HomeMy WebLinkAbout08-13-15 (2) � 1505618403
"��� pennsylvania
DEPIIRTMENTOFREVEN�X(03-14)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes Counry Code Year File Number
Po Box 2so6o� INHERITANCE TAX RETURN
Harrisburq,PA 17128-0601 RESIDENT DECEDENT 21 15 0 2 7 9
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
12 17 2014 05 09 1940
DecedenYs Last Name Suffix DecedenYs First Name MI
QUIRK JOHN W
pf Applicable)Enter Surviving Spouse's Information�Blo'w � , �
Spouse's Last Name Suffix Spouse's First Name MI
QUIRK GEORGINE G
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
priorto 12-13-82)
� 4. Agricultural Exemption(date of � 5. Future Interest Compromise(date of � 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
� 7. Decedent Died Testate � 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
� 10. Litigation Proceeds Received � 11. Non-Probate Transferee Return � 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
� 13. Business Assets �X 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
LINDA J OLSEN ESQ 717 540 4332
First Line of Address
2000 LINGLESTOWN ROAD
Second Line of Address
SUITE 2D2
City or Post Office State ZIP Code
HARRISBURG PA 1711❑
CorrespondenYs email address: �olsenCa�hazenelderlaw.com
� .�
REGIST F WILLS US�'J�ILY�
� o rn �rn-,
REGISTER OF WILLS USE ONLY � � � � p
DATE FILED MMDDYYYY �'r'; � `� � ';� �
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DATE FILECI'STA� "' —�
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Side 1
I I��I�I II��I�IIII��I�I�III��II�I II��I I�III�I�II��I��IIII II�I
L 1505618403 1505618403 �
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� 15U5618411
REV-1500 EX
DecedenYs Social Security Number
oecedent's Name: Qui�k, John W
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 13 9,7 8 8 • 0�
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 3,2 0 9 • 7 5
4. Mortgages and Notes Receivable(Schedule D).................................................... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).......... 5. 9 9 • 0 0
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 14 3,0 9 6 - 7 5
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 12,4 6� • 5 0
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 3,4 0 4 • 2 0
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 15,8 6 4 • 7 0
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 12 7,2 3 2 • 0 5
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. 12 7,2 3 2 • 0 5
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.o0 12?,2 3 2 • 0 5 15. O - 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 0 • 0� 16. 0 • 0❑
17. Amount of Line 14 taxable
at sibling rate X.12 0 • �0 17. 0 • 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 • 0 0 18. 0 - 0❑
19. TAX DUE................................................................................................................ 19. 0 - 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Under penalties of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNATURE OF ER ON RESP SIBL FILING RET Jall71 O�/QUIfI( DATE
', ��
ADDRESS
209 Cri t Avenue, ,Ard ore, PA 19003
SIGNATURE-. REPARER OT R TH EP ESENTATIVE Linda J. Olsen Esq. Q ATE
U `�
A
2000 Linglestown Roa , Harrisburg, PA
� I I�'I�I I���I�IIII��I�I�III��II�I II��I I�III�I��I II��I II�I I��I Side 2
1505618411 1505618411 �
REV-1500 EX Page 3 File Number 21-15-0279
Decedent's Complete Address:
DECEDENT'S NAME
Quirk,John W
STREET ADDRESS
2 Vine Circle
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest (3)
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4�
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00
Make Check Pa able to: REGISTER OF WILLS, AGENT.
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�.. .r>�&fdPw. ,. ,a. � �.. b,�.. � . sn+ V`�A
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:.................................. ❑ 0
c. retain a reversionary interest;or............................................................................................................... ❑ ❑X
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ �
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑ ❑x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ �
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
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.
