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HomeMy WebLinkAbout09-11-15 � J��j'�. pennsYIvania 15�5618403 ��1 DEVARTMENTOFREVENI�X�03��4� t REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes Counry Code Year File Number PO BOx 2sosol INHERITANCE TAX RETURN Harrisbur4,PA 17128-0601 RESIDENT DECEDENT 21 15 0 4 6 6 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 02 15 2a15 04 25 1933 Decedent's Last Name Suffix DecedenPs First Name MI WHITCOMB J • B (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI WHITCOMB ELEANOR L THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Retum � 2. Supplemental Retum � 3. Remainder Return(date of death prior to 12-13-82) � q, 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) � 7. Decedent Died Testate � 8. Decedent Maintained a Living Trust 0 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 T0: Name Daytime Telephone Number ,-..� IVO V OTTO III 717 243 �41 � � u, � � Fi�st Line of Address �':� � •;.r�� �� � 10 EAST HIGH STREET � �� � ' � c� ; � .�..._ <-;. —o ,� �� .�_ ._.. . ,.__ � , ��a Second Line of Address ` � ' }-' `~-�? .._a �L7 : `.'E City or Post Office State ZIP Code —i -? : �> CARLISLE PA 17013 rv r`� _ f.� �� o rn � Correspondent's email address: �otto[�martsonlaw.com REGISTER OF WILLS USE ONLY REGISTER OF WILLS USE ONLY DATE FILED MMDDYYYY DATE FILED STAMP Side 1 � I(IIIII IIIII IIIII III'I�IIII'll'I II�II IIIII IIIII I'lll IIII I�II y 5 0 5 618 4 0 3 � _�\ �v f�'�j � � 15�5618411 REV-1500 EX Decedent's Social Security Number �ecedenes Name: WhitComb, J. Benson RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 1 ,�8 0,7 5 2 • 6 5 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 5,10 4 • 7 0 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested............ 7. 5 2 3,8 7 0 • 7 8 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 1,6 2 9,7 2 8 • 13 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 1 ,6 2 9 ,7 2 8 • 13 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. 1,6 2 9,7 2 8 • 13 TAX CALCUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(�.2)X.Oo 1 ,629,728 • 13 �5. 0 • 00 16. Amount of Line 14 taxable at lineal rate X .045 0 - 0 0 16• 0 � 0 0 17. Amount of Line 14 taxable at sibling rate X.12 0 • 0 0 1�• 0 • 0 U 18. Amount of Line 14 taxable at collateral rate x.15 0 • D 0 18� 0 • U 0 19. TAX DUE................................................................................................................ 19. � • 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Under penalties of pery'ury,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 any knowledge. SIGNATURE OF PERSON ESPO SI L FOR FILING RETURN Eleanor L.Whitcomb G�i � �D TE\;^� � ADDRESS � -� 50 Lon wood Driv echanicsbur 17050 � � � C�->�� SIGNATURE OF PREP ER THA PRESENTATIVE IVO V. OttO III ATE ) ADDRESS 10 East High Street, Carlisle, PA 17013 � II�II'IIIIIIIIIIIIII�IIIII'�IIIIIII�II'IIIIIIIIIIIIIIIIII��I Side 2 1505618411 � REV-1500 EX Page 3 File Number 21-15-0466 Decedent's Complete Address: DECEDENT'S NAME Whitcomb,J. Benson STREET ADDRESS 1066 West Trindle Road CITY STATE ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 3. Interest (3) q, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �q� 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) �.00 Make Check Pa able to REGISTER OF WILLS, AGENT �� -,�f'YQ � ' �,,;. ,/�� ��,'g„Y�Q'� ✓a zW' ,�2 hR SP" L� '%ih L'y' �30"". �����. ., �`�& ��:e' ..... , r , . �,�..�h,,v ��� . i;`.,✓�a'�€N.��,"�.;�,o, ��;,�/3�:�.> ,��:�`a.�$�i.�#�`,�t.�.n.w s��s..§i,.,.��..., r 3�i.,..,,i,�*y.��s����:��„'.�����„'��. 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:.................................. ❑ Ox c. retain a reversionary interest;or............................................................................................................... ❑ � 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 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?.................................................................................................................. ❑X ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDUIE G AND FILE IT AS PART OF THE RETURN. , /��».<�x r�"�.�,� ',`s.f�����.,,. d�z , ,.:!..,, .��^s���;�,c.�w., .,,,-.:�',f,�'�,t�;v,�,'�.°x t�:'� ..r,"�.,��..w„.� <,, ., ,.?�;���. n.�:s`�.;�. .�r.,:, . . ,. ''.. .,_.� _ �TM�"v�...., ,> 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 statulory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 ears 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 lransfers to or for the use of the decedenYs siblings is 12 percent�72 P.S.§9116(a)(1.3)j. 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 EX+(OS-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 All property jolntlyownedwith right of survivorship must bedisclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH Morgan Stanley Account No.410-059316 Held as tenants in common with Eleanor L.Whitcomb (spouse)-Values listed reflect decedent's 50%share � 759351604 60.5 shares of Reinsurance Group Amer Inc-COM 89.3234711 5,404.07 Accrued dividend on Item 1 through date of death 19.97 2 01728AF50 $10,000 Allegheny County PA Hosp Dev Aut-Mature: 104.825 10,482.50 05/01/2025 4.75% Accrued interest on Item 2 through date of death 137.22 3 074851PH3 $2,500 Beaver County PA-Mature: 11/15/2017 3.75% 108.6392 2,715.98 Accrued interest on Item 3 through date of death 23.44 4 074851PS9 $15,000 Beaver County PA-Mature: 11/15/2017 3.75% 107.252 16,087.80 Accrued interest on Item 4 through date of death 140.63 5 082383LW8 $15,000 Bensalem Township PA School District-Mature: 118.4945333 17,774.18 08/1512021 5% g 11s565Ux6 $12,500 Bucks County PA-Mature:06/01/2021 4% 114.642 14,330.25 Accrued interest on Item 6 through date of death 102.78 7 1186o1GX5 $10,000 Bucks County PA Community College AU -Mature: 106.1765 10,617.65 06N 5/2016 5% Accrued interest on Item 7 through date of death 83.34 Total of Continuation Schedules See attached a es TOTAL(Also enter on Line 2, Recapitulation) 1,080,752.65 (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 B(Rev.08-12) Rev-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OFREVENUE INHERITANCE TAX RETURN continued RESIDENTDECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH g 1527357Q9 $15,000 Central Bucks PA School District-Mature: 113.5505333 17,032.58 05/15/2025 5% Accrued interest on Item 8 through date of death 187.50 g 156267JA5 $12,500 Centre County PA-Mature:06/01/2018 4% 108.93248 13,616.56 Accrued interest on Item 9 through date of death 102.78 10 157882HA2 $20,000 Chambersburg PA Area School District-Mature: 100.1795 20,035.90 3/1/2015 5% Accrued interest on Item 10 through date of death 455.56 11 165573X78 $12,500 Chester County PA-Mature: 11/15/2022 5% 119.97 14,996.25 Accrued interest on Item 11 through date of death 156.25 12 207o98HY3 $12,500 Conestoga Valley School District PA-Mature: 110.426 13,803.25 01/15/2019 4% Accrued interest on Item 12 through date of death 41.67 13 224288Hw3 $25,000 Cranberry Township PA-Mature:03/01/2019 4% 109.35552 27.338.88 Accrued interest on Item 13 through date of death 455.56 14 224288HR4 $25,000 Cranberry Twp PA-Mature: 3/1/2015 3% 100.107 25,026.75 Accrued interest on Item 14 through date of death 341.67 15 224655HG8 $15,000 Crawford Cent School District PA CRAW-Mature: 110.807 16,621.05 02/01/2018 5% Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS 8� BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN conti n ued RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH Accrued interest on Item 15 through date of death 29.17 16 230822Pv4 $25,000 Cumberland Valley PA School District-Mature: 107.716 26,929.00 11/15/2016 5% Accrued interest on Item 16 through date of death 312.50 �7 230822PL6 $37,500 Cumberland Valley PA School District-Mature: 103.3645067 38,761.69 11/15/2020 5% Accrued interest on Item 17 through date of death 468.75 18 236222EH4 $12,500 Daniel Boone PA Area School District-Mature: 108.98 13,622.50 08/15/2018 4% 19 236835GM0 $22,500 Danville PA Area School District-Mature: 104.8830222 23,598.68 05/01/2016 4.25% Accrued interest on Item 19 through date of death 276.25 Zp 246003LM7 $15,000 Delaware County PA Auth College-Mature: 111.0555333 16,658.33 11/15/2022 4.25% Accrued interest on Item 20 through date of death 159.38 21 277695FD9 $25,000 Easton PA Area School District-Mature: 4/1/2015 100.56852 25,142.13 5% Accrued interest on Item 21 through date of death 465.28 22 301896Cv6 $12,500 Exeter Township PA-Mature:07/15/2016 5.25% 106.17104 13,271.38 Accrued interest on Item 22 through date of death 54.69 Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev. 08-12) Rev-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OFREVENUE INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 23 312459EZ9 $22,500 Fayette County PA-Mature: 11/15/2021 2.625% 102.8784889 23,147.66 Accrued interest on Item 23 through date of death 747.66 24 383770FE9 $25,000 Governor Miffiin PA School District-Mature: 106.611 26,652.75 03/15/2020 5% Accrued interest on Item 24 through date of death 520.84 25 4o666oKU3 $25,000 Hamburg PA Area School District-Mature: 108.56552 27,141.38 04/0112023 4.125% Accrued interest on Item 25 through date of death 383.86 26 514383QJ0 $15,000 Lancaster PA School District-Mature:06/01/2018 109.0125333 16,351.88 5% Accrued interest on Item 26 through date of death 154.17 27 548246FF9 $12,500 Lower Merion PA School District-Mature: 117.74152 14,717.69 11/15/2019 5% Accrued interest on Item 27 through date of death 156.25 2g 563231 UD9 $10,000 Manheim Twp PA School District-Mature: 6/1/2015 101.3405 10,134.05 5% Accrued interest on Item 28 through date of death 102.78 2g 600293QC1 $15,000 Millcreek Township PA School District-Mature: 111.6415333 16,746.23 01/15/2019 4% Accrued interest on Item 29 through date of death 50.00 Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-1503 EX+(OS-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT Of REVENUE INHERITANCE TAX RETURN conti n ued RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 30 600293QG2 $10,000 Millcreek Township PA School District-Mature: 109.681 10,968.10 01/15/2019 4% Accrued interest on Item 30 through date of death 33.34 31 613579ZR5 $12,500 Montgomery County PA-Mature: 05/01/2019 5% 115.09104 14,386.38 Accrued interest on Item 31 through date of death 180.56 32 659868NM1 $2,500 North Hills PA School District-Mature: 12/15f2022 104.658 2,616.45 4% Accrued interest on Item 32 through date of death 16.67 33 67574oMW1 $17,500 Octorara PA Area School District-Mature: 109.3725143 19,140.19 06/01/2017 5% Accrued interest on Item 33 through date of death 179.86 34 709141V93 $37,500 Pennsylvania State-Mature:07/01/2018 5.375% 114.2270133 42,835.13 Accrued interest on Item 34 through date of death 246.36 35 709141W27 $25,000 Pennsylvania State-Mature: 07/01/2019 5.375% 117.307000 29,326.75 Accrued interest on Item 35 through date of death 164.24 36 7o914PJE3 $25,000 Pennsylvania State-Mature:03/15/2020 5% 115.419 28,854.75 Accrued interest on Item 36 through date of death 520.84 37 7091aPMU3 $15,000 Pennsylvania State-Mature:05/01/2020 5% 117.4115333 17,611.73 Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-1503 EX+(08-12) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OFREVENUE INHERITANCE TAX RETURN conti n ued RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH Accrued interest on Item 37 through date of death 216.67 38 70914PQV7 $25,000 Pennsylvania State-Mature: 11/15/2020 5% 118.53552 29,633.88 Accrued interest on Item 38 through date of death 312.50 39 70914PRT1 $35,000 Pennsylvania State-Mature:07/01/2022 5% 120.2585143 42,090.48 Accrued interest on Item 39 through date of death 213.89 40 70914PUS9 $10,000 Pennsylvania State-Mature: 10/15/2022 5% 120.7575 12,075.75 Accrued interest on Item 40 through date of death 166.67 41 70917RVL6 $15,000 Pennsylvania State Higher EDL FAC -Mature: 109.625 16,443.75 06/15/2017 5% Accrued interest on Item 41 through date of death 125.00 42 70917RPK5 $25,000 Pennsylvania State Higher EDL FAC -Mature: 109.625 27,406.25 06/15/2017 5% Accrued interest on Item 42 through date of death 208.34 43 717813JD2 $12,500 Philadelphia PA-Mature:08/01/2017 5.25% 110.24152 13,780.19 Accrued interest on Item 43 through date of death 25.52 44 71781LAY5 $5,000 Philadelphia PA Authority for INDL-Mature: 84.1416 4,207.08 04/15/2020 0% 45 755638RY1 $12,500 Reading PA School District-Mature: 01/15/2016 5% 103.998 12,999.75 Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-7503 EX+(08-12) scHEou�E B pennsylvania STOCKS & BONDS DEPARTMENT OFREVENUE INHERITANCE TAX RETURN conti n ued RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH Accrued interest on Item 45 through date of death 52.09 46 817207Lv3 $12,500 Seneca Valley PA School District-Mature: 101.61552 12,701.94 01/01/2021 5% Accrued interest on Item 46 through date of death 76.39 47 818a95DW0 $10,000 Sewickley PA-Mature: 12/01/2018 3% 102.385 10,238.50 Accrued interest on Item 47 through date of death 61.67 4g 838s36KN3 $10,000 South Middleton PA School District-Mature: 101.785 10,178.50 10/01/2018 2.8% Accrued interest on Item 48 through date of death 104.22 49 79306EHS6 $551 St Paul Minn Port Auth Indt DE-Mature: 12/1/2015 32.00000 176.32 9.375% Accrued interest on Item 49 through date of death 10.61 50 85732MDT1 $37,500 State Public School Bldg Auth PA Col-Mature: 110.4190133 41,407.13 10/01/2026 5% Accrued interest on Item 50 through date of death 697.92 5� 894673QB1 $25,000 Tredyferin-Easttown PA School District-Mature: 118.85 29,712.50 02/15/2021 5% 52 915464FP1 $12,500 Upper Allen Twp PA-Mature: 5/15/2015 3% 100.60552 12,575.69 Accrued interest on Item 52 through date of death 93.75 Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.08-12) Rev-1503 EX+(08-72) SCHEDULE B pennsylvania STOCKS & BONDS DEPARTMENT OFREVENUE INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 53 9162184W3 $25,000 Upper Moreland Twp PA School District-Mature: 102.26752 25,566.88 08/15/2017 2.5% 54 916507MU7 $25,000 Upper St Clair Township PA School District- 113.074 28,268.50 Mature: 07/15/2022 4% Accrued interest on Item 54 through date of death 83.34 55 932432RS8 $7,500 Wallenpaupack PA Area School District-Mature: 100.3350667 7,525.13 4/1/2015 3% Accrued interest on Item 55 through date of death 83.75 56 95203oL36 $25,000 West Chester PA Area School District-Mature: 114.351 28,587.75 05/15/2021 4% Accrued interest on Item 56 through date of death 250.00 57 955819PK7 $20,000 West Shore PA School District-Mature: 11/15/2016 104.4015 20,880.30 2.875% Accrued i�terest on Item 57 through date of death 143.75 TOTAL(Also enter on Line 2, Recapitulation) 1,080,752.65 Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.08-12) Rev1508 EX+(OB-12) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCETAXRETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-ownedwith the right oi survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Morgan Stanley Account No.410-059316-Cash 25,104.70 TOTAL(Also enter on Line 5, Recapitulation) 25,104.70 (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) Rev-1510 EX��08-09) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OFREVENUE INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 This schedule must be completed and filed it the answer to any of queslions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD�s EXCLUSION TAXABLE NUMBER HELDATE OF TRANSFER.SATTACN A CO Y OF TH�E DEED�OREREAL ESTATE. VALUE OF ASSET INTEREST ��F APPLICABLE) VALUE 1 Lincoln Financial Group-Annuity Contract 260,285.00 100.000% 260.285.00 953151741; Beneficiary: Eleanor L.Whitcomb (spouse)100%-See attached. 2 Lincoln Financial Group-Annuity Contract 263,585.78 100.000% 263,585.78 953151743; Beneficiary: Eleanor L.Whitcomb (spouse) 100%-See attached. TOTAL(Also enter on Line 7, Recapitulation) 523,870.78 (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) REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENTDECEDENT ESTATE OF FILE NUMBER Whitcomb,J. Benson 21-15-0466 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE PERSON(Sl RECEIVING PROPERTY i (Words) ($$$) j� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec. 9116 a 1.2 1 Eleanor L.Whitcomb Spouse 100°/a of Residue 1,629,728.13 50 Longwood Drive Mechanicsburg, PA 17050 Total 1,629,728.13 Enter dollar 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.SPOUSAI 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) , , F:�FILES\Clien[s\8504 Whitcomb,Ben\8504.1\8504.Lh.wi111012.Nov.Rev.wpd , � LAST WILL AND TESTAMENT I,J.BENSON WHITCOMB,of Silver Spring Township,Cumberland County,Pennsylvania, being of sound and disposing mind and memory,do hereby make,publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEM FIVE hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO I bequeath any automobiles or motor vehicles I may own at my death,my personal effects, such household goods if any as may be my individual properiy and not the property of my wife or owned jointly by me with my wife,and other tangible personal property of like nature(not including cash or securities), together with any existing insurance thereon, to my wife, ELEANOR L. WHITCOMB,providing she survives me by thirty(30)days. Should my wife predecease me or die on or before the thirtieth day following my death, I bequeath such tangible personal property and insurance thereon to such of my children as aze living on the thirty-first day after my death, to be divided between or among them with due regard for their personal preferences in as nearly equal shares as practical and as they shall mutually agree. I direct that any of the foregoing articles not selected by such children or about which there is no agreement shall be sold at public or private sale by my personal representative(s), and i further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. ITEM THREE If my said wife,ELEANOR L. WHITCOMB,is living thirty(30)days after my death,then I give,devise and bequeath all the rest, residue and remainder of my estate, both real and personal property,unto my said wife,ELEANOR L.WHITCOMB,absolutely. If my said wife,ELEANOR L. WHITCOMB, does not so survive me,then all the rest residue and remainder of my estate shall be held or distributed under ITEM FNE, C, hereof. i �%,(�'� [initials] Page 1 of 9 Pages ITEM FOUR In the event my said wife, ELEANOR L. WHITCOMB, shall disclaim all or any portion of any devise or bequest made to her under the foregoing ITEM THREE, then the amount otherwise payable shall be held by my Trustee under ITEM FNE hereof. For purposes of the Trust established under ITEM FIVE hereof,my said wife, ELEANOR L. WHITCOMB,shall not be deemed to have predeceased me by virtue of her exercise of the right to disclaim set forth herein. ITEM FIVE RESIDUARY AND DISCLAIMER TRUST My Trustee shall hold the assets received under ITEMS THREE and FOUR hereof, if any, for the following purposes: A. My Trustee shall pay the net income, at least quarter-annually, to my wife, ELEANOR L. WHITCOMB, for life. In addition,my Trustee in my Trustee's sole discretion,may invade the principal of the Trust for the proper and adequate support of my wife, ELEANOR L. WHITCOMB. B. My Trustee shall further pay to my wife,ELEANOR L.WHITCOMB,annually,such sum from the principal of the Trust as she may request in writing,provided,however,that said sum may not exceed the greater of Five 'Thousand Dollars ($5,000.00) or five percent (5%) of the aggregate value,at the time of said request,of the principal of the Trust hereunder. This power shall be noncumulative and may be exercised only by an instrument in writing signed by her and delivered to my Trustee within the first thirty(30) days of fiscal year of this Trust. C. Upon the death of my wife,ELEANOR L.WHITCOMB,my Trustee shall distribute the principal of the Trust as follows: 1. Any and all sums owed by CMW HOLDINGS to me pursuant to the terms and conditions of the Term Note dated January 1, 2001, in the principal amount of Two Hundred Sixty-eight Thousand Five Hundred Twenty-four and 00/100 Dollars($268,524.00) shall be deemed forgiven and mazked as paid in full as of the date of distribution hereof. 2. Any and all sums owed by CARLISLE MECHANICAL&WELDING,INC., to me pursuant to the terms and conditions of the Term Note dated January 1, 1999, in the l� �r � � [initials] Page 2 of 9 Pages principal amount of One Hundred Ninety-seven Thousand Two Hundred Eight and 00/100 Dollars ($197,208.00) shall be deemed forgiven and marked paid as of the date of distribution hereof. 3. All of the rest, residue and remainder of the Trust shall be distributed as follows: a. Thirty-five percent (35%) thereof unto my son, BRET JAMES WHITCOMB,with substitution of issue, subject to the terms and conditions of this ITEM FNE, subpazagraphs D and E. b. Twenty percent(20%)thereof unto my son,MARK B.WHITCOMB, in trust, for his lifetime. The Trustee shall have the power and authority to sell, transfer, convey, invest and reinvest and to pay over the net income of the trust property to,or for the use of, my son, MARK B. WHITCOMB, or to accumulate it in the sole discretion of the Trustee. 'The Trustee is also authorized and empowered to pay over to, or for the use and benefit of, my son, MARK B. WHITCOMB, such portion of or all of the principal of the trust estate as in the Trustee's sole discretion seem proper for his health,support,maintenance,education,medical care or general welfare. Upon the death of my son,MARK B.WHITCOMB,or if he disclaims this interest for any reason, then any and all property remaining in this Trust shall be distributed as follows:one half thereof in equal shazes to ANDREA HARTLJNG and MEGAN A.WHITCOMB,and one-half thereof in equal shazes to JINA M.ZEGER and her children, with substitution of issue; all of the foregoing distributions being subject to the terms and conditions of subparagraphs D and E of this ITEM FNE. c. Fifteen percent (15%) thereof unto my granddaughter, JINA M. ZEGER,with substitution of issue,subject to the terms and conditions of this ITEM FIVE, subparagraphs D and E. d. Twenty percent(20%)thereof in equal shazes to the children of JINA M. ZEGER, currently CODY ZEGER AND CALEB ZEGER, with substitution of issue, subject to the terms and conditions of subparagraphs D and E of this ITEM ,,/����� v [initials] Page 3 of 9 Pages FIVE. e. Five percent (5%) thereof unto ANDREA HARTtJNG, with substitution of issue, subject to the terms and conditions of subparagraphs D and E of this ITEM FIVE. f. Five percent (5%) thereof to MEGAN A. WHITCOMB, with substitution of issue, subject to the terms and conditions of subparagraphs D and E of this ITEM FNE. D. In the event any beneficiary hereunder shall not have reached the age of thirty-five (35) years at the time of my death, then the Trustee shall hold his or her shaze(s) in trust for the support, maintenance and education of such beneficiary. The Trustee shall use as much of the principal as he or she shall deem desirable, for said purposes. I direct that such beneficiary shall have the right of withdrawal of the principal and any accumulated income of said trust in the following manner: One-half(1/2)thereof as he or she attains the age of twenty-five(25)years and the remainder of said share as he or she attains the age of thirty-five(35)years. E. To the extent that the same is permitted by law,none of the beneficiaries hereunder shall have any power to dispose of or to charge by way of anticipation any interest given to such beneficiary;and all sums payable to such beneficiaries hereunder shall be free and cleaz of the debts, contracts, alienations and anticipations of the beneficiaries, and all liabilities for levies and attachments and proceedings of whatsoever kind, at law or in equity. ITEM SIX POWERS OF EXECUTRIX AND TRUSTEE In addition to the powers conferred by case law,by statute, and by other provisions hereof, my Executrix and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution: A. To retain any property of any nature received by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of said property in such stocks,bonds,securities or other property, real or personal, as in their discretion they shall deem proper, without regazd to � [initials] Page 4 of 9 Pages statutes limiting the property which a fiduciary may purchase; C. To sell,transfer,exchange or otherwise dispose of,any part of said property,for cash or on terms,publicly or privately,or to lease,even for a term exceeding five(5)years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; E. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; F. To assume continuance of the status of any beneficiary with regard to death,marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; G. To pay from the trust,or the income therefrom,all debts or claims against my estate, or any taxes or similaz charges on my estate; H. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of tfie property distributed, and my Trustees, in their absolute discretion, may cause the share distributed to any distributee to be composed of property similar to or different from that distributed to any other distributee; I. To exercise any subscription right in connection with any security held hereunder,to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; K. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; /��V (/ [initials] Page 5 of 9 Pages L. To compromise claims; M. To continue for whatever period of time as they shall deem necessary any ownership as a tenant in common or as a partner,in real estate or other property and to act as I could have done had I been living; N. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the mazket value thereof at the time of purchase, any securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; O. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor,or to a person otherwise under legal disability,or to a person not adjudicated to be an incapacitated person,but who,by reason of illness or mental or physicaldisability is, in the opinion of fiduciary(ies)hereunder,unable to properly administer such amounts,such amounts may be paid by the fiduciary(ies)hereunder in his,her or their sole discretion in any of the following ways as he, she or they may deem best: 1. Directly to such beneficiary; 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies)hereunder using such amounts directly to the benefit of such beneficiary. Evidence of the application or payment of an amount in such a manner shall be a full and complete discharge of the fiduciary(ies) hereunder to the extent of such payment or application. This paragraph shall be applicable to payments of income as well as principal. P. To employ agents, attorneys and proxies and to delegate to them such power as my personal representatives and Trustees consider desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. -���'" [initials] Page 6 of 9 Pages R. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. S. Whenever my Trustee, in my Trustee's absolute discretion,determines that the size of any share held in any trust does not warrant continuing the same in trust, or its administration would be impractical for any reason, my Trustee, without further responsibility: a. May pay such share to the person(s) entitled at the time to the income and principal from it; or b. If such person is a minor,or in the opinion of my Trustee is disabled by illness or other condition,my Trustee may pay such share to the person in charge of such minor or incapacitated person,or to his or her guardian,or to a custodian under the Uniform Transfers to Minors Act. ITEM SEVEN PROTECTIVE PROVISIONS All income or principal held for the use and benefit of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obIigations, IiabiIities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. ITEM EIGHT APPOINTMENT OF EXECUTRIX AND TRUSTEE I nominate,constitute and appoint my wife,ELEANOR L.WHITCOMB,as Executrix of my estate. In the event that my said wife shall predecease me or fail to act or continue to act as Executrix,then I appoint my son,BRET JAMES WHITCOMB,to act in such capacity. In the event he shall predecease me or fail to act or continue to act in such capacity,then I appoint my son's wife, PEGGY SUE WHITCOMB,to act in such capacity. I hereby appoint my wife, ELEANOR L. WHITCOMB, as Trustee of the trust governed by the provisions of ITEM FNE,A and B,if funded. In the event that my said wife shall fail to act or be unwilling to continue to act as Trustee, then I appoint my son,BRET JAMES WHITCOMB, as Trustee of such trust, if funded. In the event that my said son shall fail to act or be unwilling to � _��i�L ; [initials] Page 7 of 9 Pages continue to act as Trustee,then I appoint my son's wife, PEGGY SUE WHITCOMB,as Trustee of such trust, if funded. Either of BRET JAMES WHITCOMB or PEGGY SUE WHITCOMB, as Trustee,shall have the power to appoint his or her successor in office by written instrument,which shall be signed by the person having the power to make the appointment and filed with the court in the jurisdiction which is the situs of the Trust. I hereby appoint my son, BRET JAMES WHITCOMB,as Trustee of any trust(s)governed by the provisions created under ITEM FIVE, C, 3, b through f, hereof. In the event he shall be unwilling or unable to serve, or continue to serve in such capacity, then I appoint my son's wife, PEGGY SUE WHITCOMB, to serve as Trustee thereof. My Trustees shall have the power to appoint his or her successor in office by written instrument, which shall be signed by the person having the power to make the appointment and filed with the court in the jurisdiction which is the situs of the Trust. ITEM NINE WAIVER OF BOND I direct that neither my Executrix nor my Trustees, or their successors shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties,nor shall they be required to obtain any order or approvai of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this � day of � , 2012. �' 6 z�1.,-- �'��o��G� (SEAL) J. Benson Whitcomb SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testator,as and for his Last Will and Testament,in the presence of us,who at his request,have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. � � � � � ,- � � l, �� �'�'L<��:�__ �� ��i�'���Y��I ��ti,� Page 8 of 9 Pages COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF CUMBERLAND ) We, J. Benson Whitcomb, Ivo V. Otto III, and ;����, ��� ��� �-�=��������� , the Testator and the witnesses,respectively,whose names are signed to the foregoing instrument,being first duly sworn,do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that the Testator has signed willingly, and that the Testator executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older,of sound mind and under no constraint or undue influence. , J. enson Whitcomb, Testator -�` .�` � ��1�1J`"� Witness � � � - � r,��. ���, �.