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HomeMy WebLinkAbout08-01-07 ..J 15056051058 REV.1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year ~\ Of) File~ Date of Birth 206-22-0054 05/10/2007 07/19/1923 Decedent's Last Name Suffix Decedent's First Name MI Golden Steuart E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW :a-j 1. Original Return ,:.~~,:1 2. Supplemental Return .~"''''''.'-, 4. Limited Estate '-c.;.,_..J 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required Co, 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) '_....1 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 R. Scott Cramer r--:> (717) 834-570fh g (- . . -.oJ -"",0 REGISTEROFWIt.ij; USE ON6:: . J~.P Ci? '"'. fll I L"-c:~n '~j.i >':........ ZIP Code ,'-) C) 'lC) 11 . ) ~.i'j -~ --~ 1_...1 )> Firm Name (If Applicable) First line of address P.O. Box 159 -0 3: Second line of address N .+:"" Ut City or Post Office Duncannon State DATE FILED PA 17020 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG AT RE OF PERSON RESPON LE FOR FILING ETURN V 1 DATE . 3d . f1w 70/6- fio, &;0 IS9, V~ jl/l- 17Q~ , PLEASE USE 6RIGINAL FORM ONLY DATE 10 -07 L 15056051058 Side 1 15056051058 ..J ..J 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Steuart E Golden 206-22-0054 RECAPITULATION 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. 164,834.44 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., ...-----.- 164,834.44 15,608.56 87.66 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. 15,696.22 149,138.22 12. Net Value of Estate (Line 8 minus Line 11) ..... .. . ...................... 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. .............._.,_.."..'.....---_...._-_...~....,..... 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X .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 .15 149,138.22 .-.. -------.............--."'..... 15. 16. 17. 22,370.73 18. 22,370.73 22,370.73 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT "......... ........,.., L 15056052059 Side 2 15056052059 ..J REV-1500 EX Page 3 Decedent's Complete Address' f'i!l!.N!lmQl!f : : DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Steuart E Golden 206-22-0054 STREET ADDRESS 6 Coral Drive CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 22,370.73 1,118.54 Total Credits ( A + 8 + C ) (2) 1,118.54 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE, (5) 21,252.19 A. Enter the interest on the tax due. (5A) (58) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 21,252.19 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 No a. retain the use or income of the property transferred;.......................................................................................... [i] 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ [i] 0 c. retain a reversionary interest; or.......................................................................................................................... Ii] 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... [i] 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [iI 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [iI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [i] 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. 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 zero (0) percent [72 P.S. 99116 (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. 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 four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value oftransfers to or for the use of the decedent's siblings is twelve (12) percent [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. SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ESTATE OF : Steuart E. Golden FILE NUMBER: 2007-00488 (All property iointly-owned with Right ofSurvivorshio must be disclosed on Schedule F,) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Bank Accounts Members First Federal Credit Union 5000 Louise Drive Mechanicsburg, P A 17055 a.) Savings account # 172648-00 $ 52.91 Accrued Interest DOD $ .01 $ 52.91 b.) Checking account # 172648-11 $ 4,627.02 Accrued Interest DOD $ .22 $ 4,627.24 c.) Savings account # 172648-05 $ 5,169.35 Accrued Interest DOD $ 2.45 $ 5,171.80 d.) Certificate of Deposit # 172648-41 $ 4,800.23 Accrued Interest DOD $ 4.89 $ 2,402.56 (Joint account with John Zaengle, established 11/18/04) e.) Certificate of Deposit # 172648-42 $ 5,216.69 Accrued Interest DOD $ 6.79 $ 5,223.48 (Joint account with John Zaeng1e, established 08/22/06) f.) Certificate of Deposit # 172648-43 $ 5,546.78 Accrued Interest DOD $ 7.22 $ 2,777.00 (Joint account with Marjorie Zaeng1e, established 10/05/04) g.) Certificate of Deposit # 172648-45 $ 5,382.18 Accrued Interest DaD $ 7.01 $ 2,694.60 (Joint account with John Zaengle, established 09/01/05) h.) Certificate of Deposit # 172648-46 $ 5,362.46 Accrued Interest DaD $ 6.98 $ 5,369.44 (Joint account with Marjorie Zaengle, established 10/20/06) i.) Certificate of Deposit # 172648-50 $ 19,301.31 Accrued Interest DaD $ 16.89 $ 19,318.20 j.) Certificate of Deposit # 172648-51 $ 4,805.45 Accrued Interest DaD $ 5.91 $ 2,405.68 (Joint account with Marjorie Zaengle, established 12/06/04) k.) Certificate of Deposit # 172648-52 $ 4,855.42 Accrued Interest DaD $ 4.71 $ 4,860.13 1.) Certificate of Deposit # 172648-53 $ 9,734.66 Accrued Interest DaD $ 12.31 $ 9,746.97 (Joint account with Marjorie Zaengle, established 01/06/07) ro.) Certificate of Deposit # 172648-54 $ 10,199.78 Accrued Interest DaD $ 12.30 $ 10,212.08 (Joint account with John Zaengle, established 01/22/07) n.) Certificate of Deposit # 172648-55 $ 6,372.39 Accrued Interest DaD $ 6.48 $ 3,189.44 (Joint account with Marjorie Zaengle, established 09/03/04) 0.) Certificate of Deposit # 172648-56 $ 12,212.76 Accrued Interest DaD $ 15.03 $ 12,227.79 p.) Certificate of Deposit # 172648-57 $ 8,949.83 Accrued Interest DaD $ 11.01 $ 8,960.84 (Joint account with Marjorie Zaengle, established 02/20/07) 2. Mobil Home q.) Certificate of Deposit # 172648-59 $ 10,574.06 Accrued Interest DOD $ 13.01 $ 10,587.07 (Joint account with John Zaengle, established 03/07/07) r.) Certificate of Deposit # 172648-60 $ 4,812.13 Accrued Interest DOD $ 5.92 $ 2,409.03 (Joint account with John Zaengle, established 03/20/06) s.) Certificate of Deposit # 172648-61 $ 9,597.39 Accrued Interest DOD $ 11.81 $ 9,609.20 (Joint account with Marjorie Zaengle, established 04/05/07) 1.) Certificate of Deposit # 172648-71 $ 11 ,348.16 Accrued Interest DOD $ 12.90 $ 11,361.06 u.) Certificate of Deposit # 172648-82 $ 3,764.76 Accrued Interest DOD $ 3.43 $ 1,884.10 (Joint account with Marjorie Zaengle, established 02/04/05) v.) Certificate of Deposit # 172648-83 $ 3,756.35 Accrued Interest DOD $ 3.42 $ 1,879.89 (Joint account with John Zaengle, established 02/22/05) w.) Certificate of Deposit # 172648-97 $ 11,241.47 Accrued Interest DOD $ 14.22 $ 11,255.69 (Joint account with Marjorie Zaengle, established 06/26/06) x.) Certificate of Deposit # 172648-98 $ 7,433.56 Accrued Interest DOD $ 9.40 $ 3,721.48 (Joint account with John Zaengle, established 08/04/05) 1980 Homette 14x70 Serial number 0300324N $ 4,250.00 3. Automobile 2005 Honda CRY EX (see attachment) $ 6,303.86 4. Cash/Miscellaneous Erie Insurance Group Refund Check $ 396.00 Suburban Propane Refund Check $ 1,936.90 TOTAL (Also enter on line 5. caoitulation) $164.834.44 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Steuart E. Golden FILE NUMBER 2007-00488 Debts of decedent must be reported on Schedule I ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: Funeral Home - Ewing Brothers Funeral Home, Inc. $ 5,745.00 ADMINISTRATIVE COSTS: I. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) /EIN Number of Personal Representative(s) Street Address: City State Zip 2. ATTORNEY FEES R. Scott Cramer Law Office $ 8,220.00 3. FAMILY EXEMPTION: (If decedent's address is not the same as claimant's, attach explanation) Claimant - Street Address - City - State Relationship of Claimant to Decedent Zip - 4. PROBATE FEES - Register of Wills of Cumberland County $ 330.00 $ 339.00 $ 120.00 $ 100.56 $ 754.00 5. PMI - Lease Payment 6. Suburban Propane 7. PPL - electric 8. Darlene A. Zaengle - reimbursement for estate expenses TOTAL (Also enter on line 9. Recapitulation) $ 15.608.56 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS ESTATE OF Steuart E. Golden FILE NUMBER 2007-00488 ITEM DESCRIPTION AMOUNT 1. Tristan Associates - medical bill $ 87.66 TOTAL (Also enter on line 10. Recapitulation) (lfmore space is needed, insert additional sheers of same size.) $ 87.66 SCHEDULE J BENEFICIARIES ESTATE OF Harold L. Strawser FILE NUMBER: 5007-0061 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT SHARE OF ESTATE A. Taxable Bequests: 1. Darlene A. Zaengle no relation Entire estate ITEM AMOUNT OR NUMBER NAME AND ADDRESS OF BENEFICIARY SHARE OF ESTATE B. Charitable and Governmental Bequest NONE CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) $ (Ifmore space is needed, insert additional sheets of same Size) To: R. Scot1 Cramer Comp.ny: Attorney At LIW MEMBERS 1" PlmIUL CIlllDlT UNION fACSIMIL' COVER SHEEt D.tl: 8/2212007 . PaGI.lncludlnG cov.r: From: Daniell. A. Kline. Insurance Services SpecIalist (117) 60&-5427 or (800) 283-2328 extension 31~ FIX:(717)7;~178 I51Jnltdlll:lrnltmb.ra18~ aro Ill.: Steulrt Golden Per our telephone coversation. attached are copies of the corrected date 01 death valUII showing the origln,1 open date for 811 certiflC8t1s that were Jointly owned. PlesS. advise If any addltlona' information II needed. Thank you. 5000 Loul.. prlve. PO 10le 40, M.oh.,I"~ur;. PA 1705e www.member.1.torg e ,., 1~ MEMBERS tit .IDBIlAL ClUDrr IJIflOM flEGU!:-M SAVINGS ACCOUNT: .\" Account Number/SUffIx Date Account Eltabl1lhed Prlnclpel Balllnct at Date of Death Aacruld Interllt to Dim of Death Total Prlnclpel and Accrued Interest to Date of Death Nlme of Joint Owner CHICISlNC ACCOUNT: 11 Account Numberl$uff!x Dlte Account e.wbUshed Prl"clplll Salenee at D8te of o..th Accrued Inter..t to Date of OMth Total Principal ,"d Accrued Intnlt to DatI of Death Nam. of Joint Owner INVESTMENT MVINCHI ACCOUNT: .l( ~untNumb.t.9um~ oat. Account Eltlblishecl Principal SlIance It Detl of Oelth Accrued Intnlt to cate of ceMh Total Princlpellnd Accrued InterMt to Date of Dlath Name of Joint Owner ~!RTIFICATEI OF DEPOSIT: Account NumberJSufftx Date Account Established Principal Ballnce at Oat, of Death Accrued Intel'llt to Date of C..th Total Prlnclplllnd Accrued Intereet to Date of Death Nlme of Joint Owner Date Joint OWnel'lhlp established 172848-00 12/16/1997 $52.91 '.01 $52.92 None 172148.11 0412012000 $4.827.02 $.22 $4,827.24 None 172848.05 0212312002 $5,189.35 $2 .415 $5,171.80 None 172848~1 1111812004* $4,800.23 $4.89 $4,805.12 John Za.ngle 11/18/2004 *Rollover from certificate 172648-84. originally es1ablllhed 11/20/1999. 9ERT1'lCATIS 0' DEPOSIT: AccountNumbwr.s~x Date Account EetabUlhed PrincIpal Balance at Date of Death Accrued Interest to Date of Delth Total Principal and Accrued Int.reat to Date of Oellth Name of Joint Owner Oat. Joint OWnership Established 172141..u. 08/22120015* $5,216.e9 $6.19 $6,223.48 John Za.ngle 08/22/2006 *Rollover from certificate 172848-78. originally Istabliahed 02/2312002 _ _'O_. .___ow--'""--.-... "_.0"_'" ....._.-..~-~.....__. .-. -... ----...-.---.-- 5000 Louise Drive. P,o.llox 4{) · Mcchanksb\.,rg.l't:nnsylva!1ia 17055 · (717) 697~ 1161 · wWVV.nlt'tnbl'rsht.org CERTIFICATEI 0' DEPOSIT: Acoount Nl.lmbtrJSufflx Date Account EItablI."ed Prlnclpal S.Ilnca It O.te of Death AccnJId Interelt to Oa" of O.ath Total PrincipiI and Accrued Interest to Date of Death Name of Joint Own... Oate Joint OWnnhlp Eltablished 112148..43 10/05/2006- $5,546.78 $7.22 $8,SM.OO Marjorie Zeengl. 10/0512004 *Rollover from certificate 172648-eo.orlglnelly established 10/05'2004. ;ERTIPICATD OF DIlPOSlT: Account Number/Suffbc Oate Account e.tabll8hld Principal BIlence at Date of Deeth Accrued In.....t to Oate of Death Total Principal and Accrued Interest to Oate of Oeath Name of JoInt Own... Oate Joint Ownel'lhlp E,tsbllahed 172848-45 0910512006. $5,382.18 $1.01 Se,389.1 Q John Z_ngl. 09101/2005 -Rollover from c,ltlflcate172648-90, orlglr,ally eatebllshed 091Q1/200!l. CERTIFlCATIS OF DEPOSIT: Accaunt NumberfSufftx Date Account e"'b1l1hed Principii SlIance It CI. of Death Accrued Inttrtlt to D8t8 of Dllth Total PrlnclpW end Aocnted Interest to Date Of Oeath Name d Joint Owner Dale Joint Ownnhlp e.tebUehed 172148~ 1012012006* $5,362.46 $8.98 ",3el9.'" Ma~orle laengl. 101201200e *Rollover from ~rtifjc:ate 172648-81, originally iltabllshed 1012012004. CEtmPlCATD OF DEPOSllj J( ~untNumbwl8u~ OMe AcoOunt Eltablllhed Prlnc:lpa' 8elance at Dete of Death Accrued lnt8r.t to Oate of De.th Total Prlnc:lpallnd Accrued Interest to Date of De.th Name of Joint Owner 112848.aG 11120f2008 $19,301.31 $18.89 $19,318.20 None eEIlTIPICATl1 OF DEPOSIT: Account NumwlSufftx 172848-51 Dlte Account Eltlbll,hed 1210612008* Prlnclpel Bllence It D.t, of Death $4,805.45 Accrued Int... to Dete of o.Bth SS.D1 Total Prlnclpel and AccrUed Intereet to Dete of Death $4,811.38 Nlme of Joint OWn.. Ma~orl. Zaengle Olte Joint Ownership EstlbUshed 12/oe/2004 *Rollover from certificate 112848-44, originally 8.tabllshed 12J0612~, CIR'nffCA,... ~"'08rr: Account Numberl Ie Oate Account Eltabll,hed Princlpel Belance It Dati of Death Accrued Inter.st to DIte of D.lIth Totll Prlnclp.'lnd Accrued Intereat to Date of Death Name of Joint Owner x 112148-52 12120/2008- $4,855.42 $4.71 . $4,860.13 None -Rollover from certifioete 172848-58, ortglnally .,tabllshed 12/1812004. CIRTIFICA't:1!1 OF DEPOSI~ Account Number/Sufflx Dlte Account E.~II.hed Prtnclpal Bel,nee It Date of Oeeth Accrued InfII....' to Date of Ceath Total PrincipII and Acorued Interest to olte of Deeth Name of Joint Owner Olt. Joint Ownership Eltlblishld GIRTIFICATU OF DIPOSIT: Account NumberlSuftIx Olte AcooUnt Eetlblllhed PrincipII Blllnae It Dlte of Death Accrued Inte!'llt to Date of Ol.th 10tlll Pr\nclpeI .nd Accrued Inter..t to Dete of Death Name r:I Joint Owner Date Joint ewnnhlp EltabUlhed CIR1'1FICATD 011 DIPOSIT: Account Number/8uf11x Dete Account Eltlblllhtd Principal Balanoe It Date of Death Accrued Interelt to Date of Death Total Prlnclpalll'ld Accrued Intertlt to Date of Death Name of Jolnt Owner Olte Joint Ownerthlp Established 172148-53 0110612001 $;,734.ee $12.31 $9,746.97 Marjorie Zaengle 01/0812001 172141-&4 0112212007 $10,199.78 $12.30 $10,212.08 John Zaengle 0112212007 172M1-P 0210312007- $8,372.38 56.48 $6.378.87 Mlrjorie Zaengle 0910312004 -Rollover from ctrtlficate 112648-77, orlglnllly "tabUlheel 09/0312004. gI!RTIFICA"(U OF DEPOSIT: ~ Account Numb.'Suflbc Date Account Ettablllhld PrIncipal Wince et Oate of Death Acc:rued Int<<llt to Date of C..th Totti Prlnctpeland Accrued Interllt to Date of Death Name of Joint own.. 172....H 0211512007* $12,212.76 $15.03 $12,227.79 None -Rollover from certlfio,te 17aS48-78, origlnllly established 09/1112004. ;ERT"IeIt.Ta.,oF MPOAIT: Account Num6ii1lUffix Oete Account Eltlblllhed Principal BellI\CIe It Cate of Oe.th Accrued Intnlt to Cite of Deatn Totel Prlnclpal and AccNld Interest to Date of Death N.me of Joint OWner Cate JOint OWf'nhlp E.tablished QIllnFICA'J'D OF DIPOIrr:. AccOunt NumberlSuft'bc Date AccOunt Eltabll,hld Prlnclpel B.lance at Date of Death Accrued Inter..t to Date of Death Total PrinciPII Ind. Accrued Interest to Date of Ceath Name of Joint owner Cate Joint own.rthlp established 172M1-5T 0212012007 $8.949.83 $11.01 $8,960.IM Marjorie Zaengl! 02/20/2007 172148-58 0310712001" $10,574.08 $13.01 $10,581.01 John Zaengl. 03/0712007 ..Purchased by transfer of funds from 1121348-00. ;eRT1P1CATla OF DePOSIT: AccQunt Numb..rSufftx Date Account EItIb/1I1'1ed Prtnclpal BallnCe at Dlt. of Death Accrued Intereet to Date of D.ath Total Princlp.1 and Acc:rued tnter..t to Oate of Oeath Name of Joint OWner Oate Joint own_hip e,tIIbUshed 172648-tO 03/2012007. $4,812.13 $5.92 $4,818.Q5 John %aengle 03/20/2ooe .Ronover from certificate 172848-94, orlglnallv eltablished 03l201200fJ. ~1!.T'FICATM OF DEPOSIT: Account Number/8umx Oate Acoount EltabUlhed Prlnclpel BetanOl .t Date of Oeath Accrued IntlI'Mt to Date of O.ath Total Princlp81lnd Accrued Intereat to Date of Ceath Name of Joint Owner Dete Joint ownership Eatllbliehacl 1n&4M1 04(0612007.. $9,597.3Q $11.81 '9,809,20 Marior11 Zeengle 04/0Sf2007 ., "Purchased by u8l'11fer of fundI from 172e48-oo. ~ERT'FICATE8 OF DEPOSIT: )( ~ntNum~~X 172e4'~1 Date AccOUnt Eltabllehed 0&/2812004.. Princlpel B,.ance It Date of Death $11,348,10 Accrued Inter..t to Dlte of Dnth $12.90 Total Prlnoipeland Accrued In"rllt to Cate of Death $111301.06 N.me of Joint Owner None ..Purchased by transfer of funds from 172648-05. .' CIRTIFICIVII tJ/I DI,OSIT: Account NumbWl8umx Oetl Aceount EttlbRehId Principal BBlanCl It OMi of Death Accrued I,..t to Dlte of Ceath TotIl Principe! and Accrued Interelt to On of Death Nllme of Joint OWner Dete Joint OwnerIhlp E.t&bllshed CIRTIFICATU OF DPOSIT: Account NumberlSufl'b( Date Account Eltlbllshecl Principal BIII.notlt Date of Oeath Accrued In'" to O.te of Oeath Total PMclpIl ancI Accrued Interest to Cat. of Deattl Name of Joint owner Oate Joint Ownnhlp Established CERi.PICATD OF DI!POSlt: Account Number/Suffix Date Account EltlbU.hed Principal egnoe at Cate of Ceeth Accrued Interet' to Date of Death Total Principal and Accrued Intereat to 0_ of Death Name of Joint Own. Olte Joint ownership E.tablllhed 172&4...2 0210./2005 $3,764.76 $3.43 $3,788.19 M8~orIl Zalngle 0210412005 172148-83 02J22J2005 $3,158.35 $3.42 $3,'759.71 John Zaengle 02122/20015 172&48-87 0812812006. $11,241.47 $14.22 $11 ,255.59 M.~orl' Zlengl. 06l2e/2008 *Rollover rrom eertlflcate 172648-12, originally establiShed 812312004. CERTllliCATU Oil DEPOSIT: Account NumbtrlSuffbc Olte Account Eetllbllahed Prlnolpal Blllneel' Date of Death AocI'UId Interelt to Dete of Death Totll Prlnclpellt'1d Accrued Interest to Date of Death N.",e of Joint own. Date Joint ewntrthlp Eltablished 17.2t41'" 07/0012006. $1.433.88 59,40 $7,443.26 John laengle 0810412005 "Rollover from certiflcete 172648-89. originally established 08/0412005. 1m" of: ITEUART E. QOLDEN Date of Death: May 10. 2001 Socii. eecurlty Number: 208-22..0054 ~BERS 181 FEDERAL CREDIT UNION ~(}~.\OJ~ Danlelle A. Kiln' Insurance Serv\cee Specialist June 21, 2007 ,:., , ,'.:...;,. M.Ilal Bobby Rahal Motorcar Company AUTOMOTIVE GROUP 10701l'erryHigliway _ford, fa. 15090 (724) 935-9300 PLEASE ENJER MY ORDER FOR THE ~NG o NEW .eTUSED 0 DEMO 0 CARel TRlJC1( 0 LOANER YEA~:;/51~!t}tt11 I~l/ L~ITYPE COLOR ,<)~t;j( TRIM I g::.. ~l{ IS 11Z.lO iJIA:' .?Ulslu ~lllllJ .:?/4 'i>T~?lrl)' MILES CODE I ESTIMATED DELIVERY CASH 0 I DATE I I I TIME DAM DPM FINANCED 0 LEASE 0 . . . . . . . . I MODEL I TYPE I MILES I COLOR YEAR I MAKE srocK NO. TITLED TO: Vii I I I I I I I I I I VEHICLE BEING TRADED-~N: 0 LEASE 0 ~~ 0 PAYOFF DOES ANY OF niE FOLLOWING PERTAIN TO YOUR TRADE-IN: R-Tilled. Branded Tille. True Miles Unknown (TMU) & Grey Market DYES DNO Customer's Signlllure X LICENSE PlATE NO. I VALID EXPIRES I'~ ,..- / .... 12:'), vN'/ 1/I\!iM LIEN HOLDER !r1!wlltnf ADDRESS ACCT# I -7a (d'1 K ITITLE# PHONE 1/l9:"'~~~/'1 1~~rL~l VERIFIED BY ~o&r\e,... . . . .. NAME OF AGENT I PHONE ADDRESS POLICY NUMBER I VERIFIED BY I:~S FROM: INSURANCE CO. I COMP I COLL ., .. o FACTORVWARRANTY . ThB r.ctory warranty constitutes 811 ollhe warranties with..-peel to the.... oIlh1s lilmfltema. The 8der Mr8by 8ICpI'8UIy disdBIrns 811 warranIkts, lither eJCpI'88&8d Of imptIedlnducing any implied nfl'8rtty of men::hMtabiIiIy Of fitness tor a parlic:ufltl P\Jl1,'IOS8, and the MIIet neittI8I'_urnes nor authorizes any oeher p8f'$On to assume for II 811)' liability In connection with the sale of this itenv'ltem8. o USED CAR WARRANTY - THE INFORMAT1ON YOU SEE ON THE WINDOW FORM FOR nHS VEHICLE IS PART OF THIS CONTRACT. "FORMATION ON THE WfNDOW FORM OYERRtDES ANY CONTRARY PROVISIONS IN TtlE CONTRACT OF SALE. o AS IS - This motor vehicle is sold ~AS IS~ without any warranty either expressed Of' implied. The purchaser will bear the entire expense of repairing Of correcting any dlllIct ttlat presently exists at thlt may occur in the vehicle. PURCHASER'S .., o'! SIGNATURj{X .'/" ,'J ' '/,'." '.'- CO.PUR~R:S SIGNATURE X " >J.~1:~:~// ;:~:'D~TE ..-';' DATE THE ORDER PRICE OF THE MOTOR VEHiClE CANNOT BE INCREASED AFTER THIS ORDER HAS BEEN ACCEPTED BY THE DEALER OR THE AUTHORIZED DEALER REPRESENTATIVE UNlESS THE INCREASE IS DUE TO THE PASSAGE OF A LAW OR REGULATION OF THE UNITED STATES OR THE' COMMONWEALTH WHICH: ReQUIRES ADDITION OF NEW EQUIP- MENT TO CERTAIN VEHICLES; CHANGES IN TRANSPORTATION OR EXISTING TAX RATES: OR. IN THE CASE OF FOREIGN MADE VEHICLES, IS DUE TO A RE-EVALlLfITlON OF THE UNITED STATES DOlLAR VIS-A~VlSTHE CURRENCY OF THE COUNTRY OF MANUFACTURE. THIS ORDER IS NOT BINDING UPON EITHER THE DEALER OR THE PURCHASER UNTil SIGNED BY AN AUTHORIZED DEALER REPRESENTATIVE, YOU, THE BUYER MAY CANCel THIS ORDER AND RECEIVE A FUll REFUND ANY TIME BEFORE RECEIPT OF A copy OF THIS ORDER SIGNED BY AN AUTHORlZED DEALER REPRESENTATIVE BY GIVING WRITTEN NOTICE OF CANCellATION TO THE DEALER. Bobby Rahal VoIyO (SOlS Pony Highway -fold, Po. 15090 (724) 940-l4oo VI/JlWl-)b!.kr Bobby Rahal Jaguar 1503S Porry Highway -fold, fa. 15090 (724) 940-3500 Bobby Rahal Aston Martin IS03S Pony Highway -fold, Po. 15090 (724) 940-3S30 DEAL NO. I CliENT NO. DATE .:;~ 2.?';') : OCCU""TION ~1\1 PURCHASEfi',,'-'''' ['I1},if. L<.,1J{'./1 A/';{ -1-/!;~ i,,; I /.::" :y"l'i1I..'t~r(t::. tf1.~- /'v-~';r..:.,,,/"{~'Y.~;.l..- CO-PURCH~~ l:->!j ll~ ~:)I, 3-1"[- t..iAit /' /.:"', (~/,~~~;,*~./ -" ..' ~ r COJ;IRESPONQErolCE TO ADDRESS q;; ( ;;:.;;" /; / crr't.-,4.' STATE /JI\ c..,.-,/lt-/lt.l /71 E-MAIL . RES. PHONE C~LL ' PURCHASER'S SOC. SEC. NO. I . ,leV 1-,1J~ IF-) . V, , BUS. PHONE lpouNlj /-V..-1fJ/ FAX. ..... .. CO.PURCHASER'SSOC. SEC. NO. ~.. .. PURCHASER'S DRIVERS LICENSE NO. CO-PURCHASER'S DRIVERS LICENSE NO. / 7tl)) :V PRICE OF VEHICLE ACCESSORIES ' ;1 tv' - fit} .h~ JfI~"'.-tWlf li~ 11' I ,lff9 /l~1,?iY:6lt/'\ '-' lJ i AI."z' i/l ~ ';.!)J/, -.<'l c>f {I.nl~ ~ \....Jlt'i!p.a/r-, ,.' Il\I..'~' I (.J/~ I' ., ! .. c/; eMf'.;:.. .J,-, 1.5M1t' <4/ {;/J"'J'N t 1cJ ~("J SERVICE PLAN TYPE MONTHS MILES , SUB TOTAL 1. TOTAL SALE PRICE OF VEHICLE 2. ALLOWANCE ON TRADE-IN 3. TAXABLE BALANCE (LINE 1 . LINE 2) 4. STATE SALES TAX 5. LUXURY TAX 6. REGISTRATION TITLE TRANSFER 7. ENCUMBRANCE MESSENGER 8. TAG PA.. TIRE TAX 9. ON-LINE REG. FEE DEALER ON-LINE REG. FEE 10 DOCUMENTARY FEE LAST WILL AND TESTAMENT OF STEllART 'E. GOLDEN I, STEUART g. GOLDEN, widower, of North Middleton Township (mailing address: 6 Coral Drive, Carlisle, Pennsylvania 17013), Cumberland County, permaylvania., beins of sound and disposing mind. memory and understanding, do hereby make, publilh and declare tbis as. and for my Last Will and Teatamcflt hereby revoking and making -void any and all Wills by me III any time heretofore 'made. 1. 2. /,' J diJ~ my.~~er named Executorto.P!lY all ofmy'j~~del?tsa~~ p.,' funeral expenses 15 lOon after my death as may be found convenient to do so. I direct that my a'Cecutor sba11 make appropriate artangemems at Ewing Brothers Funeral Home, 630 South Hanover Street, Carlisle, Pennsylvania, tbr my funeral services. that there be no viewing and that my services u economical as may be reuo.nably possible, a.nd that my body be interred on my buriallQt located in Cumberland Valley Memorial OILmen! along Governor Ritm,r Highway near the Borough of' Caruste, pea.nsylvania. All of the rest. residue and remainder of my estate" real, parsonal and mixed. and wheresoever the same may be situate, I give, devise And bequeath to Darlene A. Zaengle, of935 Forge Road, Carlisle, PcoJlsylvania 17013. 1 hereby nomina to, constitute and appoint .Darlene A. Zacmgle. as Executor oftros my Last Will and Te5t8meDt and further direot that she shall not be tcquited to post any bond to secufO tbe faithful perfonnance of her duties in the commonwealth ofPetmsylvania Or in any other j~adictio~. IN WITNESS "'HEREOF. I have ho{euDtO set my hand and seal to this my Last' Will and Testament written on one (1) pa~ this J 'I _ day of ; ~c If r;,,-t; . /' 3. 'Sf;;ib-l/-t JJ~Av- (SEAL) Steuart E. Golden Sign, sealed, published and declared by STEUART E. GOLDEN, the Testator above named as and far his Last Will and Testament. in our presence. who, in his prosence. at }ris request. and in the presence> of each other, have hereunto subscribed OUT names as attesting witnesses. -' . .~... >. .' ('"')O('"');:tl CI :;, C CD ~ (1) 3 (,Q ...... C'"..... ..... ('"') (1) VI VlO~C-+ ...... C ...... (1) (1)~CI~ C-+:;, ::T 0.. 0 -co -t, ):0 C ('"') VlOE (1) C ..... ...... :;,...... .....a (/) c-+ ...... 0..0 ~ VI ......c W PJ ('"') ~ 0 (1) C ~ c-t' ::T o C VI (1) 1" ;l,,' !,' REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA INVENTORY Estate of Steuart E. Golden No. 2007-00488 Date of Death - 5/10/07 S. S. # 206-22-0054 Personal Representative (s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: R. Scott Cramer Petitioners: Darlene A. Zaengle I. D. ~ c::/ Address of Petitioner 935 Forge Road Carlisle, P A 1701 Addr ss of Attorney: Duncannon, P A 17024 Telephone No: (717) 834-5700 Dated: Description Value 1. Bank Accounts Members First Federal Credit Union 5000 Louise Drive Mechanicsburg, PA 17055 a.) Savings account # 172648-00 $ 52.91 Accrued Interest DOD $ .01 $ 52.91 b.) Checking account # 172648-11 $ 4,627.02 Accrued Interest DOD $ .22 $ 4,627.24 c.) Savings account # 172648-05 $ 5,169.35 Accrued Interest DOD $ 2.45 $ 5,171.80 d.) Certificate of Deposit # 172648-41 $ 4,800.23 Accrued Interest DOD $ 4.89 $ 2,402.56 (Joint account with John Zaengle, established 11/18/04) e.) Certificate of Deposit # 172648-42 $ 5,216.69 Accrued Interest DOD $ 6.79 $ 5,223.48 (Joint account with John Zaengle, established 08/22/06) f.) Certificate of Deposit # 172648-43 $ 5,546.78 Accrued Interest DOD $ 7.22 $ 2,777.00 (Joint account with Marjorie Zaengle, established 10/05/04) g.) Certificate of Deposit # 172648-45 $ 5,382.18 Accrued Interest DaD $ 7.01 $ 2,694.60 (Joint account with John Zaengle, established 09/01/05) h.) Certificate of Deposit # 172648-46 $ 5,362.46 Accrued Interest DaD $ 6.98 $ 5,369.44 (Joint account with Marjorie Zaengle, established 10/20/06) i.) Certificate of Deposit # 172648-50 $ 19,301.31 Accrued Interest DaD $ 16.89 $ 19,318.20 j.) Certificate of Deposit # 172648-51 $ 4,805.45 Accrued Interest DaD $ 5.91 $ 2,405.68 (Joint account with Marjorie Zaengle, established 12/06/04) k.) Certificate of Deposit # 172648-52 $ 4,855.42 Accrued Interest DaD $ 4.71 $ 4,860.13 1.) Certificate of Deposit # 172648-53 $ 9,734.66 Accrued Interest DaD $ 12.31 $ 9,746.97 (Joint account with Marjorie Zaengle, established 01/06/07) m.) Certificate of Deposit # 172648-54 $ 10,199.78 Accrued Interest DaD $ 12.30 $ 10,212.08 (Joint account with John Zaengle, established 01/22/07) n.) Certificate of Deposit # 172648-55 $ 6,372.39 Accrued Interest DaD $ 6.48 $ 3,189.44 (Joint account with Marjorie Zaengle, established 09/03/04) 0.) Certificate of Deposit # 172648-56 $ 12,212.76 Accrued Interest DaD $ 15.03 $ 12,227.79 p.) Certificate of Deposit # 172648-57 $ 8,949.83 Accrued Interest DaD $ 11.01 $ 8,960.84 (Joint account with Marjorie Zaengle, established 02/20/07) 2. Mobil Home q.) Certificate of Deposit # 172648-59 $ 10,574.06 Accrued Interest DaD $ 13.01 $ 10,587.07 (Joint account with John Zaengle, established 03/07/07) r.) Certificate of Deposit # 172648-60 $ 4,812.13 Accrued Interest DaD $ 5.92 $ 2,409.03 (Joint account with John Zaengle, established 03/20/06) s.) Certificate of Deposit # 172648-61 $ 9,597.39 Accrued Interest DaD $ 11.81 $ 9,609.20 (Joint account with Marjorie Zaengle, established 04/05/07) 1.) Certificate of Deposit # 172648-71 $ 11,348.16 Accrued Interest DaD $ 12.90 $ 11,361.06 u.) Certificate of Deposit # 172648-82 $ 3,764.76 Accrued Interest DaD $ 3.43 $ 1,884.10 (Joint account with Marjorie Zaengle, established 02/04/05) v.) Certificate of Deposit # 172648-83 $ 3,756.35 Accrued Interest DaD $ 3.42 $ 1,879.89 (Joint account with John Zaengle, established 02/22/05) w.) Certificate of Deposit # 172648-97 $ 11,241.47 Accrued Interest DaD $ 14.22 $ 11,255.69 (Joint account with Marjorie Zaengle, established 06/26/06) x.) Certificate of Deposit # 172648-98 $ 7,433.56 Accrued Interest DaD $ 9.40 $ 3,721.48 (Joint account with John Zaengle, established 08/04/05) 1980 Homette 14x70 Serial number 0300324N $ 4,250.00 3. Automobile 2005 Honda CRY EX (see attachment) 4. Cash/Miscellaneous Erie Insurance Group Refund Check Suburban Propane Refund Check TOTAL $ 6,303.86 $ 396.00 $ 1,936.90 $ 164,834.44 R. SCOTT CRAMER ATTORNEY AT LAW 5 S. MARKET ST., P.O. BOX 159 DUNCANNON. PENNSYLVANIA 17020 (717) 834-5700 FAX NO. (717) 834-9012 July 30, 2007 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, Pennsylvania 17013 RE: Estate of Steuart E. Golden Dear Sir/Madam: please find enclosed herewith an original and one (1) copy of the Pennsylvania Inheritance Tax Return along with an Inventory for the above-referenced estate. Also enclosed is a check in the amount of $21,252.19 which represents the tax owing and a check in the amount of $15.00 for the filing fee. Should you have any questions regarding same, please do not hesitate to contact my office. ~rU1Y yours Is~ott Cramer o So :n :g ,~~ /'- Enclosures (Ojf') C):71 c'-- 55 .:'.J --I ...;...> -0 3: ~ --=- (JJ l'.;> = = ....., :;.,. C GJ ,