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Home My WebLink About10-17-07 .. -.J 1505b041147 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes .~ PO BOX.280601 ~ Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Yeer INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 File Number 00481 Date of Birth 189091159 01172007 04241920 Decedent's Last Name SuffIX Dec8DenJ's Filst Name DENNIS MJ C DEVINE (If Applicable) Enter Surviving Spouse's Infonnatlon Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW :!J 1. Original Retum 2. Supplemental Return 4. limited Estate [ J 4a. Future Interest COmpromise ::. (dale of death after 12-12-a2) o o [J 3. Remainder Retum (dale of death prior to 12-13-82) 5. Federal Estate Tax Retum Required o [K] o 6. Decedenl Died Testate (Attach Copy of WIll) 7 Decedent Maintained e Living Trust . (Attach Copy of Trust) o 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10. =.~~r=J~4r- o 11 . Election to tax under Sec. 9113(A) (Attach Sch. 0) ~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number MARIELLE F HAZEN 717540~332 ' t ) Finn Name (If Applleable) HAZEN ELDER LAW . i-1 I REGISTER OF W1LLS_~SE ONL. Y First Une of address 2000 LINGLESTOWN ROAD Second line of address SUITE 202 City or Post Office HARRISBURG State PA ZIP Code 17110 DATE FILED MFHazen@Hazenelderlaw.com Kim M Reinhard Dr Marielle F Hazen 2000 Llnglestown Road, Harrisburg, PA 17110 L Side 1 .LSOSI:.O'f.It.LCf 7 1505b04:J.1.lf1 -.J ~ --.J 15056042148 REV-1500 EX Decedent's Social Security Number Decedent's Name De n n is C Dev i ne 1 890 9 1 1 5 9 RECAPITULATION 1. Real Estate (Schedule A) 1. 128 , 000 . 0 0 2. Stocks and Bonds (Schedule B).......... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)...... 3. 4. Mortgages & Notes Receivable (Schedule D).. 4. 8. Total Gross Assets (total Lines 1-7) 8. 8 078 1 1 3 4 379 16 5 8 512 72 228 969 99 2 1 940 28 1 705 1 9 2 3 645 47 205 324 52 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E).. 5. 6. Jointly Owned Property (Schedule F) , Separate Billing Requested..... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) , Separate Billing Requested.. . 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) 11. 12. Net Value of Estate (Line 8 minus Line 11) .............. ............ ............ 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J).. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13)...... 14. 205,324.52 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2)X~ 0 00 16. Amount of Line 14 taxable at lineal rate X .045 205 , 324 5 2 17. Amount of Line 14 taxable at sibling rate X .12 0 00 18. Amount of Line 14 taxable at collateral rate X .15 0 00 15. o 00 16. 9,23960 17. o 00 18. o 00 19. Tax Due 19 9 , 239 60 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. D Side 2 L 15056042148 15056042148 --.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Dennis C Devine STREET ADDRESS 309 East Portland St. File Number 21-07-00481 CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 9,239.60 0.00 3. Interest/Penalty if applicable D. Interest E Penalty Total Credits (A + 8 + C) (2) 0.00 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (58) 9,239.60 9,239.60 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ................................. ................ x b. retain the right to designate who shall use the property transferred or its income; ..................... x c. retain a reversionary interest; or.. x d. receive the promise for life of either payments, benefits or care? ............................. x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................... ............................................. ...... ................... x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not 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 zero (0) percent [72 PS 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. . Rev-1502 EX+ (6-98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Devine, Dennis C FILE NUMBER 21-07 -00481 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 property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Decedent's real property - 309 East Portland St., Mechanicsburg, PA; Per attached Agreement of Sale 128.000.00 TOTAL (Also enter on Line 1, Recapitulation) 128,000.00 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) . Rev-1508 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Devine, Dennis C FILE NUMBER 21-07-00481 Include the proceeds of litigation and the date the proceeds were received by the estate All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Home Instead Senior Care - refund VALUE AT DATE OF DEATH 1.310.35 2 Patriot News - refund 23.00 3 The Carlisle Sentinel - refund 37.76 4 Decedent's vehicle - 1999 Chevrolet Monte Carlo; Per Kelly Blue Book private party sale value 3.375.00 5 Personalty - Auction proceeds; Per attached sales statement 2.832.00 6 Personalty - items not sold at auction 500.00 TOTAL (Also enter on Line 5, Recapitulation) 8.078.11 (If mDre space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule E (Rev. 6-98) . Rev-1509 EX+ (6-98) '. SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Devine, Dennis C FILE NUMBER 21-07 -00481 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 A. Kim M. Reinhard ADDRESS RELATIONSHIP TO DECEDENT 2724 Summertree Dr. Carrollton, TX 75006 Granddaughter B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH LETTER DATE ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE 1 A 4/9/2002 PNC Bank Certificate of Deposit 2,954.30 50.000% 1,477.15 #31000041703 2 A 4/9/2002 PNC Bank Certificate of Deposit 5.717.65 50.000% 2,858.83 #31000200404 3 A 10/1/2005 PNC Bank Certificate of Deposit 21,097.84 50.000% 10,548.92 #31200275093 4 A 4/9/2002 PNC Bank Certificate of Deposit 5,538.11 50.000% 2,769.06 #31400225348 5 A 7/15/2005 PNC Bank Certificate of Deposit 11.145.55 50.000% 5,572.78 #31400268621 6 A 4/9/2002 PNC Bank Checking Account 20,887.98 50.000% 10,443.99 #5070078252 7 A 4/9/2002 PNC Bank Savings Account #5003503562 1,416.85 50.000% 708.43 TOTAL (Also enter on Line 6, Recapitulation) 34.379.16 (If mDre space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) . Rev-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Devine, Dennis C FILE NUMBER 21-07-00481 ESTATE OF 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 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER ATTACH A COpy OF THE DEED FOR REAL ESTATE 1 Allstate Non-Qualified Fixed Annuity contract 58,512.72 100.000 58,512.72 #GA0686111 - Kim Reinhard, granddaughter and beneficiary TOTAL (Also enter on Line 7, Recapitulation) 58,512.72 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc, Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Devine, Dennis C Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07 -00481 ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 1,441.79 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2. Attorney's Fees Marielle F Hazen 8,070.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees Cumberland Co. Register of Wills Office 392.00 5. Accountant's Fees Chris Eckhard, prepared 2007 income tax return 50.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 11,986.49 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 21,940.28 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Devine, Dennis C FILE NUMBER 21-07 -00481 ITEM NUMBER DESCRIPTION AMOUNT 1 American Airlines - Executrix's travel expenses to and from decedent's funeral; Executrix resides in Texas 446.80 2 Malpezzi Funeral Home - funeral expense 944.99 3 T.G.I. Friday's and Giant Food Store - lunch reception following funeral 50.00 Subtotal 1,441.79 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) . Rev-1502 lOX. (6-98) ESTATE OF . SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Devine, Dennis C FILE NUMBER 21-07 -00481 ITEM NUMBER AMOUNT DESCRIPTION 1 Allstate Insurance - insurance premium paid for dedecent's vehicle 364.14 2 Allstate Insurance - insurance premium for dedecent's residence located at 309 E. Portland St., Mechanicsburg, PA 365.76 3 Borough of Mechanicsburg - sewer/trash bill for decedent's residence located at 309 E. Main St., Mechanicsburg, PA 106.82 4 Borough of Mechanicsburg - sewer/trash bill for decedent's residence located at 309 E. Main St., Mechanicsburg, PA 106.82 5 Borough of Mechanicsburg - sewer/trash bill for decedent's residence located at 309 E. Main St., Mechanicsburg, PA 113.22 6 Carlisle Sentinel - estate legal advertisement 190.54 7 Claude C. Wolfe & Associates - auctioneer's commission for sale of decedent's personal property; per attached statement 2,554.35 8 Claude C. Wolfe & Associates - auctioneer's commission for sale of decedent's real property; per attached statement 3,840.00 9 Clauser Real Estate Appraisals - appraisal of dedecent's real property located at 309 E. Portland St., Mechanicsburg, PA 350.00 10 Constance Branch - hired by Executrix to maintain/care for decedent's house until it sold in September 2007; took out trash, regulated temperature in house, cleaned house, retrieved mail, shoveled snow, etc. 1,100.00 11 Craig Gentzler - provided lawn maintenance for decedent's property located at 309 E. Portland St., Mechanicsburg, PA 200.00 12 Cumberland Legal Journal - estate legal advertisement 75.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) . Rev.1S02 EX+ (6-98) SCHEDULE H.B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Devine, Dennis C FILE NUMBER 21-07-00481 ITEM NUMBER DESCRIPTION AMOUNT 13 Kim Reinhard, Executrix - reimbursement for freight shipping costs to ship decedent's personal property (sentimental items having no value) toTexas 1,440.00 14 Peter Seibert - personal property appraisal fee 150.00 15 PPL Electric Utilities - electric bill for decedent's residence located at 309 E. Portland St., Mechanicsburg, PA 237.94 16 UGI utility - gas for decedent's residence located at 309 E. Portland St., Mechanicsburg, PA 711.90 17 United Water - water bill for decedent's residence located at 309 E. Portland St., Mechanicsburg, PA 80.00 Subtotal 11,986.49 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) . . Rev-1512 EX+ (6-98) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Devine, Dennis C FILE NUMBER 21-07 -00481 ESTATE OF Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 American Home Medical Equipment - medical expense (oxygen equipment) VALUE AT DATE OF DEATH 236.22 2 Barry Heckard, Tax Collector - 2007 real estate taxes 454.45 3 Central PA Pulmonary Assoc. - medical expense 34.31 4 Comcast - decedent's final cable bill 60.82 5 Holy Spirit Hospital - 2007 health insurance deductible 100.00 6 Home Instead Senior Care - provided transportation services to decedent 401.36 7 Home Service United Water - water line protection for decedent's property located at 309 E. Portland St., Mechanicsburg, PA 54.96 8 Internists of Central PA - medical expense 59.15 9 PPL Electric Utilities - decedent's final electric bill 60.45 10 UGI utility - gas for decedent's residence located at 309 E. Portland St., Mechanicsburg, PA 163.58 11 United Water - water bill for decedent's residence located at 309 E. Portland St., Mechanicsburg, PA 23.91 12 Verizon - final telephone bill 55.98 TOTAL (Also enter on Line 10, Recapitulation) 1,705.19 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev 6-98) REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Devine, Dennis C NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-07 -00481 RELATIONSHIP TO DECEDENT DO Not List Trustee(s) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. 1 Kim Reinhard 2724 Carrollton Carrollton, TX 75006 Granddaughter One-hundred percent Total 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) ~t:t-'-cc-\1( 1,:':l"t t-t-<:UI'I:UIH~t:U ~UUIHWt:~1 '::J(c(lb((t:)'::J RECCEIVE:D SEP-2~-2007 01:ee PM MARIE~L~_HA,~N,ATTORHEY I U: '::J1 (l (::>"t\1"t.:\1.:\ 09/2~/L~~1 lL:~L 717 540 4~1~ t-'H~t::\1\11/\1\1"t p.el A GREEMENT FOR THE SALE AND PURCHASE OF REAL ESTATE . This Agreement made thiS;;;! di1Y of September. 2007. 1. PRINCIPALS: Between Kim M. Reinhard, Elecutrb of the Estate or Dennis C. DeYlne, of 2724 Summertrec Drive. Carroilton. Texas 75006, hereinafter called Seller. and ~ LLfJ ,of 10 I B t.U()()dl'd 'Dad J)r. ___~__i=b:r..r:;"Shv'~-I..A--LZlL.t.._ hereinafter called Buycr. 2. PROPERTY: Sdkr hereby agrees to sellllnd convey to Buyer, who hereby agrees to purchase: ALL THAT CERT AN Lot or piece of ground with buildings and improvements thereon erected, if lIny, known as: 309 East Pomand Street Mechanicsburg. Cumbt:rlunu County, I\~nnsylvanja 17055. J. ZONING: Zuning Classification: Residential. 4. TERMS~ (1\) Purcha.c:e Pricc: $ / t e", () D 0 .00 to ~.p~i9J~YJbc I),uver as. [ollows: (b) Non-refundable deposit of SIt.) 900 ,00 C10_~_of purcha::;e pri~e) to be p:r ~~ sil!ning ofthi5 wcement, receipt of which is hereby ackMwlec\gcd. tII'~ pv!brt cJ!-oIl2.21 (c) Balance of purchase price aL sl;!Ltl~'llent (cash. certified check, and/or mortgage fund5): S 115/'2.."0 ,00. TOTAL: L 1'- ~~_' on .' (d) Settlement to be made on or before Novel11b~r.l11_~OOZ. (e) The following shall be apportioned pm-rum as of nod at time of settlement: Taxes as levied and assessed, rents. interest on mortgase assumption.Ii, condominium fee~ and homeo"'ner association fees if any. water and/or sewer rents if any. together wilh any oth~,r lienable municipal services, All Realty Transfer Taxes shall be divided evenly unless otherwise pro....ided herein. 5. FINANCING CONTrNGRNCV: This agreemtml i:-;~ubjcct to the fimmcingas follows: NONE 6. STATUS or WATF.R AND SEWER: Sellerwmranls that this propel1y i!l serviced by~i~ water and DubUc sewer. 7. MUNICU' AL IMPROVEMENTS: Seller has no nlllkc of municipal improvements (such as sidewalk3, curbs, etc.), 8. SPECIAL CLAUSES: (a) Property is bejng.sold "AS IS". (b) Buyer waives all inspection contingencies. 9, PERSONAl.TV: ^Il existing plumbing, heating. air-conditioning and lighting fixtures (including chandeliers and CCilUlg fans) and ~ystem5 appurtenant thereto and fbrming a part thereof. and other permanent fixtures, as well US alll'anges, T,V. 3ntenll8.'l., masts and rotor systems, together with wall to \'waU cllrpcting, screen!;, storm SRgh and/or d()or~, shades, awnings, Venetian blinds, 111iniblinds, radiator covers, cornices, water softeners., kitchen cabinets. dr-dpery rods, Qr~l.,el"y ;wd hardware, curtain rods, curtain rod hardware, all tre\i;&, shnlbbcl")', plamings nOW in or on property, =>cr---C:C:-l:Jf ~J;~"t rt<:Un;U1Hl.:lcU =>UUI HWc=>I '::!fC:f~t>ffb'::! IU;'::!~f~fJ"tl:J"tJ~J RECEIVED 09/22/2007 12:02 SEP-22-2e~7 el :01 PM MARI~LL~_~A2EN.ATTORNEY 717 540 4313 r--Hl.:lc;l:Jl:JC:'.l:Jl:J"t P"0~ garage door openers, sheds; ifany. unless specifically excepted in thiS Agreement. are Included in the $uk und purchase price. None ofthc above mentioned items shall be removed or 5ubstituted by the ~cncr frmn prl:mlses after date of this Agreement. Any remaining heating and/or cooking fuels stored otllhc premises at. time of settlement are also inc luded under this Agreement. Seller hereby warnum thllt she will dell ver good title to all of the arriclc~ described in this paragraph, and any other Iixrurc~ or itt:l11s of pCI'S\1nalty specifically schedulcd to be included in this sale. Selin warrants 1111 pI umbing. heating, air conditiolling, mech<.mical and electric!!! systems and equipment and appliances tll be ill pTl.lpllr working order at time of settlemc::nt. Thi~ w<irranty does not survive closing. -~ ~ ~..../." "'""'- -- . ------ -- - ---- ...- /'" '\... / :::--.