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HomeMy WebLinkAbout06-16-11 (2)---~ REV-1500 1505611180 FCC (02-11) (FI) PA Department of Revenue Pennsylvania Bureau of Individual Taxes DEPARTMENT OF REVENUE Po sox 2sosol INHERITANCE TAX RETURN Harrisbur , PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 207-22-0047 Decedent's Last Name 03202011 MMDDYYYY Date of Birth Suffix BRENIZER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number OFFICIAL USE ONLY County Code Year File Number ~ ~ ~~~ MMDDYYYY 05111929 Decedent's First Name GRACE Spouse's First Name THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE BOXES BELOW REGISTER OF WILLS 0 1 O' ' MI L MI x nginal Retum 0 2. Supplemental Retum Q 3 R 0 4. Limited Estate Q 4a F . emainder Retum (Date of Death Prior to 12-13-82) ~x 6 D d . uture Interest Compromise (date of death after 12-12-82) 0 5• Federal Estate Tax Retum Required . ece ent Died Testate (Attach Copy of III) [~ 7. Decedent Maintained a Living Trust ]i 0 9. Litigation Proceeds Received Q (Attach Copy of Trust) 10 S --_. 8. Total Number of Safe Deposit Boxes . pousal Poverty Credit (Date of Death Between 12-31-91 and 1-1-95) ~ 11. Election to Tax under Sec. 9113(A) CORRESPONDENT- THIS SECTION MUST BE COMP Nam LETED. ALL CORRESPONDENCE AND CONFIDENT a O) e IAL TAX INFORMATION SHOULD BE DIRECTED TO Robert G. Frey Daytime Telephone Number 7172435838 rA.~ REGISTER OF WI _ I1SE ONLY First Line of Address ~ ~ -~ ``~~ ~ 5 South Hanover St Fr C mm f`~'' `--~ Second Line of Address Cl~_ !fS ~ 1 ; ..~ a C`_7 ,.--., CJ©~ _ ~"+ City or Post Office "L7 `~ t. ~- TTt State ZIP Code DATE F~p S. '~'~' Carlisle PA 17013 Correspondent's a-mail address: R F R E Y a1 F R E Y T I L E Y. C O M 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, corcect and com lete. Declaration of re arer other than the ersonal re resentative is based on all information of which re arer has an knowled e. SI NATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~~~ S_ W ~.9~v~ DATE ADDRESS SIGNA ADDRESS 5 South Hanover Stree ATIVE Carlisle, PA 17013 Y Side 1 L 1505611180 DATE J uv~ t C~ 1505611180 J .~ J 1505611280 REV-1500 EX (FI) Decedent's Name: GRACE L B R E N I Z E R Decedent's Social Security Number RECAPITULATION 2 D 7- 2 2- O D 4 7 1. Real Estate (Schedule A) ......... . .. .......................... 2. Stocks and Bonds (Schedule B) .......... ... 1. 235700.00 ... . ................... 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... 2. 3 35207. DO N 0 N E ... . 4. Mortgages and Notes Receivable (Schedule D) ..................... .. . a. NONE 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) . . 5 6. Jointly Owned Property (Schedule F) Separate Billing Requested .... 7. Inter-Vvos Transfers & Miscell .. , ... 6. 208881.00 N 0 N E aneous Non-Probate Property (Schedule G) OSeparate Billing Requested .... 8. Total Gross Assets total Lines 1 throw h ~ ... ~ 3 7 6 4 3. D 0 .. ,. .. ~~~~ 9. Funeral Expenses and Administrative Costs (Schedule H) .. $' S17431.p0 .............. 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) .. 9. 10913.00 .......... . . 10. NONE 11. Total Deductions (total Lines 9 and 10) ....... ..................... 12. Net Value of Estate (Line 8 minus Line 11) . 11. 10 913 . D 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not bee 12 5 D 6 51$ , D D n made (Schedule J) .......... . ......... ..13. 14. Net Value Sub'ect to Tax Line 12 minus Line 13 0 • D D .... TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at 14 5 0 6 518 . D D the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 0 16. Amount of Line 14 taxable 15' D D D at linealrateX.o 45 506518 00 . . 17. Amount of Line 14 16' 2 2 7 9 3 31 taxable at sibling rate X . 12 . 18. Amount of Line 14 taxable 1 ~• D . D D at collateral rate X . 15 19. TAX DUE ............... 1s. 0.00 ... . .................................... 19. 