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Home My WebLink About10-30-09., or~~q i~v1 G i 1505607121 REV-1500 EX 06 0 ( - 5) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN County Code Year File Number Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 2 3 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 7 8 1 6 1 0 2 0 0 1 2 2 2 0 0 9 1 1 1 1 1 9 1 5 Decedent's Last Name Suffix Decedent's First Name MI T H O M P S O N T H E L M A E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ^X 1. Original Return 4. Limited Estate OX 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust ~ (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Rr~turn (date of death prior to 12-1382) 5. Federal Estate Tax Return Required 8. Total Numberof Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. Q) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION $HOI Name Daytime Telephone ~lurr J O S E P H M F A R R E L L 717 8 3 8 Firm Name (If Applicable) F A R R E L L A N D S M A L L First line of address 2 0 1/ 2 0 3 S R A I L R O A D Second line of address P 0 B O X 11 3 City or Post Office State P A L M Y R A p A BE DIRECTED T0: 1 3 8 5 -- --- REGISTER OF VItILLS USr~NLY n r-~ { ~ ~p ~ _. d - ~ ~--~ c ~ c~ t~~ _. S T R E ~- ~ `.- _ .. , ~,~ t~ ~ v r ~. ' i ~ ~. r h -; ~ _, DA'7~ FILED ZIP Code ' y ""' I _~ ', P ~ ___ 1 7 0 7 8 0 1 1 3 ~- ``' Correspondent's a-mail address: officena farrellandsmall.com Under penalties of perjury, I dedare that I have examined this return, including accompanying schedules and statements, and to the best of my k owledge and belief, it is true, correct and cop~glete. Dedaration of preparer other than the personal representative is based on all information of which pn:pan;r has a y knowledge c T_~sFe1F a~ u occnnuSluLE FOn nuiJG RETURN 122 LYNWOOD DRIVE PALMYRA PA 17078 SIGNATURE Q~PREPARER OTHER THAII~B,EpRESENTATIVE ~ DATA --~-~-~~ ~ I 11 l1 201/203 S• RAILROAD STREET PALMYRA PA 17078 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 150560712, J J 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: THELMA E• THOMPSON 1 7 8 1 6 1 D 2 0 RECAPITULATION 1. Real estate (Schedule A) ......................... . ~ _ 2. Stocks and Bonds (Schedule B) .................................. 2. $ 5 6 5 6 , 1 5 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ...... .............. .... 4. 1 1 8 3 8 6, 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... .... 5. 1 8 1. 8 4 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 4 0 8 2 1, 3 6 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested .... ... 7. , 8. Total Gross Assets (total Lines 1-7) .............. . . . . . . .... ... g 2 1 5 D 4 5 , 3 5 9. Funeral Expenses & Administrative Costs (Schedule H) ............. ... 9. 1 9 8 2 8 , 3 7 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ......... ... 10. 11. Total Deductions (total Lines 9& 10) ................ 11 1 9 8 2 8 3 7 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 1 9 5 2 1 6 , 9 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................. 13. , 14. Net Value Subject to Tax (Line 12 minus Line 13) .... . . . . . . . ..... .. 14 1 9 5 2 1 6 , 9 8 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.o _ O. D 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .045 1 9 5 2 1 6. 9 8 1s. 8 7 8 4. 7 6 17. Amount of Line 14 taxable at sibling rate X .12 D D D 17. D. D D 18. Amount of Line 14 taxable at collateral rate X .15 D D D 18 D. D D 19. Tax Due ........................ ................. ..... ..19. 8 7 8 4. 7 6 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15D5607221 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 09 0232 DECEDENTS NAME THELMA E. THOMPSON - -- -- -- - __- STREETADDRESS - - - -_ - - ~-- - _ 325 Wesley Drive -- __ --_- CITY Mechanicsbur STATE - -- --- - ZIP PA ' 17055 Tax Payments and Credits: 1 ~ Tax Due (Page 2 Line 19) 2. Credits/Payments (1) 8 784 76 A. Spousal Poverty Credit B. Prior Payments 8, 550.00 C. Discount 439.24 3. InterestlPenalty if applicable Total Credits (A + B + C) (2) 8 989 24 D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Total Interest/Penalty (D + E) (3) 0.00 Fill in oval on Page 2, Line 20 to request a refund. (4) 204.48 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0 00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRI ATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : .............. ........................................................ ^ a b. retain the right to designate who shall use the property transferred or its income; ............................... ^ 0 c. retain a reversionary interest; or .............................................................................................. ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 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 "intrust for" or payable upon death bank account or security at his or her death? ......... ^ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. ^ 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 tMe 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 ezemot 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-0ne 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. PNC INVESTMENTS Member F!NRA and SfPC March 27, 2009 Farrell & Small 201/203 South Railroad Street P. O. Box 113 Palmyra, Pennsylvania 17078-0113 Attn: Joseph M. Farrell, Esquire RE: Thelma E. Thompson Estate 83521388 - 83521390 - 83521392 Date of Death Valuation Dear Sir: The dates of death value for the three PNC Investment Accounts owned by Thelma E. Thompson are as follows: 83521388 Thelma E. Thompson, owner -opened 05/01/2000 ~.~ ~ ~ 626.188 shares of Blackrock PA Municipal Bond A @ $10.01 per share = ~ ~ ~ ~ Y -' 83521392 Thelma E Thompson & Kathie E Mulligan, Joint owners -opened 05/01/2000 ~ ~ 820.083 shares of Blackrock PA Municipal Bond A @ $10.01 per share ~ J 83521390 Thelma E Thompson & Kristin L Thompson, Joint owners -opened 05/01/2000 3 767.098 shares Blackrock PA Municipal Band A @ $10.01 per share Please feel free to contact me if I can be of further service. Sincerely, onna J P ock, Assistant to Charles E Little, CFP .The tnformation contained herein has been obtained from sources we believe to be reliable but do not guarantee it to be accurate, correct, complete or timely, and shall not be responsible jor the results obtained from it's usG PNC Investments LLC Member of The PNC Financial Services Group Two East Main Street Mechanicsburg Pennsytvania 17055 www.pnc.com ~ •'viac Love value ,tea Bank Guarantee tmporfantlnvestorhtfcrntabon:Securities and brokerage services are provided by PNC Investments LLC, member FINRA and SIPC. i Annuities and other insurance products are offered by PNC Insurance Services LLB, a licensed insurance agency. ~~ 1, ~n ~ 1'i4 ~d~, t~e ~ ~ v G ~ ~ ~ M ~ ~ G ~ ° V ~ ~~ ~ ~ d' ~Fa a ~ ~ ~ .Fa a a c ~ ~ a y ~ U ~ W ~ n ~ "" ~ ~ i ~ • ao rn o~ o ~ .~ ~, ~ ~ ~ ¢ ~ ~ ~ o ~~+ ~ 3 ~ 7 N "' W ~cp~ pM~ ~ iA N tOA ~ ~CC ~ s~.~ ~ ~ ,~. ~ If) .C. , ~/} ~ ~ ~ CO ~ O O O d' ~ ~ u tti 3 ~ ~ ~ ~p4 y o ~ .O c~ ~ N ~~ ~ c u oo cp co to cp ~ cp in o~ N 00 N ap to O d: ° O~~ u Z N CO f0 -r .r N [~ Ch N ~ C1. to ~N,, y N ~ O M O N N ~~~ v v C ~~~~ ~ ~ w O ~dp~ 00 u7 -~ QN~ l~ O c~7 ~ .~ ° ~ ~ vii a.+ ~ ~ ^" ch C~7 M 0p 0p 0p c~ pp ~ '"~ ~ ° CJ 'VOID' u ~ `~ ~ cc ~ ~ ~ tiL ~ ° ~ u ~ r~ ~ ~ C? CD O N N h In 00~~. :3 CL ~ p 'O A ctl ~ N ~-~+ 00 to N 0) to C~7 •.y ~,, 'n ~ y w t~ [~ ~ ~ ~ t00 CNO N N G ~ °~ :: C ~' U ~ O ~ \ ~ ~ ~ ° w ~ ~ ~ ~ ~ ~ N ~ N N N N N N N N N .C ~ m b ~ ~ ~ 0• O O O O O O O O O ~" ~~ [ y ~ ~ ?i ~ u .O 'p [ ¢~ 'd ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ z ~ 8 ~ N ~ ~ ~ ~ 8 ~ ~~~~' ~~ ~ Wvsw ~~ -. ~ ~ ~ o o ~~~°~ ~@° ~ q a ti .x v a c °° °~~ ~~ ~~ ~ v ~, °' >' o 0 0 0 ~~E~~ ~~ z° ~ m 0] .'~ cd c0 _~ O ~ ~ ~~~~ ~ ~ ~ ~ p ~ y ~ ~ S] pmq ["" m d0' ~ ~ QO Y~ ~ Out ~ ~ ~C U u ~, ~ ~ ~ C ~ n ~ ~ •yA aCU~ ~ ~ .CJU. ~ ~ U ~ ~ c L~ ~ ° ° ~~~~~~yz Q ~ ~ ~ ~~~€~~ ~~ U [ ~ ~ U ~ ~ ~ ~ ~ ~ ~ ° ~ 7 \ V1 ~ a+ tq "'~ U L Z ~ ~ ~ ~j ~ v [ ~ 'Jr c? ~ ~ aQ v u ~ $ p ~ ~ ~ ~ x A ~ ~ ~ ~ a ~ ~~ ~ tom. U ~ F Q A ~~" A ° tJ a co ~ ~~ ~ ~ z ~ ~ ~ z a W ~ ~Na~~ ~~ ,~ ~j w ~ C '~ p~~ C ~ Z ~ ~ ~ ~ A ~ W ~ ~ ~ ~ o ~ ~ ~ ap cs3 0 0 ~ o o ~ ~U._ C^' (/1 ta~~ ~~r ~ L1° ~ ~'" SUs.], N q Lz ~ et ~ A a~ ~ '^' ~ U u ^ y 131 ~ z ~ ~ ~'' > Ub 'O c~ T. 'C1 cC~ u ` ~ e~~ ~~y ~ ~ V Z~ ~ ~ z tip ~ ~ ~ C ~ j ~ C ~-~ f~ a W ~ cr. cAt. ~ ~ ~ m O z a Cw7 CQ7 o v° N" c c~ c O 1tuD a J r REV-1507 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDlJLE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER THELMA E. THOMPSON 21 09 0232 All property jointty-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Central PA Conference -United Methodist Church * Promissory Note No. 8298 45,000.00 2. Central PA Conference -United Methodist Church * Promissory Note No. 8385 48,386.00 3. Central PA Conference -United Methodist Church * Promissory Note No. 8634 5,000.00 4. Central PA Conference -United Methodist Church * Promissory Note No. 8814 5,000.00 5. Central PA Conference -United Methodist Church * Promissory Note No. 9023 5,000.00 6. Central PA Conference -United Methodist Church * Promissory Note No. 9211 10,000.00 * See Attachment "C" TOTAL (Also enter on line 4 Recapitulation) ~ 118 386 00 (If more space ~ needed, insert additional sheets of the same size) CENTRAL PElVNS1(LYAIVI,~- C~1JfERfNCE UNf'tEQ METHC~p1S't CHURCH 303 MULBERRY DRt1/E.. PtO BCX 2033 MECHANfC56URG, RA 1X093 VENDOR txAATE APRlL 9, 2009 CHECK -•AD. 3'3641 DATE _' REFERENCE ACCT. N0, AMOIiNi 04/09/09 WITHDRAWAL OF INVESTMENT 1 I8,3~86.40 } ®MI~I'Bank. N.