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HomeMy WebLinkAbout06-17-081 15056041]47 ^~~~'~ IX (O6-U5} OFFICIAL USE ONLY PA Departrrterrt at Revenue Cocofy Cie Yar Numoer Bureau of Individual Taxes INHERITANCE T/4X TURN 2 1 0 7 010 2 1 Po BOx.~osot liarrisbtxg, PA t7t2a-t~o1 RESENT DECEi~1+IT Ei~TER ~ It~FORMAT~ON-BEtOY1~ SCI Security Ntunbcr Date of Death Date of Birth I64 30 3319 11 06 2007 09 13 1932 Decedemt's Last Nana LEACH Suffor Decedertt'eFirst-Name CHARLES (If Ap~Iir~bla) FJrter 3trrvitstng 3pouae's Ir~fmnt~Fort 13elotw Spouse's tact-Name Suffix Spouse's Sflcral Security Number FILL 1Pf API'ROPRtATE OYAL$ BELOW 1. Original Retum 4. Limited Estate ,, y g, Dec~mt 6iod Tr~are I 1 tAtlarlrlnpy a VMa) Spouse's FirsYNanre MI R NM THIS RETURN MUST BE Flt_ED Nr DUPLICATE Y~ITH THE ~~~ Q~ ~~ Z. Strp~emerrml Return ^ 3. Remainder Return (fie of deayl prior to 12-13-82) 4a. Futuv Irtar~u CanpromYe S. Federal Etrfste Tax RaEcrm Ragttired trace a deaeti otter tz-t2~zi ^ 1. Dint r a c.Nirg Thar fl 8. Total Numt>~ oT Sate 6epON! Boxea (~+~PYOrTrueq !~. 9. Litigntiorr Proceeds Reoelved ~ 1 Q. b iiaa and1 1.gaejr acerb ~ 11. Eketicrn to >ffx under Sac. 9113(A) (Attach Sett. W CORREBPONDENT . ThMS SECTION INUST BE COINPLETED. ALL COIi:RESPONDENGE AND CONFIDENTIAL TAX INFORNIA SHOULD t# DIRECTED TO: Name Uaytb»a Tina Nura~r A1KY M. MOYA 717 652 7323 Firm Name (if Applicable) L. O. OF SUSAN E. LEDEREH First line of address 4811 JONESTOWN ROAD, STE ZZ6 Second title ryf address City or Pi~st Office HARRISBURG Stags ZIP Code PA 17109 REGISTER O~~V1kLS USE W~..Y -, r._. ~i= -`_ ..~ _.._ -_r _ 1z- DATE.AF~D `~ rus e-maa ads: /4~~le~rer~sw.com try lJndar percagieaot pary'ury,1 dseleretrrat J ham examined this rekrrn, Ong tn~ N ~"rotor 'or~iMN~crc~prrrafr ~ivtooc , R is trcu, cone~et alit ccrrrrpre~. Detderatlonotprai~erottferth~t the of SIG OF l)N SIBLE FILM RETURN ~'-_' nooRESs .rtt~iUe, FL 37239 M: ~t1 .!€srt~vlm Rna~l, Ste ~8, Harristit~~~ PA 1T4Q9 tic/~ Rlde 1 I~5Q56041Z47 15Ef56041147 _.~ ~ _~ i --r ~ (~ I PA Inheritance Tax Return Signature of Additional Fiduciaries Leach~Charles R. I FILE NUMBER 21-07-01021 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 #2 Name Address1 Address2 City, State, Zip Date Terry S. Dinsmore 6207 Westover Drive Mechanicsburg, PA 17050 r~~/,~~,/v~' REV-1500 EX 15056042148 Decedents Name: (; h a r i e S R. L e a f h RECAPITULATION 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 i?< Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ', Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property __ (Schedule G) ', 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 8~ 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 0 0 0 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable 0 0 0 16 at lineal rate X .045 . 17. Amount of Line 14 taxable 0 0 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 1 6 2 7 7 9 8 3 8 18 , , . at collateral rate X .15 . 19. Tax Due .............................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's Social Security Number 164 30 3319 158,900.00 934,493.89 392,424.09 236,598.18 1,722,416.16 -- _ - 42,362.75 2,255.03 44,617.78 1,677,798.38 50,000.00 1,627,798.38 0.00 0.00 0.00 244,169.76 244,169.76 Side 2 15056042148 15056042148 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-01021 DECEDENT'S NAME Charles R. Leach - --- STREET ADDRESS 4124 Rosemont Avenue ITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 244,169.76 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 225,000.00 __ __ C. Discount 11,842.11 Total Credits (A + B + C) (2) 236,842.11 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 theDVERPAYMENT (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 theTAX DUE (5) 7,327.65 A, Enter the interest on the tax due. (5A) g. Enter the total of Line 5 + 5A. This is the6ALANCE DUE (56) ] , $ 27 , s 5 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 :................................ x c. retain a reversionary interest; or ............................................................................................................ z-, -- d. receive the promise for life of either payments, benefits or care? ........................................................... _ x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without _ receiving adequate consideration? ................................................................................................................. x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................................ x 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 statutedoes not exempts 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)J. 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. Rev-1502 EX+ (6-98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSV~VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF - (FILE NUMBER Leach, Charles R. 21-07-01021 All real propeAy 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 jointlyowned with right of survivorship must be disclosed on schedule F. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleA (Rev. 6-98) (If more space is needed, additional pages of the same size) Rev-1503 EX+ (6-96) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Leach, Charles R. 21-07-01021 All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 oo2osR1o2 2,850 shares of ATS:T -held at Wachovia Securities, 39.82 113,487.00 Account No. 5097-8866, titled to Charles R. Leach 2 055622104 523 shares of BP PLC Sponsor ADR -held at 79.345 41,497.44 Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 3 136385101 500 shares of CDA Natural Res LTD -held at Wachovia 83.625 41,812.50 Securities, Account No. 5097-8866, titled to Charles R. Leach 4 166764100 154 shares of Chevron Corporation -held at Wachovia 89.695 13,813.03 Securities, Account No. 5097-8866, titled to Charles R. Leach 5 191216100 700 shares of Coca Cola Company -held at Wachovia 60.67 42,469.00 Securities, Account No. 5097-8866, titled to Charles R. Leach 6 20030N101 420 shares of Comcast Corporation New Class A - 20.585 8,645.70 held at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 7 G2552X108 300 shares of Covidien LTD -held at Wachovia 40.475 12,142.50 Securities, Account No. 5097-8866, titled to Charles R. Leach g 25s2os1o3 490.002 shares of Dodge 8 Cox International Stock 50.10 24,549.10 Funds -held at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach Total of Continuation Schedules See attached pa es TOTAL (Also enter on Line 2, Recapitulation) 934,493.89 (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) Rev-1503 EX+16.98) SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Leach, Charles R. 21-07-01021 ITEM NUMBER CUSIP NUMBER DESCRIPTION VALUE AT DATE UNIT VALUE OF DEATH J 337932107 500 shares of Firstenergy Corp -held at Wachovia 68.635 34,317.50 Securities, Account No. 5097-8866, titled to Charles R. Leach 10 415864707 1,000 shares of Harsco Corporation -held at Wachovia 57.54 57,540.00 Securities, Account No. 5097-8866, titled to Charles R. Leach 11 a27s251oa 3,000 shares of Hersha Hospitality Trust -held at 10.33 30,990.00 Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 12 a37o~s1o2 900 shares of Home Depot Inc -held at Wachovia 29.81 26,829.00 Securities, Account No. 5097-8866, titled to Charles R. Leach 13 580037109 1,000 shares of McDermott International Inc. -held at 59.885 59,885.00 Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 14 2s2as~1o3 3,725.568 shares of Dryden Municipal Bond Fund H/I-A 10.19 37,963.54 - held at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 15 2s2as~2o2 2,417.758 shares of Dryden Municipal Bond Fund H/I-B 10.20 24,661.13 - held at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 16 a7s29asos 1,384.781 shares of Jennison Sector Funds Inc -held 23.42 32,431.57 at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1503 EX+ 16-96) SCHEDULE B STOCKS 8~ BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Leach, Charles R. 21-07-01021 ITEM NUMBER CUSIP NUMBER DESCRIPTION VALUE AT DATE UNIT VALUE OF DEATH 17 67065Q756 1,240 shares of Nuveen High Yield Municipal Bond - B 21.20 26,288.00 - held at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 18 693475105 150 shares of PNC Financial Services Group Inc - held 69.275 10,391.25 at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 19 707569109 2,000 shares of Penn National Gaming Inc -held at 61.67 123,340.00 Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 20 717081103 800 shares of Pfizer Inc -held at Wachovia Securities, 23.82 19,056.00 Account No. 5097-8866, titled to Charles R. Leach 21 845905108 500 shares of Sovereign Bancorp Inc -held at 13.055 6,527.50 Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach Y2 859317109 1,000 shares of Sterling Financial Corporation -held at 17.775 17,775.00 Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 23 G9144P105 300 shares of Tyco Electronics, Ltd. -held at 33.21 9,963.00 Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach 24 921138200 2,351 shares of Van Kampen High Yield Municipal 10.65 25,038.15 Fund Class B -held at Wachovia Securities, Account No. 5097-8866, titled to Charles R. Leach Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-t 566 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Leach, Charles R. 21-07-01021 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 check from Comcast (refund of cable service) 9.96 2 check from Lucent (retirement check) 31.02 3 check from Verizon (refund of telephone service) 1.55 4 Certificate of Deposit held at IndyMac Bank, Account No. 2913635216, titled to 100,000.00 Charles R. Leach 5 Share Savings held at Pentagon Federal Credit Union, Account No. 2972686-01-4, 5.04 titled to Charles R. Leach 6 Share Certificate held at Penatgon Federal Credit Union, Account No. 4227016-51i-7, 100,216.19 titled to Charles R. Leach (accrued interest $216.19) 7 2003 Chevrolet S-10, titled to Charles R. Leach (title unavailable) (sale price) 7,000.00 8 Certificate of Deposit held at Pennsylvania State Bank, Account No. 9150015106, 70,161.58 titled to Charles R. Leach (accrued interest $161.58) 9 Checking Account held at Sovereign Bank, Account No. 0571119476, titled to 2,483.43 Charles R. Leach (accrued interest $0.10) 10 Household Goods sold at auction 5,268.50 11 check from AARP (premium refund) 20.22 12 check from Patriot News (subscription refund) 32.70 13 check from United Health Care (premium refund) 2.25 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 392,424.09 (If more space is needed, additional pages of the same size) Copyright (cj 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1508 EX+16-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY continued ESTATE OF (FILE NUMBER Leach, Charles R. 21-07-01021 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 14 check from Donegal Insurance (premium refund) 682.00 15 check from Lucent (final retirement check) 891.46 16 check from Federa{ Civil Service (final retirement check) 316.00 17 105,302.19 shares of Money Market Account -held at Wachovia Securities, Account 105,302.19 No. 5097-8866, titled to Charles R. Leach TOTAL (Also enter on Line 5, Recapitulation) 392,424.09 Copyright (c12002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1510 EX+ (6-98) SCHEDULE G INTER-V1VOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Leach, Charles R. 21-07-01021 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 DE RtPTION F PR PER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 500 shares of Eaton Vance Tax-Managed -CUSIP 8,750.00 100.000 8,750.00 # 27828Y108, held at Wachovia Securities, Account No. 