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HomeMy WebLinkAbout03-03-06 Rtt~5Di} EX (6-fiW COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT l'U1BER OFFICIAL USE ONLY FILE NUMBER 2 1 - 0 5 o o 5 7 3 COLMY CODE YEAR ..- Z W o W o W C DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) WEIDMAN, DOREEN E. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 195-16-2856 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER 06-09-2005 05-23-1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) - UJ [ZJ 1. Original Return D 2. Supplemental Return I- ~::!;U) 0 4. limIted Estate D 4a. Future Interest Compromise (date of death after 12-12-82) ua::~ UJo... U [X] D IOO 6. Decedent Died Testate (Attach copy of Wi~ 7. Decedent Maintained a Living Trust (Attach copy of Trust} 00::-1 a..m Cl. D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date of death between 12-31-91 and H-95) <( o 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required --1. 8. Total Number of Safe Deposit Boxes o 11. Eleetion to tax under See. 9113(A) (Attach Sch 0) I- Z III o Z o 0... (/j UJ a:: a:: o u THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME DONN L. SNYDER, ESQUIRE FIRM NAME (If Applicable) SAUL EWING LLP TELEPHONE NUMBER 717.257.7524 COMPLETE MAILING ADDRESS P.O. BOX 1291 HARRISBURG, PA 17108-1291 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) ~~44 I 342 .12 96,570.04 0.00 0.00 / Cl (1 ) (2) (3) (4) OFFICIAL USE ONLY -!"-,.1 3 Closely Held Corporation. Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o ~ ..J :J ..- fl. <C (.J w 0::: 5. Cash, Bank Deposits & Miscellaneolis Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested t115,078.78 (5) 14,233.98 (6) i- i (' ,'~ 126,337.53 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) .........-..! (7) 8. Total Gross Assets (total Lines 1 - 7) 796,562.45 (8) 67,774.55 3,907.34 (11) --==_=_-=:=- _-=- -=-:-==.=: -=-:c:-_-=_2:ol.-L~__~}c:~~~8=~- 9. Funeral Expenses & Aoministrative 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) (9) (10) (12) 724,880.56 13. Chantable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) '==:"'-:__:=-==-=:::'====--==-=-:':=--==~..:.=:C-:::=::" ..2_-" _9_0 (14) 724,880.56 SEE INSTRUCTIONS FOR APPLICABLE RATES z o ~ I- ::::) c.. :E o (.J >< ~ 15. AmolJnt of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)( 1.2) x 0__ (15) 0 . 0 0 (16) 32,619.63 (17) 0 . 00 (18) 0.00 7 24 , 8 8 0 . 5 6 x .0 _'!.~ 16. Amount of Line 14 taxable at lineal rate 17. Amoun: of Une 14 taxable at sibling rate X '12 18. Amount of Line 14 taxable at collateral rate X .~5 19 Tax Due 20 D ~K HERE IF YOU ARE REQUESTING A REFUNr;> OF AN OYERPAY~ :,. > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < (19) 32 , 619 . 63 STFPA42021J-=1 'j Decedent's Complete Address: STREET ADDRESS 7 0 OLD FEDERAL ROAD CllY CAMP HILL I STATE PA I ZIP 1 7 0 11 Tax Payments and Credits: . 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 32,619.63 22,000.00 1,100.00 Total Credits (A + B + C) (2) 23,100.00 3. Interest/Penalty if applicable D. Interest E. Penalty 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) 0.00 0.00 9,519.63 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 Payable to: REGISTER OF WILLS, AGENT 9,519.63 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; ........................................ D b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . . . . .. D c. retain a reversionary interest; or .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D d. receive the promise for life of either payments, benefits or care? .............,................. D 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . .. ..................................... D 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? . . . ., D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . .. ............................... D [Xl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST CqMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, 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. SIGNAT RE OF PERSON RESPONSIBLE F R FILING. RETURN ..- ! No ~ [Z] ~ [Z] [Xl [Xl ADDRESS P.O. BOX 1291, DATE 02- J 7 -06 CAMP HILL, PA 17011 DATE 02:lf -06 17108-1291 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. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (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. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's sibiings 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. STF PA42021F.2 1.REV-1503 E9{ + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. u.s. SAVINGS BONDS VALUE AT DATE OF DEATH 13,436.32 2. u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH DAUGHTER - HELD IN DECEDENT'S SAFETY DEPOSIT BOX 19,504.32 3 . u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH SON - HELD IN DECEDENT'S SAFETY DEPOSIT BOX 13,707.92 4. HAMPDEN TOWNSHIP SEWER AUTHORITY 5,587.50 5. PNC INVESTMENTS 11,603.38 6. AMERICAN EXPRESS 32,730.60 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 96,570.04 STF PA42021F4 "REV-1508 E.~ + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF DOREEN E. WEIDMAN FiLE NUMBER 21-05-00573 Include the proceeds of litigation and the date the p,oceeds were received by the estate. All property jointly-owned with th~ right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 2. 3 . 4. 5 . 6. 7 . 8 . 9. 10. 11. 12. 13. 14 . 15. 16. 17. 18. 19. 20. 21. 22. 23. REFUND - SEWER AUTHORITY AUCTION OF HOUSEHOLD ITEMS - NET 1988 CHEVROLET CORSICA 1992 CHEVROLET LUMINA POSTMARK CREDIT UNION - SAVINGS 30 SILVER DOLLORS CASH IN SAFE DEPOSIT BOX CHANGE IN SAFE DEPOSIT BOX PENNSYLVANIA STATE BANK PNC BANK PNC BANK MEMBERS 1ST FEDERAL CREDIT UNION ERIE - UNUSED HOME OWNERS PREMIUM ERIE - UNUSED CARE INSURANCE PREMIUM COMMUNITY BANK CONTINENTAL CASUALTY CO. MBNA PNC BANK BLUE CROSS - REFUNDS TRAVELERS CHEQUES PATRIOT NEWS - REFUNDS CUNA 2004 TAX REFUND 124.00 5,351.25 500.00 500.00 86,442.23 30.00 37,000.00 88.25 110,257.47 10,303.60 65,664.44 1,245.02 346.00 787.00 53,720.11 527.11 41,607.4.5 71.13 54.91 250.00 128.35 27.52 52.94 STF PA42021F.9 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 415,078.78 \REV-1509 E" + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 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. KATHLEEN M. WEIDMAN 120 NORTH 21ST STREET, APT. 1 CAMP HILL, PA 17011 DAUGHTER B. JOHN G. WEIDMAN, JR. 120 NORTH 21ST STREET, APT. 1 CAMP HILL, PA 17011 SON c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE IncllKle name of financial institution am ba!i( accolllt runber or similar identifying number. DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A.-B 7-02 MBNA - CD 24,568.20 33.33 8,188.58 2 . B. 5-02 PNC BANK - SAVINGS 6,045.40 50 3,022.70 3 . A. 5-02 PNC BANK - SAVINGS 6,045.40 50 3,022.70 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL (Also enter on line 6, Recapitulation) $ 14,233.98 (If more space is needed, insert additional sheets of the same size) STF PA42021 F.10 ,REV-1510 E~ + (1-'=17) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 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 %OF ITEM INCLLDE THE NAME OF TrE TRANSFEREE, HEIR RELATIONSHP TO DECEDENT AND TrE DATE DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1. POSTMARK CREDIT UNION - IRA 3,336.21 100 3,336.21 2. POSTMARK CREDIT UNION - IRA 47,399.81 100 47,399.81 3. POSTMARK CREDIT UNION - IRA 10,861.94 100 10,861.94 4. POSTMARK CREDIT UNION - IRA 23,144.11 100 23,144.11 5 . AMERICAN EXPRESS - IRA'S 41,595.46 100 41,595.46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL (Also enter on line 7, Recapitulation) $ 126 337.53 (If more space is needed, insert additional sheets of the same size) STF PA42021 F.11 1REV-1511 E): + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: SEE ATTACHMENT 8,574.55 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) ____ Street Address B. City State Zip 2. 3. Year(s) Commission Paid: __________________.__ AttorneyFees - SAUL EWING LLP 55,700.00 Family Exemption: (~decedent's address is not the same as claimant's, attach explanation) Claimant JOHN G. WEIDMAN, III Street Address 70 OLD FEDERAL ROAD City CAMP HILL Relationship of Claimant to Decedent SON State _P A Zip 1 7 0 11 3,500.00 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 67 774.55 STFPA42021F12 I- Z :J o :E <C o~o~o~~m~~~Nm~~oroooONN~~rooooooroMro~ro ~OOroOroroN~~~~O~~o~~OOOmON~O~mOO~~~o~ NONMO~ID~~OOOO~OON~~OOO~NOONNOOOIDmID~OOOIDNmM ~NmN~ro~M~NN~~MN~O~N~N~~MO~~~~M~NON ~~~~ ~~MMN ~~ ~M~ ~ fI7 z o i= a.. 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Zo... W ZW ~ ~>- II~~>-~ ~O ~ 8~ ~(/)~8~~ ~~ o Oo...<.!JC!::~OOo...O 0.... ~ -~zt::....O-~~ O~ en....Jg:OZC!::n::C!::g:Oen....JC!::O ....~OO~w~wOO....