HomeMy WebLinkAbout11-03-08t o
15056051058
REV-1500 EX (06-OS) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 08 00153
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
202-20-5516 02/05/2008 10/02/1927
Decedent's Last Name Suffix Decedent's First Name MI
Matter Mrs Sarah ~
(If Applicable) Enter Surviving Spouse's Inforn-ation Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
• 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate ':' 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Shaun E. O'Toole (717) 695-0389
Firm Name Qf Applicable) REGISTER U$ WILLS USE ONLY _
("~>
First line of address ' -~ ;
401 North Second Street I
c:
Second line of address `
DATE AILED ~ '
City or Post Office State ZIP Code
Harrisburg PA 17101 ~
Correspondent's a-mail address: S@021 @COn1C2St.net
er p Wallies of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
is true, corcect e. claratio of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT RE PERSON S L F IL~ING RETURN ~ DATE
__ -
A DR - _ ! --
21 Pine Street, Harris rg, Pennsylvania 17101
SIG AT F PREPARE~yO THA REPRESENTATIVE ATE
- ~ ~-~~ 10 ~ 31 ~08
RESS
401 North Second Street, Harrisburg, Pennsylvania 17101
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
J
• •
J
15056052059
REV-1500 EX
Sarah J Matter
'
Decedent
s Name:
..
.
RECAPITULATION
1. Real estate (Schedule A) . ......................................... ... 1.
2. Stocks and Bonds (Schedule B) .................................... ... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3.
4. Mortgages & Notes Receivable (Schedule D) .......................... ... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... ... 5.
6. Jointly Owned Property (Schedule F) :Separate Billing Requested .... ... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested..... ... 7.
8. Total Gross Assets (total Lines 1-7) ................................. ... 8.
9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10.
11. Total Deductions (total Lines 9 8 10) ................................ ... 11.
12. Net Value of Estate (Line 8 minus Line 11) ........................... ... 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ..................... ... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0 15.
16. Amount of Line 14 taxable
at lineal rate X .0 _ 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE ....................................................... ..19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
Side 2
Decedent's Social Security Number
202-20-5516
203,451.28
374, 042.64
53,554.85
631,048.77
49,606.54
5,467.59
55,074.13
575,974.64
575, 974.64
0.00
0.00
15056052059
v ~
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 os 00153
DECEDENT S NAME DECEDENTS SOCIAL SECURITY NUMBER
Sarah J Matter _ 2.02-20-5516
STREET ADDRESS
325 Wessley Drive
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. CreditslPayments
A. Spousal Poverty Credit _ - __ _ _ _ _ __ _._
B. Prior Payments
C. Discount -
Total Credits (A + B + C) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total InteresUPenalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5g)
Make Check Payable fo: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :.......................................................................................... ^
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 care? ...................................................................... ^
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? ....................................................................................... ^ ^x
.................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX+ (6-98)
.. SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Matter, Sarah J. 21-08-0153
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
(It more space is needed, insert additional sheets of the same size)
Janney Montgomery Scott LLB:
March 20, 2008
John Killian, Attorney At Law
1064 Country Hill Drive
Harrisburg, PA 17111
Re: Estate of Sarah J. Matter
Dear Mr. Killian:
This letter is in response to your request for a Date of Death Valuation for the above
referenced account.
Please find enclosed the summary of assets held by Janney Montgomery Scott LLC on
February 5, 2008, Mrs. Matter's date of death.
Should you have any questions or require additional information, please do not hesitate to
contact me.
Sincerely,
Lisa J. Enders
Private Client Assistant
Enclosure
20 Erfc,rd hoad. Suite 315. Lemoyne. PA 17043-] 109 71 7.731.440(1 fax: i 17.731.441 I w~~~~:jntsunlinc.ctnn
Vrmber Ne•~. l'urk Stock Exchange, lnc. and uthrr principal exchanges
~1c•mher Srcurities Ineestor Yrutectiun Cutpuraticut
Estate of Sarah J. Matter
JMS Account #4685-0441
Valuation as of 2/5/08
Quantity Description Market Price Market Value
17
~ AT&T $36.73 $624.41
94 Idearc Inc. $15.40 $1,447.60
1,989 Verizon
Communications $36.83 $73,254.87
Total Account Value $75,326.88
Please note: This information is not the official record of the above account and is subject to changes, errors and omissions
cannot be guaranteed as to its accuracy or completeness. The printed confirmations and periodic account
statements constitute the official account record. This information is not a substitute for other important
information that JMS sends. The above may not be used for tax reporting purposes. JMS will send official tax
documentation regarding this account via mail.
