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HomeMy WebLinkAbout05-28-08• ~ 15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Year File Number Bureau of Individual Taxes tY Po Box 2aosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 08 0227 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 206-22-7244 102/24/2008 ' 09/08/1931 Decedent's Last Name Suffix Decedent's First Name MI WORRALL RICHARD J _ (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 1 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 ,:` ~m'• 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION $H~ULD BE DIREC,~ T0: Name Daytime Telephonei~lt7ber ` „` ' ' 7 THOMAS E. FLOWER (717) 737-3405 y =R: - Firm Name (If Applicable) _ , _ _ _ _ ,!..~'-; ;'~ ~ `i _. ' ~ ` SAIDIS, FLOWER, LINDSAY , REGISTER OF Wft;t;3~USE Ot L~"1 - "-~ First line of address --z .:.~: , ,_ 2109 MARKET STREET ::. _ j ~ cn ~, ~ fv Second line of address CJ'I City or Post Office State ZIP Code ___ .DATE FILED - _ CAMP HILL PA 17011 Correspondent's a-mail address: TFLOWER@SFL-LAW.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 preparer has any knowledge. SIG TURE OF PERSON RESPONSIB~ FOR FI ING RETURN DAT ADDR SS __ _ - - _._ ~• MARLENE W. McHALE, 1198 RAGLEY HALL ROAD N.E., ATLANTA, GA 30319-2512 - - - - _ -- - SI FU E OF PREPA THAN REPRESENTATIVE ~ D TE __: .~_ $ _ L __ _ - - - ADD~2 _ __ _ _- _ SAIDIS, FLOWER & LINDSAY, 2109 MARKET STREET, CAMP HILL, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 J 15056052059 REV-1500 EX Decedents Social Security Number Decedent's Name: RICHARD J WORRALL ' 206-22-7244 RECAPITULATION 1. Real estate (Schedule A) . .......................................... .. L 155,537.80 __ __ 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 585,093.99 ', 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. i .........._ ___.. ............. __ __ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 251,767.72 6. Jointly Owned Property (Schedule F) '"°~~ Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~".3 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/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. _ _ ~ ~w__. _,___,~we~ we.__-_., ~_ _ 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_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 975,574.56 '' 17 18. Amount of Line 14 taxable at collateral rate X .15 1,095,574.56 ~n 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1,165, 322.57 2,157,722.08 33,855.35 2,717.61 36,572.96 2,121,149.12' 50,000.00 2,071,149.12 117,068.95 164,336.18 281,405.13 4.._g 15056052059 Side 2 15056052059 REV-1500 EX Page 3 „File Number Decedent's Complete Address: 21 08 0227 ~_ _ ~._~. DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER RICHARD J WORRALL 206-22-7244 -- -- -- __ - --__ STREET ADDRESS 506 BRIGHTON PLACE -- - --- -- -- - - -- -- CITY STATE ,ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 tine 19) (1) 281,405.13 2. Credits/Payments A. Spousal Poverty Credit ___- _- _ -_ __ - B. Prior Payments 267,000.00 -- - C. Discount _ 14,052.21 - - - Total Credits (A + B + C) (2) 281,052.21 3. Interest/Penalty if applicable D. Interest - __- --_ - --- E. Penalty - -- - _ - - - Total InterestlPenalty (D + E) (3) 0.00 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 352.92 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 352.92 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ~ ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ~ ^ 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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §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. REV-1502 EX+ {6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RICHARD J. WORRALL 21-08-0227 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. tir more space Is neetletl, Insert atltlitional sheets of the same size) REV-1503 EX+ (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RICHARD J. WORRALL 21-08-0227 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH ~ 1,710.193 SHARES VANGUARD VALUE INDEX FUND @ 24.405 41,737.26 2. 7,672.410 SHARES VANGUARD GNMA FUND @ 10.32 79 179 27 3. 359.969 SHARES VANGUARD 500 INDEX FUND @ 125.775 45,275.10 4. 8,837.602 SHARES VANGUARD HIGH YIELD TAX-EXEMPT FUND @ 10.41 91,999.44 5. 