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HomeMy WebLinkAbout04-07-15 (2) Pennsylvania 1505618403 UEPARTMENTOFREVENI=X(03-14) REV-15010 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT 21 14 0832 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 08 01 2014 08 12 1928 Decedent's Last Name Suffix Decedent's First Name MI ROSENBERGER THOMAS I (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ❑X 1. Original Return 2. Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) El4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) 0 7. Decedent Died Testate 8. Decedent Maintained a Living Trust 1 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) 10. Litigation Proceeds Received ❑ 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) 13. Business Assets ❑ 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D BOGAR (717) 737 8761 First Line of Address ONE WEST MAIN STREET Second Line of Address t City or Post Office State ZIP Code C `'' G? SHIREMANSTOWN PA 17011 =X3 cry 71 r— rTt. Correspondent's email address: r:7 ­3 REGISTER QF5W 4S USgbNLY'n _'n REGISTER OF WILLS USE ONLY — .. DATE FILED MMDDYYYY * CO r— rrt DATE FILED STAMP Side 1 I IIIIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII 1505618403 1505618403 1505618411 REV-1500 EX Decedent's Social Security Number Decedent's Name: Rosenberger, Thomas I. 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. 25 ,431 - 34 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 2,18 0 - 3 2 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 27,611 - 66 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 10,6 51 - 9 4 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 10,6 51 - 9 4 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 16,959 - 72 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. 16,959 - 72 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.00 15. 0 - 0 0 16. Amount of Line 14 taxable at lineal rate X .045 16,959 - 72 16. 763 - 19 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 11 - 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 0 0 19. TAX DUE................................................................................................................ 19. 763 - 19 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has an owledg . IGNAT O-PERSON 9PO,S L O ILING RETURN Thomas E. Rosenberger DATE L11 7 ADDRESS 402 Bosler Avenue, Lemoyne, PA 17043 14L 2-1L SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Jafinnes D. BogAr I DATE ADDRESS One West Main Street, Shiremanstown, PA 17011 11111111111111111111111111111111111111111111111111111111 IN Side 1505618411 1505618411 PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Rosenberger,Thomas I. 21-14-0832 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#2 Name Brian K.Rosenberger Address1 1184 Kingsley Road Address2 City, State,Zip Camp Hill,PA 17011 Date REV-1500 EX Page 3 File Number 21-14-0832 Decedent's Complete Address: DECEDENT'S NAME Rosenberger,Thomas I. STREET ADDRESS 350 Hollow Brook Drive CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 763.19 2. Credits/Payments A. Prior Payments 822.05 B. Discount 38.16 Total Credits(A +B) (2) 860.21 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 97.02 Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 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;.................................. ❑ ❑x c. retain a reversionary interest;or............................................................................................................... ❑ R d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ ❑x 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?.................................................................................................................. ❑ 0 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 January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. 