HomeMy WebLinkAbout01-24-08 (2)
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REV-1500 EX (06-05)
P A Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
15056041158
~
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
21 07
File Number
0503
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
Date of Birth
195-38-9357
05062007
11011908
GIBSON
MARIE
MI
M
Decedent's Last Name
Suffix
Decedent's First Name
(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
[Kl 1 . Original Return
D 4. Limited Estate
[]] 6. Decedent Died Testate
(Attach Copy of Will)
o 9. Litigation Proceeds Received
Spousal Poverty Credit (date of death
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 DIRECTED TO:
Name Daytime Telephone Number
D 2.
04a.
D 7.
010.
Future Interest Compromise (date of
death after 12-12-82)
Decedent Maintained a Living Trust
(Attach Copy of Trust)
D
D
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
Supplemental Return
1- 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A)
BRIDGET M. WHITLEY, ESQUIRE
Firm Name (If Applicable)
717-233-1000
SKARLATOS & ZONARICH LLP
REGISTER <<.F'~S USE ONtl
~--.~ -~? ,
SIXTH FLOOR
r.)
First line of address
17 SOUTH SECOND STREET
.\
Second line of address
City or Post Office
State
ZIP Code
!fATE FILED
C'j
HARRISBURG
PA
17101
C det' '1 dd BMW@SKARLATOSZONARICH.COM
orrespon n s e-mal a ress:_
ES
~OHN H. GIBSON, JR.
GNATU~REP~R);.ER~ENTATlVE
ADDRESS vtrt
BRIDGET M. WHITLEY, ESQUIRE 17 S. 2ND
PLEASE USE ORIGINAL FORM ONLY
20 MOUNTAINVIEW DR., ENOLA, PA 1702
DATE I ., /
I V=:t-tJR
ST., 6TH FL., HBG., PA 17
Side 1
L
15056041158
6M4647 3.000
15056041158
....J
d,v
,
---I
15056042159
REV~1500 EX
Decedent's Social Security Number
195-38-9357
Decedent's Name:G I B SON MAR I E
RECAPITULATION
M
1 . Real estate (Schedule A) . 1.
69777.00
29784.00
0.00
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.
0.00
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E). . 5.
6. Jointly Owned Property (Schedule F) D Separate Billing Requested . 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested . 7.
64236.00
0.00
9. Funeral Expenses & Administrative Costs (Schedule H). . 9.
0.00
163797.00
9487.00
8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . 8.
11. Total Deductions (total Lines 9 & 10). . . . 11 .
1522.00
11009.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 10.
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.
152788.00
0.00
152788.00
14. Net Value Subject to Tax (Line 12 minus Line 13) 14.
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
1 5. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .orL 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .o'!5
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
0.00
15. 0.00
16. 6875.00
17. 0.00
18. 0.00
19. 6875.00
D
152788.00
0.00
19. TAX DUE . . . . . .
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042159
6M46482.oo0
15056042159
---.J
,
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENTS NAME
G S
STREET ADDRESS
File Number
0503
MARIE
M
CUMB
CITY
ENOLA
STATE
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
6875.00
0.00
5800.00
290.00
Total Credits (A + B + C) (2)
6090.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
0.00
Total Interest/Penalty (0 + E) (3)
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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
(5A)
785.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
785.00
0.00
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 payments, 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]
[K]
[K]
[K]
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.
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. 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.
6M4671 1.000
~EV-1502 EX + (&-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
Marie M. Gibson
21 07 0503
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 DESCRIPTION
NUMBER
1. Proceeds from sale of 401 Pitt Street, Cumberland County
VALUE AT DATE
OF DEATH
69,777
3W4695 1.000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
69,777
..
