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Home My WebLink About06-22-15 (2) 1 IIII'll II IIIIIII I � 1505610143 REV-1500 EX`°2_„> � OFFICIAL USE ONLY PA Department of Revenue pennsylvania co��cY code Year Fiie Number Bureau of Individual Taxes �P�TMEMOFREVEMIE Po aox.2soso� INHERITANCE TAX RETURN 21 14 1066 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 10 13 2014 03 14 1933 DecedenYs last Name Su�x DecedenYs First Name MI WACKER BERNECE g (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Su�x Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X,�, 1. Original Retum � p. Supplemental Retum r� g Remainder Retum(Date of Death � J� Prior to 12-13-82) -, J 4. Limited EState � 4a Puture Interest Compromise (- (date of death after 12-12-82) ;_� 5. Federal Estate Tax Retum Required �X; Decedent Died Testate t Maint ined a Living Trust 6 �,anacn Copy orwiq ❑ � ntea �opy of�rn,st) 8. Total Number of Safe Deposit Boxes g. Litigation Proceeds Received �I �p.Spousai P4vert��redit{Da�e of Deam Election to tax under Sec.9113 A b8tween 12-31- and 1- 5) �� -J (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE OIRECTED TO: Name Daytime Telephone Number MICHAEL L BANGS 717 730 7310 REGISTER OF WILLS USE ONLY First Line of Address 429 SOUTH 18TH STREET � �� _-: c:= �; ::-� :::� Second Line of Address ___ �, r.� ' �:� c_ ' '� <'> ,::', _., � ...,.. c:__ a �..� .., _._ .. , ,� ..1 , . .__, ..., , . ' DATE-FI�E � �. � City or Post O�ce State ZIP Code �� ; CAMP HILL PA 17011 ' " —'C) , , -- ' , :., .. �._3 . � CorrespondenYs e-maii address: mikebangs@verizon.net � F--� � -> Under penalties of pery'ury,I declare that I have examined this retum,inGuding accompanyi.ng schedules and stat ents,and tp best of my kr�owlec��aci�belief, it is true,cortect and complete.DeGaration of preparer other than the personal representatroe is based on all inf atio f w"hi preparer ha�y knowledgiq. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN �� DATE Timoth E.Wacker '��` �v�A ADDRESS 6199 Veterans Way, Newport PA 17074 SIGNATURE F PREPARER OTHER THAN REPRESENT E DATE ��,� " Michael L. Bangs r��'��0 3-. ADDRESS 429 South 18th Street, Camp Hill, PA 17011 Side 1 � 1505610143 1505610143 � `� �l � i i ' i uii i J 1505610243 REV-1500 EX Decedent's Social Security Number DecedenYs Name WaCICEr� Bernece S. -- __._--- -- RECAPtTULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 7 , 7 7 4 . 0 4 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages 8 Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Misceilaneous Personai Property(Schedule E)............... 5. 21, 7 8 3 . 19 6. Jointl Owned Pro e �' y p rty(Schedule F) � Separate Billing Requested............ 6. 1 , 775 . 84 7. Inter-Vivos Transfers 8 Miscellaneous -Probate Property (Schedule G) � Separate Billing Requested............ 7. 129, 277 . 45 g. Total Gross Assets (total lines 1 through 7)........................................................ g. 160 , 61� . 52 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 16, 319 . 81 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 4 0 . 63 11. Total Deductions(total Lines 9 and 10)................................................................ �� 16, 3 60 . 4 4 12. Net Vaiue of Estate(Line 8 minus Line 11).......................................................... �2. 14 4 �2 5 0 . �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)............................................... �q_ 144 �250 . 08 TAX COMPUTATION-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 . 00 16. AmountofLinel4taxable 144 250 . 08 �6. 6 491 . 25 at lineal rate X .045 � r 17. Amount of Line 14 taxable at sibling rate X.12 � . �� 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 � . �0 18. � . �� 19. TAX DUE................................................................................................................ 19. C, 4 91 . 