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary 2 1,000 shares of Eaton Vance Tax Man Global - 18,050.00 100.000 18,050.00 CUSIP # 278290105, held at Wachovia Securities, Account No. 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary 3 500 shares of Eaton Vance Div Tx Managed Eq 8,452.50 100.000 8,452.50 Fund -CUSIP # 27828N102, held at Wachovia Securities, Account No. 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary 4 373.340 shares of Europacific Growth Fund - C - 20,798.77 100.000 20,798.77 CUSIP # 298706300, held at Wachovia Securities, Account No. 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary 5 417.048 shares of Fundamental Inves Inc. -Class 19,259.28 100.000 19,259.28 C -CUSIP # 360802300, held at Wachovia Securities, Account No. 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary 6 520.330 shares of Growth Fund America -Class 19,012.86 100.000 19,012.86 C -CUSIP # 399874304, held at Wachovia Securities, Account No. 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary Total of Continuation Schedule ee attached page TOTAL (Also enter on Line 7, Recapitulation) ~ 236,598.18 (If more space is needed, additional pages of the same size) Copyright (c,l 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev-1510 EX+ 16-98) SCHEDULE G INTER-ViVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Leach, Charles R. 21-07-01021 ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 7 827.143 shares of Income Fund Amer Inc -Class 17,312.10 100.000 17,312.10 C -CUSIP # 453320301, held at Wachovia Securities, IRA Account No. 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary 8 Washington Mutual Certificate of Deposit -held 20,000.00 100.000 20,000.00 at Wachovia Securities, IRA Account No. ' 5097-8830, Charles R. Leach, owner, Susan N. Headle, beneficiary, CUSIP #939369D27 9 Money Market Assets -held at Wachovia 3,151.36 100.000 3,151.36 Securities, IRA Account No. 5097-8866, Charles R. Leach, owner, Susan N. Headle, beneficiary 10 World Savings 5.35%, 01I14I08 CUSIP # 100,000.00 100.000 100,000.00 98154KEF6, held at Wachovia Securities, IRA Account No. 1127-0168, Charles R. Leach, owner, Theresa Dinsmore, beneficiary 11 Money Market Assets -held at Wachovia 1,811.31 100.000 1,811.31 Securities, IRA Account No. 1127-0168, Charles R. Leach, owner, Theresa Dinsmore, beneficiary TOTAL (Also enter on Line 7, Recapitulation) 236,598.18 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (12-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RES{DENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Leach, Charles R. 21-07-01021 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 10,169.85 B. ADMINISTRATIVE COSTS: 1. 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 Law Offices of Susan E. Lederer 10,000.00 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 Cumberland County Register of Wills 314.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 21,878.90 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 42,362.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+(6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Leach, Charles R. 21-07-01021 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued ESTATE OF (FILE NUMBER Leach, Charles R. 21-07-01021 ITEM NUMBER DESCRIPTION AMOUNT 1 Bricker's Auction (auctioneer fees) 1,180.00 2 AC Rimmer (plumber) 85.00 3 Bob & Mary Harig (fee for two trucks of trash from auction) 150.00 4 Donegal Insurance (home owner's insurance) 109.00 5 Roy Miller, CPA (accountant) 905.00 6 Barbara Mowery (house cleaning) 75.00 7 Cumberland County Register of Wills (additional probate) 700.00 8 Estate Advertising -Carlisle Sentinel 102.76 9 Register of Wills - (additional short certificate) 8.00 10 Estate Advertising -Cumberland Law Journal 75.00 11 U.S. Treasury (federal income tax) 5,356.00 12 Pennsylvania Department of Revenue (income tax) 828.00 13 Pennsylvania American Water Company (water bill) 28,72 14 PPBL (electric bill) 102.41 15 Real Estate Costs -Items 16-36 (from Settlement Sheet) 0.00 16 Real EstateTransaction Fee 400.00 17 Michael Connor (Appraisal fee) 300.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Leach, Charles R. 21-07-01021 ITEM NUMBER DESCRIPTION AMOUNT 18 Taylor, Bean & Whitaker (Admin. fee) 525.00 19 Taylor, Bean, & Whitaker (tax service fee) 73.00 20 Susquehanna Lending Group (Doc Processing Fee) 345.00 21 Susquehanna Lending Group (Compliance Fee) 50.00 22 School Tax 347.75 23 Guaranteed Abstract Services, Inc. (e-mail document retrieval) 40.00 24 Lawyers Title Insurance Corporation (insured closing letter) 35.00 25 Law Offices of Susan E. Lederer (deed preparation) 200.00 26 Notary Public Fees 10.00 27 Guaranteed Abstract Services, Inc. (title insurance) 1,153.75 28 Guaranteed Abstract Services (PA Endorsement) 200.00 29 Guaranteed Abstract Services, Inc. (overnight fee/package) 12.00 30 Taylor, Bean, & Whitaker (Wire/MFRS Fee) 22.50 31 Realty Transfer Tax (city/county) 1,589.00 32 Recording Costs 107.00 33 Realty