HomeMy WebLinkAbout04-0172BUREAU OF INDIVIDUAL TAXES
INHERTTANCE TAX DTVISZOH
DEPT. Z806nl
HARRTSBURG, PA 17128-0601
COHHONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTICE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLONANCE OR DISALLOWANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
REV-Z547 EX AFP (01-03)
APR
JONATHAN H UHLINGER'
57 FAIRWAY DR
CAHP HILL ~°~17011
DATE O~-IZ-ZO04
ESTATE OF UHLINGER
DATE OF DEATH 11-22-2005
FZLE NUHBER 21 04-0172
COUNTY CUHBERLAND
ACN 101
Amoun~ Remi~od
HARTHA H
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS L/NE ~ RETA/N LOWER PORT/ON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF /NHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF UHLINGER HARTHA H FTLE NO. 21 04-0172 ACN 101 DATE 04-12-200~
TAX RETURN WAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVAT/ON CONCERNTNG FUTURE TNTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Es~a*e (Schedule A)
2 S~ocks and Bonds (Schedule B)
$ Closely Hold S~ock/Par~norshAp Zn*eros~ (Schedule C)
Not,gages/No,es Receivable (Schedule D)
Cesh/Benk Deposi~s/NAs¢. Porson~l Propor~y (Schedulo E)
6 Jointly Owned Proper~y (Schedulo F)
7 Transfers (Schedule G)
8. To~el Asso~s
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Exponsos/Ad.. Cos~s/NAsc. Expenses (Schedule H)
10. Dob~s/Hor~gago Liabili~ios/LAons (Schedule Z)
11. To~el Deductions
12. Ne~ Value of Tax Ro~urn
(1)
(2)
(3)
(~)
($) 525.00
.00 NOTE: To Ansuro proper
.00 crodA~ ~o your account,
.00 subeA~ ~ho upper por~Aon
.00 of ~his form wASh your
~ex payment.
(6) 25z$~7.72
(7) 14z$43.85
(B)
6,561.00
(9)
40,216.57
13.
1~.
NOTE:
ASSESSHENT OF TAX:
15. Amoun~ of Line 1~ e~ Spouse1 ra~o
16. Amoun~ of Line 1~ ~axablo a~ L/heal/Class A ra~e
17. A.oun~ of LAne 1~ a~ SiblAng ra~o
18. A.oun~ of LAne lq ~axablo a~ Colle~coral/Cless B ra~o
19. PrincApal Tax Due
TAX CRED/TS:
PAYNENT RECETp1 DTSCOUNT (+)
DATE NUHBER INTEREST/PEN PA/D (-)
02-19-2004 CDOO$58q 68.46
(].~) .00 x O0 = .00
(].6) $0,426.64 x 045= 1,:569.20
(].7) .00 x 12 = .00
(].8) .00 x 15 : .00
(].9)= 1,369.20
ANOUNT PAID
1,$00.74
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
Charitable/Governmental Beques~cs; Non-elected 911:3 Trusts (Schedule J)
Ne~ Value of Es~:a~:o Subject: ~:o Tax
Zf an assessment Has lssued prev/ously, llnes 14, 15 and/or
reflect figures that include the total of ALL returns assessed to date.
(].3) . O0
(].~) 30,426.64
16, 17, 18 and 19 will
IF PAID AFTER DATE /NDZCATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
1,:569.20
.00
.00
.00
{ TF TOTAL DUE IS LESS THAN $1, NO PAYNENT TS RE~UTRED.
IF TOTAL DUE TS REFLECTED AS A 'CREDTT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE STDE OF THTS FORH FOR TNSTRUCTTONS. }
(10)
5~Z28.95
(11) 9.789.9~
(12) 30,426.64
RESERVATION:
PURPOSE OF
NOTICE:
PAYRENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 11, 1981 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coaaonaaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Rills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLSj AGENT
A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications ars available at the Office
of the Register of Rills, any of the Z$ Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering: 1-800-361-Z050; services for taxpayers aith special hearing and / or
speaking needs: 1-800-447-3010 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 181011, Harrisburg, PA 17118-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 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 (5) calendar months after the decedsnt's death, a five percent (51) discount of
the tax paid is allowed.
The 1SI tax man,sty 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 sams tiaa period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning eith first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes ahich became delinquent before January 1, 1981 beer interest at the rate of
six (613 percent par annum calculated mt a daily rate of .000164. All taxes which became delinquent on and after
January l, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are:
Interest Dally Interest Daily
Year Rate Factor Year Rate Factor
1981 ZOZ .000548 ~%- 1991 111 .000501
1983 16Z .000438 1991 9Z .000247
1984 llZ .000301 1993-1994 72 .OOOlgZ
1985 131 .000356 1995-1998 92 .000Z47
1986 iOZ .000174 1999 7Z .000192
1987 lOX .000174 ZOOO 71 .000191
--Interest is calculatad as folloas:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Year Rate Factor
~ 91 .000Z47
ZOOZ 62 .000164
2003 5Z .000137
ZOO4 42 .000110
X NUHBER OF DAYS DELINI~UENT 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 data shown on the
Notice, additional interest must be calculated.