\����� �� � � � \�aN� ' � � o � � �.;�. �a�� � � \ �� � �, n , � \ � ��\\�`�<a„a\a ���,�.��'�"
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 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 step-parent 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(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-1502 EX+(12-12)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Quirk,John W 21-15-0279
All real property owned solely or as a tenant in common must be reported at fair market value.Fair markel 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 that 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 decedenYs interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate 2 Vine Circle, Camp Hill, PA-Assessed value x CLR 139,788.00
TOTAL(Also enter on Line 1, Recapitulation) 139,788.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12)
Rev-1504 EX+�09-12)
SCHEDULE C
pennsylvania CLOSELY-HELD CORPORATION,
DEPARTMENTOFREVENUE PARTNERSHIP OR
R SEDENTDECEDENTTURN SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER
Quirk,John W 21-15-0279
Schedule C-1 or C-2(Including all supporting information)must be attached for each closely-held corporation/partnership interest of the decedent,other than
a sole-proprietorship.See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Prudential Stock 37 shares 3,209.75
TOTAL(Also enter on Line 3, Recapitulation) 3,209.75
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule C(Rev.09-12)
Rev-1508 EX+�08-72)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE p E RSO NAL P RO P E RTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Quirk,John W 21-15-0279
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
NUMBER DESCRIPTION OF DEATH
1 Refund-GE Cash-unclaimed property claim submitted-under$100,exact value 99.00
undetermined at this time
TOTAL(Also enter on Line 5, Recapitulation) 99.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12)
REV-1511 EX+(08•13)
pennsylvania SCHEDULE H
DEPARTMENT OFREVENUE F U N E RAL EXPE N S ES AN D
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Quirk,John W 21-15-0279
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
MBER
q, FUNERAL EXPENSES:
See continuation schedule(s) attached 9,600.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2, Attorney's Fees Hazen Elder Law 2,500.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
Citv State Zio
Relationshi�of Claimant to Decedent
4. Probate Fees 360.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
TOTAL(Also enter on line 9, Recapitulation) 12,460.50
Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.08-13)
I
Rev-1512 EX+�12-12)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENTOFREVENUE MORTGAGE LIABILITIES AND LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Quirk,John W 21-15-0279
Report debts incuned by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Camp Hill Emergency Physicians 34.43
2 Community Life Team 102.80
3 East Pennsboro Ambulance 180.00
4 Holy Spirit Hospital 1,216.00
5 HRC Manor Care 1,824.00
6 Pathology Associates of Central Pennsylvania 32.89
7 UCPA Urology of Central Pennsylvania 14.08
TOTAL(Also enter on Line 10, Recapitulation) 3,404.20
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-12)
REV-1513 EX+(07-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Quirk,John W 21-15-0279
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$)
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
Georgine G Quirk Spouse All Rest and
2 Vine Circle Residue
Camp Hill, PA 17011
Jannet Joy Quirk Daughter
209 Cricket Avenue
Apartment 2
Ardmore, PA 19003
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
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JOHN W QUtRK
GEORGINE G QUIRK 1000
2 VINE CIR 1 0 12
CAMP HILL PA 17011-4338
- • •• � 1
/OHN IN QU/RK
GEORG/NE G QU/RK
� Deposit Accounts Account Number Average Daily Balance Current Balance
�, �A�1T;ctiND�R PRE�E1�tt�Q CH�CE;iE�G 1'6�411�0:174 :$443 Fi3 �': ? $1�1 21
_....._
D SfATEMENT SAVINGS 5741 16Z99 $0 00 $0 00
� Total Deposits S�z�.zt
�
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0
�
w
0
� � � � .. �
0
0
0
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JOHN bY Q!l/RK ACCOu.nt# 164117017d.
o GEORG/NE G QU/RK
0
B Balances
� >; �e Fnriin �a�ariep $1;�T���> :: Currerstl3afi�nc� $121 �1 ;
;,
o -. `:
o Deposits/Credits +$21 46 Average Dady Balance $443 69
; Wtthdrawatslf)efiits . . -$9�64�..::.
- ;: >. , . , . ,.
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0
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�
� Overdraft/Returned Item Fee Summary
Fee description Total for this statement period Total year to date Total prior year
i Tdtal t�verdra#t Fees $�.�� ;> $D.QQ <$2�Q.(30
; _ „
_ _ ._ _. __.
Total Returned Item Fees $0.00 $0.00 $0.00
Checks Posted
Check# Date Paid Amount Reference Check# Date Paid Amount Reference
' 322 7��'3 $�0 d6 : b874t$�a�k645; 35�;* ': 12��+� :: Si50:Qt7' 9Q1d721£321;
323 12/24 $48.85 0971449520
3 Check(s)Posted-$218.91
An asterisk(*)indicates a skip in sequential check numbers.
�� Account Activity
Date Description Additions Subtractions Balance
12-13 Beginning Balance $1,026 22
<1'�-15 >: CH.K�ARQ PUR�hlAS�MAN(7:RCARE 0��A 717;-7�7�55:1 l��,U� $12 b0: Si,014.22
12-15 CHK CARD PURCHASE MCDONALD'S F792 LEMOYNE/PA US $2 64 $1,01158
>:12-15 : ��SH W1THI�RAW,�L`'S,�NTANDER E199'C�MP ti:ILL/f'A l!5 $3DO.p�i; ; �719 58:
12-17 CHK CARU PURCHASE GIANT 6269 3301 CAMP HILL/PA US $13.71 $697 87
>:72-18 PRIfI�E�ET1Al:;:FINA�I'fG�1LD1�t;t�1�1121::8�f30�1;'85�12�3PRiJ S21.d6 $fi19<33 '
12-18 CHK CARD PURCHASE GIANT FUEL 6269 CAMP HILL/PA US $24 54 $694.79
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Copyright 2011 Esri. All rights reserved. Tue Aug 11 2015 02:24:22 PM.
