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HomeMy WebLinkAbout04-27-091505607121 REV-1500 Ex (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po sox 2aosol INHERITANCE TAX RETURN _ Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 0 8 0 1 ENTER DECEDENT INFORMATION BELOW Sociial Security Number Date of Death Date of Birth 0 7 2 5 2 0 0 8 0 6 0 7 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name MI H I N T Z E W I L L I A M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THlS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 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) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. 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 S T E V E N W F A H N E S T O C K C P A 7 1 7 ? 3 7 5 4 6 6 Firm Name (lf A licabte) PP F A H N E S T O C K A N D A S S O C First line of address 1 5 1 3 C E D A R Second line of address C L I F F D R City or Post Office C .4 M P H I L L State ZIP Code REGISTER OF WILLS USE ONLY r, ~_ c..~ _., r,., - ' ~ '<-:~ - ,,-.._ tF ~ .. ~ ,.._. ' , t, q -; -{ 1'id~~-loll Frl _. ~. r ~_; ,s .:~ P A 1 7 0 1 1 ~ r~ ~..:~ ;- - ; ~. Correspondent's a-mail address: fBhtT@StOCkt~V@fIZ011.11et Under penalties of perjury, I declare that I have examined this return, including acxiompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DeGaration of preparer other than the personal representative is based on afl information of which pn:parer has any knowledge. SIGNAI'URFy OF~RSON RESPONSIBLE FOR FILING RETURN DATE 1 ADDRESS ~ ~ ~ 504 HALDEMAN BLVD NEW CUMBERLAND PA 17070 SIGNAT'URfAF PR BE~HER THAN REPRESENTATNE DATE 'b51.I CEDAR CLIFF DR CAMP HILL PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505607121 15D5607121 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: WILLIAM H I N T Z E RECAPITULATION 1. Real estate (Schedule A) ........................................ 1. 2 3 0 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) .................................. 2. 4 3 1 1 3 5. 1 1 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 8 5 0 2 6. 3 6 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 0 • 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 2 6 7 0 6 8. 0 0 8. Total Gross Assets (total Lines 1-7) ........................... 8. 1 0 1 3 2 2 9. 4 7 9. Funeral Ex enses & Administrative Costs Schedule H P ( } ................ 9. 4 2 5 1 8 . 6 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ 10. 1 2 5 5 8. 4 3 11. Total Deductions (total Lines 9 & 10) ........................... 11. 5 5 0 7 7 . 0 3 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 9 5 8 1 5 2 . 4 4 13. Charitable and Governmental Bequests/Sec 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. 9 5 8 1 5 2. 4 4 TAX. COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X..000 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 9 5 8 1 5 2. 4 4 16. 4 3 1 1 6. 8 6 17. Amount of Line 14 taxable 0 0 0 0 0 at sibling rate X .12 17. . 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1g. 0. 0 0 19.7'ax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 4 3 1 1 6. 8 6 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 00801 DECEDENTS NAME WILLIAM HIINTZE STREET ADDRESS 228 ALLENDALE WAY CITY CAMP HILL. STATE PA ZIP 17011 Tax Payments and Credits: 1 • Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 40,000.00 C. Discount 2,105.20 3. InteresUPenalty if applicable D.lnterest E. Penalty (1) 43.116.86 Total Credits (A +B +C) (2) 42,105.20 Total InterestlPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) 0.00 0.00 1.011.66 (56) 1, 011.66 Make Check Payable fo: 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? ....................................................... ^ ^X 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^X ^ 3. Did decedent own an "intrust for" or payable upon death bank account or security at his or her death? ......... ^ ^X ~4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................ .................................. ^ ^X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [T2 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 [l2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemat 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 imposE;d on the net value of transfers from a deceased childtwenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent (72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposs~d on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent ]72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + {6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RIESIDENT DECEDENT ESTATE OF FILE NUMBER WILLIAM HINTZE 21 08 00801 Ali real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exr:hanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real ro which is ' in -owned with ri ht of survnrorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 228 ALLENDALE WAY, LOWER ALLEN TWP, CAMP HILL, PA, 17011 230,000.00 SEE ATTACHED SETTLEMENT SHEET TOTAL (Also enter on line 1, Recapitulation) ~ $ 230.000.00 (If more space is needed, insert additional sheets of the same size} REV-1503 EX + j 6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER WILLIAM HIINTZE 21 08 00801 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. VANGUARD STAR FUND ACCOUNT NUMBER 0056-09903130531 57,035.02 3,017.726 SHARES @ $18.90 PER SHARE 2. VANGUARD STAR FUND ACCOUNT NUMBER 0056-09876517087 115,937.84 6,134.277 SHARES @ $18.90 PER SHARE 3. PNC INVESTMENTS ACCOUNT NUMBER 7897-2125 249,411.47 23,355.758 SHARES FEDERATED MUN SECS INCOME TRUST @ $10.64 PER SHARE PLUS ACCRUED DIVIDENDS OF $906.20 4. PNC INVESTMENTS ACCOUNT NUMBER 7897-2125 362.12 CASH ACCOUNT 5. 140 SHARES YUM BRANDS STOCK @ $34.17 PER SHARE 4,783.80 SEE ATTACHED INFORMATION 6. 63 SHARES RAYTHEON COMPANY STOCK @ $57.22 PER SHARE 3,604.86 SEE ATTACHED INFORMATION TOTAL (Also enter on line 2, Recapitulation) ~ $ 431.135.11 (If more space is needed, insert additional sheets of the same size) REV-'1508 EX + (6-96) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RES DENTEDE EDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER WILLIAM HINTZE 21 08 00801 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CONTENTS OF HOUSE SEE ATTACHED APPRAISAL REPORT 2. 