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Home My WebLink About05-29-0915D5607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 2 1 0 8 1 1 7 7 Hamsburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 1 0 4 4 7 1 3 5 1 1 1 9 2 0 0 8 1 0 0 7 1 9 1 3 Decedent's Last Name Suffix Decedent's First Name MI J O N E S R O S E S E L V E Y (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW ^X 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of prior to 12-13-82) ~ 5. Federal Estate Tax Return Required D OX 6 d Di death after 12-12-82) ~ . ece ent ed Testate ~ 7. Decedent Maintained a Living Trust 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 TO: Name Daytime Telephone Number G E R A L D J S H E K L E T S K I E S Q 7 1 7 n7 7 4 r~ 4 3 5 Firm Name (If Applicable) C _ REGIS,. WILLS 1731E ONLY ~ S T O N E L A F A V E R S H E K L E T S K I ~~ --~ First line of address _ ~ ~ N ' s~ ~~ t~ 4 1 4 B R I D G E S T I ~ ~ ° Second line of address , ~~ ?„ ~ .:~: ~ : P 0 B O X E ~ ~ , I ' City or Post Office State ZIP Code ~___ ____ DATE FILED N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent's a-mail address: GSHEKLETSKI~STONELAW.NET Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE O_ EFLYR-FfL'1T~RETURN ~,_.,_----~ DATE .~ / 5 ~ ~' ADDRESS ROBERT C• JONES 454 GH ST•, MOUNT HOLLY NJ 08060 SIGNATU ARER ,D nnna~cc ~ ~ ~/ ~s/~ GERALD J• SH~KLETSKI, ESQ• 414 BRIDGEST•, NEW CUMBERLAND PA 17D70 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505607121 1505607121 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: ROSE SELVEY JONES 2 1 0 4 4 7 1 3 5 RECAPITULATION 1. Real estate (Schedule A) ........................................ 1. 2. Stocks and Bonds (Schedule B) 2. 2 3 7 • 8 2 .................................. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ................. ..... .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5. 1 4 3 8 7 0 5 . 8 7 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ..... .. 7. 9 7 3 2 6. 5 7 8. Total Gross Assets (total Lines 1-7) .................... ..... .. 8. 1 5 3 6 2 7 0. 2 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......... ..... .. 9. 5 6 7 6 5 . 9 4 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ..... ..... .. 10. 11. Total Deductions (total Lines 9 & 10) .................... ..... .. 11. 5 6 7 6 5 . 9 4 12. Net Value of Estate (Line 8 minus Line 11) ................... .... .. 12. 1 4 7 9 5 0 4 . 3 2 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. 1 4 7 9 5 0 4 . 3 2 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.045 0 0 0 15. 0. O Q 16. Amount of Line 14 taxable at lineal rate x .045 1 4 7 9 5 0 4. 3 2 16. 6 6 5 7 7. 6 9 17. Amount of Line 14 taxable at sibling rate X .12 Q 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1S. 0. 0 0 19. Tax Due ................................................ 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 6 6 5 7 7. 6 9 Side 2 1505607221 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 08 1177 DECEDENT'S NAME ROSE SELVEY JONES ____ __ STREETADDRESS 314 VIRGINIA ROAD CITY ;STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1 • Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments 55,000.00 C. Discount 2,894.65 3. InteresUPenalty if applicable D. Interest E. Penalty (1) 66,577.69 Total Credits (A + g + C) (2) 57, 894.65 Total InteresUPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (3) (4) 0.00 (5) 8,683.04 (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (56) 8,683.04 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 : ...................................................................... ^ X^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ X^ c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ X^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ 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? .................................................................................................. ~ ^ 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 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 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 [72 P.S. §9116(a)(1.3)j. 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. 