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Home My WebLink About03-23-07 (3) REV-1500 EX. 16-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -0 6 0 6 2 0 COUNTY"OOi5E ~Ar- - - NUMBER- - '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 SOCIAL SECURITY NUMBER 2 7 0 - 0 3 - 1 287 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- ~:$en uo::~ w 15u J: 0::9 u&llI < DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ z w c w u w c Anderson Ruth L DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) D 3. Remainder Retum (date of death pnor to 12-13-82i [XJ 5. Federal Estate Tax Return Required .f.. 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0; 6/28/2006 11/12/1913 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C Z o ll. en W 0:: 0:: o U THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS David H. Stone Es uire 414 Bridge Street FIRM NAME (If Applicable) Stone La Faver & Shekletski TELEPHONE NUMBER 717 774-7435 New Cumberland PA 17070- 1 Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) [XJ 1. Original Return D 4. Limited Estate [XJ 6. Decedent Died Testate (Allach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Retum D 4a. Future Interest Compromise (dale of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Allach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) z o i= <( ..J :J !:: a. <( u w 0:: z o i= <( ~ :J a. :!E o u >< <( ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) O~~tCIAL USE ONLY 2,831,299i~O ~~~~c__ :D .,-) -;? .r'~'-' (8) .. ._~-c.,. !'0 W -r1 0.00 X _(15) 0.00 3,264,504.54 X .045 (16) 146,902.70 0.00 X .12 (17) 0.00 35,000.00 X 15 (18) 5,250.00 (19) 152,152.70 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (6) (7) 640,006.13 c/) 10,117.68 --:: w 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (10) 1,285,022.34 4,766,445.75 99,082.65 6,560.48 (11) (12) (13) 105,643.13 4,660,802.62 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13 Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) (14) 4,660,802.62 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18 Amount of Line 14 taxable at collateral rate 19 Tax Due 20 D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 729 Oak Oval CITY Mechanicsburg I STATE PA I ZIP 17055- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 152,152.70 140.000.00 7.368.42 3. InterestJPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 147,368.42 TotallnterestJPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 4,784.28 4,784.28 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ................................................,.......................... D 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ D 00 c. retain a reversionary interest; or ...................................................................................................... D 00 d. receive the promise for life of either payments, benefits or care? ................................................ ............. D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?................................................................................................ D 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 00 D E QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS 41 et New Cumberland SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ned th' return, including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct and complete. ent ti is based on all information of which preparer has any knowledge. RING RETURN DATE 3 - 2.3.\,? PA 17070 DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent. or a stepparent of the child is 0% [72 PS. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)( 1 )]. The tax rate Imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX + (6-98) '* SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anderson. Ruth. L ITEM NUMBER 1. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 FILE NUMBER 21 06 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0620 VALUE AT DATE OF DEATH 19,645.80 25,449.50 6,122.00 45,084.00 88,687.50 27,471.36 44,394.00 24,299.50 24,675.75 22,120.00 11,039.30 14,256.30 140,584.00 22,724.00 409,313.99 35,544.96 DESCRIPTION 20000 shares Citigroup/Smith Barney-Allegheny Cnty PA Res 3.5% @ $0.98 each Due 11/01/13 25000 shares Citigroup/Smith Barney-Allegheny CO PA 5.25% @ $1.02 each Due 01/01/16 100 shares Citigroup/Smith Barney-Alltel Corp Delaware @ $61.22 each 800 shares Citigroup/Smith Barney-Apple Computer Inc @ $56.36 each 2500 shares Citigroup/Smith Barney-Bellsouth Corp @ $35.48 each 336 shares Citigroup/Smith Barney-Boeing Co @ $81.76 each 1200 shares Citigroup/Smith Barney-Campbell Soup Co @ $37.00 each 25000 shares Citigroup/Smith Barney-Carlisle PA SD 3.8% @ $0.97 each Due 09/01/14 25000 shares Citigroup/Smith Barney-Cecil Twp PA 3.75% @ $0.99 each Due 11/01/13 1000 shares Citigroup/Smith Barney-Citigroup Capital XI 6% @ $22.12 each 1093 shares Citigroup/Smith Barney-Columbia Federal Sec @ $10.10 each 15000 shares Citigroup/Smith Barney-Conewago SD PA 3% @ $0.95 each Due 09/01/11 1600 shares Citigroup/Smith Barney-Cooper Inds Ltd CI A @ $87.87 each 800 shares Citigroup/Smith Barney-Corn Products Inti @ $28.41 each 51681.06 shares Citigroup/Smith Barney-Delaware Tax Free PA @ $7.92 each 484 shares Citigroup/Smith Barney-Dominion Resources Inc @ $73.44 each TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,831,299.60 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Anderson, Ruth, L Decedent's Name Page 1 21 06 0620 File Number Schedule B - Stocks & Bonds ITEM NUMBER 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 DESCRIPTION 1200 shares Citigroup/Smith Barney-Eaton Corp @ $73.15 each VALUE AT DATE OF DEATH 87,780.00 40 shares Citigroup/Smith Barney-Embarq Corp @ $40.57 each 1,622.60 10000 shares Citigroup/Smith Barney-Erie Cnty PA Hasp 3.8% @ $0.98 each Due 11/01/11 9,843.20 30000 shares Citigroup/Smith Barney-Hempfield PA SD 3.45% @ $0.95 each Due 10/15/14 28,491.60 200 shares Citigroup/Smith Barney-Idacorp Inc @ $33.59 each 6,717.00 1400 shares Citigroup/Smith Barney-Ing Groep Nv 6.2% Pfd @ $23.13 each 32,375.00 1000 shares Citigroup/Smith Barney-JP Morgan Chase Cap 7.0% @ $24.82 each 24,815.00 3108.251 shares Citigroup/Smith Barney-LMP Core Plus Bd A @ $11.84 each 36,801.69 1472 shares Citigroup/Smith Barney-Meadwestvaco Corp @ $27.04 each 39,795.52 1000 shares Citigroup/Smith Barney-Metlife Inc 6.5% Pfd @ $24.33 each 24,330.00 107 shares Citigroup/Smith Barney-Newmont Mining Corp @ $49.24 each 5,268.15 25000 shares Citigroup/Smith Barney-PA Hsg Fin Agency 4.0% @ $0.98 each Due 10/01/12 24,431.00 25000 shares Citigroup/Smith Barney-Pittsburgh PA SD 5.5% @ $1.00 each Due 09/01/06 25,071.25 1200 shares Citigroup/Smith Barney-PPL Corp @ $31.53 each 37,830.00 12800 shares Citigroup/Smith Barney-Procter & Gamble Co @ $55.76 each 713,728.00 SUBTOTAL SCHEDULE B 1,098,900.01 Continuation of REV.1500 Inheritance Tax Return Resident Decedent Anderson, Ruth, L Decedent's Name Page 2 21 06 0620 File Number Schedule B . Stocks & Bonds ITEM NUMBER 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 DESCRIPTION 1000 shares Citigroup/Smith Barney-Public Service Ent Grp @ $65.81 each VALUE AT DATE OF DEATH 65,805.00 2120.457 shares Citigroup/Smith Barney-Putnam Tax Free High Inc @ $12.86 each 27,269.08 777.605 shares Citigroup/Smith Barney-Putnam Tax Free Inc Tr @ $12.88 each 10,015.55 128 shares Citigroup/Smith Barney-Smucker J M Co New @ $44.98 each 5,756.80 800 shares Citigroup/Smith Barney-Sprint Nextel Corp @ $19.64 each 15,708.00 3960 shares Citigroup/Smith Barney-US Bancorp Del New @ $30.80 each 121,948.20 798 shares Citigroup/Smith Barney-Van Kampen Govmt Secs @ $9.89 each 7,892.22 2100 shares Citigroup/Smith Barney-Verizon Communications @ $32.68 each 68,628.00 $5000 Legacy Treasury Direct Bill dt 11-15-04 @ $99.744019 Matures 11-15-07 4,987.20 $15,000 shares Legacy Treasury Direct Bill dt 1-31-06 @ $99.901410 Matures 1-31-08 14,985.22 $20,000 Legacy Treasury Direct Bill dt 2-9-06 @ $97.725 Matures 8-10-06 19,545.00 $10,000 Legacy Treasury Direct Bill dt 3-31-06 @ $99.801852 Matures 3-31-08 9,980.19 $20,000 Legacy Treasury Direct Bill dt 4-20-06 @ $97.598611 Matures 10-19-06 19,519.72 $60,000 Legacy Treasury Direct Bill dt 4-6-06 @ $97.639056 Matures 10-5-06 58,583.43 $115,000 Legacy Treasury Direct Bill dt 5-18-06 @ $97.563222 Matures 11-16-06 112,197.71 SUBTOTAL SCHEDULE B 562,821.32 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Anderson, Ruth, L Decedent's Name Page 3 21 06 0620 File Number Schedule B - Stocks & Bonds ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 47 $10,000 Legacy Treasury Direct Bill dt 6-30-05 @ $99.952201 9,995.22 Matures 6-30-07 48 $120,000 Legacy Treasury Direct Bill dt 6-8-06 @ $97.565750 117,078.90 Matures 12-7-06 49 33 shares Met-Life Inc. stock @ $49.24 each 1,624,92 50 7165.66 shares Wachovia Securities-Evergreen PA Tax Free Fd CI A @ $11.09 each 79,467.27 SUBTOTAL SCHEDULE B 208,166.31 GRAND TOTAL SCHEDULE B $ 2,831,299.60 REV-15G8 EX + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 0620 VALUE AT DATE OF DEATH 236.00 27,918.14 2,932.54 39,632.20 13,444.17 11,653.88 10,020.45 15,021.90 5,010.29 47,657.10 22,293.25 15,016.97 21,486.58 82,175.19 24,187.00 227.22 ESTATE OF Anderson Ruth. L FILE NUMBER 21 06 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. DESCRIPTION ITEM NUMBER 1. AARP-insuranee refund 2. Bankers Life-home healtheare reimb. 3. Cash on hand 4. Citigroup/Smith Barney-Cash 5. Citizens Bank-Cert of Deposit #6140704146 Prine. $13,431.10, Int. $13.07 6. Citizens Bank-Cert of Deposit #6140705762 Prine. $11,631.53, Int. $22.35 7. Citizens Bank-Cert of Deposit #6140705770 Prine. $10,000.00, Int. $20.45 8. Citizens Bank-Cert of Deposit #6140731860 Prine. $15,000.00, Int. $21.90 9. Citizens Bank-Cert of Deposit #6140731879 Prine. $5,000.00, Int. $10.29 10. Citizens Bank-Checking Aeet. #6100769658 Prine. $47,657.10 11. Citizens Bank-Savings Aeet. #6140231663 Prine. $22,288.97, Int. $4.28 12. M&T Bank-Cert of Deposit #031003913919197 Prine. $15,000.57, Int. $16.40 13. M&T Bank-Cert of Deposit #031003914520737 Prine. $21,424.37, Int. $62.21 14. M& T Bank-Checking Aeet. #10965424 Prine. $82,170.90, Int. $4.29 15. Messiah Village-729 Oak Oval apartment refund 16. Navistar Internal Payroll check TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 640,006.13 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Anderson, Ruth, L Decedent's Name Page 4 21 06 0620 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. DESCRIPTION Personal property appraised by Smart Move Makers VALUE AT DATE OF DEATH 1,706.00 PNC Bank-Cert of Deposit #31500192509 Prine. $12,454.99, Int. $19.24 12,474.23 PNC Bank-Cert of Deposit #31500211605 Prine. $10,000.00, Int. $2.95 10,002.95 PNC Bank-Cert of Deposit #31700042501 Prine. $10,000.00, Int. $11.99 10,011.99 PNC Bank-Cert of Deposit #3180042684 Prine. $10,000.00, Int. $14.74 10,014.74 PNC Bank-Checking Acct. #5140001294 Prine. $95,506.70, Int. $25.84 95,532.54 PNC Bank-Savings Acct. #5030125499 Prine. $75,614.39, Int. $130.93 75,745.32 PNC Bank-uncashed interest check for CD ...2836 30.52 Union Central-monthly check received 31.55 US Bank-Money Market Acct. #000008019818 15,996.36 Wachovia Securities-Sweep Acct. #1149-7609 Prine. $15,329.13, Int. $14.66 15,343.79 1994 Chrysler New Yorker @ Kelley Bluebook value 2,550.00 Proceeds from MetLife life insurance Policy No. 23-183-000-A Owner is Ruth L. Anderson and insured is Richard Anderson It is considered an asset of Ruth's not a life insurance policy on the decedent Proceeds from New York life insurance Policy No. 62-089-380 Owner is Ruth L. Anderson and insurned is Richard Anderson It is considered an asset of Ruth's not a life insurance policy on the decedent 4,523.10 47,130.16 SUBTOTAL SCHEDULE E 301,093.25 REV-1509 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Anderson. Ruth. L FILE NUMBER 21 06 0620 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Richard Anderson 120 Ramblewood Drive RR#2 Etters, PA 17319 Son 8 c JOINTl Y.OWNED PROPERTY: LEITER DATE DESCRIPTION OF PROPERTY '!oOF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. AITACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 3/31/83 PNC Bank-Savings Acct. #6130040628,Princ. 20,235.36 50. 10,117.68 $20.196.23, Int. $39.13 joint w/Richard Anderson TOTAL (Also enter on line 6, Recapitulation) $ 1 0, 11 7.68 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY ESTATE OF Anderson. Ruth . L FILE NUMBER 21 06 0620 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME Of THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE Of TRANSFER ATTACH A copy Of THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST VALUE (IF APPLICABLE) 1. Allianz Life Insurance Co-Annuity Policy No. 2163081 38,703.74 100. 38,703.74 beneficiary-Richard Anderson 2. Bankers Life and Casualty Co-Annuiity Policy No. 7,669,159 78,140.92 100. 78,140.92 beneficiary Richard Anderson 3. Bankers Life and Casualty Co-Annuity Policy No. 7,639,192 16,300.13 100. 16,300.13 beneficiary Richard Anderson 4. New York Life Insurance Co-Annuity Policy No. NP471971 68,315.35 100. 68,315.35 beneficiary Richard Anderson 5. Citigroup/Smith Barney-Orville Anderson Trust-Acct. 1,083,562.20 100. 1,083,562.20 #736-21872-18, Ruth L. Anderson, Trustee TOTAL (Also enter on line 7 Recapitulation) $ 1,285,022.34 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Anderson. Ruth L ITEM NUMBER A. B. 1. 2. 3. 4. 5. 6. 7. 2 3 4 5 6 7 8 9 10 11 12 FILE NUMBER 21 06 0620 Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: Parthemore Funeral Home-death cert. (corrected) Parthemore Funeral Home-funeral expenses Richard C. Anderson-Reimb. for travel expenses 232.00 4,855.00 1748.92 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) David H. Stone Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 414 BridQe Street City New Cumberland State PA Year(s) Commission Paid: 2007/2008 Attorney Fees Stone LaFaver & Shekletski 60,000.00 lip 17070 17,500.00 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State lip Relationship of Claimant to Decedent Probate Fees Register of Wills-Cumberland County 765.00 Accountant's Fees Tax Return Preparer's Fees Wachovia Securities-valuation fee M& T Bank-fee for check return option M& T Bank-fee for check return option M& T Bank-fee for check return option Bureau of Public Debt-acct. maintenance fee Federal Income Tax withheld-New York Life Ins Bankers Life-Insurance premium Bankers Life-Insurance premium AARP-healthcare premium Travelers Indemnity-insurance Travelers Insurance-homeowners insurance Travelers Indemnity-car and personal property ins 25.00 5.00 5.00 5.00 25.00 2,893.37 61.97 587.37 236.00 130.00 444.09 544.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 99,082.65 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Anderson, Ruth, L Decedent's Name Page 9 21 06 0620 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER DESCRIPTION AMOUNT 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 Travelers Indemnity-insurance premo Checks written by decedent but not cleared by bank AT&T-telephone service BP-gasoline services Stone La Faver & Shekletski-Reimb. on 6 short cert. Commonwealth of PA-duplicate title fee Register of Wills-3 short cert. PNC Bank-check printing fee The Union Central Life Ins. Co.-Reimbursement International Truck & Engine Corp-pension reimb. Federal Reserve-fee for sale of treasury notes Marlin A. YOhn, Sr., Treasurer-school personal tax PPL Electric Utilities-electric services Verizon-telephone service PPL Electric Utilities-services rendered AT&T-telephone services PPL Utilities-services rendered PPL Electric Utilities-electric services at home PPL Electric Utilities-electric services at home PPL Electric Utilities-services rendered Cumberland Law Journal-advertising grant of letters The Patriot News Co.-advertising grant of letters Register of Wills-filing Inh. Tax Return and Inventory Reserve for tax return preparers fee Reserve for closing expenses 44.91 4,603.36 14.90 277.75 24.00 22.50 12.00 8.99 31.55 227.22 360.00 9.80 22.25 41.69 22.26 15.75 21.47 19.69 6.09 31.61 75.00 97.14 30.00 1,000.00 2,000.00 SUBTOTAL SCHEDULE H-B7 9,019.93 REV-1512 EX + (6-98) '* SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anderson. Ruth L FILE NUMBER 21 06 0620 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Internists of Central PA-debt of last illness VALUE AT DATE OF DEATH 7.29 2 Holy Spirit Hospital-debt of decedent 38.73 3 Holy Spirit Hospital-medical expense 250.00 4 AT&T Universal Card-debt of decedent 25.90 5 AT&T-services rendered 15.44 6 AT&T Universal Card-services rendered 67.71 7 Gwendolyn Linton-care provided on 6-26 thru 6-28 263.37 8 Dorothy Williams-care provided on 6-27 164.00 9 Griswold Special Care-services on a6-26 to 6-28 211.12 10 Messiah Village-services rendered for July 937.00 11 Messiah Village-services rendered for August 937.00 12 Barbara Waltimyer-care provided on 6-26 & 6-27 91.37 13 Sue Keene-care provided on 6-24 thru 6-27 403.82 14 Messiah Village-home care services for September 877.00 15 Messiah Village-home services for October 877.00 TOTAL (Also enter on line 10, Recapitulation) $ 6,560.48 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Anderson, Ruth, L Decedent's Name Page 10 21 06 0620 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16 Messiah Village-services rendered for November 910.00 17 Messiah Village-home services for December 483.73 SUBTOTAL SCHEDULE I 1,393.73 GRAND TOTAL SCHEDULE I $ 6,560.48 "'.,"BO' '",* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Anderson Ruth L 21 06 0620 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec, 9116 (a) (1,2)] 1, Diana Kluz Collateral 1000,00 5862 Pathefinder Road Rockford I L 61109- 2 Carla Neuman Collateral 1000,00 757 S 3rd Street Dekalb IL 60115- 3 Barbara Dienst Collateral 1,000.00 2710 Stearman Street Poplar Grove IL 61065- 4 Donna Pearson Zang Collateral 1,000.00 6N971 Meredith Road VirgillL 60151- 5 Susan A Hungerford Collateral 2,000.00 1015 Kensford Drive Lewisville NC 27023- 6 Emily Bader Collateral 1,000.00 8209 San Augustine Lane Germantown TN 38138- 7 Cathleen Schad Collateral 1,000.00 3932 Beech Street Cincinnati OH 45227- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET If. 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) Continuation of REV.1500 Inheritance Tax Return Resident Decedent Anderson, Ruth, L Decedent's Name Page 11 21 06 0620 File Number Schedule J - Beneficiaries - 1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions) 8 Cheryl McClain Collateral 1,000.00 3730 Newland Drive Round Rock TX 78681- 9 Mary Bullock Collateral 10,000.00 420 South Street Geneva IL 60134- 10 Esther V Bullock Collateral 10,000.00 420 South Street Geneva IL 60134- 11 Gunnard Pearson Collateral 1,000.00 1448 Georgetown Road Batavia IL 60510- 12 Evalyn Lindeman Collateral 5,000.00 203 Mound Avenue, Apt. 136 Milford OH 45150- 13 Richard Anderson Specific bequest Lineal 5,000.00 120 Ramblewood Drive, RR#2 Etters, PA 17319 14 Richard Anderson Total of coins and car Lineal 4,256.00 120 Ramblewood Drive, RR#2 Etters, PA 17319 15 Richard Anderson Total of annuities Lineal 201,460.14 120 Ramblewood Drive, RR#2 Etters, PA 17319 16 Richard Anderson Ba!. of joint acct. Lineal 10,117.68 120 Ramblewood Drive,RR#2 Etters, PA 17319 17 Richard Anderson Value of life estate per Schedule K Lineal 3,043,670.72 120 Ramblewood Drive, RR#2 Etters, PA 17319 REV-1514 EX + (6-98) '* SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on Rev-1500 Cover Sheet, FILE NUMBER COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anderson. Ruth. L 21 06 0620 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEATH LIFE ESTATE IS PAYABLE Richard C.Anderson 12/9/1948 58 [2gLifeor o Term of Years - o Life or o Term of Years - o Life or DTermofYears - o Life or o Term of Years - Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. 00 Will 0 Intervivos Deed of Trust 0 Other 1. Value of fund from which life estate is payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " $ 2. Actuarial factor per appropriate table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . Interest table rate - 0 3 1/2% 0 6% 0 10% 00 Variable Rate 67.478 % 4,510,611.93 3. Value of life estate (Line 1 multiplied by Line 2) . . .. . . .. . . . . . . .. . . .. . . . .. . . . .. . . . . . . . . . . .. $ 3,043,670.72 NAME(S) OF ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE o Life or 0 Term of Years o Life or 0 Term of Years o Life or o Term of Years o Life or 0 Term of Years 1. Value of fund from which annuity is payable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 2. Check appropriate block below and enter corresponding (number) ................................. Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26) 0 Monthly (12) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) 0 Other ( ) 3 Amount of payout per period. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 4. Aggregate annual payment, Line 2 multiplied by Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Annuity Factor (see instructions) Interest table rate - 0 31/2% 0 6% 0 10% 0 Variable Rate % 6. Adjustment Factor (see instructions~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Value of annuity -If using 31/2%,6%, 10%, or if variable rate and period payout is at end of period, calculation is : Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ If using variable rate and period payout is at beginning of period, calculation is : (Line 4 x Line 5 x Line 6) + Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) STOXE. L\FA\'ER & SIIEKI.ETSKI ATTORNEYS AT LAW 4 f 4 BRIDGE STREET "EW r.t~II1ERI..\.'I;n. P.' 17070 LAST WILL AND TESTAMENT OF RUTH L. ANDERSON .,. ... , P:~-T2 :". A..'\DEF..3i~?~, cf -:t:.t:er A::'::'e:: T::'^'nsr::.t:, C~~-:::--.be r:' 3..:::i .-,......"- +-...- - '-' ........-- Fennsy::' ';ania, declare ttis to be :Tl ::' last will and re'lcke :. r. :." 'r,9_ ~- - -- previously made by me. ITEM I: I direct that r.,~/ Exec~.ltor hereinafter n,:;u":'~e::i s:-:a1: p3.y all my ~ust deb~s and funeral expenses as scon as ccnver.~~n~~y ~ay b~ done after my decease. ITEM II: I bequeath my a:.ltorr:obiles, household ani r:er:3<Jr.d::" effects and other tangible per~onalty of like nature (not includ:.ng cash or securities) together with any existing insur3.n=e chere~~ to " , ~ son, RICHARD :. ANDERSON. :::TEN 1:::1: I make the f:::lcwing specific bequests ~- the fc::":=~- ~~3 te~e~i=iariE3 ~~= s~rY~-.~e r~~: A. ~~ .,. -, '_ '..,I '.." . ..... ..J t:: ".1 "- -.... I R::i-L;F.: =. fu;=Er~~ :.:.; . ~ - ............. ,- "" - ~, ~ ~ ~ . ~ ~ ..,- -. . -' - = =A:":2:~ :..'- ."'7 ...--.. -...... , ,- - -,..., _ _ _.c.... r .~~ ~ :-.:: .:. .:-. :. ,_= :- - --, . ~ - ...... -" , - . - ~ :".:: : ."':: :.:.- :1 - - , ......... -- ~ ,--...-.......~- ". - - -.....--.. "------', -. - .. - - -.. - -. ...-- .. -. .-.'::' r ~- '-- - -'........... I :- ~ . ::; ~ I - (..., . ,-' _I ~"::_'= . t..:;':=:'3.;F_"'~ = =E:~37 I ,.-"....., -- ..'::::..J.. '-' ::. =>-- ~ :~ . ~ .. . - ~. ..... ....... L":' I :e:~31b I :: '-, .. ; c: - '- -.. .... -- . E. ~ i' ,""\....... :;>..L. I"'" 'J ',-, . ~,:; rw::.32 =:~:KA FEt..F,.S :~-r I 35:4 A~rf=~: ~=~j, Sy=amcre, IL 6C17S. F. $2/COO.GC t.:J ivIES. S''';SfutIJ A. HC~;32RrCE=, ~_i.:: YC::!'lf:.L::iS Cri~e, Lewisvil:e, NC 27C23. G. $l,OOO.CO to MRS. EMILY EA0ER, 8209 San ':;''-lq'':3~J..L: L3.::e, Germantown, TN 38138. H. $1, 000.00 to MF.S. CA~HYS:::'HAD / 6766 Chestn'J.c Str~E:t / Cincinnati, CH 45227. I. $l,OGO.CO t:J ~IRS. CHERYL McC:.AIN, 2390 C.::loLi3.l Eidge Court, Cincinnati, CH 45236. J. $5/000.00 to r.IR. BEF.:NAED W. LINCE~'rp.S, 495: K.r:rler Mill Road, Cincinnati, CH 45236. K. $ 5 , 0 : 0 . C C t,~ ;,,1:". WI:"'L=~'l '" J-i . L I N::; E;V!A..~ , <"""' ,-, ,'"' ..., '::::C:J..J '=:::":;:-:~a.':' ~ . . ~_l'J. '? e :'::"J.rt I -" . ',,-l:-~:: .1 r.r:a :. l I CH 452:2. L. ..::" - ...... .... ~ ~ ~' , ~ ~ _ . ~ J ~~ ~. - ..., ,-. .'-I.-:'::~ ~/'~:;'r.~" E. p....-:- ..,.. ,-",.-,-, "'-'....-~__t'_1 'tL. .. _. - - ...... - ...... --. :: - "-,-."::- --- - ...... '- - - I ""::t.::.......... .::. - -, - -- "'''-,.. ~ "'" I - - ... ...... ~ ':'___:-t. '- ~ .... J I - --....--....-. -- --,.... -...... ... ....-....... 0 -,..- - ----,-, ..:::'-'-......._, -.....0' 0':: "- _ . . ..... '- ~----.--, - -.. _ . .t, - _ .- ~ "'1: . :: .:: .,. -, ;_ ~ ~ . .' oJ t:; y;? . ......- .... ......-,.....--.-, ~~..:.~... _.::. ...... -... - ..., --...... r C:-_:.-..:::' __...'11 , ~~:-; _ - '-r- I' ___ _ -------- :: __ _t.:: , 2~.-:3~l':,re , - ,. ... ..., -. c -' _ c. ..... ~ ..... - ,-, ; J.. I U '--,''oJ . ..- .I.............. . ........-.~-"'\--~ -T"""I.....~,....,_...'" ..:: -'...~.~,:.....M....""'(.-' r !:..1-1.J.~.C--,":"\J I -= 1. C. ~...:--..::-j.::~: ::"":'1-:/ SYC3~~re, :L fC:7S. :,....,~\.... ~ - --'.... ~ ,- ~ \. : :: devise and r::e:r..:eath O'........i.. .-:f the re s:. j'-:.::: l....." eS~Ei.~~= of e'.rery nature and wl:ere'...er situ:ite, t:> the Tr..lstee , . - C..e:2:"~.:C :.r...3. r:.e ~ named, IN TRUST, for the following uses and purposes: A. To pay the net lnc<Jme therefrom to my s:n, F.. I ;:~.~F..[:, ...... \- . fu~DERSCN, for and during his ~ifetime in such periodic instctll~ents ~s Trustee shall find convenient, but at least as often as q~ctr::er- , , ar.n'ua.u.y. B. As much of the principal of this Trust as ~rustee, its sole discretion, may from time to tirre think advisab:e :C',~ t""r~ '-....- support of my son to maintain him In the station of life t:J , . . '",j r: l. .=:!. :-. e is aocustomed at my death, sh~ll be either paid to hi~ cr e~se arr-:ed Iii l-e.,: ~ ::'1" ~ " ....cr n.:.s benefit t~. ~r~3cee af:er ta%in3 ~ :::: = .~~ ': ~__ :. s ::tter rea j.:. ~ ::. ., 1- ' :r.'al_a~~e ass'2'.:s - ~.~ :..L~. -4 s':~~r,=es -~ ,-r...........--,..:::. ........... __ _ ~l. _ . :-Y'~2":,=~ _-.~~r 3.f='r:-~. ::-.e :-~~~ ~:-::::::~:e -~ -~, --~-.- - - -- - -. --- 2'''::;I:=''=:-~ . . .:: -..., ---'---"'--.. ::-_ _ _ ::r..:"'"__ .. ,..- ....... - .-' -.,,- -- - .... - . ........---0.. __ __", s:::~::. j ~~ ..... - .- -, ':~__~t:-2S s.,,~' =~::e~ -. ::":::!~ -'- '-"- -, :: ~-.;:: ..... .- - ..- ~ -.--.. -.....-..--.... -" ~r.~s::c.~;.::. I c. ::-..:: ::t; ;,t: _ ~ i: sl: ...:.rs lrJ.'} i ~ . :: ':2r..1 \,r: :...:f::;n ti:e . t- ' :lea_I: .:: ...... ...j SC:1, r ..,... ':-"...':'\ t;- .'"'I,~~ -_r_-....I,........ c. ~~,;::~:_s'=:: , ~ ,~ .~ c :: :. jea~:: sh':'.ll j ..... , , "./ ser. fredecease ,......~ dl_ / t~e ~r~s~ee sta~l jis':r.:.c...::e ::~: .:.:: talar.ce cf the frir.ciral and a:::' a::c'.l!:','.llo.ted and '.lr.distr':':::'~':2j as fcllC'....s: A. Cne-tr.:.rj tr.ereof to the EAU:::;H~ MEN:R:A:::" '_-:':=TE~ METHO~IST CHURCH, Third and Bridge Streets, New Cur.~erlar.j, "'" ~ ~.r'i . B. One-third thereof to the UNI':'ED CWJRCH :2 CHE:2T, Sherwood Lane, Norwood, CH. C. One-third thereof t:;l the METHCDIST CH:JE=H :-F GE!~E'iA, Gene'.ra, I L . ITE:'1 VI: The interests of the ber.eficiaries hereunier sh~ll net be subject to anticifation cr to vclur.tary or involuntary alienation. I':'EM VII: Tr'.lstee shall ha~e the fcllowing pc~ers J.d::L. ': i.=c: ~:..::se -.,"'~st e'i :n it t~,. ~a.~^1 .3.:::: t~/ ctr:er P~c-..":.si.:,r:s - - '- ..... ~.........: '-' _...._ .;;;;J - "1---' ,-..- - - -,..,::' - I - . , 3~t:~:"=3r:_e t- ~ 3._... I=r:~er~:" I ~r::-:-=i~3.:' :; r-.:::t -:r-.......'I"'!"'t:.. .........--_...- , . - - ... - - .. -.. - ...-......, ~......- ~ '-... -"'---:::: ...- ~r';- -.........:.....- -.. . ~ '-' - - ... .- .- ,....... .l.."=:_-", '"-:-.:.r.:rs, exer:is3:C:'= .,1; :. ~ ::::....l ~ .... _.. r-t- ::tt:;-r:T".~ , _ u_ .,. -------,,- - . ~-.... - _...;.. '- .... ~ 3'::":'~: j :. .3 ~ r :. r: '.-;. ~ :. ::: 3._~ ; l- : E=' E: r : :: ~ : =- - ~.:: _ ''1 r. , ..~.., : 1- (.: ~ .3. .:. :: -y ~&: :i.332:S ~&: ~ ~::. ;; - ...-- ',~- ---~'-~I or j;:E:rs:::::.i::', :..r...:luj:':-.:J s~~:k :~ ':cr~:~a~e 7r~stee ~~ ;: :i l-..=:-_ -= r.o::' ji::;r ::':r-L~,3.:-J.J" ~~'i t::::~J.~ re3'~rj ::: 30:1:1' pri:1::if::'e ~+= c.i i -te. -.:...- c =- f:.. c ~ .... :.. .: ~__ . E. ':'0 ir:'.-es: :.r- 3._~ f::;rrr.8 of fr:::.r:er:y, . - - :.r~:_....:J.::-_~ 2~::-.':, C::;:-:-.".'".::;n trust Ll..::ds 3.""ld rr.ort=r=:]e in-,est:,:"e::: furds wr:.etr-"er =-;-r::r3.:.ea Trustee or by others, without restriction to investmer:~s ~~:h:ri2~d for Pennsylvania fiduciaries, as they deem proper witho~~ :r.-t'..;;f 3.rj ....~ '- ~ any principle of diversification. C. To sell at pub:ic or private sale, to exchar:ge or to lease for any period of time, any real or personal proferty, a::d ....~ -'~ give options for sales, exchanges or leases, for suoh pries ar:d up:::: such terms and conditions as it deems proper. D. To allocate receipts and eXfenses to prir:::ipal en inccffie or partly to each as Trustee from time to time thinks frcper In its s:J:e discretion. E. 7,~, c;-=mprc~rise a:-..~" C~,.3.:'r"" ::r:: :-r.tr2-,rer3",". F. T,~ jistriL::e ::-- c':i.s!1 :r ~i~j ::r .......... ,._~ i .... .t---' :::t..;.. -" -- 4 '""7""'-.. ::,:::i l=~--=t:t::C:~~ .:..:: .: : s ~-.. ::i;-:". ~ ./~~ =- ": ~: = --4 '_ :J ':': ~ -=- :: :-. =-.. -= -=- ::: :-. .:: -. . r.: ::......;. ~:. .l~~j~ -- -,............, -. - -'. _ :1 ~ :;. -_..I.. _ ~ r: -F -. ,.-. ,- -- - -..=..;.;::.. ...-....... .'_~A__ . . - ",- - -.".. - - --- '-""----.....-- -----". ~--.Ii ~ . ':':-.e ::::;{'=: ::.~: ~C~- ~~~ ~:rp:r~:~ ~~~~S~~~ =~~f~~S~:l=~ ~:r :~~ fe~~cr~~~~~ ~~ ~:--_e:..r :"":Y!::::':' =':-..8 c. '':: :.--=.: "_:-..':':'t:~- a..::: ::ri-3.::-:oe 'I'.~ - .... r vv..J. '_... tr:e.:..r s~a~j~rj s2r:edu:e ......; '.." - :ees 1 f'. e::c::~ --=........ -.?'- ti~e juri~g tte Fe~i:d :ver ~~ich its servi2es are Ferf:r~E:j. =~SM :X: T' . ~ """"""''"'''''''-'-1\- ~ apt:,:;l:---~_ r_.......-~__....i-...w ~R~'-~8T SEF_"\.::r: :ES ':=>::':~;:''':~-.;.'' ~ ~~.~: -= +: '::;-2 -;= a~:" ':r..ls: :reated t..i.nier cr.:.s rr:',' :.ast ~.;.:.2.: 3.r..j ':'est:a:r.e:-.t. I ':'E~'l X: I appci~t OAVr= H. ST,J~E, Executor of ":':-.:3 -- ...,.... _ .;t ~ ~ ...... .~ --..... - . I'TEY'r XI: Upon the written request of RICHAR~ C. ~~=~2S:!J, tte TrJ.stee shall Fromptly resign; provided that RICF..AFD"" Ai;:2?S:!\, ha2 appeinted a corporation as a successor Trt..i.stee that is crga~i=ej u~jer the laws of the United States or any state thereof, ar..d is pcssessed :)f ':'rt..i.st po'....ers. ITEM XII: I direct that my Executor and Trustee or their succes- sers shall net be required to give bend for the faittful perfcr~ance of their duties in any jurisdiction. IN WITNESS WHEREOF, I I ?:J':'H L. AN~EF.s.::::N, have r:en:'..i:-.'::J ~:;.:_:: ~.. tan j a:-.j seal ttis 's .l. j.:::..:." ~f' '.." ~ ~ "\" '.). .... '.. ...... "..... --...--. .,.. - ~ - -.. -- ~- - ... .- - .. -.--."-- -~-. - -. ~.:::. .- SIGNED, SEALED, PUBLISHED_,"d DECLARED c:- ~.~-':'~ _ Testatrix atc~e na~ed, t::e ~reser:,::e f:resen:::e ~& '~.l... e.- ~).., :::t__.4. " /-~ \ " - ., . \. ' }'Jitness / / ~& '....l.. us, ether, \.. ".'~ \..... - ~.-------. - ./"" /' as and f:r ter ~as: "".....: ... - "~.4. ..I... ar:,::. w t.:: at her re:r...<est, ir: l:er preser::E: ha~~ s~ts=rited c~r na~es I. .. I' Address (, I ........... .. Address .., '., Witness /' " ./ ; -~ ,-:.... ~ .: :is .. .. -..- - - - -,,- - "- ....... - ........._._.~....... -~., 1 ~::2: :.....-':..::~: , :i::i ':~' ~ ~:.... -= 2 2 -= 2 . I , - ... ~:-:i ~.'-':'" .-- STONE. LAF AVER lit SHEKLETSKI ATTO"NEYS AT LAW 414 S."Du", m'REET NEW C\.HBERL.....O. PA 17070 -' CODICIL TO THE LAST WILL AND TESTAMENT OF RUTH L. ANDERSON - , P;:;Ti-! ~ .." ~."!"'"'~T'"' r"'o"-".""T :...J ..... ...... t<.':::: ''-.,) i. . , C! ~pper A~le~ :c^~s~i~, -= '~r:-.t E' :: 1. a~. ,j ...." -.. ,- -.. ..- '.J .-... _ _i , c r-.. j ,=~1T~~;,:)n~~1ea l: h ".c ',-, .L Fen r.. s ~: =- ~l ani. a , cIe::lare th.:s to ce trle S:2.e ...... ,'""' ""'.: -.. ~ ., -"'-"-"'_..........J..._ ~o ~v Last Will and Testament dated October 3J, 20Cl. == T Etv1 I: I hereby revoke Item III.K. of my Last Will a~d :esta- me~t and i~ its p~ace there shall be a ~ew Item III.K. wti2h shall provide as follows: "$S,COO.CO to EV.n..LY~J LnIDEtv~AN, 2:390 Colcnial Ridge c.:)urt, I: iI d Cin2innati, CH 45212." I ~ Ei/~ T T . ~ ~ . =~ all ether respects I hereby ratify, ccnficn a~d republish my Last Will and Testament dated Cctober ~ ~ ~. , -' '-' , ....... ....... -. ~ LJ ~I ~ , t: ,;e ~ (.'= ~ .,.; i. t h t h :. s rrL ~i SCle .. .., CC':1lCll.. . IN WITNESS WHEREOF, - !-'.c7e !-',-=.:reLin'::> se:. rr,~' r.a.r:d an.::: 3-::.:11 t.:-::.s _..:: :J::' ': : = ':. 3. , ~r L '., {..,' '. '" .~. !:.' '- ~ .-: -. - - - ~_. J. .... ~ '"--. ~ -,'., SIGNED, SEALED, PUBLISHED ar.j DECLARED 1:/ ;-_'~ E - ~~s~a~:--:.x aC2'Je ~esta:r~ent, r::rese[',c.~ a;:d a S l.\' i ~ Z".. e sse s . f----... I>~ ") ,. .--- "!'""'l" ~ ,', l '- r. e s s....- --.----- (. 'iH tr.ess :-.. a:rLe j, a~~ fc~ 0 S2:e C~j~=i~ as ar,d the fresence c: ~S, }--r ....c...... -.... o.i.- t.,......~ '^'.....'........ re::r~es~ , in the presence ~~ e3ch ether, have , '1, SGDSCr~ceQ 8~= ~a~es J(L~ /1-, v( ~L,. ,l'k " Acidress I~. , 1 //1;, _ . , (,.. Address _ ":"-l_=- ~ -' ._~ .- ;..:;=~?2=:~, r~::. r -,....._ :-::,....... -., --.~ ~ ..-, 1- - ..._ j,. "'::: -- ') I ~ -' REV.485 EX + (3.041 '* SAFE DEPOSIT BOX INVENTORY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 Please Print or Type MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE FILE NUMBER SOCIAL SECURITY (Required) OR DEATH CERTIFICATE NUMBER (onlv if SSN i. unknown I 21 2006-00620 270-03-1287 I DECEDENT'S NAME (LAST, FIRST. MIDDLE) ANDERSON, RUTH L. DATE OF DEATH 06/28/2006 . ADDRESS OF DECEDENT 729 OAK OVAL (STREET) (CITY) MECHANICSBURG (STATE) PA NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) DAVID H, STONE. ESQUIRE (STREET NAME) (CITY) 414 BRIDGE STREET NEW CUMBERLAND D NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT. OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAME) (RELATIONSHIP) DAVID H. STONE. ESQUIRE ATTORNEY FOR THE ESTATE (STREET NAME) (CITY) (STATE) 414 BRIDGE STREET NEW CUMBERLAND PA (STATE) PA (ZIP CODE) 17055 (ZIP CODE) 17070 b. (NAME) (RELATIONSHIP) (ZIP CODE) 17070 (STREET NAME) (STATE) (ZIP CODE) (CITY) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) . NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) M& T BANK (STREET NAME) 344 10TH STREET (CITY) LEMOYNE (STATE) PA I NAME OF PERSON MAKING LAST ENTRY RUTH L. ANDERSON DATE OF CONTRACT TO RENT BOX NUMBER OF BOX 03/20/1996 666 NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) RUTH L. ANDERSON (STREET ADDRESS) 729 OAK OVAL (CITY) MECHANICSBURG DATE AND TIME OF LAST ENTRY 2/28/2000 0:00 am b. (NAME) RICHARD C. ANDERSON (STREET ADDRESS) 120 RAMBLEWOOD DRIVE. RR#2 (CITY) ETTERS (STATE) PA (ZIP CODE) 17055 (STATE) PA . NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY DAVID H. STONE, ATTORNEY FOR THE ESTATE (ZIP CODE) (ZIP CODE) 17043 i I I RD C. RSON (ZIP CODE) 17319 m WAS A WILL IN THE BOX? = YES Xl NO If yes. a. Date of will: b. Name and address of personal representative, if named in the will (NAME: !S"7"REET NAMEI (CITY) !STATE) ,ZIP CODEI c. Name and address of attorney. jf any ,NA~.~E: ::;-:":';EE-;" ~lI;;~.IE; Ci7"Y s ~~ ~E ~~:P t~:='CE SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS Page~of~_ The Department is authorized under federal law , 42 U.S.C. 9 405(c), to use the decedent's Social Security number in administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and ensure proper credit for tax payments. (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, Le., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, fb k db h db I name 0 an an ranc , an a ance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM ITEM DESCRIPTION NO. I 1 (14) One Dollar Silver Certificates I I 2 U.S. Mint Sets -1939,1966,1975 (2) 3 (30) Morgan Silver Dollars i I 4 (51) Blue Seal One Dollar Bills I I 5 (1) Kennedy Fifty Cent Piece - 1967 I 6 (1) Kennedy Fifty Cent Piece -1969 I 7 (5) Eisenhower Silver Coins I I 8 (2) American Eagle Silver Dollars 9 Miscellaneous Silver Coins l I 10 Miscellaneous Coins I I 11 Deed to Cemetery Lot - Spring Grove Cemetery I I i ! i I I I I F ERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COpy OF E BEST OF MY KNOWLEDGE AND BELIEF. ,SAFE DEPOSIT BOX INVENTORY: SiGNATuRE : ;:':<f\j7 T'....LE DAVID H. STONE, ESQUIRE i PRiNT '~AME ANC ChECK ;'PPRCPRi.A7"E BOX 6EvJ':, I I DATE ; C"-iECK ;'PFRGPRiATE B)X ATTORNEY FOR THE ESTATE ]-12 \J 7- E,e'_....:cr [(-.I. ,.'.H~rT.," ~~:,fU, :c.< NOTE: Attach additional S'h" x 11" sheet(s) if necessary or use duplicates of this page of form.. "----_._--~_._._~---------------------'------_.. .Jia ES'd!e i"'1e~rese"~"~_~e ",c ',I >.\,'.-., ,- ,'e :t~.~,;. ~;'," REV"''''. "..., '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 SAFE DEPOSIT BOX INVENTORY MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE FILE NUMBER SOCIAL SECURITY (RlQuired) OR DEATH CERTIFICATE NUMBER (only if SSN i. unknown I 21 2006-00620 270-03-1287 Please Print or Type DECEDENT'S NAME (LAST, FIRST, MIDDLE) ANDERSON, RUTH l. . ADDRESS OF DECEDENT (STREET) 729 OAK OVAL DATE OF DEATH 06/28/2006 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) DAVID H. STONE, ESQUIRE (STREET NAME) 414 BRIDGE STREET (CITY) MECHANICSBURG (STATE) PA (ZIP CODE) 17055 NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAME) (RELATIONSHIP) DAVID H. STONE, ESQUIRE ATTORNEY FOR THE ESTATE (STREET NAME) (CITY) (STATE) 414 BRIDGE STREET NEW CUMBERLAND PA b. (NAME) (RELATIONSHIP) (CITY) NEW CUMBERLAND (STATE) PA (ZIP CODE) 17070 (ZIP CODE) 17070 (STREET NAME) (CITY) (STATE) (ZIP CODE) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) . NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) PNC BANK (MESSIAH VILLAGE BRANCH) (STREET NAME) (CITY) 939 OAK OVAL MECHANICSBURG I NAME OF PERSON MAKING LAST ENTRY RUTH l. ANDERSON DATE OF CONTRACT TO RENT BOX NUMBER OF BOX 10/27/2003 152 NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) RUTH l. ANDERSON (STREET ADDRESS) 729 OAK OVAL (CITY) MECHANICSBURG (STATE) PA (ZIP CODE) 17055 DATE AND TIME OF LAST ENTRY 9/17/20040:00 am , TiTlE UNDER WHICH BOX IS REQUESTED RUTH l. ANDERSON (STATE) PA b. (NAME) RICHARD C. ANDERSON (STREET ADDRESS) 120 RAMBLEWOOD DRIVE, RR#2 (CITY) ETTERS (STATE) PA ,ZIP CODE) 17319 (ZIP CODE) 17055 NAME AND TiTlE OF EMPLOYEE TAKING THE INVENTORY I i i m WAS A WILL IN THE BOX? [] YES il NO I I DAVID H. STONE, ATTORNEY FOR THE ESTATE If yes, a. Date of will: b. Name and address of personal representative, if named in the will 'JJAME) :STREET NAME) IC/TY) ,STATE) (ZIP CCDEi c. Name and address of attorney, if any NA"-lE) -~-~-----~--~---------,----~._- :.; "7":~t:.E~ ~~':"\~E I_CjT'T~ ::, -A-E Z,p C"='~~ ----------~._._-~._--- SAFE DEPOSIT BOX INVENTORY Page INSTRUCTIONS 2 of 2 The Department is authorized under federal law , 42 U.S.C. 9 405(c), to use the decedent's Social Security number in administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and ensure proper credit for tax payments. (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, Le., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) J C' St M 'pts tc l' t d d c'b s f II 0 s'bl --l ewe ry, oms, amps, anuscn ,e : IS an es n ea u y as pSI e. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully i as possible. I (8) All other contents. ITEM ITEM DESCRIPTION NO. 1 Miscellaneous jewelry 2 Two (2) Half-Dollar Gold Pieces I I l , I 1 I I ! i i j I I i I i ; PERSON RECEIVING COpy OF SAFE DEPOSIT BOX INVENTORY: SIGNATURE STONE. ESQUIRE PRtN~ NAME ~ND Ci-oECK .':"'PPR':::PRATE Bex BEU:"/J ~N.:f'..'r "':-LE ATTORNEY FOR THE ESTATE , DATE '~-(2-,:1 ; ChEC:i\ ,':"'FPRCPR,":':-E E::.:).\ , E'e':~~(.r :"":~, :"'~:"'J.~tra'Y' ~(\, -_. '---,---_.-- --~--""--------~~-,- - -------.--------- --,'-- ----------.- NOTE: Attach additional S'!," x 11" sheet(s) if necessary or use duplicates of this page of form. ~ E<;Lre ~e;":'rt?-')~:"~::l: '.~ j,:-n' ~ '......;,:.. :' "~i'~ >~'". ~ cltlgroupJ SMITH BARNEY One PPG Place, Suite 1300 Pittsburgh, PA 15222-5490 Tel 412-392-5800 Fax 412-392-0318 Toll Free 800-245-6100 September 19, 2006 Ms. Tina Burkey Stone, LaFaver & Shekletski 414 Bridge Street New Cumberland, P A 17070 Dear Ms. Burkey: Confirming our phone conversation, enclosed is the revised report showing the date of death values as of June 28, 2006 for the Ruth L. Anderson accounts. If you have any questions, please contact me at 412-392-5846. Sincerely, ~~VY\~ Sharon K. Martens Registered Client Service Associate Sm Encl. Citigroup Global Markers Inc. THE I"1FORMATION SET FORTH IXAS OBT,~[NE[) [,ROSl SOl'RCES WHICH WE BELIEVE RELL\BLF BUT WF DO NOT <.L'AMN rEF ITS ACCU{,\CY OR COSH'l ETf.NFSS, "'..a:rrJ..~~'lJ 1-1-1[; 1"'-'l:('lO'.! ~'rl. )1'1..1 "'-ll"'1D ",""'V I)1l1...,U)"'-, t-vnnt",-" f-r-, .. -,-..........,.-,..,.. '-r"',- . ,-.-" t,-.............".,.. ".. .._ ~ cltlgroUpJ One PPG Place, Suire 1300 Pittsburgh, PA 15222-5490 SMITH BARNEY Tel 412-392-5800 Fax 412-392-0318 Toll Free 800-245-6100 REVISED 09-18-2006 DATE OF DEATH VALUES JUNE 28, 2006 736-16721-11 RUTH L. ANDERSON Equities TOTAL Symbol Description Quantity HIGH LOW MEAN VALUE AT ALLTEL CORP DELAWARE 100 61.59 60.850 61.220 6,122.00 AAPL APPLE COMPUTER INC 800 57.30 55.410 56.355 45,084.00 BLS BELLSOUTH CORP 2500 35.66 35.290 35.475 88,687.50 BA BOEING CO 336 82.69 80.830 81.760 27,471.36 CPB CAMPBELL SOUP CO 1200 37.24 36.750 36.995 44,394.00 CPRQ CITIGROUP CAPITAL XI 6% 1000 22.20 22.040 22.120 22,120.00 CPO CORN PRODUCTS INTL. 800 28.61 28.200 28.405 22,724.00 D DOMINION RESOURCES INC 484 73.70 73.180 73.440 35,544.96 ETN EATON CORP 1200 73.67 72.630 73.150 87,780.00 EQ EMBARQ CORP 40 41.09 40.040 40.565 1,622.60 IDA IDACORP INC 200 33.93 33.240 33.585 6,717.00 ISP ING GROEP NV 6.2% PFD 1400 23.30 22.950 23.125 32,375.00 JPMPRJ JP MORGAN CHASE CAP 7.0% 1000 24.86 24.770 24.815 24,815.00 MWV MEADWESTVACO CORP 1472 27.24 26.830 27.035 39,795.52 METPRB METLlFE INC 6.50% PFD 1000 24.43 24.230 24.330 24,330.00 NEM NEW MONT MINING CORP 107 49.87 48.600 49.235 5,268.15 PPL PPL CORP 1200 31.71 31.340 31.525 37,830.00 PG PROCTER & GAMBLE CO 12800 56.02 55.500 55.760 713,728.00 PEG PUBLIC SERVICE ENT. GRP 1000 66.32 65.290 65.805 65,805.00 SJM SMUCKER J M CO NEW 128 45.30 44.650 44.975 5,756.80 S SPRINT NEXTEL CORP 800 19.75 19.520 19.635 15,708.00 USB US BANCORP DEL NEW 3960 30.94 30.649 30.795 121,948.20 VZ VERIZON COMMUNICATIONS 2100 32.84 32.520 32.680 68,628.00 CBE COOPER INDS L TD CL A 1600 88.70 87.030 87.865 140,584.00 $ 1,684,839.09 TOTAL Mutual Funds Quantity NAV VALUE CFSAX COLUMBIA FEDERAL SEC. 1093 10.100 11,039.30 DELlX DELAWARE TAX FREE PA 51681.06 7.920 409,313.99 CPBFA LMP CORE PLUS BD A 3108.251 11.840 36,801.69 PTHYX PUTNAM TAX FREE INC TR 777.605 12.880 10,015.55 PTHAX PUTNAM TAX FREE HIGH INC 2120.457 12.860 27,269.08 ACGVX VAN KAMPEN GOVMT SECS 798.00 9.890 7,892.22 $ 502,331.83 Cirigroup Global Markets Inc. THE I~FORMAT]O~ SET FORTH 'X'"A5 OBTAINED FROM SOl:R,:L\ WHICH \'(1', BELIEVE REliABLE BUT WE DO ~OT CCAR\NTEF ITS ,\GTRAO' OR COMPLEn:NF,SS. '\:F1THFR THF I~j:nRMATInN 1\inR ANY nPINH)N' F\,PIU"",\H) Ct"lN\TIT1TTF;'; .\ ,{)IJCTT~T")~ I{V IT;'; en; TWJ; r>I'QClt.l.'..1: jHJ "'111.: nl: H..:V (LFT'OITIL'C ~ cltlgroupJ SMITHBARL'ffiY One PPG Place, Suire 1300 Pittsburgh, PA 15222-5490 Tel 412-392-5800 Fax 412-392-0318 Toll Free 800-245-6100 PAGE TWO 736-16721-11 TOTAL Municipal Bonds Quantity BID VALUE Allegheny CO PA 5.25% 25,000 Due 01/01/16 101.798 $ 25,449.50 Allegheny Cnty PA Res. 20,000 3.50% Due 11/01/09 98.229 $ 19,645.80 Carlisle PA S.D. 3.80% Due 25,000 09/01/14 97.198 $ 24,299.50 Cecil Twp PA 3.75% Due 25,000 11/01/13 98.703 $ 24,675.75 Conewago S.D. PA 3.00% 15,000 Due 09/01/11 95.042 $ 14,256.30 Erie Cnty PA Hosp 3.80% 10,000 Due 11/01/11 98.432 $ 9,843.20 Hempfield PA SD 3.45% 30,000 Due 10/15/14 94.972 $ 28,491 .60 PA Hsg Fin Agency 4.00% 25,000 Due 10/01/12 97.724 $ 24,431.00 Pittsburgh PA SD 5.50% 25,000 Due 09/01/06 100.285 $ 25,071.25 $ 196,163.90 CASH $ 39,632.20 2,422,967.02 Citigroup Global Markets Inc. THE l:-.if<lR~L".TI<lN SET fORTH \XAS llBTAI:-.iED fROM SOl'RCFS WHICH WE RELIEVE RHL\Rl.E RUT WI' DO NOT CL'ARA:-.i [FE ITS ACel"RACY OR COM!'1 ErENESS. , TO 5177 (November 2005) Mailing Number: 031004080 Legacy Treasury Direcfe w_.treasurydirect.gov '-800-722-2678 '-304-480-6464 (Outside the US.) STATEMENT OF ACCOUNT Pag.1 of .3 RUTH L ANDERSON 729 OAK OVAL HECHANICSBURG PA 17055-8408 YootSite TREASURY RETAIL SECURITIES SITE P.O. BOX 567 PITTSBURGH PA 15230-0567 PHONE: (800) 722-2678 })aYiDen,(bdo....-tiOD ITeIep.9DeN~IDJ)~":1 (717) 697 -7690 IT'IP.y.,t.cI~.._.UqIlNo.:1 Confidential l'l"g:wmaJalJldlDgSt.,,-.;1 No withholding Payments made by direct deposit to: DAUPHIN DEPOSIT BANK Routing Number: 031300834 Name on Account: RUTH L ANDERSON CHECKING Account Number: Confidential .....'.. _._ _. ..._............._... '..u... _. ... ............__. .., ,.. .. ... ...._. .... ..' __H'......." -"'_.n_._, ..,......,__.. _ "", ... .. . _, - - _. ... ... "0".. _.._...... .... ...,..... _ _ _ _ ...,. . ~cyTreu.~DI#Ae~~.tN.mberll. .. ..-. ......., -...... .._-........ ----,......_",--- ,-.. ... _. ,__., _ . '.d' ""-"_p'" ... .. _. . ... . . . . , . . . . . . .- '. . .. ... ,... '. . ... . . . . . . .. .....,.,..,.., ... ....,. '.. '--'.... 4800-530-8732 ITetalPar_SOf06to~~eO~:J ... ". --" ., . . '. ..... $37~100~ ACCOUNT HOLDINGS 912795XQ9 01 20,000 02/09/06 97.725 4.669 4.500 01/10/06 BILL P.r 01/10/06 20,000 20,000.00 912795XV2 01 60,000 04/06/06 97.639056 4.149 4.670 10/05/06 BILL P.r 10/05/06 60,000 60,000.00 912795VA3 01 20,000 04/20/06 97.591611 4.934 4.750 10/19/06 BILL P.r 10/19/06 20,000 20,000.00 912795VE5 01 115,000 05/11/06 97.563222 5.009 4.120 11/16/06 BILL P.r 11/16/06 115,000 115,000.00 912795VHI 01 120,000 06/01/06 97.565750 5.004 4.115 12/07/06 BILL P.r 12/07/06 120,000 120,000.00 IF YOU HAVE QUESTIONS CONCERNING THIS STATEMENT. PLEASE CONTACT YOUR TREASURY RETAIL C-C""'IIDITI~C' ""'IT~ A "In nn_\JU"''- \.1_' ....... .. ,..,.._.....__.... n ~.....__ . TO 5177 (~k'<.m~r 2005) Mailing Number: 031004080 : LegaeY1'reuUryl>ired.A~lIat!fo.il 4800-530-8732 l I.................... $1"A'TI:Mi:NTOF ACCOUNT I .. Page2of) 3 , .. ._---........... ... ...... '... . ...... .SVrTrl'iT-rv :':'::::::<. .:~-~~:~.:~}::: . :.............>>{S~j"~$UIl-A.(;C()UNT....... . 9128280Y3 01 10,000 06/30/05 99.952201 3.65 06/30/06 3 5/8 NOTE S 07 Int.rest 06/30/07 10,000 181.25 912828ANO 01 5,000 11/15/04 99. 744019 3.09 11/15/06 3 NOTE 8 07 Int....st 11/15/07 5,000 75.00 912828EUO 01 15,000 01/31/06 99.901510 4.427 07131/06 4 3/8 NOTE R 08 Int....st 01/31/08 15,000 328.13 912828EZ9 01 10,000 03/31/06 99.801852 4.73 09/30/06 4 5/8 NOTE T 08 Int.rest 03/31/08 10,000 231 . 25 TRANSACTION HISTORY For 03/09/2006 to 06/09/2006 . . . - . . . . . .. ....... . . . . . . . . . . . . . . . . . .....-.-......... ............... ............-.... ................ ................. .............................. ............... . . . - . . . . . . . . . . . . . . . . . . . . . . . .. ................. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ................ ..... ..-................... ................ .................... .-...... ...... ........................................... ... ..........-...................-..........-..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................... ............................................... .....................-......................... ..-.....-.-........-.......................... .. ..... ..... ............. ................. ..............-.. ...................................... ......-.......... ...........................,-........ ..-................................... ..................... ...-................................-..... ...................................... ...............-............................................... ..-.-..................-......-...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . :::::~.b.I>P't.I'j&;.~ ....d......:. \)..........,..-03i09/20061:. ................;...:.:.:-:-.::.:.:-:-:....:-:-:.:-:-:-:-:.:-....:-:':-:-:-:':-:':-:-:-:-:-:-:-:-:-:':-:':':-:-:-:-:-:-:-:'. .- -..- '.' ................. . . . . . . . . . . . . . . . - . . . . . . . . - . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................ .............. . . . . . . . . . . . . . . , ....-.................. . . . . . - . . . . . . . . . . . . . . . . . . ..................... . . .. ...... ...... ......... $~!~,OOOI .... .............. .............. .............. .............. 03/31/06 912828COO 1 1/2 NOTE " 06 Int....st P.Yllent 75.00 03/31/06 912828COO 1 1/2 NOTE " 06 R......Uon -10,000 03/31/06 912828EZ9 4 5/8 NOTE T 08 R.inv.stllent Pu..ch... +10,000 Secu..ity P..ic.: 9,98'.19 03/31/06 912828EZ9 4 5/8 NOTE T 08 R.fwul P.Yllent 19.81 04/06/06 912795W7 BILL 04/06/06 R.dellption -60,000 04/06/06 912795XY2 BILL 10/05/06 R.inv.stllent Pu..ch.s. +60,00' Secu..ity P..ic.: 58,583.43 04/06/06 912795XY2 BILL 10/05/06 R.fwul P.y...,t 1,416.57 04/20/06 912795WY3 BILL 04/20/06 R.dellption -20,000 IF YOU HAVE QUESTIONS CONCERNING THIS STATEMENT. PLEASE CONTACT YOUR TREASURY RETAIL C!C:""IID1TIIt:~ C'ITI:' A "In nnl"'\\JIt"'\~ V_, I,., .& "''''_, ...~...... .....__ MET - Stock chart, Index chart - MSN Money ,,191 Honk Hotrnail r'ly ,.1SN Sign In -.., if msn' ~L Money 1:.!1 HSN ~'.~~."'4~.'__""'____.._ , Investing HCiT!C Purrfoi:o f.lark'cls Stocks Funds ETFs CJinmel~tary Brokers C'JBC TJ Page 1 of2 G http://moneycentral.msn.com/investor/ chartsl chartdl.asp ?Symbo 1= ME T &DateRange Form... 7/20/2 006 . -~~ -~----- WACHOVIA Wachovia Securities, LLC Retail Investment Group NC1164 401 South Tryon Street Charlotte, NC 28288 September 19, 2006 Stone, Lafaver & Shek1etski Attorneys At Law Attn: David H. Stone PO Box E New Cumberland, P A 17070 RE: Ruth Anderson Dear Mr. Stone: Thank you for contacting Wachovia Securities regarding the account(s) of Ruth Anderson. Attached is the information regarding the date of death valuation requested. If you have any questions regarding this matter or if you need further assistance, our Estate Support Specialists are available, 8 a.m. to 6 p.m., Monday through Friday, at 866-786-4890. Sincerely, 0/1. / / Cj;? C;//. c.7UC:l'UT'I4 //l. .J:/un~:n/ Richard H. Shinn Estate Support Specialist Wachovia Securities, LLC Securities and Insurance Products: Not Insured By FDIC Or Any MA Y LOSE VALUE Not A Deposit Of Or Guaranteed By Federal Government A enc A Bank Or An Bank Affiliate Brokerage services offered through Wachovia Securities, LLC, a registered broker-dealer and a separate, non-bank affiliate ofWachovia Corporation. Member NYSE and SIPC. CPDQArtf 138329928 9113430 9620346239 Sate 0 Jeath: 06/28/ 006 '/aluar. on Date: 06/28/ 006 Proces ing Date: 09/19/ 006 Shares (H Par Security Description 15329.13 BANK DEPOSIT SWEEP (CASH) J..ccrua 1 "165.669 EVERGREEN PA TAX FREE FD (300326105) CL A Mutual Fund (as quoted by NASDAQ) 06/28/2006 Total Value: Tctal Accrual: Total: S94,811.06 Command Account: 9620346239 Investment Account: 1149-7609 .':"~-.:.: .::'.:: ~rGj~cej ~~:~ ~state~al, a prod~ct ~~ Cie3E€ =~n:a=t E';? 5'!ste~5 aL ~IM ";5.5 Estate Valuation Ruth L. Anderson High/ASk Low/Bid 11.09000 Mkt Portfolio Endnotes t=age .l.- Estate of: Ruth Account: 1149-7609 / 96 Report Type: Date Number of Secur File 10: Mean and/or Div and I"t Adjustments Accruals 11.090000 S14.66 Estate '!al~at~c~s & Pric~~g Sys:ens, :n:. 313-6320 sr ~w~.evps;s.ccm. Re-:~s~cn- 14.66 ;-;a:'.e nderscn 0346239 f Death ties: 2 :49~EIJ9 Sec'Jri t:/ \'alue 15,3:9.13 79, 4E7 .2'""7 $94, /96. 40 -::-"':025 t:.1-:':: :".S, ~:E Citizens Bank" 525 William Penn Place Suite 153-2618 Pittsburgh, P A 15219 August 10, 2006 DA VID H. STONE 414 BRIDGE STREET P.O. BOX E NEW CUMBERLAND P A 17070 Estate of RUTH L ANDERSON Date of Death: Jun 28, 2006 SSN: 270-03-1287 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincerely, R~~ Robert Roos Operations Services ~~ Citizens Bank" Account Number 6100769658 Account Title RUTH L ANDERSON Date Opened 9/29/1976 Account Type Checking Principal Balance as of DOD $47657.10 Interest from Last Posting to DOD $.00 Account Balance as of DOD $47657.10 YTD Interest to DOD $237.42 ~~ Citizens Bank' Account Number 6140231663 Account Title RUTH L ANDERSON Date Opened 12/10/1993 Account Type Savings Principal Balance as of DOD $22288.97 Interest from Last Posting to DOD $4.28 Account Balance as of DOD $22293.25 YTD Interest to DOD $22.35 ~~ Citizens Bank' Account Number 6140704146 Account Title RUTH L ANDERSON Date Opened 4/17/1996 Account Type Time Deposits Principal Balance as of DOD $13431.10 Interest from Last Posting to DOD $13.07 Account Balance as ofDOD $13444.17 YTD Interest to DOD $198.24 ~~ Citizens Bank" Account Number 6140705762 Account Title RUTH L ANDERSON Date Opened 7/10/1996 Account Type Time Deposits Principal Balance as ofDOD $11631.53 Interest from Last Posting to DOD $22.35 Account Balance as ofDOD $11653.88 YTn Interest to DOD $214.01 ~~ Citizens Bank, Account Number 6140705770 Account Title RUTH L ANDERSON Date Opened 7/10/1996 Account Type Time Deposits Principal Balance as ofDOD $10000.00 Interest from Last Posting to DOD $20.45 Account Balance as ofDOD $10020.45 YTD Interest to DOD $159.56 ~~ Citizens Bank- Account Number 6140731860 Account Title RUTH L ANDERSON Date Opened 8/11/1998 Account Type Time Deposits Principal Balance as ofDOD $15000.00 Interest from Last Posting to DOD $21.90 Account Balance as ofDOD $15021.90 YTD Interest to DOD $221.39 )::E Citizens Bank < Account Nwnber 6140731879 Account Title RUTH L ANDERSON Date Opened 8/11/1998 Account Type Time Deposits Principal Balance as of 000 $5000.00 Interest from Last Posting to 000 $10.29 Account Balance as of DOD $5010.29 YTD Interest to 000 $103.96 11 M&fBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 July 26,2006 Stone LaFaver & Shekletski Attorneys At Law 414 Bridge Street POBox E New Cumberland, Pennsylvania 17070 Re: Estate of Ruth L Anderson Social Securitv: 270-03-1287 Date of Death: June 28. 2006 Dear Sir or Madam: Per your inquiry dated July 14,2006, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 10965424 Ownership (Names of) Ruth L Anderson ... Opening Date 01/28/68 Balance on Date of Death $82,170.90 Accrued Interest $ 4.29 Total $82,175.19 2. Type of Acc.:ount Certificate of Deposit Account Number 031003913919197 Ownership (Names of) Ruth L Anderson ... Opening Date 12/15/00 Closed 07/20/06 Balance on Date of Death $15,000.57 Accrued Interest $ 16.40 Total $15,016.97 3. Type of Account Certificate of Deposit Account Number 031003914520737 Ownership (Names oj) Ruth L Anderson * Opening Date 06/03/96 Closed 07/20/06 Balance on Date of Death $21,424.37 Accrued Interest $ 62.21 Total $21,486.58 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the William Penn Office # 717-255-2211. Sincerely, ~~C+ Nancy Clagett Records Management ~~~c?jah Continuing Care Retirement Services - Founded 1896 December 20, 2006 Richard Anderson 120 Rambelwood Dr. Apt. 9 Etters, PAl 7319 Dear Mr. Anderson: I am writing to you concerning the refund due for the apartment occupied by Ruth Anderson at 729 Oak Oval, Messiah Village. The acquisition fee paid for the unit in September 1987 was $96,750.00. The agreement was terminated November 17,2006. Seventy-five percent of the acquisition fee was amortized over 100 months leaving a refund in the amount of$24,187.00 (see enclosed amortization schedule). The payment of the refund will take place in six months or after the unit is acquired by another resident, whichever comes first. If you have any questions regarding the refund, please call me at (717) 591-7204. Sincerely, 1),/\ {(1j7W nu O~(y, C})() LL(\ Uc~ek! Maglich Brow~- Manager of Financial Operations Encl. 100 Mt. Allen Drive. Mechanicsburg, PA 17055-6100 (717) 697-4666 . Fax (717) 790-8200 . www.messiahvillage.org Enhancine Life DEPOSI'l' >>I>R'l'IZA'l'ION S'': -f 1'3707 NAME: 0,..;; Il~ i R",fl... A "I Jason I HOUSB TYPB AND t: <::..1 ~ (','" '" n... 't AK)0N'l' AMORTI ZED: 4? '. 7 ~- o. ""- TERM OF A!<<)RTIZATION: JOt) r0~'ii-h5 )1.(" RAm OF lUfJIl~I ZA~ION: . 0 0 7 ,/ f").. ( 54 '~..) K>NTHLY A!<<)RTIZA'l'ION: .-$ 704 r. ~ 3 57),'7 ') J'i7,73 N<<>R'l'IZATION BEGINNING DA'l'E: Sep .j..~...... ber- }'7 i 7 AMORTIZA'l'ION ENDING DATE: be.c.e.".. b~r }~'i~ REFUND: $ ~Lf J g 7, /)1,) I FISCAL YEAR-END DATES AMOUNT BALANCE 9t 7!:(). /)c '7 J., !~ ',.-) ~.) I' 9 I TO" 30 7 ~ ~(, ']0 &'1 93, 7() Ii 'I I TO~ 30 ~~ 5!"f~'1.J~ ~ ; 7 I TO Ju 90 Lt1 il1/ S"i ; 7 ~ . 3,lliLj,'~ ) TO jo 9/ , q I 7 TOt, 'I. ]" a, ~7D7.c;~ ,- 1 (.; TO ;0 n Z107.ru .itS' 'ST. D 2.) II/nO 1L I 7 TO J. q 7 (.) '? , S-~ '( :;;;./ ~ .3L( 13,,,(,/.3"/ '1.3 '4 7 t.. TO '0 ~'i ~ 'i 3\D.7S '''l .- )f.., I 7 /'l... TO 1/ ~J..f ;<67.0) , q- '1''- ). - . -0- TO FINAL UNAMORTIZED AMOUNT: DATE PAID: SMART MOVE MAKERS (717) 774-0485 NEW CUMBERLAND, PA 17070 Personal Property Appraisal Client: Richard C. Anderson Lewisberry, PA Item Name/Description Cond Qty Value Morgan Silver Dollars, silver, common dates G 51 $ 14/ea Eisenhower Dollars, copper/silver, common dates VG 5 $ 2/ea Wheat pennies, common dates G-F 100 $ 10/ all Jefferson nickels, common dates G-F 40 $ 20/all 2 ~ Dollar gold piece, 1911 F 1 $195 One Dollar Silver Certificates, varying dates G-F 54 $ 81/ all Five Dollar Silver Certificate G 1 $ 7 One Dollar Silver Certificates, 1957, two groups U 16 $128/all consecutively numbered Kennedy Halves, copper/silver, common dates G-F 32 $ 24/all Liberty Halves, silver, common dates G-F 9 $ 72 / all Franklin Halves, silver, common dates G-F 8 $ 88/all Susan B. Anthony Dollars VG 5 $ 5/ all Liberty Silver Dollars, common dates VG 8 $ 80/all Metal War pennies G 2 $ l/all 1982 Washington Commemorative Half Dollar, silver F 1 $ 10 1971 Eisenhower Silver Dollars, silver M 3 $ 30/all 1972 Mint Sets MU 2 $ 20/all 1975 Proof Sets MU 2 $ 20/all 1966 Special Mint Set MU 1 $ 25/all Collector Vintage Set MU 1 $ 5 1982 Commemorative Half Dollar, silver U 1 $ 6 1863 Civil War military coin, copper VG 1 $ 35 Misc. trolley/bus tokens G $ 10/all Misc. foreign coinage G $ 20/all Item Name/Description Cond Qty Value 1822 1922 Grant Co~rative Half Dollar, silver VG 1 $ 55 1809-1884 Cyrus MCCormdck Token commemorating the VG 1 $ 35 International Harvester Reaper 'fokl /,0(.,.(['0 Uet1a~ P,.. , Signature: Date: ~~~ c7 - AUG-09-2006 21:47 PNCBANK 412 768 3458 P.01 o PNCBAN< August 10, 2006 Stone LaFaver & Shekletski Attn: David H Stone 414 Bridge St. POBox E New Cumberland, P A 17070 /scp RE: Estate of Ruth L Anderson (Deceased) SSN: 270-03-1287 DOD: 06-28-2006 Dear Mr. Stone: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account #31700042501 Established 06-17-1996 RUTH L ANDERSON DOD balance: $10,000.00 + $11.99 accrued interest Account #31800042684 Established 06-17 -1996 RUTH L ANDERSON DOD balance: $10,000.00 + $14.74 accrued interest Account #31500192509 Established 07-14-2000 RUm L ANDERSON DOD balance: $12A54.99 + $19.24 aeerued interest Account #31500211605 Established 06-25-2001 RUTH L ANDERSON DOD balance: $10,000.00 + $2.95 accrued interest Cheddng Account Account #5140001294 Established 11-01-1967 RUTH L ANDERSON DOD balance: $95,506.70 + $25.84 accrued interest Page 10f2 AUG-09-2006 21:47 PNCBAtiK 412 768 3458 Savings Account Account #5030125499 Established 02-13-1990 RUTH L ANDERSON DOD balance: $75,614.39 + $130.93 accrued interest Account #5130040628 Established 03-31-1983 RICHARD C ANDERSON RUTII L ANDERSON DOD balance: $20,196.23 + $39.13 accrued interest Safe deposit box The decedent maintained safe deposit box #152. It was in one name only. RUTH L ANDERSON It is located at: MESSIAH VILLAGE BRANCH 939 Oak Oval Mechanicsburg, P A 17055-8409 717-691-4091 Please note that this oftice only provides date of death balances for deposit accounts (!RAs, CDs, Checking and Savings accounts). We do not process any fmandal transactions or provide statements. If you need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Cu:c..-- ';7 ~ Erica L Schlegel 1-800-762.1775 P7-PFSC-04-F 500 First Ave. Pittsburgh P A 15219 Member FDIC Page 2 of2 P.02 TOTAL P. 02 [!I3~~(;~ 07/22/2006 To whomsoever it may concern The account balance on June 28,2006 for account # 8019818 named under Ruth L Anderson was $15,996.36. In case of any questions please feel free to call me (630)-232- 6700. Thank you, Shen Ac a Downtown Geneva 21 N Third St. Geneva, IL 60134 630-232-6700 Kelley Blue Book - Private Party Value Pricing Report - Chrysler, New Yorker t-~fiJ ~~~ Kelley Blue Book c.~ THE TRllSTED RESOURCE . k\)bcOlW Page 1 of2 .,~. 1994 Chrysler New Yorker Sedan 40 :JLJt k )fTi;\.lt PAKY 'iMUt Condition Value '52, S .l~,) ../ Good $2,550 ( Selected) ~" -:~ " Vehicle Details Mileage: Engine: Transmission: Drivetrain: 15,(")00 V6 3.5 Liter /lutomatlc FViD Selected Vehicle Standard ,.::2.i; Povver Door Locks Cruise CI)nrrol /lfV1/Fr.-1 Stereo Cassette Dual Front /llr Ba1js Power Seat S~\:~t'riljg \.\'Ind()':;s Blue Book Private Party Value \,'cliUt~ 's ':vh~t a buyer (('II""" expect to pay I,^,','len buyinl;J a used car ~art'y. The ;>rivate Part'y' Value assumes the vehlc!e IS sold "As Is" ',ar'-\1nt'1 (other than the ~=ont:ruinq factcry v/arranty). The final .',If',' Jt;ccndlnq on tht~ vehicle's actual condition and local market 'iI-'ll ,]isc tie I_Jse,j t,;:) der've Fa!!' :1\,'1ar-~',et \;~11ue for inSur'ance ~:' ',: r- ::,-,;SI:::'5 Vehicle Condition Ratings / <) http://w\vw.kbb.com/KBB/U sedCars/Print/PricingReport.aspx?V ehicleClass=U sedCar&M... 3/15/2007 Kelley Blue Book - Private Party Value Pricing Report - Chrysler, New Yorker Page 2 of2 ../ Good '.5c'iCC""d $2,550 Good'; u;[~dlt)on !T,eans that the 'vehlc!e IS frcR of any major- defects. This has El ciCdn tltl(~ history I the pamt, body and interior have only Illlnor h:er1iISrlt:s, and ttlet"t'? are no rTlJjor nli~ctlanical problems. There ':'c' I!ttie no rust on ttl15 'Jehicle, The tires match and have tr"t:~ad/:eJr i(~ft. A "good" vehlcte "vii: r,eed soniC i'econditlonlng to -'if' crdll. r"lost conSUrner (y.':npd \/elllcies fail into thiS cateqor'l, C;..'~ . ':I:::'7~"""""'''~--'''a ~ . :: .~N.,;~".th\.i.i.~ C:CJ':>(~ L /S ,\j .. Penn';yivanla 3/15/2007 http://ww\v.kbb.com/KBB/U sedCars/PrintiPricingReport.aspx?V ehicleClass=:U sedCar&M... 3/15/2007 MetLife' METROPOLITAN LIFE INS. CO. 4550 LENA DR S-101 MECHANICSBURG PA 17055 11' Questions? Contact your MetLife Representative: 717-691-5900 Sales Office/ Agency: 56L/821 Annual Dividend Statement #BWNDYSK #QDHBJHQQQG///423# RUTH L ANDERSON 120 RAMBLEWOOD DR APT 9 ETTERS PA 17319-9102 Name of Insured/Annuitant RICHARD C ANDERSON Plan ENDOWMENT AT AGE 60 Anniversary Date January 21, 2007 Policy/Contract Number 23 183 000 A Face Amount of Insurance $5,000 Dividend Summary According to the terms and provisions of your policy, you have chosen to have your 2007 dividend pay the premium on your policy. $89.35 will be used to pay the premium. A check for the excess amount of $77.20 will be sent to you on or about January 21, 2007. 2007 Dividend: Less Premium: Excess Amount: At MetLife, we value your business and look forward to providing you with quality service -- now and in the years ahead. ~'~: s ~)\~ ~\ \ , ' - ~ -. ~ "oe-,0~'\ '~~~S '. ('[.1 q C ,"i."u ~ ,J,' ' $166.55 89.35 77.20 For questions or service, please contact your MetLife Account Representative or callI-BOO-MET -5000 /t onn et'Jo ~nnn' f\.._ L.....:.......... ...l_...:.... ....._.J_.. __!L!_ L__L L_ __II mh__~___ LL______L y:,_!J_u !~ ____!LI_ ~~ NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION (A DELAWARE CORPORATION) BOX 6'116 CLEVELAND OH 44101-6'116 1-800-6'15-'1813 EXPLAN PLEASE 01 0180 CI NOVEMBE IN FULL S POLICY NI INSURED I I" ,11111I111", 1...1""".. 111.1.., .,.", I' I, l ,II, I" I", III ESTATE OF RUTH L ANDERSON 414 BRIDGE ST NEW CUMBERLND PA 11010-1'121 PAYEE ES' THE FOLLOWING STATEMENT OF ACCOUNT SHOWS THE ELEME COMPRISE THE CASH VALUE SETTLEMENT: ANY ALLOWANCE PAID BEYOND THE CASH VALUE AS OF DATE, HAS BEEN I~ THE CASH VALUE FIGURE. CASH VALUE BENEFIT AS OF 11/03/06 $ REFUND OF LOAN INTEREST $ REFUND OF COST OF INSURANCE $ 47,142.47 0.00 62.08 SURRENDER CHARGE POLICY LOAN POLICY LOAN INTEREST FEDERAL TAX WITHHELD SPECIAL AGREEMEt AMOUNT PAYABLE (CHECK) TOTAL $ FEDERAL TAXABLE GAIN $ 47,204.55 TOTAL 28,933.70 r\ , I IF YOU HAVE ANY QUESTIONS ABOUT THE TAX TREATMENT OF THIS. CONSULT YOUR TAX ADVISOR OR THE LOCAL IRS OFFICE. THIS IS NC POLICY. IF YOU HAVE ANY QUEnlONS ABOUT THIS POLICY, PLEASE CALL YO IF YOU PREFER. CONTACT ONE OF OUR CUSTOMER SERVICE REPRES ....... ............,............,................................................................................................................................... Allianz Life Insurance Company of North America PO Box 59060 Minneapolis, MN 55459-0060 800/950-1962 Allianz (ill) August 2, 2006 STONE LA FA VER & SHEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET NEW CUMBERLAND PA 17070 Re: RUTH ANDERSON, deceased Annuity Policy Number 2163081 Dear Executor: This letter is in reference to your request for the date of death value on the above policy. Please be advised that the cash surrender value as of June 28, 2006 was $38,703.74. Should you have any questions, please feel free to contact our office. Thank you. Sincerely, John Witcpalek Claim Examiner C: William Schneider #14477 BANKERS U""'E AND CASUAIJTY COMPANY Life Division · 222 Mnv:htJllthse Mart Plaza Chicago, IL 60654-2009 . Telephone: 312-396-6000 ~ Stone LaFaver & Shekletski 414 Bridge St Po Box E New Cumberland PA 17070 August 4, 2006 Policy 7,669,159 7,639,192 ATTENTION: David H Stone RE: Ruth Anderson, Deceased Dear Mr. Stone: We are writing in response to your letter dated July 20, 2006. Both of the above referenced policies were non-qualified annuities. The cash value of policy 7,639,192 as of June 28, 2006 was $16,300.13. The cash value of policy 7,669,159 was $78,140.92. If you have any other questions or concerns, please feel free to contact us. Sincerely, (,. ~~VL-L____ Greg Sittner Jr. Life/Annuity Claim Department LCGS 756943 For local service, contact: Branch Sales Office 1051 2300 Vartan Way Fl 2 Harrisburg PA 17110 Phone (717)545-7999 81.0013 (07/'2) . NEW YORK LIFE INSURANCE COMPANY NEW YORK LIFE INSURANCE COMPANY AND ANNUITY CORPORATION (A DELAWARE CORPORATION) PO BOX 6916, CLEVELAND 08 44101, (800) 695-9873 The Company You Keep July 31, 2006 DAVID H STONE STONE LA F AVER & SHEKLETSKI A TTORNEYS AT LAW 414 BRIDGE ST PO BOX E NEW CUMBERLAND P A 17070 Annuitant/Owner: Ruth L Anderson Policy: NP471971 Claim: 944374 Beneficiary: Richard C Anderson Dear Mr. Stone: I am pleased to reply to your request for tax information on the above annuity. Since form 712 is no applicable for a contract other than life insurance, the following should be of assistance to you: Policy Issue Date Values as of the Date of Death of 06/28/06 Taxable Gain NP 471 971 07/22/1985 $68,315.35 $45,330.39 Please let me know if we may be of further service. Sincerely, " /' 1'1 /1, ,', ( Jf!,I/I; L J: , _, / tv\-") v' . (t~_lU(.ftr '> Theresa A. Hakkio Customer Service Representative CC: James D Day LUTCF, V39 ...... cltlgroupJ SMITH BARNEY REVISED 09-13-2006 One PPG Place, Suire 1300 Pirrsburgh, PA 15222-5490 Tel 412-392-5800 Fax 412-392-0318 Toll Free 800-245-6100 DATE OF DEATH VALUES JUNE 28, 2006 736-21872-18 RUTH L. ANDERSON TTEE UIWIO ORVILLE ANDERSON Equities TOTAL Symbol Quantity Description HIGH LOW MEAN VALUE T 2246 AT&T INC 27.44 27.24 27.34 $ 61,405.64 ARM 999 ARVINMERITOR INC 16.26 15.85 16.06 $ 16,038.95 BLS 556 BELLSOUTH CORP 35.66 35.29 35.48 $ 19,724.10 BA 507 BOEING CO 82.69 80.83 81.76 $ 41,452.32 BNI 513 BURLINGTON NORTHERN SANTA FE 77.74 75.17 76.46 $ 39,221.42 CMCSA 165 COMCAST CORP CL A 31.80 30.78 31.29 $ 5,162.85 FDr 600 FORT DEARBORN INCOME SECS INC 13.33 13.20 13.27 $ 7,959.00 IP 222 INTERNATIONAL PAPER CO 31 .44 31.07 31.26 $ 6,938.61 PG 1000 PROCTER & GAMBLE CO 56.02 55.50 55.76 $ 55,760.00 ROK 4000 ROCKWELL AUTOMATION INC 70.03 68.91 69.4 7 $ 277,880.00 COL 4000 ROCKWELL COLLINS INC 54.14 53.13 53.64 $ 214,540.00 SCG 1000 SCANA CORP NEW 37.90 37.40 37.65 $ 37,650.00 SLB 400 SCHLUMBERGER L TD 60.70 59.33 60.02 $ 24,006.00 SO 1000 SOUTHERN CO 31.92 31.67 31.80 $ 31,795.00 VZ 1644 VERIZON COMMUNICATIONS 32.84 32.52 32.68 $ 53,725.92 VOD 1030 VODAFONE GROUP PLC SP ADR 20.63 20.63 20.63 $ 21,248.90 $ 914,508.71 Preferreds TOTAL Symbol Quantity Description HIGH LOW MEAN VALUE ABNPRG 1000 ABN AMRO CAP FDG TR VII 6.08% 22.66 22.30 22.48 $ 22,480.00 CPRQ 1000 CITIGROUP CAPITAL X16% 22.20 22.04 22.12 $ 22,120.00 METPRB 500 METLlFE INC 6.50% PFD 24.43 24.23 24.33 $ 12,165.00 ISP 1000 ING GROEP NV 6.2% PFD 23.30 22.95 23.13 $ 23,125.00 SOPRD 1000 SOUTHERN CO CAP TR VI 7.125% 25.08 25.04 25.06 $ 25,060.00 PUKPR 1000 PRUDENTIAL PLC PFD 6.75% 24.47 24.14 24.31 $ 24,305.00 $ 129,255.00 CASH $ 39,798.49 $ 1,083,562.20 Cirigroup Global Markers Inc. THE INFORM....TION SET FORTH W:~S OBTAINED FROM SOl:RCES WHICH WE BELIEVE RHlARLE BUT WE DO NOT GUARANTEE ITS ACG:RACY OR COMPLETENLSS. ~EJTHER THF INf:()!<,\fATH)N 'JnR ..\.NY ()PINI()1'\J J..'Yr>R~o.;,~n rl'l-..Jli;:TlTTfTJ:( ~ "::n! Jr'TTATl.""1 [IV 1'(' ,\[:: TUt: nI'n,'l'..'r' .,n ,-.,.... .,.... Ok... .'__'"....~'_._~