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HomeMy WebLinkAbout11-09-09~ ~ ~ ~ o ~ _n a~ ~ O w o. N 1~ '' ~ .J ~ ~ cn o w .~ _ o Q ~ w ~ - ~a~~,- ~- - ~ o~ ~ c~ W ~ ~ ~ ~ ~ ~ ~ a }' ~ N ~ ~ M ~~ ~ z , ~ N j ~ _ O U ~ J~~ ~ _. 0 O ~ a. ° " .~ - U ~ ~ ~ 7'~ ~ ~ ~~T ~ ~ ~ Q OQ~a J ~ ~ W~f-J i-W~tn _ o ~ Cn ~ J Q w~~ a a OC U '- V a °' ~ ~ =- .. ~ . ~~~~ w U ~ >, N . ~ ~ ~ ~ Q ~. i ~ ~ t ° U ~ U Q co ~ .~ ~ CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) November 6, 2009 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 Re: Estate of June P. Deitch No. 21-09-0503 Dear Register of Wills: TELEPHONE (717) 76fi-0209 FAX (717) 795-7473 Please find enclosed for filing 2 copies of the Inheritance Tax Return for the June P. Deitch Estate as well as Check No. 4887, in the amount of $15.00 for the filing fee and Check No. 4888, in the amount of $45.00 for additional Probate. Thank you for your kind attention to this matter. Very truly yours, Charles E. Shields, III Attorney-At-Law CES/mjj Enclosures ~ ~ _.~ .; ~~~ ~ p ~ ~c ~ F...~..., -, ~ fJ ~ _ L . 4 / 15056051047 REV-15 0 0 EX (06-05) OFFICIA SE ONLY PA Department of Revenue Bureau of Individual Taxes ~ . County ode Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ ~ ` ~ ~ ©~ ~ ~ 3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth ! 98 ~~ 998'S ~50~ ~o©~ ~~#O6 ~ 9 22 Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Sp~~ojjuse's//Last Name Suffix Spouse's First Name MI ~ l /T Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 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 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust © 8. 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 11. Election to tax under Sec. 9113(A) befirueen 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 Firm Name (If A licabl h ,~" N/ C /11 ~ B u ~2 G ~~4- / 7 o s s ~S y r ~~-- ~ ~;, orrespondent's a-mail address: .es h ~ e~e~s3®Coh'~CIAst. yet ~, ,~ l ' ' .. s .._~ ,,_.., ~' pp e) '+ ~~ First line of address (o CLDl,,<s~l~ 2~•~~ Second line of address N / ~' City or Post Office State ZIP Code ~ -C ADDRESS ~~.~~ ~ ~~ /6B sfets mar. X11 c~tia~; sbur4 ~i4 /7oSo 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 has any knowledge. SIGNAT F PERSO R PONS LE FOR FILING RETURN DAT x „ SIGNAT F P PAR OTHER ~ SENT v DATE s ~ ADDRESS CHA'~LES E, S/S//El~s'11L, ~t i w ~ 70 SS' PLEASE USE OR7(GINAL FORM ONLY 1556051047 Side 1 15056051047 J 15056052048 REV-1500 EX Decedent's Social Security Number ~EITCH -~~lN~' /~ ' ~ g 8 a a~ g g S s Name: Decedent REC APITULATION D 1. Real estate (Schedule A). 1. ~ 1 ~ ~ ~ J ~ b g 2. .................................... Stocks and Bonds (Schedule B) 2. ... 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. ~ D 4. 9 9 ( ) ......................... Mort a es & Notes Receivable Schedule D 4. .... ~ ~ Q ~ ~ ~ ~ / 3 S °~" «~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .... .... 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ... .... 6. ~ ~D ~ ~* ! 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 7 « ~ 0 (Schedule G) O Separate Billing Requested.... . .... 8 ' ~ r ~ 3 8. Total Gross Assets (total Lines 1-7) ................................ . .... 9. Funeral Expenses & Administrative Costs (Schedule H) ................. .... 9. $ 55 8 .'~ ° 10. 9 9 ( ) ............ Debts of Decedent, Mort a e Liabilities, & Liens Schedule I 10. .... SS, 6 ' ~ fl 11. Total Deductions (total Lines 9 & 10) ............................... .... 11. 1 ~ I ~ + "~ p 12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. ~ T 7 g ~ • ~' r 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~~ 0 0 0 ~ D p an election to tax has not been made (Schedule J) .................... .... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .... 14. 3 1 7 ~ ~ ` T' TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 t~cable •~ 4 ~ ~ q . !y( / 16. j , C~ ~ fir' 2" at lineal rate X .0 _ J 17. Amount of Line 14 taxable D D 17 ~ Q at sibling rate X .12 . 18. Amount of Line 14 taxable ' ~ ~ 18 ~ Q ~ at collateral rate X .15 . ~ ~'' ~ 7 ~ ~ 19. TAX DUE ..................... .................................... 19. ' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ Side 2 15056052048 15056052048 J COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 01 1581 SMITH CAROL A 168 STATE ROAD MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: SSN: 198-22-9985 FILE NUMBER: 2109-0503 DECEDENT NAME: DEITCH JUNE P DATE OF PAYMENT: 08/07/2009 POSTMARK DATE: 08/06/2009 COUNTY: CUMBERLAND DATE OF DEATH: 05/07/2009 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $2,137.50 TOTAL AMOUNT PAID: $2,137.50 REMARKS: RECEIPT TO ATTY CHECK# 4878 INITIALS: WZ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1500 EX Page 3 File Number ~' ~_ 0 ~~„ C~x~ decedent's Complete Address: .J CJ DECEDENT'S NAME ~ uNF P D~-~rc~ __ __ -- STREET ADDRESS _ _ _ __ /6 8 oS~~ f~ toad -- CITY STATE ~~ ZIP r G /y1CC~aniC.S~ur ~ ~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) ~~ 7 ~ ~ ~ Sx 2. Credits/Payments O A. Spousal Poverty Credit ~ B. Prior Payments ~1 1 ~?, ~ __ C. Discount ~ ~ ! Z ._ SD d _-- Total Credits (A + B + C) (2) '' ,3'] ~~ 3. InterestlPenalty if applicable D. Interest _~_ __ __ E. Penalty __ _ - Total Interest/Penalty (D + E) (3) a 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. ~r Fill in oval on Page 2, Line 20 to request a refund. (4) 3 !