HomeMy WebLinkAbout09-23-101505607120
REV- ^ 5OO EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 0 0 9 6 3
PO 60X.280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
176 34 8325 09 21 2009 06 07 1938
Decedent's Last Name Suffix Decedent's First Name
MCCRORY JAMES
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
MCCRORY
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
C 1.Original Return
C' 4. Limited Estate
6 Decedent Died Testate
~-' (Attach Copy of Will)
9. Litigation Proceeds Received
Suffix Spouse's First Name
FAY
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Return
4a. Future Interest Compromise
(date of death after 12-12-82)
~ Decedent Maintained a Living Trust
(Attach Copy of Trust)
^ 1 C Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
MI
F
MI
B
3, Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate 1-ax Return Required
8. Total Number of Safe Deposit Boxes
u 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
MICHAEL L. BANGS 717 730 7310
Firm Name (If Applicable)
First line of address
429 SOUTH 18TH STREET
Second line of address
City or Post Office State ZIP Code
CAMP HILL PA 17011
Correspondent's a-mail address:
REGISTER O~.J~VILLS USE LY
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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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
~~,~~ ~ ~ ~~~ Fay B. McCrory y1 ~ ~ ~~o
ADDRESS /r" /~
2144 Chestnut Street, Camp Hill, PA 17011
IC~IATURE OF PREPARER OTH HAN REPRESENTATIVE DATE
~ Michael L. Bangs C.1 ~~~ ~~~
ADDRESS
429 South 18th Street, Camp Hill, PA 17011
Side 1
1505607120 1505607120 J
J
1505607220
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: James F. McCrory 17 6 3 4 8 3 2 5
RECAPITULATION
1. Real Estate (Schedule A) .......................................................................................... 1.
81,4, 394.64
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages 8~ Notes Receivable (Schedule D) .......................................................... 4.
154,539.51
5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ................ 5.
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested ............. 7,
9 E• 8 , 9 3 4 . 1 5
8. Total Gross Assets (total Lines 1-7) ....................................................................... g.
1.9, 506.06
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9.
1, 500.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10.
21,006.06
11. Total Deductions (total Lines 9 & 10) ...................................................................... 11.
947,928.09
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.
9 ~ ~ ' 9 2 8 C 9
14. ...............................
Net Value Subject to Tax (Line 12 minus Line 13) .................. 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
9 4 7, 9 2 8 0 9
15.
0 0 0
(a)(1.2) X .o0
16. Amount of Line 14 taxable
0 0 0
16 0 0 0
at lineal rate X .045 .
17. Amount of Line 14 taxable
0 0 0
17 0 0 0
at sibling rate X .12 .
18. Amount of Line 14 taxable
0 0 0
18 0 0 0
at collateral rate X .15 .
19. Tax Due .....................................................................................................................
19.
0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505607220 1505607220
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-09-00963
DECEDENT'S NAME
James F. McCrory _ ___ __
STREET ADDRESS
2144 Chestnut Street
CITY
Camp Hill STATE
PA ZI P
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
p, Interest
E. Penalty
0.00
0.00
Total Credits (A + B + C)
(1) 0.00
(2) 0.00
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box 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) 0.00
(4)
(5) 0.00
(5P.)
(5Ei) 0.0 ~
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)].
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)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by kilood or adoption.
Rev-1503 EX+ (8-98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 150 shares of Adams Express -150 certificate shares 9.85 1,477.50
2 1 share of Alcatel Lucent 4.26 4.26
3 200 shares of Arch Chemicals 31.95 6,390.00
4 16 shares of AT&T - 28 Shares 26.81 428.96
5 656 shares of BP Stock 54.24 35,581.44
6 87 shares of Comcast - 87 Shares 17.21 1,497.27
7 1,000 shares of Dupont 3.50 3,500.00
8 4 shares of EI Paso 10.21 40.84
9 8,064 shares of Exxon Mobil 69.34 559,157.76
10 6 shares of Fairpoint Communications - 6 Shares 0.80 4.80
11 1,350 shares of Ferro Corp. 9.23 12,460.50
12 74 shares of Freeport McMoRan Copper & Gold - 74 69.23 5,123.02
shares
13 1,400 shares of IDA Corp 28.63 40,082.00
14 1,012 shares of MDU Resources Group 20.20 20,442.40
15 748 shares of Newmont Mining Corp 43.93 32,859.64
Total of Continuation Schedule See attached page
TOTAL (Also enter on Line 2, Recapitulation) 814,394.64
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98)
Rev-1503 EX+ (6-98)
SCHEDULE B
STOCKS & BONDS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
16 250 shares of OGE Energy Corp 32.90 8,225.00
17 400 shares of Olin Corp 17.78 7,112.00
18 30 shares of Pactiv Corp 26.35 790.50
19 100 shares of Paramount Comm. 5.75 575.00
20 100 shares of Petroleum & Resources Corp -100 23.50 2,350.00
certifiate shares
21 162 shares of Qwest Communications 3.42 554.04
22 6 shares of Tenneco 13.82 82.92
23 1,500 shares of Texas Pacific Land Trust 31.05 46,575.00
24 16 shares of Titanium Metals Corporation -16 shares 9.91 158.56
(book entry)
25 34 shares of Valhi Inc. 13.16 447.44
26 366 shares of Verizon 29.57 10,822.62
27 883 shares of Xcel Energy 19.99 17,651.17
TOTAL (Also enter on Line 2, Recapitulation) 814,394.64
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1540 Schedule B (Rev. 6-98)
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Adams Express Dividend 135.00
2 Adams Express Dividend 7.50
3 Adams Express dividend 7.50
4 Adams Express dividend 7.50
5 Alcatel-Lucent Technologies Dividend 4.40
6 Arch Chemicals Dividend 40.00
7 Arch Chemicals Dividend 40.00
8 Arch Chemicals dividend 40.00
9 AT&T Dividend 11.76
10 AT&T Dividend 11.76
11 AT&T dividend 11.76
12 Bankers Life and Casualty Company -Cash dividends 91.64
13 BP Dividend 551.04
14 BP Dividend 551.04
15 Cashout of CVRD Canada Stock 15,067.00
I Total of Continuation Schedules See attached
pa es
TOTAL (Also enter on Line 5, Recapitulation) 154,539.51
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA continued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
16 Comcast Dividend 8.22
17 Comcast Dividend 8.22
18 Comcast dividend 8.22
19 Dupont Dividend 875.00
20 EI Paso Dividend 0.04
21 Exxon Mobil Dividend 3,386.88
22 Frontier dividend 6.14
23 General Dynamics Corporation -Redemption of funds 2,568.00
24 Idacorp Dividend 420.00
25 MDU Dividend 53.08
26 MDU Resources Dividend 159.39
27 MDU Resources dividend 53.08
28 Miscellaneous dividend checks 1,425.38
29 Newmont Dividend 74.80
30 OGE Dividend 90.63
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
co nti n u e
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
31 OGE Dividend 90.63
32 Olin Corp. Dividend 80.00
33 PA Department of the Treasury -Redemption of General Dynamics Corporation 2,568.00
unclaimed property (see attached letter)
34 Petroleum & Resources Corp. Dividend 312.00
35 Petroleum & Resources Corp. Dividend 10.00
36 Petroleum Resources dividend 10.00
37 Petroleum Resources dividend 10.00
38 Qwest Communication Dividend 12.96
39 Qwest Communications dividend 12.96
40 Qwest Communications Dividend 12.96
41 Qwest Dividend 12.96
42 State Employees Retirement System -Death benefit 92,757.77
43 Sunoco -ownership interest in SW/4 Section 4, Township 1 N Range 8ECoal Co., 2,088.00
OK, McCrory #1 well. (see letter attached)
44 Sunoco (royalties) 661.11
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-151J0 Schedule E (Rev. 6-98)
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN continue d
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
45 The Weekly Standard Refund 52.20
46 U.S. News and World Report Refund 12.60
47 Valhi Dividend 3.40
48 Verizon dividend 173.85
49 Verizon Dividend 173.85
50 Verizon dividend 173.85
51 Xcel Energy Dividend 216.34
52 Xcel Energy Dividend 216.34
53 Xcel Energy dividend 222.96
54 PNC Bank -IRA Account #65001007297 28,939.79
TOTAL (Also enter on Line 5, Recapitulation) ~ 154,539.51
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1510 Schedule E (Rev. 6-98)
REV-1151 EX+ (10-06) SCHEDULE H
,.
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A, FUNERAL EXPENSES:
See continuation schedule(s) attached
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name(s) of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Michael L. Bangs
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Fay B. McCrory
Street Address 2144 Chestnut Street
City Camp Hill State PA Zip 17011
Relationship of Claimant to Decedent SpOl1Se
6,164.00
8,000.00
3,500.00
4. Probate Fees 145.00
5. Accountant's Fees 1,300.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 397.06
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 19,506.06
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Myers-Harner Funeral Home 6,164.00
H-A Subtotal 6,164.00
Other Administrative Costs
2 Cumberland Law Journal -estate advertising 75.00
3 Register of Wills -additional short certificates 34.00
4 Register of Wills -additional short certificates 8.00
5 The Sentinel -estate advertising 145.06
6 W. B. Paynter, PC -Research 135.00
H-B~ Subtotal 397.06
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-151)0 Schedule H (Rev. 6-98)
Rev-1512 EX+ (12-08)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbursed medical expenses.
(If more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08)
REV-1513 EX+ (11-08)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA
INHER
C BENEFICIARIES
ITAN
E TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
McCrory, James F. 21-09-00963
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee s
I
• TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
Fay B. McCrory spouse
2144 Chestnut Street
Camp Hill, PA 17011
Total
Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 150 0 cover sheet, as appro priate,
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
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~orporativn, ut~~dex ~tccr~unt numhrx' ZI4~~8f L~1~. Tte sham are ~:ui-cndy held iri btrok entry fart as
our records as follows:
~ovk E_t~# ~ssu:e L7a~te # of ~.~
~~~OOOI7~? 03126~2Utl~ '1(i
Tl7e price pez share fvr t~ ~~am~any at the cMse o~ b~ei,ss €xo O'9a211?Ot~ was $9.~1 per share. The-
stocl: puce is provided b~+ an i~depe~.deaYt thud ~rarty. A'.i~am St~,l: Tr~nsfea~ ~ Tratst C:ernf+iany, l~
tlaes not ~aramtee floe tim,~liness a>r aracy of su~l~ i~a~c~o~ T#~ e~~:mF~Y txisdes on the irTY51~ and
tk~e symbol is TIE.
Rc.: TAN1E~ F MC~R~RY
Coiz~aziy: TiiE AI:3.A3vI~' EGRESS CO~iF.a~N~''
Account: C~OC}C11157~?C~
As of t#Ye date of death., tlxe share~wald+~ .held ~, L~a~mce of 1 ~0 s.}sa~,t~s of T~xe .A,~,.~xcs Express Ga~xy,
ender aceouc~t camber OOO+C~ ~.1 S7! ~0_ This h+~Idnu.~ is represents:~d ~y th,e follc:~ri~g cerL~.r ce w!tdch sE~cx+ald
be in tlYe sliar~older's ppssess~ons=
Certiticat~ # Fssue I~-a~:e # of ~~
I~~'C.7'344081. 1 Of'191~004 1,50
The prime per share for th4 atnmp~ay ac tl~ +close of b~si~ess t~~ (?~1211~(}l:~~ ura,s ~~.$5 per share. The stock
price is pr+av.~~ded by grit iila~Pt~d+attt gird Parr'- scan. ,Sta~lc Transf~~ & Trust Con~an`~, '~T..,C ~l ricer ndt
gLtar~-ntee the times ar a~uracy of such ~~rrzati~n_ The a`Qrngany ~Taa3es Qn the NYSE and fh~
symbol is A.t:)~.
1~19AAA~~~AII~~I~VmI~11~1~1~1~~
U5/ttt~ 1U1U :t_ s : ~~ k'c~a o 1 r ,~_l4 .1.rsu_t L ~ - -
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C~a~,~y: ~a~xx~~~trr~ ~ .t~st~Lr.~~s ~o~c~x~.~~~r
Accent: ~oa[~5~17
on the c~.te oaf death, dre sl~areha:~der l~l~l ~ bt~~e a~' IQU shares cif Petrc~leu~t & 1~.estnac~s ~'o~ra~a~
~unrler accoma~ number 0{l(}Q4~~ t. T 1.. '1'hss haidm~ i~ repres,~~d by the fallow. certificate ~-h~h ~:hou.id
be is the sharehultler's pnssessas~~t~:
C~rCafica to # _ _ Issue :d~a to ~ of ~~iares
rr`c.rl~~~a~ ~~f~.~~~tWoo 1t30
The price per shar+~ tvr Cbe ct~xp~y at the close cif bps ou iY}/~ 1,121109 ants $~ 3.5C~ per -~. ~'he
stock pritce is prc~vld~erl by ata ~f~pc~cieut thi~td party. Amy ~tt>~'~'r~sfeac & Trutt C~a~npany, f T,C'
dog x~ot ~uatee the tixtteli~r~c~s arr aec~.~cy of sack. i~afarxna~l~os~. 'I"he campauy ~~ an the ]"~F~'SiE and
die syrnbel is PF,o.
Yn Ctu.; event a~i oragina.~ cerd,~~c~t~ is last, please .it~arm one- host ~ecaritic~ L~c~art~t in var. a.tiu~ to the
above address. Please be s~,~re try l~ruvide al! pcrti~eaa-t or~xr~tiun xmd t~ c-~:rtificate mu,mbex wh is lust,
so we may properly .init:i~te replac~~~at prc~eciures.
We have attached a transfear i~strt ~ctit-n pacl~a.3e pscx~idin~ t.~ req~~rc~r+.e~ts t-.Q ~,~.-re~.ister the sl-t~re~.
W~ trust the above .ia~fQrrr.~aS~QV. is helpful.
~ineerely,
1V1.ichellt San~tax~a
~xh,~reht~lder Sc~ces
Attact~rr~r;nt
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BANKERS
I.IF6 AND CASUAI:1'Y (:OMPANV
Wr tprciuli:;r in x.niorr
Bankers Life a.~d Casualty Cei~~ipany
P.O. Box. 1922
Carmel, IN 46082
12/15/2009 ~~~ 400-2
FIRST CLASS MAIL
MCCRORY .TAMES F
2144 CHESTNUT ST
CAMP HILL, PA 17011
»>FINAL NOTICE«<
ITEMS ON FILE FOR MCCRORY JAMES F
BANK ACCOUNT ITEM ~ ISSUE DTE
000000002969806 0002722301 07/27/2004
A11:0UNT DESCP! IPT ION
$91.64 CASH DIVIDENDS
DEAR UNCLAIMED FUNDS OWNER:
WE ARE WRITING IN REFERENCE TO THE ABOVE UNCLAIMED F'JNDS OUR COMPANY, BANKERS
LIFE & CASUALTY, HAS BEEN HOLDING IN YOUR NAME.
DO NOT CASH CHECK DUE TO BANK WILL RETURN.
STATE LAW REQUIRES THAT WHEN MONEY HAS BEEN UNCLAIMED) FOR A TIME SPECIFIED IN
THE STATUTE, THAT MONEY IS CONSIDERED "ABANDONED PRG?ERTY" BY THE STATE, AND
MUST BE TURNED OVER TO THE STATE. 'fHE STATUTORY ESCHEAT PERIOD HAS PASSED
OR IS ABOUT TO ELAPSE AND WE ARE REQUIRED TO MAKE A FINAL EFFORT TO CONTACT
THE OWNER OF RECORD OF THIS PROPERTY BEFORE WE TURN IT OVER TO THE STATE.
