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HomeMy WebLinkAbout06-06-08 (2)15D56041147 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes ~ INHERITANCE TAX RETURN PO 60X.280601 Harrisburg, PA 17128-0601 '° RESIDENT DECEDENT 2 1 0 8 0 0 1 1 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 190 18 3124 01 17 2008 08 06 1922 Decedent's Last Name Suffix Decedent's f=first Name MI FEGLEY NELDI F (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 I X ' 1. Original Return L !, 2. Supplemental Return i ~ 3. Remainder Retum (date of death prior to 12-13-82) ___ ~ i. 4. Limited Estate qa_ Future Interest Compromise i _ ' S. Federal Estate Tax Return Required • - ~- -- (date of death after 12-12-82) ~- ,I X ~ 6 Decedent Died Testate ~ - ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes '- (Attach Copy of Will) ~ (Attach Copy of Trust) 9. Litigation Proceeds Received ( 1 p. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) L. ~ L___ between 12-31-gt and 1-1-95) __ (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAN M WILEY 717 432 9666 Firm Name (If Applicable) THE WILEY GROUP, PC First line of address 130 W. CHURCH STREET Second line of address City or Post Office DILLSBURG Correspondent's a-mail address: State ZIP Code PA 17019 REGISTER~~ILLS US~NLY___ ~ -~~ ~ -' 4 ' : . r- -,~,~ ,. .I'rt I - i ,s~~ , CIl -~~~~_ _ ) 1 I ~ _ _-.~ DD~fE FILED ~ _ `, ;, r..rt -, i-., I ,. ~ ..:i ~ -~ .~ _.; .~ ~? 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~-~~ DATE C Kathleen A. Boyd ~~?~C.ctc . ~.~ ~ ~4~.5~~! ADDRESS ~ ~ 50 Erbs Bridge Road, Mechanicsburg, PA 17055 S NATU OF PREPARER OTHER THAN REPRESENTATIVE GATE • . Jan M Wiley ~ / ~ / U ~/ /130 W? Church Street, Dillsburg, PA 17019 Side 1 15056041147 15056041147 PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Fegley, Neldi F. 21-08-00111 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. Signature #2 Name Address1 Address2 City, State, Zip Date Denise A. Dechesne 7 North Filevs Road Dillsburg, PA 17019 ~~~ ~ J 15056042148 REV-1500 EX Decedent 5 Name. N e I d I F. F e g l e y __ RECAPITULATION t 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 8 Notes Receivable (Schedule D)..._ ..............._.... _ __... ... 4 5 Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) .............. . 5. 6. Jointly Owned Property (Schedule F) Ir ~~, Separate Billing Requested ............ . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 'Separate Billing Requested ............ . 7. 8. Total Gross Assets (total Lines 1-7) ...................................................................... . g. 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. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X .00 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 1 1 8 8 3 5 7 16. 17. Amount of Line 14 taxable 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. Decedent's Social Security Number 190 18 3124 5,457.25 23,881.99 29. 339. 29 16, 898. 92 556. 75 17, 455. 67 11, 883. 57 11,883.57 0.00 534.76 0.00 0.00 534.76 Side 2 15056042148 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-00111 DECEDENT'S NAME Neldi F. Fegley STREET ADDRESS 2100 Bent Creek Road Apt. 119 CITY STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) (1) 534.76 2. Credits/Payments q. Spousal Poverty Credit - - g. Prior Payments __ C. Discount 0.00 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable - p. Interest E. Penalty Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 534.76 A. Enter the interest on the tax due. (5A) g, Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5g) 5 3 4.7 6 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 :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :................... _............... I ~ ! x c. retain a reversionary interest; or ...................................................................................................__......... f X 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?......... ~ _ i Lx ,l. 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ix', 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)]. 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. Iv E L _ _ ~_~--,} ~. . .i _ _~_ l~~ _ .~E?1~: ~1~V1\~Il i~ .. .. E'C ~.:tE .. _~i_ .-U I;P [TJ ~. - ., .1 ,:r~<. .'cs:ame~~r_ anti revc]_r= c:. ~ .1,. ' ~_.. h~,~e E~:" ] Crcc-r _r. r. ~ ~< <~, _~-.t ~.~ y _st c[~t>t_~ , - c, ,:c' __ ~, at ~cn e~_~~:,. ~ _ _,_, .. ~~~,,~. ~.. ~or;vcn~t'r.t `~:- 1FE-, ~1 1 give, de~ls~_ u~~c bequeath ail of my estate ..~;~_zi~er real , pc~r sonal or mixed, ar:Ci ~,~heresoecer same may be ~~t~~=ted to my husband, WILLIATS P_. FF~:LFY, JR. STEMS ? II . I appoint m,; Husband, WILLIASS A. F'EGLI~Y, JR. , <~~ Executor of this my Last A~ill anus 'T'estament, and I direc~~ that rc bone. or other security for the faithful performance of his duties as Executor shall be demanded or required of him. I direct that the services of HARRY G. BANZI-TOFF, Attorney at Law, with offices i.. the City cf Iiarrisburg, Dauphin County, Pennsylvania, shall be used as counsel in the settling of the affairs of my estate. ITEM I\~_ In the event that my husk and, WILLIAP4 A. FEGLEY, JR., should predecease me, or we should die in a common disaster, I then Dive, devise and bequeath all of my estate, whether real, personal or mixed, and wheresoever same may be situated in equal shares to my two daughters, KATHLEEN F. BOYD and DENISE F. DECHESNE, or their issue per stirpes. ITEM ~j. In the event that this portion of my will shall become effective, I appoint my daughters, KATHLEEN F. BOYD and DENISE F. DECHESNE, Co-Executrix and direct that no bond or other security for the faithful performance of their duties as Co-Executrix shall be demanded or required of them. I direct that the services of HARPY G. BAN2HOFF, Attorney at Law, with offices in the City of u, .-b :: ,- n~ L~; rr. ., r., nee, ,l. ci;al 1 L.o cod ~_, Cn ~ncAl DATE }' (SEAL) -1- -...~ set ti .. = cf ~ hr ~.. +a_.i s of rnp estate. ,: ; i ViS`, r'idr RLC= _ t.,=~ic~ h['r t'ttt,.i o _;~~t ~ ~ ..- t 1, ~ -_ i ,-. - ~_ ~, ~ .r. ~_.c_c_~_ ., .,~~st_.~ of two (11 ~.~~ ~ ~te~n F ~~cE~, , -- --- --- Y'-~'--- -' ~, - _. ~~ .~- ~ ~ ~ ,~ j I~ i t~ ~a (~!~ ~ Fubcc _____ _. __- -- ec 2 l9fo~h RS~• Commiss~T'k~' Cr^r~c kua;!_ e F. ~vrtaE~e!la•~~' A'•euntY SIGNED, SEf±LED, PUBLISHED and DECLARED, by the said Testatrix, ~ELDI F. Ft;Gi,EY, to be her Last will and Testament, in our presence and .in the presence of each other, who, at. her request and in her presence, have hereunto subscribed our hands and seals as witnesses, we believing her to be of sound and disposing mind, memory and understanding. //~~?i~~_->-, ~ -~~-r nJ -residing at~'~ 3 ~!zc,Y;oC~n ~c~, ~ ~ ~. 'l , n i/ --~-- L ~l ztt~v `/-l- ~ residing at~~L~3-~;~,~~~~L__~~ roc ~~ ~\ G~~ -2- Rev-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAR RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Fegley, Neldi F. 21-08-00111 All property jointly-owned with right of survivorship must be disclosed on Schedule F ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEAT!-! 1 MetLife Stock: 58.26 5,457.25 TOTAL (Also enter on Line 2, Recapitulation) 5,457.25 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) MET: Historical Prices for ME"hLIFE INC -Yahoo! I=finance Page 1 of 3 'taboo! P;y 'lahoe+ f~:}ail t~~,r,rt~ake YF R/ty i-6r~me Gage Ncnn iscr? ':~~~n 1;;; Sign In ~+~~~„ F ~ ~ ~ ~ ~ ~ Search WEB SEARCt Dow '~ 6.39% Nasdaq '~ 0.52% ti'r'ed, lun 4, 2008, 10:27AM F 1 - U.S. Markets doss { GE? i~u©TES ~ Finance Search MetLife, Inc. (MET) At lo:izaM ~~ 59.50 ~ ~~ ` ~ t ~ ~ ~~~ •'~ r ~,a, pMERlTRADE ~~~ .t.:~~ ~ TRA~~ ,----~ Pd._ i+i<i~nt~n~znce tees. ~~~~ ~ r `/ ~ V~i'E''B~~,aT ;' ~d C,Q -- ---- ---- ~ E~TF.PDE Sc[url Tler tLC _._..._,-~. Historieai Prices Get Historical Prices for: IGO, SET DATE RANGE ~~-Daily Start Date: Jan 1 2008 Eg. Jan 1, 2003 Weekly End Date: Jan 31 2008 ~.._` Monthly 'J Dividends Only Get Prices First ~ Prev ~ f`text ~ Last PRICES Adj Date Open High Low Close Volume Glose" 31-Jan-08 56.71 59.81 56.36 58.88 7,420,200 58.88 30-Jan-08 58.20 59.75 57.33 57.53 6,182,200 57.53 29-Jan-08 57.35 58.43 56.71 58.39 4,411,100 58.39 28-Jan-08 54.81 56.86 54.45 56.81 4,775,600 56.81 25-Jan-08 57.10 57.92 54.38 54.62 6,155,400 54.62 24-Jan-08 55.70 56.80 55.39 56.44 6,293,800 56.44 23-Jan-08 54.00 55.62 52.46 5529 11,450,400 55.29 22-Jan-08 54.00 57.58 52.70 55.43 13,149,200 55.43 18-Jan-08 58.88 59.00 54.77 57.43 14,602,300 57.43 17-Jan-08 60.95 60.95 57.81 58.26 8,443,700 58.26 16-Jan-OS 60.00 61.83 60.00 60.65 7,982,400 60.65 15-Jan-08 60.59 61.00 59.75 59.86 4,631,000 59.86 14-Jan-08 60.16 60.23 59.14 60.10 3,512,300 60.10 11-Jan-08 59.29 60.50 58.50 59.56 5,674,000 59.56 10-Jan-OS 58.00 60.67 57.94 60.04 5,900,400 60.04 ADVERTISEMENT http://finance.yahoo.com/q/hp?s=MET&a=00&b=1 &c=2008&d=00&e=31 &f=2008&g=d 6/4/2008 Rev-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Include the proceeds of 66ga6on and the date the proceeds were receWed by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NI II~ARFR DESCRIPTION VALUE AT DATE OF rUEATu 1 Bent Creek (refund): 1,595.70 2 Members 1st FCU CD#5103-40: 10,835.33 3 Members 1st FCU Savings Account #5103-00: 2,506.66 4 Members 1st FCU Vacation Club Account #5103-03: 416.59 5 Misc. Refunds (2 @ $100.00): 200.00 6 PNC Bank Checking Account #5140019697: 8,327.71 TOTAL (Also enter on Line 5, Recapitulation) I 23,881.99 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) _ _ _ - PN~BA3~lC March 25, 2008 The Wiley Group Attn: S Dawn Gladfelter 130 W Church Street Suite 100 Dillsbur~, PA 17019 RE: Estate of Nedli F Fegley SSN: 190-18-3124 DOD: 01!17!200$ Dear Ms Gladfelter. In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5140019697 Established 01/01!1478 NELDI F FEGLEY DOD balance: $8,327.71 + 0.04 accrued interest PIease note that this ogee only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide state:onents. If you need assistance with any of these items, please call 1-888-PNC-BANK {1-888-752-2255} or stop by your local I?I3C 13az~k branch office. Svncerely, ~~~ Garzony 1-800-762-1775 Firstside Center SQO First Avc. 4`" Floor , Pittsburgh PA 15219 Member FpIC REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner VACATION CLUB ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERT{F{CATES OF DEPOSfT: Account Number/Suffix Date Certificate Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued interest Name of Joint Owner HELOC-2ND MORTGAGE LOAN: Account Number/Suffix Date Loan Established Principal Balance at Date of Death Name of Co-Borrower Estate of: NELDI F. FEGLEY Date of Death: 01/17/2008 Social Security Number: 190-18-3124 5103 -00 03/14/1960 $5, 504.33 $2.33 $5, 506.66 None 5103 -03 09/06/2007 $416.40 $.19 $416.59 None 5103 -40 10/01!2007 $10,811.25 $24.08 $10, 835.33 None 5103 -01 09/13/2006 $3,918.68 None M RS 1ST F ~DjE~RAL CREDIT UNION - , ~T/ Denise A. Wolfe Insurance Services Supervisor March 18, 2008 5000 Louise Drive PO. Box 40 Mecharvcsburg, Pennsylvania 17055 (800) 283-2328 www.memberslst.org i<EV-1151 EX+ 112-99) COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Fegley, Neldi F. 21-08-00111 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 10,995.12 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees The Wiley Group, PC 1,500.00 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 106.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 156.00 7. Other Administrative Costs 4,141.80 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 16,898.92 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ ~6-96) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PE NNSVLVANIA INHERITANCE TAX RETURN RESIDENT DECEDEN? ESTATE OF (FILE NUMBER Fegley, Neldi F. 21-08-00111 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) ,Rev-1502 EX+ (6-981 SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continue d RESIDENT DECEDENT ESTATE OF (FILE NUMBER Fegley, Neldi F. 21-08-00111 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) RRV-1512 EX+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Fegley, Neldi F. _ 21-08-00111 Include unreimbursed medical expenses. (Ir more space Is needed, atltlltional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Fegley, Neldi F. 21-08-00111 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT Do Not List Trustee(s) (Words) ($$$) I` TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)J Kathleen A. Boyd Daughter 4,066.79 5012 Erbs Bridge Road