~~ ~ 9$ 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Q A. Enter the interest on the tax due. (5A) ~ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 :................................................................................... ....... ^ b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ c. retain a reversionary interest; or ................................................................................................................... ....... ^ d. receive the promise for life of either payments, benefits or care? ............................................................... ....... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... ^ 3. Did decedent own an "in trust 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)j. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent (72 P.S. §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. REV-1503 EX+ (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~J~) TCN' , Ju-U~ P SCHED~lLE B STOCKS & BON®S FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~'a, n n ~ I~ ~ 9~o mfil"~y S ~,o'~'~" ~ rw kP.ri'~~c, ~i•D /Ud. (o(o~ -~S~D /$cG breuktlown of Q~~~'c~l~.r ~~enas ~ Valuah'o~S obfu~nt¢1 ~~ P3rbkcr Chus, /~. Piss ~ !2 ~q9'. 8~ ~~ ~~ die he ~ ,~ ~ ~• /a~ s~areS Cammbn s}vc,k o~ f~l CP, ~ ~~~k S rnbol = HCIP ~ o, ~ e - ~ H. 2 ~. 9(o Lo ~ ~ ~4v . - .~ l 90 ~~, 3 ~ S. 2 D TOTAL (Also enter on line 2, Recapitulation) I $ / ~ ~(~ ~'~ Q g' -~-~:c ~~q/BS Estate Valuation Date of Death: 05/07/2009 Estate of: June P. Deitch Valuation Date: 05/07/2009 Account• 2662-4580 Processing Date: 06/29/2009 Report Type: Date of Death Number of Securities: 3 File ID: June P. Deitch DOD 050709 Shares Security Mean &/or Div & Int Security or Par Description High/Ask Low/Bid Adj'ments Accruals Value 1) 600 HANCOCK JOHN PFD INCOME FD (41013W108; HPI) SH BEN INT New York Stock Exchange 05/07/2009 13.30000 12.72000 H/L 13.010000 0.124000 E 05/07 R 05/11 P 05/29+00.124000 13.134000 7,880.40 2) 925 NUVEEN MULTI STRAT INC & GR FD (67073B106; JPC) COM New York Stock Exchange 05/07/2009 4.74000 4.60000 H/L 4.670000 4,319.75 3) 299.73 Cash (CASH) 299.73 Total Value: $12,499.88 Total Accrual: $0.00 Total: $12,499.88 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. Janney Montgomery Scott LLC assumes no responsibility for accuracy or completeness of .the information provided, the Date of Death and the specific securities, which are valued. While we deem this information to be reliable, we do not warranty or guarantee its accuracy. This service is not intended to constitute legal or tax advice. You should consult with your tax professional and attorney to discuss estate settlement and any legal matters. HCP: Historical Prices for HCP, INC. -Yahoo! Finance New User? Sign Up Sign In Help Get Yahoo! Toolbar Yahoo! Mail 10/1/09 3:25 PM ~'~.,~,I-3~C3C~~~ F' 1 N ~41'~ ~ E Search Web Search Dow ~ 1.52% Nasdaq ~- 2.48°lo Thursday, October 1, 2009, 3:24PM ET - U.S. Markets close in 36 mins.. __ af'~"T QiJOTB& Finance Search HCP, ~11C. (HCP) At 3:09PM Er: 27.96 • 0.78 (2.71%) .a. ~ _--~ .~~,.~.....~..M~._~.. ~~..... . f ~ ~ S "~~ az ~~'' `a, ; ;~ ;; Historical Prices Get Historical Prices for: ~'~'~' ,;GO SET DATE RANGE ADVERTISEMENT http://finance.yahoo.com/q/hp?s=HCP&a=04&b=7&c=2009&d=04&e=7&f=2009&g=d Page 1 of 2 HCP: Historical Prices for HCP, INC. -Yahoo! Finance Daily Start Date: ~ May ~ ; ~ ; 7 ~ ~ 2009 ; Eg. Jan 1, 2003 Weekly ~~ , '~' Month) End Date: r May ~ ~ . , 7 2009 ' ~ Y Dividends Only p Ges °~ ~LflAD First ~ Prev ~ Next ~ Last PRICES Date Open High Low Close Volume Adj Close* 7-May-09 22.73 22.96 20.83 21.26 8,913,600 20.89 "` Close price adjusted for dividends and splits. First ~ Prev ~ Next ~ Last r~! Download To Spreadsheet ~~~~ TRADE OPTIONS LIKE .4 F.G Gel ~t~ur free _.___ ~, copy nv~t E~ Add to Portfolio 'w~' Set Alert 1'U Email to a Friend r..~.._..,., , _~ Get Historical Prices for Another Symbol: ~ G0 Svmbol Lookup • Stock Screener Splits • Mergers & Acquisitions Copyright ©2009 Yahoo! Inc. All rights reserved. Privacy Policy -Terms of Service - CopyrighUlP Policv -Send Feedback Quotes delayed, except where indicated otherwise. Decay times are 15 mins for NASDAQ, 20 mins for NYSE and Amex. See also delay times for other exchanges. Historical chart data and daily updates provided by Commodity Systems Inc (CSI). 