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
COUNTY CODE YEAR NUMBER
I--
Z
LU
LU
(.,1
UJ
-.~oo,
Il.
z
,7
0
0
0
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
UHLINGER, MARTHA H 178-12-0146
-DATE OF DEATH iMM:DD;~;EAR) -DATE O-t~ BI~iMM-DD-YEARi THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
11/22/2003 ' 02/22/1917 REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SE~RiTY NLIMBE~
~-]1, Odginal Return
~']4, Limited Estate
FI6. Decedent Died Testate (Attach copy of
FI9. Litigation Proceeds Received
[~]2, Supplemental Return
Fmm 4a. Future Interest Compromise (date of death after 12-12-82)
F--J7. Decedent Maintained a Living Trust (Attach copy of Trust)
m--m 10. Spousal Poverty Credit {date of deatfl between 12-3%91 and 1-1-95)
[~m3. Remainder Return (date of death pdor to 12-13,-82)
[~5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
~)11. Election to tax under Sec. 9113(A) (A~ch Sc~ O)
JONATHAN H UHLINGER
'F:IRM NAME (IfApplica~i;i '
TEE~HONE NUMBER
(717) 730-8697
COMPLETE MAILING ADDRESS
57 FAIRWAY DR
CAMP HILL PA 17011-2065
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Sched.le D) (4)
5. Cash, Sank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6.
Jointly Owned Property (Schedule F) (6)
~'-] Separate Billing Requested
7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11~ Total Deductions (total Lines 9 & 10)
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)
525.00
25,347.72
14,343.85
(8)
6,561.00
3,228.93
(11)
(12)
(13)
(14)
40,2t6.57
9,789.93
30,426.64
30,426.64
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.0
16. Amount of Line 14 taxable at lineal rate
30,426.64 x .0 45
17. Amount of Line 14 taxable at sibling rate
x .12
18. Amount of Line 14 taxable at collateral rate
x .15
19. Tax Due
20. []
(15)
(16)
(17)
(18)
(19)
1,369.20
1 ~369.20
> > BE SURE TO ~NSWER~EE:QU~ON$ ON R~VE~ $!~ AND RECHECK MATH < <
Decedent's Complete Address:
ISTREET ADDRESS
CHAPE~LL POIN~T~E A~T CARLISLE
770 S HANOVER ST
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits ( A + B + C ) (2)
68.46
3. Interest/Penalty if applicable
D. Interest ....
E. Penalty Total Interest/Penalty ( D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(3)
(4)
(5)
(5A)
(5B)
A. Enter the interest on the tax due.
1,369.20
68.46
1,300.74
1,300.74
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes No
1. Did decedent make a transfer and:
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? ........................................................................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I d_~'~'re that I have examined this return, including a~,u~panying schedules and statements, and to the best of my knowtedge and belief, it is l~ue, correct and complete.
Dedaretion of p~e~arer other than the personal representative is based on all in~ma~or, of which p~eFarer has any knowledge.
DATE
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN 02/18/04
ADDRESS
57 FAIRWAY DR, CAMP HILL PA 170! 1-2065'
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
imposed on the net value of transfers to or for the use of the surviving spouse s 3%
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate
[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 d~)es 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 deaih 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 PS. §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 RS. §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-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
UHLINGER, MARTHA H
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
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. 500.00
Misc. personal property, including waering apparel, household goods and furnishings,
books, jewelry, etc.
Cash on hand
25.00
TOTAL (Also enter on line 5, Recapitulation) $ 525.00
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
UHLINGER, MARTHA H
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. UHLINGER, JONATHAN H
57 FAIRWAY DR
CAMP HILL PA 17011-2065
SON
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 03-21-85 PSECU--Account 0178120146
Savings 5.00 50 2.5(:
Checking 5,285.67 50 2,642.84
Money Market 1,090.45 50 545.2,~
CD 6,000.00 50 3,000.0C
2. A. 06-30-99 ALLIANCE DEVELOPMENT FUND INC--Account 50002716
6 CDs 37,679.06 50 18,839.52
3. A. 08-30-96 OPPENHEIMER GROWTH FUND ClassA--Account
270 2703232911
25.573 shares @ 24.84 635.23 50 317.6;
TOTAL (Also enter on line 6, Recapitulation)$ 25,347.72
(If more space is needed, insert additional sheets of the same size)
PSEC
I k# m w~ wm m I'I m ii i m l,]~m~,ilT~llh mm~
P.O. Box 67013 (717) 234-8484 (Harrisburg)
Harrisburg, PA17106-7013 (800) 237-7328 (Nationwide)
website - http://www, psecu.com
HAPPY HOLIDAYS!
USE YOUR PSECU VISA CARD
FOR ALL OF YOUR PURCHASES.
NARTHA H UHLINGER
JOINT OWNER
JONATHAN H UHLTNGER
PAGE 2
O178XXXXXX 11/30/03
1111 HITHDRANAL VIA HOHE BANKING TRANSFER TO SHARE Oq 25.96-
1150 PAYHENT: DIVIDEND 0.7501 0.01 5.01
ANNUAL PERCENTAGE YIELD EARNED 0.9q~ FROH 11/01/05 THROUGH 11/50/05
POST EFF DESCRIPTION AHOUNT BALANCE
1105 CHECK 005595 500.00- 1Z90.qO
1106 HITHDRANAL DIRECT DEPOSIT CONTINENTAL GEN. 159.65- 1150,77
TYPE~ ZNS~ PREH. iD: lq7046~7fi7
1117 NAS HAILED TO SPR[NT.
1117 ~[LLPAYER CHECK 111705 FOR ~571.~6
1118 ' PAY~ENT~ VIA HO~E ~ANKING TRAHSFER FROM SHARE 07 ~500.00 5q07.05
1119 BILLPAYER CHECK 111904 FOR ~5,176.68
1119 ~AS ~A[LEO TO CHAPEL POINTE AT CARLISLE.
