Loading...
HomeMy WebLinkAbout02-10-0915056D7121 REV-1500 EX (O6-OS) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Tazes County Code Year File Number Po6oxzfiosol INHERITANCE TAX RETURN Harrisburg, PA 17120-0601 RESIDENT DECEDENT 2 1 D 9 0 0 0 0 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 8 8 D 3 8 9 0 7 1 2 2 7 2 0 0 8 0 3 1 2 1 9 2 0 Decedent's Last Name Suffix Decedent's Firs t Name MI D E A R D O R F F K E N N E T H E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffx Spouse's First Name MI D E A R D O R F F M A R G A R E T K Spouse's Social Security Number 1 3 5 7 8 7 6 8 2 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-ffi) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-t32) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number •D A N I E L~ K D E A R D O R F F E S Q 7.1 7 2 4 3 3 3 4 1 Firm Name (If Applicable) M A R T S O N L A W O F F I C E S First line of address 1 D E A S T Second line of address City or Post Office C A R L I S L E H I G H S T R E E T State ZIP Code REGISTER OF WILLS USE ONLY r~ n o c_ O "° _, `:_'7 ` TI c~ m _~~ ~ ~m nx o - < - _,~ _ `BA~FILED i i C.J -Fi f -: ~=ri V P A 1 7 0 1 3 '' ° ~ ~`~ F Correspondent's a-mail address: DDEARDORFF(ilMARTSONLAW.COM 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 beliel, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ADDRESS Side 1 L 15D5607121 1505607121 J \y~ L0 EAST H1(,H S~I~KEE~I- CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY ~ ~~ ~ ~ .4 ~ ,,,~ ~ ~ ~~ c~~ ~ ~~ v ~~~~ --,~- 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: KENNETH E• DEARDORFF 1 8 8 0 3 8 9 0 7 RECAPITULATION ........................................ 1. Real estate (Schedule A) 1 .................................. 2. Stocks and Bonds (Schedule B) 2~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers 8 Miscellaneous N n-Probate Property (Schedule G) ~ Separate Billing Requested ..... , . 7. 8. Total Gross Assets (total Lines 1-7) ..................... ...... 8. 9. Funeral Expenses 8 Administrative Costs (Schedule H) .......... ...... 9. 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ...... ...... 10. 11. Total Deductions (total Lines 9 8 10) ..................... ...... 11. 12. Net Value of Estate (Line 8 minus Line 11) ................... ...... 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............ ...... 13. 14. Net Value 3ubJect to Tax (Line 12 minus Line 13) ......... .. ..... .. 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X.00o 2 3 5 0 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 0 0 0 18. 17. Amount of Line 14 taxable ~ Q Q at sibling rate X .12 17. 18. Amount of Line 14 taxable ~ ~ 0 at collateral rate X .15 18. 19. Tax Due ................................................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 8 4 7 8 2 7.7 0 3 2 5 1 0. 6 2 8 8 0 3 3 8, 3 2 4 6 3 4 2. 0 5 4 6 3 4 2. 0 5 8 3 3 9 9 6, 2 7 8 1 0 4 9 6, 2 7 2 3 5 0 0, 0 0 a. 0 0 ~. ~ ~ 0. 0 0 o. a o o. 0 0 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Numher 21 09 00002 DECEDENT'S NAME KENNETH E. DEAJ3DORFF STREET ADDRESS 210 BIG SPRING ROAD CITY NE W V ILLE STATE PA ZIP 17241 Tax Payments and Credits: t~ Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 4. If Line 2 is greater than Line i + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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 the TAX DUE. A. Enter the interest on the tax due. (4) 0.00 (5) 0.00 (5A) B. Enter the total of Line 5+5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCFtS 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 .......................................................................................... ...... ^ ^X d. receive the promise for life of either payments, benefits or care? ................................................. ...... ^ 2. If death occurred after December 12, 1962, 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? ............................................................................................ ...... ^ ^X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9716 (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. Far 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-halt (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(aj(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. o. 0.00 TotalCredits(A+B+C) (2) 0.00 Total InterestlPenalty (D + E) (3) 0.00 REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER KENNETH E. DEARDORFF 21 09 00002 All property jolntlycwned with right of survivorship must be dlaclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Oppenheimer & Co., Account No. A25-0009287 (see estate valuation report attached) 835,873.94 Z• ~ 3212 shares, common, General Motors Corp (370442105) 3. 2244 shares, common, Delphi Corp (247126105) 11,900.46 53.30 TOTAL (Also enter on line 2, Recapitulation) ~ $ (lf more space is needed, insert additional sheets of the same size) REV-1508 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER KENNETH E. DEARDORFF 21 09 00002 Include the proceeds of litigation and the date the proceeds were received by the estate. All oroceM lolntlvbwned with right of survivon:hip moat be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Oppenheimer & Co., Account No. AZS-0009287, Advantage Bank Deposit 8,578.75 2 December pension check from Belgium @ USD exchange rate 431.87 3 2009 Pontiac G-6 19,000.00 4 2004 Pontiac Sunfire 4,500.00 TOTAL (Also enter on line 5, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER KENNETH E. DEARDORFF 21 09 00002 Debts o1 decedent must be reported an Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home, Carlisle, Pa 2,159.23 8. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address 10 East High S City Carlisle Year(s) Commission Paid: 2009 State PA Zip 1 p Attorney Fees Manson Ltlw Offices (estimated) 3, Family Exemption: (If decedenCs address is not the same as claimant's, attach explanation) Claimant Margaret K. Deardorff Street Address 210 Big Spring Road City Newville State PA Relationship of Claimant to Decedent Spouse 4. Probate Fees Register of Wills of Cumberland County 5. I AccountanCS Fees 6. ~ Tax Return Preparefs Fees 7. Certified Mail, stock certificates R. EVP Systems, Inc., stock valuation reports 9. Register of Wills, filing fee, Inheritance Tax Retum 6.07 37.75 15.00 TOTAL (Also enter on line 9, Recapitulation) I $ 46,342.x5 20,000.00 20,000.00 3,500.00 Zip 624.00 more space is needed, insen additional sheets of the same size) REV-1513 E%* (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES ESTATE OF FILE NUMBER KENNETH E DEARDORFF 21 09 00002 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 linclude outrigQht spousal disUibutions, and transfers under Sec. 91113 (a) (7.2)] 1. Margaret K. Deardorff Spousal 23,500.00 10 East High Stree[ Sch E, Items 3-4 Carlisle, PA 17013 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 1. Disclaimer Trus[ for benefit of Margaret K. Deardorff, spouse 810,496.27 Linda D. Moyer and Daniel K. Deardortl-, children, remainder beneficiaries B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ R 10 496.27 (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT I, KENNETH E. DEARDORFF, of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO If my wife, MARGARET K. DEARDORFF, is living thirty (30) days after my ~ C,.' w death, then I give, devise and bequeath all of my estate, both real and personal property, unto my said wife, MARGARET K. DEARDORFF, absolutely. If my said wife does not so survive me, then I give, devise and bequeath all of my estate, both real and personal property, unto my children, in equal shares. In the event my wife and one or both of my children do not survive me, then I give, devise and bequeath all my estate, both real and personal property, unto my Trustee under the provisions set forth in the Disclaimer Trust herein. ITEM THREE In the event my said wife shall disclaim all or any portion of any devise or bequest made to her under the foregoing ITEM TI,VO, then the amount otherwise payable shall be held by my Trustee as the Disclaimer Trust under ITEM FOUR hereof. rr>+~,r ~nrrR V+W OFFICES I LLum F. M,~~x rs o.~ ;. _. j ~I i~ I DISCLAIMER TRUST lIy Trustee shall hold the assets of the said Disclaimer Trust for the following ~~, purposes: Page -1- (a) To pay the net income, at least quarter-annually, to my wife, MARGARET K. DEARDORFF, for life. In addition, the Trustee, in his sole discretion, may invade the principal of the Disclaimer Trust to provide for the proper and adequate support of my wife, MARGARET K. DEARDORFF. (b) The Trustee shall pay to my wife, MARGARET K. DEARDORFF, annually, such sum from the principal of the Disclaimer Trust as she may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.0) or five percent (5%) of the aggregate value, at the time of said request, of ~ the principal of the Disclaimer trust. (c) Upon the death of my wife, MARGARET K. DEARDORFF, my Trustee shall distribute the principal of the Disclaimer Trust to my children, absolutely, in equal shares. PROVIDED, HOWEVER, In the event of the death of any of my children before final distribution of that child's share of the Disclaimer Trust, the Trustee shall hold said deceased child's share in trust for the benefit of said deceased child's issue and ~ I shall distribute equally to the issue of said deceased child in a per stirpes manner that child's share of the principal of the Disclaimer Trust in the following amounts when the issue shall reach the following ages: One-third (1/3) of the principal of the trust I when the youngest issue reaches the age of twenty-one (21) years; one-half (1/2) of the 'I remaining principal of the trust when the youngest issue reaches the age of twenty- , five (25) years; the remainder of the principal of the trust when the youngest issue reaches Che age of thirty (30) years. However, in no event shall the principal of this trust vest later than twenty-one (21) years after the death of the survivor of my spouse and my children. I WW JFFICES ILLITM F. MANT=. i ._. Page -2- Prior to the vesting of said principal, the Trustee is directed to distribute the income of said trust equally to said issue and to distribute so much of the principal therefrom as the Trustee shall from time to time consider desirable for each issue's comfort, education, and support. In the event of the death of any of Settlor's aforementioned children not leaving ~ issue before final distribution of the principal of the Disclaimer Trust, the Trustee shall add such child's share, or the balance thereof, equally to the other shares provided above, to be held or distributed as if originally a part thereof. TTFM FTVF POWERS OF EXECUTRIX AND TRUSTEE In addition to the powers conferred by case law, by statute, and by other provisions hereof, my Executrix and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution: (a) To retain any property of any nature received by them for whatever period they shall deem advisable; (b) To invest and reinvest all or any part of said property in such stocks, bonds, r y d c c d :A securities or other property, real or personal, as in their discretion they shall deem i proper, without regard to statutes limiting the property which a fiduciary may purchase; (c) To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for ',.AW OFFICES LLL,M F..+.,a.~~. V .. i these purchases without the obligation to repudiate them in favor of a higher offer; p Page -3- (d) To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; (e) To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; (f) To assume continuance of the status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; (g) To pay from the Disclaimer Trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; (h) To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, and my Trustee, in its absolute discretion, may cause the share distributed to. any distributee to be composed of property similar to or different from that distributed to any other distributee; (i) To exercise any subscription right in connection with any security held L.. d C W C :~ hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; (j) To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; (k) 'Po continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; LAW tiFFICES IIiITM F. MAR'_=~:h i .~ \l) To compromise claims; ~~ Page -O- il i'I ~i (m) To continue for whatever period of time as they shall deem necessary any ~ II ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; (n) To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. iTRM CiX PROTECTNE PROVISIONS All income or principal held for the use and benefit of the beneficiaries of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. If any beneficiary of either trust shall, in the sole opinion of my Trustee, be or L Y c c d 'SAW JFFICES I I' III u become mentally or physically incapacitated, by reason of illness, accident, minority or otherwise, my Trustee may apply either income or principal for the support and welfare of such beneficiary directly or to the person who has the care and control of such beneficiary, without the intervention of any guardian and without obligation to ji supervise application of said amounts in any way. TTR.M RR.VFN APPOINTMENT OF EXECUTRIX AND TRUSTEE I nominate, constitute and appoint my wife, :MARGARET K. DE ARDORFF, as Executrix of my estate. [n the event that my said wife shall predecease me or fail to act as Executrix, then I appoint my children as Executors of my estate. Page -5- I hereby appoint my son, DANIEL K. DEARDORFF, as Trustee of any trust created hereunder. In the event that he shall fail or be unwilling to continue to act as Trustee, then I appoint my daughter, LINDA DEARDORFF MOYER, as Trustee of any trust created hereunder. ITEM EIGHT WAIVER OF BOND I direct that neither my Executrix nor my Trustee shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this /~(~ day of (1Pr~ ~ , 1982. ~"" `' ~~`~`"vG (SEAL) Kenneth E. Deardorff c~ uS L\W OFFICES ILLITM F. MART,^OV. ~, SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in )<h presence of said Testator and of each other. Cj~\~ Page -6- COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, Kenneth E. Deardorff, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last 4Vi11; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. -~-~-- Sworn or affirmed to and acknowledged before me by Kenneth E. Deardorff, the Testator, this 1 ~ ~h day of F)P~i! , 1982. Notary Public WILLIAM L.-EARP, Notary Public Carlisle, Car-•bFrlard Co., PA COMMONWEALTH OF PENNSYLVANIA ) My ~-ommision E~pnes Aug, 13, 1984 SS. COUNTY OF CUMBERLAND ) We, 2"VO V` , ~~ rTc~ ,~!;~ ``-( I I I OM~gS .S u~ i ~_L I V~;rns the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do 'depose and say that we were present and saw ,the Testator sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind an under no constraint or undue influence. ~ Addr ss ~ ,, - ~ .- i- . ~ . ~ ,,,~ x ~'H OFFICES ILLITM F. MPH~St',-V. i. ~_, Sworn or affirmed to and subscribed before me this / / `` day of nr/~~ 1982. Notary Public - ~.. wv ~~;.,, ti , _ .a, ; ~ ra P,nge -7- Date of Death: 12/27/2008 Valuation Date: 12/27/2008 Processing Date: 02/09/2009 Oppenheimer Account Estate of: Kenneth E Deardorff Account: 4824.4 Report Type: Date of Death Number of Securities: 15 File ID: 4824.4.opp.ind Shares Security Mean and/or Div and Int Securrty or Par Description High/Ask Low/Bi d Adjustments Accruals Value 1) 1333 AQUA AMERICA INC 103836W103; WTA) COM NYSE 12/26/2008 20.14000 19. 87000 H/L 12/29/2008 20.05000 19. 49000 H/L 19. 887500 26,510. 04 2) 2400 BRISTOL MYERS SQUIBB CO (110122108; BMY) COM NYSE 12/26/2008 23.90000 23. 00000 H/L 12/29/2008 23.39000 22. 63000 H/L 23 .105000 55,952. 00 3) 500 COCA COLA CO (191216100; KO) COM NYSE 12/26/2008 49.93000 94. 27000 H/L 12/29/2008 44.86000 93. 72200 H/L 94 .945500 22,222. 75 4) 41 FAIRPOINT COP49UN ICATIONS INC (305560104; FAP) COM NYSE 12/26/2008 3.48000 3. 28000 H/L 12/29/2008 3.46750 3. 22750 H/L 3 .363750 137. 91 Prices for 12/29/2008 adjusted up for di vidend (sl : 0.2575 5) 1000 HARTFORD FINL SVCS GROUP INC 1416515104; NIG) COM NYSE 12/26/2008 15.97000 15. 17000 H/L 12/29/2008 15.87000 15. 09000 H/L 15 .512500 15,512. 50 Div: 0.32 Ex: 11/26/2008 Rec: 12/01/2008 Pay: 01/02/2009 320.00 6) 3000 HONEYWELL INTL INC (938516106; HON) COM NYSE 12/26/2008 32.25000 31 .37000 H/L 12/29/2008 31.25000 30 .65000 H/L 31 .380000 99,140. 