HomeMy WebLinkAbout08-05-15 (3) � 1505610140
REV-1500 EX �°,_,°,
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po Box 2sosoi INHERITANCE TAX RETURN 2 1 1 5 0 4 0 3
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDWYY
0 3 1 6 2 0 1 5 0 7 2 6 1 9 2 6
DecedenYs Last Name Suffix DecedenYs First Name MI
H A R R I S D E A N A
(If Appiicable)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 OVALS BELOW
O 1. Original Return � 2.Supplemental Return � 3. Remainder Return(date of death
priorto 12-13-82)
� 4. Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required
death after 12-12-82)
❑X 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 Sch. O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
D 0 U G L A S G • M I L L E R 7 1 7 2 4 9 2 3 5 3
r�
�
Rfr�ISTER OF WIW.B�USE�1 ��
� Q �, rn c7
cz� � �.. �' �
First line of address � � n � `�� �
I R W I N & M c K N I G H T , P • C -
��, t�" � Cry ' C��
Second line of address 3 � � ' '�
c. � ... ^Q � -'��
� �...) �.,-i � .,. "��
6 0 W E S T P 0 M F R E T S T R E E T � r,
City or Post Office State ZIP Code - -
� DATE F�ILtD �.�` f77
N tI> Q
C A R L I S L E P A 1 7 0 1 3 � T'
CorrespondenYs e-mail address:
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.Decl ration of reparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT OF'P RSON RE N E F FILING ETURN DATE
•.S• �C�i
ADDRESS
250 BONNYBROOK ROAD CARLISLE PA 17015
SIGNA OF P PARE TH THA EPRESENTATIVE DA E
i �
ADDRE
60 WEST POMFRET STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610140 1505610140 J
�
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
DEAN A. HARRIS 21 15 0403
DecedenYs Name Page 1 File Number
Correspondents
Name Daytime Telephone Number
D O U G L A S G . M I L L E R 7 1 7 2 4 9 2 3 5 3
First line of address
I R WI N & Mc K N I G H T , P . C .
Second line of address
6 0 W E S T P O M F R E T S T R E E T
City or Post Office State ZIP Code
C A R L I S L E P A 1 7 0 1 3
CorrespondenYs e-mail address:
Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declara6on of preparer other than the personal representative is based on atl information of which preparer has any knowledge.
SIGNAT P ON RES NSI E FO ILING RETURN DAT
� �
ADDRESS
511 KISTLER ROAD ELLIOTTSBURG PA 17024
� 1505610240
REV-1500 EX DecedenYs Social Security Number
DecedenPs Name: D E A N A • H A R R I$
RECAPITULATION
1. Real Estate(Schedule A) . . ... . ... . ...... . . . . .. . . . .. . .. . . .. .. . . .. . . . �• '
2. Stocks and Bonds(Schedule B) .. .... ... . . .. .. .. . . . . . . . .. .. .. .. .. .. . . 2•
3 4 2 5 7 . ? 2
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. 1 0 2 0 � . 0 0
6. Jointiy Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 9 8 1 0 7 . 3 9
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Properry
(Schedule G) � Separate Billing Requested .. . . .. . 7. 6 0 3 6 4 0 . 4 0
8. Total Gross Assets(total Lines 1 through 7) .. . .. . .... ... .. . . . . .. . . . . .. 8. 7 4 6 2 0 5 . 5 1
9. Funeral Expenses and Administrative Costs(Schedule H) 1 3 2 1 6 . � 4
. . . .. . . .. .. .. . . . . . 9•
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) .. . .. . . . .. . . . 10. 6 7 . 9 3
11. Total Deductions(total Lines 9 and 10) .. . .. . . . . . . . . .. .. . .. . .. .. .. . . . . 11. 1 3 2 8 3 . 9 7
12. Net Value of Estate(Line 8 minus Line 11) . .. .. . . .. . . . . .. . . .. .. . . . . .. . 12• 7 3 2 9 2 1 . 5 4
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. 7 3 2 9 2 1 . 5 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 _ 0 . � 0 15. 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate X.045 7 3 2 9 2 1 . 5 4 �6. 3 2 9 8 1 . 4 7
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 � • 0 � 18. � • � �
19. TAX DUE �s. 3 2 9 8 1 • 4 7
. . . . . . . . . . . ... .. . . ... . . ... . . . . . . . . . . . .. .. . . . . .. . . . . . . .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Q
Side 2
L 1505610240 1505610240 J
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 2� 15 oao3
DECEDENT'S NAME
DEAN A. HARRIS _____
STREETADDRESS
250 BONNYBROOK ROAD
CITY STATE ZIP
CARLISLE PA 17015
Tax Payments and Credits:
�• Tax Due(Page 2,Line 19) (1) 32,981.47
2. Credits/Payments
A.Prior Payments 30,000.00
B.Discount 1,578.90
Total Credits(A+B) �2� 31,578.90
3. interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,402.57
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: ...................................................................... ❑ X❑
b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ X❑
c. retain a reversionary interest;or ....................................... ....................................................... ❑ X❑
.............................
d. receive the promise for life of either payments,benefits or care? ............... ❑ �
2. If death occurred after December 12,1982,did decedent transfer property within one year of tleath
without receiving adequate 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
contains a 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)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a suNiving 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[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
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[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.
REV-1503 EX+(8-12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DEAN A. HARRIS 21 15 0403
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1, 357 SHARES OF PNC FINANCIAL CORP STOCK 34,257.72
357 @$95.96 PER SHARE_ $34,257.72
TOTAL(Also enter on Line 2,Recapitulation) $ 34 257.72
If more space is needed,insert additional sheets of the same size
REV-1506 EX+(OB-12)
pennsyivania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
DEAN A. HARRIS 21 15 0403
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. 2011 CHEVROLET MALIBU -SOLD 10,000.00
2. PERSONAL PROPERTY 200.00
TOTAL(Also enter on Line 5,Recapitulation) $ 10 200.00
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 ,101NTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DEAN A. HARRIS 21 15 0403
If an asset was made joinUy owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. ERICKIA H. RYNARD 250 BONNYBROOK ROAD DAUGHTER
CARLISLE, PA 17015
B. BRITTA H. SCHATZ 511 KISTLER ROAD DAUGHTER
ELLIOTTSBURG, PA 17024
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY °6 OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR GATE 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. B THE BANK OF LANDISBURG 3,334.40 33.3 1,110.36
CHECKING ACCOUNT#2600439
2. AB THE BANK OF LANDISBURG 157,635.86 33.3 52,492.74
SAVINGS ACCOUNT#2634767
3. AB PSECU 12,558.18 33.3 4,181.87
SAVINGS ACCOUNT
4. AB PSECU 3,537.90 33.3 1,178.12
CHECKING ACCOUNT
5. AB PSECU 97,543.83 33.3 32,482.10
MONEY MARKET
6. AB PSECU 10,003.29 33.3 3,331.10
CERTIFICATE OF DEPOSIT
7. AB PSECU 10,003.29 33.3 3,331.10
CERTIFICATE OF DEPOSIT
TOTAL(Also enter on Line 6,Recapitulation) $ g$ 107.39
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DEAN A. HARRIS 21 15 0403
This schedule must be completed and filed if the answer to any of questions 1 through 4 on paye three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDETHENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND DATEOFDEATH %OFDECD�S EXCLUSION TAXABLE
NUMBER THEDATEOFTRANSFER.ATTACHACOPYOFTHEDEEDFORREALESTATE. VALUEOFASSET INTEREST (IFAPPLICABLt� VALUE
1. AMERIPRISE 164,141.54100.00 164,141.54
ACCOUNT NUMBER#0010 1392 9766 6 002
COLUMBIA AMT-FREE TAX-EXEMPT BOND FUND-A
2. AMERIPRISE 239,670.40100.00 239,670.40
ACCOUNT#0930 0240 3359 7 004
RtVERSOURCE FIXED RETIREMENT ANNUITY
3. AMERIPRISE 53,096.16100.00 53,096.16
ACCOUNT#0000 2974 5236 9 133
STRATEGIC PORTFOLIO SERVICE ADVANTAGE, IRA
4. AMERIPRISE 44,455.66100.00 44,455.66
ACCOUNT#0931 0263 2858 9 004
RIVERSOURCE FIXED ANNUITY-VALUE PLUS, ROLL IRA
5. EDWARD JONES 60,804.30 100.00 60,804.30
ACCOUNT#377-03610-1-6
6. EDWARD JONES 41,472.34 100.00 41,472.34
ACCOUNT#377-07000-1-5
TOTAL (Also enter on Line 7,Recapitulation) $ 603 640.40
If mo�e space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DEAN A. HARRIS 21 15 0403
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
1, RICE MEMORIAL WORKS 175.00
2. ST. PAUL'S LUTHERAN CHURCH 100.00
3. ORGANIST 100.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
��y State ZIP
Year(s)Commission Paid:
2, AttomeyFees: IRWIN &McKNIGHT, P.C. 12,000.00
3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
��y State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: REGISTER OF WILLS 185.50
5 Accountant Fees:
6. 7ax Retum Preparer Fees: PATRICIA A. ROSENDALE, CPA 375.00
FINAL FIDUCIARY TAX RETURN
7. CUMBERLAND LAW JOURNAL- ESTATE NOTICE 75.00
8. THE SENTINEL- ESTATE NOTICE 190.54
9. SOLLENBERGERS- NOTARY 15.00
TOTAL(Also enter on Line 9,Recapitulation) $ 13 216.04
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-t 2)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES 8 LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
DEAN A. HARRIS 21 15 0403
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,inciuding unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. MILSON S. HERSHEY MEDICAL CENTER-MEDICAL 67.93
TOTAL(Also enter on Line 10,Recapitulation) $ 67.93
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-1D)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
DEAN A. HARRIS 21 15 0403
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. BRITTA H. SCHATZ Lineal 366,460.77
511 KISTLER ROAD 1/2 REMAINDER
ELLIOTTSBURG, PA 17024
2. ERICKIA H. RYNARD Lineal 366,460.77
250 BONNYBROOK ROAD 1/2 REMAINDER
CARLISLE, PA 17015
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.