2 VINE CIRCLE
PIN: 10-21-0275-184
Deedbook: 00133-00525
Owner: QUIRK, JOHN W
Owner 2:
Land Use Code: 101
Property Type: R
Acreage: 0.15
Square Feet: 1334
laxable Status: T
Clean t� Green Status:
Land Assessed Value $: 35500
Building Assessed Value $: 105700
Total Assessed Value $: 141200
Sale Price $: 1
Sale Date: Mon Jan 1 1996 07:00:00 PM
Year Built: 1952
Municipality: HAMPDEN TOWNSHIP
Height in Stories: 1
Type of Dwelling; DETACH
Primary Exterior: Wood
Basement Percentage:
Air Conditioning: AC
Total Rooms: 7
Bedrooms: 2
Full Bath: 1
�S � P
TAK PARCEL 1�I0.
D E E D
MADE the 2�th day of DECEMBER , in th� y�ar of
our Lorc�, One Thousand �iine fiundred and Ninety-f ive { 1 995 ) , c:->
c;>
�
�;.';
BETWEEN: '
WILLIAM F. QUIRR, JR. : GRANTOR
AND =�_. �
c,:�
JOHN W. QUIRR� GRANTEE '
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WITN�SSETH THAT: The said GRANTOR, for and in consideration
of the su�n of One Dollar.
*�**�*�**���***�*�**�r�*�** ;¢1 .00. �****�***�*****�:r**�**���
Lawful money of th� United States unta the GRANTOR well and
truly paic� by the said GRANTEE, the receipt whereof is hereby
acknowledged, do�s hereby grant, bargain, sell, alien, enfeoff,
releas�, convey and confirm unto the said GRANTEE, its Heirs
and Assigns.
ALL THAT CERTAIN piece or parcel of land, situate in HAMPDEN
'POWNSI-IIP, CUMBERLAND COUNTY, PFNNSYLVANIA, more particularly
bounc3�d and described accordinc� to survey of George W. Walker,
Registered Engineer, dated April 16, 1954, as follows:
BEGINNING at a point on the 6Vestern side of Vine Circle, eighty
(a0) feet North of the �tarthwest corner of the intersection
of Vine Circle and Gre�n Street, also at the dividing line
k�etw��n Lots Nos. 21 and 22, T31ock "O" on hereinaft�r mentioned
Plan of Lots; thence South seventy (7Q) degrees, £ive ( 5) minutes
t�lest, along the same, �ighty (IIO) feet to a point at the dividing
line betwe�n Lots Nos. 21 and 23, t3lock "0" on said Plan ; thence
Fdorth, sixty-seven (67) degr�es, £ifty-nine ( 59) minutes ti�,lest
alonc� the same, eighty and sixty-four one-hundredths { �;0. 64 )
fe�t to a point at th� divicling line between Lots Nos. 21 and
2.7, �31ock "0" on said Plan thence North tcaenty-four ( 24 } degree�
t?ast along the same, and alang th� dividing line between Lots
Nos. 21 and 28, �31ock "O" on said Plan, forty and t}iree one-
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hundredths (40.03) feet to a point at the dividing line between
Lots Nos. 21 and 29, Block "O" on said Plan; thence North thirty-
three (33) degrees, thirty-seven (37) minutes East along the
same, sixteen and seventeen one-hundredths (16.17) feet to a
point at the dividing Iine between Lots Nos. 20 and 21 , Block
"O" on said Plan; thence South eighty-five (85) degrees, twenty-
one (21 ) minutes East along the same, one hundred nine and nine
one-hundredths ( 109.09) feet to a point on the Western side
of Vine Circle; thence Southwardly along the same, forty-seven
(47) feet to a point, the place of BEGINNING.
BEING Lot No. 21 , Block "O" on Plan of Lots known as Plan No.
3, Hampden Gardens, said Plan being recorded in the Office of
the Recorder of Deeds in and for Cumberland County, in Plan
Book 6.
HAVING thereon erected a dwelling house known and numbered as
2 Vine Circle, Camp Hill, Pennsylvania, 17011 .
W�REAS the said RUTH S. QUIRK departed this lifetime on or
about February 10, 1976, thereby vesting title in full in the
surviving tenant by the entirety, WILLIAM F. QUIRK, JR. WILLIAM
F. QUIRR, JR. , is lawful GRANTOR herein.
BEING the same premises which UNION SUPPLY COMPANY, by their
Deed dated the 9th day of August, 1954, and recorded in the
Office of the Recorder of Deeds in and for Cumberland County,
in Deed Book "X", Volume 15, Page 461 , granted and conveyed
unto WILLIAM F. QUIRK, JR. , and RUTH S. QUIRK, his Wife.