OSOZO000 ZlSQ719
P.O. Box 67013 (11 l) 234-8484 (Harrisburg)
Horrisburg, PA 17106-7013 (800) 237-7328 (Nofionwide)
website - http://www, psecu.com
HAPPY HOLIDAYS!
USE YOUR PSECU VISA CARD
FOR ALL OF YOUR PURCHASES.
HARTHA H UHLINGER
JOINT OWNER
JONATHAN H UHLZNGER
0178XXXXXX 11/30/05
PAGE
11ZZ PAYHENT: VIA HOHE BANKING TRANSFER FROM SHARE 07 250.00
1124 CHECK 111904 5176.68- 108.99
1125 PAYMENt, DIRECT DEPOSIT CHRISTIAN MISSIO 255.78 ~
ANNUAL PERCENTAGE YIELD EARNED 0,25~ FROM 11/01/03 THROUGH 11/50/05
BASED ON AVERAOE DAILY BALANCE OF 1,768.Z6
1150 r ENDING BALANCE 510,9q
00~39~ ZO0.O0 111701~ Sq.19 ll190q~ 5176.68
~ asTEeZS~ ~EXT TO aU,aEe Z~OZCnTES S~ZeTM "U,aEe s~euE.cE
1103 DIVIDEND RATE CHANOEO FROM .80~ TO 1.00~
1107 PAYHENT: ~y CHECK ~ qZZq. O0
1110 PAYHENT: BY CHECK 10~5.71 5Z6q.q5
112q DIVIDEND RATE CHANGED FROH-I:;09~ T~:'I,05~/- / .... : Y
1150 PAYHEMT, DIVIDEND 1,050~ : : ~ ~ 1.ga 1092
215q720
PSEC
P.O. Box 67013 (717) 234-8484 (Harrisburg)
Hardsburg, PA 17106-7013 (800) 237-7328 (Nationwide)
website - http://www, psecu.com
HAPPY HOLIDAYS!
USE YOUR PSECU VISA CARD
FOR ALL OF YOUR PURCHASES.
HARTHA H UHLINGER
JOINT OWNER
JOHATHAN H UHLTNGER
PAGE 4
0 17 8XXXXXX 1 1/3 0/0 3
DIVIDEND YTD: YEAR TO DATE 55.~6
841.78- 0.00
ID 51 60 HONTH IRA CERT-2 CLOSED ON 11/01/03
NONTAXABLE DIVIDENDS YEAR TO DATE 55.52
.......................... ...........................................................
8~1.78 15379.56
1103 1101 N[THgRAHAL ~Y CHECK HORHAL D[STR[~UT[ON 1035.71-1~3~.85
............................ : ................................................................................
NONTAXABLE D~V~DENDS YEAR TO DATE 816.80
ANNUAL PERCENTAGE YIELD E~i~'NJ~j) ....... ~.~..~..~.~j~.~j~....i~j)..~2.~....~..~:~.~.d~.~.~...~..~.2.~..~.2.~:~ ..................................................................
1150 NITHDRANAL TRANSFER TO SHARE O1 23.18- 6000.00
1150 ENDING BALANCE 6000,00
:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::,:.;::::::::::::::::::::::::::::::: ,........., ....,......., .,.........,....., ........ , ,.,. ...................
:::~H~: :::::::::::::::::::::::::::::::::::::::::::::::::::::::: .. : . ' ; '::::' ::i: .'"' i: ' :i" :' :' , "'.:::i'"!:?'"'": :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .....................................................
03030000
215fi721
P.O. Box 67013 (717) 234-8484 (Harrisburg)
Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide)
website- hltp://www, psecu.com
HAPPY HOLIDAYS!
USE YOUR PSECU VISA CARD
FOR ALL OF YOUR PURCHASES.
