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HomeMy WebLinkAbout10-20-08J 15056041147 REV-1500 Ex 06 05 PA Department of Revenue ( - ) OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO 60X.280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 0 8 0 8 21 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 06 09 2008 06 23 1933 Decedent's Last Name Suffix Decedent's First Name MI HUGHES R• B (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI HUGHES JUDITH L Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death pnorto 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date d death after 12-12-82) a g. Decedent Died Testate ^ (Attach Copy of Will) ~ Decedent Maintained a Living Trust 0 8. Total Number of Safe De osit Boxes (Attach Copy of Trust) P 9. Litigation Proceeds Received ~ 1 p. Spousal Poverty Credo (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) ~ (Attach SCh. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D. BOGAR 717 737 8761 .--.. , Firm Name (If Applicable) BOGAR & HIPP LAW OFFICES First line of address ONE WEST MAIN STREET Second line of address City or Post Office SHIREMANSTOWN State ZIP Code PA 17011 Correspondent'se-mail address: Jbogar@bogarlaw.com REGISTER b~IILLS US~NLY--'.- ~~ - - .~ -:r~= ~- I r~ - `_ -r- =~ W - r~ -..i .. Di~TE FILED 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, 't is true, correct and complete. Declaration of preparer other than the personal representative is on all information of which preparer has any knowledge. S NATU OF RSO PO SI L FOR FILI RET N DATE • Judith L. Hughes /p ~~rn ~~~ 324E Green S reet, Shiremanstown, PA 17011 SIGN RE O PREPAR~R ER THAN REPRESENTATIVE DATE ~, U// James D. Bogar 1/1 rlll., In ~ ADDRESS / One West Main 15056041147 PA 17011 Side 1 1505604114? _..J 15056042148 REV-1500 EX Decedent's Social Security Number Decedent's Name: R. Burton Hughes RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 4, 7 8 5. 7 4 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank De osits & Miscellaneous Personal Pro a p p rty (Schedule E) ................ 5. 1 3 8 1 9 4. 8 7 r 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 2 6 , 2 4 7 . 6 $ 8. Total Gross Assets (total Lines 1-7) ....................................................................... g. 1 6 9, 2 2 8. 2 6 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. 0 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 1 6 9 , 2 2 8 . 2 6 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. 1 6 9 , 2 2 8 . 2 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) x .o0 16 9, 2 2 8. 2 6 15. 16. Amount of Line 14 taxable at lineal rate X .045 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 18. 19. Tax Due ................................................... .................................................................. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 15056042148 15056042148 0.00 0.00 0.00 0.00 0.00 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0821 DECEDENT'S NAME R. Burton Hughes STREET ADDRESS 234 East Green Street CITY Shiremanstown STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit g. Prior Payments C. Discount 3. Interest/Penalty if applicable p. Interest E. Penalty 0.00 Total Credits (A + B + C) (1) 0.00 (2> 0.00 (3) (4) (5) 0.00 (5A) (56) ~ . 0 0 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. ^ x b. retain the right to designate who shall use the property transferred or its income :.................................... ^ c. retain a reversionary interest; or .................................................................................................................. ^ ^x d. receive the promise for life of either payments, benefits or care? .............................................................. ^ a 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving 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 decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the ~ ~W 