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Home My WebLink About03-14-08 " . -.J 15056041147 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX.280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY . County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 21 07 0618 Date of Birth 553760602 06192007 05091946 Decedent's Last Name Suffix Decedent's First Name MI PARK BARRY L (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 181 1. Original Return 0 2. Supplemental Return 0 4. Limited Estate 0 4a. Future Interest Compromise (dale of death after 12-12-82) 181 6. Decedent Died Testate 0 7. Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) 0 9. Litigation Proceeds Received 0 1 0 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) .CORRESPONDENT . THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number TERRENCE J. KERWIN, ESQUIRE 7173623215 Firm Name (If Applicable) KERWIN & KERWIN -. ) ... ., ., ,-. REGISTER OF WILLS USE<ONLY C,l . I First line of address 4245 ROUTE 209 Second line of address ~..:;~ City or Post Office State DATE FILED r r; ELIZABETHVILLE PA ZIP Code 17023 Correspondent's e-mail address:kk@kerwin1awfirm.com 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 pre parer has any knowledge. /,;;~URE OF PERSO SPONS LE F,OR FILING RETURN ~ DATE , ::/<. Peggy A. Kreiser .J ESS 3958 Lexington Street, Harrisburg, PA 17109 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE "?v: Terrence J. Kerwin, Esquire ADDRESS 4245 Route 209, Side 1 L 15056041147 15056041147 -.JC1J --.J 15056042148 REV-1500 EX Decedent's Narre: PARK, BARRY L. 553760602 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) 0 Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 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, of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 65,640.66 16. 750.00 17. 18. 19. Tax Due..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. L Side2 15056042148 Decedent's Social Security Number 304,606.28 7,103.37 11,000.00 59,040.66 381,750.31 10,416.00 304,943.65 315,359.65 66,390.66 66,390.66 2,953.83 90.00 3,043.83 D 15056042148 --.J . REV-1500 EX Page 3 Decedent's Complete Address: I .-"5 NAME Park, Barry L. STREET ADDRESS 6 Tommy lane File Number 21 - 07 - 0618 CITY Enola I STATE PA IZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 3,043.83 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 0.00 TotallnteresVPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) (5) 3,043.83 (5A) (58) 3,043.83 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;.................................................................................. b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary interest; or....... .............................................. ...... ........ .................... ........................... d. receive the promise for life of either 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?............................................. ......................................................................... Yes o o o o o o No [!] [!] [!] [!] [!] [!] 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?......... ............................................................................................................ [!] 0 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 retum 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. *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. FILE NUMBER 21 - 07 - 0618 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 VALUE AT DATE OF DEATH 119,840.00 Real property located at 45 S. 24th Street, Pen brook Borough, Dauphin County, Parcel #49-010-015. Assessed value is $85,600 times common level ratio factor of 1.40 equals fair market value of $119,840.00 2 Real property located at 6 Tommy Lane, East Pennsboro Township, Cumberland County, Parcel #09-15-1288-314. Sold on November 9,2007. Gross amount due Estate on Line 420 of HUD-1 was $184,766.28. (See settlement charges and pay-offs on Schedule I of this return) 184,766.28 TOTAL (Also enter on Line 1, Recapitulation) 304,606.28 ~ . Dauphin County Summary . Dauphin County Parcel Info Summary Printable Tab Residential Commercial Land Sales History Image Assessments Neighborhood Sales Sea rch By Property 10 Owner Street Address Deed Reference Site Functions Login/Logout Property Search Appeal Form Subscription On-Line Help Contact Us Home Page 1 of2 Site Provided by... governmax.com Tl.11 1~1~I~l~l~ Owner 1 of 1 Property ID Address 490100150000000 45 5 24TH ST Index Order Owner Card 