HARTHA H UHLINGER
JOINT OWNER
JOHATHAN H UHLZNGER
PAGE 5
0178XXXXXX
11/30/0~
im~m~ ~ ~ ~ ?.~:!~ i~:~m~ ~ ~ ~ ~ii ~ ~?:~i~? !~ ii~i ~ !!i ~::i ::=:i ::~:!~= :?:?:::ii::i i~ ::~ i~ ii=: ~==ii ii li ::?:?: i!::::i:~ ?=i! i::ii =:::i:= =:=~i i=:=~:: ::iii::===:! !=::=i==i:?= =:::=:ii ::i::~= ::== i?:?:ii:::= ?:=:i ::i==i ::::::::::::::::::::::::::::::: ::==i=: i=: i??:i?::=i ii:::==: i?:::i?:?::::::: ::=:ii :??= i?:?: ::::ii :: ?:ii?:!ili?~i?:ii??: ii i?: i== ??: ==i=:::ii?=iil =.::?:i i?: =:::ii =:i?: ?:??:?=i i?:ili ::i:=i i?:i::ii?: ii i=:i ==i=:iii::ii??:i i?: ::iii=:i:: i:: ?:i:: ii?:iii::i::iii ::?:??=iiii ?: ?:ii i i i il ii ::i::i ii iii?:i :=?: i==ii?:ii ?=?:i ::i il ==i il ii =:?:ii?=iiii?:i::ii?:?:?:i :=iii!i i?:i:?:ii?:ii ?: i~: ii
TOTAL CURRENT YEAR IRA CONTRIBUTIONS 0.00
TOTAL DIVIDEND YTD: YEAR TO DATE 547.95
215~.722
PSEC, ii,
PENNSYLVANIA
STATE EMPLOYEES
CREDIT UNION
STATEMENT OF ACCOUNT
Page
MAIN OFFICE:
1 CREDIT UNION PLACE
HARRISBURG, PA 17110-2990
234-8484 OR
800-237-7328
MAILING ADDRESS:
P.O. BOX 67013
HARRISBURG, PA 17106-7013
2
ACCOUNTNUMBER
0178120146
MARTHA H UHLINGER UONATNAN H. UHLZNGB SOClALSECURITY#
178-12-0146~
STATEMENT PERIOD
From To
/010~99~,1~99
~ ~~, FINANCEcHARGE
REGUI AR SHI~RES- S 1
0101 PREVIOUS BALANCE 494:02
0131 DIVIDEND 130 495 32
DIVIDEND RATE: 3.10 %
ANNIIAL PERCENTAGE RATE YIELD: 3.14 %
ANNIIAL PERCENTAGE YIELD EARNED= 3.14 %
0131 NEN BALANCE 495!32
CHECF ING - S 4
0101 PREVIOUS BALANCE 362527
0104 DIRECT DEBIT 5230959590 -5998 356729
PA PONER & LZGHT
0104 MAC DEPOSIT TR58252521 182q8 374977
148 NOBLE BLVD CARLZBLE PA
0104 CHECK 2809 -500 374477
0107 CHECK 2819- -2000 ' ' 372~77
0108 CHECK 2817 -2796 369~B1
0111 CHECK 2820 -54500 3151~1
0115 CHECK 2822 -5000 3101~1
0116 MAC DISBURSEMENT TR58254552 -10000 ~001~!
148 NOBLE BLVD CARLZBLE PA
0120 CHECK 2823 -2500 297681
0120 CHECK 2825 -4~07 293C74
0121 CHECK :2826 -4C100 ' 289474
0121 CHECK 2829 -8~00 280874
0122 CHECK 2821 -500 280374
0123 MAC DEPOSIT TR58255710 5500 285874
148 NOBLE BLVD CARLZSLE PA
0125 CHECK 2830 -2~02 283~72
0125 AUTOMATIC TRANSFER ~/.~./ -2402 281070:
XFR TO L 9 .
0127 DIRECT DEPOSIT ACH. : 23255 .... 304305
0127 CHECK 2827~ -500 303805
0127 CHECK .:: 2~31. ~ '4000 299805
0128 CHECK 2824 -.
~OO 299505
0129 CHECK 2828 -700 298805
0131 SHARE CERTIFICATE DIVIDEN 3C58 301863
D131 DIVIDEND 5q5 302408
DIVIDEND RATEt 2.00 %
TOTAL DIVIDEND Y~R-TO-DATE ~uN i' ZNU~U~
for afl sa~ngs except IRA. TOTAL FINANCE CHARGE Y~R-TO-DATE
for afl leans.
P~[ sh2~,.if $ ! ~ or overall! be
reported to the Internal Revenue Sen/ice
for this calendar year.
NOTICE: See reverse side for important information.
*INOICATES EFFECTIVE DATE 2208329
THE ALLIANCE DEVELOPMENT FUND, INC.
5225 North Academy Blvd., Suite 200, Colorado Springs, CO 80918
(719) 268-2250 · FAX (719) 268-2259. Toll Free (888) 878-3060
E-maiL' adf~adf-inc, com . Web site: www. adf inc. com
MARTHA H UHLINGER
JONATHAN H UHLINGER
770 S HANOVER STREET
CARLISLE PA 17013
- PAGE 1 -
ACCOUNT 50002716
TAX ID 178-12-0146
12/31/2003
T i M E D E P O S''I T
PERIOD COVERED BEGINNING 07/01/2003
S'U'MMARY ..........
ENDING 12/31/2003
NUMBER
BALANCE MATURITY INT RATE
YTD INT LAST PAY NEXT PAY
4861 8,000.00 12/01/07 4.230
14932 8,000.00 07/15/04 5.200
17775 8,862.28 08/01/07 4.800
17776 4,485.79 08/01/07 4.800
17777 4,549.26 08/01/05 5.400
17994 4,379.02 12/01/07 4.200
TOTAL .~ 38,276.35
ACCOUNT
338.40 12/31/03
416.00 12/31/03
410.55 12/31/03
207.81 12/31/03
236.06 12/31/03
1,860.94
TRANSACTIONS ....
03/31/04
03/31/04
06/30/04
06/30/O4
06/30/04
06/30/04
CERTIFICATE 4861
DATE DEPOSITS INTEREST
07/01/03
09/30/03 84.60
12/31/03 84.60
WITHDRAWALS
BALANCE DESCRIPTION
8,000.00
~INTEREST DEPOSIT TO ACH
8,000.00 INTEREST DEPOSIT TO ACH
...................... ACCOUNT TRANSACTIONS .................
