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Home My WebLink About02-05-10 (2)METTE~ EVANS & WOODSIDE A PROFE88IONAL CORPORATION ATTORNEYS AT LAW 3401 NORTH FRONT 6TREET P.O. BO% 5950 DIRECT DIAL AARR7$$jJR(}, PA 17110-0930 (717) 231-5256 JAMES A. ULSH IRS NO. E-MAIL ADDRESS 23-1985005 jaulsh@mette.com TELEPHONE FAX (717)232-5000 (717)236-1810 HTTP;//F'W WMETTE.COM February 4, 2010 VIA CERTIFIED MAIL ~,,,, RETURN RECEIPT REQUESTED c7 ~' ~~~ -n ~ " Glenda Farner Strasbaugh ~ ~ `~ ~ ~ ~ ~ _ ~ :3 Register of Wills . ~ ~ ~ ~'~" ~ c~ .~ `-` f Cumberland County Courthouse ~`.`~ ~ ~, `- . `:- One Courthouse Square ~~ ~ -'~' ~ - --- ; ~ Carlisle, PA 17013 ~)~ N ``;-,'~ `~; ;a N ~~ •..~ . Re: Estate of Jane M. Dyson File No. 2009-00837 Dear Ms. Strasbaugh: Enclosed for filing are the following: 1. Original and one copy of an Inventory; 2. Original and one (1) copy of a Pennsylvania Inheritance Tax Return, plus a copy of the cover page of the tax return; 3. A check payable to "Register of Wills, Agent" in the amount of $2,046.49 in payment of the balance of Inheritance Tax owed; 4. A check payable to your office in the amount of $30.00 in payment of your filing fees; and 5. Aself-addressed, postage prepaid envelope for return mail. Please file the original Inventory and Inheritance Tax Return. Please forward the copy of the Inheritance Tax Return to the Pennsylvania Department of Revenue. Please return adate- stamped copy of the Inventory and the cover page of the tax return to my attention in the enclosed envelope, along with your receipts for the Inheritance Tax payment and the filing fees. February 4, 2010 Page 2 Please do not hesitate to call with any questions. Thank you for your assistance. Very truly yours, C~~ ~~-' ~-'~o Lisa J. od Paralegal to James A. Ulsh LJK: Enclosures 524131v1 .~. _ __ ~ _ f - _ - m,_ --~ _ _ _ _ . - -- .z .., lkk" '. ..Y .~ :. . e~ ~4t~~ L A.A ~y} f ~1M J yI0 r i r^ ~ ;`tf ~,~i ,+~~~ ~ ~~~ w R~~~ ~U10 f EB -5 PM IZ~ 44 C ~~~~~ ~~~~ ~ GC.. FA w o o w ~, h ~ 0~3~ c Q ~ E ~ ~ w D D ~ , t /] ,~0 ~~~ °~ ~~ ~ U ~ ~ ~ ~ ~ C a ~ o ~ o ~ ~ ~ozx~x ~ w~ W ~ p '~ °v a ~ p ' w~ ~ ., z ~ ~ c~a ~Cw 0 ~~ ~ ~ CF/~ V H a ~ ~~ ~~ ~a~~o~ O H F ~ 15056041158 J REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes Po sox 2aosoi INHERITANCE TAX RETURN 21 0 9 0 8 3 7 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 193-36-4253 08282009 05131918 Decedent's Last Name DYSON Suffix Decedent's First Name JANE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW MI M MI 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death ^ 4 Limit d E t t ^ 4 F prior to 12-13-82) ^ . e s a e a. uture Interest Compromise (date of 5. Federal Estate Tax Return Required 6. Decedent Died Testate ^ 7. death after 12-12-82) Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) between 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 JAMES A• ULSH, ESQUIRE 717-232-5000 N Firm Name (If Applicable) METTE, EVANS & WOODSIDE First line of address 3401 NORTH FRONT STREET Second line of address PO BOX 5950 City or Post Office State ZIP Code ,; i:'7 R .:~: :'"r'~ C-'3 c'7 --+-, -;_.r ``1 r`"r"I ~, HARRISBURG PA 17110-0950 Correspondent's e-mail address: J A U L S H a M E T T E• C O M Under penaRies of perjury, I declare that 1 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE JESSE E • FOSSELMAN __ ~/~s._ o?l~~jo SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE JAMES A • ULSH, ESQUIRE ~~---- ~ ~~- ~ Y /(~ ADDRESS 3401 N• FRONT STREET, PO 950 HARRISBURG, PA 17110-0950 PLEASE U I INAL FORM ONLY Side 1 15056D41158 BM46473.000 15056041158 J r~ 15056042159 REV-1500 EX Decedent's Social Security Number 193-36-4253 Decedent's Name:D Y S O N .I O N F M RECAPITULATION 1. Real estate (Schedule A) 1. 2 3 7 0 0 0.0 0 2. stocks and Bonds (Schedule B) . 2. 10 2 9 9 9 7.4 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . 3. O , 0 0 4. Mortgages & Notes Receivable (Schedule D). . 4. 0 • 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . 5. 17 617 6.6 9 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested 6. 6 4 2 0.9 7 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 0 • 0 0 8. Total Gross Assets (total Lines 1-7). s. 4 4 9 5 9 5 0 6 9. Funeral Expenses & Administrative Costs (Schedule H) . 9. 7 9 5 3 5.3 4 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). 10. 1617.3 7 11. Total Deductions (total Lines 9 & 10) . 11. 81152.71 12. Net Value of Estate (Line 8 minus Line 11) 12. 13 6 8 4 4 2.3 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . 13. 10 O O O O O • 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) 1 a. 3 6 8 4 4 3 5 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 0 , 00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .04,5 0. 0 0 16. 0. 0 0 17. Amount of Line 14 taxable at sibling rateX.12 300311.16 17~ 36037.34 18. Amount of Line 14 taxable at collateral rate X .15 6 8131.19 16. 10 219.6 8 19. TAX DUE 1s. 46257.02 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042159 15056042159 BM4848 2.000 REV-1500 EX Page 3 Fle Number Decedent's Com lets Address: 21 0 9 0 8 3 7 DECEDENTS NAME STREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0 • 0 0 B. Prior Payments 4 2 0 0 0. 0 0 C. Discount 2 210 • 5 3 3. InteresUPenatty if applicable D. Interest 0 • 00 E. Penalty 0 • 0 0 (1) 4625? • 02 Total Credits (A + B + C) (2> 4 4 210.5 3 Total Interest/Penalry (D + E) (3) 0 . 0 0 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 0 • 0 ^ 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2 0 4 6 • 4 9 A. Enter the interest on the tax due. (5A) 0 • 0 0 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 2 0 4 6.4 9 Make Check Payable to: REC~STER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the 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? ^ ^ X X X^ 2. If death occurred after December 12, 1962, 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? . X 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 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. 6M4671 1.000 REV-1502 EX a (11-08) Pennsylvania DEPARTMENT OF REVENUE WHERITANCE TAX RETURN RESIDENiDECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Jane M. Dyson 21 09 0837 All real property owned solely or as a bnant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointlyowned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheetrf the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owened as tenant in common. VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Real property situate in the Borough of Camp Hill, Cumberland County, PA, knoTan as 1952 Chestnut Street; further identified as Tax Parcel Number 01-22-0536-007A-UA-1952 See attached appraisal by Mark Heckman TOTAL (Also enter on Line 1, Recapitulation.) I S awasss z.ooo If more space is needed, insert additional sheets of the same size. 237,000.00 237,000.00 REi/-1503 EX + (6-s8) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER Jane M. Dyson 21 09 0837 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. 