WILLIAM F. QUIRK, JR. , is lawful GRANTOR herein.
THIS TRANSACTION IS EXEMP'P FROM REALTY TRANSFER TAX AS A TRANSFER
FROM PARENT TO CHILD.
SUBJECT to restrictions and conditions as contained in prior
deeds.
ONDER AND SOBJECT, NEVERTHELESS, to the conditions, restrictions,
agreements, easements, riqhts of way, encumbrances, and all
other matters of record.
TOGETHER with all and singular hereditaments and appurtenances
thereunto belonging or in anywise appertaining and the reversions
and remainders, rents, issues and profits thereof; and all the
estate, right, title, interest, property claim and demand
whatsoever of the said GRANTOR, in law, equity or otherwise
of, in, and to the same and every part thereof.
TO HAVE AND TO HOLD the above described premises with the
appurtenances unto the GRANTEE, their Heirs and Assigns, forever.
2.
aooK �3 PAGE 526
�nd the GRANTOR does hereby cov�nant and agree with ttie GRANTEE,
th�t the GRANTOR, his Ex�cutors and Administrators, Shall and
Gdill Warrant and �'orever Defend. the herein above c�escribed
�remises with the hereditaments and appurtenances, unto the
GRANTEE, their Heirs and Assigns, against the 6RANTOR, and
against every other person lawfully claiming, or cvho shall
her�after cl�im, the same or any part thereof.
IN WITNESS THEREOF, tlz� GRANTOR, has hereunto set their hand
and sea2 the day and year first above written.
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SIGNED, SEALED and DELIVERED . /F �
in the pres�nce of: ,;, �` -
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COMMONWEALTA OF PENNSYLVANIA
COUNTY OF CUMBERLAND
On this, the 29th day of December , A.D. , 1995
k��fore me, the undersigned officer, personally app�ared
WILLIAM F. QUIRK, JR.
knawn to me (or satisfactorily provr�n) to b� the person whose
name is subscribed to the within instrument, and acknowledge
that they ex�cuted the sarne far th� purposes tllerein contained.
In ,w,k��s UTilereof. I k�ereuni:o set my hanrl anc� official seal:
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I hereby certify that the precise residence of the GRANTEE is
2 VINE CIRCLE, CAMP HILL, PENNSYLVANIA, 17011
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t�ttorney for ������-'G�C:�
COMMONWEALTIi OF P�NNSYLVANIA
COTJNTY OF � l'�t��� 1, �
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Recorded in the Office of the Recorder oi De�ds for said County
on the c'� day of � , 1 9�`j , in Deed Book
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Witness my h�nd and seal of said Office, the day and �+��� �` � �`" '* ", ,..
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Property ID's:9167113
PROPERTY DESCRIPTION
Property/Hoider Information{s) Prope�ty Id: 9187113
(A)Originai Owner's Name (B)Original Owner's Address as Reported
QUIRK,JOHN W 2 Vine Circle
Camp Hiti,PA 17011-4338
(C)Holder RepoRing Funds (D)Last Transaction Date
Ge Money 06/1812003
(F)Type of Funds Reponed (Gj Certificate,Policy or Check Number
Refunds!Rebates
2 of 4 7/24/Z015 11:23 AM
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
.
�
y �F C u�ye _ ., �
�,� (�.�,1� F,�� No. 2015- 00279 PA No. 21- 15- 0279
O , 9Z Es ta te Of: JOHN W QUIRK
/Firs7,Middle,Last)
� � -- D v
��� La te Of: CAMP HILL BOROUGH
- CUMBERLAND COUNTY
` M 1 li �
�� -� Deceased
Soci al Securi ty No: 172-32-0416
1750
WHEREAS, on the 16th day of March 2015 an instrument dated
March 28th 2011 was admitted to probate as the last will of
JOHN W QUIRK
(Fiist,Middle,Last)
late of CAMPH/LL BOROUGH, CUMBERLAND County,
who died on the 17th day of December 2014 and
tnTHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, LISA M. GRAYSON, ESQ. , Regi s ter of Wi 11 s in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
JANNET JOY QUIRK
who has duly qualified as EXECUTOR(R/XJ
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 16th day of March 2015.
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R ister of
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
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DECLARATION
I,John Quirk, a resident of the coinmonwealth of Pennsylvania and
county of Cumberland; and being of sound mind and memory, do hereby make,
publish, and declare this to be my last will and testament, thereby revoking and
making null and void any and all other last will and testaments and/or codicils
to last will and testaments heretofore made by me. All references herein to "this
Will" refer only to this last will and testament.
