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Home My WebLink About02-03-15 (2) � 1505610140 REV-1500 EX (02-11)(FI) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po sox 2soso� INHERITANCE TAX RETURN 2 1 1 4 0 9 7 1, Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYVYY Date of Birth MMDDYYYY 0 9 2 9 2 0 1 4 0 4 0 8 1 9 2 9 Decedent's Last Name Suffix DecedenYs First Name MI H o f m a n n N a n c y H (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N / A Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return � 2.Supplemental Return � 3. 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 _ 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 T0: Name Daytime Telephone Number - D a v i d R G e t z E s q 7 1;,�7 2 3 <� 4 1�8 2 ` . ,_,-; ,� ,"'7 RfsG45YER OF NRL*llS US� � " r"i ._ � .'. ,.-� C37 .r -':l , , � , - .::_ ., a �_i First Line of Address _ '�' W � �� I I , _� � W i x W e n g e r & W e i d n e r � � � �°� �� ' � ._,� : _,,� Second Line of Address ` ; -=.� `"e II : c� I P 0 B o x 8 4 5 ' '"`' � r n ! City or Post Office State ZIP Code DATE�F1hED c;� c-� CJ"t H a r r i s b u r g P A 1 7 1 0 8 0 8 4 5 CorrespondenYs e-mail address: dqetz@wwwpalaw.Com Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS SEE TACHED SIGNA R F PREPARER O ER TH REPRESENTATIVE TEp, � � ADDRESS Wix, Wenqer & Weidner, PO Box 845 Harrisburg PA 17108-0845 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610140 1,505610140 � Estate of Nancy H. Hofmann SSN 173-24-5515 Estate No. 21-14-071 Date of Death: 09/29/2014 Under penalties of perjury, we declare that we have examined this return, including accompanying schedules and statements, and to the best of our knowledge and belief, it is true, correct, and complete. � � �n— Mark A. Hofm nn, Co-Executor 222 Polly Pine Road Millmont, PA 17845 CG Na��ec� 1 Pamela A. Caserta, Co-Executor 3908 Brookridge Drive Mechanicsburg, PA 17050 Dated: � hn� �a , 2015 Estate of Nancy H. Hofmann SSN 173-24-5515 Estate No. 21-14-071 Date of Death: 09/29/2014 Under penalties of perjury, we declare that we have examined this return, including accompanying schedules and statements, and to the best of our knowledge and belief, it is true, correct, and complete. �� Mark A. Hofmann, Co-Executor 222 Polly Pine Road Millmont, PA 17845 4 Pamela A. Caserta, Co-Executor 3908 Brookridge Drive Mechanicsburg, PA 17050 Dated: � (�,n�f l�a2g , 2015 � 1505610240 REV-1500 EX(FI) DecedenYs Social Security Number �ecedent's Name: N a rl c y H • H o f m a n n RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. • 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. • 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. • 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 2 � 0 0 2 . 3 8 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 5 4 4 6 5 . 5 9 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Biliing Requested . . . . . . . 7. 1 3 1 3 � , 8 1 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 8 7 5 9 8 . 7 8 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9� 5 0 6 � . � � 10. Debts of Decedent,Mortgage Liabilities, and Liens(Schedule I) . . . . . . . . . . . . . 10. 1 � 2 8 1 . 1 � 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 5 3 4 1 . 1 � 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. � 2 2 5 7 . 6 8 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. 7 2 2 5 7 . 6 8 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X.0 _ � . � O 15. O . 0 � 16. Amount of Line 14 taxable at�inea�rate X .045 7 2 2 5 7 . 6 8 �g. 3 2 5 1, . 6 � 17. Amount of Line 14 taxable at sibling rate X.12 � . � 0 17. � . 0 � 18. Amount of Line 14 taxable at collatera�rate X.15 D . � 0 �g. 0 . 0 0 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3 2 5 1 . 6 � 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 � 15D5610240 1505610240 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 2� 14 0971 DECEDENT'S NAME Nanc H. Hofmann STREET ADDRESS 1000 West South Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: �. Tax Due(Page 2,Line 19) (1) 3,251.60 2. Credits/Payments A.PriorPayments 2,800.00 B.Discount 147.36 Total Credits(A+B) �2� 2,947.36 3. Interest (3) 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) 304.24 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 ...................................................................... ❑ QX b. retain the right to tlesignate who shall use the property transferred or its income ............................... ❑ ❑X c. retain a reversionary interest ..................................................................................................... ❑ ❑X d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0 2. If death occurred after December 12, 1982,tlid decedent transfer property within one year of tleath 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? ......... 0 ❑ 4. Did tlecedent 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 tleath on or after July 1, 1994, and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is is 3 percent[72 P.S. §9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For tlates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a tleceased 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 imposetl on the net value of transfers to or for the use of the decetlent's lineal beneficiaries is 4.5 percent,except as noted in p2 P.s.§s��s(a)(�)�. • The tax rate imposetl on the net value of transfers to or for the use of the decetlenPs sibiings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is definetl, under Section 9102, as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENTDECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Nancy H. Hofmann 21 14 0971 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. Santander Bank Certficate of Deposit No. XXXX8507 20,002.38 DOD Balance: $20,000.00; Accrued Int.: $2,38 TOTAL(Also enter on Line 5,Recapitulation) $ 20 002.38 If more space is needed, use additionai sheets of paper of the same size. REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENTOFREVENUE �OINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Nancy H. Hofmann 21 14 0971 If an asset was made jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT a,. Pamela A. Caserta 3908 Brookridge Drive Daughter Mechanicsburg, PA 17050 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'S INTEREST �. A. 6/2012 Members 1st Fed Credit Union CD No. 349324-58 20,555.10 50. 10,277.55 DOD Balance: $20,533.99; Accrued Int.: $21.11 2. A 6/2012 Members 1st Fed Credit Union CD No. 349324-57 4,977.24 50. 2,488.62 DOD Balance: $4,977.29; Accrued Int.: $.95 3. A 12/2011 Members 1st Fed Credit Union CD No. 349324-56 22,362.73 50. 11,181.37 DOD Balance: $22,348.16; Accrued Int.: 14.57 4. A 3/2013 Members 1st Fed Credit Union CD No. 349324-55 10,130.59 50. 5,065.30 DOD Balance: $10,127.48; Accrued Int.: $3.11 5. A 2/2011 Members 1st Fed Credit Union CD No. 349324-53 10,003.45 50. 5,001.73 DOD Balance: $10,000.00; Accrued Int.: $3.45 6. A 1/2011 Members 1st Fed Credit Union CD No. 349324-52 13,772.49 50. 6,886.25 DOD Balance: $13,767.74; Accrued Int.: $4.75 7. A 1/2011 Members 1st Fed Credit Union CD No. 349324-51 1,529.19 50. 764.60 DOD Balance: $1,528.78; Accrued Int.: $.41 8. A 2/2009 Members 1st Fed Credit Union CD No. 349324-40 20,018.26 50. 10,009.13 DOD Balance: $20,000.00; Accrued Int.: $18.26 9. A 2/2009 Members 1st Fed Credit Union Savings Account 5.00 50. 2.50 DOD Balance: $5.00; Accrued Int.: $0 10. A 7/2011 Metro Bank Checking Account No. XXXX5690 5,577.07 50. 2,788.54 DOD Balance: $5,576.85; Accrued Int: $.22 TOTAL(Also enter on Line 6,Recapitulation) $ 54 465.59 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 Nancy H. Hofmann 21 14 0971 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDETHE NAME OF THETRANSFEREE,THEIR RELATIONSHIP TO DECEDENTAND DATE OF DEATH %OF DECD�S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. MetLife TCA account 13,130.81 100.00 13,130.81 Benes: Pamela Caserta and Mark Hoffman (50/50) TOTAL (Also enter on Line 7,Recapitulation) $ 13 130.81 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Nancy H. Hofmann 21 14 0971 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. (prepaid) 2. Funeral Luncheon 136.16 3. Cremation Society 58.34 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: WjX, Wenger&Weidner(estimated) 4,500.00 3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Cumberland County Register of Wills 345.50 5 Accountant Fees: 6. Tax Return PreparerFees: 7. Santander Bank -Account Research Fee 20.00 TOTAL(Also enter on Line 9,Recapitulation) $ 5 060.00 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� iNHERiTnNCETnxRETURN MORTGAGE LIABILITIES& LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Nancy H. Hofmann 21 14 0971 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. Visa 379.63 2. Sarah Todd Home 9,815.00 3. Millenium Pharmacy 11.47 4. Ambulance 25.00 5. Carlisle Hospital 50.00 COPIES OF THE INVOICES/PAYMENTS FOR THE ABOVE ITEMS ARE NOT ATTACHED, BUT ARE ON FILE WITH THE EXECUTORS AND AVAILABLE FOR INSPECTION IF REQUESTED. TOTAL(Also enter on Line 10,Recapitulation) $ 10 281.10 If more space is needed, insert additional sheets of the same size. REV-�513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Nanc H. Hofmann 21 14 0971 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. Mark A. Hofmann Lineal 8,896.05 222 Polly Pine Road Millmont, PA 17845 2. Pamela A. Caserta Lineal 63,361.63 3908 Brookridge Drive Mechanicsburg, PA 17050 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. r LAST WILL AND TESTAMENT OF NANCY H. HOFMANN I, Nancy H. Hofmann, of 507 North Houcks Road, Lower Paxton Township, Dauphin County, Pennsylvania 17109, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all prior Wills and all Codicils made by me at any time heretofore. ITEM 1. I direct that all my legally valid debts, funeral and administration expenses, and inheritance and estate taxes incurred on account of my death shall be paid by my personal representative out of my residuary estate as soon after my death as practicable. ITEM 2. I bequeath those articles oi m_y household furniture and furnishings and those articles of my personal effects and personal property as set forth in a separate memorandum, which I shall place with my will, to the persons therein designated. �1�� N.H.H. ITEM 3. I give, devise and bequeath all the rest, residue and remainder of my estate, whether real, personal or mixed, including automobiles, together with all insurance policies thereon, to my beloved spouse, Paul E. Hofmann, provided that my spouse survives me by thirty (30) days. ITEM 4. In the event that my spouse should fail to survive me by thirty (30) days, I then give the rest residue and remainder of my estate to my children, Mark A. Hofmann and Pamela A. Caserta, in equal shares. In the event that either of my children shall predecease me leaving issue surviving, I give and bequeath unto said issue the share of my estate that their deceased parent would have received, as set forth below. In the event that any of said issue have not attained the age of 22 years at the time of my death, then I direct that said share be made payable in trust, pursuant to the following terms and conditions; a. Any share to which the children of my son Mark A. Hofmann, shall be entitled to receive, being identified as; Carl F. Hofmann (D.O.B. 3/6/85), Ann M. Hofmann, (D.O.B. 3/11/88), and Eric J. Hofmann, (D.O.B. 10/21/89) shall be payable to Joan Hofmann, as trustee, who shall immediately divide the trust fund into three equal shares and ,'.r.�X�'J�+ 2 N.H.H. these shares shall constitute and be held, administered and distributed by the trustee as separate trust. b. Any share to which the child of my daughter, Pamela A. Caserta, shall be entitled to receive, being identified as Jessica M. Caserta, (D.O.B. 8/2/90), shall be payable to Joseph M. Caserta, as trustee. c. The above designated trustee, then shall use such amounts of both income and principal, as the Trustee, in his or her sole discretion, deems proper from the support, education, maintenance and welfare of said child. The Trustee, in exercising his or her discretionary authority with respect to the payment of principal and income to the beneficiary, shall take into consideration any income or other resources available to such beneficiary from sources outside of this Trust which may be known to the Trustee. The determination of the Trustee with respect to the necessity or advisability of making payment shall be conclusive on all persons howsoever interested in the trust. � 3 N.H.H. d. To pay any accumulated income and principal then remaining in the hands of the trustee when the trust beneficiary has attained the age of 22 years. ITEM 5. I authorize my Personal Representative and any Trustee to exercise the following powers, in addition to those given by law to be exercised in their sole discretion: a. To retain any or all assets of my estate, real, personal or mixed, without regard to any principle of diversification, risk or productivity. b. To sell at public or private sale, to exchange, mortgage or lease for any period of time, and to repair, alter or improve any real or personal property, and to give options for sales, exchanges or leases, for such prices and upon such terms and conditions as they deem proper. c. To compromise any claim or controversy. d. To make distribution hereunder in cash, in kind, or partly in cash and partly in kind. � 4 N.H.H. e. If at any time the value of the corpus of the Trust hereunder, in the sole discretion of the Trustee, is too small to be economically or practically managed and administered by the Trustee, said Trustee shall terminate such Trust and distribute the balance to the beneficiary. ITEM 6. I nominate, constitute and appoint my spouse, Paul E. Hofmann, as executor of this, my Last Will and Testament. In the event of the renunciation, death or resignation or inability to act for any reason whatsoever of my spouse, Paul E. Hofmann, I hereby nominate, constitute and appoint, Mark A. Hofmann and Pamela A. Caserta, as Successor Co-Executors of this, my Last Will and Testament. � 5 N.H.H. ITEM 7. I hereby declare it to be my express desire that the Co-Executors of this, my Last Will and Testament, employ Lawrence J. Neary, Esquire, of Harrisburg, Pennsylvania, for legal advise and assistance in the probating of and carrying out of the provision of my Last Will and Testament. He, having intimate knowledge of my affairs, views and wishes, respecting many matters that may arise in the probate of this instrument, the administration of my estate and the execution of the powers therein contained. IN WITNESS WHEREOF, I set my hand and seal to this, my Last Will and Testament, this h`�`�i day of ��7�r��r' , 1999. /�� ',-r7 Na�y H. Ho��nn The preceding instrument, consisting of this and five (5) other typewritten pages, initialed at the bottom of each page for security purposes, was on the date thereof signed, published and declared by Nancy H. Hofmann, the Testatrix herein named, as and for his Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses whereof. _-------., �� " �-'� .��. ��%�< �J�!�-' r ��j i�,��1✓ WITNESS ' �°` ,'� � ��, � .-L Ct � f � WITNESS 6 COMMONWEALTH OF PENNSYLVANIA . : ss. COUNTY OF DAUPHIN . We, Nancy H. Hofmann, �c� ) �� l�o�-�,,�� and 1-�c�r �GV�� A - N�� _, the TESTATRIX and the witnesses, respectively, whose names are signed fo the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the TESTATRIX signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the TESTATRIX, signed the will as witness and that to the best of her knowledge the TESTATOR was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue Influence. /�j'�"��.�.� �...�-�-�iy� Nan . Hofm n __..___ , � � .__. ��.� � n�� ,�; � . � _ _ ITN ESS �-'--- ,.�" ,� �� i',.,,h.�v'(�� `��c�r � °i_. —,� „�—..� _ VVITNESS �� Attorn y On this, the �Sl�`" day of�_, 1999, before me � , the undersigned officer, personally, appeared Lawrence J. Neary, Esquire, known to me or satisfactorily proven to be a member of the bar of the highest court of Pennsylvania, and certified that he was personally present when the foregoing acknowledgment and affidavit were signed by the TESTATRIX and witnesses. I have signed my name and affixed my seal. Comnrt. �xp. I '7�aC�o� . . � ' Court Order Processing\Decedents- MA1-MB3-01-21 - P.O.Box 841005 - Boston,MA 02284 November 13, 2014 � y o Denise B. Williamson � Wix, Wenger & Weidner $ 508 North Second Street = P.O. Box 845 � Harrisburg, PA 17108-0845 � 9 � RE: Estate of Nancy H Hofmann a Date of Death: 09/29/2014 � a Dear Denise B. Williamson: � Per your request, enclosed please find the account information as of the date of death � for the above-named decedent. For your information, accrued interest is not included in � the date of death balance. n � � Please feel free to contact me if I can be of any further assistance. � 9 � Very truly yours, a � - _.... � c��.-_`�•'--=�A��, `3''w � Donna Penta = Lead Specialist � 617-514-5189 s � � z ' � � z 3 S C U O a� � G Z 3 � 9 e 5 .� 5 S � � Santander ESTATE OF: NANCY H HOFMANN SOCIAL SECURITY#: 173-24-5515 DATE OF DEATH:09/29/2014 Account#: 1715218507 Type: RETAIL STATEMENT CD Open date:02/02/2000 In the name of: NANCY H HOFMANN( PAMELA A CASERTA POA) Date of death balance:$20,000.00 Int.(YTD)from:01/01/2014 To: 08/31/2014 $22.37 Accrued interest to date of death: $2.38 Other info: Page 2/2 St � MEMBERS 1St FEDERAL CREDIT[JNION REGULAR SAVINGS ACCOUNT: 349324-00 Account Number/Suffix 02/14/2009 Date Account Established Principal Balance at Date of Death $5.00 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $5.00 Name of Joint Owner Pamela Caserta Date Joint Added 02/14/2009 CERTIFICATE OF DEPOSIT: 349324-40 349324-51* Account Number/Suffix p2/14/2009 08/15/2012 Date Account Established Principal Balance at Date of Death $20,000.00 $1,528.78 Accrued Interest to Date of Death $18.26 $0.41 Total Principal and Accrued Interest $20,018.26 $1,529.19 Name of Joint Owner Pamela Caserta Pamela Caserta Date Joint Added 02/14/2009 01/14/2011 "Rollover from CD 349324-44 opened 01/14/2011. CERTIFICATE OF DEPOSIT: 349324-52* 349324-53** Account Number/Suffix pg/15/2012 09/06/2012 Date Account Established Principal Balance at Date of Death $13,767.74 $10,000.00 Accrued Interest to Date of Death $4.75 $3.45 Total Principal and Accrued Interest $13,772.49 $10,003.45 Name of Joint Owner Pamela Caserta Pamela Caserta Date Joint Added 01/14/2011 02/05/2011 *Rollover from CD 349324-44 opened 01/14/2011. **Rollover from CD 349324-45 opened 02/05/2011. ME BERS 1ST FEDERAL CREDIT UNION � Tessa L Klugh Lending Insurance Support Specialist November 24, 2014 Estate of: NANCY H HOFMANN Date of Death: 09/29/2014 Social Security Number: 173-24-5515 5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org St � MEMBERS 15t FEDERAL CREDIT iJNION CERTIFICATE OF DEPOSIT: Account Number/Suffix 349324-55 349324-56* Date Account Established 03/22/013 09/06/2012 Principal Balance at Date of Death $10,127.48 $22,348.16 Accrued Interest to Date of Death $3.11 $14.57 Total Principal and Accrued Interest $10,130.59 $22,362.73 Name of Join±Owr.er Pamela Caserta Pamela Caserta Date Joint Added 03/22/2013 12/09/2011 "`Rollover from CD 349324-48 opened 12/09/2011. CERTIFICATE OF DEPOSIT: Account Number/Suffix 349324-57" 349324-58* Date Account Established 09/23/2013 09/25/2013 Principal Balance at Date of Death $4,977.29 $20,533.99 Accrued Interest to Date of Death $0.95 $21.11 Total Principal and Accrued Interest $4,977.24 $20,555.10 Name of Joint Owner Pamela Caserta Pamela Caserta Date Joint Added 06/22/2012 06/25/2012 *Rollover from CD 349324-49 opened 06/22/2012. *"Rollover from CD 349324-50 opened 06/25/2012. MEMBERS 1ST FE ERAL REDIT UNION y _----- �.� - Tessa L Klugh Lending insurance Support Specialist Noverr'�ber 24, 2014 Estate of: NANCY H HOFMANN Date of Death: 09/29/2014 Social Security Number: 173-24-5515 5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org 01I21/2015 13:31 717-920-4666 DEPOSIT SERVICES PAGE 02IO2 IVIE TRO �� 3801 Paxton Stre�t 888.937.d004 Harrisburg, PA 17111 mymetrobank.com January 21, 2015 Denise B. Williamson �x, Wenger& Weidner 508 N 2"d Sfi Harr9sburg PA 17101 RE: Estate of: Nancy H Hofmann Tax Id�ntification Number: 173-24-5515 Date vf Death; 9/29/2014 To Whom It May Conc�rn: This letter is in reference to deced�nt account information you requested for the individual listed above_ We are able to providE the foflowing: Account Type:Checking Account Number: 513356980 Date Opened: 8/21/2401 Primary Owner: Nancy H Hofmann Secondary Owner: Pamela A Caserta (Added 718/2011) Date of Death Balance: $5,57G.85 YTD interest: $11,62 Principa) Salance: $5,576_85 Accrued Interest**: $.22 *" Please note: The accrued interest will not be paid if the account is closed priar #o the date the infiaresfi is scheduled to post. Please feel free to cflntac# me at(888) 937-0004 if l may be of further assistance. Sincer�ly, ��'� Cindy Stanbery Support AssociateJDeposit Services Metro Bank MetLife Met�i f e Total Control Account PO Box 6300 Scranton,PA 18505-6300 800-638-7283 l�ovember 17, 2014 Wix, Wenger& Weidner Attn: Denise Williamson 508 North Second St Harrisburg, PA 17101 Re: Metropolitan Life Insurance Company Accountholder: Nancy Hofmann Total Control Account#4045234676 Your Clients: Mark Hofmann and Pamela Caserta Dear Ms. Williamson: In response to your request for the date of death balance for the above referenced Total Control Account, the date of death balance is $13,130.81. The beneficiaries on the account are your clients Mark Hofmann and Pamela Caserta. If you have any questions or require further assistance,please call our TCA Customer Service department at 800-638-7283, Monday through Friday, 8:00 am through 6:00 pm ET. Sincerely, TCA Administration Services Note:Metropolitan Life Insurance Company(NILIC)provides administrative services for Total Control Accounts established in connection with policies issued by MLIC or by certain of MLIC's insurance company affiliates. tca.0146.rev.03 �� ) �\I ` 1 `� WIX, WENGER & WEIDNER A PROFESSIONAL CORPORATION RICHARD H.WIX ATTORNEYS AT LAW DEAN A.WEIDNER STEVEN C.WILDS 508 NORTH SECOND STREET Of Counsel THERESA L SHADE WIX` DAVID R.GETZ HARRISBURG,PENNSYLVANIA 17101 Mailing Address: STEPHEN J.DZURANIN Post Office Box 845 JEFFREY C.CLARK Harrisburg,PA 17108-0845 PETER G.HOWLAND BRADLEY R.GORTER (717)234-4182 Suburban Office: FAX(717)234-4224 4705 DUKE STREET HARRISBURG,PA 17109-3041 'Also Member Massachusetls Bar www.wwwpalaw.com (717)652-8455 February 2, 2015 Register of Wills �., C�J � Cumberland County Courthouse `r' � � � C? C'`l c'7 One Courthouse S uare r �' �► `=-' r� q Carlisle, PA 17013-3387 ��' � `� � V `�� ;'1.J ; �..._... �, :P ' ' �, G� f,�1 Re: Estate of Nancy H. Hofmann � � Estate File No. 21-14-0971 �7 ' �' � _ r `=i -,� Our File No. 3690-16704 � ►._. , = `�' r rt - , � Y� c> Dear Sir or Madam: �'�' �`� Enclosed are the following documents for filing on behalf of the above-captioned estate: 1. The original and one copy of the Inheritance Tax Return; 2. The original and one copy of the Inventory form; and 3. Our client's check in the amount of $304.24, made payable to the "Register of Wills, Agent," representing the inheritance taxes due. Please process these documents and return time-stamped copies to our office in the envelope provided. Thank you for your assistance in this matter. If you have any questions regarding the above, please contact me. Sincerely, WIX, W�IVGER & WEIDNER gy: ' C`�LGt �Z� DerSise B. Williamson Paralegal /dbw Enclosures cc: Mr. Mark A. Hofmann Ms. Pamela A. Caserta David R. 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