HomeMy WebLinkAbout12-29-05
REV-1500 EX + (6-00)
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COMMONWEALTH OF
PENNSYL VANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
2 -05 1 0 5 7
COi:iNTYCOOE ---vEA;r-- - - NUMsER--
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Wilson, Ethel E.
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
SOCIAL SECURITY NUMBER
65- 1 6 - 5 826
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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11/11/2005 06/06/1917
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[Xl 1. Original Return
D 4. Limited Estate
[Xl 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of dealh between 12-31-91 and 1-1-95)
D 3. Remainder Return (dale of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
1. 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Gerald J. Shekletski, Es . 414 Bridge S1.
FIRM NAME (If Applicable)
Stone, Lafaver & Shekletski P.O. Box E
TELEPHONE NUMBER
717-774-7435 New Cumberland PA 17070
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
(8)
(11)
(12)
(13)
0.00
OFFIGIAL USE ONLY
3. Closely Held Corporation, Partnership or Sole-Proprietorship
8,934.25
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(6)
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(7)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
3,707.78
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
8,934.25
0.00 X _(15) 0.00
5,226.47 X .045 (16) 235.19
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 235.19
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
3,707.78
5,226.47
(14)
5,226.47
17. Amount of Line 14 taxable at sibling rate
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
Decedent's Complete Address:
STREET ADDRESS
175 Lancaster Blvd.
CITY I STATE I ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
235.19
11.76
Total Credits (A + 8 + C )
(2)
11.76
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
223.43
223.43
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; ........................................................................... D [Xl
b. retain the right to designate who shall use the property transferred or its income; ........................................ D [Xl
c. retain a reversionary interest; or ...................................................................................................... D [Xl
d. receive the promise for life of either payments, benefits or care? ............................................................. D [Xl
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.... ....... ............... ..................... ............. ................. ...... ............ D [Xl
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. D [Xl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... D [Xl
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of prepar~r other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF . ERSON RESPONSIBLE F~R Flf~QRETURN r DATE _
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ADDRESS 121 Parkview Road
New C erland
SIGNATURE OF PR
PA 17070
DATE
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ADDRE
PA 17070
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. S9116 (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% [72 P.S. S9116 (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 twenty-one 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% [72 P.S. S9116(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%, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .S. S9116(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.
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LAST WILL AND TESTAMENT
OF
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ETHEL E. WILSON
I, ETHEL E. WILSON, of the City of Harrisburg, Dauphin
County, Pennsylvania, being of Sbund mind, declare this to be my
last will, and revoke any wills previously made by me.
ITEM I. I direct that all my just debts and funeral
expenses, including my grave mar~er shall ,be paid from the assets
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I of my estate as soon as practicable after my decease, as a part
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of the expenses of the administration of my estate.
ITEM II.
I direct that any and all inheritance, estate,
succession and other death taxes, of whatever nature and by
whatever jurisdiction imposed, assessed against my estate or
payable by reason of my death, shall be paid from my residuary
estate as soon as practicable after my decease, as a part of the
expenses of the administration of my estate.
ITEM III. I devise and bequeath the residue of my
"
estate, of every nature and wherever situate, to my husband,
RICHARD Co WILSON, providing he shall survive me by thirty (30)
"
days.
ITEM IV. Should my husband, RICHARD C. WILSON, pre-
decease me or die on or before the thirtieth (30th) day following
my death, I devise and bequeath all the residue of my estate of
every nature and wherever situate, to my daughter, BARBARA ANN
P/~I'J'&
WILSON;-abso1ute1y.
Page 1 of 3 pages
f:~-c~/-' (.ai', tv "'''~-171 (SEAL)
ETHEL E. WILSON
ITEM V. I hereby nominate, constitute and appoint my
husband, RICHARD C. WILSON, Executor of this my Last Will and
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Testament. Should my husband, RICHARD C. WILSON, fail to qua1if
or cease to act as Executor, I appoint my daughter, BARBARA ANN
WILSON, to act as Executrix of this my Last Will and Testament.
ITEM~Vl. I direct that my personal representative shall
not be requir~d to give bond for the faithful performance of
his or her duties in any jurisdiction.
IN WITNESS WHEREOF, I have set my hand and seal to this
my Last Will and Testament, consisting of this and two other
pages, at the end of each page of which I have also set my hand
and affixed my seal for greater security and better identifica-
tion, this ,=5D
day of 1./), Ie .i~j/}-l_-l-l:-/?/
.
, 1964.
Page 2 of 3 pages
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ETHEL E. WILSON
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We, the unders\gned, hereby certify that the foregoing
Will was signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament, in the
presence of us, who at her request and in her presence and in
the presence of each other, have hereunto set our hands and
disposing mind and memory.
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REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Wilson. Ethel E.
FILE NUMBER
21 05
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.
1057
ITEM
NUMBER
1.
DESCRIPTION
Sovereign Bank checking account #2551707803
VALUE AT DATE
OF DEATH
3,224.25
2.
Cash in Sovereign Bank safe deposit box #176
5,710.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
8,934.25
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Court Ordered Processing I MA 1 MB3 02-10
P.O. Box 841005
Boston, MA 02284
December 12,2005
Stone LaFaver & Shekletski
Attention: Gerald J. Shekletski
P.O. Box E
New Cumberland, P A 17070
RE: Estate of Ethel E. Wilson
Date of Death: 11/11/05
Dear Mr. Shekletski:
Per your request, enclosed please find the account information as of the date of death for
the above-named decedent. For your information, accrued interest is not included in the
date of death balance.
Please feel free to contact me if I can be of any further assistance.
Very truly yours,
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Laurie DiGiandomemco
OAG Team Leader
(617) 533-1789
Enclosures
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Ethel E. Wilson
165-16-5826
November 11,2005
Account #: 2551707803 Type:
In the name of: Ethel E. Wilson
Date of Death Balance:
Int.(YTD) from 1/112005 to
Accrued interest to date of death:
Other Info:
Checking
Open date: 10/14/1980
$3,224.25
11/7/2005
$0.02
$1.52
Account #: 57-176 Type: Safe Deposit Box Open date:
In the name of: Ethel E. Wilson
Date of Death Balance:
Int.(YTD) from to
Accrued interest to date of death:
Other Info: Location: 3556 Old Gettysburg Road, Camp Hill, PA 17011
8/15/2005
Page 1 of 1
REV-485 EX + (3-04)
SAFE DEPOSIT BOX
INVENTORY
Please Print or Type
, DECEDENT'S NAME (LAST, FIRST, MIDDLE)
WILSON, ETHEL E. a/kfa WILSON, ETHEL ELIZABETH
. ADDRESS OF DECEDENT (STREET)
820 L1SBURN ROAD
DATE OF DEATH
11/11/2005
(CITY) (STATE)
CAMP HILL PA
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
(NAME)
GERALD J. SHEKLETSKI
(STREET NAME)
414 BRIDGE STREET
(CITY)
NEW CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS
COUNTY CODE FILE NUMBER SOCIAL SECURITY (Required) OR DEATH CERTIFICATE NUMBER (onlv if SSN is unknown)
21 2005-01057 165-16-5826
NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
a. (NAME) (RELATIONSHIP)
BARBARA W. PIRNIK DAUGHTER
(STREET NAME) (CITY)
121 PARKVIEW ROAD NEW CUMBERLAND
b. (NAME) (RELATIONSHIP)
LEAH M. ERBY, ASSISTANT MANAGER, SOVEREIGN BA~ NONE
(STREET NAME) (CITY)
3556 OLD GETTYSBURG ROAD CAMP HILL
c. (NAME) (RELATIONSHIP)
(STREET NAME)
(CITY)
. NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
(NAME)
SOVEREIGN BANK
(STREET NAME)
3556 OLD GETTYSBURG ROAD
(CITY)
CAMP HILL
I NAME OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY
LEAH M. ERBY, ASSISTANT MANAGER, SOVEREIGN BANK 11/14/20053:02 pm
DATE OF CONTRACT TO RENT BOX NUMBER OF BOX ' TITLE UNDER WHICH BOX IS REQUESTED
08/15/2005 176 ETHEL E. WILSON
NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX
a. (NAME)
GERALD J. SHEKLETSKI
b. (NAME)
(STREET ADDRESS)
414 BRIDGE STREET
(CITY)
NEW CUMBERLAND
(STREET ADDRESS)
(STATE)
PA
(ZIP CODE)
17070
(CITY)
. NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY
GERALD J. SHEKLETSKI, ATTORNEY FOR ESTATE
WAS A WILL IN THE BOX? iii YES 0 NO
12/30/1964
If yes,
a. Date of will:
b. Name and address of personal representative, if named in the will
(NAME)
BARBARA W. PIRNIK
(STREET NAME)
121 PARKVIEW ROAD
(CITY)
NEW CUMBERLAND
c. Name and address of attorney, if any
(NAME)
(STREET NAME)
(CITY)
(STATE)
PA
(ZIP CODE)
17011
(ZIP CODE)
17070
(STATE) (ZIP CODE)
PA 17070
(STATE) (ZIP CODE)
PA 17011
(STATE) (ZIP CODE)
(STATE)
PA
(STATE)
(STATE)
PA
(STATE)
(ZIP CODE)
17011
(ZIP CODE)
(ZIP CODE)
17070
(ZIP CODE)
SAFE DEPOSIT BOX INVENTORY Page
of
INSTRUCTIONS
The Department is authorized under federal law , 42 U.S.C. 3 405(c), to use the decedent's Social Security number in
administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and
ensure proper credit for tax payments.
(1 ) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be
designated by name of company, certificate number, date of certificate, name in which stock is registered, and
number of shares and class of stock.
(3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and
type of ownership, Le., jointly held, payable on death, etc.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book,
name of bank and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.
(7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully
as possible.
(8) All other contents.
ITEM ITEM DESCRIPTION
NO.
1. Cash - $5,710.00
2. Original Last Will and Testament of Ethel E. Wilson - dated December 30,1964
3. Army of the United States Honorable Discharge papers for Richard C. Wilson - dated December 22, 1945
4. Department of Veterans Affairs Summary Sheet for Richard C. Wilson
5. Original and copy of Marriage License for Richard Clair Wilson and Ethel Elizabeth Seacrest - dated October 15, 1941
6. Original and copy of IRS estate tax closing letter dated May 20, 1966, for the Estate of Edith V. Senseman
7. Original Birth Certificate for Richard Clair Wilson - dated February 6, 1930
8. Statement of Death by funeral director dated December 12, 1987, for Richard C. Wilson
9. Original Death Certificate for Richard C. Wilson - dated December 12, 1987
10. Enlisted record and separation Honorable Discharge papers for Richard C. Wilson - dated July 29,1946
11. Pennsylvania Railroad Company Card for C. I. Wilson - dated 1918
12. Papers listing year of birth and year of death for Ethel Frances Grubb Seacrest, James Alton Seacrest, Jean Seacrest Powers, and Jack '^
13. Original Baptismal Certificate of Richard Clair Wilson - dated March 15, 1918
14. Two (2) certified copies of Decree in Divorce - Mary Elizabeth Wilson and Richard C. Wilson - dated August 2,1966, and October 14,1941
15. Certificate of Cremation for Richard C. Wilson - dated December 12, 1987
16. Certificate of Annuity Card, United States Retirement Board, for Richard C. Wilson
17. Deed dated March 11, 1982, for cemetery plots at SI. John's Lutheran Church for Richard C. Wilson and Ethel E. Wilson
18. Certificate of Services Card for R. C. Wilson for United States of America Railroad Retirement Board
--- .--
,em"y ~= ",my o,~' ":~~OVE R'eo~~~ PERSON RECEIVING COpy OF
CORRECT OMPLETE TO THE OF MY K WLEDGE AND B LIEF. SAFE DEPOSIT BOX INVENTORY:
SIGNATU_~ ~ ~/ ./7p.~ SIGNATURE
/T~~'/I f.,,/[.;? U/~
PRINT NAME "I~-- - PRINT NAME AND CHECK APPROPRIATE BOX BELOW:
GERALD / EKLETSKI, ESQUIRE
PRINT TITLE DATE CHECK APPROPRIATE BOX:
ATTORNEY FOR THE ESTATE JJ!tJ-/o S- O Executor(trix) o Administrator(trix}
~ Estate Representative o Joint owner of safe deposit box
NOTE: Attach additional 8'1>" x 11" sheet(s) if necessary or use duplicates of this page of form.
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wilson. Ethel E.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21
05
1057
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Parthemore Funeral Home and Cremation Services, Inc. 2,873.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Gerald J. Shekletski, Esq. 500.00
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 Letters of Administration 43.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Verizon 16.65
8. Prism 26.64
9. Additional Probate Fee 25.00
10. Filing Fees - Inheritance Tax Return $15.00 Inventory $15.00 30.00
11. Comcast 49.00
12. PPL 27.84
13 Verizon 16.65
14. Reserve for closing expenses 100.00
TOTAL (Also enter on line 9, Recapitulation) $ 3,707.78
(If more space is needed, insert additional sheets of the same size)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wilson Ethel E.
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1.
Barbara W. Pirnik
121 Parkview Rd.
New Cumberland, PA 17070
FILE NUMBER
21 05
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Lineal
10&;7
AMOUNT OR SHARE
OF ESTATE
5,226.47
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
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, insert additional sheets of the same size)
IN THE OFFICE OF THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Ethek E. Wilson
also known as Ethel Elizabeth Wilson
No.21
05
1057
, Deceased
Date of Death 11/11/2005
Social Security No. 165-16-5826
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney: Gerald J. Shekletski, ESQ.
1.0. No.: 40486
PE)lrsonal Representative:
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Address: 414 Bridqe S1.
New Cumberland
Barbara W. Pirnik
I c1- / <1 -0 J-
Dated
PA 17070
Telephone: 717-774-7435
Description
PERSONAL PROPERTY
Value
1.Sovereign Bank checking account #2551707803
3,224.25
2.Cash in Sovereign Bank safe deposit box #176
, 5,710.00
REAL ESTATE
NONE
Total
8,934.25
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
PIRNIK BARBARA W
121 PARKVIEW RD
NEW CUMBERLAND, PA 17070
_nn_n fold
ESTATE INFORMATION: SSN: 165-56-5826
FILE NUMBER: 2105-1057
DECEDENT NAME: WILSON ETHEL E
DATE OF PAYMENT: 12/29/2005
POSTMARK DATE: 12/29/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 11/11/2005
REMARKS: B PIRNIK
CHECK# 2609
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 006158
AMOUNT
$223.34
$223.34
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS