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Home My WebLink About03-28-07 ....J 15056051047 REV-1500 EX (06-05) PA 0epaI1menI of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year Ale Number ""2-\ Date of Birth 070;;Ld--OOb Suffix DJ. ';-3 { 1 d.S Decedent's First Name 1)t A-N MI Decedent's Last Name (If Applicable) Enter Surviving Spouse's Infonnatlon Below Spouse's Last Name SuffIX Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Retum c:::> 2. Supplemental Retum c:::> 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required c:::> c:::> 4a. Future Interest Compromise (date of death after 12-12-82) c:::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:::> 10. Spousal Poverty Credit (date of death c:::> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes 4. Limited Estate c:::> - c:::> State ZIP Code ~A- 111 lfl rt>1N-'1? = ["REG-isTER-~S..USE()~--l I]~ ~ :11- ! C ~) ".-) ():=;-, " i NI 1 ..................J \)E'A- JJA: Firm Name (If Applicable) C.cio .." TL. First line of address 38'. 10 Do .lA De.- Second line of address City or Post Office +h Pr e- t \ s . ..'i> lL [.G-- :-n ...........J ....~J.':~.~!!::.~.~. Correspondent's e-mail address: Q...clM... Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to tha best of my knowledge and belief, It is true, correct and complete. Declaration of preparer other than tha personal representative is based on all Information of which preparer has any knowledge. SIGNATURE~~~GRETURN DAioj,tlJ/hf, ADDRIiS,S () ,j 810 .D 0 LA- 0 e. 1+/tLLg B ui.G- rA- { 711 () SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 --.J C1 .-.J REV-1500 EX Decedent's Name: RECAPITULATION 15056052048 ~ A.. CIlX>"-. 1. Real estate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c.:> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c.:> Separate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . .. 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE. . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Decedent's Social Security Number 15. 16. 17. 18. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052048 Side 2 c.:> 15056052048 .....I File Number d-ot> b -- t) G (pd.-8 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENrs NAME \) ~ ~. Ceo \::. STREET ADDRESS 51-0 ST CITY ~&J C..uM. ~t;.Q....L~ D STATE Q-A Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. CreditslPayments A. Spousal Poverty Credit B.Priorpayments C. Discount ZIP '7 C"") , (),D Total Credits ( A + B + C ) (2) 3. InterestlPenalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 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. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 c. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............ ......... .................................................................................... ..... 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...... ........................................... .................. ............................................ ......... 0 No i ~ ~ lXl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1. 1994 and before January 1. 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax. and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent. or a stepparent of the child is zero (0) percent [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is twelve (12) percent [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent. whether by blood or adoption. REV-1508 EX+ (6-9B) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF \)~ ~. CooK FILE NUMBER door;. - 00 b d-g Include the proceeds of lligation and the dale the proceeds were received by the estate. AI property Jolntty.owned with right of survlvolllhlp must be dlscloHd on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH t)1L- \ eC Cr- t:~~* 0 ~Ifv- 3S""JD. ()~ d- ~o D ~ u..\ c: f;.. CENT o...~y 3S""1'1.. 00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 109~.os BELCO STATEMENT OF ACCOUNT II ~ ~~ ~ .p- Community Credit Union L getting you there MAIN OFFICE: 403 N. 2nd StrlIlIt P.O. Box B2 Hllrisburg, PA 1 71 08 Page 1 JOINT OWNERS I.. .111.. .111...1.. .111..... .111.1.. .1. .11. .1.11... .1. .11.1..1 DEAN A COOK DEAN A. COOK JR 520 RENO ST APT 4 NEW CUMBERLAND PA 17070-1948 Q.eJ tSOo SCft (. -:;::TE"M 1. FtC-E d-Dob- Oc>,~t3 0701 0711 0711 0731 PREVIOUS BALANCE ~ ~ SAVINGS TRANSFER WITHIN SAME ACCO CLOSE ACCOUNT WITHDRAWAL NEW BALANCE 0701 0705 0705 0707 PREVIOUS BALANCE DRAFT PAID DRAFT PAID PREAUTHORIZED WITHDRAWAL li ~ CHECKING 0794 0795 0000009547 COMCAST CENTRAL CENTRAL PA PREAUTHORIZED WITHDRAWAL 2231628836 COLONIAL PENNCPL INS. PREM. TRANSFER WITHIN SAME ACCO NEW BALANCE 0707 0711 0731 -278120 ------------------------ CLEARED DRAF SUMMA V 0794 0795 ------------------------------------- ------ TOTAl DIVIDEND YEAR- TO-DATE fDr II savinp IXClpt IRA. Dividlndl shawn. If $1 0 Dr lIVIl' h~_~ ~ to the In... RlIVIIIII iHIva fCll'this caIIndIr yw. .INDICATES EFFECTIVE DATE 0.00 TOTAL RNANCE CHARGE YEAR- TO-DATE fDr II 1DanI. 0.00 NOTICE: SH r8VInI IidI far inpGr1ant infannatiDn. 0605575 Edmunds used Buick Century car appraisal. Used Buick car pricing. \(E\J- [)bD Welcome, Guest 1_.......'..... _ ~,....,.........: . "_'. ,~".'.'o' .', ...._ ,.,~ . ' ~ , ! ,'- ..' " '..' .' ....,. ...., t-....~._.--... J Page 1 of3 ~'\.e IN'- ~~ Ft cE ~tO -- 00 (,;)..0 Edmunds.com I Inside Line I Your Account "ScH E Help I "Hl"lAKETPl..ftCE Financing As Low As 7.29% APR Free Insurance Quote HllMl:: NEW CARS i ER1IF1EO CARS . Get a free CARFAX record check. Buy your next used car with confidence. ~~ E LOAN .. CAR REVIEW'; riPS & iIDVI( ! h)RUMS /'\'SIDE USED CARS Rnance Your Car at a Great Rate . Search for Used Cars In vour area . Sell vour car online · Research Used Cars ~ ~::'~~~s~l1r~ ~ PRICING AND COSTS . TMV Pricing . Appraise Your Car . Resale Values . Payment Calculators . Vehicle History Report . 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Calculate Low Pavments · Free Extended Warranty Ouote Used Car Appraiser Back STEP 5 Review Edmunds.com Prldnl Report "'~,,""""" -~.. 2000 Buick Century 4 Dr Custom Sedan ~ True Market Value@) ~ Pricing Trade-In Private Dealer ~ Bmll $3,423 $4,356 $5,271 $75 $94 $123 $28 $35 $46 $29 $36 $47 $18 $23 $30 $28 $35 $43 $-25 $-32 $-39 $78 $78 $78 C$3~ $0 $0 $4,531 $5,476 National Base Price Optional Equipment Cruise Control AM/FM/Cassette Audio System Audio Steering Wheel Controls Color Adiustment Sliver Regional Adiustment for Zip Code 17112 Mileage Adiustment 75,000 miles Condition Adiustment Clean Total Certified Used \7ehicle N/A Price Another Vehicle Print Private partv Window Sticker I Print Dealer Window Sticker http://www.edmunds.comlused/2000/buick/century/13798/options.htm1?tmvaction=vdpresult 7/12/2006 , REV-1511 EX+ (12-99) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHIDULI H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF \)~ c.oo~ FILE NUMBER ~Ob - 00' c?L6 1\-. D.bts of dIC.d.nt mUlt bt reported on Sch.dult I. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT 1. AUEiL c.~m(tl~ SER\JlC.f;S" ~~~~ ~~S-~~r- Po1kJill~ -n V~u..s Go la{ G-varJ K. be1&- Ml.....is-f..if B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. tV~r Ff?(:[ nIL (t?fJtl.N~Tl6~ of EKec.uToi- tI 3. <{Q 3 J... S"D {DO. 00 100.00 79,00 7.00 TOTAL (Also enter on line 9, Recapitulation) $ L{ 3/ . q 0 (If more space is needed, insert additional sheets of the same size) REV-l512 EX+ (12.03) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT leN.DULI I DEBTS OF DECEDENT, MORTGAGE UABIUTlES, & UENS ESTATE OF FILE NUMBER d-006 - aJ';.8 DeA-rJ Pr. (.f)O~ Report dlbtllncurnd by the decedent prior to death which remained unpaid.. of the dele of death, Including unrelmbursed medlcalexpen.... ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH J- .3 if f) b. 7. 1. Sova2..€lb-N BM~ f'ruTo Usfr^J C.Jf'ASE vrs A- ~l.lt-JT 6 fttJ f( of A-M G1l.l cA- v( S Pr Aa.out\!.., ~evr 6tJ ft(arfM.~ 5J.<J fl..Ja-J() sr New(t)MS€)tWO PA- FoQ... (("eJ L Y (.}-oO(, C-cM.CA-ST ClIrUf;" B f u.. PP~L f>t/-L VeJ~br- SlL-t- 3l:} l./3. 8"J- a-gD 1. V[" /39!"',33 (PJo,OO Lf1, bB lfo.38 IV. 93 TOTAL (Also enter on line 10, Recapitulation) $ B 8 fo 9, 51 (If more space is needed, insert additional sheets of the same size) RBI 1Q>6 ScH I UIiA. 1 F7L-~ .).00(;- 00';;..8 Page: 1 Document Name: untitled Loan Administration Payoff Display 6017 7/12/06 RETAIL LNS BIS4028 Acct Type ILN Acct No 6817409357 Effective Date 07/12/06 Override 0 Display type PO Principal Interest Insurance Fees Charges Escrow Unapplied Pending Extension Short Name COOK DEAA --Customer Payoff-- 3933.07 10.75 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Q:~~~b 0.53769 0.53769 0.07435 Loan Type SIM --Participant Payoff-- 0.00 1. 49 0.00 0.00 0.00 0.00 0.00 refund Payoff Amount Escrow Balance Perday 1. 49 PO;PO CH;AMOUNT . U P [)l\'J:'_~__~QM PLl;J:.EaL. _ _. DIS;THI Good Until 07/12/06 Ins: CLF CL2 A-H IUI HI;HI DIS;SEG ~_QK._ 0.00000 0.00000 0.00000 0.00000 Interest Dealer , Statement for account number: 4266 8410 40412965 New Balance Payment Due Date Past Due Amount Minimum Payment $2,807.45 07/21/06 $0.00 $56.00 Amount Enclosed 1$ Kef t S1J) Self- 1= ~ :If:;).., 426684104041296500005600002807455224099 I Make your check payable to Chase Card Services. New address or e-mail? Print on back. CHASE 0 Enroll me in the optional Payment Protector Plan', I understand the enclosed offer and may cancel any time mifiars -nate 68202 BEX Z 11706 0 DEAN A COOK 520 RENO ST 2 NEW CUMBERLAND PA 17070-1948 1...111.1111..1.1..1..1111.1.1'11.11.1.1...11..1.1'1111..11111 CARDMEMBER SERVICE PO BOX 15153 WILMINGTON DE 19886-5153 I: 50002. 1;0281: 20 j 2.0...0... 2. 2 ~ I; 5 2.11- CHASE 0 Statement Date: Payment Due Date: Minimum Payment Due: 05127/06 - 06126/06 07/21/06 $56.00 VISA ACCOUNT SUMMARY CUSTOMER SERVICE In U.S. 1-800-945-2000 Espaiiol 1-888-446-3308 TOO 1-800-955-8060 Pay by phone 1-800-436-7958 Outside U.S, call collect 1-302-594-8200 Previous Balance Payment, Credits Finance Charges New Balance Total Credit Line Available Credit Cash Access Line Available for Cash Account Number: 4266 8410 4:041 2965 ACCOUNT INQUIRIES P.O. Box 15298 Wilmington, DE 19850-5298 $2,937.68 -$150.00 +$19.77 $2,807.45 C~ <?c:u:c.. ~~ ~1- 0)6. ~D X- ~S:-2- 't~ LJ~I~~ r'lg~-r-2-75 TRANSACTIONS Trans Date Reference Number Merchant Name or Transaction Desc_ripli~11 $9,500 $6,692 $1,900 $1,900 PA VMENT ADDRESS P.O. Box 15153 Wilrrllngton, DE 19886-5153 )J 7(ldOh , (1;,t 0f:Z/' Amount Credit DelJit ~3i~,.. B,("-((I)<( ~ 89~-ID1..... BankofAmerica'" AP ~ oM - - ~ Customer Corner t-J c.. l.\ - \u (' -- 0 ~ St Coming soon: You will receive III'" ~ your new 2006 Privacy Policy for ~ ( (, { P l Q.ct~ \-.....u '" Consumers in your July statement. D It ' If you have other accounts with (0 vi)E '1- '1..c '1-]"" Bank of America, you may receive r I IJ L more than one copy of the 2006 4050860011426556 l.:> ~ W-lVb U. Privacy Policy. ,....? ,,.0" )0 J,. 'J-. Previous Balance 3,547 Points Earned 22 Bonus Points Earned 0 Total Points Eamed 22 3,569 Adjustments Made 0 0 Points Redeemed 0 0 Points Available 3,569 t To redeem your points call 1.888.434.2232 or visit www.bankofamerlca.comlonlinebanking t Transactions _ ,OiOnt ~ ,... '" ""''''' ..,.. .. _............._. 1 \\ ...\;jJ POST. TRANS. REF. DESCRIPTION AMOUNT ~ DATE DATE NO. CR=CREDIT ~ Jun05 Jun04 153 WWW*EARTHLlNKNET L~~-~) $21.95); Jun 12 Jun 12 987 PAYMENT - THANK YOU CR $200.00 Jun 18 Jun 18 PERIODIC FINANCE CHARGE ~ $18.18 ~ 4' II~qq{poa C,,;Y\~ 1/,qriR :we ~o~ ~ .W6!!!!!!:.D II' . ",,1:.. R E WAR 0 s~ Visa@ Platinum Card DEAN A COOK Account Number: Your Power Rewards Visa@ Platinum Account N B I $1 395 33 ---:-~ -If 3 ew a ance , . .J,;..:: Total Credit Une $12,700.00 Available Credit $11,304.67 Cash Limit $6,350.00 Available Cash $6,350.00 OverlimitAmount --- - --. - ~~ ~$O.OO .. Billing Date ~. -- --- 06/1at06 Minimum Payment Due $31.96 Payment Due Date 07/13/06 24-Hour Customer Service For Lost or Stolen Cards Power Rewards Summary Pay online! Visit www.bankofamerica.com 1.800.492.2500 1.800.848.6090 This Period Total To Date /-eob-3S~-30l3Y Need an Extra $35,OOO?t We.can.depasitthe money directly into your checking account upon approval. Call to apply. 1-888-457 -2542 Mention Priority Code MY9W tActual credit line is established based on credilworthine55~ Issued by MBNA America Bank, N.A., a Bank of America company. Please return remit coupon with your payment ." PPL Electric Utilities Electric Service For: DEAN COOK 520 RENO ST APT 2 NEW CUMBERLAND P A 17070 Questions about this bilr? Please contact us by Jul 20 at 1-800-342-5775 or 484-634-4900 or write to: Customer Service 827 Hausman Rd. Allentown, P A 18104-9392 www.pplelectric.com . ' , ~ ,Ii, J ....:.~I~:.:~:> pp J~~: ".no Page 1 .. .:>:YQUf:Bm:Ai;:pQUritN~ . 64430-79021 w .':. .;iliri.;;;,:;.:: Summary Page Balance as of Jul 3, 2006 Char~s: TotarpPL ELECTRIC UTILITIES Charges Total Charges 12 10 8 6 4 2 o KWH - Average Per Day $ 0.00 $ 22.92 $ 22.92 Account Balance $ 22.92 .I.-L .' . .. 17 II\.- ~ L-vVJ~(I}O (Ute ( (1.1 :1'\ oHl 1. JI~ I Ul( --\Df):; Me \ \ .~ v~~tli/l Electric Use This graph shows your electJic use over the last 13 months. Types of Meter Readings: Actual _ Estimated KMiB,] Customer 0 --.-- -------- ,--. - -- .-. ---- ---.- '-- -- ----. --- ----,-- - -- - - - J AS 0 N D J F MAM J J 2005 Months 2006 Meter Reading Information JVleter Jul 3 Jun 2 31 Davs Actual Actual KWH Billed 6730 6578 ---r32 2006 711' 5 Average -Jill Temllerature KWH Per Day Yearly Use: Aug 2004 - Jul 2005 Aug 2005 - Jul 2006 2005 75F 7 Total Average Use Monthly 1949 162 2083 174 Other important information 011 back ... --.-- ------------- --------- --------------------- ---------------- -- -- -- --- ----------------- ------ -------------- -------- ------- - - ~ -- - -- -- ---- -- --- - ry~:3=O;-"1 AV 01 023584 920726157 A**5DGT DEAN COOK 520 RENO ST APT 2 NEW CUMBERLAND PA 17070-1948 11..111...111...1...111'1....111.1...11.11..1.11.....1.1...111 r-b>l!i'll::':~1 PPL ELECTRIC UTILITIES 2 NORTH 9TH STREET RPC-GENN I ALLENTOWN PA 18101-1175 1 4900000229290000022929 6443079021 .~. verimD We never stop worIcJng for you. DEAN A COOK Account Summary Previous Charges Payments Received thru Jun 27 Past Due Charges $23.2B -23.28 $.00 New Charges Verizon (page 3) Total New Charges due Jul 20 $21 . 78 $21 .78 Total Due (Past Due + New) ~. \ t{ ~3 d,:ll1frJ.-7 /l10(y ~\ r Mlr.e)hcl fJ / /Lf) Oft; All tt1 !Ji / / (0 &('-C1~ (JrDrrdvrL tv /V'hj J 10 cw:fD ()J jJ 1140 rnd'rttlu Change of billing address? Go to verizon.comlbillingaddress or see page 2. Billing Date: 06/25/06 Page 1 of 5 Telephone Number: 717 774 8781 Account: 7177748781 69410 Y How to Reach Us: See page 2 OJ Convenience! Manage Your Verlzon Account Online, Anytime Order services, view & pay your bill, request repairs, anytime day or night' At verizon.com clic/( "Sign In" under "My Account. " New user? Start with: User 10: 7177748781$ Password: FN93H8 and customize your 10 as you register. OJ Convenience! Access Your Verlzon Account Online Day or Night! Enjoy the benefits of managing your Verizon account online. View and pay your bill, order services, request repair, and more. Visit us today at verizon. com/seifservice to register. ** Wilo Says You Can't Take It With You? Just because you're moving doesn1 mean you have to leave your phone and Internet service behind. Just contact us and we'll make reconnecting at your new place easier than ever. Visit verizon.com/easymoving or call your local business office. ~" veriZSlD AccoUl t: 7177748781 69410 Y New C larges Due: 07/20/06 Total Due $21.78 DEAN A COOK 520 RENO 8T APT 2 NEW CMBRLND PA 17070-1948 1...111...111...1...111......111.1...1..11..1.11.....1.1...111 Do not mail a payment. You are enrolled in Verizon's Direct Debit . payment option. The total amount due will be deducted from your bank account on 7/20/06. REV.1513 EX+(9-00) *' COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHIDULI J BENEFICIARIES ESTATE OF D~ ~, ~~ FILE NUMBER drx>b - 066J- g RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not lilt Trusteell) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] N6 ~G' -0- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET D NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE NONt B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS tJ Dev ~ TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ -cr- (If more space is needed. Insert additional sheets of the same size) D~- 0(:) b ~ LAST WILL AND TESTAMENT OF DEAN A COOK 1, DEAN A COO~ of the Borough of New Cumberland, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all other Wills by me at any time heretofore made. 1. I direct my Executor hereinafter named, shall pay all my debts and funeral expenses as soon as conveniently may be done after my decease. II. I direct my Executor, hereinafter named to sell at public or private sale, or redeem, or convert into cash, all the rest, residue and remainder of my estate, whether real, personal or ~ed, and wheresoever situate, and I give and bequeath the net proceeds derived therefrom in equal shares, per stirpes, to my son, ALBERT E. COOK, my son, DEAN ACOO~JR and . -= 1'\ 0"'\ , ~:~ "__.J c- ::.:'.1 .'-" c _:2 f~ r ':':''5--: w daJJghter, JACAL YN E. CLARK ill. ,~ ~.._.i -'n I hereby nominate, constitute and appoint my son, ALBERT E. c08Flas r~ .... Executor of this my Last Will and Testament. Ifhe should predecease me, not qualify or not -.J accept the position of Executor, then I hereby nominate, constitute and appoint my son, DEAN A. COO~ JR., as Executor. -a :(J ;.~;8" (.....;.;j :0 '::"'::'0 j-,", III ::;:]0 c';~~ :; 'o=: :J:l ". C) ::- III -.~ ~ -,,') 'Q 0<'0 -- D () C ~.~ IV. I direct that my fiduciaries, herein named, shall not have to post bond for the faithful performance of their duties. IN WITNESS, WHEREOF,!, DEAN A COOK, the Testator, have unto this my /1 j1-, Last Will and Testament, set my hand and seal this _ day of ,T L/l17 P . 2002. ~~ (SEAL) SIGNED, SEALED, PUBLISHED and DECLARED by DEAN A COOK, the above named Testator, as and for his Last Will and Testament in the presence of us who have hereunto subscribed our names as witnesses at his request, in the presence of the said Testator and of each other. f' 1itt4r,&Hr4/ m&.. Al1I@/?4 ACKNOWLEDGMEm AND AFElDAVIT STATE OF PENNSYLVANIA ) ) SS COUNTY OF CUMBERLAND ) We, DEAN A COOK, E JJlhr ,17'" f/A J and Page 2 of 3 D ~ -- Dc) b ;;ll E J) f h flJpc' 74 (" ~ Q ~ . the Testator and the witnesses, respectively, - / whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and that he signed, willingly, and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Will as witness and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. J~~ (SEAL) T or ff4t~./ 444llAU1/ (SEAL) Witness ~ cJiRffLLI q)~ (SEAL) Witness . (/' a Subscribed, sworn to and acknowledged before me by DEAN A COOK, the Executor, and subscn"bed and sworn to before me by E f J I ~ e I;; r 5", .It. f and f i If> h ;JJP(?/t S ~p ~ . witnesses, this Ii t~daY of 'Jh I, e / 2002. ~.I#~; Notary Public a-j~ ' NOTARIAL SEAL WILUP,M A. YOCUM, Notary PtlbIIc Camp Hill Bore, Cumberland COLlnty M\I Commission Expires June 2.7, 2004 ...::- Page 3 of 3