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HomeMy WebLinkAbout01-10-08CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) January 4, 2008 Mr. J. Paul Dibert Department of Revenue Inheritance Tax Division Harrisburg District Office Strawberry Square 4`h & Walnut Streets Harrisburg, PA 17128-0101 RE: Estate of Helen C. Dotter 21-06-0819 TELEPHONE (717) 766-0209 FAX (717) 795-7473 Dear Paul: This is the Return that I spoke to you about some weeks ago. It may be worth your while to personally review it in view of our conversation. Thank you for your kind help in this matter. It is most sincerely appreciated. Very truly yours, ~r~ ~ ~-.~ _ Charles E. Shields, III ~~~ ~~ `~ _ : _ ~~ - -~ -_ Attorney-At-Law ~~-;-, ~ - 0 ,. Enclosures '' -- ~ ~;,~ ~ '. c_n r~ J 15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Cede Year File Number Po Box 2sosol INHERITANCE TAX RETURN Harrisbur , PA 17128-0601 RESIDENT DECEDENT 2/ D ~+ O O g 1 9 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth ~ ~Z DSO/6S o gp9a~o~ ~7~0 ~9~ ~ Decedent's Last Name Suffix Decedent's First Name MI Do ~ TER ~;~ _ H F~ FN ~. (If Applicable) Enter Surviving Spouse's Information Below Spouse s Last Name Suffix Spouse's First Name MI N'/,~ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return Q 3. Remainder Return (date of death O 4. Limited Estate O prior to 12-13-82) 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O (Attach Copy of Will) 7. Decedent Maintained a Living Trust l 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number CH~~ZL ~S E' SH / FLDS ~ i ~ 7 / 7 ~'6b oZo 9 Firm Name (If Applicable) / ~' First line of address ~O C~ousE~ ~o.¢~ Second line of address City or Post Office State /h ~C /~~1-N i e s a uR~ p~ ZIP Code REGISO~ WILLS I„~ ONLY C__. T? ~~ .s~ _i._ _ - CJ _ ~, ;~'~ ~ _ - _ .n. ,. DATE FILEDt-n / ~asS973S' Correspondent's a-mail address: ~ e(~m~l"C rS ([tJ ~~X• 1'Jf.° fi Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAL RE OF PERSON PON~SJBiz~FI~ING RETURN DATE ~// ~ 7 n ADD SS S/fNF T L, ,4 TTiRS KOr~y , Ll/LLSl3KRG ~~ ~ Side 1 L 15056051047 15056051047 J PLEASE USE ORIGINAL FORM ONLY J REV-1500 EX 15056052048 Decedent's Name: 1~ E L E N C• ydT T~~ RECAPITULATION 1. Real estate (Schedule A) ............................................. 1 2. Stocks and Bonds (Schedule B) ....................................... 2 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. Decedent's Social Security Number l / 2 DS ~{ 16 ~ .QD . ~~ .OD ~f 1 ~S 4.93 1 276.0' 67 ~ 9 6 .SS ~%7~~~f7,•3~. 9. Funeral Expenses & Administrative~Costs (Schedule H) ..................... 9. 3 8 ~ b O p~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. ~ S S ~ 3 ! 11. Total Deductions (total Lines 9 & 10) ................................... 