The URL can be used to link to this page

Home My WebLink About04-0015JOHNSON DUFFIE 301MAIIKET SIREET PO. BOX 109 LEMOSXEPA 17043-0109 REGISTER OF WILLS OFFICE CUMBERLAND COUNTY COURTHOUSE ONE COURTHOUSE SQUARE CARLISLE, PA 17013 t ? o t'3+330 t 02 h,,llh,,llh,,,,dh,lh,,Ih,,Ihlh,,,,,llhhd,h,,,Ihl LAW OFFICES JOHNSON DUFFIE November 16, 2004 OF COUNSEL HORACE A. JOHNSON E LEE SIIIPM^N Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Thomas E. Wimbedy SSN: 191-40-7997 Our File No. 13766-1 Your File No. 21-04-00015 Dear Register: Enclosed please find a check from Jo Anne Wimbedy made payable to you in the amount of $16,433.09 representing the Estate Tax due on the above referenced Estate. The payment represents interest to November 19th, 2004. A copy of the assessment from the Department of Revenue is also enclosed. Please time stamp the enclosed duplicate of this correspondence and assessment and return to us in the enclosed self addressed stamped envelope. Should you have any questions, please do not hesitate to contact our office. Thank you for you assistance in this matter. c: Jo Anne Wimberly, Executrix #239396 Very truly yours, JOHNSON, [~UFFIE, STEWART & WEIDNER Dan~ L. WTeseman Legal Assistant ~' i~ ~ :? MARKET STREET R(). BOX 109 LEMOYNE, PENNSYI3/ANIA 17045-0109 WWW. IDSW. COIvl 717761.4540 FAX: 717,761.5015 MAIL@IDSW. COM JOHNSON, DUFFLE, STEWART & WEIDNER, P,C. BUREAU OF ZN{)IVIOUAL TAXES COHNONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSHENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN DAVID N DELUCE JOHNSON ETAL PO BOX 109 LEMOYNE PA 17045 DATE 11-01-2004 ~ ESTATE OF WINBERLY THOHAS E DATE OF DEATH 12-05-2005 FILE NUHBER 21 04-0015 COUNTY CUMBERLAND '~4 ii0¥ 17 A~ :z:~ 20z MAKE CHECK PAYABLE AND REMIT PAYHENT TO= REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701S CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR FILES "~ REV-483 EX AFP (01-03) #~ NOTICE OF DETERMINATION AND ASSESSMENT OF FENNSYLVAN/A ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~ ESTATE OF NIHBERLY THOMAS E FILE N0.21 04-0015 ACH Z01 DATE 11-01-2004 ESTATE TAX DETERHZNATZON 1. Credit For State Death Taxes as Verified ZZ~157.69 Z. Pennsylvania Inheritance Tax Assessed 5~85Z.98 (Excluding Discount end/or Interest) 3. Inheritance Tax Assessed by Other States .00 or Territories of the United States (Excluding Discount and/or Interest) 4. Tota! Inheritance Tax Assessed 5. Pennsylvania Estate Tax Due TAX CREDITS: 5~852.98 16;$04.71 PAYHENT RECE/PT DISCOUNT (+) AMOUNT PAID DATE NUHBER NTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 11-09-2004 AT THE RATES APPLICASLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORH.~ R !CEIVED ¥ 1 2 200 d~ INSON, DUFFI[~ STE~, RT AND WEIONEF TOTAL TAX CREDIT I .00 BALANCE OF TAX DUEI 16,304.71 INTEREST AND PEN. 116.58 TOTAL' DUE 16,421.29 ~[F PAID AFTER TH/S DATE, SEE REVERSE SIDE (IF TOTAL DUE ZS LESS THAN $1~ NO PAYHENT ZS REQU/RED FOR CALCULATIBN OF ADDITIONAL /NTEREST. ZF TOTAL DUE 1S REFLECTED AS A 'CRED/T' (CR}~ YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORH FOR INSTRUCT/OHS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES OEPT 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11-96) NO. CD 004642 WIMBERLY JO ANNE 593-10 GENEVA DRIVE MECHANICSBURG, PA 17055 ESTATE INFORMATION: SSN: 191-40-7997 FILE NUMBER: 2104-001 5 DECEDENT NAME: WIMBERLY THOMAS E DATE OF PAYMENT: 11/17/2004 POSTMARK DATE: 11/16/2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/05/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 201 $16,433.09 TOTAL AMOUNT PAID: $16,433.09 REMARKS: SEAL CHECK# 1296 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PETITION FOR PROBATE and GRANT OF LETTERS Estate of-'~qorhq(l% also known as Deceased SoctalSecurttyNo [61 [ -~ The petmon of the undersigned respectfully represents that Your petttloner(s), who ~s/are 18 years of age or older an the execut m the last will of the above decedent, dated , ['40VeAqq De and codicil(s) dated TO. Reg ster of Wills for the County of {'~{~LVlq~r {/,Llq~{ Commonwealth of Pennsylvania tn the (state relevant circumstances, e g renunciation, death of executor, etc ) Decendent was domiciled at death In ~ ~/{_lthq [gear { 0._b~ C[ County, penns~lvama, with ~ __ ast~amdyor~rncpaLresden~at [Ill ~VPFtl0~ ~)Y~V~ ~ (hst street, number and munc~pahty) Dec~qdent, thea ~ years of ~, dmd ~C~ ~ Except as follows, dec(Oent d~d not ~arry, was not d~vorced and d~d not have a child born or adopted after execuuon of the wdl off(red for probate, was not the wcum of a kdhng and was never adjudicated mcompetent Decendent at death owned ~p-roperty with estimated values as follows (If domiciled in Pa )~" , ~ All personal property (If not dom~ctled-m Pa,)C.x? Personal property in Pennsylvania (If not domiciled ~ Pa )~. ' Personal property in County Value of real estate tn Pdnnsylvanla s~tuated as follows WHEREFORE, petitioner(s) respectfully rqques[(sl the probate of the last will and codtcll(s) presented herewIth and the grant of letters (testamentary, administration c t a, administration d b n c t a ) theron Sworn to o~' affirmed and subset,bed ,- I,)~)tY;q{'~At~Ol~-- ~re me thts ~ ~ day of J ~ C~~~ Regtster L OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA -~ ss COUNTY OF~ , ,, The netlttoner(~)l~ibbv?e-~amed swear(s) or affirm(s) that the statements in the foregoing petition are true an~t c~ot r~c'[ f~ the b~st o~the knowledge and behef of petlttoner(s) and that as personal represen- tative(s) of~th~ above~ decedent yetlttoner(s) will well and truly administer the estate according to law No. ~ Estate of ~~.~ DECREE OF PROBATE AND GRANT OF LETTERS , Deceased AND NOW ~tO,'nL~0.~ /o ~lO~C~dr:- m cons,derat,on of the ??on on · e reverse sade hereof, sausfacto~ proof hawng been presented before me, IT IS DEC~ED that the instrument(s) dated described there~n be admitted to probate ~d filed of record m the last w:ll of ~d Letters ~ ~ ~ ~ / are hereby granted to FEES Probate, Letters, Etc. Short Certificates( ) .uon $ afl S_ TOTAL ~',~/,~", ATTORNEY (Sup Ct 1 D No) 'XDDRESS PHONE his Is to certify that the information here given Is correctly copied from an original ceruficate of death duly filed with me as Local Registrar The original certificate will be forwarded to the State Vital Records Office for perm, anent ~hng ~. WARNING: It is illegal to duplicate thru copy by photostat or photograph Fee for this cernficate, $2 00 P 9641385 No Local Regxstrar Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Thomas E Wlmberly · Male ~ 191-- 40 -- 7997 · December 5, 2003 1111 Yverdon DRVe ~_.... ....... ' ....... ~ Green Memonal Park Cam 17011 FDq)14318-L ~ w IS) WzmberlyThomas/Wllls/Ccyr LAST WILL AND TESTAMENT O__F THOMAS E WIMBERLY I, THOMAS E. WIMBERLY, of 1111 Yverdon Drive, Apartment C-4, Camp Hill, Cumberland County, Pennsylvania 17011, declare thms to be my Last Wmll and revoke any Wmll or Codicil prevmously made by me. ITEM I I direct that all expenses of my last illness and funeral, includmng my grave marker and perpetual care, shall be paid from my residuary estate as soon as practmcable after my decease as a part of the expense of the adminzstratmon of my estate. ITEM II: I direct that all taxes that may be assessed mn consequence of my death, of whatever nature and by whatever jurisdiction mmposed, shall be paid from my resmduary estate as a part of the expense of the admmnistration of my estate, without apportionment. ITEM III: I gmve, devise and bequeath all the rest, resmdue, and remainder of my Estate, of every nature and wherever situate, in equal shares, to my daughters, JO ANNE WIMBERLY and DENISE LYNNE WIMBERLY, providing that they survive me by thirty (30) days. Should emther of my chmldren, predecease me or die on or before the thirtieth (30th) day following my death, her share of my estate shall then go to her mssue, per st~r~es, as are lzvmng on the thirty-first (31st) day following my death ITEM IV I hereby authorize and empower my Executrix heremnafter named to sell all of the real property and any or all of the personal property not specmfmcally bequeathed herein, whmch I may own or to whmch I am entmtled at the tzme of my death, in the sole discretion of my Executrix at prmvate or publmc sale, wmthout an Order of Court, at such time or times and upon such terms as the samd Executrix shall deem proper for the best interests of my estate or of my beneficmaries, thereby converting the same into cash. I further authormze and empower my said Executrix to execute, acknowledge and deliver all proper wrmtmngs and deeds of conveyance and transfer