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03-26-09
n 1505607122 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Cade Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO DOX 2BDfi01 Harrisburg, pA nlzs-ofiot ~ RESIDENT DECEDENT 2 1 O 8 0 0 5 2 0 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 171 36 4657 04142!00'8 10081'946 Decedent's last Name Suffix Decedent's First Name MI WARD PHILIP K (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW • 1. Original Return v 4. Limited Estate • 6. Decedent Died Testate (Attach Copy of Will) c~ 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 0 2. Supplemental Retum 0 4a. Future Interest Compromise (date of tleath after 12-12-82) c~ 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 0 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-9fi) 0 3. Remainder Return (date of death prior to 12-13-82) 0 5. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes c~ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number hJ WILLIAM R KAUFMA;N ESQ 717 ~-~1~J,6 ~7 1; :.~ Firm Name (If Applicable) ~ o ~, ~ ~- 9 4 0 CENTURY D R I V E Second line of address SUITE B City or Post Office Slate MECHANICSBURG P A Correspondent's a-mail address: N Under penalties of perjury, I declare that I have coned and complete. Declaration o/preparer c yRE OF PERSO~itRESPOyfsl rV ~ Cn 7 1 ~ ,,_ U -i -; b DATE FILED N ZIP Code 1 7 0 5 5 4 3 7 6 0 2 "= c .. ~ including accompanying schedules and statements, and to the best of my knowledge antl belief, it is W e, represematlve Is based on all IMOrmatlon of whiUi preparer has any knowledge. ADDRESS r / 14645 BLACK BEAR ROAD, PALM BEACH GARDENS, FL 33 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE SQ ~ / ~ ~ Q ADDRESS / 940 CENTURY DRIVE, SUITE B, MECHANICSBURG, PA 1705 376 PLEASE USE ORIGINAL F RM ONLY Side 7 1505607122 1505607122 1505607222 REV-1500 EX Decetlent's Soc ial Secur(ty Number oeoadears Nam.: PHILIP WARD 1 7 1 3 6 4 6 5 7 RECAPITULATION 1. Real estate (Schedule A) t. 1 2 8 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) z. 3 5 4 0 5 .. 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. 0 0 0 4. Mortgages & Notes Receivable (Schedule D) 4. 0 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 2 0 2 1 8 2 3 6. Jointry Owned Property (Schedule F) o Separate Billing Requested 6. 0 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 1 3 3 9 4 3 1 (Schedule G) o Separate Billing Requested 7. 4 8. Total Gross Assets (total Lines t-7) a. 3 1 7 5 6 6 3 7 9. Funeral Expenses & Administrative Costs (Schedule H) g. 4 3 3 4 9 7 2 70. Debts of Decedent, Mongage Liabilities, & Liens (Schedule I) 70. 1 4 9 3 5 0 8 71. Total Deductions (total lines 9 & 10) 11. .5 8 2 8 4 8 0 12. Net Value of Estate (Line 0 minus Line it) 1z. 2 5 9 2 B 1 5 7 13. Charitable and Governmental Bequests/Sac 9713 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} 7a. 2 5 9 2 8 1 5 7 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9176 (a)(1.2) X 0. 15. Q 0 0 16. Amount of line 14 taxable at lineal rate X 0. i6. 0 0 Q 77. Amount of line 74 taxable 2 5 9 2 8 1 5 7 . at sibling rate x .t2 n. 3 1 1 1 3. 7 9 18. Amount of Line 14 taxable at collateral rate X .15 18. 0 0 0 79. TAX DUE 7s. 3 1 1 1 3. 7 9 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT • Side 2 1505607222 1505607222 REV-1500 EX Page 3 Fil¢ Number ' Decedent's Complete Address: oa-oo5zo DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER PHILIP WARD 171-36-4657 STREET ADDRESS 1054 W FOXCROFT DRIVE CITY STATE ZIP CAMP HILL PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresVPenally if applicable D. Interest E. Penalty $35,000.00 1,555.69 (1) $31,113.79 Total Credits (A + B + C) (2) $36,555.69 Total InteresVPenally (D + E) (3) $ 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT $5,441.90 $ 0.00 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 inceme of the property transferred; ^ ~ b. retain the right to designate who shall use the property transferred or its income; ^ Q c. retain a reversionary interest; or ^ D d. receive the promise for life of either payments, benefits or care? ^ ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ^ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ^ D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? D ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transferto a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defned, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TN( RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE All real property owned solely or as a tenant In common moat ba reportetl at fair market value. Fair market value is defined as the price at which property woultl ba ezchangad between a willing buyer antl a willing seller, nekher being wmpelled to buy or sell, both having reasonable knowledge o1 the relavam faces. Raal property which Is Jolndy-owned with right oT survlvorehip must be tllsctoaed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1054 W FOXCROFT DRIVE, WORMLEYSBURG BOROUGH, CUMBERLAND COUNTY, PENNSYLVANIA $128,000.00 BEING THE SAME PREMISES WHICH FOXCROFT TOWNHOUSE ASSOCIATES, A PENNSYLVANIA LIMITED PARTNERSHIP, BY ITS DEED DATED MARCH 29, 1985 AND RECORDED IN THE OFFICE OF THE RECORDER OF DEEDS IN AND FOR CUMBERLAND COUNTY, PENNSYLVANIA, IN DEED BOOK "E," VOLUME 31, PAGE 447, GRANTED AND CONVEYED TO PHILIP K. WARD, A SINGLE MAN -VALUE BASED ON GROSS SALES PROCEEDS FROM SALE ON AUGUST 29, 2008 -SEE ATTACHED SETTLEMENT SHEET. TOTAL (Also enter on line 1 more space is needed, insert additional sheets of the same size) REV-1503EX •(fi-9e) COMMONWEALTH OE PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS All orooertv Ioin6v-owned with right of survivorship must Oe dlaclosetl on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION __ OF DEATH 1. 600 SHS AMERICAN INTERNATIONAL GROUP, INC, COMMON STOCK $25,97a.00 2. 1,000 SHS BON-TON STORES, INC, COMMON STOCK 5,850.00 3. 25 SHS CAPITAL ONE FINANCIAL CORP COMMON STOCK 1,178.00 4. 100 SHS LOWES COMPANIES, INC, COMMON STOCK 2,403.00 5. 500,000 SHS OCA, INC, COMMON STOCK 0.00 •ALL PRICES ARE CLOSING PRICES ON DATE OF DEATH, PER BIGCHARTS.COM, AND ALL SECURITIES WERE HELD IN e•trade INVESTMENT ACCOUNT, #5563-0326 TOTAL (Also enter on line more space is needed, insert additional sheets of the same size) REV-1508 E%t (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY InGude the proceeds of I'Itigation and tha date the proceeds were received by the estate. All property jolydly-owned with the right ofsurvlvoBhip must be disclosed on Schedule F. ITEM NUMBER 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. DESCRIPTION PNC BANK-CHECKING ACCOUNT-ACCOUNT NUMBER 51-4020-2862 SEE ATTACHED COPY OF RECONCILED BANK STATEMENT AUTOMOBILE - 1999 BUICK CENTURY CUSTOM 4 DOOR SEDAN -VALUED AS PER ATTACHED SALES AGREEMENT COIN COLLECTION -SEE ATTACHED SAFE DEPOSIT BOX INVENTORY AND LISTING FROM COLLECTOR CONTAINING OFFERING AND FINAL SALES PRICE IRS STIMULUS PAYMENT RECEIVABLE (RECEIVED 5/9/09) 2008 FEDERAL INCOME TAX REFUND RECEIVABLE -SEE ATTACHED COPY OF FORM 1040 CASH ON HAND REIMBURSEMENT OF COUNTY TAXES -SALE OF 1054 W FOXCROFT DRIVE -SEE HUD-1 REIMBURSEMENT OF SCHOOL TAXES -SALE OF 1054 W FOXCROFT DRIVE -SEE HUD-1 REIMBURSEMENT OF HOMEOWNERS' ASSOCIATION DUES -SALE OF 1054 W FOXCROFT DRIVE -SEE HUD-1 REIMBURSEMENT OF PREPAID SEWER BILL -1054 W FOXCROFT DRIVE -SEE HUD-1 REIMBURSEMENT OF PREPAID TRASH BILL -1054 W FOXCROFTDRIVE -SEE HUD-1 REFUND OF REAL ESTATE TAX DISCOUNT RECEIVED FROM WILLIAM A. O'DONNELL, TAX COLLECTOR THE HARTFORD- REFUND OF UNAMORTIZED AUTO INSURANCE PREMIUM REIMBURSEMENT BY RICH DeBORD, REALTOR, FOR DUPLICATE FEES CHARGED AT SETTLEMENT, AND COST OF BROKEN TV CONVERTER HOMEOWNERS' INSURANCE REFUND TOTAL (Also enter on line VALUE AT DATE OF DEATH 3,000.00 8,364.43 600.00 1,264.00 100.00 174.35 802.82 7.20 27.12 16.63 19.15 47.00 112.15 143.00 (If more space is needed, insert additional sheets of the same REV-1510 EX+(6-9R) COMMONWEPLTH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INLLUOE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TOOECEOENT AND THE WTE OF TRANSFER. ATTALHALOPY OF THE OEEO FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECO'S INTEREST EXCLUSION (IFAPPLICABLE) TAXABLE VALUE 1. HIGHMARK QUALIFIED RETIREMENT 401(k) PLAN -BENEFICIARIES 119,542.10 100 119,542.10 LESLIE W. WARD (40%), ALAN J. WARD (30%), STEVEN N. WARD (30%) - SEE ATTACHED STATEMENTS 2. E-TRADE FINANCIAL ROTH IRA #6159-5349 -BENEFICIARY -ESTATE OF 8,290.22 100 8,290.22 PHILIP K. WARD- SEE ATTACHED STATEMENTS 3. VANGUARD SIMPLE IRA #81-88011881942 -BENEFICIARIES ALAN J. 6,096.03 100 6,096.03 WARD (30%), LESLIE W. WALTON (40%), STEVEN N. WARD (30%) 4. E-TRADE FINANCIAL TRADITIONAL IRA#5619-8983-BENEFICIARY 14.79 100 14.79 LESLIE W. WALTON (100%) -SEE ATTACHED STATEMENTS TOTAL (Also enter on more space is needed, insert additional sheets of the same size) REV-1511 EX+I10-O6) 'N+~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF PHILIP WARD FILE NUMBER 08-00520 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. GEORGE A. THOMA FUNERAL HOME, WEXFORD, PA-SEE ATTACHED INVOICE $6,922.00 2. CMS WEST, INC., ALLISON PARK, PA-MONUMENT, ETC. -SEE ATTACHED INVOICE 2,174.00 3. RECIPIES REMEMBERED-FUNERAL LUNCHEONANAKE 957.44 4. ALAN JWARD -REIMBURSEMENT FOR FUNERAL FLOWERS PROVIDED 321.00 B, ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Street Address City State _ Zip Year(s) Commission Paid: 2. Attorney Fees 6,310.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent _ _ 4. ~ Probate Fees CUMBERLAND COUNTY, PA, REGISTER OF WILLS _ ~ 365.00 5. I Accountant's Fees 6. Tax Return Preparer's Fees DeMUTH MANAGEMENT CONSULTANTS, 2008 FORMS 1040 & 1041 - 1,045.00 SEE ATTACHED INVOICES 7. LEGAL ADVERTISEMENT-THE PATRIOT NEWS 222.15 8. LEGAL ADVERTISEMENT-CUMBERLAND LAW JOURNAL 75.00 9. SETTLEMENT CHARGES -1054 W FOXCROFT DRIVE -SEE ATTACHED SETTLEMENT SHEET 11,091.00 10. KENNY ROCK- PAINTING- 1054 W FOXCROFT DRIVE 3,600.00 11. CARPET MART -NEW CARPETING - 1054 W FOXCROFT DRIVE 2,857.47 12. MERRY MAIDS -CLEANING - 1054 W FOXCROFT DRIVE 663.70 13. RENOVATIONS COMPANY, INC- DINING ROOM CEILING REPAIR - 1054 W FOXCROFT DRIVE 405.00 14. RENOVATIONS COMPANY, INC -DRYWALL AND PLUMBING REPAIRS - 1054 W FOXCROFT DRIVE 236.00 15. RENOVATIONS COMPANY, INC -REMOVE OLD APPLIANCES - 1054 W FOXCROFT DRIVE 200.00 16. JERRY'S CAR WASH -WASH AND DETAIL DECEDENT'S CAR FOR RESALE 33.70 17. EXPENSES PER CONTINUATION PAGE 1 5,851.26 TOTAL (Also enter on line 9, Recapitulation ) $43,349.72 (If more space is needed, insert additional sheets of the same size) REV-1512 EX t (12-03) a ~a, SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TA% RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS Report debt incurred by the decedent prior to death which remained unpaid as of the date of death, include unrelmbureed medical expenses. REV-1513 EX i (9-00) , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES NUMBER 11. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. LESLIE W WALTON AND BRUCE C WALTON 14645 BLACK BEAR ROAD, PALM BEACH GARDENS, FL 33418 2. ALAN J WARD AND NANCY WARD 651 WEST JOHNSON DRIVE, GILBERT, AZ 85233 3. STEVEN N WARD AND PATRICIA WARD 33 VICK DRIVE, SANTA CRUZ, CA 95064 Do Not List Trustee(s) SISTER AND BROTHER-IN-LAW BROTHER AND SISTER-IN-LAW BROTHER AND SISTER-IN-LAW 40% 30°h 30% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 18, ASAPPROPRIATE, ON REIr-1500 COVER SHEEP NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART D -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) CONTINUATION PAGE SCHEDULE __H__ ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, MHKbIIV IIVICRCJI CAYCIVJC-CIIJUC MVVVUIVI NJOOJ'UJLO-IVVI /CUVVICV VIV CJIHIC IIVVVIVIC TAX RETURN 2. ELECTRICITY: PPBL - 1054 W. FOXCROFT DRIVE, PAID 5/5/OB 3. ELECTRICITY: PPBL - 1054 W. FOXCROFT DRIVE, PAID 5119/08 4. ELECTRICITY: PPBL - 1054 W. FOXCROFT DRIVE, PAID 6177/08 5. ELECTRICITY: PPBL- 1054 W. FOXCROFT DRIVE, PAID 7/78/08 6. ELECTRICITY: PPBL - 1054 W. FOXCROFT DRIVE, PAID 8/20/08 7. ELECTRICITY: PPBL- 1054 W. FOXCROFT DRIVE, PAID 9/3/08 8. WATER: PA WATER COMPANY - 1054 W. FOXCROFT DRIVE, PAID 4115/08 9. WATER: PA WATER COMPANY - 1054 W. FOXCROFT DRIVE, PAID 5/28/08 10. WATER: PA WATER COMPANY- 1054 W. FOXCROFT DRIVE, PAID 7/1/08 11. WATER: PA WATER COMPANY - 1054 W. FOXCROFT DRIVE, PAID 7/29/08 72. WATER: PA WATER COMPANY- 1054 W. FOXCROFT DRIVE, PAID 9/9/08 13. TELEPHONE: VERIZON -1054 W. FOXCROFT DRIVE, PAID 4/28/08 14. TELEPHONE: VERIZON - 1054 W. FOXCROFT DRIVE, PAID 6/3/08 15. CABLE 81NTERNET: COMCAST- 7054 W. FOXCROFT DRIVE, PAID 5/7/09 i6. FEE TO REPLACE BROKEN TV CONVERTER - 1054 W. FOXCROFT DRIVE, PAID 8/21/08 17. HOMEOWNERS' ASSOCIATION DUES - 1054 W. FOXCROFT DRIVE,- FOXCROFT OWNERS' 18. ASSOCIATION, PAID 5/2/08 19. HOMEOWNERS' ASSOCIATION DUES, FOXCROFT OWNERS' ASSOCIATION, PAID 5/2706 20. HOMEOWNERS' ASSOCIATION DUES, FOXCROFT OWNERS' ASSOCIATION, PAID 6/25/08 21. HOMEOWNERS' ASSOCIATION DUES, FOXCROFT OWNERS' ASSOCIATION, PAID 8120/08 22. HOMEOWNERS' ASSOCIATION DUES, FOXCROFT OWNERS' ASSOCIATION, PAIDg~SETTLEMENT 8/28/08 23. REAL ESTATE TAXES - 1054 W. FOXCROFT DRIVE, CAMP HILL, PA 17011. PAID~SETTLEMENT 8/28/08 24. SEWER 8 TRASH - 7054 W. FOXCROFT DRIVE, CAMP HILL, PA 17017 -BOROUGH OF WORMLEYSBURG, PAID 7/7/08 25. THE HARTFORD-AUTO INSURANCE, PAID 7/22/08 26. JOHN FULLERTON SHIPPING 81NSURANCE OF COIN COLLECTION TO APPRAISER 27. POSTAGE -EXPRESS MAIL -REAL ESTATE CLOSING DOCUMENTS 26. FEE CHARGED FOR WIRE TRANSFER OF NET SETTLEMENT PROCEEDS 29. TRAVEL EXPENSES - CO-EXECUTORS -SEE SEPARATE SCHEDULE 30. FEDERAL EXPRESS -OVERNIGHT MAILING OF ESTATE DOCUMENTS TO ATTORNEY 31. FEE CHARGED FOR OVERNIGHT MAILING OF e'trade ROTH IRA PROCEEDS 33.57 30.13 42.26 26.14 42.64 30.10 16.77 28.89 14.79 14.19 18.23 37.29 9.19 31.83 75.76 73.00 73.00 73.00 73.00 146.00 957.62 121.00 72.00 174.36 16.50 10.00 3,363.27 35.05 20.00 TOTAL $5,851.26 E X GRANTED TEMPLATE Page 1 of 1 WilliarXt Kaufman From: RV, Inheritance Tax Extension [RA-InheritanceTaxExt@state.pa.usj Sent: Wednesday, January 07, 2009 11:34 AM To: 'WRKAUFMAN.WRKLAW@COMCAST.NET' Subject: PHILIP K. WARD, EST. j i'~ Pennsylvania DEPARTMENT OP REVENUE The following message is being sent from an unmonitored account. Please do not reply. Re: Estate of PHILIP K. WARD File Number 2108-0520 Dear Sir or Madam: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wilis on or before 07/14!09. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. We now offer you the option to request your extension request via a-mail. Please use the following a-mail address: RA-InheritanceTaxExt~state.pa.us. Please contact me with any questions or concerns at 717-787- 8327. Sincerely, Claudia Maffei, Supervisor Document Processing Unit Inheritance Tax Division Please do not reply to this email. This mailbox is not monitored and you will not receive a response. For assistance, visit us on the web at www.revenue state oa.us or call us at 717-787-8327 The information transmitted is intended only for the person or entity to whom it is addressed and may contain confidential and/or privileged material. Any use of this information other than by the intended recipient is prohibited. If you receive this message in error, please send a reply e-mail to the sender and delete the material from any and all computers. 3/13/2009 LAST WILL AND TESTAMENT OF PHILIP K. WARD I, PHILIP K. WARD, a resident of Wormleysburg Borough, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time previously made. ITEM I: I direct that all my personal debts and funeral and testamentary expenses be paid as soon after my death as may be feasible. ITEM II: All inheritance, estate and similar taxes becoming due by reason of my death ("Death Taxes"), whether such Death Taxes shall be payable by my estate or by any recipient of any property, shall be paid by my Executor out of my residuary estate as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any Death Taxes paid by my Executor, even though paid with .respect to proceeds of insurance or otter property not passing under this Will. ITEM III: I give, devise, and bequeath the residue of my estate, both real and personal, as follows: 1 A. Forty percent (40~) thereof to my sister, LESLIE WALTON, and her husband, BRUCE WALTON, or the survivor of them. if they both predecease me and leave living children, this gift shall be divided evenly among such surviving children. If they both predecease me and leave no surviving children, this gift shall be divided evenly among the surviving beneficiaries. B. Thirty percent (30~) thereof to my brother, STEVEN WARD, and his wife, PATRICIA WARD, or the survivor of them. If they both predecease me and leave living children, this gift shall be divided evenly among such surviving children. If they both predecease me and leave no surviving children, this gift shall be divided evenly among the surviving beneficiaries. C. Thirty percent (30~) thereof to my brother, ALAN WARD, and his wife, NANCY WARD, or the survivor of them. If they both predecease me and leave living children, this gift shall be divided evenly among such surviving children. If they both predecease me and leave no surviving children, this gift shall be divided evenly among the surviving beneficiaries. Personal property passing under this section may be divided among the beneficiaries in an amount that is as near to the above percentages as is practicable. ITEM IV: I hereby appoint my sister, LESLIE WALTON, and her husband, BRUCE WALTON, as Co-Executors of my estate. In the event that_one of the Co-Executors should fail or cease to act, the remaining Co-Executor shall serve as the sole Executor. In the 2 event that both Co-Executors should fail or cease to act, I hereby appoint PNC BANK, N.A., as fixecutor. I further direct that .my Executor shall not be required to furnish bond or securities in such capacity. ITEN V: I give my Executor the fullest power and authority in all matters and questions, and to do all acts which I might or could do if living, including, without limitation, complete power and authority to sell (at public or private sale, for cash or credit, with or without security), mortgage, lease, dispose of, and distribute in-kind all property, real and personal, at such time and upon such terms and conditions as it may determine, all without court order. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding four (4) pages, this~0~ day of P~~L 1999. Philip K. Ward Wfi, 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 each other, have hereunto set our hands and seals the day and year above,writt and we certify that at the time of the execut~at~re~f~ the said Testator was of sound and disposing (SEAL) ~~ ~.~ ~-' ~"'~'-~ (SEAL) Residing at: ~2,~~~p1a./%3~?.Q~yJ , Residing at: b'7~ (J ~" / 7 3 COMMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUMBERLAND We, 1`N ~ ~ ~r',.iALI, l . ~ iU HT.rd ,and Y~- e0 •~Yl?~o.P.~- ,the Testator and the Witrtesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instnunent as his Last Will, that he signed it willingly, and that he executed it as his &ee and voluntary act for the purposes therein expressed, and that each of the Witnesses in the presence and hearing of the Testator signed the Will as a Witness and that to the best of their knowledge, the Testator was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to, acknowledge and subscribed before me by I~µ~.-~~ is . V.IAaa , Testator, and orn to and subscribed b re me by tint ` L. .q-r• and o da a Witnesses; this t~p~ day of ) A.D.,1 ~;,~ ~.. sad Eae[ Psn~abo~ro'tYw~`., wm~haAaca~anr My Conp~don Exgrea tvov.29. less 4 JC~c-~.~, / ~.J fitness Previou` edits a obsolete A. Settlement Statement R T..no of 1 n form HUD-1 (3/B6) ref Hantlbcok 4305.2 U.S. Department of Housing and Urban Development OMB ADDroval No. 2502-0265 (expires 11/30!20091 1 ~ OFHA 2. ~FmHA 3. ElConv. Unins. 6. File Number 7. Loan Number 8. Mortgage Insurance Case Number 4. OVA 5. OConv.lns. OB-402 1096992 is orm is umis e o give you a s a amen o a ue se amen cos s. mono s pal o an y a se amen agen are s own. (;. NOfe: Moms marked "(p o.cJ" were paitl outside the closing; Ihey are shown here for information purposes end ere not includatl in the totals. TlteEXpress Settamant System WARNING: h is a crime to knowingly make false statements to the United Stales on this or any other similar form. Penalties upon conviction can include a (ne and imprisonrnenl. For details see. Title 18 LL S Code Section 1001 and Section 1070. Pflnted 06/26/2006 at 06:59 KR D. NAME OF BORROWER: JEANNE L. SCHOTT ADDRESS: 4714 Brian Rd. Mechanicsbur PA 17050 E. NAME OF SELLER: ESTATE OF PHILIP K. WARD ADDRESS: 14645 Black Bear Rd. Palm Beach Gardens FL 33418 F. NAME OF LENDER: AMTRUST BANK ADDRESS: Wholesale Lendin Division Mail Code: OH98.02081111 CHES CLEVELAND OH 44114.3516 G. PROPERTY ADDRESS: 1054 WEST FOXCROFT DRIVE, BOROUGH OF WORMLEYSBURG, CAMP HILL, PA 17011 Wormle sbur boron h H. SETTLEMENT AGENT: Homesale Settlement Services, Inc. PLACE OF SETTLEMENT: Prudential Homesale Services 3435 Market Street Cam Hill PA 17011 I. SETTLEMENT DATE: 0812912008 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales rice 128 000.00 401. Contract sales rice 128 000.00 102. Personal PrD art 402. Personal Pro art 103. Settlement char es to borrower line 1400 4 895.60 403. 104. 404. 105. 405. Ad'ustments for items aid b seller in advance Ad'ustmenfs for items aid b seller in advance 107. Count taxes 08129108to12131108 174.35 407. Count faxes 08129108to12131108 174.35 108. School Taxes 08129108to06130109 802.82 408. School Taxes 08129106 to 06130109 802.82 109. HOADues 08129108 to 08131108 7.20 409. HOADues 08129108to08131108 7.20 110. Sewer 08129108to09130108 27.12 410. Sewer 08129108to09130108 27.12 111. Trash 08129108to09130108 16.63 411. Trash 08129108 to 09130108 16.63 112. 412, 120. GROSS AMOUNT DUE FROM BORROWER 133 923.72 420. GROSS AMOUNT DUE TO SELLER 129 028.12 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De osit or earnest mone 2 000.00 501. Excess De osit see instructions 202. Princi al amount of new loans 102 400.00 502. Settlement char es to seller line 1400 13 044.62 203. Existin loan s taken sub'ect to 503. Existin loan s taken sub'ect to 204. 504. Pa off of First Mort a e Loan 205. 505. 206, 506. 207. 507. 208. 508. 209. 509. Ad'ustments for items un aid b seller Ad'ustments for items un aid b seller 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 104 400.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 13 044.62 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLE R 301. Gross amount due from borrower line 120 133 923.72 601. Gross amount due to seller line 420 129 028.12 302. Less amounts aid b/for borrower line 220 104 400.00 602. Less reduction amount due seller line 520 13 044.62 303. CASH FROM BORROWER 29 523.72 603. CASH TO SELLER 115 983.50 SUBSTITUTE FORM 1099 SELLER STATEMENT: The Inbnnallon cantalnetl herein is Important tax infonnallon and is being /umished to the Internal Revenue Service. If you are requiretl to fie a return a negligence penally or other sanction will be imposetl on you i/this item is required to be repodetl and the IRS tlelennines Thal it has not been reportetl. The Contract Sales Price tlescdbetl on line 401 above tonslilules the Gross Proceeds of This transaction. SELLER INSTRUCTIONS: If this real estate was your phndpal residence, gIe Form 2119, Sale or Exchange of Pdndpal Residence, /or any gain, with your Income lax realm{far other 12nsaclions, complete the applicable parts of Form 4]97, Form 6252 antl/or Schetlute D (Form 1040). You era required bylaw to provide the selllement agen) (Fed. Tax ID No: )with your coned taxpayer Itlentificalian number. If you tlo not provitle your correct taxpayer itlenlificallon number. you may be sublet! to civil or criminal penalties imposetl by law. ntler pens ties o pe7ury, I certify Thal the number shown on this statement is my coned taxpayer identification number. SELLER(S)SIGNATURE(S). SELLER(S) NEW MAILING ADDRESS: Previous etlilions ate obsolete U,S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT mnn nuu-r Ivooi rer nenaocox wows File Number: OS-402 PAGE 2 TitleExoress Settlement System Printed 08/28/2008 at 08:59 KR L. SETT EMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALESIBROKER'S COMMISSION basetl on rice $128 000.00 = 8 960.00 80RROWER'S SELLER'S Division of commission line 700 as follows: FUNDS AT FUNDS AT 701, $ 4 505.00 to Howard Hanna Real Estate Services SETTLEMENT SETTLEMENT 702. $ 4 455.00 to Prudential Homesale Services Grou 703. Commission aid at Settlement 6 960.00 704. $ 2 000.00 POC Earnest Mone retained as art of commission h Howard Hanna Real Estate Services 2 000.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ori ination Fee 802. Loan Discount 803. A sisal Fee 804, Credit Re od 805. A lication Fee to Homesale Mort a e Services 425.00 806. Yield S read Prem d b Amtrusto Homesale Mort a e Services 2 018.30 POC b Lender 807. Loan Set U Fee to AMTRUST BANK LR 455.00 808. Table Fundin Fee to AMTRUST BANK LR 125.00 809. Flood Certification to Homesale Mort a e Services 21.50 810, Processin Fee to Homesale Mort a e Services 150.00 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 0812912008 to 0910112008 $ 18.9400 Ida 3 Da LR 56.82 902. Mort a o )nsurance Premium for to 903. Hazard Insurance Premium for 1 ear to Done al Insurance 208.00 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance 3 mo. $ 17.33 Imo LR 51.99 1002. Mort a e Insurance mo. $ Imo 1003. Cit Pro ert Taxes mo. $ /mo 1004. Count Pro ert Taxes 7 mo. $ 42.43 Imo LR 297.01 1005. School Taxes 3 mo. $ 79.80 Imo LR 239.40 1009. A re ate Anal sis Ad'ustment to AMTRUST BANK LR •169.75 0.00 1100. TITLE CHARGES 1101. Settlement or closin fee 1102. Abstract or title search 1103. Title examination 1104. Title insurance binder 1105. Document Pre aration 1106. Notar Fees to Nota Public 35.00 1107. Attorne 's fees includes above items No: t t o8. Title Insurance to Homesale Settlement Services Inc. 7 098.63 includes above items No: 1101 110211031104 Standard Reissue Rate 1109. Lender's Polic 102 400.00 - 1 t 10. Owner's Polic 128 000.00 -1 098,63 111 t. End 100 End 300 End 820 Loarto Homesale Settlement Services Inc. 200.00 1112. 1113. Closin Service Letter to La ers Title Insurance Cor oration 35.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordin Fees Deed 50.50 Mort a e 80.50 Release 1202. Cit /Count tax/stam s Deed $1 280.00 Mort a B 131.00 1 280.00 1203. State Tax/slams Deed 1 280,00 Mort a e 1 200.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve 1302. Pest Ins eclion to POC 1303. Wire Fee to Homesale Settlement Services Inc. 11.00 22.00 1304. Intemet Doc Pre to Homesale Settlement Services Inc. 50.00 1305. Transaction Fee to Prudential Homesale Services Grou 195.00 1306. Resale Cert to Pro a Mana ement Inc. 150.00 1307. Jul and Au ust HOA Dues to Foxcroft HOA 146.00 1308. Other Disbursements 1520 2486.62 1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 4 895.60 13 044.62 HUD CERTIFICATION OF BUVER AND SELLER I have carefully reviewetl the H D-1 Seble enl lalemenl ntl to the best or my knowletlge and beliel. II is a Irue and accurate slalemenl o(all receipts and tllsDursemenls matle on my account or by me isp~112/~n1~s_aY~clVioYn~. I~~rudher ce ' ~y Ihal I ha ret IveO a r the MUD-1 Selllemenl slalemenl. ~JE77~~~T S . c/ I ~S~ _ WARNING: IT ISACRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD-1 SeQlemenl slalemenl which lhave prepare Isalrue antl accurate account or this lransacdon. UNITED STATES ON THIS OR ANV SIMILAR FORM PENALTIES UPON CONVICTION Ihave puse0 rwlll cause the funtls to be di ursedl accoMance with this slalemenl. CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE 71TLE 19: / / U.S. CODE SECTION 1001 AND SECTION 1010. ~~ ry (D( By: V "fTbT~i Previous etlilions are obsolete U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT form MUO-1 (3196) ref Handbook 4305.2 File Number: OB•402 PAGE 3 7itleEx ress Settlement S stem Printed 08!2812008 at 08:59 HR ITEMIZATION OF HUD LINE 1308 1500. SCHEDULE OF DISBURSEMENTS BUYER SELLER 1501. Home Warrant to HSA 389.00 1502. Tax Cert to Homesale Settlement Services Inc. 10.00 1503. 2008 School Taxes to William A. O'Donnell 957.62 1504. Tax Cert to Rick DeBoard 10.00 1505. Heat Pum Eval to Rick DeBoard 75.00 1506. Transaction Fee to Howard Hanna Real Estate Services 195.00 1507. Le al Fees to William R. Kauffman Es . 850.00 1508. 1509. 1510. 1511. 1512. 1513. 1514. 1515. 1516. 1517. 1518. 1519. 1520. TOTAL HUD LINE 1308 EXPENSE: 2 466.62 4 O 7 O Z ei 6 T Y Y G y e u m M a ®, W ,Q ~.. Q ~ '~ _ a 4 =~ c Z 0 a° 0 wg 3 „ N uXl P M ` ~ N O O , a S E y ~ ~ ~ z ~ `o' Y a Regular Checking Account Statement PtiCBank For the period 04!12/2008 to 0511272008 G x PHILIP K WARD 200 PINE RD PITTSBURGH PA 15237-4960 ~t~~~~~~ Primary account number: 51-4020-2862 Page 7 of 3 Number of enclostlre5:0 For 24hour banking, and transaction or Lam' interest rate information, sign on to 'a' PNC Bank Online Banking at pnc.cotn. For atstomer service call 1-888-PNC-BANK helween the hours of 6 AM and Midnight ET. Para servicio en esparto!, 1-B66-HOLA-PNC Mo~ing7 Please contact us at 1-868-PNC-BANK ®Write to: Customer Service PO Box 609 Pittsburgh PA 15230.9738 Visit us at pnc.com ® TOD terminal: l-800-531-1648 For heazin~ impaired rlicnre onlc $omelnnes bigger dreams require larger loans. With highly rnmpelilive rates and low down payments, we can offer more mongase options and betterfmancbtg solutions_ WhMhoryou'n: shopping fora new primary nsidcncc, a scrnnd home, or considering a refman~ro. w•c can tailor a jumbo. mortgage that fits your big plans perfectly. For Vlore [nfonnalion: > Visit your local PaC ]3ank bench > Visit pnnnorlgage.com Cali 1-8t)(1-778-6678 Regular Checking Account Summary Philip K ward Account numher:51-4020-2862 Balance Summary Please see the Activity Detail section for Beginning Deposits entl Checks and other other. atldiibns tl¢dudions G,nr,-G+ 6(m.(to t;.Grz.r,l ~! ~'^[ ,, ~-~rn ~~~ ~ {p ~ N"°"' . ,,Average monthly ~ balance ~j 5~"~I D J Qr 5~~13;i.Gl Transaction Sumtttary Chacka paid/. Check Card POS Check Card/Bankcard withdrawals sign¢d transactions POS PIN transactions n O (1 Totat ATM PNLBank Other Bank Iransactlons ATM transactions ATM transactons Q n D Activity Detail additional lnfonnahon. Ending , balance .Do Charges and lees .110 Deposits and Other Additions There was 1 Deposit or Other Addition Date Amount Description totaling $000.00. 05/09 G(10.0(1 llirect 1)epasil --has Refund US Treasury °_°U \l' Xl' X4G57 FORM953R-1W5 ~_.,~~.a...,<,<c~,t~g ticcuun>z acaiement For tito porioa o4/1y2oos':o as~~,v2oos For 24hour information, sign on to PNC Bank Online Banking PHILIP K WARD u ~ on pnc.com. Ftimary account number. 51-4020-2862 Account ntrmber: 51-4020.2S6Y -continued Page 2 of 3 ~,; Checks and Substitute Cheeks ~" Check Date Reference Check Date Reference... number paitl number number - paid. number `4644 351.26 0.1/18 o88a7sos7 2645 121A0 04/1G o425eaia5 "Gap in check setluence There were 2 checks listed totaling $47'2.28. Onilne and ElectreniC Banklog DednctionS There were 5 Online or Electronic Banking ; Date Amount Description Deductions totaling $792,46.! 0-4/ 15 16.77 Direct Payment -Payment PAWC 0653205 Od/23 37:9 Direct Payment-Paytnentrec Verizon XXSXX%tiXS4657 OS/0'? 73.00 Direct Payment -Debits Foxcroft i-Iomeown 1051 05,/05 33 ~7 Direct Payment - FAec Bill Pp \tiYXX%900444s 05/07 31.33 Direct Payment-CenhalPA Comcast Cenual 15197101 Othetr DedUCtions There were P Other peductions totaling Date Amount Descnption $5,947:92. 05/ 14 .00 Outstandutg Itan Close 05/ I2 5,9.17.92 Debit Memo Reference No 046513500" Daily Balance Detail Date Balance Date Balance Date Balance Date Balance 0•Ij 12 6,012.64 - 04/l8 5,523.61 05/05 - 5,379.75 - 05/12 ° .00 01/15 5,995,37 0#/23 5,436.32 05/07 5,347.92- O~i,!]ti 5,371.37 05/02 5.,413.32 .05/09 5,947.92 Paying for college? PNC Bank can provide solutions to all your education fmancing needs. Call now to n:view your options wiUt an experienced loan cntulseloi. Call PNC Bank: 1-800-762-10UI If you pmfer to apply onlnt5, visit us at pnconcatttpus.com. Regular Checlring Account Statement For 24-hour information, sign on to PNC Bank Online Banking on pnc.com. For the period 04/74/2006 tto 051.112/2008 PHILIP K WARD Primary axount number: 57-4020-2862 - Page 2 of 3 ~ Checks and Substibrte Checks Check Date Reference Check Date Reference number Amounl paitl number number ~ Amount paid, number 2644 351.26 04/18 O14847Ga57 2645 121.00. 04/16 o2zs6neas " Osp in check sequence Online and Ek~cb~tsnic Banking Deductions Date Amount Description 04/ 15 16.77 Direct Payment -Payment PAWC 0653205 04/28 37.29 Direct Payment - Paymentrec Ver-izon `YX.\'YXXl'XX4657 05,'02 73.00 Direct Payment -Debits Foxcro6 Homeown 1054 05,05 33.57 Direct Payment - Elec Bill Pp XXX7{XX9002Ws 05/07 31-33 Duect Payment - Cenual PA Comcast Central 18197101 Other Deductions Date Amount Description 05/ 12 - .00 Outstanding Item Close 05/ 12 5,947.92 Debit Memo Reference No 026513500 There were 2 checks listed totaling $47426. There were 5 Online or ElecVOnic Banking Deductions totaling $702J10. There were 2 Other Deductions totaling $5,947.82. Daily Balance Detail Date Balance 03/12. ~ 6;OL.61 Date 04/18 _. Balance 5;523.61 Date 05/05 Balance Dat¢ Balance 5,379.75 05/12 .00 04/15 5,995-37 04/23. 5,436.32 -05/07 -5;347.92 04/16 5,87=k.37 05/02 5,413.32 05/09 5,947.92 Paying for college? PNC Batik can provide solutions to all your education fmancing needs. Call now to review your options with an experienced loan cowiselor. Call PNC Bank: 1-800-762-1001 If you prefer to apply online, visit us at pnconcampus.com Motor Vehicle Bill of Sale BE IT KNOWN, that for payment in the sum of $3,000.00, the full receipt of which is acknowledged, the undersigned Bruce C. & Leslie W. Walton Executors for Philip K Ward Estate(Seller) hereby sells and transfers to Brenetta Voelker (Buyer), the following described motor vehicle (Vehicle): Make: Buick Model or series: Century Custom Vear: 1999 Color: Blue VIN #: 2G4WS52M6X1495977 Style: Sedan Odometer reading: 78,031 Title #: 54469873803 The sale is subject to the following conditions and representations: Seller acknowledges receipt of deposit of $200. Seller acknowledges receipt of $2,800.00 as payment in full (by cash, money order or certified check) which is to occur at time of title transfer. Seller certifies to the best of the SeNer's knowledge that the odometer reading listed in the vehicle description above reflects the actual mileage of the Vehicle. The Vehicle's odometer was not altered, set back, or disconnected while in the Seller's possession, and the Seller has no knowledge of anyone doing so. Seller warrants to Buyer that Seller has good and marketable title to said property, full authority to sell and transfer said property, and that said property is sold free of all liens, encumbrances, liabilities, and adverse claims of every nature and description whatsoever. Seller has no knowledge of any hidden defects in and to the Vehicle, and believes to the best of the Seller's knowledge that the Vehicle being sold is in good operating condition. Said Vehicle is otherwise sold in "as is" condition and where currently located. seller: Buyer: Page 1 of Williarra Kaufman From: bcwalton@aol.com Sent: Thursday, July 17, 2008 9:35 AM To: al.ward@ci.gilbert.az.us; ward@pmc.ucsc.edu Cc: wrkaufman.wrklaw@comcast.net Subject: Fwd: Coin Appraisal Gentlemen, attached is coin appraisal and cash offering for the Phil Ward estate coin collection. I found this offer ($8,364) to be fair and have accepted. The following email and attached appraisal should be self explanatory. We will reimburse John (my brother in law) his shipping and insurance expenses ($174.36). Matt Lerner (appraiser and full time coin dealer) is a grandson of my pazents next door neighbor of 50 years so I feel we have a trusted resource. We will have the checks deposited into the estate checking account. -----Original Message----- From: Clwf44@aol.com To: BCWalton@aol.com Sent: Wed, 16 Ju12008 2:14 pm Subject: Fwd: Coin Appraisal Bruce and Leslie, Attached is the spread sheet from Matt for the coins in the safety deposit box as well as a grand total for all of the coins. His cove letter dated July 14th spells out the quote. The estate owes me $174.36 for Flat rate shipping and insuring the coins in transit down to Middletown Maryland. If you need the receipt, let me know and I'll mail it to you. Hope everything else is going well and the best to you both and the kids, John From: CPCSaIes To: Clwf44 Sent: 7/14/2008 7:54:52 P.M. Eastern Daylight Time Subj: Coin Appraisal Hey John, I must say I had a blast going through the packages (which all arrived safely and intact) this weekend. You could tell he was extremely serious about his collection having some really neat examples throughout. I've attached an excel sheet with the total appraised value of the collection. While sometimes retail and wholesale prices do not coincide very well, I think the only box we were really off on our numbers was on the box filled with Wheat Penny Rolls, since most of the rolls were common date; the coins were only worth a little over $0.04 each. I would also like to compliment you on your grading, most coins were graded dead on, and when they weren't they were only off by one grade! Very impressive in many respects. I separated out the listings by box and notated the sheets the coins were found on when they were mentioned on the packaging. As per your request, I separated the Safety Deposit Box items as well. The total offer price is: $8,364.43 Silver right now is doing really well and I am currently offering 11 times face value for any coins made before 1965. With an every changing economy and financial climate, this price could change. I don't imagine it will be anything drastic, I just wanted to make you aware of this fact. Let me know if you need anything else done with the appraisal for estate settlement purposes 7/21/2008 Page 2 of I would love to discuss this further with you should you or those involved have any questions. This appraisal also serves as an offer to purchase from my respective company, Chili Peppers Collectibles, and with the exception of the 90% silver, all prices are guaranteed to be honored by my company should you decide to sell the collection. The price of the 90% silver will be determined at time of sale. Thank you again for allowing me to catalog such a nice collection, Happy Collecting! -Matt Lerner Owner, Chili Peppers Collectibles, LLC www,USACoinShpp,com Get the scoop on last night's hottest shows and the live music scene in your area -Check out TourTracker._com! Set the scoop on last night's hottest shows and the live music scene in your area -Check out TourTracker.com! The Famous, the Infamous, the Lame - in your browser. Get the TMZ Toolbar Now! 7/21/2008 Box 1 of 5 Jefferson Nickel Collction 3 Book 1 1965- 2.60 Roosevelt Dime 1946- Mostly Clad 5.00 Lincoln Cents 1959- Collection 3 Boak 3 3.00 Misc Forn Coins (Page 17) 15.00 1921 Morgan Dollar XF 16.00 1921 Morgan Dollar XF 16.00 1921-5 Morgan Dollar F 15.50 1923-5 Peace Dollar VF 16.00 1922 Peace Dollar Au 16.00 1921 Morgan Dollar XF 16.00 1891-S Morgan Dollar G 17.00 1884 Morgan Dollar VG 17.00 1923 Peace Dollar VF 15.50 1922-S Peace Dollar F 16.00 1921 Morgan Dollar AU 16.50 1922 Peace Dollar XF 15.50 1922 Peace Dollar XF 15.50 1921 Morgan Dollar XF 16.00 1896 Morgan Dollar AU 20.00 1921 Morgan Dollar VF 15.50 1921 Morgan Dollar AU 16.00 1879 Morgan Dollar VG 17.50 1900-0 Morgan Dollar G 17.00 1878-S Morgan Dollar VG 18.00 1881-5 Morgan Dollar VF 18.00 1921 Morgan Dollar XF 16.00 1881-S Morgan Dollar XF 18.00 1921 Morgan Dollar XF 15.50 1900 Morgan Dollar VF 17.00 1886 Morgan Dollar XF 17.00 1900-0 Morgan Dollar G 17.00 1922-5 Peace Dollar F 16.00 1921 Morgan Dollar AU 16.50 1923-D Peace Dollar F 16.00 1921 Morgan Dollar AU 16.50 1892 Morgan Dollar G 17.00 1922 Peace Do11ar XF 15.50 1923 Peace Dollar XF 15.50 1922-5 Peace Dollar XF 16.50 1922 Peace Dollar XF 15.50 1923 Peace Dollar VF 15.50 1924 Peace Dollar AU 16.00 1921-S Morgan Dollar F 15.50 1923 Peace Dollar XF 15.50 1923-5 Peace Dollar VF 16.00 1924 Peace Dollar AU 16.00 1924 Peace Dollar XF 15.50 1923 Peace Dollar VF 15.50 1922 Peace Dollar VF 15.50 1924 Peace Dollar XF 15.50 1924 Peace Dollar XF 15.50 1924 Peace Dollar AU 16.00 1924 Peace Dollar XF 15.50 1922 Peace Dollar XF 15.50 1921 Morgan Dollar VF 15.50 1904-0 Morgan Dollar F 17.00 1921 Morgan Dollar XF 16.00 1921 Morgan Dollar XF 16.00 1888-0 Morgan Dollar G 17.00 1921-5 Morgan Dollar F 16.00 1925 Peace Dollar XF 16.00 1921 Morgan Dollar XF 15.50 1881-5 Morgan Dollar XF 17.00 1922-5 Peace Dollar XF 16.00 1924 Peace Dollar XF 16.00 1924 Peace Dollar AU 17.00 1921-5 Morgan Dollar F 16.00 1923 Peace Dollar XF 15.50 1928-S Peace Dollar F 26.00 1921 Morgan Dollar AU 16.50 1921 Morgan Dollar XF 15.50 1921 Morgan Dollar VF 15.50 1922 Peace Dollar VF 15.50 1922 Peace Dollar XF 15.50 1922 Peace Dollar XF 15.50 1922-D Peace Dollar F 15.50 1922 Peace Dollar XF 15.50 1923 Peace Dollar VF 15.50 1923 Peace Dollar XF 15.50 1924 Peace Dollar AU 16.00 1922-D Peace Dollar F 15.50 1922 Peace Dollar XF 15.50 1922 Peace Dollar XF 15.50 1899-0 Morgan Dollar VG 17.00 1923 Peace Dollar VF 15.50 1925 Peace Dollar AU 16.50 1923 Peace Dollar XF 15.50 1922-D Peace Dollar F 15.50 1924 Peace Dollar XF 15.50 1924 Peace Dollar AU 16.50 1925-5 Peace Dollar VF 20.00 1921 Morgan Dollar XF 16.00 1923 Peace Dollar VF 15.50 1923-S Peace Dollar VF 16.00 1923-D Peace Dollar F 15.50 1926-5 Peace Dollar F 17.00 1924 Peace Dollar XF 15.50 1924 Peace Dollar XF 15.50 1923 Peace Dollar XF 15.50 1899-0 Morgan Dollar VG 17.00 1935 Peace Dollar VF 17.50 1934-5 Peace Dollar G 32.00 1925 Peace Dollar XF 15.50 1925 Peace Dollar AU 17.00 1925 Peace Dollar XF 15.50 1970'5 Dime Roll D-il 6.00 50 1964 Dime Roll D-4 55.00 1970'5 Dime Roll D-9 7.00 1970'5 Dime Roll D-12 7.00 1970'5 Dime Roll D-10 7.00 50 1964 Dime D-3 55.00 47 Silver Dimes D-1 51.70 30 Mercury Dimes D-2 33.00 50 D-6 Silver Roll 55.00 1965-1969 Dimes D-8 7.00 Non-Silver Dimes D-13 7.00 47 D-5 Silver Dimes 51.70 D-7 Non Silver Dimes 7.00 Total Box #1 2,030.00 Box 2 Lincoln Cent Album 120.00 i Jefferson Nickel Collection Collection 2 Book 2 2.60 1 Washington Quarter Collection 1965- 7.80 Misc. Pages 19 & 20 1961 Proof Set in Capital Plastic 10.00 1960 Proof Set in Capital Plastic 15.00 1958 Proof Set in Capital Plastic 38.00 1965 Mint Set 4.50 Ward Painted Quarter 2.00 Replica 1861 Half Dollar 1.50 Replica Confederate Restrike 1.50 Misc Forneign Paper 0.50 1923 Horseblanket Silver Certificate VG 18.00 1939 BU Jefferson Nickel 1.00 1950-D BU Jefferson Nickel 10.00 1939-D Jefferson Nickel VF 5.00 1889 Seated Liberty Dime G 8.00 1912 Barber Dime G 1.50 1913 Barber Dime G 1.50 1927-5 Standing Liberty Quarter G 34.00 1917-P Tl Standing Liberty Quarter XF 95.00 1932-5 Washington Quarter G 