The URL can be used to link to this page

Home My WebLink About11-13-08 (2)15056051047 REV-1500 EX (OS-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes ~, County Code Year File Number Po Box z8osol INHERITANCE TAX RETURN ~ I ~ ~ ~ G ~ Harrisburg, PA 17128-OS01 µ. RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Date of Death Date of Birth Decedents Last Name Suffix Decedents First Name MI J'(1 ~ Q `T t t~t ~ u' ~ {~ H (If Applicable) Enter Surviving Spouse's Information 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 O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 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 Firm Name (If Applicable) First line of address ~-- S C,. tv~ M t '~ ~ ~ Second line of address City or Post Office ~ ~ LLS~c~QG- State ZIP Code ~~ j ?o REGISTEf~Q~ WILLS USBf~JLY <-l r.. ~~ -- - - ~ - _ '~7 ~ . G? _. , ~.~ - - -- --J I~i4TE FILED ~~ Correspondent's a-mail address: V ~ ~ ~'T' ~` V ~~ C.~vY`~ ~~'~~ ~ E-r N Under penalties of perjury, I declare that I ve examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Decla tion f preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONS L FOR FILING RETURN DATE ~ ~ L~ ~~- ~7- ~ ~ ADDRESS SIGNATURE OF PREPAR ATIVE ~ DATE ADDRESS L 15056051047 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 ~~ 1 J 15056052048 REV-1500 EX 1 "-C 1 ~S ' ~ ~~ ~ ,` ~ ~ 2 ' ~ ~ ~ ~ ~ ~ ~ Decedent s Name: I - RECAPITULATION 1. Real estate (Schedule A) . .......................................... .. 1. . 2 k h l B St d B d S d 2 ~ ( ~ `Y b/ ~ d a . s an on ) ........................... ......... oc s ( c e u e .. . ( 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. 3 T ~ ~ l ~ . 6. ±ointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers ~ Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. S ~1- ~ ~ ~ ~ . 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. ~ ~ ~ (: L{ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. , ~~ ~ ~ ~ ~ -] X 12 Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. i ~ ~ ~ ~ G J~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which > ~ ~ ~ ~' ~ ~% ...................... an election to tax has not been made (Schedule J) 13. .. - J . 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. ~~ ~ ~ ~ ~ . TA)C 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 ~ l 1 -1 ~--~- ~ ~ ~ `~ 17 ~ 7 ~ ~ ": ~ ~ . at sib ing rate X .12 . ( . 18. Amount of Line 14 taxable at collateral rate X .15 • 18. • ~7 ~~ ~«~ ' 19. TAX DUE ....................................................... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056052048 15056052048 RE'J-1500 ~X Page 3 File Number Decedent's Complete Address: ~-I - ~~~- ~7 ~ `f ~ ULIiLU~iV I J IYnIVIL ~ ~~-~~ N ~ ~ ~-~-~ STREET ADDRESS CITY STATE `~'~ ZIF ~ C-ci-tAk~CSr~~ti2G- 'I '~ I ~~.5~ Tax Payments and Credits: ~ jj 1. Tax Due (Page 2 Line 19) (1) ~~ 3 ~ ~-. l 2. Credits.%Payments A. Spousal Poverty Credit B. Prior Payments ~- (a o b ~ ~ ~ n ' I .3~~.3,~~ C. Discoun~ ~ Total Credits (A + B + C) (2) ~~ ~j ~ ~. 3. InterestlPenalty if applicable -~ D. Interest E. Penalty Total InterestlPenalty (D + E) (31 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 ~ is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ ~ , ~ ~3 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) ~L(, ] 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 :......................................................................................... . ^ 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 care? ................................................................... .. ^ 2. °f death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consitleration? ................................................................................................