thereof ITEM V: The principal and income of any bequests and trusts created hereunder shall be free from antlcipatzon, assignment, pledge or obligation of any beneficiaries and shall not be subject to any execution or attachment or to voluntary or involuntary alienation ITEM VI: I appoznt my daughter, JO ANNE WIMBERLY as Executrix of thzs my Last Will Should JO ANNE WIMBERLY be unable to serve for any reason, I then appoln~ my daughter, DENISE LYNNE WIMBERLY, Executrzx of this my Last Wmll ITEM VII' I direct that my Executrzx, shall not be requmred to give bond for the of their duties in any jurisdiction or their successors, famthful performance IN WITNESS WHEREOF, ~ have hereunto set my hand and seal this 2~~ day of ~O~_--, 1998 THOMAS E WIMBERLY ~j 2 The precedzng instrument, conszstzng of thzs and two (2) other typewritten pages, zdentified by the signature of the Testator, was on the day and date thereof szgned, publmshed and declared by THOMAS E. WIMBERLY, the Testator theremn named, as and for his Last Will, zn the presence of us, who, at hzs request and in his presence and in the presence of each other, have subscribed our names as witnesses hereto of 3 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF DAUPHIN I, THOMAS E WIMBERLY, the Testator whose name zs szgned to the attached or foregomng 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 1~ willingly and as my free and voluntary act for the purposes therein expressed Sworn to o~ affirmed and acknowledged before me by THOMAS E. WIMBERLY this ~ ~ day of /K~O~--~.., 1998 THOMAS E WIMBERLY ~.A Notary Public ~ I MyComm~ssmn Expires Sept 25, 1999 NOTARIAL SEAL BRUCE D FOREMAN, Notary Publm C~ty of Hamsburgh, Dauphin County 4 COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF DAUPHIN WE, the undersmgned witnesses whose names are signed to the attached or foregoing mnstrument, being duly qualmfied accordmng to law, do depose and say that we were present and saw the Testator, sign and execute the mnstrument as hms free and voluntary act for the purposes theremn expressed, that each subscribing wmtness mn the hearmng and sight of the Testator signed the Will as a wmtness; and that to the best of our knowledge, the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue mnfluence Sworn to or affmrmed and subscrmbed before me by the undersmgned witnesses, this ~ day of ~f3~6£~ , 1998. Wmtness ! ~UL;E D FOREMAN, Notary Public [~MY C°rn~~9j City of Hamsburgh, Dauphin County Name of Decedent: Date of Death: To the Register: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) / Admin. No. 7-1' Oq- OOl.~ I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of [he 9rphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~ ]~ [0 ~- · Name Address 5q3-t0 6,entree Drive.., Mt'ch .PA I-~ 1[21 kh'cjh/otr~d Dr~vc, Mcch P/~ I~ Notice has now been given to all persons entitled thereto under Rule 5.6(a) except - Date: ! ggnature Name k_JO Address ~ '~elephone ~1~ Capacity: ~,~ Personal Representative Counsel for personal representative REGISTER OF WITIm OFFICE Cumberland Co. Courttlouse One Courthouse Square Carlisle, PA 17013 JERRY R. DUFFLE RICHARD W. STEWART C. ROY WEIDNER. JR EDMUND G. MYERS DAVID W DELUCE JEFFERSON J. SHIFMAN RALPH H WRIGHT, JR. MARK C. DUFFLE JOHN P,. NINOSKY MICHAEL J. CASSIDY MELISSA PEEL GREEVY ROBERT M. WALKER WADE D. MANLEY 1, AW O F F I C E S JOHNSON DUFFLE OF COUNSEL IIORACE A. IOHNSON E LEE SHIFMAN BRUCE ~ GI/OSSMAN: September 3, 2004 Register of Wills Office Cumbedand County Courthouse One Courthouse Square Carlisle, PA 17013 Re: ,? ~-:~' ~:i Estate of Thomas E. Wimbedy "'J SSN: 19140-7997 m Our File No. 13766-1 '-~ ~ Your File No. 21-04-00015 ~` c~ Dear Register of Wills Office: Enclosed for filing please find the following documents for the above mforenced decedent: 2 Original PA Inheritance Tax Returns. There is tax due in the amount of $5,852.98. The check is attached to the Return. Our Check in the amount of $114.00 as follows: a. $15.00 Inheritance Tax filing foe b. $10.00 Inventory Fee c. $89.00 for Additional Probate Fees 2 copies of Pages 1&2 of the Pa Inheritance tax return, which we ask that you time-stamp and return to us in the enclosed envelope. Inventory Inventory copy, which we ask that you time stamp and return to us in the enclosed envelope. Should you have any questions, please do not hesitate to contact our office. Thank you for you assistance in this matter. Very truly yours, Legal Assistant c: Jo Anne Wimberiy, Executrix #234942 501 MARKET STREET PO. BOX 109 LEMOYNE, PENNSYLVANIA 17045 0109 WWW. JDSW. COM 717.761.4540 FAX: 717.761.5015 MAIL@JDSW. COM JOHNSON, DUFFLE, STEWART & WEIDNER, P.C. REV-1500 I O ,O,ALOSEON .Y , INHERITANCE TAX RETURN~iLS.uMeER 21 04 00015 RESIDENT DECEDENT F APPLICABLE) SURVIVING SPOUSE'S NAME ( [3,ST, FIRST AND MIDDLE INITIAL) DECED~NT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) WIMBERLY, THOMAS E DATE OF DEATH (MM-DD-yEAR) DATE OF BIRTH (MM-DD-yEAR) 12/05/2003 06/01 / 1950 ~ 1. 0riginatReturn ~-~ 2. Supplemental Retum [] 4. Limited Estate [] 4a Future interest Con~gromise (date of death after 12-12-82 [] 6. Decedent Died Testate (Attach ~ [] 7. Decedent Maintained a Living Trust (Attach [] 9. Litigation Prc~eeds Received [] 10. Spousal Poverty Credit (date of death bthween SOCIAL SECURITY NUMBER 191-40-7997 THiS RETURN MUST BE PILED IN DUPLICATE W1TH THE REGISTER OF WILLS social SECURITY NUMBER r"] ~ RemthnderRe(um(dateofdeathpd~'to12-13'$2) [] 5. Federal Estate Tax Return Required 0 8. Total Number of Safe De0osit Boxes [] 11.Election to tax under Sec. 9113(A) (Attach SCh O) k~AME David W. DeLuce FiRM NAME (if al~ollcable) Johnson, Duffle, Stewart & Weidner ELEPHONE NUMSER 717/761-4540 P.O. Box 109 Lemoyne,, PA 17043 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Pemonal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Aesata(total Lines 1-7) 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) None None None None 99,266.52 1,105.44~: 73,401 53; 18,746.50 24,960.76 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequesta/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax(Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rata, or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate 130,066.23 x .00 x .045 17.Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19. Tax Due 20. I'~ - · ,- - , , ' ,e , · ~' OFFICIAL USE ONLY (8)c~ 173,773.49 (11) 43,707.26 (12) 130,066.23 (13) (14) 130,066.23 (15) (16) 5,852.98 (17) (18) (19) 5,852.98 Copyright 2000 form software only The Lackner Group, Inc. Form REV-tS00 EX (Rev. 6-00) D~ece~'ent'a Complete Address: I STREET ADDRESS 1 1 1 1 Yverdon Drive cITY Camp Hill [ST^TEJZIp I Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount interest/Penalty if applicable D. Interest E. Penalty (1) 5,852.98 Total Credits (A +B+C) (2) 0.00 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. Check box on Page I Line 20 to mquect a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUF_ A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is thelBALANCE DUE (3) 0.00 (4) (5] 5~852.98 (5A) (5B) 5,852.98 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 proper[3/transferred; ............................................................................. r"l [] b. retain the right to designate who shall use the property transferred or its income; ................................ c. retain a reversionary interest; et .............. ~ ............................................................................................ d. receive the promise for lite of either payments, benefits or care? ........................................................... 2. If death occurred after December 12, 1982, did decadent transfer property wibhin one year of death without recaivlng adequate consideration?. ....................................................................................... [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death.? ....... [] 4. Did decadent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?. ............................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS I$ YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Jo Anne Wlmberly . s ~ tl)[ff~.A.~. ~/~,~..