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Home My WebLink About07-10-09 (2)REV-1500 Ex cos-os> PA Departmentof Revenue OFFICIAL USE ONLY Bureau oflndividualTaxes INHERITANCE TAX RETURN County Code Year File Number PO BOX 280601 Harrisburg, PA 17128-0801 RESIDENT DECEDENT 21 08 1126 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 188 12 9996 10 13 2008 10 22 1923 Decedent's Last Name Suffix Decedent's Frst Name MI Haselhuhn H. Eleanor (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Frst Name MI Spouse's Sociai Security Number FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS C7 2. Supplemental Return [~ 3. Remainder Return (date of death O 4. Limited Estate prior to 12-13-82) L~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Livin Trust (Attach Copy of Will) g 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) C7 9. Litigation Proceeds Received Cl 10. Spousal Povert Credit date of death y ( C] 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 Stephanie Kleinfelter, ESq. Daytime Telephone Number 717 901 7786 Frm Name (If Applicable) Keefer Wood Allen & Rahal, LLP REGISTER OF WILLS USEONLV hJ First line of address n <:.. _ -t~ 635 N. 12th Street Suite 400 ~ , r- ,~ r ~, i__ c Second line of address '~~ ~ =,rn r,-, ; - ~ _ ~\ 1~`,.~ '`~ -j ~. - City or Post Office ' "' t ` _~, State ZIP Code Lemoyne oA~E~tLED -~ ~-" .r-; +~ ~ PA 17043 j~ : ~-~"'' ' r~~ ~ , Correspondent's a-mail address: sklelnfelter~a keeferwOOd.COm 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, correctand complete. Declaration of the preparer otherthan personal representative is based i on a nformation of wh SIG Ei F PERS R ONSIBLE FOR FILING RETURN ich preparer has any kno , wledge. ADDRESS /D See schedule attac SI NATURE OF PREPARE OTHERTH REPRESENTATIVE `' ~: ADORES Stephanie Kle nfelter, Esq. DATE / C O 635 N. 12th Street, Suite 400, Lemo ne, PA 17043 PLEASE USE ORIGINAL FORM ONLY Side 1 I ^ ^^ ^I I ^^ I ^ ^^ ^I I ^^ ~'C' Estate of: H. Eleanor Haselhuhn 188-12-9996 Executors Gary E. French Wachovia Bank Keefer Wood Allen & Rahal, LLP 210 Walnut Street, P.O. Box 11963 100 North Queen Street Harrisburg, PA 17108 Lancaster, PA 17601 ^ ^^ ^01 ^^ Rev-1500 EX Decedent's Name: H. Eleanor Haselhuhn Decedent's Social Security Number 188 12 9996 RECAPITULATION 1. Real estate (Schedule A) .......... ............................ ... 1. 383,000.00 2. Stocks and Bonds (Schedule B) ................................ 2. 4, 350, 963 03 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... .. g, . 0.00 4. Mortgages & Notes Receivable (Schedule D) ........ . .. .............. .. 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... .. 5. 1, 521 258 36 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... . 7. Inter-Vivos Transfers & Miscella ~ 6' , . 1 148 031 55 neous Non-Probate Property (Schedule G) CI Separate Billing Requested , , . .... . 7~ 592, 308.15 8. Total Gross Assets (total Lines 1 7 - ) ................... . ~~~~~~~~~~ ~~ $. 7,995,561.09 9. Funeral Expenses & Administrative Costs (Schedule H) ........ . ~~~~~~~~~~ ~ 9. 260,019.46 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. . 10. 17, 772.71 11. Total Deductions (total Lines 9 & 10) .... ................ . ~~~~~~~~.. .1,. 277,792.17 12. Net Value of Estate (Line 8 minus Line 11) ........................ . 13 Ch i 12 7 717 768 92 . ar table and Governmental Bequests/Sec 9113 Trusts for which , , . an election to tax has not been made (Schedule J) ...... . . ............. ,3. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... . 1a. 7, 717 768 92 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 .00 O, o0 16. Amount of Line 14 taxable 15' 0.00 at lineal rate x .045 7 717 768 92 17. Amount of Line 14 taxable 1s 347 299 60 at sibling rate X .12 O, o0 , . 18. Amount of Line 14 taxable 17 0.00 at collateral rate X .15 6, 00 18~ 0,00 19. TAX DUE .......... .......................................... 1s. 347,299.60 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C~ Side 2 Rev-1500 EX Page 3 Decedent's Complete Addrp~~• ~ ax rayments and Credits: 1. Tax Due (Page 2 Line 19) 2• Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments 321, 500.00 C. Discount 16,920.55 Fle Number 3. Interest/Penalty if applicable Total Credits (A + B + C) D. Interest 0.00 E. Penalty 0.00 4. If Llne 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENTnalty (D + E) Fill In oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (1) 347,299.60 (2) 338 420.55 (3) 0.00 (4) (5) 8,879.05 (sA) 0.00 (se> 8,879.05 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: a. retain the use or income of the property transferred; .. Yes No 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 fog" 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? ........ _ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE ITT( 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. Sect. 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. Sect. 9116(a)(1.1)(ii)j. The statue 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. Sect. 9116(a)(1.2)j. 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 a.5 in 72 P.S. Sect. 9116(1.2) [72 P.S. Sect. 9116(a)(1)]. ( )percent, except as noted shdeflnedt unde~Section 9102tas lan ndividual who hasoatheast onetparent ndcommonl'wrthlthe de edentpwhether b b ooSect. 