HomeMy WebLinkAbout07-29-09 (2)--~ REV-15pp 1505607120
PA Department of Revenue ~ (~ 08) OFFICIAL USE ONLY
Bureau of Individual Taxes cwmy cod. Ysa
PO 80X.280801 INHERITANCE TAX RETURN Fib Number
Harrisburg, PA 17128-0801 RESIDENT DECEDENT 2 1 0 8 10 9 0
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
Date of Birth
11 03 2008
09 08 1921
Decedent's Last Name
Suffer Decedent's First Name
L I DiD 8 RffiANN Mt
(N Appllcabls) Eller Survivlny Spouse's Informatlon Below
Spouse's Last Name
BLIZA88T$
Suffix Spouse's First Name
Spouse's Social Securiy Number
FILL IN APPROPRIATE OVALS BELOW
X^ t. Original Retum ^
^ 4. Limited Estate ^
g, deoatlenl dbd Testate
(Adatli Copy of NIA) ^
^ g. Litigation Proceeds Received ^
TNIB RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WIL~g
2. Suppkmenkl Retum ^ 3. Remainder Retum (date of death
prior to 12.13-82)
4a. FuWrs Inreiwt CanprgrASa ^
IaMe orMeth Mar 12-12-82) 5. Fetleral Estate Tax Retum Required
7, ~aceeent MalMained a UuMp Trust
(Attadt Copy d iruM) O e. Total Number of Sale Deposit Boxes
10. ~hAa: ~PS-3 i bA tda-0Sa aenn ^ 11. Election to kx under Sec. 9113(A)
1- (Attach Sch. O)
Nuns _.____.._.......,.
BRADLEY J. L888R
Firm Nuns (1/AppllpbN)
SLARBY, Y03T,
FIASt Ilns of addAess
17 8A8T MARKET
Sswnd Ilns of addrsss
Clly or Post Offlu
YORK
SUPP & RAUSCH, LLP
8TR8ST
CorrsspoAtdsrrrs e-mail address:
Stste ZIP Coda
PA 17401
on
Warren R. Lindsrrnann II
BradNy J. Leber
17 East Mark ~trest, York, PA 17101
' 1505607120
Side 1
Daytlms TNSphoru NumMr
717 845 3674
REGISTER OF~YYILLS USE IM~LY
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1505607120 J
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,~,~ 1505607220
REV-1500 EX
°aLetle"~'•N•m• Elizabeth J. Llndermann Decedent's Social Security Number
RECAPITUUTwN
1. Real Estate (Schedule A) ................................................................................... ....... 1. 3 5, 8 5 3. 4 1
2. Stocks and Bonds (Schedule 8) ..........
.....................
..................................
...... 2.
6, 4 7 3. 2 7
3. Closely Hek! Coryoration, Partnership or Sole-Proprietorship (Schedule C).... ...... 3,
4. Mortgages & Notes Receivable (Schedule D) ....
................................................ ...... 4,
5. Cash, Bank Deposfla B Miscellaneous Personal Property (Schedule E) ........... ..... 5. 5 7 , 6 2 7 • 0 7
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested
........
7. Inter-Vivos Trenafers 8 Miscellaneous Non-Probate Property
(Schedule G)
S ..... g. 6 5 6 . 4 9
~
eparate Billing Requested ........ .....
7.
8. Total Drop Aspts (total Lines t-7)
..............................................
....................
.... e.
100, 610. a4
9. Funeral Expenses 8 Administrative Costa (Schedule H)
................
.....................
.... 9. 1 6 3 1 0.14
,
70. Debts of DacedenL Mortgage LiabilNies, & Liens (Schedule I) ............................ .... 10. 3 , 3 9 3 . 5 3
11. Tohl Deductlop (total Lines 9 S 10) ..............
.................................................... ....
11.
19,703.67
12. Nst Velw o} Estab (Line 8 minus Line 11) ...........
...................
