HomeMy WebLinkAbout04-12-10 15056051058
06
05
REV-1500 EX
(
-
)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes
Po BOx zso6ol County Code Year
INHERITANCE TAX RETURN File Number
--
-
Harrisburg,PA17128-0601 RESIDENT DECEDENT p~ l ~~ 1 '
U~~~-i
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
_...
____ Date of Birth
_.__ _ _ __
113-14-0374 02/02/2010 ' 10/24/1924
_
Decedent's Last Name _
Suffix Decedent's First Name
_ __ .
MI
Shiley
__ _
_ ___ 'Mrs Ma
ry E
(If Applicable) Enter Surviving Spouse's Information B elow
Spouse's Last Name Suffix Souse's First Name
_.. _.
_ _ MI
N/A
__ N/A N/A
_ _
_ _
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 ti~°~,p 2. Supplemental Retum ~,~'.x 3. Remainder Return (date of death
"~, 4. Limited Estate
~`:°~::: ~ 6. Decedent Died Testate
(Attach Copy of Will)
;vM~;~ 9. Litigation Proceeds Received
'","`~ 4a. Future Interest Compromise (date of
death after 12-12-82)
v,~:":;::~ 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)
prior to 12-13-82)
~;;~ ~';~ 5. Federal Estate Tax Return Required
_.. Q.. 8. Total Number of Safe Deposit Boxes
°~°"""" 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
C:URRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTtAI TAX INFORMATION SHOULD BE DIRECTED TO:
Name
__ _
---
__ Da time Tele
y pone Number
Frank D. Gronin er
_ _ ..
_
Firm Name (If Applicable)
_ _ __ _ (..._- _.
_._ _...
REGISTER OF WfG~ _ E ONLY
............. .......... '. TJ -~
:' ! ~ ~jM.
First line of address
_ ~_r r..._
~-~ - ~ ,..._
_ __ _
_ _.
..........
1035 Oyster Mill Roa t ... : -..~ N
:-. `' ~ %''~
Second line of address , _ ,.,~
__.
`
t~
„~
- •r:
~~
City or Post Office _ __. State ..........ZIP Code _.. __ :.%"
_ DATE FILED .~""
Camp Hill PA .:17011-1002 __
Correspondent's a-mail address: ~'" l7 r~ Q N ~ ~DT// /'~P~` ~ ~Q~ I 1
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.
S ATU~~ ON ONSIBLE FOR FILING RETURN D E
- - _ ~ ~ as
ADDRESS - _ _ -
1035 Oyster Mill Road, Camp Ht , Pa 17011-1002
____
NATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS - -
PLEASE USE ORIGINAL FORM ONLY
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15056051058 Side 1
15056051058
J
J
15056052059
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Mary E Shiley
113-14-0374
~~...~~.,.~.~..~.,m..~.~.M.~._~..._..~..m..,~.m~. wm.......~._.~..~.~m_.~......~...~._..~.~_...._..._.~..._~~.m.~.
ECAPITULATION
_ ___ _ _
.................
1. Real estate (Schedule A). ........ 1
2. Stocks and Bonds (Schedule B) .................................. ..... 2. ' 5,058.69
3.
Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ._
.... 3
4. Mortgages & Notes Receivable (Schedule D) ........................ ..... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ... ..... 5.
6.
Jointly Owned Property (Schedule F) e~~"#"°? Separate Billing Requested .. _..
.... 6 28,137.59
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ' "~'° °" ~ "°° - -...M,
Schedule G "~~~°°
( ) ~..«...d Separate Billing Requested...
..... 7. i
8. Total Gross Assets (total Lines 1-7) ............................... ..... 8.
9. ~a~. ,., ........ ...r .. .
Funeral Expenses & Administrative Costs (Schedule H) .................... 9 3,623.00
w.... .
..
.
10.
Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ............ .
.
... .....:... .....
.... 10.
11.
Total Deductions (total Lines 9 & 10) ............................... ..
.... 11.
12.
Net Value of Estate (Line 8 minus Line 11 } ....... .... . .. . .....