1 J REV-485 EX(05-04) 48500041046 SAFE DEPOSIT�& BOX INVENTORY PA Department of Revenue PLEASE USE ORIGINAL FORM ONLY Social Security or Death Certificate Number Date of Death County Code Year File Number 08/01/2014 21 14 0832 Decedent's Last Name Suffix First Name MI Rosenberger Thomas I ©ADDRESS OF DECEDENT STREET: CITY: STATE: ZIP CODE: 350 Hollow Brook Drive Carlisle PA 17013 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX NAME: Thomas E. Rosenberger_ STREET ADDRESS: CIN: STATE: ZIP CODE: 402 Bosler Avenue Lemo ne PA 17043 • NAME,ADDRESS AND RELATIONSHIP(IF ANY)TO DECEDENT,OF PERSON(S)PRESENT AT THE BOX OPENING a. NAME: RELATIONSHIP: Thomas E. RosenbgE er _ _J_ Son/Co-Executor STREETADDRESS: CITY: STATE: ZIP CODE: 402 Bosler Avenue_ Lemoyne PA 17043 b. NAME: RELATIONSHIP: Brian K. Rosenberger _ _ Son/C6-Execdtor STREETADDRESS: — CITY: STATE: ZIP CODE: 1184 Ki_n_pler�RoadCamp Hill _PA 17011 c. NAME: RELATIONSHIP: " STREETAODRESS: CITY STATE: ZIP CODE: NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED NAME: PNC(Mechanicsburg Branch) STREETADDRESS: CITY: STATE: ZIP CODE: 2 E. Main Street Mechanicsburg PA 17055 NAME OF PERSON MAKING LAST ENTRY DATE AND T E OF ST ENTRY T41Q.n,gs E R�S�Jg 2 Zot 4: lfAM. DATE OF CONTRACT TO RENT BOX NUMBER OF BOX 1 TITLE UNDER WHICH BOX IS REQUESTED LDu p 1358G9-`-y-s- "-no S NAME AND ADDRESS OF PERSON(S)HAVING ACCESS TO BOX a. NAME: b. NAME: STRFQ I�DR�S1U—R— FV — � ST�ET�D�jRE$S/�'� CIS T ZIP CODE: CIwt TE: ZIP CODE: NAMEND TITLE OF EMPLOYEE TAKING THE INVENTORY N 011j� WAS A WILL IN THE BOX? ❑ YES X NO If yes, a.Data of will: b. Name and address of personal representative,if named in the will NAME: STREETADDRESS: CITY: STATE: ZIP CODE: c. Name and address of attorney,if any NAME: STREETADDRESS: CITY: STATE: ZIP CODE: 48500041046 48500041046 �._ �— REV-485 EX SAFE DEPOSIT BOX INVENTORY Page of INSTRUCTIONS (1) Cash:Report total only, (2) Stocks:List in detail every common or preferred certificate,warrant or other rights found in box,Stocks are to be designated by name of company,certificate number,date of certificate,name in which stock is registered,and number of shares and class of stock. (3) Obligations of U.S.Government:Number of items,date of issue,face value,names in which registered and type of ownership. i.e.,jointly held,payable on death,etc. (4) Bonds:Designate by name,amount,serial number,or other designation.(Bearer Bonds) (5) Bank and Savings and Loan Passbooks:Slate name of depositor,number of book,last date appearing in book,name of bank and branch,and balance. (6) Jewelry,Coins,Stamps,Manuscripts,etc:List and describe as fully as possible. (7) Deeds,Mortgages,Current Insurance Policies or other evidences of Indebtedness:List and describe as fully as possible. (8) All other contents. (9) Return completed form to: DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT.280601 HARRISBURG,PA 17128.0601 ITEM ITEM DESCRIPTION NO. ---- — _ - - t L, RQ ofFSR C--P- PkoPfA'CH �5v�-© -,CNOMAS E Q£.P,4 4 ""r('TLJ- F.o lZ ry 111 S y 1PpMAN _7 p1tiltaQcf. �Ece �ocZ - M�+s �sE3f.1Raf — --- Q,__,4A& W.SuQ q,, cv— ,Rvw�_Ga R -'n4ot"hs f �R-- `� ?aMML l� tom�. ��is£.k S Prgc.ticy -dt p ttt:l tsxt�tS x '�1}S-��4..JC�c,k� 12- I CERTIFK UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF _CQRRECIrAND COMPLETE THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: 5tG SMG URE _rr. _PRINTNAMEPRINT NAMkNDCq K A �SPRI ���� — ""7'y},pjyt.A$ tJ QQ1�f.. PRINT TITLE _ T DATE CHECK APP ROP IAT 6 X: fSExetutor(trlx) [:]Administrator(tri) G• +'G'� f (3 Estate Representative n-rofntownw of safe deposit box NOTE:Attach additional 812"x 11"sheet(s)if necessary or use duplicates of this page of form. The Department is authorized by law,42 U.S.C.§405(cM2)(CXQ,to require disclosure of Social Security numbers in connection with administering state tax laws.The Department uses the Social Security number to identify the decedent and personal representatives of the estate.The Commonwealth may also use the information in exchange of tax information agreements with Federal and local taxing authorities.The state lawprohibits the Commonwealth's personnel from disclosing confidential tax information except for official purposes. Rev-1508 EX+(08-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF AXRET PERSONAL PROPERTY INHERITANCE TAX RETURNRN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosenberger,Thomas I. 21-14-0832 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Members 1st Federal Credit Union-Savings Account No.8069-00. Principal balance at date 4,890.03 of death$4,890.03;accrued interest$0.00. 2 Members 1st Federal Credit Union-Checking Account No.8069-11. Principal balance at 3,372.31 date of death$3,372.31;accrued interest$0.00 3 Personal Property-Values per appraisal, including 2009 Buick Enclave. 14,865.00 4 US Treasury-2014 Personal Income Tax Refund 2,304.00 TOTAL(Also enter on Line 5, Recapitulation) 25,431.34 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12) A MEMBERS 1St FEDERAL CREDIT UNION PRIMARY OWNER: Thomas I Rosenberger REGULAR SAVINGS ACCOUNT: Account Number/Suffix 8069-00 Date Account Established 09/23/1965 Principal Balance at Date of Death $4,890.03 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $4,890.03 Name of Joint Owner None CHECKING ACCOUNT: Account Number/Suffix 8069-11 Date Account Established 02/21/1980 Principal Balance at Date of Death $3,372.31 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $3,372.31 Name of Joint Owner None LOAN ACCOUNT: Account Number/Suffix 8069-01 Date Opened 09/25/1985 Principal Balance at Date of Death $0.00 Loan Type Personal Line of Credit Collateral Secured Signature Interest Rate 11.00% Name of Co-Borrower None VISA CREDIT CARD ACCOUNT Account Number 4672090000266411 Date Account Established 07/12/1996 Balance at Date of Death $0.00 Joint Cardholder None MEMBERS 1sT FEDERAL CREDIT UNION �J Tessa L Klugh Lending Insurance Support Specialist September 10, 2014 Estate of: THOMAS I ROSENBERGER Date of Death: 08/01/2014 Social Security Number: 202-20-6450 5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 (800) 283-2328 www.memberslst.org LINDEN HALL ANTIQUES 211 N.OLD STONEHOUSE ROAD CARLISLE, PA 17015 717-2494978 To: James D. Bogar, Esquire One West Main Street Shiremanstown,PA 17011 From: William G. Rowe,Appraiser 211 N.Old Stonehouse Road Carlisle, PA 17015 Re: Estate of Thomas 1. Rosenberger D.O.D.-August 1,2014 Date: February 26,2015 Bed room set-3 pc. $215.00 2009 Buick Enclave-39,000 miles,average condition $13,500.00 Hollinger Diesel XP lawn mower-27 HP,Zero turn,72"deck, 15 years old, fair condition $1,150.00 TOTAL $14,865.00 William G. Rowe Rosenberger Appraisal 1 02/26/2015 . - -. CERTIFICATE OF TITLE FOR A VEHICLE • � ; 83 ' I , CI6 'h99'�OL11623 101313 .. 5GAITRI 5D 39'J 169 .54 9 �31II CIC b7D 3673,1 D y R0 I VEHICLE IDENTIFICATION NUMBER YEAR � MAKE OF VEHIOLE TITLE NUMBER -• '. :•1013-17 BODY TYPE •.DUP SEAT CAP I•Y PRIM TITLE STATE �., ODOM.PROCD.DATE' •'M4ODOM.MILES ••• •ODOMSTATUS""'- :: ti DATE PA TITLED DATE OF ISSUE UNLADEN WEIGHT GVWR � ...GCWR _ ~TITLE BRANDS✓ . 'ODOMETER STATUS 0ACTUAL MILEAGE L;A i�';Ttti.F:'-;�.. •h ( •i.MILEAGE EXCEEDS THE MECHAN1CAt.• Uums _ r` 2..NOT:THE,ACTUAL'MILfA(iE . •• w t� `3.NO'f,THE ACTUAL MILEAGE-ODOMETER TAMPER(1JG VERIFIEb!„"'' r + t.EXEMPT FROM ODOMETER DISCLOSURE _ Z .I TfT1.E BRANDS REGISTERED OWNER(S)'},. _ .i <.- L q e r yr Y aqy". ,+' A=AMfIC1UE VEHICLE TY �3� r+'� <.Y .r rt 'l, ,', w'. ✓ I C.CLASSIC VEHICLES'1 ' T' O!'1AS I 'R'OSENBER E# 3 rt D:CDLLE«RatF ypT;tCAF , ,� S„ � � vG4. ,F .OIIT OF'ODUNTRY^: !; v G►ORIGINAI{.Y rd..FdR NO(v 4 3511 tHOLLOIf6 �34K �•DR JOISTRIbUR614 l''�t ,. ..•`•f.• .; J +F„ >„�` <7 Aa�r�,.^7�`N H=AGRrALTURAL VEHICLE�k7 � CARLY SLC•;OA•;'1 f Q1!3 s- L .LOGGING VEHICLE P.ISIWAS A POLICE VEHICLE R.RECONSTRl1CTID R.. L }�'4 ff� �+t Yx �1.�•� �L 1 Fir Y;,.,�. S=STREEL'ROD • A = 3'!' f ,{ •1 ^q A 1 c a V.VEH CLERCONTAIN9 REISSED THEFT VE UED VIN, r • ' ` } - 7 F'K t f W.FLOOD VEHICLE IN FAVOR OF: .a r � :1.' {('' 1r�' .>"• X w[SWAB A TAXI i ; k f}f SECONOLIEIJFAVOA OF: _ - If a second lienholder is Hsted:upon sstf6Ladtpn 4r *;tha:*, Pt 1,k, first. ` flenholder must forward this Thle,to the BUmsi Of Motor Vdhl*s^Iwahtth� - appmpdate form and fee. : FIRST LIEN RELEASED DATE ' •f'• A�„ R IF ..�. BY SECOND LIEN RELEASED L' AUTHORIZED REPRESENTATIVE DATE MAILING ADDRESS " _ BY • AUTHORIZED REPRESENTATIVE THOMAS I ROSENBERGER ='h 350 HOLLOWBR00K DR / l CARLISLE PA 17013 • pennsylvania DEPARTMENT OF TRANSPORTATION • 1 �r • I certify as of the date of Issue, the official records of the Pennsylvania Department BARRY J • SCHOCH, P• E• ' of Transportation reflect that the persons)or company named herein Is the lawful owner _ "of the said veMIs. Secretary of TrnnspoHatioR - SCRIBED AND SWORN if a co-purchaser other than your spouse Is listed and you want the title to EFORE ME: ' iSUB �`- be listed as'Joint Tenants With Right of Survivorship"(On deatF�,of one TO By- r."':r MO �-" A R owner,title goes to surviving owner)CHECK-HERE13.LStlierwise,':tAg dila ( L• +U� will be Issued as'Tenants in Common"(On death of one ownef,'iritg�est,ol, 1 r C deceased owner goes to his/her heirs or estate).' 't 4 .i Ttc iA"t l's ehp Drys. t l C '✓ l !' �'' A P'R ADMINISTERING OATH t ) f ' $' s i IF NO LIEN,CHECK❑ IS THIS AN ELT?(IF YES,•FIN RfiOU)RED) YES❑ NOd ,a .,. UJ �' - IST UENHOLDER FINANCIAL INSTITUTION NUMBER:` (J, 1ST LiENHOLDER NAME ... .._.`.;.,,: - yam' _ �! -. '•i' STREET n r1 I .. CITY STATE MP .•„ I IF NO 2ND LIEN,CHECK❑IS THIS AN ELT?(IF YES,FIN REQUIRED)YES❑NO❑ 'The rdel o d hroby-kw spool. b O.Aftefe d TH. • d• vetede d—g-d wbwe,wblen In Vm enmenb—.nd atter%p l del-a*[Wh ht= 2ND LIENHOLDER FINANCIAL INSTITUTION NUMBER:.. J 2ND LIENHOLDER NAME IR t f t SIGNATURE OF APPLICANT OR Al17HORIZEO SIGNER STREET SIGNATURE OF COdPPOCANi/mLE OF AUTHORIZED SIGNER C'm STATE LP .� I Rev-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosenberger,Thomas I. 21-14-0832 If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Brian K. Rosenberger 1184 Kingsley Drive Son Camp Hill, PA 17011 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM LETTER DATE FOR JOINT MADE (NCLUDE NAME OF NUMBER OR SIMILARnANCIAL IDENTIFY NG(TUTION AND BANK NUMB R.ATTACH EEDOUNT FOR DATE OF DEATH DECD$ DECEDENT'S INTERESTVALUE OF TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST 1 A 08/23/1991 Members 1st Federal Credit Union-Savings 3,154.41 50.000% 1,577.21 Account No,7562-00. Principal balance at date of death$3,154.41;accrued interest $0.00. 2 A 08/23/1991 Members 1st Federal Credit Union-Checking 1,206.22 50.000% 603.11 Account No.7562-11. Principal balance at date of death$1,206.22;accrued interest $0.00. TOTAL(Also enter on Line 6, Recapitulation) 2,180.32 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule F(Rev.01-10) A MEMBERS 1St FEDERAL CREDIT UNION PRIMARY OWNER: Brian K Rosenberger REGULAR SAVINGS ACCOUNT: Account Number/Suffix 7562-00 Date Account Established 11/04/1964 Principal Balance at Date of Death $3,154.41 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $3,154.41 Name of Joint Owner Thomas I Rosenberger Date Joint Added 08/23/1991 CHECKING ACCOUNT: Account Number/Suffix 7562-11 Date Account Established 02/18/1984 Principal Balance at Date of Death $1,206.22 Accrued Interest to Date of Death $0.00 Total Principal and Accrued Interest $1,206.22 Name of Joint Owner Thomas I Rosenberger Date Joint Added 08/23/1991 MEMBERS 1ST FEDERAL CREDIT UNION Tessa L Klugh Lending Insurance Support Specialist September 10, 2014 Estate of: THOMAS I ROSENBERGER Date of Death: 08/01/2014 Social Security Number: 202-20-6450 5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • www.memberslst.org REV-1511 EX+(OS-13) gCHEDULE H pennsylvania DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RESIDENTDECEDENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Rosenberger,Thomas I. 21-14-0832 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 6,697.80 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State ZiD Year(s)Commission Paid 2. Attorney's Fees Bogar& Hipp Law Offices 2,415.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zia Relationship of Claimant to Decedent 4. Probate Fees 175.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,363.64 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 10,651.94 Copyright(c)2013 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.08-13) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Rosenberger,Thomas I. 21-14-0832 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Richardson Funeral Home-funeral bill 6,697.80 H-A 6,697.80 Other Administrative Costs 2 Advance Disposal Service-trash bill 40.50 3 Comcast-cable bill 116.40 4 Linden Hall Antiques-fee for personal property appraisal 65.00 5 Messick's-tractor maintenance 67.08 6 PPL-electric bill 487.80 7 Register of Wills-fee for Short Certificate 5.00 8 RESERVES:-Costs to conclude administration of the estate,including preparation and filing 500.00 of fiduciary income tax returns 9 US Postal Service-certified mail to PNC Bank and PA Dept of Revenue 12.98 10 Verizon Wireless-cell phone bill 48.69 11 Verizon Wireless-final cell phone bill 20.19 H-B7 1,363.64 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Rosenberger,Thomas I. 21-14-0832 NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) 0 Not Wst Trusteets) ITAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Brian K. Rosenberger Son One-half of rest, 1184 Kingsley Road residue and Camp Hill, PA 17011 remainder Thomas E. Rosenberger Son One-half of rest, 402 Bosler Avenue residue and Lemoyne, PA 17043 remainder Total Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as appropriate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10) LAST ST WILL AND TESTAMENT OF THOMAS I. ROSENBERGER I, THOMAS I. ROSENBERGER, of Middlesex Township, 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 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, in equal shares, to my sons, THOMAS E. ROSENBERGER and BRIAN K. ROSENBERGER, , provided that should either of my sons predecease -me, I give and bequeath such sons's share unto his issue per stirpes by representation, and if there be a failure of same, then I give and bequeath such deceased sons's share to my surviving son as provided herein. SECOND: 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 proper-, tyi, exercisable without court approval and effective until actual distribution of all property: (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. (G) 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 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. THIRD: 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 resp ect to property passing under this Will, shall be paid out of the principal of my residuary estate. FOURTH: 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 2 P beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. FIFTH: I nominate and appoint my sons, THOMAS E. ROSENBERGER and BRIAN K. ROSENBERGER, Co-Executors of this, my Last Will and Testament. I direct that my Co-Executors, 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 day of Gyo�l3Ei`� ► 2001. (SEAL) THOMAS I. ROSENBERGER Signed, sealed, published and declared by the above- named Testator as and for his Last Will and Testament in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address ` c.n/l U. 4a..rY; Address 3