...........................
13. Charitable and Governmental BequestsBec 9113 Trusts for which
.... 12.
80, 906.57
an election to tax has not been made (Schedub J) ............
.................................. ...
13.
14. Nat Valw SubJ°ot to lax (Line 12 minus Line 13) ..
......................
TAX COMPUTATK)N -SEE INSTRUCTIONS FOR APPLICABLE RATES
14.
8 O , 9 0 6 . 5 7
75, Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 0 . 0 0 75.
16. Amount of Line 14 taxable 0 • 0 0
at lineal rete X .045 8 0, 9 0 6. 5 7
17. Amount of Line 14 taxable i6.
3 , 6 4 0 . 8 0
at sibling rete X .12 0 . 0 0 17
18. Amoun! of Line 14 taxable .
0 • 0 0
at collateral rate X .15 Q , 0 0 18.
19. Tax Dw ...................... 0.00
.............................................................................................. . 19.
3,640.80
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
' 1505607220
8Mea
1505607220 J
REV-1500 EX page 3
Decedent's Complete Address;
Elizabeth J. Llndermann
130 Conodopuinet Avenue
HIII
Tax Payments and Credits;
1. Tax Due (Page 1 Line 19)
2. Credita/Payments
A. Spousal Poverty Credh
B. Prior Payments
C. Discount
3. InhrestlPenalty if applicable
D. Interest
E. Penahy
FihNumMr 21-08-1090
Total Credits (A + B + C)
Total Intereaf/PenaXy (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Cheek box on Papa 2 Line 20 b r+sgtwat 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 + 5A. This is the BALANCE DUE.
PA
17011
(1) 3,640.80
0.00
(2) 0.00
(3)
(4)
(5> 3,840.80
(5A)
(se) 3,640.80
Make Check Payable to: REG/STER 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 ro yta No
........................................................... ~ x
b. retain the right to designate who shat use theh ro~~
P Perry transferred or Its income :....................................
c. retain a reversionary interest; or ...............................
receive the promise for life of either payments, benefds or wre? ........................ .
...
2. If death occurred after December 12, 19ffi, did decatlent transfer ro ~ ~ ~~~~~~~~~~~~~~~~~~~~~~~~~'~~" "
receiving adequate wnsideretion7 ..................._.. P PertY within one year of death without
............................ ^ 0
.......................................................
3. Did decedent own an "in trust fof or payable upon death bank account or security at his or her death9.........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate props which ^
contains a beneficiary designation? ........................ ~
......................... x
IF THE ANSYYER TO ANY OF THE ABOVE QUESTIONS IS YEg, YOU MU8T COMPLETE SCHEDULE O AND FILE R AS p ~ qp ~ RETURN.
For dates of death on or after July 1, 7994 and before January 1, 7995, 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. §9718 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax reh 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)j. 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 rotum are still applicable even if the surviving spouse is the ony beneficiary.
For dates of death on or after July 1, 2000:
The tax reh imposed on the net value of transfers from a deceased child hventyrone years of age or younger at death to or for the use of a
nature) parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §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 benefiGaries is four and one-haH (4.5) percent,
except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
s bang s dafinepd untler Sedion19102, as an individuaol who has a~least one p reent rnscolmmon w~ the de tlen~t,nwhet er by blolod or adoption.
RW-1b7IX~ (aM)
co~wwr+wcxTn aF VaRRev~vu~w
ka1FNT/WCE TA%RETURN
REeOEHf OECEOENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Llndermann, Elisabeth J. (FILE NUMBER
21-09 1090
A111Y1 pegRy OYlletl blNy 0I p ~ bRYnl h CpMepR.RIIM M
9.U' Nr~ bllNlan a~ dryM aRa a YAalla NNV, Rµ•Nr ~lYr IIIYkaI v ~FW~ vYUS b tleaMG M tM Wks H vTICi gppyly Mg10 De
~q rARgMaE b
I~YwMehbplntly~R,,,ewp„~„a,W11RrtM eaClaMeoll arJnElF olRb lNSVara lRUa.
