HomeMy WebLinkAbout12-31-14 (3) � 1505610140
REV-1500 EX `°2.,,>`F'>
PA Department of Revenue Counry Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 2 1 1 4 0 3 4 7
Harrisbur , PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDm'Y Date of Birth MMD�YY�'
1 0 4 0 1 2 0 1 4 0 ], 2 6 1 9 1 1
Decedent's Last Name Suffix DecedenYs First Name MI
H A N D S H A W H A R P E R �
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's�ast 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 OVALS 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(date of � 5. Federal Estate Tax Return Required
death after 12-12-82)
Q 6. Decedent Died Testate � 7. 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 � 11. 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 SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
D A V I D H S T 0 N E , E S Q U I R E 7 1 7 7 7 4 7 4 3 5
REGISTER OF WILLS USE ONLY
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First Line of Address -� � � �
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4 1 4 B R I D G E S T R E E T r-, =r'- ;, � r��
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Second Line ofAddress ' ,,,�- rv1 � s � �j
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City or Post Office State ZIP Code , .�.� _��-#
N E W C U M B E R L A N D P A 1 7 0 7 � - � , ,-�.. C— r�'n
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Correspondent's e-mail address: D S T 0 N E a�S T 0 N E L A W • N E T
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 is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG AT F PONSIBLE FOR FILING RETURN DAT
� �
A RESS
72 P R VE NEW CUMBERLAND PA 17070
SI NA RE O P R 0 E AN REPRESENTATNE DATE
�2 �
ADDRESS
414 BRIDGE S ET NEW CUMBERLAND PA 17070
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610],40 1505610140 � �
1 1505610240
���
REV-1500 EX(FI) DecedenYs Social Security Number
�ecedent'sName: HARPER G • HANDSHAW 1 9 5 0 7 6 9 1 2
RECAPITULATION
1. Real Estate(Schedule A) �� �
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Stocks and Bonds(Schedule B) 2, 5 1 3 6 5 . 8 9
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. '
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. '
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5.
3 5 9 8 8 . 9 4
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6.
0 . � 6
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property
(Schedule G) � Separate Billing Requested . . . . . . . 7. •
8. Total Gross Assets(totai Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 8 7 3 5 4 . 8 9
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 5 9 3 2 . 3 2
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. 4 7 7 5 . 1 �
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 � 7 0 7 . 4 2
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . �2� 7 6 6 4 � . 4 7
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. � 6 6 4 7 . 4 �
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 . � � 15. � . � �
16. Amount of Line 14 taxable 3 4 4 9 . 1 4
at�inea�rate x • �4 5 7 6 6 4 7 . 4 7 �s.
17. Amount of Line 14 taxable 0 . 0 0
at sibling rate X.12 0 . 0 0 17.
18. Amount of Line 14 taxable � . � 0
at collateral rate X.15 � • � � 18.
19. TAX DUE 3 4 4 9 • 1 4
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
� 1505610240 150561�24� J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 21 14 0347
DECEDENT'S NAME
HARPER G • HANDSHAW
STREET ADDRESS
5225 WILSON LANE, APT 207
CITY STATE Z�P
MECHANICSBURG PA 17�55—
Tax Payments and Credits: ��� 3,449 .14
1. Tax Due(Page 2,Line 19)
2. Credits/Payments 3,2 0 D • 0 0
A.Prior Payments
B,Discount 16 8 • 4 2
Total Credits(A+B) (2) 3,3 6 8 • 4 2
3. Interest
(3) 0 • 0 0
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) 0 • �0
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 8 0 •7 2
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 ...................................................................... O �
b. retain the right to designate who shall use the property transferred or its income ............................... X
c. retain a reversionary interest ..................................................................................................... ❑ �
d. receive the promise for life of either payments,benefits or care? ....................................................... � 0
2. If death occurred after December 12,1982,did decedent transfer property within one year of death X
without receiving adequate consideration? ....................................................................................... � �
3. Did tlecedent 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
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
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 tloes 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 deceasetl child 21 years of age or younger at death to or for the use of a natural parent,an
atloptive 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 decedent's lineal beneficiaries is 4.5 percent,except as noted in p2 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.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the tlecedent,whether by blood or adoption.