9116(a)(1.3)J. A sibling Y d or adoption. REV-1502 EX+(6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA INHERITANCETAXRETURN REAL ESTATE RESIDENTDECEDENT ESTATE OF H. Eleanor Haselhuhn FILE NUMBER All real property owned solely oras a tenant in common must be reported affair marketvalue. Fair marketvalue is defined a ~heo$ e1126ch property would be exchanged between a willing buyerand a willing seller, neither being compelled to buy orsell, both having reasonable knowledge of the relevantfacts. Real property which isjointly-owned with right ofsurvivorshipmust bedisclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1 House and Lot Commonly Known As 492 N. 25th Street, Camp Hill, OF DEATH Cumberland County, Pennsylvania 17011 258,000.00 Deed Book 15 - T. Page 431 2 House and Lot Commonly Known As 422 E. Winding Hill Road, Mechanicsburg, Cumberland County, Pennsylvania 17055 125,000.00 Deed Book L 30 Page 758 Appraised Value TOTAL (Also enter on line 1, Recapitulation) 383,000.00 (If more space is needed, insert additional sheets of the same size) REV-1503 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENTDECEDENT ESTATE OF H. Eleanor Haselhuhn FILE NUMBER All property 'ointl - 21 08 1126 SCHEDULE B STOCKS & BONDS ITEM ~ Y owned with right of survivorhsip must be disclosed on Schedule F. JMBER DESCRIPTION VALUE AT DATE 1 54 Shares Anglogold Limted, A limited Liability Company Incorporated Under OF DEATH The Laws Of The Republic Of South Africa 1,057.05 Cusip 035128 20 6 2 50 Shares Breakwater Resources LTD Continued Under Laws Of Canada 5.88 Cusip 106902 30 7 3 500 Common Shares C.W.S. Waveguide Corp. 0.00 Worthless 4 300 Shares Enerserv Products, Inc. Cuisp 292741 10 5 75.00 5 367 Common Shares FirstEnergy Corp. Cuisp 337932 10 7 18,098.60 6 4,368.506 Units Franklin Tax-Free Trust Frankkin Pennsylvania Tax-Free Income Fund - Class I 39,185.50 Cusip 354 723 801 7 506 Common Shares Pioneer Natural Resources Company Cusip 723787 10 7 16,951.00 8 667 Shares Common Shares Pioneer Natural Resources Company Cusip 723787 10 7 22,344.50 Held Book Entry Form 9 25 Shares Public Service Enterprise Group Incorporated Cusip 744573 10 6 680.50 10 25 Shares Public Service Enterprise Group Incorporated Cusip 744573 10 6 680.50 11 1,000 Shares Temp-Stik Corporation Cusip 879704 10 4 0.00 Worthless 12 1,560 Shares The Walt Disney Company Cusip 254687 10 6 39,265.20 Total from continuation Schedule(s) 4,212,619.30 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) 4, 350, 963.03 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 2 21 08 1126 Item Number Descri tion Value at Date 13 $10,000 City Of Philadelphia Bond; of Death PA Gas Works Revenue 11,482.40 Original Issue Date June 15, 1990; Maturity Date May 15, 2020; Interest Rate 7.0% Cusip 717823KQO Accrued Interest 287.23 14 119 Shares Citadel Broadcasting Corporation Book Entry Account 01004635571 IND 46.41 Cusip 172857106 15 3,556.708 Units Dreyfus Premier State Muni Bd Fd PA Series -Class A Account No. 0058-3349909196 51,252.16 16 2737 Shares Sovereign Bancorp, Inc. Book Entry Account No. 125208054219 10,701.67 Cusip 84590510 17 Putnam Investments 4,007 Shares Putnam Tax-Free High Yield-A 42,554.34 Account No. 0040-0233318006 18 590 Shares Prudential Financial, Inc. Book Entry Shares 26,901.05 TOTAL. (Carry forward to main schedule) ..... . 143,225.26 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 3 21 08 1126 Item Number Descri tion Value at Date 19 Securities Held In Smith Barney of Death Reserved Client Financial Management Account No. 724-18041-16 180 20 1,247 Shares DailmerAG Held In Smith Barney Reserved Client Financial Management Account No 44,860.82 . 724-18041-16 180 21 1,000 Shares Covidien LTD Held In Smith Barney Reserved Client Financial Management Account No 46,100.00 . 724-18041-16 180 22 1,000 Shares Tyco Intl Ltd Held In Smith Barney Reserved Client Financial Management Account No 28,230.00 . 724-18041-16 180 23 1,000 Shares Tyco Electronics LTD Held In Smith Barney Reserved Client Financial Management Account No 21,775.00 . 724-18041-16 180 24 5,716 Shares Aetna Inc. New Held In Smith Barney Reserved Client Financial Management Account No 175,481.20 . 724-18041-16 180 25 6,000 Shares America Movil S.A.B. De CV Series L Spons ADR 212,190.00 Held fn Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 26 21,600 Shares American Express Co. Held In Smith Barney Reserved Client Financial Management Account No. 560,736.00 724-18041-16 180 27 4,320 Shares Ameriprise Financial Inc. Held In Smith Barney Reserved Client Financial Management Account No. 103,636.80 724-18041-16 180 28 8,000 Shares Amgen Inc. Held In Smith Barney Reserved Client Financial Management Account No. 414,080.00 724-18041-16 180 29 2,566 Shares Cisco Sys Inc. Held In Smith Barney Reserved Client Financial Management Account No. 47,599.30 724-18041-16 180 TOTAL. (Carry forward to main schedule) ..... . 1,654,689.12 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 4 21 08 1126 Item Number Descri tion Value at Date 30 2,000 Shares Dell Inc. of Deatn Held In Smith Barney Reserved Client Financial Management Account No. 28,770.00 724-18041-16 180 31 450 Shares Expedia Inc. Held In Smith Barney Reserved Client Financial Management Account No. 5,589.00 724-18041-16 180 32 1,000 Shares First Energy Corp. Held In Smith Barney Reserved Client Financial Management Account No. 49,315.00 724-18041-16 180 33 25 Shares General Electric Company Held fn Smith Barney Reserved Client Financial Management Account No. 533.50 724-18041-16 180 34 90 Shares HSN Inc. Held In Smith Barney Reserved Client Financial Management Account No. 816.75 724-18041-16 180 35 1,096 Shares Haber Inc. Held In Smith Barney Reserved Client Financial Management Account No. 60.28 724-18041-16 180 36 225 Shares IAC/Interactive Corp. Held In Smith Barney Reserved Client Financial Management Account No. 3,492.00 724-18041-16 180 37 5,727 Shares Intel Corp Held In Smith Barney Reserved Client Financial Management Account No. 93,836.90 724-18041-16 180 38 2,000 Shares Intl Business Machines Corp Held In Smith Barney Reserved Client Financial Management Account No. 180,560.00 724-18041-16 180 39 90 Shares Interval Leisure Group Inc. Held In Smith Barney Reserved Client Financial Management Account No. 615.69 724-18041-16 180 40 1,278 Shares Johnson & Johnson Held In Smith Barney Reserved Client Financial Management Account No. 77,159.25 724-18041-16 180 TOTAL. (Carry forward to main schedule) ..... . 440, 748.37 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 5 21 08 1126 Item Number Descri tion Value at Date 41 116 Shares LSI Corp. of Deatn Held In Smith Barney Reserved Client Financial Management Account No. 512.14 724-18041-16 180 42 5,760 Shares Lehman Brother Holdings Inc. Held In Smith Barney Reserved Client Financial Management Account No. 633.60 724-18041-16 180 43 2,000 Shares Lenovo Group LTD Spon ADR Held In Smith Barney Reserved Client Financial Management Account No. 16,650.00 724-18041-16 180 44 8,000 Shares McGraw Hill Cos Inc. Held In Smith Barney Reserved Client Financial Management Account No. 197,680.00 724-18041-16 180 45 8,000 Shares Microsoft Corp. Held In Smith Barney Reserved Client Financial Management Account No. 192,520.00 724-18041-16 180 46 588 Shares Monsanto Co New Held In Smith Barney Reserved Client Financial Management Account No. 52,528.98 724-18041-16 180 47 1,500 Shares Motorola Inc DE Held In Smith Barney Reserved Client Financial Management Account No. 7,950.00 724-18041-16 180 48 20,248 Shares Oracle Corp. Held In Smith Barney Reserved Client Financial Management Account No. 363,552.84 724-18041-16 180 49 5,200 Shares PPL Corp. Held In Smith Barney Reserved Client Financial Management Account No. 167,310.00 724-18041-16 180 50 1,000 Shares Panera Bread Co . CL A Held In Smith Barney Reserved Client Financial Management Account No. 43,635.00 724-18041-16 180 51 1,122 Shares Parker-Hannifin Corp. Held In Smith Barney Reserved Client Financial Management Account No. 48,447.96 724-18041-16 180 TOTAL. (Carry forward to main schedule) ..... . 1,091,420.52 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 6 21 08 1126 Item Number 52 Descri tion 2,415 Shares Pfizer Inc. Value at Date or Deatn Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 39,593.93 53 3,348 Shares Public Service Enterprise Group Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 91,132.56 54 1,000 Shares Reynolds American Inc . Held In Smith Barney Reserved Client Financial Management A 44,520.00 ccount No. 724-18041-16 180 55 1,000 Shares Rite Aid Corp. Held In Smith Barney Reserved Client Financial Management A 705.00 ccount No. 724-18041-16 180 56 2,000 Shares Sirius XM Radio Inc. Held In Smith Barney Reserved Client Financial Management Account No. 991.70 724-18041-16 180 57 3,147 Shares Sovereign Bancorp Inc. Held In Smith Barney Reserved Client Financial Management Account No. 12,304.77 724-18041-16 180 58 1,431 Shares Sun Microsystems Inc New Held In Smith Barney Reserved Client Financial Management Account No. 7,663.00 724-18041-16 180 59 7 Shares Supervalu tnc. Held fn Smith Barney Reserved Client Financial Management Account No. 131.69 724-18041-16 180 60 4,000 Shares Telefonos De Mexico Sp ADR Sponsored ADR Repstg Hs Sr L 94,260.00 Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 61 4,000 Shares Telmex Intl S.A.B.De Cv ADR Ser L Held In Smith Barney Reserved Client Financial Management Account No. 47,440.00 724-18041-16 180 62 90 Shares Ticketmaster Inc. Held In Smith Barney Reserved Client Financial Management Account No. 1,129.95 724-18041-16 180 TOTAL. (Carry forward to main schedule) ..... . 339,872.60 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 7 21 08 1126 Item Number Descri tion Value at Date 63 433 Shares Travelers Companies Inc. of Deatn Held In Smith Barney Reserved Client Financial Management Account No. 15,005.62 724-18041-16 180 64 14 Shares Tree.Com Inc. Held In Smith Barney Reserved Client Financial Management Account No. 34.65 724-18041-16 180 65 11,392 Shares Hancock John Patriot Premium Dividend Fund II 65,196.42 Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 66 2,750.1606 Shares PIMCO Strategic Global Government Fund Inc. Held In Smith Barney Reserved Client Financial Management Account No. 24,173.91 724-18041-16 180 67 1,000 Shares Wells Fargo Capital Trust IV Held In Smith Barney Reserved Client Financial Management Account No. 21,075.00 724-18041-16 180 68 3,941.902 Shares Dreyfus Premier State Muni Bond Fund PA Series CI A Held In Smith Barney Reserved Client Financial Management Account No. 56,802.81 724-18041-16 180 69 Emerald Mutual Funds 6,993.426 Shares Forward Growth Fund CIA 65,668.27 Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 70 1,624.492 Shares Legg Mason Partners Municipal High Income Fund Class A Held In Smith Barney Reserved Client Financial Management Account No. 20,728.52 724-18041-16 180 71 674.441 Shares Legg Mason Partners Int'I All Cap Opptny Fd CI C Held In Smith Barney Reserved Client Financial Management Account No. 3,871.29 724-18041-16 180 72 $20,000 Union County PA Higher Education Fac Fin Au Univ Rv Bucknell Univ MBIA 20,003.80 B/E OID DT 05/15/96; Interest 5.50%; Due 04/01/2016 Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 Accrued Interest 36.67 TOTAL. (Carry forward to main schedule) ..... . 292, 596.96 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 8 21 08 1126 Item Number Value at Date Descri tion 73 $20,000 Philadelphia PA Au For IDR of Death (Please Touch Museum PJ) 17,724.20 BED 11/8/06; Interest 4.25%; Due 09/01/2016 Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 Accrued Interest 99.17 74 $20,000 Pennsylvania State Turnpike Commn Turnpike Revenue Series R- AMBAC INSD-OID 16,800.40 B/E DD 03/01/01; Interest 5.0%; Due 12/01/2030 Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 Accrued Interest 366.67 TOTAL. (Carry forward to main schedule) ..... . 34,990.44 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 9 21 08 1126 Item Number Descri tion Value at Date 75 1,623.006 Shares MS U.S. Government Sec Tr 1 of Death Held In Morgan Stanley 13,406.03 Account No. 410-048223-0 76 6,448.708 Shares MS U.S. Government Sec Tr B Held In Morgan Stanley 53,201.84 Account No. 410-048223-0 TOTAL. (Carry forward to main schedule) ..... . 66,607.87 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 10 21 08 1126 Item Number Descri tion Value at Date 77 Securities Held In Smith Barney Reserved Client Financial Management of Death Account No. 724-03950-1-7-375 78 61 Shares Covidien LTD Held In Smith Barney Reserved Client Financial Management Account No. 2,812.10 724-03950-17 375 79 154 Shares Seagate Technology -USD Held In Smith Barney Reserved Client Financial Management Account No. 1,395.24 724-03950-17 375 80 61 Shares Tyco Intl LTD New Held In Smith Barney Reserved Client Financial Management Account No. 1,722.03 724-03950-17 375 81 61 Shares Tyco Electronics LTD Held In Smith Barney Reserved Client Financial Management Account No. 1,328.28 724-03950-17 375 82 600 Shares Weatherford Intl LTD NEW(Bermuda) Held In Smith Barney Reserved Client Financial Management Account No. 9,426.00 724-03950-17 375 83 218 Shares Core Laboratories NV-USD Held In Smith Barney Reserved Client Financial Management Account No. 16,843.77 724-03950-17 375 84 195 Shares Alkermes Inc. Held In Smith Barney Reserved Client Financial Management Account No. 2,082.60 724-03950-17 375 85 95 Shares Anadarko Petroleum Corp. Held In Smith Barney Reserved Client Financial Management Account No. 3,005.32 724-03950-17 375 86 210 Shares Biogen Idec Inc. Held In Smith Barney Reserved Client Financial Management Account No. 9,424.80 724-03950-17 375 87 150 Shares Broadcom Corp CI A Held In Smith Barney Reserved Client Financial Management Account No. 2,363.25 724-03950-17 375 TOTAL. (Carry forward to main schedule) ..... . 50,403.39 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 11 21 08 1126 Item Number 88 Descri tion 245 Shares Cablevision Systems Cor Value at Date of Death p Cablevision NY Group CIA 4,173.58 Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 89 110 Shares Cirrus Logic Inc. Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 496.10 90 397 Shares Comcast Corp CL A-SPL Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 6,270.62 91 170 Shares Comcast Corp CL A-SPL Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 2,685.15 92 145 Shares Cree Inc. Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 3,208.85 93 29 Shares Discovery Communications Inc. Series A Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 349.60 94 29 Shares Discovery Communications Inc. Series C Held In Smith Barney Reserved Client Financial Management Account No. 325.82 724-03950-17 375 95 220 Shares Forest Laboratories Inc. Held In Smith Barney Reserved Client Financial Management Account No. 4,979.70 724-03950-17 375 96 300 Shares Genzyme Corp. Held In Smith Barney Reserved Client Financial Management Account No. 20,716.50 724-03950-17 375 97 160 Shares L 3 Communications Hldgs Inc. Held In Smith Barney Reserved Client Financial Management Account No. 13,478.40 724-03950-17 375 TOTAL. (Carry forward to main schedule) ..... . 56,684.32 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 12 21 08 1126 Item Number Descri tion Value at Date 98 29 Shares Liberty Global Inc. Class A of Death Held In Smith Barney Reserved Client Financial Management Account No. 570.28 724-03950-17 375 99 27 Shares Liberty Global Inc Series C Held In Smith Barney Reserved Client Financial Management Account No. 515.84 724-03950-17 375 100 145 Shares Liberty Media Holdg Corp Interactive Series A 1,210.03 Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 101 79 Shares Liberty Media Holdg Corp Cap Series A Held In Smith Barney Reserved Client Financial Management Account No. 624.10 724-03950-17 375 102 116 Shares Liberty Media Corp Series A Liberty Entertainment 2,060.74 Held In Smith Barney Reserved Client Financial Management Account No. 724-03950-17 375 103 56 Shares National Oilwell Varco Inc. Held In Smith Barney Reserved Client Financial Management Account No. 1,521.52 724-03950-17 375 104 434 Shares New York Community Bancorp Held In Smith Barney Reserved Client Financial Management Account No. 6,807.29 724-03950-17 375 105 170 Shares Pall Corp. Held In Smith Barney Reserved Client Financial Management Account No. 5,273.40 724-03950-17 375 106 480 Shares Quantum Corp DLT & Storage Held In Smith Barney Reserved Client Financial Management Account No. 143.20 724-03950-17 375 107 124 Shares Sandisk Corp. Held In Smith Barney Reserved Client Financial Management Account No. 2,032.98 724-03950-17 375 108 38 Shares Teva Pharmaceutical Inds LTD ADR Held In Smith Barney Reserved Client Financial Management Account No. 1,531.21 724-03950-17 375 TOTAL. (Carry forward to main schedule) ..... . 22,290.59 Estate of: H. Eleanor Haselhuhn Schedule B -Stocks and Bonds Page 13 21 08 1126 Item Number Descri tion Value at Date 109 406 Shares UnitedHealth Group Inc. of Deatn Held In Smith Barney Reserved Client Financial Management Account No. 8,394.05 724-03950-17 375 110 First Clearing LLC Wachovia Securities LLC 10,695.81 Account No. 6001372583 1,405.494 shares Ivy Core Equity A Fund TOTAL. (Carry forward to main schedule) ..... . 19, 089.86 REV-1508 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENTDECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY w~..