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Home My WebLink About05-26-10Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) ~ 4. Limited Estate ~ 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) C~ 6. Decedent Died Testate C.., ~> 7. Decedent Maintained a Living Trust µ__0 _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received C~ 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 II~IRECTED TO: Name Daytime Tel one Numbed'- - _ __ _; , ANDREW H. SHAW, ESQUIRE (717) 243'75 ~ ~ ~' J: Firm Name If A livable ; .w- ~-~- --.---.~ ~_ _ _ __ _. REGIS~~~ILLS~E ONLY ':.~ ~ . ' ~= `~ ~; Law Office of Andrew H. -~ ~~ ` _ ~ c ~ ~ __ _~ , First line of address _ ~ , ~ _ ~ - ~ ~ ~~ . -- 200 S. Spring Garden St. -. -~ --~ .. - ~ ~ ` Second line of address ~ .~„~ '~ ... ... ~ Suite 11 1 __. _ . . ~_ CI Or POSt Office tY _ __ __ __ __ _ _ DATE FILED State ZIP Code ~._.-.~_._._...__._..._~ _ _,_.....~....~,..___._.,~_..~.__...~ __ Carlisle PA ; 17013 Correspondent's a-mail address: andrew@ashawlaw.com Under pe hies 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. Dec ration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI URE OF PERSON RES NSIBLE FOR FILING RETURN DATE ~° -~ ~V ADDRESS 703 W. ine Street , olly Springs, PA 17065 SIGNAT P R T R THAN REPRESENTATIVE DATE 200 S. Spring Garden Street, Suite 11, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 J~ J 15056052059 REV-1500 EX Decedent's Social Security Number ENID M SEITZ 176-14-3946 Decedent's Name: RECAPITULATION 1. Real estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 0.00 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 0.00 `` 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 0.00 5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ........ 5. 70,373.84 6. Jointly Owned Property (Schedule F) C~ Separate Billing Requested ....... 6. 0.00 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested........ 7. ; 0.00 8. Total Gross Assets (total Lines 1-7) .................................... 8. 70,373.84 9. Funeral Expenses BAdministrative Costs (Schedule H) ..................... 9. `' 1,216.42 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ................ 10. 2,704.46 11. Total Deductions (total Lines 9 8 10) ................................... 11. 3,920.88 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 66,452.96 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 66,452.96 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or _. trans ers under Sec. 9116 _ ... ~.w . ._.~ (a)(1.2) x .0 0 0.00 15. 0.00 .., Amount of Line 14 taxable .m , .. ,::, at lineal rate X .0 45 66,452.96 16. ' 2,990.38 17. _. _ .... Amount of Line 14 taxable _. u::: :~:~ ~ ::.~..~.... at sibling rate X .12 0.00 % 17. 0.00 18. Amount of Line 14 taxable at collateral rate X .15 0.00 18 - 0.00 19. TAX DUE ......................................................... 19. 2,990.38 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 File Number Decedent's Complete Address: t 21 10:0394 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER ENID M SEITZ 176-14-3946 STREET ADDRESS 801 N. Hanover Street CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2,990.38 2. Credits/Payments 0.00 A. Spousal Poverty Credit B. Prior Payments 0.00 C. Discount 149.52 Total Credits (A + B + C) (2) 149.52 3. Interest/Penalty if applicable 0.00 D. Interest E. Penalty 0.00 Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,840.86 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 2,840.86 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 transfer'ed :.................................................................................... ...... ^ 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 Acxount, 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 exem~ 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. LAST WILL AND TESTAMENT OF ENID M. SLOAN I, ENID M. SLOAN, widow, of North Middlton Township (mailing address: 124 Tower Circle, Carlisle, Pennsylvania 17013), Cumber- land County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found con- venient to do so. I direct that my funeral services be conducted by whatever funeral director is selected by my Executors, and that my body be interred beside that of_ my first husband, Clarence W. .Lucas, on my burial lot located in Lakelawn Memorial Park, Reynoldsville, Pennsylvania, which lot is number 28X-D in the "Garden of Everlasting Life" in said cemetery. 2. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to such of my three (3) children as shall survive me by a period of ninety (90} days, their heirs and assigns, but should any of them fail to so survive me then the share such deceased child of mine would have received shall pass to such of his or her issue as shall survive me by a period of ninety (90) days, per stirpes, and if there be no such issue the same shall lapse and be added to the other shares, per stirpes. My three (3) children are ~ Marilyn M. Miller, of R. D. #l, Box 56B, Kempton, Pennsylvania 19529; ~~~ ..~~ Noel J. Lucas, of 217 Brookside Blvd., Upper St. Clair, Pennsylvania ~`,,1 15241; and Valda C. Downs, of_ 29 West Oakwood Drive, Carlisle, Penn- J sylvania 17013. r. 3. I have made no provision herein for my step-daughters Linda Sloan and Connie Myers, not because of any want of affection for them, ~J ~~' but because each of them has already received from me all that I wish -,~ ~'~ `~ each of them to have . Page 1 of 2 Pages REV 1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER ENID M. SEITZ 21-10-0394 Indude the proceeds of litigation and the date the proceeds were received by the estate. All properly Jointly-owned with right of survivorship must be disclosed on Schedule F. (It more space is needed, insert additional sheets of the same size) Easy, Convenient Banking. ~Soverelgn Bank Checking ~ Savings ~ Loans ~~~\ CUSTOMER RECEIPT 1.877.SOV.BANK I sovereignbank.com ~tl ~~:r~ tl~t~ a~r~~r~~ ~~:~~ rig ~~i ~ ~~ ~~e~o~~:~L~ s~r~ ~~~~ ~~~~ ~a~~ ~~, c~~~. r J Q Member FDIC BR0008 9/07 Santander Strong-- Sovereign is part of Santander, "Global Bank of the Year."* Statement Period 02/01/10 TO 02/28/10 PREMIER MONEY MARKET SAVINGS 100000-0 ENID M SEITZ 703 W PINE ST MT HOLLY SPGS PA 1 7065-1 1 1 9 20061846 Irr through March t 9, ~~e ~~Idvar>;e of a great fixed 3ntrocluctar~ rage on atir Flexlocic~~ ht~rrre Egr.~it}r Lir+,e ~ CreOiit. Joist set up aiutc-rt'°~€it rnerst from a q~ffyiint~ Sowpere~n t~e~kirl-~ car ~~ngs account at~d `tl get ot~tr dial rate fc~r the firs fciur I~illirx,J c~+cles af1~ the ~ccour~& is opened.. Ater that, yqu'IF get (t~rar ~trodtiCtr~ry~ rate that ~ tied tti the Prim flats. ~+nr3, the )r~r~~~.?~C '/t7t1 tl~rr rt7r3`~ ~?E' t~Jt ciedu~~b}e. f-C~t ~~1'i+P`s rlr`rr,~ ~tilr'_~' £rlfOrt3'1dtiQn, ~ C~~I.i ~-~~~~~S~k~ L.OI't("ri; t+~5~t aC+WE.'f~E?i~t~br~t'~IC.~~1~'t~'a L~' ... ,.yo- ux.