HomeMy WebLinkAbout01-15-09a
--~ REV-7500 1505607120
EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO 60x.280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 0 3 3 6
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03122008 08181947
Decedent's Last Name Suffix Decedent's First Name MI
LIVELSBERGER NANCY A
(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
I~ 1. Original Retum ^ 2. Supplemental Return
^
3, Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ qa Future Interest Compromise
(dale of death after 12-12-82)
^ 5. Federal Estate Tax Return Re wired
4
® g Decedent Died Testate ^
(Attach Copy of Willl) ~ Decedent Maintained a Living Trust
(Attach Copy of Trust)
_ 8. Total Number of Safe Deposit Boxes
^ 9. Litigation Proceeds Received ^ 1 p. Spousal Poverty Credit (date of death
between 12-31-91 and i-1-95)
^ 11, Election to tax under Sec. 9113 A
( )
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame
Daytime Telephone Number
FREDERICK I HUGANIR 7172496272
Firm Name (If Applicable)
HUGANIR LAW OFFICES
First line of address
P.O. BOX 308
Second line of address
City or Post Office State
CARLISLE pA
REGISTER O
F WILLS US~NLY
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ZIP Code ~
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17013-0308
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Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative Is bas information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
David S Livelsberger
ADDRESS
Dr ing
TIVE
P~UUy~ox 308, Carlisle, FAA `17013-0308
Frederick I Huganir
Side 1
1505607120
1505607120 J
1505607220
REV-1500 EX
Decedent's Social Security Number
oecedent'sName: LIVELSBERGER, NANCY A
RECAPITULATION
1. Real Estate (Schedule A) ...................................................................................... 1. 1 8 5, 6 0 0. 0 0
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. 4 5 , 5 2 5 . 4 0
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............. 7. 2 4 4, 0 1 6. 2 7
8. Total Gross Assets (total Lines 1-7) .........................................................__..... 8. 4 7 5 , 141.6 7
9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... 9. 3 6 , 0 7 0 . 5 4
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 4 , 0 7 6 . 9 3
11. Total Deductions (total Lines 9 & 10) .............................__............................__.... 11 • 4 0 , 14 7 . 4 7
12. Net Value of Estate (Line 8 minus Line 11) .............................__.......................... 12. 4 3 4 , 9 9 4 . 2 0
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. 4 3 4 , 9 9 4 . 2 0
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 .00 0 . 0 0 15.
16. Amount of Line '14 taxable
at linealratex .045 434, 994 .20 16• 19, 574 .74
17. Amount of Line '14 taxable
at sibling rate X ,12 0 . 0 0 17.
18. Amount of Line '14 taxable
at collateral rate X .15 0 . 0 0 18.
19. Tax Due .............................................................. ................... 19. 19, 574 .74
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
1505607220 1505607220 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21 - 08 - 00336
DE ED NT' A
Livelsberger, Nancy A
STREET ADDRESS
584 Park Dr
CITY
Boiling Springs STATE ZIP
PA 17007
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 19,574.74
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payrrients
C. Discount
3. Interest/Penalty if applicable Total Credits (A + B + C) (2) 0.0 0
p, Interest 71.41
E. Penalty
Total Interest/Penalty (D + E) (3) 71.41
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4)
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 19, 646.15
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) 19, 646.15
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 :....................................
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? .............................................................. ^ ^
................................................... x
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ~ ^x
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 RETUR
_ - _, __ .
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 statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements
for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent,
except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
_ I
ESTATE OF Livelsberger, Nancy A FILE NUMBER
__ _ 21 - 08 - 00336
All real property owned sole)y or as a tenant in common must be reported at fair market value'=air market value is defined as the price
at which property would be exchanged between a willingg buyer and a willing seller, neither bein compelled to buy or sell, both having
reasonable knowledge of the relevant factsAeal properly which is jointly-owned with right o~ survivorship must be disclosed on
schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION
_ _ DEATH
1 584 Park Drive, Boiling Springs PA 17007 185,600.00
South Middleton Twp, Deed Book 24-N Page 06
TOTAL (Also enter on Line 1, Recapitulation) I 185,600.00
Address: 5f34 Parts Drive
City: Bong Springs County: Cumberland
LEgal Description: See aaact~ed Deed Cosy trom oe 24N PG 06
Borrower: N/A
State: ~
Unit No.: N/A
Zip Code: 17007
Lender/Client: Estaoe of Nancy A, t.iveNberger
Address: 584 Parts DriNe
Boiling Springs, Pa. 17007
Prepared By: G. Arthur Cafarnan, Pa. Cert.; RL-139418
Company: B-N Agency appraisal Services
Address: 163 N Nanorer Street
Carlisle, Pa. 17013
Phone: 717) 243-1000 ext. 216 Fax (717) 243-1718 Email: bhappraisalr~COrrrcast.net
Prepared As Of: August 13, 2008 Estimated Market Value: $ ;185,600.00
Cover Page with Photo and ConbaNs
Cover Lehr
Uniform Residenti~ appraisal Report
Certiflptlon and Limiting Conditions
Text Addendum
Subj~t PhoOOs
Building Sketch
Comparable Phobos
Location Map
Deed/LegalDesaiption
Date :August 21, 2008
Client : F_state of Nancy A. Livelsberger
Executor: David Livelsberger
In accordance with your request, I have inspected, as per Your instn~ctions, and appraised the subject property located at
