HomeMy WebLinkAbout03-0006 Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Paul K. Waltz No. 4~, ~r'O~ '"OO~ ~
also known as
, Deceased Social Security No. 185-03-3532
~wli~k~*~e~s), who i~/a~e 18 yearn of age or o~de~, a~ply(io~) for:
(COMPLETE "A" OR "B" BELOW:)
I~1 A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executor named in the Last Will of the
Decectent, dated December 20, 1989 and codicil(s) dated , , '~ O ~a./~
- /~tale F'~alll c~rcu~l~r[(~I e.~.l fon~f~c~n[ death of executor~ elc. ~ = ~ / '
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the documents offered for
probate; was not the victim of a killing and was never adjudicated incompetent:
NONE
B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: ge~dente lite; durante ab~entia; du~ante mii!oritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if
an)/) and heirs:
Name Relationship Residence J
(COMPL~:~ ~- IN ALL OASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at
100 Mt. Allen Drive, Mechanicsbur.q, PA 17055 (Messiah Villaqe) (Upper Allen Township)
(l~t ~treeL numb~ and md,',~..~,,dh"y)
Decedent, then 86 years of age, died December 20, 2002, at 100 Mt. Allen Drive, Mechanicsbur.q, PA 17055
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property ............................................... $ 900,000
(If not domiciled in PA) Personal property in Pennsylvania ............................. $
(If not domiciled in PA) Personal property in County .................................. $
Value of real estate in Pennsylvania ........................................................... $
Total ....................................................................
Real Estate s tuated as fo ows $ 900,000
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
I Si~lnature Typed or printed name and residence I
~¢~~<~ ~ ~~ Michael P. Waltz
2700 Columbia Avenue
Camp Hill, PA 17011
Alexandra Waltz Miller
1191 Kings Mill Court
Sunset Beach, NC 28468
Form RW-! Page 1 of 2 (Dauphin County - Rev. 9/g2)
17-// 4-1,
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing
Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as
personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate
according to law.
Sworn to and affirmed and subscribed
before me this 02 day of
Donna M. Otto, 1st Deputy
DECREE OF REGISTER
Estate of Paul K. Waltz Deceased No. 21-2003-0006
also known as
Social Security No: 185-03-3532 Date of Death: December 20, 2002
2003
AND NOW, January Brtl , ~, in consideration of the Petition on the reverse
side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [] Testamentary [] of Administration
(c.t,a.; d.b n c.t.; pendente lite; durante absentia; durante minoriLate)
are hereby granted to Michael P. Waltz and Alexandra Waltz Miller
in the above estate and that the instrument(s), if any, dated 12-20-1989
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........................... $480.00 -- ist '~/
_ ~' eLofWills ,(-~,, .~''z~
Short Certificate(s) (6)... $ 18.00 Donna M. O~to, ±st Deputy
Renunciation ( ) ............ $
Affidavit ( ) .................. $
Extra Pages (1]) ........... $ 33,00
Codicil ........................... $
JCP Fee ........................ $~ Attorney: Elyse E. Rogers
Inventory & Tax Forms... $ I.D. No: 41274
Other ............................ $. Address: 415 Fallowfield Rd. Suite 301
Camp Hill, PA 17011
TOTAL ................ $=.5~1_~=== Telephone: 717-612-5801
Executor w~11 pick up Letters DATE FILED: January 3rd,2003
on Jmuary 3:~c1, 2{303,,
Register of Wills of Cumberland County, Pennsylvania
· ' PETITION FOR GRANT OF LETTERS
Estate of Paul K. Waltz No.
also known as
, Deceased Social Security No. 185-03-3532
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE '%" OR "B" BELOW:)
i Letters and aver that Petitioner(s) is/are the executor named in the Last Will of the
A.
Probate
and
Grant
of
De~ce~dent, d~ated December 20, 1989 and codicil(s) dated ~,~
.,,t_~ ~-~,~v'/~-,~ /?'/,~-~, 3-,,-~,~_ (,d--/'tz d~¢o<d ,T_olI ?~
State relevant circumstances~ e,~., renunciation, death of executor~ etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for
probate; was not the victim of a killing and was never adjudicated incompetent:
NONE
E~ B. Grant of Letters of Administration
(c.t.a., d.b.n.c.l.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if
any1 and heirs:
Name Relationship Residence I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at
100 Mt. Allen Drive, Mechanicsburq, PA 17055 (Messiah Village) (Upper Allen Township)
(list street, number and municipality)
Decedent, then 86 years of age, died December 20, 2002, at 100 Mt. Allen Drive, Mechanicsbur.q, PA 1705,5
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) ............................................... $ 900,000
Personal property in Pennsylvania ............................. $
(If not domiciled in PA) Personal property in County .................................. $
Value of real estate in Pennsylvania ........................................................... $
Total ........................................................................... $ 900,000
Real Estate situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
I Si~lnature Typed or printed name and residence I
Michael P. Waltz
2700 Columbia Avenue
Camp Hill, PA 17011
1191 Kings Mill Court
Sunset Beach, NC 28468
Form RW-1 Page I of 2 (Dauphin County - Rev. 9/92)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing
Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as
personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate
according to law.
¢
Sworn to and affirmed and subscribed ~~,/~, ~, ~
before me this 3rd day of
_~_/~-;z~c~_ Jar3uary ~'% 2003
DECREE OF REGISTER
Estate of PaulK. Waltz Deceased No. 21-2002-0006
also known as
Social Security No: 185-03-3532 Date of Death: December 20, 2002
20(}3' '
AND NOW, Janu~ 3rd , 2~0~, in consideration of the Petition on the reverse
side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [] Testamentary [] of Administration
(C.t.a; d.b.n c.t.; pendente lite; durante absen£ia; durante minor~ta~e)
are hereby granted to Michael P. Waltz and Alexandra Waltz Miller
in the above estate and that the instrument(s), if any, dated 12-20-1989
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........................... $480.00 ~,~/~ ~ ~/~ .~~~ ~_
Register of Wills /2.g~~ ~
Short Certificate(s) (6)... $ 18.00 Donna M. Otto,lst DepuW ' .....
Renunciation ( ) ............ $
Affidavit ( ) .................. $
Extra Pages (11) ........... $ 33.00 ~
Codicil ........................... $
JCP Fee ........................ $ 10.00 Attorney: Elyse E. Rogers :
Inventory & Tax Forms... $ I.D. No: 41274
Other ............................ $ Address: 415 Fallowfield Rd. S~ite 301
Camp Hill, PA 17011~':
TOTAL ................ $ 541.00 Telephone: 717-612-5801
DATE FILED: Jai~uary 3rd,2003
Executor will pick up letters on
December 3rd, 2003
21-2003-0006
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA ) ....
) SS:
COUNTY OF ) ~ .
We, Elvse E. Rogers and Linda M. Gutshall, 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 Testator, PAUL
K. WALTZ, sign and execute the instrument as his Last Will and Testament; that
Testator signed willingly and that he executed said Will 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 eighteen (18) or more years of age, of sound mind and
under no constraint or undue influence.
Witness ~Wit-~.~
Sworn to and subscribed before
me this ,~ ~ day of ~
,2002.
My Commission Expires:
(SEAL)
Tiffs is to certiF: that the information here given is correctly copied from an original certificate of death duly filed with me as
l~ocal Registrar. The original certificate will be fotwvarded to tine State Vital Records Ofrice for permanent fiiing.
WAFINING: It is illegal to duplicato this copy by photostat or photograph.
Fcc fi)r this certificate, 52.00
Local Registrar
~~~t;m DEC 2 7 2002
N,~. ~ Dare
rrF~M #
,-*O!_,LOI'VS:
d
;~ .e~ ~7 COMMONWEAL~ OF PENNSYLVANIA · OEPAR~ENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
899 T~c~ora, Box 2015 RESI~<E
,.. Mechan~csb~g, PA 17055 o.'so,,~,~, ~'""
~.c~ Cumb~land .... "** ~,.D ~'~"~
,~. Michael P. Waltz [~2700 Col~bra Avenue, C~p Hrll, PA 17011
S~NATU~[~'FUNE~SER~CEL~EN~EORPER~TI~ASSUCH ILICENSENUM~R NAME~DA~RE~ Crema~o~ Socie~ oz PA
C~.L~N ~ CAU~ I ~ I''~' ~"" ~"'~ I [
REGISTER S SIGN.URE AND NUMBER' ./2.
' ' ' ' ' ' ,,. ~~~oo~
21-2003-0006
OF
PAUL K. WALTZ
I, PAUL K. WALTZ, of the Borough of Lemoyne,
Cumberland County, Pennsylvania, do make, publish and declare
this to be my Last Will and Testament, hereby revoking all Wills
and Codicils by me at any time made.
ITEM I: I direct that all inheritance and
estate taxes becoming due by reason of my death, whether such
taxes may be payable by my estate or by any recipient of any
property, shall be paid by the Executor out of the property
passing under ITEM IV of this Will, as an expense and cost of
administration of my estate. The Executor shall have no duty or
obligation to obtain reimbursement for any such tax so paid,
even though on proceeds of insurance or other property not
passing under this Will.
ITEM II: I direct the Executor to pay the
expenses of my last illness and funeral expenses from the
property passing under this Will as an expense and cost of
administration of my estate.
ITEM III: If I predecease my wife, MARY JANE
WALTZ, I give and bequeath to her absolutely and in fee simple
all of my household furniture and furnishings, books, pictures,
jewelry, silverware, automobiles, wearing apparel and all other
articles of household or personal use or adornment and all
policies of insurance thereon. If I do not predecease my said
wife, I make said bequest to my children living at the time of
my death, to be divided among them as they shall agree. Should
Page 1 '--~ ~x.J
there be no agreement, such property shall be divided among them
by the Executor in as nearly equal portions as is deemed
practical in the sole discretion of the Executor, having due
regard to the personal preferences of such children.
ITEM IV: I give, devise and bequeath all
the rest, residue and remainder of my estate, not disposed of in
the preceding portions of this Will, to my wife, MARY 3ANE
WALTZ, and THE FIRST BANK AND TRUST COMPANY, Mechanicsburg,
Pennsylvania, as Trustees (hereinafter collectively referred to
as "Trustee"), IN TRUST NEVERTHELESS, to be further divided into
two parts, each of which shall be held in trust and constitute a
separate Trust Fund to be known as "Trust A" and "Trust B".
"Trust A": There shall be placed in
"Trust A" that fraction of my residuary estate of
which the numerator shall be a sum equal to the
largest amount that can pass free of Federal estate
tax under my Will by reason of the unified credit and
the state death tax credit (provided that the use of
this credit does not require an increase in state
death taxes) allowable to my estate but no other
credit and after taking account of dispositions under
other items of this Will and property passing outside
of this Will which do not qualify for the marital or
charitable deduction and after taking account of
charges to principal that are not allowed as
deductions in computing my Federal estate tax and of
which the denominator shall be the value of my
residuary estate. For purposes of establishing such
fraction, the values finally fixed in the Federal
Page
estate tax proceeding relating to my estate shall be
used. I recognize that the numerator of such fraction
may be zero (0), in which case no property shall pass
under "Trust A" and that said numerator may be
affected by the action of the Executor in exercising
certain tax elections.
"Trust B": The balance of my residuary
estate not placed in "Trust A" shall be placed into
"Trust B" to be held, administered and distributed in
accordance with ITEM VI of this Will.
ITEM V: The following provisions shall
apply to "Trust A":
(a) The Trustee shall pay the net income arising
from the principal of this Trust in quarterly
installments to my wife, MARY JANE WALTZ, during her
lifetime.
(b) During the lifetime of my said wife, the
Trustee shall pay to or for the benefit of my said
wife so much of the principal of this Trust as may be
necessary, in the sole discretion of the Trustee, for
the proper support, maintenance and medical care of my
said wife.
(c) Upon the death of my wife, or upon my death
if she fails to survive me, the Trustee shall divide
the principal and any accretions thereto and any
accumulations of income into as many equal parts as
there are then living children of mine and then
deceased children of mine represented by then living
Page 3 /~/~
issue. The Trustee shall pay one such share to each
living child of mine, and shall pay one such share to
the then living issue of each then deceased child of
mine, per stirpes.
ITEM VI: The following provisions shall
apply to "Trust B":
(a) Trustee shall have, hold, manage, invest and
reinvest the assets of this Trust, collect the income
and beginning at my death pay over the net income in
quarterly installments to my wife, MARY JANE WALTZ,
during her lifetime. The Trustee shall also, from
time to time, pay to my wife such amounts of principal
of this Trust as the Trustee (other than my said wife)
deems necessary for the proper support, maintenance
and medical care of my wife.
(b) Upon the death of my wife, the Trustee shall
pay all accrued income and all income accumulated but
undistributed to the estate of my deceased wife and
shall thereafter transfer the then remaining principal
of this Trust to "Trust A" to be held, administered
and distributed in accordance with the provisions of
ITEM V of this Will.
(c) If my wife should not survive me, then the
provisions of "Trust B" shall be void and the part of
my estate which would have constituted "Trust B" shall
be added to "Trust A" to be disposed of in accordance
with ITEM V of this Will.
Page 4 /~ AC .lx3 .
(d) The Executor shall be authorized in the
Executor's sole, exclusive and unrestricted discretion
to determine whether to elect (under Section
2056(b)(7) of the Internal Revenue Code of 1986 as
amended, or any corresponding provision of the Federal
estate law), to qualify all, none or a fraction of
"Trust B" for the Federal estate tax marital
deduction. The decision of the Executor with respect
to the exercise of the election shall be final and
conclusive upon all persons whose interests in my
estate are directly or indirectly affected by the
election. Only property which is fully eligible for
the marital deduction under Federal estate tax law
shall be assigned to this Trust. Notwithstanding
anything to the contrary contained in this Will, the
Trustee of this Trust shall not retain beyond a
reasonable time any property which may at any time be
or become unproductive, nor shall Trustee invest in
unproductive property. Notwithstanding the provisions
of subparagraph (b) of this Item, the Trustee shall
pay to the Executor of my wife's estate, out of the
principal of this Trust upon the death of my wife, an
amount equal to the estate, inheritance, transfer,
succession and other death taxes ("death taxes"),
Federal, state and other, payable by reason of the
inclusion of the value of Trust property in my wife's
estate. Such payment shall be equal to the amount by
which (1) the total of such death taxes paid by my
wife's estate exceeds (2) the total of such death
taxes which would have been payable if the value of
the Trust property had not been included in her
estate. The determination by my wife's Executor of
the amount payable hereunder shall be final. I direct
Page 5 /J~
the Trustee to pay such amount promptly upon written
request of my wife's Executor. The final
determination of the amount due hereunder shall be
based upon the value as finally determined for Federal
estate tax purposes in my wife's estate. After
payment of the amount finally determined to be due
hereunder, the Trustee shall be discharged from any
further liability with respect to such payment. My
wife may waive her estate's right to payment under
this subparagraph by Will, executed after my death, in
which she specifically refers to the right to payment
hereunder given to her estate.
ITEM VII: My wife, MARY JANE WALTZ, shall
have the noncumulative right to withdraw FIVE THOUSAND ($5,000)
DOLLARS from the principal of either "Trust A" or "Trust B"
under this Will each taxable year during which said beneficiary
is then entitled to receive income. If said beneficiary is
living on the last day of such year, said beneficiary shall also
have the right to withdraw an amount equal to Five (5%) percent
of the aggregate net market value of the principal of "Trust A"
and "Trust B" on such last day less the amount of such FIVE
THOUSAND ($5,000) DOLLARS previously actually withdrawn from
such Trust during the taxable year. Payment shall be made
within thirty (30) days of the close of the taxable year, less
any Trustee's commission payable with respect thereto. This
right of withdrawal shall be noncumulative and may be exercised
only in writing delivered to the Trustee within thirty <30> days
prior to the last day of such taxable year.
ITEM VIII: No part of the income or principal
of the property held under any Trust created by this Will shall
Page 6 //~c-' ~
be subject to attachment, levy or seizure by any creditor,
spouse, assignee or trustee or receiver in bankruptcy of any
beneficiary prior to his or her actual receipt thereof. The
Trustee shall pay over the net income and the principal to the
parties herein designated, as their interests may appear,
without regard to any attempted anticipation, pledging or
assignment by any beneficiary under a Trust, and without regard
to any claim thereto or attempted levy, attachment, seizure or
other process against said beneficiary.
ITEM IX: In the settlement of my estate and
during the continuance of the foregoing Trusts, the Executor and
the Trustee shall possess, among others, the following powers:
(a) To retain any investments I may have at my
death, including specifically those consisting of
stock of any bank even if i have named such bank as
the Executor or Trustee herein, so long as the
Executor or Trustee may deem it advisable to my estate
so to do.
(b) To vary investments, when deemed desirable
by the Executor or Trustee, and to invest in such
bonds, stocks, notes, real estate mortgages or other
securities or in such other property, real or
personal, as they shall deem wise, without being
restricted to so-called "legal investments", and
without being limited by any statute or rule of law
regarding investments by fiduciaries.
(c) In order to effect a division of the
principal of a Trust or for any other purpose,
including any final distribution of a Trust, the
Page 7
Executor or Trustee is authorized to make said
divisions or distributions of the personalty and
realty, partly or wholly in kind, and to allocate
specific assets among beneficiaries and Trusts created
hereunder so long as the total market value of any
share is not affected by such division, distribution
or allocation in kind. Should it appear desirable to
partition any real estate, the Executor or Trustee is
authorized to make, join in and consummate partitions
of lands, voluntarily or involuntarily, including
giving of mutual deeds, recognizances or other
obligations, with as wide powers as an individual
owner in fee simple.
(d) To sell either at public or private sale and
upon such terms and conditions as the Executor or
Trustee may deem advantageous to the estate or Trust,
any or all real or personal estate or interest therein
owned by the estate or Trust severally or in
conjunction with other persons or acquired after my
death by the Executor or Trustee, and to consummate
said sale or sales by sufficient deeds or other
instruments to the purchaser or purchasers, conveying
a fee simple title, free and clear of all trust and
without obligation or liability of the purchaser or
purchasers to see to the application of the purchase
money or to make inquiry into the validity of said
sale or sales; also, to make, execute, acknowledge and
deliver any and all deeds, assignments, options or
other writings which may be necessary or desirable in
carrying out any of the powers conferred upon the
Executor or Trustee in this paragraph or elsewhere in
my Will.
Page 8
(e) To mortgage real estate, and to make leases
of real estate.
(f) To borrow money from any party, including
the Executor or Trustee, to pay indebtedness of mine
or of my estate, expenses of administration or
inheritance, legacy, estate and other taxes, and to
assign and pledge assets of my estate therefor.
Provided, however, that this paragraph shall not
authorize borrowing from "Trust B".
(g) To pay all costs, taxes, expenses and
charges in connection with the administration of my
estate or a Trust. If any estate or inheritance taxes
are payable from assets received by the Trustee, such
taxes shall be paid from the assets constituting
"Trust A".
(h) To vote any shares of stock which form a
part of the estate or Trust, and otherwise to exercise
all the powers incident to the ownership of such stock.
(i) In the discretion of the Executor or
Trustee, to unite with other owners of similar
property in carrying out any plans for the
reorganization of any corporation or company whose
securities form a part of the estate.
(j) To disclaim any interest in property which
would devolve to me or my estate by whatever means,
including but not limited to the following means: as
beneficiary under a will, as an appointee under the
exercise of a power of appointment, as a person
Page 9
entitled to take by intestacy, as a donee of an inter
vivos transfer, and as a donee under a third-party
beneficiary contract.
(k) To do all other acts in their judgment
deemed necessary or desirable for the proper and
advantageous management, investment and distribution
of the estate or Trust.
(1) In the event of a dispute between the
Trustees with respect to the exercise of any power
granted the Trustees under this Item, the decision of
the individual Trustee shall control (except to the
extent otherwise specifically provided in this Will).
ITEM X: Whenever and as often as any
beneficiary hereunder, to whom payments of income or principal
are herein directed to be made, shall be under legal disability,
or, in the sole judgment of the Trustee, shall otherwise be
unable to apply such payments to his own or her own best
interests and advantages, the Trustee may make all or any
portion of such payments in any one or more of the following
ways:
(a) Directly to such beneficiary;
(b) To the Legal Guardian or Conservator of such
beneficiary;
(c) To a relative of such beneficiary, to be
expended by such relative for the benefit of such
beneficiary; or
Page 10
(d) By itself expending same for the benefit of
said beneficiary.
Provided, however, that this power shall not apply to "Trust B".
ITEM X%: If at any time any beneficiary
entitled to receive any funds hereunder shall not have attained
the age of twenty-one (21) years at the time of such
distribution, the share of such beneficiary shall be paid to the
person hereinafter named, who shall act as Custodian under the
Pennsylvania Uniform Gifts to Minors Act for such beneficiary.
My son, MICHAEL P. WALTZ, shall act as Custodian with respect to
any property to be paid to any issue of ALEXANDRA WALTZ MILLER.
MARIE ANN WALTZ shall act as Custodian with respect to any
property to be paid to any issue of MICHAEL P. WALTZ. 30SEPH
THOMAS HOGAN shall act as Custodian with respect to any property
to be paid to any issue of SUSAN MARY HOGAN. If any of the
aforementioned individuals are unable or refuses to act as
Custodian, the Custodian shall be such individual as shall be
named by the person(s) serving as the Executor of my estate.
ITEM XII: Any person who shall have died at
the same time as I shall have, or in a common disaster with me,
or under such circumstances that the order of our deaths cannot
be established by proof, or within thirty (30) days of my death,
shall be deemed to have predeceased me.
ITEM XIII: I hereby nominate, constitute and
appoint my wife, MARY JANE WALTZ, to be the Executrix, herein
referred to as "Executor". In the event of her death or her
inability or refusal to serve, I nominate, constitute and
appoint my son, MICHAEL P. WALTZ, and my daughter, ALEXANDRA
WALTZ MILLER, to be the Executor. The Executor and Trustee are
Page 11
specifically relieved from the duty or obligation of filing any
bond or other security.
IN WITNESS WHEREOF, I have set my hand and seal to
this, my Last Will and Testament, consisting of this and the
preceding eleven (11) pages, at the end of each page of which I
have also set my initials for greater security and better
identification this ~-0 day of ~~z~, 19~
PAUL K. WALTZ
We, the undersigned, hereby certify that the foregoing
Will was 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 and in his presence and
in the presence of each othe,_, have hereunto set our hands and
seals the day and year first above written, and we certify that
at the time of the execution thereof, the said Testator was of
sound and disposing mind and memory.
~:~7-/-Onn>.~-~!. ~ ~,?n~_~,." (SEAL) Residfng at '¥~-/Q ~
i
PAUL K. WALTZ
ME'Ir'E, EVANS & WOODSIDE
ATTORNIry$ AT ~AW
HARRISBURG. PENNSYLVANIA !'7108-0729
CERTIFICATION OF NOTICE UNDER RUIJE 5.6(a)
Name of Decedent: Paul K. Waltz
Date of Death: December 20, 2002
Will No. 6~ $-- ~ Admin. No. ~.~
To the Register:
I certify that notice of estate administration required by Rule 5.6(a) of the
Orphans' Court Rules was served on or mailed to the following beneficiaries of the
above-captioned estate on
Name Address
Michael P. Waltz 2700 Columbia Avenue, C~mp Hill, PA 17011
Alexandra Tempsick 1191 Kings Mill Court, Sunset Beach, NC 28468
Susan Hogan 12130 Farley Street, Overland, KS 66213-1671
Notice has now been given to all persons entitled thereto under Rule 5.6(a).
j Signature~
Elvse E. Rogers, Esquire
Name
415 Fallowfield Road, Suite 301
Camp Hill, PA 17011 Address
(717) 612-5801
Telephone
Capacity: Personal Representative
X Counsel for Personal
Representative
/
HEATH L. ALLEN KeefeR WOOD ALLEN & RAHAL, LLP ESTABL,SHED ,N ,87s
N. DAVID RAHAL
CHARLES W. RUBENDALLTT 415 FALLOWFIELD ROAD, SUITE 301
of COUNSEL:
ROBERT L. WELDON CAMP HILL, PA 17011-4906 SAMUEL C. HARRY
EUGENE E. PEPINSKY, UR.
JOHN H. ENOS1Tr PHONE 717-612-5800
GARY E. FRENCH FAX 717-612-5805 HARRISBURG OFFICE:
DONNA S. WELDON 210 WALNUT STREET
BRADFORD DORRANCE EIN NO. 23-0716135 HARRISBURG. PA 17101
JEFFREY S. STOKES www. keefe~vood.com
ROBERT R. CHURCH PHONE ?17-2S5-8000
STEPHEN L. GROSE
R. SCOTT SHEARER
WAYNE M. PECHT
ELYSE E. ROGERS
CRA,G A. LO.GYEAR March 14, 2003
DONALD M. LEWIS TIT
BRIDGET M. WHITLEY 717-612-5801
JOHN A. FEICHTEL erogers~keeferwood.com
ANN McGEE CARBON
ELIZABETH J. GOLDSTEIN
BARBARA A. GALL
STEPHANIE KLEINFELTER
Register of Wills
Cumberland County Courthouse
I Courthouse Square
Carlisle, PA 17013
Re: Estate of Paul K. Waltz, No. 21-03-0006
Dear Sir/Madam:
Enclosed is a check in the amount of $61,000 which represents prepayment of
inheritance tax for the above-referenced estate.
Please time-stamp the enclosed copy of this letter and return it to me in the
envelope provided.
Thank you.
Sincerely yours,
lmg
Enclosures
KEEFER WOOD ALLEN & RAHAL, LLP
415 FALLOWFIELD ROAD, SUITE 301 ~"
CAMP HILL, PA 17011-4906
~ Register of Wills
Cumberland County Courthouse
-' 1 Cou~house Square
Carlisle, PA 17013
COMMONWEALTH OF PENNSYLVANIA REV-11 62 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 002298
ROGERS ELYSE E ESQUIRE
415 FALLOWFIELD RD
SUITE 301
CAMP HILL, PA 17011-4906
ACH
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold .......... _ .......
101 $61,000.00
ESTATE INFORMATION: SSN: 185-03-3532
FILE NUMBER: 2103-0006
DECEDENT NAME: WALTZ PAUL K
DATE OF PAYMENT: 03/17/2003
POSTMARK DATE: 03/14/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 12/20/2002
TOTAL AMOUNT PAID: $61,000.00
REMARKS: MICHAEL P WALTZ & ALEXANDER W
MILLER C/O ELYSE E ROGERS ESQ
CHECK//1006
INITIALS: CW
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
RELEASE
WHEREAS, Allfirst Trust Company of Pennsylvania, N.A., formerly known as Allfirst Bank,
formerly known as FMB Bank, Successor by merger to Dauphin Deposit Bank and Trust Company, is the
duly appointed Trustee under Agreement with Paul K. Waltz, late of Cumberland County; Pennsylvania; and
WHEREAS, Paul K. Waltz died December 20, 2002; and
WHEREAS, in accordance with the Second Paragraph of the Trust Agreement, upon the death of
Paul K. Waltz, the then-remaining Principal and Income is to be paid to the Executor of his Estate; and
WHEREAS, on January 3, 2003, Letters Testamentary were granted by the Register of Wills of
Cumberland County for the Estate of Paul K. Waltz to Michael P. Waltz and Alexandra Waltz Miller; and
WHEREAS, the said Trustee has submitted to the said Michael P. Waltz and Alexandra Waltz Miller
an account of its Trusteeship, which has been examined and approved by the said Michael P. Waltz and
Alexandra Waltz Miller; and
WHEREAS, in order to save the expense and delay incident to filing said account in the Orphans'
Court Division of the Court of Common Pleas of Cumberland County and having the same confirmed, the
said Michael P. Waltz and Alexandra Walter Miller have requested the Trustee to make settlement with them
at once.
AND THEREFORE KNOW ALL MEN BY THESE PRESENTS that we, the said Michael P. Waltz
and Alexandra Waltz Miller, have this day had and received of and from AIlfirst Trust Company of
Pennsylvania, N.A., formerly Allfirst Bank, formerly known as FMB Bank, Successor by merger to Dauphin
Deposit Bank and Trust Company, Trustee as aforesaid, the sum of one hundred seventy-six thousand six
hundred sixteen dollars and fifty-one cents ($176,616.51) consisting of cash in full settlement and satisfaction
of all such sum or sums of money as are due me by reason of said Trusteeship, and THEREFORE WE DO
BY THESE PRESENTS remise, release, quit-claim and forever discharge the said Allfirst Trust Company of
Pennsylvania, N.A., formerly AIlfirst Bank, formerly known as FMB Bank, Successor by merger to Dauphin
Deposit Bank and Trust Company, its successors and assigns, and of and from all actions, suits, payments,
accounts, reckonings, claims and demands whatsoever for or by reason thereof, or of and from all other acts,
matters, and things whatsoever including gross negligence, to the day of the date hereof.
IN WITNESS WHEREOF, we have hereunto set our hands and seal this
day of ,2003.
~~~'/?~d~ ~~) t/'ff-'4q/t'~t'Alexandra Waltz Miller .(_~,- ~-- ~.~e~ "~ '~ ~
COMMONWEALTH OF PENNSYLVANIA )
) SS:
county o~ ~ v ~ ~ d ~ ~ ~
On this, the O_~ day of ~-~(~O O[ ~ ,2003, before me, a Notary Public in and
for said State and County, personally appeared Michael P. Waltz, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the foregoing Receipt and Release and
acknowledged that he executed the same for the purposes therein contained and desires that the same
be recorded as such.
WITNESS my hand and Notarial Seal.
Notary Public
My Commission Expires:
NOTARIAL SEAL '
NEAT#ER WILLIAMS, NOTARY PUBLIC
CAMP HILL 90RO., CUMBERLAND COUNTY[
MY COMMISSION EXPIRES iil~. 15, 2004 I
) SS:
COUNTY OF "~ ~"~0 [ ~.~C._, )
On this, the day of ,ff~//~'~ ,2003, before me, a Notary Public in and
for said State and County, personally appeared Alexandra Waltz Miller, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the foregoing Receipt and
Release and acknowledged that she executed the same for the purposes therein contained and desires
that the same be recorded as such.
WITNESS my hand and Notarial Seal.~//'/'x~ ~/]
Notary Public
My Commission Expires:
HEATH '. ALL£N KeefeR WOOD ALLen ~ Rahal, llP ESTABUSHEDIN~BTB
N. DAVID RAHAL
415 FAllOWflELD ROAD, SUIte 30I
CHARLES W. RUBENDAll 3T Of COUNSEL:
ROBERT L. WELDON CAMP HILL, PA 17011-4906 SAMUEL C. HARRY
EUGENE E. PEPINSKY, JR.
JOHN H. ENOS~ PHONE 717-612-5800
HARRISBURG OFFICE:
GARY E. FRENCH FAX 717-612-5805 210 WALNUT STREET
DONNA S. WELDON HARRISBURG, PA 17101
BRADFORD DORRANCE EIN No. 23-0716135
JEFFREY S. STOKES www. keeferwood.com PHONE 717-2BS-8000
ROBERT R. CHURCH
STEPHEN L. GROSE
R. SCOTT SHEARER
WAYNE M. PECHT
£LYSE E. ROGERS September 17, 2003
DONALD M. LEWIS:]:]:[
BRIDGET M. WHITLEY 717-612-5808
JOHN A. FEICHTEL
ANN McGEE CARBON csw_n__e.~.~ee.vrwoo~.com
ELIZABETH J, GOLDSTEIN
BARBARA A. GALL
STEPHANIE KLEINFELTER
Via: Certified Mail
Cumberland County Register of Wills
Cumberland County Courthouse
I Courthouse Square
Carlisle, PA 17013
Re: Estate of Paul K. Waltz
File #21-2003-0006
Dear Sir/Madam:
Enclosed herewith for filing please find the following:
1. Pennsylvania Inheritance Tax Return (filed in duplicate;)
2. Inventory;
3. Copy of Form 706;
4. Check in the amount of $31.00 in payment of your filing fee;
5. Check in the amount of $884.79 in payment of tax due.
Kindly acknowledge receipt of these documents by time-stamping the
enclosed copy of this letter and returning it to our office. Thank you.
Sincerely your~ .
CI~le D. Swindler,
Legal Assistant to
Elyse E. Rogers
/cds
90756
Enclosure
COMMONWEALTH OF PENNSYLVANIA REV-11 62 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003030
KEEFER WOOD ALLEN & RAHAL LLP
415 ?ALLOWFIELDROAD SUITE 301
CAMP HILL, PA 17011-4906
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..................
101 $884.79
ESTATE INFORMATION: SSN: 185-03-3532
FILE NUMBER: 2103-0006
DECEDENT NAME: WALTZ PAUL K
DATE OF PAYMENT: 09/18/2003
POSTMARK DATE: 09/1 7/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 12/20/2002
TOTAL AMOUNT PAID: $884.79
REMARKS: MICHAEL P WALTZ & ALEXANDRA
WALTZ MILLER C/O KEEFER ETAL
CHECK# 1012
INITIALS: SK
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVAN IA
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN
HARRISBURG,PA 17128-0601 RESIDENT DECEDENT -- 2o0_3 0006
I COUNTY CODE YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ Waltz, Paul K. 185-03-3532
~lLI DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-DO-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
14J 12/20/2002 02/19/1916 REGISTER OF WILLS
ILl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~~1, ~ ~r~ 1. Odginal Return ~'~ 2. Supplemental Return ~[~ 3. Remainder Return (date of death prior to 12-13-82)
~.t,.~ ' ' 4. Limited Estate , , 4a. Future Interest Compromise (date of death after 12-12-82) '--' 5. Federal Estate Tax Return Required
OD
t, J3: ~.~'-I I~,1 6. Decedent Died Testate (Attach copy of Will) IXl 7. Decedent Maintained a Living Trust (Attach copy of Trust) i 8. Total Number of Safe Deposit Boxes
~ r~ 9. Litigation Proceeds Received r~ 10. Spousal Poverty Credit (date of death b ...... 12-31-91and1-1-95) [~ 11. Election to tax under Sec. 9113(A)(^ttachSchO)
THIS SECTION MUST BE COMPEETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BEiDIRECTED TO:
z NAME COMPLETE MAILING ADDRESS
~ Elyse E. Rogers· Esquire
Z
o 415 Fallowfield Road· Suite 301
a. FIRM NAME (If Applicable)
~ Keefer Wood Allen & Rahal, LLP Camp Hill, PA 17011
~O TELEPHONE NUMBER
i717-612-5801
1. Real Estate (Schedule A) (1) 0 · 0 0~-'' C~FFIOAL USE ONLY
2. Stocks and Bonds (Schedule B) (2) 8~0 · 926.57
3. Closely Held Corporation, Partnership or Sole-Propdatorship (3) 0. 0 0
4. Mortgages & Notes Receivable (Schedule D) (4) 0 o 0 0
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5) 5 1,
Z 6. Jointly Owned Property(Schedule F) 0 00
I-- Separate Billing Requested ""-'
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 6&1,827.24
~ (Schedule G or L)
~:~ 8. Total Gross Assets (total Lines 1-7) (8) 1, 5 3 4,18 0 · 0
LU 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 51,739.85
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 3 5, 8 7 7. ~ 3
11. Total Deductions (total Lines 9 & 10) (11 ) 87,617.28
12. Net Value of Estate (Line 8 minus Line 11) (12) 1,446,562.76
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J) (13) 0 . 0 0
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 1,446,562. ?6
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
z rate, or transfers under Sec. 9116 (a)(1.2) 0 . 00 x .00 __ (15) 0 . 00
~ 1,446,562.76 65,095 32
< 16. Amount of Line 14 taxable at lineal rate x.045 (16) ·
'~ 0 00 0 00
a. 17. Amount of Line 14 taxable at sibling rate ' x .12 (17) °
O
~ 18. Amount of Line 14 taxable at collateral rate 0 . 00 x .15 (18) 0 ° O0
I-- 19. Tax Due (19) 65,095.32
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
2W46451.000
Decedent's Complete Address:
S'IP, E ET ADDRESS
899 Tuscarora, Box 2015
CITY STATE ] ZIP
Mechani c sbu rq PA I 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 65,095.32
2. Credits/Payments
A. Spousal Poverty Credit 0.00
B. Prior Payments 61,000.00
C. Discount 3,210.53
Total Credits (A + B + C) (2) 64 ~ 210.53
3. Interest/Penalty if applicable
D. Interest 0 o 00
E. Penalty 0.00
Total Interest/Penalty(D + E) (3) 0.00
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 (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 884.
A. Enter the interest on the tax due. (5A) 0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 884
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; ....................... [~] r---]
b. retain the right to designate who shall use the property transferred or its income; ......... i---] ['~
c. retain a reversionary interest; or ................................ i-~ i-~
d. receive the promise for life of either payments, benefits or care? ................. i-'-] i-~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................ [~] i-II
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.
Declaration of preparer other than the personal representative is based on all information of which pre-parer has any knowledge.
SIGNATURE OF I~E.J~ER OTHE,~"IAN F~P~ESENTATIVE DATE
ADORESS 4 low~iel te 301
Camp ~ill, PA 1 174~.M
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 3%
[72 P.S. § 9916 (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 does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosura of assets and filing a tax ratum 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 0% [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 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )].
The tax rate im posed on the net value of transfers to or for the use of the decedent's siblings is 12% (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.
2w4646 1.000
Estate of= Paul K. Waltz 185-03-3532
Executrix
Alexandra W (Miller)Tempsick
1191 Kings Mill Court
Sunset Beach, NC 28468
EXHIBIT B
REV-1503 EX + (1-97)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Walt=, Paul K. 21-2003-0006
All prope~y jointly-owned with right ~ suwivorshlp mum be disclo~d on Schedule F.
I~M VALUE AT DATE
NUMBER ~S~I~ON OF DEAN
1 ACM Income Fund Inc. 8,146.02
800 shares of AOL Time Warner at $13.335/share 10,668.00
Per Estate Val
3 152 shares of Agilent Technologies Inc. at $17.4/share 2,644.80
Per Estate Va1
4 4943.558 shares of Alliance Mid Cap Growth Fund at $3.41/share 16,857.53
Per Estate Val
5 13,130 shares of Allied Irish Banks PLC at $26.475/share 347,616.75
Per Estate Val
6 American Century Account #020-000333244 - 6146.869 shares at 90,481.91
$14.72/share
7 268 shares of Bristol Myers Squibb Co at $23.435/share 6,280.58
Per Estate Val
8 1000 shares of Dell Computer Cor13 at $27.155/share 27,155.00
Per Estate Val
Name changed to Dell Inc. on 7/18/03
9 800 shares of Hewlett Packard Co. at $18.845/share 15,140.00
Per Estate Val
10 1500 shares of Honeywell Intl Inc. at $23.475/share 35,212.50
Per Estate Val
11 9556.734 shares of John Hancock Ser Tr Global Tech A at 24,274.10
$2.54/share
Per Estate Val
12 207 shares of Medimmune inc. at $27.9/share 5,775.30
Per Estate Val
13 1364 shares of PNC Finl Svcs Group Inc. at $41.355/share 56,408.22
Per Estate Val
14 Penn St Tax Exempt Invt Tr 3,365.05
15 400 shares of Quaker Chemical Cor~ at $22.845/share 9,138.00
Total from continuation pages .... 181,762.81
TOTAL (Also enter on line 2, Recapitulation) $ 84 0,92 6.57
2w4696 3.000 (If more space is needed, insert additional sheets of the same size)
Page 2
Estate of= Waltz, Paul K. 21-2003-0006
Schedule B -- Stocks & Bonds
Item Value at
No. Description Date of Death
15 Per Estate Va1
16 T. Rowe Price Growth Stock 41,369.21
per internet and 07/18/03 letter
17 T. Rowe Price New Horizons 66,093.27
Per internet and 07/18/03 letter
18 2,491.358 shares of Van Eck Funds Intl Invs Fd at $9.67/share 24,091.43
19 Vanguard Windsor Funds 36,191.02
Per 12/31/02 statement
20 526 shares of W P Carey & Co LLC at $24.675/share 12,979.05
Per Estate Val
21 Zimmer Holdings Inc. 1,038.83
TOTAL. (Carry forward to main schedule) ...... 181,762.81
Estate Valuation
Date of Death: 12/20/2002
Valuation Date: 12/20/2002 Estate of: Estate of Paul Waltz
Processing Date: 02/20/2003 Account: Nathan & Lewis Account
Report Type: Date of Death
Number of Securities: 17
File ID: Waltz, Paul K. Estate M&B
Shares Security Mean and/or Div and Int Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
1) 800 AOL TIME WARNER INC (00184A105) NYSE
12/20/2002 13.45000 13.22000 H/L
13.335000 10,668.00
2) 152 AGILENT TECHNOLOGIES INC (00846U101) NYSE
12/20/2002 18.00000 16.80000 H/L
17.400000 2,644.80
3) 4943.558 ~J~LIANCE MID CAP GROWTH FD INC (018636100)
CL A
NASDAQ
12/20/2002 3.41000 Bid
3.410000 16,857.53
4) 13130 ALLIED IRISH BKS P L C (019228402)
SPON A DR ORD
NYSE
12/20/2002 26.85000 26.10000 H/L
26.475000 347,616.75
5) 268 BRISTOL MYERS SQUIBB CO (110122108) NYSE
12/20/2002 23.70000 23.17000 H/L
23.435000 6,280.58
6) 1000 DELL COMPUTER CORP (247025109) NASDAQ
12/20/2002 27.59000 26.72000 H/L
27.155000 27,155.00
7) 800 HEWLETT PACK~ CO (428236103) N~SE
12/20/2002 19.01000 18.68000 H/L
18.845000 15,076.00
Div: 0.08 Ex: 12/16/2002 Rec: 12/18/2002 Pay: 01/08/2003 64.00
8) 1500 HONEYWELL INTL INC (438516106) NYSE
12/20/2002 24.00000 22.95000 H/L
23.475000 35,212.50
9) 9556.734 JOHN HANCOCK SER TR (478032303)
GLOBAL TECH A
NASDAQ
12/20/2002 2.54000 Bid
2.540000 24,274.10
10) 207 MEDI~ INC (584699102) NASDAQ
12/20/2002 28.43000 27.37000 H/L
27.900000 5,775.30
11) 1364 PNC FIN-L SVCS GROUP INC (693475105) NYSE
12/20/2002 42.03000 40.68000 H/L
41.355000 56,408.22
12) 5 PENN ST T~ EXEMPT IN~ TR (707632105)
UNIT SER 1
OTC
12/20/2002 660.95000 Bid
Carryover & daily interest: 660.950000 3,304.75
60.30
13) 400 QU~J<ER CHEM CORP (747316107)
NYSE
12/20/2002 22.99000 22.70000 H/L
22.845000 9,138.00
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 6.4.3)
Date of Death~ 12/20/2002
Valuation Date: 12/20/2002 Estate of: Estate of Paul Waltz
Processing Date: 02/20/2003 Account: Nathan & Lewis Account
Report Type: Date of Death
Number of Securities: 17
File ID: Waltz, Paul K. Estate M&B
Shares Security Mean and/or Div and Int Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
14) 2491.358 VD~N ECK FDS (921075503)
INTL INVS FD
NASDAQ
12/20/2002 9.67000 Bid
9.670000 24,091.43
15) 526 W P CAREY & CO LLC (92930Y107) NYSE
12/20/2002 24.85000 24.50000 H/L
24.675000 12,979.05
16) 26 ZIMMER HLDGS INC (98956P102) NYSE
12/20/2002 40.25000 39.66000 H/L
39.955000 1,038.83
17) 991 ACM INCOME FUND INC (000912105) NYSE
12/20/2002 8.24000 8.20000 H/L
8.220000 8,146.02
Total Value:
Total Accrual: $606,666.86
Total: $606,791.16 $124.30
Page 2
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 6.4.3)
Janua? 16. 2003
,~v~EPdC.~',! Cayle D. Swindler
~-~ '~ ~,'-: Keefer, Wood, Allen k Rahal
415 Fallowfield Road, Suite 301
Camp Hill, PA 17011-4906
American Century
Re: Accotmt 020-000333244--Growth, Paul K. Waltz
;~.o. Bo.,-4-z92s,-. Dear Cayle Swindler:
Kansas City, MO
6414J-6287 We have received notification of the death of Paul K. Waltz. Please extend our
condolences to Mr. Waltz's family.
1-800-345-8810 To transfer Mr. Waltz's non-tax-deferred Account 020-000333244 to an estate account,
please complete the enclosed Distribution Instructions form and return it with a cop), of
the appointment of personal representative (certified within the last 60 days). Unless the
funds will remain in the estate account, the personal representatives' signatures on the
~,~.~,,,~,'~c~:~e,.,~,,?~.~o,~ distribution form must be guaranteed. Each signature g~arantee must be issued by a
participant in a Securities Transfer Association Signature Guarantee Program, must be an
original ink stamp that states "Sig-nature Guaranteed/Medallion Guaranteed," and must
be sig-ned on behalf of the oc, uarantor by an authorized person. The personal
representatives may obtain signature guarantees from a bank or member firm of a major
domestic stock exchange.
Please provide us with certification of the estate's employer identification number (not
Mr. Waltz's Social Security number) and backup-withholding status by corhpleting the
New Account Information section on the distribution form. If an employer identification
number is not acquired for the estate, we will file all information returns (IRS Forms 1099-
B and 1099-DIV) under Mr. Waltz's name and Social Security number. If a taxpayer
identification number for the estate is provided to us after redemption or reregistration of
the shares, we cannot change the information or the taxpayer identification number
reported to the IRS.
To establish investor services for the estate account, please have the persona]
representatives complete, sign, and return the enclosed Investor Service Options form.
Swindler
January 16, 2003
Page o
In addition, the value of Account 020-000333244 on December 20, 2002, was $90,481.91
(6,146.869 shares at $14.72 a share).
If we may be of further assistance, please call our office at 1-800-345-8810. A Priority
Investor representative will be glad to assist you.
Sincerely,
Melissa Flanagan
Senior Correspondence Representative
00307136-mrl
Enclosure: Distribution Instructions Form
Investor Service Options Form
Business Reply Envelope
~' b~alt~ 'nc) -~. ML' 2128c~-027(,
4515 Painters M~II Roac.
Jul3' 18. 2003
Cayle D Swindler
Keefer Wood Allen & Rahal LLP
415 Followfield Rd Ste 301
Camp Hill PA 17011-4906
Subject: Estate of Paul K. Waltz
havestor 291.549
Dear Ms. Swindler:
We are writing regarding your request to transfer the T. Rowe Price fund accounts held under
the investor number shown above, registered to the late Paul K. Waltz. We have already
completed the request and sent confirmation to the executors.
This letter provides you with the account balance information you requested. Please note that
Paul K. Waltz was the sole owner on these accounts. Our records show the following
information as of December 20, 2002:
Growth Stock Fund account 558171-5
Number of shares: 2,191.166
Price per share: $18.88
Total value: $41,369.21
Date account was established: 11/30/74
New Horizons Fund account 303240-2
Number of shares: 3,952.947
Price per share: $16.72
Total value: $66,093.27
Date account was established: 01/09/75
December 31, 2002, ~ to-date Page
.~,~ ~' Va ard Windsor Fund
TH~~uR InVestor S~es
h,,llh,,llh,,,hh,hh,lh,,,,llh,,h,,llhh,hh,hl,,I Statement number: 010884163
PAUL K WALTZ
899 TUSCARORA (800) 662-2739 - Client Services
',', ~w:vanguard.com Websire
100 MT ALLEN DR
(800'%62-6273 Tele-Accounr
MECHANICSBURG PA 17055-6171 ' '~i~ -
.... Fund: number: 22
AccoUnt number: 9923661543
AC, CO U NT VA L U E On 12/31/2001 On 12/31/2002
$ 45,787.38 $ 3S,597.72
Trade date Transaction Dollar amount Share price Shares transacted Total shares owned
Balance on 12/31/2001 $15.64 2,927.582
6/21 Income dividend .08 $ ~34.21., 13.64 17.171 2,944.753
12/20 Income dividend .09 2'65.03 12.20 21.724 2,966.477
Balance on 12/31/2002 $12.00 2,966.477
Income dividends $ 499.24 Total cost basis on 12/31/2002 $ 42,420.96
Average cost per share 14.30
The c~4rrent Fund distribution was payable on
Dece. i, Der 23, 2002.
2 ;-
108295 ~468 IL}qB M1 t'lX
EXHIBIT C
REV- 04 SCHEDULE C
COMMONWEALTH OF PENNSYLVANIA CLOSELY-HELD CORPORATION,
INHERITANCE TAX RETURN PARTNERSHIP or SOLE-PROPRIETORSHIP
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Waltz, Paul K. 21-2003-0006
Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship.
See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM VALUE AT
NUMBER DESCRIPTION DATE OF DEATH
1. Centerview Assoc Limited Partnership 0.00
No value see 1998-2002 Schedule k-ls.
Executor's information regarding this limited partnership is
limited to that disclosed on attached Schedules k-1
TOTAL (Also enter on line 3, Recapitulation) $ 0. O0
2w4697 2.000 (If more space is needed, insert additional sheets of the same size)
21
SCHEDULE K-1 I artner's Share of Income, Credits, De, lions, etc. OMB No. 1545-0099
('Form 1065) / For calendar year 1998or taxyear1998
Department of the Treasury
Internal Revenue Service be.ginning ~ 1998~ and endin.g
Partner's identifying number I~ 185-05-3532 Partnershtp's identifying number I~ 52-1197489
Partner's name, address, and ZiP code PartnershJp's name, address, and ZIP code
CENTERVIEW ASSOCIATES
DR PAUL K. & MARY J. WALTZ LIMITED PARTNERSHIP
P.O. BOX 2015 C/O STANFORD MGMT GROUP 351 6TH AVE.
MECHANICSBURG, PA 17055-2015 BRADENTON, FL 34205
A This partner is a [. J general partner ] X ] limited partner F Partner's share of liabilities:
~ limited liability company member Nonrecourse .................................... $ O.
B What type of entity is this partner? I~ T~,TDIVTDUA.'r, QualifJed nonrecourse financing ............ $ 118,905.
C lsthis partnera ~ domestic or a J J foreign partner? Other ............................................. $ O.
D Enter partner's (i) Before change (ii) End of
or termination year
percentage of: G Tax shelter registration number b-
Profit sharing ...... % 3.1 6 6 6 6 0 0% H Check here if this partnership is a publicly traded partnership
Loss sharing ......... % 3.16 6 6 6 0 0% as defined in section 4691k)12) ................................................ r"--J
Ownership of capital % 3.2663850%
E IRS Center where oartnership filed return: ATT,A/~TA, GA I I Check applicable boxes: (1) r'~ Final K-1 (2) r'~ Amended K-I
J Analysis of partner's capital account:
(c) Partner's share of lines (e) Capital account at end
(a)Capital account at (b) Capital contributed 3, 4, and 7, Form 1065, (d) Withdrawals and of year (combine
13egmning.0f year during year Schedule M-2 distributions columns (a) through (d))
-57,329. -6,006. ( -63,335.
(a) Distributive share item (b) Amount (c) 1040 filers enter the
amount in column (b) on:
1 Ordinary income (loss) from trade or business activities ....................................... 0 · ~ See page O of Partner's Instruction
2 Net income (loss) from rental real estate activities ................................................ - 6,035. ~or sc~edu,, x.1 ¢o~m
3 Net income (loss) from other rental activities ......................................................
J
4 Podfolio income (toss): a Interest .................................................................. 6 1. Sch. B, Part I, line 1
~' b Ordinary dividends ~
o ....................................................................................... Sch. B, Part II, line 5
~ c Royalties ................................................................................................... Sch. E, Part l, line 4
· d Net short-term capitalgain (loss)
E Sch. D, line 5, col. (f)
o e Net long-term capital gain (loss): 11) 28% rate gain (loss)
o .................................... Sch. D, Ii, ne 12, col. (g)
_c 12) Total for year .......................................................................................... Sch."D, line 12, col. (f)
f Other portfolio income (loss) (attach schedule) ................................................ Entar on applicable lines of your return
5 Guaranteed payments to partner se~ page ~ of Partner's Instruction.,
6 Net sec. 1231 gain (toss) (other than casualty or theft) .......................................... } fo~ Schedule K-1 (Form 1085)
7 Other income (toss) (attach schedule) ............................................................... E.~' on ap¢c.a~*e lineof your return
, 8 Charitable contributions (attach schedule) ......................................................... Sch. A, line 15 or 16
~, 9 Secti°n 179 expense deducti°n._ .....................................................................
See pages 7 and 8 of Partner's
10 Deductions related to portfolio income (attach schedule) ':.....7: ............................. Instructions forSc~eduleK-1
11 Other deductions (attach schedule) .................................................................. (Form
~ 13 Oth er credits (Enter on applicable lines of your return)
"~u~ 14a Interest expense on investment debts ............................................................... Form 4952,1inel
>e ~ b (1)Investment income included on lines 4a, 4b, 4c, and 4f above .............................. 6 1 l see page o of P=n~'= ~ns~cuon=
--=.e '~ (2)Investment expenses included on line 10 above ...................................................·''1S-J'C for Schedule K-1 (Form 1005)
~ ~ 15a Net earnings (loss) ~rom self-employment ......................................................... 0 ' h SE, Section Aor B
~ b Gross farming or fishing income
..................................................................... See page g of Partnar's Instructions
~ c Gross nonfarm income ~o~ Schedule K-1 (Form 1005)
~ ~ 16 a Depreciation adjustment on property placed in service after 1986 _ 5 7
~==E: b Adjusted gaJrl or Joss ............................ see Partner's Instructions~or
~mA- ....................................................................................) Scheciule K-1 (Farm 1OCS)and
e Other adiustments and tax preference items (attach schedule) .............................. ~nstructions for Form
19 Tax-exempt interest income
........................................................................... Form 1040, line 8b
~ 20 Other tax-exempt income
22 Distributions of money (cash and marketable securities) ....................................... ' ~ (FormlnStructi°ns1055) for Schedule K-1
23 Distributions of property other than money ........................................................
JWA For Paperwork Reductio, Act Notice, see Form 1065 Instructions. No Information Required for Page 2 Schedule K-1 (Form 1065) 1998
C~NTERVIEW, ASSOCIATE, LIMITED PARTNERSHI 52-1197489
FOOTNOTES
ALL INCOME DERIVED FROM PROPERTY LOCATED IN THE STATE
OF GEORGIA.
SCHEDULE K-1 NONDEDUCTIBLE EXPENSES
DESCRIPTION AMOUNT PARTNER INSTRUCTIONS
EXCLUDED MEALS AND ENTERTAINMENT
EXPENSES 32. NONDEDUCTIBLE PORTION
TOTAL TO SCHEDULE K-l, LINE 21 32.
55 Partner Number 21
SCHEI.')UL~ K-1 P~ er's Share of Income, Credits, Deduct, ~, etc.
., i
Department of the Treasury For calendar year 1999 or tax year
Internal Revenue Service bepinnin.q ~ 1999~ and ending
Partner's identifying number · 185-05-3532 Partnership's identifying number · 52-1197489
Partner's name, address, and ZIP code Partnership's name, address, and ZIP code
~ENTERVIEW ASSOCIATES
DR PAUL K. & MARY J. WALTZ LIMITED PARTNERSHIP
P.O. BOX 2015 C/O STANFORD MGMT GROUP 9021 TOWN CENTER
MECHANICSBURG, PA 17055-2015 BRADENTON, FL 34202
A This partner is a [. I general partner t X I limited partner F Partner's share of liabilities:
~ limited liability company member Nonrecourse .................................... $
B What type of entity is this partner? · INDIVIDUAL Qualified nonrecourse financing ............ $ 122,416.
C Isthis partner a ~-] domestic ora J I foreign partner? Other $ 0
D Enter partner's (i) Befoce change (ii) End of .............................................
or termination year
percentage of: G Tax shelter registration number ·
Profit sharing ...... % 3.16; 6 6 6 0 0% H Check here if this partnership is a publicly traded partnership
Loss sharing ......... % 3.16 6 6 6 0 0% as defined in section 4§9(k)(2) [-'-']
Ownership of capital % 3.2 6 6 3 8 5 0% ................................................
E ,Rs canter where partnership filed return: ATLANTA, GA I Check applicable boxes: (1) ~ Final K-1 (2) ~'~ Amended K-1
J Analysis of partner's capital account:
(c) Partner's share of lines (e) Capital account at end
(a)Capital account at (b) Capital contributed 3, 4, and 7, Form 1065, (d) Withdrawals and of year (combine
beginning of year during year Schedule M-2 distributions columns (a) through (d))
-63,335. -9,107. ( )i -72,442.
(a) Distributive share item (b) Amount (c) 1040 filers enter the
amount in column (b) on:
1 Ordinary income (less) from trade or business activities ....................................... 0.
.................................................~ See page O of Partner's instruction.,
2 Net income (loss) from rental real estate activities - 9 , 0 8 9 · for Schedule K-1 (Form 1005)
3 Net income (loss) from other rental activities ......................................................
4 Portfolio income (loss): a interest
.................................................................. 8. Sch. B, Part I, line 1
~' b Ordinary dividends
~ Sch. B, Part II, line 5
-- c Royalties
~ ' .................................................................................................. Sch. E, Part I, line 4
· d Net short-term capital gain (loss)
E Sch. D, line 5, col.
o e Net long-term capital gain (loss): (1) 28% rate gain (loss) .................................... Sch. D, line 12, col. (g)
_c (2) Total for year
.......................................................................................... Sch. D, line 12, col. (f)
f Other portfolio income (loss) (attach schedule) ................................................ Enter on applicaOle lines of your return
5 Guaranteed payments to partner
..................................................................... See page 6 of Partner's Instructions
6 Net sec. 1231 gain (loss) (other than casualty or theft) .......................................... } for Schedule K-1 (Form 1065)
7 Other income (loss) (attach schedule) ...............................................................
Enter on applicable line of your return
, 8 Charitable contributions (attach schedule) Sch. A, line 15 or 16
~=~ 9 Section 179 expense deduction .........................................................
10 Deductions related to portfolio income (attach schedule) see pages 7 and 8 of Pa,'tner's
.................................... Instructions for Schedule K-1
11 Other deductions (attach schedule) .................................................................. (Form lO55)
· E 13 Other credits
(Ente' on applicable lines of your return)
E~ 14a Interest expense on investment debts
............................................................... Form 4952, line1
~ b (1)Investment income included on lines 4a, 4b, 4c, and 4f above .............................. 8.} see page 9 of Partner's Instructions
. · (2)Investment expenses included on line 10 above ................................................... for Schedule K-1 (Form 1055)
~5"E~ ~15 a Net earnings (loss) from self-employment ......................................................... 0. Sch. SE, Section A or B
~-' b Gross farming or fishing income
..................................................................... t See page 9 o~' Partner's Instructions
O c Gross nonfarm income for ScheduleK-l(Ferm 1005)
i~~ 16a Depreciationadjustmentonpropertyplacedinserviceafter1986 -77
b Adjusted gain or loss ........................... ~ Partner'slnstructions for
.................................................................................... Schedule K-1 ~erm 10~5) and
e Other adiustments and tax preference items (attach schedule) .............................. ~nstruct~ons for Form e=51
19 Tax-exempt interest income
........................................................................... Form 1040, line 8b
~ 20 Other tax-exempt income
See pages g and 10 of Partner's
O~ 21 Nondeductible expenses ........................... ,.,qEE... STATEMENT ............ 2 6 . ~' (FormInstructions1005) for Schedule K- 1
22 Distributions of money (cash and marketable securities) .......................................
23 Distributions of property other than money ........................................................ =
IwA ~"' ~1~ ...... ~' ~'"'~uction Act Notice, see Form 1065 Instructions. No Information Required for Page 2 Schedule K-1 (Form 1065) 1999
05-15-99
~ 21
SCHEDULE K-1 Par~"er's Share of Income, Credits, Deductir , etc. I OMB No. 1545-0099
(Form 1065) For calendar year 2000 or tax year
Internal Revenue Service be,cjinninfl .2000, and endin,q
Partner's identifying number ~. 185-05-3532 Partnership's identifying number
52-1197489
. Partner's name, address, and ZIP code Partnership's name, address, and ZIP code
CENTERVIEW ASSOCIATES
DR PAUL K. ~ MARY J. WALTZ LIMITED PARTNERSHIP
P.O. BOX 2015 C/O STANFORD MGMT_GROUP 9021 TOWN CENTER
MECHANICSBURG, PA 17055-2015 BRADENTON, FL 34202
A This partner isa I I general partner I X J limited partner F Partner's share of liabilities:
E~ limited liability company member Nonrecourse .................................... S
B What type of entity is this partner? ~. INDIVIDUAL Oualified nonrecourse financing ............ $ 120,847.
C Isthis partnera ~ domestic or a I I foreign partner? Other S 0
(i) Before change (ii) End of ...........................................
D Enter partner's or termination year
percentage of:. G Tax shelter registration number
Profit sharing ...... % 3.1 6 6 6 6 0 0% H Check here if this partnership is a publicly traded partnership
LOSS sharing ......... % 3.1 6 6 6 6 0 0% as defined in section 469(k)(2)
Ownership of capital % 3.2 6 6 3 8 5 0% ................................................
E ,RS Center where partnership filed return: ATT,A_NTA, GA I Check applicable boxes: (1) ~ Final K-1 (2)
J Analysis of partner's capital account'
(a) Capital account at (b) Capital contributed (c) Partner's share of lines (e) Capital account at end
beginning of year during year 3, 4, and 7, Form 1065, (d) Withdrawals and of year (combine
Schedule M-2 distributions columns (a) through (d))
-72,442. -222. -72,664.
(a) Distributive share item (b) Amount (c) 1040 filers enter the
amount in column (b) on:
1 Ordinary income (loss) from trade or business activities ....................................... 0, '[ s~ ~age ~ of
2 Net income (loss) from rental real estate activities ............................................... - 2 1 8. fo, Schedule K-1 (Form Instruction1065)
3 Net income (loss) from other rental activities ....................................................
4 Portfolio income (loss): a Interest
................................................................. 3 · Sch. B, Part I, line 1
'~' b Ordinary dividends
~ ............................................ Sch. B, Part I1, line 5
~ c Royalties
................................................................................................... Sch. E, Part 1, line 4
· d Net short-term capitalgain (loss)
E .................................................................... Sch. D, line 5, cot. (f)
o e Net long-term capital gain (loss): (1) 28% rate gain (loss)
c~ Sch. D, line 12, col. (g)
-- (2) Total for year .......................................................................................... Sch. D, line 12, col. (f)
f Other portfolio income (loss) (attach schedule)
5 Guaranteed payments to partner
6 Net sec. 1231 gain (loss) (other than casualty or theft) .......................................... } f~rSeeschedu~ePage 6
7 Other income (loss) (attach schedule)
Enter on applicable line of your return
, 8 Charitable contributions (attach schedule) ......................................................... Sch. A, line 15 or 16
=~ ~ 9 Section 179 expense deduction
~= 10 Deductions related io portfolio income (attach schedule) see ~,ages ? and
11 Other deductions (attach schedule) (Fo,'m ~0~5)
"E 13 Other credits
tenter on aDplicable lines of your return)
E~ 14a Interest expense on investment debts
~u~ ............................................................... Form 4952, line1
>e,~ b (1)Investment income included on lines 4a, 4b, 4c, and 4f above .............................. 3 · '~ See page g of Partner's Instructions
c:'~ (2)Investment expenses included on line 10 above for Schedule K-1 (Form 1065)
.--'_~ 15 a Net earnings (loss) from self-employment ......................................................... 0. Sch. SE, Section A or B
~c b Gross farming or fishing income
..................................................................... See page 9 of Partner's Instructions
O c Gross nonfarm income ................................................................................ for Schedule K-1 (Form 1065)
E ~ = 16 a Depreciation adjustment on property placed in service after 1986 _ 7 8
~ ~ b Adjusted gain or loss ............................ See Partner's Instructions for
~. ......................................................................................~ Schedule K-1 (Form 1065) and
e Other adiustments and tax preference items (attach schedule) .......... Instructions for Form 6251
19 Tax-exempt interest income
........................................................................... Form 1040, line 8b
~ 20 Other tax-exempt income
~ 21 Nondeductible expenses ........................... SEE... S~kTEFJ~N~ ............ 7 . See pages 9 and 10 of Partner's
22 Distributions of money (cash and marketable securities) (Form lO65)
-- 23 Distributions of property other than money ........................... ·
~t^/~ c.. ~aperwork Reduction Act Notice, see Form 1065 Instructions. No Information Required for Pa e 2 Schedule K-1 (Form 1065) 2000
O5-15-O0
10410222 758873 KD-187 2000.03031 CENTERVIEW ASSOCIATES LIMIT KD-187_l
.~Cl ;TDU,_E r~.-1 Pi. ~ s Six, re of lncon,e, O;eu~ts, L.,~ca,ctic , ~tc. I CMB ~ o
(Fo rm 1065) For calendar year 2001 or *,x year
PartneFs idenliyng number ~ Z85-05-3532 Parlnership's idendking number ~ ~2_~8~
P~r',ner's name, add,ess, and ZiP code
~ Pa:marsh:ps name, a~dress, and ZiP code
~ENTERVIEW ASSOCIATES
DR PAUL K. & ~RY J. WALTZ ~IMITED PARTNERSHIP
P.O. BOX 2015 ~/O STANFORD MGMT GROUP 9021 TO~ CENTER
MECH~ICSBURG, PA 17055-2015 ~RADENTON, FL 34202
This padner is a ~ J general panner ~ lime,ed parmer F Permit's share ol I~a~d~:i~s:
[ J limited liability company member .......
t.~ ...... Ou, _e S
What b'ge of ent,ly ,s lhis parmer~ ~ I~D~VIDUAL O~e'. fie~ nonrecourse hnanc~ng S
IS this partner a ~ domeshc o~ a ~ foreign par~ner? C:ner S 0
Enter parmer's (,) ~'~'e c~-~* (,,) E~ c.~ ..... ·
percentage of: G T~ ( snei;er ~e¢~s',ra:ion number ~
Pro[~l sharing .. % 3 . ~ ~ ~ ~ ~ 0 0% H C~,eck hare d this partnership is a publicly ~raded partnership
LOSS sharin~ ...... % 3.1 ~ 6 6 f 0 0t; ~s :~Sz, ed in section 46g(k)(2) .....
0,'.,ndrship ol C~pital % 3 . 2 6 6 3 8 5 0% .............
,=s c~,:,.,,.,~.~ ~=:,,,,,.=r,,,=,~:~,~. OGDEN, UT I Cpeck 32c. J'czble bcxes: (1) ~ Final K-1 (2) ~ Amended K-1
An¢Jvsis of pa~ner's caphal account:
(a) Cap:",31 account a (b) Cap:tel coptribu:ed (c) Pa;mat's share Of I.pes {e) Capilal account al end
be?ming of year durmo v~zr 3. ~. and 7, Form ~'.S& (d) t ~ .....
' - ' Sch~du',e M-2 dis~riau~cnS 0f year (combin~
' columns fa)~hrou;h
-72 , 654 . 2 , 254 . ,J
' -70 , 410 .
(a) O,s:r:bu::,..e s'~are i:em (b) Amo~¢t (c) i040 f,lers enter
amount in c.Dk~mn (b)
1 Cr~nary incpme (loss) from ~ra~e or ~usiness ~i,.';hes . 0 . ~
b CrP,nary ¢ivJPenPs ....... ' Sch. B. Parl Il. hne 5
c RoTa~ties
d t:el shore-term ca:.tal cam ('ass) Sch. E~ Part I, lin~ ~
- J grn D. tine 5. CCi. (f~
e (~) Ne~ .... . ..... _ .... ·
Ss~. D, 1;2¢ !2. _J. (f)
(2) 25% ra:e ;~:~
Sch. D. line 12, col (g)
(3) 0u~hf..e2 5-veer
~..:r ~'cri'.o::O ,r,:~me [Joss) (;ll~'~ q-~:~. ~'
7 C'mer income (;css~ lElipsh sche;u ~
9 Sec:ion ~79 e~pense deduCtion
11 Ciher deJuc:iio~s (a',~Ch SChedule} ¢o,m
13 0;her credds
14 a Interesl exp~se on investment ¢eD'.S I '
........ ~ Form 4952, line1
b (1)investment incom~ included on lines 4a. -b. ~. ~,.~ ~1 ~.,..,,. ~ ~ s~e ~e ~ o~ Pz-?,~'s
(2)lnves~men~ Expenses included on line lO aho,.,¢ f~, s:~=~;e K.~ {=o.~
15 a Ne~ earnings (loss} from self-empio.'men
' ............ ... 0 . j Sch. SE, Section A 0r B
b Gross farming or fishing income
c (}ross nonfarm income . . ' .............................. f=t S:he¢~;e K-1 (=¢-m
~6 a Depreciation adjustment on properb' paced m Service ~her 1936 ..... 2 0.
b AdjusJed gain or los~ ~ SeeP~-me,'s~,s,,c:,o,s
e 01her adjuslments and lax preference ilems fallach .~h~le) ~s:,u::.~s ~o, ~o,m
19 Tax-exempl in:erest income
........................................ Form 1040, line 8b
20 0:her Iax-exempl income
21 rJondeducdbie expenses ................ SEE STATEMENT. 1 0 s~e =,:,s ~ =.¢ :g =~
-
22 O~slr ;budons of money (cash and markelable Securities) (;o,m
For PaperworkReducdonAclNotiCe, s~eForm 1065 Instructions. NolnformaionRequhedlorPa2~2 Schedule K-l (Form ~06512001
ZTZ302Z3 758873 ~D-~87 200Z.03000 C~ERVZEW ASSOCZA~ES %Z~Z~ ~D-ZS?
SCHEDULE K-1 ~ ~ .ner's Share of Income, Credits, Oeduc,..~ns, etc. .~ OMB NO. 1545-0099
(Form 1065) For calendar year 2002 or tax year
2002
Internal Revenue Service and endin
Partner's identi~ing number I~ 185-05-3532 Partnershi~ number I~' 52-1197_____~489
Pa~ner's name, address, and ZiP code Partnership'$ name, address, and ZiP code
CENTERVIEW ASSOCIATES
DR PAUL K. WALTZ LIMITED PARTNERSHIP
P.O. BOX 2015 C/O STANFORD MGMT GROUP 9021 TOWN CENTEF
MECHANICSBURG, PA 17055-2015 BRADENTON, FL 34202
A This partner is a [ J general partner LX I limited partner F Partner's share of liabilities:
r"-] limited liability company member Nonrecourse $
B What type of entity is this partner? I~' TZ,TD'rVTDUAL Qualified nonrecourse financing ............ $ 1 ! ?, 2 '7 4.
C Is this partner a ~ domestic or a [ J foregn partner? Other $ 0
D Enter partner's 0) a.~ro change (i~) En,~ of ............................................. ·
or termination year
percentage of: G Tax shelter registration number
Profit sharing ...... % 3.1 ~ 6 6 6; 0 0% H Check here if this partnership is a publicly traded partnership
Loss sharing ......... % 3 · 16 6 6 6 0 0% as defined in section 469(k)(2) [---]
Ownership of capital % 3.2 6 6 3 8 5 0% ................................................
E IRS Cente~ where partnership filed retum: OGD~..~Tr UT I Check applicable boxes: (1) J---"]FinatK-1 (2) L'~--~AmendedK-I
J Analysis of partner's capital account:
(a) Capital account at (b) Capital contributed (c) Partner's share of lines (e) Capital account at end
beginning of year during year 3, 4, and 7, Form 1065, (d) Withdrawals and of year (combine
Schedule U-2 distributions columns (a) through (d))
-70,410 . -2 , 550. -72,960.
· (a) Distributive share item (b) Amount (c) 1040 tilers emer the
amount in column (b) on:
1 Ordinary income (loss) from trade or business activities ....................................... 0. 1
2 Net income (loss) from rental real estate activities - 2, 5 4~ 3 s. page e o~' Partne-'s instruct,on
3 Net income (loss) from other rental activities ................................................. fo~ Scheclu~e K-1 (Fonm 1085)
4 Portfolio income (lossi: a Interest
.............. : ......................................... ~ ........ i'. '7. Sch'. B, Part I, line 1
b Ordinary dividends
~ ....................................................................................... Sch. B, Part II, line 5
o c Royalties
~ ................ '; .......... .......................................................................... Scrr. E, Part I, line 4
,~ d Net short-term capital gain (loss) Sch. D, line 5, col. (f)
E e (1) Netlong-term capital gain (loss'i ...................................................................
o Sch. D, line 12, col. (f)
_c (2) 28% rate gain (loss) ................................................................................. Sch. D, line 12, col. (g)
(3) Qualified 5-year gain ..............
................................................................... Line 4 of wo,~sheet for Sc~. D. line 29
f Other portfolio income (loss) (attach schedule)
................................................ Enter on applicable lines of your return
5 Guaranteed payments to partner
6 Net sec. 1231 gain (loss) (other than casualty or theft) .......................................... ) s~ page e o~ Pa~ner's
for Schedule K- 1 (Fo~m 10{~5)
7 Other income (loss) (attach schedule) ...............................................................
Enter on applicable line of your return
, 8 Charitable contributions (attach schedule) ........... Sch. A, line 15 or 16
~ 9 Section 179 expense deduction .............................................
'- 10 Deductions related to portfolio income (attach schedule) s~, pages 7 and 8 of Partner's
.................................... Instructions f~ Schedule K-
11 Other deductions (attach schedule) ............................................................... ~=erm lO~5)
· E 13 Other credits
~ ' ' ............................................................................................ (Enter on a~plicable lines of your return}
E~ 14a Interest expense on investment debts
"~u~ ............................................................... Form 4952, line1
,~,~ b (1)Investment income included on lines 4a, 4b, 4c, and 4f above .............................. 7 , t See page 9 o~ Partna"s Instructions
--C>.~ (2)lnvestrnent expenses included on line 10 above ................................................... fo, Schedule K.1 (Form
-_~ 15 a Net earnings (loss) iron self-employment 0 Sch. SE, Section A or B
~-c b Gross farming or fishing income ..........................................................
............................................ for Schedule K-1 (Form 1065)
E = 16a Dep?eciation adjustment on property placed in service after ~986 ' ' ' 9 7.
E~ ~ b Adjusted gain or loss ........................... } s~ p~n~'s,,st~,c,o,s
~A'- ' ' ................................................................................... Schedule K-1 (Fof'm 1065) and
e Other adiustments and tax preference items (attach schedule) .................. ... -.. ..... ' ......... Instruct,ohs ~o¢ Form 825
19 Tax-exempt interest income
............................................................ ' ............... ' .Form 1040, line 8b
~, 20 Other tax-exempt income
~ 21 Nondeductible expenses ........................... SEE... STATEMEN.T ............ 1 z~ · Instructions ~ot Schedule K-1
22 Distributions of money (cash and marketable securities) ....................................... (F~'m 1065)
23 Distributions of property other than money ..... . .....................
JWA ~' ~)al~"';;'*~' °~"uc!ion Act Notice, see Form 1065 Instructions. No Information Required for Page 2 Schedule K-1 (Form 1065) 2002
O5-01-O2
21
EXHIBIT E
REV-1508 EX + (1-97) I
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Waltz, Paul K. 21-2003-0006
Include the ~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Nathan & Lewis Account #5W8-263563 1,255.46
2 PNC Bank Checking Account #5002026274 495.82
Per 2/6/03 letter
3 PNC Bank Checking Account #5080029665 43,847.39
Per 2/6/03 letter
4 Accrued, but undistributed income from Mary Jane Waltz Estate 4,047.88
5 Blue Cross Refund 367.32
6 67 shares of Messiah Investment Club at $21.08/share 1,412.36
TOTAL (Also enter on line 5, Recapitulation) ~ 5 1,4 2 6.2 3
2W46AD 2.000 (If more space is needed, insert additional sheets of the same size)
PNCBATxK
February 6, 2003
Keefer Wood Allen & Rahal LLP scp
Attn: Elyse E Rogers Esquire
415 fallowfield Rd, Suite 301
Camp Hill, PA 17011
RE: Estate of Paul K Waltz (Deceased)
SSN: 185-03-3532
DOD: 12-20-2002
Dear Ms. Rogers:
In response to your request for Date of Death balances for the customer noted
above, our records show the following:
Checking Account
Account~5002026274 Established 08-08-2000
PAUL K WALTZ
DOD balance: $495.78 + $0.04 accrued interest
Account~5080029665 Established 12-14-1993
PAUL K WALTZ
JANE H WALTZ
DOD balance: $43,846.44 + $0.95 accrued interest
Safe deposit box
The decedent maintained safe deposit box #161. It was in two names.
JANE H WALTZ
PAUL K WALTZ
It is located at:
MESSIAH VILLAGE
VILLAGE COMMONS - 100 MT. ALLEN DRIVE
MECHANICSBURG PA 17055
717-691-4090
Page 1 of 2
Please note that this office only provides date of death balances for deposit
accounts (IRAs, CDs, Checking and Savings accounts). We do not process any
financial transactions or provide statements. If you need assistance with any of
these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local
PNC Bank branch office.
Sincerely,
Erica L Schlegel
PNC Decedent Reporting
Firstside Center
500 First Ave, 4t~ F1 CIF
Member FDIC
Pittsburgh PA 15219-3128
1-800-762-1775
Page 2 of 2
SUMMARY OF ACCOUNT
Estate of Mary Jane Waltz
For Period 07/30/1998 Through 12/19/2002
Fiduciary
Acquisition
Page Value
Principal
Receipts $2,199,376.04
Net Gain (or Loss) on Sales or
Other Dispositions 164,571.18
Other Receipts 0.00
Less Disbursements: $2,363,947.22
Administrative Exenses $ 5,108.21
Debts of Decedent 965.77
Federal and State Taxes 206,773.33
Fees and Commissions 20,078.03
Income Taxes Principal 38,912.46
271,837.80
Balance before Distributions $2,092,109.42
Distributions to Beneficiaries 1,456,934.47
Principal Balance on Hand $ 635,174.95
Income
Receipts
$ 66 713.82
Less Disbursements:
Income Taxes
1,056.26
Balance before Distributions $ 65,657.56
Distributions to Beneficiaries 61,609.68
Income Balance on Hand $ 4,047.88
Combined Balance on Hand $ 639,222.83
ELBERT N SMITH
980 Messiah Village
POB°x 2015
Mechanicsburg, Pa. 17055
717-697-4541
January 16, 2003
Trustee for Estate of
Dr. Paul Waltz
Messiah Village
Mechanicsburg, Pa. 17055-2015
Dear Sirs:
Dr. Waltz was a member of the Messiah Investment Club and held 67 shares.
As of December 31, 2002 the value of each share was $21.08. Thus his estate is entitled to
$1,412.36.
Our policy states that distribution shall be made within three months of decease. Would you
kindly advise to whom this distribution should:!;be made?
Sincerely
~ElberYN. Smith, Trea'surer
EXHIBIT G'
RE~1510 ~ + (1-~) SCHEDULE G
INTER-VlVOSTRANSFERS &
COMMONW~LTH OF PENNSYLVANIA
INHERITANCE TM RE~RN MISC. NON-PROBATE PROPERTY
~SIDE~ DECEDE~
ESTATE OF FILE NUMBER
Waltz, Paul K. 21-2003-0006
This schedule must be completed and filed if the answer to any ~ que~ions 1 through 4 on the revers, side ~ the RE~1500 COVER SHEET is ~s.
~SCRIP~ON OF PROPER~ % OF
ITEM INCLU~ ME NAME OF ME T~NSFEREE, THEIR RE~TIO~HIP TO DA~ OF DEATH DECD'S EXCLUSION
~ ANDRE ~ OF T~FER. A~ACH A COPY OF THE TAXABLE VALUE
NUMBER ~ED FOR REAL ~TATE. VALUE OF ASSET INTEREST (iF ~ICABLE)
1. MFS Heritage Fund IRA Account 145,000.20 100.00 0.00 1~5,000.2~
15-8184060014/2
10,8%5.191 shares at
$13.37/share
2 MFS Heritage Fund IRA Account 361.09 100.00 0.00 361.0~
#5312453756
56.954 shares at $6.34/share
3 Oppenheimer Funds IRA 113,293.75 100.00 0.00 113,293.7]
3003000109725
Per 1/16/03 letter
Beneficiaries= Michael Waltz,
Susan Hogan, Alexandra
Tempsick
~ Allfirst Trust Company of PA , 176,172.20 100.00 0.00 176,172.2~
NA, Trustee under Agreement
with Paul K. Waltz dated
4/23/84~
16,968.06 shares of ARK Funds
PA Tax Free Portfolio =
$175,789.10 plus $383.05
accrued interest plus accrued
interest on Federated PA Muni
Trust $.05
5 Cash transfer to decedent~s 11,000.00 100.00 3,000.00 8,000.00
granddaughter, Betsy Hogan
03/30/02
6 Cash transfer to decedent's 10,000.00 100.00 3,000.00 7,000.00
daughter, Alexandra Tempsick
12/31/01
7 Cash transfer to decedent~s 11,000.00 100.00 3,000.00 8,000.00
granddaughter, Shannon Gomez
03/30/02
8 Cash transfer to decedent's 11,000.00 100.00 0.00 11,000.00
daughter, Susan Hogan 03/30/02
Total from continuation pages .... 173,000.00
TOTAL(Alsoenteronline7, Recapitul~ion) $
641,827.24
(If mom space is n~d~, inse~ additional sh~ts of same s~e,)
2W46AF 2.000
Page 2
Estate of= Waltz, Paul K. 21-2003-0006
Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property
Item Date of death % of Decd~s Exclusion
Taxable Value
No. Description Value of asset Interest (If applicable)
9 Cash transfer to decedent's 10,000.00 100.00 3,000.00 7,000.00
son-in-law, Stan Tempsick on
12/31/Ol
10 Cash transfer to decedent's 10,000.00 100.00 3,000.00 7,000.00
son-in-law, Joe Hogan 12/31/01
11 Cash transfer to decedent's 11,000.00 100.00 3,000.00 8,000.00
grandson-in-law, Tad Gomez
03/30/02
12 Cash transfer to decedent's 10,000.00 100.00 3,000.00 7,000.00
daughter, Susan Hogan 12/31/01
13 Cash transfer to decedent~s 11,000.00 100.00 3,000.00 8,000.00
grandson, Tim Hogan 03/30/02
14 Cash transfer to decedent~s 11,000.00 100.00 3,000.00 8,000.00
grandson, Ben F. Waltz, III
03/30/02
15 Cash transfer to decedent's 11,000.00 100.00 0.00 11,000.00
daughter-in-law, Marie Waltz
03/30/02
16 Cash transfer to decedent's 10,000.00 100.00 3,000.00 7,000.00
son, Michael P. Waltz 12/31/01
17 Cash transfer to decedent~s 11,000.00 100.00 0.00 11,000.00
son, Michael P. Waltz 03/30/02
18 Cash transfer to decedent~s 11,000.00 100.00 0.00 11,000.00
son-in-law, Joe Hogan 03/30/02
19 Cash transfer to decedent~s 10,000.00 100.00 3,000.00 7,000.00
daughter-in-law, Marie Waltz
12/31/0l
20 Cash transfer to decedent's 11,000.00 100.00 3,000.00 8,000.00
granddaughter, Kerr~ Ann ~omez
03/30/02
21 Cash transfer to decedent's 11,000.00 100.00 3,000.00 8,000.00
Page 3
Estate of= Waltz, Paul K. 21-2003-0006
Schedule G -- Inter-vivos Transfers & Misc. Non-probate Property
Item Date of death % of Decd~s Exclusion
Taxable Value
No. Description Value of asset interest (If applicable)
grandson, Paul K. Waltz, ii
03/30/02
22 Cash transfer to decedent's 11,000.00 100.00 3,000.00 8,000.00
granddaughter, Britta Waltz
03/30/02
23 Cash transfer to decedent~s 22,000.00 100.00 0.00 22,000.00
daughter, Alexandra Tempsick
03/30/02
24 Cash transfer to decedent's 11,000.00 100.00 3,000.00 8,000.00
grandson-in-law, Todd Gomez
03/30/02
25 Cash transfer to decedent's 11,000.00 100.00 3,000.00 8,000.00
grandson, Alan Miller 3/30/02
26 Cash transfer to decedent's 11,000.00 100.00 3,000.00 8,000.00
grandson, Michael P. Waltz,
Jr. 03/30/02
27 Cash transfer to decedent~s 11,000.00 100.00 0.00 11,000.00
son-in-law, Stan Tempsick
03/30/02
TOTAL. (Carr~ forward to main schedule) ...... 173,000.00
Januarx 30. 2003
DP, MICHAEL P ~.TALTZ
2700 COLUMBIA A\rj~NUE
CAMP HILL PA 17011
Reference: .0120~1280
MFS Total Return Fund-A
Account Number 8184060014-2
MFS Growth Opportunities Fund-~
Account Number 5312453756-1
MFS Heritage Trust Co Trustee
IRA R/O Paul K Waltz
Dear Dr. Waltz:
Thank you for requesting written verification of the values of the referenced MFS Individual
Retirement Accounts (IRAs) as of December 20, 2002. In addition to that information, I am providing
you with the distribution options available to you as one of the primary beneficiaries. Please accept my
condolences for your loss.
The following information represents the values of each account as of December 20, 2002.
Fund/Account Number Total Shares Net Asset Value Dollar Value
15-8184060014/2 ~0,845.191 $I3.37 per share $145,000.20
16-5312453756/1 56.954 $6.34 per share $361.09
Since IRS regulations concerning retirement plan distributions are complex, the following explanation
may not be complete. It is very important that you consult with an independenI legal or tax advisor to
determine which method of d/stribution is most appropriate for your personal situation. Neither MFS
nor any of its agents can provide legal or tax advice.
The distribution methods available to you are as follows:
5. Receive single distribution payments for your portion of the entire values of the IP~4s. According
to IRS regulations, these distributions should take place pr/or to December 31st of the calendar
year that conta/ns the fifth anniversary of the owner's death.
, P
Oppenne~merFun~¢
ILeef~r Wood _~ien
ATTN: Eiyse E. Ro~ers Te~ 800.525.7048
425 Fallo~eid Roa~. Ste. 3 0! www-oppenhe,mertunas.co=
Camp ~11, PA 1702 t-4906
Oppenheimer Capital Income Fund
Account Number 3003000] 09725
RPSS TR ROLLOVER IRA
FB O PAUL tf WALTZ
Dear Ms. Rogers:
OppenheimerFunds Servsces (OFS) recently spoke with your assistant, Linda, regarding settling
Mr. Paul K. Waltz' Oppenheimer Capital Income Fund Rollover Individual Retirement Account
(Rollover IRA), listed above.
The December 20, 2002, value and the registration of Mr. Waltz' Oppenheimer' ' '+ '
Fund account are listed below. . Capital income'
Account Account Registration 12/20/2002 Net
Number 12/20/2002 12/20/2002
Asset Value Share Balance AccoUnt Value
3003000109725 RPSS TRROLLO\rERL~A -$9.56
FBO PAULK WALTZ 11.850.811 2113 ')93 '='
As we discussed with Linda on January 16. ? ~
-00o, we will need to receive completed and signed
ZP,_A Applications and Forms W-47 for all ~fthe beneficiaries of Mr. Wahz' account. FOr your
conven/ence, three ZRA Applications and three Forms W-4P are enclosed.
If you have any additional questions` or need fi~rther assistance, please call -us-at 1-800-CALL_
OPP (225-5677). We are available Monday through F:Sday from 8:00 a.m. to 9:00 p.m. and on
Saturdays (January through April) from 10:00 a.m. to 4:00 p.m. Eastern Time. We w/ll be glad to
assist you.
Sincerel3;
OppenheirnerFunds
77~e .Right [,ycO, ~o Ira,est
Encl.- ;LR.A .And Roth ~RA .Applications (3)
Forms W-47 (3)
Rep]>, Envelopes (3) IDOC# 203275268
PAUL K. V~ AL ~. z~. T/A
DATE OF DEATH 1~,-0/0~
PRINCIPAL:
16,968.06 shs A.R.K Funds PA Tax Free Portfolio $175,789.10
Accrued Interest 3 83.05
Accrued Interest:
Federated PA Mum Trust .05
Less: Trustee's fee to Date o£Death (63.93_)
$] 76 1 08.27
REVD~_.ABLE LIVING TRUST
and Between
Paul K. ~a!:: and
Jane E. Nad.,=:
Settiors
and
DAUPHIN DEPOSIT BANK AND TRUST COMPANy
TRUSTEE
Dauphin Deposit Bank
and Trust Company
Member FDIC.
D~, transfe- to
Deposit Ban~; anc True. -;omDany f~ere~nafte- called the Truste 8 ~ennswvam~ Dam: ant
FIRST: S~ositive ~ro~isions For Our beneft[ - Dur~nc our lifetimes ant the tife[~me
SU~lVOr of Us:
A. Alt of the net income snail De Da~d ~o us. and ~o the su~vor of us, a; teas;
direct in writing; · .
B. As much of the principal as we, ortho survivorof us. may from time to time request
writinD s~all be paid to us, or as we. or the survivor of us. may otherwise direct:
C. If, .in the %rustee's opinion, either of us a; any time is unable tc act or tc aDPh' the
payments to our own best interest and advantage, the Trustee may apptv directi
deem appropriate for our welfare, i
comf0r~, support or emeroency needs, and may add
principal as much of the income as the Trustee deems adv~able.
D. Trustee shall keep true and correct books of account, w~ioh books of account
ail reasonable times De open to the inspection of Settlors or t~eir duty
representative. Trustee also shall render qua~erly to Settlors a detailed s~atement
snowin¢ all receipts and disbursements on account of the trust estate and the manner
and form in which .the trust estate is invested at t~e time of the rendition of such
statement.
SECOND: Dis~ositive ~rovisio~s After Death- U pon the death of either Settlor, this ~rust shall
continue in existence for the use and benefit of the surviving Settlor..Upon the death of the
sullying Settlor, while the trust continues, the Trustee shall pay the then-remaining principal
and income to the Executor or Administrator of the estate of the su~ivinB Settlor.
THIRD: Right to Revoke and Amend - Settiors reserve the right to revoke or amend this %rust,
in whole or in pa~, at any time and from time to time by an instrument in writing, delivered to the
Trustee and intended to take effect during our lifetimes, except that the duties, powers and
liabilities of the Trustee shall not be chaneed without its written consent. This right of
revocation and amendment also is reserved ~or the survivor of us, and is exercisable ~y the
survivor by himself or herself alone. The Trustee reserves the right, at any time upon thi~y (30)
days advance written notice to SeCtors. to resign the trust and detiver the trust estate to us, or
to the survivor of us, after deducting therefrom its fees and any expenses then due and payabte.
FOUR%H: Additions to Trust - Subject to the approval of the %rustee, either of us, orany other
entity, may add prope~y, real and personal, to the principal of this trust.
FISH: Trustee's ~owers: In addition to t~e powers ~ranted ~y law, our Trustee shall have the
following discretionary powers, applicable to princiCal and income, which shall beexercisabie
without leave of cou~ and shall continue until distribution is actually made:
A. To accept and retain any or all properly, includin¢ stock or other securities of the
Trustee or of a holdin~ company controlling the Trustee;
B. To invest in all f~rms of prope~y (including, but not by way of limitation, real estate,
all types of stock, bonds, options, and pa~icipations in common trust funds and money
market funds); without ~ing confined to investments prescribed by s~tute and without
being required to diversi~;
C. To buy investmeRts at a premium or discount;
D. To hold prope~ unregistered or in the name of a nominee;
E. To give proxies, both ministerial and discretionary:
F. To compromise claims;
G. To join in any merger, consolidation, reorganization, votJn~ trust plan, or other con-
ceded action of security holders, an'd to dele~at: dJscretiona~ duties with respect
thereto; · ~ ~ '
M. To borrow from Dauphin Deposit Bank and Trust Company or 'from others, and to
pledge real or personal prope~y as security therefor; to loan cash or securities upon
such terms and conditions as trustees deem appropriate;
I. To sell at pubJic or private sale for cash or credit or padly for each, to exchange, to
prove, or to lease for an~ period of time, any real or personal prope~y; and to give o~t OhS
for sates, exchanges' or leases: ,
COMMONWEALTN DF .:'2NNSYLVANIA }
COUNTY {DF
On this, the ' : clay of
, 198 , Defore me, z
notaff DUDiic in and for the said Commonwealth and County, personalty aDpeared
, Known to me (or saQsfactodly Droven) to De the person wt]ose
name is SuDscfibed to the foregoing RevocaZJle Living Trust, and acknowlenged that helst~e
executed the same for the purposes therein contained. WITNESS my tJand and notarial seat.
Notary PuDlic
My Commission Ezpires:
SCHEDULE OF PROPER'Pt'
Refen'ed to in the annexed Deed of Trust dated Apr±l !9 ,198 4 ,
from Paul K. Wal:z and Jane H. Waltz to Dauphin Deposit Bank and Trust
Company, Trustee
Check - $!00,000
.... · ~,,u~a[e a, )Deft? receive~ or crlarge incurrecJ to L ~a~ or mcome or
each. without De~ . oDiige~ ~c, aDDer t~e usua~ roles of trL .ccountm~:
~- To dJsTrJDule ir~ cas~ or i~ K~nc o~ Da~iv in each;
t. To retain any oa~ of al~ of out ousmess interests nejd' in tn~s Trust as ~on~ as
Trustee considers it aOwsaDte [o cc so: and ~o conquer, alone or wit~ others, anysuc~
bus,ness in wn~cn either or Dot~ of us are engaged, with all t~e Dowers of an Owner or wit~
respect tnere[o. Jnci udJn~ the Dower to Oeleoate discretl chary ~uties ~o others an d [o
adequate compensation to any such Derso
and ' ~; to invest ot~er'DroDeny in such Dusinesl
to incorpora[e it or change ils form.
SI~H: Com~nsatio~: The trustee shall ~e compensated in acco~ance with its standa~
schedule of c~arges in effect ~om time to time during the period of its sewices, and this
' pensatJon s~aJl be paid from principal or income or pauly fr~m each in the sole discretion
t~e Trust~. .
SEVENTN: No~ignment No pa~ of the income or principal of t~e Prope~ hetd undert~is
Trust shall be subject to a~achment, te~ or seizure by any creditor, spouse, assignee or
trustee or receiver in bank~tcy prior to actual receipt thereof. The Trust~ shal~ pay over the
net income and t~e principal to the persons herein designa[ed, as their interests may a~pear,
without rega~ to any a~empted anticipation (except ~ specifically provided in 'this agree-
ment), Pledging or assignment under t~e Trust, and without regard to any claim thereto
a~empted levy. attachment, seizure or other process against either or both of us.
EIGHTH: ~w Governing Trust This trust is creat~ and accepted in the Commonwealth
of Pennsylvania and shall in all respects be gov~ed by its laws and .shall have its situs at
C~erl~d Count, Pennsylvania.
Executed on
April !9 , 19 84.
NO~
Before executinB this document you may
~ _~ want to c~sult with your ARomey to as-
%~%r~3~ ~s~gs are he,nD set fo~h
The foregoing trust is h~by a~epte~.
:xecutedon ~ ~ ,19 E~
Daup~sit Ban~x~d~F~.~ompanv
~itle)
COMMONWEALTH OF PENNSYLVANIA } ~E ~R~SIDENT.TRUST OFFIC=R
COUN~ OF '
On this, the
~ay of ,198 , before
notary pub/id in and for the said Commonwealth and Countz. personally appeared me, a
, known to me (or satisfactorily proven) to be the person whose
~ame is subscribed to the foregoing Revocable Living Trust an0 acknowiedge~ that he/she
executed the same for the purposes therein contained. WITNESS my hand and notarial seal.
~otar~ Public
My Commission Expires:
(SEAL)
P-~: ?aul K. &Jarie~. Waltz, T/A ~1104895560
\,;A~LLFE AS OF 7/30/98_..
16,811.098 units ARK Tax Free Portfoho
Accrued m~erest $173,826.75
EXHIBIT H
REV-1511 EX +
SCHEDULEH
COMMONWEALTH OF PENNSYLV^N~^ FUNERAL EXPENSES &
INHERIT~C~ TM RETUR~ ADM I N ISTRATIVE COSTS
RE$1DENT.~DECEDENT
ESTATE OF
Waltz, Paul K. FILE NUMBER
2'1 -2003-0006
Debts ~ent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
AMOUNT
A. FUNERAL EXPENSES:
1. Memorial service dinner - $265.28
Flowers for service $72.08 807.83
Flowers for gravesite $61.47
Cremation Society, final balance $409
2 Minister for memorial service $100
Organist for memorial service $75 275.00
Piano player for memorial service $100
3 St. Johns Cemetery
B. ADMINISTRATIVE COSTS: 2 7 0.00
1. Personal Representative's Commissions 3 6,00 0.00
Name of Personal Representative(s) Michael
Social Security Number(s)/EIN Numberof Personal Representative(s) 210-36-7345 (M)
Street Address 2700 Colznabia Avenue 176-34-7910 (A)
City Camp Hill State PA Zip 17011
Year(s) Commission Paid: 2003
2. Attorney Fees Name : Keefer Wood Allen & Rahal, LLP 12,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant 0.0 0
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
541.00
5. Accountant's Fees
0.00
6. Tax Return Preparer's Fees
0.00
7. PNC January due - priority 50 plus
2.00
8 Allfirst trustees fee
63.93
9 PNC, Feb dues priority 50 plus
2.00
10 Allfirst, trustee fee
230.71
11 Register of Wills, short certificates
10.00
12 Allfirst, trustee fee
230.59
rom continuation pages ....
1,306.7~--
TOT~(Alsoenteronline9, Recapitulation $ 51,739.85
2W4§AG2.000 (Ifmorespaceisneeded, inse~additionalsheetsofsamesize)
Estate of: Waltz, Paul It. Page 2
21-2003-0006
Schedule K, Part A -- Funeral Expenses
Item
Description
Amount
0
4 West Shore Country Club, funeral luncheon
1,116.00
TOTAL. (Carry forward to main schedule) ......
1,116.00
Estate o~: Waltz, Paul 'K. Page 2
21-2003 -0006
Schedule H, Part B -- Administrative Costs
Item
No.
- Description
Amount
13 The Sentinel, legal advertising
115.79
14 Cumberland Law Journal, legal advertising 75.00
TOTAL. (Carry forward to main schedule) ......
190.79
EXHIBIT I
Pifiladejphta, IV. 1~255-002fi -800-~2~-8J 7~
~Your Caller Ih:
)N~nber o$'tNs Noace:
jDate of this Notice: June ~, ~00~
o~ 693 ~. ~ g5 ~s. o~o5. o o3 2 Afl. o. 5~7 ~45 o ~TaxDavej- ~d~nt/~cat/on Nuz~be::
I'"lll'"/ll,,,,,,Ih,,lhhh,,lh,,,ll,,,lllh,,lj,,,Ij,,,l
[ ~ax eonn: ] 040
PAUL K WALTZ DEOD ~TaxPenod:becemb-r31 900~
~'; N 'WALTZ
2~00 CBLUNBIA AVE Request for Payment
CANP HILL PA 1701!-5311 Amount you owe: $117.62
Due Date: June 30, 2003
According to ct= recor&, you have an amount due on yo~ income tax. Please compare yotL~ tax re~ against the
figures below, fyou ye akeady paid yo~ tmVin ~1 or ~ged for an inmI~ent agreement, please disregm-d this
notice.
Your 20 ord
~ Return
Tax On Ketum $62,000.00 -
ed Paments
Other Cre~
O~er Payments
$28,657.00-
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EXHIBIT J
REV-1513 EX.*- (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Waltz ~ Paul 14.. FILE NUMBER
21-2003-000
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
1. Hogan, Susan
12130 Farley Street Daughter 482,187.58
Overland Park, KS 66213-1671
2 (Miller)Tempsick, Alexandra W Daughter 482,187.59
1191 Kings Mill Court
Sunset Beach, NC 28468
3 Waltz, Michael P.
2700 Columbia Avenue Son 482,187.59
Camp Hill, PA 17011
--NTER 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.
3. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.0 0
2W4§A~ 1.000 (If more space is needed, insert additional sheets of the same size)
HARRISBURG. PENNSYLVANIA
o__~
PAUl. Ii. WALTZ
I, ~?AUL If. WALTZ of the Borough of Lemoyne,
Cumberland County, l~ennsy!vania, do make, publish and declare
this to be my Last Will and Testament hereby revo~%ing alt ~Titis
and Codicils by me at any time made
-
ITEM I:
I direct that all inheritance and
estate taxes becoming due by reason of my death whether such
tastes may be payable by my estate or by any recipient of any
property shall be paid by the Executor out of the property
Passing under ITEM IV of this Will as an expense and cost of
administration of my estate The
· ~'~ecutor shall have no duty- or
obTiuation to -obtain reimbursement for any ~such ta~ so paid,
even though on proceeds of insurance or other property not
passing under this Will
iTEM II.: I direct the Executor to Day the
expenses of my last illness and funeral e~penses from the
property passing under this Will as .an expense and cost of
adminis.tration of my estate.
ITEM II!: If ! predecease my wife, MARY 3AN-E
WALTZ I give and bequeath to her absolutely and in fee simple
all of my household furniture and furnishings, 'books, pictures,
jewelry, silverware, automobiles, wearing apparel and all other
articles of household or personal use or adornment and all
policies of insurance thereon. If i do not predecease my said
~ife, I make said bequest to my children' living at the time of
my death, to be divided among them as they shall agree. Should
?ag e 1
....... **~. su£n eroDe~--- shall be divided
the Bxeeu~o~ in as nearly equal portions as is deemed
prac~iaai in the sole discretion of the Execu~oz. havin
re~ard tc the personal preferences of such children.
!TEN !V: i ~ ~ devise
- =_v~ and begueath all
the rest. residue and remainder of my estate, not disposed of in
the preceding portions of this Will, to my wife, ~RY JA~
WALTZ and THE FIRST BAI~( A~ TRUST ~ ~ --
' ~0N_ AI,I~, Mechanicsburg,
Pennsylvania, as Trustees (hereinafter collectively referred to
as "Trustee"), iN TRUST NE~R~ELESS, to be further divided into
two parts, each of which shall be held in trust and constitute a
separate Trust Fund to be known as T~us~ and "Trust B".
"Trust A": There shall be placed in
"Trust A" that fraction of my residuary estate of
which the numerator shall he a sum equal to the
largest amount that can pass free of Federal estat, e
tar: under my Will by reason of the unified credit and
the state death ta~ credit (provided that the use of
this credit does not require an increase in state
death ta~es} allowable to my estate but no other
credit and after taking account cf dispositions under
other items of this Will and property passing outside
of this Will which do not quali£y for the marital or
charitable deduction and after ~ -'
~akzng account of
charges to principal that are not allowed as
deductions in computing my Federal estate tax and of
which the denominator shall be the value of my
residuary estate. For purposes of establishing such
fraction, the values finally fixed in the Federal
used ! ~o ~. ~
o_n thav the~ nume~a~o~ o~ such fra~zio~
ma~~ D~ zerc (0':. in which za~ nc propertl.- shall pass
under " ~
Truo~ A
TM and thaz sai~ numerator ma~- ~
a~ .... a b5- the acZion o~ the ~xecutor i~, exercising
certain ta:: elections.
"Trust B": The balance of my residuary
estate not placed in "Trust A" shall be placed into
"Trust B" to be held, administered and distributed in
accordance with ITE~[ Vi of this Will.
ITEM V: The following provisions shall
apply to "Trust A":
(a) The Trustee shall pay the net income arising
from the principal of this Trust in quarterly
installments to my wife, MARY J;dYE WALTZ, during her
(b) During the lifetime of my said wife, the
Trustee shall pay to or for the b.n_~lt of my said
wife so much of the principal of this Trust as may be
necessary, in the sole discretion of the Trustee, for
the proper supnort, maintenance and medical care of my
(c) Upon the death of my wife, or upon my death
if she fails to survive me the Trustee shall divide
the principal and any accretions thereto and any
accumulations of income into as many equal parts as
there are then living children of mine and then
deceased children of mine represented by then living
iivin~ child of mina. and shall pa?- one such share 5<
the the]o !ivinz~ issue of eacL the~ deceased child of
mina~ per stifles.
!TEh/ IX: The following provisions shall
apply no "Trust ~":
(a) Trustee shall have, hold, manage, invest and
reinvest the assets of this Trust, collect the income
and be=~innin~ at my death pay over the net income in
quarterl3r installments to my wife~ MARl~ JANE WALT?.:
during her lifetime. The Trustee shall also, from
time to time, ~ay to ms~ _
of this Trust as the Trustee (other than my said wife)
deems necessary for the proper support, maintenance
and medical care of my wife.
(b) Upon the death of my wife the Trustee shall
pay all accrued income and all income accumulated but
undistributed to the estate of my deceased wife and
shall thereafter transfer the then remaining principal
of this Trust to "Trust A" to be held, administered
and distributed in accordance with the provisions of
ITF~M V of this Will.
(c) If my wife should not survive me, then the
provisions of "Trust B" shall be void and the part of
my estate which would have constituted "Trust B" shall
be added to "Trust A" to be disposed of in accordance
with ITEM V of this Will.
Page 4
Tnt E~ecuzor snail o~ auznorizef ir: mae
so__, e:z~ius~ve and unres:ri£Eed discretion
nc, determine whether to elect ~under Se£niom
?056(b~''~ of the internal Revenue Code of !98~ as
amended, or any corresponding provision of the ~edera2
estate law), to gua!ifs- all, none or a fraction of
"Trust ~" for ~'~ Fede
~n~ ra2 estate tar marital
deduction. The decision of the Executor with respect
to the exercise of the election shall be final and
conclusive upon all oersons whose interests in my
estate are directly or indirectly affected by the
election. Only property which is ~ul!y eligible for
the marital deduction under Federal estate ta~ law
shall be assigned to this Trust. Notwithstanding
anything to the contrary contained in this Will, the
Trustee of this Trust shall not retain beyond a
reasonable time any property which may at any time be
or become unproductive, nor shall Trustee in~est 'i~
unproductive property. ~otwithstanding the provisions
of subparagraph (b) of this Item, the Trustee shall
pay to the Executor of my wife's estate, out of the
principal of this Trust upon the death of my wife, an
amount equal to the estate, inheritance, transfer,
succession and other death ta~es ("death taxes")
Federal sta~ and other, payable by reason of the
inclusion of the value of Trust property in my wife's
estate. Such payment shall be equal to the amount by
which (1) the total of such death 'ta~es paid by my -
wife's estate exceeds (2) the total of such death
taxes which would have been payable if the value of
the Trust property had not been included in her
estate. The determination by mv wife's Executor of
the amount payable hereunder shall be final. I direct
Page 5
the Trustee ~( ps[' sucL amoun~ prompn!~- uoo~:
~Uu=s+ of m-,- ~.,~'~ Zxeau~or Tn~. final
de~erminanion of the amount due hereunde:- snai! be
based upon the value as finally de~ermined ~oz ~ederal
estate ta:: purposes in my wife's estate. Afner
paj~ent of the ..amount~:finally .determined to be due
hereunder, the Trustee shall be discharged from
further liability with r=~n~~
~-=-~ to such payment.
wife may waive her estate's right to paymen5 under
this subparagraph by Will, executed after my .death, in
which she specifically refers to the right to payment
hereunder given to her estate.
ITEM vii: My wife, ~Y 3A~ WALTZ, shall
have the noncumulative right to withdraw FI~ T~OUSAND
DOLL.S from the principal of either "Trust ~" or "Trust
under this Will each taxable year during-which said beneficiary
is then entitled to receive income. 'If said beneficiary is
living on the last day of such year, said beneficiary shall also
have the right to withdraw an ~ount equal to Five ~5%')~. . oercent
of the a==r~a+~== ~= ~ net market value of the .orincipal of "Trust ~"
and "Trust B" on such last day less the amount of such FIVE
T~0USAND ($5,000) DOLL~S previously actually withdrawn from
such Trust during the taxable year. Payment shall be made
within thirty (30) days of the close of the ta~cable year, less
any Trustee's co.lesion payable with respect thereto, This
right of withdrawal shall be noncumulative and may be exercised
only in writing delivered to the Trustee .within .thirty (30) days
prior to the last day of such t~zable year.
ITEM VIII: No part of the income or principal
of the property held under any Trust created by this Will shall
Page 6 /-'/~
ba subjent nf atzacnmenL '-eTM o: seizur.~ b-~ an-~ £rediEo~_
Trustee sha!] pa[: ors: th~ neu income and nhe principal t~ th~
n__~n designated as ~heir ~nn_r_szs mar appear,
without regard ~c any at~empted anticipation, pledging or
assignment by any beneficiary- under a Truer, and without regard
to any claim thereto or attempted !e~q: attachment, seizure or
other process against said beneficiary.
ITEM IX: In the settlement of my estate and
during the continuance of the foregoing Trusts, the Executor and
the Trustee shall possess, among others, the following powems:
(ap To retain any investments I may have at my
death, including specifically those consisting of
stock of any bank even if I have named such bant~ as
the Executor or Trustee herein, 'so long .as the
Executor or Trustee may deem it advisable to my estate
so to do.
(bP To vary investments, when deemed desirable
~ by the Executor or Trustee, and to invest in such
bonds, stocks~ notes: real estate mortgages or other
securities or in such other property, real or
personal, as they shall deem wise, without being
, restricted to so-called "legal investments", and
without being limited by any statute or rule of law
'~ regarding investments by fiduciaries.
(c) In order to effect a division of the
principal of a Trust or for any other purpose,
including any final distribution of a Trust the
au~no_-iz_£ ~< maF, e sci.,
c~=.'~s~ons o_~ d~szribuzions of the personal~y and
real?.', part.!y or whoi!u in kind~ and nc allocate
suecific assems among beneficiaries and Trusts creased
hereunder sc long as the ~otal'market ~'aiue of an~.-
share is not .affec{ed bY .suah~division, distribution
or alioaaCion in kind. Should i~ appear desirabte.~o
partition any real estate: the Executor or Trustee is
authorized to make, join in and consummate partitions
of lands, voluntaritp- or involuntarilt-' including
sivin~ of mutual deeds, recognizances or other
obligations, with as wide powers as an individual
owner in fee simple.
(d) To sell either at public or private sale and
upon such terms and conditions as the Executor or
Trustee may deem advantageous to the estate or Trust,
an3~ or all real or 'personal-estate or 'i'nteres't therei~
owned by the estate or Trust severally or in
conjunction with other persons or acquired after my
death by the ~.xecutor or Trustee, and to consummate
said sale or sales by suffi.cient deeds or other
instruments to the purchaser or purchasers, conveying
a fee simple title, free and clear of all trust and
without obligation or liability of the purchaser or
purchasers to see to the application of the purchase
money or to make inquiry into the validity of said
· sale or sales; also, to make, execute, acknowledge and
'iii deliver any and all deeds, assignments options or
~ other writings which may be necessary or desirable in
:'i~.~ carrying out any of the powers conferred upon the
~:~,: Executor or Trustee in this paragraph or elsewhere in
! ~ ~(-- mow'~a~-u~ ~. re~_ esEaLYs , ail( Lc malqt -ease~
of real eszai£..
(f) T¢. borrow mone~- ~rom any par-_)- in£1udmn.2
the Executor oz Trustee, to pa)- indebtedness of mine
or of my estate, expenses of.~adminisnration
inheritance, legacy, estate and other
assign and pl~d=~ assets of my estate therefor.
Provided, however, that this paragraph shall not
authorize borrowing from "Trust
(g) To pay all costs, taxes, expenses and
charges in connection with the admfnistra~ion of my
estate or a Trust. If any estate or inheritan;e taxes
are payable from ass ets received by the Trustee, such
ta~es shall be paid from the assets constituting
"Trust A".
~h) To vote any shares of stock which form a
part of the estate or Trust, and otherwise ~o exercise
all the powers incident to the ownershSp of such stock.
(i) In the discretion of the ~fecutor or
Trustee, to unite with other owners of similar
property in carrying out any plans for the
reorganization of any corporation or company whose
securities form a part of the estate.
(j) To disclaim any interest in property which
would devolve to me or my estate by whatever means
including but not limited to the following means: as
beneficiary under a will, as an appointee under the
exercise of a power of appointment, as a person
!'Jvos 2£RIlsfer. and a~ ~ donee uncle: ~ tnirci_paruT..
benefiniar-.~ contract.
(k> To do ail other ac~s in their judgmen~
deemed ne.ae~sary or desirable for the proper and
advantageous management, investment and distribution
of the estate or Trust.
(1) In the event of a dispute between the
Trustees with respect to the exercise of any Dower
granted the Trustees under this Item, the decision of
the individual Trustee shall control (except to the
e~tent otherwise specifically provided in this Will).
iTEM X: Whenever and as often as any
beneficiary hereunder, to whom payments of income or principal
are herein directed to be made. shall ~be under 'lega!~.dislabi'lity,
or, in the sole judgment of the Trustee, shall other%,ise be
unable to apply such payments to his own or her own best
interests and advantages~ the Trustee may make all or any
portion of such payments in any one or more of the following
ways:
(a) Directly to such beneficiary;
(b) To the Legal. Guardian or Conservator of such
beneficiary;
(c) To a relative of such beneficiary, to be
expended by such relative for the benefit of such
beneficiary; or
Page !0
...... e::pendin[ sams fo: :ne oen~=i- cf
said bene=iciar,.-
Pro?ideal however that tilts power shat2 no: appi)-
-rTEK 2[i if at any time any bene~iciar-~
entir-led ~.o receive an~ ~und$ hereunder shall not have attained
~n~ age of twenty-one (21) years at the time of such
distribution, the share of such beneficiary shal2 be paid to the
person hereinafter named, who shall act as Custodian under the
Pennsz~lvania Uniform Gifts to Minors Act for such beneficiary.
My son, I~ICiIAEL ?. WALTZ, shall act as Custodian with respect to
any property to be paid to any issue of ALEY~%NDRA.WALTZ MILLER.
~IARIE ANN WALTZ shall act as Custodian with respect to any
property to be paid to any issue of MICI~AEL p. WALTZ° JOSEPt{
Tt~OMAS tlOGA~ shall act as Custodian with respect to any property
to be paid to any issue of SUSAN MARl' IROGAN. If an~- of the
aforementioned indi~,iduals are unable or re~uses to act as
Custodian, the Custodian shall be such individual as shall be
named by the person(s) serving as the E~ecutor of my estate.
ITEM Ifil: Any person who shall have died at
the same time as I shall have, or in a common disaster with me,
or under such c~rcumstances that the order of our deaths cannot
be established by proof, or within thirty (30) days of my death,
shall be deemed to have predeceased me.
.... T~M ~ T
...... I.I: I hereby nominate, constitute and
appoint my wife, MARY J.~E WALTZ, to be the Executrix, herein
referred to as "Executor,,. In the event of her death or her
:! inability or refusal to serve, ! nominate, constitute and
appoint my son, MICHAEL p. WALTZ, and my daughter: ALEtlA~DPg
: WALTZ MILLER, to be the Executor. The Executor. and Trustee are
'i
id BT' inself e::oendinr same fo.- the oenefi of
saici bene_=i aiarv.
Provided. however tha-~, this power
ITEM ]?~v__: If at any time any beneficiary
entitled to receive an~ ~unds hereunder shall not have attained
the age of twenty-one ~21) years at the time of such
distribution, the share of such beneficiary shall be paid to the
person hereinafter named, who shall act as Custodian under the
Pennsz~lvania Uniform Gifts to Minors Act for such beneficiary.
My son, MICHAEL p. WALTZ, shall act as Custodian with respect to
any property to be paid to any issue of ALE/~NDRA .WALTZ MILLER.
MARIE ANN WALTZ shall act as Custodian with respect to any
property to be paid to an5, issue of MICHAEL p. WALTZ. JOSEPH
THOI~AS HOGAN shall act as Custodian with respect to any property
to be paid to any issue of SUSAN MARt' HOGAN. If any of the
aforementioned individuals are unable or re,uses to act as
Custodian. the Custodian shall be such individual as shall be
named by the person(s) serving as the Executor of my estate.
ITEM ~II: Any person who shall have died at
the same time as I shall have: or in a common disaster with me,
or under such circumstances that the order of our deaths .cannot
be established by proof, or ~ithin thirty (30) days of my death,
shall be deemed to have predeceased me.
· .... .ITEM Iii/i: I hereby nominate, constitute and
appoint my wife, MAZY JANE WALTZ, to be the Executrix, herein
referred to as "Executor,,. In the event of her death or her
inability or refusal to serve, I nominate, constitute and
appoint my son, MICHAEL p. WALTZ, and my daughter, ALEXANDP~
WALTZ MILLER, to be the E~equtor. The Executor and Trustee are
Page 11
sDezificaii" relieve:' _~rom zh~ oul'- o-r ob!igamio} of fi!in: aIw-
bon.-i o:' othe:: se£uritv
IE WITNESS WHERE0,1,. i have sez m-: hand and sea! tc
this~ m5- Last Will and Testament. consisting of this and the
precedin~ eleve~ (i!~ pa~es, aZ the end of each page of which
have also set my initials foz~ ~ ~ ~= security and better
identifization this ~ 0 day of /[]J-ag~?-O~ , 19
/
/ ,
PAUL K. WALTZ
We, the undersigned, hereby certify that the foregoing
Will was signed: sealed, published and d~alared by the
above-named Testator as and for his Last Will and Testament, in
the presence of us, who, at his request and in his presence and
in the presence of each other, have hereunto set our hands and
seals the day and year first above written, and we certify that
at the time of the execution thereof, the said Testator ~:as of
sound and disposing mind and memory.
/..%-
,...<,5.,~.~'~ /'/.;, ~. , . ~:_,- (S~Ab) Residing ~E
i
L~I:F~ARTMEN"~ LTM REVENUi; ,:.
BUREAU 0= INDIVtDUi.,L TAXE.~ RE\/-1 i62 EXIt i -96
DE~T. 28060:
HARRISBURG, PA 17128-060:
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 00229S
ROGERS ELYSE E ESQUIRE
415 FALLOWFIELD RD
SUITE 301
CAMP HILL, PA 1 7011-4906
ACN
ASSESSMENT AMOUNT
CONTROL
...... ,o,~ NUMBER
101 I $61,000.00
ESTATE INFORMATION: SSN: 185-03-3532
FILE NUMBER: 21'03-0006
-------
DECEDENT NAME: WALTZ PAUL K
DATE OF PAYMENT: 03/1 7/2003
-----
POSTMARK DATE: 03/14/2003
:OUNTY: CUMBERLAND
-----
)ATE OF DEATH: 1 2/20/2002
TOTAL AMOUNT PAID: $61,000.00
~EMARKS: MICHAEL p WALTZ & ALEXANDER W
MILLER C/O ELYSE E ROGERS ESQ
CHECK# 10O6
INITIALS: CW
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY .REGISTER OF WILLS
TAXPAYER
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estateof Paul K. Waltz No. 21-03-0006
also known as Date of Death 12/20/02
, Deceased Social Security 185-03-3532
No.
Michael P. Waltz and Alexandra W. (Miller) Tempsick
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
INVe verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made
subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of ~ ~_____~ ~ Personal Repres~.//]/"~.~, ~
Attorney: Elyse E. Rogers ~ ) Michael P.
Address 415 Fallowfield Road, Suite 301 Dated:
Camp Hill, PA 17011
Telephone 717-812-5801
DESCRIPTION VALUE
1. Nathan & Lewis Account #5W8-263563 $ 1,255.46
2. PNC Bank Checking Account #5002026274 $ 495.82
3. PNC Bank Checking Account #5080029665 $43,847.39
4. Accrued but undistributed income from Mary Jane Waltz Estate $ 4,047.88
5. Blue Cross Refund $ 367.32
6. 67 Shares of Messiah Investment Club at $21.08/share $ 1,412.36
See attached sheets
(Attach Additional Sheets Ir Necessary) TOTAL $892,352.80
NOTE: The Memorandum of real estate outside the Commonwealth of Pen nsytvania may, at the election of the personal representative, include the value of each item,
but such figures should not be extended into the total of the Inventory.
Form RW-7 (Dauphin County) - Rev. 9/92
REV-1503 EX + (1~97)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Waltz, Paul K. 21-2003-0006
All prope~y jointly-owned with right of su~ivomhip must be disclosed on Schedule F.
