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HomeMy WebLinkAbout11-14-05 (2) REV-1500 EX + (6-00) '* I- Z W C W () W C w .... :.::$(/) Ull:::': w g,U J: II::g U ll.al 11. <( z o i= <( ..J :::> l- e: <( () w 0:: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Weaver Paul L. DATE OF DEATH (MM-DD-Year) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -0 5 0 6 7 9 COUN'TY"'C'Q5"E -----vEA~ - - NUMBER-- SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 2 09- 1 2 - 8 508 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 07/07/2005 04/26/1921 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) Weaver Miriam L. [Xl 1. Original Return D 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Will) D 9, Litigation Proceeds Reoeived .... z w c z o 11. (/) W II:: II:: o U NAME Joel R. Zullin er FIRM NAME (If Applicable) Zullin er Davis P.C. TELEPHONE NUMBER 717 264-6029 SOCIAL SECURITY NUMBER D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 3. Remainder Retum (date of death prior to 12-13-82) D 5. Federal Estate Tax Retum Required ~ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) COMPLETE MAILING ADDRESS 14 North Main Street, Suite 200 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) D Separate Billing Requested 7. Inter-Vivos Transfers & Misoellaneous 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 Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) Chambersbur PA 17201 (1) (2) (3) (4) (5) OFFICIAL USE ONLY h~ r::::-..,. (:-;:::> c..fl (-) ::~) ~---) 79,541.27 ; (6) ....TJ i; --L. (7) 10,961.09 I r,) <'.11 --- -~ (8) 90,502.36 (9) (10) 17,930.78 5,337.46 (11) (12) (13) 23,268.24 67,234.12 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= <( I- :::> ll.. ::E o () >< <( I- 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 (14) 67 ,234.12 29,718.76 X (15) 0.00 37,515.36 X .045 (16) 1,688.19 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 1,688.19 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 9 East Main Street CITY I STATE I ZIP Walnut Bottom PA 17266 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 Total Interest/Penalty ( D + 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 1,688.19 0.00 0.00 1,688.19 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 to designate who shall use the property transferred or its income; ........................................ 0 c. 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 without receiving adequate consideration?............................... ..... ....... ................................... ......... ....... 0 3. Did decedent own an 'in trust 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 . b f" d' t' ? 1)(1 contains a ene IClary eSlgna Ion. ............................... ................. ................. .................. .................... ~ 1,688.19 No IKl IKl IKl IKl IKl IKl 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. ADDRESS PA 17201 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 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 exempt 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 natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S, 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, 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 to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-15GB EX... (6-98) '. COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Weaver Paul L. 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. 0679 ITEM NUMBER 1. DESCRIPTION Checking Account #67348408, M& T Bank, including interest accrued to date of death VALUE AT DATE OF DEATH 35,451.69 2. Certificate of Deposit #4000004996, Orrstown Bank, including interest accrued to date of death 12,841.64 3. Certificate of Deposit #6140846242, Citizens Bank, including interest accrued to date of death 25,598.33 4. Checking Account #6204010895, Citizens Bank 5.00 5. Share Savings Account #949830, Corning Federal Credit Union 3,109.41 6. Proceeds from sale of decedent's automobile 2,500.00 7. Refund, The Patriot News 35.20 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 79.541.27 REV-1510 EX t (6-98) * SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Weaver. Paul L. FILE NUMBER 21 05 0679 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. DESCR:PTION OF PROPERTY ITEM INCLUOE THE NA.ME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DA TE 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 VALUE (IF APPLICABLE} 1. Non-Qualified Annuity with F&G Life Insurance Company, 10,961.09 100. 10,961.09 beneficiary of account is Miriam L. Weaver, decedent's surviving spouse TOTAL (Also enter on line 7 Recapitulation) $ 10961.09 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (1~-99) , '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Weaver, Paul L. ITEM NUMBER A. 1. 2. 3. 4. 5. B. 1. 2. 3. 4. 5. 6. 7. 8. FILE NUMBER 21 05 0679 Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: Fogelsanger-Bricker Funeral Home, funeral expenses Cumberland Valley Memorial Gardens, grave opening and closing Food for meal after funeral Cleaning suit for funeral Gravemarker 6,455.20 1,045.00 69.58 8.25 514.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Miriam L. Weaver Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 9 East Main Street City Walnut Bottom State PA Zip 17266 Year(s) Commission Paid: 2006 Attorney Fees Joel R. Zullinger Family Exemption: (If decedent's address is not the same as c1aimanfs, attach explanation) Claimant Miriam L. Weaver Street Address 9 East Main Street City Walnut Bottom State PA 2,000.00 3,900.00 3,500.00 Zip 17266 Relationship of Claimant to Decedent spouse Probate Fees Register of Wills - JCP fee 10.00; short certificates 16.00; will 15.00; automation fee 5.00; letters 210.00; filing return 15.00 271.00 Accountanfs Fees 0.00 Tax Return Prepare~s Fees 0.00 Cumberland Law Journal, advertise letters News-Chronicle, advertise letters 75.00 92.75 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 17930.78 REV-1512 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF Weaver. Paul L. FILE NUMBER 21 05 0679 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Shippensburg Health Care, medical services due at death VALUE AT DATE OF DEATH 4,605.00 2. Diamond Pharmacy Services, prescriptions 260.28 3. Chambersburg Hospital, medical services due at death 175.32 4. Urology Associates of Chambersburg, medical services due at death 251.34 5. Cumberland Valley Medical Services, medical services due at death 37.51 6. CP02 Billing Center, medical services due at death 8.01 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5 337.46 ",V."",""_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Weaver Paul L SCHEDULE J BENEFICIARIES 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 (a) (1.2)] 1. David Eugene Weaver, 1/3 of residue Lineal 18,757.68 9 Canal Street 1/3 of residue Big Flats, N.Y. 14814 2. Laurie J. Weaver, 1/3 of residue Lineal 18,757.68 P.O. Box 215 1/3 of residue Chemung, N.Y. 14825 3. Miriam L. Weaver, 1/3 of residue and Item 1 on Schedule G Spousal 29,718.76 9 E. Main Street 1/3 of residue and Item Walnut Bottom, PA 17266 1 on Schedule G 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. 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 0.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 .. FILE NUMBER 21 05 0679 (If more space IS needed, Insert additional sheets of the same size) ~ -', .~ l ~ \ \(~ ~. N:'< , '\ "'- '\ \. ~ \ t~ \ ~ ~ ~ <> ~ \" ~ "-. :JRZ - 5.1 2004 Septewbe::: f~':ea'/'er . 1 '1 L1 - -, LAST WILL AND TESTAMENT I, Paul L. Weaver, of Nine East Main Street, Walnut Bottom, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my will, hereby revoking any and all former wills and codicils thereto by me heretofore made. I. I direct that all my just debts and funeral expenses, including all expenses of my last illness, shall be paid from my estate as soon as practicable after my decease as a part of the expense of the administration of my estate. II. I give, devise and bequeath the residue of my estate of every nature and wherever situate in equal shares, as follows: A.One-third to my son, David Eugene Weaver; B.One-third to my daughter, Laurie J. Weaver; \ C.One-third to my wife, Miriam L. Weaver. ;:;..:::;., :-=.