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Home My WebLink About11-18-10 (2)~' f 1505610143 REV-1500 EX (D1-10) OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X.280601 INHERITANCE TAX RETURN 21 10 Harrisburg, PA 17128-0601 RESIDENT DECEDENT Fiie Number 0901 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 198 30 1255 08 21 2010 Decedent's Last Name KNOTTS (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Date of Birth O1 05 1937 Suffix Decedent's First Name MI LOIS J Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WIITH THE REGISTER O F WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ^ 4a, Future Interest Compromise ^ 5. Federal Estate Tax Return Required (date of death after 12-12-82) Decedent Died Testate 6' ^ ~ Decedent Maintained a Living Trust ~ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) 9. Litigation Proceeds Received ^ 10. between 12 3t X91 anditl(dat~e5~f death ~ t 1. 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 T0: Name Daytime Telephone IVumber JAMES D BOGAR 717 737 8'761 ,~, First line of address ONE WEST MAIN STREET Second line of address City or Post Office State ZIP Code SHIREMANSTOWN PA c~O REGISTER OF W~FrCA USE ONI f,.l. i ..I-~ n ~..... ,:~~ ~ C.U _' _^~_~~ r ~ CC- DATE FILED -- ,_, f.. .~ r .. `.t .. {.. ~., ; ~:_~ .. -. -~~ "_; ~__. _, Correspondent's a-mail address: jbogar@bogarlaw.com Under pe alti 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, orr t and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATUR F PERSON RESP,,~ SI LE FOR FILING RETURN D fE is r~ /~ 1 ~ ;a L~f E / Lisa M. Wilev ~ ADDRI=3'S / 4534 Roto Cou SIGNA :hanicsburg, PA 17055 THAN REPRESENTATIVE James D. Bogar ADDRESS ( /~ One W` est Main Street, Shiremanstown, PA Side 1 1505610143 1,5056101,43 J ~~ DATE ~ 1 ~tb ~~~ T r 1,5056],0243 REV-1500 EX Decedent's Social Security Number Decedent's Name: KnOttS, LOIS .~. 19 8 3 0 1.2 5 5 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. :?9, 930.13 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Bifiing Requested............ 6. 8,378.17 7. Inter-Vivos Transfers & Miscellaneous l~.q Probate Property Requested arate Billin Se 7 ............ g p (Schedule G) (~ . 3 8, 3 0 8. 3 0 g. Total Gross Assets (total Lines 1-7) ..................................................................... g. 16,456.27 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 165.02 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. ~" 6 , 621 ' 2 9 11. ....................... Total Deductions (total Lines 9 & 10 ............................................ 11. 21,687.01 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. c'1, 687. O1 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 O . 0 0 (a)(1.2) X .00 . 16. Amount of Line 14 taxable 21 , 6 8 7.01 1 s. 9 7 5. 9 2 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 ~- Q Q - at collateral rate X .15 . 19. Tax Due .................................................................................................................. 19. 975.92 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 ],505610243 150561D243 ,~ r T ~ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0901 DECEDENT'S NAME Knotts, Lois J. STREET ADDRESS 820 Lisburn Road Apt. 812 CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 975.92 2. Credits/Payments A. Prior Payments B. Discount 48.80 Total Credits (A + g) (2) 48.80 3. Interest (3) 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 927, ~ 2 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 :............................................................................... ^ ~x b. retain the right to designate who sha{I use the property transferred or its income :.................................. ^ Ox c. retain a reversionary interest; or ............................................................................................................... ^ 0 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 "in trust for" or payable upon death bank account or security at his or her death?....... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................................. ^ 0 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 stiN app{icable 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. .' , Rev-1508 EX+ ~6-98) SCHEDULE E j ,,F, „ CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUME3ER Knotts, Lois J. 21-10-0901 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 PNC Investments -Account No. 5114-8897 26,969.18 2 1999 Chevrolet -VIN # 1G1JC5245X7205607 -Sold at private sale 2,500.00 3 Blue Cross -Refund 131.46 4 Comcast -Refund 5.12 5 Mallard Run Apartments -Security Deposit Refund 170.00 6 Medicare -Refund 62.06 7 Progressive Insurance -Refund of renter's insurance premium 21.02 8 Progressive Insurance -Refund of car insurance premium 61.02 9 Verizon -Refund 10.27 TOTAL (Also enter on Line 5, Recapitulation) I 29,930.13 (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) ~. PN C 1NVESTIVIENTS Member FINRA and SIPC September 3, 2010 James D Bogar, Attorney At Law One West Main Street Shiremanstown, PA 17011 RE: Estate of Lois 3 Knotts Social Security No. 198-30-1255 Date of Death: August 21, 2010 Dear Mr Bogar: The Date of Death Valuation for securities held by Lois J Knotts in her PNC Investment Account No. 5114-8897 is as follows: 26,969.18 shares of Fidelity Institutional Money Market Class III @ $1.00 per share This account has always been titled in Lois J Knotts name only, and was opened November 30, 1994. Please feel free to contact me if I can be of further service. Sincerely, 0 ~~~ Charles E Little, CFP, SVP Financial Advisor CEL/djp The information contained herein has been obtained from sources we believe to be reliable but do not Guarantee it to be accurate, correct, complete or timely, and shall not be responsible for the results obtained from it's usc~. PNC Investments LLC Member of The PNC Financial Services Group 2 East Main Street Mechanicsburg Pennsylvania 17055 www.pnc.com ~ •~1acLoseValue ,TJu Bank Guaranu.e I Importantinvestorlnformation: Securities and brokerage services are provided by PNC Investments LLC, rnember NASD and SIPC. - ~ Annuities and other insurance products are offered by PNC insurance Services LLC, a licensed insurance agency. ~`i~}Y~' tr ,~d~ ,~ -~..:_ Ire ~i '~ Q u~'" ~ ~ .f~: ~Y ~. _~ ~ r~:~ 9•. ~ ~ ~ ~, ,,~~~ ~i9' ` ~ ~ ~..~1~ ,..~..~ ~ t ~ ~ , ;11' , ~.~ e. .. :.. ` , - '. .: o ..r -•~~. ,~~ .. , .~, ~: e~ ~ _ ., ~ .. A, r .~ ~ ' ~,:. _ ;~ ~ ° VENICE)- IDENTIFICATION NUtviHER EAR MAKF Cr ~lEHICLE TiT E Y'°• - I ..~ ~ ._ , .,_o,.,,... ;. ~ PIUMHEP. _ - SE i "' ATE ~ ~„ ODOM. PRnGG DATE DDOivI. MIL~.S ( " ODOMr°STATUS _: HODY TYPE DUP AT CAP PPI R"TIT E T ' -~" ~• ' .... N`• 1- DATE PA TITLED ~ DATE OF ISSUE I UNL.AUCtI IPr~IGI,T ~ ~,'~'d!R ~ GCtiVR ~ TITLE BRANDS ~~. ~ E-. ®„~ u ~~ °!'~ x,157-RED OWf E ~S~II I)II ~ r! I! r~ l ' ~1. ~ I I 11 ~ i ~ !. ~ iilr ,i~~i~'I!'I'1(l~l ~1~~!I ~{~1~~ N'~'~~~~i~' ~ ~~P. li! ~ I ~ Ilu r G ,!'III (~i~'Ih11'It~l'al' ~L 1, ~( ~ I „ ~'i~ ' . ~ i ~f~ ~~l'W!I'~ . l all±l'!,'l i~~j'R'f~ ~li 9u!pr ~~~~~l~ll ,!ilJ'' y, 1~ ;111 ,:I 6' ~jt ~ !i 1 ~; 1 ~ ~' i 1!,i ~! ° ~~ 3:.~1~~ ~ i F!' 'i~h+~ il~ii'~111~'~ ,;~j ; i~~ll~~~~,iil,~~~~~~~1_ FIRST UEN FAVOR OF: FIRST LIEN RELEASED tl` I II Iii 1111 1 I .Ili it 1 !