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04-27-09
J 15056041169 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN c~ (~~ RESIDENT DECEDENT ~~ ~ Q ~,~-\ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 181019817 11082008 05271917 Dec:edent's Last Name Suffix Decedent's First Name MI TUTHILL OLIVE `~ (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 REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ® 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Sate Deposit Boxes (Attach Copy of WIII) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ t0. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number FRA NK H KELLY EA 7177747536 Firrn Name (If Applicable) KELLY FINANICAL SERVICES INC First line of address 400 BRIDGE STREET SUITE 4 Second line of address City or Post Office State ZIP Code I~fEW CUMBERLAND PA 17070 REGISTER OF WILLS USErQSILY C•} ~-- ~~ ~:.~ - ~ ~ -ra ~• ~ r ~? "~; ~ TILED ~ C]D _`i ,- i Correspondent's a-mail address: FRANKKELLY@KELLYTAX . COM Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and 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. SIG~~TURE OF PERSON~2E,SP0 ,SfBLE FU,h{ riunci rtrsi urc~j l/ t y L, o ` !/~ % '~ ~ ~/"~ 4 1:3 JUNIPER DRIVE DOYLESTOWN PA S •~ TU E F PREPARER OTHER THAN REPRESENTATIVE DATE ADID 40 BRIDGE STREET SUITE 4 NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041169 15056041169 REV-1500 EX (os-05) PA Department of Revenue Bureau of Individual Taxes PO Box 280601 Harrisburg, PA 17128-0601 J 15056042160 REV-1500 EX Decedent's Social Security Number Decedent's Name: OLIVE A TUTHILL 181019 817 _ RECAPITULATION 1 175,900.00 1. Real estate (Schedule A) .......................................... ... . 2. Stocks and Bonds (Schedule B) ..................................... ... 2. 81 , 3 7 0 . 4 3 3. Closely Hekf Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. ~4. Mortgages 8 Notes Receivable (Schedule D) . . ........................ ... 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ..... ... 5. 4 , 3 5 0.0 0 i6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested .... ... 6. 17 , 5 0 9 .0 0 7. Inter-vvos Transfers 8 Miscellaneous Non-Probate Property 161 0 0 8 0 0 (Schedule G) ~ Separate Billing Requested .... ... 7. , . B. Total Gross Assets (total Lines 1 - 7) ................................ ... 8. 4 4 0 , 13 7 . 4 3 9. Funeral Expenses 8 Administrative Costs (Schedule H) .................. ... 9. 3 8 , 811 • 0 0 10. 9 9 ( ) ............. Debts of Decedent, Mort a e Liabilities, 8 Liens Schedule I 10. .. 3 , 10 0 • 0 0 11. Total Deductions total Lines 9 & 10 11. 41 , 911.0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 3 9 8 , 2 2 6 .4 3 13. Charftable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. 14. Net Value SubJect to Tax (Line 12 minus Line 13) ...................... .. 14. 3 9 H , 2 2 6 .4 3 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 3 8 8, 5 2 3 . 4 3 (a)(1.2) x .04 5 15. 17 , 4 8 3. 5 5 16. Amount of Line 14 taxable at lineal rate x .0 16. 17. Amount of Line 14 taxable at sibling rate x .12 t7. 18. Amount of Line 14 taxable at collateral rate x .15 18. 19. TAX DUE ...................................................... .. 19. 17, 483 .55 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042160 15056042160 J REV-1500 E:X Page 3 Decedent's Complete Address: FII9 Number 21.0 8.114 9 DECEDENT'S NAME Olive A Tuthill STREETADDRESS 609 'Warren Street CITY Lemoyne STATE PA ZIP 17043 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 17 , 4 8 3 . 5 5 2. CreditslPayments A. Spousal Poverty Credit B. Pirior Payments C. Discount Total Credits (A + B + C) (2) 0 . 0 0 3. InteresUPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) (3) 0 . 0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fi!! in box 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) 17 , 4 8 3 . 5 5 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 17 , 4 8 3 . 5 5 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 : ..................................... ..... b. retain the right to designate who shall use the property transferred or its income : ............... ..... [~ x~ c. retain a reversionary interest; or .................................................... ..... ~ 0 d. receive the promise for life of either payments, benefits or care? ........................... ..... ~ 0 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? ..... 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. ~i9116(a)(1.1)(ii}]. The statute does not exemot 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 adoptiive 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 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+ (11-08) ~ Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE qF FILE NUMBER Olives A Tuthill 21.08.1149 All reaN 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 woulci 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. If more space is needed, insert additional sheets of the same size. REV-1503 E:X+ (B-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT _ ESTATE 0'~F FILE NUMBER n~ ; ~~A A m,~rhi 11 21.08.1149__ All property Jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1504 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Olive A Tuthill 21.08.1149 Schedule C-1 or C-2 {including all supporting information) must be attached for each closely-held corporationlpartnership Interest of the decedent, other than a sole-proprietorship. See instrudions for the supporting information to be submitted for sole-proprietorships. ITIEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH I. None TOTAL (Also enter on line 3, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) REV-1505 E:X+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF `FILE NUMBER Olive A Tuthill 21.08.1149 1. Name of Corporation NOrie State of Incorporation Address Date of Incorporation City . State Zip Code Total Number of Shareholders 2. Federal Employer I.D. Number Business Reporting Year 3. Type of Business 4. 5. Was the decedent employed by the Corporation? ........................................ Yes ~No If yeas, Position Annual Salary $ Time Devoted to Business 6. Was the Corporation indebted to the decedent? .........................................[]Yes ~No If yes, provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? ............ Q Yes ~ No If yes, Cash Surrender Value $ Net proceeds payable $ Crvvn~er of the policy 8. Did I:he decedent sell or transfer any stock in this company within one year prior to death or within two years rf the date of death was prior to 12-31-82? Yes ~No If yes, Transfer Sale Number of Shares Transferee or Purchaser Consideration $ Attach a separate sheet for additional transfers and/or sales. Date 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? ....... QYes ~ No If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? ......................................................[]Yes ~ No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? ........... .. . Q Yes ~ No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? ................ . QYes ~ No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. • • •- • ~ ~ A. Det<~iled calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If this corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. ProducUService G. Any other information relating to the valuation of the decedent's stock. (If more space is needed, insert additional sheets of the same size) Provide all rights and restrictions pertaining to each class of stock, REV-1508 EX+ (9-00) SCHEDULE C-2 PARTNERSHIP COMtufONWEALTH OF PENNSYLVANIA !INHERITANCE TAX RETURN INFORMATION REPORT RESIDENT DECEDENT ESTATE OF ~~ FILE NUMBER Olive A Tuthill 21.08.1149 1. Names of Partnership None Date Business Commenced Addnsss Business Reporting Year City _ State Zip Code 2. Federal Employer I.D. Number 3. Type of Business ProducUService 4. Decedent was a ~ General ~ Limited partner. If decedent was a limited partner, provide initial investment $ 5. 6. Valve of the decedent's interest $ 7. Was the Partnership indebted to the decedent? ......................................... []Yes ~No If yes, provide amount of indebtedness $ 8. Was there life insurance payable to the partnership upon the death of the decedent? ............[]Yes If yeas, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 9. Did t:he decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12-31-82? Yes [~No If yes, []Transfer []Sale Percentage transferred/sold Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales. 10. Was there a written partnership agreement in effect at the time of the decedent's death? ......... Q Yes ~ No If yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? .......................................... QYes ~No If yes, provide a copy of the agreement of sale, etc. 12. Was. the partnership dissolved or liquidated after the decedent's death? ...................... Q Yes ~ No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners? ........................................ QYes ~ No If yes, explain 14. Did the partnership have an interest in other corporations or partnerships? .................... Yes ~No If yes, report the necessary information on a separate sheet, incuding a Schedule C-1 or C-2 for each interest. • ~ •- • ~ ~ A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete addresses and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. No REV-1507 E:X+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES 8~ NOTES RECEIVABLE ESTATE OF FILE NUMBER Olive. A Tuthill 21.08.1149 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITIEM VALUE AT DATE NUMBER DESCRIPTION _ OF DEATH None TOTAL (Also enter on line 4, Recapitulation) ~ E (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) COMAAONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ESTATE OF~ FILE NUMBER Olive A Tuthill 21.08.1149 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointhr-owned with right of survivorship must be disclosed on Schedule F. ITEiM VALl1E AT DATE NUMBER DESCRIPTION OF DEATH 1. Cash on Hand 100 2. Personal Property - valued at FMV as determined using IRS/Salvation Army tables for personal property and clothing, living room furniture dining room table, kitchen table, bedroom suite, end tables, kitchen appliances- pots - pans - dishes etc 2,375 3. 1995 Buick Century 1,875 TOTAL (Also enter on line 5, Recapitulation) I $ 4 , 3 5 0 . 0 0 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF~ FILE NUMBER Olive A Tuthill 21.08.1149 If an asset waa made joint within one year of the decedent's date of death, it must be reported on Schedule G SURVIVING JOINT TENANT(S) NAME I ADDRESS RELATIONSHIPTO DECEDENT A. Thomas Gross B. C. .IOINTLY-CIWNED PROPERTY: 1049 Swarthmore Road Son in Law New Cumberland PA 17070 ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SMAILAR IDENTIFYING NUMBER.ATTACHDEED FORJOINTLY+iELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTSINTEREST ~. A. 022608 PNC Bank Account #5003172775 8,576 100 8,576.00 2 A 022608 PNC Bank Account #5140134556 8,933 100 8,933.00 TOTAL (Also enter on line 6, Recapitulation) 5 17 , 5 0 9 . 0 0 (If more space is needed, insert additional sheets of the same sae) REV-1510 EX* (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY -- --- ESTATE OAF FILE NUMBER 01ive~ A Tuthill 21.08.1149 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 OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACHACOPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OFASSET ~ OF DECD'S INTEREST EXCLUSION IE APPLICABLE) TAXABLE VALUE t. Lincoln Choice Annuity 92.9812087 63,516 100 6 ,516.00 2 Allianz Annuity #1411033 I. 97,492 100 9 ,492.00 TOTAL (Also enter on line 7, Recapitulation) I S 161 , 0 0 8 . 0 0 (If more space is needed, insert additional sheets of the same srze) REV-1511 EX~ (10-r?8) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8 ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Olive A Tuthill 21.08.1149 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Parthemore Funeral Home New Cumberland PA 9,234 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) StreetAddress City Year(s) Commission Paid: State 21P 2. Attorney Fees 3. Famiy Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant StreetAddress 4. 5. s. ~. 8. 9. 10. City State ZIP Relationship of Claimant to Decedent Probate fees Accountant's Fees Tax Retum Preparer's Fees Kelly Financial Services 2008.2009 Form 1041 Patriot News Death Notice Advertising Cumberland County Law Journal Settlement Costs on Home Sale 360 9,903 340 525 194 75 18,180 TOTAL (Also enter on line 9, Recapitulation) ~ ; 3 8 , 811.0 0 (If more space is needed, insert additional sheets of the same size) REV-1512 E:X+ (12-OE!) ~~ Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT INHERITANCE TAX RETURN MORTGAGE LIABILITIES ~l LIENS RESIDENT DECEDENT ~~ ESTATE (IF FILE NUMBER Olive A Tuthill 21.08.1149 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH i. Moffitt Vascular Camp Hill PA ~g 2. Manor Care Camp Hill PA 452 3. Borough of Lemoyne Lemoyne PA Sewer Trash 236 4. PPL Allentown PA Electric 84 5. Smith Radiology New Cumberland PA 5 6. WESCO Energy Camp Hill PA Fuel Oil 795 7. AT & T Long Distance Telephone 48 8. Verizon Telephone 60 9. Comcast Cable 30 10. Family Physicians New Cumberland PA 11 11. Spirit Physician Servcies Camp Hill 136 12. Camp Hill Emergency Physicians Camp Hill PA 54 13. PA American Water 72 14. OSL Orthopedics Institute 14 15. Holy Spirit Hospital Camp Hill PA 1 024 TOTAL (Also enter on line 10, Recapitulation) $ 3 , 10 0 . 0 0 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (11-08) Pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT --_ __ ___ ESTATE nF FILE NUMBER Olive A Tuthill 21.08.1149 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Oo Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 2116 (a) (1.2).] I.. Patrica Gross Daughter .50 of residual 1049 Swathmore Road New Cumberland PA 17070 2. Bonnie Spahr Daughter .50 of residual 13 Juniper Drive Doylestown PA 18901 3. Carolyn Urban Grand-Daughter 24,373 704 Elena Drive Broomall PA 19008 4. David W Spahr Grand-Son 24,373 568 Summit House 568 West Chester PA 19382 5. Rebecca L Gross Grand-Daughter 24,373 1049 Swarthmore Road New Cumberland PA 17070 6. Steven A Gross Grand-Son 24,373 1071 Penn Circle Apt G301 King of Prussia PA 19406-1166 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN ].. None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. None TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I ~ If more space is needed, insert additional sheets of the same size. REV-1514 E?X~ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY ~ TERM CERTAIN heck Box 4 on REV 1500 Cover Shee _ --_ ESTATE OF FILE NUMBER Olive. A Tuthill 21.08.1149 this schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. ^ Will ^ Intervivos Deed of Trust ^ Other None ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years _ ^ Life or ^ Term of Years _ ^ Life or ^ Term of Years Value of fund from which life estate is payable .............................................. $ 2. Actuarial factor per appropriate table ..................................................... . Interest table rate - ^3 1/2% ^6% ^ 10% ^Variable Rate 3. Value of life estate (Line !multiplied by Line 2) .......................................... . ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ L'rfe or ^ Term of Years 1. Value of fund from which annuity is payable ................................................ $ 2. Check appropriate block below and enter corresponding (number) ............................. . Frequency of payout- ^Weekly (52) ^Bi-weekly (26) ^Monthly (12) ^Quartery (4) ^Semi-annually (2) ^Annually (1) ^Other ( ) 3. Amount of payout per period ............................................................ $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 ...................................... . 5. Annuity Factor (see instructions) Inteiresttablerate-^31/2% ^6% ^10% ^VariableRate 6. Adjustment Factor (see instructions) ..................................................... . 7. Value of annuity - If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 ............................. $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 ..................................................... $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax; return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If mare space is needed, insert additional sheets of the same s¢e) REV-1644 EX+ (3-04) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT F. ESTATE OF 'I'UTHILL OLIVE A (Last Name) (First Name) (Middle Initial) Thia schedule is appropriate only for estates of decedents dying on or before December 12, 1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust principal. 11. REMAINDER PREPAYMENT: F~. Election to prepay filed with the Register of Wills on NOne (Date) E3. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income or Annuitant(s) of election or annuity is payable C;. Assets: Complete Schedule L-1 1. Real Estate .............................. $ 2. Stocks and Bonds ........................ $ 3. Closely Held Stock/Partnership .............. $ 4. Mortgages and Notes ...................... $ 5. Cash/Misc. Personal Property ............... $ 6. Total from Schedule L-1 .................................................... $ D. Credits: Complete Schedule L-2 1. Unpaid Liabilities ......................... $ 2. Unpaid Bequests ......................... $ 3. Value of Unincludable Assets ................ $ 4. Total from Schedule L-2 .................................................... $ E_. Total Value of trust assets (Line C-6 minus Line D-4) ............................... $ F=. Remainder factor (see Table I or Table II in Instruction Booklet) ....................... . (3. Taxable Remainder value (Line E x Line F) ...................................... $ (Also enter on Line 7, Recapitulation) 11[. INVASION OF CORPUS: A. Invasion of corpus (Month, Day, Year) B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income or Annuitant(s) corpus or annuity is payable consumed CC. Corpus consumed .......................................................... $ D. Remainder factor (see Table I or Table II in Instruction Booklet) ....................... . E. Taxable value of corpus consumed (Line C x Line D) .............................. $ (Also enter on Line 7, Recapitulation) INHERITANCE TAX SCHEDULE L REMAINDER PREPAYMENT OR INVASION OF TRUST PRINCIPAL FILE NUMBER 21.08.1149 REV-1647 'EX+ (9-00) SCHEDULE M COMMONWEALTH OF PENNSYLVANIA FUTURE INTEREST COMPROMISE INHERITANCE TAX RETURN RESIDENT DECEDENT - (Check BOX 4a On ReV-1500 COV@r Sheet) ESTATE OAF FILE NUMBER , Olives A Tuthill 21.08.1149 Thas Schedule is appropriate only for estates of decedents dying after December 12, 1982. This schedule is to be used for all future interests where the rate of tax which wilt be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. ^ Will ^ Trust ^ Other 1. Beneficiaries NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO NEAREST BIRTHDAY 1. None 2. 3. 4. 5. ll. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. ^ Unlimited right of withdrawal ^ Limited right of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest ...................................................... $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet} .. $ 3. Value of Line 1 passing to s ouse at appropriate tax rate Check One ^ 6%, [~ 3%, ^ 0% .................. $ (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate Check One ^ 6%, ^ 4.5% ........................ $ (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 taxable at sibling rate (12%) (also include as part of total shown on Line 17 of Cover Sheet) .. $ 6. Value of Line 1 taxable at collateral rate (15%) (also include as part of total shown on Line 18 of Cover Sheet) .. $ 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1} .................. $ (If more space is needed, insert additional sheets of the same s¢e) REV-18481?X (11-99)(I) SCHEDULE N SPOUSAL POVERTY CREDIT COMMONWEALTH OF PENNSYLVANIA (AVAILABLE FOR DATES OF DEATH 011111192 7012131194) INHERITANCE TAX DIVISION ESTATE OF FILE NUMBER Olive A Tuthill 21.08.1149 This schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet. •~' • • '• 1. Taxable Assets total from line 8 (cover sheet) ............................................... 1. NOrie 2. Insurance Proceeds on Life of Decedent ................................................... 2. 3. Retirement Benefits ................................................................... 3. 4. Joint Assets with Spouse ............................................................... 4. 5. PA Lottery Winnings ................................................................... 5. 6a. Other Nontaxable Assets: List (Attach schedule if necessary) ... 6a. 6b. 6c. 6d. 6. SUt3~TOTAL (Lines 6a, b, c, d) ........................................................... 6. 0 . 0 0 7. Total Gross Assets (Add lines 1 thru 6) .................... . ............................... 7. 0 , 0 Q 8. Total Actual Liabilities .................................................................. 8. 9. Net 'Value of Estate (Subtract line 8 from line 7j ............................................. 9. Kline 9 is greater than 5200,000 -STOP. The estate is not eligible to claim the cretlit. If not, continue to Part I/. Q , 0 Q Income: 1. TAX YEAR: 19 2. TAX YEAR: 19 3. TAX YEAR: 19 a. Spouse ............ 1a. 2a. 3a. b. Decedent .......... 1b. 2b. 3b. c. Joint .............. 1 c. 2c. 3c. d. Tax Exempt Income .. 1d. 2d. 3d. e. Other Income not listed above ........ 1e. 2e. 3e. f. Total ............. . 1f. 2f. 3f. 4. Average Joint Exemption income Calculation 4a. Add Joint Exemption Income from above: (if) + (2f) + (3f) (~3) 4b. Average Joint Exemption lncome .................................................... ....... If litre 4(b) is greater than $40, 000 -STOP. The estate is not eligible to claim the credit. If not, continue to Part ///. 1. Insert amount of taxable transfers to spouse or $100,000, whichever is less .................. ..... 1. 2. MuNiiply by credit percentage (see instructions) ......................................... ..... 2. 3. This. is the amount of the Resident Spousal Poverty Credit. Include this figure in thie calculation of total credits on line 18 of the cover sheet .............................. ..... 3. 4. For Nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the decedent's gross estate ........................................................... ..... 4. 5. Multiply line 3 by line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credd. Include this figure in the calculation of total credits on line 18 of the cover sheet... ..... 5. REV-1649 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) --- - ESTATE CIF FILE NUMBER OlivE~ A Tuthill 21.08.1149 Do not complete this schedule unless the estate is making the election to taz asaeb under Section 91131 A) of the Inheritance & Estate Tax Act Ii the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital, residual A, B, By-pass, Unified Credit, etc.). if a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arcangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election onty as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule 0. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certiticate• ~~+6.(~ _ P~.48r953~ Certitication Number iEV ii2006 PRINT IN ANENT :N INK This is to certify that the information here given correctly copied from an original Certificate of Deal duly tiled with me as Local Registrar. 1'he urigia certificate will he forwarded to the State Vit Records OCCice ti>r ~ennanent filing. Local Registrar Date Issued COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH (See instructions and examples on reverse) STATE FILE NUMBER 1. Name d OBpetlenl (First. nkdtlM, last, suffix) 2. Sex 3. Social Seaeiry Number d. Date d Ddlh IMOnIh. daY. Year( Olive Annette Tuthill female 181 - O1 = 9817 November 8, 2008 s. Age Vaal Birm0ayl under t you under 1 my s. Dale a Binn Montn, de . ear) 7. Binhplece IGh ul0 stare a f cam j Be. %ad a Death CMCk ony one) Mwpw peY. t,aw, N.ax. limplMl: odpr: Ho s p cc e i d G e n c e 91 y„ May 2 7 , 1917 Honesdale , PA ^,,,pa,~,,, ^ ER / Oulpatienl ^ DOA ^ Nursing Mane ^ Resroence ®Other . $QpLlry~ W. County d Deem Bc. Cry, Born, Twp. of Death Bd. Facility Nato (a not nslnulion, give street and axMal 9. Was Oecedenl d HMpenic OnMn? ~] No ^ Yes t 0 Race. Amerkan Indian, Black, Whae, em. Dauphin Susquehanna Twp. Carolyn Croxton Slane Hospice Residers a°~ ~PIIe~UaR18.2,p,) ISM white 11. Decedents Used Oa anon Kind of woM d orp npal a work Na. Do not slate re 12. Wes Decadent ever m the f 3. Decedent's Education I~epiy ally nighest grade wrnp leled) 14. Marital $MIW: Marred, Never Monied, 15. Survrvmg Spo use (K wde, glue maiden name) Kind d NmA Kind d Buskpsa / In0u91ry U.S. Armed Forces? Elementary / SecoMary 10.12) Cdlege (1 J a Sal W~~• Divorced (Sped/y) Homemaker Domestic ^Yx ®Nn 12 Widowed 18. Decedents Mang Addreaa ISlreet, uh' /lows, spte, rip code) DecedeMe Did Decedsnl ,~~„~,„p, tya.ca,la Pennsylvania wain. t?p.^Vea,DeddenlUredn , ~ 609 Warren Street Townahq? t?d ®Np Dedead Lived wimM ,7bcamy Cumberland Lemoyne Lemoyne, PA 17043 ~~,~ nduuLlmiMa 18. FamMs Nine IFru, nddde. Met, sumxl ta. Momate Name (Ebel, nkdde, maiden Nsnsnp) Edward John Box Louise Beiner Wulff I Prm) 20e. Inlpmtse's Name (Type 200. MlompnYS MaiNp Address Israel, dry / tbvm, step, zq coder Patricia T. Gross 1049 Swarthmore Road, New Cumberland, PA 17070 2/e. Memod d Dgoosiem I ^ Cremanm ^ Daptbn 21 D. Dare d pspoanon (Monty, oaY, year) 21 c. %ad d DMPOainorl (Nome d dmHery. c~toR' or ~r pled) 2ttl. Lodnon (City I bum, stole. zip code) ~ Bares ^ RemovallromSrele °oniHOn b ` "''ra ^ November 14 200 Rolling Green Cemetery Lower Allen Twp. , PA 17011 c«a ^v„ Np - el aE. n ^ rnlpr Spey: , 22s. Sgpnwti ul F prvice licensee (a person acting es such) 22b. Ucerpe lasnber 22c. Name end Addrex d Eatery ~ ,~,~,~~"" FD 012 848 L Parthemore FH & CS, Inc., P.O. Box 431, New Cumberland, PA 17070 CaroMe Items 23et sly wtren certiMrg 23a. To the bell d nN Miawladga. dxm attuned al lime, deM end pMCe nared. (Sgnuae entl title) 23b. Lkenx Number 23c. Dale Signed (Month. day. year) p rq avairebM d nrrle d loam to physaen J Q G 7 L / ~9 ' j " a C~~J f ~P wr01y dux d dealt. ),/1~1. /C Is 3 S1 ~ ~C IMrrra 2426 met ba canpkned M parson 24. Tune of Deem 25. DaM Prapurc[d Oxd (MaaR day, Year) 2B. Was Cox Referred Medk:al Examner /Coroner br a Reason DIM( Ihan Cremation « Donan«r? wta prorrources seem. ~f ~ ~ M. ~ ~ `(,1 ~ ^ Yee CAUSE OF DEATH (Sae Inehuetbna snA sxampNa) r Appmximete Mrerval: Part II: Emer odpr ' 28. Did Tobacco Ux Caandpe M Deem? nem 27. Pan L Enta Nte g'pn d everl6 - 6sxaes, irryunx. a cgnpYrriorp - mat diredN dread Up dxm. W NOT emu IemleW events such as drdiec .neat, r Orpet p Oeam but not reselling M dp untledyarg dux even st P«t L ^ Vas ^ Probal,y rasp'retay arrest, a ven7rrnAer Abnsaeon waMd ehowvg dp etidogy. Usl oNy oner{xuae on eedr Yne. /~ ~~ r o ^ Unknown sxAEI31ATE CAl15E IFslal daxaa « C (x h L71 I ~ ~. Q ~+ ~ ~ 5 ` ; con4tMn rxdMg n ml _~, a K zs ,n~F,e/mak . Duo to for es a consequynceA ~ ~ ~ ~'~ ~ „ „ ` ~ a(N ~ SegMaiaNy ist condsiora, if any, b. U (,j(,,~t/L sr M T I7felol pregnant witMn part year ~' ~ ^ Prognanl al Imp of dxm Madq to the du90 kSled r>n Nne a. EMSr 9p UNDERLYWG CAUSE Dua to (a as a conseouerce ~ ~ ~ ~ ~ I ~•' l (6eeeae «iM«y met irrnaptl me c. C~./`I ~.+1 ~ U G 3 ; \ -„J ^ N01 prag~pnl, but Pregnant vntNn 42 Jaya d Beam evade resuning n dxmj LAST Dua to for as a consequence ~: r l C ~ Went, but pregnarrt 43 days to I year bemre seam d. t ^ Unkrpwn if pregrpnt wmsn ttre past year 30a. Wu an Aaopay 30b. Were Autopsy findings 31 Maurer d Dxm 32a. Date d Injury (Mmm, Oay, Yxr) 32b. Desabe How Irgay Occuned 32c. %ad of MNry: Homo, Farm. Street Factory, Odice BuiMing etc rSpedry) Palormed7 Avaipde Prior to Compleiron d cave of DxmT .~ ^'l~l ^ Hanicba , . Y ~ ^ Vx ~ ^ Acndent ^ Perdng Imesagatlon 32d. Time d Injury 32e. Inyxy at Wark7 321. d Trupporlelion Injuy (SpedryJ 32g. Lodtibn of Injuy IStren. cny I town. strtet x ^ ^ Sadtle ^ Cold Nd m Delermared ^ Vas ^ NO ^ Ddva / Opaal« ^ Passage ^Pedestrlen M Omx - Speay 33a. Certiller (check ody' oval 33h. antl r d Ce~ . • Certllying phyaNtlert (Physician cenilyMg coax of deem when amiher physicpn has Drorrorsrced deem and canpMted Item 23) dselh oceumcd due to fhe cwaNa) aM meapx x elated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ Ta dp best of my Nrpwledgs ' i2n f , pr«purKing amf cMKying phyaiden (Pnysicran nom prapuncing tleuh and certdymg to cause of deem) Ta the Beal d my krowMdge, dxm ottunetl at the time, date. and piece, and due to the ceuaele) and manna x sMisd_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 33c. Licenx Number t . ,x _, ~ ~~ / J _ U~ l L: 33tl. Date Slgrpd (Month, dayyearl ] ,p '~ ~( (CJ G] • Medical Essmhalr I C«ona On lM basis d oxaminabn and / or investigation. In my opmbn. death xcunad et the trine, data, and pMee. and doe to the dose(s) and ma«pr as stated.. ^ ~ Na d Per t m Illem ys7~nl / ray ~sorr~aEomp~eq // ~~R~ y / ~ l( (( { , / ~ ~. R fs SgnaNre . DMl ~ r ) 36. D Faetl (Harm. day, Yea 1 ~ r I I ~ ~/ /'( ~/ ~/;~J /y ~~, , . _ I .G , , _'r\,l s•7 ~ n ~~ Disposition Pemvt No. _ h: >CI !C~ ~ L~ r A TRUE COPY FROM RECORD 9n Testimony wherof, I here Into set my hand and the sea of said Court~Car~isla, ~O ~ ~ day of_,~____-- l ~ Cam„ ~,~, ~7 ~~--r.'~. Cterk aft .Orphans Court-_ ' -= Cumberland County . -; ~ ~ -- LAST WILL AND TESTAMENT __-~ - _ c:~ OF - ._.... _ _ OLIVE BOK TUTHILL ~-'' I, OLIVE f50fi TUTHILL, of the Borough of Lemoyne, County of Cumberland, and Commonwealth of Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I devise and bequeath all of my estate, of every nature and wherever situate, to my husband; WILSON TUTHILL, if he survives me by thirty days. ITEM II: Should my husband, WILSON TUTHILL, fail to survive me by STONE, SAJER & ST EVVART Attorneys at Law 41 4 Bridge Street New Cumberland, Pa- 17070 t1~~irty days, 1 devise .end bequeath all oL my estate, of every liatu~~-e ;and wherever situate, in equal shares to such of my children, BONNIE T. SPAHR and PATRICIA T. GROSS, as survive me. by thirty days. Should any of my above named daughters predecease me or die on or before the thirtieth day following my death, I devise and bequeath the share of such child to her issue, per stirpes, living on the thirty-first day following my death; and should any such daughter of mine leave no such issue living on the thirty-first day following my death, I devise and bequeath the share of such daughter to my issue, per stirpes, living on the thirty-first day following my death. Page 1 of 4 pages 0 ITEM ]:I: I appoint. my daughters, BONNIE T. SPA1]R and PATRICIA T. GROSS, Guardians of any property which passes either under this will or otherwise to a minor and with respect to which I am authorized to appoint a Guardian and have not otherwise specifically done so, provided that this appointment of a Guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such Guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payments for these. purposes, without further responsibility to the minor or to the minor's parent or to any person taking care of the minor. 1T_1?M 7 II: I d i_rect t-hat z{11 taxes that nuiv l~E~ asscssr,d :i_n consequ~~ncc~ of my death of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ITEM IV: I appoint my husband, WILSON TUTHILL, Executor of this my last will. Should my hushand,WILSON TUTHILL, fail to qualify or cease to ac.t as Executor, I appoint my daughters, BONNIE T. SPAHR and PATRICIA T. GROSS, Executrices of this my last will. ITEM V: I direct that my Executor and Guardians, or their successors STONE, SAJER & STEWART Attorne~rs at Law 414 Bridge Street Page. 2 of /i pages New Cumberland, Pa. 17070 t succ~~ssor.s, shall. not be reyuired t:o give bond for the faithful performance of their duties in an;~ jurisdiction. s~ --~ ~ , IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~,-~~ . ~' , day of _ ~~ ;`r (~, 1983. ~.. ~;: ti~_, j__,JYr •P,„~ ~ CrCc-~~~_ (SEAL) OLIVF, BOX TUTHILL SIGNED, SEALEll, PUBLISI'.ED and DECLARED, by OLIVE BOX TUTHILL, the Testatrix above named, as and .for her Last Will and Testament, and in the presence o.f us, who, at her request, in her presence and in the presence of each other, Have subscribed our names as witnesses. ~ -... ~ ! i ~~ ., j~lt_11C'_RS ~~ Witness COr1ifONWEALTH OF PENNSYLVANIA COUI`iTY OF CUMBERLAND SS: ~-~, ~ nn t .~ qq h .~, r ~1dd1"C'.;55 Address I, OLIVE BOX TUTHILL, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed this instrument as my last will; STONE, !i AJER & STEW ART Attorneys at Law 414 Britlg~s Street New cumberiana, Pa. Page 3 of 4 pages no;~o e that I signed it willingl;~ and that I signed it as m`~ free and voluntary act for the purposes therein contained. -,;~ y.. ~ OLI'vE BO:C TUTHILLJ Sworn or affirmed to and acknowledged before me by OLIVE BOX TliTHLLL, testatrix, this _ "_ day of ~'~:;~ ,•;,~ , 1983. _ !_ ; . _ Nofarv Public•~ COrlivIONWEALTH OF PENNSYLVANIA ~ ;; ~~ , . '. ~ - SS: ,. ,_ , ~,,, COUNTY OF CUivfBERLAND ' We,~r~J~.~~- \~t tij iG' l~5 and ~ '". ' 1. the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and exect.tte the instrument as her last: wil]; that testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; that to the best of our knowledge the testatrix was at the time eighteen or more years of age, of sound mind and under no constraint or undue influence. ,. __ . (I t' ~, __ ,~~ ., Sworn or affirmed to and subscribed to before me by (`~~", STONE, BAJER ~ ~ ~ ` , _ and '__ _ '~~, _, witnesses this - _ & ST EVIIART ~ ~ ,,r', Attorneys at Law ddy Of ~ ~' i+! ~ 1983. - ------' 314 Bridge Street ~~~ New Cumberland, Pa. _ -. 4 r 17070 t •. {~, - _- % _-._.- ~i~~ Outstanding Agents Outstanding R.~St11tS. sm 21HN) RE/MAX Inurnational, Lic. All rights reserved. Each Oflice Independently Owned and Operated. Real Estate Services Proposal Prepared Esyecially_(or: Mrs. Wilson Tuthill 609 Warren Ave Lemoyne, Pa 17043 For markelin~~ the properly Iocaled at: 609 Warren Ave Prepared 1)y: Tracy Weigel Agent RF./MAX Realty Associates, Inc. 3425 Market Street Camp Hill, PA. 17011 Office: 717-761-6300 Office Fax: 717-761-1455 E-mail: trams Weigel@hotmail.com web site: http://tracyweigel.capitalareahomes.com Mobile: 717-343-2812 February 5, 2009 This analysis has not been performed in accordance with the Uniform Standards of Professional Appraisal Practice which require valuers to act as unbiased, disinterested third parties with impartiality, objccnvity and independence and without accommodation of personal interest. It is not to be RE11LTdi~ construed as an appraisal and may not be used as such for any purpose. ~~ ~t February 5, 2009 Mrs. Wilson Tuthill 609 Warren Ave Lemoyne, Pa 17043 Dear Mrs. Tuthill: Thank you very much for giving me the opportunity to present the enclosed proposal to market your home. I appreciate the time you spent with me reviewing the features of your home and outlining your financial goals and time considerations. You will receive competent and professional service when you select me and RE/MAX Realty Associates, Inc. to represent you. We have represented many families in this area concluding transactions that realize maximum value in a reasonable time. I hope you will select me as your agent in this very important transaction. This proposal includes a comprehensive market analysis that will assist us in determining the market value and pricing of your home. I hope the information included on me and RE/MAX Realty Associates, Inc. will confirm that I am best qualified to market your home please keep in mind I have not seen the propery...this on statistic only). Sincerely, Tracy Weigel Agent, REALTOR' Each Office Independently Owned and Operated. I~/~ I~, Subject Property Profile for 609 Warren Ave The following features have been identified to aid in the search for properties that are comparable to yours. This will help in determining proper pricing for your home. City: Lemoyne Acres: .16 Bedrooms: 3 Half Baths: Style: Cape Cod Construction: Heisting: Fireplaces: Parking: Ext Feat: Ext Feat: Amenity: Basement: Other Room: Trary Weigel >,? Office:717-761-6300 ~" Ore Fnx: 717-761-1455 E-mail: tracy_weigel@hotmail.com weG site: http://tracyweigel.capitalareahomes.com Mobile: 717-343-2812 Each Office Independently Owned and Operated. Municipality: Lemoyne Year Built: 1941 Full Baths: 1 Abv Grd SF: 1232 Exterior: Heating: Cooling: Parking: carport Ext Feat: Ext Feat: Amenity: Basement: full Other Room: RFlMA1C Y ~'_k Under Contrnct Address 208 Clark St Average of Recently Sold dr s Munic 47 N Eighth Street Lemoyne 806 Sixteenth Street New Cumberland 245 tree[ Lemoyne Tracy Weigel ,'~ ? ~~~ Offire:717-761-6300 Offire Fnx: 717-761-1455 ~ ~~ E-mail: tracy_weigel@hotmail.com web site: http://tracyweigel.capitalareahomes.com Mobile: 717-343-2812 Each Office Independently Owned and Operated. Average of 3 Properties: $145,733 Comparative Analysis Sur Munic Stvle Beds Lemoyne Cape Cod 3 1 Properties: $149,831 Min: $149,831 ale Be Cape Cod 2 Cape Cod 3 Cape Cod 3 Min: $140,000 Market nmary Fbath Hbath Abv Gr Sold Price 1 0 1400 Max: $149,831 Median: $149,831 List Price $149,831 F ath Hbath Abv Gr Sold Price List Price 1 1 1545 $140,000 $149,900 1 0 1160 $140,500 $144,900 1 1 1120 $156,700 $156,700 Mnx: $156,700 Median: $140,500 RE(MAZ( ~~ ~~; Map of Comparable Properties MAVQI/EST. ~~ti 'P~ `, S~ 0~2 a ,. '~ ~: ~ ~ City a ~ ~ S Paxton St 3 ~ ~ f ParR w~~ °sS Sh a ~~ s~ ' ~'`. o / ``~a ~ s `. off ~ ~ ,~' Y ~' r '. 11.15 We s y't ~ m ""'o'pr tJ 12th St ~ D ? Q-h P~° Z Washington Ter ,n °~'`P ~~,, Pic ;.,ate Pao m~ ~ ~ O~ s~ Waahlnyton Helghta ~ ~,ty ~ e , z e ` Fort Co u ch o a t ,j/ ~ g ~ y ~ ~ St m ~ -' ~ F~P~ ~e s ' :~o 5' p oc s~ ,j,•~ atY'el5 Clark Sr M a ~ ' , x`;,~. Lemoyn o S~~a ©~~y~o~d.~, sole ~. ~~ Sl ce /y d} S' 1 ~e~ Pve 3 ~p~ ,~ d~°~ '~o ~ ~ s~''~ ~~ N~ sr set ~ ~s`° P e ~ a`~" s/, s' ~,s ~e, 'a~F 0a F "yi`~s~, .:.---~"" g ~ Clradram Rd Q~e~dt r tr ~ ~~~ ~ y Norman Rd AVe ~y PAS New Cumberland / Highland Park Q o O 6 Cad/sle Rd ~ Y Simpson Ferry Rd ~e~ a s oe 5~ y Cedar CIM RolT~ltTO~cneen Rd p ~ '-A Swarthmore Rd .~e~4 gti ~ °2 row 'QP ~ N carders `J'ldDWms°n ~ ~ a Brookhaven Rd 9S 9~ 9~ ~s, S~ X0,9 St Gu GGff Qr Lower Alien ° A a ~~ 1~ ~ ~B N p's~ Ce~oEberlya MNl ° ~ ~ ~y0~ o rexel Hilk ~~Pa ~. e+o~ 4ot` ~y~ y~ ~ Allendale Dee ~ •0 5 ~o'~RaCreeKRd ° e*~Q~ ,~'° o,O~ e M <~6 o rear lane Farms ~ ~ Lor#eU~^ ~o 'P6 N °'}~ ~~ ~ 6 7 ®2009 MaaQu est. Ina ~}~ $ $ 1 Subject Property 609 Warren Ave 2 Under Contract 208 Clark St 3 Recently Sold 47 N Eighth Street 4 Recently Sold 806 Sixteenth Street 5 Recently Sold 245 Clark Street Tracy Weigel Offire: 717-761-6300 Office Fax: 717-761-1455 s" .. E-mail: tracy_weigel@hotmail.com ' web site: http://tracyweigel.capitalareahomes.com Motile: 717-343-2812 Each Office Independently Owned and Operated. RF~MAlC u Comparative Market Analysis __ 208 Clark St 47 N Elghth Street i I ``~. ~~ ~~) ~~ I 806 Sixteenth Street 245 Clark Street y ~ I ~ 3 ~,~ i - F~f1p~f! r; ` ,~ ~F._ Status ~ P S it S S List Price ~ $149,831 ' $149,900 $144,900 $156,700 Lists SgFt $107.02 $97.02 $124.91 $139.91 Sold Price $140,000 $140,500 $156,700 Sold$ SgFt ' I $90.61 $121.12 $139.91 Contract Date ~, 01/26/09 ~ 05/27/08 i 04/28/08 ~' 08/25/08 Sold Date I 02/25/09 07/25/08 06/13/08 11/05/08 DOM ~ 21 ~ 12 9 City ~I Lemoyne ~ Lemoyne New Cumber Lemoyne Municipality Lemoyne Lemoyne i New Cumberland Lemoyne Acres 0.25 ~ 0.24 ~ 0 0.25 Year Buik ~ 1942 I 1940 ~ 1946 1940 Bedrooms 3 ~ 2 ~ 3 3 Full Baths ' 1 1 1 1 Half Baths 0 i 1 ~ 0 ' 1 Abv Grd SF ' 1400 1545 ': 1160 1120 Style Cape Cod ~ Cape Cod j Cape Cod Cape Cod Exterior Aluminum I ' Vinyl ~ Block Vinyl Construction ' Frame ~ Frame ~ Frame Stick Built Heating ! Hot VVtr Bsbrd ~ Forced Air ~ Forced Air , Forced Air Heating ~ Oil Oil I Natural Gas Oil Cooling ! Central Air Ceiling Fan Central Air I Window Units Fireplaces 0 ', 1 Parking 1 Car Garage Off Str Parking 1 Car Garage 1 Car Garage Parking Detached i Detached '~ Off Str Parking Ext Feat Patio Porch Porch Ext Feat I Storm Doors Ext Feat Ext Feat ' i I ', Amenity 'i I Library Amenity ', i Park Basement Concrete Floor Concrete Floor Concrete Floor 'i Full Basement Full ~ ~ Exterior Access Full ', Unfinished Other Room Four Season Room i ~ Laundry Room Other Room i ~ ~ Loft _ '~ ~~, Tracy Weigel Orr: 717-761-6300 Offire Fax: 717-761-1455 E-mail: tract' wcigel@hotmail.com iveb site: http://tracyweigeLcapitalareahomes.com Motile: 717-343-2812 Each Office Independently Owned and Operated. RFlMAi( ~~ ~k; Comparative Market Analysis 809 Warren Avs ' 47 N Eighth Street 806 Sixteenth Street 246 Clark Street i '.. „t ~ .'~ o "~..~ , 'i ~I, ° ~ ~~~1'~l~Rj t. i, ~ r ~,~ ~.: ~:{ n Adjustmerrts Adjustments Adjustmerns gold price $140,000 ' $140,000 I $140,500 II $140,500 $156,700 $156,700 golds SgFt $90.61 $121.12 i $139.91 _istt Price $149,900 $144,900 $156,700 _Is~tS SgFt $97.02 $124.91 $139.91 Sold Date 07/25/08 06/13/08 11 /05/08 Contract Date 05/27/08 04/28/08 i 08/25/08 DOM 21 '~ 12 ~ 9 City Lemoyne Lemoyne ' New Cumber !~ ' Lemoyne Municipality Lemoyne Lemoyne New Cumberland i Lemoyne Acres 16 0.24 0 ~ i, 0.25 Year Built 1941 1940 '~ 1946 1940 ', Bedrooms 3 2 3 3 Full Baths 1 1 1 1 Half Baths 1 ' 0 1 Abv Grd SF Style Cape Cod Cape Cod Cape Cod i Cape Cod Exterior Vinyl Block i Vinyl Construction Frame Frame ~ Stick Built Heating Forced Air i Forced Air ~ Forced Air Heating Oil Natural Gas ! i Oil Cooling Ceiling Fan ', Central Air ! Window Units Firveplaces 0 1 Parking carport Off Str Parking 1 Car Garage 1 Car Garage Parking Detached Off Str Parking Extt Feat Porch ~ Porch Ex1t Feat Storm Doors Ex1t Feat Extt Feat Amenity Library Amenity Park Basement full Concrete Floor Concrete Floor i Full ~, Basement Exterior Access I Full i Unfinished Other Room Laundry Room Other Room Loft it $145,733 $140,000 $140,500 ' $156,700 Trary Weigel O~te: 717-761-6300 Office Fnx: 717-761-1455 E-mail: tract' wcigel@hotmail.com wet site: http://tracyweigel.capitalareahomes.com Motile: 717-343-2812 Each Office Independently Owned and Operated. RFlMAlC ~k; Pricing Your Property to Sell Pricing your property correctly is crucial. You want to sell your property in a timely manner at the highest price possible. Current market conditions determine the value. Pricing too high or too low can cost you time and money. Realistic pricing will achieve a maximum sale price in a reasonable amount of time. Analysis of the comparable properties suggests a list price range of X141,361 to X150,105 Trary Weigel O~ce: 717-761-6300 Ore Fax: 717-761-1455 E-mail: tracy_weigel~a?hotmail.com iveG site: http://tracyweigel.capitalareahomes.com Mobile: 717-343-2812 Each Office Independently Owned and Operated. ~~ The Services ~Ue Provide ~Ri ^ We will help you determine the best selling price for your home. ^ We will suggest what you can do to get your home in top selling condition. ^ We will recommend reputable repair companies if necessary. ^ We will develop a strategy to show your home. ^ We will enter your home in the Multiple Listing Service immediately. ^ We will develop a comprehensive marketing plan for your home. ^ We will meet with you to review progress at least once per month. ^ We will promptly advise you of changes in the market climate. ^ We will present all offers to you promptly and assist in evaluating them. ^ We will monitor progress toward closing when a contract is accepted. ^ We will immediately advise you of events that may threaten closing. ^ We will coordinate and monitor the settlement process. ^ We will monitor the appraisal and buyers' loan approval. ^ We will stay in contact with the selling agent to make sure things are proceeding smoothly. ^ We will be present at closing to assure a successful conclusion. Tracy Weigel Ore: 717-761-6300 _ Office Fnx: 717-761-1455 ~` ~ E-mail: tracy_weigel@hotmail.com web site: http://tracyweigel.capitalareahomes.com Mobile: 717-343-2812 Each Office Independently Owned and Operated. RF/MAlC ~5i Curb Appeal Are you interested in putting your home on the market, but wonder what repairs and touch ups to do? And then there's bankrolling the work, not to mention sacrificing weekends to get it done. Slow down. Get a grip. There are some no cost/low cost ways to get your home in showing shape and help you put your best foot, er... house, forward to prospective buyers. When real estate agents and buyers refer to curb appeal, it means the initial impact the home makes when the buy- er first views it. Visualize a buyer driving up to your curb. What would he see? Landscaping in need of work? A fence in need of paint? If the outside of the house is in shambles, a buyer may not be motivated to get out of the car and come inside! So what things are important to fix-up and replace before you sell? I cover them as the buyer sees them, from the outside, in. Walk across the street from your home and pretend you're a buyer, ~ _ the home for the first time. From the parking area, glance around the front yard. Note hedges and trees that need to be trimmed. Are they cut back away from the front door, the windows, and the porch area? This is not only for aesthetics but for safety reasons as well (a big priority with buyers today.) A safe home is one that has a clear view of the parking area and walk ways, free of obstructions and overgrown foliage. What about paint trim near the front door and on the eaves? Could it use a new coat? Make sure your front door is in good repair, too -including the screen door, if applicable. Buyers' impressions as they enter the home set the stage for the rest of the showing. Let's go inside the house. The cardinal rule before putting your home on the market is making sure it's clean. In a competitive sales market, why would an eager buyer waste time viewing a house that needed elbow grease? And a less than spic and span house could also signal that other maintenance in the house hasn't been kept up -like plumbing that leaks and furnace systems in need of cleaning or repair. Don't forget that a house that doesn't show well will often take longer to sell, costing you money in the long run. Tracy Weigel Office: 717-761-6300 Office Fax: 717-761-1455 E-mail: trary_weigel@hotmail.com ive6 site: http://tracyweigel.capitalareahomes.com MoGile:717-343-2812 Each OtTice independently Owned and Operated. RF(MAX ~~ ~ ~~ -H 20 Tips For Selling Your Home As a homeowner, you can play an important part in the timely sale of your property. When you take the following steps, you'll help your RF/MAX Sales Associate sell your home taster, at the best possible price. 1. Make the Most of that First Impression - Awell-manicured lawn, neatly trimmed shrubs and aclutter-free porch welcome prospects. So does a freshly painted, or at (east freshly scrubbed, front door. If it's autumn, rake the leaves. If ii s winter, shovel the walkways. The fewer obstacles between prospects and the true appeal of your home, the better. 2. Invest a Few Hours for Future Dividends -Here's your chance to clean up in real estate. Clean up in the living room, the bathroom, the kitchen. Ifyour woodwork is scuffed or the paint is fading, consider some minor redecoration. Fresh wallpaper adds charm and value to your property. Prospects would rather see how great your home really looks than hear how great it could look, "with a Gttlc work." 3. Check Faucets and Bulbs -Dripping water rattles the nerves, discolors sinks and suggests faulty or wom-out plumbing. fumed out bulbs leave prospects in the dark. Don't let little problems detract from what's right with your home. 4. Don't Shut Out aSale - [f cabinets or closet doors stick in your home, you can be sure they will also stick in a prospect's mind. Don't try to explain away sticky situations when you can easily plane them away. A little effort on your part can smooth the way toward a closing. ~. Think Safety -Homeowners team to live with all kinds of self-set booby traps: roller skates on the stairs, festooned extension cords, slippery throw rugs and low hanging overhead lights. Make your residence as non-perilous as possible for uninitnted visitors. 6. Make Room for Space -Remember, potential buyers arc looking for more than just comfortable living space. Thcy'rc looking for storage space, too. Make sure your attic and basement are clean and free of unnecessary items. 7. Consider Your Closets -The better organized a closet, the larger rt appears. Now's the time to box up those unwanted clothes and donate them to charity. 8. Make Your Bathrooms Sparkle -Bathrooms sell homes, so let them shine. Check and repair damaged or unsightly caulking in the tubs and showers. For added allure, display your best towels, mats and shower curtains. 9, Create Dream Bedrooms -Wake up prospects to the cozy comforts of your bedrooms. For a spacious look, get rid of excess furniture. Colorful bedspreads and fresh curtains are a must. 10. Open up in the Daytime -Let the sun shine in! Pull back your curtains and drapes so prospects can see how bright and cheery your home is. 11. Lighten up at Night - Tum on the excitement by turning on all your lights, both inside and outside, when showing your home in the evening. Lights add color and warmth, and make prospects feel welcome. 12. Avoid Crowd Scenes -Potential buyers often feel like intruders when they toter a home filled with people. Rather than giving your house the attention it deserves, they're likely to hurry through. Keep the company present to a minimum. 13. Watch Your Pets -Dogs and cats are great companions, but not when you're showing your home. Pets have a talent for getting underfoot. 5o do everybody a favor: Keep Kitty and Spot outside, or at least out of the way. Tracy Weigel Office: 717-761-6300 Office Fax: 717-761-]455 E-mail tracy_weigcl~a;hotmail.com web site: http://tracyweigeLcapitalareahomes.com Mobile: 717-343-2812 Each Oflice Independently Owned and Operated. 14. 15. Relax - Be Friendly, but don't try to force con- versation. Prospects want to view your home with a minimum of distraction. 16. Don't Apologize - No matter how humble your abode, never apologize for its short- comings. If a prospect volunteers a derogatory comment about your home's appearance, ]et your experienced RE/MAX Associate handle the situation. 