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HomeMy WebLinkAbout09-25-09 (2)15056051047 REV-1500 EX (06-05) OFFIICIAL USE ONLY PA Department of Revenue Count Code Year File Number Bureau of Individual Taxes Y Po Box 2sosot ~ INHERITANCE TAX RETURN 2 1 0 9 0 0 0 5 2 Harrisburg, PA 17128-0601 "~ ~- RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 2 0 4 0 1 2 4 5 3 0 1 0.3.2 0 0 9 0 4 2 9 1 9 1 5 Decedent's Last Name Suffix Decedent's First Narne MI W E N T Z J U L _I A A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW Spouse's First Name THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI e 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O ;i. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 t3. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 1 1. Election to tax under Sec. 9113(A) bef~veen 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number M a r 1 i n R M c C a 1 e b E s q 7 1 7 6 9 1 7~ 7 0 Firm Name (If Applicable) First line of address 2 1 9 E a s Second line of address P O B o x City or Post Office M e c h a n i t M a i n S t r e e t 2 3 0 State ZIP Code ~ _ REGISTER-Q~JILLS US~NLY "" i... <7 ' i7 ?l ,`..~ - - ~ - C-'l '> ` -- - Jj "-i1 ~ i _im. - ;) ...._ DATE FILED (~ c s b u r g P A 1 7 0 5 5 i '~ Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer iias any knowledge. S~Gt~URE OFN RE IB~E FOR FILING RETURN ~ /bATE i ADDRESS Side 1 1505605],047 15056051047 Law Offices-Marlin R. McCaleb, 219 East Main Street, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY 15056052048 REV-1500 EX Decedent's Social Security Number Julia A. Wentz 2 0 4 0 1 2 4 5 3 Decedent's Name: RECAPITULATION ............................................ 1. Real estate (Schedule A). 1 _ 0.0 0 ....................................... 2. Stocks and Bonds (Schedule B) 2. 1 5 1 2 7.4 2 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0'0 0 4. 9 9 ( ) ........................... Mort a es & Notes Receivable Schedule D 4. .. 0 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 1 8 2 1 9 7 .0 1 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. 8 6 2 2 6 •3 1 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 0 0 0 (Schedule G) O Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. 2 8 3 4 5 0 .7 4 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 2 3 0 3 9 0 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 1 0 5 5 •9 8 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 2 4 0 9 5 .0 4 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 2 5 9 3 5 5 .7 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 2 g 0 4 1 6 an election to tax has not been made (Schedule J) ...................... .. 13. • 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 2 5 6 5 5 1 • 5 4 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 ~ ~ 15. 0 0 `0 16. Amount of Line 14 taxable at lineal rate X .0 ~5 2 5 6 5 5 1• 5 4 16. 1 1 5 4 4 8 2 17. Amount of Line 14 taxable 0 0 0 at sibling rate X .12 17. 18. Amount of Line 14 taxable 0 0 0 at collateral rate X .15 • 18. . 19 l 1 5 4 4. 8 2 19. TAX DUE ...................................................... . ... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056052048 15056052048 RE~i-15'7 EX Pay? 3 File Number Decedent's Complete Address: 21 - 09 - 00052 DECEDENTS NAME Julia A. Wentz STREET ADDRESS 4905 East Trindle Road CITY STATE ZIP Mectzanicsbur PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 11, 544.82 2. CreditslPayments 0.00 A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 11, 544.82 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 11, 544.82 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 :......................................................................................... ^ ~J 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 dean without receiving adequate consideration? ............................................................................................................. ^ ^X 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ 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 beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. .