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HomeMy WebLinkAbout11-17-10 (3),A ^ _J 1505610140 REV-1500 Ex `°'-'°' OFFICIAL USE ONLY PA Department of Revenue County Cade Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po sox zsosol ~~ 1 0 0 1 3 2 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY 2 0 3 1 0 1 0 1 7 0 1 2 0 2 0 1 0 Decedent's Last Name Suffix G I B N E Y pf Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffer Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ® 1.Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death pnorto 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. EleGion to tax under Sec. 9113(A) between 1231-91 and 1-1-95) (Attach Sch. O) liV KKCSF•V17UCIY 1 - 1 rle ilCb 1 Nn a1W 1 OC trV111rLC 1 CV. ALL bVAncarVnucm.c ru~u a•vnr~um ~ ~n~ , nn mr vnw,n, ,vn w rvvw ..~ .....r........... Name Daytime Telephone Number R O G E R B I R W I N E S Q U I R E 7 1 7 2 4 9 2 3 5 3 First line of address 6 0 W E S T Second line of address City or Post Office C A R L I S L E Date Of Birth NAADDYYYY 0 9 0 8 1 9 1 7 Decedent's First Name MI J R O B E R T Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS State P A WILLS USE~ILY REGISTEKOF p ~ ~'f ~~ /_~ V ~ ~~~ 3 c- -- ~ ~-TE FILED ~ ~: ZIP Code ~ 1 7 0 1 3 ~D ?7 ;,~ J~ _~n i _Ti c7 r, C_> -~ Cortsspondsnt's e-mail address: Urxter penaltlss of perjury, l declare that 1 have examinad this Tatum, InGuding accompanying schedules and statements, and to the best of my knowledge and belief, h Is true„ ConeCt and wmplela. 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Discount 3,578.84 (1) 88,237.98 Total Credits (A + B) (2) 71, 578.84 3. Interest 4. If Line 2 is greater than Line 1 +Line 3, enter the difference. This is the OVERPAYMENT. FIII In oval on Page 2, lJne 20 to request a refund. (3) 0.00 (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 16.659.14 Make check payable to: REGISTER OF WILLS, AGENT .. k 9 p ftk tl +~ ,.y ¢v W c~ ~ ~ '6w~e ~ t a +~:' tfEk e~pgi apt&Fi.~k"?v ri y~i: C+t {~¢', ~~~Ai'WL tia ar ~a € "`.,, fsL~vy_~~a1.M:ra S&~"'.C~,'..~. £~. ~.i.~~~u.w.t~.. .z5m4u~..t~, vs ~.~-l o~'ia ~. gX~c~'..Ix}~Y~ ...E~t.e, ... ..r. v 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 trensferrad : ...................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................... ^ c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for fife of either payments, benefits or care? ....................................................... ^ 2. ff death oix.urred after December 12,1982, did decedent transfer property within one year of death without receiving adequate carsiderafion? ...................:................................................................... ^ 3. Did decedent own an'in trust for' or payable-upon~ieath bank account or security at his or her death? ......... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ® ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MU~~~S~~ggjT COMPLETE SCHEDULE G AND FILE tT AS PART OF THE RETURN. ~e`+ FM~ I"1 I 1 ~ ;~I~ 'il . pM~' ~.9'E i~'45.. ~ R,Y ~~` ~ +k ~ ~z'~` ~''+GL'~+~aw~ .~+s'v"... a4''i ,~+."~r~ .i, ~2`n~`°~~~~'~G wh~l ~ m HN.. "S w 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 3 percent [72 P.S. §9116 (a) (1.1) (i)]. 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 surviving spouse is 0 percent [l2 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 benefiaary. 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 decedents lineal benefiaaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) p2 P.S. §9116(a)(1)]. • The tax rate imposed on the net 1+alue of transfers to or for the use of the decedents siblings is 12 percent (72 P.S. §9116(a)(1.3)]. Asibling is defined, unde Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 F,(+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE J. ROBERT GIBNEY 10 0132 All real property owned solely or ~ a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged tletween a willing buyer and a willing seller, neffher being compelled to lwy or sell, both having reasonaNe knowledge of the relevant facts. Real plOperty that is Jok-tlyowned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet 'ff the propeAy has been sold. ITEM Include a copy of the deed showing decedent's interest ff owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 1140 BAISH ROAD, MECHANICSBURG, PENNSYLVANIA 134,000.00 SOLD -SETTLEMENT SHEET ATTACHED 2. 501 W. SIMPSON STREET, MECHANICSBURG, PENNSYLVANIA SOLD -SETTLEMENT SHEET ATTACHED 168, 000.00 TOTAL (Also enter on Line 1, Recapitulation.) ~ _ If more space is needed. use additlonel slrears of paper of the same size. REV-1503 EX + (8-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS 8 BONDS ESTATE OF r~cc nvmocn J. ROBERT GIBNEY 10 0132 All property lointly~ovmed sihtl right of survivorship must be discbsed on &hedub F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SENTINEL INVESTMENTS -1,445.160 SHARES X $1.00 PER SHARE _ $1,445.16 1,445.16 MORGAN STANLEY SMITH BARNEY ACCOUNT #410-038986 2. BANK DEPOSIT PROGRAM -MONEY MARKET (BDPS) 15,165.83 15,165.83 SHARES @ $1.00 PER SHARE 3. AMERICAN NEW PERSPECTIVE FUND C (NPFCX) 150,034.81 5,965.599 SHARES @ $25.15 PER SHARE 4. VANGUARD LG TM TX EX INV (VWLTX) 35,380.26 3,213.466 SHARES ~ $11.01 PER SHARE 5. FRANKLIN INOOME C (FCISX) 55,697.58 26,396.956 SHARES ~ $2.11 PER SHARE 6. VALUE LINE PREMIER GRW INC (VALSX) 9,289.28 416.000 SHARES @ $22.33 PER SHARE 7. CONOCOPHILLIPS (COP) 5,283.50 100.000 SHARES (c~ $52.835 PER SHARE 8. BANK OF AMERICA CORP (BAC) 4,921.50 300.000 SHARES ~ $16.405 PER SHARE 9. CENTURYTEL INC (CTL) 10,594.50 300.000 SHARES ~ $35.315 PER SHARE 10. MS EMERGING MKTS DOMESTIC DEBT (EDD) 21,577.50 1,500.000 SHARES ~ $14.385 PER SHARE 11. D R NORTON INC (DHI) 3,660.00 300.000 SHARES @ $12.20 PER SHARE 12. FIRST AMERICAN CORP (FAF) 3,046.50 100.000 SHARES C~ $30.465 PER SHARE 13. INTEROIL CORP (IOC) 15,449.00 200.000 SHARES @ $77.245 PER SHARE 14. FORD MOTOF2 CO NEW (F) 3,478.50 300.000 SHARES C~ $11.595 PER SHARE 15. HERSHA HOSPITALITY TR CL A (HT) 3,660.00 1,000.000 SHARES X3.66 PER SHARE TOTAL (Also enter on line 2, Recapiwlation) S 721,130.37 (g more space is needed, insert acklidonal sheets of the same she) A Continuation of REV-1500 Inheritance Tax Return Resident Decedent J. ROBERT GIBNEY 10 0132 l~cedent's Name Page 1 File Number Schedule B -Stocks 8 Bonds ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 16. YAHOO INC (Y 00) 21,404.50 1,300.000 SHARES ~ $16.465 PER SHARE 17. MORGAN STANLEY (MS) 46,192.50 1,500.000 SHARES ~ $30.795 PER SHARE 18. COMCAST CORP (NEW) CLASS A (CMCSA) 3,170.99 193.00 SHARES ~ $16.43 PER SHARE 19. HONEYWELL INTERNATIONAL INC (HON) 8,457.00 200.000 SHARES @ $42.285 PER SHARE 20. DISCOVER FINANCIAL SERVICES (DES) 13,311.00 900.000 SHARES ~ $14.79 PER SHARE 21. JPMORGAN CHASE & CO (JPM) 4,319.50 100.000 SHARDS ~ $43.195 PER SHARE 22. HERSHA HOSPITAL 8.00% SER A (HT.a) 15,295.00 700.000 SHARES @ $21.85 PER SHARE 23. CBS CORP NEW CL B (CBS) 8,130.00 600.000 SHARDS (~ $13.55 PER SHARE 24. WINDSTREAM CORP (WIN) 2,242.31 206.000 SHARES ~ $10.885 PER SHARE 25. MOTORS LIQUIDATION CO (MTLOO) 626.50 1,000.000 SHARES C~ $0.6265 PER SHARE 26. SELECT MEDICAL HLDGS CP (SEM) 2,052.00 200.000 SHARES ~ $10.26 PER SHARE 27. DEERE & CO (DE) 16,906.50 300.000 SHARES cQ $56.355 PER SHARE 28. GENERAL ELECTRIC CO (GE) 13,204.00 800.000 SHARES @ $16.505 PER SHARE 29. HARSCO COMP (HSC) 20,550.00 600.000 SHARES C~ $34.25 PER SHARE «... «., ~.......... r.....,. 30. JOHNSON & ,JOHNSON (JNJ) 13,042.00 200.000 SHA ES CD $65.21 PER SHARE SUBTOTAL SCHEDULE B 188,903.80 Continuation of REV-1500 Inheritance Tax Return Resident Decedent J. ROBERT GIBNEY 10 0132 Decedent's Name Page 2 File Number Schedule B - Stocks ~ Bonds ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 31. LOWES COMPANIES INC (LOW) 40,276.25 1,750.000 SHARES (da $23.015 PER SHARE 32. PFIZER INC. (PFE) 28,161.00 1,400.000 SHAMES (c~ $20.115 PER SHARE 33. RITE AID CORIP (RAD) 12,080.00 8,000.000 SHARES (c~ $1.51 PER SHARE 34. SUSQUEHANNA BANCSHARES (BUBO) 5,133.60 720.000 SHARf~S (c~ $7.13 PER SHARE 35. UNIT IMIT MUNI INSD PA 7OPS (INPA7Q) 2,891.80 10.000 SHARES @ $289.18 PER SHARE 36. GMAC BOND 7.25°k DUE 09!15!17 (CUSIP 37042GF76) 30,000.00 37. ~GMAC BOND 6.70% DUE 12/15/19 (CUSIP 3704AOVE9) 75,000.00 SUBTOTAL SCHEDULE 6 193,542.65 GRAND TOTAL SCHEDULE B $ 721,130.37 REV•1508 EX+ (e-ea) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPER ESTATE OF rac numoort J. ROBERT GIBNEY 10 0132 Include the pprro~ceed~sq of lidpation and the dale the proceeds were received by the estate. Al- orooeAv leinUvoxmed with ripM of survHorehip must be dleelosed on Schedule F. ITEM I VALUE AT DATE NUMBER DESCRIPTION OF DEATH oFCnuel PRf!IPFRTV 500.00 TOTAL (Also enter on line 5, Recapitulation) ~ i (If more space is needed, Insert additlorlal sheets of the same size) REV-1509 EX+ (01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTIY•OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: Fat nualestec: J. ROBERT GIBNEY 10 0132 ff an asset was made Jointly owned within one year of the decedents date of death, ft must be reported on Schedule G. SURVMNG JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. CAROLYN G. CRAIG 2717 CHESTNUT STREET DAUGHTER CAMP HILL, PA 17011 s. C. JOINTLY-OYYt1ED PROPERTY: ITEM NUMBER LEl'TER FOR JOINT TENANT ATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FlNANCIAL INSTRUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HEIR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECEDENTS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 0.00 1. A. MORGAN STANLEY ACCOUNT #410045703 1. A. BANK DEPOSIT PROGRAM -MONEY MARKET (BDPS) 1,954.79 50. 977.40 1954.79 SHARES (cl3 $1.00 PER SHARE 2. A, CHESAPEAKE ENERGY CORP (CHK) 8,284.50 50. 4,142.25 300.1700 SHARES t~ $27.615 PER SHARE 3. A. MORGAN STANLEY (MS) 30,795.00 50. 15,397.50 1,000.000 SHARES @ $30.795 PER SHARE 4. A. JPMQRGAN CHASE & CO (JPM) 17,278.00 50. 8,639.00 400.000 SHARES ~ $43.195 PE SHARE 5. A. AT&T INC (T) 7,759.50 50. 3,879.75 300.400 SHARES ~ $25.865 PER SHARE 6. A. SUSQUEHANNA CAPT 9.375% (SUS.A) 23,925.00 50. 11,962.50 1,OOb.000 SHARES @ $23.925 PER SHARE 7, A, DU FONT EI DE NEMOURS & CO (DD) 10,332.00 50. 5,166.00 300.000 SHARES t~ $34.44 PER SHARE g, A, FREbDIE MAC (FRE) 1,320.00 50. 660.00 1,000.000 SHARES @ $1.32 PER SHARE g, A, FANINIE MAE (FNM) 1,075.00 50. 537.50 1,000.000 SHARES ~ $1.075 PER SHARE TOTAL (Nso enter on Line 6, Recapitulation) S 54,381.90 If more space is deeded. use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent J. ROBERT GIBNEY 10 0132 Decedents Name Page 5 File Number Schedule F-2 -Jointly-Owned Property LETTER DATE DESCPoPTION OF PROPERTY 96 OF DATE a= DEATH ITEM FOR JgNT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JgNTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 10. A. RITE AID CORP (RAD) 6,040.00 50. 3,020.00 4,000.000 SHARES C~ $1.51 PER SHARE SUBTOTAL SCHEDULE F-2 ~ 3,020.00 GRAND TOTAL SCHEDULE F-2 ~ S 54.381.90 REV-1510 EX+ (OB-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE ~ FILE NUMBER J. ROBERT GIBNEY 10 0132 This schedule must be completed and filed N tl~e answer UD any of questions 1 ihreugh 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY DATE OF DEATH 96 OF DECD'S EXCLUSION TAXABLE ITEM INCLUDE THE NMIE OFTHE TRANSFEREE,THEIR REL4TION8WPT0 DECEDENT AND NUMBER THE DATE OF TRANSFER.ATTACHACOPYOFTHEDEEDFORREAlE5TATE VALUE OF ASSET INTEREST nF~~EI VALUE 1. MORGAN STANLEY - ALLSTATE LIFE INSURANCE CO 170,029.29 100.00 170,029.29 ANNUITY #852959 2. BENEFICIARY: CAROLYN G. CRAIG HARTFORD 139,346.00 100.00 139,346.00 ANNUITY #710711107 BENEFICIARY: CAROLYN G. CRAIG 3. HARTFORD 110,906.00 100.00 110,906.00 ANNUITY #710778240 BENEFICIARY: CAROLYN G. CRAIG 0.00 MORGAN STANLEY -.UNIFIED CREDIT TRUST 4. #410-046625-038 BANK DEPOSIT PROGRAM -MONEY MARKET (BDPS) 891.70 100.00 891.70 891.700 SHARES @ 1.00 PER SHARE 5. AMERICAN BALANCED A (ABALX) 61,959.17 100.00 61,959.17 3,741.496 SHARES ~ $16.56 PER SHARE 6. AMERICAN CAP WRLD GR & INC A (CWGIX) 161,632.21 100.00 161,632.21 4,734.394 SHARES ~ $34.14 PER SHARE 7. AMERICAN INC FD OF AMERICA A (AMECX) 63,348.31 100.00 63,348.31 4,042.649 SHARES (~ $15.67 PER SHARE 8. DAVIS NEW YORK VENTURE A (NYVTX) 50,067.01 100.00 50,067.01 1,592.462 SHARES ~ $31.44 PER SHARE 9. IVY ASSET STRATEGY A (WASAX) 18,013.02 100.00 18,013.02 803.794 SHARES Q22.41 PER SHARE 10. VAN KAMPEN EQUITY & INCOME A (ACEIX) 99,492.61 100.00 99,492.61 12,467.745 SHARES @ $7.98 PER SHARE 11. BLACKROCK MUNI YIELD QUALITY FD (MQY) 20,895.00 100.00 20,895.00 1,500.000 SHARES ~ $13.93 PER SHARE 12. ENDPRO IND INC (NPO) 2,078.80 100.00 2,078.80 80.000 SHARES ~ $25.985 PER SHARE 13. FEDEX CORP (FDX) 16,788.00 100.00 16,788.00 200.000 SHARES (43'$83.94 PER SHARE 14. MICROSOFT CORP (MSFT) 26,031.25 100.00 26,031.25 850.000 SHARES ~ $30.625 PER SHARE 15. NUVEEN PENN INVT QUAL MUNI FD (NQP) 9,257.50 100.00 9,257.50 700.000 SHARES I~''$13.225 PER SHARE TOTAL (Also enter on Line 7, Recapitulation ) S _961, 902.80 If more space is needed, use additional sheets of paper of the same size Continuation of REV-1500 Inheritance Tax Return Resident Decedent J. ROBERT GIBNEY 10 0132 Decedent's Name Page 6 File Number Schedule G -Inter-Vivos Transfers & Misc. Non-Probate Property utJl.nin ivrv yr rRVr~ni ~ ITEM INCLUDEIHENWdEOFTF~7RANSFEREE,THEIRREUTIONSHIPTODECEDENfANU DATE OF DEATH 960FDECD'S EXCLUSION TAXABLE NUMBER THE DATE OFTRANSFER.;ATTACHACOPYOFTHEDEEpFORREALESTATE VALUE OF ASSET INTEREST v VALUE 16. HIGHWOOD PPTY 8.0~% CUM PERP B (HIW.B) 3,016.53 100.00 3,016.53 121.000 SHARES C~ $24.93 PER SHARE 17. IGMAC 7.25% DUE 8!1 Sl18 (CUSIP 37042G7C4) 10,000.000 SHARES C~3 $81.50 PER SHARE 8,150.40 ~ 100.00 8,150.40 SUBTOTAL SCHEDULE G ~ 11,166.93 GRAND TOTAL SCHEDULE G 15 961,902.80 REV-1511 EX+ (10-09) ' pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER J. ROBERT GIBNEY 10 0132 Deuderd'e dells must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1. PANERA BREAD -FUNERAL LUNCHEON 84.90 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Nama(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: Z, AltorneyFees: IFtWIN & McKNIGHT, P.C. 46,500.00 3, Fatuity Exemptiar. (If decedents address Is not the sarrre as claimant's, atlach explanatbn.) Claimant Street Address City State ZIP Relationship of Claimant ib Decedent 4. ProbeteFees: REGISTER OF WILLS 711.50 5 A~p,~p~: MARSHALL SACKS - 2009 INCOME TAX PREPARATION 1,500.00 6. I Tax Realm Preparer Fees: 7. REGISTER OF WILLS -FILING FEE 30.00 8. CLOSING COSTS FROM SALE OF REAL ESTATE -1140 BAISH ROAD 12,466.26 9. CLOSING COSTS FROM SALE OF REAL ESTATE - 501 W. SIMPSON STREET 9,675.21 10. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 11. THE SENTINEL -ESTATE NOTICE 187.54 12. NOTARY FEES 35.00 13. BARRY BA$ON -MISCELLANEOUS HELP 50.00 14. REGISTER'OF WILLS -SHORT CERTIFICATES 20.00 15. KATHY PROGAR -CLEANING 600.00 16. JOE'S OUTbOOR SERVICE -PROPERTY CLEANUP ~ REMOVAL OF JUNK 625.00 17. U-HAUL - F~EMOVAL OF FURNITURE FROM 1140 BAISH ROAD 105.02 18. CLEANING'SUPPLIES 20.00 TOTAL (Also enter on Line 9, Recapilulaation) S 75.185.43 If more space is needed, use additlaral sheets of paper of the same size Continuation of REV-1500 Inheritance Tax Return Resident Decedent 10 0132 J. ROBERT GIBNEY File Number Decedent's Name Page 8 Schedule H -Funeral Expenses & Administrative Costs - B5. Accountant Fees ITEM 2. ~ MARSHALL SACKS - 2010 INCOME TAX PREPRATION AMOUNT 2,500.00 SUBTOTAL SCHEDULE H-65 ~ 2,500.00 REV-1512 Ex+ (12-09) pennsylvania OEPAR7MENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE R DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER J. ROBERT GIBNEY 10 0132 Report det-b Incurred by the decedent prior to death that remained unpaid et the date of death, Including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MET-ED -ELECTRIC 158.64 2. SUSQUEHANNA OIL -FUEL OIL 1,280.15 3. WEST SHORE EMS -AMBULANCE 141.45 4. CENTURYLINK-TELEPHONE 122.32 5. CUMMINGS ASSOCIATES -MEDICAL 155.00 6. PINNACLE HEALTH EMERG -MEDICAL 33.76 7. MED-E-EERY -MEDICAL 612.00 8. ZIMMERMANS -PLUMBING 235.00 9. CAROLYN G. CRAIG -MAINTENANCE FEE (JANUARY & FEBRUARY) 800.00 10. BOROUGH OF MECHANICSBURG -SEWER 268.64 11. INTERNISTS OF CENTRAL PA LTD -MEDICAL 78.60 TOTAL (Also enter on Line 10, Recapitulation) I E If rrrore apace is needed, Inert addidonel sheets of the same size. REV-1513 EX+ (01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: J. ROBERT GIBNEY 10 0132 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trusbe(a) OF ESTATE I TAXABLE DISTRIBUTIONS pndude out~M s usal distributions and transfers under Sec. 91 f6 (a~(1.2).] 1. CAROLYN G. CRAIG Lineal 1,960,844.08 2717 CHESTNUT STREET REMAINDER CAMP HILL PA 17011 DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 1 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I S H more space is needed, use adddional sheets of paper of the same size. LAST WILL AND TESTAMENT I, J. ROBERT GIBNEY, of Monroe Township, Cumberland County, Pennsylvania, being of sound mind, disposing memory. and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. 1. I direct my Executrix to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Executrix of my estate. 2. My Executrix may, at her discretion, compromise claims, borrow money, retain property for such length of time as she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as she may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. 3. I authorize and empower my Executrix to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My Executrix is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executrix. 4. I give, devise and bequeath all of my estate of whatever nature and wherever situate to my daughter, C.4ROLYN G. CRAIG, and if she is not living at the time of my death, to my friend, KatBY BESHORE. 5. I nominate and appoint CAROLYN G. CRAIG to be the Executrix of this my Last Will and Testament. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint KatBY BESHORE as Substitute Executor with the same powers as are given herein to my Executrix. 6. No Executrix or Substitute Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 7. I hereby suggest that my personal representative retain the services of Irwin & McKnight as attorneys in the settlement of my estate. IN WITriES5 WHEREOF, I have hereunto set my hand and seal this 2~ day of April, 2007. ,: ~ ' ~ ~~/ (SEAL) J. ROBERT GIBNEY 2 ACKNOWLEDGMENT AND AFFIDAVIT WE, J. ROBERT GIBNEY, KAREN S. NOEL and SHARON L. SCHWALM, the Testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will, and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of their knowledge the Testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by J. ROBERT GIBNEY, the Testator herein;, and subscribed and sworn to before me by KAREN S. NOEL and SHARON L. SCHWALM, witnesses, this 2~ day of April, 2007. '~ .~-~ Pabiic RoOerB. Irvdn, Na~yP~ic boa s~zo~voa ber. PennsNvenfe gaeocleNon Of Note March 5, 2010 JR Gibney Testamentary Trust c/o Kirby Beshore 4507 North Front Street 2nd Fl Suite 201 Harrisburg, PA 17110 Contract Owner: JR Gibney Annuitant JR Gibney Decedent: JR Gibney Contract Number: 710778240 ~~IE t1ARTFORD We have been advised of the passing of JR Gibney, the owner of the above referenced contract(s). On behalf of The Hartford, I want to extend our sincere condolences for your loss and assure you that we want to assist in any way that we can. The enclosed document will guide you in the process of electing the annuity benefit option that best suits your needs. Please select the appropriate election on the form and. return it in the enclosed envelope. If you have any questions, please do not hesitate to contact us toll-free at 1-800-862-6568, option #5, Monday through Thursday, 8 am to 7 pm, or Friday, 9:15 am to 6 pm, Eastern Time. Sincerely, ~-~~ ~~~ ~ ' ~ Diane Krajewski, Assistant V ice President, U.S.Wealth Management Hartford Life and Annuity Insurance Company MorganStanley SmithBarney LLC Enclosures: A.S. 1 PttpEN7 p~. OMB Approval No. 2502-0265 Off' hOG~ HUD-1 ~ * * ~ A. Settlement Statement (HUD-1) 'tl ~~2 _ Page 1 of 3 `984N DEVtiyO - B. Type of Loan 1. ^ FHA 2. ^ RHS 3. X^ Conv. Unins. 6. Flle Number: 7. Loan Number: 8. Mortgage Insurance Case Number: 4. ^ VA 5. ~ Conv. Ins. 401000134-CB 1023013 C. NOTl: This form b,.. Nrnlshed to plve you a statement of eutual settlement wets. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)' were pakl'outskle the closlnp; they ere shown here for informattonal purposes end are not Included in [he totals. D. Name and Address of Borrower [. Name and Addrou of Spllar F. Name and Addross of Lander TYLER R. SMITH CAROLYN G. CRAIG, EXECUTRIX OF ESTATE SUSQUEHANNA BANK 1786 WEST LISBU0.N ROAD OF ]. ROBERT GIBNEY 4185 W. MARKET STREET, CARLISLE, PA 17015 C/0 IRWIN & MCKNIGHT 60 W. POMFRET YORK, PA 17408 CARLISLE, PA 17013 G. property Location 1140 BA1SH 0.OAD, MECHANICSBURG, PA 17055 COUNTY: NMBERLAND PA0.CEL ID: 22-11-0280-028 TOWNSHIP: MONROE TOWNSHIP 100. Gross Amount Dye from Borrower I SENRED LAND TMNSFE0.S - MECHANICSBURG Phone : (717) 901-8342 Place of settlement I. Settlement Data Da/16/zglu 485 ST. ]OHNS CHURCH ROAD„ SHIREMANSTOWN, PA 17011 Disbursement Drta 04/16/2010 1400. Gross Amount Due to Seger I ~ 200. Amounb Paid bM or in Nhalf M Borrower I 300. Cuh at SattlsmpM from/to Borrower 301. Grow amount d from borrower One 120 141 843'.63 302. amounts b for borrower Ilrle 220 130 415.84 393. Cash X' From '. To Borrower 11,427.79 The ReporlYp for tlds rnaxllon o1 h narrated at 15 mina colk+tll tlNa inforrnalbn, and you are not rapuiretl D wmpNte INs form. unbse Il diapl b mandslory. This Is daagrlsd m Proude tlra partka b a F0-9PA wvsrsd trenndla 500. Reductions In Amount Dus to 6ellar I 600. psh at Sattlamam to/from seller 1. Gross amount due Co seller Ilse 420 134 519.45 602. Lass reductbns in amount due seller line 520 21 916.26 603. Cash X To From Seller 112,603.19 t~aurenyr wIW OMB conntrol nr. No mnOdenlfallly Is aBSUnd; N dI ~y ~1 ah inkmnalbn dudng the nalarnrnt prorcn. 401000134-CB '. 700. Total Real Moksr Peas 56213A0 Psid From Pald From DNbbn of Com sion Tine 700 as follows• Borrower's Funde Seller's Funds 701. 