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HomeMy WebLinkAbout04-03-09 (2),~,, 1505607121 REV-1500 E X PA Department of Revenue (06-05) Bureau of Individual Taxes PO BOx 280601 INHERITANCE TAX RETURN County Code Year File Number Harrisbu , PA 17128-0601 ENTER DECEDENT INFORMATION BELOW RESIDENT DECEDENT 2 1 0 8 0 7 4 4 Social Security Number Date of Death 1 6 1 3 4 2 0 4 6 0 Date of Birth 7 1 3 2 0 0 8 1 2 1 4 1 Decedent's Last Name 9 4 1 L A N T Z Y Suffix Decedent's First Name MI L O I S M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS 0 1. Original Return ~ 2. Supplemental Return 3 Rem i d ^ 4 Limited E . a n er Return (date of death i . state ^ pr or to 12-13-82) 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Ret d R ^X 6. Decedent Died Testate ^ (Attach Copy of Will) urn equired eath after 12-12-82) 7. Decedent Maintained a Livin Trust T g ~ 8 ^ 9. Litigation Proceeds Received ^ • otal Number of Safe Deposit Boxes (Attach Copy of Trust) 10 S l . pousa Poverty Credit (date of death between 12-31-91 and 1-1-95) ^ 11 • Election to tax under Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX NFORMATI Name ON SHOULD BE DIRECTED T0: D A V I D H S T O N Daytime Telephone Number E P Firm Name (If Applicable) E S Q U I R E 7 1 7 eq ~", 4 7'~F 3 5 S T O N E L A F A V E R S H E K L E T S K First line of address 4 1 4 B R I D G E S T R E E T Second line of address City or Post Office N E W C U M B E R L A N D State ZIP Code .o I REGISTE ?. ^~' . l~ USlILY ~--t, ~ C l r'rl I ~ k L r"F+I ' ' j' l ~ ~ C ` ~' ~ ~e -~,; j " i ( "1 ~' ', i___ _ DATE FILED P A 1 7 0 7 0 Correspondent's a-mail address: D S T O N E a1 S T O N E L A W. N E T 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 OF PERSON RESPONSIBL ILI G RETURN ~/[_ ~ DATE ADDRESS ~~ 135 AMIT AD_ DUNCANNON SI P 9THE THAN REPRESENTATIVE PA ~ ~~20 414 BRIDGE STREE NEW CUMBER PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505607121 DATE Y /- 31~ ND PA 17070 1505607121 J 1505607221 REV-1500 EX Decedent's Name: L O I S M• L A N T Z Y Decedent's Social Security Number 1 6 1 3 4 2 0 4 6 RE CAPITULATION 1. Real estate (Schedule A) ..................................... 1. ... 1 2 0 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ................................ 2. .. 3 1 1 6 9 5, 0 2 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ...................... .. 4. • 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5. 5 8 9 9 , 7 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ..... .. 6. 0 • 0 0 7. Inter-Vivos Transfers ii Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested ....... 7. 4 9 7 3 9, 5 8 8. Total Gross Assets (total Lines 1-7) ........................... 8. 4 8 7 3 3 4, 3 0 9. Funeral Expenses & Administrative Costs (Schedule H) ................ 9. 6 4 7 3 8 , 9 1 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ 10. 1 9 2 0 , 8 8 11. Total Deductions (total Lines 9 & 10) ........................... 11. 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................. 13. 6 6 6 5 9. 7 9 4 2 0 6 7 4, 5 1 14. Net Value Subject to Tax (Line 12 minus Line 13) ........... ..... .. 14. 4 2 0 6 7 4 . 5 1 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• ~ 0 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X• 0 0. 0 0 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17, 0. 0 0 18. Amount of line 14 taxable at collateral rate x .15 4 2 0 6 7 4. 5 1 1 g, 6 3 1 0 1. 1 8 19. Tax Due .............................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 6 3 1 0 1. 1 8 Side 2 1505607221 1505607221 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 0744 Tax Payments and Credits: 1• Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 34,000.00 C. Discount 1,789.47 3. InteresUPenalty if applicable D, Interest E, Penalty (1) 63,101.18 Total Credits (A + B + C) (2) 35, 789.47 (3) 0.00 Total InteresUPenalty (D + E ) 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (4) 0.00 (5) 27,311.71 (5A) (5B) 27,311.71 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ..................................................................... . ^ 0 b. retain the right to designate who shall use the property transferred or its income; ............................... ^ ^X c, retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ ^X 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................... ....................................................... X ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent. [72 P.S. §9116 (a) (1.1) (i)J. 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-0ne years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent o(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 defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LOTS M. LANTZY 21 08 0744 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real roe which is 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ Property located at 203 Lantzy Rd Mechanicsburg Borough, Cumberland Co. 120,000.00 PA purchased by William B. Lantzy and Mary K. Lantzy, his wife on October 10, 2008 as mentioned in Item II of will for $120,000.00 TOTAL (Also enter on line 1, Recapitulation) ~ S 120,000.00 (If more space is needed, insert additional sheets of the same size) REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LOIS M. LANTZY 21 08 0744 All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ 602 shares IBM stock @ $119.335 each 71,839.67 2 1982 shares IBM stock (Wachovia Sec) @ $119.335 each 236,521.97 3 58.645 shares PNC Financial Services Group stock @ $56.840 each 3,333.38 TOTAL (Also enter on line 2, Recapitulation) 15 311,695.02 (It more space is needed, insert additional sheets of the same size) REV-1508 EX + (8-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RESIDENTED ~ DENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER LOIS M. LANTZY 21 08 0744 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. 1992 Chevy Van sold on 9-23-08 1,880.00 2 Miscellaneous deposits 129.26 3 Nationwide Insurance-refund on auto insurance 32.35 4 Penn National Insurance-refund on homeowners ins 557.00 5 Reimbursement for taxes & sewer/trash on property 1,985.09 6 Social security check issued 1,316.00 TOTAL (Also enter on line 5, Recapitulation) I S 5 899 70 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER LOIS M. LANTZY 21 08 0744 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 INCLUDE THE NAME OFTRETRANSFEREE,THEIRRELATIDNSHIPTODECEDENTAND THE DATE OF TRANSFER ATTACHACDPVOFTHEDEEDFORREALESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION QFAPPLICABLE) TAXABLE VALUE 1. 3301.05 shs Citizens Invstmt Serv.-PDVCX Putnam 29,577.41 100. 29,577.41 Diversified Inc CIA @ 8.960 each IRA Acct 2. 1.44 shs Citizens Invstmt Serv-CZCXX Citizens Select 1.44 100. 1.44 Treasury MMkt CI C @ $1.000 each IRA Acct 3. 2203.359 shs Citizens Invstmt Serv-PFICX Putnam Floating 20,160.73 100. 20,160.73 Rate Inc CI C @ 9.150 each IRA Acct 0.00 0.00 0.00 0.00 TOTAL (Also enter on line 7 Recapitulation) I 3 49 739.58 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES S~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER LOTS M. LANTZY 21 08 0744 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Gingrich Memorials-services rendered 320.00 Mary Lantzy-Reimb. for funeral luncheon 1,500.00 Mary Lantzy-Reimb on Myers Funeral Home expenses 8,300.00 B, ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Janet Peters Street Address 135 Amity Road city Duncannon state PA Zip 17020 Year(s) Commission Paid: 2009 2, AttomeyFees David H. Stone, Esquire 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Relationship of Claimant to Decedent Zip 4. ~ Probate Fees Cumberland Co Register of V~IIs 15, 000.00 15,000.00 372.00 5 Accountant's Fees 6. Tax Retum Preparer's Fees 7. Robert Cassel-appraisal fee on property 300.00 2 Computershare-lost stock certificate fee 122.58 3 US Treasury-Est. taxes pd on 2008 1040 1669.00 4 PA Dept of Revenue-Est taxes pd on 2008 PA40 76.00 5 PA Dept of Revenue-bal due on dec 2007 PA40 13.30 6 PA Dept of Revenue-Est taxes on 2008 PA40 76.00 7 Citizens Invstmt Serv-fed tax w/held on sale 4,527.84 8 United States Treasury-Est taxes on 2008 1040 1,669.00 9 Penn National Ins.-premium on homeowners ins 658.00 10 Checks written by but not cleared til after death 1,237.43 11 Miscellaneous expense 300.00 12 Miscellaneous expense 100.00 TOTAL (Also enter on line 9, Recapitulation) S 64 738.91 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent LOIS M. LANTZY 21 08 0744 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses 8~ Administrative Costs - 67. ITEM NUMBER DESCRIPTION AMOUNT 13 Miscellaneous expense 1,808.75 14 Miscellaneous expense 26.50 15 IBM-final benefit reimb. 15.80 16 Barry Deckard-real estate taxes 2,313,06 17 Settlement costs on sale of property 113.32 18 PPL-electric services at property 188.29 19 MCI-services at property 84.73 20 Comcast Cable-services at property 53.30 21 United Water-services at property 24.46 22 Borough of Mechanicsburg-sewer/trash 121.12 23 PPL-electric at property 124.71 24 MCI-services at property 48.72 25 PPL Electric-services at property 73.95 26 PPL Electric-services at property 48.51 27 United Water-services at property 24.46 28 MCI-services at property 84.35 29 Comcast-services at property 53.30 30 PPL Electric-services at property 71.95 31 United Water Co-services at property 6.98 32 MCI-services at property 26.26 33 Cumberland Law Journal-advertising grant of letters 75.00 34 The Patriot News Co.