~. TCfiAL 118,36.00 REMITtANCE Vc`UCHER - DETACH BEfO1tE DEPOS CHE ! EK. _ _ ._ ~... _ _ _ __ _ 33641 CENTRAL PENNSYL~I/.NIA, C'4hfFERENCE UNITED METHC-DIST CHURCH ~33 303 MUl9ERRY DRIVE, PO 80X 2053 MECHANICSBURG, PA 170SS vOl01f NOT CASHEO WfTHIN 90 OV1YS DATE CHKK NO. 04/09/09 33641 *118,386.00 ****ONE HUNDRED EIGHTTEEN THOUSAND, THREE HUNDRED EIGHTY-SIX AND 00/100--DOLLARS PAY T~ ESTATE OF THELMA E. THOMPSON TO THE %LAW OFFICES OF FARRELL & SMALL ~ - ~'-^ ORDER OF 201/203 SOUTH RAILROAD STREET, PO BOX i 13 DIVISION O _ PALMYRA, PA 17078 ;;,_. ,. u'0 3 364 i~~• ~:0 3 1 3008 34~: 2 2 i 7 i 568~~• , q P~ 900 S. Arlington Ave., Room M119, Hsrrisb ' No. 829$' urg, Pa. 17109 June 17 lg~ 6 On demand we promise to pay to the order of Curvfn L. And/Or Thelma E. Thom son ~**45,000.00 - -- **Forty Five Thousand And No/100-------------------~~____.` 100 - ~~ Without defalcation or stay of execution, for value received. with iatareet at 9.OQj(,, pr ~~ was empdon laws, and confer Judgment for above sum without offset, with interact smi ooab of wit, and with ~t~ and e~- lection fees. There b a 1% interest penalty on all monir not bft is the fund fora Pm' Dent for Dol. period of a~ year. THE CENTRAL PSNNSYLYANIA CONFEItENCS DIVIBIl~ON LOANB~ ~ THE UNITIID xi~tnnrrrr rwrmrQ .i> ®~o[s 416H No. 838 5 ~3 900 $. Arlington Ave., Room N119, Harrbbnrg, Pa. 17109 December 2, 1886 On demand we prombe to pay to the order ~ Curvin L. And/Or Thelma E. Thompson ; **4$,386. ***Forty Eilxht Thousand, Three Hundred, Eighty Six And---------No----------~~ . 100 Without defalcation or stay of execution, for value reoeivad, with interest at 9.O~r., per annum, waivtag inquidtiom and ez. emption Lwc, snd confer Jadipmemt for above sum wItboat offset, with interest sad costs of suit, and with Aie psr sent for col- lection fees. There b • 1% intcs+est penalty on all monies sot left in fife ifa~ for a period of one year, THE CENTRAL P$NNSYLVANU CONFERENCE DIVISION ON LOANS THE ZJN1T>:D >I[BTHODIST CHUB Attest: ` CAAIRP>tR80N OP D( 60[f No. 8 634 900 S. Arlington Ave., Boom 9119, Harrisbutg, Pa. 17109 >Kay 27, lY 87 On demand we promise to pay to the order of Garvin L. And/ Or Thelma E. Thompson ;*5,000.00 ***Five Thousand And------------------------No-----------------------------DolLrs Without de~taleation ar etsy o[ eseautiam, for value seceived, with bxtarest at 8 • ~ 100 emptloa Vws, sad confer . Pm' ~~ waiving b~quidtion and e:- judpneatfar pbovewas wItisiot a[taat, wits interest and costs of suit, and wlth flue per Dent far eo1- betloa fees. There is a 1% ~teeert penalty oa all mwabs aaR ye[t ~ tits ibnd ter • peed o! one year. TRB iAL PENNSYLVANIA t7ONFB~NCa DIVISION ON LO THE UNITED METAODI$T N // Attest: C ,~ 4 TR~~ CHAIRPSR80N OF 14iB oN ON' No. 8 814 900 S. Arlington Ave., Room M119, Harrisburg, Pa. 17109 November ~, 19 8 77 l?n demand we promise to pay to the order of Curvin L. And/Or Thelma E. Thompson =*5,000.00 * * *Five Thousand And---------------------------------No-------Do-Vu, 100 Without defalptiou or clay of execution, for value received, with interest at 8.0 OK, per annum waiving inquisition and ez- emption Lws, and contew jad~meat toe above sum without offset, wiW interest and costs of snit, and with five pee cent tos col- lectlon teen. There M a 1'X interest penalty on all monies not left is the fund toe a period of one year. 'F8B CENTRAL PSNNglfLVAMA CONF1iItRNCS DMBION ON LOANS T!i?~ UN1TEa IrISTHODL9T Attest: ~ T~~ pox o nlvisloN IAANS ®ao~s No. 9023 800, S. Arlhtrtan Ate, BAp~t $11l, li~srrtabar~, Pa. i'110M Mai 6 ~ ~. On dewsad we pronaire to pay ba the order Curvin ~,. And/Or Thelma E. Thompson ~,-*S~,OOp 00 of ****Five Thousand And----------------------No--------------_ DoHsrs Without defdestlolt ar stay as saceeut3on, tar vslae reoeired, wit1~ Interest at ~.: 5~j(., per annume.~iv~atvta; inquld. lion sad e~xaimptitaa laws. sad scales ~adgment for shove swn withoat aikset, wits tate+rest sad eesb o[ Bait, and with Svc per Dent for aolteotiaa lbes. Thew L s 196 peoslty on all monks not felt is tits laud for s peaiod of ope y~• TIDS CLNTBAL PiT~N11fSYLVANIA CONFERENC]c DIVISION OM LOANd T)SN ~ 2ifNTSODIST C Attest: ~ ~''~.~. ; - - - - _ __ _ _ _ _ _ _ _ _ _ '~ ~ OT D1V28iOTl LQAMi~ L __ Q oo~• 800 S. ArllasEon A'l"s~. ~o~u 8i1~, $tlnrfMidNpt~, ps„ 1'tI00 No. 21 December 31,L $ . On deesaad rre pron~se is pay to of- Curvin L. And/Or Thelma E Thompson t*lp,~, ***Tpn _Thonaand And--- ---- - ,I1i+~..r~ Wlt>lont detsim~Yon or stay st esadttion. for value reoeived~ with tnteerast at$.,•.Q-0.96. per snnmh, p~stvfep Iagold. tloa and enceoa~tea laws, aai ooafess~~ t far stove sam without MNet, whit is-t+eeest ssM osatis K snit, sad with live Per oeot ~ ~~~ Seca r s 196 peaaity on all monies not Mfr In the rand for s pe~rMd of sae T~'• TH>r CaNTBAL P11:PTNSYLVANIA CONF1~8Jt11T+0)l: ON ON LOANS ~ D SODIST Attest: ~avnsn a~ a -, - .. - - - ~P~ve t.EAL1l~ TNB WAY March 2S, 2009 Farrell d~ Sma11 201203 South Railroad 5t PO Box 113 Palmyra PA 17078-0113 RE: Ilielma E Thompson SSN: 178-16-1020 DOD: O 1-22-2009 . ~ '~ ~ Dear Sir/Madam: [n responx to your request for Date of Death (DOD} balances for the customer noted about, our records show the following: Certiitieatt of Deposit . Account # 31400045904 Established: 09-05-1996 # ~ 'THELMA E THOMPSON DAVID G TTiOMPSON DOD balance: $ 8,357.98 + 12.66 accrued interest .~ ~ 8 ~.3 7 0, d ~ Account # 3130027S7S3 Established: 10-06-2005 '~'~ THELMA L THOMPSON DAVID G TNOMPSON DOD balance: $ 5,743.74 + 8.19 accrued interest „ Account # 31700287944 Established: 03-30-2006 THELMA E THOMPSON ~ 3 DAVID G THOMPSON 4 DOD balance: S 6,669.83 + 7.45 accrued interest _ ~, 4 -r~ ? r Account # 31600252996 Established: 01-11-2005 ~ ~" +~ T~LMA E THOMPSON ~ ~ ERLY L MULLIGAN DOD balance: S 8 286.38 + 6.30 ace b' ~ ~ '~ ~~ rued interest r ~ ~ ~ r/ ~ ~ ~ Page 1 of 2 REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE F JOINTLY-OWNED PROPERTY ~.. nvmocR THELMA E. THOMPSON 21 09 0232 ff 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. David G. Thompson 122 L ynwood Drlve Palmyra, PA 17078 s Kathie E. Mulligan 724 Bennington Drive Raleigh, NC 27615 c Kristin L. (Thompson) Horn 8820 Carlisle Road Wyndmoor, PA 19038 JOINTLY•OWNED PROPERTY: LETTER DATE DESCRIPTION OF PR ITEM NUMBER FOR JOINT TENANT MADE JOINT OPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL EST DATE OF DEATH ATE. VALUE OF ASSET 1. A. 070596 PNC Bank 8 370 64 Certificate of Deposit Acct No. 31400045904 , . See Attachment "D" (Item No. "1") 2. A. 100605 PNC Bank Certificate of Deposit Acct No. 31300275753 5,751.93 See Attachment "D" (Item No. " 2") 3, A. 033006 PNC Bank Certificate of Deposit Acct No. 31700287944 6,677.28 See Attachment "D" (Item No. "3") 4. B. 090904 PNC Bank Certificate of Deposit Acct No. 31700245521 6,291.51 See Attachment "D" (Item No. "7") 5. B. 050100 PNC Investments Blackrock PA Municipal Bond A 83521392 8,209.03 See Attachment "A" (Item No. " 2") 6. B. 052004 Citi Smith Barney stocks 14 497 66 Account No. 724-09743-1-6-364 , . See Attachment "E" 7. C. 050100 PNC Investments Blackrock PA Municipal Bond A 83521390 7,678.65 See Attachment "A" (Item No. " 3") 8. D. 011105 PNC Bank Certificate of Deposit Acct No. 31600252996 8 292 68 See Attachment "D" (Item No. "4") 9. E. 011105 PNC Bank Certificate of Deposit Acct No. 31300254131 8,292.68 See Attachment "D" (Item No. "6") 10. F. 101403 PNC Bank Certificate of Deposit Acct No. 31200237188 7,580.61 See Attachment "D" Item No. "5" TOTAL (Also enter on line 6, Recapitulation) (If more space is needed, insert addfional sheets of the same size) Son Daughter Granddaughter OF DATE OF DEATH DECD'S VALUE OF INTEREST DECEDENT'S INTEREST 50. 4,185.32 50.E 2,875.97 50. ~ 3,338.64 50. ~ 3,145.76 50. ~ 4,104.52 50. ~ 7,248.83 50. ~ 3,839.33 50. ~ 4,146.34 50. ~ 4,146.34 50.E 3,790.31 40, 821.36 Continuation of REV-1500 Inheritance Tax Return Resident Decedent THELMA E. THOMPSON Decedent's Name 21 09 0232 Page 1 File Number Schedule F-1 -Jointly Owned Property SURVIVING JOINT TENANT(S) NAME ADDRESS D~ Erin L. (Mulligan) Graber 851 Historian Street Raleigh, NC 27603 E~ Kirk D. Mulligan 724 Bennington Drive Raleigh, NC 27615 F~ Jeffrey D. Thompson 5940 Meadow Road Elkridge, MD 21075 RELATIONSHIP TO DECEDENT Granddaughter Grandson Grandson ~P~ve 1.lADtNO THB WAY March 25, 2009 Farrell & Small 201/203 South Railroad St PO Box 113 Palmyra PA 17078-0113 RE: Thelma E Thompson SSN: 