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HomeMy WebLinkAbout04-08-09-~ R~''~u~~ ~ 0~1=1CE 0, yj 2~~9 APB -~ ~ PM i '3' - < OF GF<.i='~-~' " ~ COURT Cl" ' dJ CO., 'F~ ~~~ '~'- 4 d} ~P k{ ~ ? ~ ~ ~13~.~, ~'~ ~w ~ f t ,~ :'~ x i ~~~ ~'S { Y",:~ { .JY f ^e" u W - i ~'r ~ ~ I ~ t { ~.{ o ~_ ~~ o T~ ~ O cwn Q ~ ~~~r~' °o J ~ a N ~_ ~---__~ ~ ~ O cn o ~ ~ Q 2 W ~- o ~' LL ~ ~ ~ ~ CV ~ ~ ~ O o •^ } ~ N = Q p c~9 ~~~ ~ ~ ~ J ~ ~ M O ~` ~ ~_ r ~co V ~ U (A r a~N~." ~ n ~~~a N~o ~ ~' rn OQOC.= ~QcD-a> /A ~ ~ J 2 W H W ~ N LL. a ~~Op~ ~ ~ w ~ U Q o ~ ~ U r V a =gym .. ~ ~~~ O wiz ~ Q ~ ~ ~ U co ~ k~ k ~ ~ ~~ ~ s ~ ~ r;. '' T.~q k ~+ k •f ~6. '~ Y '~. ,~~ f~. .~ r ~ ; ~ M' '~~ 5, . / J ~ i 3 '- i T 1~ ~, ~ ~ ~~ ;Kra{~ ",~y~° k. ~ irk ~_{ f ~{,~ tK T ' - .4u1 Y~ ~ a4li .+ y , r i a t.:, ~ 4 Fµ ~ { ~ ~ ~ S -. W ~ ~ ~ Xk ~`I 5 A-S h~.~t7 f . f ' ~~ • ~ ~ , ~ ~} 1 1 xR ~ ,. r ' ~ Y. ~ R _..~ a ' ~ k ~ 'i 1 ~2 ~ a ~ ~ } ~ ~~rr sal q~ ~~ ~ ~ t {, ' $ ~ I ~~{ .~'P'. ,~ ~ ' ~' ~R ) li ~ p ,+ ~ ~ Y"S'_hT I ~1 ~j.'1fl a 4 ~ F ~ ~"~ ~ ~ ~: fi r"t ,~ ~, t ~~ ~ , ~ ~ L 1~ w Y ;T 3!,. ~~ ~" ~ ..~ ~; ~ ; t ~ ~ J, ;~ ,~, ~ ~ J .s', ~ } ~~ ~ ~ u ~, *„~ ! ~ • ~ -~ r~ ~ i ~ ..~~jjyy .. ~ ~ r .i 7. F (~'?" A .+~g r n $ ia tih~ •. ~x . V ~ ,~~ yl 3 F{¢ ~ f' ~ '~ ~ r ~ .~~ ~1 stt ~r~~ ~ i i. e ",1 R ~ w i :~ M ~ d7~1x' ~ 'y ~ ~0. 1{ ~( 'K Yk~~y t YYii11'''' '' ~ ~ . 1 c ]'+i~ ; r t _ + . y . . n ~ ,t~ ~, ~ 1 ~ y .. t arc? ;~, 2 Y ~ )}l; 0 ~ S ! ~ ~ h q~ t C I1 K ~ ~ j~.C ~ L' c } S~ l~ ~- , , x :} t '~ ~ s ~ n ~ w. < ~. < + 1 4 ~ Yy ~ ? ., ; h ~ ~~ y ! `~ ~ ~ 1•t ~ ' h a ~~ i r~ i~ s ` ~ ~ ~` ~ i ~ ? c [, ~a C Z ~" ,~ i:1'$K ~'~~: ~ r r.t~ . {{~~ .c.4 .f~ ~~~..~ .. CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M.HOUCK (1912- l 991) Apri17, 2009 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 TELEPHONE (777) 766-0209 FAX (717) 795-7473 Re: Estate of George E. Deardorff No. 21-08-0786 ` Dear Register of Wills: - Please find enclosed for filing 2 copies of the Inheritance Tax Return for the George E. Deardorff Estate as well as Check No. 9504 in the amount of $15.00 for the filing fee and Check No. 9505 in the amount of $2,436.75 for the Inheritance Tax due. Thank you for your kind attention to this matter. Very truly yours, ~sz~~ ~,~~~~~ Charles E. Shields, III Attorney-At-Law CES/mjj Enclosures ~_ c-~ c=- ~ ;; _~ ~. - -~~~ ~ `_ ,~ ' ~_ . ~~::~ i = ., _ - -~ -< 15056051047 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue ~- , " County Code Year File Number ~ Bureau of Individual Taxes PO BOX 280601 ~, ~, _ INHERITANCE TAX RETURN -7 T DECEDENT ~ ~ ~ ~ Q ° ~ Harrisburg, PA 17128-0601 ~- RESIDEN ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth o708,~008' 05~319~Y Decedent's Last Name Suffix Dece=dent's First Name MI ~~'!>~K~oi2~~ G'Eo.~~~ (If Applicable) Enter Surviving Spouse 's Information Below use's Last Name S po Suffix Spouse's First Name MI r ' N Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) 1 ~ 6. Decedent Died Testate 8. Total Number of Safe Deposit Boxes O 7. Decedent Maintained a Living Trust (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Cl-/~~L F5 E s~l.:E~.~S i~ l 7.1 7 7~ 6 ©~Zo 9 Firm Name (If Applicable) REGISTE~F--~411LLS USG~ONLY , ' ` Nl ~¢ -~ ._ ~_ ~ First line of address -'~ m t -~ .' - --,< ~~'~ '~ = -~` "`` __ r Second line of address ' ~ ~ / ~ ' S P .