CERTIFICATE 14932
DATE DEPOSITS
07/01/03
09/30/03
12/31/03
CERTIFICATE 17775
DATE DEPOSITS
07/01/03
12/31/o3
INTEREST WITHDRAWALS BALANCE DESCRIPTION
8,000.00
104.00 ~_=_~Q00.0~INTEREST DEPOSIT TO ACH
104.00 8,000.00 INTEREST DEPOSIT TO ACH
ACcouNT TRANSACTIONS ................
INTERESt· WITHDRAWALS B__A3~E DESCRIPTION
207.71 · ·
8,862.28 INTEREST coMPOITNDED '
--- CONTINUED ON NEXT PAGE
THE ALLIANCE DEVELOPMENT FUND, INC.
5225 North Academy Blvd., Suite 200, Colorado Springs, CO 80918
(719) 268-2250 · FAX (719) 268-2259 · Toll Free (888) 878-3060
£-mail: adf@adf-ine, com . Web site: Ww~.adf-inc. com
MARTHA H UHLINGER
JONATHAN H UHLINGER
770 S HANOVER STREET
CARLISLE PA 17013
- PAGE 2 -
ACCOUNT 50002716
TAX ID 178-12-0146
12/31/2003
ACCOUNT TRANSACTIONS ................
CERTIFICATE 17776
DATE DEPOSITS INTEREST
07/01/03
12/31/03 105.14
WITHDRAWALS
BALANCE DESCRIPTION
38o.6
4,485.79 INTEREST COMPOUNDED
ACCOUNT TRANSACTIONS
CERTIFICATE 17777
DATE DEPOSITS INTEREST
07/01/03
i2/3i/03 ii9.60
WITHDRAWALS
BALANCE DESCRIPTION
<4,429.
4,549.26 INTEREST COMPOUNDED
ACCOUNT TRANSACTIONS ................
CERTIFICATE 17994
DATE DEPOSITS
07/01/03
i2/ol/o3
12/31/03
INTEREST
74.77
90 07
WITHDRAWALS
BALANCE DESCRIPTION
41288.95 INTEREST COMPOUNDED
4,288.95 RATE CHANGE TO: 4.200
4,379.02 INTEREST COMPOUNDED.
'THE ALLIANCE DEVELOPMENT FUND, INC.
5225 North Acadert~ Blvd., Suite 200, Colorado Springs, CO 80918
(719) 268-2250. FAX (719) 268-2259 · Toll Free (888) 878-3060
E-mail: adf@adf-inc, com . Web site: ~w. adf-inc, com
'VMARTHA H UHLINGER
I~ONATHAN H UHLINGER
ALLIANCE DR APT 103
~ARLISLE PA 17013
PAGE 1
ACCOUNT 50002716
TAX ID 178-12-0146
......... ~- ........ T I ME DE P O S I T
PERIOD COVERED BEGINNING 01/01/2002
NUMBER BALANCE MATURITY INT RATE
4861 8,000.00 12/01/02 6.500
14932 8,000.00 07/15/04 5.200
17775 8,269.29 08/01/02 2.500
17776 4,177.38 08/01/02 4.800
17777 4,199.81 08/01/05 5.400
17994 4,065.15 12/01/02 2.800
TOTAL 36,711.63
SUMMARY
ENDING 06/30/2002
YTD INT LAST PAY NEXT PAY
260 00
208 00
116 98
97 91
110 41
56 13
06/30/02 09/30/02
06/30/02 09/30/02
06/30/02 08/01/02
06/30/02 08/01/02
06/30/02 12/31/02
06/30/02 12/01/02
849.43
ACCOUNT TRANSACTIONS
CERTIFICATE 4861
DATE DEPOSITS INTEREST
Ol/Ol/O2
03/31/02 130.00
06/30/02 130.00
WITHDRAWALS
BALANCE DESCRIPTION
8,000.00
8,000.00 INTEREST DEPOSIT TO ACH
8,000.00 INTEREST DEPOSIT TO ACH
........... ACCOUNT TRANSACTIONS'- ...............
CERTIFICATE 14932
DATE DEPOSITS INTEREST
01/01/02
03/31/02 104.00
06/30/02 104.00
WITHDRAWALS
BALANCE DESCRIPTION
8,000.00
8,000.00 INTEREST DEPOSIT TO ACH
8,000.00 INTEREST DEPOSIT TO ACH
...................... ACCOUNT
CERTIFICATE 17775
DATE DEPOSITS
Ol/Ol/O2
02/01/02
TRANSACT IONS ................
INTEREST WITHDRAWALS BALANCE DESCRIPTION
8,152.31
32.29 8,184.60 INTEREST COMPOUNDED
CONTINUED ON NEXT PAGE
OOppenheimerFunds®
The Right Way to Invest
Annual Statement
January 1, 2003 through December 31, 2003
Page 1 of 1
04.141527.01.01-C1025270332
MARTHA UHLINGER &
JONATHAN H UHLINGER
JT TEN
9 ALLIANCE DR APT 103
CARLISLE PA 17013-4145
Your Financial Advisor
HOUSE, OPPENHEIMERFUNDS DISTRIBUTOR
INC
PO BOX 5270
DENVER CO 80217-5270
At Your Service
www.oppenheimerfunds.com
24-hour automated service: 1-800-CALL OPP (225-5677)
Representatives available Mon.* Fri. 8 am - 9 pm ET and
Sat. 10 am - 4 pm ET (Jan. - Apr.)
