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Home My WebLink About03-09-06 (2) r :J , REV-1500 EX + (6-00) *' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I OFFICIAL USE ONLY I FiLE NUM;E1R 0 5 1 0 9 6 , COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 173-24-9225 1 . Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o i= < ...J :J ~ ii: < u w a:: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) I DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) ~ i Myers, Ellen E. z ~ i DATE OF DEATH (MM-DD-YEAR) ~BIRTH (MM-DD-YEAR) ~ 'I' 12-03-2005 I 12-19-1929 ~ ,(iF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER I- Z W C Z o 11. <Il W 0:: 0:: o U i x-11. Original Return 1--1 2. Supplemental Return [J 3. Remainder Return (date of death prior to 12-13-82) w I- 4a. Future Interest Compromise (date of death after lI::~<Il 4. Limited Estate 5. Federal Estate Tax Return Required uO::lI:: 12-12-82) wl1.U :1:00 6. Decedent Died Testate (Attach IJ 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes uO::...J :~ 11.1Xl copy of Trust) 11. copy of Will) c( 9. Litigation Proceeds Received U 10 S:r.ousal Poverty Credit (date of death between [J 11. Election to tax under Sec. 9113(A) (Attach Sch 0) . 1 -31-91 and 1-1-95) TELEPHONE NUMBER 717/730-7310 ~I 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (1 ) (2) (3) (4) (5) (6) (7) 276,545.58 None None None 104,704.43 None None (9) (10) 14,610.75 -- - 40,070.22 OFFICI~e USE ONLY .? (8) (11 ) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0.00 x .00 (15) 1 ',J) ~.,. r..) 381,250.01 54,680.97 326,569.04 0.00 326,569.04 15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) z o i= < ~ :J c... :E o u >< < ~ 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 13. Charitable 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) 326,569.04 x .045 (16) 0.00 0.00 x .12 (17) x .15 (18) 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. (19) 0.00 14,695.61 0.00 0.00 14,695.61 >>BE SURE TO ANsweR ALL QUESTIONS ON REveRSE SIDE AND'RECHECK MATH<< Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; ~ Decedent's Complete Address: STREET ADDRESS 765 Lancaster Avenue iS~PA : ZIP 17025 - CITY Enola Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 14,695.61 13,500.00 ---_._~~-- 710.53 Total Credits (A + B + C) (2) 14,210.53 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is th€DVERPA YMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) (4) (5) (5A) (58) 485.08 485.08 Make Check Payable to: REGISTER OF WILLS, AGENT 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;............................................................................. I xl b. retain the right to designate who shall use the property transferred or its income;................................ Ii] c. retain a reversionary interest; or............................................................u.............................................. I!J d. receive the promise for life of either payments, benefits or care?........................................................... [~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?......................................................................................... u..................... I J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.............................u................................................................................ I ] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penaijies 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 cO-"Plete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF ERSON RESPONSIBLE FOR FILING RETURN ADDRESS ryan rs I) 'f0' 0' ",(iIO;"'7} "UNG ""OR' SjGNAT~RER OT ER N REPRESENTATIVE Michael L. Bangs 1 I~ DATE 7 Sherman Drive East Berlin, PA 17316 ~I J f/~ i , IDA~ ADDRESS .