~w<.!J enowenw~w~wenenO~z OO....J~....Jw....J>....J~OO>O o....Jw<.!Joeno>w<.!Ju....J>....J 0... C!:: C!:: I W W en.... .... 0... C!::ZC!::~ 0... ~ ....J W~W~ ....J > ....J C!::OC!::Z ....J z <.!J ~L-~~ <.!J ~ z W r- W (" Z (" IZI~ '-J ~Z (f.)WWC!:: ~Zet: wO enOU)W wOW ....IN....J Wo...W~....J ....J~~.... ::> C!:: ~ -- ~ ~ ~ ~ ~ - ::> C!:: ~ ~ ~Wo...<.!J~~~~o...<.!J<(W~.... en>o...::>.,I-,o...o...::>(j)>o...~ I.OLOL{)l{)LOLO(O(Ot!)(()(O(O(O(O 00000000000000 _________0_____ (OLONOOOOO(V)(V)OI"-I"-I"- O~N(V)(V)(V)~~~~NNNO -------------- NNNNNN~~~~~~~N ~~~~~~oooaoooo (0 I"- co 0) 0 ,- N (V) V LO (0 I"- co 0) VVVvLOLOLOLOLOLOLOLOLOLO ~~~~~~~~~~~~~~ tREV-1512 ~ + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RES!DENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE liABiliTIES, & liENS ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 3,907.34 1. SEE ATTACHMENT TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,907.34 SlF PA42021 F 13 1 ~ i\ 00<'100C'l........<O~0~ o 0 0 0 0 I.C) 0> <'1 .... ,~ .... ,., OO<i.o..:-.oc-.i..:-,..:<ici<D OOo>............I.C)<O<'1........C'l ~o ~ C'l ~ cr> q ct'). t- O (j) cr> f;/t ~ ~ \- t u.1 z ~ 0 o (/) ~ ffi t 0.. Z 9: >- o ~ "i >- (/) Z 0.. Zu.1 ffi~ :]:$ >-~O<(0 o..r 'QO "i8~~"i ~fd cC';. 0..000';jj ~ ~ t: ... ~ - uJ 0 - ~~ CC.... OcC(9cCO ~~~uJ<&~0'OCCuJ(9:i i==i==ca$~ca'QuJ<!.':;{Z0 ~~~~~~(9td0$<3<3 % o t= 0- & o (/) uJ o ~ u.1:;) ?'Q 0.. ~~ X ;>\- (/) UJ(/) -z. "u.1 $0:: u...~ 0 uJ O~ \-eo . \-: \-: ..,.. :;) )-, r(/)(/)Ui:]:(/) (/)cC Z fu04:. 0 uJ4:. f-Il:! g OuJ00..-~ --,:]:~r- t:~~c(.?_o1l0-o1lCC <i..Z04:.~O(9o..W<!.I:;\!:! 0..::> 0:]: ? 0::> 0......0..--- 1.C)1.C)1.C)1.C)1.C)1.C)1.C)1.C)1.C)u:>1.C)1.C) OOOOOOOOOOoe (i';(i';(i';(i';a;(i';(i';(i';~~:;j''''' OOOOOC'lC'lC'lOee~ ;:::.;:::.t=t=t=t=t=t=(i';rJ:JrJ:JrJ:J 000000000000 ~ ~ ~ ~ $ ~ ~ \ q- I.C) <0 rJ:J 0> .... C'l <'1 I.C) <0 r- rJ:Jo 0>0>0>0>0>000000 00000.........................- ~EV-1513 t'x + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] KATHLEEN M. WEIDMAN 1. 120 NORTH 21ST STREET, APT. 1 CAMP HILL, PA 17011 DAUGHTER 2 . JOHN G. WEIDMAN, JR. 120 NORTH 21ST STREET, APT. 1 CAMP HILL, PA 17011 SON AMOUNT OR SHARE OF ESTATE 1/2 RESIDUE 1/2 RESIDUE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHO~N 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) SlFPA42021F 14 0.00 .- . W ILL I, DOREEN E. WEIDMAN, of the Township of Hampden County of Cumberland and Commonwealth of Pennsylvania, declare this to be my last Will and revoke any Will or Codicil previously made by me. ITEM I: I give and bequeath the sum of Five Thousand and 00/100 ($5,000.00) Dollars, to my husband, JOHN G. WEIDMAN, JR., providing he shall survive me by sixty days. ITEM II: I give, devise and bequeath the balance of my estate, in equal shares, to my children, KATHLEEN M. WEIDMAN, of Hampden Township, Cumberland County, Pennsylvania, and JOHN G. WEIDMAN, III, of Hampden Township, Cumberland County, Pennsylvania, per stirpes. ITEM III: I hereby authorize my Executor to sell any and all real estate of which I die seized, at such time and upon such terms as he may deem best, and to deliver good and sufficient deeds therefor to the purchaser or purchasers thereof. ITEM IV: All death taxes (not income taxes) that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be considered a part of the expense of the administration of my estate and my Executor shall have the absolute power in his discretion to pay the same at once whether or not the law under which they are imposed permits the postponement of payment of all or part of them to a later date. ITEM V: I appoint my husband, JOHN G. WEIDMAN, JR., Executor of this my last Will. Should my husband, JOHN G. .. WEIDMAN, fail to qualify or cease to act as Executor I appoint my daughter, KATHLEEN M. WEIDMAN, of Hampden Township, Cumberland County, Pennsylvania. Should my daughter, KATHLEEN M. WEIDMAN, fail to qualify or cease to act as Executrix, I appoint my son, JOHN G. WEIDMAN, III, Executor of this my last Will. IN WITNESS WHEREOF, I have hereunto set my hand and -- "C7L s.eal this)4...5 day of August, 1980. 6) ~ (J-d. 0"-' E - LJJ. ~-na j~ DO EN E. WEIDMAN (SEAL) The preceding instrument, consisting of this and one other typewritten page, identified by the signature of the Testatrix, was on the day and date thereof, signed, sealed, published and declared by DOREEN E. WEIDMAN, the Testatrix therein named, as and for her last Will and testament, in the presence of us, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses: k~~~/~ 05/ Dl1rm j -0(j ~ i&'~J-uz; QV~jK7J PI} pr:; - OMS NO 2502-0265 qr A. B. TYPE OF LOAN: 3.DcONv. UNINS. 4. OVA 17. LOAN NUMBER: 5.0CONV. INS. 1.DFHA 2.0FmHA U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMEN'T BER 6. FILE NUM : SETTLEMENT STATEMENT HESS-MPF-2006 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 1.0 3/98 (HESS-MPF-2006.PFD/HESS-MPF-200616) F. NAME AND ADDRESS OF LENDER: D. NAME AND ADDRESS OF BUYER: Brian E. Hess 64 Old Poineer Road Camp Hill, PA 17011 E. NAME AND ADDRESS OF SELLER: Kathleen M. Weidman, Executrix of the Estate of Doreen E. Weidman G. PROPERTY LOCATION: 70 Old Federal Road Camp Hill, PA 17011 Cumberland County, Pennsylvania H. SETTLEMENT AGENT: Mid-Penn Abstract Co. I. SETTLEMENT DATE: January 6, 2006 PLACE OF SETTLEMENT 125 Locust Street Harrisburg, Pennsylvania 17101 J. SUMMARY OF BUYER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BUYER: 101. Contract Sales Price 102. Personal Property 103. Settlement Charges to Buyer (Line 1400) 104. 105. K. SUMMARY OF SELLER'S TRANSACTION 400. GROSS AMOUNT DUE TO SELLER: 146,500.00 401. Contract Sales Price 146,500.00 402. Personal Property 2,730.98 403. 404. 405. Adiustments For Items Paid Bv Seller in advance 106. School Taxes 01/07/06 to 07/01/06 107. County Taxes to 108. CitvTaxes to 109. 110. 111. 112. 120. GROSS AMOUNT DUE FROM BUYER 200. AMOUNTS PAID BY OR IN BEHALF OF BUYER: 201. Deposit or earnest money 202. Principal Amount of New Loan(s) 203. ExistinQ loan(s) taken subject to 204. 205. 206. 207. 208. 209. Adjustments For Items Paid By Seller in advance 792.12 406. School Taxes 01/07/06 to 07/01/06 792.12 407. County Taxes to 408. City Taxes to 409. 410. 411. 412. 150,023.10 420. GROSS AMOUNT DUE TO SELLER 147,292.12 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 5,000.00 501. Excess Deposit (See Instructions) 502. Settlement CharQes to Seller (Line 1400) 2,943.27 503. ExistinQ loan(s taken subiect to 504. Payoff of first Mortgage 505. Payoff of second MortQaQe 506. 507. (Deposit disb. as proceeds) 508. 509. Adjustments For Items Unpaid By Seller 210. School Taxes to 211. CountVTaxes 01/01/06 to 01/07/06 212. City Taxes to 213. 214. 215. 216. 217. 218. 219. Adjustments For Items Unpaid By Seller 510. School Taxes to 6.73 511. County Taxes 01/01/06 to 01107/06 6.73 512. City Taxes to 513. 514. 515. 516. 517. 518. 519. 220. TOTAL PAID BY/FOR BUYER 5,006.73 520. TOTAL REDUCTION AMOUNT DUE SELLER 2,950.00 300. CASH AT SETTLEMENT FROMITO BUYER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amount Due From Buyer (Line 120) 150,023.10 601. Gross Amount Due To Seller (Line 420) 147,292.12 302. Less Amount Paid By/For Buyer (Line 220) (5,006.73) 602. Less f,@ductions Due Seller (Line 520) (2,950.00 303. CASH ( X FROM) ( TO) BUYER 145,016.37 603. CASH ( X "10) ( FROM) SELLE~ "\ 144,342.12 The undeffiig: nnOWledge r~iPt of "LPY of pages 1&2 of fu~ stat:::~t &~t1vl~ (~ Lie. ~ Brian E. Hess Ka an, Executrix of the Estate of Doreen E. ('.1 "" ~ c::r r- ~ p.a c:a 0 \P "" ~ , \P c::r c::r ~ ~ O.t CfJ CJJ .~ UI (\) 0 0 ~ (\) Q) ~ '% ? C. ';Z. 0 C .~ 0 ~ .,4 ~ % 0 ro (/) (\) C rQ ro ~ (\) ~ ~ rQ C. 0 c:n (J) ('.1 t5' "" ~ c. c::r .~ r- ~ ';;> p.. ro c:a (j) 0 r4 (j) .c 0 C D ro ~ CO UI o o N -- CfJ o -- 0:> o Q) ~ ro p C- O .,4 , m UI \.0 \ o N N ~ '"d Q) e (\) Q) '"d (\) ~ (J) '"d C (\) 0 .0 ~ ? 4-\ .,\J 0 ro C ~ 0' (\) .,4 -% ({) ? ~ C (\) e r\ 0 ro .,\J +l (J) 0 ? t-' 0 ~ ~ (:) r-\ '> 0 0 0 0 0 0 0 0 0 0 ('.1 0 N ('.1 \0 \0 N 0:> 0 \P ("f) N 0:> (j:) . . . . . . . . . . . . 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"i;"<'~:r:i~: / J. ~ ~~. / \. { : . '.~' ., .J ,.. .~ [..~/, //. ....:,..;. 'i '..., 1I-W. '.' <', ,.,' " /,' '"",,/.' , ESTATE OF DOREEN E. WEIDMAN C~OSAULEWING, LLP P.O. BOX 1291 HARRISBURG PA 17108-1291 ~""" ~..., II' '" 20 3 ~II' ':0 3 ~ 20 ~ j bO': QOIl.OO Q ~II' bU' ", NPXX-8201-7484-1ATO CLOSE ESTATE ACCOUNT 1107219 8/31/05 11603.38 ***11603.38 J.J.B. HILLIARD, W.L. LYONS, INC. PLEASE DETACH BEFORE DEPOSITING /' '~ '. " " .'. " ,,/~/~~,.--.' ,~~'~'~~-~""~" ", ~/>~HL~EN:' H wEiDMAN ,EXECtrrRIX, :/ ,',', '-'. -. .' . :EST OF' DOREEN E WEIDMAN p~:' Q.~O~12.91 ,<~~~-SBtrRG ,PA 17.108-1291. ~Ai//" "', ~~gf } 11.0 . J. 0 ? 2 . ~ II. I: 0 I.. j j 0 J. b 2 ? I: .00 q 5 b 2 j 5 1..11. . ' , American Express Funds CONFIRMATION Minneapolis, Minnesota 55474 AXP HIGH Y I E LD TAX - EXEMPT FUND, I NC WE HAVE RECORDED YOUR TRANSACTION AS FOLLOWS: F U L L RED E H P T ION TRANSACTION DATE CLASS PRICE SHARES 9/22/2005 A $4.460 3,660.272- SOLICITED ACCRUED DIVIDEND AMOUNT $16,324.81 $40.48 CHECK AMOUNT $16,365.29 KATHLEEN M WEIDMAN 120 N 21ST ST APT 1 CAMP HILL PA 17011-3808 TOTAL SHARES OWNED ACCOUNT NUM8ER .000 0101-1936,169-8 NON-NEGOTIABLE PlEASE READ IMPORTANT EXPLANATIONS AND OlSCLOSURES ON THE BACK OF THIS CONFIRMATION GAIN/LOSS INFORMATION WILL BE SENT AFTER YEAR END KEEP THIS STUB FOR YOUR RECORDS. OGL FOO180 (0&/2005) F327 American Express Funds AXP HIGH YIELD TAX-EXEMPT FUND, INC CONFIRMATION Minneapolis, Minnesota 55474 WE HAVE RECORDED YOUR TRANSACTION AS FOLLOWS: F U L L RED EM P T ION TRANSACTION DATE CLASS PRICE SHARES 9/22/2005 A $4.460 3,660.273- SOLICITED ACCRUED DIVIDEND AMOUNT $16,324.82 $40.48 CHECK AMOUNT $16,365.30 JOHN G WEIDMAN 70 DLD FEDERAL RD CAMP HILL PA 17011-2047 TOTAL SHARES OWNED ACCOUNT NUMBER .000 0101-1936,206-8 NON-NEGOTIABLE PlEASE READ IMPORTANT EXPLANATIONS AND DISCLOSURES ON THE BACK OF THIS CONFIRMATION GAIN/LOSS INFORMATION WILL BE SENT AFTER YEAR END KEEP THIS STUB FOR YOUR RECORDS. OGL FOO180 (06/2005) F321 . l , . BRICKERS 'AUCTION Buy & Sellon Commission - Complete Sale Service . 93 Texaco Rd., Mec'hanicsburg, PA 17055 766-5785 Persona Property 0 D DfZ~e-N E-I 4 !1/fIJ t7-ST Address Sold At Public Sale /0 .... 2- 2- 20 Os Outstanding Total Sale 7,-/ 61, 2S Total Checks 4/tJo, /J~ Total Cash Cash After Payout /)/ 2.. s-v . ,j-V A rJ'.. 0 d ",-. Expenses Auctioneer & Clerks , 7 j7J, () 0 Adv. Cost h~ o( 00 Property Fee I J Or a U Sale Setup or Help o57J, /)lJ Total Expenses JJ ..log 0, aD I I f tv /~ I 00, ? JeWel<':> { _ -,\ (\l C.A'5v\ /:2::>U( v ~r - ~l ~ ,;.{1I 03J~ B A-,vy-- ~ tf~FuA ~ ~ ,KelJ.~y Blue Book - Private Party Pricing Report - Chevrolet, Corsica . Page 1 of2 _ KelleyllleBook ..... ..... . .... ..... THE 11lUSTlDRESQIJRCli ........ advertisement Search Dealer Inventory . View CUrrent Offers . Request a Quote ., ~~ V<M CiII. v.. ct gmb'JYPo'/"er. coni USED CAIS o Quick Dealer Price Quote 0 Search Used Car Listings 0 Lis REViEWS & RATINGS ADVICE nNANCJNG Quickly brm $~ClrGhLi$ting$for This Car 600,000 USE ~i$tuYQlILC~IFQL$Cll.e.uQnUne ~~~i~a~~~C1 Quick New Car Price Quote ~ Free CARFAX Record Check Auto Loans from 4.75%) APR -adv InsuJClOCe Quote Print "For Sale" Sign P~ymeuntCC3IGlJ l~lQr BLUE BOOK. PRIVATE PARTY REPORT Pennsylvania. July 8, 2005 1988 Chevrolet Corsica Sedan 40 "'< <<~^~:%:',"~-~ > ./ ~,t~", c?.>: < ' tffit: ~ ,,~ x.:. : t, ~7'0"~~ /;~:~t~,;: : , ., '" ~;. ~ 1 ~A~ : ::% ;~~"~ ~,~,~'-" '" r-~*.< ," ~* .. < t Engine: 4-Cyl. 2.0 Liter Trans: Automatic Drive: FWD Mileage: 72,230 Equipment Air Conditioning Power Steering AM/FM Stereo Consumer Rated Condition: Fair "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean tttle history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Private Party Value Se.()rc:hdLQc:gtulJ$ting~ I Li~lThj~m.CgLtQrnSgl~ $575 Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation pu rpOses. Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars l-Q~.K.J.n...AI)JQulQan.Ha.tes__A~_lQJ'(_As~,]5?tq_ APR BLUE BOOK I StOftn Used ( Search I nvena View 0 Offers- Requ~ a Quot4 ~ V... aIt'_You http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.PA;287551;PA041&17011;sed+p&723;Chevro... 7/8/2005 r ~elley Blue Book - Private Party Pricing Report - Chevrolet, Lumina APV .... - Page 1 of2 -....11118'.... .. .... · . ... THETIlUSTED IU'.5QUXCE . ....... ad vertisement Search Dealer Inventory ~. View Current Offers . Request a QUote . ~~ Your Q". Ycu- ct gmblJypowet. coni USED CAAS C Quick Dealer Price Quote 0 Search Used Car Listings 0: lis REVIEWS & RATINGS ADVlCE fiNANCING BLUE BOOKe PRIVATE PARTY REPORT Pennsylvania · July 8, 2005 1992 Chevrolet Lumina APV Minivan . '>'f; : $earc;hL.istings.forThiS CC3J L.ist Y ourCC3f ForS~leOnline Quick New Car Price Quote free CARFAXuRecQro Check Auto Loans from 4.75% APR Insurance Quote Print "For Sale" Sign P~Ym~n!uC~!~YJ~tQ[ Engine: V6 3.1 Liter Trans: Automatic Drive: FWD Mileage: 46,890 Equipment 6-] Passenger Air Conditioning Power Steering AM/FM Stereo ASS (4-Wheel) Consumer Rated Condition: Fair "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean title history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Private Party Value Search LoealL.istings I List This c:~rfor S~I~ $575 Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Get a Used Car Trade- In Value Ge.tJDYQ.i<::e~&_.M .sHPnQIJ_~_~_w..c.grs LQck In Auto l.oan RatesAsl.Qw A$ 4.75O(cIAPR BLUE BOOII Starcb Used ( Quickly brm 600,000 USE to find exac1 you want. -adv ~Cl Search Invente View 0 Offers. Requ~ a Quot4 ~ VId aIt.Yoo http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.P A;8783 34;P A041 & 170 11 ;van+p&723;Chevr... 7/8/2005 _~2~!~~~~ POSTMARK CREDIT UNION 2630 Lingfestown Road Harrisburg, PA. 17110-3666 Phone: 717-671-5119 for first class fina.ncial servic No.028604 SHWI Check Withdrawal Voucher POSTMARK CREDIT UNION 2222- 0 WEIDMAN/DOREEN E AMT: ' -86442.23 FROM REGULAR SHARE ACCT WITH FEES: .00 BAL: 50~OO" 06/29/05 01:57PM 12783 1 5 . EFF,;"DT:06/29/05 BLS BR:Ol 28604 UNLOCK YOUR HOME'S EQUITY! CONSO~IDATE J)EBT:MA~E'HbME"IMPROVEMENTS FINANCE A COLLEGE EDUCATION ANDu~UC"HMO~f::,!.:."fl~E:I.J..I3H.IE'"TERMS AS LOW AS 4.99% FOR 5 YEARS AND 5. 99~FOR'15YEARS!!"' ""APPLY TODAY <---j~'-J?;. ::JAr~ Cy.+. RECEIVED BY . DETACH THIS PORTION BEFORE DEPOSITING ~POSTMARK CREDIT UNION 2630 Unglestown Road Harrisburg, PA · 17110-3666 . 717-671-5119 " No. 028604 06/29/05 6(}.81 0 1/23 EXACTLY.&) 86.44ZaolsZ3cts PAY EIGHTY-SIX THOUSAND FOUR HUNDRED FORTY-TWp AND .". 23/100 DOLLARS $86,442.23 TO THE ORDER OF . ESTATE OF DOREEN~ WEIDMAN VOID AFTER 90 DAYS !i~~a. Ifl 0 2 8 b 0 ... III I: 2 ~ J. j 8 J. 0 J. ~ I: III gOO 0 0 0 0 ? III ? 8 - - - - - - - - - -.- - - - - - -_._- - --- -:-- - - -- - - - - - - - - - - - - - - - - - I I, ) . --Commerce ~Ban.'~ America~ Most Convenient Bank@ ft 1-888-937-0004 commercepc.com Balance infqnnation reflects transactions fa h 6:00 PM on that business day. Some deposits may not be available for immediate withdrawal. Checks ~ and Y\ ~ Me rec'- ,,, ~ sub~ to me _ns of me UnKunn CMnm'- Code a any W-- 00_00 aQfee'- \ ~ (\ S \ \\~\) OO..CfT.:l1 ~-Ol- G7/07/0S- DOUI. . . 5. :36B488l:mi- ~ ~_ DOA DEPOSIT RCP $37!OOO,OO ~~(;~~ i3:$ MAfN OmCE x.. ( ) . ~PN<:B)\l'.J( PNC Bank, National Association 60-1273/313 Cashier's Check No. 00092401 Date June 24, 2005 o o <0 o lb C") ~ Pay to the Order of ESTATE OF DOREEN E WEIDMAN ~ 0:. o u.. w $' 65,664.44 . onal Association 2001016400 Remitter L /./ 111000 g 2 1..0 ~III 1:0 l . 3 ~ 27381: 5000 1.00 b a.. 51' THIS DOCUMENT HAS AN ARTlFICIAL WATERMARK PRINTED ON THE-BACK THE FRONT OFTHE DOCUMENT HAS A MICRO.PRINT SIGNATURE LINE ABSENCEOFTHESE FEATURES WILL INDICATE A COPY. ~ Pennsylvania State Bank Camp Hill. PA 17011 OFFICIAL CHECK NOTICE TO CUSTOMER THE PURCHASE OF AN INDEMNITY BOND MAY BE REQUIRED BEFORE ANY OFFICIAL CHECK OF THIS BANK WILL BE REPLACED OR REFUNDED IN THE EVENT IT IS LOST, MISPLACED OR STOLEN. 104018 Date JUNE 24, 2005 $110,257.47 5-709 110 . ~ /~ ,fI~'" ....if r"~ ',' ~~' ,~.,:.,,:: '-:~) ;_-~..:", -~ ~>: ~..;.'. ~'.us.{- - ,-. -j .' ,1. H~. C.Jl. _. . c -;, , . .%y k- tlte · THE ESTATE OF DOREEN EDITH WEIDMAN r -:;'7:J ,l . / .7a.iUCU.lCUJ o-u:k'& CLOSE ACCOUNT (1/ BANK ISSUED BY: TRAVELERS EXPRESS COfvlPANY, INC., P.O. BOX 9476, MINNEAPOLIS, MN 55480 DRAWER: BOSTON SAFE DEPOSIT & TRUST CO.. BOSTON, MASSACHUSETIS -----~- II. . 0 I.. 0 ~ 8111 I: 0 . . 0 0 ? 0 g 21: 0 . bOO . . 3 2 5 g b 5 II' FORM103755-QS04 Cashier's Check o PNCBAN< PNC Bank. National Association Southcentral, P A No. 01197738 60-1273/313 ~ :.=! f.:i ~:i J. r:i ~~ Date :Y: ir..iF -~:'4:, '-:;'nn:::; . T''''L! T' il""l'/~" .'01 11"- I C,!'i ! ri J );:IHI"~V Dollars .0. Security Features l!J ~On back ::;1401614$:: REMITTER ~~~~ N~tio s~~u~ n" Association ________Af' 1110 . . 9 7 ? j a III I: 0 j I. l I. 2 ? j 81 : 01-3 66217 I M 54377-M3 ~O ? 1;:;1-3 ""'0 ~~gj ~ * * .. +-3 0 .. g3 t:;j m (1) ~~~.~ (I) {/) ....., ~9~ f""t- ~ t:T' '.. ~ 0 ~ OJ tri tr1 .... C ::Jo~ m C/) o,x.. ~ r 0 ~ cn~t-' 0 '"Ij 0.. g 0 (') b:' .0 d ~ cO :;;d [J""J - tr1 tr1 0 -0 tj [J""J ~ 0 <D-.~ ::J 1-1 .. ~ ::t ~ ~V) C ::; - ...... .. m Er ri3 0 ...... 0 ~ (1) ~. Z ~ .... m 0.. .... ~ Ijj tJ ...,J 0 ~ 0 0 4 01 ~ 01 I '"r.l <- (1) ~ 0.. 0 tv -----.. ...... 0 0 ~ :- C1 ~ c: . 0 . Co ~ tD ~ :<: ~ O1tDtD".... > ~~~~~ ~ggOl~ ~ 0 ...... O. .....~CIl)(iil 0 (/1 -.) oJlo;.~tr .... -....... ~ i>> * 0 0...." 0 ~ * -.) ~?: -....... (fJ ~ 0 ~ ~. Q VI :::~ro Z S 12'>;3 l:> -l ....111" m 2"[~ c S ::0 !. if':' m OJ (fJ m o~3" ::0 :D 3 Z~ ~m 0 rn i~ c ~ ::I~ 55 <CD m rn 0 0 ~ -n " 0 ::0 m () 0 ~ J: mQ ~ 0 m :D." N 0 n )>-n ^ r- - ~ 0 0 00 ~ 0 < 0 m :D- ::0 m)> 0 0 or- N ~ =io ~ 0 c:r: \0 zm 0\ 00 0\ z" .&. 1(.... . ) .:., . Commerce ~r Danll~ America's Most Convenient Bank~ g~ K 1-888-937-0004 commercepc.com $787.00 Balance information reflects transactions through 6:00 PM on that business day. Some deposits may not be available for immediate withdrawal. Checks and other items are received for deposit subject to the provisions of the Uniform Commercial Code or any applicable collection agreement. OD53. 16 uS.! 15/05 mID3 OOA DEPOSIT Rep 5368468U7g 11:41 DOL-In to~m Office BR-17 -HB (5/05) I I j j i I I j I I i I t ...-,',' .' -..-..... ".""'. . ',-.-. .-:-:':'-". . . . -. ,.. , . - - ' - . . . ....-..,-. '.. - ---,"," - ... ". . -.-..'. -"'" "_.::.: : - " "",",' . . - ' - - . . .. . :~STJ\rEqF;D()REEN '70 OLD FEDERAL RD CAMP HILL, 17011 ...... , .-,"...-.- ,.. .::.:".. '.'. "... -- .. ...>..... ,.....................-..-. ....... ..,. Bank of ArneneaCustomefConnecti<>r1. . 64-1278 " .,.......:...,......:;......'..:.~..i,,_::~.:......:..DA':. :.'::<T:EI~~t~~ ~~~~~~~.~~~~;-' . 611 . ': ." tHECK:N(J'i~;.23i638 74 '~~~~;I~~ .......... ...................... .' .......,. -.....,. .. .... ... . - .C,',',... $7~7.00 I .< f&1Se~itv ~~i;' :<~W~~~;'ck. ' li~~~J~~i~Ij~OUP ~RIE. R:..E.F.A,.~.,.N,......,'~...'.,.....,...,.n....... . CHECK;"'W Pr$fTliUmRefund Due to Code 1,PoIici C~led Codtt2. Poficy Expired:: Code 3 . Premium Reduction Code 4 . Overpayment POUCY NUMBER Q041700243 H ....................... ...........,....... .,.... ..-' ".' .......'... '.". DOLLARS.:AND,.iOQCeN"TS AGENT AA 7172 REF. NO. W163874 ". . -':' -:',; - ;;. ':-:-: :" :': ::::: " . . :- ;'::.::, . :. ,. -. :': '- ,:, .. :. '.: : . .;:;: : ~;: ~ -'. : :;~ ; .rrJ* AU~'ZE~~~; ~ II- 2 3 ~ b 3 a ? "'"- ': 0 b ~ ~ ~ _ 2 ? a a I: :\ 2 E1 E1 ~ E1 b 5 ~ "'"- . - .. o JJ tP o .... tP ~ tP \.f'\ - .. o o r- iP ~ .....1 ~ JJ \.f'\ tP .... \.f'\ .... "'it ~ o~ '3 ~~ -' ::r n> t"'\ '" ("t f>> ("t n> o -n d yrr~ 0 " ~J'N'/ -1 ~~/~ n> 't -.J/ n> \/~ d \l.I_:t ,\q~ ::', ~;~ ..... (:? ~ J ~~ f>> 0\d ~. <:P ~.S\ '"S1 ~l""" ~~~~~ ~ \ \ \ \ \ \ \~ d ~ (..,I c: .,,-j \..(. ....... w 6l f') (:) o .." ~~), ~_:t'" -- _ Commerce ~r ftan.l~ America~ Most Convenient Bank@ g~ ft 1-888-937-0004 commercepc.com ji ~.. Balance information reflects transactions through 6'00 PM on that b' d S . and other items are received for deposit subject to the proviS~~~e: th:t jfomeeodeposlts r:nay not be available,for immediate withdrawal. Checks norm mmerClal Code or any applicable collection agreement. 0255.16 08/12/05 0002 DDA DEPOSIT RCP 12: 2E; 53B848807n $41~607.45 [}(;t.m t owr; 0 f f i C2 BR-17-HB (5/05) MBNA America Bank, N.A. Account Number Date 08/09/05 Check Number 713739 Amount 40-821269-8 $41,607.45 MBNA's TOLL-FREE NUMBER: (809)348-4632 Detach and retain this voucher. If not correct, please notify us promptly. . .. . .. .:. ... . . : . .. AtBN"- . MBNAAmericiiBank, N.A. . Wilmington, DE 198j()'5103 . . BANK OFFICIAL CHECK . 62-16 311 "MeRIC"- DATE 08/09/05 NUMBER 713739 Member FDIC PAY THE SUM OF:*****41 ,607 DOLLARS AND 45 CENTS AMOUNT $41,607.45 . '. DOREEN' EWEI])MAN ESTATE . KATHLEEN M WEIDMA~ EXEC CAJ.DONN L SYNDER ESQ: PO BOX;129i ':"-:'. .' . . HAR1USBURG PA:17108-.1291 M' ul n n n " , ., n ., ~..- 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 WEIDMAN KATHLEEN M 120 NORTH 21 ST APT 1 CAMP HILL, PA 17011 _uu___ fold EST A TE INFORMATION: SSN: 195-16-2856 FILE NUMBER: 2105-0573 DECEDENT NAME: WEIDMAN DOREEN E DATE OF PAYMENT: 03/03/2006 POSTMARK DATE: 03/03/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/09/2005 NO. CD 006392 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9,519.63 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: K M WEIDMAN CHECK#160 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $9,519.63 GLENDA FARNER STRASBAUGH REGISTER OF WILLS Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of DOREEN E. WEIDMAN No. 21-05-00573 Date of Death JUNE 9, 2005 195-16-2856 also known as , Deceased Social Security No. 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 placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verifY. hat the statements made in this Inventory are true and correct. I/We understand that false statemenu;s rein are made su t to the penalties of 18. Pa. C.S. Section 4904 relating to unsworn falsification to authorities. , Personal Representative Name of NN L. W J JF:"'- / Attorney: .thLiJ~ ~ ~A.