~.i 1 alt `II ! III 71 t,fl lln 1 u l Q' k l : ~ It ~ 1 ~ 11 1i11j1 1!., 1 ,I I ~ I I I '1 „14 t,~l { ~ 1 ~ ~~ .II I~ , i ,,,1,,,I,In ,~~,~,;I . ~t~,~.l I ~ ',I ri Ili! I' '111 , ~ t !,,, ~ ; l I . ~ ' ! ~,,,,;, ~ 71 ~1' It ~ I ,~11 i ~I ' I~ ~!~~,(~, I l ~! 1; I I . ~I'~V ~`1~~~N I ~., 111 ~~ I 1 ~ !~~ ,11!I 1 I k1ti ~ ~ ~ I~! ~ Id~~d~iil~; ~~, PI, 1 4 1 I !!~ 1 ~ ~~~'t~t ~„1 l Il11 ' ~~' It 1 !t 1"!yl ~ y Ir~u! ~I11~~tP' ' I ~~~~~1' p p ~ ~ o1,u11~ i; ` 41 ,11,. ~ 1~ ~II ~;p ~~dl~ll~~h SEC D; L ~~~ , p; 1@ II 1~ p~1!111,1,,, 11t~;~1~11" lE `VORI,IOF: N ~~P ' `u "~ ~ ~~~I'~~It~ ' , I ! a r DATE HY AUTHORIZED REPRESEPdTATIVE MAILING ADpRESS 'L~DOMETER STA2US =`_ _=°- 4 At 1UAL MICEAGC - _= Y t tILEAGE EXCEEDS Tt-lE-tvlt~rTAN1CAL LIMITS - P N07"CFiE AGtLtZ MIGE~GE s NOT71 g Zi1AL MI(=E~1GE OCOfVIETER - = TAPviPEF11FI(~VERIFIEF~". ° =' 3 = EA'EMP7 FROM ODOMETER DISCLOSURE TITLE 13RAND5 A -- ANTIQUE VEHICLE. C -= CLASS{C VEHICLE n . COLLEGTIL3f_E VEHICLE F .OUT 01= COUNTRY G =: ORIGINALLY MFGD: FOR NOM-U. S. \1111 DISTRIBUTICIN `,1` H _ AGRICULTURAL VEHICLE L =LOGGING VEHICLE P = 15/WAu A POLICE VEHICLE P. = RECOIJ5TRUCTED S =STREET ROD T ~ RECOVERED THEFT VEHICLE V =VEHICLE CONTAINS REISSUED VIt4 w =FLOOD VEHICLE X = IS/WAS A 7A;(I `1i1,p ~~i,, 1111~i 11 t 1;; h. ~'~1" ,I , 'I 1 ,1 , ~_ Ir 3 secc:~d l!e~!fl.ader ;s listed upon attsfacttol7=-~f thaw.-¢si IreLri~he first I!enholder mu5 ,onverrd this Title~o-lh~_Bureartsif _Mo[o~ahicTe~yvith the appropriate form and lee. ~~_ SECOND LIEN RELEASED DATE EY AUTHORIZEP_ RE.PRESENTATIVE ~>LJ~ s~ ~ ~~~~~ I 1 I certify as of tt?e data of issue, the oilicial records of fhe Penns LJ~~II~~ Y ~ i'i~~'~~~1~.d ylvania peparnlent of Transporiaiien retteci tl~,a! the person(si ur cornpany namca her~!r, la a of the said vehicie. is the !aw{ut owner 5ecretar}~ uP 1'ranspartation ~r ~ ppp~~~.1!~~~,~1~}~p w 1 .- ~ ~~.=r n-°wr~ z-c- ~ `mqa+~ _ ~!i a . ~ .. ~~Yi 1 ~'-4, `, .•t ~'~~ AfAw../4V~FRII.r. , ~F'~[.~%5! : i , yo k ~. r~. , r ! ~i (I~ a:~~l~j ~~~~1 ~ lk, , '~ ~. ~^l+. 3r,.,tixi~~c...~.y .Y .R~,~ ,_ -r ! r:. ~s,~!~ . ti' ... .•e ,.. • - SUB5CR10ED ANC SWORN ; If a co-purchaser other than your spouse is listed and you want the title to Tq t?EFOR~,~~,tE: ~ , „ be Usi:rd as "Joint Tenants l~Jith Right of Survivorship" (On death of one ilfl~lHlilU -,~I~IIti11 ililih~~~l1,~~!~11~~InlU+~, rl~~~dll~~4l!, Ma~l~l~~~i~r,! ~10rr~1a ~:: ~° '*F:.R: ~ ~i owner, Title goes to surviving owner.) CHE~i< HERE ^. Otherwise, the title lljl~;~Ili SIIII~!!r 'i','i` nm+i!91'((;'!1, ~~ 'I,M+~'' '!~0(>td1'l4it4~'1iy;!yy !r; will he=issued as~"Tenants to Gommori" (fin death of one oNrner, interest of ~~111j11~q rVl'~ ~ I'Iliill,~~~ ~jl~~l~'~ ~ .~li4l I'll ~!! it, I ;. I., '. -_ ,. f~~~i~~~;4 ~4~~~~~,. ~~~,~ idi'~ rr~69~GG,~~ i~'t'l~ilih (p~1l~h i „ -deceased owner goes ro hislher h~lrs or estate,. i . , I ~ 1 1661 ll, Ilo{i6~i1 ~! 111 i + `u ~ SIGN '~ AE i.F PER5bN n~ )Lill i~ It ~ ^ nll,d IIltllil 1 ' t u, !' II,r ill I,f ! 11 ! illf i I11~ ry~,i r aT LIEN DATE: IF NG LJEN, CHECK II , 1111' I'' '~ '~'~ , , ~ G N6,r~.~, ~, ~~ ..,, ,t! 'l11 U'11~~;''' ' ~{ I~,III.~~~lii~~,ll 1~j~1~11i~1' ~I r ~„"",,,, M..ar ,, ~, ,,,},,; ~... t ST LIEtJHOLDI==. ~ ~ _ Q ' : T9EETi 7 \ i i 1' ,I o T ~.TE ZiP - L -,ila,~clAL .,JS i .. ;pr, Elul:*.FE~. N f: -~ e ... ,~rr~, m.c., ac r -, !c; ~ r,.i ~: ~.-~. ..~ .. - to thr ;;.~~icle ,_.:.:,oed e~JD L'~iti ;ATE -~ IF 10 L!~t`l CHECK ^ .°iD LIEi:HJLDEF? y STREET _ = - il~ .,F: F. C::I .~=~~.r.~ ::3 '..iTM'_ ._, _..;':FR - _~~ -' I fr! IC-IfiL t S~'t! ;i Et `1iLPvtEcn sl ! T f ,I G'.~ t'..rtlHri~rr f ~= ~.Jr .l, i F,;~..~,: ~. f... ,.;n ~. .. ~ _... .. ., '~..~tt .... ...... ,. p ._, ~ .,a, n. ~ ... ~e ra ~~,v~ ZIP -_- Rev-1509 EX+ (8-98} ;; SCHEDULE F . - COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUME3ER Knotts, Lois J. 21-10-0901 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 ADDRESS RELATIONSHIP TO DECEDENT A. Lisa M. Wiley 4534 Roto Court Daughter Mechanicsburg, PA 17055 B. C. JnINTI_Y OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT 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 OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A PNC Bank -Checking Account No. 10,183.68 50.001)°t° 5,091.84 5070095976; date of death balance $10,183.65; accrued interest $0.03 2 A PNC Bank -Savings Account No. 6,572.65 50.000% 3,286.33 5080023191; date of death balance $6,572.61; accrued interest $0.04 TOTAL (Also enter on Line 6, Recapitulation) I 8,378.17 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, lnc. Form PA-1500 :>chedule F (Rev. 6-98) ~~ ~l"~JC t`EAtl13~G T~E~AY October 6, 2Q 10 James D Bogar, Esq. One west Main St Shiremanston, PA. 17011 RE: Lois J K.riotts SSN: 198-30-1255 DOD: OS-21-2010 Dear Mr. Bogar: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: ~' Checking Account Account # 5070095976 LOIS J KNOTTS LISA M W~LE~ DOD balance: $ 10,183.65 + 0.03 accrued interest Interest paid 0l -01-2010 thru OS-21-2010 $ 2.74 YTD Savings Account Account # 50$0023191 LOTS J KNOTTS LISA M WILEY DOD balance: ~ 6,572.61 + 0.04 accrued interest Interest paid 01-0 l -2010 thru OS-21-2010 ~ 3.99 YTD Established: 04-ZO-2004 Established: 04-20-2004 Please note that this off..tce provides date of death balances for deposit accounts (]R~s, CDs, Checking and Savings). ~Ve dv not process any financial transactions ar provide statements. ~f you need assistance with any of these items, please call 1-SSS-PNC-BANK (l.-S88-762-2265) or stop ~by your local PNC Bank, branch office, . Sincerely, National Financial Services Centex PNC I3an1;, N.A. Member FDIC Page 1 of I REV-1151 EX+ (10.06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF F1LE NUMBER Knotts, Lois J. 21-10-0901 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER q, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Lisa M. Wiley Street Address 4534 Rolo Court city Mechanicsburg state PA zip 17055 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 Zip Relationship of Claimant to Decedent ___ 11,678.67 1,496.00 2,205.00 4. Probate Fees 149.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 927.10 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 16,456.27 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 NUME3ER Knotts, Lois J. 21-10-0901 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exaenses 1 Gingrich Memorials -engraving 140.00 2 Malpezzi Funeral Home -funeral bill 10,693.67 3 Slate Hill Church -grave opening 845.00 H-A 11,678.67 ,other Administrative Costs 4 Mallard Run Apartments -fee for disposal of mattress 60.00 5 PPL -electric bill 55.92 6 PPL -electric bill 11.18 7 RESERVES: -Costs to conclude administration of Estate, including filing fee for PA 800.00 Inheritance Tax Return and Inventory; preparation and filing of Final Personal Income Tax Returns and Fiduciary Income Tax Returns H-B7 927.10 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+ (12-08) ~ SCHEDULE - sS DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHER{TANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUME3ER Knotts, Lois J. 21-10-091 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expeinses. (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-OS) ~~~ ~} ~ ~ ~ SCHEDULE J COMMNHERITANCEOTE PP RETURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Knotts, Lois J. 21-10-0901 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT Do N t List Trustee s (Words} ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal • distributions, and transfers under Sec. 9116 a 1.2 See attached schedule Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 15 00 cover sheet, as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LWE 13 Ur Ktv-~5uu c;vvtK 5r1tt i I Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) SCHEDULE J BENEFICIARIES (Part 1, Taxable Distributions) ESTATE OF: Lois J. Knotts 08/21/2010 198-30-1255 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Christine K. Hall 1148 Courtland Street Orlando, FL 32804 2 Derek A. Hall 2656 C Street San Diego, CA 92101 3 Brett C. Wiley 4534 Rolo Court Mechanicsburg, PA 17055 4 Lisa M. Wiley 4534 Rofo Court Mechanicsburg, PA 17055 Daughter Grandson Grandson Daughter One-half of rest, residue and remainder $1,000.00 specific bequest $1,000.00 specific bequest One-half of rest, residue and remaindE~r 1 ~~.~~ ~i11 ~n~ ~~e~~~xr~t~ert~. of LOI5 J . RNO'ITS I, LOIS J. KNOTTS, of Lower Allen Township, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I give and bequeath the sum of One Thousand and No/100 ($1,000.00) Dollars, to my grandson, DEREK A. HALL, and any other grandchildren that are alive at the time of my death. SECOND: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever- situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in equal_ shares, to my daughters, LISA M. WILEY and CHRISTINE K. HALL, provided that should any of my children predecease me, I give and bequeath such child's share unto his or her issue per stirpes by red>resentation, and if there be a f ailure of same, then I give and bequeath such deceased child's share to my surviving children as provided herein. THIRD: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries ~.' ~ acting hereunder the following powers, applicable to all property, ,~j' exercisable without court approval and effective until actual distribution of all property: C"~~ (A) To sell at public or private sale, or to lease, for ~.._~ any period of time, any real or personal property and to give . (~) options for sales, exchanges or leases, for such prices and upon such terms {including credit, with or without security) or ( conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E} To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the ,~..) ,~ ,,~~ r~,~ ,~ ,,\~~ Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (G) To make distributions to my herein nam~sd benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will,, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) t:o the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. FOURTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. FIFTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the 2 fiduciaries acting hereunder, even though vested or distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. SIXTH: I nominate and appoint my daughter, LISA M. WILEY, Executrix of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said Lisa M. Wiley, I nominate and appoint my daughter, CHRISTINE K. HALL, Executrix of i~his, my Last Will and Testament. I direct that my Executrix, and her successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my Yiand and seal ..•'~ to this , my Last Will and Testament, this day of ~~~~-~_ ~:~ `~; ~% 1988. _~ r ~. ,~ ~ ~ '~--~ ( SEAL ) Lois J. Knotts~~- Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address c, ~ Address 3