1 of 1 Valuation Summary Property ID 490100150000000 Assessed Value $85,600.00 Property Address 45 5 24TH ST Owner Name and Mailing Address Owner Address Deed Reference 2525 1095 PARK BARRY L 6 TOMMY LN ENOLA PA 17025 Details Municipality 49 PEN BROOK BORa Sq Ft Finished Living Area 2149 Neighborhood 49002 ELM WALNUT Year Built 1904 School District 22140 Central Dauphin Story Height 2 Use Code R11 Apartments - 4 or less Units Bedrooms 4 Zone R2 Residential multifamily Full Baths 1 Property Type 2 Residential Half Baths 1 Heating 2 Forced Air/Cental Basement Garage 0 Air Condo NO FirePlace(s) 0 Clean and Green No http;//www.dauphinpropertyinfo.org/propertymaxlagency /dauphinldauphin tab gassessme... 6/27/2007 Previous oditions are obsolele form HUO.' (3196) mf Hundb:-ok 4305.2 A. Settlement Statement U.S. Department of Housin9 and Urban Development B. Tvn~ nf' nan I 7. Loan NLUnber I 8. Mortgage Insuranee Case Number I. DFHA 2. OFmHA J. DConv. Unins. I 6. File Number 4. nVA , nr~v In. S 1 00-6Q9 C. Note: This 101m is tJmished to give you. staI.....m of -=tu8/ HttIement costs. Amounts paid to.OO by the seWement agent ara shown. I TJ1leExpress Settlement Systam Items marteed 1p.o.c.f....~ p-'d o..aide the oosing; they... IhOwn '*'- for inlonna1ion purpo..s If'ld an not ndudecl in lne total&. WARNING: II is . aim. to knowingty m'" taI_ alIKaments to ~ Unitedl ~ on ttU?r any other simil8!' form.. Plf\llltiM upon D. NAME OF BORROWER: Donald L. Walde and Linda M. Walde A""D~... 1023 Teakwood Lane Eoola PA 17025 E. NAME OF SELLER: The Estate of Barry L. Park '''''01'..' F. NAME OF LENDER: Orrstown Bank , ""0"... P.O Roy 2~0 ~hinnen.hur" PA 17257 G. PROPERTY ADDRESS: 6 Tommy Lane, Enola, PA 17025 P... . ~. wn<hin H, SETTLEMENT AGENT: P A Real Estate Settlement Services, LLC -. 354 A '"y.nrie . d Ste "'...1:"4 DA '701'; , 11 tn'mo07 .J 'OFBO , TlON' K SUMMARY OF ~E' I i=R'S TRANSACTION: Inn 40n. r,R()~~ AM()I INT "'IE T() ~FII FR .n. 183 SOO,OO An< 183 500.00 . no P_~.I p,..- ..no .~ 5 135.01 An. 'n.4 AnA ,n. ..n. r . I .nv~""" s nol" ~'I seller in advance 'OR ,no j n7 "n"",,, ,"".. 11/09/07 On 12/31/07 75.66 ,n' "~,",,, I..... 11/09/07 '" 12/31/07 75.66 1 nR ""hnnI 1.._ 11/09/07'^06/30/08 1 162.69 .onR ""'nol..._ 11/09/07 In 06/30/08 1 162. 69 .no .ono ,n 27.93 Hn 0_ ""u". 27.93 111 .." l' 41' 1?r> t:1'>()~" 6O.'()I'1\IT ""F I=Rm.. B()RR()IM'R 189 901.29 AOr> t:R()~~ AMOUNT Dl'F T() ~~, , ~~ 184 766.28 ,nn RM REDLJCTl E TO SI=LLER "" 2 000.00 .nl On? On? -... un", 12 185.60 ,n, '''' On.4 "".. 125 916.02 Citimortaaae 7n< 16 601. 29 'n.< 28 629.84 Orrstown Bank HFC 'M ROO On7 on, on. .n. 7nO <no , unn~irl hv ...11 "hv .. "n <1n " 1 "nun", ,"".. ." ^. ',0 ""hnn".... .. 0 Schanlt..., ", <1, ", .U 71< ... "0 '1' 717 <<7 71. ". ',0 ". ?On T()TAI 18 601. 29 "n TnTA RF"IIr.T'()'" A"'()I'I\IT 166 731. 46 ~M FR()M Ann R FR"M SF" 1= .n. ,,~.. 189 901.29 0'" ^ 184 766.28 .no 18 601. 29 On? .onn' 166 731.46 ~n~. r.A 171 300.00 ~m 1=1'> 18 034.82 :~::~~E~~~~O~~~ST~l~~~~~I===-:~i~::=~~~inf~;'::~det-:'~~~~=kJ~ =d~~~~~:d=l~de8 reun, line 401 above CONtituCts thl GRlN PfOCI.ds Of Ilis lranMdion. =,r~=~.1~1O~U;==:=S\~X~I:~ Un<lerpenaltiuot~~t:~;rr:I:~~:-=r\~~"::~~:Omynot~~yef~~:r-~~-::~ TIN:_"_"_I_-_-_ SElLER(S)SlGNATVRE(S): SElLER(SI NEW UAlLJNG ADDRESS: SElLEA:($) PHONE NUMBERS: (H) (Wl 900/S001l'l t>EEL6HLlL X1!.. U :;:1 nld: LOO<:l60111 ~reVIOl;S edl!IOns ale Obsolete U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: 5100.699 form HUD.l (:!J96) ref HDndoook .4305,2 PAGE 2 SETTLEMEI\''', STA 11=MI=I\IT _.. - .~.~ L. S"TIL"MENT "'HAR""" PAID FROM PAID FROM 700 TOTAL S '~'''''''O '/"I" .j.... <183 500.00 ~ 5.000 - 9 175.00 BORROWER'S SELLER'S FUNDS AT FUNDS AT 70' . 4 562.50 '^ Coldwell Banker Homesale Grou'" SETILEMENT SEnLEMENT 7n? . 4 612.50 ,. Re/Max 1st AdVatlt""'" 7n' . ..... . 9 175.00 7n. .. Coldwell Banker I Re/Max 1st Advantane 195.00 195.00 '''''. ITEM" PAYABLE IN "'ONN"CTlO.' '^^'M-II 04.., "'" loonnr;"in .'u . OM . OM "'" ana ,.........., OOR on7 ono 8M 01n 011 gno . "" o41n I" ._....,~- OM ,......... 0_ .. """ M_ on. . b. '^ on? tn M' anS 1nM , ~..n= F()R '00' -. "". 1- 1M? -. "". I~ 1M' -. "". I~ 1004 "~,nIv ~r ..T.. - "". I~ .00. n. .". _n "". 1_. 1Mn 0.00 0.00 11M 11M 11M ..M 1104 NnI.", '^ StIth Po_r~ 15.00 ..na "no ,........O~. .. Salzmann H"nhes P,C. 15.00 1101 11 OR T"'" In~ ~nn. On Stewart Title Guarantv/PA RE SS 1 323.51 ..no 25 000.00 - "M 183 500.00 - 1 323.51 .", O~ 1M _. OM Stewart Title Guaran-/PA RE SS 200.00 117 "1' ~ Stewart Title Guarantv/PA RE SS 35.00 101'" RE"nRDIN" 1"n. ~_.M'M"- n__H 38.50 . ...