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Home My WebLink About12-19-07 (2) " .. ~ '- ~ .....J REV -1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 '" 15056041103 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 21-07-0310 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 231-22-1356 03232007 Date of Birth 12151916 Decedent's Last Name OVERHEIM Suffix JR. Decedent's First Name JOHN MI T (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW [K] 1. Original Return o 4. Limited Estate [K] 6. Decedent Died Testate (Attach Copy of Will) o 9. Litigation Proceeds Received Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIR!CfED TO: c::::> Daytime Telephone I9.Utnber 5 ~o ';::;;g "T(; Sr-'" 02. 04a. 07. 010. Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes Supplemental Return o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required Name DAVID OVERHEIM 8(~~ :0 -0 --t > -p ::x ~ c::> ex> Firm Name (If Applicable) First line of address 3736 FARNSWORTH DRIVE Second line of address City or Post Office CHEASPEAKE State VA ZIP Code 23321 DATE FILED Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and co plete. Declaration of prepa er other than the personal representative is based on all information of which preparer has any knowledge. ESP SI E R F NG RETURN 23321 ,CPA DATE ADDRESS R.WM.WIRE ASSOCIATES, p.c. 19 SOUTH 19TH STREET, CAMP HILL, PA PLEASE USE ORIGINAL FORM ONLY 12/5/2007 17011 Side 1 L 15056041103 6W46472.000 15056041103 .....J 11 .. --.J 15056042104 REV-1500 EX JOHN T. OVERHEIM, JR. Decedent's Social Security Number 231-22-1356 RECAPITULATION Decedent's Name: 1. Real estate (Schedule A) . 1. 119757.00 2. Stocks and Bonds (Schedule B) . . 2. 15496.35 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . 3. 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E). . 5. 24766.25 10636.60 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) D Separate Billing Requested . 6. . 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 10. 170656.20 11793.14 1028.35 12821.49 . 8. 9. Funeral Expenses & Administrative Costs (Schedule H) . . 9. 11. Total Deductions (total Lines 9 & 10). . . . 11. 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) . 12. 157834.71 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) 14. 157834.71 TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 1 t Saxable at lineal rate X .0_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 157834.71 16. 7102.56 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19. 7102.56 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT D Side 2 L 6W4648 2.000 15056042104 --.J 15056042104 , ' \ REV-?SOO EX Page 3 File Number 21070310 Decedent's Comolete Address: DECEDENTS NAME JOHN T. OVERHEIM, JR. STREET ADDRESS 223 SOUTH 19TH STREET CITY I STATE I ZIP CAMP HILL PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount 7102.56 Total Credits (A + B + C) (2) o 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 7102.56 A. Enter the interest on the tax due. (5A) O. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 7102.56 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: a. retain the use or income of the property transferred; . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either paymerits, benefits or care? ........ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes D D D D D D D No [K] [K] [X] [X] [K] [K] 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. F or 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. 