The URL can be used to link to this page

Home My WebLink About03-21-14 (3) REV-1500 EX (02-11)(FI) 1505610140 OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 0 1 4 7 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 0 1 1 3 2 0 1 4 0 7 0 7 1 9 2 5 Decedent's Last Name Suffix Decedent's First Name MI K U L P M I R I A M L (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ❑X 1. Original Return E] 2. Supplemental Return E] 3. Remainder Return(Date of Death Prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise(date of 5. Federal Estate Tax Return Required death after 12-12-82) ❑X 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) 9. Litigation Proceeds Received 10.Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number D A V I D H S T O N E E S Q U I R E 7 1 7 7 7 4 7 4 3 5 N dWGISTER OF BLS U%OAPY o m C-> First Line of Address M S n CO %O - 4 1 4 B R I D G E S T R E E T n m rv�m" s nN = ~�T Second Line of Address 7iz S-,. O r r n 0 � mil, t^rl a City or Post Office State ZIP Code DAT*T-k -t r N E W C U M B E R L A N D P A 1 7 0 7 0 +? F"L, ` CJ) Correspondent's e-mail address: DSTONE@STONELAW • NET Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration or preparer other than the personal representative is based on all information or which preparer has any knowledge. SIG URE OF PERSON S BLE FOR FILING. ETURN DAT 00` 1 -CO .4/ MA, c�41 oZDI ADDRESS 355 0,LD-Q A E ROAD ETTERS PA 17319 SIGNATURE OF P,RE7 E THER THAN REPRESENTATIVE DATE I ADDR 414 BRIDGE ,STREET NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 ..J h�/ �r LV 1505610240 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: MIRIAM L - KULP RECAPITULATION 1. Real Estate(Schedule A) 1 . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 9 1 2 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 4. Mortgages and Notes Receivable(Schedule D) 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 4 6 8 8 , 2 4 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 3 5 2 4 0 , 5 4 7, Inter-Vivos Transfers&Miscellaneous N n-Probate Property , (Schedule G) 5 Separate Billing Requested . . . . . . . 7. 8 3 8 9 5 9 5 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 2 1 5 0 2 8 , 0 1 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 1 8 1 7 2 . 1 8 10. Debts of Decedent,Mortgage Liabilities,and Liens Schedule I 10. 1 1 1 0 . 7 4 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 9 2 8 2 . 9 2 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 1 9 5 7 4 5 . 0 9 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. 1 9 5 7 4 5 . 0 9 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X -0_ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x -045 1 9 5 7 4 5 . 0 9 16. 8 8 0 8 . 5 3 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19. TAX DUE 8 8 0 8 . 5 3 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505610240 1505610240 J REV-1500 EX(Fl) Page 3 File Number Decedent's Complete Address: 21 14 0147 DECEDENT'S NAME MIRIAM L . KULP STREET ADDRESS 1125-2 COLUMBUS AVENUE CITY STATE ZIP LEMOYNE PA 17043— Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 8 , 808 - 53 2. Credits/Payments A.Prior Payments 440 - 43 B.Discount Total Credits(A+B) (2) 440 - 43 3. Interest (3) 0 . 00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This Is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0 . 00 5, If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 8 , 368 - 10 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 ...................................................................... 21 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? ....................................I.............. .... X 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ............... . . .. . . .. .. .. . .. . .. ... X 3. Did decedent own an'in trust for or payable-upon-death bank account or security at his or her death? ......... ❑ 4. Did decedent awn an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?.................................................................................................. ❑X ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is is 3 percent(72 P.S. §9116(a)(1.1)(1)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and fling a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV.1503 EX+(8-12) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER MIRIAM L . KULP 21 14 0147 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 361 . 955 shares RBC Wealth Management-Cohen & Steers 4 ,719 . 89 a $13 . 040 each 2 1653 . 397 shares RBC Wealth Management-Federated 91771 . 58 Strategic Value a $5 . 910 each 3 3991 . 045 shares RBC Wealth Management-Franklin 9,738 . 15 Custodian Funds a $2 . 440 each 4 1713 . 905 shares RBC Wealth Management-Henderson 14 ,345 . 38 Global a $8 . 370 each 5 698 . 613 shares RBC Wealth Management-Loomis Sayles 11, 513 . 14 Strategic a $16 . 480 each 6 345. 119 shares RBC Wealth Management-Oppenheimer 3 ,775 . 61 Steelpath a $10 . 940 each 7 430 . 288 shares RBC Wealth Management-Pimco Funds 41806 . 32 PRLPX a $11. 170 each 8 887 : 79 shares RBC Wealth Management-Pimco Funds 9 ,614 . 77 PTTPX a $10 . 830 each 9 381 . 85 shares RBC Wealth Management-T Rowe Price 4 ,746 . 40 Intl Fund a $12 . 430 each 10 358 . 61 shares RBC Wealth Management-Templeton 4 ,604 . 55 Global Bd Fd a $12 . 840 each 11 455 . 149 shares RBC Wealth Management-Thornburg 9,617 . 30 Invt Tr a $21 . 130 each 12 300 . 852 shares RBC Wealth Management-World Funds 3 , 950 . 19 Inc New Rems a $13 . 130 each TOTAL(Also enter on Line 2,Recapitulation) $ 91,203 . 28 If more space is needed, insert additional sheets of the same size REV-1508 EX+(6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER MIRIAM L . KULP 21 14 0147 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 • Personal property from apartment 500 . 00 2 RBC Wealth Management-Prime Money Market 4 ,184 . 79 3 Verizon-refund 3 . 45 NOTE : The items mentioned in "TWO" of the will were distributed prior to her death except for the car which is mentioned on Schedule "F" • TOTAL(Also enter on line 5,Recapitulation) $ 4,688 - 24 (If more space is needed,insert additional sheets of the same size) REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MIRIAM L . KULP 21 14 0147 If an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. DARLA L RENNINGER 355 OLD QUAKER ROAD Daughter ETTERS, PA 17319- B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'SINTEREST 1 - A . 2006 Citizens Bank-Checking Acct 52,134 . 65 50 - 261067 . 33 #6100711358 joint w/Darla L . Renninger 2 A 2010 Heritage Investment Services Fund- 5,050 . 68 50 - 2,525 . 34 Acct #1011699 joint w/Darla L . Renninger Princ $5,029 . 45, Int $21 . 23 = $5,050 . 68 divided by 2 3 A 2010 Heritage Investment Services Fund- 5,050 . 68 50 • 2,525 . 34 Acct #1011700 joint w/Darla L . Renninger Princ $5,029 . 45, Int $21 . 23 = $5,050 . 68 divided by 2 4 A 2010 Heritage Investment Services Fund- 5,028 . 63 50 • 2,514 . 32 Acct #1013270 joint w/Darla L . Renninger Princ $5,008 . 46, Int $20 . 17 = $5,028 . 63 divided by 2 5 A 9/28/04 M&T Bank-Checking Acct #9836671595 558 . 41 50 • 279 . 21 joint w/Darla L . Renninger 6 A 1999 1999 Toyota Corolla at KBB value 2,658 . 00 50 - 1,329 . 00 joint w/Darla L Renninger TOTAL(Also enter on Line 6,Recapitulation) $ 35,240 - 54 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MIRIAM L . KULP 21 14 0147 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. DESCRIPT ION OF PROPERTY ITEM INCLUDETHENAME OFTHE TRANSFEREE,THEIR RELATIONSHIPTO DECEDENTAND DATE OF DEATH % DECUS EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER,ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST pr APPUCAM) VALUE 1 RBC Wealth Management-IRA Acct #311- 81243.13 100 . 00 81243 -13 70081 benef : Darla L . Renninger opened 7-27-09 2 Sun Life Financial Master Variable 75,652 . 82 100 . 00 751652 . 82 Annuity Contract #03-0305-009371 benef is Darla L . Renninger TOTAL (Also enter on Line 7,Recapitulation) S 83,895. 95 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 RESIDENT EDEN TURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MIRIAM L . KULP 21 14 0147 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1 Tri-County Memorial Gardens-opening/closing of grave 1,916 . 00 Parthemore Funeral Home-funeral expenses 11,136 . 99 Culhane ' s-Funeral meal expenses 582 . 24 Gingrich Memorial-stone 1,34D - 00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2 . AttomeyFees: David H Stone , Esquire 2, 500 . 00 1 Family Exemption:(If decedents address is not the same as claimant's,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4 • Probate Fees: Register of Wills Cumberland County 298 . 50 and filing Inh Tax Ret and Inventory 5 • Accountant Fees: 6 • Tax Return Preparer Fees: 7 • Skip ' s Hauling-moving items from apartment 50 . 00 2 Checks written by decedent but not cleared by bank 40 . 00 3 Verizon-services at apartment 26 . 33 4 PPL-electric service at apartment 146 . 54 5 PPL-electric service at apartment 22 . 