HomeMy WebLinkAbout01-31-14 � 15�5610140
REV-1500 �" `02_,,,`F'>
PA Depa�tment of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 3 0 6 0 9
Harrisbu�,PA 17�28-oso� RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Sociai Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 5 1 � 2 0 1 3 0 6 1 8 1 9 1 6
Decedent's Last Name Suffix Decedent's First Name MI
A L T L A N D L 0 U I S E D
(If Applicabte)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x 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.Remainde�Return(Date of Death
Prior to 12-13-82)
� 4.Limited Estate � 4a.Future Interest Comp�omise(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.Ele�tion 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 T0:
Name Daytime Telephone Number
D A V I D H S T 0 N E , E S Q U I R E ? 1 7 �7 ? "4 .� 4 3 5
'� ,� �a
REG� �F WILLS�E ONtTI ,
r�
� A r„ � EA �7
First Line of Add�ess � � � � � �
t-�
4 1 4 B R I D G E S T R E E T a �,; � �, �
c� �
Second Line of Address �-�, � ""� � ,� -�
. � {-.._, ',,� .�,.
-.� ~-�{ �—.. P'^- �
City or Post O�ce State ZIP Code
�' DATE F �
"�
N E W C U M 8 E R L A N D P A 1 7 0 ? 0
Correspondent's e-mail addresa: D S T 0 N E�S T 0 N E L A W• N E T
Under penalties of pery'ury,I declare that I have examined this retum,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 O�F yPERSON R S ONSIBLE FOR FILING RETURN DATE
� � f 1f,� O/�¢
ADDRESS
200 GREENWICH D V MECHANICSBURG PA 17050
SIGNATURE O T R PRESENTATIVE DATE
_Z�
ADDRESS
414 BR REET\ NEW CUMBERLAND PA 17070
PLEASE USE ORIGINAL FORM ONLY
Side 1 �
� 1505610140 15�5610140 �
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LOUISE D.ALTLAND 21 13 0609
Decedent's Name Page 6 ' File Number
Correspondents
Name Daytime Telephone Number
D A V I D H S T 0 N E
First line of address
4 1 4 B R I D G E S T R E E T .
Second line of address
City or Post Office State ZIP Code
N E W C U M B E R L A N D P A 1 ? 0 ? 0 -
Correspondent's e-mail addr
Under penal6es of pe' th t I e examined this retum,induding acoompanying schedules and statements,and to the best of my knowledge and bel'�ef,
it is true,co plete, preparer other than the personal representaWe�s based on all information of which preparer has any knowledge.
SIG UR F PERSO OR FILING RETURN /_��_ �
ADDRES � � � � l�� C�e./� . �� I 7U7�
fi 1�/
J 150561024�
REV-1500 EX(FI)
RECAPITULATION
1. Real Estate(Schedule A) . . . . ... .... . . .. . . .... . ..... . . .. . . .. . .. . ... . 1. •
2. Stocks and Bonds(Schedule B) . .. .. . .. .... . . .. . ... .... . .. .. . . . . .. . . . 2. 4 1 6 1 4 7 . 4 5
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. 3 1 3 8 7 8 . 5 5
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . .. .. . 6. •
7. Inter-Vivos Transfe�s 8 Miscellaneous N -Probate Property
(Schedule G) � Separate Billing Requested . . . . . . . 7. 2 2 0 5 1 � . 3 �
S. Total Gross Assets(total Lines 1 through 7) . . . . . . . .. .. .. .. . . . .. .. .. .. . 8. 9 5 0 5 3 6 . 3 7
9. Funeral Expenses and Administrative Costs(Schedule H) .. . . . . . .. . . . . . . . . . 9• 8 2 4 2 6 . 6 5
10. Debts of Decedent,Mort a e Liabilities,and Liens Schedule I 10. 2 � 3 8 6 . 8 4
9 9 � ) . . . . . . .. . . . . .
11. Total Deductions(total Lines 9 and 10) . ... . . . . . . . . .. . . . .. . .. . . .. . . . . . 11. 1 0 2 8 1 3 . 4 9
12. Net Value of Estate(Line 8 minus Line 11) . . .... .. . . ... . . . . .. .. . . .. . .. 12. 8 4 7 7 2 2 . 8 8
13. Charitable and Governmental Bequests/Sec 9113 Trusts fo�which
an election to tax has not been made{Schedule J) . . . . . . . . . . . .. . . . . .. . . . 13. 1 1 0 0 0 . 0 0
14. Net Value Subjeet to Tax(Line 12 minus Line 13) . . . . .. ... . . .. . . . . .. . .. 14. 8 3 6 7 2 2 . 8 8
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.0 0 . 0 0 �g, 0 . 0 0
17. Amount of Line 14 taxable
at sibling rate x.�2 1 9 5 4 0 4 . 1 7 ��. 2 3 4 4 8 . 5 0
18. Amount of Line 14 taxable
at collateral rate X.15 6 4 1 3 1 8 . 7 1 �8. 9 6 1 9 7 . 8 1
19. TAX DUE .. . .. . . ...... . . .. ..... . . ... .. . . . . . . . . .. . . . . . . . . . . . . ... 19. 1 1 9 6 4 6 • 3 1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� ],505610240 ],505610240 �
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 21 13 �609
DECEDENTS NAME
LOUISE D • ALTLAND
STREET ADDRESS
5225 WILSON LANE
��n STATE ZIP
MECHANICSBURG PA 17055—
Tax Payments and Credits:
1• Tax Due(Page 2,l.ine 19) (1) 119,6 4 6 •31
2. Credits/Payments
A.Prior Payments 13 8,9 9 3 •0 0
B.Discount 5,9 8 2 •3 2
Total Credits(A+B) (2) 14 4,9?5•3 2
3. Interest
(3) 0 •0�
4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Une 20 to request a refund. (4) 2 5,3 2 9•01
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0 •0 0
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 ...................................................................... ❑ 0
b. retain the right to designate who shall use the property transferred or its income ............................... ❑ �
c. retain a reversionary interest ..................................................................................................... ❑ �
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ �
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ �
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ 0
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 A80VE 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)(i)].
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)J.The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax retum 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)J.
• 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(�2 P.s.§9116(a)(1)J.
• 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 & BON DS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
LOUISE D • ALTLAND 21 13 0609
All property jointty owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
� 12173•163 shares Ameriprise Financial Mutual Fund 173,954 • SD
#02�148108325D02 � $14 • 290 each
2 2413•162 shares Ameriprise Financial-Mutual Fund 23,914 . 44
#010137572789�02 � $9 .910 each
3 951• 401 shares Conte Wealth Adv Acct #L NQ Pimco 10,722 • 29
Total Ret A � $11•270 each
4 Conte Wealth Pershing-Abbey Natl Treas Serv Note 10,776 • 44
�10,000 a 4i Mat 4-27-16
5 Conte Wealth Pershing-Genworth Finl Inc Note 14,994 •98
�14,000 a 5•75i Mat 6-15-2014
6 Conte Wealth Pershing-HSBC Bank USA NA CD Flt 9,711 • 00
�10,000 Mat 9-30-2016
? Conte Wealth Pershing-HSBC Bank USA NA CD Var 5,004 • 50
�5,00� Mat 5-31-201?
8 Conte Wealth Pershing-Merrill Lynch Acct 17,142 • 02
9 Conte Wealth Pershing-Morgan Stanley Global 10,653 •03
Medium Term Note Series F Fixed Rate 4 .2i Mat 11-20-14
10 Conte Wealth Pershing-TeleCom Italia Cap Gtd Sr 15,712 • 50
Note � 4 . 95i Mat 9-30-14
11 168 shares Prudential Financial Inc stock � $65•165 each 10,947•72
12 Wells Fargo Adv-$11000 Bond FHR 4�68 EE 3•5i 10,918 •6�
Bid at 99 •26, Princ $10,918•60, Int $9 •63
13 � Wells Fargo Adv-$11000 Bond FHR 4068 EE 3-5i - Accr 9 •63
Int
14 Wells Fargo Adv-$1200� Bond BFHR 4027 EE 3• 5i 11,563 • 56
Bid at 96 .363, Princ $11,563•56, Int �29 •1?
15 Wells Fargo Adv-$12000 Bond BFHR 402? EE 3• 5i - Accr 29 •1?
Int
16 Wells Fargo Adv-$12000 Bond FHR 3835 EE 4 • 5i 12,111•00
Bid at 100 •925, Princ $12,111•00, Int $13 • 50
TOTAL(Also enter on Line 2,Recapitulation) t 416,14 7• 4 5
If more space is needed,insert additional sheets of the same size
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LOUISE D.ALTLAND 21 13 0609
Decedent's Name Page 1 File Number
Schedule B -Stocks �Bonds
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1? Wells Fargo Adv-�12000 Bond FHR 3835 EE 4 • 5i - Accr 13• 50
Int
18 Wells Fargo Adv-$14000 Bond FHR 4068 BB 3i 13,592•60
Bid of 97•090, Princ $13,592 •60, Int $10•50
19 Wells Fargo Adv-�14000 Bond FHR 4068 88 3i - Accr 10 • 50
Int
20 Wells Fargo Adv-$140DD Bond FNR 12-141 CP 2 •5i 12,9?? •68
Bid of 100• 081 and factor of • 92622692 Princ $12,97?•68�
Int �14 •58
21 Wells Fargo Adv-�15000 Bond FHR 3795 DD 4 •Si 15,389.70
Bid at 102 • 598, Princ $15,389• 70, Int $],6•88
22 Wells Fargo Adv-�15000 Bond FHR 3795 DD 4 • 5i - Accr 16 • 88
Int
23 Wells Fargo Adv-$6�00 8ond BFHR 3995 YY 3•5i 5,989• 56
Bid at 99•826, Princ $5,989 •56, Int �14 • 58
24 Wells Fargo Adv-$60�0 Bond BFHR 3995 YY 3•5i - Accr 14 • 58
Int
25 Wells Fargo Adv-$6000 Bond FHR 3??2 AA 4 • 5i 6,161•88
Bid at 102 • 698 Princ $6,161 •88 , Int $6 •75
26 Wells Fargo Adv-$6000 Bond FHR 3772 AA 4 • Si - Accr 6•75
Int
27 Wells Fargo Adv-$8D00 Bond FNR 12-51 HJ 3 •5i 4,549•34
Bid of 99•724 Factor of • 57024169 Princ $4,549 •34,
Int �?•00
28 Wells Fargo Adv-$8000 8ond FNR 12-51 HJ 3•5i - 7•00
Accrued Int
28 8049•172 shares Wells Fargo Adv-Franklin Income Fd 19,237•52
C1 C � $2•390 each
29 Wells Fargo Adv-$1400� Bond FHR 12-141 CP 2 • 5i - 14 • 58
Accrued Int
SUBTOTAL SCHEDULE B ?7,9 8 2•O 7
GRAND TOTAL SCHEDULE B � 416,147.45
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERiTANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
LOUISE D • ALTLAND 21 13 0609
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointiy owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
� Ameriprise Financial �ert �00806967055?2001 3,151 •93
2 Asbury Communities-refund from Bethany Village 148 •00
3 Boscovs-credit card refund 55•5?
4 Commonwealth of PA-refund 10•00
5 Conte Wealth Pershing-Brokerage Money Market Acct 12,401•61
6 Cordier Auctions-net proceeds of personal property 889•08
sold at various times
7 Hartford Fire Ins �o-refund on homeowners ins 66 • 00
8 M8T Bank-Cert of Deposit #31003908145898 10,737.25
Princ �],0,73?•25, Int $2•68
9 M8T Bank-Cert of Deposit #31003908145898 - Accrued 2 •68
Int
],0 M8T Bank-Cert of Deposit #31003913709613 50,000• 00
Princ �50,000 •0�, Int $5• 89
11, M&T Bank-Cert of Deposit #31003913709613 - Accrued 5• 89
Int
12 M8T Bank-Cert of Deposit #31003913914056 29,829• 82
Princ �29,829•82, Int �2• 53
13 M8T Bank-Cert of Deposit #31003913914056 - Accrued 2 • 53
Int
14 M�T Bank-Checking Acct #10756183 64,042 •68
Princ $64,042 •68, Int $•24
15 M&T Bank-Checking Acct #10756],83 - Accrued Interest 0•24
16 Members 1st FCU-Cert of Deposit #162981-44 - Accr 3• 9?
Int
TOTAL(Also enter on Line 5,Recapitulation) S 313,8?8•5 5
If more space is needed,use additional sheets of paper of the same size.
Continuation of REV-1500 inheritance Tax Return Resident Decedent
LOUISE D.ALTLAND 21 13 0609
Decedent's Name Page 2 File Numbe�
Schedule E - Cash, Bank Deposits,� Misc. Personai Property
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
17 Members 1st fCU-Cert of Deposit #162981-40 34,045• 53
Princ $34,045•53, Int $5• 46 (rollover from previous
cert)
18 Members 1st FCU-Cert of Deposit #162981-40 - Accr 5. 46
Int
19 Members 1st FCU-Cert of Deposit #162981-43 16,288•62
Princ �1,6,288•62, Int �$2•01 (rollover from previous
cert)
20 Members 1st FCU-Cert of Deposit #162981-43 - Accr 2 •01
Int
21 Members 1st FCU-Cert of Deposit #162981-44 21,491•22
Princ �21,491•22, Int �3•9? (rollover from previous
cert)
22 Members 1st FCU-�hecking Acct #162981-11 5,643• 50
Princ �5,643•50, Int $•07
23 Members 1st FCU-Checking Acct �162981-1,1 - Accrued 0•07
Int
24 Members 1st FCU-Savings Actt #162981-00 40•13
25 Metro Bank-Cert of Deposit #802433 11,240 •54
Princ �11,240• 54, Int �•84
Formerly Commerce Bank as mentioned on bank inventory
26 Metro Bank-Cert of Deposit #802433 - Accrued Int 0 •84
27 Sovereign Bank-Cert of Deposit #1685392803 42,412•59
Princ �42,412•59, Int �],•39
28 Sovereign Bank-Cert of Deposit #1685392803 - Accr 1-39
Int
29 Sovereign Bank-MM Acct #1684070015 10�545•68
Princ �10,545• 68, Int $1•65
30 Sovereign Bank-MM Acct #16840?0015 - Accrued Int 1•65
31 The Hartford Wealth-annuity payment received 698•18
SUBTOTAL SCHEDULE E 14 2,41?•41
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LOUISE D.ALTLAND 21 13 0609
DecedenYs Name Page 3 File Number
Schedule E -Cash, Bank Deposits,&Misc. Personal Property
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
32 Wells Fargo Adv-Money Market ],13•89
*NOTE� The specific bequests mentioned in Item I A,
B, g C were given to the individuals prior to death
SUBTOTAL SCHEDULE E 113•8 9
GRAND TOTAL SCHEDULE E S 313,878.55
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT�ECEDENT
ESTATE OF FILE NUMBER
LOUISE D • ALTLAND 21 13 0609
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.ATfACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST nFa�uc�.� VALUE
�. Conte Wealth Adv #L NQ Prudential- 1?6,353•48 100• 00 76,353•48
#E�48154 Annuity (formerly America