139116 (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. F or 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 use of a natural parent, an adoptive parent. or a stepparent of the child is zero (0) percent [72 P.S. 139116(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. 139116(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. 6W4671 1.000 \ , REV-1~02 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER JOHN T. OVERHEIM, JR. 21-07-0310 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 jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 119,757.00 PERSONAL RESIDENCE (CUMBERLAND COUNTY, PAl 223 SOUTH 19TH STREET, CAMP HILL, PA 17011 -$105,050 ASSESSED VALUE @ 1.14 COMMON LEVEL RATIO 6W4695 1.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 119,757.00 REV-1;<J3 EX + (6-9~) , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE 8 STOCKS & BONDS FILE NUMBER JOHN T. OVERHEIM, JR. 21-07-0310 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. PRUDENTIAL FINANCIAL, INC. (170 SHARES COMMON STOCK) VALUE AT DATE OF DEATH 15,496.35 6W46961.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 15,496.35 , REV-11508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF JOHN T. OVERHEIM, JR. FILE NUMBER 21-07-0310 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. CERTIFICATE OF DEPOSIT WACHOVIA BANK, N.A. P.O. BOX 40028 ROANOKE, VA 24022 A/C #257410060315667 VALUE AT DATE OF DEATH 21,998.35 -ACCRUED INTEREST 67.90 2. PICK-UP TRUCK (SOLD 8/28/2007 FOR $200.00) 200.00 3. PERSONAL PROPERTY/CLOTHING, HOUSEHOLD FURNISHINGS, HOUSEHOLD ITEMS 2,500.00 TOTAL (Also enter on line 5, RecaDitulationl $ 6W46AD 1.000 (If more space is needed, insert additional sheets of the same size) 24,766.25 REV-1M9 EX + (6-98) COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN T. OVERHEIM, JR. SCHEDULE F JOINTL V-OWNED PROPERTY FILE NUMBER 21-07-0310 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. MARY Z. OVERHEIM 223 SOUTH 19TH STREET CAMP HILL, PA 17011 DAUGHTER B. c. JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY 0/0 OF DATE OF DEATH ITEM FOR JOINT MADE INCLUOE NAME OF FINANCIAL INSTITUTION /'H) BAN< ACCOUNT DATE OF DEATH DECD'S VALUE OF N..MBER OR SIMILAR IDENTIFYING MJMBER. ATTACH DEED FOR NUMBER TENANT JOINT JOINTLY-~REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 10/17/98 CHECKING ACCOUNT 10,695.41 50 5,347.71 WACHOVIA BANK, N.A. P.O. BOX 40028 ROANOKE, VA 24022 A/C #1000294454869 -ACCRUED INTEREST 0.36 50 0.18 2. A. 10/17/98 CHECKING ACCOUNT 10,577.42 50 5,288.71 PNC BANK, N.A. P.O. BOX 309 PITTSBURGH, PA 15230 A/C #1000294454869 TOTAL (Also enter on line 6. Recapitulation) $ 10,636.60 (If more space is needed, insert additional sheets of the same size) 6W46AE 1.000 REV-1''i11 EX + (10-06) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN T. OVERHEIM, JR. FILE NUMBER 21-07-0310 Debts of decedent must be reported on Schedule I. ITEM NUMBER A DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: MYERS-HARNER FUNERAL HOME (FUNERAL/BURIAL FEE) ROLLING GREEN CEMETARY (BURIAL PLOT) CHURCH BEREAVEMENT CONTRIBUTION 3,254.00 795.00 375.00 2. 3. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 11. 34 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant MARY Z. OVERHEIM 223 SOUTH 19TH STREET Street Address City CAMP HILL State P A Zip 17011 Relationship of Claimant to Decedent DAUGHTER 4. Probate Fees 310.00 5. Accountant's Fees 1,500.00 6. Tax Return Preparer's Fees 7. 