Loading...
HomeMy WebLinkAbout04-0313COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: ADDAMS WILLIAM A 19 BROOKWOOD AVENUE CARLISLE, PA 17013 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003749 fold ESTATE INFORMATION: SSN: 1 86-30-571 5 FILE NUMBER: ~0 _~_1- ©~- ~L~ DECEDENT NAME: HANN VICTOR BLAKE DATE OF PAYMENT: 04/01/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/24/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $12,500.00 ' F~EMARKS: SEAL CHECK//1454 TOTAL AMOUNT PAID: $12,500.00 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS DISCLAIMER BY BENEFICIARY TO: Victoria H. Reynolds Adnfinistrator Estate of Victor B. Hann 36 Sierra Vista Drive Monterey, CA 93940 For reasons that are satisfactory to me and are known to the other beneficiaries of the trust created by Victor Blake Hann, of 355 Wesley Drive, Borough of Mechanicsburg, County of Cumberland, State of Pennsylvania, as Trustor, by instrument dated August 2, 1996, I, Woodrow W. Reynolds, of 36 Sierra Vista Drive, City of Monterey, State of California, being over 18 years of age, do hereby forever renounce and disclaim any right, title, and interest of ~vhatsoever nature given to me by the provisions of that trust instrument. I declare that I will not accept, either at present or in the future, fi'om the Trustee of the Trust or the Trustee's successors, any portion of the income or principal of the trust estate or any interest therein which may be sought to be paid to me in accordance with any right, title, or interest which I had at any time before the execution of this disclaimer. It is my intention in executing this disclaimer to terminate my interest in the trust as effectively as would my death. IN WITNESS WHEREOF, I have executed this disclaimer on this r/'~ day of March, 2004. Woo~row W. Reynolds//~ Accepted this /'~r/ day of March, 2004. · >/.,/,_ . / , -.-~[~'.-~. t, ? / ' (-[C L.~,~,-,," v ~, . V~toria K. Reyh01ds ~ CO~dMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2] COUNTY CODE 04 00313 YBAR NUMBER DECBDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Hann, Victor B. 186 - 30 - 5715 tu DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ THIS RETURN MUST BE EILED IN DUPLICATE WITH THE o 01/24/2004 04/03/1902 ~ REGISTER OF WILLS IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER O0 [] I Original Return [] 2. Supplemental Return ] 3. Remainder Return (date of death prior to 12-13-82) ] 4. Limited Estate [] Futurelnterest Compromise of death 4a. (date after [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10, Spousal Poverty Credit (date of death between 12-3%91 and 1-1-95/ THIS SEC:[ ON MUST BE C~MF~EETED ~ ~ORRESP,,0~IE~E:~CE AND (~N~ £ lAME William A. Addams IRM NAME (If applicable) Hanft & Knight, P.C. ELEPHONENUMBER 717/249-5373 [] 5 Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 19 Brookwood Avenue, Suite 106 Carlisle, PA 17013-9142 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Modgages & Notes Receivable (Scheduta D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (1) None (2) 75,503.42 (3) Non~ (4) (5) 235 652.70 (6) Xon~ (7) Non~ (9) 16,032.68 (lO) 4,250.95 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/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) (11) (12) (13) (14) OFFICIAL USE ONLY 311,156.12 20,283.63 290,872.49 290,872.49 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) x .00 (15) 16.amount of Line 14 taxable at lineal rate 290,872.49 x .045 (16) 13,089.26 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x .12 (17) x .15 (18) (19) I3,089.26 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) De~edent's Complete Address: STREET ADDRESS CITY 3;~5 Wesley Drive Mechanicsburg I STATE Tax Payments and Credits: 1. Tax Due (Page I Line 19) 2. Credits/Payments A. Spousal PovertyCrodit B. Prior Payments C. Discount 3. InteresUPenaltyif applicable D. [ntarest E. Penalty PA [ZIP 17055 12,500.00 654.46 (1) 13,089.26 Total Credits (A + B + C) (2) 5. (5) )3,154.46 (3) 0.00 Total interest/Penalty (D + E) 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. (4) 65.2 0 Check box on Page 1 Line 20 to request a refund 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 (5A) (5s) 0.0 0 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; .................................................................................. I ~ [~ b. retain the right to designate who shall use the property transferred or its income; .................................... c. retain a reversionary interest; or .................................................................................................................. d. receive the promise for life of either payments, benefits or core? .............................................................. 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 decodent 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 IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. DATE 36 Sierra Vista Drive ? ]~ ~.