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Home My WebLink About08-31-07 (4) REV-1500 EX + (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -0 6 1 4 7 "'COuNTY"CoFiE ---YEA~ - - N'U'M'BER- - I- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDll"lbJITIAL) Brun ard, Frances, T DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) SOCIAL SECURITY NUMBER 1 77- 0 9 - 8 4 8 3 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- :.:: :$ Ul ull:::':: wl1.u J: 00 " II::...J ~11.1Il 11. ~ 12/2/2006 11/7/1915 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [K] 1. Original Return D 4. Limited Estate [K] 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required L 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 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 LaFaver & Shekletski TELEPHONE NUMBER 7177747435 New Cumberland PA 17070 I- Z W o z o 11. Ul W II:: II:: o U z o i= <C ...J ;:) !::: a. <C u w 0::: 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate PfoQe[ly. (7) (Schedule G or L) lKI Separate bl.J.Il.ng requested 8. Total Gross Assets (total Lines 1-7) 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) 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) ~IAL USE ONLY 125,50QAO i 281, 17oi.~_..,~ (") ~':'T' :v"' ::". (:.'::" --' :;~ c- G"J 0) 0.00 X _(15) 0.00 0.00 X _(16) 0.00 0.00 X .12 (17) 0.00 136,787.50 X .15 (18) 20,518.13 (19) 20,518.13 c.j~., 602,955.3~(;-S -0 i '-'" I ~ 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <C I- ;:) a. :e o u ~ I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) ::,.~), 6,853. tB -'--' U1 (,...) 16. Amount of Line 14 taxable at lineal rate 98,197.40 _ 17. Amount of Line 14 taxable at sibling rate (8) 1,114,676.30 18. Amount of Line 14 taxable at collateral rate 100,082.88 7,869.23 (11) (12) (13) 107,952.11 1,006,724.19 869,936.69 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < (14) 136,787.50 Decedent's Com lete Address: ~REET ADDRESS 123 Fifteenth Street CITY New Cumberland STATE PA ZIP 17070- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 20,518.13 15.554.68 818.67 Total Credits ( A + B + C ) (2) 16,373.35 3. Interest'Penalty if applicable D. Interest E. Penalty Totallnterest'Penalty ( 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 4,144.78 4,144.78 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; ........................................................................... 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 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, 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. SIGNATURE OF P ON RESPONSIBLE FOR FI G RETURN ADDRESS MD PA 17070 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 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 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 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 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-1502 EX + (6-98) '. SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER BrunQard. Frances. T 21 06 1147 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real orooertv which is iointlv.owned with right of survivorshio must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Land situate at Lot #18 New Cumberland Cumberland County, PA sold to James Smith on January 12, 2007. 2 Property located at 123 15th St. New Cumberland Cumberland County, PA sold to Michael L. Coons on May 30. 2007 VALUE AT DATE OF DEATH 17,500.00 108,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 125500.00 REV-1503 EX + (6-98) 'w SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Brunaard. Frances. T FILE NUMBER 21 06 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 1147 VALUE AT DATE OF DEATH 837.20 837.20 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 1,000.00 837.20 11,224.00 ITEM NUMBER 1. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 DESCRIPTION $1000 Series EE Bond issued 8-1994 No. M63639242EE Prine. $500.00, Int. $337.20 $1000 Series EE Savings Bond issued 8-1994 No. M63639241 EE Prine. $500.00, Int. $337.20 $1000 Series HH Bond dtd 3-1998 No. 6618534HH $1000 Series HH Bond dtd 3-1998 No. M6618526HH $1000 Series HH Bond dtd 3-1998 No. M6618527HH $1000 Series HH Bond dtd 3-1998 No. M6618528HH $1000 Series HH Bond dtd 3-1998 No. M6618529HH $1000 Series HH Bond dtd 3-1998 No. M6618530HH $1000 Series HH Bond dtd 3-1998 No. M6618531HH $1000 Series HH Bond dtd 3-1998 No. M6618532HH $1000 Series HH Bond dtd 3-1998 No. M6618533HH $1000 Series HH Bond dtd 3-2002 No. M8415121HH $1000 Series HH Bond dtd 3-2002 No. M8415122HH $1000 Series HH Bond dtd 3-2002 No. M8415123HH $1000 US Series EE Savings Bond issued 8-1994 No. M63639240EE Prine. $500.00, Int. $337.20 $10000 Series EE Savings Bond dtd 2-1992 No. X2163231 EE @ 4.0% - Prine. $5,000, Int. $6,224 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 281 170.47 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 1 21 06 1147 File Number Schedule B - Stocks & Bonds ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17 $5000 Series H Bond dtd 9-75 5,000.00 No.V5546692H 18 800 shares Chevron Corporation stock @ $72.840 each 58,272.00 19 273 shares Pepco Holdings Inc. stock @ $26.430 each 7,215.39 20 297 shares PNC Financial Services stock @ $71.170 each 21,137.49 21 13674.475 shares PNC Investments-Blackrock Multi St Mun Ser Tr @ $11.440 each 156,435.99 PA Muni Bond A 22 200 shares PPL Corporation stock @ $36.870 each 7,374.00 SUBTOTAL SCHEDULE B 255,434.87 GRAND TOTAL SCHEDULE B $ 281,170.47 REV-1508 EX.. (6. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Brun9ard. Frances. T 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. 1147 ITEM NUMBER 1. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 DESCRIPTION $1 $2 & $5 Silver Cert.- $2 & $5 Notes-Metal 1/2 dollars-proof sets-and various coins sold at auction on 5-5-07 Check dtd August 4 2006 from Sovereign Bank Citizens Bank-Checking Acct. #a6205298736 Citizens Bank-Time Deposit No. 6140697611 Princ. $20,601.30, Int. $63.55 Citizens Bank-Time Deposit No. 6140697611 - Accrued Interest Citizens Bank-Time Deposit No. 6140866111 Princ. $24,991.20, Int. $43.97 Citizens Bank-Time Deposit No. 6140866111 - Accrued Interest Citizens Bank-Time Deposit No. 6140867703 Princ. $6001.71, Int. $1.21 Citizens Bank-Time Deposit No. 6140867703 - Accrued Interest Citizens Bank-Time Deposit No. 6140894689 Princ. $31,126.86, Int. $85.32 Citizens Bank-Time Deposit No. 6140894689 - Accrued Interest Citizens Bank-Time Deposit No. 6245257498 Princ. $17,061.93,lnt. $38.57 Citizens Bank-Time Deposit No. 6245257498 - Accrued Interest Citizens Bank-Time Deposit No. 6248759168 Princ. $12,308.56, Int. $44.26 Citizens Bank-Time Deposit No. 6248759168 - Accrued Interest Citizens Bank-Time Deposit No. 6248759176 Princ. $12,000.00, Int. $43.15 VALUE AT DATE OF DEATH 687.00 20,000.00 13,010.30 20,601.30 63.55 24,991.20 43.97 6,001.71 1.21 31,126.86 85.32 17,061.93 38.57 12,308.56 44.26 12,000.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 602955.33 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 2 21 06 1147 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 31 DESCRIPTION Citizens Bank-Time Deposit No. 6248759176 - Accrued Interest VALUE AT DATE OF DEATH 43.15 Fulton Bank-Cert of Deposit No. 052-0224772 Princ. $11,900.95, Int. $23.08 11,900.95 Fulton Bank-Cert of Deposit No. 052-0224772 - Accrued Interest 23.08 Fulton Bank-Cert of Deposit No. 052-0224776 Princ. $14,241.85, Int. $27.62 14,241.85 Fulton Bank-Cert of Deposit No. 052-0224776 - Accrued Interest 27.62 Fulton Bank-Cert of Deposit No. 052-0224780 Princ. $14,241.84, Int. $29.21 14,241.84 Fulton Bank-Cert of Deposit No. 052-0224780 - Accrued Interest 29.21 Fulton Bank-Cert of Deposit No. 052-0259735 Princ. $10,000.00, Int. $39.85 10,000.00 Fulton Bank-Cert of Deposit No. 052-0259735 - Accrued Interest 39.85 Fulton Bank-Cert of Deposit No. 400-3372283 Princ. $42,625.69, Int. $548.23 42,625.69 Fulton Bank-Cert of Deposit No. 400-3372283 - Accrued Interest 548.23 Fulton Bank-Cert of Deposit No. 400-3372291 Princ. $13,218.61, Int. $210.33 13,218.61 Fulton Bank-Cert of Deposit No. 400-3372291 - Accrued Interest 210.33 Fulton Bank-Cert of Deposit No. 522-0027886 Princ. $11,186.49, Int. $19.71 11,186.49 Fulton Bank-Cert of Deposit No. 522-0027886 - Accrued Interest 19.71 SUBTOTAL SCHEDULE E 118,356.61 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 3 21 06 1147 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 32 Fulton Bank-Cert of Deposit No. 522-0027901 9,188.65 Princ. $9,188.65, Int. $310.84 33 Fulton Bank-Cert of Deposit No. 522-0027901 - Accrued Interest 310.84 34 Fulton Bank-Cert of Deposit No. 522-0052158 3,237.21 Princ. $3,237.21, Int. $5.57 35 Fulton Bank-Cert of Deposit No. 522-0052158 - Accrued Interest 5.57 36 Fulton Bank-Cert of Deposit No. 522-0072905 6,521.21 Princ. $6,521.21, Int. $22.32 37 Fulton Bank-Cert of Deposit No. 522-0072905 - Accrued Interest 22.32 38 Fulton Bank-Cert of Deposit No. 522-0092450 5,007.43 Princ. $5,007.43, Int. $12.38 39 Fulton Bank-Cert of Deposit No. 522-0092450 - Accrued Interest 12.38 40 Fulton Bank-Cert of Deposit No. 523-0000440 6,256.85 Princ. $6,256.85, Int. $18.63 41 Fulton Bank-Cert of Deposit No. 523-0000440 - Accrued Interest 18.63 42 Fulton Bank-Cert of Deposit No. 523-0034478 8,811.53 Princ. $8,811.53, Int. $134.27 43 Fulton Bank-Cert of Deposit No. 523-0034478 - Accrued Interest 134.27 44 M&T Bank-Cert of Deposit No. 031003913821285 12,457.26 Princ. $12,457.26, Int. $25.44 45 M&T Bank-Cert of Deposit No. 031003913821285 - Accrued Interest 25.44 46 M&T Bank-Cert of Deposit No. 031003914381345 3,321.54 Princ. $3,321.54,lnt. $17.53 SUBTOTAL SCHEDULE E 55,331.13 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 4 21 061147 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 DESCRIPTION M&T Bank-Cert of Deposit No. 031003914381345 - Accrued Interest VALUE AT DATE OF DEATH 17.53 M&T Bank-Cert of Deposit No. 031003914493299 Princ. $13,387.61, Int. $18.90 13,387.61 M&T Bank-Cert of Deposit No. 031003914493299 - Accrued Interest 18.90 Personal property at residence bequeathed to Russell G and Jean Brungard as mentioned in Item I of will 4,737.00 PNC Bank-Cert of Deposit No. 21001017216 Princ. $1,529.91, Int. $22.95 1,529.91 PNC Bank-Cert of Deposit No. 21001017216 - Accrued Interest 22.95 PNC Bank-Checking Acct. No. 5140008015 Princ. $33,285.01, Int. $12.28 33,285.01 PNC Bank-Checking Acct. No. 5140008015 - Accrued Interest 12.28 PNC Investments-Cash Account No. 13433608 1.23 Sovereign Bank-Cert of Deposit No. 0775146699 Princ. $3,949.09, Int. $.91 3,949.09 Sovereign Bank-Cert of Deposit No. 0775146699 - Accrued Interest 0.91 Sovereign Bank-Cert of Deposit No. 0775147218 Princ. $3,175.62, Int. $1.28 3,175.62 Sovereign Bank-Cert of Deposit No. 0775147218 - Accrued Interest 1.28 Sovereign Bank-Cert of Deposit No. 0775149677 Princ. 6,548.21, Int. $2.80 6,548.21 Sovereign Bank-Cert of Deposit No. 0775149677 - Accrued Interest 2.80 SUBTOTAL SCHEDULE E 66,690.33 . Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 5 21 06 1147 File Number Schedule E . Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 DESCRIPTION Sovereign Bank-Cert of Deposit No. 0775149974 Princ. $6,000.20, Inl. $2.59 VALUE AT DATE OF DEATH 6,000.20 Sovereign Bank-Cert of Deposit No. 0775149974 - Accrued Interest 2.59 Sovereign Bank-Cert of Deposit No. 0775150055 Princ. $4,887.24, Inl. $1.13 4,887.24 Sovereign Bank-Cert of Deposit No. 0775150055 - Accrued Interest 1.13 Sovereign Bank-Cert of Deposit No. 0775151160 Princ. $9,570.37, Inl. $3.83 9,570.37 Sovereign Bank-Cert of Deposit No. 0775151160 - Accrued Interest 3.83 Sovereign Bank-Checking Accl. #0771039727 Princ. $46,501.65, Inl. $7.56 46,501.65 Sovereign Bank-Checking Accl. #0771039727 - Accrued Interest 7.56 Sovereign Bank-Savings Accl. #0574112561 8,337.49 Wachovia Bank-Cert of Deposit No. 140312110219725 Princ. $14,050.86, Inl. $7.88 14,050.86 Wachovia Bank-Cert of Deposit No. 140312110219725 - Accrued Interest 7.88 Wachovia Bank-Cert of Deposit No. 247022055669456 Princ. $25,808.33, Inl. $639.75 25,808.33 Wachovia Bank-Cert of Deposit No. 247022055669456 - Accrued Interest 639.75 Wachovia Bank-Cert of Deposit No. 247022056533716 Princ. $13,908.22, Inl. $466.08 13,908.22 Wachovia Bank-Cert of Deposit No. 247022056533716 - Accrued Interest 466.08 SUBTOTAL SCHEDULE E 130,193.18 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 6 21 06 1147 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 DESCRIPTION Wachovia Bank-Cert of Deposit No. 247022063618463-0 Princ. $5,102.63, In1. $7.27 VALUE AT DATE OF DEATH 5,102.63 Wachovia Bank-Cert of Deposit No. 247022063618463 - Accrued Interest 7.27 Wachovia Bank-Cert of Deposit No. 247022063618625 Princ. $3,236.86, In1. $104.97 3,236.86 Wachovia Bank-Cert of Deposit No. 247022063618625 - Accrued Interest 104.97 Wachovia Bank-Cert of Deposit No. 247022063777243 Princ. $13,619.95, In1. $348.35 13,619.95 Wachovia Bank-Cert of Deposit No. 247022063777243 - Accrued Interest 348.35 Wachovia Bank-Cert of Deposit No. 247022063777499 Princ. $2,334.36, In1. $39.49 2,334.36 Wachovia Bank-Cert of Deposit No. 247022063777499 - Accrued Interest 39.49 Wachovia Bank-Cert of Deposit No. 247022064561694 Princ. $8,743.39, In1. $2.54 8,743.39 Wachovia Bank-Cert of Deposit No. 247022064561694 - Accrued Interest 2.54 Wachovia Bank-Cert of Deposit No. 247022064711858 Princ. $2,102.51, In1. $2.86 2,102.51 Wachovia Bank-Cert of Deposit No. 247022064711858 - Accrued Interest 2.86 Wachovia Bank-Cert of Deposit No. 247022066110827 Princ. $6,279.27, In1. $76.06 6,279.27 Wachovia Bank-Cert of Deposit No. 247022066110827 - Accrued Interest 76.06 Wachovia Bank-Cert of Deposit No. 247022066203093 Princ. $11,669.37, In1. $63.47 11,669.37 SUBTOTAL SCHEDULE E 53,669.88 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 7 21 06 1147 File Number Schedule E . Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 DESCRIPTION Wachovia Bank-Cert of Deposit No. 247022066203093 - Accrued Interest VALUE AT DATE OF DEATH 63.47 Wachovia Bank-Cert of Deposit No. 247022066280224 Princ. $2,000.00, Int. $.18 2,000.00 Wachovia Bank-Cert of Deposit No. 247022066280224 - Accrued Interest 0.18 Wachovia Bank-Cert of Deposit No. 247022066280943 Princ. $6,388.20, Int. $209.54 6,388.20 Wachovia Bank-Cert of Deposit No. 247022066280943 - Accrued Interest 209.54 Wachovia Bank-Cert of Deposit No. 247412060172782 Princ. $2,888.58, Int. $5.69 2,888.50 Wachovia Bank-Cert of Deposit No. 247412060172782 - Accrued Interest 5.69 Wachovia Bank-Cert of Deposit No. 247412060348228 Princ. $1,000.00, Int. $17.21 1,000.00 Wachovia Bank-Cert of Deposit No. 247412060348228 0 - Accrued Interest 17.21 Wachovia Bank-Cert of Deposit No. 247412062082748 Princ. $1,000.00, Int. $23.37 1,000.00 Wachovia Bank-Cert of Deposit No. 247412062082748 - Accrued Interest 23.37 Wachovia Bank-Cert of Deposit No. 247412062106639 Princ. $1,000.00, Int. $9.32 1,000.00 Wachovia Bank-Cert of Deposit No. 247412062106639 - Accrued Interest 9.32 Wachovia Bank-Cert of Deposit No. 247412062106760 Princ. $2,000.00, Int. $17.17 2,000.00 Wachovia Bank-Cert of Deposit No. 247412062106760 - Accrued Interest 17.17 SUBTOTAL SCHEDULE E 16,622.65 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 8 21 06 1147 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 107 Wachovia Bank-Cert of Deposit No. 247412062116367 2,000.00 Princ. $2,000.00, Int. $8.47 108 Wachovia Bank-Cert of Deposit No. 247412062116367 - Accrued Interest 8.47 109 Wachovia Bank-Cert of Deposit No. 247412062116839 1,000.00 Princ. $1,000.00, Int. $13.51 110 Wachovia Bank-Cert of Deposit No. 247412062116839 - Accrued Interest 13.51 111 Wachovia Bank-Cert of Deposit No. 247412062122456 1,000.00 Princ. $1,000.00, Int. $3.83 112 Wachovia Bank-Cert of Deposit No. 247412062122456 - Accrued Interest 3.83 SUBTOTAL SCHEDULE E 4,025.81 GRAND TOTAL SCHEDULE E $ 602,955.33 REV-1509 EX: (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Brungard. Frances. T FILE NUMBER 21 06 1147 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. Russell G Brungard 7013 Dorsey Road Nephew Laytonsville, MD 20882- B c JOINTL Y.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A 04/06/9~ Fulton Bank-Cert of Deposit No. 400-1859844 joint 13,706.19 50. 6,853.10 with Russell G. Brungard Princ. $13,357.44, Int. $348.75 TOTAL (Also enter on line 6, Recapitulation) $ 6853.10 T (If more space is needed, insert additional sheets of the same size) REV-1510 EX: (6. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY ESTATE OF BrunCJard. Frances. T FILE NUMBER 21 06 1147 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. M&T Bank-Cert of Deposit No. 031003915824592 joint 10,412.64 100. 10,412.64 with Russell G. Brungard dtd 01-10-06, Prine. $10,000.00, Int. $412.64 2 M&T Bank-Cert of Deposit No. 031003915824609 joint 17,720.81 100. 17,720.81 with Russell G. Brungard dtd 01-10-06, Prine. $17,018.55, Int. $702.26 3 M&T Bank-Cert of Deposit No. 031003915824625 joint 8,510.58 100. 8,510.58 with Russell G. Brungard dtd 01-10-06, Prine. $8,173.32, Int. $337.26 4 Allstate Life Insurance Company-Advantage Plus Annuity 61,553.37 100. 61,553.37 #GA0682374 - beneficiary Russell G. Brungard (formerly Glenbrook Life & Annuity Co) TOTAL (Also enter on line 7 Recapitulation) $ 98.197.40 (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 ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Brunaard. Frances. T ITEM NUMBER A. B. 1. 2. 3. 4. 5. 6. 7. 2 3 4 5 6 7 8 9 10 11 12 Debts of decedent must be reported on Schedule I. DESCRIPTION 1 FUNERAL EXPENSES: Parthemore Funeral Home-funeral expenses ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Russell G. Brungard Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 7013 Dorsey Road City Laytonsville State MD Year(s) Commission Paid: 2007/08 Attorney Fees David H. Stone, Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Add ress City Relationship of Claimant to Decedent State Probate Fees Register of Wills-Cumberland Co Accountant's Fees Tax Return Preparer's Fees US Treasury-estimated taxes for 2006 PA Dept of Revenue-estimated taxes for 2006 US Treasury-repayment of lost check for 2006 return PNC Bank-check printing fee PNC Bank-check printing fee PNC Bank-return of deposit item fee PNC Bank-return deposit item (AIG annuity check) Cumberland Law Journal-advertising grant of letters Russell Brungard-Executor's travel & misc. expenses Russell Brungard-Executor's travel & misc. expenses Russell Brungard-Executor's misc. expenses Auctioneers expense on sale of coins FILE NUMBER 21 06 1147 (If more space is needed, insert additional sheets of the same size) TOTAL (Also enter on line 9, Recapitulation) $ Zip 20882 Zip AMOUNT 5,470.00 38,192.00 41,098.00 430.00 1000.00 200.00 1,757.95 16.99 16.99 10.00 654.16 75.00 717.06 239.77 5.53 68.70 100 082.88 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances. T Decedent's Name Page 9 Schedule H - Funeral Expenses & Administrative Costs - B7. ITEM NUMBER 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 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 DESCRIPTION Russell Brungard-Executors misc. expenses Russell Brungard-Executors misc. expenses Patty Patterson-property managemt for Dec & Jan Patty Patterson-property management for Feb Patty Patterson-property management for March Patty Patterson-property management for April Jim Smith-yard work at property Robin Gasperetti-real estate taxes on property Settlement costs ($561.82) less reimb. ($34.18) Settlement costs ($4.908.83) less reimb. ($366.14) PA American Water-services at property PP&L-services at property Verizon-services at property Comcast-services at property AT&T-services at property PP&L-services at property PA American Water-services at property Montour Oil-services at property Borough of New Cumberland-sewer servo at prop. Montour Oil-services at property PA American Water-services at property Comcast-services at property Verizon-services at property Montour Oil-services at property Montour Oil-services at property PA American Water-services at property Verizon-services rendered at property PP&L-services at property Comcast-services at property PP&L-services at property PA American Water-services at property Verizon-services at property PP&L-services at property Borough of New Cumberland-sewer serv at prop PA American Water-services at property AT&T-services at property PA American Water-services at property PP&L-services at property The Patriot News-advertising grant of letters Auctioneers expenses toward sale of real estate not included on settlement sheet Russell Brungard-Executors travel & misc. expenses Reserve for closing expenses SUBTOTAL SCHEDULE H.B7 21 06 1147 File Number AMOUNT 6.72 79.90 60.00 30.00 30.00 30.00 150.00 458.15 527.64 4542.69 16.42 22.52 43.11 97.23 65.63 17.88 12.03 336.00 68.04 434.41 13.23 47.68 21.41 520.93 71.02 12.03 22.84 18.57 49.56 21.41 12.62 7.53 15.92 64.80 14.42 41.04 13.22 12.67 134.46 787.00 200.00 1.000.00 10.130.73 RE~-1512 EX~ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF BrunQard Frances. T FILE NUMBER 21 06 1147 Include un reimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH Philhaven-services rendered 18.86 2 Alert Pharmacy-medicine 157.48 3 Alert Pharmacy-medicine 126.48 4 Messiah Village-services for December 240.16 5 Messiah Village-November expenses 7,326.25 TOTAL (Also enter on line 10, Recapitulation) $ 7 869.23 (If more space is needed, insert additional sheets of the same size) ''':''''''. '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Brunaard Fr::lnr.A~ T ?1 On 1147 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 Russell G Brungard Nephew Collateral 105,050.50 7013 Dorsey Road M& T accts, Fulton accl. Laytonsville MD 20882- and Allstate Annuity 2 Jean and Russell G Brungard Nephew & wife Collateral 14,737.00 7013 Dorsey Road Specific bequest & per prop. Laytonsville MD 20882- 3 Helen Thieme Johnson Brother's wife Collateral 2,000.00 6177 Arlington Circle Melborne FL 32940- 4 Elwood and Charlotte Prowant Nephew & wife Collateral 45,262.37 Box 285 Specific bequest & annuity White Deer PA 17887- 5 Beverly and James McGinnis Niece & wife Collateral 4,000.00 6177 Arlington Circle Melbourne FL 32940- 6 Susan and Keith Kolanda Friend Collateral 5,000.00 1605 Liz Burns Place Mechanicsburg PA 17055- 7 Patty Patterson Friend Collateral 1,000.00 125 15th Street New Cumberlandq PA 17070- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. 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 Faith United Church of Christ 5,000.00 1120 Drexel Hills Blvd. New Cumberland PA 17070- 2 New Cumberland Library & Cultural Foundation 2,000.00 1 Benjamin Plaza New Cumberland PA 17070- 3 Thornwald Home 5,000.00 442 Walnut Bottom Road Carlisle PA 17013- TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 869.936.69 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances. T Decedent's Name Page 1 0 21 06 1147 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) Saundra Smith predeceased Frances Brungard and there are no surviving issue Elwood Prowant predeceased Frances Brun gard Continuation of REV-1500 Inheritance Tax Return Resident Decedent Brungard, Frances, T Decedent's Name Page 11 21 06 1147 File Number Schedule J - Beneficiaries - 2B B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 4 Bethesda Mission 2101 North Front Street Suite 301, Bldg. 1 Harrisburg PA 17110- 5 American Red Cross of the Susquehanna Valley PO Box 5740 Harrisburg PA 17110- 6 The Salvation Army 440 West Nyack Road West Nyack NY 10994-1739 7 Central PA Food Bank 3908 Corey Road Harrisburg PA 17109- 8 YMCA of Greater Harrisburg 1101 Market Street Harrisburg PA 17101- 9 New Cumberland Town Band c/o Randall E. Evertts 168 8th Street New Cumberland PA 17070- 10 WITF Inc. 4801 Lindle Road Harrisburg PA 17111- 2,000.00 1,000.00 1,000.00 2,000.00 5,000.00 1,000.00 845,936.69 SUBTOTAL SCHEDULE J.2B 857,936.69 1""'-"1/'''~''''''<'''-'' ' ,"'" "'1'-:t:r, "'r"'W' >>y.. i","""tr.",~....,,.,,,.,,,., ,,.., ""':t"""'"~",,,,;:w ~.,~, ~'."""