~j~ 593-10 Geneva Drive Mechanicsburg, PA 17055 q [ :;;~ i 0Z~. IG N~,~URE'O~F PER~ON RESPONSIBLE FOR FILrNG RE~RN ADDRESS DATE ADDRESS P.O. Box 109 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 uae of the surviving spouse is 3% [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 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statutadoes not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)]. T~2~ tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries Is 4.5%, except as noted in 72 P.S. §9116 [72 P.S. §9116 (a) (1)]. The tax rate Imposed on the net value of transfers to or for the use of the decadent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ESTATE OF WlMBERLY, THOMAS E SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 - 04 - 00015 Include the proceeds of litigation and the date the proceeds were received by the estate~ll property Jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 2 3 DESCRIPTION 2003 Acura MDX 4 Door SUV. Valued using Kelley Blue at KBB.Com. Valuation is attached to this Return 2003 Federal Income Tax Refund Commonwealth of Pennsylvania - Office of the Budget Final salary, Annual Leave and Sick days Reimbursement VALUE AT DATE OF DEATH 32,015.00 3,356.00 63,895.52 TOTAL (Also enter on Line 5, Recapitulation) 99,266.52 RESIDENT DECEDENT ESTATE OF WIMBERLY, THOMAS E SCHEDULE F JOINTLY-OWNED PROPERTY If an asset was made joint within one year of the decedent'e date of death, It must be reported on schedule G, SURVIVING JOINT TENANT(S) NAME A Jo Anne Wimberly FILE NUMBER 21 - 04 - 00015 RELATIONSHIP TO DECEDENT Daughter B Denise Wimberly ADDRESS 593 Geneva DriVe Apt. 10 Mechanicsburg, PA 17055 1122 Highland Drive Mechadicsburg, PA 17055 Daughter JOINTLY OWNED PROPERTY: ITEM LETTER DATE NUMBER FOR JOINT MADE TENANT JOINT 1 B 01/01/1980 2 B 01/01/1980 3 A 01/01/1980 4 A 01/01/1980 DESCRIPTION OF PROPERTY Inciude name of financial institution and bank account number or similar identifying number. Attach deed for jointiy-held real ~state. Pennsylvania State Employees Credit Union Savings Account Pennsylvania State Employees Credit Union Checkir Account Pennsylvania State Employess Credit Union Checkin Account Pennsylvania State Employees Credit Union Savings Account TOTAL (Also enter on line 6, Recapitulation % OF DATE OF DEATH DECD'S VALUE OF ASSET 'INTEREST 658.1( 50% 130.1 50% 310.2 50~, 1,112.33 50% DATE OF DEATH VALUE OF ECEDENT'SINTEREST 329.08 65.08 155.11 556.17 1,105.44 ~ SCHEDULE G COMMO,W~Lr, Or,E,,S~LV^,,^ INTER'VIVOS TRANSFERS & ~,,E,~^,c~r~x,~TU,, MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER WIMBERLY, THOMAS E 21 - 04 - 00015 This schedul® must be completed and filed If the answer to any of questions I throu h 4 on page ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF I Pennsylvania State Employees Credit Union Regular Shares 27,523.83 100% 3,000.0( Savings Account. This was a Joint Account with Daughter Jo Anne Wimbcrly. The Account was not created until June 30, 2003 therefore making this a transfer within 1 year of Dccedent's death. 2 Pennsylvania State Employees Credit Union Vacation 15,305.7~ 100% Shares Account. This was a Joint Account with Daughter J( Anne Wimbefly. The Account was not created until June 30, 2003 therefore making this a transfer within 1 year of Deccdent's death. 3 Pennsylvania State Employees Credit Union Christmas 1,728.12 100% Shares Account. This was a Joint Account with Daughter Jc Anne Wimberly. The Account was not created until June 30, 2003 therefore making this a transfer within 1 year of Decedent's death. 4 Pennsylvania State Employees Credit Union Checking 18,005.81 100% Account. This was a Joint Account with Daughter Jo Anne Wimberly. The Account was not created until June 30, 2003 therefore making this a transfer within 1 year of Decedent's death. 5 Pennsylvania State Employees Credit Union Prefix Savings 12,227.84 100% Account. This was a Joint Account with Daughter Jo Anne Wimberly. The Account was not created until June 30, 2003 therefore making this a transfer within 1 year of Decedent's death. 6 Pennsylvania State Employees Credit Union Prefix Vacation 1,409.19 100% Shares Account. This was a Joint Account with Daughter Jo Anne Wimbcrly. The Account was not created until June 30, 2003 therefore making this a transfer within 1 year of Dcccdent's dcath. 7 Pennsylvania State Employees Credit Union Prefix 200.95 100% Christmas Shares Account. This was a Joint Account with 1 Daughter Jo Anne Wimberly. The Account was not created I until June 30, 2003 therefore making this a transfer within 1 I tear of Decedent's death. TOTAL (Also enter on line 7, Pec=_~!tulatlon) is yea. TAXABLE VALUE ~4,523.83 15,305.78 1,728.13 18,005.81 12,227.84 1,409.19 200.95 73,401.53 SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued ESTATE OF WIMBERLY, THOMAS E FILE NUMBER 21 - 04 - 00015 .INTEREST 0.00 This schedule must be Completed and filed if the answer to any of questions 1 throu ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF NUMBER Include the name °~ the transferee' their releti°~shll) ~° decedent a~ the dale °f ~ransfer' [/ALUE OF ASSET DECD'S 8 Commonwealth of Pennsylvania//State Employees Retirement System Retirement Plan. Date of Death value $1,014,216.90. This is being provided for informational purposes only. A Federal Tax Return is being filed. The amount was divided between the decedent's 2 children, Jo Anne Wimberly and Denise Wimberly h 4 on page Z I_s )'es. EXCLUSION (iF APPLICABLE TAXABLE VALUE 0.00 Page 2 of Schedule G ESTATE OF WIMBEILLY, THOMAS E Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1 Rolling Green Cemetery Company Bo 2 Myers Funeral Home, Inc. Minister for Funeral Service ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(a) / EIN Number of Personal Representative(s): Street Address SCI-IEXJLE H FUNI~.AL E)~:I~ISES & ADIVI~ISTRATNE COSTS FILE NUMBER City State ~ Zip Year(s) Commission paid Attorney's Fees Johnson, Duffle, Stewart & Weidner Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address C~ty State Relationship of Claimant to Decedent Probate Fees Cumberland County Register of Wills Office Additional Probate fees due at Filing Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs C~mberland County Register of Wills Office - Filing Fees for Inheritance Tax Return ($15.001 and Inventory ($10.00) TOTAL (Also enter on line 9, Recapitulation) Reserve for final Estate Closeout Costs 21-04-00015 AMOUNT 2,175.00 9,861.50 50.00 6,000.00 146.00 89.00 25.00 400.00 18,746.50 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE ESTATE OF WIMBERLY, THOMAS E Include unrelmbumed medical expenses. ITEM NUMBER LIABILITIES, & LIENS DESCRIPTION Andorra Radiology Silver Spring Ambulance Manor Care Nursing Home, Carlisle, PA Eric Insurance Company Pennsylvania Department of Revenue Guistwite Family Practice Pennsylvania State Employees Credit Union Automobile Loan Account Oakwood Center Radiation Oneology Neighbore Care Pharmacy Carlisle Region Medical Center Bunker Associates - Final Rent Payment PPL Electric Verizon Quantum Imaging and Diagnostic Pennsylvania Neurology and Neuroscience Institute Mobile X-Ray Dr. Timothy Clark PA Counseling Services Omega Labs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 FILE NUMBER 21 - 04 - 00015 AMOUNT 199.00 250.00 7,385.53 124.00 l 15.00 81.57 13,795.41 776.09 1,247.67 134.26 590.00 40.55 36.72 5.60 29.60 8.60 86.64 39.45 15.07 TOTAL (Also enter on Line 10, Recapitulation) 24,960.76 SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES ESTATE OF WIMBE1LLY, THOMAS E NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY NUMBER L 1 II. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Jo Anne Wimberly 593 Geneva Drive Apt. 10 Mechanicshurg, PA 17055 Denise Wimberly 1122 Highland Drive Mechanicsburg, PA 17055 FILE NUMBER 21 - 04 - 00015 RELATIONSHIP TO AMOUNT OR SHARE DECEDENT Daughter Daughter OF ESTATE Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she~ NON-TAXABLE DISTRIBUTIONS: ~. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1/2 of Estate 1/2 of Estate TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE LISTING OF EXHIBITS FOR ESTATE OF THOMAS E. WIMBERLY EXHIBIT LAST WILL AND TESTAMENT SIGNED AND DATED NOVEMBER 25, 1998 EXHIBIT B KELLEY BLUE BOOK VALUATION OF DECEDENT'S AUTOMOBILE EXHIBIT C FEDERAL INHERITANCE TAX RETURN :234782 LAST WILL AND TESTAMENT THOMAS E. WIMBERLY I, THOMAS E. WIMBERLY, of 1111 Yverdon Drive, Apartment C-4, Camp Hill, Cumberland County, Pennsylvania 17011, declare this to be my Last Will and revoke any Will or Codicil previously made by me. ITEM I: I direct that all expenses of my last illness and funeral, including my grave marker and perpetual care, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate, without apportionment. ITEM III: I give, devise and bequeath all the rest, residue, and remainder of my Estate, of every nature and wherever situate, in equal shares, to my daughters, JO ANNE WIMBERLY and DENISE LYNNE WIMBERLY, providing that they survive me by thirty (30) days. Should either of my children, predecease me or die on or before the thirtieth (30~h) day following my death, her share of my estate shall then go to her issue, Der s~irpes, as are living on the thirty-first (31s~) day following my death. ITEM IV: I hereby authorize and empower my Executrix hereinafter named to sell all of the real property and any or all of the personal property not specifically bequeathed herein which I may own or to which I am entitled at the time of m} death, in the sole discretion of my Executrix a~ private or public sale, without an Order of Court, at such time or times and upon such'terms as the said Executrix shall deem proper for the best interests of my estate or of my beneficiaries, thereby converting the same into cash. I further authorize and empower my said Executrix to execute, acknowledge and deliver all proper writings and deeds of conveyance and transfer thereof. ITEM V: The principal and income of any bequests and trusts created hereunder shall be free from anticipation, assignment, pledge or obligation of any beneficiaries and shall not be subject to any execution or attachment or to voluntary or involuntary alienation. ITEM VI: I appoint my daughter, JO ANNE WIMBERLY as Executrix of this my Last Will. should JO ANNE WIMBERLY be unable to serve for any reason~ I then appoint my daughter, DENISE LYNNE WIMBERLY, Executrix of this my Last Will. ITEM VII: I direct ~hat my Executrix, or their shall not be required to give bond for the faithful of their duties in any jurisdiction. successors, performance IN WITNESS WHEREOF, ~ have hereunto set my hand and seal this Z~'~iD day of ~0~_~.-, 1998. THOMAS E. WIMBERLY ~j 2 The preceding instrument, consisting of this and two other typewritten pages, identified by the signature of the Testator, was on the day and date thereof signed, published and declared by THOMAS E. WIMBERLY, the Testator therein named, as and for his Last Will, in the presence of us, who, at his request and in his presence and in the presence of each other, have subscribed our names as witnesses hereto. of ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : : SS. COUNTY OF DAUPHIN : I, THOMAS E. WIMBERLY, the Testator whose name is signei tc the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge ~ha~ ! signed and executed the instrument as my Last Will; and that i signed iF willingly and as my free and voluntary ac~ for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by THOMAS E. WIMBERLY this ~ ~ day of ~O~--~., 1998. THOMAS E. WIMBERLY ~ NOTARIAL SEAL BRUCE D. FOREMAN, Notary Pubhc City of Harrisburgh, Dauphin County My Commission Expires Sept. 25, 1999 4 II COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN SS. WE, the undersigned witnesses whose names are 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 his 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, the 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_~a d subscribed before me by the undersigned witnesses, this ~~ day of ~6£~ , 1998. Witness Witness HUCE D. FOREMAN. Notary Public yCitYCornrnlss~on°f Harrisburgh, Dauphin CountY,'oumv J Expires Sept. 2~ Kelley, Blt~e Book - Private Party Pricing Report - Acura, MDX Page 1 of 2 O Free Dealer Price Quote O ~ea¢(:~t L~ed Car LiMing~ ~ BLUE BOOK PRIVATE PARTY REPORT Pennsylvania · August 18, 2004 2003 Acura MDX Sport Utility 4D Engine: V6 3.5 Liter VTEC Trans: Automatic Drive: 4 Wheel Drive Mileage: 5,148 Search [-!st!r)gs for This Car List Your Car For Sale Online B~ya New Car Free Record Check Auto Loans from 2,99% APR Insurance Quote Print "For Sale'~ Sign Payment ~alculator Rnd Your l I Gradu ~ c¼SSmates Equipment Air Conditioning Rear Air Power Steering Power Windows Power Door Locks Tilt Wheel Cruise Control ABS (4-Wheel) AM/FM Stereo Leather Cassette Power Seat Single Compact Disc Hoon Roof Dual Front Air Bags Privacy Glass Front Side Air Bags Alloy Wheels Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. The paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. ~n states where rust is a problem, this should be very minimal, and a deduction should be made to correct it. The tires match and have substantial tread wear left. A clean t!t!~ history is assumed. A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Private Party Value Search Local Listings for This Car $32,015 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. Get e Used Car Trade-In Value Get Invoice & MSRI~o~n New C_a_rs http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.PA;758113 ;PA041 & 17070;+p&722;Acura;200... 08/18/04 r '706 United States Estate (and Generation-Skipping Transfer) Form Tax Return (Rev. August 2003) Estate of a citizen or residest of the United States (ess esparate instructions). OMB No. 1545-0015 Department of the Treasury To be filed for deeedlllta dying after December 31, ~002, and before Janual7 1, 2004. Intel ~I R~v~ue Service For Paperwork Redudion Ad Notice, see the separate Instructions. 11 Decudent's first t'mme and middle initial (and malden name, if any) 1 b Dececlent's last name 2 Decedent'a soc. ~ec. no. Thomas E. WIMBERLY 191-40-7997 Legs residence (domicile) at time of death (county, state, and ZIP code, or 3b Year domicile established 4 Date of birth 5 Date of death P 3a ferkign country) a Cumberland County, PA 17011 1950 06/01/1950 12/05/2003 r ~ Nameofexecutor(seepage3ofthelnstructlons) 6b Executor'saddress(numberandstreetlncludlngapartrnentorsultano. orruralroute; t Jo Anne WIMBERLY clty, town, orpostofflce:state;andZIPcode) ~C Executor'ssocialsecurltynumber(seepege$ofthelnstructlons) 593 Ceneva Drive 1 188-58-3882 Mechanicsbur~ PA 17055 ?a Name and location of court where will was probated or estate admlnlsternd I 7bcase number Cumberland County Re~ister of Wills/Carlisle, Pennsylvania I 21-04-00015 8 If decedent died testate, check here · [ X I and attach a certified copy of the will. 19 If Form 4768 is attached, check here · 10 if Schedule R-1 is attached, check here · [ 1 Totel grass estate less exclusion (from Part 5, Recapitulation, page 3, item 12) ................ 884.95 ~' Totel allowable deductions (from Part 5, Recapitulation; page 3, item 23) .................. 43,707.26 3 Taxable estate (subtract line 2 from line 1) ................................. 1,186,177.69 4 Adjusted taxable gifts (total taxable gifts (within the meaning of section 2503) made by the decedent after December 31, 1976, other than gifts that are includible in decadent's gross estate (section 2001(b))) .... 0. O0 S Add lines 3 and 4 .............................................. i ,186,177.69 P 6 Tentative tax on the amount on line 5 from Table A on page 4 of the instructions .............. /+22,132.85 e 7 Tota~gi~texpayabiewithrespectt~giftsmadebythedecedentafterDecember31~1976~~nc~ud~gift r t taxes by the decedent's spouse for such spouse's share of split gifts (section 2513) only if the decedent was the donor of these gifts and they are includible in the decedent's gross estate (see instructions) .... 0. O0 8 Gross estate tax (subtract line 7 from line 6) ................................. 422,132.85 2 g Maximum unified credit (applicable credit amount) against estate tax .... 34-5 10 Adjustment to unified credit (applicable credit amount). (Thee adjustrnent T may not exceed $6,000. See page 5 of the instructions.) ......... 0. O0 1'1 Allowable unified credit (applicable credit amount) (subtract line 10 from line 9) .............. 345,800. O0 a 12 Subtract line 11 from line 8 (but do not enter less than zero) ........................ 76,332.85 x i13 Credit for state death taxes (cannot exceed line 12). Attach credit evidence (see instructions). Figure C the credit by using the amount on line 3 less $60,000. See Table B in the instructions. Enter the amount here from Table B · ..... _~_~.: _31_5_ .._3._7__ x ,50 ....... 22 ~ 157.69 o 14 Subtract line 13 from line 12 ......................................... 54,175.16 m 15 Credit for Federal gift taxes on pre- 1977 gifts (section 2012) (attach P computation) ................................ I 15 I 0.0 U 16 Credit for foreign death taxes (from Schedule(s) P). (Attach t Form(s) 706-CE.) .............................. 16 I 0.00 a 17 Credit for tax on prior transfers (from Schedu e Q) .............. 17 0.00 t · 18 Total (add lines 15, 16, and 17) ....................................... 0.00 t 19 Net estate tax (subtract line 18 from line 14) ................................. 175.16 o 20 Generetlen-skipping transfer taxes (from Schedule R, Part 2, line 10) .................... 