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HomeMy WebLinkAbout06-24-09 (3)• ~ 15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 D ~ I ~ (~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT V ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth .208-24-4953 11/03/2008 09/22/1929 Decedent's Last Name Suffix Decedent's First Name MI Fahnestock ' Janet E (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 _;:;~`~ 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ;. 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number ................................. . Denise R Fahnestock ___ ___ .................................... .................................. Firm Name (If Applicable) __ __. _ _ _ _ _ __ ___ OF WILLS USE~ILY REGISTER C a~ ~ ~ -, =~ ~~, First line of address /~ C: r "~3- p C~ C., ` ` 2630 Walnut Bottom Rd '~~ r ~ ,. ~, '~ ..... _ _ , r,~ .F' ~ .C" ~_a ~ !';7 Second line of address _.., >~ ~ _ ~ •~~ . City or Post Office State .....ZIP Code D _ LED ~ _ _,_,~ ., , ..~ .. .. •~ Carlisled _ pa 17015 -v-~, tn~,., ~_` Correspondent's a-mail address: Side 1 15056051058 15056051058 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. SIGNAT OF ERSON 14ESP SIBLE FO ~~ff DATE 1 r REV-1500 EX Decedent's Name: Janet RECAPITULATION ~_..~..~~_.~.,~.... 15056052059 E Fahnestock Decedent's Social Security Number ............................................... . ___ 208-24-4953 1. Real estate (Schedule A) ............................................. 1. __ _. 0.00 2. Stocks and Bonds (Schedule B) ....................................... 2. ' 280,191.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 ', 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. ' 0.00 ', _. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. _ __ 93,386.00 ___ __ ............................ 6. Jointly Owned Property (Schedule F) _: ::'= Separate Billing Requested ....... 6. '; 87,500.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <'`';: Separate Billing Requested........ 7. 94,323.00 8. Total Gross Assets (total Lines 1-7) .................................... 8. 555,400.00 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 7,168.00 '. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 604.00 11. Total Deductions (total Lines 9 & 10) ................................... 11.: 7,772.00 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. ', 547,628.00 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. 547,628.00 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 .0_ 15. __ 16. Amount of Line 14 taxable '; at lineal rate x .0 45 547,628.00 '' 16. ' 24,643.00 17. Amount of Line 14 taxable . at sibling rate X .12 17. __ 18. Amount of Line 14 taxable _ at collateral rate X .15 __ _ _ __ 18. 19. TAX DUE ......................................................... 19. 24,643.00', 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: N.umber_ DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER Janet E Fahnestock ___ __ _ 208-24-4953 STREET ADDRESS CITY T STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 24,643.00 2. Credits/Payments ' A. Spousal Poverty Credit B. Prior Payments 23,500.00 C. Discount 1,175.00 Total Credits (A + B + C) (2) 24,675.00 3. InterestlPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 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. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 32.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 32.00 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? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 ^ 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)j. 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 exempt 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)j. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. RSV-15u2 EX+ 'i' -:~8} ,. ~ Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Janet E Fahnestock All 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 exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F, If more space is needed, insert additional sheets of the same size. REV 1503 EX+ (6-98) SCHEDt~LE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX REtURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Janet E Fahnestock All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV 1504 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDI~ILE C CLOSELY HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Janet E Fahnestock Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. (If more space is needed, insert additional sheets of the same size) REV 1507 EX+ (6-98) ' SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Janet E Fahnestock All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDt~LE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY -_ ESTATE OF FILE NUMBER Janet E Fahnestock Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same site) REV-1509 EX+ (6-98) COMMON ~'.'EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDI~LE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Janet E Fahnestock If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A• Dennis R Fahnestock 168482515 2630 Walnut Bottom Rd. son Carlisle, Pa 17013 B. c. I I _ __ JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITU110N AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET "k OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST t • A• 2630 Walnut Bottom Rd., Carlisle Pa Real Estate 175,000.00 50' 87,500.00 TOTAL (Also enter on line 6, Recapitulation) I S 87,500.00 (If more space is needed, insert additional sheets of the same size) REV 1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDt~ILE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Janet E Fahnestock 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. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1• IRA -Fidelity -Acct 26K-836478 4,755.00 100 4,755.00 2 Annuitiy -Policy 00157394 Washington Natl 8,561.00 100 8,561.00 3 Annuity -Policy 00157168 Washington Natl 81,007.00 100 81,007.00 r TOTAL (Also enter on line 7 Recapitulation) S I 94,323.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) SCI~IEDIJLE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Janet E Fahnestock Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Ewing Brothers Funeral Home 401.00 2' Cumberland Valley Mem. Gardens 2,377.00 3 Wayne Noss Flowers 130.