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Home My WebLink About02-07-08 --.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue . Bureau of Individual Taxes PO BOX 280601 ~ Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number d ( DK! G7ql Date of Birth 160-16-2298 08/18/2007 06/03/1919 Decedent's Last Name Suffix Decedent's First Name MI Kisner Charles E (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 OVALS BELOW .' 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy ofTrust) 10. Spousal Poverty Credit (date of death 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 DIRECTED TO: Name Daytime Telephone Number 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received .0. 8. Total Number of Safe Deposit Boxes William C. Dissinger Firm Name (If Applicable) Dissinger & Dissinger First line of address (717) 957-3474 REGISTER OF WILLS U~9NLY ..... -' q -...\ I I ~-:J 400 South State Road I -..l Second line of address City or Post Office Marysville State ZIP Code " ~~'Jt;~~lLED -.\ N PA 17053 ---.-, ~~,,, ( .) \...:~) Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, includin9 accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE . ..... '-~fJ---~ - /.?II? Y ADDRESS _202 N-,-~~nt ~_tr:.~et, WOl"..mleysbur~,-~~_17043 SIGNATURE OF PRE PARER OTHER THAN REPRES IVE . DATE ADDRESS 400 South State Road, Marysville, PA 17053 PLEASE USE ORIGINAL FORM ONLY .2/7 /Dd Side 1 L 15056051058 15056051058 --.J Cj --.J 15056052059 REV-1500 EX Decedent's Name: Charles E Kisner 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) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. 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_ 16. Amount of Line 14 taxable at lineal rate X.O 45 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. 434,495.08 16. 0.00 17. 0.00 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 160-16-2298 Decedent's Social Security Number 50,940.00 106,181.23 0.00 144,000.00 17,166.93 154,486.01 0.00 472,774.17 38,255.84 23.25 38,279.09 434,495.08 0.00 434,495.08 0.00 19,552.28 0.00 0.00 19,552.28 15056052059 -.J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Charles STREET ADDRESS 200 North Front Street DECEDENTS SOCIAL SECURITY NUMBER 160-16-2298 E Kisner CITY Wormleysburg STATE PA ZIP 17043 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 19,552.28 0.00 - - ---------..-.---- 18,281.74 -----------.-.-- 962.20 Total Credits ( A + 8 + C ) (2) 19,243.94 3. InteresUPenalty if applicable D. Interest E. Penalty 0.00 0.00 TotallnteresUPenalty ( D + E ) (3) 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. (4) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 0.00 0.00 308.34 0.00 308.34 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. 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;.......................................................................................... D 00 b. retain the right to designate who shall use the property transferred or its income; ............................................ D 00 c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D !iJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D 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. 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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 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. REV-1502 EX+ (6-9W COMMONIM::ALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Charles E. Kisner FILE NUMBER 21-07-0791 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Real estate located at 311 3rd St., East Pennsboro Twp, West Fairview, PA, sold at public VALUE AT DATE OF DEATH 27,000.00 auction November 3, 2007. (Cumberland County Deed Book C24, Page 656) 2. Real estate with garage located at 301 N. Enola Dr., Enola, PA (Cumberland County Deed Book R23, Page 773) Assessed value. 23,940.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert addKional sheets of the same size) 50,940.00 REV-1503 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Charles E. Kisner FILE NUMBER 21-07-0791 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Metlife 63 shares at $62.88/share 3,961.44 2. 11 Series EE Savings Bonds (face value $75.00 each) date of death value 1,838.94 3. CTI Smith Barney Account #724-07071-12400 100,380.85 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 106,181.23 REV-1507 EX+ (6-98) SCHEDULE D MORTGAGES & NOTES RECEIVABLE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E. Kisner FILE NUMBER 21-07-1791 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. Note between Susan L. Stuart and Charles E. Kisner executed March 9, 2006. VALUE AT DATE OF DEATH 144,000.00 TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 144,000.00 REV-1508 EX+ (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Charles E. Kisner FILE NUMBER 21-07-0791 Include the proceeds of I~igation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 . Personal property sold at auction 8,709.00 2. Cash 4,500.00 3. Refund from Farmers Insurance 106.38 4. 1995 Chevrolet Pick-up truck 3,420.00 5. Additional personal property sold at auction (household goods) 211.00 6. Hammond organ (sold privately) 220.55 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert add~ional sheets of the same size) 17,166.93 REV-1509 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E. Kisner SCHEDULE F JOINTlY-OWNED PROPERTY FILE NUMBER 21-07-0791 SURVIVING JOINT TENANT(S) NAME If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. RELATIONSHIP TO DECEDENT A. Susan L. Stuart B. C. JOINTLY.OWNED PROPERTY: ADDRESS 202 North Front Street Wormleysburg, PA 17043 Daughter LETTER OATE DESCRIPTION OF PROPERTY % OF OATE OF DEATH ITEM FOR JOINT MAOE INCLUOE NAME OF FINANCIAL INSTITUTION AND 8ANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH OECO'S VALUE OF NUMBER TENANT JOINT IOENTIFYING NUM8ER. ATTACH OEEO FOR JOINTLY-HELO REAL ESTATE, VALUE OF ASSET INTEREST OECEOENT'S INTEREST 1. A. 08/25/01 Belce Credit Union Acct #766518 5,879.79 50 2,939.90 2. A. 05/04/04 Sovereign Bank Ace! #1051084741 3,283.66 50 1,641.83 3. A. 01/ /0 I Evergreen Investments Acet #1005946719 92,347.70 50 46,173,85 4. A. y/ ;)..'i5jcb PNC Bank Acet #3898186 108,026.79 50 54,01340 5. A. 1/11 /O'L PNC Bank Ace! #51-4011-1944 21,577.85 50 10,788.93 6. A. ~ I;. &'/o~ PNC Bank Acct #50-D450-8373 77,856.20 50 38,928.10 TOTAL (Also enter on line 6, Recapitulation) $ 154,486.01 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Charles E. Kisner FILE NUMBER 21-07-0791 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. AMOUNT B. 1. 10. 11. 12. DESCRIPTION 1. FUNERAL EXPENSES: Sullivan Funeral Home (cremation and services) Sullivan Funeral Home (Obituary) Stone Church Cemetery (open/close grave) Center Street Grill (luncheon after service) Payment to Pastor for graveside services 4,000.00 206.00 360.00 375.30 200.00 2. 3. 4. 5. ADMINISTRATIVE COSTS: Personal Representative's Commissions 0.00 Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City . State Zip Year(s) Commission Paid: 2. Attorney Fees 28,366.45 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00 Claimant Street Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 372.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. Costs of Auctions (Little Ike Eichelberger $3,690.31 AND Cindy Fenton, Auctioneer $84.40) PennDOT (cost to transfer truck) Advertising (estate notice) Associated Products (port-a-potty rental for auction) Ibis Appraisal services Check fee (Additional deposit slips) 3,774.71 109.15 191.06 99.22 . 180.00 21.95 8. 9. 38,255.84 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1512 EX. (12-03) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E. Kisner FILE NUMBER 21-07-0791 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Davis Pulmonary Association (final office visit) 23.25 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 23.25 REV-1513 EX+ (9-00) .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Charles E Kisner SCHEDULE J BENEFICIARIES FILE NUMBER 21-07-0791 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (al (1.2)] 1. Susan L. Stuart, 202 N. Front St., Wormleysburg, PA 17043 Daughter 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) \. ~ ~ LAST WILL AND TESTAMENT OF CHARLES E. KISNER I, Charles E. Kisner, of 200 North Front Street, Wormleysburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. ITEM I. I direct that all my debts and funeral expenses, including my cemetery lot and grave marker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my death as part of the expense of the administration of my estate. ~ ~ ITEM II. I devise and bequeath all of my estate of every nature and wherever situate to Susan Stuart. ITEM III. I direct that any and all Inheritance, Estate Transfer taxes imposed upon my estate passing under my Will or otherwise, shall be paid out of the principal of my residual estate. I I and I appoint Susan Stuart, Executrix of this my Last J:-\relieY:!