...... ......~
.... 12
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.'
29 573 28
_ __...........__.._.......,..m._~~.......~_....~.-.~...~__..u-._....~m
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
__ _ _.._ .
transfers under Sec. 9116
(a)(1.2) X .0
16. Amount of Line 14 taxable
at lineal rate X .045 29,573.28 i
17. Amount of Line 14 taxable ~ "
at sibling rate X .12
18. Amount of Line 14 taxable
;. __ _
15.
16.
17.
1,330.80
at collateral rate X .15 18
19. TAX DUE .........................................................19. 1,330.8U
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
15056052059
J
REV-1500 EX Page 3 File Mumber
Decedent's Complete Address: `
..... ,.
DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER
Mary E Shiley 113-14-0374
__ _ -
STREET ADDRESS __ _ _ _ - _ -
1035 Oyster Mill Road
CITY
Camp Hill
_-
STATE __ _-ZIP _ _
PA 17011-1002
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
- __
B. Prior Payments
C. Discount 66.54
3. InteresUPenalty if applicable
D. Interest
Total Credits (A + B + C) (2)
__ _ ____
.Penalty
- --
Total InteresUPenalty (D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(5B)
1,330.80
66.54
1,264.25
1,264.25
Make Check Payable to: REGISTER OF WILLS, AGENT
A A ,: x
.. ,:
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? .............. ^ ^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 ono ~. ~ ~ ~~ ~ ,, _ :. k ~ x o,
rafter July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the useof the survivin souse
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)), g p
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 ar after July 1, 2000:
The tax rate imposed an 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 (O) percent [72 P.S. §9116(a)(1.2)J.
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+ (fi-98)
~.
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. Shiley 1035 Oyster Mill Road, Camp Hill, PA 17011-1002
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
~ ~ 35 shares Alcatel-Lucent ADR Cusip 01390430-5 @ 3.59
125.65
2. 49 shares AT&T Inc. Common Stock Cusip 001957109 @ 25.56
1,252.44
3. 154 shares Comcast Cusip 20030N101 @ 16.10
2,479.40
4. 273 shares Qwest Communications International tnc. Cusip 749121 10 9 @ 4.40 1,201.20
I
TOTAL (Also enter on line 2, Recapitulation) I $ 5,058.69
(If more space is needed, insert additional sheets of the same size)
Historical prices for ALU (Alcatel-Lucent (ADR)) -Google Finance
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a p ces Watch this stock --- - ----
Show: Dainty I Weekly
Mar 25, 2009 _ Mar 24, 2010 UpdatM
Opsn High Low Close Volume
3.22 3.34 3.18 3.26 16,891,192
3.20 3.22 3.14 3.14 17,659,522
3.32 3.34 3.14 3.27 24,019,534
3.53 3.53 3.35 3.37 14,570,918
3.54 3.80 3.51 3,52 20 981 821
3.56 3.64 3.53 3.82 15,518,729
3.43 3.52 3.43 3.51 14,809,223
3.42 3.44 3.31 3.33 18,293,221
3.49 3.49 3.36 3.42 25,771,888
3.39 3.45 3.35 3.44 15,087,603
3.38 3.47 3.35 3.41 9,572,088
3.44 3.45 3.33 3.36 19,178,922
3.44 3.50 3.40 3.40 17,898,958
3.50 3.54 3.38 3.45.. _
21,913,047
3.59 3.60 3.52 3.59 19,318,344
3.58 3.83 3.57 3.81 20,108,247
3.72 3.72 3.72 3.72 0
3.75 3.77 3.87 3.72 23,168,085
3.71 3.82 3.69 3.78 16,582,127
3.67 3.72.. 3.81 3.69 11,328,318
3.65 3.87 3.60 3.61 10,701,488
3.82 3.82 3.73 3.75 9,975,448
3.74 3.78 3.71 3.77 12,508,121
3.75 3.79 3.69 3.78 17,549,821
3.88 3.69 3.62 3.88 14,252,184
3.85 3.69 3.81 3.69 13,530,898
3.51 3.54 3.48 3.54 14,816,383
.3.32 3.32 3.32 3.32 0
3.37 3.38 3.31 3.32 7,220,509
3.34 3.36 3.24 3.30 17,833,470
Show rows: 30 .~; 31 - 60 of 258 rows
Historical chart
Mar 25, 2009
•.oo
3.00
2.00
Msr 27, 2010
Date I~
Feb 9, 201
Feb 8, 201
Feb 5, 201
Feb 4, 201
Feb 3, 201
Jan 29, 201(
Jan 28, 201(
Jan 27, 201C
Jan 28, 201
Jan 25, 201
Jan 22, 201
Jan 21, 201
Jan 20, 201
Jan 19, 201
Jan 18, 201
Jan 15, 201
Jan 14, 201
Jan 13, 201
Jan 12, 201
Jan 11, 201
Jan 8, 2010
Jan 7, 2010
Jan 6, 2010
Jan 5, 2010
Jan 4, 2010
Jan 1, 2010
Dec 31, 2009
Dec 30, 2009
Export
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AT&T INC.
