HomeMy WebLinkAbout08-20-091505607120
REV-1500 EX (06-OS) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes count' coda veer File Number
Po Box.zaosot INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 9' 0 0 9 5
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
174 34 9451 O1 04 2009 02 29 1916
Decedent's Last Name
KOONTZ
Suffix Decedent's First Name
INEZ
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
MI
J
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Return (date of tleath
pdor to 12-13-a2)
4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Retum Requiretl
(data or deaN aner 12-12-82)
g. Decedent Dietl Testate
(Anech Copy of NAII) ~ T Decedent Maintained a Living Trust 0 9. Total NUmbef Of Safe De Sit BDxee
(Anech Copy m Trvet) ~
9. Litigation Proceeds Receivetl ~ 10. Spousal Poverty Cretlil Idete or deem ~ 11. Election to tax under Sec. 9113(A)
between 1231-91 and 1-1-95) (Aaach Sth. O)
CORRESPONDENT • THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD 8E DIRECTED TO:
Name Daytime Telephone Number
EDMUND G. MYERS (717) 761 4540
Firm Name (If Applicable)
JOHNSON DUFFIE
First line of address
301 MARKET STREET
Second line of address
PO BOX 109
City or Post Office State ZIP Code
LEMOYNE PA 17043
rv
REGISTER O~ NAMIDLS USE SLY
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DA~E FILED
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Correspondent's e-mail address: egm~JdSW.COm
Under penaldea of perjury, I tledare that I have examined this return, InGutlingg accompanying schetlulea and statements, and to the best of my knowledge antl belief
it is true, correct and complete. Declaretion of preparer other than the personal representative is based on all information of which preparer has any knowledge.
5
,.
'~
SIGNATU~-QF RESP SIBL PILING RETURN ~ D; TE/~
(/ ' Gene C. KOONTZ L//18
ADDRESS
813 Michigan Avenue, Lemoyne, PA 17043
SIGNATUR~E P~REPAREnR OTHER THAN^REPRESENTATIVE DATE
Y ~,~7fK EDMUND G. MYERS ~~~pg
ADDRESS
301 MARKET STREET, LEMOYNE, PA 17043
Side 1
1505607120 1505607120 J `
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1505607220
REV-1500 EX
Decedent's Social Security Number
o...d.m~.N.m.: INEZ J. KOONTZ 174 34 9451
RECAPITULATION
1. Real Estate (Schedule A) ..................................................................................... ..... 1.
2. Stocks and Bonds (Schedule B) ........................................................................... .... 2. 2 4 8, 7 3 3. 3 3
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... . 3.
4. Mortgages & Notes Receivable (Schedule D) ....................................................... ... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .............. .. 5. 8 8 , 6 8 3 . 8 7
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested ............. 7,
B. Total Gross Assets (total Lines 1-7) ...................................................................
-- .... 8. 3 3 7, 4 1 7. 2 0
9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... ... 9. 1 8 , 4 7 0 . 1 1
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. .. 10. 2 , 5 2 0 . 5 0
11. Total Deductions (total Lines 9 8 10) .................................................................. ....11, 2 0, 9 9 0. 6 1
12. Net Value of Estate (Line 8 minus Lina 11) ......................................................... ....12. 3 1 6 , 4 2 6 . 5 9
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............................................... .. 13.
