Loading...
HomeMy WebLinkAbout10-08-101505610143 -~ REV-1500 Ex(o,_,D, OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2sosol INHERITANCE TAX RETURN 21 10 0 657 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 098 14 9902 04 04 2010 08 13 1922 Decedent's Last Name Suffix Decedent's First Narne MI PEARSALL BETTY T (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 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 ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) s Decedent Died Testate ~ ~~ Atiach Copy~of Trust)a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) 9. Litigation Proceeds Received ~ 1D. between123`,~~a d~tt(datee5~f death ~ 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 JAMES D BOGAR 717 737 8761 First tine of address ONE WEST MAIN STREET Second line of address City or Post Office State SHIREMANSTOWN PA ZIP Code REGISTER OF WILLS USE LILY '~ c;:: n ~ __~ ~ _ c~~-~~, c--a - 'i -y r„' l - "° r it ( i ,,~ _\ ,-_ ,' ` '..~ ` ED _y DA'FE'~I - ;,-, c~ i~~ t~ ~. ~., z 'r~T1 T Correspondent's a-mail address: lbOgar@bOgarlaW.COm Under aloes 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, rrelsk and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ~~x~ ~- Gregory H. Pearsall _ ~nl~\\~ ADDRESS 1214 Kings Circle, Mechanicsburg PA 17050 SIGNATURE OF RER OT~i HAN REPRESENTATIVE DATE ~1 __ i//] James D. Bogar 10 ~ I ~ 1 p ADDRESS L One West Main Street, hiremanstown, PA Side 1 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Name: Pea~Sa) i, Betty T. Decedent's Social Security Number 0 9 8 14 9 9 0 2 RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... . 1. 2. Stocks and Bonds (Schedule B) ........................................................................... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)........ . 3. 4. Mortgages & Notes Receivable (Schedule D) ...................................................... .. 4. 18,353.16 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .............. . 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6. 126,733.54 7. Probate Property Inter-Vivos Transfers & Miscellaneous ~ (Schedule G) Separate Billing Requested........... . 7. 145 , 086.70 8. Total Gross Assets (total Lines 1-7) ................................................................... .. g. 24,107.43 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 10: Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 24,107.43 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 12 0 , 97 9.2 7 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. 12 0 , 97 9.27 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 15. 0 . 0 0 (a)(1.2) X .00 16. Amount of Line l4 taxable 120, 979.27 16. 5, 444.07 at lineal rate X .045 17. Amount of Line 14 taxable 0 . 0 0 17. 0.00 at sibling rate X .12 18. Amount of Line 14 taxable 0 . 0 0 18. 0 . 0 0 at collateral rate X .15 19 5 , 444.07 19. Tax Due ................................................................................................................. . . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0 Side 2 1505610243 1505610243 REV-1500 EX Page 3 ~av_ ~_~.-I~a.. A..Id..we. e.• File Number 21-10-0657 DECEDENT'S NAME Pearsall, Betty T. STREETADDRESS Country Meadows 4837 E. Trindle Road STATE ZIP CITY PA 17050 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 5,248.00 272.20 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. Make Check Payable to: REGISTER OF WILLS, AGENT. _. (3) (4) (5) 5,444.07 5,520.20 76.13 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 :...................................... .. ^ x b. retain the right to designate who shall use the property transferred or its income :.................................. ~ x c. retain a reversionary interest; or ............................................................................................................... x d. receive the promise for life of either payments, benefits or care? ............................................................ ^ x 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 "intrust 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? .................................................................................................................. x 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 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 21 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 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 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 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 blood or adoption. (1) Total Credits (A + B) (2) Rev-1508 FJC+ (6-98) e COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Pearsall, Betty T FILE NUMBER 21-10-0657 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 DESCRIPTION NUMBER PA Department of Treasury -unclaimed property (redemption of Baxter International, Inc.). This property was originally owned by Smith G. Pearsall, husband of Betty T. Pearsall, who died December 25, 2004. VALUE AT DATE OF DEATH 18,353.16 TOTAL (Also enter on Line 5, Recapitulation) I 18,353.16 (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} SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY Rev-1509 EX+16-98) .. ; SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Pearsall T. LE NUMBER 21-10-0657 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. Gregory H. Pearsall B. C. JOINTLY OWNED PROPERTY: ADDRESS 1214 Kings Circle Mechanicsburg, PA 17050 RELATIONSHIP TO DECEDENT Son ITEM NUMBER LETTER FOR JOIN TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OFASSE % OF DECD'S INTEREST DATE OF DEATH DECEDENT'S NTEREST 1 A 6/30/2008 Morgan Stanley Smith Barney -Account No. 221,751.93 50.000% 110,875.97 727-70678-1-0-216. This account was owned by Betty T. Pearsall and Gregory H. Pearsall as joint tenants with the right of survivorship. 2 A 12/31/2004 PNC Bank, N.A. -Checking Account No. 31,715.13 50.000% 15,857.57 9206118734; date of death balance $31,714.39; accrued interest $0.74. This account was owned jointly by Betty T. Pearsall and Gregory H. Pearsall. TOTAL (Also enter on Line 6, Recapitulation) I 126,733.54 (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 F (Rev. 6-98) Calculation of Date of Death Value Estate of Betty T. Pearsall Morgan Stanley Smith Barney Account Date of Death: April 4, 2010 # of Shares (from April 1 - Apri130, 2010 Statement) Security Price Total Value 1,232.395 Alliance Bernstein 14.35 $ 17,684.87 Intl Value Fund 1,474.781 Am Century Intl Bond 14.07 $ 20,750.17 4,518.053 Baird Core Bond Fund 10.635 $ 48,049.49 2,705.094 Blackrock High Yield 7.36 $ 19,909.49 Bond Port 667.172 Fund Investors Fund C 1 F 1 34.31 $ 22,890.67 617.821 Janus Forty Fund Cl S 32.76 $ 20,239.82 4,291.701 Pimco Total Return Fd C1 D 11.01 $ 47,251.63 800 JP Morgan Chase & Co 27.76 $ 22,208.00 2,767.79 *Western Asset Money 1.00 $ 2,767.79 Market Fund TOTAL $221,751.93 *This asset was not included on the Morgan Stanley Smith Barney date of death valuation. 300 Granire Run Drive Suite 300 Lancisrer. PA 17601 eel ?l->60-5900 roll free 800-8?3-09)0 Eix ?1;'-560-0100 MorganStanley SmithBarney July 14, 2010 James D. Bogar 1 W. Main Street Shiremanstown, PA 17011 RE: Estate of Betty J. Pearsall 727-70678-1-0-216 Dear Mr. Bogar; Per your request, enclosed are the date of death valuations for Betty J. Pearsall. Since she passed away on a Sunday, the valuations are an average of the previous Friday (4/1 /10) and past Monday (4/5/10). Also enclosed are April, May and June statements and a dividend and interest report. The account is titled: Betty T. Pearsall and Gregory H. Pearsall JTWROS. I am waiting for the new account documentation to be returned from Mr. Pearsall, then I will be able to open an individual account and move the assets into his account. Lastly, we do require an original death certificate. Could you please forward one to me? If you have any other questions, please do not hesitate to call. S' cerely, - ~,- 1~ eryl H man Client Service Asst. to Paul Kurisky Morgan Scanle~- Smith Barney LLC. Member SIPC. 300 C,ranite Kun l)riae Suite ;00 Lancaster, PA 17601 [el 717-56(1-5000 toll Free 800-873-0~>90 f,x ~]?-Sbb-0100 MorganStanley SmithBarney Average Date of Death Valuations for Betty T. Pearsall Securit Security No. Price Alliance Bernstein Intl Value A146988 14.35 Fund American Century Intl Bond A337344 14.07 Baird Core Bond Fund B056343 10.635 Blackrock High Yield Bond Port. Class A B374400 7.36 Fundamental Investors Fund Class F1 F646509 34.31 JP Morgan Chase & Co. 8.625% J043562 27.76 Janus Forty Fund Class S J141769 32.76 Pimco Total Return Fund Class D P138372 11.01 The information contained herein was Preposes by the undersigned for informational pure only and does not represent an official statement o'fi your account at the firm Please refer to yocr monthly statements fur a complete record of your transactions, holdings and balances. il9or~,an Scanlev Smith Barney LLC. Member S1PC. Betty Pearsall Estate Page 1 of 1 James D. Bogar From: Hartman, Cheryl L [MSB-PVTC] [cheryl.l.hartman@morganstanleysmithbarney.com] Sent: Monday, July 26, 2010 10:16 AM To: James D. Bogar Subject: Betty Pearsall Estate Good morning Mr. Bogar; I received your letter requesting the date in which the joint account was opened with Betty J. and Gregory H. Pearsall. This account was opened on June 30, 2008. If I can be of any further assistance, please feel free to call or e-mail. Morgan Stanley Smith Barney Cheryl L. Hartman Senior Operations Associate Phone: 717-519-4948 Fax: 717-560-0100 Important Notice to Recipients: It is important that you do not use e-mail to request, authorize or effect the purchase or sale of any security or commodity, to send fund transfer instructions, or to effect any other transactions. Any such request, orders, or instructions that you send will not be accepted and will not be processed by Morgan Stanley Smith Barney. The sender of this e-mail is an employee of Morgan Stanley Smith Barney LLC. If you have received this communication in error, please destroy all electronic and paper copies and notify the sender immediately. Erroneous transmission is not intended to waive confidentiality or privilege. Morgan Stanley Smith Barney reserves the right, to the extent permitted under applicable law, to monitor electronic communications. By e-mailing with Morgan Stanley Smith Barney you consent to the foregoing. 7/26/2010 3 ~Zao ::: m m 41 ' 7 n ~. r c ~ y ~. 10 '~ o ~ d ;. ~ °-' i O y y, ~ :. y O 1~'X J 7 A d J y d ~ ~ d N M N 0 co ~ O ~ 3$~ N rn n ~p SQOw J O N _ p ~~ d _a G a m y O O ~ 3 ° p' ~ ~ O n ; W , a %! a -' '~, < N 3 ~ ° 3 2 o `~ `~ a ~~ ~~ m m ~, n ~, ~ o ~ J ~ 8 ~ r ~ fD Z N N w u O M ~ ,N 0 ~ O O C> ~ Q QO ~. 3 8 5 o ~ ~ A ~ w J 7 ~ ~ +t ~ ~ ~ p P N ~ ~ '!h! ~ ~ ~ ~^ iv cn Q N ~ N '.1~J m y ~ ~ W p 7 U1 ' O I N Y- S O N O N N ~ N ~ d (~O 3 8 8 8 "'0 ~ ~ o ~ 0 ~ oa a c c '." c `° O ~ ~ s _ ~ m m ~ a m ... co .. m p .o a _ Q ro y n ~ „ N H N o- N o ~* ~ ~O ~ d b ~ ~ a H O a O c 3 ~ ,~ N n m (D d j a ,Sr n ~ ° d o O 7 d ~ (D a O 7 O d (D N < ~- N d d ~ 41 o ~ ~ r. o• c ~ S ~ N d N N ~d O ~ C n y 7 n d O N ~ d <d m ~ c m N 'O ~d °- a a' °o a- ? a CD o- ~ CC 00 O O ~ a ~ o g v, $ g a' .... N ~ a ~ m a ~ °m a m ~ y N O N d N a N O A N N ~ N ~ ~~ 8. N N AN ~ O i 8 O o; O i I O m ~ m i m M Ii 0 8 ~ D o 3 ~ + 3 G p v y o a rt O c~ 0 a 01 y 3 n 3 ~D 1 ~ _N n (~ 3NG~ooo ~ m ° m ~ oo c ~ i+ = ~ 7C o n-o ?4~~~~ `~ a o~~aN ~ ~~my~ c~~~no ~ mv,~~ n ~ inn Cn~ N V O O rt W `2 ~ ~ .~. W ~ C V a ~ ~m ' ~r~ ~''C~ v C~ C~ ~ 'p ~; ~ O m y- Z m n m~ r~~ c ~ j ~ Z 7C 0. _ ~ 3 r y ~ 3 ~ ~ ~ A ~ ~ D z ~ ~ . S ~ _ ~D ~ V ~ ~ ~ Ca O d ~ ~ ~ 5 ~ H O ~ ~ O ~ ~ ~ w' iii 3 ~ m ~ ~ o ~ K r ~ ~D r~ -i W T ~p ~~ 3 3 n ~ D v s ~ ~ ~ ~ O v m ~ O v = ~ ~ ~ 0 . ~. ~ ~ n 3 d ~~ ~ a d V (p O W ' ~ ~ V ~~ m ~ ~ V m ~ O ~° cc ~ a 0o c n V g ~ ~ ~ r V 0 m m O N ~ J ~ ~ ~ -~i. a ... ~ '~ A ~ ~ n ^ p ". .. y ro ~ 67 .. A . ~ ~~ b ~ < ..~ ~ coo o ~' ~ "' a1 ~, z~~- m m v p m:~ 'S1. ~ ~_ ti~~ ~ o n ~ ~ `° ~ n Q m cNi ~ `' ~ 'O 3., ~ f0 ~ A '" W W = oo GI ~~„ ~ ~ ~ ~ j ~ W D g+~ - O ~,' m p ~A°`°kb c O 2~~ ~ ~ D W k n o b a ~ w m Q, 0 ~ ~ o ~ ~~~ 5 . n ~ O ~ o:~ O ~ V, ~ ~: A N in o ~ 'A ~ A Z k ~' ~ A p ~ ~ ~ S ~~^ ~ O~ O A ~ ~ ~ ~ ~ ~_ ~ O p ~ 0 a ~ ~ s _~ °~r~oo N p A ~ O. y,Lp A A ~ ~. ~ ~ ~ ~. A a. NO N O S A y ~" O `~ t Z3 'b t~ ^' ~ 6 S O ~ ~ ~m e 3 A p p O A O b s~a~A~ A n ~ 5 ~ O ~• h ~ g y c S ti i a ~' b a. 5 ^, s ky ~ j ~ a.o~~ o ~~~~ M ~• ~ A O ~ y O .. ar ~ S. ~. b m c ~ 5 'b n `° j V, co ~. O s p O p S ~S ~ ~A ~ ~ 5 ~ ~ ~ A ti A ~ `' ti 3 `C ~ p ~~ a . ~ N M N ~S' 7fD Z '.~ D O a, n ~ a a~ ti ' ~ , o '~ -I,,'-1 ~ c o 4, " ~ p A. ~ S. °' ~~ h' ~ ~ ~'< ~ ~ ~ ~ n ~' ~ rn ~ rn ~ °'m naa ~ ~ ~' ~ p ~n m ~ ~ oo ~. ~ ~ ~ ~ y~ A m ti b ~ D ~ 3 ~ ~^ ~ ~ y ~ ~' y ~"~ ~. V pNj ~_ f p S NfD ~~ R O ~ d N pQ v ;. p 8 a= ~ ^ O W !D a H O n y fD ~ ~ n ~ C 61 y _ r ~ y = ~ -^~. O t Z~~y:33s co 0 ~ ~4 S co ~ S y ~ 3 ~, ~ A ~ y N ~ O t 5 3 01 ~~m°a3m A_ ~a 3'^ c p O R 51. ~ O 4 .3 '~~ ~=~ ! f=/I oo~~ ~ n y a w n y~ ~A p'~ Of~ ~, S ~ cO ~ ? co ~ ~ A, ~ <D ~' ~ < O ~f0ok ay O a ~ n ~ n n ~ w o a O A, a tD ~ ~ ~ ~' p ~ ~~A ~. ~a O s, ~ ~ 5' ~ A ~ b~ ~ t~ii ~• o ~ N o ~< xya,~ A' ~ ~ A ~ ~ ~ ~o ~,~ 'b n ~' ~ 0 O ~ ~ A O ~ `~ ~ ~ ~ ~ a '-~ `' p y p 4.A 3 `0 H = r., ~ A y <D a O 0.~ ~ ~ ~ ~ m°~~ ».3 ~' ~ ~ ~ ~ ~ S UI o ~ ~ ~. ~ 3 A 3n ~ ~ ~ ~ y ~ co O ~,~~ ~.~ bo°p~ n3 A ~ S' ^ iD A n `'. ~~ ~'~ ~ ~ a ~~~~ =3 ~.y rya ~~ y O A ~ N ~ C> ~ ~ o ~. co S• a. 5 <D 41 ~ sz..r a a ,~~,• ~ a ~ ~D n ~ A. ~ ~ ~y~~ 5°t ~q~ s cD C o Q, co `' ~ y ~ co ~, ~' C d ~ o ~ ~ ~ ~. ~ O1 y 5' ~ ~ C O o ~, ~. ~ w ~? ~_ ~ O cno ~0 ~ O' 'b a a~ ~ ~ ~ y 3 4.m 0 ~ ~ .. O ~` N -ml Q '~^^ V' _ ~--F ~F T~ W ~ ~• `i i a ~° n y W ~• n ~ ~ n ~ ~ C O ,,^~ ~i.i !~` n ~ O C7 ~, rh N V O o> V 0o v ~- m O o N N V O ~ ~ W ~ ~ ~ ~ V V ~ ~ Jt f N ~ ~ N V W (~D m ~ (71 N -+ ~ ~ ~ ~ m ~ m ~ o ~ 3 m ~ ~ m Z m ~ ~~ f/1 N ~ ~ ~ n c~i z > i > m m ~ n m n m m m w Z b a ~ C i o m i o m = j Z D '1 r^ r Z O Z D r WI m L7 W x ml N wl V N _ _ oz m c ~ ~~ ~'b~ ~ c o ~. ~ ~ n ~ n ~ aye ;•a y S ~ ~ -~ is _ iv ~ N w pwp W N ~ cSi a ~ ~ ~ < ~ ~ A. ~ e 5 A s ~ _ ~ ~ ~' N CqO W W CO ~ A ( N fD ~ N 61 ._ ~0 A ~ h ~ w ~ ~ ,~` • • S fp ~II ~ ~ ~ c" O~ S A Op W ~ W O D V ~ W p cwTi V O W ( OD (D OD m A . O, ~ ~ 0 ~ S S ~ c0 ~ O S ~Q ~ S ~ y ~. ~ A' ~ N fp A '~ 5 ~ O ~ ~ A A p• ~ ti f0 A S lD m 1~~~ c o m co o 9 m D m C r D ~p ; ~D a e 3~ ~p = 'a c~ 3. O ~ ~ ~, O S o~ ~.. ~a ~ ~ y p C ~ D ~ N ~ ~ ~ O O ~ 41 m< c 0 H C ~ D ~ n O ~ ~ ~ <D ~ O ~ O O c0 ~ ~ 'r to ~ ~ ~ O ~ O `'~ ~ S N ~ m n y m m p g c o ca " 4. ~ n SS S O r A A~ 7 m m n w Z ~ ..,. ? A, ~ a~ t to A~ c m c ~ w Z ~ A•, ~ ~ ~ ~ ~ A ` ~ ~ A ~ ~ Q A. b ~ ~ 7 m D - i ~ c o N ^ m ~ .- D ti m ~ D S ` S N • ~ a; 4. ~ n N pp p n o- 0., 3 ~ ~ ~ ~ c m ~ ~ O ~ ~ , p ~ o ~~ ~~ p S~ ~ A S '~ <p O• ~ S 60 y a. ~ ~ h a ~ ~ O A p ~ ~ r S ~ ~ lD D ~ , ~0 T• ~ o < ~ O ~ ~ ~ O ~ O ~ ~ coo ~ O O `G S N S iVh" 3 ~ ~ ? C. cC ~ ' ~., O (0 A A ~ ~ A X p '1~ A. A '~ < - ~~ A. b ~ ~ ~ C ~ ~ ° ~ a e ~....' A ~~ ~ ~ ~ ~ ~ ~ ~o ~ _y c a ~ ~~ ~ ~~o ~ ~ 00 ~ ~ v o ~ ~ m p a A .~. o' ~ 'b Q' ~ b ~ ~ ~ c~ ~ ~ ~ n ~ nb ~b ~°• S•~ z a ~ ~~o~- o A, r `0 a, tail ~ ~ a S t ~ ~ ;o ~ co » ~ 5 ~ ~? H o o a.A O~ ~° ~ Ty yob b ao m m w cn a N , n ro ~~ ,<o- ~ O~ ~. m o o ~, N N ~ N V V ~ ~ ~ n \ ` A (0 3~ ~ ~ r (0 ~ O rn V ~ N ~ W V ~ N ~ a. ~ `Ae ~ ~' ~• ~ p ~' S' ". ~ V W O O ~ ~.~a,S `~`° `° ' ~~ A S b S t0 Z`~ 3~ ~ W p W ~ W W ? m~ n N y~ p 3 A ti~ y ~ ~ ~ 5 5~ S A ~ ~ ~ b~ ~ A .. S O~~ ~ pp Cf pp (O V ~ ~ m N N W ~ _' _' ~ N C7 N . T' ~.. ~ ,.~ ~ f0 ~ ~ ! ~ ~ ~ '~ 5 ~ ~ O (0 ~ ~ ~~~~~~ Ab ~ ~, f Ams,~ ~ o' a. b ~ p ~ ~ ~ q~ f ~ W 47 (a w w w w W O ~ ~ A "~. A S S ?y ~ p a, co L co co ~ Sr ~0 <0 D7 W co ~ co f ~ Cf OJ co m Pc' co w N T K O b • o 5 2 y ~ ~ ~ S c0 ~ ~ ° a ~ ~ b `' t 5 `~ ~ o A, . o~~ `.C ~ ~ o• ~ O ~ ~ aa'~ n S S y a, r ~~ b O O„ A S- Q ~ ~ n ? N W C ~C ~ S ~A \ ~ 1: ~ ~ ~ybOQ pp j V~~ A C o N~ tD V ~ p [n o O Oo c N (p .~. '~~~.' Z A~ 5~ ~ • p fy0 ~ n O~~ S p~ .p ,p fN71 N O yA a p ~ T O ONi ~ 3 ~ q A Z =~ D; n A ~ O ~ S• ~ A cS0 i0 <O ~ . R ~ `~ ? Ot O O ~ ~ ~ Q, ~ `•C r ~' A, ~ `' ~ 5 a a _~~ O o' ~S y 0 N O 5 S ~~ ~ N o ~ ~ N d ~. V, A A n n O S A.b ?7 ~ S. t0 O S A, s1 ~ ~ A ~ ~ Q n ~ ~ n O y ~ ~ A . A ~ ~ (WO a (D N W -+ ~ - ~ a i. `( 0 ~ ~ ~. ~ r y Op n ~ ~. ~ N _ _ W _. _. ~~ r r r ~ A ~ A. A ~ S ~ y 1 -i -i 1 -f 'i 1 ? ~ ~ ~ ~'t7 ~ ~ a A ~ O b o ~ m 5 A~~ p ~~ ~ y a m ~ 10 f0 mm~ S O~ <D A ~ S O ~ ~~ ~•N m ~' ~ ~ O b ~ ~ Q O a_m ... m C mom O ~ ~^ Co ~ ~~ S ' '0°3 v { A ~ d ! = ~ x ~' S' `' c0 ~ a D m o ~ ~ c y < o. ~ ~ a ~ ~ A '^"' co _ A f0 ~ ~' ~ On ~ 5yy S ~ 5~~~ 3 -o m01 ~ n y' ~ O 3 ? b ~ ~ ~ ~• A ~ o ~ N ~~ ~ gi Qfll ~~ ~ , O ~ ~ i A :' p O`1 y ~ a;~ A O WS cod ~ = y y 0 5 a ~. c D o ~ n C~1 O G ~w O m CQ ~_ r-~t• `G ~ ~. D A~ ~ `+ W moww'' ~ W ~ ,~ W rt C1 PF v m m w 0 m OD N N ~ 0 Q ~ O W T1 C CW71 W ~ 0 ~ ( ~ ? ~ ~ V 01 0 N O) W 0 -{ ~ (7 T » r m C m . + D Z ~ N o 'v ~.°. N D c n ~ m n G) Z w m r^ W m D r H1 ~ _ 2 m C) 2 ~ D 0 ~ C Z v D X ~ ~ ~ ~ ~ ~ ~ 00 ~ ~ W V O o p ~ P _ op 0 p o 0 o W r N -~ Cn (T 0 op A O V ~ O V 0+ ~ W V (cnp <pn f. > W f T D .O ? O O f07i N O ~ , 1 6i O0i 8 ~ -W+ fND fND (W71 W ? (W77 ~ W W 0V W N W A ? ? ? ? A ? ? ~ A A A A ? A A N -. N -+ 0 CT1 W N ~ W ~ O ~ 0W W O ~ ~ p O p 8 y ~ Q1 (C ~ 161 D ~ (J7 W ~ ~ ~ f0 ? (Ot O O (O 1O O 0 ~ O O ~ c00 1 1 1 1 1 1 ~ N N O 8 7 ~ ~ 0W W I m O O O j ~ ~ ( J ~ 0 V 00 J ,t OD f c A 07 ~ (WD N A T1 ~ ~ :0 0<1 ~ Z1 f7 O c o m m a ° ' Q < m < M ° ' e r r ~, Di n ~ - < y m m y m `~ - v v m N~ m c m c n D~ ~ c m m ~, o. m m T , L7 ~ i ' _ > > ~ ~ 7 m O y o m m ~ _ ~ o m < a o a ~ m ~ D = ~ ~ m m m ~ ~ m n m m = m i ~ c c .. r m ~, v ~ m m m M ,o., r W O m ~ C ~ m C m ~ O m W S y X N WW O p07 0I 4J W W V V v W N W W ~ ~~ V V 01 OI W W V ~ V ~ 1 0 ~ ~ ~ V ~ j i V ~ 1 (WJ I 8' 1 ~' ,~ OD ~ 1 N i O 0 i I V ~ i (J1 ~I~ (D I m A ~ V ~ ~ O I' V ;? 01 w ~i ~ ~ ~ 1 1 o Z -1 ~ c ~ ~ ~3 ~ p 000 V ~ ~ V N (NO ~ ~ ~ p fD (O ~ Ui Ui V N Q ~ 0 W W V N 0 V 1 x1 01 W 1 ( 0 O m ~ N n -i -1 ~ ~ ~ ~ Z W T -i 1 m D p y Q o m m '* m o m D c o m 7 )C p ~ m y O Z$ 7 i m c< N 7 < fD m o ai ~ m D a~ c o ~ ~ n3i ~' N o c d+ y ua c n m c m _ n ~ N m .- ~ ~ n O O Z ID a C e O~ n c n d m S j Q ~ m n~ N N m ~ ^' m r' m n n m ~ 1 m~ m W~ O e m M Z ~ m < a e < m m a m m D W Z >> N O m a m < y 1 ~ fD ,yM, n n 0 0 2 D C m n n ~ ~ O i s •• ~ z v c ~ z 3 lQ o ^ O p „ . ~+ ' ro rt Z Q ~ ~ m ~ < D < ~ 1 m m m m m -_i y O CI) ~ m m ~ m Z ~ r} 1-=r N ~ ~~ z oo ~ ~~ O ~ 3 ~ ~ X X o (p 00 W V O A N C W a ~ 0 ~ ~. r~ N ~ r A N N ~ f0 ~ N N ~ fD o ~ W ~ N 001 Q. ~ W OD (71 1 0 ~ ~ W N p p A ~~ ~ ,pp W W J ~ W O 0) Q O (0 0 0 0 0 0 0 M A n O~ W ~ 01 ~ Aa ~ W o p W (0 (N1t N V ... ~ ~ D ~7 ~ AA`` ~ i~1~ ~ n C ~ 1 0 0 0 0 0 0 0 0 `° m v C~ ~ ~ ~~ ~ ~~~ ~ - - n ~. y . W o n ~ N ~ ~? W W N N N O O <n d C r n N O V V C00 0 m CWIi ~ (WO V 00 0 ~ ~ 01 01 2 ~ 0 OD .. O W Cp W W O 1O vt W ~ 8 ~ p ~ A ,^ (Q N N • p• ~ Q V ~ 0 W ~ 77 C ~ ~ i7 0 C 0 N W p . C ~ p p (0 p p G A pp OD ~ V V fW0 ~'' d C') /~ ~ -yi 1 ~ 1 1~ -r-I n C ` I a ~ ~ °~m ~ O p 0 W W m ` .0 0 mq ` ~! / - A W ~ ~ mmm a r* 01 ~ A ~ W 0 O °f m ~ c o a N V ~ ~ o~ O ~ ~ ~ 01 V N ~- O7 ~ ~ 'ono ~ N CD ? a ~- ~ m o ~ ~ N~ 01 -Oi. a ao ~ W ~ ~ N N ~ N pO O ~ O _ G O aN W N W Q7i1 ~ ~ V V (T ~ QD ~ O ~ W CO ~ V V 0 V V ~ A JI C OD N CD ~ m m m ro ~ ~ C r x ~ ~+ ~ G m ~ m c<o m m tOi> O o w ~ m~ 3 c n o o ~ z ~ ~ D Z A ~ ~ m m D cn ~ o y o `" o m ~ y m m D N N m < a a ~ -~ i u i o m i o c C ~ ~ c = 0 7 Z O Z c ~ • • T r T cn m -~ m K Z X 3 ~ D .Z) m 7C c m R1 ~ ~ ~ ~ X X X ~ ~ ~ ~ ~ ~ _~ OD CO CO CO V O ~ ~ $ $ ~ ~ ~ N Obi W O A W N (O p p ~ W ~ pp ~ 00 f W N ~ CO CO ~ (.~ W V ~ W y1 A N V ~ (p 00 W O j p 0 cc 0 0 O 0 0 0 0 0 ~ A CWO ~ (WJi A CTi ~ (A71 N N CVit V OD Cn W W w W W W W W W W O J N W ~ Cn W L+1 CO N in ~ O ~ (y.~a O ~ ~ V i ' W V CJi O D OD A OD C11 O ~ . W 000 O ~ OVD t p W O m W ~ CO ~ N -+ O N O ~ ~ N ~ v 0 ~ W A i C p O ) .O ~I 0 0 W V fm71 ~ OD ao ? CNJ1 p ? N N W w o m N O N N CO ~ W ~ O O V V OD A O C Op N O~ V ~ Ut ~ O .N.. ~ N V A O CJt T1 ~ m m o D . ~ m i m Q< N y m ~ C m N b C m C n T a ~ ~° a s ~ ~ o y ~ w ~ ~ ~ m ~ < ~ ~ o a m'~ C ~ ~ w m Z o n c ~ ~ D c ~ ~ D to m m ~ .O.' ~ C m b m C c m m m A O W N 001 N CO V V N 1 N li N I CJ1 O W W D7 W W 1 V N a~ ~I D 31 X ~_~ i ~` A I O I i ~ i N I ~ i O W W ;D r -i W V CD V A N JI V I N V T1 ~ ~ Z1 ~ (~ T c O m m m r C a m x~ ' y Z < ' m C m m o m N m T~ ~ m c m o . _ > m ~ > ~ 7 m O ~' H D ~ o o r m m < a < m m a m G m m ~ n ~ m m ~ v c ° o n o m ~ W m m ~ rt ~ ~ T C m m m Z C C ~ m m D T ' X .J V V P N V ~p S W W V WW O y 1 N a+ N A N N »I V N 1 oZ c ~3 N ~ m O ID fn O 7 ~ ~ O N ~ C 7 A N_ CD 7 D C. N O !D C7 3 ~ Q O ~o n °~ C fD Q 0 ~~ ~. 0 .N.. O ~ N ~ .~. N ~ C7 ~c N .~.. v~ C ~ 3 ~ C ~. ~ ~m .: 0) N N •~ a vgz m°~ m m C m ~ m m O m co a ~' D n 3 O n N~ m d fD ~a m 8N O 0 lQ '^ rF ~ ~ ~~ m ~ ~ ~ w,~• iiI A~ I II n ~ y ~ ~ a o ~ o ~ n ~ w~, O ,^P1 ~.if rf n ~ n O (~ ~ ~_ e a, ~-r <D N V V O 01 V 0p .~ ~ m o m m N Ol v ~. 01 ao 0 0 0 0 0 c o f 0 0 0 0 0 0 ~ m ~ m ~ m ~ m ~ m ~ m i N w N w N w (<D w N w (~D y' w ~~c~v mmr en r v ~~„ mmC~ ~„ C~ ~~ mm nw rr ~C )co t rr ~ ~ ZZNn ~ D 20 ~ n ZZ~~ ~ =~(n ZZ~n e 2~n mmNO Ocn O mmnm Onm mm~~ Owe Z cn(no~ ~1 O ~v D ~ O tntnrs -1-{ ~r~ D (oc~ -i1 D~ O ~ D D~ 0 2 r^ ~ -I ~ 1 DZ m ~ cn D DZ ~ ~ D r^ ~ (7 ~ n Om D D D Omcn V7 DCn ~ om ~ D r ~ D Z r r r D Z r Z = = ~-~ ~ '^ ~ ~ r^ ~~~m ~~m ~'{ ~ ~ ~ O pI m p w = -I m = -i p w m -I T Z Z Z 1 T m Z Z m z ""~ T m Z m T ~ m ~ ~ ~ ~ ~ ~ .Z7 «r O~ C Z ~ m c Z .Zl -~ m op~X~ -~ ~ m mX~ Z1 ++ O ww W ~ r" m O v, w ~ _ Z ~ w D ~ Z D ~ rn~ p Z Z Z j m v~ ~ m ~ N j O m O O w ~ m O ~ y m ~ ~ O v O N -i v O ~ ~ w w 1 i i CO V ~ ~ 8 V O ~ O ~ O u ~ $ ~ 8 :, $ N 7 ~ "I ~ o c < ~ ~ ~ _o+ ~ m y fA o c ~ o n e ~ A 3 A f ~ .. Z m w ~ ~~ D~ i c a m w n r ~ m m ~' m c ~ i m o w w w ~ -i - D ~ O m K, e m ~ n ' v' w m m m ;:. ~.,.. p w C m w m C O C Z w ~ T C ~ m ti O ~ ~ m O m ~ c 7 ~ w ~ ~; ~, i I~ ? ~ ~ ~ -i ' 0 p X ~ ;' O t < ~ f0 3 t ,~ : s A.> O ti `, ~ N ~ N ~" N ` ! R ~. ~ 1 ~ V ~ i a ": Gt?. M N M ' N ~~pp . ,. <„i D p o~ py p' w w' ~ a~ rn i D A D.1 N ; N QI I`CI ..a's'QI V ?,rw'. W3Iw w 'm r ~ « r=tn'' ~ ~ -i = -~I tD V ' V W w o p~~ p W O ,..A _ a. ,'.O p O..' I;~ ~. '. D V D V m 3 : W W ^c m 7C m ~ O a 3 t~D N_ fD v Q C N O fD r ~D i L 0 4, >~ > s o~ «~ ~n ~c >~ .~.. i n _c i~ ~c ~, 7 7 ~ ~d p N %a 7~ Z o ~ m i o < e m m w m m D 1 j 3 ~ ~'• 3 D ~ U N ~a N ^~ ''^^ W v, .=* ~ m -a ~ y ~ ~~ ~ ~ y i n a ~° n o ~. r o ~ C ~ ~~ n ~ ~ ~ ~ n i 3 C ~ a' 1~F V N V V 0 a .1 0p O m ^i W ~ ~~ b ~ ~ ~ ~ ~ m ~ o ~~ ~a m' ~ 'o 'o o m~ m A A ~ c C C C ~ m ~~ ~~ ? O A 5 o 0 0 o d z ~ ~ , ,,. m I ~ a O ~' a' < C. (7 C fA ,: ti ~ ~ O t0 ~• ~ ; N ~ '. O ~ a c~o?~ a ~ Y a - S O O ~ ~ , m ', I m ~ ' d ~O Y. A• ~ O y m S ~ ~ G ~ O a.~ a ~• W ~v C ~w 0 a 'ZS 5 ~ ~ m~ ~n ~~ ~n ~ , ~ ~ ~• ~,; 1 O ~ O n m cn ~ ,o ~ ~ ~ a A ~~ co sy ~ O n m D D r to D ~ x .. ~. ~ ~ ~ r.,' O ~ W cn O ~ D N m 2 ~ ~; Z x Q, ~ O C D C ~', A ~ ~~ ~•co 2 T DC Z r^Z ~ ~ ~ o~ 5 p m Zp T om{ O ~ S ~ cno ~ ~ ~ Z X ~ W O A ~ ~ y ,., b s o' o - D ~ z ., •~, o s, o _~ O ~ ~ m as ~ A„ SZ, ~ A J.. A O r ~ R .t A o- ~ -p r A ~ ~ ~ ~r ~ ~ 5 Z ~ S, co n_' ~ ~ 5 D D o D D ~ 2 2 2 2 ~ 5 0~ O O O O N rr ~ ~ ~ < < < G ' b Z Z Z 4~ A ~ O Z t ~ ~ ~ A, 3 V N ~! W ~. ~ O ~ A `~ ~ pgWp~ !p pN S N ~ ~. ~ . O O " y p S S 2 2 2 0 o e ~ w cn cn cn A d ~• y ~ o b e ~ s• ~ .•p S~ S. Z •A.' N O W m N ti • ' c0 ~ '.~... 07 CJt K ~ 0 S' S' ( ~ V (WO V N ~ A r ~ ~ ~'( ~ ~ O A S p^, ~ 5 ~ o s~ A ~ ~ ~ Z ~ ~ ~ ~ "' ~ . ~` ~ ~' S O o~ X d m y m e o ?Y ~., cc 5 c ~. S] n A ~ ~' . p O 0 h a A ~ _N ' O fa7 ~ ~ ~. N O Go 3 CV7I rn V ~ (00 V ~ N p c .7. ^c, o C ~ ~ ~ ~ M ~ m m N N v (p ~ y m o 0 ,. 3 C 7 M ~ NN m o O C C J .t i~ `G ~Np O m 7 a f7 ~ o ~, m ? ~ ~ S n m m > m > c o <~ Q Q C N ~ y ~ ~ ~ O V/ m mm~D ~~D ~ .--f .-i-Sy m « V ~ ~ C Ap ~ ~p ~ -WI~I~O m DSO O• ~t~ p m o rn D i m r p ~z N Z m cn c n ~ C 2~ 0 Z y 0 to O 1 T D C Z D C ~ m Z O m Z N o~ 0 m N 0 T N 2 ~_ V ~ ~ O ~ m ~ ~ • ~ ' ~ w iY ~ 'i ~ ~ ~ - A y CA o n ~ n ~ ~ o ° ~ O ~ N N rf a ~ n n C (~ ~ 0 Q' N V O w a+ V ~ ~ N ~ D p n V O 8 v o c N .~ V 01 ~ p~ M D1 3• d N ~ O ~ 4 n n ~°' o, ~.~Oy~~ ~ ~•~ ~A yA A p' O ~ O A ~ T ~~ ~ c~~oo >•3~~ a A O C ~ n Sy ~ ~ w O A ~ S Cps ~.0 ~33~A.3 ~ ~ a O ~ 5 s ~"~ C S• ~y A o ~ .n.,. n ~ ~' A ~O wA ~. ~ ov' C o A ~a~~ ~. ~5n~ A-m `~ ~ d ° 0 4, b~ ~A ~.`0 oo• o3i'o a. o e ,~ • 0 ~`c %:.~°y o ~ opQ ; ~.~ ~ 0 ~ S'n ~•A~ h ~~ o ~ ~ ~ ~ r ~ ~ v ~ '~+ p b,~ Na•~b V ~ R O'Qo ~ W ,~ (~ ~ h ~ p ~ A ~ k yW0 coc~o ~• ~ ~ t '~ ~ p (p 4 Z A ~~" a~~~~b 3~oA ~ ~. m .Q c'~ m ~ ~ ~ y s~< ~ ~~ '~ ~ o~?Cp°e '~bOO,o-a Zo a.-p ~ ~ ° ~ ~ a ACo•n~~a OS S .Z• .~ ~ (0 ~'~fq S5 ~ ^ ~ 1 ~1 ~ ~ n ~. 'r ti C1 Ot a- °Z'~ ~ ~~ O~~ ~ s A V ~ ~ C ~ ~ ~ h ~ .7 A S' d 0~ A r n ~ a `~ ~ C ~ ~ A ~ ~ C7 ~ O ^ ~ ti Z fq Vi o A ~~~n~ A y Q ~; A ~ ~ ; 0 a v~p~ ~• a 3 -ow ~ G1 0 r ~, ~o a ~ O N a A_ ~ ~ a n o•.Oi.p ~ a ~ O ~ ~ o N h h ~ co' ~ l o _ A..Ty. o- c o ~ ~ ~ 3 O • ~ ~ b O n 5 A ~ ~ A ~ Q < 5 Z ~ '~ f~0 ~~ VI ., ~ ~ ~aa A.. ti y ,~ ~•~ 0 A ~ ~ 3 ~ < < ~ A ~, ,.. p y A. ~ fD b~ ~ n ~~ ~ 21 O ~' A ~ ~ a p ~ ~ a A ~ a b ~ O ~' = to : O s1, p - 'b A y ; a A w S 3 ~. ~ n ~%, ~~ 5 Q~ , ~ y . ~• ti ~ a Sb~A a.A ~ ~ ~ ~ b A . 'yZ ~ DO ~ o ~ ~ o.~ < `y° ~ 4 ~ ~ ~ o coo R ~ R A~ a y 2 ~ e y ~ ~ ~ O ~ ~ 5 S ~ O ti A ~ ~ ~ ~ ~ ~ ~' sy m a ' ~ ~ ~„ ~ , ( ~ ~ b~ (p O ~ b om ~ .n ,n ~ O ~ ~ ~ o ~ O h ~ ~. 5 "" c o ~ A.. ~' ~ o ., ,Z A m• ~• A.. ~, .~~ A. c o S 5 A ~ ~ O ' ~ ~ n ;~, ~ o n o n ~ 0 'b po• co ~ ~ h ~ ~ a ~ sy, ~ ~ " o y a ~ ~• ~ a `' o O ~ a ~ . f0 s o ~ ~ '~ ~ y ,nom ~ 5 S~ A S'p N ~ a ~ ~ c~ O h ~. ~ or ' ~ b ~ ~ ~ II S o ~• m l ~ V/ r-F ~~ ~~ d ~ CD ~ ~ D ~ W ~. O o ~ O ~ rh D m m m 0 m Au,19, 2010 11;39AM PNC BANK 412-105-2747 ~~ lEtlDIN6 THE W~l~f August 19, 2010 James D Bogar, Esq. One W Main St Shiremanstown, PA, 17011 RE: Betty T Pearsall SSN: 098-14-9902 DOD: 04-04-ZO 10 Dear Mr. Bogar: No, 8188 P, 1/1 In xesponse to your request for Date of Death (DOD} balances for the customer noted above, our records show the :Following: Checking Account Account # 9206118734 Established: 12-31-2004 BETTY T PEARSALL GREGORY H PEARSALL DOD balance: $ 31,714.39 + 0.74 accrued interest Interest paid 01-O1-2010 thru 04-04-2010 $ 12.36 YTD Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savintgs). We do not process any Fnancial transactions or provide statements. If you need assistance with any of these items, please call 1-SS8-PNC-BANK (1-588-762-2265) or stop by your local PNC Sank branch office. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 of 1 REV-1151 EX+(10-06) COM IN~HERITANCEDTAX RETURNANIA RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Pearsall, Betty T. 21-10-0657 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 of Personal Representative(s) Street Address City State Zip Year(sl Commission paid 2_ Attorney's Fees Bogar & Hipp Law Offices 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent 2,486.52 8,400.00 4. Probate Fees 119.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 13,101.41 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 24,107.43 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 Pearsall, Betty T. 21-10-0657 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Gregory H. Pearsall -Burial trip to scatter ashes per Will 2 Myers Funeral Home -funeral bill H-A Other Administrative Costs 3 Capital Self Storage 4 Country Meadows -nursing home bill 5 Country Meadows at Home -nursing care 6 Hampden Township Ambulance -medical transport 7 PNC Bank, N.A. -Outstanding checks in personal checking account as of date of death 8 Quantum Imaging -medical bill 9 RESERVES: -Costs to conclude administration of Estate, including filing fees for PA Inheritance Tax Return and Inventory, 2010 Personal Income Tax Returns, Fiduciary Income Tax Returns and miscellaneous expenses H-B7 472.62 2,013.90 2,486.52 152.64 4,992.80 1,605.00 610.00 4,215.59 25.38 1,500.00 13,101.41 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+ (11-08) SCHEDULE J COMMNHEWRITANCE~AX RETSURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Pearsall, Bett T. 21-10-0657 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)1 See attached schedule Total ~ Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 1500 cover sheet, as a ro i NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET[ Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Betty T. Pearsall 04/04/2010 098-14-9902 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Danette M. Laucks Daughter Specific bequests of 2463 Freysville Road personal property and Red Lion, PA 17356 one-half of rest, residue and remainder 2 Daniel Laucks Grandson $5,000.00 specific 6299 Hoff Road bequest Spring Grove, PA 17362 3 Jeremy Laucks Grandson $5,000.00 specific 30 School Street bequest Tilton, NH 03276 4 Andrew G. Pearsall Grandson $5,000.00 specific 6523 Cavalier Drive bequest Alexandria, VA 22307 5 Christopher S. Pearsall Grandson $5,000.00 specific 2463 Freysville Road bequest Red Lion, PA 17356 6 Gregory H. Pearsall Son Specific bequests of 1214 Kings Circle personal property and Mechanicsburg, PA 17050 one-half of rest, residue and remainder 7 Kevin J. Pearsall Grandson $5,000.00 specific Deceased -Feb. 14, 2010 bequest Note: All items of personal property of Betty G. Pearsall, the Decedent, were disposed of by her prior to her entry into Country Meadows, Mechanicsburg, Pennsylvania. The Decedent was a resident of Country Meadows for a period in excess of two (2) years prior to her date of death on April 4, 2010. 1 LAST WILL AND TESTAMENT OF BETTY T. PEARSALL I, BETTY T. PEARSALL, of the Township of Butler, County of Luzerne, and Commonwealth of Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby declare this as and for my Last Will and Testament, hereby revoking all Wills and Codicils previously made by me. FIRST: I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. I further direct that my remains be cremated and that my ashes be combined with the ashes of my husband upon his death and be deposited into Peconic Bay off of ~ Laurel, Long Island. `~,~ SECOND: I, give, devise, and bequeath my entire estate, be it real or personal, unto my beloved husband, ~~~ SMITH G. PEARSALL. ' THIRD: ~~~ Should my beloved husband, Smith G. Pearsall, predecease me or die on or before the thirtieth day following my death, or if my husband and I should die simultaneously, or under such circumstances as to ~._ w'w` `~ render it difficult or impossible to determine the time of death for the purpose of this paragraph, it shall be conclusively presumed that my husband shall have survived me. If my husband shall predecease me and die before the thirtieth day preceding my death, I give, devise, and bequeath my estate as follows: (a) I give, devise, and bequeath the following specific bequests: 1. I give unto my daughter, Danette Marie Laucks, the following items of personalty: (i) The small pre-Victorian chair handmade with green velvet seat; and (ii) The Nortike fine white china with the marble blue band service for eight. (iii) All Steuben glassware. 2. I give unto my son, Gregory Howard Pearsall, the following items of personalty: (i) The 1501eather bound collection of books maintained as my library; and (ii) The King George Oath of Allegiance; and (iii) All the tools maintained in my workshop; and (iv) The set of Lafayette plates. (v} Lladro fine china pieces. (vi) The balance of my china, silver, and glassware. 3. I give unto both my son, Gregory, and daughter, Danette, I divide equally the English commemorative plates. (b) I give, devise, and bequeath the following monetary bequests to each of the following named grandchildren, I bequest the sum of $5,000.00: 1. Christopher Smith Pearsall; and 2. Andrew Gregory Pearsall; and 3. Kevin James Pearsall; and ~' 4. Daniel Laucks; and 5. Jeremy Laucks. fi~ ^a (c) I direct that the balance of the contents of the home be distributed pursuant to a list which has ..1.... .,~ been generated and provided to my personal representative. The balance of the personalty, shall be r. distributed to family members within the sole discretion of my personal representative, with any items of personalty not desired by members of my family to be sold at public or private sale, or to be delivered to a local charity, all within the sole discretion of my personal representative, with the proceeds from the sale of any of the personalty to be deposited into the residuary estate. (d) I direct that my personal representative sell any residence or real estate which I may own at the time of my death, for its fair market value, by listing the same with a reputable broker with the net proceeds to be deposited into my residuary estate. (e) I direct that the residuary estate be distributed equally between my two children, Gregory Howard Pearsall and Danette Marie Laucks, per stirpes. FOURTH: I hereby nominate, constitute, and appoint, my son, GREGORY HOWARD PEARSALL, as Executor of this my Last Will and Testament. If my son, by reason of death or otherwise. shall be unable or unwilling to so qualify or act, or if after so qualifying, by reason of death or otherwise, becomes unable or unwilling to act, then in either of such events, I nominate, constitute, and appoint the daughter, DANETTE MARIE LAUCKS, to serve as my Executrix. FIFTH: I direct that neither my Executor or my Executrix, as the case may be, shall be required to furnish a bond in this or any other jurisdiction for the faithful performance of her or his duties hereunder. I give my personal representative full authority to bargain, sell, convey, mortgage, lease, encumber and deal in any other way, with anv of my property without the need for authorization by any court in this or any other jurisdiction. SIXTH: I expressly direct my personal representative to retain the legal services of my attorney, Gordon L. Bigelow, Esquire, as the attorney for my estate and as the attorney for my personal representative since he has prepared this my Last Will and Testament and is aware of my motives and intentions herein, and that he is most familiar with my affairs. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this Instrument, this r' ~ ~ -~ , ; ~~ ,-, oU' day of /,~L~ ~-~~~ ~-~ , 2001. ,~ ~ ~,~ ` , BATTY T~PEARSALL '~- t~, SIGNED, SEALED, PUBLISHED, AND DECLARED by the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses the day and year first above written. rl , ~ residing at ~ 'z ' i~~, . ~ /~f`c°' f ' ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . ss. COUNTY OF LUZERNE I, Betty T. Pearsall, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed this my Last Will and Testament willingly and that I signed it as my free and vohmtary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by Betty T. Pearsall, the Testatrix, this ~~ ~'' n day of '',1,,,.u.«,,~ , 2001. /~ , B •. T~ T. PEARSALL ~~~~~ ~-, lE-3u*''~ NARY PUBLIC Notarial Seal John L. Big2{cw. Pdotary Pua!ir Coryr~i~am Boro, L;a~er~~ Co`~ray Nty Ccrnmission E;;JSres Jars. 3J, 2~JQ3 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA . ss. COUNTY OF LUZERNE and C~~z)c-f L' i. ,~ l~tiLC'cz.~~ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will and Testament; that Betty T. Pearsall, signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed before me by ,,~~ i i ,J this :;1~ day of °'~LC~tcc:~ , 2001. ~' tl NOT ~RY PUBLIC w4 a:pearsall ~ ~lotaria! Seal John L. SicJ<~!evv, M1-so`ary ~~~:'_~`:ic ~,or.+ingl~~am. Roro, Luze-r -. ~ !v