17. Keep a Low Profile -Nobody knows your home as well as you do. But RE/MAX Sales Associates know buyers -what they need and what they want. Your REJMAX Associate will have an easier time articulating the virtues of your home ifyou stay in the background. 18. Don't Turn Your Ilomc into aSecond-Hand Store -When prospects come to view your home, don't distract them with offers to sell those furnishings you no longer need. You may lose the biggest sale of all. 19. Defer to Experience -When prospects want to talk puce, terms, or other real estate matters, let them speak to an expert -your RE/MAX Sales Associate. 20. Help Your Agent -Your RE/MAX Associate will have an easier time selling your home if showings are scheduled through his or her office. You'll appreciate the results! R~(MAi( Think Volume -Rock-and-roll will never die. But it might kill a real estate transaction. When it's time to show your home, it's time to turn down the stereo or TV. ~~ ~ . Nj Sellers Earl and Michelle Frady Customer References Chris and Jennifer Marchand Mike and Christy Beardsley Nelson Chambers Craig and Tammi Himmel Randy Perdue Chris Matteson Joe Kramer Buyers Bob Williams Earl and Michelle Frady Dan and Kira Small Chris and Jen Marchand Dave and Kandi Beardsley Bob Huggler David Lasher Darwin and Prudence Williams Trary Weigel Office: 717-761 Office Fax: 717- E-mail: tracy_we u~eb site: http://t Mobile: 717-343 Each Office Ind 7 Cedar Rd Carlisle 260 Walton St Lemoyne 5233 Strathmore Rd Mechanicsburg 1141 Floribunda Dr. Mechanicsburg 35 Winding Hill Road, Mechanicsburg 108 E. Clearview Dr. Camp Hill, Pa 912 Bruton Cove, Hummelstown 335 New Bloomfield Rd, Duncannon 31 E. Factory St. Mechanicsburg, Pa 7 Cedar Rd Carlisle 129 E. South St Carlisle 260 Walton St Lemoyne 75 Honeysuckle Rd Mechanicsburg S, Enola Rd Enola, Pa 14 Hellum Rd Mechanicsburg 2432 Wayne Ave. Harrisburg, Pa -6300 761-1455 igel@hotmaiLcom racyweigel.capitalareahomes.com -2812 ependently Owned and Operated. RF/MAX ~.~ ~H In Conclusion You should choose Tracy Weigel because: ^ I will provide you with excellent service and support. ^ I have made a thorough market analysis of your home. ^ I have developed a winning marketing plan. ^ I will make every effort to sell your home promptly. ^ I have the resources of RE/1~/IAX Realty Associates, Inc.. Let Me List Your Home Now ~ /~ ~~ ~~' Each Office Independently Owned and Operated. A ~ p~ N ~ E~ 3 z m ~~ ~ N 7 ~ ~, w o °u o a o ,~ A ~ o Q V, E ~.~. U >, ~ O ~. ~ {,~~ ~O LL N ''^^ yj1 Q/ 3 o ° _,I ~„ m o Q ~ LL Q 00 _ .~ ~ a ~ ~ "' U ~ ~ z n r°Di z' ~ Y m N c ~ 0' Pte- 0~p a~w wr-ao ~ V NWC~ ~~ y ~ ~ ~: ~ w ~ .+ Y ~ ~ r` 3 ~ m vYm U`-' LL. 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U ~ C3 O C M- T C ~ ~ ..~ lC C C ~, t!f a3 v . m p .D N : ~ m ,*_" ~ m L m g m'c mp ~ O n ~ U~ uc+im Q~ Q ~ M S o ~ N ~ W ~ a ~ ~ ~ ~. ~~ ~ ~ o t3 °' ~ ~ ~ ~ ~ ~ ~ _ ~ ~ 3 0 s (=C y N l0 ~ C ~ p ~ di m o °v ~ ~ o ~ ~ ~ ~ ~ ~ ~ T ~ ~ ~ ~ ~ O U r U ~ N ~ ~ o i N C ~ ~ r N c ~° C ~ ~ m J_ ~ x 3 F^ G H w 3 O ~ ~ Q ~~ ~~ e~ U ~y .1 Ow ay X ~~ OG ~ ~~ -, , e .YI 1995 Buick Century -Private Party Pricing Report -Official Kelley Btue Book Site Page 1 of 2 '~` Kel{ey Blue Book THE TRUSTED RESOURCE Home New Gars Used Cars Research & Explore News 8 Reviews Ready io Buy Classifieds loans & Insurance RBB'~ Green . ad ~;3r r•~~re~, i :~.-ir.n :-:yd C. ar L~..hr•.gs I "er+ nn~ P=e-Orman I ':omUAre een~ ; ~.c5 I "erlyct C,ar F~noer "ost ?e~Parcl=erf J~h~~i2n -APFnt V~n~iir H~>torv welcome Back ....tnu ; s .. ~ ,.~ '~i•~rr ~ ,.. ~-,~e .,.~~:•. ~.~ Private Party value BIDE 800K' PRIYAiE PARiY VkLUE '.-YC 4 i , r„ ~ t rJrnd ~~; alur ~;yl Estimated Payments ~ __~ ~rrY Condition ~ - Value f.37 !mod 4.54% APR r ~ f `' /1 rr~irt /r~~ICIa'~ .E' / (..~ / . .. ...,, Excellent S2,150 , w. ~,. ,,,~ 1;, , o. ~, mcun,er ,zarnrus Good f 1,850 ~ -F° ~~nr1 t•n,r rd~,t Car Fair 51,525 rGEh'- =•9t _ ~~. «uarc pC<ii-!rattOn+ 1,~. ~hai:.~ ;rta Fr=r ~~arre ..~ SearchUSedCars ~~ Shopping Tools NEXT S TEPS. Free CARFA% record check ~ ~. -f f.;=0.. r ,,. __x _ ~ =- .rte " `'roc. ; ~,:,, , ice a _az Average Consumer Ra[inq (86 Reviews) «so 11e~news _, ,. ~. - ,. .r.. •:r--•:~ ar.- :.tl;~ ~:?kr'' 4.2 out of S arvrew thrs v~h~cle „r .,•,1 :~~ ,r,~ r, ,...,._ Vehicle Highlights BU" A OSED (AR on 81ue Book Classdieds" Mileage: ~0 000 Engine: d5 3.t trtar Transmission: :utnrnauc Bwck Drivetrmn: '~ND Century 30 Mires a leis ~ Selected Equipment Change Equipment 'QA S~ i:IP r.~n,tc ~': Standard To View Ads, Click Air Condi[wmnq Power Steering AM/FM Stereo PENNSYLVANIA ll'IHtKl IHnt.C ir.n INFORMATION NOTICE AND FILE N0. 21 08-1149 BUREAU OF INDIVIDUAL TAXES Po Box zBO6o1 TAXPAYER RESPONSE ACN 08161322 HARRISBURG PA 17128-0601 DATE 12'15-2008 REV-1543 E% IIFP cos-oe~ TYPE OF EST. OF OLIVE B TUTHILL SSN 181-01-9817 DATE OF DEATH 11-08-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: THOMAS B GROSS REGISTER OF WILLS 1049 SWARTHMORE RD CUMBERLAND CO COURT HOUSE NEW CUMBERLAND PA 17070-1730 CARLISLE, PA 17013 ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PNC BANK NA provided the Department with the information below, which has been used in calculating the potential. tax due. Records indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If You fuel the information is incorrect, Please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. P1^_ase call !T17? 787-8377 frith n'!estions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000005003172775 Date 02-26-2008 To ensure prover credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 8,576.29 payable to "Resister of Wills, Agent". Percent Taxable X 100.00 NOTE: If tax payments are made within three Amount Subject to Tax $ 8,576.29 months of the decedent's date of death, deduct a 5 vercent discount on the tax due. Tax Rate X . 045 Any Inheritance Tax due will becowe delinquent Potential Tax Due $ 385.93 nine months after the date of death. PART TAXPAYER RESPONSE 0 FAILURE TO CtESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT': A The above information and tax due is correct. . ~ Remit paywent to the Register of Wills with two copies of this notice to obtain a discount or avoid i nterest, or check box "A" and return this notice to the Register of C HE:C K Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K T e above asset has been or will be revorted and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y be filed by the estate representative. /C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, Please state relationship to decedent: TAX R'.ETURN - COMPUTATION LINE I. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5~. Debts and Deductions 6.. Amount Taxable 7'. Tax Rate ft. Tax Due OFFICIAL USE ONLY ~ AAF PA DEPARrHENr DF REVENUE PAD 1 2 3 4 5 6 7 8 OF TAX ON JOINT/TRUST ACCOUNTS 1 2 $ 3 X 4 $ 5 6 'S 7 X 8 $ PART DEBTS AND DEDUCTIONS CLAIMED 0 _.~~ .,.r„ pev~F DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK C ) ~..r,,..r~o crr_treTlrDF TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE ND. 21 08-1149 Po Box 280601 TAXPAYER RESPONSE ACN 08161321 HARRISBURG PA 17128-0601 DATE 12-15-2008 RFV-1545 IX AFP (00-0e) ** THOMAS B GROSS 1049 SWARTHMORE RD NEW CUMBERLAND PA 17070-1730 EST. OF OLIVE B TUTHILL SSN 181-01-9817 DATE OF DEATH 11-08-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PNC BANK NA provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a ioint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Comwonwealth of Pennsylvania, Please cell C71~) 7A7-Bb?7 with m(estions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000005140134556 Date 02-26-2008 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 8,932.58 payable to "Register of Wills, Agent". Percent Taxable X 100.00 NOTE: If tax payments are made within three Amount SUbjeCt t0 TaX $ 8,932.58 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential TaX Due $ 401 • 97 nine months after the date of death. PART TAXPAYER RESPONSE FAI$tIKE TO R£SPONi1' Ir~ILL RESULT IN AN OFFICIAL TAX ASSESSMENT'. A. ~ The above information and tau due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of C Hf.C K Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O N L Y o be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions ware paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Daie Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ ~+ 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL Ch Mer On Llns 7 OT Iax vvmpu to a uni Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK ( ) TAYDAVCD crr_uerilaF TELEPHONE NUMBER DATE ~ Lincoln Financial Groups Lincoln ChoicePlus I"O Btmx 2348 Annuity Quarterly Statement Fon Wayne. ]N 46so1 X348 3rd Quarter 2008 _ _ _. YWr ACCOttnt Gtfermation Y ur Annuit Contact Information Contract Owner: OLIVE B'I'UTHILL LincolnChoicePtusllB 92-9812087 Representative: FRANK H KELLY ~t~nnuitant: OLIVE B 1'U'I'HII,L Plan Type: Non-ilualitied Broker/Dealer: H D VEST INVESTMENT ContraM Effective Uate: 1/9/2003 If you have any questions regarding this smtement, please call Lincoln Financial Group at 800-826-6848 or visit our website at www.lfg.com Your Quarterly Account Value \%alue 6/30/08 Net Activity Gain /Loss Value 9/30/08 583.087.38 50.00 t$7,622.78) 575.464.60 F:efer to your contract for surrender charge information. Surrender Value: 572,630.11 Your Asset Allocation t., D 6~ U V •r r.+ O L 6~ O ~.t I O. O U ..Vi O O Lr rr u as W • Percentages less than I~;f may not be represented in the pie chart. Due to rounding, the percentages shown may not be equal to IOO~Yo • *Asset Class is determined by Lincoln National Life Insurance Company and is nut considered investment advice. L Your. Death Benefit As of 9/30/08. the death benefit for the owner was the greater of $55,989.78 or [he account value. The actual benefit amount may he more or less depending on the date of death, market fluctuations, premium payments and partial withdrawals. For detailed information regarding your death benefit, please refer to your contract or prospectus. Your Performance Summary Fund Name Asset Class• Percentage Account Value ~ AB Lrg Cap Grw US Large Growth 13.7 9F, 510,354.29 :i~ AB Grwth&Inc US Large Value 13.4 % $10.118.23 ~ Del Trend US Small Growth 9.9 °/a $7,488.93 i`j Del Sm Cap Val US Small Value 10.3 °b 57,761.96 ~ AF Int'I International Eqty 12.0 °k 59.077.74 ~ Del High Yield Bond 10.3 % 57,742.06 ~,~ LVIP Del Bond Bond 30.4 % 522,921.39 Annualized Performance Current Quarter Year to Date 1 Year 3 Year 5 Year 10 Year 19.17 %t 117.07 %) 118.06 %) (1.03 °k) 3.73 °k N/A • Yuur Performance Summary is the personal rate of return that represents the individual performance of the investment(s) you have selected for your portfolio. 'the calculation includes activity in your account (such as contributions, exchanges among investment options, etc.) using daily share price in effect when the activity occurred. Because the timing of your investments and withdrawals will vary. your personal investment results will generally not be the same ^s the investment returns quoted for the individual funds you have chosen. Performance data represents past performance. Past performance does not guarantee future results. Your Inception-To-Date Summary ('ontributions Withdrawals Gain/I,oss 555.989.78 $0.00 • Gain/Luss may he understated if your contract is subject to administrative fees. 519,474.82 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its aftiliates. n :008 The Lincoln National Life Imumnce Company. 92-9812087 OL[VE B TUTHILL Continued un back 0000000 S'l.HVE7 836697 KELLY. FRANK H 770N 330 Your. Fuml Summary A.s of 6/311/08 A.s of 9/30/08 Number Number Fttnd Name Unit Value of Units Value Net Activity Gain/I,oss Unit Value of Units Value ;1B Lrg Cap Grw~ 9.949663 ?.052.6160 $12.?12.37 50.(10 151.858.08 1 5.(}34437 2,052.(1160 $10.354?9 11B Grwth&Inc ~~ 11.303808 L004.4638 $11.354.27 $0.OD (51,236.04) 10.073265 I.O(k1.4638 $10.118,23 LArI 'frond $~ 7.620425 L088.1347 $8,292.05 50.00 ($803.12) 6.882358 L088.1347 57,4218.93 Del $m Cap Val ~,,{~ 21.495729 379.0814 $8,148.63 $0.()n ($386.67) 20.475719 379.0814 $7,761.96 A'F Int'I 11.714419 938.1167 $10.989.49 $0.00 ($1.911.75) 9.676560 938.1167 59 077 74 Del High Yieid~3~f}'{~j t3?34548 634.6274 $8,399.01 50.00 ($656.95) 12.199381 634.6274 , , $7,742.06 L'VIP Del Bond~L~~ 14.494536 1,634.5166 523,691.56 $0.00 ($770.17) 14.023346 1.634.5166 5?2,921.39 Your Future Allocations As of 9/30/08, your contract instntctions show that additional contributions will be allocated according to these percentages: IO% AB Lrg Cap Crw 15rYo Fid Ey-Inc IS% Drl Trend to°k Rrt Health Sc 103'o MFS Utilities IS% LVIP Del Bond I:i% AF Grwth--Inc !0°k Put Grwth&Inc ~. ~+ t7 U u .~ as a d i a O U .; Q 0 L r.+ w .Your Notifications and Disclosures • This confirmation is prepared by The Lincoln National Life Insurance Company or one of its Life Insurance company affiliates pursuant to its agreement with the principal underwriter of the insurance securities described herein, for the benefit of the selling broker dealer. • Notify Lincoln promptly if inforntation contained in this document is not accurate. Please feel free to re-confirm any oral communication in writing to further pirotect your rights. • Interest rates and crediting methodology will be provided to you upon request and free of charge. I~ ~ ~ ~ ~,t,-r.~ ~~ Sn~ n-rt_ C,A.o ,13(~~~ X ~~ yip tY~ k ~ S t ~, x;75 ~ 1C ZvS~.(~Ib 8 ~Y~ (o~U.~~3~- 773 to8~.i3~7 53 ~7 3 7~ , o ~ ~ << < 5""ya ~~ S ~ ~ C-t ~` . Y ~ °~ L>J t ~~ I'r~ ~ ~oN~ 1 ~,~ogaS ~ )° ~3~-I~~°~~y~ ~5~~~'~ ~3 S J ~° Lincoln Financial Group is the marketing mm~e for Lincoln National Corporation and its aftliates. C~ '_008 The Lincoln National Life Insurance Company. 92-98L087 OLIVE B TUTH[LL (x)(>D(xx) SZHVE7 836697 KELLY. FRANK H 770N 330 Historic Unit Values Contract Selection Account Value `Transaction History Transfer Funds Chrange Future Allocations Investment Models ~Coniract Profile ~Vi~ew Client Statements jView Client Tax Statements '',View Client Confirmations 'Investment Results :Historic Unit Values Farms Li terature/Prospectus Contract Rider Information My Profile Continuing Service Fee Stmt Client Profile Contact Us /aQ elp Index Privacy Natice Browser Support Logout Historic Unit Values Owner Name: Annuitant/Participant Name: Contract Number: Understanding the unit value What are the ticker ymbols far these.. funds'? Page 1 of 4 OLIVE B TUTHILL OLIVE 8 TUTHILL 9298120$7 The unit values reflect the most recent stock market closing values for the plan. All funds listed may not be available; due to the effective date of the contract. Unit Values As Of: 11/07/2008 (mm/dd/ccyy) Lookup Year-end flatly as of Investment Options 12/31!2007 unit 11/07/2008 unit value value LVIP DELAWARE BOND 14.601432 13.608051 LVIP MONEY MARKET 11.048795 11.134567 LVIP DELAWARE SOCIAL AWARENESS 15.679355 10.476899 LVIP UBS GLOBAL ASSET ALLOCATION 15.596442 10.509896 LVIP MONDRIAN INTERNATIONAL VALUE 24.959288 15.468313 LVIP T ROWE PRICE STRUCT MID- CAP GROWTH 16.152857 9.283783 LVIP JANUS CAPITAL APPRECIATION 14.797760 8.726811 AMERICAN FUNDS GROWTH- INCOME 14,617138 9.208433 AMERICAN FUNDS GROWTH 10.878355 6.183968 AMERICAN FUNDS INTERNATIONAL 13.391964 7.618583 AMERICAN FUNDS GLOBAL GROWTH 16.947298 10.345053 httns://ltaco!nlife.iscaccount.com/servlet/UnitValuesServlet 12/29/2008 HF1P FOR THt5 SCREEN Historic Unit Values Page 2 of 4 AMERICAN FUNDS GLOBAL SMALL CAP 18,332635 8.847123 DWS EQUITY 500 INDEX VIP 9.830250 6.247491 LVIP BARON GROWTH OPPORTUNITIES 10.808344 6.699018 DWS SMALL CAP INDEX VIP 18.113303 11.893312 NEUBERGER BERMAN MID CAP 18.348169 10.833987 FRANKLINTEMPLETON SMALL- MID CAP 8,425154 4.986565 FRANKLINTEMPLETON MUTUAL SHARES SEC 11,477257 7.428604 ALLIANCEBERNSTEIN LARGE CAP GROWTH 6.798353 4.136438 ALLIANCEBERNSTEIN GROWTH & INCOME 13 728441 7.678911 ALLIANCEBERNSTEIN GLOBAL TECHNOLOGY 5.172855 2.791218 FRANKLINTEMPLETON GROWTH SEC 15.273048 8.774279 DELAWARE VIP VALUE 14.964009 9.438339 DELAWARE VIP TREND 8.892031 4.950998 DELAWARE VIP SMALL CAP VALUE 22,412193 15.568798 FIDELITY VIP EQUITY-INCOME 14.140933 8.192278 FIDELITY VIP GROWTH 8.330490 4.669058 FIDELITY VIP OVERSEAS 12.801341 7.134780 MFS VIT GROWTH 6.656237 4.252758 MFS TOTAL RETURN 14.443041 10.980012 MFS UTILITIES 17.676164 10.862005 DELAWARE VIP HIGH YIELD 13.576412 10.366064 DELAWARE VIP REIT 23.032228 15.391575 DELAWARE VIP EMERGING MARKETS 41.237809 19.566791 FIDELITY VIP CONTRAFUND 20.224059 11.757123 PUTNAM VT GROWTH & INCOME 12.967972 7.971849 DELAWARE VIP US GROWTH 12.479122 7.303571 JANUS ASPEN WORLDWIDE GROWTH 13.677419 7.642081 JANUS ASPEN MID CAP GROWTH 18.649944 10.667110 MFS VIT CORE EQUITY SERIES 13.792184 8.407348 NEUBERGER BERMAN REGENCY 19.372914 10.305825 JANUS ASPEN BALANCED 14.595434 11.681053 PUTNAM VT HEALTH SCIENCES 11.218521 9.418596 ALLIANCEBERNSTEIN SM/MID CAP VALUE 20.954165 13.200322 AIM INTERNATIONAL GROWTH 22.222857 12.945657 httns://lincolnlife.iscaccount.com/servlet/LTnitValuesServlet 12/29/2008 Historic Unit Values Page 3 of 4 AMERICAN CENTURY INFLATION 11.205634 10 556897 PROTECTION . DELAWARE VIP DIVERSFIED 11,805674 10 853473 INCOME . DELAWARE VIP CAPITAL 10.452403 10 289179 RESERVES . FRANKLINTEMPLETON GLOBAL 11 972923 11.978995 INCOME SEC FIDELITY VIP MID CAP 14.524320 8.591455 LVIP DELAWARE GROWTH & 11.912457 7 696340 INCOME . LVIP DELAWARE SPECIAL 8,142164 5.666884 OPPORTUNITIES LVIP FI EQUITY-INCOME 11.721190 7.132068 LVIP CAPITAL GROWTH 10.704310 6.199655 LVIP MARSICO INTERNATIONAL 11.149230 509799 5 GROWTH . LVIP TURNER MID-CAP GROWTH 10.839100 5.642999 LVIP MID-CAP VALUE 8.637915 4.868653 LVIP SSGA S&P 500 INDEX 11.335227 7.189204 LVIP COLUMBIA VALUE 8.359052 6.222905 OPPORTUNITIES LVIP SSGA SMALL-CAP INDEX 9.147211 6.002391 LVIP T ROWE PRICE GROWTH 9.923617 5.858787 STOCK LVIP MFS VALUE 9.709654 6.434914 LVIP TEMPLETON GROWTH 9.794731 5.913785 LVIP SSGA INTERNATIONAL N/A 6.349950 INDEX LVIP SSGA BOND INDEX N/A 9.946677 LVIP SSGA LARGE CAP 100 N/A 6.996685 LVIP SSGA SMALUMID CAP 200 N/A 7.212723 LVIP SSGA DEVELOPED N/A 6.172831 INTERNATIONAL 150 LVIP SSGA EMERGING MARKETS N/A 5.946918 100 LVIP COHEN & STEERS GLOBAL 8.220804 4.914160 REIT ALLIANCEBERNSTEIN 12.308521 5 822645 INTERNATIONAL VALUE . FRANKLINTEMPLETON INCOME 11.462275 8.037859 SEC AIM CAPITAL APPRECIATION 12.570631 7.234378 AIM CORE EQUITY 12.305639 8.687913 LVIP WILSHIRE CONSERVATIVE 11,645017 9.154452 PROFILE LVIP WILSHIRE MODERATE 12.356010 8.779363 PROFILE hops://lincolnlife.iscaccount.com/servlet/LTnitValuesServlet 12/29/2008 Historic Unit Values Page 4 of 4 LVIP WILSHIRE MODERATE AGGRESSIVE PRFL 12.863056 8.364388 LVIP WILSHIRE AGGRESSIVE PROFILE 13.572207 7.964208 LVIP WILSHIRE 2010 PROFILE- 10.437233 7 723256 SVC . LVIP WILSHIRE 2020 PROFILE- SVC 10.283499 7.330753 LVIP WILSHIRE 2030 PROFILE- 10.390058 7 032088 SVC . LVIP WILSHIRE 2040 PROFILE- 10.215436 443180 6 SVC . Understand"ing the unit value What :zre the ticker symbols far. these funds? ©2008 Lincoln National Corporation. All rights reserved. https://lincolnlife.iscaccount.com/servlet/UnitValuesServlet 12/29/2008 Dec 23 2008 11:SORM f~LLIRnZ LIFE 7637657441 p.2 Allianz Life Insurance p0 Box 59060 Minneapdis, MN 554'. 800/950-1962 IJecernber 12, 2006 CAROLYN URBAN 'T04 ELENA DRIVE BROOMALL PA 1 pang of North America IRe: Olive B Tuthill deceased Policy Numbe 1411033 Allianz IQ Dear Beneficiary: tills extend our sym thies to you at this difficult time. Listed below is information needed to file a claim for benefits. 1. Continue the Be tt Deposlibed with Interest Optbn. Continue receiving the monthly interest payments until the last payment date of November 19, 2011. On that date you would receive the accumulation value of $24,373.21. 2. Select an Altern thre Mnuity Option Settlement. Annuitize the contract receiving the accumulation val a of $24,373.21. The minimum payout period is 10 years. IMPORTANT NO ICE: In accordance with the Internal Revenue Code and contract provisions, if ann itization is selected, the first annuity payment must be received within one year from the dot of death for non-qualified funds and by December 31°t following year of death for quay funds. After these dates, only limited options are available. 3. Select the Lump Sum Dlstributlon. Receive the reduced lump surn cash value. Claim requirements: Benefit Depo It>ad with Interest Claim Form • Copy of the rtlfled death certificate (only one Dopy is required for the deceased) Please give this matt~r your prompt attention. Once we receive your claim requirements, allow 15 business days for rocessing. Should you have any questions, please contact our office. Sincerely, Annuity Claims/blb K the contract was tasusd practices requires that our a malntalns a consumer divisi~ SprhgNetd, Illinois 132787. M the contract wee Issued Insurance Department, rt rru New Hampshire Insurance C tlw state of Illtnols: Part 919 of the Rules of the tMinois Department of Insurance gpvemin8 claims npa-q advise you that you may eu~rees arty concerns with tfie Illlnols Deparment of Insurance. K ~ at 100 W Randolph Street, Suite 8-301, Chk~go, Illinois 80808 and at 320 West Washington Street, thrr stato of IVsrr Ilsrnpshire: Should you wish to take this matter up wtth the New Hampshire loins a service d'nrisfon to Investigate oomptaints 21 South Fruit Suite 14 Concord, NH 03301. The ~artment can be readied, toN free, bydialing 1-800.862-3416. Dec 23 2008 11:50RM RLLIRIYZ LIFE 7637657441 p.3 Allianz L'rfe Insurance ~o sox ssoso hAfnneapolis, MN 554; t30W950-1962 December 12, 2008 parry of North America Allianz li DAVID W SPAHR 568 SUMMIT HODS 568 WEST CHESTER PA 19382-6559 Ike: Olive B Tuthill deceased Policy Numbs 1411033 Dear Beneficiary: We extend our sym~ a claim for benefits. 1. CoMlnue the i3sl interest payments would receive the 2. Select an Altemi accumulation vale IMPORTANT NO' provisions, if annt year from the date death for qualifiec 3. Select the Lump Claim requirements: • Benefit Dtep • Copy of the ~ to you at this difficult time. Listed below is information needed to file ieftt Deposited with Interest Option. Continue receiving the monthly until the last payment date of November 19, 2011. On that date you accumulation value of $24,373.21. five Annuity Option Ssttlemertt. Annuitize the ooMract receiving the ~ of $24,373.21. The minimum payout period is 10 years. 'ICE: In accordance with the Internal Revenue Code and contract itization is selected, the first annuity payment must be received within one of death for non-qualified funds and by December 31" following year of funds. After these dates, only limited options are available. Sum Dlstributton. Receive the reduced lump sum cash value. with Interest Claim Fonm d death certlticate (only one copy is required for the deceased) Please give this matt r your prompt attention. Once we receive your claim requirements, allow 15 business days for recessing. Should you have any questions, please contact our office. Sincerely, Annuity Claimslblb K the contract wee Issued I the slats of Illinois: Part 819 of the Rules of the IIIInoIs Department of Insurance governln0 claims practlces requires that our advise you that you may express any concerns with the liunois Departrnent of Insurance. K maintains a consumer divfe at 100 W Randolph Street, Suite 8-301, Chk~go, Illinois 80806 and at 320 West Washingbn Street, Springfield, Illinois 62787. H the contract was Issued 1 the stabs of Merv Hampshire: Should you wish to lake this matter up with the New Hampshire Insurance Departrnent, h ma ins a service division 1b inwestlgate cornplalnfs 21 South Fruk Suite 14 Canoord, NH 00301. The New Hampshire Insurance partment can be reached, tdl free, t~ydlalfng 1,800-852-3418. Dec 23 2008 11:50RM RLLIRhZ LIFE 7637657441 p.4 Allianz Life Insurance ~o sox 590so Minneapolis, MN 554; 800!950-1962 December 12, 2008 parry of North America REBECCA LYNN GR SS 1049 SWARTHMOR ROAD NEW CUMBERLAND PA 1 7070-1 730 Re: Olive B Tuthill, deceased Policy Numbe 1411033 Allianz 1~ Dear Beneficiary: We extend our sym thies to you at this difficult time. Listed below Is Information needed to file a claim for benefits. 1. Continue the tilt iDeposlted with Interest Option. Continue receiving the monthly interest payments until the last payment date of November 19, 2011. On that date you would receive the ccumulatlon value of $24,373.21. 2. Select an AI tlv~e Mnuity Option Settlement. Annuitize the contract receiving the accumulation val of $24,373.21. The minimum payout period is 10 years. IMPORTANT NO ICE: In accordance with the Internal Revenue Code and contract provisions, if ann itization is selected, the first annuity payment must be received within one year from the clot of death for non-qualified funds and by December 31~` following year of death for qualifi funds. After these dates, only limited options are available. .3. Select the Lump ~3um Dlstrlibutlon. Receive the reduced lump sum cash value. Claim requirements: • Benefit iDep ited with Interest Clalrn Form • Copy of the Mled death certlffcate (only one copy is required for the deceased) Please give this matt r your prompt attention. Once we receive your claim requirements, allow 15 business days for recessing. Should you have any questions, please contact our office. sincerely, Annuity Claims/blb IIf the CorrtraCt waa Issued Ipractkk:ee requires that our a !maintains a consumer dh~isM Springfield, Illir~oie 62787. If the oorttract wet isausd Insurance Departmer, k rrn New Hampahlre Insurance [ the elate of Illlrrofs: Part 919 of the Rules of the Illinds Department of Insurenoe governing claims ~pany advise you that you may e~gxess any concerns with the 111nois Department of Insurance. k ~ at 100 W Randdph Street, Suite 9-301, Chicago, IlAnols 80806 aril at 320 West Washington Street, tlns statr+ of Naw liampahire: Show you wish to take thie matter up with the New Hampshire rains a service division to investigate complaints 21 South Fruk Suite 14 Concord, NH 03301. The ~artment can be reached, toll free, by dialing 1-800-862-3416. Dec 23 2008 11:50RM RLLIRMZ LIFE 7637657441 p,5 Allianz Life Insurance PO Box 59060 Minneapolis, MN 554; soa95a~ss2 December 12, 2008 STEVEN A G ROSS 1071 PENN CI R APT KING OF PRUSSIA P of North America 1 9406-1 1 66 Allianz 10 Re: Olive B Tuthill deceased Policy Numbe 1411033 Dear Beneficiary: We extend our sym a claim for benefits. 1. Continue the 8ei interest paymerrte would receive the 2. Select an Alterru accumulation vale IMPORTANT NO' provisions, if annt year from the daft death for qualifies 3. Select the Lump Claim requirements: • IBensflt Data Copy of the to you at this difficult time. Listed below Is information needed to file refit Dsposifisd with Interest Option. Continue receiving the monthly until the last payment date of November 19, 2011. On that date you accumulation value of $24,373.21. Itftre Annuiity Option Settlt~rnent. Annuitiza the contract receiving the e of $24,373.21, The minimum payout period is 10 years. DICE: In accordance with the Internal Revenue Code and contract itization is selected, the first annuity payment must be received within one l Of death for non-qualified funds and by December 3tst fdlowing year of funds. After these dates, only limited options are available. Sum Distribution. Receive the reduced lump sum cash value. with Irrtereat Claim Form d dt~th t~ertlflcate {only one copy is required for the deceased) Please give this matt r your prompt attention. Once we receive your claim requirements, allow 15 business days for processing. Should you have any questions, please contact our office. Sincerely, Annuity Ctaimslblb k the contract was Nauad pratlces requires that our a malrrtaine a miner dlvbfl Springfield, IlNnols 132767. K the contract was (quad Insurance Deparbnent, H me New Hampshire Insurance C the state of IllfnoMs: Pert 919 of the Rules of the Illinois Departrnent of tnsurer~ce 9overNng deems ipeny advise you that you may ergxeae any concerns with the IAinplB Department of Insurance, It at 100 W Randdph Street, Suite 6-301, Chicago, Idinols 801308 and at 320 West Washington Street, the Mate of New Hantpthiro: Should you wiah to take fhb matter up with the New Hampshire ,alas a eeMce division to investlgate complaints 21 South Fruit Suite 14 Concord, NH 03301. The ~artment can be reached, loll free, by dialing 1-A00-852-3416. ~, ~~\ .~ ;~ ----:~~ ,,// a .. _!-- A Family Tradition Of Caring" PATH EMORE Funeral H Cremation Services, Inc. Mrs. Patricia T. Gross - 11/10/2008 1049 Swarthmore Road New Cumberland, PA 17i For the Service of Olive A. Tuthill 13t)3 Brid~~c SU'ect P.O. Bus 4.+ I New (~umherland, P_1 1 ~07~1 (~ I -1 '74-, ~ I IFax~ ^~-1-~~`~6 « ~ ~r.parthcnu~rc.cum Gilbert W. P:u-thcnu>rc. Founder Gilbcrt,l. P<~rthcmore. Supen~i:or Stephen K. Parthcnu~re. C'i~SP Bruce R. Parthenu~re. Pre-decd l'~~ordin~itor, CPC Prut;siunal1 ~1rn;hcrships: ~FD:1 • PF[):~ DC1~I)A • C(.FD~1 .,,,,,~,.,,w „, ,~,,, G(t~'.~LDEN ` ~.`.E ,, .~ T-.• ._ We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. The following is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected when making the funeral arrangements. Terms Due Date Account # Net 30 12/10/2008 2008103.0 Description Amount SERVICES & MERCHANDISE Traditional Funeral Service 5,595.00 Solid Oak Casket 2,795.00 Total Services and Merchandise 8,390.00 CASH ADVANCE ITEMS Death Notice, Harrisburg Patriot 215.57 Death Notice, The Wayne Independent, Honesdale 50.00 20 Certified Copies of Death Certificate 120.00 Hairdresser 40.00 Clergy Honorarium 150.00 Organist Honorarium 100.00 Flowers, (2) Matching Sprays 150.00 Flowers, (2) Red & (2) White Roses 18.00 Total Cash Advances 843.57 Total $9,233.57 PaymentS/Credits $-9,233.57 Balance Due $~~~ 04-16-09;15,07 ; ~~ .~~/~ 1 a . x1'~~bi ~~ _ 7744802 # 1/ 1 A family "Tradition Of Garing® ~i~EIV~~RE Funeral Home & Cremation Se~r~ces, Inc. .ianuary 6, 2008 Mrs. ,Patricia T. Gross PA 17070 1049 Swarthmore Road New Cumberland, I'A 17070 u Dear f1Ars..C~ross; ~ ~ ~ . . The following items were either not funded or not guaranteed ~in the pr~- arrangemerrts ,for 41ive Annette Ttithill: . ~. Actual Gast ~Aa Funded . ~~`, . Deafh Notice, Harrisburg Patriot` ~ . $ 215:57 $ -0- ~ Death Notice, Wayne.lndependen~ 50.U0 -0- ,~:, ~ ~~ Certified death Certificates ~ ~ .120.00 .20.00 .. Hairdresser ~ ~ ~ 40.00 30.00 Clergy Honorarium 150.00 100.00 '0~'~ ~Qrganist ~ 100.00 75.00 Flowers; (2) -A7latching Sprays 150.00 127.0 re, ~ flowers, Roses ~ 18.00 18.00 .~~r, cPC Subtotals: ~ $ 8A,3.57 $ 370.20 Difference: $ 473.37 Tatel Due: $473.37