8. SOCIAL SECURITY ADMINISTRATION; RETURN MARCH, 2007 BENEFIT MISC. ADMINISTRATIVE EXPENSES (MILEAGE, COPYING, ETC.) 1,797.80 250.00 6W46AG 2.000 (If more space IS needed. Insert additional sheets of the same size) TOTAL (Also enter on line 9, Recapitulation) $ 11,793.14 . REV-1'!i12 EX + (12-03) COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN T. OVERHEIM, JR. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-07-0310 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 238.66 100.00 135.00 309.69 1. 2. 3. 4. PHYSICIANS' FEES AND EXPENSES BANK SERVICE CHARGES TELEPHONE SERVICE (MCI) REAL ESTATE TAXES (2007 MUNICIPAL TAXES; 1/1/07 - 3/23/07; $1,378.49 @ 82 DAYS/365 DAYS 2006 INCOME TAX PREPARATION FEE 245.00 5. 6W46AH 1.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,028.35 , REV-1S13 EX+ (!l-DD) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JOHN T OVERHEIM, JR. FILE NUMBER 21-07-0310 NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(sl AMOUNT OR SHARE OF ESTATE 1. DAVID CHARLES OVERHEIM 3736 FARNSWORTH DRIVE CHESAPEAKE, VA 23321-5739 SON 1/3 2. MARY ZOELLEN OVERHEIM 223 SOUTH 19TH STREET CAMP HILL, PA 17011-5518 DAUGHTER 1/3 3. JOHN LEE OVERHEIM 601 JULIE DRIVE GALLUP, NM 87301 SON 1/3 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space IS needed, Insert additional sheets of the same size) $ N/A 6W46A11.000 MAKE CHECKS PAYABLE TO: JANET L. MILLER "J 939 WALNUT STREET CAMP HILL, 17011 RETURN SERVICE REQUESTED CAMP HILL AREA SCHOOL DISTRICT 2007/08 REAL ESTATE TAX NOTICE THIS TAX IS DUE AND PAYABLE, YOU ARE HEREBY REQUESTED TO MAKE PAYMENT THEREOF. OVERHEIM, JOHN THOMAS & MARY Z OVERHEIM 223 SOUTH 19TH STREET CAMP HILL, PA 17011 11583 - 2072 PAl D AUG 1 5 2007 Janet L. Miller, Tax Canedo TAXPAYER'S COpy · KEEP THIS PORTION FOR YOUR RECORDS MUNICIPAL CODE: 1 PROPERTY: 0223 S 19TH STREET MAP CODE: 01.22-0536-235 TAX MILLS: 13.39 iliff.U -I 1 , J '.'\ BILL DATE: 07/01/07 BILL NO.: 2072 TAXES PAYABLE TO: JANET L. MILLER. (717)763-0177 CASH CHECK # AMOUNT $ 2'Yo DISCOUNT FACE PENALTY TO 08131107 09101107 1'0 10131107 11101107 TO 12/31107 $1,378.49 $1,406.62 $1,547.28 FIRST PAYMENT SECOND PAYMENT FINAL PAYMENT N/A N/A N/A If Paid On or Before If Paid On or Before If Paid On or Before 8131107 9i3IJJ07 10131107 FULL PAYMENT OR INSTALLMENT PLAN NO DISCOUNT SEE REVERSE SIDE FOR TAX NOTICE INSTRUCTIONS .................................................................nn................................................................................................................................................................................................................................... CAMP HILL AREA SCHOOL DISTRICT 2007/08 REAL ESTATE TAX NOTICE RETURN THIS PORTION WITH PAYMENT FOR FINAL INSTAllMENT BILL #: 2072 PROPERTY LOCATION 0223 S 19TH STREET LOTS 161 &. 162 Residential Building OVERHEIM, JOHN THOMAS &. MARY Z OVERHEIM 223 SOUTH 19TH STREET CAMP HILL, PA 17011 f , I I I Please indicate: o FINAL INSTALLMENT 0 FINAL INSTALLMENT WITH PENALTY MAIL TO: JANET L. MILLER 1939 WALNUT STREET CAMP HILL, 17011 111.111.1111111111I11111111 CASH CHECK # AMOUNT $ MAKE CHECKS PAYABLE TO: JANET L. MILLER 1939 WALNUT STREET CAMP HILL, 17011 RETURN SERVICE REQUESTED FINAL INSTALU,IENT NO DISCOUNT If PaId On or Before 10/31/07 N/A If P81d After 10/31/07 N/A ........................................................................................................................................................................................................................................................................................................ MAKE CHECKS PAYABLE TO: JANET L. MILLER 1939 WALNUT STREET CAMP HILL, 17011 RETURN SERVICE REQUESTED Please indicate: o 2ND INSTALLMENT CAMP HILL AREA SCHOOL DISTRICT 2007/08 REAL ESTATE TAX NOTICE RETURN THIS PORTION WITH PAYMENT FOR SECOND INSTALLMENT PROPERTY LOCATION 0223 S 19TH STREET LOTS 161 &. 