I~M
NUMBER DESCRI~ON VALUE AT DA~
1 ACM IncoMe Fund Inc. OF DEA~
8, 146.02
2 800 shares of AOL Time Warner at $13.335/share 10,668.00
Per Estate Val
3 152 shares of Agilent Technologies Inc. at $17.4/share 2 644.80
Per Estate Val '
4 4943.558 shares of Alliance Mid Cap Growth Fund at $3.41/share 16,857.53
Per Estate Val
5 13,130 shares of Allied Irish Banks PLC at $26.475/share 347,616 75
Per Estate Val '
6 American Century Account %020-000333244 - 6146.869 shares at 90,481 91
$14.?2/share '
7 268 shares of Bristol Myers Squibb Co at $23.435/share 6,280.58
Per Estate Val
8 1000 shares of Dell Computer Corp at $27.155/share 27,155.00
Per Estate Val
Name changed to Dell Inc. on 7/18/03
9 800 shares of Hewlett Packard Co. at $18.845/share 15,140.00
Per Estate Val
10 1500 shares of Honeywell Intl Inc. at $23.475/share 35,212.50
Per Estate Val
11 9556.734 shares of John Hancock Ser Tr Global Tech A at
$2.54/share 24,274.10
Per Estate Val
12 207 shares of Medimmune Inc. at $27.9/share
Per Estate Val 5,775.30
13 1364 shares of PNC Finl Svcs Group Inc. at $41.355/share 56,408.22
Per Estate Val
14 Penn St Tax Exempt Invt Tr
3,365.05
15 400 shares of Quaker Chemical Corp at ~22.845/share 9,138.00
Total from continuation pages .... 181,762.81
TOTAL(AlsoenteronlJne2, Recapitulation) $
840,926.57
2w46963.000 (Ifmorespaceisneeded, inse~additionalsheets~thesamesize)
Page 2
Kstate'of= Waltz, Paul K. 21-2003-0006
Schedule B -- Stocks & Bonds
Item
Value at
No. Description Date of Death
15 Per Estate Va1
16 T. Rowe Price Growth Stock 41,369.21
per internet and 07/18/03 letter
17 T. Rowe Price New Horizons 66,093.27
Per internet and 07/18/03 letter
18 2,491.358 shares of Van Eck Funds Intl Invs Fd at $9.67/share 24,091.43
19 Vanguard Windsor Funds 36,191.02
Per 12/31/02 statement
20 526 shares of W P Carey & Co LLC at $24.675/share 12,979.05
Per Estate Val
21 Zimmer Holdings Inc.
1,038.83
TOTAL. (Carry forward to main schedule) ...... 181,762.81
7000
1530
0001
~ ~. ~ ? MAILED FROM ZIP CODE ~ 7 '; ~ ~
First Class Mail
415 Fallowfield Road -~
Suite 301
Camp Hill, PA 17011-4906
TO:
CUt~EP~/~D CY~JNT¥ C~DUR%~IC~J~E
CONHONNEALTH OF PENNSYLVANZA ~k_
BUREAU OF ZNDZVZDUAL TAXES DEPARTMENT OF REVENUE
~//NHERZTANCE TAX DI¥/SZON
DEPT. 180601
HARRZSBURG, PA 17118-0601 NOTZCE OF /NHERZTANCE TAX
APPRAZSEHENT, ALLOHANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
DATE 11-0:3-2003
ESTATE OF NALTZ PAUL K
DATE OF DEATH 17-20-2002
FZLE NUMBER 21 05-0006
~'*' COUNTY CUHBERLAND
ELYSE E ROGERS ESO ACN 101
KEEFER ETAL
q15 FALLONFZELD RD 30: Amount Remitted
CAHP HTLL PA 17011
i
HAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGTSTER OF NZLLS
CUH]IERLAND CO COURT HOUSE
CARLTSLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTZCE OF ZNHER]:TANCE TAX APPRAZSENENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF NALTZ PAUL K FZLE NO. 21 03-0006 ACN 101 DATE 11-05-2005
TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATZON CONCERN]:NG FUTURE ZNTEREST - SEE REVERSF..
APPRAZSE~ VALUE OF RETURN BASED ON: ORZGTNAL RETURN
1. Raal Estata (Sohedula A) (1) . O0 NOTE: To insura proper
2. Stocks and Bonds (Schedule B) (2) 8qO r926.57 credit to your account,
$. Closely Held Stock/Partnership Tntares~ (Schedule C) ($) . O0 subait fha upper portion
4. Mortgagas/Notas Recalvabla (Schedule D) (4) . O0 of this fora w/th your
5. Cash/Bank Deposits/M/sc. Personal Property (Schedule E) ($) 51 t qZ6. Z~ tax payment.
6. Jo/ntly Ownad Proparty (Schadula F) (6) . O0
7. Transfers (Schedule G) (7) 6ql;8Z7.Zq
8. Total Assets (8) 1,55q,180. Oq
APPROVED DEDUCTIONS AND EXEMPTZONS:
51,7~9.85
9. Funeral Expansas/Adm. Costs/M/sc. Expenses (Schedule N) (9)
10. Debts/Mortgage L/ab/litias/Lians (Schedule Z) (10) $5,877.~$
11. Total Deductions (11) 87. ~17.28
12. Nat Value of Tax Return (12) 1,qq6,562.76
15. Charitable/governmental Bequests; Non-alactad 9115 Trusts (Schedule J) (15) . O0
14. Net VaZua of Estate Subject to Tax (14) 1,~q6,562.76
NOTE: Z~ an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
1S. Amount of L/ne 1~ at Spousal rata (15) . O0 X O0 = . O0
16. Amount of L/ne 14 taxable at Lineal~Class A rata (16) 1,qq6,562.76 x 0q5 = 65,095.:52
17. Amount of L/ne 14 at S/bling rate (17) .00 X 12 = .00
18. Amount of L/ne lq taxable a~ Collateral~Class B rata (18) .00 x 15 = .00
19. Pr/nc/pal Tax Due (19)= 65,095.
TAX CREDZTS:
PAYttENT I RECETpT DTSCOUNT
DATE I NUMBER ZNTEREST/PEN PAZD (-) AMOUNT PAZD
05-1q-2005 CD002298 ;5,210.55 61,000.00
09-17-~00~ CO00$0~0 .00 88~. 79
TOTAL TAX CREDZT I 65,095.32
BALANCE OF TAX DUEI .00
ZNTEREST AND PEN. I .00
TOTAL DUE I . O0
a ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS RE~UZRED.
FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.
RESERVATION: Estates of decedents dying on or before December 11, 1981 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries cf the decedent after the expiration of any estate for
life or for years, the Coaeonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collataral) rate on any such futura interest.
PURPOSE OF
NOT[CE: To ~ulfill the requirements cf Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of Z000. (72 P.S.
Section 91qO).
PAYMENT: Detach the top portion of this Notice and submit mith your payment to the Register of Mills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
REFUND (CR}: A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" CREV-131$). Applications ere available at the Office
of the Register of Mills, any of the 2~ Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-36Z-20S0~ services for taxpayers with special hearing and / or
speaking needs: 1-800-q47-3010 (TT only).
OBJECTIONS: Any party in interest net satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest} as shown on this Notice oust object within sixty [60} days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should bm addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601j Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1SO1) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY: The 151 tax amnesty 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 tho tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiao period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine [9) months and Dna (1} day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of
six [6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 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 198Z through Z003 are:
Interest Daily Interast Daily Intarest Daily
Year Rate Factor Year Rata Factor Year Rate Factor
1982 ZOZ .000546 1987 9Z .000947 1999 72 .000192
1983 162 .000458 1988-1991 112 .000301 2000 82 .O00Z19
1984 112 .000301 1991 92 .000247 2001 92 .000247
1985 132 .000556 1993-1994 72 .000192 2002 62 .000164
1986 lex .000274 1995-1998 9~ .000147 2003 52 .000137
--Interest is calculated as follows:
ZNTEREST= BALANCE OF TAX UNPAZD X NURBER OF DAYS DELZNQUBNT X DAZL¥ ZNTEREST 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 date shown on the
Notice, additional interest must be calculated.
COMMONHEALTH OF PENNSYLVANIA
BUREAU OF /NDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. ZSO6O! NOTICE OF DETERMINATION AND
HARRISBURG, PA 171Z8-0601 ASSESSHENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN .Ev-48sEx,FPco~-0s)
DATE 05-05-2004
ESTATE OF WALTZ PAUL K
DATE OF DEATH 12-20-2002
FILE NUHBER 21 05-0006
COUNTY CUMBERLAND
ELYSE E ROGERS ESQ ACN 201
KEEFER ETAL J Amoun~ Remi~ed
415 FALLOWFIELD RD $0
CAMP HILL PA 17011
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~:o your account) subm/~ ~he upper portion of ~his form wi~h your ~ex peymen~c.
CUT ALONG THIS LINE ~.~ RETAIN LOWER PORT/ON FOR YOUR FTLES ~
REV-483 EX AFP [01-03) ~ NOTICE OF DETERHZNATZON AND ASSESSMENT
OF PENNSYLVANTA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~
ESTATE OF WALTZ PAUL K FILE N0.21 05-0006 ACN 201 DATE 05-05-2004
ESTATE TAX DETERHZNATTON
1. Credit For State Death Taxes as Verified 56zZ88-78
2. Pennsylvania Inheritance Tax Assessed 61z884.79
(Excluding Discount and/or Interest)
5. Inheritance Tax Assessed by Other States .00
or Territories of the United States
(Excluding Discount and/or Interest)
4. Total Inheritance Tax Assessed 61z884'79
5. Pennsylvania Estate Tax Due .00
TAX CRED/TS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT
DATE NUMBER INTEREST/PEN PAID C-)
TOTAL TAX CREDTT i .00
BALANCE OF TAX DUEl .00
TNTEREST AND PEN. .00
TOTAL DUE . O0
~IF PAID AFTER THIS DATE, SEE REVERSE SIDE (TF TOTAL DUE TS LESS THAN $1, NO PAYHENT TS REQUIRED
FOR CALCULATION OF ADDTTTONAL INTEREST. TF TOTAL DUE TS REFLECTED AS A 'CREDTT' (CR), YOU HAY BE
DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR INSTRUCTIONS.
PURPOSE OF
NOTICE: To fulfill the requirements of Section Il6,0 (b) of the Inheritance and Estate Tax Act, Act Z$ of ZOO0.
(TI P.S. Section 916,0).
PAYNENT: Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NILLS, AGENT.
REFUND (CR): A refund of a tax credit may bo requested by completing an "Application for Refund of Pennsylvania
Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of #ills,
any of the Z3 Revenue District Offices or fram the Department's Z4-hour answering service for forms ordering:
1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-BOO-6,6,?-~OZO (TT only).
OBJECTIONS: Any party in interest not satisfied with the assessment of tax as shown on this notice may object within
sixty (60) days of receipt of this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at audit of the personal representative, OR
--appeal to the Orphans' Court.
ADNIN-
ISTRATIVE
CORRECTIONS: 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 17128-0601,
Phone (717) 787-6505. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
PENALTY: The 15Z tax amnesty 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 same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: For dates of death on or after 10-5-91, Pennsylvania Estate Tax based on the Federal Estate Tax
return becomes delinquent at the expiration of nine (09) months from the date of death.
For dates of death prior to 10-5-9l, Pennsylvania Estate Tax based on the Federal Estate Tax return
becomes delinquent at the expiration of eighteen (18) months from the date of death.
Taxes which became delinquent before January l, 198Z bear interest at the rate of six (6Z) percent per annum
calculated at a daily rate of .000166,. All taxes which became delinquent on or after January 1, 198Z will bear
interest at a rate which will vary froa calendar year to calendar year with that rate announced by the PA
Department of Revenue. The applicable interest rates for 19BI through ZOO6, ara:
Interest Daily Interest Daily Interest Daily
Yaa~ Rate Factor Yaa~ Rate Factor Yaa~ Rate Factor
X98Z ZOZ .00056,8 1988-1991 Ill .O00~Ol 2001 9X .00026,7
198.% 167. .0006,~8 1992 9Z .00026,7 200Z 6Z .000166,
19B6, 117. .000301 1993-1996, 72 . D00192 2003 5Z .000137
1985 13Z .000356 1995-1998 9Z .00026,7 ZOO6, 6,2 .000110
19B6 lOX .000 Z76, 1999 7Z . O0019Z
1986 lOZ .000276, 2000 82 . OOOZ19
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBBR OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (iS) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
COHHONNEALTH OF PENNSYLVANZA
BUREAU OF /NDTVZDUAL TAXES DEPARTHENT OF REVENUE
ZNHERZTANCE TAX
DEPT. ze0e0~ NOTZCE OF DETERNZNATZON AND
HARRZSBURG, PA 171Ze-DG01
ASSESSNENT OF PENNSYLVANZA
ESTATE TAX BASED ON FEDERAL
CLOSZNG LETTER
DATE 05-10-2004
~ ESTATE OF NALTZ PAUL K
DATE OF DEATH 1Z-ZO-ZOO2
FZLE NUHBER 21 05-0006
'04 ~¥ -7 ~...i~ COUNTY CUNBERLAND
ELYSE E ROGERS ESG ACN 20Z
KEEFER ETAL kmoun~ Rem[~ed
415 FALLONFZELD RD
CAHP HZLL PA [~QI,[~:
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 1701~
NOTE: To insure proper credi~ ~o your account, subm/~ ~he upper por~/on of ~his form w/~h your ~ax payment.
CUT ALONG THZS LZNE I~ RETAZN LONER PORTZON FOR YOUR FZLES
..... - ............................
OF PENNSYLVANZA ESTATE TAX BASED ON FEDERAL CLOSZNG LETTER
ESTATE OF NALTZ PAUL K FZLE NO.Z1 05-0006 ACN Z0Z DATE 05-10-Z004
ESTATE TAX DETERNZNATZON
1. Credi~ For S~a~e Death Taxes as Verified 56,288.78
Z. PennsyZvan~a Znheri~ance Tax Assessed 61,884.79
(Excluding Discoun~ and/or /n~erest)
5. [nheri~ance Tax Assessed by O~her S~a~es .00
or Territories of ~he United S~ates
(Exc/uding Discount and/or [n~eres~)
4. To~a! Znheri~ance Tax Assessed 61z884'79
5. Pennsylvania Estate Tax Due .00
6. Amoun~ of Pennsylvania Es~a~e Tax Previously Assessed
Based on Federa! Es~a~e Tax Re~urn .00
7. Addi~iona! Pennsylvania Es~a~e Tax Due .00
TAX CREDZTS
PAYNENT RECEZPT DZSCOUNT (+) AHOUNT PAZD
DATE NUHBER INTEREST/PEN PA[D (-)
TOTAL TAX CREDZT I .00
BALANCE OF TAX DUEJ .00
ZNTEREST AND PEN. . O0
TOTAL DUE . O0
~IF PAZD AFTER THTS DATE, SEE REVERSE SZDE (ZF TOTAL DUE TS LESS THAN $1, NO PAYHENT ZS REI~UZRED
FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU HAY BE
DUE A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)
PURPOSE OF
NOT[CE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (TI P.S.
Section 9140).
PAYNENT: Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF NILLSj AGENT.
REFUND (CR): A refund of a tax credit may be requested by completing an "Application for Refund of Pennsylvania
Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Hills,
any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service for fores ordering:
1-BO0-36Z-ZO50; services far taxpayers with special hearing and/or speaking needs: 1-800-447-30Z0 (TT only).
OBJECTIONS: Any party in interest not satisfied with the assessment of tax as shown on this notice may object within
sixty (60) days of receipt of this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171ZB-lOZ1, OR
--electing to have the matter determined at audit of the personal representative, OR
--appeal to the Orphans' Court
ADHIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue,
Bureau of Tndividual Taxes, ATTN: Post Assessment Reviaa Unit, Dept. Z80601, Harrisburg, PA 17126-0601,
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
PENALTY: The 15Z tax amnesty 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 same time period as you ~ould appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Additional Pennsylvania Estate Tax assessed as a result of a change on the Federal Estate Tax closing
letter becomes delinquent at the expiration of one (1) month from the date the final notice of the increase
in Federal Estate Tax is received.
Taxes ~hich became delinquent before January 1, 1982 bear interest at the rate of six (BI) percent per annum
calculated at a daily rate of .000164. A11 taxes which became delinquent on or after January 1, 1982 ~ill bear
interest at a rate ahich ~ill vary frae calendar year to calendar year ~ith that rate announced by the PA
Department of Revenue. The applicable interest rates for 198Z through 2:00~, are:
Interest Daily Interest Daily Interest Daily
Yea__r Rata Factor Year Rata Factor Year Rate Factor
1982 ZOZ .000548 1988-1991 llX .000301 ZOO1 9Z .000Z47
1983 16Z .000438 1992 9Z .OOOZ47 2OOZ 62 .000164
1984 11Z .000301 1993-1994 7X . OOOl9Z ZOO3 52 .000137
2004 4Z .000109
1985 13Z .000356 1995-1998 9Z .000Z47
1986 IOZ . O0027~ 1999 7Z .000192
1987 9Z .000247 2000 8Z .000219
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days
beyond the date of the assessment. If payment is made after the interest computation date sha~n on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RUI,F~ 6.12
Name of Decedent: Paul K. Waltz
Date of Death: December 20, 2002
Will No. Admin. No. 21-03-0006
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned
estate.
1. State whether administration of the estate is complete:
Yes X 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. i is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No X
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 .. X No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: t [ - ~4 ~c~ ~" /" ~ S
Elvse E. Rogers, Esquire
Name (Please type or print)
415 Fallowfield Road, Suite 30]
Address
.Camp Hill, PA 17011
1
--~ (717) 612 5801
. Telephone
CaP~city: ~
_ PerSOnal Representative ~X Counsel for Personal Representative