11. T 7 7 ~ d • 6 3 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. ~ ~ 9 ~ 3 ~o • 7 .3 13. Charitable and Governmental BequestslSec 9113 Trusts for which • D D an election to. tax has not been made (Schedule J) ...._ .............. . .... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. ~ ~ / 1 3 ~O 7 ~ ' TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 . D D (a)(1.2) X .OSZ 15. 16. Amount of Line 14 taxable at lineal rate X .0~ • Q O 16. 17. Amount of Line 14 taxable / -7 at sibling rate X .12 ~~ 7 9 ~ tp 3 9 / 17. 18. Amount of Line 14 taxable •~ .r o L' ~ ~ • 7 ~ 18. at collateral rate X .15 19. TAX DUE ........................................ ................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT .O~ . D b 4 D 5~0•9~ (o ~ l 0 (o.Sq O Side 2 15056052048 15056052048 • • • ~~X C1¢L(~lG/t_T!_ay ~'.YE~"r,~ ~S _ ~ _ /~~-cr a~= ~_ _ SSE SC/YE~ F_: - _ _ _ __ - _ __ _ _ .Ti~NET _/11~TrlifS'_ "ST,~i~NG~'_T _ ,BGOoD •" 1, x_76_- ~D __ _ _~ _ 1st --- _ -- __ __ __ _ _ __ _ __ _ ___ _ S~lE_ _ ~Y~'~P/sES_ ~fD~ __ of ~3~P~.frt/~c' _^ _ 17 4~_~6 ~ 97 _ _ _ _ _ - - __ _ _ _ _ _ __ ~C~~~: _ _ ~ _ __ ~_~70, y7.?. 7~ _ _ __ 7~ T.!-~ = yy 9, 9 3G, 7 i _ REV-5500 EX Page 3 Decedent's Complete Address: File Number ~ `~ ~ 6 -' p ~ 7 HELEN ~. ~oTTc"~Z STREET ADDRESS TR~NE T 4. /l1~4 TTi A-S /6 8 LOCUST ~2ovE ~D•0~ CITY ~ ~ LLS~u~ ~ ~ STATE ~~ ZIP / 7019 - Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit ~ B. Prior Payments // _Y00 • pO C. Discount ~ (0 00 . °D - - _ - _ -- _ - - - -- - Total Credits (A + B + C ) 3. InterestlPenalty if applicable D. Interest ~ ___ -- - E. Penalty O Total Interest/Pena ty + 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (1) ~la2, I06. S~j (2) ~/2~ ODO • oO (3) ~ (4) ~ 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ .~D, /~ ••s9 A. Enter the interest on the tax due. (5A) ~~ f o~7L. 3G B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) ~ S 2~~ ~ .~ , q ~ 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 :.................................................................................... ...... ^ 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 payments, benefits or care? ................................................................ ...... ^ 2. 1f 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? ................................................................................................................. ....... ~ ^ 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. §9116 (a) (1.1} (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)j. 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 Juiy 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-hail (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA DEPARTrytENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: . `'.n . REV-1162 EX(11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 007518 MATTIAS JANET L 168 LOCUST GROVE ROAD DILLSBURG, PA 17019 ACN ASSESSMENT AMOUNT CONTROL NUMBER ~O~d ESTATE INFORMATION: ssrv: 122-o5-ass FILE NUMBER: 2106-0819 DECEDENT NAME: DOTTER HELEN C DATE OF PAYMENT: 1 2/ 06/ 2006 POSTMARK DATE: 1 2/06/2006 COUNTY: CUMBERLAND DATE OF DEATH: 09/09/2006 .101 ~ $1 1,400.00 TOTAL AMOUNT PAID: REMARf<S: SEAL CHECI<# 0994 INITIALS: MW RECEIVED BY: $1 1, 400.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER 'REV-tsaiEx.~t&~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE B STOCKS & BONDS ESTATE OF ~ 07~, f~Et.EN C. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM FILE NUMBER 2~-0~ -Big NUMBER DESCRIPTION ~' ?~ .Zn come t~td o >C ~rnerica ~ ~'. 11/a. ~ 005- if 759 -,bb b'', 6 9 Z. 11 s- 5~taneS ~ ' ~ 9. 5G doer S dare (see tia/uahon /eau- affz~h~Q/J 2. ~ssorfe~ sSliar~s o~ ~Dkl~Io~f sfmurC a r per Separt~e 5 '~Gitclule .Sett afi'~acl~e4! ~• ~ ~ 1 8W11k ~or~Tb~io /Trca~rfT~CC T3nnc1 /os{b~k r ncl ~" ~~ ~o• COI Dol 544 '~' H~s~rica~ f~"icir>q ~afit has peon re~uesfed {i-orrt i'~ ~ T ~rxirtk ~ iii cc 0 jib 1Qu Fi~a. ~v ~ N, }! C u. r ran t e5 ~7~rna~ i I~ b asea~ on besf es~irnate s {ron~ a t~rren>"'l y a/a~'1 ~.~6/a ~l G~4 d$ ~-PX G1 r S CU 5 S t vH Gu r ~+ Qa,w~ G7 r tae-.--~' on ~uC . ~f'i o~U ~ rT t jh~ Gf/P~ J~ !2o/~G4~ ~v/" C~R'!Q /L°Su ~~' in q~ G'shany~s ,ylo,~ ~ than "cue /Ylirl.iyl:s '' ih a rhou~rt, ~our~se~ a~ta~ ~7rc~ul%~ix w~// ~/c ~~ a~ena~a~ ~rh. VALUE AT DATE OF DEATH ~/ 7 0~ o / 7.7'7 ~ 19~~~76.31 has gas,a~ TOTAL (Also enter on tine 2, Recapitulation) I ~ 38'~ ~ ~ ~ Q (If more space is needed, insert additional sheets of the same size) erican Funds° CHARLES E SHIELDS III 6 CLOUSER RD MECHANICSBURG PA 17055-9735 Re: The Income Fund of America - A Account #6005-4759-06 HELEN C DOTTER Dear Mr. Shields: ~d lz~rtr~o~ American Funds Service Company Post Office Box 2280 Norfolk, Virginia 23501-2280 americanfunds.com December 13, 2006 We received an inquiry from you regarding the balance of account #6005-4759-06. Because the date you requested, September 09, 2006 was a Saturday, we are quoting the balance as of September 08, 2006 the preceding business day. The net asset value (NAV) was the same on that day. The table below reflects the share balance, per share NAV, and total value of the following account(s): Date Account Number Share Balance NAV Per Share Total Value September 08,2006 December 12, 2006 6005-4759-06 6005-4759-06 8692.115 8773.654 $19.56 $20.80 $170,017.77 $182,492.00 Mutual fund share prices vary with the fluctuations of financial market share prices. The prices of the funds are found in the financial pages of most metropolitan newspapers under American Funds in the Mutual Funds listings. The original investment was made August 20, 1993 for $45,000.00 into Cash Management Trust of America fund. It was dollar cost averaged over time into Income Fund of America where it remains today. There were no further investments made and so the difference is the growth on the investment. If