-advertising grant of letters 141.24 35 Register of Wills-filing Inh Tax Return and Inventory 30.00 36 United States Treasury-taxdue on decedents 2008 1040 5,952.00 37 PA Dept of Revenue-tax due on decedents 2008 PA40 return 987.00 38 Reserve for closing expenses 1,000.00 SUBTOTAL SCHEDULE H-B7 ~ 13,497.76 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER LOIS M. LANTZY 21 08 0744 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ (Financial Health Services-services rendered 2 ~ Lifeline Systems-services rendered 1,881.76 39.12 TOTAL (Also enter on line 10, Recapitulation) I S 1 920 88 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (g-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LOIS M. LANTZY 1'I uii U/44 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Robert Peters nephew Collateral 38,243.14 135 Amity Road Duncannon,PA 17020 2. Cheri Foreman niece Collateral 38,243.14 407 Meadow Lane Hershey, PA 17033 3. Randall Peters nephew Collateral 38,243.14 5325 South 930 East Wolcottville, IN 46795 4. Mariann Snow niece Collateral 38,243.14 5641 High Tor Hill Columbia, MD 21045 5. Andrew Lantzy nephew Collateral 38,243.14 59 Debonarie Drive Marietta, GA 30064 6. Michael Madigan nephew Collateral 38,243.14 16 Somerset Freeport, ME 04032 7. Douglas Lantzy nephew Collateral 38,243.13 533 Sunday Drive Harrisburg, PA 17111 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN A80VE ON LINES 15 T HROUGH 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 [[ -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 5 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent LOIS M. LANTZY 21 08 0744 Decedent's Name Page 2 File Number Schedule J -Beneficiaries -1 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions) 8. Scott Lantzy nephew Collateral 38,243.13 10 Ressers Drive York Haven, PA 17370 9. Dawn M. Brown niece Collateral 38,243.14 100 Sugar Maple Drive Etters, PA 17319 10. Brent Shelley nephew Collateral 38,243.13 98 Taft Lane #2 Springfield, NJ 07081 11. Lora Shelley niece Collateral 38,243.14 1131 Schoharie Turnpike Catskill, NY 12414 . J s;'' 1 ..'ATTORNEYS AT LAW ' 414 pail , EET N'Bw dUliHBRLAND, PA 17070 LAST WILL AND TESTAMENT 0 OF n `" C c-, ..o ~ ~; LOIS M. LANTZY ~ L~~ ~ C ,> r r-' _-_ m - ~ ~ ~ __ I, LOIS M. LANTZY, of the Borough of Mechanicsbur~HCumb~xland ~y O County, Pennsylvania, declare this to be my last will and rev$ke any will previously made by me. ITEM I: I direct that my Executrix hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I hereby give to my brothers and sisters, JIM LANTZY, BILL LANTZY, JANET M. PETERS, PAULINE SHELLEY, and HELEN MADIGAN- SEDOR, the option to purchase my real estate at 203 Lantzy Road, Mechanicsburg, Pennsylvania, for $120,000.00. This option shall be exercised in writing within three months after the date of my death after which the option shall expire. Settlement shall occur within forty-five days after the exercise of the option. In the event that the option is not exercised by any of my brothers or sisters, the option shall pass to my then living nieces and nephews, ROBERT PETERS, CHERI PETERS, RANDALL PETERS, MARIANN SNOW, ANDREW LANTZY, MICHAEL MADIGAN, DOUGLAS LANTZY, SCOTT LANTZY, DAWN M. BROWN, BRENT SHELLEY, and LORA SHELLEY. This option shall be exercised in writing within Page 1 of 3 six months after the date of my death after which the option shall expire. Settlement shall occur within forty-five days after the exercise of the option. In the event of a dispute arising out of the exercise of the option by more than one party, a private sale may be conducted by my Executrix. ITEM III: I devise and bequeath all the rest, residue and remainder of my estate, of every nature and wherever situate, in equal shares to the following named nieces and nephews as survive me: ROBERT PETERS, CHERI PETERS, RANDALL PETERS, MARIANN SNOW, ANDREW LANTZY, MICHAEL MADIGAN, DOUGLAS LANTZY, SCOTT LANTZY, DAWN M. BROWN, BRENT SHELLEY, and LORA SHELLEY. ITEM IV: I appoint my sister, JANET M. PETERS, Executrix of this my last will. ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I, LOIS M. LANTZY, have hereunto set my hand and seal this '~~ ff~ day of _ F-~ ~J~'V, a _: ~. 2004 . r, ~ ~, _. y~ ~ , ~~ - LOIS ~ANT'~Y ~ Page 2 of 3 r._....__.~...~.. _.u .~ _ SIGNED, SEALED, PUBLISHED and DECLARED by LOIS f~1. LANTZY, the Testatrix above named, as and for her Last Will and Testament, and in the presence of us, who at her request, in her presence and in the preserce of each other, have subscribed our names as witnesses. a Witness ~ ~ ~ - Address fi t n e s s ~ - ~ Cti~~.~'~~c ~~'" ~__, __ Address Page 3 of 3 F:',D(X'S\R61)CD\Lanvy.Lois - taccutors Decd, 203 l.antry Ruad.~~pd 3 ~ ~t 9 ~ ,(~~- TAX PARCEL NO. ADDRESS: DEED I!IIIIIIIINI~II~ oo,a~ 17-23-0563-102. 203 Lantzy Road Mechanicsburg, PA 17055 THIS INDENTURE made the ~~~ ` day of `-~L~~~ , in the year 2008, between JANET M. PETERS, Executrix of the Last Will and Testament of LOIS M. LANTZY, late of Mechanicsburg Borough ,County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, -AND- WILLIAM B. LANTZY and MARY K. LANTZY, husband and wife, hereinafter called the Grantees; WHEREAS, the said LOIS M. LANTZY became in her lifetime seised, as of fee, of and in a certain tract of land, together with the improvements thereon erected, situate in Mechanicsburg Borough, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on July 3, 2008, having first made her Last Will and Testament in writing dated February 4, 2004, duly probated and registered in the Office of the Register of Wills of Cumberland County on July 14, 2008, wherein and whereby she appointed as Executrix, the said JANET M. PETERS, to whom Letters Testamentary were duly issued by said Register of Wills on July 14, 2008, wherein and whereby an option to purchase said premises herein described was granted under Item II of said Last Will and Testament to JIM LANTZY, B1LL LANTZY, JANET M. PETERS, PAULINE SHELLEY, and HELEN MADIGAN-SEDOR, and the said JIM LANTZY, JANET M. PETERS, PAULINE SHELLEY, and HELEN MADIGAN-SEDOR executed and filed a Release of said option in the Office of Register of Wills of Cumberland County, and the said BILL LANTZY, A/K/A, WILLIAM B. LANTZY, one of the Grantees herein, timely exercised his option in writing and filed in the Office of Register of Wills of Cumberland County, as is in and by said will and the records of said Register of Wills, recourse thereunto being had, appears: NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of ONE HUNDRED TWENTY THOUSAND and NO/100--------($120,000.00)--------- Dollars, which has been paid to it by the said Grantees at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantees, ALL THAT CERTAIN piece or parcel of land situate in the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, bounded and described as follows: BEGINNING at point on the Eastern side of Lantzy Road on the hereinafter mentioned Plan of Lots, at the Southwestern corner of land of Donald K. McGee, et ux; thence by land of McGee and beyond, North 80 degrees 10 minutes East, one hundred fifty (150) feet to a point; thence by Lot No. 16 on said Plan, South -1- 9 degrees 50 minutes East, ninety (90) feet to a point; thence by Lot No. 18 on said Plan, South 80 degrees 10 minutes West, one hundred forty-two and forty-two one-hundredths (142.42) feet to a point on the Eastern line of Lantzy Road; thence by the Eastern line of Lantzy Road, North 14 degrees 39 minutes West, ninety and thirty-two one-hundredths (90.32) feet to a point, the place of BEGINNING. BEING THE SAME PREMISES by Adjudication and Decree Awarding Real Estate dated October 17, 1997, and entered in the Court of Common Pleas of Cumberland County, Orphans' Court Division, to NO. 2196-0838 in RE: Estate of Howard L. Lantzy, awarded the within described real estate to Lois M. Lantzy, deceased, said Decree being recorded October 22, 1997, in the Office of the Recorder of Deeds of Cumberland County in Record Book 166, page 493. BEING Lot No. 19 on the Plan of Lots known as ORCHARD CREST -SECTION 5, which Plan is of record in the Cumberland County Recorder's Office in Plan Book 10, at Page 4. HAVING thereon erected a single family dwelling known and numbered as 203 Lantzy Road, Mechanicsburg. TOGETHER with all and singular the buildings, improvements, ways, streets, alleys, passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and demand whatsoever of her, the said LOIS M. LANTZY, at and immediately before the time of her decease, in law, equity, or otherwise howsoever, of, in, to or out of the same. TO HAVE AND TO HOLD the said lot orpiece ofground above described, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so to be, with the appurtenances unto the said Grantees, to and for the only proper use and behoof of the said Grantees, forever. AND THE SAID GRANTOR, for herself and her respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantees, their heirs and assigns, that she, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. -2- IN V1'ITNESS WHEREOF, the said Grantor has hereunto set her hand and seal the day and year first above writt n. ~~~ (SEAL) JAN PETERS, Executrix of the Last Will and Testament of LOIS M. LANTZY COMMONWEALTH OF PENNSYLVANIA COUNTY O ~,e,,~a SS: On this, the ~~~ day o~L'~~'~2008, before me a Notary Public, the undersigned officer, personally appeared JANET M. PETERS, Executrix of the Last Will and Testament of LOIS M. LANTZY, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto my hand and not ial seal. ,,~ Notary Public COMM NWrAIT f RENNSYIVANIA O ~' Public CAROL L. TROXELL, Notary My Commission Expires Dec827n2009 -3- I hereby certify that the precise address of the Grantee is _au3 LAN ~~~ (~~n n,<<~,Pti.~~, pry ~ ~~ Date: lu -Iy -~ $ ~~j~- Att f ~ NTOR IU.T_ s -4- ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 Instrument Number - 200834494 Recorded On 10/20/2008 At 3:14:40 PM * Instrument Type -DEED Invoice Number - 30839 User ID - MBL * Grantor - LANTZY, LOIS M * Grantee - LANTZY, WILLIAM B * Customer -CEDAR CLIFF ABSTRACT * FEES STATE WRIT TAX $0.50 STATE JCS/ACCESS TO $10.00 JUSTICE RECORDING FEES - $12.50 RECORDER OF DEEDS PARCEL CERTIFICATION $10.00 FEES AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 1~CHANICSBURG SCHOOL $0.00 DISTRICT I~CHANICSBURG BOROUGH $0.00 TOTAL PAID $49.50 * Total Pages - 6 Certification Page DO NOT DETACH This page is now part of this legal document. I Certify this to be recorded in Cumberland County PA t ~Q RECORDER O D EDS *~ao " -Information denoted by sn asterisk may change during the verification process and may not be reflected on this page. III!NIVIIR~IIAI!I~IIII IBM Ord Shs (IBM) -Stock chart, Index chart - MSN Money Quote, Chart, News .i ~ ~.. , Research ,. ~ :,n... ;.. iJ.~'~= ._ie~J r',r .,arr' .. ;ar,t Guided Research P~ .... ,:h ~„_„ r, Find Stocks ,-. tr,~t ~..,....~... top ;~ap•r. tiU~rk.. Related Links ~.,, t r,.,~:~~, n~, ~w',~~. p.:, AMERITRADE Gott/ade ~, ~ ,,,,,,,,,,,, , I,,., E~~-TRADE Y Au„a/~si~r:~°C Page I of I ... - .~.. , .. _ . . _., L~ra.v d'r.,rt for, .. 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Qu,^:es supplied by I; n,~ra,a~vl~ Darn. 5rnra, pnce data provided by Norn~~ra R,r,e;rch 'n>trtuL~', i.:d. motes delayed ZO minutes Paye generated 9/G4i2008 10:01 AM Eas[ern Time Sg.~s Ss. s~ /~ 3 . L 8 ~ ~ ' S~.g y '~-e-r~9Q-- X . ~~t 93 s3 s~ 4 3,333. ~ ~" ~ .8 ~f x 5 ~3 ~ 6 4S' ~'S ~ 3 33.3 http:i/moneycentral.msn.com/investor/charts/chartdl.aspx?PT=7&compsyms=&D4=1 &D... 9/24/2008 .~ .. ~ i Member FnIC ~'~ Citizens ~~ Investment Services January 13, 2009 Stone, LaFaver & Shekletski 414 Bridge St. New Cumberland, PA 17070 RE: Account Number: L7C 050822 Registration: LOIS M LANTZY RE: Account Number: L7C 172421 Registration: CITIZENS BANK REGULAR IRA FBO LOTS M LANTZY Dear Mr. Stone: 1200 Hancock Street Ouincy, MA 02169 I am writing with regard to your recent request for the above referenced accounts. Please extend our condolences to the family of Lois Lantzy. I am providing a summary of Lois Lantzy's accounts in the tables below as of the close of business on July 3, 2008 as you requested. L7C 172421 Fund Number of Shares Share Price Value of Account PDVCX-PUTNAM DIVERSIFIED INCOME CLASS 3301.05 $8.96 $29,577.41 C PFICX-PUTNAM FLOATING RATE INCOME CL C 2203.359 $9.15 $20,160.73 CZCXX-CITIZENS SELECT TREASURY MMKT CL C 1 •~ $1.00 $1.44 Account L7C 050822 Was closed on June 11, 2007 therefore the balance as of July 3, 2008 was $CAO. Should you have any questions, please call our Customer Service Group at 1-800-942-8300. We are available Monday through Friday, 8:00 a.m. to 6:00 p.m. We will be happy to assist you. Sincerely, ~~~- 1FtRlG~b~.~j Erica Haworth Operations Specialist Securities and Investment Advisory Services offered through CCO Investment Services Corp. Member FtNRA, SiPC. S3 State Street, MB5770, Boston MA 02109. (800) 942-8300. Insurance products offered through CCO Investment Services Corp. In Massachusetts, insurance is offered through Citizens Financial Services Insurance Agency. In New York, insurance is offered through Citizens Insurance Agency of New York, Inc. CCO Investment Services Corp., Citizens Financial Services Insurance Agency and Citizens Insurance Agency of New York, Inc. are affiliates of RBS Citizens, N.A. _. ___ __ _ __ _ ___ _ __ __ BS Securities and Insurance Products are _ , • NOT FDIC INSURED NO BANK GUARANTEE MAY LOSE VALUE NOT A DEPOSIT I NOT INSURED BY ANY FEDERAL GOVERNMENT AGENCY A. Se~tlement Statement B. Type o(Loan U.S. Depaetrnent of Housing and Urban Development -- - - -- ---- ~-w- ~r -- I HA 2. FmHA 3. ^Conv. Unins. 6. File Number ---- 7. Loan Number ~B Mortgage Insurance Case Number ~ 4 L)VA 5. []Cony. Ins 21572LANTZY - _ . Th >iTixmiiTum srxdTd gne you a slatemenT s~TcoaTs~naunTa-pTdlo a-3by se9lem TgTsTiown-. ~ C. Note: Hems merketl (p.oc )' were paid anode are aoaing~ MeY are shown Here for idamatwn purposes end era rwl indudatl m the tows. TItIeEXpr@SS Settlement System WARNING. p a a rnme to k„owmgly make falp a(e}emsas to pia Urwbd Slates on Chia or any doer wmAer form P lti . ena es upon conwctwncan nd tle a Roe era impnsanment for Oslada see. Tike 18 U. 5 Cone Section 1001 and Sector tOtO. _ Printed 10/10Y1008 al 11:32 CLT _ ____ I D NAME OF BORROWER: William B. Lantry and Mary K. Lantry ' I _ ADDRESS; ______ 1.16 Winston Drive Mechanicsburg Pa 17055 ) E. NAME OF SELLER: Estate of Lois M. Lantry -- ADDRESS;______ 203 Laritzy Road Mechanicsburg Pa 17055 F. NAME OF LENDER: --- _ ADDRESS____ _ G PROPERTY ADDRESS: 203 Laritzy Road, Mechanicbburg, Pa 17055 _ __ ____Mechanicsburo Borough H. SETTLEMENT AGENT: Cedar Cliff Abstract Agency, Inc., Telephone: 717.774.7435 Fax: 717.774.3889 ~ __ PLACE OF SETTLEMENT: 414 Bridge Street New Cumberland PA 17070 I, SETTLEMENT DATE. 1011012008 __ 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 120 000.00 401. Contract sales 120 000 00 t02 Personal Property 402. Personal Pr 103. Settlement charges to borrower line 1400 50.50 403. _ 104._ _-_--- 404. 105____ __ 405. __ _ Ad'ustments for items aid b seller in advance Ad'ustrnent5 for items aid b seller in advance 106.._ Cityn°wn taxes 406. Cit flown taxes 107. _Coun taxes 10110108 to 12131108 221.88 407. Count taxes 10110/08 to 12/31108 221 88 108. Scholl taxes 10110108to06130109 1 888.87 408. School taxes 10110108to08130109 . 1 ggg B7 _109_ 409. , t 10._ Sewer/Trash 10110108 to 12131108 96.54 410. Sewer/Trash 10110108 to 12131108 98 54 111. _ 411. . 112, 412. 120_GROSS AMOUNT DUE FROM BORROWER 122 035.59 420. GROSS AMOUNT DUE TO SELLER 121 985 09 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER . 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Depositor earnest mono 501. Excess De it see instructions 202. Prins I amount of new loans 502. Settlement char es to seller line 1400 113 32 203. Existin loan s taken sub ect to 503. Existin loan s taken sub'ect to . 204. -- 504. Pa off of First Mort a 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 210. Citvltown taxes 510. Cit !town taxes 211_ Countvtazes 511. Coon taxes 212_5chooltaxes 5i2. Schoottaxes 213,. 513. 214. 514. 215__ 515. 216. 516. 217. 517. 218. 518. 21.9._ 519. 220. TOTAL PAID BYIFOR BORROWER 520. TOTAL REDUCTION AMOUNT DUE SELLER 113 32 300. CASH AT SETTLEMENT FROM OR TO BORRO WER 800. CASH AT SETTLEMENT TO OR FROM SELLE . R _ 301. Gross amount due from borrower line 120 122 035.59 601. Gross amount due to seller line 420 121 985 09 _302. Less amounts paid b/for borrower line 220 602. Less reduction amount due seller line 520 . 113.32 '__303. CASH FROM BORROWER 122 035.59 603. CASH TO SELLER 121,871 T7 lit T S ~ ~ ~S ~ l 13 1 a_ S -I~.,,~NU "yJ.. 6~ {5 ! '~! r bey{j~us~ a l9~ .0 9 en is imponam tax iMOnneson antl ie being tumishetl to tM Internal Revenue Service p you ere requiretl to Rle a rMUm, I to be raponsd antl Me IRS tlslertnines Mat it bas rql peen reported. Tfu Cooped Sales Price desulbetl on wiM yow correct taxpayer idenppcapon number. p you do not provide your correct taxpayer identiRtetlon la uea perjury, I cerpty Mat Ma number shown on Mis statement is my cored taxpayer itlenpficapon number. LLER(S) SIGNATURE(S) , (H) U S DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT File Number: 21572LANTZY PAGE 2 TitleExwess Settlement Svstem Primal tnltnnruiR ~t ~~ ~~ ri r --- ___ 700 TOTAL SALES/BROKER'3 COMMISSION based_ on price $12,000.00 - _ Division of ~mmisslon 6ne 700 as fellows, ----- -- - -- - -I----. 1 ---- --- - --- --- --------- f 701_ _ _ ~ - -1~--- --------- --- --- I 702 $ _ _ - 10-- --- _-703 Commisslon~ald at SettlemeM_-_- _ _ _800 ITEMS PAYABLE IN CONNECTION WITH LOAN - -- -- - _ PAID FROM BORROWER'S FUNDS AT SETTLEMENT -" - -- -- - -- PAID FROM SELLER'S FUNDS AT SETTLEMENT ----- _801._ Loan Origination Fee __ %_ 802 Loan Discount _ _ _ _ _ y, _ B03 Appraisal Fee _- - l_804._Credit Report _ _ --_--- -- 805_Lender's Ins ion Fee - - ----- __806 _Morlgage A~Iication Fee -_ _807. Assu~ion Fee__ C ~ --- - _ _ - _ --- -- _ _ -- ---- 8t0 _ -" 811 _ _ _ _900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE _901_ Interest .From" _ to Ida 902_MoAgage_Insurance Premium for to -_903. Hazard Insurance Premium fw to .. 