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Home My WebLink About04-25-12 (2)-~ REV-1500 Ex(°'-'°''~' PA Department of Revenue Pennsylvania Bureau of Individual Taxes °E°"""'~N}OF"~XUE PO 60X.280601 INH Harrisburg, PA 17128-0601 F ENTER DECEDENT INFORMATION Social Security Number Decedent's Last Name FOSTER 155610143 OFFICIAL USE ONLY County Code Vear File Number TAX RETURN 21 ~,~ dy~,t )ECEDENT Date of Death O1 08 2012 (lf Applicable) Enter Surviving Spouse's Information Belov Spouse's Last Name FOSTER Spouse's Social Security Number FILL tN APPROPRIATE OVALS BELOW Date of Birth 08 29 1926 Suffix Decedent's First Name MI ROBERT S Suffix Spouse's First Narne MI JANE G 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 ^ qa, Future Interest Comppromise (tlate of death attar 12-12-e2) ^ 5. Federal Estate Tax Return Required g Demtlenf Dietl Testate (Attach Copy of Will) ~ 7 (AtteUaGOPY i~~inest)a Living Trust G 0 B. Total Number of Safe Dep05i[ B°XES ^ 9. Litigation Proceeds Received ^ 10. Sppoousal Povert Credit{tlata of death 11. Election to tax under Sec 9113(A) bbtween 12-31 ~1 and -1-95) (AtlaCn SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number GARY L JAMES ESQ 717 533 3280 First line of address 134 SIPE AVENUE Second line of address City or Post Office HUI~M~LSTOWN Correspondent's a-mail address: g)Jt~BdC.COrr1 State ZIP Code PA 17036 v REGISTER OF~ILLS USE OAIrY rv ,n~'T ~ -n" - ?~ ' rr t7 D rn-. ~7 <~_V~~ CJI -i . 70'n .~: --• - tO DA LED •• ~ ; ,~ vc ~~ C. C_ ) =i I--' c:~ -r '^~ m O .~ Under penalties of perjury, I declare tha(I have examinetl this return, inGUdi~ accompanying schedules antl statements, and to the best of my knowledge antl belief, It is true, correct and complete. Declaration of preparer other than the persona representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~Q~ ~J, , Jane G. Foster ~ p~r~ t ,d p , 0101 ~, 1505610143 Side 1 1505610143 J J 1505610243 REV-1500 EX Decedent's Social Security Number oa~aanrsuema. Foster, Robert S. RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers 8 Miscellaneous -Probate Property (Schedule G) ~ Separate Billing Requested............ 7. $95 , 631.26 8. Total Gross Assets (total Lines 1-7) .................................................................... . 8. 895 , 631.26 9. Funeral Expenses&Administrative Costs (Schedule H) ....................................... 9. 28 , 039.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 11. Total Deductions (total Lines 9 & 10) ................................................................... 11. 28 , 039.00 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12. 867 , 592 .26 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. 8 67 , 5 92 .2 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 91 t6 150 943.19 15. 0.00 (a)(1.2) X .00 ~ 16. Amount of Line l4 taxable 716 649.07 15. 32,249.21 , at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17 x• 0 0 . at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 18 0.00 . at collateral rate X .15 . 19. Tax Due ................................................................................................................. . t9. 32 , 249.21 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 J REV-1500 EX Page 3 n......d.,nN~. C~mnlnfu Arhi roc¢• File Number 21 ......r.......__. ___- DECEDENT'S NAME Foster, Robert S. STREET ADDRESS 23 Grinnel Drive _ CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (i) 32,249.21 2. Credits/Payments A. Prior Payments 30,600.00 B. Discount 1,612.46 Total Credits (A + g) (2) 32,212.46 3. Interest (3) q. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (q) Check box on Page 2 Line 20 to request a refund 5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 36.75 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred' ................................................................................ ~ ^ b. retain the right to designate who shall use the property transferred or its income :.................................. ^nx c. retain a reversionary interest; or ............................................................................................................... u d. receive the promise for life of either payments, benefits or care? ............................................................ x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^ 0 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? .................................................................................................................. x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE lT AS PART OF THE RETURN 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 dleath 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. 69116 (a) (1.3)1. A sibling is defned under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1510 E%e (6-9a) CDMMONWEALTH OFPENNBYLVPNIA INHERITFNGE TAX RETORN 0.ESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF (FILE NUMBER Foster, Robert S. 2t This schedule must be completed end tiled N the ansver 1o arry of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY THE OATEO TRANSER AEl'RTACFiTA CIOPy OF THE DEED ORREAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST ( EXCLUSION IF APPLICABLE) T~+BLE VALUE 1 Lincoln Individual Fixed Annuity # 973614626 77,943.21 77,943.21 Pinnacle Health System 403 (b) tax deferred -valued per letter dated March 26, 2012; Beneficiary is spouse Jane G. Foster 2 Sovereign Bank IRA # 0578143067 -valued per letter 9,792.62 9,792.62 dated February 22, 2012; Spouse is beneficiary 3 1/2 Real Estate located at 23 Grinnel Drive Camp Hill, 84.200.00 84,200.00 Cumberland County, Pennsylvania -titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per tax assessed value "common level ratio/2 $168,400.00 * 1.00/2 = $84,200.00 4 30 shares of Alcatel Lucent -titled in the Robert S. 46.80 46.80 Foster Living Trust dated January 30, 1998; valued pe statement and public IisGng 5 220 shares of Alpine Global Premier - held in the M & 1,201.20 1,201.20 T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 6 1,444.8412 shares of AT & T Inc -titled in the Robert S. 43,012.92 43,012.92 Foster Living Trust dated January 30,1998; valued pe statement and public listing 7 197.383 shares of Bank of New York Mellon 4.087.88 4,081.88 Corporation -titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement and public listing Total of Continuation Schedules See attached a es TOTAL (Also enter on Line 7. Recapitulation) I 895,631.26 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule G (Rev. 6-98) Rev-1b10 EX+(6-98( COMMONN£ALTH OFPENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS 8L MISC. NON-PROBATE PROPERTY continued NUMBER ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OFMTRANSFRE +.SATTACNTA COPVEOF THE DEED OR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OF DECD'S INTEREST ( EXCLUSION IF APPLICABLE) TAXABLE VALUE 8 BELCO Community Credit Union Account # 624530 - 32.055.83 32,055.83 titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 9 7,139.626 shares of Btackrock Pennsylvania Municipal 80,534.98 80,534.98 Bond Fund I -held in the M & T InvesVnent Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 10 19 shares of CenturyLink Inc. -titled in the Robert S. 701.29 701.29 Foster Living Trust dated January 30, 1998; valued pe statement and public listing 11 150 shares of Concast Corporation -titled in the 3.744.00 3,744.00 Robert S. Foster Living Trust dated January 30,1998; valued per statement and public listing 12 34 shares of DirecN -titled in the Robert S. Foster 1.494.30 1,494.30 Living Trust dated January 30, 1998; valued per public listing 13 527.894 shares of Dreyfus International Bond Fund 1- 8.620.51 8,620.51 held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 14 416 shares of Exxon Mobil Corporation -titled in the 35.543.04 35,543.04 Robert S. Foster Living Trust dated January 30, 1998; valued per public listing Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev~1510 E%+ )6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT OECEOENT ESTATE OF FILE NUMBER Foster. Robert S. 21 ITEM NUMBER DESCRIPTION OF PROPERTY 7HE DAT OF TERANSFERSATTACNACOPyEOF THE 0EE0 FOOREREAL ESinTE. DATE OF DEATH VALUE OF ASSET w of oeco~s INTEREST ExcwsioN (~F APPLICABLE) TAXABLE VALUE 15 6,471.87 Federated PA Municipal Cash Trust -held in 6,471.87 6,471.87 the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 16 11.65116 shares of Frontier Communications 59.54 59.54 Company -titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement and public listing 17 2,100 shares of General Electric Company -titled in 39,270.00 39,270.00 the Robert S. Foster Living Trust dated January 30, 1998; valued per public listing 18 946.745 shares of Goldman Sachs High Yield 8,113.60 8,113.60 Municipal Fund Class 1 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 19 39.512 shares of Guinness Atkinson China and Hong 1,064.45 1,064.45 Kong Fund -held in the M 8: T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 20 66.783 shares of Harbor International Fund # 11 -held 3,540.17 3,540.17 in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev-1670 EX+ (6-96) COMMONWEALTH OF PENNSYLVPNIq INNERITFNOE TqX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued ESTATE OF 21 NUMBER ITEM NUMBER DESCRIPTION OF PROPERTY 7HE DATEN F~TRANSFERSATfACN A COPV OF TIHE DEED FOR RFAL ES~ E. DATE OF DEATH VALUE OF A$$ET %OF OECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 21 146.188 shares of Lazard Emerging Markets Portfolio 2.479.35 2,479.35 - held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1996; valued per statement dated January 31, 2012 and public listing 22 325.043 shares of Litman Gregory Masters 4.111,79 4,111.79 International Ins -held in the M 8r T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30,1998; valued per statement dated January 31, 2012 and public listing 23 69.606 shares of Loomis Sayles Small Cap Value Fund 1.845.26 1,845.26 I -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1996; valued per statement dated January 31, 2012 and public listing 24 262.96 shares of LSV Value Equity Fund -held in the 3.489.48 3,489.48 M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2072 and public listing 25 2,051 shares of M & T Bank Corporation -titled in the 161,782.88 161,782.88 Robert S. Foster Living Trust dated January 30,1998; valued per public listing 26 M 8 T Bank Certificate of Deposit # 31003913153844 - 11,344.64 11,344.64 titled in the Robert S. Foster Revocable Living Trust dated valued per letter dated March 20, 2012 Accrued interest on Item 26 through date of death 20.79 20.79 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev-1610 EX+ (698) COMMONVrEALTH OF PENNSriVANIA INHERITRNGE TAX RENRN RESIDENT OECEOENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued NUMBER ITEM NUMBER DESCRIPTION OF PROPERTY THE DATE OF TRANSERSAEI'RTACNTA COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF A$$ET ~ of oecc~s INTEREST ( EXCLUSION IF APPLICABLE) TAXABLE VALUE 27 97.51 shares of Mainstay Epoch Global Equity Yield 1.472.40 1.472.40 Fund I -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1996; valued per statement dated January 31, 2012 and public listing 28 316 shares of Manulife Financial Corporation -titled in 3,513.92 3,513.92 the Robert S. Foster Living Trust dated January 30, 1998; valued per statement and public listing 29 433.147 shares of MFS Emerging Markets Debt Fund 6,284.96 6,284.96 Class 1-held in the M 8 7 Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 37, 2012 and public listing 30 108.284 shares of Morgan Stanley Focus Growth Fund 3.861.41 3,861.41 - held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 31 401.937 shares of MTB International Equity Fund # 27 3,115.01 3,115.01 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 32 187.789 shares of MTB Mid Cap Growth I Fund # 401 - 2,629.05 2,629.05 held in the M 8 T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) COMMON WrA~TH OF PENNBYLVANIp INNERITANLE Tp%RETURN 0.E81DENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued 21 NUMBER ITEM NUMBER DESCRIPTION OF PROPERTY THE OATENOF TTERANSPRERSATTACIiTA COPyEOF THE DEED F~OREREAL ESTATE. DATE OF DEATH VALUE OF ASSET vc of oECO•s INTEREST E%CLUSION (IF APPLICABLE) TAXABLE VALUE 33 1,820.232 shares of MTB PA Municipal Bond Inst I 19,021.42 19,021.42 Fund # 476 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 34 81.665 shares of MTB Small Cap Growth Inst I Fund # 1.289.49 1,289.49 555 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30,1998; valued per statement dated January 31, 2012 and public listing 35 20 shares of Raytheon Company -titled in the Robert 961.60 961.60 S. Foster Living Trust dated January 30,1996; valued per letter dated March 5, 2012 and public listing 36 1,011.474 shares of Ridgeworth SEIX Floating Rate 8,799.82 8,799.82 High Income Fund Class I -held in the M 8 T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30,1998; valued per statement dated January 31, 2012 and public listing 37 51.214 shares of RS Global Natural Resources Fund Y 1,835.51 1,835.51 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 38 2,696.37 shares of SEI Tax Exempt Pennsylvania 29.336.51 29,336.51 Municipal Bond Fund Class B -held in the M 8 T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30,1998; valued per statement dated January 31, 2012 and public IisUng Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rev-1510 EX+ (fi-99) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY LOMMONVrEALTH OFPENNSYLVANIA INHERITANLETAX RETU0.N continued pESIDENT DELEOENT ESTATE OF FILE NUMBER Foster, Robert S. 21 _ ITEM NUMBER DESCRIPTION OF PROPERTY THE DAT NOFTRA JSFER.SATTACIIACOPV OF THE DEED FOOREREAEESTATE. DATE OF DEATH VALUE OF ASSET vc of oECO•s INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 39 40 shares of SPDR S & P Dividend ETF -held in the M 2,158.00 2,158.00 8 T Investment Account # 414367300; titled in the RobeR S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 40 282 shares of Sunoco Inc -titled in the Robert S. 11,584.56 11,584.56 Foster Living Trust dated January 30, 1998; valued pe public listing 41 396.173 shares of T Rowe Price Institutional Large 6,517.05 6,517.05 Cap Growth Fund - held in the M 8: T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 42 408.58 shares of T Rowe Price Tax Free Income Fund 4,163.43 4,163.43 #45 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 43 25,000 units of Vanguard Federal Money Market Fund 25,000.00 25,000.00 -titled in the RobeR S. Foster Living Trust dated January 30,1998; held in the Vanguard brokerage account # 09930316315; valued per letter dated February 14, 2012 Accrued income on Item 43 through date of death 0.05 0.05 44 6,696.457 units of Vanguard GNMA Fund Admiral 74,196.74 74,196.74 shares -titled in the Robert S. Foster Living Trust dated January 30, 1998; held in the Vanguard brokerage account # 09930316315; valued per letter dated February 14, 2012 and public listing Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) Rav-1510 E%+(6-96( SCHEDULE G INTER-VIVOS TRANSFERS 8r MISC. NON-PROBATE PROPERTY COMMONKEALTH OF PENNSYLVANIA INNERITANCETAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Foster. Robert S. 21 ITEM NUMBER DESCRIPTION OF PROPERTY THE DATENOF TR~MISFRERSATTACVITA COPY OF THE DEED F~oREREAL ESTATE. DATE OF DEATH VALUE OF ASSET ~ of oeco~s INTEREST E%cLUSION (IF APPLICABLE) TAXABLE VALUE Accrued income on Item 44 through date of death 51.80 51.80 45 14.015 shares of Vanguard Institutional Index Fd # 94 1,641.16 1,641.16 held in the M & T InvestmentAccount # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 46 1,772.252 units of Vanguard Long Term Treasury Inv 23,216.50 23,216.50 Fd -titled in the Robert S. Foster Living Trust dated January 30,1998; held in the Vanguard brokerage account # 09930316315; valued per letter dated February 14, 2012 and public listing Accrued income on Item 46 through date of death 14.07 14.07 47 505.092 shares of Vanguard Short-Term Tax-Exempt 8,041.06 8,041.06 Fund #41 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated January 31, 2012 and public listing 48 972.446 units of Vanguard Short-Term Treasury Fund 10,492.69 10,492.69 titled in the Robert S. Foster Living Trust dated January 30,1998; held in the Vanguard brokerage account # 09930316315; valued per letter dated February 14, 2012 and public listing Accrued income on Item 48 through date of death 7.37 1.37 49 179.743 shares of Vanguard Value Index Fund Signal 3,895.03 3,895.03 Shares #1346 -held in the M & T Investment Account # 414367300; titled in the Robert S. Foster Living Trus dated January 30, 1998; valued per statement dated January 31, 2012 and public listing Copyright (c) 2002 farm software only The Lackner Group, Inc. Fonn PA-7500 Schedule G (Rev. 6-98) Rav-1510 EX+ IB-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA%RETURN continued ftE31DENi DECEDENT ESTATE OF FILE NUMBER Foster, Robert S. 21 ITEM NUMBER DESCRIPTION OF PROPERTY THE DATENOF TRANSFER SATTACNTA C~OPVEOF THE DEED ~OR REAL ESTATE. DATE OF DEATH VALUE OF ASSET ~ of oeco~s INTEREST ExausioN (~F APPLICABLE) TAXABLE VALUE 50 344.23088 shares of Verizon Communications Inc - 73,201.25 73,201.25 titled in the Robert S. Foster Living Trust dated January 30, 1998; valued per public listing 51 100 shares of Vodafone Group PLC -titled in the 2,769.00 2,769.00 Robert S. Foster Living Trust dated January 30, 1998; valued per statement dated February 29, 2012 and public listing TOTAL (Also enter on Line 7, Recapitulation) 895,831.28 Copyright (c) 2002 form software only The Lackner Group, Inc. Forth PA•1500 Schedule G (Rev. 6-98) REV-1161 EX+110-06) COM IN(L I~~~F~rJ_jS1O~rANIA SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Foster, Robert S. 21_ Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NI M A, FUNERAL EXPENSES: See continuation schedule(s) attached ~ 14,954.00 B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio _ Yearfsl Commission Daid 2, Attorneys Fees James, Smith, Dietterick & Connelly, LLP 72,500.00 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 15.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 570.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 26,039.00 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-7500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Foster, Robert S. 2t ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 John E. Neumyer Funeral Home -funeral 8,985.00 2 Rolling Green Cemetery Company -funeral 5,969.00 H-A 14,954.00 Other Administrative Costs 3 James Smith Dietterick 8 Connelly LLP -reserve for estate administration closing costs 500.00 4 John R. Zimmerman -messenger service to Cumberland County 50.00 5 Sovereign Bank -date of death balance fee 20.00 H-67 570.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Forrn PA-1500 Schedule H (Rev. 6-96) SCHEDULE J COMIN~ry~p~ECE~ N~I,/ANIA I1UA BENEFICIARIES ESTATE OF FILE NUMBER Foster, Robert S. 21-12-0422 NAME AND ADDRESS OF RELATIONSHIP TO Sh1ARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSONfSI RECEIVING PROPERTY DECEDENT (Words) ($$$) I TAXABLE DISTRIBUTIONS [include outright spousal . distributions, and transfers under Sec. 9116 a 1.2 See attached schedule Total 867,592.26 Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 15 00 wver sheet, as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule,! (Rev. 11-OS) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Robert S. Foster 01/08/2012 208-12-7112 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 Jane G.FOSter Spouse 23 Grinnel Drive Camp Hill, PA 17011 2 Mark R. Foster Son 703 Genevieve Drive Mechanicsburg, PA 17055 3 Patricia Sosinski Daughter 8865 Tamebird Court Columbia, MD 21045 1 Lincoln Financial 150,943.19 Annuity, Sovereign Bank IRA; life estate in family trust 1/2 interest in 358,324.53 remainder of family trust 1/2 interest in 358,324.54 remainder of family trust Total REV-1574 EX* 10-0°t COMMONWEALTH OF PENNSYLVANIA IN RES DENTEDECEDENTRN SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN ;heck Box 4 on Rev-1500 Cover Sher ESTATE OF FILE NUMBER Foster. Robert S. _ 21 This schedule should be used for all single life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single Ilfe calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. """"""""~ NEAREST AGE AT TERM OF YEARS NAME OF LIFE TENANT DATE OF BIRTH DATE OF DFP.rH LIFE ESTATE IS PAYABLE Jane Foster 03/17/1927 85 ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Tenn of Years ^ Life or ^ Term of Years 1. Value of fund from which IIFe estate Is payable $ 779,856.43 2. Actuarial factor per appropriate table .08105 Interest table rate - ^ 3 112% ^ 6% ^ 10% ®Yariable Rate 1.4°1° 3, Value of life estate (Line 1 multiplied by Llne 2) - $ 63,207.38 , , '< ,.:~t,..;!I ..'. ,s:. ,d~`r.t..Fa'~f 4l,6.~,.. e. ..a..., .. x NEAREST AGEAT TERM OF YEARS NAME OF ANNUITANT (DATE OF BIRTH I DATE OF DEATH I ANNUITY IS PAYABLE 2. Check appropriate block below and enter corresponding number Frequency of payout Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quarterly (4) ^ Semi-annually (2) ^ Annually (1) ^ Other 3. Amount of payout per period q. Aggregate annual payment. Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate - ^ 3 112% ^ 6°/4 ^ 10% ^ Variable Rate 6. Adjustment Factor (see instructions) 7. Value of annuity - If using 3 1 /2%, 6%, 10% or if variable rate and period payout is at end of period, calculation is: Line 4 x Line S x Line 6 $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 NOTE: The values of the funds which create the above future interests must be reported as pan of the estate assets on Schedules A through G of the tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule K (Rev. 4-09) t. Value of fund from which annuity is payable '° Rev-1151 EX ti-8r(tl( SCHEDULE O COMMONNEALTH OF PENNSYLVANIA ELECTION UNDER SEC. 9113(AJ~ INHERITANCE TAX RETURN SPOUSAL DISTRIBUTIONS RESIDENT DELEOENT ESTATE OF FILE NUMBER Foster, Robert S. 21 _ Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust imarital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listetl On Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically itlentify the trust (all or a fractional portion or percentage) to to included in the election to have such trust or similar property treated as a taxable transfer in this estate. h less than the entire value of the trust or similar property Is inclutled as a taxable imnsfer on Schedule O, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrengement. The numerator of this fraction is equal to the amount of the tmst or similar arrengement includetl as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule O (Rev. 6-98) Part B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) 511ection to tax is being made. (If more space is needed, insert additional sheets of the same size) SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) continued ESTATE OF FILE NUMBER Foster, Robert S. 21 ITEM NUMBER DESCRIPTION AMOUNT 9113A Trust 1 Assets which comprise the Robert S. Foster Family Trust - Schedule G items 3 - 53 807,895.43 2 Less: Expenses listed on Schedule H -28,039.00 01-A Subtotal 779.856.43 911'+A Trus /EI lion Mad 3 Assets which comprise the Robert S. Foster Family Trust - Schedule G items 3 - 53 807,895.43 4 Less: Expenses listed on Schedule H -28,039.00 01-B Subtotal 779.856.43 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule O (Rev. 6-98)