1,911.386 SHARES VANGUARD SMALL-CAP INDEX FUND @ 30.455 58,211.26 6. 9,628.407 SHARES VANGUARD INSURED LONG-TERM TAX-EXEMPT FUND @ 12.16 117,081.43 7. 2,676.094 SHARES VANGUARD MID-CAP INDEX FUND @ 19.44 52,023.27 8. 176.841 SHARES NICHOLAS FUND @ 46.545 8,231.06 9. 15,353.932 SHARES EVERGREEN DIVERSIFIED INCOME BUILDER FUND-A @ 5.95 91,355.90 TOTAL (Also enter on line 2, Recapitulation) I $ 585,093.99 (If more space is needed, insert additional sheets of the same size) REV-15D8 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC, PERSONAL PROPERTY FILE NUMBER RICHARD J. WORRALL 21-08-0227 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. tir more space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER RICHARD J. WORRALL 21-08-0227 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTAND THE DATE OF TRANSFER. ATTACH ACDPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE ~ 139.605 SHARES FEDERATED AMERICAN LEADERS FUND @ 15.94 7 , TRANSFER-ON-DEATH TO SISTER MARLENE McHALE AND BROTHER- IN-LAW THOMAS M. McHALE ...................................................................... 113,805.30 100 113,805.30 2. 1,101.659 SHARES FEDERATED STOCK & BOND FUND @ 17.04 TRANSFER-ON-DEATH TO SISTER MARLENE McHALE AND BROTHER- IN-LAW THOMAS M. McHALE ...................................................................... 18,772.27 100 18,772.27 3. T ROWE PRICE MUTUAL FUNDS (ATTACHED VALUATION) TRANSFER-ON-DEATH TO SISTER MARLENE McHALE AND BROTHER- IN-LAW THOMAS M. McHALE ....................................................................... 930,427.57 100 930,427.57 4. T ROWE PRICE BROKERAGE ACCOUNT #306476254 (ATTACHED VALU- ATION) TRANSFER-ON-DEATH TO SISTER MARLENE McHALE AND BROTHER-IN-LAW THOMAS M. McHALE ..................................................... 30,665.25 100 30,685.25 5. T ROWE PRICE IRAs, (ATTACHED VALUATION) TO SISTER 71,632.18 100 71,632.18 MARLENE McHALE and BROTHER-IN-LAW THOMAS M. McHALE TOTAL (Also enter on line 7 Recapitulation) 3 I 1,165,322.57 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER RICHARD J. WORRALL 21-08-0227 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 MUSSELMAN FUNERAL HOME, PROFESSIONAL SERVICES 3,495.00 2 CASKET AND OUTER BURIAL CONTAINER 3,225.00 s FLOWERS, OBITUARY, DEATH CERTIFICATES, GRAVE OPENING/CLOSING AND HONORARIA 1,335.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)lEIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 25,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 314.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees ~. PUBLISH EXECUTOR'S NOTICES, THE SENTINEL (182.56), COMB. LAW JOURNAL (75) 257.56 s. ADDITIONAL SHORT CERTIFICATES AND FILING FEE 50.00 s. BRIGHTON PLACE, ASSOCIATION FEE 120.00 ~o. UCN, PHONE SERVICE 25.15 ~ i FEDERAL EXPRESS, SHIPPING COSTS 33.64 TOTAL (Also enter on line 9, Recapitulation) $ 33,855.35 (If more space is needed, insert additional sheets of the same ;size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER RICHARD J. WORRALL 21-08-0227 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (g-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RICHARD J. WORRALL 21-08-0227 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)i 1 MARLENE W. McHALE, 1198 RAGLEY HALL ROAD N.E., ATLANTA, GA sister 1/2 residue 2 THOMAS M. McHALE, 1198 RAGLEY HALL ROAD N.E., ATLANTA, GA brother-in-law 1/2 residue 3 Janice W. Lalich, 19 Cricklewood Ln, Norwalk CT 06857 niece 10,000 ~ Linda W. Adams, 3308 5th Ave, Phoenix City, AL 36869 niece 10,000 5 Judith W. Crowe, 24 Kite Town Road, Seale AL 36875 niece 10,000 6 Jeffrey Worrall, 6741 B Arthur Rd., Lowville, NY 13367 nephew 10,000 7 Clifford Worrall, 325 Washington Ave S #245, Kent WA 98032 nephew 10,000 8 Kenneth Worrall, 6128 Cedar Hill Ln, Florence, KY 41042 nephew 10,000 9 Robert Worrall, 7139 Hwy 85 #204, Riverdale, GA 30274 nephew 10,000 see continuation sheet ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROU GH 18, AS APPROPRIATE, ON RE V-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 1 St. Luke's Episcopal Church, Keller Street, Mechanicsburg, PA 50,000 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (Ii more space is needed, insert additional sheets of the same size) SCHEDULE J Beneficiaries (Continuation Sheet) Estate of Richard J. Worrall Number Name and Address of Person(s) Receiving Property 10. Angela Shook 3049 Hidden Drive, Lawrenceville, GA 30244 11. Michelle McHale 4313 Martingale Lane, Acworth, GA 30101 12. Kathleen Newbern 472 Whittington Court, Atlanta, GA 30342 13. Thomas McHale 19426 Sandy Springs Circle, Lutz, FL 33558 14. Michael McHale 5054 Bel Air Bluff Court, Mableton, GA 30126 File Number 21-08-0227 Relationship to Decedent Amount or Share of Estate niece 10,000 niece 10,000 niece 10,000 nephew 10,000 nephew 10,000 TaxDB Result Details Page 1 of 1 Detailed Results for Parcel 42-24-0791-164.-U506 in the 2004 Tax Assessment Database DistrictNo 42 Parcel ID 42-24-0791-164.-U506 MapSufTix HouseNo 506 Direction Street BRIGHTON PLACE Ownerl WORRALL, RICHARD J C/O PropType R PropDesc LivArea 1674 CurLandVal 0 CurImpVal 127490 CurTotVal 127490 CurPretVal Acreage .00 CIGrnStat TaxEx 1 SaleAmt 124900 SaleMo 12 SaleDa 10 SaleCe 20 SaleYr 02 DeedBkPage 00254-04505 YearBlt 1994 HF File Date 11/09/2004 HF_Approval_Status A http://taxdb.ccpa.net/details.asp?id=42-24-0791-164.-U506&dbselect==1 3/7/2008 (3/26/2008) TORRIN CAVANAUGH - Re: prod -Date of Death Request From: DATE OF DEATH REQUESTS To: CAVANAUGH, TORRIN Date: 3/26/2008 7:41 AM Subject: Re: prod -Date of Death Request To: Torrin 3/26/2008 Please print a copy for your files. Please find below the date of death balance for: Richard) Worrell, social security # 206-22-7244 1. Account # 91653622, Balance $27,988.01 + accrued interest $ 0.61 = $27,988.62 total Records Management /DOD Unit M&T Bank- "Understanding what's important." »> <tcavanaugh@mtb.com> 3/21/2008 9:38 AM »> Account Information Date of death: 02/24/2008 Account Number: 91653622 Product Type: Deposit Account Request Details Deliver to: Requestor Delivery Options: E-mail Delivery Details: ebrnl3i Page 1 ?~banc r Fund Services, LL ~~ ~~ 615 East Mich. Milwaukee, WI SAIDIS, FLOWER & LINDSAY March 21, 2008 ATTN: MARLENE W. MCHALE 2109 MARKET ST CAMP HILL PA 17011-4723 REFERENCE NUMBER: 00313656 NICHOLAS FUND, INC. ACCOUNT NUlV1I3ER: 398875000 RICHARD J WORRALL Dear Ms. McHale: Thank you for contacting Nicholas Funds in regard to Richard J. Worrall's account. Mr. Worrall's account registration is referenced above. This account was held individually with no beneficiaries. I -----~~~liquidate or change the registration of the above account, we will require: A letter of instruction signed by the Personal Representative of the Estate. The signature must be guaranteed. The signature guarantee requirement is to ensure that the Representative has authorized this transaction to occur. You may obtain a signature guarantee at many commercial banks, credit unions, savings associations or broker dealers. A notary public is unable to provide an acceptable guarantee. • A completed W-9 form for the Estate tax identification number. • To change the registration, please also complete the enclosed application for the new registration. Due to the shareholder's death occurring on a weekend, we are providing information on the account for the preceding Friday and following Monday. The following table shows the value of the account as of the close of'business on February 22, 2008 and February 25, 2008: Date Number of Shares Net Asset Value Total Value 2/22/2008 176.841 $46.14 $8,159.44 2/25/2008 176.841 $46.95 $8,302.68 Please return all necessary documents in the enclosed envelope. Federated Shareholder Services Company 1'itthur~h. Yelln~~ 1~-ania N~~~-York. Ne~~'York l hlbliu. Ireland Federatedlnce.roricom March 31, 2008 Sadis, Flower & Lindsay 2109 Market St Camp Hill PA 17011-4723 Reference: 00210258 Federated American Leaders Account Number: 5811433513 Federated Stock & Bond Fwid Account Number: 312128523 Richard James Worrall TOD Dear Sir or Madam: Thank you for contacting Federated; we welcome the opportunity to assist you. Federated WORLD-CLASS INVESTMENT MANAGER On, February 24`'', 2008, the value of the Federated American Leaders Transfer on Death (TOD) account was $113,805.30, based on 7,139.605 shares at the net asset value of $15.94 per share on that date. The shareholder has another TOD account with Federated. It is the Federated Stock & Bond Fund. On, February 24`h, 2008, the value of the Stock & Bond TOD account was $18,772.27, based on 1,101.659 shares at the net asset value of $17.04 per share on that date. The designated beneficiaries for both accounts are Mrs. Marlene A McHale and Mr. Thomas M McHale Sr. To transfer or redeem shares, please use the enclosed Change of Ownership or Redemption by Mail Form. Each outlines the information needed to process the transaction. An original Medallion guarantee is required; see the forms for details. - Please return the form that meets your needs with: 1. The O r~ of Appointment naming the legal representative(s) of the decedent's estate. The court or clerk of p the~eburt must certify the document within 60 days of the transaction request. The certification, usually ink N ~ tamp or raised seal, must be original. 2. The enclo Form W-9 to certify the Tax Identification number (TIN) for the decedent's estate. The legal r~~ repres ative(s) of the estate, including capacity (e.g., Thomas Greene, Executor), must sign the Form W- Y 9. a TIN has not been established for the estate, the transfer or redemption will be processed under the currently listed on the account. J 3. An original Tax Waiver may be required by Pennsylvania, the decedent's state of residence. If so, the waiver needs to show the number of shares owned on the date of death. Please contact the Pennsylvania State Department of Revenue for information about this requirement. ESTATE OF RICHARD J. WORRALL T, ROWE PRICE ACCOUNTS/DOD VALUATION A. TOD MUTUAL FUND ACCOUNTS: Equity Income #630081338-6 [PRFDX] 3,943.791 X 26.68 = $ 105,220.34 Growth and Income #2785271440-4 [PRGIX] 4,330.378 X 20.725 = 89,747.08 Growth Stock #84681-1 [PRGFX] 1,703.651 X 30.535 = 52,020.98 International Stock #630081342-5 [PRIX] 2,549.282 X 15.56 = 39,666.83 New Era #311128656-1 [PRNEX] 1,956.814 X 59.95 = 117,311.00 New Horizons #10181113-0 [PRNHX] 904.147 X 27.46 = 24,827.88 International Bond #610109078-0 [RPIBX] 1,402.496 X 10.28 = 14,417.66 New Income #4040247014-6 [PRGIX] 12,034.117 X 9.02 = 108,547.74 Tax-Free High Yield #200704469-8 [PRFHX] 27,343.404 X 11.26 = 307,886.73 Summit Cash Reserves #1579989-8 70,781.33 Total d.o.d. value of TOD Mutual Fund accounts: $ 930,427.57 B, TOD BROKERAGE ACCOUNT #30B476254: CAMPBELL SOUP CO [CPB] 200 SH. @ 32.70 = $ 6,540.00 DELPH{ CORP COM [DPHIQ] 200 SH @ 0.15 = 30.00 ECLIPSYS CORP COM [ECLP] 300 SH. @ 21.0025 = 6,300.75 GENERAL ELECTRIC [GE] 200 SH. @ 33.6925 = 6,738.50 HERSHEY CO COM [HSY] 300 SH. @ 36.92 = 11.076.00 Total d.o.d. value of TOD Brokerage account: $ 30,685.25 C. INDIVIDUALLY HELD ACCOUNT #5001291465-5: Summit Cash Reserves: $ 213,014.10 D. IRAs Capital Appreciation #520782445-3 [PRWCX] 1,537.67 x 19.435 = $29,884.62 Growth and Income #630062360-2 [PRGIX] 690.938 X 20.725 = 14,319.69 Summit Cash Reserves #1506279-0 27,427.87 Total d.o.d. value IRAs: $ 71,632.18 Total d.o.d. value for all T. Rowe Price accounts: $ 1,245,759.10 Kelley Blue Book -Private Party Pricing Report -Chrysler, Sebring -~ Official Kelley Blu... Page 1 of 4 ~~~ ~~~ rlro ~tES+~u~ Home New Cars Used Cars Research & Explore News & Reviews Classifieds Auto 1. 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Or Search by Category Or Change ZIP Code Vehicle Highlights 2008 Dodge Avenger Esti Photos $ 103 , Review _ Pricin Get a Pi More Results » ' ' 6.09°i° , ___ __ YourCr Get a Fi ', Mileage: 88,000 ', Engine: V6 2.7 Liter Transmission: Automatic Drivetrain: FWD Selected Equipment Change Equipment Standard Air Conditioning Cruise Control Leather ', Power Steering AM/FM Stereo Power Seat ', Power Windows Cassette Alloy Wheels ', Power Door Locks Single Compact Disc ', Tilt Wheel Dual Front Air Bags Optional Sun Roof Blue Book Private Party Value ', Private Party Value is what a buyer can expect to pay when buying a used ', car from a private party. The Private Party Value assumes the vehicle is sold L "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings Check Vehicle Title History Excellent $5,775 http://www.kbb. com/KBB/LTsedCars/PricingReport.aspx?Manufacturerld=10&Yearld=20... 