1990 GMC VAN SEE ATTACHED INFORMATION 3. 1990 PONTIAC GRAND PRIX SEE ATTACHED INFORMATION 4. FEDERAL AND STATE INCOME TAX REFUNDS 5. IPNC CHECKING ACCOUNT NUMBER 5140220593. JOINT OWNER WAS ONLY ADDED FOR CONVENIENCE. 4, 570.00 890.00 1, 005.00 6,574.00 71,987.36 TOTAL (Also enter on line 5, Recapitulation) ~ $ (-f more space is needed, insert additional sheets of the same size) REV-1510 EX + (8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS ~ MISC. NON-PROBATE PROPERTY FILE NUMBER WILLIAM HINTZE 21 08 00801 This schedule must be completed and filed ff 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 ' ir+cxuoEr~wnMeoFn+~rnnNSF~e,rH~er~o.nnoNSriiProoECeo~rnrio THE DATE OFTwv+SFER ATfACHACOPYOFTHEDEEDFORREALESTAiE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION pFnppuc/~~ TAXABLE VALUE 1. VALUE OF LOAN FORGIVEN - WAYNE HINTZE (SON) 183,123.00 100. 3,000.00 180,123.00 2. VALIJE OF LOAN FORGIVEN - CATHRYN A HINTZE 77,445.00 100. 3,000.00 74,445.00 (DAUGHTER) 3. VALUE OF LOAN FORGIVEN - WILLIAM Y HINTZE (SON) 3,500.00 100. 3,000.00 500.00 THESE LOANS WERE FORGIVEN BY DECEDENT ON JANUARY 9, 2008 (SEE PARAGRAPH 2 OF DECEDENT'S LASI-WILL PROV)DiNG FOR SPECIFIC BEQUESTS TO EQUALIZE EFFECT OF THESE TRANSFERS.) 4. GIFT TO WILLIAM Y HINTZE ON JULY 24, 2008 12,000.00 100. 12,000.00 TOTAL (Also enter on line 7 Recapitulation) , $ 267 068.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RIESIDENT DECEDENT ESTATE OF FILE NUMBER WILLIAM HINTZE 21 08 00801 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1, AUER MEMORIAL HOME 1,480.00 B. I ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) WILLIAM Y HINTZE 4,100.00 Street Address 228 ALLENDALE WAY City CAMP HILL State PA Zip 17011 Year(s) Commission Paid: 2009 2, AttomeyFees SCOTT M DINNER ESQUIRE 3,000.00 3, Family Exemption: (If decedents address is not the same as claimant's, attach explanation) 3, 500.00 Claimant WILLIAM Y HINTZE Street Address 228 ALLENDALE WAY City CAMP HILL State PA Zip 17011 Relationship of Claimant to Decedent SON 4. ~ ProhateFees CUMBERLAND COUNTY REGISTER OF WILLS ~ 610.00 5 Acx;ountant'sFees STEVEN W FAHNESTOCK, CPA 2,500.00 6. Tax Retum Preparers Fees STEVEN W FAHNESTOCK CPA 320.00 7. LEGAL FEES - MARTSON LAW OFFICES 130.00 8. PERSONAL PROPERTY APPRAISAL - BARRY K TOLBY 195.00 9. ADVERTISING -CUMBERLAND LAW JOURNAUPATRIOT NEWS 202.38 10. REPAIRS TO HOUSE TO PREPARE FOR SALE 7,351.00 11. MEDICAL CARE 300.00 12. HOUSE CLEANING SERVICES 500.00 13. CUMBERLAND COUNTY REGISTER OF WILLS FILING FEE 15.00 14. SETTLEMENT EXPENSES ON SALE OF HOME (NET OF TAX ADJUSTMENT) 18,315.22 TOTAL (Also enter on line 9, Recapitulation) 3 42.518.60 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER WILLIAM HINTZE 21 08 00801 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH CHECKS WRITTEN PRIOR TO DATE OF DEATH WHICH WERE STILL I 12,558.43 OUTSTANDING AND INCLUDED IN DATE OF DEATH VALUE FROM PNC BANK. TOTAL (Also enter on line 10, Recapitulation) I $ 12.558.43 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9~-00) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHEF2ITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER WILLIAM HINTZE ~~ nn nnQn~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS pnGude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)J ' 1. WILLIAM Y HINTZE Lineal 239,538.11 228 ALLENDALE WAY DAMP HILL PA 17011 2. CATHRYN A HINTZE Lineal 239,538.11 1'949 DAYBREAK CIRCLE HARRISBURG PA 17110 3. ELAINE H TORRE Lineal 239,538.11 8563 LAWSON AVE NORFOLK VA 23503 4. WAYNE H HINTZE Lineal 239,538.11 2Ei01 BERT FOWLER RD MANCHESTER MD 21102 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ ilr more sp~e Is neeaea, Insert aaalnonat sheets of the same size) REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: 40.000.00 Discount: _ 2,105.20 Interest Table Year Days Delinquent this time period Balance Due this year Interest this period Before 1981 1982 1983 1984 1985 1986 1987 1988 throe h 1991 1992 1993 throe h 1994 1995 throe h 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Tatal Balance Due on January 17, 1996: Penalty: F:~FILES'~.Clients~12843 HintzeU2843.1,wi11 ORIGINAL RE7;;iN~C ~i: ~® ~~Q~ ~ ~'~K LAST WILL AND TESTAMENT ~ARTSOrr I.~w or~lc~s 10 EAST HIGH STREET CARLISLE, PA 17013 0717) 243-3341 I, WILLIAM HINTZE, of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils made by me. 1. I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all death taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under 1`his Will. 2. In order to take into account certain advancements made to certain of my said children by me prior to my death I make the following specific bequests: $183,123.00 to my daughter, ELAINE H. TORRE. b. $179,623.00 to my son, WILLIAM Y. HINTZE; and c. $105,678.00 to my daughter, CATHRYN A. HINTZE I give, devise and bequeath all the rest residue and remainder of my estate, both real and personal property, unto my children, WILLIAM Y. HINTZE, ELAINE H. TORRE, CATHRYN A. HINTZE and WAYNE H. HINTZE in equal shares absolutely. 3. I nominate, constitute and appoint my son, WILLIAM Y. HINTZE, as Executor of my estate. In the event he is unwilling or unable to so act, then I appoint my daughter, CATHRYN A. HINTZE, to act in such capacity. In the event, she is unwilling or unable to so act, then I appoint my son, WAYNE H. HINTZE to act in such capacity. In the event he is unwilling or unable to so act, then I appoint my daughter, ELAINE H. TORRE, to act in such capacity. 4. I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. Page 1 of 3 Pages ~~. 5. I authorize and empower my Executor, or his successor, in their sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the :protection and preservation of my estate; to mortgage or pledge any real or personal property forming ,a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my Executor, or his successor, considers desirable and to pay reasonable compensation for such services as maybe rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my Executor, or his successor shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this cl '~ day of ~~ S. ~~~ ~,. (SEAL) William Hintze SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. ~~ Q w~ Page 2 of 3 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) We, William Hintze, No V. Otto III, and ~ c~ ,; /'0 (,., ~L,, ,the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that the Testator has signed willingly, and that the Testator executed iit as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in l:he presence and hearing of the Testator, signed the Will as a witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. William tz stator Witness it s Subscribed, sworn to and acknowledged before me by William Hintze, tie estator, and e No V. Otto III and ~.--1/~ ~~ the subscribed and sworn to before m by ~.s- ~~~ , witnesses, this !'`day of ~ ,~ad8 r ~!V ~~ / V Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL Victoria L. Otto, Notary Public Carlisle Borough, Cumberland County My commission expires December 20, 2010 Page 3 of 3 Pages REV-485 EX (1-07) SAFE DEPOSIT _: BOX INVENTORY PA Department of Revenue 48500041046 PLEASE USE ORIGINAL FORM ONLY Social Security or Death Certificate Number Date of Death County Code Year File Number - , ~ :, ~~ v..., y!Pl'vE F~Y. .~!'.^ i:S~4~ ~~dc _..+£ ,.-,M ;^--~:.w:-:.Vr? ~ ~:i 2m~s .._ '"tv ~_.. Decedents Last Name Suffix Flrst Name ~ MI ~Y*'SF .. ._~. ~ ~*:~ek4^d'lfi"'}~g-.-'yt~iv4 .a...v.ea2EY£vTK~..,Q ?S,RBf-L<`.~5'~,~ .. ~ '.i;`• +L'~' 'y.~ +W.+~~"'.ZLSI+~J.,+~~~F T~ •tv~ '9k C~~ ...2SC~ .`e~fi Y`...v^T. 2~i'~`CG4 2 'D~ ~i.Mt _ ^~"'R..~ :,'~^'.!iG 'n'S __ ~ ~ -_ © ADDRESS OF DE EDENT 3TF2E I ` ~ ~ STATE: ZIP CODE: I i INAME AND ADDRE S OF PERSON REQUESTING THE OPENIN OF THE SAFE DE OSIT BOX ~ `\ t STREET ADDR`~ `ESS:,, ~ ~ CITY: ~\ ZE: Z{P CODE: ~ ,~fJAME ADDS AND RELATIONSHIP (IF ANY) TO DECEDE , OF PERSON(S) PRESEN AT THE BOX OPENING ~ a. NAME: RELATIONSH ~ ` STREET ADDRESS: ~ ~ a v s CITY: ~ - S Z{P CODE ,` c o _ -~ LR \'~~ ~ ~ -- -- 1 ~ - TE: ' ZIP CODE: I STREET ADDRESS: -, ~ ` ' ~ ~ '~' i C ` c. ME ~ RE ONSHIP; TR ET,ADDRE 7Y: STATE: ZIP COD ~4ME AND ADD SS OF FINANCIAL INS ITUTIO WHERE THE SAFE DEPOSIT 80X fS LOCA 1 NAME: ~ ` ~ i `'v `,~ ~ - ------ ~~---- - y 1 ,:~ ~~~r . ~~n~~~. ., - CITY• -- STATE: ZIP GODE: NAME OF PERSON MAKING ST EN. Y DAT AN TIME OF LAST ENTR~ ~ ~ ~.~ .~~ ~ ~~T OF CO TRACT TO RENT BOX NUMBER OF BOX 1 TITLE UNDER W BOX IS REGIST D NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX i i a. NAME: b. NAME: i STREET ADDRESS: STREET ADDRESS: } CITY: \ ~ STATE: ZIP CODE: CITY: STATE: ZIP CODE: l i NAME AND T LE O_ F EM YEE KING HE INVENTORY f, i ~ ~ ~C WAS A WILL IN THE BOX? YES NO If yes, a. Date of wiN: b. IVame and address of personal representative, if named in the will i NAME: i STREET ADDRESS: CITY: STATE: ZIP CODE i --- - - ~ { ~ t c. blame and address of attorney, if any NAME: ' ------i STREET ADDRESS: CITY: ~ STATE: ZIP CODEi 48500041046 48500041046 ~~ Z-~.. SAFE DEPOSIT BOX INVENTORY Page._________of_ :~_.:_____ . REV-485 EX INSTRUCTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death; etc. (4) Bonds: Designate by name, amount, serial number, or other designation. {Bearer Bonds} (5) Bank and Savings and Loan Passbooks:-State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6} Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. {7) Deeds, Mortgages, Current Insuranc"e Policies or other evidences of indebtedness: List'and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 ITEM ITEM DESCRIPTION _~.._- Q.~,\C~'~-~~ t V 1~~' ~1~J ~ ~ .Ci1~a ~~LVL=_~-~-'7~.~~ ~~~~~_ L \ [ - ~~ t -- ----~-"L~~~Q-~ ---------- - --__--- -- --- --- - - ,D , < ~ ~~ ' t CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF CORRECT AND COI O THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SI ATUR~ SIGNAT RE _ __ ___ _ 1.~/ P ~ ~- - ---~~ PRINT NAME AND CHECK APPROPRI BOX BELOW: t~:l l: a.. ~ ~`~~ ----------------- - PRINT TITLE DATE CHECK APPROPRIATE BOX: ~~ h ~ Executor(trixJ ~ Administrator(trix) O v ~ Estate Representative ~ Joint owner of safe deposit box NOTE: Attach additional 8'/~" x 11" sheet(s) if necessary or use duplicates of this page of form. The Department is authorized by faw, 42 U.S.C. §405 (c)(2)(C)(7, to require disclosure of Social Security numbers in connection with administering state tax laws. The Department uses the Social Securityy number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities- The state law prohibits the Commonwealth's personnel from disclosing confidential tax information except for official purposes. V' ~~$ lortn HUO-1 (ya6) rel Hantlbook 4305.2 A. Settte~IlEnt st2te1~1e11t LLS. Department of Housing and Urban Development B. Type cf Loan _ OMB AOOroval Nn_ 7sn9-rocs r<~nire~ ~ ~yvnnnnm nun/ 1. QFHA 2. OFmHA 3. BConv. Unins. 6. File Number 7. Loan Number 8. Mortgage Insurance Case Number { 4. QVA 5. QCanv.lns. 09-132 0116201412 ~Zii,Tm e: urru gne you a s a emen o a ua se emen ms s. moon : pal o an y se men agen are s C. Note: Items marketl "(p.o.G)" ware paid oul5ide the clps4lq; they are shown here for n4amalion purposes and are not inrAudetl in the lolals. TItIeEXpfess .Settlement Sy$tem WARNING: a is a vme 1o knowingly make lalse alalMlenls to me United Stales on 1143 W any deer similar Iolm. Penellies upon comidion <an ildutle a ( e antl im i5onmenl. For details see: Tick ie U. S. Lode Section 1001 antl SBGipn 1010. Printed 0210612009 at 1 0:00 KR D. NAME OF BORROWER: JEFFREY A. HULFISH ADDP.ESS: 150 Rathton Rd. York PA 17403 E. NAME TJF SELLER: ESTATE OF WILLIAM HINTZE I ADDP,ESS: 504 Haldeman Blvd. New Cumberland PA 17070 I F. NAME OF LENDER: Sovereign Bank ADDP,ESS: Mail Sto 10-6438-CAS 601 Penn Street Readin PA 19601 G. PROPERTY ADDRESS: 228 ALLENDALE WAY, LOWER ALLEN TOWNSHIP, CAMP HILL, PA 17011 Lower Allen townshi H. SETTLEMENT AGENT: Homesale Settlement Services, Inc. PLACE OF SETTLEMENT: Prudential Hgmesale Svcs 3435 Market Street Cam Hill PA 17011 I I. SETTLEMENT DATE: 02/06/2009 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUIJT DUE FROM BORROWER 400, GROSS AMOUNT DUE TO SELLER 101. Contract sales price 230 000.00 401. Contrail sales rice 230 000.00 102. Personal Pro rtv 402. Personal Pro rt 103. Settlement char es to borrower line 1400 7 058.67 403. 104. 404. 105. 405. Adjustments for items aid b seller in advance Ad~ustrnents for items paid b seller in advance 4 108. Sctlool Taxes 02106109 to 06130109 739.48 408. School Taxes 02106109 to 06/30/09 739.48 109. Sewer - 02/06109to03/31109 22.48 409. Sewer 02106109to03/31109 ~ 22.48 t 10. Trash 02106!09 to 03/31109 34.32 410. Trash 02106/09 tD 03!31109 34.32 4 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 237 854.95 420. GROSS AMOUNT DUE TO SELLER 230 796:28 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE 70 SELLER 201. Deposit or earnest nrone 3 000.00 501. Excess Oe sit see instructions '~ 202. Principal amount of new loans 150 000.00 502. Settlement char es to seller line 1400 19 030.00 ~ 203. Existing loan(sl taF:en sub'ect to 503. Existin loans taken sub'eil to 204. 504. Pa off of First Mort a e Loan 205. 505. 206. 506. j 207. 507. 208. 508. 209. 509. Adju;stments for items un aid b seller Ad'ustments for items un aid b seller 211. Count taxes D1101109to02106109 ~ 81.50 511. Count taxes 01101/09 to 02106109 61.50 213. 513. 214. 514. 215. 515. ~ 216. 516. 217. 517. '~ 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 153 081.50 520. TOTAL REDUCTION AMOUNT DUE SELLER 19111.50 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT_ SETTLEMENT TO OR FROM SELLER 301. Gross amount due Iran borrower line 120 237 654.95 601. Gross amount due to seller line 420 230 796.28 302. Less amounts paid b ffa bonower line 220 153 081.50 602. Less reduction amount due seller line 520 19 111.50 303. CASH FROM BORiROWER 84 773.45 603, CASH TO SELLER 211684.78 S1185TITUTE FGRM 1099 SELLER STATEMENT: Tne m/armauon canlained Herein i5 imgptant tat Inlorrtlatipn an0 a 1m+ng lumished to the lnlemal Revenue Service. If you are requital lo~fik a return. ^negligence penalty rx omen sarrclion will be imposed on you it mi5 item is 2quiretl to oe reportetl and the IRS delernune5 mat it Has not been repaied. TAe Gmlratl Sales Rice desnibetl on ~ e 401 above consliluleS the Grass Proceeds W This transaction. SELLER INSTRUCTIONS: IS tn+5~eaf estate was your principal resitlence. fie Form 2719, Sale or Ezcnange or Prinupal Residence, (or any gain, wim your Income las return: for other IransaClionS. mn,pele me appicaole pans of Fcvm 4797. Form 6252 and/or Schedule D (Form 1040). Yomare req,nretl by law to pmvMe me Settlement agent (Fed. Tax ID No: ) wiln yWr correct Taxpayer identi6celian number. d you do not provide correct taxpayer idenl~ Wkon nu ben, you may be sublecl (o civil ar cmmnal penalkes inposed by Ww. er~rjury, I ttni/y Thal the nurl~er shown On mis statement is my mrfetl laxpa~yer iden4fication number. TIN: I_ SELLER($)SIGNATURE(S): SELLER(s) NEW MAILING AODRE:SS' rrevrous ¢onran are oosplel¢ U.S. DEPARTbIENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT loan HUD-i (3/B6) ref Hantlbook 4305.2 File Number: 09.132 FINAL PAGE 2 TitleExpress Settlement System Printed 02/06/2009 at 10:00 KR L. SETTLEMENT CHARGES PAID FROM PAID FROM i 700. TOTAL SALES/BROKER'S COMMISSION based on rice 5230 OOO.DO =16 DOD.OD 60RROWER'S SELLER'S Division of Comrnission line 700 as follows: FUNDS AT FUNDS AT ' 701. S 10 SETTLEMENT SETTLEMENT , 702. S t6 000.00 to Prudential Homesale Services Grou i 703. Commission paid at Settlement 16 000.00 800. ITEMS PAYABI'_E IN CONNECTION WITH LOAN 801. Loan Origination Fee j 802. Loan Discount I Soverei n Bank P.O.C. 500.00 Bu er LR •500.00 ~ 803. Appraisal Fee to R r31 L A raisal Associates LR 300.D0 ~ 804. Credit Report (D CBC Com anies LR 19.00 i 805. Lender's Inspection Fee 806. Mortgage Application Fee to Soverei n Bank P.O.C. 299.00 Bu er 807. Tax Service Fee tD LSI Tax Services LR 63.00 808. Document Preparation to Soverei n Bank LR 200.00 r 809. Flood Certification to FIS Flood Services LR 7.54 810. Document Delive fee to Soverei n Bank LR 3.50 811. Mers Registration fee to MERS LR 4.95 j 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. interest From 0210612009 to 03101I20D9 $ 20.7917 !da 23 Da s LR 478.21 902. Mortgage Insurance Premium for to ' 903. Hazard Insurance Premium for to State Farm Insurance P.O.C. 460.00 Bu er 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1041. Hazard Insurance 4 mo. $ 38.33 /mo LR 153.32 7002. Mongage Insurance mo. $ Imo tOD3. City Property Taxes mo. $ Imo 1004. County Property Taxes 13 mo. $ 68.86 /mo LR 895.18 17005. School Taxes 9 mo. $ 155.12 Imo LR 1 396.08 i 1009. Aggregate Analysis; Ad ustment to Soverei n Bank LR •543.69 0.00 ' 1100. TITLE CHARGES i 1101. Setflementorclosin fee j 1142. Abstract or title search 1103. Title examination I 1104. Title insurance binder 11105. Document Preparation i 1106. Notary Fees to Nota Public 25.00 10.00 1107. Attcrney's fees includes above items No: 1108. Title Insurance to Homesale Settlement Services Inc. 1 659.62 { (includes above iterns No: 1101,1102 1103 1104 Enhanced Basic Rate 1109. Lender's Policy 150 000.00 11110. Owner's Policy 230 000.00 •1 659:62 - + 1111. End 100 End 300 i=nd 900 to Homesale Settlement Services, Inc. 150.00 11172. i 1113. Closing Service Letter to Law ers Title Insurance Cor oration 35.00 1240. GOVERNMENT F;ECORDING AND TRANSFER CHARGES 1201. Recording Fees Deed $ 50.50 Mon a e $ 80.50 Release $ 131.00 7202. City/County tax/slams Deed 52 300.00 Mon a e $ 2 300.00 ~ 1203. State Tax/stamps Deed 52 300.00 Mort a e $ 2 300.00 i 1204. ii 1205. '' 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey 1302. Pest Inspection 1303. Wire Fee to Homesale Settlement Services tnc. 11.00 i304. Internet Doc Prep to Homesale Settlement Services Inc. 50.00 1305. Express\Handling Fee to Homesale Settlement Services Inc. 25.00 1306. Legal fees to Scott M. Dinner Es 225.D0 1307. Transaction Fee to Prudential Homesale Services Grou 195.00 1308. Other Disbursements 1520 495.00 1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 7 058.67 19 030.00 MUD CERTIFICATION OF BUYER AND SELLER 1 have carefully reviewed In¢ HIID~ 1 S¢Illemenl $lal¢m¢nl and 10 Ilse b¢sl of my knowledg and beli¢I, it is a Irue and accurate Slaf¢menl O( all receipts arltl diSbUra¢menl5 made On my aGCOUnt a by me nseclio fur er cerlily Iha1 I have received a Co d the HUD 5 4t1¢m¢nl Sla nl. / A / ~~ ~~~ STATE-OFYJRLT)ORFIIRT~ `MARNING: T I$ A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD~1 Sel:lemenl Stalem2fl which I nave prepared K a We and accurate accpurtl W this Iransauion- UNITED STATES ON THIS OR AN'/ SIMILAR FORM PENALTIES UPON CONVICTION I nave caused pr vnll.causrthe funds to be disbursed in accwtlance with ttks statement. CAN INCLUDE A FINE AND IMPRI:iONMENT. FOR DETAILS SEE TITLE 1B: / U.S. COOS SECTION 100+ AND SECTION 1010. 9y ~ _~-'' ~./~i A~ Willi<3m Hintze 228 ,411endale Way Camp Hill, PA 17011-8402 1, ~ Page > 1 of 2 Report for 07725/2008'x; :,., - Voyager Services: 800-284-7245 Total report value: $172,9722 86 (Total report value includes any accrued dividends.) 7 ~ Y 'f Sri .~aC ~ -r-*- - ~ ~ ~ ,z i~. Accoun~va~ue summary'" '"'~4 ~"s'~~ ;~, ~ ~ -~ } G ,_ v:l i .raa ~4 _ Name ~ Fund & Account. Date ~LL ~ Pnce Per ~ A~~rued Number Opened Shares Share Value" ' :Dividends ' STAR Fund 0056-09903130531 11/04/19 96 3,017.726 $18.901 $57,035.02 _ '' Totals $57,035.02 $0.00 Doesn't include accrued dividends. -- ~---- ----.. 0187515695 02/05/2009 15:49:26 f. ~ Page > 2 of 2 " 1lan,~ard~' William Hintze Report for 07/25!2008 228 Allendale Way Voyager Services: 800-284-7245 Camp Hill, PA 17011-8402 Total report value: $172,972.86 (Total report value includes any accrued dividends.) ~ ~ ~~ ~ ~ ~ ~ ' - . . - ..~~ x ~ ` - _. ~.. ~_ Accountvalue sumrnary~ . ~14..Y ~~ ~ ~ + °r, - r ~ ~ ; - i ~ F ~ ~ Name Fund & Account ~ ii y D t -- a e ~ Pnce Per ~ Number ' Opened Shares >Share ti::cruvd Value' Dividends STAR Fund 0056-09876517081 10/14/1991 6,14.277 -- $18.90 $115,937.84 --- * ' Totals _ $115,937.84 ' $0 00 Doesn t include accrued dividends. '~ . 0187515695 02/05/2009 15:49:26 Bstate valuation Date of Death: 07/25/2008 Valuation Date: 07/25/2008 Processing Date: 01/07/2009 Satate of: WILLIAM HINTZS Account: 7897-2125 Report Type: Date of Death Number of Securities: 2 File ID: HINTZS,WILLIAM Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 1) 23355.756 FEDERATED MU13 SBCS INCOME TR (313923708) PA MDN INCM A Mutual Fund (as quoted by NASDAQ) 07/25/2008 10.64000 Mkt __ 10.640000 248, 5_0_5.27 --ISiv: 6:6388-Ez~ O~f24 0 Rec: 07 23 2008 Pay: 08 O1 2008 ~ 906.20 2) 362.12 CASH (SVPO1) 07/25/2008 1.00000 1.00000 1.000000 362.12 Total Value: $248,867.39 Total Accrual: $906.20 Total: $249,773.59 Page 1 This report was produced with Sstateval, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact SVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) -."' ' .~ ~~ i ~ ~ ~,x s S `"f, az, i. `, s~-y. AST Sharct~r~ider 5ervi.~s Cer~rTal fharetsafd~r Irrlorsr~tiar; _ Account Information - Change your Mailing Address ~ Receive Company Mailings via E-Mail - Revoke Online Consent i' Receive Dividends via Direct Deposit - Enroll in Diividend Reinvestment ~ View Outstanding Checks ~ Replace a lost or Stolen Check P View Share Detail ~ Replace a Lost or Stolen Certificate h Combine Identical Accounts in One Company i f Retrieve a Duplicate 1099 Form ?~ Access Your Dividend Reinvestment History Access Your Dividend Reinvestment History Prior to 2004 ~ Purchase Adlditional Shares !' Request a Certificate for D/R Shares . ! Sell D/R Shares fa€I+IIAAE. r~Ci:~t~1+8T f~Fl)~i~A~f~tti rage 1 of 1 WILLIAM HINTZE ge - f ~ .. a .t < .r ~ .... ~. _ ._ .t .. ~ a .r ..._ _r _ . _ ~ - = - - _ .. v DOROTHY HINTZE 7T TEN 228 ALLENDALE WAY CAMP HILL, PA 17011-8402 ~'~ Account Balance Certificated Shares 35.000 Plan Shares 105.000 Book Shares _ 0.000 Total Shares ~ 140.000 rPrice -~ $36.140 Total Values $5,059.60 "Please note that some of these shares may be restricted from trading. To view such restrictions, please click 'View Share Detail' on the left and note the restriction or stop reasons displayed." ~ Account Registration Detail -~ Account Type ~ Joint Tenants WROS Direct Deposit Status Direct Deposit Credit DR Status Cash Oniy DR Participant Account Email N/A Account Coded for Email Distribution N/A **If you would like to setup your account for email distribution, please click on the Ilnk in the left toolbar entitled °Recelve Company Mailings via E-mail." Stock prices are provided by an independent third party. American Stack Transfer & Trust Company does not guarantee the timeliness or accuracy of such information. .~.'xx.` ~ .,-:.. .,~ ": _... h, a,~~,a-s-Z~.~~saax~Fa-z-a~~:-;~a J~;'r~€~ ~' ~'s" ~"v' 5.... ~ ,~ .: ___A~t. Use of this website represents consent to the Tenns and Conditions of Use. '~ ~ ~'~ ©2003 American Stock Transfer & Trust Company ~ttps: //secure. anlstock. com/shareholder/sh_detail. asp 8/11/2008 fimencan arocx iransrer ana 1nlslr t,ompany Historical prices for YUM (Yum! Brands, Inc.) -Google Finance http://www.google.com/finance/historical?cid=660822&startdate=Jul... Web Images Maps News Video Gmail more • Portfolios ~ Sign In ~ Get quotes Stock screener e.g. "CSCO" or "Google" !J Historical prices « Back to overview Yum! Brands, Inc. (NYSE:YUM) - Daily ~ Weekly Ju125, 2008 j ~Ju125, 2008 Update ~ Download to spreadsheet Gate Open High Low Close Volume 25~-Jul-08 34.59 35.06 34.00 34.17 3,646,000 24--Jul-08 35.90 35.92 34.20 34.37 4,527,700 International Google Finance: Canada - U_K. - ~4~cpX (China) - ~~}'~xlHong Kong) Information is provided 'as is' and solely for informational purposes, not for trading purposes or advice, and may be delayed. To see au e~achange delays, please see disclaimer. ©2009 Google Google Home -Help -Privacy Policy -Terms of Service 1 of 1 4/21/2009 9:41 AM t1ItlGlll~i111 ~7Wl;K 11iLI1J1C1 4.ilU lIUJt.I.Vlltpiatly rage ;< or i p~° ~~ ASS ~ISar~f~aiG~r S~rvice~ i=eai Sh~src~?a:rf~ irrf~+Itioe Ae~_~:!ss~t Ae~.trs.s . Account .... , , ..... _ ... . Information ~ Change your Mailing Address - Receive C'.ompany Mailings via E-Mail I' Revoke Online Consent E Receive Dividends via Direct Deposit Enroll in Dividend Reinvestn'ient ~ View Outstanding Checks ~ Replace a Lost or Stolen Check w View Shane Detail - Replace a Lost or Stolen Certificate ~ Combine Identical Accounts in One Company i ~ Retrieve a Duplicate 1099 Form Access Your Dividend Reinvestment History Access Your Dividend Reinvestment History Prior to 2004 - Purchase Additional Shares ~ Request a Certificate for D/R Shares - Sell D/R Shares ~ERERAL a~i`f~iv~ [lt€f~f$i~t,fitTtf}l~ WILLIAMHINTZEBc i `' ___...=a.._.~.__ _ :.. .__ 3,a _ .,s DOROTHY HINTZE ]T TEN 228 ALLENDALE WAY CAMP HILL, PA 17011-8402 Aceourtt Balance Certificated Shares 0.000 Plan Shares 0.000 Book Shares 63.000 Total Shares 63.000 Price $58.530 Total Values -l $3,687.39 ~„o r C'~ Lo "Please note that some of these shares may be restricted from trading. To view such restrictions, please click 'View Share Detail' on the left and note the restriction or stop reasons displayed." Account Regi9tration Detail Account Type ~ Joint Tenants WR05 Direct Deposit Status ~ No Direct Deposit DR Status Non DR Participant Account Email N/A Account Coded for Email Distribution N/A --~r you wouio ire m setup your account for email distribution, please click on the link in the left toolbar entitled "Receive Company Mailings via E-mail." Stock prices are provided by an independent third party. American Stock Transfer & Trust Company does not guarantee the timeliness or accuracy of such information. V }~ ~.. _. .F. _~._ ~ S -:r '~~.:_. jai ~~$ RTShB '• ,~ ~~ ~'~K~•TSfi3l~,~' ~ b Use of this website represents consent to the terms and Conditions of Use_. - p20D3 American Stock Transfer 6c Trust Company https: //secure. almstock. com/shareholder/sh_detail. asp 8/11/2008 thstorical pnc:es for x1 N (Kaytheon Compaq) -Google 1''inance Web Images Maps News Video Gmail more Portfolios ~ Sign In Yi-_ ~ Get quotes Stock screener ---~ -:. e.g. "CSCO" or "Google" Historical prices « Back to overview Raytheon Company (NYSE:RTN) - Daily ~ Weekly ;Jul 25, 2008 I -;Ju125, 2008 Update. s Download to spreadsheet Date Open High Low Close Volume 25••Jul-0$ 56.75 57.69 56.66 57.22 2,006,500 24••J of-08 57.98 58.92 56.52 56.96 4, 914, 900 International Google Finance: Canada - U.K. - ~~r#'3~ (China) - ~~~X !Hong Kong) Information is provided'as is' and soleiy for informational purposes, not for trading purposes or advice, and may be delayed. To see all e~achange delays, please see disclaimer. ©2009 Google Google Home -Help -Privacy Policv -Terms of Service ~. http://www.google.com/finance/historical?cid=9078870&startclate=Ju... 1 of 1 4/21 /2009 9:42 AM Appraisal Report MR. WILLIAM HINTZE, ESTATE APPRAISAL 228 ALLENDALE WAY CAMP HILL, Pennsylvania 17011 (717)761-1316 Prepared for: MR. BILL HINTZE, EXECUTOR 228 ALLENDALE WAY CAMP HILL; Pennsylvania 17011 (717)761-1316 File #APPR002-08 Prepared by: Barry K. To1by, AUCTIONEER AND PERSONAL PROPERTY APPRAISER EMERALD AUCTION AND APPRAISAL SERVICE 15 SYCAMORE CIRCLE ETTERS, Pennsylvania 17319 (717) 938-3306 Member: Certified Appraisers Guild of America Table of Contents Title Page 1 Table of Contents 2 Summary 3 Analysis 4 Conditions of Appraisal 5 Certification 5 Purpose of Report 6 Method of Valuation 6 Definition of Value 6 Basis of Appraisal { Description (> Appraiser Qualifications 7 Value Listings Appendix A Page: 2 of 9 Summary On August 13, 2008, at the request of MR. BILL HINTZE, I personally inspected the assets of MR. WILLIAM HINTZE, 228 ALLENDALE WAY, CAMP HILL, Pennsylvania. Value Fair Market Value The Fair Market Value for the property in total is: $4,570.00 This is not the appraisal report. The appraisal report must lie read in its entirety. Page: 3 of 9 Analysis Local Market THESE ITEMS ARE BEING APPRAISED FROM AUCTION AND LOCAL MARKET VALUES Page: 4 of 9 Conditions of Appraisal The value stated in this Appraisal Report is based on the best judgment of the appraiser given the facts and conditions available at the date of the valuation. The use of the report is limited to the purpose of determining the value of personal property for Estate Tax purposes. Any additional reseazch or testimony required by the client or the court will be billed at the current rates. Disclosure of the contents of the report is governed by the Standards and Practices of the Certified Appraisers Guild of America. Certification of Report Neither Barry K. Tolby, EMERALD AUCTION AND APPRAISAL SERVICE nor any of its employees have any present or future interest in the subject properly. No prohibited fee was ,assessed for this report. iBarry K. ToIby of EMERALD AUCTION AND APPRAISAL SERVICE has successfully completed the personal property appraiser certification program with the Certified Appraisers tJuild of America and is a member in good standing. This report was prepared in accordance with the Uniform Standards of Professional Appraisal Practice and with the Standards and Practices of the Certified Appraisers Guild of America which has review authority of this report. I3arry K. Tolby has personally examined the subject property. The statements of fact contained in this rep~-t are true and correct to the best knowledge and belief of the appraiser. CTION AID? PRAISAL SERVICE Page: 5 of 9 Purpose of the Report The purpose of this report is to determine the value for Estate Tax purposes for MR. BILL HINTZE, CAMP HILL, Pennsylvania. Method of Valuation The method of valuation used for this appraisal is the Fair Market Value. Definition of Value Fair Market Value Under the United States Treasury regulation 1.170-1 c Fair Market value is def ned as: The price at which the property would change hands between a willing buyer and a willing seller, neither being under compulsion to buy or compulsion to sell and both having reasonable knowledge. Basis of Appraisal Valuation Date The date of valuation for determining the value estimation is August 13, 2408. Date Appraisal Conducted This appraisal was conducted on August 13, 2008. Limitations of Property There were no limitations on use or disposition of this property. Description .An itemized list with descriptions is in Appendix A. Page: 6 of 9 Barry K. Tolby, AUCTIONEER AND PERSONAL PROPERTY APPRAISER EMERALD AUCTION AND APPRAISAL SERVICE 15 SYCAMORE CIRCLE ETTERS, Pennsylvania 17319 (717} 938-3306 Education & Special Training I am a graduate of Harrisburg Area Community College School of Auctioneering. I have been and auctioneer for 14 years. I am a graduate of the Certified Personal Property Appraisers school. Professional Membership I am a member in good standing with the Certified Appraisers Guild of America I am a licensed and bonded auctioneer in good standing for the State of Pennsylvania. I am a member in good standing of the Pennsylvania Auctioneers Association :Professional Designation ]' am a licensed Auctioneer in the State of Pennsylvania 1 am a Certified Personal Propery Appraiser Page: 7 of 9 Appendix A Fair Market Value COLLECTABLES 100.00 LLYADROS---ONE HAS FINGER BROKEN OFF (2 @ $SO.OOea) 150.00 ASSORTED F[iJMMEL FIGURINES AND PLATES (5 @ $30.OOea) FURNITURE i 5.00 ENTERTAINMENT CENTER 25.00 MAPLE CHEST OF DRAWERS 15.00 WHITE SPINDLE CHAIR 25.00 LEATHER ARM CHAIR 20.00 BOOK CASES (2 @ $10.00ea) 65.00 DRESSER AND MIRROR 30.00 OAK SINGLE BEDS (3 @ $10.00ea) 20:00 FLOOR LAMPS (2 @ $ l O.OOea) 10.00 23 INCH TV 20.00 SMALL WALNUT TABLE 100.00 SECRETARY DESK 75.00 PIANO AND BENCH--MAKER UNKNOWN 5.00 SMALL NITE STAND 50.00 2 RECLINERS AND 3 LIVING ROOM CHAIRS (5 @ $10.00ea) 45.00 2 LIVING ROOM COUCHES AND 1 SLEEPER (3 @ $1 S.OOea) 80.00 ASSORTED TABLE LAMPS (8 @ $10.00ea) 100.00 CURIO 40.00 ROCKING CHAIRS (2 @ $20.04ea) 20.00 WROUGHT IRON BOOK SHELF 10.00 DESK LAMPS (2 @ $S.OOea) 40.00 END FABLES (4 @ $1 O.OOea) 15.00 WOODEN CHAIRS (3 @ $S.OOea) 25.00 ROUND BACK CHAIR 15.00 OAK ARM CHAIR 20.00 CHEST OF DRAWERS (2 @ $ I O.OOea} 35.00 KITCHEN TABLE AND 4 CHAIRS 20.00 WOODEN DESKS (2 @ $1 O.OOea) 175.00 DINING ROOM TABLE/HUTCH/CHINA CLOSET/6 CHAIRS 10.00 TELEVISIONS (2 @ $SAOea) ]VIISC 12.00 3 SUIT CASES AND 1 GARMENT BAG (4 @ $3.OOea) 8.00 SNACK TABLES (4 @ $2.OOea} 15.00 FOLDING CARD TABLES (3 @ $S.OOea} 35.00 FREEZER 10.00 METAL CLOTHES CABINET 10.00 2 DRAWER STORAGE CABINET Page: 8 of 9 1.5.00 MICROWAVE AND STAND 5.00 SMALL ROUND TABLE 125.00 ASSORTED WALL HANGINGS, PICTURES, ORNAMENTS 25.00 ASSORTED COLLECTION OF VCR TAPES AND BOOKS @ 1.00 EACH 100.00 ASSORTED BRIG-O-BRAG OUTDOOR FURNITURE 35.00 BLACK ROUGHT IRON TABLE AND 2 CHAIRS 50.00 WHITE WROUGHT IRON GLASS ROUND TABLE AND 4 CHAIRS 25.00 BLACK WROUGHT IRON PLANT STAND 45.00 GLIDER WITH CUSHIONS AND 2 CHAIRS SPORTS EQUIPMENT 30.00 GOLF CLUBS (3 @ $10.00ea) 25.00 -PING PONG TABLE 525.00 9' POOL TABLE--MAKER UNKNOWN 2,100.00 PIN BALL MACHINES (3 @ $700.OOea) 4.570.00 Total Page: 9 of 9 Kelley Blue Booik -Private Party Pricing Report -GMC, Vandura -Off... http://www.kbb.com/KBB/LJsedCars/PricingReportaspx?Yearld=19... l~lley B~ BaQk THE TRUSTED RESOURCE advertisement C Homey New Cars Used Cars Research 8c Explore News & Reviews Classifieds Loans 8e Insurance KBB® t Used Czrr Values I Classifieds I CertiFied Pre-Owned I Compare Vehicles I Perfect Car Finder I Most Researched Vehicles I CARFAX Vehicle H'r Wek:om~e Badc (My KBB ZIP Code 17011 I Change Home :> Used Cars > 1990 > 1CM~ > Vandura > 2500 Cargo Van 1990 GMC Vandura 2500 Cargo Van Trade-In Value Private Party value BLUE BDOK~ PRIVATE PARTY VALUE <lli4R?'_'THYS' Sugigested Retail Value Photo Gallery Condition <~~~~?•~ THI:+- Value Compare Vehicles r:ewi Blue Book Review ' Excellent $1,140 Consumer Ratings GOOd $890 Find Your Next Car Specifications Fair $550 Mo r e Photos r„~ Shopping Tools 1 - ~* ~ ~~ Search Used Cars L . 1 ` Free CARFAX record c heck Free CARFAX Record Check Check Your Credit Score for -- _._ Free Compare Insurance Rates Average Consumer Rating (13 Reviews) Read Reviews Payment Calculator Extended Warranty Quote ~' "~"~'~? 4.5 out of 5 Review This Vehicle Print. For Sale Sign __ _ _ __ EUY A USED CAR Vehicle Highlights on Blue Book ClassifiedsTM Mieage: 170,000 j GMC Engine: V8 6.2 liter Diesel Transmission: Automatic Vandura Drivetrain: RWD 30 Miles or less ZIP Cade ';17011 To View Ads, Click Selected Equipment Change Equipment Standard Afr Conditioning Power Steering AM/FM Stereo SELL YDUR USED CAR __ _ __ __ ___ _ On Blue Book ClassifiedsTM' Reach millions of shoppers on kbb com - - , . BIUe BOOK PrlVate Party Value AutoTradencom, and other Iwpular sRes. private Party Value ~ what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle ~ sold "As To Sep it Now, Click Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and bcal 1 of 4 8/29/2008 10:31 AM Kelley Blue Book -Private Party Pricing Report - GMC, Vandura -Off... llttp://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld-19... market conditans. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. FIND THE RIGHT tAR Compare Used vs. New I Under $5,000 Both New and Used ~I Van1'Minivan 1 To View List, Click ___ _ _ __ VIEW ~NDTHER YEHICIE Se :Year... rSelect'Make... I Selects Model.. Or Search by Category Or Change ZIP Code Estimated Payments S11 /mo 5.29% APR [t,cx fpr drCgi/s Get aPre-Owned Loan from 6.095% APR Your Credit Score for Free Get a Free Insurance Quote Vehicle Condition Ratings Check Vehicle Title History Excellent ~~#~ $1,140 • Looks new, is in excellent mechanical condition and needs no reconditioning. • Never had any paint or body work and is free of rust. • Clean title history and will pass a smog and safety inspection. • Engine compartment is clean, with no Fluid leaks and is free of any wear or visible defects. • Complete and veriFlable service records. Less than 5% of all used vehicles fall into this category. Good pdp~: ; $890 • Free of any major defects. • Clean title history, the paints, body, and interior have ony minor (if any) blemishes, and there are no major mechanical problems. • Little or no rust on the vehicle. • Tires match and have substantial tread wear left. • A "good" vehicle will need some reconditaning to be sold at retail. Most consumer owned vehicles fall into this category. Fair I~©© $550 • Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professbnal. • Tires may need to be replaced. • There may be some repairable rust damage. Poor p N/A • Severe mechanical and/or cosmetic defects and is in poor running condition. • May have problems that cannot be readily foced such as a damaged frame or crusted-through body. • Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appreisal to determine its value. * Pennsylvania 8/29!2008 Accurate Condition Appraisal Change Condition Accurately appraising the condition of a vehicle is an important aspect in determining its Blue Book value. Taking our 16 question condition quiz will ensure you know the correct condition rating. ~" ~,("~" ("~` ~ n ~ . Search Used Cars lt.