~c yr - H. Eleanor Haselhuhn FILE NUMBER 21 08 1126 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 Scheduel F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Cash On Hand 8, 844.20 2 Western Asset Money Market Fund Class A Held In Smith Barney Reserved Client Financial Management Account No. 993,520.54 724-18041-16 180 Principal $992,700.84 Accured Income $ 819.70 3 Western Asset Money Market Fund Class A Held In Smith Barney Reserved Client Financial Management Account No. 5,597.96 724-03950-17 375 Principal $5,597.96 4 ~ Citizens Bank Circle Gold Checking Account No. 610071-664-3 7,409.69 5 Wachovia Bank Checking Account No. 1000590322831 3,827.97 6 Wachovia Bank Certificate of Deposit No. 247402112827705 54,881.24 4.07% Interest; Due September 6, 2009 Principal $54,795.87 Accrued Interest $ 85.37 7 Morgan Stanley Check Dated September 30,2008 207.34 8 Citi Smith Barney Check Dated October 2, 2008 205.44 9 Putnam Investments Check Dated 09/30/08 225.52 10 Dreyfus Premier State Muni Bd Fud PA Series Class A 185.37 Check Dated 09/30/08 11 Pioneer Natural Resources Company Semi-Annual Dividend Check Dated 10/10/08 80.96 Total from continuation Schedule(s) 446,272.13 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 1,521,258.36 Estate of: H. Eleanor Haselhuhn Page 2 Schedule E -Cash, Bank Deposits, and Misc. Personal Property 21 08 1126 Item Number Descri tion Value at Date 12 Pioneer Natural Resources Company of Death Semi-Annual Dividend Check Dated 10/10/08 106.72 13 Leffler Energy -Credit Balance Account No. 452467-1 14 Bank Deposit Program 1,264.06 Held In Smith Barney Reserved Client Financial Management Ac 579.34 count No. 724-03950-17 375 Principal $578.05 Accured Income $ 1.29 15 Pimco Strategic Global Gov Fund, Inc. Dividend 178.76 Record Date 10/11/2008; Payable 11/03/08 16 Comcast Corp New -Dividend Record Date 10/08/2008; Payable 10/29/08 35.44 17 General Electric Co Dividend 7.75 Record Date 09/22/2008; Payable Date 10/27/2008 18 Monsanto Co New Dividend 141.12 Record Date 10/03/2008; Payable 10/24/2008 19 Motorola, Inc. Dividend 75.00 Record Date 09/15/2008; Payable 10/15/2008 20 Covidien LTD Dividend 169.76 Record Date 10/09/2008; Payable 11/06/2008 21 Tyco Intl Ltd Dividends 212.20 Record Date 10/01/2008; Payable 11/03/2008 22 Highmark Refund Check For Unused Premiums 23 American Express Dividend; Record Date 10/03/08; Payable Date 11/10/08 59.00 24 1987 Mercedes Benz Sedan 3, 888.00 25 Household Furnishings and Goods 3, 500.00 2, 950.00 TOTAL. (Carry forward to main schedule) ..... . 13,167.15 Estate of: H. Eleanor Haselhuhn Page 3 21 08 1126 Schedule E -Cash, Bank Deposits, and Misc. Personal Property Item Number Descri tion Value at Date 26 Coin Collection of Death 54,232.00 Appraised Value 27 Pro Rata Share Of Net Settlement Fund from the Tyco International Ltd. Class Action Securities Litigation; 1,720.56 Checks dated 03/04/09 $860.28 Checks dated 04/03/09 $860.28 28 860 Limited Partnership Units Centerline Holding Co. - 915.90 A Publicy Traded Partnership; EIN: 13-13949418 Held In Smith Barney Reserved Client Financial Management Account No. 724-18041-16 180 29 Commonwealth of Pennsylvania - 2008 Individual Income Tax Refund 2, 007.00 30 Verizon -Refund Of Overpayment 5.18 31 QLT Consumer Lease Services Equipment -Refund Of Overpayment Of Service (Telephone Equipment) 51.00 $34.00 05/15/09 $17.00 32 Commonwealth of Pennsylvania -Unclaimed Property 43.45 33 CitiGroup Global Markets Inc. Class Action Proceeds $463.19 463.19 34 Proceeds of Martha Stewart Living Class Action Securities Litigation 55.25 35 The Guardian Life Insurance Company Of America Whole Life Insurance Policy No. 3025596 196,756.79 Owner: Eleanor Haselhuhn Insured: Mary A. Haselhuhn Owner's Designee (Owner Of Policy Upon The Death Of Eleanor Haselhun): Mary Ann Haselhuhn (Mohr), the Decedent's Daughter See Attached Form 712 36 Investors Life Insurance Company Of North America Flexible Premium Adjustable Life Insurance Policy No. 1011220115 176,854.66 Owner: Eleanor Haselhuhn Insured: Mary A. Haselhuhn Owner's Designee (Owner Of Policy Upon The Death Of Eleanor Haselhun): Mary Ann Haselhuhn (Mohr), the Decedent's Daughter TOTAL. (Carry forward to main schedule) ..... . 433,104.98 Estate of: H. Eleanor Haselhuhn Page 4 21 08 1126 Schedule E -Cash, Bank Deposits, and Misc. Personal Property Item Number Descri tion Value at Date 37 5/5 Power Under The Non-Skip Trust Created Under the Last Will and of Death Testament of Donald H. Haselhuhn, Deceased 0.00 (created Under The Will Of The Decedent's Husband) TOTAL. (Carry forward to main schedule) ..... . 0.00 REV-1509 EX+(8-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENTDECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY w ~iv~c yr H. Eleanor Haselhuhn If an asset was made joint within one year of the decedent's date of SURVIVING JOINT TENANT(S) NAME ADDRESS A. Mary Ann Haselhuhn (Mohr) 103 Ennerdale Lane Non-Probate Pittsburgh, PA 15237-4024 s. Devon Haselhuhn Non-Probate 422 E. Winding Hill Road Mechanicsburg, PA 17055 c. JOINTLY-OWNED PROPERTY: RELATIONSHIP TO DECEDENT Daughter Granddaughter LETTER DATE DESCRIPTION OF PROPERTY INCL ITEM NUM FOR JOIN . TENANT T MADE JOINT . UDE NAME OFFINANCIAL INSTITUTION AND BANKACCTNUMBERORSIMILARIDENTIFYING NUMBER. ATTACH DEED FORJOINTLY-HELD REAL ESTATE DATE OF DEATH DECD'S DAVAOEOFTH . VALUE OF ASS ET INTEREST DECEDENT'SINTERESI 1 A 02/16/0 6 Sovereign Bank Money Market Account $581,240.62 50.000 290,620.31 No. 2334082279 Date of Death Principal Value $689,421.62 Accrued Interest $ 1,256.21 Sub-Total $690,677.83 Less Amounts Transferred To Account in May 2008 And Reported On Schedule G ($109,437.21) Total Value Reported As Joint Account $581,240.62 2 B 01/08/85 $50 U.S Series EE Savings Bond 89 14 50 000 Issued January 8, 1985 . . 44.57 Serial No. L184184762EE 3 A 09/19/06 Citizens Bank 484,638.11 50.000 242 319 06 Circle Gold Money Market Account No. 621549- , . 