«~ w ~r~w PrC~t.eC# ~ro~r valuables ar~d i~~s~rt~an~ c~~c~al~ner~ts ar~d g~~ ~t~le ~~~ of mind ~ha~ cc-~I~s fry knaWinc~ ~the~+ are i~ a safe dace.. ~~ ~h~e ~ ~ ~n~anced s~rurit~r cif a S~ar~erei~~l safe deposit fax. ~F tt~~.:: Sovereign Bank is a Member FDIC and a whaNy owned subsidiary of Banco Santander, 6.A ~ 6overelgn and its logo and Santander and its page 1 of 2 logo are registered trademarks of Sovereign Bank and Santander, r 2891024052 espedivdy, or their atf~liates or wbsidiaries in the United States and other +,-^-~ countries. •?iccording to TAe Banker, December, 2009. ENID M SEITZ For your convenience our Customer Contact Center is available from 7 am - 8 pm EST, 7 days a week. Call us at 1-877-SOV--BANK (1-877-768-2265). Hearing impaired may call 1-800-428-9121 (TTY/TDD). www. sovereignbank. com 0000 70320 Account # 2891024052 Balances Beginning Balance $36,047.10 Current Balance $36,062.31 Deposits/Credits + $15.21 Average Daily Balance $36,047.10 Withdrawals/Debits - $0.00 ~~- ~~ r Page: 1 Document Name: untitled STFD 1 THE TRANSACTION STMT FORMAT 10/04/13 14.58.14 STMT CO 96 OP EBRN ~ MS 50852 ACTION COMPLETE ACTION COID PROD CODE DDA ACCT 690708 SHORT NAME SEI TZ ENID M CURR CODE PAGE 1 SEARCH FROM 110 /02/11 THRU 110/04/02 ACTN POST EFFECTIVE CHE CK NUMBER TRAN AMOUNT D/C BALANCE TRACE ID DESCRIPTION * 02/11 10,000.00 C 24,638.99 6504496100 DEPOSIT * 02/16 2776 6,939.02 D 17,699.97 8107292701 CHECK NUMBER 2776 * 02/22 2777 283.60 D 17,416.37 8108962933 CHECK NUMBER 2777 .....__. -._ * 02/26 306.65 C C a__ _. ._. 17,723.02 ~~ 0055009861479 PA TREASURY DEPT ANNUITANT - . -• --- -- - --- - - - - * 03/01 2778, 9.70 D 17,713.32 8002624449 CHECK NUMBER 2778 * 03/03 1,129.00 C 18,842.32 010060002097842 US TREASURY 303 SOC SEC * 03/03 .14 C 18,842.46 I-GEN110030300001228 INTEREST PAYMENT * 03/11 03/03/10 1,129.00 D 17,713.46 EACHBPN REVERSE DIRECT DEPOSIT PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO -STSM Date: 4/13/2010 Time: 2:58:45 PM REV-1511 EX+ (12-99) SCHEDULE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ENID M. SEITZ 21-10-0394 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 0.00 Name of Personal Representative(s) Valda C. DOWnS Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 703 W. Pine Street City Mt. HOlly Springs .State PA Zip .17065 Year(s) Commission Paid: 2. Attorney Fees 750.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 214.50 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. Estate Advertising 251.92 TOTAL (Also enter on line 9, Recapitulations I $ 1,216.42 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDVLE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER ENID M. SEITZ 21-10-0394 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical eYeenAaA tir more space is needed, insert additional sheets of the same size) • __. _ _~ ... ~_L ~.. , .i. a 1. .i. ~..~ i 1 ' c~ t~3 ill L' t_t 1 i '~ W? .L i . r~.•r- ....__"Pr._.. i~r`,4)j'~i{_TP"tf}:! ~ !`~S~.~` ~::J~f~4.~ ~ f~'i~ ' ' r'ti ~ _ .1. ~•;~.~--~~~-- ~- r ~-~c~ lU is ~ ~ ~~ ~ F'1 f~iW i ~ ~. ~':.~a i_ :7 ~ r r• _. i'~ ~z l~( '~ fe ~. _ a {~ ~ i t ~•; ~: _. _.._.._ ~._~..~ •t n s~ i~t.,fr~ i ~. j ~i~~ #rv ~__~~:'~.~: ~~~L_L 1 ~-~=~t~-.~'~5-s_'~ I~ ~~: T : 1 ~t'J~' ~_ _.._.________..______~__..._..._____w__ _._______.__.._..._...____.~._ _ ,~ _ __ ~, ~_ ~ ~ ~ ~ i.. U'G a r _c ?- ~~ n ~ i s~ '[" ~ tCt -=~ .__.. ,~ ~„! _:#. ~ ~ L 1~ '~'~~ i'1 ltJ 1 G !'1 . _ ~:} ~ ~ fil ~? Tl `G -- _ _. k ~r3~~t7Y~~'#'~ {j~t~: €,c c 4urtt #~: f^nouzt ~n='_ l os~~ 3.Uw~fJ~i'~~S~L~ G4~t~ '! '` ~'p~ ~ l ~ 1-1~ ~~~sl~~~l°~ ~~.- ~ x 9 07852 858HIMA 0 0 01228 ~~ SLd.: ~^ t W~jtV! 'rl ~i.~ 45 Sprint Drive MEDICAL CENTER Carlisle, PA 17013 ADDRESS SERVICE RE:pUESTED ' ~ ! UP~DN RECEIPT '-' Enid M Seitz 801 N Hanover St w Car9lisle a PA 17013 ~. IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIf'1111111111 IF PAYING BY CREDIT CARD, FlLL Ol1T BELOW AND SEE REVERSE SIDE CHECK CARD USING FOR PAYMENT rte- ~, ~ # ~ ,--_ - - -- '~" ~ MASTERCARD ISCOVER vr~4 VISA AMERICAN EXPRESS ACCOUNT NO. STATEMENT DATE BALANCE DUE' r ~ ~ 9458570 03/31/2010 52,097.73 MAKE CHECKS PAYABLE TO: CARLISLE REGIONAL MEDICAL CENTER P.O. BOX 281442 ATLANTA GA 30384-1442 IIIIIf111111111/111111111111/II1111111111111111111111111111111 00000945857000000209773ENID M SEITZ 6 ^ Please check If above address is incorrect and indica~.e change on reverse side. TO INSURE PROPER CREDIT, DETACH AND RETURN THIS PORTION IN THE ENCLOSED ENVELOPE. .PATIENT NAME P TIE ACCOUNT N0. DATE OF SERVICE - TYPE F SE IC Enid M Sa z 9458570 OZ/27/201D INPATIENT DATE DESCRIPTION PAYMENTJADJtISTMEN?S :03/26/1.0 ADJUSTMENT 471.:33- 03l26/10 INSURANCE PAYMENBT 7,809.98- .. PAYMENTS AND CHARGES RECEIVED AFTER THE STATEMENT DATE WILL BE REFLECTED ON THE NEXT STATEMENT. ~ t : ~ ~ ! 52, 097.73 `MESSAGES ' The amount shown on this statement js outstanding at FOR BILLING QUESTIONS, PLEASE CALL: this tune. Your prompt payment will be greatly C~1 ~ 960-1 s80 aPPrecia#ed. .~- fs-~~ ~~~,~ 1~ Bills can be paid online at our hospital Internet web site www.caHisietTnc.con~ ~' ! PON ,RECEIPT MEDICAL ~ COSMETIC DERIIAATOLOGY 1300 BENT CREEK BLVD. STE 202 MECHANICSBURG, PA 17050 ADDRESS SERVICE REQUESTED »REPORT CREDIT CARD TO PRACTICE ONLY. ENID M. SEITZ 801 N HANOVER ST CHURCH OF CLOD HOME CARLISLE, PA 17013 laol Statement Date Chart Number Page o~2v2o~lo sae~oo ~ To pay by credit card, complete all, sign, and return Ck card type Mastercard Visa 6cp Date Card# 3 digit sec code Cardholder Name Chg Arrt Cardiolder sign $ M~IG4L 8e WSMETIC DHiMATOLOGY 1300 BEM CREEK BLVD. STE 202 MEC~iANICSBlA2G, PA 17050 w w w Make Checks PAYABLE and SB~D to the above w w w ** THIS B#.L WAS PREPARED BYA~Jh1ED BILLING. ** FOR ALL BK1lNG QUES'TxONS PLEASE CALL 1-800-Z90-2.52 Amount Endo~ed ~ q~edc # __---_ _--_.__-_. _ _. _.. _ -- _ __. __.phse_cut on doi~d line and relum tnp portion wi>~h PaYmerrt Balance Forward From Previous Statement 0.00 Patient: ENID M. SERZ Case Descrip: OV/PROGMEDI Primary Ins. UNITED HEALTI-IGARE Amount Paid h'Y Amount Paid By Dates Procedure Procedure Description Charge Insurance Guarantor Adjustments Remainder 01/110 99202 DEDl1G"T7BL.E 01/18/10 17000 DEDl1CTiBl_E OFFICE OUTPT NEW 20 117.00 0.00 0.00 -51.96 65.04 DSTRJ ALL PRMLG 1ST LES 124.00 0.00 0.00 -53.98 70.02 ~ ~- is = f~ LAST PATIENT PAYMENT ~ '"""' Before: you are billed, charges are submitted to any insurance carriers y+ou provided. Ties balance is now the patient's responsibility. Payment is due within 15 days from the statement date. Amount Due 1Me Thank You for paying your account promptly! MEDICAL ~ COSMETIC DERMATOLOGY ; • ~ 135.06 -y.- i1~-,~.~.~. ~- jam-, ,/D ~~_'-t it - f ~t cd-~E~~ '~ J '~ ~ [:.~~~ . R. Q~~-- _,~;.~,t2.-.~ - ~~~cz,r_._ fie--i.~• REV-1513 EX+ (9-00) SCNEDVLE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ENID M. SEITZ 21-10-0394 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 • Marilyn M. Miller, 47 Pebble Creek Drive, Lititz, PA 17543 daughter 21,204.03 2• Valda C. Downs, 703 W. Pine Street, Mt. Holly Springs, PA 17065 daughter 21,204.03 3• Jennifer Domain, 19 Catbriar Court, Simpsonville, SC 29680 grand-daughter 10,602.02 4• Stephanie Berens, 5605 Reynolds Road, Morrow, GA 30260 grand-daughter 10,602.02 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROU GH 18, AS APPROPRIATE, ON RE V-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S (If more space is needed, insert additional sheets of the same size) 0.00