0.00 n 21 Total transfer taxes (add lines 19 and 20) ................................ 54,175.16 22 Prior payments. Explain in an attached statement ............. 23 United States Treasury bonds redeemed in payment of estate tax ..... i ?.3 0.00 24 Total (add lines 22 and 23) .......................................... 0.00 25 Balance due (or overpayment) (subtract line 24 from line 21) ......................... 175.16 under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, end to the best of my knowledge and belief, It Is true, correct, and complete. Declaration of preparer other than the executor Is based on all information of which preparer has any knowledge. Sig~ure(s) of executor(s) qlsIo+ Bath Sl~ture of preparer ~ther t~l'~n executor Address (and ZiP code) Date/ / f RGA Copyright (c) 2003 form software only T he Lackner Group, Inc. Form ?~ (Rev, 8 -03) Form706(Rev. 8-2003) Est~eof: Thomas E. WIMBERLY SS~/ 191-40-7997 12/05/2003 Part 3 - Elections by the Executor Please chock the "Yes" or "No" box for each quastion. (See instructions be~innin~ on pa~e g.) Yes No 1 Do you elect atternata valuation? ................................................ 1 X 2 Do you elect special use valuation? .............................................. 2 X If "Yes," you must complete and attach Schedule A-1. 3 Do you elect to pay the taxes in installments as described in section 6166? .......................... 3 X If "Yes," you must attach the additional information described on parle 9 of the instructions. 4 Do ~'ou eioct to postpone the pan of the taxes attributable to a reversionar~ or remainder interest as described in section 6163? 4 X Part 4 - General Information (Note: Please attach the necessary supplemental documents. You must attach the death certificate.) (See instructions beginning on page 10,) Authorization to race ve conf dent a tax information .u. nder Regs. sec. 601.504(bX2Xi) to act as the estate's representative before the IRS; and to make written or oral presentations on behalf of the estate if return prepared by an attorney, accountant, or enrolled agent for the executor: Name of representative (print or type) State Address (number, street, and room or suite no., city, state, and ZIP code) David W. DeLuce PA IP.O. Box 109, Lemoyne~ PA 170~3-0109 I declare that I am the ~ attorney/[..._J certified public accountant/[_._l enrolled agent (you must check the applicable box) for the executor and prepared this return for the executor. ~ am not under suspension or disbarment from practice before the Internal Revenue Service and am qualified to practice in the state shown above. Signature . CAF number Date Telephone number 717/761-4540 1 Death certificate number and issuing authority (attach a copy of the death certificate to this return). P9641391/ 2 Decedent's business or occupation. If retired, check here · [] and state decedent's former business or occupation. Mans&er 3 Marital status of the decedent at time of death: [Married Widow or widower - Name, SSN, and date of death of deceased spouse · ............................................. ................................................................................................. Legally separated Divorced - Date divorce decree became final · 02/28/1995 4a Surviving spouse's name 4b Social security number 4c Amount received (see page 10 of instructionS)S0.00 5 Individuals (other than the surviving spouse), trusts, or other estates who receive benefits from the estate (do not include charitable beneficiaries shown in Schedule O) (see instructions), For Privacy Act Notice (applicable to individual beneficiaries only), see the Instructions for Form 1040. Denise Wimberly 175-64-1739 Daughter L/2 of Estate Jo Anne Wimberly 188-58-3882 Daughter 1/2 of Estate ~llunasce~aioableben~iclerlesandthosewhoreceivelessthan$5,000 .......................... · 0.00 Total ............................................................. O. O0 Please check the "Yes" or "No" box for each question. Yes No 0 Does t he 9ross estate contain an}/section 8084 pro?rt~ (~uallfled terminable inmmst proper ty (G?lpt from a prior 91ft or estatet(see pa~e lo or the instructions)? X (continued on next page) Page Z Copyright (c) 2003 form software only The Lackner Group, Inc. Form 706 (Rev. 8-03) Form 706 (l~ev. 8-:2003) Part 4 - General Information (continued) Esl:a'ce of Thomas E. VIMJ~ERLY Please check the "Yes" or "No" box for each question. 7a Nave Federal gift tax returns ever been filed.'? ........................................... If "Yes," please attach copies of the returns, if available, and furnish the followin~l information: 7b Period(s) covered 7c Internal Revenue office(a) where filed No If ye, onowor "Yes" to any of questions 8-16. you must attach additional information es described In the Instructions. ~a Was there any Insurance on the decedent', life that Is not ~ncluded on the return as part of the gross estate? .................... b Did t he decedent own any Insurance on the life of anot her that le not Included In t he gross estste? ........................ g Dld thedecedentatthetlmeofdesthownanypropertyasaJolnttenantwlth right of survlvor~hlpln which (a)one or more of the other Joint mnanta was someone other than the decedent's spm~e, and (b) less than the full value of the property le Inclndnd on the return aa part of the gross estate? ~f "Yes," you must complete and attach Schedule E Did the decedent, at the time of death, own any interest in a partnership or unincorporated business or any stock In an Inactive or closely held corporation? ...................................................... 10 X × Did the decedent ever possess, exercise, or release any general power of appointment? if "Yes," you must complete and attach Schedule H ........ ~( 14 Was the rnarltal deduction computed under the transitional rule of Public Law 97-34, ~ectlon 403(e)(3)(Economic R~cove~/Tax N:t of 1981)? ....... If 'Yes," attach a separate computation of the marital deduction, enter the amount on Item 20 of the Recapitulation, en<~ note on Item 20 "computation attached," 15 Was the decedent, imrnedlete~y before death, receiving an annuity described in the "General" paragraph of the Instructions for Schedule I? If "Yes," you must complete and attach Schedule I .............................................. X 16 was t he decedent ever t he beneflcla~ of a trust for which a deduction was claimed by t he estate of a pre-deceased spouse under section 2056~b~7~ and which is trot reported on this return? If 'Yes," ~'ou must attach an explanation Part 5 - Recapitulation Item Gross estate Alternate value Value at date of death number 1 Schedule A - Real Estate ............................. 1 0.00 2 Schedule B - Stocks and Bonds .......................... 2 0.00 3 Schedule C - Mortgages, Notes, and Cash .................... 3 67,251.52 4 Schedule D - Insurance on the Decedent's Life (attach Form(s) 712) ........ 4 40 ~ 000.00 5 Schedule E - Jointly Owned Property (attach Form(s) 712 for life insurance) .... 5 76,401.53 $ Schedule F - Other Miscellaneous Property (attach Form(s) 712 for life insurance). 6 32,015.00 7 Schedule G - Transfers During Decedent's Life (attach Form(s) 712 for life insurance 7 0.00 8 Schedule H - Powers of Appointment ....................... 8 0.00 9 Schedule I - Annuities ............................... g 1,014,216.90 10 'Total c. lross estate (add items 1 through 9) ..................... 10 1 ~ 229 t 884.95 11 Schedule U - Qualified Conservation Easement Exclusion ............. 11 0.00 12 Total gross estate less exclusion (subtract item 11 from item 10). Enter here and on line 1 of Part 2 - Tax Computation ....................... 12 1 1229 ~ 884.95 Item 1:3 Schedule J - Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims ..... 13 18,7/+6.50 14 Schedule K - Debts of the Decedent ..................................... 14 24,960.76 15 Schedule K - Mortgages and Liens ...................................... 15 0.00 16 Total of items 13 through 15 ......................................... 16 43,707.26 17 Allowable amount of deductions from item 16 (see the instructions for item 17 of the Recapitulation) ..... 17 43,707.26 18 Schedule L - Net Losses During Administration ................................ 18 0.00 19 Schedule L - Expenses Incurred in Administering Property Not Subject to Claims .............. 19 0.00 20 Schedule M - Bequests, etc., to Surviving Spouse .............................. ~0 0.00 21 Schedule O - Charitable, Public, and Similar Gifts and Bequests ....................... 21 0.00 22 Schedule T - Qualified Family-Owned Business interest Deduction ...................... 