/1/2013 Beginning Shares Balance $75,900.15 6/30/2013 Ending Shares Balance 1,766.352 $42.97 1,766.352 $80,916.59 1,766.352 $45.81 1,766.352 Chanye In Value Since 3/31/2013 : $5,016.44 Change In Value Since 12/31l2012: $9,167.37 ---------- -------------------- ------------- Parnassus Investment Sli -�- -�- "�------ Account#: 08924600 p CARL w. LEHMAN Parnassus Fund: $_ Please make your check payable to: 641 LONGS GAP ROAD Pamassus Equity Income Fund: $ CARLISIE PA i7013 Parnassus Funds Parnassus Mid-Cap Fund: $ Parnassus Smali-Cap Fund: $ Mail checks and investment slip to: , Parnassus Workplace Fund: $ Parnassus Funds � �4ddress Change Pamassus Asia Fund: $ 1 Market Street,Suite 1600 Pamassus Fixed-income Fund: $ San Francisco,CA94105 —" Total Investment: $ _ Phone#:(800)999-3505 For(RA ac�ounts nniy: Fax#:(415)776-0228 Telephone: ����f�kl�{���Q��Y�?�E„ REV-15o9 EX+(01-10) � Ps pennsylvania SCHEDULE F ��� DEPARTMENTOfREVENUE )OINTLY-OWNED PROPERTY INHERITANCE TAX REfURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Carl W. Lehman 21-13-1317 If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING)OINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• Isabel G. Lehman 581 Longs Gap Road, Carlisle, PA 17013 spouse B. C. ]OINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY "/o Of DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANpAL IN5TITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1' A' 01/20162 Real Estate located at 641 Longs Gap Road,North Middleton Twp 169,700.00 50 ' 84,850.00 TOTAL(Also enter on Line 6, Recapitulation) $ $4,850.00 If more space is needed, use additional sheets of paper of the same size. c,l S�f a >i �� . ( :u.�r—w.....a u..a,anw.r....��.a i�. . . . . _. .. .__. _ ._. . , N«.n M.14 Iee..tedl.n.,Pr 90�K�Q FACE 36Q � / � � � � � � � , MADE THE °< �� day oj Jarruary in tke y�r oJ oKr Lord mu thoeaand ni�e hundred o izLy-two (1962). J BF,TWEEN ABRAM N. LEHMAN and ANNA 3. L1�3iMAN� hia yQ fe� of A. D. ?, Carliel'e� Pennaylvania� hereinaft�er oslled Gmnto.e , an�' CARL W. LEriMAN and ISABII. G. LSHMAN, his xife, of R. D. 2� Carlisle, Pennsylvania, hereinaPter oalled Grnntee e: i{'lTNESSETN,that in conaideration o/ One ($1.00) Dollsr in hand paid,Ehe reeeipt whereoJ ia hereby atknauledped,the snid grnxtor9 do he�eby�grn�n and convey to the aaid praateea, their heirs and assigna� ea tenanta by tihe entireties: ALL that certain trect oP land situate in North Middleton . Toxnship, C�berland County, Pennsylvanie, bounded and described as follo�rs: BEGINNING at a point in the center of Longs Gap Road; thence by land now or formerly of C. W. Geiman, South 72 degrees 15 minutes West 200 feet to a point•t thence by lend of the Granteea, North 1T degreea l{5 minutea West ierroneously deaiF�ated North 17 degreea � �5 minutes East in a prior description) 15 feet to an iron pin; '. thence by tha same, North 72 degreea 15 minutes Esst 200 feet to a point in the center of Longs Gap Road; thence along the center of esid road, South 17 degraea �5 minutes Fsst (erroneously deisgnated Sonth 17 degrees 45 minutea NeaS in a prior dascription) 15 feet � to the Ylace of Beginning. � BEING part of the property which was conveyed to Abram N. � Lehman and Mary E. Letunan� his wife� by Annie Lehman, uidow, by ! deed daLed November 18, 1940� and recordod in the Office of ths � Recorder of Deeds for �unberland CounL7 in Dead Book "F", Volwne 12, Page 596; and being the Northern 15 Peet of the .q18 Acre re- served to Abram N. Lehman and Mary E. Lehman, hia xife, in the deed � to Lhe Grantee9 dated Auguat 30, 1951� and reoorded in the Offioe aforeasid Sn Deed Book "U" Volume 11�, Page bs. Mary E. Lshman died on January $ � 195�� thue •eating oompleLe tible in Abram 4 N. Lehmen, es aurviving benant b� the entirstT, sinae remarrisd to � Anna S. Lehman. ; 1'his c�veqanoe ia from parenti Lo chfld and apouss. ( , I 3 l . :. ._ _ . . ,__ __� �............ �..�,,.....................................................,�.:�,:................_.................-.--..---.--.-.--...:�.-::�.�...............,� �..........:...........•--•--.................:...................................._..........................._.....•-••••:......................._,;,.y...............' r__ .•,,,� s�'w . . . _. ♦ . . . _. _'s ` � � I IANU,ll�r.xnid prruilnr 9,rin hrrr6U covcra�nt nnd aprer. Eo and taiEk lhe x¢id p�rvntec �, lhat � i they , tha pra�t�„rs�theirAeira,•ezeadora aral admirtiatratora,ahal!and wiU marmnE generally nnd Jorever deJet�d the Aercin nGoue dcecri6cd j 1 ! Pr��a�i.w:c, �cilh Ihr perediG�mr.nts and appurtenancea,anto the aaid yraxtte a� th011` heira ( 4 arid n,yxtpna,a,y�tinxt thr xni�l pranlor q¢nd apainat evtry otktr peraon law/uUy e4eimixp or uho 4 ; sha/l hrrrrtJfcr rlaim Nir.anmc or an�part theteoJ. • I , , ' ; � 1 � 1 F.rreb� cerli(� t6at t6e Reudeaa � I �md Posl 0((itt oi wit6io Gnotee a I � �_�_.__���-- I { I ��d. �.______ �"'kr�r Attr I � - I i i i � /N WITNESS WHEXh'OF,8¢id yrnntor a have hereuxto aet th hunds und xrnl e+ ' tht dnv rtnd vrar firxE rtbnve�nritten. � � I . , ���� � �. 61gatA.6ealeD anL$rlintre� ���'� ���G="•-'••"�-=L.�-•••.. r�w� � X'bram A"."I:e n � i ' - ia tqc resrnre nt ! I �/�,,,, I ` � -..../.....�...............�. ...........------.......... ee�� � � ...........Y.�.':\ ._L.1.. ...f�1�...... � /,"....,'__/,.._. , � � _.L..3:?:?.:.^..!S----- :.....':.�i...?!:?La3'7✓ ^ i . , 1►nna $. L9�1m8II . ...._......°............. aa�� � � �� �. ` _........... ................................................._""'.. ......"_"._...........""_'.'.........""".. ....."_"'.........: s�►L I "'.__.. i � • I � I � � i , � � ; I � ' � I i ; ; � � � , �,,,,,�,E,,, ,�,� I ti�r'��:,.,��,� i,irus i i � ��.7,/9�i� i3./�� I � I ..�.,�;rw�, .�r.ounrv� . r�va,iiq � � Stnte nJ Pennaylvania I � aa. _ i Cov�nty af �umberland � { i On Uiia,the �� dny of Jenuary ,I9 62, Gejorr mr. I � � the undcraipned ojficrr,ycraortaUg a�earrd Abr9m N. LehlpBri and Ai1Re S. Lehman, ; hia wife� I i knotun to me(or srtliaJacEorilv proven)to bt Ehc person s whose�ame� are 8��6acribed to thc with- � in i�uvtnimcat,rtxd neknowledged�hat th¢y execated the a¢me Jor the purpoaee thercin eoa- I taiacd, � � � � !N iV/TNF;SS li'HEREOF, 1 herettnto set my hand and o�'icial aral. � �. „ _ ,..• . i `,1, �E '+� ................... . -� �--... — --............. ,, : R .., � _ ... ' �� Y' ... , � ; .. . , •., _ , -. ..: .. .. 1iAL i..� ;`�,;:�'.�.f � ��i, . ......_btYCo N07ARY PUBLIC- ................... ! � ,. . �,, ��; mmrssah E'x'ires _ _ i ' �3; : � •�,•.c� >? Boro.of Carllsle,pPa.�MaY10,�lc oJ OQterr. � :�•,o.�O o. �' Cumb. f i .�on j"-P�.;���� j • , '�..�'O�'.: . BOOK��O PAGE :;bl � i ( i � Property Mapper Cumberland County, PA . �. , - . . ,. . . .. , �.�i� Copyright 2011 Esri. All rights reserved.Tue Sep 9 2014 11:10:26 AM. 641 LONGS GAP ROAD PIN: 29-06-0021-009 Deedbook: 0020L-00360 Owner: LEHMAN, CARL W Land Use Code: 112 Property Type: A Acreage: 82.1 Square Feet: 1824 Taxable Status:T Clean&Green Status: A Land Assessed Value$: 57400 Building Assessed Value$: 112300 Total Assessed Value $: 169700 Sale Price$: 1 Sale Date:Thu Feb 14 1974 07:00:00 PM Year Built: 1820 Municipality: NORTH MIDDLETON TWP Height in Stories: 2 Type of Dwelling: DETACH Primary Exterior: Asbestos Basement Percentage: 100 Air Conditioning: NO Total Rooms: 8 Bedrooms: 5 Full Bath: 1 Half Bath: 1 REV-1510 EX+ (OS-09) r pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Carl W. Lehman 21-13-1317 This schedule must be completed and filed if the answer to any of questions i through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE �INCLUDE THE NAME OF THE'fRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF 1RHNSFER. ATfACH