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)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1503 FJC+ (8-98) COMMONWEALTH OF PENNSVI.VANIA INNERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS 8~ BONDS ESTATE OF FILE NUMBER Hughes, R. Burton 21-08-0821 All property JoiMlyowned with right of aurvivorahip must be disclosed on Schedule F. ~~~ iiiuic space Is neeoea, avamonal pages or the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) PepsiCo -Historical Price Lookup P~PS~co Historical Price Lookup Page 1 of 1 Symbol Closing Price $65.37 PEP (Common Stock) Volume 9,046,44 Lookup Date __ Split Adjustment Factor 1.0000: !June 09 2008 Open $65.92 diuu uu ii""'iii o! ~ioiir" Day's High $65.92 ~~ Day's Low $64.65 Actual Price $65.37 Date Requested 06/09/C NOTE: The Closing Price, Day's High, Day's Low, and Day's Volume have been adjusted to account for any stock splits an d/or dividend: which may have occurred for this security since the date shown above. The Actual Price is not adjusted for splits or dividends. The Split Adjustment Factor is a cumulative factor which encapsulates all splits since the date shown above. The closing price above is not necessarily indicative of future price performance ©2008 PepsiCo, Inc. http://phx.corporate-ir.net/phoenix.zhtml?c=78265&p=irol-stocklookup~rint&t=HistQuote 8/6/2008 BNY MELLON SHAREOWNER SERVICES P.O,Box 358035 Pittsburgh, PA 15252-8035 0011251 O1 AT 0.3d6 «AUTO TS 1 3702 17011-671734 COl B1MAI -1 - I~r,lli~„III~~~r~Iit„rII,II~~IIr~I~I~IIIdd~Irlll,rllll,Il~ll R BURTON HUGHES 234 E GREEN ST SHIREMANSTOWN PA 17011.6717 Year-To-Date Account Summary AS OF: 07104/2008 CASH - TOTAL ~IARY.ET VALUE (:) ~ CLOElNG PRICE (F) - ~tJVESTMENTS(S) _ _ 4,814.67 65.7600 TRADING FEES PAID BY (i) SERVICE FEES PAID BY (i) SALE OF PLAN SHARES (S) COMPANY HAREHOLDE COMPANY HAREHOLDER GROSS PROCEEDS TAX WITHH 0.12 r'Ulrcnt drtivifii Infi~rm~i:.... 3702 01 0011251 0024182 Page 1 of 2 Shareholder Of.• r~r~lct~, Ilvc. BUYDIRECT PLAN STATEMENT PRINT DATE: 07/03/2008 CUSIP: 001-450-71344810 SYMBOL: PEP ACCOUNT KEY: HUGHES-R-80000 INVESTOR ID: 124893308909 FOR QUESTIONS CONCERNING YOUR ACCOUNT PLEASE CALL 1-800-226-0083 Save this Statement for Tax Pur os( DIVIDENDS NEi AMOUNT -TOTAL (S) ... TAX WITHHELD (;) AMOUNT TO INVEST (S) ..INVESTED (i) 85.04 85.04 85.04 CERTIFICATED SHARES HELD SHARES HELD BY TOTAL' ELp SHARES HELD BY YOU BY PLAN OTHER PLAN(S) SHARES 732158 73.2158 RECORD DATE TRANSACTION DIVIDEND SHARES ACQUIRED PAYABLE DATE DESCRIPTION ~ RATE OR WITHDRAWN CASH INVESTMENT (i) TOTAL GROSS (S- 06/Ob/2008 COMMON DIVIDEND 0.4250000 0 4797 . or,r3a2oo8 . 30.91 TAX TRADOJG FEES PAIO EY ISI SERNCE FEES PAID aY IS) TOTAL .~,~, CERTIFICATED SHARES ,v~rn ~ uv~ r«~.vrc SHA u vA I C UW I KICU I IUN WITHHELD (i) carwir wugeatoeR eowun aHanea~oex NET (E) HELD BY YOU RES HELD BY PLAN SHARES HELD BY OTHER PLAN(S) TOTAL SHARES 0.05 30.91 72.7361 I 72.73611 Year-To-Date Transaction Detail DATE TRANSACTION .DESCRIPTION CASH INVESTMENT (S) NET DISTRIBUTION (E) TRADING FEES (S) SERVICE FEES {S) .AMOUNT INVESTED (S) PRICE PER SHARE S) SHARES ACQUIRED SHARES HELD ( OR WITHDRAWN BY PLAN BALANCE FORWARD 01/02!08 COMMON DNIDEND 01/0?/OS C011MON DMDEND 24.38 0.03 24.38 75.3890000 0.3234 71'9995 72 3229 03/31!08 COMMON DIVIDEND 2.62 27 13 0 04 '2.62 75.3890000 . 0.0348 . 72.3577 06/30/08 COMMON DNIDEND . . 27.13 71.6888106 0.3784 72.7361 30.91 0.05 30.91 .64.4317000 n d~e~ ~ .,,~„ PEPSICO, INC. CUSIP: ool-4sa71344810 ACCOUNT KEY: HUGHES-R-80000 R BURTON HUGHES 234 E GREEN ST SHIREMANSTOWN PA 17011-6717 Ap owner(s) must sign and date above Contact Number Partial Withdrawal (Continue Plan Participation) Issue a certificate for this number of shares: Sell this number of shares: Full Withdrawal (Terminate Plan Participation) Issue a certificate for all full shares and a check for fractional shares. a Selt all plan shares. Additional Cash Investments Write the amount enclosed: Make check payable to:' BNY MELLON/PEPSICO YOU MAY INCREASE YOUR SHARES WITH OPTIONAL CASH INVESTMENTS OF $50 UP TO $10,000 PER TRANSACTION Deposit of Certificates Deposit the enclosed number ~~ of shares: J 7575 124893308909 00145071344810HUGHES---R---BOOOOIR00136 Rev-1508 EX+ (8-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY CONIMONVVEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Hughes, R. Burton 21-08-0821 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntlyowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Members 1st Federal Credit Union -Certificate of Deposit # 237323-41; principal 10,417.79 balance $10,405.98; accrued interest $11.81. 2 Members 1st Federal Credit Union -Certificate of Deposit # 237323-43; principal 34.230.52 balance $34,198.89; accrued interest $31.63 3 Members 1st Federal Credit Union -Certificate of Deposit # 237323-46; principal 23,152.17 balance $23,138.12; accrued interest $14.05 4 PSECU -Certificate of Deposit # C50; principal balance $7,593.30; accrued interest .7,601.99 $8.69 5 PSECU -Certificate of Deposit # C51; principal balance $14,876.64; accrued interest 14.893.66 $17.02 6 PSECU -Certificate of Deposit # C52; principal balance $700.69; accrued interest 701 46 $0.79 . 7 Sovereign Bank -Certificate of Deposit #0575430852; principal balance $12,661.09; 12,675.51 accrued interest $14.42 8 Sovereign Bank -Certificate of Deposit #0575539457; principal balance $10,913.82; 10,928.27 accrued interest $14.45 9 Sovereign Bank -Certificate of Deposit # 2335538464; principal balance $3,254.01; 3,259.36 accrued interest $5.35 10 Belco Community Credit Union -Savings Account # 869656; principal balance 506 30 $505.65; accrued interest $0.65 . 11 Members 1st Federal Credit Union -Regular Savings Account #237323-00; principal 10,269.79 balance $10,267.54; accrued interest $2.25 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 138,194.87 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1508 FJ(+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA WHERRANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Hughes, R. Burton 21-08-0821 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) St MEMBERS 1St FEDERAL CREDIT ANION PRIMARY OWNER; Judith Hughes REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established LIFE SAVINGS ACCOUNT: 82972-00 03/07/1987 $2,568.34 $.56 $2,568.90 Robert B. Hughes 07/22/2000 Account Number/Suffix 82972-04 Date Account Established 02/01/2001" Principal Balance at Date of Death $4,000.00 Accrued Interest to Date of Death $.gg Total Principal and Accrued Interest $4,000.88 Name of Joint Owner Robert B. Hughes Date Joint Ownership Established 02/01/2001 'Opened by transfer of funds from 82972-00. MONEY MANAGEMENT ACCOUNT: Account Number/Suffix 82972-05 Date Account Established 03/06/2001 Principal Balance at Date of Death $5,468.21 Accrued Interest to Date of Death $1.37 Total Principal and Accrued Interest $5,469.58 Name of Joint Owner Robert B. Hughes Date Joint Ownership Established 03/06/2001 IRA CERTIFICATES: Account NumbedSuffix 82972-12 Date Certificate Established 02/23/2000 Principal Balance at Date of Death $21,195.08 Accrued !nterest to Date of Dea±h ~~ ~0 W~•~ Total Principal and Accrued Interest $21,200.38 Name of Beneficiary R. Burton Hughes IRA CERTIFICATES: Account Number/Suffix 82972-17 Date Certificate Established 09/08/2001 Principal Balance at Date of Death $10,699.14 Accrued Interest to Date of Death $9,78 Total Principal and Accrued Interest $10,708.92 Name of Beneficiary R. Burton Hughes 82972-16 11/18/2000 $3,914.14 $3.54 $3,917.68 R. Burton Hughes M~~R}S~1sTQ F DE L ~~IT UNION Danielle /{"Kiine~~ ~- 1`~.ib..~_ Insurance Services Specialist August 12, 2008 Estate of: R B HUGHES Date of Death: 06/09/2008 Social Security Number: 168-26-5307 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org St MEMBERS 1St FEDERAL CREDTr [JNION REGULAR SAVINGS ACCOUNT: Account Number/ Suffix 237323-00 Date Account Established 11/04/2003 Principal Balance at Date of Death $10,267.54 Accrued Interest to Date of Death $225 Total Principal and Accrued Interest $10,269.79 Name of Joint Owner None IRA CERTIFICATE: Account Number/Suffix 237323-15 Date Account Established 12/02/2003 Principal Balance at Date of Death $15,928.97 Accrued Interest to Date of Death $15.40 Total Principal and Accrued Interest $15,944.37 Name of Beneficiary Judith Hughes CERTIFICATES OF DEPOSIT; Account Number/Suffix 237323-41 237323-43 Date Account Established 08/25/2007* 12/11/2004** Principal Balance at Date of Death $10,405.98 $34 198.89 Accrued Interest to Date of Death $11.81 , $31.63 Total Principal and Accrued Interest $10,417.79 $34 230.52 Name of Joint Owner None , None *Purchased by transfer of funds from 237323-00. **Purchased by transfer of funds from 237323-00. CERTIFICATES OF DEPOSIT: Account Number/Suffix 237323-46 Date Account Established 06/15/2006* Principa! Balance at Cate of Ceath $23 "' ~'' , IJV. IL Accrued Interest to Date of Death $14.05 Total Principal and Accrued Interest $23,152.17 Name of Joint Owner None *Rollover from certificate 237323-40, originally established 12/13/2003. M BERS 1ST FEDERAL CREDIT UNION ~anielle A. Kline Insurance Services Specialist August 12, 2008 Estate of: R. B. HUGHES Date of Death: June 9, 2008 Social Security Number: 168-26-5307 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org JAMES D. BOGAR ONE WEST MAIN ST SHIl2EMANSTOWN, PA 17011 Dear MR. BOGAR: The following is the status of R. BURTON HLTGHES's account with PSECU as of the date of death. Joint Owner's Name NONE Date of Death 06.09.2008 Date of Birth 06.23.1933 Share Description Open date Balance Accrued Dividend S O1 Regulaz Shares 02.04.1999 $ 1,494.99 -$ -0.41 C50 24 Month Certificate-1 02.04.1999 7,593.30 8.69 C51 24 Month Certificate-2 03.16.1999 14,876.64 17.02 C52 24 Month Certificate 07.27.1999 700.67 0.79 The dividend earned from January 1, 2008 through the date of death was $531.67. The decedent had no loans with us. We do not have safe deposit boxes for our members. If you have any questions, please call 234-8484 in Hamsburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, ;~ Meacie Fa' Member Service Representative Finance Support Unit Pennsylvania State Employees Credit Union Main Address: 1 Credit Union Place, Harrisburg, PA 1 71 1 0-2990 • 717.234.8484 • 800.237.7328 Mailing Address:. PO. Box 67013, Harrisburg, PA 1 71 06-701 3. • 717.777.2100 (TDD) 800.472.1967 (TDD) This credit union is federally insured by the National Credit Union Administration. Equal Opportunity Lender www.psetu.eom _. ~~ S~'G~L•f ~.ii.t K2 {. [~~~~iLF~~..~Ll ~~. }YG' 1 i~FI 1.. f R~~~ 6~L'{~ L~i+EL LYJ *-rl. L~.. k P.O. Box 841005 Boston, MA 02284 August 19, 2008 James D. Bogar Attorney at Law One W. Main St. Shiremanstown, PA 17011 RE: Estate of: Robert B. Hughes Date of Death: June 9, 2008 Dear Mr. Bogar: Per your request, enclosed please find the account information as of date of death for the above-named decedent. Please note the balances do not include accrued interest. If you should have any further questions, please do not hesitate to call. Very truly yours, n ~: Linda Spavento Team Leader Court Order Processing (617) 533-1789 (617) 533-1931-fax Sovereign Bank ESTATE OF Robert B Hughes SOCIAL SECURITY #: 168-26-5307 DATE OF DEATH: June 9, 2008 Account #: 0571113737 Type: Checking Open date: 8/21/1999 In the name of: Robert B Hughes or Judith L Hughes Date of Death Balance: $8,059.52 Int.(YTD) from 1/1/2008 to 5/13/2008 $20.14 Accrued interest to date of death: $3.13 Otherlnfo: Account #: 0571113745 Type: Checking Open date: 8/21/1999 In the name of: Judith L Hughes or Robert B Hughes Date of Death Balance: $14,961.81 Int.(YTD) from 1/1/2008 to 5/13/2008 _ $27.40 Accrued interest to date of death: Otherlnfo: $4.98 Account #: 0574175784 Type: Money Market Open date: 9/15/2006 In the name of: Robert B Hughes or Judith L Hughes Date of Death Balance: $23,244.99 Int.