178-16-1020 DOD: 01-22-2049 {1 f ~ / ` /~ Deaz Sir/Madam: In response to your request for Date of Death (DOD} balances for the customer noted above, our records show the following: Cextifiicate of Deposit # t 'Account # 3 i 400045904 Established: D7-OS-1996 THELMA E THOMPSON DAVID G THOMPSON DOD balance: $ 8,35'7.98 + 12.66 accrued interest ~ $ ~.3 70. b-t ~ Account # 31300275753 Established: 10-06-2005 ~ a THELMA E THOMPSON DAVID G THOMPSON DOD balance: $ 5,743.74 + 8.19 accrued interest ~ ,,~ Account # 31700287944 Established: 03-30-2006 ~ 3 THELMA E THOMPSON DAVID G THOMPSON DOD balance: $ 6,669.83 + 7.45 accrued interest _ ~, ~ -r `t ~` ~ /~Account # 31600252996 Established: Ol -11-2005 ~' ~ THELMA E THOMPSON ERL~T L MULLIGAN ~~ DOD balance; $ 8,286.38 + 6.30 accrued interest .., 8 '~ ~ `~ '' f f ~ tf Page 1 of 2 d7~7RS~7d7 96i P.02 r ~ ~ , ~ ~~ c #~, Account # 31200237188 Established: l 0-14-2003 THELMA E THOMPSON JEFFREY DAVID THOMPSON 'fDOD balance: $ 7,577.62 + 2.99 accrued interest ~ ~ ~s` $o ~ 1 ,/Account # 31300254131 Established: O 1-11-2005 ~ b THELMA E THOMPSON KIRK D MULLIGAN ~,~ DOD balance: $ 8,286.38 + 6.30 accrued interest ~ !s , a9 ~ /Account # 31700245521 Established: 09-09-2004 ~ -~ THELMA E THOMPSON KATHIE E MULLIGAN DOD balance: $ 6,2$5.86 + 5.65 accrued interest ~ 4 ~, R i '~ 1 ~. ~ / Checking Account Account # 5140064113 THELMA E THOMPSON DOD balance: $ 181.84 + 0.00 accrued interest Established: 11-OI -1956 Investnteat Account The decedent maintained Investment Account 83521388 ~ 83521390 & 83521392. For fiuther information, you may call the Brokerage Department at 1-800-762-6111. Please note that this office provides date of death balances for deposit accoutrts (IItAs, CDs, Checking and Savings). We do sot process any 5nancial transactIaaa or provide statements. If you aced assistance with any of these items, please call 1-888-PVC-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 u Page 2 of 2 MAR-25-2009 02:07 4127052747 ~:. ~'E?~ ~ _ _ ~~i~7 1- ~ 96i P. 02 PNe INVESTMENTS . CVtarch 27, 2009 Farrell & Small 201/203 South Railroad Street P. O. Bos l 13 Palmyra, Pennsylvania 17078-0113 Attn: Joseph M. Farrell, Esquire RE: Thelma E. Thompson Estate 83521388 - 83521390 - 83521392 Date of Death Valuation Dear Sir: The dates of death value for the three PNC [nvestment Accounts owned by Thelma E. Thompson are as follows: 83521388 Thelma E. Thompson, owner -opened 05/01/2000 ~' ~ 626.188 shares of Blackrock PA Municipal Bond A @ $10.01 per share .. v 83521392 Thelma E Thompson & Kathie E Mulligan, Joint owners -opened 05/01/2000 ~ ~ 820.083 shares of Blackrock PA Municipal Bond A @ S 10.01 per share _ g t ~ ~ 9 .0 3 ~ J 83521390 Thelma E Thompson & Kristin [, Thompson, Joint owners -opened OS/0l/2000 3 767.098 shares Blackrock PA Municipal Band A @ S 10.01 per share z , ~ 4 ~ i& ~ ~ ~ Please feel free to contact me if I can be of further service. Sincerely, i~~ nna J P ock, Assistant to Charles E Little, CFP . Thr lnfornwtlon contalnrd bereln kas born obtainrd from sourcrs wr belirvr to be nllab/r bat do not guarnnler It to br accarate, correct, conrplrte or t/mely, and shall not be rapons/b/i jor the nesalts obtainrd from it's asp Y A +[ PNC Investments LLC /G~ Member of TAe PNC financisl Services f3roup Two East Main Street Mechanicsburg Pennsytvama 17055 www.pnc.com ! ~ • ~1aa Luse ~,~e '~ .~~~~~~~~ tmportritbwKtorlydarnfatlOn: Secunties and brokerage serr~ces are provided 6y PNC Imestmen;s LLC, member FWRA antl StDC. 1/~ Annwt:es antl ether Insurance products are o}£ered by PNC !ns~rance Serv!ces LLC, a Licensed >r:;uran¢e agency. ~ ~~~~~t;~ a t al Ncrth 3rd Sir2et Tel 717 780 1700 2nd Floor Strawberry Square fax 717 233 2090 Harrisburg, PA ?7101 Toli Free 800 2371700 March 26, 2009 JOSEPH M. FARRELL, ESQ. Farrell & Small 201/203 South Railroad Street P.O. Box 113 Palmyra, PA 17078-0113 %"~ smith barney RE: Thelma E. Thompson Estate Date of Death: January 22, 2009 Account #724-04150-1-3-364 (Thelma E. Thompson) Account #724-09743-1-6-364 (Thelma E. Thompson & ~ Kathie E. Mulligan) Dear Attorney Farrell: Account 724-04150-1-3-364, single account of Thelma E. Thompson was opened on March 15, 2001. Account 724-09743-1-6-364, joint tenant with rights of survivorship account of Thelma E. Thompson and Kathie E. Mulligan was opened on May 20; 2004. I have enclosed the date of death prices for both of the accounts. Sincerely, Ann M. Dunkelberger Senior Client Service Associate to John J. Fabian, Jr. Senior Vice President -Wealth Management Financial Advisor /amd Enclosures li _ ~ Citiqroup Global Markets Inc. ~~ The information set forth was obtained from sources which we believe reliable but we do not guarantee its accuracy or completeness. Neither the information nor any opinion expressed constitutes a solicitation by us of the purchase or sale of any securities. Account of Thelma E. Thompson & Kathie E. Mulligan Account #724-09743-1-6-364 Date of Death Prices 1 /22/2009 uantit Description Price Value 9000 Bank of America Funding 58.26 $5,243.40 Corp. 5.5% Due 11/25/35 5000 Credit Suisse First Boston 50.902 2,545.10 6% Due 12/25/35 8000 Bank of America Funding 56.702 4,536.16 Corp 6% Due 3/25/36 2173.00 Bank Deposit Program 1.00 2,173.00 TOTAL: $14,497.66 "The information herein has been obtained from sources we believe to be reliable, but do not guarantee its accuracy or completeness." REV-1511 EX + (1 D-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHED!!LE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER THELMA E. THOMPSON 21 09 0232 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: 1. Parthemore Funeral Home & Cremation Services, Inc. B• ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative (s) N/A Street Address Cdy State Zip Year(s) Commission Paid: 2, Attorney Fees Joseph M. Farrell, Esq (Hourly) 3. Family Exemption: (If decedents address is not the same as claimant's, attach explanation) Claimant N/A Street Address City State Zip Relationship of Claimant to Decedent 4• Probate Fees Register of Wills -Cumberland County 5. ~ Accountant's Fees 6• I Tax Return Preparers Fees Smoker, Smith & Associates 7. Hampden Physicians 8• Reverend Jim Browning -Funeral Services 9. Ann Royer -Funeral/organist 10. Parthemore Funeral Home 11. Postmaster -Certified mail fee -United Methodist Church 12. Postmaster -Certified mail fee -tax returns 13. Continuing Care RX -prescription fee 14. United States Treasury - 2008 Federal Income Tax 15. Department of Reveue - 2008 PA Income Tax 16. Cumberland County Law Journal -Estate Notice 17. The Sentinel -Estate Notice 18. Bethany Village -Invoice # 2407 TOTAL (Also enter on line 9, Recapitulation) ~ $ AMOUNT 2,619.43 7,695.00 355.00 295.00 59.41 150.00 100.00 36.25 6.07 11.80 28.06 843.00 195.00 75.00 251.26 329.02 (If more space is needed, insert additional sheets of the same size) i~ .37 Continuation of REV-1500 Inheritance Tax Return Resident Decedent THELMA E. THOMPSON Decedent's Name 21 09 0232 Page 2 File Number Schedule H -Funeral Expenses ~ Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. Bethany Village -Invoice # 2112 20. Bethany Village -Guest house fee 225.03 21. Bethany Village -Final balance 360.00 22. Stewartstown Cemetery 1.31 23. Glen Rock Mill Inn Family Meal 125.00 24. Reimbursement David G. Thompson for Tombstone Inscription 352.00 25. IRS - 2008 Additional Tax Due 205.00 26. Larry Kunkle - Charge to open grave 210.73 300.00 SUBTOTAL SCHEDULE H-B7 I 1,779.07 REV-1513 EX + (9-0p) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES wihi~vr THELMA E. THOMPSON NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. David G. Thompson (Son) 122 Lynwood Drive Palmyra, PA 17078 2. Kathie E. Mulligan (Daughter) 724 Bennington Drive Raleigh, NC 27615 50% 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 FILE NUMBER 21 09 0232 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE Lineal Lineal TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET 13 (If more space is needed, Insert addltlonal sheets of the same size) ,-., c-~ ~_, . -~~ '~--~ -.: r-~ ...._ LAST 1PILL AND TESTA~Tr ~ : ' . ' ., . ,-~ ; . _-~ ~_~ _.. r,~ .i __ 3'$ELD~ 8 _ THOIJ~SON .~ ca I, THELMA E. THOMPSON of 105 Oak Drive, Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby expressly revoking any and all prior Wills, Codicils and writings in the nature thereof previously made by me. CITY OF T83TATRIX'S FAD~ILY I declare that I am a widow, my husband CURVIN L . THOMPSON having died on October 14, 1991. I have two children now living; DAVID G. THOMPSON of 122 Lynwood Drive, Palmyra, Pennsylvania 17078; and KATHIE E. MULLIGAN of 724 Bennington Drive, Raleigh, North Carolina 27615, and all references to "my children" herein are to them. I have no deceased children. 1 Thelma E. Thompson s$coND SILLS AND S%P~iT SS I direct that all my just debts and expenses of my last illness shall be paid by my Co-Executors, hereinafter named, from my estate as soon after my death as shall be found convenient. TBIRD DISPOSITION OF R8~1INS I direct that the expense of my funeral. and burial, including a suitable grave site, marker and perpetual care, if deemed appropriate, be paid out of my estate in such a manner as my Co-Executors, hereinafter named, may deem proper and without regard to any limitation in the applicable law as to the amount of such expense. FOIIR~'H 9PBCIFIC BSOOSSTS I hereby give, devise and bequeath my residence located at 105 Oak Drive, Camp Hill, Cumberland County, Pennsylvania, which had been previously reconveyed to me by him, if owned by me upon my death, to my son, DAVID G. THOMPSON. 2 ~" i p( zL~ Thelma E. Thompso I further give, devise and bequeath the additional sum of FIVE THOUSAND DOLLARS ($5,000.00) to my daughter, KATHTE E. MULLIGAN, not in representation of any greater love or affection than held for my son David, but in recognition of certain greater past benevolences, during my lifetime, given to my son. FI_ FT~I RESIDIIABY L$GAT$LS AND ALTLRNATB A88IDIIA&Y IEGATggS I direct that the rest, residue and remainder of my estate, whether real, personal or mixed, wherever located, be liquidated, and the proceeds divided into two (2) equal shares and distributed as follows: (1) One share to my son, DAVID G. THOMPSON, or if he predeceases me, then to his issue per stirpes who survive me according to the terms and conditions enunciated in the Seventh paragraph hereinafter, if appropriate because of age. (2) One share to my daughter, KATHIE E. MULLIGAN, or if she predeceases me, then to her issue per stirpes who survive me according to the terms and conditions 3 ~%?7~ Thelma Thompson ,~ enunciated in the Seventh paragraph hereinafter, if appropriate because of age. IXTH CO-8X$CIITORS I name my son, DAVID G . THOMPSON and my daughter, KA.THIE E . MULLIGAN, CO-EXECUTORS of this, my Last Will and Testament with the authority to liquidate any and all items of personalty and realty, along with any additional funds from any sources whatsoever, including, but not limited to, proceeds of any policies of insurance, whether passing through my estate or otherwise, after considering in their sole discretion the retention of certain items beneficial to the best interests and well-being of my children or grandchildren and distribution of same such items to them, the proceeds of any such liquidation or sale to become part of the residue and pass into the hands of my Legatees as provided for in the Fifth paragraph of this instrument. 4 /~~ helms E. Thompson ~~ TRII3T If, pursuant to the Fourth or Fifth paragraph of this instrument, any part of my estate does vest in ownership in any of my grandchildren before he or she attains the age of 21 years, such funds created I direct should be tendered unto ELAINE A. THOMPSON (if David should predecease me) in the case of Kristin and Jeffrey Thompson, and unto JAMES R, MULLIGAN (if Kathie should predecease me) in the case of Erin and Kirk Mulligan, to act as TRUSTEE and to hold, administer, invest and reinvest the separate fund amounts tendered to them for the benefit of my grandchild(ren) on the following terms and conditions: A. To pay the income and so much of the principal of the fund as may, in the sole discretion of my Trustee, be necessary for the education of each grandchild. B. The amount to be paid for the benefit of each grandchild shall be determined from time to time by his (or her) needs and the amount and time of said payments shall be determined by such need. Said payments may be 5 ,J ~ e ma T ompson made by my Trustee directly to each grandchild, or may be made by him to the person(s) having custody and care of him (or her), or may be made by my Trustee directly to any other person(s) or institution(s) entitled to such by reason of services rendered to said grandchild(ren). In making the aforesaid payments, my Trustee(s) shall give primary consideration to the individual needs of each grandchild, and to other sources available to him (or her) . C. My said Trustee is directed to pay the total accumulated interest and principal of each fund then remaining in his/her hands to each grandchild upon his (or her) attaining twenty-one (21) years of age, or successful graduation from a post high school, four year formal degree-conferring course of college study, whichever occurs first. D, In the event that any grandchild should die before termination of his (or her) trust fund according to Subparagraph C above, LEAVING ISSUE, then the fund shall continue for the benefit of his (or her) 6 --~`-~ ~~ . ~1 iZd~yc. , Thelma E. Thompson issue (in equal shares where appropriate) according to the terms and conditions of this paragraph. H01P8VgR, if any grandchild should die before termination of his or her trust fund according to Subparagraph C above WITHOUT LEAVING ISSUE, then any balance therein remaining shall be paid unto his (or her) surviving siblings' fund, or directly, whichever is appropriate. $IGBTS SP~IiiDTERIFT PROVTSZON The interests, whether in income or principal, passing under this Will to any legatee or trust beneficiary, shall not be subject, while said interest is in the hands of my Co-Executors or Trustee acting under this Will and before said interest is actually paid or delivered to the person entitled thereto, to voluntary or involuntary anticipation, encumbrance, alienation or assignment, either in whole or in part, nor shall such interest be subject to any judicial process to levy upon or attach the same for or on behalf of such person's creditors or claimants. 7 Thelma E. Thompson NINTH ~PAIV$x OF HOND I direct that no Executor or Trustee named in this Last Will and Testament shall be required to post any bond or give security of any type, for any purpose whatsoever, any rule or laws of the courts of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. PAYNSN'P OF TAXES I direct that any and all federal, state or local income or inheritance taxes outstanding and/or arising out of my death, be paid out of the residuary share of my estate. ELEVENTH 1PILL CONTESTS If any beneficiary or remainderman under this Will in any manner, directly or indirectly, contests or attacks this Will or any of its provisions, any share or interest in my estate given to that contesting beneficiary or remainderman under this w'i11 is revoked and shall be disposed of in the same manner grovided herein S Thelma E. Thompson as if that contesting beneficiary or remainderman had predeceased me without issue. T~LFTH G8N8&Ar, 8tlact of Inoperative, Invalid or_ I114ca~ Provision If any provision of this Will or of any Codicil thereto is held to be inoperative, invalid or illegal, it is my intention that all of the remaining provisions thereof shall continue to be fully operative and effective insofar as is possible and reasonable. geading~ The headings above the various provisions of this Will have been included only in order to make it easier to locate the subject covered by each provision and are not to be used in construing this Will or in ascertaining my intentions. IN WITNESS WHEREOF, I, THEM E. THOMPSON, hereby set my hand 9 n Thelma E. Th~mpso and seal to this, my Last Will and Testament, typewritten on twelve (12) sheets of paper, including the attestation clause, signatures of witnesses, and acknowledgment and affidavit, upon each of which I have also written my name this ~9 ~i,. day of September, 1995. ~~~~~ l.e`-= ~ s~-~--, ( SEAL ) Thelma E. Thompson Signed, sealed, published and declared by Thelma E. Thompson, the above-named Testatrix, 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, all being present at the same time, have subscribed our names as witnesses. .__-. residing at ~ ~ •~,~ ~.1 ~ ~ ~7 ~ ~ ~~ -~- residing at ~t~~".~. --'~~~~, 10 Thelma E. Thompsa CONIl~ONWEALTH OF PENNSYLVANIA SS. COUNTY OF LEBANON I, THELMA E. THOMPSON, whose name is signed to the attached or foregoing statement, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as 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 expressed. Thelma E. Thompson SWORN TO and acknowledged before me, the undersigned officer, by Thelma E. Thompson, the Testatrix, this 29th day of September, 1995. 11 _~~ ~ _ ~~ Thelma E, Thompson ' CONIlKONWEALTH OF PENNSYLVANIA COUNTY OF LEBANON SS. We, Joseph Michael Farrell and Karen L. Umberger the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and says that we were present and saw the Testatrix, Thelma E. Thompson, sign and execute the instrument as her Last Will and Testament, that she signed it willingly and that she executed it as her free and voluntary act for the purpose therein expressed; that each of us in the sight and hearing of the Testatrix signed the Will as witnesses and that to the best of our knowledge, the Testatrix was at the time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ,, ..-- -~ ' C-° f .~ .rr /,~~..:~..?-tom SWORN TO and acknowledged before me, the undersigned officer, by the above-named witnesses this 29th day of September, 1995. . , ~~ tam. 1~~~ N ~S t a ry Pub 1 i c" . •--~~--- -----.,.------~ 12 f ~` .. Thelma E. Thompso