Loading...
HomeMy WebLinkAbout10-24-13 (2) 1505610140 REV-1500 EX (02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO Box 280601 INHERITANCE TAX RETURN 2 1 1 3 0 4 6 3 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW 0 4 1 9 2 0 1 3 0 4 1 8 1 9 3 1 Decedent's Last Name Suffix Decedent's First Name MI W E I G L E M I L D R E D L (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 Q 1.Original Return F� 2. Supplemental Return ❑ 3. Remainder Return (Date of Death Prior to 12-13-82) ❑ 4. Limited Estate 4a. Future Interest Compromise(date of 5. Federal Estate Tax Return Required death after 12-12-82) © 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 1 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9. Litigation Proceeds Received 10. Spousal Poverty Credit(Date of Death 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytimg.7elephone Number D A V I D H S T O N E E S Q U I R E 7 1c7 7 7 rill; 7Un423 5 REGISTER OF WILLS USE.OiNL_1 First Line of Address C? 4 1 4 B R I D G E S T R E E T c� Second Line of Address City or Post Office State ZIP Code DATE FILED N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent's e-mail address: DSTONE@STONELAW • NET 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. -:-,<SGNATURE O ERSOy RESP NSI E FOR FILING RETURN DATE ��/h� ADDRESS 309 NEBINGER STR LEWISBERRY PA 17339 SIGNATU PA R H HAN REP ADDRES ESEN I E DATE A 414 BRIDGE STREE NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J 1505610240 REV-1500 EX(FI) RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 1. 2. Stocks and Bonds(Schedule B) . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 8 3 0 4 , 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 1 7 2 8 4 • 3 3 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . 1 6. 7, Inter-Vivos Transfers&Miscellaneous N -Probate Property (Schedule G) t Separate Billing Requested . . . . . . . 7. 1 7 5 6 1 , 0 1 8. Total Gross Assets(total Lines 1 through 7) S. 4 3 1 4 9 , 3 4 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 1 6 8 7 9 . 6 3 10. Debts of Decedent, Mortgage Liabilities,and Liens Schedule I 10. 4 1 3 . 4 7 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 7 2 9 3 . 1 0 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 2 5 8 5 6 . 2 4 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. , 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 2 5 8 5 6 . 2 4 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)x.0 _ 0 . 0 0 15, 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x .045 2 5 8 5 6 . 2 4 16. 1 1 6 3 . 5 3 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18, 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 1 1 6 3 . 5 3 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 L 1505610240 1505610240 REV-1500 Ex(FI) Page 3 File Number Decedent's Complete Address: 21 13 0463 DECEDENT'S NAME MILDRED L - WEIGLE STREET ADDRESS 54 GARDEN PKWAY CITY STATE ZIP CARLISLE PA 17015- Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 1,163 . 53 2. Credits/Payments A. Prior Payments 11000 - 00 B.Discount 52 - 63 Total Credits(A+B) (2) 1,052 . 63 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. (3) 0 . 00 Fill in oval on Page 2,Line 20 to request a refund. (4) 0 . 00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 110 - 90 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN 'X' IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred ...................................................................... ❑ ❑X b. retain the right to designate who shall use the property transferred or its income .................I............. ❑ ❑X c, retain a reversionary interest ..................................................................................................... ❑ ❑X d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ ❑X 2. If death occurred after December 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ ❑X 3. Did decedent own an"in trust for'or payable-upon-death bank account or security at his or her death? ......... ❑ ❑X 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. © ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is is 3 percent[72 P.S. §9116(a)(1.1)(1)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and fling a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent[72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in p2 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. REV-1503 EX+(8-12) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER MILDRED L . WEIGLE 21 13 0463 All property Jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 150 shares Prudential Financial Inc stock a $55 . 360 81304 . 00 each TOTAL(Also enter on Line 2,Recapitulation) $ 8, 3134 - OD If more space is needed, insert additional sheets of the same size REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE DASH, BANK DEPOSITS & MISC. INHERITANCE TAX R RESIDENT DECEDENTTURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: MILDRED L . WEIGLE 21 13 0463 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly owned with right of survivorship must be disclosed on Schedule F, ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. 2000 Buick Century sold to Perry Hall 3 ,000 . 00 2 Chase Card Services-refund 44 .86 3 Hellers-gas refund 81 .22 4 M&T Bank-Checking Acct #9838?86391 61126 .06 Princ . $6126 .06, Int $ •03 5 M&T Bank-Checking Acct #9838?86391 - Accrued Int 0.03 6 Mobile Home sold 61500 .00 ? Retirement check received 59 . 16 8 Social security check received 1,273 . 00 9 United Healthcare-refund 200 . 00 TOTAL(Also enter on Line 5,Recapitulation) $ 17,284 - 33 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX-(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MILDRED L . WEIGLE 21 13 0463 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %,OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST �iFAPP-icne�E� VALUE 1 Prudential Alliance Acct Sery-Acct 17,561 . 01 100 . 00 17,561 . 01 #4351001253124 w/Kenneth E Hall and Brian S Hall as beneficiaries TOTAL (Also enter on Line 7,Recapitulation) 61 • 01 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX-(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MILDRED L . WEIGLE 21 13 0463 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1 Brian Hall-Reimb for dinner at Dukes after funeral 781 . 38 Perry Hall-Reimb on funeral expenses 3 ,791 . 70 Brian Hall-Reimb on funeral expenses 3,791 . 70 Kenneth Hall-Reimb on funeral expenses 3,791 . 71 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Years)Commission Paid: Z AdomeyFees: David H Stone , Esquire 2,000 . 00 3. Family Exemption:(If decedents address is not the same as claimants,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent a. Probate Fees: See 06 below 6 Accountant Fees: 6. Tax Return Preparer Fees: 1 Computershare-commission on sale of stock 23 . 00 2 DISH Network-tv service at property 82 . 00 3 Century Link-phone service at property 53 . 52 4 Sigmars-lot rent for April 310 . 00 5 Sollenbergers-title fee for mobile home 39 . 50 6 Kenneth Hall-Reimb for probate costs 168 . 50 7 Check order fee 6 . 00 8 Kenneth Hall-Reimb for dumping items and gas 150 . 00 9 Kenneth Hall-Reimb on gas 111 . 55 10 Century Link-phone service at property 12 . 05 11 Kimberly Clark-repayment of overpayment 259 . 12 12 M&T Bank-Repayment of social security check 1,273 . 00 TOTAL(Also enter on Line 9,Recapitulation) $ 16 ,879 - 63 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent MILDRED L. WEIGLE 21 13 0463 Decedent's Name Page 1 File Number Schedule H - Funeral Expenses &Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 13 Robert Cairns , tax collector-head tax due 4 . 90 14 Register of Wills-filing Inh tax return and Inv 30 . 00 15 Reserve for closing expenses 200 . 00 SUBTOTAL SCHEDULE H-B7 234 - 90 REV-1512 EX-(12-12) pennsylvania SCHEDULE I DEPARTMENTOF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES& LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER MILDRED L . WEIGLE 21 13 0463 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Chase Card Services-debt of decedent 66 . 98 2 Cumberland Goodwill Fire Rescue EMS-services 346 . 49 TOTAL(Also enter on Line 10,Recapitulation) $ 413 - 47 If more space is needed, insert additional sheets of the same size. REV-1513 EX-(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MILDRED L . WEIGLE 21 13 8463 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include ouNght spousal distributions and transfers under Sec.9116(a)(1.2).j 1 KENNETH E HALL Lineal 81618 . 75 389 NEBINGER STREET LEWISBERRY PA 17339- 2 PERRY L HALL Lineal 81618 . 75 210 D STREET SW GLEN BURNIE MD 21061- 3 BRIAN S HALL Lineal 8,618-74 12206 TOLUCA DRIVE SAN RAMON CA 94583- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. U. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: t. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART ii-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, E If more space is needed,use additional sheets of paper of the same size. . ���.a aau�• J. aavvV ATTORNEY AT LAW 19 S.HANOVER STREET-SUITE 101 CARLISLE,PENNSYLVANIA 17013 (717)245-2698•FAX.(717).245-0829 WILL OF MILDRED L. WEIGLE I, Mildred L. Weigle, of Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will and hereby revoke all prior Wills and Codicils. 1. I direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. 1 direct that all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. 1 direct that my entire estate be distributed as follows: A. I leave all of my property, real and personal, to my children Keith A. Hall, Perry L. Hall, Kenneth E. Hall and Brian S. Hall in equal shares; B. Should Keith A. Hall, Perry L. Hall, Kenneth E. Hall or Brian S. Hall predecease me, their share shall lapse and shall pass to my surviving children. 4. 1 appoint Kenneth E. Hall as the Executor of this my last Will. Should Kenneth E. Hall predecease me or cease to act in such capacity, I appoint Brian S. Hall as alternate executor of this my last Will. 5. The Executor of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. 6. 1 direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. IN WITNESS V{OEREOF, I have hereunto set my hand this day of C w;12004. STEPHEN J. HOGG 11) ' nANO V ER srREET Mildred L. Weigle stunt 101 �'AitrISLE. M 1700, The preceding instrument consisting of this and one other page was on the day and date hereof signed, published and declared by Mildred L. Weigle, as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. WITNESS ITNES LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE,PA 17013 ACKNOWLVN `IVIENT�-- State of Pennsylvania ss County of Cumberland I, Mildred L. Weigle, the testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to- law, do hereby acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Mildred L. Weigle Sworn to or affirmed 4CLd acknowle ed before by Mildred L. Weigle, the testatrix, this day of .,, 1= 2004. s� NOTARIAL SEAL _ STEPHEN J.HOGG,NOTARY CARLISLEBORO,CUMBERLANOCO. Pry Notary Public/A r ey MY COMMIEBNN!EXPIRES SEPTEMBER 3,300 AFFIDAVIT State of Pennsylvania ss County of Cumberland We, MAMA 5 u D(95end ;JSa P.b1 )be LL, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. rn to or affirrrped and su Abed o before me by witnesses, this day of LA OFHCESOl �� G rEPHEN J. HOGG ECARLIS NOTARIAL SEAL ary Public/Attorn 9 S. HANOVER STREET PHEN J.HOGG,NOTARY PLIOLIC SUITE 101 LE BOBO,CU MBERLAND CO. PA CARLISLE, PA 17013 MISSION E%PIpES SEPTEMBER 3,2WS STONE LAFAVER & SHEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET DAVID H. STONE POST OFFICE BOX E OF COUNSEL GERALD J. SHEKLETSKI NEW CUMBERLAND.PA 17070 CHARLES H.STONE w ..stonelaw.net JON F. LAFAVER TELEPHONE(717)774-7435 FACSIMILE (717)774-3B6S June 18 , 2013 Pennsylvania Department of Revenue Harrisburg District Office Lobby, Strawberry Square Harrisburg, PA 17128-0101 Re: Estate of Mildred L. Weigle Date of Death: April 19, 2013 Social Security No . 177-24-7377 Estate No: 21-13-0463 Greetings : Please find enclosed an original Safe Deposit Box Inventory for Box No . 019 . Thank you for your attention in this matter . Should you have any questions, please feel free to contact us . Very truly yours, STONE LaFAVER 6 SHEKLETSKI Jennifer A. Mea-rk eS Para1`egal to David H . Stone, Esquire /jam Enclosures cc : Kenneth E . Hall, Executor Tana Emery, Vice President of M&T Bank J 48500041046 REV-485 EX 105'04) SAFE DEPOSIT . BOXINVENTORY PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY Social Security or Death Certificate Number Date of Death County Code Year File Number 177-24-7377 04/19/2013 21 13 0463 Decedent's Last Name Suffix First Name Mi Weigle Mildred L ©ADDRESS OF DECEDENT STREET; CITY: STATE'. ZIP CODE:' 54 Garden Parkway Carlisle PA 17015 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX NAME: Kenneth E. Hall STREETADDRESS: CITY: — — STATE: ZIP CODE: 309 Nebin er Street P.O. Box 216 Lewisberry PA 17339 NAME,ADDRESS AND RELATIONSHIP(IF ANYi TO DECEDENT,OF PERSON(S)PRESENT AT THE BOX OPENING a. NAME: RELATIONSHIP: Kenneth E. Hall son STREETADDRESS: CITY: STATE: ZIP CODE: 309 Nebinger Street, P.O Box 216___, - ____—_- Lewisberry PA ---1713-39 b. NAME: RELATIONSHIP. STREETADDRESS CCTY: STATE: ZIP CODE: c. NAME: RELATIONSHIP: STREET ADDRESS CITY: STATE: ZIP CODE: NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED NAME M&T Bank STREETADDRESS: CITY: STATE: ZIP CODE: 100 South Spring Garden Street Carlisle PA 17013 NAME OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY Mildred L_Weigle 9117/07 0:00 am DATE OF CONTRACT TO RENT BOX NUMBER OF 80% 1 TITLE UNDER WHICH BOX IS REQUESTED 09/17/2007 019 Mildred L. Weigle NAME AND ADDRESS OF PERSONS)HAVING ACCESS TO BOX a. NAME: b. NAME: Mildred L. Weigle STREETADDRESS: STREET ADDRESS: 54 Garden Parkway__,___ CITY. STATE, ZIP CODE CITY: STATE: ZIP CODE: Carlisle PA 17015 NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY Tana Emery WAS A WILL IN THE 80X7 R YES ❑ NO If yes, a. Data of will: 1 111 6/2 004 b. Name and address of personal representative,if named in the will `-------T--- —....__ __�- NAME: Kenneth E. Hall ST'REETADORESS: CITY: STATE: ZiP CODE: 309 Nebinger Streets P.O. Box_216 __ —_ _ Lewisbegy PA 17339 c. Name and address of attorney,if any NAME Stephen J- Hogg Esquire STREET ADDRESS: CITY'. STATE: ZIP CODE. 19 South Hanover Street, Suite 101 Carlisle PA 17013 48500041046 48500041046 REV.485 EX SAFE DEPOSIT BOX INVENTORY Page __of INSTRUCTIONS (1) Cash:Report total only. (2) Stocks:List in detail every common or preferred certificate.warrant or other rights found in box.Stocks are to be designated by name of company,certificate number,date of certificate,name in which stock is registered,and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items,date of issue,face value,names in which registered and type of ownership, i.e.,jointly held,payable on death,etc. (4) Bonds:Designate by name,amount,serial number,or other designation,(Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book,last date appearing in book,name of bank and branch,and balance. (6) ,Jewelry,Coins,Stamps,Manuscripts,etc:List and describe as fully as possible. (7) Deeds,Mortgages,Current insurance Policies or other evidences of indebtedness:List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT 280604 HARRISBURG,PA 17128-0601 ITEM ITEM DESCRIPTION NO. 1 Copy of Will of Mildred L.Weigle,dated November 16,2004, 2 Copy of Power of Attorney of Mildred L.Weigle,dated November 16,2004. {t CE PENAL OF ERJ RY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF �C RECTA D CO ET O HEB ST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: SIG TUBE—_--------_ (0 - —" SIGNATURE ----- -- --- - —iR/L.- _ _ PRINT NAME PRINT NAME AND CHECK APPROPRIATE BOX BELOW David H. Stone, Esquire_ __ PRINTTITLE GATE CHECK APPROPRIATE BOX, _ Attorney for Estate of Mildred L. Weigle (/_ }{1 \j- Y ( Estat9 R9presen46np JNVt ownM nt sate aeppAt box NOTE: Attach additional 8'la"x 11"sheet(s) if necessary or use duplicates of this page of form. The Department is authorized by law,42 U.S.C,§405(c)(2)(C)(i),to require disclosure of Social Security numbers in connection with administering state tax laws.The Department uses the Social Security number to identify the decedent and personal representatives of the estate.The Commonwealth may also use the Information in exchange of tax iNomialbn agreements with Federal and bcal taxing authorities.The state law prohibits the Commenmaith's personnel few disdosirxl confidential tax Information except for oBkAal purposes. Prudential Financial Inc„ PRU Historical Quote - (NYSE) PRU, Prudential Financial Inc. ... Page 1 of I Enter SYmbc4s lx Ke2ynadsSEtRLN i• Is Another Bear Market Around the Corner? if you have a$500,000 portfolio,you should download the latest report by Forbes columnist Ken Fisher's firm.it tells you where we think the stock market is head"and why.This _ Charts+ must-read repel includes our latest stock market forecan,plus research and analysis you can '+^A����/ r� use in your portfolio right now, u,plt0k Hora to Downloatl rl 113! . Fmm diddi t atRi pru aastc mart Aavan�ea on J he"1.charc Horn. ODotes News Indusmnfa Markets Historical OUolas OoR.P.rw ..w,.✓.�•.....>«..�.�,,....aavn.•....,+.....r.n w,..«,+aw...mm.....�..u+rr«...............o,...+.:�rea,wwnwr+ww This K tmaAi 4,wtas iwI algyt3 Ton to b�k up P.ss<vRq3 eaeUd651p0�s- Slmyry(y4w r111FU zympoi and n hlsloircni dale to alpw v qudo antl rrJnl cllgrfor IhalaxcJlrty. {_rl Enter SymboF. pN Enter Oat.. yg119113 l—_— _ ---- .—_ � Prud nfial Fi,ldn.iaf Mc Fol Apy Is 20u me, 55.13 l nss � _ 55.81 6,111 No Spills Warren Buffett Confesses Warren Buffetts Shockirg Confession VAN Change your Investing Strategy .naw l,+rvinnnldnasyn»I,cam Now Rule in PENNSYLVANIA: ' (JUL 2013):If You Pay For Car Insurance You Better Read This— C r J+p 1 ww!'G rsnrrfil.snceJntlY~axn J `f �t How To Win Mega Millions 11 O -7 y ('` Professor Discusses 1 Tip To Match 5 NAnning Numbers. a s }L w,Aame:,�lnmlemnelanwo..to J Lose 241-bs In Weeks? t5V SIj j, Celelomy Doctor EXPOSES His'9/1 Miracle In A Bottle To Bum Your Fat" ll PnlpPngubollvhebma anm 93 o q.GD m.ue3w.msomsa coma s Armsr7frwM SIMe Treaster Fpt$ ism ar:A.,q T.d.kce bit W 0., RNS:dea,No SerW 1161 up 16 A en "6!Op en feel.No Annual Fpe3. eaoOR tMsy Nome IA..I Blp ew'.i V[I[...I HLg CnirynpXi$6)3 MmMniNhln Inc AX""N 8,d,—d rs sne wit nglee le Iha T emn of Uia and Privacy Pblky InPbareG,g»&1g31} Inlrznay Data nlbvitl¢d ey SIY 1t,d1del lnlo:ma[ion antl yw,; llv iHms of bfe N.dlyalanOCUttunl!ntl-o4d.,w.,6toau:Ne dy bl%"'b."Vallnlo,malmm l......date delaybd Ya,axohanyer 358r'NOw JVn¢a IM¢e315 M IIr...Daw..... C011ry]nV.InC.lJlquu¢tl 4le nlocal evtl,Dn4tll afinalLmeytrt;al! dab n`ov Vbtl Cy NRSUW Mme�n,m�:mium-an NASDAQ tntle0 SyTOdiandR ,,., yd.... .iMUa mrtetbY namtlelnw1I5 mmme3 ro.ueva, a mm b", 'nmrn9as SevNnw JOnes In d¢vz IBM 6emnow.leneaA,at asat m nEN4 mvaa.y data n nromaee cy sz rmanoei mlotmalion and ie euzezt sommmee tlelevea All quobs limo http://bigeharts.marketwatch.com/historicaltdefault.asp?symb=pru&closeDate=04%2F 19%... 712/2013 p M&T Bank 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services Phone 888-502-4349 F ax (302)934-2955 May 24,2013 Stone LaFaver& Shekletski Attorney at Law 414 Bridge Street P.O.Boa E New Cumberland,PA 17070 Re: Estate of Mildred L. Weigle Social Security: 177-24-7377 Date of Death: April 19, 2013 Dear Sir or Madam: Per your inquiry on May 15,2013,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type ofAccount Checking Account Account Number 9838786391 Ownership(Names of) Mildred L. Weigle Opening Date 0810112005 Balance on Date ofDeath $ 6,12606 Accrued Interest $ .03 Total $ 6,126.09 2. Type of Account Safe Deposit Box Bar NumberlLocanan 019ISpringGarden Ownership(Names ofJ Mildred L. Weigle Opening Date 0911712007 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the Spring Carden at 717.240-4525. We were unable to locate any soft deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers, Representative Payee,or Trustee under a Written Agreement Sincerely, Valarie Mercer Adjustment Services Prudential Alliance Account Services Pe Prudential Company of America Philadelphia,PA 19176 V.,,v,Pjv Prudential ADDRESS SERVICE REQUESTED MILDRED WEIGLE ALLIANCE ACCOUNT 54 GARDEN PARKWAY CARLISLE PA 17013-9221 11645 Statement Closing Date: 3/31/2013 Account Number: 4351001253124 ACCOUNT INFORMATION CUSTOMER SERVICE Balance Last Statement 'nit. Balance This Statement 817,431.59 Contact Information: 817,561.01 Prudential Alliance Account Services The Prudential Insurance Company of America SUMMARY P.O. BOX 41582 Philadelphia, PA 19176 +CREDITS $129 42 - CHECKS and DEBITS $000 Internet: www,prudenbal.com ENDING BALANCE $17,561.01 Phone: 1-877-255-4262 RATE HISTORY 8:00 AM to 8:00 PM, Eastern Time, M-F Access to your Account Information is also available CURRENT INTEREST RATE 3 000% 24 hours a day 7 days a week. Please have your INTEREST CREDITED YEAR-TO-DATE $12942 Account Number(located above)available when calling Toll-Free. ACCOUNT TRANSACTIONS DATE DESCRIPTION AMOUNT BALANCE 01/31 CREDIT-INTEREST 02128 CREDIT-INTEREST $44.47 $17,476.06 03/30 CREDIT-INTEREST $40.26 $17,516.32 EFF DATE 03-31-13 $4469 $17,561.01 SEE REVERSE SIDE FOR IMPORTANT REMINDER AND UPDATED TERMS AND CONDITIONS 803-1 Pagel