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HomeMy WebLinkAbout07-15-11 t 15056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Count Code Year !=ile Number Bureau of'Individual Taxes ~ INHERITANCE TAX RETURN y Po Box ~aosol 21 11 00111 Harrisburg, PA 17128-0601 ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 160-36-4310 10/17/2010 11 /06/1944 Decedent's Last Name Suffix Decedent's First Name MI Thorne James q (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Luther E. Milspaw, Jr. (717) 236-3141 ~-j Firm Name (If Applicable) .-~ =~ ., . ~ ~~ ~ ;"~"t w Z ~ C~ r ~ t .~ .;:~ ~ z ~:~ __~ First line of address x=• ~'rn ~ s ~ Ci ~-`~~~ _~-; - ~ ~ J 130 State Street ~' ~~~ ~~ ..,. 1 ~a -r~ ~ ~ . Second line of address ~--~ ~-- ~ ""' - ~::=:-~ : - -I ~';' 'M c ~ ~.~'3 t~ City or Post Office State ZIP Code "` Harrisburg PA 17101 Correspondent's a-mail address: IuthermilSpaW@milspawlawfirm.COm 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. SI l~ E F ERSON RE ONSIBLE F R FILING RETURN `DATE DRESS 351 Idg y Roa 'burg 1' 17109 SIGN TU E E O E AN I~P SEN TIVE ATE rr~ l~ ~ t 1 ADDRES 130 State Street, Harrisburg, PA 1 PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 !~' J 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name: James A Thorne 160-36-4310 RECAPITULATION 1. Real estate (Schedule A) . ........................................... . 1. 107,500.00 2. Stocks and Bond~:(Schedule B) ...................................... . 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3. 0.00 4. Mortgages & Notes Receivable (Schedule D) ............................ . 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... . 5. 5,996.55 6. Jointly Owned Property (Schedule F) Separate Billing Requested ...... . 6. 2,042.07 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested........ 7. 39,008.76 8. Total Gross Assets (total Lines 1-7) .................................... 8. 154,547.38 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 12,885.79 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 59,701.72 11. Total Deductions (total Lines 9 & 10) ................................... 11. 72,587.51 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 81,959.87 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 81,959.87 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 .o_ 0.00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 45 81,959.87 1g. 3,688.19 17. Amount of Line 14 taxable at sibling rate X .'12 0.00 17 0.00 18. Amount of Line 14 taxable at collateral rate }; .15 0.00 18 O.QQ 19. TAX DUE ......................................................... 19. 3,688.19 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 11 00111 DECEDENT'S NAME James A Thorne STREET ADDRESS 400 North Second Street CITY Wormleysburg DECEDENT'S SOCIAL SECURITY NUMBER 160-36-4310 STATE ZIP PA 17043 Tax Payments and Credits: 1 Tax Due (Page 2 Line 19) (1) 3,688.19 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3,688.19 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 3,688.19 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 : ............................................ ^ ^X c. retain a reversionary interest; or .......................................................................................................................... ^ L'-zcl 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? .............................................................................................................. ^ ~I 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? ........................................................................................................................ ^ ^x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FIL E 