4/28/2008 Kelley Blue Book -Private Party Pricing Report -Chrysler, Sebring -Official Kelley Blu... Page 3 of 4 • Looks new, is in excellent mechanical condition and needs no reconditioning. • Never had any paint or body work and is free of rust. • Clean title history and will pass a smog and safety inspection. ', • Engine compartment is clean, with no fluid leaks and is free of any ', wear or visible defects, • Complete and verifiable service records. Less than 5% of ail used vehicles fall into this category. Good ~ $ 5, 265 • Free of any major defects. • Clean title history, the paints, body, and interior have only minor (if any) blemishes, and there are no major mechanical problems. • Little or no rust on this vehicle. • Tires match and have substantial tread wear left. • A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Fair " $4, 640 • Sarne mechanical ar cosmetic defects and needs >ervicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professional • Tires may need to be replaced. • There may be some repairable rust damage. Poor ~:~ N/A • Severe mechanical and/or cosmetic defects and is in poor running condition. • May have problems that cannot be readily fixed such as a damaged frame or a rusted-throuyh body. • Branded title (salvage, flood, etc.) or unsubstantiated mileage. !. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal' to determine its value. * Pennsylvania 4/28/2008 Accurate Condition Appraisal Change Condition Accurately appraising the condition of a vehicle is an important aspect in ~~,! determining its Blue Book value. Taking our 16 question condition quiz will ', ensure you know the correct condition rating. http://www.kbb.com/KBB/UsedCarslPricingReport. aspx?Manufacturerld=10&Yearld=20... 4/28/2008 LAST WILL AND TESTAMENT OF RICHARD J. WORRALL I, RICHARD J. WORRALL, of Mechanicsburg Borough, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST ~.~ 1 direct the payment of my just debts and the f:xpenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be ~~ no cemetery lot available for my interment owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefor funds from my estate in such amount as she shall consider necessary and desirable, and 1 authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, I authorize my personal representative to expend funds from my esta#e, in such amount as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. SAIDIS, SECOND AWER &z LINDSAY I give and bequeath to Wichita State University the sum of Two Hundred Fifty ~.~:>aW 109 Muker Srreer cep xm, rn Thousand ($250,000) Dollars, in memory of Forrest Eugene Richert. 1 desire that these funds be devoted by the University to create a memorial scholarship fund in the name of Forrest Eugent Richert. I further specify that the funds are intended for the educational support of students in the Voice and/or Theater Performance Programs; provided, th {,, ~_ rte. ~w~ ~~ ~~l ,~ i ~`~ ,~ ~~ each recipient of scholarship funds shall be required to pursue concurrently a major in voice or theater performance, along with a minor in one of the following fields: business, accounting, economics, physics, biology, chemistry, education, engineering, mathematics, pre-medical studies, or another field of Equivalently practical knowledge. My purpose in so specifying is to deter any such scholarship recipient from relying upon music as his or her sole prospective career. It is my intention to make this gift to the University during my lifetime, and, in the event that I have done so before my death, this gift under my will shall have been fully satisfied thereby and shall be void. THIRD I give and bequeath the sum of Fifty Thousand ($50,000) Dollars to St. Luke's Episcopal Church, Keller Street, Mechanicsburg, PA. I request that this bequest be devoted to specific tangible purposes of the church, and it shall not simply be devoted to the current, general operating expenses of the congregation. It is my intention to make this gift to the church during my lifetime, and, in the event that I have done so before my death, this gift under my will shall have been fully satisfied thereby and shall be void. FOURTH To each of the following nieces and nephews of mine who survive me l give and SAIDIS, LIl`JDS~ erroer~s,~ uw 109 Market Street Camp Hill, PA bequeath ;the ~surn of Ten Thousand (:$1-0,000) Dollars: Linda M. (Worrall) Adams, JaniceL. (VI/orrall) Lalich, Jeffrey L. Worrall, Clifford R. Worrall, Kenneth Worrall, W. Worrall, Angela M. (McHale) Shook, Michelle A. (MrHale) Reisweber, Kathleen P. (McHale) Newbern, Thomas M. McHale, Michael J. McHale and Judith A. (Worrall) Crowe. 2 ~ ~ 'r=• „, ~, , FIFTH I give, devise and bequeath all the rest, residue and remainder of my estate unto y MARLENE W. McHALE and THOMAS M. McHALE, of Atlanta, Georgia, or the survivor of them; or, in the event they both predecease me, then to their issue, per stirpes. SIXTH I direct that any and all inheritance, estate, and transfer taxes imposed upon my estate passing under this Will or otherwise shall be paid out of the principal of my residuary estate. SEVENTH In addition to the powers conferred by law, I authorize any personal representative acting under this instrument, in her absolute discretion: (a) To retain in the form received, or to sell either at public or private sale any real or personal property; (b) To exercise any options to subscribe for stocks, bonds, or other investments; (c) To join in any plan of lease, mortgage, consolidation, exchange, reorganization or foreclosure of any corporation in which my estate or any trust may hold stocks, bonds or other securities; (d) To sell, transfer, convey, mortgage, pledge, lease or exchange any property, real or personal, which at any time may form part of my estate, for the SAIDIS, SOWER ~ LINDSAY nrmw~~s~ruw 2109 Mazkct Street Camp Hill, PA payment of debts or taxes, or for any purpose of administration or distribution, for such prices and upon such terms as they, in their sole discretion, may deem, wise, and to execute and deliver deeds of conveyance or transfer thereof; 3 _ _ - __ (e) To make settlements and compromises on such terms as she, in her sole discretion may deem wise without the necessity of obtaining any court approval thereof; (f) To make distribution hereunder either in cash or kind, as she, in her discretion may deem wise. EIGHTH I do hereby nominate, constitute and appoint my sister, MARLENE W. McHALE, of Atlanta, Georgia, to serve as executrix of this my Last Will and Testament. to the event that MARLENE W. McHALE is unable or unwilling to serve in that capacity, I appoint my brother-in-law, THOMAS M. McHALE as alternate executor. NINTH I direct that no personal representative or other fiduciary appointed under this instrument shall be required to give bond for the faithful performance of his or her duties in any jurisdiction. IN WITNESS WHEREOF, I, RICHARD J. WORRALL, have hereunto set my hand and seal to this my Last Will and Testament, consisting of four (4) typewritten pages, the first three (3) of which bear my signature in the margin for identification, this. ~, ~D -day of , 2006. WER ~ .~~~' LINDSAY I ARD J ORRALL, Testator enna~vs~nnuw 2109 Mazket Stteet Camp Hill, PA 4 Signed, sealed, published and declared by the above-named Testator, RICHARD J. WORRALL, as and for his Last Will and Testament in the presence of us, who have hereunto subscribed our names at his request as witnesses thereto, in the presence of s~' Testator and of each other. 1.f ., f ~~ ' ~~ ADDRESS a I ~ ~' /~"(.~,-~ - ~• Witness -, ~~ ~` ~~ Witne ADDRESS ~~ ~ /~, ~~ ~ /7Dir COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. WE, RICHARD J. WORRALL, ~©ir~s~ ~-u,;r~~/Z and~~y/~L CU,~~'P~, the Testator and witnesses, respectively whose names are signed to the foregoing or attached instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he signed willingly and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Will as witness and that to the best of their knowledge the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. 0 ~~-C~'. RI HARD ORRALL, Testator SAIDIS, LIlVDS~ .~rtow.~s•eT.uw 2109 Mazket Street Camp Hill, PA ~ v~ Witness Witne s Subscribed, sworn to and acknowledged before me by RICHARD J. WORRALL, the Testator and subscrib~ to and/ sworn or affirmed to befor~ me by .Os. ~ Dt~/f~e-- and /,o~yuA ~. ~l/il?,C'~ witnesses, this ~~~ day of ' , 200. /f COMMONWEALTH OF PENNSYLVANIA ~ 2 Notarial Seal Sara J. Ensinger, Notary Public N tary Pu C Carlisle Boro, Cumberland County 5 My Commission Expires Oct 17, 2009 Member, Pennsylvania Association of Notaries