REV-1503 EX+(8-12)
pennsylvania SCHEDULE B
DEPARTMENTOFREVENUE STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HARPER G • HANDSHAW 21 14 0347
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 109 shares Alcatel-Lucent stock a $4 • 020 each 438 • 18
Charles Schwab acct
2 1,00 shares AT&T stock � $34 • 895 each 3,489 • 5D
Charles Schwab acct
3 Comcast Corp C1 A New dividend Charles Schwab acct 70 • 42
4 313 shares Comcast Corp C1 A New stock � $50 • 005 ea 15,651 • 57
Charles Schwab acct
5 543 shares Frontier Communications Cor stock � 3,057 • 09
$5 • 630 each Charles Schwab acct
6 32 shares LSI Corp stock a $11 • 065 each 354 • 08
Charles Schwab acct
? 54 shares NCR Corp stock a $36 • 692 each ]„981 • 40
Charles Schwab acct
8 54 shares Teradata Corp stock a� $48 • 635 each 2,626 • 29
Charles Schwab acct
9 264 shares Verizon Comm stock a� $47 • 490 each 12,537 • 36
Charles Schwab acct
10 225 shares Weis Mkts Inc stock a $49 • 600 each 11,160 • 00
Charles Schwab acct
11 42 shares Fairpoint Commun stock under bankruptcy 0 • 00
Charles Schwab acct
TOTAL(Also enter on Line 2,Recapitulation) $ 51,3 6 5• 8 9
If more space is needed, insert additional sheets of the same size
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC.
INHERITANCETAXRETURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
HARPER G • HANDSHAW 21 14 0347
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 . PNC Bank-Checking Acct #5000978757 33,477 • 5�
Princ $33,477 • 5�, Int $ •16
2 PNC Bank-Checking Acct #5000978757 - Accrued Int 0 •16
4 Schwab US Treas Money Fund 456 • 51
5 Social security check received 1,412 • 90
6 American Arts Gold Medallion (1/2 troy ounce of gold 641 • 87
and 1/18 of copper) Value using "Only Gold" quote
on one ounce value divided by 2
TOTAL(Also enter on Line 5,Recapitulation) $ 3 5,9 8 8 •9 4
If more space is needed,use additional sheets of paper of the same size.
REV-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
HARPER G • HANDSHAW 21 1,4 0347
If an asset was made 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. JAMES M HANDSHAW 723 HILLTOP DRIVE SON
NEW CUMBERLAND, PA 17070
s.
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 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 • 12-4-02PNC Bank-Savings Acct #5003783437 0 • 11 50 • 0 • 06
joint w/James M Handshaw
TOTAL(Also enter on Line 6,Recapitulation) $ p . 0 6
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HARPER G • HANDSHAW 21 14 0347
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Parthemore Funeral Home-funeral expenses 1,315• 42
B. ADMINISTRATIVE COSTS;
1. Personal Representative Commissions;
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2 . AttorneyFees: Dc3Vld H Stone, Esquire 4,000 • 00
3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4 • Probate Fees: S 2 2 #2 b e 1 o w
5 . Accountant Fees:
6 • Tax Return Preparer Fees:
7 . Prudential Ins-premium due 13• 40
2 Stone LaFaver & Shekletski-Reimb on probate 273 • 50
3 Stone LaFaver & Shekletski-filing ITR/Inventory 3� • 00
4 Reserve for closing expenses 300 • 00
TOTAL(Also enter on Line 9,Recapitulation) $ 5,9 3 2 • 3 2
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
HARPER G • HANDSHAW 21 14 0347
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 X-ray bill-services rendered 10 • 00
2 Omnicare-services rendered 165• 56
3 Home Instead-services rendered 214 • 74
4 Bethany Village-services rendered 3], • 50
5 Bethany Village-services rendered 2,136 • 00
6 Bethany Village-services rendered 210 • 00
7 Home Instead-services rendered 2,�07 • 30
TOTAL(Also enter on Line 10,Recapitulation) $ 4 .,7 7 5•10
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
HARPER G • HANDSHAW 21 14 0347
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(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, . JAMES M HANDSHAW Lineal 38,323 • 74
723 HILLTOP DRIVE
NEW CUMBERLAND PA 17070-
2 • NANCY A SILVERMAN Lineal 38,323 •73
236 MADISON STREET
STATE COLLEGE, PA 16801
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE,
II. NON-TAXABLE DISTRIBUTIONS;
A.SPOUSAI 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 needetl,use atlditional sheets of paper of the same size.