130 Shares Apache Corp.common stock CUSIP: 037411105 11,265.80 Held in Janney Montgomery Scott Account #2958-3257 2 200 Shares Arch Coal, Inc. common stock CUSIP: 039380100 3,534.00 Held in Janney Montgomery Scott Account #2958-3257 Dividend accrued on 8/28/2009 18.00 3 100 Shares Canadian Natural Resources, Ltd. common stock CUSIP: 136385101 5,930.00 Held in Janney Montgomery Scott Account #2958-3257 4 100 Shares Consolidated Energy, Inc. common stock CUSIP: 20854P109 3,897.50 Held in Janney Montgomery Scott Account #2958-3257 5 100 Shares EOG Resources, Inc. common stock CUSIP: 26875P101 7,344.50 Held in Janney Montgomery Scott Account #2958-3257 6 35,000 Par Erie PA Swr Auth Swr Rev Dtd:06/O1/O1; Mat:06/01/21; 5.125 CUSIP: 295533HR7 36,050.00 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 433.49 7 553.181 Shares Evergreen Etiinds Utility & Telecommunications Class A CUSIP: 300237849 6,002.01 Held in Janney Montgomery Scott Account #2958-3257 8 50,000 Par FHLMC Remic 3098 Cl BG; Dtd:01/01/06; Mat:01/15/36; 5.50 CUSIP: 31396GRF0 39,945.94 Total from continuation schedules 915,576.16 TOTAL (Also enter on line 2, Recapitulation) $ 1, 029 , 997.40 swasss ~.ooo (If more space is needed, insert additional sheets of the same size) Estate of: Jane M. Dyson 21 09 0837 Schedule B (Page 2) Item Value at Date No. Description of Death Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 158.39 9 100,000 Par FH7~MC Remic 3099 C1 WG; Dtd:01/01/06; Mat:ll/15/35; 5.50 CUSIP: 31396GV40 35,870.57 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 146.25 10 25,000 Par FHLMC Remic Ser 2891; Dtd:ll/01/04; Mat:ll/15/34; 5.0~ CUSIP: 31395JYC4 5,353.71 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 20.00 11 28,000 Par FHLMC Remic Ser 2898; Dtd:12/01/04; Mat:12/15/34; 5.00 CUSIP: 31395K4T7 13,775.74 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 51.36 12 100,000 Par FHLMC Remic Ser 2981; Dtd:05/01/05; Mat:10/15/34; 5.50 CUSIP: 31395U5V9 4,550.71 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 18.77 13 150,000 Par FHLMC Remic Ser 3015; Dtd:08/01/05; Mat:08/15/35; 5.00 CUSIP : 3139570`i50 44 , 236.11 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 165.87 14 20,000 Par FHLMC Remic Series RO10 Cl AB Dtd:02/01/07; Mat:12/15/19; 5.5~ CUSIP: 31397EUZ6 12,690.15 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 50.36 15 400 Shares First Eagle Global Fund C1 A mutual fund CUSIP: 32008F507 15,228.00 Total (Carry forward to main schedule) 132,315.99 Estate of: Jane M. Dyson 21 09 0837 Schedule B (Page 3) Item Value at Date No. Description of Death 16 49,000 Par FNMA Remic Ser 2003-92 C1 GA Dtd:08/01/03; Mat:09/25/18; 4.50 CUSIP: 31393TAJ5 21,374.26 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 70.59 17 671.247 Shares FPA Capital Fund, Inc. mutual fund CUSIP: 302539101 19,868.91 Held in Janney Montgomery Scott Account #2958-3257 18 826.49 Shares FPA Paramount Mutual Fund, Inc. CUSIP: 302546106 11,579.12 Held in Janney Montgomery Scott Account #2958-3257 19 28,000 Par GNMA II Pool #000410; Dtd:10/01/92; Mat:10/20/22; 8.00 CUSIP: 36202AN37 316.98 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 1.69 20 26,000 Par GNMA II Pool #000545; Dtd:12/01/92; Mat:12/20/22; 7.50 CUSIP: 36202ATA5 231.36 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 1.17 21 80,000 Par G,NMA II Pool #001654; Dtd:04/01/94; Mat:04/20/24; 6.50 CUSIP: 36202BZT5 2,071.16 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 9.44 22 25,000 Par G}NMA II Pool #001843; Dtd:06/01/92; Mat:06/20/22; 7.50 CUSIP: 36202CBL6 515.54 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 2.61 23 35,000 Par G~ II Pool #002054; Dtd:08/01/95; Mat:08/20/25; 7.00 CUSIP: 36202CH71 750.44 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 3.61 Total (Carry forward to main schedule) 56,796.88 Estate of: Jane M. Dyson 21 09 0837 Schedule B (Page 4) Item Value at Date No. Description of Death 24 50,000 Par GN14Pi II Pool #002443; Dtd:06/01/97; Mat:06/20/27; 7.00 CUSIP: 36202CWC3 1,141.44 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 5.49 25 70,000 Par GNMA Pool #322798; Dtd:05/01/92; Mat:05/15/22; 8.00 CUSIP: 36224ART0 690.49 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 3.67 26 25,000 Par GNMA Pool #331557; Dtd:02/01/93; Mat:02/15/23; 7.50 CUSIP: 36224LJA6 198.22 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 1.00 27 25,500 Par GNMA Pool #359365; Dtd:06/01/93; Mat:06/15/23; 6.50 CUSIP: 36203UFE7 2,115.31 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 9.68 28 50,000 Par G'NMA Pool #359938; Dtd:12/01/93; Mat:ll/15/23; 7.50$ CUSIP: 36203UZB1 1,357.93 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 6.84 29 25,000 Par GNMA Pool #384142 Dtd:05/01/94 Mat:05/15/24; 7.50 CUSIP: 36204YWB5 93.19 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 0.47 30 25,000 Par GNMA Pool #404275; Dtd:08/01/94; Mat:08/15/24; 8.00 CUSIP: 36205YCL4 452.40 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 2.40 31 25,000 Par GNMA Pool #458553; Dtd:07/01/99; Mat:07/15/29; 7.50 CUSIP: 36208RMA9 786.84 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 3.95 Total (Carry forward to main schedule) 6,869.32 Estate of: Jane M. Dyson 21 09 0837 Schedule 8 (Page 5) Item Value at Date No. Description of Death 32 25,500 Par GNMA Pool #469699; Dtd:ll/01/98; Mat:ll/15/28; 7.00$ CUSIP: 36209EX49 508.29 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 2.42 33 35,000 Par GNMA Pool #484551; Dtd:10/01/98; Mat:09/15/28; 7.50$ CUSIP: 36209XH45 1,276.36 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 6.41 34 49,000 Par GNMA Remic Ser 2005-16 C1 BC; Dtd:02/01/05; Mat:ll/20/33; 5.00 CUSIP: 38374KWN9 46,134.64 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 176.32 35 200,000 Par GNMA Remic Ser 2006-62 Cl PC Dtd:ll/01/06; Mat:ll/20/36; 5.5~ CUSIP: 38374N2M8 101,679.02 Interest accrued to 8/28/2009 413.10 36 50,000 Par GNMA Remic Ser 2007-78 C1 PC Dtd:12/01/07; Mat:12/20/37; 4.75 CUSIP: 38374DJW0 50,970.02 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 178.13 37 50,000 Par GNMA Remic Ser 2009-29 Cl KA Dtd:05/01/09; Mat:10/20/37; 4.50 CUSIP: 38374UNR8 49,386.05 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 168.75 38 113,000 Par GNMA Remic Ser 2009-34 Cl DG Dtd:05/01/09; Mat:03/20/34; 4.00 CUSIP: 38374TJ39 111,797.58 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 336.56 Total (Carry forward to main schedule) 363,033.65 Estate of: Jane M. Dyson 21 09 0837 Schedule B (Page 6) Item Value at Date No. Description of Death 39 100,000 Par GNMA Remic Ser 2009-68 Cl ED Dtd:08/01/09; Mat:08/20/39; 5.00 CUSIP: 38373ASS6 100,750.00 Held in Janney Montgomery Scott Account #2958-3257 40 100,000 Par GiNMA Remic Trust 2005-73; Dtd:09/01/05; Mat:03/20/35; 5.00 CUSIP: 38374L6P1 30,727.84 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 115.18 41 100,000 Par GNMA Remic Trust 2006-69; Dtd:12/01/06; Mat:12/20/36; 5.50 CUSIP: 38375JBZ7 1,706.59 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 7.03 42 Money Market Obligations Trust U.S. Treasury Cash Resvs Instl Svc Shs mutual fund CUSIP: 60934N674 74,879.67 Held in Janney Montgomery Scott Account #2958-3257 43 200 Shares Ne~vmont Mining Corp. common stock CUSIP: 651639106 8,195.29 Held in Janney Montgomery Scott Account #2958-3257 44 200 Shares Norfolk Southern Corp. common stock CIISIP: 655844108 9,348.00 Held in Janney Montgomery Scott Account #2958-3257 Dividend accrued on 8/28/2009 68.00 45 10,000 Par North Wales PA Water Auth Dtd:10/15/03; Mat:05/01/16; 4.00 CUSIP: 663226JNo 10,107.50 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 130.00 46 20 Shares Patriot Coal Corp. common stock CUSIP: 703367104 183.50 Held in Janney Montgomery Scott Account #2958-3257 Total (Carry forward to main schedule) 236,218.60 Estate of: Jane M. Dyson 21 09 0837 Schedule B (Page 7) Item Value at Date No. Description of Death 47 100 Shares Peabody Energy Corp. common stock CUSIP: 704549104 3,416.00 Held in Janney Montgomery Scott Account #2958-3257 48 25,000 Par Penna St Ref 2nd