NUMBER DESCRIPTION
1 1s0 Conodopulnst Avenue, Camp Hill, Hampden Township, Cumberland County,
Psnnsylvanbl-net proceeds from eels to unrobKed third party, SN •ettlemsM
sheet attached.
TOTAL (Also erKer on Line 7, RscaplWlaGOn)
CoPY~9ht (c) 2002 form Software ony The Lack era Gm p nln~~~ a~~l ~0~ o! tM mma size)
OF DEATH
s9,99s.a1
s9.963.41
Forth PA•1600 Schedule A (Rev. 6-l38)
ftw-7007 E%~ (aae)
COfa1pMWFKTM ov Reamr~voig~
WIERITMiCE T/J(RETURN
RE810EMp[CF,DFRr
ESTATE OF
Llndermann, Elizabeth J.
SCHED!/LE B
STOCKS 8 BONDS
LE NUMBER
21-08-1080
N~ a^~rlamar<an.e wan Rpht MauMVOrahlp napt M eaelaaae an ecn.w. P.
ITEM CUSIP
NUMBER NUMBER DESCRIPTION
UNIT VALUE
1 os2watw 2pp shams of Akrla Group Inc - Com. Held In Janney 19.705
Montgomery Scott Account No. 79193514. Valor as
of dab of death.
2 oz4o3Tfa 186 shares of Amerkan Cap Strabgiss ~ _ ~. 14.185
Hshi In Janney Mwdgomery Scott Account No.
73193614. Valor as of dab of death.
TOTAL (Alto enter on Line 2, RaeapltulaUon)
(If more apace le nsedeQ adtlltlonal papas of the game alze)
Copyright (c) 2002 form software only The Laekner Group, Inc.
OF DEATH
9.833.00
2,840.27
6,479.27
Fonn PA•7600 Schedule B (Rev. 8-98)
a..-,Foe ~.,...,,
~OM.IOMWEPLTN Or FEnwenvu~u
MIIF1bTRNCE TAK RETUi W
REeF]ENTOECEOEM
ESTATE OF
SCNEDI/LE E
CASH, BANK DEPOSITS, dF MISC.
PERSONAL PROPERTY
Eltsabsth J.
ImAW, tlro,rgalCe of aWaeen 8110 tie Ebb Uw M~esEe vote ncNVeE M Uie esWS.
~ F~YJeMM1Y~'.M4 „Iel ale,lyle erw,vlvaFlep 1,IIIM M W4wW ql ~ee111e F.
ILE NUMBER
21-08-1090
ITEM
NUMBER DESCRIPTION VALUE AT DATE
1
Janney Montgomey Scott Account No. 7318x614 -cash balance as of date ~
death OF DEATH
. 17.868.41
2 Sovereign Bank Savings Account No
8867228087
.
_ Balance as of dab of death.
142.90
3 Tyw - payment of decedsrlYs final pensbn check.
740.37
4 1988 Cadillac DsVllk -value per pk to unrelated third party,
4.250.00
5 Chase Credit Card -refund of crodk o
n account
4.00
8 Chap Mortgage .refund of credk on
account.
181.66
7 Comcast Cable -refund of crodk on account.
10.50
8 Cordla -rotund of crodk on account
82.00
9 Erie Insurance .refund of credit on account
58.00
10 Erie Insurance -rotund of credR on account.
178.00
11 Erie Insurance .refund of credk on account.
98.00
12 Firestone -refund of overpaymer-t on dscedsrlYs credit card account
.
60.17
13 ProgropNe Insurance -refund on decedent's automobile Insu
rence.
133.04
14 Shipley OII -refund of credk on account,
258.38
15 Urology of Csntrel PA -refund of crodk on account.
5.00
Total of Continwdon Sehsduls
TOTAL (Alw enbr on Line 5, RecapltulaUonl
Copyright (c) 2002 form software only The Lackner Group, ~lan~c ~~ e~ro~81 w~ of Me wme aiu)
See aaaehsd papa
57,627.07
Form PA•1600 Schedule E (Rev. 69t;)
a«.fea ex+(eJSI
C ETAI PETMNµw
nEeioENr cecEnENr
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
continued
Ellzatlath J.
ILE NUMBER
21-08-1090
ITEM
NUMBER DESCRIPTION VALUE AT DATE
16 Msti.ifa Non-Qualiflsd Mnuily Co~ract No, 007p80718A6 . of DEArrI
as of dab of death. Payable to ssbb. Value 17,288.83
17 National Wasbm Non-QualHlad MnuHy Contract No. 0101114610 -
sabb. Value as of dab of death. Payable to 16,290.71
TOTAL (Also erner on Line 6, Rscapitulatlon)
67,827.07
Copyright (c) 2002 forth software only The Lackner Group, Inc.
Fonn PA.7600 Schedule E (Rev. &98)
RW-tEOY EXi ({qs)
SCHEDULE F
CO~^I^°N'A'EN.TN OF reNNSnvANU
INNERITMlCE TA% JOINTLY-0WNED PROPERTY
RETURN
RE&DEfR pECEpEIR
ESTATE OF
Llndemmann, Elizabeth J. FILE NUMBER
rm r..e.l-. ewlwnl wlrYn „~ 21-00-1090
Y~YMtlM d~ONMY WM e/e-,Ily M wlwt M,ppIW pR K„qy 0.
SURVIVING JOINT TENANT(S) NAME
A- Wamn R. Lindemann II ADDRESS RELATIONSHIP TO DECEDENT
20 Maln Street
Dover, PA 17575 Son
B. Suzanne B. Lindemann 45 Vlns Drive
Carlisle, PA 77018 Daughter
C.
JOINTLY OWNED PROPERTY:
ITEM LETTER DATE DESCRIPTION OF PROPERTY
NUMBER FOR JOINT
TENANT JOINT INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT
NUMBER OR SIMIURIDENTIFYING NUMBER. ATTACH DEED FOR DATE OF DEATH % GF OA7E OF DEATH
DECD'S VALUE OF
1 JOINTLY-NEED RFAL ESTATE, ALUE OF ASS INTEREST DECEDENf'61NTEREST
A B 9/6/2001 Sovsrelgn Bank Checking Account No
.
2531023913 -Joint account vvlth son 1,969.67 33.330X gag,49
,
Warren R. Lindemann, II, and daughbr,
Suzanne B. Lindemmann. Relents as of
date of death.
A 8 9/6f2001 Accrued Inwme on Item 1 throw h dab
g
of death 0.01 35.330% 0.00
TOTAL (Also snbr on Line 6, ReppltMlatlon)
656.49
Copyright (c) 2002 form software ony The Lack en re Gro p, I~nc.~ ~ro~l ~gBB °f ~ °8I^° size)
Forth PA-1600 Schedule F (Rev. 6-g8)
RW71N EX~ (1tN)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAx RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES 8
ADMINISTRATIVE COSTS
Pllss~.sar. ,
Dettb of drllcederlt must be reportW on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPI=a1AO4.
FILE NUMBER
21-08-1090
AMOUNT
8se continuatbn schedule(s) attached
10,382.00
B• ADMINISTRATIVE COSTB:
t ~ Personal Representative's Commissions
Wamn R. Llndermann II
Social Security Number(s) / EIN Numhwr
Street Addroas 20 Maln Slroet
city Dover state PA
Zip
Year(s) Commission paid 2009
2. Anorney's Fees Blakey, Yost, Bupp b Bausch, LLP
3. Famiy F~remption: (If decedent's address is not the same as Uafmant's, anaon explanation)
Claimant
Street Address
City State
Relationship of Claimant to Zlp -
Oecedent
4• I Probate Fees
5• I Aecountant's Fees
S. I Tax Retum Preparers Fees
7
copyright (c) 2002 forth sotiwaro only The Lackner Group, Inc.
Other Administrative Costs
See continuatlon schedule(s) attached
TOTAL (Also enter on Ilrw 9, Recaphulatlon)
1,000.00
1.000.00
280.00
3,678.14
I ro,.a7V.74
Fonn PA-7ligp Schedule H (Rev. 6-g8)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF
Llndsrmann, Elizabeth J. (FILE NUMBER
21-08-1090
ITEM
NUMBER DESCRIPTION
AMOUNT
Funeral s.n.a.
1 Camp Hill Unibd Methodist Church - funeral reception.
390.00
2 Nslll Funsrol Home -funeral expenses.
9.982.00
H-A SutROfal 10.362.00
Other Administrative Costs
3 Bronneman's Titre d, Notary - fee for tIW transfer of Cadillac DsVllls
4 .
Comcast Cable - payment of December cable bill Tor 130 Conodopulnet properly
61.60
6 .
Comcast Cable . payment oT January cable bill for 130
Conodopulnet 10.00
properly 10.00
6 Comcast Cabk - Payment of February cable bill for 130 Conodopulnst
ro
t
p
per
y, 10.00
7 Cordla -payment of December phone bill for 130 Conodopulnst properly.
8
Gordis - payment of January phone bill for 130 Conodopulnst 60.00
properly.
60.00
8 Cordla -payment of Fsbrwry phone 6111 for 130 Conodopulnst
properly.
60.00
10 DeardorPs Auto -fee for Inspection of Cadlilac DeV11N In preparation Tor sak
11 .
Erie Insuroncs - payment of homeowner''s Insurance promlum.
64+43
12
Erle Insurance -payment of homeowner's Insurance promlum. 163.00
13
Erie Insurance -payment of homeowner's Insurance promlum. 163.00
176.00
Copyright (c) 2002 form sofNrere only The Lackner Group, Ine.
Forth PM1600 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF
Llndsrmann, Elizabeth J.
ITEM
NUMBER
DESCRIPTIO
ILE NUMBER
21-06-1080
N
14 Expenses Tor removal of decedents AMOUNT
Personal property. 606.00
15 Jiffy Lube - tN Tor oil change on Cadillac DeVllle In preparetbn Tor aale.
62.50
16 Payment of 2009 property taxes for 130 Conodogulnet property.
488.88
17 Payment of Insuroncs on Cadillac DeVllle from December 2008 through March 2008,
182.00
18 PPL Electric -payment of March electric 6111130 Conodogulnst Avenus property, 62.84
18 PPL Electric - payment of April electric 6111130 Conodogulnet Avenue property,
63.83
20 PPL Electric - payment of December electric 6111130 Conodogulnst Avenus
Property 84.82
21 PPL Electric . payment of January elecWc b1111S0 Conodogulnst Avenue properly
22 .
PPL Electric -payment of February electric bill 130 Conodogulnet Avenus property 84~
23 .
Shipley Oil -payment of December oil bill for 130 Conodogulnst property, 85.00
24
Shipley OII - payment of January oil 6111 for 130 Conodogulnet
ro
t 170.00
p
per
y
170.00
25 Shlpisy OII - payment of February oil bill for 130 Conodoguinst property,
26
8ovsrolgn Bank - Penahy fee for rotumsd pensbn check. 170.00
27
York Waste Disposal -fee Tor removal oT fresh from 130 C 10.00
onodogulnet properly.
830.38
H-B7 SutROfal
Copyright (c) 2002 form software ony The Lackner Group, Ine.
Forth PA.7800 Schedub H (Rev. 6.98)
nw-uu e%. teas)
CCIRADNNEALTN ~ rENNanvANu
WIIERRANCE TAX RETURN
REEEIENT DECEDENT
ESTATE OF
SCHED!/LE /
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8e LIENS
Lindermann, Elizabeth J.
R~nnDee WxnmDU..a Rleaw a,Re,ree,
ITEM
NUMBER
DESCRIPTION
1 I Advantra .payment for decadence hwkh Insurance.
2 Chaw Mortgage . payment of decedents oubtanding home equky loan.
3 Chaw Mortgage _ Payment of decedents outstanding horns equity loan.
4 Chew Mortgage - payment of decedent's outstanding home squky loan.
5 Chaw Mortgage - payment of decedents outstanding home equky loan.
6 I Comcast Cable -Payment of decedent's final cabb bill.
7 I Cordla -payment of decedent's final phone bill.
ILE NUMBER
21-08-10x0
VALUE AT DATE
OF DEATH
sa.oo
336.73
356.73
356.73
356.73
10.00
8 CnMk First, N.A. - payoff of decedent's Firestone crodk card account number
662980250.
9 Credk First, N.A. - payment on decedents Firestone credk card.
10 Crodk First, N.A. - payment on decedent's Firestone cmdk card.
11 Cumberland County - Wyment of 2008 property taxes for 130 Conodogulnet
property.
72 Hoy Spirit Hospkal -payment for services provided prior to death.
13 PA American Water -payment of dscedsMy final water bill.
14 Penn CnMk -payment of decedents 2008 per capita tax.
15 PPL EhrcMc - payment of decedent's Mal ehtctrlc bill.
1 B Shipley OII -payment of decedent's final oil 6111.
Total of CorltlnuaUOn Schedule
TOTAL (Also enter on Line 70, Recapltulatlonl
CoPYd9ht (c) 2002 form software ony The Laeknerup nleedad, aadmorwi papas of the serrre sue)
50.00
852.29
60.00
80.00
513.32
50.00
90.00
36.00
156.00
340.00
See athchexl papa
3,393.63
Form PA-7600 Schedule I (Rev. 6-96)
COMMONWEgL77{ OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
I.
SCHEDULE J
BENEFICIARIES
I FILE NUMBER
21-09-1090
SHARE OF ESTATE AMOUNT OF ESTATE
(woma) (ssa)
Gall M. DaNy
X02 Good Lans Dau hbr
g One~hird of
Pktsburgh, PA 15237 rosldw
Suzanne B. Lindertnann
OS Vlns Drive Daughter One-third of
Carlble, PA 17015 residua
Warron R. Lindermann II Son
20 Maln Street One-third o1
Dover, PA 17315 residue
nano, EIL:absfh J.
PERSON(Sj RECEIDVMG PROPERTY
~tions shown above on lines 15 throw h 18, as a pro riateTon~Rev 150
IS:
UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
....,,n ~a~~~ kk:) ckw[ roan sOltware ony The Lackner Group, Inc.
Form PA-1600 Schedule J (Rev. 8.98)
LAST WILL AND TESTAMENT
of
ELIZABETH ~T.
LINDERMANN
I, Ellaabeffi J. Lindermann, of Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and declare the following as and for
my Last Will and Testament, hereby revoking and making void any and all Wills and Testaments or
writings in the nature thereof by me at any time heretofore made.
ITEM L I direct that all my just debts and funeral expenses shall be paid from my residuary
estate, as soon as practicable after my decease as an expense of the administration of my estate.
ITEM II. I give and bequeath all the rest, residue and remainder of my estate, real, personal
or mixed, and wherever situated, which I may own or have the right to dispose of at the time of my
death, to my three children, Warren R. Lindermann, II, Suzanne B. Lindermann, and Gail M. Daley,
in equal shares, per stirpes.
ITEM III. I direct that all state and federal estate, succession, legacy, inheritance or other
transfer taxes, however designated, that shall become payable by reason of my death with respect to
anY PmPertY which is included in my estate for purposes of computing any such taxes, shall be paid
from my residuary estate as an expense of administration and without apportionment. My
Executors shall have no duty or obligation to obtain reimbursement for any such tax paid by them
even though on proceeds of insurance or other property not passing under this Will.
ITEM IV. I appoint my son, Warren R. Lindermann, II, Executor of this my Last Wil] and
Testament. In the event that he cannot or does not desire to act as such Executor, then I appoint my
daughter, Suzanne B. Lindermann, to serve in his place and stead. I direct that my
executor/executrix(s) enlist the services of the law firm of Blakey, Yost, Bupp & Rausch, LLp to
serve as counsel for my estate. All shall serve without bond.
IN WITNESS WHEREOF, I have hereunto set my signature to this my Will this ~ day
of 200.
.r
El' ~eth J. indermann
Signed, sealed, published and declared by the above-named Testatrix, Elizabeth J.
Lindermann, as and for her Last Will and Testament, in the presence of us, who, at her request, in
her presence and in the presence of each other, al being present at s e tim ,have hereunto
subscribed our names as witnesses.
~,` I`
`~
2
Commonwealth of Pennsylvania
County of York ss.
I, Elizabeth J. Lindermann, the Testatrix whose name is signed to the attached or foregoing
Last Will and Testament, having been duly qualified according to law, do hereby acknowledge that
I signed and executed my Last Will and Testament; that I signed it willingly, and that I signed it as
my free and voluntary act for the purposes therein expre~ ,
~ ~~
Sworn and subscribed to Elizabe .Lin ermann
before me this ~ (L day
of ~)l,,a 200.
~ ~.
Notary Public
Commonwealth of Pennsylvania
County of York ss.
OMMONWEALTH OF PENNSYLVANIA
JaimeeL No1er(el Seal
Wes, Notary Public
cay or vork, vark Cainly
MY Consnission Expires Jan. 27, 2010
Member, Pennsylvania Association of Notaries
We the undersigned witnesses whose names are signed to the attached or foregoing Last
Will and Testament, being duly qualified according to law, do depose and say that we were present
and saw the Testatrix sign and execute her Last Will and Testament, that the said Testatrix signed
willingly and that she executed it as her &ee and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the
best of our knowledge the Testatrix was at that time eighteen or more years or age, of sound mind
and under no constraint or undue influence.
~~ ~~.~
Sworn and subscribed to
before me this ~~y
of 200 ~.
r
Notary Public
COMMONWEALTH OF PENNSYLVANIA
Jaimee l_. ~~Seaf
M City Ol York~York any bM
Y Commission EW~es Jan. 27, 2010
Member, Perms: y: ~,,;.,i~ a,,~.rcfatlon of Notarlee
3
A. Settlement Statement
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Estate Valuation
Estate Account: 2135-8503
Date of Death: 11/03/2008 Estate of: Elizabeth Lindermann
Valuation Date: 11/03/2008
Processing Date: 11/20/2008 Account: 7319-3514
Report Type: Date of Death
Number of Securities: 3
File ID: Elizabeth Lindermann DOD110308
Shares Security Mean &/or Div & Int Security
or Par Description High/Ask Low/Bid Adj~ments Accruals 'Value
1) 17869.41 CASH (CASH)
17,869.41
2) 200 ALTRIA GROUP INC (022095103; MO)
COM
New York Stock Exchange
11/03/2008 19.39000 18.94000 H/L
19.165000 3,633.00
3) 186 AMERICAN CAP LTD (024937104; ACAS)
COM
NASDAQ - Industrial
11/03/2008 14.75000 13.64000 H/L
14.195000 2,640.27
Total Value:
Total Accrual: $24,342.68
Total: $24,342.68 $O.UO
Page 1
This report was produced with EatateVal, a product of Estate Valuations &
Pricing Systems, Inc. Janney Montgomery Scott LLC assumes no responsibility for
accuracy or completeness of the information provided, the Date of Death and the
specific securities, which are valued. While we deem this information to be
reliable, we do not warranty or guarantee its accuracy. This service is not
intended to constitute legal or tax advice. You should consult with your tax
professional and attorney to discuss estate settlement and any legal matters.
07/23/2009 THU 1d: 69 FAX
IQJ90!/003
Sovereign Bank
ESTATE OF Elizabeth J Lindennann
SOCIAL SECURITY #: 102-12-8300
DATE OF DEATH: November 3, 2008
Account #: 2331023913 Type: Checkin
~ Open date: 9/5/2001
In the name of: Elizabeth J Lindermann or Warren R Lindetmann II or Suzanne B Lindermann
Date of Death Balance: $1,969.67
Int.(YTA) from 1/1/2008 to 10/11/2008 $1.19
Accrued interest to date of death: $0,01
Otherlnfo:
Account#: 9857229067 Type: Savings Open date: 3/25/2006
In the name of; Elizabeth J Lindermann d
Date of Death Balance: $142.90
Int,(YTD) from 1/1/2008 to 10/31/2008 $10.54
Accrued interest to date of death; $0.00
Otherlnfo:
Page 1 of 1
Metropolitan Life Insurance Company
P.O. Box 10342
Des Moines IA 50306-0342
MetLife
of Value of Annuit Contract
ddress of Insurance Company
Metropolitan Life Insurance Company, One Madison Avenue, New York, NY 10010
2. Name of Annuitant 3. Date of Annuitant's Death
ELIZABETH LINDERMANN 11103/2008 4• Annuitant's Soy
5. Contract Number 102 12 8300
6. Type of Annuity 7. Date of Issue
007080118AB NONQUALIFIED
8. Owner's Name 08/01/1986
(Attach copy of Application) 9. Assignee's Name 10. Date As
(Attach copy of assignment)
ELIZABETH LINDERMANN N/A
ESTATE OF ELIZABETH LINDERMANN -WARREN LINDERMANN II, EXECUTOR
12. Description of Contract
NONOUALIFIED TAX DEFERRED ANNUITY
13. Value of annuity contract on date of riParn of e......;..._.
$17,298.83. This represents the death benefit as follows:
Accumulation Value on Date of Death $17,280.03
Cost Basis/Return of Payments $5,136.323
Interest
Total Payout $12,162.51
$17,298.83
X ~ See Remarks
The death claim proceeds were paid on November 14, 2008.
16. Date of Certific
July 17, 2009
Annuity Representative -Post Issue Processing
®NATIONAL
~~ WESTERN
LIFE INSURANCE COMPANY
July 16, 2009
BLAKEY, YOST, BUPP & BAUSCH, LLP
Attn: Jaimee L. Wallerius
17 E Market St.
York, PA 17401
Insured/Owner: Elizabeth J. Lindermann, deceased
Policy Number: 0101 1 145 10
Deaz Ms. Wallerius:
The above referenced policy was issued to Elizabeth Lindermann as anon-qualified
annuity.
The annuity certificate value as of November 3, 2008 was $16,290.71
The full certificate value of $16,290.71 was paid to the Estate of Elizabeth J.
Lindermann, in care of Warren Lindermann II, Executor, on 3-9-09.
If we can be of further assistance, please let us know.
Cordially,
~~~~~~~
Dazlene Childress
Claims Auditor
POLICY BENEFIT DEPARTMENT
850 EAST ANDERSON LANE AUSTIN, 7EXA5 78752-1602 512-836-1010
AUTOMATED VO1CE RESPONSE TOLL-FREE 888-695-5001 WATS 800-531-5442
CLIENT SERVICES DIREC7 WATS LINE 800-922-9422 CLAIMS 800-531-5442
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