a � � 1
t • e
11lJ�A.Y� _`��V V ��� ��� ��A..Y������
OF
DEAN A. HARRIS ,
I, DEAN A. HARRIS, of Southwest Madison Township, Perxy County,
Pennsylvania, do make, publish and declare this to be my Last Will and Testament,
hereby revoking all Wills and Codicils by me at any time mad�.
ITEM I: I direct that all inheritance and estate
taxes becoming due by reason of my death, whether payable by my estate or by any
recipient of any property, shall be paid by the Executor out of'the residue of my
estate, as an expense and cost of administration of my estate. The Executor shall
have no duty or obligation to obtain reimbursement for any suc�h t� so paid, even
though on proceeds of insurance or other property not passing under this Will.
ITEM II: I direct the Executor to pay the expenses
of my last illness and funeral expenses from the residue of my estate as an expense
and cost of administration of my estate.
ITEM III: I may leave a written list in my safe
deposit box or elsewhere disposing of certain items of my tan�ible personal property.
The Executor shall dispose of items of my personal property as specified in the
written list. If no written list is found in my safe deposit box or elsewhere and
properly identified by the Executor within thirty (30) days after the probate of my
Will, it shall be presumed that there is no other statement or list. Any subsequent
discovered list shall be ignored. I give and bequeath my hausehold furniture and
furnishings, books, pictures,jewelry, silverware, automobiles, wearing apparel and all
Page 1 ���•
4 � ,
1
" v
other articles of household or personal use or adornment not mentioned in the
written list and all policies of insurance thereon to my daughter.s, BRITTA H.
SCHATZ and ERICKIA H. RYNARD, to be divided between them as they shall agree.
Should the beneficiaries be unable to agree, the Executor shall divide this property
between them in as nearly equal portions as the Executor, in the sole discretion of
the Executor, deems practical, having due regard to the personal preferences of the
beneficiaries.
ITEM IV: I give to my daughters, BRITTA H.
SCHATZ and ERICKIA H. RYNARD, in equal shares, the largest percentage possible
of the residue of my estate, as will result in the imposition of na federal estate taxes.
I recognize that this may be the entire residue of my estate. The balance, if any, shall
be paid to ST. PAUL'S LUTHERAN CHURCH CEMETERY ASSOCIATION,
Loysville, Pennsylvania. However, if this entity is not qualified to receive a
charitable deduction pursuant to Section 2055 of the Internal Revenue Code, then I
make this gift to ST. PAUL'S LUTHERAN CHURCH, Loysville, Pennsylvania, for
the use of the cemetery insofar as is possible without jeopardizing the charitable
deduction available to my estate.
If either of my daughters does not survive
me, her share shall be paid to her then living issue, per stirpes. However, if any issue
has not attained the age of twenty-seven (27)years at the time of my death, the share
of that issue (the "Beneficiary") shall be held by my surviving daughter, as trustee,
IN TRUST NEVERTHELESS, to be administered and distributed as follows:
(a) Trustee shall pay to or for the benefit of the Beneficiary so
much of the net income, in convenient, at least annual in.stallments, as
is necessary, in the sole discretion of the Trustee,for the proper
Page 2 ��
s � , +
. P a
support, maintenance, medical care and education of the Beneficiary.
Income not distributed shall be accumulated and added to principal.
(b) The Trustee shall also pay to or for the benefit of the
Beneficiary so much of the principal as the Trustee, in the discretion of
the Trustee, considers necessary to maintain the Beneficiary in the
proper station in life, including proper support, maintenance, medical
care and college or higher education.
(c) Upon the attainment of the age of twenty-seven (27) years
by the Beneficiary, the Trust shall terminate and the Trustee shall pay
to the Beneficiary the remaining assets of the Trust.
(d) Should the Beneficiary die before final distribution of the
assets of his or her Trust, the Trust shall terminate and the Trustee
shall pay the assets of the Trust to the then living issue af the
Beneficiary, per stirpes. However, if any issue has not attained the age
of twenty-one (21) years at the time of distribution, th� Trustee shall
continue to hold the share for that issue as Custodian under the
Pennsylvania Uniform Transfers to Minors Act for the benefit of that
issue.
(e) If at any time before final distribution af the assets of the
Trust, there are no living beneficiaries of the Trust, the Trust shall
terminate, and its assets shall be paid to the other then living issue my
deceased child, per stirpes. If there are no other then living issue of my
deceased child, the principal of the Trust shall be distributed to my then
living issue, per stirpes. If there is then in existence any Trust created
Page 3 • •�{•
a � , �
p .
under this Will for the benefit of my issue, the share that would have
been paid to that issue shall be added to the principal af his or her
Trust, to be administered and distributed as provided herein.
ITEM V: No part of the income or principal of any
Trust created by this Will shall be subject to attachment, levy or seizure by any
creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior
to his or her actual receipt of income or principal distributed. The Trustee shall pay
the net income and the principal to the beneficiaries specifi.ed by me, as their
interests may appear, without regard to any attempted anticipation, pledging or
assignment, and without regard to any claim or attempted levy, attachment, seizure
or other process against the beneficiary.
ITEM VI: The Executor and the Trustee shall each
possess the following powers, each of which may be exercised without court approval
and in a fiduciary capacity only:
(a) To retain any investments I have at my death, including
specifically those consisting of stock of any bank even if I have named
that bank as the Executor or Trustee.
(b) To vary investments, and to invest in bonds, stocks, notes,
real estate mortgages or other securities or in other prc►perty, real or
personal, without being restricted to so-called "legal investments", and
without being limited by any statute or rule of law regarding
investments by fiduciaries.
Page 4 G� 1�
� o
. �
(c) In order to divide the principal of a Trust or for any other
purpose, including final distributions, the Executor and Trustee are
authorized to divide and distribute personal property and real property,
partly or wholly in kind, and to allocate specific assets arnong
beneficiaries and Trusts so long as the total market value of each share
is not affected by the division, distribution or allocation in kind. The
Executor and Trustee are each authorized to make,join in and
consummate partitions of lands, voluntarily or involuntarily, including
giving of mutual deeds, or other obligations, with as wide powers as an
individual owner in fee simple.
(d) To sell either at public or private sale real and personal
property severally or in conjunction with other persons, and to
consummate sale(s) by deed(s) or other instrument(s) to the
purchaser(s), conveying a fee simple title. No purchaser shall be
obligated to see to the application of the purchase money or to make
inquiry into the validity of any sale(s). The Executor and Trustee are
authorized to execute, acknowledge and deliver deeds, assignments,
options or other writings as necessary or convenient to any of the power
conferred upon the Executor and Trustee.
(e) To mortgage real estate, and to make leases of real estate.
(f� To borrow money from any person, including the Executor
or Trustee, to pay indebtedness of mine or of my estate, expenses of
administration or inheritance, legacy, estate and other taxes, and to
assign and pledge assets of my estate or any Trust established by this
Will. .