(YTD) from 1/1/2008 to Accrued interest to date of death: Otherlnfo: 5/13/2008 $269.19 Account #: 0574175849 Type: Money Market Open date: 9/21/2006 In the name of: Judith L Hughes or Robert B Hughes Date of Death Balance: $29,084.58 Int.(YTD) from 1/1/2008 to Accrued interest to date of death: Otherlnfo: Account #: 0575430852 Type: In the name of: Robert B Hughes Date of Death Balance: $12,661.09 Int.(YTD) from 1/1/2008 to 5/31/2008 $217.01 Accrued interest to date of death: $14.42 Otherlnfo: $36.32 5/13/2008 $28.97 CD Page 1 of 2 $339.76 Open date: 10/14/1999 Sovereign Bank ESTATE OF Robert B Hughes SOCIAL SECURITY #: 168-26-5307 DATE OF DEATH: June 9, 2008 Account #: 0575539457 Type: CD Open date: 9/15/2006 In the name of: Robert B Hughes Date of Death Balance: $10,913.82 Int.(YTD) from 1/1/2008 to 5/31/2008 $217:09 Accrued interest to date of death: $14.45 Other info: Account#: 0578176521 In the name of: Robert B Hughes Type: IRA Open date: 1 /6/2000 Date of Death Balance: $8,542.80 Int.(YTD) from 1/1/2008 to 5/31/2008 $126.40 Accrued interest to date of death: $8.45 Other Info: Beneficiary: Judith Hughes Account#: 0578177198 Type: IRA Open date: 11/12/1999 In the name of: Robert B Hughes Date of Death Balance: $1,750.30 Int.(YTD) from 1/1/2008 to 5/31/2008 $26.09 Accrued interest to date of death: $1.73 Other Info: Beneficiary: Judith Hughes Account #: 2335538464 Type: CD Open date: 2/21/2006 In the name of: Robert B Hughes Date of Death Balance: $3,254.01 Int.(YTD) from 1/1/2008 to 5/21/2008 $46.18 Accrued interest to date of death: $5.35 Other Info: Page 2 of 2 August 29, 2008 James D Bogar Attorney At Law One West Main Street Shiremanstown, Pennsylvania 17011 Re: Estate of R. Burton Hughes S.S. 168265307 Mr. Bogar, Judith L Hughes, Administrator of the Estate, closed the account of R. Burton Hughes on August 8, 2008, the closing balance was $ 506.30. If you have any further questions please do not hesitate to contact me in our Finance Department. Sincerely, Yvonne J e Finance Department Belco Community Credit Union 449 Eisenhower Blvd. Harrisburg, PA 17111 717-232526 in Harrisburg area 800-642-4482 outside of calling area 1. Name(s) in which the account was held: BELCO COMMUNITY CREDIT UNION DECEDENT ESTATE INFORMATION R. BURTON HUGHES ~. Hccount number: 869656 3. Balance as of date of death: 5/19/1901 Balance Accrued Dividends YTD Dividends For Regular Savings: $ $505.65 $ $0.65 $ $6.30 Christmas Club: $ $ $ Whatever Club: $ $ $ Checking: $ $ $ Money Market: $ $ $ Certificates: Balance Accrued Dividends YTD Dividends For $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 4. Date the account was initiated: 5/30/2008 5. Name(s) in which Safe Deposit Box was held: o. uaie zne oox was Inltlally rented: 7. Branch address at which the box is located Certificate Number 8. Loan Information: Balance Accrued Interest Per Diem Int LINE OF CREDIT Unsecured Loans: $ $ VISA $ B. Secured Loans: $ $ $ $ $ $ C. Mortgage Loans: $ $ $ $ $ $ Miscellaneous: JUDITH LHUGHES/ ADMINSTRATOR OF ES TATE CLOSED THE ACCOUNT ON RiRmR Rev-1510 EX+ (6.95) COMMONWE4LTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY ESTATE OF (FILE NUMBER Hughes, R. Burton 21-08-0821 This schedule must be completed and filed rf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER utSC;K(F' I ION OF PROPERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET ~ OF DecD•s INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Members 1st Federal Credit Union -IRA # 15,944.37 15,944.37 237323-15; principal balance $15,928.97; accrued interest $15.40. The Decedent's wife, Judith L. Hughes, is the named beneficiary. 2 Sovereign Bank -IRA #0578176521; principal 8.551.25 8,551.25 balance $8,542.80; accrued interest $8.45. The Decedent's wife, Judith L. Hughes, is the named beneficiary. 3 Sovereign Bank -IRA #0578177198; principal 1,752.03 1,752.03 balance $1,750.30; accrued interest $1.73. The Decedent's wife, Judith L. Hughes, is the named beneficiary. TOTAL (Also enter on Line 7, Recapitulation) I 26,247.65 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REGULAR SAVINGS ACCOUNT: Account Number/ Suffix 237323-00 Date Account Established 11/04/2003 Principal Balance at Date of Death $10,267.54 Accrued Interest to Date of Death $2,25 Total Principal and Accrued Interest $10,269.79 Name of Joint Owner None IRA CERTIFICATE: Account Number/Suffix 237323-15 Date Account Established 1Z/OZ/2003 Principal Balance at Date of Death $15,928.97 Accrued Interest to Date of Death $15.40 Total Principal and Accrued Interest $15,944.37 Name of Beneficiary Judith Hughes CERTIFICATES OF DEPOSIT: Account Number/Suffix 237323-41 237323-43 Date Account Established 08/25/2007* 12/11/2004** Principal Balance at Date of Death $10,405.98 $34,198.89 Accrued Interest to Date of Death $11.81 $31.63 Total Principal and Accrued Interest $10,417.79 $34,230.52 Name of Joint Owner None None *Purchased by transfer of funds from 237323-00. **Purchased by transfer of funds from 237323-00. CERTIFICATES OF DEPOSIT: Account Number/Suffix 237323-46 Date Account Established 06/15/2006* Qr:ncipGl Balance ~ D:v f De ::h $7? 4 ? O 4 ^1 00:: ' Accrued Interest to Date of Death $14.05 Total Principal and Accrued Interest $23,152.17 Name of Joint Owner None "Rollover from certificate 237323-40, originally established 12/13/2003. :, M BERS 1sT FEDERAL CREDIT UNION Danielle A. Kline Insurance Services Specialist August 12, 2008 Estate of: R. B. HUGHES Date of Death: June 9, 2008 Social Security Number: 168-26-5307 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org ~~ 1-~- _ ~~~~l-3~'`.~L~: I~~i ~1.~...~~~~f~:~~.~.i.(~~. ~~~ Ltt~~~ A".R~F~~ ~~xi~ L~~'~~~ ~~r ~ ~t P.O. Box 841005 Boston, MA 02284 August 19, 2008 James D. Bogar Attorney at Law One W. Main St. Shiremanstown, PA 17011 RE: Estate of: Robert B. Hughes Date of Death: June 9, 2008 Dear Mr. Bogar: Per your request, enclosed please find the account information as of date of death for the above-named decedent. Please note the balances do not include accrued interest. If you should have any further questions, please do not hesitate to call. Very truly yours, ~ ~ Linda Spavento Team Leader Court Order Processing (617) 533-1789 (617) 533-1931-fax Sovereign Bank ESTATE OF Robert B Hughes SOCIAL SECURITY #: 168-26-5307 DATE OF DEATH: June 9, 2008 Account #: 0571113737 Type: Checking Open date: 8/21/1999 In the name of: Robert B Hughes or Judith L Hughes Date of Death Balance: $8,059.52 Int.(YTD) from 1/1/2008 to 5/13/2008 $20.14 Accrued interest to date of death: $3.13 Otherlnfo: Account #: 0571113745 Type: Checking Open date: 8/21/1999 In the name of: Judith L Hughes or Robert B Hughes Date of Death Balance: $14,961.81 Int.(YTD) from 1/1/2008 to 5/13/2008 $27.40 Accrued interest to date of death: $4.98 Otherlnfo: Account #: 0574175784 Type: Money Market Open date: 9/15/2006 In the name of: Robert B Hughes or Judith L Hughes Date of Death Balance: $23,244.99 Int.(YTD) from 1/1/2008 to 5/13/2008 $269.19 Accrued interest to date of death: $28,97 Other Info: Account #: 0574175849 Type: Money Market Open date: 9/21/2006 In the name of: Judith L Hughes or Robert B Hughes Date of Death Balance: $29,084.58 Int.(YTD) from 1/1/2008 to 5/13/2008 $339.76 Accrued interest to date of death: $36.32 Other Info: Account #: 0575430852 Type: CD Open date: 10/14/1999 In the name of: Robert B Hughes Date of Death Balance: $12,661.09 Int.(I'TD) from 1/1/2008 to 5/31/2008 $217.01 Accrued interest to date of death: $14.42 Otherlnfo: Page 1 of 2 Sovereign Bank ESTATE OF Robert B Hughes SOCIAL SECURITY #: 168-26-5307 DATE OF DEATH: June 9, 2008 Account #: 0575539457 Type: CD Open date: 9/15/2006 In the name of: Robert B Hughes Date of Death Balance: $10,913.82 Int.(YTD) from 1/1/2008 to 5/31/2008 $217:09 Accrued interest to date of death: $14.45 Otherlnfo: Account #: 0578176521 Type: IRA Open date: 1/6/2000 In the name of: Robert B Hughes Date of Death Balance: $8,542.80 Int.(YT'D) from 1/1/2008 to 5/31/2008 $126.40 Accrued interest to date of death: $8.45 Other Info: Beneficiary: Judith Hughes Account #: 0578177198 Type: IRA Open date: 11/12/1999 In the name of: Robert B Hughes Date of Death Balance: $1,750.30 Int.(YTD) from 1/1/2008 to 5/31/2008 $26.09 Accrued interest to date of death: $1.73 Other Info: Beneficiary: Judith Hughes Account #: 2335538464 Type: CD Open date: 2/21/2006 In the name of: Robert B Hughes Date of Death Balance: $3,254.01 Int.(YTD) from 1/1/2008 to 5/21/2008 $46.18 Accrued interest to date of death: $5.35 Other Info: Page 2 of 2 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF -FILE NUMBER Hughes, R. Burton 21-08-0821 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustee(s) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Judith L. Hughes Wife One hundred 169,228.26 234 East Green Street percent of rest, Shiremanstown, PA 17011 residue and remainder Total 169,228.26 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II~ NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0 00 Copynght (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TESTAMENT OF R. BURTON HUGHES i I, R. BURTON HUGHES, of Shiremanstown, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over .which I hold power of appointment and together with any insurance policies thereon, unto my wife, JUDITH L. HUGHES, provided she survives me by sixty (60) days. SECOND: Should my wife, JUDITH L. HUGHES, predecease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, as follows: (A) Twelve and One-half (121/0) percent thereof to EAST STROUDSBURG UNIVERSITY, East Stroudsburg, Pennsylvania, for general purposes as the governing body of the school deems appropriate. (B) Twelve and One-half (121/z°) percent thereof to WEST VIRGINIA UNIVERSITY, Morgantown, West Virginia, for general purposes as the governing body of the school deems appropriate. (C) Twenty-five (25 a) percent thereof to my brother, JOHN E. HUGHES, provided that should he predecease me, then I give and bequeath his share to his issue per stirpes by represen- tation, as provided herein. (D) Twenty-five (250) percent thereof to my sister, VIRGINIA DALTON, provided that should be predecease me, then I give and bequeath her share to her issue per stirpes by represen- tation, as provided herein. (E) Twenty-five (25~) percent thereof, in equal shares, to my nephew, KIRK HUGHES, my nephew, JOHN MICHAEL HUGHES, my niece, SHEILA RAIN, my nephew, JOHN DALTON, and my niece, LYNE MARIE DALTON, provided that should any of these specifically named nieces or nephews predecease me, I give and bequeath their share unto their issue per stirpes by representation and if there be a failure of same, then I give and bequeath such deceased niece's or nephew's share to my surviving nieces or nephews as set forth herein. THIRD: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give ~ options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without securit ) or Y conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate J and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- 2 arses, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. FOURTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, ~ which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be_ paid out of the principal of my residuary estate. "® y FIFTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. 3 SIXTH: I nominate and appoint my wife, JUDITH L. HUGHES, Executrix of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said JUDITH L. HUGHES, I nominate and appoint my brother, JOHN E. HUGHES, Executor of this, my Last Will and Testament. I direct that my Executrix or Executor, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this t3 day of °`-r 2004. l~.r /c}'~~{, Q~~bt ~~ ( SEAL ) R. BURTON HUGHES Signed, sealed, published and declared by the above- named Testator as and for his Last Will and Testament in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~-, Address Address 4