_.......... .. 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? ...................................................................................................................... .. ^ ,~ 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 Juiy 1, 2000: The tax rate irnposed 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, er a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate irnposed 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 ?2 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to cr 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 EX+ (6-98) t~ v '~~~X.~° COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~~~~~~~ STOCKS & BONDS ESTATE OF FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUME3ER DESCRIPTION OF DEATH ~~. ~ ', ~ , L°. I S C,,, ~ ~. 'f" ..~ '-~ i~ , r ~ / I ..... .n./ / C.. .ti .~ 1'~ .. ~ ~"..• ...- , ~ ~" ~, r^°' bay "~ ~.a... i f ri `.J ~, -, ,.. ~( ~ _, _r y } T ~ ~ Y ~; ,,. _ ~ 4~ -~ ! S L~~~ ~ ~. ,,W ,, - ~, ~-! F, ,.ter ,~ ~ .,-- r ; __ '~"'G~ c~.~...~` ,~ ~ ~ , . ~ ~ ~ . ', N t ~3- ~ ~ C ~: , ~' ~- .. -~ ~ j ,~ • ~ , ~,~~. r ~- ~~ , ~~ <r ~ -- ,~ f i.= ,--. ~~ v ,. ,. r- s ~ ~, S y C_ ~, ~A ~ _ r. ~~, ..t - ~ ~ i`~ ~c. ~ `~-- ,, ~,~~ „ ,,-- j ,~ TOTAL (Also enter on line 2, Recapitulation) $ ~ 4~ (If more space is needed, insert additional sheets of the same size) REV-7508 EX. p-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8c MASC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF ,. FILE NUMBER II Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~ I..._ (ti ~_k t ~ "kv..la.'. _.. ~ I CJ i« ~ l ~, 4 _..~ ~ .; +-~. '~ ~ Z ,(~ ~ j ~ r v. ~~ ~ / i to <- , ':'~ .~.. ~i i r ,. ,.-,.... .^-~~ r r 11 I /' ~ 1.!` ~,a. , ~ ~, ~> ~. __~ ~ ~ ^1 r,~_ C- .~ ,~~ ! ? ,_~. ~__ ~~ ~'N e` ~: ~, r~. ' ~ ~ I ~ ~ ~`z `? <~ ~ ~'' ~( ,..~ art-'-~ , (1~ ~-.~b. \E / / 7 ~, /~" ,;~,_C2ES,-~ I~I~~~ _- ~(~~lo~ _ a , ,-. P, ~ , C'' >, .:; ~ _- `- !:; , ° °. 1 to ~~ H. ' . _ ) ., r---- /" .°--- ~ r ~., r , ~- ~ ,. ._,.,_. _ .~..- ~ - ~ ,,~ ~ ~ a a . , . f' ~ ^, ~. %u: .. ._ < < __- ,, ... - . ... , --~ .. ~ c. ~~ _ ~~ - F~--. ~ /y,~ ~~ ~ ~ . ' t. ~ a a '~ .~ (~ '.,.~, `/ ~,~( 3`~ ~#-e. ~"'"~", y~ .^y ,'~,,. °*~k': y ~? ;°„r`,,,,, rte'' ~ ,' .... ~ ±~ ~~' ^/ _. ~ ~ ( _ P .~ -- .~ y _ _~ ,~. }.~ _. > 1!i~, "'r l -J.- ~~~ "1 ;:? ~ I r ;;^t\ '~ ` ~~r-.f\ 4?~: Y'!~ 1~ l_. .~~ ~ ~-r ~~ ~~ ~ {r ,~ J i TOTAL (Also enter on line 5, Recapitulation'( $ ~ -' ~~ ~"" E ~`~ (If more space is needed, insert additional sheets of the same size) REV-1508 EX t ~ 1-9?) ti f ~ COMMONWEALTH OF PENNSYLVANIA INFIERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY , ~ ~ FILE NUMBER ESTATE OF yy Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. .~ ~' ( ~'. j ~ -. ~~..-,. .-1- ,~'f~- .rff ~ / ._ ° .i--- j ~:-1 m,, 1" ,f4... \ n f ~- ~'~ ;r-F:- ~J C.I~; _ `I -? _~ *' ~,_._, ~ -. ~7 ~ < 4 ~, ... G» " (~., lr- . ,~ _ ~, , ~ ~ ~ 'mil 4- p ~' ~r `. twl.:- a t~'; W.-~ ~~t M ~ '~ ~"`~ ,I/~ ~'u ~_` ~t' C"~ ` ,~- ! y -~ ,~ „., ~, 1 ~~~...~. ~~. ~ y ~ ti G- lip. 6': ~'~r, .... ~`4 ~_ ~'~h .. ~ ~ ... ~ ~ '"' ~~~ .. " %" _ (`- ~ ~ c,~.a ~,. ~ ~~ c °nn In ~ S _ _ . i .. TOTAL (Also enter on line 5, Recapitulation) ($ :~~ l ~~, ~~ ~ ~~"~ ~ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(1006) t ~~~~ ~ COh4MONWEAI_TH OF PENNSYLVANIA FUPIERAL EXPEPISES & INHF_RITANCF TAY RETURN A,DMINISTR2ATIVE COSTS RF=SIDENT DECEDENT ESTATE OF FILE NUMBER ; ~. Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: - ;, ~. ,y`" e. 1 2 3 4. 