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HomeMy WebLinkAbout09-07-05 COMMONWEALTH Of PENNSYLVANIA REV- 1162 EX(1 1-96) OEPARTMENT Of REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 005772 FREY ROBERT M 5 S HANOVER STREET CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER --~---~- lold __n_n___ ~nn_n 101 I $96.00 ESTATE INFORMATION: SSN: 174-05-2486 I FILE NUMBER: 2105-0358 I DECEDENT NAME: WEIMER EMMA F I DATE OF PAYMENT: ~t/07/2005 i I POSTMARK DATE: )a/07/2000l\fC>'.l I COUNTY: CUMBERLAND I DATE OF DEATH: 04/05/2005 I I TOTAL AMOUNT PAID: $96.00 REMARKS: CHECK# 6152 INITIALS: MW SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 217 REV-1500 OFFICIAL USE ONLY RE"-HIOO EX I -00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX. RETURN DEPT. 2B0601 FILE NUMBER 21-05-0358 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT COUNTY COOE ""R NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I- Emma F Weimer 174-05-2486 z w DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE ALEO IN OOI"LICJI.TE WITH THE 0 W 4/5/2005 11/11/1908 REGISTER OF WILLS 0 w (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 0 ~ Original Return o 2. Supplemental Return 03. RemaJnderRetum(daleOfdeathpriorto12-13-1l21 ,,"~ D4a. Future Interest Compromise (date of death after 12-12-82) 05. Federal Estate Tax Return Required u~" LimitedEstat~ w~g ~~~ D 7. Decedent Maintained a liVing Trust (Attacn copy of Trust) u~m Decedent Died Testate (Attach copy of Will) _ B. Total Number 01 Safe Deposit Boxes ~ " D1o.spousa'Po""rlycred~{daleord8athbetween12-31.91and1'1.95) 011. Election 10 lax under Sec. 9113(A) (Attach. Scn OJ Litigation Proceeds Received I- .)fg" w ~1'~If(!,OR!IIATIONSHOULDBE DIRECTED to: z NAME w COMPLETE MAIliNG ADDRESS 0 5 South Hanover Street z Robert M. Fre ~ FIRM NAME (If Applicable) Carlisle, Pennsylvania 17013 m '" '" 0 0 717243-5838 1. Real Estate (Schedule Al (1) NONE OFFICIAL ~E ONLY ~J = = :..U -=:0 en n, 2. Stocks and Bonds (Schedule B) (2) 1,397,687 d en C) _.J r'l C) 3. Closely Held Corporation, partnership or Sole-Proprietorship (3) NONE ~ ,- C) --0 :T.J <;1"- r..::J 1'1\ I rn 4. Mortgages & Notes Receivable (Schedule D) (4) NONE ::J -.J 0 ;---c..: 5. Cash, Bank Deposits & Miscellaneous Personal Property C> --0 -n (Schedule E) (5) 597 ~ --...,\ .('""5 19,185 ~,J - __ fTl 6. Jointly Owned Property (Schedule F) (5) ~..J '--1 .. , Z Dseparate Billing Requested . ."C) 0 U1 -;"1 ;:: CO " 7. Inter.Vivos Transfer & Miscellaneous Non~Probate Property -' (7) NONE ::l (Schedule G or L) l- ii: " 8. TOTAL GROSS ASSETS (total lines 1-7) (8) 1,417,469 0 w '" 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 43,370 10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) :10) 111 11. TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 43,481 12. NET VALUE OF ESTATE (Une 8 minus Une 11) (12) 1,373,988 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 137,398 14. Net Value Subject to Tax (line 12 minus Line 13) (14) 1,236,590 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Une 14 taxable at the spousal tax rate ,or transfers under Sec,9116 (a)(1.2) x .0 - (15) 0 Z 0 ;:: 16. Amount of Line 14 taxable at lineal rate 1,236,590 x .O~ 55,647 ~ (16) ::l Q, :IE 17. Amount of Line 14 taxable at sibling rate x .12 (17) 0 0 0 X ~ 18. Amount of Line 14 taxable at collateral rate x .15 (16) 0 19. Tax Due (19) 55,647 200 . 1"_' ' ~'..~ t, ~,~'!' I , -, I -j= I. ~ ;.j::;-;q~IJl ...1: ~1,1 ..\'I~~ ~r.;1"~\ ~~tl: > ~t~g~Jl1!E;'t,fiI~E;~HECK.MATH < < 217 Emma F Weimer 174-05-2486 Decedent's Complete Address: STREET ADDRESS 442 Walnut Bottom Road CITY I:TATE I~IP Carlisle PA 17013 Tax Payments and Credits: ,. Tax Due (Page 1 Line 19) (1) 55,647 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments 52,773 C. Discount 2,778 Total Credits (A + B + C) (2) 55,551 3. InterestJPenalty if applicable D.lnterest E. Penalty TotallnterestJPenalty < 0 + E ) (3) 0 4. If Line 2 is greater than Line 1 ... Line 3, enter the differenCEl. This is the OVERPAYMENT. Check box on Page 1 line 20 to request a refund (4) 0 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) 96 A. Enter the interest on the tax due. (SA) 8. Enter the total of Une 5 + 5A. This is the BALANCE DUE. (5B) 96 Make Check Payable to: REGISTER OF WILLS, AGENT , :'<~"'.::;ijP,;': . """~'H 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 0 b. retain the right to designate who shall use the property transferred or its income; 0 0 c retain a reversionary interest; or 0 0 d. receive the promise for life of either payments, benefits or care? 0 0 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequflte consideration? 