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Home My WebLink About05-20-13 J 1505610143 REV-1500 Ex�o2-ii) � OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPPRTMENTOFREVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 12 0920 Harrisburg, PA �7�2s-o6o� RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth p8 17 2012 10 24 1918 DecedenYs Last Name Su�x DecedenYs First Name MI RUGGABER ANNE E' (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW �XJ 1. Original Retum L_� 2. Supplemental Retum i 3. Remainder Retum(Date of Death Priorto 12-13-82) � 4. Limited Estate �� 4a. Future Interest Compromise �I 5. Federal Estate Tax Return Required (date of death aftar 12-12-82) �;� 6 Decedent Died Testate �__� �� Attach Co aiotained a Living Trust 1__, 8. Total Number of Safe Deposit Boxes L�� (Attach Copy of Will) py f Trust � 9 Litigation Proceeds Received L_� 10. Spousai Povert Credic�(Dare ot�eam ! ��.Election to tax under Sec.9113(A) between 1231�t and -�-s5) �_- (Attach Schedule 0) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPOMDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD W STEWART (717) 761 4540 � REGISTEFf�iF WI,I��.ttSE ONLY Q �,�3 rt� � �, — b a First�ine of Address � -• _ '- r+'1 �': =c: - -.. 3 01 MARKE T ST ``� r,, _. � , Second Line of Address .. ,. PO BOX 109 4 _ City or Post Office State ZIP Code - .. ' DATE FILED LEMOYNE PA 17 0 4 3 E�10 9 - , _- "w CorrespondenYs e-maii address: RWS@JDSW.COM Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE '��,(� ,/��%,�� Richard W Stewart �'> % �/�r° , ApDRESS � � 301 Market Street, Lemoyne, PA 17043 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE �� ,✓f�-',.-��{ RICHARD W. STEWART �` �j 7��s� ApORESS 301 Market St., Lemoyne, PA Side 1 � 1505610143 1505610143 J _ � . !J � 1505610243 REV-1500 EX DecedenYs Social Security Number oa�ede�rSName RUGGABER� A�lile F ___ _ _ RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... � 3�7 � �� . �� 2. Stocks and Bonds(Schedule B)................................................................... 2 2 ,295 , 556 . 80 3. Closely Held Carporation, Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)........................................................ 4. 91 176 . 97 5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. � 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous�nq-Probate Property (Schedule G) �J Separate Billinq Requested..... ...... 7. 1 , 303 , 843 . 85 g. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 4 , 0�7 , 577 . 62 ----------- - - -- -- - -_---------- . 141 800 . 82 9. Funeral Expenses and Admirnstrative Costs(Schedule H).................................... 9. � 36 006 . 78 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. � 11. Total Deductions(total Lines 9 and 10)................................................................ �� 17 7 , 8�7 . 6� 12. Net Value of Estate(Line 8 minus L.ine 11).......................................................... 12. 3 , 859 , 770 . 02 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 3 , 4 98 � 871 . OZ 14. Net Value Subject to Tax(Line 12 iminus Line 13)............................... ............... 14. 3 6O , 8 99 . 00 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 �5 O . 0� (a)(1.2)X AO 16. Amount of Line 14 taxable � . Q Q 16. 0 . �� at lineal rate X .045 17. Amount of Line 14 taxable �� . �� at sibling rate X .12 18. Amount of Line 14 taxable 360 , 899 . 00 �s. 54 , 134 . 85 at collateral rate X .15 19. TAX DUE............ ................................................................................................... 19 54 , 134 . 85 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 150561D243 15�5610243 � REV-1500 EX Page 3 File Number 21-12-0920 Decedent's Complete Address: DECEDENT'S NAME RUGGABER,Anne F —_-------- -- -----------,_.----_--- - - --_—------- _____- STREET ADDRESS 2828 Russell Road CITY � � STATE I ZIP ' Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 54,134.85 2. Credits/Payments A. Prior Payments 10,000.00 B. Discount 526.32 Total Credits(A + B) (2) 10,526.32 3. Interest (3) q. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 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) 43,6�$.�J3 Make Check Pa�rable to REGISTER OF WILLS, AGENT `' 't �. ,.y:, , . �. �..;y � a� . da -3 i�. ��. }� ',. 1 � „t ` : E� E '. : � , . .� <<_ . �, ,: �` , r _ „._ , ; �:. . _ , .�� . . . , _ . , , ,. , �� ,�. . ,.��.. ' � `..., ....�;°'. .... . ..... . ��:� . .. E •;�',.'��. „_ a. PLEASE ANSWER THE FOLLOWING QU�STIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain tne use or income of the property transferred:.................................._...................................__._. ❑ Ox b. retain the right to designate who shall use the property transferred or its income:..............................._ [J � c. retain a reversionary interest;or....................................................................... .................. ............. .._ . � 0 d. receive the promise for life of either payments,benefits or care?..................._................................ ...._ �� [] 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without __ receiving adequate consideration?..................................................... ....... � '�� _...................._....._......... _ __, 3. Did decedent own an"in trust for" or payabie upon death bank account or security at his or her death?. ..... � � 4. Did decedent own an individual retirement account, annuity,or other non-probate property which _ contains a beneficiary designation?............................................................................................................ .... �� ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. . -,�.3 . . , 4 ,..�:, '.� ,o- . . . _ . , . . �.-?�, � . 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)J. 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 requirernents for disclosure of assets and filing a tax return are stiN applicable even if the surviving spouse is ihe 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 40 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in [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. RFV-1162 EX(11-96) COMMONWEALTH OF PENNSY�'JAIVIA DEPARTMENT OFREVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBUflG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NQ. CD 016799 STEWART RICHARD W 301 MARKET STREET PO BOX 109 LEMOYNE, PA 17043 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- -------- 101 � S 10,000.00 ESTATE INFORMATION: ssrv: I FILE NUMBER: 211 2-0920 � �ECEDENT NAME: RUGGABER ANNE F I DATE OF PAYMENT: 1 1/1 9/201 2 � POSTMARK DATE: 1 1/1 6/201 2 � couNTY: CUMBERLAND I DATE OF DEATH: O8/1 7/201 2 I � TOTAL AMOUNT PAID: $10,000.00 REMARKS: RECEIPT TO ATTY CHECK# 1010 INITIALS: HMW SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER �L=CEIV�D NOV�� 2012 J��1�ON U(JFFIE Rev-1502 EX+�01-70) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OFREVENUE INHERITANCE TAX RETLIRN RESIDENT DECEDENT ESTATE OF FILE NUMBER RUGGABER, Anne F 21-12-0920 All real proparty owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged behveen a willing buyar and a willing seller,neither being compeiled to buy or sell,both having reasonable knowledge ot the relevant facls. Real property that is jointly-owned with right of survivorship must be disclosed o�schedule F. Attach a copy of the seKlament sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTfON OF DEATH 1 Residential Real Estate located at 2828 Russell Road,Camp Hill, Cumberland County, PA- 210,000.00 Contracted Sales Price. Real Estate Closing was held on April 18, 2013. A copy of the HUD -1 Settlement Sheet is attached to this Return 2 Residential Real Estate located at 309 Manchester Road, Camp Hill, Cumberland County,PA 137,000.00 -Cumberland County Assessed Value x. CLR TOTAL(Also enter on Line 1, Recapitulation} 347,000.00 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 01-10) Rav-7503 EX+�6•98) SCHEDULE B STOCKS & BONDS COMMONN/EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENTDECEDENT ESTATE OF FILE NUMBER RUGGABER, Anne F 21-12-0920 All property jointly-owned with right of survivonhip must bedisclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH "" rrill nch�"lealth h"anaaement Acco�nt No 872-56856 � 022091S103 800 shares of Altria Group Inc. 35.305 28,244.00 2 037833100 100 shares of Apple Computer Inc-Com 643.5 64,350.00 3 o925aJ1oz 1,457 shares of Blackrock Municipal Assets Fund Inc. 13.727 20,000.17 Accrued dividend on Item 3 through date of death 13.727 91.06 4 097023105 435 shares of Boeing Co-Com 73.69 32,055.15 Accrued dividend on Item 4 through date of death 73.69 191.40 5 110122108 1,445 shares of Bristol Myers Squibb Co-Com 31.77 45,907.65 g 17275R102 1,288 shares of Cisco Systems Inc-Com 19.095 24,594.36 7 125581801 61 shares of CitiGroup Inc. 38•�7 2.322'27 g 192a7L�06 1,150 shares of Cohen &Steers Quality Income-Com 10.875 12,506.25 g 256677105 100 shares of Dollar General Corp New 51.40 5,140.00 10 30231G102 1,600 shares of Exxon Mobil Corp-Com 88.535 141,656.00 Accrued dividend on Item 10 through date of death 88.535 912.00 11 314195108 3,400.621 shares of Federated High Income Bond Fund-CL 7.69 26,150.78 A 12 345370860 200 shares of Ford Motor Co Del -Com Par$0.01 9.69 1,938.00 Total of Continuation Schedules See attached a es TOTAL(Also enter on Line 2, Recapitulation) 2,295,556.80 (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-1503 EX+�6-98) SCHEDULE B STOCKS � BONDS continued COMMONVVEALTH OF PENNSVL`JANIA INHERITANCE TAX RFTURN RESIDENTDECEDENT ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 ITEM CUSIP VALUE AT DATE NUMBER NUMBER UESCRIPTION UNIT VALUE OF DEATH Accrued dividend on Item 12 through date of death 9.69 10.00 I 13 352518104 15,454.471 shares of Franklin Calif Tax Free Income-CL A 7.47 115,444.90 14 3696oa103 2,400 shares of General Electric Co-Com 21.02 50,448.00 15 45200FUZO 20,000 shares of Illinois Fin.Authority Rev 104.62 20,924.00 Accrued dividend on Item 15 through date of death 104.62 5.67 16 5949181 oa 600 shares of Microsoft Corp-Com 30.755 18,453.00 Accrued dividend on Item 16 through date of death 30.755 120.00 17 6a5916R58 40,000 shares of New Jersey Economic Development 103.91 41,564.00 Authority Accrued dividend on Item 17 through date of death 103.91 344.44 �g 70a326107 705 shares of Paychex Inc -Com 33.205 23,409.53 19 709221HK4 10,000 shares of Pennsylvania St TPK Commn Oil 100.263 10,026.30 Accrued dividend on Item 19 through date of death 100.263 105.56 20 9311a2103 140 shares of Wal Mart Stores Inc -Com 72.265 10,117.10 Accrued dividend on Item 20 through date of death 72.265 55.65 USAA�"dealth ManaqPment Investment Acco�nt 2� 1,361.49 shares of USAA Growth Fund Account Ending 8003 16.38 22,301.21 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.6-98) Rev-1503 EX+(6-98) SCHEDULE B STOCKS & BONDS continued COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENTDECEDENT ESTATE OF FILE NUMBER RUGGABER, Anne F 21-12-0920 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE I OF DEATH 22 5,266.595 shares of USAA Short Term Bond Fund— 9.22 48,558.01 36900433483 Accrued dividend on Item 22 through date of death 59.45 Z3 55,062.734 shares of USAA Tax Exempt Intermediate-Term 13.63 � 750,505.06 Bond Fund—44900680331 Accrued dividend on Item 23 through date of death 1,397.01 24 2,477.574 shares of USAA Total Return Strategy Fund� 8.91 22,075.18 55900019462 Vangsiard Individual Acco�nt No.09881980243 25 204.213 shares of 500 Index Fund Account No.0540 131.12 26,776.41 -09881980243 26 5,922.332 shares of GNMA Fund Admiral Shares Account 11.02 65,264.10 N o.0536-098819980243 27 15,976.17 shares of Inter-Term Tax Exempt Adm.0542 14.30 228,459.23 -09881980243 2g 4,525.568 shares of Morgan Growth Fund Adm 0526 62.19 281,445.07 -09881980243 29 5,814.451 shares of PA LT Tax-Exempt Admiral 0577 11.65 67,738.35 -09881980243 30 Long Term Tax Exempt Adm Account No.0543-09881980243 11.70 81,923.93 31 334.448 shares of Northeast Investors Trust 5.88 � 1,966.55 �� Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.6-98) Rev-1508 EX+(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE pERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 Include lhe proceeds of litigation and the date the procseds were received by the estate. All propeAy jointly-ownad with the right of survivorship must be disclosad on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Cash-Cash located in Residence and Safe Deposit Box 264.00 2 USAA Senior Bonus Distribution 157.28 3 USAA Subscribers Account Distribution-Cash Received 65.72 4 M&T Bank Free Checking Account No. 10292306 3,170.75 5 Members First Federal Credit Union Regular Savings Account No. 164732-00 20.01 6 Merrill Lynch Bank Deposit Program -Cash Account 35,541.47 7 2 Still Life L. Francis Painting-Valued and Appraised by Erica Taylor, Certified Appraiser 50.00 and Auctioneer, Kerry Pae Auctioneers 8 2005 Volvo V50 Station Wagon-Contracted Sales Price 11,500.00 9 3 Piece Mantle Clock Set-Valued and Appraised by Erica Taylor,Certified Appraiser and 500.00 Auctioneer, Kerry Pae Auctioneers 10 Bisque Figurines-Valued and Appraised by Erica Taylor,Certified Appraiser and 50.00 Auctioneer, Kerry Pae Auctioneers 11 Bristol Pink Vase-Valued and Appraised by Erica Taylor, Certified Appraiser and 75.00 Auctioneer, Kerry Pae Auctioneers 12 Dining Room Rug 125.00 13 Gaudy Welsh China Pieces -Valued and Appraised by Erica Taylor, Certified Appraiser and 100.00 Auctioneer, Kerry Pae Auctioneers 14 Kerry Pae Auctions-Proceeds from the Sale of DecedenYs Personal Property including all 34,777.95 jewelry inventoried in safe deposit box Total of Continuation Schedule See attached page TOTAL(Also enter on Line 5, Recapitulation) 91,176.97 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) Rev-1508 EX+(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OFREVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 15 Matched Pair of Victorian Gold Bridal Bracelets with Black Enamel-Valued and Appraised 275.00 by Erica Taylor, Certified Appraiser and Auctioneer, Kerry Pae Auctioneers 16 Victorian Gold Cuff Bracelet-Valued and Appraised by Erica Taylor, Certified Appraiser and 125.00 Auctioneer, Kerry Pae Auctioneers 17 Deposit to Account-Anne Ruggaber MASVIAACH 2,521.14 18 Residential Real Estate located at 2828 Russell Road,Camp Hill, Cumberland County, PA- 1,595.35 Reimbursement on County and School Taxes and Sewer Payments. A copy of the HUD-1 Settlement Sheet is attached 19 United Health Care Insurance Premium Payment-Reimbursement of Premium Payment 12.30 20 USAA Credit Card Account-Refund on Credit Card Account 241.73 21 Verizon Communications-Refund on Account 9•27 TOTAL(Also enter on Line 5, Recapitulation) 91,176.97 Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) Rev-1510 EX+�OS-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENTOFREVENUE MISC. NON-PROBATE PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER RUGGABER, Anne F 21-12-0920 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-150C1 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH �OF DECD'S EXCLUSION TAXABLE NUMBER THELDA E OFnTRANSFERSATTACFI A COPY OF TI�HE DEIED FOR REAL EST T�E VALUE OF ASSET �NTEREST (IF APPLICABLE) VALUE 1 Fidelity &Guaranty Life Non Qualified Annuiry 299,217.00 299.217.00 Contract No. L9077291 -Beneficiary:AFR Foundation 2 North American Company Annuity Number 1,004,626.85 1,004,626.85 8000024678-Beneficiary: AFR Foundation 3 Pacific Life Annuity-Purchased FROM Decedent's 0.00 Assets as directed under Item VI of DecedenYs Last Will&Testament. Purchased for$100,000 for the life benefit of Joan Dern with AFR Foundation being the beneficiary. . Schedule K is attached TOTAL(Also enter on Line 7, Recapitulation) 1,303,843.85 (If more space is needed,add�tional pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) REV-1511 EX+�70-09) SC H E D U LE H pennsylvania DEPARTMENT OFREVENUE F U N E RA L EX P E N S E S A N D INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N MB R q, FUNERAL EXPENSES: See continuation schedule(s) attached 1,532.90 B, ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Richard W Stewart Street Address 301 Market Street City Lemoyne state PA zio 17043 Year(s)Commission Paid 64,000.00 z. Attornev's Fees Johnson Duffie 64,000.00 3, Family Exemption: (If decedenYs address is not the same as claimanYs, attach explanation) Claimant Street Address City State Ziq Relationshi�of Claimant to Decedent 4. Probate Fees 735.50 5. AccountanYs Fees 6. Tax Return Preparer's Fees 1,500.00 7. Other Administrative Costs 10,032.42 See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 141,800.82 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex e�es 1 Myers-Harner Funeral Home -Final Funeral Costs 413.00 2 West Shore Country Club-Memorial Reception 1,119.90 H-A 1,532.90 Other Administrative Costs 3 Charles Schwab Estate Account -Doubleline Total Return Transaction Fee 25.00 4 CMA Annual Charge 125.00 5 Cumberland County Register of Wills Office-Additional Short Certificates 15.00 6 Cumberland County Register of Wills Office-Filing Fees for Inheritance Tax Return and 30.00 Inventory 7 Cumberland County Register of Wills Office-Additional Probate fees 900.00 8 Duty's Lock, Safe and Security, Inc. -Lock Change at Residence 155.68 9 George R. Ulsh-GRU Appraisal Associates, LLC -Appraisal of Residential Real Estate 350.00 10 Joan Dern -20 Hours of services rendered 400.00 11 M8�T Bank Estate Checking Account Account 9848366028-Bank Fees-Check Order 25.20 12 Mark E. Shedlosky,Landscaping-Lawn maintenance -August 1,013.78 13 Mark E. Shedlosky,Landscaping-Lawn maintenance-September 1,096.54 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 ITEM AMOUNT NUMBER DESCRIPTION 14 Mark E. Shedlosky,Landscaping -Lawn maintenance-October 1,326.00 15 Mark E.Shedlosky,Landscaping -Lawn Maintenance- November 874.50 16 Mark E. Shedlosky,Landscaping-Lawn maintenance-December 517.50 17 Mark E. Shedlosky, Landscaping -Lawn maintenance -JanuarylFebruary 475.00 18 Merrill Lynch Bank Deposit Program -Account Transfer Fee 95.00 19 Mike Sheely Home Inspections-Radon Mitigation System 795.00 20 Quality Digital Office Technology-Computer/Wipe Out of Hard Drive 265.00 21 Reserves: Additional Miscellaneous Costs and Expenses 500.00 22 The Cumberland Law Journal -Notice of Estate Administration 75.00 23 The Patriot News -Notice of Estate Administration 116.45 24 The UPS Store-Shipment of Personal Property to Beneficiaries 349.90 25 The UPS Store -Shipment of Personal Property to Beneficiaries 26.66 26 USAA- Homeowners Insurance 458.68 27 WorfdWide Express -Overnight Delivery of Documents 21.53 H-B7 10,032.42 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1512 EX+�12•08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, °EPARTMENT oF RE��N�E` MORTGAGE LIABILITIES AND LIENS INHERITANCE TAX REl"URN RESIDENT DECEDENT ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 Raport debts incurred by the decedent prior to death that ramained unpaid at the date of death,including unreimbursed medical expensas. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 ADT Security Services -Final Invoice on Account 139.27 2 Bonnie K. Miller,Tax Collector-2012 West Shore School District Taxes 1,274.10 3 Bonnie K. Miller,Tax Cotlector-309 Manchester Road Property/2013 Real Estate Taxes 658.45 4 Borough Of Camp Hill-Sewer Department-Invoice for July 1, 2012 to September 30, 2012 165.00 5 Borough Of Camp Hill-Sewer Department-Invoice for October 1, 2012 to December 31, 165.00 2012 6 Borough Of Camp Hill-Sewer Department-Invoice for January 1,2013 to March 31, 2013 165.00 7 Ehrlich 97.52 8 Janet L. Miller, Tax Collector-2012 Real Estate Taxes 2,934.46 9 Janet L. Miller,Tax Collector-2012 Personal Taxes 15.00 10 Joan Dern-Caretaker Services through September 2012 690.00 11 Joan Dern -Caretaker Services through September 2012 420.00 12 Johnson Duffie-Attorneys fees prior to Death 1,710.00 13 PA American Water-UtilitylResidential Real Estate 264.31 14 PA Department of Revenue-2012 Final State Estimated Payment 1.600.00 15 Penn Waste- Utility/Residential Real Estate 48.75 16 PPBL� Residential Utility 699.54 Total of Continuation Schedule See attached page TOTAL(Also enter on Line 10, Recapitulation) 36,006.78 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) Rev-7572 EX+�12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OFREVENUE: INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT continued ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17 Residential Real Estate located at 2828 Russell Road,Camp Hill, Cumberland County, PA- 19,631.90 Settlement Charges to Seller. A copy of the HUD-1 Settlement Sheet detailing expenses is attached. 18 U.S.Treasury-Final 2012 Individual Federal Income Estimated Tax Payment 3,600.00 19 UGI 2�•2$ 20 UGI 72�•�$ 21 United Health Care Insurance Premium Payment 12.30 22 USAA Credit Card Account No. Ending in 2088 503.83 23 Verizon Communications 457.99 TOTAL(Also enter on Line 10, Recapitulation) 36,006.78 Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1573 EX+�07-10) pennsylvania �iCHEDULE J DEPARTMENT OFREVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER RUGGABER,Anne F 21-12-0920 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116 a 1.2 1 Mary Francis Breen Cousin Victorian 125.00 105 Upper Toyon Drive Bracelet with Kentfield,CA 94904-1088 Black Enamel 2 Joan Dern Friend Residential Real 759,674.00 309 Manchester Road estate in Camp Camp Hill, PA 17011 Hill,Annuity 3 Elizabeth Francis Sather Cousin Items of 600.00 105 Upper Toyon Drive Personal Kentfield, CA 94904 Property 4 Mark&Krista Shedlosky Friend $200,000 Cash 200,000.00 312 West Main Street bequest for care Shiremanstown, PA 17011 of DecedenYs Dog 5 Cathie Mayhew Wright Friend Mantle Clock and 500.00 4913 Mac Arthur Blvd N.W. Candelabra Washington, DC 20007 Tota I 360,899.00 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 AFR Foundation, Inc. 3,490,397.55 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 3,490,397.55 Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) REV-1514 EX+(4-09) SCHEDULE K pennsyfvania LIFE ESTATE,ANNUITY pEPpKfRtENf OF REVENLE Bureau of IndlNdual Tvices &TERM CERTAIN Po eoxz8o6oi (CH�CK BOX 4 ON REV-9500 COVER SHEET) Ha�risburg PA 17128-060� ES7ATE OF FILE Nll3VIBER AN�IE F. RUGGABER This schedule should be used for all single-life,joint or successive life estate and term-certain calculations. For dates ofdeath prfor to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Acfuarial factors can be found in IRS Publication 1457,Actuariaf Values, Alpha Volume for dates of death from 5-1-$9 to 4-3a-99, and in Aleph Volume for dates of death from 5-3-99 and thereafter. Indicate below the type of instrument that created the future interest below and attach a copy of it to the tax return. X�Wiil ❑intervivos Deed of Trust � Other . . � NAME OF 4.IFE TENANT DATE OF BIRTH NEAREST AGE AT TERM OF YEARS DATE OF DEA7H I.IPE ESTATE 1S PAYABLE J OAN DEBN 8/16/19 5 8 5 4 X �ite or 'rerrn of Years Life or Term of Years Life or 'i'erm of Years Life or Term of Years Life or 'I'erm of Years 1. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 100 ,000 .Ofl 2, Actuarial factor per ap ro riate tabie . . . . . . . . . . . . . . . . . . . . . . . . . . (1 .0/o; 0.22674 Interest table rate- � 3.5% ❑ 6% ❑ 10% ❑ Variable Rate % 3. Value of life estate(Line 1 multiplied by Line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22 � 674.04 • NAME OF LIFE ANNUITANT DA7E OF BiRTH NEAREST AGB AT TERM OF YEARS DATE OF DEATH ANNUITY IS PAYABLE Li#e or Term of Years Life or 7erm of Years Life or Term of Years n l.ife or n Term of Years 1. Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2. Check appropriate block below and enter corresponding number . . . . . . . . . . . . . . . . . . . . F�requency of payout-�Weekly(52) � Bi-weekly(26�Monthly(12) Quarterly(4) ❑Semi-annually(2) Annually(1) Other( ) 3. Amount of payout per period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4. Aggregate annua�payment, Line 2 multiplied by Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . 5. Annuity Factor(see instrucdons) Interest table rate-0 3.5°/a ❑ 6% ❑ 10°/a ❑Variable Rate % 6. Adjustment Factor(See instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7, Value of annuity-if using 3.5, 6, or 10%, or if variable rate and period payout is at end of period, calcufation is Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . $ If using variable rate and period payout is at beginning of period,ca�ulation is (Line 4 x Line b x l.ine 6)+Line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ N07�:The values of the funds thaf create the above future interests must be reported as part of Ehe estate assets on Schedules A through G of the tax return.The resulfing life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. If more space is needed,use additional sheets of the same size. 1 W48AJ 1.000 ESTA TE �F ANNE F. R UGGABER SCHEDULE OF EXHIBITS EXHIBIT A Last Will and Testament for Anne F. Ruggaber signed and dated August 14, 2012. EXHIBIT B HUD-1 Settlement Sheet for Real Estate located at 2828 Russell Road, Camp Hill, PA 17011. Property sold on April 18, 2I13 EXHIBIT C Cumberland Counry Real Estate Assessment for property located at 309 Manchester Road, Camp Hill, PA 17011 EXHIBIT D Merrill Lynch Wealth Management Investment Account No. 872- 56856 EXHIBIT F LI.SAA Wealth Management Investment Account 638 62 49 EXHIBIT F Vanguard Individual Investment Account No. 09881980243 EXHIBIT G EstateVal Valuation of Northeast Investors Funds as of Date of Death EXHIBIT H Dczte of Death Letter from M&T Bank for Decedent's Checking Account EXHIBIT I Date of Death Letter from Member's First Federal Cr�edit Union for Decedent's Regular Savings Account EXHIBIT J D�zte of Death Valuation from Merrill Lynch ��or Bank Deposit Account EXHIBIT K Valuation of Miscellaneous Specific Bequests to Beneficiaries by Kerry Pae Auctioneers EXHIBIT L Proceeds received from Auction/Consignment by Kerry Pae Auctioneers EXHIBIT M Fidelity & Guaranty Life — Value of Annuity Contract No. L9077291 EXHIBIT N North American Company — Value of Annuity Contract No. 80000024678 558196 i I I � i � Last Will and Testament . OF ANNE F. RUGGABER � I, ANNE F. RUGGABER, of the Borough of Camp Hill, County of Cumberland, Commonwealth of Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. ITEM I: I bequeath the following items of my personal property to my cousin, ELIZABETH FRANCIS SATHER: my two gold bridal bracelets located in a blue box contained in my jewelry armoire, my Gaudy Welsh collection on the divider between the living room and dining raom, my paix of bisque figurines on the living room mantle,rny pink glass vase with long crystal in the what-not in the dining room, my two oil paintings by Lizzie Francis over the sofa in my living room. If my cousin, ELIZABETH FRANCIS SATHER, does not survive me, I bequeath such items to her daughter, JODI. ITEM IL• I bequeath my gold Victorian bracelet with black enamel to my cousin, MARY FRANCIS BREEN, if she survives me. If my cousin, MARY FRANCIS BREEN, does not survive me, I bequeath said bracelet to my cousin, ELIZABETH FRANCIS SATHERS' daughter, JODI. ITEM III: My cousin, ELIZABETH FRANCIS SATHER, shall have the option to purchase any automobile that � own at my death for its appraised value. Such option must be exercised within thirty (30) days after my said cousin is notified of the appraised value by my Executor. 1 "� ` �h�b�.� � J W a a � � J J Q I � � � ITEM IV: I bequeath the mantle clock and candelabra now located in my living room to CATHIE MAYHEW WRIGHT, if she survives me. ITEM V: I bequeath the sum of Two Hundred Thousand ($200,000.00) Dollars to my friends MARK SHEDLOSKY and KRISTA SHEDLOSKI', or the survivor of them if at least one of them survives me, and if they agree to care for my Bichon-frese, Remi, as long as he lives. ITEM VI: If my caretaker, JOAN DERN, survives me, I direct my executor to expend $100,000.00 from my estate to purchase a single life annuity for the benefit of said JOAN DERN during her lifetime with the residual to be paid to AFR FOUNDATION, INC., a tax exempt organization. ITEM VII: I devise my real estate known as 309 Manchester Road, Lower Allen Township, Cumberland County,,Pennsylvania to my caretaker, JOAN DERN, if she survives me. ITEM VIIL• I devise and bequeath the residue of my estate of every nature and wherever situate to the AFR FOUNDATION,INC., a tax exempt organization. ITEM IX: I appoi.nt RICHARD W. STEWART, Executor of this my Last Wil�. Should the said RICHARD W. STEWART fail to qualify or cease to act as Executor, I appoint EDMTJND G. MYERS, Executor of this my Last Will. Should both the said RICHARD W. STEWART and the said EDMIJND G. MI'ERS fail to qualify or cease to act as Executor, I appoint DAVID W. DELUCE, Executor of this my Last Will. ITEM X: I direct that my Executor or his successors shall not be required to post bond for the faithful performance of their duties in any jurisdiction. 2 � ; � � IN WITNESS WHEREOF, I have hereunto set my hand and seal to this,my Last Will and Testament,this_ _� day of_ ��;�„�--- 2012. J i/ -J r-� , 1 :'` t-'� / � /� ,�vfJ G-%� �'�1 i p��"��-�','� i% /1 l, �'��' i -- _(SEAL) ANNE F. RUGGABER ;_ �;-. Signed, sealed, published and declared by the above-named Testa.trix, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other,have hereunto subscribed our names as witnesses. f�;�� ',, '::1� ;:`�i �.'�s-r-,� ��S��';-�'�_._.�'� �,.- ____ - ,. 3 . i AFFIDAVIT AND ACKNOWLEDGMENT COMMONWEALTH OF PE�TNSYLVANIA . . ss. COUNTY OF CiJMBERLAND . We, ANNE F. R�UGGABER, �,c L,c,.-��l �.�....�� t�,c�� ,- � and :r�;t- f1- ��ti�b�� , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly and that she executed it as her free and voluntary act far the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. . � - _ � "'s -� ; __: . I�' ;f\.'I!�. j,' ��l -�� a AN1�E FGRUG�GABER • ;` ��-� ''%�-:%r��; � Witness , .:- - - j -__. _ , _ --. �� ~ j .. (I � ,� ... . (. �. .-_. �' /�-i 1✓� � �Y y/ Witness � � � �-i'�� Subscribed, sworn to and acknowledged before me by ANNE F. RUGGABER, 'Testatrix, and subseribed and sworn to before me by j'��c i=4--`� Gti: Si"�c��,� � and L i��-- it ��: �::,} 'b� 14 ,witnesses,this (`�1 s�day of �C!G��y�- , 2012. .I � �_, 'r k� 1 , l�i� ( d�. y.'•�; ,�:1'i;� �� Notary Public CC�MfWfSfV'1N�AL'i`Fi OF PENNSYLVANIA :370122v4 Notarlal Seal I Lari A.Richard,Notary Public Lemoyne Boro,Cumberland County My Commission Expires Nov.12,2014 I Member.P�nnsvlvania Assoclation of Notarles 4 OMB Approval No 25G2-0?65 iiii�ii . � �� 6ement Statement (HUD-1) ' FINAL ��": - . .: '^'�HA 2.Q RHS 3. XQ Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number: �r 13-0t-6-27319 XXXXXX7358 ❑�A 5.Q Conv.Ins Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown Items marked "(p.o.c)"were paid outside the closing,they are shown here for informational purposes and are not included in the totals Name&Address of Borrower: E.Name&Address of Seller: F.Name 8 Address of Lender: �ber?D,Willis,Janet E Willis =state of Anne F.Ruggaber f/k/a Anne F.Keller Wells Fargo Bank;N.A. �4� Stoner Avenue,Shiremanstown,PA 1?0'1 301 Markel Street,Lemoyne,PA 17043 2701 Wells r"argo Way;Minneapolis,MN 55408-0002 Property Location: H.Settlement Agent: I.Settlement Date:04/18/2013 32f Russeli Road Barristers Land Abstract Company Disbursement Date:04/18/2013 amp Hill,PA 17011 3310 Market Street,Camp Hill,PA 17011 amp Hill Borough 717-761-6190 Place of Settlement: TitleExpress 3310 Market Streel,Camp Hill,PA 17011 Printed 04/18/2013 at 1 D28 am by KL 9D. Gross Amount Due from Borrower 4D0. Gross Amount Due to Seller )t �ontrad sales pnce 210,000.00 401. Contract sales price 210,0OO.OD )2. Personal ro ert 402. Personal ro ert )3 Settlement charges to borrower(line 1400) 8,654.26 403. )4. 404. )� 4D5. d'ustments for items aid b seller in advance Ad'ustments for items aid b seller in advance )n Cityltown ta�ces to 406, City/town taxes to ]? County taxes 04118/2D13 to 12/31/201' 866.24 407. County taxes 04118'2013 tc 12I31I20?3 866.24 )E School Taxes 04l1812013 to 06130120?� 5P4.93 408. School Taxes 04/18I2013 ro O6l30/20^3 594.93 )9 Sewer 04/18/2013 to 06130i20;� 1�4.18 409. Sewer 04/1812Dt3 to 06/30/2013 134 18 lu 410. 4'1. 412. Z� Gross Amount Due from Borrower 220,249.61 420. Gross Amount Due to Seller 211,595.35 �0. Amounts Paid b or in 8ehalf of Borrower 500. Reductions In Amount Due to Seller '1. Deposit or eamest money 2,0OO.OG 50t Excess deposit(see instructions) )2, Frincipa!amount of new ioan(sl 168,000.00 502. Settiement charges to seller(line i40D) 56,031 90 '�. �isfin loan s taken subiecf to 503. 6cistinq loan s taken sub'ect to )4 504. Pa off of first mort a e loan �5. 505. Pa off ofsecond mort a eloan �o, 506. :i� 507. JS. 508. �9 Seller Assisiance 3,000.00 509. Seller Assistance 3,000.00 diustments for items unpaid by seller Ad'ustments for items unpaid b selfer 10. Cityftown taxes to 510. Cityltown taxes to 11, County taxes to 511. County ta�ces fo ?�. School Ta�ces to 512. School Taxes to 13. 513. ?4 514. 15. 515. 16. 516, '7. 517. ?� 518. `S 519. Z�• Total Paid b lfor Borrower 173,000.00 520. Total Reduction Amount Due Seller 59,631.90 D0. Cash at Settlement fromfto Borrower 600. Cash at Settlement tolfrom Seller �^;, Gross amount due from borrower Qine 120) 220,249.61 gp�. Gross amount due to seller(line 420) 211,595.35 pz, Less amounis paid bylfor borrower(line 220) 173,000.00 602. Less reductions in amount due seller(line 520j 59,631.90 03. Cash QX From ❑ To Borrower 47,249.61 603. Cash ❑X To ❑ From Seller 151,963.45 aoo�no � en o� �:�o e o�o��o�a�ao�a�ma o e,, m�o�u a�resaor�e o ��o.a��e..,no= ,��c e e a. �s.ve��r m.r�o�o yo�,re�o rea��b o wmv e e iom;.uniess u aiso�.ys.a,ne��ry�aue oMa wm�oi numeer.r�o�=onaaenvawr�s ass�rea�,miz o�,aa�sure is maMx�ory.T�k u Cesipnea lo provl0e Oie pe�ies lo e RESPA wvereU vanvaion wnn�imormm�on ou��a��e arr�em wo�s. � J °vlous editions are o6solete Page 1 of 4 HUD-1 w ��.� � n � a ___:!i_.Y_��.'�.-..'.��','i;.<.. nc. 7oea�Rea�::_state I3.o,:er=��es � i 12,825.0o Paid F-rom� Paid Fror� �ivisior o`cornn,�_slon nine_'o01 a:foiiows___ Borrower's SeUer's �"� $c.30C OC _ ______ to Lawyers Realty LLC Funds et Funds at �: ��,52�0;: �e Noward Hanna Faxtang Settlement Settlement ,_. Gommissior.palc a:,,2tlleme�t � 225.00 12,000.00 �C. Items Payable in Connection with Laar Gur ongir,ation cnarge (Incwoes Orig�nallon Poi�i O.D00%or�0.00) $605.00 (from G��#11 „�. 7bu�credi;o�cnarQe(poin?s io�the specific in�sresr.rate chosen $ (from GFE#21 Your adjusted ori�inatlon cnarg�,s (from GPE A) 665.00 �4 A�praisai tee tc Rels Valuation (from GFE#3) ?5.00 �� Credi'repo�- to Rels Credit (from GFE�13) 02.00 �F. Tax seNice ___ to (from GFE#3 �lood certificaiior to from GFE#3'� JS ---- to D0. Rems Required hy Lender to be Paid in Advance �1. Daiiy interest charges from frorr��04�11812��1�.to 05/01/2013 @�11i.11001day (from GFE#10) 209.43 �2. Mortgage ins °remium for montii;to (from GF�#3j ��. Homeowne�s insurance for 12 Tonths to Allstaie (from GFE#i 1) 571.54 �4 nonths to (from GFE#11' D00. Reserves Deposited with Lender - � )�1. Initial deposit for you�escrow a�count (from GFE#9) 2,488,41 OC2.Homeowners irsurance � months r�$ 47.631month �142.89 OC3 Morigaae Insurance months�?$ O.00lmonth S Ou4.City Properly T� � months r�� 57.1 tlmonth $�71.33 005.County Property Tax 3 montns(�� 42.971month �1Z8.°� 005.School-a�es '1 months�� 239.65imonth $2,636.15 OG7 Hggreaate Adjustmen: $-590.87 100. Title Charges 101. Title services and lender's title insurance (from GFE#4) 1,746.86 102. Settlement or closing fee lo $ 103. Owners title insurance-First Americar Tille insurance Co-Hbg (from GFE#5) 23":.00 704. Lender':.title insurance-Firs!American Title Insurance Co-Hbg $1,639.00 iC5. Lender's title policy limit$16&,000.00 Lender's Policy 1D6. Owner's title policy Ilmil$210,000.00 Owner's Policy 10?. AgenPs portion of the totai title insurance premlu�r $1,615.50 108. Underwri�er's portion of the tofal title Insurance premium $254.50 105. �scrow ree to Barristers Land Abstract Ge 25.00 200. Government Recording and Transfer Charges 201. Govemment recording charges $ (from GFE#71 161.00 202. DeeC$65.00 Mortqa e�96.00 Release 5 2G3. Trar.sfer tares � (from GFE#8) 2,100.00 204. CitylCounty t�istamps Deed;�2.100.D0 Mortqa e$ 205 Staie Ta�stamps Deed�2,100.00 Mortgaqe$ 2,100.00 Z�E Deed 5 Mortaaqe$ Release� 20Z � 300.Additional Settlement Charges 301.Required services thal you can shop for (from GFE#6) 119.00 302. Tax Service Fee to Wells F2r o Rea Estate Tax $�00.00 303. Flood(Life of Loan) to Wells Fargo Bank,N.A, $19.00 304. Tax CertlPostage Reimbursement to Barristers Land Abstract Cost-Hb 10.92 305. 2013 Cty/Twp Tax to Jariet L.Miller,T�Coilector 1,200.98 306. inheritance Tax Escrow to Bamster Land Abstract Escrow-Hb 40,000.00 307. Sewer-Apri!,May,June to Cam HiII Borou h Authorit 1 fi5 00 308. Notary Fee to Kandi Lenker 10 00 305. Home Warranty to AHS 520 D0 310. FesURadonlHome Inspections to Virtus Grou -POC Bu er "' - � � � � 8 654 26 56 631 90 aid outside of closing by(B)orrower,(Sleller,(L)ender.Qjnvestor,Bro(I�er."Credit by lender shown on page 1.""Credif by seller shown on page?. �vious editions are obsolete Page 2 of 4 HUD-1 mparisor�r Go�G`r�i'_±ti EsSmate iG'rc�and Hil:•-1 Charges Good Faitt Estimate HUD-1 ;narges That Cannot Increase ` HUD-1 Line Number iur onglnaiion charge # 8�� 605.00 66Ci.00 bur:redit or charge(poin�s)ior the specific interest�are chosen # 8�2 0.00 0.00 our adjusted origination charges � 803 665.00 665.00 ;ansfertaxes _ � 1203 4,200.00 2,100.00 tharges That in Total Cannot Increase More Than 10°/ Good Faith Estimate HU0.1 �ovemment recording charges � '201 180.00 161.00 ,�oraisal fee # 804 380.00 75.00 ;redi!report # H05 23.32 6'<'_00 �Service Fee � 1302 100.00 10G.00 �looa(Life of Loan) � 1303 � 19.OD ?9.00 # -_ � # 702.32 417.00 � $ -285.32 or -00.6254% ;harges That Can Change Good Faith Estimate HUD-1 iitlai deposii for your escrow account _ # 1001 1,485.00 2,488.41 �aily interest charoes from � 901 $16.1100/da 32.22 � 209.43 lomeowner's insurance � p 903 420.00 571.54 itle services and lender's title insurance # 1101 ",,31870 1,746.86 �wne?s title insurance-First American Title insurance Co-Hbg � 1103 10.00 231.00 � # .oan Terms >ur iniiial loan amount is $168.000.00 �ur loan term is 30 years �u�initia'interest rate is 3.5000% �u�initial monthly amount owed for principa;,interest,and any morlgage 575�+.40 incWdes >urance is QX Principal QX Interest ❑Morigage Insurance 3n your interest rate risz? ❑X No. ❑Yes,it can rise to a maximum o! �6. The firs(change will be on / ! and can change again every years after I ! Every change date,your interest rate can increase or decrease oy °/. Over the life of the loan,your interest rate is guaranteed to never be lower than %or higher than °/. ien i`you make payments on time,can your loan balance rise7 QX No. ❑Yes,it can rise to a maximum of$ �en I`you make payments on time,can your monthly amount owed for ❑X No. ❑Yes,the first increase can be on ,' ( and the monthly incipal,interest,and morigage insurance nse? amount owed can rise to$ The maximum it can ever rise to is$ �e�your loan have a prepayment penalty? QX No. ❑Yes,your maximum prepayment penalty is$ �ee your loan have a balloon payment? QX No. ❑Yes,you have a balloon payment of$ due in years on / / �fai monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for ifems,such as property taxes and homeowners insurance. You must pay these ilems directly yourself. ❑X You have an additional monthly escrow payment of�387.36 thaf results in a total initial monthly amount owed o!$1,141 J6. This includes�nncipa;,interes:,ai mortgage insurance and any items checked below �propertytaxes QX Homeownersinsurance �,=1ood insurance �X Borough Tax ❑ ❑ te: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. >vious editions are obsolete Page 3 of 4 HUD-1 ��::,��'�" I�UD CERTIFICATION OF BUYER AND SELLER ave care'uliv reviewec the HU:.•-1 Setl�em�:mt Staiemen?and to the best of my knowledge and beiief,it is a true and accurate statement oi ali recefpts and s�ursements raaoe on my account o:-�y me in tr�is transaciior.I further certify that I have received a copy of the HUQ1 Settlement Statement. '��!��----�fi� �'�:�� '�..�` � oec D_Willis � ---t � i --��,-��_;!��-�� ie!E WililS� TF,TS OF ANNE F.RUGGABER=lK/A ANNE��.KELLER -!%/�� i�� haro N'.Stewar.,Executor, e HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be bursed in accordance with this statemenL - � — --�, � " , � y � /� TT�EMENT A NT, DATE �RNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON iNVICTION CAN INCLUDE A FINE AND IMPRtSONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 10'10. �vious editions aro obsolete Page 4 of 4 HUD-1 • • f 1 � 1� Jame o!Borrowec Name of Sellec File Number � Robert D.Willis Estate of Anne F.Ruggaber flk/a Anne F.Keller 1 3-01-6-2731 4 .;anet E.Willis � TitleExpress Prepared 04/18/2G13 at 1029 art� aoce: This page is furnished to give you an itemization of the amounts shown on Paid From Paid From �ines 110�, 1103 and 1�04 of the Settlement Statement(HUD-1). This page BofTOWe�'s Sellef's accompanies but is not a part of the settlement statement. If a discrepancy Funds at FUnds at� exists,the information shown on the Settlement Statement(HUD-1)applies. Settlement Settlement 1D0. TitleCharges Amountsincluded In iine 11D1 101, Title services and lender's title insurance 1,746.88 a. Nofarv Fees � 3�.00 � -- b Wire Fee 10.00 ' c, Overnight Fee 22.88 d Electronic Doc Transmitta:Fee __ 45.00 --- $ 107.68 I � � 1 C2. Settlemen(or closing fee ' 1C3 Owner's title insurance ('policy) $ 231.00 231.00 104. Lende?s title insurance �policy) 1,364.00 � 1,639.00 a Gosing Service Letter 75.00 t. Exp Cov Res Shor1 200.00 (Toial 1103-?1041 $ 1,870.00 105 Lender's title poficv limit$168;000.00 __ � ? p y ; ; O6. Owner's fitle olic limit $290,000.00 I 10?�.��AqenYs�portioo-of the total title insurance pramium �$ 1,615.50 I 108, Underwritets portion of the total title insurance prem. 254.50 I ~I �Toca��o��roe) 5 1 870 OC� ' I -I i � 1C9. -- 110. �— i'1. �---- � 1 Total Borrower Borrower Seller � 100. Title Charges with Payee __ Char e POC or Credlt I, Line 1101 Paid J 10'�� Title services and lende�s title insurance $ � a. Notary�ees to Kandi Lenker 30.00 30.00 ~'I b Wire Fee to Barristers Land Absiract Wire-Nbg 10.00 ' 10.00 � c, Ovemight Fee to Barristers Land Abst•act Fostage-Hbg 22.88 22.88 � d =lectronic Doc Transmittal Fee to Barnsters Land Abstract General-Hbg 45.00 45.00 ?Ok. Lender's title insurance to Barristers Land Absiracl Company 1,639.00 �,639.00 � --_ $ 1,746.88 ?,746.88 � � i � a � � � � � � • � � ' � • ' Payable To: BONNIE K MILLER,TREASURER Office Hours: MON,TUES 8 THURS 9-4 Bilt No: 4494 2233 GETTYSBURG ROAD CLOSED WED,FRI AND ALL HOLIDAYS Bill Date: 3/1/12 CAMP HILL,PA 1 701 1-7302 BMILLER�LATWP.ORG Controi No:1313000632 PHONE(717)737-5671 MAP NO: 13-23-0545-380. Assessed Value: Land:26,100 Improvement: 110,940 Total: 137,000 Desc: 309 MANCHESTER ROAD Acres 0.14 Discount Face Penalty County RE 1.902 $255.36 $260.57 $286.63 HIGHLAND PARK County Lib .143 $19.20 $19.59 $21.55 LOT 9 BLK R PB 5 PG 24 IIII�I Ilil�IIIII II'��(IIII II��I IIIII IIIII III'�III+�li�l�I Twp/Boro 1.23 $165.14 $168.51 $185.36 �� Fire Srvs 0.41 $55.05 $56.17 $61.79 St Light 1 $28.60 �28.60 $28.60 Tax Payer: Debt Svc 0.41 $55.05 $56.17 $61.79 RUGGABER,ANNE F TAX AMOUNT DUE $578.40 $589.61 $645.72 309 MANCHESTER ROAD CAMP HILL,PA 17011-6123 If Date Of Payment Is On 3/1/12 thru 4/30/12 5/1/12 thru 6/30/12 7/1/12 or Later � J � Q � 1�� w J W � Q � J J Q � < 0 W � o °� v � A � � � � v � o � � o� ° � � 3 � �� =°. d eD � c � � v � s � 0 � � � � � � �' � 3 � o p O O O � 00 � m m � '� y �j . . . . . . � � .� 0o O O O � � � � � O O O O � fI1� O O O � _ oZC� D � opZ �v '� � o � Z � r � o � Z �� Z p c�i� ao 0o ao ^� o� � � � ._. w � D � oiTl .-.. °° -iD � r ,-' °° � D -iArn co � � r`v � � JC/17� � fl � � (� pcOZ p � OCnpZ p � � (n � U� C � � � � J � m � � 0 0� N Z N � � W � � � O C� C � � N N N N D NOD � N � � NOD � O � N � D � -� L . 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" � � � y� y C�) ;O- pl �p n O N � � n C O W ��:(R� p, � C 7 y � ��Cl��. (�D y � 7 n O S 7 ID. y �p CD y O �,� �. � S�. C O O � y ��.d� N� N 6�i � �' =' i y � m c� � j �6 '�.7�. � �� a y Q� '',,�I. N Q�. <D = a' .�.Q.. �{ � ' � O + O� '�. y' C O L1 � -� -o a fD m � fD ° � c y m ' , �. �� 3 0 � ' � °' c < � °� ' � � o � n� ? : � - � � - j 6 m x � _� c a. � O � � ��. � y d � (� � ��. .. S (� ? � � � � � al N" N Q p �. � G �D � '�. � C N 3 y a � `�� a =� N � 1 1 � ..... — � � a x 3' � m � m � c� m �, � v � � c'c � �' � m T � 3 °1 '.v°� � �m =• x � �' o o� ' � ,�! � m - � � m m ,� � a .A!� � m cni � 0� f7 X � - '. � (D C ? O � .; ' rn �: N caD � ��'. � �O Z/, -t � M p S Q N N � V� (� � T �'. � o�O � � %r �- fl: � ' �' m � � � lJ � p, D ' ' o �m -� I v � ° d G_ r- S � � c ' ' �' n o l�" � � � w � �' � � � .� � � � o \ � �, - • � , N s ro d a ' � m @ � J � ' a � N N � . � � N � � n O � � : C (D 7 � � � O7 � N. r � Uy�i�� Frcd�-ri<�kshur,;R��,ad � � S.in Anlonio,Tc�;i>,S=SS 1 � �1$AA° 02350 . NWJB . JSS473902065 . 01 . 01 . 19 EST OF ANNE F RUGGABER September 25, 2012 C/O DANA L WIESEMAN CAMP HIL1, P.A 17011-2140 LAW OFFICES JOHNSON DUFFIE 301 M.qRKET STREET LE'VIOYNE PA 17043-0109 Dear Ms. Wieseman: llSAA is corrimitted to nroviding exccl_lent servicc to it� membcrs. .As you requested, I am providing the following information for the accounts of the Iate Anne F Ruggaber. Account Registration: ANNE F RUGGABER USAA �: 638 6? 49 Account � ending in Fund Name 8003 Growth Fund 9462 Total Return Strategy Fund 033] Tax Exempt Intermediate-Term Fund 3483 Short-Term Bond Fund The account values on August 17, 2012 were: Account *� Share Accrued Account ending in Shares Price Dividends Value 8003 1,361.490 $16.38 NA� �22,301.21 9462 2,477.574 $8.91 NA'� $22,075.18 0331 55,062.734 $13.63 $1,397.01 $751,902.07 3483 5,266.595 $9.22 $59.45 $48,617.46 Total Value $844,8�5.92 �Fund does not accrue daily dividends. If you have qucstions, please call a USAA member service representative at 1-800-531-USAA (8722). Thank youu, USAA Shareholder Account Services R�CEIVE� OCT o 2 �012 JOHNSDN � J Q � W 63R 62 49-49216-G2026�DM02350-SAS.SAS45 ;�R�Zg_ w ¢ � � J J Q � . Page > 1 of 1 ��r' Vanguard� Anne F.Ruggaber y 2828 Russell Rd Client Services:800-662-2739 Camp Hill, PA 17011-2140 Total report value: $752,273.25 (Total report vafue includes any accrued dividends.) Name Fund&Account Date Price Per Accrued Number Opened Shares Share ' Value* Dividends PA LT Tax-Exempt Admiral 0677-Q9881980243 10/18/2010 5,814.451 $11.65 $67.738.35 $115.50 500 Index Fund Adm 0540-09881980243 10/18/2010 204.213 �131.12� $26,776.41 - GNMA Fund Admiral Shares 0536-09881980243, 10/18/2010 5,922.332, $11.02' $65,264.10' �79.94 Long-Term Tax-Exempt Adm 0543-09881980243 05/21/2001 7,002.045 $11.70�I $81,923.93 $141.59 inter-Term Tax-Exempt Adm i 0542-09881980243! 05/21/2001 � 15,976.170 $14.30', �228,459.23 ', $329.13 Inter-Term Bond Index Adm � 5314-09881980243 I 10/18/2010 0.000 $11.99 $0.00 $0.00 Morgan Growth Fund Adm 0526-09881980243 I� 05/21/2001 ' 4,525.568 j �62.19� $281,445A7, - Totals $751,607.09 $666.16 i _ _ `Doesn't include accrued dividends. '=��5 � � ��C� 07856478251 J a A � w y'-��-- F ��'YIl � � J J Q Estate Valuation Date of Death: OSi17/.'_012 Esta�_e of: Estate of Anne Ruggaber Valuation Date: O8i17/?012 Account: 15099-1 Processing Date: OSi16/?013 Report Type: Date of Death Plumber of Securities: 1 File ID: ruqgaber Shares SecuriT.y Mean and/or Div and Int Security or Par Descr.iption High/ASk Low/Bid Adjustments Accruals Value 1) 339.998 NORTHEAST INVS TR (669210101) SH 3EId INT Mut�al Fund (as quot°d by NASDAQ) OE/17i2C12 5.88000 Mk.t 5.880000 1,966.55 Total Value: $1,9E�6.55 Total Accrual: SO.GO Tota'�: $1,966.5'; Page 1 This report was procuced with EstateVal, a product of Estate Valuations & Pricing 3ystems, Inc. If ycs � please contact EVP Systems at (818) 313-6300 or www.ecpsys.com. (Revision 7.3.1' a c� W 'lbt� w a � � J J Q ✓ 0 M&T��nk 499 Mitchell Road.Millsboro,DE 19966 A.djustment Services Phone 888-502-4349 � F;ix (302)93��-2955 September 26,2012 � Law Offices Johnson Duffie 301 Market Street �-=A--- P.O. Box 109 ��'� ,�� Lemoyne, PA 17043-0109 ;�'- ..} �� - . �� .� . , '!~''-�f's I L:''�`,' � ��;�'�� t'Ze: Estate of�nneF:� Date of Death: Au�ust 17, 2012 Dear Sir or Madam: Per your inquiry on September l"7, 2012, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 10292306 Ownership(Names o� Anrce F.Ruggaber Richard W. Stewart(POA) Opencng Date 1123/1992 Bala��ce on Date of Death $3,170J5 Accrued Interest $ .pp ------------------- -- - Total - - --- -------------------- $3,170J5 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the West Shore Plaaa at 717-731-�730. We were unable to locate any safe deposit box for the above-mentioned decedent This letter dces not include any aaounts m wtuch the deceased may have been listed as Power of Attorney,Custodian of Uniform TY�ansfers, Representative Payee,or TrusTee under a Written Agreement Sincerely, Valarie Mercer � Adjustment Services � �y�� a �� J J Q St � MEMBERS 1St FEDERAL CREDTT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 164732-00 Date Account Established 1/16/1997 Principai Balance at Date of Death $20.01 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $20.01 Name of Joint Owner None SAFE DEPOSIT BOX: YES Date Established 11/10/2004 Branch Location Camp Hill Name of Leasee Anne F Ruggaber MEMBERS 1ST FEDERAL CREDIT UNION ��s�� Tessa L Klugh Lending Insurance Support Specialist September 18, 2012 Estate of: ANNE F RUGGABER Date of Death: 8/17/2012 Social Security Number: � J � �� Q 5000 Louise Drive • P.O. 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(D � N �L ''�. � d N n � � �7 f7.fD � r« � � ,� a � � �� m o � o o a ' o�o rn a c -�°o � m d -° °- m m° ' � (D y C < X �p ''. a S � a m c c m �' �n � ? � . y n m 7 � O N � O y = 7 I� C �D � O 7 � �� y. N SV p (p l � N I = � C � Q .�+ � O D7 . � � � � y v �' O-n � D K N N � r' ? co v 7C m � � � y � C� a � � y � �o m � m a o � I v v r m O iS ` �p � � a7 (D'�Q � � '' J CD G (/) m � � �' v m O O � � � o � y � O O c ° m � �� o o �Z � o m � s m y � � Q-C �+ `�' fl' a :o °� , � � �, O o' Q � o m fD l�n N O 91 � n � ��. �'�. � 67 _ �. � 6 � � a • ,� � �;,� I ! D �-�, 3 � T � a � a' � � — � p � Q .J v � � (7 _ d � m °<-' � m.N � crno 3 � = m m m �°. � ! ° ° � av�• � -o °� y'o O o � � p N v � y o � ��. .. c � � � �• N � �' N � o � � �D � n� i i � � �x m � a � � 0 � `° m � o t� e� D < n m � � � '� n� W � � � s vi cn C.n Ul � G C' m a p y N v°1, m ao ' oo tA .�-' � : 3 O a? N � N �I � �, w � Q v v �:v Ji � � X � N O� ;N O CTi � t„�jt � y y � �l :� �l s A —� (T � ,� �,� N CO 'N CO: J� Ui .A Q Oo N !CO N i0 A O 1 � Q _ '�� j X �l Cfl iJ CO iJa c0 �I p � / �11• v I� W I '�;� W i'�I O OJ p F L y Y�_ � � 3 � � J J Q Rega rds, Erica Taylor, Certified Appraiser&Auctioneer Kerry Pae Auctioneers Estate ofAnne F. Ruggaber Richard Stuart, Executor Appraised items: Gaudy Welsh China Pieces $100 Bisque Figurines $50 3-Piece Mantle Glock Set $500 Bristol Pink Vase� $75 Mahogany Smalf China Cabinet $1pp � ` �Black Lacquer Cabinet $175 (2)Still Life L. Francis Prints $50/pair Victorian Gold Cuff Bracelet $125 J t Matched Pair of Victorian Gold Bridal Bracelets $275 G� With Black Enamef Erica S. Tay/or, C.A.G.A. Certified Appraiser&Auctioneer Kerry Pae Auctioneers PO Box 416 Hershey, PA 17033 Ce/l: 717.587.8000 11/7/2012 � J �q�y►�b� . W J W I� Q F- J J Q �_ �� / � 1 / i / \\ . � ■F�� ``, 4. 1�� / � ` �Y I 1\ � � 4 I �� i I I � l � I i I i ANNE F. RUGGABER ESTATE f � f � SETTLEMENT STATEMENT ' ( ' 4 � GROSS PROCEEDS $ 40,863.00 i � � COMMISSION 10.% 4,086.30 , � MARKETING 1,500.00 ; i INVOICE/RUG 423.75 � i � � ' APPRAISAL FEE 75.00 ; i � k I f i i � NET PROCEEDS $ 34,777.95 � f ! � i ; i � I i i � ��f�� D ! t�r ��2 � 2p�� I ; ��Spl� p�� ; � i � f ' , I , i � KE�t.RY F�AE AU G'i`1 O N!E E RS � �� •i'-.:lC.tOf'}2�fS •LIC�UIdc`iIO�S "CO:^.S'��t8rt!g 4 • • i � 2 Chickadee Circle, Paimyra, °A 1'078 � (717)236-3752 W ��""�� 4v,^,�v.kerrypae.com � J J Q Flf��'Ilt �C FIDELITY 8� GUARANTY LIFE Y ° ,�� INSURANCE COMPANY �� 777 Research Drive, Lincoln, NE 68521 C��aranty �if� P O Box£32068, Lincoin, NE 68501 866-702-2194 (Office) 402-479-0198 (Fax) www.fglife.com October 18, 2012 RICHARD STE�'ART JOHNSON DLFFIE ATTORNEY OFFICE �,��,�� 301 MARk;ET STREET LEMOYl�TE. PA 17043 �C�' � � �0�7 JOHNSUN QUFFIE Policy: L9077291 Owner: Anne Ruggaber Annuitants: Anne Ruggaber Dear Mr. Ste�art: �'e have been notified of the death of the policy owner. VVe wish to convey� our sincere sympathy to the famili� in their recent loss. According to our records the beneficiary of this policy is the AFR Foundation Trust. The approximate benefit amcunt is $299,217.00. The approximate taxable gain is $99,217.0�. A beneficiary. who is a natural person (i.e. not a corporation, estate, trust, etc.;l, may choose only one of the follow�ing settlement options. A beneficiary that is not a natural person (e.g. corporation, trust. estate, etc.) may only choose option 1 or 3. If you are selecting any of the options 2 — fs, please enclose a letter of instruction to indicate whc yoa �vauld like ��our bere�ciary,ii�s t� �e. Plf,ase pro��i�e their na_me and relationship to ��ou, and also sign and date the attachment. 1. Lump Sum Pavment— The beneficiary will receive a single lump sum �ayment of the policy proceeds through a Fidelity & Guaranty Life Asset Account. The personal Asset Account is an interest bearing checking account established in the beneficiary's name. The account currently earns interest at a rate of 1%. We will mail the beneficiary a personalized checkbook. To access the funds, the beneficiary would simply write a check. We would also send the beneficiary monthly statements for the account, just like a bank. Please be advised if your portion of the processed does not exceed $10,000.00 your processed will not be set up in a Retained Asset Account. 2. Substitute Owner Election — **XTffiS OPTION IS AVAILABLE TO THE SURVIVING SPOUSE ONLYxxX - The surviving spouse beneficiary will become the new owner of the policy. All terms and conditions of the policy remain unchanged, including any remaining surrender charge period. J Q �-,,I�� W `<L� Fidelity&Guaranty Life is the marketing name of Fidelity&Guaranty Life Insurance Company and.in New York oNy,Fidelity 8 Guar w �� Company of New York Only Fidelity&Guaranty Life Insurance Company of New York is authorized to sell insurance and annudies i � � J J Q Explanation of Your Benefits North American Company Prepared By: Connie Baker For Life and Health Insurance Thursday, October 25, 2012 Mailed to: AFR Foundation,Inc. Claim Number: 2149489 301 Market St. Policy: 8000024678 Lemoyne PA 17043 Date Paid: 10/26/2012 Insured: Anne Ruggaber Total Settlement:$I,009,925.22 Annuity Amount $1,004,626.85 Claim Interest 2J5% �5,298.37 Taxable Amount of this settlement is: $279,626.85 Cash Settlement of$1,009,925.22 Paid to: AFR Foundation, Inc. 301 Market St. Lemoyne PA 17043 Annuity Service Center*P.O.Box 79905*Des Moines, IA 5032�-0905 � Phone:877-880-6367*Fax 877-586-0249 F ��'I l;1 �T � N � J Q �� . " + (""'`►�` �y�, �� `�.. " ��`y` ,,^!) � � � 1� �,�' ->> � ��- �-��`� , ��C.�1 �--�� :: �` v `, . ,� � , c�� , _ _ , INVENTORY � REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-12-0920 Richard W Stewart Personal Representative(s)of the Estate of Anne F RUGGABER deceased, depose(s)and say(s)that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent,that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedenYs death,and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which app�ears in a memorandum at the end of this_�nventory. I veri that the statements made in this Inven- - r ��,�,.��'� n - "� � ��-�f�/��t''_-__ —_ c a _ _'--rrr r'r� � tory are true and correct. I understand that false state- Richard W Stewart � � ��_a _'� ,G_± � ments herein are made subject to the penalties of �_ -� , � _ ti„a , 18 Pa.C.S. §4904 relating to unswom falsification to - -rn "r'- - ; • - r•.;. authorities. �� • c] - —- - - - - - :,�.�-_ _ .:-: _ . — . _. ___ -- - —__ . . , , � Attorney-- (Name) RICHARD W. STEWART (Su�reme CocCrt�:D. No.) : �; 18039 -- -- _----- ----._ �F""'� Johnson Duffie � � �- ' -- - -- --- �,, ___- — - _- _��-- (,address� _301 Market St., Lemoyne, PA 17043-0109 — —__-- ----- -- ----- ____ -- (Telephone) (717) 761-4540 DATE OF DEATH LAST RESIDENCE 2gZg Russell Road DECEDENT'S SOC.SEC.N0. 08/17/2012 Cam Hill, PA 17011 FIGURES MUST BE TOTALED Personal Pro�r X Cash............................................................................................... 43,599.02 PersonalProperty........................................................................ 47,577.95 Stocks/L isted................................................................................ 2,210,340.63 Stocks/Closely Held..................................................................... Bonds............................................................................................ 81,923.93 Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... AllOther Property........................................................................ Total Personal Property........................................ 2,383,441.53 Total Real Property................................................ 347,000.00 Total Personal and Real Property........................ 2,730,447.53 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may,at the election of the personal representative include the value of each item,but such figures should not be extended mto the total of the Inventory.(See 20 Pa.C S.§3301(b)) Form RW-09 Re� io-�s-zooe j INVENTORY . REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-12-0920 DATE OF DEATH LAST RESIDENCE ZgZg RusseLi Road DECEDENT'S SOC.SEC.N0. 08/17/2012 Camp Hill, PA 17011 Cash Cash -Cash located in Residence and Safe Deposit Box 264.00 Deposit to Account-Anne Ruggaber MASVIAACH 2,521.14 M&T Bank Free Checking Account No. 10292306 3,170.75 Members First Federal Credit Union Regular Savings Account No. 164732-00 20.01 Merrill Lynch Bank Deposit Program -Cash Account 35,541.47 Residential Real Estate located at 2828 Russell Road, Camp Hill, Cumberland County, 1,595.35 PA-Reimbursement on County and School Taxes and Sewer Payments. A copy of the HUD-1 Settlement Sheet is attached United Health Care Insurance Premium Payment-Reimbursement of Premium Payment 12.30 USAA Credit Card Account-Refund on Credit Card Account 241.73 USAA Senior Bonus Distribution 157.28 USAA Subscribers Account Distribution -Cash Received 65.72 Verizon Communications-Refund on Account 9 27 Total Cash 43,599.02 Personal Pror�ert� 2 Still Life L. Francis Painting-Valued and Appraised by Erica Taylor, Certified 50.00 Appraiser and Auctioneer, Kerry Pae Auctioneers 2005 Volvo V50 Station Wagon-Contracted Sales Price 11,500.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 2,730,441.53 INVENTORY �- REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-12-0920 DATE OF DEATH LAST RESIDENCE 2828 Russell Road DECEDENTS SOC.SEC.N0. 08/17/2012 Camp Hill, PA 17011 3 Piece Mantle Clock Set-Valued and Appraised by Erica Taylor, Certified Appraiser 500.00 and Auctioneer, Kerry Pae Auctioneers Bisque Figurines -Valued and Appraised by Erica Taylor, Certified Appraiser and 50.00 Auctioneer, Kerry Pae Auctioneers Bristol Pink Vase-Valued and Appraised by Erica Taylor, Certified Appraiser and 75.00 Auctioneer, Kerry Pae Auctioneers Dining Room Rug 125.00 Gaudy Welsh China Pieces-Valued and Appraised by Erica Taylor, Certified Appraiser 100.00 and Auctioneer, Kerry Pae Auctioneers Kerry Pae Auctions-Proceeds from the Sale of DecedenYs Personal Property including 34,777.95 all jewelry inventoried in safe deposit box Matched Pair of Victorian Gold Bridal Bracelets with Black Enamel -Valued and 275.00 Appraised by Erica Taylor, Certified Appraiser and Auctioneer, Kerry Pae Auctioneers Victorian Gold Cuff Bracelet-Valued and Appraised by Erica Taylor, Certified 125.00 Appraiser and Auctioneer, Kerry Pae Auctioneers Total Personal Property 47,577.95 Stock / is d 334.4480 shares Northeast Investors Trust 1,966.55 M rrill ynch Wealth Management Ac�ount No. 872-56856 800.0000 shares Altria Group Inc. 28,244.00 100.0000 shares Apple Computer Inc -Com 64,350.00 1,457.0000 shares Blackrock Municipal Assets Fund Inc. 20,000.17 -2- , INVENTORY R REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS courvn oF Cumberland } File Number 21-12-0920 DATE OF DEATH LAST RESIDENCE 2g2g Russell Road DECEDENT'S SOC.SEC.N0. 08/17/2012 Camp Hill, PA 17011 435.0000 shares Boeing Co-Com 32,055.15 1,445.0000 shares Bristol Myers Squibb Co-Com 45.907.65 1,288.0000 shares Cisco Systems Inc -Com 24,594.36 61.0000 shares CitiGroup Inc. 2 322 2� 1,150.0000 shares Cohen&Steers Quality Income-Com 72,506.25 100.0000 shares Dollar General Corp New 5,140.00 1,600.0000 shares Exxon Mobil Corp-Com 141.656.00 3,400.6210 shares Federated High Income Bond Fund-CL A 26,150.78 200.0000 shares Ford Motor Co Del -Com Par$0.01 1,938.00 15,454.4710 shares Franklin Calif Tax Free Income-CL A 115,444.90 2,400.0000 shares General Electric Co-Com 50,448.00 20,000.0000 shares Illinois Fin.Authority Rev 20,924.00 600.0000 shares Microsoft Corp-Com 18,453.00 40,000.0000 shares New Jersey Economic Development Authority 41,564.00 705.0000 shares Paychex Inc-Com 23,409.53 10,000.0000 shares Pennsylvania St TPK Commn Oil 10,026.30 140.0000 shares Wal Mart Stores Inc-Com 10,117.10 USAA Wealth Management Investment Account -3- . INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } File Number 21-12-0920 DATE OF DEATH LAST RESIDENCE 2g2$ Russell Road DECEDENI'S SOC.SEC.N0. 08/17/2012 Camp Hill, PA 17011 1,361.4900 shares USAA Growth Fund Account Ending 8003 22,301.21 5,266.5950 shares USAA Short Term Bond Fund�36900433483 48,558.01 55,062.7340 shares USAA Tax Exempt Intermediate-Term Bond Fund-44900680331 750,505.06 2,477.5740 shares USAA Total Return Strategy Fund-55900019462 22,075.18 Vanauard Individual Account No 0988198024'� 204.2130 shares 500 Index Fund Account No. 0540-09881980243 26,776.41 5,922.3320 shares GNMA Fund Admiral Shares Account No. 0536-098819980243 65,264.10 15,976.1700 shares Inter-Term Tax Exempt Adm.0542-09881980243 228,459.23 4,525.5680 shares Morgan Growth Fund Adm 0526-09881980243 281,445.07 5,814.4570 shares PA LT Tax-Exempt Admiral 0577-09881980243 67,738.35 Total Stocks/Listed 2,210,340.63 Bond$ 7,002.0450 Long Term Tax Exempt Adm Account No. 0543-09881980243 81,923.93 Total Bonds 81,923.93 Real Estatp Residential Real Estate located at 2828 Russell Road, Camp Hill, Cumberland County, 210,000.00 PA-Contracted Sales Price. Real Estate Closing was held on April 18, 2013. A copy of the HUD-1 Settlement Sheet is attached to this Return Residential Real Estate located at 309 Manchester Road,Camp Hill, Cumberland 137,000.00 County, PA-Cumberland County Assessed Value x. CLR -4- INVENTORY � REGISTER OF WILLS OF _ CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS couNn oF Cumberland } File Number 21-12-0920 DATE OF DEATH LAST RESIDENCE Zg2g Russell Road DECEDENT'S SOC.SEC.N0. 08/17/2012 Camp Hill, PA 17011 Total Real Estate 347,000.00 -5- Page 1 of 1 Blanche A. Morrison , From: Elizabeth D. Snover Sent: Friday, May 17, 2013 8:31 AM To: Blanche A. Morrison Subject: Re: Letter to Phyllis Levin (Donald B. Owen) She called me and told me she got it. Sent from my iPhone On May 17, 201.3, at 8:23 AM, "Blanche A. Morrison" <B�1Y1'%,1I)�ti�'.c��in> wrote: Liz, I just wanted to let you know that I still keep checking the Post Office for the status of the certified letter that was sent to Ms. Levin on April 23rd. It still has not been signed for. We also sent this letter out on May 2, 2013, regular mail. Is there anything else you want me to do? Thanks, Blanche S/17/2013 a i.l,'� ii �� 11 �;— -- ',�I � 11'>I�i�ll �) ti1ii�� l� hJt II',1-.1 kt ` . .� �, � +I`'�. I,. 1�It t�l 1'��. � l;1ll :[1 t; 1i11s1��, i l \1 U ;� ; i ; �< ��,II`� �a i.i��i --- — -- - [� ,��C 11 � i . �� _ �1 � , lti�!�� ,�, ON � , ��,� ; �, i ;, ; i. , , 1'i 1,.�i;, �l 1 I i�l l� � l�i �f i�; L1 ti�ll�I�.SF �ill)E I ! ,��, �:�� UFFIE �. �; �, t;� �� ti ,� �, ��; , �� ;.� lll��ii�'�EI_�_ ; -�ti ;�.�; OFCOUNSF,L ��I�1 li��' 1 �.il;;I_�i�� tl(��li:A(�� '1 �OII'�,<.(i�. �'1�_111i�. i) j1�1_`�I_f'.'. l� ��i)1'��'l�.11)l�(�H. lli i'n�.�',�Ci\l'l.� IiliUV'I May 17, 2013 Register of Wills Office c �_.� -== s'�; ?� �' — �:� c- Cumberland County Courthouse �., --.� ___ ._ r, One Courthouse Square rn -;; c� =t= �-:: �,; Carlisle, PA 17013 � =': =�- �',;, � �� L� , :, :.._ .. , , ��, .. -- � ----, _.. :.... RE: Estate of Anne F. Rugga,b�r�:�' .=: - -; �� _ . Date of Death:August 1�;:2�.1:2 �� - Your File No.. 21-2012-(192�`-: � � - °-'� Our File No. 15094-1 ; t�� '' `�-' .�J '�5 Dear Register: Enclosed for filing, please find the following: 1. 2 Original Pennsylvania lnheritance Tax Retums. There is tax due in the amount of$43,608.53. Estate Check No. 1037 is attached. 2. Inventory 3. One copy of Page 1 of the Inheritance Tax Return that we ask that you time-stamp and return to us. 4. One copy of Page 1 of the Inventory that we ask that you time stamp and return to us. 5. Estate Check No. 1038 in the amount of$30.00 representing the filing fees. Thank you for your assistance in this matter. Should you have any question or require any additional information, please contact the undersigned Very truly yours, J SON, q , STEWART&WEIDNER ��i.�(;'�-�Lb'�___. �ana Wieseman Estate Administration Paralegal Enc. 558301 i01 i�I�RKf�-1 STREET P.O. BOX l(i'� I.E1IU!��I��,. I'!�:�'�ti�I�:-a�I � i;il-�j-Ol��i »��t��t�s��'r.r.��-� it7�h� a��o ►�:��, t� ;t,i ,��i, ��i��u.�,;v�»,t�'c�>�� JOHNS0 �1, DUFFIE, STEWART & W'EIDNER, P.C. �� 4� � ..,a � �k� � . a� � � ��'� � ^ �� e.l�;d`.� � � � ,i �� . a �,'I � ttS tS) ;�� .� .�� ... �... � � � , , -_ :� .�� .� � : � � r. �: r. � �+ � ,� :.` � ,�„ r�, —�! ^ �,: : .�' ,- '.� w �, � ~ C~ O _ r-- � w <,wj p � u- U � 8Y61-0009t-0891 � � "- r c3 CIOZ'ueP 0041aqel M ,. (/ � O Z � cM- ^ J � J� J � w O �� NE �� U O � �F � � 00 S n°�.a "`' w "- z f=-- o¢._ _!f "`.�"' N �� `= � O �� Mo � � W W � � �' �� h �o� �r "' � w � Z*�� !i t�+4� ' ^ w � z Q Y _..._,_.,_ `p h�� { } � U O c.� M� S c� .: �FM■�r� ►,�jd V Q� � O s a��o �„j � h" O��@ � � U '•�' �N �r+�.�� ip o � � W� a� o o� ` t/�� o ,. �Q �� W � �� !�' q f �� c. U �p� �� , � � � �� Cll t``-t , ^� `�J� �2�LP � � W �,� r--{ ►�'- � � �b`�J`� ��A. ry`�'^y ,'� :;:y: � :,;.. � G� �� ' 4�,r0 s�S� Co��„9 Y l„') - �;. Sd� C1., `� U � O �j d�'� d�S `b� :': �� c � � �e�j � ��'�,r �'r'S Gf `-!� O (j,} s � r►� �� 7 �.„ u-" N ..3 'Q � ` �y� ;,� �-- �,,,, tJ � ti! �� 'n � �- � � C:a � Q � `� it.! 7 .�� C � ti � - ..� �� COMMONWrALTH OF PENNSYNANIA RFV-1162 EX(11-96) DEPARTME�T OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280607 HARRISBURG,PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 017634 STEWART RICHARD W 301 MARKET ST LEMOYNE, PA 17043 ACN ASSESSMENT AMOUNT CONTROL NUMBER __"__'__ fold "'"""""" 101 � 543,608.53 ESTATE INFORMATION: SSrv: I FILE NUMBER: 2112-0920 I �ECE�ErvT NAME: RUGGABER ANNE F � DATE OF PAYMENT: 05/2O/2013 I POSTMARK DATE: 05/17/2013 I CourvTY: CUMBERLAND ( DATE OF DEATH: 08/1 7/201 2 I � TOTAL AMOUNT PAID: 543,608.53 REMARKS: RECEIPT TO ATTY CHECK# 1037 INITIALS: CJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS