Loading...
HomeMy WebLinkAbout08-09-11 (2)1505610143 REV-1 S00 Ex (D,-,o, OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code veer File Numt»r Bureau of Individual Taxes °v""i°^°r"e1°"'° Po Box.2eo6o1 INHERITANCE TAX RETURN 21 10 0224 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 191 26 3466 02 12 2010 O1 22 1936 Decedent's Last Name Suffix Decedent's First Name MI YORK MARIA C (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 x^ 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12.13-82) 4. Limtted Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Retum Required (tlNe o! dselh elver 12-12.92) ® g. Decedent Dad Testate ~ ~. Dece~er~t Meir~i ~ined~ Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of WAQ (Alta opy runt 9. Litigation Proceeds Received ~ , D. 6~$tw:~r,i$"-3(`~~e °~,<•°fi=3e$r death ~ t f, Election to tax under Sec. 8113(A) (Attach SG,. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number EDMUND G MYERS (717) 761 4540 First Ilne of address 301 MARKET STREET Second line of address PO BOX 109 City or Post Office LEMOYNE State ZIP Code PA 17043 ;., REGISTER (~1~LLS USE-9NLY ~ ~. r- ~ ~ _~ ~ ~ ;„gym t .~ I QOT ~ ~ __ ~~ ~ DRE FILED --- ~ ' ~ h 1~"_ r'' j -T ^-r, ~i corresponaerrt's e-mail address: egm(a~,jdsw.com Under penalties of perjury, I deGare that I have examined this return, including accompanying schedules and statements, and ro the best of my knowledge and belief, it Is true, correct and complete. DeGaretion of preparar other than the persona representative 19 based on all infonnatlon of which praparer has any knowledge. KATHLEEN Y. WITTEN ~"~~~~~ 460 MILLER ROAD YORK HAVEN PA 17370 SIGNAT OF PREPARER/OATHER THAN REPRESENTATNE DATE ~/ EDMUND G. , MYERS, ESQ. _ ~J'~~!/I ennoccc 301 Market Street, Lemoyne, PA 17043 Side 1 1505610143 1505610143 v~b op~~ o'\'~j~ ~~~~ ~~ J 1505610243 REV-1500 EX Decedent's Social Security Number oecedem~. Noma: YORK, MARIA C. 191 2 6 3 4 6 6 RECAPITULATION 1. Real Estate (Schedule A) ...................................................................................... . 1. 193 , 107.60 2. Stocks and Bonds (Schedule B) ........................................................................... .. 2. 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 (Schedub E) .............. . 5. 47 9 , 7 33.17 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 5 9.78 7. Inter-Vivos Transfers & Miscellaneous -~oq Probate Property Se arate Billin Re uested h d l S G p g ............ q ) u c e u e ( 7. 77 , 68 6.63 8. Total Grose Assets (total Lines 1-7) ................................................................... .. 8. 750 , 587.18 9. Funeral Expenses & Administrative Costs (Schedule H) ...................................... . 9. 53 , 612.0 8 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............................. . 10. 13 , 52 9.2 7 11. Total Deductions (total Lines 9 8 10) .................................................................. . 11. 67 , 141.35 12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12. 683 , 445.83 13, Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................................. . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .............................................. . 14. 683 , 445.83 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 15 0 0 0 (a)(1.2) X .00 . . 16. Amount of Line 14 taxable 683 , 445.83 at lineal rate X .045 16. 30 , 755.06 17. Amount of Line 14 taxable 0 00 17 0 00 . at sibling rate X .12 . . 18. Amount of Line 14 taxable 0 0 0 18 0 0 0 . at collateral rate X .15 . . 19. Tax Due ................................................................................................................. . 19. 