~ ------- HI. TITLE ANI) COSTS: (a) The premisl:s are to be conveyed in fee :simple by ~'Pt:clal warranty deed, free and clear of illlt krls, cncnm branccs and casements. EXCEPTING HOWeVER, the following: Existing huilding restrictions. ordlnancc~, ea.scmcnt5 of roads. privileges or rights of public service l'ompnni~s. if any; or ca..emcnts or restrictions visible upon thc ground, otherv.risc the title to the above described real c~tllte shall be good cu'lU ml.trkdll.ble or such liS will be insured by II re~utable title insurance company at the regular rates. (b) The Buyer will ,pay for the following: (i) The premium for title insuran(:c. mechanic" Hen insuranoe and/or title search, or fee foX' cancellation (If Sllme, if any. (ii) The premium for flood in!lurance and/or fire insuran<:e with extended coverage, insurance binder chargcs or cancellation fee, if any. (Hi) Appraisal fces and charges pltitl in ,l(Jvancc to mongagee, if any. (iv) Buyer's normal ~ltlement costs and accruals unless otherwiF:c stated herein. (c) Any surveyor surveys which may be required by the Title 111!Jumnce Company or the ahslT<lcting attorney for the preparation of an adequatc lcgfl,1 description ofthl; premises (or the correction thereof), l,lnall ht' secured and paid for hy the Seller. However, any SUl'Vey or stU'veys desired b)' the Ruyer or required by their mcmgagce snail be secured and paid for by the Buyer_ (d) In the event the Sellcr is untlblt: to give a good and marketable title or such as will be insured by a reputable title company. subjecT as aforesaid, Buyer shall have the option of laklng such title as the Seller mn give without abatement of price or of being repaid all mllni cs paid by the Buyer 10 the Seller on account of the purchase price and there 5hall be no further liability or objection Ol1 either ortne partic~ hereto and this Agreement shnll become NULL AND VOID. t 1. PAYMENT OF OEPOSt'i'; Otposits, regardless 0 r the form of payment and the pernon designated as payee, shall be paid to Seller, nnd shall be l}onref}mdabl~, except a.c; described in Paragraph 10. 1.2. l'OSSESSIOS AND TENDER: (a) Po~session is to be delivered by deed, k~ys and physical possession to 9. vacant building al uay Wld time of settlement, (h) Formal tender of an executed deed and purchase money is hereby waived, (c) Buyerreservcs the righl to make 11 pl'e-!lCttlemcnl inspeclion or-the lIubjec\ pr<:>mil<<':\4, and w\\l ~x\:cu..~ appmpriate documentation of such inspection. 2 ::Ocr-'-C::C::-\:Jr ~...l; L.> r-t<::UI'I:U1H\:lcU ::OUUIHWc::01 '::j rc:: r~b r n:::l'::j IU:'::j~r~r:"'>"I\:J"I...l~...l r-'H\:lc:\:J\:J...l'"\:J\:J"I RECEIVED 09/22/20@7 12:62 SEP-22-2~07 01:01 PM MARIELLE_HAZEN.ATTaR~EY 717 ~40 4S13 P.83 13. RISK OF LOSS: (Il) Seller shall maintain the property and an~- personal property specifically scheduled herein in its present condition, normal wear and tear excepted. (b) Seller shall bear risk of loss from fire OT other casualty until time of settlement. In the event of dllltUl.ge to the property by fire or other casualty. Buyer shall have the option of rescinding this agreement and receiving hand money paid on aocount or of accepting the property in its then condition with the proceeds of any insura.nce recovery obtainable by Seller. Buyer is hereby notified that he may in!)ure his equitable interest in this property as of the time of the acceptance of this agreement. 14. REPRESENTATIONS: it is understood th<.tl Buyer has inSllectcd the property, or hereby waives the right to dQ :;0 and lle ha.'lllgTCCd to plll'chase it as 11 result of such inspection and \'lOt because of or in rcliance upon any representation m~de by the S-eller ('lr any representative of Seller, and that he has agreed to purchase it in iL'i pre$cnt condition unless otheTWisc specified herein lUld further acknowledges that the aforementioned parties arc not qualifled to render an opinil'ln on construction, engineering, or environmental mattei'S and that the buyer has been advised that he may require or wish to seek the assistance of experts in tho:;e field!>. It is further understood that this Agreement conlains the wh~)k llgreemtml between the Seller and Buyer and there arc no other terms. obligation, covenants, representations, statemenL;; or conditlons, oral or otherwise of any kind whatsoever concerning this sale. Furthermore, this Agreement shall not be alt~red, amende.d, changed or modified except in writing executed hy the parties hereto- 15. RECORDING: Thisagreementsh.\ll not be recorded inthe Office for the Recording ofDccds or in any other office or place Qf pu1;llic record, and if [luyer shall record this agreement of cause or permit the: O5tUI1C to be recorded. Seller may, at his option, elect to treat such DCt as a breach of this agreement. 1(i. ASSIGNMENT: This Agn:cmcnt shall be binding upon the respective heirs, executors, administrators, successors and, to the extent assignablc, on the assign!; of the parties hereto,lt being expressly understood, however. that the Buyer shall not tran~fer or assign thi~ Agreement without the written consl:Ilt of the Seller being first obtained. 17. DEFAVL T -- TIME IS OF THE I1:SSENCE: The said time for settlement and all other items rcferred to for the pcrfom1aIlce of any of the obligations of this Agreement are hc..