X3/19/2008 05: 4d 717-545-1009 KILLIAN & GEPHART
Calculated Value of Your Paper Savings Bond(s)
Calcula#ed Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 02/2008
18.670.4
15.445.
Bonds: 1-51 of 51
PAGE 01
Page 1 of 7
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http://www.treasurydirect.gov/BGSBCPricc 2/l 4/2008
@3/19/2008 05:44 717-545-1009 KILLIAN & GEPHART PAGE 02
Calculated Value of Your Paper Savings Bond(s) Pagc 2 of 2
NA EE 5100 12/1982.06/2008 12/201,2 $50.00 $179.96 4.0090 ;229.96:
NA EE 5100 07/1983 07/2008 07/2013 $50.00 $143.96 3.62% ;193.96
NA EE $100 05/1983 05/2009. 05/2013 $50.00. $143.96 3.62% ;193.96
NA EE $100 03/1983 03/2008 03/2013 X50.00 $150..52 4.26% 6200.52. .
NA EE $100 11/1982 05/2008 11/2012 $50.00 $179.96. 4.00°6 6229.96
NA EE $100 11/1982 05/2008 11/2012 $50.00 $179.96. 4.00% ;229.96
NA EE $100 10/1983 04/2008 10/2013 $50.00 $140.00 4.18% X190.00
NA EE $100 06/198306/2008 06/2013 $50.00 $143.96 3.62% 6193.96'
NA EE $100 03/1984 03/2008 03/2014 $50.00 $132.28
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Totsis for 51 Bonds 3 225.00 15 445.40
NI Not Issued •
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PS .Includes 3 month interest penalty
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http://www.t~+caswrydiz~ect.gov/BC/SBCPrice 21] 4/2008
.03/19/2008 05:44 717-545-1009 KILLIAN & GEPHART
Calculated Value of Your Paper Savings Bond(s)
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 02/2008
00
8.00
8.
00
Bonds: 1-54 of 54
PAGE 03
Page 1 of 2
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$1,000:08/1986'08/2008 :
.. .
8/2016: _ $
00.00..
.-..
$500 00 $1,147.20
1,147.20
: 4.00%.
.00%' 81,647.20
...
$1,647.20°.
NA
_ _ ....., EE . $1,000 08/1986.,.08/2008
- 08%2016 ;
.••._• - _ -
8500 00
„ .... _
$1,147,Z0
~
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•.; •$1,000_:10%1986;04/2008. 10/2016 .
$500.00; •
,
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_,
4.00%: ,
~1614.80~
NA;
NA' EE
EE $1,000 01/1987,:0712008
$1
00Q
'
O1
19 01/2017
' X500, 00•_ $952.00:. " 4.00%; #1,452.00:
~"'
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,
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/
87 07/2008
$1 000:03/1987.03/2008.:
.. ~ ,._.. ....- - ~
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$923.60 4. 0.0%
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.
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00 091987_.03/2008
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12/2017. •, .
~500 00• $695 60„_,
$500 00 895 60 4 00%.,
4 00% ,
_81,395 60_
81395 60
http://www.treasuryditect.gov/AC/SBCPrice 2/14/2008
.03/19/2008 05:44 717-545-1009
C~.iculated Value ofYour Paper Savings Bond(s)
NA EE $1,000 12/1987 06/2008 12/2017
NA EE $1,000 12/1987 06/2008 12/2017
NA EE ;1,000 12/1987 06/2008 12/2017
NA EE $1,000 02/1989 08/2008 02/2019
NA EE ;1,000 02/1989 08/2008 02/2019
NA EE $1,000 02/1989 08/2008 02/2019
NA EE $1,000 02/1989 08/2008 02/2019
NA EE $1,000 02/1989 08/2008 02/2019
NA EE $1,000 0.2/1989 08/2008 02/2019
NA EE .$1,000 10/1989 04/2008 10/2019
NA EE #1,000 10/1989 04/2008, 10/2019
NA EE . .$1,000 07/1991 07/2008 07/2021
NA
EE ..$1,000 07/1991 07/2008 07/2021.
