HomeMy WebLinkAbout07-11-0815056041125
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 7 0 2 1 8
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2 3 4 1 4 7 6 4 4 0 2 2 4 2 0 0 7 0 7 1 1 1 9 1 9
Decedent's Last Name Suffix Decedent's First Name MI
M A R K S T H E L M A L
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
M A R K S ROB E R T C
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
2 0 7 0 7 8 1 4 1 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return
4. Limited Estate
OX 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
2. Supplemental Return
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
~ 8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
D A V I D H S T O N E E S Q U I R E 7 1 7 7 7 4 ~,,4 3 5
~~
Firm Name (If Applicable) n - `'~
REGISTL~(LF~rUILLS US~ ONLY , ; y
S T O N E L A F A V E R ~ S H E K L E T S K I -'; `-w ~' ~-
i I "-1 ~~ ~ 1_- _-j
~
First line of address ~~'r ^'" `
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4 1 4 B R I D G E S T R E E T - J ~---, -~ -.
Second line of address .~ _,,.~
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N -
'- _
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City or Post Office State ZIP Code A E FILED GJ
N E W C U M B E R L A N D P A 1 7 0 7 0
Correspondent's a-mail address: DSTONE@STONELAW.NET
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.
NATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
a ~
6ADDRESS
325 WESLEY DRIVE, PT. 106 MECHANICSBURG PA 17055
SIGNATU REPA ER THAN REPRESENTATIVE DATE
Y ~ .-_ ~ ~ - ~ ..4 !.?
414 BRIDGE STREET NEW CUMBERLAND PA 17070
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125 15056041125
._J
15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: THELMA L. MARKS 2 3 4 1 4 7 6 4 4
RECAPITULATION
1. Real estate (Schedule A) ........................................ 1.
2. Stocks and Bonds Schedule B 2. 1 1 9 4 5 2 2 6
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages & Notes Receivable (Schedule D) ........................ 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
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.
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, or
transfers under Sec. 9116
(a)(1.2) X.oO_ 1 4 0 8 4 6 6 3 15.
16. Amount of Line 14 taxable
at lineal rate X .0 _ 0 0 0 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 1 g
19. Tax Due .......................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15056042126
0 • 0 0
3 0 5 0 4. 5 5
1 4 9 9 5 6. 8 1
9 1 1 0. 1 8
9 1 1 0. 1 8
1 4 0 8 4 6. 6 3
0 • 0 0
1 4 0 8 4 6. 6 3
0.00
0. 0 0
0. 0 0
0. 0 0
0. 0 0
15056042126
REV-1500 EX Page 3
Decedent's Complete Address:
~ DECEDENT'S NAME
THELMA L. MARKS
STREET ADDRESS
325 WESLEY DRIVE, APT. 106
CITY
MECHANICSBURG
Tax Payments and Credits:
~ Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit _
B. Prior Payments _
C. Discount
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
File Number
21 07 0218
STATE ZIP
PA 17055-
0.00
0.00
0.00
0.00
(5) 0.00
(5A}
(56)
Make Check Payable fo: 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 ........................................................................................... ...
. ^
d. receive the promise for life of either payments, benefits or care? .................................................. .
..... ^ Q
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .................................................................................. ..... ^ ^X
3. Ditl decedent own an "in trust for" or payable upon death bank account or security at his or her death? .... ..... ^ XQ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................................................................................. ..... ~ ^
0.00
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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX + (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THELMA L. MARKS 21 07 0218
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
~ 44 shares Alcatel stock @ $13.290 each 584.76
2 15 shares AT&T stock @ $37.140 each 557.10
3 2746 shares City Holding Company @ $39.920 each 109,620.32
4 48 shares Comcast stock @ $26.940 each 1,293.12
5 9 shares Idearc stock @ $35.040 each 315.36
6 2 shares LSI stock @ $9.840 each 19.68
7 184 shares Verizon stock @ $38.380 each 7,061.92
TOTAL (Also enter on line 2, Recapitulation) I $ 11
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
scHE~u~e ~
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
THELMA L. MARKS 21 07 0218
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER.ATTACHACOPYOF7HEDEEDFORREALESTATE.
DATE OF DEATH
VALUE OF ASSET
%OF DECD'S
INTEREST
EXCLUSION
(IFAPPLICABLE)
TAXABLE
VALUE
~ Union Central-Fixed Annuity Contract #A640012038 30,504.55 100. 30,504.55
Beneficiary Robert C. Marks, surviving spouse
TOTAL (Also enter on line 7 Recapitulation) I $ 30 504 55
(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
THELMA L. MARKS 21 07 0218
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
~ Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)IEIN Number of Personal Representative(s)
Street Address
City State _ Zip
Year(s) Commission Paid:
z. Attorney Fees David H. Stone, Esquire 5,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Claimant Robert C.Marks
street Address 325 Wesley Drive, Apt. 106
c;ry Mechanicsburg State PA Z;p 17055
Relationship of Claimant to Decedent Husband
4. Probate Fees Cumberland Co. Register of Wills 264.00
5 Accountant's Fees
6. Tax Return Preparer's Fees
~. Cumberland Law Journal-advertising grant of fetters 75.00
2 The Patriot News Co.-advertising grant of letters 141.18
3. Filing Inheritance Tax Return and Inventory 30.00
4. Reserve for closing expenses 100.00
TOTAL (Also enter pn line 9, Recapitulation) I $ 8,110.18
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + i9-00)
SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
THELMA L. MARKS ~1 n7 ()~1R
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
t. Robert C. Marks Spousal 140,846.63
325 Wesley Drive, Apt. 106
Mechanicsburg, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET
l 1. NON-TAXABLE DISTRIBUTIONS:
1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
i
STONB. LAFAVEH ~ STONB'
ATTORNE`fS AT LAW .
+~~ 414 OR~(iE STREET R ,,.~.,...~;
NEN QtJ![HEItLAND. !ati t70?'O
LAST WILL AND TESTAMENT
OF
THELMA L. MARRS
I, TBELMA L. MARR3, of New Cumberland, Cumberland County, Penn-
sylvania, declare this to be my last will and revoke any will previ-
ously made by me.
ITEM I: I devise and bequeath all of my estate, of every nature
and wheresoever situate, to my husband, Robert C. Marks, if he sur-
vives me.
ITEM II: Should my husband, Robert C. Marks, fail to survive me,
I devise and bequeath all of my estate, of every nature and wherever
situate, to such of my daughters, Cinda S. Rose and Kathryn D. Miller,
as survive me, in equal shares. Should either of my children prede-
cease me, I devise and bequeath the share of such child to her issue,
per stirpes, and should any such child of mine leave no such issue
living following my death, I devise and bequeath the share of such
child to my issue who survive me, per stirpes.
ITEM III: I appoint my Executor and his successors guardian of
any property which passes, either under this will or otherwise, to a
minor and with respect to which I am authorized to appoint a guardian
and have not otherwise specifically done so, provided that this
appointment of a guardian shall not supersede the right of any fidu-
Page 1 of 4
ciary in its discretion to distribute a share where possible to the
minor or to another for the minor's benefit. Such guardian shall have
the power to use principal as well as income from time to time for the
minor's support and education (including college education, both
graduate and undergraduate) without regard to his or her parent's
ability to provide for such support and education, or to make payment
for these gurposes, without further responsibility, to the minor or to
the minor's parent or to any person taking care of the minor.
ITEM IV: I appoint my husband, Robert C. Marks, Executor of this
my last will. Should my husband, Robert C. Marks, fail to qualify or
cease to act as Executor, I appoint my two daughters, Cinda S. Rose
and Kathryn D. Miller, Executors of this my last will.
ITEM V: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of her duties in
any jurisdiction.
IN WITNESS WHEREOF, I, THELMA L. MARKS, have hereunto set my hand
and seal this / ~ `'~ day of ~:~-~ , 1998.
~~ ~.
THELMA L. MARKS
Page 2 of 4
SIQNED, SEALED, PUBLISSED and DECLARED by Thelma L. Marks, the
Testatrix above named, as and for her Last Will and Testament, and in
the presence of us, who at her request, in her presence and in the
presence of each other, have subscribed our names as witnesses.
-~~~~~
Witness
~~
Address
~ _ ~..~
Witness
COMMONWEALTH OF PENNSYLVANIA:
SS:
COUNTY OF CUMBERLAND
Address
I, Thelma L. Marks, the Testatrix whose name is signed to the at-
tached or foregoing instrument, having been duly qualified according
to law do hereby acknowledge that I signed and executed this instru-
ment as my last will; that I signed it willingly and that Z signed it
as my free and voluntary act for the purposes therein contained.
