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1505607121
REV-1500 Ex (06-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601
RESIDENT DECEDENT 2 1 0 8 1 1 2 1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2 0 4 2 8 2 4 1 7 1 0 2 2 2 0 0 8 0 3 0 3 1 9 2 3
Decedent's Last Name Suffix Decedent's First Name MI
F E R R Y E L L E N F
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
0 1. Original Retum ~ 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 Retum Required
death after 12-12-82)
® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust D 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wili) (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. 0)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
J O E L R Z U L L I N G E R 7 1 7 2 6 4 6 0 2 9
Firm Name (If Applicable)
Z U L L I N G E R D A V I S P C
First line of address
1 4 N O R T H M A I N S T R E E T
Second line of address
S U I T E 2 0 0
City or Post Office
C H A M B E R S B UR G
State ZIP Code
REGISTER OF WILLS USE ONLY ~
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Correspondent's a-mail address:
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.
~rwygtzE o~ F ~Iy~ON~ESPON~SIBL~~E ~Oy FILING RETURN DATE
%yl W`fiu C'` ~' ~I / 3 a ~ G~ 9
ADDRESS
333 EAST BURD STRE T SHIPPENSBURG PA 17257
URE OF P EPA THAN P SENTA~NE DATE ~-+
ADD S J
14 NORTH MAIN T EET, SUI 200 CHAMBERSBURG PA 17201
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607121 15056D7121
1505607221
REV-1500 EX Decedent's Social Security Number
Decedent's Name: ELLEN F• FERRY 2 0 4 2 8 2 4 1 7
RECAPITULATION
1.
........................................
Real estate (Schedule A) 1
2.
..................................
Stocks and Bonds (Schedule B) 2• 8 3 1 5 • 0 3
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages & Notes Receivable (Schedule D) ........................ 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 8 2 0 2 . 1 6
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6•
7. Inter-Vivos Transfers 8~ Miscellaneous N n-Probate Property
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7
epara
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eques
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8. Total Gross Assets (total Lines 1-7) ........................... 8. 1 6 5 1 7. 1 9
9. Funeral E enses & Administrative Costs Schedule H 9. 5 6 9 9. 8 8
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ... .. .... ... 10. 5 0 • 5 0
11. Total Deductions (total Lines 9 8~ 10) ............. ..... .. .... ... 11. 5 7 5 0 . 3 8
12. Net Value of Estate (Line 8 minus Line 11) ........... ..... .. .... ... 12. 1 0 7 6 6 . 8 1
13. Charitable and Governmental Bequests/Sec 9113 Trusts for wh ich 2 6 9 1 7 1
an election to tax has not been made (Schedule J) .... ..... .. .... ... 13. .
14. Net Value Subject to Tax (Line 12 minus Line 13) .... ..... .. .... ... 14. 8 0 7 5 • 1 0
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1z)x.o _ 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate x .045 8 0 7 5. 1 0 16. 3 6 3. 3 8
17. Amount of Line 14 taxable 0 0 0 0 0 0
at sibling rate X .12 17. .
18. Amount of Line 14 taxable
0
0
0
0
0
0
at collateral rate X .15 . 18• .
19. Tax Due ................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
3 6 3. 3 8
^X
1505607221 1505607221 J
REV-1500 EX Page 3
Decedent's Complete Address:
Total Interest/Penalty (D + E) (3) 0.00
DECEDENTS NAME
ELLEN F. FERRY
STREET ADDRESS
101 North Prince Street A t. 207
CITY
Shi ensbur STATE
PA ZIP
17257
Tax Payments and Credits:
~• Tax Due (Page 2 Line 19)
2, Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
(1) 363.38
384.75
20.25
Total Credits (A + B + C) (2) 405.00
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.
(5A)
B, Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 0.00
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; ............................... ^
c. retain a reversionary interest or ................................................................................................ ^
d. receive the promise for life of either payments, benefits or care? ....................................................... ^
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 [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not 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
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)],
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent p2 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.