you have any questions, please contact your financial adviser or call us at 800/421-0 l 80. You can reach one of our service representatives Monday tln-ough Friday between 8 a.m. and 8 p.m. Eastern time. You may also obtain account infornlation by visiting our website at www.americanfunds.com. Cordially, American Funds Service Company Enclosure The Capital Group Companies American Funds Capital Research and Management Capital International Capital Guardian Capital Bank and Trust ~, ~S T. pF' 1?o T f~~t' ~ h'Et E~/ C • r'/G E ND. Z/ DG -8/ 9 ~'' SToC.C' Sey~Du4c ~n~r~rtafio~I /Slot : ~cee~rnf ,~c/_ ___6cen_ a _,f~ia~hd/c~c~ pct vlc/ ~~t`~r~at`rA' fi T ~r ~ s~v~/~ wti ~ ~~ has ~cv~c 1~i~r ~1 f~ ~any_ ~ ~,sarys, ~ra~~ ~~9~s, ~-~ - e~~s~~~~ dohs, ~~~~s- i~ll~ _ )NC ~ ~~. ~t /~ SA'G~r Sl~c~ c~~t l.J'T~ ~l0lr/ GtS lr.~/~ i aS Rt11/ %~ei" S~~s ~ti~i.~i ~erc~~~~ DRirt cd 2~ ~c ~,nc _ __ __ _ _ _ __ _,_ /~// ay~t^a~ _valuU ass~y~r~d //Cr_ slate r. o6~inec~_ _ _ __ __ _ _ .T~t. frr~.r~____ ~~'1, _~/ .~~ ,~gf a~iofrr _.a~ Je~o1~ ~' ~rB/ _ . . ~retyj,_ _ ,!! /ues _ _ as. __ r~ ~~ls -. _ _ _ __ ~_l~~l~.,l_ _ l/G~/~__ d~~iil<9~ ____~1_ _.~li`too, ~i~~c~rc~o~ G%~/or _ _ __ ~ _ _ _ _ _ d.3 s~. ~i._sf,~ _ ave. fy ~~ _ ~33~6f~ ~.~.); /{~CQ~/--L.k.CC~1t Cusip._ _ 3~f(v0 ~`lOl~ l~~s!- ~eM._sf,~. avc. %/.8'S ~, yyS.7o ._ ~ x,37/ . sti• gym. Sf~f 4vC.•_ .3/. yY 7~',~y~{?y ~,Rn,eri~`trh { Sd C htG~ear' ink' itcaJ ~T~ % C'trCa /9q~) ~; ~U~/4 _ ~i~%f' ...053 y 59 a~P 74s1. C'~/~t• Stk lcve. ¢/o, loo ¢7~f2,o0 beeunre ~rurt' o1C astc/ r~t,~wr1 ~S l/er,"zany --o -- sce rf here~ti ok• _ _ _ _ _ C6.), /.3e1/ ~Svk11i Cus%~ 07.9~~v/oZ ~, ~~ ~ 5~, . ~~x• sff. avc, fy~ ~3 ~~f 8, I56, by Cz~ Co,~cast Wasp 315 Ski. CmA1. s~i~ aye. ~3X,' 7,~ ~l 3, 7 i 8: 3S SST o~- DOTTED, f/ELEn! (~, ), _ Z dears (vrrlZo~ _ Yella~_ ,/~a.ycs ~. _ ,Th. s l~zs , %r~ _~x. t`urce _ _ QS a -sp%~•bf~ BF_,!!Ekizo./ un~i%_ ~re Z _mos. Ql~c~. .L.a.~1. _ !T/<td ~c~c4~ `li- cl O.4~ l~`cl/,la/)GVl ~ i'E71lZ~N_ ,b~mrv _ ~ -- _ _ _ __ ~~J ~u~Lnf Tt~,np/o~:e _ _C'us~ S~9 4~63l07 _ o?/D,S~1• L~BYlI•_Sf/l. Lzve. ~~.,?l 5~'~7G.7c~ /off , ~!/u,~tcr~ _ ,~~nn~. /-~i~.m~um Vin. cent ,f1%I ccn, c~~a/ d ..Z _ r _.: Cus~,p- (v~7QG51y«~. lino-/~,~-rn~T- z) _ _ _ _ _ _ _ .. . ~ ~ _ _ _- .~_---_ Est? u~•'la_ _ _!ltvve..__ 13._34.___ ___ __ ___ . __ . _ _ _ _ __-_ __-____ ~,_ 3 5~7, o - fir/ 1~ _ _,~'J',~l/EX _ ~,t 3--_~-c~-u;,~e4!_.~ ~ . _,f..~// ~'f/ais~S~ ~~'~ - s~,~c~ _ __ _ __ __._ .!_6~cat~,. _~.r~._ ~-_~.~G!/~~an!~G-___~Vlii' 1_ ~'s _//_,~i1Bu_s~ _~s __ _ ___ _ ~: ~~R ~ zo,N -ca ._ ~i~)., Pa C ~~~-- _T less _1l~!~~a~~, liar%~us_ 4, v,;rons, nrx~ e/a~u~s _ _. _ .- .~ f ~, A'L°L'D~!.6i~14 ~o!_~s. _ _ ~s _..rtvw' ~tot~ _ ~,S ,¢ Ts ~ _ _ _ -~-,o '" _ _ _ ~3,J , __ ~~ _-._ _.~o~iim.~%ca.~~/u _ L5t3C 6mu~~~ .Q~ _Z~_ _ S~~-~~ _ _ _ . f~r"'s`T a-~/ _l~r~s _,Siit~e ~~~ ~r' dta.~rlc ~ ~ _Lc~rr~~ __ _- ~-Qbo~c l~~ ~T~ ~: ---- _~~~` _ _~ou~r_~!