-.... '-- ':1-'; c....."'J 0..) ~ .~ )" K \'-' \ \~ \~ " " '" ,~ ~ .,~ \ ~'" ~ ~ '~ ".-( ! '\~ ~ "\\ \ ' . .<,' III. Should my son, my daughter, or my wife predecease me or die on or before the thirtieth day following my death, their share of my estate shall be distributed to said beneficiary I s issue I per stirpes, living on the thirty-first day following my death. IV. Any fiduciary under this will 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 and all of the assets of my estate, real or personal, without regard principle of to any diversification of risk. B.To invest in all forms of property including stock, common trust funds and mortgage investment funds without restriction to investments authorized for pennsylvania ,'~ '" fiduciaries as they deem proper, without regard to any principle of diversification of risk. 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 Page 2 ---.J \ '0. '" V \ '\' ~\'\ '~ ~ \\~ ~\, ~ \ '~ ~\ ,..-. .. i \ \ 0. \'':' \\ '~ ~. I such prices and upon such terms or conditions as they deem proper. D.To allocate receipts and expenses to principal or lncome or partly to each as they from time to time think proper. E.To compromise any claim or controversy. F.To distribute In cash or in kind or partly in each. G.To hold property in their names without designation of any fiduciary capacity or in the name of a nominee or unregistered. V. I direct that all taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. VI. I appoint my wife, Miriam L. Weaver, as executrix of this my will. Should my wife predecease me, fail to qualify or cease to act, I appoint my stepson, Kenneth Byers, as executor of this my will. Page 3 VII. No bond shall be re~~ired of any fiduciary hereunder In any jurisdiction. IN WITNESS WrlEREOF, I hereunto set my hand and seal to this my last will and testament, consisting of five typewritten pages, the first three of which bear my signature in the margin for the /'1i&- of identification this day of purpose ~ "-(J~~ , 2QQj. , ---.., ','" -' ./ / L/" ~ 4-11;. ~/ ~ /r:1:-~?;-f/1 - I /. (SEAL) Signed, sealed, published and declared by the above-named testator as and for his last will and testament in our presence, who in his presence, at his request and in the presence of each other have hereunto set our hands as attesting witnesses. ~ ,If.2J/~~ Ht{/~~-t1J~~ClJ~ tIiJ OJ! ,;'lLJ if VU!2-4i-IJJ J/L-u1 ~1 t7 j/L.d_L~,(A CL- i jJa . I a 0 / 1/ 0 ' Weaver, ~ ~. ~L.Jli"D~ Paul L. and ;A , the testator and the witnesses respectively, instrument, being first duly sworn, do hereby declare to the undersigned Page 4: authority that the testator signed and executed the lnstrument as his last will and testament and that he executed it as his free and voluntary act for the purposes therein expressed and that each of the witnesses, in the presence and hearing of the said testator signed the will as witnesses and to the best of their knowledge said signer was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by the above-named signer and subscribed and sworn to bef/~ me by the ~named witnesses this ~ day of ---- ~ 0 ~ ~ , 'YLD-f-. ~~=- ~4IAkMd.tU Notar Public) ", "- // / "'. j./7/ d~" I;(vv .", ~a~V. 4<./!-?Vt7':1 Testator ' ~ 7<?~' ~L. ~ Witness .. d /.u f1~, Witess {j COMMONWEALTH OF PENNSYLVANIA Notarial Seal . Teresa J. Burkholder. Notary Public Shippensbur~ Boro, Cumberland County My Conumssion Expires Aug. 6, 200g Member. Pennsylvania Association of Notaries Page 5 ~ M&rBank 499 :YlitchC!1 Road, \llllsboro, DE 19966 \lail Code DE-\lB-12 Phone (888) 502-4349 Fa\; (302) 934-2955 September 9,2005 Law Offices Zullinger - Davis 14 North Main Street, Suite 200 Chambersburg, PA 17201 Dear Sir or Madam: Per your inquiry dated September 01, 2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: Re: Estate or Paul L Weaver Social SecuritY',' 209-12-8508 Date of Death: JulY' 07. 2005 L Type of Account Checking Account Account Number 67348408 Ownership (Names of) Paul L Weaver * Opening Date OS/28/84 Closed 08/19/05 Balance on Date of Death $35,451.52 Accn/ed Interest $ 0.17 Total $35,45/.69 Interest Paid YTD -- "-. -- --,.. --- _.--~- $ 4,31 (Accnted interest is not included) 2. Type of Account IRA Account Number 035004201773345 Ownership (Names of) Paul L Weaver * Miriam L Weaver, Beneficiary * Opening Date OS/29/84 Closed 07/22/05 Ba/ance on Date of Death $23,079,79 Accrued Interest $ 306.49 Total . . ....-.-. .... -.., -. ..'. -~. $23,386.28 Interest Paid YTD .. s7ii j9(A~~~~di~t~~~;t'is';;~ti~d~d~d) Please be advised, there was no safe deposit box found for the above decedent *For further account information, regarding ownership and any changes, closures and/or reimbursement of funds, etc., please call the King Street Office # 717-532-4132. Sincerely, Nancy Clagett OQr"A....rl... l\If<'Jo~ra......ornont ~~ ORRSTOWN BANK ~ ./,,? ~.f September 9, 2005 TO Law Offices Zullinger Davis 20 East Burd Street Shippensburg PA 17257 FROM Timothea Moose Cust. Service Specialist P,O BOX 250 SHIPPENSBURG PA 17257-0250 RE: ESTATE OF Paul L Weaver DATE OF DEATH: July 7, 2005 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: CHECKING ACCOUNTS ACCOUNT NO, TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST SAVINGS ACCOUNTS ACCOUNT NO TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST CERTIFICATES OF DEPOSIT ACCOUNT NO, TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 4000004996 Paul L Weaver 11/22/04 12,828,88 12,76 ....r-J".. ~~..'_..~ L._~ 11"'\;'1. A-:""llr-, ,~ ,..,.....,\ r'""\..... rAl..... _ ;-,,.,-.,\ _r""'}.Wt A...~' 'C,........ __ ~..."n.... ..............+....,..~'"'-.. _.-_...~" ~~ Citizens Bank 525 William Penn Place Suite 153-2510 Pittsburgh. PA 15219 September 27,2005 ZULLINGER - DAVIS 14 NORTH MAIN STREET CHAMBERSBURG PA 17201 Estate of PAUL L WEAVER Date of Death: Jul 07. 2005 SSN: 209-12-8508 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 412-867-2205 Sincere.IY' ~ C1fit;. '.. ~I ;1' ~,~~. C/'''' Daniel Peters Operations Services ~~ Citizens Bank Account Number 6140846242 Account Title PAUL L WEAVER Date Opened 11/19/2001 I Account Type Time Deposits Principal Balance as of DaD $25558.95 Interest from Last Posting to DaD $39.38 Account Balance as of DaD $25598.33 YTD Interest to DaD $374.01 ~~ Citizens Bank Account Number 6204010895 Account Title PAULL WEAVER Date Opened 3/19/2003 Account Type Checking Principal Balance as of DOD $5.00 Interest from Last Posting to DOD $.00 f.------ - Account Balance as of DOD $5.00 YTD Interest to DOD $.00 Se? 07 as ~1:a3p ~ ..--- .......... Cc~nin~ Credit Union 7175974336 Law Offices Zullinger-Davis Professional Corporation 14 North Main Street Suite 200 Chambersburg P A 17201 Dear Sir, Here is the information that your office requested concerning the Estate of Paul L. Weaver. Mr. Weaver had a share savings account, member number 949830, account number one. The account was opened in June 1960. The account is only under Mr. Weaver's name. The balance was 53109.41 at the time of death. The account earns 1.00% interest that is paid quarterly, Sincerely, r ' '._1,1, .<2 _ ~ ~ (lIJ-[)" r- ", __ '''-., '/ l{ir.l<.-O)"'<.)w ~ "J Corning Credit Union Corning Federal Credit Union, 677 S. Antrim Way, I. Greencostle, PA 17220 717-597-4400: 800-677-8506 except Corning-Elmira. N,Y. coUing area: http://wlN'\Vcorningcuorg p.3 S ::\.''''' tV: ":~OS""~\hf\J P.A \IV. .....,.\.,..,: 71753292;! 2; S:OP.12.05 4:48PM; i .~ . , ~ ~ .~ Ci.1rol, f . ,~s per our ~i"cussion,.l ha:vl' obtaine? the date of d~ath vahw fM Palll L \vC'avt'l NOll- Q}lahfied Annully wIlh F&G Life lnsuran("~ Company. Tht" value for PA ~ Inhcrilallc(" Tax pUrpoSES as ofJuly 7, 2005 was $10,961.09. Named benef i-:f ciary is Miriam L. Weaver, spouse of Paul L. Weaver. i rf you have any other (luestions or conct'ms, please call me at (717) 530-3S25. j , ~ j I f ~ ~ ~ I ~ Ii ~ , ~ s I : 1 ~ 4 ~ .~ i 1 J. i I I ~ ! s ~ ~ i \'t j ~ ~ ~ j Septemlx:r 12, 2005 VIA FACSI:VULE Thank,,! Chrissy Ward Cfl>>J PAGE 1 /1 :; ~ j ; ;