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Home My WebLink About08-13-15 (2) -� REV-1500 EX(01-10) 1505610143 PA Department of Revenue 1� OFFICIAL USE ONLY P Penns OFREVE a County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 13 01294 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 10 05 2013 12 25 1931 Decedent's Last Name Suffix Decedent's First Name MI GALLAGHER ANNA J (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI GALLAGHER FRANCIS E 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 ❑ 5. Federal Estate Tax Return Required (date of death after 12-12-82) ® 6 Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust 0 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 TO: Name Daytime Telephone Number CRAIG A DIEHL ESQUIRE CPA 717 763 7613 REGISTER OF WILLS USE ONLY First line of address � . 3464 TRINDLE ROAD CDC-.N, C"O '] D Second line of address rC-3 C7 DATErFLED City or Post Office State ZIP Code - -� CAMP HILL PA 17011 r—a c:> t ;."1 fV t r1 __11r - CD Correspondent's e-mail address: cdiehl@cadiehllaw.com c `r3 Undr 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 u correct and comple De a ation of prep other than the personal representative is based on all information of which preparer has any knowledge. SIG E SON R PO SIB FO (LING T N DATE Kathleen A. Gallagher 5 AD RESS 1110 Spruce Hills Drive, Gle Gardner, NJ 00826 SIGNATURE OF PREPARER OT ER THAN REPRE,5ENTATIVE DATE r Craig A Diehl Esquire CPA ADDRE S 3464 Trin le Road, Camp Hill, PA 17011 Side 1 1505610143 1505610143 J J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: GALLAGHER, ANNA JOYCE RECAPITULATION 1. Real Estate(Schedule A).......................................................................................... 1. 255 , 000 . 00 2. Stocks and Bonds(Schedule B)............................................................................... 2. 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3. 4. Mortgages&Notes Receivable(Schedule D).......................................................... 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 20 , 464 . 31 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 1 , 933 . 01 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7. 8. Total Gross Assets(total Lines 1-7)....................................................................... 8. 277 , 397 . 32 9. Funeral Expenses&Administrative Costs(Schedule H)......................................... 9. 63 , 658 . 05 10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1)................................ 10. 22 , 757 . 09 11. Total Deductions(total Lines 9&10)...................................................................... 11. 86 , 415 . 14 12• Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 1 90 , 982 . 18 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. 190 , 982 . 18 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X .00 15. 16. Amount of Line 14 taxable at lineal rate x .045 190 , 982 . 18 16. 8 , 594 . 20 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due..................................................................................................................... 19. 8 , 594 . 20 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 1505610243 1505610243 REV-1500 EX Page 3 File Number 21 - 13 - 01294 Decedent's Complete Address: DECEDENT'S NAME Gallagher, Anna Joyce STREET ADDRESS 1900 Cooper Circle CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 8,594.20 2. Credits/Payments A. Prior Payments 82.48 B. Discount 4.34 Total Credits(A +B) (2) 86.82 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 8,507.38 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;.................................................................................. F] x b. retain the right to designate who shall use the property transferred or its income;.................................... ❑ LxJ c. retain a reversionary interest;or.................................................................................................................. H d. receive the promise for life of either payments,benefits or care?.............................................................. Nx 2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?....................................................................................................................... ❑ a 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?...................................................................................................................... ❑ F 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 January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax re urn are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: •The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. •The tax rate imposed on the net value of transfers to or for the use of the 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)1. A sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,w ether y blood or adoption. SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gallagher, Anna Joyce T21 ILE NUMBER - 13 -01294 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 1900 Cooper Circle 255,000.00 Camp Hill, PA 17011 (See Attached HUD-1) TOTAL(Also enter on Line 1, Recapitulation) 255,000.00 lNi��' A. Settlement Statement (HUD-1) OMB Approval No.2502-0265 nim JAL .'of Loan 1.❑FHA 2.❑RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number: 15-1201GT 7529384 28773304 4.❑VA 5.Q Conv.Ins. G.Note:This form is fumished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown items marked "(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals. D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender: Clifton R.Guise,Jessica E,Guise Estate of Anna Joyce Gallagher ACNB Bank 9 College Avenue,Stewanstown,PA 17363 16 Lincoln Square,PO Box 3129, Gettysburg,PA 17325 G.Property Location: H.Settlement Agent: I.Settlement Date:07/24/2015 1900 Cooper Circle Guardian Transfer Disbursement Date:07/24/2015 Camp Hili,PA 17011 485 St.John's Church Rd,Shiremanstown,PA 17011 Camp Hill Borough Phone:717-393-7050 Fax:717-735-0548 Place of Settlement: TitleExpress Halbruner,Hatch&Guise,LLP,2109 Market Street,Camp Printed 07/23/2015 at 11:39 am Hill,PA 17011 by PS J.Surnm f Borrower's Transaction K.Summary of Seller's Transaction 100. Gross Amount Due from Borrower 400., Gross Amount Due to Seller 101. Contract sales price 255,000.00 401. Contract sales price 255,000.00 102. Personal property 402. Persona{property 103. Settlement charges to borrower(line 1400) 8,094.85 403. 104, 404, 105, 405. Adjustments for items paid by seller in advance Adjustments for Items paid by seller in advance 106. City/town taxes to 406. City/town taxes to 107. County taxes 07/24/2015 to 12/31/2015 741.91 407. County taxes 07/24/2015 to 12/31/2015 741.91 106. School taxes 07/24/2015 to 06130/2016 4,069.23 408. School taxes 07/24/2015 to 06130/2016 4,069.23 109. Sewer 7/24-9/30/15 122.39 409. Sewer 7124-9/30/15 122.39 110. Trash 7/24-9/30/15 30.18 410, Trash 7124-9/30115 30.78 111. 411. 112. 412, 120• Gross Amount Due from Borrower 268,059.18 420. Gross Amount Due to Setter 259,964.31 200. Amounts Paid by or In Behalf of Borrower 500. •Reductions In Amount Due to Seiler 201. Deposit or earnest money 2,000.00 501. Excess deposit(see instructions) 202, Principal amount of new loan(s) 242,250.00 502. Settlement charges to seller(line 1400) 30,980.29 203. Existing loa s taken subject to 503. Existin loans taken subject to 204. 504. Payoff of first mortgage loan 205. Application Fee Credit 490.00 505. Payoff of second mortgage loan 206. 506, 207. 507. Inheritance Tax Escrow 17,578.65 208. 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by setter 210. City/town taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to 212. School taxes to 512. School taxes to 213. 513, 214, Radon Mitigation 975.00 514. Radon Mitigation 975.00 215. 515. 216. 516. 217, 51T 218, 518. 219. 519, 220• Total Paid by/for Borrower 245,715.00 520. Total Reduction Amount Due Seller 49,533.94 300. Cash at Settlement fromito Borrower 600. Cash at Settlement tolfrom Seller 301. Gross amount due from borrower(line 120) 268,059.16 601_ Gross amount due to seller(line 420) 259,964.31 302, Less amounts paid by/for borrower(line 220) 245,715.00 602, Less reductions in amount due seller(line 520) 49,533.94 303. CashX❑ From ❑ To Borrower 22,344.16 603. Cash ❑X To ❑ From Seller 210,430.37 Uist u epgr mp n w u q to ma mm s per rosponse or np,rerrewmp, nW a ngngy mer rma ron,a W.Ste M+e4 e omY uniesstta&ptaysaturteNry tulle 0MB cgnlrgFpwMerS ft-fid mlerey isassM:UtS Cisgbsu(BBmsMatory.l7LLs is deslynetl WPI- .UL. W tae RUPR P-- cgveretl iro aQton,�sti Info icon elmn4 tM smnemgnt ,�C f'144Ae /I Previous editions are obsolete Page 1 of 4 HUD-1 M Totaleal Estate Broker Fees $f5,300.04 Pald From Paid Frorrl .50sloofcommSsslan Iine700 astoliows: Borrower'sr's.50 to ColdwellBankerResidentialBrokerage Funds at Funds at 90 to Coldwell Banker Residential Brokerage Sett)emenIt Settlement .50 to Remax Town &Valley Realtyssion paid al settlementtion Fee 15,300.00 to Coidweit Banker Residential Brokerage 400 705. Transaction Fee to Coldweii Banker Residential Brokerage 300.00 800, Items Pa able in Connection with Loan 801. Our origination charge (includes Origination Point 0.000%or$0.00) $530.00 (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2) 803. Your adjusted origination charges (from GFE A) 53p,0p 804. Appraisal fee to ACNB/1st American (from GFE#3) 410.00 805. Credit report to ACNB/E uifax (from GFE#3) 60.32 806. Tax service to from GFE#3 807. Flood certification to ACNB/1st American (from GFE#3) 10,00 808. to 900. `Items Re irked by Lender to be Paid in Advance 901. Daily Interest charges from from 07/24/2015 to 08101/2015 @$31.9635/day (from GFE#10) 255.71 902. Mortgage Insurance premium months to from GFE#3 903. Homeowner's insurance for i Years to Liberly Mutual (from GFE#11) 698.00 904. months to from GFE 911 1000. Reserves Deposited-With Lender 1001.Initial deposit for your escrow account (from GFE#9) 1,134.82 1002•Homeowner's insurance 3 months @$ 58.17/month $174.51 1403.Mortgage insurance months 0$ /month 1004.Property taxes months 2$ /month 1005.County taxes 6 months @$ 140.16/month $840.96 1006.School taxes 2 months 0$ 369.081month $738.16 1007.Aggregate Adjustment $-618,61 1100.Title Charges 1101.Title services and lender's title insurance $ from GFE#4 1,890.00 1102.Settlement or closing fee to $ 1103. Owners title insurance-First American Title Insurance Company $ from GFE#5 60.00 1104. Lender's title insurance-First American Title Insurance Company $1,890.00 1105. Lender's title policy limit$242,250.00 Lender's Policy 1106.Owner's title policy limit$255,000,00 Owner's Policy 1107.Agent's portion of the total title insurance premium $1,642.50 to Guardian Transfer 1108.Underwriter's portion of the total title insurance premium $307.50 to First American Title Insurance Com an 1109. El- 1200. Government Recording and Transfer Charges 1201. Government recording charges $ (from GFE#7) 196.00 1202.Deed$79,00 Mortgage$117,00 Release$ 1203.Transfer taxes $ (from GFE#B) 2,550.00 1204.City/County tax/stamps Deed$2,550.00 Mon a e$ 1205.State Taxtstamps Deed$2,550.00 Mortgage$ 2,550.00 1206.Deed$ Mortgage$ Release$ 1300.Additional Settlement Charges 1301.Required services that you can shop for (from GFE#6) 1302, to 1303. to 1304.2015-16 School Taxes to Diane Nei r $ 4,342.09 1305.2015 Counly/twp taxes POCSeller to $ 1306.Sewer 7/1.9130/15 to Camp Hill 11--1 $ 16500 1307.Reimburse far Homes Expenses to Patrick Gall", 7,673,20 1308. Move Piano to Steven Santiago $ 350.00 1309.Weed and Mowing to Steven Santia o $ r r M r r 8,094.85 30,980.29 "Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er."Credit by lender shown on page 1.-Credit by seller shown on page 1. Previous editions are obsolete Page 2 of 4 HUD-1 SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAXAXRETURN RESIDENT DECEDENT BER ESTATE OF Gallagher, Anna Joyce 21 -FILE NUM- BER 1294 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 1996 Chevy Cavalier-good condition, 57,000 miles 500.00 (Value determined by Kelley Blue Book, sale to private party) 2 County Taxes- Reimbursement 741.91 3 School Taxes- Reimbursement 4,069.23 4 Sewer- Reimbursement 122.39 5 Trash Bill- Reimbursement 30.78 6 Personal Property 15,000.00 TOTAL(Also enter on Line 5, Recapitulation) 20,464.31 SCHED ULE F COMINHEW ANCETAXR TURNANIA JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Gallagher, Anna Joyce 21 - 13-01294 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT Patrick D. Gallagher 2006 Savannah Circle Son A Lewes, DE 19958 JOINTLY OWNED PROPERTY: ❑E N[�(O p ITEM LETTER DATE Include name of Fina tial inOsti u�tio nanOd bank account numbe DATE OF DEATH %OF DATE OF DEATH NUMBER FOR JOINT MADE or similar identifying number.Attach deed for'ointl -held real VALUE OF ASSET DECD'S VALUE OF TENANT JOINT 9 y INTEREST DECEDENT'S INTEREST estate. 1 A 04/18/1983 Belco Community Credit Union 3,866.01 50% 1,933.01 Savings Acct. No. 122400 TOTAL(Also enter on line 6, Recapitulation) 1,933.01 SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FU1\ AL BODIE ES& INHERITANCE TAX RETURN ADMINISTRATIVERESIDENT DECEDENT COSTS ESTATE OF Gallagher, Anna Joyce FILE NUMBER 21 - 13 -01294 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Myers-Harner Funeral Home, Inc. - Funeral Services 6,854.00 2 Phillipsburg Memorial - Headstone 695.00 3 Hillside Cemetary-Grave 150.00 4 Tom Cryan -Setting of Headstone Foundation 216.00 5 Saint Anne's Catholic Church -Memorial Mass 450.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission paid 2. Attorney's Fees Law Offices of Craig A. Diehl 7,628.43 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 465.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 The Sentinel - Estate Advertisement 190.54 TOTAL(Also enter on line 9, Recapitulation) 63,658.05 C ,� Sd*dulle.,.,..,H COMMONWEALTH OF PENNSYLVANIA Funeral & INHERITANCE TAX RETURN Adminis�Costs continued RESIDENT DECEDENT ESTATE OF Gallagher, Anna Joyce FILE NUMBER 21 - 13 -01294 2 Cumberland Law Journal - Estate Advertisement 75.00 3 Law Offices of Craig A. Diehl - Postage Reimbursement for DPW Letter 6.49 4 Saidis, Sullivan & Rogers - Legal Fees 402.00 5 Patrick Gallagher- Reimburse for Home Expenses (i.e., taxes, electric, trash, phone, 7,673.20 water, sewer, insurance, oil) (See HUD-1) 6 Steven Santiago- Move Piano, Weed and Mowing (See HUD-1) 550.00 7 Radon Mitigation to Sell Home (See HUD-1) 975.00 8 Shawn M. Gallagher, Repair Home to Sell (See HUD-1) 27,973.00 9 County Club Self Storage-Store Items from Home and Pay Workers to Move Items 488.65 into Storage 10 Delaware River Joint Toll Bridge Commission -Toll from New Jersey 50.00 11 Kathleen Gallagher-Trips from New Jersey to Camp Hill to clean out Home (Mileage- 7,000.00 50 trips @250.00 miles per round trip= $12,500.00 x .56) 12 U-Haul Equipment- Rental of U-Haul Truck to Move Personal Property 276.40 13 Car Rental -8 times to come from New Jersey to Camp Hill 1,538.84 Page 2 of Schedule H SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMNOF HERITANCE TAX RETURNANIA LIABILITIES, & LIENS RESIDENT DECEDENT BER ESTATE OF Gallagher, Anna Joyce 21 -FILE NUM- BER 1294 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 Realtor Commission Paid at Settlement 15,300.00 2 Coldwell Banker-Transaction Fee 400.00 3 Deed -State Tax/Stamps 2,550.00 4 Diane Neiper-2015/2016 School Taxes 4,342.09 5 Camp Hill Borough - Final Sewer Bill 165.00 TOTAL(Also enter on Line 10, Recapitulation) 22,757.09 REV-1613 EX+(11-08) SCHEDULEJ COMMONWEALTHINHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Gallagher, Anna Joyce 21 - 13-01294 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) ITAXABLE DISTRIBUTIONS[include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Kathleen A. Gallagher Daughter 100% Residual 1110 Spruce Hills Drive Estate Glen Gardner, NJ 08826 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. IIS NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 rte: LAST WILL AND TESTAMENT n -- C as OF rn-!-, c s. 70: ANNA JOYCE GALLAGHER ALSORNOWNAS JOYCE A. GALLAGHER cn p Ca I, ANNA JOYCE GALLAGHER, ALSO KNOWN AS JOYCE A. GALLAGHER,presently residing and domiciled in the Borough of Camp Hill, Cumberland County,Pennsylvania,hereby declare this to be my Last Will and Testament, and I hereby revoke any and all prior wills and codicils previously made by me. ITEM 1: All my personal effects, clothing, furniture, furnishings,jewelry, automobiles, other tangible personal property of every kind,and insurance thereon, I give to my daughter, KATHLEEN A. GALLAGHER, if she survives me'for a period of thirty (30) days. ITEM II: All the rest,residue, and remainder of my estate I give, devise, and bequeath unto my daughter, KATHLEEN A. GALLAGHER, if she survives me for a period of thirty (30) days. ITEM III: I have purposely made no provision in the my Last Will and Testament for my other children,PATRICK D. GALLAGHER,TIMOTHY J. GALLAGHER, SHAWN M. GALLAGHER, TERENCE J. GALLAGHER, and MICHAELA A. BEALMEAR. It is my intention that the residue of my estate pass to my daughter, Kathleen, who is familiar with my desires for its application, although I recognize that the desires and intentions I previously expressed to Kathleen shall not bind her in any way,either in law or in equity. ITEM I4v: All estate, inheritance, and other death taxes,together-with interest and penalties thereon, with respect to any interest passing under this my Last Will and Testament, or any codicil thereto, shall be paid out of the principal of my residuary estate without apportionment. It is my specific intention that any tax due upon any non-probate asset shall be paid by the person receiving the asset, and not from any portion of my probate estate.. ITEM V: I appoint my daughter,KATHLEEN A. GALLAGHER, as Executrix of this my Last Will and Testament. I direct that my Executrix shall not be required to furnish security in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal,this 91" day of August, 2013. C�~ QQ,0_6 AL) ANNA J C GALLAGH oavz "'t4 (SEAL) J A. GALLA ER WITNESSETH: The foregoing instrument was, on the date stated above, signed, published, and declared by ANNA JOYCE GALLAGHER, ALSO KNOWN AS JOYCE A. GALLAGHER,the Testatrix named therein, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of one another, have subscribed our names as witnesses thereto. W(ness Witness 1:32- s �o� �� s� L )3a�71 . Address Address ncl�cr) PA 02 Address Address ACKNOWLEDGEMENT Commonwealth of Pennsylvania ss. County of Dauphin AND NOW, this 9t1' day of August, 2013, 1, the Testatrix, whose name is signed to the attached or foregoing instrument,having been duly qualified according to law, do hereby acknowledge that I signed the instrument as my Last Will and Testarbent,that I signed it willingly and as my free and voluntary act for the purposes expressed therein. ,eN ANNA C GALLAGH J(VCBIA. GALLAG Sworn to, subscribed, and acknowledged before me by ANNA JOYCE GALLAGHER, ALSO KNOWN AS JOYCE A. GALLAGHER, the Testatrix, known to me,this 9"' day of August,2013. Notary Public My Commission Expires: COMMONWEALTH OF PENNSYLVANIA Notarial Seal Shana R.Geyer,Notary Public City of Harrisburg,Dauphin County My Commission Expires July 20,2014 Member.Pennsvfvania Association of Notaries • , I f I . • I f . . / f AFFIDA VI Commonwealth of Pennsylvania ss. County of Dauphin AND NOW,this 91h day of August, 2013, we,JAMES D. CAMERON and CYNTHIA L. CAMERON,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 presenearid-saw the Testatrix sign and execute the instrument as her Last Will and ' Testament;that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as a witness; and that,to the best of our knowledge,the Testatrix was at that time at least eighteen (18) years of age, of sound mind, and under no constraint or undue influence. Wit ess , Witne s Sworn to and subscribed before me by JAMES D. CAMERON and CYNTHIA L. CAMERON, the witnesses,known to me,this 91h day of August,2013. Notary Public —0 My Commission Expires: COMMONWEALTH OF PENNSYLVANIA Notarial Seat Shana R.Geyer,Notary Public City of tianisburg,Da July 0 2014 hin county My Commission Exp Member.Pennsvivanla Association Or Notaries