-� Witne s Subscribed,sworn to and acknowledged before me by J.Benson Whitcomb,the Testator,and subscribed and sworn to before me by Ivo V.Otto III and %`'���v u 3- 4' C�Y��;���r- ,the witnesses, this�day of`�v;/�,�-`u-�- , 2012. '� � J ,��` �� Notary Public (;U�tMO;VWEALTH OF PENNSYLVA`IIA NOTARIAL SF.A1. Victoria L.t?;to,�Votary Public Carlisle Boru,�'umberland County h1y cemu�i�sioa eepices D�cember?0,2014 Page 9 of 9 Pages C�Lincoln Financia) Group� PO I30X 7880 FORT WAYNE, IN �6801-7880 Martson Law Offices Melissa Scholly 10 East High Street Carlisle,PA 17013 June 29, 2015 J. Benson Whitcomb; Deceased 953151741/953151743; Contract Dear Ms. Scholly, I am writing in response to your request for the date of death values on the two contracts mentioned above. Contract 953151741 - $260,285.00 Contract 953151743 - $263,585.78 If you have any questions please contact claims customer service at 800-454-6265 ext. *8200 5incerely, s�-�.�� c��. Stephanie Corum Claims Examiner Registered Representative of, and securities offered through, Lincoln National Life Insurance Company and Lincoln Financial Advisors Corp., broker-dealers. Lincoln Retirement is the marketing name for the annuities operation of The Lincoln National Life Insurance Company. Lincoln Financial Group is the marketing name for Lincoln I�Iational Corporation and its aftiliates. i � ,, �-�`_��`�y"1 '; \ �" `� __.�.h �� , _ Cstate Valuation Date ot Deal-h: 02/15/2015 Estal•e of: Whitcomb Valual-ion Date: 02/15/2015 Account: A10-059316 Processing Date: O8/05/2015 Report 'fype: llaCe of peath Number of Securities: SB Cile ID: Whitcomb 410-054316 Shares Security Mean and/or Div and Int Security or Par nescription High/Ask I,ow/Bid AdjusCmenCs Accruals Valua 1) 50269.4 Cash (CASH) 50,2p9.40 �L�` L 2) 121 RCTNSUItANCR GROUP AMER INC (75935160A; RGA) �tt � ' COM NI?W New York Stock Exchnn9a 02/13/2015 89.53000 88,56400 li/L 02/17/2015 90.26000 08.940U0 It/L 89.323500 10,008.1�1 Div: 0,33 Ex: 02/11/2015 Rec: 02/13/2015 Pay: 03/06/2015 34.93 3) C0000 CHAMBL+RSI3URU @A ARf�'.A SCN DIST (1578821�A2) InteracCive DaCa Corporation • llTD: 11/15/2005 Mat: 03/O1/2015 5$ 02/13/2015 100.18600 Mkt 02/17/2015 100.17300 Mkt 100.179500 90,071.80 Int: 09/O1/2019 to 02/15/20�5 911.11 4) 50000 CRANBERRY 7Y�P PA (22428BHR�) Interactiv@ Da�a Corporation . DTD: 30/05/2011 Mat: 03/O1/2015 3k 02/13/2015 100.11100 Mkt �2/17/2015 100.10300 Mkt 100.107000 50,053.50 Int: 09/O1/2014 to 02/15/2015 663,33 5) 50000 EASTON PA ARPA SCH DISP (277695FD9) Interactive Data Corporation DTD: 12/61/2008 Mat: 04/O1/2015 5� DZ/13/2015 100.57500 Mkt 02/17/2015 100.56�00 Mkt 100.566500 50,284.25 TnC: 10/O1/2019 to 02/15/2015 930.Sb 6) 15000 WALL4+NPAUPACK PA ARG)1 SCH DIST (932432RS0) InterActive bata Corporation l71'D: 07/15/2009 Mat: OA/01/2015 3$ 02/13/2015 100.33900 Mkt 02/17/2015 100.3J100 Mkt 100.335000 15,050.25 Int: 10/O1/2014 to 02/15/2015 167.50 7) 25000 [1PPER ALLEN TWP Pn (91546�AP1) Interactive Data Coryoration dCD: 03/24/2010 Mat: 05/15/2015 38 02/13/2015 100.60900 Mkt 02/17/?.015 100.60200 Mkt 100.605500 25,151,38 Int: li/15/2014 l-0 02/15/2015 187.50 8) 20000 MANHEIM TWP PA SCH DIST (563231UD9) Interactive Data Corporation IYPD: 12/15/2008 Mat: 06/O1/20�5 58 02/13/2015 101,34700 D1kt 02/19/2015 101,33400 Mke 101,346500 20,26£l.10 Int: 7.2/Oi/2014 Co 02/15/2015 205.56 9) 1101 ST PAUf, MINN PORT AUTH INDL DL� (79306EHS6) Interactive DaL'a Corporation IYPp: 12/O1/1985 MaC: 12/O1l2015 4.3758 02/13/2015 32.00000 MkC 02/17/2015 32.00000 MkC 32,000000 352.32 � Tnt; 12/0]/2014 Co 02/15/2015 21•ZZ In deEault, princ.ipal and interest Page 1 This report was produced wil'h EsLaLeVal, a product of GsL'aCe Valuations & Pricing Systems, Inc. IE you have questions, please conlacl rVP SysLems nt (818) 313-G300 or www.evpsys.rom, (Rev.is.ion 7.3.1) � (;� i_, --�,:��-��N � -r t-' /) '.��_� 1__1 a --' / DaCe of Death: 02/15/2015 �state of: tVhiecomb Valual'ion Date: 02/15/2015 AccounC: A10-059316 Processing Date: OB/05/2015 Report 'Pype: Uate of Death Number of Securities: 58 File ID: Whitcomb 410-05931G Shares Security Mean and/or Div and Inl• Security or Par Description High/Ask Low/8id AdjusLmenCs Accruals Value 10) 25000 RGAOING PA SCH AIST (755638RY1) Interactive Data Corgoration D'fD: 12/15/2005 Mal; O1/15/2016 SB 02/13/2015 104,00900 Mkt 02/17/2015 103.99200 MkC 103.996000 z5,999.50 Int: 01/15/2015 eo 02/15/7.015 10A.17 ].1) A5000 DANVILLE PA AREA SCH DIST (236635GM0) InCeractive DaCa Corporation DTD: 07/15/2007 MaC: OS/01/2016 4,258 02/13/2015 109.88800 Mkt 02/17/2015 109.89800 MkC 10Q.B83000 47,197.35 Int: 11/O1/2019 L•o 02/15/2015 552.50 12) 20000 BUCKS CNTY PA CMNTY COLI.EGS AU (118fi01GX5) Interactive Daka Corporation DTD: 06/25/2008 Mat: 06/15/2016 5$ 02/13/2015 106.16300 Mkt 02/17/2015 lOG.l'1000 MkC ' 106.176500 21,7.35.30 Int: 12/15/2014 to 02/15/2015 166.67 13) 25000 GXETER TWP PA (301896CV6) Interactivo DaCa Corporation DTD: 07/15/2007 �fat: 07/15/2016 5.259 02l13/2015 106.17700 Mkt 02/1'7/2015 146.16500 Mkt 106.171000 26,SA2.75 Snt: 01/15/2015 to 02/15/2015 109.38 1�) 50000 CUMAG1tLAND VALLEY PA SCIi DIST (230822PV4) InCeractive Data Corporation DTI): 06/15/2008 Mat: 11/15/2016 5B 02l1]/2015 107.72200 Mkt 02/1'T/2015 ].07.71000 MkC 107.716000 53,058.00 Int: il/15/2019 to 02/15/2015 625.00 15► 40000 WEST SHORB PA SCH DIST (955819PR7) Interactive Data Corporation IYI'D: 03/15/2009 BaL: I1/15/2016 2.875t D2/13/2015 104.40500 Mkt 02/17/2015 10A.39800 MkC 10A.901500 41,T60.60 int: 11/15/2014 to 02/]5/2015 287.50 161 35000 OC1`ORARA PA AREA SCH DI5T (6757hOMW1) Interactive llaCa Corporation nrn: o3/i5/2009 Mac: o6i01/2Di9 5� 02/13/2015 109.39000 MkC 02/17/'Z015 109.35500 MkC 109.372500 38,280.38 ZnC: 12/O1/2019 to 02/15/2015 359.72 17) 30000 PENNSYLVANIA ST IiICfiGR GDL FAC (70917RVL6) Interactive Date Corporation DTD: 07/O1/7.009 Mat: 06/15/2017 SB 02/13/2015 109.64300 Mkt 07./1"7/2015 109.G0700 Mkl- 109.625000 32,887.50 Int: 12/15/201A to 02/15/2015 250.00 18) 50000 PBNNSY[,VANIA ST NIGHER EDL FAC (70917RPK) Interactive Data Corporation ATD: 03/O1/2008 Mat: 06/15/2017 5$ 02/13/2015 109.6A300 Mkt a2/17/2015 109.60'100 Mkt 109.625000 59,812.50 Int: 12/15/2014 Co 02/15/2015 �16.67 Page 7, 7'his report was produced with EstaCeVa1, a producC of Gsl•aCe Valuations & ericiug Systems, Inc. IE you