~ ~-L Monterey, CA 93940 / R FILING RETURN ADDRESS DATE ADDRESS 19 Brookwood Avenue, Suite 106 Carlisle, PA 17013-9142 DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 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 0% [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 4.5%, 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 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF I-Iamb, ¥ictor B. FILE NUMBER 2! - 04 - 003 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM I VALUE AT DATE O NUMBER DESCRIPTION UNIT VALUE DEATH 1 A.G. Edwards & Sons, Inc. - Bond Account 75,503.42 TOTAL (Also enter on line 2, Recapitulation) 75,503.42 COMMONWF~LTH OF PEN N SYLVAblIA ~NH ERITANC E TAX RETURN RES~OENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Harm, Victor B. FILE NUMBER 21 - 04 - 00313 Include the.proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the r ght of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF ~NUMBER DESCRIPTION DEATH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 PNC Certificate of Deposit #31600220220 PNC Certificate of Deposit #3140022016 I PNC Certificate of Deposit #31500209781 PNC Checking Account PNC Savings Account Monterey County Bank Certificate of Deposit ;gl 06110 Monterey County Bank Certificate of Deposit #106208 Monterey County Bank Certificate of Deposit #106197 Monterey County Bank Certificate of Deposit #106169 World Savings Bank Money Market Account Coin Collection in Safe Deposit Box - appraisal attached Federal 2003 Income Tax Refund Bethany Village Refund Verizon Retired UNUM - Medical Insurance Sprint Refund 5,176.54 19,027.43 13,079.80 7,421.73 1,021.42 10,000.00 20,000.00 20,000.00 30,000.00 105,298.55 426.00 861.00 1,904.00 18.01 1,392.00 26.22 TOTAL (Also enter on Line 5, Recapitulation) 235,652.70 COMMONWEALTH OF PENNSY[.VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Ham~, Victor B. FILE NUMBER 21 -04- 00313 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 2 3 4 5 6 B. t. FUNERAL EXPENSES: Myers - Harvey Funeral Home Two Memorial Services Blooms by Vickery - flowers US Postal Service - mailing notices New Bloomfield Cemetery Association - opening grave Gingrich Memorials ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State __ Zip Year(s) Commission paid Attorney's Fees to Hanft & Knight, P.C. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees to Register of Wills State Zip Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Printing Memorial Programs Telephone expense from Califomia Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 7,597.00 1,355.00 63.60 125.53 350.00 110.00 3,000.00 15.00 437.76 68.45 2,910.34 16,032.68 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Schedule H ESTATE OF Harm, Victor B. FILE NUMBER 21-04-00313 Travel expenses for daughter and son-in-law and grandson from California Greenwalt & Co. 2,075.34 835.00 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Hann, Victor 13. FILE NUMBER 2l -04- 00313 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 6 7 8 9 10 11 12 Kaplan's Cleaning Pinnacle Health Bethany Village AT&T Verizon Dickinson College - pledge Sprint Maryland stamps and coins - appraisal PNC Service charge Silver Spring Ambulance PA Unemployment Comp. World Savings Bank - Service Fee 5.13 25.00 3,754.64 I0.07 2.93 250.00 11.34 75.00 20.00 90.00 3.84 3.00 TOTAL (Also enter on Line 10, Recapitulation) 4,250.95 SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Victor B. Hann 21 04 00313 FILENUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) 2o II. Victoria K. Reynolds 36 Sierra Vista Drive Monterey, CA 93940 Jeffrey Harm Reynolds 36 Sierra Vista Drive Monterey, CA 93940 daughter grandson 1/2 1/2 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET 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 (If more space is needed, insert additional sheets of the same size) DISCLAIMER BY BENEFICIARY TO: Victoria H. Reynolds Administrator Estate of Victor B. Hann 36 Sierra Vista Drive Monterey, CA 93940 For reasons that are satisfactory to me and are known to the other beneficiaries of the trust created by Victor Blake Harm, of 355 Wesley Drive, Borough of Mechanicsburg, County of Cumberland, State of Pennsylvania, as Trustor, by instrument dated August 2, 1996, I, Woodrow W. Reynolds, of 36 Sierra Vista Drive, City of Monterey, State of California, being over 18 years of age, do hereby forever renounce and disclaim any right, title, and interest of whatsoever nature given to me by the provisions of that trust instrument. I declare that I ~vill not accept, either at present or in the future, from the Trustee of the Trust or the Trustee's successors, any portion of the income or principal of the trust estate or any interest therein which may be sought to be paid to me in accordance with any right, title, or interest which I had at any time before the execution of this disclaimer. It is my intention in executing this disclaimer to terminate my interest in the trust as effectively as would my death. WITNESS WHEREOF, I have executed this disclaimer on this //¢' day of March, 2004. Accepted this /~ day of March, 2004. VICI'OR B IIAIIN TrEE wc~oe s ~u~# tv~ TeUST u/A om o81o21~ 36 SIERRA VISTA DRIVE MON1TREY CA 93940-&012 PAGEIOF3 You're invited to share our excitement as we begin a national rollout o~ our new look. On TueSday, Feb. 17, our Chairman and CEO Bob Bagby, Director of Sales & Marketing Peter Miller, and otherA.G. Edwards erep~oyees will participate in one o~the ~tock market's oldest traditions- dnging the opening bell of the New York Stock Exchange. Mark your calendar to tune your TV in to CNBC and celebrate with us. Also see the enclosed insert to learn more about our new look. ~4600 SILVER CLOUD COURT SUITE 2~ MONTEREY CA g39aO PHONE: (8:3~) ~-521 t (800) 947-5211 Toll Fr~ · Cash & MoneyFund [] laxable Bonds Net Cha~ge -4,512.84 :322.28 ..~..~0.H TOt*AL ACCOUNT VALUE $7S,503.42 Total' Banking Statement Activity Detail Deposits and Other Additions Daily Balance Detail Certifioatos of Deposit PNCBAN For th~ period 12/t812003 to 01/1S/2004 VICTOR B HANN LVG TRST Primary account nuo~ber: 50-7007-5297 Page 3 of 3 There was 1 Deposit or Other Addition totaling ~.17. -~'~- ~'~-----'~" --'~---'"-----~-- --'-"-- ~ ~ Utd 080296 \ /- Victor B Hann Living Trust Victor B Harm TIEE Utd 080296 3111n)221H61 I~M mdj(s)l:ixcdRale 02 1t;'21)I~3 1 i()!~' I~. OI i8~ _ I, Vi~or B Harm Lvg Total o~re~ v~e ~7,285.77 Toial Banking Statement PN(; lLmk For the psrlod ¶2/1~1~003 tG 0111512004 VICTOR B HAHN LV6 TRST UTD 080296 C/O VICTORIA HAHN REYNOLDS 36 SIERRA VISTA DR HONTEREY CA 93960-6012 4 PNCBAN( ~For 24-hm~r banldng, customer sel¥ice and interest rate informatlon~ sign-on to Account Link ~' byWeb on pncbank,com PO Box 609 Pittsburgh PA 15230-9738 ~Visit ~s at pncba~k.com Relationship Overview Bank Deposit Acoonnts 'l',md of 3 Premium Plan Interest Cheoking Aeoount Summary Account number: 50-7007-5?.97 hbnoe Summary %f*~(, 15 1o,616 31 12,291 1i3 Avafage .6.158 I Deposit ~alance 7,t2~ 73 1.02! .12 45,726,92 Victor B Harm Lvg Trst Utd 080296 Please see the Activity Detail section for additional information. Transaction Summary Interest i) Ao~ Debll Deposits end Other Addition. As of 01/15, a total of f},7~l irt interest was earned this year. There were 7 Deposits and Other Additions totaling '"t Time Certificate of Deposit Flnam~ial Institution: MONTEREY COUNTY BANK, MONTEREY BRANCH 601 MUNRAS AVENUE, P.O. BOX 1309, MONTEREY, CA 93940 Account Name: VICTOR B, HANN REVOCABLE LIVING TRUST U/D/T 08/02/96 OWNERgHIP TYPE: Trust Account Number tam~e Date I D~x~lt Amount Term M~urlty Date 106110 February 21, 2003[ $10,000.00 36 Months February 21, 2006 Rate Information: This Account is an interest bearing account. 3'ne interest rate paid on the entire balance in the account will be 3.30% with an annual percentage yiald of 3.30%. The interest rate and armual percentage yield will nut change for the term of the account. The interest rate will be in effect until February 21, 2006. Interest begins to accrue on the business day you dapccit noncesh items (lot example, checks). Interest will be compounded annually and will be credif~ annually. We will mail the interest in a check to you. Int.'est will be credited to you by mailing a che~k annually to 36 81ERRA VISTA DR., MONTEREY, CA 3940. The annual percentage yield assumes interest will remain on deposit until maturity. A withdrawal will reduce earnings. Balance Information: We use the daily balance n~thod lo calculate the interest on the account. This method applies · daily periodic rail to the pricolpal in the account each day. We will use an interest accrual basis of 365 for each day in the year. Limitations: You must deposit $1,000.00 to o~en this account. You may not make additional deposits into this account. You may not make withdraw~s from your ac~nt until the maturity date. Time Account Intorrnatlon~ Your account will r'n~ture on February 21, 2006. We reserve the r~ht to redeem the account At the descretlon of the icctitutiOn. If you withdraw any of the principal before the maturity date, we may impose a penalty of SIX (6) MONTHS INTEREST. This account will automatically renew. You will have TEN (10) DAYS after the maturity date to withdraw funds witho~q penally. Account Fees: The following fee app#es to this account: Photocopies: $2.00 each. )N TRANSFERABLE - NON NEGOTIABLE FDIC 106110 SSNnlN: 186-30-5715 TIME DEPOSIT AGREEMENT - 36 MONTH CERTIFICATE OF DEPOSIT We al~oreciale your de~ision to open a tithe deposit account with us. This Agreement sets forth c~tai~ ¢ondr~i~ns, r~tes, a.nd rules that are specific to your Account. Each s~nar acknowlodges that the Account Holder named has ~ilceff on deposit with the F~nenc~al institution the Deposit Amount ~n, dicated, and has agreed to k~p the ~nds on deposit un~l the Maturity Date. As u~ed in this Agreement, the words "you", "your" or "yours' mean the Account Holder st.the word "Account" means this Time Deposit Account and the word "Agreement" means this Time Deposit Agreement, ar~ the wo~ds "we", "us" and 'our" ~ the Financial Institution. This Account is effective as of the lesue Date and is vaJld as of the date we receive sredi~ for roncesh items (such as checks drawn on other financial institutions) deposited lo open the Account. Deposits of foreign currency will be converted to U.S. funds as ot the data of deposit and will be reflected es such on our records. INTERE~r RATE. The interest rate is the annual rate of interest paid on the Account whiCh does nut reflect compounding {"Interest Rate'}, and is based upo~ ~he interest accrual basis described above. AUTOMATiC RENEWAL POECY. if the Account will automatically renew as described above, the principal amount and all paid earned interest that has not been withdrawn will automatically renew on each Matu .ri.-b/ Date for an ktentical pedod of time es the original deposit te~n. Interest on renewed accounts will be calculated at the interest rate then in errect for time deposits of that Dedo~it Amount andtarrn. If you wish to wffhdraw funds from your Aouount, you must notify us during the grace period alter the Maturity Date. EARLY WITHDRAWAL PENALTY. You have agreed to kee~ the funds on deposit unit1 the Maturity Date of your Account. Any withdrawal of all or part of the funds from your Account prior to maturity may result in an early withdrawal penalty. We will consider requests fo~ catty withdrawal end, if granted, the penalty as specir~:l above will apply. Minimum Requlre~l Penalty. If you withdraw money within six (6) days after the date of deposit, the Minimum Required penalty is seven days' simple i~ters~t on the w[t~lre~vn funds. If.partial ead, y ..withdrawal(s) are permitted,.we are required lo impose the Minimurn Required Pena~ c.n the amount s withdrawn w~[h~n s~x (6) days a~er escl?.pertlal withdrawal The early w~hdrawal penalty may be more than the Minimum Required Penalty. You pay the early w~th.Jrawal penalty by furfeit~ng part of the accrued interest on the Account, It your Account has not earned enough interest, or if the interest has been paid, we take the difference frown the principal amount of your Account. Exceptions. We may let you wffhdraw mone~ from your Account before the Maturity Date without an early with0rawal penalty: (1) when one or more of you dies or is derermined legally incomperent by a court or other administrative body of competent urisdictio~ or (2) when the Account is an thdiv~Jual Retirement Account (IRA) established in accordance with 26 USC 408 and the i"noney is paid within seven (7) days after the Account is opened; or ~) when the Accoupt is ~, Keogh Plan (Keog/n, ifyou furtalt at least the interest earned on the withdrawn funds or (4) if the Account is an IRA or a I~eogh Plan esilbhshed pursuant to 26 USC 408er 26 USC 401 when you reach age 59 1/2 or become disaoled; or 5) within an applicab e grace pe iod (if any}. RIGHT OF SE-TOFF. Subject lo applicable law, we may exercise our right o seteff or secur ty nte est against any and all o! your Accounts except IRA, Keogh plan and Truer Accounts without notice, for any liability or debt of any o you, whether joint or individual, whether direct or contingen, whether ~ or hereafter pxisting, and whether ;~rising .from ove.rdraffs~ endorsements, guarantees loans, attachments, gam shmen s, eviss, attern~ys ree~, or other obtlgat~cns. If the Account is a J?nt or multiple-party account, each olnt or multiple-party account holder authorizes us lo exem~ea our nght of setoff against any and all Accounts or each Account Holder, OTHER ACCOUNT RULE~. The following rules also apply to the Account. AS~.urr~d ,m'` of I.nllru,m. enL Wa may require you to endorse and. surrender this Agreement to us when you withdraw f~rlds, transfer or close ~?~__r ~.co. unr. ~r ~/.o...u ~cc~ tnjs Agr~rnan. t, you agr~o al;p any affidawt of lost ;nstrument, or other Agreement we may require and agree to hold us arrr4ess ~renn ;~aom~y, prior to our honoring your w~thorawal or request. Death o! Account Holder. Each A~count Holder ;~grees to nc~if~ us immediately upon the death of any other Account Holder. You agree that we may hold ~ funds in your Account until we have received all redu~red documentation and instructions, Indemnity. If you ask us to follow instructions that we believe might expose us to any c a m, isbility or damages, we may refuse to follow your instructions or may require a bo~ld or other protection, including your agreement to indernn;fy us. Pledge. You agree not to pledge your Account without our prior consent. You may not withdraw funds from your Account until all obligations secured by your Account ere satisfied. ' Page 1 of 2 { Time Certificate of Deposit Financial thatitt~tlon: MONTEREY COUNTY BANK, M~ONTEREY SRANCH 601 MUNRAS AVENUE, P.O. ~OX 1309, MONTEREY, CA 93940 Account Name: VICTOR B. HANN REVOCABLE LIVING TRUST U/D,'T 08/02/96 OWNERSHIP TYPE: Trus~ I Issue Date 1 Deposit Amount Term 106208 Augusl 29, 2003 $20,000.00 60 Months August 29, 2006 Rets Information: This Account is an ~nterest beading account, The interes! rate ~:aid on the entire balance in the account will be 3~25% an annual percentage yield of 3,25%. The interact rate and annual percentage yield will not change for the term of the account The interest rate will be in effecl until August ~.g. 2006 interest iDol;ins to accrue on the business day you deposit noncash items (for example, checks) Inmrect will be compot~nded Annually a~'td will be credited annually We will n~il the interest in a check to you. thtereet will ce credited to you by maillrtg a checit annually to 36 SIERRA VISTA OR., MONTEREY , CA 93940. The annual percentage yietd assumes interest will remain on deposit ur,Iii maturity. A withdrawai w~l re(]uce earnit~gs. Balance Information: We uae the daily balance method to calculate the Interest on the account. This melhod applies a (tally periodic rate to the brincipai in the account each day We w[fl use ar~ interest accrual basis of 365 for each day ir* the year. Llmftetlona: You m~st deposit $1,000.00 to epee, this account. You may not make additional dei:~sits into this accounL You may not w~thdrawals from your account untii the matunty date Time Account Irltermetlon: Your accoul~t will mature on August 29, 2008 We ~e~erve the right to redeem the ~count At the desc~etic;~ of th~ i~titution. If you withclraw spy of the principal before the maturity clare, we may impose a penalty of SIX (6} MONTHS INTEREST This w*l~ automatically renew. You will have 'T'en (10) Days after the maturity ($ate to wl~draw funds withou'; Account Fee~: The fotlowin~ fee applies to this account: Photocop~s: $200 each. NON TRANSFERABLE - NON NEGOTIABLE 106208 SSN/TIN: 18-6305715 Maturity Date TIME DEPOSIT AGREEMENT OF DEPOSIT i.~ner acknowledges that the Account Holder las placed or~ the Financial th?.t~tu,t, lo? the.. De,?~_'it ~ed to kee? the t-u.n, ds (~ deposit until the Maturity Date, As used *, is Ag;ea,,ment, the words 'you, 'your or yours t~e wo~d ~AccoBnt ~ean$ t~is Time D.ep~.sit Acceunt and,the word A~Lreement' mean~ this ~T:rna Deposit Agreement, and th~ for noncash items such as chect(s drawn on ~the; financia/ institutions depeaited to open the Account Depos~ of foreig~ currency will be converted to L).S fuhds as o the date of deposit and wB be reflected as such no out records. INTEREST RATE. '~e interest rate is the annual ra~e of interest paid on the Account which does nnt re~ect comPOunding ("Interest Rate"), and is Minimum Required Penalty. if you withal;aw money within six (6) days after the date of deposit the Mioimum Required penalty is sever~ ~d~.,ys' simple interest c~ the withdrawn fuhds. Ifpartial early withdrawal(s) are permitted~ we are required ~o irr~ose the Minimum Req;Jired Penally Penalty. You pay the eatty withdrawal penal;y by forfeiting pad cf the accrue~ interest on the Account, If your Account has not e~rnad enough applicable grace period f any). ' Pape 1 of 2 J Time Certificate of Deposit Financial thatltulton: MONTEREY COUNTY BANK, MONTEREY BRANCH 601 MUNRAS AVENUE, P.O. BOX 1309, MONTEREY, CA 93940 VICTOR B. HANN REVOCALE LIVING TRUST U/D/T 08/02/96 OWNERSHIP TYPE: Trust 106197 SSN/I'IN: 186-30-5715 Account Number I~ue Data Deposit Amount Term MaturRy Date 106197 June 271 2003 $20,000.00 84 Months I. June 27, 2010 Rate Information: This Account is an interest bearing account. The interest rate paid on the entire paience in the account will be 3.05% w{th an annual percentage yield of 3,0~ The int~est rate and annual percentag~ yield will not change for the tei'm of the account The mterest rate will be in effect until June 27, 2010 Ir,t~rest begins to accrue on the business day you bebosit nonuash items (for example, cnecksj. Interest will be compounded monthly and will be credite~ monthly. We will mail the interest in a check to you Intereet will be credited to you by mailing a check monthly to 36 SIERRA VISTA DR,, MONTEREY, CA 3940. The annual perce~ltage yield assumes inleresl will remain on deposit until maturity. A wkhdrawal will reduce e~rnings. Balance Information: We use the daily balance method to calculate the interest on the account. This method applies a dai!y peried~c rate to the principal in the account each day. We will use an interest accrual basis of 365 for each day in the year, Limllationa: You musl deposit $1,000 00 to open this account. You may not make additionai deposits into ',his Account You may not make with~Pawais Item your account until the matority date. Time Account Information: Your account will mature on Jure, 27, 20 tO Wa reserve the right to redeem tr~e aecount At the descretion of institution. If you withdraw any of the principsi before the maturi~~ date, we may impose a penalt./of SIX (6) MONTHS INTEREST. This ecooun~ will autorrkatically renew. You wlll have Ten (10) Days after' the maturity date to withctraw funds without penalty Account Fee~: The following fee applies to this account: Photocopies: $2.00 each. NON TRANSFERABLE - NON NEGOTIABLE i TIME DEPOSIT AGREEMENT - 84 MONTH CERTIFICATE OF DEPOSIT re open a time ~ispoelt account ,~vis~ us. This A~raement sets forth certai[~ c~;lit~)ns, r?.e?, ~l~.rule.,s tna_t are ~ .l~ci,,fi~.' t? t keep the ~nds on d,r~osit unit! the Maturity Date. As used In. th~s Agra_tent, the wo~_.s you', "y~r" or yours" rqe~n ord "Account' meeos this Time Deposit Account and the word Agreement' rnea~,~ th~s ?me DeL~a~t Agreement, an~ thee for noncesh items (such as cheeks drawn on other fina;~cial institutions) deposited to open the Accot;nt. Deposffs et foreign currency will be INTEREST RATE. The interest rate is the anoual rate of interest paid on the Account v,,hicb does not reflect compounding iqntarest Rate':), and is AUTOMATIC RENEWAL POLICY. I If e Account w au omatica!ly renew as described ebov~ the pi[inclpal amoun ~ncl all paid. earned interest that has not been withdrawn will automatically renew on each Matur~y Date few an ~per~t~cm pe[iod of time as the ongmal deposit ~er~; Inie~s! on EARLY WITHDRAWAL PENALTY. You have aoreed to keep the funds on deposit until the Maturity Date qf your Account Anv w,thdrawal et all or part of the funds from your Account prior to nl~tunty may result in an eady withdrawal panetty. We will consider requests for early w~thdrawal and, if grantee, the penalty as specified above will apply. Minimum Required Penalty. If you witr, draw money within six (6 days after [he date of deposit, days' s*mple interest on the wal~rewn funds. It,~artiat early w~thdrawa{(s) are permitted, we am requirecl to impose on the amount s) withdrawn within six (6) days aner each partlal withdrawal. The early withdrawal penalty may, co more Penalty. You pay the eady withcirawal penalty by Iorfeiting part of the accrued interest on the Account. ~f your Account has not earned Excepltone. We may let you withd~,aw money from your Account before the Maturity Date without an early wi~trawal penalty: 1 when one or more of you dies or is determined legall~ incompetent by a cou~t or other administrative body of comdetant jurisdicticn; or (2) when the Account is an Individual Retirement Account (iRA) established in accordance with 26 USC 408 and the money is paid w,hin seven (7~ days after the Account is opened; or 3) when the Account is a Keogh Plan (K,,e~..h) ifyou fodeit at least the interest earned on the withdrawn funds; or {4 if the Account is applicable grace bedod (if any). RIGHT OF SEt'OFF. Subject to applicable taw, we may exercise our .ght et setoft or security interest agains an~., a~l all of you, Accounts (except whether ,now or hereafter existing, and whether ,~rising from overdrafts, endorsen~nts, guarantees, loses attachments, garnishments, ~vies, a[lomeys fees, or other obligatiolls, ~f the Account is a joint or rnultip!e-party account each joint or multiple-;:~rty account holcle~ authorizes us to OTHER ACCOUNT RULES, The fc41owing rules also app,y to the AccounL your Account. if you lose this Agreement you agree to slg~ any Affidavit of lost insfrumen, or other Agree nan '~ e may requ re, en~ agree to t~old us Page ? of 2 I Time Certificate of Deposit }- Financial Inltltuflon: MONTEREY COUNTY BANK, MONTEREY BRANCH 601 MUNRAS AVENUE, P.O. BOX 1309, MONTEREY, CA 93940 Account Name: VICTOR B. HANN REVOCALE LIVING TRUST U/D/T 08/02/96 OWNERSHIP TYPE: Trust Account Number leeue Date Deposit Amount I Term 106169 April 29, 2003 $30,000.00 J 84 Months 106169 SSN/rW: 186-30-5715 II~turlty Date April 29, 2010 Rate Information: This Account is an interest bearing account. The interest rats paid on the entire balance in the account will he 4.00% with an annual percentage yield (~ 4,00%. The inlerest rate and annual percantags yield w~l not change for the term of the account The interest rets will be in eitect until Apit~ 29, 2010. Interest begins to accrue on the business day you deposit rmncash items (for example, checks), Interest will be compounded ann[~aity and will be credited mc~nthly. We will mail the interest itl a check to you. interest wltl be credited to you by mailing e check monthly to 36 SIERRA VISTA DR., MONTEREY, CA 3940. The annual percentage yieid assumes interest will remain on c(eposif until maturity. A withdrawal wili reduce earnlngs. Balance reformation: We use the daily balance method to calc. uiale the interest on the account. This method applies a daily periodic rate to the principal in the account each day. We will use an interest accrual basis of 365 for each day in the yasr. UmttaUona: You most deposit $1,000.00 to open this account, You may not make edoifional deposits into this accounL You may not make withdrawals from your account until the maturity date. Time Account thl'ormatlon: YOUr account wilt mature on April 29, 2010 We reserve the right to redeem the account At the descretion of the institution, If you withdraw any of the principal before the maturity date, we may impose a penalty of SIX (6) MONTHS iNTEREST. This account will autcmaticalty renew You will have Ten /10) Days a~ter the maturity date to withdraw fuods without penarr~,. Account Feee: ';'ha following fee applies To this account: Photocopies: $200 each. NON TRANSFERABLE-NON NEGOTIABLE FDIC We appreciate your decision to open a time deposit account with us. This Agreement sets forth certain ccnd teens, rates, and rules that are specific to your Account. Each signer a, cknowiedges that the Account Holder namedhas pieced on d~pestt with the Financial Institution the Deposit Amount indicated, sod has agreed to Ke~p the funds on deposit until the Maturity Date. As used in this Agreement, the w~rds "yco". ",/our" or "vcurs" mean the Acc. ou~t .H.._c~. er(s~,the word "Accouof" means this T~me Deposit Account and the word "Agreement' rr~ans this 3'irn~ DepoSit Agreer~nt, and ~e words we, us eno our" mean the Finaccial thetit~i~. This Account is effective as of the Issue Date and is valid as ct the d~te we receNe c,'edit for n~Yash items (such as checks drawn on other finarc~,l institutions) deposited to open the Account. Deposits of foreign currency w~ll be converted to U.S, funds as of the date of deposit and w#l be reflec~K~ as such on our records INTEREST RATE. The interest rate is the annual rate of interest paid o'~ the Account which does not reflect compound ng (" ntarest Rate"l based upon ~ interest accrual baals described above. ' hAUTOM~, TIC R~NEWAL I~UCY, If the Account wil~ automatically renew as described above, the proc pa amount a;td all paid earned interest that as no[ osen w~rawn w~ll auton3etically renew on each Meturif~ Dote Ior an ]dentica pored of time as the origh~ai deposit term Inter~st on .r,.e?~e~_v_ ._ed__acc.o, unt. s_ will b? caiculet?:l a~ the Ir!to.rest .rate then in .e~ec~ fo~ time da[~(~its of that Deposit Amount end term II you wish th withdraw EARLY W~FHDRAWAL PENALTY. You have a~raed to keep the funds on deposit until the Maturity Date of yc~r Account. ,N4y withdrawal of art or part of the funds from your Accourit prior to maturity may result In an earty withclrawal penalty We w+~ consider requests for eady withdrawal ancO, if granted, the penalty as specified above will apply. , Mthlmurn Required Penalty. If you wi'J'~draw money within six (6 days after the date of daDos~, the Minimum Required pane y s sever (7) days s~mple interest on the withdrawn funds, If ~artial early withdrawal(si ara pem~it~ed.~, we are required to impose the IV~nlmum Req.~ired Penalty ?.n th.e. am.o. unt(s} withdrawn wi~ln six (6) days attar each pertiat withdrawal, The early withdrawal pane!fy may be more than the Minimum Requireo i-.enatiy, You pay the early withdrawal penalty by forfetng part of the accrued lnteras on me Account f your Account has not earned eno oh interest, or if the interest has bee~ paid, we take the difference from the ptincipa! amount of your Account. ' Exception)i. W.e rn~y let.you w~thdra, w money from yo~ r Account before the MaturJ~ Date without an early withdrawal pana~y: (11 ..~le~ one or .r??.o? y.o[ d!~s or i~ .derern'l[n ..ed_{..e~all¥ [n~o,m~tent by a court o~ other administrative body of cempetJ~nt iudepiction; or(2) when the Account is ~,~[~v..~3~e~r~e..m~e~.A~c..~c~,nt.(!HA)~sta?,so~ed i,n. acc~o, rd~.. nco .with .2.6 ~SC 4~8 ~nd the money is paid w~in seven (7) days after the Accaunt a ~;'.~, or a ~.ecgn P'lan established pursuant to 26 USC 408 or 2S USC 401, when you teac ego 59 1/2 or become disabled; or (5) withir~ an .~pptlcable grace pednd (if any). RIGHT OF SE-TOFF, Subject to applicable Iaw, we may exam se our rgh of setoff or ses~)rlty interest against any and al~ of your Accounts (except iRA, Keogh plan and Trus[ Accounts~ without notide, for any liability or debt of any of you. whether joint or individual, whether direct or contingent, awhelto~,~p?_w__or_ r~?~e_a_ft?r.,.ex~ting, ~n~.. whether .~rising from ov?.rd,refts, eodorsemen(s, ~u~rer~ees loans attachments, garnishments, eries, exercise our rl~nt or astor~ against any and all Accounts oreech Accoun~ Holder. ' OTHER ACCOUHT RULES. The fc~lowtng rules aisc ap~y to the Account. Sur/~ndar of thatnJmeet. We may require you to endome and surrender this Agreement to us when you withdraw funds transfer or close your Account, if y(~u ids? this Agrasm~it, you agree to sign any afl day t of os nsfrument or other Agreement we may require, ac~l agree to hold us r~rmiaea from tian~hty, pr~- to our honoring your withdrawal or request. D~a..~, of Account Holaer. F_~ch A~count Holder agrees to notify' us immediately upon the death of any other Account Holder. You agree that we may ~ ~ luods in your Account until we have received all required documen~tion and instructions. fndemnlty, tf you ask us to fbllow nst~uctions that we be eve might expose ~'~ to any c a m liability or damages, we rosy refuse to fo~idw your Pledge. You~gree not to pledge your Account without our priol' consent. You may ecl withdraw funds from your Account until ell obligations sest~red by your Account are seliafie(~ .... J Pa~}~ 1 of 2 WORLD SAVINGS ~ Our strength is your secudty. ~ WORLD SAVZNGS BANK, FSB MONTEREY J018 1050 DEL MONTE CENTER MONTEREY, CA 95940 ACCOUNTS INSURED TO LEGAL FOR INFORMATION CALL MAXIMUH BY THE FDIC (851) $73-$215 2 018 VICTOR B HANN LIVING TRUST V[CTOR B HAHN TRUSTEE 56 SIERRA V[STA DR MONTEREY CA 95940 PAGE 1 ACCOUNT NUMBER q2-565204-1 BEGINNING STATEMENT DATE 01-02-04 ENDING STATEMENT DATE 01-31-04 CHECKS ENCLOSED 3 Ill IIIII WORLD SAVINGS I~ANK UPDATE HIM BIG! ENTER HORLD'S ONLTNE BA~INO S~EEPS*FA~ES TO HZN & BIG ~REEN TV AND HONE THEATER SYSTEM, VEEN BALANCES AHO TRANSACTTOHS, TRAHSFER FUNDS BETHEEN ACCOUNTS, ORDER CHECK COPt'ES AND HUCH HORE. S~IEEPSTAKES ENDS MARCH 27. EOOq. HURRY! ENROLL TODAY AT HHH,HO~LDSAVTNG~.CC~NBZg III HI-YIELD INSURED MONEY MARKET ACCOUNT SUMMARY E~Z~ BALANCE I CRED~T~ I PAZO I DEB~ I Cl,lA/~ff~ 129.810.78 [ __ ~6~&,7~ J 141.26 I 31,GOO,GO ] o.oo SEQUENTIAL CHECK LISTING I~ER DATE /L~OUNT I NUflBER ORT~ -- AFd3UNT f NUMBER DATE MJ~T I 14JMBER 119 01-02 11.000.00 ! 120 01-0~ 11,000.00 I 121 01-07 9.000.00 DATE A,I~U~T. I ! I DATE 01 02 01 OZ 01 00 01 07 01 09 01 15 01 23 "I Oi 31 I OX $1 HI-YIELD iNSURED MONEY MARKET ACCOUNT ACTIVITY 11.000.00 CHECK 119 11.000,00 CHECK 9,000.00 CHECK 4~01~.07~ DEPC~T CHECK 110.00+ DEPOSIT CHECK 28.03+ DEPOSZT CHECK 96.67+ OEPOSZT CHECK MI-YIELD INSURED MONEY MARKET ACCOUNT INTEREST THE AlgAL PERCENTAGE YZELD EARNED FO~ yOUR ACCOUNT OU~ZNG THZ$ PER3OD HAS ZNTEREST PAZD YEAR-TO-DATE NDTE; 2003 ZNTEREST PAZD ON THZS ACCOUNT KAS $ E~036.95 BALANCE ~8,~10.78 103,433.8S XOS,6~.TS INFORMATION For recent ac:ivity on your checking account go to www.worldsavings.com today. If'you have a VVorld ATM Card or ATM/Check Card, call toll-Free 1-88S-BANK-WORLD (1-888~226-$967)~ And all Worid cus[omers enjoy around-the-clock access to World's current iqteres~ rates by callin~ 1-800-HOT-RATE (1-800-468-7283L Maryland Stamps & Coins Hei'i ian Most David Most 7720 Wisconsin Ave., Store #5 Bethesda, Maryland 20814 Phone (301) 654-8828 (301) 654-1900 (soo) 424-$7z3 Fax (301) 654-1923 April 29, 2004 SUBJECT: Appraisal of a Coin Collection ESTATE OF: Victor B. Hann FOR: Jeffery H. Reynolds "Personnel Representative The following is an Appraisal of a coin collection belonging to the Estate of Victor B. Hann, and is based on the current cash market value. 1) Half and Dollar coins (copper/nickel) which are worth the face value only. $53.00 2) 1995 Confederate two piece proof set issued by the US mint. $40.00 3) Two USA 1910 gold pieces ($2&1/2 face), in xfcondition. $290.00 4) George Washington Commemorative half dollar. $3.50 5) Misc. more modem currency valued at there face value. $36.00 6) Three each ofRonald Reagen commemorative coins (nickel). $3.00 7) Assorted wheat back pennies. .50 Total Cash Market Value $426.00 Appraisal Fee: $75.00 David Most SUPPLIES - WHOLESALE AND RETAIL - YOUR FULL SERVICE STORE Safe Deposit Box Inventory Safe Deposit Box Number Drilled - Date / / Rental Paid To Lessee Address Invento~ Drilled in the presence of the contents verified /I/ Place one copy with contents in sealed envelope. File One copy with lease agreement in Branch Office filc. Sealed envelope with contents placed in Safe Deposit Box Number BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLO#ANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-154? EX AFP (09-D4) NILLIAH A ADDAHS HANFT & KNIGHT 19 BROOKNOOD AVE 106 CARLISLE PA DATE ESTATE OF DATE OF DEATH FILE NUNBER COUNTY ACN 11-29-200~ HANN 01-2~-200~ 21 0~-0515 CUNBERLAND 101 Amount VICTOR HAKE CHECK PAYABLE AND RENZT PAYNENT TO; REGISTER OF gILLS CUH]~ERLAND CO COURT HOUSE CARLISLE, PA 1701:5 CUT ALONG THIS LTNE ~.~ RETATN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03} NOTICE OF INHERITANCE TAX APPRATSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCT/ONS AND ASSESSNENT OF TAX ESTATE OF HANN VICTOR ~ FILE NO. 21 0~-0:515 ACN 101 DATE 11-29-Z00~ TAX RETURN NAS: { X} ACCEPTED AS FTLED { } 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/Partnership Interest {Schedule C) (3) 4. Nortgages/Notes Receivable (Schedule D) (q) $. Cesh/Benk DeposA~s/Nisc. Personal Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/Adm. Costs/Nisc. Expenses (Schedule H) (9) 10. Debts/Hortgege Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Not Velu® of Tex Return 75~50:5.~2 .00 2:55~652.70 .00 .00 NOTE: To insure proper credit to your account, submit the upper por~ion .00 of ~his for. with your tax payment. .0O :511,156.12 13. lq. NOTE: (8) 16,0:52.68 ~250.95 (11) 20.283.~3 (~2) 290,872.~9 Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Sub,oct to Tax If an assessment ~as issued previously, lines 14, 15 and/or reflect flgures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. Amount of Line 14 at Spouse1 rote 16. Amount of Line lq taxable at Lineal/Class A rate 17. Amount of LAne 14 at Sibling re*e 18. Amoun* of Line 14 taxable at Collateral/Class B rate 19. Prlncipel Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUNBER INTEREST/PEN PAID (-) 0~-01-200~ CD00:57~9 65~.~6 11-ZZ-Z00~ REFUND (15) . O0 (14) Z90,87Z.~9 16, 17, 18 and 19 Hlll (1~) .00 x O0 = .00 (16) 290,872.~9 x 0~5= 1:5,089.Z6 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= 1:5,089.26 .0O AHOUNT PAID 12,500.00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 65.20- TOTAL TAX CREDIT I 13,089.26 BALANCE OF TAX DUEl .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CA): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 11, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class 8 (collateral) rate on any such futura interest. To fulfill the requirements of Section 21q0 of the Xnheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available online at mae.revenue.state.om.us, any Register of Hills or Revenue District Office, or from the Department's Iq-hour answering service for forms orders: 1-800-361-2050~ services for taxpayers with special hearing and/or speaking needs: 1-800-qq7-3010 (TT only). Any party in interest not satisfied with the appraisaent) allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object aithin 60 days of the date of receipt of this notice by filing one of the folIowing: A) Protest to the PA Department of Revenue) Board of Appeals. You may object by filing a protest online at wew.boardofappeals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid) you must receive a confirmation number and processed date from the Board of Appeals aebsite. You may alsu send a aritten protest to PA Department of Revenue) Board of Appeals P.O. Box 181011) Harrisburg, PA 17118-1011. Petitions may not bm foxed. B) Election to have the matter determined at the audit of the account of the personal representative. C) 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 Revise Unit) P.O. Sox Z80601) Narrisburg~ PA 171Z8-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (51) discount of the tax paid is allowed. The 15Z 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 mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of six (6X) percent par annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January 1, 1981 will bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through ZOOq are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor 1982 ZOX .O00Sq8 ~)'~'& - 1991 111 .000301 1983 162 .000~38 1992 91 . O002~7 198~ 112 .000301 1993-199~ 7Z .000191 1985 132 .000356 1995-1998 9Z .0002~7 1986 lOX . O00Z7q 1999 71 .000192 1987 101 . O00Z7q ZOO0 7Z .000191 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor Lr~"E[ 9Z .O00Z~7 ZOOZ 6Z .00016q 2003 SZ .000137 ZOOq ~Z .000110 X NUHBER 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 the Notice) additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE TAX ~', ~r-m~c ac INHERITANCE TAX TNHERZTANCE TAX B/V/SIGN ~.~F~l~r~ ~ATEHENT OF ACCOUNT HARRISBURG, PA 17128-0601 ~ ~ ~ ~ ~,j ~ ~L.~,r~J REV-1607 EX AFP (09-04) 2OOq DEC 29 AH 9:12 CLERK OF ORPHAN'S COURT WILLIAM A ADD~0~MS~co /'i','F' PO HANFT 8 KNIGHT 19 BROOKgOOD AVE 106 CARLISLE PA 17015 DATE 12-06-200~ ESTATE OF HANN DATE OF DEATH 01-2~-200~ FILE NUMBER 21 0~-0515 COUNTY CUMBERLAND ACM 101 Amoun{: Remi'l:~:ed VICTOR B MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To Ansure proper credi~ ~o your account, subeA~ ~he upper portion of ~his for. wASh your ~ax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -,eM ESTATE OF HANN VICTOR B FILE NO. 21 0~-0315 ACM 101 DATE 12-06-200~ THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAHED ESTATE. SHONN BELOW IS A SUMMARY OF THE PRINCTPAL TAX DUE, APPLICAT/ON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED TNTEREST F/GURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-ZZ-200~ PRINCIPAL TAX DUE: ........................................................................................... PAYMENTS (TAX CREDITS): 13,089.26 PAYMENT DATE O~-Ol-ZO0q 11-22-Z00~ RECEIPT NUMBER ""~CD0057~9 REFUND IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. /F TOTAL DUE 1S REFLECTED AS A "CRED/T" (CR), DISCOUNT (+) INTEREST/PEN PAID (-) 65~.~6 .00 AMOUNT PAID 12,500.00 65.20- TOTAL TAX CREDIT 15,089.26 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS. )