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Home My WebLink About04-15-05 (3) N l) A1>1>1-~RMf\ 1"E DtLt ~ REV.1500 OFFICIAL USE ONLY INHERITANCE TAX RETURN FILE NUMBER 21 05 RESIDENT DECEDENT COU~ODE YEAR SOCIAL SECURITY NUMBER ~. '. REV.1Soo ex + (&-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 * 0034 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Newcomer, Pearle I. DATE OF DEATH (MM-DD-YEAA) 234-26-7965 ~ W Q W CJ W Q DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 03-12-1919 12-27-2004 (IF APPUCABLEj SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) o o 3. Remainder Return (date of death prior to 12-13-82) o 1. Original Return 0 2. Supplemental Return O 4. Umited Estate 0 4a. Future Interest Compromise (date of death after 12-12-82) [!] 6. Decedent Died Testate (Attach 0 7. Decedent Maintained a Living Trust (Attach copy of Will) copy of Trust) o 9. Utigation Proceeds Received 0 1 O. f:P-~~-~~' ~~~~~?redit (date of death betwean 0 11.Election to tax under Sec. 9113(A)(Attach Sch 0) THISsecnoN Ml.JsTBEcoMPi:.ETED~AI..LCORREsPONDENeEANDiCONFiDENTlAlwAii'~~qR'MA,]lOr:lS'iitpt:JmBE'DjREa~Dl;o: .,.< i'i'ii" '" . NAME COMPLETE MAIUNG ADDRESS James D. Bogar FIRM NAME (If applicable) Bogar & Hipp Law Offices W ~;<II ua::~ wQ.U :00 ua::... Q.lD Q. cc 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes Ii w Q ~ Q. <II W II: II: o U One West Main Street Shiremanstown, PA 17011 TELEPHONE NUMBER 717-737-8761 OFFICIAL USE ONLY (1) (2) (3) (4) (5) (6) (7) None None None None 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship ) 4. Mortgages & Notes Reeeivable (Schedule D) 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 0 Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 265,546.11 67,893.15 None z o i= ~ :::l .... it < CJ w a: ~3,439.2'6 (8) (9) 14,633.95 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule 1) (10) 11. Total Deductions (total Lines 9 & 10) (11) (12) 14,633.95 318,805.31 0.00 318,805.31 12. Net Value of Estate (Line 8 minus Line 11) (13) 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subjectto Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate. 0.00 x .00 (15) z or transfers under Sec. 9116(a)(1.2) 0 .045 (16) i= 16. Amount of Line 14 taxable at lineal rate 318,805.31 x ~ :::l a. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) :!E 0 CJ 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18) )( < .... 19. Tax Due (19) 0.00 14,346.24 0.00 0.00 14,346.24 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Form REV-1500 EX (Rev. 6.Q0: Copyright 2002 form software only The Lackner Group, Inc. Decedent's Complete Address: STREET ADDRESS 123 Ridge Hill Road CITY Mechanicsburg ISTATE PA IZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 14,346.24 13,551. 75 713.25 Total Credits (A + B + C) (2) 14,265.00 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnterestJPenalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) 81.24 (5A) (5B) 81.24 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;................................................................................ ~ ~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? ............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ... ..................... ............... .... ... ... ... ..... ... ..... ... ... ............... .......... .................... o [!] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 [!] 4. Did decedent own an Individual Retirement AccDunt, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................................... 0 [!] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPI..ETE SCHEDUI..E G AND FII...E IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return. including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on ail information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FlUNG RETURN ADDRESS William H. L. Peterson DATE 123 Ridge Hill Road Mechanicsburg, PA 17050 4/I()')0!5 ADDRESS DATE i-./ I, a-J 0.5 ADDRESS DATE One West Main Street Shiremanstown, PA 17011 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (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% [72 P .S. 99116 (a) (1.1) (Ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one 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% [72 P.S. 99116 (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%, except as noted in 72 P.S. 99116 1.2) [72 P .S. 99116 (a) (1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedel'!t's siblings is 12% [72 P .S. 99116 (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.1sba EX+ (8-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALlli OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Newcomer, Pearle I. FILE NUMBER 21-05-0034 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right 01 survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Capital Blue Cross - Refund of Premium VALUE AT DATE OF DEATH 98.58 2 Claremont Nursing Home - Refund 483.09 3 M&T Bank, Checking Account No. 950278962 - date of death balance $42,658.37, accrued interest $0.81 42.658.37 Accrued income on Item 3 through date of death 0.81 4 M&T Bank, Checking Account No. 950279025 - date of death balance $220,877.73, accrued interest $42.53 220.877.73 Accrued income on Item 4 through date of death 42.53 5 Personal Property - Value as listed on attached appraisal 1.385.00 TOTAL (Also enter on Line 5, Recapitulation> 265.546.11 (If more space is needed, additional pages of the _same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) m1 M&fBank 499 Mitchell Road, MilIsboro, DE 19966 Mail Code DE-MB-12 Phone (888)502-4349 Fax (302) 934-2955 January 25, 2005 James D. Bogar Attorney At Law One West Main Street Shiremanstown, Pennsylvania 17011 Re: Estate of Pearle 1 Newcomer Social Security: 234-26-7965 Date of Death: December 27, 2004 Dear Sir or Madam: Per your inquiry dated January 13, 2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 950278962 Ownership (Names of) Pearle I Newcomer William H L Peterson, POA Opening Date 8/31/99 Closed 1/13/05 Balance on Date of Death $42,658.37 Accrued Interest $ 0.81 Total $42,659.'18 2. Type of Account Checking Account Account Number 950279025 Ownership (Names of) Pearle I Newcomer William H L Peterson, POA Opening Date 10/1/99 Closed 1/21/05 Balance on Date of Death $220,877.73 Accrued Interest $ 42.53 Total $220,920.26 Please be advised, there was no safe deposit box found for the above decedent For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the Mechanicsburg Office # 717-255- 2031. Sincerely, ~7o/ Nancy Clagett Records Management To: James D. Bogar, Attorney One West Main Street Shiremanstown, PA 17011 From: William G. Rowe, Appraiser 211 Old Stone House Rd. Carlisle, PA 17013 Re: Personal Property Appraisal Pearle Irene Newcomer Estate 30 Greensprings Drive Mechanicsburg, PA 17055 Date: January 4, 2005 LINDEN HALL ANTIQUES 211 OLD STONE HOUSE ROAD CARUSLE, PA 17013 717 -249-1978 1. William Petersen Hutch 2. Paula Sue Fuhr Handmade chest Red wool coverlet Wool coverlet Victorian picture album Fostoria glass collection Candle sticks 3. Janice Miller Blue quilt Napkin set - Philippine 4. Seline Ostheimers Quilt Crystal basket Set silverware 5. Steven V. Petersen Blue pitcherlsugar bowl (Hall's) 6. Thomas L. Petersen Shaving mug - damaged Paintings at $25 each x number 7. Susan McDonnell Silver wedding cups (2) 8. David Petersen Mantle clock Paintings at $25 each x number Newcomer Appraisal $40.00 $45.00 $110.00 $35.00 $65.00 $145.00 $35.00 $125.00 $15.00 $60.00 $15.00 $45.00 $30.00 $5.00 $20.00 $35.00 1 01/0412005 9. Ronald Petersen Wrist watch Paintings at $25 each x number 10. Larry Petersen Italy vase Paintings at $25 each x number Prooertv co-owned bv estate and William Petersen Desk Sewing machine 3 pc. Coffee set Dining room set Sofa - older Chair - older T.V. Patio set \........- $30.00 $15.00 $20.00 $10.00 $50.00 $350.00 $15.00 $5.00 $35.00 $30.00 William G. Rowe ---""---- ~ Newcomer Appraisal 2 Q 01/0412p05 Rev-ls1l9 EX+(6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL V-OWNED PROPERTY . ESTATE OF Newcomer, Pearle I. FILE NUMBER 21-05-0034 If an asset was made joint within one year of the decedent's date of death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. William H.L. Peterson ADDRESS RELATIONSHIP TO DECEDENT Son 123 Ridge Hill Road Mechanicsburg, PA 17050 B. Maydell Peterson 123 Ridge Hill Road Mechanicsburg, PA 17050 Daughter-in-Law 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 DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSEl INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATIE. 1 A&B 8/31/1999 Real Estate - All that certain piece or 135.786.30 50.000% 67.893.15 parcel of real estate having erected thereon a townhouse style dwelling unit known as 30 Greenspring Drive, Mechanicsburg, Cumberland County, Pennsylvania, being Tax Parcel No. 38-23-0571-176. The property was acquired by Pearle I. Newcomer, single woman and William H. L. Peterson and Maydell Peterson, husband and wife, by Deed dated August 31, 1999, a copy of which is attached hereto and incorporated herein. It is respectfully suggested that the fair market value of the real estate is as follows: $122,330 (county assessed value) x 1.11 (common level ratio factor) = $135,786.30 TOTAL (Also enter on Line 6, Recapitulation) 67.893.15 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. - Form PA-1500 Schedule F (Rev. 6-98) l~~~;'-'~~~~~;-'~;~;#D~ ib~. ~ ttb If!!':)-,, ".... ^ . _ ~ -;l'l;';;';'''\~l' ! I:O:JL! ,V C'-\. .' "-... '.... ~: . . -, r\ '99SEP 2 Af195~ !'fADE THE 3 l ~~ day of. ~ll~+- In the year one thousand nmehundred nmety-nme (1999) TAX PARCEL NO. 38-23-0571-176 BETWEEN MAUREEN CHEROK, single woman, of Mechanicsburg, Pe.nnsylvania, Grantor, AND ,............-.............. .... '. . ..;.~-~-,....::.. .~.__.,- ,;..._--_..;.~~:..:~~..., ..~~.~,...-~---. .~ ........,.---+ ,.. ''''-'.-- .'.- -..",- -~ .- -- _...- PE~E' k~Y;~~21."1ER~ sirigIfi7oman~-of Sy~esville, Maiyland.,arid. WILLIAM H~ r;~_ P~T~RS9Nand MAYDELL PETERSON. of Mecharucsbmg Pennsylvarua, as Joint Tenants. with the Right of Survivorship; Grarltees~.-:-- . . -_._--.-...".~..:.-';............;~-,.--~_.. --,,, .' . *husband and wife, ':~-:'~~~~.::: -.. - -~~:;:~~~jf-;:~..~'~ E:=~,!~~~ETH, that in consideration of ONE HUNDRED NINE THOUSAND NINE HUNDRED--------- .~-..:-:.:7"':.~..:,.=::::;.._;::;:::::=_~-=::~.:.--:::- ._-_._....._.~. -_._~.._-_.~ ,_. - ';1::. =~~L_~~-:::;.:..-------------------------------------{$1 09,900. 00) ------------------------------------------------ Dollars, ,....------.- '. - ~:=:=~t-~....:---..:.: :::.. iri~'h~dp~d, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and . convey to. the said grantees, their heirs and assigns, . - ::.- Ai.t;T~T 'CERTAIN messuage, tenement and tract of land situate in the Township of Silver Spring, CoUnty of Cumberland and Commonwealth of Pennsylvania, more particularly bounded and described as follows, to wit: . BEGINNING at a point on the southern side of Greenspring Drive at the dividing line between- Lot . Nos. 83 and 84 as shown on the hereinafter mentioned Plan of Lots; thence along said dividing line . between Lot Nos. 83 and 84, South 19 degrees 51 minutes 45 seconds East, a distance of 124 feet to a point at other lands to be developed as part of Westfields; thence along the latter, North 70 degrees 08 minutes 15 seconds East, a distance of 36 feet to a point at the dividing line between Lot Nos. 83 and 82 as shown on the hereinafter mentioned Plan of Lots; thence along said dividing line between Lot Nos. 83 and 82, North 19 degrees 51 minutes 45 seconds West, a distance of 124 feet to a point on the southern side of Greenspring Drive; thence along said southern side of Greenspring Drive, South 70 degrees 08 minutes 15 seconds West, a distance of 36 feet to a point on the same at the dividing line between Lot Nos. 83 and 84 as shown on the hereinafter mentioned Plan of Lots, the place of BEGINNING. BEING Lot No. 83 as shown on the Subdivision Plan of Lots entitled "Final Subdivision Plan of Westfields Phase No.3", as recorded to Cumberland County Plan Book 57, Page 90, revised at Plan Book 58, Page 99. HAVING THEREON ERECTED a townhouse style dwelling unit known as 30 Greenspring Drive, Mechanicsbutg, Pennsylvania. .....,.,.-. -'. BEING THE SAME PREMISES which Samuel C. Hoff and Georgia S. Hoff, his wife, by Deed dated August 17,1993 and recorded August 18,1993 in the Office of the Recorder of Deeds in and for Cumberland County in Deed Book L, Volume 36, Page 1152, granted and conveyed unto Maureen Cherok, single woman, Grantor herein. .' Q*9~:7~8~~8~~~ ...,.. 11) 11) rtI., ~ r- :x "'1 ,.., ,.., '" ,""I ,""I .-. a >-l '=' <: = '=' '=' '=' _::0:- ';t:;" ';t:;" ::: J"l"1 J"l"1 ======_""=' I "" I I ::0 ::x ::0 r- tT.I....._-'"'='Q:::>~;::..;:r.I:&: r. o:r o:a o::r ~ <: ...... -r.:r ::z: ...... ::0 to C:;"aO"C1'<:m=::a:tr.::a~1-+ .... I:.IJ I:.IJ r~ ::z: :::....... --I <oO'>O--IrrJ %<:c.t:I t'D ...... Co '..0 % C':l :J> --I Q. ..., -I r- ;::.. a c: --Ir--I a %..., :&:""'J"l"1 . '=' ::z:: -r:J -< : '=' . . ::z: = J"l"1 "'1 ?i5::: 0= :X~ ~o ::0 _r- -r:J ;::.. ~= -10 ,.,., ::0 ~ % - - r~ ...... ... ,..re. _ .. ..... ~,~~S3~- w~':i!e (..0.1 '-0 -.0 CJr _ ..... ...... 'OJ:I -C ...0 ..... ...... ::r,:l rtI ill W .... -,::" 1Jl .. ....... ::l "" ...,.. .... == - '..Q ...c '..0 , <::- c...l c...l ..... .J:- c..f'/ '>0 ...... .0 r~ ....... ..... ..0 -a ..0 co ...0 .. t;.t1 ~ rtI .""1 I'D _. ." ...,.. == C""J 5: is O!' ra .... - '" :::l Q.. ....... ., :::I 0 L/'Ie: M- ::l .... M- e: '< liiI 11) ::0 :::It'D ,..,.. (j CI .,., ... .....0. _to _. .., ::l ~C1 -1\ '=' ru rtI Q.. L/'I A fllllf t") /"I t"7 ". _ _ r..;r (..0.1 ,...;r CJI -:! N hd the said grantor does hereby Warrant Specially the property hereby conveyed. IN WITNESS WHEREOF, said grantor has hereunto set her hand and seal the day and year first above written. 3itigneb, 6taI.elJ anb Jlelibmll ~"^c~ MA REEN CHEROK in tfJe Jnsence at ~.J/h " . STATEOF ~nnslJlUaf\LU. COUNTYOF Cu.m~c1 On this, the 31jl- day of (hJ...gl.l'St , 199~, before me, the undersigned, officer, personally appeared MAUREEN CHEROK, single woman, known to me (or satisfactorily proven) to be tJ.;,e person whose name is subscribed to the within instrument, and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and Offi~ (SEAL) NOtaryPu~ ~ ~~'io:ol~"":a. .,' ..~ :~.:~~~ ~~:~~~~~-r~~~ ~~~~~~~~ ....~.-.;, .... ~ ,~,.~~~.....,.e,...~"~ ~~~~ ~~~~~~~,. y;....;~!..... Jan B Notarial Seal :~Pde~ ~~~uNotary Public y ",ommlSSi"'.,., Ex ~berlanc:t County 4 . Pires M Member, Penn""I..... . ay 28, 2001 Wr '"'''' A,S . . Ol:latlon of .. . "Olir~s BOOK 207 PAGt 64 . do hereby certify that the precise residence and complete post office address of the within grantees LS: CERTIFICATE OF RESIDENCE \:;)3 ~l~.e H\l \ (ld. (nL.C~,(sbUJ'j I PA - IIC~ ()r;/(Jopp htM,,<y/-Agentfor ~~ .~..~;.1--' :;~: 'f";;'.<-~ . = -. "",-=<;::., ",!":~~;~~':.~;,;'''-:-'.:~:-':'=~~''''''~;' .~.~:..i;v-~ .. ..-.-....... ...._~......'. -....~.#,....-.::..'.~. ~..~~- ~.;;~G~~~,"'i'-$u.: .3~~;:~8-:"...;(,"""'-:-~-...~~.; .:iF~~~~~~r-:~~ . '''J'''..._..t:i~~'.-~..'e6;:;',r,,,;.t..v :.r,;?~:~:",,?;~~A~i.l:fh.:t ......":'" ~.~...;....;;;.:.....~~i1;#,. ";T;;.9~~~ "~,;",,,:~,; . .;''":i;_t:",/;i,~.:~~~..t1'.~:l::~,,,, ,,-, ''f;J~~' : COMMO~TH OF PENNSYLVANIA : countyof~,~}nn~ : RECORDED on this '2. day of~l'f A. D. 19SiS in the Recorder's office of the said County, in Deed Book J. 07 -, Vol. -- , Page Co 't.- S5 Given under my hand and the seal of the said office, the date above written. ," /'; ,/ /", . .;t.~ -,< _ / .!-!:./r..-' ,,-,'1 j2 2~~- ~ /r;1 Recorder. I)OO~ ~C7 f~G~ · 65 REV-1151 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Newcomer, Pearle I. Debts of decedent must be reported on Schedule I. FilE NUMBER 21-05-0034 ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 4,096.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attomey's Fees Bogar & Hipp Law Offices 8,n5.00 . 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 352.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Other Administrative Costs 1,410.95 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 14,633.95 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX R~RN RESIDENT DECEDENT Newcomer, Pearle I. FILE NUMBER 21-05-0034 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Malpezzi Funeral Home - Funeral 4.096.00 Subtotal 4.096.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6-98) . SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMlAClNWEAL TH OF PENNSYlVANIA INHERITANCE TAX R~RN RESIDENT DECEDENT Newcomer, Pearle I. IFILE NUMBER 21-05-0034 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal - Estate Notice 75.00 2 H & R Block - 2004 Personal Income Tax Preparation 150.00 3 Linden Hall Antiques - Personal Property Appraisal 85.00 4 RESERVES: - Costs to conclude administration of Estate including filing fee for PA Inheritance Tax Return, Inventory and First & Final Account; preparation of Personal and Fiduciary Income Tax Returns 1.000.00 5 The Patriot News - Estate Notice 100.95 Subtotal 1.410.95 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REV-1513 EX+ (9-00) *' SCHEDULE .J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Newcomer, Pearle I. 21-05-0034 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not Ust Trusteets) I. TAXABLE DISTRIBUTIONS [include outright sProusal Clistributions, and ransfers under Sec. 9116(a)(1.2)] 1 Paula Sue Fuhr Granddaughter Specific 9 Milan Manor Drive bequest see Milan, OH 44846 Attached Will 2 Susan McDonnell Granddaughter Specific 20 Cumberland Estates Drive Bequest-See Mechanicsburg, PA 17050 Attached Will 3 Janice Miller Granddaughter Specific 901 6th Street bequest-See Findlay,OH 45850 Attached Will 4 CeUne Ostheimers Granddaughter Specific 13417 Bellamy Road Bequest-See Collins, OH 44826 Attached Will 5 David Peterson Grandson Specific 9 Butternut Lane Bequest-See Mechanicsburg, PA 17050 Attached Will See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE . B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) SCHEDULE .J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Pearle I. Newcomer 234-26-7965 12/27/2004 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Larry Peterson Grandson Specific Bequest-See 0.00 34 Cabin Hollow Road Attached Will Dillsburg, PA 17019 7 Maydell Peterson Daughter-in-Law Joint Specific 0.00 123 Ridge Hill Road Bequest-See Mechanlcsburg, PA 17050 Attached Will 8 Ronald Peterson Grandson Specific Bequest-See 0.00 359 Maple Lane Rt. 8 Attached Will Carlisle, P A 17013 9 Steven P. Peterson Grandson Specific Bequest-See 0.00 8100 Emmaus Church Road Attached Will New Kent, V A 23124 10 Thomas L. Peterson Grandson Specific Bequest-See 0.00 16275 Lucky Bell Lane Attached Will Newbury, OH 44065 11 William H.L. Peterson Son Joint Specific 0.00 123 Ridge Hill Road Bequest; rest, Mechanicsburg, PA 17050 residue and remainder '. Total 1 LAST WILL AND TEST AMENT OF PEARLE I. NEWCOMER I, PEARLE I. NEWCOMER, of Mechanicsburg, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I give and bequeath to my son, WILLIAM H. L. PETERSON, and his wife, MAYDELL PETERSON, the kitchen hutch. SECOND: I give and bequeath to my granddaughter, PAULA SUE FUHR, the following items of personal property: Grandpa Upton's handmade chest; Grandma's red wool coverlet and natural wool coverlet; Grandma's old picture album; Fostoria glass collection; one pair of silver candle holders. THIRD: I give and bequeath to my granddaughter, JANICE MILLER, the Philippine cut-work luncheon set and the blue quilt. FOURTH: I give and bequeath to my granddaughter, CELINE OSTHEIMERS, the handmade quilt by G. Grandmother, the crystal basket and my silver plate silverware. FIFTH: I give and bequeath to my grandson, STEVEN P. PETERSON, the blue pitcher and the blue sugar bowl. SIXTH: I give and bequeath to my grandson, THOMAS L. PETERSON, the great grandpa's shaving mug and a choice of a painting. SEVENTH: I give and bequeath to my granddaughter, SUSAN MCDONNELL, the silver wedding cups. EIGHTH: I give and bequeath to my grandson, DAVID PETERSON, any remaining wall painting pictures by Daniel Newcomer and the Seth Thomas mantle clock. NINTH: I give and bequeath to my grandson, RONALD PETERSON, any wall painting pictures by Daniel Newcomer not chosen by David Peterson, along with the gold watch of Daniel Newcomer. TENTH: I give and bequeath to my grandson, LARRY PETERSON, one antique vase with pansies and his choice of any wall painting pictures by Daniel Newcomer not chosen by David Peterson and Ronald Peterson. ELEVENTH: Should any individuals set forth in Clause FIRST through and including Clause TENTH predecease me, I direct that those bequests shall lapse and shall be and become a part of the rest, residue and remainder of my estate to be distributed as set forth hereinbelow. TWELFTH: I devise and bequeath the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, to my son, WILLIAM H. L. PETERSON, provided that should he predecease me, then to his wife, MAYDELL PETERSON. THIRTEENTH: Should both William H. L. PETERSON and MAYDELL PETERSON predecease me, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, to the children of my son, WILLIAM H. L. PETERSON, that are alive at the time of my death, in equal shares. FOURTEENTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and effective until actual distribution of all property: 2 (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted. in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. (8) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of paYment under any qualified retirement plan (pension plan, profit sharing plan, employee 3 stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. FIFTEENTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. SIXTEENTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. SEVENTEENTH: I nominate and appoint WILLIAM H. L. PETERSON, Executor of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said WILLIAM H. L. PETERSON, I nominate and appoint MAYDELL PETERSON, Executrix of this, my Last Will and Testament. I direct that my Executor or Executrix, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this \~k day of ~,d , 2003. ~of/tAlf ~ ~ 1)..Lbij!~~ (SEAL) PEARLE I. NEWCOMER 4 Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. a"/J~ ~ (j ~cn{,;t i~ ::r. l--,WJ)lCt:~.L0 Address Address 5