22 0.00 23 Total allowable deductions (add items 17 throu,~h 22). Enter here and on line 2 of the Tax Computation . . 23 43 ~ 707.26 Page 3 Copyrlg ht (c) 2003 form software only T he Lackner Group, inc. Form 70~ (Rev. 8-03) Form706(Rev. 8-2003) Eetateo~; Thomas E. WIMBERLY SS~ 191-40-7997 12/05/2003 SCHEDULE C - Mortgages, Notes, and Cash (For jointly owned property that must be disclosed on Schedule E, see the inst~ctions for Schedule E.) ItemDescription Alternate Alternate value Value at date of death 1 2003 Federal Income Tax Return Refund 3,356.00 2 Commonwealth of Pennsylvania - Office of 63,895.52 the Bud§et - Final Salary, Annual Leave and Sick Days Reimbursement Total from continuation s, chedules (or additional sheets) attached to this schedule ....... TOTAL. (Also enter on Part 5, Recapitulation, pa,c}e 3, at item 3.) ................ I 67 ? 251.52 (If more space Is needed, attach the continuation schedule from the end of this package or additiona~ sheets of the same size.) (See the instructions on the reverse side.) Schedule C - Pege 13 Copyright (c) 2003 form software only T he Lackr~r Group, Inc. Form 706 Schedule C (Rev. 8~03) Form706(Rev. 8-2003) E~tateof: Thomas E. WIMBERLY SS{/ 191-40-7997 12/05/2003 SCHEDULE D - Insurance on the Decedent's Life You must list all policies on the life of the decedent and attach a Form 712 for each policy. Item Description Alternate Nternate value Value at date of death number valuation date 1 Prudential Life Insurance - Policy paid to 40,000.00 2 beneficiaries: Jo Anne Wtmberly, Daughter and Denise Wimberly, Daughter Total from continuation schedules (or additional sheets) attached to this schedule ....... TOTAL. (Also enter on Part 5, Recapitulation, pa,c}e 3, at item 4.) ................ z~0 1000.00 {If more space ts needed, attach the continuation schedule from the end of this package or additional sheets (See the instructions on the reverse side,) Copyright (c) 2003 form software only T he Lackner Group, inc. of the same s;ze.) Schedule D - Page 15 Form 7~6 Schedule D (Rev. 8-03) Form 706(Rev. 8-2003) £~ateef: Thomas E. WIMBERLY SS~/ 191-40-7997 12/05/2003 SCHEDULE E - Jointly Owned Property (if }~ou elect section 2032A valuation, you must compieta Schedule E and Schedule A-1.) PART 1. - Qualified Joint interests - Interests Held by the Decedent and His or Her Spouse as the Only Joint Tenants (Section 2040(bX2)) Item Description Alternate Alternate value Value at date of death number For securities, give CUSIP number, valuation date Total from continuation schedules (or additional sheets) attached to this schedule la Totals ............................................. 0.00 lb Amounts included in ~ross estate (one-half of line la) ..................... 0.00 PART ?.. - All Other Joint Interests ?.a State the name and address of each surviving co-tenant. If there are more than three surviving co-tanants, list the additional co-tenants on an attached sheet. Name Address (number and street, city, state, and ZIP coda) A. Jo Anne WIMBERLY B. Denise WIMBERLY 593 Geneva Drive Apt. 10 Mechaniesbur~, PA 17055 1122 Hi§hland Drive Mechanicsbur~, PA 17055 item Enter co-tenant number letter for i A 2 A 3 A 4 A Description (including alternate valuation date If any} For SeCUrities, ~llve CUSIP number, Pennsylvania State Employees Credit Union Vacation Shares Account. Pennsylvania State F~mployees Credit Union Prefix Savings Account. Pennsylvania State Employees Credit Union Prefix Christmas Shares Account. Pennsylvania State Employees Includible 100.00~, 100.00 100.00 100.00 Total from continuation schedules (or additional sheets) attached to this schedule .... 2b Total other joint interests .................................... 3 Total includible joint interests (add lines lb and 2b), alternate Value Includible value at date of death 15,305.78 12 , 22 7.84 200.95 Also enter on Part 5, Recapitulation, pa~e 3, at item 5 ..................... (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule E - Page 17 Copyright (c) g003 form software on¥ The Lackner Group, Inc. Form 70~ Schedule E (Rev. 8-03) 1,409.19 47r257.77 76r401.53 76t401.53 Estate of: Thomas E. WIMBERLY Soc Sec #: 191-40-7997 Date of Death: 12/05/2003 Continuation of Schedule E-2 (Jointly Owned Property - Other) Item Ltr for Description # Co-Tenant For securities, give CUSIP #. Percent Includible Includible Alternate Value Includible Value at Date of Death 5 A Credit Union Prefix Vacation Shares Account. Pennsylvania State Employees Credit Union Regular Shares Savings Account. 6 A Pennsylvania Credit Union 7 A Pennsylvania Credit Union Account. 8 B Pennsylvania Credit Union 9 B Pennsylvania Credit Union 10 A Pennsylvania Credit Union 11 A Pennsylvania Credit Union State Employees Checking Account. State Employees Christmas Shares State Employees Savings Account State Employees Checking Account State Employees Checking Account State Employees Savings Account 100.00% 100.00% 100.00% 27,523.83 18,005.81 1,728.13 0.00 0.00 0.00 0.00 47,257.77 Form 706(Rev. 8-2003) Estateof: Thomas E. WIMBERLY SS~ 191-40-7997 12/05/2003 SCHEDULE F - Other Miscellaneous Property Not Reportable Under Any Other Schedule (For jointly owned property that rn~st be disclosed on Schedule E, see the instructions for Schedule E.) (If you elect section 2032A valuation, you must complete Schedule F and Schedule A-1.) Did the decedent at the time of death own any articles of artistic or collectible value in excess of $3,000 or any collections whose artistic or collectible value combined at date of death exceeded $10,0007 ............................... If "Yes," submit full derails on this schedule and attach appraisals. Has the decedent's estate, spouse, or any other person, received (or will receive) any bonus or award as a result of the decedent's employment or death? ......................................................... If "Yes," submit full derails on this schedule. 3 Did the decedent at the time of death have, or have access to, a safe deposit box? .......................... If "Yes," sate location, and if held in joint names of decedent and another, state name and relationship of joint depositor. If any of the contents of the safe deposit box are omitted from the schedules in this return, explain fully why omitted. 1 2003 Acura MDX 4 Door Sport Utility 32,015.00 Vehicle - Valued using Kelley Blue Book webstte at KI~.com. Valuation is attached to this Return Total from continuation schedules (or additional sheets) attached to this schedule ....... TOTAL. (Also enter on Part 5, Recapitulation, parle 3, at item 6.) ................ 32 ~ 015.00 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule F - Page Copyright (c) ZO03 form software only The Lackner Group, Inc. Form 706 Schedule F (Rev. 8-03) Form 706 (Rev. 8-2003) Estate of: Thomas E. WIMBERLY 55~ 191-40-7997 12/05/2003 SCHEDULE I-AnnuE~s Note: Generally, no exclusion is allowed for the estates of decedents dying after December 31, 1984 (see page 14 of the instructions). A Are you excluding from the decedent's gross estate the value of a lump-sum distribution described in section 2039(fX2) Yes No (as in effect before its repeal by the Deficit Reduction Act of 1984)? ................................... X If "Yes," you must attach the information required by the instructions. Item Description Arternste includible Includlbui number Show the entire value of the annuity before any ~xcluslons, valuation date alternate value value at date of death 1 Commonwealth of Pennsylvania State 1,014,216.90 Employees Retirement System Retirement Account paid to 2 beneficiaries, Jo Anne Wtmberly, Daughter and Denise Wtmberly, Daughter. Total from continuation schedules (or additional sheets) attached to this schedule ....... TOTAL. (Also enter on Part 5, Recapitulation, page 3, at item 9.) ................ [ ~ 0[4 ~ 216.90 (If more space is needed, attach the continuation schedu~ from the end of this package or additional sheets of the same size. Schedule I - Page 22 (The instructions to Schedule I are in the separate instructions.) Copyright (c) Z003 form software only The Laclcner Group, Inc. Form 706 Schsdule I (Rev. 8-03) Form706 (Rev, 8-2003) ;~-,-~: Tbom-~ E. WTHRR~LY SS~ 191-40-7997 12/05/2003 SCHEDULE O - Funeral Expenses and ExpenseslncurredlnAdmlni~erlng Property Subje~ to Claims Note: Do not list on this schedule expenses of administering property not subject to claims, For those expenses, sea the instructions for Schedule L. If executors' commissions, attorney fees, etc,, are claimed and allowed as a deduction for estate tax purposes, they are not allowable as a deduction in computing the taxable income of the estate for Federal income tax purposes. They are allewabla as an income tax deduction on Form 1041 if a waiver is filed to waive the deduction on Form 706 (see the Form 1041 instructions), A. Funeral expenses: Minister Services for Funeral 50.00 Myers Funeral Rome, Inc. 9,861.50 Rolling Green Cemetery Company - Burial 2,175.00 Plot Total fu nera, expenses .................... . ..... _1.2. ! 9.8.6_ ._ _5_0_ B. Administration expenses: Executors' commissions - amount ~ (Strike out the words that do not apply.) ....... Attorney fees - amount e st irna t · d/al~e~[~[~(i~ (Strike out the words that do not apply,) ............ _ ...... _6_ ~_ .0_0.0... _0_0. Accountant fees - arnount~l~4~J~(Strike out the words that do not apply.) ........... . ................. Cumberland County Register of Wills Office 146.00 Cumberland County Register of Wills Office 89.00 - Additional Probate Fees to be filed with Return Cumberland County Register of Wills Office 25.00 - Filin§ Fees for Return ($15.00) and Inventory ($10.00) Reserve of Costs for Closeout of Estate 400.00 Total miscellaneous expenses from continuation schedules (or additional sheets) attached to this schedule ................................ Total miscellaneous expenses ............................................. 660.00 TOTAL. (Also enter on Part 5, Recapitulation, pa,~e 3, at item 13.) ............................. 18 ~ 746.50 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule J - Parle 23 Copyright (c) ZCO3 form software only T he Lackner Group, Inc. Form 706 Schedule J (Rev. 8-03) Form706(Rev. 8-2003) Thomas E. WIM~E~LY SS~ 191-40-7997 12/05/2003 SCHEDULE K - Debts of the Decedent, and Mortgages and Liens Amount claimed as Item Debts of the Decedent - Creditor and nature of claim, Amount unpaid to date Amount in contest number and allowable death taxes a deduction 3 4 5 6 7 8 9 10 Andorra Radlolo§y Bunker Associates - Final Rent Payment Carlisle Region Medical Center Dr. Clark - Medical Expenses Erie Insurance Company Gutstwite Family Medical Practice Manor Care Nursin§ Home, Carlisle, PA Mobile X-Ray Services Nei§hbor Care Pharmacy 0akwood Center Radiation Oncolo~¥ 0.00 0.00 O. O0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total from continuation schedules (or additional sheets) attached to this schedule ...................... TOTAL. (Also enter on Part 5, Recapitulation, pa~e 3, at item 14.) .............................. Item Mortgages end Liens - Description number Total from continuation schedules (or additional sheets) attached to this schedule ...................... TOTAL. (Also enter on Part 5, Recapitulation, pate 3, at item 15.) .............................. (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (The instructions to Schedule K are in the separate instructions.) Copyright (c) 2003 form software only T he Lackner Group, Inc. 199.00 590.00 134.26 86.64 124.00 81.57 7,385.53 8.60 1,247.67 776.09 14~327.40 24~960.76 Amount 0.00 Schedule K - Page25 FormT06 ScheduleK(Rev. 8-03/ Estate of: Thomas E. WIMBERLY Soc Sec ~: 191-40-7997 Date of Death: 12/05/2003 Continuation of Schedule K-1 (Debts of the Decedent) Item Description Amt unpd to date Amt claimed as Amt in contest a deduction 11 Omega Labs 12 PA Department of Revenue - Tax due on 2003 Individual Income Tax Return 13 Pennsylvania Counseling Services 14 Pennsylvania Neurology & Neuroscience Institute 15 Pennsylvania Power & Light 16 Pennsylvania State Employees Credit Union Automobile Loan Account 17 Quantum Imaging and Diagnostic 18 Silver Spring Ambulance 19 Verizon Telephone 0.00 15.07 0.00 115.00 0.00 39.45 0.00 29.60 0.00 40.55 0.00 13,795.41 0.00 5.60 0.00 250.00 0.00 36.72 14,327.40 Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of WIMBERLY, THOMAS E also known as No, 21 - 04- 00015 Data of Death 12/5/2003 , Deceased Social Security No. 191-40-7997 Jo Anne Wimbcrly The Personal Representative(s) of the above Estate, deceased, verify that tho items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located 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 the 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/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unswom falsification to authorities. Personal Representative I.D. No.: 4]687 Signature: Address: Signature: P.O, Box 109 Lemoync,, PA 17043 Address: 593-10 Geneva Drive Mechanicsburg, PA 17055 Telephone: 717/761-4540 Telephone: 717-691-0760 Dated: ~ Personal Property 2003 Acura MDX 4 Door SUV. Valued using Kelley Blue at KBB.Com. Valuation is attached to this Return 32,015.00 2003 Federal Income Tax Refund 3,356.00 Commonwealth of Pennsylvania - Office of the Budget Final salary, Annual Leave and Sick days Reimbursement Total Personal P~Operty r~ 63,895.52 ¢~9~ 266.52 (Attach additional sheets if necessary) Total Personal Property and Real Estate $99,266.52 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIOUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT Rt~V-1162 EX(11-96) NO. CD 004349 WIMBERLY JO ANNE 593-10 GENEVA DRIVE MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 191-40-7997 FILE NUMBER: 2104-0015 DECEDENT NAME: WlMBERLY THOMAS E DATE OF PAYMENT: 09/07/2004 POSTMARK DATE: 09~03~2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/05/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,852.98 REMARKS: TOTAL AMOUNT PAID: $5,852.98 CHECK# 118 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF TNDZVIDUAL TAXES INHERITANCE TAX D/VIS/OH DEPT. Z80601 HARRISBURG, PA 171Z8-0601 DAVID N DELUCE JOHNSON ETAL PO BOX 109 LEHOYNE PA 17045 CONNONNEALTH OF PENNSYLVANIA BEPARTNENT OF REVENUE NOTICE OF BETERNINATZON AND ASSESSHENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN 11-01-2004 NIHBERLY 1Z-05-2005 21 04-0015 CUHBERLAND 201 REV-~DS EX &FP (01-D5) BATE ESTATE OF THOHAS E BATE OF DEATH FILE NUNBER COUNTY ACN Amoun~ Remi*~ed HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF N]:LLS CUNBERLAND CO COURT HOUSE CARLTSLE, PA 17015 NOTE: To insure proper credi~ ~o your account, subei~ ~he upper por~:ion of ~hls fore wl*h your ~ex paylllen~. CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR FILES ~ REV-483 EX AFP (01-03) ~ NOTICE OF BETERHZNATZON AND ASSESSNENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~ ESTATE OF NIHBERLY THOHAS E FILE NO.2! 04-0015 ACN 201 BATE 11-01-2004 ESTATE TAX DETERt4ZNATZON 1. Credit For State Death Taxes as Verified 22z157.69 Z. Pennsylvania Tnheritance Tax Assessed (Excluding Discount and/or In'cerest) :5. Inheritance Tax Assessed by Other States .00 or Territories o~ the United States (Excluding Discount and/or Interest) 4. Total Inheritance Tax Assessed 5. Pennsylvania Estate Tax Due TAX CREDITS: 5z852.98 5~85Z.98 16z:504.71 PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) .? INTEREST IS CHARGED THROUGH 11-09-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORH.~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ~IF PA/D AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. .00 16,:504.71 116.58 16,421.29 (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS RE{iUIRED IF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR TNSTRUCTIONS.) PURPOSE OF NOTICE: PAYNENT: REFUND OBJECTIONS: ADNZN- ISTRATIVE CORRECTIONS: PENALTY: INTEREST: To fulfill the requirements of Section 2140 (b) of the Inheritance and Estate Tax Act, Act 13 of 2000. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF #ILLS, AGENT. A refund of a tax credit may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" [REV-IS13). Applications are available at the Office of the Register cf Nills, any of the 13 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-3010 (TT only). Any party in interest not satisfied with the assessment of tax as shown on this notice may object within sixty (60} days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281011, Harrisburg, PA 17118-1011, --electing to have the matter determined at audit of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assesseant Reviea Unit, Dept. 180601, Harrisburg, PA 17118-0601, Phone (717} 787-650S. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in ~ha same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. For dates of death on or after 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of nine (09) months from the date of death. For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at the expiration of eighteen (18) months from the date of death. Taxes which became delinquent before January 1, 1981 bear interest at the rata of six (61) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 1981 wi1! bear interest at a rata which will vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2004 ara: Interest Daily Interest Daily Interest Daily Yea~ Rate Factor Yea.....~ Rate Factor Yaa~ Rate Factor 1981 ZOZ .000548 1988-1991 11X .000301 2001 91 .000247 1983 161 .000438 1992 91 .00024? ZOOZ 61 .000164 1984 11X .000301 1993-1994 72 .000191 2003 5Z .000137 1985 132 .000356 1995-1998 92 .000147 Z004 41 .000110 1986 102 .000174 1999 72 .000191 1986 XOZ .000174 ZOO0 87. .000119 --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPA'rD X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days beyond the data of the assessment. If payment is made after the interest computation date shown on the Notice, additianal interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 1712B-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-I~I~? EX AFP (01-03) -1 DAVID W DELUCE 'Od ~-~ JOHNSON ETAL PO BOX 109 ~,.:: LEHOYNE PA",/L70~.$ DATE 11-01-2004 ESTATE OF WIHBERLY DATE OF DEATH 12-05-2005 FILE NUHBER Z1 04-0015 COUNTY CUHBERLAND ACN 101 I Amount RemAtted THOHAS E HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUHBERLAHD CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETA/N LOWER PORTTON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF WIHBERLY THOHAS E FILE NO. 21 04-0015 ACN 101 DATE 11-01-2004 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1). 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/PartnershAp Interest (Schedule C) (3) q. Hortgages/Notes ReceAvable (Schedule D) (4) 5. Cash/Bank Daposits/NAsc. Personal Property (Schedule E) (5) 6. JoAntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G} (7) 8. Tote1 Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/MAsc. Expanses (Schedule H) (9) 10. Debts/Mortgage LAabAIAtAes/Liens (Schedule 1) (10) 11. Total DaductAons 18. Net Value of Tax Return 99/266.52 lz105.44 75/401.55 18,746.50 24~960.76 (11) (12) 13. 14. NOTE: O0 NOTE: To Ansure proper O0 cradAt ~o your account, .00 submit the upper portAon 00 of this form wi~h your tax payment. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5) Nat Value of Estate Subject to Tax (14) Zf an assessment Has lssued previously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. 175,775.49 ASSESSHENT OF TAX: 15. Amount of L/nm 14 at Spousal rate 16. Amount of Line 14 taxable at LAneal/Class A rate 17. Amount of LAne 14 et SAblAng rata 18. Amount of LAne 14 taxable at Collateral/Class B rate 19. PrAncApel Tax Due TAX CREDITS: PAYHENT RECEZP1 DISCOUNT DATE NUNBER /NTEREST/PEN PA/D (-} 09-05-2004 CD004549 .00 43.707.26 150,066.25 ZF PAID AFTER DATE /ND/CATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL INTEREST. .00 130,066.25 18 and 19 ~ill (1~) .00 x O0 = .00 (16) 130,066.25 x 045 = 5,852.98 (17) .00 x 1Z = .00 (~B) .00 x 15 = .00 (19)= 5,852.98 AHOUNT PAID 5,852.98 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 5,852.98 .00 .00 .00 ( ZF TOTAL DUE XS LESS THAN $1, NO PAYNENT 1S REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR /NSTRUCT/ONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 11, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateraI) beneficiaries of the decadent after the expiration of any estate for tile or for years, tho Coemoneoalth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate an any such future interest. To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILLS~ AGENT A refund of a tax credit, ahich ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour ensnaring service for forms ordering: 1-B00-361-2050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-5010 (TT only). Any party in interest not satisfied aith the appraisement, allomance, or disallowance of deductions, or assessment of tax (including discount or interest) as shomn on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA I?IZ&-IOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviam Unit, Dept. 180601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. Sea page 5 aT the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax duo is paid within three (3) calendar months after the decedent's death, a five percent (EX) discount oF the tax paid is allowed. The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning mith first day of delinquency, or nine (9) months and Dna fl) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1981 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes Nh[ch became delinquent on and after January 1, 1982 wiZ1 bear interest at a rate which will vary fram calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZOO4 are: Interest Daily Interest Daily Year Rata Factor Year Rate Factor ~'~ ZOZ .000548 1988-1991 llZ .000501 1983 161 .000438 1991 91 ,000247 19Bq llZ .000301 1993-1994 77. .000192 1985 13Z .000356 1995-1998 97. .000 Z47 1986 IOZ .000274 1999 77. .O0019Z 1987 ZDZ .000174 ZOOO 77. .O00IaZ --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rata Factor ZOO1 91 .000147 ZOOZ 61 .0D0164 Z003 51 .000137 ZO0~ 41 .000110 X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on tho Notice, additional interest must be calculated. BUREAU OF TNDTV'rDUAL TAXES TNHERTTANCE TAX DIVTSION PO BOX 280601 HARRTSBURG PA 171Z8-0601 DAVID W DELUCE JOHNSON ETAL PO BOX 109 LEMOYNE PA 17043 CONNONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN RE¥-1607 EX *FP (12-04) 1Z-Z7-ZO04 WIMBERLY THOHAS E 12-05-2003 21 04-0015 CUHBERLAND 201 Aeoun~ Remi~ed MAKE CHECK PAYABLE AND REMIT PAYNENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account`' submi~ ~ha upper portion of ~his form wi~h your ~ax payment. CUT ALONG THXS LXNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS --~ ESTATE OF WIMBERLY THOMAS E FILE NO, 21 04-0015 ACN 201 DATE 12-27-2004 THIS STATEHENT ZS PROV/DED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELO# ZSA SUHHARY OF THE PRZNCZPAL TAX DUE., APPL/CATZON OF ALL PAYHENTS`' THE CURRENT BALANCE`' AND`' ZF APPLICABLE`' A PROdECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-01-2004 PRINCIPAL TAX DUE: ...................................................................................... PAYMENTS (TAX CREDITS): 16`'304.71 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 11-16-2004 CDOO464Z 128.38- 16,433.09 TOTAL TAX CREDIT ZF PAID AFTER THIS DATE`' SEE REVERSE SIDE FOR CALCULATION OF ADD/TZONAL INTEREST. ZF TOTAL DUE ZS LESS THAN $1`' NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. 16,304.71 BALANCE OF TAX DUE .00 INTEREST AND PEN. .75 TOTAL DUE .75 STATUS REPORT UNDER RULE 6.12 Name of Decedent: THOMAS E. WIMBERLY. Date of Death: December 5.2004 Admin No. 2004-00015 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the Estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's Account is: c. parties of interest? Did the personal representative state an account informally to the Yes X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. 0'") ID W. D LUCE JOHNSON, DUFFIE, STEWART & WEIDNER 301 Market Street P.O. Box 109 Lemoyne, P A 17043 ) (717) 761-4540 Capacity: Personal Representative , (x) Counsel for Personal Representative J?ate: February 14, 2005 DAVID W DELUCE JOHNSON ETAL PO ('BOX 109 r.l"",,! LEftt.QYNE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 REV-1!' EX AFP <12-114) 03-01-2005 WIMBERLY 12-05-2003 21 04-0015 CUMBERLAND 202 Allount Rellitted THOMAS E PA 17043 I;,';;> MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE~ PA 17013 ::';NoTE: Te;insul"'e ~~I'" cl"'edi t to youl'" account ~ suni t the uppel'" pOl"'tion of this f01"'1I with youl'" tax paYlHmt. cot ALONG:,THIS UN.> ... RETAIN LOWER PORTION FOR YOUR FILES ~ -----------.~--------------------------------------------------------------------------------------------------- REV-736 EX AFP (01-02) .. NOTICE OF DETERMINATION AND ASSESSMENT S\ OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF WIMBERLY THOMAS E FILE NO.2l 04-0015 ACN 202 DATE 03-01-2005 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 22~157.69 2. Pennsylvania Inheritance Tax Assessed 5~852.98 (Excluding Discount and/or Interest) 3. Inheritance Tax Assessed by Other States .00 or Territories of the United States (Excluding Discount and/or Interest) 4. Total Inheritance Tax Assessed 5.852.98 5. Pennsylvania Estate Tax Due 16.304.71 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return 16~304.7l 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE~ SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $l~ NO PAY"ENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR) ~ YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) ~