-n___1~1__ _,bec~e_-a ~~~~_ ~'__s~3c__ ~ ~is~e`u _ _ _ Lor~+~r-~__ Lug _~_ L't~.rr~rt~ /1~ir~. ~ ~ Tf T _"" ° . ~' ~ ~ ~, S: _ GL~sf i'?r~s_ Subs~r~ e~fly _ ~eame ~'u~ qs _ _ ~GIJc~ Co,~,~u~n- . %caT7 <r~S -~h~e,~`ra ha,~a/ ~tcs.~, 79`! !z/ /D.r?' ~r~,> , C~~ {~u'iZa,n ~llsi~ goZ3 513!/ /~~ 1i~ s~, Cv~. Stk Svc. 35, y~ l~Ol/a~nhC G',hr~u, p ,~L C 56 ~ sh. C'v~i, sf~ C~as i~o a/ 90 ~ 100 ~ ~~e. fa/. a7 a3, 9 9~. a~ ~3a, s3a, 9z ~~~ oft. 3 6 ~ 1 ~_~ 37(~.3t R'cV-0508 E%.~1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHRESIDENTDECEDENTRN PERSONAL PROPERTY ESTATE OF ~OTTL~2~ HEL~ to . FILE NUMBER ai -o~ - 8i 9 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ ~ PNC /~ CcnK ~SQV%nys sect. No. Soo 3 s3 yV~/ ~d o o s. a 7 .P 2, .ant accrued to d.a.a/, mry Z/e~ quo. / ~~~ oq Cse~ va.luah'oti let/'er of ~'NC /3an/l a 1`l`ac!•,~c/~ 3. /}') ~ T ~ank ~ow~ngS A-r-~#'• /~/o. DIS OoS~ 2oS 7'}0.697 ~3, 6 3Y. Z/ I.s~: a.ccrue~ ¢o d•o•d• oK Z,kyt Na.3 ~o.6D (see vQ/uaf~c~ /~1~" off' /!?s~T" /3a~rk ~tffircl:edJ ,3. Cifizt~S ~ank Cleek~ny ~~' No (o/d 67~{ ,,TS'~7 '~//~ 753. 9G 6. .Zn~ Gt ccrued ~ a~.o,d. d.s Z{rnitr No. S D. Do (sec ,va/ua~ioh /erY~r of L~.¢:zens ,~zr~ a~a~hc~J `7. '~.r.~-t~ al ~2e,~n d ~ C h u rc ~r d~ ~'soc~ f-l d vl7e, C ~.r'~ ~ s I G, ~R~ ~,~ no. o`I7132 ¢t 3Y~, o0 TOTAL (Also enter on line 5, Recapituiationj ~ $ ~ ~ ~ (~!~ g3 (It more space is needed, insert addiiional sheets of the same size) s ~~~~ i~ecemc,e~ ~'F. ~`0~5 C't~aries >~,. Shlelcis ill 6 Clouser Ftoae ~: >~siaie ~z liele~r C Goner, Cle:-;cas:.d Gear Shzeids~ iri 1'ZS~Oi`SC Fes` 1~~U;' TCQll~Si IO:r GaCd ()i G°~itl ~~:idr1C:=• for t13e GLISt.O:t1Cs`. TICt.~~. C7~1V1'C, l~Ut' ICGOr:jS ;;l'i4'v' ills I0110~'lil'~: ~CCOU::i -=>U~~::.~}~~i~! .C',.S"'.?}'!dS:I(; ` ilt `~ . '?OOl i. ~ ~. i - %GG balallcc: ~2s},SC5,C7 t °~! 7.0~% ace±r~cd irtere~;; w8S u:lable to locate 4 SaYr: r}:.~c~:;i~ Bo,: for the :i;.~ccient. T~1°%S: r10t;: `t"13~ ti'215 CIi:ICC OIt1V ~"Cii%I~c'S .n1.c~.s:; Vi dCai111Ja1a~--^_•e5 ICtii C1C?'1pSli ;3000311x1: 1,1~'.raS, CGS, C~htiCi:9:'l0 2I1Q ~•i~~'irl~ 2i.'.L'OUiltSj. ~+~'C' fCL 31+,Si ~iYi~iL~~ r~ge'+ ~1R31tSc~SBi $Y^aI75~C~iufiS i3' ~~f~~iclae s.a#e:rea~ts. II Yli~'! T1CCC 355lSLI1r1Ct ~K'iIr 221i' ~` Yhese lICtT'1S, plca3e Ca11 ~ -£$~-Pl~!C _~fi~~: ~, (-~so~-7l)%-^'~~c ; C):' STGt,'~ ~Jv VC~UI lOC~',~ `~N~.` L~i~Il1C C1.3.i~Ch Of*1ce. ~ - Sincerely. ~ } ~' Rrchelie ~~`eil P i -Pr SC-~=+-r J00 1ir;: ,4ve Pittr,hurGh PP, i _ ~; ~i i•eter:be; ^DiC' Q MBTBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 12/6/2006 Charles E Shields III Attorney At Law 6 Clouser Road Mechanicsburg, PA 17055 Ke: Estate of.' Helen C Dotter Social Security: 112-OS-4168 Date o~'Death: September 09. 2006 Dear Sir or Madam: Per your inquiry dated November 28, 2006, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Savings Account Account Number 015004205740697 Ownership (Names o~ Helen CDotter Opening Date OII29/04 Closed 12/05/06 Balance on Date of Death $3, 634.21 Accrued hzterest $ 0.60 Total $3, 634.81 Please be advised, there was no safe deposit box fom~d for the above decedent. * For. further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the Trindle Road Office # 717-737-2308. Sincerely, .~~~~~t- Nancy Clagett Records Management /,JaZ~ December 27, 2006 CHARLES E SHIELDS III 6 CLOUSER RD MECHANICSBURG PA 17055 Estate of HELEN C DOTTER Date of Death: Sep 09, 2006 SSN: 1 12-OS-4168 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pittsburbh, PA 15219 In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at I-800-708-6680. For all other inquiries, please call 888-999-6884 Sincerely, Pfeil, Marnie Operations Services CUSTOMER HAS A SD BOX # IS 000010420 OPENED 08/03/1998 `.., Account Number 6106742547 Account Title HELEN C DOTTER Date Opened 1/23/1975 Account Type Checking Principal Balance as of DOD $11753.96 Interest from Last Posting to DOD $ .00 Account Balance as of DOD X11753.96 YTD Interest to DOD ~ •0U Account Number 6140221404 Account Title HELEN C DOTTER JANET MATTIAS Date Opened 6/16/1997 Account Type Savings Principal Balance as of DOD $252.81 Interest from Last Posting to DOD $ .78 Account Balance as of DOD $253.59 YTD Interest to DOD $31.96 REVd505 EX+~i-97, SCHEDULE F COMMONWEALTH OF PENNSI ~VANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Da7'T~', f/EGF'N C 2/-06 -&/~ 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..J~N~ T L , iY1 ~4TYli4-~S /6 ~+' Lo C ~cSf Grove ~a~ ~i//sbu~~,o•¢ /90/9 F~;ena~ B. C. JOINTLY-OWNED PROPERTY: ITEM DUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed forjointly-held real estate. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A, b~/b~ C i fi x en s ~ain~ ~ra,v; h ~~ N'e ~: ~fo. 6 i~{ ozz /Ycy Prlpei/!q~ ~d, 55~. P/ i/? t: D, 78 ~~~ SS3. S9 .Sat ~ ;?7~0. ~D (see vR/aa /S'o,~ /e11`tr !c ~acl>fe~/ ~ SrleeQ! , E above. TOTAL (Also enter on line 6 kecapitulation) i ~ f ~ ~7(Q ~~ (If more space is needed, insert additional sheets of the same size) REV-1570 EX.(1-W) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER ~DoT?`Ei~, ~ICL~/I/ C . ~/-off - ~/y 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 NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTANOTHE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE 1. jrarls- /f/Xc,~/'%ca L~o~ Si~Suran~c f}n~u;7y ~' a6 /~0 7s3 $enG>Ci C i a~~ : ~sfr~ ~~ ~eeea/en~ -~• o- D. Ya/ua~on lvas o,6~.net/ by Coaas2/ ~y ,o6io~e G'a!l ~' ~yoh .TnveS~r~x~1~`s ~%s' ,g ~'-r~HiarzJ on ~t`. ~ , .Zoa ~ 6 7, ~ 9(~. SS :/oo ~a - o -- 6 7, ~ 96. S TOTAL (Also enter on line', Recapitulation} I $ ~ 7 ~9~, .,~,5 (If more space is needed, insert additional sheets of the same size) S EV-1511 EX+ (12-99) t SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ~o TT~e, ~E~EN C. a ~ - o~ - Fs/ 