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,000.00 claimant Dennis R Fahnestock Street Address 2630 Walnut Bottom Rd. city Carlisle state pa .zip 17015 Relationship of Claimant to Decedent SOn 4. Probate Fees 910.00 5. Accountant's Fees 350.00 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation} $ 7,168.00 =- (If more space is needed, insert additional sheets of the same size) REV-1512 EX7 ~2-08j ~ .~- pennsylvania SCHEDULE I [)EPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 E~ - ; ~~ Y.._~ ~§sylvania SCHEDULE ~ bE:PAi;i!'["N'T OF REVENUE ~. ,-E TAX RETURN BENEFICIARIES f DECEDENT ESTATE OF FILE NUMBER Janet E Fahnestock RELATIONSHIP TO DECEDENT AMOUNT OR SHARE _ NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I Tr~;tti~~L DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 2116 (a) (1.2).] 1. Dennis R Fahnestock, 2630 Walnut Bottom Rd, Carlisle, Pa 17015 son 20% '' 2 Lynn I Fahnestock, 245 Smith Rd., Shipp, Pa 17257 daughter 20% 3 Kathy A Beam, 303 CountryClub Rd., Carlisle, pa 17013 daughter 20.% 4 Joel E Fahnestock , 629 Bloserville Rd., Newville, Pa 17241 son 20% 5 Judy K Klingensmith, 4910 Beech Ct, Schnecksville, Pa 18078 'daughter 20% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. ~HAP,ITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $: If more space is needed, insert additional sheets of the same size. PAYER'S name, street address, city, state, and ZIP code AF/d~e/l NATIONAL FINANCIAL SERVICES LLC ~ N Y I t f M t N f AGENT FOR FIDELITY MGT TRUST COMPANY 200 LIBERTY ST. 5TH FLR. NEW YORK, NY 10281 RECIPIENT'S Name and Address 0689808 01 AT 0.348 ""AUTO T6 00620 18078-28001084 736078 001 001 ~111'IIII~II'111'1~1 "~1'IIIIII~t'I~I'/11 "111/II'I"IIIIIII'~ ESTATE OF JANET E FAHNESTOCK JUDY K KLINGENSMITH 4910 BEECH CT SCHNECKSVILLE PA 18078-2900 ORIGINAL DEPOSITOR: JANET E FAHNESTOCK Customer service phone number 800-544-6666 PAYER'S Federal ID # RECIPIENT'S ID # 04-3523567 80-6060078 FORM 1099-R 1 Gross distribution 2a Taxable amount OMB No. 1545-0119 zoos $ 30.57 $ 30.57 Form 1099-R: b axable amcwrtt x et>3tl Distributions m Pensions Fr Trot detemtined disMbution , o 3 I ~, i I o t 4 d Annuities, (Included in box 2a) ax ara ttc ntt e tr~held Retirement or Profit-Sharing $ $ Plans, IRAs, 5 Employee contributions/ designated-Roth contrib. 6 Net unrealized appreciation in empbyer'~ securities Insurance Contracts, @tC. or insurance. premiums This information is being furnished to the Intemal $ $ Revenue Service. 7 Distribution. code(s) ~ ~ 8 Other COPY C SIMPLE 4 x $ °i° For 9a Your rcentage of ~ 9b Total employee contributions Recipient's stribution total Records °i° $ 10 State tax withheld ~ 11 State/Payer's state numbers 12 State distribution $ PA-92989574 $ Account number 13 Locai tax withheld 14 Name of locality 15 Locai disMbution 145-972436 $ $ Department of the Treasury -Intemal Revenue Service i V•2i1-2'179 '':d6i~ trcJN-iiO:FE i s-+e~REP CEO.?;,RS -Z t2d30d;2 '-64:i = J;5/J'3 ~-9J~ YVOLFE S SH'r:ARER AFPRkiSAL SE.R~rICES 33 Sauifi Pitt Street, CariiNe, Pernsyivania t7C i 3 = AF{N ~S TGCii F~;n Ab. 09-OC~~ ~***'*'"'* INVOICE *'""'*'y*" ±.e N4mber: C~-004 January 9, 2ik)rJ =state of Jarx~t E. Fahnestock ;;,o Cennis R. F~rhneetCCk 26;x; Wa!nut if3ottom Road G.arf;sle, Pennsylvar,ie 17U t 5 [iicrrower : nia Invoice #~ : Gig-004 Order Date- ~ 01?09r1o':,a =iefere~s.;elCase ~ : FAHNESTQCK 26.30'/va:nut 6a*Wm Road CariiNe, °A 9 7615 Apprhisaf Repar. Icn`~.rvica Total Moto ~~ T~ QQpO$it i30pOSlt Arrwunt L~ue ~ 35J.C0 ~; 35;-.CJ S Ct.QL' ~~ (, vl ~ 35t~.00 ten^nb: To oe paid at t~rne of pra~crty Infection cr upen receipt oC they 57pra~S2i. I ~ I ' F'leare Make Check Payabit; Ta: 'vv(?l.FE 8 SHEARER APPRaiSA~. SERVICES I 3:3 South Pitt Street Ca~lisis, PA 17U13 Fetl. `.D ~: 23-2385405 Tha~K you' Larry 1rV. Slusser, Gartii•:ed Rosic:entia! .~cp~a:ser I RL-000:30-L PA i i ~~ ~`f i I~ EI ;~ ~~ ~,y-ze-2A~i 1.38~M FRGS-'~~LFE i S-:~aER REAL':RS •T':t24304i2 *-9A@ ~ ~~2 :-EfOil VVOLFE ~ 3HEIlRER APPRAISAL SERY~CES ' 33 South Pitt Street. Carlisle. Pennsy,vani~ 178".3 FAHNrSTOCK ', t APPRAisAI of 3VRIMARY APPRAISAL RE?ORT LOCATED AT: 2630 Wa~n~~t Bctitcm Road Cart~sle. PA t7095 FOR: ~, ;Cl;ant Oennis R. Fahneslock 2830 ,~Yainut Sodom Rosd Carl;ste, PA ;701 BORROWER: i rua ~ I l ~~ ~1 ~' AS OF: 'I tiovember 3, 2008 , }~ i ~ BY: {{i I L8srry Vv. SI~t3er, C~ertifiod Residential Appfsi~er K_-UOOBG2-L PA I ~'~-i:i°3~a ; 33~N =4:v't~C~=E i SreaRER REA~'ORS +i' i 24374.2 VIOL=E 8 SHEARER APPRAi9AL SERVICES •;.? South P!td Street. Garlistd, P~anns)rtvarn;a :7Q'13 "-3~: ~ ]73 ~-87ii FAHNc87OCK ~~~c tile. U9-004 .,ar;u~ary 9: 2U09 i ~Uani Dfmla ~. Fahnestock 2~3U Watnuc t3otton Rcac CaN;g~e. PA 17J15 ri!e'vumbe~r c,~•OC~ -n acc~~reance with your request, 1 gave appraised the reel propsrty~ at: 2630 Walnut QotLv~ Rood Carlisle, PA ', 7Q15 Tt,e purpose of his appraisal ~s to develop sn opinion cf the defined valor 01 the sub~trct proper•,y, as i.^~oroved. The property r+gh;s appraa~d are the fee simple interest in the sire and improvBreMs. In my opinion, tho market va.uo of the property as of November 3.2oot's ~ s' S1 ~S,OC~0 One HuMroa Seventy-Five Tha.~anc t)otiers i~na attached report contains the dESCription, ana:ys~s and supportive data for the conclusions. final up:r.,on o= value, descriptive pho!ographs, assignment cunCitions and appropnale csrti~icationa. Sincr,.rely yours r i..ssrry ~I Slusser. Certifec! 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The Private Party Value assumes the vehicle is sold F N1 I'1_ I+~"I .AK "AS is" and carries no warranty (other than the continuing factory warranty). Compare Used vs. New The final sale price may vary depending on the vehicle's actual condition and This value may also be used to derive Fair Market nditions t l k . co mar e loca Value for insurance and vehicle donation purposes. Under 85,000 ~ Check vehicle Title History Both view and used Vehicle Condition Ratings Sedan Excellent ;3,500 To View List, Click v!E'~ti 11H~Ji~IER'.~iICtE Select rear... ~ .. ii --~_t_1_ _----/T~T1Tl/TT.....7!"r....../D.«..:,"..vo.,,.,.+i~nn~ nn~nA Q4rafi,te dn~4 ~1iVAtP. ~7~~ 171/1)(1 6107596099 EPEECH4~10RK.S PAGE 01 Fax Transmittal __... 49to beech Court Scix~ecksvrlle, PA 18078 :: Lu Ann Siegfried t; :. wre~ner's Tax & Accounting Set'vic~ 1 ~ . 71 ?-243-83 l4 i= : ~ 717243-a2b69 c:.,: 1;1o-oy NAe~ a 3: ~~: Lu Atin- Fr~m~ Judy Klinper-sntRh E-msi1: j.kling~nsmith~a att.net Tai: (610) 949-9913 Fex: (610) 799-f~099 Sul~sct: Estate of Janet ~. Fahn~stack Asper our phone conva~sataon this morning, following arc the amounts of the Washington Nations! insuranuce Company Annuities as of the date of Janet k'ahnastvck~ s death (11-3-08~. Account Number: 00157394 - S8,560.85 Account Number: OOXS?lb8 - ~$1, 007.06 Also. following is tb~e spread sheet faxed by Washington National for Aecaum #00157168. Ples~se note that there is rnv Washingto~a lvatianal title listed on that spread sheet. Sk~ould you require arty other information, please feel freo to use my email yr fax number as well as phone number. Thank you for your assistance. Judy Kling~e~tsmith Number of pages (including this cover page}: 2 tf you !lave say difficulties with this trrmsmiasion, please Dell (61019t1~I-9~ 13 $ ~3 Sc~4- ~Fl~e©~~ 2008 Ferro 5498 IRA Contribution Information INVI ~TM~NT! ~' IdA~riuNAL FINANCIAL SERVICES 1_LC • ~ s •- kyent. for Fidelity Mar~at?arneni Trust Company 145-972436 80-6080078 1 of 2 ?OrJ ~.Ii~cRi'r ST, 5TH FLR. - Nk'twf YDRK siY 20281 ~~ ~~ 1•e:1er•a~ ID slumber: U4-3523567 ~~ Envelope 702021.065 ESTATE OF JANET E FAHNESTOCK •.IULiY i; KLINGE~iSMITIi ~' 4a10 BEECH Ci• Jtr iiNECK SVILLE PA 18078-2900 Customer Service: 800-544-6666 Visit Us Online: Fideli.tv.eom .Form 5498 ZOU8 IRA Contribution InfurmaiioR E3MB No. 1545-0747 11tis info:ma:iou is being furnished to the lriterual Revenue Service. Copy H for 1'articipsut 1. IRA C.ontribucions 2 Reliever 3. Roth Conversion 4. Flechsrscterized 5. Fair Wlarket 7. IRA 8. SEP 9. SIMPLE 10. Roth IRA (o:nc~r thus Contributiorw Amount Contributions Vehte of dboount i'ype Contribuitiorrs Conributions Contributions amounts in boxes 2, : , 4, and 8-iO) C+.Oil 0.00 0.00 0.00 4,874.02 IRA' 0.00 0.00 0.00 Original Depositor: JANET E FAHNESTOCK 11. Required Minimum Distribution for2009 - No It is an IRS : syuirer--ent to report Beneficiary Distribution Accounts (RDAs) as IRAs, Roth IRAs, or SIMPLES as applicable. Please see the IAA Portfolio section in this statement to further identify your account. _~ IRA Portfolio as of December 31, BU08 (Not reported to IRS) 4ccouM 'typo Security CtJSp (~uarttity Price 1Aarkat Vslta •~ IRA-BDA~ 145-972436 Original Depositor: JANET E FAHNESTOCK ..^.:~Sla DE131T DALANC:E -?0.5?rJ0 1.000 F1DEL.ITY ASSET MANAGER 50% 316069103 452.4530 10.840 Fair Market Value of Your IRA Portfolio as of 12/31/2008 Fair Market Value of Your IRA Portfolio as of 12/31/2007 'Required Minimum Distributions from Be+netkiary Distribution Accounts (QDAs) must be calculated in accordance with different rules tiwn are applkable to 1RAs generally. -30.57 4,904.59 4,874.02 0.00 IR~~- Beneficiary Summary Statement as of December 31, 2008 (clot reported to IRS) Primary or Share Dates of Relationship Lagal Neir Account Cw~tingatt Mme Perosr>< BMh/Tnat Option ,~~. IRA-RDA 145-972436 Original Depositor: JANET E FAHNESTOCK No beneficiary information on record ~ ' • N O 0 N W cn Oro O A O A 8 7 . .~ ~V -C ~~~ - , . 0 :r 3 ~ , 4 ' m ~ ~ j ,J o.~ ~ ~ - ~ n :,. ~ ~ < ~. ~ o , ~. /~ ~ ~ _ ° ~ m m m °m `} w~ 4~-. ~ . r ~ ,~ ` o.~~ o ~ ~. ~~.. ~ m m~ ~ ~ o ~~ N crr ~' o W 'p ~ frl .. C3:; Z ~ .:" . ~ O O ~~ ~ 3 _in to ~~ W O O V ti v~ ~, ~: ~ m ~. 4 4 4 ;~ us . ~~i" '+ ~ /~ M~M w W ~ i ~ 4 g cfl A W ~I N W ~ ~ ~ ~ e. ~~ ~ ~ W ~~ A N N l ~ .. ~ ~. ,V -+ - ov ~ ~ ~ s s v ~ oo o ia o v S o N N o~ ~» v cr, ~ (~ ~ . cJ 0 . O Q $. ~ o o © ` a V co (D (fl N N -~ 3>3~ b~ H O N O ~ N ._.. -i V C~71 N W ~ ~ t0w tJi J ~ ~~ V/ ~ -+ V = 1 c .O O -+ G -+ y ~ A J Cd .OP N ~ O ~` Z L> 11 t CT1 W <fl 7. O ,,~ J ~ ~~~c~ ' ~ a ornv ~ Q- 7 N t 0 ~ ~ b ~ • ~ ~ W O ~ (!1 ~ O c~ (J1 O N , ~ ~ W ~ cD N ~ . J ( p J O ~ N tVD ~ ~ ~ ~ J ~ V ~ N :. ,,..~ ~ ~ ~ V Wi {p 7 7Y A U C ~ ~ N ~ ~~~. ~ ~f C 11 7'I C Q ~. .,c~ ;• 4 it i ~; ~_ C r ~_ ~_ ~~~ c m~ yy~ ;~ ~a\ H' ~_ n N 3 O l~D 3 m ~ ~~ 0 3 00 .~ o ~ `m 'p ~' 0 ~' W O Np O OD Total B ankin S ta.tement .PNC B PNC: Bank For the period 10/2S/2008 to 11 /21 /ZOO$ Primary account number: 51-4043-8576 Page 1 of 2 Number of enclosures: 0 JANET E FAHNESTOCK 2630 WALNUT BOTTOM RD CARLISLE PA 17015-9329 For 24-hour banking, and transaction or interest rate information, sign on to 'a PNC Bank Online Banking at pnc.com. For customer service call 1-888-PNC-BANK .between the hours of 6 AM and Midnight ET. Para servicio en espaffol, 1-866-HOLA-PNC Moviny~ Please contact us at 1-888-PNC-BANK ® Write to: Customer Service PO Box 609 :Pitt~bu~Ii_RA.1.5~3Q-9738 _ __~____. __ .. . ._ ~ Visit us at pnc.com TDO terminal: 1-800-531-1648 For hearing impaired client-s only R`i~il~'~~~il~ O~~ier~ir Bsnk Deposit Aaoounts Description Account Number Deposit Balance Int~:i•cst Checking 51-4043-3576 .00 Pcr•Crn•~nance Money A4ar•ket 50-4:1$5-1209 •00 Crr•t.if ~:atc(s) C)f Dep~~sit Total ~~f 1 50 `~~-_ .. Total Deposits 5Q,125.241;/ Important n~fonnation on PI)IC Deposit Insurance Coverage: 1'he FDIC announced a temporary deposit insurance coverage increase from $100,000 to $250,000, per depositor, through 12/31/09. Also, any person, charity or non-profit may be named as a beneficiary on a payable on death or living trust account. This is a i~crt~t>a~nenl: 4ha~n~e. To lcara ur<orc~ stop by any branch or ~o to pnc.con>t or www.fdic.kov -- Intewast Checking iAacount Summary Janet E Fahnestock Account number: 51-4043-8576 Balance 'Siummary__._~.,~.___._ . _._. .. _.. _.. .. .._ .. Beginning Deposits and Checks and other Ending balance other additions deductions balance 10,503.84 371 .c)0 11,379.134 .OA Average monthly Charges balance and fees 1U,693.~~i .00 Please see the Actlvtty_Detail ~oction~ for' ~~~ additional information. Interest Summary Annual Percentage Number of days Average collected Interest Paid Yield Earned (APYE) in interest period balance for APYf this period a.aox 27 l i,o39.50 .oo As of 11/21, a total of $1.6.51 in interest wa paid this year. Activity Detail Deposits and Other Additions Date Amount Description 11/03 371.00 Direct .Deposit - Soc ,Sec LTS 'Treasury 3031YYYY5317D There was 1 Deposit or Other Addition totaling $871.00. FnRMOF4a.trlr .~ Bunking Statement For tho period 1 O/2S/2008 to 11 /21 /Z0~8 ~ For 24hour information, sign on to PNC Bank Online Banking JANET E FAHNESTOCK on pnc.com. "' ~ Primary account number: 51-4043-8576 Account number: 51-4p43-$576 -continued ~ Page 2 of 2 .__1~ Other Deductions Oth Deductions totaling Date Amount Description $11,378.84 11f 21 .00 Outstanding Item Glose 11/21 11,379.$4 Drbit Memo Reference No H216691774 Daily Balance D~aitail Date Balance Date Balance Date Balance ltij 25 1o,5os.s4 ~ 11/03 11,s7U.s4 11/21 .cx~ Seniors -don't forget, PNC' Mortgage, LLC offers Reverse Mortgages. Stop by or call your local branch to speak to a Reverse Mortgage Specialist. Borrower must be at least b2 years.of age. All first mortgage products are offered and provided by PNC Mortgage, I.I,C which may arrange loasis with third peaty .providers. PNC Mortgage, LLC may not be available in your area. (c)20~8 PNC; Mortgage, LLC. All lights resen-ed. OVERDRAFT' PROTECTION for your PNC Bank checking account. If you haven't already done so, stop into your local PNC Bank branch today to open and enroll your PNC Bank Select RewazYls Visa Platnnnn Card. What could be better than. the safety and comfort of knowing you're protected`? Performance Monoy Markot Account Summary Janet E Fahnestock Account number: 50-0385-1209 Balance Summary Beginning Deposits and Checks and other Ending balance other additions deductions balance 27,622.14 .00 27,622.14 .00 Average monthly Charges balance and fees 26,6~5.6~ .oc~ Interest Summary Annual Percentage Number of days Average collected Interest Paid Yield Earned {APYE) in interest period balance for APYE this period o.cx~~ 27 27,622.14 .ctc~ Please see the Activity Detail section for additional information. As of 11/21, a total of $348.21 in interest was paid this year. Activity Detail Other Deductions Date Amount Description 11,; 21 .00 Chitst.anding Item Close 11/21 27,G22.14 Dehit Memo Reference No H2166y1772 -~her~~re~ ether D actions totaling Daily Balancs Dstail Date Balance Date Balance 10/2.5 27,62 2.14 11; 21 .U0 Certificates of Dapasit Janet E Fahnestock Investment Description Maturity date Interest Original or number rate renewal value 31500062f38Fi 24 Mnn.th(s) Fixed Rate 04,'22/2009 3.16 % 50,000.00 Current value 50,125.2() Totsl current value 50,125.2() LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. .... Fee for this certificate, $6.0O Certification Number ~/ This is to certify that the information here given i~ correctly copied i-tom an original Certificate of Ueatl~ duly tiled with me as Local Registrar. The origina certificate will be forwarded to the State Vital Records Office for permanent filing. Local Registrar Date Issued -nos.t~.T nev ttnooe COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VRAL RECORDS CERTIFlCATE OF DEATH ~~ (See inetyucdone and examples on roveree) eTATE PLE fNJrAeER { • a t. NMM a Dooodu~ (FIA< ni0do, ar, rdhq L 8a a 8ottol 8wuly Nuobor 1. Dqo d OrMt pmt, dry `1c~.v~~~- E. ~~~eSbC~ F 208 - 24 - 4953 /l' -aZ0(~t~ s. ~yo Itaa err~enq ~rdr t Undr t s. wb a grin T. rd wb « Ia Pba a DoIIt atr 797 tom. trn. o.t. N... w.ow 9/22/1929 Harri , PA NoopBot ®bpawu ^et~ot~arr ^oa OIt«: ^NworgNonb ^nwrwb. Ow~•t•s1+~hr b. Canty d Doob Ie CIy, Bab. Twp. a DoaA ed. FoeBy Nrno p na1 rulrron, ~ Drop rd rwroq 0.1Nro Cubodotl a NlyrQo OtgM No Yot 10. Roo: Ma~lt~ Wean. Baek Whb. ob. G~m)bexland South Middleton Zip Carlisle Regional Medical Center n.b` w ,.a.) yfilte t ~. ooatdub ww d wok d mo a r.. a na qw 12 tws Dobodrl «« a b to ooeodrlt Firaat rao.dM ary aa~p .bap u. tlrlot ebrrr rar,ad, Nowt rt.nbe. is BuMrYq 8oa w d•~•. b» ~n ~•~ KYd d war tOr d Iiaraoo I adur U.B. 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