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HomeMy WebLinkAbout03-13-12 (2)1505610143 REV-1500 Ex (°'-'°' PA De artment of Revenue OFFICIAL USE ONLY p pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2aosol INHERITANCE TAX RETURN 21 11 0714 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 172 24 4651 06 19 2011 O1 29 1924 Decedent's Last Name Suffix Decedent's First Namme MI THUMA ARDYS E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ^ 4a. ~ uture Interest Compromise) date of death after 12-12-82 ^ 5. Federal Estate Tax Return Required g Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) 1 B. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ^ 1 p. Spousal Povert Creditl(date of death between 12-31 ~Jt and -1-95) ^ 11. Election to tax under Sec. 9113(A) (gttaCh SCh. O) CORR ESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL T'AX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number WM D SCHRACK III ESQ 7:17 432 9733 r_, First line of address 124 W HARRISBURG STREET Second line of address City or Post Office DILLSBURG State PA ZIP Code c REGISTERILLS US~<ONLY te; ? : Jc, ~ r rn ` ~ .. r' ~ :~ cn, W r.iu ti.1 f'._ .fit, _~ .: ,._ ~ DATE FILED "~ 170191268 ~~r1 r7 C~ T~ ~:.-, rr7 c~~ ~~'1 _;, C `1 f rt ~"} -:~ Correspondent's a-mail address: SChracklaW~COmCast.net Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statemenl:s, 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. ~ir.~:.~~ ~i~~ yr r~navrv rtr.~r.~rv.~ini r Ff1R FII INf: RFTI IRN ADDRESS 519 W. Lisburp RoadaMech SIGNATURE OF P THAN REF PA 1 Wanda E. Thuma-McDermond ~ 3 Wm. D. Schrack Esq. 124 W. Harrisburg Street, Dillsburg, PA 17019-1268 Side 1 15D5610143 1.505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number ~eceaenrs"eme: THUMA, Ardys E. 172 24 4651 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 9 , 000.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................................................ 4. 1, 592.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 72 5 , 22 7 . 0 6 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers & Miscellaneous fin; Probate Property (Schedule G) u Separate Billing Requested............ 7, 19 , 32 9.43 8. Total Gross Assets (total Lines 1-7) ..................................................................... g. 755 , 148.4 9 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 2 9 , 258 , 99 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 53 6.81 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 2 9 , 7 95.8 0 12. Net Value of Estate (Line 8 minus Line 11) ................................. ......................... 12. 725 352.69 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which , an election to tax has not been made (Schedule J) ............................................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14, 72$ , 352.69 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 15. 0 , 0 0 16. Amount of Line 14 taxable at lineal rate X .045 725 , 352.69 1s. 32 , 640.87 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 X .15 0.00 18. 0 , 00 19. Tax Due .................................................................................................................. 19. 32,640.87 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 21-11-0714 DECEDENT'S NAME THUMA, Ardys E. STREET ADDRESS 222 Messiah Circle CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 27,000.00 1,421.05 (1) Total Credits (A + B) (2) (3) 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 32,640.87 28,421.05 (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,219.82 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 :............................................................................... ^ 0 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, benefits or care?............ ^ O .. ....................... . I 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?....... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................. 0 ^ .. ... ... . 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 tiling 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. TOTAL (Also enter on Line 2, Recapitulation) I 9,000.00 (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 B (Rev. 6-98) Rev-1507 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER _ THUMA, Ardys E. 21-11-071d All property jointly-owned with right of aurvivorahip must bedisclosed on Schedule F. - av~.uivnai Hayes vi ule same SIZej Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule D (Rev. 6-98) Rev-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER THUMA, Ardys E. 21-11-0714 Include the proceeds of litigation and the date the proceeds were received by the esl:ate. All property jointly-owned with the right ofaurvivorship must be dfaclosedon schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 MorganStanley Smith Barney -Financial Management Account #527-10394-13-145 345,656.06 2 PNC Bank, N.A. -checking account #5000001866 36,896.42 3 PNC Bank, N.A. -savings account #5002055665 29,759.55 4 PNC Bank, N.A. -savings account #5080031933 32,069.75 5 PNC Investment Account #001428779 218,391.41 6 MetLife Total Control Account #4058061606 (proceeds on life insurance claim on death of decedent's spouse in 2009) 61,453.87 7 Ohio State Teachers Retirement Fund -Account #31-0795647 (residual value) 1,000.00 TOTAL (Also enter on Line 5, Recapitulation) I 725,227.06 (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 E (Rev. 6-98) Rev-1510 EX+ (8-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF THUMA E. FILE NUMBER 21-11-0714 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ~~~ ~~~~~~ ~~_~~ ~~ iiccueu, oval^onal pages or me same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) REV-1151 EX+ (10-06) COMM~~WEALT~i Q~_ PEN~$1YLVANIA IN R ' IIDEN EDE ED N N SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER THUMA, Ardys E. 21-11-0714 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N M R A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 10,249.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address Gity State Zip _ Year(sl Commission oaid 2. Attorney's Fees Wm. D. SChrack III Esq. 13,000.00 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 574.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 5,435.49 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 29,258.99 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 FILE NUMBER THUMA, Ardys E. 21-11-0714 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Cocklin Funeral Home and associated funeral expenses 10,249.00 H-A 10,249.00 2 Other Administrative Gosh Civic Center Title Services, Inc. -transfer title of Velur Holdings to Estate name 13.00 3 Clerk of Orphans' Court -Fiduciary Release filing fee 5.00 4 Cumberland Law Journal -estate advertising 75.00 5 Miscellaneous expenses during period of administration -postage, photocopies, etc. 25.00 6 PA Dept. of Revenue -quarterly estimated tax payment 220.00 7 Register of Wills -additional Short Certificates 24.00 8 Register of Wills -Inheritance Tax Return filing fee 15.00 9 Reserve for future administrative expense 750.00 10 Social Security Administration -refund overpayment 3,999.00 11 The Patriot News -estate advertising 276.99 12 United States Postal Service -mail packages 32.50 H-B7 5,435.49 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1572 EX+It2-OS) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8t LIENS ESTATE OF FILE NUMBER THUMA, Ardys E. 21-11-0714 Report debts incurred by the decedent prior to death that remained unpaid at the date of death. Including unreimbureed mwdieai wxnwn:.: to more space Is neeaeD, aDOmonal pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-05) COM INHERI pANCE E~EpE]'~R"VANIA SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER ~ nun~n, r~~u a c. ~ 21-11-0 714 NUMBER NAME AND ADDRESS OF PERSON(Sl RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 Wanda Thuma-McDermond Child 25% of residuary 519 W. Lisburn Road estate Mechanicsburg, PA 17055 Meryl K. Thuma Child 25% of residuary Progresso Intnl School - Aptdo 226 estate EI Progresso, Honduras Central America Barbara A. Thuma Child 25% of residuary 5112 Woodmark Drive estate Fort Wayne, IN 46815 Philip E. Thuma Child 25% of residuary 23 Welty Avenue estate Dillsburg, PA 17019 Total Enter dollar amounts for distributions shown above on lines 15 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-OS) -> +, ~` ~, F , .= ,~- BRINSER, WAGNER.& ZIMMERMAN "°; r-: :. .- ,,,, ,,,,,,, ,,,,,ATTORNEYS AT-LAW __ ~` "~ "' "/ 22 NORT}i RAILROAD STREET .. ;, .. -." ,~ ._ _ P. O. BOX 323 _ _ _ -~-~~ PALMYRA, PENNSY~ ~~ ia`J-7p78 T.K`~ ~r ,.. - ~ - ,. ~~---r' a- , , ~r+.~. ;~s`~"~?k s~te;>"sf^ r ~- a:,,,.~ ,-(7 l 7), 838=6348 .~ ,., .. ~, .: WILL OF ARDYS E. THUMA I, ARDYS E. THUMA, a1k/a ARDYS L. THUMA, currently of Upper Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. I. I direct that all my just debts and funeral expenses be paid from the assets of my estate as soon as practicable after my demise. II. I direct that all estate and inheritance taxes that may be assf;ssed in consequence of my death, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. III. I bequeath equally unto my children all tangible personal property which I own at my death. IV. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath unto my husband, Alvan E. Thuma. V. In the event that my husband, Alvan, does not survive me, I devise and bequeath my entire estate that would have otherwise passed under Paragraph IV above equally unto my children, namely, Meryl K. Thuma, Dr. Phillip E. Thuma, Wanda Thuma-McDermond and Barbara A. Thuma, or their issue per stirpes. VI. I appoint my son and daughter, Dr. Philip E. Thuma and Wanda Thuma- McDermond, Executors, or the survivor of them as sole Executor, of this my Will. VII. I direct that no bond be required of my fiduciaries for the l-aithful performance of their duties in any jurisdiction. ,~ -1- IN WITNESS WHEREOF, I, ARDYS E. THUMA, herewith set my hand to this my Last Will, typewritten on two (2) sheets of paper including tl~e attestation clause and signatures of witnesses, this j 3-iti, day of March, 2001. ARDYS ' .THUMA Signed by ARDYS E. THUMA, by her declared to be her Will in our presence, who have hereunto subscribed our names as witnesses in her presence and at her request, this 3~ day of March, 2001. a ~ ~2~ residing at ~~~;_~~~_ y ~ ~~~ ~~~ ;J . L2.[ ~rr~l residing at C<= ;~~ -2- • COMMONWEALTH OF PENNSYLVANIA COUNTY OF WE, ARDYS E. THLIMA, GERALD J. BRINSER and ~,tG ~ n ~ ~. T_ 13 vG os ~~ the testatrix and the witnesses, respectively, whose names are ;signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as Iler Last Will and that she signed willingly (or willingly directed another to sign for her), 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 our knowledge the testatrix was at that time eighteen years of ao;e or older, of sound mind and under no constraint or undue influence. ARDYS L. THLIMA ~ ~_, WITNESS U ~ ~. WITNESS Subscribed, sworn or affirmed and acknowledged before me by ARDYS E. THLIMA, the testatrix, GERALD J. BRINSER and v~~r2•F s. a ~~~ ~ . ~.+ ,witnesses, this day of March, 2001. Notary Publ' ivoi~rsa~l Seal DOIOrBS .f !'ii3!ZI° :~U'?i t p•• e: Up¢er Mien T~t•p., C:!,~z~ba;~~~.ri 7~iy C:omm~s6en cx;;isr•;5 'riay i„ ~._._ ^ ~ t MER~G.":r,PBfttIS~iV3R28~A.ScoCiBr,!~nUf Mu%~irieS -3- 485D0041046 REV-485 EX (OS-04) SAFE DEPOSIT BOX INVENTORY PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY Soaal Security or Death Certificate Number Date of Death County Code Year File Number __ __ _ . 172-24-4651 June 19, 2011 21 __ ___ _ Decedent's Last Name 11 0714 Suffix First Name _. __ MI TI~MA _. _ __ .......... © ADDRESS OF DECEDENT STREET: ARDyS '' E Messiah V111a 222 CITY: STATE: ZIP CODE: mo• PA 17055 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX NAME. Win D Schrack III AttornP~- a Tats STREET ADDRESS. 124 W I~arrisbur St CITY: STATE: ZIP CODE: Dill pq 17 019 • NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT OF PERSON(S) PRESENT AT THE BOX OPENING a. NAME: Wanda EThum-N1cDerrrbnd RELATIONSHIP': Daughter / )~~ecut r i x STREET ADDRESS: 519 W Lisburn Road CITY: STATE: Mechanicsb ZIP CODE: b. NAME: ur PA 17055 RELATIONSHIP: STREET ADDRESS: CITY: STATE: ZIP CODE: c. NAME: RELATIONSHIP: STREET ADDRESS: CITY: STATE: ZIP CODE: NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED NAME: PNC Bank, N.A. STREET A D 2~~~essiah Ci l CITY: sTATE: DE rc e PA Mechanicsburg : 17 0 5 5 NA M E OF PERSON MAKING L A ST ENTRY (f AA /I ~ / ~J ~/ DATE AND TIME OF LA ST ENTRY DATE OF CO TRACT TO RENT BOX NUMBER 115 X ` ~~ ~ lam' ~y 1 TITLE UNDER WHICH BOX IS REIS REQUESTED Ardys iE Thuma NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. NAME: _ Ardys E Thutna b. NAME: STRE~eSS RE8S:V11 lag@ ah STREETADORESS: CRTY: STATE: ZIP CODE: CITY: STATE: ZIP CODE: NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY ~T/a WAS A WILL IN THE BOX? ^ YES ~ NO If yes, a. Date of will: Removed afl:er wi 11 search b. Name and address of personal representative, if named in the will ---- NAME: Wanda E Th~xna-McDermond STREET ADDRESS: 519 W L i sburn Road CITY. STATE: Mechanicsbur ZIP CODE: c. Name and address of attorney, if any PA 17055 NAME: STREET ADDRESS: __ __ .. ._....._ _...._..._... CITY: STATE: ZIP CODE: 48500041046 ~48500041D46 2 2 REV-485 EX SAFE DEPOSIT BOX INVENTORY Page of_ I~InTr1~ ~ATtaA~ ~~ _ IIVJ 1 RUIr i IVIVJ (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, anti number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 tTEM NO. ITEM DESCRIPTION 1. Velur Land Investment, c. e i Ica e o eres e ec ' r~tsul~anre ~olic~#11742f~Z(fa P a,,,.,,,.,+ X1,000.00 believed to be 4. Great American Life Insurance Company Certificate O1U1044662 (without e tneate face value) 5. mit arney accoun s a emen - ~ ---- I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVEN7~ORY: SIGNATURE SIGNATURE PRINT NA ~ ~ ~ /~~ PR~ T NAME AND~CK APPROPRIATE BOX BELOW: PP,INT TITLE (.~6 --- ~~ ~~GtU ~. /NL•'Mp-NI('~~',~1G ~V ____ DA T E C H E CK APPROPRIATE BOX: ~- - /> ~ ~~~ 777 , ' ~~. 7n ~ ~ y~,~ ~D h ~~ f,!~-~ ~- G ~ / r V ~ ' y~ I Execuror(trix) ~ Atlministralor(Irix) ~/ ~ ~" /`~ r L / //uS Estate Representative ~ Jdnt owner of safe tleposit box NOTE: Attach additional 8'/:" x 11" sheet(s) if necessary or use duplicates of this page of form. The lkpartrltent is authorized bylaw, 42 U.S.C. §405 (c)(2xCKi), to requke disdosure of Socal Security numbers in connection with administering state tax laws. The Department uses the Social Security number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the in`ormation in exchange of tax information agreements with Federal and local taxing authorities. The state law ixohhitc the rnrnrnnn,.,o~uF,~~ , ..............~ r.__ ~:_ _,_ _• _ ~~~ uiau~aniy wnnaennal rax mromlatlon except for offiaal ~ ~ \ ~,~~ q . ~ ~ x ~ ~ ~ ~~~ ~ y, rte- `) L .. \ e 5 `~ hs~"`~-_s"?g^ ~+ .~,- T, `~"~ .?a, .+e ~ ~"'~~°anti _ "~"~?';x'~`~"z~,`~En?s. w ,a ,~~ 3 :~ ~ ~~" cn ~ ~ ~ n H ~~ ~. . ' + to ~ L1. rn n ~~ ~t ~ ~ ~ ~ ~~ '= *~i ~ rte. "p m „p ¢. z ~~ ~: -'- ~ ~~vl Nn O ~ _ ~, ~ Y ~ y ~! rtT ~ ~ ~ ~• ~ ~ w ;T IP ~Y~- ~~~ g~j `,• ~-] T R9 Oq -+ ~ ~ io 'e ram ~ ~ gyp. ~ ~ n m 'til ~ ~~ Q '> y~«y ~ 1 ~. n ~ r1 ~ '~, ~ ~ ~. ~. _ ~ ~~~ ~ ,, ~' ~~ ~ °`~ o~ c •~ ~ '-'~ '~~' ~ `G `t r W,~t ~ ~ O ~ O ~ ~ 7 [rr7 ~ O ~ ' ~` ~„ ~ ~ ~' [7y °` ~ [r1 fl' I a~ ~ ~ t .,i ~ rn T (9 Q. d ^~ Q1 ~µ ~~ Ali ~~ ~ r rt L1.. n rt II` t ~~ ~~~ ~ (D y 00 fD ~ ~ I1 ~„~ t.~ .-r ~~, r y ~ ~, ~ art E. ,~7 ij 'v ctin ~ "" ~ ~ '* I F u ~ rt rt rt !t ~~~ rp.., fD (9 lD fD (A ~r~. ~. i ~ . -;, __ _ . +l '~L. .~ ~ ~ ~ -..- .., ~a~n...~~ K a sg. w,. a s`"~a ~~;~,a .say ,+8. ; ~ ...~,,.:.~.ned.~ - ~ .'~ ~ Select Income Properties July 20, 2011 Mr. Wm. D. Schrack III 124 West Harrisburg St. Dillsburg, PA 17019 Re: Estate of Ardys Thuma Dear Mr. Schrack: Ms. Thuma owns 30 units of Select Income Properties 6, a California Limited Partnership. The partnership owns one ~~roperty, Stenner Glen, a student housing facility in San Luis Obispo and rents to students attending Cal Poly University and Cuest.a Community College. Distributions are paid to partners four times a year. The amount of the distribution depends on cash available from operations. At the present time, distributions have been paid a.t the rate of $20.00 per unit per quarter. The next distribution will be paid the first week of October. Our occupancy at that time will determine the amount of the distribution. There is no public market for the units. As units become available from existing partners, I contact other partners who have expressed an interest in buying more units. There were three sales in 2009 at $300.00 per unit and one sale in 2010 at $300.00 per unit. There have been no sales in 2011. For asset valuation, $300.00 per unit would be realistic. However, __,....as a Curren e, ecause t e market is reduced, I could try but not guarantee,a $300.00 per unit offer for a.ll units. Thank you for the Letters Testamentary. To transfer the units, all I will need is a copy of the Death Certificate a.nd the name, address and Social Security or Tax ID number of the new limited partner(s). Cordially, SELEC'~ INCOME F.ROPERTIES 6 ~:. _ 7. f ' -L,.t-t_'-C_'- Lam„ ` ~ ~-fr7.~-t~-~__.. -Arlette T. O'Donnell General Partner 1050 Foothill Blvd., San Luis Obispo, CA 93405 805/544-8414 ',rlt~~ Ct.'~' DO NOT DESTROY THIS ORIGINAL NOTE: When paid, said original note, together with the Deed of Trust securing same, must be surrendered to Trustee for cancellation and retention before reconveyance h+ill be made. V-14715;7386P20 $9.600.00 NOTE SECURED BY DEED OF TRUST (INSTALLMENT -INTEREST INCLUDED) Van Nuys, California J1JNE 25.2002 In Installments as herein stated, for value received, I/we, jointly and severally, promise to pay to PHYLLIS E SA TZMAN SUCCESSOR TRUSTEE OF THE ENGL E TRUSTS ESTABLISHED UNDER THE CHARLES E. ENGLE AND KATHRYN W. ENGLE TRUST DECLAI'.ATION DATED JUNE 18, 1984, AND AS AMENDED ON FEBRUARY 17. 1997 . r order, at place des~nated by the Beneficiary the sum of ............................ . * * * * * NINE THOUSAND SIX HUNDRED AND NO/00 * * * * * $9 600.00 * ~' * * * DOLLARS ... . ith interest from date endorsed on the unpaid principal balance at the rate of ............. . * * * * * Seven * * * * * per cent per annum; principal and interest payable in installments of . * * * * * * ONE HUNDRED ELEVEN AND 46/00 * * * * * * $111.46 * * * * * * DOLLARS* * ..... . r more on the same day of each calendar month, beginning on the 4th day of October , 20 02 ,and continuing until Qaid. Amortized over Ten years. f Beneficiary's request Trustor to issue more than two checks for each payment, Trustor will hars?e and deduct $10.00 from the amount due each party on EACH check issued. _ _ _ _ _ _ --------------------------------------------------- --------------------------------------------------- --------------------------------------------------- --------------------------------------------------- --------------------------------------------------- --------------------------------------------------- --------------------------------------------------- ich payment shall be credited first on interest then due and the remainder on principal; and interest shall thereupon cease upon the princi~ credited. Principal and interest payable in lax, fu! money of the United States. This note is secured by DEED OF TRUST to CHICAGO TLE CO.tIPANY a California Corporation, as TRUSTEE. 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N O W N ti d ~ d f! °' A M N ~ M ,,.~ m m ~ nQ m ~ H ~ ° R J ~ o a ~ ~ c 2Si .tea' fD 38AQ o~~,°;8N e ~ H a m e a 3 m v ~ r* a a m V ~ m ' r iv ? J y no~ ~ asw d d~ N a ~ ~ ' m b P N ~ 'c 8 ~ M ', °~ , ~ g r N > Q a 9 T e 1 ~ ~ . O 0 9 e m ~ ~ 0 M 3m V V a ~~ > D i o ~ 3 C n u_ D Q a' 'o c v c~ 0 m 3 m M y A 3 a. a N n 7 'n a i y A S 3 7 y 3 a D h IA S N 0 m 0 a m ~_ S' ~ A n ~ rn m~ o~ o 8 SS = C ~ O O ~ray o ° v y~ sc ~ ~ aoA-~3 n ~ ~ZC ~ c~ v d n 3 y C!?~ V ~ N o n ~ C1} o ~ ~ c ~ a ~ ~~~~~ 0 3 L ~ • w N y ~ W ~ ~ ~ ~ m CJi ~ T '~ ~ y ~ ~ ~ ~ ~ / ` ~ ~ O ~ i ~ A n y L in r ~ a. 3 - ~ 3 D` ~.~p ° ° ~ ~ r a. ~ m ~ ~+' N W ~ ~ -' ° ~ N ~ S O ~ o W 3 0> ~ ~ ~ ~ r n ~ rf 1 ~ T W l ~ 7 ~ ~ ° .7 •/ O 7 (n co m ~ 3 ~' m ~ ~ n~i~ 3 ~ ~. °, m ~ v ~ ~ N y v V ~ 4° ~ W ~ ~ e ~ W s V N ~ M Ju. 2&• 2011 1:42PM PNC BAVK No, Q66i P. '~ ~~ t:~hD1~+iG t1iE ~'fAY July 28, 2011 WD. D. Schrack IIZ, Esquire 124 West Harrisburg Street Dillsburg, PA 17019-1268 1tE: Ardys E Thuma SSN: 172-24-4651 DOD: 06/19/2011 Dear Sir/Madam: In response to your request for Date of Death {DOD) balances for the customer noted above, our records show the following: Checking Account Account # 500000186b ARDYS E T]HUMA DOD balance: $ 36,896.42 + accrued interest Interest paid O1/O1/20l 1 thru 06/19/2011 - $8.43 Savings Account Account # 5002055665 ARDYS ~' T'~~ ~~'s_ DOD balance: $ 29,754.06 + 5.49 accrued interest in±erest vaid O1 /O l/20 i } =*+*u 06/19/20 _ ? - X46.04 .,., ~ ., ARDYS E THUMA. DOD balance: $ 32,062.65 + 7.10 accrued interest Interest paid 01/01/2011 thru 06/19/2011 - $70.98 nn _ ~ t n ~ i n c ~ ~_ ~ o n°~ _____a :_a____. . : e 7. Established: 03/09/1998 Established: 08/03/2001 lnvestment Account ~.~ b The decedent maintained Investment Account #1428779. For further information, you may call the Brokerage Department at 1-800-762-6111. • Page 1 cf 2 pNc INVESTMENTS Member F W RA antl SIPC August 15, 2011 WM. D. Schrack III 124 West Harrisburg Street Dillsburg, PA 17019-1268 RE: 001-4287791 Ardys E. Thuma (Individual) Dear Mr. Schrack: The value of the above-referenced account on June 19, 2011 is as follows: z;:b - ~ ~, ~4mount: , ~~ ~'~ ~~,r~ ~cnptro ~Symb ~ ~SU p, ~ . ~ I ~ ~ _ ~ ~~ i ` cctued , :,:~ Interest ~~<i s 22.370 _ Prime Fund Daily Money Class FDAXX ~ $ 1.G0 $ 9,322.37 301.261 American Europacific Growth Class F1 AEGFX $41.43 $ 12,481.24 760.858 American Growth Fund of America Class F1 GFAFX $ 30.19 $ 22,970.30 196.947 Artisan Mid Cap Value ARTQX $21.18 $ 4,210.73 1,523.767 Eaton Vance Lar a-Cap Value CIA EHSTX $17.99 $ 27,412.57 764.459 Federated Kaufmann Class A KAUAX $ 5.41 $ 4,135.72 89.520 JP Mor an Emer in Mkts E uity Select JEMSX $23.16 $ 2,073.28 10,892.796 Federated Total Return Bond CIA TLRAX $11.28 $122,870.74 316.458 1 Fidelity Advisor FI Rate High Inc CI T FFRTX $ 9.81 $ 12,914.45 , $ 218,391.41 $ - Grand Total (Market Value + Accrued Interest) $ 218,391.41 If you have any questions, please contact our Estate Resolution Desk at 800-622-7086. Sincerely, PNC Investments, LLC. Estate Resolution Desk KSJ CC: Charles Little The summaries, prices, quotes and/or statistics contained herein have been obtained from sources believed to be reliable but are not necessarily complete and cannot be guaranteed. They are provided for informational purposes only. Past performance does not guarantee future results. PNC Investments LLC Member of The PNC Financial Services Group 1900 East Ninth Street B7-YB13-16-1 Cleveland Ohio 44114-3404 www.pnc.com Important Investments Information: Brokerage and insurance p s ar G~%^K/~C- Not FDIC Insured • Nat Bank Guaranteed • May Lose Value Securities and brokerage services are provided by PNC Investments LLC, member FINRA and SIPC. Annuities and other insurance prcduds are offered by PNC Insurance Services. LLC a licensed insurance agency ___ ___ - _._ I --_... -_ ~~i.20. 2011 1:42PM PNC BANK ~~ t:~D13~G T1iE W,~Y July 28, 2011 WD. D. Schrack III, Esquire 124 West Harrisburg Street Dillsburg, PA 17019-1268 RE: Ardys E Thuma SSN: 172-24-4651 DOD: 06/19/2011 Dear Sir/Madam: No. 0661 P. 1 In response to your request for Date of Death {DOD) balances for the customer noted above, our records show the fallowing: Account 5000001'Sb6 DOA balance: $ Interest paid 01/01/20 ARDYS E THUMA + accrued interest u 06/19/2011 - $8.43 Savfngs Account Account # 5002088665 AID DOD balance: $ 29,754.06 + 5.49 accrued inE in+erest paid 01 /01!2011 -~ni 06/19/20':. - 4f ARDYS E TIIUMA DOD bal $ 32,062.65 + 7.10 accrued interest In paid 01/01/2011 thru 06/19/2011 - $70.98 II2A Account Account # 75400009373 ARDYS E TH-UMA DOD balance: $ 19,310.51 + 18.92 accrued interest Interest paid 01/01/2011 thru 06/19/2011 - $386.26 For beneficiary info~rniation, please call 1-888-762-4727. Establi shed: 03 /09/ 1998 Established: 08/03/2001 Established: 03!10/ 1998 Investment Accoamt ~'b b The decedent maintained Investment Account #1428779. For further information, you may call the Brokerage Departmbnt at 1-500-762-6111. - Page 1 ~f 7 - /l~ ' `` 'Teal Control ccount° r"account No. 4058061606 gH-011240-TCA1PA01 ARDYS L THUMA C/U ESTATE OF ARDYS L THUMA WANDA E THUMA-MCDERMOND 519 W. LISBURN ROAD MECHANICSBURG PA 17055-6171 August 2011 Statement Period From 8!01/11 To 8/31/11 Page 1 of 1 Customer Service: (800) 638-7283 September is Life Insurance Awareness Month. Life insurance is a way to provide some financial protection to your family in the event of your death. It is a way of making sure that there will be enough money to pay for burial expenses, debts, and loss of income. To learn more about life insurance, contact your Financial Services Representative who can help you with these issues, or visit www.metlife.com to view and/or download the Life Advice brochure "Life Insurance." TCA SETTLEMENT OPTION EFFECTJVE ANNUAL YIELD 3.00°,% AS OF Oa131/11 Account Summary Beginning Balance ` $61,453.87 Interest $139.68 Other $61,453.87- Ending Balance $0.00 1"ear To Date Interest $1,187.15 tear To Date Federal Tax Witit~heid'' $0.00 Transaction Details __ _ ___ i'rat~s Date ; rt?ate Written Activity Check No Uescriptioo Amount , ,,,•'29 Customer Closeout $61,453.87- ~, °'2y Closeout Interest $139.68 ~f ~s~ ~' ~ s ~ ~ F-r~ F' a ~ ~ z ~ ,psi` ~~,a. ,~. J i ~~ ~:4~, ' I~~IAnn~~~pl~ll~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT QF (BEVfiNUE BUREAV OF INDIVIDUAL TAXES 06PT.,T80601 HARR189URGi, PA 77128-067 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THUMA-MC®ERMOND WANDA E 519 W LISBURN ROAD MECHANICSBURG, PA 17055 REV-1162 EX111-961 N0. CD 015697 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- tpld ESTATE INFORMATION: sSN: 172-2a-asst FILE NUMBER: 211 1-0714 DECEDENT NAME: THUMA ARDYS E DATE OF PAYMENT: 03/13/2012 POSTMARK DATE: 03/12/2012 COUNTY: CUMBERLAND DATE OF DEATH: 06/ 19/201 1 REMARKS: RECEIPT TO ATTY SEAL CMECK#1001 101 ~ 54,219.$2 TOTAL AMOUNT PAID: 54,219.82 INITIALS: HEA RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS R&61~,~ER QF WILLS LAW OFFICE OF WNI. D. SCHRACK III 124 WEST HARRISBURG STREET DILLSBURG, PA 17019-1268 'T'elephone 717-432-9733 Telefax 717-432-1053 E-Mail Address: Schracklaw@comcast.net March 12, 2012 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013-3376 Re: The Estate of Ardys E. Thuma D/D: June 19, 2011 File #: 21-11-0714 Dear Register: n r .., ~ ~ _ ~ ~.. ~ ~7 ~ ~"~ ? ~ ~ ~ w = _ _: n ~g° ~ ~ ~~ .x, -- r r, .~.- ~ ~ c~ r~~ You will find enclosed herewith two copies of a completed REV-1500 "Resident Decedent Inheritance Tax Return", submitted on the above-noted Estate, accompar.~ied by a single face page marked "COPY". Attached to the bottom of this letter you will find the following: A. Executor's check #1001, payable to the Register of Wills, Agent, for the sum of $4,219.82, which represents additional Inheritance Tax due; B. Executor's check #1002, payable to the Register of Wills, foi• the sum of $50.00, which represents additional probate due; and C. My trust account check #5511, payable to the Register of V~Tills for the sum of $15.00, which represents the filing fee for the enclosed Return. Please accept the Return for filing, time-stamp the copy page of the :REV-1500, and return it to me. In addition, I enclose the original and one copy of the Rule 6.12 Status Report, the original of which has been signed and is submitted for the file. Please time-stamp the copy, return that to me with the copy of the REV-1500 and the appropriate receipts in the envelope provided. Very truly yours, W chrack III WDS/jsg enc. N O N C W 'S ~ O O y A p~ ~ h; ,yl 4,'S ~V o } n (.~ ~ o U~ ; ~° ~Q ~ S ~ ~~' U G7 ~ ,. ,(s '+es~' ~ ~ ~~1~N;1 0 0 ~ ~- ~ , r . :~° '. ~ , .$~~. :~}r a :11 • t.J.1 - --' -~' ~~ x~~' _:L ~ ~ __.. ~ ~ ~_ " ~ r ~, •~ CL'' ~ C : C_~ ; v'--j /~'~..'".. ~1 I~ _,c~- 1.~ ~~ - J (`+d