HomeMy WebLinkAbout12-15-06
· ~.2J
-- REV-1500 EX (05-04)
PA Department of Revenue '*
Bureau of Individual Taxes .
Dept. 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
15056041046
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Date of Birth
Decedent's Last Name Suffix
Decedent's First Name
MI
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
_ 1. Original Return
c::::>
2. Supplemental Return
c::::>
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
-
c::::> 4a. Future Interest Compromise (date of
death after 12-12-82)
c::::> 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
c::::> 10. Spousal Poverty Credit (date of death c::::> 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
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
D
8. Total Number of Safe Deposit Boxes
c::::>
4. Limited Estate
c::::>
c::::>
Firm Name (If Applicable)
Correspondent's e-mail address:beamerc.sli) ejJ i x. nt,t
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
I
DATE
12. 1'1 "
Side 1
L
15056041046
15056041046
~
--.J
REV-1500 EX
Decedent's Name:
RECAPITULATION
15056042047
1. Real estate (Schedule A). .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .'. . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation, Partnership orSole4JroprietorshiptScheduleC) . ; .... ;3.
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
6. Jointly Owned Property (Schedule F) c::::> ~eparate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c::::> 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 Subject to 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 .o-'L
16. Amount of Line 14 taxable
at lineal rate X .ol/S...
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable'
at collateral rate X .15
f
.. ........ .,
....
Decedent's Social Security Number
15.
16.
17.
19. TAX DUE. . . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . .. . 19.
18.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
c::::>
L
15056042047
Side 2
15056042047
---1
REV-1500 EX Page 3
r _
Decedent's Complete Address:
File Number
~I - [)6 - ~1'..3
DECEDENT'S NAME
VIfC ~ ((E. LINE -r: HUlUey
--
STREET ADDRESS
S~32 ~eE ~A-'/)
- - I STATE I ZIP
CITY /J1 EeJlAl/lC S lSu/t&. /lA 17oS-S-
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. CreditslPaymentl)
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
Jd..1 08'8'. ;). tf
I
I/J- .ll~P~_
, SI s-, "0
Total Credits ( A + B + C )
(2)
~
/IJ 71JD. OD
3. InteresUPenalty if applicable
D. Interest
E. Penalty
f)
()
TotallnteresUPenalty ( 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)
o
o
~"3 B'f. ~cf.
o
~ 3 B t. ,,1. &./
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)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN IIX"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... D fgj
b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~
c. retain a reversionary interest; or.......................................................................................................................... D IKI
d. receive the promise for life of either payments, benefits or care? ...................................................................... D f!l
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D IKl
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ~ D
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. ~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 four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 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.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
f DEPT. Zs*0601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 006851
DUPLICA TE
WEITZMAN DIANE H
5232 TERRACE RD
MECHANICSBURG, PA 17050
__n____ fold
ESTATE INFORMATION: SSN: 008-28-4724
FILE NUMBER: 2106-0283
DECEDENT NAME: HURLEY JACQUELINE T
DATE OF PAYMENT: 06/19/2006
POSTMARK DATE: 06/16/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 03/21/2006
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $ 1 1, 1 1 5.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: DIANE H WEITZMAN
CHECK# 118
SEAL
INITIALS: CM
RECEIVED BY:
TAXPA YER
$ 1 1, 1 1 5.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REV".1502 EX+ (6-98)~
f . ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Hl/~Le-y/ J/lCtfUE'LINF 7:
FILE NUMBER
.2/ -~m - ;l.? 3
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
VALUE AT DATE
OF DEATH
Plb, 01= t.lMJ1> lJuP1l.DVE'.D By A ;DWEL.L/Nt; HouSe,
5232. T€~CG /2bAb" MEC.H/I-;f/ICS/!/uIlG" CUmI3ER-
L,flf/J) t!l;a/Vry" /JEIV;f/A ~ t:4J.Nr,.,.,/,IV//V& . 3'f~ /k.JeE
AS :DESC,(U BED AMA!& Ftti.LY tifT LA-/f!.GG //11
1JE"e1) /3oDJ< .;1.1./-5- '17/.1 /fAIt> 61:JNG LoT Nf),
J IS , PLA-N::z. I 'Pt.IrN f3()t)J( 7, fJ/fGE"'.
HA VIIIIG If. Cum 6ETl~j) &IIN ry TA-y ~~E.lHG11IT
CF '-"f# ;(j,A()#~O ,hiS> A- /:l/hti.€L #:- /()-ltf-/3/'1-1'3~
(!.D<<Nty AfUt..rl/l.t.IE7( AT Z>.tP.,i>. ;:::- /."D J?l-t.tlE;:
(SEE /HH~t!H .:2~ -r~ tSlt:.L /frVfC!He.o)
IJAAlIE"L. S.. Ntl/eLEY,/ iJE"eetJGNr~ S~&1<<S€
/:l~E~~ lJEfU:ZJsvr", P/#s&:u~A/ <.WE
/!3E'aAAlG ~€' SCI!.E" 7? /?:G NIJ'L()b7rl -n; ~€
P;te-D1I$~
.
I~G,/ ,2,0.. D()
TOTAL (Also enter on line 1, Recapitulation) $ / ~ ~/ ~ 2 t:J.. De)
(If more space is needed, insert additional sheets of the same size)
:t~
g:!!
,,0
!'.'1lI
"T1~\lO~
~Cnl':'.i>.
(')__,f>.--
r~)>~
0" r"
(J)~(J)~
m<oO<o
O~-Ij,.
: I\) :J: "
, )>" Ul to>
0-;-1(;)9
0-10-1
r:J:~~
:t<o-o:J:
..~
~~. ~
~"T1~
~....tp~
........
?o I\)
-0
"1
:0
(I)
C
3
~
~
~
-0
III
'<
3
(I)
;a.
"T1
~
III
:0
(I)
o
(I)
'S
m
::l
o
0'
(Jl
(I)
(J)
(I)
:::;:
~
Q.
(i)
(Jl
(Jl
(I)
Q.
(J)
Iii
3
'0
(I)
Q.
m
::l
<
(I)
0'
'0
~
'V
~ -1
gj~
:0 :IlraG'))>~ ~)>
m(l) 0(')(;5)>(J)
(J) !e. -I 0 :Ill\) -0 (J)
ag.=om-lzm
m;a.UlJ:(J)mO(J)
z -' 0 :Il'"
-I~"O :0 Z
-03r"-o )>.....0
)>c)>m ()o
r"::z-l(.)m':"':"
%I\)~~:o!g
<0 -0:0 0 to> 0
03)> )>.....to>
-..I() otp~
-om ..........
G') g ~
en m 03
o
o
o
I\)
,f>.
CQ
o
o
:J
.....
~(Jl\lOJ:
ml\)c...C
()~)>:o
:J:-I()r
)>rnO~
Z :Il c.
o:omo
(J))>C)>
O3()ZZ
cmm-
:O:Il-lP:!
G')OJ:(J)
-O)>C
)>0:0
r
~ ~
o
(Jl
o
:
f./)
m
m
:D
~
~
m
f./)
is
m
o
'T\
g!
1=
'T\
~
>
as
:D
m
>
,..
c
~
z
o
'T\
-<
o
c:
:D
n
o
c:
~
-I
>
><
o
o ...
~ ~
:c ii3
f./) g
* en
0((')-
or-n
e:>Z
:tIiS
"Oal"O
:tie:>
O:tl-
"OmO
m>al
~e:o(
<-n....
, oil!
:tI....
(')~
F8
g~
oui
z~
I'"'
~I'"'
o~
:nl=
~tll
Ci)"'
o:tl
""a
>:Il
!:z
i~
&;d
~-I
%~
~
o
m
Ul
o
3:1\)3:
mto>)>
()o:o
J:U>-
)>(J)m
z-o:J:
oO~
(J)~m
03-:0
cZ.
:OG')-I
~~~
~F~
.....:0-..1
-..10....
0)>-..1
~o~
~
.i>.
~
'V
6~
.. ~
1ft
-1-
S<~
oS<
Om
Fen
m'"
o'll
-1m
0-
'llZ
rom
On
"Tl'll
:!!o
o~
m-
"Tl"Tl
S<~
-l~
~~
180
%6
tis:
coO
~
Q
~
m
o
9
a " -I n ''In " (') <: :J:' (')
z~gg~g~9e'..~o
Ht1lCZt1lZt1l"'Ct1l~
?m~~m~m~~~2.
_ 0( (1)
~ ~~ ~ 0 D-~
tIl ODl tIl -n
"" g ~
$ c 0
, C . . al
g"O g gg} ~
.... ~o ~",~r-~ --
> \U1CO~I)ICX>W"'~ ~~
)( Ng Ng~~og:;l
NO NO~O oD-
~~ ~
o
c:
~
c
c:
m
1
l-!l-!
HI"'
Ill~
O\lI
.......
gogo
00
.,~
00
liH
lJI>'
""'
111C1'
OGl
tiH
It
~~
wo
~t::
IVN
00
00
",,,,
",1)1
--
wo
~t:
",N
00
00
",,,,
~
o
~
--
N
o
o
0'1
o
o
o
t->~
...CO
o
..]0
..]0
o :::,
o 0
owN
N~O~
...coN\,()
O. -J
..]OWO
...:IOtJ1O
...
~
...
-.l
UI
I\)
tv
'"
;"tv
"'*
~
8.
i
tv
'"
'"
'"
~
en w
c:I) OJ,....
i:7I ;"0
U1 "'*
H
~
l"\~
~o I:)
~~cn
"'~ f./)
IV;:l;
0("1';'
3
(I)
::l
~
o
-
9
w 1II
tv tJ1 n
'" co 0
;"N~NS
",*...*..
N
'"
'"
'"
""
'"
".,
o
0\
"" ~ ~
OJ tv ::I
;"~o-6~
",*...:1*
:!:
...
~
\;1:xJ
o....t
l1'
i
-I
l>>
~
(II
~ ~
:~ (i ~
2~E.N
:to
0....
c:!!
?6g
"T1~\lO~
~Cn~.i>.
(').....~.....
r"~)>~
0.' r.'
(J);5:(J)3:
m<oO<O
0'-1'
· ;.; :J: :I:-
;"'(Jl~
0+'.'
o~~-I
r~~~
-.-<o-oJ:
.......~
~~. ~
03.:.."~
..(.....tp.:..
)> .........
-0 N
~
:0
(I)
C
3
~
~
~
-0
III
-<
3
(I)
::l
~
"
g
III
:0.
(I)
o
-I (I)
)> '0'
>< ,...
(')
o
F
m
()
-I
o
:0
Ci
o
-0
..(
g'
o
0'
(Jl
(I)
(/)
(I)
::;:
~
~
~
0.
(i)
~
~
(/)
Iii
3
'0
(I)
Q.
g'
<
(I)
0'
'0
~
~
~
~
i
'V
~~
:llX
~(1I\lO:J:
ml\)c..C
(')~)>:O
:J:-I()r
)>rnO~
z:oc.
o:omo
(J))>C~
OJ()ZZ
cmm-
:O:o-l~
G>O:J:(})
-o)>C
)>0:0
..... r
-I ~
o
(]I
o
~
t/)
m
m
:D
~
~
f./)
m
t/)
o
m
o
'T\
sa
~
'T\
o
:D
>
to
:D
m
)10
,..
o
o
~
z
o
'T\
~
C
::0
n
o
c:
~
-I
>
><
o
o ...
~ ~
)10 U1
:D g
en 0
; en
:o:orOG'))>~~)>
m(l) 0('){;5)>(J)
(J) !e. ~ 0 :0 N -0 (})
5~~om-lzrn
m~(Jl:J:(J)mo(J)
z_. 0 :0'"
-l~-O :0 Z
-OJr"-O )>.....0
)>c)>m (')0
r _,Z-I' ~ '
g;l\)m~mO)o
~ -0:00:0':"0
03~ ~~8
-1(') 0'P~
-om ..........
,..., 0 en
UJ m <il
C1l m OJ
o
o
o
N
~
CQ
o
o
.;.
:i
0(<"1-
01'"'''"
e:>Z
:IliS
"Oal-a
!e:)It
"O:D6
~~~
""Ie:-
o(-n'"
. ota
:Il'"
(')~
0'"
I=~
~i
~-
0(1)
z21
>1=
z~
0_
:nl=
2tD
Ci)m
~~
>:D
!:z
~~
~a
>~
2>
(1))(
-I
I:l!: ::e ... n ::oln ::e nl< ::-\(')
c ?l 0 0 ;u 0 Sl> 011>> (J) 0
~;; ~ ~ ~ ~ ~ c~~ ~ ~
~ m ~ ~ m ~ m ~\~ ~ '[
:: 0<: (1)
~ :a ~ ~ 0\ D- ~
tIl otXl tIl"l'l\ .
~ g\ s
. ~ . ,~\ 0
g.., g g g}\ g
-\ ;:: ~ ;:: 0\ ~ >',~ ~
>' ~ <Xl Z IJ1 co\w \D -,' C' O?
, 0 ' o. -J ~,o III \-
)<. IV 0 tv O\-l 0 0\0 Cl
':I> tv 0 tv 0\"'" 0 :0 Co
i:L- \ \' ~
o . .' i ~
c: 0 0 0 I M~
~ g g w ~ \~ ~ Q
-, OJ"'" tV>-'\O~' \-J(1)CtI
_:>~ :"'~~~ ."miif./)
~ -J 0 -J 0 w 0 i"" ';:l or
c: ...: 0 -J 0 \J\ 0 !o ("I' ~
m \ 3
I \ ~.~
v \ ~-
\oe'..i
~
:\0\
.., I~\
~ ~ ~ \S'I
;... N ;.. tv ~ tv\S \
\0 df \0 tN' ~ o\""--l
, ,
toll-!
"'"'
l'CIll
III III
"', joIo
gogo
00
I' .,
00
ti H
tIS>'
III I'tl
1'tlC1'
o III
HH
&
~~
..,0
~t::
to.) tv
00
00
0'1'"
0'11.11
.....-
wO
~~
o-)N
00
00
0'10\
..]
.....
o
t::
to.)
o
o
0'1
o
III
9
~I\)~
mto>)>
(')0:0
:J:(J)-
~(/)m
z-o:J:
oO~
(J)~m
03-:0
cz-
:oG')-I
~ :J: :Il
-opm
)>rfu
.....:0-..1
-..10....
0)>-..1
g;o~
<il
-..I
j,.
0)
I\)
I\)
...
~
...
-.l
UI
I\)
~
I\)
en
e:.
~
to.>
\D
\D
\D
~
""
c:I)
i:7I
U1
...,
N~
;"0
"'*
-0
6~
.. (0
1ft
-1-
"."Tl
)(-1
0>
o~
j:cn
m-;
~m
0-
JJz
chffi
00
"Tl:JJ
:!!o
o~
m-
-;\"
".0
XJJ
--!~
~;
j80
~d
tis:
coO
~
G)
>
Q
m
o
9
-I
S<
-0
~
f\
:J.
(
(
u;'
....
l>>
....
(I)
-;}
><
Ii
\ \
: \,....2 _
u.> I .en
~ ~ \."t <5 0
,tl,,,, r1' III
\D 0 '.~\:-' III $.
\0 0'\ ;'1'" \0' )--I .
, I
\ \
\ \ \<il
I~i
... 'l'), 3
~ ~ ~ ,....\i\ i\5
\~ ::. ~ ::'i\ \g
. P-201-CT-Warranty Deed--Short Form-Act 1909-Arrangec! For Photo-Recording
Henry Hall, Inc., IndiaDa, Pa.
MADE THE
of our Lord one thousand nine hundred
utbi~
7;"
I~-
1!\ttb,
day of ~
SEYENTY-~ (~72)
in the yea'f
BETWEEN
BENJAHIN L. BRENEHAN, A SINGLE MAN, OF
HECHANICSBURG, PENNSYLYANIA
ltJ " ""
~(/)>- it-
I.L. Cl f- W
o lU 2:..:t" <'., :I::
w~~z ~ti~
~." q~ ~ c:;:l
l.L..o.:::.>..\< ~
I.L.. x >="~JJ
'-? ~ j (/) ~~~, N
000::2
UJ 0: W :z: :r-
~gQ)g:.s ":n
~.::!~ N ~
a:: ~
Grantor ,
and
DA.NIEL S. HURLEY AND JAOQUELINE T. HURLEY,
HIS WIFE, OF H~HPDEN TOWNSHIP, CUMBERLAND
COUNTY, PENNSYLVANIA
Grantees :
WITNESSETH, that in consideration of-':' THI R PI THREE THOU SAND SEZEN HUNDRED
AND NO/l00----------------- ($55, 700.00)---------------- Dollars,
in hand paid, the receipt whereof is hereby acknowledged, the said grantor doES hereby grant
and convey to the said grantees ,
ALL THAT CERTAIN PIECE OR PARCEL OF LAND, SI~UATE IN HAMPDEN
TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, MOBE PARTICULARLY
BOUNDED AND DESCRIBED AS FOLLOWS, TO WIT:-
BEGINNING ON THE WESTERN LINE OF TERRACE ROAD, FOURTEEN HUN-
DRED (1400) FEET BOUTH OF A STEEL PIN, WHICH PIN IS ON THE'
WE8T..W LINE OF TERRACE ROAD BETWEEN IOT No. 100 AND LOT No.
101 OF SAID PLAN; THENeE SOUTH ALONG THE WESTERN LINE OF
TERRACE ROAD, ONE HUNDRED FEET (100) TO A POINT; THENCE WEST
ONE HUNDRED FIFTY (150) FEET TO A POINT: THENCE NORTH ONE
HUNDRED (100) FEET TO A POINT, WHICH POINT IS DUE WEST FROM
THE POINT OF BEGINNING; THENCE EAST ONE HUNDRED FIFTY (150)
FEET TO THE POINT OF BEGINNING.
BEING LOT No. 1~5 AS SHOWN ON PLAN No.2 OF"GOOD HOPE TERRACE",
RECORDED IN THE RECORDER'S OFFICE OF CUMBERLAND COUNTY, PENN-
SYLYANIA ON THE 19TH D~Y'OF NOVEMBER, 1954, IN PL.AN BOIIK 7.1
PAGE 6.
HA. rING THEREON ERECTED A BRICK AND .AL)1TfINUTf BI-LEVEL DWELLING
NUKB1J:RED ~,,'_.-4_ /i?e(.. ~-a' ~~ -;r;..-,.~
BEING THE SANE PREl1ISES WHICH GOOD HOPE, INC., BY DEED DATED
SEPTEMBER 25, 1971 AND RECORDED IN THE CUMBERLAND COUNTY RE-
CORDER'S OFFICE IN DE~D BOOK "nU, VOLUME 24, P.AGE 1004, GRANTED
AND CONVEYED UNTO BENJ.A.lfIN L.BRENEM.A.N, .A. SIN(1LE MAN, THE
GRANTOR HEREIN.
UNDER AND SUBJECT T.O RESERYATION, RESTR.ICTIONS .AND E.ASElfENTS
OF RECORD, AS WELL .AS PROPOSED SEWER E.ASEMENT~.
UNDER AND SUBJECT ALSO TO A 20 FOOT WIRE S.ANITAR.Y AND STOR.M
SEWER RIGHT-OF-WAY AS SHOWN ON SURVEY OF D. P. RAFFENSPER.GER
DATED DECEMBER 8, 1971.
BOOK 5' 24PAGE 4 (:1.
UNDER AND SUBJEOT TO E.ASElfENT IN F.AVOR OF GOOD HOPE~ INC. ~ FOR
SEWER LINES' .AS RECORDED IN THE CUnBERL.AND COUNTY RECORDER'S
OFFICE IN HISC. BOOK 196~ P.AGE 1096.
BOOK 5 21 rAGE' 473,
,"
~',
/
AND the said grantor
hereby covenant sand ag1tee S that HE will war1'ant
GENERALL Y the p1'operty hereby conveyed.
IN WITNESS WHEREOF, said grantor ha S hereunto set
the day and year first above written.
HI8 hand and seal
~inni!.ll, ~CRltb HUll JleJitT.erell
in t4c Jrt5.en't of
/// ~
~<)~'d!-1'~0-~ ,/' ._ t';/~)~-U'/;;tt. €?"'?-'H_-<,-_~
-------mBEJd'A7rrNujj-;---JJR:rNEKAN.-----um.... \.~
.- ----- - _nn_ .u___ -- ---- _On_ - ___u__ ---- - _nn - unn______ ------ -----. ... - -" - - - e
., __on _ _n_._ ______ u____ u_n__O____ ___n_______ __u__ __on _ ___On __u_ _ _n u _ _ - - {~
/'?~
_u_._u...nu_....__n..._._____ .____...___.___________n_nn __n_ __ ____. _.n_. ' '" EAL
\~
~ . ~--tIt-z
u.... ......m.uuu...m7~.mmm~
State of
}S8'
County of CUMBERLAND a;l4
On this, the I (J - day of
A NOTARY PUBLIC
the undersigned officer, personally appeared.
BENJAHIN L. BRENEHAN, A SINGLE MAN
PENNSYLYANIA.
J'...~~ ,1972,beforeme,
known to me (or satisfactorily proven) to be the person whose name I S subscribed to the
within instrument, and acknowledged that HE executed same for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand a
. . 1,1\ (,J .-t",
.. ,\ \,J t {I" ,
,'... .. r
.'
\' ",-.'
State of
.' _, \,' L -:-
N01AAY PUSt,.;> ; i; ". ".- ;
U.. ""'.......--:-- IO:...J.~ . ." , \""'. -
-m.-m.------.----.---I;_~--~_!JI:~-~;:.;~.:--.-~ .;~;)/
,""... .~... . . . . I" .-'. .'. -.) <.:,->:.,
t 88.
County of
On this, the
day of
, 19 , before me,
the undersigned officer, personally appeared.
'".
k1Wwn to me (or satisfactorily proven) to be the person whose name subscribed to the
within instrument, and acknowledged that executed same fO'}o the purposes therein
contained.
IN 'WITNESS WHEREOF, I hereunto set my hand and official seal.
.__.____._._n__.....nnn_______._n__ ._____n_n - ---._- ----.- ---- -- -.- -- -. ----- - .. - e
Title of Officer.
~ do hereby certify that the precise residence and complete post office address
(If the within named grantee is ~~~,-.a.~ ~~ ~Z) ~~
''},Je- -!'.l;2 ~~~d ~ ".~ b2-~~/~~
..i-owMhlp of . 0 0 . 0 0 0 ~.~ . 0 0 0 0 0 . . . . . . 19 r
Cumbo Co., Pe.
!.% Real Estate Transfer Tell
'. ,r'll- l'j)'.~'~
Oet. :.. 0 . . . 0 . . .. Amt.. ....
CCi:.{,.j .f' .-Itt--., j
Cumbo Co. Oist. Col. AQ+I'\)
(. . ( , . { .~. ( ,. ..' .1;'1! (.;
School Dist. Cumbo CO'1 P.~
-=4:-. ~~;f
"~::~::;:;;}i--;~~.:~../.....w
I ,. Real Estate Truster TIIX
BOOKS24PAGE 4"12
Dde .':.. ~ f.'.':.".. Am+/(X~;I";~"
,,.II'. ;; ,;
/
tIl "
I--t "
~ l1t
... ... ..It
~ ~~ ,~ !~I&
&I ~ "OIl! ~ Iltl E-t a
~ ~~
~f" ~~~ ~ C) ..~ ~ J cJ
-JI ~ ~ . ~l~!
"'.. ~ ~ t-4 a
,~ ~ ~~ ~. ~ a
"~ Pa :t: . ~E--i c-....
. 0 ... ~I.
t-4 ra;l E-t .~ t<)
~ I ~ t<)
:c; t; ~~ ~ "69-
~ 2; !:4~ p~
t--t
~ tI.l P4t:l .. '. ~
!-i Q:$. ~ ~ "
~ ~~
g; a
~ t)
,;.:..0.:;...:.
~~:::;:~J:l~;~=~~:.~~~:~~..m.- }ss.
RECORDED on this __.___.m._..j1.f~__m_ day of _.._g_:kt:~............_____u_.____________~
A. D. 19_Zl!.~: in the Recorder's office of the said County, in Deed Book ~'S'
VQl. _.c.2.1~_________m.-._, Page __lflL_m_m__m.
Given under my hand and the s.al of the sa~ :: ~ov. writt....
t""......,.,Q.. .. ..., Reoorder.
":''''''''''". '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HU~LE~ JAe~U~L/~€ T
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
2/- t),,- il,f,3
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
31 .scJeIErS €F v. s: ~r/;f/6$ ~.s o/:'" ~<<)~"'O
lJ€1V~1II /;#',11. 7/ ~A".
(.s~E (;()V7 4IJN/)-.sl'r~ eN.t!tlU'l-7};.I(' "Jt/~r-()tlr
,A..77;feH IF"J> )
.,
3,3;Z7#/~
;?
It h'lE/Q, PR.ISt: - 'IDS M (,l.. "'u..Al. FUND A- ceo u..N TS
C St:G yllLlC A-11DN L E 7TBi!. II- 'T7i4-C H ED )
(SEE /Il$D J..If~~ LE77J;;1< DP EXF'LANIfTIt)/tJ ItT1)f.CHGl>)
#
i"~ t 9 s. 'IS
TOT At (Also enter on line 2, Recapitulation) $ 'I ()~ '- ~ ~. , I
(If more space is needed, insert additional sheets of the same size)
JI -
Savings Bo"~ Calculator
04/12/200611:02 AM
-
Vtllue As Of
103/2006
1-
Bond IlIfo
Series
{EEBonds 'h.'~
Denomination
Serial Number
$1100 H~
Results
# Bonds
38
Total Price
$1,900.00
Total Interest
$1,427.16
Total Value
$3,327.16
Issue Interest
Serial Number Issue Date Series Denom Price Interest Value Rate
C638598903EE 01/1998 EE $100 $50.00 $19.88 $69.88 3.61%
C640167765EE 04/1998 EE 100 50.00 19.28 69.28 3.42%
C578877901EE 11/1996 EE 100 50.00 20.56 70.56 3.41%
C605440335EE 02/1997 EE 100 50.00 20.56 70.56 3.41%
C611423257EE 04/1997 EE 100 50.00 19.44 69.44 3.23%
C615433200EE 06/1997 EE 100 50.00 22.16 72.16 3.61%
C622307536EE 09/1997 EE 100 50.00 21.52 71.52 3.61%
C543304758EE 11/1995 EE 100 50.00 23.88 73.88 3.41%
C556540695EE 01/1996 EE 100 50.00 23.88 73.88 3.41%
C559496768EE 03/1996 EE 100 50.00 23.88 73.88 3.41%
C563089720EE 06/1996 EE 100 50.00 22.16 72.16 3.41%
C584344423EE 08/1996 EE 100 50.00 22.16 72.16 3.41%
C497815216EE 10/1994 EE 100 50.00 31.00 81.00 3.28%
C5104738156EE 01/1995 EE 100 50.00 30.36 80.36 3.44%
C520107551EE 04/1995 EE 100 50.00 29.16 79.16 3.10%
C527238726EE 06/1995 EE 100 50.00 25.84 75.84 3.41%
C536566468EE 08/1995 EE 100 50.00 25.84 75.84 3.41%
C443990256EE 10/1993 EE 100 50.00 34.72 84.72 3.19%
C461937046EE 01/1994 EE 100 50.00 34.00 84.00 3.62%
C471159278EE 03/1994 EE 100 50.00 34.00 84.00 3.62%
C481828345EE 05/1994 EE 100 50.00 32.32 82.32 3.42%
C488511789EE 08/1994 EE 100 50.00 32.32 82.32 3.42%
C388597081EE 10/1992 EE 100 50.00 55.76 105.76 4.00%
C400856588EE 12/1992 BE 100 50.00 55.76 105.76 4.00%
C407911098EE 03/1993 EE 100 50.00 38.16 88.16 3.60%
C426266393EE 05/1993 EE 100 50.00 36.08 86.08 3.35%
C439946888EE 08/1993 EE 100 50.00 36.08 86.08 3.35%
C36693 831 OEE 07/1992 EE 100 50.00 57.88 107.88 4.00%
http://wwws.publicdebt.treas.gov/BC/SBCPrice
Issue Date
l_lIBII\
YTD Interest
$27.72
Next Final
Accrual Maturity Note
04/2006 01/2028 110fIJil
04/2006 04/2028 [jjjjl
OS/2006 11/2026 1m
08/2006 02/2027 lIB
04/2006 04/2027 [ID
04/2006 06/2027 11B.I
04/2006 09/2027 ID.t~
OS/2006 11/2025 Il.l~
07/2006 01/2026 II!I~
09/2006 03/2026 1!Ij:l11
06/2006 06/2026 111"~
08/2006 08/2026 I!~~
04/2006 10/2024 1180
07/2006 01/2025 II'II~
04/2006 04/2025 IIUri
06/2006 06/2025 11DB
08/2006 08/2025 IIDI~
04/2006 10/2023 11Mil;1
07/2006 01/2024 Ilorll.1
09/2006 03/2024 Ilal~
OS/2006 OS/2024 liDIot!
08/2006 08/2024 111I'ill
04/2006 10/2022 liDlil1
06/2006 12/2022 liDiiU1
09/2006 03/2023 l!Dilll
OS/2006 OS/2023 lillil:l
08/2006 08/2023 Ilail!
07/2006 07/2022 liliUnl
Page 1 of 2
. ....
Savings Bonrl Calculator 04/12/200611:02 AM
'C359716261EE 05/1992 EE 100 50.00 57.88 107.88 4.00% OS/2006 OS/2022 ~qi1i
C345369546EE 03/1992 EE 100 50.00 60.04 110.04 4.00% 09/2006 03/2022 I;Drel~
C339647564EE 12/1991 EE 100 50.00 60.04 110.04 4.00% 06/2006 12/2021 IJm.
C327772196EE 10/1991 EE 100 50.00 60.04 110.04 4.00% 04/2006 10/2021 11m~'
C308305013EE 07/1991 EE 100 50.00 62.24 112.24 4.00% 07/2006 07/2021 -
l' f.'
C301142910EE 05/1991 EE 100 50.00 62.24 112.24 4.00% OS/2006 OS/2021 lID
C29071360 1 EE 02/1991 EE 100 50.00 64.48 114.48 4.00% 08/2006 02/2021 IlD!lI'1
C2831 0 1906EE 12/1990 EE 100 50.00 64.48 114.48 4.00% 06/2006 12/2020 !lIB
C275828458EE 09/1990 EE 100 50.00 66.76 116.76 4.00% 09/2006 09/2020 Iii]
C632994043EE 11/1997 EE 100 50.00 20.32 70.32 3.61% 04/2006 11/2027 IlDlBt~
1~~I~11 Viewing Bonds 1-38
Le(end
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
MA Matured and Not Earning Interest
Please rate this service.
(Please print and/or save this page before submitting your survey)
Service Excellent Good Fair Poor
Savings Bond Calculator
o
G
o
o
t'submlt"surveV' fReset'
http://wwws.publicdebt.treas.gov/BC/SBCPrice
Page 2 of 2
--
David A Berkebile
05/02/2006 04:35 PM
May 2, 2006
To:
cc:
Subject: 14571836 7001
JACQUELINE THURLEY - DEATHSETTLEMENT
REQUIREMENTS - PLEASE DO NOT DELETE
DAVID RAYMOND LYON
STE 201
5006 E TRINDLE RD
MECHANICS BURG, P A 17050-3651
. Dear DAVID RAYMOND LYON:
IDS Life Insurance Company
RlverSource Funds
Ameriprlse Certificate Company
Amerlprise Brokerage
70100 Ameriprise Financial Center
Minneapolis, MN 55474
Thank you for your recent inquiry regarding JACQUELINE T HURLEY.s accounts. These are the values of the
accounts as of 03/21/2006.
Mutual Funds
Account Number
010105600802002
010105600810002
010111626957002
010111642749002
010111642756002
010111642764002
01011164277 2 002
010111642780002
010111642798002
010111642806002
010111642814002
02124206051 1 002
023142060518002
02434206051 4 002
Annuities - Post 1985
Account Number
93102254551 7 004
931074211711004
# of shares
551.413
1024.207
647.184
717.309
651.202
317.450
475.524
1155.276
388.859
405.154
263.544
2450.372
2171.124
1140.139
Total Value
$5680.99
$8951.57
$6188.38
$3149.15
$3080.32
$3272.06
$3048.11
$7012.53
$3472.51
$2690.22
$2667.07
$11689.25
$11810.91
$14582.38
1 R'7; ~9~ L.I~
Asset Value Per Share
10.27
8.74
9.54
4.38
4.72
10.27
6.41
6.07
8.93
6.64
10.12
4.76
5.44
12.79
Total Value (1: M)
$3239.44 , ()
will send later '1'1 ft) 9.1)() rf/iA
The date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be
-a.
subject to market fluctuation as governed by each product. Please note that the values indicated for any Life
Insurance product(s) reflect the gross death benefit at date of death, not the cash value. Values for any proprietary
mutual funds include accrued dividends as applicable. Values provided for brokerage products are manually
calculated, and should be used as estimates only. The prices used to provide values are estimates obtained from
outside sources believed to be reliable. Ameriprise Financial does not guarantee the values.
We appreciate the opportunity to be of service to you. Please contact us if you have any questions.
Sincerely,
Willard Steinberg
Death Settlements Processing Team
70100 Ameriprise Financial Center
Minneapolis, MN 55474
1-800-862- 7919, Option 5,1
>>>>>>>>
Willard J Steinberg I Senior Associate I Estate Settlements
Client Account Administration
Ameriprise Financial
Willard.J .Steinberg@ampf.com
ameriprise.com
· The Personal Advisors of 4
Ameriprise ~
Financial
David R. Lyon, ChFce
Senior Financial Advisor
Chartered Financial Consultant
Ameriprise Financial Services, Inc.
Suite 201
5006 East Trindle Road
Mechanicsburg, PA 17050
Tel: 717.441.4801
Fax: 717.441.4808
Toll Free: 877.460.8120
david.r .Iyon@ampf.com
CA Insurance #0891098
An Amerlprlse Platinum
Ananclal ServlcesSM practice
November 2912006
Mr. Charles E. Shields III, Attorney-At-Law
6 Clouser Road
Mechanicsburgl Pa. 17055
Dear Charlie,
The answers to your questions are as follows:
1) Were all of the non-qualified mutual fund accounts held in Jacq. Hurleyls
name alone? Yes.
2) Were any of them subject to TOD arrangements rather than the will? Yes I all
of them had transfer on death arrangements and passed directly to Diane
Weitzman.
3) Was annuity account number 931022545517004 a standard annuity payable
directly to Diane? No. It was an IRA that was rolled directly into a beneficial IRA
for Diane.
4) Annuity account number 931074211711004 was also an IRA and was rolled
directly into the same beneficial IRA for Diane. The date of death value was
$491909.00.
If you need any additional information at aliI please call.
Thank you.
Sincerely,
~~ /1, ~ frl
David R. Lyon, ~~ J--
Chartered Financial Consultant
Senior Financial Advisor
Advanced Advisor Group
An Ameriprise associated franchise. Brokerage, investment and financial advisory services are made available through Ameriprise Rnancial Services, Inc.
Member NASD and SIPC. RiverSourcesr.\ products are provided by affiliates of Ameriprise Financial. RiverSource'"' insurance and annuity branded products are
issued by IDS Life Insurance Company, Member NASD, a wholly-owned subsidiary of Ameriprise Rnancial.
~""""". '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
.:J /- 0' - :'l /'.3
1-/ u ItLe-~ J~(! tPu c L /.AJ E 7:
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sUNivorship must be disclosed on Schedule F.
ITEM V ALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
~-
FINAl.. ~IV/IIul1y jJII-Y-btl7" 70 ES7)1I.T€ ~ t)E(!E()a;T
~mw_ Or /Je-N;f/A" S7A7E E"m~~DYcE"S~ IZETlA.E'AtE1V7 .Iys.
~Y21-'7 (fx.t.w(lt f,..,~ 1'M1a.7~_ p" a.~h.T~J,f CH$-'rnan i/'f.ID)
A~{!f;II~ Ifi /JtE/H~~ FillS, A!mEJeAL Cj!8JJ7 u/ll/~1/J
~_ ~ 3 3Z2.t:J- DO SA-J//A'63
18. IN7: 1!-t!ChtLJ) 7D 'D. D. P. tJA/ II-..
C. tJ; 3 E Z2f)-lf CHee.k/Alr;
D.. IN1: ~et:J 7D J).. 0 - D. 0111 c."
~ ... 3~ ZZO- oS /HI)NR'}' mAN/16E/JIGIVT
,.
r. /N?: A-t!t!.RpEb 7D -p.D.1). oN E:
~
(SEE' YA-tJl!f7/,,,; ~~r"-E1(' A rrACH ElJ )
'* IItJID PfJ'!E: ;I>AIf/IEt.. HlJli./..ey tf)A-$ sPouSE" DP- J'A~UE-
'-
'-I/fIE r: Hulf/.e-y. H.E=' fleEfJE' (!E1I/$ei> I-1I9l. IcJNG12EttIh/IJ
SHE' I9Et1IfME FuLl AAlI) A-I3Sol.l.t.~ O/,UPI!l!.. oJ::' sA/ i>
A-eeou Airs) _
PERs otJ A:-L TV Lf)~"'n:D IN I!!ESI1J~cE
(SEE mMI?~ INt'EN1bIlY t.IST A -rrAaHGtJ)
(tINF() ~Dn:: fi).ECIJ..Tef'J.//)"'U&H7'i:1f /Hovli1) INlb fJ/lEh//sES
~I7H NIFN IHt;nt/:7( /N .:J~P/l, "D/lUGNTE7t 8hH'HT ~
SenE ~r NEIl. Pltllll PhPErl'TX htolJlSf ~A-YE' >AII~lIr4?1f
fJplJfE t?EIIIS /11#IlE 7H4N IJ'#~ YEAI( ,8F~/l,F "/),0. D. ~LJ
1l7lltA /~m.s 1tI/1'1I1N ~"E YE1f1'( oJ:: ))" ().t> 'P/&J6E ~/YSV
~r1Jl1N /)/1, VE~ /bU' 1<E1'/)!l rEtJ eJ~ SCNGO _ t:.)
~'-o-
(,-...,.t.lc. Y4./",)
~
'I D 3.. 1.1"
.22
tf
S;' 9f. 'I1f
. 9'1
! S,a 97
.ok
-f ~/". HJ
TOTAL (Also enter on line 5, Recapitulation) $ ~ II 3. 1(,
(If more space is needed, insert additional sheets of the same size)
1st
MEMBERS 1st
FEDERAL CREDIT UNION
SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
MONEY MANAGEMENT ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
HOME EQUITY LlNE-OF-CREDIT LOAN:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Daily Interest Accrual
Payment/Frequency
Next Due Date
Name of Co-Borrower
Security Interest
Estate of: JACQUELINE T. HURLEY
Date of Death: 03/21/2006
Social Security Number: 008-28-4724
33220 -00
04/18/1983
$403.46
$.22
$403.68
Daniel S. Hurley (deceased)
33220 -11
04/14/1983
$5,699.44
$.99
$5,700.43
Daniel S. Hurley (deceased)
33220 -05
08/31/2001
$590.97
$.08
$591.05
Daniel S. Hurley (deceased)
33220 -02
10/26/2004
$25,636.47
5.2989
$464.00/Monthly
06/30/2006
Daniel S. Hurley (deceased)
-5232 Terrace Road
Mechanicsburg, PA 17055
-Shares and/or deposits
M~ERS 1;:/EDERAL CREDIT UNION
~dd2t:
Denise A. Wolfe
Insurance Servic s Supervisor
May 8,2006
5000 Louise Drive · P.o. Box 40 · Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www.members1st.org
HURLEY ESTATE - SCHEDULE E
KITCHEN
Assorted hand appliances, pots, pans & utensils
OFFICE
2 Industrial Metal Filing Cabinets (surplus)
Metal Filing Cabinets
Non-operable old computer
Assorted Books on Weather Forecasting and Masonry
MASTER BEDROOM
Bedroom Suite
GARAGE
Snow blower (doesn't work)
Hand Lawnmower
Assorted rakes & shovels
TOTAL SCHEDULE E
$ 65.00
$ 10.00
$ 30.00
- 0-
$ 20.00
$250.00
$ 10.00
$ 15.00
$ 18.00
$418.00
,REV.1510EX.(1.97) ~
. ~ ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF H Lt 1< LeY/ cJAC G,u E t.. /lJe 7.
e;L1-/)'- ;lf3
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV -1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.
ATTACH A COPY OF THE DEED FOR REAL ESTATE.
ITEM
NUMBER
1.
{rNNlA' 'TI€S / /ltA Aeco tiNTs:
,4.) AOOr. hi. 93/ f)J.2. 5'15 S/ 7 00'1-
6) A--Mr: fYP. 9.31 D 1~ ,,;1./1 7/ 7 ODY.
(SEt INFO~lt'fll-nf)AJ ANIJ VAt.tllf7JbN
t.Errti7iS /I rr/l OilS n 5 CN[;"/). 8.
!f8orE) .
':1.
(;, F rJ WI TII'N OIJE YeA-R tJt= b.o. I>.
(SE-E /1EmIZ/d) //tv'ElVnlty ArrA-fJH/!1)
AN/) CAtJ$S- JfE~~~ 7lJ Sl!IIGi).E.)
DATE OF DEATH
VALUE OF ASSET
~
3~ ~ 31. i'f
f
Lj.q, 909. DD
'907.sr;
%OF
DE CD'S EXCLUSION TAXABLE VALUE
INTEREST /IF APPLICABLE)
loat, ~
-I!)- 3,2.39. fl"l
J DOlo ~
-0- l/-tf J '10'1. ~D
IDO?"
It
3/fJ{)thJ!JO
A1Er ~
TOTAL (Also enter on line 7, Recapitulation) $ 5'.3, I L/ 8, If 'I
(If more space is needed, insert additional sheets of the same size)
HURLEY ESTATE - SCHEDULE G
LIVING ROOM
2 Couches & chair
Old Stand-up Radio
Hutch
Coffee Table
Small Round Table
Coffee Table Lamp
DINING ROOM
Dining Room Table & 6 regular chairs
Corner Hutch - (bought at Lowe's)
Spinning Wheel with planter in it
Small 2 drawer Hutch
TV ROOM
Couch & 2 chairs
Small Coffee Table
2 Small End Tables
2 Small Table Lamps
Stand up Lamp
Old TV & VCR player
Small Hutch
Antique China - 1 year before date of death
BATHROOM
Plastic waste can
BACK BEDROOM
2 Small Hutches
2 Table lamp lights
HALL BATHROOM
Wicker waste can
BEDROOM
Dresser
What - Not
Bedside Table
TOTAL SCHEDULE G
$ 75.00
$ 15.00
$100.00
$ 4.50
$ 10.00
$ 2.00
$200.00
$ 30.00
$ 25.00
$ 50.00
$130.00
$ 10.00
$ 10.00
$ 5.00
$ 3.00
$ 50.00
$ 45.00
$ 1.00
$ 75.00
$ 8.00
$ 1.00
$ 50.00
$ 5.00
$ 3.00
$907.50
REV.1511 EX+ (12-99) .
~i.1~.~
~ . ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
~/-~' - ~/3
ESTATE OF H ~
u',;,LEY, oIlCauE l.INE
T.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
1.
FUNERAL EXPENSES:
/A.J.OLl'llt-E KI lit ME"l rJiIfJE72Ai- HtlIIIE; INC.
t.~~ Y1EW' tJE/HE"rQeY
VENJh1()/lE Slbll/l= ~-
raNf/eAl. f,l)1rJC.€ ~ En!. b',IIIIJIf/tSF?/HG'Alf -n /HtAlT erA SIIIn.
.t.
3..
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) D IIrAJE H. 4J Li'ITZ MA N
Social Security Number(s)/EIN Number of Personal Representative(s) /, 7- 91- "13fj
Street Address 5"5 t ~ I&JA-I>
City /JIE(!HAIIICS8t{~(; State.M-Zip /70$"0
2.
3.
4.
5.
6.
f.
9.
10.
II.
1Sl.
Year(s) Commission Paid:
AMOUNT
~
I, S,~.()O
""'~Dl:). f)D
~ J.J'1 ()" 1f
&00.#0
~A(Vt:D
if
~S(/O~DD
I
~ 4l)
3; SfJt},
fill e, ()t)
f1,
'-I-SD.fJO
~J:/. DO
'1l ~. tJO
~7~.oo
'It
, 107.97
~ 50. .0
"'5.00
Attorney Fees CHI/illES E. SHIEt-DS 7ii
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant -PlANE JI, /vEITZMAtI
Street Address 5<<3 :z. '7EA/lA(!/; /Q;A-b
City /JIE-CJlIfIY/CS~<<teG
Relationship of Claimant to Decedent D/l-1A.6HIElC
State ~ Zip /7 () SO
Probate Fees 4M.J Dr;aill,J ;.s-'Lte f)f ShD...t Ct..tt"h'c..o.te.r
Accountant's Fees J \.-'~~ore1"", r,.ILH,t.t' ~ 1)4.....\. -'r c..lOSl. .""t lo'ltJ, jJl~
f".ID'lIJ OA-I./I,dJ', ~'I-.
Tax Return Preparer's Fees
7.
J''''''IO.J isSue. '* Sltllrt (!U"f/h~fL$
lIei M~ ""rs~m",nt ~ ChV"les e. Sh" e-fds J1[ - 1ecI ~ SH i P ~
A-dy'~t;.s"'!J in -Me Cte..mQe,1t1Ala Lt.w JDu.rnAJ
II-tlrel't,'s"i'1 )'1 ~ ell.'" I ,. sle cJ.,nt"n~ I
11-1'//1>1,,41 ;:'/'P#de f;,e.
r,VA; ;:e.. (:See ~"l.itk..b~1t :lltt.I.f Ilfarld)
TOTAL (Also enter on line 9, Recapitulation) $ /~, 37th 77
(If more space is needed, insert additional sheets of the same size)
S ~I{E".D. It CJ}lZtJ.
_lE~r:_f!_E_u_lllJl!~_~~t-_;[,~_~!f~_~~~___T__________...__.. .-----_.___.____._.__E'--'...€./t~~___~ /- /)_~_:u~_~l
. ... ._____u._____ ) J.-L_li~~!!lk~rJell1Ll1i----t ..Chl.J:l~l_..g~_~I'~ Ji[___f!:.I?~~..l.t.-6Ji~--------__--_...-.
_1.fe4rdt tee .... b.. -r;/~ a Ci!lo/ rU?sj!:y}~d__ ___.______u._________._______________._,~~~_~__._
. ..... ...1'1.. ..c.i A. ~'~~~fIff~m..__._._ ......._~~d~!.6J). ......
<W
{)~(Jl[[z: !J(immz:[ 'Junz:~a[ d-I-otnZ:J
JJnc. 1 )
NafntrfJ
2001 MARKET STREET . HARRISBURG, PA 17103
TIMOTHY A. HOBBS, SUPERVISOR (717) 238-2502
STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items. we will
explain in writing below.
If you selected a funeral that may require embalming, such as a funeral with viewing. you may have to pay for embalming. You do not have to pay for embalming
you did not approve if y u selected angeme ts suc as a direct cremation or immediate burial. If we charged for embalming. we wi xpla' why elow.
::::~ic.or ,J3;J. m:.;xrDc;; (G
Address ity
A. CHARGE FOR SERVICES SELECTED:
1. PROFESSIONAL SERVICES
Services of Funeral Director/Staff ..... $
Embalming ......................................... $
Other preparation of body (Dress/Cosmetize)
........................................................... $
SUB.TOTAL OF PROFESSIONAL SERVICES ...... At $
2. FACILITIES. EQUIPMENT & STAFF
Use of Facilities & Staff
for ViewinglVisitation .................... $
Use of Facilities & Staff
for Funeral Ceremony.................... $
Use of Facilities & Staff
for Memorial Service ..................... $
Use of Equipment & Staff
for Gmveside Service ..................... $
Use of Equipment & Staff
for Church Service ......................... $
Other use of Facilities
................................................................$
SUB.TOTAL OF FACILITIES/EQUIPMENT .......... A2 $
3. AUTOMOTIVE EQUIPMENT
Vehicle to transfer remains to Funeral Home
Local.................................................. $
Hearse (Casket Coach)
Local.................................................. $
Limousine
Local.................................................. $
Family Car
Local.................................................. $
Flower car or floral disposition
Local.................................................. $
Lead car/clergy car
Local.................................................. $
Car for pallbearers
Local.................................................. $
Out of town transportation ................. $
$
$
SUB.TOTAL OF AUTOMOTIVE EQUIPMENT .... A3 $
TOTAL OF PROFESSIONAL SERVICES,
FACILITIES AND AUfOMOTIVE
EQUIP~IENT ..................................................................... A $
B. CHARGE FOR MERCHANDISE SELECTED:
Casket ................................................ $
(Description)
Other Receptacle ................................ $
(Description)
Outer burial container ........................ $
(Description)
Acknowledgment cards ..................... $
Register book{s) ................................. $
Memory folders ................................. $
Prayer cards ....................................... $
Temporary grave marker ................... $
Burial clothing ................................... $
Other clothing
$ --
~::~~o:~ .{;/Q~~i5~....fIosd ~ r;,o
OTHER $
$
$
TOTAL MERCHANDISE SELECTED .................... B $
;2 !io/
C. SPECIAL CHARGES:
Forwarding of remains to
$
(Funeral Home)
Receiving of remains from
$
(Funeral Home)
Immediate Burial...............................
Direct Cremation ...............................
$ ~ ..,
$ '1 ij'
$
SUB.TOTAL OF SPECIAL CHARGES ................. C
$'10/5/
D. CASH ADVANCED
Opening grave .................................... $
Cemetery Equipment ......................... $
Headstone Engraving ......................... $
Lot and Deed ..................................... $ ./
Newspaper Notices - Local................ $1rXJ
Newspaper Notices - Out-of-Town... $
Telephone & Telegrams .................... $
Airfare ................................................ $
Clergy/Mass Offering ........................ $
Organist Honorarium ......................... $
Pallbearers Honorarium ..................... $ Lfi1" -
Certified Copies of the Death Certificate $ __
Vault Service Charge ......................... $
F1O~fiiie;""'~~'~ffii4~: ;J.r;>~
$
$
$
SUB-TOTAL OF ADVANCES ....................................... D
$ ~7f/
We charge you for our services in obtaining:
(specify cash advances lhal are markel-up)
SUMMARY OF CHARGES C\<.A* ID~
A. Professional Services, Facilities and
::~::;:;..~~~.~~~~~~~~~.~............... $ ~ q 1/1
B. Merchandise....................................... $ ..
C. Special Charges ................................. $
D. Cash Advance .................................... $ ~
' '"
TOTAL OF ALL SELECTIONS ............................. .
PAID AT TIME OF OR PRIOR TO
ARRANG EMENTS .......................................................... $
BALANCE DUE ............................................................... $
REASON FOR EMBALMING ~ /SIP? pi!>
If any law, cemetery. or crematory requirements have required the purchase ,iaI Am
of any of the items listed above, the law/uirement is explained below. tI
~
I agree that I have examined the items of goods and services selected above and found them to be correct and according to the arrangements I have requested. I
acknowledge receipt of a copy of this Statement of Funeral Goods and serviceste~ I represent that I have/ufficient funds available for payment of the cash
price for the goods and services selected. I also agree to make payment of $ J. ~ within J days. I agree to be jointly and severally
liable with anyone else who signs below. A late charge of 1/2 % permonf.h amounting to 6 % per year will be applied to the unpaid balance beginning
30 days from the date of this agreement. I will also pay to the Funeral Director all reasonable costs paid by the Funeral Director to collect amounts
T owe under this agreement. Those costs may include attorneys' fees, court costs and other costs. Any additional services or merchandise ordered or requested after
the date of thjsareement will be con~der.f~ PfIt of ~!s agree~ent and the cost thereof will be reflected 0 the al bill or statement.
(Seal) ~./ :' (? -' i J f,/ /l, (~I.. / ') n hIll....> ~ l5t
. -~. (purChaser) ,," (a)
(Seal)
(purchaser)
.f~~ I:;f\Il !;IAu:...A d/Od
-rm 5 C '" II 1 ; II} f''''' G II (-tTT.:-;-~-;;,-;.-;-r:-S~~=~€~~-~~~~~~~~i~J~..j J ~bl
~ Esitl~ :r:Ja.(!t~La~ 7: !I~J''''
1Jtc~ 'l/ A!)-e( 1/,1rJtLr/--
.3.;J. -r .-e../I../L t1.- C,L j! cf-;
.ec.hOAU.e~j) 8f:: 17CJSO
~r~~D,0bpp~1~f~--
1t/1M-Jv~fiI1 d/iRA-
0091
60-184/313
03
i
~
I '
III
DATE
1,1- 3 - 61,
1$ 7M-
DOLLARS ftJ =E'"
:Ommerce
"Sanl, America's Most Convenienl Bank.
~ 1-888-YES-0004
II- 0 0 0 0 q ~ II- I: 0 3 . ~ 0 . B l. b I:
-'~ I } l-
S j ~~~:~;~l_iUJL~}U12_..
)R
(/
I
~
..........
~~"R'".
~~~.-~
Ll .. j
ot;eio~AC
~.:r-.. ~
Burlington Stoneworks, Ine dba
Densmore Stone Company
Serving the Community since 1911
June 8, 2006
Diane Weitzman
5232 Terrace Road
Mechanicsburg, P A 17050
Dear Diane:
Enclosed is an order form for a matching footstone to be installed in Lakeview Cemetery.
I enclosed a page with rose designs for you to choose from. There are two different
options for the type of carving: Flat: in which there is no change to surface of stone Gust
lines are sandblasted in) , and Shaped: in which the leaves and flowers are shaped into the
stone.
The price for the stone with a Flat carving would be $490.78 mcl. tax ($463.00+27.78)
The price for the stone with Shape carving would be $540.60 incl. tax($510.00+30.60)
Please indicate on the order form flat or shaped. and place the amount indicated above in
the highlighted area at the bottom of the form. We require 50% down to start the order,
with the balance due upon delivery.
Sign the order form at the bottom and return the white copy along with your choice of the
carving picture and a check for 1/2 of the total.
Please feel free to call me at 863-3775 or try my cell 324-2973 if you have questions.
Sincerely,
~ry
Francis Socinski
, m'1512:' (12-OJ) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
I-IU~lex "A(!.~U.et.IAI€ 7.
FILE NUMBER
;l.1-t:J6I -,;<,r3
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
.1.
3.
..5;
HS I1C ere", 't /l-ed: AID. sif07 07()() ~b3' ~Sbl) I paid
t Crut,'It,rf l/-$sigl1t!t!, Ph;/I"s tMfII &hUJ Assoc,'Ji.s, Liil.
(,Jt!e. k.h au! ~r /)f chuJi 4t1a.dv.a')
HD}Ite ElILtITY LINE ()F CJeED/T Lf)IJ.N,; A-~~-r. Alo" 3~ 220-02
II-T AtEIII/JEltS 1ST FE'DEltIW.. CIlEJ>rr uAJIO,J
(SE'E LE T7~ ;/rr,l/(!HE".D 7D Sa,#ED. E.)
U, s. -rLEi-SuIlV ~It PefSDIJA-/. IN(!.DI'JtE T~GS t;U
//)~ ~72tJtAI ~,f' V€M ~oS
f;
-TAx 161{.t./AI~ - /JfAI!./E /ltt,s&e ~.,; #;1-11/,-1181 ~
'/,
6'07. rJ/)
11
~; ~3 to. Lf7
1's; "3 I . 00
~
~. It)
~
'1/7,.5Z
7JJ.Jr IJ/~t./~ - /WHbE /I" /it;?(, r~, h',f-;Jf ,ot,79'V Twl2
TOTAL (Also enter on line 10, Recapitulation) $ 3 .2., Sf) I. 7 'I
(If more space is needed, insert additional sheets of the same size)
, .
CHARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner ofTrirulle and Clouser Roads
MECHANlCSBURG, PA 17055
GEORGE M. HOUCK
(1912-1991 )
TELEPHONE (717) 766-0209
FAX (717) 795.7473
April 21, 2006
Ms. Patty Hanifee
Phillips and Cohen Associates, Ltd.
258 Chapman Road, Suite 205
Newark, DE 19702
RE: Estate of Jacqueline T. Hurley
Your Client: HSBC Bank
Your Account No.: 4791950
Dear Ms. Hanifee:
Please find enclosed for your ready reference and convenience a copy of your fax
communication of April 20, 2006. It is my understanding that you are fully authorized and
empowered to act on behalf of HSBC Bank with regard to the Hurley Estate. Accordingly, I am
enclosing a check in the amount of $807.00 drawn on my IOLTA Attorney's Trust Account.
Acceptance of this payment is an acceptance as a final payment in full and in satisfacti on of the
balance. I have marked the check with the usual attorney's notations.
Thank you.
Very truly yours,
Charles E. Shields, III
Attorney-At-Law
CES/mjj
Enclosure
cc:
Diane Weitzman
CHARLESE. SHIELDS III
IOLTA ACCOUNT
6 CLOUSER RD.
MECHANICS BURG, PA 17055-9735
708
Date I//~I/{)h
3-76 Hi/aGO
301
Pay to the I'/j b'O
Orderof r'Nll..llp.slMl/J We-AI Assoe/1f7l:S. LTJ:>. I $ 30 7~
.
B(;I/r /J/-',A//JREtJ S/E]/l:7f) ~ eHJ.o. -......
/'TJr. ,,-'>Dollars ~:::.::::"....
t: CITIZENS BANK
Pennsylvania
::~~~.rZrZ;:Z;~!~ .~._{;~~!:~___.._~
':0 ~ bD ? b .501: b .000 b 1:11..00111 0708
. .. .
6121
** TAXPAYER COpy **
"AYABLf
TO
MARIE HUBER. TREAS 717-737-4822
230 S SPORTING HILL ROAD
MECHANICSBURG. PA 17050
)=S'.
CTL
10
2375
r~ 1 0
~t~1l)b3
IAXE5
)UE
!\NO
'AYABLE
:ROM
HURLEY. JACQUELINE
5232 TERRACE RD.
MECHANICSBURG PA 17050
fAX
:::OLL
3/1-4/30; M 9-4:30. T-TH 9:30-11
& 2-4 ALSO TH 5:30-7PM F 9-12
5/1-6/30' M 9-12. T-TH 9:30-11
CLSD FRIDAY***ADD'L HRS BY APPT*
)FFICE
10URS
IF TAXES ARE IN ESCROW, FORWARD TO MORTGAGE CO.
TAX COLLECTOR'S OFFICE FAX 717-920-9439
'AYABLE
TO:
)ESC:
MARIE HUBER, TREAS 717-737-4822
230 S SPORTING HILL ROAD
MECHANICSBURG, PA 17050
ASSESS.NO -10003561
MAP NO: 10-18-1319-163B
5232 TERRACE ROAD
ACRES .340 DEED 00248' 00471
GOOD HOPE TERRACE
LOT 115 PLAN 2 PB 7 PG 6
Residential Building
RESIDENTIAL
HURLEY, DANIEL S ~I ~ 7) \ D'{P
& JACQUELINE T HURLEY ~~J - vull
5232 TERRACE ROAD 1
MECHANICSBURG PA 17050 CJ<j!:: IDr!
TAX
'AYER
IFFICE 3/1-4/30; M 9-4:30; T-TH 9:30-11
lOURS: & 2-4 ALSO TH 5:30-7PM, F 9-12
5/1-6/30; M 9-12; T-TH 9:30-11
FRI CLOSED ** ADD'L HRS BY APPT*
BILL DATE
3/01/2006
BILL NO
6121
2006 PERSONAL TAX NOTICE
COUNTY OF CUMBERLAND
TOWNSHIP OF HAMPDEN
PLEASE COMBINE PAYMENTS W/ 1 CHECK
UNPAID TAXES SUBMITTED TO DELINQUENT COLl 12/15/06
. . ,
5.00000 4.90
5.00000 4.90
5.00
5.00
5.50
5.50
9.80
DISCOUNT
3/01/2006
TO
4/30/2006
10.00
FACE
5/01/2006
TO
6/30/2006
11.00
PENALTY
AFTER
6/30/2006
TAXPAYER COPY
Bill No:
Bill Date'
4458
3/01/2006
Control No' 010 - 003561
2006 Statement of Real Estate Taxes
Assessed Land Improvement Mineral Total
Values 29.000 137,620 0 166,620
COUNTY OF CUMBERLAND Discount Face Penalty
Rates .00219700 .00219700 2 % 10 %
COUNTY R/E 63.71 302.35 358.74 366.06 402.67
Rates .00018000 .00018000 2 % 10 %
COUNTY LIB 5.22 24.77 29.39 29.99 32.99
TOWNSHIP OF HAMPDEN
Rates .00018000 I .00018000 2 % 10 %
MUNIC. R/E 5.22 24.77 29.39 29.99 32.99
TAX AMOUNT DUE -> $417.52 $426.04 $468.65
If Paid On or After ~~~1/2006 5/01/2006 7/01/2006
If Paid On or Before 4 30/2006 6/30/2006
IF NOT PAID BY 12/15/2006 THIS BILL WILL BE RETURNED TO TAX
CLAIM BUREAU FOR COLLECTION AND FILING OF A UEN AGAINST
YOUR PROPERTY.
12/1512006
... SEE REVERSE SIDE OF BILL FOR A BREAKDOWN OF YOUR COUNTY TAX DOLLARS **
Return Bill with Payment. For a Receipt, Enclose Self Addressed Stamped Envelope.
REV-1513 EX+ (9-00)
.... .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
/-If,( /llIEY, .YA{!I( ul?L'AlE 7:
FILE NUMBER
.2/-t)&' -d1'3
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
V/AUE {.I. WEITZA1A-N
5 J 32 TEIl~A-(!.E" /b;A-J>
{YJ E'C)-/ II- All e58 u /?c;., I A /7 os- ()
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
NUMBER
I
I>Au~HT€1t.
lo/) iD
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)
;f 'It
~
~ ., ....
,=~...:'
LAST WILL AND TESTAMENT QF .JACQUELINE T. HURLEY
I, JACQUELINE T. HURLEY, an unremarried widow, currently of 5232 Terrace Road,
Mechanicsburg, Hampden Township, Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this my Last Will and Testament,
hereby revoking and making void any and all prior Wills by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses as soon after my decease as the
same can conveniently be done.
2.
All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and
wheresoever situate, is to be distributed to my daughter DIANE H. WEITZMAN, also known us
DIANE S. WEITZMAN, currently of 5232 Terrace Road, Mechanicsburg, Hampden Township,
Cumberland County, Pennsylvania.
In the event illY daughter. DIANE H. WEITZMAN predeceases me, then I direct that my
estate be divided into two equal shares and distributed as follows:
A.) One share to my sister, EVA SnElL, Del' stirpes.
s.) One share to my brother, MICHAEL TI~ONO, lJer stirlJes.
3.
I nominate, constitute and appoint my daughter, DIANE H. WEITZMAN, also known
as DIANE S. WEITZMAN, to be the Executrix of this my Last Will and Testament. In the
event that she is unable or unwilling to act as Executrix, I appoint my sister, EVA SHEIL to be
the Executrix in her place and stead. In the event that she is unable or unwilling to act as
Executrix, I appoint my brother, MICHAEL E. TRONO, to serve as the Executor in her place
and stead. I further direct that they shall not be required to file bond or other security in the
Office of the Register of Wills for the purpose of administering my Estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 7K day of
J1/~ , A.D. 2004.
~E~y-
;I~~~
\l/.:.cf.' -<.I-. -<-- -r: ~
lACQ ELINE T. HURLEY
(SEAL)
j -.
" .. t trp.
Signed, sealed, published and declared by the above-named .JACQUELINE T. IIlJRLEY, as
and for her Last Will and Testament, in the presence of liS, who at hcr reqllcst and in her
presence, and in the presence of each other, have hereunto subscribed our names as witnesses.
~L'~
~-----------------
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHIELDS CHARLES EDWARD III ESQ
SIX CLOUSER ROAD
MECHANICSBURG, PA 17055
_nu___ fold
ESTATE INFORMATION: SSN: 008-28-4724
FILE NUMBER: 2106-0283
DECEDENT NAME: HURLEY JACQUELINE T
DA TE OF PAYMENT: 12/15/2006
POSTMARK DATE: 12/1 5/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 03/21/2006
NO. CD 007569
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $388.24
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$388.24
REMARKS:
CHECK# 168
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS