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HomeMy WebLinkAbout94-00913 , , ' .' n ., ,~ . 1).(_1. ',,' ~"j:~i" <.::.r/!r: I-l ' ' ' "il.,\ I '.' .~.\ ..:, '. , . .'. ,'r i I "(I; ), ", ,,".1'1: ..ij,<;,);,i\..,\i;,~,: " ,'/1,:;; '. R b '- ~ ?tft P ';-5' .- ~ COMMONWIALTH OF PINNSYLVANIA COUNTY OF CUMIIRLAND } III JOHN E. S.LIKE beln9 duly is Executor SWP.!!L.__ ~ccordln~ to lew, depolel and uys th.t h. _ ____....._.___.. 01 tho Estato 01 _. Helen M. Skivinqton I.t. 01 _'_'n ".-. IlClE.()U9.h. of"~lIrnp..I~i.11______,, Cumberland County, P.., decelled and that the within Is en Inventory mede by ....____...._.._.___.him.._..... .__._., the uld executor 01 the .ntlre utale ols~ld decedenl, consisting 01 all the personal prop.rty Md rill III.t., exc.pt reel IIhle ou"lde the Commonwlllth 01 Pennsylvania, and that the ligures opposite OIch Item 01 the Inv.ntory r.pre..nllt's 1.lr v.lue U 01 the date 01 decedont's death, . March 27 . . /'1' /I' .j,I).l1J2~.i!.:('(J 1'.,. 19 95 ~!t n./" .___~~~i~[l . e..a.tar. Admlnltl"t., Sworn to and lublorlbod bolore me, 2109 Market Street -rc NOTARIAL SEAL THElMA S, McCAUSLIN, Nolary PubliC Camp Hili, Cumberland Counly MY.GommlSSlon fxplrcs ,JuIV ~ 1996 011. 01 O..th _. Camp Hill, PA 17011 Add"" October 1994 OIY Month V,,, INSTRUCTIONS I. An Inventory mull be flied within three months alter appointment 01 plllonal rtprllent.tlv.. 2. A suppl.ment Inventory mull be flied within thirty days 01 dlloovery 01 addltlon.I....... 3. Addltlonalshee" may b. attaohed u to plllonllty or realty 4. See Artlcie IV, Flduolarlu Aot 0/1949. III l!> Z P 0 ~ l! ~ ~ E-t Cl 0 ; ~ ~, ill ... II ~ m H ~ l~ ~ ~ 2 ~ ~ Q I i ~ u. i 0 III III H u. rn 0 . B f r~ > ~ . Z o Q ILl - ~ ~ ~ ~ 0 iij Z 4It ... "0 [;j c 0 ... . t-:l "C 0 1 I : 1 ... I j (j it J cOM~~~~\m'\oJ:M\o'1!l)"\lANI^ HAAAIS~5~~,\lR~~ \".060 I /'I.,~,/?r f INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS VEA" .", .f ,'"v. "" ~x. (l'.~ll . FOA OATJBOF OEAltl APTEA 12/0" CHICKHEAE IFAOf'O BAL POV! RTV OREOI1'O C~AIMED FILl! NUMBER 209-12.8301 t Xl. Original RaMn ~ ~ t D 4, Urrl10d E.lalo ~ ! ~ []] 8. Decedent Dle~ Testalo l (A"ach copy of Will) 19. If IIno 10ls g,oalo, Ihsn line 17, entor Iho dlllorenco on IIno 19, Thl.I. Ihe OVERPAVMENT. ~ D ~ht,." y~.,. requ..ll11111 tlfund 01 your ovtlJllymenl.1 20, II line 17 Is groater Ihen line 10, elllor the difforenco 011 line 20, This Is tho TAX DUE. A, Enle' Iho Inlo"sl on tho belenco duo on IIno 2M, B, Entor !hI> toIel 01 line 20 and 20A on IIno 208, This Is Ihe BALANCE DUE, M.ke ChICk P. 1Il1. to: R It.. 01 Willi A n' .. .. II! SUAE TO AHSWER ALL QUESTIONS ON PAGE 2 AHD TO RECHECK MATH .. .. UiiJ,r pln,lll.."f plrjury, I dlcl.lr,th,t I h.~. '""'mlned HilS '1Iurll,lncludll1g.c,;ompAnymg sch,dul.. IMl 8l1"fl1lnls,lt1d to lh. but 01 myknowl.dg.and blll",Ulttrue, r,OHllcllno cOml)tutll, I dIe""" thai all 'UI"I.11 hu bun r.pollod at \fue marklt valul. OeclA/allon ollHlp4flr olh., than tho pllllon,l "pl,..nl(ll...e II baud on all infQrmllion of Wh1chpFlplr.thulnyknowl.dOI, C P o 0 n N R D E E S N - T - CUMBERLAND ~malnder R~lurn (Icr dalo. of doalh prier 10 12-13-02) o 6, Fodoral F.etato Tax ROlurn Requlrod o 8, Total Numbe, of Sale De~call Bo"o. 19911.00913 COUNTY CODE I DcCEOIi~T'S NAME (LAST, FIR9T, AND MIDDLE INITIAL) SKIVINGTON, HELEN M. DECEDENT'S CO!.AflL ETE A(J[)RE5!l 1700 MARKET STREET CAMI' HILL, I'A 170Jl SOCIAL SEClJRITYNUMBER County D 4a, Futuro Inlorosl ComplOmlse (lor d~I" 01 do~lh ellcr 12,12-82) []] 7. Decodont Malntalnod a Living Truol (Mach a copy of Tlusl) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DI~ECTeD TO: NAME COMPLETf MAILlNO ADORESS R E C A p I T U ! N JOH~, SLIKE, ESQUIRE TELE: PttDNE NUMDER 717 737.31,05 1. Rool Eslete (Schodulo A) 2, Stocko and Bonds (Schedule B) 3, Cloooly Held Stock/Partner.hlp Intorosl (Schodulo C) 4. Mortgage' and NOlen Rocoivablo (Schod'llo D) 6. Cash, Bank Deposll. & MI.cellaneou. POlsonal Property (Schodule E) 6. Jclnlly Owned Property (Schedule F) 7, Tran.'~rs (Schodule G) (Schodulo L) 8. Tolel G,os. Asseto (lotallln091'7) 9, fUlle..1 E"pen911', Admlnl.tratlvo Cosls, Mlsc8l1anaou, Expenses (Schl>dule H) 10. Debhl, Mortgage Llabllltlos, Lions (Scho~ulo I) 11. Tolal Deducllon. (Iotalllno. 9 & 10) 12, Not Valuo of Eslalelllno 0 mlnusllno 11) 13, Charlleblo and Govornmontel Boque.'s (Scho~llle J) 14, Not Value Subject to Tax (line 12 minus line 13) 16. Amounl 01 line 141axablo alO% ralo (Includo vlluo, from Schodule K or Schodulo M,) 10. Amount olllne14 taxeble at 18% relo (Include value. Irom Schodule K or Schedule M,) 17, Principal ta" due (Add tax from line 18 and from line 18,) 18.CredIl8/Sp Pcvorty Prior Paymenl. DIS(;ounl SAlOIS, GUIDO, SHUFF & MASLAND P. 0, BOX 737 CAMP HILL, I'A 17001-073'1 (1) None (2) Non~ (3) None (4) Non!, ~) 399,387,60 (6) (7) None -0- (8) 19 , B72, 95 3,198.94 (11)_, (12) (13) (14) 0,00 K ,06 ~ 0,00 X ,18' (17) Inloro.t (9)_ (10) (16) T A X C o M r, 'f A T b N (16)_ + + (18) (19)__ (20) (20A) (2OB) r-i/-'I I ' L.- (" 1I~L.- .... . .... .~... ~.... -. _€......................... r., ..: J. Q~. .7.~?..................................__ C P HILL, PA 17001.0737 ,AlDIS, GUIDO, SHUFF & MASI.AND i;: -0 ~. .liox" "j3 7................... -.....".... -..-. -. ciiMP - iiii.i:: -PA.'. i ]ci6i :0.i3]....."................. SIt)NATURE OF PE R90N RESPONSIBLE FOR FILING RE TUltN SIGNATURE OF rREPAREROTHER THAN "!;PRESENTATIVE --- CUflYftQII1 {c11i1il1 f(lr", 'OltWIII only C3n\I' "llcI Suit..,.,,., Ino NUMOER 399,387,60 23 , 071. 89 3'16,315.71 376,111.11 nn,on 0.00 0,00 0,00 0,00 0,00 0,00 0,00 0.00 DATE :; 1J.,7!tpS- DATE V~7/~"r Form lSoo (R..... 11"1iI11 . . SAID/S, GlilDO " MASLASD llO9 Mllkel 51/<<1 Camp Hili, PA . .1 Trustee shall hold, maintaJ.n, invest and reinvest the trust estate for the benefit of settlor. It shall collect the income therefrom and first pay any expenses of the trust, including trustee's reasonable expenses incurred in performance of its duties and reasonable compensation to the trustee for its services. Trustee shall pay to settlor, at least quarterly, the net income of tha trust est3te and shall further pay to settlor all of the principal or such portion of the principal as settlor may from time to time request in writing. In the event settlor becomes ill, incompetent or upon the written request of settlor, trustee shall pay such part of the income and principal as the trustee, in its discretion, believes is necessary and proper for the support and mainten- ance of settlor, and may disburse such amounts in anyone of the fOllowing ways: A. To that person or. corporation who is taking care of or has custody of the settlor; B. Dirsctly to the settlor; C. To any creditor of settlor for his benefit. 2 COM~l~~W~ANIA _STAn Of' ' SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Pie... Prinl or T PI NUMII!R 1994-00913 ..REV. 1I0Hx+ 12-171 HELEN M. SKIVINGTON SSII 209.12 - 8301 10/18/9ft All ITEM NUMBER . , -owned wtIt1 RI!IhI of Burvlvollhlp mUll III choloeod on BoIMduIl PI DESCRIPTION VALUl! AT DATE OF r.EATH 1 Dauphin Deposit 8ank checking ac~ount 0079391699 Jewelry per attached appraisal Series E, EE, Hand HH bonds per attached list 195.32 , '. 2 55.75 3 108,542.28 4 lIalance of trust account with Dauphin Deposit' BlInk and Trust Company payable to estate of settlor under Agreemsnt of Trust dated March 12, 1993; per attached. statement Trust income to dat~of death 1.90,010.24 584.01 5. ,. , ~ i" I. , " ,. " ., , ,. i' " " )'1 ,. " " '.. , I "~I " \ '. ,_. , I ,. , , , I,l' ". , " , , ,. , , , "i , , , " " , " " " I, " , " , " ."1 , " " " " ,. '. " " .., I " , " mAL Alto enl81 on line & Reo IIIllllion , (Afteoh additional & 1;2" ~ ,,' ahee1& ~ morelfllOlll needed,) Copyrlght(o) 1..1 farm loftw.ltllnlv elnte, Pilot aoft~.r'l Ino. 3993H7.60 FOIm 1100 S,hldu~ ! IRay, 1-17) .' '" United States. Savings Bonds - Series E, registered in the the name of Helen M. Skivington: DATE OF DEATH VALUB ISSUB DATB NUMBBR VALUE $ 25 06/73 Q6 412 857 321 E 'Kif, (,0 $ 25 06/73 Q6 412 857 320 E Y.'/. ~o $ 25 08/74 Q6 412 857 322 E 1'13(. . $ 25. 09/74 Q6 412 857 323 E '/'I .'3 &- $ 25 10/74 Q6 412 857 324 E n::t, $ 25 11/74 Q6 412 857 325 E '1/, "/1 $ 25 12/74 Q6 412 857 326 E 11.16 $ 25 09/75 Q6 412 857 327 E '/~ I. I $ 25 10/75 Q6 412 857 328 E 7(., I. I $ 25 01/76 Q6 412 857 329 E 1{; :'[) $ 25 03/76 Q6 412 857 330 E '1~;' ~6' $ 25 07/76 Q6 412 857 331 E 1;1. 9 ,/ $ 25 09/76 Q6 412 857 332 E /'.~" 'N $ 25 07/77 Q6 412 857 333 E '/1,,10 $ 25 04/78 Q6 412 857 334 E (,I 'II United States Savings Bonds - Serios E I registored In A I, /'1f.(.\ 2 the name of Helen M. Skivington: VAI,UB ISSUB DA TB NU~ $ 50 07/73 L2 220 980 013 E 1ft !:, X r $ 50 08/73 L2 220 980 014 E 11.fr.' 'I $ 50 09/73 L2 220 980 015 E. 11,1, ; (. $ 50 09/73 L2 220 980 016 E /1,1, J I,. $ 50 10/73 L2 220 980 017 E 1/,(,"'1. $ 50 11/73 L2 220 980 018 E 1(.(", ;. '" $ 50 12/73 L2 220 980 019 E /U,~:I. $ 50 02/74 L2 220 980 020 E / (.1. :: (. $ 50 03/74 L2 220 980 021 E / (,/, ~. (. .$ 50 03/74 L2 220 980 022 E I (r/, ,; (, '$ 50 04/74 L2 220 980 023 E I (,' . ~: Cco $ 50 05/74 L2 220 980 024 E I~; 1. ...:, $ 50 06/74 L2 220 980 025 E I~; 1', 7 'I $ 50 09/74 L2 220 980 026 E / ~; ,(.7 2_ $ 50 10/74 L2 220 980 027 E I to' Y, 72. $ .50 10/74 L2 220 980 028 E I.:: 9, 'I L $ 50 11/74 L2 220 980 029 E I - . -, , , . -.j ..'.... $ 50 12/74 L2 220 980 030 E 1!.,!",7(,. $ 50 01{75 L2 220 980 031 E /., ,; 'i.1 ...... . $ 50 02/75 L2 220 980 032 E I r " '10../ ~I.... $ 50 05/75 L2 220 980 033 E It., .', l' (. $ 50 06/75 L2 220 980 034 E I.'" ~', ~'1 ::~ ;(";"~72. .',- ... . U, S. Savings Bonds - Sarlos E cont'd. Dl\TE OF OFATIl VALUB ISSUB DA TB NUMBBR VALUE $ 60 08/76 L2 220 980 036 E 15:',22- $ 60 10/75 L2 220 980 036 E 1.5 3, ;I I- $ 60 11/75 L2 220 980 037 E I !:,'[), ;' I. $ 60 12/76 L2 220 980 038 E /~D. !:,I $ 60 06/76 L2 220 980 039 E /'l7lfo $ 60 10/76 L2 220 980 040 E N7,f1 $ 60 10/76 L2 220 980 041 E /'I 'lJ 'i $ 60 01/77 L2 2?0 980 042 E "/, .) r $ 60 ~) . 03/77 L2 220 980 043 E If I " ;: 7' $ 50 03/77 L2 220 980 044 E !<I:;3)i $ 50 09/77 L2 220 980 045 E 1'/1 h) $ 50 01/78 L2 220 980 046 E Il'/!,'t) $ 50 01/78 L2 220 980 047 E I;; '/, ~ () $ 50 03/78 L2 220 980 048 E I ):, r I. $ 60 07/78 L2 220 980 049 E , ;',. ,f $ 50 01/79 L2 220 980 050 E /.'11(, . $ 60 03/79 L2 220 980 051 E I ;'JI 'It(. $ 60 10/79 L2 220 980 052 E 1-'" () $ 60 10/79 L2 220 980 053 E /2/, (<0 T>--:l"TT',:- $ 76 07/74 K 222 056 520 E .lJx, (.'1f $100 04/73 02 112 229 168 E :j:::,7,~ ,/ $100 07/73 02 112 229 169 E ,:-'::'1 /1., $100 10/73 02 112 229 170 E ':l:j' J {;"L $100 01/74 02 112 229 171 E 3-;J:~, ,2- $100 01/74 02 112 229 172 E !o23. I 2.. $100 04/74 02 112 229 173 E 3;;..~ /2- $100 04/74 02 112 229 174 E ?J -'.!!. , 2- $100 07/74 02 112 229 175 'E B '70/1/ $100 07/74 02 112 229 176 E :::, 17, '1'1 $100 08/74 02 112 220 177 E ?,J/ '1, ,1,1 $100 08/74 02 112 229 178 E ." I"~ '1<1 $100 11/74 02 112 229 179 E .Ell" $100 12/'14 02 112 229 180 E ~/I, Q :z.. $100 12/74 02 112 229 181 E :)/1 ?L $100 01/75 02 112 229 182 E BII ! f $100 01/75 02 112 229 183 E :;'1/ ~ ,. $100 01/75 02 112 229 184 E ~,'/,rf $100 02/75 02 112 229 185 E :;,'1)1 $100 03/75 02 112 229 186 E .~II Pf $100 03/75 02 112 229 187 E "''', ~ $100 03/76 02 112 229 188 E .31/ ~1 $100 03/75 02 112 220 189 E ~/I,n . , I U. S, Savings BOllds -' Sorlos E oont1d. DATE OF DEATH VALUB ISSUE DATE NUMBER VI\UJE $100 04/75 02 112 229 190 E .::ill,tf $100 04/75 02 112 229 191 E .~w,~f $100 05/75 02 112 229 192 E f.l'L '/.. $100 05/75 02 112 229 193 E :!:.(.l!. ?2. $100 07/75 02 112 229 194 E :>.0)' ,/ 'I $100 07/75 02 112 229 195 E .9 (\. ./" $100 0'1/75 02 112 229 196 E .'101, 'N $100 08/75 02 112 229 197 E 3"i- ,N $100 09/75 02 112 229 198 E .-3,,~ ,1/'1 $100 10/75 02 112 229 199 E 3o~ ,/" $100 11/75 02 112 229 200 E !.u_x.'ll/tl $100 12/75 02 112 229 201 E .1,,/, ()~ $100 12/75 02 112 229 202 E ~ol,()r $100 01/76 02 112 229 203 E _,>of. I 'l.. $100 02/76 02 112 229 204 E ~11";i' ,l- $100, 02/76 02 112 229 205 E 3uftl. $100 03/16 02 112 229 206 E !lot ,'l.. $100 04/76 02 112 229 207 E 3(;)//2- $100 04/76 02 112 229 208 E 30/ ,z- $100 04/76 02 112 229 209 E ~-.;c,1 /1- $100 04/76 02 112 229 210 E .3 "/ / 1- $100 05/76 02 112 229 211 E ,)(/, ,), $100 06/76 02 112 229 212 E ,F/'" f 0 $100 06/76 02 112 229 213 E )(/:'~() $100 07/'i6 02 112 229 214 E ) '? " l~ ~100 07/76 02 112 229 215 E .Jfl"' 7 t.. 100 07/76 02 112 229 216 E ~ r/!, 7" >r- $100 01/76 / 02 112 229 217 E ~\t /1_ . '-mo 09/76 <'cf 112 229 219 E .),q.', 7~ $100 09/76 02 112 229 220 E ./ '/;' 71. $100 10/76 02 112 229 221 E /'is,7/-, $100 10/76 02 112 229 222 E )1~, 1(,. $100 10/76 02 112 229 223 E )'i~;, 'I'" .$100 11176 02 112 229 224 E ~l<1, '1}. $100 11/76 02 112 229 225 E 11/9. '(l $100, 12/76 02 112 229 226 E 2 ?t, 71. $100, 12/76 02 112 229 227 E l1o?/" $100' 01/77 02 112 229 228 E .290,11., $100' 01/77 02 112 229 229 E l 90, 1 ~ $100 02/77 02 112 229 230 E ;>90 1 I., $100 03/77 02 112 229 231 E Me>, 1 /,. $100 03/77 02 112 229 232 E 1.90, 7"" $100 04/77 02 112 229 233 E ;?{I,7/-' $100 04/77 02 112 229 234 E ; (Ir\ 'It. *' #'/00 ()gln Ci /12 )39 )IA & ;,'I/$,?ID , '. , , , " ' u. S. Savlnga Bonds - Serlos E cont'd. Dl\TE OF DEATH VALUB ISSUB DATB NUMBER VAUJE $100' 04/77 02 112 229 235 E ;i'?!.' ./ Ie $100 05/77 02 112 229 236 E ;l.g b"'t $100 . 05/77 02 112 229 237 E 2 X~: ^ '1 . $100 06/77 02 112 229 238 E ,)X:;.I.<I $100 07/77 02 112 229 239 E .2[J.\(.d $100 07/77 02 112 229 240 E .I {.s:: (,,0 $100 . 08/77 02 112 229 241 E ."';htD $100 08/77 02 112 229 242 E Jts 1,0 $100 08/77 02 112 229 243 E 71.~.("t> $100 09/77 02 112 229 244 E :!F;. Ml " $100 10/77 02 112 229 245 E 2h t,.() , $100 10/77 02 112 229 246 E l?F I,e. $100. 11 / 77 02 112 229 247 E ' . I ;<j" ~tJ~" ..-: .$100 12/77 02 112 229 248 E :I":.;',:, lIt' ~100 12/77 02 112 229 249 E ',J. . ,... i. ..'.,' ,. 100 12/77 02 112 229 250 E ;I .6.~ f (> $1011 01/78 02 112 229 251 E .) .!.~.~, ,",.1 $100 01/78 02 112 229 252 E ;/ ~~.~, , I $100 .02/78 02 112 229 253 E ./ t', ," , " ....1 $100 02/78 02 112 229 254 E ".I'" .j ... ....' $100 .03/78 02 112 229 255 E ./"7~'1 $100 04/78 02 112 229 256 E 1.'/1/, c./ $100 .Om8 02 112 229 257 E )."1 ?o/ $100 04/78 02 112 229 258 E },'/7(.</ $109 04/78 02 112 229 259 E ) ,17, I.. tJ $100 05178 02 112 229 260 E .2-/.,r;r,'( $160 06/78 02 112 229 261 E .?I{ i: 7 z. $100 07178 02 112 229 262 E .? 'I'::' 7(.. $100 07178 02 112 229 263 E )..h, It.. $100 08178 02 112 229 264 E 2.11:';7(.. $100 09178 02 112 229 265 E 1.1{::: 7~ $100 10178 02 112 229 266 E )..11 !.' 7 Ie, $100 10/78 02 112 229 267 E ;<1.",: 7 &- $1M 11/78 02 112 229 268 E ;;'1:':',)0 $100 11178 02 112 229 269 E .;J I/.....! D $100 12178 02 112 229 270 E ' 'I!:, l';f $100 01179 02 112 229 271 E ';"/.0: '1 '- ~., $100 01/79 02 112 229 272 E l.l/ ..:1, ('/~" " $100 02179 02 112 229 273 E ;~ II:" ('I a.. $100 03179 02 112 229 274 E ..~ (I ~" ,( 2- $100 04179 02 112 229 275 E ,N~~, '12. $100 04/79 02 112 229 276 E )'I~ 1(2- $100 04/79 02 112 229 277 E 1.1 :;" q 'J-. $100 05179 02 112 229 278 E J 'I' ,/II $100 06179 02 112 229 279 E l4,;'.r~ . U. S. Savings Bonds - Series E oontfd. DATE OF DEATH VALUB 188UB DATB NUMBER VALUE $100 06179 C2 112 229 280 E 2. ..(? . c) $100 07/79 C2 112 229 281 E ,,</) ,,) $100 08179 C2 112 229 282 E .'''). ,J $100 09/79 C2 112 229 283 E .2 /.1 ~'1, II 1'1 . $100 09/79 C2 112 229 284 E ) ./7, N' $100 10/79 C2 112 229 285 E ,. ,/..', r d $100 11179 C2 112 229 286 E ;~ - I' ,1 tf $100 11/79 c:2 112 229 287 E ~":., ,I" ....... $100 12/79 C2 112 229 288 B ....;1: t/r ~;;'m:)(., $500 01/78 D 211 000 434 E /. ;;....1.~, ",) $1,000 01/78 M 211 924 370 E ,.2,.:;,..';\" t,d $1,000 01/78 M 211 924 371 E 1, !J, t, ,,~ '1. _... "~--""'---"'. ~ 100. ' .. , , U. S. Savings Bonds, Series EE I registered in the name of Helen M. Skivington ,. VALUB 188UB DATB NUMBER $200 07/80 R4 7858739EE .)tq,ll.. $200 01/81 R4 7858740EE ~U,'o $200 10/81 R4 7858741EE 1.:'11, r,/ $200 04/82 R4 7858742EE 21..'. ~... $200 04/82 R4 78587 4311E n~:.91. $200 04/82 R4 7858744EE .ll.f .,2 $200 06/82 R4 '1858745Ell ;>~;(,,). d $200 06/82 R4 7858746Ell ~~f(,;4 $200 10/82 R4 7858747EE ,,1'::' I~ 1 (/ $200 11/82 R4 7858748EE .< .:,.,. I '" $200 02/83 R4 7858749EE )j'I, ,h $200 02/83 R4 7858750EE :UI',II. $200 04/83 R4 7858751EE ;> ! 0,1 h $200 04/83 R478587521111 ' , . I ~ '" ,J(' $200 07/83 R4 7858753EE .l/~,'J $200 12/83 R4 7858754Bll 1. I:: I 2- $200 03/84 R4 7858755EE ;1/;', , a. $200 05/84 R4 7858756EE .10 i' F f $200 0'1/84 R4 7858757EE .le'l' H $200 08/84 R4 7858758EE ..?f.'~. ~f $200 11/84 R4 7858759EE ).01... '1 $200 01/85 R4 7858760EE h,/.I."! $200 01/85 R4 7858761BE ),I:>/,I.'i' $200 08/86 R4 785876211E 1 <1(1, 3. V ". , u. S. savings Bonds. Serica EE I roglstered in tho naml.' of Helen M. Sklvington DATE O~. DFATIl VALUB ISSUB DATB NUMBBR ' VALUE $200 08/86 R4 7858763EE I x,':, ,I 'I $200 . 10/86 R4 7856764EE ,gf' ~., .., $200 ' 01/87 R4 7858765EE 15't 1'1.- $200 01/87 R4 7858766EE I:; r" 1 'Z.. $200 ' 01/87 R4 7858767EE 15g, 1 z.. $200.. . 01/87 R4 7858768EE I!.i'i 7 'l- .$200 01/87 R4 7858769EE /:'i~, 7 1.- . $200. 01/87 R4 7858770EE I~~ J2.. $200 01/87 R4 7858771EE 1$1-, 7.. $200 01/87 R4 7858772EE /: fi, 1z. $200.. 01/87 R4 7858773EE I~',~ ./ 2- $200 01/87 R4 7858774EE /'!,r 7l 1200 05/87 R4 7858775EE n:.:"... I' 200 05/87 R4 7858776EB I!.: ':oIl) 2. ~ 't f 9(),,i" '2_ $500 . 04/84 D 19840059EE t.~' :... ','0 $500 04/84 D 19840060EE ~.: t,' (0. $500. 04/84 D 19840061EE ~'3(', I.() $500 04/84 D 19840062EE :.) ~,->. )';{) $500 06/85 D 19840063EE cf~":"ll $500. 01/86 D 19840064EE 4t,~/,C.1) $500 03186 D 19840065EE 111<'/ t,. (J (, $500 03/86 D 19840066EE 1/~r. (, /) $500 03/86 D 19840067EE I/I,,/~ll $500 03/86. . D 19840068EE l/!.y,I,6 $500 03186 D 19840069EE Illr;' t-iJ . $500 03/86 D 19840070EE 1~1(,.() $500 05/88 D 19840071EE ':'I./.!,l> 'i.t"UI,; 0 $1,000 03/84 M 28894274EE /, IG (), ~/) (, $1,000 03/84 M 28894275EE I, / tic), ~o , $1,000 11/ 84 M 28894276EE I, (J(,.:, , I,{) $1,000 11/84 M 28894277EE I. 0(, i.: "cl $1,000 11/84 M 28894278EE /, (It.. l' f,V $1,000 11/84 M 28894279EE I, ,) If" f., tJ $1,000 03/86 M 28894280EE 7 '," ._ !~', .~ ('I $1,000 09/87 M 288942818E 7(~7, (,0 $1,000 09/87 M 28894282EE 'It.' . ~ ,/d. tJ $1,000 .09/87 M 28894283EE 1I..1(,(,,{> $1,000 . 09/87 M 28894284EE 1t,'I,I,.I.' $1,000 09/87 M 28894285EE "It.'Ul' $1,000 09/87 M 28894286EE 'JI, 't, (,.1" ., . COM\1RJ\l~/A\,g~AN'A IISTAl1! SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Plene Prlnl or T PILE NUMBl!1l 1994-00913 , 6EV- "111iK + II-Iel HELEN M. SKIVINGTON 1Ti:'M NUMBER A. FUnllIll!JqlIn_: SS# 209-12-8301 10 18 94 DESCRIPTION AMOUNT 1 Myers-Harner Funeral Home 2,086.00 2 Oingrich Memorialo - grllvemarker' 920.00 " .. AdmlnlllrlUv. CoIlIl 1. Personll Repr88entltlve Convnlsslons 13,950.00 S<x:lal Security Number 01 Personal fI~pr811enlltlve: 251-69-/,606 Year Convnlsslons paid ~ 2. Morney Fees .2,000,00 3, Family Ex8l11'1Ion Clllmanl Relllkmehlp Addrees of Claimant II decOdent'e dellh streel Addross City Stete Zip Code 4. Problle Fees 328.00 0, MlIoIlllneoul/!xpln...: I Cumberland I.aw Journal - legal ads 40.00 2 Patriot.News Co, - legal ads 48.95 3 Register of Wills . short certificates .15.00 4 Register of Wills - filing fees 25.00 5 Landis Jewelers - appraisal 10.00 6 Reserved fDr account fees and future expenses. 450.00 '" " TOTAL (Also enler on line 9, Rooephul.tIon) (II moro 'P10818 needed, Inserf Iddhlonal8heele of 811118 aizt,,) Copyrlght(o) 1..1 form IOUW.,. onlV C,n'., Pile. Sollw'''t Ino, 19 ill~ parm 1100 eanadull H IROY, HS) i SAIDIS, GUIDO, SHUFF. MASLAND . 2109 Mllkel S\l'OOI . Camp Hili. PA 104 shares of PP&L Liquidated at Inventoried at U.S. Savings Bonds Liquidated at Inventoried at Dauphin Deposit Capital Liquidated at Inventoried at $ 1,914.59 2.060.50 $107,045.00 12.8.542.28 ReRerve Account $ 5,075.00 5.069.54 Dauphin Deposit Fixed Income Fund Liquidated at Inventoried at 7130 Units Wellington Fund Liquidated at Inventoried at NET GAIN ON CONVERSION OF ASSETS $ 47,954.22 .4.L.337.99 $172,712.21 140.761. 36 PRINCIPAL DISBURSBMlNTS D.bt. of DeQedentl Lindeman Moving Co. Susquehanna Surgeons Health South A. Z. Ritzman Associates West Shore Anesthesia Associates HealthSouth Rehab of Mechanicsburg Cumberland Ambulance Service runeral IXDen...1 Mrers-Harner Funeral Home G ngrich Memorials - grave marker .4 " 145.91 1,497.28 5.46 3,616.23 31.144.13 $43,487.34 $ 560.00 40.00 20.00 30.93 100.00 1,218.00 164.00 $ 2,132.93 $ 2,086.00 920.00 $ 3,006.00 I. " SAlOIS, GUIDO, SHUFF " MASLAND ~109 MubI SuoOl Camp Hili, PA " jNCOMl ACCOUNT . BlQIIPTS Exxon Corporation - dividend Dauphin Deposit Bank - trust lncome from date of death to 4/3/95 U. S. 'reasury - Series "H" bond interost Dauphin Deposit Bank - interest Ameritech - dividend AT&T - dividend Exxon Corporation - dividend PP&L - dividend PNC Bank - interest on estate ohecking aocount to 9/14/95 PNC Bank - interest on eatate checking account to 12/30/94 Dean Witter Reynolds - income 6/28/95 to 9/30/95 PNC Bank - interest on certificate of deposit to 11/1/95 Dauphin Deposit Bank - interest on certificate of deposit to 11/1/95 TOTAL . D~SBURSIMI.TS ". John E. Slike ~ commission on income receipts NET INCOME RECEIPTS .,r, 6 $ 300.00 2,285.76 159.84 11.n 476.00 75.~0 300.00 43.42 720.47 49.77 1,092.11 1,077.40 1. 295.32 $ 7,887.71 $ 394.00 $7,493.71 " , , i , RECEIPTS OF PRINCIPAL DllSui:'iption Fiduoiary Adquis i tion Value I, 1993-03,.31 Reoeived from Helen M. Skiving ton to Fund Trus t : '."< $20,000 Dauphin Deposit Bank & 20,000,00 Trust Co. Certificate of Deposit 6.7% due 1/8/94 $25,000 Dauphin Deposit Bank & 25,000,00 Trust Co, Certificate of Deposit 4,4% due 1/14/96 , ' $5,000 Dauphin Deposit Bank & 5,000.00 Trust Co, Certificate of Deposit 5% due 12/16/93 $5,000 Harris Savings Assn, 5,000,00 Certificate of Deposit 6.54% due 10/8/94 ., Dauphin Deposit Bank and Trust 25,475,65 Co, . Savings Aocount #4901.7.25521 Harris Savings Assn, . Savings 12,083,37 Acoount #01-4712 476 shares Ameritech Corp 34,599.25 ", I 230 shares American Telephone 13,1l~,00 & Telegraph Co, 400 shares Exxon Corp. 25,025,00 104 shares Pennsylvania Power 3,055,00 & Light Co, , , $17,100 U,S. Treasury Series E 43,466,59 Savings Bonds due 12/1/2008 $300 U.S, Treasury Series EE 433,92 Savings Bonds due 1/1/2010 $100 U,S, Treasury Series EE 144,64 Savings Bonds due 2/1/2010 .3. I , . , $400 U.S, Treasury Series EE Savings Bonds due 1/1/2015 $200 U,S, Treasury Series EE Savings Bonds due ,10/1/2016 $2,000 U,S. Treasury Series EE Savings Bonds due 1/1/99 $400 U,S. Treasury Series EE Savings Bonds due 5/1/99 $500 U.S, Treasury Series EE Savings Bonds due 6/1/95 $500 U.S. Treasury Series EE Savings Bonds due 1/1/2016 $500 U,S. Treasury Series EE Savings Bonds due 5/1/2000 $2,000 U,S. Treasury Series EE Savings Bonds due 3/1/2014 $6,000 U,S. Treasury Series EE Savings Bonds due 9/1/99 $1,000 U.S. Treasury Series H Savings Bonds 7,5' due 8/1/95 $1,500 U,S. Treasury Series H Savings Bonds 7,5' due 9/1/95' $2,000 U,S, Treasury Series H Savings Bonds 4' due 8/1/2003 $2,000 U,S, Treasury Series H Savings Bonds 4' due 7/1/2003 $1,000 U,S. Treasury Series H Savings Bonds 7,5' due 8/1/95 $1,000 U,S. Treasury Series H Savings Bonds 7,5' due 9/1/95 $3,000 U,S. Treasury Series HH Savings Bonds 7,5' due 12/1/2005 $1,000 U,S. Treasury Series HH Savings Bonds 7,5' due 4/1/2006 $200 U.S. Treasury Series EE Savings Bonda due 11/1/2012 .5. 1&~I~~1Jf.(;l-;',i;H8AUStll~-\'I;.qr.;.\dl . '" f' . ",- "" ,'"'' . '",. "1-"'" 360,48 161. 44 1,489,60 288,16 1134.40 418,60 322.80 1,940,00 4,322,40 1, 000 , 00 1,500,00 2,000,00 2,000.00 1 ,000 , 00 1 , 000 , 00 3,000,00 1,000,(1'1 , 213.92 ,; " 1994.12.22 Vanguard Wellington Fund Inc. 69,32 . Capital Goins Dividend 1995.01.10 Transfer from Income . Income 2,741.86 Cash Ba1anoe ............... 29,051. 02 Stocks/Listed: 1993.05.28 1804,219 sharss Wellington 35,001,85 Fund Inc. ................ 35,001,85 Bonds: 1994.10.26 Received $80,000 U,S. Treasury 80,000,00 Suries HH Savings Bonds 4' due ........................ .. 9/1/2024 in exchange of Series E & EE Blmds 80,000.00 Adjustment to Carrying Value to Date of Death I 1994.11.01 Ameriteoh.Corp 1994.11.01 ~nerican To1ephons & Telegraph Co. 2,290,75 (1,114.06) 1994.11.01 Pennsylvania Power & Light Co, 1994.11.01 Vanguard .We11ington Fund Inc. ,(1,675,00) (994.50) 365.77 ............. . (1,127.04) 1994.11.01 Exxon Corp, Total Receipts of Prinoipa1 412,046,93 - " i ,. " . " " .9. .<....." ,.,.'-"ro,t)'d;\' f,j<--- !1I,; , , ..,...-___ _"'_..11...... ........ ....'.., ,'_..~..,~..-.. ,.....-,~ ~ . GAINS AND IDSSES ON SALES OR OTHER DISPOSITIONS/PRINOIPAL Gain Loss 1993-06-11 .219 share Vanguard Wellington Fund Inc, Net Proceeds 4./13 . Fid. Acq. Vslue 4,25 .0.18 0,00 1993-12-16 $5,000 Dauphin Deposit Bank & Trust Co, Certificate of Deposit 5% due 12/16/93 Net Proceeds 5,000,00 Fid, Acq. Value 5,000,00 , 0,00 , 0.00 1994-01-10 $20,000 Dauphin Deposit Bank & Trust Co, Certificate of Deposit 6.7% due 1/8/94 Net Proceeds 20,000,00 Fid. Acq, Value 20,000,00 0,00 0,00 1994-09-02 194 units Fixed Income Collective Investment Fund Net Proceeds 2,002,04 Fid. Acq, Value 2,118,78 0.0.0 116.,74 , 1994.09.21 ,134 share Vanguard Wellington Fund Inc. Net Proceeds 2,73 Fid. Acq, Value 2,62 0,11 0,00 , , , , 1994.10.14 $5,000 Harris Savings Assn, Certificate of Deposit 6.54%. due 10/8/94 Net Proceeds 5,000,00 Fid. Acq, Value 5,000.00 0.00 0,00 19~4.11.03 4,383 units Fixed Income Colleotive Investment Fund Not Proceods 44,096,27 Fid, Acq. Value 47,869,02 0,00.. 3,772.75 -10. ,. I ~ ;(' ". 'I" , J. to"~ \' I ~ , " " 'i' " I' " I .' 1994-12.01 1,1 (I: " !' 1\" Ii" , " " , ,. "I ," -I ;, $1,000 ij,S, Treasury Sedes 11\1 Savings Bonds 4' due 10/1/2013 Net prooeeds Fid, Aoq. Value 1,.000 , 00 1,000 , 00 Total Gaina and 1.osses/Prinoipl1 Less Loss ,Net Loss , 1 ,. ,. I' ,. " ',t " , " ,. 'E"i " " ,. ',ji i., , " I' " ,. ,I " " q' ',; ,lj " ,.I!l \" ,. I'" "II' 1\ " " j " ',j I'" ,I , , I'" I'J ',. ," ?.' 'I, II' , I" ,I '. ,. , " ,. , - ~ , ; ,(. " , .11. I' ,. I' , I., '. 0,00. 0,29.. 3,889,49 .................. (3/889,20) --------- , ,. ,. }-" ii' n\ '" ;11;' " " , , .."', ,( ,0.00', i' 3,889,49 ", j " .' " DISBURSEMENTS OF PRINCIPAL General Disbursements: 1993-06-29 Transfer to Income 500,00 1993-06-30 Transfer to Income 500.00 1993.08-05 Transfer to Income 1,000,00 1993-06-11 Transfer to Income 5,000,00 1993.09-09 Transfer to Income 1,000,00 1993-10-07 Transfer to Income 1,000,00 1993-J.1-09 Transfer to Income 1,000.00 1993-12-06 Trantier to Income 955,36 I 1993.12-27 Transfer to Income 40,12 1994-01-05 Transfer to Income 3,000,00 1994-03-08 Transfer to Income 2,000,00 1994-04-07 Transfer to Income 1,,000,00 1994-04.29 Transfer to Income 1,000, 00. 1994-05-05 'transfer to Income 2;000.00 1994-06-06 Transfer to Income 1,000,00 1994-07-08 Transfer to Income 1,000,00 1994-07-27 Transfer to Income .200,00 1994-07-29 Transfer to Income 460,56 1994-08-05 Tuns fer to Income 900.00 1994-09-08 Transfer to Income 2,000.00 1994-10-14 Transfer to Income 3,600,00 1994-10-21 Exchanged $17,100 U,S, 43,466.59 Treasury Series E Savings Bonds due 12/1/2008 for Series ,I HH Bonds 1994-10-21 Exchanged $300 U.S, Treasury 433,92 Series EE Savings Bonds due 1/1/2010 for Series HH Bonds -12- 1994-10-21 Exchanged $100 U,S. Treasury 120,76 'Series EE Ssvings Bonds due 11/1/2011 for Series HH Bonds " .1994.10.21 Exchanged $100 U.S. Treasury . 120,76 Series EE Savings Bonds due 1/1/2012 for Series HHBonds " 1994-10.21 Exchanged $700 U,S, Treasury 855,80 Series EE Savinga Bonds due !l 4/1/2012 for Serios HH Bonds ,I" 1994.10-21 Exchanged $400 U,S, Treasury 468,96 " Series EE Savings Bonds due ,'. 6/1/2012 for Series HB Borlds 1994.10.21 Exchanged $200 U.S. Treasury' 234,48 Serios EE Ssvings Bonds due . '. 10/1/2012 for Series HB Bonds " 19~4-10.21 Exchanged $200 U,S, Treasury 213,92 'Series EE Savings Bonds due ,1 " 11/1/2012 for Series HH ,Bonds , '199L.-10-21 Exchanged $400 U,S, Treasury 427,84 " , Series EE Savings Bonds due ' 2/1/2013 for Series HH Bonds " 1994.10-21 Exchanged $500 U.S. Treasury : 548. 60 " Series EE Savings Bonds due 4/1/2013 for Series HH Bonds 1994.10-21 Exchanged $200 U,S, Treasury 201.2~ 1 . Series EE Savings Bonds due 7/1/2013 for Saries HH Bonds " . 1:994.10-21 Exchanged $200 tJ. S .1'reasury 1911.00 ,. 'I " , , " "I , " Series EE Savings Bonds due , 12/1/2013 for Series HH Bonds It I'" " " 1994-10.21 Exchanged $2,200 U,S, Treasury 2,134,00 Series EE Savings Bonds due 3/1/2014 for Series HH Bonds " 1994-10.21 Exchanged $2,000 U,!;, Treasury . l,!l08,8o Series EE Savings Bonds due : . ,. I. 4/1/2014 for Series HH Bonds 1994.10-21 Exchanged $200 U.S, Treasury i87,04 Series EE Savingo Bonds due 5/1/2014, for Series HH Bonds 1994-10-21 Exchanged $200 U.S. Treasury 187,04 'I Series EE Savings Bonds due 7/1/2014 for Series HH Bonds. -14- ,. \ " , , , , , 1994-10-2'1 Exohanged $200 U,S, Treaeury 187,04 Series EE Savings Bonds due 8/1/2014 for Series 1111 Bonds " 1994-10-21 Exchanged $4,200 U,S. Treasury 3,785.04 Serles EE Savings Bonds due 11/1/2014 for Series 1111 Bonds 1991+-10-21 Exchanged $400 U.S, Troasury 360,48 Series EE Savings Bonds due 1/1/2015 for Series IIH Bonds 1994-10-21 Exchanged $500 U,S, Treasury 434,40 " Series EE Savings Bonds due " 6/1/95 for Series 1111 Bonds 1994-10-21 Exchanged $500 U,S, Treasury 418,60 Series EE Savings Bonds due 1/1/2016 for Series 1111 Bonds 1994-10-21 Exchanged $4,000 U,S, Treasury 3,348,80 Series EE Savings Bonds due 3/1/96 for Series 1111 Bonds 1994-10-21 Exchanged $400 U.S. Treasury 3~2,88 Series EE Savings Bonds duo 8/1/96 for Series 1111 Bonds , 1994.10-21 Exohanged $400 U,S, Treasury 322.88 ' , . Series EE Savings Bonds due 9/1/96 for Series 1111 Bonds , 1994-10-21 Exohanged $200 U.S. Treasury 161.~4 I,.; Series EE Savings Bonds due 10/1/2016 for Series IIH Bonds 1.994.10- 21 Exchanged $2,000 U,S. Treasury 1,409,60 ,., Series EE Savings Bonds due 1/1/99 for Series 1111 Bonds ". 1994-10.21 Exohanged $400 U.S, Treasury 288,16 I Series EE Savings Bonds due 5/1/99 for Series 1111 Bonds 1994-10-21 Exchanged $6,000 U,S, Treasury 4,322,40 Series EE Savings Bonds due 9/1/99 for Series HIl Bonds 1994-10-21 Exchanged $500 U,S, Treasury 322,80 ., Series EE Savings Bonds due 5/1/2000 for Series 1111 Bonds 1994-10-21 Exchanged $2,000 U,S, Treasury 1,047.20, Seriee EE Savings Bonds due 2/1/2004 for Series IIH Bonds -15- 'I; ,. ,. " " " , , " " .1994.10-21 .Exohanged $1,000 U,S, Treaaury Series EE Savings Bonds due 3/1/2004 for Series HH Bonds \! . I' ".. ,. 011' d .. " 1994-12.01 1995-01.10 i' " ,. 't"" ,1,'0, I' " Dauphin Depo~it Bank and Trust Co, Commission to Date of DlIath Dauphin Deposit Bank and Trust Co. TerminAtion Fee . 5,21: 6'0 330,28 .............. 1,000,,00 Total Disbursements of Pdncipa1 ,. , 1 , f\ ,. , , , , , , '.", , , I ',I \ " ,. '1 , , II , " h' , " , ,I I' /, ,.(' ,,11: I'J' 'f" I' " " , " Ii "'1 '16-. " " , ~ ~ I,' , ," I,i " " ',! , " ',' '." 103,759,15 ..........,...... 103,759,15 ---....~ I'". , , " I' 'j " " - (.} '" 'i'. I! "I " ., 19.94-11-09 John ~, Slike, Exocutor of 1,000,00 Helen M. Skivington Estnto $1,000 U,S, Treasury Series H Savings Bonds 6' due 5/1/2001 19911-11-09 John E, Stike, Exocutor of 2,000,00 Helen M, Skivington Estate $2,000 U,S, Treesury Series H Savings Bonds 4' due 7/1/2003 1994-11-09 John E, Slike, Executor of 2,000,00 Helen M, Skivington Estate . $2,000 U,S, Treasury Series H Savings Bonds 4' due 8/1/2003 1994-11-09 John E, Slike, Executor of 2,000,00 Helen M. Skivington Estate . $2,000 U,S. Treasury Series H Savings Bonds 4' due 9/1/2003 1994-11-09 John E. Slike, Executor of 2,000,00 Helen M, Skiving ton Estate - $2,000 \J, S, Treasury Series H Savingo Bonds 4' due 10/1/2003 1994-11-09 John E, Slike, Exocutor of 1,500,00 Helen M, Skivington Estate - $1,500 U,S, Treasury Series H Savings Bonds 4' due 11/1/2003 1994-11-09 John E, Slike, Executor of 80,000,00 Helen M. Skivington Estate $80,000 \l.S, Treasury Series HH Savings Bonds 4' due 9/1/2014 1995-01.10 John E. Stike, Executor of 28,029.22 Helen M. Skivington Estate Principal Caah Balance 1995-02.08 John E, Slike, Executor of 36,890,00 Helen M, Skivington Estate 952 shares Ameritech Corp, 1995.02.08 John E. Slike, Executor of 11,995,94 Helen M. Skivington Estate 230 shares American Telephone' & Telegraph Co. 1995-02-08 John E, Slike, Executor of ,23,350,00. Helen M. Skiving ton Estate 400 shares Exxon Corp. 1995-02.08 John E. Slike, Executor of 2,060,50 Helen M. Skivington Estate 104 shares Pennsylvania Power & Light Co. -18- , , " \' " , , , ' " " !. 19'95- 02-08 " '\'1' , , I." I': 1'1. "~Iii " I, " , .,~ , ','"~ , " " ,. ., /. I'. ';1 " ': " John E. Slike, Executor of Helen M. Skivington Estate 2,311 shares Vanguard Wellington Fund Inc, Total, Distributions of Prlncipal " .' , I" I " II' l " 'I" " I< " ,. " " " : " I ,. I' " , :\f " ,. " " , " " ,. I " '/1. " " " " " pI , " " ,. ;"J , " ,. 'I " /' ,.'1' '",' " " " " ",' ,. ,I' " ,I I" ,. .19- " ., , ". , , " II", " (I '" I , ';, I.,' '" , I l II .1" " 45,572,92 I". ", , , " , , " , " ;1, i" " , " - \. p .-':,. I,"! 'i, !I' "d ,""I " I,' 'j, I, , , " I' " 304,398.58 304,398.58 I, , 1 1 ,'OJ , , ~ I , "i, ". , " ,. I '" " (, 'I 1",/ 1 l " I; ,. l' " ,. " ,t" l' I, .., ,I, INFORMATION SCHEDULES--PRINCIPAL Investments Made: 1993-05.05 1,816 units Fixed Income 19,99},43 Collective Investment Fund 1993-07.06 906 units Fixed Income '9,997,93 Collective Investment Fund 1993-01-19 17,977 sharee Vanguard 360,80 Wellington Fund Inc, 1993-07-19 48.102 shares Vanguard 9.65,40 Wellington Fund Inc, '; , 1993-10-26 47.093 shares Vanguard 965,40 Wellington Fund Inc. 1993-10-26 18,245 shares Vanguard 374,02. , Wellington Fund Inc, 1994-02-03 908 units Fixed IncoMe 9,997.98 Collective Investment Fund 1994.04-04 107.5 shares Vanguard 2;163.97 Wellington Fund Inc. 1994-04-04 26.875 shares Vanguard 540:99 Wellington Fund Inc. 1994.04-04 100,781 shares Vanguard 2,028,73 Wellington Fund Inc, 1994-04-05 947 units Fixed Inc~me 9,994,46 Collective Investment Fund. 1994-04-07 68,18 shares Vanguard 1,399.~1 Wellington Fund Inc, I' 1994.-07-05 72,381 shares Vanguard 1,413,35 Wellington Fund Inc. Changes in Investment Holdings: 1993-10.04 Delivered $1,000 U.S. Treasury (1,000,00) Series H Savings Bonds 7,5' due 10/1/93 in exchange for $1,000 U.S. Treasury Series HH Savings Bonds 4' due 10/1/2013 1994.01-24 476 shares Ameritech Corp 0,00 2-for-1 stock split -21. , . 1994~05-06 American Telephone & Tehgraph 75,90 Co, 1994-06-10 Exxon Corp. 288,00 1994-07-05 Vanguard Wellington Fund Inc, 1,413,35 1994-07.07 Pennsylvania Power & Light Co, 43,42 1994.08-01 Arneritech Corp .456.96 1994-08,01 American Telephone & Telegraph 75.90. Co, 1994.09-12 Exxon Corp, 288,00 1994-10-03 Pennsylvania Power & Light Co, 43,42 1994-10-04 Vanguard Wellington Fund Inc. 1,427,60 1994-11.01 Ameritech Corp 456,96 1994-11-01 American Telephone & Telegraph 75,90 Co, 1994-12-12 Exxon Corp, 300,00 1994-12-22 Vanguard Wellington Fund Inc. 1,998,64 1994-12-22 Vanguard Wellington Fund Inc. 144.81 - Capital Gains Dividend 1995-01-03 Pennsylvania Power & Light Co, 43,42 1995.02-01 Ameritech Corp 476,00 1995.02-01 Almerican Telephone & Telegraph 75,90 Co, ~ .. .. .. .. .. .. .. .. .. .. .. .. 17,431,56 Interest: 1993-04-14 Dauphin Deposit Bank and Trust 294,36 Co, - Savings Account 1993.05-03 Capital Reserve Account 29,73 1993-05-21 Harris Savings Assn, . Savings 199,70 Account 1993-06-01 Capital Reeerve Account 23,00 1993-06-03 $5,000 Harris Savings Aesn. 23,62 Certificate of Depoeit 6.54% due 10/8/94 -24- , I ,. 1993-07.01 Capital Reserve Acoount 41.88 . 1993-07-01 $5,000 Harris Savings Assn. 27,25 Certificate of Deposit 6.54' due 10/8/94 1993-08.03 Capitn1 Reserve Aooount 20.76 1993-08.03 $5,000 Harris Savingo Assn. 27,25 Certificate of Deposit 6.54' due 10/8/94 1993.09.02 Capital Reserve Account 20,28 1993.09-02 $5,000 Harris Savings Asan. 27.25 Certificate of Deposit 6,54' due 10/8/94 1993.09.03 $2,500 U,S, Treasury Series H 93.75 Savinl\s Bonds 7,5' due 9/1/95 1993.09-03 $2,000 U,S, Treasury Series H 75.00 Savings 80nds 4' due 9/1/2003 1993.10-01 $5,000 lIarris Savings Assll. 27.25 Cerci~icate of Deposit 6,54' due 10/8/94 1993-10-04 Capital Reserve Account 17.79 1993.10.12 $1,000 U.S. Treasury Series HH 37,50 Savings Bonds 7,5' duo 4/1/2006 1993-10-12 $2,000 U,S, Treasury Serios H 75,00 Savings Bonds 4' due 10/1/2003 1993-10-12 $1,000 U,S. Treasury Series H 37.50 Savings Bonds 7,5' due 10/1/93 1993-10-12 $1,000 U.S, Treasury Series II 37,50 Savings Bonds 7,5' due 10/1/95 1993.11-01 $5,000 Harris Savings Assn, 27,25 Cortificate of Deposit 6.54' due 10/8/94 1993.11.02 Capital Reserve Account 14.32 1993-11-02 $1,500 U,S, Treosury Series H 56.25 Savings Bonds 4' due 11/1/2003 1993-11.02 $1,000 U,S. Treasury Series H 30.00 Savings 80nds 6' due 5/1/2001 -25- , , 1994-04.01 $5,000 Harris Savings Assn. 27.25 Certificate of Deposit 6.54% due 10/8/94 1994.04.05 $1,000 U.S. Treasury Series HH 37.50 Savings Bonds 7,5% due 4/1/2006 1994-04-05 $2,000 U,S. Traasury Series H 40.00 Savings Bonds 4% due 10/1/2003 1994-04-05 $1,000 U.S, Treasury Series H 37.50 Savings Bonds 7,5% due 10/1/95 , 1994-04-25 $1,000 U.S. Treasury Series HH 20.00 Savings Bonds 4% due 10/1/2013 1994-05-03 Capital Reserve Account 20.14 1994.05-03 $5,000 Harris Savings Assn. 27.25 Certificate of Deposit 6.54% due 10/8/94 1994-05-05 $1,500 U,S. Treasury Series H 30.00 SavIngs Bonds 4% duo 11/1/2003 1994-05-05 $1,000 U,S, Treasury Series H 30.00 Savings Bonds 6% due 5/1/2001 1994-06-01 Capital Reserve Account 16.94 1994-06-02 $5,000 Harris Savings Assn. 27.25 Certificate of Deposit 6,54% due 10/8/94 1994-06-06 $3,000 U.S. Treasury Series HH 112.50 Savings Bonds 7,5% due 12/1/2005 1994-07-01 Capital Reserve Account 12.59 1994-07.01 $5,000 Harris Savings Assn. 27,25 Certificate of Deposit 6.54% due 10/8/94 1994-07-06 $2,000 U.S, Treasury Series H 40,00 Savings Bonds 4% due 7/1/2003 199/.-07 -06 $2,000 U,S, Treasury Series HH 60,00 Savings Bonds 6% due 1/1/2011 1994-07.06 $3,000 U.S. Treasury Series HH 112.50 Savings Bonds 7,5% due 1/1/2006 1994-08-02 Capital Reserve Account 9.12 -27- , I 1994.11.01 Capital Reserve Account 7,54 1994.11.02 $1,500 U.S, Treasury Series H 30,00 Savings Bonds 4' due 11/1/2003 1994.11.02 $1,000 U.S, Treasury Series H 30.00 Savings Bonds 6' due 5/1/2001 1994.12.01 Capital Reserve Account 89,83 1994.12.06 $3,000 U.S, Treasury Series HH 112,50 Savings Bonds 7.5' due 12/1/2005 1995.01.03 Capital Reserve Account 116.55 1995.01.11 $3,000 U.S. Treasury Series HH 112,50 Savings Bonds 7.5' due 1/1/2006 I, 1995.01.11 $2,000 U. S, Treasury Series HH 60,00 Savings Bonds 6' due 1/1/2011 1995.01.11 $2,000 U,S, Treasury Series H 40,00 , Savings Bonds 4' due 7/1/2003 1995.02.01 Capital Ruerve Account .5,5,32 1995.02.02 $2,000 U,S. Treasury Series H 40,00 Savings Bonds 4~ due 8/1/2003 1995.02.02 $2,000 U.S, Treasury Series H 75.00 Savings Bonds 7,5' due 8/1/95 1995.02.02 $1,500 U,S, Treasury Stiries HH 45.00 Savings Bonds 6' due 2/1/2010 1995.03.01 Capital Reserve Account 12.65 1995-03-08 $2,000 U,S, Treasury Series H 40.00 Savings Bond 4~ clue 9/1/2003 1995.03-08 $2,500 U.S, Treasury Series H 93.75 Savings Bond 7.5' due 9/1/95 1995.03.08 $80,000 U,S, Treasury Series HH 1,600,00 Sav1ngsBond 4' due 9/1/2014 1995.04.03 Capital Reserve Account 11,72 ........................ .. 6,424,lIO .29- , , ,1993-11-03 Fixed Income Collective 166.67 Investment Fund 1993-11-04 U, S, Treasury - Social 585..00 Security Benefits 1993-11-09 Transfer from Principal 1,000,00 1993-12-01 Commonwealth of Pennsylvania 697,92 Benefit Payment 1993-12-01 PEBTF Medical Reimhursement 225.09 1993.12-02 Fixed Income Collective 161.65 Inves tment Fund 1993-12-06 Transfer from Principal 955,36 1993-12-06 U. S. Treasury - Social 585,00 Security Benefits 1993-12-27 Transfer from Principal 40.12 1994-01-04 Commonwealth of Pennsylvania 697,92 Benefi t Payment 1994-01-05 Fixed Income Collective 163.63 Investment Fund 1994-01-05 Transfer from Principal 3,000.00 1994-01-05 U. S. Treasury - Social 597.00 Security Benefits 1994-02-02 Commonwealth of Pennsylvania 697.92 Benefit Payment 1994.02-03 Fixed Income Collective 165.31 Investment Fund 1994-02-08 U, S. Treasury - Social 597.00 Security Benefits 1994-03-02 Commonwealth of Pennsylvania 697,92 BeneH t Payment 1994-03-02 Fixed Income Collective 206,71 Investment Fund 1994-03-08 Transfer. from Principal 2,000.00 1994.03-08 U. S. Treasury - Social 597..00 Security Benefita 1994-04-01 Commonwealth of Pennsylvania 697,92 Benef! t Payment -31- .. 1994-07-29 Transfer from Principal 460.56 1994.08-02 Commonwealth of Pennsylvania 798,42 BeneH t Payment 1994-08-03 Fixed Income Collective ,259.86 Investment Fund 1994-08-05 Transfer from Principal 900,00 1994-08-05 U. 5, Treasury - Social 597.00 Security Benefits 1994-09-02 Commonwealth of Pennsylvania 798:42 Benefi t Payment 1994.09-02 Fixed Income Collective 255,34 ,1nves tment Fund 'I 1994-09.07 U, S, Treasury - Social 597,00 .( Security Benefits 1994-09-08 Transfer from Principal 2,000,00 ., ' 1994-09-14 AARP - Refund of duplicate 5,29, payment 1994-09-14 PEBTF - Medical Reimbursement 57,34 1994-10-04 Commonwealth of Pennsylvania 798,42 Benefit Payment 1994-10-04 Fixed Income Collective 239,31 Investment Fund 1994-10-04 PEBTF - Medical Reimbursement 9.48 1994-10-05 Sammons Communications - Cable 14.77 Refund 1994-10-06 U, S. Treasury - Social 59.7.00 Security Benefits 1994'10-14 Transfer from Principal 3,600.00 1994-11-01 Vanguard Wellington Fund Inc. 1,544,64 - Adjustment of carrying value to date of death 1994-11-02 Commonwealth of Pennsylvania 798,4? Benefit Payment 1994-11-03 Fixed Income Collective . 241,72 Investment Fund -33- , , ,. . , OAINS AND LOSSES ON SALE~ OR OTHER DISPOSITIONS/INCOME Oain' 'Loss " 1993-06-11 ,396 share Vanguard Wellington . . FUnd Inc, " Net Prooeeds Fid, Aoq, Value 8,00 7,68 0.32 0,00 Total .Oains and LosRss/Incom~ Lass Loss 0,32: 0,00 0,00' Net Oain 0,32 ----.....- , ,. I'.; ." I , " , I' ": , " " .. ,. " " \, ," , ,,, ., , " " ,. ;"1 " " " \, , " ,. ,I',' " .. '" ,: , " I, I, " " I' " ,. I I!'! , "I' " " , " " " ., " '.'! ,,' i' I, , , " "i I " I.' " ,)' ,. i' " " " ,. " " " '" ,. " '" " , 'I, '1\' , ", I " .. " " I I , I I, , , " " " " " , Ii, ., I. ,. " , I, " ,. " , ., " , Ii ", ,I' , ",. , ,,' i" .. .. . " " ,. "II " ,. ',', I, " , " , I ,I' " " -35- 1993-09-07 PA Department of Revenu. - 100.0Cl 1993 3rd Quarter Estimated Personal Income Tax 1993-09-14 Bell of Pennsylvania 1. 72 Telephone Expense 1993-09-14 Haar's Inc, - Commission from 87,95 sale of household merchandise 1993-09-27 AMP - Medical Expense 81,25 . 199:l-09-28 Dauphin Deposit Bank and Trust 296,93 Co. - CommIssion 1993-10-06 Country Meadows of West Shore 2,297.79 - Convalescent Home Expense 1993-10-14 Bell of Pennsylvania 13.12 Telephone Expense 1993-10-25 AMP - Medical Expense 81. 25 1993-10-26 Dauphin Deposit Bank and Trust 254,43 Co. - Commission ," 1993-l0~26 Transfer to Principal 965.40 1993-11-08 Country Meadows of West Shore ,2,242,48 - Convalescent Home Expense 1993-11-15 Bell of Pennsylvania 13,12 Telephone Expense 1993-11-26 AMP - Medical Expense 81,25 1993-11-26 Dauphin Deposit Bank and Trust 325,44 Co. - Commission 1993.12-03 Country Meadows of West Shore 2,242.61 - Convalescent Home Expense ,: 1993.12-10 Bell of Pennsylvania _ 13,12 Telephone Expense 1993-12-23 PA Department of Revenue 100,00 . I 1993 4th Quarter Estimated ,. Personal Income Tax 1993-12-24 Internal Revenue Service .800,00 i ,. 1993 4th Quarter Estimated I Personal Income Tax I"' . I 1993.12-27 AMP - Medical Expense 81,25 I, I -37- 1993-12.28 Dauphin Deposit Bank and TruDt 291,18 Co, - Commlss ion 1994-01-04 Country Meadows of West Shore 2,310.29 - Convalescent Home Expense 1994-01-12 Bell of Pennsy1vanill - 13,12 Telephone Expense 1994-01-25 AARP . Medical Expense 81.25 1994-01-26 Dauphin Deposit Bank and Trust 306;01 Co, - Commission 1994-01-31 Dauphin Deposit Bank and Trust 28.10 Co, . Fee for safe deposit box rental 1994-02-09 Country Meadows of West Shore 2,247.85 - Convalescent Home Expense 1994 -02 .14 Bell of Pennsylvania . 13.12 Telephone Expense 1994-02-24 Dauphin Deposit Bank and Trust 308,87 Co. - Commiss iOIl 1994-02.25 AARP . Medical Expense 81. 25 1994-03-04 Country Meadows of West Shore 2,239.36 - Convalescent Home Expense 1994-03-11 Bell of Pennsylvania - 13.12 Telephone Expense 1994-03.25 AARP . Medical Expense 81.25 1994-03.28 Dauphin Deposit Bank and Trust 279.41 Co. . Commiss ion 1994-03-30 H 60 R Block Inc. - 1993 Personal 75.00 Income Tax Preparation Fee 1994-04-04 Transfer to Principal 2,163,97 1994.04.05 Country Meadows of West Shore 2,283..70 . Convalescent Home Expense 1994-04-07 Transfer to Principal 1,399.51 1994-04-12 Inter.nal Revenue Service 650.00 1994 1st Quarter Estimated Personal Income Tax .38. , ' ,~994-04-12 PA Department of Revenue - 80,00 1994 1st Quarter Estimated Personal Income Tax 1994-04.14 Bell of Pennsylvania 13,12 Telephone Expense 1994-04-25 AARP . Medicnl Expense 81. 25 1994-04.26 Dauphin Deposit BanI: and 'rrust 479.10 Co. . Commission 1994-05-04 Country Meadows of West Shore 2,387.6~ - Convalescent Home Expense 1994-05-10 Bell of Pennsylvania 13.12 Telephone Expense 1994-05.25 AARP - Medical Expense 81,25 1994-05.26 Dauphin Deposit Bank and Trust 323,10 Co, . Commission 1994-06.02 Country Meadows of West Shora 2,289,23 - Convalescent Home Expense 1994-06-07 Internal Revenue Service . 650,00 1994 2nd Quarter Estimated Personal Income Tax '1994 - 06 - 07 PA Department of Revenue 80,00 1994 2nd Quarter Estimated , Personal Income Tax " 1994-06.10 Bell of Pennsylvania 13,12 Telephone Expense 1994.06-27 AARP - Medical Expense 81. 25 1991,-06-27 Dauphin Deposit Bank and Trust 315,61 Co, - Commission 1994-06-28 Dauphin Deposit Bank and Trust 125,00. " Co, - 1993 Fiduciary Tax Preparation Fee 1994-07-05 Transf.er to Principal 1,413,35 1994.07-07 Country Meadows of West Shore 2',343,22 " - Convalescent Home Expense ,1994-07-12 Bell of Pennsylvania - 13,16 Telephone Expense , 1994-07-25 MRP - Medioal Expense 81,25 -39- "\' .. ~ , '. ,I: ':1 ,,' 19!}/,.11.25 Dauphin Deposit Bank and Trust 238.61 Co, .' Commission 1994.11.25 Transfer to Principal 241.72 1994.12.01 Dauphin Deposit Bank and Trust 8,17 Co. - Commission from 10/19 to 10/25/94 ,1994.12-27 Dauphin Depoait Bank and Trust 348.82 Co, . Commission 1995.01-10 Transfer to Principal 2,741.86 1995.01.26 Dauphin Deposit Bank and Trust 181. 68 Co, . Commission 1995'02.23 Dauphin Deposit Bank and Trust 52.46 Co, . Commission 1995.02.27 State Employee's Retirement 1,916,16 System . Reimbursement for Payment made after Date of Death 1995.03.28 Dauphin Deposit Bank and Trust Co, - Commission , 101,31 Total Disbursements of Income . , ,. I' " iJ,' " " " " ' " ':" '" ,. .41. . " '.' ,j,{\,.,~,'Jjit'ii~itoJl~iM~;.(i4.IW~l.i!ii'4'I.,\,,"*,H,"'" ..rtiltll. .,1",1 1'l'f . . ..,,, 66,915,87 66,915,87 ...--- " '.1. I, ,. , " '! , '\i ,. , , DISTRIBUTIONS OF INCOME TO BENEFICIARIES 1993-04-30 Helen M. Skiving ton - Income 148,55 Di'stribution 1993.05-28 Helen M, Skiving ton - Income 467,20 Distribution 1993-06-30 Helen M. Skivington - Income 500, 00 Distribution 1993-07.30 Helen M, Skivington - Income 500.00 Distribution 1993-08-31 He10n M, Skiving ton - Income 500 . 00 Distribution 1993.09-30 Helen M. Skivington - Income 500,00 Distribution 1993-10-29 Helen M, Skivington - Income 500 , 00 Distribution 1993-11.30 Helen M. Skivington . Income '500.00 Distribution 1993-12.31 Helen M, Skiving ton - Income 500 , 00 Distribution 1994 - 01- 31 Helen M. Skiving ton . Income 500,00 Distribution 1994-02-22 Helon M, Skivington . Income 200,00 Distribution 1994-02-28 Helen M. Skiving ton - Income 500,00 Distribution 1994.03.31 Helen M, Skivington . Income 500.00 " Distribution 1994-04.25 Helen M. Skivington . Income 200,00 Distribution 1994-04-29 Helen M, Skivington . Income '500.06 Distribution 1994-05.31 Helen M. Skivington . Income 500 . 00 Distribution 1994.06.30 Helen M. Skiving ton . Income 500.00 Distribution 1994.07-29 Helen M, Skivington . Income 500.00 Distrib'ltion .42. 1\ (,' 1',1 , ,. ,'.' II ',1'\ ,. 1,1, ''i. "I I, ," ", " " , Ii 1\ 1994-08-31 Holen M, Skivington Distribution 1995-02-08 1995-04-03 ,,' ',I, ., " '! " \ i" ,i 1'" " :'" ',I " ',I, / " " '" , II.. ",:'P,; "i "'f'l h, Inoome John E, Slike, Executor of Helen M, Skivington Estate 4,827 shares Vanguard Wellington Fund Inc, 95,188.44 Helen M, Skiving ton Eotate Balanoe of Income Cash to, Date 2,8111 .49 .....oo............oooo .. Total Distributions of Income I, 'i,' , I, '" I" ., 'I' ,,',. 'i I'! il. " ,I, I> , ", ,. I'n I " d ., i'i" , " , 11 ,: I'; i\_.. " , ,. . ,I " " /, ,Ii '" " " I' .' , I , , " "I' " , , , , "j) " 'i , " I.' i{ .. ''.! i'i. " ,. ,. , .. '" ',. " " , , ',/,1 ',. \1 " ,., ", -43-' 500.00 " ,. .,' " " 106,585,68 ....................... .. 106,585.68 ,----.---, l'i , '. " '. " '" ,. , . '1(' I, ,I,' ,,'I , , \", ',ll"; :d , , I. , ,. ,. , ,. ,'.'j, " " ': " I" .' " , , ., /, I', i,:i ., , ' " I: ,.".( '\ " d', . \ .. . " INCOME BALANCE ON HAND 'il " Cash: .-. ':'. '" , Uninvested Oapi tal Reserve.. 'Account Current Value 04/05/95 ..1........ 0,00 0,00 Fiduciary Acquisition Value 0.00 0,00 0,00 0.00 ----*------- -----~---- , " " " " , " I'", , ,,' , , ", ,. " ". , ,',If>, , .' " ,.1 ,. , , , " ,. " \\\ " 'I . : .t, ". " , ., " ,. , ,/i I , , , .' ,. [ .' ; , ~ . 1 , .. , ", ,. ,. " " ". ',., '" " I.' , If " " " ", ,. " , , \ , , ,. , .. , , , , , '. , , ;' . " " \, , " \' , " ,: ,. " " '\ " " 1"\ "Ii " , " , , I'"~ ,I. .. I ~ 'i, ,. , ,> '" " jJ- ~. I I ,; ,. " ,. I," ,. "" ,; ,. , I' I ." "" " 'I:' I' d.:!.!, .. \ Ii 'I!; " :'" " " " " " " 'j" . "1 i',I' ,..,' " , , ['" '.. 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" Ii ' .' ~ , I ~ !f6 JI Ii . ~i ii" ~1&jS; ~ W hi I ~ i f~ihu I 'C ~~ J If, I I 8 , , , , " '," , , ,. , ; " " , I,', , , R.i... 't) ='S~'&lL~15:Sc( , ,.' "\' ;-I'" ~:i:'i; , \-Cd": .:1'11" [....'\.'., ft/,', I"l' I), ", , ,1,<') I 4~'r1J:;~! ,I '," ; I t,l//! ,"_"i,\l, I~J'L.rr',',,: ,1~\:Ji!.r '.,' j ,.' ,1V{"! Illtl~\;~IJ'._,,:t(,.,: '," ,-."/. d'--/I! ';..,,'; ,. -.... ,'(.' ,~;,-I~,:/ ,,' 'j,!!'" ,; "," \. ...j"},', .... '-, . "')"1''-1,1,'-.,' ;';' l 'it;\f""~ I"'j ,I'l'! " if':-'d "," I" Ill, I; " II' , "~I I' .. ,. ., -,i-,J \ .. , , 11.' , ' ,,' , " , , ,- Pi .-" ,., ,. J~U i~~~ J~f'R !IJ tE~ M~~~ un ~~u H~f'f' if ~E ~ h , \ .il ," ' , \, ',I h 1 .. ~. ,:-. ,I. , I', '_,\,1d! './ " "'-~''',.' ".j ,.!lI'