~ /Tt 1! 1J, 1{ !C Free CARFAX record check of 4 8/29/2008 10:31 AM Kelley J31ue Book -Private Party Pricing Report -Pontiac, Grand Prix ... 11ttp://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=l9... ~y ~ ~~~ THE TRUSTED RESOURCE R advertisement Home New Cars Used Cars Research ~ Explore News & Reviews Classifieds Loans >I< Insurance KBB® i Used Car Values I Classifieds I Certified Pre-Owned I Compare Vehicles I Perfect Car Finder I Most Researched Vehicles I CARFAX Vehicle Hr Welcome Back I My KBB ZIP Code 17011 I Change Home > Used Cars > 1990 > Pontiac > Grand Prot > SE Coupe 2D 1990 Pontiac Grand Prix SE Coupe 2D Trade-In Value Private Party Vaiue Suggested Retail Value Photo Gallery Compare Vehicles New! Blue Book Review Consumer Ratings Find Your Next Car Specifications ~ Shopping Tools Free CARFAX Record Check Check Your Credit Score for Free Corn pare Insurance Rates Payment Calculator Extended Warranty Quote Print For Sale Sign ` BUY A. USED tAR on Bk~e Book ClassiFiedsTM P~ac -~._._..___- Grand Prix ___, 30 Mliles or less ZIP Code 17011 ~, To View Ads, Click __ BIDE 640K~ 4RlYATE WARTY YALIlf ~ lUHRT~$ THi6? Condition <U3HgT'S THf'e? Vaiue Excellent $1,180 F -, ~-; Good $1,005 Fair $700 More Photos ~~~ ~'t`~ {~~, Search Used Cars 11 !{+ . Free CARFAX record check Average Consumer Rating (83 Reviews) Read Reviews ~~~~~ 4.4 out of 5 Similar New Vehicles 2008 Porrtiac Grand Prot Photos Review ' in Review This Vehicle 2008 Hyundai Sonata Photos Revi w in More Results Vehicle Highlights SELL POUR USED (AR On Blue Book CiassiFiedsTM Reach millions of ` :shoppers on kbb.com, -- -- - AutoTrader.com, and other popular sites. To Sell A Now, Chdc Mieage: 101,000 Engine: V6 3.1 Liter Transmission: Automatic Drivetra~: FWD Selected Equipment Change Equipment Standard Air Conditioning AMJFM Stereo 1 of 4 8/29/2008 10:29 AM Kelley Blue Book -Private Party Pricing Report -Pontiac, Grand Prix ... http://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=19... Power Steering Alloy Wheels - _ __ _ _ FIND THE RIGHT tAR Compare Used vs. New under gs,ooo ~ Blue Book Private Party Value Both New and Used j Private Party Value is what a buyer can expect to pay when buying a used car ___._........__.__.__....~ Coupe ! from a private party. The Private Party Value assumes the vehicle is sold "As IS" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and bcal To View List, Cfidc market conditions. Thy value may 21so be used to derive Fair Market Value for insurance and vehicle donation purposes. __ . _ _ YtEW ANOTHER YEHICLE Vehicle Condition Ratings Check Vehicle Title History LSelect: Year... ___ Excellent Select Make.. _,i $1,180 ;Select Model._ Looks new, is in excellent mechanical condition and needs no Or Search by Category reconditioning. • Never had any paint or body work and is free of rust. Or Change ZIP Code • Clean title history and will pass a smog and safety inspectan. • Engine compartment is clean, with no fluid leaks and is free of any wear or visible defects. • Complete and verifiable service records. `'" Less than 5% of all used vehcles fall into this category. Estimated Payments S20 /mo C~ 5.29% APR Good :5ck fcr brrai7s -.. $1,005 Get aPre-Owned Loan from • Free of any major defects. 6.09°jo APR • Clean title history, the paints, body, and interior have only minor (if any) blemishes, and there are no major mechanical problems. Your Credit Score for Free Little or no rust on this vehicle. • Tires match and have substantial tread wear left. Get a Free Insurance Quote • A "good" vehicle wilt need some reconditioning to be solo at retail. Most consumer owned vehicles fall into this category. Fair ~?© $700 • Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professanal. • Tires may need to be replaced. • There may be some repairable rust damage. Poor D ,' N/A • Severe mechanical and/or cosmetic defects and is in poor running conditon. • May have problems that cannot be readily faed such as a damaged frame or crusted-through body. • Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley &ue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. * Pennsylvania 8/29/2008 Accurate Condition Appraisal Change Condition Accurately appraising the condition of a vehicle is an important aspect in determining its Blue Book value. Taking our 16 question condition quiz will ensure you know the correct condition rating. ~[~ (' ~ ~ n ~ • Search Used Cars fI'l `JR fC • Free CARFAX record check of 4 8/29/2008 10:29 AM tact, 31. 2608 7:02AM PNC BAND 412-7U5-2747 t.~t~t:37~~~~~ October 30, 2008 Steven W Fahnestock CPA Attorney at Law 1513 Cedar Cliff Dr Camp Hill, PA 17011 RE: William Hintze SSN: 577-32-7582 ?aUD: 07-25-2008 Dear Mr. Fahnestock: No, 3128 P. 1 In response to your request for Date of Death ~bOD) balances for the customer noted above, our records show the following: Checking Account Account # 5140220593 WILLIAM HINTZE CATHRYN A HINTZE DOD balance: $ 7 (,983.76 + 3.60 accrued interest Interest paid 01-01-2008 thru 07-25-2008 $16.45 YTD Safe Deposit Boa The decedent maintained safe deposit box l O1T located at: New Cumberland Branch 331 Bridge St New Cumberland, PA 17070 (717) ~ 7742982 Established: 12-12-200b Page 1 of 2 SCOTT M. DINNER, ESQUIRE TEL: (7 1 7) 761-5800 FAX: (71 7) 76 i -5008 Glenda Farner Strasbaugh Register of Wills and Clerk of the Orphans' Court One Courthouse Square Carlisle, PA 17013 Re: Estate of William Hintze ("Estate") #21-08-00801 The following items are being submitted on behalf of the Estate: 31 17 CHESTNUT STREET CAMP HILL, PA 1701 1 April 27, 2009 1. REV-1 SOO Inheritance T ax Return Resident Decedent [2 copiesJ. 2. Estate check # 134 in the amount of $1, 011.66 payable to the `Register of Wills, Agent' representing the balance due per the REV-1500. 3. Estate check # 136 for $I5. ding fees) payable to `Register of Wills'. Thank you. n~l~_ Scott M. Dinner, Esquire enclosures (4) cc: William Y. Hintze, Personal Representative c ~_. ~~ ? o ~ _~ , _;~ ' ~ -~v ! l7 ~ i ~ ~ _~ _ - ~ _ c~ J o ,• - J~. -: _, ~ _.._., ~ N ~° HAND DELIVERED f~~