14. Net Value Sub}ect to Tax (Line 12 minus Line 13) .............................................. ... 14. 3 1 6 , 4 2 6 . 5 9
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.z> x .o0 0. 0 0 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate x .045 316 , 4 2 6. 5 9 i6. 14 , 2 3 9. 2 0
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17~ 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 18. 0. 0 0
1s. Tax Due ................................................................................................................ .. >s. 14 , 2 3 9 . 2 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
1505607220 1505607220 J
REV-1500 EX Page 3
Decedent's Complete Address:
Flle Number 21-08-0085
DECEDENT'S NAME
INEZ J. KOONTZ _
STREET ADDRESS
5225 Wilson Lane
CITY
Mechanicsburg STATE
PA ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 14,239.20
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 10,000.00
c. Discount 526.32
Total Credhs (A+g+C) (2) 10,526.32
3. Interest/Penalty if applicable
p, 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. (4)
Check box on Page 2 Llne 20 to roquest a refund
5. If Line 1 + Line 3 is greater than Line 2, enter tho difference. This is the TAX DUE. (5) 3, 71 2.88
A. Enter the interest on the tax due. (5A)
g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 3, 7 ~ 2.88
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :.................................................................................^ [x]
b. retain the right to designate who shall use the property transferred or its income :.................................... ^ [x_~I
c. retain a reversionary interest; or ................................................................................................................^
d. receive the promise for life of either payments, benefits or care? .............................................................^ 0
2. If death occuned after December 12, 1962, did decedent transfer property within one year of death without
receiving adequate consideration? .....................................................................................................................^L~
3. Did decedent own an "in trust for" a payable upon death bank account or security at his or her death?......... ^__ 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
,--
contains abeneficiary designation? ..........................................................__.....................................................U x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is three (3} percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero
(0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not 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 benefciaries is four and one-half (4.5) percent,
except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-760J EX~ )e-t/0)
COMMONWEALTH OF PENN6YLVRNM
INHERITRNCE TN( REIDRN
REBIOENr OECEpENT
SCHEDULE B
STOCKS 8 BONDS
ESTATE OF FILE NUMBER
KOONTZ, INEZ J. 21-08-0095
All propsry )olnllyownatl wlih right o/ survivonhlp mu6t bs Ebelo~b on Schstluls F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 19,727.003 shares of Delaware Tax Free Pennsylvania 7.15 141,048.07
Fund A
M8T Securities Brokerage Account Account No.
ACZ-235738
2 087873703 123.9 shares of Bond Fund American Inc -Com 10.73 1,329.45
3 740193703 121.891 shares of Capital Income Builders Fund - 41.98 5,108.59
Shares Ben Interest
4 463320103 149.855 shares of Income Fund American Inc -Com 13.17 1,973.59
5 12,047.771 shares of Pioneer Tax Free Income Fund 8.24 99,273.83
TOTAL (Also enter on Line 2, Recapitulation) 248,733.33
m more spew Is neepec, apartlonal papea or Ine same sae)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98)
Rev-7808 El(+ (e-88)
COMMONwEALTN OF PENN6YLVANIq
INHERITANCE Tq%RETURN
RE61DENi DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
KOONTZ, INEZ J. 21-09-0085
Include the Pmcsetls o! IttiOetion antl the tlate the prxsetle were received Dy the estate.
All property joln8y-owned wAM the fight of sunivonhip must lro disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Cash 33.53
2 M&T Bank Certificate of Deposit Account No. 31003911470357 80,130.18
3 M&T Select Account with Interest Account No. 210708 27,088.16
4 PNC Bank Savings Account No. 50-0378-3308 784.16
5 Bedford Grange Mutual Insurance Co. -Return of Premium for Policy HO-7012286 56.00
6 IRS -Refund received on 2008 Individual Income Tax Return 78.00
7 Pennsylvania Department of Revenue -Refund received on 2008 Individual Income 226.00
Tax Return
8 Professional Insurance Services, Inc. -Refund for Dental and Vision Insurance 181.20
9 PSERS -Final distribution of pension paid to the Estate 115.83
TOTAL (Also enter on Line 5, Recapitulation) I 88,883.87
(I! more space is needed, adtlltional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule E (Rev. 6-98)
REV-itbt Ex+112-98)
COMINMENR ACE T~RETURN~~
RESa~N7 DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
KOONTZ, INEZ J. 21A9-0095
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A, FUNERAL EXPENSES:
See continuation schedule(s) attached
9,830.68
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Secudty Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zlp
Year(s) Commission paid
2. Attorney's Fees JOHNSON DUFFIE 7,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 364.00
5. Accountant's Fees
6. Tax Return Preparer's Fees 300.00
i. Other Administrative Costs 475.43
See continuation schedule(s) attached
TOTAL (Also enter on line 8, Recapitulation) 18,470.11
Copyright (c) 2002 form software only The Lackner Group, Inc. Fenn PA-7500 Schedule H (Rev. 6-9a)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
KOONTZ, INEZ J. 21-09-0085
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Bedford Cemetary 1,300.00
2 Ed's Steakhouse -Funeral Luncheon 78.80
3 Louis Geisel Funeral Home 8,304.08
4 Rev. Joseph Puleo -Honorarium For Funeral Service 150.00
H-A Subtotal 9,830.68
Other Administrative Costs
5 Cumberland County Register of Wills Office -Filing Fees for Inheritance Tax and 30.00
Inventory
6 Postage 8.40
7 Reserves: Additional Administrative Costa 200.00
8 The Cumberland Law Journal -Notice of Estate Administration 75.00
8 The Patriot News -Notice of Estate Administration 152.03
H-BT subtotal 475.43
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule H (Rev. 6-96)
Rav-1613 EX~ (8-69)
COMMONNFALTH OF PENNSYLVANIA
INHERITANCE TA%RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
KOONTZ, INEZ J. 21-09-0095
Inclutls unrolmburoatl m~tlleM axpenw~.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 Bethany Skilled Nursing -Room Fees for January and December Expenses 1,371.80
2 Bonnie K. Miller, Treasurer - 2009 Personal Taxes g,gp
3 Clem A. Ciccarelli, MD. -Physician Invoice 47.82
4 Continuing RX Care -Prescriptions for December 2008 122.58
5 Hampden Physician Associates -Remaining Doctor Bills 42.02
8 M&T Select Account with Interest Account No. 210708 -Expense to M&T Securities 1.80
Account
7 PA Department of Revenue -Estimated Payment 140.00
8 West Shore EMS-ALS 7g4,gg
TOTAL (Also enter on Line 10, Recapitulation) I 2,520.50
(If more space is neetle4 additional pages o/the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7600 Schedule I (Rev. 6-98)
REV-1613 E%* 19-00) ~
SCHEDULE J
COM WHERW TANCE TA%RETURNANw BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
KOONTZ, INEZ J. 21-09-0085
NUMBER NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO
DECEDENT SHARE OF ESTATE
(words) AMOUNT OF ESTATE
($$$)
Do Not LI~1 Tru~bs
I TAXABLE DISTRIBUTIONS [include outright s ousel
distributions and transfers
under Sec. $116(a)(7.2)]
Clara Ann Bretton Daughter 105,475.53
2149 Raby Road
East Lansing, MI 48823
Gene Koontz Son 105,475.53
813 Michigan Avenue
Lemoyne, PA 17043
Howard J Koontz Grandson 52,737.77
3445 Duncan Bridge Drive
Buford, GA 30519
Susannah Koontz Webb Granddaughter 52,737.77
4011 Turnberry Circle
Houston, TX 77025
Total 316,428.80
Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 7500 rov er sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 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-7500 COVER SHEE 0.00
Copyright (c) 2002 form software only The Laekner Group, Inc. Form PA-7600 Schedule J (Rev. 6-98)
ESTATE OF INEZ J. KOONTZ
CHEDULE OF EXHIBITS
EXHIBITA Copy of Decedent's Last Will and Testament signed and dated on
the 4`h day of June, 2001.
EXHIBIT B Delaware Tax Free -Pennsylvania Fund A -Date of Death
Valuation
EXHIBIT C M&T Securities Brokerage Account
A. Bond Fund American, Inc.
B. Capital Income Builders Fund
C. Income Fund American, Inc.
EXHIBIT D Pioneer Tax Free Income Fund
EXHIBIT E M&T Bank Date of Death Letter
EXHIBIT F PNC Bank Date of Death Letter
:374539
EXHIBIT A
Last Will and Testament
I, Inez J. Koontz, of the Township of Bedford, Bedford County, Pennsylvania, hereby
declare the following to be my Last Will and Testament, hereby revoking all other wills and
codicils heretofore made by me.
ARTICLE I: I direct that my debts, the expenses of my last illness and funeral, and
the costs of administration of my estate be paid from the principal of my residuary estate as
soon as may be reasonably practicable after my death.
ARTICLE LT: I give and bequeath .such items of my tangible personal property as
are set forth and described in a written Memorandum signed by me and to be found with
my valuable papers to the persons named as the recipients thereof in such Memorandum.
ARTICLE III: I give, devise and bequeath the rest, residue and remainder of my
estate, of whatsoever nature and wheresoever sifuate, in three equal shares, share and share
alike ,as follows:
A. An undivided one-third (1/3) share to the children of my deceased son,
Joseph C. Koontz, who axe Susannah Koontz and Howard J. Koontz, in equal shares
between them, share and share;
B. An undivided one-third (1/3) share to my daughter, Clara Ann Bratton; and
C. An undivided one-third (1/3) share to my son, Gene C. Koontz.
ARTICLE IV: Tn the event anV of said residuary beneficiaries should predecease m e
leaving issue to survive him or her, then the share of such beneficiary shall pass to his or her
issue per stirpes and in the event any of said beneficiaries should predecease me without
leaving issue to survive him or her, then such share shall lapse and shall pass to the other
residuary beneficiaries hereunder in proportion to their respective shares or interests in the
residue.
ARTICLE V: No interest in income or principal shall be assignable by a beneficiary
or available to anyone having a claim against a beneficiary before actual payment or
distribution to the beneficiary.
ARTICLE VI: I appoint my son, Gene C. Koontz, executor under this Will. In the
event of his death, adjudication of legal incapacity or unwillingness to so serve for any
reason whatsoever, I appoint my daughter, Clara Ann Bratton, executrix under this Will.
No fiduciary acting hereunder shall be required to give bond or other security for the
faithful performance of his or her duties. Any fiduciary under this Will shall have the
following discretionary powers in addition to those given bV law:
A. To accept, retain and invest in real or personal property, without restriction
to legal investments.
B. To sell, exchange, partition or lease for any period of time any real or personal
property and to give options therefor #or cash or credit, with or without security.
C. To borrow money and to mortgage or pledge any real or personal property.
D. To compromise, arbitrate or abandon claims.
E. To make distribution in cash or in kind or partly in each.
F. To make such elections, decisions, concessions and settlements in connection
with all income, estate, inheritance, gift or other tax returns and the payment of such taxes,
>t the distributive share of income or principal of any person
C
fiate'fiaxes; inheritance taxes, transfer taxes and other taxes of a
~..,: - ~ ..E , ,:. -, . .
sr. i ar na a payable by reason of my death to any government or subdivision thereof
upon or with respect to any property subject to any such tax shall be paid by my executor
out of the principal of my residuary estate and all interest with respect to any such taxes
shall be paid by my executor out of the income or principal or partly out of the income and
partly out of the principal of such portion of my estate, in the absolute discretion of my
-2-
executor, without reimbursement from or apportionment among the beneficiaries, recipients
or owners of such property for any such taxes or interest.
IN WITNESS WHEREOF, I, Inez J. Koontz, have hereunto set my hand and seal this
~ ~ day of June, 2001.
(SEAL)
<o ntz
The foregoing instrument, consisting of this page and two others, was on the date and
day thereof, SIGNED, SEALED, PUBLISHED and DECLARED by Inez J. Koontz, the
Testatrix, as and for her Last WiII and Testament, in the presence of us, who, at her request
and in her presence and in the presence of each other, have hereunto subscribed our names
as witnesses.
Address: 6 llt7y~ ~7~. (' ~i& TYILV (d.G/
-3-
AddresseZoa W%rh.~ ,~.
Commonwealth of Pennsylvania
County of Bedford
AFFIDAVIT
SS:
W e. Inez J. Koontz, the Testatrix in, and L/ ~` /K`v~ ~ /~
and ~ /~ ~~ /'//1/1.se~ ,the witnesses to, the attached or foregoing instrument,
who have signed the same, having been duly qualified according to law, do depose and say:
(a) that I, the Testatrix, do hereby acknowledge that I signed and executed the
instrument as my last Will, that I signed it willingly and as my free and voluntary act for the
purposes therein expressed; and
(b) that we, the witnesses, were present and saw the Testatrix sign and execute the
instrument as her last Will, that he signed it willingly and executed it as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of
the Testatrix signed the Will as a witness and that to the best of our knowledge the Testatrix
was at that time 18 or more years of age, of sound mind and under no constraint or undue
influence.
ez J ~ iCCoontz
t`k~r ~ff~~'° .ca "s~°.~,n~. ~`~ ~ ~~O~C,fil/ c ~ PA
Wi ess
Sworn to or affirmed and acknowledged before me by Inez J. Koontz, the Testatrix, and
sworn to or affirmed and subscribed to by C~/rF ~ ycrc ~' ~ and
Q HIV ~~'(2(,lS~.~ ,witnesses, this '~ ~ day of June, 2001.
~~ V
~-NOTARIAL SEAL N tary Public
TAMMY L. IASURE, NOTARY PUBLIC
BEDFORD BOROUGH, BEDFORD CO., PA
IdY COMMISSION EXPIREB AUCi,18, 2091 •' -
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Vision -Account Value by Date
Page 1 of 1
Sign Out Contact 1
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Client List Client Households Recent Transactions
Clients > Client Accountr > Accoun[ De[afls
Assets & Prices
Account Value by Date
11C1`dt]~'~ Account #: 5077056470
TTom„.~rp c~v.~t}m~°~r~~~}yc.._
lily li.7 LJ.11411W BSN: 50593105
Tax ID/SSN: 174-34-9451
A,.r~r,y„duwwFasr. Registration: INEZd KOONTZ
813 MICHIGAN AVE
Statements LEMOYNE PA 17043-1207
Phone a:
Statements -Day: (717) 737-5396
- Evening: (717) 737-5396
Maintenance view client Acc ounts
Auto Agreements
Enter a price date to retrieve an account value from a previous day.
Details
Acct Overview Price Date: 01/04/2009
Acct Value by Date
Transaction Nistory Current Price Date: 02/20/2009 Price Date:
Maintenance Nistory Current Net Asset Value: $7.4600 Net Asset Value:
Back-End Sales Current Total Shares: 19,684.2180 Total Shares:
Charge Calculator Current Value: $148,336.27 Value:
Au P ha
Bank Information
2008 Tax Summary Too of oaoe
X009 Tax Summary
Breakpoint Center:
_Riohtr of
Accumulation
Mgmt Co: DELAWARE INVESTMENTS
Fund Name: TAX-FREE PENNSYLVANIA FUND A
View Fund De ails
Fund Code: 7
Ticker: DELIX Total Shares: 19,884.2180
CUSIP: 233216100 Aeeount Value: 5148,336.27
Account Type: 02 -INDIVIDUAL
01 /02/2009
$7.1500
19,727.0030
$141,048.07
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EXHIBIT C
American Funds -Historical Prices
~:~il~f`r1G8ii 1'IiT1C~S
Historical Prices
The Bond Fund of AmericaSM - Class A shares
(began operations: May 28, 1974)
View the fund's results oraoh.
Page 1 of 4
https://www.americanfunds. com/filnds/historical/prices.htm?fundGroupNumbel=8&fundC... 2/16/2009
American Funds -Historical Prices
Page 2 of 4
January 2009
Prices are at NAV Legend
Sun Mon Tue Wed Thu Fri Sat
DX ' dividend ex-d a ',
1 21 3
DR I dividend reinvest date
- 10.72
i CX ' capital gain ex-date
4 5 6 7 8' 9 10
CR ' capital gain reinvest
10.73 10.80 10.85 10.87 10.90 i ' date
blue , stock solit ratio
11 12 13' 14 25 16 i7
10.92 10.91 10.93 10.91 10.90 black ' net asset value
18 19 20 21 22 Z3 24'
- 10.84 10.78 10.74 10.72
DX DR
25 2G 27 28 29 30 3],
10.72 10.76 10.76 10.72 10.73
Income Cap
Dividend Gain Reinvest Reinvest
Ex-Date ($)' (fi)t NAV ($) Date
01/23/2009 ' Special: Short 10 .72 01/23/2009
0.0000000 term:
0.000
Regular:
0.0280000 Long
term:
0.000
The calendar displays the daily prices (net asset value or NAV) for the history of the fund's Class A
shares.
NAV for A shares is the amount per share you would receive if you sold shares that day.
To determine an account value, multiply the total shares owned by the NAV price for that day.
If you need the purchase price for a particular date, please call Shareholder Services.
Since the fund's dividends are declared and credited daily, the amount paid to each shareholder is
https://vvww. americanfunds.com/funds/historical/prices.htm?fundGroupNumber=8&fundC... 2/ 16/2009
American Funds -Detailed Fund Information -The Bond Fund of America -Class A
~ml=rican Iaunds`
Detailed Fund Information
The Bond Fund of Americas" (bond fund)
Class A shares
-- -_ _
Updated February 13, 2009, 3:03PM Pacific time I
Net Asset Value (NAV) $ 10.72
NAV Change $ -0.06 I
Maximum Offering Price (MOP) $ 11.14
(All prices are subject to revision.)
i __ _ ;
Fund Number
Ticker/Quotron Symbol
Newspaper Abbreviation
CUSIP Number
Page 1 of 5
08_
ABNDX
BondA
097873 30 3
Also on this page: R~St~rns_r?s.Ex-en_5€s I Hol in I Portfolio Counselors '',
Fund Description
Fund Objective Seeks to provide as high a level of current income as is consistent with
preservation of capital.
Distinguishing One of the most broadly diversified fixed-income funds available, giving the
Characteristics fund's managers great flexibility in responding to bond market conditions.
Types of Invests in corporate debt securities, U.S. and other government securities,
Investments mortgage-related securities and cash.
Non-US. .May invest up to 25% of assets in fixed-income securities of corporations and
Holdings government entities outside the United States.
Maturity .Typically, the fund will be invested in intermediate- to long-term securities.
Portfolio The fund generally invests at least 80% of its assets in bonds, including corporate
Restrictions bonds, U.S. government securities and money market instruments. At least 60% '
of its assets will be invested in securities rated A or better at the time of
purchase. The fund may invest up to 40% of assets in lower-rated bonds. It is the
fund's current practice not to invest more than 15% of its assets in debt
securities rated Ba and BB or below.
Fund Facts Related Materials
Minimum Initial Investment $250 • Prospectus (PDF)
• Statement of additional information (PDF)
Shareholder Accounts (aggregated 2,155,457 • Annual report (PDF)
for all share classes; updated monthly) • Semi-annual report (PDF)
https://www.americanfunds.com/funds/details.htm?fundNumbet=8 2/16/2009
American Funds -Historical Prices
:'~I~1P,t'EGaTI 1'Ul1t~S~
Historical Prices
Page 1 of 2
apital Income Builder Class A shares
ra ions: July 30, 1987)
View the fund's results gra~Jh.
January 2009
arices are at Nnv Legend
Sun Mon Tue Wed Thu Fri Sat
DX dividend ex-date
I' 2' 3 _
DR dividend reinvest date
- 42.13
CX ' capital gain ex-date ',
4 5 6 7 8 9 to
CR capital gain reinvest
41.98 42.08 41.66 41.81 41.18 date
blue ', stock split ratio
11 i2 13 14 - 1,5 ' 16 17 ' ''
40.74 40.44 39.72 39.65 39.84 black ' net asset value
18 Z 9 7.0 21 ' 22 23 , 24
- 38.57 39.29 38.83 38.92
25 ' 26 27 ' 28 29 ' 30 3i ''
39.23 39.51 40.05 39.24 38.88
The calendar displays the daily prices (net asset value or NAV) for the history of the fund's Class A
shares.
NAV for A shares is the amount per share you would receive if you sold shares that day.
To determine an account value, multiply the total shares owned by the NAV price for that day.
If you need the purchase price for a particular date, please call Shareholder Services.
To see the price history for another fund, choose the fund name, share class, month and year. Then click
the "Show prices" button below.
. ! 2. Ghoose a date ~ ..
https://www. americanfunds.com/funds/historical/prices.htm?fundGroupNumber=l2&fund... 2/ 16/2009
American Funds -Historical Prices
Arrl~ric~~~ l~ur~cis'k'
Historical Prices
Page I of 3
t'he,incgme Fund of America`s Class A shares
(under Capital Research Management since: December 1, 1973)
View the fund's results arch.
]anuary 2009
Prices are at NAV Legend
Sun Mon Tue Wed Thu Fri Sat DX dividend ex-date
Z 2 ; 3
DR ' dividend reinvest date
- 13.25
CX ' capital gain ex-date
R .5 6 7 8 9 ZO
CR ' capital gain reinvest
13.17 13.24 13.08 13.11 12.95 ' date
' blue stock split ratio
11 12 Z.3 14 IS 16 27
12.80 12.75 12.51 12.49 12.54:
black
net asset value
18 19 20 21 ' 22 23 ; 24 ',
- ' 12.18 12.38 12.25 12.29
25 2_C 27 28 29 30 31
12.34 12.43 12.61 12.35 12.23
The calendar displays the daily prices (net asset value or NAV) for the history of the fund's Class A
shares.
NAV for A shares is the amount per share you would receive if you sold shares that day.
To determine an account value, multiply the total shares owned by the NAV price for that day.
If you need the purchase price for a particular date, please call Shareholder Services.
Since the fund's dividends are declared and credited daily, the amount paid to each shareholder is
determined by the number of days that shares are held in the account.
https://www.americanfunds. com/funds/historical/prices.htm?fundGroupNumber-6&fundC... 2/16/2009
EXHIBIT D
p M&TSank
499 Mitchell Road, Millsboro, DE 19966 Mail Cade DE-MB-I2
Phone (886)502-4349
Fax (302)934-2955
February 20, 2009
Law Offices
Johnson Duffle
301 Market Street
P.O. Box 109
Lemoyne, Pennsylvania 17043-0109
Re: Estate of.• Inez J Koontz
Social Security: 174-34-9451
Date of Death: January 04. 2009
Dear Sir or Madam:
Per your inquiry dated February 12, 2009, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1. 7j~pe ofAccount
Account Number
Ownership (Names ofJ
Opening Date
Balance on Date of Death
Accrued Interest
Tota!
2. Type ofAccount
Account Numher
Ownership (Names on
Opening Date
Balance on Date of Death
Accrued Interest
Total
Checking Account
210708
Inez JKoontz*
//1/64
$ 27, 068.32
$ 0.84
___ _.
$ 27, 069.16
Certificate of Deposit
310039/1470357
Inez J Koontz*
4/13/92
$ 60, 000.00
$ 130.19
$ 60,130.19
Please be advised, there was no safe deposit box found for the above decedent. * If upon reviewing the information
above, you believe there are additional accounts not referenced, please provide us with an account number and/or
name of any possible joint account holder. For any additional information on the above accounts, including
ownership and any changes, closures and/or reimbursement of funds, etc, please contaM our Hartley Office # 814
623-6117.
Sincerely, ~~
J~.(rC~P 4'n"C~
Trade Hare
Adjustment Services
EXHIBIT E
Feb.2~. 2009 2:d9~M °NC 5A4'K 412-145-2747
~p~ve
t R-nu+orl+~w~-~r
February 24, 2009
Rana Wiesetnan
Johnson Duf~ie Stewart
301 Market St
PO Box 109
Lemoyne PA 17043-0109
RE: Inez J Koontz
SS'N: 174-34-9451
DOD: 01-04-2009
Dear Sir/Madam:
In response to your request for Date of Death (DOD) balances for the customer noted above, our
records show the following:
Savings Account
Account # 500378330b Established: 08-19-2002
INEZ J KOONTZ
DOD balaace: $ 794.09 + 0.07 accrued interest
Interest paid OI-O1-2009 thru 01-04-2009 $0.00 YTD
Please note that this offiAC provides date of death balances for deposit accounts (IRAs, CAs, Chocking and
Savings). We do not process any financial transactions or provide statements. If you need assistance with
any of these items, please call 1-888-PNGBANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Bank, N,A.
Member FDIC
Page 1 of 1
EXHI$IT F
Pioneer Investments: Historical Pricing
Page 1 of 1
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http://us.pioneerinvestments. com{hplGetPrice. jhtml?Usertype=SHO&FundSel=Pioneer+T... 3/18/2009