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HomeMy WebLinkAbout09-06-07 REV-1500 EX + (6-00) }.- " COMMONWEALTH OF PENNSYLVANIA DEPP.'TMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W (,) W C W I- ~ :$U) U lf~ wou ::t~g UD-lXI D- c( DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) He ford Samuel P. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY - - - --'-- FILE NUMBER '6 1 2l-___--96:ti_ COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 1 95- 0 7 - 4 4 3 8 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return [date of death pliorlo 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 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 Paul W. Kil ore Es uire 522 South Eighth Street FIRM NAME (If Applicable) SPITLER KILGORE & ENCK PC P.O. Box 1188 TELEPHONE NUMBER 717 273-7621 Lebanon PA 17042 z o i= <C ...J ::) l- n: <C (,) w 0::: z o i= <C I- ::) a.. :E o (,) >< <C I- 10/17/2006 03/19/1916 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) IK] 1. Original Return o 4. Limited Estate IK] 6. Decedent Died Testate [Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death aller 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrusl) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 1- 0.00 I (') r::; OFFICIAL USE ONLY -.; I- Z W o Z o D- U) W ~ ~ o o 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) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 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. () ..[- ~ n_ i~~j C) 1--'" --......-1 " I en -I. - '-' .~ /..-..... 4,702.29'+ _ (, f:..- "i", 90, 705.14f, =-~ :!k';"" ~ rv N \.::> t :-: -") 1\ 0.00 X _(15) 0.00 91,151.61 X .045 (16) 4,101.82 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 4,101.82 14. Net Value Subjectto Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. [8] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONSQN REVERSE SIDE AND RECHECK MATH < < (8) 95,407.43 4,120.00 135.82 (11) (12) (13) 4,255.82 91,151.61 (14) 91,151.61 Decedent's Complete Address: STREET ADDRESS 1700 Market Street CITY I STATE I ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 4,101.82 3.899.90 205.25 Total Credits (A + B + C) (2) 4,105.15 3. Interest/Penalty if applic"ble D. Interest E. Penalty Total Interest/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 3.33 0.00 0.00 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 IKI b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IKI c. retain a reversionary interest; or ...................................................................................................... 0 IKI d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IKI 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?... ................................ ....... ....... ............ ............ ..... ....... ..... .... 0 IKI 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 IKI 4. Did deced':lt own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 IKI 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 perjury, I declare that I have examined this return, inc1uding 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 PERSON RESPONSIBLE FOQI~I& RETURN DATE ~ ~ ~ ~ '6-JLJ-07 ADDRESS 4 Cedarview Drive Le non SIGNATURE OF PARER 0 ETHAN RE PA 17042 DATE ~- /l/-O'7 ADDRESS PA 17042 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. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements fOi 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 11% [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Hepford Samuel P. FILE NUMBER 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Personal Property (See Appraisal Attached) 3,751.00 2. HCR ManorCare - Refund 720.00 3. Comcast - Refund 30.31 4. IRS 1040 Refund (2006-Tax Year) 156.00 5. Motorist Mutual Insurance Camp. 44.98 TOTAL (Also enter on line 5, Recapitulation) $ . (If more space is needed, insert additional sheets of the same size) 4 702.29 REV-1509 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Hepford Samuel P. FILE NUMBER 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. Dianne G. Dilger 4 Cedarview Drive Lebanon, PA 17042 Daughter B c JOINTL Y.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY '10 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 INTEREST 1. A, 6/24/96 317 Fourth Street, Summerdale, PA 17093 148,222.80 50. 74,111.40 Map No, 09-12-2994-024 2. A. 11/18/98 Sovereign Bank Account No, 0921714637* 876.07 50. 438.04 3. A. 11/18/98 Sovereign Bank Account No. 0921714637 Accrued* 0.03 50. 0.02 Interest 4. A. 9/10/05 PNC CD No. 31000271074 16,520.78 50. 8,260.39 5. A. 9/10/05 PNC CD No. 31000271074 Accrued Interest 54.36 50. 27.18 6. A. 2/1/70 PNC Checking Account No. 5140113368* 15,736.00 50. 7,868.00 7. A. 2/1/70 PNC Checking Account No. 5140113368 Accrued Interest* 0.21 50. 0.11 Date of Death for Grace I. Hepford 06/21/2005 Survived by Samuel P. Hepford (Spouse) and Dianne G. Dilger (Daughter) TOTAL (Also enter on line 6, Recapitulation) $ 90,705.14 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF Heoford Samuel P. Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Com,missions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attomey Fees Paul W. Kilgore, Esquire 3,750.00 3. Family Exemption: (If decedent's address is not the same as c1aimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. AccOlJ ,tanfs Fees 6. Tax Return Prepare~s Fees 7. Claude C. Wolfe & Associates - Appraisal Fee 295.00 8. Fax, Copies, Postage & Notary and estimated cost to close estate 75.00 TOTAL (Also enter on line 9, Recapitulation) $ 4,120,00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) . SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Heoford. Samuel P. FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH PPL Electric Utilities 48.91 2. Pennsylvania American Water 12.62 3. PPL Electric Utilities 56.26 4. PennsYlvania American Water 18.03 TOTAL (Also enter on line 10, Recapitulation) $ 135.82 (If more space is needed, insert additional sheets of the same size) 1emor amue 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. Dianne G. Dilger Lineal 1.00 4 Cedarview Drive Lebanon, PA 17042 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. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ,,,,->on,,. ",* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF H f d S IP SCHEDULE J BENEFICIARIES FILE NUMBER (If more space is needed, insert additional sheets of the same size) CLAUDE (. WOLFE' & ASSOCIATES AUCTIONEERS & APPR.A.!SERS F.JJf!LY OWNED Sr.vCE PIO 2009 LINCOLN STREET · CAMP HILL, PA 17011 717-737-0734 November 9.1006 Appraisal for the Estate of Samuel P. Hepford 317 Fourth Street, Summerdale, P A 17093 LIVING ROOM Recliner - worn Dining room table - scratched Loom Table/stand "March" & "May" framed pictures 2.00 10.00 35.00 2.00 10.00 Loveseat Pair of floor lamps Basket/knitting supplies Alarm clock Bookends 5.00 2.00 5.00 2.00 2.00 Credenza Wall mirror Shredder Panasonic TV Zenith VCR 45.00 10.00 3.00 45.00 15.00 Entertainment center Misc. stuffed animals Sofa Ottoman - tom Green chair - worn 20.00 10.00 8.00 1.00 1.00 Brass floor lamp Clock Misc. coments ofliving room 7.00 2.00 25.00 J ~U\UDE Co WOLFE & ASSOCIATES ALC:TlOi'iEERS & APPRAISERS FJ\([LY OWNED SINCE 1910 2009 UNCCL;'~ STREET · Ci>..M? Hill, PA 17011 717 -737 -0734 Hepford appraisal Page 2 of 6 KITCHEN Table & 6 chairs Utensils Gold Star microwave Mr. Coffee Misc. cookware 65.00 3.00 15.00 3.00 10.00 Flatware Misc. everyday dishes Kitchen Aid refrigerator Misc. contents of kitchen 8.00 10.00 60.00 20.00 ENCLOSED PORCH Misc. patio furniture Misc. contents of porch 10.00 20.00 FRONT BEDROOM Serpentine desk with chair Remote telephone 10-Drawer metal cabinet Chest of drawers, double bed & dresser - worn Misc. jewelry, trinkets & East Pennsboro badge 60.00 6.00 10.00 80.00 15.00 Folding stand Woven trunk Coffee table Alarm clock Misc. costume jewelry 1.00 20.00 12.00 1.00 7.00 Misc. contents of bedroom 15.00 J CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRA.ISERS FHflLY OWNED SINCE 19:0 2009 liNCOLN STREET. CAMP HilL, PA 17011 717-737-0734 Hepford appraisal Page 3 of 6 REAR BEDROOM Bookcase & books Trash can White dresser White chest of drawers Table lamp Zenith TV - old Brass floor lamp Key chain puzzle collection - approximately 60 pieces Ironing board Kirby upright vacuum cleaner Sony boom box radio Sewing machine Table lamps Misc. knick-knacks Bench Large loom Binoculars 33 1/3 RPM record albums Misc. contents of room BATH Linens Scales ATTIC - REAR ROOM 4 large & 15 small Chandler books Misc. Boy Scout patches, etc Trunk Metal cabinet Health aids 10.00 1.00 10.00 15.00 2.00 8.00 7.00 10.00 1.00 15.00 7.00 6.00 5.00 5.00 5.00 65.00 15.00 5.00 25.00 5.00 2.00 400.00 20.00 10.00 4.00 5.00 CLAUDE (9 WOLFE & ASSOCIATES \Li':'TIO\.iEERS & APPRAISERS FA,\IfL i OWNED SfVCE 1910 2009 LINCOLN STREET. CAMP HILL, PA 17011 717-737-0734 H::, 'ord appraisal - _ 4 of 6 ATTIC - REAR- ROOM - continued l'v!l~.:, contents of attic-rear room ATTIC - MAIN ROOM Lin~:1.s Trunks Cedar chest 4-D:.