2 5 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � Side 2 � 150561�243 1505610243 � i iu i � ii i REV-1500 EX Page 3 File Number 21-14-1066 Decedent's Complete Address: DECEDENT'S NAME Wacker, Bernece S. STREET ADDRESS 824 Lisburn Road,Apt. 411 ---------- -,-- — — --- I CITY ---- -- ------ — — � STATE i ZIP i Camp Hill PA ' 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 6,491.25 2. Credits/Payments A. Prior Payments 11,000.00 B. Discount 324.56 Total Credfts(A +B) (2) 11,324.56 3. Interest (3) If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �4� 4,833.31 Check box on Page Z,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 Pa able to: REGISTER OF WILLS, AGENT. ��,��,�� . . ��'��I��:i' ._ 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:.. ............................... ❑ z j c. retain a reversionary interest;or............................................................................................................... �� d. receive the promise for life of either payments,benefits or care?............................................................ � ',�xJ, 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without _ � receiving adequate consideration?.................................................................................................................._ ' Lx I 3. Did decedent own an"in trust fo�' 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?.................................................................................................................. �XJ L� IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. � rtfi x�;,:;� �u.; �, sr�� :k''..� �� > ,....,. �. . .,_.. . _ . _ ,,._ . 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)]. `=or 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 ;�2 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 disdosure of -;ssets 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 individual who has at least one parent in common with the decedent,whether by blood or adoption. , , . , , Rev-1503 EXa(6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSVLVANIA INHERITANCE TAX RETURN � RESIDENT OECEDENT ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 All property jointty-owned wIM right oi survivonhip muat be diaclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 424 shares of Manulife Financiat Corporation-stock 18.335 7,774.04 TOTAL(Also enter on Line 2, Recapitulation) 7,774.04 (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 B(Rev.6-98) � i � ■ i� . � Rev-1508 EX+(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCETAXRETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 Inclutle the proceeds of litigation and the date the proceeds were recsived by the estate. All property joint�yow�ed with the right of survivonhip must be diaclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Manulife Financial dividend 49.51 2 Members 1st Federal Credit Union-Regular savings 5.00 3 PNC Bank, NA-Checking account 14,973.01 4 Refund of health insurance 253.00 5 Santander -Money Market Savings 5,992.67 6 Teamsters Pension Fund 464.00 7 U.S.Treasury-2014 income tax refund 46.00 TOTAL(Also enter on Line 5, Recapitulation) 21,783.19 (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 E(Rev. 11-10) � i ' � � i� � Rev-1509 EXr(01-10) pennsylvania SCHEDULE F OEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 _ H an asset was made joint within one year of fhe decedenYs date of death,it muat be reported on achedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Timothy E.Wacker 903 Jay Court Son Glen Burnie, MD 21061 B. Thomas R.Wacker 612 W. Shade Lane Son Enola, PA 17025 C. JOINTLY OWNED PROPERTY: LETTER DATE INCLUDE NAME OFDENANRIAPI.INONITUO�ONRAND NK ACCOUNT %OF DAVEAO E O TH ITEM FOR JOIN MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR DATE OF DEATH DECD�S OECEDENTS INTEREST NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST 1 Af 06/01/2010 Members 1st Federal Credit Union- 2,694.52 33.000% 889.19 � Certificate of Deposit#386475-d0;the decedent and her two sons,Timothy E. Wacker and Thomas R.Wacker owned this account jointiy. The decedenYs interest was one-third. 2 A/� 08/31/2010 Members 1st Federal Credit Union- 2,686.82 33.000% 886.65 � Certificate of Deposit#386475-42;the decedent and her two sons,Timothy E. Wacker and Thomas R.Wacker owned this account jointly. The decedenYs interest is one-third. TOTAL(Also enter on Line 6,Recapitulation) 1,775.84 (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) � i � ■ i� . � �. Rev1510 EX+(08-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE �NHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 This schedule must be completed and filed rf the answer to any of questions 1 through 4 on page three oT the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S �CLUSION TAXABLE NUMBER THE DATE OF RANSFERSATTACFi A CO YEOF THE DE�ED�OREREAL E3TATE. VALUE OF ASSET �NTEREST �IF APPLICABLE) VALUE 1 CB&T Cust IRA-Account 00074136591;the 5.888.38 5,888.38 decedent's two sons Timothy Wacker and Thomas Wacker are the sole beneficiaries of this IRA. 2 John Hancock Perspective II 05/05-Account 123,389.07 123,389.07 1014146462;the decedenYs two sons Timothy Wacker and Thomas Wacker are the sole beneficiaries of this annuity. TOTAL(Also enter on Line 7, Recapitulation) 129,277.45 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) � iu�u �. a..i� � REV-1511 EX+�70-09) pennsyivania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 DecedenYs debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT ' A. FUNERAL EXPENSES: See continuation schedule(s) attached 8,715.53 ` B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. Attornev's Fees Michael L. Bangs 7,000.00 3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zio Relationshi�of Claimant to Decedent 4. Probate Fees 165.50 5. AccountanYs Fees 190.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 24g,7g See continuation schedule(s) attached TOTAL(Also enter on line 9, Recapitulation) 16,319.81 Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex e� nses 1 Stone&Murray Funeral Home 8,715.53 H-A 8,715.53 Other Administrative Gost� 2 Cumberland Law Joumal-estate advertisement 75.00 3 The Patriot News-estate advertisement 173.78 H-B7 248.78 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) �i i � i� � Rev-1512 EX+(12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENTOFREVENUE MORTGAGE LIABILITIES AND LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 Report debb incurted by the decedent prior to desth that remained unpaid at the data of death,Including unrelmbuned medical expensea. VALUE AT DATE ITEM DESCRIPTION OF DEATH NUMBER 1 Pinnacle Health Medical Group 10.00 2 Public School Employees Retirement System -return of uneamed retirement benefit 30.63 TOTAL(Also enter on Line 10, Recapitulation) 40.63 (If more space is needed,additional pages oi the same size) Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX+�01-10) pennsyivania SCHEDULE J DEPARTMENT OFREVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Wacker, Bernece S. 21-14-1066 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT �Words) ($$$) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116 a 1.2 Thomas R.Wacker Son one-half of estate 612 W.Shade Lane Enola, PA 17025 Timothy E.Wacker Son one-half of estate 6199 Veterans Way Newport, PA 17074 Total Enter doilar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Fortn PA-1500 Schedule J(Rev.01-10) J6�I, 1`t. [V ;J I I . ,1/nitl I !YL Uc!IR IIU. LLUL f• i! I ��•� January 14,2015 Michael�Bangs�sq. Bangs Law Di�ices LL,C 429 South ]8�Stz�eet Camp Hill PA 170I 1 R.�: �eme�e S'Q4racker SSN�: 210-26-9I 45 DQD: 10-I3-2Q14 17ear Mr.Bangs: Tn respanse to yaur request for 17ate of�eath(D0�)balances for the customer nated abave,our records sho�ov the follo�ring: Checking Acconnt Account#5140066194 Established: 11-02-199d B�1�CB S'WA�KER DOD balance: $ 12,165.43 non-interest bearing Please nabe t�at this office pro�vides date of death bal2ncEs for depnsit accounts(ntAs,(�s,Checking az�d Sa�vings). 't�VVe do not process anq 5nancial trunsactions ar pmvide state�e�ta. If�ou need assistance with a�y o�these items,please call 1-88$-PN'C-BAN�(1-S$$-762-2265) or s�op by your local P�1G Ba�k branch office. Sincerely, Natianal Financial Seiviccs Ccnter PNC�amk,N.A_ Member FDIC This rrtessage is fntended�'or the use of the individual or entity to which it is addr-essed cmd may cnntain informa�ion that is privileged, confidenttal and exemptfram disclosure under applicahle law. If the re�der of this message is nof the ir�te»ded recipient ar rhe emp7oyee or ctgent resporrsible for delivering this mesxage to the ir�iended recipienr,you are hepeby�zoTifted thai ctrry dissemanation, distribution or copying of this communica�ions is strictTy prohibatec� If you have received thrs eommur�r.catior� in error,please notify me immediately by reply or hy telephone at 80Q-762-1�75�nd rmrnedic�teXy destroy thzs firred document. Page 1 of 1 � � MEMBERS 15t FEDERAL CREDIT lJNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 386475-00 Date Account Estabiished 06/01/2010 Principai Balance at Date of Death $5.00 Accrued Interest to DaCe of Death $0.00 Total Principal and Accrued Interest $5.00 Name of Joint Owner- None CERTIFICATE O� DEROSIT: Account Number/Suffix 386475-40 Date Account Established 06/01/2010 Principal Balance at Date of Death $2,694.52 Accrued Interest to Date of Death $0�27 Total Principal and Accrued Interest $2,694.79 Name of Joint Owner Thomas Wacker Timothy Wacker CERTIFICATE OF DEPOSIT: Account Number/Suffix 386475-42 Date Account Established 08/31/2010 Principal Balance at Date of Death $2,686.82 Accrued interest to Date of Death $0�27 Total Principal and Accrued Interest $2,687.09 Name of Joint Owner Thomas Wacker Timothy Wacker MEMBERS 1 ST FEDERAL CREDIT UNION �./ Tessa L Klugh Lending Insurance Support Specialist November 24, 2014 Estate of: BERNECE J WACKER Date of Death: 11/2412014 Social Security Number: 210-26-9145 5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsj=lvania 17055 • (800) 283-2328 • wwwmemberslst.org Santander ESTATE OF: BERNECE S WACKER . SOCIAL SECURITY#: 210-26-9145 DATE OF DEATH: 10/13/2014 Account#:0774100451 Type: MONEY MARKET Open date: 07/09/2007 In the name of: BERNECE S WACKER Date of death balance: $5,992.67 Int.(YTD)from:01l01/2014 To: 09/21/2014 $$•79 Accrued interest to date of death: $0.76 Other info: Page 2/2 Holdinqs by Investor ___.__ Bernece J Wacker Steven Zeigler Combined Account Portfolio 824 Lisburn Rd Apt 411 CFP,CPA Date: 10/13/2014 ,=i�"1��0� Camp Hill,PA 17011 Keystone Financial Management Created: 11/17/2014 1 � 4909 Louise Dr,Ste 104 � Financial bianagement Mechanicsburg,PA 17055 � ____ _ 717-697-7333 Bernece J Wacker Acct Name:BERNECE J WACKER 824 LISBURN RD APT 411 CAMP HILL PA 17011 US Acct No:2545095 AcctType:Non-Qualified Product: VENTURE VARIABLE ANNUITY _ ;�': Polfcy�lrtfo' ;� -�� } �,: � .��f� � ��`��. �°�� ` . . _. � ., ,.. .� _ , �3 , .. ..:-.�-.� .s.�.: .�_. _ � .�,...��. _ . -." , �" Variabie Annutty AProducts Owtser B�RNECE J WACKER Carrier. JOHN HANGOCK,LiFE INSURANCE COM�ANY(U.S.A.) So�iffi Securiiy'Number; XXXXX9145 Status: AcY�ve DOB:. 03/14/1933 _ _ _ ___ ._ _.__. Policy Values . . A��: HIIL�PA 1�70N RUS PT 411,CAMP --- ------------------- Cost Basis: $30;320:65 Add(tlonai-Parties Death Benefit: $25;264;48 Beneficiary: TIMOTHYWACKER 50 0% Original'Investment Value: $20.000•Ul? Beneficia�"• THOMAS WACKER 50-0°/a Post-TEFRA Cost; $30;320:85 OwnedAnnuitant or Insured: BERNECE J WACKER Protected PaymeM Amount: ` �952.94 Protected Payriter�t Base _ $'f,47`T:94 Amount: RPC: ;$952.94 Remaining Protected $2�,�;&' Balance: Surrender Value: $31,004.67 TotaF Premium: $39;604:85 Totai Withdrawal: $14,725.00 Poifcy Dates _ _ __ Issue Effective: 06/15l2006 Maturity: 04/01/2023 Account Total: $0.00 Incomplete if presented without accompanying disclosure pages Page 1 of 4 Holdinqs by Investor ------ Bernece J Wacker Steven Zeigler Combined Account Portfolio 824 Lisburn Rd Apt 411 CFP,CPA Date: 10/13/2014 .'�j7"�jC�o� Camp Hill,PA 17011 Keystone Financial Management Created:11/17/2014 j�,jv 4909 Louise Dr,Ste 104 s Financial Management Mechanicsburg, PA 17055 - 717-697-7333 Acct Name:BERNECE WACKER 824 LISBURN RD 411 CAMP HILL PA 17011 CAMP HILL PA 17011 Acct No:1014146462 AcctType:Non-Qualified Product: PERSPECTIVE II 05/05 P6��£ � � �*�� - .�c�� e �� ` P�� r,.�,� �� 'nw�♦ �-�,��,�� , �� ,.�..�.��,��:. ��5 .R._�,, .v .�,. ��_v.�... �� , : ... .,. ; .. : . VaHaWe Annuity Products �. Owner - Bernece Wacker Carrier: JACKSON NATIONAI LIFE INSURANCE COMPANY Social Security Number: XXXXX9145 Status Active DOB: 03/14/1933 __ _ ___ _ - ------- ---_.__ _____--_ Policy Values Add[ess: 8��sburn Rd 411,Camp Hill,PA —- ------- ---- Actuarial Present Va1ue: $0.00 Additional Parties Annuitized Amount: 50.00 Annuitant; Bernece Wadcer Commuted Value: $O.OU Beneficiary: Tim Wadcer Cost Basis $1'14,320:65 Beneficiary: Thomas Wacker Death Benefifi $f24;366.32 Gross Death Benefit: $124,366.32 Loan Amount; $0.� Original Investment Value: $�;�.� Post-TEFRA Cost: . $t'14;32Q:65 . Pre-TEFRA Cost: $O.Ob : Projected Guaranteed lncome ��,4�.� Base Amount: Protected Payment Amount: $7,477:36 Protected Payment Base $130,041.09 Amount: Required Minimum $�•� Distribution Basis: Surrender Value: $115,568.21 Total Premium: $115,402.78 TotaF WithdrawaL• $0.00 Year End Vafue: $0.00 __...___ _ __ . Policy Dates issue Effective: 09/09/2013 Valuation Date: 10/10/20i4 Surrender Charge Expiration 09l16f2020 Date: Received: 09/06/20]3 Maturity: 09/09/2028 Ag�,�� *' ��'�� ; �� r�� s�� .._ �� '; � Q��,� :,�� . �� v��ay .,� ��, � � ,.: �..�... ��.�.-� + .� JNUAMERICAN Bl INC&GRTH US STOCKS JACKSON 2,135.59 15.33 32,745.17 NATfQNAL ANNUITIES JNUAMERICAN GLOBAL BOND BONDS JACKSON 2,181.69 10.97 23,936.68 NATIONAL ANNUITIES Incomplete H presented wfthout accompanying disclosure pages Page 2 of 4 Hoidinqs by investor _ _____. — Bernece J Wacker Steven Zeigler Combined Account Portfolio 824 l.isburn Rd Apt 411 CFP,CPA Date: 10/13/2014 ._�jC�O�j� Camp Hill,PA 17011 Keystone Financial Management Created: 11/17/2014 �111�1J 1V1� 4909 Louise Dr,Ste 104 � Financi:il Managemrnt Mechanicsburg, PA 17055 : _ ._--_ ___. _ 717-697-7333 AAs�t�IalriB k .-i,.�� I ,�<: Tid".c�T C 'Aas��°��`�- ��v . s.i'^ �``� 1, "�uft�1� .t�.��a/ VSIO@"(V) s ' ��.� ' ^ - �- , . ,.. -��,..,._. JNUAMERICAN GROWTH-INCOME US"STOCKS JACKSQN' 2,089.55 }5:18 31,716.92 NATI�NAL ANNUIT[E5 JNUAMERICANINTERNATIONAL NON-USBTOCKS NAf10NAL �'496'27 11.66 17,450.04 ANNUITIES JNUCAPITAL GUARDIAN GIBL SAL NON-US STOCKS JACKSON 1,271.48 13.80 17,540.26 NATIONAC ANNUITIES Ac�ount Total: $123,389.07 - -__ _--------- ----- __-------------- _ __ _ - _ Acct Name:C6&T CUST IRA BERNECE J WACKER/DEC'D 824 LISBURN RD APT 411 CAMP HILL PA 17011-7100 Acct No:00074136591 AcctType:CB&TIRA aasi�t�tarr�e a 71(�er -�� _.� ,��°,. `Qu�tty ',.�M��s)- va��e�s) AMERICAN FUNDSvBND FD OF ABNDX BONDS , AMERICi4N 96.22 12.83 1,234.52 AMER A fUNDS AMERICAN FUNDS INC FND OF AMECX US STOCKS FUNDS AN 67.94 20J0 1,406.44 AMFi A AMERICAN MUTUAL FUND-A AMRMX US STOCKS FUNDS AN ` 47.56 34.97 1,663.03 CAPITAL INCOME BUILDER-A CAIBX US STOCKS FUNDS AN 27.35 57.93 1,584.39 Account Total: $5,888.38 _.__ ------- __ _---------- ---- ------- _------___—_ investor Total: $129,277.45 . _ _ ______ _ _ _ _ Incomplete if presented without accompanying disclosure pages Page 3 of 4 Holdings by Investor ___ Bernece J Wacker Steven Zeigler Combined Account Portfolio 824 Lisburn Rd Apt 411 CFP,CPA Date: 10/13/2014 .�I�'�JC►j�o� Camp Hill,PA 17011 Keystone Financial Management Created:��/17/2014 1 ,L;1 J 1 4909 Louise Dr,Ste 104 � Financial Management Mechanicsburg,PA 17055 � -- 717-697-7333 Disclosure: Securities and/or Advisory Services offered through Signator Investors,Inc.("the Firm"),member SIPC/FINRA. This report ts being generated as a courtesy and is for Informational Purposes only and is not intended,in any manner,as an oHicfal brokerage or mutual fund statement.This report is not to be used as an official books and records statement of the Flrtn.Please contact the relevant product aponsor ff you have any questtons about the statements. Values are as of 10/13/2014.We believe the sources to be reliable,however,the accuracy and compieteness of the information is not guaranteed. In the event of a discrepancy,the sponsor's valuation shall prevail. Data reflected within this report may reflect data held at various custodians and may not be covered under SIPC. The Firm's SIPC coverage only applies to those assets held at the Firm. In addition,certain other reported entities may be SIPC members that provide coverage for assets held there. You should contact your financial representative,or the other entity,or refer to the other entity's statement,regarding SIPC coverage. Assets reflected on this report that are not held at the Firm on your behalf are not part of the Firm's books and records. DATA DISPLAYED ON THIS SITE OR PRINTED IN SUCH REPORTS MAY BE PROVIDED BY THIRD PARTY PROVIDERS. Performance data quoted represents past performance and does not guarantee future results.The investment return and principal of an investment will fluctuate so that an investor's shares when redeemed may be worth more or less than original cost.The values represented in this report may not reflect the true original cost of your initial investment. Cost basis information may be incomplete or may not accurately reflect the methodology used by a particuiar client. Ciients should consult with their tax advisor. For fee-based accounts only:The data may or may not refiect the deduction of investment advisory fees.If the investment is being managed through a fee-based account or agreement,the returns may be reduced by those applicable advisory fees.The information contained in these reports is collected from sources believed to be reliable.However,you should always rety on the official statements received directly from the custodians.If you have any questions regarding this report,please call your representative. The source data for the following accounts was provided by DST FAN Mail: 00074136591 The source data for the following accounts was provided by Depository Trust&Clearing Corporation(DTCC): 1014146462 2545095 Page 4 of 4 �� e � ��eZ � � _� I, BERNECE S. WACKER, of Fairview Township, York County, Pennsylvania, declare t�, � � this to be my last will and revoke any will previously made by me. \ ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker � � and all expenses of my last illness, and any and all taxes and assessments imposed by any � �, governmental body as a result of my death, whether on property passing under this will or _> � otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a �� part of the expense of the administration of my estate. �� ITEM II. I give and bequeath all of my household goods, automobiles,jewelry, and all other articles of household and personal use, equipment and ornament, together with all � -,�, insurance thereon and relating thereto, to those of my issue, per stirpes, as survive my death y � thirty (30} days. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate to those of my issue, per stirpes, as survive my death by thirty (30) days. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. 1 ITEM V. I appoint my son TIMOTI-�Y E. WACKER executor of this my last will. Should my son predecease me or otherwise fail to qualify or cease to serve as executor of this my last will, I appoint my son THOMAS R. WACKER executor of this my last will. � ITEM VI. In addition to the other powers and authorities granted to my personal .J t� representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby �o give to my personal representatives the following powers and authorities effective without court \ approval and until actual distribution of all property: to compromise any claim or controversy; � to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as � � my personal representatives may determine and at valuations finaily to be fixed by them; to � invest in all forms of property, including any stock or other securities in any corporate fiduciary ,� or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my � personal representatives deem proper, without regard to any principle of risk or diversification; a � ' to retain any or all assets of my estate, real or personal, without regard to any principle of risk or :;;t � diversification; to sell at public or private sale, to exchange, 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 or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. 2 IN WI7�VF.SS ��RF'AF, I have her�unto set my harid this � -s day of � r`-L�1.L . ZWl). . -�-� c LL� �� BERNECE S. WACKER 3 -Ihe p�ing insu�uinent coasisting of this and THREE other t}pewritten pages, each identified by the signature of the testatrix was on the date thereof si�ned, published, and declared by BERNECE S. WACKER, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. , � - � � t/� ( _�v�� 4 .�_��- _— - --- . . �I O�P'E:N�'SYLYANIA ) ( SS: COv''�'IY OF CL"MBERLAND 1 The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will,that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ��.��a_ � ��% BERNECE S. WACKER . � - wwtsin or affirmed to and acknowledged . , t�efo � e by the ix ame�above -_ � ��t�``�1�" d y° � , 2006. = . t �r� - _ �o�a�y�ubl NQTMSAl.8�Al - _� Y 3.CHE38kOC��,�INo�ry Pi�bic - Lawr AMen Twp., xland Gwti!!r My comm�ssia,E�aa Msy 10,z�o� COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) WE, ��I ��-�`� !� � �f�(.� � ar►d �6�� 1 I • `�� ,the wimesses whose names are signed to the attached or foregomg instrument, being duly qualified according to law,do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will;that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of t}�e testatrix signed the will as witnesses; and that to the best of our knowledge,the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. � r.�J �� i � -. Swo or affirme to an acknowledged _ be h' _day of - - - - � ` , 2006. _ --- � - � � _ � �- � � � � 11�a 1'ublic , _ SE/li. � - - _M17El�DY 8.CF�38�tOc��P�ic �Co�s�Er�irea MaY 10,2007 -_,..,�.._�,a.-x.. 5 $�1�T� I.��O�IC�, LLC 429 SOUTH 18T"STRI:ET PHONE: 717-730-7310 CAMP HILL,PA 170f 1 FAX: 717-730-7374 E-mail: mikeban�s(a�verizon.net MICHAEL L. BANGS,Attorney-at-Law WENDY K. STRAUB,Paralegal June 19, 2015 Lisa M. Grayson, Register of Wills Cumberland County Courthouse �-., <-:�� One Caurthouse Square " �::�-� ;::� �', Carlisle, PA 17013 �"�; �� .:. ','-,; �`' , 7 i !� . ,r� RE: Estate of Bernece S. Wacker - v � i;y File No. 21-14-1066 -r� �; Dear Ms. Grayson: F�, , ,, � :� �� :: �� Enclosed you��ill find the following: � ` ' -`_�; 1. �'he original and �ne copy of th� inheritance tax return. 2. "The orig�nal i.n�entory. Please file these documents accordingly. If you require anything i:urther, please contact me d�rectly. V�rv truly yours, �---�> , ichael L. Bangs wks �;nclusures cc: Mr. Tim�othy� E. Wacker ii i iii i � � �' � � � � c � �.:, n ::_� �� c.. c� �1-, "'; r.-� . c_ ' `I c� ,a r� �..� r�.J �� .._ ._... ___^ ." -,,.. , .i _.,._ ;,�.. r_.-� r,., , __7 I I �) , �;� � ; 1"V :� ..,.� > � ` - � . � � t �__�" :'? n � � r J ,� �'�,� __ r';1 � � � �. : � � A� , �""1, t;'� CJ in� (� a- y CIl ��'l (D O � a b � � � Y o Q..� � � n � o � � � w.s� � � � � � O�' � � � � � O � `"? ��-��- � �-- �� - 1