-{".""'~"{~-flJlll'H"'"1RH~~\"j;;~'~'" 't~""'~"""""'" ~;rt;+'~;'r;~;n~lt{~:)~~~~~J!i~i0...,~;~~~tt~~tl~~f5~1~~~l~t~%t~~f'~~'lli ~,',o., ',.t, '~"'..''',,' '~~'JI-..".I!-~"~"iv"~"'" ....""/1;.,, .:\i.A'#r" " <r, ,,",' .. ..,' ~...,' .,t;,~PNn<i;~r((~':~':r;r''; ";~~:t!~i,~,~1!~r' .,;:~~'_J:.1~"m~~",,(i~i~ :MJ/f ,Mh{~\ t..,,;;:.:t" ',; "'IiI', 'l"::;;' :.~< .;,;::.,.,.~',.. , .;'.1< ~';;';-I'I' ,.;;.~' t. '''~'!~;': ","t ,,"~';;l:......~.,f !', ~'';''\'';..,.1t''''4........;Ui"J;; '~'~".i_"'''~''''''''h,I",-~ ,,' ..1',.~"..1, '.. 'i.. , ;W.~....;;1-'..;,.;.;.J.~~:t ~Li~.;.."..''l'.':''''t.j~~:~..i..._ ".;.......1--.'.' ,"... "., _ ,.~, ...;' ','.,.. .......,,_ ,,_ _ ._,"'" ,,".,.",' _ _.,' , _ _ ',' ~ f--- ':~ LAST WILL AND TESTAMENT OF FRANCES T. BRUNGARD I, FRANCES T. BRUNGARD, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I give, devise and bequeath to my husband's nephew and his wife, RUSSELL G. BRUNGARD and JEAN BRUNGARD, as tenants by the entirety, the sum of $10,000.00 and the tangible personal property situate in my home (but not including cash, securities, certificates of deposit, or other intangibles) at the time of my death. ITEM II: I give and bequeath to my brother's wife, HELEN THIEME JOHNSON, the sum of $2,000,00. ITEM III: I give and bequeath to my husband's nephew and his wife, ELWOOD PROWANT and CHARLOTTE PROWANT, as tenants by the entireties, the sum of $5,000.00. ITEM IV: I give and bequeath to my brother's daughter and her husband, BEVERLY AND JAMES McGINNIS, as tenants by the entireties, the sum of $4,000. ITEM V: I give and bequeath to my friends, SUSAN and KEITH - 1 - KOLANDA, as tenants by the entireties, the sum of $5,000.00. ITEM VI: I give and bequeath $1,000.00 to my friend and neighbor, Saundra Smith. ITEM VII: I give and bequeath $1,000.00 to my friend and neighbor, Patty Patterson. ITEM VIII: I give and bequeath to the FAITH UNITED CHURCH OF CHRIST of New Cumberland, Pennsylvania the sum of $5,000.00. ITEM I~: I give and bequeath to the NEW CUMBERLAND LIBRARY AND CULTURAL FOUNDATION of New Cumberland, Pennsylvania, the sum of $2,000.00. c-o \.... f\- ITEM X: I give and bequeath to the THORNWALD HOME of Carlisle, Pennsylvania, the sum of $5,000.00. ITEM XI: I give and bequeath to BETHESDA MISSION of Harrisburg, Pennsylvania, the sum of $2,000.00. ITEM XII: I give and bequeath to the AMERICAN RED CROSS, Harrisburg Chapter, the sum of $1,000.00. ITEM XIII: I give and bequeath to the SALVATION ARMY, Harrisburg Chapter, the sum of $1,000.00. ITEM XIV: I give and bequeath to the SOUTH CENTRAL PENNSYLVANIA FOOD BANK of Harrisburg, Pennsylvania, the sum of $2,000.00. ITEM XV: I give and bequeath to the YWCA of Harrisburg, pennsyl- vania for the benefit of homeless women and children, the sum of $5,000.00. - 2 - ITEM XVI: I give and bequeath to the NEW CUMBERLAND TOWN BAND, the sum of $1,000.00. ITEM XVII: All gifts in this will to named persons shall not lapse if the beneficiary, or beneficiaries, fail to survive me, but shall be saved for the issue of the beneficiary or beneficiaries. ITEM XVIII: I give, devise and bequeath all the rest, residue and remainder of my estate to WITF, Inc., or its corporate successor, to be used one-half for the support of public television and one-half for "~-', the support of public radio. Should WITF, Inc., or its corporate \., ~~ successor, no longer qualify as charitable organizations as defined by the Internal Revenue Code, then this residuary gift shall be applied, with the approval of the Orphans' Court, to similar or compatible charitable uses. ITEM IXX: I appoint my Executor and his successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appoint- 1ment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to - 3 - . provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. ITEM XX: I appoint my husband's nephew, RUSSELL G. BRUNGARD, Executor of this will. If he fails to qualify or ceases to act as Executor, I appoint PNC BANK, N.A., or its corporate successor, Execu- tor of this my last will. ITEM XXI: No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. IN WITNESS WHEREOF, I, FRANCES T. BRUNGARD, have hereunto set my my hand and seal this ).~ day of _.:2.,..,<'; 'l J .. (; , . I ~ - '-. , 1999. ~;. -- ~ { . "I _'. - .. ~ ,~ '-\1\ f' . I' I, .'1-/,1 ~" ,''!-..ct '-. 11__ F CES T. BR GARD U SIGNED, SEALED, PUBLISHED and DECLARED by FRANCES T. BRUNGARD, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. Q{{c~~ if ~ Witness / ./ (......_ [/I ~ . L - ! ~ ~~, f71.i- / Address :) {(' ..)( I iJ. " (l~i Chrt~ Address \..--~? - 4 - .-~,.. ,- .. -...-- " ,..,.~ '..-' /...~::,! -~r-:-"_ ..-_ ~~";' '--.;.- "---.:........~._,......~._,., REV.485 EX . (3.04) .. .y-. ~ > .', #-' SAFE DEPOSIT BOX INVENTORY Please Print or Type DECEDENT'S NAME (LAST. FIRST. MIDDLE) BRUNGARD, FRANCES T. . ADDRESS OF DECEDENT (STREET) 123 FIFTEENTH STREET DATE OF DEATH 12/02/2006 (CITY) NEW CUMBERLAND (STATE) PA COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 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 IReQuiredl OR DEATH CERTIFICATE NUMBER (onlv if SSN is unknown} 21 2006-01147 177 -09-8483 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) DAVID H. STONE, ESQUIRE (STREET NAME) 414 BRIDGE STREET (CITY) NEW CUMBERLAND (STATE) PA 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) (STREET NAME) (CITY) (STATE) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) . NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) PNC BANK (STREET NAME) BRIDGE STREET (CITY) NEW CUMBERLAND (STATE) PA I NAME OF PERSON MAKING LAST ENTRY RUSSELLG.BRUNGARD DATE AND TIME OF LAST ENTRY 11/2/200412:12 pm TITLE UNDER WHICH BOX IS REQUESTED HARRY G. BRUNGARD & FRANCES T. BRUNGARD DATE OF CONTRACT TO RENT BOX 12/01/1980 NUMBER OF BOX 308B NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) FRANCES T. BRUNGARD (STREET ADDRESS) 123 FIFTEENTH STREET 'b. (NAME) RUSSELL G. BRUNGARD (STREET ADDRESS) 7013 DORSEY ROAD (CITY) NEW CUMBERLAND (STATE) PA (ZIP CODE) 17070 (CITY) LA YTONSVI LLE (STATE) MD . NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY DAVID H. STONE, ESQUIRE, ATTORNEY FOR THE ESTATE 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 ~,jA~,1E) -STREET NAI.1E) ,CITY) ,ST,.\TE; c Name and address of attorney. if any r-~;"'~.lE -~._------ .~-----_.__._~--._---------- --_._----------~-~---_._.__._~ S~":;:Et:~ r'~;~}Jt: ':i7"'. S~t':.~Ei .., --_._._~~.._-._-----------_._--_..__.- _.~--_...._-_._---------_._- ---- --- --~ - --------- (ZIP CODE) 17070 (ZIP CODE) 17070 (ZIP CODE) 17070 (ZIP CODE) (ZIP CODE) (ZIP CODE) 17070 (ZIP CODE) 20882 .ZIP COOEi ;:p ,~Cc)E SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS Page 2 2 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, name of bank and branch, and balance. (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 I as possible. (8) All other contents. I ITEM ITEM DESCRIPTION NO. 1. (34) $1.00 Silver Certificates 2. (2) $2.00 Silver Certificates 3. (5) $5.00 Silver Certificates , I , 4. (6) Large $2.00 Silver Certificate 5. (1) Large $5.00 Silver Certificate 6. (1) 1972 Bicentennial Commemorative Medal 7. (2) 1982 One-half Silver Dollar 8. (1) 1990 Mint Proof Set 9. (1) 1991 Mint Proof Set I I 10. (1) 1980 Mint Proof Set i , I 11. (1) 1976 Mint Proof Set 12. (1) 1977 Mint Proof Set 13. (1) 1976 Bicentennial Commemorative Proof Set I 14. 1 1978 Mint Proof Set I I I I ( ) ~i (1) 1979 Mint Proof Set I 16. (35) Roosevelt Dimes , I I I I I I ! '.e ,';' T 'E F PERJURY THAT THE ABOVE RECORD IS : PERSON RECEIVING COPY OF HE BEST OF MY KNOWLEDGE AND BELIEF 1 SAFE DEPOSIT BOX INVENTORY: . SIGNATURE PR,~T NANE AI\C ''::MECK ':"FPFi.:)PR:ATE E();, DEl.'':'''.' . ~~TE ':rlEC1\. ;'PPRCPRi,"..TE e,,:;x A no R N EYp~~ ~ ~~~_ ~ST A T_~_ ____ __~~l_~ l-____.__J;~::_~;;=,~~~~:~~~~~~~:'e' ','e >'c" cC. NOTE: Attach additional 8'/;" x 11" sheet(s) if necessary or use duplicates of this page of form. .. REV-485 EX + (3-04) ~;.l~,t. ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT 280601 HARRISBURG, PA 17128-0601 SAFE DEPOSIT BOX INVENTORY 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 21 2006-01147 DECEDENT'S NAME (LAST, FIRST MIDDLE) BRUNGARD, FRANCES T. . ADDRESS OF DECEDENT (STREET) 123 FIFTEENTH STREET SOCIAL SECURITY IReQuired) OR DEATH CERTIFICATE NUMBER (only If SSN is unknown) I 177-09-8483 DATE OF DEATH 12/02/2006 (CITY) NEW CUMBERLAND (STATE) PA NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) DAVID H. STONE, ESQUIRE (STREET NAME) 414 BRIDGE STREET (CITY) NEW CUMBERLAND (STATE) PA 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) (STREET NAME) c. (NAME) (STREET NAME) \. ~\-- - y/~4 ..... . NAME AND ADDRESS OF FINANCIAL ;NAME) PNC BANK (STREET NAME) BRIDGE STREET I NAME OF PERSON MAKING LAST E RUSSELLG.BRUNGARD DATE OF CONTRACT TO RENT BOX 01/31/1980 vb NUMBER OF BOX 695 NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) FRANCES T. BRUNGARD (STREET ADDRESS) 123 FIFTEENTH STREET I I (ZIP CODE) I 17070 j ICITY) (STATE) i NEW CUMBERLAND PA 1m NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY DAVID H. STONE. ESQUIRE. ATTORNEY FOR THE ESTATE m WAS A WILL IN THE BOX? = YES ii NO I , b. Name and address of personal represenlative, if named in Ihe will ,~,;;~IE ' If yes, a. Dale of will: ,.STREE-r NA~IE.' c. Name and address of a"orney, If any ~~,..;\ tE -.---.--- -.---- ~ ----'..---..----.-------- -.--------~._..___.~.u.._.___ __ S~;..(f:c~ ~~A',;E ---- ------------_...~_..~--------_.- (CITY) (STATE) (ZIP CODE) 17070 (ZIP CODE) 17070 (ZIP CODE) 17070 (ZIP CODE) (ZIP CODE) (ZIP CODE) 17070 DATE AND TIME OF LAST ENTRY 7/7/200512:30 pm TITLE UNDER WHICH BOX IS REQUESTED HARRY G. BRUNGARD & FRANCES T. BRUNGARD ,ZIP CODE) 20882 (ZIP CODE; ._---~._~------,~~---------,_..__._----- -----_.._--_._--~ ,:=,p '-=I_--,~:.t: (RELATIONSHIP) (CITY) (STATE) ,OX IS LOCATED (CITY) NEW CUMBERLAND (STATE) PA b. (NAME) RUSSELLG.BRUNGARD (STREET ADDRESS) 7013 DORSEY ROAD ICITY) LA YTONSVILLE ISTATE) MD (CITY) lSTATE) ,CIT'yi S"""''':',r-:; SAFE DEPOSIT BOX INVENTORY Page INSTRUCTIONS 2 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 h d bl type of ownership, Le., jointly el ,paya e on death, etc. I (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) i (5) Bank and SaYings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (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 I I as possible. (8) All other contents. ITEM ITEM DESCRIPTION NO. i 1. John Alden Life Insurance Company Annuity Application i i 2. Chevron Corporation Stock Certificate #ZQ SFZ A352395 (200 Shares) ! 