=!It\~. '. J.C,\\f:rorn the necessity of , oi{'::'~h ,Zduties as such in any upon to act. i~ IN WITNESS WHEREOF, I have hereunto set my hand to this my Last will and Testament, which consists of ~ page~, to each of which I have affixed my signature this . ~/~f day of (LLL9Li\-t two thousand six (2006). vf ~ /,:' - &:? a,iz1c~ / ~'ILC-'0 Charles E. Kisner , I "',~ COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF PERRY We, Charles E. Kisner, and I.l rLL~CI')C. '6/~/ljC;fr' , ...., respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes __so u :5 (;.J7 L. ~~h l Ci ~.-t testator and the and the witnesses therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as witness and that to the best of their knowledge the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. J j<V1"\...L/L-) ~/Gq?J Witness Subscribed and sworn to and acknowledged before me by Charles E. Kisner, Testator and subscribed and sworn to and acknowledged before me by ,,'>u.....'Jl.nL....... -Sf-U__Ci vi- , and a )( 1-)/(1/,/7 C"/:y,(.'//.1((f,- , wi tnesses this '- :':'/::'1- day of -' (Lu.(/i J t , 2006. (J ,/0~! ~~1 . ";I . , . (' ')- ~1/1/,/.rrJ ". /" , /lv__ICf/f v]/I, ( , Ll .< i ;' Notary( Public) ~- 11M...... ...., IIUIIIc r........tc>>a UII""" CQNY .., eonw.-.........Oct 11, .. , I , i. II -10- c.......... -....;.;",. ;;:: 0 55 (/) c;;~ ~ w::;o>z ~f=~=1G) ~..mc:~m b:~:tffi:::O ~~~~Qo ~~~~g ""'!:ems;:(/) ~ )> :;0 ::;: (/) ~~o Z :::E; G) .... rn ~ ;0 (J :r: :l::' ::tl t'" t;Ij en ~ . :;.:: H en Z t;Ij ::tl .. ~- ""to, ~ ~ - 11 Nortll 3rd Street, 2nd Floor I 180 1700 Strawberry Square F 717 233 2090 Harrisburg, PA 17101 Toll Free 8002371700 ,,-... smith barney October 9, 2007 William C. Dissinger Dissinger and Dissinger 400 South State Rd. Marysville P A 17053 Re: Estate Charles E. Kisner Date of Death: 8/18/07 Dear Mr. Dissinger: This letter is in response to your request regarding date of death values on Charles E. Kisner's account with us. The information is as follows: 1. Registered owner: Charles E. Kisner 2. Account established: 07/02/2002 3. No ownership changes Values on securities are as follows: Amount Description Price 8/18/07 Value 6,229.58 Bank deposit program 1.00 6,229.58 94 AT&T Inc 38.76 3,643.44 293 Comcast Corp 25.14 7,366.02 - 100 Harsco 51.87 5,187.00 80 ldearc 31.84 2,547.20 30 LSI Corp 6.24 187.20 1,616 Verizon Communications 41.04 66,320.64 181 Wachovia 49.17 8,899.77 i I TOTAL I I 100,380.85 I Should you require additional information please let me know. -fa Ie Koons ., Business Development Assoc. ..~ ,~ ., ,. ..... /dak ,. cc: Sue Stuart Citigroup Global Mar~ets Inc " ~ ~ .'" a .", ~ : 0;' "';J> m s ~ ~. ~ -- VI ri" ..... t;~ zoo ~ ~o ~ ;;;: ~-< .... ~ ~ ~ Iq - ~~ ,... ~ 01 G'J ~ ~ ~ ~ ~ :: ~ ., &. g a j:;: ~., ii . il 1=" ~- ~["l~2~ .. 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V1 o N l;J N ~Q ~~ ::~ -< r:; . w :~ g~ ......~ c:s ~ ~ -... ~ ~ t:b c8~ ~g g,-'" en ~ ~ 5' Serllor Premium Plan Af PNC Bank 'unt Statement o PNCBANK For the period 08/18/2007 to 07/17/2007 Primary account number: 51-4011-1944 Page 1 of 3 Number of enclosures: 0 L CHARLES E KISNER SUSAN L STUART 200 N FRONT ST WORMLEYSBURG PA 17043-1111 S For 24-hour banking, and transaction or interest rate information, sign on to !t PNC Bank Online Banking at pnc.com. For customer service call1-888-PNC-BANK between the hours of 6 AM and Midnight ET. M Para servicio en espar'iol, 1-866-HOLA-PNC Moving? Please contact us at 1-888-PNC-BANK 8 Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 Q Visit us at pnc.com I TDDterminal: 1-800-531-1648 For hearing impaired cJi.."t., only Senior Premium Plan Intereat Checking Account Summary Account number: 51-4011-1944 Charles E Kisner Susan L Stuart Balance Summary Average monthly balance 21,683.25 Endi ng balance P ~ase see the Activity Detail section for ad~itional information. Beginning balance 22,365.85 Deposits and other additions 234.48 Checks and other deductions 1,022.48 Transaction Summary Checks paid/ withdrawals Check Card P~S signed transactions Check Card/Bankcard P~S PIN transactions 7 o o Total ATM transactions PNC Bank A TM transactions Other Bank ATM transactions o o o Interest Summary Annual Percentage Yield Earned (APYE) Number.of days in interest period Average collected balance for APYE Interest Paid this period As of 07/17, a total of $65.87 in interest was paid this year. 0.50% 32 21,671.53 9.48 Activity Detail Deposits and Other Ad,Jitions Date Amount ~scrlPtion 07/03 225.00 v I;>eposit Reference No 07/] 7 9.48 vfnterest Payment 025104511 There were 2 Deposits and Other Additions totaling $234.48. Checks and Substitute Checks