140.00 1916-D Walking Liberty Half Dollar G 40.00 1916-D Walking Liberty Half Dollar G 40.00 1921 Walking Liberty Half Dollar G 135.00 1921-5 Walking Liberty Half Dollar G 35.00 1938-D Walking Liberty Half Dollar G 85.00 1909 VDB Lincoln Wheat Cent 10.00 1909 VDB Lincoln Wheat Cent 10.00 1895 Indian Cent AG 1.00 1898 Indian Cent AG 1.00 1905 Indian Cent AG 1.00 1907 Barber Dime G 1.50 1906 Barber Dime AG 1.20 1898 Barber Dime AG 1.20 1866 Shield Nickel Cull Almost NO Date 3.00 1911 Liberty Nickel XF 24.00 1858 Flying Eagle Indian Cent AG 12.00 1856 Seated Liberty Quarter G 12.00 1899-0 Barber Quarter XF 110.00 1856 Seated Liberty Quarter G 12.00 1847 Large Cent AG/G 8.00 1844 Large Cent G 14.00 1817 Large Cent G Cleaned 12.00 1988 Mini Mint Collector Item Lincoln Cent 0.05 1905 Quarter Eagle Liberty $2 1/2 Dollar Gold XF 190.00 17 Partial Liberty Nickel Roll 14.45 1,290.80 Safety Deposit Box Coins 51 Roll 1 Silver Dime Rolt 56.10 50 Roll 6 Silver Roosevelt Dimes 55.00 50 Roll 2 Silver Roosevelt Dimes 55.00 50 Roll 5 Silver Roosevelt Dimes 55.00 50 Roll 7 Dimes 55.00 50 Roll 3 Dimes 55.00 50 Roll 9 Dimes 55.00 50 Roll 4 Dimes 55.00 50 Roll 10 Dimes 55.00 44 Roll it Dimes 48.40 50 Roll 8 Dimes 55.00 40 Roll 17 Quarters 110.00 40 Roll 16 Quarters 110.00 40 Roll 12 Quarters 110.00 22 Roll 14 Quarters 60.50 20 Roll 13 Quarters 55.00 20 Roll 15 Quarters 55.00 1,100.00 Page 1 Safety Deposit Box 1909-S VDB Lincoln V-12 850.00 1950-D Jefferson Nickel VF 8.00 1904 Indian Head G 1.00 1898 Indian Head G 1.00 1889 Indian Head G 1.00 1883 w/o Cents V Nickel VG 6.00 1901 Liberty Nickel G 1.00 1910 Liberty Nickel AG 1.00 1912 Liberty Nickel G 1.00 1912 Liberty Nickel G 1.00 1905 Liberty Nickel VF Pourous 3.00 1867 Shield Nickel G Damaged 8.00 42 Misc Common Date Lincoln Cents 1.68 4.67 Canadian Coinage 5.00 2 Silver Nickels 1.70 890.38 Misc Coins Page 2/3 Safety Deposit Box 1942-D, 42-5, 45-D, 44-5, 55-D, 52-5, 45-5 Quarter 21.00 1932-D Washington Quarter VG 135.00 1905 Barber Quarter VG 5.00 1914 Barber Dime G 1.50 1922 Peace Dollar VF 15.00 1886-0 Morgan Dollar VF 17.00 1921 Morgan Dollar VF 16.50 1892 Morgan Dollar G 17.00 1885-0 Morgan Dollar VF 21.00 1873 Seated liberty Half Dollar G 16.00 1877-5 Seated liberty Quarter AG/G 10.00 1875-5 Seated liberty Dime G Damaged 8.00 1943-5 Walking Liberty Half G 5.50 1933 Chicago World's Fair Token 5.00 29 Mercury Dimes Mixed Dates 31.90 4 Standing Liberty No Date Quarters 11.00 11 Washington Silver Quarter 30.25 2 Franklin Half Dollar 11.00 3 Misc. Forn Coins 1.00 21 Silver Roosevelt Dime 23.10 19 State Quarters Circulated 4.75 406.50 Total Safety Deposit Coins 2,396.88 Total Box #2 3,687.68 Box3of5 Mercury Dime Set w/72 Coins 26-s, 31-D 90.00 Liberty Nickel Set w/ 22 Coins 83 w & wo Cents, 84A( 45.00 Jefferson Nickel Set w/o 1950-D 14.00 Buffal Nickel Set (See Below) 40 Common Dates 26.00 1913 Type 1 Buffalo VG 8.00 1914 AG 5.00 1914-D AG 25.00 1915/16 AG 4.00 1917/17-5 G 8.00 1918PD5 AG 15.00 Jefferson Set Complete w/1950-D Circ 26.00 61 Washington Silver Quarters from Set 198.25 Jefferson Nickel Set w/o 1950-D 16.00 1959-Date Lincoln Cent Set 3.00 1909-1940 Lincoln Cent Set 12.00 1909-1940 Lincoln Cent Set 18.00 1941-1974 Lincoln Complete Set 4.50 Jefferson Set missing Keys 6.00 Indian Cent Set (See Below) 1859 CN AG 5.00 1864 Bronze G 4.50 1863 CN Poor 3.00 1865 G 3.00 1866 Poor 10.00 23 Common Indians 19.55 1 1909 G Damaged 5.00 35 Roosevelt Dimes in Album 38.50 42 Roosevelt Dimes in Album 46.20 Walking Liberty Half Set w/16 Coins (19-D G) 110.00 1917-D Type 1 Unreadable Date 5.00 1917-5 Type 1 Unreadable Date 5.00 1918 Standing Liberty Quarter G 12.00 1920 Standing Liberty Quarter VF/XF 35.00 1925 Standing Liberty F 3.50 1926-D G 4.00 1926-5 VG 4.00 1927 G 3.00 1927-D G 10.00 1928 PDS G 10.00 1929 PD G 7.00 1930 AU 48.00 1930-S F 3.00 4 1926-S G 12.00 1 1917 Typei G 15.00 6 Common Standing Liberty Quarters 18.00 Total Box #3 963.00 1/2 Roll Box 4 of 5 Quarter and half Rolls 15&16 33 Roll I Standing Liberty/Barber Quarters 90.75 38 Roll B Washington Silver Quarters 104.50 40 Roll C Washington Silver Quarters 110.00 Roll M Non Silver Quarters 13.00 47 Silver Quarters Roll A 129.25 39 Roll D Quarters Silver 107.25 41 Roll F Silver Quarts 112.75 Roll LNon-Silver Quarters 13.00 J Bi-Centennials 13.00 39 Roll E Silver Quarters 107.25 Roll K Non Silver Quarters 6.50 Roll H (See Below) 1976 Half 0.60 1895-0 Barber Half 12.00 1964 Half 5.50 1963 Half 5.50 3 Barber Halves 17.00 20 Walking Liberty Halves 110.00 Pre-60 Nickel Roll N-10, 9, 8, 2, 6, 3, 7 21.00 2 1945-P Nickel Roll 68.00 1 1944-P Nickel Roll 34.00 19 Silver Nickels N-1 16.15 23 BU 1970-D Nickels 2.00 1 1943-P Nickel Roll 34.00 1 1943-5 Nickel Roll 34.00 1 1943-P Nickel Roll 34.00 1 1942-P Nickel Rol 34.00 1 1945-S/D Nickel Roll N-5 34.00 5 1942.42-D Circ Nickels 2.00 1 Silver Nickels N-4 34.00 36 Buffalo Nickels BN-2 23.40 39 BN-1 Buffalo Nickels 25.35 1 1913-P Type 1 Nickel VF 10.00 113 No Date Buffalo Nickels 16.95 13 1959-Date Lincoln Cent Rolls 8.45 3 Common Date Wheat Cents 6.00 Roll L4 1930'5 8.00 L-1 w/1909 Damaged, 1915-5 G 22.00 L-2 1910'5-20'5 Roll 10.00 L-3 1920'5 Roll 6.00 L-4 1930'5 Roll 6.00 L-5 1930'5 Roll 6.00 1,453.15 Box5of5 1943 Lincoln Roll 6.00 2 1937 Lincoln Roll 4.40 2 1936 Lincoln Roll 4.40 3 1959-D Lincoln Roll 6.60 2 1953-D Lincoln Roll 4.40 2 1939 Lincoln Rolt 4.40 2 1956-D Lincoln Roll 4.40 2 1955 Lincoln Roll 4.40 1 1938 Lincoln Roll 2.20 5 1944 Lincoln Roll 11.00 4 1940 Lincoln Roll 8.80 7 1943 Lincoln Roll 42.00 7 1958-D Lincoln Roll 15.40 2 1944-D Lincoln Roll 4.40 5 1941 Lincoln Roll 11.00 5 1951-d Lincoln Roll 11.00 2 1952-D Lincoln Roll 4.40 1 1934 Lincoln Roll 2.20 1 1945 Lincoln Roll 2,20 2 1947-D Lincoln Roll 4.40 3 1956-D Lincoln Roll 6.60 3 1956 Lincoln Roll 6.60 2 1957 Lincoln RoII 4.40 4 1945 Lincoln Roll g,gp 2 1946-D Lincoln Roll 4.40 4 1946 Lincoln Roll g,gp 1 1969-D BU Lincoln Roll 2.20 3 1957-D Lincoln Roll 6.60 3 1951 Lincoln Roll 6.60 1 1945-d Lincoln Roll 2.20 2 1970-D Lincoln Roll 4.40 1 1935 Lincoln Roll 2.20 2 1942 Lincoln Roll 4.40 1 1948 Lincoln Roll 2.20 1 1958 Lincoln Roll 2.20 230.60 Total Value of Collection 5,364.43 4850~~41046 ~ ~ C~~ REV-485 EX (t-07) O L( SAFE DEPOSIT BOX INVENTORY PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY Social Security or Death Certificate Number Date of Death Decedent's Last Name Suffix r- a ee,.~<. s ~ ~ . S ~+wrteq~;r G ~ ~ R ~ A~ t R~ © ADDRESS OF DECEDENT STREET: ~ ~~ Count~Code Year 2~ l °I. File Number First Name MI ~~ 1 °~ ~~ CITY. STATE: ZIP CODE: I J_D`~!- ~ Fa~c.c~uF`1- DRt'V~ Q,R9'~P i-~tLL F'Pf 17C~i 1 NAME AND ADDRESS OF PERSON REOUES7ING THE OPENING OF THE SAFE DEPOSIT BOX NAME: (2 )Z t~GE Cam. H L~SLIC- W -Wf+I~TON STREET ADDRESS: CITY: STATE: ZIP CODE: I~t(~S L3LkC~LISG7~R-20~}D f~L..yl (3'',71'Ck~ -~-rU)t~/ f=L 33~t/g NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING .~ NAME AND ADDRE~SjS OgF~FIN~A1NCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED ' STR ET ADDRESS: CITY: STATE: ZIP CODE: ~a wD s e'r- ~ ~~ c Hrw ~'rkP r ~,~~ ~P ,~. a. NAME://~1 ~~ r ~ ~ f ~},~ I STREET ADDRESS: S~ E b. NAME: RELATIONSHIP: CU- (,~~1-lC 1.tP , i,t11A-L-TUd~-S S~,ST~ ~`~ZtcuTCx' STREET ADDRESS: CITY: STATE: ZIP CODE: 56ZJ /1~3vJ~ c. NAME: RELATIONSHIP: STREET ADDRESS: ~U^ ZIP CODE: RELATIONSH`P: " ~..._. CITY: CITY: STATE: ZIP CODE: NAME OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY t~ A- r3c-I- -t~k- ~>r pr~C t31FftK v iteA (3Y PuG ~ GATE OF C NT CT TO RENT BOX ' NUMBER OF BOX 1 TITLE UNDER WHICH BOX IS REGISTERED t Derv © - 01o-I plft ~ tN' NAME AN ADD ESS OF. PERSON(S) HAVING ACCESS TO BOX ~ a. NAME: b. NAME: ' _~t i~u a ~.. wk~ '~ STREET ADDRESS: STREET ADDRESS: i ~oS4- l.(9. ~e1XC~FT Vr)2l V~ CITE r ~ ~ ~ ~ ~ STATE: ZIP CODE: CITY; STATE: ZIP CODE: OF EMPLOYEE TAKING THE INVENTORY WAS A WILL IN THE BOX9 U YES ~ NO If yes, a. Date of will: b. Name and address of personal representative, If named In the will NAME: STREET ADDRESS: c. Name and address of attorney, if any NAME: cin: STATE: ZIP CODE: STREET ADDRESS: CITY: STATE: ZIP CODE: j L 48500041046 48500041046 SAFE DEPOSIT BOX INVENTORY Page_L-_Gf_~'-_ REV-485 EX 'INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certifcate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. {8) Jewelry, Coins, Stamps, ManuscHpts, etc: List and describe as fully as possible. (T) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 ITEM NO. ITEM DESCRIPTION - --__ _.- _ _ _[ e~U"T"t>t~t(3~'Dii.E ~'1'TLes i k E7 ~ r ~t(e~t% C,c~T~t ~~ - - ~~y r ~~Z-~__~ _~_iri.E 1-J5. ~'c)I,~ - iuS~ it1. FvX Ca'~~T r~~: __ 2se ~- 3 - C z 671JT `~-~3 t ~- H- GAT' ~l ~-CE ~1 G1~xrc~ - ~9`~ i ~E ~"~L D _C~~Srlr A.rG T~erv GUA(L'1~~'~~t~_-.---~~is~ ~,~% ~ _ ~q'42 D ~c_s.. t~:f~Si+)~;~T.c~~S _c~t~ru~T~ Cc---- - _1_ iQ1~5!-Etn!eTV_~__c~ 1~~-_ ~ ~~ 5 u~ s- ~94~t / L / ( r ~ 1' ~ . I,trftS~tltir E-~TCr ~S~? U•J ~ ~5`~`~ _ ~ 41. ~s~t" 1_. `~ ~ /7.. / ~ / -~'~~J ~ r a~5 5_(/ _.J~ ~t~1~ I NC (VIV ly U /CI LL LV'~ _~C~,~_._ SOU. s lvA~i~i 11 -Z~N~ u~C~z~'~~E~ ---- -- R 2 -U ` 5 , '~ 1 M~'_S Pr~;'Gt ~ ~ i ~Iv~~S FRo M 1 4-lu - I G. ~~ ~ .~_F _ _~ ui , 5,_D i_M ESQ ~ u- r20 M_`L~ _ 14 ~~ F ___ .ins , m E cLa2~D1(~5,_I~CGi n;C ins y1Ls ~ltc:,r~t iL3~`~~- C~- ..I C9;5 C~C}Ik2.Tt~5 ALL AGM `%t IR(o'-I- CF~ _ r (L'z ,~Itic~ 19:3 ~ ~i lk1 ~ (?2 i~AL'T~ ~- ~L~~~~~ ~ 2~ ~4 $ _ ,. _ _ _ _ _,__ L, 1 ~ - ~ _ _' 2 U . s _ ~u Arr ran S _[~t~NN~i ~ C~- ti Y ~s ~c rr~l.~S._1_t!~?- (.~_ _~~ .~~~_~llN~1~'~S~ f~;4tSGi>v~, iii _Y~~_S_~~2~1_t ~3~-) lS4CF _ 2~r ~a 7 Li : 5 U r~t'~-Tr7-~S I C~*- i ~1 C-,- i N YG7~tZ5 ~~'1 i f'~1- -( l 4: U _F I CERTIFY UNDER PENALTY OF PERJURY THAT TH ABOVE RECORD IS CORRECT AND COMPLETE T THE B ST OF MV KNOWLEDGE AND BELIEF. PERSON RECEIVING COPY OF SAFE DEPOSIT BOX INV TORY: sIGNAT E ~ - •' ~ URE /pn 2_,. PRIM NAME ~~ *1 :. l~~ _ _ PRINT NAME ANb CHECK APPROPRIATE BOX BELOW: G~ C . (:cl~Ai~o~ ~' i~u t=i.~; . G.~14'>,7- PRINTTITLE DATE C ECKAPPROPRIATE BOX: _ (~ L ~" ~' S/(J//~C/ / l• j ~Execurrn(irix) ^Atlminislratorttrix) r safe deposit Eox ~ Estate Representative ~ Joint owner o NOTE: Attach additional 8'l:" x 11" sheet(s) if necessary or use duplicates of this page of form. The DepaRment is authorized by law, 42 U.S.C. §405 (c)(2)(C)(i), to require disclosure of Social Security numbers in connection with administering state tax laws. The Department uses the Social Security number b identity the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities. The state law prohibits the Commonwealth's personnel from disclosin confdential tax information except for official purposes. ifLj ,• ~~ 0 y ~' o ~ ~ z oz -1 ~~ ~ ~Z 0 "~ O ~ ~ 1 c l m m !~ G~ `` ~ 1 `~ r ~ ci.. C.I. ~ ~ ' c . Q ~ t~ l.L U. (!. m ~ ~ H U- . 2 ~ >~" > ~ ~ rG ~ a ~ _ 11 ~s 1 ("~ " 1 .J ~ ^~ . V '~J J l9 d O - W w W O .~. -" . 1 v, J .~.- Mf lj - i~ ~~ ~" , .J V Y i G )• ~ ` C ~ ~ I.L':i li ~:r .~ 2 .~ .. m, " . ~ f ~' 4~l ~, ~- v ~ ~ C ~ z ~ ~ ~ y 1 Q ~ L ~ ~ .~ `J y~ '~9 y' ~ 11 7 w - ~ : ~ 1^ ~~ ` P ~ ! Z ~ I.J. ~ C~. 1 ) z ' a_ ~ u ' v ^ A C ~` ' I , J ` ~ ~ .~ 1 ` v r ~ ~ ~ v ~ ~ ~ ~ o Z o _:~ '~ ~ 5 ~ ~ ~ ~ ~ 3 3 ~ J v V 'A' v W W ~ N LL LL m Q O O N 6 =ZOU' Q~m~ O m 3~aN /~/\ O w < u Il ` V `~ 0 g = O U ~ ~ Q - ~ w N ^ \^} ~ ~ ~ ~ _~ O ZW ~ _ j w K O Deceased: PHILIP K WARD 4!14/08 _ ~ _ ~ Department of the Treasury -Internal Revenue Service Far the ear tan 1 -Dec 31, 2008, or other tax ear h ~nnin 2008 endi , 20 Label Vour first name MI Last name (see instructions.) pHILIP K WARD If a joint return, spouse's first name MI Last name Use the IRS label. BRUCE C WALTON AND LESLIE W WALTON OtherWlSe. Home address (number and streeq. If you have a P.O. box, see instructions. Apartment no. oretype Print 14645 BLACK BEAR ROAD City, town or post office. If you have a foreign address, see instructions. Slate 21P code Presidential ~ pALM BEACH GARDENS, FL 33418 Election Campaign , Check here it you, or your spouse if filing jointly, want $3 to go to this fund? (see instructions) ....... . ....... ~ 171-36-4657 Spouse's so[lal »cudty number You must enter your social security number(s) above. Checking a box below will not change your tax or refund. YouSpouse Filin Status 9 1 ~X~ Single 4 U Head of household (with qualifying person). (See ld B 2 Married filing jointly (even if only one had income) Instructions.) If the qualifying person Is a chi but not your dependent, enter this child's Check only 3 Married filing separately. Enter spouse's SSN above & full name here. ~ one box name here . ~ 5 (~ Qualifying widow(er) with dependent child (see instructions) Exemptions 6a X Yourself. If someone can claim ou as a de endent, do not check box 6a ........... 6exas [heck>a v p ~ on 6a and 6b.. 1 b S Onse ...... ......................... ..... No. or children (2)Dependent's (3)Dependent's (4) ;f ons[wno: c Dependents: social security relationship qualifying • Iivaa child for child witn yon .... . number to you tax credit • did not (1) First name last name (see instrs) Iiv. with „a„ If more than four dependents, see instructions. above. 1 7 Wages, salaries, tips, etc. Attach Form(s) W-2 ........... ............................ 7 9 954. Income Sa Taxable interest. Attach Schedule B if required ........... .............................. 8a b Tax-exempt interest. Do not include on line 8a. ,......... .. 8b Attach Form(s) 9a Ordinary dividends. Attach Schedule B if required ........ ............................. . 9a 285 . W-2 here. Also b Qualified dividends (see instrs) ................................ .. 9b 2 B 5 . ':~ attach Forms 10 Taxable refunds, credits, or offsets of state and local income taxes (see instructions) ..................... . 10 W-1G and 1099-R if tax was withheld. 11 Alimony received.. _ ................................... .............................. 11 12 Business income or (loss). Attach Schedule C or C-EZ . . .............................. 12 It you did not get a W-2, 13 Capital gain or (lass). Att Sch 0 if regd. If not regd, ck here ........... ............... ~ ~ 13 -3, 000 . see instructions. 14 Other gains or (losses). Attach Form 4792 ............... .............................. 14 15a IRA distributions ............ Yaa bTaxable amount (see instrs).. 15b 16a Pensions and annuities...... 16a bTaxable amount (see instrs).. 16b 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . 17 Enclose, but do 18 Farm income or (loss). Attach Schedule F ... . ............ .............................. 18 not attach, any 19 Unemployment compensation ........................... .............................. 19 payment. Also, please use 20a Social security benefits........... ~ 20a~ ~ b Taxable amount (see instrs).. 20b Farm 1040-V. IN LIEU OF_DIVIDENDS _ _ _ _ _ _ _ PAYMENTS 21 Other income E_TRADE _ 21 40 . _ _ 22 Add the amounts in the far ri ht column for lines 7 throw h 21. This is our total income..... ~ 22 7 279. 23 Educator expenses (see instructions) ................... ... 23 Adjusted 24 Certain business expenses of reservists, performing artists, and fee-basis GYOSS government officials. Attach Form 2106 or 2106-EZ ................. ... 24 Income 25 Health savings account deduction. Attach Form 8889.... ... 25 26 Moving expenses. Attach Form 3903 .................... ... 26 27 One-half of self-employment tax. Attach Schedule SE ... ... 27 28 Self-employed SEP, SIMPLE, and qualified plans ...... ... 28 29 Self-employed health insurance deduction (see instructions) .......... ... 29 30 Penalty on early withdrawal of savings .................. ... 30 31 a Alimony paid b Recipient's SSN.... ~ 31 a 32 IRA deduction (see instructions) ........................ ... 32 33 Student loan interest deduction (see instructions) ....... ... 33 34 Tuition and fees deduction. Attach Form 8917 ........... ... 34 35 Domestic production activities deduction. Attach Farm 8903......... ... 35 36 Add lines 23-3la and 32-35 ............................... .......... _.,.._............. 36 0. 37 Subtract line 36 from line 22. This is our ad'usted ross income .................... - 37 7 279. BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. Folnon2~ ronaroa Form 1040 (2008) ' Form 1040 (2008) PHILIF K WARD 171-36-4657 Paae 2 Tax and 38 Amount from line 37 (adjusted gross income)..... 38 7 279. Credits 39a Check ~BYou were born before January 2. 1944, 8 Blind Total boxes if: Spouse was born before January 2, 1944, Blind. checked - 39a Standard b If your spouse itemizes on a separate return, or ygu were actual-status alien, see instrs and ck here ~ 39b Deduction a Check if standard deduction includes real estate fazes or disaster lass (see instructions)........ ~ 39e for - 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ..................... ;.`. 40 450 . • People who k h d b 41 Subtract line 40 from line 38 ................ _ ........................................ 41 1, 829. any ox c ec e on line 39a, 39b, or 39c or who 42 If line 38 is over $119,975, or you provided housing to a Midwestern displaced individual, see instructions. Otherwise, multiply $3,500 by the total number of exemptions claimed on line 6d .......................... > 42 3, 500 . can be claimed as a dependent, 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0 ....................... .......... ...................... 43 0 see instructions. • All others: 44 Tax (see instrs). Check if any tax Is from: a b e Form(s) 8814 Form 4972 .......................... 44 0 . ~ Anemative minimum tax (see Instructions). Attach Form 6251 .......................... 45 0 . Single or Married filin aratel se . ~ Add lines 44 and 45 ............................................................... 46 0 . y, g p $5,450 47 Foreign tax credit. Attach Form 1116 if required............ 47 Married filin ~ Credit for child and dependent care expenses. Attach Form 2441.......... 48 g jointly or 49 Credit for the elderly or the disabled. Attach Schedule R.... 49 Qualifying id 50 Education credits. Attach Form 8863 ....................... 50 w ow(er), $10,900 51 Retirement savings contributions credit. Attach Form 8880.. 51 0. 52 Child tax credit (see instructons). Attach Form 8901 it required .......... 52 Head of household 53 Credits from Form: a ~ 8396 b ^ 8839 c ~ 5695 ...... 53 , $8,000 54 Other crs from Form: a ^ 3800 b ~ 8801 e ~ 54 55 Add lines 47 through 54. These are your total credits ........ ...... ..................... 55 56 Subtract line 55 from line 46. If line 55 is more than line 46, enter -0-. ................. ~ 56 0. 57 Self-employment tax. Attach Schedule SE ....................................... . ............... 57 Other 58 Unreported social security and Medicare tax from Farm: a ~ 4137 b ^ 8919 ....................... 58 t ptans, etc. Attach form 5329 if required ................. . . TaXeS 59 Additional tax on IRAs, other qualified retiremen 59 n 60 Additional taxes: a ^ AEIC payments b LJ Household employment taxes. Attach Schedule H........... 60 61 Add lines 56-60. This is our total tax ...................................................... ~ 61 0 . ments 62 Federal income tax withheld from Forms W-2 and 1099..... Pa 62 1 042 . -`. y 63 2008 estimated tax payments and amount applied from 2007 return. ... 63 If you have a qualifying 64a Earned income credit (EIC) , .... ....... .. 64a 222. child, attach Schedule EIC. b Nontaxable combat pay election.. ~ 64b 65 Excess social security and tier 1 RRTA tax withheld (see instructions). '~ 66 66 Additional child tax credit. Attach Form 8812 ............ .. 66 67 Amount paid with request for eMension to file (see instructions) ......... 67 66 Credits from Form: a ~ 2439 4 ^ 4136 c ^ 8801 d ~ 8885. 68 69 First-time homebuyer credit. Attach Form 5405 ............. 69 70 Recovery rebate credit <see worksheet) .................... 70 `~ 71 Add lines 62 throw h 70. These are our total ayments ................ ..... ................... ~ 71 1, 264 . fund 72 If line 11 is more than Ilne 61, subtract Ilne 61 from Ilne 71. This is the amount you overpaid............ R 72 1, 2 69 . e it? 73a Amount of line 72 you wa Di t d nt refunded to ou. If Form 8888 is attached, check here. ~ ~ 73a 1 264 . epos rec See instructions . bRouting number........ 267084131 ~ c T e: X Checking ~ Savings and fill in 73b, . d Account number ....... 3573979140 73c, and 73d or Form 8888. 74 Amount of line 12 you want a lied to your 2009 estimated tax ....... ~ 74 Amount 75 Amount you owe. Subtract line 11 from line 61. For details on how to pay, see instructions .............. ~ 75 YoU OWe 76 Estimated tax enalt see instructions) ....... 76 Third Party Do you want to allow another person W discuss this return with the IRS (see instructions)? .......... U Yes. Complete the following. U No Designee's Phone Personal itlentitication Designee - PreDarer no ~ number (PIN) ~ Under penalties of peryury, I declare that l have examined tltis return and accompanying schedules and statements, and to the best of my knowledge and Sign belief, they are true, correct, and complete. Oedaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Your signature Dale Your o<cupatron Daytime phone number Joint return? ' ~ PRINTER OPERATOR See instructions. Keep a copy Spouse's signs 1 i t re ust iyn. Date Spouse's ocwpation for your records. / - Date Preparer's SSN or PTIN Preparer's P01d signaure / William R. Kaufman CPA JD Check itselhem toyed X 208-38-7696 Preparer's Firm's name DeMuth Mana ement Consultants Use Only seitYemployetl)- 940 Centur Dr EIN 23-2871292 7055-4376 Form 1040 (2008) FDIA0112L 10/13/08 SCHEDULE D (Form 1040) DepaAment of the Treasury Internal Revenue service Name(s) shown on return PHILIP K WARD OMe No. 1545p0074 2008 Attachment .~,~ Seouence No. Your social sacudy number 171-36-4657 '.Part I "' Short-Term Capital Gains and Losses -Assets Held One Year or Less pp(ra) Description of 7 W she es xXYZ Co) (t1) Date acquired (MO, day. yr) (a) Date sold (Mo, day, yr) (d) Sales price (see instructions) (e) Cost or other basis (see instructions) (f) aain or (loss) Subtract (e) from (d) t 150 shs WASHINGTON MUTU , INC 12/13/07 1/22/08 1,945. 2 350. -405. 500 shs RITE AID CORP 12/20/07 1/31/08 1 926. 1,485. -59. 200 shs BON-TON STORES, NC 2/06/08 2/11/08 1,411. 1 299. 112. 300 shs BON-TON STORES, NC 1/08/08 2/11/08 2,121. 1 796. 325. 2 Enter your short-term totals, if any, from Schedule D-7, line 2... 2 ~ ~_'~ 3 Total short-term sales price amounts. Add lines 1 and 2 in column (d).......... 3 6, 903. r - ` + .:, -i . , 4 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824............ 4 5 Nel short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 .... 5 6 Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions ........................................................................... 6 -2 35 2 64 . 7 Net short-term capital gain_or (loss .Combine lines 1 throw h 6 in column ............................... 7 -235 291 . Partll` Long•Term Capital Gains and Losses -Assets Held More Than One Year (a) Description of property (Example: 100 shares %YL Co) (b) Date acquiretl (MO, day, yrj (C) Date spltl (MO, day, yr) (d) Sales price (see instructions) (e) Cost or other basis (see instructions) (Q Gain or (loss) Subtract (e) from (tl) 8 9 Enter your long-term totals, if any, from Schedule D-1, line 9.... 9 10 Total Iongg-term sales price amounts. Add lines 8 and 9 in column (d) ........ ......... ....... ............... 10 .-., ... '~ - ~• ':. ', 11 Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) from Forms 4684, 6781, and 8624 ............................................................................ 11 12 Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1... 12 13 Capital gain distributions. See instrs ................ _ .......................................................... 13 74 Long-term capital loss carryover. Enter the amount, if any, from line 15 of your Capital Loss Carryover Worksheet in the irtstructions .......................................................... l4 -9 260 . 15 Net long-term capital gain or (loss). Combine lines 8 through 14 in column (f). Then go to Part III on aaae 2 ................................................................................................. 15 -4 2 60 . BAA For Paperwork Reduction Act Notice, see Form 1040 or Form 1040NR instructions. Capital Gains and Losses Attach to Form 1040 or Form 1040NR. -See Instructions for Schedule D (Form 1040). Use Schedule D-1 to list additional transactions for lines 1 and 8. Schedule D (Form 1040) 2008 FDIA0612L 11/06/06 ° Schedule D (Form 1D40) 2008 PHILIP K WARD 171'36-4657 Page 2 F81t111 :, Summary 16 Combine lines 7 and 15 and enter the result ............................................................. 16 -239 551 . If line 16 is: • Again, enter the amount from line 16 on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 17 below. • A loss, skip lines 17 through 20 below. Then go to line 21. Also be sure to complete line 22. • Zero, skip lines 17 through 21 below and enter -0- on Form 1040, line 13, or Form 1040NR, line 14. Then to go line 22. 17 Are lines 15 and 16 both gains? Yes. Go to line 18. No. Skip lines 18 through 21, and go to line 22. 18 Enter the amount, if any, from line 7 of the 28°! Rate Gain Worksheet in the instructions ................ ~ 18 19 Enter the amount, if any, from line 18 of the Unrecaptured Section 1250 Gain Worksheet in the instructions ...................................................................................... ~ 19~. 20 Are lines 18 and 19 both zero or blank? Yes. Complete Form 1040 through line 43, or Form 7040NR through line 40. Then complete the Qualitied ~- Dividends and Capital Gain Tax Worksheet in the Instructions for Form 1040 (or in the Instructions for Form 1040NR). Do not complete lines 21 and 22 below. No. Complete Form 1040 through line 43, or Form 1040NR through line 40. Then complete the Schedule D Tax Worksheet In the instructlons. Do not complete lines 21 and 22 below, 21 If line 16 is a loss, enter here and on Form 1040, line 13, or Form 1040NR, line 14, the smaller of: • The loss on line 16 or ~ ......... 21 -3, 000. • ($3,000), or if married filing separately, ($1,500) Note. When figuring which amount is smaller, treat both amounts as positive numbers. 22 Do you have qualified dividends on Form 1040, line 9b, or Form 1040NR, line tOb? Yes. Complete Form 1040 through line 43, or Form 1040NR through line 40. Then complete the 4ua0tied ' ~ I Dividends and Capital Gain Tax Worksheet in the Instructions for Form 1040 (or in the Instructions for Form 1040NR). No. Complete the rest of Form 1040 or Form 1040NR. Schedule D (Form 1040) 2008 FDIA0612L 11/09/08 r Form 4952 Department of the Treasury Internal Revenue Service i Investment Interest Expense Deduction ~ Attach to OMB No. 15650191 2008 Attachment 51 Sequence No. Name(s) shown on return Idantilying number PHILIP K WP.RD 171-36-4657 Part I Total Investment Interest Expense 1 Investment interest expense paid or accrued in 2008 (see instructions) .................................... 2 Disallowed investment interest expense from 2007 Form 4952, line 7 ...................................... 3 Total investment interest ex nse. Add lines 1 and 2 ..................................................... 3 14, 326. $art.ll Net Investment Income 4a Gross income from property held for investment (excluding any net gain from 4 285 - - the disposition of property held for investment) ............................... a . - . b Qualified dividends included on line 4a ............... . ....................... 4b 285. ~~' c Subtract line 46 from line 4a ................................................ ............................ 4c d Net gain from the dlsposition of property held for investment .................. 4d e Enter the smaller of line 4d or your net capital gain from the disposition of properly held for investment (see instructions) ................................ 4e t Subtract line 4e from line 4d ................................................ ............................ 4f g Enter the amount from lines 4b and 4e that you elect to include in investment in come (see instructions)... 4 h Investment income. Add lines 4c, 4f, and 4g ................................. ............................ 4r 5 Investment expenses (see instructions) .................................................................. 6 Net investment income Subtract line 5 from line 4h If zero or less enter -0 ............................... I 6 I 0 . 'Part III "' Investment Interest Expense Deduction 7 Disallowed investment interest expense to be carried forward to 2009. Subtract line 6 from line 3. If zero or less, enter ~0 ........................................................................................ 7 14 32 6 . BAA For Paperwork Reduction Act Notice, see separate instructions. 