Ser NPFG Dtd:06/10/03; Mat:07/01/19; 3.90 CUSIP: 709141D85 25,616.25 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 154.38 49 20,000 Par Penna Tpk Comm Rev Ser R Dtd:03/O1/O1; Mat:12/01/20; 5.00 CUSIP: 709223NJb 20,840.20 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 241.67 50 50,000 Par US Treasury Inflation Index Note; Dtd:04/15/06; Mat:04/15/11; 2.375 CUSIP: 912828FB1 51,265.63 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 438.01 51 15,000 Par US Treasury Inflation Index Note; Dtd:10/15/01; Mat:04/15/32; 3.375 CUSIP: 912810FQ6 18,182.85 Held in Janney Montgomery Scott Account #2958-3257 Interest accrued to 8/28/2009 186.73 Total (Carry forward to main schedule) 120,341.72 REV-1508 EX + (698) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Jane M Dyson 21 09 0837 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinUyowned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Bethany Village - refund of application fee 2 Cash 3 Comcast - refund, cable television service 4 Household goods and furnishings and miscellaneous items of personal property See attached appraisal by Cordier Antiques and Fine Art 5 Janney Advantage Insured Sweep Money Market Account 6 Jewelry See attached appraisal by Cherie Lynn Grove, Mountz Jewelers 7 Lonq term care insurance - refund of unearned premium 8 Susquehanna Bank Checking Account #4601893709 See attached correspondence. Interest accrued to 8/28/2009 9 Uncashed check from insurance company on homeowner's insurance claim 30.00 103.00 5.78 37,240.00 101,949.15 16,470.22 387.10 19,172.61 0.16 818.67 3W46AD 1.000 TOTAL (Also enter on line 5, Recapil (If more space is needed, insert additional sheets of the same size) 176,176.69 REV-1509 EX * (698) COMMONWEALTH OF PBJNSYLVANW IJHERfTANCETAX RETURN ESTATE OF FILE NUMBER Jane M Dyson 21 09 0837 H an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURV NMIG JOINT TENANT(S) NAME A Meminger, Alan S JOINTLY-0WNED PROPERTY: ADDRESS 20 Erford Road, Suite 315, Lemoyne, PA 17043 RElATIONSHP TO DEC®FM ~~ NUMBER LETTER FOR JOIN TENANT DATE MADE ~~ DESCRIPTION OF PROP92TY INCLUDE NAME OF FINANCL4L INSTRUTKNI AND BANKACCOUNT NUMBER OR SIMIILAR DY HTELD REAL ESTATEATTACH DEED FOR DATE OF DEATH VALUE OF ASSET DECD'S INl'B~EST ~ VA~UE OFTM DEC®ENT'S MVTEREST 1 A 11/26/2003 Metro Bank Checking Account #0536323009; owned jointly with Alan S. Meminger 12,841.94 50.0000 6,420.97 See attached correspondence TOTAL (/~so enter on line 6. Recapitulation) I $ 6 , 420.97 (f more space is needed, insert additional sheets of the same size) SCHEDULE F JOINTLY-OWNED PROPERTY 3W46AE 1.000 REV-1511 EX+(10.06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Jane M. Dyson 21 09 0837 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~ Myers Funeral Home Funeral services 3,765.97 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Je33e E . FOSSelman Street Address 5132 KylOCk Road City Mechanicsburg State PA Zip 17055 Year(s) Commission Paid: 2010 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 40,000.00 30,000.00 Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 1, 0 0 5.0 0 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Camp Hill Borough Sealer rental 62.50 Total from continuation schedules 4,701.87 TOTAL (Also enter on line 9, Recapitulation) $ 79 535.34 7W48AG 1.000 (If more space is needed, insert additional sheets of the same size) Estate of: Jane M. Dyson 21 09 0837 Schedule H Part 7 (Page 2) 2 Chestnut Court Condominium Association Condominium association fees - September through February 2,270.00 3 Cordier Antiques Appraisal of personal property 617.50 4 Cumberland Law Journal Legal advertisement 75.00 5 Duty Lock 6 Safe Change locks on condominium 60.00 6 Estate Valuation Valuation of securities 112.70 7 Mark Heckman Real Estate Appraiser Real estate appraisal 400.00 8 Mountz Jewelers Appraisal of jewelry 655.00 9 Peterson Interiors Shipping expense to return wallpaper ordered prior to death 16.00 10 Postage Return of Life Line medical equipment 17.18 11 PPL Electric 290.95 12 The Sentinel Legal advertisement 187.54 Total (Carry forward to main schedule) 4,701.87 REV-1512 EX + (12-OB) Pennsylvania SCHEDULE I DEPARTNENTOF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES ~ LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Jane M. Dyson 21 09 0837 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. swasAH z.ooo If more space is needed, insert additional sheets of the same size. REV-1513 EX+(11-08) SCHEDULE J Pennsylvania DEPARiIuENTOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT OF FILE NUMBER Jane M. D son 21 09 0837 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 2116 (a) (1.2).) 1, Alan S. Metninqer 20 Erford Road, Suite 315 Lemoyne, PA 17043 Metro Bank Checking Account #0536323009; owned jointly with Alan S. Meminger Inventory Value: 6,420.97 None 6,420.97 2 Katie Eames 256 East Louther Street Carlisle, PA 17013 General Bequests: 2,000.00 Caregiver 2,000.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APP ROPRIATE. I[ NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1• See Attached 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 1 000 000.00 If more space is needed, insert additional sheets of the same sig. BW46AI 2.000 Estate of: Jane M. Dyson Schedule J Part 1 (Page 2) Item No. Description 3 Doris Foose 240 Perry Valley Road Millerstown, PA 17062 General Bequests: 2,000.00 4 Vince Monica 3933 Concord Street Harrisburg, PA 17109 General Bequests: 2,000.00 5 Debbie Stackhouse 3100 Cypress Road South Dover, PA 17315 General Bequests: 2,000.00 Household goods and furnishings and miscellaneous items of personal property Inventory Value: 399.99 6 Francis Groff 27 Burr Oak Drive Millersville, PA 17551 Jewelry Item #4 on jewelry appraisal Inventory Value: 1,001.70 7 Jackie Fosselman 5132 Kylock Road Mechanicsburg, PA 17055 Jewelry One-half appraised value less Item #4 on jewelry appraisal Inventory Value: 7,734.25 8 Jesse E. Fosselman 5132 Kylock ROad Mechanicsburg, PA 17055 Household goods and furnishings and miscellaneous items of personal property Inventory Value: 6,125.01 Relation Caregiver Caregiver Caregiver None None None 21 09 0837 Amount 2,000.00 2,000.00 2,399.99 1,001.70 7,734.25 6,125.01 I Estate of: Jane M. Dyson Schedule J Part 1 (Page 3) Item No. Description 9 Karen Martin 3504 Stockwood Street Mechanicsburg, PA 17050 Household goods and furnishings and miscellaneous items of personal property Inventory Value: 4,149.99 10 Patricia Martin 1210 E. Powderhorn Road Mechanicsburg, PA 17050 Household goods and furnishings and miscellaneous items of personal property Inventory Value: 2,824.99 11 Ramey Smith Cardenas Eras 2 [Puente del Fresno] 28708 San Sebastian de los Reyes Madrid, SPAIN Jewelry One-half appraised value less Item #4 on jewelry appraisal Inventory Value: 7,734.27 12 Marianne Weldon 600 North Eagle Road Havertown, PA 19083 Household goods and furnishings and miscellaneous items of personal property Inventory Value: 23,740.02 13 John Clayton Martin 1210 E. Powderhorn Road Mechanicsburg, PA 17050 100 of Residue: 300,311.16 Relation Niece-in-law Sister-in-law None Niece Brother 21 09 0837 Amount 4,149.99 2,824.99 7,734.27 23,740.02 300,311.16 e Estate of: Jane M. Dyson Schedule J Part 2B (Page 1) Item No. Description 1 Christopher Reeve Foundation d/b/a Christopher and Dana Reeve Foundation c/o Bea Torre, Estate Administrator 636 Morris Turnpike, Suite 3A Short Hills, NJ 07078 Cash Bequest 1,000,000.00 21 09 0837 Amount 1,000,000.00