Page 5 ��T�.•�
� o � �
o ,
(g) To pay all costs, taxes, expenses and charges in connection
with the administration of my estate or any Trust established under this
Will.
(h) To make distributions of income and of principal to the
proper beneficiaries, during the administration of my estate, with or
without court order, in such manner and in such amounts as the
Executor deems prudent and appropriate.
(i) To vote shares of stock which form a part of my estate or
any Trust established under this Will, and to exercise all the powers
incident to the ownership of stock.
(j) To unite with other owners of property similar to property
in my estate to carry out plans for the reorganization of any company
whose securities form a part of my estate.
(k) To disclaim any interest in property which would devolve
to me or my estate by whatever means, including but not limited to the
following means: as beneficiary under a will, as an appointee under the
exercise of a power of appointment, as a person entitled to take by
intestacy, as a donee of an inter vivos transfer, and as a donee under a
third-party beneficiary contract.
(1) To prepare, execute and file tax returns of any type
required by applicable law, and to make all tax elections authorized by
law.
Page 6 � •
0 4
i �
D �
(m) To employ custodians of property, investment or business
advisors, accountants and attorneys as the Executor or Trustee deems
appropriate, and to compensate these persons from assets of my estate
or trust, without affecting the compensation to which the Executor and
Trustee are entitled.
(n) To divide any Trust created in this Will in.to two or more
separate Trusts so that inclusion ratio for purposes c�f the generation-
skipping transfer tax shall be either zero or one, in ord�r. that an
election under Section 2652(a)(3) of the Internal Revenue Code may be
made with respect to one of the separate Trusts, or for any other reason.
(o) To allocate administrative expenses to income or to
principal, as the Executor or Trustee deems appropriate. However, no
allocation to income shall be made if the effect of the allocation is to
cause a reduction in the amount of any estate tax marit;al deduction or
estate tax charitable deduction.
(p) To do all other acts in their judgment necessaxy or
desirable for the proper and advantageous management, investment and
distribution of the estate and Trusts established under this Will.
ITEM VII: The Trustee, on an annual basis, shall
provide each income beneficiary who has attained the age of eighteen (18)years, and
the Guardian of the person of any income beneficiary who has not attained the age of
eighteen (18) years, statements showing transactions in each Trust established for
the benefit of that beneficiary. The beneficiary, or the Guardian of the person of such
beneficiary, may waive this right to receive an annual accounting. The Trustee may,
Page 7 �����
� ' o •
s
at any time, settle any account, or questions concerning the administration of any
Trust established under this Will, by agreement with the then current income
beneficiaries of the Trust, if legally competent, or if not legally competent, with the
Guardian of the person of the beneficiary, the legally competent spouse of the
beneficiary, or the oldest legally competent relative of the beneficiary who would take
a portion of the estate of the beneficiary were the beneficiary to die at that time
intestate under the laws of the Commonwealth of Pennsylvania. Any settlement
made in accordance with this Item shall bind all persons who have an interest in the
Trust, and shall constitute a release and discharge of the Trustee with respect to
transactions specified in the settlement.
ITEM VIII: In the absence of actual knowledge of a
breach of trust, or information concerning possible breach of trust that would cause a
reasonable person to inquire, a successor Trustee is under no duty to examine the
accounts and records of a predecessor Trustee, or to inquire into the acts or omissions
of the predecessor, and is not liable for any failure to seek redress for any act or
omission of the predecessor. The successor Trustee shall have responsibility only for
property which is actually delivered to him or her by the p.redecessor and shall have
all of the powers conferred upon a Trustee hereunder.
ITEM IX: The Trustee is authorized to distribute
principal and/or income in any one or more of the following ways if the Trustee, in
the sole discretion of the Trustee, considers the beneficiary unable to apply
distributions to the beneficiary's own best interests, or if the beneficiary is under a
legal disability:
(a) Directly to the beneficiary;
Page 8 .
si l
' ' , e
(b) To the legal guardian or conservator of such beneficiary;
(c) To the Trustee, or to another person selected by the
Trustee, as custodian under the Pennsylvania Unifarm Transfers to
Minors Act as to a beneficiary under the age of twenty-one (21)years;
(d) To a relative of the beneficiary, to be expended by that
relative for the benefit of the beneficiary; or
(e) By directly applying distributions for the benefit of the
beneficiary.
ITEM X: Any person who has died within thirty
(30) days of my death, or under such circumstances that the order of our deaths
cannot be established by proof, shall be deemed to have predeceased me. Any person
(other than myself� who has died at the same time as any k�eneficiary under this Will,
or in a common disaster with that beneficiary, or under such circumstances that the
order of deaths cannot be established by proof, sha11 be deemed to have predeceased
that beneficiary.
ITEM XI: I make the following provisions with
respect to Executors and Trustees:
(a) I appoint my daughters, BRITTA H. SCHATZ and
ERICKIA H. RYNARD, to be the Executors.
Page 9 ��:.�i'•
I
p Q ♦
, � •
(b) I appoint my surviving daughter to be ths Trustee of any
Trust established under this Will. Each Trustee shall have the power to
appoint his or her successor.
(c) Each appointment of a successor Trustee shall be in
writing and shall be filed with the court in the jurisdiction which is the
situs of the Trust. The written instrument shall be signed by the person
having the power to make the appointment.
(d) Each Executor and Trustee shall have the r.ight to receive
reasonable compensation for services rendered.
(e) Each Executor and Trustee is specifically relieved from the
duty of filing bond or entering security.
IN WITNESS WHEREOF, I have set my hand and seal to this, my Last
Will and Testament, consisting of this and the preceding nine l9) pages, at the end of
each page of which I have also set my initials for greater security and better
identification this ��day of , 2000.
_��� C.c �YG'ra�.rA (SEAL)
DEAN A. HARRIS
We, the undersigned, hereby certify that the fore�oing Will was signed,
sealed, published and declared by the above-named Testator as and for his Last Will
and Testament, 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 and seals the day and year
� , e � y �
first above written, and we certify that at the time of the execution thereof, the said
Testator was of sound and disposing mind and memory.
.�2 � (SEAL) Residing at J���,-�—
c ��� �J- ! � ''
� t�r., � �'�I�V �
(SEAL) Residing at�� , .s�.�,�
��r�d ��-
� (SEAL) Residing at�Od
z �d5
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
, ) SS:
COUNTY OF ����`�" )
I, DEAN A. HARRIS, Testator, whose name is si�ned to the attached or
foregoing instrument, having been 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 m,y free and voluntary act
for the purposes therein expressed.
� ,
(SEAL)
DEAN A. HAR,RIS
Sworn to and subscribed before
me this�_day of
, 2000.
�,��� �
Notary Public
My Commission Expires:
(SEAj,) Notarial Seal
� Meiisa M.Lucas, Notafy Public
Harrisburg, Dauphin CoU�ty
; '`�1V Carnmission Expires Oct. 13,2Q03
%�:}�'";:-"u„nnsyh�aniaAssocia�
tiw�ofNotaAes
� � T � 9 �
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
�/ ) SS:
COiJNTY OF �4-� )
We, � l C � � C��� , __�_ �Rh( and
/ �
�l.�f�o�a/���S�J�l�l� , 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, DEAN A. HARRIS, sign and. execute the
instrument as his Last Will and Testament; that Testator signed willingly and that
he executed said Will as his 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 (18) or
more years of age, of sound mind and under no constraint or undue influence.
�o
Witness Witness
Witness
Sworn to and subscribed before
mg this o�y� day of
Ju� , 2000.
Notary ublic
My Commission Expires:
(SE�� Notarial Seai
Melisa M.Lucas,Notary Public
Harrisburg, Dauphin County
My Commission Expires Oct. 13,2003
Member,PennsyNaniaAssociationotNotaries
:228726 1
PNC Historical Prices � PNC Financial Services Group, I Stock-Yaho... http://finance.yahoo.c-om/q/hp?s=PNC&a=02&b=16&c=2015&d=0...
Home Mail Search News Sports Finance Weather Games Answers Screen Flickr Mobile I More
N���� Mail
U�
Finance Home My Portfolio My Quotes New§ Market Data Yahoo Originals Business&Finarire F'ersonal Finance CNBC Contributors
Enter Symbol _ ` Thu,Apr 9,2015,228PM EDY-U.S.Markets Gose in 1 hr 32 mins Report an Issue
DowO.f._. .. , ----� ,.., ..._.. . .... .