-awer painted chest 5-Section Oak Barrister bookcase Oak roll top desk - middle drawer missing .22 Caliber rifle Regulator style clock 2-Dr1wer file cabinet Old desk 4-Drawer file cabinet Misc. contents of attic-main room MAIN BASEMENT 2 Old cabinets Electric drill Be It sander Grinder Electric chain saw Dremel style kit Mis'':, hand tools 6" B~lt sander with stand B& 1) y{ini Workmate B& D S tandard Workmate 50.00 5.00 30.00 10.00 5.00 500.00 350.00 30.00 100.00 8.00 1.00 5.00 50.00 50.00 4.00 8.00 4.00 10.00 10.00 25.00. 55.00. 12.00 20.00. CLAUDE C. WOLFE & ASSOCIATES .; :_'CT[O~~EERS & APPR.-\ISERS FAMILY OWNED SINCE 19/0 2009 LINCOLN STREET. CAM? HILL, PA 17011 717-737-0734 Hepford appraisal Page 5 of 6 MAIN BASEMENT - continued Chest freezer Whirlpool washer Whirlpool dryer 2-Door cabinet Dust collector Shop vac Misc. contents of main basement SHOP Delta table saw RockwelllDelta wood lathe Craftsman 10" table saw Craftsman 12" band saw RockwelllDelta drill press Swing ann drill Bench grinder Table top drill press Shop vac - old Craftsman machinists tool box Craftsman bench grinder on stand Craftsman sander/grinder on stand Misc. Hand tools Misc. contents of shop GOAT PEN 2 Humane traps Wheel barrow Scythe Garden tools Hand plow 1.00 20.00 15.00 30.00 60.00 8.00 50.00 60.00 65.00 45.00 40.00 100.00 25.00 10.00 30.00 1.00 75.00 25.00 65.00 75.00 75.00 10.00 10.00 6.00 10.00 10.00 CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAfSERS FA,\IILY OWNED SINCE 19IO 2009 LINCOLN STREET. CAMP HILL, PA 17011 717-737-0734 Hepford appraisal Page 6 of 6 GOAT PEN - continued Large and small garden tillers Cart Antique cast iron crusher Misc. contents of goat pen 65.00 2.00 15.00 25.00 APPRAISAL TOTAL $ 3,751.00 This Fair Market Value appraisal is true and correct to the best of my ability as an auctioneer and appraiser with 35 years experience. Member: Certified Appraisers Guild of America CLAUDE C. WOLFE & ASSOCIATES \J .Y- ~<~\ ~(Z~v- W. K. Dusty Chapman, CAGA /'0)-26-2006 21: 34 Pi'1CBAi'1K 412 768 3458 P.01/02 o PNCBAN< November 27, 2006 Paul W. Kilgore 522 South Eighth Street P.O. Box 1188 Lebanon, P A 17042 RE: Estate of Samuel P. Hepford, (Deceased) SSN: 195-07-4438 DOD: 10/17/2006 Dear: Mr. Kilgore In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account # 31000271074 Established 09/10/2005 SAMUEL P HEPFORD DIANNE G DILGER DOD balance; $16,520.78 + $54.36 accrued interest Interest Paid: 1/112006 - 10/17/2006 - $520.78 Account # 31900245578 Established 08/23/2004 SAMUEL P HEPFORD IRRV BURIAL RESERVE F1JNERAL HOME SULLIVAN TI'EE DOD balance; $4,299.13 + $12.46 accrued interest Interest Paid: 1/112006 - 10/17/2006 - $139.68 Cbecking Account Account # 5140113368 Established 02/01/1970 SAMUEL P HEPFORD GRACE I HEPFORD DIANNE G DILGER DOD balance: $15,736.00 + $0.21 accrued interest Interest Paid: 1/112006 -10/1712006 - $67.90 The decedent maintained investment Account (IN\' # 43276996). For further information, you may call the Brokerage Department at 1~800-762-6111. NOV-25-2006 21:34 PNCBRNK Safe deposit box Account # 40108157 It is located at: 412 768 3458 P.02/02 Established 12/09/1987 SAMUEL P HEPFORD GRACE IRENE HEPFORD f.NOLA 235 NORTH ENOLA ROAD ENOLA, P A 17025 (717) 732-5388 Please note that this office only provides date of death balances fot deposit accounts (!RAs, 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 call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, c;li~ 1-800-762-1775 P7.PFSC-04-F 500 First Avenue Pittsburgh PA 15219 Member FDIC TOTRL P.02 tSovel~_~ S~cess ,is ron_lCe, Ui ca~ ,brJP ~ ge:f' _,,:" Court Ordered Processing I MA 1 MB3 02-10 P.O. Box 841005 Boston, MA 02284 November 21, 2006 Spitler, Kilgore & Enck, PC Attention: Samuel P. Hepford P.O. Box 1188 Lebanon, PA 17042 RE: Estate of Samuel P. Hepford Date of Death: 10/17/06 Dear Mr. Hepford: Per your request, enclosed please find the account informati~n 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. Very truly yours, A<-~ Ofi_e>-nf1i!tnOAi:"-<./ Laurie DiGiandomenico OAG Team Leader (617) 533-1789 Enclosures Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Samuel P. Hepford 195-07-4438 October 17,2006 Account#: 0921714637 Type: Checking Open date: 11/18/1998 In the name of: Samuel P. Hepford or Grace I. Hepford or Dianne G. Dilger Date of Death Balance: $876.07 Int.