22793.31 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYME NT 0 Side 2 L 15D5611280 1505611280 J REV-1500 EX (FI) Page 3 Decedent's Complete Address: GRACE L BRENIZER STREET ADDRESS CITY 21-11-0394 File Number STATE Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 19500.00 B. Discount 975.00 3. Interest Total Credits (A + g ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in 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. ZIP 207-22-0047 (1) 22793.31 (2) 20475.00 (3) (4) 0.00 (5) 2318.31 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLO~, 1. Did decedent make a transfer and: a. retain the use or income of the property transferred ...................................................................................... Y^es b. retain the right to designate who shall use the property transferred or its income .......................................... c. retain a reversionary interest ........................ .... ^ d. receive the promise for life of either payments, benefits or care? ................................................................... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................. . 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. Y , For dates ofp eath o[ or after§Jul 1( ) (4, j (~, before Jan. 1, 1995, the tax rate imposed on the net value of transf l* . spouse is 3 ercent 72 P.S. 9116 a 1.1 i ers to or for the use of the survroing 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 Jufy 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in [72 P.S. §9116(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)j. 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+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: G FILE NUMBER: All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value?s defined a94he 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. ITEM Attach a copy of the settlement sheet if the property has been sold. NUMBER Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE DESCRIPTION OF DEATH ~ • 7829 Wertzville Road, Carlisle, PA; house and lot of ground. 2010 Asessment Attached. Common Level Ration Factor = 1.00 235, 700 TOTAL (Also enter on Line 1 Reca it I t' SCHEDULE A REAL ESTATE If more space is needed, use additional sheets of paper of the same s ze Ion REV-1503 EX+ (5_gg~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF SCHEDULE B STOCKS & BONDS L Brenizer FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM N 1 • Series EE Bonds, see itemization attach d 2• Series HH Bonds VALUE A7 DATE OF DEATH 12,207 23,000 (If more space is needed, insert additional sheets~of thelsame size) REV-1508 EX+ (11-10) Pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC INH , . ERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: Grace L Brenizer FILE NUMBER: ITEM Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorshi 21-11-0394 p must be disclosed on Schedule F. NUMBER DESCRIPTION VALUE AT DATE 1 Members 1st Account No. 10259-00 OF DEATH 2 Members 1st Account No. 10259-04 3 Members 1st Account No. 10259-43 15,759 4 Members 1st Account No. 10259-44 4,001 5 M&T Account No. 449903 30,013 6 M8~T Account No. 15004198150599 34,888 7 M&T Account No. 31002912754768 31,825 8 M8~T Account No. 31003918612340 23,719 9 M&T Account No. 35004202941404 30,015 10 11 1995 Ford Explorer, Kelley Blue Book value attached 22,850 10 361 1996 Chevrolet 1500 pick up truck , 1, 750 3, 700 TOTAL (Also enter on line 5, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. 208,881 REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT Grace L Br SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILEFILE M Thic erhva~d.. --- ~ ••--• ~~ ...,~~~N,aica ana med if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND JMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECD'S EXCLUSION 1. TRANSAMERICA ANNUITY VALUE OF ASSET INTEREST (IF APP~ICgg~) 2. THRIFT SAVINGS PLAN 30,111 100.00% 7,532 100.00% TAXABLE VAL- U--E 30,111 7,532 If more space is needed, use additional sheetseof paper of theesameusazlel REV-1511 EX + (10-09) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT GCTw Tr r.~ SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS race L Brenizer FILE NUMBER Decedent's debts must be reported on Schedule I.21-11-0394 ITEM NUMBER A• FUNERAL EXPENSES: DESCRIPTION 1• Hoffman-Roth Funeral Home AMOUNT 2. Whispering Pines, luncheon facility 602 3. L&D Catering, funeral luncheon 800 1,113 B• ADMINISTRATIVE COSTS: 1 • Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2• Attorney Fees: 3• Family Exemption: (If decedent's address is not the sam ' 7,500 e as claimant s, attach explanation.) Claimant SVeet Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: 5• Accountant Fees: 398 6• Tax Return Preparer Fees: 7• SARAH TODD NURSING HOME 8. ADVERTISING, CUMBERLAND LAW 425 JOURNAL 9• 75 If more space is needed, use additionaOs Bets olf paper of he same i eecapitulation) $ 10,913 REV-1513 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE SCHEDULE J INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT CQTI~Te~ I~ 3race L Brenizer NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).) 1 ROBBIN VIORAL 2 ANDREW BRENIZER 3 SHARI BRENIZER 4 CHARD WERT 5 JAMA WERT 6 BARBARA S. WILLIER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) GRANDDAUGHTER GRANDSON GRANDDAUGHTER GRANDSON GRANDDAUGHTER DAUGHTER FILE NUMBER: 1-11-0394 AMOUNT OR SHARE OF ESTATE 5,000.00 5,000.00 5,000.00 5,000.00 5,000.00 DUE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV 1500 COVER SHEET AS APPROPRIATE ~~ NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET If more space is needed, use additional sheets of paper of the same size. TaxD6 Result Details 6/6/11 10:20 AM Detailed Results for Parcel 21-1 ~-(197 _ni 9, in the 2010 Tax Assessment Database ttp://taxdb.ccpa.net/details.asp?id=21-13-0971-019.&dbselect=l Page 1 of 1 •-- .. ..u ~aNc, savings ~ona(s) Calculated Value of Your Paper Savings Bonds Calculator Results for Redemption Date 03/2011 a ~•.~.'. r 9 C ~w~ ~~+1.5 'ir~G~w~:~~ ~d '~z'r9a «-"S e"` $3,075.00 ~`~~~ -e.~,~.e~,.~, '~~ ~~~~~ $12,206.72 $9,131.72 $120.30 Bonds: 1-123 of 123 4/22/11 3:20 PM w A 9£2i . . 4.~tlL~ OW`~ii4y3gi $~~g3~,31~ ~g F~~L1~ ~:YgMg pp 48 ~#. ~6.~ 15 ~»i.~0.R LA/ 6'A d~3,tia E~~@. $~~!MEyLga ~~i;~ q+~qq..~y ~y ~@M$.G ~L.~ ~il ~'~~'~'i,+~~ µ~ p, ~T C~' ~~ R~~~~ NA .. <. EE .... _ _. .. . , ,$50 ._04/,1,981 X04/2011 ~ 04/2,011 ,_ _ W.+ _, _$25 00 125 42 ~ $ ~~~ 4.00 /o ° $ 150 42 NA . _ NA EE EE $50~06/1990 ; 06/2011 ' 06/2020 ,., . $50 6 199 06 ,, $25 .0"0 ~ „- ___ _ . _ _ _ ~ ....$46 18..m , o . 4...00 /o , $71 18 ,_ . . . A _ EE 410 / 0: /2011 06/2020 ' $50 05/1 990 05/2011 OS/2020 ...?5,00.... 5 ..._.$4618.:.. . . :.4..00%,..... .. . :........:.. . ~. ,......$7118: ~ - NA_; EE _ ,__ . ; _ _ _ X50 ,,.04/1990 «04/201.13 04/2020 .. -$2 00 . ... $25 OO . . n$46 18 ; $46 18 o 4.00- /o . 4 0 % $71 18 M .... . NA .. EE .µ~ -$50 03/1990.09/2011 ~ 03/2020 ` .. ~ .A. ._25 OO w _, ~_, _., $47 6Oµ . 0 ,... 4.00% $7.1 18:. _ ` _ `~ $72 60 NA' ' EE $SOT02/1990 08/2011:02/2020 . _,. . . $25 00 _. _..~ . $47 60 .._ 4.00 % . ~-.- $72 60 NA : ; NA EE " a EE .$50 ;,01/1990 :07/2011,,; ,01/2020 $50:121 989 06/2011 l / 019 ,. , $25 00 _ u.. , . 7 60 __ . - o " 4.00 /0 .., _ ,. _ .... ...... " 72 60 - .. , $...... .. . ._ . _._,. ,..NAw_.EE. .. .. . . _, ro_ ? z _ _ _ .._... .....$50;..11/198.9:05/2011, 11%2 019. . .$25 00 .. ,. $25 00 _ . $47 60 $47 60 4 00% ... .__ 0 00 / - 72 60 ......~_.:_ ...... NA : n ~.. NA ' EE .,,.. ,-,, EE " , ...~ . ~ _$50.10/1989 04/2011 ' 10/2019 ,. , _ . M .. $25.00 ` r .. _ .._ ..47 60 < ..:4... o o 4.00 /o $72 60 . . .. -. $72 60 4 .,.~ NA ........... E .._$5Q.:09/,1,98,9 09/2011w.09/2019 ,.... 5 . ,$25.0...... ..._ $49 04 _ v 4 00% ..... $74 04 NA - E . EE 0 08/1989 08/20~11 08/2019 ....$ _ .. - . _ ~ .. ~ .: _ $50 ' 07/1989 07/2011 07 . $25.00:... .....$49 04 ~ _... - _ 4 00% . ` " ... _ _ $74 04 . ... NA EE. _.... _ . " X 4 /2019 ' w_.. ..:.$50 07/198907/2011: 07/2019 ;' ,., $25.OO.w. ~ $25.00 .. ..$49 04_ $49 04 4 00% 0 $74 04'_ .... ~_ _ ,., .... . NA . NA .. EE EE .. • ,.... $50:06/1989 06/2011 ~ 06%2.019 . . , _ ~ ~. ,:.. $50 O5/19 89 05/2011 0 . .., . $25..00 , _ .... ..;. ,$49 04,;... 0% . 4. .4 00% ... $74.04 ` ~ ~ ~ -- $74 04 ° ` _ , ., NA:. ~ .. ... , EE , , , µ ,., 5/2019 ,. _ .$50 04/1989.04/2011: 04/2019 ~ ~25w 00 _ . $25.00 . .. $49..04 ' .. $49 04 4.00% ..... 4 0 . ... .. .. $74 04 .~ NA A EE ... _. $50 T03/1989.',09/201"1 A .03/2.019. . ~.... 25.00 " . ... ,. ~ N $50 524; 2 0% ... 4 00% $74 04:. . .,.. $75 52 ` . ,., EE_ ." EE , $50 ~02/1.989 ~08/2011 _02/2019 .... , , . .$25.00 " ~ , $ 50 52 a . o 4 00 /o . _ .... ., .. . $75 52 NA : .,._ NA ..._._ .. EE .,..$50701/1989 07/2011: 01/2019 , "." _ _ . .,$25.00 ; . . _50, 52 o 4.00 /o .._ .. $76 52 _:, ~ ~ NA . EE $50 12/1988 06/2011 12/2018 _ _:.._ .....a l 1/1988 05/201 1 $5 0 11/2018 . $25.NOO µ_. . , $50..52. , 4 00%. .. .__ u$75.52 ~ - ~ - _ . NA . „ . EE ,. .. E rv _.. ; „ " .. . ; ~...... .: ,$50 :10/198,8 04/2011 : 10/2018 ... _ .. _ . ~ ..... : $25.00 ~ .. .$25.,00 ... .:: $.50 52 M ~ $50 52 ..4 00% , 4 00% - .. $75.52 = . . .... X75 52 NA' . _ ~ _ E ..._ . ,... ,$50 ,-09/1988M09/2011 :..09/2018 ;_..... . _$.25.._00.: . . , ~. _ 52.04 . 4.00 /o ° . .... $77 04 NA ., - EE „ .$50 08/1988, 08/201;1,_ 08/2018 ; .. _... _, $?5,:00 ,._ .. .. ,_.. $52 04 .. ... ~ 4.00% . . ...... $77 04 NA .-. - . , ,._ , N EE EE _$50 "07/1988.07/2011 ;:07/2018 - . .... _ $25.004.,, ,. ., ... ... . $.52 .04« ..:.. o 4.00/0 . ._ .. . .. 77.04 AT..... NA ,, EE _ .$50 ;"07/1988 07/2011: _07/2018 r $25..00:., _ _. , ., . $52 .04 .. ,..._ 4.00% . .... $77 04: .. .. , , ~.., NA; .. . EE . $50 06/,198.8.,,.06/2011 06/2018: ._ r . $50.05/1988 05/2011 05/20 18 $25..00. _ , . $52..04 ~ _...,... ~4 00% . ._. ... ._.. ... 77.04, . - . .~.. . _ . NA EE . . - ....:. $50 04/1988:04/2.011:.04/2018. ...$25,..00.._ ... . $25..00 .. $52.04.. _ $52.04 :.4.00%, ... 4.00% .. $77.04.... $77 04 NA . EE $50.03/1988: 09/2011 03/2018 _: ..... ,..:.. . $25.0Oµ_ ... .:._ $53.58: ,: 4.00% . $78 58 NA .. EE $50 02/1988,; 08/2011 02/2018 .. . 25.00 ~ .. ..:... $53.58 . . 4.00% . ;... .. $78 58 NA _ NA.... EE EE $50 01/1988 ' 07/2011 01/2018 _ ..~ . $50 12/1987 ` 06 . . $25,,._00.. .... $53,.58:._. ~ . .4.00% . .. - $78.58 : /2011:12/2017 _ _ _ $25.00 $53.58 _ 4.00% $78..58. , tp://www.treasurydireci.gov/BC/SBCPrice Page 1 of 3 Calculated Value of Your Paper Savings Bond(s) 4/22/11 3:20 PM NA EE $50 01/1984 07/2011 01/2014 ° $25.00._... $_77.40 4.00% $102.40 ... . NA EE $50 12/1983 06/2011 12/2013 NA EE 25 00 : $77.40 4.00% $102.40 $50 ,11/1983 ,05/2011; 11/2013 $25 00 : $77.40 ; 4.00% $102.40 ' NA EE $50 _10/1983 04/2011 10/2013 NA EE -. - .... $25.00 , $78.20 4.00% $103.20 ....$50 ..,10/1983 04/2011 :10/2013 $25 00 ; $78.20: 4.00% ; NA EE - $103.20 . ., 09/2013 _ $25.00. $79 44 `~ 4.00% $104 44 09/1983 09/2011 $25.00 o ,. ....$50..0.8/198. .._. , .. .. 2013 NA EE $79 44 4.00 /o : 104.44 _.. NA EE ,... ....... . 2013 $50 07/1983 07/2011 07/ _ _ $,104 44 . _. _ . 11..: 08/ ,... _ $25 00 ... $79.44 . 4.00% ` .. NA EE $50 ;.06/1983 06/201,1 y 06/2013: _ _„ $25 00 . $79". 44 ~ ..4.00% ... _.. ,, $,104 44 . _ NA' EE _ $50005/1983 ,05/2011 05/2013 ,.~. . $25 00~... ...:_$79 44 4,00%,;.__...$104 44.E NA EE $50 04/1983.04/2011: 04/2013 25 00 0 " " -- -~- $ $8410 2.10/0: $.10910: . NA, EE . ... . ...$50n03/1983_09/2O11µ 03/2013...,_,. $25 00 n _ $85 24„ ,.1.42% _,.,_._$_110 24: . NA EE .... _ _ _$50 X02/198,3 .,08/2011; 02/2013 .` o ~ ` ` .. $25 00 <.... _, $_1.04 50.,:....4.00 /o :_.........$i2µ9 50: ,NA. EE _$50,.01/1983.07/201.1 ~ 01/2013 0 .. m, , „ $25 00_r " _.$,104 50 4.,00 /o . $129 50 NA' EE . :._.,,_$5012/1982~06/2011µ,12/2012 _ _$25 00.. Y$104 50,tt .4.00% ._ NA EE ~ ,...., _ _$,129 50 ~.. _......_..w.. .~~$50~11~1.982 05/2011y11/2012.,,; $2500';,,,".,$_10450` 4.00%' NA ° EE $1.29 50 ,. _ ,, , , ,., . . _ "$50 10/1982 „_04/2011,," 10/2012: $25 OOr_4 . ,$110 70 ~ 4 00% ~ ~ _ NA:: EE ~ $135 70 ..._. .. ,.. _... ~ ....$50;..10/.1:982 x04/2011 10/2012 . _~ ., ..$25 00 '.. $110 70.~. 4 00% $135 70 . NA EE _ „ ,$50 09/1982 09/2011 Y 09/2012 -o - • ° . NA EE . n _ ~ ~25 00 :..... _ $:113 42 4'.00 /o _ $138 42 ' . .. ....~ ... _ s .. _ ........50.08/1982 08/2011..x .08/2012 _ „_ $25. _OO µ. o ~ ........ :$1.13 42a 4.00 /o , n.,,,$138 42 NA ° EE $50 ~ 07/1982 07/2011: ,07/2012,,... $25y OO s $8113 42 y _ 4.00% ' __ ..._:.$138 42 NA EE $50 06/198,2 X06/2011 ,06/2,012 ; $25 00..:.:. o $,1.13 42_ , 4.00 /o $138 42 u. NA ; EE , _ $50 05/198.2 05%2011 05/2012 v_ ~ $25 00 $1,13 42 4.00% ,~ ~ V `, NA ~ EE . $138 42 $50x04/,1982 04/2011 04/2012'„ ~ ""o "" $25 00 $113 42 4.00 /o NA EE , . . ..: $138 42 ,,_ _ _. _$50 _03/1982 09/201w1 y 03/2012 „ . u $25 00 _, $116 18 ^, 4.00%' $141 18 NA .EE„ ,.. ,, _..$50 02/,1982 08/2011:..02/2012 ;..... ,. $25 0,0 ; . $_1:16 18 4 00% ... _ NA; EE ....._$14.118;: $50 0,1/1982 ,07/201.1 ~ 01/2012 _ $25 00 0 NA '. EE :. ~._ ,_. ,$_116 18;,. 4 00 /o ...... $141 18 _ $50 _12/1981 06/2011 ,12/2011 ` . , $25 00 ;, „ $116 18 : 4 00% .. NA EE ...... _ $50 _10/198.1, ,04/2011 10/2011 ,' ~. w• ... .. _ . ~ .... $1.41 18 $25 00 $116 18 ' 4.00% NA EE .. $14118 _ .,... ..:...:., . _,_._.$50 ;10/198.1 04/2011 ~ ._10%2011 ' .' .° - . . _ _ ... _ $25 00_......$y116 18_:,. 4.00 /0 ,,..... $141 18 .. NA EE $50 :.09/1981 09/201,1 ^ ,09/2011 0 ' a _ .,., $,25.00 ',,.,,,,$119 02 ` 4 00 /o : _ $144 02 NA EE , ,........$50 ; 08/1981 08/2011 :08/2011 'o ...._ ,_ ,. _r , $25 00 . "w$119 02, 4 00 /o $144 02 NA' EE $50 07/198.1 _07/2011' 07/2011 ~~ ~~o '" .. ... 25.00 $.119 02 4 00 /o .,,..:,,,_$144 02 NA EE $50 ;,06/198.1 .06/2011 ` _06/2011 _ _ $25.00: 119 02 4 00,% $144 02 ... NA; EE $50 05/1981 05/2011 05/2011 _ ..- ,. $25 00 $119 02 4 00% , ,$144 02 NA ": , EE ...... _ .$50 ",03/198:1 ' ....,. _ - . 03/2011 .,, _ $25.00....... ,.x $.128 44...,.. .. _ ................:..$153 44 ;; MA .. NA EET:.._..,~„$50 ,02/1.981 ._ µ ._..,.02/2011 ~ $25.00: _,. ,, ~_.. ~ _. $128 44*~ _ w ......$153 44 .MA NA : EE .,._,$5001/1981 .y _ ..2 01/2011 y $25.00 ~ , $128 44 _ . _.. _._.... ._...:....$153 44;r.MA. Totals for 123 Bonds $3,075.00 $9,131.72 ~ $12,206.72 N ~t~~ NI Not Issued NE Not eligible„for payment ... .. P5 Includes 3 month interest penalty MA ;Matured and not earning interest ttp: //www.treasurydirect. gov/BC/SBCPri ce Page 3 of 3 MEMBERS 1St FEDERAL CREDTT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 10259-00 Date Account Established 06/12/1968 Principal Balance at Date of Death $15 757.37 Accrued Interest to Date of Death , $2.05 Total Principal and Accrued Interest $15 759.42 Name of Joint Owner , None LIFE SAVINGS ACCOUNT• Account Number/Suffix 10259-04* Date Account Established 02/01/2001 Principal Balance at Date of Death $4,000.00 Accrued Interest to Date of Death $.52 Total Principal and Accrued Interest $4 000.00 Name of Joint Owner , None *Opened by transfer of funds from 10259-00. CERTIFICATES OF DEPOSIT• Account Number/Suffix 10259-43 10259-44 Date Account Established Principal Balance at Date of Death 02/20/2010* 05/06/2010** Accrued Interest to Date of Death $30,000.00 $13 27 $34,860.62 Total Principal and Accrued Interest . $30,013.27 $27.04 $34 887 66 Name of Joint Owner None , . None "Rollover from certificate 10259-41, originally established 03/20/2009 . **Rollover from certificate 10259-42, originally established 06/06/2009. MBERS 1s~r FnED~ CREvD~T~ION (/jl,~lX. ~. I...x,/~~ Danielle A. Kline Lending Insurance Support Specialist April 15, 2011 Estate of: GRACE BRENIZER Date of Death: 03/20/2011 Social Security Number: 207-22-0047 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org O 1VI8TBank 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Phone 888-502-4349 F ax (302) 934-2955 April 12, 2011 Frey and Tiley 5 South Hanover Street Carlisle, PA 17013 Re: Estate of Grace L Brenizer Social Security: 207-22-0047 Date of Death: March 20, 2010 Dear Sir or Madam: Per your inquiry on April 7, 2011, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 449903 Ownership (Names o, fl Grace L Brenizer Barbara S Willier (POA) Opening Date 09/01/67 Balance on Date of Death $31,823.34 Accrued Interest $ 2.10 Total $31,825.44 2. Type of Account Savings Account Account Number 15004198150599 Ownership (Names ofl Grace L Brenizer Barbara S Willier (POA) Opening Date 01/04/01 Balance on Date of Death $23,717.35 Accrued Interest $ 1.65 Total $23,719.00 1995 Toro txplorer Explorer Sport Utility 4D Trade In Values & Reviews -Kelley Blue Book f ,~ • tr ;~f '~+a~~+~ ~~~ ~R 1H~'1`ItL15t'EC1ft£~SUUItt~° ~; '~ _ f ~~- 1995 Ford Explorer Sport Utility 4D Mileage: 209,000 change edit options ? change style values ;specs ~~ new car finder fi used cars for sale s {, I ( r Trade- I n/Sell Values _.. __.. Excellent $1,975 .___..Good-._......... _.__ $1,750 Change condition See Used Car Prices Now choose.your Next Step: • Price new cars • Use our Perfect Car Finder° tool Or explore a specific new car Make : Model ~ Year KBB Expert Suggestions .~.. ~.. 2011 Ford Explorer 2011 Mazda CX-9 2011 GMC Acadia Search Used Cars for Sale near Carlisle View actual photos, compare prices, and buy your next car. ~Seled Make :~• select Model 5/10/11 11:58 AM ................ I want to list my car for sale Get your free seller's Toolkit . _._... I want help selling my car Read 10 tips to sell your car :Recent News for This Car Top 10 Family Cars: #5 2011 Ford Explorer Review --Anew era begins More News ... ttp://beta.kbb.com/ford/explorer/1995-ford-explorer/sport-utility-4d...mileage=209000&pricetype=private-party&condition=good&printable=true Page 1 of 2 ..~ 1996 Chevrolet 1500 Regular Cab 1500 Regular Cab Long Bed Trade In Values & Reviews -Kelley Blue Book ~~ s--• ~ THE fltv5l'EC3 RESUUT~C>`° ~: ~"'`~ , '~?{'f ' , hi' -_,,., 1996 Chevrolet 1500 Regular Cab Long Bed Mileage: 84,061 change edit options ~ change style r.._..._....~., j t______..._..._.-,k i~._~_.~. _._.,~.... ---._.... __...... __._......_._...__,. values f ~ specs ~ new car finder used cars for sale i ' ' ; i Trade- I n/Sell Values .~. Excellent °O ~~~~~~~~~ s4,ooo $3,700 Change condftion Now choose your Next Step: • Price new cars • Use our Perfect Car Finder tool Or explore a specific new car Make ~ Model : Year ' ; Search Used Cars for Sale near Carlisle View actual photos, compare prices, and buy your next car. ' Select Make ; Select Model ;' ; Up to 75 Miles : away ftom ZIP !~17013~~ ~.. Get Prepared to Buy Your Next Car .«~.~..~,..~«~.,.~.. BankofRmerca Check a car's history before Get your credit score and Apply for an auto loan you buy. credit reports. starting at 2.99% S/10/11 12:00 PM What if my credit's not perfect? Apply with a specialist now I want to list my car for sale Get your free Seller's Toolkit I want help selling my car Read SO tips to sell your car Latest N ews Fat 500s bring pear trees to New York Cit... Supercharged Mugen Euro Honda CR-Z Concept... Nissan NV200 chosen as New York City Taxi ... More News ... ittp://beta.kbb.com/chevrolet/1500-regular-cab/1996-chevrolet-1500-...mileage=84061&pricetype=private-party&condition=good&printable=true Page 1 of 3 ** * Thrift Savings Plan Death Benefits Processing Unit * THRIFT DEDIS P.O. Box 4450, Fairfax, VA 22038-4450 SAVINGS PLAN 0200011 02 SP 0.640 "SNGLP i 1 5093 17013-&10929 -C01-P0001 1-11 2 3 VIII(1111(I'IIIIIIIIIII'1'IIIIIIIIIIIIIIIIIIIIIII~II~IIIIIII~ ,,;~~ BARBARA WILLIER , ,. 129 W MIDDLESEX DRIVE ~•~ 05/13/2011 CARLISLE PA 17013-8409 RE: Estate of G BRENIZER Dear Sir or Madam: The Thrift Savings Plan (TSP) has determined that you are a beneficiary of the TSP account of the deceased participant named above. You are entitled to receive 100.00% of the account balance. As of 05/13/2011, the vested account balance was $7,532.34. The account balance at the time of disbursement may differ from this amount as a result of earnings, late deposits, or other adjustments. Your payment is scheduled to be made in 60 days. If the amount you are entitled to receive is $200 or more, any amount paid directly to you (including a payment sent to your savings or checking account) is subject to mandatory 20% Federal income tax withholding. This tax withholding cannot be waived, but you may request additional withholding by completing the enclosed Form W-4P, Withholding Certificate for Pension or Annuity Payments. You can defer paying tax on all or any portion of this payment if you transfer it directly to an "inherited" IRA. An inherited IRA i5 specifically established for the purpose of transferring money inherited from a plan such as the TSP. Inherited IRAs may provide significant tax benefits since the required distributions for the IR.A can generally be spread across the lifetime of the beneficiary. However, Internal Revenue Service rules and restrictions governing inherited IRAs ai'e complicated. If you are interested in transfemng your benefit to an inherited IRA, you should read the enclosed TSP tax notice and consult your tax advisor before you make your decision. To request a transfer, subir~it the encloses; Form TSP-81, Death Benefit Election fora 3eneficiai y Other Than a Spouse, to the TSP at the address on the form within50 days from the date of this letter, to allow time for processing. For the portion of your payment that is not transferred, you may also use this form to request payment by direct deposit. Please ensure that your form is complete and that you send it to the TSP in sufficient time for processing. Otherwise, the TSP will have to make a payment directly to you and withhold 20°/D for Federal income tax. A payment that is issued directly to you may not be returned for reissuance as a transfer payment. Further, you cannot roll over a payment that you receive into an inherited IRA. If you need additional time to complete Form TSP-81, please contact the TSP. If you would like to have your payment sent directly to you, you do not need to take any action. The TSP will apply the mandatory 20% Federal income tax withholding and make a payment to you in 60 days. You can expedite the payment by completing the Waiver of Tax Notice Period form. You can also request to have your entire payment sent to your savings or checking account via direct deposit by completing ebsite: www.tsp.gov ThriftLine: 1-TSP-YOU-FRST (1-877-968-3778) TDD: 1-TSP-THRIFT5 (1-877-847-4385) Fax Number: 1-703-592-0170 Notice: DC4023 000017446596420110513DC4023 LAST WILL AND TESTAMENT OF GRACE L. BRENIZER I, GRACE L. BRENIZER, widow, of Middlesex Township (mailing address: 7829 Wertzville Road, Carlisle, PA 17013), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter-named Executor to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral services be conducted by Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsylvania, in a manner substantially similaz to the arrangements which I made for my husband Clarence Brenizer who died on April 13, 2008, and that my body be interred beside his on our burial lot located in Cumberland Valley Memorial Gazdens located along Governor Ritner Highway, near the Borough of Carlisle, Pennsylvania. I bring to the attention of my Executor that I. have pre-paid various funeral expenses including grave opening, casket and vault to Cumberland Valley Memorial Gardens. 2. I direct that all inheritance, transfer, succession, estate and death taxes, including interest and penalties thereon, which may be payable onaccount of my death shall be paid from the residue of my estate regardless of whether the assets upon which such taxes are based are included in my probate estate. 3. I give and bequeath the sum of $5,000.00 to each grandchild as shall survive me by a period of ninety (90) days, but should any grandchild of mine fail to so survive me, the share that person would have otherwise received shall lapse and be added to the remainder of my estate. At the present time I have five (~ grandchildren, they being Robbin Viorai, Andrew Brenizer, Shari Brenizer, Chad Wert, and Jama Wert. 4. Al] of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath to my daughter BARBARA S. WILLIER, her heirs and assigns, of 129 West Middlesex Drive, Cazlisle, PA 17013, provided she shall survive me by a period of ninety (90) days, but should she fail to so survive me, then to such of her two children as shall survive me by a period of ninety (90) days, their heirs and assigns, per stirpes. 5. I hereby nominate, constitute and appoint my daughter, BARBARA S. WILLIER, as Executor of this my Last Will and Testament, but should she predecease me or fail to qualify or cease serving as such, then in such event I nominate, constitute and appoint her son, CHAD WERT as alternate or successor Executor, and I further direct that neither of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. 6. In addition to the powers conferred by law, my hereinbefore named Executors and Trustees and their successors are empowered: a. To invest any part of the trust corpus in such securities, investments, or other property as may be deemed advisable and proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. b. With respect [o any corporation, the stocks, bonds, or other securities of which may be held, to vote in person or by proxy on any shares of stock; to consent to the merger, consolidation or reorganization of such corporations; to consent to the leasing, mortgaging or sale of the property of any such corporations; to make any surrender, exchange or substitution of such stocks, bonds or other securities as an incident to the merger, consolidation or reorganization of such corporations; to pay all assessments, subscriptions and other sums of money which may be deemed wise and expedient for the protection and maintenance of the proportionate interest of the investment in such corporations; to exercise any option or privilege which may be conferred upon the holders of such stocks, bonds, or other securities of such corporations either for the conversion of the same into other securities or for the purchase of additional securities, and to make any and all necessary payments which may be required in ~7 Y,(Y ~,\s connection therewith; and generally to have and exercise as to all such stocks, bonds and other securities, the powers of an individual owner who is not under trust obligation. c. To hold the trust corpus in one or more consolidated funds in which sepazate shares shall have undivided interests. d. To sell at public or private sale for cash or upon credit, or partly for cash and partly on credit, and upon such terms and conditions as shall be deemed proper, any pazt or parts of the estate, and no purchaser at any such sale shall be bound to inquire into the expediency or propriety of any such sale or to see to the application of the purchase moneys arising therefrom. e. To keep on hand and uninvested such money as may be deemed proper and for such period as may be found expedient. f. To compromise, settle or arbitrate any claim or demand in favor of or against the trust estate. g. Ahd authorized in the discharge of fiduciary duties, to employ counsel and to determine and to pay such counsel reasonable compensation which shall be charged against the principal or income of the trust fund, and shall further be entitled to charge against the principal or income such other reasonable expenses and charges as may be necessary and proper to incur for the proper discharge of fiduciary duties and for the proper management and administration of the trust estate. h. In making any division of property into shares for the purpose of any distribution thereof directed by the provisions of the trust, to make such division or distribution, either in cash or in kind, or partly in cash and partly in kind, as shall be deemed most expedient, and in making any division or distribution in kind may allot any specific security or property or any undivided interest therein to any one or more of such shares, and to that end may appraise any or all of the property so to be allotted and the judgment as to the propriety of such allotment and as to the relative value for purposes of distribution of the securities or property so allotted shall be final and conclusive upon all persons interested in the trust or in the division or distribution thereof. i. And authorized to register any shares of stock or other assets of any trust in their own names or in the name of a nominee. j. To retain and invest in shares of stock of my Trustee. k. To retain any investments including mutual funds which I may own at the time of my death and in addition to invest any par[ of the Trust corpus in such mutual fund or mutual funds as may be deemed advisable or proper, irrespective of whether the same aze authorized for the investment of trust funds under the laws of any governing jurisdiction. I. To determine from time to time whether all or some portion of realized capital gains shall be treated as ordinary income for distribution to a beneficiary or treated as principal to be retained as part of the corpus, and such designation need not be consistent from one year to another. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on three (3) pages, this 13th day of November, 2009. ~J. ~~ - ~~~ (SEAL) GRACE L. BREMZER Signed, sealed, published, and declared by GRACE L. BRENIZER, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ..~ ~ ,~~L~z \~`'~