0.00 REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ROSE SELVEY JONES 21 08 1177 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 22 SHARES NEWELL RUBBERMAID COMMON STOCK 237.82 ACCOUNT NUMBER 00000271527 22 X 10.81 PER SHARE (DATE OF DEATH VALUE) _ $237.82 TOTAL (Also enter on line 2, Recapitulation) I b 237 82 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E + COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8c MSC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER ROSE SELVEY JONES 21 08 1177 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. PNC BANK CERTIFICATE OF DEPOSIT ACCOUNT #31500218880 11,982.88 2. PNC BANK CERTIFICATE OF DEPOSIT ACCOUNT #31800222233 3. PNC BANK CERTIFICATE OF DEPOSIT ACCOUNT #31600250247 4. PNC BANK CERTIFICATE OF DEPOSIT ACCOUNT#31500200635 5. PNC BANK CHECKING ACCOUNT #5140032285 6. PNC BANK SAVINGS ACCOUNT #5130178715 7. CHARLES SCHWAB INVESTMENT ACCOUNT #71925627 8. DELAWARE INVESTMENTS ACCOUNT #7-5077571080 9. DWS INVESTMENTS ACCOUNT #4295084698 10. VANGUARD FUND & ACCOUNT NUMBERS 0042-09885612895, 0063-09885612805, AND 0077-09885612805 11. USAA FEDERAL SAVINGS BANK ACCOUNT 12. LADIES 18K WHITE GOLD 4 PRONG RING 13. SIERRA MERGER CORPORATION -UNCLAIMED PROPERTY - AVAYA, INC. 14. READERS DIGEST REFUND CHECK 15. NEWEL RUBBERMAID DIVIDEND CHECK 16. WOMEN'S DAY REFUND CHECK TOTAL (Also enter on line 5, Recapitulation) ~ $ 705.87 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent ROSE SELVEY JONES 21 08 1177 Decedent's Name Page 1 File Number Schedule E -Cash, Bank Deposits, 8~ Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17. HEALTH INSURANCE COVERAGE REFUND CHECK 500.20 18. FOR INFORMATIONAL PURPOSES ONLY -THE OPAL GOLD RING REFERENCED IN ARTICLE II(A) OF THE DECEDENT'S WILL WAS GIVEN TO ROBERT C. JONES MORE THAN ONE YEAR PRIOR TO THE DECEDENT'S DEATH. FURTHER, SAFE DEPOSIT BOX C16 REFERENCED IN THE LETTER FROM PNC BANK DATED DECEMBER 24, 2008, WAS CLOSED PRIOR TO THE DECEDENT'S DEATH. SUBTOTAL SCHEDULE E ~ 500.20 GRAND TOTAL SCHEDULE E I $ 1,438,705.87 REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY FILE NUMBER ROSE SELVEY JONES 21 08 1177 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.ATTACHACDPYOFTHEDEEDFDRREALESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IFAPPLICABLE) TAXABLE VALUE 1. USAA ACCOUNT NUMBER ENDING IN 7224 100,326.57 100. 3,000.00 97,326.57 TRANSFEREE- ROBERT C. JONES, GRANDSON TOTAL (Also enter on line 7 Recapitulation) ~ $ 97 326 57 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-OB) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER ROSE SELVEY JONES 21 08 1177 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. CREMATION SOCIETY OF PENNSYLVANIA 925.00 B. Year(s) Commission Paid: State Zip 2, Attorney Fees GERALD J. SHEKLETSKI, ESQ. 45,000.00 3, Family Exemption: (If decedents address is not the same 8s claimants, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4, Probate Fees LETTERS TESTAMENTARY 610.00 5 Accountant's Fees JOHN VICE -PREPARATION OF FINAL INCOME TAX RETURNS 460.00 6. ~ Tax Return Preparers Fees 7. LEGAL ADVERTISING -THE PATRIOT-NEWS 141.24 8. LEGAL ADVERTISING -CUMBERLAND LAW JOURNAL 75.00 9. SHORT CERTIFICATES 20.00 10. PINNACLE HEALTH EMERGENCY SERVICES 451.00 11. PINNACLE HEALTH MEDICAL SERVICES 455.00 12. MESSIAH VILLAGE 5,540.08 13. PINNACLE HEALTH MEDICAL SERVICES 206.00 14. ALERT PHARMACY SERVICES 17.83 15. SPECIAL EVENT EMERGENCY MEDICAL SERVICES 166.79 16. UNITED STATES TREASURY - 2008 FEDERAL INCOME TAX 1,523.00 17. PENNSYLVANIA DEPARTMENT OF REVENUE - 2008 STATE INCOME TAX 95.00 18. ADDITIONAL PROBATE FEE 300.00 TOTAL (Also enter on line 9, Recapitulation) $ 56.765.94 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Street Address City (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent ROSE SELVEY JONES 21 08 1177 Decedent's Name Page 2 File Number Schedule H -Funeral Expenses ~ Administrative Costs - B7. ITEM NUMBER DESCRIPTION _ AMOUNT 19. FILING FEES -INHERITANCE TAX RETURN AND INVENTORY 20. RESERVE FOR CLOSING EXPENSES 30.00 750.00 SUBTOTAL SCHEDULE H-B7 ~ 780.00 REV-1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Qnc~ cFl vFV _InnIF~ 21 08 1177 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. ROBERT C. JONES Lineal 1,182,866.30 454 HIGH ST. MOUNT HOLLY, NJ 08060 2. DAVID W. JONES Lineal 220,900.05 1532 SOUTH CHESTNUT CIRCLE MESA, AZ 85204 3. DOROTHY E. JONES Lineal 25,245.99 314 VIRGINIA AVENUE MECHANICSBURG, PA 17050 4. GABRIELLE R. JONES Lineal 25,245.99 454 HIGH ST. MT. HOLLY, NJ 08060 5. ISABELLA ROSE JONES Lineal 25,245.99 454 HOLLY ST. MOUNT HOLLY, NJ 08060 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 TAXIS 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 S (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 010924 JONES ROBERT C 454 HIGH STREET MOUNT HOLLY, NJ 08060 -------- told ESTATE INFORMATION: SSN: 210-44-7135 FILE NUMBER: 2108-1 177 DECEDENT NAME: JONES ROSE SELVEY DATE OF PAYMENT: 02/19/2009 POSTMARK DATE: 02/19/2009 couNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 9/2008 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 555,000.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTORNEY CHECK# 8827 SEAL INITIALS: AJW REV-1162 EX111-96) 555,000.00 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER LAST WILL AND TESTAMENT of Rose Selvey Jones 1, Rose Selvey Jones of Cumberland County, Pennsylvania, declare this to be my Will and revoke all other Wills. ARTICLE I 1 authorize my Personal Representative to pay such sums as my Personal Representative deems proper for my cremation, including the disposition of the ashes regardless of any limitation fixed by statute or rule of court and without order of court. ARTICLE II (A) My Personal Representative shall make the following distributions to the following persons who survive me: I order and direct that all stocks held in my name shall be given to ROBERT C. JONES. I order and direct that the funds held in a money market account at PNC Bank be divided into five (5) equal shares between the following persons: ROBERT C. JONES (grandson), DAVID W. JONES (grandson), DOROTHY E. JONES {daughter in law), GABRIEL~JONES (great-granddaughter) and Gabriel sL~ as yet unborn and unnamed brother or sister with an expected birth date in or around October 2006 (great-grandson orgreat-granddaughter). I order and direct that the diamond ring in DOROTHY E. JONES' possession and insured through USAA be given to ROBERT C. JONES. I order and direct that the Opal Gold Ring be given to Robert's new daughter to be born in or around October 2006 or to THERESA JONES if Robert has a son or the daughter is not born in or around October 2006 as the birthstone will be inconsistent. ARTICLE III I order and direct that the rest of my property not disposed of in Paragraph (A) of Article II be distributed to the following persons who survive me into two (2) co-equal parts which parts, I give, devise and bequeath unto each of my grandchildren, namely, ROBERT C. JONES and DAVID W. JONES if they should survive me for a period of 30 days. If they shall not so survive me, I give the rest of my estate, per stirpes, to my issue who survive me for a period of thirty (30) days. ARTICLE !V The provisions in this Will for the distribution of my estate shall be supplemented by the following: (A) My Personal Representative shall pay all taxes (including inheritance taxes) owed because of my death (including any interest and penalties) out of the residue of my es#ate. My Personal Representative shall create out of the residue a separate fund for the purpose of paying state inheritance taxes in the amount necessary to pay said inheritance taxes. The payment of the taxes shall be made regardless of whether the taxes are owed on property passing under this Will or outside of this Will and regardless of whether the taxes are owed by my estate or by any beneficiary. My Personal Representative shall not be entitled to reimbursement from any beneficiary for the payment of the taxes. z (B) Each beneficiary shall be deemed not to have survived me unless the beneficiary is living on the thirtieth day after the date of my death. (C) Whenever any beneficiary of my estate is under a legal disability or, in the judgment of my Personal Representative, is for any reason unable to apply any distribution to the beneficiary's own best advantage, my Personal Representative may nevertheless make the distribution directly to the beneficiary or to the conservator of the beneficiary's property or to a person with whom the beneficiary resides at the time of the distribution in whatever manner my Personal Representative shall deem best. In the alternative and if the beneficiary is under twenty-one years of age, my Personal Representative may, in the discretion of my Personal Representative, distribute the property to a custodian for the beneficiary under a Uniform Transfer or Gift to Minors Act. The receipt by the beneficiary, conservator, custodian or