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Home My WebLink About10-01-14 � 1505610105 REV-1500�`�°Z-11>�F" � OFFICIAL USE OIdLY PA Department of Revenue p�nsylvania Counry Code Year File Numbe Bureau of Individual Taxes �`�Ap'�`�'��E��` PO BOX28o6o1 INHERITANCE TAX RETURN / �/ Harrisbu ,PA i i28-06oi RESIDENT DECEDENT � �lJ ENTER DECEDENT INFORMATION BELOW Sociai Security Number Date of Death MMDDYWY Date of Birth MMDDYYYY 12/29/2009 10/08/1927 DecedenYs Last Name Suffix DecedenYs First Name � MI Peffer II P r I�v I L�L/A� K (If Applicable)Enter Surviving Spouse's Infortnation Below Spouse's Last Name Suffix Spouse's First Name MI _ Spouse's Social Security Number - THIS RETURN MUST BE FILED 1N DUPUCATE WITH THE _ REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW t� 1.Originai Retum O 2.Supplemental Return O 3. Remainder Retum(Date of Death Prior to 12-13-82) p 4.Limited Estate O 4a.Future Interest Compromise{date of O 5. Federal Estate Tax Retum Required death after 12-12-82) � 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) {Attach Copy of Trust.) O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 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 T0: Name Daytime Telephone Number William S. Oaniels (717)243-3831 0 c� _ s � rn REC�ISTER OF WILLS� LY p �—mj n €77 � — � m � n � � � First Line of Address � %7 y}, f'-" t—� �147 � 1 West High Street �~ �: �=� . � c� �: , . __..,� -,� _ � -- ..� , Second�ine of Address �, :` � _ ""�7 Suite 205 .a� ' �,.�'—'., 1�= r�rt DATE FILED � ' � City or Post Office State ZIP Code ._� � � Q � Carlisie PA 17013 correspondent°s e-maii address:humeranddanieis@outlook.com Under penalties of perjury,I dedare that i have examined this retum,including ac�mpanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and compiete.Declaration of preparer other than the personal representative is based on all information of which preparer has any krrowledge. SIGNATUF�F PERSON RESPOtJ�i6�FO�G RETURN ��AZ �// ` ADDRES / �� ' r ,T-T,S� Carol K.Wilcox, 75 Victory Chur R d, ardners, PA 24 SIG R OF�P P ft OTHER TH P EN A IVE D Z � �� ADDRESS William S. Daniels, Esq., Humer&Daniels Law Office, 1 West High St, Suite 205, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610105 15056101�5 � � � 1505610205 REV-1500 EX(FI) DecedenYs Social Security Number �ecedenrs Name: WilliBm K. Peffe�, II RECAPITULATION 1. Real Estate(Schedule A). . . ................... ....... . ............... 1. 464,172.00 2. Stocks and Bonds(Schedule B) ...... .. . .................. . ........... 2. 192,936.99 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00 4. Mort a es and Notes Receivable Schedule D 4. 0.00 9 9 � ).............. . ..... . .... .. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 45,039.16 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 0.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 0.00 8. Total Gross Assets(total Lines 1 through 7).................... . . . ...... 8. 702,148.15 9. Funeral Expenses and Administrative Costs(Schedule H)...... . ............ 9. 48,213.95 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. 32,600.96 11. Total Deductions(total Lines 9 and 10). ..... . . .. ....................... 11. 80,814.91 12. Net Value of Estate(Line 8 minus Line 11) . ........... . ....... . .. . . . .. .. 12. 621,333.24 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .................. . ..... 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) ........... . ............ 14. 621,333.24 TAX CALCULATION-SEE INSTRUCTtONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 {a)(1.2)X.0_ 15. 16. Amount of Line 14 taxable at iineal rate X.0 45 621,333.24 16. 27,960.00 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. T,vc DUE .. ............. .............. .. . ................ .. ....... 19. 27,960.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Slde 2 L 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number � / -� v / �— � � � � Decedent's Complete Address: DECEDENTS NAME William K. Peffer, II STREETADDRESS 4 Ladnor Lane CITY STATE ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 27,960.00 2. Credits/Payments A.Prior Payments 28,000.00 B.Discount 1,474.00 Total Credits(A+g) (2) 29,474.00 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) 1,784.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 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.......................................................................................... ❑ � 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 Dec.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?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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)].The statute does not exempt a transfer to a suroiving 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 indivitlual who has at least one parent in common with the decedent,whether by blood or adoption. . ___. .._ " ' �-� `_=- 1� � !T ' � , 1 I 1 1 �_�..%X I 1 ' I , . � p � � I, WILLIAM K. PEFFER, 2nd, of South Middleton Township, Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any will previously made by me. I. I give, devise and bequeath all my estate of every nature and wherever situate to my daughter, CAROL K. WILCOX, providing she shall survive me by thirty days. II. Should my daughter, Carol K. Wilcox, , predecease me or die on or before the thirtieth day following my death, I give, devise and bequeath all of my estate of every nature and wllerever situate to her issue per stirpes living on the thirty-first day following my death. III. All federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this will, including any interest or.penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my � , � estate without apportionment or right of reimbursement. `� , �v N. I appoint my daughter, CAROL K. WILCOX, executrix of this my Last � Will. Should my said daughter fail to qualify or cease to act as executrix, � � I appoint my grandchildren, DELILAH WILCOX, DYLAN WILCOX, � �; -� 3 ,a; 4_� ,., t r . ... .., f +, ; , � ,• � c R � M � „ � s '..\ . �•. t� �,t f�� ..i ��, �Ji�.; � 1 ; `�" � . �� l� ',�5�• K4�1 n .�'.{, i'! _A . � > -� and WAYLON WILCOX, as co-executors, or the survivor(s) of them, executor(s) of this my Last Will. V. I direct tha't my executrix, or her successors shall not be required to post bond or other security for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this f � �� day of January, 2009 �'��~ � ��, � (SEAL) WILLIAM K. EFFER, 2nd The preceding iristrument, consisting of this and one other typewritten page identified by the signature of the testator, WILLIAM K. PEFFER, 2nd, was on the day and date thereof signed, published and declared by WILLIAM K. PEFFER, 2nd, the testator therein named, as and for his last will, in the presence of us, who, at his request, in his presence, and in the presence f each other have subscribed our names as witnesses hereto. �/ �.---. _ .� � S �� c.�.� o,.r. ck w'�. > � G�•��-�� (7 32� � ��_ �,C/�';�G ./U �G`' �7 ,�S'7��,- � G� ��r-;..��'/.� !"'.S'� ��/�'J Z/ � COMMONWEALTH OP PENNSYWANIA REV-1162 EX�11-96) DEPAFTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 � HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 012140 DANIELS WILLIAM S ONE W HIGH STREET STE 205 CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER ""'___ fold ""'""__ '__'___' 101 � 528,000.00 ESTATE INFORMATION: SsN: i�4-2o-$�93 � FILE NUMBER: 2109-0936 � �ECEDENT ►vAME: PEFFER 2ND WILLIAM K � DATE OF PAYMENT: 12/23/2009 � POSTMARK DATE: 1 2/23/2009 � CouNTV: CUMBERLAND � DATE OF DEATH: 09/29/2009 � � TOTAL AMOUNT PAID: 528,000.00 REMARKS: CHECK# 1825 INITIALS: JN SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS ; ,-� � � ,T, ��. � ;� r' ,. 1 ,� � �'ra`' ' < TAXPAYER d ;-, x, , � � r�/ L�� f�`f�r:��,�'" , °�..: .. . . . : < .�, r � : �r -.�' � � 1�r�l��l,�`l�; i `ti � ` � ° - �. � ��, '� '`� �,,'� �. � � ,� � �� , �t�r�,��,�� , ` � .�,� , ��,�,� �� `��'��2'�� f�� r�r�l�� :` �.:. , � �� , , .�,,��`��,��, ��„��,��f�r��r�,�� tir�r��,�`� �� ; ,� �� ,. �,��,,��,��,,��,��,��f��,�r�r�1� � r �f�f�.��,r �;�'� � � �,��t�� `�t`��r��`��`��f�r�f�f�r�r,��. � � �fti��r��f�� f� � �� `�f'`�j`ti f�r�ftir'`,��f�,,r`�r� . f� �j�r� �rti j�r =, ��• . �ftir�r��f��`��`�r``s.�'�� 1�r�r�ftirtir�f�f� ti �.r� . . . � �, ti � �, .� ti � � ti � �, � � � '� `� �� ti � � `� ti ti= �, `r�� l r' ,�r�r��f �,��.�, � ��rti��j��r��4��rtirtir�j�,f�,��,f�r�r�j�,r�1�r r r � r r r r r.��r�r�rt�� 1 � � ��r�r�f��.�j��f�f��f�r��,�r�r�r��,.�f�f��r`r��j��f �._ o�`� ' �r?oao. ;` ; � '.�� r�j� jti� ��f ��r� � l�l�/�r`�I r��r�r .� l ,� r�r�r�r�r��r,�r�r��i`'f�`� ,; , � � � . � � � � � � � `'� � Df�� ` ��l "°°�.' , ; � � � ° . � 'lt l�F � � `�, '`S �1 `� `, � `'� � � � � � � � � � � �` �l�` �j'� �•;\ . � �r� , � � ;�'��,�`��``��1�f`��r4l�r��1��r�r�r�r�>�'�; : � �j '`+�,j`"��r��`�,��,��'�,��1��.��'��1`��''�f�r�/`�f�r'�'f�1�,.�r�f�/�,;j , � �r� l � ,��' ��'��''�''��'�'��'��r�j�` `��'�''�;''�,��''f�,`f�f�� f�j�f�f�j >�� fti f� '`��' '��,��'��,��r �1��'��f�� r�j��r��;;�. , � �l� '�,� � ` =�'`�� j, �;. t,f�, '�,��,f`,1��'� l�/� 1� `� �f� 1��;�� ,�.`. � . `� `'' l j�r��'''��' �' ` l -. , �.� ,= j. , ,� � ��f�f�f�1 �: . � , . �� , -�. . �� -�� ,� : r ,� � � r r r ?�-�J� ; � �r�f�f��f�`� � �, ' �� '.,��. � f �, ;� `��r�f�=��r��r�r�r�!�j�;r,�:,;�� :5 �tir�/.�r�r�l�l.�1,�..1..�.1�,�'�l.�1:�. .l.��k,��,.fK�.��r� .y r�.��. .r.�.��.��,r.�r�.r,`rt r� r.`r.�r.�r,`r.`�:`.,'�,i ' �� REPOSIT TICKET ' �cnsH►� � �°'' ��„�'�a`�.�� so� �•. ' � " HUMEFI& DANIELS 60-295313 � �, � ` _ � �g � �� a,��r��",.� � �s � IOLTA ATTORNEY TRUST /i� � "" � �� , 1 WEST HIGH STREET STE.205 �v �/�� }�� CG�'j��C ; �� . . CARLISLE,PA 17Q13 • I � � �� ""�` '�'� �° � � �� f —23 --g � �a,��;�,�...� .�:� ��< ' �� DAT� � � g + � � ; ��gy DEPOSITS MAY NOT BE AVAILABLE FOR/MMEDIATE WITHDRAWAL. _� : , § � yf�� X � . . ' (qiTOTKFf1DNOTNFASCE) .,,.,�.'w,f °`.�s�� ,��,�73,.^- • � �; � � � sue 1orn� ►rs� 00 p �`� ' _�� ' �i , BiON HENE FOR CASN RECEIVED(IF REOUIRED)* � g G �, �+ 'wa�-��.�Aktl'�s%o s,��:;�'� J��'.' � �� I�M&TBanlc � .LES3 CASH 't � � g�= g RECEIVED �I }��i; �� Hipli StrwFCarlbN Olfiw � _,'� �'� �� Y��b �;�'�..� �s �y'(v,?�,t< ,�q a.: �a $ G ��G�aO��,. � ��. . fi�G. � �,.'�°. �i.� ♦ \ ��ef `�.�: 50 10000 5�9�: , 88 9 24 4 30 2 2u' , . ' �•.. . = — , � �.-Tw_.—..� _ _�- :.-,�`~,�,: �. °: � � ._ �.. ,.--'^.,,,,,,.-�-�.;��..--,. 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'�.,,,, � � -- �.r�+'�"� � r �r � � .,+.. „'� ,.-..�„� �... .. • ^- �.."�...., ..� ...-° .,r-"'`.'<•+...o'"v�^,`.�, . . �-�,y „ ,.•�S-F� -�"✓-...a'"""..�:�-' ".�� -.>�'�+.,y " '^ `�� v-. _ -, - w `�'DQLL`ATtS�IJ `�r...�".-P ` ,,t.y,,,�� /( ` ,�,,,��,,,, .,�_,,. „�'`=-°�,,�,.-�.,�,�"'"`",.-�,4. ..G�...�"":"'`...�.�"v""�,. _ ''r'``�.�.^�. .�t`�-~o+"O ��,�yY�,,,,�"w..%'`v'�v�`""'�.,..-�` .s+``...,r- .r� l,,,- ��a,,.,,• �: �. + �rV"�"`s�._ I��w ' "'r 'r..`" ��✓�.."'� ...� ✓•"�► _�..`�" ,,,r^�< Ir`y. ..�.� �,�� .°=�' �� . �- `- �, .� � " :;�''�.. -^ y_`,;�-'7! � �..-�w .�., �'�- ,i!„'4..r-� �;, . � .. w . .`,�''.., � r�. ,� . : o' . .fi- , - � � x,� � :: �:,��L 3�0.�2 9�`5� �'-�..�_$�8:�4�3 0�2"2 u,°L 8� .�W�,,,�� ....�.,�.�.""= � �� • "�y..' _ � ��L''"`' -^�'`"!'-°`„`"-W,,,,�``°✓y,y...°,"r,�.:.�''�'..-�,`�--'.A-•,.�i°-' �•:-- �^' -�.,.�- :•�r .. '�..w'�""_. .._„� ...,...>^a. '"`. ��..."' -,- . �.. .r^.,.. .+n^.,.. � . ' _. -.s"`� ..�'�t _...'^'S '"_......,,.. _ � � , \ \ . ...-++._'.`.../^�.. _ . - , ,-.r . ��"sie_'.,.✓"� . .. < ' ... � .\ . . � ♦ , . . . \ , i A REV-1502 EX+ (12-12) �pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Peffer, William K, 2nd 21-09-0936 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedenYs interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1• Residential Property,Tax Parcel No.40-30-2646-026: 4 Ladner Lane,Carlisle,PA 17015-FMV by County Assessessment: 158,850.00 2. Residential Property,Tax Parcei No.23-32-2336-227: 5 N.Baltimore Ave,Mount Holly Springs,PA 17065-FMV by County Assessment: 124,083.00 3. Residential Property,Tax Parcel No.23-32-2335-147: 235 N.Baltimore Ave.,Mount Holly Springs,PA 17065-FMV by County Assessment: 116,334.00 4. Unimproved Land,Tax Parcel No.23-12-0340-005 Approx.15 Acres of Land,Mount Holly Springs,PA 17065-FMV by County Assessment: 64,905.00 TOTAL(Also enter on Line 1, Recapitulation.) � 464,172.00 If more space is needed,use additional sheets of paper of the same size. REV-iso3 EX+(8-�z) � pennsylvania SCNEDULE B DEPARTMENTOFREVENUE INHERtfANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Peffer,William K., 2nd 2109-0936 All properly jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' Stocks Heid at Edward Jones,Acct.#377-10431-1-8,Value on 10130/2009 174,302.43 2 Mutual Funds Held at Edward Jones,Acct.#377-10431-1-8,Value on 10l30/2009 18,634.56 TOTAL(Also enter on Line 2, Recapitulation) $ 192,936.99 If more space is needed,insert additional sheets of the same size - -_ . _ _ __ / � �� Don't Predict-Prepare , What's next for the economy and financial markets? Rather than trying to predict the future, � � we believe one of the best ways to survive a crisis is to have a weil-thought-out strategy and stick to it. It's also important to have realistic expectations, because market corrections ,� are unpredictable and can happen at any time. For more advice on developing your personal � financial strategy,visit www.edwardjones.com and look for the latest"Edward Jones � Perspective"video. I �� ! � � � a� �170159215045� � WILLIAM K PEFFER II $$SEQ$$ � N ;; 4 LADNOR LANE � - CARLISLE PA 17015-9215 ° � L O - i� ��.� �J. �✓ 1:1 �i e i;� . - ll - _ � :t? ' L - Your Edward Jones�nancial advisor i ART AMUNDSEN I 717-258-4688 I 21 WEST H1GH STREET I CARLISLE PA 17013 I I Other contact information: www.edwardjones.comlaccountlink Edward Jones Attention:Client Reporting Edward Jones MasterCard: 800-362-6299 201 Progress Parkway Maryland Heights, MO 63043 Edward Jones VISA debit card:888-289-6635 Client Relations: a�m_�p�Cent al time Monday-Friday � i I O C � � I i � O N � � O ._ � � � tn a+ � V Q (C 'L c � X � �' c ca L c� -a � o E � m � `1 � � � 3 � � L � � � � � W U > � � � � (a `�' L L O >+ f6 C � � �- � � � � � O � O C � � N O � � Q 4' r-�+ � � t0 L Nf L' �� r � �, € o € � '� � � c � � � rn rn � = � � �i � N p (0 > M M tli � QI L 4; A t0 +-� �? 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'= • � -a c�a �, � -> . �' � N O O � O O N Cfl M I C — y_ �`. _ ;i; '`�� C � M e- O O O� N � � � N (4 �tC L - _ � d' �t N � N � � E _ � tA � L .. ._ .. s� � 7 L "'' O+ N L C C y O � U v�i � � c cTo z _ a= ca -a Q .� � � � o j aNi ° c a a�i � N > tL o c� E . � Z � � � � � U O a � � L m � U' � � � OE � 1- J � G1 d p U W 'a C .� OU � � w a d � '� � � m =U' � �U ? p O O i. � vi � a�i � O -� a a � Y p � v v � = c a3i � -a � u� � � V Z U a Z Z d � � •> � 3 Z � O O > m w � O O � i � o o -o p O c� c� F- z c� � � - m � .«.. v �, + O a d ¢ z w Q X X 111 � � o � � ! � � � a a a E- > w . y >. � t ao W � �Y `� � = i 1 � �n m � �• us u� � -a -> T N Q o � � � N l M �' rn � � � w°• 1 O � M >_ � '�o w } � � a- G� L ' w � � a� 1` L' � � O � �' f�0 �- M �Gi � -a j W = 3 � a m m � a � � W � r � � � N � w °w W > > > > > > � � i > > > C �' a� �'� w w w w w w w w w w � � ,a > > U U U U U U U U U > d ++ � W W W W W W W W W W _ � Q Q � � � �.' � �' � � Q-' � O � ++ t�• C'3 M CO � I � N N Y � N N N ` ` N N N N N O Q O O O O O O O O O O r � r r � � � ! � � REV-i5o8 EX+(o8-iz) � pennsylvania SCHEDULE E DEPAHTMENTOFREVENUE CASH� BANK DEPOSITS & MISC. INHERIfANCE TAX RETURN pERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Peffer, William K., 2nd 21-09-0936 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. PNC Checking Account,#51-4018-9485 29,945.23 2, Personal Property,Appraisal Attached 907.00 3. Cash in Pocket 200.00 4. Highmark Blueshield,Refund 168.38 5. The Sentinel,Refund 16.15 g. N Guide>Refund 2q.�2 7. Allstate Insurance,Refund 83.30 g, Intemal Revenue Seroices,Tax Refund 600.00 g. Honda Accord Sedan(2006),Private Party Pricing Report from Kelly Blue Book(attached) 12,895.00 10. Highmark Blue Shield,Refund for Joyce Peffer(reissue) 199.38 TOTAL(Also enter on Line 5, Recapitulation) $ 45,039.16 If more space is needed, use additional sheets of paper of the same size. :�-�J.�:��2��'; �� _��-� �� d��.�°�z��:'�'.o�r//�.� �� y,�/�Z�'��2�.�� .,C�Lp � �� .�C i�. �,,.�.��-�f'/2�-�_ �' /°�--��. � G� :f �.4,.�Z� ' s� 1�� -��.��Z �P,� .,r�.,� r �� ,��. ^ � � � � � �._.�� . :�G��G'_"� L�"�Z"c��D'� r �� * � f A ��'��._.��!�>.:• � , , � �/'O�-`t-��--.`�,�Q1-r--�.�Q G��,;�s��E��•/��'��"-�`� p . , � � .1 � � � a�L r � �A �e�;�" ,� �'�r-� �,/1, ��,- ,- � �� ' � ��< �y:� ��_ .z� �� , , � � f�`l� ^ '`��'/�...L��11c`-� _ d�'t�I��? �Q�L� l�� `��__-- .--�. / _" .--�`t�j,¢ /�' r,�v�� -1�� --'' jlJ;�'i � . �f��-��2�n�'� �-�d� -��' �';� ��'� � � ��z- � ��=,�� 5-=`� �� - ��u� �� '�:�?�� (� --1�� '�c� � ��A y//^� � �� ,��) :o�✓,n9 L.�%,'sGs�'i�l.- ��2e�� L�."� �s � � :`C� r ��2��„�v��,�,<��.��-�`-= ��c� .r--�-� li�� fi��-�c��.��, . ��a� /`� , �� -2 y�.��_ L= j� +�--i 1��.-�',r�Z��6��-�-*� .�r�x.�' ,�� v --'� � �� -��'�� d� ��.,� . ��T � . �� -�'� ��..,�...--�-�j�� , i�'� ��f��'��iCi�!% ��2-L�� `` -��E-��:�``Q �y r'l]'�;� l�i��%� s'� _. �--��L-/�� `� � �; l � ��d�L-��.a'�� !'�-Q?`�l'��2�`�r�"� � �� A ' �/�� - ` `�� _ �� --��.�.��.��-.�.� _ a� �� , � � . ,� � . , � l�.fG=�� ' y� � � � '- �= �� /�� :��' �k�-e3-��/�Z� �� c� �`_ ��- c�O� �� 3��!�- � �� / � � �� ,,�z.,i� _ v��:�t.� .�:��C�.�-�`�- /�4 � ,/�1��?��%�j � � ��j�� '��"--�� i1 �'�-��-�r�/� ` ��--t�� , , �y��r_. , ` �-/�'//`°' i � 6 z � �. � J i ��p�� _-�'�-G��-UL�,� `�� s�?'z��-'��L. ` �-��?.�� `� !G� r �� - �� ---�'-1� � �J .-�'E°� r . 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'"��-- _ �.��.�W :0- . � .y' 90 i� , �,° � _ Priority 50 Plus Account Statement For the period 09/01/2009 to 09/30/2009 �For 2a-hour infortnation,sign on to PNC Bank Onli�e Banking WILLIAM K PEFFER,II on pnc.com. Primary account number:5t-4018-9485 Account number:51-4018-9485-continued Page 3 of 3 Transaction Summary Checks paid/ Check Card POS Check Card/Bankcard withdrawals signed transac[ions POS PIN Vansactions 8 0 0 Total ATM PNC Bank OUier Bank transactions ATM transactions ATM transactlons 0 0 0 interest Summ�ry As of 09/30,a total of 58.78 in interest was Annual Percenta Number of da Aver p8id thiS yeaf. 9e ys age Collected Interest Paid Yield Eamed(APYE) in interest period balance for APYE this period 0.05� 30 31,077.08 1.26 Activity Detait Deposits and Other Additions There were 2 Deposits and Other Additions Date AmouM Description totaling $1,399.26 . 09/04 1,398.00 Deposit Reference No 521444982 09/30 1.26 interest Payment Checks and Substitute Checks Check Date Reference Check Date Raference number AmouM paid number number Amount paid number 9754 5.25 09/09 s2ssaaa�a 9758 589.40 09/21 oe32a338� 9755 554.19 09/10 os3�s2s�s 9759 87.35 09/30 oasssa25s 9756 50.�3 09/14 oeaasss2� 9760 364.56 09/25 osasassso 9757 76.33 09/22 oe3895650 9761 539.90 09/25 oe52a2ais *Gap in check sequence There were 8 checks iisted totaling $2,267.71 . Other Deductions There was 1 Other Deduction totaling Date Amourn Description $2.00 . 09/30 2.00 Cancelied Check Return Fee Daily Balance Detail Date Balance Date Balance Date ealance 09/01 30,815.68 09/10 31,65424 09/22 30,937.78 09/04 32,213.68 09/14 31,603.51 09/25 30,033.32 09/09 32,208.43 09/21 31,014.11 09/30 29,945.23 � : �., , �, �� ,. ;a >,� . ,��, �. . .. . .. � . .� Kelley Blue Book-Private Party Pricing Report-Honda,Accord rd�C 1 �l 1 �lECtp �L1�l�l�S � ... ,.. , ^''o� '�,,;� .• `> - , �`�,�t � � +;fE� �e�tctt;�}7�t*t�is�ii`3,: ... ._ . .. , ..., �a .` 1�w... �`..-.-.,.,,.�.. Ke�1�ey Blue$Q�� THf 1RUSTfD RESUURCE. �: .- �.: AOL T�EYISION PRESENTS �;'" ��!':E RiCiK PR{��:i*P",� o ':.v"t Pennsylvania Oeteber22,2009 SLASH 2006 Honda Accor+d EX Sedan 4D • � • �.,� ="_ . • . �1,.'i!�'. ° • Watch Now ��.r� �. ._ �,� � � ., .�e� ��..R_ � -�; ,��:� Y -. � _,� _..:ibOiCl C�°I:i,it7C�c�{e't'EO:`i'_.'�- a �,�e� ..� Engine:V6 3.0 Liter VTEC g�r yo��r n�xt��G�c1 c�r. •. Trans:Automatic � Drfve:FWD 'Siarf:-�ith e,Fres CARFAX ReeoM Chatk, Mileage:70,000 y�N: ' ; _ , . � ;No VIN AvaUableT �..._ - -� - i EquipmeM __._..__.._.___.._�.. _, _ ^ Air Conditioning Cruise Control ABS{4-Wheel) �inc.-er r�:�;�:v;t Power Steering AM/FM Stereo Moon Roof Searr,h Lsed�,;eh;�ie;;��:a�;s Power Windows Single Compact Disc Alioy Wheeis ��,�n��•,,,,,:;,"�,,.i� Power poor Locks Dual Front Air Bags ,_ Tilt Wheel Front Side Air Bags ��-�"e��`'��c��ivv Consumer Rated Condition: Good "Good"condition means that the vehide is free of any major defects.This vehicle has a ciean citt�hi:tory, the paint,body a�d interior have only minor(if any)blemfshes,and there are no major mechanicat problems.There should be Iittle or no rust on this vehide.The tires match and have substandal tread wear left.A"good"vehicle wfi!need some reconditioning to be sold at retail.Most conwmer owned vehicles fali into this category. Private Party Val� 572,885 PNvate PartY Value is what a buyer can expect to paY wt►en buyfng a used car from a private party.The Ptivate Patty Velue assumes Me vehide is sold°AS Is"and carries no warraMy(other than the corrtinuing factory warcanty).The flnal sale pMce may vary depending on the vehide's actual condition and iocat AHHafWtet d9ndtN�ris.T#tts vglue fi�gy 815es t�us�d to dertve falr Market velue f+�r lnsue�nt�and vehlctE donation purposes. Honde Accord " �� ltP�t ;i �.. �:; i� 3:��' �..,��..�emao: . . p 2009 KCIIly&ue Book Co..Inc.Ap rights reservai.10/16/09-10/2?J09 Editlon for PennSyNani2.Th2 SpEtiflC't�f011tf0d011 rEqUi�Ed t0 deorimine the value tor Mis particular vehide was supptied by the person qenerating tfiis report.Vehlde vatuadons arc opinions and may vsry {rom vehicle po vehidt.AtZUaI wluatiais will v2ry based upOn markM OondiHons,specificatlons,vehkb mndlpon or other partku�ar drturt�rroes PErti�ent to tAiS PBrUNIar vehkk w Me transadion or the ParNg to the transac[IOn.This re0ort is inOrnded for the individual use of the P�9��9��Y arW shall not be sokl or transmltLed 6o a�mtlur Da�Y.��M'Blue Book aswmas rro resPO�s�bNlty for errors or anBslons.(v.09103) http://cm.syndication.kbb.com/kb/ki.dlUkw.kc.ur?aolwp;9388�3;8c+p;&722;Honda;2006... 10/23/2009 REV-1511 EX+ (08-13) `ijpennsylvania SCHEDULE H �� DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Peffer, William K., 2nd 21-09-0936 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Hollinger Funerai Home&Crematory, Inc. 10,193.73 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: 14,781.00 Name(s)of Personal Representative(s) Ca�ol K. Wilcox Street Address 75 Victory Church Road city Gardner state PA Zip 17324 Year(s)Commission Paid: z• Attorney Fees: 21,064.44 3• Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation.) 0.00 Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: 62.00 5� Accountant Fees: 0.00 6� Tax Return Preparer Fees: 75.00 �• Recorder of Deeds and Cumberiand County Tax Mapping Office,Deed Transfers(3) 286.50 8. The Sentinei-Legal,Advertising 26328 9. Cumberland Law Journal,Advertising 75.00 �o. Short Certificates 8.00 ��. Roy D.Gottshall,Auctioneer-Personal Property Appraisal(2) 115.00 Subtotal from Page 2: 1,29�.00 TOTAL(Also enter on Line 9, Recapitulation) $ 48,213.95 If more space is needed,use additional sheets of paper of the same size. Page 2 - Schedule H, Continued ESTATE OF PEFFER, WILLIAM K., 2ND FILE N0. 21-09-0936 Item Number Description Amount 12. Additional Probate 540.00 13. Reserve 750.00 Subtotal to be added to Page 1 1290 TOTAL (Entered on Page 1 of Schedule H) 48213.95 ��_ ��.d -- .��.��_. ��r. �� ;� � �_ � � �, �.�� .T�� Hollinger Funeral Home &Crematorq, Inc. Eric L. Hollinger,SupErvisor Octaber 6, 20�9 Carol K.Wiicox 75 Victory Church Road Gardners, PA 17324 The Funeral Service for Wiiliam K. Peffer: We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. 7HE FOLLOWlNG IS AN ITEMIZED STA7EMENT OF THE SERVICES, FACILITIES,AUTOMOTiVE EQUIPMENT, AND MERCNANDiSE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. Professionai Service Traditionai Package $4qgp.pp Merchandise Casket-Batesville Hartfieid Popiar 230Q.00 . Vault-Clark 12 Gauge Staintess Steel 1675.00 � Memorial Package-Fish Register Book, Memorial Folders, ' Acknowledgement Cards, Bookmarks No Charge AT THE TIME FUNERAL ARRANGEMENTS WERE MADE,WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACGOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHAR6ES. Cash Advances ;ye�,�,�rlu�rn.r(Ur�t6c�s-P�tri�t-^!e��:s $253.32 r Newspaper Notices-Sentinel 150.51 Grave Opening-Mt. holly Springs Cemetery 600.00 Cemetery Equipment 325.00 Certified Copies af Death Certificate{10@$6) 60.00 Flowers-Casket Spray I74.90 Reverend Richard L. Reese 125.Q0 � Honar 6uard 50.0� Current Balance: 10193J3 cc:Attorney Wiiiiam S. Daniels 501 NORTH BALTIMORE AC7ENUE •MOUNT HC�LLY SPRIIVGS, PENNSYL\7ANIA 17065 • (717)486-3433 • FAX(717)486-3215 www.hotIingerfuneralhome.com Ib^) °►-c�� fa.--.. �—~� RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date : 10/05/2009 Cumberland County - Register Of Wills Receipt Time : 12 :44 :44 One Courthouse S quare Receipt No. : 1058482 Carlisle, PA 17613 PEFFER WILLIAM K 2ND Estate File No. : 2009-00936 Paid By Remarks : HUMER & DANIELS CJ ------------------------ Receipt Distribution ----------------------__ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 20 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 12 . 00 CUMBERLAND COUNTY GENERAL FUN JCP FEE 10 . 00 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 1817 $62 . 00 Total Received. . . . . . . . . $62 . 00 Harold S Fraker Jr 44 Summerfield Dr Carlisle� PA 17015-6931 • (717) 245-9441 Invoice William K Peffer, II 4 Ladnor Ln , Mt Holly Springs, PA 17065-1911 � . , Invoice Date;April 06,2010 Statement of Charaes Fee for Preparation of 2009 Federal,State and Local Tax Retums ' 75.00 TOTAL 75.00 . ,_ �..�, � ...� ..��, , ,� �„�� , RETAIN THIS PORTION FOR YOUR RECORDS REMITTANCE ADDRESS BILL TO THL SLI+TTINEL - LSGAL HUMSR & DANIELS P.O. BOX 130, CARLISLE, PA 17013 AD NUMBER CLASS SALESPERSON BILLING DATE LINES 375779 10 PUBLIC NOTICES shiek 10/23/09 40 * 2 AD DESCRIPTION START DATE STOP DATE LETTERS TESTAMENTARY LETTERS TESTA 10/09j09 1Q/23/09 PUBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT 3 THL SENTINEL - LEGAL 3 LGL 212.40 TOTAL AD CHARGE 212 .40 3 PROOF OF PUBLICATION OlPRF 7. 00 DAYS RUN � PURCHASE ORDER PAY THIS AMOUNT 219.4O 6 ZH'Y , Est william Peffer AFTER 1 1/ 9 � MESSAGE: � �`� � � Thank you for advertising with The Sentinel. � l � /�� _ X i � "i Deadlines for in column legal advertisements: Monday is Thursday at �,/ 5 p.m; Tuesday is Friday at 5 p.m. ; Wednesday is Monday at 5 p.m; Thursday is Tuesday at 5 p.m; Friday is Wednesday at 5 p.m ; Saturday �, is wednesday at 12 Noon; Sunday is Wednesday at 5 p.m. If you have any questions regarding your Legal bill please call Classified Manager at 717-240-7176 Fax your legals to 717-243-3754 attention Classified Manager You can also EMAIL your legal to Classified ads: classified@cumberlink.com Please send a cover letter including your name and address as an attachment /`/-- 3 --�'y J��D �ti � � �9.e�trscx.,P,�� CUMBERLAND LAW JOURNAL 32 SOUTH 6EDFORD STREET CARLISLE, PA 17013 Tele: (�1�249�166 Fax:(71'7)249-2683 October 30, 2009 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the �ourt of Common Pleas as the offcial legal publication for Cumberland County and the tegal newspaper for pubiication of legal notices. TO: William S. Daniels, Esquire William K. Peffer Estate RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: October 16, October 23, and October 30, 2009 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 75.00 Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director CUMBERLAND COUNTY RECORDER OF DEEDS RECEIPT _ n9/fA Inv Number: 163687 Invoice Date: 06i27/2014 3.32.33 PM rctCEiPT tcegiurw iu v�� Customer: Last Change: Receipt By:COUNTER By� �M DANIELS Ch # Char e 1 Pa ment/Fee Descri tion Amount Inst#/Inst Date Munici ali 1 DEED $68.00 201413891 SOUTH MIDDLETON Grantor-PEFFER,WILLIAM K 2ND 06/27/14 3:32:44 PM TOWNSHIP Grantee-WILCOX,CAROL K Total Pages:6 Consideration- $0_00 Tax Basis- $0.00 Return Via-PICKUP PARCEL IDENTIFICATION NUMBER 40.30-2646-026- Fee Detail: $11.50 AFFORDABLE HOUSING FEE $11.50 COUNTY RECORDING FEE $2.00 IMPROVEMENT FEE-COUNTY $3.00 IMPROVEMENT FEE-RECORDER $23.50 JCS/ATJ/CJEA FEE $15.00 PARCELS FEE $1.00 STATEMENT OF VALUE FEE $0.50 STAT�WRIT FEE SOUTH MIDDLETON MUNICIPAL REALTY TAX FEE $0.00 SCHOOL DISTRICT REALTY TAX 2 DEED $68.00 201413892 MT.HOLIY SPRINGS Grantor-PEFFER,WILLIAM K 2ND 06127/14 3:32:45 PM BOROUGH Grantee-WILCOX,CAROL K Total Pages:6 Consideration- $0.00 Tax Basis- $0.00 Return Via-PICKUP PARCEL IDENTIFICATION NUMBER 23-32-2336-227- Fee Detaii: AFFORDABLE HOUSING FEE $11.50 COUNTY RECORDING FEE $11.50 IMPROVEMENT FEE-COUNTY $2.00 IMPROVEMENT FEE-RECORDER $3.00 JCS!ATJ/CJEA FEE $23.50 PARCELS FEE $15.00 STATEMENT OF VALUE FEE $1.00 STATE WRIT FEE $0.50 MT HOLLY SPRING MUNiCIPAL REALTY TAX FEE $0.00 SCHOOL DISTRICT REALTY TAX 3 DEED $68.00 201413893 MT.HOLLY SPRINGS Grantor-PEFFER,WILLIAM K 2ND 06/27/14 3:32:46 PM BOROUGH Grantee-WILCOX,CAROL K Total Pages:6 Consideration- $0.00 Tax Basis- $0.00 Return Via-PICKUP PARCEL IDENTIFICATION NUMBER 23-32-2336-147- Fee Detail: $11.50 AFFORDABLE HOUSING FEE g�1.50 COUNTY RECORDING FEE $2,00 IMPROVEMENT FEE-COUNTY $3.00 IMPROVEMENT FEE-RECORDER $23.50 JCS/ATJ!CJEA FEE $15.00 PARCELS FEE $1,00 STATEMENT OF VALUE FEE $0.50 STATE WRIT FEE MT HOLLY SPRING MUNICIPAL REALTY TAX FEE $0 00 SCHOOL DISTRICT REALTY TAX 4 DEED $68.00 201413894 MT.HOLLY SPRINGS Grantor-PEFFER,WILLIAM 2ND 06/27/74 3:32:47 PM BOROUGH Grantee-WILCOX,CAROL K Total Pages:6 Consideration- $0.00 Tax Basis- $0.00 Return Via-PICKUP Page 1 Date:Jun 27,2014 3:41:28 PM CUMBERLAND COUNTY RECORDER OF DEEDS RECEIPT PARCEL IDENTIFICATION NUMBER 23-12-0340.005- Fee Detail: AFFORDABLE HOUSING FEE $11.50 COUNTY RECORDING FEE $11.50 IMPROVEMENT FEE-COUNTY $2.00 �MPROVEMENT FEE-RECORDER $3.00 JCS 1 ATJ/CJEA FEE $23.50 PARCELS FEE $15.00 STATEMENT OF VALUE FEE $1.00 STATE WRIT FEE $0.50 MT HOLLY SPRING MUNICIPAL REALTY TAX FEE $0.00 SCHOOL DISTRICT REALTY TAX $0.00 TOTAL CHARGES $272.00 PAYMENTS CHECK:1153 $272.00 TOTAL PAYMENTS $272.00 AMOUNT DUE $272.00 PAYMENT ON INVOICE ($272.00) BALANCE DUE $0.00 Date:Jun 27,2014 3:41:28 PM Page 2 CUMBERLAND COUNTY RECORDER OFDEEDS RECEIPT Reg/DrwID: 0201 inv Number: 34384 Invoice Date: 12/2412008 2:35:41 PM RECEIPT gy: �K Customer. Last Change: Receipt By:COUNTER CASH Amount Inst#/Inst Date Municipatity Ch # Char e/Payment/Fee Description $2.50 1 COPIES Fee Detail: $2.50 COPY FEE ' $2.50 TOTAL CHARGES PAYMENTS $3.00 CASH $3.00 TOTAL PAYMENTS $2.50 AMOUNT DUE ($2.50) PAYMENT ON INVOICE $0.00 BALANCE DUE $0.50 REFUND DUE ($0.50) CASH REFUND Page 1 Date:Dec 24,2008 2:42:59 PM CUMBERLAND COUNTY RECORDER OF DEEDS RECEIPT RECEIPT Reg/Drw ID: 0101 Inv Number: 35959 Invoice Date: 01/26I2009 3:27:42 PM COUNTER By' �M Customer: Last Change- Receipt By: W DANIELS Amount Inst#/Inst Date Municipaliry Ch # Char e/Pa ment!Fee Description $�.00 1 COPIES Fee Detail: $1.00 COPY FEE $1 00 TOTAL CHARGES PAYMENTS $1.00 CASH $1 00 TOTAL PAYMENTS $1.00 AMOUNT DUE ($1.00) PAYMENT ON INVOICE $0.00 BAI.ANCE DUE Page 1 Date:Jan 26,2009 3:28:Z4 PM _ 111 Office Monday,January 26,2009 Cumberiand County Tax Mapp g One Courthouse Square Carlisle, PA 17013 717-240-6362 fax 717-240-6354 __ Receipt - - _ _ --- Customer Company Cash Company ID: 2 Name: Address 1 Address 2 City: State: Zip: Phone Number RequestlD: Type: Description of Request: (3uanity: Unit Price: Balance Due: 8431 Paper Map ARCGIS Piot 11x17 1 $7.50 $7.50 Total Due: $7.50 Paid In Fuli Signature � (n D�ICe Thursday,April 23,2009 Cumberiand County Tax Mapp g O�e Cs�urthouse Square CarTsle, PA 17013 717-240-6362 fax 717-240-6354 Receipt _ ___ __ --- -- Customer Company Cash Company ID 2 Name: Address 1 Address 2 Gity: State: Up� Phone Number RequestlD: Ty�; Description of Request: Quanity: Unit Price: Balance Due: 8573 Paper Map ARCGIS Plot 11x17 1 $3.50 $3.50 Total Due: $3.50 �: � � ,.__ -.� 4, � �:.4A`i. ,, "��, .r"`° d' ,..,w. � � ., .r �..�e�-d..,�^„ . , ,..� ,:'�a. . � ��z F� ¢y%- y � �¢ ',r"'._ �. `. �. �:: Paid In Fuil Signature 113 Forge Rd., Boiling Springs, PA 1700? �/ �� * � M.__ �i,��-�`�� ''��'z ^ � _� �i� 2 �� Q�9�_ In Account With ROY D. GOTTSHALL, � AUCTIONEER � F � �G� �' ' - _ �' 4 I, , 113 Forge Rd., Boiling Springs, PA 17007 .Z---'_�'G• �.�o�.- �'�-'� � % � � ,- jVj�f Gc=:��.�-�' �"f �.�=�:��z ..�"�-..t,�.��" � � _ . , �/� / . � ` �� L ' L-°K-�-�' .^ ��%!7�-'z-."� ,7 f . - .�:��-y.r t?1 � In Account W�th /�"GlS`�' ROY D. GOTTSHALL, AUCTIONEER . -. . 2..� ° ��2 � � i ; REV-1512 EX+(12-12) �� pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERifANCE TAX REfURN MORTGAGE LIABILITIES &LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Peffer, William K., 2nd 21-09-0936 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expeases. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• Postage,Stock Transfer Certified Letter(William&Joyce to William) 14.89 2. PNC,Safe Deposit Box Rental 55.00 3. Hollinger Funeral Home&Crematory-Buriai for Joyce L.Peffer 12I23/2008 9,482.00 4. William S.Daniels,Personal Affairs Planning and Homeplace Administration(4 Ladnor Ln.) 3,250.00 5. PA Income Tax Due 11.00 6. 4 Ladnor Lane-Expenses(Heating,Utilities,Taxes,Repairs): 10/01/09-12/31109 2,046.82 7. 5 Baltimore Ave.-Expenses(Heating,Utilities,Taxes,Repairs): 10/01I09-12131/09 3,761.24 8. 235 Baltimore Ave.-Expenses(Hea6ng,Utilities,Taxes,Repairs):10/01109-12I31/09 883.00 9. 4 Ladnor Lane-Expenses(Heating,Utilities,Taxes,Repairs): 111I10-6130110 5,204.54 10. 5 Baltimore Ave.-Expenses(Heating,Utilities,Taxes,Repairs): 1/1/10-6I30110 5,446.36 11. 235 Baltimore Ave.-Expenses(Heating,Utilities,Taxes,Repairs):1/1110-6130110 2,396.44 12. Hill Street Lot-Taxes: 10101/09-6/30/10 43.67 13. Notary 6.00 TOTAL(Also enter on Line 10, Recapitulation) $ 32,600.96 If more space is needed,insert additional sheets of the same size. Hollin�er Funeral Home & Crematory, Inc. Eric L. Hollinger, Supervisor ° 501 North Baltimore Avenue Mount Holly Springs, Pennsylvania 17065 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for those items that you selected or that are required.If we are required by law or by a cemetery or crematory to use any items,we will explain the reason in_writing below. If you selected a funeral that may require embalming,such as a funeral viewing,you may have to pay for embalming.You do not have to pay for embaim- ing you did not approve if you lected arrange nts such as direct�don or immediate burial.If we charged for embalming,we will explain why below. For the Service of n �" ��4'-'�� yt°—��"� Date of Death � �'� : Charge to: �� ,+a-w� ��til 6.. ,a'cs ti �t✓ �i. � ,S . . � � Name Address City tate A, CHARGE FOR SERVICES SELECIBD: Other dothing 1. PROFESSIONAL SERVICES Services of Funeral DirectodStaff.. .... $ Cremation um ....... . .. ......... S Embalming ............... ...... � (Description) Other preparation of body OTHER $ $ .... .. .. .. ... ................ S TOTAL MERCHANDISE SELECTED .................B $ Q�� SUB-TOTAL OF PROFESSIONAL SERVICFS. ....... ..A1 S� G SPEQAL CHARGES: 2. FACILITIES AND SERVICES Forwarding of remaias to Use of facilities and services for S viewing(Visitation°::ake? ......... 5 (Funeral Home) Use of facilities and services Receiving of remains from for funeral ceremony ............ $ $ Use of facilities and services for (Funeral Home) Memorial Service .... ......... .. $ Immediate Burial .... ... .......... $ Use of equipment and services Direct Cremation . . .. ............. $ for graveside setvice .. ....... .... $ $ Other use of facilities SUB-TOTAL OF SPECIAL CHARGES .... ............0 $ D.CASIi ADVANCED ............. ...... . .... ...... � Opening Grave ...... ............ $ �'j} SUB-TOTAL OF FACII.ITTFS/EQIJIPMENT .•••• •._•••A2 S_� Cemetery Equipment .. ............ �� 3. AUTOMOTTVE EQU[PMENT Lot and Deed ....... ...... .... $ Newspaper Notices-Local . .... .. �� ; Vehicle to transfer remains to Funeral Home Newspaper Notices-Out-of-town .... .. $�Q_��Si,�L��D Local . . . . ...... . .............. 5 Telephone&Telegrams ..... . . ... . . 5 Hearse(Casket Coach) Airfare ......... .... ........... $ Local .... . ....... ..... . . .. .... $ Clergy/Mass Offering . .:.. ......... 5 �it Limousine Pallbearers ..................... $ Local .. ........ .... ......... .. $ Certified Copies of the Death ...... .. $� Family car Gertificate ..... . ... .... ... ...... $ Local ...... . . ......... ..... ... $ Police Escort �—p�•��C Flower car or floral disposition Flowers ... . ........ .. .......... S1.,.L_L— Local . ....... .... .... . .. ...... � Vault Service Charge . .............. $ Lead cu/clergy car $ Local .... .. ..... . . . ... .. ...... 5 $ Car for pallbearers S Locai .. .............. ..... .... 5 $ Ouc of[own transponation .... ...... S $ >,�'� � � SUB-TOTAL OF ADVANCES ....... ............... .D $.L_-� SUB-TOTAL OF AUTOMOTIVE EQUII'MENT.........e� $ We charge you for our services in obraining: TOTAL OF PROFESSIONAL SERVICES, (specijy casb advances that are marked-up) FACILITIFS AND AUTOM� �.�-�j� EQUIPMENT . .... ...... �t� L'.�s.....A $��I/kJ4• SUhiMARY OF CHARGFS B. CHARGE FOR� S��j SEI,E •!� A.Professional Services,Facilities and Casket.. ... �� . � �?.�C✓�..�•�� `�'�Z� Equipment,and Automotive (Description) �''V Equipment ........ ............. $�Q �N1 ' B.Merchandise ...... . ....... ...... $�� Other Receptacle .... .... .. . .. .... � C. Special Charges .................. $ (Description) D.Cash Advances .................. $_,�� Outer burial co iner ... .......... $ TOTAL OF ALL SECTTONS .......... ............. $ �"�C. • (Description) � .+slsYT_ PAID AT TIlKE OF OR PRIOR TO ARRANGEMENTS ...... ....................... $ ArknnwlrrlaPmrnt rarrl� . 1 - � BAIANCE DUE .......... ...................... $� __ __ _ , ! r7��'L.. �ARLI5LE t�IPO CARLISLE, i'ennsy{vania 170132935 4134670013 -0093 01i`29/2009 (80Q)275-8777 04:U�:�4 Fhi Sa i�s P,ac a i pt -----�--�----- Product Sale Unit r;r�al Description Qty Price Price SAI'taT PRUL i�ih� 55104 $0•�9 Zone-5 First-Class Latter '1.50 oz. �eturn Rcpt (Gr�een Card} �2.20 '"" Registered $1?•'a Insured �/alue : $255.G� Article Value : $255,OQ La�el #: RE33459007�L'�; Issu2 PV1: ..$-�`�•�� i'o��i c $:4.fiJ Pa�d by: l�tastrrCard Y�1��:8� nccount �: XiiX7(XX��XXxk=r8D7 Approval #�: 02905Z Transaction #: 85 23 90311002s ��N Js3V8 t�°i7S T'eCSlpt ds �V1t�8f10E Of insutance_ Fcr inforu�ation rsgardirg domestic insurance, visit oiir uet,site ai �isps.cc�m!i rs�+rancei p�stoffi ca.r�t:n O�der starnps at USPS,comishop or �all 1-800-Sta�n�24. uo ta USPS.cvn�iclic'r,nsi�ip to pt�int shiNP�ng labets uith p65tn�@. For other informatioii call 1-8�G-A�K-USFS. 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REV-1513 EX+(O1-10) ��'� `pennsylvania SCHEDULE ] DEPAHTMENT OFHEVENUE SNHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Peffer, William K., 2nd 21-09-0936 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1• Carol J.Wilcox,75 Victory Church Road,Gardners,PA 17324 Daughter 100°� 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: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II—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.