THELMA L. MARKS
Sworn to or affirmed to and acknowledged before me by Thelma L.
Marks, the Testatrix, this / ~ ~ day of r~~t'.`~ _S , 1998.
~: / ~ i
< ~~,
Notary Public 't
Page 3 of 4
---
{ ;~
__
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
We, ~~ ~...~ /~ ~.. and ~-,+~u~-! -- ' /~~~~~ ~ ,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, depose and say that
we were present and saw Testatrix sign and execute the instrument as
her last will; that Testatrix signed willingly and that she executed
it as her free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testatrix signed the
will as witnesses; that to the best of our knowledge, the Testatrix
was at that time eighteen or more years of age, of sound mind and
under no constraint or undue influence.
Witness
Witness
Sworn to or affirmed to and acknowledged before me by
~~ ~ A~ i t.~ ~ ~~~~~~ r~ ~ and ~; er ~~.,cr1 ~T" ~-~ ~~ ,~~ ~~ i~ ~. _s ,~ r ,
~+-!,
witnesses, this /S~ day of r .f ! ~ ~~_ ~'' , 1998.
`~ Notary'Publi~
- !`~. .~
Page 4 of 4
?l~fr. l~~,dward 1'. Ci~?rn~le) Al:gust $, 2(3(17
Susrlt~ehannti Fiti;ani;ial rld~zis~>rs
~3~)9~) I_c~uise t~}rir~~e
S~fite 113()
?~~1GC~-anicsbitrg, AA 17(355
Dear ~1r. Uc~rrnle}~:
The tt~llctwing Stt~cks have teen transferred into Mr. Marks name and there value on the
date ~af~ Mrs. ~'~~larks" death. Fel~rvary° 24, 2UD7, was as tt~llvws:
ry
1. A`1'&T: Average of High and Ltrw price on I~ebruar}~ 23 and 26 was $a7, t~ x 15
Shares = '557. ~. 03.
Average value A'T&"T an 2~23f?Utl? was $36.99 (Nigh $37.17 cat Lc~w $36.8(1) and on
2.~'2612(3t)7 was $37.2A (k3igh $37.57 &Lvw $36.98).
2. ALCATEL -Lucent: Average v# I-Iigh and Low price can February 23 and 2fi was
$1 3.29 x 44 Shares 5584.7b.
average value vt"Lucent v^ 2/2312(3()7 was $13.27 {Nigh $13.3 7 & I.ow $1.3.1 b) and on
2f26/Zt)tJ7 was ~ 13.3 l lHi~;h $13.39 & Lc~w 13.22j.
3. Sovereign €~dncc~rp, Inc.: Average vf' Nivh and Lt~w price on ~eUruar}' 23 and ~6 was
$2ta. 32 x 63 I Shares = $ I b,bU7.92.
Average value <:~f Svvereign cm 2/23/2UU7 was $26.34 (High $2ta.45 ~ Lvu° $26.23) and
c~« 2l2612f1U7 was $26.3(1 {:Nigh $26.55 &Lvw 2~ti,QS).
4. C'ity~ Bolding C'ompany_ Average of"High and Lc~w price vn Februar,~ 23 grid 26 was
$39.92 x 2746 Shares = S1U9,62U.32.
Average value of City I-Iv[ding t'vmpany vn 2123%ZUU7 was X39.73 (t-iigh $4t3. I b ~ Low
$39.3Uj and on 2;`26/2()U7 was $4U.IQ {High $4Q.t~i(3 &Lvw 39'.tit3).
S. IDEARG: Average u#'High and Lvw price on ~ebniary~ 23 and 2b was $35.()4 x 9
Shares = '~315.3b.
f~verage value ot'IDEARC' cm 2/23/24()7 was $34.87 {H.igh $35.24 &Lvw $34.SE}) and
inn 2126,"?9D7 was $35.20 (High $35.SD ~ Lvw 34.9()j.
6. I.SI: Average of High and Low price on Februan- 23 and 26 was $9.84 x 2 Shares
$19.b8.
Average value of I.SI on 2~%"23/2(347 was $9.b5 (~-iigh $4.78 ~~ Low $9.,53) and an
2 ~26~ 2t)O7 was $1 U.t32 (High $1(3.19 ,& Low 9.85).
7. C()MCAS~T: Average of High and Low price cin Fehruan,~ 23 and 26 was X26.94 x ~8
Sharer = 51,293.12.
:~~~~erage value of CUMC'AST ern 2i~23I2Ot)7 u-as $27. I 1 (;High $27.=~U & Lc~w $26.81)
and on 2~~26.~~2007 was $26.77 {High $27.3(3 & Law 2b.23).
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View Balances
Information updated as of:
Page 1 of 2
Stta Map j Leya(~ Prh-acy j Locate a Fidancla( Advisor j Con'
? Frequently Asked Cuestlons
hose
07128!2007
Coverages E-Documents Perms
Contract Yaluea atld lnfORl7attOn...
Contract Number. A04001203$ Product Type: Fbced Mnuily
Billing Status: Palo Up Single Premium plan Descrlptlon: SPOA TDA Empbyee Before Tex
Contract Date: 07/51/2000
Account Value: ;30,504.55 ? Show Interest Rates
Surrender Value: $30,504.55 ? Show Surrender Value Detatl
Surrender Charge: - 5.00 ~ Show Surrender Schedule
Invested Sinos (nceplloa: 590,084.07
Initial Payment: 530,084.07 Inkial Payment Doh: 07!3112000
Syatematlc Wtthdrawals
Amount:
MDR Cateulated
Next Annuai WlthdrawaL
11110/20D7
Tix Withholding: Yas DlstribuNon Method: Check
? Show Payment History ? Show Accounting History
Clients olthe Contract...
Name Relationship: Tax ID Birth Data
TMlrra L MarM.s MnuRant, Payor Owner ~aoc-sac-x6AA 07/11/7818 ?
Robert C Marks Benefk:hry xxx-xx-x1 d1 03/13/1877
Correspondanaa Information...
Agent Contact Information Agency Contact Intonnation
Mk~ael J t3arofeto Jr alatleltsr Ins Oro '
2851 YYhiEelbrd Rd Loader Heiphb Brokerage
ate 901 Susquehanna Commerce Ctr ~
York, PA 17961 PCJ BOx 2928
Ph: T17-755-2i 18 Fax: 717-757-1454 York, PA 17406
Ph: 717-~i2-8000 Fax: 717$193149
fet?sYe dbraker.~m
To conUd a customer aervioe repnsserrtatlve, pfeasa G11:1 (800) 319-8602.
Ore-maN ua by cNckirq on the Corrtaat Ua Onk at the top of the papa.
CI a to return to the top.
hops:/lwww.unioncentral. com/serviceJIRIS/balances.asp 7/27/2007
INVENTORY
REGISTER OF WILLS OF CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF r~u~~"~-~+~~ ~ SS
COUNTY, PENNSYLVANIA
File Number ?1
Personal Representative(s) of the Estate of THELMA L. MARKS
deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate
and all of the real estate in the Commonwealth of Pennsylvania of said 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 appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven-
tory are true and correct. I understand that false state-
ments herein are made subject to the penalties of
18 Pa. C.S. § 4904 relating to unsworn falsification to
authorities.
~C~-~.~---~J C:. ~ 7, ~~r
OBERT C. MARKS, EXECUTOR
Attorney -- (Name) DAVID H. STONE, ESQUIRE (SupremeCourtLD. No.) 39785
(Address 414 BRIDGE STREET NEW CUMBERLAND PA 17070-
(Telephone) (717) 774-7435
DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO.
325 WESLEY DRIVE, APT.106
2/24/2007 MECHANICSBURG PA 17055 234-14-7644__
44 shares Alcatel stock @ $13.290 each
15 shares AT&T stock @ $37.140 each
FIGURES MUST BE TOTALED
2746 shares City Holding Company @ $39.920 each
48 shares Comcast stock @ $26.940 each
9 shares Idearc stock @ $35.040 each
2 shares LSI stock @ $9.840 each
631 shares Sovereign Bancorp Inc stock @ $26.320 each
(Attach additional sheets as
C7
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-. -a
--~ .
~J i
;.:~
- .s
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ra
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r-
-Q
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W
584.76
557.10
!'"1 fl9z620.32
~~ .
-c j
_"t :.=-;
_~ ~ ~__ ~
~~t315.36
19.68
16,607.92
TOTAL: I 136,060.18
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))
07 0218
Form R11~-09 rev. 10.13.06