904. -_- 905, _ "1000. RESERVES_ DEPOSITED WITH LENDER FOR 1001 Hazard Insurance __ mo. /mo 1002_ Mort Insurance mo. Imo 1003. Citv P~r~Tax mo. Imo 1004_County Procertv Tax rno (a1$ 82 53 !mo 1005._School taxes mo. 192.76 Imo 1.009_Aggr ate Anal sis Ad ustment 0.00 0.00 1100. TITLE CHARGES _ 1101. Settlement or dosin tee 1102. Abstract w title search 1103. Title examination 1104. Title insurance binder 1105_Document Preparation 1106. Notary Fees 1107. Attwne 's fees !includes above items No: __1108. Title Insurance includes above items No: _ 1109. Lender's Caver e 1110. Owner's Cover a 120 000.00 _ 1111. 1112. - - -- 1113 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES _1201. Recording Fees Deed 50.50 • Mort • Release 1202. Cit !Count tax/stam s Deed • Mort a 50.50 1203. State Tax/stam s Deed • Mwt a e 1204. 1205.__ _ _ 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve _1302. Pest Inspection 1303, Tax Cert Fee to Stone Lafaver 8 Shekletaki _1304. Sewer/Trash~th tr to Mechanicsbur Borou h _1400. TOTAL SETTLEMENT CHARGES enter on fines 103 Section J and 502 Section 50.50 5.00 108.32 113.32 .,w .,cn r m~~n i i~N ur CuT[N ANU SELLER I nave carehdly revi eel the HUD-1 Settlemen( Statement and best or my krowletlge end belief, it is a true and eccurNe statement d all recaipls erM tlisbunemenls made on my account or by me in Mie Ir y /udher certify foal 1 recei a y d the HUD-7 Settlanenl Statement. ~.y~ l Lary ~T~-- Ur r ~ Y Estate d Lois M. Lant:y 6y 78ne WARNING IT IS AO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD-7 SeM I Statement which I na UNITED STATES ON THIS OR ANy SIMILAR FORM PENALTIES UPON CONVICTION tronsauYian. I he caused a will cause M n to ~~ p ~ ~tl accurate account d this CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TIRE 18: a e w aaortlanu with (hie slalamML U S. CODE SECTION 1007 AND SECTION 1010. SETTLEMENT A NT: DATE. _LO ~~v REV-1509 EX + (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER LOTS M. LANTZY 21 08 0744 If an asset was made joint wkhin one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME a. Janet Peters 135 Amity Road ADDRESS (RELATIONSHIP TO DECEDENT Sister Duncannon, PA 17020- 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 INTERESI 1. A. 10/03/0 AmeriChoice FCU-Share Cert suffix 60 joint 3,321.01 50. 1,660.51 w/Janet Peters TOTAL (Also enter on line 6, Recapitulation} I S 1 660 51 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER•VIVOS TRANSFERS 8 MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER LOIS M. LANTZY 21 08 0744 This schedule must ~ completed and filed if the answer to any of questions t through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RElAT10NSNIP TO OECE~ENi AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THEOATEOFTRANSFER.ATTACHACORYOfTHEDEEDFORRFKESTATE. VALUE OF ASSET INTEREST uFARFtilcae~Et VALUE 1. AmeriChoice FCU-Share Cert suffix 61 1,090.71 100. 1,090.71 beneficiary Pauline Shelley 2 IAmeriChoice FCU-Share Cert suffix 62 beneficiary Helen Madigan-Sedor 3 IAmeriChoice FCU-Share Cert suffix 63 beneficiary Mary Lantzy 4 AmeriChoice FCU-Share draft suffix 13 joint 2-3-08 w/Janet Peters and Mary Lantzy (w/in one year) 5 AmeriChoice FCU-Share Savings Suffix 01 joint 2-3-08 w/Janet Peters and Mary Lantzy (w/in one year) 6 Wachovia Securities-cash account (tod) benef: Janet Peters, Helen Madigan-Sedor, and Pauline Shelley 7 223.23 shares Wachovia Securities-Franklin SM Mid Cap A @ $30.450 each benef: Janet Peters, Helen Madigan-Sedo and Pauline Shelley 8 345.564 shares Wachovia Securities-Mutual Shares CI A @ $21.180 each benef: Janet Peters, Helen Madigan-Sedor and Pauline Shelley 9 565.722 shares Wachovia Securities-Templeton Foreign Fd @ $10.430 each benef: Janet Peters, Helen Madigan-Sedor and Pauline Shelley 1,090.71 100. 1,041.61 100. 11,116.44 100. 1,421.09 100. 362.63 100. 6797.35 100. r 7,319.04 100. 5, 900.48 100. 10 fidelity Invstmts-Fidelity Cash Reserv s 8.24 shs @ $1.00 per sh. Beneficiarie are Janet M. Peters, Helen Madigan-Sedo and Pauline C. Shelley IRA Acct. 8.24' 100 TOTAL {Also enter on line 7 (If more space is needed, insert additional sheets of the same size) ation 1, 090.71 1,041.61 6,000.00 5,116.44 1,421.09 362.63 6,797.35 7,319.04 5, 900.48 8.24 REV 1500 Inheritance Tax Return Resident Decedent Decedent's Name: LOIS M. LANTZY Social Security No.: 161-34-2046 Schedule "F" and Schedule "G" Attachment Statement Please issue a separate bill to the following people for the various joint accounts, annuities and IRA's set forth on the attached Supplemental Schedule "F" (*) and Schedule "G". Also, please note the tax that was paid by each beneficiary with the 5% discount. Mary Lantzy, sister-in-law 116 Winston Drive Mechanicsburg, PA 17055 AmeriChoice $1,041.61 $2,558.22 710.55 $4,310.38 x 12% Janet M. Peters-sister 135 Amity Road Duncannon, PA 17020 AmeriChoice $1,660.51 $2,558.22 $ 710.54 $4,929.27 Fidelity Wachovia $ 120.89 $2,265.78 $2,439.68 $1,966.83 Total $ 2.74 $6,793.18 $11,725.19 x 12% Pd w/disc Owe $ 517.25 owe $1,407.02 815.17 $ 591.85 REV 1500 Inheritance Tax Return Resident Decedent Schedule "F" and Schedule "G" Attachment Statement Con't Pauline Shelley 59 Greenspring Drive Mechanicsburg, PA 17050 AmeriChoice Fidelity Wachovia $ 120.87 $2,265.79 $2,439.68 1 966.82 Total Helen Madigan-Sedor 15501 White Willow Lane Rockville, MD 20853 AmeriChoice Fidelity Wachovia $ 120.88 $2,265.78 $2,439.68 1 966.83 Total $1,090.71 $ 2.75 6 793.16 $7,886.62 x 12% $ 946.39 Pd w/disc 815.17 $ 131.22 Add'1 paymt 132.64 Refund due $ 1.42 $1,090.71 $ 2.75 6 793.17 $7,886.63 x 12% $ 946.40 Pd w/disc 815.17 Owe $ 131.23 ~ AmeriChoice F E D E R A L CREDIT U N I O N Building Relationships For Life September 15, 2008 Stone LaFaver & Shekletski 414 Bridge Street PO Box E New Cumberland, PA 17070 RE: Estate of Lois M Lantzy Dear Sir: The following is the information that you had requested in your correspondence. The decedent had one member number with a share savings, and four share certificates. Date of death balance is as follows: Share savings suffix O l - $1421.09 Share draft suffix 13- $11,116.44 Share certificate suffix 60-$3321.01 Share certificate suffix 61-$1090.71 Share certificate suffix 62-$1090.71 Share certificate suffix 63-$1041.61 Share savings O1, share draft 13 are listed as joint with Janet Peters and Mary Lantzy, the effective date is 2/3/2008. Suffix 60 is listed as joint with Janet Peters; the effective date is 10/3/2000 Suffix 61 named a beneficiary of Pauline Shelley. Suffix 62 named a beneficiary of Helen Madigan-Sedor. Suffix 63 named a beneficiary of Mary Lantzy. All four share certificates were distributed to the joint or beneficiary in the following amounts: Suffix 60- $3442.29 to Janet Peters Suffix 61- $1104.50 to Pauline Shelley Suffix 62- $1105.37 to Helen Madigan-Sedor Suffix 63-$1065.24 to Mary Lantzy Main Office: 2175 E3umble Bee Hollow Road • Mechanicsburg, PA 1 7055 • Phone: (71 7) 697-3174 • Fax: (71 ?) 697-371 3 Website: wevw.americhoice.org ~~ ~eraoew ~ °~--~-- ~ (.REUIT UN[ON$" © AmeriChoice F E D E R A L C R E D I T U N I O N Building Relationships For Life If you have any more questions concerning this account, please contact me at 717-591- 1281. Sincerely, ~~- Maggie Strohm Operations Administrator Main Office: 2175 Bumble Bee Hollow Road • Mechanicsburg, PA 1 7055 • Phone: (71 7) 697-3474 • Fax: (717) 697-3713 ~ Website: www.americhoice.org ~~~ ',= r NCUA ~ .,. . , ~ei+oed .,.,-.~ (ENDER (;REDPI'UNIONS" ,Fide/ice August 27, 2008 David H Stone C/O Stone LaFaver & Shekletski 414 Bridge St PO Box E New Cumberland, PA 17070 Dear David H Stone: We are responding to your request for information about Lois M Lantzy's account with Fidelity. The table below lists the account holdings and values as of Thursday, July 03, 2008. Fidelity account 2B0-101923: LOIS M LANTZY -TRADITIONAL IRA Securit Descri tion CUSIP Quantit Unit Value Market Value Fidelity Cash Reserves 316067107 8.240 $1.00 $ 8.24 Total Value $ 8.24 The beneficiaries of the IRA are Janet M. Peters - 34%; Helen Madigan Sedor - 33%; and Pauline C. Shelley - 33%. The balance of the account was transferred to Citizens Bank on October 4, 2006. We hope this information is helpful. For questions concerning account holdings or instructions on how to transfer the ownership of the accounts, please call our Inheritor Services Group at 800-544-0003 between 8:00 A.M. and 6:30 P.M. Eastern time Monday through Friday or visit our website at www.fidelity.com. Sincerely, Fidelity Investments Our file: W007920-21AUG08 Wachovia Securities, LLC Eberly, DeFluri & Collins Wealth Management Group of Wachovia Securities WS6232 3 Lemoyne Drive Lemoyne, PA 17043 Tel 717 975-8424 Fax 717 975-8484 Toll Free 866 837-3186 August 13, 2008 Stone LaFaver & Shekletski 414 Bridge Street New Cumberland, PA 17070 Attn: David H. Stone Dear Mr. Stone, `V~CHO~'IA ~F.C'L'12ITIES I am enclosing the date of death value for Lois M. Lantzy. Ms. Lantzy had only one retail account with Wachovia Securities. There were three securities in her account at the time of her death: Share amount Name of Fund Symbol Cuslp High Low 223.23 Franklin SM Mid Cap A FRSGX 354713109 30.45 30.45 345.564 Mutual Shares Class A TESIX 628380602 x1.18 21.18 565.722 Templeton Foreign Fd A TEMFX 880196209 10.43 10.43 Her cash balance was $ 362.63 Please call me with any questions at 717-975-8424 or toll free 1-866-837-3186. Sincerely, Patty Jakeway Senior Client Associate ~~ ~~ ~ ~~ .~~ ~p~ ~~~ .~ 2~ ~~~- ~~;.,