� � • E#TRADE 'NO ATM FEES
hade �N nN nCCounrr �}
Nox�,
The PNC Financial Services Group,Inc.(PNC) -NvsE � Watchlist Add to PoRfolio uk• a�
93.0� 0.19(0.20%� 2:27PM EDT-Nasdaq Real Tme Price
Historical Prices Get Riistorical Prices for. GO
Set Date Range .�***,k�.a,�,�
s Daily MorningslarRaling'"'
Start Date: Mef 16 2015 Eg.Jan 1,2010 " Weekly fas of 12/31/14).
End Date: Mar 16 2015 Monthly
Dividends Only
Get Prices
First�Previous I Next�Last
P�CeS T.Rowe Price
Date Open High Low Close Volume Adj Close' Strategic
Mar 16,2015 96.22 96.65 95.60 95.96 2,706,000 95,96 Income Fund
'Close price adjusted for dividends and splits. A global bond fund
First�Previous�Next�Last combiningEundacnental
creclit reseazch trith
�Download to Spreadsheet sectoraDceation.
Currency in USD.
T.Rdo�ePlioe�i►
��u!!s A„���a e
ro merket risk,including paeside
lass of prircipal.
Ad Topics That Might Interest You...
1. PNC Stock History 5.Best CD Rates
2. PNC Stock Predictions 6. PNC Stock Report
3.Buy PNC Stock 7.Best Mutual Funds
4.Top 10 Banks 8.Top 5 Savings Rates
Feedback ads
Pr��acy-nno�t o�rnds-rerms-sena Feedeack Yahool-ABC News Network
�uotes are real-time for NFSDAQ,NYSE,and NYSE MKT See also delay hmes for otherexchanges All informa6on provitled"as is�"^:r�,nforrr��a6onal purposes onty,nol mtended for trading
purposes or advice Nedher Yahool nor any of independent providers is liable for any mformational errors,mcompleteness,or delriys...r h;r an�i actions taken in reliance on infortnalion contained
herein By accessing the Yahool sde,you agree not to redislnbute the information found therein
1 of 2 4/9/2015 2:28 PM
�c r ta .;ti. � 1 �. �� �,-. � ��..!-`✓�„ :^�, ,yS.• � ��I� � ���� � '�ti�c�" Fr'h
*�£ � � ���//y/;� s
%
� ti ''� ���'��',�pyy� � _ 41� /m r'�'� n
` �� \Ni, `�'�" �
\ � �z � �/
� T�{ Ix � /J ��� �* ly
> y �� `'� yt �� �T ' � i.�;r �,�y(
l } h � y x {' i
.4��� . � ��ti y' - '�,'"� j . 5¢. I Jr � I 1 S'c :� j/`* .�+�++��ti
`�—�--� � � �� � "� �,�'�1 � � �..�..a �1�„ 'E�--�t��j �;.;�°��� `'���4 �.`,
� � .:. .� � � f ��.° � �� �� _ . �
z . � � ,� � � �� � �` i , �'� � y��%� � �`
. i
��� �� ', ��0.� �� ` �
� �, �� ti � `, � � •; � a � r " ; �t ;
� - .Y- � o �
.,. I.� ,�-
�`�.�� � ''?�:,�.,; � «��� s�...�F� �""��
��;��.� „�
,� _ . , , .
�,��� -
��, ,�.,,s..,.,. ... .
.
;-�,
:,,;:. .
,,
,.,.,:;, :,.::z;;;,;;.,„ i
;,•,;,::, . ":;-;;f;;��:�;-��..;:;;��;,:;,:•�!. ' :
-�;;:
� ;;.;:�%•';.;,,;;�;;%•;,,,.••.;,.::•.:;,;•,;,,,;-,,
;:i'j•l„i;?�iZ;i�i;l��i%j�;%�:iii:�'�r'!,i;�{
� i.;.;;;;.
;:::!{S ji ij�j/(:;.,.//.:;�•��i•rfi/����',''�"�i'�;%�/,/%�':,j:: '1
,i�, /r„'A;S�,%'Y.;i',i�//r%35;;�%;^�i';,�� • -,
"'`wi�:%%�-�z:..,;c.�/�i��i:%i:'1l'i�:°.; '
' sr��/:,ii::ii%;�'„/:', �%..,,,-;%^;;:i� �
. ; j� .%���c�/`'�,�''�,f';f��'�
- :;�i%�bRi :�i,r�(��:2�:;/"�i,H/r.%`F.�i
;%. ,1�i•,d:i�';;:,� �,%/�.,�i�/is�p"'.•�
� '���i�%r�(1./fi��i,/;%%';�i��i�:lyi�i,?:�i�,f
�:���i��i�%i%�/:?;'t%i%�i��i��ii,''�e%:•%^;'�.
y;;i i;;;�„F�������i/„%r���,o,:,�>yi'
� �r,'ti;lj't•,�'i����k'ifi����!�%i?Fi i��ii�.f!
'"":'�H,t,'r,;„•'%i%/�%'��/�%/::;:iii3�;�ii�i�l.TL
'i,� :���.Y i;•,•1,,:• � � ����1/
� ��Y�'���'%'f�`iiy;%�/�/''%�,'C'��i'ii�J;,///
�': /! / � � . �' .. /
!4�%%i�.'i,'•''��'!'',%�i/;:.i�.;,%%/:.n�
;f:%;y:P�'.;;�%i,i„a.i�i f � %4�/�:�i��
�lF��% :��'�i`�:. . "'%,?.�;�:� ,
� /.ii � '.i
,,,•:i �
6 r �/�/ r % � . �� . ��i,�i 1� _ �s � .
\ ;�;Fi i i��� ��/i i �. �� i� �G!% � {� �
;:�„ii���/i�i� i/ � �v��¢��/�/��/ � ���.. P �
!'�i;:?%r,:',•„i-ii!� i� . i��%%�
t�.• ,�,� � � r ,,, J,- �;ir��,;, f 9 a S
��f;'ri�ri �� %/�//ii:7 �� '' '�� l �' ti�
��:i� �ri i� �ii i � i����i.J � ,�
?iv�� r 9 ����il��i��� �r�Iii� i�i%„ 1 I � �
.,r,�// // /� // !�/ ��//�/% �
q�...i�i•,%i:7�j��� � i i f�' � . ,�q. `x
�'i�!i�iii%;:ii;;�i�%% /ilf�/ ���/� �!I '��I ?^'k' -m
,,,.;,r�,:,i.,..,-:•.,ri.,,, .//;,,�,/ �, , , �,r ��i`�
• '%r.'f�;i%i;"�+�1��;�/L��i/�i� �/��ii y i. n- .�� i��'is
;�„7�i?.ij'r,%://d y /�y /������, . — .,��
� i?%i;�„���'���j!%if/�f�N,4,'f2� � 9. '� 13r���.-
+:s���i¢,ii'i57 i�% i�% ''� i r%
� ?%�i�sii,�i�'i���j J i ��i �,f�// » {
.. ii?iiJ/';'S�%��i%`� �% �ii��%�2�ir ii,%fi 1� � �o�� .
� �,/�/�»i l i�i�� �� ��i�/�i�/... ��i�' 4� � ,��.`: /F,a
..f,j r �� � /I � � ' ��/ir�/.7/r �� ��' � .
� � ii/_i G✓ %�/i%�i;Y
�fi ,���,.�i�, � .,��� �.
�%?�•%;s�;if;%,5,�r�� .. �/ ����i�i�� �'r !
/ �
����i /N�i �ii � �ir �:��, ���i%i { '� �
iif i / � ii /i�i:v;,i�,�.,� w
f i �� r�� i re;';•..",%•/'%:;;'i � �I.� � �i
i i 1 �� i�/�;.:�f%;i'/���%
\ .�a��iJ,/l��:��i��i%/�;li:,:�Fyi�iii ti �; � ��
�
t� C � � � /./¢�v J C.
ly�i� �� :i�ii+;�::%%•i���.�;���(iij�;���i �%�i �1 s� s
� �%'�i�if 5 �i�/,,i�i�f��F�%�//•'3f ��` }�''. � '�1 S
� � ��,�� y �i�� r ��i;, ri��jl�iG'�i,iiii%i/ �` :
���ii���5�ii/��ii��i//i�i��,�j/'i i�Fr ��-�'��hT
� y��:%%' %��;�ii%%' i;�i�� �� �fi,�a �t �',���
;;: l ^
�i.
•i"'��'i�i� .,, %�l:5„i lG;''r,%i�� • � M�� . ,.