0 0 3 Did decedent own an "j trust for" or payable upon death bank account or security at his or her death? 0 0 4. Did decedent own an I ividual Retirement Account, annui1y or other oon.proba1e property which contains a beneficiary signation? 0 0 IF THE ANSWER TO ANY Of TH ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have exami ed this return, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, and com lete. Declaration of re erothef tnan the ~, entative is based on an information of which re rer has an knowled e. SIGN PERSON RESPONSIBL F R FlUNG RETURN DATE q "/6S ADDRESS 1542 Hemlock Avenue Carlisle Penns Ivania 17013 ER OTHER THAN REPRESENTATIVE DATE q 'fl,t ".-- ~ ADDRESS 5 South Hanover Street, Carlisle, Pennsylvania 17013 For dates of death on Of after July 1, 1994 and before January 1, 1995, the tax rale imposed on the net value of transfers to orfor the \lse of the surviving spouse is 3% [72 P.S. Section 9116 (a)(1.1)(i)l. For dates of death on or after January 1, 1995, tl\e t;l.x. rate \frIposed on the net value ollransfers to or for Itle use of the surviVing spouse is 0% (72 P.S. Section 9116 (a)(1.1)(ii)]. The statute does not exempt a transfer to a surviVing spouse from I8x, and the statutory requiremenls for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the ooly benefICiary. For dates of death on or after July 1, 2000: The tax rate imposed on the nel value of transfers from a deceased child twenty-one years of age or younger at death 10 or for the use of a natural parent. an adoptive parent, or a stepparel1t of the child is 0%{72 P.S. Section 9116(a)(1.2)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal Ileneficiaries is 4.5%, except as noted in 72 P.S. Section 9116(1.2) [72 P.S. Section 9116(a)(1l\ The tax rate imposed on the net value of transfers to Of for the use of the decedent's siblings is 12% [72 P.S. Section 9116(a)(1_3)] .A sibling is defined, under Section 9102, as an individual Who has at least one parent in common with the decedent. whether by blood or adoption. 217 REV.1503 EX+ (6-98) SCHEDULE B COMMONWEALTH OF PENNSYlVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Emma F Weimer 21-05-0358 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Van Kampen Investments-Van Kampen US Mortgage Fund 40-177971 49,529 (3,586.4310 shares @13.81) 2. Cadaret Grant and Company Inc.-Pershing 43C-050523 1,348,158 Carlisle Companies Stock-(15,300 shares @70.10) M&T Bank Stock-(2,670 shares@102.81) Money Market $1,125.60 TOTAL (Also enter on line 2 Recanitulation Is 1 397687 (If more space is needed, insert additional sheets of the same size) . - - - GIBB FINANCIAL SERVICES, INC. = 16 West Pomfret Street. Carlisle, PA 17013 (717) 249-3737 FAX (717) 249-8010 April 22, 2005 Frey and Tiley Attn: .Carol 5 South Hanover Street Carlisle PA 17013 RE: Estate of Emma F- Weimer Dear Carol, As requested, following is the information on the accounts for Emma Weimer. Scudder Investments Emma F, Weimer & Robert E. Weimer JTWROS Scudder Total Return Fund Account established: 10/2/1995 (opened as Joint) 2-10427167 4/5/2005 (date of death) Market Value: 3137.828 shares@ $8_84 MV-$27,738.40 Van Kampen Investments Emma F, Weimer Van Kampen US Mortgage Fund 40-177971 4/512005 (date of death) Market Value: 3586.4310 shares@$13.81 MV-$49,528.6I Cadaret Grant and Company Inc Emma F, Weimer Pershing 43C-050523 4/512005 (date of death) Market Values: Various holdings as listed MV-$1,348,158.30 . Money Market- MY $1125,60 . Carlisle Companies Stock- 15,300 shares @ $70_10 MY $1,072,530,00 . M & T Bank Stock- 2,670 shares@ $102,81 MY $274,502,70 Please do not hesitate to contact us if we can be of further assistance. Z:~~~~ Lisa Riggleman Registered Sales Assistant Branch Office: Cadaret. Grant & Co., Inc., Member, NASD and SIPC 217 REV.1508 EX'" (6~98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Emma F. Weimer 21-05-0358 Include the proceeds of litigation and the date the proceeds were received by the estate. All n..onArtv iointlv-owned with riaht of survivorshlD must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Commonwealth of Pennsylvania, Bureau of Unclaimed Property 597 (Prudential Financial Inc., Demutualization Cash) TOTAL (Also enter on line 5, Recapitulation) $ 597 (If more sDace is needed. insert additional sheets of the same size) comn;~=~~~~~:rl~~~~vania IIIII~I'I~I'IIIIII'IIIH UIBIIII~ 1111 Bureau of Unclaimed Property 99588602 ~;"!:;~cr:~~7~t'~~~~'""~~-~~'--'--'-- ~~'-""G~l~f~l ~-~ 7'~ -; 7", - -~--~-~ 1 ~~~=-~~~~-~'~~~-~,------,=-------=--~::,,::.~~-~_~_..:.J (A) anginal awne(s Name (B) Original awne(s Address as Repor1ed WEIMER EMMA F 119 CHESTER ST SUNBURY PA 00000-0000 (C) Holder Reporting Funds (O) Last Transacllon Date PRUDENTIAL FINANCIAL INC DEMUTE Kl 01/25/2002 (E) Holder Address and Contact (F) Type of Funds Repor1ed 150 ROYALL STREET 230210096156896 CANTON NJ 02021 (G}Cer1Iflcate, Policy or Check Number Demutualization Cash (H) Amount Reported $597,24 Total Shares Claimed 0,0000 Total Cash Claimed $597,24 OWNER CLAIM FORM l"c.ItAi..'IrM'Ni.~'I. "-.-,' " ." -"" . - -, ,. . ~i,.:.',"'-_",_" '.. ..,.".,.___'_........,_. ~",.,. "," . ..... ," '_. "" -- ',' ., '.:.' -, ..' - .', PLEASE COMPLETE ALL INFORMATJON BELOw' NAME OF CLAIMANT: E. J E ~/' ~ X~.:..l7a-<-- SOCIAL SECURITY NUMBER: 2.r>":; - 2~ -' ~- DATE OF BIRTH: u. ADDRESS: /S-4Z- ~M~<::A<. ;(fc/AT;j.J~ CITY: LAA..LNi..e.lE' STATE: P,,4 ZIP: /708 PHONE NUMBER: (.., (7) 2.,.9- 7.s-0 '- EMAIL ADDRESS: I certify that I am legally entitled to claim the property, as stated, that has been reported and delivered to the Treasury Department, Bureau of Unclaimed Property, I I further certify that the information provided, herein, is true and cdrrect . nd subject to the penalties of 18 C,S. Sec. 4904, relating to unswom falsification to ~ SIGNATURE OF CLAIMANT (IN INK): _ ~ - - ~ ~ DATE: ~ 1z.p,A~- SIGNATURE OF ADDITIONAL CLAIMANT (IN INK): DATE: State law iimits the fee a third party can charge an owner for the recovery of unclaimed property to 15 percent of the property value. Please contact the Bureau of Unclaimed Property at 1-800-222-2046 with any additional questions. DOu....T..~..~ JIUlY"'_.... '-' 'T;>'_'..#t;;B~.. I~ rw'Rr..Jiii,......j- ;~~ - -. ~ '_','~">"'.'_"'.;." .,' ....Iii PROCESSED BY: DATE: APPROVED BY: DATE:. Commonwealth of Pennsylvania Treasury Department Bureau of Unclaimed Property AFFIDAVIT AND INDEMNIFICATION AGREEMENT Robert P. Casey, Jr, CLAIM NUMBER 99588602 State Treasurer STATE OF ~;J~:sy ~vA~,1~ COUNTY OF C<..J1118E;4L.A...0 BEING lirst duly sworn, ApJ2/ L- /.9- ~S- ("Claimant(s)j deposes and represents as follows: THATClaimant(sjresidesat /<<Jl~ &A?~..1~ ..,(<./'~.;V'dF: THAT Claimant(s) has made a claim for unclaimed property held by the Treasury Department; THAT Claimant(s) is unable to present to the Treasury Department, as proof of entitlement to the Unclaimed Property, the follOwing original property information: Property ID Property Description Cash Claimed Shares Issue Name Holder 4759996 Demutualizallon Cash $597.24 0,00 PRUDENTIAL FINANCIAL INC because such property described above has been lost, stolen. destroyed, misplaced, or never received and Claimant, hislher heirs, assigns or successors have not received or enjoyed any benefit from the property or proceeds therefrom; THAT Claimant(s), in exchange for payment by the Treasury Department of said claim, agrees to at all times indemnify, save, defend, and keep harmless the Treasury Department, its employes and representatives, from and against any and all claims, demands, actions, or suits against them, whether groundless or othelWise, and any and all losses, damages, liabilities, costs and fees arising out of or in any way connected with the payment of the claim, particularly by reason of a claim for payment to any third person claiming an ownership interest therein or who may hereafter come into possession of the original security, regardless of whether such claims, actions, losses, damages, suits or liability arise in whole or in part from the gross negligence or willful misconduct of the Treasury Department; THAT Claimant(s) agrees that this Affidavit and Indemnification Agreement shall be const"7~ in accordance with the laws of the Commonwealth of Pennsylvania; and I THAT Claimant(s) acknowledges and understands that any information and/or doc entation supplied with the claim, if false, will subject Claimant to prosecution under 18 Fa. C.S.5.$904, relatln to unsworn falsification to authorities; the conviction of which could subject Claimant on term of up two years and a fine of up to $5, 000. . , Signature of Claimant(s) BEFORE ME, the undersigned authority, on this day personally appeared -M. ,... known to me (or introduced to me by 1, to be the person whose name is subscribed to the foregoing instrument, and acknowledged so helshe executed the same for the purposes and conSidera,ti\n therein expNSSed and ~SCRIBED AND SWORN TO ME this the .;:2'fl,-"'-' day of A~. A.D. 20 , ~ Q ~. Notary Signature: a \~<> " l\.., 1l'/-.L-- Printed Name of Nota~(,.l(\RL.\ ~. _ ~\.-,\ ~-(>,..... y 0;--.., . My Commission Expires: ,\'--." 'n'l"'''''~'-' \ fj: ,l.c,olo "- NOTARY STAI\,'P NOTARIAL SEAl. , PeNaOPE J. SAlLHAMER, NoIaty Public Cartialo Bora, Cumbadand CoUnty Comml881on Expltes f-eb. 18, 2008 217 REV-1509EX+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Emma F Weimer 21-05-0358 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. Robert E. Weimer 1542 Hemlock Avenue Son Carlisle Pennsylvania 17013 B. C. JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %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 TENANT JOINT IDENTIFYING NUMBER. ATTACH PEED FOR JOINTLY,HELD ReAL ESTATE_ VALUE OF ASSET INTEREST DECEDENT'S INTEREST NUMBER ,. A. 10.2.95 Scudder Total Return Fund 2-1 047167(3,137.828sh@8.84) 27,738 50.00% 13.869 2. A 9.20.00 M&T Bank, Checking Account #3741148732 10,631 5.00% 5,316 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 TOTAL (Also enter on line 6 Recanitulation $ 19185 (If more space is needed, insert additional sheets of the same size) ~ M&fBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 April 26, 2005 Frey & Tiley Attorneys At Law 5 South Hanover Street Carlisle, Pennsylvania 17013 Re: Estate of: Emma F Weimer Social Securitv: 174-05-2486 Date of Death: Avril 05, 2005 Dear Sir or Madam: Per your inquiry dated April 18, 2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: I. Type of Account Checking Account Account Number 374/l48732 Ownership (Names oj) Emma F Weimer, Joint Owners * Robert E Weimer, Join/ Owners. Opening Date 09/20/00 Closed 04/19/05 Balance on Date of Death $10,631.13 Accrued 1n/erest $ 0.27 ._____.___.~__c____..______________.._____~______~.___.___.____.._____.~_... TOlal $10,631.40 Please be advised, there was no safe deposit box found for the above decedent. . For further account information, regarding ownership, closures andlor reimbursement of funds, etc., please call the Ston.ehedge Office # 717-246-4524. Sincerely, ~~C/~ Nancy Clagett Records Management . - - - GIBB FINANCIAL SERVICES, INC. 16 West Pomfrel Street, Carlisle, PA 17013 (717) 249-3737 FAX (717) 249-8010 April 22, 2005 Frey and Tiley Attn: Carol 5 South Hanover Street Carlisle PA 17013 RE: Estate of Emma F, Weimer Dear Carol, As requested, following is the infurmation on the accounts for Emma Weimer. Scudder Investments Emma F. Weimer & Robert E. Weimer JTWROS Scudder Total Return Fund Account established: 10/211995 (opened as Joint) 2-10427167 4/512005 (date of death) Market Value: 3137,828 shares@$8.84 MV-$27,738.40 Van Kampen Investments Emma F. Weimer Van Kampen US Mortgage Fund 40-177971 4/512005 (date of death) Market Value: 3586.4310 shares@ $13.81 MV-$49,528.61 Cadaret Grant and Company Inc Emma F. Weimer Persbing 43C-050523 4/5/2005 (date of death) Market Values: Various holdings as listed MV-$1,348,158.30 . Money Market- MY $1125.60 . Carlisle Companies Stock- 15,300 shares@$70,10 MY $1,072,530,00 . M & T Bank Stock- 2,670 shares @ $ \02,81 MY $274.502.70 Please do not hesitate to contact us if we can be of further assistance. iL:~Ii~~ Lisa Riggleman Registered Sales Assistant Branch Office: Cadaret, Grant & Co., Inc., Member, NASD and SIPC 217 REV-1511 EX+(12-99) SCHEDULE H COMMONWEALTH Of PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Emma F Weimer 21-05-058 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Carlisle Memorial, Funeral 531 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 41,624 3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 848 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Cumberland Law Journal, Advertising 75 8. The Sentinel, Advertising 137 9. Vital Records, Death Certificate for David E, Weimer 16 10. Register of Wills, (6) Short Certificates 24 11. Register of Wills, Filing Fee for PA Inheritance Tax Retum 15 12. Register of Wills, Additional Probate Fee 100 TOTAL IAlso enter on line 9 Recanitulation $ 43 370 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) 217 SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Emma F Weimer 21-05-0358 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbur'Sed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Dr. Hartzell. Medical 111 TOTAL (Also enteron line 10 Recaoitulation\ $ 111 (If more space is needed. insert additional sheets of the same size) 217 REV~1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Emma F Weimer 21-05-0358 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON!S) RECEIVING PROPERTY Do Not LIst Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (0) (1.2)J Robert E. Weimer Son 60% residue of estate 1542 Hemlock Avenue, Carlisle, Pennsylvania 17013 2 David G. Weimer Grandson 30% residue of estate 506 North College Street, Cartisle, Pennsylvania 17013 3. Council of St. Paul's Evangelical Luther Church Church 5% residue of estate 210 West Louther Street, Carlisle, Pennsylvania 17013 4. Council of St. Pete~s Lutheran Church Church 5% residue of estate 210 Brick Church Road, Newville, Pennsylvania 17241 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Council of St. Peters Lutheran Church 68,699 201 West Louther Street, Carlisle, Pennsylvania 17013 2 Council of St. Peters Lutheran Church 68,699 210 Church Brick Road, Newville, Pennsylvania 17241 TOTAL OF PART 11- ENTER TOTAL NON~TAXABLE DISTRIBUTIONS ON LINE 130F REV-150D COVER SHEET $ 137398 (If more space is needed, inser! additional sheets of the same size) 1 < LAST WILL AND TESTAMENT - OF EMMA F. WEIMER I, EMMA F. WEIMER, widow, of 5-E Todd Circle in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind. memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executor to pay all of my just debts including any and aU inheritance and estate taxes payable on account of my death regardless of whether the assets giving rise to such taxes are includable in my probate estate or not. I direct that my funeraJ services be conducted by Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsylvania, in accordance with arrangements made by me and prepaid by me, 2. I give and bequeath to my son, Robert E. Weimer, his heirs and assigns, all articles of tangible personal properly which I may own at the time of my death, including automobiles, household goods and furnishings, elc" provided he shall survive me by a period of ninety (90) days. but should he fail to so survive me then to my grandson, DavidG. Weimer, his heirs and assigns, provided he shall survive me by a period of ninety (90) days. 3. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate. I give, devise and bequeath as follows: a) Five (5%) percent to the Council of St. Paul's Evangelical Lutheran Church. 20 I West LoutherStreet, Carlisle, Pennsylvania 17013, to be used to provide a suitable memorial to my husband. David E. Weimer. and me, the selection of which. shall be made by said Council in consultation with my son, Robert E. Weimer. b) Five (5%) to the Council of SI. Peter's Lutheran Church, sometimes known as Upper Frankford Lutheran Church and sometimes locally known as the "Brick Church", with present mailing address of Box 203, R, D, #4, Newville, Pennsylvania 17241. to be used to provide a suitable memorial to my husband. David B. Weimer, and me, the selection of which shall be made by sald Council in consultation with my son, Robert B, Weimer. c) Thirty (30%) percent to my grandson, David G, Weimer, his heirs and assigns. provided he shall survive me by a period of ninety{90) days, but should he fail to so survive me then to such of his legitimate issue, their heirs and assigns. as shall survive me by a period of ninety (90) days and if there be no such issue then to his parents, their heirs and assigns. provided at least one of them shall survive me by a period of ninety (90) days, d) Sixty (60%) percent to my son, Robert E. Weimer, his heirs and assigns, provided he shall survive me by a period of ninety (90) days, but should he fail to so survive me, then to my grandson, RobenE. Weimer, his heirs and assigns, provided he shallsurvive me by a period of ninety (90) days, but should both of them fail to so survive me, then to such of the legitimate issue of Robert E. Weimer. their heirs and assigns, as shall survive me by a period of ninety (90) days, per stirpes, If neither my son, Robert E, Weimer, nor my grandson, David G, Weimer, nor any legitimate issue of my grandson. David G. Weimer, shall survive me by a period of ninety (90) days. then the amounts which would have been paid to them shall he distributed as follows: I) Fifty (50%) percenlto the Council of St. Paul's Evangelical Lutheran Church, 201 West Louther Street. Carlisle, Pennsylvania 17013, to be used for such purpose or purposes as the Council of said Church shall deem best; 2) Fifty (50%) percenlto FinancialTrust Services Company, and its successors, One West High Street, Carlisle, Pennsylvania, in trust, to add the same to the endowed care fund which it presently maintains for the benefit of the cemetery at 81. Peter's Lutheran Church in Upper Frankford Township, Cumberland County, Pennsylvania, which is sometimes known as Upper Frankford Lutheran Church and sometimes known simply as "Brick Church", which has the present mailing address of Box 203, R D, #4, Newville, Pennsylvania 17241. the income from said addition by me to the endowment fund to be used for the care and maintenance of the lots and the monuments thereon erected: on which the bodies of my parents. George H. Frey and wife are buried, the bodies of my husband, David E. Weimer and of myself are buried, and the bodies of my brother-in-law, John A. Mountz and his wife. are buried, and for the care and maintenance of all of the lots in said cemetery including the monuments erected thereon. Page I of 3 Pages d4?fl-?CA ;/ ~H((-V ,. 4. I hereby nominate, constitute and appoint my son~ Robert E. Weimer, as Executorof this my Last Will and Testament but should he predecease me or fail to qualify or cease serving as such, then in such event I nominate. constitute and appoint my grandson, David G. Weimer, as altemateor successor Executor, but should he fail to qualify or cease serving as such, then in such event I nominate, constitute and appoint Financial Trust Services Company and its successors, One West High Street, Carlisle, Pennsylvania 17013, as alternate or successor Executor, and 1 further direct that none of them shall be required to post any bond to secure the faithful perfonnance of his or its duties in the CotnI1\Qnwealth of Pennsylvania or in any other jurifidiction. 5, In addition to the powers conferred by law, my hereinbefore named Trustee and Executors are empowered: a. To invest any part of the trust corpus in such securities. investments, or other property as may be deemed advisable and proper, irrespective of whether the same are authorized for the investment of trust funds under the laws of any governing jurisdiction. b, With respect to any corporation, the stocks, bonds, or other securities of which may be held~ to vote in person or by proxy on any shares of stock; to consent to the merger, consolidation or reorganization of such corporations; to consent to the leasing..mortgaging or sale of the property of aoy such corporations~ to make any surrender, exchange or substitution of such stocks, bonds or other securities as an incident tQ the merger, consolidation or reorganization of such corporations; to pay all assessments, subscriptions and other sums of money which may be deemed wise and expedient for the protection and maintenance of the proportionate interest of the investment in such corporations; to exercise any option or privilege which may be conferred upon the holders of such stocks, bonds, or other securities of snch corporations either tor the conversion of the same Into other securities or for the purchase of additional securities, Bnd to make any and all necessary payments which may be required in connection therewith; and generally to have and exercise as to all such stocks, bonds and other securities, the powers of an individual owner who is under trust obligation. c. To hold the trust corpus in one or more consolidated funds in which separate shares shall have nndivided interests. d. To sell at public or privatesalefor cash or upon credit. or partly for cash and paJtly on credit, and upon such terms and conditions as shaH be deemed proper, any part or parts of the trust estate. and no purchaser at any such sale shall be bound to inquire into tbe expediency or propriety of any such sale or to see to the applica~ion of the purchase moneys arising therefrom. e. To keep on band and uninvested such money as may be deemed proper and for sucb period as may be found expedient. f. To compromise, settle or arbitrate any claim or demand in favor of or against the trust estate. g. And authorized in the discharge of fiduciary duties, to employ counsel and to determine and to pay such counsel. reasonable compensation which shall be charged against the priucipalor income of the trust fund, and shall further be entitled to charge against the principal or mcome such other reasonable expenses and charges as may be necessary and proper to incur for the proper discharge of fiduciary duties and for the proper management and administration of the trust estate, b. In making any division of property into shares for the purpose of any distribution thereof directed by the provisions of the trust, to make such division or distribution, either in cash \ or in kind, or partly in casb and partly in kind. as shall be deemed most expedient. and in making any division or distribution in kind may allot any specific security or property or any undivided interest therein to anyone or more of such shares. and to that end may appraise any or all of the property so to be allotted and lbe judgment as to the propriety of such allotment and as to the relative value for purposes of distribution of the securities or property so allotted shall be final and conclusive upon all persons interested in the trust or in the division or distribution thereof. i. And authorized to register any shares of stock or other assets of any trust in their own names or in the name of a. nominee. j. To retain any investments including mutual funds which I may own at the time of my death and in addition to invest any part of the Trust corpus in such mutual fund or mutual funds as may be deemed advisable or proper, inespective of whether the same are authorized for the investment of trust funds under the laws of any governingj'lrisdiction. Page 2 of 3 Pages !!(-V1?t- 4' "I', - {/)tUl-tVL . ." . IN WITNESS WHEREOF, ! have hereunto set my hand and seal to this my Last Will and Testament written un three (3) pages, this 18th day of July ,1997, (' -:f. %.....t:&& &.'4?'f " (SEAL) Emma F, Weimer Signed, sealed, published and declared by EMMA F, WEIMER, the Testatrix above-named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting wirnesses. ~-4.. 7-.) f~~'1 , Page 3 of 3 Pages Marjorie A. Wevodau First Glenda Farner Strasbaugh Deputy Register of Wills and Clerk of Orphans' Court KirnS. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 I INVOICE I Bill To: InvoiceNo: 531 Invoice Date: 9/7/2005 ROBERT M FREY ESQ E state of: Emma F. Weimer 5 SOUTH HANOVER ST Estate No: 21-2005-358 '" CARIlSLE, PA 17013 Qty Fee Description Fee Total 1 Additional Probate 50,00 $50.00 Total: $50.00 O1ecks should be made payable to the Register of Wills, Terms: Net 30. Please return one copy of this invoice with your payment. Thank you.