Check Date number Amount;" paid 1 D62 .1li2.68'/ /06/] 9 ] 96,~ 100.00 II' Oli/20 I 96'1 I 00.00.1 Ot~/ 19 I D66 * 100.00 VI 06/27 Reference number 0&1506976 025015fi98 026348050 02'1790903 Check number 1967 19G8 1969 Amount 100.00 a/ !'iO.OO........ 9.80 v" Date paid 07/06 07/0(1 07/17 Reference number 02!8:i!ili98 (}2.!G9liO 10 02770Gli28 ~.. mRM953R.1005 emi~ Plan Account Sta C Wealtll Management ment o PNC"BANl< For the period 08/2812007 to 07/25/2007 Primary account number: 50-0450-8373 Page 1 of 2 Number of enclosures: 0 CHARLES E KISNER SUSAN L STUART 200 N FRONT ST WORMLEYSBURG PA 17043-1111 Q For 24-hour banking, and transaction or interest rate information, sign on to 'It PNC Bank Online Banking at pnc.com. For customer service call 1-888-762-6226 between the hours of 6 AM and Midnight ET. Moving' Please contact us at 1-888-762-6226 12!33 Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 Q Visit us at pnc.com I TOO terminal: 1-800-531-1648 For hearing impaired client> only ~remium Plan ~remium Money Market Account SumRlary \ccount number: 50-0450-8373 Charles E Kisner Susan L Stuart Average monthly balance 74,272.94 Please see the Activity Detail section for additional information. Deposits and ther additions 57,359.85 Checks and other deductions 1,800.00 rransaction Summary Checks paid! withdrawals Check Card POS signed transactions o o Total ATM transactions PNC Bank ATM transactions Other Bank A TM transactions o o o Annual Percentage Yield Earned (APYE) Number of days in interest peri ad Average collected balance for APYE Interest Paid this period As of 07/25, a total of $527.7t in interest was paid this year. Interest Summary 3.32% 30 74,133.54 199.18 Acdvity Detail Depoaite and Other Additions Date Amount gescription 06/28 52,878.35 v'peposit Reference No 06/28 4,282.32 /Deposit Reference No 07/25 199.18/1nterest Payment 024286742 024287554 PAA~ ~ M-w m>J.-r There were 3 Deposits and Other Additions totaling $57,359.85. Checks and Substitute C~CkS Check Date number Amount paid 1,800.00 07/03 Reference number 025104514 ~ There is 1 check listed totaling $t,800.00. FORM953R-l005 .......', ... Premiwn Plan Account ~tatement ILl For 24-hour information. sign on to PNC Bank Online Banking ~ on pnc.com. Account numher: 50-0450-8373 - continued Daily Balance Detail Balance 22,296.35 Date 06/26 Date 06/28 Balance 79,457.02 o PNCBAN< 040 32ND STREET BRANCH (106) 1400 CAMP HILL SHOPPING MALL CAMP HILL PA 1701' Cashbox 07 AM * Deposit Check 13:38 JUN 28 2007 Account Number Tran Amount XXXXXX8373 $52,878.35 W/S 10 WWSH1061 Sequence Number 00018 Batch 401 This deposit or payMent is ~cePted SUbje~t to verification and to the rul, and regulatIons of this bank. DepOSits lay nol be available for I..edlete wlthdrewel. Rec~Pt should be held until verified with your ~ate.ent. For the period 08/28/2007 to 07/25/2007 CHARLES E KISNER Primary account number: 50-0450-8373 Page 2 of 2 Date 07/03 Balance 77,657.02 Date 07/25 Balance 77,856.20 o PNCBAN< 040 32NO STREET BRANCH (106) 1400 CAMP HILL SHOPPING MALL CAMP HILL PA 17011 Cashbox 05 AM * Depos it Mu 1t i 13:43 Account Number Tran Amount Cash Amount Tran JUN 28 2007 XXXXXX8373 $4,282.32 $0.00 W/S 10 WWSH1064 Sequence Number 00176 Batch 301 Thl s deposit or paYlllent I s accepted subject to verification and to the rules end regulations of this bank, Deposits lIIay not be available for immediate withdrawel. Receipt should be held until verified with your stlltelllent. , "- 9/20/200709:2914 AM 83981867 - KISNER CHARLES E Account Workbook Account Info Page: 1 8398-1867 NPOA CHARLES E KISNER AND SUSAN L STUART JT TEN WROS 10 CSt MMF Home A 4C FMM 717/221-8201 MMF Bal 3,994.24 Total Acct Val Funds Available 108,994.24 3,994.24 J CHARLES E KISNER AND SUSAN L STUART JT TEN WROS 200 N FRONT ST WORMLEYSBURG PA 17043-1111 Auto MMF Sweep - All Types Primary MMF - FMM Proxy Disclosure Network Eligible - 3 ACH Deposits MAN ACH Withdrawals MAN Mgmt Group - OMNI Statement Code - S Dividend Reinvest - N Cash Inst Divd Inst Invest Obj Institution Street Name-Hold/Hold Funds Hold Funds A Joint Account Taxpayer Id 160-16-2298 W9 Form On File Open Date 04/27/2006 SEPL20/2007/THU 02:09 PM 1"\ 0fl/'i -:, UUL ESTATE OF CHARLES E. KISNER (000 VALUATION AUGUST 18,2007) The information provided in this report is believed to be reliable, but its accuracy cannot be guaranteed. A mean price is calculated as an average of the high and low on the valuation date when available. If these prices are not available, such as on weekends or holidays, the mean price