A COPY OF THE DEED FOR kEAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE VALUE 1. Met Life IRA,#550011951 32,546.91 100 0.00 32,546.91 , TOTAL(Also enter on Line 7, Recapitulation) $ ' 32,546.91 If more space is needed,use additional sheets of paper of the same size. �� �� Metropolitan Life Insurance Company Preference Plus Select B Plus Class P.O.Box 10342 Overnight Address: Quat"�grly StBt@YTI@tlt � Des Moines,IA 50306-0342 4700 Westown Parkway,Suite 20o April 01, 2013-Ju�e 30, 2013 �1 (800) 638-7732 West Des Moines, IA 50266-0266 www.metlife.com Advisor Name(s): SCOT WHISKEYMAN (717)724-9700 � � ` CARL W LEHMAN � 641 LONGS GAP ROAD ° CARLISLE PA 17013-8526 ,. �er�er�f Gontr.act lt�'form�ho� � ` ' . "� ,. '�.__,..,.� . "� .�,M-.. .�, .,� k -. � � Contract Number � 550011951 Total Purchase Payments Since Issue _ Issue Date 09/09/2002 $45,254.29 _ Account Type(Tax Market) . IRA . Total Withdrawals Since issue = Owner(s) CARL W LEHMAN $28,940.43 _ Annuitant(s) CARL W LEHMAN - �u�rte�;ly Accounf Sur�ntiaat'� _ _. . .f ._r. __� ._ . _. .�..0... ,. ,.� _ Y April 01, 2013 Opening Account Value�'� $32,289.73 - Purchase Payments $0.00 _` Gross Withdrawals $0.00 . Gain or(Loss)04/01/2013-06/30/2013 �2� $257.18 � June 30,2013 Account Value �3� $32,546.91 � ..� �.. „ .,� r "'� :� »� a�� fh ��zr�-�.*, .�� '� �'���„�"" 5 ���r'.��,'* ,.. a!"��,�"�`� �'��y. .�.. .y�r� 2��r,�,,�„�.; . . . .. �.,��. ,�a `, .. �F���,�a i �. �.a -� ,�t -s'���� ._,� ,. r�� .� ,��'�,�+,� „p a�.-� , ,„��',�€'��..�z.��'������,�"..��:. . ���,l+1.{4+�}.�VP.��pi� "�'�.,a.�.� .h����';x,�,r_Fns.�,�`"' .F�....s.ta�',,,Z�r�� ��''",�.%'=;.r�.��w,�,va,��ks,a..�����'.�::f.�`�,:"� r�a.�r,�'#Y-s'.�,�xrw.�ey����`af`�,'ry.�a+��.�.wr„v�``�-���.-`�� . �,SO��d.1_ � �« � . � Death Benefit Features Death Benefit Value °� $32,546.91 .:k ,. ��.7.._ y, ..:,�. . h' �'",�S' �,r r .�,y� '�,, �' �$" � �q ^ : �i>i si� �y�./, "l��,';E`2�����+��2`r t ��� .'s��; y„tIr t� ,c�y x v . �-,�£ �1l���V;:20131�a�u+�-��-�.�. . �" �..� ,�F.°^.�.�h��'S��'�`.�'C.`��t,a'`.,,dS�`�_, , ;. vr`'�'�, vC��k'"'��`.z��.xs....:�0?R�T,e�� _ �,,�,.�'.d���, � �_�d�''dX� .�r-� .5:., �c- >s..;,�+.' �r Fund Name #of Units�4� Fund Balance Ailocation% 4merican Funds Growih Fund 25.30 $4,794.43 15.0% Percentages may not equal 100%as ihey �larion Global Real Estate Portfolio(Class B) 188.96 $3,158.69 10.0% are rounded to the nearest perce�t. N/A $14,041.05 43.0% g p��S.0°� � 15.0/o =ixed Interest Account ,T,--� ° _ord Abbett Bond Debenture(Class E) 104.89 $2,259.71 7.0% ��°�::> '��'� �i:« _ord Abbett Mid Cap Value Portfolio 77.14 $2,387J2 7.0% 7.0% " 10.0% vISCI �!� F Index Portfolio(Class E) 89J5 $1,247.63 4.0% Veuberc;:r Berman Genesis Portfolio 95.57 $2,068.04 6.0% 43.0% Nestern Asset Management U.S.Government 137.59 $2,589.64 8.0% �o�ttolio *Other �5� 4�i2os--Qo2 i P-oiaoa9i REV-1511 EX+ (10-09) � k� pennsylvania SCHEDULE H ` DEPARTMENT OFREVENUE F U N E RAL EXP E N S ES AN D INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Carl W. Lehman 21-13-1317 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: L B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 0.00 Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 600.00 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees; 128.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL(Also enter on Line 9, Recapitulation) $' 728•50 If more space is needed,use additional sheets of paper of the same size. _ REV-1513 EX+ (O1-10) ; ���� pennsylvania SCHEDULE J DEPARTMENT OF REVENUE ��� INHERITANCETAXRETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Carl W. Lehman 21-13-1317 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECE[VING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2),] 1• Isabel G. Lehman,581 Longs Gap Road, Carlisle,PA 17013 spouse 100% 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.