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 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 twenty-one 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. REGISTER OF 1~VIILLS CUMBERLAND COUNTY PENNSYLVANIA CIE~F-TIFICATE OF GRi41VT OF LETTEI~S No. 201-001~~ PA No. ~'~-- ~~-01~~ Estate Of : JAMES A THORNS (First, Middle, Lastl Late Of : WORMLEYSBURG BOROUGH CUMBERLAND COUNTY Deceased Social Security No : 160-36-4310 WHEREAS, on: the 25th day of January 2 011 an instrument dated February 5th 2009 was admitted to probate as the last will of JA MES A THORNS (First, Middle, Lastl late of WORMLEYSBURG BOROUGH, CUMBERLAND County, who died on the 17th day of October 2 010 and, WHEREAS, a true copy of the wi 11 as probated i s annexed hereto . THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wi 11 s in and for CUMBERLAND County, in the Commonwealth of Pennsyl vani a, hereby certify that I have this day granted Letters TESTAMENTARY to: KA THLEEN E BADDICK who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to law, all of which fully appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE, CA RL lSL E, PENNS YL. VA NlA . IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 25th day of January 20 ~ ~. ,~ `" Regis t~ o Wills / ~` -. , ..1 --- ~ ePuty - __ ..i * *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMENT Off' JAMES A. THORNS ~ -' -::~ ~ ,. ~-; , ~ - .a~ ,~ __.. ~ .~ I, JAMES A. THORNS, of Cumberland County, Pennsylvania, bein o~f/so~ii~d --,~ ; _~' g, _ _ mind, memory and understanding, do make and publish this, my Last Will ancT'~ ~ `~~' ~= ~~ .-~- Testament, hereby revoking all former wills by me at any time heretofore made. ~ ~ IT_ I direct all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property shall be paid by my Executrix out of the property passing under Item II of this Will, as an expense and cost of administration of my estate. My Executrix shall have no duty or obligation to obtain reimbursement of any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. In the absolute discretion of my Executrix, such taxes may be paid immediately, or the Executrix may postpone the payment of taxes on future or remainder interests until the time possess1o11 thereof accrues to the beneficiaries. ITEM II. I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate at the time of my death, to my Page 1 of 2 pages James A. Thor~le ~` ' ~~' ~ to my children, Kelly T. Boyle, Kerry Ann Kenney, Karen T. Bolus and Kathleen E. Baddick, in equal shares. ITEM III. I nominate, constitute and appoint my daughter, Kathleen E. Baddick, as sole Executrix of this, my Last Will and Testament. It is my desire that my Executrix serve without bond. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, typewritten on one (1) other page, this C~, da of .~ ~- Y ~v~-~-~.-t _, 2009. J orne ~~ ~-, .: .,.: , . Commonwealth of Pennsylvania County of ~>a-~--~1C~r~~~~: I, JAMES A. THORNS, testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein contained. Sworn or affirmed to and acknowledged before me, by JAMES A. THORNS, the testator, this day of ~.~..,Cr , 2009. State of Pennsylvania County of £~n C4'r`~3c~#~=L.~~G',~?~ s A. Thorne _. .;. ~~--.~.~ Notary Public COiv1MC)N`J`,t~~Ai_."i'l-i U1= PkNNSYLVANIA Notarial Seal ~ Pa.tricia A. Meck, Notary Public Middi~usex Tvvr~., Cumberland County ~._iviy C~~,~~rr~is_inr, Expires Nav. 8, 2009 J P/I~I?~iG%~i c-lf.'~,?:!t~d!~I.'Z u.ssOCi~:t!On of Notaries We,' Gc1~ , ~~ ~ risk and ~~~~~~ ~ ~ ~~ t~Mc~ ,the witnesses, respectively, whose names are signed to the a tached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will and Testament; that JAMES A. THORNS signed willingly and that he executed, it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator was at that time eighteen or more years of age, of sound mind or under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by ,J~ ~~. ~ ~;,~ `,;.,s~,;~ and ~.- -~~~~~`~~~ ~~~~c~~-~- ,the witnesses, this~-~ day of ~..,~.~.-rte..,. 2009. _ ~-- ' Witness Witness Notary Public Vuluriai Seai ! t'atricia A. !`fleck, iVotary Public i "":,' , -;~-r, ~., Gumberlar;d Csurty ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER James A. Thorne 21-11-0111 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 property that is jointly-owned with right of survivorship must be disclosed on Schedule F. If more space is needed, insert additional sheets of the same size. REV-1508 EX+ (6-98') ~~ COMMONWEALTH OF PEIVNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER James A. Thorne 21-11-0111 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. (It more space is needed, insert additional sheets of the same size) Sold to: Patrick Pe~Ty, Dealer 717-586-8218 1990 Mercedes Benz, 300CE VIN WDBEA51 DSLB 118425 Mileage: 122,298 For: $1,000.00 By the Estate of James A. Thorne, March 20, 2011 PSEC~ ~~ " °t (~ ~ ~ C June 1, 2011 Account # 0160XXXXXX LUTHER E MILSPAW JR ESQ ATTORNEY OF LAW 130 STATE ST HARRISBURG, PA 17101 Dear MR MILSPAW: The following is the status of JAMES A THORNE's account with PSECU as of the date of death. Joint Owner's Name NONE Date of Death 10.17.2010 Date of Birth 11.06.1944 Share Description Open date Balance Accrued Dividend S O1 Regular Shares 08.10.1992 $78.67 $0.02 S 04 Moneyhandler 08.10.1992 31.36 0.00 The dividend earned from January 1, 2010 through the date of death was $ 0.28. The decedent had no loans with us. We do not have safe deposit boxes for our members. If you have any questions, please ca11234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. S' cerely J o ber Service Representative Finance Support Unit Pennsylvania State Employees Credit 1,lnion Main Address: 1 Credit Union Place, Harrisburg, PA 1 71 1 0-2990 • 717.234.8484 • 800.237.7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 1 71 06-701 3 • 717.777.2100 (TDD) • 800.472.1967 (TDD) psecioa.com This credit union is federally insured by the National Credit Union Administration. Equal Opportunity Lender REV-1509 EX+ (6-98} ~ `~ ~;,~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER James A. Thorne 21-11-0111 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 DE:CD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST ~~ I I A' 08/24/06 Metro Bank checking account (xxx3129) 4,084.14 I 50 I 2,042.07 TOTAL (Also enter on line 6, Recapitulation) $ 2,042.07 (If more space is needed, insert additional sheets of the same size) If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. ~ pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER James A. Thorne 21-11-0111 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1~ Kathleen A Baddick daughter 8/17/2010 . , , 42,008.76 100 3,000.00 i 39,008.7E TOTAL (Also enter on Line 7, Recapitulation) $ ( 39,008.76 If more space is needed, use additional sheets of paper of the same size. METRO BANK June 15, 2011 Luther E Millspaw, Jr 130 State St Harrisburg, Pa 17101 3801 Paxton Street Harrisburg, PA 17111 RE: Estate of: James Andrew Thorne Tax Identification Number: 160-36-4310 Date of Death: October 17, 2010 888.937.0004 mymetrobank.com To Whom It May Concern: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Savings Account Number: 7760448402 Date Opened: August 17, 2010 Primary Owner: James A Thorne Secondary Owner: Kathleen E Baddick Date of Death Balance: $42,017.68 Account Type: Checking Account Number: 537443129 Date Opened: August 24, 2006 Primary Owner: James A Thorne Secondary Owner: Kathleen E Baddick Date of Death Balance: $4084.14 Please feel free to contact me at (717) 412-6126 if I may be of further assistance. Sincerely, Pamela Lighty Savings/CI F Associate Metro Bank ~ pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER James A. Thorne 21-11-0111 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Wiedeman Funeral Home 4,966.80 2. Kathleen E. Baddick, funeral luncheon 898.00 s. Kerry Ann Kenney, funeral flowers 200.18 B, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 3,000.00 Name(s) of Personal Representative(s) Kathleen E. Baddick Street Address 3512 Ridgeway Road city Harrisburg state PA ZIP 17109 Year(s) Commission Paid; 2010-2011 2. Attorney Fees: 3,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 277.50 5. Accountant Fees: 6. Tax Return Preparer Fees: Turbo Tax 92.90 ~• The Patriot-News (legal publication) 300.41 $. Cumberland Law Journal (legal publication) 75.00 s. Cumberland County Register of Wills (filing Inheritance Tax Return) 15.00 ~ o Cumberland County Register of Wills (filing Family Settlement Agreement) 40.00 ~ ~ ~ Cumberland County Register of Wills (filing Receipt and Releases, and Disclaimer) 20.00 TOTAL (Also enter on Line 9, Recapitulation) $ 12,885.79 If more space is needed, use additional sheets of paper of the same size. - ~edem FUNERAL Dennis L. WiAderr~an, f.D.-Sup~n~i;o- H O lv1 E 357 South Second StrEe# Steelton. PA. 17113 Phone: 717.939.~3a4 Fax '17939 1999 ~~mz5 W rayon, F.D. STATEMENT 4 F ACCOUNT ~-~,~~i~ W~~~~rr~,r fn~a-~-~rz;~-~,~t rti~r W'lliam A Siberi F D i IJsa M. N,'iecemc~~~-Krosnar,F.D, December 9, 2010 Mrs. Kathleen E.'Buddick 35,12 Ridgeway Road Harrisburg, PA 17'109 The Funeral Service of: Mr. James A. Thorne A. CHARGE FOR SERVICE`S SELECTED: 1. PROFESSIONAL SERVICES $ 3315.00 2. FACILITLESISERVIGESIEQUIPMENT:$ -0° 3.-AUTOMOTIVE EQU[PMENT: $ -o- (A) TQTAL OF PROFESSIONAL SERVICES,. $ 3315,00 FACILITIES AND AUTCOMOTIVE B. CHARGE fOR MERCHANDISE SELECTED: Casket ..............:.............. . $ -0- (Description Outer Receptacle ... , .....:........... . $ -0- (Description} _ Outer burial container - - • • • ~ • • • - - - • • $ -0- (Description) - Acknowledgement Cards ........ $ -0- Register Book(s) .. . .... .:.::.......... $ -0- Memory Folders ........ ....... . $ -0- Prayer Gatds ...` . ...:.....:......... . . $ -0- Temporarygrave marker ...:......... . .. $ -0- Burial Clothing :.....:.....', .......... . $ -0- Other Clothing . ... . .:............... . $ -0- Custom Graphic Design & Printing ........ $ 200.00 Flowers Spray;gf Flowers on Ease! +.. • . , $ 84.80 $ -a- C. SPECIAL CHARGES: Fortivarding of remains to $_ -0- (Funerai Home) Receiving cf remains from $ -0- (Funeral Nome) Immediate B~riai $ _0_ Direct Cremation $ -0- $ -o- SUB-TOTAL OF SPECIAL CHARGES .. ..... ... C $ D. CASH ADVANCES: Openi;~g Grave ..... . .............. $_ -0- Cemetery Equipment........ ~ _0_ Newspaper !Notices -Local .. $` 317.00 Newspaper Notices -Out-of-town . $ -0- Telephone & Telegrams .... - ....:... $. _0_ Airfare ............. .. ; , ... ; . , . ' $ -0- :Clergy Honorarium ................. $ 150.00 Pallbearers ................. . . .. .. $_ -0- Certified Copies of Death Certificate :.. $_ 60,00 Crematory Charges ....... . .. . ...... $ 225.00 Organist ......................... ~ 125.00 Soloist ........................ .. ~ 75.C0 Other Seminarian David Richards $ _____ 25.00 Other Altar Servers 3~ $5.00 each $ 15.00 Qther Coroner Cremation Authorization $ 25.p0 0- . Cremation UrnRr~,db.ury,,P.~~an UrO .:. , ..... $ 450.00 SUB-TOTAL OF CASH ADVANCES ... D $ 101 7.OC Interior & Exterior Crucifixes ...... ; :....'. $ -0- Refrigeration.:...... ,_ . . :.. . ............:. $ 0- {B) TOTAL MERCHANDISE:SELECTED $ 734.80 an ~. LESS PAYMENTS.RECEIVEO ...', ... _ $ 5066.&0 BALANCE DUE .. , ....... $ 0.00 Famifv Cwned and C SUMMARY OF CHARGES: A. Professional Services, Facil,ties and. Equipment and Automotive Equipment .................... . . .. $ 3315.00 B. Merchandise ..... . ............. .. ~ 734.80 C. Special Charges ...... . ......... $ -0- tJ Cash Advances ........ ...... $ 1017.00 TQTAL OF ALL SELECTIONS ... ...... ....... $ 5066.g~} 14:54:19 Wiedeman Funeral Home, Inc. DETAILED CUSTOMER HISTORY LINING Printed on: Thursday December 09, 2G10 Decedent Last Name:T~~orne First: James Buyer Last Name: Buddick First:"athleen Address 1 :351'' Ridgeway Road City :Harr.isburg Home Phone (717) 651-0960 Pa~~e . Tnitial:A Initial:L State: PA Zip Code: 17109 Work Phone: (717) 651-•Q960 Trans. Code T4ade By/Remarks Date Service Check # Amount C' Business Agreement Form (1) 10/17/2010 2010-W-104 5066.80 F' Cumberland Cc . Veteran Affairs 11122;%2010 2010-W-104 776`;95 -100.00 P r.athleen E. E~uddick 12/09,/2010 '_'010-W-104 914 (J. -9966.80 BALAf~cE D~ r~ : ~ c . ~ ~_~ 14:54:19 Wiedeman Funeral Home, Inc. DETAILED CUSTOMEF. HISTORY LISTING Page : 1 Selection Limits:r;o Date Limits Service Number: 2C}10-W--104 Check Images Pa e 1 of 1 g ~`'~1 Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 914 ~ Date Posted: 12/13/2010 ~ Amount: $4,966.80 Zoom In ~ Zoom Out ~ Print ~fA~+tES /lNDREW TftORME 914 400 N 2ND STREET MIORMLEYSBURG.PA 17043 I~~,,~~I~ i4ttY3~tt (; owl YAY TO THE ~~ ~ ~ ~~~ ~~1CL U~~ ~ I~-~ J `~' ~ ~ 1X LY. ~V ORbER OF is~8~s~.~L 1~~s:~~v s;r aler/~...rl a.v~- ,~' ~„ botu,as ~ ',~ ~~ ETRO BANK ~~ ~ ~~ ~ x:03 X30 ~H~6~: 5~ ?~43 ~ 2 9ii' D9 ~~ A•T~Y..n 1 'nw ./t• .aM .44n r• r a-r.~•. v r.~• •t. r-..n ..... .~ • • n • . ~1 yV`.1• r~ •~.Ny.•~ i { .t rp '~ m ~ ~ ,~ ~z~ ~. ~ „ o o <<~ ~ m ~ ~~ ~ ~ ~: ,. ;, o ~~ - ~ ~ ~. ~~;~ -=+ ~: ~~ T~,,- -, ~; .~ ..~ Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(i1V6wJIWgFzgyh1g6Q9M)/Accounts/CheckImageViewe... 4/13/20 11 Check Images BANK ?('~~/li7l~~ I_„'.:~i}bill j~.7l ~i ~~)5~'~~~i~~~lt~ Page 1 of I Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 912 ~ Date Posted: 11/18/2010 ~ Amount: $898.00 Zoom In ~ Zoom Out ~ Print __ ~_ _,__._.._._ _~~..~_ ~~_______. __ _---~____~.T.. __ . _ _... _ _ . _ _ ~ JAMES ANDREW THORNE ~~ 2 400 N 2ND STREET ' W~RMLEYSBURG, PA 17043 GO-t84r313 ~ 1 ~ d o, DAi E ~~ PAY TO THE e ~ ~n ~ ~r~.~' ~K. ~ 898, 00 ORDER OF L- `~ r ~ // -= : w:: -'~ C~. ~~ ~S CiGtc~ ouARS ~ ~;a. N ETR~ BANK FOR M' ' ~:0313018~,6~: 53 744312 9i~' 0912 '.~' ~~.~~.. =,,, - . V ~_ . 1 ~~ Je tw'\~ 4 - - _ 1 ~ - ~ - ., - ~~ .i ~. .. ~ = _ c i ~' Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro B<3nk Ltd, Great Britain https:/%online.mymetrobank.com/html/af(iIV6wJIWgFzgyh1g6Q9M)/Accounts/CheckImageViewe... 4/13/2011 Check Images ~~~f\ ~ti~ ~~'.:~:y r ~7~~J Page 1 of 1 Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 911 ~ Date Posted: 12/7/2010 ~ Amount: $200.18 Zoom In ~ Zoom Out ~ Print 1Z:~T.` ~CS.1 ~~ L2.71R r-i tit r ~ r.. sz_~-• r_z i r_Z ~MICT.Z3~C t.1 7rt- r.S]~iJ~s~~~ •.T ~~ z~s.v .-t ..~.r L3_'~y! 1=I.71416t. [ T ~ JAMES ANDREW THORNE 9 ~ ~ X00 N 2N0 STREET WORMLFYSBiJHG, PA 17043 ~ ~~~C'~~D ~ «iJ of J ~j^ '^ pAiE ORD R OFE_ _1- ~~L.. ~-~ ~'_.-1' LV~~~! ~~~~v_- -~.~ ~ ~~.. " /(1 r8 ...... ~: ~TRO BANK +:0 3 130 1846+: 5 3 ?~,~, 3 ~ ~ 9~~' 09 ~ 1 ~ ~i OOOOQ ~QO i$><'' ,..._.__- _~ C~~ ! 1 ~ V_L l U•~4 1 '~ L L. ~ ~ vJ ~ ~ t i ~.~"Z Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(i1V6wJIWgFzgyh1g6Q9M)/Accounts/ChecklmageViewe... 4/13/201 I Check Images ETRO BANK ~~t.i l~Yri i~~ll ~. `~.~Ir1~/,~I I~,~ ~I~~~~ti~~! 4~~1~j~1i! Page 1 of I Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 921 ~ Date Posted: 1/27/2011 ~ Amount: $277.50 Zoom In ~ Zoom Out ~ Print JAMES ANDREWrTH~RNE 404 H 2ND STREET WORMLEYSBURG, PA 17043 PAY 70 THE ORDER OF. f ~ // fi0-1&4/313 01 DAre 77 .~1~•~ - ti DOLLARS oo"ula oa ETR~ "~" BANK FOR IVP x:03130 ~8~6~. 53 7~,~3 i1 2 9n' 09 ~ i `Ii~a'Aa~nd CIOIKJ a~ l ~ ~ ~f ~~' 921 >031315036< -~ Orrstown Bank Shippensburg, PA 17257 Phone: 717-532-6114 Bus Date: 01/26/2011 Branch/Teller 0008/0127 01/26/2011 10:41:18 n- :"! t~ R ~ T ~'"'' ~ T r w- ., s-.; ~ ,~ ~ C ~- rT r'ri ~ ~- ~ C r_ _ ~•~ y _ ~~ -; J - s7 ~ ~ r-~;z :~, :s= x -,. a -,rt Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro B<3nk Ltd, Great Britain -------- -.I https://online.mymetrobank.com/html/af(ilV6wJIWgFzgyhlg6Q9M)/Accounts/ChecklmageViewe... 4/13/2011 Windows Live Hotmail Print Message Your TurboTax Order Confirmation TurboTax Customer Service (No_Reply@notifications.intuit.com) Fri 4/ 15/ 11 10:30 PM stuffinm@hotmail.com ti s ~, .~~ ~ ~ ~ ~r~ t ~- =y Page 1 of 2 http://sn 134w.sntl34.mail.live.com/mail/PrintMessages.aspx?cpids=2de3da4f-67d1-11 e0-a6a0-00... 5/24/2011 Check Images ETRO BANK ~7~~1 ~.?Il i~j L~t.~l ?1~L)I 17~_~~~`~t~~~~y~l~~l fit: L }C.'l i~iA ill `7 i}~ Page 1 of 1 Check Images Account: 50 PLUS CHECKING (*3129) (Check Number: 925 ~ Date Posted: 5/20/2011 ~ Amount: $92.90 Zoom In ~ Zoom Out ~ Print JAMES ANDREW TKORNE 400 N 2ND STAEEf WORMLEYSBURG, PA 17043 j PAY TO TtiE ~j ORDER OF- /la.r,, 925 k~ ~ '~ /' 601&1/313 Oi ` DATE `~" ,f :~~ pI ~ ga.5v ~' ~ ,q 4 V DOLLARS U w~,~ ErtRO - BANK foa ~v~u 1"~,,.r ~a ~~x -- JET t ~._, ~:03~3pL846~: 53 ?~,~3L~ 9n' 095 ~1~lIQ LVIt1 ^~ '" .. -~ l , - ~ - - _ - - ~ . ._ _ _ I ~ - i I I _ } Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(fdTfg3 W9RQeUiVxl8gZ)/Accounts/ChecklmageViewer... 5/24/2011 Check Images Pa e 1 of 1 g ~~ l ( + ,,)t ?1 ~4r1 i~~t~~ 1.rr.:~f1~1L11 1~~: ,'~~j~~~y ~:'1 }i'~ijl~li~ lam} C.' l ,~~ . } .~ ~ L.! ~ 7 y Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 924 ~ Date Posted: 3/2/2011 ~ Amount: $300.41 Zoom In Q Zoom Out ~ Print ;I ~' JAN[ES ANDREW THORNE 924 ~~ 400 N 2ND STREET WORMLEYSBURG, PA 17043 ea~e4rata ~~ 2. J ~ o~ ~ ti DnrE ~ ..~ PAY TO THE ~ ~ ` V ~ , ~ I~ ORDER OF ._.`L~'+ Q w J ~ J~ J~ ~ ~~ I~ ~~ ..~. ~~ ,q see I~ SI j't ,t/D !1 t~~3 ~ K /~"~? pOltARS L'1 ~:',',.`o„ ~.« ~, ET~a BANK ~~ ~' FOR ~~ _ ~ lYP I i z: 0 3 L 3 0 ~ 8 4 6 ~: 5 3 ~ ~. ~. ~ Z~ q ~E^ fl 4 a L !~' -~ ~rn~ ~ ~~~ w O D n~.~~~~ 0 ~ D ;~ O ~ Z Z ~ zv ~ °z mn~ Q Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(ilV6wJIWgFzgyh1g6Q9M)/Accounts/CheckImageViewe... 4/13/2011 Check Images ETRO BANK ~' I a i :~t'f~'~'i;?C; L.t'(~t1~.r+ ~~t.'1J11*it'~,"w`~Jflt;; .. ~, ~, i . ,, -T , Page 1 of 1 Check Images Account: 50 PLUS CHECKING (*3129) I Check Number: 922 ~ Date Posted: 2/14/2011 I Amount: $75.00 Zoom In ~ Zoom Out ~ Print JAMES ANDREW THORNE ~ 922 ai 400 N 2ND S7REEr WORMLEYSBURG, PA 17043 .~ ~ c3 ~ ~ ~ 60-184(313 ~ y T 01 `i DATE PAY TO THE ~~ ~/ , !. .,. ~ j ~'7 ORDER OF ww~` ~ 1 y* i~.~,{,,~ ~ e~la.lr Vl(~Q I ~ ~ / S. C) ~ ~ ~~} / ~ V t ~^O ,q 9ecv rrt, \/ l DOLLARS L.1 ~aR~:a~ , ETR BANK FOR ~ w Jrr ~:03i30~846~~ 53 ?4432 9~i" 0922 iWYLF ...r A'.n.7L Ti0.w I N. - - a ano ~ianlo ~.,,. ~ { p~>~ ~ ~ O1 ~ r... ~ ~, ~ o >031315036< ~ to A N ~,~ x Orrstown Bank ~ n p~ ~ cn ~ o Shippensburg, PA 17257 .A.t ~ ~ o~ ~ Phone: 717-532-6114 ~~ ~ ~~ .o Bus Date: 02/11/2011 ~ ~ ''~ Branch/Teller 0008/0127 _ 02/11/2011 15:49:20 Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(i1V6wJIWgFzgyh1g6Q9M)/Accounts/CheckImageViewe... 4/ 13/2011 ~ pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER James A. Thorne 21-11-0111 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical exuenses. 1t more space is needed, insert additional sheets of the same size. Check Images ETRO BANK Page 1 of 1 Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 913 ~ Date Posted: 11/18/2010 ~ Amount: $250.00 Zoom In Q Zoom Out ~ Print -- -- ~~ zt ~a~~s nHORFw ~nlta~ ~ aoo N ago sr~r 913 ~ WORMLEYSBiJRfl, RA tTQ43 f I .7 u gta.~8~t3 ' b! 01 n~ie var To rye ~~~~ _ 1 ~ Z ~ . t ~G ORDER QF - ET~o BANK ~~ FOR '~~~!-~!_air~~'~ 6~ 4~ ~ - ~ ~I J ~~~~ F1 i:03L30i846~. 53 ?44312 9u' Q9i3 - ~~ -~,.~. ~ ~~ ~. -- }_~ ~~ __ `. ,~ 1~~ Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(i1V6wJIWgFzgyh1g6Q9M)/Accounts/ClleckImageViewe... 4/13/2011 Check Images ETRO BANK t~~}r ~/`ii 7l~~ 1~::~i ~1~i!i~ i-~l..~r~~,~ti~r~74~t~~~~fi~ Page 1 of 1 Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 906 ~ Date Posted: 10/20/2010 ~ Amount: $80.00 Zoom In Q Zoom Out ~ Print JAMES ANDREW THORNE 906 ~ 400 N 2ND STREEC ~~ ~ WORMLEYSBURG, PA 17043 ea>!r~~~3 ~~ /L l.~ /U o~ ~ o~rE s ~+ ,~ Q ~ y /Q ,.Q ~ y- , O~ I Qom' _.~,~ s« j: ~c+ I+~!-~--~`~____<S~Y.ii ~~ ,r 171 DOiLARS U o:'::~::, ..~. ETR~ BANK FOR ~ ~ INS `L x:03 i3 L84~'a~: 53 ?443 i 2 9~~' 0906 _ .. _ -, .. .. _:....._..:.,._ . 1 - _ ~ ~ . - - ~- ~ ~ - Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https:%%online.mymetrobank.com/html/af(ilV6wJIWgFzgyhlg6Q9M)/Accounts/ChecklmageViewe... 4/13/2011 Check Images •' / ,, ._)f>r ~yrl ~~~lj 1.~::~~/l tJ~~il i f~i ~~~~l,~'•1 Lf ~.lf ~.l<~ c`'t ~ iii . ~:~. 5 /' l~ ~~ 1.}ti Page 1 of 1 Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 905 ~ Date Posted: 10/20/2010 ~ Amount: $450.00 Zoom In ~ Zoom Out ~ Print -.r:. _ ~i t Ir~ JAMES ANDREW TH~RNE ' 905 - I 400 N 2ND STREET ~' WORMLEYSBURG, PA 17043 /v ~Z//o ~}~, o, II DATE ~! PAY TO Tii E J ' ~ l D ~ ' ~~ ORDER OF 1~~~~ 1' 1-fL.L~t.~~ 1 ~/`~ I ~ ~~ . DO ti s ~O ,a, S«~~~~, DOLLARS L' I ~~~ ETRt3 BANK ,; ~ FOR- 'l S OC/T Q• _~ ~a~/"tlyP x:03 il30 L846~: 53 ?443 ~ 2 9i~' 0905 „~,". ,-.,~~,~ - i~.~s,-micas- ~, - _=3'i ~-,-r--,--: -i~ u---_:.:.,~:,ik,:a-tom;.. `. . ;:= _ ~, ~ __ ' j_ _: - ~ .._ -~ . .. 'l'_ - _ ~ - 3 i 1 w .- . 1 l r ~._ Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(i1V6wJIWgFzgyh1g6Q9M)/Accounts/ChecklmageViewe... 4/13/2011 Check Images ~~ ~ ~ ~ •• I ~ ~~ r ( 1~ ~ 1.. ~r 4 ~ ~ ~ ~ ~~ ~ j (~ . L ~ ~' i - t ,~ 1 / / ! ~ 1 Yt ~ ~4 ~ l ~ ~ i) t ? Page 1 of 1 Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 907 ~ Date Posted: 10/21/2010 ~ Amount: $60.00 Zoom In ~ Zoom Out ~ Print :z~r.r~: +c rs brace ~rr.~r.~~t ~.r•c.~i rrr~a•.z_~:Y.r~ rt..~s JAMES ANDREW TNOpNE 400 N 2ND STREET 907 WORMLEYSBURG, PA 17043 -- ~p~gV~t~ DINE PAT TO T}iE !' ' .~.~~~ $ V v , OQ oao~a of ~ U~n~ ~` 1 C c.`~n YvC~ ll ~u-,~~s ao ,..,t, ,... ETR~3 .. ~:~ rr• . : r :. t ' ~.. ~ ~ . ..:-,-~aiati,c- B A N ~'C i f~ t ? i !~ ~~~_s i ~' iG'-i c.~ ~ v ~i rr~ ti ,.~..>..1 ~:0 3 L 30 L846i: 53 ?~,~ 3 L 2 9i~' 090? ~~'000000600tJ~~' wW.~;.t art i:Aa~+. rs. - --~ i.c ate. ~. • =1~:1 a!~ u ~ u~ Z:t~.a:l'..ax.4~,3:i_.as.i.r s~ati~-sr ,......, .1... i Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https://online.mymetrobank.com/html/af(ilV6wJIWgFzgyhlg6Q9M)/Accounts/CheckImageViewe... 4/13/201 1 ,METRO BAN K 05],91 6759254 001 092140 JAMES A THORNS OR KATHLEEN E BADDICK 400 N 2ND ST WORMLEYSBURG PA 17043-1106 Metro Bank 3801 Paxton Street Harrisburg PA 17111-1418 1-888-937-0004 mymetrobank.cam We're here 7 clays a week, 24 hours a day at 1-888-937-0004 50 PLUS CHECKING statement Balance as'of 12/12/10 $10,062.61 ; Plus 1 Deposits and Other-Credits $2,000.QO Less 6 Checks and Other Debits - $9,371.6Q Plus. Interest Paid $O.SB ' Statement Balance as,of 01}11111 $2,fi91.59 Transactions By Date Date Description Debit Credit Balance 72/13/10 CHECK # 9i4 $4,9fi6.80 $5,095.81 `- 12l20110 WEB TO DDA FR SAV 007760448402 $2,000.00 $7,095.81 TFR 12/28110 AMWATER AMWATER $130.00 ~i `r $6,965.81 .JAMES A THORNS 12!28!10 Payment Fee 8008207479 $1.80 $6,964.01 JAMES A THORNS 12130M0 VA DEBT MGMfi PAYIVIENT $2,fi73.00 $4,291.0'1 SERIAL NUMBER; 0916 JOHN MANDERFELD 12/30/10 MORTGAGE SVC CTR CHECKPYMT $850.00 $3,441.01 SERIAL NUMBER: 0917 0007488083 12130110. MORTGAGE SVC. CTR CNECKPYMfT $750.00 $2,691.01', SERIAL NUMBER: 0918 4007488083 01/11111 INTEREST PAYMENT $0.58 $2,691.59 Check Transactions Number Date Amount Number t3ate Amount Number Date Amount 914 12113 $4.966.80' Items denoted with an "E" are electronic entries and will nol have a check image. Items denoted with an ""' indicate processed checks out of sequence. Interes# Summary Beginning Interest Rate 0.15%0 Number of Days in this Statement Period _ 30 Interest Earned #hIs Statement Periad $D ~~ Annual .Percentage Yield Earned this Statement Period ~APY) 0 15°l0 .interest Pafd Year to"Date $0$8 8 a S c ~, c 0 0 m N ti 0 11 Cycle Page 1 of 6 NOTE :SEE REVERSE SIDE FOR IMPORTANT INFORMATfON Member FDIC Check Images ETRO BANK -. . , ,~ ;~~'(','.;7i; l.':'."jr.Ji ~~"d','JIJ:i4`1V~JIli;? "~= tf'~ ~ ' Ip~ 1 ~ L~ C.~ l 1 .. • Y !. l.- ~..• l.. ~ ~-r Page I of 1 Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 919 ~ Date Posted: 1/13/2011 ~ Amount: $212.19 Zoom In ~ Zoom Out ~ Print it's+-_- r_, ~ r_Z ~-...s:Z~"~.e 1~[ ~..• x_z.~ t.3 ~++s.rt -~.. =a7~ar_ c a..r r ., ~ ~: r~ ~..r_ -i awcsl :aF.I~.~.~ r Z _..e!. rz ,.~~ L= - JAMES ANDREW THORNE 9 ~ 9 400 N 2ND STREET WORMi_EYSBtJFiG, PA 17043 i4~84913 ~~~~_~ oT DATE ORDER O`E ~~J~ _ G~ ~.f~~L,_ZL. -~f-~L~ /~ ~~ ~~J ~ ~ ~ ,Z /~ J ~~-. DOLLARS ' o•~•~~ ETRO ~~~ ~ BAN K ~ 1• 1~ x:03 X30 Lf3~,6~. 53 7ti~3 1 2 9-i' 09 ~9 00000 ~ ~ 2 ~9~ .... . i1 ,Ara 7ri. •f~.Rr ~• ~~. i-f a..: i'1 .aar .L'.C ~. i'.r .~ 1'.[i.F~ x:t+w.- is c a.c- L•1 ~: L;s.. ~1 rl. ~~a-:1.-~. -L'.L.~,'.l: ~..et= i'r ~c t~.c r OR DEPOSIT Qii~ +' NNE E:EEC l R IE: U t I~ t T IES Z T 3~~ X33 88S507I©D~ BNB ~iEs ~Oai B3~c~71©Q~ 1=~`~~~0 z15 2I.5 ~?n,a.s~~ t't~~1` r ~t~'~i;~4?~ 5~+6 k?~~ SI~ET F!~#, F~ i.~-d18 $J1Iiai1 Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd. Great Britain https://online.mymetrobank.com/html/af(i1V6wJIWgFzgyh1g6Q9M)/Accounts/CheckImageViewe... 4/13/2011 Check Images Page 1 of 1 ETRO BANK .7C.'f«rli7lj t..,'.'i 1r ~~~ll ~~~...'1 ){)ti~''1 «'ii111<: ~ ~, ti, , C`t.~v .JAS;?l~'l~l~~+' Check Images Account: 50 PLUS CHECKING (*3129) ~ Check Number: 920 ~ Date Posted: 1/13/2011 ~ Amount: $140.00 Zoom In ~ Zoom Out ~ Print JA~AES MIDREW THORNE 400 N 2N0 STREET WORMlEYS8UR0. PA 17043 PAY TO THE ORDER OF. 920 ~ ~o-><w3>i ~ o>I OAT! ~ lyv.vd ~~~~~~1 n s.<~M~ ~ GL--DOIIARS ' ::r:.: ~TRO ~ , BANK FoR v 2~,3 -v ,~ ~:03130L8~,~~: 53 ?44322 9u' 0920 >031301846< Metro Bank Hub #01 2011-01-13 018476676 aQ a © ..~ C O ~ --C ~ z ~ 0 ~ ~"- x ~ rn =-~ ~ ~ o ~ ~ ~ ~ ~ -~~,o m -,•, c Technical Support: 800-204-0541 Copyright ©2009 Metro Bank Online Banking. Member FDIC All Rights Reserved. -Metro Bank is a wholly owned subsidiary of Metro Bancorp, Inc. and is not affiliated with Metro Bank Ltd, Great Britain https:/ionline.mymetrobank.com/html/af(i1V6wJIWgFzgyh1g6Q9M)/Accounts/ChecklmageViewe... 4/13/2011 • ~ pennsylvarna DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF James A. Thorne 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. Kathleen E. Baddick, 3512 Ridgeway Road, Harrisburg, PA 17109 2. Kerry Ann Kenney, 6261 South Legend Court, Gilbert, AZ 85298 3. Karen T. Bolus, 339 Furnace Road, Lewisburg, PA 17837 4. Kelly T. Boyle, 400 N, 2nd Street, Wormleysburg, PA 17043 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Daughter Daughter Daughter ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN ff 1. E B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. FILE NUMBER 21-11-0111 AMOUNT OR SHARE OF ESTATE 25%~ 25°/~ 25%~ 25% TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ If more space is needed, insert additional sheets of the same size.