other person of any distribution so made shall be a complete discharge to my Personal Representative regarding the distribution. ARTICLE V In addition to the existing authority of my Personal Representative, my Personal Representative may: (A) Seil or grant options with respect to any real or personal property in such manner, for such purposes, for such prices, and upon such terms, credits and conditions as may be deemed advisable. (B) Make any division or distribution of my residuary estate in money or in other property or partly in both upon the basis of fair market value and cause any share 3 to be composed of money, property or undivided fractional share in property, different in kind from any other share. (C) Permit any beneficiaries of my estate to use any tangible personal property or real property, without paying any rent, without giving any bond or security and without liability for any loss or damage. My Personal Representative shall not be liable or responsible for any injury to, consumption of or loss of any such property so used. (D) Take charge of any real property as part of the probate administration of my estate for such period as my Personal Representative shall determine; collect any income therefrom; and pay the taxes and expenses thereof, including the cost of keeping such property in adequate condition and repair, in the manner and to the extent that my Personal Representative shall deem advisable. ARTICLE VI (A) I appoint ROBERT C. JONES, as Personal Representative of my estate. If such Personal Representative shall fail to qualify or cease to act as Personal Representative, lappoint the following persons or bank or trust company as alternate or successor Personal Representative to serve in the order specified below, and if the first alternate Personal Representative shall fail to qualify or cease to act as Personal Representative, the second alternate Personal Representative shall serve as Personal Representative. DOROTHY E. JONES -First alternate DAVID W. JONES -Second alternate 4 TO the extent permitted by law, my Personal Representative shall be authorized, in the discretion of my Personal Representative, to have my estate administered without adjudication, order or direction of the court having jurisdiction over my estate. (B) No bond or surety shall be required of any Personal Representative serving hereunder. . ~, ~'~' ,y;~ I, the Tes ator, sign my name to this instrument this ~ day of _L!~_/~'N, ~~~ ~ , and being first duly sworn, do hereby declare to the undersi ned authonty that I sign and execute this instrument as my will and that I sign it willingly (or willingly direct another to sign for me), that I execute it as my free and voluntary act for the purposes expressed in the will, and that I am eighteen years of age or older, of sound mind, and under no cons#raint or undue influence. yy; "Rose Sylvey Jones j We, the witnesses, at the Testator's request, sign our names to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the Testator signs and executes this instrument as the Testator's will and that the Testator signsrt willingly (or willingly directs another to sign for the Testator), and that each of us, in the presence and hearing of the Testator, hereby signs this will as witness to the Testator's signing, and that to the best of our knowledge the Testator is eighteen years of age or older, Qf sound mind, and under no constraint or undue influence. of ~CCy~tal"1l CS~~Gtr••y ~77 W' ess of ~~~ ~ ~~ s Commonwealth of Pennsylvania Cumberland County We, the Testator 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 Testator signed and executed the instrument as the Testator's will and that the Testator had signed willingly (or willingly directed another to sign for the Testator), and that the Testator executed it as the Testator's free and voluntary act for the purposes expressed in the will, and that each of the witnesses, in the presence and hearing of the Testator, and at the request of the Testator, signed the will as witness and that to the best of the witnesses' knowledge the Testator was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influehce. -, ~> ,, Rose S~Ivey Jones ,. `~ WI 5S ..-- j Witnes~ .',,~ Witness ,,~ , ~ Subscribed, sworn to and acknowledged before me by, Rose Stl+vey Jones, the Testator, and subscribed and swornt,Qq before me by ~(}~c~ , and ~Pnn~ gee ~~`ke~ncx ,witnesses, thi day of ~ c~- ~ ;ti1Q.~a.• .(Seal) (~PP~,r ,~ ~ ~ ~,~ ~} ' f~ til'-, hl tr t ~~ h s ;f ~ , r:x~ ' ~' __ ___ __. -"` C-` (Signed) L =~A.~~. (Official capaci of officer) 6 Newe!lRubbermaid Brands That Matter ~omputershare Computershare 0 0 2 016 PO Box 43078 . Providence, RI 02940-3078 Within the US, Canada 6 Puerto Rico 877 233 3006 Outside the US, Canada 6 Puerto Rico 312 360 5217 www.computershare.com~nvestor ROSE JONES 314 VIRGINIA ROAD MECHANICSBURG PA 17050 For a change of address please call the above number or visit us at www.computershare.comlinvestor Holder Account Number Irrrlllrnlll~~rrl~l~llnurllrllr~~~ll~rlrr~l~~rll~lr~l~ll~~l 00000271527 I N D Record Date 29 Aug 2008 Check Number 0034340182 SSNITIN Certified Yes IX)I(:ti0005.r)OM.NWLR.22311N IR209/IIO:OINI)0201Ni6 ' Newell Rubbermaid Inc. -Dividend Payment Simplify your life! Manage your accounts online quickly and conveniently with Computershare's Investor Centre. Register today at www.computershare.com/US/register. Dividend Confirmation P t D t I Participating Dividend Gross I Cl D i ti Deduction Deduction Net aymen a e ass escr p on ShareslUnits Rate Dividend ($) Amount ($) Type Dividend ($) 15 Sep 2008 COMMON 22 $0.21000 4.62 0.00 NIA 4.62 Year-To•Date Paid 13.86 0.00 13.88 1 UDC NW L R '+' OOtCD70002 OOHXDA PLEASECASWDEPOSITTHISCHECNPRCMPTLY Historical prices for NWL (Newell Rubbermaid Inc.) - Google Finance Page 1 012 Web Images Maps News ShopF;ing Gmail more . Portfolios ~ Sign In _..~ Get quotes ~ Stock screener Historical prices « Back to overview Newell Rubbermaid Inc.(NYSE:NWL) - Daily ~ Weekly - _.. --- Jan 14, 2008 _ Jan 12, 2009 Update ~ Download to spreadsheet Date Open High Low Close Volume 5-Dec-08 12.65 13.27 12.27 13.03 3,344,089 4-Dec-08 12.74 13.27 12.47 12.74 2,091,196 3-Dec-08 12.30 13.03 12.29 12.94 2,960,802 2-Dec-08 12.14 12.65 11.98 12.59 3,098,919 1-Dec-08 13.08 13.16 11.80 11.81 4, 350,877 28-Nov-08 12.27 13.43 12.23 13.36 2,307,353 27-Nov-08 12.30 12.30 12.30 12.30 0 26-Nov-08 11.01 12.34 10.94 12.30 3,326,387 25-Nov-08 11.15 11.16 10.33 10.95 3,874,145 24-Nov-08 10.21 11.22 10.04 10.97 3,169,145 21-Nov-08 10.34 10.34 9.42 10.10 3, 778,183 20-Nov-08 10.69 11.26 10.01 10.08 4,443,772 19-Nov-08 11.58 11.69 10.76 10.81 2, 398, 805 18-Nov-08 11.95 12.05 11.14 11.60 2,637,255 17-Nov-08 11.90 12.32 11.62 11.93 1, 787, 848 14-Nov-08 12.70 12.87 12.01 12.05 3,589,715 13-Nov-08 12.05 12.96 11.27 12.95 3,503,804 12-Nov-08 12.87 12.93 11.98 12.01 2,938,790 11-Nov-08 12.88 13.11 12.58 12.84 3,611,898 10-Nov-08 14.04 14.04 12.72 12.88 2,561,353 7-Nov-08 13.77 13.88 13.37 13.79 1,810,200 6-Nov-08 14.23 14.37 13.52 13.66 2,638,800 5-Nov-08 14.36 14.58 14.05 14.33 3,344,400 4-Nov-08 13.98 14.63 13.82 14.55 3,383,700 3-Nov-08 13.73 13.91 13.52 13.71 2,641,300 Result Page: PrevlOUS 1 3 4 5 6 7 8 9 1011 Next http://finance.google.com/finance/historical?q=NYSE:NWL&start=25&num=25 1 /12/2009 ~~~ lfAD1NA Tl~iB W#Y' December 24, 2008 Jennifer A Mearkle Attorney at Law 414 Bridge St P O .Box E New Cumberland, PA 17070 RE: Rose S Jones SSN: 210-44-7135 DOD: i 1-19-2008 Dear Ms. Mearklc: In response to your request for.Date of Death (DOD) balances for the customer noted above, our records show the following: Certificate of Deposit Account # 31500218880 Established: 09-ZO-2001 ROSE S JONES DOD balance: $ 11,972.71 + 10.17 accrued interest Interest paid 01-01-2008 thru 11-19-2008 $ 432.01 YT'D Account # 31800222233 ROSE S JONES DOD balance: $11,756.95 + 3.93 accrued interest lrrterestpaid 01-01-2008 thru I1-19-2008 $ 463.24 YTD Account # 31600250247 ROSE S JONES DOD balance: $11,420.24 + 2,g8 ~~ interest Interest paid O1-Q1-20{}8 thru 1 I-19-2008 $ 287.39 YTD Account # 31500200635 ROSE S JONES DOD balance: $ 14,388.68 + 6.42 accrued interest Interest paid Ol-O1-2008 thru 11-19-2008 $ 456.83 YTD Established: O l -16-2002 Established; 11-15-2004 Established: 10-13-2000 Page 1 of 2 ~~~~ iVV I I ~ L .` Checking Account Accotmt # 5140032285 Established: 06-01-1960 i 1 ROSE S JONES DOD balance: $ 22,298.62 + 1.78 accrued interest Interest paid 01-01-2008 thru 11-19-2008 $ 26.57 YTD Savings Account . Account # 513017871 S ROSE S JONES DOD balance: $ 126,174.25 + 55.71 accrued interest Interestpaid Ol-o1-2008 tlnu i 1-19-2008 $ 2,099.46 Y'rD Safe Deposit $oz The decede~ maintained safe deposit box C 161ocated at: ~ 32°d Street Branch 1400 Camp Hill Shopping Mall Camp Hill, PA 17011 (717) 761-2099 Established: O 1-01-1980 Please note that this office provides date of death balances for deposit accounts (IItAs, CDs, Checking and Savings). We do not pmeess any i3nandal tra~asacdoas or provide st~ttemeats. you neod assistance with any of these items, please call 1-888-PNC-BAIJK (1-888-762 2265) ar stop by Your local PNC Bank breach office. Sincerely, National Financial Services Center PNC Bank, N.A. 