DUE TO A PERIOD OF TIME HAS ELAPSED SINCE THE ISSUANCE OF THIS PAYMENT, PLEASE
UNDERSTAND THAT IT IS NECESSARY FOR US TO VERIFY YOUR OWNERSHIP. PLEASE BE
AWARE THAT IF THE CLAIM INVOLVES A DEATH CLAIM, A MATURITY OR ANNUITY,
ADDITIONAL PROCESSING TIME MAY BE REQUIRED DUE TO THE NATURE OF THESE CLAIMS.
ANY OF THE ABOVE MAY INVOLVE ANOTHER llEPAR'TMEN'T.
IF THE LETTER I5 ADDRESSED TO A FERSON THAT IS DECEASED, PLEASE SEND IN A
CERTIFIED COPY OF THE COURT APPOINTMENT OF THE EXECUTOR (OR ADMINISTRATOR
OR PERSONAL REPRESENTATIVE) OF THE ESTATE & A DEATH ~~ERTIFICATE. IF SOMEONE IS
ACTING ON BEHALF OF THE INDIVIDUAL, PLEASE SEND IN A COPY OF THE LEGAL
DOCUMENTS LISTING THE RELATIONSHIP. SEE OTHER SIDE FOR FURTHER INFORMATION.
IF YOU HAVE QUESTIONS, PLEASE E-MAIL US AT ABANDONEL~PROPERTYHELP@CONSECO.COM
OR CALL 1-800-894-2908. ON E-MAILS, PLEASE LIST THE COMPANY LISTED
WITHIN THE 1ST PARAGRAPH ON THE SUBJECT LINE & THE ~,TEM~~/AMOUNT IN THE E-MAIL.
PLEASE COMPLETE THE BACK OF THIS FORM WITH YOUR CURRENT ADDRESS & MAIL THE
ENTIRE LETTER ALONG WITH ANY APPLICABLE DOCUMENTS BACK TO THE COMPANY'S RETURN
MAILING ADDRESS LISTED ABOVE. IF WE NEED FURTHER INFORMATION, WE WILL CONTACT
YOU.
ABANDONED PROPERTY DEPARTMENT
STLBLC 105!071
ir~ ; •~
~~YIV• ~~~ ~~~
June 1, 20I0
Michael I, B~xrg~
Attvrne~r at Law
429 South 1 S~` St
. Ca~ap .Hill, PA I COI 1
R.E: Ja~cs 1~' Mc~rory
SSN: 176-~4-825
]~(~~: a9-21-2009
Dear Nfr. $an~s:
~~~ _ , ~:: ~ _; C" ,
In respo~e to your request for Date of Death ~C~I~) ~~.l~ce~ fir the custa~mer r~ot~e~d al,~ve, our
records shc~v~ the fc+llo~,irig:
~"er#~fi~c~te of ~+eposf
Account # 1102aQ28471
1/ A~ ~ 1V~C~Rf.~~~''
J~~rI~S F 1U1~~Rt~RY
~t~Ll balance: $ 6,Q14.b2 + t~. ~7 a~ccraed ia~terest
..A.~c~uz~t # ~ ~ a20t~28472
~'A~ ]~ IV1C~.(~~.Y
JAMES F MC~~.0~.5'
I~OI7 balance: 6,561.89 + 4 ~. l2 a~~~ued i~~ferest
Acc:ourtt ~ ~ 15002I 2~S 1
JABS F MC:Cl~~l~.~
FA'Y $ M~~R.t~R~
T~-OD bala~~c: $ $7y427.~3 + t ~ 8.56 accn~ed interest
Account # 31~Oa?I~~'1~
JA~M~S F ~~~~~1~.
FAY ~ 1VI~GR~iR~
Dt~l~ balance: ~ 27,$68.4 + ~7.R0 accrued interest
Established: Q4-?0-?QQ4
Establ~she~ : 03 -22-2002
Established.: ~~-a~-~~~ 1
Established: 07-[~6~-2(1Q 1
Page 1 +~f 3
ACCQIl~l~ ~ ~ ~. 31~1~22~25~
JA.I4~S F MC~l~O1~Y
. FAY l~ MCROI~.Y
DOD.ba~a~ce: ,~ ~2,~9~.03 + 23.37 accnied interest
Account ~ 3790f1238~8~1
JAMES F Iv~~C:~ORY
FAY B M~~RORY
DOD ba3.a~cc. ~ 3 ~,54~.~6 + $.~7 accr~.ted interest
Account ~ ~ 1 Q4023+~922
JAMES F ~~~~~?~~
FAY ~ ~G~I~OI~Y
DOD bala~cet ~ 19,~(~.~lS + 3.~1 acer~ed interrest
~h~+c#i.~~ Ac+caunt
Account # 51120~f~~8
. rl .C 14' 111 1 ~ 1l ~f ~~ .L
I~OD balan~~~ ~ ~9,~27.~7 ~- 1,71 accr~t+~d interest
Account # ~ 1 ~OO~QO 15
JAiVIE~ F MCC~C~~Y
DC~D balance: $ +6,82$.4 + Q, i ~ accn~ed interest
I Account
Account ~ ~~00100?29?
JAMBS F'_V1C~:l~OI~Y
DOD balance: ~ 28,939.?~ ~- 93.?4 ~.~cr~~d i~texest
Far beneficiary inforrnatian, please call 1.888-767-4?2?,
safe Deposit ~c~a
The decedent ~ai-rat~.i.ned safe dasrt box 01 ~ 84
FAY 1~ 11r~C~l~OkY
JAS F M~~~.~l~Y
Located at
:amp Hi1Z Branch
2145 Market St
~an~.p dill, P~- 170I l
~?17) 730-10?0
Establlshed. ~~~~~-~~~~
Established: ~? - i ~,? 0{l~
Established: 02- I8-20
Established: 04-~ 1-20D0
Established: 01 ~01-19? i
Est,~blislted: !09-11-19~
Pale 2 of 3
Pieas~ ~.~~e t.~a~ -~l~i~ of~aGe ~~c~vi~~s d~rte .~~eath ba~~ces ~~~ ~~pc~s~t aceo _~;~t ~ ,~Il~.As, CUs, t~:r~~eck.~n~ a~c~
~avin~s~. ~V~ c~~a ~~t ~r~ess ~~~~ ~n~~ci:~l tx~.a~~ac~ti~~ts car pr+a~d~ 1~ ~~.~~#~. If vQU Ll.~'~'-C~ assistance ~vif~
any of these items, please call ~ -~:~~ ~~i~~-~.A. (~-8~8-?6?-265} ~~ sto~~ ~~~~ yot~~ local F~~ l~an~ bunch
office.
~ ince~oly,
~iatio~~l F~aa~~~~ services C~~ter
FNS Bask, I`+1.~.
1Vtem1~~ FT~I+~
Page 3 of ~
PROPERTY DESCRIPTION
Property /Holder lnform~tion I•' ~opercy Ip 925447IJ
(A) Original Owner's Name (B) Original Owner's Address as Reported
MCCRORY JAMES F 2144 CHESTNUT ST CAI:~DP HILL PA 17011-5410
(C) Helder Reporting Funds (D) Last Transaction Date
GENERAL DYNAMICS CORPORATION 01/26/2001
(E) Helder Address and Contact (F) Type of Funds Reported
C/0 COMPUTERSHARE 250 ROYALL ST M/S 3A REDEMPTION
CANTON MA 02021- (G) Certificate, Policy a Check Nu-nber
GENERAL DYNAMICS CORP
(866)500-2398 (H) Amount Reported $2 ~g 00
Total Shares Claimed
0.0000 Total Cash Claimed $2,568.00
RETURN CLAIM FORM AND DOCUMENTATION TO:
Bureau of Unclaimed Property I P.O. Box 1837 I Harrisburg, PA 17105-1837 11.800.222.2046
www.patreasury.org
100594323
Page 5 3/31/2010
September 7, 2010
From: Robert Blanchard
PO BOX 57
Tupelo, OK 74572
To: Mr. Michael L. Bangs, Attorney-at-Law
429 South 18t" Street
Camp Hill, PA 17011
RE: McCrory #1 Well SW/4 Section 4, Township 1 N Range. 8E Coal Co. Okla.
Ownership Interest: .0625000000 RI
Dear Mr. Bangs:
Let me first express our deepest sympathy in the passing of Nlr. James F. McCrory.
Our company does operate the McCrory # 1 well and accord;: ~~g to our records the
information you provided is correct.
Based on current energy prices your interest would pay, for example: $ 58.00 average per
month in royalty on a six month basis. The going price is 36 times your recent 6 montl~- average
for your producing royalty interests. That would translate into a $ 2088.00 Lump sum payment to
the interest holder of record. The valuation of the interest is estimated at $ 2088.00
You indicated that the parties involved would like to sell this interest. Our company
purchases royalty interests and if the valuation provided is satisfactory to all parties im~olved, we
would like to make the transaction.
If all parties involved approve the transaction our company will send you an initial
payment of $522.00, one-quarter of the lump sum payment. Your final payment of $1566.00 will
be made upon receipt of a mineral and royalty deed signed, notarized and witnessed by all the.
parties involved.. This offer is intended to convey to our company, any and all of the mineral and
royalty interest that the parties own within the lateral boundaries of the property referenced on
said deed.
Please send our company a letter to the address above indicating your decision.. If the
transaction is approved, our company will draw up the mineral and royalty deed along other
necessary paper work. The initial payment of $ 522.00 will be included payable to the parties you
specify in your acceptance letter.
Sincerely,
Robert H. Blanchard
Blanchard Oil Company
.._r..r---~---'.
'~- ' .
PENNSY.LVANI A
.. ..........................
T~~~. ~ ,AS~[.rTRY
UNC~L,A[M:EU PR(JP~R.TY
July O1, 2010
Mccrory James F Estate Of
Attn Michael L Bangs Esq
429 South 18Th Street
Camp Hill, PA 17011
Re: Claim ID 100594323
Dear Ms Mccrory:
We are writing to you about the following property (or properties) for which you have
filed a claim:
Property ID:
Property Type:
Holder:
Claim Amount:
Owner(s) of Record:
9254470
REDEMPTION
General Dynamics Corporation
$ 2,568.00
Mccrory James F
2144 Chestnut St, Camp Hill, PA 17011-5410
To ensure that property is returned only to its rightful owner, we carry out a thorough
review during which we look at various types of evidence. In the case of your c;laim,
we need the following:
• A photocopy of your signature identification in the form of a SIGr1ED Social
Security card or driver's license
Please send the evidence to us at the Bureau of Unclaimed Property, P.O. Box 1837,
Harrisburg, PA 17105-1837, along with a copy of this letter. VVe will then resume
working on your claim.
We ask for your patience during the claims process. It takes tame for us to complete the
appropriate research, verification, and approvals that are so nc;cessary to prove entitlement.
Therefore, as much as we would like to return property immediately, it may take as long as
eight weeks, and sometimes longer. In the meantime, if you have any questions, please call
our office at 1-800-222-2046 from 7:30 a.m. to 4:30 p.m. Eastern Time;~or call me directly at
412-880-0400 from 8:30 a.m. to 5:00 p.m..
Rob McCord, Treasurer ~ Pennsylvania Treasury ~ P.O. Box 1837 ~ Han-isbi!rg, PA 17105-1837 ~ 800-222-2046
www.patreasury.org