~.~ ATE FILED ~ City or Post Office tate ZI Code ~~Gy~ir//Csf3 ~fRG ~~4 /7o.SS~73S Correspondent's e-mail address: Cesh~ e~cJs3~ yet Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE O PERSON R~E+SPONSI LE FILING RETU N DATE x _~ / ~ ~ ~~6~05 ADDRESS L`tj~ ~+. ~E~~Da/ZF~ l~, (i]~r~c~:rta d-a ~ II 17r: UP - rn~ h nrr~burG - '~fl' l7aS~ SIGNATU F P ARER O~-IER TH d PRES-NTATI~ v D~~/~OC ADDRESS ~J-I2LES ~. SH/EL,ps ]T ~jLQ, - H ~S G o u Ser Road , f Y1 eC,1~1 GL n t c-5 btx r4 . Pf~4 t-7o ss PLEASE US'E ORIGINAL FORM ONLY 15056051047 Side 1 15056051047 1,5056052048 REV-1500 EX Decedents Name. ~EG~GF F ~E/~DO/eF~ RECAPITULATION 1. Real estate (Schedule A) . ............................................ 1. Decedent's Social Security Number ,D D 2. Stocks and Bonds (Schedule B) ..................................... .. 2 • ~ ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. ~' ~ 4. 9 9 ( ) ........................... Mort a es & Notes Receivable Schedule D 4. .. ~ ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... . 5. ` ~ 3 ~ ~ 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. ~ ~ 7 b • 7 '~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property - ~ '?' ~ °~ u ~ ~°' (Schedule G) O Separate Billing Requested...... .. 7. 7 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. - J 7 5 ~ ~~ . .3 U 9. Funeral Expenses &Administrative Costs (Schedule H) ................... 9 pZ ~ p ~ ~°D 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. I ~ ~ 3 ~ .? 11. Total Deductions (total Lines 9 & 10) ................................. .. 11 3 3 p ~ . y Z 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. ~ ~ 1 ~ ~ / b 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which a b an election to tax has not been made (Schedule J) ...................... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13} ...................... .. 14. L, .J T ,/ l 7 p C ~ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .O(Z ~ ~ 15. ~ © D 16. Amount of Line 14 taxable at lineal rate X .0~ S ~ ~ "- 1 l ~ 16. o~ 'r `~ ~ / ~v 7 17. Amount of Line 14 taxable ~ ~ ~ ~ at sibling rate X .12 17. 18. Amount of Line 14 taxable ~ ~ © ~' at collateral rate X .15 18. 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT a~36.~s O Side 2 1,5056052048 15056052048 RSV-1500 EX Page 3 File Number ~,~-~ ~% . 7~~ Decedent's Complete ~Oddress: Utl.tUtlV I J IVHtUIt ~~'ORG~ ~'. !~El~ie~a2FF STREET ADDRESS aioo sQE/vT ~~ /~cvv- ,~ viz CITY ~E~~ti~e s ~ ~~~ _ _ STATE ~~ ZIP _ ~ 7G~~ Tax Payments and Credits: ~, 1. Tax Due (Page 2 Line 19) (1) ~~ C~/3(o, 7S 2. Credits/Payments ~ A. Spousal Poverty Credit _ __ __ B. Prior Payments 0 C. Discount fj Total Credits (A + B + C) (2) Q 3. InterestlPenalty if applicable D. Interest ~ E. Penalty D Total Interest/Penalty (D + E) (3) Q 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) Q 5. If L ine 1 + Line 3 is greater than Line 2 enter the difference. This is the TAX DUE. (5) .'~~ y36~ 7~ A. Enter the interest on the tax due. (5A) ~ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~ ~~ y 36. 7S Make Check Payable fo: REGISTER OF VIi1LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ r~ d. receive the promise for life of either payments, benefits or care? ...................................................................... V 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? .............. ^ ~j 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ® ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent. or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent. except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX+ (6-98) } ~' S~1~E®ULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BON®S INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~1~74210D12 F ~! CSC--D(~C~E F~ FILE NUMBER o2/_~ c` 7c~ All property jointly-owned with right of survivorship must be disclosed on Schedule F. O 0 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 ~a><e, ~m8it ~X ~/N.YIID~, =}~rn Na.~ ~isfis ~sl~w,~ 6t ~o~Lt~YlDii 5~cll e>C GC-'lu^al f is bloc U.fi'~i fi'es (mrp. C(,t5 l ~ 370 550 105 clued ~~", z q, ~ 9 ~S, C~~rf ,~~ Nv. F'A~ Sl 9 / &` ~ . %Li.s ~sf~ck h/uS a/Cady ~a~~c/ ~Gy1~/ ~~eQ:fed ~ c%ce~ent oh a~ z, Zooz. See /e1~er ,~nH, /3a/Y f17e/%n c~l~ureou~ner ~r~.c~s -- o -- Q/f!lC~tEu~ ll~iY,~/• TOTAL (Also enter on line 2, Recapitulation) I ~ - O -- BNY Mellon Shareowner Services P.O. Box 358333 Pittsburgh, PA 15252-8333 August 29, 2008 CHARLES E. SHIELDS, III ATTORNEY AT LAW 6 CLOUSER ROAD MECHANICBURG, PA 17055 RE: GENERAL PUBLIC UTILITIES CORPORATION A/C - GEORGE E DEARDORFF Dear Mr. Shields: ~N~ M1wl;~l:~C~N SHAREtJWN~k SER111CE5 (Company Name ;Account Key f ;!Control Number ~ 200808180003140 ;Telephone Number j~800-522-6645 I~ Thank you for your inquiry requesting information for this account. According to the Financial Stock Guide, General Public Utilities Corporation had a name change to GPU, Inc. on 08/01/96. On 11/07/2001 GPU, Inc. merged into FirstEnergy Corporation at $36.50 per share held. Our records indicate that the above shareholder held 2 certificates @1 share each. Certificate # FA 519182 @ 1 shares, along with certificate #GPU 00277363 @ 1 share were surrendered for the cash exchange and was paid $73.00 on 10/02/02. To further research this matter please contact UPRR - Unclaimed Property Reporting & Reco~~ery as they processed the exchange. They are located at: 450 Seventh Avenue, Suite 1300 New York, NY 10123 1-800-895-4701 We hope that this information has been helpful. If you have additional questions, please call our Customer Service Center at the number listed above. Sincerely, Dennese Reddie-Fraser BNY Mellon Shareowner Services REV 1508E%+ ~1 ~97J SCHEDULE E 9 /~ COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8r MSC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER ~~~-r~~o I~ ~ ~ ~ Fore E ~: ai-a~- ~~~ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 ~/.oa 6~ L'o:as ~er i~r~ 2 D~ cS¢~ d~osif dok ,n/~.n{~~, ~•oo a• I ~~// roue ~x 6/e, G~'~~pirsse%aoa' a~ o? ~ra~^~S' I X30 , afl 3. 3 oaf ,So~r ~6 S o0 ~• d/q~ Cl~lair -re~~i~cr ~S~D • ~a ~' ~~, ¢ /DD, DO ~. ~' sLi i~? Gr/~t!/et /30,00 7 Lamp ~/S o0 lira/l ~~~ ~r ~QinP ~/ a, 0 0 00 TOTAL (Also enter on line 5, Recapitulation) $ ~~~ ~~REV~1509 EX ~ (197) ~6i SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ~~iQ-l2.OD~ F,C, GED.~pGE E. ~/-0 ~- 7~~ If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. Lo-J ~'. 