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(0 YaD C ' O O U.0 (6 ('J y ~ ~ " y 4J F- ' cn O O C ~ 6 ~ y O ~ O ~ h0 -O co (n ~ ~, ~ O ~ T ~ O > O ~ N ~ ~ Q cB V ~ ~ ~ ~ OU N - ~ C O 'U C Q N O - a-~ O U ~ U (D ~ ~ O ~ >, U ~ 4-- ~ »- c ~ d ~ O ~ ~ U (~ ~ L ~ (6 In C (n ~ ~ O ~ ~ ~ y ~ ~ ~ ' ~ ~ O U C C C U (6 O ~ N C >, (6 Q ~ N i ~ ~ Cil +-~ ~ -O ~ . ~ ~ C O O_ ~ ~ ~ ~ O t3 >, ~ ~ o +~ c9 -o in }' ~ ui o m ~ ~ ~ O O ~ ~ Q O O O ~ +J . -. ~ ~ C ~ ~ Q U '~ C N ~ ~ ' QJ (9 c 0 +-~ ~ ~ (6 w~- O O (G C C O U C N c s N O (B O C6 C O L +~ (6 O C O N U U {~9 `~' d O ~ ~ o -moo 01 G a o N 7 .~ O i C6 bA c O O C m O N a O L O 'U hD ti U (6 N .C ~, O +~ O O O O 6 (B U O _~ L +: Y C o ~ ~+ (6 t6 ~p > ~ (B N O ~_ (6 a C C O O v m 0 L_ C 0 LOL Ti G 0 co L N O O .Q C c a V O .Y N U ` O r ~ ~° O Q c 0 O (D d O O rl O s U O (0 T C (O O s O UO C C O Q N 0 U C C O V N T 7 V as N a~ w a~ a .~ cn 0 N C U L _~ O O C O U N ~ ~ _~ O f6 +-' U 'i O 7 ~ V (n l~ ++ C H 7 'o Q G C R C~ C m 3 J Y h wo T D 0 E a> Q .~-~ O ti _T U ~_ ui c O .O O LL N U .Q C O E O T O .~ N U Q C O E y .p C d 'C Y V O i tC D _~ U QJ N c O N ~_ O U t W O U a~ O O N a U c N a Q O N N a N. i 'a C O 00 d D N ~ O U L ~ ~ C O fn U Q 3 O ~ (6 boo ~ •~ O ~ Co j ~ ~ ~ ~ ~ O ~ U ~ a~ U Q N -O ~ Y N 3 ~ ~ ~' -O o ~ CO U ~ ~ j ~ ~ (B U U Q N ~ U ~ Y ~ ~ C O -C UD L ~ •' O h0 (p > (6 ~ +~ ~ ~ ~ ~, ~ ~ .U .~ O U a C ti a, E N Y ~ +~ w O O 3 a~ O C .~- ~3 ~ (O ~ C6 O ~ ~ N ~ ~ 'J +~ (n ~ ~ ~ U y ~ Y O ~ ~ ~ :n ~ ~ N ~ U y aj ~ ~ ~ o c (6 ~ CO a-~ ~ ~ V ~ ~ ~ ~ ~ 'L3 ~ Q ~ m ~ tL0 C ~ X ~ N ~ C U ~ o 4J Y ~ O ~ ~ U ~ ~ ~ N ~ O Q" ~ N T •~ U (n O ~- O U ~ j U H ai ca tL0 x O C6 -O ~ ~ ~, U Q i N ~ N O > ~ ~ N ~ U o. ('O ~ > U O cB c C~6 C U ~ ~ (Jj ~ un c V V O C hp N +O+ C O Q C U U N a~ U U C 0 U L QJ C +~ C L U i O ti N F- Delaware Investments A member of Lincoln Financial Group December 11, 2008 Stone LaFaver &Shekletski Attn Gerald Shekletski 414 Bridge St New Cumberland PA 17070 Re: Delaware Tax-Free Pennsylvania Fund A #7-5077571080 Rose S Jones 00295241 780NT-DOD Wkdy Dear Sir or Madam: 2005 Market Street Philadelphia, PA 19103-7094 We aze writing in response to your recent correspondence with our office. We are pleased to provide you with the information requested on the above account. On November 19th, 2008, Rose S Jones owned 3,107.807 shares of the Tax-Free Pennsylvania Fund. This is a mutual fund with a daily fluctuating price per share. The net asset value of the fund on that date was $7.30 per share. Therefore, the value of the account on November 19th, 2008 was $22,686.99. If you have any questions or require assistance please contact our Service Center at 1-800-523-1918. Our representatives are available between 8:00 a.m. and 7:00 p.m. Eastern Time, Monday through Friday. Sincerely, ~~~~ Todd M. Sicks Unit Manager ww~w.dclaw~arcinvestments.com Delaware Investments is the marketing name for Delaware Management Holdings, Inc. and its subsidiaries. P.O. Box 219151 Kansas City MO 64121-9151 December 10, 2008 Stone LaFaver &Shekletski Attorneys at Law Attn: Gerald J. Shekletski 414 Bridge Street Post Office Box E New Cumberland, PA 17070 Fund: Multiple Funds Class-S Account#: XXXXXXX4698 Registration: Rose S. Jones Dorothy E. Jones POA Dear Mr. Shekletski: DWS INVESTMENTS Deutsche Bank Group I am writing in response to your letter regarding the above-referenced DWS fund account. Please extend our condolences to the family of Rose S. Jones. Registration of Account The registration of this mutual fund account is as follow: Rose S. Jones Dorothy E. Jones, POA Balance of Account Below I have provided the number of shares, share prices, and dollar values of the funds in this account as of November 19, 2008. Fund Name Class-S Number of Shares Share Price Dollar Value DWS Mana ed Munici al Bond Fund 4,246.462 $8.25 $35 033 31 DWS Short Duration Plus Fund 4,840.099 $8.76 , . $42 399 27 DWS Growth & Income Fund 2,866.415 $9.43 , . $27,030.29 The accrued dividend on