Transfer Tax (state) 1,589.00 34 County Township Tax 50.56 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (6.98 SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF - (FILE NUMBER Leach, Charles R. I 21-07-01021 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-67 (Rev. 6-98) Rev-1512 EX+ (6-98) SCHEDULE t DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Leach, Charles R. 21-07-01021 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Holy Spirit Hospital (medical bill) 353.72 2 PA Neurosurgery (medical bill) 34.32 3 Golden Living Center (nursing home bill) 380.67 4 Verizon (phone biN) 23.58 5 Andrews 8~ Patel (medical bill) 55.60 6 AT~T (cell phone bill) 39.30 7 PPS<L (electric bill) 250.94 8 Waste Management (trash bill) 87.50 9 Comcast Cable (cable bill) 53.00 10 VA Clinic (medical bill) 747.00 11 Dr. Powers (medical bill) 142.74 12 Pennsylvania American Water Company (water bill) 33.08 13 AT8~T (internet service) 27,47 14 Verizon - (phone bill) 26.11 TOTAL (Also enter on Line 10, Recapitulation) 1 2,255.03 (If more space is needed, additional pages of the same size) I Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+(4A°) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER L_eacn, ~nartes rt. 21-07-01 021 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) Do Not List Trustee(s) ~~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Gregory Bowers Nephew $130,000 130,000.00 3 Linden Court Camp Hill, PA 17011 2 Linda Krone Niece $130,000 130,000.00 814 Moores Mountain Road Lewisberry, PA 17339 3 Susan N. Headle Niece $130,000; 50% 635,386.97 972 Blackberry Lane of the Estate 8. Jacksonville, FL 32259 IRA 4 Ronald Jones Nephew $130,000. 130,000.00 122 Wapping Road Portmouth, RI 02871 5 'Terry S. Dinsmore Friend $130,000; 50% 602,411.41 6207 Westover Drive of the Estate St Mechanicsburg, PA 17050 IRA Total 1,627,798.38 Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS See continuation schedule(s) attached 50,000.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI 50,000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) Rev-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J-IIB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued ESTATE OF (FILE NUMBER Leach, Charles R. _ 21-07-01021 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J-If6 (Rev. 6-98) v ~~~ ~`~~~~ ~~~,~ . No. sts .~; Made the Tw£NTY-SEVENTH day of DEODADER a in t(~e year :±. ~. one thoasand nine hundred and SEYEHT^r.-TMq [ietreeeA 1~ FROS1~T~ E. CH%.-1YACNP AND. ELlZA3E'iH •bL- C~FIAAIPAGNEa HI s WIFE, Of _ LOMER PA%TON IbWNSHIP, MTVfRIN COUNTY. PENNSYLVANIA, GRAN30ftSt ' ..: .. A '~~' D 1 ONAfttFS R. LEACH AHD KAAEH f. LFApa ~'iX IS WIFE CW TN£ BOROU Cx Of `,~y, ';. . , NEw CU)IDERLANO~ YgRK COUNTY, YENNSYLVA Ni A~ GR ANT££3, ~ ~ ~ ~ .,. WiOirsxch,.rhat in'conaidenrion of FOUR 7HDU$ANO PIVE'.HUNpRED ($4•JSCD•DD} Ddl - in hand paid, Khe rceaipc whueof is hereby AclrAOrledged, she uid'Grintot 5.,+- ~~~ dp ~ ' fure'Py grant apd convey to rke said Grantees ,,y;, . '~ ALLTH~SCERTAIY TRACT OF LaNA SITUATE NI THE_f~7,~fIP,OF.'L,gWER.ALIEN, COUNTY ~_..;~~:." ~. bF CUttBERLA1tD~ ANO STA TE~OF i'EHNSYLVgNiA, MORE PART ruCVIARIY BOUNDED AND DESCRIBED ~' AS.f01.LOw5, TO W)7: F i- } ~, y 1i: :. > r` 8EG1NIliNG A7 A P91N7 ON THE HORTx SIDE OF SOS ES4pNT AVENUES WK ICN POt NY IS AT THE SOU YHWEST OORNER OF LANDS NOW DR LATE OF REBECCA SHENK~ AID T1$NCE IN A' SOVTN£RLY '-'~;•~;.' , DI RE4TI ON `SDUTX SEVENTY DEGREES FtfTEEN LitNUTES WEST [S. ?OD IS' W} Nf N£7Y•-NINE . AAC S)%-TENTHS (99.6t) FEET ALONG TH1: NDRT1, 379E OF Ros ELONT AYE.NUE TO A Ppi NTH ' ~ VHiCH PO)NT_TS THE $OU TN£AST 60RNFR OF LANDS $OW bR LATE DF A• rdILLE R~ TNENC £. ALONC ;_~~~, LANDS HOW' OR LATE .Oi'. R• BILLER, t N A MOR7H ERlY DIRECT{ ON ~''IORS:H Tld£NT WEI G)T DECREES Alt$ .'~:' id0 L{INUTES WEST (ri. 26~ COQ .J..) O3iE KUNDRED'TtiENTY-FIVE AND, TN)tEE OHE-HUNORE07HS ~~ ~(.I25.0~1} FEET TO A a$IN7, ~TNcHCE,; IN 4N £AS7t:RLY DI~REOT)DN AOROSS (ANDS qF 6RgNTDRi ~ '"~' HEREIN fIORTH..51X~ sWO.~'iECRLES ANb NO }MINUTES EAST (N. Es20 OOt E.} ~INETY•g404R - r;', ' AHO SEYEMTY-EICUT ONE-HUNDREDTHS (98.78t} FEET TO A POINT ON SHE LtNE.~OF LAHOS Of ~' ~"~ MOW OR LATE: OL' itEBEt CA~jHENK~ 7HEN'CE, AI.ON f. THE uxD~.N OW OR LATE of Rg3e+.Y.A $HENK~ SOUTH TWEN7Y~SEYEN OE CREES r'IF7Y~Fi YE Gil '<UTES EAST L~ 27D 55t ~•} ONE HUNDRED ' THIRTY-NINE ANO TNIRTY~THREE ONE-~r~ONDREDTHS (139.w*} FEE7 TO A,PV{NT ON THE NlORTH ~~ {' - BIDE of ROSEUONT AVf.NV6y.TH'C t'LRCE~,OF BEGtN6)ItaG. ., . ? ~~ 'E)CCfr'T)fdG k.ND RESERY;31G UNrO THE SRA NTOR$r THEIR HEIRS AND ASS tCN5~ THE FVLI• FREE L16ERTY AHD RICNY~'A•T ALL T)uE'NEREAFTER PDREVER~ TO HA YE A PASSA6>11IAY. TWENTY (2Dt} FeET wiaE ALONG THE EA :T SIDE Of SAID LOT HER£OY GRANTED FDR TUE ~Ai HT£NANCE pNLY'OF SEWER LINp LDCA7bD T'N IiRE1N• \J, ~ ~ .. BFtNG A PART tK THE SAttE PREI)i3ES.WHICN 6WERNY SNTTN ARR PAUL L. SuiTNr TIER NUSBgND~ RY DEEO~ DATED•h3AY 4,. 1955'ANO RECORDED IN THE OFFICE f.OR THE RetxsRDtNC DF -' .:~~; DEEDS IN AND FO R'CUtq)@RLiti ND COUNTY] NENNS YLVANIA IN DE&D SODK VK^~ VOLUME ^ib^~ ~ _;ti% :' FACE N174~~~ CRANT ED ARD CONVEYED UNTO ERNEST E• GHATAPACNE qND ELi zgeETN W CKAIaPAQNE• '_';3 N) S MIFF. GRAKYORS HEREIN. ~ ~ ~ 'r a'?~ ' .:ty t..Nr~r .t~'••• ~..pa...:::. ;chod Dist Comb, Coy. ~ ~ ~~' ,~ ~. .~ x xa•I EN.i. Tna!•r f•a ) Y Awl Tal•M irafar Ta• s`y'~`F ,e 1 ~ o (. ~~ r.'iial. G. DtiL GI. MA t3 , ~.~. Cw DM. Gd. A1+- ~?> ~? } dC ~ ~ . ~ - ~~ ~ ~ ~ .. 41 .a;?•a li -iux ~:, ~. ,~ -~S: BD~c ~,2~'rz~ 549 • vn r aoo~aood u,azi~~o eaoa oe ~~r. A B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING 8 URBAN DEVELOPMENT 1.QFHA 2.QFmHA 3. QCONV. UNINS. 4. QVA 5. QX CONV. INS. SETTLEMENT STATEMENT 6. FILE NUMBER: 1TTERLY 7. LOAN NUMBER: 2325360 B. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid fo and by the settlement agent are shown. Items marked "(POCj" wee paid outside the closing; they a2 shown here for informational purposes and a2 not included in the totals. 1.0 393 (ITi'ERLV.PFd17TERLYn3) D. NAME AND ADDRESS OF BORROWER: JILL M. ITTERLY E. NAME AND ADDRESS OF SELLER: SUSAN HEADLE, co-execuVix TERRY S. DINSMORE,co-executrix of the ESTATE OF CHARLES R. LEACH F. NAME AND ADDRESS OF LENDER: TAYLOR, BEAN 8 WHITAKER MORTGAGE CORP. 1417 N. MAGNOLIA AVE. OCALA, FL 34475-9078 G. PROPERTY LOCATION: 4124 ROSEMONTAVENUE CAMP HILL, PA 17011 H. SETTLEMENT AGENT: 20-1624913 GUARANTEED ABSTRACT SERVICES, INC. I. SETTLEMENT DATE: F b 4 2008 LOWER ALLEN TWP, CUMBERLAND CO. PLACE OF SETTLEMENT PRUDENTIAL THOMPSON WOOD REAL ESTATE 3815 Market St, Camp Hill, PA 17011 ruary e , J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 700. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contrail Sales Price 158 900.00 401. Cornrad Sales Price 158,900.00 102. Personal Pro 402. Personal Pro 103. Settlement Che s to Borrower Line 1400 6,387.14 403. 104. 404. 105. 405. Ad'ustments For Items Paid B Setter in advance Ad'ustments For !tams Paid B Seller in advance 106. Coun R Taxes to 406. Cou !Tw Taxes to 107. C' Tax to 407. C' Tax tc 10B. School Tax 02104/08 to 07/01/08 109. 1ST QTR SEWER/REFUSE $87.50 02/04/08 to 04/01/ 468.14 54.81 408. School Tax 02/04/08 to 07101!08 409. 1ST pTR SEWER/REFUSE $87.50 02104!08 to 04!01/ 468.14 54.81 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 165,810.09 420. GROSS AMOUNT DUE TO SELLER 159,422.95 200. AMOUNTS PAID BY OR tN BEHALF OF BORROWER: 600. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. D sft or earnest m 1,000.00 501. Excess D Dail See Instructions 202. Prima al Amount of New Loans 138 900.00 502. Satllemerrt Ch es to Seller Line 1400 11,243.00 203. Existin bens taken sub'eil to 503. Existin loans taken sub'ect to 204. 504. Pe off of frcst Mortga e 205. 505. P of second Mo a e 206. 506. 207. 507. De osit disb. as roceeds 208. 508. 209. SELLER ASSIST 5000.00 509. SELLER ASSIST 5,000.00 Ad'ustments For (lams Un aid 8 Seller Ad" stments For Items Un aid B Seller 210. Cou (l'w Taxes Ot/D1/08 to 02/04/08 50.56 510. Coun fTw Taxes 01/01/08 to 02/04/08 50.56 211. C' Tax to 511. C" Tax to 212. School Tax to .512. School Tax tp 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 300. CASH AT SETTLEMENT FROMRO BORROWER: 144,950.56 520. TOTAL REDUCTION AMOUNT DUE SELLER 600. CASH AT SETTLEMENT TO/FROM SELLER: 16,293.56 301. Gross Amount Due From Borrower Line 120 165,81D.09 601. Gross Amount Due To Salter Line 420 159 422.95 302. Less Amount Paid By/For Borrower (Line 220) ( 144,950.56) 602. Less Reductions Due Seller (Line 520) ( 16,293.56 303. CASH (X FROM) ( TO) BORROWER 20,859.53 603. CASH (X TO) ( FROM) SELLER 143,129.39 The undersigned hereby aGcnowledge receipt of a completed copy of pages 182 of this statement 8 any attachments referred to herein. Borrower Seller JILL M. ITTERLY TERRY S. DINSMORE,co-execuVix SUSAN HEADLE,co-executrix ~.ati i'~ J ~~ ~ ~ L. SETTLEMENT CHARGES 700, TOTAL COMMISSION Based on Price $ 153,900.00 6.0000 % 9 234.00 PAID FRAM PAID FROM Division of Commission Ilse 700 aS FO/LOWS: BORROWER'S SELLER'S 701. $ 9,234.00 tD PRUDENTIAL THOMPSON WOOD FUNDS AT FUNDS AT 702. $ tD SETiLEMENr SE7'REMEM 703. Commission Paid at Settlement 9,234.00 704. TRANSACTION FEE. to PRUDENTIAL THOMPSON WOOD REAL ESTATE 200.00 200.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ori ination Fee % to 802. Loan Discount % to 803. Appreisal Fee to MICHAEL CONNOR 300.00 804. Credit Report to 805. Lenderslnspection Fee to 806. Flood Certfee to 807. Tax Service Fee to TAYLOR, BEAN &WHITAKER 73.Op 808. Documerd Prep Fee 809. Admin Fee to TAYLOR, BEAN 8 WHITAKER 525.00 810. Wire/MERS Fee to TAYLOR, BEAN &WHITAKER 22.50 811. Par Premium pd to SUSOUEHANNA LENDING by T8W $1732.08 POC 812. Doc Processing Fee to SUSQUEHANNA LENDING GROUP 345.00 813. Compliance Fee to SUSQUEHANNA LENDING GROUP 50.00 814. 815. 816. 617. 818. 819. 6ao. 900. ITEMS REQUIRED BY LENDER TO SE PAID IN ADVANCE 901. Interest From 02/04106 to 03/01/08 $ 20.930000/day ( 26 days %) 544.18 902. Mort Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 ears to POC 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months $ 26.92 r month 80.76 1002. Mort Insurance 0.000 months $ 75.24 r mortth 1003. Cou !rw Taxes 13.000 months $ 44,52 r month 578.76 1004. C Tax months $ r month 1005. School Tax 9.000 months $ 94.55 per morrth 850.95 1006. months $ r mortth 1 7. onths r 1008. AGGREGATE ADJUSTMENT months $ r month -339.76 1100. TITLE CHARGES 1101. Settlement or Closin Fee ro 1102. E-Mail Document Retrieval to GUARANTEED ABSTRACT SERVICES, INC. 40.00 1103. T e m n 'on to 1104. Insured Closi Letter to LAWYERS TITLE INSURANCE CORPORATION 1105. Document Pre aration to LAW OFFICE OF SUSAN E. LEDERER DEED 35.00 200.00 1106. No Fees to CASH 20.00 10.00 1107. AHomey's Fees to irtGudes above item numbers: ~ 1108. T le 4n ur to ARANT ABSTRA T RVI IN GA -010 1 153.75 irxludes above item numbers:1101 1103 -BASIC 1109. Lertdefs Coverage $ 138,900:00 L08-0030185 1110. O.vners Coverage $ 158,900.00 C70-0028439 111'1. PA ENDOR5EMENTS:100,300,900 to GUARANTEED ABSTRACT SERVICES, INC. &ARM 200.00 1112. Overnight Feelpadcage to GUARANTEED ABSTRACT SERVICES, INC. 12.00 1113. Tax CeR Fee to TERRY FABIANO 10,00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 40.50 ;Mortgage $ 66,50; Releases $ 107.00 1202. Cit /Coun Tax/Stam s: Deed 1589.00• Mort a 1,589.00 1203. State Tax/Stam s: Reverxie Stam s 1 589.00; Mort 1 589.00 1204. RECORDER OFD EDS 1205. RECORDER OF DEEDS 1300. ADDITK)NAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins coon to POC 1303. 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 6,387.14 11,243.00 s• nyn,.ro w~ • ~ •~",•••a••w~ , .~R r ~,,.~ oww....~ ~ eceipr or a canpeceo copy ar page [ or tors two ppe Certified to be a hue copy, GUARANTEED ABSTRACT SERVICES, INC. Settlement Agent ( ITTERLY ! ITiERLY / 13 --~ ~ ~ n 1 :~ n~ ~~ ~~ o~ c9 ~z nm om Z T :~ z ~ N ~~ ~~ a~ C -~"~ >Z ~rn m y~ t~ ~ c~ ~a =~ ~~ ~c r ~ m~ ~~ N ~ m $ ~ ~' v ~ ~ sn ~ gn m ~ m T ~ n~ ~o ~~ ~~ ay oa O ~ n ~ crn z -a ~ . z v z a +:. `> ~-k m rn m O -i ~_ O ...j rn }~ F-~ N W lJ~ 00 W A V .A lp lD N 1-~ N I--~ ~ V (J1 F-+ W F-+ O N lJ~ a~ oo w w O cn oo O Y N V V ~n O O O O Vi O w .~. 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W ..-+ 00 00 U1 ~ ~ d v 00 ~ ~ ~ ~ SZ+ ~D -P +-r A •-~ w ~-. ~ N a\ D\ N N ~ ~ ~ N ~. to O~ to A N 01 0o Oo ~1 w ~~y+ fU ~--~ O~ w O w ~l w w -r ~p ~ w 0 0 ~ ~ 0 ~l oo O O O O ~ w ~.p ~.p r~ ~ w o\ t~ D1 N v O oo O~ N N -P N ~-- oo co w i~ p~ .-• ~. i,n O~ pt O\ w oo ~ .P ~-- v to ~--• J v, N ~.1 ~.l O N O ~D oo .-• w .P W O ~.1 0o a ~D N -P N ~ C t!t V1 l!1 C!1 CJl lJi t!~ Vt V1 l!1 ~ C ~D ~i 69 69 69 b9 69 b9 69 b9 ffj b5 69 EA b9 b9 b4 69 64 ffi 69 b4 L-f} b9 69 69 b9 b4 N N w N ~ ~ a\ ~ ~ ~ N w N w v~ N w to w N ~-.. c7o J~ •-r .P .A •-r O a1 J Cn ,~ J ~ ~D N O O~ N .P ~ r0 Q~ O J rP rP N ~ N w ~ ~ ~--• ~; a1 ~ O O w O w Q~ w ~1 v N v O cn ~''~ w w `p N oo ~A w O~ O~ ~D a1 o0 0o 00 N `O ~ to A W ~.. vi c.n ~..• -P .(~ cn J~ a1 o0 ~-. 00 +-~ .P ~ W ~ ~ O w O oo ~ v, ~ O~ .P ~-- oo +-~ •-• w v, ~p O O J O N ~ ~O w N ~ o0 O `O O ~ O O O O O N O v~ ~ ~ 0 0 0 0 CIi O c~ O cO O to .P ~ O `I ~ vi O 0 0 vi O ~l w .p. O O O O O O O O w 0 •? O O O I ~C~t~~~- 5 - ~.-~ ~+- ~~ ~~ N m 3 N T c c. z ~' H a 1 S 2 m -t :~,m: ~ G A, W 2 7 .T r y v 1 9 9 ._~ ~ .! A.= ~ ~ C 9 Z N yrn ~° ;r a ;m T.N ~ a . N .' O ~.. 9 9 .o o z mm m ~ N ~, D Z 2 .~ '+ _~ a m3 r ~ _ T1 ~+ .z ~.+o m nvu~ ~~~ viaan ars zm~ «:o --+~r rcnm rmva m~ ~~ -C TI r rrm za c> w ~ N N ~ \.. T m~ r-y ~, Z ~2~ ~~~ ~~~ aim z to ~~D ~~f i Q ~ .~ ~ ~~r=rt ~ ~ "+~ ~ C }~ 5~"~es~ v ~..~ ~ ~~ Trust Prices Pennsylvania Insured Municipals Income Trust (I- PA0022) .n - n ,~ E *~ ~~t~' ._ ~ , ..,_ Q ~ PRINT THIS High Liquidation Price on 4/1/1986 was $1056.62000 Deposit Date: 4/7/1983 Low Liquidation Price on 5/7/2008 was $150.70000 Termination Date: n/a CUSIP: Detail Secondary Date: 4/25/1983 ® Download all search results to Microsoft Excel Search Historical Prices Distributions Pricing Date Offer Price $ Liquidation Price ~ 11/08/2007 $0.00000 $179.46000 11/07/2007 $0.00000 $179.48000 11/06/2007 $O.000DO $179.54000 11/05/2007 $0.00000 $179.64000 ~, 5fi~.KTuTs,? Thera is no assurance that a unit investment trust wil! achieve its investrT~ent obi2ctive, An irves%:rent .n this unit investment trust is subect to market risk, which is the Possibility that the market values pf securities owned by the trust will decline and that the value o` trust units may therefore be less than vahat you acid for them. Ar_cordingly; you can lose money investing in this trust. Please consider the investment objectives, risks, charges and expenses of the unit investment trust(s) carefully before investing. The prospectus contains this and other information about the unit investment trust(s). To obtain a prospectus, contact your financial advisor or download and/or order. Please read the prospectus carefully before investing. Not FDIC Insured-Offer No Bank Guarantee-May Lose Value Not Insured By Any Federal Government Agency-Not A Deposit ! icens Disclosure ~ Privacy once ~ U.S.A. Patriot Act C>;pyrigl?t ,c:, Z00H Van 4<am;,er; F;;nds inc. Ail rights reserved. 1 Parkvie4v P4a<a, vakbrook Terrace, Ii_ '00181 r•~ember FINRA;SiPC. De not dua'sicate or redistribuc it arv Perm, Page 1 of 1 ~~ ~ a-~' http://www.vankampen.com/vkapp/Search/LJTSearchPrice.aspx ~/i oi~nno COMCAST CABLE vON3MU1*11+,1r",1 IONS "" .. ; _n~,;!~,,,!'s;1 4008 N. DIJPONT HIGHWAY ATTN: SUPPORT S;=R~IICES NEl^_i CASTLE, CE 1 G'20 . 03031 CHARLES LEACH 4124 ROSEMONT A'JE CAMP HILL, PA 1,'011-731; f.„f f t ,,, i f t,,,,,, t t~„t t L, J t„1.,,, f i t„t t„t, 1, t„4„~ t l t ~omcast ~-~ vr1 Dear Charles Leach. ___._ The attached check represents a subscriber refund for account number 0964x-223265 in the amount of $9.96. if you have any questions or concerns regarding the refund check y+JU can write us at the address above or calf Comcast's tol! free customer service number at 1-888-COMCAST. __ ~_ .._... Check Date: 12!19/2007 ~"' Check Number: 1 x9131413 ._..-. _~ ~~ --- ,..._ ._.._ ~~ _~ ._._ ;r -- ia~:r:~c~t~ ;»n ~xr.: r:tis~ r~ai{~; ~-r:~i:r.tis~:~~r 7?i~6 fTA3'i'.lSfi ("r!4~^~ !S !~ P-11?.lEi^! ~iP .';?".:5 OtiS('}tlfiitD At401'k' 11' `0'1-S' )R,tl C.'. F!I,E 1~E .7i'it ~ 1:} :'„S~t''S'4" ~f1 NLt..?~,Pf Jr~alAii7: sGi~~.r ~. e ~~ Cti-4145i74Di~0D2433-c"0-a80L4-S0o82-AFN 12S0D i ~"'1 ;JN13ED HEA.TI-#CARE SNSUfs.ANC~ CJF~PA.NY -~ Lt1CENT PPD INDEMNITY P. D. BDX 740842 ATLANTA, GA 3A374-0802 PFiDNE: 1-300-5?7-3557 VISIT 4JWW.MYUFIC.COM FOR SELF SERVICE rNARL~S ! £ACH 4124 RaScMONT Al's CAi~1P HIE.L PA 175)11 I~nitec~H~altheare __ ~;~ $ ~t:^~4u HF'iili.~. ~N~f'v:~!'~~il}'.V .n__.--.... , ~. ~ ~~. PAGE : 1 aF 3 ~~ DATE: 41114/08 I D # : A 875829871 EMPtDYEE: fl1pRLES LEA~t - GDNTRACT : usl7ooa ~.~., BENEFIT PLAN: ALCriTEL - IUCETrT ~_ . GHECI4.:IyUMEER::.1P aos9sa2a _ SUMMARY -- E~PLANATIaN - ~F SE~iEFtTS oz fl~ aavc ,./ ^' i PL'iSN+~Sw Y~~{ ~ r~rr;« _`' :53i C'~Z '~ /~ x°-, ~ .P_~i~11~4£f~f s5~~+7T-'F€1'~`~'RDY~I3~it~S~ ;- F ~ `5a ~'~a ~r~YDtIR. ~#~ x ~„ ~N _537.02' } YDUR EXPLANATIP~LEASE$CDN3AC5 USC~iPYDUEFiAVEIANYUQUESTIDNSOR INFORMATIgN CALL: t-300-577-856?. Detach Check Detach Check -y Sc-4.~c~~ ~s~,- C, ~-~~- ~-~-, ~ December 20, 2007 To Whom It May Concern: Charles R. Leach has an account with IndyMac Bank. The account number is 2913635216. It is an individual account with no beneficiaries. The account was opened on .7uiy 2u, 2007 for a term of one year. 1 be value at the date of death was ~ 10u,000.00. He was having the interest sent monthly to another bank so there is no additional interest posted to the account. I am enclosing our Affidavit for the executrixes to complete and have notarized for closure of the account. If there is anything else I can help you with, please feel free to call 1-500-998-2900. Sincerely, ~'~% :, L ~.,. _i 2' iJill Gatti Customer Service Representative IndyMac Bank Consumer Banking Group ,,,,,. ~ ;,a~ ,.._~;. PO Box 247009, Omaha, NE 68124-7009 December 12, 2007 Amy M. Moya Susan E. Lederer, Law Offices 4811 Jonestown Rd, Suite 226 Harrisburg, PA 17109 Dear Ms. Moya, ~aopersmr;~~~es. ~rr~ven ~erv6ce: 1-800 247-5626 www.PenFed.o~g ~ ~~ Re: Charles R. Leach Re File #: 2972686 We are writing in response to your request concerning the above referenced account. Our records indicate that Charles R. Leach had the following accounts as of November 6, 2007: • Share Savings Account 2972686-O1-4 individually owned. The account had a principal balance of $5.04 with $.00 in accrued yet not posted dividends for a total date of death balance of $5.04. • Share Certificate 4227016-56-7 individually owned. The account had a principal balance of $100,000.00 with $216.19 in accrued yet not posted dividends for a total date of death balance of $100,216.19. V~'e have enclosed the Death Certificate and Short Certificate as we have made copies for our file. If you have any questions please do not hesitate to contact us at 1-800-247-5626. Sincerely, .,~ _..----. ~ .,.. ; __-aca A. Rinehart Estate Accounts Specialist Omaha Service Center ~~~w,~ - O a~-- SL~ ~.~ A ~ m -~ N r ~oQ~ „ ~J{ ~ -, s ~ W } ~m W ~ s- y rn ~oc~ ru Ln W m~D,m v~zm © o o~~ be ~ ' ~~ z fl ~ ~ zy ~ v W n~~f ! D ~~~ ., .~, r 'a l ~ ~, .- ~: ~~~ r '~, i i I 1 :1 N ~~~ :J 3 N yr„ 1 W N t~ W '~+.. ~ ~' ,yU V Cj `"~' W W 1 r ~. ~~ ~~ .~ A ~ H ~ N ~ ~~.- ~ G H ~ a D '! r• ~ ~ ~ ~~ ~~'. ~ R r., H n; e m rw ~,.. ~Q a N G ~ (~/~/~~ ~ CDC ~M ~ ~ _ gr ,J. ~_ _. ry A T :'"- ~ -- ~ _ ~ i a .~ - ,~ ,; ~. _- _ ~. -- _ _ ~~ ~~ o .~, _ _ 1L1 _ c ~ i'1 ~ LV gip. ~- _. ~ W C~ ~ Cm'1 ' `~ m a ~' ~,~ n ~~ ea ~F yd (', ',~ / ..~ Page: 1 Document Name: untitled ~DDHIST Demand Deposit Display History 6017 01/25/08 Acct 0571201 474 Request ALLTRANS Alpha key ESTCHARLOI Last stmt 01/18/08 S --Date-- ----Description----- -Serial Nbr- -Reference- ------Amount------ * O1/02108 CHECK 109 06227504430 (630.50) * 01/02J08 DAILY BALANCE 6,015.67 * 01/03/08 CHECK 108 06237104590 (55.60) * 01/03/08 DAILY BALANCE 5,960.07 * 01/07/08 DEPOSIT 06711204480 ~ 5,000.00 * 01/07/08 CASH CHK 107 06272901300 {316.85) * 01/07/08 CASH CHK 108 06272901290 (26.11) * 01107/08 DAILY BALANCE 10,617.11 * 01!08!08 DEPOSIT 0&206209440 365.23 * 01/08/08 CHECK BOOK FEE 0007790Q000 (13.25) * 01/08/08 DAILY BALANCE 10,969.09 * 01/16/08 DONEGAL MUTUAL 00077900000 (109.00) CASH TRANS G1057758 _ DDDHISTREQ _ DDDHISTBAL DDDMAIN DDDACCT DDDINT There is additional information b efore and after+this page. _ _ GN20000203 COMMAND =__> F2=Retrieve F3=Exit F4=CRFwindow F7=Backward F8=Forward SO~~REIGN BANK 3556 OLD GETTYSBURG ROAD CAMP HILL, PA 17011 _.~ ._ ~.. ... ,~ ' ~ 4 S ~= lv~ct vl~ C~fi~~~ Date: 1/26/2008 Time: 9:46:47 AM ~ ~ ~ 3 ~ -a .~ ~ ~~ ,~c ~ ~~' m O ~ ~ `~ CD ~ ~ n, =-'~- " N ~ N ~ 'O t4 ~ C'1 tD C1 "6 t~ r N ro 0 ~. v ~. m y =.,, w, it -.- ~~ ~~O ~,a Z 'D C7 O ~ G ~ ~ ~ O O~ v OA O N ~ N ~ Z ~ d n 3 t~A m ~~ ~ -. ~ ~+ c j ~ ~ m '~ ~ N ~ O ~ ~ ~ ~ ~ Q a. ~ cD tN O tD N ~ N m to .~ s Z r Z 'TI Z Z n r. C~ O ~0 O O Z ~~:: I~ d ~ C~ E ~~ ~ ~ ' ' m ~ az~ ~- ,_, L7 .. . ~ o "' ~ 'y p'~ y H w c z p ~,, r ~ o mo~,~ a n F 0 ow~~ ,y,~.1 ~ Z ~} '~ ..{ rn~ ~ ~ c o rn ~v w m'~,.~ Nv -:. BRtCKERS AUCT1~~t ~~ ~ ;a Buy & Sell on Commission -Complete Sale Servioe 93 Texaco Rd., Mechanicsburg, PA 17055 765-5785 Personal Property of ~ ~'~-~ ~~~ ~ ~ 5 Sold At Pccblic Sate OL C ~ j~ 2O~~i j a fiutstanding Tota! Sale ~ ~ ~_ .~ iota! checks ~ ~ ~ r . ~ L, Total Cash i ~ (, ~, ~~ Cash After Payout l Expenses Auctioneer ~ Clerks ~~ ,~~,; L%~ Acly. cost I ~ ~, j ~; ~ ~ Vy ~ S % jj , Safe Setutr or help ~ ,~,-~ J~ v Uv 4'~J 4 1-~ ~~"`"~' l iota! Expenses ~ ~ ~;' L ~'~~~ ~,~:u:r Y~ ~a ~ - /( ~ '1 u •,, ~~ ~`~ ~ ~~j ~ n ~ -- J Gl ~-tic~C~l',_;~ ,~ ~ m rv 0 Q ~~~ =o ~~ o ~r t x -;t o 1 =; ~ ~ Z ~ ~G J ^J 3 G. x a o• 0 1~ `1= :f n - 1J m ~ ~ ° v c ~ ~---` -~ ~ ~~ N O N N! C7 N ,N ~ { J '~, a N ~My o s ` J ,p Nrj .~ ..+. X~ C1 y ~ ~ p n ~ ~~ Q ~ ~{ 3 ~ ~ m ~ r! N T"HE 3':~Ti23Q'i'-\I~:WS ~~.G~:~ ~ i.. ~'~,, w-~ ~ ~. PO f3t>x'_2fi~ ~ Nutriskxtra. PV 1' 10~ Cl;eck Uatc: 11;1t5-'UO"r Vendor lnmbcr: ~)9y999999+~ C;hrck `o. u4{)tit)ifiK99 ~.._..,:..., .~...,.i...,. o,,.:,..,•.. n.. r,. Voucher 1D Gsnss ;lmnunt I)iaount'1'y~kcu Paii :\nu~unt ? uceat Tec~aoiogies getl ?:1b5 4YfINdIkMS ..sren;; ens;fln Sew4ce Center -X-~...e c~,v~ G ~ 5i9CY•tl.'N Ji9u:! ODO; :5403 N.90: GNP: ?~'ti .~ UM.i•<. IfF:. M3 353fM .`5rie ~..:.._.... .. ~TR'i ~Y C LEACH 4I2~~ROS~MON".' :EVE CA1~? HI~~ PA .?01? ''41 POP, PAYMENT CUESTtONS PRASE CALL ?-666-428-5764 (TDD: ?-866-429-5765, 1NTEANATIONAL i-994-791-2747} MCNDAY THROi:GY. FRIDH" 3ETVd EEN 6:99 AM AND E:DC PM c5T .r' YDL'R AOORE55 !S NOT CDRP.ECT, YOU CAN LOG ON TC THE VJEB AT HTTP;±;LUC'eNTPENS~ON.CSPLANS.COM TC MAKE CHANGES OR PRINT ?'HE CORRECT ADDRESS ON THE BACK OF 7H15 STUB ANO MAIL iT TO THE ADDRESS LOCATED ON THE LEFT. c t~~ank ACCOUNT !D LUCENT S -REPR- R PERIOD BEGINNING: 12!01/2007 PLAN NAME LUCENT TECHNOLOGIES {NC. PERIOD ENDING: 12!3112007 _ _ _ ___.. ~....-_.. ~ __ .._.~ -_-____. _ _. _v ___ _ _ _ .. _ _. - --- -- PA~E~ [i~1~E1R1UlA~'iC}N d PAYMENT DATE ,._._; __..._ ..._ _..._.._. CHECK NO. PAYEE SOC. SEC. NO. ~~ NET PAYMENT ____.,ANUARY 01, 2008 000200148 "~-"-"~' -.?' INSUREDS COPS' -~ ~ ~ YY c lr~c~ vC~ C- ..,..,,.....w...b...... _ _._. ...+.. .«. 3.ty 1k7.a. ::Yi`. ... lift i)i»'i'~ ,:t.Sa:T:C'_,`izn" ,::"dSJRANL~C0~+1rA^!Y ~J'.S!741.CaSU;Ui~Lli+iaiiRCS1Cw.:?4i.>F.6i`' ( ~ ~ ne~R ih.~+ :~!LWC4 ~„takAPANY . PE'vl*e~l.f.~, 3R-~ aqn,; rny,Q~ y t'`'_ \ , ~ ~ "'1" ~3w - ..^ ._;.'!.~ ...avi'.~tNC'e vti?~Pah'Y SCu" .~."tr: i -r..i; 1. ,.~ , ?*TP:. ~v ^c ?.........., ~i ` .... ...... ~~,., .nN..,;; -~'it.. ?:k `.?:. 'uW ,°,G`; .... ~Ei00 'ir'WMt.~i'M'Lw.ii itri tl;,L'Otn DONEGAL MUTUAL INSURANCE COMPANY' BILLING IN,~UIRIF:S CALL; 1-800-$77-0600 0::12/'08 CA33CELLA`I'ION MEMO 00056.;.1 PAF 3050626 01C~? i N AuTQMQBILE ~ LEACH C:iARLES ~ ~i24 ROSEMONT AVE ~ CAMP HILL PA 17011-7$17 ~liil~~tlil1~ifiiili~iifl~~iiii~il~fififitiiifii~fifiiiiiff7~1 ROLiCY ~L"Ft'~CTiVE: ~.Lijr.L~/UI TOTAL POLICY PREMIiIM: S$9$.00 ACCOUNT BALANCE 0.00 PRO-RATA CANCELLATION EFFECTIVE Oij151`0$ 6$2.OOCR t3D RE~iUEST {3F ~'' STATE: INSURED DECEASED A REFUND DUE S6$2.00* ~ ~ A CHECK F~v'ILL BE SENT LiNDER SEPARATE COVER. D N ` T A HURRAY INSURANCE ASSOC INC T ~ ~ ROSSMOYNE BUSINESS CENTER ~ '~ ~ E 4999 LC}UISE DRIVE SUITE 2G1 ,,..r O ~ ~` u N MEC:ANICSBURG PA 17055-6907 N S :,~';~; T A T ..,.,~``` h.=' TELEPHONE (, 717 ) 620 - 2a00 ` a, _~^ i ~ d~S ,,,y.r.,: dSiGaL. i3~¢' s': rA:n'. '~"'~~:`.•r i„' ~'..: ~-»~9r yt-:. ti,.,.::, ~_ ~'., ... , ~... +~ tats- „~.c 'p'S ~'_'`..~4Jt r~i~cr^ -, v it.,i~''ly FA"A~LE '~ ~ u. _.~._,_.~..-...__._.........._.....,..-..___•-- ,, .. - _. . - cep` i - ~~; „s gg ~ ~1t~.L7r~i~SS C?-ti~JvGEt~ % t ~' SSW 'att33V`•, 4~'G'?GSS ~:-!A.(dGc Vi'i': '~ rr~ : ~(; c i pan- ins- cuur~ uy : cy wn tr7trc5uN Instrument ~ va i ve Svc yu4- ~~l-~~~~ ~~~~~ Luednt Teefinologies er uM rnewron Lu~nl Pension sendce Gents PA Sax 57518 Jscksonv5e,F1 31241.7678 waNO~~u Rwamrit fM N!f OM~•41~ pOT4 g9i1 c c.•~••••• ~~ Ar1ZA RO6}I;itONT PAVE C $z1rI+ PA x.707.7.-781? 8/46 ~- ~ ~ I S KOfl PAYMENT 4UES'CIOiVS PLEASE FALL 1-1149-4~-b7~ 1TDtti 1.8B8.4Zp-6?e6, tNTEgNATIONAL 1.504-7p1-9147! MONDAY THROUtiH FRiAAY BI;TM-EEN X00 AM ANQ &00 PM &3T IF YDUR ADDR>t9t? 19 NOT CORK@CT, YDLI CAN LDG DN TO THE MISS AT H7TP:JfLUCENTPEN9fON.CSPLAH9.C0M TO MARE CHAN6B9 OR PRINT THE CDRRtFCT ADDRE95 ON SNE EACX DF THIB 9TUG ANO MAIL 17 TG THE ADDR865 LOCATED DN TH6 48FT. ~ ~~b~r~k AGCOtiidT' tD LUCENT Q -REPR PE~tiOC BEt3tNNING: 11lUi12aD7 FLAN NAME LUCENT TECHNOLOGIES INC. PENSION PLAN FF.RIQD ENDIAiG: 11130120!}7 ~~~ i -t ~ {f1 ii~~i~' J1,ri .~ .: 12~Z. .Yii N -i.i r)i Y')u ~3 ;Y r );v(i::;i. "~f~i~ Fi`..~'•. i14i ~!~)~ :~;,,~ ... `,h~ . ,i7. tiCc. ~ ~qU "?GV£ C~UE'SttJ~1S.:,~~~ •aS O: rf:a.1: iG' ~a1C 3CSC2'8SS Sho+n+n C)C'~OW, 'u~.~sr,^ ar r, etrir;!". Yau may use this nQ#s~e as ~roa~ nr dour trrrertt rafe of ~~n~Ky. 5~1,~dv~., G ',~-^ yl ~~ 1 `°~l.;r: v~i.l i:ic~SS ?"~ti's..i' r`~?~NLJ:-''Y s'= _..75 ih~ ?. .:% .. '... -~_v;.!~.G r~.ti~i.~?MFHT. 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O p W ..~ O r N t!i J Vr lh N ~ W t!~ O ~ ~ ~ W N N N `J 00 ~ O ~ O~ N ~-' 0o N ~1 O O O O O O O~ 00 J O J ~C~CQ ~~ 'T~ "'~S June 16, 2008 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Charles R. Leach Social Security Number: 164-30-3319 File No. 21-07-01021 To Whom It May Concern: Enclosed for filing with your office is one (1) completed Form REV-1500 with date of death valuations, in duplicate, together with the following attachments for the above decedent: 1. Check for Filing Fee and additional probate ($730.00); 2. Check for additional inheritance tax ($7,327.65); and, 3. One (1) copy of the Last Will and Testament of Charles R. Leach. Also enclosed for filing with your office is one (1) original Inventory for the above-referenced Estate. One (1) additional photocopy of the front-page of the completed REV- 1500 form and one (1) additional photocopy of the front-page of the completed Inventory for the Estate have been provided. Please time/date stamp these copies as received and return them to me in the envelope provided. If there are any questions or further requirements regarding this return, please do not hesitate to contact me. :, ~~ ~ ~ .~ Sincerely, Ft_~ _ A~fny M Moya -- _:~~ ~' . Enclosures -_ 4811 Jonestown Road Suite 226 Harrisburg, PA 17109 Phone 717.652.7323 Fax 717.652.7340 susan@ledererlaw.com www.ledererlaw.com .Ne/ /e~apa{ /o uo/;e/o/n a aq few esnsy y ~/epy.yuoud Bu/puas ui asn raj d/a/os papMo~d s/ pue eapuaS /e;sod •S n ay; ~o d}~ado~d ay; s/ 6u/Be~/aed s/yl ~~ w g ~ n m ~ o y ~ n '* a m w 4 ~^~~ ~ ~' a ~~a n N N 4 m a~ c~ ~ Q~~ ~ c~c°c~u ~ 30~ ~.~~' ;. ~ ~. 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