Oppenheimer Growth Fund Class A
Account Number Tax ID Number
270 2703232911 178-12-0146
Account Registration
MARTHA UHLINGER & JONATHAN H UHLINGER JT TEN --
Year-to-Date Transaction Detail ~
Transaction Transaction Dollar Share Number Total ~~'-~
Date Description Amount Price of Shares Shares Owned ~
No Activity ~ __
Fand Value as of 12/31/2003
Shares owned 25.573
Share price $26.22
~arket value $6 70.52
Activity Summary
Beginning Ending
Account Value Additions Withdrawals Change in Value Account Value
as of 01/01/2003 Year-to-Date Year-to-Date Year-to-Date as of 12131/2003
$573.60 0.00 0.00 + $96.92 $670.52
OppenheimerFunds News
* **IMPORTANT*** P/ease retain this 2003 annual account statement for your records. You will generally not
receive a Form 1099-DIV if you have a retirement account, or if your account earned less than $10.00 in
dividends in 2003.
Sign up for Oppnews, our monthly electronic newsletter that delivers fund and service updaies, as well as
market commentary. Go to www. oppenheimerfunds, com and click 'Create a User ID and Password' to sign up.
OFD-OPBSSSN__O31231__~4-1-24.M ET / 47554 / 0047549 / 0047556
.CCOUNT NUMBER 2.70 27032.32.91 1
,llh,,llh,,,,,Ih,lh,l,,I;,,llll,,,,I,I,h,,lil,,,,,,lll
DEALER NUMBER 98
REP. NAME HOusE
A. E. NUMBER
tTRANSACTION DATE TYPE OF TRANSACTION DOLLAR AMOUNT SHARE SHARES THIS TOTAL
OF TRANSACTION PRICE TRANSACTION SHARES OWNED
BALANCE FORWARD ~ 171819
1218!97 DIV REIN $.6637/SH 11i83 34i41 1344 18~163
121897 SHORT TERM CAP GAIN 7~97 34i41 i232 18i395
REINVEST $.4471/SH ' '
12.1897 CAP GAIN REINVEST 61i55 34i41 11789 201184
$3.4540/SHR : ' i
DISTRmU'r~ON ~V~DENDStSHORT-TERM CAmTAL ~AINS LONG-TERM CAPITAL ~A~NSI C~RT~ICATED SHARES I BOOK SHARES
OPTIONS REINVEST REINVEST ~ .000I 20.184
YEAR-TO-DATE DIVIDENDS YEAR-TO-DATE SHORT-TERM YEAR-TO-DATE LONG-TERM ~TOTAL YEAR-TO-DATE
ICAP TAL GAINS $7 IcAP TAL GAINS IDISTRIBUTIONS
$11.83 .97 $61.55 $81 35
PLEASE RETAIN THIS STATEMENT AS a RF~:~R[3 ¢31:: Vnlll~ TI3Z~lC~.,~,w'if'~&~¢, ~3, =/.~ ~ ................... '
SE DO NOT USE THE ABOVE FIGURES FOR TAX PURPOSES.
VIEW YOUR ACCOUNT BALANCE ONLINE 24 HOURS A DAY VISIT OUR WEBSITE AT
WWW.OPPENHEIMERFUNDS.COM. '
S IS ~3~OU. OWN 2'0.184 SHARES AND THE VALUE OF YOUR
THE BOARD OF TRUSTEES OF OPPENHEIMER GROWTH FUND HAS DECLARED A DIV-
IDEND ON CLASS A SHARES OF $.6637 PER -SHARE FROM NET INVESTMENT IN-
COME ~ 4471 PER SHARE FROM NET REALIZED SHORT-TERM CAPITAL GAINS AND
A DI~T iBUTION OF $3 45 PER SHARE FROM NET REALIZED LONG-TERM CAPITAL
GAINS, PAYABLE ON DECEMBER 19 1997 TO SHAREHOLDERS WHO OWNED THEIR
SHARES AT THE CLOSE OF BUSINESS ON DECEMBER 17, 1997.
YOUR 1997 ANNUAL STATEMENT AND OTHER YEAR-END TAX INFORMATION WILL BE
MAILED TO YOU BY JANUARY 31, 1998.
.... SEE REVERSE $ DE FOR ADD TONAL NFORMAT ON
Oppenheimer Growth FUnd A
ro MAKE AN ADDITIONAL PAYMENT:
~LEASE COMPLETE THIS STUB AND RETURN IT WITH YOUR CHECK MADE PAYABLE TO THE
:UND LISTED ABOVE. MAIL STUB AND CHECK TO: P.O. BOX 173672. DENVER. CO 80217-3672.
693
MARTHA UHLINGER &
JONATHAN H UHLINGER
JT TEN
770 S HANOVER ST
CARLISLE PA 17013-4105
AMOUNT OF PAYMENT $
THANK YOU FOR YOUR ADDITIONAL INVESTMENT.
'--~ FOR CHANGE OF ADDRESS, CHECK THIS
BOX AND FILL OUT REVERSE SIDE.
270 27032329114
REV-1510 EX+ (6-98)
COMMONWEA~H OFPENNSYLVANIA
INHERITANCETAX RETURN
RESIDENT DECEDENT
ESTATE OF
UHLINGER, MARTHA H
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
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 ~es.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME O6 THE TRANSFEREE. THEIRRELATIONSHIPTODECEDENTAND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE
NUMBEI~ THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (~F APPLICABLE) VALUE
1. PSECU IRA 14,343.85 100 14,343.~
TOTAL (Also enter on line 7 Recapitulation) $ 14,343.8
(If more space is needed, insert additional sheets of the same size)
PSEC
HARTHA H UHLINGER
P.O. Box 67013 (717) 234-8484 (Harrisburg)
Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide)
website - http://www, psecu.com
i~ii~iiii;~;~i;~i!i~;~ ~ ~?~ ~ ~ ~ii!iii~;i~?~;;~;iiiiii;~ilOFTHETO YOUR THE FAIR IRA INTERNAL HARKETSERVICE HILL BE VALUE, REVENUE REPORTED ° 7 xxxxxxI (FHV)
ANNUAL IRA-SUHHARY
FOR CALENDAR YEAR ZOO3
PAGE OZ
~APyE = 'ANNUAL PERCEI~TAGE YIELD EARNED
IRA TYPE: TRADITIONAL CONTINUED
11/31 01/31 S5q:DIVIDEND 6.310~ 73.93 0.00 13,869.30
APYE~ 6.50~ FROM 01/01/05 THROUGH 01/51/03
~Z/Z8 02/28 S5q DIVIDEND 6.510% 67.1q 0.00 15,936.4q
: APYE~ 6.50% FROH 02/01/05 THROUGH 02/28/05
3/51 05/51 S54 DIVIDEND 6.510~ 74.69 0.00 14,011.13
APYE~ 6.50~ FROH 05/01/05 THROUGH 05/31/05
4/50 04/50 S54 DIVIDEND 6.510% 72.67 0.00 14,083.80
APYE~ 6.50% FROH 04/01/05 THROUGH 04/50/03
5/31:05/$1 S54 DIVIDEND 6.310% 75.48 0.00 14,159.28
APYE~ 6.50~ FROM 05/01/05 THROUGH 05/51/05
6/50 06/50 S5q DIVIDEND 6.310~ 75.43 0.00 lq,ZSZ.71
APYE~ 6.50% FROM 06/01/05 THROUGH 06/50/03
7/51 07/31 S54 DIVIDEND 6.310% 76.28 0.00 14,308.99
APYE~ 6.50% FROM 07/01/03 THROUGH 07/51/05
8/51 08/31 S54 DIVIDEND 6.310~ 76.68 0.00 14,585.67
APYE~ 6.50~ FROH 08/01/03 THROUGH 08/31/03
9/50 09/30 S54 DIVIDEND 6.510% 74.61 0.00 14,460.28
APYE~--~6.50~.-FROM-Og/01/03 THROUGHY09/$O/O$--~
0/51 10/5] S54;DIVIDEND 6.510~ 77.50 0.00i 14,557.78
APYE~ 6.50% FROM 10/01/05 THROUGH 10/$1/05
1/05 11/01 S54 DEPOSIT 841.78 0.00 15,579.56
TRANSFER HITHIN PSECU
1/0~i11/01 S54 NITHDRANAL 1,055.71- 0.00
~ NORMAL DISTRIBUTION
1/50 11/30 S54 DIVIDEND 6.310~ : 7q.39 0.00 14,418.24
~' APYE~r~6.50% FROM 1'1/01/05 THROUGH 11/50/03 ·
2/Oq lZ/04 S54 DIVIDEND ;; ' 7.48 OLOO:"I4;qZ5L7Z
; i ApyE~ i6.51~ FROM 12/01/05 THROUGH 12/03/05
Z/Ot 12/01 S5i, HITHDRAHAL~ i 14,425.72- 0.00 0'.00
; TRANSFER TO ANOTHER INSTITUTION : '
Z/31 554 ENDING BALANCE ~
0'.00
TRADZTZONAL SUMNARY
PREVIOUS YEAR CONTRIBUTIONS 0.00
CURRENT:YEAR CONTRIBUTIONS 0.00
DISTRIBUTIONS 15,q61.43
· OZO20000 S012~25
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
UHLINGER, MARTHA H
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule [.
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
LeTORT CEMETARY -- for grave opening
HOFFMAN-ROTH FUNERAL HOME, INC -- for services, casket, vault, misc, expenses
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State__Zip
Year(s) Commission Paid:
Attorney Fees
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
Accountant's Fees
Tax Return Preparer's Fees
State __Zip
550.00
6,011.00
TOTAL (Also enter on line 9, Recapitulation) $ 6,561.00
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
UHLINGER, MARTHA H
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UABILITIES, & UENS
FILE NUMBER
Include unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Check #111904 -- written on 11/19/03 but not removed from PSECU account
0178120146 until 11/24/03
To Chapel Pointe for Martha's nursing care expenses for October & room expenses for
November
Check was 5,176.88, but Chapel Pointe later refunded 1,718.81 for reimbursed
services and/or unused days in November after death -- net liability = 3,457.87
Valued at 50% of net liability since related to account with JTWRS status = 1,728.93
Family loan from Jonathan to Martha -- on line transfer into PSECU account
0178120146 on 10/20/03, with online repayment transfer from that account on
12/24/03
To help cover Martha's expenses temporarily (to avoid withdrawing certificate of
deposit prior to maturation date)
Liability = 3,000.00
Valued at 50% of liability since related to account with JTWRS status = 1,500.00
1,728.93
1,500.00
TOTAL (Also enter on line 10, Recapitulation) $ 3,228.93
(if more space is needed, insert additional sheets of the same size)
FRONT/BACK CHECK IMAGE VIEW Page 1 of 1
Bill Payer Check #111904
363
Please Note: Information written on a check using a Gel Pen may cause the information to not
appear as part of the check image.
https://homebank.psecu.com/homebank/Checklmages/PrintView.asp?FNAME= 1S%2CyMeU%25y... 2/19/2004
PSEC
P.O. Box 67013 (717) 234-8484 (Harrisburg)
Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide)
website - http://www, psecu.com
TAKE THE HASSLE OUT OF HOLIDAY
SHOPPING.
USE YOUR PSECU VISA CARD.
NARTHA H UHLINGER
JOINT OWNER
JONATHAN H UHLZNGER
PAGE 4
O178XXXXXX 10/31/05
FROH UHLII XXXXXXXXXX SHARE 07
IOZO HITHDRANAL 6100.00- 5.~5
1051 PAY~IENT.- DIVIDEND 0.800~ 1.29 ~.7~
pOST EFF DEscRIPTION ' AHOUNT BALANCE
1001 ID 51 6~ HONTH IRA CERT-Z BEGINNING BALANCE 858.50
NONTAXABLE DIVIBENDS YEAR TO DATE 55.5Z
1051 ENDING BALANCE lq557.78
60 HONTH ZRA CERTZFZCATE N[LL HATURE ON 0~/17/05
.............................................. ~"~'~'~ ........................................ ~.~.~.....~Y~..~.~......~.d.~.~.~....~.b.~.~.ff~..~.~.~.~.~...~.~.~6f~.~.~.6...~.[~.~.~ ................................................................... &'~'O'~';"e'e' ...............
Z051 PAYHENT~ ~ZVZ~END ~.700~ Z~.95 60Z5.95
~,~U~L PERCE.T~E Y~EL. E~RNE. ~.~0~ FRO. ~0/0~/0~ T.ROU~. ~0/~/0~
03030000
21q9854
P,O. Box 67013 (717) 234-8484 (Harrisburg)
Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide)
website - http://www, psecu.com
IHPORTANT
TAX RETURN DOCUHENT
ENCLOSED
HARTHA H UHLINGER
JOINT OWNER
JOHATHAH H UHL'rNGER
PAGE
O178XXXXXX 12/31/03
1ZIZ PAYHENT: BY CHECK Z600.O0 569Z.45
1Z15 DIVIDEND RATE CHANGED FROH 1.09% TO 1.00%
1Z15 HITHDRANAL VIA HOHE BANKING TRANSFER 550.00- 51~Z,fi5
· FROtt UHLINGER,JONATHA XXXXXXXXXX. SHARE 0fi
:;i:i iii; ......................... .....................
ANNUAL PERCENTAGE YZEL9 EARNED 1.0Z~ FRO, 1Z/01/03 THROUGH
1Z~1 ENDING BALANCE 1695.
..................................................... :~':E:'~'g ......................................... ~:~:..~:.~:.:.....g~.~..~.:.:~:~:.~:.~:E.~:~.:~.:~.:~A.:.:~:.EE.E`~:~.~.:~:E.~:~:~:~...~.~.~.~.~.~.~.~.~.A.[.A~E~`..~.~:~.:.:.~...~`~..?: :'''''''''~ ................................................. ~"':'"~"~ ...............................
1ZOfi PAYHENT~ TRANSFER FROH SHARE 5fi TRANSFER FROH ANOTHER iNSTiTUTiON
~ e ~ , Z~zs.zz I~ZS~..7.z ................................
NONTAXABLE DIVIDENDS YEAR TO DATE 69.85
2228629
0~030000
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003584
UHLINGER JONATHAN H
57 FAIRWAY DR
CAMP HILL, PA 17011-2065
........ fold
ESTATE INFORMATION: SSN: 178-12-0146
FILE NUMBER: 2104-01 72
DECEDENT NAME: UHLINGER MARTHA H
DATE OF PAYMENT: 02/20/2004
POSTMARK DATE: 02/1 9/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1/22/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $1,300.74
REMARKS:
CHECK# 4829
SEAL
TOTAL AMOUNT PAID:
$1,300.74
INITIALS' JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: Alberta M. Lang
Date of Death: 11/30/2013 File Number: 21 - 14-0172
Pursuant to Pa. O.C. Rule 6.12, 1 report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete: [91 Yes ❑ No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court? ❑ Yes [91 No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? ❑ Yes 191 No
d. Copies of receipts, releases,joinders and approvals of formal or informal accounts may be
filed with the Clerk of Orphans' Court and may be attached to this report.
Date 07/10/2014 ( .
Signature of Person Filing this Form
l N Capacity: ❑ Personal Representative Counsel
Q
�-.�
Gerald J Brinser #09655
y = L U
CD J fl- - 7 Name of Person Filing this Form
"D 6 E. Main Street
Jw P.O. Box 323
_ G)`C' C-cc address
W rl b= Palmyra, PA 17078
S
U City,Slate,Zp
7171838-6348
Telephone
Form RW10 Rev.10-13-2006 Copyright(c)2000 form software only The Lackner Group,Inc. \(