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HomeMy WebLinkAbout11-15-06 -1 15056051058 REV-i'SOO EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes . PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year ~I O~ File Number INHERITANCE TAX RETURN RESIDENT DECEDENT og'q, Date of Birth 171-30-5084 1 0/02/2006 12/07/1909 Decedent's Last Name Suffix Decedent's First Name Diehl Evelyn (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name 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) 5. Federal Estate Tax Return Required 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 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. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number . o 8. Total Number of Safe Deposit Boxes 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received . Norman M. Yoffe, Esq. Firm Name (If Applicable) Yoffe & Yoffe, P.C. (717) 975-1838 ~ C) c;:::l REGISTER ~i ~LS USE ~y 'i';o. (") <:: ,P:, ~~~ cJ1 . (j)::;:>'.: C)Q -0 <:') -n :1t.: (-- "J W ~ '0 ):> N DATE FILED \.0 First line of address 214 Senate Ave., Ste 404 Second line of address City or Post Office State ZIP Code Camp Hill PA 17011 Correspondent's e-mail address: Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. DATE lt~ DATE \\ , ' f' /"4 L 15056051058 Side 1 15056051058 MI P MI ,-:r':'; C) '} '~b C"J r~'c.~ l2:1 (--.... ::''']', ; ~~ ./--J (-.-) :.-:', --.J .-J 15056052059 REV-1500 EX Decedent's Name: Evelyn P Diehl RECAPITULATION 1. Real estate (Schedule A). ............... . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 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. 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 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). ... . . . ... . ... . .. ... . ... . . ...... ... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subjectto Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. 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 .0_ 16. Amount of Line 14 taxable at lineal rate X.o 45 17. Amount of Line 14 taxable at sibling rate X. 12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 171-30-5084 Decedent's Social Security Number 115,100.00 57,243.49 3,238.75 118,557.45 175,582.24 21,887.26 1,537.83 23,425.09 152,157.15 152,157.15 6,847.07 6,847.07 15056052059 --.J REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER Evelyn P Diehl 171-30-5084 .--- STREET ADDRESS 502 E. Coover Street CITY I STATE I ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 6,847.07 342.35 Total Credits ( A + B + C ) (2) 342.35 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 6,504.72 A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 6,504.72 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN IIXII IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... [iJ 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ [iJ 0 c. retain a reversionary interest; or.......................................................................................................................... [iJ 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... D [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [iJ D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [iJ 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (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 zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot 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 zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (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' (6-9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Evelyn P. Diehl FILE NUMBER 2006-00891 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. ITEM NUMBER 1. DESCRIPTION 502 E. Coover St., Bore of Mechanicsburg, PA. See Cumberland County Deed Book J, Volume 24, Page 218. See Cumberland County tax assessment #17-24-0789-069. See also VALUE AT DATE OF DEATH 115,100.00 Cumberland County Record Book J, Volume 24, Page 218; Land fair market value assessment $22,730, improvement fair market value assessment $92,370 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 115,100.00 REV-1S07 EX, (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF Evelyn P. Diehl FILE NUMBER 2006-00891 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH PNC Bank, certificate of deposit #...897; 4.41 %; $1,000.00 principal 1,018.67 2 Interest on above for 1 day to date of death 0.12 3 PA State Bank certificate of deposit #...540; 4.16% 20,849.53 4 Interest on above from 5/5/06 to date of death 361.80 5 Fulton Bank certificate of deposit #...461; 4.65%; $35,000.00 principal 35,000.00 6 Interest on above to date of death 13.37 TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 57,243.49 REV-1508 EX+ (6-98) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Evelyn P. Diehl FILE NUMBER 2006-00891 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 AllState Auto Insurance refund 65.30 2 Fulton Bank interest on certificate #...461 due 10101/06 134.01 3 PNC Bank interest bearing checking account #...308; 0.015% 3,014.44 25.00 4 Fulton Bank checking account #...608 (non-interest bearing) TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,238.75 REV-1510 EX+ (6-98) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Evelyn P. Diehl FILE NUMBER 2006-00891 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INClUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Glenbrook Life and Annuity Company flexible premium deferred annuity 44,680.00 100 44,680.00 issued pursuant to Master policy #64900001, individual policy #GA274088, with Gloria Jean Marsh and Patricia Ann Long equal beneficiaries 2 PNC Bank CD #...592, principal amount $4,000.00; revocable trust owned by Decedent with Gloria Jean Marsh and Patricia Ann LonQ as beneficiares; 5.367% interest rate with accrued interest to date of death 4,026.80 100 4,049.00 3 Sovereign Bank CD #...551; principal and accrued interest to date of death; 3.52% interest rate, revocable trust owned by Decedent with Gloria Jean Marsh and Patricia Ann Long as beneficiaries 53,365.25 100 53,365.25 4 Sovereign Bank CD #...831; principal and accrued interest to date of death; 3.35% interest rate; revocable trust owned by Decedent with Gloria Jean Marsh and Patricia Ann Long as beneficiaries 11,237.04 100 11,237.04 5 Sovereign Bank CD #...991; principal and accrued interest to date of death; 3.69% interest rate, revocable trust owned by Decedent with Gloria Jean Marsh and Patricia Ann Long as beneficiaries 5,226.16 100 5,226.16 TOTAL (Also enter on line 7 Recapitulation) $ 118,557.45 (If more space is needed, insert additional sheets of the same size) INHERITANCE TAX RETURN RESIDENT DECEDENT SUPPLEMENT TO SCHEDULE G Trust Copies The Schedule G trusts are all simple bank trust which used York Federal (YF) forms. We have and attach only two of such trust documents. The numbers on the two trust forms don't correspond to the Schedule G numbers since YF merged and became Sovereign, who then used their new account numbers and which appear on Schedule G. Revocable TNst Agreement Account Number(s) 700-010800 I (we) apply for a discrelioD&Jy revocable tlUSt account ("TlUSt Account") in York Federal C'York Fedeml"). You are dimed to act penU8Dl to writings bearing the JeqUired nmnbCl' of sigllltUla oCthe tlUStee(S) designated on the aa:ount signature card. Yau lI'C Uhori2l:d to supply any endorsement of any aa:ount holder on any check or other instrument tendered f)r thilllaiOUllt, and you are relieved of any liability in connection with collection of items wbich are handled by YOll without negligence and you sball not be liable fur the lI:ts of your agents, subagents or others or for .y casualty. Withdmwals may DOt be made on aa:wnt ofm items until collecled, and any amount DOl coJJected may be charged back to this lI:tOUDl, iIdudiag expense iDaUIed, and any outside e:KperlSe inculNd relative to this lI:QOunt may be charged to it. It is agn:ed by:oo gJ8Dto1(s) and the lNSlee(ll) lhlllmy 1i.md& p~ in or added to the lICcount by anyone or the pmies, whether'in tlUStoo or individual CIplICity, is and sball be oonclusive1y illlended to be a gift and delivClf at dill time of such 1illlds to tbe tlUSl estate. York FedeIaI may pay or deliver the withdnlwal value of the Trust Account or any pad, upon instruction of 8Il81thori2lld party to the Trust Account, who shall ace fi11lt, 8I1d sucb payment, de1iveJY, recei~, or aoquittance signed by any I1UthoIized pe11y shall be valid. sufticient release and discharge of York Federal. The funds in the Trost AcooWlt together with the earnings, 8lld any tinuIe additions are conveyed to the tlUStee(S) fur the benefit oftbo bc:aeficiary(ics). The conditions ofthc Trust Account are: (I) The tlUStee(s) is/lUll authori2Jed to bold, manage, pledge, invest and 1l:iuvest imds in SMDiti or cenificate accounts. Yorlc fedem1; (2) the gllllltOz(S, or ifmote than one, either of them. reseJVe the right to revoke the TRJSt Account in part or in full at any time and any paltial or complete withdIa'a1shall be a leVoc.ion oftlul portion ofthe tlUSt by the pto1(s); (3) In the event oCtile death, resigDll1ioD, nmoval or incompetence oftbe tlUStec(S), tbe individual design.ed below is appoimed stJCCeSllor trustee; (4) Tbis Trust A~ subjea to the rlgbt of lWocaIion, sball continue for the life oftbe goooJ(s) and themfter until the Jast surviving hene1icWy(ies) either lives to the age speciti.ed below, or die(s) berOte reaching such age; (5) Upon delib oftbe gra.l1Ol(S) and as each beoeficialy IIlIIChes the age specified below, the TlUSt Account shall teaninate at tbe lime but only llll to sucb beneticiary, and such bc:oeficiary's pro llIta alae shall then beJong and be distributed by the trustee(s) to such beneficiary. The pro nia sbare oreach beneficiary upon rea:bing the specified age shall be detlllllined by dividing tbe amount of the tlUSt fimds in the TlUSt Account C'TNSt Fwlds'') then existing by the number ofthe beneficiary(ies) then Jiving as to whom s~h pro mta distribution hlll not previously been made. If any btneficiwy(res) should die prior to ~hi.ng the specified age, such beneficimy(ie6) beneficial interelll in the Trust Funds shall terminate at thllt time and the Trust Funds Bhatl continu.e to be Trost Rmds subject to all the other terms of the tlUSt agreement. Iu the eve.. the last sUlViving beneficilll)' sbould die hem rellChing the age specified, the 1IUSt Account shalJ then tem1inate and tbe Trost Funds shall revert to the sole OWD<<Ship oftbe gamtoJ(s) then sUlViving or the estlf.e ofthe last sulVivor ofthma. 1 (we) understand the Trust Ao;:ount ill subject to such roles. reguJations and files as you may from time to time establish. Date of Distribution UPON DEATH GLORIA JANE MARSH Beneficiary DAUGHTER Relationship 07/30/1932 DOB-- PATRICIA A LONG Ben"PtfcraiY-'-- ---------- --- DAUGHTER Relationship 06/27/1937 -DOB 8erlf,nCiary- Relationship DOB Successor truStee -..--..- Witness ~i~&~12'd4n__._______ ____ __ _ ~~ Date Slgnature"- ------ Date-- Vork Federal (05/99 Revocable Trust Agreement Account Number(s) 800-058164 I (we) lIIIP1y for. diSCJetioDll)' leVoCIbIe tNst a:counl ("'flUSt AccollU") in Yolk Fedeul ('York FedeAI."). You lII\\ diRlCled to lU pemuW to writiDgs bearing the IlllJIind IILIIIlber of sigmiures oCthe lJUStee(S) designaled on tbe aa:DUDl signature and., Vou _ IlIhorimd to s~ my endonemeot of 8trf account holder on -y c:heck or other instlUlllenl tendenld lOr this aount, aDd you lW Illlieved of any liability in oollllllCtion with collection of items which lIRl handled by you without negligeoce and you shall not be liable tor lhe a;:ts of your agents, subagents or others or filr lilY alSualty. Witbdntwals may IlOt be male on aa:oont of such items nnti I collected, and lIIlY amount oot ~l1cctcd JiaA}' 00 charged Udcii. 10 this .x:DUIIt, including expeue incwred, and any OUlside elpeusc incurred Idative to this lIXOUJIl may be clwged to it. It is agml by the gDIIlol{s) lIld the tJUStee(s) tbat .y 1iulds placed in or added to the account by any ODe of the parties, wherher in trustee or individual Cll*ity, is and shall be conclusively intended to be a gift lI1d delivery at that time of such funds to the tnut estate. Vork Fedenl may pay or deliver tbe withdrawal value of the Trust Account or any part, upon insttuttioD of an lI.tthori7Alll pIIty to the T lUSt Account. who shall act filSt. and su:h payment, delivery. receipt. or acquittance signed by any autholi:md pIIty shall be valid, sufficient release lIId discbaJge ofVode Federal. The fi.mds in the TNSt Account together with the earnings, and any futuJe additions IUe conveyed to the tlUStee(S) for the benc:tit oftlle beDeficiM)'(ies). The conditions ofth4l Trust Accouu.t /IRl: (1) The tJUStee(s) is/B lIUlhorimi to hold, DIaIIlIge. ple!fge. invest and Rlinvll6! fuoo~ ir. savings o. ~iJiallc accounts It York. Federal; (2) The gl3ltOltS) or if more than pDe. eitha' of them, reserve the right [0 revoke the T lUSl Account in pm or in full at any lime and any p~ial. or complete withdmvll shall be a mvocat.ion oltlul portion oflhe llUst by the grantOI(S); (3) In the evClll of the death. rosigtlliion, mnoval or inlXlDlpdawc ofthc tJuatee(s), the individual desigtl.lled below is appointed successor Imtee; (4) Tbis Tl1IIt Aa:ouat, subject to tbe rigbl ofrevOCllion, shall contimae for the Iim of the granlol(s) and theaeafteruntil the last surviving beneficill)'(ies) either lives to the age specified below, or di(s) before IalCbing such age; (5) Upon demh of the grantol{s) and as each bencfic8y MlI:hes the age specified below. the Ttust Account shall taminate al tbe time but only as to such beneficiary, and such beoefici8J)"s pro .... shIUe shall then belong and be distributed by the ttustee(s) to such beneficial)'. The pro ... sbate of e8CI1 benefici8J)' upon a:hing the specified age shall be d<<amined by dividiug lhe amount ofthe tlUSl funds in the TIUst Aa:oUDl ("'flUSt Funds") then existing by the DlOllbet' of the beneficial)'(ies) then living lIS to whom such pro nia distribution has not p11lViously been made. If any beneficimy(ies) should die prior to reaching the specified age, such bene1i.ciSl)'{ies) beDefic:illl interest in the Trust FUnds shall teoninlie at tbar time and the Trust Funds shall coatinue 10 be TI1ISt Fund. subject to all tile other teons ofthe trust agn:anent. In the event the last surviving beneficiaJy should die before reaching the age specified, the TrusI AcooUDl shall then tamiJllle and the TlUSt Funds shall revelt to the sole ownemhip oCtile gramol{s) then surviving or tbe oalie ofthe last survivor ofthem. I (we) understand the TtuSl Account is sWject 10 such JUles, rcgularions 8Ild fees as you may fiom time to time eslltJlish. Date of Distribution UPON DEATH PATRICIA A lONG Beneficiary DAUGHTER RelatiOnship 06127/1937 DOB GLORIA JANE MARSH Beneficiary DAUGHTER Relationship 07130/1932 DCB Beneficiary DOB Relationship Witness Signature Date York Federal (05199 REV-1511 EX+ (12-991* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Evelyn P. Diehl FILE NUMBER 2006-00891 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Myers Funeral Home Patricia A. Long for funeral acknowledgement cards Postage for above Giant foods for post-funeral lunch Gingrich Memorial for grave marker 9,096.00 12.00 7.80 36.58 575.00 2 3 4 5 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 6,490.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Gloria Jane Marsh Street Address 502 E. Coover Street 3,500.00 City Mechanicsburg Relationship of Claimant to Decedent daughter Sta~ PA _~p 17055 4. Probate Fees 390.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 475.00 7. Yaffe & Yaffe, P.C. for mileage, notaries, working lunch and misc. Gloria Jane Marsh for mileage ($10.00); Patricia Ann Long for mileage ($250.00) 235.00 260.00 27.00 38.50 175.00 485.00 8 9 Patriot-News for advertisement of vehicle sale 10 Cumberland County Recorder of Deeds to record deed from Estate to legatees Cumberland County Law Journal and The Sentinel to reserve for advertisement of Letters Testamentary To reserve for house expense for #502 E. Coover St., to 12/31/06 anticipated disposition date 11 12 21,802.88 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) , . INHERITANCE TAX RETURN RESIDENT DECEDENT SUPPLEMENT TO SCHEDULE H 13. S. M, Berkheimer for furnace maintenance................................................... $84,38 REV-1512EX> ("-<13) .. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Evelyn P. Diehl FILE NUMBER 2006-00891 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 2 Comcast 47.84 AllState Insurance for #502 E. Coover Street 524.24 United Water for #502 E. Coover Street 22.69 Zimmerman Plumbing for #502 E. Coover Street 669.00 Petmart for door repair for #502 E. Coover Street 61.47 Humana for drug invoices 20.28 Verizon for service to #502 E. Coover Street 61.95 UGI for service to #502 E. Coover Street 79.86 PP&L for service to #502 E. Coover Street 50.50 3 4 5 6 7 8 9 1,537.83 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) _1513EX'{""", .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Evelyn P. Diehl FILE NUMBER 2006-00891 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Gloria Jane Marsh daughter one-half 2 Patricia Ann Long daughter one-half 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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) LAST WILL AND TESTAMENT OF EVELYN P. DIEHL I, Evelyn P. Diehl, of Cumberland County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last Will and Testament, hereby revoking any and all Wills by me heretofore made. FIRST: I direct that my funeral be conducted in a manner corresponding with my estate and situation in life, and that all my just debts and funeral expenses be paid and satisfied by my Co-Executrixes hereinafter named, as soon as conveniently may be after my decease. SECOND: I give, devise and bequeath all of the rest, residue and remainder of my estate, both real, personal and mixed, of whatsoever kind and wheresoever situate, to my daughters, Gloria Jane Marsh and Patricia Ann Long, in equal shares; providing however, that my real estate and home at 502 E. Coover Street, Mechanicsburg, Pennsylvania shall descend to my aforesaid daughters as joint tenants with the right of survivorship. TIDRD: I hereby nominate, constitute and appoint my aforesaid daughters, Gloria Jane Marsh and Patricia Ann Long, or the survivor of them, to be the Co-Executrixes of this my Last Will and Testament. I direct that my personal representatives be excused from entering and/or filing any bond to assure the proper performance of their duties. PAGE 1 OF 2 PAGES C. A fJ. B.P.D. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 'Iolftt.. day of ~ ,2005. TESTATRIX ~9~EAL) EVEL . DIEHL WITNESSED: ~q-JM) ~ IJJ .:;Ii ADDRESS cilifrolnm ~~ (AI-<p'-lJ,11 fJl/;'v' ADDRESS t21~j{ ~r4M~ dA ~ IIJI( PI ~7t1 COMMONWEALTH OF PENNSYLVANIA : : gg COUNTY OF CUMBERLAND Evelyn P. Diehl, the Testatrix, and the above witnesses, whose names are signed to the foregoing instrument, being first duly sworn, each hereby declares to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament in the presence of the witnesses and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by the Testatrix and the witnesses, this If!)'*"' day of "JiU1e... , 2005. ~ ..... NIt ~ IlL ..,. J!I'!I' ... ~_ ~~...... /~ ~Y4- NOTARY PUBLIC My Commission Expires: PAGE 2 OF 2 PAGES E. !? 17 B.P.D. dichl\will