��;%if��'�%r���;.,J�ii%si�i��j j�a,iiiY 1� ,
%r:� , �+ �j� ..�, ��""1
riii�/����� ���F,��;ii��''flj%� • 1 .�i'x
°`;:�;�:•�;:¢�9%::';�;%;;g%!ji/l¢;�!%?;%;'j�;�i -
`I ��I �� • �a,�!i/ii'%:';:�i%;i�G12:i;�r��;�:.%'Jr,:��i%'//;�/
\�r.. �p��i,�'%�i;;i'' '.'�l'%'%i�%!�°i/jf/%�� �
4 �'siF�FFii��i,�J��r�,`%;���`i�//,��;!'�•�i,%���i�
!,�i;:;�¢,,% / //i J, Y
�� r `/,,•i.,/.::i�'.i:%i/;�`��:Sii�:,.:��iri�i/r�
�t:A2%';%fv!";l�r��;:;4a'r,i?%;�;?;.'r�;;i�;�'£%%��%
�..y:a,•.i:;rr;:i;;�; � � i
\ G�',v.�;'%;/,',i� F ' ''' J!j�ii,'��
• ��6 ,,/,,,.072:•,; .,/,,;�� ,,�:/,�.�,.;;./,:�,
1� ..,,,,,,...,:,,. .
':;:i�:iii:''r.'i%i!%,��:f�•.�".%"'::�'�•'%ii�;%�;''r'.�:i�,�
� ��iq,�:;i�;l�Y'/,��l;;�;��.�:�%.:;�•;%;�•�J„%'.'�f;���.�%i •
�„%%/i;�7:�::;^,',,.,,:•, ,.,i�'.-�.;;�Y•%i:':'/i;.::/
III, � "%%;j;i%;'t:'J.'��ii.r,7;,:ii-:{"i�nY;Y;f;;lJl;•y�l!%
��i�;��''i'�/,�.,ziP:;�:f"r:;%,�%'-r�.�'�i";��'s'1%,';'iyi%¢?i
� � i s%�!;�`���/��"�. ",i; '�iK��i%;J�
\ '%�:�,.�;i,:'t�i�(,•,: c'r;•s'c>:i;�s�% � �%
� i�'�J�i�'%";li i:'so ;;''�c';���'��i��%�'� �
�i;�i''"�i;�,;i,';'s''` f'b" i,;,.;li'i�:% ••
• "�;;�i��������;'�� �..�,;°i,;:i��';i��J�`;i�
'�y�i�;i�'i%�'`i•,^ ;i•; ^j,�;r�;�,
,�;i�i„ :i, "��
i
�c•��'�, `�,"",'�� .�"""Y'�` �" 'r}-"t'a'�'.' �^�,�'�,.
�" ys °fiT* 'Oaa °`S, .�•� �`a�`�r� �� a-, :a `��� .; '� � , �� " ��`r
„+ A �+IF7i � ' t� �:t `� Y�✓ .
�2 �Y� y� �+ i �"„{� � `�A4 �.,,,4�.}� °`a����\ I � . ! �``` �M`�`� ,;'����
� ��� �
� �Yi ,. �» . r
t � rK � � �
`� :� i � �: j� ,� t{ i\ �x:`; ��� F� .� -7�¢ { j � d��
s
�� � � ��� � � ��-x' �,�� ,� `� ���: e� �.�»--�
� � � 7 � � � -� �
;�..�,�i;�����.��--�:�� �`-� �;�*-�'`` 7 � � �,
�
� ;,� � � � � �' � � � .t'�`�, . $. ,���. � c ��'� 1 � y` -� ' J�'', "`�;��
� � ``� � `c ' � ,� y t w�I� �i �� �" f, � ,� �`v�'�i
�� � �. � ,
�r r" '1r �� aW� � �i��' � `��'A��`'��.� �` � Y v�C: ��i�� �� ff A ��y1't�
�t# � "� ,�� � '`� tt`�l � {�t 4 �;� ° ,`�� tit� 't,:� '`f "�- �.
�, ��f4 � : c,.f� � .. �. , s � � �1�� ;�r �.� '?�
� � ��'��;"P' ���i, �s.,
�:��`�:.,��"�'�`�.,.����„„�,. °���',
The �� oF La nd i sbu t� ESTABLISHED 1 903
Q �
�
P.O. BOX 179 • LANDISBURG, PA 17040
Bank records indicate the following account
balances on March 16, 2015 for:
Dean A. Harris SS# 184-26-5043
250 Bonnybrook Road
Carlisle, PA 17015
Acct Sole Jt. Acct. Account Type Balance Interest Accrued
Opened Ownership With Number Bearing Interest
4/8/1983 No Erickia H. Rynard/Britta H. Schatz 2600439 Snovu $3,334.40 Yes $0.28
9/10/1993 No Erickia H. Rynard/Britta H. Schatz 2634767 MMA $157,615.16 Yes $20.70
...�� [iY 1-:
t':K "�' .�G �.�j'
y����, F_�. t_i J 3�'���
''' f , 1 i.iT
!;i��';I!��t�Y rS;Y;"'��iitir;�..
t q'1�f � �
"..i 1_!�.;.'i;.;=i.�
Respectfully,
_ �(��' I�Q,/�
Community Offic Manager
C'�'�"v P.�
LANDISBURG - 717-789-3213 • BLAIN - 536-3118 • SHERMANS DALE - 582-851 1
0
�; ti- �
� ����.�:��Y� i��
04/22/2015
����E � 4 `;;�' .
Irwin&McKnight P.C. �:�:'::`,i;�`�c��:±��Eil`ilGi��
� �,in r,r_:����c
Douglas G.Miller f'- ��J��` +�-�:
West Pomfret Professional Building
60 West Pomfret Street
Carlisle,PA 17013-3222 '
'
Re:DEAN A HARRIS,Deceased.
Dear Attomey Douglas G.Miller:
The above referenced person has an account with PSECU which was opened on Apri13, 1984. The
Share accounts were jointly held by DEAN A HARRIS and Erickia H.Rynard and Britta Schatz. This
account is a Tentative Trust Account.
The following are the Date of Death Balances for DEAN A HARRIS's account with PSECU:
Account DateofDeathBalances Interest—Marc� l-16
Savings (S1) $ 12,55735 $0.83
Checking (S4) $ 3,537.74 $0.16
� Money Market (S7) $97,535.28 $ 8.55
Certificate (S50)y $ 10,000.00 $3.29
� Certificate (S60) $ 10,000.00 $3.29
The account has been closed.
If you have any questions,please contact our departrnent toll-free at(800)237-'7328,press 6,extension
3120 or email accountservicesn,psecu.com.
Sincere ,
Sherry Getz
Member Service Representative
PSECU
P. O. B O X 6 7 0 1 3 H A R R I S B U R G, P A 1 7 1 0 6-7 0 1 3 800.537.7358 »psecu.com
THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION.EQUAL OPPORTUNITY LENDER.
d � � m � z W � �
c�e m r,. � °�' '� �. �
F► � � a a � a n =
o �� m � _ `° a j' � �
�' g �• �: � � o � �.
A a n�i c�n � °' � � D U��
v m R° C � �D �° �° fD
a� .-� � � I Q .TD1 � �
v� � � � ;
� � � ? �
ln � � � � '� � � �, �
� � � � c
�, ! �
o � � � ; O � � ,
o �' ° � w I '� C7 0
A � �I\
� n � 0 ' O n �
o � N� '�f} �i � �' �
s o � q o � N m �
� ¢ c a � �' � � � �
o �, cn o t� � c4 d � c�
w vi o tn � i 'p ~, ~ � ,� � �'
� ? p O_ W i O�o � A y N � I-�
N
� o � p � W A � � � Q
tt � O � O� I O�o N O � � rr N
-++ O
� o a � O C�n
� o• v O
� OO o� o o X � n�i �n � I �
� N •�+ '+ �'y+ cp c tn � i � n �
� � � r � � v�i n c� � {� � p • <
rn � ^� a ip � < `� � I � '"'' �,
� a, o o �; fiF m m �' � � j � z �
• � o N � � -. � � � o c
00 � o'a � � � o � I ~' �° � c �
v � y � � � �
� O t,�i� N � � O W N O � � 3 (D
1 � �p. 6
'O � O � O � O7 i � O N G � .P
_` " � � O O �
� o � n a w U'
o � � � �� O W
� o � � p�p o�o
C y di tA � O N W
� m � �o�i � � � rt � O
�' � c0 c0 N � � t�D � w rn a n'i o aAo rn � O
� O � N � � � o 0 o n o 0 o O
c��'u 4 cD O t0 c4 rn W �q � o 0 0 0 � o �o 'O �
� CO o OD CO O �D O
O
� T-T-i� �
� M+ CO 00 � I �
� � � � � ��.�, � � � � � �l � M
� O i i
� � G � � � � � � ti = C ��e1
� 'Np W a����'p I � d � ,f� � o
I I �
e�. � � cD
`��4 �. (p,V SiI I�yi � � � � � O (/.� � �
y A .�P N W ��' �� � i 0 � O m �
� i � � `� � � � p C>
� t0 �O � � � A I I 0
m �n
Z7 � � � � � � m d N � �`r� � p�j `� a
� � EA � � C�T� � � �. '� W ' t�Q� ' I i � � I f� O W N
N N O N N O O G � e-� p � }'r3� ��.. , �' I', w � O
o O a I r I i F.a � vi
i
O W ~ ao � C '� I a' , i O�
� N w ����' ��' O �
Q � F' t '
� � C A t I a� I I i �i � V)
i
� � �'�Fi����, �.A I {�y
" ' ' O
i �
� C�T1 C�71 � � A t,:I �'"" �. I
6� W 69 � I-� .r.- a, ,�r x� .�
� O O W � F..a A � �'�'"Y"� � �I C�
N � ' W
w w �p I � � i
ha� W p W .�p C�J7 W = A .. ,. � }� ¢ 'a`���� �gl:: i �1
p � . , ;r� �....:�x..��. � �; �
��• O� O O� N N N C, � � I I, „� i
I
n V� ' � I �
n � �-+ c0 �I O I� I '. i I . ''�
�Q p W T
� , �
BUREAU OF INDIVIDUAL 7AXES Penns Ivania lnheritance Tax � enns Lvania
Po BOX z8o6o� y P y
HARRISBURG P/�17128-O6o1 Information Notice DEPARTMENT OF REVENUE
� And Taxpayer Response REV-15636 E%DocEXEC �oB_�z�
FILE NO.2115-0403
ACN 15504082
/ DATE 05-12-2015
�
Type of Account
Estate of DEAN A HARRIS Security
SSN 184-26-5043 X SEC Acct
Date of Death 03-16-2015 Stock
ERICKIA H RYNARD County CUMBERLAND Bonds
250 BONNYBROOK RD
CARLISLE PA 17015-9286
AMERIPRISE provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No. 10139297666002 Remit Payment and Forms to:
Date Established REGISTER OF WILLS
Account Balance $164,141.54 1 COURTHOUSE SQUARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $82,070.77 �
Tax Rate X 0.045
Potential Tax Due $3,693.18 NOTE*: If tax payments are made within three months of the
With 5%Discount(Tax x 0.95) $(see NOTE' decedenYs date of death, deduct a 5 percent discount on the tax
� due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Ste 1 : Please check the a p
� P ppro riate boxes below.
A �No tax is due. I am the spouse of the deceased or I am the parent of a deCedent who was
21 years old or younger at date of death.
P�oceed to Step 2,on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
g �The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
� �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent, child, grandchild,etc.)of the deceased.
(Select correct tax rate at
right,and complete Part � 12% I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships (including none).
p �Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania
PO BOX 2so6o1 Information Notice DEPARTMENT OF REVENUE
HARRISBURG PA B-0601 REV-15438 E%DocE%EC�oe-iz�
� And Taxpayer Response FILE NO.2115-0403
ACN 15504083
DATE 05-12-2015
Type of Account
Estate of DEAN A HARRIS Security �
SSN 184-26-5043 X SEC Acct
Date of Death 2015 Stock
BRITTA H SCHATZ County CUMBERLAND Bonds
511 KISTLER RD
ELLIOTTSBURG PA 17024-9022
AMERIPRISE provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Remit Payment and Forms to:
Account No.930024033597004
Date Established REGISTER OF WILLS
Account Balance $239,670.40 1 COURTHOUSE SOUARE
CARLISLE PA 17013
Percent Taxable X 50
Amount Subject to Tax $119,835.20
Tax Rate X 0.045 NOTE': If tax payments are made within three months of the
Potential Tax Due $5,392.58 decedenYs date of death,deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
1
A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step,2 on reverse. Do not check any other boxes and disregard the amount
__._ ------ __._ __.--- ___ _ __ __.
shown above as Pofential Tax Due.
g �The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right,and complete Part � 12% I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships (including none).
p �Changes or deductions The information above is incorrect and/or debts and deductiorrs were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania
PO BOX 280601
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
� REV-15438 El(OocEXEC (OB-I2)
� And Taxpayer Response Fi�E No.21�s-o4os
ACN 15504079
DATE 05-12-2015
Type of Account
Estate of DEAN A HARRIS Security �
X SEC Acct
Date of Death 03-16-2015 Stock
BRITTA H SCHATZ County CUMBERLAND Bonds
511 KISTLER RD
ELLIOTTSBURG PA 17024-9022
AMERIPRISE provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Remit Payment and Forms to:
Account No.297452369133
Date Established REGISTER OF WILLS
Account Balance $53,096.16 1 COURTHOUSE SQUARE
Percent Taxable X 50
CARLISLE PA 17013
Amount Subject to Tax $26,548.08
Tax Rate X 0.045
Potential Tax Due $1,194.66 NOTE`: If tax payments are made within three months of the
decedent's date of death,deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) $(see NOTE*) due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
1
A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
__ __ _ _ _ Proceed to Step 2 on reverse. Do not check any olher boxes and disregard the amount
shown above as Potential Tax Due.
g �The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent, child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right, and complete Part � �2% I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships(including none).
p �Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
BURFAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania
PO BOX 280601 DEPARTMENT OFREVENUE
HARRISBUR A 17128-0601 Information Notice
And Taxpayer Response REV-15438 E%OoeE%EC �oe-,z�
� FILE NO.2115-0403
ACN 15504078
DATE 05-12-2015
Type of Account
Estate of DEAN A HARRIS Security �
SSN X SEC Acct
Date of Death 03-16-2015 Stock
ERICKIA H RYNARD County CUMBERLAND Bonds
250 BONNYBROOK RD
CARLISLE PA 17015-9286
AMERIPRISE provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.931026328589004 Remit Payment and Forms to:
Date Established REGISTER OF WILLS
Account Balance $44,455.66 1 COURTHOUSE SGIUARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $22,227.83
Tax Rate X 0.045
Potential Tax Due $1,000.25 NOTE*: If tax payments are made within three months of the
decedenYs date of death,deduct a 5 percent discount on the tax
With 5% Discount(Tax x 0.95) $(see NOTE*) due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
,
A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
` shown above as Potential Tax Due. �
g �The information is The above information is correct, no deductions are being taken,and payment wil►be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right,and complete Part � 12% I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships (including none).
p �Changes or deductions The information above is incorrect andlor debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate orr the back of this form.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
�.��QwDDo o � � � o =� D � � Da „ �
c°c �nmo 0 o d � � � N � � vi o � � Q C � y A
�.',� �'� c c c � m m � � � ; c 3 �• � 3 Q "« C!
o�o�� ,�~. ^. v+ < 23 2i � � �- �cQ j A� p� C <D O
3�Q�� � � � N � � � � � � � a� s1 � �
�rt a�< � � � � c c .. o ? c� � � � � � � ,-«
� o 0 3 � � � � o o �
-D� o �m � 3 ,, m r" '� A .� � � o � ..+ � N .* �
ci=w a�Q- � � � � e� � o' � � � a�°i C �p .0 C
•�—�a o C. o � C1) � -+ �
�� u,-am o o �« e�i c o � o � � uw � � �
'fl�oa c c e � � -� � .�, o � � �
o��.c�o N �i �i c v� � � � � � � a- �D d � �
� o._.c � � 3 u� � v � � p m -t � 'O
�wy�o a c � � m � � � � cu ry-r A � W
C� A � _
p�O Q.Pt � � � N =^ � `G (Q �p � N (D V
O o�,�W� �L �L � a � fn C N � a, ~ � �
C m��� �. hm� � � � �' 3 O a �
� -3w 3.-►'C � � <� C7 V) < (p � ��Q ...► �
O fD�3(D � � (D Q O -w � O
1
� ���Yp� N p-�p d � p � � �a
C� o o �a'� � @ a � �. � N �'� �
�
3 -..K �� � � � ^�* �
� S � 3 � e
� ��`Nc v v QD _ p� mm v v QD � ?m �' o �• ? �
� oo�'c�ia D D 23 �' � �' a �' y D D b � � � w wc� m 11
�A��CN 7C � (D � ' Z Z C StQ 7 7 n
a oQ'� �.� D D � ^� � �' � � � D D � "'+ ~' � � � O � ^7+
.y/ �Q rt N N� � = O (� N Vl � L Q C = O O (� � Q � (� � W
�.mww�i z 7Do o- cn � o � � � Z � a �� � c o � � m �
��Qym = � � � � c � Nd = �p � o � � � � � Q �.
m ��sta D N � � -, m a v u� 3 �, m � w _
��' �. 7p � c � � � ao m � o
�aQN� N � � c. � � d N � ? � cQ �`�o v�i �
rt
r.r► �' s� mNoc� � c
�n�c Q� o � o c� � � � = o � w �• � �D
�'��v;c � o � �' 3 � � � _ � � N
��-�3�D � o � � "` � v� m � D u, o
��30o m m Qm � '� � o N �p �' �
pg�w�c � � � � � � w � � � 'i � �.
o-� ��c � ofvm � 3 Qcpw � y � sv
rt w p�` �' � � p„ � h ,d,t L ,.• � ,.�.� � p� O
g -�.-� c tD' mom � Z � aim � Zaa
m � �
�3�im,3 ? �p ,uNi � �p � �' �' v' � V�io �
� � � on� � rrt � �
��D�� w w D : � � ¢ ua G'� QD O tn '� N O p
�y ��� v v � Q p� N O C1 V �I G7 � (D �. � � � C
�'t '�p n p p C f11 � � C1 O O � `< � lN/� � "" � fA
W� �..,'�g V W 3 `. � � N Q v W ,�.,, CD C �, �I(O "a
3..��O � � "' _(Q .-. O � � < tD � N � � F � N
p�� ��p � O C C O � � S � Q '� C � C � A� N � �; m � � o
K J J � � �� � J J � � � � � � C n Q ry � �
G
Q.� � �� N � � � Q3 � � � � � �"'C � � �� � � � _ �
� C al��n � n 7 � � � � -1 � � � $ � N � a fD
t �/1� � � � � � (v � � @ � Q � `' Q � �- � VI
7 O Q.3 � � �F � � . Q.. (� �- � � .=r C7 . N
.T Q (���� C n Q' � Q -��S � � � N � S �
�� � C �t � N � � � n Q m � � N
V .a tp p�<p Q O •< Q n d � N z�
� � C t� �`� � � � .-« O `t A> � � f
� (D p.�p�� p� -� �' Sv C p � � � N o p �
� t�i� 3 y.`G � W 7 n � .0 � � CD � 3
7 �� ��co Pi n (D � .'. n � � � a o
U <,�� �� 0 0 � � � � � N — O � O � W
D ��C C. A3 0 (D (D -s � � � � `� w
j ����• O O (D n � — � A� � � �, � � �
�p�°a o.p.."•� m m � Q- c�i a-cQ � u' m �v
�n �� .� � � o � n om �
� y s�� 3 m � .-�. �, � v� m o 0
", a A o o,�D m � � �' � o � rn -��. � m c� .c � �
-.. (D � C p T
�3�A� � � .�N+ � � � � N V UI .�i� LU r' "'� � � O
� �
J Q(D(�D� C (ol VI A� � O O 0� N w 7 `< N n � y D
O � m�3,� � � N •�► � GJ GJ O C f� � ' n ^� '~ � �
m�w�c�c rn � cn m m � � o � o- Z �
y� ��C � � � � O � y
�0� 3 � -a � � �, � � m �
ao c�� tfl tfl � � � � � � Z �
y �t�/�NN N N � � � � � C m �
G
�o m a -,m �. o � �'. � m o �- � `�
a'c'�Q� o rn m � r,: �, pi� O
�¢�i p�.p� . • Q- .r� � -�. � � Z
ma� mm " < � m � aQ c �
��.¢,�g � � �- .. <, � N /�
�3$� � D m ,�, pi � o vi � �Y
�.y��� �, o �' Qm � � Z yo
� rt 0 O � {fl {fl ifl � � L � � � L�
� .y--:� N W N � Oo t�0 � � � � fD �
�
� N � � � � v � � N N � O �
O � � N N C�11 O
B�R�►o oF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennS�/LVa111a
PD BOX 280601 , DEPARTMENT OF REVENUE
HARRIS URG PA 17128-0601 Information Notice .
REV-15438 E%DocEXEL (OB-12)
And Taxpayer Response FILE NO.2115-0403
ACN 15503724
DATE 05-04-2015
Type of Account
Estate of DEAN A HARRIS Security _
SSN X SEC Acct
Date of Death 03-16-2015 Stock
ERICKIA H RYNARD CountyCUMBERLAND Bonds
250 BONNYBROOK RD
CARLISLE PA 17015-9286
EDWARD JONES provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.37703610 Remit Payment and Forms to:
Date Established REGISTER OF WILLS
Account Balance $60,804.30 1 COURTHOUSE SC�UARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $30,402.15
Tax Rate X 0.045
Potential Tax Due $1,368.10 NOTE': If tax payments are made within three months of the
decedent's date of death,deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below. ,
1
A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
.__ _ --___-_ ._- - _ __._ __ shown above as Fotential Tax Due. - - -
g �The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child, grandchild,etc.)of the deceased.
(Select correct tax rate at
right, and complete Part � 12% I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships(including none).
p �Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E �Asset wilf be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
BUREAU oF INDIVIDUAL T,�ES Pennsylvania lnheritance Tax ' � pennS�/LVa111a
PO BOX 280601 Information Notice DEPARTMENT OF REVENUE
HARRISBURG PA 171ZS'OGOZ -" REV-1543B EX DocE%EL (OB-12)
And Taxpayer Response FILE NO.2115-0403
ACN 15503735
DATE 05-04-2015
Type of Account
Estate of DEAN A HARRIS Security
SSN 184-26-5043 X SEC Acct '
Date of Death 03-16-2015 Stock
BRITTA H SCHATZ County CUMBERLAND Bonds
511 KISTLER RD
ELLIOTTSBUR6 PA 17024-9022
EDWARD JONES provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Remit Payment and Forms to:
Account No.37707000
Date Established REGISTER OF WILLS
Account Balance $41,472.34 1 COURTHOUSE S(�UARE
CARLISLE PA 17013
Percent Taxable X 100
Amount Subject to Tax $41,472.34
Tax Rate X 0.045 NOTE": If tax payments are made within three months of the
Potential Tax Due $1,866.26 decedent's date of death, deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
�
A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above asPotential Tax Due. - � ` ��
g �The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary (parent,child,grandchild, etc.)of the deceased.
(Select correct tax rate at
right, and complete Part � 12% I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships (including none).
p �Changes or deductions The information above is incorrect and/or debts and c�eductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any ofher boxes.
Please sign and date the back of the form when finished.
Rice Memorial Works
421 W. Main Street
� New Bloomfield, PA 17068
(717) 582-2512
Britta H. Schatz I/�VO/C@ 5/26/2015 �
511 Kistler Rd
Elliottsburg, PA 17024
. . o -
13-31650 4/3/2015 Dean A Harris Lynne Trace
1 Cemetery Inscription
Order Total: $175.00
2�ank you, your memorial or cemetery
Payments: $0.00
inscription is fini,shed.
Balance Due: $175.00
RECEIPT FOR PAYMENT
LISA M. GRAYSON, ESQ. Receipt Date : 4/13/2015
Cumberland County - Register Of Wills Receipt Time : 13 :25 : 05
One Courthouse S quare Receipt No. : 1081062
Carlisle, PA 17613
HARRIS DEAN A
Estate File No. : 2015-00403
Paid By Remarks : IRWIN & MCKNIGHT
CJ
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 90 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 10 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 35 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 1016 $185 . 50
Total Received. . . . . . . . . $185 . 50 ,
� �J����D �G��
�,
� ,
�-
_.. �
��tssoc�°
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
Tele: (717)249-3166 Fax:(71�249-2663
May 29, 2015
Cumberland Law Journal is published every Friday by the Cumberiand County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Douglas G. Miller, Esquire
RE: Dean A. Harris Estate
Legal advertisements must be received by Friday Noon. All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on following dates:
May 15, May 22, and May 29, 2015
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 75.00
Total Amount Due $ 0.00
Becky H. Morgenthal, Executive Director
��
« �,
�
u� � � � o
Z � 3 ao r� �
0 � � 1e'� W �V � N � f/� �• .
Z � w t� Q � ? * Q � � � O
d O W W
Q �' W d � � � O LL Q �
a � � o � Q W (a Q •
� y .. v z � o p
H � �d o � � � W W x �
Q w ao cn r� Eg fA W � W
m � � � Q � �jZ � 69 � � � W JmQ N
� "' Q `- � � � v Z � ua � J
Z a�0 � O � N m
� � J p Q p a ~
a m � � w J m �' �
� J � � � C
Q d
N — 7
��p O
= U
y �- E a� �t
o Q °' � o � o
m � M a > °�' � ° ` �
� .- o
y C X � C � M
� N � O N �-r �
= y � V � � @� C
F- � � a pM 0 -0 � `
W � � N t� N '`y
N M Z � p_Y O � C C f� 't
W _ �n � �
�U' � � a � y � c`o � aci c�i � � c�6i :
� � � �- - � a� E � � °
Y� pa, cn cvi� W - � � m m � � c '
�O w
a LLj M o N y�_, � '3 �-o .c E ° n
� J N p U -O +� d tA
°�(/)f/�O� Q W � ` �`p � 3 j
Z J N .. a N V p, rn0 6
� � � � � � � 3 C �
Q f� .-. ___ � ' �'
��Uti J @ � � � � �n �
W � C U N � y
C
V tA �� C +L-� -�p � O
� i � � � � � �' �
� N O � O � 0 � C
Z = �
d y V �i � O C �
C � O � T �
N y � � �C �
Z � �� C � T � � �
J O � a C � L V 'p
� E � W Q y C � � f C
� � �: p J W J W W U �
U J � m �
� � �
. � � W � Z � Wa � J .
K � o `o � c� � �- $ E
� ` � Z M � W � w O " W
T�E � O '� Cl (1) � m O S
VL � � Q � _ � � � `
� � �; 3 t- p � a �
3 � a co r M M a
�13 u
_ _ -�
Sollenbergers - Carlisle
Sollenbergers-Carlisle Record#: 53235
29 Westminster Dr •
Carlisle,PA 17013
(717)249-8149
For: Date: 04/24/2015
ERICKIA A RYNAR Time: 05:18 PM
250 BONNYBROOK RD
CARLISLE,PA 17015
Clerks Initials: CAM
Vehicle Registration Information _ _ Agency Fees
4/24/2015 5:18:17 PM CAM: AFFIDAVIT OF RESIDENCE/ In store processed-Notary 0.00
DEATH CLAIM
�
Agency amount paid 0.00
ICheck to state 0 0.00
Surcliarge 0.00
Total Agency Fees 0.00
Service Fees
Messenger Fee 0.00
Notary/Clerical Fee 15.00
Copy/Fax Fee 0.00
I/We swear that I/we have applied for the above item(s). Other Fee 0.00
Payment Type MC
Total Service Fee 15.00
4 Surcharge _ 0.00
__.— -----
--- --- -
Sworn and subscribed to before me on 24-Apr-2015. Total Surcharge 0.00
Total Amount Due 15.00
Amount Tendered 15.00
i,r Change Due - --- -- —— 0.00
�No Refunds on Service or Notary fees.We are not responsible
for the work the State fails to process.
Notary Seal ________ —_ -------
Welcome to Sollenbergers-Carlisle
Your Direct Connection with PENNDOT,"Online",State&Service Fees Apply
a�si�umcr�� �Ir �'rIT,IViAP1 ,CKY14CJ
PAOE
►��� �"�`E ����' DEAN A HARRIS 1 0� 2
250 BONNYBROOK RD
• CARLISLE PA 7701�9286 STATEMENT
.��4I1 �. ��I'S�I�� uare: 04/01/15
�A,�a�^,�-� ��� LASESTATEMENT
iViGU,14CLL ACCOUNT# 1453325
tF Amr au�rioets,P�►se coNracr: MSHMC PATIENT FINANCIAL SERVICES FED T/UE ID# 257857035
.itj"> ,�� t{ ,a '� S::�j', 1 ,.�3 ! 1 � � - - S y �� .
� ''F a'ti�—�i� i� S'�Ery �;�`��1'�i:4F.Yq,��} y�7�fsf h. �kd' � ,�S ��.�s��, 4 U -i�t t ��;M' .t r J�JE:it�s � vh: �. t:^i�' N�. �ry +�
r�. �'� .;� � 4■ � a a#x e� `i S+� t r'$. �' S�' �' � :
Y,� t �x E �.:�-"�' dis��sar.� �+r�a, ��I�r',A�T, r��s�'v A��[��r�q3°�')tu�'et 3L�� '�f�������tfi <r, `� �>t ` n!
.(�.�.. .kf r� �. 4Y�'.i. �N �. ."�F;�__,h, h� � "'G� :�A'33� -'v K-:'F '.�i�'�:r }J{.� Y.'��F {�1�' ::1�-0�fiY .�'��. pX� ..i`"i �
.a. H �* l+°; , � a.�, sr n�'x�n/"�5.� � :,n. Ha ,��',�rn 4.kror,�1'{r§xLP. � � s'.,S.nY A : � 1 5., �� .1f,..-' ���1"II�If�����r� Y
�.:u�.w:�J'.+�.a,:�:.�.���,:,.�"Hn+,� :.{„ :.. �*:d:�Ss.��S?,r,ax?"F3�,..Y..�+t.w?r4,.wu��ta�XL ...�?��a� � �.� h� v � �'..;.a':�Y�� i.� �::, ...� , ,.;..� �.;:,t�P�rS.I�.,::r ,.,r ,...M... .`s'}.:n�fs: �r t.:..�,�7.�... .ciY4:.i
y» PATIEF�T: DElW A HdRRIS 1453325 �� .4 �'.�"` .� Y"�"'��.r.., .:.�� ;_w.
22344472
03/15l15 TD 03�16115
RERFOI�IED BY: D�IALD J FLEFlRN6 MD DIV OF DIA6 RADIOLO6Y
PLIf�E OF SYC: INPATIENT
03/15/75 7400026.6C V58.82 ABD�IEN SIN6LE YIEW 88.00
03/2b/15 AETNA PAYMEFl1'* D.DD
03/26/15 AETNA t:p�ITRACTUAt AD.� 78.SD-
03/30/]5 SMALL BAL�NCE ADJI�STMENT 4.20- 0.00
PERFOI�IED BY: SUS1W A 6LDD MD DIWISION PdLLIATIVE CARE
03I16/15 94253 431 INITIAL INPT Cd�SULTATIW 388.D0
D4lOL15 AETNA PAYt¢Nf� 33.01-
04t/O1�]5 AETNA CONTRAGTUdI AD.� 0.67-
04/OL15 pETNA Cp�R'RAC'NAL AD.� 286.39-
OQr/OL15 INSURMICE DEDlJCTIBLE* 67.43
BALANCE: DEiW d HhRRIS Sb7.93
INDICATES NEi�I FINM1CIdL ACTIVITY SINCE LAST BILL.
DTHER CHAR6ES BILLED TO YOUR INSURANCE C�IPlWY. 1478.00
AS A t�URTESY TO Q1R PATIENTS, pSH NEDICAL 61�1JP WILL
SI�MIT BILLpBLE CHARSES TO II�LSlJR1WCE t�IP1WI�S. IF YOU HAVE
QUESTIONLS ABaJT THE AFQU�f YaJR II�LSURMICE COMPANY PAID, PLEpSE
Cpdf iNCT THEI�I DIRECTLY.
THIS STATEMENT IS FOR PHYSICIAN SERVICES �ILY. IN ORDER TO
KEEP YOUR A�CQ�1'T CURRENT, OUR POLICY IS TO APPLY YOUR PAYMENT
iD THE OLDEST OUfSTpNDIN6 BALMICE. YDU MAY aLSD RECEIVE A
STATEMENT FQR FDSPITAL FEES. TNMK YDU FDR t1SIN6 PSN
lIEDICAL 61� FDR YOUR PHYSICIAN SERVTGES. (
FINIWCIAL ASSISTANCE IS AVAIUIBLE TD PATIEN�S FdD CAN�T AFFDRD
TD PAY TNEIR FIEDICAL BILLS.IF YOU HAVE QUESTIONS RE6ARDIN6 YDUR
BILL CALL jee68D0-254�-2619 OR 717-531-5064�eeE OR VISIT US dT
TH� ACMEMIC SUPPDRT BLD6., 40 NDPE DRIVE, I�Q4 21D6. FDURS
ARE l�qd 8pM-8PM, TUES & FIED 8AM-5:30PM, TILJRS & FRI 8AM-4:30PM.
�U►' y�`���
C� �` �2S
CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK