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HomeMy WebLinkAbout01-1084 Estate of WANDA W. MACOMBER also known as PETITION FOR PROBATE and GRANT OF LETTERS ~I-OI~ lOgy. No. To: Register of Wills for the , Deceased. County of CUMBERLAND in the Social Security No. 385 - 2 0 - 9 0 8 3 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut or in the last will of the above decedent, dated Jul v 23, 2001 and codicil(s) dated named ,19_ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in h er last family or principal residence at Cllmhp.rl rlnn County, Pennsylvania, with 3452 Lisburn Roan Lower Allen Township (list street, number and muncipality) Decendent, then 74 years of age, died October 12, 2 001 , u Holv5pirit Hosoital Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 2,000.00 $ $ $ $ Nnnp. WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codici1(s) presented herewith and the grant of letters Tes tamen tarv theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) - '" 'U' u c .., "0_ .- '" "'- '" .. ~.., C -00 c'= CU"= 3~ "''- ;0 cu c 00 rn ~~~~ 3452 Lisburn Road Mechanicsburq, PA 17055 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1. ss COUNTY OF CUMBERLAND j The petitioner(s) above-named swear(~) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and administer the estate according to law. J 7 - Z3 - k3 C;'} QQ. ::s Cl - s::: ~ ~ No. Estate of WANDA W. MACOMBER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW NUll. Z B 200 ~ in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated J u 1 Y 23, 2001 described therein be admitted to probate and filed of record as the last will of Wanda W. Macomber and Letters Testamentary are hereby granted to Victor D. Macomber 25.00 Probate, Letters, Etc. ......... $ Short C.ert.ificate~(~_. :..: . . . . . .. $ (p. 00 II....."..... '/-.. ~ :a TOTAL _ $ . Filed " NtTV.. Z fL. JJ!l) I. . . . . . . . . . . . . . . . . . FEES ;:'A_# A~Wills Rich~~~~Stewart (18039) Johnson, Duffie, stewart & Weidner A TIORNEY (Sup. Ct. J.D. No.) 301 Market St., P. O. Box 109 Lemovne, PA 17043-0109 ADDRESS (717) 761-4540 PHONE ~~. .(~ Cl Cti u(I) (1)0: 0: '. .- lJ") - E:E l"'- N ::> ~ .- p t:: ,<::( ::1 0..: :) . " j ') '. .,I;J q) . ..0 'C l= (1)= _ oJ Uo '-1'('[<:;.0(\0; ~,'V 0;'0(; This is to certifY that the information here given is correctly copied from an original certificate of death d';lly filed with me as Local R~gistrar. The original certificate will be forwarded to the State Vital Records Office fot permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. p, 7691405 {Mg,>1<A":' ~j,Lk <9'M Local Registrat d Fee for this certificate, $2.00 No. &~v I ~ ;J.tJO I Date Hl05 l43Aew 2/87 COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH iYPEJPRiHT IN PER.....NENT BLACK INK 74 Vr.. IJHOER 1 OM tbn ! MlnuI.. SEX ,female STATe FilE ~UM8ER SOCIAl. SECURITY NUMBER NAME OF DECEDENT tFI(SI. Middle. Lasl 1. 3.385 - 20 IJ. J,6Q I AGE 1laSS BlI'tfloay) UNOER 1 YEAR -.. Dayo B...-THPLACE le,1y <lAd StawI 01 fcreogn Couflll'VI Ubly, MI =",0 COUNTY OF OERH . ...Cumberl and DECEDENl'S USUAl occuf'IVION jGo.... tund oflKWk c:1or'-. dvfll'lQ moll .( r-ff 'St'''' u.."....., "L ". OECEDENT'S MAIlING AOORI!SS (Sel_. CIIyITown. s.M.. Zip Code' 3452 Lisburn Road ~echanicsburg, PA 17055 ..E. Pennsboro Art WAAlTAl STATUS. Maned Newel WWriM, WicIDtwM. -- 14. Mar r i e d SUAV1\/1NO SPOUSE iM.... ~maden '*'-I ,~. ... - ..... Cumberl and -' 17..0:"-::'-':::.. MOTHeR'S NAME 'F.... Modale. M8ldlIn SllfRamllI ". Pearl G. Gifford INF~T"S ""IL'l'GAflDREss....... ~..... ZipCodol _j452 LlsDurn ra.Mect'ianlcsburg, PA 17055 PlACE OFoeSf'QSlTION .NMMofc.m.tery. CferMlOry lOCAllOH.~ SlaM. Zipeo. .. ..... ...... "c. Conolite Crematory 17c.I&l......~IWM... ..Victor D. Lower Allen Macombe OECEDENT'S ACTUAl REsmEHCE ........... --, 17.. SlalII "'P. - FRHER'S NAME (First. Middle. LUll ,.. 1Nf000000.S...... (T_on<) Frank A. Wilson Victor D. Macomber ~ o w ~ o ~ >: 0( z c,---x:lI __.....0 Schaefferstown, 21111. PA ill Ul :> '::I ~ 0( PA 17055 :l OATE PAONOUHCEDDEAD(MonIto. Day. 'lleaf) ... lO'.tO II H.O.:.;hbv 12. :J.l>Ol 27. H.RT I: EnI...lhlt diM...., qurieaor c:ompIit....wtlichcaUHdIM dlalh Oonotenwrlhe modIi ofctying. such uc..dlacor respi'atory .."aI. shocIl Of Mart flliklfe LISI oNt one c...... on aKh line ()'tlttsh.hc: ):MCdl- ~rce v- DUE 10 (OR AS ACONSEOUEMCE Of); Da:g V&t-..l'6)L~ ~bO'i-tO . ~ (OfIAS.,~ONSEOUENCEOf): 'VH.Uv, DUE 1O(OA AS ACONSEOUfNCE Of): I Apptoxil'nMe :=.:= , I PART I: ClIhet~condiIione~lOdMIh.br.c ftOl tMUIing iD... ~,*,",giwen in fNIT I l : 'NERE AUlOPSV FINOtNGS UAHNER OF DEATH NMUlA81E PRIOR 10 COYPLETtON OF CAUSE. 0 DEATH' ........ ........... Acc:idef'lI 0 PendIng lnYnIiQation 0 _0 No 0 Suic;g 0 CoukS not blIlHlafl"N!\fKi 0 DATE Of INJURY t~.Day.-"'1 TIME Of iNJURY INJURY /IJ 1NORI<1 DESCRIBE HOW INJURY OCCURRED. .... 0 NeO II. '~!'//~ I.N.II,+./I~ I ,~ ze.. 28b. CERTiFIER 100000k ~ 00It} .CERTlFVtNG ~YStclAN(Ph)'$lC'&f'c.lrty"'9c.ause ~dnlto wh8f1 atlOlh6f phYSOCIMl hupoonouncea death ana cornpleleo Ilem 231 To...... of "'1 kno.......... occurnd"'''''' CMlM(.J and INIAM1r.. _Wed. zo. PlACE Of INJURY. AI home. rarm. ..'....Iac:tofy. otAc:e buikiinQ. Me. c$pec""1 .... (- 'PIltOMOUNCIHG AND CERTIFYING PHYSICIAN (Ph.,SlCtoan boIf1 OlfOflOUncong oeath.and cerulVIf'KJ 10 cause 01 aeatt11 To" best; 01 "'1 knolllle4ge. de...occw,............. dille, and place, and due to.... cau....) end manner.. .'ated., .MEDtCAl EXAUINE.RlCOAOHER On I'" u.ia 0' examination andlortnv.stlQ"ton. in my opinion. dea'h occuned at the Ume. da'a, and place. ..nd due to Ihe cau..(s) and m~n.r...t.'e4.. .......... ..... ............ ................... ........ ...... .......................... ..... ". REGISTRAR'S StGNATURE AND NUMBER ;u-o/ - IO~LJ 0 ;""'" ",-::( '0 l!) - ;~ :1 0.: ..- ) .~O ~"~,.-" :a: ( "-...' ..,;:.io ;,,,,,,,,~ l"- i (') N I' lh ([;1 E; ft,;:: m ,- ~:'~~ 0 :~~I Z j,- '1.,.... '.:;) (I) 0 .0 ~ (l) ~, ~ ex: ..- .... p 0) C5 c.1 009206-00002/7.12.01/RWS/DCP/147611.1 ,'. ~i East Will anb {!testament OF WANDA W. MACOMBER I, Wanda W. Macomber, of the Township of Lower Allen, Cumberland County, and Commonwealth of Pennsylvania, declare this to be my last Will and revoke any Will previously made by me. I' ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practical after my decease as a part of the expense of the administration of my estate. ITEM II. I bequeath my automobiles, household and personal effects, and other tangible personalty of like nature (not including cash or securities) together with any existing insurance thereon, to my husband, Victor D. Macomber, if he survives me by thirty days. Should my husband, Victor D. Macomber, not be living on the thirty-first day after my death, I bequeath such tangible personalty and insurance thereon to such of my children as are living on the thirty-first day following my death, to be divided among them by my Executor with due regard for their personal preferences in as nearly equal shares as practical. '. ITEM ill. I devise and bequeath the residue of my estate, of every nature and wherever situate, including any property over which I shall have any power of appointment, to my husband, Victor D. Macomber, providing he shall survive me by thirty days. ITEM IV. If my husband, Victor D. Macomber, does not survive me by thirty days, I devise and bequeath the residue of my estate, of every nature and wherever situate, including any property over which I shall have any power of appointment other than any such power given to me in any Will or inter vivos trust created by my husband, Victor D. Macomber, to Mid Penn Bank, Trustee of a certain Revocable Trust Agreement created by my husband, Victor D. Macomber on ...)0\1 2.3 Zoo ( , 2001, to have and to hold, IN TRUST, for the uses and purposes and subject to the terms and provisions thereof, including any alterations or amendments thereto, or any other inter vivos trust which may hereafter be submitted therefor. 009206-00002l7.12.01/RWS/DCP/147611.1 ITEM V: I appoint Mid Penn Bank, of Dauphin County, Pennsylvania, Guardian of my property which passes, either under this Will or otherwise, to a minor and with respect to which I am authorized to appoint a Guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not apply to property distributable to a minor for whom I have otherwise made special provision and provided further that this appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility to the minor, or to the minor's parent to any person taking care of the minor. ITEM VI. All federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my estate without apportionment or right of reimbursement, provided that any taxes in my estate on any portion of the revocable life trust created by my husband on :Jv\f ;:l3 ,2001, may be paid from the assets of that trust as provided herein. ITEM VII. My Executor and Guardian shall have the following powers in addition to those vested in them by law and by other provisions of my Will, applicable to all property, whether principal or income, including property held for minors, exercisable without court approval, and effective until actual distribution of all property: A. To retain any or all of the assets of my estate, real or personal, including stock of my corporate fiduciary, or of its parent holding company, without regard to any principle of diversification. B. To invest in all forms of property, including stocks, common trust funds and mortgage investment funds whether operated by my corporate fiduciary or others, without restriction to investments authorized for Pennsylvania fiduciaries, as they deem proper, without regard to any principle of diversification. 009206-00002l7.12.01/RWS/DCP/147611.1 C. 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 and conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. E. To borrow from, or to sell to, the Trustee under my husband's inter vivos trust mentioned above, even though such Trustee may be my Executor. F. To join my husband, Victor D. Macomber, or his personal representative in filing a joint income tax return without requiring him or his estate to indemnify my estate against liability for the tax attributable to his income and to consent to any gifts made by my husband during my lifetime being treated as having been made one-half by me for purposes of the federal gift tax law. ITEM VIII: I appoint my husband, Victor D. Macomber, Executor of this my last Will. Should my husband, Victor D. Macomber, fail to qualify or cease to act as Executor, I appoint my son, Dwight F. Macomber, and my daughter, Gay L. Macomber, Executors ofthis my last Will. Should all ofthe foregoing fail to qualify or cease to act as Executor, I appoint Mid Penn Bank, Dauphin County, Pennsylvania, Executor of this my last Will. ITEM IX: My corporate fiduciary shall be entitled to compensation based on its regular schedule of fees for such services in effect from time to time during the period over which its services are performed. ITEM X: I direct that my Executor and Guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ;?3.J.. day of Ju \ i ' 2001. ~fI) 1/tt~ (SEAL) ANDA W. MACOMBER 009206-00002l7.12.01/RWSIDCP/147611.1 .. . SIGNED, SEALED, PUBLISHED AND DECLARED, by Wanda W. Macomber, the Testatrix above named, as and for her Last Will and Testament and 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. #~~ Witness ~7(0~ Wi ess 'J.~ 1>- Address C-A~- /3f ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA :SS: COUNTY OF CUM BERLAND I, Wanda W. Macomber, Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~j...~ .~~Itl . WANDA W. MACOMBER Sworn to or afftrmed and acknowledged before me, by Wanda W. Macomber, the Testatrix, this ~ ((\ day of 3' U\J- ,2001. Notarial Seal Daria C. Parmer, Notary Public Lemoyne Boro, Cumberland County My Comml$Slon Expires Dec. 29, 2001 _ t.~t;""."",r p,,'<"')!'Y"~ f'~fooi.tit'tll,l' Not.rlll ~~ C rClJ~",- Notary Public My commission expires: 009206-00002/7.12.01/RWS/DCP/147611.1 " " " AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA :SS: COUNTY OF CUMBERLAND We, ~\<..W GJ 5tCh"'\- and~IZGA/L. ;;;...fi::/I.).::>, the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will and Testament; that she signed 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 the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time at least 18 years of age, of sound mind and under no constraint or undue influence. ~/Ydu --, ~d.Cf~ Sworn to or affirmed and subscribed to before me by ~,. (\JJ. 3~~ \ and \~e","" l. T u( "'S. , witnesses, this 2~ ."'C\ day of \J\ \ 2001. -~~~~ ?~ Notary Public My commission expires: CERTIFCATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: WANDA W. MACOMBER Date of Death: October 12, 2001 Will No.: 2001-01084 Admin No.: To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5 .6( a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on November 28, 2001; Name Address victor D. Macomber 3452 Lisburn Road, Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none. Date: ~~ L ;l[-( 4v~ Si ature Richard W. Stewart, Esq. Name Johnson, Duffie, Stewart & Weidner 301 Market St., P. O. Box 109 Lemoyne, PA 17043-0109 Address GC ,.- ".., =- {':' ::5 .. c:5 N (717) 761-4540 Telephone ..." rn co N -...1 Capacity: 0 Personal Representative [lg Counsel for personal representatiye '~~" -.J . Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Also known as WANDA W. MACOMBER No. 21-01-01084 Date of Death: Social Security No. 10/12/2001 385-20-9083 . Deceased L VICTOR O. MACOMBER Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation place opposite each item of said Inventory represent its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: RICHARD W. STEWART, ESQ. ~ S 'A--?~~C# ORO.M ~~EXECUTOR J.D. No.: 18039 Address: 3452 Lisburn Road Address:Johnson, Duffie, Stewart & Weidner Mechanicsburg, PA 17055 301 Market Street P.O. Box 109 Telephone: 717/766-6995 Dated: C' 1- ~'.2 - t::1"L Lemoyne, PA 17043 Telephone: (717) 761-4540 Description Value 1. 178 Pieces of Fine Art Date of death value $ 287,760.00 2. MidPenn Bank - Account No. 9013822 Date of death balance 1,830.39 3. MidPenn Bank - Account No. 9504085 Date of death balance 297.38 4. AUL Long Term Care Solutions, Inc. - refund 119.88 TOTAL: $ 290.007.65 r I 0:: W Z C W ~ ~ ~ CO') 0::;: ~ ~ <tClSm.....OO ~-IO"r"'"~N W'1U"r"'"<c"N ~CI)~a..~>' UJ >-_ ft ::J 0)....0)........., WftC . 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Internal Revenue Service fEll Cincinnati, OH 45999 Contact Person: Brian Kaufmann Badge Number: 17-14026 Telephone: 1-866-699-4083 (Toll Free Number) , i)'11 Februarv 12. 2003 Estate Tax Closing Dogum~m (Not a bill for tax due) RICHARD W STEWART ESO 301 MARKET ST PO BOX 109 LEMOYNE PA 17043-0109 Estate Name: WANDA W MACOMBER Social Security Number: 385-20-9083V Date of Death: 10/12/01 We have determined the following: NET ESTATE TAX: $ STATE DEATH TAX CREDIT: $ GENERATION-SKIPPING TAX: $ 0.00 0.00 0.00 These figures do not include any interest and penalties that may be charged. Please keep this document in your permanent records. You may need it to complete administration of the estate, such as: close probate proceedings, transfer title to property, and settle state taxes. Keep it with your cancelled check(s) to show that you have met the estate tax obligation. Proof of payment in the amount shown above releases you of personal liability (IRC 2204). If the time for payment in the amount shown above is extended under section 6161, 6163, or 6166, personal liability is not released until full payment has been received. We will not reopen this return unless you notify us of changes to the return, or there is evidence of misrepresentation of a material fact, a clearly defined substantial error based upon an established Service position or a serious administrative omission. (See IRC 7121). it . . Field Director, Cincinnati Compliance Service Center \, /?-c;t$- /-.3 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN '* REY-485 EX AFP 100-D2l RICHARD W STEWART JOHNSON HAL PO BOX 109 LEMOYNE "l-Y , ESQ I:~ 1C1 1_,. DATE ESTATE OF DATE OF DEATH FILE NUMBER '1 COUNTY ACN 08-19-2002 MACOMBER 10-12-2001 21 01-1084 CUMBERLAND 201 WANDA W Allount Rellitted PA ltb.43 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ REV=48i--EX--AFP-Toi":.-02r----.-.-ii;cfficE--OF--iETERMINAfIoN'-ANi-As-sEs'ifMENY----------------------- -- --- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF MACOMBER WANDA W FILE NO.21 01-1084 ESTATE TAX DETERMINATION ACN 201 DATE 08-19-2002 1. Credit For State Death Taxes as Verified .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed .00 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ 1--;; - ,2,.3- /-9 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER gOUNTY ACN 08-19-2002 MACOMBER 10-12-2001 21 01-1084 CUMBERLAND 101 RICHARD W STEWART JOHNSON ETAL PO BOX 109 LEMOYNE rr)'., ESQ Ul , PA 1704~,\ I ". .''. ,i Allount Rellitted '* REV-1541 EX AFP (01-021 WANDA W MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4-j-EX-AFP-foY=02Y-NOTicE--OF-YtiHEifiiA'NCE-TAirA"PPRA-isEi"-ENT~--AL1-oWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MACOMBER WANDA W FILE NO. 21 01-1084 ACN 101 DATE 08-19-2002 TAX RETURN WAS: [X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate [Schedule A) 2. Stocks and Bonds [Schedule B) 3. Closely Held Stock/Partnership Interest [Schedule C) 4. Mortgages/Notes Receivable [Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property [Schedule E) 6. Jointly Owned Property [Schedule F) 7. Transfers [Schedule G) 8. Total Assets [ ) CHANGED (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 290,007.15 .00 51, 090.53 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses [Schedule H) 10. Debts/Mortgage Liabilities/Liens [Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: DATE n~_~_' . NUI1BER [+J INTEREST/PEN PAID [-) (9) (10) 9,123.81 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 341,097.68 9.123 81 331,973.87 .00 331,973.87 14, 15 and/or 1&, 17, 18 and 19 will returns assessed to date. .00 .00 .00 .00 .00 .00 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) .00 (11) (12J (13) (14) 331,973.87 X 00 = .00 X 045= .00 X 12 = .00 X 15 = (19)= AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE C/~ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: WANDA W. MACOMBER Date of Death: October 12, 2001 Will No.: 2001-01084 Admin No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 2S. No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: . 3. If the answer to NO.1 is yes, state the following: A. Did the personal representative file a final account with the Court? Yes No 2S. B. The separate Orphans' Court No. (if any) for the personal representative's account is:. C. Did the personal representative state an account informally to the parties in interest? Yes No X The Executor and the surviving spouse of the decedent was the sole beneficiary. D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: dj;! ~ 3 ../c/ 4A- Signature Richard W. Stewart, Eso. Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemovne. PA 17043-0109 Address (717) 761-4540 Telephone No. Capacity: Personal Representative 2S. Counsel for Personal Representative / '? -c:2c::3 - /~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 RICHARD W STEWART ESQ JOHNSON ETAL PO BOX 109 LEMOYNE PA 17043 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' REV-15' EX AFP <O1-O2l 11-24-2003 MACOMBER 10-12-2001 21 01-1084 CUMBERLAND 202 WANDA W Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ...... RE-V:736--EX--AFP--[oi~-02)-----iii-Nifficif-oF--iETifRMliiATlo-N-Aiii-ASisEss-MENir---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF MACOMBER WANDA W FILE NO.2l 01-1084 ACN 202 DATE 11-24-2003 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified .00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed .00 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE. SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1. NO PAY"ENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) ,.,. oXIEXI&-OO). COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT REV-1500 OFFICIAL USE ONLY G 17- ),3-r~ ~._-,--~._------- FILE NUMBER 21-01 01084 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 385 - 20 I- Z W C W o W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) MACOMBER, WANDA W. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) October 12, 2001 February 14, 1927 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) victor D. Macomber w I-, ~:$UJ 0"''' w"O ",00 0"'.... .... .. '" [Xl 1. Original Return o 4. limited Estate [Xl 6. Decedent Died Testate (AUach oopy of Will) o 9. litigation Proceeds Received 9083 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 2. Supplemental Return o 4a. Future Interest Compromise (date of death aller 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrusl) D 10. Spousal Poverty Credit (dele of death between 12-31-91 and 1-1-95) o 3. Remainder Return (date of death prior 10 12.1J.82) IZl 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to lax under Sec. 9113(A) (AlIachSch0) ,TH",S SEC::'1:IO~ r.ltiSt,BE: COMPLETEp.'ALI.:C;:.RRESPONDt=NC; NAME I-, z w o z o .. '" w '" '" o o Richard W. Stewart Es FIRM NAME (If Appllcableb . Johnson, uffle, Stewart & Weidner TELEPHONE NUMBER ANqtiNF"IPE TIAI";-rAi((NFORMA'ndN:SHo:YTD'B~ojR 3:::tE;PlP:"i COMPLETE MAILING ADDRESS 301 Market St. P. O. Box 109 Lemoyne, PA 71043-0109 (717) 761-4540 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage liabilities, & Liens (Schedule I) 11. Total Deductions (total lines 9 & 10) 12. Net Value of Estate (line 8 minus Une 11) z o ~ :J !::: Q. < o w ~ (1) -0- OFFICIAL USE ONLY (2) -0- (31 -0- (4) -0- (5) 290,007.15 (6) -0- (7) 51,090.53 (B) 341,097.68 (9) 9,123.81 (10) -0- (11) (12) (13) 9,123.81 331. 973.87 -0- 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax has not been made (Schedule J) 14. Net Value Subject to Tax (Une 12 minus Une 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 331,973.87 z o !;;( I-' :J Q. :i!: o o >< ~ 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount ofUne 14 taxable at sibling rate 18. Amount of Une 14 taxable at collateral rate 19. Tax Due 20.0 > >BE SURE TO ANSWER ALL QUESTIONS ON .REVERSE SIDE AND RECHECK MATH < < 331,973.87 x.o~ (15) -0- x.O_ (16) -O- x .12 (17) O- x .15 (18) -0- (19) -0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS 3452 Lisburn Road CITY Mechanicsburg I STATE PA piP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credil B. Prior Payments C. Discount -0- Totai Credits (A + B + C ) (2) -0- 3. InteresVPenalty if applicable D. Inlerest E. Penalty (3) (4) (5) (SA) 4. TotallnteresVPenalty ( 0 + E ) If Line 2 is greater than Line 1 + Line 3, enler the difference. This is Ihe OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is grealer than Line 2, enter the difference. This Is the TAX DUE. -0- A. Enter the interest on the tax due. B. Enter lhe total of Line 5 + SA. This is the BALANCE DUE. (5B) - 0- Make Check Payable to: REGISTER OF WILLS, AGENT ~\f~l\I:i'lJ~':W~~~~,iI~~~~~~w~E!j!Elli;!lm,II~~;~1!;:~~,ill;;l PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right 10 designate who shail use the property transferred or its income; ............................................ 0 0. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death wilhout receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trusl for" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an individual Retirement Account, annuity, or other non-probate property which conlains a beneficiary designation? ........................................................................................................................ 0 No IKI IKI IKI !Xl ~ [Xl o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare lhat I have examined this return, including accompanying schedules and statements, and to the besl of my knowledge and belief, it is true, correct and complete. Dedaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. RESPONSIBLE FOR FILli'j/3 RETURN /' nVt ~ C:'e"-<' acorn er, xecu or 3452 Lisburn Road, Mechanicsburg, PA 17055 SIGNATURE OF PREPARER OTH T N ;;KTIVE DATE 07- (::J Z. C! ADDRESS ADDRESS DATE G-- ]7-02.- 301 Market st., P. O. Box 109, Lemoyne, PA 17043-0109 ~'.:_:;~:~~~;~~?ff~SS[~~g1/&;i.r;Z~~~fgif3~F~I~;S@Zf\,~D:yi:::~Sf:i~,:j;~~f~;;?~if~E1Jt1}~2:!f~-~~:~!~;D:~:.~f;Q;'0N€~;~ji;r;::~~7iT0i~T~Jd~IZ~iS~-tf:fbl~U~2:iifJ32(ti~i~n!IZid?:',- For dales of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax 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 twenty-one years of age or younger at death to or for the use of a nalural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)J. The tax rate imposed on the net value 01 transfers to or for Ihe use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers 10 or for the use of Ihe decedent's siblings is 12% [72 P.S. 99116(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. . FlEV.15Oll EX+ (1.97) ESTATE OF '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT MACOMBER, WANDA W. FILE NUMBER 21-01-01084 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sUNivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4 . DESCRIPTION VALUE AT DATE OF DEATH 178 pieces of Fine Art (See List attached) Date of death va1ue* *(Mrs. Macomber, the decedent, was the artist who painted practically all the paintings on the list and the values listed were the asking values by the artist) . 287,760.00 MidPenn Bank - Account No. 9013822 Date of death balance 1,830.39 MidPenn Bank - Account No. 9504085 Date of death balance 297.38 AUL Long Term Care Solutions, Inc. Refund 119.38 TOTAL (Also enteron line5, Recapitulation) $ 290,007.15 (If more space is needed, insert additional sheets of the same size) Paintine: Title 701 701 + 2 ADayofMeditation AddedDimensions Ages Past, CanyonDeChelly Ages Past, Canyon DeChelly No. N ALineofSight AmericanPyrarnid American PyramidNo. II Angel No. VI AngelNo.IX ArizonaLandscape Arizona Landscape ArizonaLandscape ArizonaLandscape Arizona Landscape ArizonaSeriesNo.II ArizonaSummitt Arizona Tapestry ArtDeco Transition A Terrace View At Peace with the Land August September Autumn A WindowWithin Baltimore BaltimoreHarbor Scene BeforeDawn BigBridge Black & White Collage Black Gold Blue Water Blue WaterPrint Bridge Canyon Canyon Series NO.1 Canyon Series No.2 Canyon Series No.2, Canyon NO.9 Canyon Series No. 7 Canyon Series No. S Canyon Series No. IS Canyon Tapestry No. 17 List of Fine Art Page 1 of5 Size 3S"x54" 40"x54" 26114" x 34" 36"x4S" 20112" x 30" 20"x30" 6"xS" 36" x 4S" 36"x4S" 16112" x 22112" 12" X 21I12" 29"x34" IS"x24" 20"x24" 22"x30" 22"x30" 19" x2S" 121/4" x 141/4" IS"x4S" 36"x4S" 141/4" x 27114" 20114" X 253/4" 21 X 291/4" 21" X 25112" 36" x4S" 40"x54" 36"x4S" IS"x IS" 40"x54" 12"x4S" 24"x36" 40"x54" 20"x2S" 2S"x4S" 19 x 2S" 191/4" X 2S1/4" 15" x 25" 141/4" x IS]/4" 19" X2S112" 20"x27" 111/4" x 141/4" 12"x20" Value $ 4,500.00 4,500.00 1,800.00 4,500.00 750.00 750.00 50.00 3,500.00 3,500.00 400.00 285.00 500.00 500.00 500.00 400.00 400.00 350.00 125.00 1,800.00 6,000.00 550.00 575.00 1,200.00 500.00 3,000.00 4,500.00 4,500.00 250.00 5,000.00 500.00 750.00 5,000.00 75.00 2,000.00 650.00 500.00 350.00 350.00 500.00 500.00 175.00 250.00 Artist Nancy Ames Reed List of Fine Art Page 2 of5 Paintinl! Title Size Value Artist Central Soya 38"x40" $ 900.00 Cities, Today & Tomarrow 12"x38" 500.00 City of Gold 18114" x 221/8" 385.00 City TransitionNo. VII 14"x24" 150.00 Cloud Capture 30"x54" 4,500.00 Cloud Cover 36"x48" 4,500.00 CloudWalk 40"x 54" 4,500.00 Clouds Under Glass 40"x54" 4,500.00 Contained 18"x32" 1,000.00 Death Cry 17"x 18112" 250.00 Departure 36"x48" 3,000.00 DimensionE 15"x22" 150.00 Strickland DouglasArizona 18"x22" 500.00 Dusk 38"x50" 4,000.00 Earth's Treasure 12" x 16" 225.00 Earth's Treasure No. ill 121/4" X 181/4" 225.00 Earth's Treasure No. IV 121/4" X 21112" 300.00 Earth's Treasures 153/4" X 18" 150.00 Enunciation 223/4" x 303/4" 850.00 JanvanEyck Ethereal Series No. I 21"x34" 650.00 Ethereal Series No. n 22"x34" 650.00 Ethereal Series No. ill 36" x 48" 1,000.00 Ethereal Series No. IV 36"x48" 1,000.00 Ethereal Series No. V 30"x42" 650.00 Fields of Glory 185.00 Flight of the Clouds 40"x54" 5,400.00 ForestEtude 22"x24" 1,000.00 Fort No. n 6"xlO" 175.00 FullMoon 30"x42" 2,000.00 Full Sail No. I 42"x54" 3,000.00 FullSailNo.ill 36" x48" 3,000.00 Globe, Arizona 18"x24" 350.00 InwardJourneyNo.n 900.00 Inward Journey No. ill 131/4" X 22114" 460.00 Island of San Juan 400.00 Jettisoned West 18"x37" 2,000.00 JungleHeat 24"x24" 800.00 Lake Powell No.n 30"x42" 2,000.00 Lake Powell No. ill 21"x243/4" 450.00 Light and Space 20"x24" 600.00 Light TransitionNo. IV 36"x42" 900.00 Lunar Temple 36"x48" 3,000.00 List of Fine Art Page 3 of5 Pain tine Title Size Value Artist Mary 151/4" X 19112" $ 400.00 Mauve City No. IT 20"x36" 1,000.00 MechanismNo. I 38"x54" 4,000.00 Mimey 22\/4" X 221/4" 350.00 Minnie 22114" x 221/4" 350.00 Montage No.2, Collage 12"x48" 750.00 Mushrooms 24"x36" 2,000.00 My ViewZilwaukee 40"x54" 5,000.00 Network 42"x48" 3,000.00 Network No. IT 32"x48" 4,000.00 New York 10" x 16" 225.00 Night Cityscape 20"x24" 300.00 Night Magic No. I 163/4" x 151/4" 325.00 Night Magic No. IT 133/4" x 131/4" 275.00 Night Magic No. ill 151/4" x 181/4" 300.00 Night Magic No. IV 151/4" X 181/4" 300.00 NightMagicNo. V 151/4" X 201/4" 300.00 NightMagicNo. VI 113/4" X 20" 275.00 NightMagicNo. vn 133/4" x 20114" 325.00 Night Magic No. VII 143/4" x 18114" 380.00 NightMagicNo. IX 131/4" x 181/4" 350.00 NightMagicNo. X 131/4" x 171/4" 350.00 Oasis 40"x54" 6,000.00 Oil Montage 34"x48" 3,000.00 Onward Upward 36"x48" 4,500.00 Open Door 40"x54" 4,500.00 Passing Through 36"x48" 4,500.00 Patterns of the Past 20"x30" 750.00 PennsylvaniaHills 16"x42" 750.00 Rebirth 12" x 12" 300.00 Reflected Glory 30"x54" 3,500.00 Road Stop 18"x40" 2,000.00 San Juan Fort No. ill 193/4" x 253/4" 425.00 Sea Series No. IT 42"x54" 5,500.00 Sea WorldNo. IT 15112" x211/4" 375.00 Second Street 18"x48" 1,000.00 ShimmeringNight 14"x21" 300.00 Sky & Sea 40"x54" 5,000.00 Skyward 13"xI5" 350.00 Small Windows - Series No. I 13"x 16" 185.00 Small Windows - Series No. IT 12"x 18" 185.00 List of Fine Art Page 4 of5 Paintine Title Size Value Artist Small Windows - Series No. ill 12112" X 15112" $ 185.00 Small Windows - Series No. IV 11112" X 15112" 185.00 Small Windows - Series No. V 13"x 18" 185.00 Small Windows- Series No. VI 123/4" X 151/4" 185.00 Smelter Plant 28" x38" 3,000.00 Snow Painting 22"x30" 350.00 South Western Montage No. ill 20"x30" 750.00 South WesternMontageNo. IV 20"x30" 750.00 South Western Montage No. V 21"x29" 750.00 South Western Montage No. VI 111/4" x 161/4" 225.00 Space Age 1989 15" x 183/4" 600.00 Space Piece 21"x29" 350.00 Space TransitionABC 48" x 108" 2,400.00 SpaceWalkNo.I 211/4" x 221/4" . 400.00 Space Walk No. IT 16" X 261/4" 400.00 Space Walk No. ill 141/4" X 221/4" 325.00 Space Walk No. IV 181/4"x23" 425.00 Space Walk No. V 131/4" X 231/4" 375.00 Space Walk No. VI 13"x201/4" 325.00 StillLife 24"x30" 150.00 Boggs Strawberry Square 36"x48" 4,000.00 Strawberry Square No. I 40"x54" 4,500.00 Strawberry Square Collage 20" x20" 150.00 Summer Shadows No. IT 26"x54" 2,000.00 SunReflecred3Bridges 36"x48" 4,000.00 Superstition Mountain 20"x24" 300.00 The5:18 30"x40" 3,000.00 The Day the Clouds Came Down 40"x54" 5,400.00 The Fort at SanJuan 171/4" x 221/4" 385.00 The Fort No. ill 20"x26" 425.00 The Maze 36"x48" 4,500.00 TheMeetingPlace 36"x48" 4,500.00 The Red Doors 161/4" x 143/4" 450.00 The Sentinal 36"x48" 4,500.00 The Sentry SanJuan 171/4" x 211/4" 385.00 The Sentry 36"x50" 3,000.00 The Vista 40"x54" 5,000.00 Three Angels 13112" x 161/4" 225.00 TransitionNo. II 30"x42" 2,000.00 TransitionNo. IV 24'~x36" 4,000.00 TransitionNo. XI 38"x48" 4,000.00 TransitionBlue Water 36"x48" 4,500.00 Totals 178 pieces $ 287,760 ~.""~"'.n '*' COMMONWEAlTH OF PENNSYLVANlA 'NHERlTANCE TAX RETURN RES' DENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY ESTATE OF MACOMBER, WANDA W. FILE NUMBER 21-01-01084 This schedule must be completed and filed W the answerto any of quaslions 1 through 4 on tha reverse sIde of the REV.1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INClUOETllENoWEOfTHETRANSfEREE.1llEIRRElATlOHSHIJlTODECSlENTANOTHE OA.TEOFTRANSFal. DATE OF DEATH DECD'S EXCLUSI~~ TAXABLE VA ATTAQl A COPY Of TliE oeeo FOR REAl ESTATE. NUMBER VALUE OF ASSET INTEREST nFAPPlICA.BtE 1. Allfirst Bank - Individual Retirement Account Account No. 8-700-025-8342001 Beneficiary: 51,090.53 100% 51. 090.53 Victor D. Macomber, Spouse I. - TOTAL (Also enter on line 7, Recapitulation\ $ 51,090.53 (If more space Is needed, Insert additional sheets of the same size) REV-15'1 EX+ (12-99) . . ~.,~..O 1f>('~Vflf :>'1'1 .~~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF MACOMBER, WANDA W. FILE NUMBER 21-01-01084 Debts of decedent must be reported on Schedule J ITEM AMOUNT NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1. 2,884.00 Myers Funeral Home B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representalive(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City Slale _ Zip Year(s) Commission Paid: 2. Attorney Fees - Johnson, Duffie, Stewart & Weidner 2,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, aUach explanation) Claimant Victor D. Macomber Street Address 3452 Lisburn Road 3,500.00 Cily Mechanicsburg, Slala~Zip 17055 Relationship 01 Claimant to Decedent Husband 4. Probate Fees - Register of Wills - Cumberland County 48.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Cumberland Law Journal - legal advertisement 75.00 8. The Patriot-News - legal advertisement 96.81 9 . Register of Wills - file Inv. & Inheritance Tax Return 20.00 TOTAL (Also enter on line 9, Recapituiation) $ 9,123.81 (If more space is needed, insert additional sheets of the sama size) - REV..,miOX.!,.S7) ESTATE OF NUMBER I. SCHEDULE J BENEFICIARIES . , FILE NUMBER 21-01-01084 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Husband AMOUNT OR SHARE OF ESTATE Tangibles and Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT MACOMBER, WANDA W. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) victor D. Macomber 3452 Lisburn Road Mechanicsburg, PA 17055 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size)