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HomeMy WebLinkAbout02-22-11 505610101 REV-1500 Ex f°1.1°' ~ OFFICIAL USE ONLY PA Department of Revenue Pennsylvania °E°~~,ME~. °F A. ~F.~~~E County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA i~i28-0601 RESIDENT DECEDENT ~-~~ ~ ~ (., ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 194-60-0911 02/10/2010 05/08/1964 Decedent's Last Name Suffix Decedent's First Name MI Dunkleberger Jr. Robert p (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Dunkleberger Sheila L Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THIE; REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tai; Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust __ 8. Total Number of S;aie Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Patricia M Dunkleberger (717) 448-4848n -~--} :~ REGISTER OF'-~A(IL~;S USE ONt'I~. ~? ~ ~'~ ~" K--a r~ ~ First line of address , :..:- '-~ ~•,> "Y 1686 W. Lisburn Road Second line of address ' - ` ~ °• ° r r - - - ~ ~ "I . , ~: _ _ 1; ~' .- . 'T-1 a ~.. ` t. City or Post Office State ZIP Code DATE FILED C.. '; ____ ' ~ Mechanicsburg PA 17055 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my'knowledge and belief it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. , SIGNATURE OF PERS N O RESPO FILING RETURN DATE . ~ /~ ,L ADDRESS 1686 W. Lisburn Road, Mechanicsburg, PA 17055 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS --- PLEASE USE ORIGINAL FORM ONLY L 150561D101 Side 1 150561011 J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: 194-60-0911 RECAPITULATION 1. Real Estate (Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) ...... ................... .. 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 'i. 40,431.26 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. Ei. 0.00 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 0.00 8. Total Gross Assets (total Lines 1 through 7) ........................... .. F3. 40,431.26 9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9• 14,338.10 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule 1) ............ .. 10. 0.00 11. Total Deductions (total Lines 9 and 10) ............................... .. 1'I . 14,338.10 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 26,093.16 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13} ...................... .. 14. 26,093.16 TAX CALCULATION -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 .0~_ 26,093.06 15. 0.00 16. Amount of Line 14 taxable at lineal rate X; .0 _ 0.00 1 Ei. 0.00 17. Amount of Line 14 taxable at sibling rate X .12 0.00 1 ~ 0.00 18. Amount of Line 14 taxable at collateral rate X .15 0.00 18 0,00 19. TAX DUE ....................................................... .. 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Robert D. Dunkleberger STREET ADDRESS 227 Meals Drive ___ -- -- - _ _ - - CITY Carlisle ~ STATE 'ZIP' PA ', 17013 ~--- Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments ---- A. Prior Payments ___ ----___ _-- ------ -----____--_ _-- B. Discount -___---- _ _ ------- - -- - _ - 0.00 Total Credits 1 A + B) (2) 3. Interest -~~ (3) ____ 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 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 :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ [x] d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ [x] 2. If death occurred after Dec. 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 awn an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .......................................................................... ^ [X] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after 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 [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 l~ercE~nt, 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;1] 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-1502 EX+ (01-10) ~ Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Robert D. Dunkleberger, Jr. 2010-00204 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as t:he price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts, Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Ir more space is needed, use additional sheets of paper of the same size. REV-1503 EX+ (6-98) ~~ SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert D. Dunkleberger, Jr. 2010-00204 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ~~ (ir more space is needed, insert additional sheets of the same size) REV-1504 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHED~lLE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Robert D. Dunkleberger, Jr. 20'10-00204 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. (It more space is needed, insert additional sheets of the same size) REV-1507 EX+ (6-98) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert D. Dunkleberger, Jr. 2010-00204 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (It more space is needed, insert additional sheets of the same size) REV-iso8 EX+ (11-io) ~ pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Robert D. Dunkleberger, Jr. 2010-00204 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship mus# be disclosed on Schedule F. If more space is needed, use additional sheets of paper of the same size. REV-15og EX+ (01-10) ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Robert D. Dunkleberger, Jr. 2010-00204 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS REtAfIONSHIP TO DECEDENT A. B. C JOINTLY OWNED PROPERTY: Il'EM 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 ASSET % OF DECEiDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. NONE NONE TOTAL (Also enter on Line 6, Recapitulation) ~ 0.00 If more space is needed, use additional sheets of paper of the same size. A REV-1510 EX+ (08-09) ~ Pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER. Robert D. Dunkleberger, Jr. 2010-00204 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A CDPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET 9/o OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. NONE TOTAL (Also enter on Line 7, Recapitulation) $ ~ 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) i pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Robert D. Dunkleberger, Jr. 2010-00204 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Professional Services 4,625.00 2. Equipment & Merchandise 4,400.00 3. Cemetery Equipment 165.00 4. Death Certificates 72.00 s. Newspaper Notices 361.30 s. Cash Advances/Special Charges 598.30 z Grave marker 3, 304.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) _ _ -_ _ .-- Street Address ~--- City ____ __ State ____ ZIP _ Year(s) Commission Paid: __f_ - __-~___ _- 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant _ ~- ---- Street Address 4. 5. 6. 7. City ____ State _ _ ZIP Relationship of Claimant to Decedent _ _ _. __ _____-- Probate Fees: ~ ~ ~ b ~, ~ ~ ~ +n c~ ~. 4 In v`~~k'~~ ~ e,~ '~ S ~'"c: ~' U ~ ~/ i 1 ~ S Accountant Fees: Tax Return Preparer Fees: 163.50 649.00 14,338.10 TOTAL (Also enter on Line 9, Recapitulation) I ~ _ 14,338.10 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-0$1 i pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Robert D. Dunkleberger, Jr. 2010-00204 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If mare space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10} ~ pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Robert D. Dunkleberger, Jr. 2010-00204 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING. PROPERTY Do Not List Trustee(s) OF ESTATE I I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1 • Brian Shughart 632 S. Middlesex RD Carlisle, PA 17015 Friend A TC Encore 300 Win Mag B 12 gauge Mossberg non-camo 500 model c 22 Mag Marlin 8821 model D 45 Cal buckwacka inline E 30-30 Marlin 336 C model w/ scope F 25-06 H-R Single Shot w/ scope (not-operable) (Distributed prior to death) 0.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1' NONE 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 I NONE I 0.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (O1-10) ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE ~ BENEFICIARIES ESTATE OF: FILE NUMBER: Robert D. Dunkleberger, Jr. 2010-00204 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).) 1• Cody Wickard 221 N. Middlesex RD Carlisle, PA 17013 A 12 gauge Mossberg 500 model B 22 Mag 20 gauge Savage w/ scope 24 model C 20 gauge Remington 870 model D Charles Daly 50 Cal Flintlock E Bounty Hunter Pearson Bow w/arrows F H Farmall Tractor (Distributed prior to death) Nephew 0.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1' NONE 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS; 1 I NONE I 0.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (01-10) ~ pennsylvania SCHEDULE ] DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT E5TATE OF: FILE NUMBER: Robert D. Dunkleberger, Jr. 2010-00204 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSONS} RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).) 1 • Patricia Dunkleberger 1686 W. Lisburn RD Mechanicsburg, PA 17055 Sister A White DFX Metal Detector B ~ Telescopes C Handgun 357 Mag Taurus (not located) D Small Coin Collection (not located) (Distributed prior to death) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1• NONE 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 I NONE ( 0.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1513 EX+ (01-10) ~ pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT __ ESTATE OF: FILE NUMBER: Robert D. Dunkleberger, Jr. 2_010-00204 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) __ OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.~).J 1• Sheila L. Dunkleberger 227 Meals Dr Carlisle, PA Spouse A ~ Residue of estate (Assets transferred prior to death) 26, 093.16 26, 093.16 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS r A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1~ NONE 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 I NONE I 0.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ 0.00 If more space is needed, use additional sheets of paper of the same size. STATEMENT GF ACCOUNT 70-41969 **""**********"~*AUTO**3-DIGIT 170 2607 0.5570 AB 0.360 11.1 76 -- 1 -- ROBERT D DUNKLEBERGER JR 151 SHUGHART RD CARLISLE PA 17015-9228 STATE=MENT PERIOD FROM THROUGH 01-11-'10 02-10-10 PAGE 1 of 1 ENCLOSURES 0 5 MONEY MANAGEMENT AC BEGINNING BALANCE NUMBER 32, 034.03 1 INTEREST PAID THIS YEAR :COUNT PERSONAL DEPOSITS/ CREDITS NUMBER 21.77 0 ACCOUNT INTEREST INF( 49.47 ACCOUNT: 70-41969 CHECKS/ SERVICE - ENDING DEBITS FEES BALANCE . 00 .00 32, 055.80 _... )RMATION ACTIVITY DATE DESCRIPTION CREDITS DEBITS BALANCE 01-11 BEGINNING BALANCE 32,034.03 02-10 INTEREST CREDIT 21.77 32,055.80 02-10 ENDING BALANCE 32,055.80 "`** ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 1-11-10 THROUGH 2-10-10 *'`* ANNUAL PERCENTAGE YIELD EARNED .80 AVERAGE DAILY COLLECTED BALANCE 32,034.03 INTEREST EARNED 21.77 SERVICE FEE BALANCE INFORMATION FROM 1-11-10 THROUGH 2-10-10 ' AVERAGE LEDGER BALANCE 32,034.03 AVERAGE COLLECTED BALANCE 32,034.03 MINIMUM LEDGER BALANCE 32,034.03 MINIMUM COLLECTED BALANCE. 32,034.03 DIRECT F&M TRUST -BOILING SPRINGS OFFICE INQUIRIES TO: 3 E 1ST ST BOILING SPRINGS, PA 17007-0400 TELEPHONE: 717-241-4130 OR 717-241-4131 STATEMENT OF ACCOUNT 33-08855 ****"`****'`***'`*AUTO**3-DIGIT 170 1315 0.8730 AT 0.357 6 1 163 1 -- ROBERT D DUNKLEBERGER JR SHEILA L DUNKLEBERGER 227 MEALS DR CARLISLE PA 17015-3182 33-08855 CHECKS/ DEBITS 964.80 .MATION 5 CHECKING WITH INTEREST BEGINNING BALANCE NUMBER 3,671.01 4 INTEREST PAID THIS YEAR DEPOSITS/ CREDITS 5,669.25 ACCOUNT 66 i ACCOUNT: NUMBER 7 INTEREST INFOR ACTIVITY DATE DESCRIPTION CREDITS 01-21 BEGINNING BALANCE 01-29 ATM CASH W/D 003490 F & M TRUS 3EFIRSTST BOILING SPNGSPA 02-01 POS RETURN 698754 NATLCOLLE NATLCOLLEC 800-452-4381 NY 02-01 CHK CARD PUR 097895 WC'~VACATI WC'~VACATIO 877-349-4840 MN 02-03 CHK CARD PUR 053631 MEDCOHEAL MEDCOHEALT 08006544390 PA 02-16 DEPOSIT 00300100107 02-16 CHK CARD PUR 008264 WC'~VALUE WC'~VALUEPLU 800-475-1942 MN 02-17 CHECK 125 00400007223 02-18 CHASE CHECK PYMT 00077900000 100217 0128 02-19 DEPOSIT 00600006867 02-19 CHECK 127 00600006012 02-19 INTEREST CREDIT 02-21 ENDING BALANCE 48.90 620.00 5,000.00 .35 DEBITS 1so.oo 19.95 40.00 19.95 174.90 500.00 60.00 BALANCE 3,671.01 3,521.01 3,549.96 3,509.96 4,110.01 3,935.11 3,435.11 8,375.46 8,375.46 DIRECT F&M TRUST -BOILING SPRINGS OFFICE INQUIRIES TO: 3 E 1ST ST BOILING SPRINGS, PA 17007-0400 TELEPHONE: 717-241-4130 OR 717-241-4131 STATEMENT PERIOD FROM THROUGH 01-21-10 02-21-10 PAGE 1 of 3 ENCLOSURES 2 SERVICE ENDING '~ FEES BALANCE .00 ~ 8, 375.46 STATEMENT OF ACCOUNT 33-08855 STATEMENT PERIOD FROM THROUGH 01-21-'10 02-21-10 ***"`***'`'~******AUTO**3-DIGIT 170 1315 0.8730 AT 0.357 6 1 163 PAGE 2 of 3 -- ROBERT D DUNKLEBERGER JR SHEILA L DUNKLEBERGER 227 MEALS DR ENCLOSURES 2 CARLISLE PA 17015-3182 5 CHECK NO AMOUNT 125 174.90 TOTAL NUMBER OF CHECKS CHECKS * -denotes missing check number in sequence R -denotes returned check CHECK NO AMOUNT CHECK NO 127 * 60.00 128 3 TOTAL AMOUNT OF CHECKS 734.90 *** ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 1-21-10 THROUGH 2-21-10 *** ANNUAL PERCENTAGE YIELD EARNED .10 AVERAGE DAILY COLLECTED BALANCE 4,020.19 INTEREST EARNED .35 SERVICE FEE BALANCE INFORMATION FROM 1-21-10 THROUGH 2-21-10 AVERAGE LEDGER BALANCE 4,039.56 AVERAGE COLLECTED BALANCE MINIMUM LEDGER BALANCE 3,435.11 MINIMUM COLLECTED BALANCE: AMOUNT 500.00 4, 020.19 3,435.11 DIRECT F&M TRUST -BOILING SPRINGS OFFICE INQUIRIES TO: 3 E 1ST ST BOILING SPRINGS, PA 17007-0400 TELEPHONE: 717-241-4130 OR 717-241-4131 ACCOUNT: 3308855 PAGE: 3 of 3 ROBERT D. DUNKLEBERGER, JR. ~Q016 12 5 151 SHUGHART RD. 900077 11 CARLISLE, PA 17013 ~-:~~ t onrc ~ 1 23i3~~at~ j r,AVmnic V~ 1' oNU~I urn .L2C~L ~ ,, ~ 1'1'-I yqV~ Q,TCC ~ ~cnr~n o~~ ~~~{~' ~' `~~/o Ul1LLARti LI _ •'~f ._~ ~~- ...ImI~.,..~.~.,, `,p~,~a~~~Qc~.L~L~e-tree-~ AIL~N] ~:0 3 1 30 4 306~: 33~~IOgB55ii' 0125 t 02/17/2010 125 $174.90 ' "ROBERT D.'DUNKLEBEROER,.IR.' - -• - ~ 161 31iUG.7F1Afii R0 ~°~~°18:~ _ _ _: ,1Z7:-:, - 770EEfE ~ - _ . - CMt1SLl PA 17013- _-' f '~,. _ _ _ ._ bA7E'~ ~ l ~~ I ~~~ " ~~ rnrror~ - L21 ~'1 C. ~- (fLll'N1 ['.Q ry znoe r ow ; ___.. _ r.._. .~. ~ I $ ~ (, 0 , °O~ '- i ff [ j fi0 l u ~ ~ 0D tl _ Al iTl) .( 1 l - - IflWl ~ - ~ DG LARS ~1 C~ -.. _ _ . ~I--wM~.sr..ean - ~ - MGMO _nuill_.~I(a~~~i3~(~ ~.~lD l4f ~ ~~~ -hl~nbl~l»t~~ ,q.~) ~*. ••~~:03-13043061: 33"~088'S51~'..O127 ~ _ .. .~__ _ _-. _. - _ _. 02/19/2010 127 $60.00 f /j _ ,_ a ~~ ~ ~ _ ~ ..~ .. _ ~~ : _ ~ .. _ ~. _.- 8 Market Plaza V~~a}' (;~ 171697-4696 1t-lechanicsbur~; PA 1705 w~~w<-.znalpezrifuneralhome.com J~rerrfy J. Shartzer, FD Michael J. iblalpezzi, O~vne:, FD kyle C'. snipe, FD 14'Iarch 8. 2010 1\~Irs. Sheila L. Dunkleberger 227 Meais Drive Carlisle, PA ] 7013 The Funeral Service for Robert David Dunkleber~-er Jr. We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact. us if you have any questions in regard to this statement. THE FOLLO~~~ING IS AN ITEMIZED STATEI\~IENT OF THE SERVICES, FACILITIES, AL"TOMOTIVE EQUIP>\~1ENT', AND I~~IERCHANDISL THAT YOU SELECTED ~~'HEN MAKING THE FUNERAL ARR.ANGENLENTS. 1. PROFESSIONAL SERVICES: Services of Funeral Director,'Staff $4,67J,0Ci FUNERAL HOME SERVICE CI-DIRGES $4,675.1}0 SELECTED MERCHANDISE: 18 Gauge Steel Casket $2,810.00 Sentinel 'Fault $1 ~,~2J.00 Register Book Package 595.00 Custom Panel 570.00 THE COST OF OUR SERVICES, EQUIPMENT, Al\D MERCHANDISE THAT YOU HAV E SELECTED $9,075.00 AT THE TIA~IE FUNERAL ARRANGEMENTS WERE MADE, WE ADVA'~1CED CERTAII~j PA~'NIENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOLTTLNG FOR THOSE CHARGES. CASH ADVANCES: Cemetery Equipment $16.00 Certified Death Certificates 572.()0 Newspaper Notices -Patriot $2~7 f;7 Newspaper ~lotices -Sentinel $10J •~l3 TOTAL CASH ADVANCES AND SPECLAL CI-IARGES SS98,_3t} SUB-TOTAL $9,623.:30 NITL4I. PAYMENT /DISCOUNT /CREDITS 50.00 TOTAL AMOUNT DUE ~~•~~ $9,623.;>0 :~ ~J"_ f .-~ ~t ~ ~ y ~ r~/'- i y / I! f /.~ ' ~~~i, /1 L 1 ,- ~' "~ ~- ~ C~ ~e ~~ ;~ ~,V~=_ row; .~, ,.,;~,.-.„ ~y`~_ r~ F r T ,. 4t ~:~ ~ / ~y~ r i=~rice J. ~~ •J~~ ~ ' :.J . .rr~arilSi° I't~!er"T?:,rl ci COrVlC' nC. - C':~i ?r{C?, ~,~ .~ .~. . L,.~rlrslp, ~ .-.. ; Plecse deSlon anu ulll(~ til°'iCli,~,t'il~itt i~:crn:~r:cl r~t.l ~ . -. . f=or .:~ i~{,~--. ~ .t~' ~ .......~ ~,' '.1.~-~- ~-~.~?c.:.. ~ ~~... ~~~~~ ..................... ........... . address .. ~ . ~ . ~... ~~. ~. ~~ ~ S ....~.~.. ~ ~ LA .'~......:.t`-. ~~~ ~' ~iS ~ ~ , ....~ .:~. ~ `.~ ... . Design No. .~-.~.~ ....... _- . Material ~ .L .L T.I ~ . ~`3-C ~}- ~. ~'~ ~ ~ . . ,,. Die - Base .~.-.j.~ ~'`...f. M ~. ~ ~">f~ PAarlcers ............... Posts ... _. •---...... Price =~ J t~~ Tax ...... . Deposit .~-3.~7..... 1~ .'j~-? ~~+~ Balance Due ............ ~'""+~ Family Name .......... .. 9~ C~ ~~,' t~ l~ Inscription .. .. .... .. - ! r Style of LettersS~~fl~.,`. -/ (i~,~t~ Foundation to he furnished by .. ... ~ l~ ~ ~-t 5 L ~=- ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ .~-.' ........ . . . . . fJtaterial to be best selected monumzntal grade anr! to be free from imperfections one first class in every tvay. l~l+ork to be finished in a t~aorkmanlike manner. / ~) 1` {i~ l~ L l~ ~ ~ t~ !J This memorial to be erected in - . _ .Cemetery in or near - during the month of . ~.P.rQ) .~-+~~. - . unless unavoidably delayed by labor troubles and other contingencies beyond our control and then as soon as possible. Additional lettering and other ~~rork on this memorial in the future is not lnt+ud~d in the Contract Price. ;ltle and right of possession and removal of said stone, monument or appurtenances s:~ali remain for ~Il purposes i..~ C:arlisle Memorial Servics until work and rnateriais ordered are fully paid by purchaser or purchasers. In consideration of the acceptance by Carlisle lrlemorial Senrice of ibis order, the undersigned (hereina'ter kno+:~'n as the purchaser) agrees io pay Caliisle Iviemoria! Service ............... . ........................................................................................................ ------Gollarsonor before the 15'I~ day follo~n~ing the billing of the t~~arl< or job upon completion thel-eot by Carlisle M~2morial Service said billing to be notice of completion thereof, this order shall become a contract bet~rveen the purchaser and Carlisle Memeral Service upon acceptance thereof` in tl~e space belo~:~ by a duly authorized representative of said Carlisle 1~emcrial Service; it being understood that this nlstrument upon such acceptance covers all of the agreement betv~reen the purchaser and Carlisle fvremoria! Service and that no agent or representative of Carlisle P11emorial Ser<~ice has made any statements or acrreements, verbal or ~rrritien. modified or addir!g to the terms and conditions herein Set forth. It is further understood [hat upo+1 the acceptance c?~ ibis order the contract so made car:not be cancelled, altered, or modified by the purchaser or by any agent of Carlisle Memorial Service or in any manner exce,~t by agreement in vJriting bett~~een the purchaser and Carlisle \(emorial Service, and it is hereby understood and agreed by ~!! partiC, involved that in case of default by purchaser or purchasers, twenty-five per cent of the total original cost of the work or ~~~ork and n;at:;rials ordered, zs the case may be, shall be specified correct sum as liquidated damages which purchaser shall owe Carlisle PJierrzorial Service. less any payrner.t en account made prior to such default, this specification of damaoes to be due regardless of removal and taking possessior, of stone, m<~nun':(:nt pr materials from purchaser or purchasers by Carlisle Prtemorial Service upon follo•~nring such default. r r, ~~~G...~~.)~..~~~ ~ ................. .........---...............------ - ......................(spa! I ............................................... 20....... .............. ............ ..................................................................... (SEAL) - _ ~/ ~ ~ Carlisle Memorial Sen~ice Approval ~y ..Z~~ l.'. - .~-~~ - (SEA! l L~'dhite: ~fic Cope, Crlnary: Custo:rter Cot:y: 'r'' r,: SalF~sr^an Ccpy:.Gold: Office Copy LA~'I' WILL STD TE~T.~.MEI~T g~ r~ y-~~T~~ i~®~DER 9. Do D ~J i\ ~~~~1~~~Rg . I, Ig®~ERT D. D~;tt.1E~ERGER, JR., of 227 Meals Drive, Carlisle, Cumberland County, Pennsylvania 1701 S, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as my Last Will and Testaanent, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. I direct that all inheritance taxes imposed or payable by reason of my death an interest and penalties thereon with respect to all property, whether or not such property ~ passes under this Will, shall be paid by n1y personal representative out of my estate. 1 SEC~liID: I give all tangible property owned by me, except far the specific bequests made below, at the tune of my death, including without limitation personal effects, clothing, jewelry, furniture, furnishings, household goods, automobiles, and other vehicles, together with all insurance policies relating thereto, to my wife S1HClE~i.,.t~. DE~I~LE~ERC-ER, of 227 Meals Drive, Carlisle, Pennsylvania, providing she shall survive me by thirty (30) days. 'TRIRD: Should the second paragraph above fail, I give devise and bequeath. all tangible property owned by me, except for the specific bequests made below, at the time of my death, including without limitation personal effects, clothing, jewelry, Page 1©f 1 furniture, fizrnishings, household goods, automobiles, and other vehicles, together with all insurance policies relating thereto, to my sister, P1~TRffC~A l~~e DI.It~KI.EBE~tGEB-• ~'G~T~: I make the following specific bequests: A. I give the following belongings to my friend, B~.A~N STGI~~`I', providing he shall survive me by thirty (30} days: 1. TC Encore 300 Win Mag 2. 12 Gauge Mossbury non-camo 500 Model ~ 3. 22 Mag Marlin 881 Model 4. 45 Cal $uckawacka inline 5. 30-30 Marlin 336 C Model ' 6. 25-06 H-R Single Shot wl Scope B. I give the following belongings to my nephew, CC)BY 'V6~ICI~AI~1), providing he shall survive me by thirty (30) days: l . 12 Gauge Mossbury 500 Model 2. 22 Mag 20 Gauge Savage w/ Scope 24 Model 3. 20 Gauge Remington 870 Model ~I 4. Charles Daly 50 Cal Flintlock '~ 5. Bounty Hunter Pearson Bow w/ arrows 6. H Farmall Tractor C. I give all my tools, hand and power, to be divided equally to my wife,, S~EIE~, I)~JN~EBE~GEI~ and my friend, B~lv S~I~TGT, providing they shall survive me by thirty (30) days. D. I give the following belongings to my sister, P.A.'T1~ICIA Imo. DUNl~I.,EBERGER, providing she shall survive me by thirty (30) days: Page Z of 2 I . A.II Coin Collections 2. White DFX Metal Detector 3. Telescopes 4. Handgun - 357 Mag Taurus E. I give all my Hides and Mounts to my wife, S~E:~.A I~~TrIEZ,EBE~tGER, Providing she shall survive me by thirty (30} days. If my wife does not want the hides and mounts, I ask that they be given to my friend, ~ItIAl~i SHIJG~l~T. FIFTH: I give, devise and bequeath the residue of my estate, of every ~~ nature and wherever situate as follows: 100% to my wife, S~E~ I)I~TI~,EBEIaGE~, providing she shall survive m.e by thirty (3 0) days. ~~ SIXTH: Should the fourth paragraph fail, I give, devise and bequeath the residue of my estate, of every nature and wherever situate as follows: 100% to my sister, PAT~ICI.A~ 1~. I)~JIvT~.EI3EIaGER, providing she shall survive me by thirty {30) days. SEVEl~1TI~: I nominate, constitute and appoint my sister, P.ATR.ICIA 1VI. 1)~JI~T7KI,E~ERGE~, as Executrix of this my Last Will and Testament, to serve without bond. If she does not survive me, or shall fail to qualify for any reason as my Executrix, or having qualified shall die, resign or cease to act for any reason as my Executrix, I appoint my friend, BRIAI`T Sl~TG~[ART, as my Executor, also to serve without bond. Page 3 of 3 Il'~t VV~Tl~iESS W~~+®P, I have hereunto set my hand and seal to this, my Last Wilt and Testament, each identified by my signature, this ~ y day of January 2010. ROBERT D. DUNKLEBEY2 ER, dR. Signed, sealed, published and declared by the above-named person as and for a Last ~Wil:l and Testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~~~1Nll A . U~~~\; C--- ""'" Page 4 of 4 ~~l~l~ ~ ~'i' LE~~~Ei'~ T ~D I` ~~ ~' 1T r. - - o r i~~. ^ i ~~~~ ~- ~R~~ aid WE, RrSERT D. DIJNI~.E3ERGER, JR., ~i1z S~v ~~ ~ the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly swum, 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 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 the time, eighteen years of age or older, of sound mind and under r~o constraint or undue in#luence. y~~~'~ ROBERT D. DUNKLEBERGER, JR. Page 5 of 5 ~~lq&l~`E~l'~ V'~` ~ti31.~~~ V~ P~l~ll~i7 13.E i' `~ . 5S: Subscribed, sworn to and acknowledged before me by RO~El~'I' D. I~Ui~TKLE~E12GE1~,, JIt., the testator herein, and subscribed and sworn to before me by . ~ ~%,v -t ~ . +3 r~~ w~ ,and k~ ~ ~ 5 ~vd~ ,witnesses, this z~ '~- day of 7anuary, 2010. l~iotary Publie ; ~' COiVIMONWEALTH OF PENNSYLVANIA Notarial Seal Roger B. lnMn, tVotary Public Carlisle Boro, Cumberland County My Commission Expires pct. 3, 2012 Member, Pennsylvania Association of Notaries Page 6 of 6