FAMILY
At the time of executing this Will, I am married to Georgine Quirk. The
names of my children are listed below. Unless otherwise specifically indicated in
this Will, any provision for my children includes the below-named children, as
well as any child of mine hereafter born or adopted.
jannet joy Quirk
D�BT
I direct that as soon as is practical after my death, the executor named
pursuant to this Will review all of my just debts and obligations, including last
� illness an:l funeral expenses, except for those secured long-te�•m debts that may
be assumed by the Ueneficiary of such property, unless such assumption is
prohibited by law or on agreement by the beneficiary. The executor is further
directed to pay any attorneys' fees and any otller estate adriinistration expenses.
The executor shall pay these just debts only after a creditor provides timely and
sufficient evidence to support its claim and in accordance with applicable state
law.
Page 1 of my Last Will and Testament_ 't '.�i. �' i;% (initial)
DOC#5004276(6
I direct that any estate, inheritance, and succession taxes, including �ny
interest and penalties thereon, imposed by the federal government or any state,
district, or territory, attriUutable to assets includible in my estate, passing either
under or outside of this Will, be apportioned among the persons interested in my
estate in accordance with applicable state and federal law. My executor is
authorized and directed to scek reiinbursernent froin the beneficiaries of iny
estate of any taxes paid by my executor to the extent allowed by law.
If my executor cannot collect from any person interested in the estate the
amount of tax apportioned to that person, the amount not recoverable will be
equitably apportioned among the other persons interested in the estate who are
subject to apportionment.
If a person is charged with or required to pay tax in an amount greater
than his or her prorated amount because another person does not pay his or her
prorated amount, the person charged with or required to pay the greater amount
has a right of reimbursement against the other person.
I further direct that if any beneficiary named in this Will is indebted to me
at the time of my death, and evidence of such indebtedness is provided or made
available to my executor, that share of my estate that I give to any and each such
beneficiary be reduced in value by an amount equal to the proven indebtedness
of such beneficiary unless: (i) I have specifically provided in this Will for the
forbearance of such deUt, or (ii) such beneficiary is the sole principal beneficiary.
PRINCIPAL REMAINDER DISTRIBUTION
If my spouse, Georgine Quirk, survives me, I give, devise, and bequeath to
my spouse all of the rest, residue, and remainder of my property and estate, real,
personal, and mixed, tangiUle and intangible, of whatever nature and wherever
situated, including all property I may acquire or become entitled to after the
execution of this Will, including all lapsed legacies and devises (but excluding
any proper�y over which I may have a power of appointment, i� being my �
intention not to exercise any such power), outright and free of trust, after
payment of all my just debts, expenses, taxes, and specific bequests, if any.
� F
Page 2 of my Last Will and Testament-' i.��C? (initial)
i �
ALTERNATE REMAINDER BENEFICIARIES
If my spouse does not survive me, I give, devise, and bequeath all of the
rest, residue, and remainder of my property to the persons named below, in the
percentages set forth below. Unless otherwise indicated in this Will, these shares
will be distributed outright and free of irust.
1. Name: Jannet Joy Quirk
Relation: Daughter
Percentage: 100%
DISTRIBUTION IF NO LIVING BENEFICIARIES
If at any time before full distribution of my estate all of my beneficiaries
are deceased and this instrument directs no other disposition of the property, the
remaining portion of my estate will then be distributed to my heirs determined
according to the laws of intestate succession, unless specifically disinherited
elsewhere in this Will.
CREDIT SHELTER TRUST
My spouse has the right to disclaim all or a portion of any property or
other interests left to him or her under this Will, provided that my spouse do so
within the qualifying time limit for the disclaimer pursuant to Section 2518 of the
Internal Revenue Code of 1986, as amended from time to time (the "Code"), or a
corresponding provision in any successor statute. Anytlling in the "Alternate
Remainder Beneficiaries" clause to the contrary notwithstanding, if my spouse
makes any such disclaimer, all such disclaimed property or interests will be
distributed in trust to Georgine Quirk, as trustee of The John Quirk Credit
Shelter Trust.
During my spouse's lifetime, the trustee shall distribute r.et income and
principal of the Credit Shelter Trust in accordance with the following provisioi�s:
a. The trustee shall pay to my spouse or apply for 11is or her
benefit all of the net income of the trust, with such payments to be inade at
regular intervals as determined in the trustee's sole discretion, except that
the trustee shall make payments at least annually.
, ,,�;
Page 3 of my Last Will and Testament,'' ��� (initial)
i- �
b. The trustee may also pay to or apply tor the benefit of my
spouse from time to time so much of the principal as the trustee
determines is necessar��� for my spouse's health,education, maintenance,
and support.
c. In inaking any such discretionary distributions, the trustee
may take into consideration all relevant circumstances, including but not
limited to my spouse's accustomed standard of living and other assets and
sources of income or support available to my spouse and known to the
trustee.
