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Home My WebLink About06-04-07J 15056051047 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 H ' b PA 17128-0601 RESIDENT DECEDENT ams urg, ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death r~. -n ~~~a,~,~F 55"a ,.S ~;~ / ono 0 Decedent s Last Name Suffix (If Applicable) Enter Surviving Spouse's Information Below Spnuse's Last Name Suffix OFFiC,IAL USE ONLY Countv Code Year File J;rumber Spouses Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) O) (Attach Sch . between 12-31-91 and 1-1-95) CORRESPONDENT - THIS SECTION MU ST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED 70: Name Daytime Tel hone Number ~ ~ Q r b~a r ~ ~- ~~ a ~ G1~~ ? ( (,,v, rL... 7~ Firm Name (If Applicable) First line of address Second line of address Cit or Post Office a~ ~ ~ Correspondent's a-mail address: State ~~ ZIP Code REGISTER OF WILLS USE ONL3r r~ --~- i -~ > -~ ,i _ DATE FILED .' ~~c~os . ~~rvi j Under penalties of perjury, I declare that f have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG T i RSO~ RESPOff~IBLE F l; ~ URN ~~~ AD ~/~ l/ 17L/.f J !J-l I U( ~ fvl /'C.(~~I~ { -/ / V /~ '(JUv SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY 15056051047 n -r-D r P s `t ~~ i ~~ Side 1 15056051047 J REV-1500 EX Decedent's Name: ~ N 15056052048 Decedent's Social Security Number ~2 ~~a~~ ss o~ RECAPITULATION 1. Real estate (Schedule A) ............................................ . 1. ~" • d i- -' , 2. Stocks and Bonds (Schedule B) ...................................... . 2. .,. ~ tJ 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. -r .._•~l'_-±;f 4. 9 9 ( ) ............................ Mort a es ii Notes Receivable Schedule D . 4• y . " ~ ; _.,y. E l h d S 5 may ~~ ~ / ~'~ ~, ~ 5. ) ....... u e c e Cash, Bank Deposits & Miscellaneous Personal Property ( . . , .. , , 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6. -' O 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested....... . 7. ~~; O ~ ` 1 7 . 8. ~~ y~ 7' ~~ 8. ) ................................... - Total Gross Assets (total Lines 9. Funeral Expenses & Administrative Costs (Schedule H) .................... . 9. ~ ~ ~ .b+/ J! (~ ... & Liens (Schedule I) biliti Li . 10. ~ "~ ~~J ~+ 10. ............ es, a Debts of Decedent, Mortgage , ......................... s (total Lines 9 & 10) ti d l D . 11. - ~ ~.~ ~.~ . / Q 11. ......... on uc e Tota i..~ ,. ~_. ................ Line 8 minus Line 11) t f E t .. 12. ^ ~.~ 12. ............ e ( a s Net Value o 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 13 --Q[ _.--- an election to tax has not been made (Schedule J) ...................... .. . 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. ~ ~ 7~3~' ~ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable ? at lineal rate X .0 ~ ~ 7 Jf~ l ~ 16. ~ ~ ~ / •~ 17. Amount of Line 14 taxable 17 at sibling rate X .12 . _ 18 . Amount of Line 14 taxable 18 • at collateral rate X .15 . 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT N ~~ ~~I~ l ~ ~ `~ O Side 2 15056052048 15056052048 J REV-1500 EX Page 3 Decedent's Complete Address: STREET ADDRESS ~~ / Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit _ B. Prior Payments _-__ C. Discount File Number ~D QC~ --~0 5 -. P~. ~ v ~----- - STATE ~~ - i ZIP / ^ ` ~ c1) >, 3 3"7 g ~ Total Credits (A + B + C) (2) 0 3. Interest/Penalty if applicable ~ x ~ ~~~8 D. Interest V(~C.U`~ -~ ' ~!~ °~ ` ~~! ~~ -~ E. Penalty -- - - - _ --- Total InterestlPenalty (D + E) (3) S ~ S 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) _ v 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ ~) ~ ~ , O U A. Enter the interest on the tax due. (5A) (5B) f ~ ~ f~ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ~~- at' - ~:~, .. = 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 :.................................................................................... ...... ^ b. retain the right to designate who shall use the property transferred or its income : ...................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death ^ without receiving adequate consideration? ....................................................................................................... ....... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ....... ....... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ contains a beneficiary designation? ................................................................................................................. ....... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent (72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. al-t'At IX•(18n W1~IONWEALTFI of f'EN~1f1.VM11A IMIERITAIICE TAX REl'URN SCHEDULE E CASH, BANK DEPOSRS, ~ MISC. PERSONAL PROPERTY :STATE OF ~ ~ ~ / ~ / ~G /~ / ~ FILE NUMBER _ _ ~ ` ~C~ Indude the prooee~is of Gti9ation and the data the proceeds were received by the estate. Ag property jointly-owned with. the right of wrviwxship nwst be diedosed on Sdbdule F. ITEM VALUE AT DATE ~~ DESCRIPTION OF DEATH ,. ~p o S d 5~ o ~2 .~ n~a~b,/P / d, SAD ov a C'rA~ un>v~ G-k~t #~~03~ /~PmG~PrS ~5~ 7~'cOPr4~CY~ ~ ~ l , l9 3 D ~7 ~0 ~ X ~O ~ /~CcGtcpr~,csl~ur5, {~ /ASS 3 CI~PC~~n QC'~Dun-f ,flccf~50~/~~, '•~~.oSp.`~ ~wc ~G,~~ ~ rr~v~ey ma~P-f a~~ ~ ~-~ dal, /C~~ ~ PN c c~i~J~ ~~ a,~, Pd 3d x Sys a 3d Q~ ~c.~ ash, ~- /x-53 TOTAL (Also enter on bne 5, Reppilulaiion) I S ~ ~~ ~ ~ ~~ ~~ ~~~~ ~~ ~ ~~ Qet'~eic l~~ i>riee 13.~ET31~A1~^~ Horne > t;srd Cars . 2~~5 > E?udaP : Seon > SXT Sedate 4D > Equipment 2~0~ ~odg+i' Neon $XT .'S~C1C'~n 4~D ~- - ._ Trads-Ili Value ----------------------------•--------...................-------.........-----•------------------------------- ._ .. - - - ;' ~- Rrevate ~artyvaius........... ~~.~ ~~=~ ~~~'~~,~ ~**~~ ~ ~~_;-::3•a :~~~> ~= Suggested Retail Value • ~~ Photo gallery . Re`,rlev~~ ;;;: Shopping 3'oois Free CF+t'eFhJt Record Check >: Auto Loa:t iron: 6.65"l~ APR Compare Insurance Rates t~> Payrrtent Calr_uiator Extended `dJarranty quote • Print For Sala Sign ': on Blue Book Classifieds'" badge '! ?0 Ali es or less . ~. 2It= Code ~i7~11^ s~ More Photos Condition Excellent GOOD S+aarclts tlsad Car ltaltie $10,570 {elected} Iwa~ilt` `~~r~.~~ ~'"~~~~ ~ w` SearYour Sedanventary Vel!sicte Details ~'~ ;~ttar?9e Eq~iu:n2nt Engine: 4-Cyf. 2.~ Liter TZ•8ftS1~1iS810R: AUtOrr{atlC - Drivetra~n: F4fiG Mileage: 4, 3f~} - Select~ Standard Equipment Air : onditionirsg Power Door Locks SEng~ Compar Disc = Power Steering Tlt 4sjheeE Duai Front Air Sags _ Pourer Windos~;s AM/F?r! Stereo A'si,,y Wneels Selected t?ptional Eyvlprrtent To Vitw Ads Click ~•~`~~~~~ l :ip-Up Roo` `~">-, - on Blue Book Classifieds:" ': Reach millions of shoppers on kbb.cotn; Cars.com, and other popular siEes. ~: Find out more, %` a.:, "' Click Blue Book Pl~vate Party Value 'a"~ E.ist Your Gar fr Print This ?age Estimated Pe~rmE ,:.~2liittwt'r7.4A9roA ~-- C-CE a ?re-t?wtsed lean fionT 5.653b APR ~- Yout i:redit Score for Fre ~• ter a t=ree Insurance c~u ..-....---.-..... 3d YF rt[Sen i8 Rt Private Pat±y Value :s what a buyer cat: expect to pay when buying a used car from a private party. The Prn+ate Party Value assumes the vehicle is sold "As Is° and carries no warran±y {other than fire continuing factory warranty}. The final sale pricy assay ~Qry depending on the vehicle's aduaE condition and local market corsditions. This value r:,ay also t;e used to derive Fair hlarkat Value for insurance and vehicle donation ps:.~posas. - 4lehlcle Condltlan i{atings ~<~ Check Vehicle Title ~±istorv ~~~,290 Statement of Accounts St sew, lrwu;e~ to: 5000 Louise Drive ~ May 01, 2006 thru May 31, 2006 ~ ~ PA„~„ www.memberslst.org Main 9witchlwerd: (717) 697-1t6t or (800) 283-2328 Account Number : 232033 EZ Call: (Tt7) 897-4372 or {800) 283-4372 l'pD: (7t7) 897-5312 or (800) 283-2328 ext 5312 MEMBERS 1~ Te'°e'a'~''~ `"'' 7 °` (~°' ~7 ~ Account Balances at a Glance Chedcing : 0.00 FEDERAL CRIDTT UNION Savings : 891.23 _ 1907 1 AV 0.293 1907-1907 Certificates: 0.00 I„~Ill~~rlll,~~rrrlL~~IIJJ,II~r,~I~IJrlr,ll~„~~IlrLrl~l ~ Loans : 0.00 _ SAMUEL H BALDWIN ~ -~- 3521 SEPTEMBER DR IVE APT 3 Money Management: 0.00 ~ CAMP HILL PA 17011 ~. J ~ Page : 1 of 1 ~- . _, Please read the enclosed insert regarding important changes to statement ._,____ Production beginning June 2t?g6. SAVINGS ACCOUNTS OQ -REGULAR SAV{NGS Date Transaction DescxiDtion Addlbons Subtractions ~~ May D7 Ba/anoe Fonrard 1,389.25 May 03 Deposit ACH SOC SEC 301.00 1,690.25 ID: 3031036030 May Q8 Withdrawal 500.00- 1,190.25 May 19 Withdrawal ~•~- ~~~' May 31 Deposit Dividend 1.00096 0.98 891.23 Mnua/ Percenhdgie Y~rtd Earned 1.Oi710aG bnm QS/Of/1~G U~nugi~ GtS/31/1t71fXi May 31 ~ EiMi~g Balance 891.23 YTD SUMMARIES st MEMBERS 1St FEDERAL CREDIT TJNION P.O. Box 40 Mechanicsburg, Pennsylvania 17055 Check Purpose SHARE WITHDRAWAL Check# 204541 $1,193.07 Acct XXXXXXX033 HALDWIN,SAMUEL HEffect: 06/27j06 Post: 06/27/06 Tlr: 0218 ID DUE DATE PRINCIPAL INT$REST FSI~S NEW BALANCE TRAN AMOUNT SSQ (See receipt for reference) n a"')TL~,;"1t'" `71.2 ~ f1 t Interest Checking Account Statement ~ ~. Ire esr~rzoos +eo o~i~srzoos For 24-hour information, sign on to PNC Bank Online Banking SAMUEL H BALDWIN DECD on pnc.com. Primary account number: 50-0421-1465 Page 2 of 2 Interest ~%9 Account ~ Samuel H Baldwin Decd Account number. 50.0421-1465 Balance Sammary Beginning Deposits and Checks and other Ending balance other additions deductions balance 1,050.42 .00 1,050.42 .00 Average monthly Charges balance and fees 98.47 .00 Interest Sumnwry Annual Percentage Number of days Average collected Interest Paid Yield Earned (APYEI in interest period balance for APYE this period Please see the Activity Detail section for additional information. As of 07125, a total of $AO in interest was paid this year. O.OOX 4 787.81 .00 __ - - Activity Detail.. Other Dednctiiai>r~s Date Amount Description 06/27 1,050.42 Debit Memo Reference No. 025647793 06/28 .00 Outstanding Item Close There were 2 Other Deductions totaling S~,osoas. Daily Balance Deta~ Date Balance Date Balance Date Balance 06/24 1,050.42 06/27 .00 06/28 .00 Performance Money Market Account Statement ~ m. p..ioa esrx;zrzeos m u~r~vsoos For 24hour information, sign on to PNC Bank Online Banking SAMUEL H BALDWIN DECD on pnc.com. Primary account number: 50-0430-2121 Account number. 50-0430-2121-continued Page 2 of 2 Activity Detail OM~er p~q~ jp~~s There were 2 Other Deductions totaling Date Amount Description $Zi.16~A7. 06/27 21,164.47 Debit Memo Reference No. 025647794 06/28 .00 Outstanding Item Close Daly Balance Dstai Date Balance Date Balance Date Balance 06/23 21,164.47 06/27 .00 06/28 .00 REV-1511 FaC+(t2-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scNEOU~ x FUNERAL EXPENSES & AawNisrRArnE cows ESTATE OF ' ' , / / ~ FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM IUMBER DESCRIPTION AMpUptT A. FUNERAL EXPENSES: 1. ~TV'Y'-~'z d'-~Ot,U S~r-~t~~lt°1~,~ ~~~, Z~ ~ ~~~'~.~D ~I /i7`~ir' ~~ 7~f.(i'1 pr'4 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Soaal Security Numbet(s~E1N Number of Personal Representative(s) Street Address City State Tap Year(s) Comrrtission Paid 2. !~~, Attorney Fees - Pr~-~Ir~(~~oh, - Q~rf-h ~ ~s~ r`~ ~`n S ~ ~ ~ o d , ~r~ss 3. Family Exemption: (If decedent's address is rwt the same as claimant's, attach explanation) Claimant Street Address City State Zlp Relationship of Claimant to Decedent 4. Probate Fees ~ /-~~ a 5. Accountant's Fees 6. Tax Return Preparers Fees 7 TOTAL (Also enter on line 9, Recapitulation) I ; 3j?`C./~O. 3 RHI-;SiY IX ~ (1-9~) SCHEDULEI COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF ~~ J( `~ FILE NUMBER ~~ include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT -;~ ~. ~pn,p ~/l ~u~ ~ - i nu a~orr~~rt-f rPrrl- ~a33 5 S` / ~ S 8 ~2 ~ r i ~ l ~'ur a ~ 8. ~ C sJe ~ rc,~n c ~ ~~~ ~ ~, ~ / ~'~/ CHC~ r~ S -- C ~~CPYI i n ~ Td-- ~ - -~ n ~ 1 ~~on~ -Ion ~~~Gn~ d~~~ ch Sr Ps ~S~ 8d ,~, // ~ ~' cSPu rS C r ~d ~" ~ n ~ / ~, ~ I/ - 4~~v~rrlf ~ 5 . ~ d Card CIOS°~ 9. T~ ~d lo~l~ .-~, n~ ( ~~I ~ ~~ar~ C~a~ 3 ~ c~~ ~`" Ina rP(e'~~~ TOTAL (Also enter on Gne i0, Rec~itulation) , S ~/. " ~'~ Dear valued customer, The Dodge Durango features an available 5.7aiter HEMI~ V8 engine that offers best-irfclass* 335 horsepower, 370 pound-feet of torque, and maximum towing capacity of 8.950 pounds. There's best-io-dass* overall interior room and the mast ava~able seat~g in its dass* for up to eight passengers. Durango's best-ir}class* features in power and room are matched with Five-Star, the highest governmerrt frontal crash test rating. *Based on Automotive News classification. When properly equipped. Excludes performance package vehicles. 2(N~lt DODGE 3~~-- Your AGCOtilnt Overview. AocountNtunber 1026522248 VehicieDescription 2003 DODGE NEON SXT Yehicle Identification Nurser 1B3ES56C55D281552 Statement Date 06/21 /2006 Statement Number 7 of 24 Payoff Amount 54,763.32 *PayoffAmount as of statement dot®. See reverse for details. Yemr 11i1t Ay#~? Drie DeerxlptlonofAetfirity Mrorrrk 06/12/2006 Payment Received-7hankYou $278.88 07/ 10/2006 Current Amount Due $278.88 07/10/2006 7otsl Amount Due 1278.88 Paymerrts received aR`er statement date aye not reflected. ~~~%~ ~~~ ~~ ~ /D~ And for the latest information on the 2006 Dodge Durango, check out DDDGEcom/durango. Please ee. reverse sloe !or Mnporanc IMonaaRion an are~r corwersbn. Cc~>>;~t 3s VYeb /Wdress chryslerfln~cl~.com Visit us online to reviewyour account make your payment or update your personal informatfaw. Custarreer Service Center 1-SO0~955~4553 Hours of Operation Mon -Fri 7 am 6110 pm (E>) Sat 8 am 616 pm (ET) Payrrrsrrt Address P O BOX 1728 NEWARK, Ni 07101-1728 Keep ~ p O Wvn~d y~=lil~e ter ~earne=~auom? _~ - To find out more information on any of the Dodge vehicles, check out dodge.com or cats 800-4ADflDGE. ~~~p ~~~I PtaZ~ Jtily 7, 2006 Samuel Baldwin 116 Green Forest Drive ^<;den. PA 1~^"~ Dear Samuel: 121 November Drive Camp Nill, PA 17011 You vacated your apartment at 3521 September Drive #3 on July 3, 2006. Upon inspection of your apartment the following charges are due. Cleaning Ch~t~ges $ 80.00 I=final ista billii ~~ $ 67.92 Total t~efore S~.urity $147.92 Total ,4mount Due $147.92 Peas pay ti~r~ wove amount due within 10 days of receipt to avoid further collection. If you have any questions please ca11737-4081. S i ncr~ rely, Pamela Mumford Book~o~;eper GC: resident I`iie ~~,~~~~ ~,~~_~ .~ ~o~ Your AT&T Statement )une15-Ju1y14,2006 #swNC.~a •09230224821011~-051801 01 AT 0.308 800262 38A892N Inrlllurlllunnllrrrllrlrlrllunlrl~lrlnllnnrllrlnlrl BALDWIN H SAMUAL 3521 SEPTEMBER DR APT 3 CAMP HILL PA 17011-5059 ~$..~~ at&t Customer ID: 717 737-7996 0224821 Page 1 of 4 Customer Service: 1 800 222-0300 Text Phone (TTY): 1 800 833-3232 Internet Address: www.att.com Ir~llllllrrrrlllrlrllllrlrltrrtrrlllll.Irllrlrlrllrrll.lll.lr{llr.lrrlll Previous balance ................................... Payments .............................................. Extra! Extra! For collect calls jus# dial down the center 1 800 C-A-L-L-A-T-T. Continued b Current charges due Jul Z8, 2006 ...............................50.32 Total amount due 526.12 We did not receive fu{I payment of your previous balance. Your total amount due includes a late fee not to exceed the greater of $5.00 or up to 3.0% of the unpaid balance for each service. o Benefit news Never Mail Another Check to Pay Your AT&T Bill. For the ultimate convenience, enroll in AT&T Automatic Bill Payment (ABP) and have your future payments automatically deducted from your enclosed check. To enroll, check the box and sign on the line on the back of the remittance coupon, and return with your payment. Or sign up for online billing to review and pay your bill each month by logging onto your AT&T Online Billing account at http://wvuw.att.comlremitdoc •~~'.t~. Sign up for ATS~T Online Billing and you won't get another paper bill! To sign up just visit http: /lwww. att. com/online Continued b ~°''"- ~~ ~~ `7 /~v d ~o ~/~~ Continues on back UNPAID BALANCE DUE UPON RECEIPT ...................525.80 Other charges and credits .............................p 3_....._.__....0.32 .:. Bitting Date: 06/27!06 Page 1 of 5 '~;~,,,,~-~"~ Telephone Number: 717 737 7996 Account: 717 737 7996 242 84 Y We never stop working for you. How to Reach Us: See page 2 SAMUAL H BALDWIN Account Summary Prev'wus Charges ~•~ Payments Received thru Jun 27 •~ Past Due Charges (Please Pay Now} ~iU.45 New Charges Verizon (page 3) $15.54 Total New Charges S -15.54 Total Due tvasi Due * ~1 X4.91 Mail payments to: Verizon, PO Box 28000, Lehigh Vly PA 18002-8000 Change of billing address? Go to verizon.com/billingaddress orsee page 2. Conven/ence! Access Your Verizon 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/selfservice to register. / ri Who Says You Cant Take b With Yau? Just because you're moving dcesnY mean you have to leave your phone and Internet service behind. Just contact us and well make reconnecting at your new place easier than ever. Visit verizon.com/easymoving or call your local business office. 7~ ~/6 ~~~~i .~tio ~ - - - - - - - - - - - - - - - - - - - - - - - - - - ~ Detach R retwn Qayment s:~ tit your check. payable to Verizon.- - - 0 ~f~ e ^ a a ^ ~~ Visit www.my.t-mobile.com to pay your bill online, check your balance & minutes, get product support, and shop for the latest ringtones and wallpapers for your phone! ummary of fiarges Previous Balance $ 36.74 Pmt Recd -Thank You $ (36.74) Monthly Service Charges $ 35.75 Tota/Amount Due ~; 35.T Total Amount Due 6 7/14/06 Your Statemerrt Statement For: SAMUEL H. BALDWIN Mobile Number : (717} 379-8432 Account Number. 360551688 MB 01 068737 65890 H 324 A Page 1 of 3 SAMUEL H. BALDWIN 3521 SEPTEMBER DR APT 3 CAMP HILL PA 1701 i-5059 I...tl1...III......11...II.1.1.I1....l.l.l.l..ll.....ll~l~rlrl 7~~~ - ~~S . 7 J _Ld Monthly Service Summary Monthly service charges from 5J19N6 - Ca/18J06 Mobile Number Monthly S~arvrce Adjusfinenls ~~ Onrs T~ ~~ Taxes 8 To1a1 Char9 9~ Charges Charges Surcharges Charges 717-379.8432 $ 29.99 $ - $ - $ - $ - $ 5.76 $ 35.7'5 Available Service Type WHENEVER WEEKEND NW Basic Plus ree Minutes Minutes 300 - Use Them Or Lose Them Minutes - Unlimited Semi's Premier Card Make Checks Payab~ to Sears Credit Cards 1 OF 1 ACCOUNT STATEMENT Account Number 5049 9480 5077 5063 Customer Service: 1-800-917-7700 Billing Cycle posing Date Account Balance Total Credit Line Total Credit Available 06ro2ro6 $15.10 $7,500.00 $7,484.90 Total Mirrimum Due Payment Due Date $10.00 D6/2sros ccount Summary Current Activity Previous Balance $0.00 Payments ~ Credits $0.00 Purchases 8 Debits $15.10 Other Charges $0.00 Total FMANCE CHARGES ;D.00 Account Balance 15.10 Trans Date Post Date Description Charges/ Credits 05120 05!21 REMOTE $15.10 IF YOU PAY MORE THAN THE TOTAL MINIMUM DUE, WE MAY REDUCE OR NOT REDUIRE A MINIMUM PAYMENT FOR UP TO 2 BILLING CYCLES. IF YOU CHOOSE TO MAKE THE REDUCEDMO MINIMUM PAYMENT, YOU WILL NOT REDUCE THE BALANCE ON WHICH YOU PAY FINANCE CHARGES ~,-~/~ AS QUICKLY. YOU MAY CHOOSE TO PAY MORE. THE SOONER YOU PAY THE ACCO T NC LJ THE LESS YOU PAY N+l FINANCE CHARGES. ~ ~ ~ ~~ Finance Char es Da In Billin Period: 31 Correspond'mg ANNUAL Periodic Rate Transaction Balance Average Daily PERCENTAGE t3-Day Periodic Type _ _ - - - Balance RATE M-Month FINANCE CHARGE Sears Regular $15.10 $0.00 25.15 %' 0.0689 % {D)' 50.00 External Regular $0.00 $0.00 25.15 %' 0.0689 % (D)' ;D.00 Cash Access Regular x.00 $0.00 26.15 %` 0.0717 % (D)' 50.00 txn `The Rate Varies. NOTICE: See reverse side for important information and billing rights summary. CaN 1-800-917-7700 for customer service or to report your card bst or stolen, Mon-Sat 9AM-9PM, SUN 1 OAM-6PM. Mail 8iiling Error Notices to PO BOX 6924 THE LAKES NV 88901-6924 4 M ~` s s 1 ~ ~ '.;.•~ .,.',- Page 1 ._ :--' Doer ctt Aeoo~ ..:..:: ;_; PPL Electric p~ ;~~ V#Iti#Ie5 °~ 'G 02680-74139 _ _. ., rw Electric Summary Page SerV jCe Balance as of dal 11, 2Q06 $ 30.61 Chaz es_ For: Tota~PL ELECTRIC UTILITIES Charges $ 24.28 SAMC?L'L H BAt.DWiN 3521 SEPTEMBF,tt L7R APT 3 Total Charges $ 54.89 CAMP HILL PA 17011 ,_ 5 Account Balance $ 54.89 Questions about this bill? Please contact us by Aug 1 at1-800-342-5775 (1-840-DIAL-PPL) ~ ~ ~~ or write to• Cnstoroer Service , / ~ 827 Nausman Rd. ~ ~ ~ !7( Allentown, PA 1 8 1 04-9392 www.pplelectric.com ~ ~~~ Electric Kwx -Average Per Day Meter Reading IAformatio® 24 Use This graph shows yow• elecli-tc use over the last 13 months. Tvpes of Meter Readings: Actual }estimated Customer 20 16 I2 8 4 0 JASnNDJFMAMJJ 2005 Months 2006 eter _ Julll Actual 8050 Jun 9 Actual 7986 32 Da s R:WI~$ilfed- ~4 Average - J d 2005 2006 Te rature 76F 73F KWPer Day 17 2 Yearly Use: Total Averagg Use Monthl Aug 2004 -Jul 2005 3023 25 Aug 2005 - Ju12006 269b 22 Other important information on back '~ s tea, ~.~ r a a ~; Important Ir>!formatlon This is your final bill for wireless serve and reflects all charges applied to your account through 7!18/06. Payment of this bill is due in full by S/14/O6. Summary of harges Previous Balance $ 35.75 Pmt Recd $ - Past Due Amount $ 35.75 Monthly Service Charges $ 34.68 Total Amount Due ~ Total Amount Due by 8/i4l~6 Your Statement Statement For. SAMUEL H. BALDWIN Mobile Number : (717} 379,8432 Account Number: 360551688 Page 1 of 3 AT 01 053832 99791 H244 A '3DGT SAMUEL. H. [3ALDWIN 3521 SEPTEMBER DR APT 3 CAMP HiLL PA 170115059 1...111...Iii......Ii...il.1.III.~.~I~I~I~l~~tl~~~~~ll~l~~iri ~~~~~ d~ ~/% Monthly service charges from 6719p6 _ 7/18!06 Mobile Number iLMrrtMy Servir:e /Wju Usage ane Time Qtltier Taxes ~ Total Charges Charges Charges Charges Surcharges Charges 7i7-379-8432 $ 28.99 $ - S - 3 _ ~ _ ~ c c~ Q ~. ~~ 0 RE~Fi513 EX+ (9-00) COMMOtVWEALTH OF PENNSYLVANIA INHEARANCE TAX RETURN RESIDENT OECEDENT scNEODUE ~ BENEF~fAR1ES ESTATE OF ~` ~ FlLE NUMBER NUMBER NAME AND ADDRESS OF PERSON{S) RECENING PROPEfifY RELATIONSHIP TO DECEDENT 1>b Not Ust'ltvstse(s} AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) I ~ lQ C'r~°h ~oIr+PS-~' ZY',~a~pn ~ ~C,~ u~'PY- o'? 