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h1ARY E SHILEY
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s Date... _ _ 16 Mar 2.01.0 i;
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Select Date:
16 ~ _
Mar
_
2010* r:
; ~
,
Share Class Re aster
9~ Balance
Pri ,'
ce Value
COMMON STOCK . __.._ _ .
.Book Entr
Y 49
US$25.78
`~
US$1,263.22
tlccotant Det.t}15
Account Number ******91587
Category Issued Capital Stock
Tax Certification Standard W-9Certified***-**-0374
• f~lrrify
Reinvestment Plan Not enrolled
:,r
f-': ~_ C:: i y
Payment Instructions There are no Payment Instructions on File r,l;,~,,p.Y
1035 OYSTER MILL RD
Address CAMP H[LL PA .1.7011-1002
,;,A r.y,
UNITED STATES
Email Address No details
Important Note: Market data from close of ;~re~vo~;~ duly. ~Ih~~ ~~bovf, bE~!a!r,:'e {lees not
rr,c!t.rde any trans-3rlr(~n in tf7e course c:~f iirot~Hssine~. 'fhi ,balance rs ft~r infe.,!-matron ~,r.rrpo~~~~s
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Show: Daly ~ Weekly
Date
Feb 9, 20 0
Feb 8, 20 0
Feb 5, 2010
Feb 4, 201
Feb 3, 201
r Feb 2, 201 ~,
Feb 1, 201
Jan 29, 20 0
Jan 28, 20 0
Jan 27, 20 0
Jan 28, 20 0
Jan 25, 20 0
Jan 22, 2010
Jan 21, 201
Jan 20, 201
Jan 19, 201
Jan 18, 201
Jan 15, 201
Jan 14, 201
Jan 13, 201
Jan 12, 201
Jan 1 1, 201
Jan 8, 2010
Jan 7, 2010
Jan 8, 2010
Jan 5, 2010
Jan 4, 2010
Jan 1, 2010
Dec 31, 200
Dec 30, 200
Mar 25, 2009 _ Mar 24, 2010 Update Historical chart
Open High Low Close Volume 2e.oo
25.18 25.42 25.05 25.28 34,839,725
25.19 25.27 24.98 24.98 27,177,112
25.12 25.31 24.96 25.24 50,884,828 28.~J
25.43 25.49 25.03 25.03 32,334,559
25.83 25.81 25.40 25.58 22,954
152
25.37
25.84
25.27
25.89 ,
31,119,897 24.67
25.87 25.71 25.28 25.38 38,774,304
25.61 25.75 25.35 25.38 38,925,412 Msr 25, 2009 Mar 27, 2010
25.70 28.15 25.29 25.54 52,073,088
25.21 28.12 25.10 25.82 58,991,723 Export
25.40 25.51 25.08 25.33 34,173,192
tg
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s~rc~d~e$1
25.73 25.90 25.32 25.58 29,904,560 _
-
25.52 25.83 25.38 25.39 38,382,937
25.92 25.98 25.40 25.87 40,078,444
28.03 28.03 25.70 25.83 39,089,554
25.92 28.25 25.80 28.20 33,988,471
25.79 25.79 25.79 25.79 0
28.25 28.27 25.85 25.79 64,018,227
28.64 28.85 26.08 28.19 42,251,520
27.00 27.10 28.53 28.64 42,597,501
28.85 „ 27.11 28.78 28.98 28,314,372 ~ ~~ : ~~~' f f