00 7) 500 INTEL CORP (958140100; INTC) COM NASDAQ 12/26/2008 19.31000 14 .06000 H/L 12/29/2008 19.35000 13 .91000 H/L 19 .157500 7,078 .75 8) 500 JOHNSON & JOHNSON (478160109; JNJ) COM NYSE 12/26/2008 59.39000 58 .20000 H/L 12/29/2008 58.88000 57 .34000 H/L 58 .940000 29,220 .00 9) 500 NEWMONT MINING CORP (651639106; NEM) CDM NYSE 12/26/200A 39.20000 36 .79000 H/L 12/29/2008 41.13000 39 .23000 H/L 39 .087500 19,543 .75 Div: 0.1 Ez: 12/03/2008 Aec: 12/05/2008 Pay: 12/29/2008 50.00 Paqe 1 This report was produced with Esta [eVal, a product of Estate Valuations & Pricing Systems, Inc. If you have cP~zstions, please contact EVP Systems at 1818) 313-6300. (Revision fi.4.1) E.chibit to Schedule "E", Item ! (1/2) Date of Death: 12/27/2008 Estate of: Kenneth E Deardorff Valuation Date: 12/27/2000 Account: 4824.4 Processing -ate: 02/09/2009 Report Type: Date of Death Number of Securities: 15 File LD: 4829.9.opp.ind Shares Security Mean and/or -iv and Int Security or Paz Description High/Ask Low/Hid Adjustments Accruals Value 101 19500 PENN NATL GAMING INC (707569109; PENN) COM NASDAQ 12/26/2008 21.91000 20.55000 H/L 12/29/2008 21.06000 20.25000 H/L 20.817500 405,991.25 11) 900 PROVIDENT ENERGY TR (74386K104; PV%1 TR UNIT NYSE 3.99000 3.85000 H/L 12/26/2008 12/29/2008 4.21000 3.96000 H/L 4.002500 3,602.25 Div: 0.07158 Ex: 12/18/2008 Rec: 12/22/2008 Pay: 01/15/2009 54.42 121 9000 SCHERING PLOUGH CORP (806605101; SGP1 COM NYSE 12/26/2008 16.72500 16.46000 H/L 12/29/2008 16.66000 16.21000 H/L 16.513750 66,055.00 13) 771 STAAWOOD HOTELS&RESORTS WRLDWD (85590A901; HOT) COM NYSE 17.20000 16.62000 H/L 12/26/2008 12/29/2008 17.53000 16.58000 H/L 16.982500 13,093.51 Prices for 12/29/2008 adjusted up for dividend(s): 0.9 14) 1000 TATA MTAS LTD (876568502; TTM) SPONSORED ADA NYSE 12/26/2008 4.38000 9.23000 H/L 12/29/2008 4.61000 9.21000 H/L 9.357500 4,357.50 15) 2196 VERIZON COMMUNICATIONS INC (92393 V109; VZ) COM NYSE 12/26/2008 33.30000 32.88000 H/L 12/29/2008 33.93000 32.58000 H/L 33.047500 72,572.31 Total Value: $835,439.52 Total Accrual: $434'42 Total: $835,873.99 Page 2 This report was produced with EstateVal, a product of Estate Valuations 6 Pricing systems, Lie. If you have questions, please contact EVP systems at 18181 313-6300. ~Aevision 5.9.11 Exhibit to Schedule "E'". Item ! (2/2) F:~FaES~cre~~.~aaza oeareo,maeza n.eixia~m.. IN RE: ESTATE OF : IN THE COURT OF COMMON PLEAS OF :CUMBERLAND COUNTY, PENNSYLVANIA KENNETH E. DEARDORFF, ORPHANS' COURT DIVISION DECEASED : NO. 21-09-00002 DISCLAIMER AND RENUNCIATION I, Margaret K. Deardorff, by her Agent, Daniel K. Deardorff, hereby exercise the rights granted to me in Chapter 62 of the Probate, Estates and Fiduciaries Code (the "PEF Code"), and I hereby disclaim and renounce any interest to which I may be entitled under Item Two of the Last Will and Testament of Kenneth E. Deardorff dated April 14, 1982, and probated at the above number and under applicable law, with the exception of the following assets: Date of Death Value 2009 Pontiac G-6 19,000.00 2004 Pontiac Sunfire 4.500.00 IN WITNESS WHEREOF, intending to be legally bound hereby and intending that this Disclaimer and Renunciation shall be filed of record in the Office of the Clerk of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Penn$ylvania, as rovided in Section 6204 of the PEF Code, I have hereunto set my hand and seal this c.~ day of ~ ~,- , 2009. Dantel K. Deardorff, PO r Margaret K. Deardorff COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND ) On this, the ~~ ~~~ day of I~ chi-u rz, < , 2009, before me, a Notary Public, the undersigned officer, personally appeared Danie( K; eazdorff, known to me (or satisfactorilyproven) to be the person whose name is subscribed as agent/attorney-in-fact for Mazgaret K. Deardorff, and acknowledged that he executed the same as the free act of his principal for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. Notary Public ~- ~/ ~~AIYION`.A~.-LLlli OF fE~AS}L.Y:A~IA V~)C\RLAL SF_AL tbni net then, tiotap' Public I Carii~ic Rern~:gh. C~rnherland l ounry ~1y comnics6m ._~pir<~ A7av _'Z _UI I