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By accessing the Yahoo! site, you agree not to redistribute the information found therein. http://finance.yahoo.com/q/hp?s=HCP&a=04&b=7&c=2009&d=04&e=7&f=2009&g=d 10/1/09 3:25 PM Page 2 of 2 REV-1507 EX+ (1-97) ~~;~ sc~~~uL~ ~ COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF ~.~ TC~~ ~~N~ P FILE NUMBER ai-aq- s~3 All property jointly-owned with right of survivorship must be disciosPrl nn Srhprliilp ~ ~~~ nwic sNace is neeaea, insert aaamonai sheets of the same size) Note U.S. $30,000 June 5, 2001 Mechanicsburg, PA FOR VALUE RECEIVED, KING'S FIRE PROTECTION, INC., (The "Maker") hereby promises to pay to the order of June Deitch (The "Payee"), the principal sum of thirty thousand and no/100 dollars ($30,000) together with interest thereon from June 5, 2001 at six and one-half percent (6 %2 %) per annum. This NOTE will not be redeemable until June 5, 2006, interest will be re-negotiated with the Maker for the subsequent years. literest to be paid in four quarterly payments per annum. In the event of death or disablement of Payee, KING'S FIRE PROTECTION, INC., promises to pay Carol Smith, (daughter of June Deitch) the principal sum together with interest based on said amount above. Demand shall be made in writing by the Payee to the Make1• by hand delivery to the below address or first class mail, postage prepaid, addressed as follows: 1 Bremleman Circle, Mechanicsburg, PA 17050 The Maker hereby empowers any attonley of any court of record within the United States of America or elsewhere to appear for the Maker and, with or without complaint filed, confess judgment, or a series of judgments, against the principal debt, together with unpaid interest thereon, costs of suit and an attorney's commission for collection of ten percent (10%) of the total indebtedness. The Maker hereby forever waives and releases all errors in said proceedings, waives stay of execution, the right of inquisition and extension of time of payment, agrees to condemnation of any property levied upon by virtue of any such execution, and waives all exemptions and levy and sale of any property that now is or hereafter maybe exempted bylaw. The Maker hereby waives presentment, notice of dishonor, and protest. IN WITNESS WHEREOF, the Maker has caused this instrument to be executed and declared on its behalf by its duly authorized officer this d6 day of ;~%G, , 2001. ATTEST KING'S FIRE PROTECTION, INC. G~ . , - Secretary Fit ~ J ~~, .~~ ~ ' Hai y M. Smith, President (corporate seal) REV-1508 EX •,(t•97) z SCHEDULE E QQ COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, a MASC. INHRESIDENTDECEDENTRN PERSONAL PROPERTY ESTATE OF ~~,I TC ~, ~u N~, ~ FILE NUMBER Z ~ a 9 s o3 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyovmed with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. pQr~',aI R~~c.+nd h'1c.nnbn;~'~ l~wtual ,/~,d A~ssoc~a~oh r~s-.s-, 7S a - ~arl-i civ~ G~>~ ~1 u.m a~r-Q ~ ,3 Q SO 3. l~0 Yl so) e T 1r' (relota~i vel y of ~Q ~ o(c! - (~zS{~ ~ ov-~ I t/ ! ble,~ . ~a a , ~ ~. pre ss~.~- '~,~'Y da 5, CGt.~sf • v~ Or~u~ ors ~ ©,~ DD G. ~i a rrlo~d ~~n ~s~ra /l~ ~- oQ r3 _ .. ?- ~} . O ~G1i/14 C~SCt' D/A~ L~ ~~~ pia ~'r' ~ ~""o . O v ~~Z7 . po l~~o ,yv~ : ~cet~ent ~a.~ /Zo ~.sl c~ ~~ ll~ ~ ~ ~ ~'vcn a,u~a~- a // iv~lr uAe~l ~ a~Gli~zCe. off. one ye4.Y I"7~,/~ Q4 ~ D, q~. TOTAL (Also enter on line 5, Recapitulation) I $ ~, 3.~a, 7S ~REV•1509 EX + (t-91) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~E17.CH , ~kti~ ~ 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 A. F{A.RIp y ~, sm/ Tiy B. C ~1Zoc A~, Sm ~TI-1 c. FILE NUMBER ADDRESS ~ b 8 ~ ~aad 1'Y- a c.~4,n is s b ~ r~, P~ ~ ~es-a / 6 ~' s~u..fi'c Gcoad /'1'I e chrcrt i c s ~u r~, P~' 1 cos b JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach NUMBER TENANT JOINT deed for jointly-held real estate. 1. A. y~//o.Z z Do ~ !3 u~CK Sedan , Cu,~I-on~ y d r v/N a~~twss2~~~r~3t~t~ 67, Ooo n,~lea~e ear I~alkahoh by Edmunds.Cor>r, = i~y,7B~. °° (•see rYalu~.hoH ~Sheef Off~zcl>led) far 1/,t1aa~-'ch by belley ~bve ~k=~,I, 47Soo O (Sea.. va qua ~;oh .,S,lieet Q'fh7cl~rQ/~ ~~{, 7 87, eo f +~ ~f, '175. vo ~,ve. = µ, (0 31. °° ~, ~ i6~ , oa Q. 3~~5/ I~/UC dank /}rc~: No. Sol o// So33 pri nc i~al ~Ip~ 73G, 8'~O Aker. ~fi. ~f ~ o~ $ /o, 7~Fo- 9 s DATE OF DEATH VALUE OF ASSET ~~},(°31,00 o?/-p~j_ S03 RELATIONSHIP TO DECEDENT soh-in -/¢W d a.~l~f~er OF DATE OF DEATH DECD'S VALUE OF INTEREST DECEDENT'S INTEREST ,~, ~, 3/S, s`b .5ofo ~ ¢ S. 3 7o.'f S TOTAL (Also enter on line 6, Recapitulation) I $ ~~ (~$ ~', 4 "~,`> ., R , CERTIFICATE flF TITL>~ FOR A VEHICLE ._ ..f.~,~_ ___,__.~..~_____ _ ...-- w___.._. y .. T Y ~ ~ _ , _ ,~~~ .~ _. ,. ~ fi4. C ~~ a;S52:~182]~2' ~~~1:~b . ~~IQ2 ~ H~iII ~K~ .,`5~'~'8~.~~2~`Q~ Sn . VEHICLE IDENTIFtGA710N NUMBER ~ YEAR ~ MAKE OF VEHICLE ~ ,T T i f 1 LE NUMBER +~ ~ ... _... ... ... ~ I ) ;. .: fYfF N ~ "~ ... - ..- ..- ..... 