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HomeMy WebLinkAbout06-13-0815056041125 Y -1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of {ndividual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 0 8 0 3 2 8 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 0 0 3 2 0 0 7 0 9 1 6 1 9 3 3 Decedent's Last Name Suffix Decedent's First Name MI M Y E R S MAR Y A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M1 M Y E R S R O B E R T D 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) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number T ]:i O M A S L W E N G E R E S Q 7 1 7 2 3 4 4 1 8 2 Firm Name. (If Applicable) W :L X W E N G E R & W E I D N E R First line of address 5 0 8 N O R T H Second line of address P O B O X 8 4 5 City or Post Office H A R R I S B U R G S E C O N D S T R E E T State ZIP Code REGISTER OF WILLS USER~JLY ~ ~-=-' ~ ~ ~.. " ~? -• ~ ~ -- L~~~~ < ~~ , - - BAT~FILED N ~ ~ ~~~: P A 1 7 1 0 8 0 8 4 5 t -~-, ~' -- ;._~ .s Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of an the personal representative is based on all information of which preparer has any knowledge. SI EAfI P RSON RESPONSIBLE FOR FILING RETURN DATE, ADDRESS 100 MT. ALLEN DRIVE, MECHANICSBURG, PA 17055 SIG URE OF PREPARE T R T AN REPRESENTATIVE DATE I^ /~ WIX, WENGE & WEII) R, PO BOX 845, HARRISBURG, PA 17108 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 15056041125 REV-1500 EX Decedent's Name: MARY A . MYERS Decedent's Social Security Number RECAPITULATION 1. Real estate (Schedule A) ,,,,,,,,,,,,,,,,,,,,,,• ................. 1. 0 • 0 0 2. Stocks and Bonds (Schedule B) .................................. 2. 1 9 2 6 8 • 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0 • 0 0 4. (Mortgages & Notes Receivable (Schedule D) ........................ 4. 0 , 0 0 5. Cash, Bank De osits & Miscellaneous Personal Pro e • .. , ... p p rtY (Schedule E) 5. 2 4 3 3 5 6 , 8 0 6. ,Jointly Owned Property (Schedule F) ^ 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) ........................... 8. 2 6 2 6 2 4, 8 0 9. Funeral Expenses & Administrative Costs (Schedule H) ......... ....... 9. 1 4 0 8 9 • 2 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ..... ....... 10. 11 • Total Deductions (total Lines 9 & 10) .................... ....... 11. 1 4 0 8 9 , 2 5 i2. Net Value of Estate {Line 8 minus Line 11) ....... ! .......... ....... 12• 2 4 8 5 3 5 • 5 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which a.n election to tax has not been made (Schedule J) ........... ....... 13. i4. Net Value Subject to Tax (Line 12 minus Line 13) ........... ....... 14. 2 4 8 5 3 5 • 5 5 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 .00 2 4 8 5 3 5 5 5 15. 16. Amount of Line i4 taxable at lineal rate X •0 _ 0 0 0 16 17. Amount of Line 14 taxable 0 0 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 0 0 0 at collateral rate X .15 18 19.Ta:K Due .......... ............................ ... ..... ..19. 20. FNLL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042126 0. 0 0 0. 0 0 0. 0 0 0. 0 0 0. 0 0 L 15056042126 15056042126 REV-1500 EX Page 3 File Numb Decedent's Complete Address: 21 os ~a2s DECEDENT'S NAME MARY A. M'YERS STREET ADDRESS 100 MT. ALLEN DRIVE CITY MECHANIGSBURG STATE PA ZIP 17055 Tax Payments and Credits: ~ • Tax Due (Page 2 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penatty (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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLE',ASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a, retain the use or income of the property transferred; ...................................................................... ^ ^X b. retain the right to designate who shall use the property transferred or its income; ............................... ^ ^X c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ ^X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 3. Did decedent own an °in trust for° or payable upon death bank account or security at his or her death? ......... ^ Q 4. Did decedent own an Individual Retirement Account, annutty, or other non-probate property which contains a beneficiary designation? .................................................................................................. 