30,755.06 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-10-0224 DECEDENT'S NAME YORK, MARIA C. STREET ADDRESS CITY STATE PA ZIP Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Peyments A. Prior Payments B. Diswunt 20,000.00 1,052.63 Total Credits (A + B) (2) 30,755.06 21,052.63 3. Interest 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 rofund 5. If Line 1 + Line 3 is greater then Line 2, enter the differonce. This is the TAX DUE. Make Check Payable to: REGISTER OF AGENT. (3) 228.67 (4) (5) 9,932.10 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 tranaferced :............................................................................... z b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................................................................................................... x d. receive the promise for life of either payments, benefds or care? ............................................................ x 2. If death occurced after December 12, 1982, did decedent transfer property within one year of death without ^ ^ roceiving adequate conaideration? .................................................................................................................... x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ 0 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 end 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)J. For dates of death on or after January 1, 1985, 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) (il)]. 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)]. (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 blooodd or adoption Rw-180Y EXa (71-08) SCHEDULE A REAL ESTATE COMNIONNiEALTN OF PENNBVLVANIA INNERITANLE TA%RETURN RESIDENT DECEDENT E8TATE OF (FILE NUMBER MARIA C. All n^I prop^rty owned solely or u ^ tenet In common mwt M reported et rair market vaiw. Fair market vakle is tlsimsd as tM prig al which property would tb azchanged t»tween a well tzryer end a wlllkp selbr, neRher being compelled to buy or cell, bosh Mvinpp rawrnrble knowhdge of Me rebvant face. Rs property which le Joindyowned whh right of survivorehlp mwt be dlulosad on uheduN F. Attach a copy of the settlement cheat N the prepsrty has be^n wld Include a copy of Ms deed showing dacedsnt'a intaroet N owned p tenant In common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real Estate -Property located at 2080 Clarendon Street, Camp HIII, Cumberland County, 193,107.60 Pennsylvania. Assessed Value of 6183,260.00 x CLR (1.28. A copy of the Assessment is Attached to this Return TOTAL (Also enter on Line 1, Recapitulation) I 193,707.80 (If more apace is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rsv-160e EX+(8.88) SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY COMMONV~FALTH OF PENNSYLVANIA INHERITANCE TA%RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER YORK MARIA C. pprr qq y 21-10-0224 All proipMy jolntlyownWlwNhltM Ag11t oT aunWashrC ip~i~w' at bs dlacloESd onEacAMula F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Eria Refund -Homeowners Insurance 255.00 2 Life Insurance Proceeds from the Umbenhower Estate -Beneficiary Proceeds paid to Estate 334.66 3 Proceeds from the sale of bedroom fumlture 450.00 4 Tricor Indirect Purchaser Claims -Court Approved Settlement 11.58 5 Fulton Bank Free Checking Account No. 3623-75852 - A Copy of the Date of Death Letter is 104,059.52 Attached 6 Metro Bank Certificate of Deposit Account No. 7000170424 - A Copy of the Date of Death 79,420.90 Letter is Attached Accrued income on Item 6 through date of death 85.33 7 Metro Bank Certificate of Deposit Account No. 7000170425 - A Copy of the Date of Death 79.420.91 Letter is Attached Accrued income on Item 7 through date of death 85.33 8 Mid Penn Bank Certificate of Deposit Account No. 317000145 - A Copy of the Date of Death 104.687.49 Letter is Attached to thla Retum. Accrued interest on Item 8 through date of death 283.95 9 Susquehanna Bank Certificate of Deposit Account No. 10005759112 - A Copy of the Date of 104,494.48 Death Letter is Attached. Accrued income on Item 9 through date of death 144.34 10 1999 Toyota Camry -Sales Price 3,500.00 Total of Continuation Schedule gee attached page TOTAL (Also enter on Line 5, Recapitulation) 479,733.17 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Forrn PA-1500 Schedule E (Rev. 8-98) Rw•760E Ex+ Is-881 SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY COMMONNEiALTH OF PENNBVLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER YORK, MARIA C. 21-10-0224 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 11 Personal Properly 1,151.41 12 Carlisle Propane -Refund on Account 201.15 13 Comcast Cable Refund 11.50 14 Discover Card Refund 27.02 15 Erie Insurance -Refund on Car Insurance 161.00 16 US Treasury 947.59 TOTAL (Also enter on Line 5, Recapitulation) ~ 478,733.17 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 8-98) R.v-tliof tex+ te•eaJ SCHEDULE F DOMHONwEALTH OF PENNBYLVANN JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER YORK, MARIA C. 21-10-0224 H an.awt wa m°de Joint within on° ys°r d th° d°cad°nr° d°b of death, It mwt M nport°d on schsdub G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Kathleen Witten B, Thomas A York C. Richard N Witten JOINTLY OWNED PROPERTY: 460 Miller Road Daughter York Haven, PA 17370 3316 Conewago Street Son Middletown, PA 17057 460 Miller Road I Son-in-Law York Haven, PA 17370 ITEM NUMBER LETTER FOR JOIN 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 ALOE OF ASSE "h OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A, C 9/17/1882 New Cumberland Federel Credit Union 78.37 33.333% 28.12 Account4580 - S4 Checking. A Copy of the Date of Death Latter is Attached to this Retum. 2 A,B 9/8H 888 New Cumberland Federal Credit Union 100.98 33.333% 33.88 Account 865981 - S1 Savings Account. A Copy of the Date of Death Latter is Attached to this Retum. 3 A 1/28/2010 New Cumberland Federal Credit Union 1,483.21 100.000% 1,483.21 Checking Account No. 81293- S4 - A Copy of the Date of Death Letter fa Attached to this Retum. TOTAL (Also enter on Line 8, Recapitulation) I 1,522.99 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Forrn PA-1500 Schedule F (Rev. 6-88) Rsv-1610 EX. (e-99) SCHEDULE ti INTER-VIVOS TRANSFERS 8r, MISC. NON-PROBATE PROPERTY COMA~NWEALTN OF PENNSYLVANIA INHERITANCE TAX RETURN REBIDENi DECEDENT ESTATE OF (FILE NUMBER YORK, MARIA C. ___ _ 21-10-0224 This achedub must De completed and filed rf iM ansvnr to any or questions 1 throu0h 4 on the reveres aide of the REV-7500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF~TROAFNSFERSA TACK A COPY OF THE DEiED ~OREREAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 New Cumberland Federel Crodit Union Certificate 1 42,429.75 42.429.75 Account -IRA -IRA Account Beneficiary: Elizabeth A. Witten A Copy of the Date of Death Letter is Attached to this Retum. 2 New Cumberland Federal Crodit Union Account 4560 - 1,537.36 0.000°k 3,000.00 0.00 S1 Savings. A Copy of the Date of Death Letter is Attached to this Retum. 3 New Cumberland Federal Crodit Union Checking 3,101.28 100.000°~ 3,000.00 101.28 Account No. 8094254 -Joint Checking Account with Kathleen Witten created within 1 year of Date of Death. A Copy of the Date of Death Letter Is Attached to this Retum. 4 New Cumberland Federal Crodit Union Checking 1,463.21 0.000°~ 0.00 Account No. 81293- S4 - A Copy of the Data of Death Letter is Attached to this Return. 5 New Cumberland Federal Credit Union Savings 34,425.81 100.000% 3,000.00 31,425.81 Account No. 80942 - S1 -Joint Savings Account with Kathleen Witten created within 1 year of Date of Death. A Copy of the Date of Death Letter is Attached to this Retum. 6 New Cumberland Federel Credit Union Savings 6,729.79 100.000% 3,000.00 3,729.79 Account No. 81293- 81 -Joint Savings Account with Kathleen Witten croated within 1 year of Date of Death. A Copy of the Date of Death Letter is Attached to this Retum. TOTAL (Also enter on Line 7, Recapitulation) I 77,888.63 (Ii more apace ie needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule G (Rev. 6-98) REV-1767 EXa (10-08) connr~~~~rwv, SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COST; ESTATE OF FILE NUMBER YORK, MARIA C. 21-10-0224 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT q, FUNERAL EXPENSES: See continuation schedule(s) attached 13,434.12 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) KATHLEEN Y. WITTEN Street Address 460 MILLER ROAD city YORK HAVEN state PA Zip 17370 Year(sl Commission oaid 18,000.00 z. Attomev's Fees JOHNSON DUFFIE 20,000.00 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 473.50 5. Accountant's Faes 6. Tax Return Preparer's Fees 132.00 7. Other Administrative Costs 1,572.46 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 53,612.08 Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1600 Schedule H (Rev. 10-08) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER YORK, MARIA C. 21-10-0224 ITEM NUMBER DESCRIPTION AMOUNT Fjineral Expgnses 1 American Legion -Funeral Services/Wake 250.00 2 Giant Food Stores -Products for Funeral Service Luncheon 59.08 3 Gingrich Memorials -Headstone Contract No. 1-01127 3,110.00 4 Hancock -Black Fabric 12.57 5 Matinchek and Daughter Funeral Home and Cremation Services, Inc. 8,741.00 6 Royer's Flowers - Flowere for Funeral Ssrvice 255.46 7 Ruttere Newspapere 8.00 H-A 13,434.12 8 Other Administrative Costs Chad Gallaher -Trimming of Trees/ShrubslWeeds 150.00 9 Cumberland County Register of Wills Office -Additional Short Certificates 20.00 10 Cumberland County Register of Wills Office -Filing Fees for Inheritance Tax Retum and 30.00 Inventory 11 John Messick -Snow Removal for Property 135.00 12 John Messick -lawn Care Services for Residential Real Estate 885.00 13 Kathleen Witten -Replacement Fuse for Treadmill to ready for Sale 4.23 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1600 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER YORK, MARIA C. 21-10-0224 ITEM NUMBER DESCRIPTION AMOUNT 14 Reserves _ Additional Miscellaneous Administrative Expenses 300.00 15 Rick Witten -Reimbursement for repairs to Stair Treads at Residence 25.06 16 The Cumberland L.aw Journal -Notice of Estate Administration 75.00 17 The Patriot News Co. -Notice of Estate Administration 148.17 H-67 1,572.46 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 6-98) Rav-1612 l.X+(12.08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8r LIENS COMMONWEALTH OF PENN8YLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER YORK, MARIA C. 21-10-0224 Report Mtda Ineurrad by Ma dacadant prior to Mrth thrt ramdnsd unpNd rttlra dab o! Math, Including unrsimburaed mMkal axpenap. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 AutoZone - Repair to Decedent's car 5.82 2 Borough of Camp HIII Sewer 445.00 3 Checks clearing after date of death 86.13 4 Comcast 58.15 5 East Pennsboro Ambulance 106.80 6 Erie Insurance -Homeowners Insurance 454.00 7 Erie Insurance -Automobile Insurance 343.00 8 Erie Insurance -Homeowners Insurance 528.00 9 Erie Inaurance -Homeowners Insurance 525.00 10 Janet L. Miller, Tax Collector - 2010 Per Capita Taxes 4.90 11 Janet L. Miller, Tax Collector -Real Estate Taxes - 2010 870.26 12 Janet L. Miller, Tax Collector -School District Taxes 2,324.86 13 Janet L. Miller, Tax Collector -Real Estate Taxes 951.42 14 Janet L. Miller, Tax Collector -School District Taxes 2,322.31 15 Monroe Muffler -Auto Emissions Test on Decedent's car 22.30 16 PA Department of Revenue -Tax Due on 2008 Individual Income Tax Returns 459.00 17 PA Department of Transportation 22.50 Total of Continuation Schedule see attached page TOTAL (Also enter on Line 10, Recapitulation) 13,529.27 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule I (Rev. 12-OS) Rev-1612 EX+ (8-99) $CNEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS coNeioNwFauN of rENN9nvANIA INNERITANDE TAX RETURN continued RESIDEM DECEDENT ESTATE OF (FILE NUMBER YORK, MARIA C. 21-10-0224 Copyright (c) 2002 forth software only The Lackner Group, Inc. Form PA-7500 Schedule I (Rev. 6-98) REV-~a» ex.l»ael `~' SCHEDULE J °ON1~fi~~2~-~c'Y""'" BENEFICIARIES ESTATE OF FILE NUMBER YORK, MARIA G. 21-10-0 224 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER pERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright s ousel ~ distrbutions, and transfers under Sec. 9116 a 1.2 1 In Trust For Sophia York Granddaughter 112 of Tangible 316 Conewago Street Personal Middletown, PA 17057 Property; 1/2 of Residue 2 In Trust for Elizabeth Witten Granddaughter 1/2 of Tangible 460 Miller Road Personal York Haven, PA 17370 Property; 112 of Residue Total Enter dollar amounts for distributions shown above on Ilnes 15 throw h 18 on Rev 150 0 cover sheet as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedub J (Rev. 11-OB) ESTATE OFMARIA C. YDRK SCHEDULE OF EXHIBITS EXHIBITA Last Will and Testament for Maria C York signed and dated December 18t1i, 2009 EXHIBIT B Cumberland County Assessment for Property Located at 2060 Clarendon Street, Cano Hill, PA EXHIBIT C Date of Death Valuation Letter from Fulton Bank for Checking Account EXHIBIT D Date of Death Valuation Letter from Metro Bank for Certiftcate of Deposit Accounts EXHIBIT E Date of Death Valuation Letter from Mid Penn Bank for Certificate of Deposit Account EXHIBIT F Date of Death Valuation Letter from Susquehanna Bank for Certificate of Deposit Account EXHIBIT G Date of Death Valuation Letter from New Cumberland Federal Credit Union for IRA and Joint Accounts :453941 _{ --_ __ - -. _ - __-._.' __-__. y.. `L i - . Last Will and Testament OF MARIA C. YORK I, MARIA C. YORK, of the Borough of Camp Hill, 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 or Codicils at any time heretofore made by me. ARTICLE I DEBTS I direct the payment of all my legal debts and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II FUNERAL ARRANGEMENTS /GRAVE MARKER I direct that Matinchek and Daughter Funeral Home and Cremation Services, Inc., of Middletown, Pennsylvania, be given charge of my funeral arrangements. I direct that my place of burial be in my cemetery lot in St. Mary's Cemetery in Middletown, Pennsylvania., beside the grave of my son, Patrick Andrew York, and that the date of my death be inscribed on my grave marker. It is my wish that there not be a funeral mass held, but that a priest attend a graveside ceremony. ARTICLE III TANGIBLE PERSONAL PROPERTY I give and bequeath my tangible personal property, including my motor vehicle(s), 1 ~:. '~" ~' f ~...`~ ~ ~~~' ..mil ~ ~ ~:.- ~ r :• E. 3 ~ ~ ~. ` :. ,~.1 ~ ._ i household and personal effects and other tangible personalty of like nature (not including cash and securities), together with any existing insurance thereon, unto my granddaughter, ELIZABETH WITTEN, and my granddaughter, SOPHIA YORK, to be divided among them by my Executor with due regard for their personal preferences in as neazly equal shazes as practical. It is my wish, but I do nor require, that my son, THOMAS A. YORK, and my daughter, KATHLEEN Y. WITTEN, each be given any items from among my tangible personal property which may be of sentimental value to them. I direct that under no circumstances shall my ex-husband Stanley A. York, be given access to my residence at 2060 Clarendon Street; Camp Hill, Pennsylvania, or receive any item of my tangible personal property. ARTICLE IV REST, RESIDUE AND REMAINDER I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatever nature and wherever situate, in equal shares to such of my grandchildren as shall survive me. ARTICLE V TRUST FOR THE BENEFIT OF BENEFICIARY UNDER THE AGE OF TWENTY' THREE' (23) With respect to any property which shall pass either under this Will or otherwise to a beneficiary who has not achieved the age of twenty three (23) years of age, I give, devise and bequeath the share of such beneficiary unto my TRUSTEES hereafter named, IN SEPARATE TRUST, to hold, manage, invest and reinvest the shaze(s) so received and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in Trustees' discretion, may be necessary or appropriate for such beneficiary's support and j education (including college education, both graduate and undergraduate, and vocational training beyond high school) after considering all resources reasonably available to him or her 2 - ~ 1 ( iI~ ~J t~ y ~ ~y I~ { `.l ~.~~ l ~ i /t ~..]~ ~ ~ ~ F~n v ~ .lf"C~ ~Y.`~ C ~°T~.` ~ K~ ~'J~.^fs:~~ `~ E~i!k~ ..Y+ !C l^ 4~4.'~~~1'~r ` n ~-a (including but not limited to the beneficiary's parents), or to make payments for these purposes without further responsibility to such beneficiary or to any person taking care of such beneficiary. Trustees shall distribute the balance of principal and any net undistributed income thereon unto such beneficiary when such beneficiary shall have reached the age of twenty three (23) yeazs. In the event that any beneficiary dies before receiving his or her final distribution hereunder, the Trust as to that beneficiazy shall terminate and the balance of principal and any net undistributed income shall be paid over to such beneficiary's Personal Representative. ARTICLE VI SPENDTHRIFT PROVISION I direct that the interest of the beneficiaries shall not be subject to anticipation or to voluntary or to involuntary alienation. ARTICLE VII POWER TO~TERMINATE SMALL TRUSTS If at any time during the continuance of any Trust created hereunder, the Trustees in their sole and absolute discretion determine that the size of any. individual Trust has become so small as to be impractical to continue to hold in Trust and uneconomical to continue to administer as a Trust, then in such circumstances, the Trustees may without further authorization, distribute the balance of the principal and income in such Trust to the beneficiary then entitled to the income therefrom, and upon such distribution, the Trustees shall be released from any further obligation with respect to that Trust and shall not be subject to any claim from any person who may have had a future interest of such Trust had it been continued in Trust. 3 _ _ i ~ '~ 5.."~ ~ .. ~t~ ~ ... ~..'1 ...F -„°_ ~~ 1 ~~ : ~y ,y~ ya_ S r:'.l~v Sy ~ € _~ r -~ -0_ '- c;~~~i~ -.. :1 ~. C ~ rc x.:`.. r'~-.~~''.. -~+.. ~ _rG~'. .'~~Y,. 1i ~'~~^~. ~j..~:a•:P .. ~~.s ~ ~. ~'\~, J...S~ f'~ k ~f':'" r• .i' ~o 1 ... __ , .._.._~ , :..,.~: ,.~~n W..,nY.~. ARTICLE VII POWERS OF PERSONAL REPRESENTATIVE AND TRUSTEES My Personal Representative and Trustees shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, including property held for minors, exercisable without court approval and effective until actual distribution of all property: A. To make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as they may determine. B. To retain any or all of the assets of my estate, real or personal, without restriction to investments authorized for. Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. C. To invest in all forms of property without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification or risk. D. To sell at public or private sale, to exchange, or to lease for any period of time any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as they deem proper. . E. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. F. To compromise any claim or controversy. G. To make such elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift, generation skipping or other tax refunds and the payment of such taxes as my Personal Representative and/or Trustee shall deem appropriate, without obligation to adjust the distributive shaze of any person thereby affected. 4 ~._ -r,r.Y` ?•~ i~~'.\~~\~'~~.. .t~i'`~.f\r~..~F:4..t~9 ~~'+~k..~~~httt~~~~` n..".n .;~J"?,~.`CK~'..~- e..-- ~.,/~;~r./ ~-. ^?" ... _. r; i ,- =; ~- H. To combine, without prior court approval, 'any Trust contained in my Will with any other Trust with substantially similar provisions, although such Trust may have been created by separate instrument. ARTICLE IX TRUSTEES I name, constitute and appoint ORRSTOWN BANK, and my daughter, KATHLEEN Y. WITTEN, Co-Trustees of any Trust created under my Will, and should my daughter, KATHLEEN Y. WITTEN, fail to qualify or cease to so act, I name constitute and appoint my friend, ROSEANN M. ViJKMANIC, of Bressler, Pennsylvania, an individual successor Co- Trustee . I further direct that my individual Co-Trustee(s) shall have the power, exercisable not more than once every five (5) yeazs, to require that the corporate Co-Trustee resign and to appoint a successor corporate Co-Trustee. I direct that no Trustee appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. ARTICLE X PERSONAL REPRESENTATIVE I name, constitute and appoint my daughter, KATHLEEN Y. WITTEN, Executrix of this my Last Will and Testament. Should my daughter, KATHLEEN Y. WITTEN, fail to qualify or cease to so act, I name constitute and appoint my friend, ROSEANN M. VLTKMANIC, of Bressler, Pennsylvania, alternate Executrix to complete the administration of my estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. 5 4 -: -~ -a-. ,5. ~ ~. _ ~~ _ ;~lt~'~,J.-~ l~ ,tom `~,~ z:~.'. ~ '~'_~ S 4 :~~~ y ~_, ------_--2..-.. n.~__.-_. _ .. ~~ti v -~. :~Y b°~, urt i .. 'ln ....,. r,. .".?M1'' ..2-~!r. ~1j" rX,i ~`.,r'~FR~. '_l ARTICLE XI TAXES I direct that all taxes that may be assessed in consequence of my death, of whatever nature or by whatever jurisdiction imposed, shall be paid out of my residuary estate as a part of the expense of the administration of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ! g r~ciay of _ p ~- ~ ~X~ d4 2009. ~-- . ~ ,~-~- p l (SEAL) MARI C. YORK Signed, sealed, published and declared by the above-named Testatrix, 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 hereunto subscribed our names as witnesses. :250966 -r 6 _ J r~~l, ,.(. ~1~F`,-~--~~V ,. .., ..si-Y~. ~'i-,7t^.~~..3 r~ J,,. `ii. t~ ~.'•S ~_' .~-`i~`F'/11r.. ?. i~ AFFIDAVIT AND ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS //~) /~We, MA//R))IApp C. YORK, ~~~ lit~~~ f-. and G(,rrtLrLnJ ~ 1t~~C..C,~-titn ,the Testatrix and the/ witnesses, respectively, whose names aze signed to the attached or foregoing instrument, being first duly sworn, do hereby declaze to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had 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 witness and that to the best of his/her knowledge the Testatrix was at that time eighteen yeazs of age or older, of sound mind and under no constraint or undue influence. e C. YORK Witness Wi e s ' Subscribed, sworn to and acknowledged before me by MARIA C. YORK, Testatrix, and su/b~scri~bed and s om to before me by ~ li(/ii ~(. and (.l~,.I[~,,.1 ~ ~~,,,.~ ,witnesses, this ~ day of , 2009. t~M CANtiiN i .IiM11EF1 Notary luDlk! f4~MC1., 1MO ~ CM~ArIMear MOt 1 ~. l019 7 TaxDB Result Details Detailed RI.ellsults for Parce101-21-0271-148. in the 2004 Tax Assessment Database ® ~~~ _ _ of O 1-21-0271-148. CLARENDONSTREET YORK, MARIA C x 1597 28180 125080 1S3~b0 ............... .21 ~_ -_ _._ 1 ___ _ _ _ 09 _~_ _ ____~___I 106 & 107 PB 1 PG 90 12/23/2008,A O1 20 OS 00270-03870 1967 __._ _____-- n ~~~ . ~~•/~, ~ 1. ~~ ~~~~ ~q~1~0 Page I of 1 http://taxdb.ccpa.netJdetails.asp?id=01-21-0271-148.&dbselect=l 03/05/ 10 ~ultonBank LISTENING IS JUST THE BEGINNING.s"" Apri15, 2010 Johnson Duffle 301 Market Street P.O. Box 109 Lemoyne, Pennsylvania 17043 Dear Ms. Wieseman: RE: Maria C. York, deceased February 12, 2010 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking # 3623-75652, open 2/15/2008, date of death balance $104,059.52, in her name only. Non-interest bearing account. If you should have any further questions, please do not hesitate to contact me at (717) 291-2437. Very truly yours, ~~~ Karen D. Hillegas Credit Inquiry Processor ~~ ~,yG ~„ , ,a _ . a i This in#.~rn,~r^~i ,~ f:uni.^,~....~ 's -. ni-'._r ;~.! ` si~~ss c:uriesy li'1 dYlbt~eur t~ ta't' t'.t.~'~'+Y ~., i~ ~ r '.i,,r ^' ~ ~'!~I li(7:J 0!':iy. ~j.'Gat~.ld'.~." ,' ~ ..,. .;::k ..:"(...'. -i ~~ ~ ~'~"Itll'p° i:oi *.r'e intcrtnat:o~~ ,, ~..C:`?. `.- °;;~. ~1.°.'; K i.::rSUir:~r .~.:y ttiB ~'l,^`slff Q~ ?~'~' C: f {~ U.tG:.~~.::.;.~:;.iC`r...,:..ii -" ~ ~ '::;. r~l:~ l:r~il?~.,n herein °itQ~_-~vi: i:i „_. ;:~ ':;i frl'I~~.,' t`i1yJL't not!CE P O Box 4887 ~ Lancaster, PA 17604 fultonbank.com 1-800-FULTON-4 'METRO BANK 3801 Paxton Street Harrisburg • PA • 17111 mymetrobank.com 888.937.0004 March 26, 2010 Johnson Duffie Attn: Dana Wieseman 301 Market St Lemoyne PA 17043 RE: Estate of: Maria C. York Tax Identification Number: 191-26-3466 Date of Death: February 12, 2010 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: Time Deposit Account Number: 7000170424 Date Opened: 07/16/2009 Primary Owner: Maria York Principal Balance: $79420.90 Accrued Interest: $85.33 Date of Death Balance: $79506.23 Account Type: Time Deposit Account Number: 7000170425 Date Opened: 07/16/2009 Primary Owner: Maria York Principal Balance: $79420.91 Accrued Interest: $85.33 Date of Death Balance: $79506.24 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, ~._ Diana Reynolds Metro Bank Research Associate/Deposit Services ~ ~ Apri16, 2010 Law Offices of Johnson Duffle PO Box 109 Lemoyne, PA 17043-0109 Re: Estate of Maria C. York Date of Death: February 12, ZO10 SSN: 191-26-3466 Dear Ms. Wieseman: In response to your recent letter requesting information on the accounts of Maria C. York, I have accumulated the necessary data below: Account Name: Maria C. York Account #: 317000145 -Certificate of Deposit Date Opened: 9/17/2008 Date Closed: 4/5/2010 Balance DOD: $104,687.49 Balance Accrued Interest DOD: $283.95 Total DOD Balance: $104,971.44 Joint Ownership Name: N/A If you have any questions, please contact me at (717) 896-5381. Sincerely, ~~G ~~--- Jessica Kerwin Deposit Processing Specialist 349 Union Street, Millersburg, PA 17061 • 1-866-bHAPPEN • 1-877-9HAPPEN • www.midpennbank.com Member FDIC Susquehanna Susquehanna Bank 26 North Cedar Street P.O. Box 1000 LRitz, PA 17543-7000 Toll free 800.311.3182 April 8, 2010 JOHNSON DUFFIE LAW OFFICES ATTN: DANA L. WIESEMAN PO BOX 109 LEMOYNE, PA 17043-0109 RE: Maria C. York Estate SS#: 191-26-3466 DOD: February 12, 2010 To Whom It May Concern: In response to your letter of March 24, 2010, here is the above customer account information as of February 12, 2010. Account #1 • Account Title: Maria C. York • Account Type/# CD/10005759112 • Date Opened /Maturity 9/18/08 / 11/18/10 • Interest Rate: .90% • Account Balance*: 104,574.37 • Accrued Interest: 64.46 • YTD Interest: 79.88 *Account balance does not include accrued interest. The title of this CD was changed to Maria C. York Estate on 3/23/10. There is no safe deposit box in the name of the decedent. If I can be of further assistance, please feel free to call. Sin,(c~rely, ~~J ~j ~, Support Services Lead 1-717-625-6546 DMB/LJR New Cumberland Federal Credit Union Your Community Credit Union P.O. Box 658, New Cumberland, PA 17070-0658 Phone: (717) 774-7706. 1-800-716-2328 • Fax: (717) 774-7996 • Web: www.ncfcuonline.org March 25, 2010 Johnson, Duffle, Stewart & Weidner, P.C. 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 RE: Estate of Maria C. York Dear Ms. Wieseman, Pursuant to your letter dated March 24, 2010, pertaining to the above referenced member the information that you requested is as follows: ~~l.f~.. Owner(s) on Account: Maria C. York Kathleen Witten -added 1/26/10 Date acct opened: 10/25/02 DOD Balances: S1 (Savings) $34,425.81 S4 (Checking) $ 3,101.28 DOD Dividends $ 10.38 DOD IRA Dividends $ 131.48 Dividends as of 2/28/10 $ 19,9g IRA Dividends as of 2/28/10 $ 235.02 Owner(s) on Account: Maria C. York Kathleen Witten -added 1/26/10 Date acct opened: 2/18/03 DOD Balances: S1 (Savings) $6,729.79 S4 (Checking) $1,463.21 DOD Dividends: $ 2,08 Dividends as of 2/28/10 $ 4.05 ~tbcount Number: 66596 Owner(s) on Account: Thomas A. York Maria C. York Stanley A. York Date acct opened: 9/8/99 DOD Balances: S1 (Savings) $100.98 DOD Dividends: $ .03 Dividends as of 2/28/10 $ .06 Rtccount Number: 4560 Owner(s) on Account: Kathleen Witten Maria C. York Richard N. Witten Date acct opened: 9/17/82 DOD Balances: S1 (Savings) $1,537.36 S4 (Checking) $ 78.37 DOD Dividends: $ .46 Dividends as of 2/28/10 $ .64 If you need anything additional in regards to this information, please feel free to contact me directly. Sincerely, Barbra J. Wri Branch Manager Enclosures