1 ;: , .BODY TYPE ) DUP ~ SEAT CAP i PRIOR TITLE STATE 1 ODOM. PROCD. DATE ~ ODOM. MILES ~ ODOtvi STATUS _. ~i It3 , ... ,- .. . DATE PA TITLED DATE OF ISSUE UNLADEN WEIGHT ~ GVWR i GCWR' `~-'t[ ~ ~ ~ ~D 1 - ~~~- ~ a ~d ¢:~~:;n; I- I C,. - 3~, ~o~T o~NER~Hip aITH ~~~~~rs ~lR~tl ~QRSNI °' REOISTEREO OWNER(S) tY-~'~ ~ ~„$ t~ ~ ~ti oO Ir/"~l'~~~r~ HARRY x'I 5~1ITH c`~~~~Jfirrr~,~r;~~rr-~~~t,,~tu~~>•~E~~~I `~~~ .. , ~ ~b ~ ~~` ATE R~ . _ _~ . . ~. _} ,~- ~:- ~~ ,~ ~_ '' i _~ ~ ~ Q~ FIRST LIEN FAVOR OF; SECOND UEN FAVOR:OF: t ` ~ , k- ;~ ii a second iienhoitler is listed upon satisfac lienholdgr must onward this Tttie to the Sure _. .--_..,, ,.~,,,,,,a, wetn Tne FIRST LIEN RELEASED ~ appropriate torm and tee. 'DATE.. i. + BY SECOND LIEN RELEASED ~; AUTHORIZED REPRESENTATIVE DATE r - MAILING ADDRESS ~lii~~'~$e~ ~ HARRY ri ~~[ I T ~ Lb8 STATE R3~ l~E~CNA{~I CS®QR~ PA 3,?Q5Q BY _ r'iViii.iiilLLU i,i iICJ_i>..~i,vi. ~. 1 certify as of the date of issue, the ofliciai records o1 the Pennsylvania Qepartment At..LE~I ~? BI EMLER of Trertspnrtetion reflect that the person(s) or company named herein-isdhe-tar+hrt-ownar ------ a • of lire said vehicle. • - Sec eta Transports r ry n Finn . , r ~ '+' hfr ~ .r ~:` rc, f! i~~ t. t!{ r F! filcT •.'s1 ,w i..~Fi:_:Sx:`icl s ~~"e, i~~r • r - SU$SCRIBED AND SWORN ~ if a co-purchaser other than your spouse is listed and you .want the iitie to TO BEFORE ME: be listed 8s "Joint Tenants With Right of Survivorship" {Qn death of one ~ ~ v vsAR owttei'; title goes t0. surviving owner) CHECK HERE ^. Otherwis$, the title will tie issued;as "Tenants in Common" (On death of one owner, interest of deceased owner goes to his/her heirs ar estate). T R F P N A M 1 iNG T - J r 1F NO LIEN, CHECKI~ IS THIS AN ELT7 (1F YES, FIN REQUIRED) YES ^ NOC~ 1 I. -' ~ +GT I IG~IUI1/ nCD C!l~I tllar!`i At IF~nT}TI ITII'IAz htl Il II]CD~ i '•.~~ ~ ~, ( TST L1EN~IOLDER NAME - 0.. ~Q ~ STREET ~S ,f-- ~ CITY STATE ZIP The untla,s+ ned 7 b IF NO 2ND LIEN, CHECK ~ tS THIS AN ELT? IIF YES FIN AEOUIRED) YES r NO n g »tfl y makes BpprM,etbn Ipr Cer3eficefe of Thia to lt+0 veAtCe tlesClfhetl i ...,e ., ..F.,.. e..M .,r .M:........ Ana .flu. u q : , V ~... ... . . n,r,- ...., ..a... L. ~.~ .. .. ..~. ~~-.:T . ..~ -'. 2ND LIENHOLDER NAME .SIGNATURE OF APPLICANT OR AUTHORIZEn SIGNER i STREET TI . t i SIONATLIHE OF CU~APPi.ICANTlTITL£ OF AUTHORIZED 516NER G(TY STATE Zip Edmunds used Buick Century car appraisal. 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Get a Free CARFAX Re~co~rTd Check. ~~4aI[! +.ws~ .aTUr uwn • Auto Loans as low as 5 49% APR • Get a Bad Credit Car Loan STEPS Review Edmunds.com Pricing Report ~"'^""} True Market Values"' ],,,...~.•,~ Pricing 2002 Buick Century Custom 4dr Tra -In Priv Party Sedan National Base ~i1ce $3,251 $3,954 Oational Eauiameni $84 $102 Power Driver's Seat $33 $40 AM/FM/Cassette Audio System $26 $31 Cruise Control $25 $31 Color Adjustment white $-25 $-30 Regional Adjustment for Zip Code 17055 $12 $14 Mileage Adiustment 67,000 miles $747 $747 Condition Adiustment Clean $0 $0 Total 54,o6s Sa,~a~ 6/22/09 11:25 AM TRUE MARKET VALUE Find Out What Others Are Pavlna For The Car You Want I With Edmunds TMV® you get a customized I price estimate based on your Zip Code, your '~ car, and your desired options. ~_ _.___.____r__~___~.....___.____..___..~__ ..-.----_._______~______e Going ~o a car dealer... M . • , ~ Dealer Retail $x,644 Ga to Dealer Ratings & Reviews $133 $52 edtntlnds '~ C4ICKHER ,,a., ...,~~;.. $41 $40 $-35 ,TIPS & ADVICE $16 ± 10 Steps to Buying a Used Car 10 Steps to Selling Your Car $747 Confessions of a Car Salesman Fuel Economy Center $0 Car Safety Guide 'Car Audio & Electronics Center 55,505 http://www.edmunds.com/used/2002/buick/century/19004/options.html?tmvaction=vdpresult Page 2 of 3 Edmunds used Buick Century car appraisal. Used Buick car pricing. • Auto Loan Calculator Certified Used Vehicle Helpful Tools Price Another Vehicle • Maintenance Print Window Stickers: Tr -In I Private Partv I pealer Retail h ul Buying a New Car? Get new car pricing in your area. • Recall Notices _ _ _ ____ • Technical Service Select a Make s' ~ ` ~ Select a Model J•v ZIP: ,' 17055 Bulletins Buying This Car Used? Search 2002 Buick Century Listings Near You Zip Code: 17055 Research a New Car • 11/ ~ ! !! Sedan Truck Minivan /Van • ., • +- +~ Convertible Coupe LuXUN H ri Browse by Make: New Car Buyina Guides: ( Select a Make ,'- ~._____~_ A Smart Look at What s New for 2009 Ready to SeU Your Car? Create an ad that will reach the most buyers anywhere and sell your car fast! Enter your zip code to get started: -~-~~ '~ ~„` ~~ ZIP: , 17055 i ~-Continue pow~ne by AxriCOTl eder' -v~A Get A FREE CARFAX Record Check Order a CARFAX Vehicle History Report ... your best protection against buying a used car with costly, hidden problems. ' Fri:e CARFAX' Record Check's • Search Used Buick Listinos • Auto Loans as low as 5 49% APR • Sell Your Car Qnline • G~ a Bad r riit ~ r Loan i(.r,;~: IJi.~ ;. ~. Itti 1 f ),, ~ ~,. t i F .v~ 1.. ~i liUvf(t ) ~.~fr t~ri<: r. i. t. iii u~ ar.-.r (irtri( r.