File Number
21 08 1121
(4)
41.62
(5) 0.00
REV-1503 EX + (8.98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ELLEN F. FERRY 21 08 1121
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Account #3522435, John Hancock Funds, LLC, including 2,422.49
dividends accrued to date of death as shown on attached
valuation
2. Account #00223923, Van Kampen as shown on 5,892.54
attached valuation
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed, insert addfional sheets of the same size)
REV-1508 I~ + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
IN RESIDENT DECEDENT N PERSONAL PROPERTY
ESTATE OF FILE NUMBER
ELLEN F. FERRY 21 08 1121
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. Cash 181.19
2. Proceeds from private sale of decedent's 1990 Chevrolet 400.00
Corsica
3. Proceeds from sale of table 30.00
4. Checking Account #103006431, Orrstown Bank 427.12
5. Savings Account Orrstown Bank, including interest 1,480.92
accrued to date of death
6.. Irrevocable Burial Fund Certificate of Deposit #30048440, 2,001.21
Orrstown Bank, including interest accrued to date of
death
7. Irrevocable Burial Fund Certificate of Deposit #30051309, 2,242.64
Orrstown Bank, including interest accrued to date of
death
8. Nationwide Insurance, premium refunds 339.30
9. Net proceeds from sale of personal property by 543.24
Dan Hershey Auctioneering Service
10. Embarq, refund 9 28
11. Episcopal Towers, refund 110.82
12. PA Department of Treasury, unclaimed property recovered 436.44
TOTAL (Also enter on line 5, Recapitulation) I S Q ~m ~ a
(If more space is needed, insert additional sheets of the same size)
REV-1511 6J(+ (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE H
FUNERAL EXPENSES 8~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
ELLEN F. FERRY 21 08 1121
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Fogelsanger Bricker Funeral Home, funeral services 4,224.88
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City State
Year(s) Commission Paid:
Zip
2, Attorney Fees Joel R. Zullinger 1,350.00
3, Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4• Probate Fees Letters - 45.00; will - 15.00; JCP fee - 10.00; short certificates - 20.00; 125.00
automation fee 5.00; additional probate fee 15.00; filing return 15.00
5 Accountants Fees
6. Tax Return Preparers Fees
7
TOTAL (Also enter on line 9, Recapitulation) I ;
(If more space is needed, insert additional sheets of the same size)
REV-1512 E~X + (12-03)
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES ~ LIENS
RESIDENT DECEDENT ~
'ATE OF
FILE NUMBER
ELLEN F. FERRY 21 08 1121
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
Embarq, balance due on telephone service
34.68
2. ~Penelec, balance due on utilities ~ 15.82
TOTAL (Also enter on line 10, Recapitulation) I ~
(It more space is needed, insert additional sheets of the same size)
REV-1513 EX t (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUOMBER
CI I CAI C CCDDV 21 ~g 1121
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
j TAXABLE DISTRIBUTIONS [include ou ht sppoousal distributions, and Vansfers under
Sec. 9116 (a~ (1.2)]
1. Stephen A. Ferry Lineal 2,691.70
2816 Jahrom Lane one-fourth of residue
Modesto, CA 95355
2. David A. Ferry Lineal 2,691.70
333 E. Burd Street one-fourth of residue
Shippensburg, PA 17257
3. Alice A. Davidson Lineal 2,691.70
676 Walnut Bottom Road one-fourth of residue
Shippensburg, PA 17257
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. Our Lady of Visitation Church 2,691.71
305 N. Prince Street
Shippensburg, PA 17257 one-fourth of residue $2,691.71
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S 2 691.71
(If more space is needed, insert additional sheets of the same size)
JRZ:cb - May 31, 1990
LAST WILL AND TESTAMENT
I, Ellen F. Ferry, of 333 East Burd Street, Shippensburg,
Cumberland County, Pennsylvania, being of sound and disposing mind,
memory and understanding, do hereby declare this to be my will,
hereby revoking any and all former wills and codicils thereto by
me heretofore made.