584 Park Drive, Boiling Springs, S. Middleton Twp., Cumberland County, Pa. 17007.
As per your instructions, the purpose of this appraisal was to determine "Market Value" in unencumbered fee simple title of ownership, and
was done in compliance with and as defined try "USPAP" and the Appraisal Standards Board.
This report in it's entirety is interxJed and valid only for the intended use of the Client named in this report, and is invalid if photocopied or
electronically transmitted, whether in part or in whole by anyone other tlian the CNent or the State Certified Real Estate Appraiser(s) named
in this report. It is intended solely for the Client, and shall not be used by anyone other than the Client without the prior written consent of
the Client, and the State Certified Real Estate Appraiser(s) conducting the appraisal process.
Note :This Is a Summary Appraisal Report, and contains li pages (plus attachments or addenda as necessary), and any single page is
inva~d ff detached or used separatety from the errtire report as originally submitted.
This report was conducted and prepared with the utmost care and confidentiality, and was established with no pre-determined opinion of
value on the part of the appraiser(s).
Thank you for choosing B-H Agency Ap t Services
/- }
Art Cala an
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF Livelsberger, Nancy A
FILE NUMBER
21 - 08 - 00336
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
NUMBER DESCRIPTION VALUE AT DATE OF
- -- DEATH
1 Contents of residential home 8,678.00
2 RV - 2005 Thar America M-30T 18,000.00
3 Auto - 2006 Honda Accord cpe 13,000.00
4 Conerstone Fed. Credit Union, Carlisle, PA 569
93
Checking account 445749000 0010093 .
5 Cash
889 97
6 US Treasury - 2007 1040 refund
2,798.00
7 Highmark Insurance refund
1,589.50
TOTAL (Also enter on Line 5, Recapitulation) I 45,525.40
APPRAISAL CERTIFICATE
I hereby certify that upon request for valuation of the personal
property of The Estate of Nancy Livelsberger, deceased. By David
Livelsberger, 584 Park Drive, Boiling Springs, Pa. 17007. I have personally
and physically inspected the following listed personal property for the
purposes of appraising and reporting the FAIR MARKET VALUE, AS OF
this 15th. day of October, 2008.
The information and values contained in this report are based upon
my experience as an antique dealer and appraiser, and other reliable sources.
The personal property was found to be in very GOOD condition, unless
otherwise noted. Values are reported piece by piece, and as a whole. All
values reported have been determined with consideration to condition of
item, market conditions, and sale ability factors.
APPRAISAL SUMMARY
It is in my opinion that, as of this 15th. Day of October 2008, the
FAIR MARKET VALUE of the listed personal property for the Estate of
Nancy Livelsberger, is.
(Eight Thousand Six Hundred Seventy Eight Dollars)
($ 8,678.00)
Signed,
J
Mary A. Roell
Antique Business Owner & Appraiser
STATEMENTS OF QUALIFICATIONS
MARY A. ROELL, ANTIQUE DEALER & APPRAISER
• PROFESSIONAL ACCOMPLISHMENTS
In the antique business for over 25 years.
Furniture and Art restoration business for 25 years
General Manager of Albion Point Antiques & Collectibles, a
successful antique co-op in Carlisle, Pa with 120 dealers. Member
of the design and implementation team for start up of Albion Point.
In business from September 1998 to March 2003.
• PRESENTLY
Owner of Bedford Street Antiques, LLC, a successful award
winning co-op in Carlisle, Pa with over 90 dealers. Opened for
business in December of 2003.
Work with Rich Murry Auctions. Auction set-up and clerk.
Started in March 2000, to present.
