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HomeMy WebLinkAbout09-21-12rrrrrrrrJ 1505610143 REY-1500 Ex(°'-'°' PA De artment of Revenue OFFICIAL USE ONLY p Pennsylvania covrrcy coda veer Fila Number Bureau of Individual Taxes °L'""*'•11iOF"a'~1YE Po Box.2sosot INHERITANCE TAX RETURN 21 12 0696 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Data of Death Date of Birth 186 24 9033 06 03 2012 O1 13 1919 Decedent's Last Name DUNK Suffix Decedent's First Name RUTH (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Sutx Spouse's First Name MI J MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FELL IN APPROPRIATE OVALS BELOW 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13-92) 4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Retum Required (data of deetn etler 12-72-82) e Decedent Died ieatate ~ T Deoa~er~t NaiM~jrrec~ a Living iruat 0 a. Total Number of Safe Deposit Boxes Art (Adach CopyMwl9 a opy ruej ( 9. .Litigation Proceeds Receivetl ~ 10. bi°hveeoipld191 ~~{de~SW deaN ~ 11,Election to tax under Sec. 9113(A) (Amach Sch. O) CORRESPONDENT • THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Numher AARON C JACKSON ESQ 717 234 4121,,, First Ilne of address 2 LEMOYNE DRIVE Second line of address SUITE 200 City or Post Office LEMOYNE Cortespondent's e-mail ADDRESS Stafs ZIP Code PA 17043 schedules and is based on all Side 1 L 15D561D143 REGISTERLLS US~NL r t _=====rrrr~55~~~ii [~ C~ v C , 7 4N.' L . c ; c ,-,. - C _, ,y. ~.:J = ` ~ A D TE FILED 155610143 .7 A _~ n .=J y -Ti ~7 1505610243 REV-7500 EX Decedent's Social Security Number o.ud.nr. n..,.: Dunn, Ruth Jane ].86 24 9033 RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 23 , 582.40 3. Closely Held Corporation, Partnership ar Sole-Proprietorship (Schedule C)...... ... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ...................................................... .. 4. 5. Cash, Bank Deposit9 8 Miscellaneous Personal Property (Schedule E) ............. .. 5. 31O , 980.23 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6. 7. Inter-Vivos Transfers8 Miscellaneous -Probate Property (Schedule G) ~ Separate Billin R ted g eques ........... . 7, 8. iota) Groaa Aaaets i(total Lines 1-7) ................................................................... .. 8. 334 , 562.63 9. Funeral Expenses 8 Administrative Costs (Schedule H) ..................................... .. 9. 22 , 966.85 10. Dehts of Decedent, Mortgage Liahilities, 8 Liens (Schedule I) ............................ .. 10. 3 , 324.84 11. Total Deductions (total Lines 9 8 10) ................................................................. .. 11. 2 6 , 2 91.69 12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12. 308 , 270.94 13. Charitable and Goverfimenlal Bequests/Sec 9113 Trusts forwhich an election to tax has hot been made (Schedule J) .............................................. . 13. 14. Net Value SubJectto!Tax (Line 12 minus Line 13) ............................................. .. 14. 308 , 270 , 94 TAX COMPUTATION - SEA INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable al the spousal tax rate, or transfers untler Sec. 9116 (a)(1.2) X .00 15. O . OO 76. AmountotLine74taxdble 308 270.94 at lineal rate X .045 ' r 1s. 13 r 872 - 19 17. Amount of Lina 14 taxable at sibling rate X .12 O . O 0 17. O . OO 78. Amount of Line 14 taxable at collateral rate X.15 0 - OO 78. 0.00 ts. Tax Due ................................................................................................................. . ts. 13 , 872.19 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 150561043 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-12-0898 DECEDENT'S NAME Dunn, Ruth Jane STREETADDRESS 824 Lisburn Road #210 CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Pricy Payments B. Discount 12,430.42 654.23 i1) Total Credits (A + 8) (2) 3. Interest q. If Line 2 is greater than Line 1 + Like 3, enter the difference. This is the OVERPAYMENT. Check!box on Page 2 Line 20 to request a re/und 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) {q) (5) 13,872.19 13,084.85 787.54 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 dr income of the property transferred :............................................................................... x b. retain then ht to desi nate who shall use the roe transferred or its income :............ c. retain a revPrsiOnary merest; or......P.y......... P.. P. ~ ........................................................................... ~ x .......... d. receive the ro ise for life of either a merits, benefits or ca~ ?P .~ ................. Y......... 2. If death occurred aR~r December 12, 1982, did decedent transfer roe within one ear of death without receiving adequate rpnsideration9 .............. ........ ^ ^x 3. Did decedent own an'~,°in trust fob' or payable upon death bank account or security at his or her death?....... ^ ^x 4. Dontai ces aebenefic an Nndividual Retirement Aceount, annuity, or other non-probate property which ryldesignation? .................................................................................................................. ^ IF THE ANSWER TO ANY OF THE ABQVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For tlates of death on or after July 1, 19~ and before Jan. 1, 1995, the tax rata 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) (i)]. For dates of death on or after January 1,11995, 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 statul:ory requirements for disclosure of assets and filing a tax return are still appl cable 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 valuejof 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 bf 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 bf 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, 85 an individual who has at least one parent in common with the decadent, whether by blood or adoption. Rsv-1803 E%~ (8-atl SCHEDULE B STOCKS & BONDS DOMMONWFPLTN OF PENNSYLVANIA INHEPoiANOE TA%RETURN RESIOENr DECEDENT ESTATE OF FILE NUMBER Dunn. Ruth Jane 21-12-0696 All pmpeRyjolrNy-ownstl wIN rlpM of survlvorMlp mwt M Afsclosstl on ScMtlWS F. ITEM NUMBER CUSIP NUMBER DESCRIPTION 11N1T VALUE VALUE AT DATE OF DEATH 1 Srpries EE US Saving Bonds -Twelve (12) Series EE 23,582.40 V luation from Treasurydirect.gov S e attached Exhibit "C" S ecific Bequest to great-grandchildren Article Eighth TOTAL (Also enter on Line 2, Recapitulation) 23,582.40 (It mare specs is rweded, additlonal pages o! the same aizal Copyright (c) 2002 Corm software only!rhe Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) aevn soe ax+IS-sal SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMON W EµTH OF PENV BYLV/ NIR INHEa1TPNOETlXRETURN REBIOENT DECEOENi ESTATE OF FILE NUMBER Dunn, Rl~th Jane 21-12-069fi Intlutle me proceeds o(liggatlpn and the tlets Ne proceeds wero rodivM by me estate. FII pcapary Ipbdly<wmd wkh the rlpM W aurvivo,ahip must M disclosed on scMJUM i. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Checking Acco nt - MB:T Bank Account #29364787 195,749.27 Attached as pant of Exhibit "D" 2 Checking Acco~lnt - M&7 Bank Account #9852437590 41,389.74 Attached as part of Exhibit "D" 3 Savings Accou~t - MS:T Bank Account #15004214931534 65,446.22 Attached as pa of Exhibit "D" 4 1996 Oldsmobile-Specific Bequest to Nikki Vorkapich 1,000.00 Per Article Seco d 5 Antique Server-ISpeciflc Bequest to Michelle Eureaux 200,00 Per Article Fourdh 8 Antique Table - ~peciflc Bequest to Nikki Vorkapich 200.00 Per Article Seco d 7 Cluster Diamond Ring -Specific Bequest to Jan E. Robinson 1,000.00 Per Article Third ~. 8 Diamond Wedding Band -Specific Bequest to Nicole Perry 300.00 Per Article Sixth '.. 9 Pear Shaped Dimond Ring -Specific Bequest to Nikki Vorkapich 1,000.00 Per Article Seco d 10 Single Diamond Ding -Specific Bequest to Elizabeth Eston 300.00 Per ANCIe Fifth 11 PEBTF-Retirement 361.84 12 The Woods a[ Cedar Run -Refund for overpayment 4,033.16 '. TOTAL (Also enter on Line 5, RecaOitulaUon) 310,980.23 (If more space is needed, additional pages o(the same size) Copyright (c) 2002 form software only The Lackner Group, Ino. Form PA-1600 Schedule E (Rev. 6-98) aeviiai ex+liaoal ~~NNTTCC ,qq)ppx(Eq y[$~ GOMMN IOENTEpECEO~"~VLVANIA SCHEDULE H FUNERAL EXPENSES 8 ESTATE OF I FILE NUMBER I]unn_ Ruth Jane 21-12-0696 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT A. ~ FUNERAL Sae continNation schedule(s) attached 4,644.19 B. ADMINISTRATIV COSTS: 1. Personal Represe tative's Commissions Name of Personal~epresentative(s) Streel Address City State Zio Year(sl Commis ion Deed ~ 11,122A9 2. Attomev's Faes j Tucker Arensberg, P.C, 3, Family Exemption: j(If decedent's address is not the same as claimant's, attach explanation) Gaimant Street Addressl City ' State Zfo Reladonshio o Claimant to Decedent 4. Prohale Fees 647.60 5. Accountant's Fees '. 6. Tax Retum Preparerjs Fees 260.00 7. Omer Administrative ~~ost5 6,402.67 See continua«ion schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 22,966.86 Copyright (c) 2009 form software onlyiThe Lackner Group, Inc. Forme PA4 b00 Schedule H (Rev. 10-OB) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Dunn R~rth Jane 21.12-0696 ITEM NUMBER DESCRIPTION AMOUNT 1 Funeral 675.00 2 Hetrtck$itner F1unenl Home 3,627.51 3 Royers Flowers', 177.68 4 Woodlawn Mem'prial Gardens 164.00 H-A 4,644.19 5 Other Administrative Gosts Castaway Critte~s -Charitable Gift 200.00 6 Cumberland Lev} Journal -Estate Advertising 75.00 7 Estate Check Fe~ 21,97 8 Hospice of Centr~l Pennsylvania i 100.00 9 Mechanicsburg F}ost OfRce • Mailing Costs for Specific Bequesb 45.46 10 PEBTF - Reimbur~e Overpayment 402.04 11 The Sentinel -Estate Advertising 157,68 12 The Woods at Cedar Run -Final Bill 10.52 13 The Woods at Cer~ar Run -Residence 6,390.00 H-BT 6,402.67 Ccpydgnt (y 2002 form software ontN The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-ibi3 EX+t13-0el COMMONWFXTHOF PENNSTLVIWIA INNEWTgNfE TA%FEnIPN REaIOENi 0ECE0ENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF NUMBER Report a.m mw a ny rn. a«a«a w+or eo esm um nmslnba Mnpala at mb a.n a a..en, m<iMama vnMmnvrssa m.ei<al asp.,w.. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Lower Allen Township Emergency Medical Services -Ambulance 71.50 2 Med Staffers ~ 1,184.63 3 Messiah Village~Home Care, LLC -Final Medical 1.722.73 A Nationwidelnsl~rance-Carlnsurance 85.24 5 Pinnacle Health Wospitals -Final Medical 50.00 6 Spartan Pharma~y -Medicine 197.50 7 i Verizon -Final P~lone Bill 13.24 TOTAL (Also enter on Line 10, Recapitulation) I 3,324.84 (If more apace is needed, additional pages of the aema size) Copyright (y 2009 form soHware only ~hhe Lackner Group, Inc. Form PA-600 Schedule 1 (Rev. 12-08) HIOS.nnS ItL'l'19ni~ Lt)CAL REGISTRAR'S CEI3TIEICATI~IN OF DEATH WARNING: It is illegal to duplicate this copy by photosi:at or photograph. Fee for [his certificate, X6.00 P 186S~25a Certification Number P./P,Int In This is m certify that the information here give. correctly copied from an original Certificate of D - duly filed with me as Local Registrar. The uric certificate will be fo warded to the State Records Of"c f r p anent filing. _ / / Local Reeistrar Date Issued cOMMONW GITH OF PINNSVLVIINIw ~ OEPwRTMENT OP NEILLTN + V ITnc RELOROz State FII. Number: a an aewl Namv (FIraC De < l Itltlle, LaR, SuM.j 1, Sv 8, zecln a u[IN Numn.r e1 pu[n 1Ma O.Y/Vn (5p~ll Mol e RU h ,] D Fama1 165-18-9897 .lun¢ 3a 2012 . wv.-ua 91.<na.Y n[al sn. na.f 1 • se. wen i O. e. mt. Pf 91nM1 (Mn/p.r/YOII zoal MPn<n) >.. gyen 1. 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P - : . w bu of a a I ntl/ atl8atlan, In m nlon, tl a<n P retl a[ m elms tla4 aria 1 ew, n a to [ a a~ .wlal antl m vd a n vna[u[v al cartlflar: /~ olprtlfl~ TI e </Lf > clwnae NUmear /~w.l~~f/ Y/y~ [1 Aran antl t P Ceea of b. ~A' a i on mplaeln8 4ua Oaa[M1 11<am 36 L ~yla N e C ~~ O ' " ' r t. D.b: n.a P/D•Y/Yr d 1 S c h ¢ e n .. /t 5 ( Hc~ . L er- 3 S A OU: T j. i 90, a81a<raYf atllct Ny~]~ w Y3. Ry zl8nature a la< a b (Me O r ~ l- P ~ V3. wm.namanu _~ _ DItPOfltlon P.[mlt No. l ]~ V '1 rt~ T - H105-1a3 qEV OT/1011 REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS No. 2D 12- 00696 PA No. 21- 12- 0696 Estate Of: RUTH JANEDU.NN !First, Middle, La50 Late Of: LOWER ALLEN i~OWNSHlP CUMBERLAND COUNTY Deceased Social Security No: 186-24-9033 WHEREAS,I on the 22nd day of June 2012 an instrument dated April 10th 008 was admitted to probate as the last will of RUTH JANE DUI+1N iFinr. Mitldle, Caaq late, of LOW~R ALLEN TOWNSN/P, CUMBERLAND County, who died on the 3rd day of June 2012 and, wHEREAS,'a true .copy of the will as probated is annexed hereto. THEREFOR$', I, GLENDAFARNERSTRASBAUGH Register of Wi11s in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that ~ I have this day granted Letters TESTAMENTARY to: NIKK! VORi~I PICH who has duly,,qualified as EXECUTOR/R/XI i and has agre~d to administer the estate according to law, all of which fully appears! of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PFNN~YLVANIA. IN TESTI of my office i Iii * *NOTE!* WHEREOF, I have hereunto set my hand and affixed the seal the 22nd day of June 201." ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LAST WILL AND TESTAMEivT OF RUTH JANE DUNN I, Itluth Jane Dunn, of Lower Paxton Township, Dauphin County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last Will and Testament, hereby revoking ar~d making void any and all wills by me heretofore made. FI IST: I order and direct that all of my just debts and funeral expenses be paid by my hereinafter gamed Executrix as soon after my death as may be found convenient. To my daughter, Nikki Vorkapich, I give my peaz-shaped diamond ring, my antique dro~-leaf table and any automobile which I own. To my daughter, Jan E. Robinson, I give my cluster diamond ring. H: To my daughter, Michelle Eureaux, I give my antique server. To my granddaughter, Elizabeth Easton, I give my single diamond ring set in gold. To my granddaughter, Nicole Perry, I give my diamond wedding band. I direct that any gifts which have been given to me by my daughter, Nikki Vorkapich, q'r by my daughter, Jan E. Robinson, be returned to the giver. EIG TH: I direct that my United States Savings Bonds be divided equally among the following gr~at grandchildren: Haney Vorkapich, Katelyn Vorkapich, Janelyn Vorkapich and Chandon Vo~kapich. If any recipient has not yet reached eighteen (18) years of age, my daughter, Nikki Vorkalich, shall hold that child's shaze in trust until the child reaches eighteen (18) yeazs of age. vd ' o~ ar~rd3awno i~~~^ S, t~~dljC) ~ ~ ~1 J - ~L W~ ` I.'~LL~L 1 Ruth Jane Dunri~ - ts :b i,!~ z~ Mrr?!~~ ~- y ~~ 3J!j~t' tli'i'i/,rj~_ NIi TH: I direct that each beneficiary under my will pay all tales which are attributable to his or her share of my estate. The taxes which are covered by this Paragraph shall include, but not be Limited tb, Pennsylvania Inheritance Tax, Federal Estate Tax and federal and state income taxes. TE TH: All the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my death~l I give, devise and bequeath as follows: A. Twenty-five (25) percent to my daughter, Jan E;. Robinson. !. B. Twenty-five (25) percent to my daughter, Nikki. Vorkapich. C. Ten (10) percent to my daughter, Michelle Eureaux. D. Five (5) percent to my grandson, Matthew Robinson. ', E. Five (5) percent to my grandson, Andrew Vorkapich. F. Five (5) percent to my grandson, Mark Vorkapich. G. Ten (10) percent to my granddaughter, Elizabeth Easton. ~~ H. Ten (10) percent to my granddaughter, Nicole Perry. I. Five (5) percent to my grandson, Edward Easton. ii ELE ENTH: I hereby nominate, constitute and appoint my daughter, Nikki V orkapich, as Executrix ofthis, my Last Will and Testament, and I do direct that no bond shall be required of such Executrix he~eunder. My said Executrix shall have full power at her discretion to do any and all things neces~ary for the complete administration of my estate, including the power to sell at public or private salt and without order of Court, any real or personal property belonging to my estate, and 2 Ruth Jane Dun LAST WILL AND TESTAMENT OF RUTH JANE DUNK I, Ruth lane Dunn, of Lower Paxton Township, Dauphin County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last Will and Testament, hereby revoking a~d making void any and all wills by me heretofore made. FI I ST: I order and direct that all of my just debts and funeral expenses be paid by my hereinafter (named Executrix as soon after my death as may be found convenient. SE OND: To my daughter, Nikki Vorkapich, I give my peaz-shaped diamond ring, my antique dco~-leaf table and any automobile which I own. THIRD: To my daughter, Jan E. Robinson, I give my cluster diamond ring. FO RTH: To my daughter, Michelle Eureaux, I give my antique server. FIF H: To my granddaughter, Elizabeth Easton, I give my single diamond ring set in gold. To my granddaughter, Nicole Perry, I give my disunond wedding band. I direct that any gifts which have been given to me by my daughter, Nikki Vorkapich, ~r by my daughter, Jan E. Robinson, be returned to the giver. I direct that my United States Savings Bonds be divided equally among the following gy~eat grandchildren: Hailey Vorkapich, Katelyn Vorkapich, Janelyn Vorkapich and Chandon Vorkapich. If any recipient has not yet reached eighteen (18) yeazs of age, my daughter, Nikki Vorkapich, shall hold that child's share intrust until the child reaches eighteen (18) years of age. tld "Oa C] d39W(l~ i~ t n^ 5. ~"!-{dd0 ~S ~b td~ 7~Z Ht';f ?i0 1 Ruth Jane Dunn! Nii TH: I direct that each beneficiary under my will pay all taxes which are attributable to his or her share of my estate. The taxes which are covered by this Paragraph shall include, but not be limited tp, Pennsylvania Inheritance Tax, Federal Estate Tax and federal and state income taxes. TE TH: All the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wheresoever situate, which I may own or have the right to dispose of at the time of my deathlllI give, devise and bequeath as follows: li ~ A. Twenty-five (25) percent to my daughter, Jan E. Robinson. B. Twenty-five (25) percent to my daughter, Nikki Vorkapich. C. Ten (10) percent to my daughter, Michelle Eureaux. D. Five (5) percent to my grandson, Matthew Robinson. E. Five (5) percent to my grandson, Andrew Vorkapich. F. Five (5) percent to my grandson, Mark Vorkapich. G. Ten (10) percent to my granddaughter, ElizabetFi Easton. H. Ten (10) percent to my granddaughter, Nicole Perry. I. Five (5) percent to my grandson, Edward Easton. I hereby nominate, constitute and appoint my daughter, Nikki V orkapich, as Executrix of (his, my Last Will and Testament, and I do direct that no bond shall be required of such Executrix hereunder. My said Executrix shall have full power at her discretion to do arty and a1I things necessary for the complete administration of my estate, including the power to sell at public or private sa1e~ and without order of Court, any real or personal property belonging to my estate, and ,~ "7 <- 2 Ruth Jane Durir ~f to compound, compromise or otherwise to settle or adjust any and all claims, charges, debts and demands, Whatsoever, against or in favor of my estate, as fully as I could do if living. In ttJe event that Nikki is unable or unwilling to serve, then I nominate, constitute and appoint my idaughter, Jan E. Robinson, as the alternate Executrix. Said alternate Executrix shall have all of tl~e powers, privileges, duties and immunities as hereinbefore more fully set forth for my original Exe~utris. IN WITNESS WHEREOF, I, Ruth Jane Dunn, the above Testatrix have set my hand and seal to this my L~t Will and Testament, which consists of three (3) :pages, to each of which I have ~ ~~ '~~ ~ . affixed my s~gnature this day of ~~ ~ ' , 2008. ~, ,-~ ,. n ~~„ Ruth Jane Dunn {~ sealed, published and declared by the above named Testatrix as and for her Last Will and eacl in the presence of us, who at her request and in her presence and in the presence of hereunto subscribed our names as witnesses. ,i'l ~ ,. ~ i _ 1 I ,f~ +. ,' ;` n (,, Calculated Value of Your Paper Savings Bond(s) Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 06/2012 Total Price Total Value Total Interest YTD Interest Bonds: 1-12 of 12 Page 1 of 1 Serial # Seri~s Denom Issue Next Final Issue Interest Interest Value Note Oate Accrual Maturity Price Rate M14509451EE EE~~ $1,000'OS/1986.11/2012 05/2016 $500.00 $1,468.40 4.00%. $1,968.40 M14504453EE EEII $1,000,OSf1986.11j2012.06f2016. $500.00_ $1,468.40_ 4.00%: $1,968.40 M14509440EE EEi, .$1,000 05/1986 11/2012..05/2016 $500.00 $1,468.40; 4.00%. ;1,968.40 M14509455EE, EE''i $1,000 05/1986 11/2012 05/2016' $500.00 $1,466.40. 4.00%,. ;1,968.40_ M14509452EE~ EE $1,000 05/1986 11/2012 05/2016 $500.00 $1468.40 4.00°/a (1,968.40 ,. M14509446EE. EE $1,00006/198611/2012 OS/2016 $500.00' $1,468.40 4.00°/a '. ;1,968.40 M14509457EE EEI $1,000:,05/1986.11/2012 05/2016. $500.00 $1,468.40 4.00% X1,968.40: M14509442EE. EEi $1000.06/1986 11/2012 05/2016 $500.00 $1,468.40' 4.00%.. X1,968.40 M14509445EE. EE $1,000 05/1986 11/2012 05/2016 $500.00 $1,468.40_ 4,00%'.. {1,968.40 M14509448EE EE~ $1,000 05/1986 11/2012 05/2016 $500.00 $1,458.40.. 4.00% ~1,968.40~ M16053582EE: EE -$1,000:08/1986.08/2012 08/2016. $500.00 $1,430,00 4.00°10 ;1,930.00 li $1,000 06/1986 11(2012 05/2016 $500.00 $1,468.40. 4.00% (1,968.40 M14509450EE EEi '~ Notes NI Not Issued 'I NE Not eligible for payment PS Includes 3 month interest penalty _ , http://www.treasuryd~rect.govBC/SBCPrice I 8/27/2012 r II `R: 2 I i {:~..,\ I - +~ U ~ ~, i~.,v Hiae .7 elf IIF~ IAa~'I 1~~' 1, ~r WEF'~j„ ~a~1PF?'3x~i(~~~ ( )`V •'1 } Fii~1 T ' ' ' : ~. s ~~, ,! ~ i IS(,~Lrli~~-, , ,S S ..- 186 24- ~ ~!_ , ~ ~~~ - o . ~ 4033 ~ , ,, <'!~ ~ .~~ ~ ~ ~;, Rnth yJane Dunn ~~~ ~ ~ ~ 4000 Woodvale Bd ~•: ~; ~ ~;;_~ Harrisburg, Pa 17.1,09 \ _ e~aa ~ _ `'`~ _ 1:000090007 :07 _ 6'`J c 3 Oi4509445~i' ~ ~~ ~ U 8 ' 9 ~r~~J~o~~~~g ~ ~' jia6-z4-9o33 '- E<<.~ o , - ' ~, _ ~ , x~ ,.. Ruth Jane Dunn ~I I q~ ~~ ~ ~ 400© 4toodvale R~'~ Harrisburg} Pa ~_ ~ ~ ~,f 1 ~ . ,.: ' 7 3 3 ~ _ S1 ~~ T ' a s ~ s r ~~ 9 tl 1 ~ .,1.~A;4 .- . .. P ] P ] ] ~._ i ~ . x:00009000 7~0 Y ~~y, a~ }f3YJ'.Lr13.1~}fis s. i9 a. .: ~ ~ ] ~T ~~4509440ii''' 07-:13-'12 114~:36~Fi30M- T-842 P000210003 F-217 ' ~ lYl~ 499 Mitclxll Aoatl, Mil$Ixtto, DE 19966 Adjosdncnt Services PFwne 888-502-03x4 Fax {302) 934.2955 Iuty 13,2012 '1'uclser ArenBberg Attorneys 2 Lemoyne Drive, Suite 200 Lemoyne, PA 17043 ate: Rotate of Ruth Jane Dunn Social Security' 186-24-4033 Date of Death: June 3.2012 Dear Sir or Mad: Per your inquiry July 5, 2012, please be advised that at the time of death, the abwo-named decedent had on deposit with this tbanlc the following I. Type ol~{ccounr Acco>a+t Number Ownersl~p (Naves ofJ Openntg~Jare Balaru~ c#n Date afDeath Accrued/hrerest Taal 2. Type ofAgeounr AccowuNprm6rr Ownerstuj~ {Names a~ Openirgi7vte Balance al Dme arlkaai Accruedlr$erest Tad CheckrngAcovuuf 29364787 Roar J. Dorm Nikk1 q. Y~1ch(POAJ 07/2$/!970 5195, 747.98 5 tze 5!95, 749.29 Checking Aaowt 9852437590 Rua, J. Dunn RichordF. Duren Nikki A. Yorkapich(POAJ 01/!5/2010 541,389.51 S .23 541,389.74 a7-'L3-' 12 14: 3S FROM- ' 2. Type ofArxotmt Savi,:gs Accaam AccroantNtwnber 15004214931534 Ownership (Names o~ Ruth J, pram NrkkfA. varkc~ich(POA) Opening pare 11f27/2t706 Balance on pore of Death 865,441.63 Acavedlraeresr S 3.59 Toed1 $65,4422 T-842 P0003/0003 F-217 Fa aoy addidoul inf rmetlob oa tke ahorc aecpnnte, focloding mruanbip end nny cbeogea, docurm and+or rcimbaracmnt of tondo, pkace Cw0 doe A,in d T17-6SL0BB5. we wxrc enable to bca'pe aoy eeh dcppylt Dos for the above-meatloaW drecdcot. ltie klRr dtny pot ind¢de wy aoeouots In wtrt6 the daaed euY love hem Yukd u Power of Attatvey~ Cucbdiea of IlOiferm TnnaRra RegrafeRlndre FsY~, or1(~veeee under ^ wMttca.4pneeaan4 Sincerely, Valerie Mercer Adju~ent. Services