9 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: n ,. ~ ers ~u,rtcra~ ~hlnme o7- lY1ee~~,n~esbur~ fa7oD `/ B. ~ ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) T/4/~LCT L.. Ijftlr ~T~~.r ~(o'~,,,D~. ~¢ Social Security Number(ps)IEIN Number of Personal Representative(s) 036 - p~- dress ~bp LOC6lST G,Qp,~E iPDA~ City ~/LL.Sg/(/QG State _~,~ Zip /70 /4 Year(s) Commission Paid: 2. Attorney Fees Cy/¢IQL~ ~. e~/EI~S ~ ~/~/ 500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant ND/yF NDrYE Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees G,yd p(-j~i/IQ~I ~SSl~le v~ `S/ID'rr C~"7~ PC~TGS 9.500 5. Accountant's Fees ~LDy~ Ff}HNLCSTDCK rR. .fir CIoSCou.>L /o~fD, ~h~~ ~ 1 a.b0•vo 6. ~± ~/ Tax Return Preparer's Fees Q,{~ , OIaA~ '.t~P £StA~G 7~Q.Y`s~ ~ D 41~ j~/~ 41~ Q'~- ~ o0 3 25 ~. ~~%iA~ ~ , % 5'.DO 9 ~A~!/Erf%~si~4 in Curti gGJ~~ttylG7 ~/ ~~~`~~~ ~7 S. vo /o, ~f-a/der~iSiD~ %n ~ar/i~s/~ os~Ilfii7e~ #/© 7. 49 ~!, Lids 11T ~r aara~i~i~ona.~ RciM6krse/IJr~ to` G'ha~cS E Sh% X / 5~tert Ctrf;r~Ga~'ts See Coi1~iKKd fi'Ba s~ieet) 56. DD TQTAL (Also enter on line 9, Rscapituiatlon) (~ ,3 ~ ~ ra a, ~ ~ Itf more space is needed. insert additions! sheets of the same sizel ' SCHED. 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Serut ~/~/07 `4 ~i-»ker ~nrq~ iPe4~s/a~ Cnis~ ~~ll; 67 Cep f o . 3/ ' ~~ ~S o v SCE-/~cc~F a~ ~~i~E Cy~~~ _~~ G~TiZ~~r' ~.~v,~ /hoH~Y fyj~~KET ~O ~!.~T~ CH~-C/<<•i!G ~¢G~C'oG~iv T.r. 1, C~Ceck%r~~ _ ~7, ZS -?. /`~~E~y /yh P _ /G, an .3_ ; QQ „ ,, %. oo f ' " '~ ~/ ~ ,, .~ _ _ . ~ ~),j ~~ i~ f 6., o0 9, ~ ; ~, o0 __ _ _ _ _ __ _ /D• __ fG,vO _ __ ._ _ _ _ _ _ __ - ___ ~`.Da ~~ ~ n ii ~~e mac _ __ - _ _ __ [3,__ _ » b _ _ _ _ %.~ __. ,_ _ _ -_ _ _. __ __ _ _ _ ~9~zS -_ __ __ ___ RF~~_~~5? i r-Ya ~~ 2-r)31 i Y~ ~. ,a3 ! ~C~E~~~~ CCMIv10NWEALTH OF PENNSYUJANIA DEBTS ~~ OECE~ENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF ,~T,r~~, ~~,~ E,~ ~• FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) dEV-1513 E~C+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF f~ ~/ n FILE NUMBER ~J r p ~d7T~/ //~G/l~ G... OC ~T~ Os~p ~'lf ~ / RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distribuiions, and transfers under Sec. 9116 (a) (1.2)] 1. SUSa11 O1''QGh ~DBL.Of'e-~~ ,~wsbamds n~ec.G ~ 0 ~b ~Fo g8tl, R•ve. Nvr~h ~~. PGrersbw,~, FL 337oz, ~• ~ d war~I ~o'M'Gr SSY~ ~9fli /~+~e• Nvrf~a I•us~aotds rtyol~ /o fo oft /~eter~6yr~, FG 3 3 70 4 Caro/ ~3ender niece ~0 ~~ a8<OS C~jq~vk~i,n /hiSSion (/ie~o , CR 9.Z(o 9~ '~ f~G,n ryy sCj7l~tleifZe/' ~ ~ h GpJiew ~ ~o 3 3 bec~ ~/.%/ ~Pd. Gardner, /7~,¢ Dl4r~fd s; ~c~~fl Tobin s;sfrr 4~0 ~ , ~m0 I~lii Gr L/1. /{~vt, 3~.Z ~~ ~ ~~ O ~ O D~ ER R AM O U S F R R BUTTONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF ?ART II - Eh!TER TOTAL NOf~!-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ (If more space is needed, insert additional sheets of the same size)