5. 6. 7. y /~ ,} ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal P.epresentative(s) Street Address City Year(s) Commission Paid: State Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City ___ State __ Relationship of Claimant to Decedent probate Fees Arcountant's Fees Tax Return Preparer's Fees ~- I +• _ ~, ,_ r-- - ~._ _. ~,- .. :-- S~s, .d_.. i. ~' ,.;; ~ ~ __ _, ~.. y r1 ,_ ~ -_ Zip Zip ,..~ ;~:" if=~,'7J .}` .--' I y~ ~,fi. -~> _.7 ~- ~~-, . L-r' .4, , TOTAL (Also enter on line 9, Recapitula!ion) $ ~ I ~~ ~ ~ ~~ (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) ~. SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~~~ FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] °" L' 7 i ~. .~ _:.- ~. a r t ~ ~ i <.,.-. ~,~, ~ ,,.. .,. ~~ ~ ~._ a, ~~- ~ ~., Gs~- ~, -a '~ 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 ~._-. ~,,' '_' 1. - •- - ~~ ~ M ..., ,, .1 , ~ ,~ .~.; ..~ ~. %~ •J TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ ~ '~~ ~~ g~ (If more space is needed, insert additional sheets of the same size) t t,'~~ ~~ SI~HWAB Account Statement Retain for Your Records Statement Period: May 1, 2008 to May 31, 2008 Last Statement: Apri! 30, 2008 Schwab OneC) Account Going paperless is easy. Log on [o: Account Opened m: 1999 Account Number: 5962-6939 www.schwab.com/estatements Page 1 Questions? Call 1-800-435-4000 3005-CN5D2105-013737-SML-170199589001323496 RUTH H MARTIN ~....._.. CIO VERNON MARTIN M~s~w~eiw 12 SUMMIT DR DILLSBURG PA 17019-9589 .~~. Account Value Summary Cash & Sweep Money Market Funds $ 0.00 Investments $ 0•.00 Total Account Value $ 0.00 0 .1 W V W V J Change in Value Summary ~ Starting Account Value $ 145,135.93 °~"' Transactions & Income This Period $ (149,588.31) ..~.. Income Reinvested This Period $ 0.00 Change in Value of Investments This Period $ 4,452.38 Ending Account Value $ 0.00 ..,.~. Change in Account Value Since 1/1/08 $ (158,305.39) ^~^°~- ....~,. .°~.~... ~~ Transaction Detail Settle Trade Date Date Transaction Description Quantity Price Tota( Cash Activity 05/21 05/21 Funds Paid CLIENT REQUEST NETCSH $ (149,588.98) 05/21 05/21 Credit Interest SCHWABI INT 04/29-05/20 0.67 Investments Activity 05/19 05/16 Sold SCHWAS TOTAL STOCK MARKS (955.9440) $ 24.7500 $ 23,634.61 T-INVESTOR: SWTIX 05/21 05/16 Sold AGILENT TECHNOLOGIES INC: A (427) 34.8210 14,830.53 °~ 05/21 05/16 Sold HEWLETT-PACKARD COMPANY: HPQ (2,240) 47.2000 105,670.85 0 05/21 05/16 Sold VERIGY LTD F; VRGY (52) 21.4000 1,074.$4 ~ w 04;'29 through 0;5/28: $0.67 based on . 164% average Schwab One interest rate paid on 22 days in which your accounf had an _ ..-~ ~--- -- y average daily balance o($6,526.31. ~ .. ,•- - ~ ~~ ~ ' ~ S : ,. 7 o _..-------- __"~ ~~ o Income 5ummar ~~. Description t Federally Taxable Schwab One Interest $ 0.67 $ 8.85 Cash Dividends ~ 358.40 Total Income $ 0.67 \ $ 367.25 c~004 Charles Schwab & Co., Inc. All rights reserved. Member SIPC. CRS 22640 (0001-0386) STP10479R2-03 (12/04) CN5D2105-07:3737 323496 ~51'(] Distribution Confirmation S4L00003=1 RI_K-BLK1PA01 VERNON M MARTIN EXEC RUTH H MARTIN ESTATE 12 Sl1MMIT DR DILL`.iBURG PA 17019-9589 BLACKROCK .Statement Date 05/19/2008 Your Investment Dealer METLIFE SECURITIES INC '101 ERFORD RDSTE200 CAMP HILLPA 17011-1802 Dealer Branch 6235 PA-56L Rep Number/Name 56L4831 /KRISHINGNER, DAVID Account Assistance 1800) 441-7762 from Sam-6pm EST Mon-Fri. Personal Account Activity Hf~H YIILID BCiND-CLASS A BHYAX Fund N~: 0123;_; .Account No: 002803276 i Trade Transaction Share Number of Shares Total Number Date Transaction $ Amount Price This Transaction of Shares 05/19/08 New Act Transfer In 0123-5002491131 118.60 $7.56 1,470.714 1,470.714 05/19/08 Redemption -$11,166.07 $7.56 1,470.714 0.000 Accrual ._~~ 123,0 13LK-13LKIPA01 SII 5 1 31 34 6235 PA-56L 0028032761 0 RUTH H MARTIN Certificate of Deposit ACCOUNT NO: 1010788675 CAPITAL ONE BANK (USA), N.A. Statement Period: 01/01/2008 - 05/01/2008 At a Glance geyinninc3 balance as of 01/0172008 $ Deposits and other additions (less interest) $ Interest earned $ Withdrawals and other deductions $ Ending balance as of 05/01%2008 $ Interest Earned Year-To-Date Transaction History Deposits and other. additions (+) 01/18/2008. INTEREST EARNED 02/15/2008 INTEREST EARNED 03/18/2008 INTEREST EARNED 04/18/7.008 INTEREST EARNED 05/01%2008 INTEREST EARNED Total Deposits (+) Withdrawals and other deductions (-) 05/01/20(.)8 W/D NO f ENALTY ESTATE OF RUTH H MARTIN ST8C C_/O VERNON MARTIN, JR., EXECUTOR Total Withdrawals (-) Direct Banking Pagelof1 Account Access • Check rates • Access your account balance • Obtain other ar_count 35,051.05 information 0.00 638.35 Visit: 35,689.40 wvvvv capitalonedirect.corm O.UU -~ -. '~ or call 1-888-810-4013 i " ';.. 638.35 ~ ~ ,~ Specialists are available: _`_~,~ ~ Monday - Friday 8 a.nl. - 8 I:~.nJ. __. ___._. _-_._..._ and Saturday 8 a.m. - Z p.m. EI $ 145.5F, $ 146.18 $ 137,29 $ C~8~ $ 638.35 $ 35,689.40 $ 35,689.40 r---- ~ - (,r. ~ ~ ~~~ .- _. - ~~" `~.; - 1 ;~ ~. _.- {'~l-„ 1 -, i.~ Capital Une, N.A. Capital Une [lank (USA), N.A. Direct Banking RUTH H MARTIN Certifir_ate of Del:~osit Page 1 of 1 ACCOUNT NO: 1010458983 CAPITAL ONE BANK (USA), N.A. Account Access Statement f ~riod: 01/01/2008 - 05/U1/2U08 .._-- - ___. __. ... -- -- • Check rates _ _. _ . .. _ _ ....... . .. .. . . __ • Access your accorlnt L~alance • Obtain ether aCCOUnt At a Glance geginniru3 balance as of 01/01/20(18 $ 59,600.05 inforl7~atiol~ Dep~~sits and other adrii(ions (less interest) $ 0.(10 Interest earned ;~ 1(115.1G Visit: Withdrawals and ot.lrer dE:drrctions " $ (10,615.21 www.capitalc:>nf°direct.con~ Endine3 balanr_e as c>f 05/(:) 1/2008 $ .0.00 _-_ ar call 1-888-810-4013 't--- In(eresl Earned Year-To-Date $ ` 1,015.16 - ._._____-- Specialists are available: Monr.lay -Friday 8 a.ni. - 8 L~.ni _. -- ._ __ _..__. _._ __ ----. _ __ __..: _ __ _.. aria Saturday 8 a.ni. - 2 p.m. L=1 Transaction History Deposits and other additions (+) 01/03/2008 I~ITEREST EARNED $ 208.40 01./01/2008 INTEREST EARNED $ 20).12 03/03/2008 INTf_RES~f EARNED $ 196.30 04/03%2008 INTEREST EARNED $ 21(1.54 I~ ;,, ~'~ -."S ~c ~ ~~ 6 `~ " 05/(11/)_008 INTERf-.ST EARNED $ 190 .8( 1( ~ ~ ; ~ Total Deposits (+) $ . 1,01 6 ` Withdrawals and other deductions (-) 05/01/2008 UIi/D NO f [NALTY $ 60,615.2'1 ESTATE Of RUfH H MARTIN STSC C/O VERNON MARTIN, 1R., EXECUTOR Total Witf~drawals (-) $ 60,615.21 r~- ~ - ~~.. ~ ~ ~ - .. , „- :~ 's F ' ~ ~' Capital One, N.A. Copilal One Eanl< (USA), N.A. Direct Banking RUTH H MARTIN Cc_•rtificate of Deposit ACCOUNI~ NO: 1010294889 CAPITAL ONE BANK (USA), N.A. Statement Period: 01/01/2008 - 05/01/Z0 i7t a Glance geginnin~ balance as of 0'1/01/2008 Deposits and other additions (less i Interest earned Withdrawals and other deductions Endiny balance as of 05/01%x008 Interest Earned Year-To-Date Transaction History Deposits and other additions (+) 01/30/2008 INTEREST EARNED 02/29/Z008 INTEREST EARNED 03/28/2008 INTEREST EARNED 04/30/2008 INTEREST EARNED 05/01/2008 INTEREST EARNED Total Deposits (+) Withdrawals and other deductions (-) OS/0"1/2008 W/D NU PENALTY ESTATE Of- RUTN H MARTIN C/O VERNON MARTIN, JR., EXECUTOR Total Withdrawals (-) Payelof1 __.. _ _ .. __ . _ _.__ _ __ Account Access 8 ...__-.. __._...__ . _~_ ___.__ _. _-- • Check rates _---_. .......... _.. __... _. • Access your account balance • Obtain other account $ 51,744.14 information terest) $ 0.00 $ 857.91 Visit: $ $ 52,602.05 U 00 www.capitalonedirect.com . _ ' ' or call 1-888-810-4013 $ i , 1 857.91 ~ ,~' Snecialistis are available: `~`-------'~ Monday -Friday 8 a.rm. - 8 L~.ri. _._ _... _ ___ 0 - n and Saturday 8 a.rm. - 2 p.rm. ET STSC $ 2`I 4.89 $ 208.81 $ 209^65 , ; $ ~7.,~0.~~ J ~ : ~ $ 857.91 ~--~-----`." ~~~"~~ '1~ ~.~a.,~ $ 57_,602.05 $ ~Z,602.05 -- !' ~ `~` ~ i' -- ._„_ ~. - ~ ! - ~_., ..S-... < - ~ q . ( ~ - ;, r- ::-..( __._ ~ ~..~..~.____-_-,.. s % ~ r ;~ .~ Capital One, N.A. Capital Une Bank (USA), N.A. rni~ iN~nrrrn ~ Countrywide Bank CERTIFICATE OF DEPOSIT Country~~de Bank ACCOUNT NUMBER P.O. Box 1422 Alexandria, VA 22313-1422 1600015618 Customer Care (800) 601-1218 ACCOUNT TITLE ADDRESS ACCOUNT TYPE RUTI-I H MARTIN Certificate of Deposit 710 OAK OVAL MECI-1ANICSBURG PA 17055 ~~ 1. __ AMOUNT ~ ~`~ "~~ $20,271.47 ,,~'' ~ , ~ ISSUE DATE ' yi13i2oo6 '!^ MATURITY DATE ` - ~ ` 9/13/2010 TERM 48 months INTEREST. PAYMENT FREQUENCY Monthly INTEREST PAYMENT DISPOSITION Annuial Percentage Yield (APY) /Interest Rate _. ("~~~~ f 02% l h h Pa to account y rats o This account will earn interest at arrannua _.5. w ic _.- (APY) of 5:15%~Ttre APY results in an Annual Percentage Yield . assumes the interest earned remains~m tte account for one year. AGREEMEPJT Your Certificate of Deposit is governed by additional deposit account disclosures that have been given to you as part of the account opening process. These disclosures include the terms and conditions that govern this account, including early withdrawal penalty information. All terms defined in that agreement have the same meaning as those specified here. ~}1(' %I ~ r- , ~ ~~3,~`~ ~:..f ~i~.~~' ~~~.~ ~a ~ ~7 1, ~.{. '7 'x: ~ ! ~ ~. MEMBER 'pL l ~ C~ "~ , !~~~ _ ,~ -- - 4W' q ~ ~ d ai~;_~rsss lir ~.~- c;.~l.le~t~ci: managers Distribution Confirmation May 15, 2008 Page 1 of I TH-000008-A13-A131PA02 Estate ofi Ruth H Martin C/C- Vernon M Martin Jr, Executor 12 Summit Dr Dil.lsburg PA 17019-9589 Questions about ,your account? Call our Investor Line at 800.548.4539 Monday -Friday 8:00 am - 8:00 pm EST or visit us at; www.managersinvest.com Transaction Detail by Fund Registration Fund Name Vernon i\~t ~~lartin Jr Exec Ruth H Martin Estate Managers Fremont Bond Transaction Transaction Date Descriution Vernon M Martin Jr Exec Ruth H Martin Estate 12 Summit Dr Dillsburg PA 17019-9589 Account Number: 0002599702 rand Number Account Number 407 0002599702 Number Shares Share Price 05/15/08 Redemption 2,78E"ill $10.67 $29,676.59 --- Accrual $53.71 - - i' ~ ~ 'L~~ % 2U. h ~ ~'~ ~ Lea C P+-^~ -5-- -h_e, ~~/:... c S A13-A131PA02 TH 5 l 12 0 1.00005 000 0002599702 12 0 N!H WaMu° P.O. BOX 2437 CWATSWORTH, CA 91313-2437 20090245 R'.UTH H MARTIN C:/O VERNON MARTIN 12 SUMMIT DR C)ILLSBURG PA 17019-9589 This Statement Covers From: 04/01 /08 Through: 06/30/08 Need assistance? To reach us anytime call 1-800-788-7000 or visit us at wamu.com Your Certificate f3f ®epo~it ®etail Information RUTH H MARTIN Account Number: 989-1010747-0 Washington .Mutual Bank, FA Current Term Information Beg'~inning of Term: 0812812005 Term: 36 Months Maturity Date: 0812812008 Your Account at a Glance Beginning Balance $43,169.19 .~ Interest Rate Withdrawals -$43,560.49 ~~~ YTD Interest Paid Deposits +$391.30 ~YTD Interest Withheld Ending Balance $0.00 ~3.84 % ~1 $801:5~-''...~i $0.00 Date Description !~ .Withdrawals (-) Deposits (+) 04/28 Interest Payment ' $140.63 05/28 Interest Payment $136.54 06/23 Interest Payment ~ $114.13 06/23 Total Payoff ~~ $43,560.49 f .~ !: ~~~-~TEr,:.~F sue-- ~~z-i5 - ~/ I ~'~.~ b' 1 ~-~, ~~ ~ 1 ~~3~s ~1 ~sl ~~6 VR~-~- ~ I a _` ~'~~-3~~~ rC~'e~ ~c ~k S~ ~'~cE~J~v YOUR CERTIFICATE OF DEPOSIT STATEMENT --___-- I-----' ~~ ~~ ~,`~/~ ~~~~D• ~ u 0 -S-J'1 Page 1 of 1 Deposits are FDIC Insured LENDER 7782 0003 NNGR 001' 07 30 063008 PAGE 1 of 1 COLR737C 7253 3200 OlAA7782 20090245 9 fl ~ T ~ Date: 04-28-08 Account: 1 6000119518 NEXITY BANK P.O. BOX 43600. BIRMINGHAM, AL 35243-3600 Telephone: 877-738-6391 ~ ~ ~ ~ I ~ ~ ~ ~ ~ ~ ~ ~°®~ ~ R E RUTH H MARTIN VERNON M MARTIN JR POA C/O VERNON MARTIN 12 SUMMIT DRIVE DILLSBURG PA 17019 FINAL STATEMENT ROTH OR TRADITIONAL IRA SMALL STEPS NOW CAN .MAKE A .BIG DIFFERENCE LATER. START PLANNING NOW FOR YOUR RETIREMENT. MONEY MARKET ACCOUNT 6000119518 (RUTH H MARTIN) SUMMARY Balance Last Statement 03-31-08 $104,871.85 Number of credits 1 $136.67 Number of debits 1 $105,008.52 Balance This Statement 04-28-08 $0.00 TRANSACTIONS Description Debits Credits Date Balance Balance Last Statement 03-31 $104,871.85 INTEREST $136.67 04-25 $105,008.52 CLOSING WITHDRAWAL $105,008.52 04-25 $0.00 Balance This Statement '` ,,~_ fs * * * Continued * * * 13 ~, C~ ~ . ;~_- 04-28 $0.00 wvvvv.nexitybank com NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION. Senior Checking Plan Account Statement PNG bank ,PNCBA~IK Primary account number: 50-8003-0543 Page 1 of 3 For the period 04/09/2008 to 05/07/2008 Number of enclosures: 0 c H RUTH H MARTIN ~ For 24-hour banking, and transaction or 12 SUMMIT DR ~ inCerest rate information, sign on to 'r,:' PNC Bank Online Banking at pnc.com. DILLSBURG PA 17019-9589 For customer service call 1-888-PNC-BANK between the hours of 6 AM and Midnight ET. Para servicio en espar5ol, 1-866-HOLA-PNC Moving?' Please contact tls at 1-888-FNC-BANK ® Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 Visit us at pnc.com TDD terminal: 1-800-531-1648 for hearing in,pau ed clients only ~w - - _ _ Sometimes bigger dreams t~equire larger loans. With highly competitive rates incl. low dovt~tt payments, we can oCler more moltgage options and better financing solutions. Whether. yyou'te shopping (or a new primacy residence, a second. home, or considering a t~:linance, we can tailor a jumbo mortgage that Tits your big plans perPcctly. I~or 1\lote Information: > Visit your local PNC Bank b<<znc1, > Visit pncntortgage.com > Call 1-800-773-6C7S senior Checking flan Ruth H Martin i ~tegular Checking Accouint summary Account number: 50-8003-0543 Balance 'summary Beginning batance I O,Ci 1.~i Ali Deposits and Checks and other other additions deductions 1,024.51 9,254.25 Average monthly balance G,~83.<l`3 Please see the Activity Detail section for ~ additional information. Endin~ 1 '0- balance (`~..~ i '~ uW 2,283::12 ~..~,- ~ \y .1, Y ~~ "Yj~ Ch s ~ ,,, n--~ , and fees .on Transactiion Summary ~' ~~ . ; - Checks paid/ Check Gard POS Check Card/Bankcard withdrawals signed transactions POS PIN transactions ~ , ~ ~^ 6ti ~ Total ATM PNC Bank Other Bank / ~ ;°t >"1 ~ / < ~ transactions ATM transactions ATM transactions - tw `- ___.,_~-~_,__.,~_._---- %~ ~- Activity Detail ;~-~- _ _ Deposits and Other Additions Date Amount Description 04/29 1 U.00 Refer Tu 1\faker Rett.n•n. Gk 000000000001 G39 Effective 04-28-03 ' 01/30 1,O1~LCi l Direct Deposit - Anrntit:ant. PA Treasury Dept YXX~CYXXXYXXl05=} There were 2 Deposits and Other Addition totaling $1,024.51. FORM953R-ti ORIGINAL 499'] ~J~1 ecu-uec~~aurie.~ ~~~~ FEDEAATE- .~0. ,.' ~` ACCT. NO. ~ ~~ Funeral Services -.. ~ . Nerne o~ Deceasad ~„r L~CHECK#_____.._~_ _ '-! cReDiT COCKLIN FUNERAL HOME, INC. CARD ---------------- '~_~ OTHER ---------- ~ ! ~ ~~~~,,~~ - Y V Y/ --` -- f -flu-.<~ ~~'~f.:,</ '~,'" ~ LAST BALANCE $ r'~~~j/~ '" J -- I ~~ INTERE51- ~- I I~I~ LASE PAYMENT L_J CIS- A_RGE _-- _ . _ i sus rora~ ~ - -:-_ -i- LESS PAYMENT ~~7 tg^ ~~ ~~ "" J NEW BAi.ANCE ~ ~_ l.~' ~ ;.~ ~ „' ~~ ...~- ~/ '- 02581 ~ ~ 79, s( i ..., l 7 1, ~ ._ w ... F~~ ~ ~ I r' _ 1, "~~~.Q READ: ~ ~ _. ,_.. t~~J~ 1 t, ~:~;. REV nxcs COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS +n141 IN n, u~NPI~ CERTIFICATE OF DEATH ,~`~"''"'N" (See Inslructlons and examples on reverse) STATE FlLE NVMBER __ __-__ ____ oa Cr•.Neae ne.rn 2\IC oie.ren ceMiaq 2k to to Celt d my bewtadge, deal mvned r M prtw, daro aM Pena sblM. IS'7waa rd Ipel 2J6. theme NumEer 2Jt. Deb Sgbd IMerm, M Rat) - P'n'ema b rM arwT.da r Ime d deep b ~ _ ~ ales d dta. nwre 2t-fi mm Ct unlpMaO h person 21. Tone d Daadl 25. Deb Pnrqurcetl Oeed Ibwdl. dai• RM 26. Waa Cn Rthrted b Me6ry ELxiw I Cworln r b I Ream Ollw pm Gemeum v Ma1omT - do Plma.l~. anei : s'O P• Mi M. C~ /S ~ 0 ^ r° ~"6 n ~ ~, -. - - - .. - - - -.... - - _ -- . - -, I .,.,,.__._........~. awn P. Pail t Enbr M {~ ~l+y®! - dfaelea. njaba, a wlplolkre -M dnN/ urswl M ben. DO NOT Mer rornlW Harp fudl n wdc ener, poet b Dash Iledvsbry armt w verpinLY Ibrdabl wkp! sMrlg Rs eEdopt. !bl mfr am ulna m sea kM. bnluatee+meaeDDml~aval~ M ml h M ~9 a^aalMhO ulna yNel h Pit L 10. lea IWdC9 Uae Ddlleinae b Deep1T ^ 7u ^ Ro4Hr \ ~ w I ~ ~^a"^ n deelCl ->. . ~JS~~P Ps ,s., t 2a. i E.rw~ Doe Iw ea a Ke dl. ^ Nd m,yri wlr, ca Tew ~ s.v...atd. bl R Sllble, i +^f, b ~-~ 5~/'~eQ(~fiL~ ~PJ'/L[r~Cei. - r.a~ b M arras blwl m be e ^ Rpat r rl. d e..m . Entr En VNDERIYMG CAUSE b la ss a mmplArce all: ^ Nd pegletl bt pegwi earl 12 dba Ida~.aae a .Ij.y tee Yaialed he e.wp naNy n deehl UST. t d dpq, pn b a n e mrneprrcs d1: 1 ^ Nd laagwi. w weyeee u awe b l w.w d ' Colors daft ^ Udtben i prepwt eli'il h past Ter '~ Ina alu n heWaT ParbmeRl ]LL- Wen NpnT Fetkga llcablb Pdrr b Lonpebl Ji. atrelef d DeMI ~ Jta Deb d aMaT Rimdr. dry, ReI) 72C. Dearab flew w}tT QnerM R Oalu BWdr4 at ISyedrl e0. FerbrT. d (' d DeehT L.JA°"'• ^ 11°d'ide -i ^ ~ ~b ^ Ytl "^ !b ^ IcLwi ^ PeMrq Iweahrem 12d ~ d ar,.T J2a. MdurJ r Wak7 ]21, i TlwaporMlm kllr! 15Ddd'JT 72q luilbn d MeT Gael. dry! lent rebl ^ Se We [] CNd Nd b Dabmiiad ^ Yea ^ M ^ Odaw / Doerebr ^ Pa~9w ^~aabl Al [M+r' ~beo7 JJa CeM' n Idea mlr wnl JJe. sT~laaa• rd Tel. d c.rdbr . ~ CwdlTl^9 PhRkbn IrnraEvn qrr fr9 une d de0r wMn Mlw pM4d~ w PnrwwecM daaM aM tmTealsd Hem nl . A ' , 7D dro bnidmT bbwkdye,brhttNrted due bdn eetaMsl sad nrreroruabaN..________________________________ ^ _ /~. JV~ _ • Pronolwdnq wrd lnlryalq perakm Inn+den eth pro,nntly dbn.d rrxNtlq ro w.r d aaaml Te Dn bM d mT bbwledge, dlela dttaated M Rw Mrn, dale. eM plea, end dw b dw twreelsl eM mrxw r ebted_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . lkerw NunCw J]1. Deb Slgled Moral, .tart • realt« Eawnmer / ermw On dro !rob d arnbedm rod l a YtaaaDU MIM deetlt eeeurred M dM dlrn dal eeO h eM M M A l d d ^ /~f ~-3 3 O' 3 / 0 4 / G- t , p aq e. ece, e n rw.slel en a7 Pp w b I mwlnw n ebb _ J/. Noma aM,aMroa d Prom Ydb forrpeled Crone d Dever ' T I . 15. Reysbef' SfNaet Yd Uukl ~ G ]B. Dale Fhd IMmal. . Rer) s ~ 3 n/ Qi S / ..ST~PFE T~~ ~. ~ ~ .aG 1~. ~~c.._ - ~, _ _ C~'r--P J' cJ pKh,,,;,,oPermdNO 009267.8 STATE= OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA EARNER STRASBAUGH Register for the Probate of Wi11s and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that= on the 24th day of April, Two Thousand and ~;ight, Letters TESTAMENTARY in common form were granted by the Regist=er of_ said County, on the estate= of RUTH HMART/N late of UPPER ALLEN TOWNSH/P (First, Middle, Lastl in sa.i d county, deceased, to VERNON M MARTIN JR (First, Middle, LasU and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office a t CARLISLE, PENNSYLVANIA, this 24th day of Apri 1 Two Thousand and Eight. File No. 2008-00466 PA Fi 1 e No . 21- 08- 0466 Date of Death 4/15/2008 S . S . # 195-26-3258 Register Of Wills NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL WILL ~,~ ,_,^ ~.. OF ~~ ~' - . -i ~ ~w - ~ ~- R UTH H. MARTIN - ~ '~ ~ ' --- r-n rv ~:,-, c~ c ,-o -- I, RUTH H. MARTIN, currently of Upper Allen Township, Cumberran'~ CourrLy, =~ `~ Pennsylvania, declare this to be my Last Will and Testament, hereby revokirr~'any and~ll `' ' `- prior Wills and Codicils made by me. I. I direct that all my just debts and funeral expenses be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate and inheritance taxes that may be assessed in consequence of my death, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath as follows: A. Twenty-one and one-fourth (211/4%) percent unto my sister, Esther M. Heisey or her issue per stirpes; B. Twenty-one and one-fourth (211/4%) percent unto my brother, Clarence James Martin or his issue per stirpes; C. The remainder unto the Brethren In Christ Foundation, Grantham, Pennsylvania, to be used as it determines best. IV. I appoint Vernon M. Martin Executor of this my Will. In the event that he fails to qualify or ceases to act as Executor, I appoint my sister, Esther M. Heisey, Executrix of this my Will. V. I direct that no bond be required of my fiduciary for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, RUTH H. MARTIN, herewith set my hand to this my Last Will, typewritten on two (2) sheets of paper including the attestation clause and signatures of witnesses, this 5'f-~' day of eJ c.~_ , 2007. ~~i` SEAL) RUTH H. MARTIN Signed by RUTH H. MARTIN, by her declared to be her Will in our presence, who have hereunto subscribed our names as witnesses in her presence and at her request, this ~" da of dJ ~-~.- , 2007. ~, residing at L~~i~,7~/~~ "/ ~. ~~Y.~ ~~ c ~ ~= '`~• .f f :, .t,~~ residing at ~~ .~''2.t. -~F>. ,J i -2- COMMONWEALTH OF PENNSYLVANIA COUNTY OF t-~~/k~ C} WE, RUTH H. MARTIN, GERALD J. BRINSER and IAA-T1~ ~ ~ . PE`I~~S , the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witnesses and that to the best of our knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ,' ~ ~ ~~ RUTH H. MARTIN ~--` TNESS _ ~ ~-~ WI ESS,~~f Subscribed, sworn or affirmed and acknowledged before me by RUTH H. MARTIN, the testatrix, GERALD J. BRINSER and K-g-7I-{ y ~ . ~c~1~S ,witnesses, this ~ day of ~~.~-~- , 2007. .ill (SEAL) tart' Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL WENpY L. CRAWFORD..Notary Public Palmyra Boro., Lebanon County Commission Ex fires Se tember 10, 2009 -3- ~ - t 1 y ~ j~ ^ n !! ~ .'" M ` y ~~ • ~ ' # ~ I ~~ ~ ^. _ - , ~ } I ~ f ~ I ~ y~ 'tl~ 'T( II y1~ { .. r _ •. i. j f a 4"/ -~ ~> ~r~, `' ~ ', 7 i~ 4y..~ t r i^ e ~ ~ .~ F ~.~'. a _ ! i~ f 'v v t i 3'-: < .. y~ ~ .~-< f ~ ~ ~ ~ ~ i! ~.~ ' ~ ~ ~~i7 ~,~,r~ ~ ~ ~,`~h;,~,n ' tw ~ L #.µ F t, r ?f~ ~ ,{ i -w. ~ ~ - ,~ ~ ~ 1 { q _ - __ i ~,~ ~r ' yt ~ " p to '' '..h - a~ ~ _ - - ~ .,~, o f °~ ~ - " A ~+ ~ ~ "q RyT.~. 17 ~ t ~ 7' f " 4 _ _ r l ~~ ~ 'Ti . i v _. - ~ "'~ ~' ~ ~ ~ ~ ' ~ ~,'~- ;~~ r ;F~._ - , :ii qtr ~~ F 'R~ - f ~ pv :, _ - k i- ~ yi~'~ i~ - ~ '~ ~ ~, ~. ~J S ~ I + 3,. ~ p' ~ r ` ~ : z a ti~yy~ ~ ~ ~ " * I4 .3 I~ d r+3. ~.~..~ ~.Y F