"� NEW CUMBERLAND,PENNSYLVANIA 17070 "
�
IAST WIIZ AND TESTAI�NT
OF
HARPER G. HANDSHAW
I, HARPER G. HAI�IDSHAW, of New Cumberland, C�be;rlan�d Co�ty,
� e2u�sylvania, being of sami mind, mana�ry and underst-anding, do hereby makre,
�I lish and declare this as and for my Last Will and Testament hereby revdcing �
�� �
�laz�d making void any and all other wi.11s by me at any time heretofare made.
�
I.
I direct that my Executsix hereina£ter na�ed shall pa.q all my just
' ebts and fimeral expe�ses as soan as ccmveaiently may be done after my decease.
�
II. I
z All the rest, residUe and remaiuxier of my esta.te, whether real, (
�
`� p�rsrnal o�r mixed� arvd wheresoever situate, I hereby give, devise and bequeath �
\ to my wife, Al�1A M. HADIDSHAW, if she survives me by a period of thirty days. f
�I ` �
'�If my said wife does not survive me by a period of thirty days, then this gift I
,�� divested and I thaz ive, devise and bequeath my e�ntire esta.te ,
�.,;to her shall be S �
�as follc�as:
�� A. (he-half (1/2) tmto my s�, J�'S I� f�I�IDS'HAL�I. �
� �
l B. One-half (1/2) tmto my da�ghter, NANCY A. SILVERN1t1N: '
.;
III.
I hereby n�*�te, canstitute ani appoint my wife, � M. ��5��
!as Fxecutrix of this, my Last Will az�d Test�nent. If the said Anna M. Handshaw �
�should predecease m�e, fail to qualify or cease to act as swch, then I '�`n""a�� I
I
'canstitute and. appoint my svn, JAMES M. HAND6Fi�1W, as Executor. If both the saidl
�Arma M. Handshaw and James M. Handshaw sYwuld predecease me, fail� to qualify or �
�.,w o..�«, �
JON F. LwrAVHR
a�� rH�Ro �r�cct i� PSg@ OI12 Of t�W� P3ge3
NLW CUM�[IILAND��A. '�
f
�
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cease to act as such� the11 I nrm1T�ate, c�stitute and ap�point my daughter,
NANCY A. SILUERMAN, as Executsix.
IV.
No fidtyciary acting under this Will shall be required to post b�d �
� in this j�isdictio�n or in any juri-sdiction in which he may act.
IN WI'I'I�SS TnhiEREOF, I, HARPER G. HANDSHAW, the Testato�r, have unto
� this, my Iast Will and Testament, set my hand ar�d seal this �J � da.y of
���� , A. D. , 1982.
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' sic�, s�Ev, Pus�s� �a D� by x�. c. �sxaw, r.r,� {
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`abave-x�amed Testatar, as and fo�r his Last Will and Test�t, in the presence j
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�of us who have heretimto svbseribed a� names as witn�esses at his request, in �
�the gresence of the said Testator and of each other.
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JON F. LAFAVER '�.I Pc�Qe tw� of tw�f�Pages
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NLW CUM�L�LAND.PA. ii '
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� 48500041046
REV-485 EX(OS-04)
SAFE DEPOSIT
BOX INVENTORY
PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY
5ocial Security or Death Certificate Number Date of Death County Code Year File Number
195-07-6912 04/01/2014 21 14 0347
Decedent's Last Name Su�x First Name MI
Handshaw Harper G
�ADDRESS OF DECEDENT STREET: CITY: STATE: ZIP CODE:
5225 Wilson Drive, APT 207 Mechanicsbur PA 17055
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
"A"'E: David H Stone Esquire
STREETADDRESS: CITY: STATE: ZIPCODE:
414 Brid e Street New Cumberland PA 17070
NAME,ADDRESS AND RELATIONSHIP(IF ANY)TO DECEDENT,OF PERSON(S)PRESENT AT THE BOX OPENING
a. NAME: RELATIONSHIP:
James M. Handshaw son
STREET ADDRESS: CITY: STATE: ZIP CODE:
723 Hilltop Drive New Cumberland PA 17070
b. NAME: RELATIONSHIP:
STREET ADDRESS: CITY: STATE: 21P CODE:
c. NAME: REIATIONSHIP:
STREET ADDRESS: ' CITY: STATE: ZIP CODE:
NAME AND ADDRESS OF FINANCIAL IN3TITUTION WHERE THE SAFE DEPOSIT BOX tS LOCATED
NAME:
PNC Bank
STREET ADDRESS: CITY: STATE ZIP CODE:
325 Wesle Drive Mechanicsbur PA 17055
. NAME OF PERSON MAKINO LA3T ENTRY DATE ANO TIME OF LAST ENTRY
James M. Handshaw 4/3/14 0:00 am
DATE OF CONTRACT TO RENT BOX NUMBER OF BOX 1 TITLE UNDER WHICH BOX IS REQUESTED
� 12/14/2011 54 Har er G. Handshaw
NAME AND ADDRESS OF PERSON�S)HAVING ACCESS TO BOX
a. NAME: b. NAME:
Harper G. Handshaw James M. Handshaw POA
STREETADDRESS: STREETADDRESS:
5225 Wilson Drive, APT 207 723 Hilltop Drive
CITY: STATE: ZIP COOE: CITY: STATE: ZIP CODE:
Mechanicsbur PA 17055 New Cumberland PA 17070
NAME ANO TITLE OF EMPLOYEE TAKINf3 THE INVENTORY
Lynn Niner
WAS A WILL IN THE BOX9 ❑ YES ,�[] NO If yes, a. Date of wili:
b. Nams and address of personal representativs,if named In the wili
NAME:
STREETADDRESS: CITY: STATE: ZIPCODE:
c. Name and address of aKorney,if any
NAME:
STREET ADDRESS: CITY STATE: ZIP CODE:
L 485�0041046 485�0041046 �
.
REV-485EX SAFE DEPOSIT BOX INVENTORY Pa9e � of �
INSTRUCTIONS
(1) Cash:Report total only.
(2) Stocks:List in detail every common or preferred certificate,warrant or other rights found in box.Stocks are to be designated by
name of company,certificate number,date of certificate,name in which stock is registered,and number of shares and class of stock.
(3) Obligatfons of U.S.Government:Number of items,date of issue,face value,names in which registered and type of ownership,
i.e.,jointly held,payable on death,etc.
(4) Bonds:Designate by name,amount,serial number,or other designation.(Bearer Bonds)
(5) Bank and Savings and Loan Passbooks:State name of depositor,number of book,last date appearing in book,name of bank
and branch,and balance.
(6) Jewelry,Coins,5tamps,Manuscripts,etc:List and describe as fully as possible.
(7) Deeds,Mortgages,Current Insurance Policies or other evidences of indebtedness:List and describe as fu�ly as possible.
(8) Ali other contents.
(9) Return completed form to: DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT.280601
HARRISBURG,PA 17128-0601
ITEM ITEM DESCRIPTION
NO.
1 American Arts Goid Medallion(112 troy once of goid 81118 of copper)
I CERTIFY UND ENALT ERJ Y THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF
CORRECT A LETE T E T Of MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY:
SIGNAT SIGNATURE
� PRINT NAME PRINT NAME AND CHECK APPROPRIATE BOX BELOW:
vav:c� �-1.��� `,
PRINT TITLE DATE CHECK APPROPRIATE BOX:
J �Executor(trix) �Administretor(trix)
Attorney for Estate '�/�y �Eslete Representative �Jomt owner of safe deposil box
NOTE:Attach additional 8'/�"x 11"sheet(s)if necessary or use duplicates of this page of form.
The Department is authorized by law,42 U.S.C.§405(c)(2){C)(i),to require disclosure of Social Security numbers in connection with administering state tax laws.The DepaAment uses the
Social Security number to identify the decedent and personal representa6ves of the estate.The Commonwealth may also use the information in exchange of tax informatbn agreements
with Federal and local taxin authonties.The state law prohibits the CommonweaRh's personnel from disclosin confidential tax infortnation except for official purposes.
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May. 6, 2014 2:23PM PNC Bank No, 2039 P, 1
����
May 6,2014
Da�vid H Stone Esq
Sto�e�a�avex& Sh.e�Cletslci
414 Bridge St
p48oxE
Ne�v Cumberland pA 17074
RE: Harper G Handsha�
SSN: X95-07-6912
DOD: 04-01-2014
I)ear Mr. Stone:
In zespanse to your request for Date o�Ueattx (I�OD)balances for the customer noted abo�re,our
records show the follo`wing:
Checlzing Accot�nti
Account#5000978757 Established: 06-27-2000
x�ax����xarnasxA,w
UOD bataz�ce: $ 33,477.50+0.16 accrued interest
7nterestpaid 01�01-2014 thru 04�41�2014$0.79 'Y'I`�7
Sa�K�,gs Accor�nt
Account# SOd37$343� Bstablishecl: 12�04-2002
����xa,rinsxAw
JAMES M�T.ANDSHA�1'
D017 balance: $ 0.11 + 0.00 accrued interest
Tnterest paid O 1�01-2014 thru 04-01�2014$0.00 Y'Tb
�afe Deposit Boa
- �`b.e decedez�t zz�aamtaaz�ed safe deposit box# 00054
� �PER.Cr HANI7ST�A'W
Located.at: Bethany�V'illage Branch
325 'Wesley 17rive
Mechanicsburg PA 17055
(7�7) b9X-4087
�lease noie that this office pm�vides dat�of death balances for deposit accounts(IRAs,GAs, C�ecking and
Savings). We do not Rrocess any financial transactions pr pro�viide statemeats. T�you nee�assistance wi�tY►�
any of these items,please call 1-888-pNC-BANK.(1-888-762-2265)or stop tay y�wr local PNC Banlc branch
o�.ce.