Skandia) Robert Willig, Jr as benef
2 Ohio Nat Fin Serv-Annuity #E1244267 2,537•?1 100• 00 2,537•71
�51 • 79 per month times 49 paymts =
�2,537.71 Robert 8• Willig Jr benef
3 Santander Inv Serv-Western Natl ACL 14,693•83100• OD 14 ,693•83
SPDA IV P1usFixed Annuity #17,BX202732
w/ Harold Altland as benef
4 The Hartford Wealth Managemt-Annuity 26,925.35100• 00 26,925• 35
#710950561 Robert Willig Jr as benef
*NOTE : The two accounts mentioned
in Item V were combined into one
account as stated in #1 above
TOTAL Also enter on Line 7,Recapitulationj s 2 2 0,510•3 7
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
LOUISE D • ALTLAND 21 13 0609
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
� Stone & Murray Funeral Home-funeral expenses 5,603•12
Robert Willig-Reimb for grave at Rolling Green Cem 1,495•00
Robert Willig-Reimb for luncheon after funeral 150 •23
Stead Fast Chapter �479-services at funeral 1D0 •00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) A r t h u r R D a y, I I I 3 0,9 0 0 • 0 0
StreetAddress 200 Greenwich Drive
c;�y Mechanicsburg S�te PA ZiP 17050
Year(s)Commission Paid: 2 014
2. AttomeyFees: Stone �aFaver & Shekletski 37,01D •00
3, Family Exemption:(If decedenCs address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
, Relationship of Claimant to Decedent
4. pro��F�: See #12 below
5 Accountant Fees:
6. Tax Retum Preparer Fees:
� Citizens Bank-service charge 2 •00
2 �itizens Bank-service charge 2 • 00
3 Citizens Bank-service charge 2 • 00
4 Citizens Bank-service charge 2 • 00
5 Citizens Bank-service charge 2 • 00
6 Citizens Bank-service charge 2 • 00
? Computershare-commission on sale of stock 24 • 44
8 United States Treasury-2012 income taxes due 1,658 • ?9
9 Checks written by decedent but not cleared 3,510• 94
10 Cumberland Law Journal-adv grant of letters ?5•00
11 Sovereign Bank-dod balance fee 20 •00
12 Stone LaFaver & Shekletski-Reimb for probate costs 778• 50
TOTAL(Also enter on Line 9,Recapitulation) S 8 2,4 2 6• 6 5
If more space is needed,use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LOUISE D.ALTLAND 21 13 0609
Decedent's Name Page 4 File Number
Schedule H -Funeral Expenses�Administrative Costs-B7.
ITEM
NUMBER DESCRIPTION AMOUNT
13 Stone LaFaver 8 Shekletski-Reimb for bank fee 20•00
14 Stone LaFaver S Shekletski-Reimb to file ITR & Inv 30•00
15 The Sentinel-adv grant of letters 189• 54
16 The Hartford-refund on payment 349•09
17 Reserve for closing expenses 500•00
SUBTOTAL SCHEDULE H-B7 1,0 8 8 •6 3
REV-1512 EX+(12-12)
pennsyivania SCHEDULE 1
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCE TAX RETURN MORTGAGE LIABILITIES& LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
LOUISE D • ALTLAND 21 13 0609
Report debta incurred by the decedent prior to death that remained unpaid at the date of death,including unreimburaed medlcal expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
� OmniCare-King of Prussia - debt of decedent 1,868 •65
2 Bethany Village-final bill 18,370 • 19
3 Bethany Village-final bill 148 •00
TOTAL(Also enter on Line 10,Recapitulation) 5 2 0,3 8 6•8 4
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:
LOUISE D • ALTLAND 21 13 0609
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Truatee(a) OF ESTATE
I. TAXABLE DISTRIBUTIONS [Indude outrg' ht spousal distributions and transfers under
Sec.91'�6(a)(1,2j.)
�. ARTHUR R DAY III 1/3 residue Collateral 185,404 •1?
200 GREENWICH DRIVE
MECHANICSBURG PA 17050-
2 DONALD A DAY Collateral 10,000•00
10612 SOURWOOD COURT
LAUREK MD 20723-
3 DORIS E MYERS Collateral 20,000 •OD
41? BOYER DRIVE
EAST BERLIN PA 17316-
4 MARJORIE D HAMLETT �ollateral 20,000• DO
914 CABRIOLE COURT
EUGENE OR 97401-
5 ROBERT P WILLIG SR brother-in-law Sibling 10,000 �00
580 BRIGHTON PLACE
MECHANICSBURG PA 17055-
6 NERISSA D WILLIG 1/3 residue Sibling 185,4D4 . 17
580 BRIGHTON PLACE
MECHANICSBURG PA 17055-
? JOYCE E ALTLAND 1/3 residue Collateral 185,404 •17
1320 VILLAGE DRIVE
SPRING GROVE PA 1?362- .
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
�. SUSQUEHANNA CONFERENCE FOR THE UNITED METH CHURCH 10,000•00
303 MULBERRY DRIVE SUITE 100
MECHANICSBURG PA 1705�-3141
2 HUMANE SOCIETY OF HARRISBURG AREA INC 1,0�0 •00
� 7790 GRAYSON ROAD
HARRISBURG PA 17111-
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF RART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 11,0 O O.O O
If more space is needed,use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
LOUiSE D.ALTLAND 21 13 0609
Decedent's Name Page 5 File Number
Schedule J - Beneficiaries-1
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 pndude out n'ght s usal distributions and transfers under
Sec.91 i6(a�1.2).J
8 HAROLD ALTLAND Sch G• #3 Collateral 14,693•83
1320 VILLAGE DRIVE
SPRING GROVE, PA 17362 _
9 ROBERT P WILLIG JR Sch G� #1,2, 8 4 Collateral 205,816•54
..��.....,,....�......�. ... .,..a...a..r..�..a
� „�,�,.� ATTORNEYS AT LAW
.�. . �---a
�.
,. 414 BRIOGE STREET .
NEW CUDtHERLAlYD Pl 1TOT0
LA3T WILI� AND TE3TAMENT
OF
LOUISL D. ALTLAND
I, LOUISE D. ALTLAND, of Lower Allen Township, Cumberland County,
� Pennsylvania, declare this to be my last will and revoke any will
previously made by me.
i�'I'�;M I : I make the fo�lowing specific bequests:
I
�
A. My sterling silver flatwar� and my 12 place china dinr,er
set to WANDA JO BOWMAN.
B. My automobile to my sister, NERISSA D. WILLIG. �
C. My diamond ring to JOYCE E. ALTLAND.
ITEM II : I bequeath to the following named persons the amaunt set
opposite his or her name provided such named pers.on survives me. Shou•ld I
an of the followin named
Y g persons fail to survive me, the bequest to I
the �eceased person shall lapse and shall be distributed as part of my
residuary estate. �
i
A. DONALD A. DAY $10, 000 . 00 � �
�
B. DORIS M. MYERS $20, 000. 00
C. MARJORIE A. HAMLET $20, 000. 00
D. ROBERT P. WILLIG, SR. $10, 000. 00
ITEM III : I bequeath the sum of 510, 000. 00 to ST. PAUL' S UNITED
METHODIST CHURCH of Front Street, Wormleysburg, Pennsylvania, to be used
as the church desires .
Page 1 �f 3
,._ •
.
� .