162 Residential Building BILL #: 2072 :J 2ND INSTALLMENT WITH PENALTY MAIL TO: JANET L. MILLER 1939 WALNUT STREET CAMP HILL, 17011 1.1111111I11111111111.111 II CASH f , I I I {O 9'1_ AMOUNT $ /31 L> .tf1 OVERHEIM, JOHN THOMAS &. MARY Z OVERHEIM 223 SOUTH 19TH STREET CAMP HILL, PA 17011 CHECK # SECOND INSTALLMENT NO DISCOUNT If Paid On or Before 9/30/07 N/A If PaId After 9/30/07 N/A Revenue: Cumberland County Page 1 of 2 . . . 'Pennsylvania Department of Revenue Common Level Ratio (CLR) Real Estate Valuation Factors Cumberland County ACCEPTANCE CLR ACCEPTANCE CLR DATE FACTOR DATE FACTOR FROM TO FROM TO 7-2-1986 6-30-1987 9.52 7-1-2006 6-30-2007 1.14 7-1-1987 6-30-1988 10.00 7-1-2007 6-30-2008 1.22 7-1-1988 6-30-1989 10.53 7-1-1989 6-30-1990 11.11 7-1-1990 6-30-1991 12.05 7 -1-1991 6-30-1992 12.35 7-1-1992 6-30-1993 12.50 7-1-1993 6-30-1994 12.82 7 -1-1994 6-30-1995 13.33 7-1-1995 6-30-1996 13.70 7-1-1996 6-30-1997 14.29 7-1-1997 6-30-1998 14.29 7-1-1998 6-30-1999 14.71 7-1-1999 6-30-2000 15.15 7-1-2000 12-31-2000 15.63 * 1-1-2001 6-30-2001 1.00 *7-1-2001 6-30-2002 1.00 7-1-2002 6-30-2003 1.01 7-1-2003 6-30-2004 1.05 7-1-2004 12-31-2004 1.11 **1-1-2005 6-30-2005 1.00 **7-1-2005 6-30-2006 1.00 * Adjusted by the Department of Revenue to reflect assessment base change effective January 1, 2001. ** Adjusted by the Department of Revenue to reflect assessment base change effective January 1, 2005. http://www.revenue.state.pa.us/revenue/cwp/view.asp? A=3&Q=204123&pp= 12&n= 1 11/30/2007 Estate Valuation Date of Death: 03/23/2007 Valuation Date: 03/23/2007 Processing Date: 11/30/2007 Estate of: JOHN T. OVERHEIM, JR. Account: 21-07-0310 Report Type: Date of Death Number of Securities: 1 File ID: OVERHEIM Shares or Par Security Description High/Ask Low/Bid Mean and/or Div and Int Adjustments Accruals Security Value 1 ) 170 PRUDENTIAL FINL INC (744320102) COM NYSE 03/23/2007 91.60000 90.71000 H/L 91.155000 15,496.35 Total Value: Total Accrual: Total: $15,496.35 $15,496.35 $0.00 Page 1 This report was produced with EstateVa1, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.1) . . Prudential ~ Financial ~ (,omputershare + = - -- = -- - - 000361 Computershare Trust Company. NA PO Box 43033 Providence Rhode Island 02940-3033 Telephone: 8003059404 www.computershare.com - -- - JOHN T OVERHEIM JR 223 S 19TH ST CAMP HILL PA 17011-5518 1111111...11111111.111..11.1.1111.1....1111.1...1.111111111..1 Prudential Financial. Inc. is organized under the laws of the state of NJ. - - = = Holder Account Number = C 0011421083 - ~ n UIIIIIIIIIIIIIII Company ID SSNfTlN Certified PRU Yes Prudential Financial, Inc.... Direct Registrati()rr(DSS) Advice Transaction(s) Date Transaction Description I Total I Shares/Units CUSIP I Class Description 05 Jun 2007 Transfer -170.000000 744320102 COMMON STOCK Account Information: Date: 05 Jun 2007 (Excludes transactions pending settlement) Certificate Balance Held by You Current Direct I Registration Balance Total Shares/Units I CUSIP I Class Description 0.00 0.000000 0.000000 744320102 COMMON STOCK IMPORTANT INFORMATION RETAIN FOR YOUR RECORDS. This advice is your record of the share transaction affecting your account on the books of the Company as part of the Direct Registration System. It is neither a negotiable instrument nor a security, and delivery of this advice does not of itself confer any rights on the recipient It should be kept with your important documents as a record of your ownership of these shares. No action on your part is required, unless you wish to deposit your existing certificates, sell or request a certificate, or transfer your book-entry shares. Upon request, the Company will furnish to any shareholder, without charge, a full statement of the designations, rights (including rights under any Company's Rights Agreement, if any), preferences and limitations of the shares of each class and series authorized to be issued, and the authority of the Board of Directors to divide the shares into series and to determine and change rights, preferences and limitations of any class or series. Assets are not deposits of Computershare and are not insured by the Federal Deposit Insurance Corporation, the Securities Investor Protection Corporation, or any other federal or state agency. . 40UDR + 001CD40015 OOH5AB-PRU Please see important PRIVACY NOTICE on reverse side of statement IJO] CSIJ092.G.DOM.EQS.B_302l1JOO36111JOO7741i '0.#1 c... I ,,",V'V I .....,. oJ.., .r-u.'.1 r~""'L.. c...IVV~ 1- a^ 1",}~.1. y Ci,L . . . 'WAcmJvIA. Refe1ence lD: 2155855 Wachovia Bank N.A. Balance Confirmation Service9 POBox 40028 R03110h, VA 24022-7313 August 27, 2007 DA VII> C OVERHEIM 3736 FARNSWORTH DRTVF. CHESAPEAKE, VA 23321 SLHJHCT: Verification / ContiJ:mation of Account and Balance lntormation provjded for: Cwtomer: JOHN T OVERHEIM JR (SSN# 231-22-1356) Date of Death: March 23, 2007 Deposit Account Information Account Type Account Number Date of Death Bala.ace Average Balance"' Dale Opened 2/2812000 Malurily ateIest Accrued \TD Date Dale Rate alercs! lo.terc<t Paid Closed CF.RTTFlCA TF. OF DF.POSIT 2.H41 006011511I\1 :l21 ,998..~.5 S~7. 90 S111.20 5/1 011.007 LEGAL TITLE: IT OVERHEIM JR. CLOSlNG BALANCE: $713.:1.15 CHECKING ] 000294454869 LEGAL IflLE: J"I OV!::liliElM JR. MARY7.0VF.RHFTM $] 0,695.41 8/21/199] $0.36 $2.5] ACCOUNT L'> JOINT WITH RlGHT OF SURVIVORSHIP OUR RECORDS INDICATE ACcr HAS BEEN JOINT AS Fr.R.BACK. AS 10-11-1998 . Due [0 system limitatiOllS, we can onlY"I",,;de a Iwelve month ave~e balucc OD. dCJlo<itory accounts. r~x !lanSm15510n 'd1'L.'1/2007 8: 55 AM PAGE 3/003 Fax Server . WAcHovJA. R.felone. ID: 2155855 No Safe Ueposit Hox lOund lor euslomer. . Date of death balance does not include accrued interest . If date of death OCCUl'J'5 on a weekend or a holiday. dale of death balance does not include any transactions that were made during that time period. ~.""Q.~ Teresa Bennett S<:rvicent.eT A~~ciate PllOIll:: (540)563-7323 abs; tb Senior Choice Plan Account Statement Q For 24-hour information, sign on to PNC Bank Online Banking on pnc.com. Account number: 51-4004-8009 - continued For the period 03/08/2007 to 04/06/2007 J T OVERHEIM, JR Primary account number: 51-4004-8009 Page 2 of 2 Activity Detail Deposits and Other Additions Date Amount Description 04/03 1 ,797.80 Direct Deposit - Soc Sec US Treasury 303 XXXXX1356A 04/06 4.39 Interest Payment There were 2 Deposits and Other Additions totaling $1,802.19 . Checks and Substitute Checks Check Dale number Amount paid 1868 24.52 03/22 Reference number 024267925 Check number 1871 * Amount 20.00 Dale paid 03/23 Reference number 026720218 . Gap in check sequence There were 2 checks listed totaling $44.52 There were 6 Online or Electronic Banking Deductions totaling $2,457.82 . 