52988.00 to Ke9e, WlBbms of Central DA East (53275.00 less f287.00 cowards home warrenri) At Settemenrt At Settlement I aM Try. a~o~Ll~ li Pww~rHww .riM. I new I 801. Ouro Inetlon a 895.00 from GFE #1 802. Your c it or chs a inb fo the s i8c Interest rate chosen from GFE 2 803. Your ad sled o Instbn dta es hom GFE A 95.00 804. ra I Fee to inc. bat Istic Solutions Inc. hom GFE #3 10.00 805. Cndfc re rt to K Facn»I Date Cor from GFE #3 11.59 806. Tax Service to Fl t Amartun Mal Estate Tax Service from GFE #3 90.00 807. Flood Cert. Fee toy Flrst Amerkan Flood Data Servke.4 from GFE #3 38.00 BOB. If you haw sIry 9uaabna'~ab0ul lM aMUsmanl cherpes aM loan temre listed on Ihb form, pbaee coraad your tinder. Setlbmsnt spent b not reaponatxs ror oomem or brdsr's ewswrnerrb on HUO. TM sslbrs and botrowsrlt siprattxae:hersort acknowledge rhea approval and slpni(y rhea underelalMirq that taz and tlenanee proralione and raaerves aro beaed on ~sde f6atvreen bower M d oaNrr daecBy~An de8e8 de8rquent taxes or~mortpape apayolfe vd9 be PtomDty teMnbtasstl b eeltls~rd epeM by6y 8 e aelpsr~mb ~I ~ I haw aletully rovlewad ~ HUD-1 $NBemsM StstsmeM and b the best of my knovdedgs end txWaf, a b Wa and actuate sutament d cep remlpb and diaburwmenb made on my eooount a by me b thb irsneaclbn. 16xltler esrtHy that I haw reraWad a copy of the HU0.1 Settlamsnl Sblemanl. BUYERS SELLER8 - . Esbb ~ .Robert Gibney ~ ~~~ Tybr R. Smth ' n G. Cre ewMx Ths HU0.1 SstlbmeM Statement aAlk:h I haw pmparad b a true and accurate saouM of tltb tnnsectbn. l haw caused or vdX cause the flmde b be dbburaM b accordance vdlh ads sbidmant. SaltMmsnt Apanl ~/f Data O Q I a n C li. Y~~ 04/1812010 SECURED LAND TRA ~FERS•MECHANICSBURG 401000134-CB HUD-1 Page 3 of 3 J • IT~~J l~liL l~il~~i~ /l!!!\ ~~J YIIA-1 /~tIf MYQ HUD-1 Una Good Fekh Chargq That Gnnot Inaaaw Number Eedmsb HUD-1 Our Inadon d:s # 801 895.00 895.00 Your aedk or ch is for the s Interest rote dmsen # 802 Yaur us0ed o inatlon the # 803 895.00 895.00 7romfer texas # 1203 1 400.00 1 340.00 Chargq That in Total gnnot inereaw More Than 10% HUD-1 Una Numbm Good Fskh Estimate HUD-1 Government recortll # 1201 120.00 152.00 ~ ~ #804 385.00 10.00 Oedk R froe # BOS 25.84 11.59 Taz Service Fw #806 90.00 90.00 Plood CaNfimdon #807 18.00 18.00 e Inw nee #902 Title Serviw - l:rlder Iruurona # 1101 Owner's Title Insuro # 1103 TOgI ~- 5638.64 _ 601.59 Incnasa between GFE and HUD-1 Cha as 2.75 or 6.69% G o d Charges That qn Change maN HUD-1 6s tl Inlpal d k for our amount # 1001 1 248.59 812.26 pal I the # 901 19.37 da 426.18 290.58 Homeowner's Irquro # 903 480.00 599.00 Surv # 1302 pest Ins n # 1303 Loan TefmS Loan Number: 1023013 Yourinkislloan amduntis ;123,980.00 Your loan term is 30 years Your Initlal Irrtmest fate fs 5.625 % Your initial monthly amount owed for prindpal, interest 713.70 includes and any mortpaga Insurance is X Pdndpal X Interest Mortgage Insurance 'Gn your Interest rate riw? ~ No. ^ Yes, it can nse to a maximum of %. The first change will be on and can change again every aker .Every change date, your Interest rate can increase or decrease by %. Over the Ilfe of the loan, your interest rote is guaron[eed to never be lower then % or higher than %. Eros K you make payments on dme, nn your loan balance ~ No. ~ Yes, it un rise to a maximum of 3 MwT the first increase can be on an0 the ~ Yes 0 No Even If you make paymwts on time, un your montfily , . amount owed monthly amount owed can rise to; .The maximum It can for prlndpal, IMerert and mortgaps Insursnu rise? ever rise ro Is; Q No. ~ Yes, your maximum prepayment penalty is; DOw your ban have a propaymalt penaltyT No. ^ Yes, you have a balloon payment of S due in Dow your Iwn have a balloon paymsM7 years on Total monthly amowrc owed Indudinq escrow aaouM ~ You do not have a monthly esuow payment for Items, such es property payments taxes and homeowners insurance. You must pay tMse items directly yourself. X^ You have en additional monthly escrow payment of S 180.55 that results In a total Initial monthly amount owed of S 894.25 . This includes principal, Interest, any mortgage Insurance and arty Items checked below: Property taxes ~ Homeowners insurance Flood insurantt School Tax non: lr you nave arty quesoons aoeUC me x[[remenc ularges eno roan 1 emis 115[ea on [n13 roan, pleeae COntem your lender. [niGals r>a~ Me. 2802-0266 I~ B. TYPE of LOAN: A. t.OFHA 2. FmF1A 3.©OONV.UNINB. 4.QYA 5. CONV.INS. UJL. DEPARTeIENT OF HOU8640 i URBAN DEVELO 8, FILE NL9ABER: 7. LOAN NUMBER: 8ETTLEMENT STATEMENT 50twE3rn7•to 6. MORTGAGE INS CASH NUMBER: C. NOTE: 7hh ram h IInYShsd M 9fi'a Yar a ararsrnsra daclud nflhraerd Wsh. Artpanb P~ h) road aY Mro aelNSrnsnr sprod are ahawtr. : fhsY roe shown Mrs hx MAwmaSand purpoass and are not Nswrdsd In Mro folds. falds ers obdn ftl ' ou gPOCp wero Pa Mama msdrsd 0 to aw aawmn-tarroamwemr- D. NAME AND OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: 501 WEST S88PSON, LLC J. ROBERT GIBNEY ESTATE PNC BANK, NA 842 OBSERVATORY DRIVE 1110 BAISH ROAD 91 ClN8BERIAND PARKWAY LEYNSBERRY, PA 17539 MECHANICBBURO, PA 17055 sAECt1M11C3BLMtG, PA 17066 G. PROPERTY LOCATNDN: N. 8ETTLEMENT AGENT: 26-1818811 I. SETTLEMENT DATE: 601 riEBT 38aP80N STREET TRI-COUNTY ABSTRACT SERVICE MECHMIICSBURO, PA 17065 M.y 14, 2010 CUAABERLAND Counly, ProsreyNerria PLACE OF SETTLEMENT ae CENTRAL Blw. CAMP HILL. PA 17011 J. PROM 100 400: 0~ U UE TO 888.1.91: . 101. CorlLnd Saha 188 000.00 1. ~Conlraet Bshe Prloa 188000.00 ~•` 102. Proecrrd 102. PertorlN 103. BeWroaM >o Bonorrer 1 4775.26 103. 104. 404. 106. ~. For Paid Ss9srh edvanas Fa Mems Paid $sMrin adwrnoa 108. own Tans 06MI110 b 01AHM1 9 108. own Troaa 06/14H0 to 01N11/11 .4 roes ro 107 407. Taan to . TAX OSf14M0 to 07/01110 329.99 408. TAX 06I14H0 to 07N11/10 ~ 108 329.39 . 109. 8EIA8eRlTRA8F1 .RRE ON14M01o 07101/10 119.56 109. BEWER/TRILSH ApRILJUNE 05/14M0la 07/01/10 119.b5 110. 111. 411. 112. 412. 120. GR083AMOUNTDUEFROMBORROWER 175,873.61 420. GROSSAAgUMDUE7OSELLER tN,096.38 84 BOR IWYYER : 800. M AMOt1NT DUE TO TELLER: ewreat 201 b 000.00 601. Ex77ese . Arrnra6 New 134100.00 602. m Se6ar 1 9875.21 209. a b 603. a taken h ~. 604. of8rst 206. 208. ~. 207. 607. dab. n 608. ZOB. ~. Mama 8 SsBw ForNsms SsNro 210. awl T~ to 610. !Town Tarty to 211. Tana to 671. Taan b 212. 8CF100LTAX to 812 SCHOOL TAX to 213. 815. 214. 614. 216. 516. 218. 518. 217. 617. Y18, 518. 21 618. 220. TOTAL PAN) BYA=OR BORROWER 1~,400.00 520. TOTAL REDi1C710NAMDUATOUE SELLER 9,875.21 CA81H AT 800. CA881 AT SELLER: . 901. Gras AmourR Frem Borrowsr LYrs 720 179873.81 801. Oran AnrouM Dr1e To 8s8ar 189 ~•~ 902. Lan Arrwwrt or Borrower 199100. 802 Lan Reduc6oa Da Sella 9.676.21 909. CA3h1(X FRO81 J ( TD J BORROWER 34,473.81 Q09. CASH (X TD J ( FROM) SELLER 159.429.16 TM I Flf TO.THE BEST OF I°11N~ wHK:H w Twul3ACnoN. WARNING: R IS A CONVICTION CAN ps receipt oT o arnPlsted copy of papas 182 d thh ~rorwM 8 arty athlehmenb roterted to Mrdn. HE HUD•1 3EITLEMENT STATEMENT AND TO THE BEST OF MY KNOYN.EDGE EF R IS A TRUE AND RECEIPTS AND DISBURSEMENTS MADE ON MY ACCOINdT OR BY ME IN N3 . I FURTHER CERTIF OF THE HUD•18ETTLEMENTSTRTEMENT. _ Se6sr r 8'SON, LLC A iE, 7H~ MUD-1 MENi STA'¢EAIENT WHKMi I WOVE PREPARED 18 A AND ACCURATE ACCOUNT OF TH AND FTAVE BEEN BY THE UNDERSIGI~D AS PART OF THE SETTLEMENT OF THIS FALSE STATEME1fF3 TO THE UNRED STATES ON TNIS OR ANY SIMILAR FIXLM. PENALTIES UPO aLMENT. FOR DETAILS 8EE: TRLE 78 U.B. CODE SECTION 7007 8 SECTION 1010. v.w z 70 L. SETTLEMENT CHARGES 0. TOTAL Beesd OII Prize 188000.00 4.0000 % 6720.00 °"1D ~~ eoeew~ses seuHl'B u A FIIHM AT ' pUHU6AT TTIlMeMr SEl R.el1ENT BE m 8 00. PAY CONIO~TION VYRFI LOAN 1. Loen % m 8 02. LNn Disesad % m N m m s m ms. m m t. 9 00. LENDER TO BE PAID Ni ADVANCE 9 01. hdSISN Fran 06/1 0 ~ 08I01N0 S 18 %) m 9 03. Haurd Mtutena for 1.0 m 9 04. 9 06. 1 W9.REEERYES WI7HLENDER 1 001. NNwd mwrNa' madM mm~lh 1 002. mm~tln 1 008. SwiTaxN' monMe monM 1 001. Teen months mm~lh 1 005. SdI00LTAX marlr i madh 1 007. nantlis i mon8~ 1 d monllr r madh 1 100. TITLE 1 101. SeOMenNta FN m 11 LETTER m FOIST AMERICAN TffLE INSURANCE COMPANY 11 m TRI-COUNTY ABSTRACT BERNICE 76.00 14.60 1104. Tile Nweenoe m 11 . Deaelltld m 11 FNS m CASH 1107. FeN m 15.00 8.00 1 T F 1 Nerll IMNnbeB: 11 134;100.00 1 1 1 1,198.7 1 00 8.1 m 1. 11 . 1 11 1208.OOVERIElNT AND TRAM CF111ROEB 1201. FNS: Deed i 82.00: i 92.00: ReNNN S 1 1203. Stile T Revema 1880.00: 120{. RENTS m 1208. NIBPECTiON ANS INSPECT POC 436.00 154.00 1880.00 41.00 1 1700. ADDITIONAL CFNi00E8 1301. m 1302. Peet n to 1703. FOR TAX CERi m TR4000NTY A68TRACT SERVICE 1304. V191 TE 1o MEC11AlSC8811RO BOROIIOIi 1308. 2010 COUNTY P TAXES m BARRY L HECKARD, TAX COLLECTOR 1 TOT on Linty 1 Ssstlon J end 8Se8on ~ ,T7b.2 10.00 10.50 1,021.71 6 9 878.21 of q~ryyy~iwnf ~Il.~yi„A ~VN„~ep~l~iq~w~WnpAY W1PMY~fwmwrv ~. ~$ETTLEMENT OFFICER`S Ssltlsmsnt Agsnt CSANfsd m M a true copy. (lOtNIEBT6rd0/lMNEBTb7-00/e); DAILY INCOME FUND - US GOVT PORTFOLIO PO BOX 149 MONTPELIE VT 05601-14g9 J ROBERT GIBNEY ooot,~a 1140 BAISH ROAD MECHANICSBURG PA 17055-9727 Rep. 99998 HOUSE ACCOUNT -GENERAL EQUITY SERVICES INC 1 NATIONAL LIFE DR MONTPELIER VT 0564-0001 (DENT. NO. OR SOC. SEC. NO. 2841 910000872 Confirm Trade oouar wmouni ghare Prica ""°'°° Data Date Transaction Of Transaction Transaction Shares Owned 1/20 1/20 WITHDRAWAL PAYMENT -CHECK 100.00 1.00 100. 0 1,445.160 ~~~ a~,~~ Fund (dent. No. Your Payment Option Check Check 03-035803 Dividends Cap. Gains Date NO• u REINVEST REINVEST 01/20/10 254233 Total Shares Held In Certificate Form + Non-Certificate Form 1 , 44j : 1 ~j0 = Total Shares Held 1 , 44 160 ColMkm Trade Traneeotlon Daaription TnrmAotbn t?<h~n Date Date Dollar Amount Prioe ~g 6 8hws ThM S e~ Traneaotlon Owner Prior Balance 01/20/10 01/20/10 WITHDRAWAL PAYMENT -CHECK -100.00 1.00 -100.000 1,545.180 1,445.180 02/78/10 02/19/10 WITHDRAWAL PAYMENT -CHECK -100.00 1.00 -100.000 •180 03/18/10 03/19/10 WITHDRAWAL PAYMENT -CHECK -100.00 1.00 -100.000 1,245.180 03/31/ 10 0.9/91/ 10 DIVIDEND REIN 0.01 1.00 0.010 1,245.170 DNtrlbulbn GpthMSO Dividends: Reinvest CapNal Gains: Reinvest SYSTEMATIC 01/20/2010 ®$lAt~ll@L WITHDRAWAL investme~ts° STATEMENT PO Box 1499, Montpelier, Vermont OS(~ Tlar>SferAger>t, SentinetPdminetratiwe Services, Inc. 18ooz&z.FUND I sentinelinvestrrtentscom 4507 North Front Street Suite 201 ~ Hazrisburg, FA 17110 tel 717 255 6G6G fax 717 255 G651 .. toll free 800 G7G OG73 MorganStanley SmithBarney June 15, 2010 ~~~~~~ Irwin & McKnight, P.C. Attn: Douglas G. Miller ~ ~~~ 1 6 20~~ 60 West Pomfret Street lRWIN & INcKNIGHT Carlisle, PA 17013-3222 1AW OFFICES ibn ey state of J. Robert G RE: r / T jJ.1N@.. V<1 /VN,.h• O1/Yo/'201U SSN: 203-10-1017 Dear .Atty. Miller: Please be advised that I;.Robert,Gibney.);teld. two. accou,.nts with Morgan Stanley Smith Barney (acct #41.0-a3&986-~03,and.#410-O457A3-003) at th~.,fime,of.his death.. Account #410-038986-003 was anindividually-owned brokerage account titled J. Robert Gibney with no change in ownership.or registration .within the past year,, The account was opened .on March 10, .1992. Account, #4J0-945703-003. was jointly-awned, with his daughter, ~arolyti ~r.'Crag. This account vas ope~le~1 on November 25, 1996 Arid is titled I; Robert Gibney: & Carolyn G::Craig'J3' `tEN ;: . _; -.. -- _ __ -- _-- .. ... .. ~.. .. .. The following inforrttation represents;the~datc~, of death :values.for ah secFirities held iri acct #410-038986 b3~ J', Robert.Gibney on his date'of death (January 20, 2010): Sew N nie/ S 1 No. of Shares price Total Valllg oa 1/20/10 BANK DEPOSIT PROGRAM - 15,165.83 shs $1.00 $15,165.83 MONEY MARKET (BDPS) _ _ AMLRiCAN,'YEVVPERSPECTIVE i 5,965.599::hs ( $25.15 $150,U.i4.5) FUND C (NPFC}~ _ VANGUARD LG TM 1'X EX INV 3.213.466 shs $ 11.O1 $35,380.26 __ (vwLTx) FRANKLIN INCOME C (FCiS;O i ''6.396.956 shs $2.1 ? I $55,697.58 VALISE T...INF PI2FMIER GRW . I T!NC V Al_5kj 1----- ----._.-. r. 416.000 shs ~ ------ _ $i33~ i ' _-_ $<L.'.89.28 tO~K1C(,a EiII.LIP~ it'(~!').__ r- '-- _.. _. ~ Ii)0 OUl? 51',s . _ $52 8?5.. ~5,2$3_5C? --- - IirtiNK t}k lv;f;_.hICA:.(;.tl' . ~ 3ij0 ('01; shs, , $16 4f)5 .. ; ~~.921.5(; ` ~ Investments and services i~if~Cre!. thtcwgh 1VIaa'gaa Stanley Smith Barmy LLC, and accouais carried by yloroan Stanley & C;o. Incorporated; members SIPC. .. Morgan Swnley Smirh Barney LLC. Member SlI'C. .., '1!r'"- ~- CENTURYTEL INC (CTL) 300.000 shs $35.315 $10,594.50 MS EMERGING MKTS 1,500.000 shs $14.385 $21,577.50 DOMESTIC DEBT (EDD) D R HORTON INC (DHI) 300.000 shs $12.20 $3,660.00 FIRST AMERICAN CORP (FAF) 100.000 shs $30.465 $3,046.50 INTEROIL CORD (IOC) 200.000 shs I $77.245 I $15,449.00 FORD MOTOR CO NEW (F) 300.000 shs ( $11.595 ~ $3,478.50 I HERSHA HOSPTTALITY TR CL 1,000.000 shs $3.66 $3,660.00 A (HT) I YAHOO INC. (YHOO) I 1,300.000 shs: ~ $16..465 y21,=404.50 ~ MOR CAIN STANi..~Y (MS j I 1,500.000 shs $30.795 $46,192..50 COMCAST CURP (1YEW) CLASS 193.000 shs ~ $16.43 $3,170.99 A (CMCBA) HONEYWELL INTERNATIONAL 200.000 shs $42.285 $8,457.00 INC (HON) DISCOVERFINANCIAI. 900.OOOshs $14.79 $13,311.00 SERVICES (DFS) --- -- ~ 7PMORGAN CHASE $ CO (JPM) i :00.000 shs: T i x;43. ] 95 ~ $4, 14..10 . -~.I ----- f--- - - ii __ I ._ ~-.~~ HERSHA'HOSPITAL 8.00%n SER i 700.000 shs i $2L85 ~ $15.295.00 A (I~r.A) CBS CORP NF_W CL B (CBS) 600.000 shs $13.55 I $5;130.00 - --•- ~ _ ~ WINDSTREAM CORP (WIN) 206.000 shs ~ I $10:885 i " $2 42.31 ~ ry 6 50 MOTORS LIQUIDATION CO j 1,000.000 s .65 $0.5s $52 . ~_ (MTLQQ) ~ - __ ~ Investments and seniccs offered dvouoh Morgan Stanley Smith Barney L.LC, and accounts carried by Morgan Stanley & Cci. In:orporated; members SIPC. t> ~---- SELECT AQEDICAL HLDGS CP ~ 200:000 shs ~ $10.26 $2,052.00 (SEM) DEERE & CO (DE) 300.000 shs $56.355 $16,906.50 GENERAL ELECTRIC CO (GE) 800.000 shs $16.505' $13,204.00 HARSCO CORP (HSC) I 600.000 shs $34.25 $20,550.00 JOHNSON & JOHNSON (JNJ) i~ 200.000 shs ~ ~ ~ $65.21 $13,042.W LOWES COMPANIES LTC (LOW) ; 1,750.000 shs I $23.015 ~ $40.276.25 PFIZER INC (PFE) 1,400.000 shs $20.115 $28,161.00 RITE AID CORP (RAD) 8,000.000 shs $1.51 $12,080..00 ~__ 13 I l'<3 60 $5 SUSQUEHANN A BANCSHARF.S (SLJSQ) i 720.000 shs $7. -~-~ . > i --- --__ I UNIT IMIT MUM INSD PA 7QPS (INPA7Q) 10.000 shs $289.18 $2,891.80 GMAC 7.259'o DUE 09/15/17 3Q000.000 shs $100.00 -$30,000.00 (CU$IP 37042GF76) GMAC 6.70% DUE 12!15/19 I 75,000.0!x1 shs i $100.00 $75,000.00 (CUSIP 3704AOVE9) ~ _ ~ ~ The following information represents the date of death values for all securities held in acct #410-045703 (joint account) on his date of death (January 20, 2010): ~-1 )` ~~~, ~~~; ~N mel mbol No. of Shares Share price Total Value on 1!20/10 BANK DJ~POSIT PROGRAM - 1,954.79 shs $1.00 $1,954.79 L_MONE MAR1CFi:T (BOPS) . ~ Y,_ ~ CHFSAP$AKE EN):RG'Y CORF i 300.000 shs $27.615 $8.284.:10 (C1IK) ~__. ~ ._. _.._~ ~ MORGAI~ ST.p~1I.EY' (MS) 1,000.000 shs $30.795 $30,79~d ( Invesunek;ts and services offered through Morgan Stanley Smith Bazney LLC, and accounts carried by M~r~«n Stanle~• & Co. Incorporated; members SIPC. JPMORGAN CHASE 8c CO (JPM) 400.000 shs $43.195 $17,278.00 AT&T INC ('f) 300.000 shs $25.865 $7,75.9:50 SUSQUEHANNACAPT 9.3759'0 1,000.000 shs $23.925 $23,925.00 (SUS.A DU FONT EI DE NEMOURS & 300.000 shs $34.44 $10,332,00 CO DD) FREDDIE MAC (FRE) 1,000.000 shs $1.32 $1,320.00. FANNI)~. MAE:(FNM) 1,000.000 shs $1.075 --•-- - __ $1,075.00 RTI'E AID CORP (RAD) ~ 4,000.000 shs $1.51 $6,040.00 Please feel free to contact our office at 717-255-6690 with any questions. ly> ~" v/ Emily L. Biden Reg'd Cliept Service Associate The Beshore/Owen/Tltomas Group This report ha8 been generated from irtfornation that Morgan Stanley Smith Barney LLC and its Flnaricial Advisors and Investment:Represerttatitr~ (collectively "we" or "us") believe to be reliable and accurate. We do not, however, represent or warrant the; accaracy or t~mpleteness of the information contained' in this report. You, the client, have provided us the datafrom which this report:has~baen generated: The report ha8. been caiculatecf frorrsnftware and formulas that were not developed by us. As such, all calculations, estimates and opinions iruduGed in this report constitute our best judgment 2s of this date and upon the Infornation you have provided us and may he subject to change. It is yqurreaplamsibility to,da-your own evaluation, and check calculations to determine the accuracy of the informaton contained in this report. Neither we nar our affiliates will be responslbis for the consequences of your reliance upon any opinion; cakulation or other information contained herein or for any •amlasion. Investments and services offered through Morgan Stanley Smith Barney LLCM and accounts carried by Morgan Stanley & Co. Incorporated; mamhars SIPC. ~Y r 4507 North Front Screec Suite 201 Harrisburg, PA 17110 cel 717 255 G666 Eax 717 255 6651 toll free 800 6760673 August 4, 2010 Irwin & McKnight, P.C. Attn: L'ouglas G. Miller 60 W"est Ponli.'ret Street Carlisle, PA ]7013-3222 RF,: 'Unified Credit Trust Under Last Will & Testament DTD 01/18/1996, J. Robert Gibney & Kirby Beshore 1TEES Trust Tax-Id: 23-7874945 Dear Atty. Miller: MorganStanley SmithBarney RECEIVED AU6o52010 1 & iVlcKNIGHI LAW OFFICES The following, infermafiori represents the date of death valuss.for all securities held in the Unified Credit 'Trust acct#410='046625=039'ori'J: Roberfi CJibney's date of death (January 2U, 20; 0): _~ T Share ,Sfxnn :~a~t.r5vtnbol _ ~ S 'Vo of Shuxes i -. ~191.1Q0_shs.... _ Piice ~ .. ~? 00 • ~ ~ •- Totai'~aluwdn 112.Of10 ~ r ~ 5891 70 'DPS MO1~E~ IYfAItKET .: , AMERICAN-BALANCED A _. - 3,741.49! shs $16.56 , $61,959:1.7 (ABALX) _ AMERICAN CAP WRLD GR & 4,734-394 shs $34.14 $161,632.21 INCA (CWGIX) _- AMERICAN INC FD OF AivIElitICA A (AIy1cCX) 4,~;42.649 shs _ $15.67 ~ ~ $63,348.31 ~ DAVIS NEW YORK VENTURE .A 1,592.462 shs $31.44 $50,067.01 -NYVTX ~ -- iVY ASSET STRATEGY A 303.794 shs $22.41 $18,013.02 (WASAX) V:AN ILAMPEN EQi;TIT'Y, & - 119C(7IvIE`Q~,(ACL''I}~) ~ - -.12,4.6.7.745 shr -- -- -'$7.98 ,. I x99.492.61 -. ~~ `I RiiA.~-''$1R,CJ ~~ A2U r~'I)sL.D ..~ L-- QIJAL.Y~FD ~~`1 ^_ ~ i ; i00 000 clt5 1- ---__ -- - i I_ $ i 3 93 ~ 1-~---1. - . ~ n2U.895 tHl : ~ --•------ - ._..J Investments and services offered though Morgan Stanley Smith:Barne-y LLC, and accounts carried by 'Morgan Stanley & Co. Incorporated; members SIPC. Morgan Srxnlty Smith 8amty LLC. Memher SIPC. ENllPRO IND INC (NPO) 80.000 shs $25.985 $2,078.80 FEDEX CORP (FDX) 200.000 shs $83.94 $16,788.00 MICROSOFT CORD (MSFT) 85U.W0 shs $30.625 $26,031.25 NUVEEN PENN INVT QUAL ~ MUNI FD (NQP) 700.000 shs $13.225 $9,257.50 HIGHWOOD PPTY 8.0046 CUM . PF,RP B (HIW.B) 121.000 shs $24.93 $3,016.53 GMAC 7.2596 DUE 08/15/18 (CUSTP 37042G7C4) 10,000.000 shs $81.50 $8,150.40 ALLSTATE CHOICE RATE 10 YEAR GUARANI RD-11/17 SD2 W/ STANDARD DEATH BENS AMR GROWTH-INCOME SD2 W/ STANDARD DEATH BENE AMR GROWTH-INCOME Sincerely, ~~~ 151247 ~~852959 1~ 9.29 "- 82,546.66 7107 82,546.66 56,676.09 710r 78240 56,676.09 Emily L. Biden Reg'd Client Service Associate The Beshore/Owert/Thomas Group m This report has been generated from information that Morgan Stanley Smith Bamay LLC and Its Financial Advisors and Irnestment Representatives (collectively "we" or "us') believe to be reliable and accurate. We do not, however, represent or warrant the accuracy or completeness of the information contained in this report. You, the client, have provided us the data from which this report has been generated. The report has been calculated from software and formulas that were not developed by us. AS such, all calculations, estimates and opinions included In this report constitute our best judgment as of this date and upon the information you have provided us arrd may be subj5ct to change. It +s your responsibility to do your own evaluation, and check calculations to determine the accuracy of the information container! in this report. Neither we nor our affiliates will be responsible for the consequences of your reliance upon any opinion, ca~ulatlon or other information contained herein or for any omission. Investments and services offered through Morgan Stanley Smith Barney LLC, and accounts carried by Morgan Stanley 8r Co. Incorporated; members STPC. ~ Web~EST Receipt Page 1 of 1 ,, Contract No.: 81566355 Saturday 1/30/2010 3:08 PM Customer Name: Carol Craig 2717 Chesnut Dr Camp HIII, PA 17011 1568K ~: AD49853 Cust Ph -Email: 717-737-4874 U-HAUL MECHANICSBRG 4725 GETTYSBURG RD (811055) MECHANICSBURG,PA.17055 Rental Date/Time: 1/30/2010 10:02 AM Ratorn Dste/Tima: i/30/2010 3:08 PM Wa Rarrtrl Parioda: 1 X (717)763-7677 ----- E ~ ~4 ~ ~ ~ ~ i~ lnvironmantal Paa: SabTOtal: rani Tax: $1.00 $39.83 $3.19 ' ~ ~ ~' ~ I ~ I ~ ~ ~ I ~ ~ Motor Vanida Tax: ~~ ~~; PravMua Paid: $2.00 545.02 $0.00 Card Type: Account: Auth: Visa X)Od(XXXXXXXX43400 09329G Cradlt Card Payatatet: Nst Pald Today: $45.02 $45.02 • I conflmt that during the teen of my rental there was not an aaldent Invoivinq the rented U-Haul equipment and no Incidence where this equipment struck or otherwise caused damage to any person or property either while on a public road or private property. Thera was no Injury or damage sustained by me or any other drivers or passengers of this equipment. ~` Customer Signature - (Carol Craig) Scott Greenfield CoMrad: Ramarka See Ed at time of rental....Ed How are we doing? Please go to http://www.uhaul.com/review and let us know if you received the level of quality and service you expect from this U-Haul location. rt ~~iro ~Ur~ 1-0 rndvFi yj~i~i Sf~ GV6,~v1 X165 `~lduS~ YvuUL y5 ate, I~ ~~. ~~, i v -- =printinjt obiects&sruid=6B1D103F-4... 1/30/2010 ~~ Joe's Outdoor Services r~ 1731 Monterey C~ ~' .,~~ ~~ ~.u-,~"~ ~~ ~ r ~` :, Dover, PA 173ti6 Date 2/3/2010 Invoice # 307 .~ --t-- : ~ ,---T- -: ~..`~fir Y,y w`~w'a~~~rta r);}"4p9t ~~~~..y:i iht}~r'~f~,:~}'.~, L~~_:.__.~~._`~ i;: i' ,u,.£•' I ~~.:1f Carol Craig 2717 Chestnut St. CampHill PA 17011 P.O. # Terms hauling job i Ship Date 2/3/2010 Due Date 2/3/2010 Other cleanup for property ~ 1140 Baish Rd. Mechanicsburg, ! 375.00 i Pa 17055-9727 I i '. i I ,I j i i ,~ i I Thank You! Joe ....._ _. ~._ .>be's Outdoor Ssnvicss R2Glrlsi~aoi.com ,~ i i I i I Subtotal Sales Tax (6.09 _i Total 717-764-6177 Payments/Credits Fax 717-764-6177 Balance Due 375.00 $375.00 $0.00 $375.00 $-375.00 $0.00 ~~ ~~ ~' m ~~ u l~.