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HomeMy WebLinkAbout05-01-09 (3)x ~ 15056041158 REV-1500 EX (OB-OS) PA DeparMenf of Reeanue OFFICIAL USE ONLY Bureau of IndiWdual Taxes County Cotle Vear File Number Po Box zeosol INHERITANCE TAX RETURN 21 08 1078 Harrisburg, PA 17123-0607 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Secudty Number Date of Death Date of Birth 163-36-9125 07302008 08271917 Decedent's Last Name WARNER Suffz Decedent's First Name BETTY (If Applleable) Enter Surviving Spouse's Irdormation Below Spouse's Last Name Suffix SDOUSes First Name Spouse's Social Severity Nvnber THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS MI A MI FILL IN APPROPRIATE BOXES BELOW 1. Original Return ^ 2. Supplemental Retum ^ 3. Remainder Return (date of death ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of prior to 12.13-82) ^ 5. Federal Eslale Tax Return Required 6. Decedent Died Testate (Attach Copy of Will) ^ 7. tleath attar 12-12-ffi) Decedent Maintainetl a Living Trust A (]_ 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Rec i d ^ 10 ( ttach Copy of Trust) ^ ve e . Spousal Poverty CredR (tlata 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 13E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAx INFORMATION SHOULD BE DIRECTED TO: Noma Daytime Telephone Number RICHARD W• STEVENSON, ESQ• 717-237-5208 Firm N If ame ( Applipble) r~> REGISTER , ,ILLS USE ON MCNEES WALLACE & NURICK LLC ~ ~' First line of address -T'n ~ - 'l.~%__ < 100 PINE STREET ';;'~', I Sawnd line of address - -~ PO BOX 1166 =~ '?~~ City or Posl Office State ZIP Cade FLED •• HARRISBURG PA 17108-1166 cn Correspondent'semailaddress: RSTEVENSONaMWN•COM Under penal0ee of pert I declare lost I nave examined this return, Including aceompanying schedules antl stelemenls, antl to the oast of my knowledge and belie. it is Ime, tyre[! antl plate. Dxlaretbn of preparer other than the per6onal reprasantatire h boned on all Information of whicn preparer has any knowledge. ~ -v y 15056041158 Side 1 15056041158 6Mi6C] 3.000 f 15056042159 _•-1 REV-1500 EX Decedent's Social Secudty Number 163-36-9125 DecadenPeN LIARN R B TTY A RECAPITULATION 1. Raal estate (Schedule A) .. .. 1. 0•~~ 2. Stocks and Bonds (ScfXrtlule B) . . . . . . . . . . . . . . . . . . . . . . . . 2. 0 • a ~ 3. Closely Held Corporation, Partnership a SolaPraprietorship (SChetlule C)- . . . . . 3. ~ • ~ ~ 4. Mortgages & Notes Receivable (Schedule D). .. 4. 0 0 Q 5. Cash, Bank Deposits 8 Miscellaneous Personal Property(Schetlule E). . . . . . . . 5. 64 59 • 69 6. Jointly Owned Property (Sdtedule F) ~ Separate Billing Requested .. ... 6. 16 5813 9 9 7. Inter-Vivos Transfers 8 Miscellaneous Nan-Probate Propert • y (Schedule G) ~ Separate Billing Requested .. . . . 7. s347.o0 6. Tote) GroscASSrrls (total Lines 1-7) . . . . . . . . ............. ... 6 1776 0 68 9. Funeral Expenses 8 Administrative Costs (schedule H) . . .. . . . . . .. . .. . 9, 4 532 • 9 9 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I). .. . . . .. . . . 10. 237'7 • 16 11. Tout DedueBans (total Lines s d 10) . .. .. 11. 