~/~/ DATE ADDRESS 429 South 18th Street Camp Hill, PA 17011 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. s9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 39116 (a) (1.1) (ii)]. The statutedoes not exemDt 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. 39116 (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. 39116 (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. s9116 (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-1502 EX+ (6-98) *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Myers, Ellen E. IFILE NUMBER I 21-05-1096 ESTATE OF All real property owned solely or as a tenant in common must be reported at fair mar1<et value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable Knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Real Estate - 765 Lancaster Avenue, Enola (see settlement sheet attached; sold on 2/15/06) 276.545.58 TOTAL (Also enter on Line 1. Recapitulation) 276.545.58 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) i .I OMBN "1r ......-- B. TYPE OF LOAN: A. 3. ~CONV. UNINS. 4.0VA 5.0CONV INS. 1.QFHA 2.0FmHA U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 6. FTCt NUMBER: I 7. luAN NUMBER SETTLEMENT STATEMENT RUDE.SM 77776112RUDE 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 settJement agent are. shown. Ita s marked "[POCr were paid outside the closing' they are shown here for informational purposes and are not mcluded In the totals. m , 1,0 3198 IRUOE,SM.PFDlRUDE,SMl34) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SEllER: F. NAME AND ADDRESS OF lENDER: STEPHEN G. RUDE and COMMERCE BANK/HARRISBURG NA MICHEllE RUDE BRYAN MYERS, Executor 100 SENATE AVENUE of the Estate of Ellen E. Myers CAMP Hill, PA 17011 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2402316 I. SETTLEMENT DATE: 765 LANCASTER AVENUE PURITY ABSTRACT COMPANY ENOLA, PA 17025 February 15, 2006 CUMBERLAND County, Pennsylvania PLACE OF SETTLEMENT 3329 Market Street Camp Hill, P A 17011 J. 1(. 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 340,000.00 401. -Contract Sales Price 340,000.00 102. Personal Property 402. Personal Property 103. Settlement Charges to Borrower (Line 1400) 11,533.19 403. 104. 404. 105. 405. Adjustments For ttems Paid By Setter m advance Adjustments For Items Paid By Seller In advance 106. GountyfTWp Taxes to 406. CountyfTwp Taxes to 107. City Tax to 407.- City Tax to 108. School Tax 02115106 to 07/01/06 1,312.17 :-408. SChool Tax 02/15106 to 01/01706 1,312.17 109. 1ST UTR SI::WER &IRAS~027157a61o 04101/06 57.50 409. 1 ST aTR SEWER & TRASH 02/15/06 to 04101/06 57.50 110. -410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 352,902.86 420. GROSS AMOUNT DUE TO SELLER 341,369.67 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 1,500.00 501. Excess Ueposit (See fnstructions) 202. Principal Amount of New ['oan(s) 272,000.00 502. Settlement Charges to Seller (Line 1400) 23,810.00 203. Existing IOan(s) taken sUD)ect to 503. EXIsting loan(s} taken subjecllo 204. 2NLJ LOAN 33,422.24 504. Payoff of first Mortgage to MEMBERS 1ST FEDERAL CI 37,904.40 205. OOO~ Paytitr6Tsecona Mortgage 206. 506. 207. [--S07. ([Jeposif(fiso. as proceeds) 208. 508. 209. SELU"R A::;SI~ lANCE 3,000.00 509. SELLER ASS1SiANCE 3,000.00 Adjustments For Items Unpaia By Seller Adjustments For Items Unpaid By Seller 210. GounlyfTwp Taxes 01101/06 to 02115/06 109:69 1010.-C-ountyfTwp Taxes 01/01/06 to 02115106 109.69 211. City Tax to '-511. City-Tax to 212. SChool Tax 10 512. School Tax to 213. 513. 214. 514. 215. 515. 216. 516. 217. 017. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 310,031.93 520. TOTAL REDUCTION AMOUNT DUE SELLER 64,824.09 1300. CA5H AT SE""TLEMENT ~K()M/TO : 1IDlf. \,;A5H A I;:'~ I LI:M~N' 'UII"KUNI SELLER: 301. Gross Amount Duet'rom Borrower (LIne 120) 352,902.86 601. Gross AmounllJue To seller (Line 420) 341,369.67 302. Less Amount Paid By-W-oillorrower (Line 220) 310,031.93 602. Less Reductions Due Seller (Line 520) 64,824.09 303. CASH ( X FROM) ( TO) BORROWER 42,870.93 603. CASH ( X TO) ( FROM) SELLER 276,545.58 o 2502 0265 ~ Borrower Seller , . L. SETTLEMENT CHARGES PAID FROM 700. TOTAL COMMISSION Based on Price $ 340,000.00 @ 6.0000 % 20,400.00 BORROWER'S U1VISlan at l.;ammlSS/an (line fUU) as Follows: FUNDS AT {Ul. ;jllu,225.UU to KSK TnR'" SETTLEMENT {U~.:Ii lu.175.00 to L'I., KeAL TY, INL;. {U;j. L;OmmlSSIOn PalO at oeUlement REALTY, INL;. 195.UU {U4. I reI:: to ~l , 800,ITEMS'PAYABLE IN CONNECTION WITH LOAN 801. Loan Oogmation Fee % to 680.00 802. Loan 'Discount 0.2500 % to CUMMERCE BANKfHARRISt;URG N.A. 1803. Appraisal ree to I He n. "'.vn.. rIKM, INL;. 300.00 ra04.-CreditReport to ......VlI...' I"'U l:SY ..... ...,..., : $50.00 I/::SU::>. AOmlnlstration ree to ' ,....... N.A. 575.00 806. Flood Cert Fee to PD BY LENDER POC $6.00 807. Tax Service Fee to 808. Underwriting fee PU l:SY POC $30' .00 tlU~. Ml::Ko FEE PU l:lY I"I\Inl"R t-'UL; :ti4.UU tllU. MAILfl::1:: t-'Ul:lY j;;l\lnj;:R POC $50.UU 811. gOO. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 02/15/06 to 03/01/06 @ $ 45.330000/day ( 14 days %) 634.62 YUZ. Mortgage Insurance premium for months to 903. Hazard Insurance Premium for 1.0 years to LIBERTY MUTUAL INSURANCE POC'$916.00 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months @ $ 76.33 per month 228.99 1002. Mortgage Insurance months @ $ per month 1003. CountylTwp Taxes 13.000 months @ $ 72.66 per month 944.58 1004. City Tax months @ $ per month 1005. School Tax 9.000 months $ 287.60 per month 2,588.40 1006. months per month 1007. months per month 1008. AGGREGATE ADJUSTMENT months per month -748.65 1100. TITLE CHARGES 1101. Settlement or Closing Fee to 1102. E-Mail Document Retrieval to 1103. Title Examination to 1104. Insured Closing Letter to First American itle Insurance Co. 35.00 1105. Document Preparation to DEED 1106. Notary Fees to CASH 20.00 1107. Attorney's Fees to MICHAEL L. BANGS, ESQUIRE POC (Inc/udes aoove Item numbers: ) 1108. Title Insurance to PURITY ABSTRACT COMPANY P.06-022 2,058.75 (includes above item numbers: ) 1109. lender s COverage :!> 272,000.00 'Irt'\L 11110. Owner s Coverage :!> ;j4U,UUU.uu .~ ITiIT.t-'A II;:': .vv,vvV,"vv to t-'UKII Y Al:lS I KAL; I ~~.... , .. 15IT.O' 11112. Uvernlght Fee/pacKage to I"'UKII Y Al:So I KAL; I ....~.... n., 15.5 11113. Overnight Fee/payoff 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 40.50; Mortgage $ 60.50; Releases $ 101 1202. CitylCounty I aXlotamps: ueeO ; Mortgage 3,40e 1203. State Tax/Stamps: Revenue Stamps 3,400.00; Mortgage 1204. RECORDER OF DEEDS 1205. RECORDER OF DEEDS 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to BIECHLER & TILLERY & HOME INSP. .- , 1303. 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K) 11 """"" - , d .;, '"""~, .. .",._ .~""",.,.. ,_, d. ~""_ ""," ",., of.".. ~ ..dt-lf iflth . . / :> PURITY Al:SO;tyD7NY Certified to be a true copy. Settlement Ag nt ,. Rev-1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Myers, Ellen E. FILE NUMBER 21-05-1096 ESTATE OF 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 DESCRIPTION 1 Allstate Insurance Company - Refund of unused Automobile Insurance Premium VALUE AT DATE OF DEATH 37.10 2 Members 1st Federal Credit Union - Savings Account 11416-20-00 27,481.26 3 Members 1st Federal Credit Union - Checking Account 11416-20-11 10.094.19 4 Members 1st Federal Credit Union - 60 Month IRA Certificate 67.091.88 TOTAL (Also enter on Line 5, Recapitulation) 104.7( (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleE (Re REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death ,t.I,ccrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner IRA CERTIFICATE OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Beneficiary HOME EQUITY LOAN: Account Number/Suffix Date Loan Established Principal Balance at Date of Death Payment AmounUFrequency Daily Interest Name of Co-Borrower Security Interest VISA CREDIT CARD ACCOUNT: Account Number Date Account Established Balance at Date of Death Name of Joint Cardholder Estate of: ELLEN E. MYERS Date of Death: 12/03/2005 Social Security Number: 173-24-9225 MEMBERS 1st FEDERAL CREDIT UNION 11416 -00 02/24/1970 $27,481.26 $1.51 $27,482.77 None 11416 -11 01/13/1989 $10,094.19 $.13 $10,094.32 None 11416 -20 06/09/2000 $67,091.88 $16.57 $67,108.45 Bryan Myers 11416 -04 11/16/2005 $38,427.83 $637.21/Monthly $7.8032 None 765 Lancaster Avenue Enola, PA 17025 Cumberland County 4121449998114164 01/19/1990 $195.04 None ~MBERS ~JFE,DERAL CREDIT UNION vV%~ I/Iaz: enise A. Wolfe Insurance Service Supervisor January 19, 2006 5000 Louise Drive · Po. Box 40 · Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www.membe ... 1". REV-1151 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myers, Ellen E. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-05-1096 ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,498.85 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Michael L. Bangs 6,500.00 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 360.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 500.00 7. Other Administrative Costs 1,751.90 TOTAL (Also enter on line 9, Recapitulation) 14,610.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) .., .JI", Rev-1502 EX+ (6-98) *' SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myers, Ellen E. FILE NUMBER 21-05-1096 ITEM NUMBER DESCRIPTION AMOUNT 1 Richardson Funeral Home, Inc. 5.498.85 Subtotal 5.498.85 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) " ) Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Myers, Ellen E. FilE NUMBER 21-05-1096 ESTATE OF Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION VALUEATDA OF DEATH 1 Allstate Insurance Company - Homeowners Insurance Premium 7!i 2 Associated Cardiologists 2~ 3 AT&T 1~ 4 AT&T long Distance -11/26/05 to 12/25/05 5E 5 A T& T Long Distance 1l 6 Comcast Cable -12/21/05 to 1/20/06 4! 7 Com cast Cable -1/21/06 to 2/20/06 4! 8 East Pennsboro Township - Sewer and trash 11l 9 Members First FCU - Home Equity Loan 38.42 10 Members First FCU - Visa Payment 1f 11 PAWC - Water bill 11/16/05 to 12/16/05 12 PAWC -12/16/05 to 1/18/06 13 PAWC - Final Bill (1/18/06 to 2/21/06) 14 PP&L Electric -12/16/05 to 1/18/06 15 PP&L Electric - Final Bill 16 PP&L Electric Utilities -11/16/05 to 12/16/05 17 The Hartford - Return of unearned retirement income from annuity Total of Continuation $chedule(s) See ai TOTAL (Also enter on Line 10, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Sched ') Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myers, Ellen E. FILE NUMBER 21-05-1096 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 18 Verizon -12/1/05 to 12/31/05 39.38 19 Verizon -12/1/05 to 1/31/06 133.11 20 Verizon 28.25 TOTAL (Also enter on Line 10, Recapitulation) 40,070.22 Copyright (c) 2002 form software only The Lackner Group, Inc, Form PA-1500 Schedule I (Rev, 6-98) .... , REV 1513 EX+ (9-00) ESTATE OF NUMBER I. *' SCHEDULE .J BENEFICIARIES Laurie J. Heikel 765 Lancaster Avenue Enola, PA 17025 Robin Dluzeski 2380 Bellair Drive Dover, PA 17315 Cynthia A. Marsh 23 Annette Drive Enola, PA 17025 Barry L. Myers 94 Oliver Road Enola, PA 17025 Bonnie J. Myers 219 Fawn Court Marysville, PA 17053 See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Myers, Ellen E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 2 3 4 5 RELATIONSHIP TO DECEDENT Do Not List Trustee(sl FILE NUMBER 21-05-1096 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) Daughter One-seventh Daughter One-seventh Daughter One-seventh Son One-seventh Daughter One-seventh II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ (Rev. 6-98) ... ,. , SCHEDULE .. BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Ellen E. Myers 173-24-9225 12/03/2005 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Bryan H. Myers 7 Sherman Drive East Berlin, PA 17316 Son One-seventh 0.00 7 Susan E. Potteiger 10511 Segebrook Drive Riverview, FL 33569 Daughter One-seventh 0.00 Total 1 ~ \.:) I '::t ....... \ ~ '~ "~ ~ '{ 'iI ~ ~, '~'\ 41 6)f1fj ~ COtI~/ Y5 91flbJ0 I, ELLEN E. MYERS, of Enol a, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, to those of my issue, per stirpes, as survive my death by thirty (30) days. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate to those of my issue, per stirpes, as survive my death by thirty (30) days. ITEM IV. Should any of my issue entitled to a share of my estate not have attained the age of twenty-five (25) years at the time for distribution to him or her, I devise and bequeath the share of such issue to my hereinafter named trustee, IN SEP ARA TE TRUSTS, to hold, manage, invest, and re-invest, the shares so received, and the accumulation of income thereon, and to use and apply from time to time such portion of income and principal thereof as my trustee thinks 1 ~ ~ ~ ., ~ ~ ~ \ ~ ... proper for the comfortable support, maintenance, health, welfare, and education of the issue or to make payment for such purposes, without further responsibility, directly to such issue, or directly to any person taking care of such issue. Any principal or income not so applied shall be distributed to such issue when he or she attains the age of twenty-five (25) years, or ifhe or she dies prior thereto, to his or her personal representative. ITEM V. I appoint my daughter, SUSAN POTTEIGER, trustee of the trust or trusts created by this my last will. Should my said daughter, Susan Potteiger, predecease me or fail to qualify or ceases to perform her duties hereunder, I appoint my son, BRYAN MYERS, trustee. In addition to the other powers and authorities granted to my trustee by Pennsylvania Law and by the preceding paragraph of this my last will, I hereby give my trustee the following special powers and authorities: A. To retain any or all of the assets of my estate, real or personal (including any stock or securities of any corporate fiduciaries), without any regard to any principle of diversification, risk, or productivity; B. To invest and re-invest in all forms of property without restriction to investments authorized for Pennsylvania Fiduciaries, as my trustee deems proper, without regard to any principle of diversification, risk or productivity; C. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my trustee deems proper and in the best interest of the beneficiary or beneficiaries of said trusts; 2 ... to r.{ '\J \ 1- I " ~ ~ ~. ~ ~ D. To allocate receipts and expenses to principal or income or partly to each as my trustee from time to time deems proper in its sole discretion; E. To compromise any claim or controversy; F. To exercise any option, right, or privilege granted in insurance policies or in any other investments; G. My trustee may accumulate the income from this trust during the term thereof but may, from time to time, distribute from current income or from accumulated income or from principal such amounts as my trustee, in its sole discretion, deems advisable for the education, welfare, and comfort of the trust beneficiary . ITEM VI. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM VII. I appoint my son, BRYAN MYERS, Executor of this my last will. Should my said son predecease me or otherwise fail to qualify or cease to serve as Executor of this my last will, I appoint my daughter, SUSAN POTTEIGER, Executrix of this my last will. ITEM VIII. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as 3 .. .;A. my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries. as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM IX. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~. ,2002. 1..../ 4tf day of /&~~ ELLEN E. MYERS f ~~4~ / 4 ~ The preceding instrument, consisting of this and FOUR (4) other typewritten pages. each identified by the signature of the testatrix was on the date thereof signed, published. and declared by ELLEN E. MYERS, the testatrix therein named, as and for her last will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. 5 ., ... COMMONWEAL TH OF PENNSYLVANIA ) ( SS: ) COUNTY OF CUMBERLAND The undersigned, being the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~ ~;~ ELLEN E. MYERS ,z 7A~ Sworn or affirmed to and acknowledged befol~1 me by the t, e.,statrix ,n., amed above this H dar, O.,f '-.[,.~)~.' (jL,~.' ~r,v,,'j ('2002, . -\ : i 'I' J ' ,}. i I I { .' '\.. ''Y"'l 0 ~ \ ,,,C l\ t~j~' Y' '-\ \. l LL, '}' J I ' o1'ary Pub"",.~m_~"",".'-, "'c~"'__~.',""'__'~' ..- . I ~ ~~'j'l,1\~.i!.~. ~,~,~! \1:'t~"\r:l.~', $. C :h,!r:;!ir'~'f'\,"',' ~~, P!.~~~:::, hM"~ ,I\!l",,'l '1''''1'., (':I,fm~fll'd ~ M,y C.(i'!'\'lm~~1'! Enpl;~.fikfy 10, %oo:il COMMONWEALTH~~~YLV- - ) ( SS: COUNTY OF CUMBERLAND ) WE}{. .Au, I L ~r-''''j and f)/2:i&; ~\ff.mv f1Ngl1l, the witnesses whose names are signed to the attached or ore going instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last will; that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and under no constraint or undue influence. ./::' f ,-, / / 6 BANas LAW OFFICE 429 SOUTH ISTH STREET CAMP HILL, P A 17011 E-mail: mikebangslWverizon.net PHONE: 717-730-7310 FAJ{: 717-730-7374 MICHAEL L. BANGS, Attorney-at-Law WENDY K. STRAUB, Paralegal WILLIAM E. MILLER, JR. Of Counsel March 8, 2006 Glenda Farner Strasbaugh, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PAl 7013 RE: Estate of Ellen E. Myers File No. 21-05-1096 Dear Mrs. Strasbaugh: Enclosed for filing as part of the above-referenced estate you will find the following: 1. The original and one copy of the Pennsylvania inheritance tax return; 2. The original inventory; 3. A check in the amount of $485.08 to pay the tax liability shown to be due; and 4. A check in the amount of$30.00 to pay the filing fee. Please file this return accordingly and return a paid receipt to me in the enclosed, stamped, pre- addressed envelope. If you have any questions or require anything further, please contact me directly. Very truly yours, ~ Michael L. Bangs wks Enclosures cc: Mr. Bryan Myers , Z : I Hd 6- ann7 JeiJ& ~ 00 '[3 <t: (00 <t: (l.. aM t; . -' '~M OCl~_oo__ (l..~.....~a~~ .(l..:I: -0:: 0- ~ ~ ia :::J <t: U ~ .... . 5N i~ -= -: -: - -: - 1 :::: ~ :::: ~ - lI'~ ('.1 L.....- (7\ -. ... " \ -~ (/'l a ~ ~ t d1 0) '5b ~ 0) 0 ~~-€ ~?O) ~ 0 ~ ~ 0 ? rr) ~ ?:: r'ct. -- ~ d v~ 0 ~?O)r- f./)O(/'l__ ~ 0 5 -< ~~-:S~ ~ ~ ~ <IS ~-HO"tii ~,g0~ ~%~~ 6000