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Home My WebLink About05-29-08 (3) .-I 15056041046 REV-1500 EX (05-04) PA Department of Revenue Bureau of Individual Taxes Dept. 280601 Harrisburg, PA 17128-0601 ENTEIR DECEDENT INFORMATION BELOW Social Security Number Date of Death Og Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth Decedent's Last Name Suffix MI Decedent's First Name (If Applicable) Enter Surviving Spouse's Information Below SpoLlse's Last Name Suffix 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 C) 2. Supplemental Return C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) 4. Limited Estate C) C) C) 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit (date of death C) 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 Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received ~ 8. Total Number of Safe Deposit Boxes ~ First line of address REGISTER:Q~WILLS U~NLY -,' ('") -< ~)~ r~~-,. ..... r1 N ~-,Q u:> ............ f'-', \__.-J -T"\ -0 1 ~ ~... -') '-~ - ~~ s;: \.D DATE FILED Correspondent's e-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, orrect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. DATE pI} /75~2 S'/7/d( Side 1 L 15056041046 15056041046 .-I --I 15056042047 REV-1500 EX Decedent's Name: Adeline s. r~ert R:ECAPITULATION 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. 13. Jointly Owned Property (Schedule F) c:::::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::::> Separate Billing Requested.. . . . . .. 7. 13. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. B. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 1'1. 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.045- 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 69' O,T~~77 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT c:::::> (f ~ L. Side 2 15056042047 15056042047 --I REV-1500 EX Pa983 Decedent's Complete Address: DECEDENT'S NAME File Number Adeline S. Hmmnert STREET ADDRESS 100 South street CITY STATE ZIP Carlisle PA 17013 Tax PaymEmts and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payment~ A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 17,410.85 J6,QOQ.OO_ 870.54 Total Credits (A + B + C ) (2) 16,870.54 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 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) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) 540.31 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. 540.31 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 'I. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 Gl b. retain the right to designate who shall use the property transferred or its income; ........................................... 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [1g 2:. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ Ii] 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 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. SCHEDULE "B" STOCK AND BONDS Estate of Adeline S. Mummert 2008-0186 1. American Funds Balanced A #64343008 3,774.958 shares @$18.20/share $ 68,704.23 2. Putnam Money Market #0008-0281057455 10,000.00 3. Northtrack S&P 100 #0000230102 92.507 shares @$34.34/share 3,176.69 4. FPA New Income Fund #5115565 5,511.111 shares @$11.12/share 61,283.55 5. Fidelity Dividend Growth #2BQ-067784 779.981 shares @$27.23/share 21,238.88 6. Allied Irish Bank 4,158 shares @$39.53/share 164,365.74 7. John Hancock 1,547.464 shares @$6.42/share 9,934.72 TOTAL $338,703.81 SCHEDULE "E" CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Estate of Adeline S. Mummert 2008-0186 1. Wachovia Bank Checking Acct #1010008369020 $ 1,522.22 2. Morgan Stanley Active Assets Acct #410018593140 30,428.36 3. Wachovia Bank Checking Acct #1010040072281 311.09 4. Wachovia Bank Savings Acct #3000031060896 16,008.23 5. U CC Homes refund - nursing home refund 2,948.40 TOTAL $ 51,218.30 SCHEDULE "G" INTER-VIVOS TRANSFERS & MISCELLANEOUS NON-PROBATE PROPERTY Estate of Adeline S. Mummert 2008-0186 1. Union Central A64002922S $12,291.95 TOTAL $12,291.95 SCHEDULE"H" FUNERAL EXPENSES, ADMINISTRATIVE COSTS, AND MISCELLANEOUS EXPENSES Estate of Adeline S. Mummert M08-0186 ITEM NO. DESCRIPTION AMOUNT Funeral 1. W. Orville Kimmel Funeral Home, Harrisburg, P A $ 4,816.14 Pro bate 1. Letters Testamentary 423.00 2. Dennis M. Hartranft, Jr., Esq. 9,500.00 Miscellaneous 1. Pharmacy - medical expense 217.15 2. Miscellaneous Executor Expense 350.00 TOTAL $15,306.29 SCHEDULE"]" BENEFICIARIES Estate of Adeline S. Mummert 2008-0186 ITEM NO. NAME AND ADDRESS RELATIONSHIP AMOUNT OR OR BENEFICIARY SHARE OF ESTATE 1. Gail Gastrock 636 Maltese Drive S+tp Punta Gorda, FL 33950 Daughter 50% of residue 2. Jack Mummert 104 Wentworth Drive ~hp Claymont, DE 19703 Son 50% of residue @ A;:;i~;~'F~;ds. ~~'::; ~~~~5012280 . ~U~ B :W \ AV OJ, 190461 67812H708 A:**5DGT ) 1...111'111.1.1...1.1111.1..1.11...1111.111'11.1.1....11.11111 GAIL L GASTROCK JAC~, A MUMMERT TTEES MUMMERT FAMILY TRUST C/O DENNIS M HARTRANFT 151 E MAIN ST EPHR:ATA PA 17522-2720 Important information Unless there is subsequent activity with your account, this will be your last statement. Please keep this statement for your records. If you need additional information about your American Funds account(s), please visit americanfunds. com. Quarterly Statement March 31,2008 Page 1 of 1 I Your finandal adviser DOVER (800) 283-3842 AMERITAS INVESTMENT CORP. 151 E MAIN ST EPHRATA PA 17522-2720 For more account information ..................................................................................................... . Call your financial adviser . Automated information and services Website - americanfunds. com American FundsLine (j) - 800/325-3590 . Personal assistance - 8 a.m. to 8 p.m. Eastern time M-F Shareholder Services - 800/421-0180 Quarterly summary a anuary 1 - March 31, 2008) ............................................................................................................................................................................................................................. Reinvested S;hange in Value on dividends and account Value on Ending 12/31/07 + Additions + capital gains - Withdrawals +/- value = 03/31/08 share balance .....hu...............h...............................h......................................................................................................................................................................................................................................................... American Bal~rced.F.~pd-A Account #~)i,tii' $72,338.00 ro.oo $524.46 Year-to-date dividends and capital gains -$66,363.76 -$6,498.70 ro.oo 0.000 ................................................................................................................................................................................................................................ Short-term Long-term ............................................................................................~~.~.~.~.~!..~.............f.~!!.~..~..............................~!~!~~':'.~~...........................~~I!.!~~!.g~!f!.~............................~.~p.!~~!.gl!.!~.~ American Balanced Fund-A 64343008 11 $505.73 $0.00 $524.46 Year-to-date history ..................,......................................................................................................................................................................................................... American Balanced Fund - Class A Account # 64343008 Fund # 11 Symbol ABALX Trade date Description Dividends in cash and capital gains reinvested Per-share average cost: Not available (please see back. of statement) Dollar amount Share price Shares transacted Share balance h...n...................................................................................................................................................................................................................................................................................... 01101/08 Beginning balance $72,338.00 $19.31 3,746.142 02/15/08 Income Dividend O. 135 $505.73 3,746 . 142 02/15/08 Capital Gain 0.14 $524.46 $18.20 28.816 3,774.958 ~ 03/10/08 Telephone Redemption -$66,363.76 $17.58 -3,774.958 0.000 03/31/08 Ending balance $0.00 $17.90 0.000 Taxable capital gain. The fund's February payment included a taxable long-term capital gain distribution of 14 cents per share. * 11111111111111111111111111111111111 6 1 1 :!l 0 Af5.."'4Q1HQ1r<.07392Q005.24MO.24696.CNSAFS01.INVMCR. .....AF1.......0152579021sITEt02 190461/0??oo01 PUTNAM fN11]STMENTS )L~ BI j}~ONFIRMATION OF ACTIVITY Z-- 3/11/2008 >01698 3798246 002 092033 GAIL l GASTROCK &JA<;:K A MUMMERT TTEES OF MUMMERT FAMILY TRUST DTD 01126/1996 CIO DENNIS M HARTRANFT JR ESQ 1S1 E MAIN ST EPHRATA PA 17522-2720 Fund: PUTNAM MONEY MARKET FUND-A Account 0008-0281057455 Capital Gairts: CASH Dividertds: CASH '1.4-""""'" LtJili :&; TO INVEST BY MAil. please retum this slip artd your check payable to Putrtam Irtvestmertts irt the enclosed envelope. To establish a systematic irtvestmertt plan, see other side. Amount of check: Founded in 1937, Put.nam Illvest.ment.s began with the principle that a balance bet.ween risk and reward is the mark of a well-rounded iinancial program. Today, we manage money wit.h a foclls 011 consistent results, and this prudent approach remains the foundalion of ollr investment. philosophy. $[0], DIJ.OJ 0000000000 011 002810574559 0000858 0000008 9 -----------------------------------------------------------------------------------------------------------------------. Please print spellirtg or address changes above. GAil L GASTROCK & JACK A MUMMERT TTEES OF MUMMERT FAMILY TRUST DTD 01/26/1996 Fund: PUTNAM MONEY MARKET FUND-A Account 0008-0281057455 ..'