~ I.D. No.: 06858 P.O. BOX 1291 HARRISBURG, PA 17108-1291 (717) 257-7524 Address: Dated: ~ - I 7 -0 (a Telephone: Description REAL ESTATE: See Schedule "A" Attached PERSONAL ESTATE: See Schedule "B" Attached See Schedule "E" Attached See Schedule " F" Attached See Schedule "G" Attached Vahje \.....,-1,..; 144,342.12 96,570.04 415,078.78 14,233.98 126,337.53 TOTAL (Attach Additional Sheets if necessary) 796,562.45 121736.12/13/06 ~ 1:-' REV-1502 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER DOREEN E. WEIDMAN 21-05-00573 All real property owned solely or as a tenant in common must be reported at fair market value. F air 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 property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION 70 OLD FEDERAL ROAD, CAMP HILL, PA 17011 DEED BOOK W, VOL. 24, PAGE 524 NET PROCEEDS FROM SALE OF HOME VALUE AT DATE OF DEATH 144,342.12 SlF PA42021F.3 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 144,342.12 REV-1503 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. u.s. SAVINGS BONDS VALUE AT DATE OF DEATH 13,436.32 2. u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH DAUGHTER - HELD IN DECEDENT'S SAFETY DEPOSIT BOX 19,504.32 3. u.S. SAVINGS BONDS - HELD IN JOINT NAMES WITH SON - HELD IN DECEDENT'S SAFETY DEPOSIT BOX 13,707.92 4. HAMPDEN TOWNSHIP SEWER AUTHORITY 5,587.50 5. PNC INVESTMENTS 11,603.38 6. AMERICAN EXPRESS 32,730.60 STF PA42021F.4 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 96,570.04 REV-1508 E)t + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3 . 4 . 5 . 6. 7. 8. 9 . 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. DESCRIPTION REFUND - SEWER AUTHORITY AUCTION OF HOUSEHOLD ITEMS - NET 1988 CHEVROLET CORSICA 1992 CHEVROLET LUMINA POSTMARK CREDIT UNION - SAVINGS 30 SILVER DOLLORS CASH IN SAFE DEPOSIT BOX CHANGE IN SAFE DEPOSIT BOX PENNSYLVANIA STATE BANK PNC BANK PNC BANK MEMBERS 1ST FEDERAL CREDIT UNION ERIE - UNUSED HOME OWNERS PREMIUM ERIE - UNUSED CARE INSURANCE PREMIUM COMMUNITY BANK CONTINENTAL CASUALTY CO. MBNA PNC BANK BLUE CROSS - REFUNDS TRAVELERS CHEQUES PATRIOT NEWS - REFUNDS CUNA 2004 TAX REFUND VALUE AT DATE OF DEATH 124.00 5,351.25 500.00 500.00 86,442.23 30.00 37,000.00 88.25 110,257.47 10,303.60 65,664.44 1,245.02 346.00 787.00 53,720.11 527.11 41,607.45 71.13 54.91 250.00 128.35 27.52 52.94 STF PA42021F.9 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 415,078.78 REV-150\1 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 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. KATHLEEN M. WEIDMAN 120 NORTH 21ST STREET, APT. 1 CAMP HILL, PA 17011 DAUGHTER B. JOHN G. WEIDMAN, JR. 120 NORTH 21ST STREET, APT. 1 CAMP HILL, PA 17011 SON c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY - %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and barll accolllt number or similar IdentifYing number DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT Attach deed for Jointly-held real estate VALUE OF ASSET INTEREST DECEDENT'S INTEREST - 1. A.-B 7-02 MBNA - CD 24,568.20 33.33 8,188.58 2. B. 5-02 PNC BANK - SAVINGS 6,045.40 50 3.,022.70 3. A. 5-02 PNC BANK - SAVINGS 6,045.40 50 3,022.70 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 , 0.00 0.00 0.00 TOTAL (Also enter on line 6, Recapitulation) $ 14,233.98 STFPA42021F10 (If more space is needed, insert additional sheets of the same size) HEV:1510 E~ + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF DOREEN E. WEIDMAN FILE NUMBER 21-05-00573 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 %OF ITEM INCLLOE T~ NAME OF T~ TRANSFEREE. T~IR RELATIONSHP TO DECEDENT AND T~ DATE DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER OF TRANSFER. ATTACH A COpy OF TI-E DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE) 1. POSTMARK CREDIT UNION - IRA 3,336.21 100 3,336.21 2. POSTMARK CREDIT UNION - IRA 47,399.81 100 47,399.81 3. POSTMARK CREDIT UNION - IRA 10,861.94 100 10,861.94 4. POSTMARK CREDIT UNION - IRA 23,144.11 100 23,144.11 5. AMERICAN EXPRESS - IRA'S 41,595.46 100 41,595.46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL (Also enter on line 7, Recapitulation) $ 126 337.53 (If more space is needed, insert additional sheets of the same size) STF PA42021 F 11