04/04 Online and Electronic Banking Deductions Date Amount Description 03,'08 43.91 Direct Payment - Payment PAWC 0633493 03,'15 319.82 Direct Payment - UGI UGI Utilities XXXXXXXXXXXO-07 1,797.80 Direct Payment - Reversal US Treasury 303 XXXXX1356A 79.28 Direct Payment - Elec Bill Pp XXXXXX8009Ws 168.50 Direct Payment - Premium AARP Health Care XXXXXX2211 48.51 Direct Payment - Payment PAWC 0633493 04/04 04/05 04/05 Daily Balance Detail Date 03/08 03/15 Balance 10,941.76 10,621.94 Date Balance 03/22 10,597.42 ~.R_~iI; Date 04/03 04/04 Balance 12,375.22 10,498.14 Date 04/05 04/06 Balance 10,281.13 10,285.52 Your Money. Your Business. YOUR FUTURE. PNC Investments can help you plot the course of a solid financial journey! Whether your destination is education, retirement or somewhere along the way, we have the products and services to help you create a sound financial plan. For more information call 1-800-PNC-611 1; Stop by your local PNC Branch; or Visit pnc.com Not FDIC Insured * May Lose Value * No Bank Guarantee Important Investor Information: Securities and brokerage services are provided by PNC Investments UC, member NASD and SIPC. Annuities and other insurance vroducts are offered bv PNC Insurance Services. LLC a licensed insurance af!ency. Pay the protected way with your PNC Bank Visa Check Card. Use your card to set up automatic payments - your information is protected by Visa's multiple layers of cardholder protection, including 24-hour fraud monitoring. Find out more at pnc.com/paybycard. . .... , . STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA FARNER STRASBAUGH Register for the Probate of wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 30th day of March, Two Thousand and Seven, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of JOHN THOMAS OVERHElM JR , late of CAMP HILL BOROUGH (First. Middle, Last) in said county, deceased, to DA VID CHARLES OVERHElM (First. Middle, Last) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 30th day of March Two Thousand and Seven. File No. 2007-00310 PA File No. 21- 07- 0310 Date of Death 3/23/2007 S.S. # 231-22-1356 jJjllJ;,Jav_e~J~~l ./ Reg er 0 I S r(~ ~M " - L./ 3- Deputy NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL -4 REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS ~- . ~ ......----. ......... --::-.::.., '_.'_ _: ._,".J ' .. .' ~#//'-'~~ -. ~ /: .. ~~ ~ . /,- _': '/;. - - f~' .. ,'^ _.... ~ ' r . .. " ~.~- ~ -:# ...... -: :... .. J';" . . " ,. ..- _-...... ~t/ ~ .._". .." '^' ~~,' J ...... .....~~...::-.'., ~., ..::::-" .. ...~....:,...-;,~" ,., ., .. -a No. 2007-00310 PA No. 21-07-0310 Estate Of: JOHN THOMAS OVERHElMJR (First, Middle, Last! r Late Of: CAMP HILL BOROUGH CUMBERLAND COUNTY Deceased Social Security No: 231-22-1356 WHEREAS, on the 30th day of March 2007 an instrument dated March 1st 2007 was admitted to probate as the last will of JOHN THOMAS OVERHElM JR (First, Middle, Lastl late of CAMP HILL BOROUGH, CUMBERLAND County, who died on the 23rd day of March 2007 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: DA VID CHARLES OVERHElM who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 30th day of March 2007, * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) . Will of John Thomas Overheim, Jr. Part 1. Personal Information I, John Thomas Overheim, Jr., a resident of the State of Pennsylvania, Cumberland County, declare that this is my will. My Social Security number is 231-25-134~'8 I - -, Part 2. Revocation of Previous Wills I revoke all wills and codicils that I have previously made. C) C..l ~) , I Part 3. Children f'_, I have the following children now living: David Charles Overheim, John Lee Overheim c,; and Mary Zoellen Overheim. \.i.:J Part 4. Grandchildren I have the following grandchildren now living: Alicia, Allison Mercer Lesher, Anthony David Overheim, Christopher Todd McClure, Cynthia, James Robert McClure IV, Jennifer Robin Mathias, John Lee Overheim n, Katie Ann Overheim, Lydia Ann Overheim, Thayer and Willis Fox Daniels. Part 5. Failure to Leave Property If I do not leave property in this will to one or more of my children or grandchildren named above, my failure to do so is intentional. Part 6. Disposition of Property All beneficiaries must survive me for 45 days to receive property under this will. As used in this will, the phrase "survive me" means to be alive or in existence as an organization on the 45th day after my death. All personal and real property that I leave in this will shall pass subject to any encumbrances or liens placed on the property as security for the repayment of a loan or debt. If I leave property to be shared by two or more beneficiaries, it shall be shared equally by them unless this will provides otherwise. If I leave property to be shared by two or more beneficiaries, and any of them does not survive me, I leave his or her share to the others equally unless this will provides otherwise for that share. "Entire estate" means all property I own at my death that is subject to this will. .':>.,._.J 1/1' m I C -~ I 0'7 Page 1 of 4 Initials:j.)(/ Lj,;-' '- --1.!.1.!::! Date:,..j / / / / / l/ ~ . . Will of John Thomas Overheim, Jr. I leave my entire estate to my children David Charles Overheim, John Lee Overheim and Mary Zoellen Overheim in equal shares. Part 7. Executor I name David Charles Overheim to serve as my executor. No executor shall be required to post bond. Part 8. Executor's Powers I direct my executor to take all actions legally permissible to have the probate of my will done as simply and as free of court supervision as possible under the laws of the state , having jurisdiction over this will, including filing a petition in the appropriate court for the independent administration of my estate. I grant to my executor the following powers, to be exercised as he or she deems to be in the best interests of my estate: 1) To retain property without liability for loss or depreciation. 2) To dispose of property by public or private sale, or exchange, or otherwise, and receive and administer the proceeds as a part of my estate. 3) To vote stock, to exercise any option or privilege to convert bonds, notes, stocks or other securities belonging to my estate into other bonds, notes, stocks or other securities, and to exercise all other rights and privileges of a person owning similar property. 4) To lease any real property in my estate. 5) To abandon, adjust, arbitrate, compromise, sue on or defend and otherwise deal with and settle claims in favor of or against my estate. 6) To continue or participate in any business which is a part of my estate, and to incorporate, dissolve or otherwise change the form of organization of the business. The powers, authority and discretion I grant to my executor are intended to be in addition to the powers, authority and discretion vested in him or her by operation of law by virtue of his or her office, and may be exercised as often as is deemed necessary or advisable, without application to or approval by any court. "-..1(1# I."Lf *" / Page 2 of 4 Initials: YI L4. " ) Date: ~ '/ / C,' (/ ,/ /' " ..r .. , Will of John Thomas Overheim, Jr. Part 9. Payment of Debts Except for liens and encumbrances placed on property as security for the repayment of a loan or debt, I want all debts and expenses owed by my estate to be paid in the manner provided for by the laws of Pennsylvania. Part 10. Payment of Taxes I want all estate and inheritance taxes assessed against property in my estate or against my beneficiaries to be paid out of all the property in my taxable estate, on a pro-rata basis. Part 11. No Contest Provision If any beneficiary under this will contests this will or any of its provisions, any share or interest in my estate given to the contesting beneficiary under this will is revoked and shall be disposed of as if that contesting beneficiary had not survived me. Part 12. Severability If any provision of this will is held invalid, that shall not affect other provisions that can be given effect without the invalid provision. Signature I, John Th~mas Overheim.J~..the testator, sign my name to this instrument, this 7~ .dayof /lZL#. d.co,1 ,at 2-~ S; f f rr. (i'~ 11:(( fJ: 117' ; _ I declare that I sign and execute this instrument as my' last will, t at I sign it willingly, and that I execute it as my free and voluntary act. I declare that I am of the age of majority or otherwise legally empowered to make a will, and under no constraint or undue influence. Signature: ~7~~ Witnesses We, the witnesses, sign our names to this instrument, and declare that the testator willingly signed and executed this instrument as the testator's last will. In the presence of the testator, and in the presence of each other, we sign this will as witnesses to the testator's signing. lr/lf r %/ / 1--' / l' 'h ,~ I'.l- --"?- Page 3 of 4 InitialS:;-;' /CA.;.'/ .. .. fj hI Date:'~ '//'{,.'? // ./,,, v v: , v - . Will of John Thomas Overheim, Jr. To the best of our knowledge, the testator is of the. age of majority or otherwise legally empowered to make a will, is mentally competent and under no constraint or undue influence. Residing at:'/ "72 9 $'". / 'd 'l Sf O/'h'11;O It-I/..- L i Ftf I 70 \( . I Witness #2: vJlJC01;0 d7ct~) Residing at: ;)? '-S / Y..xl) J-t Qvr.r~ %.fj) f jJq /)tJ J / 9 0f)j . 9ft fMLC .3 ~ f.1 Page 4 of 4 Initials: . / / ~ I I / I Date: / IJC: ! 'tI " ~. .. . Affidavit ACKNOWLEDGMENT Commonwealth of Pennsylvania County of: C~.)"\""lbei-lo.1...J I, the testator whose name is signed to the attach r foregoing instrume , having been duly qualified according to law, do hereby acknowledge that I signed and executed the ,instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Testator: ~ T(fJ ~j- Officer\Q12.L() (l~l-'_ J COMMONWEALTH OF PENNSYLVANIA Notarial Seal Wendy A. Witmyer, Notary Public OIiverTwp.. Perry County My Commission Expires Jan. 4, 2009 Member. Pennsylvania Association Of Notaries Affidavit - Page 1 of 2 . ~ ... Affidavit AFFIDA VIT Commonwealth of Pennsylvania County of: C~l~.l~aJL I We, rJ<f1dc.cc; f {:- A ;?Z and (f/C1 r tj l-e.J~ Fq 1(' , the r I witnesses whose names are signed to the attached or foregoing instrument, having been duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his/her Last Will; that the testator signed willingly and executed it as his/her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by h-arye,j p. f"a.J', and IlJOiiY I-ee. fa J.r this lei- day of ~7 , witnesses, Witnes . Witnes : ~ t1.ffi-1 ~~. (fiCUv / Officer\nOO O\0B21~.0 COMMONWEALTH OF PENNSYLVANIA Notarial Seal Werd-j A. Witmyer, Notary Public OflVerTwp., Perry County My Commission Expires Jan. 4, 2009 I Member, Pennsylvania Association Of Notaries Affidavit - Page 2 of 2