• PROFESSIONAL DESIGNATIONS
C.A.P.P., designation earned with successful completion of
Certified Appraiser's of Personal Property, 30-hour program with
intense study of appraisal fundamentals, February 2000.
C.R.A.D.A., Capital Region Antique Dealers Association,
Member for 7 years, Director for 2 years. Vice President and
Social Director for 2 years.
P.A.D.A., Pennsylvania Antique Dealers Association,
Member for 10 years, Director for 4 year.
Secretary ~ Downtown Neighborhood Connection, (Elm Street
Project) and on Committee for Facade Improvement Program.
Signi ~~
'~ ~ ~~
Mary A~ ~oell
Antique Business Owner & Appraiser
w-~tt
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CORNERSTONE FEDERAL C.U.
P.O BOX 1181
CARLISLE PA 17015
(717) 249-1661
IZ-Member Inquiry Date Printed: 03/26/2008
Member: 255 - NANCY A LIVELSBERGER
TID: 199-34-8427
Date Range: 03/01/2008 - 03/26/2008 Transaction History
Share Record: 07 - SHARE DRAFT ACCOUNT
Tran Post Transaction Chk Post Trace Ending
No. Date Description No. Srce Amount Number Fee Balance
280 03/03/08 DEBIT CARD PURL 18 -35.00 .00 538.73
003-016760-SHEETZ 00001917-CARLISLE-PA-US
281 03/03/08 DEBIT CARD PURL 18 -39.14 .00 499.59
003-009805-SHEETZ 00001917-CARLISLE-PA-US
282 03/03/08 DRAFT CLEARED 4761 20 -36.00 0011047719 .00 463.59
283 03/05/08 DRAFT CLEARED 4766 20 -30.00 0011071738 .00 433.59
284 03/06/08 DRAFT CLEARED 4769 82 -185.00 .00 248.59
SUBURBAN PROPANE-CHECK PYMT
285 03/06/08 DEBIT CARD PURL 18 -50.58 .00 198.01
12345678-012917-SMOKER' S EXPRESS #1403-CARLISLE-PA-US
286 03/07/08 DEPOSIT 80 901.52 .00 1099.53
CUMBERLAND COUNT-PR PAYMENT
287 03/07/08 DRAFT CLEARED 4770 20 -54.36 0013015049 .00 1045.17
288 03/10/08 DEBIT CARD PURL 18 -195.00 .00 850.17
0001-021629-CHIROPRACTIC FITNESS C-EAST BERLIN-PA- US
289 03/10/08 DEPOSIT 1 500.00 .00 1350.17
PERSONAL CK
290 03/11/08 DEBIT CARD PURL 18 -238.94 .00 1111.23
12345678-017512-KARNS QUALITY FOOD-BOILING SPRIN-PA-US
291 03/12/08 DRAFT CLEARED 4771 20 -541.30 0011030385 .00 569.93
292 03/20/08 WITHDRAWAL 82 -71.25 .00 498.68
CM :INS. SOC. JOI-CMIS LIFE
293 03/21/08 DEPOSIT 80 889.87 .00 1388.55
CUMBERLAND COUNT-PR PAYMENT
End
NAME . NUMBER PERIOD CHECK NO CHECK DATE EXEMPTIONS! FILIhG STATUS
LIVELSBERGER, NANCY A. 7544 03/02!2003-03/15/2008 01140646 3/21 /2008 i
~
a°1' ~ t ~1~R~
e
i
DESCRIPTION HOURS RATE AMOUNT YTD AMOUNT TYPE DESCRIPTION AMOUNT YTD AMOUNT
REGULAR 48.00 14.15 679.20 5,879.32 TAX FICA MED 18.37 106.90
E LVBVN 25.88 14.15 366.20 366.20 o TAX FICA SS 78.52 45
7.08
A SICK NEW 8.00 14.15 113.20 452.80 E TAX FWT 133.77 .
752
88
R LVBSK 4.00 14.15 56.60 56.60 o TAX LST 2.00 .
12.00
N COMPPYNR 2.88 14.15 40.75 40.75 ~ TAX LWT 20.27 117.96
j ~ OVERTIME .50 21.22 10.62 106.16 ~ TAX UC .76 4.42
LWOP
N 32.00 TAX SWT
T 38.88 226.33
OTHOL 339.60 PRETAX RET PRE 40
15 345
43
~ VACATION 113.20 ~ AFTERTAX BUYUP EE .
22.78 .
136.68
s ADO REG 10.61 a AFTERTAX LIFE EE 16.20 97
20
COMPTAKE 7.08 N ' AFTERTAX UN WAY 5.00 .
30.80
s
A
N
D
T
A
x
E
S
TOTALS EARNINGS GROSS PAr TAXABLE. PAY NET PAY UCTIONS TAX PRETAX COMPANY.. AFTER TA%
?N:8 PERI~JQ 11~. 7 1 Z 2 89.97 29 4 4? 4
rA 7 7. 9
0 DESCRIPTION ACCOUNT AMOUNT YTD AMOUNT DESCRIPTION BALANCE DESCRIPTION BALANCE DESCRIPTION EIALANCE
I CHECKING 0620325506 889.87 a COMPTIME
00
.
e ~ PERSONAL 24.00
~ R SICKTIME 4.00
T e VACATION .00
D U
E T
P
1
o at
S
E
T
S
I
a
4
CUME3ERLAND COUNTY
'~ REMOVE DOCUMENT ALONG THIS PERFORATION ~ '
i COUNTY OF CUMBERLAND DATE RECEIPT NUMBER
CARLISLE, PENNSYLVANIA 03/21/2008 01140646.
AMQUNT ~
i;
""'""'889.87"' ~
AMOUNT DEPOSITED
TO THE ACCOUNTIS) I
THE NANCY A. LIVELSBERGER LISTED ABOVE ;
ACCOUNT 584 PARK DR
of BOILING SPRINGS, PA 17007
a• a a ' a a e a a s a i~
DIRECT DEPOSIT ADVICE -NOT NEGOTIABLE
COMMONWEALTH OF PENNSYLVANIA SCHEDULE G
INHERITANCE TAX RETURN INTER-VIVOS TRANSFERS &
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Livelsberger, Nancy A FILE NUMBER
21 - 08 - 00336
This schedule Imust be completed and filed if the answer to anv of auRt~rinnc ~ +hr~r~„ti n .,., .,~,.e ~ ,~ .,,.~
ITEM
NUMBER DESCRIPTION OF PROPERTY
Include the name of the transferee, their relationship to decedent
and the date of transfer. Attach a copy of the deed for real estate. DATE OF DEATH
VALUE OF ASSET q OF
DECD'S
INTEREST EXCLUSION
(IF APPLICABLE)
TAXABLE VALUE
1 American Funds IRA No. 58721234 46,150.23 46,150.23
PO Box 2280
Norfolk VA 23501
2 American Funds IRA No. 58819820 197
866
04
~ ,
. 197,866.04
PO Box 2280
I Norfolk VA 23501
TOTAL (Also enter on line 7, Recapitulation) 244,016.27
The right choice for the long term$
American Funds`
PO Box 2280
Norfolk VA 23501-2280
AV 03 002118 70848H 14 At*SDGT
~n~~~~n~~~~u~~~n~~n~~~~~n~~i~~~~nu~~~i~n~n~u~~~~u~
NANCY A LIVELSBERGER
584 PARK DR
BOILING SPRGS PA 17007-9503
Best wishes for the New Year
This statement shows your complete account activity for 2007,
so please keep it for your tax records. Our online Tax Center
offers an Interactive Tax Guide and can help you with duplicate
tax forms, average cost information, and mare. You can also go
online to make your IRA contributions. Visit us at
americanfunds. com.
Year-End Statement
December 31, 2007
Page 1 of 5
Your t3nandai adviser
MCQUEEN/STEPP
(856) 273-9017
AMERICAN PORTFOLIOS FINANCIAL
SERVICES, INC.
305 ELBO LN
MOUNT LAUREL NJ 08054-9638
For more account information
^ all your financial adviser
^ Automated information end services
Websrte - americanfunds.com
American FundsLine ° - 800/325-3590
^ Personal assistance - 8 a.m. to 8 p.m. Eastern time M-F
Shareholder Services - 800!421-0180
Year-end summary (Janua.ry 1 -December 31, 2007)
..............
.........
Value on
Reinvested
dividends and .............. .........................
Change in ..................
...•..
..•...~.~~~~~~~~~~~~
„ . 12/23/06
................................... ..............
+ Additions +
......................................
capital gains - Withdrawals
..............
......................................... account
+/- value Value on
= 17/31/07 Ending
share balance
NANCY A I.RrELSBERGER ....... ..........................
......
..............................
..........................
New Perspective Fund-A
Account # 58T~'1234` $28,853.66 $0.00 $1,663.81 -$11,500.00 $1,796.81 $20,814.28 613.267
American Mutual Fund-A
Account # 58TT123t $26,323.15 $0.00 $1,181.32 -$10,000.00 -$208
16 $17
296
31
The Investment Company of America-A . ,
. 611.393
Account # 5872123i'.' $19,923.20 $0.00 $1,427.91 -$1,500.00 -$257
06 $19
594
05
The Cash Management Trust of America-A . ,
. 594.660
Account # 5872'1238 $603,09 $23,000.00 $168.05 -$23,701.08 $0
00
$70
06
......... .....
...................... , . 10.060
$75,703.10
CBdtT CU3T IRA R/O $23,000.00 $4,441.09 $46,101.08 $1,331.59 $57,774.70
1~iANCY A LIVELSBERGER
New Perspective Fund-A
Account #58819820 $70,148.51
American Mutual Fund-A
Account #58819820 $18 811 09
The Investment Company of America-A
Account #588'19828 $108,282.67
$191,242.27
Totals 3272 945 37
$0.00 $6,506.53 $0.00
$0.00 $1,245.45 -$10.00
SD.00 $8,237.16 $0,00
50.00 515,989.14 -510.00
523.006.00 ,320,430.23 -346.711.08
$4,741.80 $81,396.84 2,398.257
-$620.11 $19,426.43 686.689
-$1,801.90
.................. 5114,717.93 3,481.576
................
52,319.79 ...........
5215,541.20
33,651.38 3273,315.90
12 ~ s oo~ee/ooool
AFS..~Sl IU0~.064012p00]Ot]!6.]gS06.ONSAF501 iNVMCN.. AF 1... . 0010]'}41]ISITE102
• The right choice for the long term'
American Funds~~
PO Box 2280
Norfolk VA 23501-2280
NANCY A LIVELSBERGER/DEC'D
584 PARK DR
BOILING SPRGS PA 17007-9503
I,~~III~~~III~~~II~~~I,~~II~I~~~I~I~II~~~~~II~I~~I~~I~~I~II~~I
Confirming a change
As requested, the change described below has been made to the
accounts) listed. Please checkthe accuracyofthis information.
If you have further changes, please notify yourfinancial adviseror
call us at 800/421-0180.
Change
.......................
Registration
Account Change Page 1 of 3
Confirmation
March 26, 2008
Your flnandal adviser
MCQUEEN/STEPP
AMERICAN PORTFOLIOS FINANCIAL
SERVICES, INC.
305 ELBO LN
MOUNT LAUREL NJ 08054-9638
~L~l/
17
For more account information
............................................................
^ Call your financial adviser
^ Automated information and services
American FundsLine'~ 800/325-3590
Website - americanfunds.com
^ Personal assistance - 8 a.m. to 8 p.m. Eastern time M-F
Shareholder Services 800/421-0180
Id CB&T CUST IRA R/q
NANCYA LIVELSBERGER New CB&T CUST IRA R/0
NANCYA LIVELSBERGER/DEC'D
Account(s) changed
....
Accountowner
• •~•••••••~.••• ..................... ..................................................
Fund name .....................
Fund ...................
Account
CB&T CUST IRA R/O
American Mutual Fund-A number number
NANCY ALIVELSBERGER/DEC'D The Investment Company ofAmerica-A 3 58819820
New Perspective Fund-A 4 58819820
7 58819820
Change
Registration .................................................
..........................................
.....................
..................
Old NANCYA LIVELSBERGER ....................................................................................
.~_... .~,,.~,.., . , ,..~...________ ........................... .......................
Account(s) changed
Accountowner Fund name
.....................................
.............. ....... Fund Account
..............................................................................................................
NANCY A LIVEISBERGER DECD .. .............................
/ American Mutual Fund-A number
.......................................... number
............... .
The Investment Company ofAmerica-A 3 58721234
New Perspective Fund-A 4 58721234
The Cash Management Trust ofAmerica-A 7 58721234
9 58721234
The right choice for the Ions; term
American Fundsk
PO Box 2280
Norfolk VA 2350:1-2280
AV 02 004326 57108H 20 As*SDGT
~n~~~~u~~~~u~~~u~~ni~~~~ni~~~~~~nni~~~~n~n~n~i~~u~
NANCY A LIVELSBERGER/DEC'D
584 PARK DR
BOILING SPRGS PA 17007-9503
Enhancing your security online
Did you know we offer a number of ways for you to log in to
your accounts at americanfunds.com? Along with using your
account or Social Security number, you can now create a user
name. Easy to update at any time, user names can be as long
as 32 letters or numbers. Create your user name now by
clicking the banner on our home page.
Quarterly Statement
March 31, 2008
Your tlnaudal adviser
MCQUEEN/STEPP
(856) 273-9017
AMERICAN PORTFOLIOS FINANCIAL
SERVICES. INC.
305 ELBO LN
MOUNT LAUREL NJ 08054-9638
Page 1 of 4
For more account information
.......................................................................
...........................
^ Call dour financial adviser
^ Automated information and services
Website - americanfunds. com
American FundsLine ~ - 800/325-3590
^ Personal assistance - 8 a.m. to 8 p.m. Eastern time M-F
Shareholder Services - 800/421-0180
Quarterly summary (January 1 -March 31, 2008)
............
...
alue on
Reinvested
dividends and ...................... ...................
.......
Change in
.........................
...................
11/31/07
..................................................................
+ Additions
+ capital gains
- Withdrawals account
+/- value
Value an
.31/08
Ending
share balance
NANCY A LIVEISBERGEIt/DEC,D ....... ...............
............ ..........................
New Perspective Fund-A
Account # 58721231>-' $20,814.28 $0.00 $0.00 -$5,000.00 -$1,280.67 $14
533
61
American Mutual Fund-A ,
. 462.118
Account # 58721Z3t- $17,296.31 $0.00 $68.20 -$5,000.00 -$1,171.26 $11
187
25
The Investment Company of America-A ,
. 428.959
Account # 5872tZi1' 519,594.05 $0.00 $101.09
50
00
-$1
860
13
The Cash Management Trust of America-A . ,
. $17,835.01 5gg.p89
Account # 58721231 $70.06 $10,000.00 $27.40 57
503
t0
-
~)
~
............... ........................... ,
.
..............
•
$2,594.36
2,594.360
$57,774.70
CB&T CUST IRA R/O
$10,000.00
$196.69 .................
517.503.10 .........................
-$4,318.06 .
........$46,150.23
NANCY A I-n'ELSBERGER/DEC'D
New Perspective Fund-A
Account # 588198 $61 396 84 ~ ~ ~ ~
$0.00 -55,971.66 575,425.18 2
398
257
American Mutual Fund-A ,
.
Account # 58819820 $19,426.43 50.00 $109
87
~
~
. • -51,514.73 $18,021.57 691
011
The Investment Company of America-A .
Account # 58819820 5114,717.93 $0.00 5591
87
.
. $D.00
................ $10,890.51 5104,419.29 3,501.653
- 5215,541.20
50.00
$701.14 ...............
$0.00 .................. .
-$18,376.90
S197,866.04
Tote Is
5273,315.90 510,000.00
S89E.43
-517,503.16 -522,694.96 3294,016.27
AFS ~g6110. 0)39194006 U]561.11569 CNSAFS0I ~NVM~C11... AFI .00101561 ]~SITE101 16 004316(0000001
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Livelsberaer. Nancy A
FILE NUMBER
21 - 08 - 00336
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION
A. 1 ;Hoffman-Roth Funeral Home
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
David S Livelsberger
Social Security Number(s) / EIN Number of Personal Representative(s):
200-60-0095
Street Address 584 Park Dr
City Boiling Springs State PA Zip 17007
Year(s) Commission paid 2008
2. Attorney's Fees Huganir Law Offices
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Eric M. Livelsberger
Street Address 584 Park Dr
City Carlisle State PA Zip 17007
Relationship of Claimant to Decedent SOn
4. Probate Fees Register of Wills of Cumberland County
Estate Notice -Evening Sentinel
Estate Notice -Cumberland Law Journal
5. Accountant's Fees
6. Tax Return Preparer's Fees Group's Tax & Payroll, 524 S Pitt St, Carlisle PA 17013
7. Other Administrative Costs
1 ~ Mary A. Roell, Appraiser -personal property
44 N Bedford St, Carlisle PA 17013
TOTAL (Also enter on line 9, Recapitulation)
8,200.54
8,200.00
18,000.00
480.00
160.00
75.00
175.00
480.00
36,070.54
SCHEDULE H
FUNERAL F~ENSES &
ADMINISTRATIVE COSTS
AMOUNT
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Fuleral E~er~ses &
~711t1~'~1lrr ~.06~'S O01'~CIIIBd
ESTATE OF Livelsberger, Nancy A FILE NUMBER
21 - 08 - 00336
2 B-H Appraisal Services -real property
163 N Hanover St, Carlisle PA 17013
300.00
Page 2 of Schedule H
Hoffman-Roth Funeral Home & Crematory, Inc.