5 °~o I SAS z ~ c~tr cl. ~ ~a~~) -2 ~~ ~ ~°/b ~i~a~ C~~rn~on ~~ rcl~. C C~ . ~O SAS' ~ Ova ~c~ n ~ ~ 3 1 ~ t~l l'~C t~l S ~- ~ u ~ ~ (tom ~ ~ h ~'S~~ ~-u rn rn e (s~c~t-e~rL C A ~ ~7d ~ ~ ~ ~ ~~~~ ~ G--rard~~ P ~u ~~ as C I c,• re rnOrP , Ok ~4oi ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATE, ON REV•1500 COVER SHEET II 1. 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 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET I S REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No . 2006- 00572 PA No . 21- 06- 0572 Estate Of : SAMUEL H BALDWIN ff7rst, Middle, LasrJ Late Of : CAMP HILL BOROUGH CUMBERLAND COUNTY Deceased Social Security No: 232-24-5505 WHEREAS, on the 26th day of June 2D06 an instrument dated July 11th 1979 was admitted to probate as the Iasi will of SAMUEL HBALDW/N /First, Middle, Last) Late of CAMPH/LL BOROUGH, CUMBERLAND County, who died on the 10th day of June 2006 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: BARBARA A BALDWIN who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 26th day of June 2006. '~ ,.t,, ~~~ s ._~ .~ N:~~.u<.. ..~ eg/s er of Wil/ ~r ~i~~~:.-~-~ ~~'~ ~lt~ .~..~-'.~ ~ty ~~.t~t~t ~i11 ttn~ ~P~Y~cmPtrct OF SAMUEL H. BALDWIN T, SAMUEL H. BAI1?WIN, of Fairview Township, York County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I direct the payment of all my just debts and the expenses of my last illness and funeral from my estate, as soon after my death as conveniently may be done. SECQND: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate unto my wife, NACI~II H. BALDWIN, provided she survives me by sixty (60) days. THIRD: Should my wife, Naomi H. Baldwin, predecease me or die on or before the sixtieth (60th) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate unto my children, ~ A. BALDWIN, RI(1~ARD H. BALDWIN, MARCUS A. BALDWIN and JAY T. BALDWIN, or the survivors thereof, in equal shares. FOURTH: My Executrix and personal representative shall have the following powers in addition to those vested in them by law and by other provisions of this Will, applicable to all property, exercisable without court approval and effective until actual distribution of all property: (A) To sell at private or public sale any real or personal property for such prices as they deem proper. (B) To compromise any claim or controversy. (C) To exercise any option, right or privilege granted in insurance policies or in other investments. FIFTH: I direct that any and all inheritance, estate and transfer taxies imposed upon my estate passing under my Will or otherwise shall be paid out of the principal of my residuary estate. SIXTH: I nominate and appoint my wife, NAOMI H. BALDWIN, Executrix of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for ?any,,~eason:;tsoever of the said Naomi H. Baldwin, I ~L:. r ~ v s,~ JGi~~f~f J3.i~L