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1,1994 and before January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §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) (il ,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 ofi 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 fior 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 FILE NUMBER MARY A. Mti'ERS 21 08 0328 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 survivorshia must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE 0.00 TOTAL (Also enter on line 1 (If more space is needed, insert additional 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 MARY A. M`~'ERS 21 08 0328 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SERIES I SAVINGS BONDS {SEE ITEMIZATIONNALUATION ATTACHED) 19,268.00 TOTAL (Also enter on line 2, Recapitulation) ~ $ 19 (If more space is needed, insert additional sheets of the same size) REV-1504 EX + i;6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP OF NUMBER MARY A. MYERS 21 08 0328 Schedule C-t or C-2 (including all supporting information) must be attached for each closely-held corporation(partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. NONE 0.00 TOTAL (Also enter on fine (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ ('8-98) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE Rf=SIDEN7 DECEDENT TE OF FILE MARY A. M'YERS 21 08 0328 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER _ _ DESCRIPTION OF DEATH NONE TOTAL (Also enter on line 4, 0.00 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC, PERSONAL PROPERTY FILE NUMBER MARY A. MYERS 21 08 0328 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. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. ONE-HALF TENANT IN COMMON INTEREST IN BROKERAGE ACCOUNT 115,508.75 MAINTAINED AT CHARLES SCHWAB/BMC FINANCIAL ADVISORS #XXX3036 (VALUATION REPORT ATTACHED) 2. ONE-HALF TENANT IN COMMON INTEREST IN PRIME BROKERAGE ACCOUNT 127,848.05 MAINTAINED AT CHARLES SCHWAB/BMC FINANCIAL ADVISORS #xxx5507 (VALUATION REPORT ATTACHED) TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF F{LE NUMBER MARY A. MYERS 21 08 0328 Han asset was made joint within one year of the decedents date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. JOINTLY-OWNED PROPERTY: RELATIONSHIP TO DECEDENT ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPT{ON OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET °k OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTA SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY NUMBER MARY A. M'YERS 21 08 0328 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,THEIRREUTIONSHIPTDDECEDEMAND THE DATE OF TRANSFER.ATTACHACDPYOFTHEDEEpFORREALESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION (IFAPPIICABLE) TAXABLE VALUE 1. NONE TOTAL (Also enter on line 7 Recapitulation) ~ $ (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 MARY A. M~YERS 21 08 0328 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME, MECHANICSBURG, PA 8,972.86 B. ADM{NISTRATIVE COSTS: 1 Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 AttomeyFees WIX, WENGER &WEIDNER (ESTIMATED) 4,500.00 3, Family Exemption: (Ifi 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 CUMBERLAND COUNTY REGISTER OF WILLS 302.00 5 Accountant's Fees 6. Tax Return Preparer's Fees 7. CUMBERLAND LAW JOURNAL (ADVERTISING) 75.00 8. THE SENTINEL (ADVERTISING) 182.56 g. WIX, WENGER &WEIDNER (OUT OF POCKET EXPENSES) 56.83 TOTAL (Also enter on line 9, Recapitulation) ~ $ 1 (lfi more space is needed, insert additional sheets of the same siie) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE=SIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ~"""""""" MARY A. M'YERS 21 08 0328 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-i)o) SCHEDULE J COMMON4IIEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RE:iIDENT DECEDENT ESTATE OF F1LE NUMBER MARY A. M'YERS ~1 nu n~~Q RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2]] 1, ROBERT D. MYERS Spousal 248,535.55 100 MT. ALLEN DRIVE MECHANICSBURG, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET II. NOPJ-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS L TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (Ir more space Is neeaea, Insert atldltlonal sheets of the same size) LAST WILL AND TESTAMENT OF ~„ MARY A. MYERS , ~ ~_ 1, Mary A. Myers, of Camp Hili, Cumberland County, Pennsylvania, being Hof sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made. U'EM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my Estate or by any recipient of any property, shall be paid by my Executor out of the property passing under this Will, which is not specifically devised or bequeathed, as an expense and cost of administration of my Estate. My Executor shall have no duty or obligation to obtain reimbursement for arr~ such tax paid by my Executor .even though on proceeds of insurance or other property not passing under this Wil{. ITEM II: I hereby exercise all powers of appointment which I may have at the time of my death in favor of my residuary estate, and all property subject to all such powers shall be included in my Estate. ITEM Ilf: I give and bequeath all my household furniture and furnishings, automobiles, books, pictures, jewelry, china, linen, silverware, wearing apparel and all other like articles of household or personal use and adornment to my spouse, Robert D. Myers, if he survives me, or, if my spouse does not survive me, to my then living children, to be divided among them in as equal shares as practicable, as they may agree. In the event my children fail to agree on the division of such items, my Executor shall determine Page 1 of 7 the distribution of such items and her decision shat! be final. Any undistributed items shall be sold and the proceeds added to the residue of my estate. ITEM IV: If my spouse does not survive me, I give, devise and bequeath the sum of Two Thousand Dollars ($2,000.00) to the Endowment Fund of Messiah Lutheran Church of Harrisburg, Pennsylvania, or its successor. ITEM V: l give, devise and bequeath aN of the rest, residue and remainder of my property, real, personal and mixed, to my spouse, Robert D. Myers, ifi he survives me. If my spouse does not survive me, then I give, devise and bequeath all of the rest, residue and remainder of my property in equal shares to my children or their issue, perstitpes, subject to the provisions set forth in item VI herein. Provided, however, that any distribution made to my children or their issue shall be adjusted to account for any indebtedness owed to me by them at the time of my death. Such indebtedness shall be determined, without interest, by my Executor by reference to a Book of Account which I have maintained and kept at my desk at my residence, or such other place made known to my Executor, and shall be offset against the amounts the indebted child, or persons claiming through the indebted child, would otherwise be entitled to receive. ITEM VI: For purposes of this Will, the term "issue" shall be deemed to exclude each and every one of the children born of the union of my son, Robert P. Myers anti Ann Helen Cannon (also known as Ann Helen Myers), it being my express intent that such child or children not receive any distribution as an heir or beneficiary of my estate. ITEM VII: fn the settlement of my Estate, my Executor shall possess, among others, the following powers to be executed for the best interest of the beneficiaries: Page2of7 (a) To self either at public or private sale and upon such terms and conditions as my Executor may deem advantageous to my Estate, any or all real or personal estate or interest therein, whether owned by me severally or in conjunction with other persons or acquired after my death by my Executor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable in carrying out any of the powers conferred upon my Executor in this Paragraph VII(a) or elsewhere in my Will. (b) To pay all costs, taxes, expenses and charges in connection with the administration of my Estate. My Executor shall pay expenses of my last illness and funeral expenses. (c) To distribute my Estate in kind or in money. if any assets are distributed in kind, they shall be distributed at their respective value(s) on the date(s) of their distribution. (d) To retain any investments I may have at my death so long as my Executor may deem it advisable to my Estate so to do. (e) To vary investments, when deemed desirable by my Executor and to invest in such bonds, stocks, notes, money markets, real estate mortgages or other securities or in such other property, real or personal, as he shall deem wise, without being restricted to so-called "legal investments." (f) To mortgage real estate and to make leases of real estate. (g) To borrow money from any party to pay indebtedness of mine or of my Estate, expenses of administration or inheritance, legacy, estate and other taxes. (h) To vote any shares of stock which form a part of the Estate and to otherwise exercise all the powers incident to the ownership of such stock. (i) fn the discretion of my Executor, to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of the Estate. Page 3 of 7 (j) To distribute my personal property directly to the Guardian of the person of any minor beneficiaries hereunder. (k) To elect such settlement options as deemed most appropriate by my Executor with respect to any pension, profit sharing or other retirement plan in which I am a participant. (I) To do all other acts in the judgment of my Executor necessary or desirable for the proper and advantageous management, investment and distribution of my Estate. ITEM VIII: Any person who shall have died at the same time as me, or in a common disaster with me, or who sha11 fiait to survive me by ninety (90) days, shall be deemed to have predeceased me. ITEM IX: If at any time any minor child or legally incompetent person shall be entitled to receive any assets hereunder, I hereby nominate; constitute and appoint my Executor to act as Guardian of the assets payable to such person. Said Guardian may receive and administer all assets authorized by taw and shalt have full authority to use such assets, both principal and income, in any manner said Guardian shalt deem advisable for the best interest of such person, including college, university, post-graduate or other education, without securing court order. Said Guardian shall have all the rights and privileges as to the Guardianship and the assets thereof as are herein granted to my Executor as to my Estate and the assets therein. ITEM X: I nominate, constitute and appoint my spouse, Robert D. Myers, to be my Executor. In the event of the death, resignation, refusal or inability of Robert D. Myers to serve as my Executor, I nominate, constitute and appoint my daughter, Rebecca S. Myers, to serve as Executor in his place. My Executor and Guardian are specifically relieved from the duty or obligation of filing any bond or bonds. Page 4 of 7 IN WITNESS WHEREOF, I have set my hand and seal to this my Last Will and Testament, consisting of this, the next two pages, and the preceding four pages this _~ day of ~_, 2001. `o~~ Mary A. My rs SIGNED, SEALED, PUBLISHED AND DECLARED by the above named Testator, Mary A. Myers, as and for her Will, in the presence of us, who, at her request, in hE;r presence and in the presence of each other, have hereunto subscribed our names as witnesses in attestation thereof. 1 Address 2 ~ -~~ ` ~ Address/Q ~~~~r,~ -~- ' ~~ Address f ~ l ~l~v~~ Page 5 of 7 COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~~QN tn..l, SS. I, Mary A. Myers, the Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sv~(n to or affirmed and acknowledged before me by Mary A. Myers, the Testator, this ~ day of Sr,a~ tc~k~ f , 2001. Notarial Seal Denise B ~Niamson, Notary Public Harrisburg, Dauphin County My Commission Expires May 1, 2004 ''"°^'a Association of Notaries Page 6 of 7 My Commission Expires: ' (SEAL) COMMONWEALTH OF PENNSYLVANIA COUNTY OF DA~~-t~~~ SS. We, '"~nrca_° (. i.t).px"~C,rr'~ YIl ~U , arld ~av~t e~ ~ct~ ~ ,the witnesses whose names ar signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as her Last Will; that the Testator signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness, in the hearing and sight of the Testator, signed the Will as a witness; and that to the best of our knowledge, th+:; Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by'~~tta~,o:~ C .. ~~~s~a r~~- ~Zt'~a E G ~ and Jan',~.t y~ e u rw witnesses, this ~~ day of S~~mb~,~ , 2001. ~' F:\dbw\Wilis\Myers\Mary - Will.doc ~~ 'in Witness Notarial Seal Denise 8 Williamson, Notary Public Harrisburg, Dauphin County Page 7 of 7 MY Commission Exprres May 1, 200a Member, Pennsylvania Assoriaricn of (`Ir ~ - ••,::, My Commission Expires: (SEAL) O CJ O O N CV d p Z x ~ ~ O O cOD •- C~ r- ~ N M O O ~ ce w ~ ffl i . RJ R+O+ C7 0 C'7 0 C'7 0 ~ ~ [~ ~ ~ N N N (SS ~ ~ ~ ~ ~ ~ ~: _ > _ LJ ~ .y . 0 d. N O - ° - _'~ d ~ ~ ~ co LL, ~ 4+ 0 0 0 ar N • ~ t0 N N N y ~" ~ w W Z T T T y ^/ a o ~ 0 0 d j- d- ~ ~t ~ v O o 0 0 0 o O ; ; rr ~ v ~ / ~ L~ ~' a .F V ~' •y a ~n ffl ° O ° o O O rn rn ~ ~ ~ ~t N i j ~ cfl cD O ~, ~ ~, O o O ~ ~ N N N ~ V ~ L ~ ~ N O ~ = T ~ T T ~ ~ _ ~ Q O O O ~ 0 0 0 •V p. ~n ~ ~n W d 0 0 0 ~++ 000 ~ Q N N N O O O m E r~ co ~n Z d°- ~ ~°r ~ • ~ T ~ T ~ T ~ O O O > > ~ O O O O O O O ~ ~ ~ U ) m ~ ' ° ~ - - - ~ ~ Z ~-- N C7 o~ ~ p~ m m ~ N ~ ~ O y ~ ~ N ~+0~ .n ~ its 'a N ~ ~ ~ a Z~ ~'~ ~ X O ~ "d ~, U O o~~~ .n ioZcQ'v ='a°~ 2 '~ 0 •r Q ~ ;, ~ .Q .Q ~~~~a~ ~°-~ NitS co~~-° ~ m ° x c° °~~~o ~ .~] M N 'a mW m~,~ 3a~~~$ >,~E~ ~ ~ U ~ C ~Z C ~~ a X-a ~~ W~~T.n _ ~' W >+3a ~Z~ ~~ 'LS . ~~_ $~_ ~s ~~~ `~Opo ~~•~~~ 3 ~ ~ ~ N ~~~_~ S ~ ~ ~ L U ~ i (A fA x Va~i33w ~WW c a°p~ -~ ~~~~ ~ ~/~ •''~^^ Q V/ V/ ~ cC 3 •~ ~ ~a C O ~ ~ ~ ~ Qa~ ~ • .• 0 N t~ d a N .~ Financial Advisers April 10, 2008 Denise B. Williamson Wix, Wenger & Weidner 508 North Second Street Post Office Box 845 Harrisburg, Pennsylvania 17108-0845 Re: Estate of Mary Ann Myers Dear Denise, Please find enclosed two Portfolio Holdings reports for Robert D. and Mary A. Myers, TEN/COM accounts. These holdings are as of Mary Ann Myers' date of death (10/03/2007). On these reports, you will find the following information that you have requested: 1. Account type 2. Account numbers 3. Asset values as of the date of the decedent's death (10/03!2007). 4. Amount of unpaid accrued interest 5. Names of owners of accounts and dates accounts were established. Thank you for your assistance with this matter. If you should have any questions, please do not hesitate to contact our office. Sincerely, BEARD MILLER FINANCIAL ADVISORS LLP Heidi Betz Client Relations Specialist /hlb Enclosures C: Mr. Robert D. Myers Rebecca Myers Registered Investment Advisors Financial Advi~c~rs 1869 Charter Lane Suite 301 Lancaster, PA 17601-5879 Phone (717) 393-9721 Fax (717) 393-8343 Portfolio Holdings As of 10/03/2007 Robert D. & Wary A. Myers Acct #: 66573036 Joint Tenants in Common c7' Q~/~.r/ad~~ Brokerage Account c?p2nP cio Rebecca Myers ~ 8006 Eastern Drive, Apt. 102 Silver Spring, MD 20910 Current Svmboi _ Descriution Quantity Price Mutual Funda ARTVX Artisan Small Cap Value 955.916 18.590 BGRFX Baron Growth 40.816 55.670 CHCGX Chesapeake Core Growth 705.581 21.030 DODFX Dodge & Cox Intemational Stock 241.047 49.430 DODGX Dodge & Cox Stock Fund 211.97 159.710 SGOVX First Eagle Overseas A 68.368 27.560 PISRX Forward Intl Sma{I Co Inv 116.009 20.760 GCMAX Goldman Sachs Mid Cap Value A 210.104 41.500 HAINX Harbor Intemational Instl 26.409 75.210 JAMCX JP Morgan Mid Cap Value 314.876 27.650 ICSLX Mainstay ICAP Select Equity 148.412 46.300 MFOCX Marsico Focus Fund 889.217 21.770 SNXFX Schwab 1000 Index Fund Inv 306.312 45.420 SLASX Selected American Shares 111.235 49.690 SSHFX Sound Shore Fund Inc 629.851 42.020 TASCX Third Avenue Small Cap Value 90.416 27.430 VFINX Vanguard Index 500 154.088 141.830 Current Value 17,770.48 2,272.23 14,838.37 11,914.95 33,853.73 1,884.22 2,408.35 8,719.32 1,986.22 8,706,32 6,871.48 19,358.25 13,912.69 5,527.27 26,466.34 2,480.11 21,854.30 200,824.63 Cash and Money Funda MMF Schwab Money Market Fund 30,192.67 231,017.50 Financial Advisers 1869 Charter Lane Suite 301 Lancaster, PA 17601-5879 Phone (717) 393-9721 Fax (717) 393-8343 Portfolio Holdings As of 10/03/2007 Robert D. & Mary A. Myers Acct #: 30955507 Joint Tenants in Common ,, / / /~ Prime Brokerage Account ~~~~7eU a -~ ~ G~ c/o Rebecca Myers 8006 Eastern Drive, Apt. 102 Silver Spring, NID 20910 Current Current Symbol Description Quantity Price Value Mutual Funds DODIX Dodge & Cox Income Fund 1,566.223 12.540 19,640.44 MWLDX Metropolitan West Low Duration Bond 2,107.482 9.350 19,704.96 VBIIX Vanguard Interm-Term Bond Index 965.667 10.280 9,927.06 49,272.46 Fixed Income 02209SAA1 Altria Grp Inc 10,000 108.822 10,882.23 11/04/2013 7.00% Accrued Interest 289.72 2515AOBZ5 Deutsche Bank Flt 2022 Note 15,000 95.910 14,386.50 30yr-2yr CMS Spread Range 04/20/2022 8.00% Call 04/2012008,100.00 Accrued Interest 243.33 277461 BDO Eastman Kodak Co 10,000 99.000 9,900.00 11/15/2013 7.25% Accrued Interest 277.92 35,979.70 Cash and Money Funds SWQXX Schwab Advisor Cash Reserves 170,443.94 Total Accrued Interest 810.97 255,696.10 WIX, WENGER &WEIDNER A PROFESSIONAL CORPORATION THOMAS L. WENGER RICHARD H. WIX ATTORNEYS AT LAW ROBERT C. SPITZER DEAN A. WEIDNER 508 NORTH SECOND STREET STEVEN C. WILDS Of Counsel THERESA L. SHADE WIX • POST OFFICE BOX 845 DAVID R. GETZ HARRISBURG, PENNSYLVANIA 17108-0845 STEPHEN J. DZURANIN JEFFREY C. CLARK PETER G. HOWLAND Suburban Office: (717) 234-4182 4705 DUKE STREET FAX (717) 234-4224 HARRISBURG, PA 17109-3041 ' Also Member Massachusetts Bar www.wwwpalaw.com (717) 652-8455 June 12, 2008 Glenda Farner Strasbaugh, Register of Wills ,-~ ~o Cumberland County Courthouse One Courthouse Square ~ ~ ~ ~ i Carlisle, PA 17013-3387 _ - r..~ }~~ ~ _, -- -~ - Re: Estate of Mary A. Myers (Estate File No. 21-08-0328) . `--~ ~ rv __ r -- L Dear Ms. Strasbaugh: G' We enclose the following documents for filing on behalf of the Estate of Mary A. (Myers: 1. The original and one copy of the Inheritance Tax Return; 2. The original and one copy of the Inventory; and 3. Our check in the amount of $80.00, made payable to the "Register of Wills," representing: a. $15.00 filing fee for the tax return; b. $15.00 filing fee for the Inventory; and c. $50.00 additional probate fee due. Please process these documents at your earliest convenience and return atime- s,tamped copy of the tax return cover page and Inventory form to our office. A self- alddressed, stamped envelope is enclosed for your convenience. Thank you for your assistance in this matter. If you have any questions regarding the above, please call me. Sincerely, /clbw Enclosures cc;: Mr. Robert D. Myers Thomas L. Wenger, Esquire WIX, WENGER &..WEIDNER , ;~ Denise B. 1Ni{liamson Paralegal it ~' i ' i'~. ., i -..3t"-' 1, . ~. . ~ ~,, ~~ ~~~ {~`4`'~C~ n~~PA Lx '"~ ~ ~ ~ ~ W ~ s "~ H Z JW oCJ `%~ ~; G r W W f w z W ~, x ., ~, u r~ ~~~c ~~~~ ~+ x p 1I N_ ~ ~ N N (~ O ~~ O ~ ~ Q~ ~~ i ~ ~ N O 1~1 NV O{ II I Q ~ ~ o- 1 c~ ~ V N ~~. _ ~ g N ~ C t+3 ii ~V~V i