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HomeMy WebLinkAbout11-18-10 (4)~~ -' a ~ ~ 1505610140 ~ REV-1500 ~` ~~,_,~> OFFICIAL USE ONLN PA Department of Revenue County Code Year File Number Bureau of individual Taxes Po sox 280601 INHERITANCE TAX RETURN 1 b 0 9 1 5 2 1 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 8 6 4 6 4 0 8 1 0 8 2 1 2 0 1 0 0 4 1 2 1 9 1 9 Decedent's Last Name Suffix Decedent's First Name MI R A K E R P A U L I N E R (If Applicable) Enter Surviving Spouse's Information Bslow ~I Spouse's Last Name Suffix Spouse's First Name I MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE VVITH THE REGISTER OF 1AiILLS © 1.Original Return ~ 2. Supplemental Return ~ 3. Remainder etum (date of death pnor to 12-1 -82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of [~ 5. Federal Es t o Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Num r of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty G~redit (date of death ~ 11. Election to under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sah. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Tefephtxl Number B E N J A M I N J B U T L E R 7 1 7 6 ~4 ~, ~ ~ r•T~.c ~ REGIS 1Mt~LS U ONL ~,:y ~} ~ CX~ ."7 First line of address © C"? ,? ~ ~ ._ t-~ ~ 5 0 0 N T H I R D S T R E E T ~ __- . f`J Second line of address ~ ~ ~n : ~ P O B O X - 1 0 0 4 i Stat ZIP Code DA FILED City or Post Office e H A R R I S B U R G P A 1 7 1 0 8 ~, Correspondent's e-mail address: LAWYERS U'TLERLAWFIRM.COM 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, r:orrerti and rbmplete. Dedaretion of preparer other than the personal representative is based on elf information of which preps r has any knowledge. SI AT E OF PER IBLE FOR FIL G RETURN A Q ADDRESS 400 S MMIT STREET LEMOYNE P 17043 SIGNAT OF ~AR~R O R THAN R SENTATIVE DATjc/ / G ~~ ~~ O 500 N THIRD STREET, 1505610140 OX 1004 HARRISBUR PLEASE USE ORIGINAL FORM ONLY Side 1 Pip 17108 -----r 1505610], 0 ,` r j ~ *~ 1505610240 REV-1500 EX Decedents Socials Security Num ber Deoedenrs Name: P A U L I N E R• RAKER 1 8 6 4' •6 4 0 8 1 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. 2. Stocks and Bonds (Schedule B) ...................................... 2. 8 I 1 1 7. 5 9 3. Closely. Held Corporatlon, Partnership or Sole-Proprietorship (Schedule C) ..... 3. II 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 1 6 3 3. 0 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 1 3 1 7 9 0 . 0 7 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ S t 8 ~ 8 0 4 5 9 1 epara e Billing Requested ....... 7. . 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 2 2 9 5 8 6. 5 7 9.. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 9 2 5 9 . 3 3 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10, 1 5 5 4 2 . 8 7 11. Total Deductions (total Lines 9 and 10) ............................... 11. 2 4I 8 0 2. 2 0 12. Net Value of Estate.{Line 8 minus Line 11) ............................ 12. 2 O 4 7 8 4 . 3 7 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. 2 0 4 7 8 4 . 3 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or ' transfers under Sec. 9116 (ax1.2) X.0 _ 0. 0 0 15. O. D 0 16. Amount of Line 14 taxable at lineal rate x .045 2 0 4 7 8 4. 3 7 1 s. 9 2 1 5. 3 0 17. Amount of Line 14 taxable at sibling rate X .12 0. O O 17. 0. 0 O 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 D 1 S. ~~ 0. 0 0 19. TAX DUE ...................... .............................. 19. 91 2 1 5 . 3 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I i ^ Side 2 L 1505610240 15056102 0 REV-1500 Elf Page 3 Decedent's Complete Address: File Number 21 10 0915 DECEDENT'S NAME PAULINE R. RAKER STREET ADDRESS 100 Mt. Allen Drive I I CITY Mechanicsburg STATE '~~ PA ! ZIP 17055 Tax Payments and Credits: t • Tax Due (Page 2, Line 19) 2. CreditslPayments 8,754.54 A. Prior Payments B. Discount 460.75 3. Interest (1) ~ 9,215.30 i Total Credits (A + B ) 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 ZO to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (2) (3) (4) (5) Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APP 1. Did decedent make a transfer and: a. retain the use or inooira: of the property transferred : ...................................................................... b. retain the right to designate who shall use the property transferred or its inf~me; ............................... c. retain a reversionary interest; or ................................................................................................ d. receive the promise for life of either payments, benefits or care? ....:.................................................. 2. If death ofx;urred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate oonsideration7 ....................................................................................... 3. D~ decedent aim an 'intrust for' or payable-upon-death bank aa~unt or security at his or her death? ......... 4. Did decedent own an individual retirement account, annuity or other non-probate property, which f~ntains a beneficiary designation? .................................................................................................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE 17 TE BLOCKS No 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 orf r the use of the surviving spouse is 3 percent (72 P.S. §9116 (a) (1.1) (i)j. For dates of death on or after Jan.1,1995, the tax rate imposed on the net value of transfers to or for the use of the survivin spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)j. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory require ents for disclosure of assets and filing a tax return are still applicable even if the sunvving 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. §911.6(a)(1.2)j. • The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is 4.5 percent, ex~ept 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 decedents siblings is 12 percent (72 P.S. §911,6~a}(1.3)j. 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. ~~ I 5 i b t _ _ _ REV-1503 EX + (6-98) ~1 T ~ ~ SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBERR PAULINE R. RAKER 21 10 0915 All property Jointlyowned with rtgM of survivorship must be discbsed on Schedule F. ' ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 363.00 shares Principal Financial Group, Inc. (PFG) @ $22.3625 8,117.59 TOTAL (Also enter on line 2, Recapitulation) ~ ; 8.117.59 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) 3 ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER PAULINE R RAKER 21 10 0915. i ' Ir-dude the proceeds of titlgation and the dad the pnx:eeds were received by the estate. All property jointly~owned with right of survivorship must be discbsed on Schedule F. ITEM I VALUE AT DATE NUMBER DESCRIPTION ~ OF DEATH L Fields Family Dentistry -Refund 900.00 2. IMedicaze -Refund 3. ~ 2010 PA-40 -Refund (estimate) TOTAL (Also enter on line 5, (If more space is needed, insert additional sheets of the same size) i 1 250.00 483.00 _ ~ TT 1 REV-1509 EX+ (01-10) pennsylvania ~ SCHE~WI~E F DEPARTMENrOFREVENUE I JOINTLY-OWNED PROPERTY INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: R. FILE ff an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Paula S. Williams 400 Summit Street Daughter Lemoyne, PA 17043 B. I I ~I C. I JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY 9G OF DATE OF DEATH IIEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANKACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 7/24/92 BELCO -Savings Account (S1) 5.00 S0. 2.30 2. A. 6/13/08 BELCO -Checking Account (S4) 3,191.28 50. 2,393.64 *net of checks written before death but clearing after death* 3. A. 11/3/07 BELCO -Money Market (S6) 309.63 S0. 254.82 4. A. 6/9/08 BELCO -Ruby Money Market (313) 70,432.28 50. 33,226.14 *net of transfer into joint account within one year of death that ~ is being reported on Schedule G, Item 1 S. A. 7/27/98 8,364.00 shares Juniata Valley Financial Corp (JUVF.OB) @, $17.00 142,188.00 50. 71,094.00 6. A. 8/13/09 780.00 shares Wells Fargo & Company (WFC) @ $24.3123 19,119.73 S0. 9,339.88 7. A. 3/3/93 Mainstay Investments -Account No. 79828175 24,318.73 50. 12,139.37 8. A. 7/27/98 Juniata Valley Financial Corp -Accrued Dividend 1,756.44 II S0. 878.22 9. A. 8/13/09 Wells Fargo & Company -Accrued Dividend 39.00 ~, 50. 19.30 TOTAL (Also enter on Line 6, Recapitulation) i 131 790.07 If more space is needed, use additional sheets of paper of the same sae. ~~~ T REV-1510 EX+ (08-09) •pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVO 1`(~NS~~F~S AND MISC. NON•PROBATE PROPERTY ESTATE OF FILE NUMBER PAULINE R. RAKER 21 10 0915 This schedule must be completed and filed 'rf the answer to any of questions 1 through 4 on page three of the REV-1500 ~ yes. ITEM NUMBER DESCRIPTION OF PROPERTY p~~~pF7}iETRNJSFEREE.THEIRRELAT10N6WPTODECEDENTAI~ THE DAIS OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE DATE OF DEATH VALUE OF ASSET 960FDfCD'S '', INTEREST ', EXCLUSION of TAXABLE VALUE 1. Transfer from National Westem -Non-Qualified Annuity No. 26,180.44 100.00 1,500.00 24,680.44 0101065106 to BELCO -Ruby Money Market (S15) within one year of date of death 2. National Western -Non-Qualified Annuity No. 0101065106 56,615.47 100.00 ~ 0.00 56,615.47 Beneficiary: Paula S. Williams (lineal) 3. Transfer from joint BELCO account within one year of death 16,500.00 50.00 1,500.00 6,750.00 Transferee: Paula S. Williams (lineal) 4. Transfer from joint BELCO account within one year of death 300.00 50.00 150.00 0.00 Transferee: Laura S. De Zordo (lineal) 5. Transfer from joint BELCO account within one yeaz of death 300.00 50.00 150.00 0.00 Transferee: Gregory J. Williams (lineal) 6. Transfer from joint BELCO account within one yeaz of death 300.00 50.00 150.00 0.00 Transferee: Justin D. Williams (lineal) i i I I I I TOTAL Also enter on Line 7, Rec~itulation , ; 88 045.91 If more space is needed, use additional sheets of paper of the same size. ,.ise@t REV-1511 EX+ (10-09) ~pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL ~Xi~EN5E3 AND ADMINISTRATIVE COSTS T T r _ ~ ESTATE OF FILE NUMBER D A T TT TATII D D A YL`D 71 1 n 1101 S ~' 1 AVLll~li 1\. 1~(11ti1\ ' Decedents debts must be reported on Schedule I. ', ITEM NUMBER DESCRIPTION .AMOUNT A. FUNERAL EXPENSES: 1. Farrow Funeral Directors '~ 3,492.52 B. ADMINISTRATIVE COSTS: 1. Persons Representative Commissions: Names} of Personal Representative(s) Street Address City State ZIP Yearis) Commission Paid: 2, Attorney Fees: Butler Law Firm 4,260.00 3. Fatuity Exemption: (If decedenCs address is not the same as claimants, attach explanation J Claimant Street Addn~s City State ZIP Relationship of Claimant tp Decedent 4. probate Fees: 108.50 5. I Accountant Fees: li i 6. Tax Return Preparer Fees: 2010 1040 & PA-40; 2010 1041 & PA-41 1,000.00 7. Cumberland Law Journal -Estate Advertising 75.00 8. The Sentinel -Estate Advertising ~ 219.40 9. Cumberland County Register of Wills -Filing Fee 30.00 10. Photocopies 28.80 11. Cumberland County Register of Wills -Short Certificates 20.00 12. Postage ~ I 25.11 TOTAL (Also enter on Line 9, Recapitulati ) S 9 259.33 H more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER PAULINE R RAKER 21 10 0915 ' ~ Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbur>~ ed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Alert Pharmacy Services, Inc. 1,397.84 2. ~ Messiah Village 14,135.03 3. I Messiah Village Home Caze, LLC ~ i I II i ~I III !, . I ~~ 10.00 TOTAL (Also enter on Line 10, RecapitulaG ) S 15 542.87 If more space is needed, insert additional sheets of tiie same size. r REV-1513 EX+(01-10) enns Ivania P Y SCH~~IJt~~ J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: PAULINE R. RAKER ~ t t o na i s ~' RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS pndude outright I distributions and transfers under Sec. 91 f6 (a (1.2).] 1. Paula S. Williams Lineal ~ 204,784.37 400 Summit Street ~ Lemoyne, PA 17043 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER HEET, AS APPROPRIATE. II. NONTAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ; n more space Is neetletl, use atltlitional sheets of paper of the same size. LAST WILL AAD TBSTAMBIIT OF PADLIIIS 8. BA1C88 B~ IT B~ExSD, that I, PAULINE R. RARER, residing in t~e Borough of Lewistown, County of Mifflin and Commonwealth of Pennsylvania, d~ hereby make and publish the following as and for my Last Will and Testamen and do hereby revoke all other Wills, Codicils and Testamentary Instrument heretofore made by me. FIB.ST: I direct that my funeral be conducted in a manner sponding with my estate and situation in life and that all my just funeral expenses be fully paid and satisfied as soon after my dece~a be practicable. corre- iebts and ae as may SBCOPD: I give, devise and bequeath all the rest, residu~ and re- mainder of my estate of whatsoever kind, nature and description of which I may die seized or possessed or that may be capable of testamentary lisposition by me, to my husband, HEAL FREDERICK RARER, his heirs and assigns forever. THIBD: If my husband, HEAL FREDERICK RARER, shall predec ase me, or if he and I shall die simultaneously, or as the result of a co n accident or catastrophe, or under such circumstances as to render it difficuilt or impossible to determine with certainty whether he survived me, then and in any of said ~~ events, I give, devise and bequeath all the real and personal propejrty of 4 J ~~~~~~' vwV ~ ~~ which I may die seized or possessed or that may be capable of testamentary disposition by me, to my daughter, PAULA S. WILLIAMS, or to her issue, per stirpes. FOHBTB: I appoint my son-in-law, JOHN WILLIAMS, as Guard~an with powers I, (a) To receive and hold for minor children of my da~ghter, Paula, all property distributable to them under this Will and pagab~e by law to a Guardian appointed by my Will; I (b) To invest such property and all accumulated inc~me without restriction to investments authorized for fiduciaries; and (c) To use income and principal for the minor's and education, either directly or by payment to any person selected to dispense it whose receipt shall be a complete acquittance therefore. All un xpended principal and income shall be paid to the minor at majority. III The Guardian, in discharge of all duty hereunder, may pay any minor's share deemed impractical of administration to the person standing i place of the minor's parent or to the minor or may deposit it in an inter~eat bearing account in the minor's name. FIFTH: In addition to powers given them by law, my Executor and his successors and any Guardian acting hereunder shall have the following powers, applicable to all property held by them, effective withoutCourt order and until actual distribution: - 2 (a) To retain, in their absolute discretion and for'such periods as to them shall seem advisable, any and all investments and other properties held by me at mq death without liability for any loss incurred by r aeon of retention of such investments or properties;. '~, (b) To invest in all forma of property (including sock or other securities of any corporate fiduciary or its successor, or of,a holding company controlling the corporate fiduciary or its successor, and c moron trust funds and mortgage investment funds whether maintained by my torpor to fiduciary or its successor or others), without restriction to investments sut orized for Pennsylvania fiduciaries, as they deem proper, without regard t any prin- cipal of diversification or risk; ', (c) To sell at public or private sale, to exchange, lease for any period of time, any real or personal property and to for sales, exchanges or leases, for such prices and upon such terms ditions as they deem proper; (d) To allocate receipts and expenses to principal or partly to each as they from time to time think proper; or to 3ive options or con- ~r income (e) Generally, to exercise for the benefit of my estate in respect to any property, real or personal, constituting part thereof all rights, power and privileges of every name and nature which might or could ~be exercised - 3 - by one owning such property absolutely and in his own right, even though my Executor or his successors may have individual interests which may ~e in conflict with their fiduciary ones. SIZ?Hs I direct that all estate, inheritance, transfer, ~egacy or succession taxes or death taxes which may be assessed or imposediwith respect to my estate or any part thereof wheresoever situated, whether or n t passing under my Will, shall be paid as an expense of administration and wi bout appor- I tionment. i SSVSRIB: I appoint my husband, NEAI. FREDERICK RARER, Exe utor of this, my Last Will and Testament and of any Codicil or Codicils her to. If he shall predecease me or fail to qualify, or having qualified shat die, resign or become incapacitated during the administration of mq esta e, I appoint mq daughter, PA't3LA S. WILLIAMS, Executrix. All power, authority an discretion conferred upon my Executors may be exercised by such of them as aha 1 qualify and be acting hereunder from time to time. BIGHTHz The selection of the attorney for my estate sha1~ be made by my Executor or Executrix in his or her sole discretion. II IP.WI'17RBSS ABB~OF, I have hereunto set myl!,,,,hand and seal ~o this my Last Will and Testament, this __~ day of N ~___-, A.D., 1991. ~, PAtTLINE R. RARER ' (SEAL) - 4 - WITNESS: ~ residing at . ~ ~~ti /o~~n i4 t 7 ~+' ~a . A'`bc~' residing at ,Z~l--f- ~~%, .1t~ tOf r-__--- ~~.~ c wow P~ ~ 7.d - 5 - COMMONWEALTH OF PENNSYLVANLA ) /'~j ~~/i h SS. COUNTY OF ) We, PAULINE R. RAKER, ~ ~, , and _ ~_, the estatrix and the witnesses r apect- ively, whose names are s gored to the attached or foregoing inatrume t, being first duly sworn, do hereby declare to the undersigned authoritq th t the Testatrix signed and executed the instrument as her Last Will and t at she had signed willingly (or willingly directed another to sign for het and that she executed it as her free and voluntary act for the purposes then in expressed, and that each of the witnesses, in the presence and hearing of the estatrix, signed the Will as witness and that to the beat of their knowledge, the Testatrix was at that time eighteen years of age or older, of sound mind and nder no constraint or undue influence. 'i PAULINE R. RAKER I Witness Witness Subscribed, sworn to and acknowledged before me by PAULINE R. RARER, t e Testatria, and subscribed and sworn to before me by ~. ' and _ ~(olt.~1. 1~. ZayacrE!L , the, witne ses, his '~ day of CL+.~, 1991. Notary Public My Commission Expires s ~ 0(~ - 6 - IftHreea;A. ~•~ ~c Jtdy t0, 953 ~Aerrit:er, Pe ~ AQaadabon of NatarieA PLEASE NOTE THE FOLLOWING STATEMENT IS APPLICABLE TO THIS ESTATE When a tax is imposed upon a transfer of 'ointl owned roe b ri t of surviv rshi (see Schedule F) or a taxable inter vivos transfer (see Schedule G), the deductions will a allowed to the transferee (Paula S. Williams) only to the extent that the transferee has actuall 'cl the deductible items and either the transferee was obligated to pay the deductible item or the estate sub' ect to administration b a ersonal r resentative is in ufficient to a the d ctible items. The transferee must show that the same debts are not also claimed by an executor, dministrator, or other personal representative handling the administration of the decedent's estat . PFG Historical Prices ~ Principal Financial Group Inc CStock -Yahoo! Finance Page 1 of 1 New User? 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Delry tunes are 15 rlvns for NASDAQ, Nl'SE and Arrex. See also delay limes for . Qtrotes and odrx kKomiatlen suppaed by indeperxfent provMers identified on the Yahoo! Finarce .Cxales are rpdeled automaarary, but wig be firmed off after 25 minutes of inaclMty. Quotes are delayed at least 15 rdrtules. AB klforrnation provided'as a' for fr!fnm!aadnal purposes only, not intrndetl for trading ptrposes or advice. Neitlter Yalnol nor any M independent provWers k Gable for any Mbmiatlortal errors, InGOnplefeness. or delays, or for arty acliorts taken M reaartce Mt intotrnatia! conWned herein. eY aoCCSSing the Yahoo! site, you agr~ not M redlsYiMde the infomggal found axxetn. Furtdaniantel carpartY data provWed by Cmilal IQ. t9sbrical cfy~t data and daily updates provided by cormrodiN Svaretrrs. k1c. (CSt1. lydenlaUalar hisWrica! U1art data. da1N updates, fund smnnlary, iun0 periorrtxlnce. diNdeftd data atxf Momirgstar Orden data provyed by Momirtastar. try. ~ ', http://finance.yahoo.com/q/hp?s=PFG&a=07&b=20&c=2010&d~7&e=23&2010& 9!1/2010 • ~~.....v ..~..........+r.......... , w Pauline Rakes Members 1st Bus Che Patient Refund Patient Refund -, 9/6/2010 2504 900.00 900.00 __.... i ,, _ ~~ ~ _ ~y ~ ~ DBPA~TMBr+I'T QF FIBALTH do FiUMRI'~i BB~YICffi 4fAca d tt~e 5aaat~xy ~ ~ 1n~slitr~on, D.C. ~oQO'I .~ PAULINE R RAKER 08/09/010 400 SUMMIT ST '~~ LEMOYNE PA 17043-1638 ~~~ XXXXX0535D .~~ Dear Medicare Beneficiary: - .-, . .The Affordable Care. Act,.a. new la~v passed by. Congress and signed by l __ _ _ President Obama on March 30, 2010, provides cone-time rebate to hel~ with your drug costs. The rebate is sent automatically to most people enrolled in Medicare Part D who reach the Medicare drug plans coverage gap ("doughnut holed in 2010. '~ Medicare records show that you have reached the coverage gap. To male your prescription drugs more affordable, your $250 rebate check is included with this letter. !. This one-time rebate check is designed to bring you some needed relief on your prescription drug costs, and it is the first step toward closing your coverage gap to make prescription drugs more affordable. It is important to know that this one-time rebate check will not impact or change your current Medicare benefits. As part of this new law, starting next year, you will get a SO% discount on covered brand name drugs if you reach the coverage gap. On top of this, Medicare will add even more savings over the next '~, several years until the coverage gap is closed by 2020. The Affordable Care Act has many other provisions that protect and ~, _ _ strengthen_.your :Medicare. ,reduce .your costs, and give you and your - ~ ~ family more control over health"~care:-S~ay ti~nec~~or mole-information"- from Medicare in coming days and weeks on how this new law will help make Medicare more financially secure and provide you with higher quality and more affordable health care, including free preventive care. In the meantime, if you have any questions right now about your rebate check or about the Affordable Care Act, feel free to call us at 1-800-MEDICARE, or visit our new and improved website at www.medicare.gov. Thank you, Kathleen Sebelius 10080057861 10437896 -~-. -----R.~-__,R..-~-_-~- _ _ _ , , _, ELCO COMMUNITY CREDIT UNION Benjamin J Butler, Esquire 500 N Third Street P.O. Box 1004 Harrisburg, Pa. 17101 October 13, 2010 RE: Estate of Pauline R. Raker ', Social Security No. 186-46-4081 Dear Attorney Butler, Here is the information for the above referenced account. If you need an~ further information, please call me at 717 720 6414. Sincerel Yvo amen Finance Department .. ~ z. r ~ 1. Name(s) in which the account was held: DECEDENT ESTATE INFORMATION PAULINE R RAKER (PRIMARY OWtr' PAULA S WILUAMS (JOINT OWNER 2. Account number. 474430 ~I 3. Balance as of date of death: 8/21/10 $102,358.63 Balance Accrued Dividends YTD Dividends ~ Regular Savings S1 $5.00 Christmas Club: S2 Money Market: S6 $509.63 $0.55 $2.46 Checking: S4 $5,211,28. $10.31 $41.47 Money Market: S15 $96,632.72 $181.10 $738.88 Certificates: Balance Akx;rued Dividends Certficate Number $ $ 4. Date the account was initiated: NONE 5. Name(sj in which Safe Deposit Box was held: Opened 7/24/1992 11/5/2007 6/13/2008 6/9/2008 YTD Dividends 6. Date the box was initially rented: 7. Branch address at whicfi the box is located: 8. Loan Infomnation: A. Unsecured Loans: L14 Classic Asa Card B. Secured Loans: C. Mortgage Loans: 9. MisoeNaneous: Pauline had a S16 1131 90.30 and 215 $11.23 which is ind~ Balance Accrued Interest $ $ rket acct that was dosed 2/5/10, dividends earned v Per Diem Int JL3VF.OB Historical Prices ~ JLTNIATA VALLEY FINL Stock -Yahoo! Finance New User? Register Sign in 'Help Preview Maii wt Yahoo! Mail Toolbar ~"~,f3t~Q'~e FINANCE search ~ webSearch Dow ! 2.2T% Nasdaq t" 2.61% HOME INVESTING NEWS 8 OPINION PERSONAL FINANCE MY PORTFOLIOS TECH TICKER oET ~T~ Finance Seardt Page 1 of 1 Wed, Sep 1, 2010, 2:18PM EDT - U.S. ~Aari:ets close in 1 hr 45 mirts Juniata Valley Financial Corp. (JUVF.OBj At 1:oaPft EDT: 17.00 0.00 ~o.twx~ ,___ ._.ev~,.~-,_, 3~ ~# ~.°i ~ rRaoE~° ~~r ~ , ~ ~-~` FREE ~Yx ~i(I _~. ___._~._:__:. ~a Histortcal Prices act eiatoricat vrtces ror: _ _ .. __ __ , Go _....ADVEFtTISEMENT Set Oate Ranye l~1 Daily WI18t Start Dace: Aug day2o Year2o10 Eg.Jan1,2010 ~;weeky Terrifies End Data: Aug day 23 _ Year201o '= I"1O"~'~' Bill Gates.. ~~ Dividends Ony Get Pfices First ~ Previous ~ Next ~ Last'. Prices ~ Dots Open High Low Cbss Volume ~~ CI°se' g~ c~p~ Aug 23, 2010 17.00 17.00 17.00 17.00 400 17.00 ~~ i" 1975 BNt Ciffie9 h~ held Aug 20, 2010 17.00 17.00 17.00 17.00 0 17.00 an aMrtost peAect ' pose prke adJusted for dividends and 5pllts. may'"' First ~ Previous ~ Next ~ Last i~rr ~ tadt lip a X11 f01hai8. ~' Downl9ad to Sorsadsheet But r[ght raw. he is ~ 1 ~ x 8 36 ~l - rtttnaus. 7296 pf.lap>anese are tt uarng the tecttmolo9,r thatwif replete iL New report reveals ~ ~~ the stock tkker of tram ~ ~ p / tl ie 'D ea@t W hutrosOrt". Cpck Here i~ Instant Access to This Fteoort! _ _ _ _ _ ._ _ a-- . _..... _ _ __ _.. _. Please provide wur feedback on cotes pages. CopydgM ®2010 Yataot inc. AH rights reserved. Privrav Policy - but our Ada - Terms w service - coovrlontAa aolkv - sefw Feedback - Yahool News Network Dur>&a delayed, except where irtrticahd otl+ennnse. Dewy Dines are 15 wens ror NASDAp, NYSE and Amex. See also delay lirties for per. plates and odrer irilbnrgann Supptled by ~ ponders identified On gte Yahool Finance Q.Olales are updxed at>tanattcatly, Md will be t4rrhed oR otter 25 rttn1AlS Of inaCtkMy. Qtates are delayed at keel t5 nanutes. M nbrmation provided'as is' Gx ktfon»atlonai purSases oroy, rxit interrikNl for Vatling pugases or advice. Nelyter Yatao! nor any ofiridependent providers h liable fa any infomtatbrial errors, kicontpletaness. or delays, or for arty actions Vaken M reliance on irJorrriatiort cont~rtad herein. BY aaesaittg the Yattopl site, you agree rat b redistribute the inbrntalbn found aterein. Fundamental cas+pany data provided DY . F1NkxiCal Bred data and daily tpdates provided by OormtorNN Svsteim. inc. ICSII. Imenta(iOnal historical than data, dalM updates, turd srrrmtary, kNb pedormance, raYkJefrl data and Mominpstar trtdex data provided Dy klom~tar. Inc. http://finance.yahoo. com/q/hp?a~7&b=20&c=2010&d=07&e=23 &201 9/1/2010 WFC Historical Prices ~ Wells Fazgo & Company Common St Stock -Yahoo! Finance a New User? Register Sign In Help Trending: Lady Gaga Yahool Mail YA~~'~® FINANCE Search Web Search Dow + 2.29% Nasdaq if 2.63% HOME INVESTING NEWS & OPINION PERSONAL FINANCE MY PORTFOLIOS TECH TICKER Page 1 of 1 GET QUOTES Fir~rtt~ Seardr i WAd, Sep 1, 2010, <^: t i PM EDT - U.S. dace in ~ hr d3 mire Wells Fargo & Company (VVFC) rr~ pFA~,t 2:02PM EDT: 24.55 * +.oo taa3~~ IQ ~ s5Q0 Apple 204TitA~0E,5 _._........_ __..._.., Go Historical Prices Get Hiatortul t+rius for: $et Date Retlge nurcrc r wcmcr ra_^, Daily F'ICW ~~~ Start Daa: Aug day:20. Yea 2010 ,.._ _.. Eg. Jan t, 20t0 l_J Weekly QOt iie~crt _ .::. End Data: Aug day 23 Year 2010 l.) MontlUy r'_ :~ Dividends Only GetP _s _ First ~ Previous ~ Next i Last ._______.__ __,____ __~._T..______ ~ ---___.._.___..._ Prkes ___._..---- ----_. - tlyarren Btlfielt used Adi ~~~~ I Die Open High Low Cbse Volume Close• get rich at age 22 I 2 {~. S 3 ~ 2010 Aug 23 24.86 24.88 24.19 24.23 33,786,900 24.23 T~ ~~r ~ , used wtwldntwotk N R Zy Aug 20, 2010 24.43 24.71 24.27 24.60 40,025,600 24.80 {~ ~ these days. • Close prke adjtuted for dividends and splits. He has too much ~lgyr to invest. First i Previous i Next ~ Last Hut iE you have Tess i ~; Downbad to Stmac~he et ~a tn~eat t i And a file bit tK patience I, I 7 ~-~ ,~ 2 y.s~~~ . You maybe able ifl ~~~~d~ II ~->y he ' used to get tkh. ~ The BuNehBarfkers ~ 7 ~ ~ ~ ~ 19 mor8tlyresearch st~ ~ . , satire slodcsa yang Hulfett wottld ~~>~, Click Here ~.~ Please oar v ide vow fee dback on gtwtes pages. copnght 82610 YahDO! hrc. AN rights reserved. prirarw Potev -About OutAds - Terms of Service • CaovdohtllP Poscv -seat Feeeback -Yahoo! News Network pirates dNayed, except where indicated otlierwise. Delay tunes are t5 Mns for NASDAQ, NYSE and Amex See etso delay dfrres for other excharoea. Quotes afxl other Rlydtmatl0n suppYed bl' Irgepergerrl provideB idenlMer! On tlM Yahoo! 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Box 8401 Boston, MA 02266-8401 800-MAINSTAY (800-624-6782 mainstayinvestrnents.com BENJAMIN J BUTLER ESQ 500 N THIRD ST PO BOX 1004 HARRISBURG PA 17101 REFERENCE: 06296158 MAINSTAY FUNDS XXXX8175 PAULINE R RAKER PAULA S WILLIAMS Dear Mr. Butler: September 15, 2010 JT TEN I am contacting you regarding the recent request about the above referenced MainStay joint tenant for information accoun . Our records indicate that this is the only account rega;tered to Pauline R. Raker with Paula S. Williams registered as a~'~joint tenant. The account was established as a joint tenant $ccount on May 3, 1993. The following balance information applies to this accou~t as of August 20, 2010: Account Shars Balance Net Asset Value Total ~ lus 643-xxxx8175 4,203.756 $ 5.78 $ 24,29 .71 Please note August 21, 2010 was not a business date; th~refore, the above table also represents the balance informationlfor this date. The following balance information applies to this accouzi~t as of August 23, 2010: ~, Account Share Balance Net Asset Value Total V lus 643-xxxx8175 4,203.756 $ 5.79 $ 24,33 .75 Mr. Butler, I hope this information is helpful. If yout'have any questions, please contact MainStay Shareholder Service~''by calling 800-MAINSTAY (624-6782), option #2. A Mainstay Shareholder Services is a division of NYLIM Service Company LLC, a Registered Transfer Agent of New Yak Life Investment Management LLC. Securities distributed by NYLIFE DisMbutors LLC,169 Lackawanna Avenue, Parsippany, NJ 07054 representative will be happy to assist you any business day between 8 AM & 6 PM, ET. Sincerely, uQ~;~~~ Caren Hendricks Correspondent ~! CC: WILLIAM M TILLETT PAULA S WILLIAMS _. _,I_... _i. MHCAX Historical Prices ~ MAINSTAY FUNDS HIGH YIELD CORPO Stock -Yahoo!... Page 1 of 1 New User? Register Sign In Help Preview Maii w/Toolbar Yahool Maii ~'~~,T3Q'C7~~ FiN,41VCE Search '.~WebSearch ' Dow i~ 1.70% Nasdaq # 1.8ah HOME INVESTING NEWS & OPINION PERSONAL FINANCE MY PORTFOLIOS TECH TICKER GET QUOTES Frence Seardt Mainstay Higih Yield Corporate Bond A (MHCAX) clove Irt 2 his and d4 mMs Tue, Npv 16, 2n1U, 1:15Dm FST - US On N~v.15: rJ.94 ~ 0.01 (0.17%) ~'~tT~ oaEN AN Accoum i~runoraourm,cs ue .. Historical Prices t"»t Historkal Pikes tor: I. GO __. ,__~ Set Dab Range _AdCnoices V Deily Start Dab: Aug 20 :2010 Ep. Jan 1, 2010 ;'yj Weekly End Dab: ;Aug 23 :2010 O Morltltly c~ Dividends ony Get Prices Asset Menpanrent You never stop growing." First i Previous ~ Next ~ Last Prices Date Open High Lotv Close Vdurne Adi Cbse` Aug 23, 2010 5.79 5.79 5.79 5.79 0 5.69 Aug 20, 2010 5.78 5.78 5.78 5.78 0 5.68 ` Cldse Dtks adlua[ed far dividends and splMs. First ~ Previals ~ Next i Last ~ Download to Spreadsheet Currency in USD. S .7gS Ask your advisor how <iur stratac~lc expertise and risk managamnnl expereance may hctlp yntrr dreams ccmte true. Stnnmary prospectuses, it ~ available, of prospectuses far the ~ Funds containing urwle inlurmalion stay rte oWailted from your !inanraai athisor. Please cwlsitlnu a Fund's objerAives. risks, anti titargos artd j atponsea, and ut;ad the summary piosprr;hls and the proslvxlus uhretully ttnlwe invcstirug. Ttte stxnmary prospectus, alMior the prospectus cwlain Btis arld outer inlbrnuatial abaft the Fmttl. Ocklma~. SactF h Cn. is Iht Jf4r;hAor at '. rFerinkk~mn Sxhx fad. L`. e'Y77a 6!ddre~i. Sneiis a+:o. All nlpgn fiaznnd: Copyrighta^J 2010 Yahoo! Inc. All rlgtrt5 reserved. Privacy Policy -About Out Ads • Terms of Service - CopyrighNP Policy -Sand Feedback • Yahool News Network ', Quotes dslayed, except where indicated odrewise. Delay tlmes are t 5 mtts for NASDAQ, NYSE and Amex. See also delay bores for otlter exchanges. 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II http://finance.yahoo.com/q/hp?s=MHCAX&a~7&b=20&c=2010&d=07&e=23&2010 11/16/2010 Stock Splits & Dividends :: Investor Relations :: Juniata Valley Bank Page 1 of 1 Home Contact Us Calculators Kids Place Security Site Search,.. Bus+res; i~ankillg I t~ctra Investor ReiaUons News Financial Higtdighfs Peer Malvsis Mercers & AcauisNions Deposit Marketshare Analvst Estimates Market Makers Documents Seen 1& FUings InsiderTransacflons Event Calendar Email Notiflca6on Intortnation Request FA~C Stock Splits & Dividends ', l~l JUNIATA VALLEY FINANCIAL CARP. {OTCt3B -JUVF) Stock Splits Sr Dividends (orc66 - JuvF) Ex-Lividend Datg Record Date Announce Date Pav Date ~ Tv~e of Dividend 1 iH2O05 10!17/2005 9120!2005 10/31!2005 ii 2-for-1 Split 3/29/2001 4/2/2001 3/20!2001 4/27!2001 I 10% Stock Dividend I 9/8/1997 7/29/1997 7/15/1997 9/5/1997 i 5-for-4 Split 1/10/1996 12/1/1995 11/21/1995 1/9/1996 ~ 5-for-4Spiit 9/30/1994 - - 5-for-4 Split Dividends {OTCBB -JUVF) Description: LTM Dfvidend Pa ut Rat[o {%): 71.43 Common stock, $1.00 par value Current Divi end Yield ('/o): 4.94 Ex-0ividend Dat® Record Date Announce Date Pav Date nt Freauencv 8/11!2010 8H 3/2010 7/20/2010 9/1/2010 ,2100 Quarterly O I 5/12/2010 5/14/2010 4/20/2010 6/1/2010 012000 Quarterly 2/10!2010 2/15/2010 1/19!2010 3/1/2010 012000 Quarterly 11/10/2009 11!13/2009 10/20/2009 12/7/2009 02000 Quarterly 8/122009 8/14/2009 7/21/2009 9/1/2009 0 2000 Quarterly 5/13/2009 5/15/2009 4/21/2009 6/1/2009 01900 Quarterly 2/11/2009 2/16/2009 1/20/2009 3/2/2009 01900 Quarterly 11/12/2008 11/14/2008 10/212008 12/1/2008 01900 Quarterly 8113/2008 8/15/2008 7/152008 9/22008 011900 Quarterly 5/1312008 5/15/2008 4/152008 6/22008 0.1800 Quarterly 2!13!2008 2/1512008 1/152008 3/12008 0.1800 Quarterly 11/13/2007 11{152007 10/162007 12!12007 O11800 Quarterly More Information Copyright 2010, ®SNL Financial LC Terms of Use ~, ~~ Privacy Policy Site Map ~', ~"r~tlE~itl ,$~;('f't? ~tl.#' ~f i,'li (il~t `~ idttejr, Employee Resource I i~ t41GITAL IN5IGHT' as rnpat'egsylsay http://www.snl.com/irweblinkxJdivs.aspx?lid=100607 ~ 9/1/2010 About Wells Fargo -Stock Price and Dividends Page 1 of 4 Stock Price and Dividends To contact our transfer agent, Wells Fargo Shareowner Services, please call 877-840-0492. Information on our two-for-one stock split announced June 27, 2006 and distributed August 11, 2006 II i~ Stock Price ', Check the Wells Fargo stock price, as well as stock charts and historicai quotes. Dividend History History prior to November 1998 refers to Norwest Corporation. ' Dividends per share have been restated for the corporation's two-for-one stock splits, effected in the form I f a 100 percent stock dividend, distributed on August 11, 2006 and on October 10, 1997. For full details about any~of the quarters, refer to the following tables. Dividend Details ~~ Declared 2010 ~~_ Record Payable Amount '~ 7!27/10 8/6/10 9/1110 $.05 ~~ 4127/10 5/7/10 611 /10 $.05 1/26/10 2/5/10 3/1!10 $.05 '' 2009 10!27/09 11!6!09 12/1/09 $.05 7/28/09 817/09 9/1/09 $.05 ~i 4/28109 5/8/09 6/1 /09 $.05 1/28/09 2/6/09 3/1/09 $.34 ~ 2008 10/22!08 11 R/08 1211 i08 $.34 7/16108 8/8108 9/1/08 $.34 ', 4/29/08 5/9/08 6/1 /08 $.31 1 /22/08 2/8/08 3/1 /08 $.31 2007 10/23/07 11 /9/07 1211107 $.31 7/24/07 8/10/07 9/1 /07 $.31 4/24/07 5/4/07 6/1 /07 $.28 1/23/07 2/2/07 3/1/07 $.28 2006 https:!/www.wellsfazgo.com/invest relations/dividend 9!1/2010 :.~_ ~ J • ~,. NATIONAL ~~^^ WESTERN ~ L>gE iNSUxANr.~ coMPANx • September 27, 2010 Benjamin J. Butler Attorney At Law P O Box 1004 Harrisburg, PA 17101 Subject: Certificate No. 0101065106 Annuitant/Owner: Pauline R Raker, deceased Dear Mr. Butler: ~~~ We received a request from Pauline Williams, Executrix of the Estate of P aline R. Raker, to provide you with the account and surrender values of the above r ferenced annuity as of August 21, 2010. The Accumulation Account Value of this annuity as of 8/21110 is $62,150.74. I!i ,, The Surrender Value of this annuity as of 8/21/10. is $56,615.47. If we can be of further assistance, please contact our office at 800-541et us know., Cordially, arlene Childress Policy Benefit Department ', I 850 EAST ANDERSON LANE • AUSTIN, TEXAS 78752-1602 512-836-1010 AUTOMATED VOICE RESPONSE TOLL-FREE 888-695-5001 •WATS 800-531-5442 ~, CLIENT SERVICES DIRECT WATS LINE B00-922-9422 CLAIMS 800-531-5442 W W W.NATIONALWESTERNLIFE.COM