3. Chevron Corporation Stock Certificate #ZQ STF 15436 (200 Shares) i 4. Pennsylvania Power & Light Company Stock Certificate #CL 101539 (200 Shares) 5. PNC Financial Corporation Stock Certificate #CPT 210269 (297 Shares) 6. United States Savings Bond Series EE #X2163231EE (10,000) 7. United States Savings Bond Series EE #M63639240EE (1,000) 8. United States Savings Bond Series EE #M63639241EE (1,000) 9. United States Savings Bond Series EE #M63639242EE (1,000) I 10. United States Savings Bond Series HH #M6618531 HH (1,000) i I 11. United States Savings Bond Series HH #M6618532HH (1,000) I 12. United States Savings Bond Series HH #M6618533HH (1,000) I 13. United States Savings Bond Series HH #M6618534HH (1,000) ! t 14. United States Savings Bond Series HH #M6618527HH (1.000) ! 15. United States Savin s Bond Series HH #M6618528HH 1 000 ~ i 16. , I 17. I 18. , , , g ( , 19. 20. United States Savings Bond Series HH #M6618529HH (1.000) United States Savings Bond Series HH #M6618530HH (1000) United States Savings Bond Senes HH #M6618526HH (1.000) Deed to 123 15th Street. New Cumberland, PA 17070 Cemetery Deed - Rolling Green Cemetery Company - Section 272, Box A. Graves 4 & 5 . PERSON RECEIVING COPY OF SAFE DEPOSIT BOX INVENTORY: , SIGNATURE ! PRiNT NAME A.....C c:HECK APPRCPRI~\TE B':''', BELC':; i :-.:..', T ;--'....t: : ~,4TE , C:-"'EC....: ':'PPRC PRiA 7"E f.":'..J-'.. ATTORNEY FOR THE ESTATE ~ 1'1 F q_''': .'-," ;" :':r--,,<;" I:;....;.'.. t.:,:.3'c ",_.;:...~i"'.,l:.e ,,'11,-. - -"._---~----~-~~--..__._--. --~._---,-_.- .- -~---~--_._--...._.__.._- NOTE: Attach additional 8'/;" x 11" sheet(s) if necessary or use duplicates of this page of form. . ,,' d,',!'liKI '(,\RllI'I.\ 11"",111 PARCEL #26-23-0541-126.\ DEED I "crV\ \h.., 'J Ii') ~ THIS I:-;DE:-;TJ:RE made the i'-Y day of 'J 1'.AMV, j , io the year 2007, hetweeo RUSSELL G. BRUNGARD, Executor of the Last Will and Testament of FRANCES T. BRUNGARD, late of the Borough of New Cumberland, County of Cumberland and Commonwealth of Pennsylvania, of the tirst part, hereinafter called the Grantor, -AND- James A. Smith, III, of the second part, hereinafter called the Grantees; \VHEREAS, the said Frances T. Brungard became in her lifetime seised, as of fee, of and in to a certain tract ofland, together with the improvements thereon erected, situate in the Borough of New Cumberland, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on December 2,2006, having first made her Last Will and Testament in writing dated April 21, 1999, duly probated and registered in the Office of the Register of Wills of Cumberland County on December 27,2006, wherein and whereby she appointed as Execlltor, the said Russell G. Brungard, to whom Letters Testamentary were duly issued by said Register of Wills on December 27,2006, wherein and whereby said premises hereinafter described were not specifically devised, all as in and by said Will and the records of said Register of Wills more fully appears: ~O\\" THIS I~DE~TrRE WIT~ESSETH. that the said Grantor. for and in consideration of the slIll1nf Se\enteen Thollsand Fi\ c Hundred and ~o 100 ($ 17.500.(0) Dollars, which has been paid tll him h~ the said Grantee at nr befnre the scaling and delin:ry hereof. n:ceipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantee, ALL THAT CERTAI~ tract ofland situate in the Borough of New Cumberland, Cumberland County, Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the northwestern corner of Kathryn Street and Charles Avenue; thence westwardly along the northern line of Charles Avenue, 34 feet to a point on the eastern line of Lot No. 17; thence northwardly along the eastern line of Lot No. 17 to a point on the southern line of 151'2 Street; thence eastwardly along the southern line of 151'2 Street 34.12 feet to a point, the southwestern corner of 151'2 and Kathryn Streets; thence southwardly along the western line of Kathryn Street, 105 feet more or less, at the place on BEGINNING. BEING Lot No. 18, on Plan of Lots of Charles H. .MiIler, at Elkwood, New Cumberland, (formerly Lower Allen Township), Cumberland County, recorded in Plan Book 2, Page 74. BEING THE SAME PREMISES \VHICH Walter K. Chiles, Widower, by his deed dated April 15, 1977, and recorded April 20, 1977, in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Record Book C27, Page 802, granted and conveyed unto Harry G. Brungard and Frances Brungard, his wife. Harry G. Brungard died December 20, 1991, thus by operation of law vesting title in Frances Brungard, deceased. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, rents, issues and protits thereof. and all the estate, right, title, interest, property, claim and demand whatsoever of her, the said Frances T. Brungard. at and immediately before the time of her decease, in law. equity. or otherwise hO\\ socn:r. of: in, to or out of the same. - ..:.:. - TO HAVE AND TO HOLD the said lot or piece of ground above described, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned. and intended so to be, with the appurtenances unto the said Grantee, to and for the only proper use and behoof of the said Grantee, forever. And the said Grantor, for himself and his respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, his heirs and assigns, that he, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof. is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. IN \VITNESS "'HEREOF. the said Grantor has hereunto set his hand and seal the day and year first above written. / I '/. ~. C(,CJ.;Ji.... ! /;'~I /,j. .C, ,.....1(1 ) (~ (SEAL) RUSSELL G. BRUNGARD, Exe(flttor of the Last Will and Testament of Frances T. Brungard 1/, I, CO\I\IONWEAL TH OF PE~~SYL VA.~L~ SS: ,I I' ,I I II :1 II II il :1 'I II ,I I !/ II :/ " :/ II : COL'~TY OF CCMBERLA~D , ''-hI? J\.. " On this, the Jd;I day of y/l'Ldl?f ' 2007, before me a Notary Public, the undersigned officer, personally appeared RCSSELL ~. BRUNGARD, Executor of the Last Will and Testament of Frances T. Brungard, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. I~ \VITNESS WHEREOF, I have hereto set my hand and notarial seal. .' ('f i-'tNNS'{LVAN~ COMMQNWi:J.>.LI r1 ' " AL - NOTARiAL ';:'~otary Public DANIEL l.\. HAR~MAN'cumberland Co, New CU\I,uilrland exorfr'Ss Jan. 21, 2009 LMy CommIssIon P Notary Public I hereby certify that the precise address of the Grantee is 121 15th Street. New Cumberland. PA 17070 :\ttomey tt)f - -1: - :1 Ii '& \' ~kd HI<I'C j \RDI-,"'il \ T1'..\."0011.......:\ l'l.\.kl..'J :1 Parcel #26-23-0541-125 DEED THIS INDENTGRE made the ~ day o~ ~ , in the year 1007. bet\,<een RLSSELL G. BRUNGARD, Executor of the Last Will and Testament of Frances T. Brungard, late of the Borough of New Cumberland, County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND- MICHAEL L. COONS, of the second part, hereinafter called the Grantee; WHEREAS, the said Frances T. Brungard became in her lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in the Borough of Ne\\ Cumberland, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on December 2, 2006, having tirst made her Last \Vill and Testament in writing dated April 21, 1999, duly probated and registered in the Office of the Register of Wills of Cumberland County on March 19, 2007, wherein and whereby she appointed as Executor. the said Russell G. Brungard, to whom Letters Testamentary \vere duly issued by said Register of Wills on March 19,2007, wherein and whereby said premises hereinafter described were not specitically devised. all as in and by said Will and the records of said Register of Wills more fully appears: :\OW THIS I~DE:\TLRE WIT:\ESSETH. that the said Grantor. for and in consider~ltil)1l llt' the slim of One Hundred Eight Thousand and \10: 100 (SIOR,()()O.OO) Dollars. \\'hich has been paid to him by the said Grantee at or before the sealing and deli\el")' hereof: receipt \\ hereof is hereby II . II acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does i grant, bargain, sell. alien, release and confirm unto the said Grantee, II :1 [II ALL THAT CERTAIN lot or tract of land, together with the improvements thereon erected, situate in jl!I' the Borough of New Cumberland, Cumberland County, Pennsylvania, more particularly bounded and described as follows: I I BEGINNING at a point on the North side of Fifteenth Street, said point being thirty-four (34) feet West I of the Northwest comer of Fifteenth and Kathryn Streets; thence northwardly by a line parallel with Kathryn Street and thirty-four (34) feet distant therefrom One hundred and Sixty ( 160) feet to a point on the southern line of Charles Street; thence westwardly along the southern line of Charles Street thirty-four (34) feet to a point, the line of property No. 125 East Fifteenth Street; thence southwardly along the line of said property one hundred sixty (160) feet to a point on the North side of Fifteenth Street; thence eastwardly along the North side of Fifteenth Street thirty-four (34) feet to a point, the place of BEGINNING. HA VING thereon erected a dwelling house No. 123 East Fifteenth Street. BEING THE SAME PREMISES WHICH Caleb M. Wenger and Esther E. Wenger, his wife, by their deed dated March 14, 1946, and recorded March 18, 1946, in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book D, Volume 13, Page 531, granted and conveyed unto Harry G. Brungard and Frances T. Brungard, his wife. Harry G. Brungard died December 20, 1991, thus by operation of law vesting title in Frances T. Burngard, deceased. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, \vaters, \vater-courses, rights, liberties, privileges, hereditaments and appurtenances \vhatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereot: and all the estate, right, title, interest, property. claim and demand whatsoever of ht:r. rhe said Frances T. Brungard, at and immediately before the time of her decease. in 1<1\\. equity. or vtht:r- wise howsoever. ot: in, to or out of the same. - 2 - TO "AVE AND TO HOLD the said lot or piece of ground above described, with the buildings and ill1pron~ments thereon erected, hereditaments and premises hereby granted or mentioned. and intended so to be, with the appurtenances unto the said Grantee, to and for the only proper use and behoof of the said Grantee, forever. And the said Grantor, for himself and his respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantees, their heirs and assigns, that he, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title. charge. estate or othef\vise howsoever. IN WITNESS WHEREOF, the said Grantor has hereunto set his/her hand and seal the day and year first above written. /1 (7 I /~~.{A._4.t.if,~a, /Uc, L tk-, (SEAL) Russell G. Bnmgard, Executor' fthe Last Will and Testament of Frances T. Bnmgard II . ,i ,I I' i 'i I, I, II " II 'I COM!\tONWEAL TH OF PENNSYL VANIA: COLNTYOF~~~ On this, the '"1~ day ~'0~~~ SS: ,2007, before me a Notary Public. the undersigned officer, personally appeared Russell G. Brungard, Executor of the Last Will and Testament of Frances T. Brungard, known to me or satisfactorily proven to be the person whose name is subscribed to the within MONWEALlH OF PENNSYlVANIA COM NOTARIAL ~~~; Public CAROL L.1R~:~o cumberland COg New cumb~r ~onn Expires Dec. 27,200 Wry Commlssl instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set ~~and and notarial seal. .'" <~ Notary Public I hereby certify that the precise address of the Grantee is: Attorney for -.J, - C~lculate the Value of Your Paper Savings Bond(s) Page 1 of 1 \/diue ,l-,. ot ':)'.~r,es: D~nomlniltion: Bond Seri..ll Number: Issue D,lte: EE Bonds 1,000 feL1llJrice: Total V<1lue: .~ Total Interest: YTD 1ntc'rest: 5"'-1,,1 " Issue D<lte i')'; Issue Price Value ',837.20 S"rl"':> Next Accrual Interest Note D"'l'.ill Findl M.Jturity Interest R3te ':'1'.'(\,'1 " Issue O<lte l'-_J')-, Issue Price Vdlue $837.20 ';i'rlf'<,. Next ACCru<,1 Intere_..t Note ,) "1')<.) r11 Final Maturity Interest Rate "'_"I'idi ~ IsslJC Date J_'.... ISSUt' Price Valut' ,58]7.20 SI.:l"l\'" Next Accrual Interest N{Jt~"\ D"r1UI1l Final M<lturity Interest R.Me ~ l~ 'i.; I ~ I'isue Odtc Issue Price VdJue $11,224.00 '-.\",...-. Next ACCrtJ..ll Interest Noll_:. ;),''--''11, Fin~lj M,l'urlly Interest Rilte Ni ;'<f P'j f-'l^ HU'o"J 'xould yOU r,Ht~ thIS tCl()I? SUBMIT http:// \V\V\V. treasurydirect.gov /BC /SBC Price 2/15/2007 C?evron Corporation - Stock chart, Index chart - MSN Money msn' ~AI. 1V1olley Investing Stocks Quote, Chart, News ,-':1 Sign [n Chevron Corporation Or:er 71.01 High: 71.44 LO'.'j 70.75 Clos,' 71.36 ChevronTexaco Cp r/'_"! i'~ '..;\ ^, c; 1~/29/ 2006 12/28/2006 Research 12/27;2006 12/26/2006 12;.22/2006 1:)/21/2006 12;:)0/2006 12/19/:2006 " ~2;]8;2006 12/15; .'006 12/H/2006 12/13.0006 :>~~ 12/12/' 2COG 12/11/2006 12/8/2006 12/7/2006 12/6/2006 Guided Research Find Stocks 12/5:,2006 ] 2;4; 2006 12/1/:006 :.;';11.1 jJfOVldt!l'S -), iL~ p; O',iCed bi c;~ 74.1000 74.5100 7.1.1400 73 04000 73.5100 74.1600 74."100 /,.1.1'900 754300 76.~~i)O 76.2000 74.7200 745700 71.0'100 7..) 0000 7.1.0000 74.nOo 74.1700 73.5JCO /3. !6DCl C."- "-,,\ -'-'--~..--I 73.5000 7..\.0100 73.2600 72.5300 72.6600 72.5'\00 73. 4800 72. 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(IJS.PCI'.1) Last: 26.43 Change: 0.16 Day's HIl)h: 26.61 Day's '-ow: 26.41 PCC"JlOUS C,ose: 26.27 Volume: 33,400 Eastern Time Quote, Chart, News 1 ' ~ ::; '~ Pepco Holdgs Inc i".,,-lt" Research 12/6/2006 12/5/2006 12/4/2006 12/1/2006 llnO! 2006 1 :/29/2006 11/28/2006 11:27/.'006 (" ;0 c-", :,:,..J 26.6100 26.2400 26.5-lDO 26.8100 26.5200 266800 26 9900 26,4 700 2b.'-~/OC 2601200 25.8500 26. 1800 25.9400 25,:3900 2~)..s--tO() 25.9500 25.530U 25.(Y)00 25.6800 25.lI:JOO 25.=~.! UO 25.7000 25.1300 .~5.7000 2(1.3900 'j9?, /00 1,13Q,.-:tUC 26.tAOO 2~J.6bul} 1'!() ~6A2110 2.:~17,3GO ::;,',)"~('::O 1,t}.:U,~,U( 2J.:)/U:) /J2,40U .J5.:)2GU S94/000 75.2GOO 1,/] 63, lOG Data prOVIders DiJ~a prOVided by Quotes supplied by C)"i:,t,:d, an Interactive Data com~any. :i'ri~rd(~"ii' Cei!,! an Interacti'",..:.: Data Company. Steck price data priJVided by QUote's rJr-liwed 20 minutes. Guided Research Paqe qen.crated 3/8/2007 10:54 AH Eastern Time Find Stocks Related links Avv"W'- ~ ~ d~ f l- Y { 1- \ 53 .4t" ~ 02 ..,. .). l" . 07 3 5.J. l7 -;;l.. )..b. /3 s ;).~ b ..,. l cl ~.Lj3 ~hCl.re... )73 ,shs. f? It :2b,L{-3 ~d)j ~~~/S.31 ~ http://moneycentral.msn.com/investor/ charts/ chartdl.aspx?PT= 3 &05= 1&02 =0&03=0&C... 3/8/2007 Pt'Ic Financial Services - Stock chart, Index chart - MSN Money msn C;:'''~~;-1.l 11\1\'.' ",:1I! .Jr I ~. Y fn \le~tin9 Stock~ Quote, Chart, News E! TRADE) Rese;Jrch Guj(jcd Research ~- iil(J Sto...:ks Relilted links B'H;itO[ lank mlfmt.~, rOle ,.:f ':,,;'l ~~_" , .~{ _~_f: "~, "_. ':- - ,",i}, ~~l.~.-,-~ PNC Financial Services 75.52 r1.\jh' 75.87 i.ow: 75.05 ~ /.1' 2~t/ 7U06 PNC Financial Services Group ~ ---) 7~t. 9bOO 12/28./2006 1 ~/2712006 1.:/26/2006 lL 2,?/2C'!)fj :i. 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J, ~, ~." . eyq~ J2 I;), <{ 1 J-I ;)q7 shS Estate Valuation Date of Death: 12/02/2006 Valuation Date: 12/02/2006 Processing Date: 01/25/2007 Estate of: FRANCES T. BRUNGARD Account: 13433608 Report Type: Date of Death Number of Securities: 3 File ID: BRUNGARD,FRANCES Shares or Par Security Description High/Ask Low/Bid Mean and/or Div and Int Security Adjustments Accruals Value )c1 G 1) 61553.37 ALLSTATE ADVANTAGE PLUS (02003J762) 12/02/2006 /. I ' S~ B 2 ) 13674.475 BLACKROCK MULTI ST MON SER TR (09253A755) PA MONI BD A Mutual Fund (as quoted by NASDAQ) 12/01/2006 :;c~ r; 3) 1. 23 CASH (EVP01) 12/02/2006 1. 00000 1.00000 1.000000 61,553.37 11. 44000 Mkt 11. 440000 156,435.99 1.00000 1. 00000 1. 000000 1.23 Total Value: Total Accrual: Total: $217,990.59 $217,990.59 $0.00 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) . PPL Corporation - Stock chart, Index chart - MSN Money msn [\Ioney i>E;;.Lt [nvestiny Stocks Quote, Chart, News > ~ . - - -' ";,' ':'~ f:j 1M. ~.~.~ PPL Corporation 36,76 r1lCJn: 36.92 PP&L Cp :7/29/2006 i'--":.', 12/28/2006 Resc<lrch 12/;27/2006 12/26/2006 12/22/!006 12.'2i.,i?!)t)6 l/,.?O/::UtJ6 -: ~i' 19:' ~:>JU6 : 2/18/21]06 l.~, lS/.-::'006 12/1,.t;:20Gb 12/ \]/2006 1)/12/2006 :2/l1/2006 12; 8i 2006 1217; 20')6 Guided Re'ieilrch ~ .2,:Oi20C6 rind Slock-; , , : =~ \~-Ct) {...::,.;;:;r;I: - 2i),Jb [),'ttd P"')i.iideiS Ddtcl ~J!\)'.'ic;(:C:G by 36.53 C:),-,;' 36.90 "--', ( --", ./ 36.0600 36.1300 36 3200 36./:200 35.9100 3G.G~D(j 2 S, 'JI ~.!{~-(J L.'i.!IY: 3D.::~:OI) '::6,] 3(\0 J~). 5:= O\J :)tJ.5000 J().'tO(JU '36 JdOO 36.1000 36_ 5400 -31),t;.800 ~! ''',' i; "', '.-l";C 31_1,t:; ~ ,OJ;] an InteractlVt? Dat.] CG.-n;:{~n".. 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CGC J6.J3CO 2G2S,JU /';...;'(]IO) 36.2800 3().~~SGIJ !"; 7,),8')0 36. JUGa 3L._~4GO 1;S5~),."200 )rJ. + /(~:O :"., ,'1' /"7\ 3C;i) .j,>: , 'J;j .,:j '-.{l, ,,~,>j n ;"'3C'J J ).:. jf.i .:f: ~- ) l, '")IJ(i oJ\.:'!;I, t:d ~Il) 73 ,74,::, ;;L~3~,g7 ~~-sI,_ ,100 5 h5 . 'X ~ sf:" ~ 7 ::; ~ 7, J 7 y, 07) http:.moncycentral.msn,com/investor/charts/chartdl.aspx,?PT=3&05= I &02=O&03=O&C... 'J 16<~007 fo. _. t... .-. ~, ~ ,_. ,- ,.. ,_. -. - ~.. _. I ...... i :cr' -.r'. -- ...-. . ' 525 William Penn Place Suite 153-2618 Pittsburgh, P A 15219 i'tiz...e"ns.. '8.'a nl.f ~ ".' . ,. .j; ", January 25. 2007 DA \lID H STONE 414 BRIDGE ST PO BOX E NE\\. CUMBERL4ND PA 17070 i I I I Estate of FRANC S T BRUNGARD Date of Death: Dec 02, 2006 SSN: ] 77-09-8483 Dear Sir/Madam: In accordan ce with Iyour request, the attached iofoonatioo sheet has been provided in the above decedent's name as of his/her ~ate of death. - ... i For IL or LC accoupts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 888-999-6884 I I .... ." .... ... '. "'. .... Sincen:ly. ... '>1' ~'.. Pfeil. Marnie Operations Servicef I - -- .- .- ,~'..~ .......~ ~ :lit'. ~. Account Number i Account Title Date Opened Account Type Principal Balance Interest from Last Account Balance YTO Interest to 0 itizens Bank " 6205298736 FRANCES T BRUNGARD OR RUSSELL G BRUNGARD 5/21/2004 Checkin $13010.30 $.00 $13010.30 $ .00 .- .... ,...... '....... ... .- .- .- ....... lit 1= I~ izens Bank Account Number , Account Title Date Opened Acc(?unt Type Principal Balance Interest from Last Account Balance YTD Interest to D 6140697611 FRANCESTBRu~GARD 4/18/2005 Time Deposits $20601.30 $63.55 $20664.85 $454.33 .- .- .- ".. ..... ,+ .... <-..... - ..- ......' .... ~. ,,", .... ~. ~. !e' .. i .'\ccl1unt \:umber . i .\ccuunt Tilk f)~lk'( >p'-'Ih.'d h_.\cC(~~'l1l1 :p,-' ! Principal Balance as of 000 ! Illter~st from Last Posting to 000 I Account Balance as of 000 i 't'TD Interest to 000 6140866111 F~\NCES T BRUNGARD 56.1992 Time Deposits__ $24991.20 $43.97 525035. I 7 $524.92 ..... tr. ~ _. ; .\CC(lllllt \..lIl11bl'r I .\ccollnt Tille Date Opened Accollnt T \pe ~_.._~"--- "- I Principal Balance tis of DOD . Interest from Last Posting to DOD \(((lunl B~dallce as of DOD YTI) Inter,-'s! lO DOD 6140866-+05 FRANCES T BRUNGARD 6/4/1992 Tim.e Deposits ~-$ .QQ;>- s .00 $ .00 $399.96 tt: ~ ".w. .. 3 :lIt.~ :ar'- :m- an- !=! ~- Sir. .. I I ~~ Cj~iZenS Bank ! I .. ... .. ; Account Number 6140867703 I Account Title FRANCESTBRUNGARD Date Opened 12/2/1992 Account Type Time Deposits Principal Balance s of DaD $6001. 71 Interest from Last Posting to DaD $1.21 Account Balance c s of DaD $6002.92 YTD Interest to D DD $221.46 I ..,. - - .... ... ... .... ..-, .- ... ... .. ... .,. ..... - - .- 1>...... - .- .- ,.... .~...... .- .- .- -.- Ci~izens Bank I I I I I i I /\ccount Number Account Title Date 0 ened Account Type Principal Balance Interest from Last Account Balance 'of DOD YTD Interest to D D ... ., 6140894689 FRANCES T BRUNGARD 7/5/1990 Time Deposits $31126.86 $85.32 $31212.18 $912.25 .- .- ... ... ... '.... '... ..... '-<Ii - .- .- .- ........ - .-.., . ~.- t: r- r. t'" . .' ..' .' e' 1"' ! AccL1unt .\umber . ! Account Title Oak Opened '\ccnullt T) pc h-!I1\.:lpai Babnce as of DOD Interest from Last Posting to DOD \c('( )lIllt B~lLI11(,~' as of 000 1 ID Inkr,,'sllo DOD 6145157498 FRA.NCES T BRLNGARD 9113/1004 -_ __ _Jln~peE.o_~i!_s_ u_ ___ __.. $17061.93 538.57 517100.50 S533.76 ........ ~- !tri.. ~ ~. .. - I I I I : \ " I I i .. CCl)lInl ." lIJl1 1er I I ..\ccollnt Title I Date Opened I Account T: pe I Principal Balance as of 000 ! Interest from Last Posting to 000 i AccoLlnt Balance as of DOD I YTD Inkrest to 000 6248759168 FRA.NCES T BRl0:G.:-\RD 6/9/2006 Time Deposits $12308.56 $44.26 $12352.82 $270.87 .. Ii -= -- c.- a:- ar- If-.' r.- r- ..-- r!- ~-- t!~ Jf! .'\ccount Number I Account Title Date Opened :\cc()unt Type i Principal Balance s of DOD I Interest from Last Posting to DOD i Account Balance s of DOD YTO Interest to OOD 6248759176 FRANCESTBRu~GARO 6/9/2006 Time Q~129_~i!~______ ________ $12000.00 $43.15 $12043 . 1 5 $264.08 "-...... . Fulton Bank LISTENING. January 25,2007 Stone, LaFaver & Shekletski 414 Bridge Street Post Office Box E New Cumberland, Pennsylvania 17070 Dear Mr. Stone: RE: Frances T. Brungard, deceased December 2,2006 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: ACC CD# BALANCE INT RATE OPEN ROLL OVER MATURITY 052-0224772 $11,900.95 $23.08 4.16% 3/15/2006 9/15/2007 052-0224776 $14,241.85 $27.62 4.16% 3/15/2006 9/15/2007 052-0224780 $14,241.84 $29.21 4.40% 3/15/2006 6/15/2007 052-0259735 $10,000.00 $38.85 4.88% 11/3/2006 11/3/2007 400-3372283 $42,625.69 $548.23 3.92% 8/5/1991 8/5/2005 8/5/2007 400-3372291 $13,218.61 $210.33 3.92% 7/8/1991 7/8/2005 7/8/2007 522-0027886 $11,186.49 $19.71 2.57% 12/7/1992 12/7/2004 12/7/2008 522-0027901 $9,188.65 $310.84 3.68% 7/6/1993 1/6/2006 2/6/2007 522-0052158 $3,237.21 $5.57 3.92% 8/16/1994 8/16/2006 2/16/2008 522-0072905 $6,521.21 $22.32 3.78% 1/31/1995 4/30/2006 5/30/2007 522-0092450 $5,007.43 $12.38 3.92% 7/9/1996 7/9/2005 1/9/2007 523-0000440 $6,256.85 $18.63 4.02% 9/5/1996 9/5/2006 9/5/2008 523-0034478 $8,811.53 $134.27 3.68% 1/5/1998 1/5/2006 2/5/2007 * Russell G. Brungard as Power of Attorney for all above CD's. 400-1859844 $13,357.44 $348.75 3.92% 4/6/1992 4/6/2006 5/6/2007 * above CD joint with Russell G. Brungard. If you should have any further questions, please do not hesitate to contact me at (717) 291-2437. CONFIDENTIAL ;r~:~~ Karen D. Hillega~ -~- Credit Inquiry Processor This information is furnished 3S a matter of business courtesy in answer to your inquiry, and is '::r your confidential use only. No responsibility is assumed by t~,js hank or any of its officers. Any opinion herein expressed IS SUb;3ct to ch:mge w:thout i1c:ice. POBox 4887 Lancaster, PA 17604 fultonbank.com 1-800-FULTON-4 4 !a M&fBank 499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 January 16, 2007 Stone LaFaver & Shekletski Attorneys At Law 414 Bridge Street POBox E New Cumberland, Pennsylvania 17070 Re: Estate of: Frances T Brun2ard Social Security: 177-09-8483 Date of Death: December 02. 2006 Dear Sir or Madam: Per your inquiry dated January 12, 2007, 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 Certificate of Deposit Account Number 031003913821285 Ownership (Names oj) Frances T Brungard * Opening Date 11/15/99 Closed 12/28/06 Balance on Date of Death $12.457.26 Accrued Interest $ 25.44 Total $12.482.70 2. Type of Account Certificate of Deposit Account Number 031003914381345 Ownership (Names oj) Frances T Brungard * Opening Date 10/16/92 Closed 12/28/06 Balance on Date of Death $3,321.54 Accrued Interest $ 17.53 Total $3,339.07 . 3. Type of Account Certificate of Deposit Account Number 03/003914493299 Ownership (Names of) Frances T Brungard * Opening Date 11/20/95 Closed 12/28/06 Balance on Date of Death $13,387.61 $ 18.90 Accrued Interest Total $13,406.51 4. Type of Account Certificate of Deposit Account Number 031003915824592 Ownership (Names of) Frances T Brungard * Russell G Brungard * Opening Date 01/10/06 Closed 12/28/06 Balance on Date of Death $/0,000.00 Accrued Interest $ 412.64 Total $/0,412.64 5. Type of Account Certificate of Deposit Account Number 031003915824609 Ownership (Names oj) Frances T Brungard * Russell G Brungard * Opening Date 01/10/06 Closed 12/28/06 Balance on Date of Death $17,018.55 Accrued Interest $ 702.26 Total $17,720.81 . 6. Type of Account Certificate of Deposit Account Number 031003915824625 Ownership (Names of) Frances T Brungard * Russell G Brungard * Opening Date 01/10106 Closed 12128/06 Balance on Date of Death $8.173.32 Accrued Interest $ 337.26 Total $8,510.58 7. Type of Account Certificate of Deposit Account Number 031003914381171 Ownership (Names of) Frances T Brungard * Opening Date 12114/84 Closed 01110106 Balance on Date of Death $ 0.00 Closed prior to the date of death ** 8. Type of Account Certificate of Deposit Account Number 031003914381311 Ownership (Names of) Frances T Brungard * Opening Date 01/08190 Closed 01110106 Balance on Date of Death $ 0.00 Closed prior to the date of death ** 9. Type of Account Certificate of Deposit Account Number 031003914381337 Ownership (Names of) Frances T Brungard * Opening Date 08104192 Closed 01/10106 Balance on Date of Death $ 0.00 Closed prior to the date of death ** * 10. Type of Account Certificate of Deposit Account Number 031003915824584 Ownership (Names of) Frances T Brungard * Russell G Brungard * Opening Date 01/10/06 Closed09/12/06 Balance on Date of Death $ 0.00 Closed prior to the date of death * * 11. Type of Account Certificate of Deposit Account Number 031003915824617 Ownership (Names of) Frances T Brungard * Russell G Brungard * Opening Date 01/10/06 Closed 11/24/06 Balance on Date of Death $ 0.00 Closed prior to the date of death ** Please be advised, there was no safe deposit box fOWld for the above decedent. 1<1< Please contact the West Shore Plaza office regarding any questions on accounts closed prior to the date of death. 1< For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the West Shore Plaza Office # 717-25S-2271. Sincerely, 2' /1" '7'- /~?,'y~->"" / ',,' ''be;' v{~' '/(v( .J :/ Nancy Clagett Records Management CLAUDE C. WOLFE & ASSOCIATES AUcnONEERS & APPRAISERS FAMILY OWNED SINCE 1910 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 Public Auction for Date Address Auction Estate of Frances T. Brungard May 5, 2007 123 15th Street, New Cumberland. PA 17070 Gros 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4. 737 . 00 EXPENSES Shoppers Guide MY. , Sale Bills . . . . . . . . . . . . . . $ 371 .30 Pa triot News MY. ............................. 341 .00 Paxton Herald My. ............................ 165.05 Other Mv. ......... ..... ......... ... ... ....... Other Mv. .................................... Other Mv. .................................... Sign for Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State Fumigation Tags ...... ......... .......... Registration Nwnbers ......... ................. Ten t/ Tarp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mise. Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ;, 4 Clerks at $ 70.00 4 Runners at $ 70.00 ~r Sale preparation ~r ~r Labor Personal Items Fee at each . . . . . . . . . . . . . . . each . . . . . . . . . . . . . . . 10 ,.................. Total Expenses for Auction ..................... Real E s ta te Gross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Real Estate Fee at 3 % (Due at Settlement) . 25.00 10.00 10.00 280.00 280.00 655.00 473.70 . . . $ 2,611 .05 \ \ '767.0lJ -lvW'-trJ. R~a;l r;-h~ $ 108.000.00 3.240.00 // .. ~ 'I) \.!. \.', :-..~ l"'~~-- . 'I .". J VoJ. ~/ . Auctione~r or Cashi~r: '/ -/3/ ) I //, /,' . / . . ,. . '7 .-. r~L(Af dL.L-f,l LU_.-'vt.Cj U. LL... i/ /.. Approved by:' $ 4.737.00 - 2,611.05 2,125.95 - 3,204.00 1,078.05 Auction Gross Expenses Net Checks Owed to~ Auctioneer .~~ ~ II) e c: M en 0 I- .!!! I '(jj Zo 0 :I: ,r!! (j) l- E :::>0 0 It) o . r-I ... E :20 M 0 ~~ <::) N () ... M <::) I en ; z .. 0 ; 0 () fit I It:ct f'o.. I 0 ~c5 (') LlJO lXlcr: ;;; ~N z:::> 2; 00 ZCO co M W(/) co >. i o.ffi g ns Q....J ~ -....J I ~~ I i I I- z ~5 (') ~g 2! ~. ;::: W t;) ct ~:J _ -lX8~ "UI-",....J Z~~~ - W:::> I- ~~g~ ffio~i9 ~~~uj o o .... (3 o -g CIJ ~ o U. "0 l! -g ;:, r o ~ ~ "0 C CIJ II) ;:, o oS: ~ Ql l! oS: ~ I .. (I) S ns 'i <( O/:l ~ ~ Q) "0 ::J ns U LlJa; ILlJ >-1-0 a:2i5~ J' ~; ~- ~. ~ \~ ~ ~ ...... .., fI , , " tJJ - - J rt'l LIl ... o ... .. - C'- o ca ca o rt'l ... rt'l o ':: ~ C'- ... cr ... o o ~ .....LC- 100 ~""t...)O r .l:JJ./ l:J.I. .. ~ PNCBAN< January 22, 2007 David H. Stone 414 Bridge Street P.o. Box E New Cumberland, P A 17070 RE: Estate of Frances T. Brungard, deceased SSN: 177-09-8483 DOD: 12/212006 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 #21001017216 Established 06/16/1986 FRANCES T BRUNGARD DOD balance; $1,529.91 + $22.95 accrued interest Checking Account Account #5140008015 Established 02/01/1958 FRANCES T BRUNGARD DOD balance: $33,285.01 + $12.28 accrued interest The decedent maintained Investment Account (INV #13433608). For further infonnation, you may oontaot the Brokerage Department at 1-800-762-6111. Please note that this office only provides date of death balances for deposit accounts (lRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (lw888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~~ Rachelle Wells t -800-762-1775 P7-PFSC-04-F .500 first Ave. Pittsburgh PAl 5219 Mcrnbtr FDIC TOTAL P.01 tSovereign Dank s~ is~. .. am beiIl.)lO<<l_ tbI1t&'- MAl MB3 02-10 Court Ordered Processing P.O. Box 841005 Boston, MA 02284 January 18, 2007 Attorneys at Law Attn: David H. Stone 414 Bridge Street P.O. Box E New Cumberland, PA 17070 RE: Estate of Frances T. Brungard Date of Death: 12/02/06 Dear Mr. Stone: Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. v cry trol y yours, i / { /; I /i, ///AJ I ~ .. ( . ..(.....V' ./ Ii' Ie "i I -./ I Nicole Job--- COP Specialist III Decedent Department (617) 533-1364 Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Frances T. Brungard 177 -09-8483 December 2, 2006 Account #: 0574112561 Type: Savings Open date: 7/18/1980 In the name of: Frances T Brungard (Russell Brungard POA) Date of Death Balance: $8,337.49 Int.(YTD) from 1/1/2006 to 9/30/2006 : $28.55 . Accrued interest to date of death: $7.98 (".,+ r(.c-C:l~-((') Other Info: Account closed on 12/28/06 for $8337.49. Account #: 0771039727 Type: Checking In the name of: Frances T Brungard (Russell Brungard POA) Date of Death Balance: $46,501.65 Int.(YTD) from 1/1/2006 to 11/30/2006 Accrued interest to date of death: $7.56 Other Info: Account closed on 01/03/07. Open date: 11/19/1998 $864.68 Account #: 0775146699 Type: CD In the name of: Frances T Brungard Date of Death Balance: $3,949.09 Int.(YTD) from 1/1/2006 to 12/2/2006 Accrued interest to date of death: $0.91 Other Info: Account closed on 12/28/06 for $3955.26. Open date: 4/5/1999 $89.42 Account #: 0775147218 Type: CD In the name of: Frances T Brungard Date of Death Balance: $3,175.62 Int.(YTD) from 1/1/2006 to 12/2/2006 Accrued interest to date of death: $1.28 Other Info: Account closed on 12/28/06 for $3184.24. Open date: 2/15/2000 $80.97 Account #: 0775149677 Type: CD In the name of: Frances T Brungard Date of Death Balance: $6,548.21 Int.(YTD) from 1/1/2006 to 12/2/2006 Accrued interest to date of death: $2.80 Other Info: Account closed on 12/28/06 for $6567.13. Open date: 9/4/1997 $156.45 Page 1 of 2 Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Frances T. Brungard 177 -09-8483 December 2, 2006 Account #: 0775149818 Type: CD In the name of: Frances T Brungard Date of Death Balance: . Account closed prior to death Int.(YTD) from 1/1/2006 to 8/4/2006 Accrued interest to date of death: $0.00 Other Info: Account closed on 08/04/06 for $26,242.77. Open date: 8/3/1992 $332.08 Account #: 0775149974 Type: CD In the name of: Frances T Brungard Date of Death Balance: $6,000.20 Int.(YTD) from 1/1/2006 to 12/2/2006 Accrued interest ~o date of death: $2.59 Other Info: Account closed on 12/28/06 for $6017.76. Open date: 8/29/1996 $140.44 Account #: 0775150055 Type: CD In the name of: Frances T Brungard Date of Death Balance: $4,887.24 Int.(YTD) from 1/1/2006 to 12/2/2006 Accrued interest to date of death: $1.13 Other Info: Account closed on 12/28/06 for $4894.88. Open date: 2/28/1997 $107.80 Account #: 0775151160 Type: CD In the name of: Frances T Brungard Date of Death Balance: $9,570.37 Int.(YTD) from 1/1/2006 to 12/2/2006 Accrued interest to date of death: $3.83 Other Info: Account closed on 12/28/06 for $9596.34. Open date: 4/18/1996 $283.95 Page 2 of 2 :>--s-'-:- -~,.:'~ _c:- ...... 'WAcHovL\. Wachovia Bank N.A. Balance Confirmation Services POBox 40028 Roanoke, Y A 24022-7313 January 22, 2007 -.--,--_. ~v........., c-u." rC""'},'\.lIJ,."o .L I VVU .. o.A ....,o~ V v~ Reference ID: 1894278 STONE LAFAVER & SHEKLETSKl 414 BRIDGE STREET POBOX E NEW CUMBERLAND, P A 17070 SUBJECT: Verification / Confinnation of Account and Balance Infonnation provided for: Customer: FRANCES T BRUNGARD (SSN# 177-09-8483) Date of Death: December 2, 2006 Account Type Account Number CERTIFICATE OF DEPOSIT 140312110219725 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD Deposit Account Information Date ofDeatb Balance Average Balance. Date Opened 9/1312006 Maturity Interest Accrued YTD Date Date Rate Interest Interest Paid Closed SI4,050.86 57.88 S152.89 12128/2006 CERTIFICATE OF DEPOSIT 247022055669456 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 525,808.33 2/16/1990 S639.75 5950.67 12128/2006 CERTIFICATE OF DEPOSIT 247022056533716 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 513,908.22 4/13/1998 $466.08 5694.13 12/2812006 CERTIFICATE OF DEPOSIT 247022063618463 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 55,102.63 1lI18/1985 57.27 5163.17 1212812006 CERTIFICATE OF DEPOSIT 247022063618625 1212812006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 53,236.86 12116/1985 5104.97 50.00 CERTIFICATE OF DEPOSIT 247022063777243 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 513,619.95 3/3i! 986 5348.35 5100.26 1212812006 .& U,^ Uv.A. V Do&. :>-.,.7- -~ -..- ~ ....~ _.:.-- ....... "'iVAc1lOVlA Reference ID: 1894278 CERTIFICATE OF DEPOSIT 247022063777499 S2,334.36 6/9/1986 S39.49 S20.22 12128/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247022064561694 S8,743.39 1211/1986 S2.54 S243.34 12128/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247022064711858 S2,102.51 11118/1987 S2.86 S65.43 12128/2006 LEGALTITLE:FRANCESTBRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247022066110827 S6,279.27 6/16/1997 S76.06 S80.98 12128/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247022066280224 S2,000.00 1213/1997 SO.18 S66.55 12128/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247022066280943 S6,388.20 1211211997 S209.54 SO.OO 12128/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247412060172782 S2,888.58 8/15/1983 $5.69 S92.19 12/28/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247412060348228 SI,ooo.OO 1212011983 S17.21 S8.67 12128/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247412062082748 SI,ooo.OO 1/21/1980 S23.37 S26.96 1212812006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247412062106639 SI,ooo.OO 1217/1981 S9.32 S18.97 12128/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247412062106760 $2,000.00 12121/1981 S17.17 S18.84 1212812006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD CERTIFICATE OF DEPOSIT 247412062116367 S2,000.00 71711982 S8.47 S5338 I 2/28/2006 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD .a. &Aor.. '-''-'.6..,. '-'.L :>..,..2""- --;.5.....