........'.-..'.'....-.... .......,s/i.:-:-:.,.:.:.:..:.:..... i:i:i~:::::l':'::'eli:.::. Q~M$ilQQ$.B.gQ~MP:tjpN:::: b3iiiiiboB bivlDENDPAibH -:.:.......:.;......., ....................................................... ..................... . .. ............... . ... ... .... ................ . .................. .......'............'............. ......... .... ... ..................".. ............."...... '. ............................................ ............,.,...... Take advantage of Putnam's 90 day Reirtstatement Privilege which allows you to return all or a portion of this check into your account without incurrirtg an additional sales charge. Send check to: Putnam Investments ~.O. Box 8383 Boston, MA 02266-8383 InvestmentFirm: AMERITAS INVESTMENT CORP Representative: MR. RICK A. DOVER 800-283-3842 For Putnam assistartce: 1-800-225-1581 I1IIIII 11111/1111111111111111111 1111111111111111111111111111111111111111111 379824601WL01 Detach Here PUT-lOO ~. ~,~- ~",~-" ~:-'---:~",-":~", ~,-,~,"'-____,'_;:"':':-'~'"~-~''' '~',''''''''''7''"'-'''C7.':':-;:'''''"'''~;~ ~,~,,,~---~,-,-.,-,,,,,,-,,,,,,.._-,..,.,....,.........-- ~~W~ A0THORI D SIGNATURE' PUT IV AM INVESTMENTS 019338562 DATE: 03/11/2008 .'_::~_'_':':'_";:--" ,,-:,,"\':-,.:,:\ .:-'-'-':',:::,:-,i-::'~:' ,0:',. , :: ",;,_-,_'--,::,:,.-';,':"',::: " , ",: <' :-~-i-'<:',_:-: '.>-~ -..--:---:',-.,':-',,''---'~- ACCOUNT NUMBER: 0008-0281057455' . PAY TOTHE ORDER OF: . . GAIL lGASTRPC;:K &.JACK A MUMMERJ TTEESOf MUMMERT FAMILY TRUST DTD 01/26/1996 C/ODENNISM HARTRANFT j,R ESq 151 E MAINST EPHRATA PA 17522-2720 The Northern Trust Company Chic(J,go, 1L0710 Paya~lethrolllJ,'h Northern, TmstBank/Dupage Oak Brook IL N~Track FUNDS SL~ '7j4f; Quarterly Statement January 01 through March 31, 2008 V' Page 1 of 2 SH-001489-A05-A052PA01 MUMMERT FAMILY TRUST C/O DENNIS M HARTRANFT JR ESa LIM POA 151 E MAIN ST EPHRATA PA 17522-2720 AMERITAS INVESTMENT CORP C/O WEAVER FINANACIAL INC 151 EAST MAIN ST EPHRATA PA 17522 Questions about your account? Please call our Shareholder Services at 1(800)826-4600. Account Number: 0000230102 Rep Name: Dover Rick Rep #: 53884 Portfolio Summary FpSf' )( - - Account Value on lan 01, 2008 Purchases/Reinvestments Redemptions Withholdings Account Value on Mar 31,2008 $3,483.81 $0.00 $3,114.71- $0.00 $0.00 - - - - - - - - - - - - - - - - ==== - - Summary of Portfolio by Fund Registration: MUMMERT FAMILY TRUST C/O DENNIS M HARTRANFf JR ESQ LlM POA Account Number: 0000230102 Fund Name Beginning Value Purchases/ Reinvestments Redemptions Ending Value S&P 100 Index CL A Total $3,483.81 $3,483.81 $0.00 $0.00 $3,114.71 $3,114.71 $0.00 $0.00 Transaction Detail by Fund Registration Fund Name Fund Number MUMMERT FAMILY TRUST C/O DENNIS M HARTRANFT JR ESQ LIM POA S&:P 100 Index CL A 025 Cap Gains: Cash Dividends: Cash 01/01/08 03/11/08 03/31/08 Beginning Value Redemption Ending Value -SJ 92.507 92.507 - 0.000 Share Dollar Price Amount $37.66 $3,483.81 $33.67 $3,1l4.71- $33.84 $0.00 Transaction Date Transaction Description Number of Shares I FPA Funds FPA Funds PO Box8115 ",m^~ ;:k~>" Confirmation Statement tz Investor Services: 1.800.638.3060 "lfl- Internet: www.fpafunds.com '/!) E-mail: mfa@firstpacad.com Investment Rep: RICK A DOVER ., AMEIlIT AS INVESTMENT CORP ** 5900 IJ ST FL 1 LI NCOLN N E 68510-2234 ooom'! Investment Rep No: 53884 Broker/Dealer No: 0010756 Account Owner: GAIL L GASTROCK TTEE & JACK A MUMMERT TTEE MUMMERT FAMILY TRUST UA DTD 7/02/99 151 E MAIN ST EPHRATA PA 17522.2720 Fp;t/ IX Account: Transactions FPA New Income, Inc. Account Type REGULAR e,03/11/08 Transaction Description Beginning Balance , ' . ~hares Redeemed., . Ending BaJanc!l a,s of 3/11~8 . ',. ' , . '()n.s~lIjng yoUrSharl!~,You .~nay payasllles ch~rge.Forth~~har~eand !Itherfee~.see the prospe~tu~; .,'. . . <: <.Or U) N '" o N U) e ~' ~_..".~ CjJ~ B)~ Transaction Confirmation Confirm Date: March 11, 2008 / Mutual Fund Account Number 2BQ-061784 TRUST - UNDER AGREEMENT MUMMERT FAMILY TRUST 10000647 DENNIS M HARTRANFT JR ESQ MUMMERT FAMILY TRUST 151 E MAIN ST EPHRATA PA 17522-2720 Online F AST(sm)-Automated Telephone Customer Service Fidelity.com 800-544-5555 800-544-6666 11111111111.1.111.1.11.1.11.1.111111,,1.111'1111"111111111111 _ FIDELlTY__DI'!1PEND_ GBQ.WTl:Hf!J~f-Xl~lgL________ You sold 779.981 shares at $26.71/share Check Issued Unsolicited Order -Your ending balanceln this fund islfo6"oshares -------------- -----------------------------------------------$O".