6 910 • 15 12. Nel Value of Esuu (Line B minus Line 11) . . . . .. .. . . . . . . . . . . 12 13. Charitable antl Governmental Bequests/Sec 9113 Trusts for which . . 170710.53 an election to tax has not been made (SMedule J) . . . . . . . . . . . . . . . . 13. O • 0 o 14. Net Value SubJeM u Tu (Line 12 minus Line 13) .. . . . .. . . . . . . 14. 170 7 ~ 0 53 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9118 (a)(1.2)X O~ . O.OQ 15. 2.~~ 16. Amount of Line 14 laKeble at lineal rate x .045 17 0 710.5 3 16. 7 6 81.9 7 17. Amount of Line 14 taxable at sibling rate X .12 Q • 00 17. ~ • 00 18. Amount of Lina 14 taxable at collateral rate X.15 O. OO i6. 0.00 19. TAX DUE . . . . . . . .. . . . . . . .. . . . . . . .. . . .. . .. . .. 19. 7681.97 20. FILL IN THE BOX IF VOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042159 15056042159 su4sae 2.000 REV-1500 Ex Page 3 Decedent's Complete AddrxrA~• Flb Number ~, nn ~„ uu yu ro DECEDENPS NAME A N R TTY p SIREET ADDRESS CITY STATE ZIP M H N BU G Tax Payments and Credits: 1. iaz Due (Page 2 Line 19) 2. CretlitsrPeymems A. Spousal Poverty Credit ~ . Q 0 B. Prior Payments 7 ~ 0 ~, ~~ c. Discount 368 • 42 3. InleresUPenalty N apDlicabb D. Interest ~ , ~ ~ E. Penalty _ 0 , 0 (t) 7681.97 Thal Credits (AaBaC) (2) 7368.42 Trial lntaresdPemXy(D «E) (3) (]I] 4. If Line 2 is greater Ihan Line 1 + Line 3, enter the d4terence. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to nquaat a refund 1<) O • ^ (] s. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the 7AX DDE. (5) 31 ~ . 5 5 A. Enter the interest on the tax due. (6A) ~ . ~ ~ B. Enter the total of Line 5 + 5A This a the BALANCE DUE. (58) 1. Make Check Payable to: REGISTEROFWILJLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Ditl decadent make a transfer and: Yes No a. retain the use or income of the property Vansferred : .... . .. .. .. .. ^ 0 . . . . .. . b. retain the right to designate who shall use the property Vansfemed or its income: ^ X^ c. retain a reversionary iMeresC. or .. . ... . .... ... . x d. receive the Dromise /or life d either payments, benefits ar care? ..... .. .. ... .. ^ 2. If tleath occurred alter December 12, 1982, ditl tlecetlent transfer property within one year of death without receiving atlequate consideration? ... .. .. ...... . . . . . ..... . ^ ... 3. Did decedent own an "in Irusl for" or payable upon death bank account or security at his or her death? . ^ 4. Did decedent own an Indivitlual Retirement Acwunl, annuity, or other nan-probate PrWerty which contains a beneficiary designation? . ... .. ... . . .. . . . . . . ... . .. .. ... . . . ^ IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS YES, VOU MUST COMPLETE SCHEDULE G AND FO-ERAS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the lax rate imposed on the net value d transfers to a for the use of the surviving spouse is three (3) Percent p2 P.S. §9116 (a) (1.1) (i)]. Fa dates of death on or after January 1, 1995, the tax rate imposed an the net value of transfers to or for the use of the surviving spouse is zero (0) percent 172 P.S. §9116 (a) (1.1) (ii)]. The statute does not axe t a transfer to a surviving spouse from lax, and the statutory requirements (or disclosure of assets and tiling a tax return are still applicable even if the surviving spouse is the ony beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of trensfers from a deceased chiltl twenty-one years of age or younger at death to or for use of a natural parent, an ado0llve parent, or a stepparent o! the child is aerc (0) percent p2 P.S. §9116(x)(1,2)]. The tax rate imposed on the net value of transfers to or !or the use of the decedent's lineal beneficiaries is tour and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) P2 P.S. §9116(x)(11]. The tax rate imposed on the net value o! transfers to or (or the use of the decedent's siblings is twelve (12) percent 172 P.S. §9116(a)(1.3)]. Asiding is defined, untlar Section 9102, as an individual who has at least one parent in common with the decedent, whether by Nood or atloption. fi MOB)1 LOOD REV-1508 E%~ (69B) SCHEDULE E COMMONWFA~EOTA%RETURNVANIA CASH, BANK DEPOSITS, & MISC. RESIDEIR DECEDEM PERSONAL PROPERTY OF - - ---- y. loom space is neeaeo, maeR epOSbnal BheMa of (ha Game site) nEV~tsoe Fx. (s5e( BETTY A. WARNER 1 1078 k an asset was made point wkhin one year o(the tlecedent's date of death, k moat be reportetl on ScMtlule Q SCHEDULE F JOINTLY-OWNED PROPERTY SUNNhq JOM TENANr(S)NAFE I ADDRESS RHATgNSHP TO OEC®BJf PSC 76 Hox 5367, APO, AP 96319-0032 A Warner, Hollace H Warner, Steven JOINTLY-0WNED PROPERTY: -_ (~ IFLTEq DATE DESCPoP~gN OF RiOPH2TV INC O %OF b1TE OF OFF TH NJhHBt FOq JOIN rExnNT AM DE Jppn W E MOMF OF FINPNC~AL MSiITUiION qNO flViK OGCWMi NurgsFA Oq slx xiarosrvrE~p~~ss~nnpcN Oaogoq GATE OF CEATH DECD'S VALUE DF J VALI.E OF ASSET IMEREST DEC®BJi'S M8tE5T THE DECEDENT HELD AN INTERNET BROKERAGE ACCOVNT NO. 22415996 JOINTLY WITH HER SON, HOLLACE WARNER; SEE ATTACHED VALUATION INFORMATION: 1 A Equities and Options held in above-referenced account 95,905.00 50.0000 47,952.50 2 A Cash Balance 209,516.13 50.0000 104,758.06 THE DECEDENT HELD AN INTERNET BROKERAGE ACCOUNT NO. 22398960 JOINTLY WITH HER SON, STEVEN WARNER; SEE ATTACHED VALUATION INFORMATION: 3 B Options held in above-referenced account 4,012.50 50.0000 2,006.25 4 B Cash Balance 22,194.37 50.0000 11,097.18 1212 Weat Heaver Avenue, State College, PA 16801 TOTA (p r r R R pilulH4an1 ~ S 165 813 99 ([ more space is needed, insert atltlrtional sheets al the aerre soe) 3w.snF t o00 RE Vd510 E% ~ (s.96) SCHEDULE G TH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & VCE TAX RETURN MISC. NON-PROBATE PROPERTY :Nf DE<~DENT BETTY A. WARNER 21 081078 This schetlule must be completed antl flletl It the answer to any of quastbns 1 Nrough 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBE vuux.rE~DESCRIPf10N ~F PROPErewarooscsoErvr ua l1E wlEamaisrn •nawnmcorraoeso voa iax ssTSrt. DATE OF DEATH VALUE OF ASSET Yo OF DECD'S INTEREST EXCLUSION FApPUCrsIE TVALAUEE t~ Allstate Annuity - The beneficiary of the annuity is decedent's grandson who is entitled to 99 monthly payments of $64. The present value of this payment stream is $5,347.00 (July 2006 interest rate was 4.26) 5,367.00 100.0000 0.00 5,347.00 TOTAL (Also enter on line 7, Recapitulation) I E _ _ _ (I! more space is needed, incan adddipnal sneers o(ihe same size) SwasAr vsso REV49t E%~ (1p067 COMMOMNFALTM OF PENNSYLVANIA INHERITANCE TA% RETURN ADMINISTRATIVE COSTS: Personal Representative's Commissions Name d Personal Representative(s) Slrcel Address COIMIC Vr FILE NUMBER BETTY A. WARNER ~ R1n~R Debb of tlecedent moat ba reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t, Auer Memorial Home and Crematory 9arvices 1,626.60 B. t SCHEDULE H FUNERAL EXPENSES 8 ADMINISTRATIVE COSTS City Year(s) Commission Paid: State Zip 2. Attorney Fees McNees Wallace & Nurick LLC (Estimated) 2,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanatbn) Claimant Street Address 4. s 8. 7. 1 TwasAC Laos City Slate Zip Relationship of Claimant to Decedent Prabele Fees Accountant's Fees Tax Return Preparefs Fces Central Penn Business Journal Legal Advertising Total from continuation schedules . TO7AL (Also enter on line 9 R Qf mare space is needed, insert addhional sheets d the same size) 103.00 109.00 194.39 REV~1513 EX ~ (12-08) Pennsylvania SCHEDULE I ~"m``F"ro` `+ErE""E DEBTS OF DECEDENT, ~M~~M"'"" MORTGAGE LIABILITIES 8 LIENS ESTATE OF - FILE NUMBER BETTY A. WARNER 21 08 1078 nepon septa incurred 6y the decedent prior to death that remalnatl unoald at [hw nw1. n. nw.u.:...u.w:.... .....e:_....__. __.~__~ ________ _.. __.,°.,__„ ~~ :wo:e apace s peeped, mean additwnal sheets d the same sine. REV-1513 E%t (H-0B) rennsylvania SCHEDULE J OEPtRR.ENIOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT a¢mmv n manvco FILE NUMBER ___-_ __ . ...__._.. 210 81078 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE I raxnBLE o1sTRIeuTloNS pnauce outngm spousal alslnoullona, ens Iranakrs under Sec. 2116 (a) (1.2).] 1. Steven A. Warner Allstate Annuity - The beneficiary of the annuity is decedent's grandson who is entitled to 99 monthly payments of $64. The present value o£ this payment stream ie $5,347.00 (July 2008 interest rate was 4.28) Inventory Value: 5,347.00 Grandson 5,347.00 2 Steven Warner 1212 West Beaver Avenue State College, PA 16801 Joint Account - $13,103.43 Estate Residue - ($225.23) - see attached calculation Son 12,878.20 EN1ER DOLLAR AMOUNTS FOR DISTRIBU110NS SHOWN ABOVE ON LINE515 THROUGH 1 B OF REV-0500 COVER SHEET, AS APPR OPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTON 2113 FOR WHICH AN ELECTION TO TAx IS NOT TAKEN 1. 8. CHARRABLE AND GOVERNMENTAL DISTRIBUTIONS 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. n......_'____:____'_• ._. ..... _ S 0.00 ...o.., sow .....~. ..vo..o w „aww. nrsan aoaNOnal seems of IRe same sva. Estate of: BETTY A. WARNER 21 OB 1078 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 3 Hollace Warner PSC 76 Hox 5367 APO, AP 96319-0032 Joint Account - 152,710.56 Estate Residue - (225.23) - See attached calculation Son 152,485.33 ESTATE OF BETTY WARNER ESTATE RESIDUE -PENNSYLVANIA INHERITANCE TAX RETURN Estate Assets (taxable for inheritance tax) PNC Checking Account 6,159.69 US Treasury -Refund 300.00 6,459.69 Assets payable to Estate (not taxable for inheritance tax) Board of Pensions -Death Benefit/ Life Insurance 8,406.60 Total Assets available to pay estate expenses 14,866.29 Estate expenses reported on inheritance tax return* Funeral/Administration Expenses 4,532.99 Debts 2.377.16 6.910.15 Residue Available to pay inheritance taxldistribute to estate beneficiaries 7,956.14 'expenses are deductible regardless of whether assets comprising the decedent's taxable estate are employed in payment thereof (72 P.S. § 9126) Calculation of residue for inheritance tax ourooses Taxable Estate Assets 6,459.69 Less: Deductible Expenses 6.910.15 Residue to distribute to beneficiaries -450.46 50% to Horace Warner -225.23 50% to Steve Warner -225.23 ESTATE OF BETTY A. WARNER DEPT. OF REVENUE NO. 21-08-1078 LETTERS TESTAMENTARY AND COPY OF DECEDENT'S WILL REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No . 2008- 0 9078 PA No . 2 9 - 08- 1078 Estate Of: BETTYA WARNER (Firsq Mitldle, Lastl a/k/a: BETTVALEXANDER WARNER Late Of: LOWER ALLEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No: 163-36-9125 WHEREAS, on the 30th day of October 2008 an instrument dated November 18th 1998 was admitted to probate as the last will of BETTYA WARNER (Firsq Middle, Lastl a/k/a BETTY ALEXANDER WARNER Late of LOWER ALLEN TOWNSHIP, CUMBERLAND CQUnty, who died on the 30th day of July 2008 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBA UGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARYto: STEVEN H WARNER who has duly qualified as EXECUTOR(R/XJ and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the -30th day of October 2008. % '1 - " 1 l~j ~I pp egrste~ of Wilr V r ~ (l.~ kC.-,--J De$u ~. ~ ~ ~ Q G~ - `I~ **NnTF.** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMENT OF BETTY A. AARNER I, BETTY A. WARNER, of Mechanicsburg, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath-all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my children, STEVEN H. WARNER and HOLLACE H. WARNER, provided, however, that should either of my children predecease me, then to their issue per stirpes by representation. SECOND: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder. the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (~rcludirg credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. THIRD: I direct that all inheritance, estate, trans- fer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property. passing under this Will, shall be paid out of the principal of my residuary estate. FOIIRTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. 2 FIFTH: I nominate and appoint STEVEN H. WARNER and HOLLACE H. WARNER, Co-Executors of this, my Last Will and Testa- ment. I direct that my Co-Executors, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this /~j~', day of ~('6sti~>7-c'~-' , 1998. ~'',_.~i O ~~~ i,yu•~ (SEAL) BETTY A~ WARNER Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address ~.,,, lU~ G {rS'L~f.~''L~ U '~ !