- __c: - ..... "W'AcmJvIA Reference ID: 1894278 CERTIFICATE OF DEPOSIT 247412062116839 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 51,000.00 12129/1982 513.51 515.57 1212812006 CERTIFICATE OF DEPOSIT 247412062122456 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 51,000.00 10/20/1982 53.83 531.24 1212812006 CERTIFICATE OF DEPOSIT 247022066203093 LEGAL TITLE: FRANCES T BRUNGARD POA RUSSELL G BRUNGARD 511 ,669. 37 10/5/1997 563.47 5378.79 1212812006 · Due to system limitations, we can only provide a twelve month average balance on depository accounts. No Safe Deposit Box found for customer. · Date of death balance does not include accrued interest · If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were made during that time period. ~~ Audrey Troutt Servicenter Associate Phone: (540)563-7323 pwb; at <..::7L.ENBROOK LIFE .,1. U*""her q/'t!.>e AI/state Ciroup Glenbrook Life and Annuity Company P.O. Box 94042 Palatine. IL 60094-4042 Telephone: 1-800-755-5275 FAX: 1-847-402-5313 SPECIAL SERVICES AUTHORIZATION Contract # Owner(s) \ame Owner(s) Signatur oJ Soc. Sec. \0. 111 - ()q - "3''-/ 'S' ~ Date S-!3!02. , tt..vA--' Phone \0. 7/7- 77'-1- ~~1-7 ~ Transfer of Ownership This proposed change in ownership may result in a taxable event for you. Please consult your tax advisor to determine the potential tax consequences. This change of ownership does not affect the present beneficiary or annuitant. o Replacing existing owner 0 Adding joint owner \ame .-\.ddress OM OF .)treet City Stale Zip Soc. Sec. \0. Phone No. Birthdate / I Relationship 10 cxisun~ owner \ew Owner Si~na(ure ~ Change Name, Addre.. and/or Beneficiary Change for: J Owner .) Annuitant 'XBeneficiary* P~4A.J{!'e5> ~ ktuq.4~i) OM .;):F / J-3 /5 t:.i Sf-'. A/~tJ"Nl.fu/'/~..L p 14 I 7070 Street Citv State Zip /77 - 09 - Bt.JB3 Phone No. l/7 - 771./- .U'"Z.2Birthdate -1L I ~ I IC}- /<; \ame Address Soc. Sec. \0. Ad-U~S'. f:::. 10\::' t3bJ5~ Qd. l.../.:.L-\.j+()T1~\) \ \ \Q. ~O~~ * I hereby cancel all prior Beneficiary designations and make the following designations: Relationship to Owner fJ~Pf+EW Q Name . ~GL.L- ~~.UJ6Aefl Percentage lCO % % % % % ------.., Primary Primary Primary Contingent Contingent ~ Automatic Additions [nless otherwise directed. equal shares will be paid to the primary beneficiaries surviving all owners. If no primary beneficiaries survive the owners, payment will be made to the contingent beneficiaries. ..-................ -........... ......_.... ................_ .n ............................ ............... ............... ......... ....... .. ....... ........... ............ ......,........... ......................... ........._...._............ ................................... ........... ............... ......................_.....__ ................... ..........................~ !lr!)grams I authorize Glenbrook Life and Annuity Company (Glen brook) to begin automatic debits from the account designated below. The funds withdrawn from this arrOUll! shall be aiMed to my af'.'1ui~' 1$ 1Il A~l!oma!!c Addition (Purchase Payment). (Minimum addition $100.) Th" ophit amount should be allocated as follows: ~' Ulv (aL&d QijJ s f-Z;:1i.. - t amount is $ y (check one) .J Checking Account ,circle one) 5th or 25th day of each al Institution s The debits should begin in o Savings Account J Month < lIonlb I o Quarter ). Acct. No. A VOIDED BLANK CHECK FOR TIlE ABOVE ACCOUNT MUST BE AITACHED. ~ Additional Purchase Payment Please add $ Please make check payable to Glenbrook Life. Amount Guarantee Period Amount $_____ ~ar S to my existing Glenbrook Life Annuity ($100 minimum). Guarantee Period Years Amount S Guarantee Period Years Owner ~ame (Please Print): Tax Qualified ) Yes ) \0 If yes please indicate: ) IRA Rollover ) IR\ T,"n~fer ) IR\ Direct Rollover ) IRVYear of Contribution Age: ) Other GL\R181 3/00 ---- ...,... ---- ~... . 'i\. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.r lFHA 2.rlFmHA 3. rXlCONV. UNINS. 4.DvA 5. lCONV. INS. SETTLEMENT STATEMENT 6. ~~~~~_~~~~~T~_~T I 7. LOAN NUMBER: 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POCr were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3/98 (COONS-123-15TH-ST..PFOICOONS-123-1STH-ST./25) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Michael L. Coons The Estate of Centric Bank P.O. Box 31 Frances T. Brungard 3601 Vartan Way Lemoyne, PA 17043 Harrisburg, PA 17110 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2083639 I. SETTLEMENT DATE: 123 15th Street Kerwin & Kerwin New Cumberland, PA 17070 May 30. 2007 PLACE OF SETTLEMENT Tax Parcel No. 26-23-0541-125 414 Bridge Street New Cumberland, PA 17070 '. RY JF BORR~!ACTI'N K.Sl Y OF SEI_lE~'S BACTI IN 1M. lie. ...... ~D^.."'_ 1 01. Contract Sales Price 1 08,000.00 401. Contract Sales Price 108,000.00 102. Personal Prooertv 402. Personal Prooertv 103. Settlement Charaes to Borrower (Line 1400) 2,298.15 403. 104. 404. 105. 405. 106. Sewer Bill to 406. Sewer Bill to 107. County Taxes 05/31/07 to 01/01/08 275.38 407. County Taxes 05/31/07 to 01/01/08 275.38 108. School Taxes 05/31/07 to 07/01/07 77.61 408. School Taxes 05/31/07 to 07/01/07 77.61 109. Trash Bill 05/31/07 to 07/01/07 13.15 409. Trash Bill 05/31/07 to 07/01/07 13.15 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 110,664.29 420. GROSS AMOUNT DUE TO SELLER 108,366.14 200. AMOUNT'll PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deoosit or earnest money I 10,800.00 501. Excess Deoosit (See Instructions) 202. Princioal Amount of New Loan(s) I 108,000.00 502. Settlement Charaes to Seller (Line 1400\ 4 891.56 203. Existina loan(s) taken subiect to i 503. Existina loan(s) taken subiect to 204. I 504. Payoff of first Mortgage 205. I 505. Payoff of second Mortaaae ! 206. I 506. Deoosit retained bY seller 10,800.00 207. 507. 208. 508. 209. 509. An/ustmen s For Items UnDaid Bv Seller Adiustments For Items unDatll ~v seller 210. Sewer Bill 04/01/07 to 05/31/07 i 17.27 510. Sewer Bill 04/01/07 to 05/31/07 I 17.27 211. County Taxes to I 511. County Taxes to 212. School Taxes to 512. School Taxes to 213. I 513. 514. , 515. j 516. _~:tL~~:~i.~.rtL ~_. 517. I 518. .. 519. P~.@. L&3. ls-MSh... 118,817.27 520. TOTAL REDUCTION AMOUNT DUE SELLER I 15,708.83 - 8M. ~AAN A,T 110,664.29 601. Gross Amount Due To Seller (Line 420) 108,366.14 - - ~ a_ ___~_~____ -.- - -~-~~---- .- ( 118,817.27 602. Less Reductions Due Seller (Line 520) ,( 15,708.83 " 8152.98 603. CASH ( X TO) ( FROM J SELLER 92,657.31 ....s: 48q I. 5(, (1.'l-? L{q6&,&3 JC"k.. il./ 'Lf.5 LfJ...~ C} , " L ~~ 5 fe..trr.h. (1Y\ -f(1..'j'(' S .... tT<i\. ~ ...... !eted copy of pages 1&2 of this statement & ~~t~ Seller I t)/(]Z/tcl - The Estate of Frances T. Brungard By: Russell G. Brungard, Executor HUO-' (3.86) RESPA. HB430S.2 ~ _. . ..~..~. \orvu.._ 701. TOTAL COIIMISSION ... on PrIce $ 10R 00000 ail 3.0000 % 3.240.00 PAID FROM PAID FROM Division of Commission (fine 700! as Follows: BORROWER'S SELLER'S 701. $ 3,240.00 to Claude Wolfe & Associates FUNDS AT FUNDS AT 702.$ to SETTlEMENT SETTlEMENT 703. Commission Paid at Settlement 3,240.00 704. to JIM III.N I LOAN 801. Loan Orioination Fee % to 802. Loan Discount % to 803. Appraisal Fee to 804. Credit Report to 805. Tax Service Fee to 806. Mortoaoe Ins. ADD. Fee to 807. Assumption Fee to 808. Flood Certificate 809. 810. 811. ...... ........ , ..v . ......... 901. Interest From 05/30/07 to 06/01/07 @ $ /day ( 2 days %) 902. Mortoaoe Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 years to 904. 905. 4_ 111.....11.. 1001. Hazard Insurance months $ per month 1002. Mortgage Insurance months $ per month 1003. Sewer Bill months $ Der month 1004. County Taxes months $ per month 1005. School Taxes months @ $ per month 1006. months @ $ per month 1007. months @ $ per month 1008. months l'cil $ oer month 1101_ TI'II II 1101. Settlement or Closing Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Attorney's Fees to 1105. Document Preparation to Stone, LaFaver & Shekletski (Deed Prep) 125.00 1106. Notarv Fees to Kerwin & Kerwin 10.00 1107. Attorney's Fees to (includes above item numbers: ) 1108. Title Insurance to The Guarantee Title & Trust Co. 1 048.75 (includes above item numbersEndorsements 100, 300 and 8.1 ) 1109. Lender's Coverage $ 1110. Owner's Coverage $ 1111. Closing Protection Letter to The Guarantee Title & Trust Co. 35.00 1112. 1113. Trash Disposal to Derr's Trash Haulino 375.00 1HO. 1201. Recording Fees: Deed $ 39.50; Mortgage $ 57.50; Releases $ 97.00 1202. City/County Tax/Stamos: Deed 1,080.00' Mortaaoe 1,080.00 1203. State Tax/Stamos: Deed 1,080.00; Mortaaae 1,080.00 1204. Assionment of Rents to Recorder of Deeds 23.00 1205. Recorder of Deeds 14_ 1301. Survey to 1302. Pest Insoection to 1303. Overnioht Mail to DHL 14.40 1304. Sewer Bill to New Cumberland Borouoh 22.96 1305. Trash Bill to New Cumberland Borough 38.60 1_. TOTAL SETlLEIIENT CHARGES (Em.r on Unee 103. SectIon J and 502. SectIon 10 2,298.15 4,891.56 By signing page 1 of this statement, the signatories acknowledge receipt of a completed copy of page 2 of this two page statement. Certified to be a true copy. BUYER IS RESPONSIBLE FOR PAYMENT OF 2007 SCHOOL TAXES ( COONS-123.15TH.ST. j COONS-123.15TH-ST. J 25) ,'r.,,,,,, .":,1.",,,. ."0 \.t!'",jlllu form HUD.l (3186) reI Hdllltbook 4:1f,~ l A Settlement Statement US. Department of Housing and Urban Development B lyp" of L,,"n ._ __~ ____ _________ __~B ~v~l'io. 2502-0.2.!)5 ~XE"e~913QI~qQl5L____ __ ~ [,FHA 2 i:FrnHA J i JCanv. unins'J 6 File Number --l-'-L;"nNumber tMortgage Insurance Case Number , I J 'I A nl\c.;~ ~~~,~"~~~'o-q;,.'",-" .'.liilO",en 0 acJ:.-~;.~~!n!~~~.. po" 10 .~nfiigonl ar. snown -- k---:- _ _,__ ___.,__ __' _ C Note I".JI"':; 'T1J. rlo.lld -(P. .".'~ t Wf1I. r.". p.aK101;ISide the. closing; they are shown .ne,,, tOl infOfmation purpnS8s and iIIe nollncluded In Ih.Et lolalli . .. .. T.'tleExpress Settlem. en.t System \~i:~~~,~~\:~S,,: ~:~': ~o~;'.:',;::'4;~~~~:" ::~~;:.~-.:.~ "T~"~O;~ s~"~~; ~,:;;o'~&f;h.e,:;~~,:,",'~;:; I~.o'."'_u,:=--_~ __ ~~tE!.d..0.111~2007_!lt_083~MH D. NAME OF BORROWER JAMES A. SMITH, III ADDRESS _ g1 J_5.!!! StreetL New Cumberland, Pa 17070 E NAME OF SELLER THE ESTATE OF FRANCES BRUNGARD ADDRESS . 1illSTH STREETLNEW CUMBERLAND, PA 1707L~_________ F NAME OF LENDER ADDRESS G PROPERTY ADDRESS . -~'----,--,--_._-,----- - --- -,._--- -----'-_._---, --'--'-~-'-'--,------ ----.---. ~,--- Lot #18, New Cumberland, PA 17070 N.llw Cum~rland Borough __________ ___._ __ __ __ ____ Cedar Cliff Abstract Agency, Inc., Telephone: 717-774-7435 Fax: 717-774-3869 _~1~~t1iIge Street, New Cumberland, PA 17070 _______________ 01/12/2007 H SETTLEMENT AGENT PLACE OF SETTL~",ENT I SETTLEMENT DATE . J. SUMMARYQF~ 100. GROSS AMOU~T DUE..E~ 101 Contraetsales pnce_ 102 _Personal Property.__ 10 3 Settlernent charrle_s to.l~orr()!,,_ 104 105 bR~OWER'S TRANSACTION: ,.-----:-KSUMMARy Of=SELLER'SfAA-NSA~!lOt( OM BORROWER 400. GROSS AMOUNT DUE TO SELLER -----'-------- >----- 17.500.00 401. Contract sales price ----==+=--=~J - - 402. Persanal Property --, - ---,~-- +- ----- e~(!ifl~..1400) 663.50 403. -~- 404. -~---- - 405. ----.- -,- ~.rtems paid bv seller in advance ____Adjustments for items~~~~ln...advi!~_.. - 408. Citvltawn taxes ------'-'-'--- ----- --- 407. Cauntv taxes -----~- -- 07 to. 06/30107 34.18 408. School taxes 01/12/0710.06130/07 409. ------ -.-- --'--- 410. .--'- ---- 411 -'------ --_._~--- -."-'-----.-- 412. ..____~___ ____ O~ BORRO~ER 18197.68 420. GROSS AMOUNT DUE TO SELLER ___ _____1 ~ BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER --------- 5Ol. Excess Deposit (see instructians) --- 502. Settlement charges to. seller (line 14O<1L-___ --'-'--- to. 503. Existino loanls) taken subiectta - --_._-.-- 504. Payoff af First Mnrtn""e Laan 505 .---.- -----,--- -- - 508. -------.- ---~- - -~----- 507. -----,- ----_.,----- ---~--,---- 508. ----- ---,--- 509. -or items unDaid by seller Adjustments for items unDaidbY seller--- -'-- 510 City/tawn taxes ------ ----. --,-- '-- /07 to. 01/12/07 4.82 511. Cauntv taxes 01/01/07ta01/12/07 -- ----.-.------ - ----------- 512 Schoollaxes -------,----- --------- - ----- 513 '-- ----- --,-,- 514. -f--- 515. -- >-__h___ -- 516. - f---_ 517. --------".'- 518. --,- 1------ ---'--- 519. ~.Q!'iER 4.82 520. TOTAL REDUCTION AMOUNT DUE SELLERr== ROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER ----'---- w.fJr~ 120) ~--.1!..197.68 601 Gross amaunt due to. seller (line 420) -- ----- -.- rower Q~ne ?lOL_ _I 4.82 602. Less reductian amount dU.E!.seller i1i~,g01_____ ---.- Ad.J!!.St~e.':'~s fo C'tYitow_n tax~~ Caunty taxes Schaqltax~ 106 107 108 lu9 110 111 112 _ 120. GROSSA""OI,lN,T QU~ FR 200. AMOUNTS PAID IiY.QI!_Q. 201 DepOSit Of earfle~Lmoll.eL_ 202 Pnnc'pal a_maunt'" newJ()~'!L 203 E"Slln.9..lo'!nlslt~k..eDs.lJ~fL 204 205 206 207 208 2u9 01/12/ ___Ad~~'!..ts f Clt~/ta!"n taxes._._ Ccunty taxes_ 0.1101 Schaol taxes 210 211 212 213 214 215 216 217 218 219 220. TOTAL PAIQ B_Y/FClR ~OR 300. C~SHAT SETTI..~ME.NT F :iiJ 1 Gross arnount du.efram borr<l... 102 Less "moun.tspdld bYiforbar 303. CASH FROM B()RR()W~R_ 18,192.861 603. CASH TO SELLER 'i'-,f,:IJ , "'.'";.,,, "..,1"1,,1, Jr1anl tall flf{Vrroil..-:,n J1nd III heH'9 tUrI1/sl"ed to the inletnal Re"'8nub S8f\dC., If you are rttqu,rftd t'J f'ld 4 ftllt<rn :1Qt1ed dnd the IRS ,lelermmes thai " netS not been reported The COlltrad Salt1s Price ,jesolbe<j ()(! - n ~ ~ttJS ,,\........:-c CO~ ~ Lvi * I g SlGNATURE(SI _ ~ , I '. ~', ,.. ] w'th;OlJr ([,rrOCf l<lllpa.,er idol1llflCatl(')r'\ number ~'you do nOI pro'oJe }"'Jllf C()"fK'I Itlllpayer "jent/flr-allon perJury. ~ ,-mtlfo, '''al the n'Jmber ...hown on thiS sl.temonl IS my '-:onlK_lla~paytlr J6nl,fl,:..tJQn 1"l\Jfl>bttr ,( If-II'-.l S&.'~J.- 3~1'K j.5 J. 7 .~ Y . '0''1 i L., ~~ f el,T'h +~~.} fn =-=-~--j )=-@~Qo-1 I . I ------1 -----1 ! I I -.--- - i ~- - I _34.1!j -j I 1 i 7,534.18 i - --I 557.00 I -- ..... I : I I ---I --- -~ ! I _~-==.8~j --'-----j ~..----I ....."."... "",,,;,11'; .H'! oll:."lt:ft- US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETT~M~NTSI~IEMENT _ L. SEnLEMENTCHA~G~_S ___ ___ 700 TOTAL SALES/B~O_K_ER~SfC?~MISSION based on price $17,500.00 = D,v,s,on of commission U~e }OOlas follow~:__ 701 S _ to.. 702 S t() ___ 703 CommISsion paid at ~ttle.n!ent BOO. ITEMS. PAYABLEt~g>!!t!E_CTION WITH LOAN 801 Loan Onglnatl<J.ll fee _ _-Y'__ 802 Ladn Discount 'l''-___ 803 Appraisal Fee ___.______ 804 Credit Report __ _ _____ __ 80S_ Lender's Inspec!'on Fee __ 806 Mort9.<l!Je ~pplicatl!ln_F~e____ 807 Assumption Fee_ 808 ; 809 ! 810 I . 1_811 - --._---- - ----- i900, ITEMS REgll~~D BY~~t{!>ER TO BE PAID IN ADVANCE I 901 Interest ErO'll____ to @.$ _902 Mortg<lge.lnsl!'a'lfe-,:r~mium for 10 903 _ _H~~rd In~Jlra_n.f~ "remiumJ<Jr 10 _904 905 ! .109.0. RESERVESD~~OSITED WITH LENDER FOR ~.1 00 1 H..~ard I~sura.ncen_ _ __ _ _ mo_ @. $ 1_.1 0021~~9.'!9.el.n_suJ:a~ce mo I!il $ i.1003 9tYf'~~ax____ mo_ $ f _lQQ4. ~ C._. Ol!~..lt p~. rty Tax mo_ $ 1__lO_05 School t~~~______ mo $ i - 1009 AJl9Iegale Ana1i'!is ~~~__ , 1100. T!!L_E~HAR~~ ____ 11101 Seltlemell! (jr 9.o.sin9.-'e~ __ 110L AQstr~ct or~~e_~~ 1110}_Dt~e.ar!Jln~0~___ I ! 104 TJlle Ins_uf!n~lJl~~L-.-. llO5. DocurnenJ P~~n ___ 1106 _ Notary Fees _ ____ to Cash ! 107 _Attornej"s fees __ _ ___ to Slone Lafaver & Shekletski 1_ _ _ _{incll,ldes al1!l.ve items No: 11_10~ Title 1!1~~___ ~ _U.nflu~es above items No: [1109 Lender's Cove~$ . 1110 Owner'sCov!'f'!9.eJ._____ 17,500.00 11!_11Ta.._CertF~_ to Slone Lafaver& Sheklelski I 1112 _ ____ ____ ____ i 1113 ___ ___ _____________ 1.1?O._..O_.....~..Q...V~B_N~~..NT~~~~DING AND TRANSFER CHARGES - 1 ~01. Recor.9.!'1.9.fees De~ 3B.~ __ ; Mortgage $ ; Release $ 120~ S;,ltI~ounl}'~~s@~__ Deed $175.00 ; Mortgage $ 1203. St~Je Ta~~.@mps__ ______ Deed $175.00 ; Mort a $ - 1_20<1 Re_c):ee.:!'Q~__ _ nHn -1.0 Cumberland County Recorder of Deeds 1205 1300. A-DQ!!IQ.N~'=-~~TTLI:"'~~ll!HARGES 1301 Survey__ ______ _____ 13(j2 Pestl~lI~n ______ _. __.______ File Number; 2B293SMITHJAMES PAGE L TilleEx ess Settlement S stem Printed 01112/2007 at 0836 DMH PAID FROM-r-PAID FROM BORROWER'S J SELLER'S FUNDS AT FUNDS AT SETTLEMEN~ SETTLEMENT flAm HuO 1 (:I!i6) fe' H,II'(1tJ('<J~ 4 IU" ',{ Iday -C~=~i~~-= ====t___ Imo Imo Imo 12.24 Imo 6.15/mo -~-f _ ---- I ---- --- I - n_ _ --- _I ------- - -- - - I --- -- - -- -- -- I --- - ----- I 0.00 0.00 --- - -- - I I I I I --j I I ----- --- I 10.00 I __450J)0 -=~_15i.901 ----~l - - -~- - -~ -- -- -- --~--- - - - ~-~ ----- ~JlO 14Q~, TQ!A.1 SETTLEMENT CHARGES (enter on lines 103, Section J and 502, Section K) Hun CERTIFICATION OF BUYER AND SELLER -_:~1__m- I ---- ----~{t:~~-1 --- ~- ---~~l =r-~---=~-- ! ----- -- ! I ____..663.50 __ _ 5_57.00 ' I ,",,1111.' riJrl'lull~ f(tIIl'" t Ih~ HUO., Sett1emonl Slalemenl a ,,' b, m" '" Ih" \"'"' oun I ""h~ ,"'f; tha'?:-- JA....,; A UM'.- 11'-6 10 the beal of my knowlfKIge and belle', it IS a true and accurate statemenl of aU receipts and disbursements made on m)l iKcounl a copy uf Itle HUO-1 Settlement Statemenf --- ..eM-I if' ,JA....~.:N', II I.') A C!-tIMf rl) kNGWiNGl Y MAKt:: FAlSE STATEMENTS TO THE .;NI! f IJ S r A I[ S UN THIS OR ANY SIMllAH f.ORM PFNAl TIES UPON CONVICTION ':,,'" ~"'CI tIDE" F'Nf A~jlJ IMPRI~ONMENT FOR DE TAILS SEE TITlE '8 iJ ~ ((Jor SfU'tJN 10t'll AND Sh~TrON ~OIO IS a Ity" anll an:uralu at:uH..Int of lhl!i sbur~ In dCU1f.1df'l..:tl WIth ",,~ :.l.llt!,".-"I DAll (f?~7 '0 ~ . REV-1500 Inheritance Tax Return Resident Decedent Decedent's Name: Frances T. Brungard Social Security No.: 177-09-8483 File No.: 21-06-1147 Schedule "Gu attachment statement Please issue a separate bill to Keith Kolanda at 1605 Liz Burns Place, Mechanicsburg, PA 17055 for the annuity set forth on the attached supplemental Schedule "Gu. .REV-1"~ EX' '6. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Frances T. Brungard ITEM NUMBER 1. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-06-1147 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 INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER, ATIACH A copy OF THE DEED FOR REAL ESTATE, Sun America Life Insurance Co-AIG Supplemental COntract No. 022579 Annuitized figure $72,406.14 minus payments made $32,143.77 for dod valu~ of $40,262.37 beneficiary-Keith Kolanda (Elwood Prowant predeceased decedent DATE OF DEATH VALUE OF ASSET 40,262.37 % OF DECO'S INTEREST EXCLUSION (iF APPLICABLE) TAXABLE VALUE 40,262.37 TOTAL (Also enter on line 7 Recapitulation) $ 40 , 262 . 37 (If more space is needed, insert additional sheets of the same size) 100. . . SunAmerica Life Insurance Company Fixed Annuity Administration P.O. Box 9006 Amarillo, TX 79105-9006 m SunAmerica Financial February 6, 2007 Stone LaFaver & Shekletski, Attorneys at Law Attn: David H Stone 414 Bridge St PO Box E New Cumberland, P A 17070 Re: Deceased: Frances Brungard Supplemental Contract #: 022579 Reference #: A634051456D Dear Mr. Stone: This letter is in reference to your correspondence of January 31, 2007. Please note that this is an annuitized supplemental contract that receives scheduled payments for a specified period oftime. This type of contract does not have a value, so we are unable to provide a value as of the date of death. Please be advised that Frances Brungard received monthly payments of$683.91 from January 23,2003, through November 23,2006, which equals a total of 47 payments totaling to $32,143.77. Should you need further assistance, please call our toll-free number, 1-888-333-2349 to speak with a representative in our Customer Care Unit. They are available Monday - Friday, 8:00am to 6:00pm Central Time. We appreciate this opportunity to serve you. Sincerely, 0Lld1 Cu--cCt ~mpJc~ Sandra Simpkms, Claims Examiner SunAmerica Life Insurance Company C!l..lLh-L 3 -.1- 07 cvd. S pc> f-k tc ~~ A-f)f)L116~ed t-5"-re.- -I7~(4o{,. / If- PO::Jm+S IYIqde 31ft'!3. /1 VC~ 6~'.. Cl/JI) /J { @ ctPCi!.' , Lf4).(d_ 37 Sun America Life Insurance Company . Anchor :\ationaI life Insurance Company First SunAmerica Life Insurance Company. Administrator for The Central "'ational Life Insurance Company. of Omaha Administrator for John Alden life Insurance Company \Iemh~r o/.-lmeric<-III InI~n/(J{/(J,.,(/1 (;roup. Inc. _ -~~UITY OPTION SELECTION FORM E. BE~EFICIARY If you are annuitizing your policy(ies) at this time it is advisable to reconsider YOur-b;~eficiary DESIGNA TION designations. By designating the beneficiary(ies) below and signing this form, you hereby revoke all earlier designations. (No designation is necessary for options; 3, 6, 7, 8, 9, and 10 in Section B.) If this section is left blank, the beneficiary of any remaining guaranteed payments will be the current beneficijry under the existing contract. (~ rr20W J1,f'-( f~~i, ~ ttf 8:-\.-UlCD e PRIMARY BENEFICIARY LAST NAME (S) FIRST NAME k ~n&.tLJ F. SOCIAL SECURITY CERTIFICA TION G. TAX WITHHOLDING ELECTION H. SIGNATURES '\\" \i! , \; MIDDLE INITIAL r{ ~fll~ ~'^l RELATIONSHIP TO ANNUITANT \;( 0 k~ r( \) A- CONTINGENT BENEFICIARY LAST NAME (S) \,( ~l )" \~ FIRST NAME MIDDLE INITIAL ~ a.. \ E.- rlfu RELATIONSHIP TO ANNUITANT Under the federal income tax law, your are subject to certain penalties as well as withholding of tax on future distributions at a rate of 31 %. If you have not provided us with your correct Social Security or Taxpayer Identification number, you may be subject to a $50 penalty imposed by the Internal Revenue Service. In addition, interest and other payments that we make to you may be subject to backup with- holding. If backup withholding applies, a payor may be required to withhold 31 % of interest, dividends and other payments made to you. Backup withholding is not an additional tax. Rather. the tax liability of persons subject to backup withholding will be reduced by the amount of tax withheld. If withholding results in an overpayment of taxes, a refund may be obtained through your yearly tax return. Please complete the certification below: ~ My correct Taxpayer Identification number, employee identification number, or Social Security number is j 11 - c:) ~ - rt 1'>> ~ . I am neither a resident nor a citizen of the United States and I am not subject to withholding. Under penalty of perjury, I certify that the foregoing information is true, correct and complete. o Federal income tax law requires withholding of tax from the taxable portion of pension and annuity payments. SELECT ONLY ONE OF THE ELECTIONS BELOW. A. 0 I do not want federal income tax withheld from my periodic payments. B. f I want a specified amount of federal income tax withheld from each periodic payment. Dollar Amount: $ OR Percentage: ~ %. Your withholding election will remain in effect until you change it. You may change your election at any time. You may want to discuss your withholding election with a,qualified tax advisor or your local Internal Revenue Services office. You could be subject to tax penalties if your payments of estimated tax and the amount you ask to withhold, if any, do not cover your tax liability. I have read the foregoing and understand the options available to me and those which I have chosen. I hereby request that the option I have marked, the beneficiary designation I have made and the withholding election I have chosen be effected. "Ga~1.lf "4.1 -( 6 ,,'-~ D.d ev: /~, :;I-oo'l. SIGNATURE OF OWNER'S SPOUSE (REQUIRED IN COMMUNITY PROPERTY STATES) DATE SIGNATURE OF JOINT ANNUITANT DATE ,-/'