()()-- Transaction Detail T ransac/ion Summary -- --------------------$20~833.29----- -- - -=-20':83329- ~ Account questions? Customer service is open 24 hours. Call toll free 1-800-544-6666. Eidelityj)wirlbY.tQ(~ (;;Q(t!.oLClliQ!'L __ _ __ __ _ _ __ __ _ __ _12~J~~tt UtJ~ e.QR.JLOll~j:EQ.R.LCt\9.til~G. ~HE..9.L __ __ _ _ . _. __ _.. . _ . ", . . -.;- .. ., ~ " . ,,\" "e.:" ......;c./:.(.,-:./- ," .." dot Valid Mer 90- D'lYi ' ,- Ul S~cu~ fe~t~r9S included, Details o~ b,\ck_ '~- ,~",.. -:',' ;~ ~ ,: '.','\ .-- >:,: "">:,' .~:~ . :' ~":\--'~::t \.~.~'r~' , _. ~Jfj~R'~El~;~,~~~~">'J " 101!M1ttm~~_!J!;~~..un'm:.3';D'15Al!~---.:.~~:.::..::.~~::...._;~.~_ . ~ ~'\ ---S;, ) CA ~ John Hancock Funds, LLC MEMBER FINRA PO Box 9510 Portsmouth, NH 03802-9510 9ck &;4J1 / Confirmation statement April 22, 2008 Page 1 of 2 SH-000006-JHF-JHF2PA01 GAIL L GASTROCK TTEE JACK A MUMMERT TTEE MUMMERT FAMILY TRUST utA DTD 1/26/1999 151 E MAIN ST EPHRATA PA 17522-2720 Contact information Investment professional Dealer Web site JHF customer service Rick Dover Ameritas Investment Corp www.jhfunds.com 1-800-225-5291 For your information Did you know that you can reinvest all or part of your redemption proceeds* back into this account without any sales charge if we receive the deposit within 120 days of the date of the redemption?** Please be sure to include a written\l1otation with your deposit that you are taking advantage of this privilege. 1M *Must mE!et fund minimums **RequirE!d Minimum Distributions (RMD) cannot be reinvested. Transaction summary Fund name Strategic Income A Fund number 91 Account number 850419140 Account owner Gail L Gastrock TIEE Jack A Mummert TIEE Mummert Family Trust U/A Dtd 1/26/1999 Description Beginning balance Shares Redeemed Dividend Cash Dollar amount Share price ( 15Y1 'Ybb~) S~iS q \- - - - - - ---- - . ~ - - - - N N "'tJate ~ ~41 17/2008 0:94/22/2008 $10,050.29 $31.02 $6.46 1,555.772 Shares owned 1,555.772 0.000 0.000 transaction JHF SHR CRD 2 1 11 D UHD20090l513 10848746 04/23/08 50347 00028 053884 NNNNN DETACH THIS CONFIRMATION AND RETAIN FOR YOUR RECORDS BEFORE CASHING OR DEPOSITING CHECK. CHECK MUST BE ENDORSED BY ALL PAYEES RP~~-d~-dl:lijtl 11 : 1b C'( -% , \u --S: \J 0'\ >. CJ) ....", C CO +oJ en c: <<1 ~l o ~ ! ~ gf @ ).. E-4ct Z~ i;la: OlZl ~~ <(:J OO~ E-4~ ~1I.i ~~ ~i t;3 <'l co $ \'0 u... (IJ 0 0 u .... '~ ,~ uJ al C '- Vl C (.9 ,80 '-<0<( <( c.. 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Q) E (lJO E~ 0- Uo.. .!:E Q)Q) - )C ~~ XX <tlCO I-f- . ..~~ Crown Classic Banking 01 1010040072281 036 30 o 18 68,302 ~CHO"'\i'IA 00020822 02 AV 0.437 02 5DG 65 1'111",11,1,1, "1,1,11,,,1,,1,111' "1,1,,1,1,,,11,,11"1111,1 ADELINE S MUMMERT POA GAIL L GASTROCK OR PB JACK A MUMMERT 636 MALTESE DRIVE PUNTA GORDA Fl 33950 Crown Classic Banking Account number: Account owner(s): 1010040072281 ADELINE S MUMMERT POA GAllL GASTROCK OR JACK A MUMMERT 5 [, ~ 8' J -#)8/2008 thru 3/27/2008 :: ;;;;; ;;;;; == Account Summary Opening balance 2/28 Deposits and other credits Interest paid Other withdrawals and service fees Closing balance 3/27 - ;;;;; $311.09 ~ ~OO+. . 0.01 + ~ 51.08 - '4 (L.. . .. fez.. ~ C'~ $307.100 C'QJlJlAkI.J2'j .:3L t ~ I . J == - ;;;;; $ - !!!! ;;;;;; - ;;;;; ;;;;; ;;;;;; !!!! !!!! Deposits and Other Credits Date 2/28 Amount Description 3/03 /" 1/ 16.00 V 31.08 ,.../" 0.01 $47.09 DEPOSIT BURNT STORE sa OFF 02/28#2922 10001 BURNT STORE PUNTA GaRDA FL 7016W002319 AUTOMATED CREDIT BENEFIT PAYMENTS PENSIONS CO. 10. 9186063000 080303 PPD INTEREST FROM 02/28/2008 THROUGH 03/27/2008 t 3/27 Total Interest -.NumberoLdiays.thisstatementpel'iodc_'__~_ Annual percentage yield earned Interest earned this statement period Interest paid this statement period Interest paid this year ..29 0.04% $0.01 $0.01 $0.21 Other W'ithdrawals and Service Fees Date ..-Xmount' Description 3/04 V 31.08 AUTOMATED DEBIT BENEFIT PAYMENTS REVERSAL 3/27 20.00 ~~~~~~1::~63~O,~~~~ r Lt". D~. /\ I n Total $51.08 '-f~U.Jj Lt~ l5V\L ILJ1.l 1)0\1 '. . ~ ~d:1Lc +0 · 11\0,1'1.1, CAJ1-'PlYiub.' ~~iL 00. :Wl.v~,' ) LtJO lDl.'JfJ'JJ w 4~l-InVIA J~ANJ( N A RIIRNT ~TnRJ: CUll I ARJ: . -~~- ~..- ~CHOVJIA. Premium Savings 01 3000031060896 036 60 o 18 1,636 0000075401 AT 0.33401 3DGS 4 I" 11...11.1.1...1.1.11...1..1.11....1.1111.1...11..11....11.1 ADELINE S MUMMERT POA GAIL L GASTROCK OR PB JACK A MUMMERT 636 MALTESE DRIVE PUNTA GORDA FL 33950 Premium Savings Account number: A.9coul'l!~ own~r(s): 3000031060896 ___ AD.EL.I~E-S~MUMMEBT POA GAIL L GASTROCK OR JACK A MUMMERT 2/28/2008 thru 3/27/2008 5Lk-fy-*Y ;;;;;; - - ;;;;;; = Account Summary Opening ba.lance 2/28 Interest paid Other withdrawals and service fees Closing balance 3/27 - ;;;;;; $16,007.05 1.18 + 16,008.23 - ~ SO.OO !!!! i!! - ;;;;;; - ;;;;;; - - ;;;;;; ;;;;;; !!!! !!!! Deposits and Other Credits Date 3/05 Total Amount Description 1.18 INTEREST FROM 02128/2008 THROUGH 03/05/2008 $1.18 i Interest Number of clays this statement period Annual percentage yield earned Interest earned this statement period Interest paid this statement period Interest paid this year 6 0.45% $1.18 $1.18 $16.46 Other Withdrawals and Service Fees Date Amount Description 3/05 16.008.23 DEBIT TO CLOSE ACCOUNT Total $16,008.23 AS YOU REQUESTED YOUR ACCOUNT /S NOW CLOSED, AND THIS IS THE FINAL STATEMENT. IF YOU HA VE ANY QUESTIONS OR WISH TO REOPEN THIS ACCOUNT, CALL USAT800-WACHOVIA (800-922:4684), OR CONTACT YOUR LOCAL FINANCIAL CENTER. WE APPRECIATE YOUR BUSINESS. u,. I"'L.I^'II A n A "'" .... "tlnklT L'Tnnr- r"'n. I A nr- /r p." ,..,.r '-. ~( . ~ x " :~. "._._l _v.~.~.___.'__'_" /' S(,h t ...r'...." ..,,,.Jl p w JeCH United Church of Christ Hom.es 30 North 31st Street · Camp Hill, PA 17011 (717) 303-1502 W.oI..CHOVIA BANK, N.A. LANCASTER.PA17603 3-50 310 qJk,? ~ 043299 AMOUNT' $2,948.40*** DATE 04/09/2008 CHECK NO, 43299 ~AY TWO THOUSAND NINE HUNDRED FORTY-EIGHT AND 40/100 DOLLARS TO THE ORDER OF Estate of Adeline Mummert c/o Gail Gastrock 636 Maltese Drive Punta Garda, FL 33950 '~, ~~~ ));;d~~ <,;c:,/- (,~.: .,. TWO SIGNATURES REOUIRED IF S50,000 OR MORE NOT VALID AFTER 90 DAYS 1110 l. :i ~ 1111111 ':O:i .00050 :il: 20000 * :i0 98 . :i jlll UNITED CHURCH OF CHRIST HOMES ACCOUNTS PAYABLE DATE CHECK NO. AMOUNT n I'. 3 1') 9. \~I ~ L..,., MEMO INVOICE NUMBER AMOUNT DISCOUNT NET RESIDENT REFUND SARAH TODD HOME ADELINE MUMMERT 03/13/2008 101366 2,948.40 2,948.40 (~ \~ ,'. - \0... .1) ~UJ M.\ \'\ - . S:. \ \\ -r-A t " ...."_~~^,\..J." _........1 \\ ,'" f, '.' ;" I '\.01.1\\: '\ \\'vQ \\{~ ~'!)'...J, : .--\..~ J<.A Ji.-----, ..], -t^-. 11.1Lil Uti L: C~..1\ Q.,(' \C_.iJ\\h. _ _ ' f' r-r (x'r \ t+ \ \..~ \. ~;_.. r~ lr~~\" ._ .--" ~ _,L ~ I - n. I J , LL~...v. CSS - Contract 'nformaUon updated as of: Number: A64002922S Billing Status: Paid Up Single Premium Plan Description: SPDA NON QUALIFIED Clients of the Contract... Name Relationships t,ejeiine.s Mumme:t Annuitant, Payor Owner G?jLG<($1rQ9~ Beneficiary Jac_k J.1\Jll1meli Beneficiary Correspondence Information... Agent Number, Name and Status Contact Information AG00043E.46 Dennis M Hartranft Active Dennis M Hartranft 151 E Main st Ephrala, PA 17522-2720 Important Information... Contract llate: Next Anniversary Day: Issue state: 1012912001 10129 Pennsylvania Product Specific Information... Account Value: $12,291.95 Surrender Value: $12,291.95 $.00 Surrender Charge: Pre-Tetra 'Cost Basis: $.00 Billing Infclrmation... Initial Dep'oslt: $107,469.49 Effective Date: Annuitant: Product Type: Adeline S Mummert Fixed Annuity TaxlD 189-07-8824 Birth Date 11/0411915 Agency Number, Name and Status Contact Information EN00000028 Weaver Financial Active W~~Y"LfJnjmcj?1 151 E Main SI Ephrata, PA 17522 Ph: 800-283-3842 Fax: 717-733-2176 Y{~?\j"rJID.?ncJQI@,te.@??(j99m Billed To Date: 1 012912001 86 Base Issue Age: <: ragt:: 1 U1 1 5zh 6 /Jr Post-Tetra Cost Basis: $11,328.10 1012912001 Transaction Date: 1013012001 https://c:ss.unioncentral.com/contract.asp? contract= A64002922S 2/18/2008 . 1 q.~ Page 2 of 2 83-6A3f670 CIfWl(;K 0QdQ , \'\\(\ \tJ, \'l ~[))~ s~:.r\::\.\\\\~~~\\\ ~li~tJ~ t 0 $ ~\~\Lc.\t.t ~\"'\~,~ ~ jW<. \\n '^ \ ~A l11-t 0 ~ 11\ Cl. aJ- u... l?l Ei'::. " WACHOVIA ~\1 ~~Xi~ NA~ itot ~th.) L ~;C In.,, UJJl- ~_~ ~O~?OO&~i~~~O~02 ~lqlaOl~ ESTATE OF ADELINE S MUMMERT GAIL L GASTROCK EXECunux 636 Maltese Dr Punta Corda, FL 33950 1001 lOO l' ....oOQo..ili~.; 1b.1 r;.- ~. - ~ ~ ., { .... ~~'" ~ -~. , . . ') I , .J . ) f"1 ., c} ',rl. '.) I.. ~ ~~t J irt t .. - ? ,.~ ... ~+,--~~ i-+ ~~~. .~-:_ , . .. : ~ - ; . .:. ) --.. .i ~ . I .93 ~2~)0730" ' !:r;aJ, J hi WA Sr;.7~'l 1~ r'n ~ rh IV" "oK. ~f It.n.. rH 'I.J lr::vc~ ^"'ol.! .