~i~ir ( i ~ ~ :.,~t A i ,, rata(` `>~~(i.:~; '~)il ~' ; r,(~ i i~..~ l„ ~ h.-`: iii .iC .I 1, r,r, a N ~.. .. .r,'r. _ <.fF 1 .,(uE t.t; i>... h Cc~.rs ~ Aut., ,t.i,~.n _„i:~. , ,.>.~ r, (,u ;[r ~i, ,.li ~ .i,at~~c- .., C_tinit;nds ~, hinry~ Ea~ployrtfent Qppprt~anitias f~ y(i~:i')-._Ii:)~;' C:i IYl lJlli~`. :f'""!.. r'i Vd ~,; F:( ,?r~.'E'f i[ ' !>ii.Vt ~ _)I'!~?w(;1(?(!' http://www.edmunds.com/used/2002/buick/century/19004/options.html?tmvaction=vdpresult 6/22/09 11:25 AM Page 3 of 3 2002 Buick Century -Private Party Pricing Report -Kelley Blue Book 6/22/09 11:28 AM Kelley Blue Book THE TRUSTED RESOURCE e .,...,,,~ i•~ri Uar~ sea tears rcesearcn ~ Explore NeWS & Reviews Dealers & Inventory Classifieds Lc-ans & insurance Used ~f~ar Prices I Search Used Car Listings I Certified Pre-Owned ~ Compare Vehicles I Perfect Car Finder I Most Researched Vehicles I CARFAX Vehicle History Welcome Back I Sign In I Create Account I My KBB ZIP Code; 17055 Recently Viewed You Might Also Like Free Dealer Price Quote Latest Car News Top 5 pad Sedans for 2009 More News Home > Used Cars > 2002 > Buick > en r' > Custom Sedan 4D 2002 Buick Century Custom Sedan 4D Trade-In Value __.. _ _. _. Private Party value BLUE BOOKS PRIVATE AARTY VALUE <,,,„„,., „y,~. Suggested Retail Value i~ i Photo Gallery Condition <u,~R,, ; ,„,:, Value Compare Vehicles n+cuir . Review Excellent $4rgpp i Consumer Ratings Find Your Next Car GOOd 4,475 Specifications ~ - Fair $3,975 More Photos s~ Shopping Tools ~y JT a ~ ~ ^ ~~ SCAftCN LC7CAL LISTINGS ~ hree CARFAX R ecord Check / ~ ` '" ~ Auto Loan from 5.49% APR ,~ ~ , _ ra_ ,~ Get Your Credit Score Now , ,~ Free CARFAX Record Check Powered by Get a Free Insurance Quote """"""""' Payment Calculator ,..__,,.,,,,,,,~ Extended warranty quote VIN; , + Print For Sale Sign No VIN? No Problem! BUY A USED CAR Average Consumer Rating (240 Reviews ' ` ,:, ) Read Reviews On Blue Book Classifieds'" 'iQ'Q'~y~~.:- 4.4 out of 5 Review this Vehicle _ ____ r3uick _ . ~ ----- Vehicle Highlights . * ~ Century 25 Mlles or less ~~ Mileage: 67,000 Engine: V6 3.1 Liter ZIP Code 17055 Transmission: Automatic To View Ads, Click Drivetrain: FWO i _ . ,. ., ... ,,~. , ,. , _,. , ~,_ ~~ a, ~n~~ ~~a~u„t~ ~~~-. "LIST YOUR EAR FOR SATE ' :selected Equipment Change Equipment Special Package Offer! ~ Standard 'ii)i:I) For one low price you ' can reach millions of qir Conditioning Tilt Wheel Dual Front Air Bags ! ~ used car shoppers. , power Steering Cruise Control ABS (4-Wheel) power Windows AM/FM Stereo Traction Control Learn more now Power Door Locks Cassette ' Optional , ., ~" Power Seat fINO THE RIGHT CAR Compare Used vs. New _ _~ Under f 5,000 ~ • - _J , . - ; Both New and Used :~! Blue Book Private Party Value :----------~--- -- Sedan ~ : ' Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "AS Is" and carries no wan-anty (other than the continuing factory Save Vehicle Print ~ Emafi ;>~ BOOKMRRK ,~! ~~~ m,,, http://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=2002&M...%7c17055%7c0%7c0%7c133963%7ctrue&Condition=Good&QuizConditions= Page 1 of 3 2002 Buick Century -Private Party Pricing Report -Kelley Blue Book To View List, Click VIEW ANOTHER VENI(lE Select Year... Select Mike... Select Model... ' Or Search by Category Or Change ZIP Code warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Falr Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings Check Vehicle Title History Excellent ~ $4,900 Looks new, is in excellent mechanical condition and needs no ' reconditioning. Never had any paint or body work and is free of rust. • Clean title history and will pass a smog and safety inspection. Engine compartment is clean, with no fluid leaks and is free of any wear or visible defects. • Complete and verifiable service records. Less than 5% of all used vehicles fall into this category. Good ~L'il~° '; $4,475 Free of any major defects. • Clean title history, the paints, body, and interior have only minor (if any) blemishes, and there are no major mechanical problems. Little or no rust on this vehicle. • Tires match and have substantial tread wear left. A "good" vehicle will need some reconditioning to be sold at .retail. Most consumer owned velilcles fall into this category. I^air °L'#' -.-., .e $3,975 Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professional Tires may need to be replaced. • There may be some repairable rust damage. Poor ~3 :' , N/A • Severe mechanical and/or cosmetic defects and is in poor ' running condition. • May have problems that cannot be readily fixed such as a damaged Frame or a nrsted-through body. Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. Pennsylvania 6/22/2009 Accurate Condition Appraisal Change Condition Accurately appraising the condition of a vehicle is an important aspect in determining its Blue Book value, Taking our 16 question condition quiz will ensure you know the correct condition rating. ~~~ ~~ ~ • aFRF2CN L.UU~1L L.I~`1tt+tCu CG 2009 Kelley Blue Book Co., Inc. All rights reserved. 6/19/2009-6/25/2009 Edition. The specific information required to determine the value for this particular vehicle was supplied by the person generating this report. Vehicle valuations are opinions and may vary from vehicle to vehicle, Actual valuations will vary based upon market conditions, specibcations, vehicle condition or other particular circumstances pertinent to this particular vehicle or the transaction or the parties to the transaction. This report is intended for the individual use of the person generating this report only and shall not be sold or transmitted to another party. Kelley Blue Book assumes no responsibility for errors or omissions. (v.09063) 6/22/09 11:28 AM http://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=2002&M...%7c17055%7c0%7c0%7c133963%7ctrue&Condition=Good&QuizConditions= Page 2 of 3 2002 Buick Century -Private Party Pricing Report -Kelley Blue Book Estimated Payments X89 /mo Cd, 5.99% APR ,l~tk 1lt. I>C(Ci~'. Get a Pre-Owned Loan from G.49% APR Get Your Credit Score Now Get a Free Insurance Quote - - - advertisement --,______ pn K6E,.t.um rijr~.; t::r , ir:' i ,~ 1.. .:J -._<+is ~iCSGdrta. ~ -:>_~~i0,r A;~ :<< +_ ~<:v~9 •., L;edic,<; ~~ invr?nio~}' C.~d;3ff~GtlS. l..Odi~i' k ..~,9l~tc+~'Gi (f;_,'.~G~-CB~i i.iZC':"-ti0v~i;: +~iOIG~Cy`.ii't: Featuring Car Insurance Gas Mileage Champs Find A Car Dealer Best Car Deals 5 Great Car Deals Car Reviews Cars For Sale Car Videos 6/22/09 11:28 AM About KBB About Us Contact Us Careers FAQ Media Advertising Linking Privacy Site Map Copyright & Trademarks Terms of Service © 1995-2009 Kelley Blue Book Co., Inc. http://www.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=2002&M...%7c17055%7c0%7c0%7c133963%7ctrue&Condition=Good&QuizConditions= Page 3 of 3 Jul• 8. 2009 12:46PM .PNC BANK 412-705-2747 QPRiC LfA0N1GTHEWAY July 8, 2009 Charles E Shields III Esq 6 Clouser Rd ' Mechanicsburg, PA 1706 RE: Name: June P Deitch SSN: 198-22-9985 DoD: vs-o7-2009 Dear Mr. Shields: No. 5961 P. 1 ~~/~/09 In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Checking Account Account # 5070115033 Established: 03-26-2002 JUNE P DEITCH CAROL A SMITH DOD balance: $10,736.86 + 4.09 accrued interest Interest paid 01-01-2009 thru OS-07-2009 $24.96 YTD Please note that this office provides date of death balances for deposit accounts (ZRA,s, CDs, Checking and Savings). We do not process any f na~ncaal 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 >3auk branch office. Sincerely, National FXnancal Services Center PNC Bank, N.,A.. . Member FDIC Page 1 of 1 REV• 1510 EX + (0.97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE GEED FOR REAL ESTATE . '~~'VIBER VALUE OF ASSET INTEREST IFAPPLICA ~ . SUN L -~E F ~N,~1V ~J~~ ~s /gam/~-!! ~¢'i,~ ~ I S C.GDS~ X012 ! /U F'vl~Z kl~To/U,~iL ,I~u,l~p0 SE5 /,~' loo _...~ ~ ~~" ati c. y ~4 ,/~o ,~3ENE,~/% G~L~/~I ~~ N~3C -- / 8~/ ~~~TC~, r~~~- oEc~~r ~~~~~~v, ,s ~L-=l~ ~/JfDliE~_ //l/ /~E5'/~o~1/SF Ta /C,~ Tia/,~/ DiY T~l-S ~Co u~ T, /' Wi9fS //1'Eo/~~l~J ~~S/~T ~~ /9771 /1~~~T ~~ CD~Es',/r'oiv~'avc~' o~ ~~y ~8, ~ .~ TT,~c~~~ ~~ TOTAL (Also enter on line 7, Recapitulation) I $ /~-t~'-D DNLy tee a Sun ~:` Life Financial May 18, 2009 Carol A Smith 168 State Rd Mechanicsburg, PA 17050-3156 RE: Policy Number: 50-1 1-1 1 50-049763 Claim Number: NBC-188188 Deceased: June P Deitch Dear Ms. Smith: Please accept our sincere condolences upon the death of June P Deitch. We are contacting you to let you know that a Claim has been established on the above Policy. However, this ,Claim has no financial outcome and is referred to as a No Benefit Claim (NBC-). As the contact person and owner, we would appreciate your help in providing the following documents in order to assist us in completing our internal requirements: * Original certified death certificate (with raised seal or colored stamp) listing the cause or manner of death. * Please include a signed letter of instruction requesting to remove the deceased annuitant, Include your date of birth and social security number. Please return to us the completed forms and documents listed above in the enclosed business reply envelope. If you need assistance completing any forms or have any questions, please call us at (800) 752-7215. Sincerely, Claims Administration Department Sun Life Financial PO Box 9133 Wellesley Hills, MA 02481 Sun Life Assurance Company of Canada (U.S.) and Independence Life and Annuity Company are members of the Sun Life Financial group of companies. ~'~~I A Sun ~; Life Financial SM Sun Life Assurance Company of Canada (U.S.} P.O. Box 9133 Wellesley Hills, MA 02481 Tel: (800} 752-7215 CAROL A SMITH PART JUNE P DEITCH ANN 168 STATE RD MECHANICSBURG PA 17050 I~~~III~~~III~~~~I.I~I1~~~11~~~11~~~11~~~11~~~1~~~11 SUN LIFE FINANCIAL MASTERS CHOICE FIXED/VARIABLE ANNUITY 1N1~ESTAh~P1T ~GRQSS:~dNTRIf3UTlc~l>1S `GROSS: Of'TJ~N P1,AN Tfl C~~iTE l'E:4R;7~-Dt~T~ PLAN ~'O C7ATE .. . Fidelity VIP Mid Cad Svc2 . . FVM 1,500.00 0.00 0.00 SC Goldman Sh Duration SDC 0.00 0.00 0.00 MFS Bond Portfolio MF7 1,500.00 0.00 0.00 MFS Research Internation RIl 4,500.00 0.00 0.00 MFS Utili ties Portfolio MFE 1,500.00 0.00 0.00 MFS High Yield Portfolio MFC 1,500.00 0.00 0.00 31843E CONFIRMATION STATEMENT February 23, 2009 Page 2 of 2 Contract# 11-1150-049763 Broker/Dealer: TIMOTHY G LONG PROEQUITIES INC 176 CUMBERLAND PKWY STE 202 MECHANICSBURG PA 17055 WITWDRAWALS ~l1RREN~' NllfalBER ""UI~IIT YAL.LIE" ` 1fALU!_ .= FEAR-T"d :C3,4~E ~~SF t]h11T5OWNEi7 BY'QPTIQN 0.00 146.03126 6.4034820 935.11 0.00 292.76071 10.2070390 2,988.22 0.00 90.60751 11.2951790 1,023.43 0.00 212.76278 11.7515900 2,500.30 0.00 46.56036 20.1691200 939.08 0.00 102.00465 10.4095960 1,061.83 * * TOTAL VALUE $ 18 , 526.92 * PER YOUR INSTRUCTIONS FUTURE INVESTMENTS WILL BE ALLOCATED AS FOLLOWS: FMS 20% OCA 10% SRE 5% IGB 10% SVV 5% FUM 5% SDC 15% MF7 5% RIl 15% MFE 5% MFC 5% PLEASE REVIEW THIS STATEMENT CAREFULLY. DISCREPANCIES REPORTED WITHIN 60 DAYS WILL BE ADJUSTED. OUR TOLL FREE NUMBER IS 800-752-7215. INFORMATION CONCERNING COMPENSATION ARRANGEMENTS MAY BE FOUND IN THE PROSPECTUS. FOR FURTHER COMPENSATION INFORMATION, PLEASE CONTACT THE BROKER/DEALER LISTED ABOVE. REV-111 EX+ (12-99) ,~' ~1,~, SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF ~~' TCHi ~.~~~ ~• FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. ,(-~ a) aYt ~G dui. fio ~I1pt,lPe z2 ~ ~Lb h+~ >kn la'u D ~ wf11 f:~l ~ l C ~ u r 9 -~ r po~~~ort --,of pra•~a~d or c~+r~e.d~t'ed U ~ j• oStS', ~o B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) CCt,1^o) ~, S~ iT11 (,~a~ ve d Social Security Number(s)/EIN Number of Personal Representative(s) Street Address ~ `~ pS T'A~ e ~ p q,~ City ~ GC.~1 GtXl~f CSbt~l,rt, State p~' Zip ~7b SD Year(s) Commission Paid: 2. Attorney Fees ~ ~ ~~k 5 C• ~ ~ ~ P~crlS ~. ~~ 9 D~ • ~D l 3. Family Exemption: (If decedent's a ddress is not th~ep same as claimant's, attach explanation) a Claimant CQ,?"b~ i7'- SM~ ~ h 3~ SDo• Dp Street Address ~ b ~ S~a.~ ~ d City _ m 2 G`'1alJY1 I C S b u~ State ~~' Zip lI 7 o S ~ Relationship of Claimant to Decedent _ da~t~q~ter of w h~~e b l o a cQ . 4. Probate Fees ~ p~~~~hq,l} /SSKG OT' S~ph~ L''e1"f't C~~Ca,teS '~ 9 9.00 5. Accountant's Fees Sat-y Wetl~er, H ~a2 ~Io~k, Mechrvn;csbwr~ (es~,) X700 00 6. Tax Return Preparer's Fees ~-I osc o ~ l D~D~ 114 ~f ~1, Etc , /Qt j1~ ~0/f ~ j~ ems, , ~. fildrtr,~'is~j~ ih Flint~r/std ~~J T ~rna~ 9 ~ da ^7s . 8. Q ~~re~,t~ s~~ say ~a r/~'s/e csca~. ~e / ~ i 3 y, yy 9. /i~c.i~1d~,/se~,nh~ ro ~~lur~pS C oS'Li ~~~45 ~ ~" ~,r ~~~e• , ~GrZ~i ~r'~l /!1A/~ ~l AS/ ~f/Zp~~P/QS~ P.+~ • r~2S17/h •~ ~a7,~/ Jr'o ~- ~da~.{idad~ ~hvl~a~ ~e ~v ~eg-is~'r o~ ~i. %/s ~ ~S• 00 a . l'e~~~t,~s>~c~~ ~ Gloms ~: --sh•~~s rte, Q:~~~ S, ~. 1~ .~o. 00 TOTAL (Also enter on line 9, Recapitulation) I ~ ~~ $,s~f', ~~ r as ~ ~ ; ^ ~:~ ~~~ Malpezzi Funeral Home ~ ~ ` °;,.A ` ~ ~ ' ~ ~` 8 Market Plaza Way Mechanicsburg, PA 17055 (717)697-4696 Michael J. Malpezzi, Owner, FD Jeremy J. Shartzer, FD Kyle C. Knipe, FD September 8, 2009 Mrs. Carol Ann Smith 168 State Road Mechanicsburg, PA 17050 The Funeral Service for June P. Deitch We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff , _ $4275.00 FUNERAL HOME SERVICE CHARGES $4275.00 SELECTED MERCHANDISE: Stainless Steel Protective Casket $3750.00 Sentinel Vault, $1335.00 Kinkade Register Package _ $165.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $9525.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. CASH ADVANCES Opening Grave, $800.00 Cemetery Equipment , $160.00 Newspaper Notices -Patriot, $311.12 Newspaper Notices - Shippensburg $135.00 Newspaper Notices -Carlisle $150.71 Newspaper Notices -Everett, $28.12 Clergy/Mass Offering, $100.00 Certified Copies of the Death Certificate , $72.00 Flowers . $190.80 Monument Engraving _ $150.00 TOTAL CASH ADVANCES AND SPECIAL CHARGES . $2097.75 CONTRACT PRICE $11622.75 HISTORY 05/18/2009 Pmt-Forethought $-9977.81 09/08/2009 Guaranteed Pre Need $-599.48 TOTAL AMOUNT DUE $1045.46 REV-1512 EX+ (12.03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ~~~ r C~, ~~ N~ ~ FILE NUMBER a~-oq-s~3 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death. inrliirlinn ~inroir.,h„rcnrl Me,,~,.,~ .............._ x p ~ ~ v m ~ m ~ D C n ~ ~ "0 cn m x - m D =y~y cn m~°m_ -i mom m ~ z-c `s~~ _ ~ ~ n w cn DOD m _ c.. ~ ~ ~ _ D m W ~ZN ~m~°~ n C ~~oz OD (jQD ~nu'cn W = rn~~~ ~Ou,,_. Om ~~~ O c~0 Z U, O ~ m ~ G) ~ mm N ~~~Z co ' D r Z - ~ ~ ~ D r Qo ~ Cn ~ ~ Z ~ _C -I v ~ ~ ~ D m m C co m o o N -zi `° W o ~ r r ~1N] 1 0 ~i~n~C~C~C7 ~aOzapav~o ('t ~ ' "3 ~'t C ~ F-' U1 ~ G ~ o ~ - N n ~ ~ ro ~ u c ~ - ~ ~ p ~ 'n a o . p_p ~ ~ C ~ o ~ ~ ~ < ~ ~ m ~ ~ o J ~ p ° A '~d ~ M H Mme, O~ oz o o d a a D ~ c~ ~ ~ as C ro 0 ~ cn O O p p ,Z ~ c°a n ` ~' ~ O O o .Nr ~, ~ -~ ~ ~ ~ c m x m n o ~ ~~ ~~ ~ "~* n ~ , ~ M H ~ ~ m ~ V ~ n CAD ~ N ~ ~ ~ .P w ~ d ~ C7 Q. H ~ to Q d. N N 0 ~ 'O iG ~ ~A ~ O 7 ~ N '~ .. ~ ~ 0~ ~~ 0 .N 0°4° N o,p .. 