6. Form 0. FDIZt2a IL O6ne/o8 Form ~ 31 ~ Statement of Person Claiming OMB NO. 15450074 (Rev November 2005) Refund Due a Deceased Taxpayer Department of the Treasury Internal Revenue Service ~ See Instruction S. AHachment sepuence No. 87 Tax year decedent was due a refund: Calendar ear 2008 , or other tax ear be innin ,and endin Name of decetlent Date of tleath DacadanCZ social security number PHILIP K WARD 4/19/08 171-36-4657 Please Name of person claiming retuntl your socisl security number type SEE STATEMENT SEE STMT or Home atltlress (number and slreeU. If you have a P.O. box, see instructions Apartment number print 14695 BLACK BEAR ROAD City, town or post onice. If you have a foreign atldress, see instructions State ZIP code PALM BEACH GARDENS, FL 33418 Part I. , ' i Check the box that applies to you. Check only one box. Be sure to complete Part III below. A Surviving spouse requesting reissuance of a refund check (see instructions). B X~ Court-appointed or certified personal representative (see instructions). Attach a court certificate showing your appointment, unless previously filed (see instructions). C ~ Person, other than A or B, claiming refund for the decedent's estate (see instructions). Also, complete Part II. $art IF '?` Complete this part only if you checked the box on line C above. Yes No 1 Did the decedent leave a will? ........................................................................................ 2a Has a court appointed a personal representative for the estate of the decedent? ......................................... b If you answered 'No' to 2a, will one be appointed? ..................................................................... If you answered 'Yes'to 2a or 2b, the personal representative must file for the refund. _ 3 As the person claiming the refund for the decedent's estate, will you pay out the refund according to the laws of the state where the decedent was a legal resident? ............................................................................. If you answered 'No' to 3, a refund cannot be made until you submit a court certificate showing your appointment as personal representative or other evidence that you are entitled under state law to receive the refund. 'Pant"III ' ' Signature and verification. All filers must complete this part. I request a refund of taxes overpaid by or on behalf of the decedent. Under penalties of perjury, I declare that I have examined this claim, and to the best of my knowledge and belief, It is true, correct, and complete. Signature of person claiming refund ~ Date ~ BAA For Privacy Ad and Paperwork Reduction Ad Notice, see separate instructions. Form 1310 (Rev 11-2005) FDIA2001L 11/08/05 2008 Federal Supplemental Information Page 1 PHILIP K WARD 1 FORM 1310 - NAMES AND SOCIAL SECURITY NUMBERS OF PERSONS CLAIMING REFUND BRUCE C WALTON - 182-56-8428 LESLIE W WALTON - 159-54-6123 05/22/2008 15:42 FAX CORP RETIREMENT BENEFITS ' Retirement Services -Balance History ^ ^a V~a \a Employer. NIOHMARK p!'"~ ! HIGHMARK INVESTMENT PLAN ~~;~~, Go Employee SSN: Seeroh ~ . ,,,,... i ~n Search Name; I ___. Current Hmployee: PHILIP K WARD 171-0ed867 ®alancs History Pleaea oe11 Partlclpant Account Sarvioes at 1.800-847-7227 if you need additional balance history Information. From I Apr ,;;, to ~Q' aotie'~ TO I Apr i >.a ~ip~~Cf'zooe~`I~ search Date: ' - Date: ~ ~ - Fund: ,, . ,uitlil~, CoMrlhution Type: I iNl Transaotlon Category Ca9h Unih Baglnning Balance 5119,916.27 linrealixed OeinlLoas -5373,17 Ending Balance $119,642.10 To reeuest a coo by mail click here ~ 003/003 Page 1 of 1 contact us: Participant Aocount Sen 1-600-847.7227 lam -11 pm ET Monday-Frlday Enter Symbol Go ~FOr quotlnp, eherdnp end news Por that symbol. Market Indox ~~~li!, D ' -' ~ i 10 19 12 ~ 1 2 3 4 p~ 12861.4a -1 e ~$~Q 2464.83 -Z7 saP ~c 1400.08 -13 t11ey Z1, ~~09 t10 PM ET -" ouolee delayed al least 20 minl _ Quoles provldsd by Gam~sls• Powered by Marrd•Werld(R1 Helpful Inforrnatlon Celcul re tZuartgy Newsletter l~ojgtJ de not2-_ i lea tNme r~~/ innne 05!22!200@ 15:42 FRf( CORP RETIREMENT BENEFITS f~002/003 I~iGHNW2Ka May 22, zoos Attorney William R. Kaufman 940 Century Drive Mechanicsburg PA 17055 Dear William: Thank you for sending in the death certificate for Philip K. Ward and the addresses for his sister and brothers. Philip was untitled to a defemd vested pension benefit flrom the Highmark Retirement Plan. The only person entitled to a benefit after he died, would have been his spouse. Since Philip was not married, thore is no further pension benefit. I will contact his sister and brothers and let them know this. I will also let them know that they are the beneflciariea of his Iiighmark investment Plan account. Wachovia Bank wlll be in contact with them about their share of his account. Attached you will find information about the data of death value of Philip's Highmark Iavestment Plan account, If you have any questions, please contact our office at 1.800-341-1524, retirement opdon. Sincerely, 5hany Finnerty Benefit Representative Enclosure ~w.i nn.: n ~_ O o. t c O a C V Q .C . d S a~ A m „ cc ~ ~~•;~~ O Np M 4 O N Q O um. c E a N :J Q '~ O '! c Q, ~ Zm _ Q, m ~.!" 5 m ~ ~ LL V- W~ Y O a , ~ ~ c N C N U O ~ e e[ 6 P R' N N r ~ ,y ' iu c c~ o g Y ~ ^ , C ~j W Y r i W 01 (~! ^ m y I 4W i w~ w o e u ~ % ~~w~ odd ~ "G't W r H 1 ~ O N ~~ ~ M W p C ~S N O b m 9 ~ 8+ ~ 9 ~ C d .~C ~ C ~} r .~ ~~LL mU v N 0 q N ~ ~~ w 5 O coEEy = o O Kro "awl o ~ o~ ~": a ~ v aW~ u °m °~, ~ G m ,Q ~ p~ C N ~ ~ ~ ;d m ~ m i ~ mm0 ~W G ' m e ~~~ it ~ m ~ y Uf 5~ $ ~ ~~° ( 4 3g~ ~ Y Z 7 .y g ~' u ~ W Z ~ ~ I d = 4~s .~ Y N -.,n Z Y " Q LL t C P E ~ U .w;o 2 ~ ~ pa o00 d d U F Ia ~ ~W a F W Z~ ,, z Nn dt Z p O Z p S -~ O x 40 ~,,AF Z P.O. Box 2600 Valley Forge, PA 19462-2600 May 23, 2008 BRUCE & LESLIE WALTON 14645 BLACK BEAR RD PALM BEACH GARDENS, FL 33418 Dear Mr. & Ms. Walton: www.vanguard.com Thank you for your continued interest in Vanguard. We received your correspondence and it is our understanding that you wished to receive information regarding Philip K. Ward's Vanguard account. Below is the information that you requested. 1) SIMPLE IRA fund/account number: 81-88011881942 2) Date opened: February 28, 2006 3) Type of account: SIMPLE IRA 4) Balance as of date of death: $6,096.03 5) Beneficiaries listed: Alan Ward (30%), Le lie Walton (40%) and Steven Ward (30%) If you have any questions about this letter, please contact our Small Business Services Department toll-free at 1-800-662-2003. An associate will be happy to assist you. Sincerely, Small Business Services Department nt 30268381 m a m 0 S 0 9 .Q «M1 C O s Z e~ O ^ LL m ~ B E ¢ v z ~;°s y ~ W a w a G J o'a ~ g O r a O a 0 O N a R O 7 ~x x os s oe e ~~ ~. ~~ ° w vs w n~ n ~~ v w~ } b ~ w vi w ~ ~~ 8 y ~ .- W O 7 9e ~ • m >_ '~ F •Q p ~ ~ ~ Q V U~ Z a N>._____ _ __..___._ ._._ _,. .. G M p n n S G E $ m N y !9 N M Q m ~ ~ ~ y 'a GL d ~ ~~ a Q m ~ ~ ~ ~¢ ~ ~ W N c c U V C pmpmt~ W LL 41 m 2 ~. 00 oa M M 0 0 G o W tl! 0 0 as U S ~ N N a .~ w9~ ~~ ~~ Oeor- go A. Thorira Supervisor George A. Thoma fl~ rner~a( Horne, Inc. 10418 Perry Highway Wexford, Pa, 15090 .724-935-3400 Other clothing i f Cremation urn .......................................:.... i (Decdpdon) -~--^- Margaret Funeral STATEMENT OP PUNERA,L GOODS AND SERVICES SELECTED Charges ue only (or thou ltemr that yyoou selected or riot arc requked, Ifrre are required bb}tu' hw or by a cemetery or crenutary to use any l[ems, we wBl aplaln In wddng below. If rou telecteda funeral That may «quke embalming,:uchaa a funen(wldt Nesing, you mayhave {o payforembalmNg. You do not have to payfor emhalmtng you dkl not appmrc Ifyou selected arrangeme~tttiaaa~/,,,aaa',~/a/~~I},,~f( u a dkctt crc don ImmcAate burW. BFe durged fa anbrlming, we xW'apWn why below, J Por the Servl a of "_ l~lX 1,f~ )., GA ~ Date of Death t~1 r LI ~ f ) A. CHARGE POR SBRViC$S SHLECTEDr 1, PROPFSSIONAI.SF.RVICPS Service of Puned DlrectorBmff..,,...,»... •i ..... Embalming ............:...................... ........: i Dressing, layout, and Cosmetlzing .......... i Other pmpantlon of body ................................................................... i SUHTOTAL OP PROFHSSIONAL SERVICE ............. Al { Z.'PACILITIES AND SERVICES ~ ,rfy" . Use of facWtla and seMcrs6~ viewing (Viaitatlon/Wake) .:.....,...y ... i c ~° Usc of facllitle and service for funeral ceremony ............................... {_ Use of fadlltle and aeMce for Memorial Service ..............:...................... { Use of equipment and service for gravrslde service ...........:.................... i~'I~.i . .Other use of facUlUe , ... ...,,. Q SUBTOTAL OP PACILITLES/A ................... { UfPMENr ............... A2 { 3. AUTOMOTIVE EQUIPMENT Vehlde to transfer remains to Pursed Home.n laeal ............................................................ J~ Hrarse (Casket Coarh) J.ocal.... .Umaustne Locai .......................................................... {_ Famtfy Car , Loral,.:.. ..............i .- . ' Flowu ar or god dtspoddon Lotal ............................................................~~ Lead pr/rJergy ar/Brneral purpose nr ' Car (or pallbcatets Lacal ............................................................ i Out of rown ttansporudon ....................... i_, i i SUB•70TAL OP AUiOMOTJVe EQUIPMENT.......... A3 i TOTAL OP PROPES910NAL SERYfCHS, -" -- - ~ PACILITIE9 AND AUTOiHOTfVB~ EQUIPMENT ........:................ ..........-Ail z B. C1LUlGE POR MERCHAND198 SELECrEDr ~. .Casket .......,,. y'~' ..................». - . r} 15 (Deulptlon) ,l `~(0 A Ifu -~L~t_.hL'-./' Other Rtxepmrle ............:......................:.. { . OtherburialmntaMer ..........:...»...............5 . iDesedotlon OTHER i i „y { - 70TAL MEACHANDISH SHLHCTED ......................... B i ~ ~+ C. SPECIAL CHARGES: Forwaiding of rcmatna so S (Puncd Home) Receiving of rcmabu from i (Funeral Home) lmmedlateBurlal ..............».......»............., f Direct Cremation ............:.......................... S i BUBTOTAL OP SPECLU. CHARGES ........ ......... ....... C i D,CASH ADVANCED ~.. OpeningGrave ...................:.:..................... S ~p Cemetery Equipment .............»................. J Int and Deed ...................................... : w a dtts-lo ~~ ); ~: N erN { + f~o • p . . . e sp o ~ D ~5 / NewapsperNotce--Outaftown......:.. '~' '" Telephone&Telegrams..».,» .........:.......... i Aldarc ...... ..... .. S l9~ Clergy/Mau Offertttg~ ..,..:. ...:..: i ! (_ /lJ 'PaBbcaten ...... ... ................. i r _ Cued Gopie of the Deth ~,/ e~ Fbwcrs .............................:......:.................: i Vault Service Charge .................................. 3 Cemetery Rmd Pee ................................... S Hahdreuer ................................................ J i f r7 i i SUBTOTAL OP ADVANCES ..........:............................ D i_ 1. C ?_L We charge you for our service In obuloing; (spacUy crib adtanr;es tbar are marked-up) sue, SUMMARYOFCHARGES A Professional Service, PacElUa and Equipment, and AutomaUve ~~ ~ %~ `-- Equlpment .................................................. S_~ ,~ B. Merchandise ............................................... J.,f__ ~ C. Sp4riai Chuge . i. r cc~-) d _ t,/ •~ ,., t;~) D. Cash Adv+nces :..,..,.. .:.;....:, i" r r. t ~ r~LG' ~1. TOTAL OP ALL SECTIONS ................................... i • ~ PAID AT TIME OP OR PRIOR TO ~ 1 .__...__.._--. ~ ' 4 n d,~~-.. ~_.- ~ .N O O I ~ V R U V O v y ~ i m 5 ?. $ c Y o °~ ~ '~ ~~~ $ F o ~ , :? d G ~~ ~ ~1.; ~ ~ ^ O ~~ ij ~ t 11 q ~~ S ~ P ~ N S v 'O ~' ~1 ~ `r/ 'S j 1 `~ v v c ,/ m ~ `~ a o c /~ 4 1 ) ) 1.~~ `\ O f . C A 'O N V h,_/ y d t ~ A ~ Y L C1 0. 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N g d " a ~a3 ~ pW,~ ~+ w m ~_ y o-. ~% 'y 'ob o r- V~ ~ e, v' ~ ,~ o "` a Q ~ v' Ca O t`tW~. p. ~ ~y m m ' ~ p, ~ ~C A ~. W o ~ z t7 ~ \\'i `~~ m ~i o Qz'~~y' ~ ri .gyp i^" ~ e) G ~ ~ a ~~~ ,rte, ~ ~ ° c ~'g`~' 0 o s w d W~ ~ y 9 R~ °b. g c °p~ •. A F _ C,~ ~ °r~' v ~ xn 5 ~ ~ ya U~ ~ S F. ~'~Fa ~ Fi ~ v a> ~ o ~ 9 °~ rh " ~ m $ PG ~ w .n o H w ~ ft ~ v G G' fJ- v- ~., ~ E ''o+ 'ob '~ ~ a ~ o ae °' ~ u Q fi ~'d CWJ 'L Q N F o d °d d ~ v .~- o H g K ~':'+ v c~' c ~{, _ r ~ ~% ~ d ~QF+' oO ~~ ~ ~ "o o F c ~ ~i ~ ~ 7 ,`~ ~ ~`" g c tl ~ 3 m '.~ ~ Q ~ (s~ c~ H~7, ~ ~ d ba ~ ° ~ y y a y X'd ~ a ~c c E '~ r~ ~~ o .5 0 ~ o c~ 6p't~~. d ~y o r, ~m ~, ~6 ya d ~L ~~ ~, ~ `v ~m > ~ 9 W d ~ OU'+ "' d r dam' ~ J ~ G ? ~ e ~ 'F. h` ~ ac 5 '7 ~°w~WO ~ `'~ °' 6 > ° "~ °' W ea O ~ m 3 ~ ~ O ~, C F '~ a ~.'' er' °~ A 9 ~+ `~ 'C ~ami .TO a+l~ " ~ .~ p E a ~ " j a .C,~ °~ 6+r ~ ~ U ~ '~, ~ 3~ Y° R E~~'+ G ~ V... d ~ "0. U~J .y yFy N ~typ _ y ~~ W N~ A ~ O O G H F ~p V W R-' Y Y iU N S+ Y .~ {L ~ ~ T U¢ C ~ ~ p m ~ou o E ~ w W ~ W ~ ~ v ~ ~ o ~ b ~ vi, o ~i ~ ~ ~ 2 ~' y C' ~ ~! .~ d r U ~ T~ y C7 ~ r O .+ ~ 'N ~ ~ i~ ,, s G ? ~ ~' Ui Y W v°~i °v d V1 d ~ d Q 6 '~ " i ~ "' ~~~ .j o'3 aJ rYU ~~~~pp d a Z. R, o C~ Cdr ~ W~ ZU _.." - ti 7 s N~ x O `-"` f ~~= ON - --__" z v j r M Williamnm R. Kau//~~fman ,~fEforney at daw 940 Century Drive Mechanicsburg, PA 17055 717-766-7702 Fax: 717-790-9031 Email: wrkaufman.wrklaw@comcast.net June 2, 2008 Mr. and Mrs. Bruce Walton, Co-Executors 14645 Black Beaz Road Palm Beach Gardens, FL 33418 ---. Re: Estate of Philip K. Wazd, deceased 4/15/2008 2.25 Initial meeting with clients to discuss matters related to 4/18!2008 0.50 administering the estate, including related meeting 4/28/2008 0.25 preparation and review of file; preparation of Petition for 4/29/2008 0.25 Grant of Letters Testimentary and Estate Information 4/30/2008 1.00 Sheet for clients to submit to Register of Wills and 5!612008 0.25 calculation of related Fee; for preparation and processing 5/8/2008 0.75 of request for estate tax identification number, estate advertisements, Estate Recovery request, notices to beneficiazies, and Certification of Notice For Register of Wills. Hours 4.25 Hours Billed Fee 5/9/2008 5.50 Meeting with executors, conducting safe deposit box 5/12/2008 0.25 inventory at PNC Bank, appearance with client at Cumberland County Courthouse to obtain letters testimentary, completion of initial estate documents as required, and preparation of correspondence requesting date of death values and other information from E*TRADE and Vangaurd accounts 5.75 Hours Fee $ 722.50 977.50 M + , a Mr. and Mrs. Bruce Walton, Co-Executors June 2, 2008 Page -2- 5/16/2008 0.50 Ongoing communication with executors, including 5/21/2008 0.75 forwarding correspondence received to executors, and 5/27/2008 0.50 review of documents and coaespondence received from 5/28/2008 0.50 executors; and closing safe deposit box accommt with PNC Bank 2.25 Hours Fee 382.50 Total Fees $ 2,082.50 Less, amount paid from client's retainer account (352.85) Balance due 1.729.65 William R. Kaufman ~9tto.ney ~ oCa~, 940 Century Drive Mechanicsburg, PA 17055 717-766-7702 Fax: 717-790-9031 Email: wxkauEman.wxklaw@comcast.net August 1, 2008 Mr. and Mrs. Bruce Walton, Co-Executors 14645 Black Bear Road Palm Beach Gardens, FL 33418 FOR PROFESSIONAL SERVICES RENDERED 6/10/2008 3.25 Review and accumulation of estate expenditures; 6/11/2008 0.25 completion of required Vanguard IRA Adoption 6/18/2008 0.25 Agreements and Distribution Requests and accompanying instruction letter to beneficiazies and separate letter discussing income tax effects of IRA distributions, both dated June 10, 2008 7/8/2008 2.00 Calculate prepayment of estimated inheritance tax 7/9/2008 0.50 prepayment, including related consultation and follow-up with executors regarding assumptions used, and of a source of funds for tax payment 6.2.5 Hours Fee $ 1.062•~Q } WilliamAm R. Kau//l1fman .