-.. __ _ _ ,.., ~ ?rr, t:J /;.5f)52 466 :~ < . . ; REQUEST 000028192090100000004816.14 ROLL REDE 20080317720524664 JOB REDE P ACCT 0031 01 020419] 801 REQUESTOR CRYSTAL WALKER (jAIL L (jASTROCK 636 'MALTESE DR PllNTA GORDA, FL 33950 LAST WILL AND TESTAMENT OF ADELINE S. MUMMERT I, ADELINE S. MUMMERT, of Mecbanicsburg, County of Cumberland and Commonwealth of Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any wills or codicils heretofore made by me. ITEM 1. I direct that all my legally collectible debts and funeral expenses, including reimbursement to any individuals for any expense of my last illness paid by them, shall be paid . from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I bequeath my household and personal effects and other tangible personalty of like nature (not including cash and securities), to my beloved husband, RUSSELL Eo. MUMMERT, PROVIDED he survives me by thirty (30) days. ITEM III. I bequeath all of the shares of stock, common and preferred, and all of my interest in any notes, mutual funds, and bonds of any kind, which I own as of the date of my death, provided, that this bequest shall be of an amount which shall not exceed the Federal Estate Tax exemption equivalent, to the Trustee hereinafter named, IN TRUST, for the following uses and purposes. For example, if the current exemption equivalent is $600,000.00 and the sum of my such securities at the time of my death is $400,000.00, the entire $400,000.00 shall be placed into this Trust. However, if the current exemption equivalent is $600,000.00 and the sum of my such securities at the time of my death is $700,000.00, only $600,000.00 shall be placed into, this Trust. The remaining balance of $100,000.00 shall be given to my husband as part of the marital gift described in ITEM IV herein. A. To pay the net income therefrom to my said husband for and during his lifetime; B. As much of the principal of this Trust as Trustee shall, in its sole discretion, determine is needed for medical, educational, support and health expenses in the event my spouse's other assets are depleted; C. Trustee may apply the net income of this Trust for the support of my husband, should he by reason of age, illness or any other cause, in the opinion of the Trustee, be incapable of disbursing it; D. No property ineligible for the marital deduction or any similar benefit shall be distributed to this gift for my husband pursuant to this Article; E. Upon the death of my husband, the Truste-,e shall first deduct and pay to the personal representative of my husband's estate an amount equal to the increase in federal estate tax or state death taxes which his estate will have to pay because of the inclusion of the assets under this Item of my will in his gross estate (unless he directs otherwise in his will) and all then-remaining principal shall be distributed as follows: 1. The balance of the then-remaining principal shall be distributed as follows: i. I give one (1) equal share to my son, JACK MUMMERT, if he survives me. If he does not survive me, and he has children, I direct that such share be divided equally between or among his children; and ii. I give one (1) equal share to my daughter, GAIL A. GASTROCK, if she survives me. If she does not survive me, and she has children, 1 direct that such share be divided equally between or among her children. F. This Item of my will is intended to empower my Executor to qualify this gift or as much thereof as they deem advantageous for the qualified terminable interest property provision set forth in Section 2056(b)(7) of the Internal Revenue Code as amended by Section 403 of the Economic Recovery Act of 1981 and my Executor is hereby authorized to make the election to qualify or not to qualify. As such I direct that (1) if any provision of my will shall result in depriving this Item of the benefits of IRe Section 2056(b)(7), if elected, such provision is hereby reyoked and my will shall be read as if any portion thereQf which would result in such disqualification is null and void; (2) my Executors are hereby excused from liability to any person for the decision to elect to have this Item qualify for the marital deduction or for the decision to elect not to so qualify it; and (3) no reimbursement or other adjustment shall be made as among beneficiaries by reason of the consequences of such election or failure to elect. ITEM IV. I devise and bequeath the rest, residue and remainder of my estate of whatever nature and wherever located to my beloved husband, RUSSELL E. MUMMERT, PROVIDED he survives me by thirty (30) days. In the event I am not survived by my husband, or if he fails to survive me by thirty (30) days, I direct that my estate be distributed to my children, JACK MUMMERT and GAIL A. GASTROCK, in equal shares, per stirpes. ITEM V. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM VI. I appoint JACK MUMMERT and GAIL A. GASTROCK, as Co-Trustees of any trust created under this will, and I direct that they shaH serve without bond, and further, I direct that they shall be able to give good title to any real estate without order of court. ITEM VII. The interests of the beneficiaries hereinunder shall not be subject to anticipation Of" to voluntary or involuntary alienation. ITEM VIII. My Executor and Trustee shall have the following powers in addition to those vested in them by law and by other provisions of my will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval, and effective until actual distribution of all property: A. To retain any or all of the assets of my estate, real or personal, including any shares of stock or other securities I may own, without restriction to investments authorized for Pennsylvania fiduciaries, but to invest as a prudent man of intelligence and not for speculation, giving due regard to the safety of the principal and the adequacy of the income; B. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, but to invest as a prudent man of intelligence and discretion would buy for himself, for investment and not for speculation, giving due regard to the safety of the principal and the adequacy of the income; C. To sell at public or private sale, to exchange, or to lease for any period of time, . any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they may deem proper; 4 "' D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper; and E. To borrow from, or to sell to, my Trustee even though such Trustee may be my Executors. ITEM IX. I appoint my husband, RUSSELL E. MUMMERT. Executor, of this my last will. Should my said husband fail to qualify or cease to act as Executor, I appoint my children, JACK MUMMERT and GAIL A. GASTROCK, or the survivor of them, to serve as my alternate Co-Executors. I further direct that my Executor or his successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction, and shall give title to real estate without order of court. IN WITNESS WHEREOF, I have hereunto set my hand and seal this \ k", ", , ',',. , 1996 __ '-l.~; ,-IV~.~,I4-.! ,.. i .;2 l~ day of , ~ i /l !,.i~~":! /) l,.i.~? ~ 1 .;\ It":/r ,,/;;<x, t;.t.. (Sea) ADELINE S. MUMMERT Signed, sealed, published and declared by the above-named Testatrix, ADELINE S. MUMMERT, as and for her last Will and Testament, in the presence of us, who at her request, and in her presence, and in the presence of each other, have subscribed our names as witnesses hereunto. r') '" Iii I L(,:f'.r J J,}"I'lJilA,..bl r~"'i' ;..t.l.,-::~':~ "...../ ' . I '. "J ; I ..,.{::J1\ {:/i rz.. " residing at residing at ---1fAi.~ .. ~ LAST WILL AND TEST AMENT OF RUSSELL E. MUMMERT I, RUSSELL E. MUMMERT, of Mechanicsburg, County of Cumberland and Commonwealth of Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any. wills or codicils heretofore made by me. ITEM I. I direct that all my legally collectible debts and funeral expenses, including reimbursement to any individuals for any expense of my last illness paid by them, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I bequeath my household and personal effects and other tangible personalty of like nature (not including cash and securities), to my beloved wife, ADELINE S. MUMMERT, PROVIDED she survives me by thirty (30) days. ITEM III. I bequeath all of the shares of stock, common and preferred, and all of my interest in any notes, mutual funds, and bonds of any kind, which I own as of the date of my death, provided, that this bequest shall be of an amount which shall not exceed the Federal Estate Tax exemption equivalent, to the Trustee hereinafter named, IN TRUST, for the following uses and purposes. For example, if the current exemption equivalent is $690,000.00 and the sum of my such securities at the time of my death is $400,000.00, the entire $400,000.00 shall be placed into this Trust. However, if the current exemption equivalent is $600,000.00 and the sum of my such securities at the time of my death is $700,000.00, only $600,000.00 shall be plac~ into this Trust. The remaining balance of $100,000..00 shall be given to my wife as part of the marital gift described in ITEM IV herein. A. To pay the net income therefrom to my said wife for and during her lifetime; --.', n- --"._!ij;Q.f . B. As much of the principal of this Trust as Trustee shall, in its sole discretion, determine is needed for medical, educational, support and health expenses in the event my spouse's other assets are depleted; C. Trustee may apply the net income of this Trust for the support of my wife, should she by reason of age, illness or any other cause, in the opinion of the Trustee, be incapable of disbursing it; D. No property ineligible for the marital deduction or any similar benefit shall be distributed to this gift for my wife pursuant to this Article; B. Upon the death of my wife, the Trustee shall first deduct and pay to the personal representative of my wife's estate an amount equal to the increase in federal estate tax or state death taxes which her estate will have to pay because of the inclusion of the assets under this Item of my will in her gross estate (unless she directs otherwise in her will) and all then-remaining principal shall be distributed as follows: 1. The balance of the then-remaining principal shall be distributed as follows: i. I give one (1) equal share to my son, JACK MUMMERT, if he survives me. If he does not survive me, and he has children, I direct that such share be divided equally between or among his children; and ii. I give one (1) equal share to my daughter, GAIL A. GASTROCK, if she survives me. If she does not survive me, and she has children, I direct that such share be divided equally between or among her children. F. This Item of my will is intended to empower my Executor to qualify this gift or as much thereof as they deem advantageous for the qualified terminable interest property . provision set forth in Section 2056(b)(7) of the Internal Revenue Code as amended by Section 403 of the Economic Recovery Act of 1981 and my Executor is hereby authorized to make the election to qualify or not to qualify. As such I direct that (1) if any provision of my will shall result in depriving this Item of the benefits of IRC Section 2056(b)(7), if elected, such provision is hereby revoked and my will shall be read as if any portion thereof which would result in such disqualification is null and void; (2) my Executors are hereby excused from liability to any person for the decision to elect to have this Item qualify for the marital deduction or for the decision to elect not to so qualify it; and (3) no reimbursement or other adjustment shall be made as among beneficiaries by reason of the consequences of such election or failure to elect. ITEM IV. I devise and bequeath the rest, residue and remainder of my estate of whatever nature and wherever located to my beloved wife, ADELINE S. MUMMERT, PROVIDED she survives me by thirty (30) days. In the event I am not survived by my wife, or if she fails to survive me by thirty (30) days, I direct that my estate be distributed to my children, JACK MUMMERT and GAIL A. GASTROCK, in equal shares, per stirpes. ITEM V. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM VI. I appoint JACK MUMMERT and GAIL A. GASTROCK, as Co-Trustees of any trust created under this will, and I direct that they shall serve without bond, and further, I direct that they shall be able to give good title to any real estate without order of court. ITEM VII. The interests of the beneficiaries herein under shall not be subject to anticipation or to voluntary or involuntary alienation. ITEM VIII. My Executor and Trustee shall have the following powers in addition to those vested in them by law and by other provisions of my will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval, and effective until actual distribution of all property: A. To retain any or all of the assets of my estate, real or personal, including any shares of stock or other securities I may own, without restriction to investments authorized for Pennsylvania fiduciaries, but to invest as a prudent man of intelligence and not for speculation, giving due regard to the safety of the principal and the adequacy of the income; B. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, but to invest as a prudent man of intelligence and discretion would buy for himself, for investment and not for speculation, giving due regard to the safety of the principal and the adequacy of the income; C. To sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they may deem proper; - D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper; and E. To borrow from, or to sell to, my Trustee even though such Trustee may be my Executors. ITEM IX. I appoint my wife, ADELINE S. MUMMERT, Executrix, of this my last will. Should my said wife fail to qualify or cease to act as Executrix, I appoint my children, JACK MUMMERT and GAIL A. GASTROCK, or the survivor of them, to serve as my alternate Co-Executors. I further direct that my Executrix or her successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction, and shail give title to real estate without order of court. IN WITNESS WHEREOF, I have hereunto set my hand and seal this jCt~LUCV'Y , 1996. ,'2e; day of rL fl- . ' JJ;\;, ~~S~al) RUSSELL E. MUMMERT Signed, sealed, published and declared by the above-named Testator, RUSSELL E. MUMMERT, as and for his last Will and Testament, in the presence of us, who at his request, and in his presence, and in the presence of each other, have subscribed our names as witnesses hereunto. II p() -~.~ residing at qJ11~ It. I'll residing ~t