3 ~ Q k W ~ ~.. H H ~ o w NN 4A ~.. lTt (!~ ~ .; wO ' Z O CD ~ O O t0 l0 O O O O O O S2 w .~+ CD CD ~ i ~ O W 0 00 ~ ~ ~ O 00 ~ l0 O. dp O do CO r ~r ~, :\ One Team ...One Minion CUMBERLAND COUNTY AGING & COMMUNITY SERVICES June P Deitch 168 State Rd Mechanicsburg, PA 17055 16 WEST HIGH STREET, SUITE 100 CARLISLE, PA 17013 (717) 240-6110 OR 1-888-697-0371 ExT 6110 FAx: (717) 240-6118 Gary Eichelberger Chairman Richard L. Rovegno INVOICE FOR SERVICES Vice Chairman Barbara B. Cross Secretary Terry L Barley Director ~1 . Invoice Number: March-nn09-Deitch ll~vl)Il.~ DatC: 1•lay '7, LVVS SERVICE PROVIDED: Personal Care MONTH OF SERVICE: March, 2009. ACTUAL COST PER Hour 18.70 YOUR REDUCED SLIDING FEE SCALE RATE PER Hour 13.65 TOTAL Hour(s) OF SERVICE YOU RECEIVED 16.00 PLEASE PAY THIS AMOUNT 218.40 Payment Due Upon Receipt of Invoice. Payment Is Delinquent if not paid by May 28, 2009. Contact CCOA if any issues. Make Checks Payable To: CUMBERLAND COUNTY OFFICE OF AGING Please keep this copy for your records ~, :~ One Team ...One Mission June P Deitch 168 State Rd Mechanicsburg, PA 17055 16 WEST HIGH STREET, SUITE 100 CARLISLE, PA 17013 (717) 240-6110 oR 1-888-697-0371 ExT 6110 FAx: (717) 240-6118 Gary Eichelberger Chairman Richard L. Rovegno INVOICE FOR SERVICES Vice Chairman Barbara B. Cross Secretary Terry L Barley Director Invoice Number: April-09-Deitch Invoice Date: June 4; 2009 SERVICE PROVIDED: Personal Care MONTH OF SERVICE: April, 2009. ACTUAL COST PER Hour 18.70 YOUR REDUCED SLIDING FEE SCALE RATE PER Hour 13.65 CUMBERLAND COUNTY AGING & COMMUNITY SERVICES TOTAL Hour(s) OF SERVICE YOU RECEIVED 20.00 PLEASE PAY THIS AMOUNT 273.00 Payment Due Upon Receipt of Invoice. Payment Is Delinquent if not paid by June 29, 2009. Contact CCOA if any issues. Make Checks Payable To: CUMBERLAND COUNTY OFFICE OF AGING Please keep this copy for your records a~. One Team ...One Mission June P Deitch 168 State Rd Mechanicsburg, PA 17055 16 WEST HIGH STREET, SUITE 100 CARLISLE, PA 17013 (717) 240-6110 oR 1-888-697-0371 ExT 6110 FAx: (717) 240-6118 Gary Eichelberger Chairman Richard L. Rovegno INVOICE FOR SERVICES Vice Chairman t3arbara B. Cross Secretary Terry L Barley Director Invoice Number: May-09-Deitch invoice Date: July 2, 2009 ,. SERVICE PROVIDED: Personal Care MONTH OF SERVICE: May, 2009. ACTUAL COST PER Hour 18.70 YOUR REDUCED SLIDING FEE SCALE RATE PER Hour 13.65 TOTAL Hour(s) OF SERVICE YOU RECEIVED ~ 4.00 PLEASE PAY THIS AMOUNT 54.60 Payment Due Upon Receipt of Invoice. Payment Is Delinquent if not paid by July 27, 2009. Contact CCOA if any issues. CUMBERLAND COUNTY AGING & COMMUNITY SERVICES Make Checks Payable To: CUMBERLAND COUNTY OFFICE OF AGING Please keen this copv for your records REV-1513.EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~ ~~ TCH, Tu ~~ ~? NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. e~ /1,bL ~, s,~~7,~/ /7bSD FILE NUMBER ~~- 09- So3 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE 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' 11(1 e.chQn'~ ~sbwry aPe~fifC-1 ~, Chr~sf Church U SCHEDULE J BENEFICIARIES .5'; 000. °" TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ ~O om • °C LAST WILL AND TESTAMENT OF TUNE P DEITCH I, JUNE P. DEITCH, of Monroe Township, Cumherland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do 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. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. I hereby give and bequeath as a charitable contribution to the Mechanicsburg Brethren in Christ Church (1050 South York Street, Mechanicsburg, Pennsylvania), the sum of five thousand ($S,000.O0) dollars. 3. I give, devise and bequeath all the rest, residue, and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate to my daughter, CAROL A. SMITH, ner stir~~es. 4. I nominate, constitute and appoint my daughter, CAROL A. SMITH, to be the Executrix of this, my Last Will and Testament. In the event that she should predecease me or for any reason be unwilling or unable to act as such Executrix, I nominate, constitute and appoint HARRY M. SMITH to be Executor in her place and stead. In the event that he should predecease me or for any reason be unwilling or unable to act as such Executor, I nominate, constitute and appoint DOUGLAS SMITH to he Executor in his place and stead. In the event that he should predecease me or for any reason be unwilling or unable to act as such Executor, I nominate, constitute gild appoint CATHY JO SHELLY to be Executrix in his place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~?~ ~ '(, ``. /, ~ day of +} ;~ ~' - , A.D. 200 ! _ - JU P. DEITCI-h-' Signed, sealed, published and declared by the above-named JOHN W. DEITCH, as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunt/sitb Bribed our Mmes as a,~itnesses. i .fir C ~- ~~~~~ ~~o, ~ off " ~\~ ~~~~ 5 ~ ~ o ~a ~~~~ ~ ~ ~,~~,~ ~6