~dffornay at daw 940 Century Drive Mechanicsburg, PA 17055 717-7G6-7702 Fax: 717-790-9031 Email: wrkaufman.wrklaw@comcast.net August 29, 2008 Mr. and Mrs. Bruce Walton, Co-Executors 14645 Black Bear Road Palm Beach Gardens, FL 33418 Re: Estate of Philip K. Ward, deceased 8/5/2008 1.00 Preparation of deed, authorization to represent client at 8/6/2008 0.25 settlement, and letter to settlement agent concerning 8/7/2008 0.50 estate tax status; related consultation with, and 8/8/2008 0.50 instructions to, client regarding execution of documents 8/19/2008 0.75 in advance of settlement; review of Form HUD-l, 8/27/2008 1.00 including related consultation with client; and attendance 8/29/2008 0.50 at August 29, 2008 closing 4.50 Hours Billed Fee William R. Kaufman ~9tr~.,~y at e('aw 940 Century Drive Mechanicsburg, PA 17055 717-766-7702 Fax: 717-790-9031 Email: wxkaufman.wrklaw@comcast.net March 13, 2009 Mr. and Mrs. Bruce Walton, Co-Executors 14645 Black Bear Road Palm Beach Gardens, FL 33418 Re: Estate of Philip K. Ward, deceased Fee for preparation of Pennsylvania Inheritance Tax Return (14.5 hours) $2,465 Less: Courtesy discount -465 $2,000 Estimate of fees to draft estate closing documents and finalize estate 400 Fee charged 40 DONALD L. DEMUTH PROFESSIONAL MANAGEMENT CONSULTANTS 990 CENTUBY DRIVE MECHANICSBURG, PA 17055 (717) 790.9001 FAX: (717) 790.9051 DONALD L. DeMUTH, C.H.B.C., M.B.A., C.P.A./P.ES./A.B.V. WILLIAM R. IIAUFMAN, C.P.A., J.D. February 26, 2009 Estate of Philip Wazd Mr. and Mrs. Bruce C. Walton 14645 Black Bear Road Palm Beach Gazdens, FL 33418 Fee for Prepazation of 2008 Personal Income Tax Returns 2 0 .~ DONALD L. DEMUTH PROFESSIONAL MANAGEMENT CONSULTANTS 990 CENTURY DRIVE MECHANICSBURG, PA 17055 (717)790.9001 FAX: (717) 790.9081 DONALD L. DeMUTH, C.H.B.C., M.B.A., C.P.A./P.FS./A.B.V. WILLIAM R. KAUFMAN, C.P.A., ].D. March 3, 2009 Estate of Philip Wazd Mr. and Mrs. Bruce C. Walton 14645 Black Beaz Road Palm Beach Gazdens, FL 33418 Re: Philip K. Ward Estate Fee for Preparation of 2008 Income Tax Return for Estates and Trusts: 65 -~ Tl~e Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8292 WILLIAM R. KAUFMAN ATTORNEY AT LAW 940 CENTURY DRIVE MECHANICSBURG PA 17055 c~he~latriot~~ews Now you know THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Joseph A. Dennison, being duly sworn according to law, deposes and says: That he is the Assistant Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the date(s) indicated below. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COPY This ad # 0007851430 ran on the dates shown below: May 74, 2008 May 21, 2008 MM May 28, 2008 ~J ~~ worn to and subscribed before me this 28 d May, 2008 A. D. ~~ Notary Pu li COMMONWEALTH OF PENNSYLVANIA Notarial Seal Chyle L. Sheppard, Notary Public City OI Harrisburg, Dauphin County My Commission Expires May 29, 2010 Member, Pennsylvania Association of Notaries The Patriot-News Co. ~~ 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8292 WILLIAM R. KAUFMAN ATTORNEY AT LAW 940 CENTURY DRIVE MECHANICSBURG c~he atriot~~ews Now you know PA 17055 INVOICE ALL CHARGES ARE NET ACCT# NAME AD ORDER # DATE EDITION ADDTL. INFO. TYPE OF CHARGE AMOUNT 93620 WILLIAM R. KAUFMAN 93620 WILLIAM R. KAUFMAN 93620 WILLIAM R. KAUFMAN 93620 WILLIAM R. KAUFMAN 0001851430 05/14/08 REGULAR 0001851430 05/74/08 REGULAR 0001851430 05/21!08 REGULAR 0007851430 05/28/08 REGULAR TOTAL: REMITTANCE ADDRESS The Patriot-News Co. 23794 Network PL Chicago, IL 60673-1237 Please include the Account # or Ad Order # (above) with your remittance--Thank You BOLD TEXT CHARGE $4.00 BASIC AD CHARGE $71.05 BASK AD CHARGE $71.05 BASIC AD CHARGE $71.05 AFFIDAVIT CHARGE $5.00 $222.15 NOTE: This Invoice replaces the Order Confirmation which we previously sent with Proofs of Publication CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 June 6, 2008 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: William R. Kaufman, Esquire Philip K. Ward Estate RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: May 23, May 30, and June 6, 2008 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 75.00 Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Cazlisle in the County and State aforesaid, was established Januazy 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: Mav 23, Mav 30, and June 6, 2008 Affiant filrther deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the Foregoing statements as to time, place and character of publication are true. ~~ ~ ~ isa aria Coyne, Editor SWO TO AND SUBSCRIBED before me this 6_day of June, 2008 Ward, Philip K., decd. Late of Cumberland County. LQ/ Co-Executors: Bruce C. Walton NOtar and Leslie W. Walton c/o William y R. Kaufman, Esquire, 940 Cen- tury Drive, Mechanicsburg, PA 17055-4376. Attorney: William R. Kaufman, Esquire, 940 Century Drive, Me- NOTARL4L SEAL chanicsburg, PA 17055-4376. DEBORAH A COLLINS Notary public CARLISLE BORO, CUMBERL4ND COUNTY My Commission Ezplres Apr 28, 2010 189468 lNVO1CE SOL TO ~ O ~ ~ ( ~ ~ i SHIP TO ADDRESSG ~ ~ v I ~ ~ ~ ADDRESS CITY, STATE, IP CITY, STATE, ZIP CUSTOMER ORDER NO. 2 SO D BY ~e~ ~~ c TERMS our Cows e a FO.B. DATE lvz-ate ORDERED SHIPPED DESCRIPTION PRICE UNIT AMOUNT ~~60;Oo ~ /~ `0; b~ 'P ~ s-P 1 ~ovov .e.mr 5840 r ~ CeM\/~I,A V WAf1AC9I 1t1~l7eV H9ajdS r~ ... 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Z0 ~7tld -~~. latlWL'ad21H'J HJ3V ~~LEBZ5L6LTL 95~ET 800Z/4T/50 f t Jerry's Carwash Wexford 1`,150 Perry Hwy. 724-935-3380 Car# 273 Sale# 9305471129? 05/24/2008, 12:16 PM C# 2501, Sh# 1 WashCashiert 1 Jerry's..Special 22.53 1 Air Fresheners 1.98 1 Novelty 6.99 Subtota 1 31 50 Tax T 33.7 Cas 40.00 ange -- ------ 6.30 -------------- - --------------- Your wash service advisor +.~ias Gross,Saan #2368. Jerry's Carwash Check us out on the web! www.JerrYSCarwash.com } PHILIP K. WARD ESTATE REV-1500 File Number: 21-08-00520 Continuation Page 1, Schedule H -Travel Expenses-Co-Executors Apri114-17, 2008 Initial gathering of decedent's possessions, initial meeting with attorney, and initial analysis of needed repairs and maintenance on decedent's residence Airfaze $ 632.00 Rental car 282.33 Gasoline-rental car 38.66 Caz service and cab faze 256.90 Total $1,209.89 May 8-12, 2008 Meetings with attorney, obtaining Grant of Letters Testamentary and addressing vazious other estate administrative matters, contracting with realtor and other service providers for clean-up and repair of decedent's residence and further gathering of decedent's possessions and papers Airfare $1,227.00 PA Turnpike tolls 11.50 Rental caz 731.18 Meals 12.80 35.31 16.72 17.86 Airport parking, Palm Beach, FL 44.00 Gasoline 57.01 Total $2,153.38 Grand Total 3.363.27 l~Ianage Reservation a ll'~ ,f'l..L~VY~i~ Confirmation 691HDW Date Issued 4/29/2008 Form of Payment American Express ""-""-`""-2008 Grand TOtal $1,227.00 Unflown Value $1,227.00 Passenger Information Parly of (2) Dividend Miles # Ticket # BRUCEC WALTON 1693606 03721697989796 LESLIE WALTON 2J348H0 03727697989811 If you have selected an exit row, please view Emergency exit row/Airport check in kiosk notice Contact Information Contact Name Day Phone Destination Phone BRUCEG WALTGN (567} 70i-84['7 Page 1 of 2 Seals 10F, 15F, 12F, 11A 10E, 16F, 12E, 1l8 Depart V Arrive Flight # and Details 7:10 PM 08 May 2008 9:07 PM 08 May 2008 Flight: 770 Boeing 737-300 Meal: None West Palm Beach, FL Charlotte, NC Class: Coach -Time: 80-90% O n Travel Time: 1 h 57 m 10:20 PM OB May 2008 11:54 PM OS May 2008 Flight: 2696 ~- , r M Canadair Regional Jet 900 Meal: None Charlotte, NC Harrisburg, PA Class: Coach On-Time: 90-100% Travel Time: t h 34 m 3:40 PM 11 May 2008 5:10 PM 11 May 2008 Flight: 1683 Boeing 737-400 Meal: None Pittsburgh, PA Charlotte, NC Class: Coach On-Time: 80-90% Travel Time: 1 h 30 m 6:10 PM 11 May 2008 8:03 PM 77 May 2008 Flight: 1823 Boeing 737-400 Meal: None anotte, NC C h West Palm Beach, FL Class: Coach On-Time: 70-80% Travel Time: 1 h 53 m ~ - e M Flight operated by Mesa Airlines doing business as US Airways Express Summary (2 Passengers) Base Fare $1,071.62 Taxes and Fees $155.38 Grand Total $1,227.00 Terms and Conditions • Ticket is non-transferable. • Ticket isnon-refundable. • Unused tickets must be cancelled by midnight on the date of departure to retain value. • Any change to this reservation, including flights, dates, or cities, is subject to a fee per passenger. The new itinerary will be priced at the lowost avslabb pubbsh~d fare at the time of change, which may rasu!t ir. ware increase. • Mesa Airlines will operate one or more Flights in this itinerary. • Due to smaller-sized overhead compartments on our Express aircraft, carry-on bag size is limited to the following dimensions for these flights: 19"x15"x11". • Ticket expires one year from original date of Issue. Unflown value expires one year from original date of issue. • Changes to the country of origin are not permitted, except for changes between the United States and U.S. territories. Travel Tips January 23, 2007: All U.S. citizens (including infants and children) must have a valid passport to travel to and from Bermuda, Canada, Mexico, Central and South America, and the Caribbean (excluding Puerto Rlco and the U.S. Virgin Islands). You need a valid passport to re-enter the U.S. This policy also applies to foreign nationals of Canada, Bermuda and Mexico. International travel Required documents and helpful information on international travel. Carry-on update http://www.usairways.comlawe/managereservation/Printmanagereservation.aspx?print= l 5/612008 American Express/Cards/Cazds Registered with American Express Online Services 0.5/052008 ~ US AIRWAYS PHOENIX AZ 18]00'. TKt#03]2169]989]905105 Rafererwe No: 80020060505 '. More Detail ''.OSIp52006 ~ US AIRWAYS PHOENIX AZ 16200 ' TKT# 03]2189]98981 0&05 Referenm No: 60020080565 More Detail 04/292008 Q US AIRWAYS PHOEND(AZ 446.50 TKT# 03]2189301409 0429 '.. Reference Na: 60020080429 Mote Detail .04292008 Q US AIRWAYS PHOENIX AZ 44850 TKi# 03]2189301411 0429 Relarewe NO: 60020060429 More Detail / ~~ Page 1 of 1 https://www99.americanexpress.com/myca/estatement/us/action?request type=authreg_St... 5/ 13/2008 Y s PENNA TURN=:t. COMM FARE RECEIPT PLAZA 039,:;1 6U7LE9 VAL,- DATE TIME '~OLL IRAN EN TAY J5i10/08 i8:15 2843 2526 23fi/P LANE ~L AS; rP Uu" °A:D 04 ~A $1:.50 Por E-ZPass, call 1-877-736-6727 I~QnfC~~ CGS' ~ S I. ~Q C-GS ?. NATIONAL ?,CAR RENTAL RA 61A955604. Ihv 660727954x#2 Rental 69=¢1AAY-2008 12:16. RN HAR0.ISBURG ARPti Return 11 -2008 92:19 PN PI'tTSBURGN A , BRUCE C WALTON __ Vehtele 11`„88302374 r~a, '' Nodal tSRD CA0.4YAN, .. ttasa Ari~`„+ NV¢R LtasB titwMged FCAR L;cansat BCP4398 `StataJProvince VA N!l6n6 Drivgn 302 ~ M/IHm Outi i ?;8686,: , . M/%MS In 18468", Sharges '; No Unit ~ Prig, Amotmt Ts B:;M ;; 3 goy; 199.08'sa:. 597.0@ UNL~M MF0.tt ^+@ M/Xns 0.00+ DSCNT 'fG~,M 5.00K ~', ~~-29-65+' ` GPS, NAVYGA 3 Days:: -:: 10.99 32.97... CFL' 3.01/DAY 9.68 AYRpOR~;USE FEL~< ~ 6d,@11~ YEN CLE~ F.NN~AL T7itt 2 PCT 13.26 ~'Lp E~1 REt~3'AE-IAX 6.60 ,' SAlI:, ""~A7C'. .600 sV 39.79 T i Ta1:at C~M ~ U56 731.18 ~;~~ ,x i7&ld BY AMAX .2008 . -731.18- Mig4rN Duc USD 0.00 • 1'g8able. I,~tams 5ubjatt tip /audit Your Emerald Club N ~ er is 410311705 Ep~erald CYub reMaledics,will be postedw(}hin 24 hours; a,We hope~!ggu en'ogad driving your rpd"ed"Emerc~d Club vehicia. tamer serviceaunbar ]:-80B-4fi8-3334 ~ . ~-- SSP America SAM ADAMS PIT AIRPORT, PA (412) 472-3030 ~_ O -~ C] I ~ 1 r C7 m O I I ~, S r 3 _ N i~ l -~ a m 3 I I W .-O c'Jam C]C~a~o n I ~ 1 r _ rcnz SfL 3D C C 1 l a O -1 m -1 a 41 O X Q] m I M i p- -i ' l7 (n -1 Z T C -i i l ~~ ti C C7- 2 L1 Z O 3 1 I O m _ UJ O b m -I --i m i 3 1£ -y ZC"") Z a O I D I d O-O O -1 O T. r I K I< O h-i - 3 DZ I ~ I ~. C ZS mC~C]K 1 --+ 1 L70~ -Imo I - 1 r o rt~ ~c I o I aox x~l Z- 1 m 1 cn rno 3 O C/J t r U. VJ i S 1 I H a ---1 S 1 O 3- f 1 fJl I Z -i O W ~9 VJ 1 -- 1 -1 O Cn (Jl 2 O i A I - -1 CD D O CJ I r 1 C C7 i _O I i]Am-1 ' 1 3 1 a 3 ~ '-1 - - - - I I ~J Ol I--I N O O m O CD 1 GJ I -O O O O N m O D 1 CA t O o a I ti t ~ ~ f~ \ 1 1 ti •J 1 N I ~~ ~~~ w ~ ~„ ~- C P ~( A S P, P GINGERBREAD MAN CARLISLE CHAkLOTTE DOUGLAS INT'L AIRPORT Dinira3Rest jCheck Tab Cov Server Time Date 8103 A Ih E L E W O R 115579 8 3 12 1:58:59 PM 5/9/2008 - - - - - ~ - ~ - - - - - - - - - - - - - - - - - - -1--------------------------------- --- ' 1 5033 MAY11'08 5:18PM GST fAIEST#1 it Italiano 1 MUSH PEP SSG PZZ 7.99 ~1 Tuna/Prov. Grind DDNT MAI(E FOOD ! Seasoned Fries 1 BOTTLED .SODA Z.u9 '1 Hot Sausage 1 SNAPPLE 2.59 ;3 Pepsi Cash i-4.00 ' Subtatal 12.67 I Food Sub-"total SUB TOTAL T a x 1 .0 5 ~ SALES TAX 29 Michael ----------------------------------- Chk 2470 Maytt'08 02:54PM ------------------------------ Eat In 1 Ginger Ale 1.! 1 Chili 4.~ 1 Long Island 6. TELL US ABOUT US! For feedback or comments: Call 1-866-663-9586 Subtotal Tax 02:54PM Total 13. 1. 14.8 TELL US ABOUT U5! For feedback or comments: Call 1-866-663-9586 Amt Patd 1 ~ 7.2 C h a n g e O u e 0 .28 -j-+ --------- THANK YOU, HMSHOST _-- i..~NECK COMMENTS, CONCERNS,OFt,QUES?ION! PLEASE CONTAET 704-35.9--4316 7(_-------- CLTCUSTO!'I R#HMSHO~ i . COM TLtnNK ,~~~et5~,i~$el4fiilt.r•. .~t:~~~ aura ~.OrJ' ~i~ 8.50 6.95 i.00 5.95 5.25 27.65 27.65 1.66 Tf'r4L YOU 29.31 - ~ ~~l PLEASE HELP US SERVE YOU BETTER 3 Q ~ ./ CIRCLE YOUR RESPONSE FOOD QUALITY SUPERB AVERAGE POOR SERVICE SUPERB AVERAGE POOR ~O' ~ ATMOSPHERE SUPERB AVERAGE POOR i Palm Beach Intl Airport 1000 PBIA, Unit 104 West Palm Beach, FL 33406 (561) 471-7459 x~ww.pbiaorg RECEIPT ~~ IRAN IN TIME OUT TIME FEE CC# X459 05108 17:Z5 05/11 Z0: 03 X44.00 1006 r Dpening/GosingDate: Payment Due Date: 05/08/08-06/03!08 l)6/2 CUSTOMER SERVICE Minimum Payment Due: 8I08 $10_(10 In U.S 1-800-4A6-81 Eapairol i-8o0.5pp.pg TD[) .1-300.95580 P9Y by phone 1-800-49879 Qateld0 U,S. Cafi COIIeDC ~UNTSUMMARY Axonntnumas:42x7sstoz647asate 1.480~9607t '~ ?$8868 Total Credit L"me $8(10 ACCOUNTIN<IUIRIES ~fLClivNta --$98.66 AvafieWaCrediC P.D.SmcA5298 seen. CaeIL Debits :. J9 Caelt Access lJms - ~~ Wilmington, DE 19860.6298 New Belarrce $'91:39 ". Available for Cash $240 PAYMENT ADDRE88 q P.O. Soz94012 ~. ~ ~2,.U..p Palafine,iL ti0094-4012 VISIT US AT: ~~~J ~ www CI18A. a comlbo. $P REBATES SUMMARY Remember,,.every firne you eam $26In rebates;: Previous rebeteB balance - -- ---- RemeiNn9 rebe6se be(erwa $S.Sp Ywr're eligible for a $25 9P GIR Caal or a $25 - ~.t9 Rebatasdue Wexgre,t?72009 _--. $3.30 check)-. rRANSaenoNs Trans - -. Amount Date Reference Number Merdrant Name or Transaction Daecdptbn ~ Credit OfiY1134806378t P07964311 OPOUS PA .Ot(-" (16:4) 'SELFSERVICEREGULARUNLEADE _$1i7A1 Ofi1261148148Q.9000004480113t4 Pavment Thank You Ekictmnic Chk 33;~ Ofi/0334905B78t68000402102029 BP 06(199620 > ROMULUS MI '. - - 34.93{x` (7:9} SELF-SERVICE REGULAR UNLEADE $34.38 FINANCE CHARGES - Flnarroe Charge Daily Poriodic Rate. Corteap. Avem ~ Defy Due To Tmnsaofion Accumulated FlNAtJCE. Category 91 da sin y cycle APR Balance Perbdic'Rate Fee Fin Charge CHARGES Purchases ~ V .06/61°. 20:98% $0.00 $0.00 $0.00 $0.00 $O.OD Ceah advances V .06847% .24:98% $0.00 $0:00 $0.00 $0.00 $0.00 Total finance charges $0.00 _..E1txUw.Annwl,PeraanhpsRa6e(AIBR): _.._..0.00%. _. _. _. _.. __.. .. _.. Please nee Informaton About Your Armtmt section for balance computation method, grace period, and o3ter important information. The Coneaporrdirtg APR is the rata of vtterest you Pax when you carry a balance on any iraneaofion category. The Effecfive APfi~representa your total flrerrce cheiges - indud'mg bensaofion fees - auch as cash advance and balance 6anaferfees - eXpreseed as a pemerttage. IMPORTANT NEWS Join BP MororClub for $1 For the first month Second Iroueehold member covered at no additional cost 24 hour roadafde assistance. Up to 100 towing miles Call i-BOo-917-7298 or vis(t www.bpmotorclub.com -, 0' W1001c FlS3~Y~18o D^len 000 N Z 09 OBABroe Peye t of 1 Op2B1 Mq Mq 43804 16piW0a1 t0IZA38YgOt ~~ } 0800111167 PA-40 - 2008 Pennsylvania Income Tax Return ENTER ONE LETTER OR NUMBER IN EACH BOX. Do Not Use Your PrepHnted Label 171364657 WARD PHILIP K occupation PRINTER OP Occupation 14645 BLACK BEAR ROAD PALM BEACH GARDENS FL 33418 21900 N Extension. N Amended Return. R Residency Status. PA Resident/Nonresident/Part-Year Resident from to D Single/Married, Filing Jointly/Married, Filing Separately/Final Return/Deceased Date of death 41408 N Farmers. School District Name WEST S H O R E 1 a Gross Compensation. Do not include exempt income, such as combat See St 1 zone pay and qualifying retirement benefits. See the instructions. 1 b Unreimbursed Employee Business Expenses. 1 c Net Compensation. Subtract Line 1 b from Line la. 2 Interest Income. Complete PA Schedule A if required. 3 Dividend and Capital Gains Distrihutions Income. Complete PA Schedule B if required. 4 Net Income or Loss from the Operation of a Business, Profession, or Farm. 5 Net Gain or Loss from the Sale, Exchange, or Disposition of Property. 6 Net Income or Loss from Rents, Royalties, Patents, or Copyrights. 7 Estate or Trust Income. Complete and submit PA Schedule J. 8 Gambling and Lottery Winnings. Complete and submit PA Schedule T. 9 Total PA Taxable Income. Add only the positive income amounts from Lines 1c, 2, 3, 4, 5, 6, 7, and 8. DO NOT ADD any losses reported on Lines 4, 5, or 6. 10 Other Deductions. Enter the appropriate code for the type of deduction. N See the instructions for additional information. 11 Adjusted PA Taxable Income. Subtract Line 10 from Line 9. PAIA0612L 11I06/0e EC Page 1 of 2 FC 1a 10312 1b o 1c 10312 2 0 3 285 4 0 5 -27 6 0 7 0 8 0 9 10597 10 0 11 10597 0800111167 m m 0800111167 J PA-40 - 2008 Social Security Number 080211161 171364657 Name(s)WARDT PHILIP K 12 PA Tax Liability. Multiply Line 11 by 3.07 percent (0.0307). 13 Total PA Tax Withheld. See the instructions. 14 Credit from your 2007 PA Income Tax return. 15 2008 Estimated Installment Payments. 16 2008 Extension Payment. 17 Nonresident Tax Withheld from your PA Schedule(s) NRK-1. (Nonresidents only) 18 Total Estimated Payments and Credits. Add Lines 14, 15, 16, and 17. Tax Forgiveness Credit. Submit PA Schedule SP. 19a Filing Status: 01 Unmarried or Separated 02 Married 03 Deceased 19b Dependents, Part B, Line 2, PA Schedule SP 20 Total Eligibility Income from Part C, Line 11, PA Schedule SP. 21 Tax Forgiveness Credit from Parl D, Line 16, PA Schedule SP. 22 Resident Credit. Submit your PA Schedule(s) G-R with your PA Schedule(s) G-S, G-L and/or RK-1. 23 Total Other Credits. Submit your PA Schedule OC. 24 TOTAL PAYMENTS and CREDITS. Add Lines 13, 18, 21, 22, and 23. 25 TAX DUE. If Line 12 is more than Line 24, enter the difference here. 26 Penalties and Interest. See the instructions. Enter code: If including form REV-1630, mark the box. N 27 TOTAL PAYMENT. Add Lines 25 and 26. 28 OVERPAYMENT. If Line 24 is more than the total of Line 12 and Line 26, enter the difference here. The total of Lines 29 through 35 must equal Line 28. 29 Refund -Amount of Line 28 you want as a check mailed to you. Refund 30 Credit - Amouni of Line 28 you want as a credit to your 2009 estimated account. 31 Amount of Line 28 you want to donate to the Wild Resource Conservation Fund. 32 Amount of Line 28 you want to donate to the Military Family Relief Assistance Program. 33 Amount of Line 28 you want to donate to the Governor Robert P. Casey Memorial Organ and Tissue Donation Awareness Trust Fund. 34 Amount of Line 28 you want to donate to the Juvenile (type 1) Diabetes Cure Research Fund. 35 Amount of Line 28 you want to donate to the PA Breast Cancer Coalition's Breast and Cervical Cancer Research Fund. SignaturKa)• Untler penalties of perjury. I (we) declare that I ( h examined this return, including all accompanying schedules antl statemrents. antl t e b~~elief, they are true, correct, antl complete. Your Signature l ~ n se's nature, if filing jointly Preparer's Name and Telephone Number (717) 790-9001 William e. Kaufman CPA JD DeMuth Management Consultants 940 Century Dr Mechanicsburg, PA 170 0800211161 12 325 13 315 14 0 15 ~ 16 0 17 ~ 18 0 19a ~~ 19b 00 20 D 21 0 22 0 23 0 24 315 25 10 26 0 27 10 28 0 29 0 3D 0 31 0 32 0 33 0 34 0 35 ~ Firm EIN Pre arer's SSNIPTIN 232871292 208387696 P~e2of2 0800211161 J PAIA 2L 01 /30109 ~~ J 0801910027 PA SCHEDULE W-2S Wage Statement Summary of PA Taxable Name shown first on the PA-40 (it filing Icintly) Social Security Number (shown firsU PHILIP K WARD 171-36-4657 Use this schedule to list and calculate your total PA taxable compensation and PA tax withheld from all sources. Part A Instructions: List each Federal Form W-2 for you and your spouse, if married, received from your employer(s). In the first column enter T for the taxpayer's Social Security Number that appears first on the PA tax return and enter S for the second or spouse SSN. From the Forms W-2, enter each employer's Federal Employer Identification Number (EIN). Enter the amounts from the Forms W-2 in each column. IMPORTANT: You do not have to submit a copy of your Form W-2 if you earned all your income in Pennsylvania and your employer reported your PA wages correctly and withheld the correct amount of PA income tax. You must submit a copy of your Form W-2 in certain circumstances. See the PA Schedule W-2S instructions for a list of when a copy of a W-2 is required. Part B Instructions: List each source of income received during the taxable year on a form or statement other than a Federal Form W-2. Enter each payer's name. List the payment type that most closely describes the source of your non-employee compensation. Enter the amount of other compensation that you earned. If the form or statement does not have separately stated amounts, enter the amount shown in both Federal and PA columns. IMPORTANT: You must submit a copy of each form and statement that you list in Part B, whether or not the payer withheld any PA income tax and regardless of whether or not the income was taxable in PA. CAUTION: The federal and Pennsylvania (state) wages may be different in Part A and Part 8. If you need more space, you may photocopy this schedule or make your own schedules in this format. Part A -Federal Forms W-2 TIS Employer EIN from box b Federal wages from box 1 Medicare wages from box 5 PA compensation from box 16 PA income tax withheld from box 17 T 23-2367569 9,959. 10,272. 10 272. 315. Total Part A -Add the Penns Ivania columns 10, 272. 315 . Part B -Miscellaneous and Non-employee Compensation from Federal Forms 1099R, 1099MISC, and other statements YOU MUST SUBMIT COPIES OF EACH FORM OR STATEMENT LISTED IN THIS PART A Trs B Type C Payer name D IUAH CMB E Total federal amount F Adjusted plan basis G PA compensation H PA tax withheld Total Part B -Add the Penns Ivania columns 0 . 0 . TOTAL -Add the totals from Parts A and B 10, 272. 315 . Enter the TOTALS on your PA tax return on: Line to Line 13 Payment type: A Executor fee B Jury duty pay C Director's fee D Expert witness fee E Honorarium F Covenant not to compete G Damages or settlement for lost wages, other than personal injury H Other nonemployee compensation. Describe: Distribution from employer sponsored retirement, pension, or qualified deferred compensation plan J Distribution from IRA (Traditional or Roth) K Distribution from Life Insurance, Annuity or Endowment Contracts L Distribution from Charitable Gift Annuities L 0801910027 PAIA0601L nrz6ros 0801910027 J ,, , PA SCHEDULE D Sale, Exchange, or Disposition of Property PA-0e b r09A8I (D Name of ,he Idxpayer riling this schedule Social security Number (shown firsh PHILIP K WARD 171-36-4657 Important: Each spouse must file a separate PA Schedule D to report his or her sales. If selling jointly owned property, spouse must suhmit a separate PA Schedule D for only that property. A spouse may not offset his/her gains (losses) against the other spouse's gains (losses). If filing separately but selling jointly owned property, each spouse reports his/her share of the gain (loss) from the PA Schedule D for the joint sale. Taxpayers must each submit a copy of the 'joint' PA Schedule D. Read the instructions. Enter all sales, exchanges, or other dispositions of real or personal tangible and intangible properly, mcludmg inherited properly. Amounts from Federal Schedule D may not be correct far PA income tax purposes. Nonresidents should read carefully the instructions concerning intangihle property. If the result is a loss, check the box next to the line. 1 (a) Describe the property: 100 shares of XYZ stock, or 10 acres in Dauphin County (b) Date acquired: Mo/day/year (c) Date sold: Mo/day/year (d) Gross sales price less expenses of sale (e) Castor adjusted hasis of the property sold (f) Gain or loss: (d) minus (e) (iF a lass, check the box) 150 shs WASHINGTON M TUAL, IN L oss 12/13/07 1/22/08 1 945 2 350 L X 405 500 shs RITE AID CO L 12/20/07 1/31/08 1 426 1,485 L X 59 200 shs BON-TON STO S INC Ls 2/06/08 2/11/08 1,411 1,299 L 112 300 shs BON-TON STO S, INC 1/08/08 2/11/08 2,121 1 796 L 325 L L L L s s L S L L 2 Net gain (loss)from above sales .............................................................. ~X 2 2 7 3 Gain from installment sales from PA Schedule D-1 ..................... ............................. 3 4 Taxable distributions from C corporations ..... Enter total distribution Minus adjusted basis. = 4 LOSS 5 Net gain (loss) from the sale of 6-1-71 property from PA Schedule D-71 .......................... ~ 5 L F Net PAS rornoration and oartnershlo gain (loss? from your PA Schedule(s) RK-1 or NRK-1 ....... _.~ 6 TeXeble em trbm 5lllln a nnGl al re s,aenee. r,om fet e artu suumn rn a s rcumn v. eau, mm wmnin a a (a) (b) (c) ~~ (!) W Address of residence Date acquired: Date sold: Gross sales price Cost or adjusted basis Gain or loss: Mo/da /ear Mo/da /ear less ex enses of sale of the ope sold (d) minus e) 7 Taxable gain from the sale of your principal residence. If you realized a loss on the sale of your principal residence, enter a zero. If you realized again/loss on the sale of the nonresidential portion of your rinci al residence, enter the information on Line 7 .................... ... ........... ...... ....... .... 7 8 Taxable distributions from artnershi s from REV-999 PT ............................................. 8 9 Taxable distributions from PA S cor orations from REV-998 PT . .................... ................... 9 10 Taxable ain from ezchan a of insurance contracts ................................................... 10 Lo 11 Total PA taxable gain (loss). Add Lines 2 through 10. Enter on Line 5 of your PA-40. (Ifa net loss. check the hox) ............................................. .. ........................... X 11 2 7 USE ONLV 0801310020 20~$ 0801310020 PAIA0501L ,o,z,roa 0801310D20 J 2008 Pennsylvania Statements Page 1 PHILIP K WARD Statement 1 Form PA-40, Line 1a Gross Compensation 171.36-4657 E-TRADE -PAYMENTS IN LIEU OF DIVIDENDS .............................................. $ 40. Wages, Salaries, Tips ............................................................... ..... ... 10, 272. Total $ 10,312. ! k I ??. ] l2 j l r ~P~b RIP 10 F~~~NSACUON PAYMEM/ l / BALANCE ~~': OEDR V IIF ANYI OEPW;T1CREDR ISM t ~: q. 9 -l R5 519~ PPL . $ 3Of _ i3 /s s 1,.791. ~9 n ' 97 5-~ ~ L,esl,e ~A/al 1-on / a~ ~~ ~~ i '- 9~ s-a1 _ o,~cr-cft NoA ~ t 7a 60 i o0 /' aSyy ~~q ~ __ ~ p Ph ~I a v .~on2 /~ _ 1_- {l -,: L~ I 98 5-,~ Renodat~ons Co. Lnc. 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