7~F'A-~~~FF ADDRESS I~ wt/JD~nIG Ht(.~ D~2fvF MFCH/f/vlcSQu~2G, PA~ l7os-s RELATIONSHIP TO DECEDENT S® n/ B. C JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. ~1~~~1 CheckJn /fc~t /Iln. ~9/d ~'f cct .`Yl ~ T ~ ~ 61 n K ~See Va /u~~ Dh /e~c/' u~dcuq~ /~C~, ~~, / 9 2 - ~ ~ S7>/~o ~s, ~ 9(0 • ~/.? TOTAL (Also enter on line 6, Recapitulation) I $ J , D 9(P , ~'~ ~~ © M&T Bank 499 Mitchell Road, Millsboro, DE 19966 Mail Code D1/-MB-12 Charles E Shields III Attorney At Law 6 Clouser Road Mechanicsburg, Pennsylvania 17055 Rc: Estctie o f. George E Deardor Social Securih~: 196-I8-6762 Date o{Death: July O8, 2008 Phone (888) X02-4349 Fax (302)934-2955 August 4.2008 Dear Sir or Madam: Per your inquiry dated July 30, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type ofAccozrnt Checking Account Account Number 191624 Otinnershlp (Names oJJ George E Deardorff Opening Date Balance on Date of Death Accrued Interest Total Lon E Deardorff * 08/01/71 810,192.84 ~ 0.00 810,192.84 Please be advised, there was no safe deposit box found for the above decedent ''` If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our Carlisle Pike Office # 717-795-1710. Sincerely, Nancy Clagett Records Management REV4510 E%~ 1i~W1 ~r.~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF ~ ~~~ ~O~ ~ ~ ~ E0~6E E FILE NUMBER ~/_ D ~- ~~~ 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 ~NCLUDETHENAMEOPTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTANDTHEDATEOFTRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF APPLICABLE TAXABLE VALUE ~~ paru~, ~ ~~~/ A•/~ ~¢nnur'fi .1nsurance Conti ~ n ~r~~c~, of ~ia~i//o, T-xas, C.O/1~RCCt /UO. g SZ, a a ~. I oo~~ -- a - S-~, od~gG VP ~ass~~ I~a~ya b le wt _~ ua,l Y~ shares fi~ sons: ~.vn ~. ~rdo~ff See c~ y ~ puy-out ~' Y~ value ~; ~~ F. ~k~ardorF~ ~ ~er~ a5 V~IuaKn~ 5•l7etl•~ TOTAL (Also enter on line 7, Recapitulation) $ .,/ off, o a yi 9~O 15594 AIG ANNUITY INSURAfJCE COMPANY Insurance Services - X811 P.O..Box 570 Rockland, MA 02370-0570 Ae~ ~nr~~~~y ~r~suran~e ~~~p-~~~r A Mer~~ber of Arnericar~ International Group, Inc. LON E DEARDORFF~ 18 WINDING HILL DRIVE MECHANICSBURG PA 17055-5642 I„~III„.III....I.I.~I~I~~l~i~~ll~,~i~~l,~l~i~~~lll„I~~II~~i Page ]. 111170669 9/25/2008 PRIMARY STATEMENT ACCOUNT NUMBER CLOSING DATE TAX ID NO: AIG ANNUITY BRIDGE ACCOUNT NO. 111170669 BALANCE CREDITS CHECKS AND DEBITS BALANCE LAST STATEMENT NO. A TOTAL AMOUNT NU. TOTAL 1~N10FI1VJ. `rtil~ S1_H1'.C:i~lEiv~.l, 0.00 ~ 2 26,012.46 2 26,012.48 0.00 ACCOUNT TRANSACTIONS DATE...........AMOUNT .............BALANCE....DESCRIPTION 09/05 25,983.99 25,983.99 DEPOSIT-CASH 09/25 25,983.99- 0.00 CY.# 501 09;25 28.49 28.49 CREDIT-INTEREST 09/25 28.49- 0.00 DEBIT-ZERO BAL CLOSE RATE HISTORY DATE............RATE DATE............RATE DATE ............RATE 09/05 2.000 ****** CURRENT INTEREST RATE 2.000 ****** ****** INTEREST CREDITED YEAR-TO-DATE 28.49 ****** ********** END OF STATEN~NT ********** REV-1511 EX+ (12-99) /P~ij`~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SHE®UEE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF .~El~-r~~o2 FF~ t~~~G~ ~ FILE NUMBER ~/ ~~_ 7~~ Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. ~ocKl;n 1=•~neral f-~b-vte, inc. ~alan~e d+~ ~3oS.18 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) LO,/~i ,,~, ~~~0/eFF ~A, ~ t/L D Social Security Number(s)/EIN Number of Personal Representative(s) Street Address ~~ W/ND//Ills /~,~/LL ~iQ/yE City ~'I~G'r4//¢/l~/CS~Lf/PG State ~ Zip /7~SS Year(s) Commission Paid: 2. Attorney Fees Cly/~'/ZL~$ E; c~~Elf>.S 1, SOD. Do 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant ,/I/Oil/E EG/G/./,~LF /VOA/~=' Street Address City State Zip Relationship ofC laimani to Decede nt 4. / ~ Probate Fees AA~1~t oriyrd1~.l /sskC of 5h0-'~ C2,I^~;~cafies ~76,Dd 5. ~~ Accountant's Fees ~cc.-~~{' I~l'GtGkb~~~ ~ !~(~ ~ ~~OG/~ B¢' Mecitan acs bu ~, i7>r ¢ ~ G . ov P~ Iv~o~ P/~ `f p 6. Tax Return Preparer's Fees ~ /~cld. i~onQ~ ~Nar1' C er~j~, Ca ~ ~l. ~dd¢rt~sr~q in C'u.mbc,~'~wn~l Lr~ ~bu~rnn,~ ¢ ~ 9• f1-dver~isi~c~~ ;n ('ar/~s/e Sen~i~el 7S.oo ¢ /O. ~e~tirdarse~e~ts {br `/OS~9C~ C'Grfif /l1Qi~/1y5~ ~/tOrDCp~!/eS~t~c /1~,7.? P~ ~ D i~ ' ~ n /l/Kq fee ~ lt'G~~Sf~r o ~//~~S 1. S ~ /,S~.oO TOTAL (Also enter on line 9, Recapitulation) ~ ~ ~ ~g~, 7~ REV-1512 EX+ (12-03) ~y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SC~IED~dl~E 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ~~/I',2DO~ ~~ G~D/t'G E ~' FILE NUMBER ~~ off- 7~6 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. REV-1513 EX+ (9.00) SC~IE®~JLE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Lop ~, ~/'c~Or',FT" soh '~{D o /~B~laa ~~r 5 ~/ur~, ,~/~ / 70 55' ~• ~i^P.C/b/ /~, .L~a'~a'or~~ Soh ~~ /o low 9 Iis~i,inar~ Loop U~e% ~G 3d 7~S 3 1~irk 6Ji%y / y.~Qn~lson d -?D ~o 3yS /~1t, view /~oad Sh{r/yi¢•ns bale, ,d~ /7090 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ LAST WILL AND TESTAMENT OF GEORGE E. DEARDORFF 1, GEORGE E. DEARDORFF, an unremarried widower, currently of 47 Ashburg Drive, Suite 40, Mechanicsburg, Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposine mind, memory and understanding, do make, publish and declare this my Last WiII and Testament, hereby revolving and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to be divided and distributed as follows: .A. Forty percent (40%) to my son, LON DEARDORFF, per stirpes. B. Forty percent (40%) to my son, GREGORY DEARDORFF, per stirpes. C. Twenty percent (20%) to my grandson, DIRK WILEY, per stirpes. As of the date of this will, my said grandson has no issue. In the event he predeceases me without issue then this share shall lapse and shall go to my issue then living, per stirpes. In the event either or both of my said sons predeceases me and is not survived by issue, then his or their shares, as the case may be, shall likewise go to my issue then living, per stirpes. 3. 1 nominate, constitute and appoint my son, LON DEARDORFF, to be the Executor of this my Last Will and Testament. In the even[ [hat he is unable or unwilling [o act as Executor, I appoint my son, GREGORY DEARDORFF to be the Executor in his place and stead. In the event that he is unable or unwilling to act as Executor, I appoint my grandson, DIRK WILEY, to be the Executor in his place and stead. 1 further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ / ll~l day of A.D. 2005. 0 1 ! AL) GEORGF ADEARDORFF Signed, sealed, published and declared by the above-named GEORGE E. DEARDORFF , as and far her Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. c