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HomeMy WebLinkAbout06-14-11 (2)1505610143 REV-1500 Ex(o,_,o, PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes Pennsylvania County code Year File Number DEVARTLENT OF REVENUE Po Box.zBOSO~ INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 10 0 9 9 g ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 171 30 6015 09 19 2010 07 31 1937 Decedent's Last Name Suffix Decedent's First Name GOCHENOUR MI BEVERLY D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name GOCHERNOUR MI KENNETH E Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ qa, Future Interest Compromise (date of death after 12-12.82) ^ 5. Federal Estate Tax Return Required g Decedent Died Testate ~ ecede^t Main ned a Living Trust 0 (Attach Copy of wli) ^ Attach Gopy of(~rust) 8. Total Number of Safe Deposit Boxes ^ 9. Litigation Proceeds Received ^ 1 p. s usal Pove~Credit (date of death b~tween 12-31- and T-1-ss) ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number WM D SCHRACK III ESQ 717 432 9733 REGISTEt~QF WILLS USA'-0NLl~ First line of address G ~ ~ ',- -n 124 W HARRISBURG STREET ~ m "" ~-' '~;~' ~ ~~ ~. ,R ., --_ Second line of address ~~ ~ ~- City or Post Office State ZIP Code D LED ~~ DILLSBURG PA 17019 ~ Correspondent's a-mail address: SChraCklaW@COmCast.net 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. SIGNATUIjE OF PERSON RESPONSIBLE FOR FILING RETURN Kenneth E. Gochenour iv- Q 7. 2 p 1505610143 Side 1 1505610143 J 124 W. Harrisburg Street, Dillsburg, PA 17019 1505610243 REV-1500 EX Decedent's Social Security Number oe~de"''3"ema: Gochenour, Beverly D. 171 30 6015 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 417.40 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 7 , 8 69.73 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested 6 7. ............ Inter-Vivos Transfers & Miscellaneous I~oq Probate Property (Schedule G) . 14 , 0 0 9 . 5 9 LJ Separate Billing Requested............ 7• 8. Total Gross Assets (total Lines 1-7) ................ ..................................................... g• 22,296.72 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 19 , 7 $ 6 . 8 8 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ......................... .......................................... 11. 19, 786.88 12. Net Value of Estate (Line 8 minus Line 11) ........ 13. ........................ . ......................... Charitable and Governmental Bequests/Sec 9113 Trusts for which 12. 2 , 50 9.84 an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .... ........................................... 14. 2,509.84 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 2 , 5 0 9. 8 4 16. 112.94 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 O. Q Q 1 g. 0. 0 0 19. Tax Due .................................................................................................................. 19. 112.94 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 L 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Gochenour, Beverly D. STREET ADDRESS 907 Robert Street CITY Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. STATE ZIP PA 17055 (1) 112.94 0.00 112.94 Total Credits (A + B) (2) (3) (4) (5) 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 :............................... . x b. retain the right to designate who shall use the property transferred or its income :.................................. ^ c. retain a reversionary interest; or ............................................................................................................... ^ 0 d. receive the promise for life of either payments, benefits or care?............ ^ .............................................. . death occurred after December 12, 1982, did decedent transfer property within one year of death without ^ ^ receiving adequate consideration? .................................................................................................................... x 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0 percent [72 P.S. §9116 (a) (1.2)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. . 