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Marie M. Gibson
21 07 0503
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.2,911.871 Shares
Vanguard GNMA Fund
Dividend accrued on 5/6/2007
DESCRIPTION
VALUE AT DATE
OF DEATH
29,759
25
3W4696 1.000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
29,784
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Marie M. Gibson
FILE NUMBER
21 07 0503
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
VALUE AT DATE
OF DEATH
1
PNC Bank Certificate of Deposit No. 31900029983
16,807
2
PNC Bank Certificate of Deposit No. 31100087496
Interest accrued to 5/6/2007
1,359
3
3
PNC Bank Checking Account No. 5140301481
Interest accrued to 5/6/2007
43,764
14
4
PNC Bank Safe Deposit Box 375 - Empty
o
5
Household goods and personal property
1,000
6
Capital Blue Cross - premium refund
135
7
Department of Revenue - 2006 Property Tax/Rent Rebate
500
8
Comcast Cable - refund
30
9
PSERS - Final Pension
624
3W46AD 1.000
TOTAL (Also enter on line 5. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
64,236
REV-1511 EX+ {10-06}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Marie M. Gibson
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
1. Church for funeral service
2
Soloist for Funeral
Total from continuation schedules
B. ADMINISTRATIVE COSTS:
1 . Personal Representative's Commissions
2.
Name of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
Attorney Fees
State
Zip
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
4.
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
5. Accountant's Fees
6.
7W46AG 1.000
Tax Return Preparer's Fees
7.
1
Randy Myers
Cumberland Law Journal - Estate Advertisement
2
State
Zip
Total from continuation schedules
FILE NUMBER
21 07 0503
TOT AL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
AMOUNT
500
100
6,870
5,900
302
900
40
75
2,270
9,487
Estate of: Marie M. Gibson
195-38-9357
Schedule H Part 1 (Page 2)
Item
No. Description
Amount
3 Sullivan Funeral Home, Inc.
6,870
Total (Carry forward to main schedule)
6,870
Estate of: Marie M. Gibson
195-38-9357
Schedule H Part 7 (Page 2)
3
Debbie LupoId - Real estate taxes
1,135
4
Register of Wills (Dauphin County) - Fee to
administer oath of office
20
5
The Sentinel - Estate Advertisement
167
6
Estate of Marie M. Gibson - Settlement charges
925
7
PNC Bank
Fee to replace safe deposit box key
15
8
Register of Wills
Additional short certificates
8
Total (Carry forward to main schedule)
2,270
Rt':V-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Marie M. Gibson
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 07 0503
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
1. Ki tner Brothers
2 Comcast Cable
3 PA American Water
4 Keystone Oil
5 East Pennsboro Township
6 Kinkora Pythian Home
7 PPL
8 PSERS
Return pension paYments made post-mortem
VALUE AT DATE
OF DEATH
360
60
74
188
115
25
115
585
3W46AH 2.000
TOT AL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1 522
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Marie M Gibson
NUMBER
I
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
John H. Gibson, Jr.
20 Mountain View Drive
Enola, PA 17025
0% of Residue: 50,929
2 Dennis F. Gibson
806 Chester Street
Enola, PA 17025
33.33%: 50,929
3 Anna V. Henry
55 Valley View Drive
Tolland, CT 06084
0% of Residue: 50,929
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
FILE NUMBER
21 07 0503
AMOUNT OR SHARE
OF ESTATE
Son
Son
Daughter
50,929
50,929
50,929
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
\I NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46AI 1.000
TOT AL OF PART \I - 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)
$
o
ESTATE OF MARIE M. GIBSON
FILE NO. 2207 - 21-07-0503
INHERITANCE TAX RETURN - SCHEDULE A
/'.
OMS NO 2
o
~
502- 265 ,r-
A. B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.DFHA 2.DFmHA 3.I!ICONV. UNINS. 4.DVA 5.0CONV. INS.
6. FILE NUMBER: I 7. LOAN NUMBER:
. SETTLEMENT STATEMENT r.An07 tl.Ofi
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "[Pac]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1.0 3198 (CAD07 406. PFD/CAD07 406/6)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
LEHMAN INVESTMENTS, LLC ESTATE OF MARIE M. GIBSON
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1638737 I. SETTLEMENT DATE:
401 PITT STREET CRAIG A. DIEHL, ESQUIRE
ENOLA, PA17025 November 16, 2007
CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT
3464 TRINDLE ROAD
CAMP HILL, PA 17011
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100 GROSS AMllUN DUE FROM d.OO GROSS AMOUNT nilE TO ~J:ll J:Q.
101. Contract Sales Price 69,000.00 401. Contract Sales Price 69,000.00
102. Personal Property 402. Personal Property
103. Settlement Charges to Borrower (Line 1400) 1,203.50 403.
104. Payoff 1 st Mortqaqe 404.
105. 405.
A' f-or ItAm.t:: Prlid Rv- Seller in ~rl"~~M . ~rl;1 ,,,,trn~nt,,, For Items Paid Bv Seller in advance
106. CityfTown Taxes to 406. CitvfTown Taxes to
107. County Taxes 11/16/07 to 12/31/07 32.06 407. County Taxes 11/16/07 to 12/31/07 32.06
108. School Taxes 11/16/07 to 06/30/08 546.00 408. School Taxes 11/16/07 to 06/30/08 546.00
109. Sewer/Refuse 11/16/07 to 01/01/08 57.50 409. Sewer/Refuse 11/16/07 to 01/01/08 57.50
110. Keystone Oil Service Agmt 141.03 410. Keystone Oil Service Aqmt 141.03
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 70,980.09 420. GROSS AMOUNT DUE TO SELLER 69,776.59
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or earnest money 100.00 501. Excess Deposit (See Instructions)
202. Principal Amount of New Loan(s) 502. Settlement Charges to Seller (Line 1400) 825.00
203. ExistinQ loan(s) taken subiect to 503. Existinq loan(s) taken subiect to
204. 504. Payoff of first Mortgage
205. 505. Payoff of se9Qnd_Mortqaqe
206. 506. Deposit retained by seller 100.00
207. 507.
208. 508. .
209. Closing Costs Paid By Seller 509. Closinq Costs Paid By Seller
Adiustments For Items Unoaid Bv Seller Adiustments For Items Unoaid Bv Seller
210. CitylTown Taxes to 510. CityfTown Taxes to
211. County Taxes to 511. County Taxes to
212. School Taxes to 512. School Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 100.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 925.00
300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower (Line 120) 70,980.09 601. Gross Amount Due To Seller (Line 420) 69,776.59
302. Less Amount Paid By/For Borrower (Line 220) ( 100.00) 602. Less Reductions Due Seller (Line 520) ( 925.00
303. CASH ( X FROM, ~( TO) BaR )WER 70,880.09 603. CASH ( X TO) ( FROM) SELLER 68,851.59
The undersigned here ~:n:o:er ~ceipt of a completed copy of pages 1 &2 of this statement & rN..ts r~ herein.
Borrower } C\\~ .L -- Seller. . ~
LEHMAN INVE: MENTS, LLC _"n-..: ~STATE OF MARIE M. GIBSON
f}
Paae 2
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price !t. @ Gin PAID FROM PAID FROM
Division of Commission (line 700) as Follows: BORROWER'S SELLER'S
701. $. to FUNDS AT FUNDS AT
702.$ to SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement
704. to
800. ITEMS PAYABLE IN CONNECT!ON W!TH LOAN
801. Loan Oriqination Fee % to
802. Loan Discount % to
803. Appraisal Fee to
804. Credit Report to
805. Lender's Inspection Fee to
806. Mortqaqe Ins. App. Fee to
807. Assumption Fee to
808.
809.
810.
811.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCI=
901. Interest From to @ $ /day ( days %)
902. MIP Totlns. for lifeOfLoan for months to
903. Hazard Insurance Premium for 1.0 years to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance months @ $ oer month
1002. Mortqaqe Insurance months @ $ per month
1003. CitvfTown Taxes months @ $ oer month
1004. County Taxes months @ $ per month
1005. School Taxes months @ $ per month
1006. months .~ $ per month
1007. months @ $ per month
1008. months @ $ per month
1100. TITLE CHARGES
1101. Title Search to TRI COUNTY ABSTRACT 135.00
1102. Attornev Certificate of Title to CRAIG A. DIEHL, ESQUIRE 340.00
1103. Wire Fee to
1104. Courier Fee to
1105. Deed Preparation to SKARLATOS & ZONARICH, LLP 125.00
1106. Notarv Fees to LACY JAY 5.00
1107. Electronic Document Prep to
(includes above item numbers: )
1108. Title Insurance to
{includes above item numbers: }
1109. Lender's Coverage $
1110. Owner's Coverage $
1111.
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 38.50; Mortgage $ Releases $ 38.50
1202. City/County Tax/Stamps: Deed . MortqaQe
1203. State Tax/Stamps: Revenue Stamps 1,380.00; Mortqaqe 690.00 690.00
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302. Pest Inspection to
1303. Tax Certification Fee to STEPHANIE M. RIDER 5.00
1304. .
1305.
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 1,203.50 825.00
By signing page 1 of this statement. the signatories acknowledge receipt of a completed copy of page 2 of this two page statement.
Certified to be a true copy.
~ a rkLl,,),j 5, yy....
CRAIG A. 01 L, ESQUIRE
(CAD07406/CAD07406/6 )
ESTATE OF MARIE M. GIBSON
FILE NO. 2207 - 21-07-0503
INHERITANCE TAX RETURN - SCHEDULE B
Marie M. Gibson
401 Pitt St
Enola, PA 17025-2234
'VanguardfS
tt.PQFtf()t()5/()6/~()07
Client Services: 800-662-2739
Total report value:
(Total report value includes any accrued dividends.)
Marie M. Gibson - Individual Account
Account value.summary
Name
Fund & Account Date
Number Opened Shares
0036-09885263115 03/04/1993 2,911.871
Totals
GNMA Fund Investor Shares
* Doesn't include accrued dividends.
** As of the prior business date, 05/04/2007, since the report date is a nonbusiness day.
Price Per
Share'"
$10.22
Value*
$29,759.32
$29,759.32
Page 1 of 1
$29,784.29
Accrued
Dividends
$24.97
$24.97
036804263207/20/200714:03:37
ESTATE OF MARIE M. GIBSON
FILE NO. 2207 - 21-07-0503
INHERITANCE TAX RETURN - SCHEDULE E
~-21-2007 17:47
PNCBANK
412 768 3458
P.01/04
~ PNCBAN<
June 21, 2007
Bridget M. \Vhjdey
Skarlatos & Zonarich Building
17 South Second Street, 6th Floor
Ramsburg, PA 17101-2039
RE: Estate of Marie M. Gibson, deceased
SSN: 195-38-9357
noD: 5/<>/2007
Dear Ms. Whitley~
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Certificates of Deposit
Account #31900029983
Established 03/06/1996
MARIE M GIBSON
DOD balance: $16,807.36 + $0.00 accrued interest
Interest Paid 1/112007 - 5/6/2007 - $220.95
Account #3 I 100087496
Established 05109/1997
MARIE M OmSON
DOD balance: $1,359.06 + $3.13 accrued interest
Interest Paid 1/1/2007 - 5/6/2007 - $13.92
CheckiDg Atcount
Account #5140301481
Established 07/01/1978
MARIE M GIBSON OR
JOHN H GmSON
DDD balance: $43,764.16 + $13.76 accrued interest
Interest Paid 1/1/2007 - 5/612007 . $28.95
Sale Deposit Box
#375
Established 03/08/1987
MARIEMGIBSON
Page 1 of2
JL.N-21-2007 17: 47
PNCBANK
412 768 3458
P.02/04
Located:
ENOLA BRANCH
235 NORTH ENOLA ROAD
ENOLA, P A 17025
(717) 732-5388
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts ). We do aot proeess any financial
trauaetioDs or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely, , . ~
@)~ LV
Rachel1e Wells
1-800-762-1775
P1-PFSC-04-F
SOO fU'st Ave.
Pittsburgh P A 15219
Page 2 of2
Member IDle
REV-485EX+ i3'l41 .
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
SAFE DEPOSIT BOX
INVENTORY
Please Print or Type
MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS
COUNTY CODE FILE NUMBER
21 07 -0503
DECEDENT'S NAME (LAST, FIRST, MIDDLE)
GIBSON, MARIE M
ADDRESS OF DECEDENT (STREET) (CITY)
401 Pitt St Enola
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
(NAME)
John H. Gibson
(STREET NAME)
20 Mountain View Drive
DATE OF DEATH
05/06/2007
SOCIAL SECURITY (ReQuired) OR DEATH CERTIFICATE NUMBER Conlv If SSN is unknown)
195-38-9357
(STATE)
PA
(CITY)
Enola
(STATE)
PA
NAME, ADDRESS AND RELAT!ON!HIP (I~ A.NY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
(ZIP CODE)
17025
(ZIP CODE)
17025
a. (NAME) (RELATIONSHIP)
John H. Gibson Son
(STREET NAME) (CITY) (STATE) (ZIP CODE)
20 Mountain View Drive Enola PA 17025
b. (NAME) (RELATIONSHIP)
Bridget M. Whitley None
(STREET NAME) (CITY) (STATE) (ZIP CODE)
17 S. 2nd St., 6th Floor Harrisburg PA 17101
c. (NAME) (RELATIONSHIP)
(STREET NAME) (CITY) (STATE) (ZIP CODE)
· NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
(NAME)
PNC Bank
(STREET NAME)
235 North Enola Road
(CITY) (STATE)
Enola PA
DATE AND TIME OF LAST ENTRY
3/6/19863:33 pm
· nTLE UNDER WHICH BOX IS REQUESTED
Marie M. Gibson
I NAME OF PERSON MAKING LAST ENTRY
John H. Gibson
DATE OF CONTRACT TO RENT BOX NUMBER OF BOX
03/06/1986 375
NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX
a. (NAME)
John H. Gibson
(STREET ADDRESS)
20 Mountain View Drive
(CITY) (STATE)
Enola PA
NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY
Bridget M. Whitley, Esq., attorney for Estate
b. (NAME)
-
(STREET ADDRESS)
(ZIP CODE)
17025
(STATE)
(CITY)
'.~ ,,~:.._:~,~.~ ,~);:: ~:J)LLcC'ft(:,:,~~)
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~J\i1HiSSVf'~ uiS~R1Cl{0RaE
WAS A W1U IN THE BOX? 0 YES iJ NO If yes, s. Date of will:
b. Name and address of persona' representative, If named In the will
(NAME)
(STREET NAME)
(CITY)
C. Name and address of attorney. If any
(NAME)
(STREET NAME)
(CITY)
(STATE)
(ZIP CODE)
17025
(ZIP CODE)
(ZIP CODE)
(ZIP CODE)
INSTRUCTIONS
The Department is authorized under federal law , 42 U.S.C. 9 405(c), to use the decedent's Social Security number in
administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and
ensure proper credit for tax payments.
(1) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be
designated by name of company, certificate number, date of certificate, name in which stock is registered, and
number of shares and class of stock.
(3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and
type of ownership, Le., jointly held, payable on death, etc.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book,
name of bank and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.
(7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully
as possible.
(8) All other contents.
ITEM ITEM DESCRIPTION
NO.
Nothing - box empty
'.
I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF
CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY:
SIGNA~ dA' 1i~ SIGNATURE
/' 'd ~J>k ',j~nJO
PRINT NAME (.I (/ PRINT NAME AND CHECK APPROPRIATE BOX BELOW:
Bridget M. Whitley, Esq. John H. Gibson, Executor
PRINT TITlE DATE CHECK APPROPRIATE BOX:
Attorney 07/31/2007 \jG Executor(trix) o Administrator(trix)
o Estate Representative o Joint owner of safe deposit box
SAFE DEPOSIT BOX INVENTORY Page
of 1
NOTE: Attach additional 81/2" x 11" sheet(s) if necessary or use duplicates of this page of form.
ESTATE OF MARIE M. GIBSON
FILE NO. 2207 - 21-07-0503
INHERITANCE TAX RETURN
LAST WILL AND TEST AMENT
SKARLATOS &: ZONARJrCH LLP
ATTORNEYS AT LAW
17 S. SECOND STREET, 6TH FLOOR
HARRISBURG, PENNSYLVANIA 17101
(717) 233-1000
WILL
I, Marie M. Gibson, of Enola, East Pennsboro Township,
Cumberland County, Pennsylvania, 17025, declare this to be my last
will and revoke any Will or Codicil previously made by me.
ITEM I. I give all my automobiles, and all other articles
of personal and household use, together with all insurance relating
thereto, in equal shares, to my children, John H. Gibson, Jr., Anna
J. Henry, and Dennis F. Gibson, if they survive me by thirty days.
If any of my children do not so survive me, then that child's share
shall be added to the share or shares for my other children.
ITEM II.
I give all the residue of my estate, real and
personal, to my children, John H. Gibson, Jr., Anna J. Henry, a~d
Dennis F. Gibson, provided that they survive me by thirty (30)
days; if any child does not so survive me, then that child's share
shall be added "to the share or shares for my other children.
ITEM III.
No interest in income or principal shall be
assignable by, or available to, anyone having a claim against a
beneficiary before actual payment to the beneficiary.
ITEM IV. My personal representative, hereinafter named, is
directed to pay all my just debts, funeral and testamentary
Page 1 of 5 pages
stater and other death taxes payable on the property
\
-;;:"-" ~--:-.----:--'-- _.~--:-:-:-:-:-~~--_............-~-~---.._~-
-J&':'t':\" " t
expenses r including taxes r out of the~\pr;ntf'12
',,"~'r::,~'~f:tl~f+ '
estate as soon after my death as may be practicable
gross estate for tax purposes, whether or not it passes under this
Willr shall be paid out of the principal of my residuary estate
just as if they were my debts, and none of those taxes shall be
charged against any beneficiary.
ITEM V. I authorize my executor:
A. to retain and to invest in all forms of real and
personal property, regardless of (i) any limitations imposed by law
on investments by executors or trusteesr (ii) any principle of law
concerning delegation of investment responsibility by executors or
trustees, or (iii) any principle of law concerning investment
-diversification;
B. to compromise claims and to abandon any property
whichr in my executorr s opinionr is of little or no value; to
borrow fromr and to sell property to others r and to pledge property
as security for repayment of any funds borrowed;
c. to sell at public or private saler to exchange or
to lease for any period of time any real or personal propertYr and
to give options for sales or leases;
Page 2 of 5 pages
. .
D. to join in any merger, reorganization,
\
""",~~,,,...,,,,,,~"~T~-~~
plan or other concerted action of security holders, and
discretionary duties with respect thereto;
E. to use administrative or other expenses of my estate
as income tax or estate tax deductions and to value my estate for
tax purposes by any optional method permitted by the law in force
when I die, without requiring adj ustments between income and
principal for any resulting effect on income or estate taxes; and
F. to distribute IN KIND and to allocate specific
assets among the beneficiaries in such proportions as my executor
may think best, so long as the total market value of any
beneficiary's share is not affected by such allocation.
These authorities shall extend to all real and personal
property at any time held by my executor and shall continue in full
force until the actual distribution of all such property.
All powers, authorities, and discretion granted by this
Will shall be in addition to those granted by law and shall be
exercisable without leave of court.
ITEM VI.
I appoint my son, John H. Gibson, Jr., executor
under this Will.
Should my son, John H. Gibson, Jr., fail to
qualify or cease to act as executor, I appoint my son, Dennis F.
Page 3 of 5 pages
. .
\
~"". r
_....',.~., ...~
Gibson, executor under this will.
No personal representative
appointed hereunder shall be required to give bond or furnish
sureties in any jurisdiction.
ITEM VI I.
The term "executor" or any pronoun used to
indicate the executor, any other fiduciary or any beneficiary shall
be deemed to apply to one or more than one person or corporation
and to the masculine, feminine or neuter gender as the case may be.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my Last Will, this ~~n& day of September, 1997.
7Jt . JHd~
~. T'b
MarJ.e M. GJ. son
(SEAL)
SIGNED, SEALED, PUBLISHED, and DECLARED by the above
testator, as and for her Last Will, in the presence of us, who
thereupon at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
g)/i #/1-
,-.sIL'J>i. 0< ~.#:.
Page 4 of 5 pages
\
s:
OF DAUPHIN
We, Marie M. Gibson, &erwt\..s. 'l? _..s"'PQLL~,,.. , and
...s:~A..,.o-v-... L. SYn~t::i-... , the testatrix andJ::r witnesses,
respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the
undersigned authority that the testatrix signed and executed the
instrument as her Last will and that she had signed willingly and
that she executed it as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence
and hearing of the testatrix, signed the will as witness and that
to the best of our knowledge, the testatrix was at that time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
111 /Df~ ~ Vi~
Marie M. Ginson
q;)z1((J .
Wit:"ness { 1'1--
~O<~
Witness
SUBSCRIBED, sworn to or affirmed, and acknowledged before me
by the above-named testator and by the witnesses whose names appear
above on 5~p-l~......\y~r 22"'d , 1997.
~i%c!~J
Nota Pu ic
My Commission Expires:
fYJ/q/ /, 2tJOO
'--' E. ~ ,., Nic
My ~~~=-:! 2000
......, ....... .... ", IatIriIs
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