-reby s,greed to be of the essence of this Agreement, Should the B\lyer: (a) Fail to make an)' additional paymcnt5 fl5 specified in Paragraph 4, (b) Furnish false or incomplete i nfolmnlion to thl: Seller, the Seller's agent, or the mortgage lender, conccrning the Buyer'!; legal or financial status, or fail to cooperate in the processing of the mortgftgeloan application, which ants would result ill the failure to obtain the approval of a mortgage loan commitment, Of (c) Violate or fail to fulfill and perform any of the tems or conditions ofthi$ Agreement. then in sUl:h case, all deposit monies and other sums paid by the Buyer on aooount of the purchasl; price, wheLhcr required by this Agreement or not. may be retained: (i) by the Seller on aCl,;,)unt of the purchase price. ShllU}d the seller demand the full purchase price, or (ii) as monies to be applied to the Seller's damages. Qr (iil) ll.5 liquidated daml'lge8 for such breach. As the Scller may elect, and in the event that the Sdl!!r elects to retain the monics a.o; 3 ::>t:.t""'-cc-l<Jf ~J:~:"> r-KUI'I:U1H\:lt:.U ::>UUIHWt:.::>1 ';;jfcl.~bfn:j';;j IU;';;j~f~f:..>"tI<J"tJ~J RECEI\JEI) 69/22/2007 12: 02 SEP-22-~ee7 01:0Z ~M MARIELLt_HAZEN,ATTORNEV 717 ~40 4~1~ t""'H\:lc.:I<JI<J"t'.I<JI<J"t p.04 liquidated damages in /lCcordal1ce with Paragraph 20(c)(iii), the Seller shall be released from all liability or obligation as this Agreement shall be NULL AND vOID. 18. DESCRIPTIVE HEADING: The detlcriptive headings used herein are for convenience only and they are not intended to indicate all of the matter in the sections which follow them. Accordingly. they shall bave no effect whatsoever ill deTermining the rights or obligations of the partios, 19. AGREEMENT: THIS AGREEMENT CONTAINS THE WnOLE AGREEMENT BF.TWEEN THF SFT.U:,R AND I3UYCR. TllERP. ARF. NO OTHeR TERMS, OBUGA nONS. COVENANTS. REPRESENTATIONS, STATEMENTS OR CONDITIONS, ORAL OR OTHER WISE, OF ANY KIND WHATSOEVER CONCERNfNG TIllS SALE, EXCEPT AS A rr ACHED TO THIS CONTRACT. Thill ill a legally binding contnlct; if rwt understood, consult your attorney. Fax Statement: This Document and any amendments thereto, may be executed in multiple CO~Lnterparl.~ by lht: parties and delivered by way oflrul'lsm;::;sil.lTI through a faosimi.le (FAX) machine and such countctparts shall have the ~me legal enforceability and binding effect as though it were signed by all parties in original rorm. ,\PPROV AL BY BUYER; In witness whereof. the pI\rties herel(t, intending to be legally bound hereby. have hereunoer set their hands and scals the duy and year first above written. APPROV AL BY BUYER: ~-F .2007. L-~~~ER'-._ Buyer hereby <Lppmvc:s this contract this _ ~-z.. day of BljYER :..~--fiyiJ e- -- ~_.. -. ~I'lIOV 4." '1Y SF.LLER: Seller hereby 'PP""" 1M, contract th;s d ~y of < ~007. WITNESS AS T SELL Kim M. Reinhard, Executrix of'tb~e afDennise.Devil.. ~. 4 Kelley Blue Book - Private Party Pricing Report - Chevrolet, Monte Carlo Page 1 of2 Kelley Blue Book THE TRUSTED RESOURCE m.m. A Send to Printer T~~a...Ei. 1999 Chevrolet Monte Carlo LS Coupe 20 BLUE BOOK PRIVATE PARTY VALUE aclvertiserne!lt Condition Value Excellent $4,235 Good $3,860 ../ Fair $3,375 (Selected) Average Consumer Rating (0 Reviews) Read Reviews Be the first to review this vehicle Vehicle Highlights Mileage: Engine: Transmission: Drivetrain: 34,000 V6 3.1 Liter Automatic FWD Selected Equipment Standard Air Conditioning Tilt Wheel Power Steering Cruise Control Power Windows AM/FM Stereo Power Door Locks Cassette DUdl Front Air Bags ABS (4-Wheel) Blue Book Private Party Value Close Window Private Party Value is wtlat a buyer can expect to pay when buymg a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). T:,e final sale price may vary depending on the vehicle's actual condition and local market conclitions. ThiS value Illay also be used to derive Fair Market Value for Insurance and vehicle donation purposes. Vehicle Condition Ratings Excellent .'.i/I""__'1I!."1l\.~.~. LJ:l..,1\...Ilw%L3 $4,235 http://www.kbb.com/KBB/UsedCars/PricingReport.aspx?ManufacturerId=9& Y earId=1999 ... 7/6/2007 Kelley Blue Book - Private Party Pricing Report - Chevrolet, Monte Carlo Page 2 of2 "Excellent" condition means that the vel11cle looks new, IS In excellent mecllanlcal condition and needs no recondltlonlllg. This vehicle Ilas never had any palllt or body work and IS free of rust. The vehicle has a clean title history and will pass a smog and safety Inspection. The engine compartment IS clean, with no fluid leaks and IS free of any wear or vIsible defects. The vehicle also has complete and verifiable serVice records. Less than 5% of all used vehicles fall Into tillS category. Good $3,860 "Good" condition means that the vel11cle IS free of any nlajOr defects. ThiS vehicle has a clean title history, the paint, bOdy and Intenor have only nllnor (II any) blemishes, and there are no major mechanical problems. Tl1ere should be little or no rust on thiS vehicle. The tires match and have substantial tread wear left. A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall Into thiS category ../ Fair (Selected) woe $3,375 "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still In reasonable running condition. This vehicle has a clean title t1lstory, the paint, body and/or Interior neecl work performed by a professional. Tt1e tires may neelj to be replaced. There may be some repairable rust damage. Poor N/A "Poor" condition means that the velllcle has severe Illechalllcal and/or cosmetic defects and IS in poor running condition. The velllcle may Ilave prolJlellls that cannot be readily fixed such as a damaged frame or a rusted-through body. A vehicle with a branded title (salvage, flood, etc.) or unsutJstantiated mileage is conslderecl "poor." A vehicle In poor condition may require an If1dependent appraisal to determine its value. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of cars in thiS category varies greatly. * Pennsylvania 7/6/2007 http://www.kbb.comlKBB/U sedCars/PricingReport.aspx?ManufacturerId=9& YearId= 1999... 7/6/2007 Uct U I U"/ II: "tea ~laude ~. WaITe ~ Hssoc. lO/I"/J "/::Jo/ U"/::J"t p. I CLAUDE C. WOLFE & ASSOCIATES AUCTIONEERS & APPRAISERS FAMILY OWNED SINCE 19/0 2009 LINCOLN STREET . CAMP HILL, PA 17011 717-737-0734 Public Auction for Estate of Dennis C. Devine Date September 22, 2007 }ujdress 309 E. Portland Street, Mechanicsburq, PA 17055 Auction Gross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,832.00 EXPENSES Shoppers Guide }ujv. & Sale Bills ..............$ Pa triot News }ujv. ............................. Paxton Herald Adv. ............................ other Adv. Other }ujv. Other Adv. ..... ..... ...... ..... ..... ..... .... ... .... ......... ..... ........................... ........ ......... ......... .........." Sign for Property............................. State Fumigation Tags......................... Regie tra tion Nwnbers . . . . . . . . . . . . . . . . . . . . . . . . . . Ten t/ Tarp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Misc. Expenses................................ 4 Clerks at $ 70.00 each. . . . . . . . . . . . . . . 4 Runners at $ 70.00 each . . . . . . . . . . . . . . . Labor Sale preparation Labor Labor Labor Personal Items Fee at 10 % . . . . . . . . . . . . . . . . . . Total Expenses for Auction ... ............ ...... Real Es tate Gross . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ Real Estate Fee at 3 % (Due at Settlement) . $ 2,832.00 - 2,554.35 277.65 - N/A 277.65 Auction Gross Expenses Net Checks Owed ~by Auctioneer 371.30 413.00 159.85 25.00 10.00 10.00 280.00 280.00 722.00 283.20 . . . $ 2 , 554.35 128,000.00 3,840.00 Auctioneer or Cashier: Approved by: COMMONWEALTH OF PENNSYLVANIA DEPAR~MENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 - INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0481 07138896 09-13-2007 REV-15l't3 EX AFP (09-00) EST. OF DENNIS C DEVINE S.S. NO. 189-09-1159 DATE OF DEATH 01-17-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS o CHECKING o TRUST o CERTIF. KIM M REINHARD 2724 SUMMERTREE DR CARROLL TON TX 75006 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. CUf~stions may be an5WQrp-n h:v calJing (717) 7~7-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5003503562 Date 04-09-2002 Established To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 1,416.85 X 50.000 708.43 X .045 31. 88 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] [CHECK ] ONE BLOCK ONLY A. [J The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. ~e above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [J The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due 2 3 X 4 5 6 7 X 8 PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS . ~.!!!:" 1. D~tu :~ta~1.tlhe~ PART ~ DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ r ury, I declare that the facts nowledge and belief. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG. PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0481 07138897 09-13-2007 REV-1543 EX AFP (09-00) EST. OF DENNIS C DEVINE S.S. NO. 189-09-1159 DATE OF DEATH 01-17-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [X] CHECKING o TRUST o CERTIF. KIM M REINHARD 2724 SUMMERTREE DR CARROLL TON TX 75006 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent. you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questi~r.s may b~ an~w~r9d by ~~lling (7!?) 787-8327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5070078252 Date 04-09-2002 Established To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 20,887.98 X 50.000 10,443.99 X .045 469.98 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the decedent's date of death. you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] [CHECK] ONE BLOCK ONLY A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "An and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. 8. ~e above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. c. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. LINE l. Date Established 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART ~ DATE PAID PAYEE X PART @] TAX If you indicate a different tax rate. please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS X DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) t Perjury, I declare that the facts ~ knowledge and belief. I COMMONWEALTH OF PENNSYLVANIA DEPA~TMENT OF REVENUE BUREAU OF INDIVIOUAL TAXES DEPT. 280601 HARRIS8URG, PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0481 07138898 09-13-2007 REV-154! EX AFP (09-00) EST. OF DENNIS C DEVINE S.S. NO. 189-09-1159 DATE OF DEATH 01-17-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS D CHECKING D TRUST !iJ CERTl F . KIM M REINHARD 2724 SUMMERTREE DR CARROLLTON TX 75006 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this for~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Com~onwealth of Pennsylvania. Questions may ba ~nswered by cal1i~g (717) 787~8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31400225348 Date Established 04-09-2002 To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable X Amount Subject to Tax Tax Rate X Potential Tax Due 5,538.11 50.000 2,769.06 .045 124.61 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] [CHECK ] ONE BLOCK ONLY A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of ~ Wills and an official assessment will be issued by the PA Department of Revenue. B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. c. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: LlNt:: 1. Date EstaDllshed 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART ~ DATE PAID PAYEE X PART [!] TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS X DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ , I declare that the facts ledge and belief. )1J7 COMMONWEALTH OF PENNSYLVANIA DEPA~MENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B060I HARRISBURG, PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0481 07138899 09-13-2007 REY-1543 EX AFP (09-00) EST. OF DENNIS C DEVINE S.S. NO. 189-09-1159 DATE OF DEATH 01-17-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [i] CERTI F . KIM M REINHARD 2724 SUMMERTREE DR CARROLLTON TX 75006 REMIT PAYMENT AND FDRMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Qupstions may tip answQred by calling (717) 7~7-83027. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31000041703 Date Established 04-09-2002 To insure proper credit to your account, two (2l copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable X Amount Subject to Tax Tax Rate X Potential Tax Due 2,954.30 50.000 1,477.15 .045 66.47 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3l months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9l months after the date of death. PART [!] [CHECK ] ONE BLOCK ONLY A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. ~e above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ~ ~:' be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: PART [3J TAX LINE . . Date Eslab:iished 2. Account Balance 3. Percent Taxable 4. Amount SUbject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED [!] DATE PAID PAYEE DESCRIPTION AMOUNT PAID OTAL (Enter on Line 5 of Tax Computation) * clare that the facts and belief. have reported abov HOME c17d; WORK Q I TELEPHONE COMMONWEALTH OF PENNSYLVANIA DEPA~TMENT DF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '*' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0481 07138900 09-13-2007 REV~1543 EX AFP (09-00) EST. OF DENNIS C DEVINE S.S. NO. 189-09-1159 DATE OF DEATH 01-17-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS D CHECK I NG D TRUST [i] CERTIF. KIM M REINHARD 2724 SUMMERTREE DR CARROLL TON TX 75006 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of P~nnsylvania. Questions may be answered hy calling (717) 787-8327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31200275093 Date 10-01-2005 Established Account Balance 21,097.84 Percent Taxable X 50.000 Amount Subject to Tax 10,548.92 Tax Rate X .045 Potential Tax Due 474.70 To insure proper credit to your account, two {Z} copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent".. NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] TAXPAYER RESPONSE [CHECK ] ONE BLOCK ONLY A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. ~ above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. c. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: DEBTS AND DEDUCTIONS CLAIMED PART @] TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINe 1. Data Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART [!] DATE PAID PAYEE 1 2 3 X 4 5 6 7 X 8 DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ eclare that the facts e and belief. have repor~ HOME (I /: WORK (.,;:) I TELEPHONE COMMONWEALTH OF PENNSYLVANIA DEPA~TMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0481 07138901 09-13-2007 REV-lS43 EX AFP C09-00) EST. OF DENNIS C DEVINE S.S. NO. 189-09-1159 DATE OF DEATH 01-17-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [Xl CERTIF. KIM M REINHARD 2724 SUMMERTREE DR CARROLLTON TX 75006 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent. you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution. attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pen~sl-flvania, Q",:u.i:ions may b~ answ(I!"'pd by raJI iog (7J.7) 787-8327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31400268621 Date 07-15-2005 Established Account Balance 11,145.55 Percent Taxable X 50.000 Amount Subject to Tax 5,572.78 Tax Rate X .045 Potential Tax Due 250.78 To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to. "Register of Wills. Agent". NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] TAXPAYER RESPONSE [CHECK ] ONE BLOCK ONLY A. [] The above information and tax due is correct. 