_
NA EE $1,000 07/1991 07/2008 07/2021
NA EE $1,000 07/1991 07/2008 07/2021
Totals for 54 Bonds
NZ .Not Issued.
.. ...,
NE Not eligible for, payment
P5 Includes 3 month Interest penalty _
MA ,Matured and not earnln Interest
http://www.treasurydirect.govBC/SBCPrice
KILLIAN & GEPHART
;500.00 $895.60 4.00°~
$500.00 $895.60 4.00°r6
$500.00 ;895.60 4.00°i6
$500.00 $841.20 4.00%
$500.00 $841.20 4.00%
$500.00 $841.20 4.OOa/o
$500.00 $841.20 4.00%
$500.00 $841.20 4.00%
$500.00 $84.1.20. . 4.00%
$500.00 $789.20 4.00%
$500.00. $789.20 4.00%
$500.00 $714.80 4.00%
$500..00 _ $714.80 4.00%
$500.00' $714.80 4.00%
.
$500.00.,...
., X714.80, . .
.
4.00%:
PAGE 04
Pegs 2 of 2
$1,395.60
$ i, 395.60
$1.,395.60
~ 1, 34 i. 20
$1,341.20
$1,341.20
$1,341.20,
$1,341.20
_$1,341.20
$1,269.20
i, 289.20
$1, 214.80
_ $1,214.80
~ i, 214.80
2/14/2008
03/19/2008 05:44 717-545-1009 KILLIAN & GEPHART
C`~aeulated Value of Yow Paper Savings Hond(s)
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 02/2008
zso.
Bonds: 1-25 of 25
56.00
160.
PAGE 05
Page 1 of ]
NA EE $500:.11/1962.05/2008.1,1/2012 $250.00: X899.80 4.00%. $1,149.80
NA EE $500 09/1982 03/2008. 09(2012 $250.00 $955.00 4.00°Ao jif205.00:
NA EE 5500 12/1982 06/2008 lz/2012 $250.00 $899.80 4.00% 61,149.80
NA: EE $500: 12/1982 06/2008 12/2012 $250.00 $899..,80. .
- 4.00°~' 61,149 80:
NA
..., EE _
~ 5500. 12/1982 06/2008 12(2012 $250.00 $899.80
. . 4.00% 1,149.80:
NA
...... . ....
EE _ _
...
5500.05/1983, OS%2008_ 05%2013:.
:. $250.00 ,
5719 80
3 6Z%: _
~i969.80:
NA, EE_ 5.50005/1983.05/2008 05%2013 :$250.00 $719.80 3.62% :.
X969.80
NA EE $500 ~ 04/1983 04/2008.04/2013 $250.00. _
.
, 5752,60.; " 4,26% $1,002.60:
NA
EE
$500;09/1982 03%2008 09/2012:
_.
$250.00
$955 00
4;00%
: _.....
$1,205.00
,. ,., .".. .,, - . $500:02/1983 08/2008.02/2013 $250:00 $899 80; .
4,00%. $1,149.80
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"
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$250 00 , ,,
¢899.80 _.
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~
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- 4 08°ib , ~9z8.00f
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02/2014
..
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.08% 92$.00
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09/2016
. _
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., .
, _ $557 40 .
.
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5500:09/1986.03/2008: 09/2016:
"
_ $250 00
_ , $557 40 _
,
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NA:
EE _ .,
5500 08/1986 08/7008.08/2016 ~
_ 5250.00 , •
_ $573 60 : _
-.
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.....
X823.60 ~
NA_
EE __
$500 07/1986 07/2008 07/2016
$250.
00
X573 60 _
4.00% _
6823.60
NA
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_ $500 04/1986:04/2008
04/2016 :
.
$250 00 ,.
$573 60 ..
4 00% __
. .
6823.60
NA:
---~ ~
NA EE
E _
$500; 03/1986 03/2008.' 03/2016
_.,.. _
- ~ , -~--
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_ 3573 60 0
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.
... ,.., .
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,..,"._..;._
__,500. 02/1984;08/2008__ 02/2014.,.
s0
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~~928.00
. ".. ......
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.,,,.",. _.
„~ .. 0 02~19t34 08/2008. 02(2014...
,, $250. 00;
. • $678 00 _
4 08°10 .
-..
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EE
$500.; 01/1984•; 07/2008 , 01(2014.
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$678 00 , , ".
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. ,
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,.,•„NA:_._
.
EE_._
---~~-
..500 12/1983.,06/2008 12%20.13_
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~ ,
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.
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. ........ EE
... .... . .
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$250.00 .
.,..
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4 08%0 "..
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Totals for T5 bonds $ 6,250.00 ;18,556.00 ~ ~ ~ _
.
.
.
'~~-• ~ •
~
1
NI :Not Issued
NE Not ell Ible for a ment ~ ~~ ~ ~~
.....
... .. .... .. p. Y.
P5 :Includes 3 month Interest ,enal
MA Matured and not earnln Interest
http:/h'vH'v~'•a'easuryditect.gov/BC/SBCP~tice . 2/14/2008
REV-1508 EX+ (6-98)
SCHEDULE E
p
CASH, BANK DEPOSITS
8c MISC.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ,
PERSONAL PROPERN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Matter, Sarah J. 21-08-0153
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Bank -checking account (xxx5484) 21,210.13
2. Halifax National Bank -checking account (129580910) 2,451.46
3. Belco Community Credit Union -savings account (43680) 5,546.01
4. Belco Community Credit Union -savings account (98110) 5,545.69
5. PNC Bank CD (xxx3796) 11,058.35
6. PNC Bank CD (xxx2311) 8,434.78
7. PNC Bank CD (xxx7895)) 11,130.65
8. PNC Bank CD (xxx7748) 11,156.41
9. PNC Bank CD (xxx4284) 107,750.30
10. PNC Bank CD (xxx9564) 10,896.83
11. PNC Bank CD (xxx4868) 4,926.61
12. PNC Bank CD (xxx1418) 7,221.18
13. PNC Bank CD (xxx7147) 14,003.11
14. PNC Bank CD (xxx7323) 4,076.60
15. PNC Bank CD (xxx6713) 10,724.85
16. PNC Bank CD (xxx1769) 10,803.01
17. PNC Bank CD (xxx1224) 10,819.65
18. Belco Community Credit Union CD (17729) 8,166.30
19. Belco Commnuity Credit Union CD (18065) 8,112.96
20. Belco Community Credit Union CD (18809) 6,072.60
21. Belco Community Credit Union CD (19832) 6,093.42
22. Belco Community Credit Union CD (34975) 6,093.42
23. Belco Community Credit Union CD (16845) 3,448.51
24. Belco Community Credit Union CD (17249) 8,442.25
25. From attached Schedule E supplement 69,857.56
TOTAL (Also enter on line 5, Recapitulation) E 374,042.64
(If more space is needed, insert additional sheets of the same size)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF:
Matter, Sarah J.
Belco Community Credit Union CD ( (#17420) $ 8,322.62
Belco Community Credit Union CD ( (#17572) $ 10,001.78
Belco Community Credit Union CD ( (#17633) $ 8,272.78
Belco Community Credit Union CD ( (#20159) $ 2,994.93
Belco Community Credit Union CD ( (#30579) $ 5,779.59
Belco Community Credit Union CD ( (#30589) $ 5,138.23
Cash
Refund: Bethany Village Aptment $ 23,944.00
Oppenheimer Distribution $ 2,800.00
Pension Check $ 733.76
Social Security Check $ 888.00
Refund: Health Insurance $ 276.58
Refund: West Shore ALS $ 705.29
FILE NUMBER
21-08-0153
$ 69,857.56
~ PNCBANK
John Killian
1064 Country Hill Dr.
Haz~risburg, PA 1711 !
February !4, 2008
Regarding Sarah J Matter
As of the date of Sarah's passing (February 5,2.008), the balance of her checking account (X7{XXXXS484) was
$21,210.13. !>; you have any further questions, please do ztot hesistate to call uae apt the number listed below) .
Thank you]
Sincerely
~ a~r)
~.ora Zinunerman
Banking Officer
Bramch Manager
PNC Banc
Union Deposit
7.717.652.5520
F.7! 7652.2489
A member of the PNC Finanaei SeMcp Group
www.pnct~ank.com
~PNCBANK
John Killian
1064 Country Hill Dr.
Harrisburg, PA 17111
February 14, 2008
Regarding Sarah J Matter
I have listed below the cds in, Sarah's Warne and there balance as of the day she pas:red (.February 5, 2008).
Interested is credited only once a month. If the interest was credited in February alfter the day Sarah passed it will
not show in the figures below. If you have any £urtkier questions, please do not hesistate to call zne at the number
listed below. Thank you)
xxxxxxx3796 ~ $11,058.35
xxxxxxx231 ] _ $8434.78
xxxxxxx7895 = $11,130.65
xxxxxxx7748 = $11,156.4 l
xxxxxxx4284 = $107,750.30
xxxxxxx9564 = $10,896.83
xxxxxxx4868 = $4,926.61
xxxxxxx1418 = $7,221.18
xxxxxxx7147 = $14,003.11
xxxxxxx7323 '- $4,076.60
xxxxxxx6713 = S10,724.85
xxxxxax1769 = $10,803.01
xxxxxxx1224 = 510,819.65
Sincerel
(,~ r~~rn~irl
Lora Zi~onrnerman
Banking Officer
Branch Manager
PNC Bank
A member of the PNC F~ngnclal Services Group
SS
www. pncbank. eom
. .
~n~
Iialifax Noti~ortal Bonk
3RD AND MARKET STREETS PO BOX A
HALIF=AX, PA 17032
PHONE: (717) 896-3433
www. halifaxnational.com
Sarah J Matter
~ Nelson L Beard
914 Lower River Road
Youngstown NY 14174
Account Number 129580910
Statement Date 1/15/08
Page 1
Effective February 1, 2008, the Halifax Drive Thru will close at
3:00 PM on Wednesdays.
TYPE OF ACCOUNT--Regular DDA
Statement Summary
Beginning Balance 10/16/07
Deposits/Credits
Checks/Debits
Ending Balance
0 Credits
0 Debits
2,451.46
.00
.00
2,451.46
0 C~
_3-26-20oa ruE a5: ~~ P~
.. ~,.
Ca®m~itp C~'ed$ U~Omi.
wwW.belco.of~p+
.~. ~; •r
:. ~;.
~•
~.
~,
• To'vVhonn It May concern:
KILLIAN & GEPHART
PAG
P~ UU 1
" _ ~ Here arc the values of the CD's, as of Febo~uary 5, 2008. in account number 043680, 4ttled
;' iua the names of Sarah J. Matterr and Harold E. Matter Jr.:
Cestificat~e Number: Value:
17729 $8166.30
i8o6s $sl 1a.96
1 ssa9 $6072.60
19832 $6093.42
34975 $6093.42
Here are the values of the GD's, as of pebruary 5, 2008, in account number 098110, titled
in the names of Harald E. Matter Jr. and Sarah J. Mauer.
Certificate Number: Value:
l,f>845 $344851
17249 $8442.25
17420 $8322.62
17572 $10001.78
17633 $8272.78
20159 $2994.93
30579 $5779.59
30589 $5138.23
If there are any questions, please feel free to contact me. Thank you.
Sincer?ely,
~l
Allison Shuff
Bich I.,oan Officer
Belco Community Credit Union
' ~ •403 N_ Second Sfieet
~' : Hancisburg, Pa 17101
~~ \ {717) 232-3526 e7tt 5659
fax: (717) 720-6276
`~`~, shuffa(~ belco.or~
.,
.:~
r . ~~.
~1ro~:C:ommuni}y`~t~dit Union
Ebenhdwgi Bh-d P6:'Box:B~`•r„\
Hdnisburg,. PA ~ 71'Q8.. .
717;t31~.526~iitHa~itbu~g'grecs `~`~•
800d42~1482ntigldE••.of.cadnp~ore6~'~:: ~ ~~` *`~
a ~•
~~ ~.~ L11V9 THU 0322 Pik
r £'
r..:`'5~~~tJ~'.
'xvwi.1701CO.Oll~ ~ .t
. i. '~~~
~j
.. ~;'~.
.. ,'%
r"
To Whom Xt May Concern:
KILLIAN & GEPHART
The value of account number 043680, titled in Sarah, Mattes' and Harold Matter 7r.'s
names, on l;ebzuary 5' 2008 was 55546.01.
The value of account numaber 098110, titled in the names of Harold Matter .Jr. and Sazah
Matter, on Febntary 5, 200$ was S554S.69.
If you have any questions, ploase feel free to contact me. T'hanac youl
Sincerely,
Utz
Allison Shull
Branch Loan Officer
Be1co Co~auanunity Credit Umion
403 N. Second Street
Harrisburg, Pd 17101
(717) 232-3526 ext. 5639
fax: (717) 720.6276
shuffa belco.o~
~,
•.~
..
_~ ~,
~,
Belcc corru~rinnty.~~edit unior+ .
149'Eisanhowec$Md:,{±(~B9ot&~„ .
Harrlsbtu~p, PA 1~1.Od ::_'~''; ~ ~'~
~. ,~ ~ ~.:
~.Y.~~-
717=232526 iR NcrtllbllfgrQOq.:.~ti:.~r ~ ~;-i. •~,
NC'J-6/~.2+4A62 OiAalde~'oFcanlig~~n~cf.'f,E;~i~:;~:~.
PAG
P. UUl
REV-1510 EX+ (6-98) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Matter, Sarah J. 21-08-0153
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OFTHETRANSFEREE,iHEIRRELATIDNSHIPTODECEDENTAND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
°~aOFDECD~S
INTEREST
EXCLUSION
QF APPLICABLE)
TAXABLE
VALUE
~ ~ IRA -Oppenheimer Strategic Income Fund (#002322321481964)
53,554.85 100 0.00 53,554.85
12,143.957 sh. @ $4.41/sh p
TOTAL (Also enter on line 7 Recapitulation) $ I 53,554.85
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Matter, Sarah J. 21-08-0153
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
~' Neumyer Funeral Home, Inc., 1334 N. 2nd Street, Harrisburg, PA 17102 8,512.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 20,000.00
Name of Personal Representative(s) John D. Killian
Social Security Number(s)/EIN Number of Personal Representative(s) 090-22-0721
Street Address 218 Pine Street
city Harrisburg .state PA Zip 17101
Year(s) Commission Paid: 2008
2. Attorney Fees 20,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State .Zip
Relationship of Claimant to Decedent
4. Probate Fees 830.00
5. Accountant's Fees
6. Tax Retum Preparer's Fees
~. Neumyer Funeral Home, Inc. -death certificates for deceased husband 54.00
s. Carlisle Sentinel -legal advertisement 190.54
s. Banking Charge -purchase checks 20.00
TOTAL (Also enter on line 9, Faecapitulation) $ 49,606.54
(If more space is needed, insert additional sheets of the same size)
March 12, 2008
~ni~~~ni~iii~~in~~~~ii~~~ni~
Shaun E. O'Toole
Law Office of Shaun E. O'Toole
2813 North Second Street
Harrisburg, PA 17110
Re: Oppenheimer Strategic Income Fund
Account Number 002322321481964
RPSS TR IRA
NELSON BEARD GDN
FBO SARAH J MATTER
UO JAN OS 07
Dear Mr. O'Toole:
OppenheimerFunds
Op~~enheimerFunds Services
A C~ivision of OppenheimerFunds,Inc.
P.O. Box 5270
Denver, CO 80217-5270
www.oppenheimerfunds.com
Thank you for informing us that Sarah J. Matter passed away. Please extend our condolences to
the family of Sarah J. Matter. We recognize that this is a difficult time for the family, and we
want to do all w~e can to ensure that the account changes are handled efficiently and accurately.
As of February 5, 2008, the total dollar value of the account was $53,554.85, based on
12,143.957 shares at a share price of $4.41 at Net Asset Value (NAV).
Our files show that the estate is the designated beneficiary to receive the benefits from the above
OppenheimerFunds-sponsored retirement plan. Before a distribution of the plan assets can be
made, we need the following documentation:
• Asignature-guaranteed Letter of Instruction from John D. Killian, signed in his legal capacity.
This Letter of Instruction must include a request to establish a beneficial ;account for the estate
and indicate the distribution option selected (see below). Signature Guarantee Instructions are
enclosed. Please note that notarization, Endorsement Guaranteed stamps., and "signature
compares favorably" stamps are not acceptable substitutes for a guaranteE~d signature, nor can we
accept signature-guaranteed documents via fax. Please reference our intE°rnal tracking number,
IDOC 105426613, in the correspondence to help expedite the request.
• A photocopy of the death certificate for Sarah J. Matter.
• A completed and signed Traditional IRA and Roth IRA Account Application, which can be
found in the enclosed IRA Account Establishment Kit, completed with the information for the
estate. Per the IRS regulations, we are unable to distribute from a decease°d individual's Social
Security Number. Please contact the IRS at www.irs.~ or 1-866-816-2065 to apply for the
estate's Taxpayer Identification Number.
• A completed and signed USA PATRIOT Act Supplemental Insert For ~~pplications, completed
with the personal information for John D. Killian. We have enclosed th~~ form for your use.
This is not required if we are distributing the estate account in full immediately upon transfer.
• A completed and signed Required Minimum Distribution Request Form, which is enclosed in
the provided IRA Distribution Form Instruction Booklet, if a distribution will be requested.
The following are the distributions options available for the estate as beneficiary of an IRA, one
of which must be indicated in the aforementioned Letter of Instruction:
1. The "Life-Expectancy" option, which is based on the effective age of the deceased shareholder
in the year of death.
2. A lump-sum distribution.
A determination of one of the above-referenced distribution options must: be received by
OppenheimerFunds on or before December 31 S` of the year following the year of the decedent's
death. The separate account must be established for the estate by December 31S` of the year
following the year of death. If the separate account is not established by this deadline,
distributions will be made over the life expectancy of the decedent. It is :recommended to consult
a tax advisor before commencing with distributions from a retirement account.
Once completed, please mail the required paperwork to us in the enclosed postage-paid reply
envelope. After we receive the required documentation, we will be pleased to honor the request.
If you have any questions or need additional assistance, please email us via the "Contact Us"
section of our website, www~.oppenheimerfunds.com, or call us at 1-800-CALL-OPP (225-5677).
We are available Monday through Friday from 8:00 a.m. to 8:00 p.m. Ea:~tern Time. We will be
glad to assist you.
Sincerely,
Customer Contact Center
OppenheimerFunds
The Right Way to Invest
Encl: IRA Account Establishment Kit
IRA Distribution Form Instruction Booklet
USA PATRIOT Act Supplemental Insert For Applications
Signature Guarantee Instructions
Postage-Paid Reply Envelope
ss
IDOC# 105426613
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Matter, Sarah J. 21-08-0153
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, includin13 unreimbursed medical expenses.
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (g-00)
F
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Matter, Sarah J. 21-08-0153
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Tnlstee(s) OF ESTATE
t TAXABLE DISTRIBUTIONS [include outrighi spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
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 MiaDE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 ~ I Smoky Mountain Children's Home (formerly Church of God Home for Children)
449 McCarn Circle, P.O. Box 4391, Sevierville, Tennessee 37864-4391
100%
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)
i - ~
OF
SARAH JANE MATTER
I, SARAH JANE MATTER, declare this to be my Last Will and
Testament and hereby revoke all prior wills and codicils made by
me.
FIRST: My Executor shall pay from the residue of my estate
all my debts, funeral and administration expenses and all estate,
inheritance, succession and transfer taxes impo;~ed by the United
States or any state, territory or possession w~lich shall become
payable by reason of my death. It shall not be necessary to file
any claims therefor, nor to have them allowed by any court.
SECOND: In the event my husband, HAROLD E. MATTER, JR. , fails
to survive me by sixty (60) days, I give and be~~ueath the sum of
Eight Thousdnd ($8,000.00) Dollars to my sister, I>OROTHY ANN JOHNS,
if she survives me, on the condition that she use a portion of this
bequest to pay for the removal of the mobile home located on my
property in which she now resides in order to facilitate the
eventual sale of my property.
THIRD: I give and devise the residue of my estate, real,
personal and mixed, of whatever kind and nature, and wherever
situate at the time of my death, including any property over which
I now have or hereafter acquire a power of appointment, to my
husband, HAROLD E. MATTER, JR., provided that h.e survives me by
sixty (60) days. If my husband, HAROLD E. MATTER, JR., predeceases
J •
LAST WILL AND TESTAMENT
OF
SARAH JANE MATTER
me or is not living on the sixty-first (61st) day after my death,
I give and devise the residue of my estate to the TRUSTEES OF THE
CHURCH OF GOD HOME FOR CHILDREN, Box 391, Sevierville, Tennessee,
IN TRUST, the income of such trust to be used for educational
purposes to benefit the children residing in such facility.
FOURTH: I nominate, constitute and appoint my husband, HAROLD
E. MATTER, JR. , Executor of this my Last Will <~nd Testament, to
serve without bond or security, and to make distribution of my
estate in cash or in kind, or partly in cash and partly in kind,
and in such manner as he may determine. I authorize, empower and
direct him to sell and convey, by good and sufficient deed, in fee
simple estate, any and all of my real estate, at public or private
sale, for such price or prices, upon such terms and conditions, as
in his judgment is best for my estate, and to ghat end to sign,
seal, execute, acknowledge and deliver all deeds or other
instruments necessary therefor, as effectively as I could do if I
were personally present.
In the event my husband does not survive me, or refuses to act
as Executor or does not complete the duties of Executor, then I
nominate, constitute and appoint JOHN D. RILLIAN, ESQUIRE, as the
alternate Executor, to serve without bond oz- security. My
alternate Executor shall have all of the powers, privileges, duties
and immunities granted to my Executor as provided herein.
2
1• •
LAST WILL AND TESTAMENT
OF
SARAH JANE MATTER
FIFTH: No beneficiary shall have the pow.=r to anticipate,
encumber or transfer his, her or its interest in. my estate or any
trust created herein in any manner. No part oi= any trust or my
estate shall be liable for or charged with any debts, contracts,
liabilities or torts of a beneficiary or subject to seizure or
other process by any creditor of a beneficiary.
IN WITNESS WHEREOF, I, SARAH JANE MATTER, tree Testatrix, have
to this my Last Will and Testament, set my hand and seal this ~j
day of ~~~~', 1998.
"~ ( SEAL )
SARAH J ~ MATTER
Signed, sealed, published and declared by the above named
Testatrix, as and for her Last Will and Testament, in the presence
of us, who have hereunto subscribed our names ai. her request, as
witnesses hereto, in the presence of the said Testatrix, and of
each other. The preceding document consists of this and two (2)
other consecutively numbered typewritten pages.
residing at ~
residing at ~ `J CL
3
.• •
ACKNOWLEDGMENT
CONIl~IONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
SS..
I, SARAH JANE MATTER, the Testatrix whose name is signed to
the attached or foregoing 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 it willingly and
as my free and voluntary act for the purposes tYierein expressed.
Sworn to or affirmed and acknowledged before me by SARAH JANE
MATTER, the Testatrix, this ~ R.p day of lggg,
Notarial Seal
Jody Lynn Crist, Notary Public ~
Harnsburg, Dauphin County
My Commission Expires Oct. 1, 2001 T tatrix
Member. Pennsyivania Association o Notaries
(SEAL)
N i
Attorney-at-Law
AFFIDAVIT
'~ Notarial Seal 1 t rig S S
{{ Jody Lynn Crist, Notary Public
I( Harnsburg, Dauphin County
~ A4y Commission Expves Oct. 1.2001 ~/l/~'~
s
+~9~mber. Pennsylvania Association of otar es ,
Witn
(SEAL)
No y lic
or
Attorney-at-La~n-
COMMONWEALTH OF PENNSYLVANIA
SS..
COUNTY OF DAUPHIN
We , ~ ~V~nl ~~Prm~~ e,~~, and 1 C h, 1 T ~ 1 Ca ,
the witnesses whose nam s are signed to the a tached or foregoing
instrument, being duly qualified according to l~~w, do depose and
say that we were present and saw the Testatrix sign and execute the
instrument as her Last Will; that the Testatrix signed willingly
and executed it as her free and voluntary act for the purposes
therein expressed; that each subscribing witness :gin the hearing and
sight of the Testatrix signed the Will as a wit~zess; and that to
the best of our knowledge the Testatrix was at thi:~t time 18 or more
years of age, of sound mind and under no constraint or undue
influence.
Sworn to or affirmed and subscribed to before me by
~ ~N C>~m ~ te.SV and ~- p_,(c.~ C ~- -TT lt' ,
witnesses, this ~~~ day of .~a3-p, 1998.
~~-