219 North Hanover Street
Carlisle, PA 17013
(717)243-4511
April 3, 2008
Michael Livelsberger
584 Park Drive
Boiling Springs, PA 17007
The Funeral Service for Nancy Livelsberger 15276-69
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
OUR SERVICE:
Traditional Funeral Service Package $4150.00
FUNERAL HOME SERVICE CHARGES $4150.00
SELECTED MERCHANDISE:
Sterling 18 ga Steei Casket , $2140.00
Monticello Interment Receptacle _ $1320.00
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED $7610.00
Cash Advances
Newspaper Obituary Notice- Sentinel , $146.54
Newspaper Obituary Notice: -Hanover Evening Sun $85.00
Clergy Offering _ $100.00
Certified Copies of Death Certificates , $60.00
Flowers , $159.00
Hairdresser. $40.00
TOTAL CASH ADVANCES AND SPECIAL CHARGES . $590.54
Total
Total Cost , $8200.54
TOTAL AMOUNT DUE $H2OO.S4
7.~~, Si
~ ~ 33 ~ 1-~,~c~
~ 133 s ~-~~:~
This statement is net and payable in full within 30 days of receipt.
SCHEDULEI
' DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Livelsberger, Nancy A FILE NUMBER
21 - 08 - 00336
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1 West Shore EMS -medical 1,648.46
2 Carlisle Regional Medical Center -medical 35
00
Carlisle, PA 1 "7013 .
3 James D Spertzel, D.O. -medical 88
00
23 N Main St, Biglerville, PA 17307 .
4 Suburban Propane 185.00
5 Nationwide Insurance Co. 541.31
6 Pennsylvania Dept of Revenue
2007 PA 40 386.00
7 Cornerstone Fed Credit Union -credit card
822.10
8 Bon Ton Dept Store -credit card
201.98
9 Peck's Septic Service
110.00
10 South Middelton Twp. Mun. Authority 41
00
Boiling Springs, PA 17007 .
11 CTCB -Local Income Tax
18.08
TOTAL (Also enter on Line 10, Recapitulation) I 4 076.93
LAST WILL AND TESTAMENT
OF
NANCY A. LIVELSBERGER
I, NANCY A. LIVELSBERGER, of Cumberland County,
Pennsylvania, being of sound mind and memory do make, publish and
declare this to be my Last Will and Testament hereby revoking all
prior wills and codicils heretofore made by me.
FIRST
I direct that my funeral be conducted in accordance with the
wishes I have made known to my Executor, hereinafter named.
SECOND
I direct the payment of my debts and funeral expenses from
my estate as soon after my death as conveniently may be done. I
direct that my Executor shall pay all inheritance, estate,
succession and legacy taxes to which my estate or the transfer of
any property hereunder may be subject, and to charge such taxes
as part of the expenses of administration, payable out of my
estate.
THIRD
In the event that I am survived by granddaughters, I give,
devise and bequeath my jewelry to them to be divided between
them, share and share alike. In the event that I am not survived
by any granddaughters, I direct my sons to jointly decide upon
the distribution of my jewelry.
FOURTH
I give devise and bequeath to my Executor those certain
items of treasured personal property owned by me at the time of
n-y death and listed on an Addendum to be attached to this, my
~ Last Will and Testament, or otherwise identified to my Executor.
I request that he distribute the i
terns mentioned in accordance
with the wishes I have made known to him.
R
FIFTH
I give, devise and bequeath the entire rest, residue and
remainder of my estate, whether real, personal or otherwise, to
my son, DAVID S. LIVELSBERGER, IN TRUST NEVERTHELESS, to be held
by him and used for my directed purposes as follows:
I direct my Trustee to hold the estate in a general trust
fund and to use and expend such amounts of the assets held
therein, and any interest or income earned thereby, as he shall
deem necessary and or appropriate to provide for the care,
support, health, education, maintenance, well-being and happiness
of my youngest son, ERIC M. LIVELSBERGER.
I: authorize my Trustee to continue to maintain our home as a
residence for himself, ERIC and my other son, JEFFREY M.
LIVELSBERGER, during Eric's minority.
I' grant my Trustee absolute discretion with regard to the
assets of the trust and direct only that he exercise his
discretion in accordance with his best judgment for the welfare
of ERIC. Nonetheless, I direct, that in deciding on the amount
and timing of distributions, my trustee take into account any
other monies available to ERIC.
SIXTH
At such time as ERIC reaches age 18, I direct my Trustee to
add the fair market value of the residence to the trust fund.
This shall be accomplished either by sale of the residence to any
of my sons who shall wish to purchase the home at its agreed upon
or appraised fair market value, or, if none of my sons wish to
purchase the home, or if they cannot otherwise agree on the terms
of the sale, then by sale to a third party. The resulting
balance of the trust fund, with real estate proceeds, shall be
divided into three (3) equal shares, two shares of which shall be
distributed as follows:
- - One share shall be paid outright to my son, DAVID S.
LIVELSBERGER;
- One share shall be paid outright to my son, JEFFREY M.
LIVELSBERGER;
I direct that the remaining one third share shall continue
to be held in trust for the benefit of ERIC, in accordance with
the purposes and directions set forth above, except that my two
sons, DAVID S. LIVELSBERGER and JEFFREY M. LIVELSBERGER, shall
. serve as Joint Trustees of the trust fund.
At such time as my son, ERIC, reaches age 25, I direct my
Trustees to release to him the remaining principal and
accumulated income, if any, of the trust assets.
SEVENTH
I hereby request and direct that my son, DAVID S.
LIVELSBERGER, be appointed guardian of the persons and estates of
ERIC. I request that in carrying out his responsibilities in
such regard that he consult with his brother, JEFFREY.
In the event that DAVID is unable or unwilling to accept the
responsibilities of guardian of ERIC, then I request and direct
that JEFFREY shall serve in such capacity if he is 21 years of
a9e• If JEFFREY is not yet 21 years of age, then I appoint my
deceased husband's sister, ANGELA MC CUSTER, of Hanover, PA to
serve as guardian of ERIC or authorize and direct her to appoint
a guardian for my son until such time as JEFFREY reaches 21 years
of age.
EIGHTH
I hereby nominate, constitute and appoint my son, DAVID S.
LIVELSBERGER, Executor of this my Last Will and Testament, to
serve without bond or security of any type for any purpose
• whatsoever, and I hereby authorize, empower and direct him to
sel]_ 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 that 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 that DAVID is unable or unwilling to serve as
Executor, then I name and appoint my son, JEFFREY M.
LIVELSBERGER, to serve in such capacity if he is 21 years of a e.
If JEFFREY is not yet 21 years of age, then I appoint m deceased
Y
husband's sister, ANGELA MC CUSTER, of Hanover, PA to serve as
f Executrix.
I grant my alternate Executor and Executrix named
herein, the same authority as granted herein tom E
y xecutor, and
direct that neither such named alternate shall be required to
post bond or security of any type for any purpose whatsoever.
We, having been duly qualified according to law, depose and
say that we were present and saw her, sign the foregoing
instrument as her Will; that she signed it as her free and
voluntary act for the purposes therein expressed; that each of us
in her sight and hearing and at her request signed the Will as
witnesses; and that to the best of our knowledge she was at that
time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Witness
Witness
Subscribed, sworn to or affirmed,
and acknowledged before me by the
above named T~St~trix and by the
witnesses whose names appear
0 os te, on . -~` %u ~% 19 91.
;,.~~~
~, ~~~
~~Ai(1TNDST nrtr~r r~ _ ,
i ~
~~cecs.~,c-~..•na~. ,. - =w....r -:.s _ - x,.z.~..,ns~:~as a
'i,i~4> t rEff~t r~
~ ~ I; ~ Il 1, ~~~ ~ ,':V I R. ~ rig:: Li`
,l'.
,~
IN WITNESS WHEREOF, I have hereunto set my hand and Seal to
this, my Last Will and Testament, consisting of ~'~
typewritten pages, the first ~ of which bear my signature in
the ,margin for the purpose of identification, this `=~~'-~ day of
..r, ,,
1991.
.,, '.
NANCY A. LIVELSBERGER
SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Testatrix, as and for her Will, in the presence of us, who, at
her request, in her presence, and in the presence of each other,
have hereunto subscribed our names as witnesses in attestation
thereof."
~-•
'~ residing at '
~ ~ r~
\ ~~ i
l Y
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
residing at.~^ I ~~,,~~'~-~~~. ~t 'r:ti:<_~:::t
,~ ,
i~
I, NANCY A. LIVELSBERGER, having been duly qualified
according to law, acknowledge that I signed the foregoing
instrument as my Will, and that I signed it as my free and
voluntary act for the purposes therein expressed.
~.
NANCY A: LIVELSBERGER