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HomeMy WebLinkAbout05-23-0815D56041125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PoBOx28oso1 INHERITANCE TAX RETURN 2 0 0 7 0 0 8 8 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 8 8 0 7 6 2 1 0 0 8 2 6 2 0 0 7 0 3 1 :3 1 9 1 4 Decedent's Last Name Suffix Decedent's First Name MI N A R D I A U R O R A (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) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 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. O) wrcrctarvnuen r - i nw atc i wn mua ~ rst cvmr~t i tu. Hcc t,vrcrctarvnutnt,t Hnu t,unriutrv i iHC i ru ~nrurcmH i iun anuuw tst uirctc i to i u: Name Daytime Telephone Number J O H N A C A R P E N T E R E S Q 5 7 0 2 8 6 7 0 0 0 Firm Name (If Applicable) C A R P E N T E R & C A R P E N T E R First line of address 1 0 1 N E L E V E N T H S T R E E T Second line of address City or Post Office S U N B U R Y State P A REGISTEFtf~F WILLS USE~NLY <_.LLa <<1 4_._. r.3 ...i _ 1 ) ._~ _ - C,.J _, --;7 ;`., g71T~ FILED _.. _.' _~ i ZIP Code L 1 7 8 0 1 N Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN RE O~ P R$ N ESP~ONS~IBLE FOR FILING RETURN DATE ADDRESS 50S HILLSIDE ROAD NEW CUMBERLAND PA 17070 SIGNAT E AR T E THAN E SENTATIVE DATE ADDR S / 101 ELEVENTH BEET SUNBURY PA 17801 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 15056041125 J 15D56D42126 REV-1500 EX Decedent's Social Security Number Decedent's Name: AURORA NARD I 1 8 8 0 7 6 2 1 0 RECAPITULATION 1 0, 0 0 1. Real estate (Schedule A) ...................................... .. 2 9 5 1 2 9, 1 2 2. ................................ Stocks and Bonds (Schedule B) . .. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ...................... .. 4. 9 2 9 2 6 8 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5. , 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 7 0 7 8 4 , 4 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ..... .. 7. 8. Total Gross Assets (total Lines 1-7) ......................... .. 8. 1 7 5 2 0 6, 2 0 9. Funeral Expenses & Administrative Costs (Schedule H) .......... ...... 9. 1 0 8 6 6 , 3 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...... ...... 10. 2 1 9 5 , 5 2 11. Total Deductions (total Lines 9 & 10) ..................... ...... 11. 1 3 0 6 1 , 8 8 12. Net Value of Estate (Line 8 minus Line 11) ................... ......12. 1 6 2 1 4 4, 3 2 13. Charitable and Governmental Bequests/Sec 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. 1 6 2 1 4 4 , 3 2 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 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 1 6 2 1 4 4 3 2 16 Amount of Line 14 taxable 17 . at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18 19. Tax Due ......... ........................... .. ..... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15D56D42126 0. 0 0 7 2 9 6. 4 9 0. 0 0 0. 0 0 7 2 9 6. 4 9 15D56042126 REV-1500 EX Page 3 Decedent's Complete Address: File Number 20 07 00888 DECEDENT'S NAME AURORA NARDI STREET ADDRESS 508 HILLSIDE ROAD CITY NEW CUMBERLAND STATE PA ZIP 17070 Tax Payments and Credits: ~ Tax Due (Page 2 Line 19) (1} 7,296.49 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. InterestlPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D +E ) 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. 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. (3) (4) 0.00 (5) 7,296.49 (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (56) 7,296.49 Make Check Payable fo: 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 : ................................................................ ...... ^ ^X b. retain the right to designate who shall use the property transferred or its income; ......................... ...... ^ ^X c. retain a reversionary interest; or .......................