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)]. 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. File Number 21-10-0999 Rev1503 EX+(6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Gochenour, Beverly D SCHEDULE B STOCKS ~ BONDS FILE NUMBER 21-10-0999 All property jointly-owned with right of survivorship must bediaclosed on Schedule F. ITEM CUSIP NUMBER NUMBER DESCRIPTION 13.188 shares of common stock of Wells Fargo @ $31.65 pe share TOTAL (Also enter on Line 2, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. UNIT VALUE I VALUE AT DATE OF DEATH 417.40 417.40 Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+(g-88) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-10-0999 ESTATE OF Gochenour D. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survlvonship must be disclosed on schedule F. t~~ ~~~~~~ ~Na~ ~s neeaea, aaamonal pages or the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+(6-98) COMMONYYEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Gochenour, Beverl D. FILE NUMBER 21-10-0999 Han 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 ADDRESS RELATIONSHIP TO DECEDENT A. Carly J. Schaeffer 70 E. Barrens Valley Road Grandchild Dillsburg, PA 17019 B. Deidra L. Schaeffer 70 E. Barrens Valley Road Daughter Dillsburg, PA 17019 C. Diana L. Bruce 640 Copper Circle Daughter Lewisberry, PA 17339 JOINTLY OWNED PROPERTY: DE ITEM LETTER FOR JOINT DATE MADE SCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH % OF TH DA VA NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSE DECD'S UE OF DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE. INTEREST 1 C 06/03/2009 Heritage Investment Services Fund -Account 690 93 50 000% 1010964 . . 345.47 2 C 06/03/2009 Heritage Investment Services Fund -Account 660.51 50.000°/a 330 26 1010965 . 3 A 08/13/2009 Heritage Investment Services Fund -Account 1,584.50 50.000% 792 25 1011106 . 4 C 08/19/2009 Heritage Investment Services Fund -Account 1,583.21 50.000% 791 61 1011129 . 5 B 10/21/2009 Tax Parcel49-MD-11L, known as Lot#3, 23,500.00 50.000°/a 11 750 00 containing 4.608 acres, located in Warrington , . and Washington Townships, York County, Pennsylvania TOTAL (Also enter on Line 6, Recapitulation) I 14,009.59 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV-1151 EX+(~0-OB) COMCNN RESID N~DECED~RN/ANIA ESTATE OF Gochenour~ ITEM NUMBS A. FUNERAL EXPENSES: SCHEDULE H FUNERAL EXPENSES & D. FILE NUMBER 21-10-0999 Debts of decedent must be reported on Schedule I. DESCRIPTION See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(sl Commission Daid 2. Attorney's Fees Wm. D. Schrack III Esq. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Kenneth E. Gochernour Street Address 907 Robert Street city Mechanicsburg state PA zip 17055 Relationship of Claimant to Decedent SpOUSe 4. I Probate Fees 11,797.60 3,500.00 3,500.00 111.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 877 78 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 19,786.88 AMOUNT Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF Gochenour D. FILE NUMBER 21-10-0999 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Cocklin Funeral Home 11,797.60 H-A Other Administ ti G 11,797.60 2 ra ve ost~ Clerk of Orphans' Court -Fiduciary Release filing fee 20.00 3 Cumberland Law Journal -estate advertisement 75.00 4 Miscellaneous expenses incurred during period of administration 30.00 5 Recorder of Deeds -fee to record three Deeds @ $65.50 each 196.50 6 Register of Wills -additional Short Certificates 24.00 7 Register of Wills -additional Short Certificates 8.00 8 Register of Wills -Inheritance Tax Return filing fee 15.00 9 Reserve for future administrative expenses 250.00 10 The Patriot News Company -estate advertisement 259.28 H-B7 877.78 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) REV-1513 EX+(11-08) SCHEDULE J COMINwEP,A4To ~P p~N7R,N,gNIA BENEFICIARIES ESTATE OF f~nnhn.,.,... Qe.....~., n FILE NUMBER NUMBER I~ --- - '-'' - NAME AND ADDRESS OF PERSON(Sl RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 RELATIONSHIP TO DECEDENT Z1-10-0 SHARE OF ESTATE (Words) 999 AMOUNT OF ESTATE ($$$) 1 Diana L. Bruce Daughter 640 Copper Circle Lewisberry, PA 17339 2 Robert M. Bruce Grandson 640 Copper Circle Lewisberry, PA 17339 3 Keith A. Gochenour Stepchild 5 Randall Drive Enola, PA 17025 4 Kenneth E. Gochenour Husband 907 Robert Street Mechanicsburg, PA 17055 5 Kent E. Gochenour Stepchild 1122 Baldwin Street Mechanicsburg, PA 17055 See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 1 5 throw h 18 on Rev 150 0 cover sheet, as a r o riate. II NON-TAXABLE DISTRIBUTIONS: . A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Beverly D. Gochenour 09/19/2010 171-30-6015 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) ~ ~.--'-- .. ..c...~ v. vvna~.nc~ 70 E. Barrens Valley Rd. Dillsburg, PA 17019 uranaaaugnter 1 `~~ts# t1.C ~txtd BPS#~tmPxt# OF BEVERLY D. GOCHENOUR BE IT REMEMBERED, that I, BEVERLY D. GOCHENOYTR of 907 Robert Street, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that my hereinafter named Executor pay all my just debts, my funeral expenses, and the expenses of the administration of my estate. With this direction, I authorize and empower my Executor to expend for my funeral expenses and interment such amounts as he may consider necessary and proper, without regard to any limit that may be prescribed by a court of law. ITEM 2: I direct my Executor to pay all inheritance, estate, succession, and legacy taxes of whatsoever na±ure and kind, to which my estate, or the transfer of any property passinJ hereunder or otherwise passing by reason of my demise, may be subject, and to charge such taxes against my ';k~~ residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to who.n any benefit accrues. ITEM 3: I give and bequeath unto my grandchildren, CARLY J. SCHAEFFER and ROBERT M. BRUCE, in equal shares, any common stock which I may own and is issued by Wachovia Corporation, or any other corporation or banking institution into which Wachovia Corporation may have merged. ITEM 4: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power ofappointment, I give, devise and bequeath unto my spouse, KENNETH E. GOCHENOUR, provided he survives me for a period of thirty (30) days. ITEM 5: In the event that my beloved spouse should predecease me or fail to survive me for a period of thirty days, I direct that my Executors hereafter named accomplish the following distributions: A. I give, and bequeath unto my daughter, DIANA L. BRUCE, the 10.470 acre parcel of land identified as Lot #5 on a final plan of subdivision prepared for me by Associated Land Measurers, Inc., dated June 19, 1987, and recorded in the York County Recorders Office in Plan Book JJ, at page 767. B. I give, and bequeath unto my daughter, DEIDRE L. SCHAEFFER, the 4.697 acre parcel of land identified as Lot #3 on a final plan of subdivision prepared by Rodney Lee Decker & Associates, dated November 22, 2002, and recorded in the York County Recorders Office in Plan Book RR, at page1228. C. I give and bequeath unto my husband's sons, KENT E. GOCHENOUR and KEITH A. GOCHENOUR that 10 acre parcel shown as Lot #2 on a final plan of minor subdivision prepared for Kenneth E. Gochenour by Rodney Lee Decker & Associates, dated March 29, 1990, and recorded in the Office of Recorder of Deeds of York County, Pennsylvania in Plan Book KK, at page 253. 2 ITEM 6: All the rest, residue and remainder of my estate, of whatsoever nature, and wheresoever situate, whether it be real, personal, or mixed, including property over which I have a power of appointment, I give, devise, and bequeath unto my daughters, DIANA L. BRUCE and DEIDRE L. SCHAEFFER, and my husband's sons, KENT E. GOCHENOUR and KEITH A. GOCHENOUR, in equal shares, per stirpes. ITEM 7 : I nominate, constitute and appoint my husband, KENNETH E. GOCHENOUR as Executor of this my Last Will and Testament. In the event my husband, KENNETH E. GOCHENOUR should predecease me, fail to qualify, cease to act, or renounce probate, I appoint my daughters, DIANA L. BRUCE and DEIDRE L. SCHAEFFER, and my husband's sons, KENT E. GOCHENOUR and KEITH A. GOCHENOUR, or the survivor of them, to serve as alternate Executors of this my Last Will and Testament. ITEM 8: I direct that my hereinbefore named Executor shall not be required to give bond for the faithful performance of his duties in this or any jurisdiction. IN WITNESS EREOF, I have hereunto set my hand and seal this ~~ '~ day of 2004. r `` ti BEVERLY D.~~GOCAENOUR The preceding instrument, consisting ofthis and three (3) other typewritten pages, was on the day and date thereof signed, sealed, published, and declared by the Testatrix herein named, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses hereto. .~ ~ , s' ;.,,~ .= ~, s -` ,- e v JJ r ._. A f~ f / OF~' 3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF YORK ~~ / n e, BEVE Y D. GOCHENOUR, C ~u !.~ and ~ ,the Testatrix and the witnesses, respectively, whose names are signed to the att ch or for going instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament, and that she signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as witnesses, and that to the best of their knowledge, the Testatrix was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. BEVERLY D~ GOCHENOUR ~ 1 SWORN TO AND SUBSCRIBED /~9RE BE ME THIS /~ ~1C DAY (( ~ 4Gf Q`~ , 2004. NOT. n~.~isi~~ .tsnetS. Gores, ~.~'~~~~~~ ~iilsbt.7~, Coro, fork %eur, r~~r;rsbfvars~i ~~ ~~ ~Q Direct Purchase Plan Transaction Request Mall to: Wells Fargo Shareowner Services NW01 4002691358 Wells Fargo & Company Direct Purchase Plan PO Box 64856 St Paul MN 55164-0856 Please change my address as indicated. i ~J All registered owners MUST sign on the back of this form. KENNETH E GOCHENOUR EX EST BEVERLY D GOCHENOUR 907 ROBERT ST MECHANICSBURG PA 17055-3452 Illlu iiiii iiiii iiiii iiNi iiiii iiiii iiiri iiiii ilia ~9lill I IIIUiii a iiiiii niii,iiq IIII 0302„ Detach here. Forward top portion to the address shown above. Direct Purchase Plan Account Statement _ IMPORTANT: Retain this statement for your investment, tax and cost-basis records. Questions: U.S. telephone number: 877-840-0492 Local and Outside U.S.: 651-450-4064 For online account information, please visit www.shareowneronline.com Fax number for transaction requests: 651-450-4085 .-....:..., .,..~-,.,..,.. , of 1 OPTIONAL CASH PURCHASE ELECTION [J Enclosed is a U.S. dollar check drawn on a United States bank, made payable to Shareowner Services for: $ ____ Minimum $25.00/Maximum $10,000.00 per month Next deadline for Shareowner Services to invest your payment is 5 p.m. CT on Wednesday. Shares are purchased every Thursday Shareowner Services will process your purchase instructions according to your Plan prospectus/brochure upon receipt of your properly completed request which includes account number and company name. We will not be liable for any claim arising out of failure to purchase shares on a certain date or at a specific price. Requests, other than address change, submitted on this form will only affect Direct Purchase Plan shares, not shares held in DRS. 223101 O1 par 7302 Account Summary Wells Fargo 8 Company Account # 4002-- 6- 9- 1 8 KENNETH E GOCHENOUR EX EST BEVERLY D GOCHENOUR 907 ROBERT ST MECHANICSBURG PA 17055-3452 Share Balances Direct Purchase Plan Certificate(s) Direct Registration Total Shares March 2, 2011 Record Date Current 0.167 0.188 0.000 0.000 13.000 13.000 13.167 13.188 Year-to-Date Amounts Current Dividend Gross Dividends Reinvested $0 66 Record Date 02/04/11 Federal Tax Withheld . $0 00 Payable Date 03/01/11 Nonresident Alien Tax Withheld . $0 00 Dividend Rate $0.05 State Tax Withheld . $0 00 Account Value Cash Investments . $0 00 Market Value Date 03/01/11 Service Charges Paid by You . $0 00 Market Value Price $31.6500 Service Charges Paid by Company . $1 60 Account Market Value $417.40 Commissions Paid by You . $0.00 Transaction or Transaction Settlement Date Type Gross Amount of Service Transaction Charge Net Amount of Price Shares Increased Transaction Total Shares er Share or Decreased p Held in Plan ALANCE FORWARD 03/04/11 Div Reinvested $0.66 $0.00 $0.66 $32.0202 0.021 0.167 0.188 PURCHASE EXECUTED ON 03/01/11. SHARES ARE CREDITED AS OF SETTLEMENT DATE 03/04/11. .Unless otherwise specified, Wells Fargo Shareowner Services`. default method tvr disposing of shares is in the order they were acquired, also known as FIFO (First-In First-Out).:-This includes, but is not hmrted to, sales; transfers and exchanges. II IIEItlIIRIIIIIII~IYllllllllilillllllllllillllllll~!Illllllllllldn =„,,,F~,, , eHEOU~E 4651 Westport Dr Mechanicsburg PA 17055 (717)796-9784 Estate of Beverly D Gochenour 907 Robert St Mechanicsburg PA 17055-3452 ~tY~ 111' Y riJ .S lt~z' V r~ ~'~~:{LS F~.iNL7 iv~<frn€nf ~}iat tizor;.-~ Quarter Ending Sep 19, 2010 Account Rate Matures 1006616 3.25% N/A °° N/A 1010965 5.00% 101110fi 5.00% 1011129 5.00% 8/13/2014 Page 1 Deposits Interest Withdraws Penalties Balance $2,750.00 $98.09 $0.00 $0.00 $6,101.58 $100.00 $14.70 $0.00 $0.00 X33 0.00 $21.61 $0.00 $660.51 $0 $0.00 $0.00 51,584.50 $0.00 $51.38 $0.00 51,583.21 TOTAL PER100 INTEREST $302T3LTAL ON QEPOSIT (includes unposted interest; 516,696.78 /,r ,< ~~~ ~ ~~~~ H~RIT ~~ Asi ar y'?tr•'v`:.`~'`t-~'v`?t-'`v`W`?t-~€~r:~--'v`~`v?`t-`~'v`:.~V`~V`:.~'~r::`y<:a~y~ty~'yv7,-: -v~;~v.'v?;`v? ~-~.n,-:n,.-.n.=;,n.=;n.->n.=~n.;.n.°.,~.>A.=:n.~>c~;w.-n<~~•~~~~~~=;n.=•,n,.A.: ;,A=°.s~-:.n,=:~ A.~.A=.r~.:.n~ Y :'Y:: Y:: Y: ~`~1I'''' ~~ f. :~~: Y~`:Y=: Y:. '~1` Y:'Y: ~tl': Y: ~l_= A `.(1 ~1.?.(L.s ~~ ~~ ~Fl.* ~:.~~~1., ~:Al.~e.fi~!~F#sb~ ~ %~f'i.~ ~ ~:~t~ :A.% ~A: ~' ;(l~'.~1.- !~ r/' vs~vEHA~~A ALLEY FEDERAL C R E D I T U N I O N October 26, 2010 Law Office of William D. Schrack, III 124 West Harrisburg Street Dillsburg, PA 17019 Re: Beverly D. Gochenour Revenue File #: 21-2010-0999 Dear Mr. Schrack, The following is the information in which you requested regarding the accounts of Beverly D. Gochenour. Please be advised that we still need to view an original certified copy of the Death Certificate for Mrs. Gochenour. Please forward that to my attention at your earliest convenience. Account number 15517 was an individual savings account in Beverly's name only. The balance on September 09, 2010 was $1,768.15. Additionally, Mrs. Gochenour had a joint account with her husband. This account (#12495) has a savings account, a club account and a checking account. Mrs. Gochenour was added as joint owner to the account when it was opened on February 17, 2001. The date of death balances were as follows: 12495-00 (savings): $266.34 12495-09 (club): $197.28 12495-40 (checking): $1,059.75 ~,~!; Please let me know if you need any additional information. Kind regards, Kathy Jo McCabe - ~ ~ ~ ~~- ~~ Member Services Supervisor www. S VFC~I . org u 4651 Westport Dr Mechanicsburg PA 17055 (717) 796-9784 Estate of Beverly D Gochenour 907 Robert St Mechanicsburg PA 17055-3452 SERVYCE.S .~UN7 An inv~stm~nt >~iat x~c~rT~s Quarter Ending Sep 19, 2010 V Account Rate Matures Deposits Interest Withdraws Penalties Balance 1006616 3.25% N/A $2,750.00 $98.09 $0.00 $0.00 $6,101.58 1010964 3.25% N/A $100.00 $14.70 $0.00 $0.00 $690.93 1010965 5.00% 6/3/2014 $0.00 $21.61 $0.00 $0.00 $660.51 1011106 5.00% 8/13/2014 $0.00 $51.42 $0.00 $0.00 $1,584.50 1011129 ana~-cc~~ 5.00% - ~^°~ 8/19/2014 11/11~1A $0.00 ~ $51.38 $0.00 $0.00 B:Av- $1,583.21 ---$6;9Z6.Q5-- Page 1 TOTAL PE,/RI/OD INTEREST $302T~2TAl_ ON DEPOSIT (includes unposted interes%? 616,696.78 ~c~A ~ ~~ s!r r< w O z LIB O ~. w ^~ `u.a z ~ :..... v C G:, u .~ v s c a~ G T .i y H z W h ~ . '- cn ~ . ~w ~ ,: ~w U C7 ~Hy ~ .. 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C "'~ s Tl v 7 j~D rD _ .r C ,.~ +~ v, a' ~ ~o Oa~Z~ Z ~~, s~. ,,,~ ~ N z:; z z .. ~ ~~ ~~ ~ ,, o o ,-~ ~ D p ;r, :r. ~ ~ C~ J ~ "h ~ ~ '~ z ~ v: CC .^ ," y 'l: :~ z ~_ _ ter. ~~-yy L i~ D ~~yi ~ /,' `~ ~ ~~-1 n o n r-Lr L ~ ~~ /'-< ~ G1 t _ '~- --~ -c -~ .. ;~ fl.. ~ ^~ ~y ~-i D zT. o Y~ -- ~. ~ --l rn m O s ti F`. ;r ~~ ~~ <~; ~ ~ ~a~O~ C A: I~. ;, rn ~ ,~ -~zNC"z =iC ~:>' •r, j~ /°` // r N M ^ /~" r-~ =_ ~ z Cn '- Cn 7~ -- ~ F~ t~ y V Pu ~_ f A '~7 C ~. r~ ~ ,_.7 ~ 5`:>:~'. ~` ,.~' +.'Y ~` .i~'~ ~ ~ . - . _ ;.~, ; "X >.y., _ .i J .~..iy ~ :>.~.~ ~.>S~',i-'~;,i~„~ ~ri~'t'i~.:~ : '-`rte ~. , ~- i-- . `: ~~G YORK COUNTY i ' ~ ~' J ASSESSMENT OFFICE 'y Q ~~ ~~ \~ ~~ ~ 09 ~ 03653 7~ TAX PARCEL N0..3~-MD- l l DEED THIS DEED made this day of /`~°' ~..,~'~, , 2009, by and between KENNETH E. GOCHENOUR an~BEVERLY D. GOCHENOUR,~husband and wife, presently of 907 Robert Street, Mechanicsburg, Pennsylvania, parties of the first part, hereinafter called Grantors, ..?. -iuvu- ~~ T BEVERLY D. GOCHENOUR and DEIDR~ L. SCHAEFFER, as joint Tenants with the Right of Survivorship, and Not as Tenants in Common, parties of the second part, hereinafter called Grantees. AS A CONVEYANCE BETWEEN PARENTS AND DAUGHTER, THE WITHIN TRANSFER IS EXEMPT FROM PENNSYLVANIA REALTY TRANSFER TAXES. WITNESSETH, that in consideration of ONE DOLLAR ($1.00) in hand paid, the receipt whereof is hereby acknowledged, the said Grantors do hereby grant and convey unto the said Grantees, their heirs and assigns, ALL THAT CERTAIN tract of land situate partially in the Township of Warrington, and partially in the Township of Washington, County of York, and Commonwealth of Pennsylvania, being more particularly bounded and described as follows, to wit: BEGINNING at a point in the center of the cartway of Pennsylvania Traffic Route 74 1SR0074) at the common point of adjoiner of the within described tract with lands now or formerly of Ruth E. Cook; thence extending in and through the center of the cartway of Pennsylvania Traffic Route 74, South thirty-three (33) degrees forty-seven (47) minutes fifty (50) seconds East, for a distance of four hundred ninety-six and fifty-three hundredths (496.53) feet to a point in the center of said cartway at Lot #2 of lands now or formerly of the Grantors herein; thence departing from the cartway of Pennsylvania Traffic Route 74 and extending along Lot #2 aforesaid, and through a point on the dedicated right-of--way line of Pennsylvania Traffic Route 74, a distance of thirty and thirty-nine hundredths (30.39) feet from the origin of this call, for a distance of three hundred sixty-three and sixty-three hundredths (363.63) feet to a steel pin at Lot #4 on ~~ *.he hereinafter mentioned plan; thence continuing North fifty-six (56) degrees thirty- ~•INS .N1f~AGN LAW OFFICES two (32) minutes forty (40) seconds East, for a distance of three hundred ten and twenty- three hundredths (310.23) feet to a steel pin at lands now or formerly of Randall E. _J~;:: .~s_H~~r't15F_ ~~''`=.zy, ~ // fi ND~'E'f'" ~~ ~W OFFICE OF WNI. D. SCHxACK III 124 WEST HARRISBURG STREET DILISBURG, PA 17019 E-mail Telephone 717-432-9733 Schracklaw@comcast.net Telefax 717-432-1053 June 13, 2011 ~ `r Register of Wills of Cumberland County ~.•„ rr, ~. ~ `~ ` Cumberland County Court House ~ ~ z - • - \ . ; One Courthouse Square ~ ~ r r ` ' ` ` _ ~:-~ :--~ Carlisle, PA 17013-3387 b ~";~~' <~% Estate of Beverly D. Gochenour O~ ~ ~ .- ~~= ~ Dom; September 19, 2010 -- ~ File #: 21-10-0999 To Whom It May Concern: You will find enclosed herewith two copies of alo ev Pl 0ase acbept the Return,~andltime Executor, covert sheet and return ithoeme in the envelope provided. stamp the Appended to the bottom of this letter is the Executor's check for the balance of the Inheritance Tax that is due on the account. Sincerely, WM. D. SCHRACK III WDS/jsg enc.