~_.. 50.50 . R.,..... . 89.00 ..n. "......1 835.00 '''......ana' 1 835.00 1"'" "....1 835.00 ..._... . 1 835.00 '00. 1?n< 1~nn AnnITIOl\lAI "En' "M .on< In Coldwell Banker Homesale Grou'" 917.50 .oM 'n AHS Warrantv 425.00 "n, In",.linn"= ~ Sherwood Court Homeowners Assooiation 100.00 "n. .. Bast Pennsboro Townshi'" 115.00 "na .. American Radon Solutions 800.00 "no a.,_ " Donna Fleetwood 10.60 .on' t^ Donna Fl..twood 40.00 """ T/"ITAL SFTTl ~"'~"'T ,......41".,"'" n_~'u~ 5 135.01 12 185.60 HUO CERTIFICA.TION OF BUYER AND SEllER I have CIIeful!y ltlltewaa the HUO.fSetllernent Statement and to !he best ofmy know4edgt and bIIiIt, tril. true and acar.a in' sac:tion. I further certII'y tNt I hive rltCeMtd a co Of the HUQ., SetOemtnl SI.temenl Undo M. w_ ~"-~ Th<::-~LP" d;J /'" WARNiNG: IT IS ACRNE TO KNOWINGl YMA.KE FALSE STATEMENTS TO THE UNITED STAreS ON lHlS OR ANY S!MIlAR FORM. PENAlTIES UPON CONVtCTION CAN INCLUDE A FINE AND IMPRISONMENT FOR DETAILS SeE TITLE 18' U.S, CODE SECTMJN 1001 AND SECTION 1010. ent INhleh J h8.... prepered is. tn.Ie.nd aa:uf'lle ac:oounl of !his lransa:1ion. funds to be cbburaea in <<:cordBnOl!l wilh this statemenl 900/9 0 O~ HUHZL 1L X1!d H 'cl Hid LOn/60/11 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. FILE NUMBER 21 - 07 - 0618 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 1 PSECU Checking Account DESCRIPTION VALUE AT DATE OF DEATH 25.00 2 PSECU Savings Account 200.00 3 Antique bedroom furniture, marble top tables, clock, Hummel figurine 750.00 4 Accl. #6914-9063 Charles Schwab 6,128.37 TOTAL (Also enter on Line 5, Recapitulation) 7,103.37 ,,/,'/7<1)-;' ('\- SCHWAB _, J~'-", .~C~I Account Statement Retain for Your Records Statement Period: September 1, 2007 to September 30,2007 Last Statement: August 31, 2007 Schwab One@ Account Account Number: 6914.9063 Going paperless is easy. Log on to: www.schwab.comlestatements Questions? Call1-BOO-435-4000 Account Opened in: 1993 Page 1 28/09-PN9M2104-015271-SML-171092618005257252 '1-2 BARRY L PARK c/o PEGGY KREISER, EXECUTRIX 3958 LEXINGTON ST HARRISBURG PA 17109-2618 o .... 01 '" -...I .... - - - - - - - - - I Account Value Summary Cash & Sweep Money Market Funds Margin Loan Balance Investments Total Account Value I ._ $ 6,128.37 - $ (6,128.37) - $ 0.00 $0.00 $ (5,699.81) - I Change in Value Summary Starting Account Value Transactions & Income This Period Change in Value of Investments This Period Ending Account Value Change in Account Value Since 1/1/07 Cash + Margin I $ 0.00 $ 0.00 I Rate Summary Margin Loan Rates vary by balance I 7.75% to 10.25% - - - - - -- I Total Funds Available: Available to Withdraw Securities Buying Power i Transaction Detail Settle Trade Date Date Transaction Cash Activity 09/04 09/04 Funds Paid 09/04 09/04 Credit Interest Description Quantitv Price Total CLIENT REQUEST NETCSH SCHWAB1 INT 08/30-09/03 $ (6,128.97) 0.60 08/30 through 09/26: $0.60 based on .880% average Schwab One interest rate paid on 4 days in which your account had an average daily balance of $6,128.37. I Income Summary Description Federally Taxable Schwab One Interest Cash Dividends This Period \Iear to Date >> (') o o o .... 01 N -...j .... , $ 0.60 $ 0.60 111.22 o .... o N < >> I Total Income $0.60 $111.821 @2004 Charles Schwab & Co" Ine. All rights reserved, Member SIPe. CRS 22640 (0001-0386) STP1 0479R2-03 (12/04) ic___....r,,1 . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. I FILE NUMBER 21 - 07 - 0618 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 Maggy L. Neely ADDRESS 45 S. 24th Street, Penbrook, PA 17103 RELATIONSHIP TO DECEDENT None A JOINTLY OWNED PROPERTY: ITEM LETTER DATE ~~1?f_RlPIIO~5lF PRca'lERTY DATE OF DEATH %OF DATE OF DEATH FOR JOINT MADE Include name 0 Inanclallns u Ion an Dank account number DECD'S VALUE OF NUMBER or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET TENANT JOINT estate. INTEREST DECEDENTS INTEREST 1 A 2005 2005 GMC Yukon 22,000.00 50% 11,000.00 TOTAL (Also enter on line 6, Recapitulation) 11,000.00 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. FILE NUMBER 21 - 07 - 0618 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF EXCLUSION TAXABLE VALUE NUMBER Include the name of the transferee, their relationship to decedent VALUE OF ASSET DECD'S (IF APPLICABLE) and the date of transfer. Attach a copy of the deed for real estate. INTEREST 1 American Funds Acct. #67394395 7,896.30 100% 7,896.30 Growth Fund of America - Class A 2 American Funds Acct. #67394395 18,345.68 100% 18,345.68 Capital World Growth and Income Fund - Class A 3 American Funds Acct. #67394395 15,531.75 100% 15,531.75 The Investment Co. of America - Class A 4 American Funds Acct. #67394395 16,085.58 100% 16,085.58 American Balanced Fund - Class A 5 American Fund Acct. #67394395 1,181.35 100% 1 ,181 .35 The Bond Fund of America - Class A *NOTE: Beneficiary of all American Funds is Bryce A, Park, son of the decedent. TOTAL (Also enter on line 7, Recapitulation) 59,040.66 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. .I The right choice for the long term<!> @ American Funds. Quarterly Statement September 28, 2007 Page 2 of 4 Year-to-date dividends and capital gains ..................................................................................................................................................................................................................... Short-term Long-term Account I Fund I Dividends capita! gains capita! gains ................................................................................................................................................................................................................................................................................ CB&T CUST IRAjROUOVER BARRY L PARK/DEC'D Capital World Growth and Income Fund-A The Investment Company of America-A American Balanced Fund-A The Bond Fund of America-A 67394395 67394395 67394395 67394395 33 04 11 08 $255.99 $148.32 $308.71 $35.96 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 T ota Is $748.98 $0.00 $0.00 Beneficiary information ..................................................................................................................................................................................................................... .............................................................................................. ~.~.~.~~ ~~.~......... !:!.!'!'..~ Y...................................................................... E~.~!!~g ~~~...................................................... . CB&T CDST IRA/ROLLOVER BARRY L PARK;DEC'D 67394395 BRYCE A PARK-l00% Not provided To update and read important legal information about your beneficiary designations, please go to americanfunds.com/beneficiary Year-to-date history .................................................................................................................................................................................................................... CB&T CUST IRAjROUOVER BARRY L PARK/DEC'D The Growth Fund of America - Class A Account # 67394395 Fund # 05 Symbol AGTHX Dividends and capital gains reinvested Per-share average cost: Not available (please see back of statement) Trade date Description Dol/er amount Share price Shares transacted Share balance ................................................................................................................................................................................................................................................................................ 01/01/07 06/13/07 06/13/07 08/31/07 09/28/07 Beginning balance Fed W/H - Normal Dist Normal Distribution Transfer To *********625 Ending balance $10,695.37 -$750.00 -$3,000.00 -$7,896.30 $0.00 $32.87 $35.84 $35.84 $35.77 $37.49 -20.926 -83.706 -220.752 325.384 304.458 220.752 0.000 0.000 Capital World Growth and Income Fund - Class A Account # 67394395 Fund # 33 Symbol CWG IX Dividends and capital gains reinvested Per-share average cost: Not available (please see back of statement) Trade date Description Dol/eramount Share pric e Shares transacted Share balance ............................................................................................................................................................................................................................................................................... 01/01/07 Beginning balance $20,276.93 $41.93 483.590 03/16/07 Income Dividend 0,20 $96.72 $41.10 2.353 485 . 943 05/09/07 Fed W/H-Normal Dist -$800.00 $45.57 -17.555 468.388 05/09/07 Normal Distribution -$3,200.00 $45.57 -70.222 398.166 06/15/07 Income Dividend 0.40 $159.27 $46.21 3.447 401.613 08/31/07 Transfer To *********625 -$18,345.68 $45.68 -401.613 0.000 09/28/07 Ending balance $0.00 $48.23 0.000 11111111/11/111111111111111111/1111 I 1 2 0 0 AFS.....93260....05S4663001. 19673.981 ]2.CNSAFSO 1.INVMCIt ......AF 1.......0 184468]J/SITE 1 02 7319]1??oo2 The right choice for the long termalJ @ American Funds. Quarterly Statement September 28, 2007 The Investment Company of America - Class A Account # 67394395 Fund # 04 Symbol AIVSX Page 3 of 4 Dividends and capital gains reinvested Per-share average cost: Not available (please see back of statement! Trade date Description Dollar amount Share price Shares transacted ............................................................................................................................................................................................................................................................................... Share balance 01/01107 Beginning balance $16,550.39 $33.51 03/02/07 Income Dividend O. 16 $79.02 $32.93 2.400 05/09/07 Fed W/H - Normal Dist - $450.00 $35.63 -12.630 05/09/07 Normal Distribution - $1 ,800.00 $35.63 - 50.519 06/01107 Income Dividend 0.16 $69.30 $36.14 1.918 08/31/07 Transfer To *********625 -$15,531.75 $35.70 -435.063 09/28/07 Ending balance $0.00 $36.59 Dividend change. Beginning with the September payment, the fund increased its quarterly dividend from 16 cents to 17 cents per share. American Balanced Fund - Class A Account # 67394395 Fund # 11 Symbol ABALX 493.894 496.294 483.664 433.145 435.063 0.000 0.000 Dividends and capital gains reinvested Per-share average cost: Not available (please see back of statement) Trade date Description Dollar amount Share price Shares transacted ............................................................................................................................................................................................................................................................................... Share balance 01/01/07 Beginning balance $15,151.01 $19.02 02/16/07 Income Dividend O. 125 $99.57 $19.29 5. 162 05/18/07 Income Dividend 0.125 $100.22 $19.87 5.044 08/17 /07 Income Dividend O. 135 $108.92 $19.40 5.614 08/31/07 Transfer To *********625 -$16,085.58 $19.80 -812.403 09/28/07 Ending balance $0.00 $20.28 Dividend change. Beginning with the August payment, the fund increased its quarterly dividend from 12.5 cents to 13.5 cents per share. The Bond Fund of America - Class A Account # 67394395 Fund # 08 Symbol ABNDX Trade date Description 796.583 801.745 806.789 812.403 0.000 0.000 Dividends and capital gains reinvested Per-share average cost: Not available (please see back of statement) Dollar amount Share price Shares transacted ............................................................................................................................................................................................................................................................................... Share balance 01/01107 Beginning balance $1,161.46 $13.32 01/25/07 Income Dividend $2.83 $13.27 02/23/07 Income Dividend $4.59 $13.38 03/23/07 Income Dividend $4.61 $13.40 04/25/07 Income Dividend $4.63 $13.43 OS/25/07 Income Dividend $4.64 $13.32 06/25/07 Income Dividend $4.66 $13. 18 07/25/07 Income Dividend $4.99 $13.17 08/24/07 Income Dividend $5.01 $13.12 08/31/07 Transfer To *********625 -$1,181.35 $13.14 09/28/07 Ending balance $0.00 $13.25 Daily dividend. Since the fund declares dividends daily, the amount of your income dividend depends on the number of days between the day you paid for your shares and the day the dividend was paid. Dividend change. Beginning with the July payment, the fund increased its monthly dividend from 5.25 cents to 5.60 cents per share. 0.213 0.343 0.344 0.345 0.348 0.354 0.379 0.382 -89.905 //1111//111111111111111111111111111 I , 3 0 0 87.197 87.410 87.753 88.097 88.442 88.790 89 . 144 89.523 89.905 0.000 0.000 73193/00003 . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H RJNERAL EXPENSES & ADMINIS1RATIVE COSTS ESTATE OF Park, Barry L. Debts of decedent must be reported on Schedule I. FILE NUMBER 21 - 07 - 0618 ITEM NUMBER FUNERAL EXPENSES: A. 1 Jesse H. Geigle Funeral Home B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. DESCRIPTION AMOUNT Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Kerwin & Kerwin -- Terrence J. Kerwin, Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Bryce Park Street Address 6 Tommy Lane 2. 3. City Enola State P A Zip 17025 4. Register of Wills Relationship of Claimant to Decedent Son Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs Cumberland Law Journal - estate notice TOTAL (Also enter on line 9, Recapitulation) 285.00 6,000.00 3,500.00 360.00 75.00 10,416.00 *' 5c::hErl.E H Funeral Expenses & AchinistraIive Cos1s continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. I FILE NUMBER 21 - 07 - 0618 2 The Paxton Herald - estate notice 38.00 3 Register of Wills - additional Short Certificates 28.00 4 Register of Wills - release of claims 50.00 5 Register of Wills - filing fee for inheritance tax return & inventory 30.00 6 Register of Wills - tax certification for real estate 50.00 Page 2 of Schedule H . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. FILE NUMBER 21 - 07 - 0618 Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 GMAC Accl. # 020-9075-51772 - car loan balance due of $23,945.42. 11,972.71 1/2 of obligation equals $11,972.71 2 AT&T Platinum - credit card 9,345.36 3 Orchard Bank - Visa 190.20 4 ING 255.00 5 PSECU - two credit cards - account balance 7,560.61 6 Verizon 101.94 7 Com cast 64.78 8 Citi Mortgage - mortgage payments 8,420.27 9 Penn National - Insurance premium 640.00 10 Sears Credit Cards 134.51 11 M&T Bank - mortgage payments 2,593.20 12 Cingular - account payable 116.29 13 PA American Water - water bills 123.81 14 UGI - gas bills 317.87 15 Pinnacle Health, Medical Services - account payable 35.00 TOTAL (Also enter on Line 10, Recapitulation) 304,943.65 . . . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYlVANIA LIABILITIES, & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT continued FILE NUMBER ESTATE OF Park, Barry L. 21 - 07 - 0618 Include unreimbursed medical expenses. ITEM DESCRIPTION NUMBER AMOUNT 16 Bank of America - FIA Card Services 4,428.00 17 Bank of America - FIA Card Services 19,670.00 18 Discover Card 5,500.00 19 Phillips & Cohen Assoc., Ltd. - collection agency 7,392.74 20 East Pennsboro Township - sewer bills 416.44 21 T W Company - account payable 792.70 22 PPL - electric bills 718.90 23 Sherwood Court Homeowners' Assoc. 340.00 24 AT&T Mobility - cell phone bill 196.30 25 M&T Bank - mortgage payoff (Pen brook Property) 44,729.83 26 HFC - mortgage payments (Tommy Lane property) 2,516.00 27 HFC - mortgage payoff from Tommy Lane settlement 28,629.84 28 Settlement charges (Page 2 of HUD-1) 12,185.60 29 Citi Mortgage - mortgage payoff from Tommy Lane Settlement 125,916.02 30 Classic Maintenance - Pen brook property repairs 4,598.57 31 Protect America, Inc. - account payable 69.90 Page 2 of Schedule I . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEALTH OF PENNSYLVANIA INHERrr ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. FILE NUMBER 21 - 07 - 0618 Include unreimbursed medical expenses. ITEM NUMBER 32 DESCRIPTION AMOUNT Penn DOT - title transfers 22.50 33 Reimbursement to Mary Ann Kreiser for house repairs (plumbing, drywall, studs) 450.00 34 Jean I. Horst, Tax Collector - taxes on Pen brook property 4,498.76 Page 3 of Schedule I . Bankof America ~ ~ www.bankofamerica.com BARRY L PARK c/o TERRENCE KERWIN 4245 ROUTE 209 ELIZABETHVILLE PA 17023 November 28, 2007 Account No.: 5490995999341818 Dear Barry L Park, Thank you for your final payment toward the settlement of $4,428.00. This payment serves as the full settlement of the above-referenced account, and your account will be reported to the consumer reporting agencies (Experian, TransUnion, and Equifax) as a settled account, legally paid in full for less than the full balance. Any future credit balances on the account will be the property of Bank of America. Although this account is now closed, please note that any new or third-party charges posted to this account will be your responsibility. If this account is linked to any new charges or preauthorized third party fees or services (such as Internet services or gym memberships), other charges may still post to the account. It will be your responsibility to cancel any third party serVIces that mayor may not require authorization to charge the account. If the remaining amount is equal to or greater than $600.00, we are required by federal law (IRS section 6050P) to report this amount. You will be receiving a Form 1099-C from Bank of America no later than next January 31st. If you have any questions regarding your personal taxes, we recommend that you consult a certified public accountant or other tax professional. - If you have any questions, please call 1-800-242-3328, Monday through Thursday from 8 a.m. to 10 p.m., Friday, 8 to 8, or Saturday, 9 to 2 (Eastern time). If you prefer, you may write to Bank of America at P.O. Box 15971, Wilmington, DE 19850-5971. Our knowledgeable Account Managers are ready to assist you. - - - - - Sincerely, Brian Kilpatrick Customer Assistance department MBM BL14 1-1 US-EN 01 of 01 07-333-00148 - 1028 . . BankofAmerica ~ ~ www.bankofarnerica.com BARRY PARK C/O TERRENCE KERWIN 4245 ROUTE 209 ELIZABETHVILLE PA 17023 November 28, 2007 Account No.: 5200010999985357 Dear Barry Park, Thank you for your final payment toward the settlement of $19,670.00. This payment serves as the full settlement of the above-referenced account, and your account will be reported to the consumer reporting agencies (Experian, TransUnion, and Equi fax) as a settled account, legally paid in full for II~SS than the full balance. Any future credit balances on the account will be the property of Quantum. Although this account is now closed, please note that any new or third-party charges posted to this account will be your responsibility. If this account is linked to any new charges or preauthorized third party fees or services (such as Internet services or gym memberships), other charges may still post to the account. It will be your responsibility to cancel any third party serVices that mayor may not require authorization to charge the account. If the remaining amount is equal to or greater than $600.00, we are required by federal law (IRS section 6050P) to report this amount. You will be receiving a Form 1099-C from Quantum no later than next January 31st. If you have any questions regarding your personal taxes, we recommend that you consult a certified public accountant or other tax professional. - - - ~ - If you have any questions, please call 1-800-242-3328, Monday through Thursday from 8 a.m. to 10 p.m., Friday, 8 to 8, or Saturday, 9 to 2 (Eastern time). If you prefer, you may write to Quantum at P.O. Box 15971, Wilmington, DE 19850-5971. Our knowledgeable Account Managers are ready to assist you. ~ - - Sincerely, Brian Kilpatrick Customer Assistance department MBM BL14 I-I US-EN 01 of 01 07-333-00148 - 836 . BURLINGTON, NJ 609.914.0437 CHICAGO, IL 847.940.9812 CINCINNATI,OH 513.723.2200 CLEVELAND,OH 216.685.1000 DETROIT, MI 248.362.6100 PHILADELPHIA, PA 215.599.1500 PITTSBURGH, PA 412.434.7955 WELTMAN, WEINBERG & REIS CO., L.P.A. ATIORNEYS AT LAW 175 South Third Street, Suite 900 Columbus, Ohio 43215 800.325.9965 614.801.2710 614.801.2604 (fax) www.weltman.com July 30, 2007 Register Of Wills One Courthouse Square Carlisle, PA 17013 RE: Estate of BARRY PARK CLAIM OF: DISCOVER BANK OUR FILE NO.: 06125352 Dear Sir or Madam: This law firm represents DISCOVER BANK in connection with its claim which we wish to file on our client's behalf into the estate of:BARRY PARK , deceased. Our client's claim is based upon its account number 6011002465297109 in the amount of$7,886.41. Included with this letter is the claim form which we wish to present to this court and which we are forwarding to the attorney and/or fiduciary of this estate. It would be appreciated if all correspondence and disbursements with respect to this matter be forwarded to our office and to the attention of the undersigned. Additionally, it would be appreciated if any notices of any hearings also be forwarded to the undersigned. Thank you for your cooperation in this matter. This law firm is a debt collector attempting to collect this debt for our client and any information obtained will be used for that purpose. Very truly yours, 1f,iKJ .fl-{ Michele Mehan ---- Authorized agent for claimant MLM:ani CC: PEGGY KREISER, PERSONAL REPRESENTATIVE AND TERRENCE KERWIN, ESQUIRE Enclosure F1:1 ~Bank Manufacturers and Traders Trust Company - - 12-84353 ACCOUNT MANAGER FOR INQUIRIES CALL W.LEADER .p.:J..s'S---~/;;"/ ()P~ I r: "':'::~<NUM&.ER:: . 00-0030314-9 I:::::::'~~~~':::~~~R 44 PRINCIPAL DUE INTEREST DUE FEES DUE CURRENt'A:MOUNTnut<' , BARRV L PARK 6 TOMMV LANE ENOLA PA 17025 .................. ............-....... .............,.... '" .'. ............ . . . . . . . . . . . . . . . . . . ....-................. ................ .... ..."..,........ ................ . ., , ,.. .. --' .... . . . . . . . . . . , . . . . ..--....."...,.. ............., .. ................ ....... ,,,,,. .. .. ............ 'II .11.... . '::":::OVE:;OATE::::- ":".:' ., 07/05/2007 . :~~Co7~~b~: :::1 41 953.23 $358.44 $0.00 $42 311.67 PLEASE PAY PROMPTLY TO 000-0030-022 $0.33 $41,953.23 $12.03 $346.41 $2,417 . 83 $44,729.83 7/05/2007 6/05/2007 6/06/2007 $41,953.56 $42,266.89 $41,953.56 6/05/2007 7/04/2007 10.25% 10.25% $41,953.23 $358.44 $42,311.67 $2,418.16 ., RIME RATE AS OF WELCOME TO M&T BANK. PLEASE NOTE THAT YOUR NEW ACCOUNT NUMBER APPEARS ON THIS INVOICE. BARRY L PARK 12-84353 CLNIV1 7 ACCOUNT INVOICE NUMBER 00-0030314- NUMBER 0710168 7 COMMERCIAL LOAN INVOICE DATE L015 (4/94) PAST DUE PRN PRINCIPAL INTEREST INTEREST PAST DUE LC TOTAL TOTAL PRIN DUE TOTAL INT DUE TOT CURRENT DU TOTAL PAST DUE .........................-........ ..............._----,..", ." . ....... . . . . . . . . . , . . ',' . , . . . . . , ',' . . . .,. . ............. ..."..., ... ..............,................... ..".... ..'.....".".."..... i9t~#M~AA~t< ~U~11()5:/~Q~1>... REv-1513 EX+"-oO) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Park, Barry L. I FILE NUMBER 21-07-0618 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS [include outright sgousal aistributions, and ransfers under Sec. 9116 (a) (1.2)] 1 Michael Park Brother antique furniture, 750.00 18 Colony Hill Court #3B clock, marble top Arbutus, MD 21227 tables, Hummel figurine 2 Bryce A. Park Son 100% residue 6 Tommy Lane Enola, PA 17025 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 , .REG0Fl'l' M I"\E~WIN EFlFlE:-iCr J KERWIN JOSEPH 0 KERWIN LAST WILL AND TESTAMENT OF BARRY L. PARK I, BARRY L. PARK, currently of the County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Executor to pay all my legally enforceable debts, funeral expenses, administration expenses, and inheritance, estate, successIOn or excIse taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. SECOND: I give and bequeath my antique furniture in the third bedroom, my clock above the television in the living room, my marble top table in the living room and my Hummel figurine all located in my residence at 6 Tommy Lane, Enola, Pennsylvania, to my brother, MICHARL PARK, ifhe survives me. THIRD: I give, devise and bequeath all of the rest, residue and remainder of my property, be it real, personal and mixed, whatsoever or wheresoever the same may be situate at the time of my death to my son, BRYCE PARK, providing he has attained the age of twenty-one (21) years at the time of my death. In the event my son, BRYCE PARK, has not attained the age of twenty-one (21) years at the time of my death, I direct that his share of my estate shall pass In Trust as set forth in Paragraph Fourth of this, my Last Will and Testament. FOURTH: In the event my son, BRYCE PARK, has not attained the age of twenty- one (21) years at the time of my death, then I direct that his share of my estate shall pass In Trust, and I nominate, constitute and appoint PEGGY KREISER, as Trustee for the benefit of my son, BRYCE PARK. I authorize PEGGY KREISER, as Trustee, to expend so much from the principal and/or income of the Trust as may be necessary 111 her sole dIscretion for h~< 1 ()J BARRY L. PARK '" MCCCUR' "RWON Page 1 of 2 Pages (SEAL) .. ." .. GREeaRY M, i"\ERw\N TERRENCE. J. KERWIN JOSEPH D. KEAWI.... Jl,.LY MCCLURE I\.(RI'....IN ATTORNEYS AT LAW the health, education and support of my son, BRYCE PARK The Trust created herein shall terminate when my son, BRYCE PARK, attains the age of twenty-one (21) years, at which Hme the remaining principal and any accumulated income shall be paid to him outright. FIFTH: I nominate, constitute and appoint my son, BRYCE PARK, as Executor of this, my Last Will and Testament, providing he has attained the age of twenty-one (21) years at the time of my death, In the event my son, BRYCE PARK, has not attained the age of twenty-one (21) years at the time of my death, then I nominate, constitute and appoint PEGGY KREISER, as Executrix of this, my Last Will and Testament, In the event my son, BRYCE PARK, has not attained the age of twenty-one (21) years at the time of my death and PEGGY KREISER predeceases me, I nominate, constitute and appoint TERRENCE J. KERWIN, ESQUIRE, as Executor of this, my Last Will and Testament. I authorize and empower my Executor to sell and convey any and all real estate which I own at the time of my death, I further direct that my Executor or personal representative shall not be required to post bond to act in said capacity, IN WITNESS WHEREOF, I, BARRY L. PARK, have hereunto set my hand and seal, to thiS, my Last Will and Testament, this' :; 7f1\..day of ~~' ,2006, SIGNED, SEALED, PUBLISHED and DECLARED by the above- named Testator, BARRY L. P ARK, as and for hiS Last Will and Testament, In the presence of us, who at his request and in the presence of each other, have hereunto set our names as witnesses: iBl. .j /". /) ;2 OM.-l- ( U (L-v/~ ,(SEAL) BARRY L. P RK , ~~';1'-i .:If-ME. b~ r.i 17.:J/1 Resi ng at: ,J n f LA,."., b /1, u I / '1d f.J...t '/ ':'" in,. ( ..t Re;J.ding at: F/S k!.,,-,-,-.L4-,-->.,--i~{- ." <i ">iLl) I" " (_" /) >/ I Ie ({ Page 2 df 2 Pages " D:TJK\lak\....il1tP ARK.BlP