have questions, please conracC EVP Systems at (818) 313-6300 or www.evpsys.com. IRevision 7.3.1) Dal•e of �eath: 02/15/2015 Estate oE: Whit-comb valuation Date; 02/15/2015 Account: 91�-05931G Processing UaCe: 09/OS/2015 Report Type: Dale ot DeaLh Number oE Securi.lios: 58 File ID: Whitcomb A10-U59316 Shares Security Mean and/or Div and int Security or Par Description High/Ask Low/Did Adjustments Accruals Value 19) 2500U PHILADELPI{IA PA ('117813JU2) InCeractive Data Corporation DTD: 12/20/2007 Mat: 08/O1/2017 5.'LS�B 02/13/2015 110.26000 Mkt 02/17/2015 110.22300 Mkt 110.2A1500 27,560.38 Int: 02/O1/2015 l'0 02/15/2015 51.04 20) 500D0 UPPG'R MORF.4AND TWP PA SCH DIST (916218QW3) zn�eractive nata Corporacion D�PD: 09/06/2011 Mat: 08/15/2017 2.56 02/13/201ti 102.27700 Mkt 02/17/2015 102.25800 Mkt l02.267500 51,133.75 I+ull coupon paid on 02/15/2015 21) 5000 BEAVER CN7'Y PA (074851PH3) Interactive Data Corporntion IYfp: 02/01/2009 Mat: 11/15/2019 3.758 02/13/2015 108.65800 Mkt 02/17/2015 108.G2000 MkL 108.639000 5,�31.95 InC: 11/15/2014 Co 02/15/2015 �6.86 22) 10000 BEAVLR CN'PY PA (074851PS9) Interactive Data Corporation DTD: 02/O1/2009 Mat: ]1/]5/2617 3.756 02/13/2015 107.27000 Mkt 02/17/2015 107.21A00 MkC 107.252000 32,175.60 InC; 11/15/2014 Co 02/15/2015 291.25 23) 300D0 CRAWFORD CF.NT SC►i Dlsm PA C(tAW (22A655KG8) InCeracrive uata Corporarion IYPD: 08/O1/2008 Mat: 02/O1/2018 58 02/13/2015 110.85800 MkC 02/17/"1015 110.'75600 Mkt 110.847000 33,202.10 Int: 02/01/2015 to 02/15/2015 58.33 • 2A) 30000 CENTRAL EtUCKS PA SCH DIST (152735TQ9) Interactive Data Corporation pTD: 03/15/2008 Mat: 05/15/2025 5� 02/13/2015 113.G0000 Mkt 02/17/20]5 113.49300 Mkt 113.550500 3�.065.15 Int: 11/15/201A l•0 02/15/2015 375.00 25) 25000 CL�NTRE CN7'Y PA (156267JA5) InCerACClve uala CorS�oration IYrD: 08/18/2011 Mat: 06/O1/2618 A8 02/13/2U15 Ip8.98700 MkL• 02/17/2015 108.87800 Mkt 108,932500 27,233.13 InC: 12/O1/2019 to 02/15/2015 205.56 26? 30000 LANCASTGR PA SCK qIST (519383QJ0} Interactive Data Corporation pTD: O1/15/2007 Mat: 06/�1/2018 5L 02/13/2015 109.05900 Mkt 02/17/2015 108.9'I100 Mkl• 109.012560 32,703.75 InC: 12/O1/2014 to 02/15/2015 308.33 27) 75000 PRNIdSYLVAN'fA S'P (769141V93) Interactive Data Corporation D'PD: 12/21/2009 Mat: 07/al/7.018 5.375$ 02/13/2015 114.37600 Mkt 02/17/2015 114.07600 Mkt 114.22�000 85,6�0.25 InL•; 01/01/2015 l0 02/15/2015 992.71 Page 3 This reporC was produced wiCh GstateVal, a pr.oduct oE Gstal•e Valuations & Pricing SysL•ems, Inc. IL you have questions, please con�act GVP Syslems nL 1818) 313-G300 or www.evpsy�.cam. (Revision '7,3.1) Dal-e o[ Death: 02/15/1.015 Csl•aCe of: WhiCcomb V�lualion Dal•e: 02/15/2015 Account: A10-0593�6 Processing Date: 00lOS/2015 Report 7'ype: Uate oL Oeath Number of Securities: 58 File ID; whitcomb 410-059316 Shares Security Mean and/or Uiv and Int Security or Par Descziption liighlAsk Low/8id AdjustmenCs Accruals Value 28) 25000 UANIEL HOON6 PA AR�A SCH DIST (7.36222EN4) Interactive Data Corporation ffPD: 08/15/2008 Mat: 08/15/2018 4$ 02/13/2015 109.03700 t9kt 02/17/2015 108.92300 Mkt 108.980000 2'7,2A5,00 Full coupon paid on 02/15/7.015 29) 20000 SOUTH MIDALSTON PA SCH DIST (83A836KN3) InLeractive Date Corgoration DTD: 02/16/2011 Met: 10/O1/2018 2.8i 02/13/2015 101.80400 Mkt 02/17/2015 101.76600 Mkt 101.785000 20,357.00 Int: 10/01/2014 to 02/15/2015 208.44 J4) 20000 SEWICKLEY PA (818495DW0) Tnteractive Data CorporaCion � D'PD: 03/28/2011 Mat: 12/O1/2018 18 02/13/4015 102.40700 Mkt 02/17/2015 102.36300 Mkt 102.385000 20,4�'l.00 Int: 12/O1/2014 to 02/15/20I5 123.33 31) 25000 CONESTOGA VALLL�Y SCH DIST PA 1287098HY31 InCeractive Data Corporation DTD: 06/21/2012 MaC: O1/15/2019 48 ' 02/13/2015 110.�9000 Mkt 02/17/2015 130.36200 Mkt 110.92G000 'L7,606.50 Int; O1/15/Z015 to 02/15/2015 83.33 32) 30000 MILLCR�L�K TWP PA SCH AIST (600293QC1? interactive Data Corporation DTD; 11/23/2010 MaC: OI/15/2019 A� 02/13/2015 111.70706 Mkt 02/17/2015 111.5'1600 MkC 111.691500 33,492•45 Int: O1/15/2015 to 02/15/2015 100.00 33) 2000D MILLCREEK TNIP P11 SCH DIST (600293QG2I . InCeractive Datn Corgorotion DTD: 11/23/2010 Mat: O1/15/2019 96 02/13/2015 109.74A00 Mkt 02/17/2015 109.G1800 Mkt 109.681000 21,936.20 Int: O1/15/2015 to 02/15/2015 66.67 34) 50000 CRANSBRRY TFlP PA (224288HW3) Interactive Data CorporaCion D'PD: 10/OS/2011 Mat: 03/O1/2019 4B 02l13l2015 109.02D00 Mkt 02/17/2015 109.29100 Mkt 109.355506 59,6"I7.75 Int: 04/01/2014 to 02/15/2015 911.11 35) 25000 MON'PGOMCRY CNR'Y PA (6135792R5) Inteructive Data Cor.poraCfon i7rn: OSiO3/2013 Mac: 05/01/2019 56 02/13/2015 115.16200 Mkt 02/17/2015 115.02000 Mkt 115.091000 28,172.75 Int: 11/O1/2014 to 02/15/2015 3G1,31 3G) 50000 PL�NNSYLVNiIA ST (709191W27) InteracCive Data Corporalion DTDo 12/21/2004 Mat: 07/01/2019 5.3758 02/1]/2015 117.A')560 Mkt 02/17/2015 117.13900 Mkt 117.30?000 58,653.50 Int: 01/O1/2015 to 02/15/2015 328.A7 Page 4 This report was produced wiCh GstateVal, a product oE GSCate Valuationa & Pricing Systems, Inc, S£ you have questions, please contact EVP Systems aC (810f 313-6300 or www.evpsys,com, {Revision 7,3.1) Date of oeath: 02/15/2015 Cstal•e of: whiCcomb Valuation Aate: 02/15/2015 Account: �10-059316 Processing Daca: O8/05/2015 Reporl- 7'ype; Date o[ Death Number of Securities: 56 File ID: whitcomb 410-059316 Shares Securil•y Mean and/or Div and Tnt SecuriCy or Par Description High/Ask Low/Hid Adjusl•ments Accruals Value 37) 25000 LOWER HERION PA SCH DIST (5A8246FF91 SntaraCtive Data Corporation DTp: 09l25l2012 Mat: 11/15/2019 Sa 02/13/2015 117.82200 Mkt 02/27/2015 il?.G6100 MkC 117.741500 29,435.30 InC: 11/15/2019 Co 02/15/2015 312.50 38) 500Q0 GOVERNOR MTFFLIN PA SCH AIST (383770CC9) InCeractive DaCa Corporation �PU: ]1/15/2006 Mato U3/15/2020 58 OZ/13/2015 106.6d100 Mkr 02/17/2015 106.58100 Mkt 106,611000 53,305.50 InC: 09/15/2014 ro 02/15/2015 1,091.67 39? 