is the inversely weighted average of the high and Iowan the nearest trading dates before and after, when these prices are available within one week of the valuation date. If actual trades are not available, the nearest bid and ask prices are substituted. Note that securities traded on the Toronto Exchange are in Canadian dollars. If an equity is ex-dividend for a cash distribution on or before the valuation date but is of record after the valuation date, the dividend is'included in the val'uation report and is added to the security's value. This is reported as an adjusted value on the report. If the date of death is on or after the record date and the dividend is payable after that date, the accrued dividend is listed separately on the report and added to the portfolio's total value. Prices for which daily updates are not available are priced according to a Corporate Pricing Cy.c1e. These pricing dates occur on the last business day of the week, and the last business day of the month, unless the end of the week update falls within three business days or less, of theend-of-month update. Prepared: 20 September 2007 c T:'p 12 "/2" " 7/"'crU :) 1'.. to U l- G 1 t. - 02: 1 C PM Estate Valuation Date of Death: OS/18/2007 Valuation Date: OS/lS/2007 P~ocossing Date: 0~/20/2007 Shares or Pal' Security Deecdpt10n High/AsIC 1) 50000 AIMBANK LItTLEFIELD TBX (00aa9WABS) Financial Timee Interactive Data DTD: 05/11/200? Wac: 05/09/200S 5% 08/1.7/2007 08/20/2007 Int: oa/09/2007 to oa/18/2007 55000 PACIFIC CONTL'BK EUGENE ORE (69413CAR5) Financial Times Interacti~e Data DrO: 05/18/2007 Mat, 05/16/2008 5.05% 08/17/2007 08/20/2007 Int; 08/16/2007 to 08/18/2007 3296.02 MONEY MARKET FUND (EVP01) 08/18/2007 1. 00000 2) 3) Total Value; Total Accrual: Total, $108,026.79 LOW/Bid 99.65625 A/P, 99.6'5220 Mkt 99.68750 A/B 99.678S0 Mkt J..OOOOO P. 003 Estate of; CHARLES E. ItISN5R Account: 63981867 R.eport Typo: Date of neatb Number of Securities: 3 rUe IV: KISNER, CHARLES Mean and/or Div and Int Security Adjustments Accruals value 99.654225 49,S27.11 62.50 99.6S3150 54,825.73 15.43 1.000000 3,296.02 $107,948.86 $77.93 pa.ge ,1 This report was produced with ~stateVal, a product of Bstate Valuations ~ Pricing Systems, Inc. If you have questions, pleaso'contact BV~ SY$t~a at (elS) 313-6300. O~ ~.evpsys.com. (Revision 7.0.4) , . -' . . AT 02 109384037398467 A**3DGT I" .111".111." .1"1,, 11,".11" ,1111.11, 1,1111." 11'"1..111 WANDA L KISNER CHARLES E KISNER SUSAN L STUART JTWROS 200 N FRONT ST WORMLEYSBURG PA 17043-1111 VJI Your Portfolio Value as of 06/30/2007 Change Opening Value Additions $92,347.70 This Quarter Year-to-date $92,718.93 0.00 0.00 1,312.52 -1,683.75 $92.347.70 $91,136.08 0.00 0.00 2,641.47 -1,429.85 $92.347.70 + Withdrawals + Reinvested Income +/ - Change in Value Closing Value Learn More The most current information for all Evergreen funds can be found at Evergreenlnvestments.com under the Fund Performance tab. Visit the Web site to check the performance of your investments, keep track of market trends, and learn more about the products and services that can help you reach your financial goals. Allocation Below you will find your current investments and the percentage that each represents in your Evergreen portfolio. Asset Category Total Assets Percent FIXED INCOME FUNDS $92,347.70 100.0% April 1, 2007 - June 30, 2007 Page 1 of 3 Contact Information f) G o Call Us 1-800-343-2898 Visit us online www.Evergreenlnvestments.com Rep Name/Rep Number Robert Teague/Q42 Your Financial Advisor CUNA BROKERAGE SERVICES ClO HARRISBURG BELCO FCU 403 N 2ND ST HARRISBURG PA 17101-1343 Help on the Web Calculate your future EvergreenInvestments.com offers planning calculators that can help answer important questions about managing your money. The calculators are designed to assist you when planning for your financial future. You can review the result') with your financial advisor to help develop a customized investment plan that meets your goals. Planning calculators cover such topics as asset allocation, retirement = planning, and women and investing, and = can be found on the Evergreen Web site under the Investing Essentials tab. = - - - - - - - - - Asset allocation is a diversification strategy used to determine the blend of stocks, bonds, and cash appropriate for your investment goals and risk tolerance. You should work with your financial advisor to develop an asset allocation plan. Need a financial advisor? Evergreen can help. Contact us at 1-800-343-2898 or visit Evergreenlnvestments.com. 77756 1/2 o Evergreen Investments" www.Evergreenlnvestments.com 12 ~ Evergreen Investments Quart,. '~y Statement. .. , April 1. 2007 - June 30. 2007 Page 2 of 3 Evergreen Express Line: Call 1-800-346-3858 Evergreen's Express Line olTers automated account infonnation 24 hours a day, 7 days a week by touch-tone telephone. 1 , 1 I T -1 1 Fund prices and Account Performance Information and Statements lI'Iatchlist Instructions Year-End Information Transaction Information Press #1 Press #2 Press #3 Press #4 Access the most recent price, yield, total return and dividend/capital gains distributions for individual funds, or for funds on your watchlist. Obtain balance and performance information in your account and/or portfolio. Review and/or process financial transaction. Order an eccount statement or a checkbook (if applicable). Keep track of all the funds you own by keeping a walchlistthat allows you to check prices, yield and total return for any Evergreen Fund. Press #5 Press #6 Obtain mailing instructions, wiring instructions or the fund's Internet address. Get alllhe information you need for year-end tax purposes; your year-end account balances, dividend and capital gain distribution and ordering duplicate lax forms. At an time Press: How to Reach Evergreen Investments: "0 To reach a Client ServIces Representative "1 To return to the main menu "2 To return to the previous menu "3 To enter a different Social Security Number "4 To update your Personalldentiflcation Number "5 To hear a tutorial on special features By Phone Client Services 1-800-343-2898 8am-6pm Eastern time, Monday-Friday . To request account investments or redemptions with Evergreen Express Line, you must first authorize Evergreen to transfer funds on your behalf by completing a direct deposit application. The direct deposit application can be obtained from our web site at Ever ",reenlnvestments.com TTY Line 1-800-343-2888 8am-6pm Eastern time, Monday-Friday By Mail Evergreen Service Company P.O. Box 8400 Boston, MA 02266-8400 (Express, certified or registered mail) Evergreen Service Company 30 Dan Road Canton, MA 02021-2809 VERIFICATION OF ACCOUNT STATEMENTS: If you have any questions about this statement or about specific transactions, call us at 1-800-343-2898. This account statement reflects financial transactions for the period indicated. Carefully review all of the information to verify the accuracy of the transactions. Please notify us immediately if there is an error. If you fail to notify us of an error within 60 days of the transaction, each transaction will be deemed accurate. Data is historical. Past performance is not a guarantee of future results. More recent returns may be more or less than those shown. Investment return and principal value will fluctuate, and you may have a gain or loss when you sell your shares. To obtain performance information current to the most recent month end, please go to Evergreenlnvestments.comlfundperformance. Investments in stocks, bonds and mutual funds: NOT FDIC INSURED I NOT BANK GUARANTEED I MAY LOSE VALUE Evergreen Investments Management Company, LLC is a subsidiary of Wachovia Corporation and is an affiliate of Wachovia Corporation's other Broker Dealer subsidiaries Evergreen mutual funds are distributed by Evergreen Investment Services, Inc. 200 Berkeley Street, Boston, MA 02116. INVESTMENT INSTRUCTIONS: . Make your check payable to the Evergreen fund of your choice . Please be sure to include your account number on the ~hp.~k Mail your check and investment instructions to: Evergreen SelVice Company P.O. Box 8400 Boston, MA 02266-8400 e Evergreen Investments' www.Evergreenlnvestments.com . nC::T 11487.3 (6107) ~ c" . . April 1,2007 - June 30,2007 Non-Retirement Account Activity Page 3 of 3 Registration WANDA L KISNER CHARLES E KISNER SUSAN L STUART JTWROS Account Number Income Summary Year-to-Date Distribution 1005946719 Dividends Short Term Cap Gains Long Term Cap Gains Total Beginning Value Reinvested Change Fund Summary as of 0410112007 Additions Withdrawals Income in Value Diversified Bond-A $92,718.93 $0.00 $0.00 $1,312.52 -$1,683.75 Total $92,718.93 $0.00 $0.00 $1,312.52 -$1,683.75 Diversified Bond-A Share Number of Fund Number 645 Date Transaction Description Amount Price Shares Ticker Symbol EKDLX Opening Balance $92,718.93 Share Balance 6,521.730 Share Price $14.16 04/30/2007 Div Reinvest 440.66 14.45 30.496 Closing Value $92,347.70 05/31/2007 Div Reinvest 449.46 14.26 31.519 06/29/2007 Div Reinvest 422.40 14.16 29.831 $0.00 $0.00 $0.00 $0.00 Ending Value as