On the death of my spouse, the remaining Credit Shelter Trust assets will
be distributed in accordance with the provisions of this Will, as if I had died on
the date of my spouse's death and my spouse had not survived ine.
GENERAL TRUST PROVISIONS
Trustee Powers
(a) General Powers and Duties. Each trustee of a trust created under
this Will will have all of the powers deemed necessary and appropriate to
administer that trust, including all powers granted under Pennsylvania law,
subject to the trustee's fiduciary duties to the beneficiaries and any restrictions or
limits set forth under Pennsylvania law.
(b) S�ecitic Powers. In furtherance of subsection (a) above, the powers
of the trustee include, but are not limited to, the powers to:
1. Collect, hold, maintain, manage, and administer the assets of
the trust as if the trustee were the absolute owner of it;
?. Sell, trade, deal, encumber, mortgage, pledge, option, lease,
lend, or improve the assets of the trust;
3. Invest, reinvest, and make purchases with the profits and
principal of the trust in every kind of property, asset, and
investment;
4. Borrow money from the trust for trust purposes;
Page 4 of my Last Will and Testament�j,j�� (initial)
�
5. Einploy and pay reasonable tees to counsel, accountants,
financial advisors, and any other professionals deemed
necessary or advisable for the proper administration of the
trust;
6. Ell�er into contracts and othcrwisc execute ariy instrumenis
on behalf of the trust;
7. Establish bank, brokerage, and other financial and
nonfinancial accounts for and on behalf of the trust, and
execute any and all documents on the trust's behalf in
relation thereto, including any resolutions, certifications, or
certificates required for such accounts;
8. Distribute or divide the assets of the trust in accordance with
this Will (subject to any restrictions or limits set forth under
Pennsylvania law), and execute any documents necessary to
administer any trust or subtrust created by this Will;
9. Continue, operate, expand, manage, and sell any business
that is a trust asset;
10. Commence, defend, arbitrate, and settle legal claims or
actions concerning the trust or the assets and property in the
trust;
11. Exercise voting rights, give proxies, and enter into voting
agreements with respect to stock and other business
ownership interests held by the trust;
12. Prepare tax returns and take any necessary or desirable
actions with governmental agencies; and
13. Purchase and modify insurance.
Physical Se regation of Trust Shares Not Required
If more than one trust is created under this Will,the trustee is not required
to physically segregate or divide the assets of the various trusts, except if
physical segregation or division is required on the termination of any of the
trusts. Notwithstanding the forgoing, the trustee shall maintain separate books
and records for each separate trust.
Page 5 of my Last Will and Testament;�.1�„�--, (initial)
i.
Bond Not Rec�uired
No trustee of any trust createa under this instrument is require�i to post a
bond.
Distril�ution Aulhority
If the trustee is required by this Will to divide any trust property into
parts or shares for or otherwise, the trustee is authorized, in the trustee's sole
discretion, to make that division and distribution in identical interests, in kind, or
partly in kind or partly in money, pro rata or non pro rata. For this purpose, the
trustee may sell such trust property not specifically devised as the trustee deems
necessary.
Trustee Compensation
The trustee is entitled to annual reasonable compensation for services
rendered in that capacity. Trustee fees will be prorated for any partial years of
service in amounts proportionate with the period of service during that year.
S�endthrift Provision
No interest in the principal or income of any trust created under this
instrument may be anticipated, assigned, encumbered,or subjected to a
creditor's claims or legal process until it is actually received by the beneficiary.
This spendthrift provision constitutes one of the material purposes of the trusts
created hereunder.
Pavments to Minor Beneficiaries
The trustee may make distributions from a minor's trust share, up to the
whole thereof, to the guardian of the minor's person, a custodian for the minor
under the applic�ble Transfers to Minors Act, or Gifts to Minors Act, or the
trustee may apply distributions directly for the minor's benefit.
Qualified Subchapter S Trust Provision
It is my intent that any trust created herein holding stock in a qualified
subchapter S corporation, if any, for any Ueneficiary qualify as a qualified
subchapter S trust ("QSST"). A QSST will have at least one beneficiary and the
income of that trust will be distributed at least annually. If a trust is coinprised of
shares in a "small business corporation," as defined in Section 1361 of the Code
Page 6 of my Last Will and Testament�r'_�)1�tl (initial)
i
or any successor thereto, the trustee may segregate said trust property into a
separate trust and, as trustee, may modify the terms of said trust (it necessary) so
that said trust will be a QSST as defined in the Code or anv successor thereto.
The trustee shall make any such modification by a �vritten docuznent signed by
the trustee and delivered to the beneficiary of said trust or to the guardian of any
i�nulor beneficiary or conservator any inconlpetent beneficiary. The terins of the
so-called QSST will continue for so long as necessary as long as an election under
Section 1362 of the Code or any successor thereto, is in effect. When the trust
property is no longer comprised of small business corporation stock or a Section
1362 election has not been made, the special QSST will terminate and the trust
property will be held in accordance with the terms of the original trust.
EXECUTOR NOMINATION
I nominate my daughter, Jannet Joy Quirk, to be the executor of this Will.
If,for any reason, my first nominee executor is unable or unwilling to
serve or to continue to serve as executor of this Will, I nominate my spouse,
Georgine Quirk, to be the executor of this Will.
If, for any reason, all of the nominees designated above are unable or
unwilling to serve or to continue to serve as executor of this Will, I nominate my
cousin, Allen Quirk, to be the executor of this Will.
If none of the nominated executors are able and willing to serve or
continue to serve, and the vacancy is not filled as set forth above, the majority of
estate beneficiaries shall nominate a successor executor. If the majority of estate
beneficiaries are unable to nominate a successor executor, the vacancy will be
filled pursuant to a petition filed in a court of competent jurisdiction Uy the
resigning executor or any person interested in the estate.
MISCELLANEOUS EXECUTOR PROVISIONS
The term "executor" includes any executrix, personal representative, or
administrator, if those terms are used in the statutes of any state that has
jurisdiction over all or any portion of my estate.
My executor will have broad and reasonable discretion in the
administration of my estate to exercise �ll of the powers permitted to be
exercised by an executor under state law, including the power io sell estate assets
� .
Page 7 of my Last Will and Testament �,.��1�-_�'1 _ (initial)
i•
with or without notice, at either public or private sale, and to do everything he or
she deems advisable and in the best interest of my estate and the beneficiaries
thereof, all without the necessity of court approval or supervision. I direct that
my executor perform all acts and exercise all such rights and privileges, although
not specifically mentioned in this Will, with relation to any such property, as if
the absolutc owner thereof and, in connection therewith, to make, execute, 1nd
deliver any instruments, and to enter into any covenants or agreements binding
my estate or any portion thereof.
If there are two co-executors serving, they shall act by unanimous
agreement. If there are more than two co-executors serving, they shall act in
accordance with the decision made by the majority of co-executors.
Subject to specific provisions to the contrary, I authorize my executor to
distribute a share of my estate given to a minor beneficiary, up to the whole
thereof, to a custodian under the applicable Transfers to Minors Act or Gifts to
Minors Act, if in the executor's discretion, it is in the best interests of the
beneficiary. The executor may also make distributions to a minor by making
distributions to the trustee of a trust created under this Will for a minor
beneficiary, the guardian of the minor's person, or the guardian of the minor's
estate.
No person named as an executor is required to post any bond.
I authorize my executor to make the following choices or elections in my
executor's absolute discretion, regardless of the resulting effect on any other
provisions of this Will or on any person interested in my estate or in the amount
of any of the taxes referred to: (a) choose a valuation date for estate or inheritance
tax purposes or choose the methods to pay estate or inheritance taxes; (b) elect to
treat or use an item, for either federal or state tax purposes, as either an income
tax deduction or as a deduction for estate or inheritance tax purposes; (c)
determine when a particular item is to be treated as taken into income or used as
a tax deduction, to the extent the law provides that choice; and (d) disclaim all or
any portion of any interest in property passing to my estate at or after my death,
even though any of these actions may subject my estate to additional tax
liaUilities. No person adversely affected by my executor's exercise of discretion
under this clause is entitled to any reimburseinent or adjustment, and my
executor is not required to make any adjustment between income and principal
or in the amount of any property passing under this Will as a result of any
election under this provision.
Page 8 of my Last Will and Testament�9�.i"��-� (initial)
v`
IN WITNESS 4VHEREOF, I, the undersigned testator, declare that I sign
and execute this instrument on the date written below as my last will and
testament and further declare that I sign it willingly, that I execute it as my free
and voluntary act for the purposes expressed in this document, and that I am
eighteen years of age or older, of sound mind and memory, and under no
consiraint or undue influence.
' r, � �
�::�,%J�/ �i t�,�..1�
(Signature of John Quirk)
Date: 1� -; ��-- :r�
�,
Page 10 of my Last Will and Testament i.;��1�� (initial)
!,
L'
ATTESTATION
This last will anc.i testament, which has been separatel�- signed by Jol�n
Quirk, the testator,was on the date indicated below signed and declared by the
above named testator as his or her last will and testament in the presence of each
of us. We, in the presence of the testator and each other,at the testator's request,
under penalty of perjury, hereby subscribe our names as witnesses to the
declaration and execution of the last will and testament by the testator, and we
declare that, to the best of our knowledge, said testator is eighteen years of age or
older, of sound mind and memory and under no constraint or undue influence.
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1. !�r t���I.zi i� �) �,!(����'�- i� !it��r 1'��� l �%�l�c:J�"�
(Signature of wifiess) (Print Name)
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Date: '� �rJ��}" � � _� )�XsL_�'��G" �
(Address)
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��'d � �� ��I�' �i 7 / 7 v .
(City,Sta e,ZIP)
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2. ��; .�" � x ;
(Signature of witness) � (Print Naine)
Date:
'" 1� � ^�cU�l � S 3(� � o<?C J`(. S�I~
(Address)
C��,�,-�' ;�, ��, �� � �� i �
(City,State,ZIP)
Page 11 of my Last Will and Testament '�.. l,( ,.� � (initial)
SELF-PROVING AFFIDAVIT
Commonwealth of Pennsylvania
Countv of Cumberland
I,John Quirk,the undersig;ned testator,being first duly sworn do declare to the
undersigned authoriiy that I signed and executed the attached or annexed i�istrument as
my last will and testament and that I signed it willingly, or willingly directed another to
sign for me, that I execute it as my free and voluntary act for the purposes expressed in
that document,and that at the time I signed the document, I was eighteen years of age
or older, of sound mind and memory, and under no constraint ar undue influence.
�L, ;,., t:� —, � �� —.
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Date:'.� -- ;� u �_ ��t;a' ' i.;,%-._. , ,r. ; ,
?� __y.—�._�' "J� -.. I I 1 b �.
(�ignature of John Quirk)
We, the undersigned witnesses,being first duly sworn,do each declare to the
undersigned authority the following: (1) the testator declared to each of us that the
attached or annexed instrument is his or her last will and testament; (2) the testator
executed the last will in our presence; (3) each of us,in the presence of the testator and in
the presence of each other, and at the testator's request, signed the last will and
testanlent as witnesses; and (4) to the best of our knowledge the testator is eighteen
years of age or older,of sound mind and memary,and under no constraint or undue
influence. -•� ,.-� _
, ,q,:' '� , i .. �
1. `:�-�;j �/_..���� �� y�.��,.� �� ,f°..;.�;°�'��t� !t yra-��►..
(Sigr�.a�#ure of witness) U'� (Print Name) �
,� � i,, �-� �.
2. ;"�zz�� �, ������-� �a mP-`c� � l�1'��r� r�
(Signature of witness) (Print Name)
CUMMONWEACI"s�.;r�•:iN^lSYLVAN�A)
C70�INTYOFCUMl3Fl2L.ANI) p g+�;
Acknowled�ement of Notary Public:
�`� /�
Subscribed, sworn and acknowle �ed to me on t�j�s�- day of�'�''l�����G�.--- ,20 l�,
b olu-i �-• ��'" �l� �v�._. —
Quirk, as testator, and �' it` and
��'���'- � �'�a rcai+�-- ,as itnesses. -�
Wilness my hand and seal. !��
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, ,.,
Signature of Notary Public:��-�-.-•- ����, ���-�-��-----�
COl��iU�vw� �� ur� ��t��SYLVANI�
NATARIAL SEAL
CNERYL R. GARMAN, Notary I�ublic
�amp Hill Boro, Cumberia�d County
NIy C.Qmmission Expires May 20, 2012
,�,,,�,,,.,,,,a..,_.�
HAZEN � LAW GROUP
�
PLAN TODAY. SECURE TOMORROW.
Estate Planning � Elder Care and Disability Planning
2000 Linglestown Road, Suire 202
Harrisburg, PA 17110
Phone7l7-540-4332
Fax 717-540-4313
www.Hazen LawG roup.co m
August 1 1 , 2015
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-� c� rn
Register of Wills � .� � �? c
Cumberland County Courthouse � � " � �-i �
One Courthouse Square � µ �=�` w ��` �
Carlisle, PA 17013-3387 ` � �� `�
� ,� �
._., �
Re: Estate of John W. Quirk ; �-�' � rn
File No.: 21-15-0279 �� � �
�c �
Social Security No.: 172-32-0416
Inheritance Tax Return
To: The Register of Wills:
Enclosed for filing please find the original and one copy of the
above-referenced Inheritance Tax Return and Inventory, along with a
copy of the first page of the Inheritance Tax Return. Please date stamp
the first page of the return and a copy of the Inventory and return them to
my office in the enclosed self-addressed envelope.
If you have any questions or require any additional information,
please do not hesitate to contact me.
Sincerely,
�.._��._�._._..
1�� �- /
Tiffany J. Mutza augh
Paralegal
Enciosures
cc: Jannet Joy Quirk, Executor
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