~~~~. C~. ~~h~er~~ ~-- ~ 3 ESTATE OF BETTY A. WARNER DEPT. OF REVENUE NO. 21-08-1078 OFFICIAL RECEIPT - 3 MONTH TAX PAYMENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 ] t 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX~11-96) N0. CD 010478 WARNER STEVEN H 1212 WEST BEAVER AVE STATE COLLEGE, PA 16801 loll ESTATE INFORMATION: ssN: is3-3s-si25 FILE NUMBER: 2108-1078 DECEDENT NAME: WARNER BETTY A DATE OF PAYMENT: 10/30/2008 POSTMARK DATE: 10/29/2008 COUNTY: CUMBERLAND DATE OF DEATH: 07/30/2008 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 57,000.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT MAILED TO ATTY CHECK# 0613 57,000.00 INITIALS: JN sEA~ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER ESTATE OF BETTY A. WARNER DEPT. OF REVENUE NO. 21-08-1078 PNC BANK ACCOUNT INFORMATION ~~ t FA6lh€GfiHEAY December 8.2008 Linda M Eshelman Mcnees, Wallace & Nurick PO Box 1166 100 Pine Street Harrisburg, PA 171 08-1 1 66 RE: Betty A Warner SSN: 163-36-9125 DOD: 07-30-2008 Dear Ms. Eshelman: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Checking Account Account # 5080032514 Established: 04-12-1994 BETTY A WARNER DOD balance: $ 6,159.69 + 0.00 non interest bearing account Please note that this office provides date of death balances for deposit accounts (IRPs, CDs, Checking and Savings). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 of 1 ESTATE OF BETTY A. WARNER DEPT. OF REVENUE NO. 21-08-1078 BROKERAGE ACCOUNT NO. 22415996 -HELD JOINTLY WITH HOLLACE WARNER is Z O O F ~ a K G U w ~ ~ r ~ ti w ~ w ~~ ~ x W ~ a m m ~ w O ~ N F N N O N v V F- R ~ 0 ~ Rf .C. m D N U io~~oo~o~~o o :pi o ,p, o , o . to 0 0 }~~ ~,,~ N ~ N N ~". [-' ~ F f,c d-~4¢ Ut~ U~U V:Q ~+{'„~Q ~ !: co ~~ o x ~ ~ ~ $i a w ~m 6 ~ ~ vii Q ; ¢' G""tiZ '..G mf~'l.m~ m,w .~ o ~Si'. o o~~ a a1' m o cai o a o tt~ ~n lujti in OO O 3~`~IN t 0 O ~ °o k °o °o ~ o }o b.o' ~~ ~ ~ u ~ ~ yt ?' w ~ O .fF •w-l ~ > F x o 0 40 ,~ c c w R R G FR F [-. ~ L 'v Q ¢>'U m; m ~~~~ Q Q .i Q sQ w w m mo ~ ~. I , [ . 00 0 o v vii F O ~{O god OO re#: c. M N O n d _0. M O W N d W ~Q~ 'N y E ~ ~ O ~O O , ~ O i ppp m aJ ry . 00 NO 00 x ~ ~ ~ i~K "*nX F A ~ ,~ ` y . r. .;. w~ ~ r dd ~ i.t l~ Y u~t ~ .: Y ~. ~ of~o~ ~ ,~ N d W i ~ ~~~ Q ~ ' ~ a ~~ ~ ~ r ~ " a ~ et~ N ~Si ., i div. W S G.: ~ iyu m ~ E 5:~ ~ ~ .'A.I r4..' A~ i" 'S p. 3 , ~' ~q. 1 ~. t ~' ~ W ~3 N Y W N J s,4 N b N w d N F °o a ° > '~ o O'> ~ 0 ~ ' 6 ~6? E6 iQ' Q Q ~! U~,'~U~ V Y3~nho 7o (h [+) K1 U °" gyn N .' U U . in ~;v> pJ OJ ~» aN-# h' l11 ' TE' '} ~ ~i ~ ~ - s t~ . ~ is i ~ ~ ; , ~ W :' ~ `} I k ~ j( ~~ O fS)f O fG O ^w . y. O ~'t 3y` ~ $. I O O i ~ ~? w ~gg a ? ~ .g iii ~' ~ a, b OZ '~i.~~ E4 nd". 4s ~{I ~ d (GJtr ~ t „ ~x, ~Ct" Yt ie .vE ~Ep k~'J ~' C W ~. ~ ~ ~~~ kU] W d V1 ~. o ^ 'a ~- ~ 'a ~~ ~~ ~ v ~ ° w ~u~ §§3)~p' x~~' ~yg 4. c c O o ._ ~ II k. ~ o ~ '- A v~ ~ v~ ~ C '4' 3 s w ~I~X'; ~I~ 4Q ~t~ . a ~ ~` W J Y a' Q Z l7 Q f a 0 z W d O a Z O d K u ~ ~ w ~ ^ J a c 10 J ~m O f H N '~ 0 O W 0 o g i r~ C. d~ N O O y m ~ ~ E ~ m ~ ~ P. N ~ M o N O ~] u ., v a z °° a ~~ N N vNi ~ o n .o .. ~ ri ~ m -r w v G rn C O A Q `v 0 o ~. ~ '" °° O T q 5 ~ ~' ~ m O n [ u o J p, v n O r ESTATE OF BETTY A. WARNER DEPT. 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