the DWS Managed Municipal Bond Fund Class-S as of November 19, 2008 was $107.24. The DWS Short Duration Plus Fund Class-S and the DWS Growth & Income Fund Class-S do not accrue dividends daily. Documentation Required To reregister the account into an Estate account, please submit the following documentation: • A signature guaranteed Change of Account Ownership form signed in capacity by Robert C. Jones as the named Executor. • A certified copy of the Short Certificate for the Estate of Rose S. Jones. To be properly certified, the copy must bear an original seal or stamp by the court of the appropriate jurisdiction and be dated within 60 days of your request. We received this document and will retain it on file. The document is valid until January 25, 2009. What is a Signature Guarantee? A signature guarantee is designed to protect an account from unauthorized activity and can be obtained at a bank or brokerage firm. Please note that a notary public is not an acceptable guarantor. Mailing Instructions Please submit the appropriate documentation in the enclosed postage paid envelope. Contact Us If you have any questions, please contact one of our Shareholder Services representatives at (800) 728-3337 (for Class S). A representative will gladly assist you Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. Central Time. Sincerely, -b- Megan Lair Mutual Fund Representative 20876453 Enclosure(s): Change of Account Ownership form Postage Paid Envelope \~ . ~~~ Vanguazd~ December 9, 2008 GERALD J SHEKLETSKI STONE LAFAVER ET AL PO BOX E NEW CUMBERLAND PA 17070 Estate of Rose S. Jones Dear Mr. Shekletski: Po. aox 2soo Valley Forge, PA 19482-2600 www.vanguard.com We are responding to the letter we received notifying us of the death of Rose S. Jones, and requesting a valuation of her Vanguard account on November 19, 2008. First, please convey our condolences to the family for their loss. The information requested is included on the enclosed account value report. If you have additional questions about a transfer or a transition of assets, please call us at 888-237-9045. Specialists are available on business days from 8 a.m. to 8 p.m., Eastern time. Sincerely, ~d ~~s- Andrea Walker Registered Representative Enclosure(s): **Rose S. Jones -- Account Value Report 51112770 Rose S. Jones 314 Virginia Rd Mechanicsburg, PA 17050-3067 Page > 1 of 1 Vanguazd~ 7y ?~ Voyager Services; 800-284-7245 Total report value: $158,179.46 (Total report value includes any accrued dividends ) wh5r.'r.~~.4j3k.~' ap,~ ~,4'i rb.~irty~~~~~`~~'-~o ~a's'~.~~~ ttt~:?'~ ~3"~~,""+'~',~...~_~' ,'y''~.Y.'F~k.n,Ai~'x_`'k~~~~_ ~f.~r ' f:.~ ._ aye -t ?." Name Fund & Account Date Price Per *.,; , ,. d:.~. Accrued Number Opened Sfiares Share Value' pividends Inter-Term Tax-Exempt Inv 0042-09885612805 04/04/1994 2,374.631 $12.76 $30,300.29 $64.51 PATax-Exempt Money Mkt 0063-09885612805 03/22/193 109,746.730' $1:00 $109,746.73 $80.89 PA LTTax-Exempt Investor 0077-09885612805 03/22!1993 1,730.457 $10.37 $17,944.84 $42.20 Totals ;157,991.86 ';187.60 Doesn't include accrued dividends. 1724109309 12/09/2008 16:00:53 USM Fedeol Savinpr Bank 10750 McDermott Freeway San Antonio, Terar 78288-0544 USAA® EST OF ROSE S JONES C/O GERALD J SHEKLETSKI 414 BRIDGE STREET NEW CUMBERLAND, PA 17070 Reference: Estate of Rose Jones Dear Sir or Madam, April 28, 2009 As you requested, we're providing the balance of Mrs. Jones's account on the date of her death Aooount 'I~pe Account Ending in Interest Accn~ed Balance Savings account b952 524.05 584,b75.32 If you have questions, please call a member service representative at 1-800-531-USAA (87ZZ). Thank you, USAA Federal savings sank BKDATEDEATH 66072.0408 ~ ~ ~~(` LENDER ~6 ~~ ~~ Jewelers Since 1939 / /j I 1 S r ,~ o a ~~~ ~.~. .~,~,~ ~ y ~~ ~~ -~~ ~~~ ~ D ~.~-- l; Co/ar• - ~o /f i C/2~i~r- sT / _ (jL ~~ ~ d ~ ~ d i~ _ / ~~~~~ ~~~ iTix~w 4 ;.~ ,r ~~ ~. w 144'Strawberry Square * Harrisbur , PA 17101 * Phone 717 232-8425 9 027397466 UPRR1 Letter of Transmittal for Unclaimed Property: AVAYA, INC. • UNCASNED CHECK FILE Sierra Merger Corporation C/O UPRR LLC P O Box 2262 New York, NY 10116 197299 027397466 JONES---•ROSES0000 ROSE S JONES 314 VIRGINIA RD MECHANICSBURG, PA 17050-3067 AMOUNT OWED TO YOU: 5670.0000 1 For account verHlcatfon purposes, please provide the last four digits of your Social Security number or Tax ID number below. (K the payee is deceased, provide tfie last four digits of the decedertYs SSS) Soc. Sec.# or Tax I D#: XXX-XX- 71 3 5 Your eMck wJaU i!e nlsautd b the Hama sttbrtm uNesa otlntrwlse lnstrueted bNow. (CompM» otNy when ehanplnp tlee account rpisvaLion.) Name: Estate of Rose S . Jones Address:. Gerald J. Shekle- ~tnnc T.aFacscr R ~hckl etski 414 Bridge Street City/State2ip: Tict~ C tmhPrlanr3~ PA 17070 Dear Shareholder: Cm October 26, 2007, Avaya, Inc. ("Avaya") merged into Sierra Merger Corporation in an alt cash transaction. Aa a result of the merger, you were entitled to receive 517.50 in exchange for each of your Avaya shares. Following the merger a check in the amount shown above was issued and mailed to you by the paying agent. :lccording to the shareholder records, this check has not been cashed. i."nclaimed Property Recovery & Reporting LLC ("i3PRR") has been retained to locate shareholders who have not yet cashed their check(s) and to asist them in claiming their property. You may receive your property through this voluntary program, by completing this Letter of Transmittal and rcturtting it to UPRR in the enclosed envelope. Upon receipt of your properly executed Letter of Transmittal, UPRR is auWorized to send you a check for the amount shown above, less a processing fee of 15%. Frequently Asked Questions 1. Do I need to e[aun my propsrtyl 1'ou may claim your property through this voluntary program by properly completing the enclosed Letter of Transmittal and retrunirrg it to UPRR in the enclosed envelope. Alternatively, you may contact the Paying Agent directly at 1-8?7-296-37 ] 2. If you fail to clsin yoar property, w6et6er directly or throu~r this program, the property due you will eventually be remitted to the appropriate state as required under the applicable unclaimed properly laws. :. Do I have to send is Nee origisd chtckl `1u By completing this form with applicable documentation (ifnecessary), your checks} will be presumed lost and will be replaced as part of the proUr •am. +. 1 edidn't approve ojdlrt merge, why »rre Hey shares erchaegedl :~ca~ a mashed utto Siena Merger Corporation. After shareholder and subsequent regulatory approval you were entitled to receive $1 ? .50 cash for each share ofAvaya swck rh tr . ~ ~~~ hnl~i Thrre was nn st~xk rl/rtinn ?t pare of she .^.!~:ae+r Mrsideration. t. Rrgreirenunts jar Special Proeessiaa: RayuvetnenLi for Special Situatioru: 1-Transmittal Forms executed by trt>steea, executors, administrators, guardians, o~cen oCcorporations, or others acting in a fiduciary capa,:ir • who are nut identified as such m the ownership registration must be accompanied by proper evidence of the signets authority to act 2- If the new check in to be i.uaJ iu a patson(s} other than the registered owtter(sj, a transfer of ownership moat be executed. We would be happy to answer atry additional questions cancemirtg rtgutr~uun changes for decedent, custoJial, ur trustee accounts. Please tail us at the number below. If you have any questions, please call 1-80A-869-7145 You must enter your Tax ID # (1) and sign below (2). AUTHORIZATION have a legal claim to these funds and wish to prevent such funds from being reported as Unclaimed Property. I irrevocably appoint UPRR as my agent with respect to this transaction I agree that a processing fee of 15% ~s to be paid to UPRR to defray the cost of processing. Estate o ,: -.~-®---- -, 2 r ~~•-•~-z--~ =-'----------___ rcjones@ethical Rose S. Jones -:~ ~! G-' ~Qg_2g4-j 232 engineering.com Signature of aronet Signature of Co-own Telephone Number E-mail address 45UU F'rrdrricksbuR; Road San Antonio,'1'esas?S2S3 LISAA® STONE I_AFAVER & SHEKI_ETSKI ATTN: MR. GERALD J. SHEKI_ETSKI 414 BRIDGE STREET P.O. BOX E NEW CUMBERLAND, PA 17070 Dear Mr. Shekletski: April 27, 2009 LISAA is committed to pnformation for thesaccount of the lat eRosesS Jonesuested, I am providing the following Account Registration: TOD ROBERT C JONES iJSAA #: 962 54 82 Fund name: Tax Exempt Intermediate-Term Fund CIJSIP #: 903289-20-5 Account # ending in: 7224 The account value on November 19, 2008 was: Share Accrued Account Shares Price Dividends Value 8,489.421 $11.79 $236.30 $100,326.57 If you have questions, please call a i1SAA member service representative at 1-800-531-LISAA (8722). Thank you, tSAA Shareholder Account Services SRI26-0108 062 54 R2.4Fi731-45065-UM02350-SAS.SAS45 .l~u~ g1~.0o -'t ~l 5~~.. o~ 3c5o . 1'~~D .~. ~ ~~ ~ ~