page 1 of 2
May. 6. 2014 2; 23PM PNC Ba�k No. 2039 P, 2
Sincere��,
National Fina.ncial Services Center
pNC �ank,N.A:
Member�'bTC
This message is intendedfor the use of the irulividual or entity to which it is add�-essed and'�nay
contain inforrraa#on that as privilegec� confidential and exempt from disclosure unde�applicable law.
If the reader of this message is not the interided recfpient or the emplayee or agent responsible for
del'rverrng thrs message to the rntended recipient,you are�ereby notifaed that any dissemination,
dist�ibution or copying of this communications is strictly prohibited �f you have received this
CpmmuniCatiOn in errpr,ple�Se�tpt�me immediately by repdy or by telephone at 800-762-177�and
immediately destroy this fmced document.
I'age 2 of 2
Search Historic Gold Prices Page 1 of 2
��������!.l�� The Definitiive Site For Gold �O��aC� �S
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Recent spot prices Gold prices since 1972 200 years of prices Value of all forms of gold All the gold in the world
�r�rirww�+www .nw. ..M...w �., �,..,...�..�.- _,ro,�,.a �...�..�
.
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,
��� � �
Search Historical Gold Prices
Spot Gold: $1,196.05 Spot Silver: $16.08 Spot Platinum: $1,200.25 Spot Palladium: $810.00
Closing Gold Prices Since 1973 TuesdayAprOl,zoi4 �i,283J5
Monday Mar 31,2014 $1,291.75
Friday Mar 28,2014 $1,294.75
Enter date to find> �Format like: 12/30/98 Thursday Mar 27, 2014 $1,296.00
Wednesday Mar 26,2014 $1,304.00
Returns entered date and previous 14 official trading days.
Tuesday Mar 25,2014 $1,313.50
If entered date is not an official trading day- Monday Mar 24, 2014 $1,310.75
then the previous 15 official trading days are returned. Friday Mar 21,2014 $1,336.00
GO Thursday Mar 20, 2014 $1,327.00
Wednesday Mar 19, 2014 $1,338.00
Tuesday Mar 18, 2014 $1,355.75
Monday Mar 17,2014 $1,378.50
Clear your entry and start ove� Friday Mar 14, 2014 $1,385.00
Thursday Mar 13, 2014 $1,368.75
Restore latest 15 trading days Wednesday Mar 12, 2014 $1,366.00
http://onlygold.com/Info/Search-Gold-Prices.asp 12/19/2014
Search Historic Gold Prices Page 2 of 2
�� Onlygold did business at the same location for more
BBB
� ���i��� than sixteen years. CMI Gold &Silver Inc. has done
'_`
�.+, business from three locations in Phoenix since 1973.
�p� as�f
i3 iz/s9��ota Both firms are Accredited Businesses with the Better
�' '�c;;ck fv���wi�,v Business Bureau, and neither firm has had a complaint
filed with the BBB—ever!
In addition to gold, silver, platinum, and palladium in coin and bullion form, we also
purchase a wide range of numismatic coins and currency for our retail business. Feel free
to call us for quotes or price indications on anything in coins, bullion, and paper money.
We have really strong bids for gold and silver bullion and coins.
OnlyGold.com is owned &published by CMI Gold &Silver Inc. Copyright - CMI Gold &
Silver Inc. All rights reserved.
All checks, shipments, and correspondence should be sent to:
CMIGS-Onlygoid 3800 N. Central Avenue, llth Floor, Phoenix, AZ 85012
http://onlygold.com/Info/Search-Gold-Prices.asp 12/19/2014