121-0 4 A 10/26/06 Manufacturers and Traders Bank 367,347.66 50.000 183 673 83 Account No. 015004214960731 , . A 1 0/26/06 Accrued Interest 214.63 50.000 107.32 Total from continuation Schedule(s) 431,266.46 FILE NUMBER 21 08 1126 it must be reoorted on Srh~~~ie r. TOTAL (Also enter on line 6, Recapitulation) I 1 148 031 55 (If more space is needed, insert additional sheets of the same size) Estate of: H Eleanor Haselhuhn Schedule F -Jointly-Owned Property Page 2 21 08 1126 Letter Date Item for Joint Made % of Date of Death Num. Tenant Joint Description of Property Date of Death Decd's Value of 5 A 07/30/96 Sovereign Bank Value of Asset Interest Decedent's Interest Checking Account No. 2331043825 40,341.83 50.0000 20,170.92 A 07/30/96 Accrued Interest 5.46 50.0000 2 73 6 A 01/21/05 1,368 Shares Sovereign Bancorp Inc , . Book Entry Account No. 125208054219 5,348.88 50.0000 2,674.44 Cusip 84590510 7 06/26/06 Securities and Cash Held In Smith Barney Reserved Client Financial Management Account No. 724-09190-17 600 8 A 06/26/06 Citicrop Trust Bank FSC , Bank Deposit Program 19,257.67 50.0000 9,628.84 Held In Smith Barney Reserved Client Financial Management Account No. 724-09190-17 600 9 A Citibank NA South Dakota Bank Deposit Program 98,588.71 50.0000 49,294.36 Held In Smith Barney Reserved Client Financial Management Account No. 724-09190-17 600 10 A 125 Shares Covidien LTD Held In Smith Barney Reserved Client Financial 5,762.50 50.0000 2,881.25 Management Account No. 724-09190-17 600 11 A 125 Tyco Int. Ltd Held In Smith Barney Reserved Client Financial 3,528.75 50.0000 1,764.38 Management Account No. 724-09190-17 600 12 A 125 Shares Tyco Electronics LTD Held In Smith Barney Reserved Client Financial 2'721.88 50.0000 1,360.94 Management Account No. 724-09190-17 600 13 A 921 Citadel Broadcasting Corp. Held In Smith Barney Reserved Client Financial 359.19 50.0000 179.60 Management Account No. 724-09190-17 600 TOTAL. (Carry forward to main schedule) ..... . 87, 957.46 Estate of: H. Eleanor Haselhuhn Schedule F -Jointly-Owned Property Page 3 21 08 1126 Letter Date Item for Joint Num. Tenant Made Joint Descri tion of Pro ert % of Date of Death Date of Death Decd's Value of 14 A 2,000 Shares Citigroup Inc Value of Asset Interest Decedent's Interest . Held In Smith Barney Reserved Client Financial 30,780.00 50.0000 15,390.00 Management Account No. 724-09190-17 600 15 A 12,000 Walt Disney Co. Held In Smith Barney Reserved Client Financial 302,040.00 50.0000 151,020.00 Management Account No. 724-09190-17 600 Sold 11/26/08 16 A 134 Shares Ecolab Inc . Held In Smith Barney Reserved Client Financial 5,637.38 50.0000 2,818.69 Management Account No. 724-09190-17 600 17 A 500 Shares General Electric Co . Held In Smith Barney Reserved Client Financial 10,670.00 50.0000 5,335.00 Management Account No. 724-09190-17 600 18 A 333 Shares Kuala Healthcare Inc . Held In Smith Barney Reserved Client Financial 0.00 50.0000 0.00 Management Account No. 724-09190-17 600 19 A 1,000 Shares Martha Stewart Living CIA 6,405.00 50.0000 3,202.50 Held In Smith Barney Reserved Client Financial Management Account No. 724-09190-17 600 20 A 722 Shares Medco Health Solutions Inc . Held In Smith Barney Reserved Client Financial 29,266.27 50.0000 14,633.14 Management Account No. 724-09190-17 600 Sold 11/21/08 21 A 3,000 Shares Merck & Co Inc . . Held In Smith Barney Reserved Client Financial 85,365.00 50.0000 42,682.50 Management Account No. 724-09190-17 600 22 A 1,000 Shares Qualcomm Inc . Held In Smith Barney Reserved Client Financial 40,505.00 50.0000 20,252.50 Management Account No. 724-09190-17 600 23 A 113 Travelers Companies Inc . Held In Smith Barney Reserved Client Financial 3,916.02 50.0000 1,958.01 Management Account No. 724-09190-17 600 TOTAL. (Carry forward to main schedule) ..... . 257,292.34 Estate of: H. Eleanor Haselhuhn Schedule F -Jointly-Owned Property Page 4 21 08 1126 Letter Date Item Num. for Joint Made Tenant Joint Descri lion of Pro ert % of Date of Death Date of Death Decd's Value of 24 A 362 Shares Waste Mgmt Inc De Value of Asset Interest Decedent's Interest . Held In Smith Barney Reserved Client Financial 10,459.99 50.0000 5,230.00 Management Account No. 724-09190-17 600 25 A 1,000 Gabelli Dividend & Income Tr E uit G y Portfolio 10,295.00 50.0000 5,147.50 Held In Smith Barney Reserved Client Financial Management Account No. 724-09190-17 600 26 A 1,000 Shares Aegon NV 6.875% PFD Held In Smith Barney Reserved Client Financial 8,830.00 50.0000 4,415.00 Management Account No. 724-09190-17 600 27 A 913.242 Franklin Pennsylvania Tax Free Income Fund Class A 8,191.78 50.0000 4,095.89 Held In Smith Barney Reserved Client Financial Management Account No. 724-09190-17 600 28 A $25,000 Allegheny Co. PA Hsp Dv Au-Rev Hlth Sys-B-West Penn Alleghny 28,034.50 50.0000 14,017.25 B/e OID DD 08/09/00; 9.25% Interest; Due 11/15/2010 Held In Smith Barney Reserved Client Financial Management Account No. 724-09190-17 600 A Accrued Interest 1, 066.32 50.0000 533 16 29 A 08/2006 Fidelity Preferred Retirement S i . erv ces Fidelity Funds Account 2EA-658588 105,155.72 50.0000 52,577.86 2,082.704 shares Fidelty Contrafund TOTAL. (Carry forward to main schedule) ..... . 86, 016.66 REV-1510 EX+(6-98) SCHEDULE G COMMONWEALTHOFPENNSYLVANIA INTER-VIVOS TRANSFERS & IN RESIDENTDECEDENT N MISC. NON-PROBATE PROPERTY ESTATE OF H. Eleanor Haselhuhn FILE NUMBER This schedule must be completed and filed if the answerto any of questions 1 through 4 on the reverse sid 21 08 1126 e of the REV-1500 COVER ITEM INCLUDE NAMEO ETRANS~FEIROEEORELPATOIpNSH PTO DECEDENT& DATE OF DEATH NUM D SH EET is yes. ' % OF DE ATE OF TRANSFER. ATTACHCOPYOFDEEDFORREALESTATE VALUE OF ASSET INTERE C S EXCLUSION ST TAXABLE (IFAPPLICABLE ) VALUE 1 Amounts Deposited into Sovereign BankMone y 109,437.21 1 Market Account 00 0.00 109,437.21 No. 2334082279 (Joint Account With Mary Ann Mohr, Decedent's Daughter) Within 1 Year Of Death Proceeds Of Sovereign Bank Certificate of Deposit No. 2335538993 $ 54,723.14 Proceeds Of Sovereign Bank Certificate of Deposit No. 2335540809 $ 54,714.07 Total $109,437.21 2 November 27, 2007 Cash Gift 7,000.00 100 3,000.00 Beneficiary: Mary Ann Mohr, Daughter 4,000.00 3 June 17, 2008 Cash Gift 5,000.00 100 3,000.00 2,000.00 Beneficiary: Mary Ann Mohr, Daughter 4 Split Rock Time Share 8,995.00 100 Gift March 2008 0.00 8,995.00 Beneficiary: Mary Ann Mohr, Daughter See Attached Valuation Letter From Vacation Charters, LTD 5 Union Central 114,590.62 100 SPDA 2000 114,590.62 Single Premium Deferred Annuity Non-Qualified Policy No. A61002298C Beneficiary: Mary Ann Haselhuhn (Mohr), Daughter 6 Union Central 28,651.28 100 SPDA 2000 28,651.28 Single Premium Deferred Annuity Non-Qualified Policy No. A61002302C Issue Date January 19, 1983 Annuitant: Devon Haselhuhn (Granddaughter) New Owner: Estate of Eleanor Haselhuhn Balance as of January 19, 2008 $27,834.56 Accrued Interest Ocotber 13, 2008 $816.72 Total from continuation Schedule(s) 324, 634.04 TOTAL (Also enter on line 7, Recapitulation) 592,308.15 (If more space is needed, insert additional sheets of the same size) Page 2 Estate of: H. Eleanor Haselhuhn 21 08 1126 Schedule G -Inter-Vivos Transfers and Misc. Non-Probate Property Item Num Date of Death % of Dec's Exclusion Taxable Descri tion of Pro ert Value of Asset Interest 7 The Prudential (if applicable) Value Annuity Contract No. 99 711 008 231,660.22 100 231,660.22 Investment Option 1 Year Fix 3.350% Rate Principal $225,734.84 Accrued Interest $5,925.38 Beneficiary: Mary Ann Haselhuhn (Mohr), Daughter 8 Metlife Individual Retirement Annuity 64,978.07 100 64,978.07 Account No. 9072983 Beneficiaries: 50% Mary Ann Haselhuhn (Mohr), Daughter 50% Lannetta Haselhuhn, Daughter-In- Law 9 Wachovia Securities 27,995.75 100 Inherited IRA 27,995.75 Michael H. Haselhuhn (Deceased Son) Account No. 4101-2079 Beneficiary: Estate of Eleanor Haselhuhn TOTAL. (Carry forward to main schedule) ..... . 324,634.04 REV-1511 EX+(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENTDECEDENT CJ IAIt VF H. Eleanor Haselhuhn ITEM A. FUNERAL EXPENSES: See schedule attached SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 08 1126 Debts of decedent must be reported on Schedule I. 9, 926.57 B. ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name 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) Claimant Street Address City Stafe Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees See schedule attached 116,792.00 100,000.00 3,410.00 511.25 29,379.64 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) 260, 019.46 Estate of: H. Eleanor Haselhuhn Schedule H, Part A -Funeral Expenses Page 2 21 08 1126 Item Number Descri tion 1 Musselman Funeral Home & Cremation Services, Inc. Amount 8,130.02 2 West Shore Country Club Funeral Reception 1,681.50 3 Giant -Funeral Reception 62.61 4 Westy Beer Distributor -Funeral Reception 29.67 5 Staples 22.77 TOTAL. (Carry forward to main schedule) ..... . 9,926.57 Estate of: H. Eleanor Haselhuhn Schedule H, Part B -Administrative Costs Miscellaneous Expenses Page 3 21 08 1126 Item Number Descri tion 7 Cumberland County Register of Will Amount s Miscellaneous Charges 271.00 Will $ 15 Codicil $ 15 Short Certificates $164 Automation Fee $ 5 JCP Fee $ 10 Misc. $ 2 (1) Exemplified Copy OF PA Probate Proceedings $ 40 Filing Release $ 5 Filing Petition $ 15 8 Cumberland County Register Of Wills - Fees For Filing Pennsylvania Inheritance Tax Return 3,160.00 and Inventory $ 30 00 . -Estimated Filing Fee For Filing Accounting $3,130.00 9 Cumberland Law Journal -Legal Advertisement 75.00 10 The Sentinel -Legal Advertisement 150.64 11 PP&L Account No. 39360-69003 480.92 Electric Service To Decedent's Residenc e 11/10/08 $ 75.74 12/10/08 $ 69.55 12/28/08 $ 54.54 01/28/09 $ 63.11 02/24/09 $ 50.26 03/30/09 $ 54.23 04/27/09 $ 31.12 05/27/09 $ 51.02 06/29/09 $ 31.34 TOTAL. (Carry forward to main schedule) ..... . 4,137.56 Estate of: H. Eleanor Haselhuhn Schedule H, Part B -Administrative Costs Miscellaneous Expenses Page 4 21 08 1126 Item Number Descri tion 12 Pennsylvania American Water Amount Account No. 24-0637444-3 174.71 Service To Decedent's Residence 11/12/08 $ 25.55 12/11/08 $ 29.03 01/07/09 $ 27.64 01 /28/09 $ 3.98 02/26/09 $ 20.82 03/27/09 $ 18.09 04/27/09 $ 21.74 05/26/09 $ 14.64 06/25/09 $ 13.22 13 Borough Of Camp Hill Sewer Account No. 1163-0 Serivice Location -Decedent's Residence Due 11/24/08 $52.50 02/02/09 $62.50 04/27/09 $62.50 177.50 14 Don Wagner Landscaping -Yard Maintenance At Decedent's Camp Hill Residence 1,476.00 11/ /08 $547.00 12/24/08 $105.00 01 /07/09 $ 45.00 02/05/09 $200.00 04/07/09 $265.00 05/05/09 $ 36.00 06/09/09 $278.00 15 Comcast Cable Service To Residence 234.29 Due 11/07/08 $ 53.33 Due 12/_/08 $ 57.25 02/23/09 $121.87 04/17/09 $ 1.84 16 QLT Consumer Lease Services (Phone) Account No. 717-737-3023 55.44 10/02/08-12/02/08 36.96 12/08/08 18.48 17 Giant -Cleaning Supplies 14.16 18 Lowe's -Home Maintenance Items 43.31 TOTAL. (Carry forward to main schedule) ..... . 2,175.41 Estate of: H. Eleanor Haselhuhn Schedule H,.Part B -Administrative Costs Miscellaneous Expenses Page 5 21 08 1126 Item Number Descri tion 19 Rowe's Auction Service -Tangible Personal Property Appraisal Amount 85.00 20 Dutys Lock, Safe & Security, fnc. 170.50 21 Crop Bros. Inc. -Plumbing Repairs To Decedent's Residence 139.99 22 Leffler Energy - Furnace Maintenance At Decedent's Residence $129.00 337.00 - Service Call and Repair at Winding Hill Road Property $208.00 23 Leffler Energy -Heating Oil For Decedent's Cam Hill Residence 11/18/08 $ 309.57 2,240.42 12/12/08 $ 361.06 01/14/09 $ 348.99 01/27/09 $ 112.83 02/11/09 $ 255.97 03/09/09 $ 298.40 03/31 /09 $ 291.97 06/05/09 $ 261.63 24 Lefler Energy -Heating Oil Winding Hill Road Property 01/06/09 $458.21 1,434.39 02/18/09 $529.94 04/07/09 $446.24 25 Q Credit Card Account 603 9002 5850 Finance Charge 1.50 12/05/08 $1.50 26 Verizon 717 737 3023 488 35Y 227.79 1 0/2 5/0 8-1 1 12 4/0 8 $ 28.14 11/25/08-12/24/08 $ 23.13 01/20/09 $ 58.63 03/17/09 $ 11.00 27 Lowe's -Smoke Detectors and Cot Detectors for Decedent's Residence 166.29 28 Steinmetz Coins & Currency -Coin Collection Appraisal 450.00 29 Penn Waste, Inc. 01/01/2009-03/31/2009 $ 48.75 48.75 30 Mark Heckman Real Estate Appraisers -Appraisals of Camp Hill Property 700.00 TOTAL. (Carry forward to main schedule) ...... 