ITEti9 IV: I bequeath the sum of $1, 000. 00 to the HUMANE SOCIETY
OF HARRI SBURG AF.EA, INC.
ITEM V: I beque�th my America Skand�a Account N�. E0481542 and my
Prudential Annuity Policy Number EOfl1542, ta m.y neph2w, ROBERT P.
WILLIG, JR. , subject *o any Pennsylvar�ia lnheritance Taxes �due there�n.
I h�ve nar�Ed ROBERT P. WILLIG, JR. , as �he ber�efi�iaxy of �hese
�c:coun�s . The purpos� �f thi.5 bequest is t� cor�f�rm that designation.
ITEM VI : I devise and beq�seath all the rest, residue and remainder
of my Fstate, of every nat�re and wherever situate, in equal shares to
the f.o�ilowi.:�g then living r,am�d persc►r,s and entities:
A. ARTHUR R. DAY�, III �
B. NERISSA D. WILLIG
C. JOYCE E. ALTLAND
ITEM VII : I appoint ARTHUR R. DAY, III, 3nd DAVIU H. STONE,
�
Co-Executors of this my last will .
ITEM VIII : No fiduciary actin� hereunder shall be requirPd to post
bond or Pnter security for the faithful perf�rmance of his or her duties �
in any -jLr�_sdiction. '
i
IN WITNESS WHEREOF, I, LOUISE D. ALTL.�ND, have hereunto set my hand i
t
2010 . `
and sea�� this � day of �` < � .�: ► I.
I
i
" . i f � ' . � !
� ` �� �• , � �
� � � ` � ;
LO�UISE D. ALTLAND I
�
�
I
�
�
i
,
;
Page 2 of 3 ;
{
i
�
.- . •
+ . " ..
SIGNED, SEALED, PUBLISHED ar.d DECLARED by LOUTSE D. ALTLANG, rhe
Testatrix abovP named, as and for her Last Will and Testament, and ir�
the presence of us, who at her request, ir� her presence and in tr�e
presenc� ��f each ,�other�, have subscribed our names as witnesses .
�
�`� ,,
�
�� '��� � - � �
�� � � i
� ����'� ; � k1 1-..,, _ � I , ,
r + �.�
t ,�_�.� .:. , ,-
Witness Address
.
- - ,
. ,
,-�
. �
/ 7
n I ���.
��
.,i � .:�- . � . ' `I .'� � '�./ i�•-/, � �''� -�
C� i
Witness Address
Page 3 `�f 3
J
�
�
J 4850D041046
REV-485 EX(05-04)
SAFE DEPOSIT
BOX INVENTORY
PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY
Social Security or Death Cerdficate Number Date of Death County Code Year File Number
183-12-3346 05/10/2013 21 13 0609
DecedenYs Last Name Suffix First Name MI
Attland Louise D
�ADORE8S OF DECEDENT STREET: CITY: STATE: ZIP CODE:
5225 Wilson Lane Mechanicsbur PA 17055
NAME AND ADDRESS OF PERSON REQUESTING THE OPENIN(i OF THE SAFE DEPOSIT BOX
NAME:AI"tFlll�R. Day, III �
STREET ADDRESS: CITY: STATE: ZIP CODE:
200 Greenwich Drive Mechanicsbur PA 17050
� NAME�ADORESS ANO RELATIONSHIP(IF ANY)TO DECEDENT,QF PERSON(S)PRESENT AT THE BOX OPENINti
s. NAME: RELATIONSHIP:
David H. Stone, Esquire attorney for estate/caexecutor of estate
STREET ADORESS: CITY: STATE: ZIP CODE;
414 Bridge Street New Cumberland PA 17070
b. NAME: RELATIONSHIP:
Arthur R. Day, Iil co-executor of estate
STREET ADDRES3: CITY: STATE: ZIP CODE:
200 Greenwich Drive Mechanicsburq PA 17050
c. NAME: RELATIONSHIP:
STREET ADDRESS: CITY: STATE: ZIP CODE:
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS�OCATED
NAME:
M&T Bank
STREET ADDRES3: CITY: STATE: 21P CODE:
5219 Sim on Fe Road Mechanicsbur PA 17050
NAME OF PERSON MAKINO LA3T ENTRY DATE AND TIME OF LAST ENTRY
Jo ce Altland, POA 5/7/13 0:00 am
S DATE OF CONTRACT TO RENT BOX • NUMBER OF BOX 1 TITLE UNDER WHICH BOX IS REGUESTED
05/11/2005 183 Louise D.Altland
NAME ANO ADORESS OF PERSON(8)HAVING ACCESS TO 80X
s. NAME: b. NAME:
Louise D.Altland Joyce Altland
STREET ADDRESS: STREET ADDRESS:
b2251Nilson Land 1320 Village Drive
CITY: STATE: ZIP CODE: CITY: STATE: ZIP CODE:
Mechanicsbur PA 17055 S nn Grove PA 17362
NAME AND TRLE OF EMPLOYEE TAKINCa THE INVENTORY
Belinda Lawrence
WAS A WILL IN THE BOX� ❑ YE3 � NO If y�s, a. Dats of wiil:
b. Nsm�and addross of psnonal npnsentativ�,if named in th�will
NAME:
STREETADDRESS: CITY: STATE: ZIP CODE:
c. Nsm�and addnss of attom�y,if any
NAME:
STREET ADDRESS: CITY: STATE: ZIP CODE:
� 48500041046 485�0041046 J
� �
�
REV-485 EX SAFE DEPOSIT BOX I NVENTORY Pa9e o'
INSTRUGTIONS
(1) Cash:Report totai only. �.
(2) Stocka:List in detail every common or preferred certificate,warrant or other rights found in box,Stocks a�e to be designated by
name of company,certiflcate number,date of certificate,name in which stock is registered,and number of sha�es and class of stock.
(3) Obilgations of U.S.Govemme�t:Number of items,date of issue,face value,names in which registered and type of owne�ship,
i.e.,jointly held,payable on death,etc.
(4) Bonds:Designate by name,amount,serial number,or other designation.(Bearer Bonds)
(5) Bsnk and Savings and Loan Pasabooks:State name of depositor,number of book,last date appearing in book,name of bank
and branch,and balance.
(6) Jswelry�Coins,Stamps,Manuscripts�etc:List and describe as fuliy as possible.
(7) De�ds,Mortgages.Current Insurance Policies or other evidences of indebtedness:List and describe as fuily as possible.
(8j All other contents.
(9) Retum completed fonn to: DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT.280601
HARRISBURG,PA 17128-0601
ITEM ITEM DESCRIPTION
NO.
1 CD-Commerce Bank:Issue Date-10/212008,Maturity Date-4/2/2009,Account No.-802433,Deposit Amount-$10,800
2 American Skandia Annuity:Contract No. E0481542
i CERTIFY UNDER NAl OF PERJURY THAT THE ABOVE RECORD IS PERSON RECENING COPY OF
CORRECT AND C PLET TO THE BE8T OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY:
SIGNATURE
y
PRINT NAME PRINT NAME AND CHECK APPROPRIATE BOX BELOW:
i� -f
PRINT TITLE DATE CHECK APPROPRIATE BOX:
�Exscutor(trix) �]Administrator(trix)
� �- �� ,( � �Estate Reprosentative �Joint owner of safa deposit box
NOTE:Attac additlonai S'/:"x 11"shest(s)if necessary or use duplicates of this page of form.
The Departrnent is authorized by law,42 U.S.C.§405(c)(2KC)(i),to requi�e disdos�ue of Social Security numbers in conneciion with administering state tax laws.The DepaM�e�t uses the
Social Seaxity nwnber to idenMy fhe dec�dent and persa�a!represerttatives of fhe estate.The Commo�wealth may also use the informatbn in exchange of tax iniortnatan agreements
with Federal and bcal tax' authorities.The state law prohibits the Commonweakh's nel from disclosi confidential tax infortnation ex t for official ses.
06/12/2013 07:44 7174414808 AMERIPRISE FINANCIAL PAGE 02/05
Lyon, David R
�an: K��n,Ankush P on behalf of SbLifeEventsCommun�cafiionCen#er
S�n� Thursday,,)une 06�2013 7:56 PM
To: Lyon,David R
5ubj� 24607718 0 001 �OUISE D A�tIAN[7 D�ATN S�TTLEMENT REQUIREMENTS- PLEASE
DO NOT DEt.ETE
R�v�ouro�L�In�uran�
��ll
� �p�M�+�P��f►
70't�0 M�Ipe1N lqnsnd�i C�nMr
Mh�nMpoNs.MN i8474
hm�6,2413
DAYiD RAYMC)ND LYON
3TE 206
490Si LpUISE DR
MECI�IA1�iIC8HURC�.�+A 17055-69�0
���ia 000�
D�car DAVld RAYMOND LYON:
We have raceiv�d.noti�icatbn of LOUi9E D AL'�'L�A1VD'a de.eth. 'T�dcccasara name appeu�on die foliawin�ac:caunt�. Account
value�sa of 0�/10�2013 are listred below. At the�nd of d»a kttac,you.wilt tind s hst vf benefciarie,s st�wn in air initial re,wlew of
the�+ocount�
,�►�onnt Tnfot�nation
Mutu�i Frods
Accow�t Numb� �
o�a�3�sr�rs 9 ooz r�;�a�
02014810�3Z S 002 Mdhrlduai
CtrtNiates .
A�i11L�]i�� ��p
OOS09670SS'!2�1 i.nd�viduat
1V�ntdii Fnoda ,
�Nnmbar �of shsma. �aa�Va1nc Per�are
01013757Z7E 9 OOZ 523,9a4.44 2,4 l3.l6Z �9.91
02014S1ds32 S t)42 51�3,9S4.S0 12,�73_163 �14.29
Cer�tee�
i
06I12/2013 07:44 7174414808 AMERIPRISE FINANCIAL PAGE 03/05
Acc�,n Numbtr
rwrr
QOa096?055?2 001 �3.151.93
The date of death vaiues provided�f�eat�te tax�rpo�es end ar�e ro��►value to be pstd. Accounrs miy be subject ta marloet
lluctuatiat ss g+overn�d by each prodact. Pl�se oo�te that the vslues ind{ceted for any Lifti ins�rence praducts with the iasured
dec�ased refl«�d�e�+v�s de�bQnefit at date of death and not the east�vatua. Vah,ea indiceted fvr�.if�I�su�c�nc:a prodacts with only
the aamer deceased rotloct the csstt value a�af the d�e�of derth. V�►lves fo�sny proprietary mufiial fi�nds�aclude�ocrued di�vid�enas
as appiicabk.Vatu�prov�ded foc�prodacn are msnually r,alcul�cd,�nd slwoufd be used�datimates onty. Tho pric,es used
to provida valu�s are�stimel�.�ob�in�ed fro�m artside�rr�es beliaved to be nliable. Amer(prise Finar�cial provide�du�e valuas�s a
secvice�o ita dirRts. Actu�l vatnes nud in preperatian of tax r�eturns or�'or pia�min�PurPoses should be ver[fial by your legsl snd
ec�ntinp�advisars. '
Account!)isposition
Acoourt dis�ait�oo is b�aed on how�n acoount is owned(the ownership typ�). The folbwing in�ormet;an wil�hekp yau unde.�and
the p�oeose that will be used to�ettfc th+e�cxourita. Aceourts may be subject to mulc�t fluctu�rtion�s�ov��ed by e�ch produet.
Diepo�itio��for Iadiridw!ow�ership
UpOA dIC d�Ctdi Of�O�YtI�[,all�IU'11d1y�OCOW1ts i�Ued bCf41't J�1t1st'y 19� 19$Si tt1uW�1�tleid�Ce�t��iCOte,bCO��1d Life
inaurance acoaante�ro�istered in individual ownershtp became part of the esb�te for dietrtb�tion. lf dvere ie a eanting+�nt owner nemed
o+�a life insucance or dmuity�unt,o�wnerahiP pa�s dinctly ao the contm�ent owner.
R,eqa�red Doena�ent�a
In order�take s�pp�ro�priaba�eps to setde d�a account�we will naed tbese documents:
E�bttr Stttk�ewt Fond(314�
(F'a�sooamts:OOe09�670537 2 001,Ot013y5'�'278 9 002,02014810532 S 002)
'�'o p�nvc:e�a�att�t on a Matuai�und,Certifica�tee�ccaant,esch cll��nts�s well�s�ec�ians�end tba farn to bc
3248�. 'Th�s�ona inclndea sep�s�e a�ctior�a for qualifled�nd non-qu�
signed end d�ed by dt new►�cx,�mt hoider�ibr a11 a�x�. The�ccanu leve!aui�bitity inforn�e�ion r�q�an the form i�
required if you intend b e+atsitt th�investrnants yat teceiv+a throu�h thi:prvicess. if suitabiiity infb�n�tivn is fi�omptebe w+e wi11 not
delay�tttement,'�ow�ve�r,�tivit�Y sibv►ed on any accour�s c�ca�od through e�tttcment wil)bc 1�tiod ta liquidetton oaly. We vri11
not oontao�you to ooe�pkie tbe suitability infrxmation. Instrvctions�'c�omplation af the��9attlament FoRm m availeble as
Forta 3?.4�-iNST. Hvth farms�are av�ii�bte d�rou��an Anteriprik Fir�ciat Advisor or online a�
h�tpJ/www.arn�tipcfse.aamismp/gioballeu�orr�er-s�vice/a�Wservice.asp undar the list headina"�be Seukm�ent".
Copy o[Certlfied�Ce�rtf�iwte
(For accou�s:OOSty96�03�7�00 t,01 O�375�278 9 vo2,o2ut 4s�v832 s ao2) or tacal s�r
Tlu dea�oati�¢ean be a photaoapy of the ori�inat d�ocun�nt ttat beus oerti�cation fi�om the health depardn�nt reg�
u�d inciudes tha c�use of death•
Cop�►of Certiti�t�ers of Ta�ee�t�ry/L�ttera of I►druin�tr•tian
(Fqr�:008Q9670SS7 2 001,O1013?S?278 9 002,02014810832 S O�Z)
'T'�is�octut�ant eoat�rms rvlw�a appvintod�a tha bgal re:pre�entativt of the estate. The�ocument can be s plho�ocePY o�tt�e c�ou�t
issti�ed dowment■nd dated within 60 dqys of tbe dvoe tbe c�orpor�e ot'fkx receivaa it.�n Tovva,Mw+tana.�nd Nea+Yark,iet�rs must
be d�itd wit�in l SO dtys Ia sdditio��Est�blishing a New F�ductsry�Fo�'m 4b?..541)�nnst be�tbsnit0ed�ot d�e le�l repnede�rtsdve.
' s�tv#iisble ba�ed on U�e 3t�e of t�sidenor,,the si�,emd oomploac[ty of the
Ple�ee ch�ck witl�y�our kg�tt co�u�ei bo revlaw o�hex op�ion
da�ederrts�.C�n po�11y less expe�s�vr apcia�s may include�n orde*of aammsy admini�r�tion,bond in hai of probate
or atnatl es�e al�idavit.
�sbibtbi�irK�H�+.Fid�ei�ry(1+"orm�0�34�)
(Foc a�:008096?OSS7 2 001,010137�72'�8 9 002,02014810832 S 002)
Sub�mit a�F.�►mbtiahtng s Nea Fiducf�y(Fam 402541)without any att�retions to�crm�nent te�ct i�'the ctaimant ar named
ben�f�ery ia a oo�por�tian or we vv�l1 nquire Corporate a�F.��Y Resolutian(Farm 402400)eccompanied bg+efther s
copy of a C�ov�rnn�ent issued Busine�Gic�en�e or Articla of ' .
Z
06/12/2013 07:44 7174414808 AMIERIPRISE FINANCI�. PAGE 04/05
.
t �
in o�r to be oo�np�iaot with fiir elsitns pr�ctices of ineny�we wiil be imm�iately e�a�di�with the benef.ic�li�ied
foc any L.ife and Am�uity�hetd by the deoo�ed clk�nt. Similacly we witl be cocreaponding with tha benefici�ari�oc claimaats
of#Il accounts held by�e+iecedent within a mi�in�um of six Rwnths af the d�e of thts ktt�r. Plesse contsct us if you wish to sat a
copy af thes�oomaapande�ces.
We elso r�quast�uny infam�Nion you may bave that may facilite�ta ou�r�tFor1�to contact otixr beneficinriea on the ac.coRmta�nvotving
d�e d�ed.
T�m e�.brt to ItnpTOVe onr proce�s,we imvi�e y�u to sha�e your fvedback with ua by�ndin�a Lotus Note to:t,ife Ev�enri Mtilbax.
1f you have qne�ion�ibou�t this la�oa or need a!�i�tsnoe de�erminir��xt steps,plesse ca11
t{�rZ9?-66�63 and tay�Se�tt�to be oonnected whh an oper�tor. Asic to be cannecbed to t6e Bstae 9e�ttiaments
Team. Yon an'11 be car►t�ec�ed to ona of t�e knowledgtable I.ife Events Cu�v+mer 3er.vice Professlonals who w�tl be ready to�asist
Y���P�•
Moe+e fotbrrn�tioa ro�,trding d�e Esnt�S�tle,nne�t prooa�s�s av�il�ble o�the Ameriprise.com v�ite. To vfew the"E�e 9�ttl�mQnt
Froqu�ntty A,�d Questiora"p�a oa du webai�e,type"Fstau Setticmcnt FAQa"in th�s+e�+ch Setd on the websi�e ttoin�agE.Pr�ees
th�"Entaer"loey end aelect thc firot i�em on t�e"(�LLOBAL"tist
S�tioe.noiy,
De�h Settlea�ts Proc�g Team
Atneripri�e Fittancial Cen�
Mhme�polla,MN 35474
peatfi gettlemenq�Pnace�ing Tarm: E00-297-6663,PIN,say I�eeth 9ettioments
Lif�i�Ct�s: E00-29'I�b663,PiN,�j►Li fe Claims
�►ttachment:��'icf�ry tnforn�tion
Benettici�ry Ioforrnation
Wt have the fiollowing benefici�iea vn recvrd fvr tt�e deceaaad's eccvimts.
Acoo�rtt ridmber. �a09670557 2 001
A�s1�+tloa:
Not appHc�bie for thia owner�hip type.
Acco�t Plump�: 0I 0137S7Z7�9 Oi)2
��.
.
Nat�ppl�atble fo�r this ovvne�h�►type.
Aa:o�et l�ont�er: 02Aa4$10832 S 002
��:
N��pNcable�o�r thia ownerahip type.
3
Hoidings by Investor
Louise Altland Anthony M Conte MSFS,CFP� Louise Altiand
5225 Wilson Ln Apt#1121 Conte Wealth Advisors,LLC Date: 05/10/2013
Mechanicsburg,PA 17055 2009 Market Street Created:07/09/2013
Camp Hill,PA 17011
717-975-8800
Louise Altland
Acct Name:L N�Pershing
Acct No:XXXXX3897 Acct Type: . (Individuai)
Ass�E Pisms-:: : , Ticks�� Ass�t1'�tp�rt� . : . _ M�t Mams�: 4uanttl��' Prici�{�� <. Valur(i�
ABBEY NATI TREASURY SER1! SAN36910 FIXED INCOME 1 O,OOQ.OQ 10T.62 10,7T6.44
NOTE 04.0000096 04l2712016 94
BROKERAGE MONEY MARKET CASH OR BROKERAGE 12,401.61 1.00 12,401.61
E�U{VALENTS MONEY
MARKET
GENWORTH FINt INC NT 5.750°r6 GNW.GO FfXED INCOME 14,000.00 104.T9 14,994.98
06J15/14 B/EDTD 08l13/04
HSBC BANK USA NA CD VAR 40431GS FIXED INCOME 5,000.00 100.09 5,004.5t}
0.0000096 05/31/2017 EO
HSBG B!E lJ9A N A MC k.EAN VA FIXED tNCOME 10.000.0� 97.t1 9,71t.00
CTF DEP l��'/38� ANN INCC�M�
OPRTY�D 0.00�96 09i30/18 BIE
MERRILL LYNCH BAC.HMZ FIXED INCOME 15,000.00 111.38 1T,142.02
MORC3Ahf 3TANLEY ' G�OBA1. M3.HMX FIXELI INCOME 10,000.00 104.55 t0,653.03
MED(UII�tTERl�A NT SER F FIX�a
RT 4.20096 11/20/t4 8/EDT�
11/20/08
TEIECOM ITALIA CAP GTD SR TI.GG FIXED INCOME 15,000.00 104.20 15,712.5�
NT 4.954�6 09/30/14 B/EDTD
09/30/05 CLB
Account Total: $96,396.00
Acct Name:L N(]Pimco
Acct No•XXXXXXX9011 AcctType:lndividuals
Ass�t Nsms;; Tick�t Ass�tZy�; Mgt�Nan�� � Qusntit�: , Prics(3�-:' Vslw:,(i�1
PIMCO TOTAL RETURN A PTTAX FIXED INCOME PIMCO FUNDS 951.40 11.27 10,722.29
-RETAIL
Account Total: $10,722.29
Incomplete if presented without accompanying disclosure pages Paga 1 of 3
Prudential Financial Inc., PRU Historical Quote-(NYSE) PRU, Prudential Financial Inc. ... Page 1 of 1
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http://bigcharts.marketwatch.com/historical/default.asp?symb=pru&closeDate=05%2F 10... 7/25/2013
Wells Fargo Advisors,LLC
1250 Broadcasting Road
Suite 100
Wyomissing,PA 19610
Office:610-376-1700
Fax:610-478-1352
Toll Free:800-288-2437
June 13, 2013
Stone LaFaver&Shekletski
Attn: Jennifer Mearkle
414 Bridge Street,Box E
New Cumberland PA 17070
RE: Louise D. Altland
Wells Fargo Account: 1115-3415
Dear Jennifer
� Per your request,enclosed is the date of death valuation for the above referenced account.
Kindly contact me at 610-378-3074 if you have any questions or concerns.
Thank you for allowing Wells Fargo Advisors to be of service to you.
Linda Capellupo,Officer
Senior Registered Client Associate
Notary,BSA
FnclQ�iare
Together we'll go far
Member FINRA/SIPC � ___ . _. _ _ .._. _ _. . ._. ----
Wells Fargo Advisors,LLC
1250 Broadcasting Road
Suite 100
Wyomissing,PA 19610
_ _
Office:610-376-1700
Fax:610-478-1352
DATE OF DEATH VALUATION Toll Free:800-288-2437
MAY 10, 2013
Louise Alttand
Account: 1115-3415 � �
DOD: 5/10/2013
uanti S�mbo1 CUSIP Name NAV Value
8,049.172 FCISX 353496-80-5 FRANKLIN INCOME FD CL C 2.39 19,237.52.
Acc=
BID Factor Interest
14,000 3136AA-AV-7 FNR 12-141 CI�2.5%122542 100.081 0.92622692 14.58 12,992.26
8,000 3136A5-6C-5 FNR 12-51 HJ 3.5%052542 99.724 0.57024169 7.00 4,556.34
14,000 3137AR-MB-9 FHR 4068 BB 3%031542 97.090 10.50 13,603.10
12,000 3137A9-WF-9 FHR 3835 EE 4.5%031541 100.925 13.50 12,124.50
15,000 3137A5-MH-4 FHR 3795 DD 4.5%121540 102.598 16.88 15,406.58
6,000 3137A4-G5-0 FHR 3772 AA 4.5%061540 102.698 6.75 6,168.63
6,000 31399C-NA-1 BFHR 3995 W 3.5%021542 99.826 14.58 6,004.14
12,000 31399C-PC-5 SFHR 4027 EE 3.5%041542 96.363 29.17 11,592.73
11,000 3137AR-MU-7 FHR 4068 EE 3.5%061542 99.260 9.63 10,928.23
MONEY MARKET 113.89
TOTAL ACCOUNT VALUE �112,727.82
mutual fund calculation: quantity*NAV
bond calculation: quantity*bid*factor plus accrued interest
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. Together we'll go far
_�_,_.
,.♦ _ .:�._ ___ _.
Member FINRA/SIPC _ _ _ . _- - ,-- - ---- --_ . __ -.--
499 Mitcheli Road,Milisboro,DE 19966 Adjustment Services
Phone 888-502-4349
F ax (302)934-2955
June 14,2013
Stone LaFaver& Shekletski
Attorney at Law
414 Bridge Street
P.O.Boa E
New Cumberland,PA 17070
Re: Estate of Louise D.Altland
Social Securit�: 183-12-3346
Date of Death:Max 10,2013
Dear Sir or Madam:
Per your inquiry on June 3,2013,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 Accourrt
Account Number 10756183
Owrrership(Names o,� Joyce E.Altland(POA)
Louise D.Altland
Operting Date 08/28/1964
Balance on Date of Death $64,042.68
Accrued Interest $ .24
_______________________________________________________.___-----------
Total $64,042.92
2. Type of Accou»t Certificate of Depasit
Accow�t Number 31003913914056
Ownership(Names o,� Joyce�Altland(POA)
Louise D.Altland
Openireg Date 03/OS/1999
Balancae on Date ofDeath $29,829.82
Accrued Interest $ 2.53
.____.._______________.._________________________________..__.____.._____...
T�� $29,832.35
3. Type of Account Certificate of Deposit
Account Nurriber 31003913709613
Ownership(Names o,� Joyce E.Altla»d(POA)
Louise D.Altland
Opening Date OS/24/2000
Balance on Date of Death $S0,000.00
Accrued Interest $ 5.89
...._.._...__..__.._______..-----___..__..___________.._..._..______.._______�._______
Total $S0,005.89
4. Type of Accow�t Certificate of Deposit
Accow7t Number 31003908145898
Ownership(Nmnes o,�} Joyce E.Altland(POA)
Louise D.Altland
Openirtg Date 06/04/2001
Balance on Date of Death $10,737.25
Accrued Interest $ 2.68
................_.._......_.................._.................._..__......__......_......................_....................
Total $]0,739.93
5. Type of Account Safe Deposit Bax
Bax Number/Location 183/Mechanicsburg
Ownership(Names o,� Louise D.Altland
Ope»ing Date OS/11/2005
For any addidonal information on t6e sbove acco�nta,includi�ownero6ip and any c6soges,closuns aad/or reimbaroemeat of funds,
plau ap t6e Ma�aoicsburg�t 717-697-1S1S.
We were ua�bk to locate aey a�fe deposit boi for t6e above-mentioned deceden�
T6is kt�er doa not indnde any aocounts m whic�the da�aised may lave been�s1ed aa Power of At�orney,C�o d Uniform Tranders,
Represenhdve Prya,or Trus�ee�nder a Wrhben Agreement
S1IICCI��,
Valarie Mercer
Adjust�nerrt Services
St
.
MENiBERS 1�
F8D8RAL CRfiDTf UIVION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 162981-00
Date Account Estabiished 10/09/1996
Principal Balance at Date of Death $40.13
Accrued interest to Date of Death $.00
Total Principal and Accrued Interest $40.13
Name of Joint Owner None
CHECKING ACCOUNT:
Account NumbeNSuffix 162981-11
Date Account Established 09/20/2002
Principal Balance at Date of Death $5,643.50
Accrued I nterest to Date of Death �.07
Total Principal and Accrued Interest $5,643.57
Name of Joint Owner None
CERTIFICATE OF DEPOSIT:
Account Number/Su�x 162981-40 162981-43 162981-44
Date Account Established 02/15/2013'` 04/06/2012"`* 10/01/2012''"
Principal Balance at Date of Death $34,045.53 $16,288.62 $21,491.22
Accrued Interest to Date of Death $5.46 $2.01 $3.97
Total Principal and Accrued Interest $34,050.99 $16,290.63 $21,495.19
Name of Joint Owner None None None
*Rollover from certificate 162981-41, originally established 03/15/2012.
"''Rollover from certificate 162981-50, originally established 03/09/2011.
**"Rollover from certificate 162981-49, originally established 11/01/2010.
M ERS 1ST FEDERAL CRE T UNION
1
�� v�
Danielle A. Kline
Lending Insurance Support Specialist
June 14, 2013
Estate of: LOUISE D ALTLAND
Date of Death: 05/10/2013
Social Security Number: 183-12-3346
5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org
3801 Paxton Street 888.937.0004
BA N K Harrisburg, PA 17111 mymetrobank.com
June 21, 2013
Stone LaFaver 8� Shekletski
414 Bridge St PO Box E
New Cumberland PA 17070
RE: Estate of: Louise D. Altland �
Tax Identificatio� Number: 183-12-3346
Date of Death: May 10, 2013
To Whom It May Concern:
This letter is in reference to decedent account information you requested for the
individual listed above.
We are able to provide the following:
Account Type:6 Month Certificate of Deposit
Account Number: 802433
Date Opened: 10/2/2008
Sole Owner: Louise M. Altland
Date of Death Balance: $11,240.54
Principal Balance: $11,239.70
Accrued Interest: $.84
Please feel free to contact me at (888) 937-0004 if I may be of further assistance.
Sincerely,
� .
Cindy Stanbery
Support Associate/Deposit Services
Metro Bank
Soverei ri . • -
g
Court Ordered Processing\Decedents- MA1-MB3-02-10 - P.O.Box 841005 - Boston,MA 02284
�
�
i
� June 18, 2013
�
�
�
Jennifer A. Mearkle
d Stone LaFaver& Shekletski
� 414 Bridge Street
� Post Office Bax E
` New Cumberland, PA 17Q70 .
�
� RE: Estate of Louise D. Altland
� Date of Death: 05/10/2013
�
�
� Dear Jennifer A. Mearkle:
�
� Per your request, enclosed please find the account information as of the date of death
� for the above-named decedent. For your information, accrued interest is not included in
the date of death balance.
�
j Ptease feel free to contact me if I can be of any further assistance.
!
,
� Very truly yours,
�
3
�
� Nicole Jo
� Specialist
� 617-514-5189
� . .
�
0
�
�
�
�
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�
�
,
' .
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.
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Sovereign Bank
ESTATE OF Louise D. Altland
SOCIAL SECURITY#: 183-12-3346
DATE OF DEATH: May 10,2013
Account#: 1684070015 Type: Money Market Open date: 10/10/2008
In the name of: Louise D Altand (Joyce E Altand POA)
Date of Death Balance: $10,545.68
In�(YTD)from 1/1/2013 to 4/19/2013 : $8.66
Accrued interest to date of death: $1.65
Other Info:
Account#: 1685392803 Type: CD Open date: 8/4/I997
In the name of: Louise D Altland (Joyce E Altand POA)
D$te of Death Balance: $42,412.59
In�(YTD)from 1/1/2013 to 5/9/2013 : $70.13
Accrued interest to date of death: $1.39
Other Info:
Account#: 0931078164 Type: Checking Open date: 7/28/2009
In the name of: Louise D Altland (Joyce E Altand POA)
Date of Desth Balance: Account closed prior to deatti ��
In�(YTD)from 1/1/2013 to 5/10/2013 : $0.00
Accrued interest to date of death: $0.00
Other Info: Account closed on OS/O1/2013.
Account#: 1685211326 Type: CD Open date: 7/23/1997
In the name of: Louise D Altland (Joyce E Altand POA)
Date of Death Balance: Account closed prior to death
Int.(YTD)from 1/1/2013 to 5/1/2013 : $42.3 8
Accrued interest to date of death: $0.00
Other Info: Account closed on OS/Ol/2013. �
Page 1 of 1
Holdings by Investor
louise Aitland Anthony M Conte MSFS,CFP� Louise Altland
1320 Village Dr � Conte Wealth Advisors, LLC Date: 05I10/2013
Spring Grove,PA 17362 2009 Market Street Created:05/29/2013
Camp Hill,PA 17011
717-975-8800
Acct Name:L NQ Prudential .
Acct No:XXXX1542 AcctType:Annuity
-a �..y.R„..q,.!,H;.'�". �� '� �� . .,e ���,."> ��, _y� ��,": � � � ���-u" *r t r�w. $�e �' �x rh°` �.
� >.�C�.,`�"��.'�_.;.£ �m�+; ;��.n,�`'.�" k.�"ri �sw�'.f'��a�"Y";`� �`.i,s.x y:�. ��c��i�.��.�'�i�'. ��;.� ��<��Ya����_�?sS
n��i� . ��t,va�tt� �aur��3 � - �P�u��r�i�u�.. ���a� ��.�-. s,�:ew�-
P +��
AST FEQEi�/4TE�AGGRESSIVE EGIU�TY PRUDENTtAL 411.87 21.2� 8,T47:8�1`
GRQ1�tT'�t _ _
a�T It�N�M�1RKE'�" CASH C?R PRUQENTtAk� 1n,509.1�' 9.8� 1Q�►�.t�r
EQUIVAtENTS '
AS�NEUB�RGER BERMAN/LS1/ EQUlTY PRUDENT(A�. 447.�2 22:Q8 9.872.�4
M!D-GAP�fALU�i
A�T IV��t�Rt3�ER BEE2A�4/tN MtQ�- �C1iJl't`1'' PRtJt��t+l7'IAL. 52�,3T 18.3E�: 9,5��:�;
CA�Ct�IYTl� . :
AS'f 8t1A�4U.GAF VAL.UE EQUITY PRUDEfrlTlAt. 44Q.8� 24.6? 9,554,37
A�'."�:.' P�tC�[.Ai��-�� EQt.lt'�"`� F�I�E��"f�, :8��:4�: 't�i.��'. 8�5?`!��'
,., _ ,,,
WF A►t�111�'INl"L E�UtTY�LA�S� EQt1ffY , PRUDENTIAL. . 94�.23 16:68 18�010.86`
Accou�t Total: $176,353.48
� Investo�Total: 5283,471.86
Incomplete if presented without accomparrying disclosure pages Page 2 of 3
Une Hinancial Way
Cincinnati,Ohio 45242
Posc Of�'icc Box 237
���,/ Ohio National cincinnati,Ohio 4SZOi-oi37
r • • �.w • Telephone:S13•794•6ioo
� F1IZa11Clal �crV1CeS,� wwwohionacional.com
June b,2013
ESTATE OF LOUISE D ALTLAND
5225 WILSON LN APT 1121
MECHANICSBURG PA 17055
Contract: E1244267
Annuitant: LOUISE D ALTLAND
Dear Executor:
We were recently notified of the death of Louise D. Altland.Please accept our sincere
condolences in this time of sorrow.
The above referenced Contract provided variable monthly payments ranging from$27.00
to$57.00 for her lifetime with 120 vari�ble payments guaranteed. At the time of her
death,she had received 71 such payments. Upon death,the payments continue to
Robert B. Willing Jr.,as beneficiary. These payments will begin starting with the June 1,
2013 payment.
In order to continue the payments to the beneficiary, we will need a completed Death
Claim Form 9104-A and Electronic Funds Transfer Agreement Form 4620-ON-A
(optional). We also require a certified death ceRificate listing the cause/manner of death
in order to proceed.
If you have any questions or concerns regarding this matter,please do not hesitate to
contact me at(800)366-6654,Option 3 or e-mail lestie walkerC�ohionational.com
Sincerely,
( �` `
Leslie Watker
Annuity Administracion
Cc:Jack Snavely II 2253-105
"the Ohio National Life Insurance Company
Ohio National Life Assurance Corporation
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GO1 3 12:15 FAX 866 215 7550 THE HARTFORD �002/002
Au �tE
gust 14,2013
TFORD
stoae LaFav�r dt shekletski
414 Bridge Street
PO Box E
New Ctnnberland,PA 17070
REFERENCE: Account#710950561
Dec�ent:Louise D Atland
-�;..� . .
Dear Stone LaFaver dt Shelcle�ski
As You nQuestod,the Death of Death Va1ue as of OS/l0/2013 was S 26,925.35.
Please be advised this Sgure is for tbe date of date value purpos�only,it d�oes nart
n:p�esent tbe desth benefit amount Mark�t and surrender values change daily: .
If you have any ot�er questions or con�cerns, please feel froe to contact your invc,�tment
pzof�ssional, or an Annuity Service Specialist by calling I-800-862r66b8, Mon+day
t�nbu�h Thur�day fi�om 8 am. to 7 p.m.,ar�Friday 9:15 a.m. to 6 p.m.F�tern-tir�e.�We
will be happy to assist you.
Sinc,�r�ely,
� � � SP.1''1/4C�P�r .� .
The Hertford ,.
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L�od�qlo�k KY,Oi11 _
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P.O.eotr�4�. .
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...�.._......,....—,�.._.. �_
STONE LAFAVEI3 & 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
www stonelaw net JON F.LwFAYER
Januar 2 9� 2�14 TELEPHONE(717)774-7435
y FACSIMILE (717)774-3869
Register of Wills Of f ice
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3887
RE: Estate of Louise D. Altland
No. 21-13-0609
Greetings:
Enclosed please f ind an original and one copy of the Inheritance
Tax Return and Inventory for the above mentioned estate. Please
clock in the copy of the Inventory and send it back to my office
along with any receipts in the enclosed stamp addressed envelope.
Should you have any questions, please do not hesitate to contact
my of f ice.
Very truly yours,
STO aF R & SHEKLETSKI
vid . on
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