The URL can be used to link to this page

Home My WebLink About05-12-14 (2) J 1505610143 EX(02-11 i"' EV-1500 � �" OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTI.ffNTOFREVENUE PO BOX.280601 INHERITANCE TAX RETURN 21 13 0630 Harrisburg, PA 17128-os01 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 229 56 2137 04 19 2013 04 02 1932 DecedenYs Last Name Suffix DecedenYs First Name MI ALBEE B��A B (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 X❑ 1. Original Return � 2. Supplemental Return � 3, Remainder Return(Date of Death Prior to 12-13-82) � 4. Limited Estate � qa. Future Interest Compromise� � 5. Federal Estate Tax Return Required (date of death after 12-12-82 � g Decedent Died Testate � Decedent Maintained a Living Trust 0 (Attach Copy of Will) � (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes � 9. Litigation Proceeds Received � ��•betweenP2 31�Jj a dit(Da95�f Death � 11.Electioitta tax under Sec.9113(A) T (Attach Schedule O� CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX II4�0 ATION SIiBEJLD B IRRCi�ED TO: Name Dayti�Te�phone�ber � � > GARY L JAMES ESQ 717 tTb�3r�32$0 � =� � � A �y ~ r'+i �"1 ,�,'' -�-�: ..� REGFS-TE�QF:WILLS USE,�11� C'3 C.7 � � `'� '�'T First Line of Address < t7 C � °°� � 13 4 S I PE AVENUE � � �-' �" r�i r Second Line of Address �' � � � Q� �7 City or Post Office State ZIP Code DATE FILED HU1��LSTOWN PA 17036 CorrespondenYs e-mail address: glj(a�isdc.com Under penalties of perjury,I declare that I have examined this return including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the persona-I representative is based on all information of which preparer has any knowledge. SIGN URE OF ERSON RESPONSIBLE FOR FILING RETURN D TE Terril n Broderick ,�� ADDRESS 1323 Eaqle Crest Drive, Mvrtle Beach SC 29579 SIGNA E OF PREPAR THAN REPRESENTATIVE DATE Gary L.James Esq. �- �� 2� ADDRESS 134 Si Av ue ummelstown, PA 17036 � Side 1 � 1505610143 1505610143 J 1505610243 REV-1500 EX DecedenYs Social Security Number DecedenfsName: AIb@e� Barbara B. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 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. 2 , 737 . 35 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous -Probate Property (Schedule G) � Separate Billin9 Requested............ 7. 1 � 645, 1�5 . 38 8. Total Gross Assets(total Lines 1 through 7)........................................................ g, 1 , 647, 842 . 73 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 10 3 ,2 8 6 . 95 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 3, 003 . 51 11. Total Deductions(total Lines 9 and 10)................................................................ ��, 1 O G,2 90 . 4 6 12. Net Value of Estate(Line 8 minus Line 11)............................. ........................... �2, 1 ,541,552 . 27 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. H4S, 903 . 48 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... �q, 695 , 648 . 7 9 TAX COMPUTATION-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.00 15. Q . Q 0 16. Amount of Line 14 taxable at�inealratex .045 637 , 796. 18 16. 28, 700 . 83 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable atcollatera�rateX.�5 57 , 852 . 61 �8. 8, 677 , $g 19. TAX DUE................................................................................................................ 19. 37 � 378 . 72 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21-73-0630 Decedent's Complete Address: DECEDENT'S NAME Albee, Barbara B. STREETADDRESS 1021 Jenkins Grove C�� STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 37,378.72 2. Credits/Payments A. Prior Payments 35,500.00 B. Discount 1,868.42 Total Credits(A +g� (2) 37,368.42 3. Interest �3� 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �q� Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) ��.3� Make Check Pa�rable to REGISTER OF WILLS, AGENT. � / � . ,,;v:- � 'ri..,� �i_<_ rir ��_„ �,� .�^�a.'ii*.�,�F`;�..,. � , ��- .:� .., p ,.`� i/G��"�j�/�F�i��yiy �;��Y ,y::_, � x.�; , ., ,. ... .., , . .. .. �'>,�.�JG,� ,,,ax..�, n�.w,ia.... ,.... �,�� M � i:^�� l� z,..�.��s � �'.i.��`� .N'` , .. ..., ., , ��/Yink.�w, .% .,�1i1:.......'� �. ,. h�i/,�� z'- �� .i 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:.................................. � � c. retain a reversionary interest;or........................................ � � d. receive the promise for life of either payments,benefits or care?.................. X ..... .. . .............................. . I death occurred after Dec. 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. � e r .�:;, - - -, . '"��'�i>.. ��,>,. mMm �a�� %� ..�.: �� iD. O/�f /..._ �e.�.�.:� ,r...�.y .,..::: ...: ,. ,.. Ui ' �, :.; � •; ,,:,..• .. , ' v ,..>,.rr� ,,.,. „�,..,.��...:Y,. �� , i' i��,v.,,. , �i/��.. ./ �� „�, �� ., . . For dates of death on or after July 1,1994 and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse � �� is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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. _. ___ _ :.: s,.. F..�� £ �u �.. .�� ,, � � � , .. ,. Rev-1508 EX+(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-ownedwith the right ofsurvivorship must be disclosedon schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Discover Card-refund 23.61 2 Discover Card-refund 25.00 3 PA Department of Revenue-2012 personal income tax refund 147.00 4 PA Department of Revenue-2013 personal income tax refund 176.00 5 United States Treasury-2013 personal income tax refund 1,160.00 6 USAA-homeowners insurance refund 1,205.74 TOTAL(Also enter on Line 5, Recapitulation) 2,737.35 (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-1510 EX+�08-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OFREVENUE INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 This schedule must be completed antl filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH °k OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TR�NSFER SATTACH A COPY OF TIH�E DEIED�OR REAL EST TE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1 Fidelity Personal Retirement Annuity contract# 99,905.27 99,905.27 232654930-valued per letter dated July 6, 2073; beneficiary is Terrilyn Broderick 2 Prudential Annuity contract#E1110890-valued per 57,852.61 57,852.61 statement; beneficiary is Jack A.Smith 3 Scottrade IRA Account#12479988-valued per letter 122,707.87 122,707.87 dated June 5, 2013 and public listing; beneficiary is Terrilyn Broderick 4 Vanguard Annuity Contract#700029141 -valued per 408,755.50 408,755.50 letter dated May 20,2013; Beneficiaries are the Barbara B.Albee Living Trust Dated June 6, 1994 (90%of annuity)and Terrilyn Broderick(10%of annuity) 5 2,500 shares of Aberdeen Asia-Pacific Income Fund 78,900.00 18,900.00 Inc-held in the Scottrade brokerage account# 72479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5, 2013 and public listing Accrued dividend on Item 5 through date of death 87.50 87.50 6 3,172.782 units of Alpine Dynamic Dividend Fund 11,267.25 71,261.25 Institutional-held in the Scottrade brokerage account #12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5, 2013 and public listing Total of Continuation Schedules See attached a es TOTAL(Also enter on Line 7,Recapitulation) 1,645,105.38 (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-1570 EX+�08-08) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OFREVENUE INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH °�OF DECD'S NUMBER INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND INTEREST EXCLUSION TAXABLE THE DATE OF TRANSFER. ATTACFi A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET (IF APPLICABLE) VALUE 7 200 shares of Anadarko Petroleum Corporation -held 16,052.00 16,052.00 in the Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5,2013 and public listing 8 300 shares of Archer Daniels Midland Company-held 9,633.00 9,633.00 in the Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5,2073 and public listing 9 8,000 shares of Barclay IPath DJ-UBS Natural Gas Tr 25,680.00 25,680.00 Sub-Idx-held in the Scottrade brokerage account# 12479867;titled in the Barbara B.Albee Living Trust dated June 6, 7994;valued per letter dated June 5, 2013 and public listing 10 300 shares of Consumer Staples Select Sector-held 12,225.00 12,225.00 in the Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 7994;valued per letter dated June 5,2013 and public listing 71 500 shares of DRDGoId Spon ADR-held in the 3,175.00 3,175.00 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2073 and public listing 72 1,000 shares of Enerplus Corporation-held in the 12,800.00 12,800.00 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing Accrued dividend on Item 12 through date of death 90.00 90.00 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) Rev-7510 EX+(OS-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OFREVENUE INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD�s NUMBER THE DATE OF TR�ANSFERSATTACII A COPY OF TIH�E DEIED�OR REA�L ESTA E. VALUE OF ASSET (IF APPLICABNE) TAXABLE INTEREST VALUE 13 100 shares of Goldcorp Inc New-held in the 2,795.00 2,795.00 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing Accrued dividend on Item 13 through date of death 5.00 5.00 14 500 shares of IShares Silver Trust-held in the 11,270.00 71,210.00 Scottrade brokerage account#72479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing 15 300 shares of Market Vectors Junior Gold Miners ETF 3,564.00 3,564.00 -held in the Scottrade brokerage account#12479867; titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5,2013 and public listing 16 924.23 units of Money Market Account-held in the 924.23 924.23 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 77 Orrstown Bank Checking Account#111800170-titled 2,477.07 2,477.07 in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated May 7,2013 Accrued interest on Item 17 through date of death 0.02 0.02 18 400 shares of Pembina Pipeline Corporation-held in 12,340.00 12,340.00 the Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) _ _. ,> �.�� _K� :�..,�.�,,.�.� �. �sn-��,. , �� . � ,. . Rev-1510 EX+(OB-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S NUMBER THE DATE OF TRANSFER.SATTACIi A COPY OF THE DEIED OR REAL ESTATE. VALUE OF ASSET �NTEREST (IF APPLICABCE TAXABLE � VALUE Accrued dividend on Item 18 through date of death 54.00 54.00 19 Personal Property 2,500.00 2,500.00 20 300 shares of ProShares Short Real Estate Fund-held 7,473.00 7,473.00 in the Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5, 2013 and public listing 21 Real Estate located at 1021 Jenkins Grove, Enola, 253,000.00 253,000.00 Cumberland County, Pennsylvania-titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per selling price HUD 1 settlement sheet enclosed 22 400 shares of SPDR Gold Trust Shares-held in the 54,124.00 54,124.00 Scottrade brokerage account#12479867;titled in the ` Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing 23 200 shares of Suncor Energy Inc-held in the 5,476.00 5,476.00 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing 24 Susquehanna Bank Certificate of Deposit# 20,000.00 20,000.00 10006171721 3.93%maturity date 11/24/2013-valued per letter dated May 13,2013; account is payable on death to Terrilyn Broderick Accrued interest on Item 24 through date of death 62.44 62.44 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.0&09) _ __. _ � � ..,� �� . ��=�� , , , _ . Rev-1510 EX+(08-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE�RANSFERSATTACFiTA COPY OF THE DEIED OR REAL ESTATE. VALUE OF ASSET �NTEREST (IF APPLICABLE) VALUE 25 Susquehanna Bank Checking Account#4601942409 11,114.34 11,114.34 valued per letter dated May 13, 2013;account is payable on death to Terrilyn Broderick Accrued interest on Item 25 through date of death 0.50 0.50 26 100 shares of TransCanada Corp-held in the 4,744.00 4,744.00 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing Accrued dividend on Item 26 through date of death 46.00 46.00 27 USAA Federal Savings Bank Certificate of Deposit# 20,295.57 20,295.57 8625-valued per letter dated May 16,2013; payable on death to Terrilyn Broderick Accrued income on Item 27 through date of death 0.61 0.61 28 USAA Federal Savings Bank Savings Account#7262- 23.54 23.54 valued per letter dated May 16,2013; payable on deat to Terrilyn Broderick 29 100 shares of Utilities Select Sector SPDR-held in the 4,045.00 4,045.00 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing 30 1,579.779 units of Vanguard Convertible Securities- 20,884.68 20,884.68 held in the Vanguard brokerage account# 09892758228;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated May 14,2013 and public listing Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) . � �, � ��_ a��.�n; �.� Rev-1510 EX+(OS-09) � SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S NUMBER INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND INTEREST EXCLUSION TAXABLE THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET (IF APPI.ICABLE) VALUE 31 3,588.521 units of Vanguard Dividend Growth Fund- 66,710.61 66,710.61 held in the Vanguard brokerage account# 09892758228;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated May 14,2013 and public listing 32 552.792 units of Vanguard Growth Index Fund-held in 21,708.14 21,708.14 the Vanguard brokerage account#09892758228;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated May 14,2013 and public listing 33 282.838 units of Vanguard Health Care Fund-held in 46,357.15 46,357.15 the Vanguard brokerage account#09892758228;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated May 14,2013 and public listing 34 201.491 units of Vanguard Mid-Cap Index Fund-held 22,873.26 22,873.26 in the Vanguard brokerage account#09892758228; titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated May 14,2013 and public listing 35 400 shares of Vanguard Natural Resources LLC-held 11,420.00 11,420.00 in the Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5,2013 and public listing Accrued dividend on Item 35 through date of death 81.00 81.00 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) ,. �,� �.-q.,.�..;� 3 s.: � _ ��.�,��.;�, ��n,.� �� _...,�,�,,, �, F�� .._ Rev-1510 EX+�OS-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S NUMBER HE DATE OF Tf ANSFER.SATfACFI A COPY OF THE DEED OR REAL ES ATE. VALUE OF ASSET �NTEREST (IF APPLICABLE TAXABLE � VALUE 36 200 shares of Vanguard Short-term Corp Bd Idx -held 16,100.00 16,100.00 in the Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated June 5,2013 and public listing 37 20,266.028 units of Vanguard Short-Term Invest-Gr- 219,075.76 219,075.76 held in the Vanguard brokerage account# 09892758228;titled in the Barbara B.Albee Living Trust dated June 6, 1994;valued per letter dated May 14,2013 and public listing Accrued income on Item 37 through date of death 200.46 200.46 38 500 shares of Windstream Corporation-held in the 4,295.00 4,295.00 Scottrade brokerage account#12479867;titled in the Barbara B.Albee Living Trust dated June 6, 1994; valued per letter dated June 5,2013 and public listing TOTAL(Also enter on Line 7, Recapitulation) 1,645,105.38 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08-09) . . .x �.,�-4, � , � ,,�.��« y��.� �: _ p REV-1511 EX+(10-08) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND R SEDENTDEC ENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 DecedenYs debts must be reported on Schedule I. ITEM N MBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached 8,683.40 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Terrilyn Broderick StreetAddress 1323 Eagle Crest Drive city Myrtle Beach state SC z;o 29579 Year(s)Commission Paid 2013/2014 45,906.00 2. Attorney's Fees James, Smith, Dietterick 8�Connelly, LLP 12,500.00 3. Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation) Claimant Street Address City State Zio Relationshio of Claimant to Decedent 4. Probate Fees 5. AccountanPs Fees 6. Tax Return Preparer's Fees 7. OtherAdministrative Costs 36,197.55 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 103,286.95 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 Albee, Barbara B. 21-13-0630 ITEM NUMBER DESCRIPTION AMOUNT Funeral Exoenses 1 Jesse H.Geigle Funeral Home-funeral 8,326.12 2 Panera Catering-meal after funeral 357.28 H-A 8,683.40 Other Administrative Gost� 3 American Home Shield-home warranty per HUD 7 settlement sheet 460.00 4 Central Telecom 11.85 5 Crossing Homeowner's Association-resale cert per HUD 1 settlement sheet 35.00 6 Crossing Homeowner's Association-resale cert per HUD 1 settlement sheet 35.00 7 Cumberland County Recorder of Deeds-transfer tax per HUD 1 settlement sheet 2,530.00 8 DaFlure Heat and Air-service for residence 40.00 9 East Pennsboro Township-Sewer/trash cert per HUD 1 settlement sheet 10.00 10 East Pensboro Township SeweNSanitation-service for residence 138.00 11 East Pensboro Township Sewer/Sanitation -service for residence 138.00 12 East Pensboro Township Sewer/Sanitation-service for residence 138.00 13 ERA-NRT, LLC-brokerage commission per HUD 1 settlement sheet 7,590.00 14 Hixon&Simko-tax preparation fee for 2013 returns 324.00 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) . . , , �, :, �nm, . ��. �,..�:, �: .��. � �_-. . �,�.� SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM NUMBER DESCRIPTION AMOUNT 15 Keller Williams of Central PA East -brokerage commission per HUD 1 settlement sheet 10,420.00 16 Loney Contracting-removal of Dish per HUD 1 settlement sheet 100.00 17 Luther E. Milspaw Jr.-deed preparation per HUD 1 settlement sheet 110.00 18 Michael Powell-electrical repair 300.50 19 PA American Water-service for residence 28.45 20 PA American Water-service for residence 64.37 21 PA American Water-service for residence 39.87 22 PA American Water-service for residence 38.92 23 PA American Water-service for residence 44.61 24 PA American Water-service for residence 25.15 25 PA American Water-service for residence 25.15 26 PA American Water-service for residence 26.11 27 PA American Water-service for residence 25.85 28 PA American Water-service for residence 22.15 29 PA American Water-service for residence 26.62 30 PPL Electric-service for residence 45.50 31 PPL Electric-service for residence 17.85 Copyright(c)2002 form software only The Lackner Group,Inc. Forrn PA-1500 Schedule H(Rev.6-98) ., ,...� . �,�-.�-�� N�...;�� . �� . .� .� SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM NUMBER DESCRIPTION AMOUNT 32 PPL Electric-service for residence 86.40 33 PPL Electric-service for residence 43.04 34 PPL Electric-service for residence 54.58 35 PPL Electric-service for residence 54.09 36 PPL Electric-service for residence 56.11 37 PPL Electric-service for residence 104.15 38 PPL Electric-service for residence 133.92 39 PPL Electric-service for residence 76.59 40 Stanley Granite 125.00 41 Susquehanna Bank-bank fee for checks 22.63 42 Terrilyn Broderick-reimbursement for postage, packing and hauling,miscellaneous items 1,231.66 43 Terrilyn Broderick-reimbursement for lodging,meals,mileage to administer trust estate 7,303.29 44 Terrilyn Broderick-reimbursement power wash house 300.00 45 Terrilyn Broderick-reimbursement for house leaning,snow removal;junk removal 820.00 46 Terrilyn Broderick-reimbursement for hand truck to remove remaining items from house 87,17 47 UGI Gas Service-service for residence 26.19 48 UGI Gas Service-service for residence 20.36 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) _ .ti � � .��-� Y�.�� . � .�� . �H��.. �.�� SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 ITEM NUMBER DESCRIPTION AMOUNT 49 UGI Gas Service-service for residence 367.57 50 UGI Gas Service-service for residence 19.20 51 UGI Gas Service-service for residence 19.45 52 UGI Gas Service-service for residence 24.41 53 UGI Gas Service-service for residence 39.30 54 USAA-homeowners insurance 1,507.18 55 Verizion-service for residence 85.53 56 Verizion-service for residence 154.86 57 Verizion-service for residence 1.05 58 Verizion-service for residence �5 2� 59 Verizion-service for residence 74.04 60 Verizion-service for residence 75.04 61 Verizion-service for residence 85.64 62 Verizion-service for residence 85.35 63 Verizion-service for residence 182.53 64 Whelan Crossing-homeowners association dues 45.00 H'B� 36,197.55 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) � _.s� r�..�,� �,;� --.��.�,� ��. _��, ;.m� :�. ,�.�, Rev-1512 EX+��y_08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 Report debts incuned by the decedent prior to death that remained unpaid atthe date of death,including unreimburaed medical expenses. �TEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Carlisle Medical Group-medical expense 60.54 2 DCM Chase Credit Card 806.87 3 Debbie Lupold Treasurer-real estate taxes 761.52 4 Discover Card 731.71 5 East Pensboro Township Sewer/Sanitation -service for residence 138.00 6 PA American Water-service for residence 50.19 7 PPL Electric-service for residence 78.39 8 UGI Gas Service-service for residence s�2$ 9 Verizion-service for residence 100.55 10 West Shore EMS-medical expense 208.46 TOTAL(Also enter on Line 10, Recapitulation) 3,003.51 (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 Albee, Barbara B. 21-13-0630 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT �Wards) ($$$) I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116 a 1.2 See attached schedule Total 695,648.79 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Episcopal Diocese of Central Pennsylvania 845,903.48 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 845,903.48 Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) SCHEDULE J BENEFICIARIES (Part I,Taxable Distributions) ESTATE OF: Barbara B.Albee 04/19/2013 229-56-2137 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$� 1 Barbara B.Albee Living Trust dated Trust 100% residue in trust 322,810.49 June 6, 1994 fbo Terrilyn Broderick c/o Terrilyn Broderick (income only); Balance 12932 Claxton Drive of trust paid to Laurel,MD 20708 Episcopal Diocese upon death of Terrilyn Broderick 2 Terrilyn Broderick Daughter Fidelity Annuity, 314,985.69 1323 Eagle Crest Drive Scotttrade IRA; 10% Myrtle Beach,SC 29579 Vanguard Annuity, Susquehanna Bank accounts, USAA accounts; 3 Jack A.Smith Friend Prudential Annuity 57,852.61 PA Total ss�.s48.�s 1 ,. �:� .� .,.� .��.-.� ,r_ ��.� v REV-7514 EX+(4-09) SCHEDULE K COMMONWEALTHOFPENNSYLVANIA LIFE ESTATE, ANNUITY INHERITANCETAXRETURN & TERM CERTAIN RESIDENT DECEDENT (Check Box 4 on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Albee, Barbara B. 21-13-0630 This schedule should be used for all single life,joint or successive life estate and term-certain calculations.For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457,Actuarial Values,Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. ,�� „�, ,� ❑Wi,ll �Intervivos Deed of Trust ❑Other ` � �y��y I.��E E�"1"�1"f"��II+1'�'��tt�-v'�"�Al��,�l"��?�?l��-;��,�� ,� �"� �. �''�'F � y��. ��-`v:� «� ^� �� /�fiF � � __ ..... ..-, .. . .....� �:, . .:..> �. ... ' . . ...':�: . �._. , ... . .�,� .F� ..,us i : . v .-: . .»P}�-r.t8 .. „v...... ;,�''.. ua3-_.�,�',..:. „n..� NEAREST AGE AT TERM OF YEARS NAME OF LIFE TENANT DATE OF BIRTH DATE OF DEATH LIFE ESTATE IS PAYABLE Terrilyn Brodderick 09/25/1958 55 ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years 1. Value of fund from which life estate is payable $ 1,168,713.97 2. Actuarial factor per appropriate table .27621 Interest table rate- � 3 �/y% ❑ 6% ❑ 10% �Variable Rate 1.31% 3. Value of life estate(Line 1 multiplied by Line 2) $ 322,810.49 x��-�� 3��-��b�� ,�� ;N#�t��fiY��1�-'��R��T GA�.��,A'T�t�� -� ��F� .�� :�,� ' ...'�_„abfeF aF,,,,..,�, .r-, , -w,,, .,,., ., .:. ., - �.., , �,,,, .., � �fi : � � . .,... .. .. ...�� . , �w .�. , tf.. _, � � ".s.� ..&�,,..... .. .. .......:...i <�.,r n�. .:, r�_�,�� :... ..,mm.�: NAME OF ANNUITANT NEAREST AGE AT TERM OF YEARS DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding number Frequency of payout�Weekly(52) ❑Bi-weekly(26) ❑Monthly(12) ❑Quarterly(4) ❑Semi-annually(2) ❑Annually(1) ❑Other 3. Amount of payout per period $ 4. Aggregate annual payment. Line 2 multiplied by Line 3 5. Annuity Factor(see instructions) Interest table rate- ❑3 �/2% ❑ 6% ❑ 10% ❑Variable Rate 6. Adjustment Factor(see instructions) $ 7. Value of annuity-If using 3 1/2%,6%, 10%or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 $ If using variable rate and period payout is at beginning of period,calculation is: (Line 4 x Line 5 x Line 6)+Line 3 NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return.The resulting life or annuity interest(s)should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule K(Rev.4-09)