of 06/3012007 $92,347.70 $92,347.70 Share Balance Investment News Distributions paid by Evergreen Diversified Bond Fund on April 2, 2007 on all classes of shares were comprised in total of approximately H6.5% net investment income and B.5% paid-in capital. Distributions paid by Evergreen Diversified Bond Fund on May ], 2007 on all classes of shares were comprised in total of approximately 88.7% net investment income and 113% paid-in capital. Distributions paid by Evergreen Diversified Bond Fund on June 1, 2007 on all classes of shares were comprised in total of approximately 88.5% net investment income and 11.5% paid-in capital. These amounts are computed on a financial statement basis and are informational only and do not impact a shareholder's income tax reporting. Information regarding the final tax character of distributions will be provided to shareholders Oil Form 1099. Distributions p:lid from financial statement paid-in capital do not "f'fed the lotal rdurn of the Fund. 7i7~f1 ;: 2 o Evergreen Investments'. www.Evergreenlnvestments.com 6,429.884 6,460.380 6,491.899 6,521.730 - - - - - -- -- - - - - - = t Sovereign Bank STATEMENT OF ACCOUNTS C' 1-877-SQV-BANK (1-877-768-2265) www.soverelgnbank.com statement PerIod 01/14/07 TO 07/15/07 TM SOVII8IGN ON! ACCOUNT THE SOVE::REICN ONE ACCOUNT ',' ,r c: ):,-'~ r 'I i,"! "1 ': ,.7 '17 1 -:; [17 CHARLES E KISNER SUSAN L STUART Account # 1051084741 Balances $6.86 Paid last Year $522.29 III - ill ill iiI - II - - ~ ==- ~ iiiiliiilliiiii -=- = - .. - !!III i!IIi ~ !ii!!iIII!! Deposits/Credits + $6.85 Average Daily Balance $3,945.22 Interest Earned this Period P8lfJE~T~;\;"':'\,~',.0ii&rti;"t~:':t;4t',~;;,i "'The interest earned and the interest paid may differ depending on when interest is credited to your account. ,~ ( \. Checks Posted Check tI Date Paid Amount Reference # ~ Check. # DatePald Amou(1t Reference # ~~~ 1 Check(s) Posted = $397.00 An asterisk (*) indicates a skip in sequential check numbers which may be caused by one of the following: . A check not yet received · A check that was converted to an electronic transaction, which will be listed in the "Electronic Checks Posted" section below. If no checks were electronicalty converted. this section win not appear. Account Activity Date Description Beginning Balance Additions Subtractions Balance / $4,180.94t/ ""'~~'"' ~~:~~~.i~~:::~~~~~;}t~~i:if.:~."~.Jf $~190. 79 (C~'Y INTEREST CREDIT EndIng Balance , , page 3 of4 /05/08474/ r.D~MONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIvIDUAL TAXES DEPT. 280601 HARRIS8URG. PA 17128-0601 - INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0791 07146870 11-02-2007 REV.lS43 EX AFP (09.00) EST. OF CHARLES E KISNER S.S. NO. 160-16-2298 DATE OF DEATH 08-18-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [i] CHECKING o TRUST o CERTIF. SUSAN L STUART 202 N FRONT ST WORMLEYSBURG PA 17043 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Departllent with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent. you were a joint owner/beneficiary of this account. If you feel this information is incorrect. please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions Ilay be answered by calling (717) 787-8~27. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1051084741 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART ill Date 05-04-2004 Established To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". 3,283.66 X 50.000 1,641.83 X .15 246.27 TAXPAYER RESPONSE NOTE: If tax paYllents are made within three (3) months of the decedent's date of death. you may deduct a 5X discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. A. 0 The above inforllation and tax due is correct. 1. You Ilay choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY 8. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. ~The above inforllation is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 3'2--'i(~. ~~ 5ll% Jlf;o../-/. ~3 PART ~ TAX If you indicate a different tax rate. please state your relationship to decedent: PA- Ul# H--r €--t LINE 1- Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART [!] DATE PAID 6 7 X 8 /(;L/f, $'3 ()Lf~ 13. y<)( AND to 'I f1 AMOUNT PAID PAYEE Jf DEBTS 3. 70, I DEDUCTIONS CLAIMED t;>ISUUN-J S "I,; DESCR I PTI ON TOTAL (Enter on Line 5 of Tax Computation) $ declare that the facts have reported above are true, cor~ct and and belief. HOME ( 117 ) 1{P~-L/tJ(j0 WORK ( 1 ('7 ) ~2 {/ f2d/ Ii/<I/d .-, TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA OF~ARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 .* INFORMATION NOT1~E AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0791 07147592 11-05-2007 REV-1543 EX AFP <09-DO) EST. OF CHARLES E KISNER 5.5. NO. 160-16-2298 DATE OF DEATH 08-18-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS o CHECK I NG o TRUST o CERTIF. SUSAN L STUART 202 N FRONT ST WORMLEYSBURG PA 17043 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BELCO COMMUNITY CU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent. you were a joint owner/beneficiary of this account. If you feel this information is incorrect. please obtain written correction from the financial institution. attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Com~onwealth of Pennsylvania. Questions may be answered by calling (717) .787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 766518 Date 08-29-2001 Established To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 5,879.79 X 50.000 2,939.90 X .045 132.30 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the t's date of death, you may deduct a 5Y. disco t of the tax due. Any inheritance ax u will become delinquent nine (9) months after the date of death. PART [!] A. ~ The 1. above information and tax due is correct. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "AU and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK] ONE BLOCK ONLY B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. c. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. X /3..).3& fA. ~ I I :? 5". (09 DEBTS AND DEDUCTIONS CLAIMED (5d1 ) PART ~ TAX If you indicate a different tax rate. p~se state your relationship to decedent: nA1J~H-r RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE I . Date Established 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 e. Tax Due e PART @] DATE PAID PAYEE X DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ of perjury, I declare that the facts my knowledge and belief. have reported above are true, correct HOME (1/1 ) 1~3-LfOO~ WORK (1n) 2-2/- Y~'I TFI FPHnNF NIIMRFR and 11/ {p/Q? nATF COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RECEIVED FROM: REV-1162 EX(11-961 NO. CD 008931 STUART SUSAN 202 NORTH FRONT WORMLEYSBURG, PA 17043 ACN ASSESSMENT CONTROL NUMBER -------~ fold 07147592 ESTATE INFORMATION: SSN: 160-16-2298 FILE NUMBER: 2107-0791 DECEDENT NAME: KISNER CHARLES E DA TE OF PAYMENT: 11/08/2007 POSTMARK DATE: 11/07/2007 COUNTY: CUMBERLAND DATE OF DEATH: 08/18/2007 TOTAL AMOUNT PAID: REMARKS: SUSAN STUART CHECK# 209 INITIALS: WZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS SEAL TAXPAYER AMOUNT I 1 I I I I I I I $125.69 $125.69 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128.0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RECEIVED FROM: REV.1162 EX(l '.961 NO. CD 008942 STUART SUSAN 202 NORTH FRONT WORMLEYSBURG, PA 17043 ACN ASSESSMENT CONTROL NUMBER - ~ - ~ - -, tolli 07146870 ESTATE INFORMATION: SSN: 160.16.2298 FILE NUMBER: 2107-0791 DECEDENT NAME: KISNER CHARLES E DA TE OF PAYMENT: 11/09/2007 POSTMARK DATE: 11/05/2007 COUNTY: CUMBERLAND DATE OF DEATH: 08/18/2007 TOTAL AMOUNT PAID: REMARKS: CHECK# 07146870 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS SEAL TAXPAYER AMOUNT I \ I I I I \ I I $70.19 $70.19 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-15~B EX AFP (06-05) SUSAN L STUART 202 N FRONT ST WORMLEYSBURG PA 17043 DATE 01-14-2008 ESTATE OF KISNER CHARLES E DATE OF DEATH 08-18-2007 FILE NUMBER 21 07-0791 COUNTY CUMBERLAND SSN/DC 160-16-2298 ACN 07147592 APPEAL DATE: 03-14-2008 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REV=is4S-EX-AFP-C03=OSj-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 01-14-2008 ESTATE OF KISNER CHARLES E DATE OF DEATH 08-18-2007 COUNTY CUMBERLAND FILE NO. 21 07-0791 TAX RETURN WAS: S.S/D.C. NO. 160-16-2298 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 07147592 FINANCIAL INSTITUTION: BELCO COMMUNITY CU ACCOUNT NO. 766518 TYPE OF ACCOUNT: DATE ESTABLISHED ~ )SAVINGS () CHECKING ()TRUST ()TIME CERTIFICATE 08-29-2001 Account Balance Percent Taxable Amount Subject t~ Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X 5,879.79 0.500 2,939.90 .00 2,939.90 .45 132.30 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPP~R pnRTIO~ OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT DATE 11-07-2007 RECEIPT NUMBER CD008931 DISCOUNT (+) INTEREST/PEN PAID (-) 6.62 AMOUNT PAID 125.69 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRJ. YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TI-lT~ FnD" "nD T""TDlI"'T'"..~ , 132.31 .OlCR .00 .OlCR