(YTD) from 1/1/2006 to 9/21/2006 $0.33 Accrued interest to date of death: $0.03 Other Info: Page 1 of 1 111 UJ/ ,IHIO tKl ~: \I,) d,l tgj \lUll IJUl ,~. Sovereign Bank'. I. MAl MB3 02-10 Court Ordered Processing P.O, Box 841005 Boston, MA 02284 November 3, 2006 Spitler, Kilgore & Enck, PC Attention: Paul W. Kilgore P.O. Box 1188 Lebanon, PA 17042 VIA FACSIMILE & mail 717.273.1693 Re: Estate of Samuel p, Hepford Date of Death: 10/17/06 Dear Mr. Kilgore: We have received your request for date of death balances on the accounts of the above named decedent. In order to complete your request, we need additional infonnation. The infonnatiot'l is required in order to comply with recent changes in privacy laws regarding bank accounts. This will ensure that account information is provided only to those authol'ized to receive it. Please send the documentation checked off below to my attention at the address listed above. _X_ Death Certificate (a copy is sufficient for information only) /" -L Short Certificate/Surrogate Certificate (a copy is sufficient for information only) ~R _( __ Authorization from Executor to release information (if you are representing the Executor) _ (( Other: Authorization fromjoint owner (Grace I. Hepford or Dianne G. Dilger) (in lieu of Short Certificate) If you would like to liquidate the accounts, please return certified copies afthe Death Certificate and Certiftcate of Appointment and a notarized letter of instruction :flUID the executor or coholder. Very truly yours) ~O'9-~td'~' Laurie DiGiandomenico OAG Team Leader Phone (617) 533-1110 Fax (617) 533.1931 ---. Special Warranty Deed Instrument #______ Tax Parcel to # 09-12-2994-024 THIS DEED .. }j~twEEN : ,".1' '. r: ."...., , -~._r_E "itt - '. (~"..,. ~ ~,. i - .... . l~." _.~ " ~;?~~i _ :"" " ; . ~ , - ~~~~i.~;_~~\. . _:;_ii~~;t~~l~~~:~w~,~:~~ "'.';";I:..:"'"*J '. '.''':)~':'<:-.' ~.- ""'-'- ,. .. 'w,_. '''~', ":~. ',c.":: , . ;::,; aEING THE SAME tract of ja0.d~hich theGr~l1tors, SAMUEL. r:'.../. '.' .' . .:'::~:~~~:J~~:'.;' :.i.' ,\~," , HSP~g~!? .~d GAACE I. Hf:Pt=c>.~t>./hl.J~~~h~;..~~~...yi~ei"ref~iyed by deed .d~ted ;,' .'ff. ":1:1)'-,." .. . .'.. ...... . . '..' '; .... ';:~~'(~:: '.;.t"',;:-,;:,;~/:;,. .,\. . ;.::;;J,"'l,..,. M.Y}~3,~fO~9, from H. M. HOAN~JI:fAI:;NCE'M/HO~NER, HLJsbarltf) ...... ?:;:'~t~ ....(~/~:.,> . .' .',: . .7~~*'{ :"..;~~~';Js~~E*,~i~~\;.'~!;i'(: . ., .\:r~;""l?/:ft"i:..,." !r\d wW ,recorded In tha CUrflbetf ' u rth6 use'''', aecotder of Deeds,:.::l',";:;?~:-~;":j ....~~:t. .;- }:"";;:'f~ . .... };':';"~';~;?:.;:,S1,~~;ti::~~::~:.'" ..". .... :;:~~ . ;,;,\} ""'~J~' ,~. dH:~3 May 1939 ...... ;,' 'r<'. ..... .":,,,.~ ~~"'<';;,",'V,:,;'i~;I,~~// ;:~~ ~~:~~.~:,.,' - . ..j- ,::1~ ~1 ~. - "" - ..; '~,." "':,,""~ .,. :~-' . 'I ,;~ . , " "~ :,.,,.-: ':\:~~~. ,;' ~": .0.. : '. b~.r~;f',!;~, '"; , THIS IS A CONVEYANCE =~OM MOfH~{:'ANd FArHERto THEMSELVES ' ~:\.~-:~ '~~~',~~~.~~':;~):~".?t';;;<,.. , , ' .'< ar1drHEI~ OAUGHTE8 and IS, THEF1e:~b "I',t'trbm'PENNSYLVANIA \' ~', "'O":$;.",}'i~~',<"Y;'::;;'" "';'''' <' "<, ReAlty 1RANS~t:R TAx. ' ~,t ,~5{:,~':';" .;;:.~.~ ~~J . -.\ .-.~~\; .,^ - - .~ -.' ~~t~ .~. i : ,.~ .'. .4 \;::;.~r!~ :;'!f{~. LAST WILL AND TESTAMENT OF SAMUEL P. HEPFORD I, Samuel P. Hepford, a resident of, and domiciled in, Cumberland County, Pennsylvania, do make, publish, and declare this to be my Last Will and Testament, in the manner following, hereby revoking all of my previous Wills and Codicils (but not that certain Trust Agreement referred to in Articles IT and IV herein, if the same be determined to be testamentary in nature). ARTICLE I GENERAL PROVISIONS (1) STATEMENT OF CITIZENSHIP I declare that I am a citizen of the United States of America, and that my Social Security Number is 195-07-4483. (2) FAMILY MEMBERS At the time of the execution of this Will, my spouse is Grace I. Hepford (hereinafter referred to as "my spouse"), and my child is Dianne G. Dilger (hereinafter collectively and individually, as the case may be, referred to as "my children" or "my child"). For purposes of this instrument and for all other purposes, the terms "child," "children," "grandchildren," "descendants" and "issue" shall exclude adopted persons, step-children, step-grandchildren and their issue; the term "issue" shall include only the Testator's blood line descendants of whatever degree. Furthermore, for purposes of this instrument and for all other purposes, a person in gestation, later born alive, shall be considered a person in being. ARTICLE n DEBTS AND TAXES (1) PAYMENT OF DEBTS, EXPENSES, AND TAXES I direct that all of my legally enforceable debts and expenses, including, but not limited to, any expenses of my last illness, any funeral or cremation expenses (including, but not limited to, the costs of memorials of all types and memorial