HomeMy WebLinkAbout06-21-05
WIX, WENGER & WEIDNER
RICHARD H. WIX
THOMAS L WENGER
DEAN A. WEIDNER
STEVEN C. WILDS
THERESA L SHADE WIX'
DAVID R GETZ
STEPHEN J. DZURANIN
STEVEN M. WILLIAMS
JEFFREY C. CLARK
PETER G. HOWLAND
STEPHEN P SMITH
KATHRYN L WIX
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
508 NORTH SECOND STREET
POST OFFICE BOX 845
HARRISBURG, PENNSYLVANIA 17108-0845
4705 DUKE STREET
HARRISBURG, PA 17109-3099
(717) 652-8455
FAX (717) 652-6290
. Also Member Massachusetts Bar
(717) 234-4182
FAX (717) 234-4224
www.wwwpalaw.com
June 22, 2005
Ms. Glenda Farner Strasbaugh
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
( '.
..,_f.,'
Re: Estate of Clayton E. Zimmerman
Estate No. 21-05-0162
Dear Ms. Strasbaugh:
We enclose the following documents for filing on behalf of the above-captioned
estate:
1. The original and two copies of the Inheritance Tax Return;
2. Our check in the amount of $349.88, made payable to the "Register of
Wills, Agent," representing the additional inheritance tax due;
3. Our check in the amount of $15.00, made payable to the "Register of
Wills," representing the filing fee for the tax return;
4. The original and one copy of the Inventory; and
5. Our check in the amount of $10.00, made payable to the "Register of
Wills," representing the filing fee for the Inventory.
Please process these documents at your earliest convenience and return time-
stamped copies to our office. A self-addressed, stamped envelope is enclosed for your
convenience.
WIX, WENGER & WEIDNER
Ms. Glenda Farner Strasbaugh
June 22,2005
Page 2
Thank you for your assistance in this matter. If you have any questions
regarding the above, please call me.
Sincerely,
By:
GER & WEIDNER
! tLV}(J#~
nise B. Williamson
Paralegal
/dbw
Enclosures
cc: Mrs. Beulah A. Barger
Thomas L. Wenger, Esquire
c,,<~:
-~,,"<~
-
Ii REV.150G.~X + (6.00)
'*
COMMONWEALTH OF
PENNSYL VANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 5 0 1 6 2
""COuNTYCOOE ---VEAR- - - N'UMBER- -
I-
Z
W
C
w
U
W
C
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
Zimmerman Cia ton E.
DATE OF DEATH (MM-DD-Year)
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
1 5 9 - 0 9 - 5 6 2 5
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
02/12/2005 10/23/1912
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
SOCIAL SECURITY NUMBER
W
f-
:0:: :! U)
uD:::O::
w~u
:I:D::g
u a-Cll
a-
c{
IX] 1. Original Return
D 4. Limited Estate
[KJ 6. Decedent Died Testate (AttachcopyolWillj
D 9. Litigation Proceeds Received
D 2. Supplemental Retum
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (AttachcopyofTrusl)
D 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-'-95)
D 3. Remainder Return (date of death prior to '2-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach SchO)
THIS SECTION MUST BE COMPLtreD..AL.L CORRESPONDENGE!AND.COtll: DEtal.L TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Thomas L. Wen er Es uire 508 North Second Street
FIRM NAME (II Applicable)
WIX, WENGER & WEIDNER P.O. Box 845
TELEPHONE NUMBER
717 234-4182 Harrisbur PA 17108-0845
f-
Z
W
o
z
o
a-
U)
w
D::
D::
o
U
z
o
i=
<(
-l
:::>
I-
a..
<(
u
W
0::
z
o
i=
<(
I-
:::>
a..
:::!:
o
u
X
<
I-
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) (6)
D Separate Billing Requested
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
OFFICIAL USE ONLY
(1)
(2)
(3)
(4)
(5)
0.00
46,880.63
0.00
0.00
67,970.90
0.00
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9 Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11 Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
114,851.53
(8)
18,010.81
176.87
(11)
(12)
(13)
18,187.68
96,663.85
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
96,663.85
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 of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
0.00 X _(15) 0.00
96,663.85 X .045 (16) 4,349.87
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 4,349.87
20 D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE\TO ANSWERALQUESTIONS ON REVERSE SIDE AND; RECHeCK MATH . < <
:!oo.....~;'"'"'__...~~"_""'~.".,_;",..,....._...
Decedent's Complete Address:
STREET ADDRESS
129 Clouser Road
CITY
Mechanicsburg
STATE
PA
ZIP
17055
Tax Payments and Credits:
1. T ax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
4,349.87
3.800.00
199.99
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
(2)
3,999.99
Total Interest/Penalty ( 0 + E) (3)
4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check to: REGISTER OF WILLS, AGENT
0.00
0.00
349.88
349.88
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; ........................................................................... 0 IXJ
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IXJ
c. retain a reversionary interest; or ...................................................................................................... 0 IXJ
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IXJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. 0 IXJ
3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ................. 0 IXJ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 IXJ
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 pequry, I declare that I have examined this return, including accompanying schedules and statements. and to the best of my knowledge and belief. it is true. correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF P SON RESPONSIBLE FOR ING RETURN DATE
~-;?~-o
DATE
ADDRESS
ADDRESS
Q
homas L. Wenger, Esquire/WIX, E GER & WEIDNER
508 North Second StreeUP.O. x 845, HarrisburQ, PA 17108-0845
For dates 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 PS S9116 (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. S9116 (a) (1.1) (i1)].
The statute does not plt'pmnt ., tr~~~'-- '- " surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
{\~Yb
.3: t:\'L\ST
1sfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
1116(a)(1.2)].
Isfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)].
sfers to or for the use of the decedent's siblings is 12% [72 P.S. s9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
Imon with the decedent, whether by blood or adoption.
Il_~~__.'>-"""",,,,,",,,~,,,~,,,.
REV-1;;02 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
EST ATE OF FILE NUMBER
Zimmerman. Clayton E. 21 05 0162
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller. neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real oroDerty which is iointlv-owned with riaht of survivorship must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
None
0.00
TOTAL (Also enter on line 1. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0.00
..
REV-1~03 EX + (6-98)
'*
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Zimmerman. Clayton E.
FILE NUMBER
21 05
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0162
ITEM
NUMBER
1
DESCRIPTION
50,000 GMAC Smartnotes 3.35% (CUSIP 3704AOJS2)
held at Wachovia Securities
VALUE AT DATE
OF DEATH
46,880.63
VALUATION DOCUMENTS ATTACHED
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
46,880.63
REV-1~04 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSEL Y.HELD CORPORATION,
PARTNERSHIP OR
SOLE.PROPRIETORSHIP
ESTATE OF
Zimmerman. Clayton E.
FILE NUMBER
21 05
0162
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
None
0.00
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0.00
~/l' -..;..,..___~;;.a,;"....,._".~~~-,~.,
REV-1507 EX + (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
Zimmerman. Clayton E.
FilE NUMBER
21 05
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
0162
ITEM
NUMBER
1
DESCRIPTION
VALUE AT DATE
OF DEATH
None
0.00
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
0.00
.....~....;;~~
'Jft.1~
REV-1.508 EX + (6-98)
'*
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Zimmerman. Clayton E.
FILE NUMBER
21 05
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0162
ITEM
NUMBER
1
DESCRIPTION
Wachovia Securities Money Market Account
VALUE AT DATE
OF DEATH
90.52
3.
Sovereign Bank Checking Account
DOD Balance: $15,072.50
Accrued Interest: $64.22
Sovereign Bank Money Market Account
DOD Balance: $30,879.20
Accrued Interest: $46.10
Savings Bonds
(itemization attached)
15,136.72
2.
30,925.30
4.
21,818.36
VALUATION DOCUMENTS ATTACHED
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
67,970.90
'^"."".;,i.._",.,."-.'''';''-'__.;'''''.''~'''''''''''_'"_""~~~'> ,. .,^,......o,..,.--...._,"';__~"-.,.,_~"_"....,"..,,
"'~.~'"..__.....-........_~I_~_~'".,..O_
REV-1;;09 EX + (6-98)
'*
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zimmerman. Clayton E.
FILE NUMBER
21 05
0162
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
B
c
JOINTLY -OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
TOTAL (Also enter on line 6, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
r 1iIl1lo.'\1....~_._U___....,,~",
REV-1:;10 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBA TE PROPERTY
ESTATE OF
Zimmerman. Clayton E.
FILE NUMBER
21 05
0162
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAl ESTATE VALUE OF ASSET INTEREST (IF APPlICABlEI VALUE
1 None 0.00 0.00
TOTAL (Also enter on line 7 Recapitulation) $ 0.00
(If more space is needed. insert additional sheets of the same size)
REV-H;11 EX + (12-99)
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zimmerman. Clavton E.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
FUNERAL EXPENSES:
Musselman's Funeral Home
Slate Hill Cemetery
Pastor Donations
James R. Gingrich Memorials
1.
2.
3.
4.
B
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Beulah A. Barger
Social Security Number(s)/EIN Number of Personal Representative{s)
Street Address 129 Clouser Road
City Mechanicsburg State PA
Year(s) Commission Paid: 2005
1.
2.
3.
Attorney Fees Wix, Wenger & Weidner (estimated)
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
Relationship of Claimant to Decedent
4.
Probate Fees Cumberland County Register ot Wills
5.
Accountant's Fees
6.
Tax Return Preparers Fees
7.
8.
9.
Cumberland Law Journal
The Sentinel
Wi x, Wenger & Weidner (estimated out-ot-pocket costs)
FILE NUMBER
21
05
0162
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
Zip 17055
Zip
AMOUNT
7,037.00
625.00
125.00
100.00
5,750.00
3,750.00
315.00
75.00
158.81
75.00
18010.81
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zimmerman. Clayton E.
FILE NUMBER
21
05
0162
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
Verizon
25.13
2.
West Shore EMS-BLS
151.74
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
176.87
"..'W";..~,,,,,,,,,,,",,,,,_.,,,,_,,,,,,,,,,~_,,,,,,,,,>_,,,,,~_"_"';"""'''l__';~''''
''',"'m.'',*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
Zimmp.rm;:ln r.1;:lvtnn E. 21 05 01R?
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s} OF ESTATE
I. TAXABLE DISTRI BUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1 Cephas Zimmerman Lineal 32,221.28
257 Salem Church Road
Mechanicsburg, PA 17050
2, Lester Zimmerman Lineal 32,221.28
406 Cocklin Street
Mechanicsburg, PA 17055
3. Beulah A. Barger Lineal 32,221.29
129 Clouser Road
Mechanicsburg, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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
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)
"~"""".""..~,<<,,-_ r
: '!'
lHast 2fllIill cllt~ ~~2stam~nt?
"-,
__J
- -'.I
OF
--.I
CLAYTON E. ZIMMERMAN
..: '''11
- ..>",
I, CLAYTON E. ZIMMERMAN, of the Borough of Mechanicsbu~,
County of Cumberland and state of Pennsylvania, being of sound
and disposing mind, memory and understanding, do make, publish
and declare this my Last will and Testament, hereby revoking and
making void any and all prior wills by me at any time heretofore
made.
1.
I order and direct the payment of all my just debts and
funeral expenses as soon after my decease as the same can be
conveniently done.
2.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, of whatsoever
nature and wheresoever situate, to my wife, THELMA I. ZIMMERMAN,
absolutely and unconditionally.
3.
In the event my wife, THELMA I. ZIMMERMAN, should predecease
- 1 -
, \
me, or should she die at about the same time ,as I do, such as in
an accident common to both of us, then in such event, I give,
devise and bequeath my entire estate, of whatsoever nature and
wheresoever situate, to my three (3) childen, to wit: CEPHAS C.
ZIMMERMAN, BEULAH A. BARGER, and LESTER J. ZIMMERMAN, share and
share alike, per stirpes.
4.
For the purpose of facilitating the settlement and
distribution of my estate, I authorize and empower my Executors
hereinafter named to sell any and all real estate which I may own
at the time of my decease at either public or private sale or
sales.
5.
LASTLY, I nominate, constitute and appoint my wife, THELMA
I. ZIMMERMAN, to be the Executrix of this, my Last will and
Testament, and in the event my said wife should predecease me, or
should she be unable or unwilling to serve in such capacity for
any reason, then in such event, I nominate, constitute and
appoint my son, CEPHAS C. ZIMMERMAN and my daughter, BEULAH A.
BARGER, Co-Executors of this, my Last will and Testament, in her
place and stead, each and all to serve without bond or other
- 2 -
'. "
security for the faithful performance of their duties in any
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 1/
day of March, A. D. 1998.
~.~-
Cla~n E. Zimmerman
( SEAL)
Signed, sealed, published and declared by the above named,
CLAYTON E. ZIMMERMAN, as and for his Last Will and Testament, in
the presence of us, who, at his request and in his presence, and
in the presence of each other, have hereunto subscribed our
names as witnesses.
- 3 -
.. ..
COMMONWEALTH OF PENNSYLVANIA)
SSe
COUNTY
OF
CUMBERLAND)
I, CLAYTON E. ZIMMERMAN, the testator whose name is signed
to the attached or 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 and deed, for the purposes therein contained.
Sworn and affirmed to and acknowledged before me by
CLAYTON E. ZIMMERMAN, the testator, this lifl-- day of March, 1998.
COUNTY
OF
CUMBERLAND)
COMMONWEALTH OF PENNSYLVANIA)
:. ss.
We, the undersigned, J. ROBERT STAUFFER and SUSAN A. McCOY,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, depose and
say that we were present and saw the testator, CLAYTON E.
ZIMMERMAN, sign and execute the instrument as his Last Will and
Testament; that the said testator, CLAYTON E. ZIMMERMAN, executed
it as his free and voluntary act for the purposes therein
expressed; that each of us, in the hearing and sight of the
testator, signed the will as witnesses; and that to the best of
our knowledge, the testator was, at the time, eighteen (18) or
more years of age, of sound mind, d un er no constraint, duress
or undue influence.
Sworn and subscribed to before
me this //-f..-- day of March, 1998.
~flA;:J(_ [' W~
Nota~y J;blic
- 4 -
FROM :PURSELL ASSOCIATES INC
FAX NO. :7172433216
Apr. 19 2005 09:28AM P1
_.~_-.-.J-
_.--
\..-.-:
April 1, 2005
.Wix., Wenger & Weidner
508 North Second Street
Post Office Box 845
Harrisburg, P A 17108
Dear Ms. Williamson:
Per your request dated March 22,2005, below I am providing you with the
information pertaining to the Individual account for Mr. Clayton Zimmerman, who
passed away on February 12,2005.
'.,---'
Clayton E. Zimmerman
6621-1182
QUANTITY DESCRIPTION PRlCE ACCRUED VALUE
50.000 GMAC Smartnotes 3.35% 04/15/2007 93.51 125.63 46,880.63
Death Put Option Available**
90.40 Money Market 1.00 .12 90.52
Total Account Value.. ... . .. . . .. . . . . . . . .. . . .. . ., . . . . .. . " .. . . .. .. . . ., . .. .... '" _ ... 46,971.15
If you need any additional information, please contact me at 717-243-0619.
Barbara Miller, Associate
Pursell Associates Inc.
** Death Put option allows this item to be exercised at par value
',,--,,"
205 York Road · aUlisle, PA 17013 · (717) 243--0619 · 1-866-443-0619 · Fax (71") 2.43-3216
. .
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Clayton E. Zimmerman
159-09-5625
February 12,2005
Account #: 1681707136 Type: Checking
In the name of: Clayton E Zimmerman or Thelma I Zimmerman
Date of Death Balance: $15,072.50
Int.(YTD) from 1/1/05 to 2/12/05
Accrued interest to date of death: $0.00
Other Info:
Open date:
9/3/97
$64.22
Account #: 1681733765 Type:
In the name of: Clayton E Zimmerman
Date of Death Balance:
Int.(YTD) from 1/1/05 to
Accrued interest to date of death:
Other Info:
Money Market
Open date: 10/28/03
$30,879.20
1/31/05
$0.00
$46.10
Page 1 of 1
t::
o
Q.
Q)
0:::
~
I..
o
-
s:::
Q)
>
s:::
~
o
+-'
C
Q)
>
c
Q)
>
:.;::::;
()
<(
l.() l.()~
00
00
NN
-- --
1"- N
00
--
(0 ..
00)
-
.. CO
20
CO
Oc
-'0
.~ 'C
ttCl..
0)
LL
!<< 1<<
I
CIl
....
o <<
z
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
<<
>. I
....
'C
:::::J
7;S-s:!
:!:co
_0
co
t:
LL
--
....
III
e ~~~~~~~~~~~~~~~~~~~~~~~~~~~
CIlCllOOOOOOOOOOOOOOOOOOOOOOOOOOO
........000000000000000000000000000
t:CONNNNNNNNNNNNNNNNNNNNNNNNNNN
....O~~~~~~~~~~~~~~~~~~~~~~~~~~~
~ 000000000000000000000000000
f ~ ~ ~I~ ~ ~ eft. eft. eft. eft. eft. ~ eft. eft. eft. eft. eft. eft. eft. eft. eft. eft. eft. eft. eft. eft. eft.
I ~ lro ro ::n ::n ::n ::n ~ ~ ~ to to ::n ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
'>-!!! ~I~ ~ ~ ~ C"') C"') C"') C"':! C"! C"! ~ ~ C"') C"') C"') C"') C"') C"') C"') C"') C"') C"') C"') C"') C"') C"')
~~~~~"<t"<t"<t"<t"<t"<t~~~~~~~~~"<t"<t~~~"<t"<t
tOtOt'-t'-t'-t'-t'-t'-t'-tOtOt'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-
NNNNNNNNNNNNNNNNNNNNNNNNNNN
000000000000000000000000000
NNNNNNNNNNNNNNNNNNNNNNNNNNN
................-....---....-....---------....---....-....-....-....-....-....---....-.....-...-..---....-............
NN~~~~~~~NN~~~~~~~~~~~~~~~~
000000000000000000000000000
I
CIlIeft. $ $ $ $ $
7;S:I~NNC"!C"!N
O:::C"')MMC"')C"')C"')
!
[0000000
OO~~~~~
CIli~ ~ Lri Lri ~ Lri ~
:::::J IN.N en en en en en
iO t'-.t'-.~ ~ ~ ~ ~
>~~
,EI7! I
I I
000
....~~~
1Il"<t"<t~
CIlNNen
~ t'-. t'- ..-
....1-.:- ~
.E I EI7
eft. eft. eft.
~~ ~
C"!C"!C"!
C"') C"') C"')
eft. eft. eft. eft. eft. eft. eft. eft. eft. eft. eft.
~~~~~~~~~~~
NNNNC"!C"!NNNNN
MMMMC"')C"')MMMMM
eft. eft. eft.
~~~
C"!C"!C"!
C"')C"')C"')
~~
~~
C"!C"!
C"') C"')
~?ft.
~~
NN
MM
00
~~
LriLri
en en
~~
OONNNNNNNNNNNNNNN~
~~~~~~~~~~~~~~~~~~
NN~~~~~~~~~~~~~en~en
t'-t'-C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')~
~~~~~~~~~~~~~~~~~
OOOOOOOONNNNNNNNNNNNNNN~
~~~IDIDID~~~~~~~~~~~~~~~~~~
~LriLriLri~LriNN~~~~~~~~~~~~~~~en
enenenenenent'-t'-C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')..-
-,:-~,....,....,....,....,....,....
I
!g g g ~ ~ ~ ~ ~ ~
CIllolooooo000
,~ ~ gig ~ ~ ~ ~ ~ ~ ~
Q: ~ILri I
I I
tOltO t'-
~!~ ~
""'1"'" ,....
NiN co
010 0
000
~~~
000
000
..- ..- ..-
00000
00000
00000
00000
,.... ,.... T""" ,.... ,....
0000
~~~~
0000
000~
..- ..- ..-
0000
~~~~
0000
0000
~ ~ ..- ..-
00
00
00
00
...- ..-
'CIl CIl
I :J ....
III co
,!!!O
t'-t'-t'-t'-t'-t'-tOtOt'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-
en en en en en en en en en en en en en en en en en en en en en en en en
en en en en en en en en en en en en en en en en en en en en en en en en
,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....,....
-....-----....-....-....-------...---....-....-....-...-...-....-....--........-...-....-...-....
~~~~~~NN~~~~~~~~~~~~~~~~
000000000000000000000000
... I ': I I
~ WWWWWWWWWWWWWWWWWWWWWWWWW
Ewwwwwwwwwwwwwwwwwwwwwwwwwww
:::::JwwC"')"<t~~t'-tOo..-en~~~~R~~~~~~ffi~~~~
zgo~~~~~~g~~~~~~~~~~~~~~~~~o
-= I 0 0 t'- t'- t'- t'- t'- t'- t'- ..- ..- en en en en en en en en en en en en en en en ..-
~NN"<t"<t"<t"<t"<t"<t"<tNNOOOOOOOOOOOOOOON
"'tOtOtOtOtOtOtOtOtOtOtOt'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-t'-..-
CIlNNtOtOtOtOtOtOtOOOC"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')C"')..-
~~~~~~~~~~t'-t'-..-..-..-..-..-..-..-..-..-..-...-..-..-..-..-~
XX~~~~~~~~~~~~~~~~~~~~~~~~U
EIOIIOO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0100000000000 N N N N N N N N N N N N N N N..-
a; OO,......~~l~.;.;,.......;~ i
C~,,....: l
III
CIl
'C
CIl
~
(J)
-0
c:
o
co __
, , I
WIW LLJIW W W W L.U W W W W W W W W W W W W W W W W W W W
WWW1WWWWWWWWWWWWWWWWWWWWWWWW
~I"- N C"'):"<tl~ ~ t'- to en ~ ~ ~ ~ ~ ~
I,
~I~ ~
enO..-NC"')"<t~~t'-
...-NNNNNNNN
<<
~
C"')
to
..-
to.
CIl"-
.=~
co
>
~
C"')
to
....~
lilt'-
CIlLri
~E17
....
.E
o
~
o
~
CIl O.
(,)~
;tE;l
(J)
CO
-
o
I-
o III
C-gt'-
a>ON
~1O
'+-
o
aJ
Ol
ro
ll..
'0'0
aJ_
::JO
rnrn
,!!2....CQ)
C m.Q ro
al >. ro '0
.olnU'O
-rn-6Q)
~:; Q) g'
-c~ro
Ooro.c
Z.o'O~
rnQ)cQ)
ro.co....
.c-uo
'O:E31'O
cC'Q)
O::JUl.c
I .o>.orn
I''O'-C.ro
g_Cii....u
I.oZ a5E~
IOQ.'O-
I -31E
c:......~~L...
ro a5 ....:<:: ,Q
oE~c.a.
- >", E .$
as ~fi Q) ro
cX'O
g'OoQ)ro
ro-Exc
i3~M~O
X,QroQ)'O
wgrn.o8
rn W Q) ~'c
ro Q) '0 E c.
:i: >..2 Ol
'0 _ g ~ ,S
C 0._ ro Q)
OZ'O .0
.orncorn
. .- ro C]) .-
X'Or--~:;
wgC])~.o
o.o~ro-o
I~~C:
cwroffi.8
-Z::2:....,
"C. ,-,-I
Q) Q)Q)I
.c .;::.;:: c
rn rororo
rn...... '- L..
!Urnooo
C/)~cclot-
ro Q)'-'- '0
:i:'E'O'O Q)
'0 .- ~ ~ g'
cOlrnrnro
.8 .S.!!! rn.c
, E rn';;;~
_rororoLlJ
UQ):i::i:
oouiuio
c LlJ LlJ C
1:),-10...-
coo'O
ro__~
'Ornrnrn
Q)Q)Q)ro
.a .~ .~ U
<4,(f)(f)rn
:Eroro~
.!!!.!!!.!!! '0
'O'O'Oc
ccco
000.0
.0.0.0
--
-
:i:
.n
(/)
~
ro
E
E
:::::J
Cf)
(/)
'0
C
o
a:l
(/)
Ol
C
'S;
ro
~
--
c
ro
E
....
aJ
E
E
N
<4, In <<
:E':o
...-
o
to
--
(/)
aJ
1\1
en
LlJ
~
.n
"0
-:-:
LL
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
WENGER TOMAS L
508 N 2ND ST
PO BOX 845
HARRISBURG, PA 17108-0845
____n__ fold
ESTATE INFORMATION: SSN: 159-09-5625
FILE NUMBER: 2105-0162
DECEDENT NAME: ZIMMERMAN CLAYTON E
DATE OF PAYMENT: 06/27/2005
POSTMARK DATE: 06/23/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2005
NO. CD 005490
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $349.88
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 4152
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$349.88
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS