HomeMy WebLinkAbout01-04-111505610143
REV-1500 EX (01-10)
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARThENTOFREVENUE
Po Box.2sosol INHERITANCE TAX RETURN 21 10 0793
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
165 14 9386 07 13 2010
Decedent's Last Name Suffix
MCKINLEY
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Date of Birth
02 15 1919
Decedent's First Name MI
CATHERINE M
Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER O F WILLS
FILL INAPPROPRIATE OVALS BELOW
1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise
(date
of
death af
t
er 12-12-82) ~ 5. Federal Estate Tax Retum Required
g Decedent Died Testate
(Attach Copy of Will) ~ ~~
rr~~
~
l
~• (AttacheGoMaof Tnest a Living Trust
PY ) ~ 8. Total Number of Safe Deposit Boxes
9. Litigation Proceeds Received ~ 1 D• Spo~/ueenP~v~rt~~ a ditl(dat8es~f death
ba ~ 11, Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
WM D SCHRACK III 717 432 9733
~,.
,,
First line of address
124 W HARRISBURG STREET
Second line of address
City or Post Office State ZIP Code
DILLSBURG PA 17019
Correspondent's a-mail address: Schracklaw@comcast.net
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REGISTER OF WISE ONL~f_
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Under penalties of perjury, I declare that 1 have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, co and compl e. Declaration of preparer other than the persona representative Is based on all information of which preparer has any knowledge.
I NATURE ERSON ONSI E FOR FILING RETURN DATE
Victor J. Marnien
ADDRESS
41201 Delaire Landin Road Philadel hia PA 19114
SIGNATURE OF PREP R R EP ENTATIVE DATE
Wm. D. Schrack III ~o~. ~ b''~ld
ADDRESS
124 W. Harrisburg Street, Dillsburg, PA 17019
Side 1
1505610143 1505610143 J
J 1505610243
REV-1500 EX
Decedent's Name: MCKlniey, Catherine M.
Decedent's Social Security Number
165 14 9386
RECAPITULATION
1. Real Estate (Schedule A) ....................................................................................... 1.
2. Stocks and Bonds Schedule B
( ) .............................................................................
2. 18 4, 4 7 2. 3 5
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3.
4. Mortgages 8~ Notes Receivable (Schedule D) ........................................................ 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5.
8 62 , 4 92.92
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous fan; Probate Property
Se
arate Billin
S
h
l
R
d
t
d
G
p
g
(
eques
c
e
u
) u
e
............
e 7,
8. Total Gross Assets total Lines 1-7
( ) .....................................................................
8. 1, 0 4 6 , 9 65.2 7
9. Funeral Ex enses & Administrative Costs Schedule H
P ( ) ....................................... g 62 , 218.58
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10.
11. Total Deductions (total Lines 9 8~ 10) ................................................................... 11 62 , 218. $8
12. Net Value of Estate Line 8 minus Line 11
( ) ..........................................................
12. 9 8 4 , 7 4 6 . 6 9
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
l
ti
h 1 0 0 0
0 0
an e
ec
on to tax
as not been made (Schedule J) ............................................... 13. .
~
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. 9 8 3 , 7 4 6. 6 9
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 0 , 0 0 16.
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 0 0 17.
18. Amount of Line 14 taxable
at collateral rate X .15 9 8 3, 7 4 6. 6 9 18.
19. Tax Due ................................................. ................................................................ . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
0.00
0.00
0.00
147,562.00
147,562.00
a
Side 2
1505610243 15U5610243
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-10-0793
DECEDENT'S NAME
McKinley, Catherine M.
STREET ADDRESS
Messiah Village
100 Mt. Allen Drive
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
142,500.00
7,378.10
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Total Credits (A + B)
(1) 147,562.00
(2) 149,878.10
(3)
(4) 2,316.10
(5)
Make Check Pa able 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 :............................................................................... ^ 0
b. retain the right to designate who shall use the property transferred or its income :.................................. ^ ^x
c. retain a reversionary interest; or ............................................................................................................... ^ 0
d. receive the promise for life of either payments, benefits or care? ............................................................ ^ 0
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? .................................................................................................................. ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)j.
. 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)j.
. 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)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.
Rev-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FILE NUMBER
All property jointly-owned with right of survivorship must bedisclosed on Schedule F.
ITEM
NUMBER CUSIP
NUMBER
DESCRIPTION
UNIT VALUE VALUE AT DATE
OF DEATH
1 4,226 shares of AT&T Inc. - 4,226 shares (see attached) 28.173902 119,062.91
2 637 shares of Comcast Corporation - 637 shares (see 18.2 11,593.40
attached)
3 237 shares of Frontier Communications Corporation - 237 8.62 2,042.94
shares (see attached)
4 14 shares of MetLife common stock (see attached) 40.93 573.02
5 496 shares of Qwest Communications International Inc. - 6.3345947 3,141.96
496 shares (see attached)
6 990 shares of Verizon Communications, Inc. - 990 shares 31.93 31,610.70
(see attached)
7 612 shares of Vodaphone Group PLC. - 612 shares (see 26.87487 16,447.42
attached)
TOTAL (Also enter on Line 2. Recapitulation) 184,472.35
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98)
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF _ (FILE NUMBER
InGude 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.
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
REV-1151 EX+ (10-08)
COM N RESIDAEN~DECED~N~~~ANIA
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
McKinley, Catherine M. 21-10-0793
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
15,823.95
B.
1. ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Victor J. Marnien
Street Address 41201 Delaire Landing Road
City Philadelphia State PA Zip 19114
Yearlsl Commission paid 28,500.00
2. Attorney's Fees Wm. D. Schrack Ill 13,500.00
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
4. Probate Fees 727,50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 3,667.13
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 62,218.58
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
McKinley, Catherine M. 21-10-0793
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex e~nses
1 Gallo's Seafood -funeral luncheon 776.95
2 Walter J. Meyers Funeral Home 15,047.00
H-A 15,823.95
3 Other Administrative Costs
Clerk of Orphans' Court -Fiduciary Release filing fee
20.00
4 Commission to liquidate securities 797.82
5 Cumberland County Law Journal -estate advertisement 75.00
6 Miscellaneous expenses during period of administration (phone, fax, postage, etc.) 50.00
7 Notary Public fees for stock transfers 35.00
8 Register of Wills -additional Short Certificates 40.00
9 Register of Wills -Inheritance Tax Return filing fee 15.00
10 Reserve for future administrative expenses 2,500.00
11 The Patriot News -estate advertisement 134.31
H-B7 3,667.13
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
REV-1513 EX+ (11-08)
COMIN~ ID N~DECE~~RNANIA
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
McKinle ,Catherine M. ~ 21-10-07 93
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF ESTATE
NUMBER PERSONISI RECEIVING PROPERTY DECEDENT (Words) ($$$)
t
I TAXABLE DISTRIBUTIONS (include outright spousal
• distributions, and transfers
under Sec. 9116 a 1.2
1 Ayne and Alfred Helwig Sister-in-Law 1,000.00
41 12th Avenue
Seaside Park, NJ 08752-1914
2 Victor J. Marnien Nephew 325,720.22
41201 Delaire Landing Road
Philadelphia, PA 19114-5305
3 Sister Patricia Marnien Niece 325,720.22
Holy Cross Convent
149 E. Mount Airy Avenue
Philadelphia, PA 19112-1722
4 Christopher and Roberta McKinley Brother-in-Law 1,000.00
977 W. Saddle River Road
Ho Ho Kus, NJ 07423-1207
5 Eileen V. O'Sullivan Niece 325,720.22
76 Audubon Park
Dillsburg, PA 17019-9140
Total 979,160.66
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet, as a r o 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
~ St. Leo Roman Catholic Church 1,000.00
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 1,000.00
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
~zzs# iU ttn~ des#tztrroent
of
CATHERINE M. McKINLEY
BE IT REMEMBERED, that. I, CATHERINE M. McKINLEY, an unremamed widow,
presently a resident of Messiah Village, at 100 Mt.. Allen Drive, Mecllallicsburg, t lpper Allen
'lownsl)sp, Culnberlalld C;oullty, Pennsylvania, being of-sound mind, memory alld ululerstalldillg, do
make, publish and declare this as alld tar Illy Last. Will atlcl Testarllent, hereby revolting a.ncl makill~
null and void any and all Wills and Testalllellts and tivritillgs in the Ilature thereof by Ilse at any time
lleretoi-c)re made.
ITEM 1: I direct. that my 1lereillafier 1lallled liJxecutor pay all Illy just debt-S, Illy tullet x'11
e`CpC'.115('S, ail(1 the expenses Ul the adII11I115tI'at1011 0l lily CStat('. Wlt.ll thls dlrCCtlO11, I authoriic an(1
CII1pOWCI" IIly L' XCClltOr t.U E;XpeIld lOr Illy iuI1L1'al CxpCI1SCS itll(1 lnterlllellt SllCll itIT10L1I11S ati Illay 1)C
COIlsldered I1CCeSSary and proper, Without. re,E~clyd t0 ally llIlllt that maybe prCSCrlbed by a CC)urt. O1•laW,
My FJxecutor shall remit to the Church through which my funeral is conducted the sum of
ONE THOUSAND DOLLARS ($1,000.00). My wish is that Iny burial be tllrougll tllc St. Lev
Rcnn~ul Catholic Church, at 6G58 Keyst.cnlc Street, I'lllladclpllla, Pellnsyhrallia 19135, btlt Il ll IS nc)t.
possible, then my requirement. is that. burial be through .~t.. DOI111111C~S Rolllall Cat11011C Church, aIld
Illy rClllalilS bC 1I1tCrre(1 Wltll tllase ()1 Illy late HUSI)a[1(1 at..~t.. DoIl11I11C's ROIn~tll Catholic CI-lttrcll's
ccmelery.
ITEM 2: I direct my I~Jxecut.or to Pay all iuheritallce, estate, successloll, and legacy taxes
of• whatsoever nature and kind, t.o which my estate, or the transfer of ally property j)aSS1I1~T 11CI'(',tlll(l('r
or otherwise passii~~; by reason of my demise, may be ~tiliject, and to ch~uge such taxes ag.~i»st my
residuary estate, it l~ci~lg my intention that none of the :ll~<.~resaid taxes, either federal or stag, on ~u1y
property required t.o be included in my gross estate, under dze provisions of any state or federal law
now in force or hereafter enacted, shall be prorated among the persons interested in my estate to
whom such property is or may be transferred or to whom any benefit accrues.
ITEM 3: I give and bequeath the sum of ONE THOUSAND DOLLARS ($1,000.00)
to my late husband's sister, AYNE HELWIG and ALFRED, her husband.
ITEM 4: I give and bequeath the sum of ONE THOUSAND DOLLARS ($1,000.00)
to my late husband's brother, CHRISTOPHER McKINLEY, and ROBERTA, his wife.
ITEM 5: All the rest, residue .and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed, including property over which I have a
power of appointment, I direct my Executor hereafter named divide into three (3) equal shares to be
distributed as follows:
A. One (1) share to my niece, SISTER PATRICIA. MARNIEN, presently of Holy Cross
Convent, 149 East Mount Airy Avenue, Philadelphia, Pennsylvania 19119-1722;
B. One (1) share to my niece, ELf FFN V. O'OSULLIVAN, presently of 76 Audubon
Park, Dillsburg, Pennsylvania 17019; and
C. One (1) share to my nephew, VICTOR J.11~iARNIEN, presently of 41201 Delaire
Landing Road, Philadelphia, Pennsylvania 19114.
Page -2-
at&
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IMPORTANT TAX RETURN DOCUMENT ENCLOSED
OOD180
llll~l~lllllllllllr~ll~l~~llll~llllll~lllll~~lll~l~~l~llll~l~llll
Recipient
VICTOR J MARNIEN EX EST CATHERINE M MCKINLEY
41201 DELAIRE LANDING RD
PHILADELPHIA PA 19114
Computershare ~"
Computershare Trust Company, N.A.
P.O. Box 43078
Providence, RI 02940-3078
Within USA, US territories 8 Canada 800 351 7221
Outside USA, US territories 8 Canada 781 575 4729
vvww.computershare.com/att
01002085344 FID
~~~~~~~~~~~~~M~~S~~~~~~
SSNITIN Certified Yes
Symbol T
_ Cusip 002068102
- OO1CS00(17.SAL.C.REG.D.L.CIS.051629_296!/0(x)1 80/000 7 80/i
aY ~~4.. v •C~ !~ ~a~it t i; 5"~-~,: eG ~'~^"'+ryTi .~~j ~ ~ +` is ~ m+'.'' ~yF. ~ <K 4~' ~ s t
'""ii plc, r ~ s. ~ +i '~ ~ d ~d t r ,~Y ~ F + Y . ~ `..,
~.~~'pp.,,. s>.a'.' ?- wYc r~ ~*~. ~.r••w, ' . ,• u v. j»-,/ <E*~s .r~h1'~ :.., F 7 - ~, ~' ~i..yr x t r ~ ", _
~: rr st~....;~*Y.a tY ,„Y.~.t, ,..1s.:'t ~:-a fibs&:a'. C'+-....fiG. .t.:+r;.-..~-'~!~ .'~ii':ni~, }..~ [..R ~. X.x+:d~. .3x 'ir ,~:i ..i~.'.
^ Corneccted (if checked) Copy B -For Recipient
Form 1099-B -Proceeds from Broker and Barter Exchange Transactions 2010
This is kttportaM tax information and is being tumfshed to the Mtemal ltevsntre Service. If you are required b 8k a retain, a negligence
penaky or other sanctlon may be imposed on you ff ihls income Ia taxable and the tRS deearmlrres that it has not been reported.
VICTOR J MARNIEN EX EST CATHERINE M MCKINLEY
Recipient 41201 DELAIRE LANDING RD
PHILADELPHIA PA 19114
to Date of Sale ft, - 2 Stocks, Gross Proceeds
or Exchange ~ CUSIP No. Bonds, etc. ($) Reported to IRS
08 Oct 2010 002068102 119,062.91 Yes
FEDERAL INCOME ~
TAX WITHHELD. (S). Descnption: Name of :issuer Transaction
0.00 ATBT INC. Sale - 001
NOTE: Computershare wiN report the amount in Box 2 to the IRS. The difference between the gross proceeds amount in Box 2 and the net proceeds
you received represents any fees, charges, or withtx>fd'mg taxes you may have ppd.
Form 1099=6 (Keep for your records)
Summary This advice is a result of the sale of Plan and/or Direct Registration shares.
Account Number 1002085344
Recipient's ID No. Z7-6747586
Payer's Federal ID No. 43-1912240.
OMB No. 1545=0715
Department of the Treasury - Inlemal t3evenr~ Service
Payer's Details
COMPUTERSHARE
P.O. BOX 43010
PROVIDENCE RI
02940-3010
Trade Transaction Description Shares/Units Price Per Gross Amount Deduction Deduction Net Amount
DatelTime I I Sold (Share/Unit I - of Sales l
($) ($) I Amount ($) I Type { of Sale $
(. )
10/081201014:02 Sale 4,226.000000 28.173902 119,062.91 432.60 Transaction Fee 118,630.31
Computershare Trust Company, N.A., as agent, upon written request, will provide the name of the executing broker dealer assodated with the transaction(s), and within a reasonable amount of time will disdose the source
and amount of compensation received from third parties in connection with the transaction(s), if any. If trade time is not inducted above, it may be available upon written request
71UTX
A T T 'f"'
001CD70008 OOHX2E-(FT)
Comcast.
IMPORTANT TAX RETURN DOCUMENT ENCLOSED
000470
Illl~lllliilllllli~lll~l~~llllrlillllrlllll~lili~i~~irllll'1'1111
Reapient
VICTOR J MARNIEN EX EST CATHERINE M MCKINLEY
41201 DELAIRE LANDING RD
PHILADELPHIA PA 19114
Cpmputershare
Computershare Trust Company, N.A.
PO Box 43078
Providence, RI 02940-3078
Within USA, US territories ~ Canada 888 883 8903
Outside USA, US territories ~ Canada 781 575 4730
vuvvw.computershare.com/comcast
Holder Account Number
03018172967 FID
SSN/TIN Csrtlfled Yea
Symbol CMCSA
Cuaip 20030N101
ooic~ooo~swt..cxac~.rat..c~s.osi6s~.,2~s~vooa~aoooam~
~r~ce ~~~~~~I ~ ~f~x :Form '109~i~ 4 ' ~ ~ ~ f 1F` ~k ~~ ~ ~' ~ _ ~ ~ , ¢ a.~ ~ ~ ,
Comec~ed (if checked) Copy B -For Recipient
Foram 1099-B -Proceeds from Broker and Barter Exchange Transactions 2010
This is important tax Irrfomatlort and k being fumbhed to the Internal RererNre Servkre. M you are required m tik a ret-rm, a negligence
penalty or other sanction may be Imposed on you if this trtcorne b taxable and the IRS determines that It has not been reported.
VICTOR J MARNIEN EX EST CATHERINE M MCKINLEY
Recipient 41201 DELAIRE LAN~NG RD
PHILADELPHIA PA 19114
Account Ntsrtber 3018172967 :~~
Redpient's ID No. 27.6747586.
Payer's Federal ID No. 43-1912740
OMB No. 1545-0715
Department of the Treasury - Irdemal Revenue Service
~a Date of Sale 1b CUSIP No. (~ Stocks, Gr~ Proceeds I Pa er's Details
or Excha e . I Bonds, etc. $) Re reed to IRS Y
13 Oct 2010 20030N101 11,593.40 Yes COMPLITERSHARE
P.O. BOX 48010
FEDERAL INCOME ~ PROVIDENCE RI
TAX WITHHELD (;) Description: Name of Issuer Transaction
02940-solo
0.00 COMCAST CORPORATION Sale - CA1
NOTE: Computershare vriq report the amount in Box 2 to the IRS. The difference between the gross proceeds amount in Box 2 and the net proceeds . .
you recenred represents arty fees, d~arges, or withholding taxes you may have paid.
rv~ ~ ~ ~ ~ varo ~neep rvr your recvras~
Summary This advice is a result of the sale of Plan and/or Direct Registration shares.
Trade Shares/Units Price Per Gross Amount Deduction Deduction Net Amount
I Transaction Description I I ( I
Date/Time Sold Share/Unit (~) of Sales ($) Amount (aj Type of Sale (~) ~.
10/13/201014:01 Sale .6:17.000000 18.200000 11,593.40 109.18 Transaction Fee 11,484.22
Canputershare Trust Company, N.A., as agent; upon written request; w0 provide the name of the exeartirtg broker dealer aasodated with the transadiort(s), and wittidn a reasonable amount of ti-rrte wiN d~sdose the source
and amount of corr~tensetbn received from thkd parties In oortnectlort wl>h the tranaec6on(s), if any. y trade Yme la not inducted above, K may be available u written oast. .
P~ feq
71 UTX C M C S ~"'
001CD70008 nnNx~F_tFTi
o~n er®
Communications
IMPORTANT TAX RETURN DOCUMENT ENCLOSED
000694
i~llr~~li~~il~il~irlllrlrrli~~~i~llilrl~lllrliliri~ri~~llirlrilli
Recipient
VICTOR J MARNIEN EX EST CATHERINE M MCKINLEY
41201 DELAIRE LANDING RD
PHILADELPHIA PA 19114
~,omputershare
Computershare Trust Company, N.A.
PO Box 43078
Providence, RI 02940-3078
Within USA, US territories & Canada 877 770 0496
Outside USA, US territories tr Canada 782 575 2382
www.computershare.com~tnvestor
Holder Account Number
X0000353981 FID
i I~II1~LIUi e~m ~~iil ~~m ~~i~~ a:~l. ~us~ mn nIn um iui i~
ssNmN cer~tied
Symbol
Cusip
ooicsooo~.s,~-[..r:..x~.n.[..cas.osi6sz..x~sro
~,~a~ ~, ~ ~, x =,. ~ w ~ ~ ~ . - '
n~~Y~~:~~t;n±~:~ °.
Yes
FTR
35906A108
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~-
. ~ ~e
Corrected (~ ~~~) Copy B -For Recipient
Form 1099-B -Proceeds from Broker and Barter Exchange Transactions 20'10
Thb is Important tax infonrtratiort and i, belrrp rumiehed to the Irrtsrrrat Revenue service. I(you are required to gle a return, a negllQence
penalty or other sancgon maybe irnpoeed on you i< this inexarrre is taxable and the !R§ deterrnirtes that it has not been reported.
VICTOR J MARN(EN EX EST CATHERINE M MCKINLEY
Recipient 41201 DEUURE LANDING RD
PHILADELPHIA PA 19114
Accour>t Number 0000353981
RedpieM's ID No. 27.6741586
Payer s Federal ID No. 43-1912740
OMB No. 1545-0715
DeparlnieM of the 7reaeury - Internal Revenue Service
to Date of Sale 2
'b CUSIP No Stocks, Gross Proceeds Payer's Details
or Exchange . Bonds, etc. ($) Reported to IRS
13 Od 2010 359J6A108 2;042.94 Yes COMPUTERSFIARE
P.O. (30X 4301fl
FEDERAL INCOME ~
Description: Name of Issuer Transaction PROVIDENCE RI
TAX WITHHELD (s) 02940.3010
0.00 FRONTIER COMMUNICATIONS CORPORATION Sale - C01
NOTE: Computershare vriU report the amount ~ Box 2 to the IRS. The difference between the gross proceeds amount in l3ox 2 and the net proceeds
you received represents any des, charges, or withholda~g taxes you may have paid.
Form 1099-B
(Keep for your rer;orcisj
Summary This advice is a result of the sale of Plan and/or Direct Registration shares.
Trade ) Transaction Description (Shares/Units ~ Price Per ~ Gross Amount ~ Deduction ~ Deduction J Net Amount
DatelTime I I Sotd Shace/Unit ($) of Sales (~) Amount (~) Type I of Sale (~)
1a13no1o ~a:o1
Sale 237.000000 8.620000 2,042.94 43.44 Transaction Fee 1,999.50
Computershare Trust Company, N.A., es agent, upon written request, ws pr~(de the name of the exeaAhtg broker dealer associated with the transaction(s), and wnhirt a reasonable amount of time ws rxsdose the sauce
and amount of contpensatlon njceNed from 1ftM parties in txxtrtectlon with the transac~on(s), if any. y trade tlme Is not included abare, tt may be avaUable upon written request.
7 1 U T X F R O N "~"`
001CD70008 nnuv~c_~tri
1 'o a o- _ x. ~ ~ ®w ~~~ ~ ~ ®i
1
~'~
' CATHERINE MCKINLEY
i
,.
i
i
Acxount Market Vallee
Stock Price as of
11 09 2010 Total Market
Value
$40.530 $567.42
The aggregate amourrt paid to all
Trust Beneficiaries in this distribution
is $165,579,185.12.
Investor ID eos2 ~ao9 ease
2010 Dividend Summary
Record Date Total Trust
Interests Dividend per
Trust interest Current
Distribution
11/09/2010 14.0000 $0.74 $10.36
Payable Date Tax Wfthheld Net Distribution Prior Year
Distribution
12/14/2010 $0.00 $10.36 $10.36
For inquiries about your account, you may visit www.bnymellon.com/shareowner/equityaccess, or call 1-800-649-3593.
Trust Beneficiary Information
You may purchase or sell shares of MetLife, Inc. common stock through
the MetLife Policyholder Trust'(the 'Trust"). free of any commissions or
other fees, under the MetLife Purchase and Sale Program. es amended. A
copy of the brochure describing the program is available on the Internet
at www.metlife.com by selecting Investor Relations and then the
Shareholder Services Information page, or by calling the number listed
above. You are permitted to transfer your Trust Interests only in the
circumstances described in the brochure. You may also instruct that all
(but not less than all) of your shares of MetLife, Inc. c:orrtmon stock held
by the Trust be withdrawn from the Trust. Information regarding your
withdrawal rights may be found in the Purchase and Sale Brochure or by
calling the number listed above
0182619 t33
An annual shareholders' meeting to elect members of the Board of
Directors of MetLife, Inc. and for the transaction of other business is
expected to be held on Apri! 26, 2011. The deadline for submitting
shareholder proposals for consideration at this meeting is November 23,
2010. A copy of MetLife, Int.'s annual report and proxy statement will be
available free of charge on or before March 31, 2011, along with other
MetLife, Inc. and Trust filings under federal securities laws, (i) on the
Internet at www.Metlife.com by selecting About MetLife, Corporate
Governance, under Related Links, (ii) by writing to MetLffe, Inc., c% BNY
Mellon shareowner Services, PO Box 358447, Pittsburgh, PA 15252-8447
or (iii) by calling the number listed above. These and other SEC filings by
MetLife and the Trust are also available on the Internet at www.sec.gov-
Pi~i~Be Nt~t~: it1'ipOr~r~ 2010-Tax Ilr3fi~i'rYti'd'tlori MIJ~`~0
FORM 1099-DIV. U.S. TAX INFORMATION FOR 2010 OMB No. 1545-0110
DIVIDENDS/DISTRIBUTIONS
COPY B FOR
RECIPIENT
RECIPIENT'S TOTAL ORDINARY
IDENTIFICATION NUMBER DMDENDS QUALIFlED DMDENDS FEDERAL INOOME TAX MIITFI~IELD
BOX 1 A X 16 BOX 4
165-14-9386 $10.36 $10.36 50.00
'AVER'S NAME PAYER'S FEDERAL IDENTIFICATION NUMBEF
8NY MELLON SHAREOWNER SERVICES AS
CUSTODIAN OF THE METLIFE POLICYHOLDER TRUST 51-6516887
SECURITY DESCRIPTION TO WHOM PAID
TRUST INTERESTS CATHERINE MCKINLEY
41201 DELAIRE LANDING RD
PHILADELPHIA PA 19114-5305
IMPORTANT 201 O TAX INFORMATION FOR INFORMATION REGARDING THE
REPORTED BY
THE BANK OF NEW YORK
MELLAN
480 WASHINGTON
BOULEVARD
JERSEY CITY, NJ 07310
ABOVE, CALL 1-800649,3593
This Is important tax information and is being furnished to the Internal Revenue Service.
If you are required to file a return, a negligence penalty or other sanction may be
imposed on you if this income is taxable and the IRS determines that It has not been
reported.
Box 1A -Shows total ordinary dividends that are taxable. Include this amount on line 9a of
Form 1040 or 1040A. Also, report it on Schedule B (Form 1040) or Schedule 1 (Form 1040A),
if required. The amount shown may be dividends a corporation paid directly to you as a parti-
cipant (or beneficiary of a participant) in an employee stock ownership plan (ESOP). Report it
as a dividend on your Form 1040/1040A, but treat it as a plan distribution, not as investment
income for any other purpose.
Box 1B -Shows the portion of the amount in box 1A that may be eligible for the 15~° or zero
capital gains rates. See the Form 1040/1040A instructions for how to determine this amount.
Report the eligible amount on line 9b, Fonn 1040 or 1040A.
.,. #; a ..2.-. rnR'.'^I~'C. +Rn!+C.. ri`.
Box 4 -Shows backup withholding. For example, a payer must backup withhold on certain pay
menu at a 28% rate if you did not give your taxpayer identification number to the payer. Se.
form W-9, Request for Taxpayer Identification Number and Certification, for information a
backup withholding. Include this amount on your income tax return as tax withheld. ,
Nominees. If this form includes amounts belonging to another person, you are considered ,
nominee recipient. You must file Form 1099-DIV with the IRS for each of the other owners t.
show their share of the income, and you must furnish a Form 1099-DIV to each. A husband e
wrfe is not required to file a nominee return to show amounts owned by the other. See the 201
General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and W-2G.
.! R
Please Note: The "Check Date," noted below, represents the settlement date of this transaction. Under normal market
conditions, sale transactions are traded 3 business days prior to the "Check Date".
,_
BNY MELLON
SHAREOWNER SERVICES
111 GCt~C:
Logijz ro
Investor ServiceDirect~ ar
www,bnvmellon.com/shareowner/isd
RETAIN FOR YOUR RECORDS
DESCRIPTION
-•
QWEST COMMUNICATIONS INTERNATIONAL INC.
- - ---- ---- ----
--- ~ SHARES SOLD
MNE3TOR /D ~
r
- ---- _-------- ---
CUSIP i ACCOUNT KEY - ------ --_ _..
~ CHECK NUMBER .. __ .. ___._ ...._ ._..._
~ CHECK DATE
_ _ ......
~ _ __ -- ~---
'CHECK AMOUNT
12b338247800__
.
. _ 001 450 74912110 I MCKINLEY-CATHMOF00
I
~ 1 7441252 ~ 10/21/2010 ! $3,082.36
_
_
__
SHARES/UN~T'S SOLD _ _ .
_
--~---T _- -~- - ...- ---
- -- --- -_. ----....- ---
~~ PRICE PER SHARE (S) ~-+-----_ _...._ _ - -- _... .. _ ... .._ .---.. _ .._ _ .._. .. _ - _ -- ----
~ TRADING FEES PAID BY i SERVICE FEES PAID BY
496.0000 6.3345947 , i
GROSS PROCEEDS .TAX WfTHHELD
~ ;COMPANY : SHAREHOLDER .'COMPANY SHAREHOLDER
$3,141.96 $0.00 $0.00 $49.60 $0.00 ~ $10.00
NET PROCEEDS ~ SHARES HELD BY PLAN ~ - ~ - _
$3,082.36 ~ 0.0000
~: ,~
~.
PLEASE DETACH BELOW
CHECK NUMBER: 7441252
by
veri~or
-MPORTANT TAX RETURN DOCUMENT ENCLOSED
006094
Illl'lllllllllllll~lllrl~illll~llllll'11111'llll'l"I'llll'I'Illl
Recipient
VICTOR J MARNIEN EX EST CATHERINE M MCKINLEY
41201 DELAIRE LANDING RD
PHILADELPHIA PA 19114
~omputershare
Computershare Trust Company, N.A.
PO Box 43078
Providence, RI 02940-3078
Within USA, US territories & Canada 800 631 2355
Outside USA, US territories 6 Canada 781 575 3994
www.computershare.com/verizon
Holder Account Number
00013554072 FID
SSNIT1N Certified Yes
Symbol VZ
Cuaip 92343V104
ooit~ootns,~-t..c~.n.L.crs.osi~u
Corrected (if checked) Copy B -For Recipient
Form 1099-B -Proceeds from Broker and Barter Exchange Transactions 2010
Thf: b Important tax won and fa betrtg furrtiahed to the tr~rrwl ReverNre Service. ~ you are required b Bb a return, a negligence
penaky or other sanction may be imposed on you tf thia Income fs tarrabk and the IRS deterrnlrtem that ~ has not been reported.
VICTOR J MARNIEN EX EST CATHERINE M MCKINLEY
Recipient 41201 DELAIRE LANDING RD
PHILADELPHIA PA 19114
Account Number 0013554072
Racipfent's ID No. 27-674758fi
Payer's Federal ID No. 43.1912740 '
OMB No. 1545-0715
Department of the Treasury -Internal Revenue Service
d
to Date of Sale 1b z Stocks, Gross Proceeds
or Exchange CUSIP No. Bonds, etc. ($) Reported to IRS I Payer's Details
22 Od 2010 92343V104 31,610.70 Yes ~~~
~ P.O. BOX 43010 .
FEDERAL INCOME Description: Name of Issuer Transaction PROVIDENCE RI
TAX WRHHELD (S) 02940,301
0.00 VERIZON COMMUNICATIONS INC. Sale -001
NOTE: Computershare will report the amount in Box 2 to the IRS. The difference between the gross proceeds amount in Box Z and the net proceeds
you received represents any tees, charges, or withholding taxes you may have paid.
roan -ruay-ts
(Keep for your records)
Summary This advice is a result of the sale of Plan and/or Direct Registration shares.
Trade I (Shares/Units I Price Per I Gross Amount I Deduction Deduction I Net Amount
Transaction Description
DatelTime Sold Share/Unit ($) of Sales ($) Amount ($) ~ Type of Sale ($)
10J22/201014:02 Sale 990.000000 31.930000 31,610.70 81.80 Transaction Fee 31,528.90
Computershare Trost Company. NA, as agent, upon wtitbn request, wdl provide the name of the exetxrtirtg trrdcer dealer associated with the transactlon(s). and within a reasonable amount of time wdl disdase the source
and amount of oompensatiort received Iran third pattfees in txxmectlon with the transadiat(s), if any. ff trade time is not included above, it may be evadable upon written request.
71 UTX
VZN '~"'~
001CD70008 nr1HX~F-lFTI
Please Note: The "Check Date," noted below, represents the settlement date of this transaction. Under normal market
conditions, sale transactions are traded 3 business days prior to the "Check Date".
`®
BNY MELLON
SHAREOWNER SERVICES
Login to
Investor ServiceDirect®ar
www.bnvmel lon.com/sha reowner/isd
RETAIN FOR YOUR .RECORDS
SHAREHOLDER OF
VODAFONE GROUP PLC ~ DESCRIPTI N
SHARES SOLD
INVEST'DR ID CUSIP t ACCOUNT KEY ~ CHECK NUMBER ;CHECK DATE ~ CHECK AMOUNT
1263.36247800 001 451 92857W20 ! MCKINLEY-CATHMOF00 7441351 ~ 10/21/2010 j $16,376 22
SHARES/UNITS SOLD ~ PRICE PER SHARE (S) TRADING FEES PAID BY SERVICE FEES PAID BY
612.0000 ~ 26.8748700
----- --.._. -_._.. _..------ -- -- _.-
-------
- --~- --T - -- -.. _ _.... - - --__
---- "--------
GROSS PROCEEDS -r-------------`------'------'---'-
---~-----
TAX WITHHELD ~
-- . ------
COMPANY ;SHAREHOLDER ;COMPANY
SHAREHOLDER
$16,447.42 ~ $0.00 ~ $0.00 I $61 20 $0 00
- ~- _-~_ . _. . _ _
- $10.00
NET PROCEEDS -
~ SHARES HELD BY PLAN - -- ----- -~ - - _~~ - _ ». - ~
- ~
~
$16,376.22 I 0.0000
PLEASE DETACH BELOW
..
CHECK NUMBER: 7441351
/'~,,
....,.n i i Q,11~71111 ~? ~ l vll O/ G J/ G v l y 1: G G: 1 G Y1~7 YA(~1r 1/ O ~'L t'~d.X ~BrPE3r
F
V
~~~HZ~ Rcferrn~x ID: 31363'72
Wachovia Bank
Balance Confirmation Services
P ~ Box 40028
Roanoke, VA 24022
August 23, 2010
WM D SCHItACK III LAW OFFICE
SUBJECT: Verification /Confirmation of Aooount and Balance Information provided for:
Customer: CATSERINE M MCIaNLEY (SSN# X~~ XX-938f~
Date of Death: July 13, 2010
Deposit Account Information
Account Aaoo~uit Tate of iarath Averngc Aalance iaate Maturity Tnterr,Rt Accrued V'I'II Tate
Type N~ber Balance Opened Date Rate I~emt Iatere~t Paid Closed
CHl?CKTIVC3 94 $4(),G23.2S 1()/iQ~2fHl7 _ ~i0.OG $12.52 RP9/2010
T F.C3AT. TIT1.F.: CATHF.R TNF. M MCKTNT.F.Y
CHECKING 563 $16,b80.1~ 4/ZM2009 $O.S'J SZ.46 83/2010
I.N;C3A1, "1'i'1'l~: CA'1'HL~R1Nl; M MC:1G1N.[.EY
GI~C3CTNG 576 $805,189.48 4/Z4/Z009 ~$Z38.Z6 $1,663.52 8/9/2010
LEG.AL'ITI'iB: CATHERINE M MCKINLEY
Papa 1 of 2