~ f REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Julia A. Wentz SS~~ 204-01-2453 01/03/2009 21-09-0052 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 484 shares PPL Corporation, - common stock. 31.255 15,127.42 TOTAL (Also enter on line 'c:, Recapitulation) 15 , 127 .42 ~~~ ~~~~~~ ~Na~~ ~~ ~irrueu, insert aaaaionai sneers of the same slze) Copyright (c) 1996 form software only CPSystems, Inc.. Form REV-1503 EX (Rev. 1-97) 3 r REV-1508 EX . (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Julia A. Wentz SS~~ 204-01-2453 01/03/2009 21-09-0052 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 American Express Travelers Cheques, - five (5), each a 100.00 denomination of $20.00. 2 Members 1st FCU, Savings acct. ~~ 339960-00, - Principal balance 5.00 as of D.O.D.; no accrued interest. 3 Members 1st FCU, Certificate of Dep. acct. ~~ 339960-4(), - 50,009.45 Principal balance as of D.O.D.: $ 50,000.00; interest accrued to D.O.D.. $ 9.45. 4 Members 1st FCU, Certificate of Dep. acct. ~~ 339960-4(), - 146.51 interest check dated 01/02/2009. 5 Morgan Stanley Group Inc., - interest check dated 01/02/2009. 125.00 6 PNC Bank, Checking Acct. ~~5004997971, - Principal balance as of 2,804.10 D.O.D.: $2,803.91; interest accrued to D.O.D.: $ 0.19. 7 PNC Bank, Checking Acct. ~~5112030063, - Principal balance as of 27,360.67 D.O.D.: $ 27,349.75; interest accrued to D.O.D.: $ 10.92. 8 PNC Bank, Money Market Acct. ~~5004716893, - Principal balance as 20,234.48 of D.O.D.: $ 20,223.06; interest accrued to D.O.D.: $ 11.42. 9 PNC Bank, Certificate of Deposit Acct. ~~11020064132, ~- Principal 10,034.02 balance as of D.O.D.: $ 10,002.82; interest accrued to D.O.D.: $ 31.20. 10 PNC Bank, Certificate of Deposit Acct. ~p31100289690, ~- Principal 19,126.70 balance as of D.O.D.: $ 19,125.00; interest accrued to D.O.D.: $ 1.70. 11 PNC Bank, Certificate of Deposit Acct. ~~31100289690, -- interest 52.67 check dated 01/03/2009 for December's interest. 12 PNC Bank, Certificate of Deposit Acct. ~~ 31600313367, - Principal 12,155.90 balance as of D.O.D.: $ 12,124.66; interest accrued to D.O.D.: $ 31.24. 13 PPL Corporation, - dividend check dated 01/01/2009. 162.14 14 Central PA Conference, United Methodist Church, - promissory note 12,115.72 dated 10/31/1986; Principal balance as of D.O.D.: $12.,000.00; interest accrued to D.O.D.: $115.72. Total of Continuation Schedule(s) ~ 27.664.65 TOTAL (Also enter on line 5 Recapitulation) I3 182 , 097 Ol (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) Estate of: Julia A. Wentz Soc Sec ~~: 204-O1-2453 Date of Death: 01/03/2009 Continuation of Schedule E (Cash, Bank Deposits & Miscellaneous Personal Property) Item Description ~~ Value at Date of Death 15 Central PA Conference, United Methodist Church, - promissory noted dated 07/14/2008; Principal balance as of D.O.D.: $25,000.00; interest accrued to D.O.D.: $241.10. 16 Household goods, contents, furniture and furnishings. 17 PA Department of Revenue, - 2008 state income tax refund. 18 U. S. Treasury, - 2008 federal income tax refund. 19 U. S. Treasury, - 2008 federal income tax refund (amended return). 25,241.10 2,225.00 45.00 40.00 113.55 27,664.65 REV-1509 EX + (1-97) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Julia A. Wentz SS~~ 204-01-2453 01/03/2009 21-09-0052 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Betty Eshelman 923 Thornton Drive Daughter Mechanicsburg, PA 170'5 B. C. JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed forjointly-held real estate. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTERES' 1 A 04/29/04 Morgan Stanley Group Inc - 172,452.61 50.00% 86,226.31 Account ~~ 604-67401-45 in names of Decedent and Betty Eshelman as JTWROS, made joint on or about 04/29/2004. TOTAL (Also enter on line 6 Recapitulation) I $ 86 , 226 31 (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) REV-1511 EX i (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS "" ^ "_ "~ FILE NUMBER Julia A. Wentz SS~~ 204-O1-2453 01/03/2009 21-09-0052 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Myers-Harner Funeral Home, - funeral expense. 10,168.00 2 Rolling Green Cemetery, - grave opening. 1,345.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney's Fees Law Offices-Marlin R. McCaleb 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 4. 5. 6. 7. 1 2 3 4 5 6 Street Address City State Zip _ Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal, - advertising grant of Letters. Postmaster, - certified, insured mail, RRR, to return stock certificate Re ist f W'll h 10,500.00 360.00 75.00 14.89 g er o i s, - s ort certificate. 4.00 Register of Wills, - Short Certificate. 4.00 Register of Wills, - filing Inventory and Appraisement. 30.00 Skip's Hauling, - truck rental for hauling furniture. 225.00 Total of Continuat ion Schedule(s) 313 17 TOTAL (Also enter on line 9, Recapitulation) $ 23 , 039.06 (If more space is needed, insert additional sheets of the same size) Copyright(c)1996formsoftwareonlyCPSystems,Inc. FormREV-1511 EX (Rev.1-971 Estate of: Julia A. Wentz Soc Sec ~~: 204-01-2453 Date of Death: 01/03/2009 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Amount ~~ 7 Snoke Family Practice, - account payable, medical. 10.00 8 The Patriot-News, - advertising grant of Letters. 148.17 9 Whitcomb Tax and Financial Services, - preparation of 2008 155.00 federal and state income tax returns. -------------- 313.17 REV-1512 EX t (1-97) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INRESIDENT D EDEN RN MORTGAGE LIABILITIES, AND LIENS ESTATE OF FILE NUMBER Julia A. Wentz SS~~ 204-01-2453 01/03/2009 21-09-0052 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 FIA Card Services, - account payable, credit card bal<~nce. 68.88 2 PA Department of Revenue, - account payable, 2008 estimated 110.00 income tax. 3 Snoke Family Practice, - account payable, medical services. 27.09 4 Spirit Physician Services, - account payable, medical services. 32.92 5 U. S. Treasury, - account payable, 2008 estimated income tax. 807.00 6 Verizon, - account payable, telephone service. 10.09 TOTAL (Also enter on line 1U, Recapitulation) I$ 1 , 055.98 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 farm software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX +I9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Julia A. Wentz SS~~ 204-01-2453 01/03/2009 21-09-0052 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Lisi Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions.and transfers under Sec. 9116(a)(1.2)J 1 Betty M. Eshelman Daughter 86,226.31 923 Thornton Drive Mechanicsburg, PA 17055 2 Barry L. Eshelman Grandson 56,775.08 2338 22nd Avenue, South Seattle, WA 98144 3 Brenda M. Staab Granddaughter 56,775.08 3018 Harvard Avenue Camp Hill, PA 17011 4 Kelly Ann Staab Great-Granddaughter 56,775.07 3018 Harvard Avenue Camp Hill, PA 17011 ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON R EV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Calvary United Methodist Church, - charitable bequest per Item 3 2,804.16 of Will (PNC Bank Checking Acct. ~k5004997971, the "tithe checkin account"). TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 2 , 804.16 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group. Inc. Form REV-1513 EX (Rev. 9-00) ~Ghe '~f.a~t ~i[[ anb ~e~tament of JULIA A. WENTZ I, JULIA A. WENTZ, a/k/a Julia Ann Wentz, a/k/a Julia Ci. Wentz, of Hampden Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United States, or any state or territory thereof, or by any foreign government or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governments, whether the property passes under this will or otherwise. 3. I give and begeuath the proceeds of my "tithe checking account" to CALVARY UNITED METHODIST CHURCH, of Lemoyne to be used at its discretion. -1- 4. All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath in three (3) equal shares to the following: a.) to my granddaughter, BRENDA M. STAAB. b.) to my grandson, BARRY L. ESHELMAN c.) to my greatgranddaughter, KELLY ANN STAAB. 5. I nominate, constitute and appoint my granddaughter, BRENDA M. STAAB, to be the guardian of the estate of my greatgranddaughter if she is not of age on the date of my death, and direct that said guardian, in her sole discretion, shall apply principal as well as interest for the maintenance, education and support of her when the same is in her best interest, without the necessity of petitioning the Orphans' Court for permission to make such expenditures. I direct that said guardian shall take possession of all insurance or annuity contracts on my life to which said minor is entitled, and any and all pensions or death benefits from my employer or from any society or organization of which I am a member, said proceeds to be added to the her share under this will. No bond shall be required of the guardian to guarantee the faithful performance of his duties. 7. Lastly, I nominate, constitute and appoint my daughter, BETTY M. ESHELMAN, to be Executrice of this my Last Will and Testament and I further direct that no bond or other security be required of my her to guarantee faithful performance of their duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this~~~ay of March, 2006. ~~ ~ ~ AL) u is A. entz -2- COMMONWEALTH OF PENNSYLVANIA ) SS COUNTY OF CUMBERLAND ) I, JULIA A. WENTZ, the testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the same instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act and deed, for the purposes therein expressed. .-~ -~~ ~ (SEAL) u a entz Sworn and subscribed to before m/e~t~h~is~a3 day of March, 2006 _ _ `~h`-~-~ ~ ~~ HEIDI M. N~HSON, Notary P~tbNc Notary u is ~ Commi~ssio~n ~ -~ ]une~27ntl~~ COMMONWEALTH OF PENNSYLVANIA ) SS COUNTY OF CUMBERLAND ) We, the undersigned, Betty M. Eshelman and John M. Eakin, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and sad that we were present and saw the testatrix, JULIA A. WENTZ, sign and execute the instrument as her Last Will and Testament; that the said testatrix executed it as her free and voluntary act for the p oses therein expressed; that each of us, in the hearing and sight of the testatrix, signede Will as witnesses; and that, to the best of our knowledge, the testatrix was, at the time, eighteen (1 S) or more years of age, of sound mind, and under no Sworn and su scribed to before me th/i~s- ~a day of March, 2006. otary u is NOTARIAL SEAL HEIDI M. NELSON, Notary Pint MyGom ~~ ~ ~~ 007 -3- St MEMBERS 1St FEDERAL CREDIT DNION SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATE OF DEPOSIT• Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Estate of: JULIA WENTZ Date of Death: 01/03/2009 Social Security Number: 204-01-2453 339960-00 09/25/2008 $5.00 $.00 $5.00 None 339960-40 09/25/2008 $50, 000.00 $9.45 $50, 009.45 None MBERS 1ST FEDERAL CREDIT UNION ~-JC~~-~~ ~ ~ lC~..e~ Danielle A. Kline Insurance Services Specialist February 3, 2009 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 28:3-2328 www.memberslst.org SCHEDULE E.2,3 LING ~'H~ ~f/tlf March 2, 200.9 Marlin E Mccaleb, esq. 219 East Main St P O Box 230 Mechanicsburg, PA 17055 RE: Julia a Wentz SSN: 204-01-2453 DOD: 01-03-2009 Dear Mr. Mccaleb: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Certificate of Deposit Account # 11020064132 JULIA WENTZ DOD balance: $ 10,002.82 + 31.20 accrued interest Account # 3 1 1 00289690 JULIA A WENTZ DOD balance: $ 19,125.00 + 1.70 accrued interest Account # 31600313367 JULIA A WENTZ DOD balance: $ 12,124.66 + 31.24 accrued interest Checking Account Account # 5004997971 Established: 04-08-2008 Established: 04-03 -2006 Established: 06-06-2007 Established: 03-27-2006 JULIA A WENTZ DOD balance: $ 2,803.91 + 0.19 accrued interest - ~ Account #-5.112030063• ~ •~ ~ ~ Estal;lisheu: 03-26-2007 JULIA WENTZ DOD balance: $ 27,349.75 + 10.92 accrued interest Page 1 of 2 SCHEDULE E.6,7,8,9,10&12 Savings Account Account # 5004716893 Established: 03-27-2006 JULIA A WENTZ DOD balance: $ 20,223,06 + 11.42accrued interest Please note that this office provides date of death' balances for deposit accounts (IRAs, CDs, Checking 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-PNC-BANK (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 2 of 2 SCHEDULE E.6,7,8,9,10&12 ~tiuE X31 CEN~'RAL PENNSYL~fANIA CONFERENCE T'Hl= UNITED METHQDIST CHURCH 3 Iu1+JLBERRY DRIVE • ?.O. EtOx 2063 • MFr:NANIC58Ua~G, C-'417r~y55-2053 • TELEl:'NOhE +;71y! a5ai•52P S September 22, 2609 Attrarr;ajy Marli;i H, McCaleb Frarlkeber~er Place '? 19 East Main Street Pd Boy 234 Mec!?anicsburC PA 17055 k~e: Julia A. Wen's, beceased Dear Attorney McCaleb 7'r~is letter is in reference tG the investment account th2~t Julia A Wentz had established ar+t31 the Central Pe~~rlsylvarlia ronferenoe_ At the time of her death, January 3, 2Gn9, tl,~fl; value of her 'nvestment ~ertifica!es was Thirty-seven Thousand ~oiiars ($37,OOO.t~iJ). The interest rate on these ce~titicate~ was being paid at 5.50 percent. ~"he interest that had aaacrued firam t`1r;vember 1.2008 f,the 'asi date interest va+as paid; to January 3, 2009 ~~as $356,48. We have also done same pa'°elimirtary research as to the date the interest rate was changed from 6.50°!0 tc 5.50% ?hat rate change occurred May 1, 1593, the interest check that Mrs, Wentz received November 1, 2008 in the arnaunt of ~1,C~25.t36 was arty r~~er;~ayrr;a~nt rf interest in the amount of ~2t32,53. IVirs, 1~~entz added $25,GOO.Oq to her irlvestrrtgnt aGCAUnt on July 14, 2G08 Unfarturataly the l~ovember interest check reflected irit@r95i ol'~ tt'~at ari~ount fCr than entire E rn~:,nth period: May 7 throl.~gh Nvv~mber i . Tt-at overpayment was then deducted frrsm tf;e interest that ~n+as paid on May 1, 2005. It ig our understanding that ya;a do want ~0 Clas4' out that account. il~~1e will be happy to process that withdraws :~pc~nrBCG'I~t of the ta~+o rnv¢sttner~t Gertif+^~tes in our nifice. At that time we v'W=~l! ..ut a check fa€- ti'le ~+a!ue ~:f tide certificates but the interest that u~ouid de clue from May 1 ±o tI-+e actual data3 cf va.~ithdrauval will not be paid until November 1, 2QG9. IF *here are aCditional uesticn;?, please feel frAe to contact our officaa, ~yyyincereiy, J `~ ~ •,~ Gary A. Smith TREASVRr R GC3JIVCIL t'~N ~IN,ANCE ANC3 AC11vtINISTf~ATION SCHEDULE E.14&15 900 S. Arlington Ave., Room #119, Harrisburg, Pa. 171'09 No. 8307 OCTOBER 31. 19 86 On demand we promise to pay to the order of JULIA ~ %~ 12 , 000.00 --_ %:•^^-:TWELVE THOUSAND AND-------------------------N0~100-----•----------------Dollars Without defalcation or stay of execution, for value received, with interest at 6 . S OoJo~ p~ ~~~ waiving inquisi- tion a.nd exemption laws, and confess judgment for above sum without offset, with interest and costa of snit, and with five percent for collection fees. There is a 1% penalty on all monies not left in. the fund for a period of one year. THE CENTRAL PENNSYLVANIA CONFERENCE COMMITTEE N LOAN THE UNITED METHODIST CHURCH '~ .Attest: ~ ,,.A_._.«) by ~• ~ • = - TREA~JRT;I{, CHAIRPERSON OF TIC CO ON LOANS ® 1994 Gces 416'/ peniesad s~y61tl IIV No. 21278 of OZ46 sao~ 4661® 303 Mulberry Drive, P.O. Box 2053, Mechanicsburg, PA 17055-2053 Date JULY 14 , 2008 On demand we promise to pay to the order JULIA WENTZ 525,000.00 - ~'~~TWENTY FIVE THOUSAND AND----------------------NO/100-------------------Dollars Without defalcation or stay of execution, for value received, with interest at5.50 %, per annum, waiving inquisition and exemption laws, and confess judgment for above sum without offset, with interest and costs of suit, and with five percent for collection fees. There is a 1% penalty on all monies not left in the fund for a period of one year. THE CENTRAL PENNSYLVANIA CONFERENCE COMMITTEE ON LOANS T E UNITED METHODIST C RCH Attest: ~. • -yu./ C -'t. • !.-t~s ~ TREASURER CHAIRPERSON OF E COMMITTEE ON LOANS SCHEDULE E,14&15 Morgan Stanley March 2, 2009 Francis H. Gehman III First Vice President Financial Advisor Mr. Marlin R. McCaleb Frankeberger Place 219 East Main Street P. O. Box 230 Mechanicsburg, PA 17055 Keith J. Yanders Branch Manager Vice President FinanczalAdvisor The Gehman Yanders Group 1550 Pond Road Suite 202 Allentown, PA 18104 toll free 800 827 9077 direct 610 398 6500 fax 610 398 G057 Re: Estate of Julia Wentz Dear Mr. McCaleb: Per your request, please fmd enclosed the value of assets held in the Morgan Stanley account for the above-referenced as of the date of death, January 3, 2009. Please refer to the column titled "Adjusted Cost." Please note that this was a joint account titled "Julia Wentz & Betty Eshelman JTTEN." If you have any questions or need further information, please do not hesitate to contact our office. Sincerely, U-'V~ ~ ~9-9Y~J Nanci J. Mickel on Sr. Registered Client Service Associate NJM Enc: Gain and Loss Summary SCHEDULE F.1 Unrealized Gain and Loss ,. , Julia Wentz Home: (717) 737-9747 TIER: GOLD 4833 E TRINDLE ROAD APT 506 Mobile: MECHANICSBURG PA 17050- Business: 3652 Unrealized Gain and Loss for Year 2009 ............................................................................................ Date Unit Security Name Quantity Acquired Cost Municipal Bonds Page 1 of 2 ACCT 604-07401-45 Retail Sweep Fund BDPS ........................................................................ Total Adjusted Market G/(L) Holding Cost Cost Value Amount Period KUT2:TOWN AREA S!D 5.000 3-15-24 Long 35,000.000 1/3/09 100.15 35,308.OOP 35,051.33 35,049.00 (2.33)ADJ 2/26/09 PHILA GO BE 5.000 3-15-28 Long 15,000.000 1/3/09 101.15 15,282.OOP 15,172.08 15,170.25 (1.83)ADJ 2!26/09 S FORK AUTH-B BE 5.000 7-01-28 Long 5,000.000 1/3/09 75.49 3,774.25P 3,774.25 3,868.80 94.55ADJ 2/26/09 SHARON HLTH BE 5.000 12-01-28 Long 25,000.000 1/3!09 75.24 18,810.OOP 18,810.00 20,171.00 1,361.OOADJ 2/26/09 Total Municipal Bonds 73,174.25 72,807.66 74,259.05 1,451.39 Corporate Fixed Income CAPITAL ONE BANK 6 112 6-13-13 Long 25,000.000 1/3109 88.17 22,041.25P 22,041.25 23,181.00 1,139.75ADJ 2/26/09 FORD MOTOR CREDIT 7 114 10-25-11 Long 27,000.000 1/3/09 74.85 20,208.15P 20,208.'15 14,635.89 (5,572.26)ADJ 2/26!09 M L CAP TR 16.45 6.450 12-15-66 long 600.000 1!3/09 16.81 10,083.OOA 10,083.00 5,292.00 (4,791.00)ADJ 2/26/09 Total Corporate Fixed Income 52,332.40 52,332.40 43,108.89 (9,223.51) Certificates of Deposit DISCOVER BANK CD 5.100 3-23-09 47,000.000 113/09 100.67 47,312.55 47,312.55 47,102.46 (210.09) Long Total Certificates of Deposit 47,312.55 47,312.55 47,102.46 (210.09) GRAND TOTAL 172,819.20 172,452.61 164,470.40 (7,982.21) A -Information for this transaction reflects your requested adjustments to existing Morgan Stanley 8 Co trade history. P -You have provided the trade history for this transaction; it was not available through Morgan Stanley 8 Co records. Disclaimer: The Estimated Gain and Loss information is provided for informational purposes only and may not be relied upon in making any tax, accounting or regulatory filing or report This Estimated Gain and Loss Summary is not a substitute 1099 form (or any other appropriate tax form) and should not be filed with your clients taxes. The Total Cost, Unit Cost and Proceeds of eligible equity and options transactions with Choice Selects"' pricing do not include commissions paid on your purchases or sales and therefore may not equal the acquisition price or principal amount of the sale. The figures should be independently verified. Estimated Gain and Loss information does not take into account a taxpayers particular circumstances such as the existence of hedging transactions, constructive sales ormarked-to-market pricing adjustments on certain options held at year-end. Please note that although Morgan Stanley & Co makes every effort to adjust the cost basis for such securities' capital changes, it does not adjust the cost basis for all events, including amortization ofnon-municipal bond premiums; exercise of unlisted stock options; securities deemed to have been sold and simultaneously repurchased; receipt of cash in lieu of fractional shares; or the net effect of wash sales and/or short sales against the box. For securities not purchased through Morgan Stanley & Co, for example, securities purchased elsewhere and later transferred to it, any data included in the Estimated Gain and Loss information has been provided either by the client or another fnancaa! institution. Whether provided by the client another financial institution or Morgan Stanley & Co, it is your client's responsibility to ensure the accuracy of all of the Estimated http://ideas.msdwis.com/Secure/GainAndLosslPrintUnrealized.asp?Off ce=604&Accoun~6... 3/2/2009 SCHEDULE F.1 3~ ~~, P~- ~ ~~~