6,001.63 Estate of: H. Eleanor Haselhuhn Schedule H, Part B -Administrative Costs Miscellaneous Expenses Page 6 21 08 1126 Item Number Descri tion 31 Mark Heckman -Appraisal Of Winding Hill Road Property Amount 400.00 32 Anderson's Chimney Sweeps, Inc. -Level 1 Inspection Of Furnace Chimney 104.94 Flue At Camp Hill Residence 33 Carst Fuel Products, Inc. Service Of Furnace At Winding Hill Property 204.00 34 Anderson's Chimney Sweeps, Inc. Repair of Chimney Flue At Camp Hill Property 2,334.45 35 Don Wheatley -Replacement of Doors at 422 Winding Hill Road, Mechanicsburg, Pennsylvania 1,081.62 36 Upper Allen Township Sewer Service 342.19 Account No. 553002 Serivice Location - E Winding HIII Road 12/12/08 $ 118.19 01/12/09 $ 112.00 04/06/09 $ 112.00 37 Corroon Insurance Corporation -Insurance Premiums On Camp Hill Residence 3,622.00 12/23/08 $1,143.00 06/04/0/9 $2,479.00 38 Corroon Insurance Corporation -Annual Insurance Premium On Winding Hill Road Property 1,682.00 12/23/08 $ 548.00 06/04/09 $1,134.00 39 Tiger Waste of York -Rental Of Dumpster To Clean Ourt Camp Hill Residence 450.00 40 Joe Newson -Trash Removal At Camp Hill Residence 250.00 41 Trash Dumpster Camp Hill Property 75.00 42 Plumber Camp Hill Residence -Repair Toliet Leak 248.00 TOTAL. (Carry forward to main schedule) ..... . 10, 794.20 Estate of: H. Eleanor Haselhuhn Schedule H, Part B -Administrative Costs Miscellaneous Expenses Page 7 21 08 1126 Item Number Descri lion 43 Keefer Wood Allen & Rahal, LLP Amount - Reimbursement For Filing Fees, Copies, Telephone charges, Death 543.56 Certificates, Telecopier Usage, Postage, Federal Express, etc. Statement Dated March 10, 2009 $543.56 44 Keefer Wood Allen & Rahal, LLP Reimbursements: 563.73 Filing Fee re Petition For Resignation/Removal Of Co-Administrator $ 15.00 Exemplified Copy Of Probate Prceedings $ 52.00 Filing Fee Ancillary Probate $144.00 Postage $ 48.47 Copies $128 28 Capitol Copy Service -Tax Retura Exhibits $ 89.41 Messenger Service $ 25.85 WestLaw Charges $ 36.00 45 Keefer Wood Allen & Rahal Estimated Additional Out-Of-Pocket Costs 600.00 46 Pennsylvania Vital Records - Death Certificates 135.00 12/01/08 $90.00 12/11 /08 $45.00 47 Morgan Stanley -Service Charges 105.00 48 Janet Miller, Tax Collector - Certification Of Real Property Taxes For Camp Hill Residence 5.00 49 S&R Contracting - Repairs/Maintenance Winding Hill Road Property 500.00 (Mold Remediation) Paid $4,000.00 Paid $5,390.85 Insurance Reimbursements $5,868.07 $3, 022.78 50 S&R Contracting - Repairs/Maintenance Decedent' Residence 1,718.08 (Mold Remediation) - 05/12/09 51 QLT -Lease Phone Charges 42.88 TOTAL. (Carry forward to main schedule) ...... 4,213.25 Page 8 Estate of: H. Eleanor Haselhuhn 21 08 1126 Schedule H, Part B -Administrative Costs Miscellaneous Expenses Item Number Descri tion Amount 52 Smith Barney -Investment Advisory Fee 1,128.59 Charged To Account No. 724-03950-17 on 10/17/08 53 PA Vital Records -Death Certificates 36.00 54 Wachovia Bank - Service Charges On Checking Account No. 1000590322831 10.00 55 Rotor-Rooter - Drain Cleaning/Floor Drain at Decedent's Residence 199.00 56 Roto-Rooter Winding Hill Road 259.00 Cleaning/Maintain Sewer Line 57 Cleaning of Camp Hill Residence 275.00 58 GearClear - AirConditioner Maintenance 150.00 Camp Hill Residence TOTAL. (Carry forward to main schedule) ...... 2,057.59 REV-1512 EX+(12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENTDECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS H. Eleanor Haselhuhn FILE NUMBER Report debts incurred by decedent prior to death which remained unpaid as of date of death, Including u 08mbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE 1 Good Shepard Church OF DEATH Outstanding Check Which Cleared Decedent's Citizens Bank Circle Gold 25.00 Checking Account No. 610071-664-3 on October 14, 2008 2 PA American Water Direct Payment From Decedent's Citizens Bank 26.58 Circle Gold Checking Account No. 610071-664-3 On October 15, 2008 3 Upper Allen Township Sewer Service 112.00 Account No. 553002 Serivice Location - E Winding HIII Road Billing Period 07/01/08 to 09/30/08 $112 4 QCard Credit Card Account No. 603 9002 5850 29.63 5 Janet L. Miller, Tax Collector 2008 Personal Taxes (Bill Date 03/01/08; Due Without Discounts 07/01/2008) 5.50 6 $5,000 Demand Note dated March 20, 1996 to the Non-Skip Trust U/W of Donald H. Hashelhuhn, Deceased 5,000.00 7 I $5,000 Demand Note dated March 20, 1996 to the Skip Trust U/W of Donald H. Hashelhuhn, Deceased 5,000.00 8 U.S. Treasury - 2008 Individual Income Tax 7,389.00 9 Checks Clearing After Death On Wachovia Bank Checking Account No. 1000590322831 185.00 Check 1301 $100.00 Check 1310 $ 85.00 TOTAL (Also enter on line 10, Recapitulation) I 17,772 71 (If more space is needed, insert additional sheets of the same size) REV -1513 EX+ (g-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENTDECEDENT ESTATE OF H. Eleanor Haselhuhn SCHEDULE J BENEFICIARIES NUMBE NAME AND ADDRESS OF PERSONS RECEIVING PROPERT I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] See schedule attached FILE NUMBER 21 08 1126 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not Llst Trustees OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-150 (COVER SH EET zz NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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) Page 2 Estate of: H. Eleanor Haselhuhn 21 08 1126 Schedule J, Part I -Taxable Distributions Num. Name and Address of Person(s) Receiving Property Relationship to Decedent Am of Estatehare Mary Ann Haselhuhn (Mohr) Non-Probate Daughter 2,024,770.52 103 Ennerdale Lane Pittsburgh, PA 15237-4024 Devon Haselhuhn -Residual Estate Granddaughter 2,799,891.40 422 E. Winding Hill Road Mechanicsburg, PA 17055 Lannetta Haselhuhn Daughter-in-law 32,489.03 422 East Winding HIII Road Mechanisburg, PA 17055 Mary Ann Haselhuhn (Mohr) Residual Estate Daughter 2,799,891.40 103 Ennerdale Lane Pittsburg, PA 15237-4024 Devon Haselhuhn Non-Probate Granddaughter 44.57 422 E. Winding Hill Road Mechanicsburg, PA 17055 Mary Ann Mohr -Tangible Personal Property Daughter 60,682.00 103 Ennerdale Lane Pittsburgh, PA 15237-4024