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ ^X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. ..... ^ ^X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .... ..... ^ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................................. ..... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after 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. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1,3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 0.00 0.00 REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER AURORA NARDI 20 07 00888 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 544 shs Morgan Stanley stock @ $63.92 per share 34,772.48 2. 272 shs Discover Financial Services stock @ $23.70 per share 6,446.40 3. 349 shs Sears, Roebuck & Co. stock @ $50.00 per share (mandatory buyout price) 17,450.00 4. 646 shs Allstate stock @ $56.44 per share 36,460.24 TOTAL (Also enter on line 2, Recapitulation) I $ 95 129.12 (If more space is needed, insert additional sheets of the same size) REV-1508 ~X + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISCn INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER AURORA NARDI 20 07 00888 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must he disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Wachovia Crown Classic Banking account no. 1000653531721 246.19 2. Wachovia Money Market account no. 1010049472578 5,842.67 3. Allstate, dividends on stock 2,616.30 4. Morgan Stanley, dividends on stock 587.52 TOTAL (Also enter on line 5, Recapitulation) I $ 9 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER AURORA NARDI 20 07 00888 If an asset was made joint wkhin one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS 508 Hillside Road, New Cumberland, PA 17070 TIONSHIP TO DECEDENT Son A. Daniel D. Nardi B C JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET °k OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 1/31/95 House and lot located at 508 Hillside Road, New 141,568.80 50. 70,784.40 Cumberland, Cumberland County. Value per Cumberland County tax assessment of $116,040 and Cumberland County common level ration of 1.22 TOTAL (Also enter on line 6, Recapitulation) I $ 70,784.40 (If more space is needed, insert additional sheets of the same size) atm-w•n.oh. o..a-sno.e so.m-pct trust-noun. sn..l Inn/P Molt Ina, Intllnna, Pa. TAR PARCEL 9 25-'L4-08(1-214 t~ ~~~ MADE THE ~ S ~ 4 day of OC 7fG 6v~ ix the year o/ our Lord oxe thousand tlixe hundred ninecy-four (1990 BETWEEN LEO N. EPPLEY find CAROLYN D. EPPLEY, Ids wife, of the Borough of New Cumberland, Cumberland County, Pennsylvania, Grantor s and DANIEL D. NARDI and AURORA M. NARDI, ttis mother, of Harrisburg, Dauphin County, Pennsylvania, as joint tenants with [he right of survivorship, Gruxtees ; , WITNESSETH, that in consideratiux of EIGHTY-SIR THOUSAND---------------------------- (:86,000.00)------------------------------------------------------------- Dollars, tin Rand paid, tht receipt tahcreoJ is hereby ackxotofedged, the said grantors do hereby graxt and conusy to the said grantees, ALL THAT CERTAIN piece or parcel of land situate in the Borough of New Cumberland, Cumberland County, Pennsylvania, more particularly bounded anJ described as follows, [o wit: BEGINNING at a point on the westerly line of Ni11s1Je Road, said point being 86.87 feet meaeu[ed southwardly along Nillslde Road Eton [hc southerly iLte of Beacon Ro:IJ; [hence along the westerly line of lllllside Rund, South 16 Jegrcus 07 minu[ea 4:asc, a distance of 65 fee[ to a point; thence South 73 degrees .57 minutes Wust, a distance of 120 feet to a point; thence North 16 degrees 03 minutes West, u distance of 65 feet to a point; thence North 73 degrees 57 minutes East, a distance of 120 feat to the westerly line of Hillside Road, the place of 6ECLNNINC. RAVING thereon erected a single duelling (louse known as No. 508 }I1llside Road, New Cumberland, Pennsylvanla 1~ BEING the same premises which William A. Latchaw, et ux, by deed Jated Plarch 15, ]979 and recorded in Deed Book "I", Volume 'L8, Page 179, Cumberland County liecorJs, grunted and conveyeJ unto Leo 11. Eppley anJ Carolyn D. Eppley, his wife, [he grantors hereto. UNDER AND SUBJECT, never[heleae, to the easements of the Pennsylvania Power and Llgltt Company and the Bell Telephone Compnny of Pennsylvania, across the westerly side of said lot. REGISTERED HY THE 19 r~ c u , ,~ w• ~ ~; rata 1 , E: ~„ ' , ~ ,~ t~ :.=~~g : , i ~ - m ~ .~ - ~ ,., i %r a pc ~ o .. °x .. ~i u i , y. bz a v cn w -s _. :~ o~~~o ! ~~~~:<a ~~~ And the Sald itTfUltnfS hneby covenant and agree that they will warrant generally the property hareby conveyed. !N {YITNCSS WFIERF,OF, said pxnntore !uc vshertuntoset their handy, and seals the day and year first above writteex. ' ~'gt tD, ~rnir n thbt[tD 'C`eo~l'f:--rPP1eY - J~~r~~ ....._-----. ea~aa. tryr cr~rn of ~it~,,,~_/ !03'-[~'`l'`~c.._.. ~-- t e ---• -..-.-.-°-.. eswr. -----•------•---------------------°--------°--._...---.__..-.-..--.. easy. ... -- ----- - -- -------- .....----------•--._._.- - -- ...-................-.. sear. State o/ Pennsylvroila ds. Cmrnty oJ~~A,t,~lLr On this, flee Z,$~ day o , LD 94 ,before me, the undersinned officer, personally appeared Leo li. Eppley and Carolyn D. Eppaey,, .his vij~,., known to ma (or satin/actor•ily yrovan) to 6a the persons whose ruame s ate "3u6sera~C~ a rrnthin inslnxment, and ackrwwiedped that they eseented same for the prirpQBi'aZ~ernn,n :;'•' contained. Y•{,~;'._,.-•-' •_~.•a.~- r,= 1N WITNF,SS WIfh:RF.OF 1 her n ha ar o xciad se F,,,I~,•.i,....:;.•~ .•° ••. ~, y 1~ ~ ~. •... .. ,° ¢~,~t~,t~a,seat - Nan~h~rg,parp+n~YPlbilc ,ra n ' -M .aaa E~p-os Marl" 1996 Title of O~cer. MMnbx, nc~ocpMmol State o/ sa. Cnunty of On L/~is, the day of , 19 , 6e/ore nxe, the undersigned o]jccr, personalty appeared known to me (or sans/actorily proven) to be the yarson whose Warne subscribed to the aoithin instrument, and aclnxotul¢dycd that executed same Jor t/ie purposes therein containrd. 1N {V1TNF.SS WIfF.ItJ;'OF, 1 hereunto sat my )oared arul o~cinl srni ~~ .-....._-.-....._ ...........................................---------....-°.`•- scar. Title of O~cer. I do hareby certify that the precise residance and comphtta post oQito address of tlta within Warned prante~5is SCAB ~~~-ctt ~al~, C.G,r~.1~Pit.(t~ t~ f~D 19 ~_ V U ....----._-...------- nooK X118 ~aeE 43 Irr•a COMMONW/A1TN Or /ENNSy1VAN4 OtYARIMtNT Of RtVtNUt W RlAY OP IIIOIVmUAt IAaES OEPI. 21••0] NA•RIIMItG. M tYl]•oe0] Ca•pIN• •odr t•cfion and 81e 4 dupica• wi+b R•cord•r of D«dt when (1( the fuN roluJmmid•ration n aol aN forth n rho deed, (2( khan rh• da•d it wi+hew tOnYd•roNoa, or by gih, or (J) a Loa •a•mpti0n it daim•d. A Sta1•nwnt d Volw is wa r•gwr•d i) the Iramfw it wholly eaampt from race. boNrd o0: (1) FasilY r•k+iwtlup ar ~) P11b~ uhnly •ot•w•nt. If nron Wac• n n••Gd; oaack odddloaol th••t(s(. • ' • 1 Name T•I•pko•• Numbr: U.S. Land b Abstract Co. ArwCod•(717 (561-8484 SaM •u Cry Stn. Zip Ced• '6 8150 De Street llarrisburg YA 17111-51 0 • . Da• AnMro•ce 0•wm•,rf GrMedrpLwrwla eN..(.IA.N..I.I Leo N. Eppley and Curalyn D. Eppley, h/v Daniel D. Nurdi and Aurura M. Nairdi, hie mutt rM •N Sr..r Addr.N 1426 Bradley Drive 508 Hillside Road ray s+ar. zip cad. A.r. up cede Cnrllsle YA 17013 New Cumberland YA 17070 •• • • SaM wddr•N tbr. re,.•drlp, ew•.Rk 508 hillside Road New Cumberland ewy atria as Pwal Nr•nb« Cumberland / • •~ Best Shore 25-24-0811-21~ 1. Aa•d Cai Cwrderarl•rr 2. O16a Cea><Mrad•• ]. Tercel Ca•dd.roiw. 86,000.00 + 0.00 = $86.000.00 t. o,aay Awc Vokn 5. Lw Rm:o actor 0. faw Maka Vd,.• $6,770.00 x 13.33 90,24.10 • la. Anew d Ea•mpiw ckim.e - Ib. P.ru•age of InNr•,r Ceweyd T. Check Appropdau Oox Ddow For Exemption Claimed ^ win or inr•gob waetuon ^ Tronder +a Indutviol Dawlopm•M Agency. ^ Tronal•r to a trmt. (Attach complete copy of Iruq agre•men+ idaniilying aR han•ficiari•c.( ^ TronJa b•hee•n principal and agan+. (Attach samplers copy of ag•nrylatrow parry agreement.) ^ Trombn +o rh• Commoewobh, tM Unir.d Stoaa and Inarum•nrali+ier by gih, dedica+ion, co,d•mnotion or in Geu of conJemnarion. (11 cond•mnaien or in liw of cond•mna+ion, onech copy of r•aolurion.( ^ Tronder from mortgagor ro o holder d e moAgag• in defoah. Mortgage Book Number , Pog• Numbar ter ^ Cornoivs or confirmatory deed. (Ano<h samplers copy of ehs prior deed being cwrenad or confirmed.( ^ Statutory <wporOb consondorion, merger or di.irioa (Attach copy of anidea.l ^ Other (PI•ou •aplain •aemp+ion daim•(ld, J mh•r than .,e:e~d-abo/re.) /~ ~ (~ ~C ^n-'~'.L~4C •M /N.P-f.. /LL9 ~Gl.f ~y e/1a~ aC_C (~ K~~. /Oy.. ~ ..._~i _.,t-Fdc-N _ ~~) ... 4 b . J rY~l M9u.P..~.,~ Hrew n~,.[~,. ~~,.c.a.G,.r !~Ce-..-e~etV • VV/ Under pen}HJ~t of tow. 1 d•daro +hat l hove •aamin.d +hia Smbm•nb Including accompanying iniormaJOn, and to +he best of my knewl•dg• and baliyl,.f~ 4 trw, corc•cy and cemPl.+..~~ FASLURE TO COAAPLETE THIS FORM PROPERLY'bR ATTACH APPLICABLE DOCUMENTAYION MAY RESULT IN YNE RECORDER'S REFUSAL TO RECORD T DEED. PACE ~4 eboK f18 REV-1511 EX+(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER AURORA NARDI 20 07 00888 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Stone & Murray Funeral Home, funeral expenses 1,522.00 B. 2. 3. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Carpenter & Carpenter Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address 4. 5. 6. 7. 8. 9. 10. 11. 12. City State Zip Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills Accountants Fees Tax Retum Preparer's Fees Wachovia, bank charges Carpenter & Carpenter, reimbursement for Federal Express charges Patriot News, advertising fees Cumberland Law Journal, advertising fees Morgan Stanley, fee for lost certificate Cumberland County Register of Wills, Inheritance Tax and Inventory filing fees 8,404.32 190.00 57.00 49.10 253.26 75.00 285.68 30.00 TOTAL (Also enter on line 9, Recapitulation) I $ 10.866.36 (If more space is needed, insert additional sheets of the same size) REV-1512 ~X + (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER AURORA NARDI 20 07 00888 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. Quantum Imaging, medical invoice 59.64 2. East Pennsboro Ambulance Service, medical invoice 315.41 3. Camp Hill Emergency Physicians, medical invoice 11.77 4. Susquehanna Internal Medicine, medical invoice 307.58 5. David A. Wiegand, medical invoice 168.75 6. Kunkel Surgical Group, medical invoice 4.24 7. OSL DBA Orth. Institute of PA, medical invoice 26.59 8. Pinnacle Heath, medical invoice 107.93 9. Holy Spirit Hospital, medical invoice 1,193.61 TOTAL (Also enter on line 10, Recapitulation) I $ 2 195.52 (If more space is needed, insert additional sheets of the same sizel REV-1513 EX + (9-00) ' ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER AURORA NARDI 20 07 00888 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 (a) (1.2)) 1. Daniel D. Nardi Lineal 162,144.32 508 Hillside Road New Cumberland, PA 17070 Collateral ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1$, 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 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (It more space is needed, insert additional sheets of the same size)