services), any allowances by court order for those individuals dependent upon me, any expenses of the administration of my estate (including any expenses of any ancillary proceeding that may be necessary in another state or country), and any estate, inheritance, or other death taxes of any nature (together with any interest and penalties) that may be payable upon or with respect to any property, or any interest therein, required to be included in my estate or taxable to any person receiving any such property, be paid as soon as practical after my death by my Personal Representative, and I hereby authorize and empower my Personal Representative, in the case of any claim made against my estate, to settle and discharge any such claim, in the sole and absolute discretion of my Personal Representative. Moreover, to the extent that the assets of my probate estate, exclusive of any real estate or tangible personal property, are insufficient to pay all, or any part of, the legally enforceable debts and expenses of my estate, any estate, inheritance, or other death taxes of any nature, or any cash bequests under this Will, if any, my Personal Representative shall demand pay~ereof from ~Trustee of the Samuel. P. and Grace I. Hepford Revocable Trust dated '", ..,.,.J6.-e~ Q , 1994, but subject to the terms, conditions, and limitations of that certain Trust Agreement which are applicable to the payment of any such sums. (2) DISCHARGE OF liENS In the event that any property, or interest in any property, passing under this Will, or otherwise, by reason of my death, shall be encumbered by a mortgage or lien, or shall be pledged to secure any obligation (whether or not the property, or the interest in any such property, so encumbered or pledged shall be owned by me individually or jointly), then it is my intention that any such indebtedness shall not be charged to, or paid by, my estate. ARTICLE m SPECIFIC DEVISES (1) SEPARATE WRITING I may at this time, or at some time or times in the future, prepare a written statement or list disposing of certain items of my tangible personal property not otherwise disposed of herein or by other means. If any such written statement is found among my personal papers within thirty (30) days of the date of my death, I hereby direct my Personal Representative to follow the instructions for any distributions contained therein. If no such written statement is found within the said thirty (30) days, my Personal Representative shall proceed as if no such written statement ever existed, and my Personal Representative shall distribute all of my tangible personal property in accordance with the further terms and conditions contained in this Article. (2) PERSONAL EFFECTS All of my clothing, jewelry, personal effects, boats, automobiles, and all other tangible personal property, not otherwise specifically disposed of herein or otherwise, which are owned by me at the time of my death (except any cash on hand or on deposit, any property used in a trade or business, and any other property held for the production of income), I devise to my spouse. If my spouse shall not survive me, this devise shall lapse and shall pass to my residuary estate. (3) PROPERTY INSURANCE POliCIES All of my insurance policies which provide indemnity for the loss of any of my personal or real property by fire, windstorm, or any other casualty, including any claim for any such loss of any such property which I might have at the time of my death against any insurance company, 2 I devise any such policies or claims respectively to those persons who shall become owners of the applicable properties by reason of my death, whether or not any such ownership be acquired under this Will or otherwise. (4) COST OF DEUVERY If, with resPect to the aforementioned devises, it is necessary to effect the delivery of my tangible personal property or any insurance policies to a beneficiary who is to reSPectively receive the said devises, my Personal Representative shall arrange for, and pay the costs of, any shipments incurred in making any such deliveries. ARTICLE IV RESIDUARY ESTATE (1) RESIDUARY DISTRIBUTION I give the balance of my estate, all of which is herein referred to as my ~siduary estate, to the Trustee of the Samuel P. and Grace I. Hepford Revocable Trust dated LY ~~.s-: 1994, to be administered by the terms provided in the said Trust Agreement as it now exists or as it may be amended at the time of my death, notwithstanding that any such amendment or amendments may have been made subsequent to this Will. It is not my intention to exercise any power of appointment I may have, except as any such power of appointment may be specifically exercised. The receipt of the said Trustee under the said Trust Agreement shall be a full acquittance and discharge to my Personal Representative for the property so distributed. Upon distribution to the said Trustee, the administration of my estate shall cease with reSPect to the assets passing to the said Trustee, and the said Trustee shall not be subject to the control of any court in which my Will may be probated. (2) SAVINGS PROVISION If, for any reason, the aforementioned Trust Agreement shall not be in existence at the time of my death, or, if for any reason, a court of proper jurisdiction shall declare this transfer to the said Trustee of the said Trust Agreement to be invalid, then I direct that the residuary estate shall be held, managed, invested, and reinvested in exactly the same manner described in the said Trust Agreement, giving full effect to all of the then existing amendments to the said Trust Agreement, and the residuary estate shall managed by the same Trustee (or, as appropriate, the successor or successors therein named, as defmed in that certain Trust Agreement). Thus, for those purposes, I do hereby incorporate that certain Trust Agreement by reference, into this, my Will. Notwithstanding the foregoing, if my Personal Representative has presumptive evidence that the reason the said Trust Agreement is not in existence at the time of my death is due to my intention and act to revoke the said Trust Agreement (by physical destruction or otherwise), then it is my intention that my Personal Representative and any court 3 of proper jurisdiction shall, in good faith, ignore the dispositive scheme called for under the said Trust Agreement, and instead, my estate shall be distributed in accordance with the controlling intestacy laws then in effect. ARTICLE V THE PERSONAL REPRESENTATIVE (1 ) NOMINATION I hereby nominate Grace I. Hepford as my Personal Representative. In the event that my Personal Representative is unable or unwilling to serve or to continue to serve in such capacity for any reason, then I nominate Dianne G. Dilger as the Successor Personal Representative. (2) COMPENSATION Any Personal Representative shall be entitled to compensation which is allowed to Personal Representatives by the laws of the Commonwealth of Pennsylvania. Any Personal Representative shall also be entitled to reimbursement for any expenses necessarily incurred by any such Personal Representative in the administration of my estate. (3) BOND To the extent allowed by law, no Personal Representative shall ever be required to give bond or other security, to qualify, to make an accounting to any court under the provisions of any present or future laws of any state or territory, or to obtain the approval or order of any court in the exercise of any power or discretion herein given (unless otherwise provided in this instrument) . ARTICLE VI THE POWERS AND DUTIES OF THE PERSONAL REPRESENTATIVE (1) GENERAL POWERS AND DUTIES My Personal Representative, or any successor, shall be governed by the appropriate provisions of the Pennsylvania Statutes, as amended, that are not in conflict with this instrument, and shall have all of the additional powers and protection granted by statute to Personal Representatives. In addition to, but not in limitation of, any common-law or statutory authority, and without application to any court, the Personal Representative, or any successor, shall follow the directions hereinafter given and shall exercise, in the Personal Representative's sole and absolute discretion (unless otherwise provided in this instrument), the powers and responsibilities hereinafter given. The aforementioned shall also apply to any Trustee, at the time of application, with respect to any Trust Agreement created under this instrument. 4 (2) INVESTMENT AND OTHER POWERS AND DUTIES With respect to both real and personal property, and for the purposes of obtaining funds for the payment of any debts, expenses of administration, taxes, payment of devises, and for making distributions, conversion into cash, management of property, and for every other purpose, my Personal Representative may acquire, retain, invest, reinvest, exchange, lease, sell, borrow, mortgage, pledge, transfer, and convey in any such manner, on any such terms, and at any such times, all without limit, as my Personal Representative may deem advisable (unless otherwise provided in this instrument), even if any such terms may extend beyond the expected administration of my estate. No person dealing with my Personal Representative shall be required to inquire into, or shall be held liable with regard to, the necessity or propriety of any transaction, nor as to the application of any money or property paid or delivered in connection with any such transaction. (3) POWER TO DISPOSE OF ESTATE ASSETS I hereby give to my Personal Representative the full power and authority, at any time, to sell, mortgage, pledge, exchange, dispose of, or otherwise deal with any property comprising my estate, upon any such terms as my Personal Representative shall deem advisable; to settle and compromise any and all claims in favor of, or against, my estate as my Personal Representative shall deem advisable; and for any of the foregoing purposes, to make, execute, and deliver any and all deeds, contracts, mortgages, bills of sale, or any other instruments necessary or desirable therefor. My Personal Representative is expressly authorized to postpone the fInal distribution of my estate pending the fmal determination of any tax liabilities in connection therewith. (4) PAYMENTS OR DISTRIBUTIONS TO MINORS In the event that there is to be a payment or distribution from my estate to a donee who is a minor at such time, then at such time, as my Personal Representative's deems advisable, any such payment or distribution shall be made by my Personal Representative (i) to any such minor directly, (ll) to any such parent of the minor, (ill) to any such other person having custody of the minor, (iv) to the legally appointed guardian, conservator, or committee of any such minor, or (v) to a custodian selected for any such minor under a Uniform Transfers to Minors Act (or similar or successor statute), whether or not the applicable custodian is selected by my Personal Representative or has already been serving as the said custodian. If there is no such custodian, the applicable custodian may be appointed by my Personal Representative, and any person or entity serving as my Personal Representative may be appointed as the said custodian (unless otherwise provided in this instrument). (5) CHARITABLE PLEDGES My Personal Representative may pay any pledges made by me in writing, if, in the discretion of my Personal Representative, I would have wanted such pledges paid. l 5 (6) TAX MA TIERS (a) Tax Returns: I specifically authorize and empower my Personal Representative to execute and fIle any applicable income tax returns for the year in which my death occurs, and for any years prior thereto. I also authorize and empower my Personal Representative to execute and fIle any gift tax returns, if any such gift tax returns are required for the year in which my death occurs, and for any years prior thereto. My Personal Representative shall incur no personal liability for any action taken in good faith in accordance with either of the foregoing authorizations. If I leave a spouse, my Personal Representative may fue any joint income or gift tax returns with my surviving spouse. (b) Elections In General: My personal representative shall have the power to allocate to the income or the principal of my estate, in whole or in part, any of the receipts and the disbursements of my estate, in my Trustee's reasonable discretion (unless otherwise provided in this instrument). It is my direction that any applicable property interests, which may be determined as a result of my Personal Representative's reasonable discretion, shall, in fact, be the interests that any such beneficiaries shall receive under this instrument. ARTICLE vn SIMULTANEOUS DEATH PROVISIONS (1) SPOUSE If my spouse and I shall die under such circumstances that there is not sufficient evidence to presumptively determine the order of our deaths, then it shall be presumed that my spouse shall have survived me, and my estate shall be administered and distributed in all respects in accordance with such a presumption (unless otherwise provided in this instrument). (2) OTHER BENEFICIARIES If any beneficiary, other than my spouse, and I shall die under such circumstances that there is not sufficient evidence to presumptively determine the order of our deaths, then it shall be presumed that I shall have survived any such beneficiary, and my estate shall be administered and distributed in all respects in accordance with such a presumption (unless otherwise provided in this instrument). ARTICLE VIII JOINTLY-OWNED PROPERTY If, at the time of my death, I am a joint owner, co-owner, or individual owner of any real estate, bank account, or savings account in any commercial bank or savings institution, bond, or any other security or instrument of indebtedness which is registered or issued in my name and that of another person or persons, or any other property held as tenants by the entirety or as joint tenants with right of survivorship, or which is payable to either a co-owner or to the 6 survivor of them, then I give, devise, and bequeath all of my right, title, and interest in any such property to the surviving joint owner thereof. It is my understanding that all of my right, title, and interest in and to any such property will pass to any such surviving joint owner or owners upon my death by operation of law, but I do, nevertheless, make these provisions in order to eliminate any question as to the right of any such surviving joint owner or owners to succeed to the ownership of any such property upon my death. ARTICLE IX RULES OF INTERPRETATION (1) HEADINGS The headings used in this instrument are for convenience only and shall not be resorted to for any intetpretation of this Will. (2) MISCELLANEOUS Whenever the context so requires, the masculine shall include the feminine and the neuter, the feminine shall include the masculine and the neuter, the singular shall include the plural, and the plural shall include the singular. If any portion of this Will is held to be void or unenforceable, the balance of this Will shall, nevertheless, be carried into effect. Also, the provisions of this Will shall be intetpreted pursuant to the laws of the Commonwealth of Pennsylvania, in which state I have made my domicile. IN WITNESS WHEREOF, I have afflXed my signature to this, my Last Will and Testament, cgysisting of eight (8) typewritten pages, including the next page, on this S-- day of t-Y~.1994. d~~ Samuel P. Hepford, or SIGNED, SEALED, PUBllSHED, AND DECLARED by the said Samuel P. Hepford, as the Testator's Last Will and Testament, in the presence of the undersigned who, at the Testator's request and in the Testator's presence and in t~ presenc~nof each other, have hereunto subscribed our names as witnesses thereto, this ~ day of ,L.:)~ , 1994. Witnesses: CLw.v e ~ 4 J. >-{4? Residence: _(2~ fL.' J /q __ t.f ti IJJ ~ . ~1ft (7bq3 ; 3tJo ~~ ~ ~~ /1; /7(/93 -) 7 AFFIDAVIT OF PROOF OF WILL COMMONWEALTH OF PENNSYLVANIA We, Samuel P. Hepford, ) ) SS. ) tl~-- ~<.~~ 4 (Witness) c a.~ I m (Wi s) , the Testator and the COUNTY OF CUMBERLAND and witnesses, respectively, whose names are signed to the foregoing Last Will and Testament, being fIrit duly sworn, do hereby declare to the undersigned officer that on the ~r- day of JY ~ , 1994, the Testator signed, sealed, published, and declared the foregoing instrument as the Testator's Last Will and Testament; that the Testator signed the instrument as the Testator's free and voluntary act for the putpOses therein expressed; that each of the witnesses, in the presence and hearing of the Testator, at the Testator's request, and in the presence and hearing of each other, signed the Last Will and Testament as a witness; and that to the best of the knowledge of each of the witnesses, the Testator was at that time eighteen (18) or more years of age, of sound mind, and under no constraint or undue influence. ~90:~ o /fVI\~) g. rr-~ w~ d. ~A . Wime~ ~ SWORN TO AND ACKNOWLEDGED BEFORE ME by the Testator, Samuel P. Hepford, and sworn to and acknowledged before me by {(~r. ~ and~O. ~ the witnesses, this S day of A 0 - - .. - , 1994. My Commission Expires: &~r~ No~ Public /' ! . . \. NoIariaI seal PaIne T. SeIfaSS. Notary PLdc Milford Twp., Bud<s County My Co! I a ,Iission Expires Jan. .'Zl. 1 'iS7 ~~NC1arieS 8 KEITH L. KILGORE PAUL W. KILGORE JOHN D. ENCK Law Offices SPITLER, KILGORE & ENCK, PC 522 South Eighth Street P.O. Box 1188 LEBANON, PENNSYLVANIA 17042 (7 I 7) 273-7621 (VOICE) (717) 273-1693 (FAX) ske@skelawfirm.com CAL VIN D. SPITLER (1942-2003 ) THOMAS A. EHRGOOD (1952-2006) August 14, 2007 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Samuel P. Hepford S.S. No. 195-07-4438 DOD: 10/17/2006 Dear Sir or Madam: Enclosed please find an original and two (2) copies of Rev-1500 Inheritance Tax Return for the above estate. Please file and return our time-stamped copy per the enclosed envelope. If you have any questions, please give me a call. ,Jt.:i.;J'-i.i..;.;:-:; PAUL W. KILGORE PWK/kab Enclosure cc: Dianne G. Dilger () ~-o '::-C~ -rJ ~ ,=L:..Q ~.2~ \~j J: ~/, ",,) ',,""',) -~ if; i-r'"\ -0 \ 6' --c ..;,.~' .~ ".."'- ~ /'::~ r:~ v:> o