FIRST
I direct that all my just debts and funeral expenses,
including all expenses of my last illness, shall be paid from my
~ estate as soon as practicable after my decease as a part of the
~~'; expense of the administration of my estate.
~._.
M1
~' SECOND
~~~
I give, devise and bequeath the residue of my estate of every
.~~ nature and wherever situate to my children, Stephen A. Ferry, David
A. Ferry, and Alice A. Davidson, and Our Lady of Visitation Church,
'~
*~.~,~ Shippensburg, Pennsylvania, in equal shares, provided that the
share of any child who predeceases me or dies on or before the
thirtieth day following my death shall be distributed to said
beneficiary's issue, per stirpes, living on the thirty-first day
following my death, and in default of any such then-living issue,
Page 1
such share shall be divided equally among my other children.
THIRD
Any fiduciary under this will shall have the following powers
in addition to those vested in them by law and by other provisions
of my will applicable to all property whether principal or income,
including property held for minors, exercisable without Court
approval, and effective until actual distribution of all property:
A. To retain any and all of the assets of my estate, real
or personal, without regard to any principle of
diversification of risk.
B. To invest in all forms of property including stock,
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., _._
common trust funds and mortgage investment funds without
restriction to investments authorized for Pennsylvania
_1~, fiduciaries as they deem proper, without regard to any
I ti
principle of diversification of risk.
~`^ C. To sell at public or private sale, to exchange or to
lease for any period of time any real or personal
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\ property and to give options for sales, exchanges or
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leases, for such prices and upon such terms or conditions
~-! ~~~ as they deem proper .
\_%
D. To allocate receipts and expenses to principal or income
or partly to each as they from time to time think proper.
E. To compromise any claim or controversy.
F. To distribute in cash or in kind or partly in each.
G. To hold property in their names without designation of
Page 2
any fiduciary capacity or in the name of a nominee or
unregistered.
FOIIRTH
I direct that all taxes that may be assessed in consequence
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.
FIFTH
I appoint my son, David A. Ferry, as executor of this my will.
`.,:; ` :>
Should my son predecease me, fail to qualify or cease to act, I
.tom'
-~~ appoint my daughter, Alice A. Davidson, as executrix of this my
~ will .
~`
~.„~ SIXTH
1
No bond shall be required of any fiduciary hereunder in any
~,, jurisdiction.
., `.
'~~
`\
~ IN WITNESS WHEREOF, I hereunto set my hand and seal to this
~~~
my last will and testament, consisting of five typewritten pages,
the first two of which bear my signature in the margin for the
purpose of identification this _f~~ day of
19 9a .
/~/~ ~ ~,
(.k--J'`-~' ~, ~, .,/ (SEAL)
Page 3 `
Signed, sealed, published and declared by the above-named
testatrix, as and for her last will and testament in our presence,
who in her presence, at her request and in the presence of each
other have hereunto set our hands as attesting witnesses.
residing at i ~ ~,r~~~~~---- G~ ~~
r
`,~::.~~.,~~..~~~.L< ,!~_~-~ residing at ~~~~~ ~ :..lC< ~.;~-..
We, Ellen F. Ferry, ~O~G, ~ „~CILL//~~~~ , and
~,~ pf'/ ~' (~~ S/P~~s the testatrix and the witnesses,
respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn do hereby declare to the
undersigned authority that the testatrix signed and executed the
instrument as her last will and that she had signed willingly (or
directed another to sign for her), and that she executed it as her
free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the testatrix
signed the will as witnesses and to the best of their knowledge,
the testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
Page 4
:~J.2t ~,2t~-.(/mot .~...~..~t-,c...
Witness
Subscribed, sworn to and acknowledged
before me by the above-named testatrix
and subscrib and sworn to before me
by the abo = arced witnesses th's ~~
day o fj~ 19 ~d
Public
~iOTAP.IRL SEAL
TER ESA J. BURf:HOLDER, Notary Public
Shippensburg Boro, Cumberland Co., Pd.
My Commission Expires Sept. 9, 1991
Page 5
John Hancock Funds, LLC
Mutual Fund Operations
P.O. Box 9510
Portsmouth, NH 03802-9510
(800) 225-5291
www.jhancock.com/fu nds
John Hancock Signature Services, Inc.
December 15, 2008
Joel R Zullinger Esq
Zullinger-Davis PC
14 North Main St Ste 200
Chambersburg PA 17201
Reference: 00981527
Account Number: 1828462
Estate of Ellen F. Ferry
Dear Mr. Zullinger:
the future is yours
Thank you for contacting John Hancock. As requested, we changed the ownership of the John
Hancock mutual fund shares. To change the account registration to reflect the new ownership of
the shares, it was necessary for us to establish the new account listed above prior to redeeming the
shares. A check and confirmation have been sent to David A. Ferry.
The value of account number 3522435, which was registered to Ellen F. Ferry, on October 22,
2008, was $2,422.49. This amount includes $5.76 in dividends that had accrued but had not been
paid. The net asset value per share of the Government Income Fund A was $8.96 and there were
269.724 shares in the account. Please remember that the share price fluctuates daily.
If you have any questions, please call our customer service center at 1-800-225-5291 any
business day between 8:00 a.m. and 7:00 p.m., Eastern time. For additional account and product
information, please access our Web site at www.,jhfunds.com.
Sincerely,
Josette Johnson
Correspondence Associate
i :~iG7 John Hancock Funds, LLC, 601 Congress Street, Boston, MA 02210-2805, Member FINRA • Sovereign Asset Management, LLC
VAN KAMPEN
INVESTMENTS
December 12, 2008
JOEL R ZULLINGER ESQ
14 N MAIN ST STE 200
CHAMBERSBURG PA 17201-1814
Reference: 00223923
Re: 28 / 671527936
Ellen Ferry
Dear Mr. Zullinger:
Van Kampen Investments Inc.
2800 Past Oak Boulevard
Houston, TX 77056
As requested by your client, David A. Ferry, we are providing you the following
summary of the share balance and net asset value (NAV) information for the above
referenced Van Kampen account as of October 22, 2008.
Share Balance NAV Resulting Value
787.773 $7.48 $5,892.54
We hope this information is helpful. If we may be of further assistance, please contact
our Client Relations Department at 1-800-847-2424 between the hours of 8:00 AM and
5:00 PM Central Time, Monday through Friday.
Sincerely,
~,~
R L Solano
Sr. Correspondence Representative
A Tradition of Excellence
November 21, 2008
To: Zullinger -Davis
14 North Main Street
Chambersburg Pa 17201
From: Traci Yohe
Orrstown Bank
Customer Service Center
PO BOX 250
Shippensburg, Pa 17257
Re: Estate of Ellen F Ferry
Date of death Ocotber 22, 2008
IT IS HERERBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON THE
ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
CHECKING ACCOUNT
Account # Title of Account
103006431 Ellen F Ferry
SAVINGS ACCOUNT
Account # Title of Account
11/30/07 Ellen F Ferry
Date opened Principal Accrued Interest
07/05/06 427.12 0.00
Date o ep ned Principal Accrued Interest
11/30/07 1480.71 0.21
CERTIFICATE OF DEPOSIT
Account # Title of Account Date Opened Principal Accrued Interest
30048440 Ellen F Ferry 06/21/93 2001.06 .15
Irrevocable Burial Fund
30051309 Ellen F Ferry 03/15/95 2241.26 1.38
Irrevocable Burial Fund
P.O. Box 250 • Shippensburg, PA 17257 • 717.530.3530 • 717.532.4143 fax
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