50000 PENNSYLVANIA ST (70914PJE3► Interactive DaCa CorporaCion DTD: 03/19/2009 Mat: 03/15/2020 56 02/13/2015 I15.48900 Mkt 62/17/2015 115.39900 Mkt 115.919000 57,709,50 Int: 09/15/201a to 02/15/2015 1,0�1.6T 40) 10000 PHILADELPHIA P7� AUTH FOA INDL 171781LAY5) Tnteractive Dr►ta Corporation D'tD: 02/03/1999 HAt: 09/15/z020 08 02/13/2015 89.33000 Mkt 02/17/2015 8J.95300 Mkt 84.141500 8,414.15 41) 30000 PENNSYLVANIA ST (70919PMU3) Tnteractive DaCa Corporation 17CD: 05/27/2010 MaC: U5/O1/2020 58 02/13/2015 117.A9800 Mkt 02/17/2015 11'7.32500 Mkt 1]7.911500 35,223.A5 Int: 11/O1/2014 Co 02/15/2015 933.33 A21 75000 CUMBERLAND VALLI3Y Pp SCH DIST f230822PL6) Tntezactive Data Corporation DTA; 07/15/2005 MaC: 11/15/2U20 Si 02/13/2015 103.38200 Mkt 02/17/2015 103.3�700 Mkt 103.36A500 97,523.38 Int: 11/15/7.01� to 02/15/2015 937.50 93) 50000 PENNSYLVANIA ST (70914PQV7) InteraCtive Data Corporation D7'A: 10/27/2011 Mat: 11/15/2020 5� 02/13/2015 118.63000 Mkt OZ/17/2015 118.49100 Mkt ISA.535560 59,267.75 Int: 11/15/2014 to 02/15/2015 625.00 44► 7,5000 SGNI:CA VY PA SCH DIST (81720'1LV3) InCeracCive �aCa Corporation m�n: oaiisizaos MBr: oiiaiizozi s� 02/13/20I5 101.62700 Mkt 02/17/2015 101,60A00 MkC � 101.615500 2�,903.86 Int: O1/O1/2015 to a2/15/2015 152.76 451 50000 'PREDYFFRIN-EASTTOVJN PA SCN DIS 1899673Q1i1) Tnteractive DaCa Corporation arD: 07/15/2010 Mac: 02/15/2021 56 62/13/2015 118.93500 Mkt 02/17/2015 118.76500 Mkt 118.850000 59,A25.00 Full coupon paid on 02/15/2015 Page 5 'Phis xeporC was produced wiCh EstateVal, a produce oE P.state ValuaL•io�is & Pricing Systems, Inc. Sf you have 9uesl•ions, please contact EVP Syslems at (818) 313-6300 or www.evpsys.com. (Revision 7_3.11 1)aLe oF oeath: D2/15/7.015 Estate of: WhiCcomb Valua�ion Dar.e: 07./15/2015 Account: C10-059316 PYocessinq Dale: 08/OS/2015 Report Type: Date oE Death Number of Securities: 58 File ZD: Whitcomb 910-059316 Shazes SecuriGy Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 46) 50000 WES'P CHESTGR PA ARL� SCH DIST (952030L36) Interactive DaCa CorporaCion DTD: 08/28/2012 Mat: 05/25/2021 48 02/13/20]5 11A.45000 Mkt 02/1'1/2015 11A,25'L00 Mkt 114.351000 57,175.50 Int: 11/15/2014 to 02/15/2015 500.00 97) 25000 uUCKS CNTY PA (118565Ux6) Interactive Data CorporaCion DTD: 12/OS/2011 Mat: O6/O1/2021 96 02/13/2015 119.74260 Mkt 02/17/2015 114,54200 Mkt 114.6A2000 28,660.50 int: iZ/01/2014 to 02/15/2015 205.56 48) 30000 OENSALEM 'PWP PA 5CH DIST (082383LW6) Tnteractive DaCa Corporation D'CD: OB/Oi/2012 MaC: 08/15/2021 5$ 02/il/2015 118.59800 Mkt 02/17l2015 118,39100 Mkt 110.A94500 35,540.35 nll covnon paid on 02/15/2015 A9) M15000 FAYL+TTS CNTY PA (312C59E29) Interactive Data Corporation DTD: OB/21/2012 Mat: 11/15/2021 2.6258 02/13/2015 102.97A00 Mkt 02/17/2015 102.7830U MkC 102.8'76500 46,295.33 InC: 11/15/2014 to 02/15/2015 295.31 50) 70000 Pt3NA15YLVAN2A ST (70914PRT1) Interactive Data Corporation IYPA: 10/27/2011 Mat: 07/O1/2022 58 120.37600 Mkt 02/13/261� 02/17/2015 120.1d100 Mkl 120.7.58500 �9,180.95 TnC: O1/O1/2015 to 02/15/2015 ���'78 51) 50000 UPBEA ST CL11IR TwP PA SCH UIST (916507MU7) InterncCive Data Corporation pTp: 10l2�/2012 Mat: 07/15/2022 4i 02/13/2U15 113.18600 Mkt 02/1?/2015 112.96200 Hkt 113.07A000 56,537,00 Int: O1/15/2015 to 02/15/2015 166.67 52) 20000 PBNNSYLVTNIA ST l'1091APUS9) Interactive Data Corporation DTA: 11/07/2013 Mat: 10/15/2022 56 02/13/2015 120.87900 Mkt 02/17/2015 120.63600 Mkt 120.757500 29,151.50 Int: 10/1S/2014 eo 02/15/2015 333.33 5�) 7.500U CI�GSTER CNTY PA (165573XT8) Interactive �ata Corporation rirD: 12/22/2011 Mat: 1�/15/2022 56 02/13/2015 120.01900 Mkt 02/17/2015 119.66100 Mkt 119.970000 29,992.50 Int: 11/15/�019 Co 02/15/2015 312.50 54) 30000 DELAWARE CNTY PA AUTH COLLEGE (2�60031517) Interactive Data Corporation DTD: 04/29/2010 Mdt: 11/15/2022 9.25� 02/13/2015 111.13700 MkC 02/17/2015 110.97400 Mkt 111.055500 3J,316.65 Int: 11/15/2019 to 02/15/'1015 318.75 Pago 6 This report was produced with Gstal•�Val, a producL• of rstate ValuaL•ions & Pricinq SysL•ema, Ine. IE you have quesCions, please conCact GVP Systems at {818) 313-6300 or www,evpsys.com. {Revision 1,3.1) Da�e of Death: 02/15/2015 Bstate oE: t�iitcomb Va].uation llate: 02/15/2015 Account: 410-D5931G Procesaing UaCe: 08/OS/'LO1S ReporL Type: DaCe oE Death Number of Securieies: 58 rile IDc Whil-comb 410-05931G Skares Securily Mean and/or Div and InC 5ecurily or Par Descriplion High/�sk Low/Bid AdjustmenCs Accruais Value 55) 5000 NORTH )iILI,S PA SCti DIS'P (659868NM1) Interactive Dara CorporaCion DTD: 11/O1/2006 Mut: 12/15/'L022 AB 02/13/2015 109.66900 Mkt 02/17/2015 109.62700 Mkt 10A.658000 5,232.90 Int: 12/15/2014 to 02/15/2015 33.33 56) 50000 H7�MBURG PA AREA SCH DIST (406660KU3) InteracCive DaCa Corporatian DTD: OA/29/2011 Mat: 09/01/2023 C.1258 02/13/2015 108.63600 Mkt 02/17/2015 108.99500 Mkt 108.565500 54,282.75 Int: 10/01/2014 to 02/15/2015 767.71 57l 20000 ALLEGHENY CNTY PA HOSP DCiV AUT (01728A1750) Interactive Data Corporation m�D: 02/O1/2007 Mat; OS/O1/2025 4.756 02/13/2015 109.82800 Mkt 02/17/2015 109.82200 Mkt 109.825000 20,965.00 Int: 11/O1/ZQ19 to 02/15/2015 27�•�� 56) 75000 STATII PUB SCH DLIXi AUTH PA COL (85732MDT1� InCeracCive Data Corporation DTD: 03/19l2008 Mat: ]0/0]/2046 5i 02/131Z0]5 110.A8800 Mkt 02/17/2015 110.35000 Mkt 110.919000 82,814.25 int: 10/01/2019 to 02/15/2015 1,395.83 • Totul V�lue: $2,192,118.40 'Potal Acczual: S19,595.5� Totnl: $2,211,713.99 Page 7 This reporl was produced wil-h L'stakeVal, a product of GsCate ValuaLions � Pr.icing Systems, Inc. IE you have quesl-ions, please contacC EVP Systems aC (8161 313-6300 or www.evps,ys,com. {Reviaion 7.3.1) �Lincoln Financial Group� PO E30X 7880 FOR"r WAYNE, (N �6801-7880 Martson Law Oftices Melissa Scholly 10 East High Street Carlisle, PA 17013 June 29, 2015 J. Benson Whitcomb; Deceased 953151741/953151743; Contract Dear Ms. Scholly, I am writing in response to your request for the date of death values on the two contracts mentioned above. Contract 953151741 - $260,285.00 Contract 953151743 - $263,585.78 If you have any questions please contact claims customer service at 800-454-6265 ext. *8200 Sincerely, s�-�.�� c��. Stephanie Corum Claims Examiner Registered Representative of, and securities otfered through, Lincoln National Life Insurance Company and Lincoln Financial Advisors Corp., broker-dealers. Lincoln Retirement is the marketing name for the annuities operation of The Lincoln National Life Insurance Company. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. r� r ��; -- ` 1 ^ ���� �r r.\. / �_ ?; �--' ° ,� , _�� i,�i� _, ✓ � � �