HomeMy WebLinkAbout12-12-13 (2) J 1505610143
REV-1500 Ex(D2_„> ff
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO BOX.280601 INHERITANCE TAX RETURN 21 13 0443
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03 15 2013 04 24 1926
Decedent's Last Name Suffix Decedent's First Name MI
WATTS HARRIET V
(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
1. Original Return 2. Supplemental Return 3. Remainder Return(Date of Death
Prior to 12-13-82)
4. Limited Estate 4a.Future Interest Compromise F-1 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
8 Decedent Died Testate y Decedent aintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) Copy of Trust) _ P
❑ 9. Litigation Proceeds Received 10.Spousal Poveny Credit(Date of Death 11.Election to tax under Sec.9113(A)
between 12-31. land 1-1-95) (Attach Schedule e
CORRESPONDENT-.THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
WM D SCHRACK III III 717 432 9733
ROISTER OF VSMLS USE91LY
M C_
First Line of Address w e? Q
124 W HARRISBURG STREET c-,
r—
r- -'
M rvt rrT
ry
Second Line of Address � � � � r--)
C7 C�
• Cam? t;.? � =3
City or Post Office State ZIP Code a �°UATE FILED:
rn
DILLSBURG PA 17019 `� n r--
Correspondent's e-mail address: schracklaw @comcast.net
I
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.
SIGNAT F PERSON RESPONSIBLE FOR FILING RETUR DATE
uzanne V. Ritter
AD SS
I
21 Ne onsit IanV, CeMIQHM-,)1PA 17011
SIGNATURE OF P ARER T E T N R DATE
-- Wm. D.Schrack III
/d
ADDRES
_124W. Harrisburg Street, Dillsburg, PA 17019
Side 1
1505610143 1505610143
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Watts, Harriet V.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B).......................................................I..................... 2. 32 ,302 . 59
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 17 , 893 . 85
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 30 , 814 . 51
7. Inter-Vivos Transfers&Miscellaneous Nnn Probate Property
(Schedule G) u Separate Billing Requested............ 7. 186,205 . 88
8, Total Gross Assets(total Lines 1 through 7)........................................................ 8. 267 f216 . 83
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 27 , 926 . 60
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 12 ,7 7 6 .20
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 40 , 702 . 80
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 226,514 03
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. 226,514 . 03
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15. 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable
at lineal rate X .045 226,514 . 03 16. 10f193 . 13
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE.................................... 19. 10 , 193 . 13
............................................................................
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
L 1505610243 1505610243 J
Rev-1506 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Watts, Harriet V. 21-13-0443
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 PNC Bank checking account#5070090526 17,893.85
TOTAL(Also enter on Line 5, Recapitulation) 17,893.85
(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-1509 EX+(01.10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Watts, Harriet V. 21-13-0443
If an asset was made joint within one yearof the decedent's date of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Suzanne V. Ritter 21 Neponsit Lane Daughter
Camp Hill, PA 17011-7917
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE (NUMBER OR SIMILAR rIDENTIFY IDENTIFYING ER.ATTACH EEDOFOR DATE OF DEATH DECD'S DECE EN S IONTEREST
NUMBER TENANT JOINT VALUE OF ASSE INTEREST
JOINTLY-HELD REAL ESTATE.
1 A 08/09/2011 Members 1st C.D.#428332 39,252.25 50.000% 19,626.13
2 A 08/09/2011 Members 1st C.D.#428332 20,246.07 50.000% 10,123.04
3 A 08/09/2011 Members 1st Checking Account#428332 2,130.68 50.000% 1,065.34
TOTAL(Also enter on Line 6, Recapitulation) 30,814.51
(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 F(Rev.01-10)
Rev-1510 EX+(08.09)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE �+
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Watts, Harriet V. 21-13-0443
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1501 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH °k OF DECD'S EXCLUSION TAXABLE
INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Wells Fargo Advisors IRA#8641-8769 186,205.88 186,205.88
TOTAL(Also enter on Line 7, Recapitulation) 186,205.88
(If more space is needed,additional 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+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
RESIDENT EDEN TURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Watts, Harriet V. 21-13-0443
Decedent's debts must be reported on Schedule I.
ITEM
UMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 16,734.72
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attornev's Fees Wm. D. Schrack III 111 8,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant to Decedent
4. Probate Fees 388.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 2,803.38
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 27,926.60
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
Watts, Harriet V. 21-13-0443
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Funeral luncheon 700.00
2 Parthemore Funeral Home 12,217.72
i
3 Rolling Green Cemetery-monument and engraving 3,817.00
H-A 16.734.72
Other Administrative Costs
4 Cumberland County Law Journal-estate advertising 75.00
5 Miscellaneous expenses during administration(copies,faxes,etc.) 25.00
6 Register of Wills-Inheritance Tax Return filing fee 15.00
7 Register of Wills-Inventory filing fee 15.00
8 Reserve for future administrative expenses 2,500.00
9 The Patriot News-estate advertising 123.38
10 Wells Fargo-account information"processing fee" 50.00
H-137 2,803.38
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
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Watts, Harriet V. 21-13-0443
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE OF DEATH
1 Alert Pharmacy 569.95
2 Messiah Village 11,826.00
3 United Healthcare-insurance premium due 380.25
TOTAL(Also enter on Line 10, Recapitulation) 12,776.20
(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-1513 EX+(01.10) -
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Watts, Harriet V. 21-13-0443
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal Do Not List rustee s
distributions,and transfers
under Sec.9116(a)(1.2)]
Suzanne V. Ritter Daughter 226,514.03
21 Neponsit Lane
Camp Hill, PA 17011
Total 226,514.03
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
I
I
Ic:\myfi lcs\wills\I-I.trrictWattsasg)
I
rt Vill any � .eAamrnt
OF
HARRIET V. WATTS
BE IT REMEMBERED, that I, HARRIET V. WATTS, of 1102 Floribunda Lane,
-VechKnicsburg, I;pNer Allen Township, Cumberland "Ounty,'Pennsylvania* being of sound mind,
memory, and understanding, do make, publish, and declare this as and for my Last Will and
Testament, hereby revoking and making null and void any and all Wills and Testaments and writings
in the nature thereof by me at any time heretofore made.
ITEM 1: I direct that my hereinafter named Co-Executors pay all my just debts, my
funeral expenses,and the expenses of the administration of my estate. With this direction,I authorize
and empower my Co-Executors to expend for my funeral expenses and interment such amounts as
may be considered necessary and proper, without regard to any limit that may be prescribed by a
court of law.
ITEM 2: I direct my Co-Executors to pay all inheritance,estate, succession, and legacy
taxes of whatsoever nature and kind, to which my estate or the transfer of any property passing
hereunder or otherwise passing by reason of my demise, may be subject and to charge such taxes
against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or
state, on any property required to be included in my gross estate, under the provisions of any state
or federal law now in force or hereafter enacted, shall be prorated among the persons interested in
my estate to whom such property is or may be transferred or to whom any benefit accrues.
ITEM 3: All the rest, residue, and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed, including property over which I have a
E
power of appointment, I give, devise, and bequeath unto my Co-Trustees hereafter named for the
following uses and purposes:
A. I direct that all income earned by the Trust be paid to my daughter, SUZANNE V.
RITTER, presently of 103 Neponsit Lane, Camp Hill, Pennsylvania, no less
frequently than quarter-annually.
B. I authorize and direct my Co-Trustees to utilize or distribute for the benefit of my
daughter, SUZANNE V. RITTER, any amount of the principal, even if it includes
all of the principal, as my Trustees, in their sole discretion, may deem appropriate
under the circumstances.
My failure to provide for other members of my family is not an oversight, but a
decision made after much soul searching, and is not to be construed as an expression
of greater love for one member than another, but a disposition deemed appropriate
under the circumstances.
ITEM 4: On the occurrence of the death of my daughter, Suzanne V.Ritter,I direct that
all funds which remain in the Trust be distributed to my granddaughter, MEAGAN PRYOR, per
stirpes.
ITEM 5: I appoint PRUDENTIAL BACHE and my granddaughter, MEAGAN
PRYOR, as Co-Trustees of the Trust hereinbefore established, directing that they be appointed and
authorized to serve without the need to post bond.
ITEM G: I nominate, constitute, and appoint my daughter, SUZANNE V. RITTER,
Page 2
and my granddaughter, MEAGAN PRYOR, or the survivor of them, to serve as Co-Executors of
this my Last Will and Testament,directing that they not be required to post bond to assure the faithful
performance of their duties in this, or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of
, 2001 .
HARRIET V. WATTS
The preceding instrument, consisting of this and two(2) other typewritten pages, was on the
day and date thereof signed, sealed,published,and declared by the Testatrix herein named,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 subscribed our names as witnesses hereto.
OF
OF i2
Pan 3
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF YORK
We, HARRIET JV. WATTS, and
�- the Testatrix and the witnesses,
respectively,whose name 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 Testament, and that she signed willingly, and that she executed it as her free and
voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and
hearing of the Testatrix signed the Will as witnesses, and that to the best of their knowledge, the
Testatrix was at the time eighteen(18)years of age or older, of sound mind, and under no constraint
or undue influence.
HARRI TTS
SWORN TO AND SUBSCRIBED
BEFORE ME THIS //,�t DAY
O , 2001.
NOT R UBLIC
Notarial Sea! _-
Janet S,Gore,Notary Public ,
Dilisburg tioro.York County
RP,y Commission Expires Oct.25,21002}
Member, `\Np'nric,
REV-485 EX(05-04) m 48500041046
SAFE DEPOSIT
BOX INVENTORY
PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY
Social Security or Death Certificate Number Date of Death County Code Year File Number
186-30-6038 03/15/2013 21 13 0443
Decedent's Last Name Suffix First Name
ml
Watts Harriet V
®ADDRESS OF DECEDENT STREET:
1102 Florabunda Lane CITY: STATE: ZIP CODE:
EF NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOXanICSbUrg PA 17055
NAME: Wm. D. Schrack III, Esquire
STREET ADDRESS: CITY.
124 W Harrisbur St. STATE: ZIP CODE:
q Dillsburq NAM PA 17019
E,ADDRESS AND RELATIONSHIP(IF ANY)TO DECEDENT,OF PERSON(S)PRESENT AT THE BOX OPENING
a. NAME:
Suzanne V. Ritter RELATIONSHIP:
Executrix
STREET ADDRESS: CITY:
21 Ne onsit Lane STATE: ZIP CODE:
b. NAME:
Camp Hill PA 17011_
RELATIONSHIP:
STREET ADDRESS: CITY:
STATE: ZIP CODE:
c. NAME: RELATIONSHIP:
STREET ADDRESS: CITY: STATE: ZIP CODE:
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
NAME: _.
PNC Bank N.A.
STREET ADDRESS: CITY: STATE: ZIP CODE:
127 Kim Acres Drive CITY:
burg AT ZIP CO
NAME OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY
Suzanne V. Ritter 4/1/13 10:00 am
DATE OF CONTRACT TO RENT BOX NUMBER OF BOX I TITLE UNDER WHICH BOX IS REQUESTED
02/03/2000 336 Harriet V. Watts
NAME AND ADDRESS OF PERSON(S)HAVING ACCESS TO BOX
a. NAME: b. NAME:
Harriet V. Watts
STREET ADDRESS: STREET ADDRESS:•
1102 Florabunda Lane
CITY STATE: ZIP CODE: CITY: STATE: ZIP CODE:
Mechanicsburg PA 17055
NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY
Wm. D. Schrack, III, Attorney for Executrix
WAS A WILL IN THE BOX? ❑ YES ® NO If yes, a. Date of will:
b. Name and address of personal representative,if named In the will
NAME:
_Removed at time of Will search on April 1, 2013
STREET ADDRESS: CITY: STATE: ZIP CODE:
c. Name and address of attorney,if any
NAME:
STREET ADDRESS: CITY: STATE: ZIP CODE:
L 48500041046 48500041046 J
r
REV-1,85 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 an death,etc.
(4) Bonds: Designate by name,amount,serial number,or other designation.(Bearer Bonds)
(5) Bank and Savings and Loan Passbooks:State name of depositor,number of book,last date appearing in book,name of bank
and branch,and balance.
(6) Jewelry,Coins,Stamps,Manuscripts,etc:List and describe as fully as possible.
(7) Deeds, Mortgages,Current Insurance Policies or other evidences of indebtedness:List and describe as fully as possible.
(8) All other contents.
(9) Return completed form to: DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT.280601
HARRISBURG,PA 17128-0601
ITEM
NO ITEM DESCRIPTION
Nothing of economic value except for a Whale Life Policy underwritten by the National Life and Accident Insurance Company
identified as policy number 2045162 on the life of Harriet V.Watts,face amount of police$1,832.00
i
I
I
I
�I
I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF
CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY:
SIGNATURE SIGNATURE
I
PRINT NAME PRINT NAME AND CHECK APPROPRIATE BOX BELOW:
Wm, D. Schrack, III
PRINT TITLE DATE CHECK APPROPRIATE BOX:
Counsel for Executrix 04/3Q/2Q13 E]Executor(trlx) r-1 Administrator(trix)
Estate Representative ❑Joint owner of safe deposit box
NOTE:Attach additional 87="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 information agreements
with Federal and local taxing authorities.The state law prohibits the Commonwealth's personnel from disclosing confidential tax information except for Official purposes.
William D. Schrack 11, Esquire
Page Two
May 17, 2013
Harriet V. Watts
Individual Account#8641-8785
DOD
Quantity Description Symbol Price DOD Value
CASH 10374.82
1464.005 JPMORGAN SHORT OSTCX 11.0298 16,147.79
287.003 PRUDENTIAL JENNISON PBQAX 20.1390 5,779.98
GRAND TOTAL 32302.59
rriet V. Watts
IRA count#8641-8769
DOD
Quantity cription Symbol Price DOD alue
CAS 0.00
285.704 ARBITRA FD ARBNX 12. 3639.87
251.311 BLACKROCK II BIICX 1.13 2797.09
744.566 BLACKROCK GLO ALA,,,LLOC MALOX 20.77 15464.64
893.638 UNIFIED SERI ESTRUST� BULLL�L. 17.88 15978.25
289.781 CALAMOS INVTTR NEW �C,f�`IfNix 12.78 3703.40
279.630 COMPASS EMP FDS TR CAIAX 9.92 2773.93
303.462 FIRST EAGLE FDS INC SNP 51.36 15585.81
748.777 IVY FDS INC IVAE 27.28 20426.64
1150.566 LOOMIS SAYLES Ff) II• LSWWX 17.88 20572.12
1435.520 'LOOMIS SA,Y � NEZYX .87 22781.70
1944.155 PIMCO U..eONSTRAINED BD PFIUX 11. 22416.11
247.158 PIM PAUIX 11.06 2733.57
1138.358 CE FUND RGVIX 13.22 15049.09
1445.,,53 TEMPLETON FUNDS TGBAX 13.44 9427.95
302?'S12 NATIXIS FDS TR II ASFYX 9.44 2 5.71
GRAND TOTAL 186205.
The above summary of prices/quotes/statistics has been obtained from sources believed to be reliable, but is not
necessarily complete and cannot be guaranteed. Prices may not reflect the value at which securities could be
sold. This summary is for information purposes only. Past results do not indicate future performance. This is not
a substitute for Verification of Deposit(or similar form)or the official statement of account holdings at the firm.
,.N Sri Oi r FILAR A.!-,T P '
Ma Y, 6. 2013 2: 13PM PNC Bank No. 4014 P. 1
May 6, 2013
W 11'am D Schrack III Esq.
124 VI Haari.sburg St
Dillsburg, PA 17019-1268
RE: Harriet'%Watts
SSN:
DOD: 03-15-2013
Dear.Mr. Sclu.-ack:
In response to your request for Date of Death (DOD)balances for the customer noted above,our
records show the following:
Checking Account
Account# 5070090526 Established: 04-09-1982
HARRIET V WATTS
DOD balance: S 17,893.83 +0.02 accrued interest
Interest paid 01-01-2013 thru 03-15-2013 $ 0.62 YTD
Please note t1-xat this office provides date of death balances for deposit accounts(U1 As,CDs, Checking and
Savings). *We do not process any financial transactions or provide statements. If you need:assistance with
any of these items,please can 1-888-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Sercrices Center
PNC Baa,,N.A.
Member FDIC
This message is intended.for the use of the individual or enriry ro whicl, it is addressed and may
contain information rhat is privileged, confidential and exempt ftom disclosure under gvplicable lcnv.
If the reader of this message is not the inrended recipienr or the employee or agent responsible for
delivering this message to the intended recipient,you are hereby notified tlwt any dissemination,
C.IiSt)'IbZitiOn or GOpyir2g Of this GOrrTMUllications is strictly prohibited lj yoid have tviceh ed this
commamication in error,please note me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this faxed document.
Pkge 1 of 1
BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax ' -'r pennsytvania
PO BOX 280601 ''
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
REV-3543 EX DocE%EL (08-12)
And Taxpayer Response FILE NO.2170
ACN 13117166
DATE 04-01-2013
Type of Account
Estate of HARRIET V WATTS Savings
SSN Checking
Date of Death 03-15-2013 Trust
SUZANNE V RITTER County CUMBERLAND X Certificate
21 NEPONSIT LN
CAMP HILL PA 17011-7917
MEMBERS 1ST Fcu provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.428332 Remit Payment and Forms to:
Date Established 08-09-2011 REGISTER OF WILLS
Account Balance $39,252.25 1 COURTHOUSE SQUARE
Percent Taxable X 50
CARLISLE PA 17013
Amount Subject to Tax $ 19,626.13
Tax Rate X 0.045
Potential Tax Due $883.18 NOTE`:. If tax payments are made within three months of the
decedent's date of death,deduct a 5 percent discount on the tax
With 5% Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART I Step 1 : Please check the appropriate boxes below.
1
A FJ No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
B The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C The tax rate is incorrect. F-1 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased.
(Select correct tax rate at
right,and complete Part F—] 12% 1 am a sibling of the deceased.
3 on reverse.)
15% All other relationships (including none).
D Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on re/verse. Don eck any other boxes.
Jc
Please sign and date the back of the form when finished.
f
BUREAU OF INDIVTDUAI TAXES zn i'e
PO BOX 280601 Pennsylvania Inheritance Tax y' pennsy varna
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
And Taxpayer Response REV-1543 EX D..EXEC 106.12)
FILE NO.2170
ACN 13117165
DATE 04-01-2013
Type of Account
Estate of HARRIET V WATTS Savings
SSN Checking
Date of Death 03-15-2013 Trust
SUZANNE V RITTER County CUMBERLAND X Certificate
21 NEPONSIT LN
CAMP HILL PA 17011-7917
MEMBERS 1sT Fcu provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.428332 Remit Payment and Forms to:
Date Established 08-09-2011 REGISTER OF WILLS
Account Balance $20,246.07 1 COURTHOUSE SQUARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $ 10,123.04
Tax Rate X 0.045
Potential Tax Due $455.54 NOTE*: If tax payments are made within three months of the
With 5%Discount Tax x 0.95 decedent's date of death,deduct a 5 percent discount on the tax
( ) $(see NOTE*) due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART
1 Ste 1 : Please check the appropriate boxes below.
AF]No tax is due. I am the spouse of the deceased or 1 am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
B The information is The above information is correct, no deductions are being taken, and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C El The tax rate is incorrect. F—] 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased.
(Select correct tax rate at
right,and complete Part 012% 1 am a sibling of the deceased.
3 on reverse.)
15% All other relationships(including none).
DO Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E F—]Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. P d to Step 2 on reverse. Do not check any other boxes.
roce C_ h�
Please sign and date the back of the form when finished.
py
BUREAU OF INDIVIDUAL TAXES F';):; }�i
PO BOX 280601
Pennsylvania Inheritance Tax t'== }; pennsylvania
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
And Taxpayer Response REV-1543 EX DOCEXEC (08.12)
FILE NO.2170
ACN 13117164
DATE 04-01-2013
Type of Account
Estate of HARRIET V WATTS Savings
SSN X Checking
Date of Death 03-15-2013 Trust
?I NEPONSIT LN SUZANNE V TITTER County CUMBERLAND Certificate
2EP
CAMP HILL PA 17011-7917
MEM9ERS 1ST FcU provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.428332 Remit Payment and Forms to:
Date Established 08-09-2011 REGISTER OF WILLS
Account Balance $2,130.68 1 COURTHOUSE SQUARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $ 1,065.34
Tax Rate X 0.045
Potential Tax Due $47.94 NOTE`:.If tax payments are made within three months of the
With 5%Discount(Tax x 0.95) $(see NOTE`) decedent's date of death,deduct a 5 percent discount on the tax
due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
1 ..
AF-]No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
B The information is The above information is correct, no deductions are being taken, and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C The tax rate is incorrect. 4.5% I am a lineal beneficiary(parent,child, grandchild,etc.)of the deceased.
(Select correct tax rate at
right,and complete Part F—] 12% 1 am a sibling of the deceased.
3 on reverse.)
15% All other relationships(including none).
p F-]Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E F�Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not ch k any other boxes.
Sch if Q& -?�
Please sign and date the back of the form when finished.
William D. Schrack I1, Esquire
Page Two
May 17, 201")
Harn atts
Individual Accou 41-8785
DEV
Quantity Description of Price DOD Value
CASH 10374.82
1464.005 JPMORGA T OSTCX 16,147.79
287.003 P NTIAL DENNISON PBQAX 20.1390 5,779.98
GRAND TOTAL 32 b9_ ,.
Harriet V. Watts
IRA Account#8641-8769
DOD
Quantity Description Symbol Price DOD Value
CASH 0.00
285.704 ARBITRAGE FD ARBNX' 12.74 3639.87
251.311 BLACKROCK FDS II BIICX 11.13 2797.09
744.566 BLACKROCK GLOBAL ALLOC MALOX 20.77 15464.64
893.638 UNIFIED SERIES TRUST BULLX 17.88 15978.25
289.781 CALAMOS INVTTR NEW CMNIX 12.78 3703.40
279.630 COMPASS EMP FDS TR CAIAX 9.92 2773.93
303.462 FIRST EAGLE FDS INC SGIIX 51.36 15585.81
748.777 IVY FDS INC IVAEX 27.28 20426.64
1150.566 LOOMIS SAYLES FDS II LSWWX 17.88 20572.12
1435.520 LOOMIS SAYLES NEZYX 15.87 22781.70
1944.155 PIMCO UNCONSTRAINED BD PFIUX 11.53 22416.11
247.158 PIMCO PAUIX 11.06 2733.57
1138.358 ROYCE FUND RGVIX 13.22 15049.09
1445.532 TEMPLETON FUNDS TGBAX 13.44 19427.95
302.512 NATIXIS FDS TR 11 ASFYX 9.44 2855.71
GRAND TOTAL 186205.88
The above summary of prices/quotes/statistics has been obtained from sources believed to be reliable, but is not
necessarily complete and cannot be guaranteed. Prices may not reflect the value at which securities could be
sold. This summary is for information purposes only. Past results do not indicate future performance. This is not
a substitute for Verification of Deposit(or similar form)or the official statement of account holdings at the firm.
lveal T
'�ic???hc r 1-1\IZfe'ti1i'��