Mechanicsburg, PA 17055 Denise A. Dechesne Daughter 4,066.79 7 North Fileys Road Dillsburg, PA 17019 Total 8,133.58 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on Rev 1500 cove r sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I U.UU Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } Kathleen A. Boyd and Denise A. Dechesne Personal Representative(s) of the Estate of N@Idi F. Fegley COUNTY, PENNSYLVANIA File Number 21-08-00111 deceased, de~ose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and al of the real estate in the Commonwealth of Pennsylvania of saki Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which a pears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- ~ ~,~,F-J~~ /1~,~~ j°"~-, c.~,/s/ ~10 tory are true and correct. I understand that false state- L~ _ -- - ments herein are made subject to the penalties of ~ K thleen A. B y Q 18 Pa.C.S. § 4904 relating to unsworn falsification to ~„Q/~,(~,3.Q- ~,~,Q~l.!Q1,2 ~a''<~ ~/S/~O authorities. Denise A. Dechesne Attorne y - (Name) Ja M Wiley (Supreme a~rr LD. No.) `~' ~ 0697 (Firm) T e Wiley Grou PC _ P~ .`"~'~ ~ - - ~ _~ -~- f ~t (Address 130 W. Church Street, Dillsburg, PA 17019 ~ ~ -t:>.~~""-, ~ ':',` ~ `:~ (Telephone) 717-432-9666 >= ~._ ~";', -~ DATE OF DEATH 01/17/2008 LAST RESIDENCE 2100 Bent Creek Road DECEDEN•6r;!SEC. i - ~ ,.-~_.~ 15 f ? - Mechanicsburg, PA 17050 190- 24 ` FIGURES MUST BE TOTALED ~' u~ Personal Proue Cash ............................................................................................... Personal Property ......................................................................... Stocks/Listed ................................................................................. Stocks/Closely Held ...................................................................... Bonds ............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ......................................................................... Total Personal Property ......................................... Total Real Property ................................................ Total Personal and Real Property ......................... 23,881.99 5,457.25 29,339.24 29,339.24 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b)) Form RW-09 Rev. ~a~3-loos INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-08-00111 ___ __ DATE OF DEATH LAST RESIDENCE 2100 Bent Creek Road DECEDENTS SOC. SEC. NO. 01/17/2008 Mechanicsburg, PA 17050 190-18-3124 Cash Bent Creek (refund): Members 1st FCU CD#5103-40: Members 1st FCU Savings Account #5103-00: Members 1st FCU Vacation Club Account #5103-03: Misc. Refunds (2 @ $100.00): PNC Bank Checking Account #5140019697: Total Cash Stock /Listed 93.6707 MetLife Stock: Total Stock /Listed 1,595.70 10,835.33 2,506.66 416.59 200.00 8,327.71 23,881.99 5,457.25 5,457.25 (Attach additional sheets if necessary) Total Personal Property and Real Estate 29,339.24 Jan M. Wiley David J. Lenox THE WILEY GROUP Attorneys at Law June 6, 2008 n `~' _ `tea Register of Wills ~', ~ r ~ :-`:'~ ~~~ Cumberland County Courthouse '-~ ~' ~; One Courthouse Square `~ 'O ` ;,__ ~,,~ Carlisle, PA 17013 ~~ ~~` ` °' ,~ . , ._~ ~ In Re: Estate of Neldi F. Fegley, deceased ~ v' File Number 21-01-00111 Dear Register: Enclosed for filing please find an Inventory, the inheritance tax return in duplicate, and the status report with regard to the above captioned estate. Also enclosed is a check in the amount of $534.76 representing the tax due, and a check in the amount of $30.00 representing the filing fee. Please return the recording receipts to my attention in the enclosed envelope. Thank you for your cooperation. Sincerely, F~L/t- Dawn Gladf~ter/Legal As istant /dg encl. 130 W. Church Street, Suite 101 Dillsburg, PA 17019 • Phone: (717) 432-9666 (800) 652-4250 Fax: (717) 432-0426 _ - -- _ r' N r ~ ~ k ~j~ 4. ~ ~LL a ~~ ~ ,~ ~ ~ n n ~ ~ ~ ~ ~" C:~ ~~ N ~ ~ ~ '~ +~ r~ ~1` r- ~. ~~--' ~ `L3_ ~.w_ _ ~ ~~~~ ~~, ~_~' ~. , ~~ r ~~ ~ _- r ;-• .ter--, ~~ ~~ =~ r ~ .- ~ ,,,~. _:. _. .:~.. ~.. ~_ ::... ._.. G O ~ U ~ ~ M O U ~ '.~ '4 ~ a n ~ ,;~~o~ ~~ ~v ~~~u ~, ~, o 0 0 v ~o . ,.. ~~ ~a~ ~~ `~ ;, N W ~ v s 4 ,~G ~_ ~~ u ~ W x M ~~