50 6 PPL-final electric services 13 . 08 7 Reserve for closing expenses 100 . 00 TOTAL(Also enter on Line 9,Recapitulation) $ 18 ,172 • 18 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER MIRIAM L . KULP 21 14 0147 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Dr . Rich-services rendered 67 . 80 2 Holy Spirit Hospital-debt of decedent 67 . 32 3 West Shore EMS - ALS - ambulance service 975 . 62 TOTAL(Also enter on Line 10,Recapitulation) E 1,110 - 74 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: MIRIAM L . KULP 21 14 0147 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1 DARLA L RENNINGER Lineal 1951745 . 09 355 OLD QUAKER ROAD ETTERS PA 17319- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. ]). NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1 • B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 • TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. • r r , LAST WILL AND TESTAMENT OF MIRIAM L . KULP I , MIRIAM L . KULP, being of sound and disposing mind , hereby make , publish, and declare this my Last Will and Testament, hereby revoking and making void all prior Wills and other testamentary writings at any time heretofore made by me . ONE: I direct my Executrix , hereinafter named, to pay all of my just debts and testamentary expenses as soon as conveniently can be done after my demise . TWO : I give , devise and bequeath the following property to my daughter, DARLA L . RENNINGER: Honeymaple Dining Room Suite ( 2 piece Hutch, Round Table , Lazy Susan, matching Captain' s Chairs wire sides ) ; Kitchen ( 3-piece ) set with Wrought Iron Legs; Floor model 25 inch T .V. ; Simmons Hide-a-Way Sofa-Tuxedo style; White Reed/Wicker Sofa with cushions; Crystal Punch Bowl ( ladle and 12 matching cups ) ; Corning Ware 8-piece set , Cornflower Pattern; Silver 2-cup Coffee Pot; car; 20-piece Red Crystal (Ruby dishes ) ; All accessories Dishes; Antique Kerosene Lamps; Long Mirror; 36- inch round Pine Table; Roll Bed with mattress; 40-inch Round Sunbeam outdoor table; all pictures; Maple Deacons Bench. THREE: I give, devise and bequeath all the rest of my estate to my daughter , DARLA L . RENNINGER. FORTH: I nominate, constitute and appoint my daughter, DARLA L . RENNINGER, as Executrix of this my Last Will and Testament and further direct that she shall serve without bond . Said Executrix shall have the power to discharge all the debts , liens and encumbrances upon my estate , as well as any taxes thereon, to pay for the cost of the final disposition of my remains and final illness, if any, to receive any and all commissions and other compensation for services rendered by me during my lifetime , and to perform any and all fiduciary duties authorized by statute . Further , I direct my Executrix to preserve my estate and any instructions pertaining to the distribution of the same from any attachment or anticipation while in the hands of the said Executrix , it being my express intent that all legacies shall be free from any attachment or anticipation while in the hands of the accountant for my estate . y IN WITNESS WHEREOF, I , MIRIAM L . KULP , Testatrix , have this day of /i+{--, , 1•z� 1994 , set my hand and seal to this my Last Will and Testament. �f 'MIRIAM L ..KULP ( SEAL ) SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testatrix , MIRIAM L. KULP, 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, all being present at the same time , have hereunto set our hands as witnesses . , COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF DAUPHIN I , MIRIAM L . KULP , Testatrix , whose name is signed to the attached or foregoing instrument , having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed . i A� / If IAM L . KUL —' Sworn and subscribed to before me by MIRIAM L . KULP , the Testatrix, this ">- day of N 't- 1994 . ( SEAL ) Notary Public NOTARIAL SEAL _ LBRUCE D. FOREMAN, Notary Public COMMONWEALTH OF PENNSYLVANIA sburg, Dauphin County, Pa. s s mission Ex pires Sept.25, 1995 COUNTY OF DAUPHIN We , /&he/e w /�h,��ch�C� Cl�ar��l, �- 1� 11er the witnesses whose names are signed to the attached or foregoing instrument , being duly qualified according to law, do depose and say that we were present and saw MIRIAM L . KULP , Testatrix, sign and execute the instrument as her Last Will and Testament ; that MIRIAM L . KULP signed willingly; that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at the time 18 or more years of age , of sound ind and under no constraint or undue influence . r , Sworn to and subscribed before me this day of :..�•. _, - 1994 . ( SEAL ) Notary Publ c --j BRUCE D. [-DUMAN, Hotenl !'!^•' F'a rrlhnr,. rl,"'hln , RBC Wealth Management Renaissance Place,2nd Floor 635 North 12th Street Lemoyne,PA 17043-1225 ■ Phone: 717-724-4200 Toll Free:800-480-7497 Fax: 717.724-4239 March 4, 2014 David H Stone, Esquire Stone, LaFaver & Shekletski 414 Bridge Street P. O. Box E New Cumberland, PA 17070 RE: Miriam Kulp Estate Dear Mr. Stone: Please find enclosed the items you requested on 2/19/2014 for the Estate of Miriam Kulp. There are two accounts that Miriam held at RBC. IRA Account #311-70981 opened 7/6/2009 IND Account#311-70911 opened 7/6/2009 Please find account statements for both accounts, Date of Death Values for both accounts, and a beneficiary designation for the IRA. If there is any information needed in addition to what is provided, please do not hesitate to call. Sincerely, Timothy ngle, C ® Senior Vice President-Financial Advisor 4717-724-4222 Enclosure RBC Wealth Management,a division of RBC Capital Markets,LLC,Member NYSE/FINRA/SIPC. _ RBC Wealth Management Renaissance Place,2nd Floor r: 635 North 12th Street Lemoyne,PA 17043.1225 • D ° Phone: 717.724.4200 Toll Free:800-480-7497 Fax: 717.724.4239 Miriam L Kulp Date of Death Values 1/13/2014 IND#311-70911 Name of Company Symbol Date of Death No. of Shares Cost Per Share Cost Basis Prime Money Market 01/13/14 4184.79 $ 1.00 $ 4,184.79 Cohen & Steers CPXIX 01/13/14 361.955 $ 13.04 $ 4,719.89 Franklin Custodian Funds FRIAR 01/13/14 3991.045 $ 2.44 $ 9,738.15 Federated Strategic Value SVAIX 01/13/14 1653.397 $ 5.91 $ 9,771.58 Henderson Global HFQIX 01/13/14 1713.905 $ 8.37 $ 14,345.38 Loomis Sayles Strategic NEZYX 01/13/14 698.613 $ 16.48 $ 11,513.14 Pimco funds PTTPX 01/13/14 887.79 $ 10.83 $ 9,614.77 Pimco funds PRLPX 01/13/14 430.288 $ 11:17 $ 4,806.32 T Rowe Price Intl Fund PREMX 01113/14 381.85 $ 12.43 $ 4,746.40 Oppenheimer Steelpath MLPZX 01/13114 345.119 $ 10.94 $ 3,775.61 Templeton Global Bond Fill TGBAX 01/13/14 358.61 $ 12.84 $ 4,604.55 Thornburg Invt Tr TIBIX 01/13114 455.149 $ 21.13 $ 9,617.30 World Funds Inc New Rems RREIX 01/13114 300.852 $ 13.13 $ 3,950.19 Total $ 95,388.07 The information contained in this letter has been derived from sources believed to be reliable,but is not guaranteed as to the accuracy and completeness and does not purport to be a complete analysis of the material discussed. The opinions expressed herein do not necessarily reflect those of RBC Wealth Management, and are subject to change without notice. RBC wealth Management,a division of RBC Capital Markets,LLC,Member NYSE/FINRA/SIPC. A� Citizens Bank 2001 Market Street,Suite 600 Philadelohia,PA 19103 To Whom It May Concern: February 8, 2014 This letter is to verify that as of January 13`h, 2014 Miriam Kulp had a balance of $52,134.65 in her checking account ending 1358. If you have any Questions or concerns please feel free to contact us at (717) 731 —4858. Sincerely, Jess' a Deimler Senior Personal Banker Universal Citizens Bank—Cedar Cliff 1510 Cedar Cliff Dr Camp Hill, PA. 17011 (717) 731-4858 WQ,o M0.dR�6tn � tf i�h''nn � I� 1�ar1� - k-h n I r�eier I.n ctwer-s,�'--6 cam, 1F RBS 3 Kacey Ct Ste 101 t Mechanicsburg PA 17055-9221 (717)796-9784 HERITAGE INVESTMENT SERVICES FUND An investment that works Miriam L Kulp 1125 Columbus Ave Apt 2 As of:Jan 13,2014 Lemoyne PA 17043.1728 Account RaW MatYI.aSS De osits Interest Withdraws Penalties Balance 1011699 5.00% 5/12/2015 $0.00 $21.23 $0.00 $0.00 $5,050.68 1011700 5.00% 5/1212015 $0.00 $21.23 $0.00 $0.00 $5,050.68 1013270 4.75% 12/29/2016 $0.00 $20.17 $0.00 $0.00 $5,028.63 �ofnt wI l�arlck L . I�Q�n n Ct s Per hone c QQQ , INTEREST FOR THIS PERIOD:$62.63 Page 1 ENDING BALANCE:(includes unposted interest)$15,129.99 M&TBank 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services _ Phone 888-5024349 F ax (302)934-2955 Miriam L.Kulp February 11,2014 Darla L.Renninger 355 Old Quaker Road Etters,PA 17319 Re: Estate of Miriam L Kulp - Social Security: Date of Death: January 13 2014 Dear Sir or Madam: Per your inquiry on February 6,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following. 1- Type ofAccount Checking Accowtt Account Number 9836671595 Ownership(Names o,) Miriam L.Kulp Darla L Renninger Opening Dote 0912812004 Balance on Date of Death $ 558.41 Accruedinterest $ .00 Total - ------------------------------- $558.41 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the Highland Park at 717-737-322. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as power of Attorney,Custodian of U form TYanst Representative Payee,or Trustee Dods a Written Agreement Sincerely, Valarie Mercer Adjustment Services Kelley Blue Book Page I of 2 iwwl Kelley Blue Book The Trusted Resource' TOYOTA ^ - ± tery oovmr.a _--_.Why ads? 1999 Toyota Corolla Sell To Private Party Pricing Report G„d rsl, candid. Vey Good Gondieon $3,058 cmMaion $2,658 _ $3,158 Style:VE Sedan 9D dMa r �1 Ga.dua'omn Mileage:75,o0o a, $3,333 7=777 i- Vehicle Highlights Fuel Economy' Max Seating:4 Private Party Values valid for your area through 3/13/3014 City 25/Hwy 33/Comb 28 MPG Doors:4 Engine:4-Cyl,1.8 liter Drivetrain:FWD Transmission:Automatic EPA Class:Compact Cars Body Style:Sedan Country of Origin:Japan Country of Assembly:United States Your Configured Options Our Pre-selectcKI op110m5,based df IyPiol epulpawl for this Car. Options that you added while configuring this or. Engine Comfort and Convenience Safety and Security 4-Cyl, 1.8 Uter Air Conditioning Dual Air Bags Transmission Steering Wheels and Tires Automatic Power Steering Steel Wheels Drivetrain Entertainment and Instrumentation FWD AM/FM Stereo Glossary of Terms Kell"Blue Bookp Trade-in Value-This Is the amount You on expttt to receive when You trade In Tip: your or to a dealer.This value Is dims,Plrred Based on the style,condition,mileage and options It's crucial to know your car's indicated' true condition when you sell it, Trade-in Range-The Trade-in Range is Kelley Blue Book's estimate of what you can reasonably expect so that you can price it to mKOPe this week based on the style,condition,mileage and opdms of your vehicle wnen you trade it appropriately.Consider having in to a dealer.However,ovary dealer is different and values are not guaranteed, your mechanic give you an objective report. Kelley Blue Bookp Private Party value-This is the Starting print for negotlatkm 0(a used-or sale between a private buyer and seller.This Is an-as is'value that does net Include and warranties.The final Price depends on the ors dual condition and loot market(adds. Private Party Range-The Private Pad Range is Kelley Blue Book's estimate of what you on reasonabh'expecl to receive this week for a vehicle with stated mileage In the selected condition and configured with your selected options,excluding taxes,title and fees when wiling to a private party. http://www.kbb.com/toyota/corolla/l 999-toyota-corolla/ve-sedan-4d/?condition=fair&vehi... 3/13/2014 RSC Wealth Management Renaissance Place,2nd Floor der: 635 North 12th Street 'fir Lemoyne,PA 17043-1225 s ° Phone: 717-724.4200 ToR Free:800-480-7497 Fax: 717-724-4239 Miriam L Kulp Date of Death Value 1/13/2014 IRA#311-70981 Name of Company Symbol Date of Death No. of Shares Cost Cost Basis Per Share Income Fund of America AMECX 01/13/14 392.971 $ 20.48 $ 8,048.05 Prime Money Market 01/13/14 195.08 $ 1.00 $ 195.08 Total $ 8,243.13 The information contained in this letter has been derived from sources believed to be reliable; but is not guaranteed as to the accuracy and completeness and does not purport to be a complete analysis of the material discussed. The opinions expressed herein do not necessarily reflect those of RBC Wealth Management, and are subject to change without notice. RBC Wealth Management,a division of RBC Capital Markets,LLC,Member NYSE/FINRA/SIPC. -Sun Life Financial Masterst Variable Annuity Quarterly Statements October-1, 2013 through December.31,2013 - C E L A W A R E LIFE" 0159801 01 SPO.46d —SNGLP 010117318 401-P6013041 MIRIAM L KULP 355 QUAKER ROAD Contract number 03-0305.009371 ETTERS PA 17319 Product Masters Fxtra Variable Annuity Mid RIAM L KULP �l"1118i111111'!�l`1111)!lnlllrllhdl)!`III'!I"IPlldillrl Annuitant(s) A!IRIAM L KULP Plan type NorrOualified Summary OF Values Year to date This quarter issue date February S.2007 Account activity Beginning Account Value 573.630.93 S74,445.57 Withdrawals and fees -56.050.00 -$1,500.00 Earnings(gain/loss) $8,07119 52.707.25 Fading Account Value.......................__........................................................_......S7S.6S2.82 Surrender Value — S73.453.21 Personal rate of return 11.33% 166% Beneficiary protection Death benefit value................................._........_...............................................VS,6S2.82 When reviewing this statement.please keep in mind that the values are current as of the statement date and may fluctuate. Please refer to the current prospectus for more detailed information. %sued by Sun Life Assurance Companv of Canada(U.S.1,P 0.Box 9133.Wellesley Hills,MA 02481-9133.Sun t ife Assurance Comoarw of Canada(U.S.)is a member .0 the Delaware Llle group of companies and is not affiliated with Sun Life Financial,the Sun Life names and marks are used under license.Sun Life Assurance .omoanv of t.anaoa(11S,)Drowdes this conrrrmahon on behalf of the brokeridealer listed in the Contract information'section,who is acting as an agent of Sun Life 1..ssurance Companv of Canada W.S.I. � www.delawarelife.com (j) 24-hour automated service 800-752-7218 1f Customer Service 800-752-7216 M—F 8:30 a.m.-6 p.m.ET 1 of 5 October 1, 2013 through December 31, 2013 (xtrent allocation continued As of 09/30/2013 For This Statement Period As of 12/71/2013 �. Begirmint� jAccount g•, Value r InterestRatem Fixed Income MFS VIT III Limited Maturity Portfolio Initial Class 15% $10,256.27 $974.05 -510.05 $11,220.27 1105.82084 $10.1465520 PIMCO Total Return Portfolio(Admin) 10% $6,682.77 $817.68 -$34.93 $7,465.52 482.47453 515.4734020 Total 2S% $18,685.79 Grand total 100% $75,652.82 'Net activity is the end result of certain financial transactions for this statement period and excludes investment experience. Percentages may not be exact due to rounding. Transaction details Unit Price or., 0 of Units Date- 10/25/2013 Systematic withdrawal PIMCO Total Return Portfolio(Admin) 2.81878 515.6770110 -$44.19 First Eagle Overseas Variable Furl 11.33396 $13.3413160 -S151.21 Franklin Income Securities Fund 11.89454 $12.5780390 -$149.61 .MFS VIT III Mid Cap Value Portfolio Initial Class 5.70096 $15.3658390 -$87.60 MFS VIT III Limited Maturity Portfolio Initial Clam 6.62474 S10.1724720 -$67.39 Total -$500.00 11/25/2013 Systematic withdrawal PIMCO Total Return Portfolio(Admin) 2.80461 $15.6456600 -S43.88 First Eagle Overseas Variable Fund 11.27535 $13.3574570 -$150.61 Franklin Income Securities Fund 11.83288 $12.6452740 -$149.63 MFS VIT III Mid Cap Value Portfolio Initial Clam 5.67173 $15.6601130 -588.82 MFS VIT III Limited Maturity Portfolio Initial Clam 6.59026 $10.1756170 -567.06 Total -5500.00 12/20/2013 Rebalance From First Eagle Overseas Variable Fund 1.705.18599 $13.1986720 -$22,506.19 Franklin Income Securities Fund 1.789.52962 $12.6525650 -522,642.14 MFS VIT III Limited Maturity Portfolio Initial Clam 996.63781 $10.1524190 -510,118.28 MFS VIT III Mid Cap Value Portfolio Initial Class 857.74042 $15.7352230 -$13.496.74 PIMCO Total Return Portfolio(Admin) 424.10193 $15.5127110 -$6378.97 Total -$75,342.32 Rebalance to First Eagle Overseas Variable Fund 1,712.49729 $13.1986720 $22.602.69 Franklin Income Securities Fund 1,786.41169 $12.6525650 S22.602.69 MFS VIT III Limited Maturity Portfolio Initial Class 1,113.17017 $101524190 $11,301.37 MFS VIT III Mid Cap Value Portfolio Initial Clam 718.21925 $15.7352230 S11.301.34 PIMCO Total Return Portfolio(Admin) 485.68107 515.5127110 57.534.23 Total $75,342.32 12/26/2013 Systematic withdrawal PIMCO Total Return Portfolio(Admin) 3.20654 $15.4401380 -549.51 First Eagle Overseas Variable Fund 11.30600 $13.2938300 -5150.30 .klin Income Securities Fund 11.79351 $12.7281840 -5150.11 MFS VIT III Mid Cap Value Portfolio Initial Clam 4.74138 515.9215320 -$75.49 MFS VIT III limited Maturity Portfolio Initial Clam 7.34933 510.1492180 -$74.59 q Total -S500.00 `o 9 0 Contract number:03-0305-009371 Masters Extra Variable Annuity vww.delawarelife.com 3 of Ju1-29.2009 09 03 AM RG9 Wealth Management 7177244239 45147 _ as RBC Wealth Management' ��1��1/�l�lt�ilitli�lliilllll111�111��t1 ■,esiw. } AesaumNumher 3117oaa1 Rap ID 000CAU Ahomata Bmnoh 010LE CUSTODIAL INDIVIDUAL RETIREMENT ACCOUNT ADOPTION AGREEMENT Name and Address Date of Birth Miriam L Kula individual Retirement Account OT/07/1425 RSC Coplial M00 Corp Cust SSN 369 QuakerROad Etters FA 17318 211.18-0828 SelectOns: s IR ❑ IRA DI ❑ Deeadant IRA IR ❑ IRA Rollover from Qualified Plan,TSA/443(h),or IP R SEPIIRA ausbu sa Name Oovemmental 437(b)-Commingled(Complete (Attach copy of employer's SBP document.) Rollover Certification) Employer's SBP or SAR/SBP Account Number, RR❑ IRA Rollover from Qualified PJmL TW403(b),or IS ❑ SAR/SBP Business Name: t7ovamrrumml 437(b)-6ogregatcd(Complete (Attach copy ofSBP form.) Rollover Certification) Employer's SBP or SAR/SEP Amumt Numbon DESIGNATION RciattonshipDollin l0ns: S=S o N Non oose PPBnti T=Trust arkonvinihobox mvblad. At each Sonafiviary duaignat on,indicate if such llanntio)ary dies bcforc you,how their portion should bo pold: Pro Rate—To the romairinsprimu%Bmwgoiarlws named oat this tlarm proportionate to thotrruledva paroonurgas(or tftham we no romsining primary Beneficiaries,to iha aoni{ngcnt Bet xftalartss(tstod), Per Stirpas—Equally to such Amefiaiary's descendants,who survive you,by right of reprosentation, please note,if no selection is made the Pro Rata designator will apply, Beneficiary Name and Address IM Primary I Retaiivusttip SSNIEIN Darla LRenninger Na45 ouse 177.443843 366 Old Quaker Road O Contingent Ettem PA 17319 DatoofBirth % 06111/1961 10000 ❑ Pro Rata ❑ Per Stirpos Beneficiary Namo and Addross ❑ Primary Relationship SSNIEB4 ❑ Contingent Date of Binh % ❑Pro Rata ❑ Par Stirpas Beneficiary Namo and Address ❑ Primary Relationship SSN/BIN ❑ contingent Data of Birth % ❑ Pro Rata ❑ Por Sdrlws Baneficiory Name and Addmas ❑ Primary Relationship SSN/BiN ❑ Contingent Data ofBirth % ❑ Pro Raw ❑ Par stirpaa Page 1 of 3 RBC Wealth Management,a division of RBC Capital Markets Corporation,Member NYS&pINRAISIPC. UTAA(10109) Jul-29-2009 09 03 AM RG9 Wealth Management 717/244239 46147 I! RBC Wealth Management' �• i Amount NumIr 3'i1T�0(BJ61 ! ! J J Rep ID OOOCAU Altamato Smnrh 010LE CUSTODIAL INDIVIDUAL RETIREMENT ACCOUNT ADOPTION AGREEMENT it SECTION THREE.' a SeneOctary Name and Address ❑ Primary Relationship SSWEIN ❑ Contingent Date of Birth % ❑ PraRata O PerStirpos U For additional Beneficiaries,too atta daId form, 51;rTION FOUR; , . I nastily that the above Information is eonaot I appoint RBC Capitol Markets Corporation as Custodian In aaordana witk the terms and conditions of this individual Retirement Custodial Agreement and consent to thin Custodian's lows in the fee schedule,no Ibes are subject to change upon netice to the Account Owner.I acknowledge receipt of a copy of the plan document under which this Individual Retirement Account is established,a copy ofthis Adoption Aggrrenement,and a copy of the Dlsolosma Statement with respect to this Individual Rolimmont Account idirad the Custodian to invest available uninvested Cash balauacs army account on a daily basis Ina money market fund.I diroot all bonefas upon my death be paid as indicated above,in the event that this Is a rollover contribution,I irrevocably elect,pursuant to the requirements of lA02(s)(*jT of rho IRS rogulatiom,to treat this contribution as a rollover contribution.THIS AGREEMENT CONTAINS A PREDISPUTE ARBITRATION CLAUSE AT ARTICLE S OF THE INDIVIDUAL RETIREMENT CUSTODIAL AGREEMENT AND PAGE 3 OF THIS ADOPTION AGREEMENT. Peer,Annual Maintmanw:$45 Closingl`tannlantian:$125 CliontSignaturo �into Print Name ?/'p 0, "�t l r Client Signature Data Print Name ? �0 Aaaptod By 9G�G'' James A.B )amts A.Bergeron ECTION FIVE: CONSENT OF spouse ❑1 consent to the above iianoficlaty designation. (NOTE:Cement of your spouse may he required In a commanlw property or marital property slam to allbaively designate a Doeallelary other dun or in addition to your sports.) DISCLAIML•R FOR COMMUNITY AND MARITAL PROPERTY STATES:Your spouse may lave a property interest in your account and the right to dispose of the interest by Will,ThcralbrC,the Custodian disclaims any warranty as to die efibodvaness of your BanoOciary,designation or as to theownu*sbip of the Account oftor die death of your spouse.For additional information,please consult your legal adviser. Spouse Signature Dam Print Name Or Marital States.❑ 1 cortay at the time of signing,i am notmarriea, Client Signature Date Print Name Nanny Signature(fir either choice above) Data Sind flan Title document mutt accompany the Custodial Traditional IRA Agreement and Disclosure Statement(M2103)AND the Client Account Agreement(M0161) Page 2 011 RBC Wealth Management,a dlvlslon of RBC Capital Markets Corporation,Member NYSFJFINFWSIPC, UTAA(701011) Jul-29-2009 09 03 AM RG9 Wealth Management 7177244239 47/47 ry��ry RBC Wealth Management' II IIIIIIillllilllll IIIIIIillll I II III I IIII III Hi"i'u• l Aoaaunl Number 31170991 Rep ID 000CAU AltemateBmnch 01nLE CUSTODIAL INDIVIDUAL RETIRBM6NT ACCOUNT ADOPTION AGREEMENT COMPLETION I. Rood carefuily the accompanying Custodial Traditional IRA Agreement and Disclosure.(Capitalized terms In the IRA Adoption Agreement have the some meanings as in the IRA Agreement and Disclosure Statement.) 2. Complete or correct Sections I,2,3,4 and 4,if applicable. 3. Complete addldanal forms If indleated by the box In Section 2. 4, Keep the client copy and the IRA Agreement and D'uclosuro Statement far your records. S. R6tum the original document in the envelope provided. UncriCl Arty s I. Primary Beneficiaries.Unless the Amount Owner C'Ownige)otherwise specifics,the Account will be paid in equal shores to the printery Benefiaituy or Beneficiaries who survive the Owner.if the Ownerapeclfics percentage(or fractional)shares for tho primary Benefidarics and If some but not all such Benafhdories fail to survive the Owner,the Account will be divided omen$the Surviving primary Bcnegclarias in proportion to the rotative percentage(m National)shame of each,unless the owner has stpulowd a Per Stirpu designstion. 2, Contingent Beneficiaries.If no primary Beneficiary survives the Owner,the Account will be paid In equal shares(unless otherwise specified in the Bonoficiory designation)to the contingent Beneficiary or Beneficiaries who survive the Owner,following the rule in paragraph(1)above. 3, Death Before Full Distribution,Unless the Owner has otherwise specified in lire Beneficiary designation,the Beneficiary will become fixed as of the Owner'(death so that,if a Beneficiary survives eta Owner but diet before the receipt of oil amounts due such Beneficiary,the remaining amounts wl II be payable to the representative of the Beneficiary'a estate or to one or more Beneficiaries designated by such Beneficiary. 4. Designation by Relationship Only.Any designadae of a Beneficiary only by stutomant of relotionehlp to the Owner(or Beneficiary)will be effective only to designate the person or persons standing In such relodonship at the Owner's(or Beoefieiory's)death. Iron Beneficiary designation Is in Pone at the time of the Owner's death,tits Beneficiary shall be the spouto of the Owner.Ifthere Is no living s Ouse, to Beneficl shall be the Owner's estate. r This agreement eontalmi s prcdlspute arbitration clause.By signing an arbitration agreement the parties agree as follows: 1. All larder la this agreement are givinp.up the right to sue each other in court,including the right to a trial by jury,except as provided by t a rules of the arleitnlion forum n which a claim it filed. 2. Arbitration awards aro generally final and binding;a parry's ability to have a court reverse or modify an arbitration award Is very limited. 3. The ability of the parties to obtain(106111119114,wi(nass statements and otter discovery is generally more limited In arbitration than in court proceedings. 4. The arbitrators do not have to explain the roason(s)for their award. 3. The panel of arbitraten will typically Include a minority of gridtraton who were or are of illatedwilh the securities industry. G. The rules of some arbitration forums may Impose time limits for bringing a claim In arbitration In some cases,a claim that it ineligible for arbitration may be brought in court. 7. The rules of the arbitration forum to which the claim is filed,and any amendments Iheratoi shall he incorporated into this agreement. The Client agrees that any controversy arising out of or relelins directly or indirectly to this Agreement,or any investment by the Client hereunder,or with respect to transactions of an kind executed by or With RBC Wealth Management,a division of RDC Capital Markets Corporation"RBC Witt",Member WYSC/r=113IPCI its officers,directors,ACenter,employees,or affiliate,or with rospset to this Agreement or any other agreements entered In to with RBC VVM relating to the Accounts With RBC WM or the breach thereof,stall be settled by arbitration pursuant to rise Federal Arbitration Act and is accordance with the rules,then in effect,of the Financial Industry Regulatory Authorlqq••.Notice preliminary to,in conjunction with or Incident to arbitration,may be sent to the Client by mail and porsonnl servica is heroby walvcd. Judgment upon any award rendered by the arbitrators maybe entered In any court having jurisdiction thereof. No parson shall bring a putative or certified class action to Arbitration,nor seek to enfant any predisputo arbitration against any porous who het Initiated In court a putative class action;or who Is a member of u putative clan who has not opted out of the class with respect to any claims encompassed by the putative Clan Notion until:((i)the request for clan certification is denied;(ii)the class Is dceertified;or(ih) the customer is excluded from tiro tiara by mho mart.Such forheorunce to onforac an agroement to arbitrate shall net constitute a waiver of Any rights under(Iris Agreement except to the extent stated heroin. Page 3 of 3 RBC We911h Management,a oNlstcn of RBC Capital Markets Corporation.Member NYBPJPINRAIBIPC. UTAA(10108)