27.18 27.22 28.85 28.97 25,794,831
27.29 27.39 28.88 27.10 27,835,225 ~ ~ j ~;~s ; "` ~- ',
27.58 27.69 27.12 27.30 33,800,552 i
---------~~
-W _- -- -~
27.95 28.03 27.55 27.81 37,901,928 ~ ~~ ~~
28.70 28.73 28.35 28.44 35,234,454
28.41 28.81 28.28 28.58 29,139,478 '"~
28.03 28.03 28.03 28.03 0 ______-----
28.29 28.43 28.02 28.03 18,072,405 ~ ~ ~f
28.28 28.81 28.22 28.32 23,550,077
Show rows: 30 w 31 - 80 Of 258 rows ;~yJ-" ~~y -//~ ~
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-.-.".._. .... .. Share Class Register Balance Price
_ _ .....-_._._._ Value
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LASS A COMMON STOCK Book Entry 154 US$17.53 US$2,699.62
Account Number «* " * r "01547
Category Issued Capital Stock
Tax Certification Standard W-9Certified***-**-0374
Reinvestment Plan. Not enrolled
Payment Instructions There are no Payment Instr
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ons on File p;i,,,., r:,,,
1035 OYSTER MILL RD
Address CAMP HILL PA 17011-1002
~
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UNITED STATES ~
Email Address No details
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Historical prices for CMCSA (Comcast Corporation) -Google Finance
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prices Watch thi:s~toGc __.. .
Show: Da ly ~ Weekly
bats Open
Feb 9, 201 0 15.38
Feb 8, 201 15.45
Feb 5, 201 15 51
Feb 4, 201 15 80
Feb 3, 201 18.55
2 2 15.85
Feb 1, 201 18.08
Jan 29, 20 0 15.75
Jan 28, 201 0 15.97
Jan 27, 201 15.83
Jan 28, 201 15.91
Jan 25, 201 15.87
Jan T2, 201 18.01
Jan 21, 201 18.52
Jan 20, 201 18.58
Jan 19, 201 18.73
Jan 18, 201 18.83
Jan 15, 201 16 74
Jan 14, 201 18 82
Jan 13, 201 16.88
Jan 12, 201 18.75
Jan 11, 2010 16.87
Jan 8, 2010 16.93
Jan 7, 2010 18 71
Jan 8, 2010 18 78
Jan 5, 2010 18.93
Jan 4, 2010 18.75
Jan 1, 2010 16 86
Dec 31, 2009 17.08
Dec 30, 2009 17 12
Mar 25, 2009 _ Mar 24, 2010 Updato
High Low Clos• Volume
15.70 15.27 15.39 24,394,685
15.47 15.20 15.21 15,683,998
15.73 15.15 15.42 28,721,582
15.95 15.52 15.52 22,718,957
18.60 15.85 15.97 29,190,913
18.35 15.84 18.29 19,263,183
18.10. 15.88. 15,84 18,340,824
16.13. 15.51 15.83 27,193,207
18.12 15.55 15.82 19,309,305
16.09 15.58 15.85 20,389,913
16.05 15.58 15.70 21,284,885
16.17 15.78 16.01 15,248,528
18.38 15.81.... 15.85 28,332,713
18.58
. 15.84 18.00_.
.
.
32,888,208
18.88 18.20 .
_
18.52 _.._
21,688,388
18.88 18.82 18.81 12,659,437
16.83 16.83 16.83 0
18.82 18.39 18.83 21,617,972
16.83 16.81 18.67 17,411,781
16.85 16.62 18.77 15, 768, 833
18.75 16.41 18.51 18,142,894
17.00 16.73 16.81 19,054,574
17.07 18.81 16.92 12, 726, 949
17.08 16.55 16.97 15,107,314
18.80 16.53 18.62 13,870,822
18.98 16.55 18.74 17, 746,483
17.13 16.75 16.97 13,573,388
16.88. 16.88 18.88 0
17.15 18.86 18.86 8,122,931
17.20 18.98 17.07 8,841,852
Show rows: 30 ~-' 31 - 80 of 257 rows
Historical chart
Mar 2S, 2009
Export
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16.33
14.87
Mar 23, 2010
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2010
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- ;~ --~~-~~ ~~r~~~~~~ j11~~ your Hank account insreC
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Have one of your chj
handy. You will need to refer to the bank information prin
RETAIN FOR YOUR RECORDS
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:::::
SHAREHOLDER ~ TRANSACTION DESCRIPTION
INVESTOR /D ~ ACC UNT KEY ~ ISSUE/CLASS OF STOCK
80Q4.3T01381•J i 001 450 74912110 SHILEY---MARYE0000 COMMON STUCK
RATE PER SHARE CE TfFICATED SHARES BOOK-ENTRY SHARES 'GROSS AMOUNT
30.0800000 ~ 273 0.0000 321.a4
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TAY 111CAITIFI( ATInN NI IMR~p
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nc. historical prices
t~h thia std _ ... .
Show: Da
Date
Feb 9, 201
Feb 8, 201
Feb 5, 201
Feb 4, 201
Feb 3, 201
Feb 1, 201
Jan 29, 20'
Jan 28, 20'
Jan 27, 201
Jan 28, 201
Jan 25, 201
Jan 22, 201
Jan 21, 201
Jan 20, 201
Jan 19, 201 ~
Jan 18, 201 i
Jan 15, 2011
Jan 14, 201(
Jan 13, 201(
Jan 12, 201C
Jan 11, 201a
Jan 8, 2010
Jan 7, 2010
Jan 8, 2010
Jan 5, 2010
Jan 4, 2010
Jan 1, 2010
Dec 31, 2009
Dec 30, 2009
~ Weeks Mar 25, 2009 _ Mar 24, 2010 UPdeUt Historical Chart
Opsn High Low Close Volume
4.38 4.37 4.23 4.27 34,113,775
4.41 4.48 4.28 4.29 38,138,348
4.30 4.44 4.28 4.41 30,719,389
4.41 4.43 4.29 4.30 ~ 20,880,188
4.43
~ 4.49 4.40 4.44 22,100,284
4.38 4.50 4.29 4.43 52,288,989
4.23 4.23 4.11 4.22 35,588,838
4.21 4.30 4.20 4.21 22,474,023 Mar 25, 2009
4.24 4.25 4.15 4.19 20,880,980
4.24 4.28 4.17 4.24 14,987,417 Export
4.33 4.33 4.20 4.23 32,421,207
4.35 4.40 4 29 4 33 Download to spreadsheet
s.oo
4.33
3.67
Mar 23, 2010
.....Show rows: 30 ""; 31 -80 of 258 rows 'jf '~C) ~ c~ ~~ '- /c~4/, o~
4.38
4.41,,.
4.27 •
4.31 23,779,938
21,253,788
4.44 4.50 4.34 4.38 27,102,935
4.49 4.58 4.40 4.48 24,859,123
4.48 4.57 4.39 4.51 22,842,841
4.48 4.48 4,48 4.48 0
4.49 4.49 4.40 4.48 20,828,879
4.55 4.58 4.43 4.47 27,190,885
~0
~
4.51 4.59 4.48 4.55 15,171,840 ~
4.83 4.64 4.51 4.52 29,102,283 ~. r+'~ ~
'
4.81 4.69 4.55 4.89 21,932,003 ,
4.70
4
57 4.72 4.81 4.65 23,641,054 Q ~
~~
. 4.77 4.49 4.68 74,750,448 ,
" '
4.52 4.84 4.44 4.51 75,788,233 ° ~
4.28 4.51 4.28 4.48 42,330,900 _
4.23 4.35 4.22 4.28 15,889,044
....4.21
4
23 4.21 4.21 _4.21
......_ 0
~~
. 4.27 4.19 4.21 6,393,108....
4.23 4.28 4.18 4.24 12 347 591
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dad y-~ ~ • ~= w.google.com/finance/historical?q=NYSE%3AQ&start=30&num=30
3/24/2010
REV-1509 EX+ (h-98)
I
SCMEDt~ILE F
COMMON ALTH OF PENNSYLVANIA JO~NT~Y OWNED PROPERTY
INHE ITANCE TAX RETURN
R SIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. Shile 1035 Oyster Mill Road, Camp Hill, PA 17011-1002
If an asset was made )olnt wlthln one year of the decedant'a data of death, It must be reported on Schedule G.
SURVI ING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A• Frank D. G oninger 1035 Oyster Mil Road, Camp Hill, PA 17011-1002 Son
e' Joanne R
m P.O. Box 169, 4801 Riverside Drive, Galesville, MD I Daughter
20765-0169
C.
JOINTLY-OWNI
LETTER
ITEM FOR JOIN
NUMBER TENANT
A.
2. ~ B.
PROPERTY:
DarE DESCRIPTION OF PROPERTY
MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
Sovereign Premier Checking 2331025452
M&T Bank Account 021000001124669
96 OF DATE OF DEATH
DATE OF DEATH DECD'S VALUE OF
/ALUE OF ASSET INTEREST DECEDENT'S INTEREST
40,550.90 50% 20,275.45
15,724.28 ~ 50% ~ 7,862.14
TOTAL (Also enter on line 6, Recapitulation) I = 28,137.59
(If more space is needed, Insert additional sheets of the sa )
MARY E HILEY
FRANK D GRON/NGER
Balan
inn
Deposi
Withdr~
Intere:
Paid thf
Earned
Paid Ye
'The int
Accou
Date
02-08
Account # 2331025452
$40,547.7'9 ' Current Balance
+ $3.11 Average Daily Balance
$t1.00
$40,550:90 .
$40, 547.79
eriod • ~ 3.11 Annual Petcenta a Yit~ld Earned
Period $ 3.11 0.10%
Paid Last Year $58.12
Co-Date ~ 9.98 '`
st earned and the interest paid may differ depending on when interest is credited to your account.
Activity
ing Balance
'BT CREDIT
Balance
Additions Subtractions
$3.11
Balance
$40,547.79
55Q.9t?
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS
CALL YO R CUSTOMER SERVICE CENTER AT THE NUMBER SHOWN ON THE TOP OF YOUR STATEMENT OR WRITE TO THE BANK
FOR DEBIT CARD ISSUES:
Sovereign Bank FOR ALL OTHER ISSUES:
Attn: Debit Card Services Sovereign Bank
MA1 MB 301-06 Attu' Client Relations
P.O. BOX 841003 ]0-421-CRl
Boston, MA 02284-1003 P.O. BOX 12646
READING, PA 19612-2646
Please contact us if you think your statement or receipt is wrong or if you need additional information about a transfer on the statement or receipt. We must hear
from you no I er than 60 days after we sent you the FIRST statement on which the error appeared.
• Tell us y ur name and account number. • Describe the error or the transfer that you are unsure about and explain as clearly as you can why
• Tell us t e dollar amount of the suspected error. you believe there is an error or wh
If you tell us o lly, we may require you to send your complaint or question in writing within 10 business aysrther information.
We will promp ly investigate the matter and call or write to you with an answer within 10 business days (10 calendar days in Massachusetts). If we need more time,
we may take u to 45 days to investigate your complaint or cuestion. If we do, we will credit xour account within this 10-day period for the amount you think is in
error, so you w ll have the use of the money during the time ~t takes us to complete our investigation. [f we ask you to put your complaint or question in writing
and we do not eive it within 10 business days, we may choose not to credit your account.
For errors invol ing new accounts, point of sale purchases or foreign transactions, we may take up to 90 days to investigate your complaint or question. For new accounts,
we may take u to 20 business days to credit your account for the amount you think is in error.
We will tell you the results of our investigation within 3 business days after completing our investigation. if we decide there was no error, we will send you a written
explanation. Yo may ask for copies of the documents we used in our investigation.
Important information about your Sovereign Debit Card
The networks th ough which some of your Sovereign Debit Card ppurchases are processed have begun allowing merchants to process your purchases without
either a signatur or a PIN. [f you are not required to enter your I~[N when you make a purchase, your purchase may be processed either through the Visa
network or thro h the STAR or NYCE networks. If your purchase is processed through STAR or NYCE, different terms apply and you will not be eligible
for the rights an protections available through Visa. Please see your Personal Deposit Account Agreement for more information.
,;:~~:' 2 of 2
233102S4S2
Page : 1 Document Name : untitled
S~'FT 1 'TYIF TRANSACTION STMT FORMAT 10 / 0 3 / 2 4 9. 3 6 ~ 4 !
STMT CO 96 OP EBRN MS 50861 LAST PAGE OF TRANSACTIpNS
ACTION COID
PROD GO E RSV ACCT 21000001124669 SHORT NAME SHILFY MARE
CL7RR CO E PAGE 17 SEARCI~ F~tOM 10 3 / 0 7 / 2 9 THRU 110 / 0 3 / 15
ACTN OST EFFECTIVE CHECK NUMBER TR.AN AMOUNT D/C BALANCE
TRACE Ill DESCRIPTION
11/17 4,500.00 ]~ 15,615.23
6508578551 aTITHDRAWpiL,
1 /25 26.27 C 15,641.50
009328002757663 THE HARTFORD RFS 04 ATF GA20192-0101
1 /29 26.27 G ~.5, 667.77
009362002800252 THE HARTFORD RPS 04 ATF GA20192-0101
__ _ _ 1 /31
I-•GENT09123100004914 INTBRE3T PAYMENT GBNSRATED e 15,670.15
0 /2'7
01002601074$2$2 HARTFORD RPS O42ATF7 C 15,696.42
0 /24 GA20192-0101
26.27 C 15,722.69
010054008566644 THS HARTFORD RPS 04 ATF GA20192-0101
0 /1S 1.59 C 15,724.28
- EN110031500000001 INTBR$ST PAYMENT GgNgRATED
_____ 0 /15 ~ ~ 74612399
MQWBRF99 15,724.28 D .00
PF : 1- II$ P 3 - PLVL 6 - TNQ 7 - SB 8 FSFO9 -ASUM 1II1 TCUTOAY$TgMCRUND IDiTEREST
,, ) .
~. 6 a la„ ~ ~ Zva s f ~ ~1 ~
•S ~` Ea-t. ~-~,tn ~ ~~J~s . G/~Z`:I1 hen.
~I ve Cir y / e~ ~ G/ e
~~~_ ,
l , /~
969-3 Z000/Z 00d fii05-Z -WO~i3 L5 ~ - -
80 0L, bZ E0
V ~.
'~~ SCHEDULE H
~ ..~ pennsylvania
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. S iley 1035 Oyster Mill Road, Camp Hill, PA 17011-1002
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Administrative Expenses at Funeral Home
63.00 ":
10 death certificates @ $6.00 each 60.00
j
_ _ _ _ __ _
B. DMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City Stake ZIP
Year(s) Commission Paid:
Z• Attorney Fees:
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation,) 3,500.00
Claimant Frank D. Groninger
Street Address 1035 Oyster Mill Road
city Camp Hill state PA ZIP 17011
Relationship of Claimant to Decedent SOn
_. _.
____.
4• Probate Fees: '
S• Accountant Fees:
6• Tax Return Preparer Fees:
7.
TOTAL ;Also enter on Line 9, Recapitulation) I ~ 3,623.00
If more space ~s needed, use additional sheets of paper or the same size.
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