1. You may choose to re~it payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU may check box "An and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. ~bove asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. c. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate. please state YOUr relationship to decedent: LINE 1- Dat.:;: E~tabll.shecJ 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 S. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART [!] DATE PAID PAYEE X PART @] TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS X DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID CEnter on Line 5 of Tax Computation) $ facts COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 1712B-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0481 07138902 09 -13-2007 RfV-15li3 EX AFP (09-00) EST. OF DENNIS C DEVINE S.S. NO. 189-09-1159 DATE OF DEATH 01-17-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS D CHECKING D TRUST [iJ CERTIF. KIM M REINHARD 2724 SUMMERTREE DR CARROLLTON TX 75006 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of P",..nsylvani-a. QI~l3.stionc::; mav h~ a".o;werq~ hy ca~ Itng (717) 787-8327 COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31000200404 Date 04-09-2002 Established Account Balance 5,717.48 Percent Taxable X 50.000 Amount Subject to Tax 2,858.74 Tax Rate X .045 Potential Tax Due 128.64 To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] TAXPAYER RESPONSE A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or YOU may check box "A" and return this notice to the Register of ~IS and an official assessment will be issued by the PA Department of Revenue. B. ~he_ above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. [CHECK ] ONE BLOCK ONLY C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART If you indicate a different tax rate, please state your ~ ~elationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 LINE i. Date t::staolished 2. Account Balance 3. Pe~cent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PAYEE DESCRIPTION AMOUNT PAID (Enter on Line 5 of Tax Computation) t facts have repor LAST WILL AND TEST AMENT OF DENNIS C. DEVINE FILE I, DENNIS C. DEVINE, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. .' Article III I gIve, devise and bequeath my tangible personal property III accordance with any memorandum which I have handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. To the extent no such memorandum is found, or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal property shall be added to my residuary estate and pass under Article IV hereof. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath to my granddaughter, KIM M. REINHARD, of Carrollton, Texas. However, if my granddaughter, KIM M. REINHARD does not survive me by thirty (30) days, but leaves descendants who survive me by thirty (30) days, those descendants shall receive, Per Stirpes, the share KIM M. REINHARD would have received had she survived me by thirty (30) days. Article V I nominate, constitute and appoint my granddaughter, KIM M. REINHARD, as Executrix of my Last Will and Testament. I direct that my Executrix be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in 2 cash or in kind, in like or in unlike shares, and to file any qualified disclaimer I could have filed if living. My Executrix shall receive reasonable compensation for services rendered to my estate. Article VI In addition to the powers conferred by law, I authorize my Executrix, in her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, ( c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executrix; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and 3 CD to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, DENNIS C. DEVINE, hereby set my hand to this my Last Will and Testament, on :J --/~ ~d' { ,2004, at Harrisburg, Pennsylvania. JJe~C: ~ DENNIS C. DEVINE In our presence, the above-named DENNIS C. DEVINE signed this and declared this to be his Last Will and Testament and now at his request, in his presence, and in the presence of each other, we sign as witnesses. Name Address ~~~~~~ljO .. . 363 '11 7/IiJ 4 I, DENNIS C. DEVINE, Testator, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and Acknowledged before me by DENNIS C. DE NE, the Testator on S /2 ,2004. ~~ o bhc J)~/l4"ii @~j)~ DENNIS C. EVINE -... NOlanal Seal I Marielle F. Hazen, Notary Public City of Harrisburg. Dauphin Count~ My Commission Expires Sept. 23. 2Ul~ We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testator sign and execute this instrument as his Will; that he signed and executed it willingly as his free and voluntary act for the purposes therein expressed; that each of us in his sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and Subscribed to b~reJ% . by ~/t() '. l/tl /7(1 and K ,. (Y) m, ~}YY) /' ..u. witnesses, on ~)( J ) t /,2 ,2004. cdlhi~ Notary Pu ic -_...--~. Notarial Seal I .Mariel/e F.. Hazen, Notary Puhsc City of Hllrnsburg, Dauphin Count" My Commission Expires Sept. 23, 2()06 I