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HomeMy WebLinkAbout02-22-11 (3)1505607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Coun Code Year File Number Bureau of Individual Taxes tY POBOx28oso1 INHERITANCE TAX RETURN y~Q / - Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~'I I ~ l'V U ~ ~.f' ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 9 6 1 4 2 7 2 6 0 8 0 7 2 0 1 0 1 0 1 4 1 9 2 4 Decedent's Last Name Suffix Decedent's First Name MI W R I G H T S T O N E M A R I A N E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 0 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) L A N E CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number G R E G O R Y R R E E D E S Q 7 1 7 2 3 8 0 4 3 4 ~. Firm Name (If Applicable) - First line of address 3 1 2 0 P A R K V I E W Second line of address City or Post Office H A R R I S B U R G State ZIP Code 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) { ~7 -I7 r) ~~r 1 ,~ 7 C7 ~e -r~ C-l dTl REGISTER=O~IILLS USE-ANLY " C S 7 °"t r . r r ~~ C"') .. C"7 i i i }-~,r- C~~" -' ~ ~ t ? r crJ ~ . C ~ ~;ti~ -r7 4) ~ .. -. -O ; + ~ -DATE FILED ~~~ r ` , P A 1 7 1 1 1 Correspondent's a-mail address:lBWOffCet~r@edp818W.C0171 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 ~s based on all information of which preparer has any knowledge. IGNATURE OF PERSON RESPON IB E FOR FILING RETURN DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 J 1505607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: MARIAN E- WRIGHTSTONE 1 9 6 1 4 2 7 2 6 RECAPITULATION 1. Real estate (Schedule A) 1, 7 1 8 3 7, 5 0 ........................................ 2. Stocks and Bonds (Schedule B) 2, 6 2 6 1 4. 9 1 .................................. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 1 2 0 8 . 6 9 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1-7) ........................... 8. 1 3 5 6 6 1. 1 0 9. Funeral Ex enses & Administrative Costs Schedule H 9. 9 0 6 1 . 0 7 P ( ) ................ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ 10. 11. Total Deductions (total Lines 9 & 10) ........................... 11. 9 0 6 1 . 0 7 12. Net Value of Estate (Line 8 minus Line 11) ......................... 12. 1 2 6 6 0 0 . 0 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .................. 14. 1 2 6 6 0 0 . 0 3 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 .0 _ 15. 16. Amount of Line 14 taxable at lineal rate x .045 1 2 6 6 0 0. 0 3 16. 5 6 9 7. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505607221 5 6 9 7. 0 0 1505607221 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 0 0 DECEDENTS NAME MARIAN E. WRIGHTSTONE STREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1 ~ Tax Due (Page 2 Line 19) 2. Credits/Payments A Spousal Povert Credit y B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) (1) 5,697.00 0.00 Total InteresUPenalty (D +E) (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) 5,697.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (5B) 5,697.00 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 ........................................................................................... ..... ^ d. receive the promise for life of either payments, benefits or care? .................................................. ..... ^ 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? .... ..... ^ 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (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 zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot 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 twenty-0ne 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 zero (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 four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling 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 + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARIAN E. WRIGHTSTONE _ _ ___ 0 0 All real property owned solely or as 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 between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real ro which is ' int -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATM Real estate located at 439 State Street, East Pennsboro Township, Cumberland County, 71,837.50 Pennsylvania. A copy of the deed and tax assessment documentation is attached hereto, collectively marked Exhibit "A" and incorporated herein by reference. TOTAL (Also enter on line 1, Recapitulation) ~ s 71.837.50 (If more space is needed, insert additbnal sheets 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 MARIAN E. WRIGHTSTONE 0 0 All property jointty-owned with right of suninrorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Highmark (prescription drug refund) 75.21 2. Computershare (stock sale) 4,130.03 3. Highmark Blue Shield (refund) 523.32 4. M&T Bank -Checking Account # 91740630 10,869.82 See copy of M&T Bank letter attached hereto, marked Exhibit "B" and incorporated herein by reference. 5. M&T Bank -Savings Account # 15004219712567 30,666.85 See copy of M&T Bank letter attached hereto, marked Exhibit "B" and incorporated herein by reference. 6. Wells Fargo IRA 15,312.59 See copy of WeIlsFargo letter attached hereto, marked Exhibit "C" and incorporated herein by reference. 7. Wells Fargo money market fund ggg.Og See copy of WeIlsFargo letter attached hereto, marked Exhibit "C" and incorporated herein by reference. 8. Westfield Insurance Company (home owner's rebate) 149.00 TOTAL (Also enter on line 2, Recapitulation) I S 62,614. (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER MARIAN E. WRIGHTSTONE 0 0 ff an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME a. Marlin C. Wrightstone Jr. 439 State Street Enola, PA 17025 ADDRESS (RELATIONSHIP TO DECEDENT son e c JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A. PNC Bank -savings account 2,417.38 50. 1,208.69 TOTAL (Also enter on line 6, Recapitulation) I S 1,208.69 (If more space is needed, inseR additional sheets of the same size) REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MARIAN E. WRIGHTSTONE 0 0 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Gingrich Memorials 140.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: 2, Attorney Fees Gregory R. Reed, Esq. 3,000.00 3, Family Exemption: (If decedents address is not the same as daimanYs, attach explanatron) 3, 500.00 Claimant Marlin C. Wrightstone, Jr. Street Address 439 State St City Enola State PA zip 17025 Relationship of Claimant to Decedent SOn 4. Probate Fees Register of Wills 278.50 5 AcxountanYs Fees 6. Tax Return Preparers Fees 7. Patriot News -advertising 36.75 8. UGI 22.24 9. West Shore EMS -BLS gg.g0 10. Verizon 106.44 11. Mechanicsburg Meals on Wheels 154.00 12. Stamp/certified fees 41.69 13. West Fairview United Methodist Church 140.00 14. PA American Water 34.88 15. Comcast cable 66.99 16. Commonwealth of PA -car title transfer 22.50 17. PP&L 100.50 18. West Shore EMS - ALS 977.90 TOTAL (Also enter on line 9, Recapitulation) S 9.061.07 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent MARIAN E. WRIGHTSTONE Decedent's Name Page 1 File Number Schedule H -Funeral Expenses & Administrative Costs - 67. ITEM NUMBER DESCRIPTION AMOUNT 19. NVSF 20. MSF 21. Holy Spirit Hospital 22. Quantum Imaging 23. Douty -locks/keys 24. Natural Diabetic (a pledge made before death) 10.00 20.00 9.15 44.73 235.00 20.00 SUBTOTAL SCHEDULE H-B7 ~ 338.88 REV-1513 EX+ (11-08) Pennsylvania SCHEDULE ~ DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER MARIAN E. WRIGHTSTONE 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. Marlin C. Wrightstone, Jr., 439 State Street, Enola PA 17025 Son 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. # If more space is needed, insert additional sheets of the same size. Exhibit A .~1~ ~ DEED NIAIIla~991111~ Map No. 45-16-1050-048 MADE THE ~ day of ~ ~JQ~ ~.~~,~ in the year of our Lord two thousand ten (2010) BETWEEN MARLIN C. WRIGHTSTONE, JR., Administrator of the Estate of MARIAN E. WRIGHTSTONE, deceased, late of the Township of East Pennsboro, County of Cumberland and Commonwealth of Pennsylvania, Grantor A N D MARLIN C. WRIGHTSTONE, JR., individually, of West Fairview, Cumberland County, Pennsylvania, Grantee WHEREAS, the aforesaid MARIAN E. WRIGHTSTONE and her late husband, MARLIN C. WRIGHTSTONE, by deed dated April 27, 1962 and recorded April 28, 1962 in Deed Book M20, Page 787, in the Recorder's Office of Cumberland County, Pennsylvania, became seized in fee of a certain tract of land, together with the buildings and other improvements thereon erected, known and numbered as 439 State Road, Enola, West Fairview Borough (now East Pennsboro Township), Cumberland County, Pennsylvania; WHEREAS, the said MARLIN C. WRIGHTSTONE died on the 13`" day of September, 2006, thereby vesting the entire fee simple title in and to the said MARIAN E. WRIGHTSTONE, his surviving spouse; WHEREAS, being so thereof seized, the said MARIAN E. WRIGHTSTONE died intestate on the 7th day of August, 2010, leaving as her sole intestate beneficiary her son, MARLIN C. WRIGHTSTONE, JR., the Grantee herein; and WHEREAS, the Cumberland County Register of Wills duly issued Letters of Administration to the aforesaid MARLIN C. WRIGHTSTONE, JR. on August 25, 2010, as in and by the records of the said Register of Wills to Estate No. 2010-00876, recourse thereunto being had, more fully and at large appears. WITNESSETH NOW THIS SAID INDENTURE WITNESSETH, that the said MARLIN C. WRIGHTSTONE, JR., Administrator as aforesaid, for and in consideration of the sum of One and 00/100 ($1.00) Dollars lawful money of the United States, to him in hand paid by the said MARLIN C. WRIGHTSTONE, JR., individually, Grantee herein, at and before the sealing and delivery hereof, the receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said MARLIN C. WRIGHTSTONE, JR., his heirs and assigns all of the said MARLIN C. WRIGHTSTONE's interest in, ALL that certain lot of ground situate in East Pennsboro 'township (formerly the Borough of West Fairview), Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a point, said point being on the curb line along State Road and at the intersection of said State Road and a twenty foot wide alley; thence by said alley in a northeasterly direction fifty-three and thirty-five one hundredths (53.35) feet to a point; thence by same in a northeasterly direction sixty-seven (67) feet to a point on the Enola Road; thence by said Enola Road in an easterly direction eight and thirty-eight one-hundredths (8.38) feet to a point on Enola Road; thence in a westerly direction along the residue of Lots Nos. 3 and 4 and through the partition line between house No. 437 and No. 439 on lot herein one hundred fifteen and twenty-one one- hundredths (115.21) feet to a point on the curb line along State Road; thence by said State Road twenty-four and seventy one-hundredths (24.70) feet to the place of BEGINNING. HAVING thereon erected atwo-story semi-detached frame dwelling known and numbered as 439 State Road, West Fairview, Pennsylvania. This is a transfer from the estate of a deceased mother to her son and as such is exempt from state and local real estate transfer taxation. UNDER AND SUBJECT, NEVERTHELESS, to rights of way, easements, streets, roads and alleys of record or ~~~hich are apparent on or near the premises. TOGETHER with all and singular ways waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging, or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof; and also, all the estate, right, title interest, use, trust, property, possession, claim and demand whatsoever, in law, equity or otherwise howsoever, of, in, to or out of the same: TO HAVE AND TO HOLD, the said MARLIN C. WRIGHTSTONE, JR., Administrator, aforesaid, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said MARLIN C. WRIGHTSTONE, JR., individually, his heirs 2 and assigns, to and for the only proper use and behoove of the said MARLIN C. WRIGHTSTONE, JR., Administrator, aforesaid, his heirs or assigns, forever. And the said MARLIN C. WRIGHTSTONE, JR., Administrator, aforesaid, covenants, promises and agrees, to and with the said MARLIN C. WRIGHTSTONE, JR., individually, his heirs and assigns, by these presents, that the said MARLIN C. WRIGHTSTONE, JR., Admiiustrator, aforesaid has not done, committed, or knowingly or willingly suffered to be done or committed, any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered in title, charge, estate, or otherwise howsoever. WITNESS the due execution hereof the day, month and year first above written. /~~ Witness r Marlin C. Wrigh stone, ., Administrator of the Estate of Marian E. Wrightstone, deceased COMMONWEALTH OF PENNSYLVANIA COUNTY OF !~r'l; ~ P~-tT+v ss On this, the , .~ day of ~~ ~~-w-6 ~= ~" , 2010, before me the undersigned officer, personally appeared MARLIN C. WRIGHTSTONE, JR., Administrator of the Estate of MARIAN E. WRIGHTSTONE, deceased, known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledged that he executed the same in the capacity therein stated and for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. CO~I~10NUt'EALTfI OF PENNSYLVANIA ~~~~ (SEAL) N(?TARIAL SEAL GREGURY R. REED, Notary Public 5watara Twp., Dauphin County My Commission Expires April 26, 2011 CERTIFICATE OF RESIDENCE I do hereby certify that the precise residence and complete post office address of the within named grantee is 439 State Street, Enola, PA 17025. i~ti 3 , 2010 Attorney for Grantee 4 ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE CARLISLE, PA 17013 717-240-6370 Instrument Number - 201033729 Recorded On 11/18/2010 At 10:49:20 AM * Instrument Type -DEED Invoice Number - 76936 User ID - MSW * Grantor - WRIGHTSTONE, MARIAN E * Grantee - WRIGHTSTONE, MARLIN C * Customer -GREGORY REED * FEES STATE WRIT TAX $0.50 STATE JCS/ACCESS TO $23.50 JUSTICE RECORDING FEES - $12.50 RECORDER OF DEEDS PARCEL CERTIFICATION $10.00 FEES AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 EAST PENNSBORO SCHOOL $0.00 DISTRICT EAST PENNSBORO TOWNSHIP $0.00 TOTAL PAID $63.00 * Total Pages - 6 Certification Page DO NOT DETACH This page is now part of this legal document. I Certify this to be recorded in Cunnberl~nd County PA ~~ cf cuMe~ ,D <' . Q F RECORDER O D EDS i~ao * -Information denoted by an asterisk msy change during the verification process and may not be reflected on this page. Illpllllllllllllllllll .._ ~....,~..s._ ., REV-i83 EX (oq-io) ~; Pennsylvania DEPARTMENT OF REVENUE Bureau of Individual Taxes PO BOX 280603 Harrtsburq,PA i~i28-0603 REALTY TRANSFER TAX STATEMENT OF VALUE See reverse for instructions. RECORDER'S USE ONLY Tax Paid eoox Number Page Number Uate ReCOrtletl Complete each section and file in duplicate with Recorder of Deeds when (1) the full value/consideration is not set forth in the deed, (2) the deed is without consideration or by gift, or (3) a tax exemption is claimed. A Statement of Value is not required if the transfer is wholly exempt from tax based on family relationship or public utility easement. If more space is needed, attach additional sheets. A. CORRESPONDENT -All inquiries may be directed to the following person• Name Telephone Number: Gregory R. Reed, Esq. _ _ (717)_238-0434 Mailing Address City State ZIP Code 3120 Parkview Lane Harrisburg ~ PA~17111 B. TRANSFER DATA _ __ C. Date of Acceptance of Document Grantor(s)/Lessor(s) Grantee(s)/Lessee(s) Marlin C. Wrightstone, Jr. (Admin. of Estate of Marin E. Wrightstone, deceased) Marlin C. Wrightstone, Jr., individually Mailing Address Mailing Address 439 State St _ 439 State St City State ZIP Code City State ZIP Code Enola PA 17025 Enola PA 17025 D. REAL ESTATE LOCATION Street Address City, Township, Borough 439 State St East Pennsboro County School District Tax Parcel Number Cumberland East Pennsboro 45-1(i-1050-048 E. VALUATION DATA -WAS TRANSACTION PART OF AN ASSIGNMENT OR RELOCATION? ^ Y ® N 1. Actual Cash Consideration 2. Other Consideration 3. Total Consideration 1.00 +0.00 = 1.00 __ 4. County Assessed Value 5. Common Level Ratio Factor 6. Fair Market Value 57,470.00 X 1.25 = 71,837.50 F. EXEMPTION DATA 1a. Amount of Exemption Claimed lb. Percentage of Grantor's Interest in Real Estate ic. Percentage of Grantor's Interest Conveyed 100% 100% 100% Check Appropriate Box Below for Exemption Claimed. ® Will or intestate succession. Marian E. Wrightstone ___ 21-10-0876 (Name of Decedent) (Estate File Number) ^ Transfer to a trust. (Attach complete copy of trust agreement identifying all beneficiaries.) ^ Transfer from a trust. Date of transfer into the trust If trust was amended attach a copy of original and amendedtru~ -- -- ^ Transfer between principal and agent/straw party. (Attach complete copy of agency/straw party agreement.) ^ Transfers to the commonwealth, the U.S. and instrumentalities by gift, dedication, condemnation or in lieu of con- demnation. (If condemnation or In lieu of condemnation, attach copy of resolution.) ^ Transfer from mortgagor to a holder of a mortgage in default. (Attach copy of mortgage and note/assignment.) ^ Corrective or confirmatory deed. (Attach complete copy of the deed to be corrected or confirmed.) ^ Statutory corporate consolidation, merger or division. (Attach copy of articles.) ^ Other (Please explain exemption claimed.) Under penalties of law, I declare that I have examined this statement, including accompanying information, and to the best of my knowledge and belief, it is true, correct and complete. Signature of Correspondent or Responsible Party Date FAILURE TO COMPLETE THIS FORM PROPERLY OR ATTACH REQUESTED DOCUMENTATION MAY RESULT IN THE RECORDER'S REFUSAL TO RECORD THE DEED. Exhibit dy-IOy-' 110 15,'L4 rlitkl-ClrU-2S4ytS'!4 ;ild'Ly;i4Lb110 '1'-4'L4 YIObb1/bION;i r-1y:~ ssg NNttheN goad Millsboro, DE 19866 Mall code DE-M8-12 Phone: 98&502-4349 Fax: 302.934.2966 Fax To: Gregory R Reed 0 M~TBank From: Sue Kimble Fex: 717-238-8469 Dais: September 9, 2010 Rs: Estate of Marian E Wrightstone Pages: 2 •Gommonb: Attached, please find the information you requested for the Estate of Marian E Wtightstone, as of August 7, 2010. If I can be of further assistance, please do not hesitate to call me at 888-502.4349. Thank you and have a great day! Sue Kimble ~ M 8~ T Bank This communk;atlon contains Information whk;h may be confldentlsi and proprietary. You may nol use, disseminate, dlsMtxAe or copy al or any paR of this conxnun~etlon without the express consent of M 8 T Bank, Atlflrst Financial Inc. or their respectlve subsidiaries or afflllates. in addltlon, ff you are not the addressee (or are authorized to receive this Infom~atlon by the addressee), you are not authorized to receive or review the contents of this communication. If you have received this communicator in error, please return it to M 8 T Bank at P.O. Box 1596, Baltimore, MD 21203 and delete any copy of this communication from your systems. Thank you. 09-09-'10 15:24 FROM-MFD-849874 3029342610 T-424 P0002l0003 F-193 1. Type ofAccount CheckingAccount Aavtttir Number 9!740630 Ownership (Ncancs qn Maricrn C Wrightstune Sr Marian E Wrightstvne Opening Date OF/?8/64 Bulanc~ on lhrte of Ueiuh J- l U, 869. d1 ACL77tN(IlntE'YE 34 $ U. UU Tutrd 51U 865-.8~ 2. Type ofAceount Sc:vingsAccvunt Account Numhcr 1 SfXI4219712567 Ownership (Names vJ) Marian E Wrightctone Opening Date 10/03/(18 Balance on Date of Death 530,666.93 Acx:rreeJlntc~•cvt ,~ .42 real ,~~0.666.8s For further w<xau-t Urfornwtba, cbsmrw~ ondMr reL-tWu~arKUt of footle l~~ cell the Sm~wrerdele M~ Olllce at tf117-252261. We v~ere unaAle to locate •ny ufe depo9lt AoY for the ~Ao~'rmentipned decedent. Sll]C~d'P.IYe Suz~ume M Kimble Adjustment Services Exhibit Buehler Wealth Management Group of Wells Fargo Advisors Wells Fargo Advisors, LLC 3 Lemoyne Drive Lemoyne, PA 17043 Member FINRA/SIPC Gregory R, Reed 3120 Parkview Lane Harrisburg, PA 17111 RE: Estate Marian E. Wrightstone August 7, 2010 Dear Attorney Reed: Te1717-761-7344 Fax 717-975-8426 800-468-8685 September 15, 2010 W~r., :~... . WELLS ,.Y~ :"' •y. FAR GO '~°~=..- ... - ::; Listed below is the date of death values for the shares held in Mrs. Wrightstone's IRA. The date of death was on weekend so I have provided both Friday, August 6 and Monday, August 9. August 6, 2010 Number of Shares 130.5360 243.8000 466.5040 Company First Eagle JP Morgan Wells Fargo Asset Price per share Value $40.91 $5,340.23 $19.76 $4,817.49 $11.05 $5,154.87 August 9, 2010 130.5360 First Eagle $40.97 $5,348.06 243.8000 JP Morgan $19.91 $4,854.06 466.5040 Wells Fargo Asset $11.08 $5,168.86 The shares are all mutual fund companies and are only priced at the close of the day. $888.09 in money market fund The account was opened February 7, 1994 Marian E Wrightstone IRA. I have transferred the shares to her grandchildren 50/50 per the beneficiary form. If I can be of further assistance, please give me a call. Sincerely, ~, i ,~---- L ~ K. Neff ~, ~` Se for Client Associate Jennifer L. Buehler, MBA E. Thomas McKee, MBA, CRPC• Senior Vice President -Investments Financial Consultant Financial Advisor tom.mckee@wellsfargoadvisors.com jenniferbuehler@wellsfargoadvisors.com Lyada K. Neff Kendra Meyer Tricia Mankoski Senior Client Associate Registered Client Associate Registered Client Associate lynda.neff@wellsfargoadvisors.com kendra.meyer@wellsfargoadvisors.com tricia.mankoski@wellsfargoadvisors.com