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HomeMy WebLinkAbout04-17-06 REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER II 06 COUNTY.CODE YEA,Bm NUMBER I- Z W o w u w o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) McAulay, Evelyn G. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 12-12-2005 04-17-1912 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) w .... "'~'" ull:'" w,,-u J:OO ull:-' ,,-Ill "- q; X 1 Original Return 2 Supplemental Return 0032 SOCIAL SECURITY NUMBER 559-34-6342 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3, Remainder Return (date of death prior to 12-13-82) X 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 4a, Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10 Spousal Poverty Credit (date of death between . 12-31-91 and 1-1-95) 8. Total Number of Safe Deposit Boxes 4 Limited Estate 5. Federal Estate Tax Return Required 11.Election to tax under See, 9113(A) (Attach Sch 0) 'THIl>, SECTION MUJlmBE COMPLETED.ALL CORRE~PONDENCEANDCONFIDENTIAL TAXINFORMATION~HQULDBE DIRECTED TO:.______ NAME I COMPLETE MAILING ADDRESS Michael L. Bangs . FIRM NAME (If applicable) .... z w o z o "- '" W II: II: o U TELEPHONE NUMBER 717/730-7310 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) z 6, Jointly Owned Property (Schedule F) ~ Separate Billing Requested :5 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) a::: 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) 429 South 18th Street Camp Hill, PA 17011 (1 ) None (2) 845,478.11 --------- (3) None --------------- (4) None (5) 149,807.41 (6) 30,170.86 (7) None (8) 1,025,456.38 (9) 19,397.40 ---------- (10) 2,791.53 (11) 22,188.93 1,003,267.45 0.00 (12) 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) (13) (14) 1,003,267.45 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0.00 15, Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) or transfers under See, 9116(a)(1 ,2) z 0 0.00 .045 (16) i= 16 Amount of Line 14 taxable at lineal rate x <( I- ::l D.. 17,Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ::ii: 0 u 18, Amount of Line 14 taxable at collateral rate 1,003,267.45 x .15 (18) >< <( I- 19 Tax Due (19) 20,0 0.00 0.00 150,490.12 150,490.12 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. >> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH << Copyriqht 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00: Decedent's Complete Address: STREET ADDRESS 105 Linden Drive CITY Camp Hill STATE P A I ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 150,490.12 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT (4) 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 theT AX DUE (5) 1 50,490.1 2 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBAlANCE DUE (58) 1 50,490. 1 2 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;............ .............................. ..............on...... b. retain the right to designate who shall use the property transferred or its income;.................. c. retain a reversionary interest; or... ..........................__............................n.................... 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?................ ........ ............... ....... .......... ............... ................ on..................... 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?... ................ ......... ...... ........ ........ ........._............. ......... ..... .... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Jnder 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 :omplete. p'e~~ation ~!_prf3~?_~er other t~an the_E~rsonal repres~nt<3tive is__~~sed on all Information of whIch preparer has any knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS R~,RjIld M. 'N,.jlson , ~ / '_A"AI /JP ~1cR. SlNkWbt~Rflili?i~.ES~SI~~NG RETLiRN I/L,t_~./l1/( ~/ ,~. 'J lGNATURE OF PREPARER-OTHER H REPRESENTATIVE Michael L. Bangs DATE 105 Linden Drive Camp Hill, PA 17011 ~j3j;f; DATE ADDRESS ADDRESS c./ ;' / ; / j j 429 South 18th Street CampHiII,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. S9116 (a) (1.1) (ii)]. The statutedoes 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. S9116 (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. S9116 1.2) [72 P.S. S9116 (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. ~ev-1503 EX+ (6-98) . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McAulay, Evelyn G. FILE NUMBER 21-06-0032 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 924 shares of Allegheny Power 31.05 28.690.20 2 32 shares of Allete 46.50 1,488.00 3 1,260 shares of Allied Irish 43.54 54.860.40 4 80 shares of Avista 18.49 1,479.20 5 1,697 shares of Axcelis Stock 4.85 8.230.45 6 232 shares of Bell South 27.60 6,403.20 7 3,644 shares of Boeing 69.89 254.679.16 8 139 shares of Delphi Automotive .36 50.04 9 234 shares of Devon Energy 66.79 15.628.86 10 2,880 shares of Eaton 65.56 188.812.80 11 400 shares of Entergy 70.49 28.196.00 12 1,394 shares of Exxon Mobil 58.82 81.995.08 13 672 shares of Florida Power & Light 42.19 28.351.68 14 480 shares of Fortune Brands 76.72 36.825.60 15 480 shares of Gallagher Group 62.42 29.961.60 16 200 shares of General Motors 22.96 4.592.00 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 2, Recapitulation) 845,478.11 (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 B (Rev 6-98) KeV-l::>U~ I:.A+ {ti-::HSJ SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT McAulay, Evelyn G. FILE NUMBER 21-06-0032 ESTATE OF ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 17 1,472 shares of Mead Westvaco 28.29 41.642.88 18 344 shares of Texas Utilities 52.59 18.090.96 19 16 Series HH Savings Bonds 15.500.00 ! ! TOTAL (Also enter on Line 2, Recapitulation) 845.478.11 CopyriQht (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Frank R. Baker 146 Springhouse Lane Spring Grove, P A 17362 Phone: 717/225-5450 Fax: 717/225-0494 e-mail: frankr.baker@suscom.net January 20, 2006 Bangs Law Office 429 S. 18th St. Camp Hill, PA 17011 Here is the information you requested concerning the values of the holdings owned by Evelyn G. McAulay as of Dec. 12,2005. Equities High Low Average Shares Value Axce1is ACLS 4.92 4.77 4.85 1697 8,230.45 Allegheny Power AYE 31.25 30.84 31.05 924 28,690.20 Allied Irish AIB 43.81 43.26 43.54 1260 54,860.40 Fortune Brands FO 77.20 76.23 76.72 480 36,825.60 Bell South BLS 27.70 27.50 27.60 232 6,403.20 Boeing BA 70.24 69.54 69.89 3644 254,679.16 Devon Energy DVN 67.53 66.04 66.79 234 15,628.86 Eaton ETN 66.00 65.12 65.56 2880 188,812.80 Entergy ETR 71.25 69.73 70.49 400 28,196.00 Exxon Mobil XOM 59.13 58.50 58.82 1394 81,995.08 FPL FPL 42.42 41.97 42.19 672 28,351.68 Gallagher Group GLH 62.57 62.26 62.42 480 29,961.60 General Motors GM 23.22 22.70 22.96 200 4,592.00 Mead Westvaco MWV 28.4 7 28.1 0 28.29 1472 41,642.88 Texas Utilities TXU 53.17 52.00 52.59 344 18,090.96 Avista AVA 18.84 18.13 18.49 80 1,479.20 Delphi Automotive DPHIQ .40 .32 .36 139 50.04 Touchamerica 1200 Bankrupt Allete ALE 46.93 46.07 46.50 32 1,488.0C Total $829,978.11 If you have any questions, please call me at 717 225 5450. 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ITEM NUMBER DESCRIPTION 1 Automobile - 2004 Buick Century Automobile (see Bill of Sale attached) VALUE AT DATE OF DEATH 11,990.00 2 Wachovia Bank, N.A. - Certificate of Deposit #247402052266750 7,137.24 3 Wachovia Bank, N.A. - Checking Account #1010110809203 23,627.61 4 Wachovia Bank, N.A. - Checking Account #1010118641560 107,052.56 TOTAL (Also enter on Line 5, Recapitulation) 149,807.41 (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 E (Rev. 6-98) - --=....~ -- ""' --~~. . WACHOVIA Reference ID: 1499434 Wachovia Bank N.A. Balance Confirmation Services POBox 40028 Roanoke, VA 24022-73 13 February 2, 2006 BANGS LAW OFFICE 429 SOUTH 18TH STREET CAMPHILL,PA 17011 SUBJECT: Verification / Confirmation of Account and Balance Information provided for: Customer: EVELYN G MCAULAY (SSN# 559-34-6342) Date of Death: December 12, 2005 Deposit Account Information Account Type Account Number Date of Death Balance Average Balance* Date Opened Maturity Date Interest Accrued YTD Date Rate Interest Interest Paid Closed CERTIFICATE OF DEPOSIT 247402052266750 $7,137.24 5/24/2005 $9.48 $137.24 1/26/2006 LEGAL TITLE: EVELYN G MCAULAY RONALD M WILSON CHECKING 1010110809203 LEGAL TITLE: EVELYN G MCAULAY RONALD M WILSON $23,627.61 3116/2005 $1.67 $10.61 CHECKING 1010118641560 $107,052.56 8/24/2005 $87.49 $598.14 1 /26/2 006 LEGAL TITLE: EVELYN G MCAULA Y RONALD M WILSON * Due to system limitations, we can only provide a twelve month average balance on depository accounts. Other Account Information Account Type Account Number Date of Balance Date Opened Date Closed Ledger Collected SAFE DEPOSIT BOX 0758534800759 4/21/2005 LEGAL TITLE: EVELYN G MCAULAY LOCATION: 1200 CAMP HILL MALL CAMP HILL, PA 17011 0000 000614 II! """ ~-, rVACHOVIA Reference ID: 1499434 * Date of death balance does not include accrued interest. * If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were made during th~~ time period. I \ (\ (.... ..), ~. ,,-~u.1..c.!".J.'-'\ j()\.SL"CLst:..A.' Audrey Troutt Servicenter Associate Phone: (540)563-7323 abs; at BILL OF SALE The Estate of Evelyn G. McAulay, by and through the Executor, Ronald M. Wilson, sells all of its right, title and interest in and to the 2004 Buick Century automobile for the sum of Eleven Thousand Nine Hundred Ninety and 00/100 ($11,990.00) Dollars, to John Miller. Date: 1/27/06 /) /t '/ l/ pLIII-k.. / A ;L-' ~. ~ !;ltrryf: . . .I" }..)/' h % p-c- RONALD M. WILSON, Executor Rev-1509 EX+ (6-98) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McAulay, Evelyn G. FILE NUMBER 21-06-0032 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 A. Ronald M. Wilson ADDRESS RELATIONSHIP TO DECEDENT 105 Linden Drive Camp Hill, PA 17011 Nephew B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH LETTER DATE ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST JOINTLY-HELD REAL ESTATE. 1 A 1/22/1997 First Citizens Bank - Certificate of 13.517.13 50.000% 6.758.57 Deposit #0130777475 (JTWROS) 2 A 10/11/2000 First Citizens Bank - Certificate of 23.226.80 50.000% 11.613.40 Deposit #0130998569 (JTWROS) 3 A 1/22/1997 First Citizens Bank - Checking Account 23.597.78 50.000% 11.798.89 #0136752486 (JTWROS) TOTAL (Also enter on Line 6, Recapitulation) 30.170.86 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleF (Rev. 6-98) ~RSr CITIZENS BANK Estate of Evelyn G McAulay Date of death: 12/12/2005 Account No.: 0130777475 Type of account: Certificate of Deposit Current Balance: $13,769.52 Principal Balance on Date of Death: $13.517.13 Interest Accrued but not Paid on Date of Death: $225.88 Interest Paid This Year up to Date of Death: $141.20 Account No.: 0130998550 Type of account: Certificate of Deposit Current Balance: Account Closed 10/11/2005 Principal Balance on Date of Death: Interest Accrued but not Paid on Date of Death: Interest Paid This Year up to Date of Death: 1/20/2006 cu,LJ,,-CL.. \cLC~CL- By: First-Citizens Bank FIRST CITIZENS BANK ACCOUNT SIGNATURE CARD CDtT 0130777475 Acct Type 01/22/97 Branch 017 Opened by CLAUDINE BURRIS EVELYN G MCAULAY RONALD M WILSON Account Ownership Designation JOINT ACCOUNT WITH RIGHT OF SURVIVORSHIP (G S 53-1461) We understand that by establishing a JOint account With nght of survIVorship under the provIsions of North Carolina General Statute 53-1461 that (1) The Bank may pay money In the account to, or on the order of, any person named In the account unless we have agreed With the Bank that Withdrawals reqUIre more than one signature, and (2) Upon the death of one JOint owner the money remaining In the account will belong to the surviving JOint owner(s) and Will not pass by rnhentance to the heirs of the deceased JOint owner or be controlled by the deceased JOint owner's Will We DO elect to create the fight of survivorship In this account This account IS subject to the proVIsions of the First CItizens Bank DepOSit Account Agreement, as the same may..be amended from time to time, and to applicable state and federal law (Includrng the provIsions of N C G S 53-1461), as the same may be amended from time to time I acknowledge receipt of the First Citizens Bank DepOSit Account Agreement and applicable Truth In Savings Disclosures pnor to openrng this account Under penalties of perJury, I (the first signer below) certify (1) that the number shown on this form IS my correct taxpayer Identification number and (2) that I am not subject to backup withholding either because I have not been notified that I am subject to backup withholdmg as a result of a failure to report all mterest or dividends, or the Internal Revenue.service has notified me that I am no longer subject to backup wlthholdmg. (IRS regulations require that you strike out the language certlfymg that you are not subject to backup wlthholdmg due to notified payee underreportmg If you have been notified that you are subject to this type of withholdmg and you have not received a notIce from the IRS advismg you that backup wlthholdmg has term mated) NOTE: The Internal Revenue Service does not require your consent to any proviSion of this document other than the certIfication required to aVOId b ckup withholding. ) SSN 559346342 1'8t. ,2'r{' ] 13'..r Signature Date 1-J.)-L11 Date .2-;- 7'7 Account Owners Signature Signature Date Authonzed Signers The AuthOrized Signers Identified below are authorIZed signers only and have no ownership Interest In this account The Bank may honor the signature of any Account Owner or AuthOrized SIgner In the transfer or payment of funds or the transaction of any bUSiness relating to this account JI"-"- 'I""lI.q,.,\O"I~ rrl') 1 1 f991 SpeCial ReqUirements ~ST CITIZENS BANK Estate of Evelyn G McAulay Date of death: 12/12/2005 Account No.: 0130998569 Type of account: Certificate of Deposit Current Balance: $23,270.24 Principal Balance on Date of Death: $23,226.80 Interest Accrued but not Paid on Date of Death: $1.39 Interest Paid This Year up to Date of Death: $505.39 Account No.: 0130999772 Type of account: Certificate of Deposit Current Balance: Account Closed 09/29/2004 Principal Balance on Date of Death: Interest Accrued but not Paid on Date of Death: Interest Paid This Year up to Date of Death: 1/20/2006 ~.. \LZ-C'.~ By: First-Citizens Bank 1111111111111111111111111111111111111111111111111111111111111111111111 ~ ACCOUNT SIGNATURE CARD .- FIRsr CITiZENS BANK I 111111 111111111111111 lUll 11111 11111 11111 1111111111111 000130998569 Acct Type Cert~f1cate of Depos~t - 24MO 10/11/2000 Branch 017 Opened by C Burr1S EVELYN G MCAULAY RONALD M WILSON Account Ownership Designation JOINT ACCOUNT WITH RIGHT OF SURVIVORSHIP (N C G S 53.1461) We understand that by establishing a JOint account wIth right of survivorship under the provISions of North Carolrna General Statute 53-146 1 that (1) The Bank may pay money In the account to, or on the order of, any person named In the account unless we have agreed with the Bank that withdrawals reqUire more than one signature, and (2) Upon the death of one jornt owner the money remaining In the account will belong to the survIving JOint owner(s) and will not pass by inherItance to the heirs of the deceased JOint owner or be controlled by the deceased JOInt owner's WIll We DO elect to create the nght of survivorship In thiS account ThiS account IS subject to the prOVIsIons of the First Clbzens Bank DepOSit Account Agreement, as the same m.ay be amended from time to time, and to applicable state and federal law (Including the prOVISions of N C G S 53-1461), as the same may be amended from time to trme I acknowledge receipt of the First Citizens Bank DepOSit Account Agreement and applicable Truth In Savings DIsclosures pnor to opening thiS account Under penaltIes of perJury, I (tht\ first signer below) certify (1) that the number shown on thIS form IS my correct taxpayer IdentificatIOn number and (2) that I am not subject to backup wlthholdmg either because I have not been notified that I am subject to backup wlthholdmg as a result of a failure to report all Interest or diVidends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding (IRS regulations require that you strike out the language certifying that you are not subject to backup wlthholdmg due to notified payee underreportmg If you have been notified that you are subject to thiS type of withholding and you have not received a notice from the IRS advlsmg you that backup wlthholdmg has terminated). NOTE The Internal Revenue Service does not require your consent to any prOVISion of thiS document other than the certificatIon required to a I backup wlthhol 109 Account Owners Signature X /oh/pt7 SSN 559346342 Date Signature )( Date //)j~ ~tl Signature Date Authonzed Signers The Authorized Signers Identified below are authorized signers only and have no ownership Interest In thiS account The Bank may honor the Signature of any Account Owner or Authorized Signer In the transfer or payment of funds or the transaction of any busmess relatmg to thiS account SpeCial ReqUirements FCB0102 REV 5/99 ~ CITIZENS BANK Estate of Evelyn G McAulay Date of death: 12/12/2005 Account No.: 0136752486 Type of account: Quest Checking With Interest Current Balance: $21,173.39 Principal Balance on Date of Death: $23,597.78 Interest Accrued but not Paid on Date of Death: $1.70 Interest Paid This Year up to Date of Death: $17.39 Account No.: 5407641000130376 Type of account: MasterCard Current Balance: Paid in full 12/30/2005 Principal Balance on Date of Death: $82.55 Interest Accrued but not Paid on Date of Death: Interest Paid This Year up to Date of Death: 1/20/2006 /"'1 C) LL.Y1.Af-u?1.- \~e . e...____ By: First-Citizens Bank FIRST CITIZENS BANK ACCOUNT SIGNATURE CARD 0136752486 Acct Type Quest Account 01/22/97 Branch 017 Opened by CLAUDINE BURRIS EVELYN G MCAULAY RONALD M WILSON Account Ownership DeSignation JOINT ACCOUNT WITH RIGHT OF SURVIVORSHIP (G S 53-1461) We understand that by establishing a JOint accour.t With right of sUrvlvorshlp under the provIsions of North Carolina General Statute 53-146 1 that (1) The Bank may pay money In the account to, or on the order of, any person named In the account unless we have agreed With the Bank that Withdrawals require more than one signature. and (2) Upon the death of one JOint owner the money remaining In the account will belong to the surviVing JOint owner(s) and will not pass by inheritance to the heirs of the deceased JOint owner or be controlled by the deceased JOint owner's will We DO elect to create the right of survIVorship In thiS account ThiS account IS subject to the provISions of the First CitIZens Bank DepOSit Account Agreement, as the same may be amended from time to time, and to applicable state and federallaw (Including the provISions of N C G S 53-1461), as the sam; may be amended from time to time I acknowledge receipt of the First Citizens Bank DepOSit Account Agreement and applicable Truth In Savings Disclosures prior to opening thiS account Under penalties of perjury, I (the first signer below) certify (1) that the number shown on thiS form is my correct taxpayer Identification number and (2) that I am not subject to backup Withholding either because I have not been notified that I am subject to backup Withholding as a result of a failure to report all Interest or diVidends, or the Internal Revenue.Servlce has notified me that I am no longer subject to backup withhold mg. (IRS regulations require that you stnke out the language certifYing that you are not subject to backup withholdmg due to notified payee underreportmg if you have been notified that you are subject to thiS type of withholdmg and you have not received a notice from the IRS advlsmg you that backup wlthh.oldlng has termmated) NOTE: The Internal Revenue Service does not require your consent to any prOVISion of thIS document other than the certification required to aVOid backup Withholding. '1t!1~ 1 !~~(i^~~__~ Oat, Signature t _~ _.. L _ _-I.. .....L"-,-J ~ ----4}- Date Account Owners SSN 559346342 Signature /-u-:17 ~!h7' /'31. 27 J?~ j Signature Date AuthOrized Signers The AuthOrized Signers Identllied below are authonzed signers only and have no ownership Interest In thiS account The Bank may honor the signature of any Account Owner or AuthOrized Signer In the transfer or payment of funds or the transaction of any bUSiness relating to thiS account BECE'VED FES 1 1 19D7 SpeCial ReqUirements KeV-l::m" t:A.+ {b-~tIi' SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT McAulay, Evelyn G. FILE NUMBER 21-06-0032 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal - Estate Advertising 75.00 2 Fackler-Wiedeman Funeral Home - Additional death certificates 374.40 3 Register of Wills - Additional Short Certificates 160.00 4 The Sentinel - Estate Advertising 100.00 Subtotal 709.40 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT McAulay, Evelyn G. FILE NUMBER 21-06-0032 ESTATE OF Include un reimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Cingular VALUE AT DATE OF DEATH 4.53 2 Cingular 3 Kelly Home Care Services, Inc. 4 Kelly Home Services 5 Kelly Home Services 6 MasterCard - First Citizens Bank 7 PP&L Electric 8 PP&L Electric 24.19 403.75 1.517.25 684.25 82.55 39.60 35.41 TOTAL (Also enter on Line 10, Recapitulation) 2,791.53 (If more space is needed, additional pages of the same size) CopyriQhl (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Kt:.V-l~lJ t:.AT {~-UU' *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER McAulay, Evelyn G. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-06-0032 ESTATE OF RELATIONSHIP TO DECEDENT Do Not List Trustee(s) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. See attached schedule Total 33,000.00 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ (Rev. 6-98) SCHEDULE ,J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Evelyn G. McAulay 559-34-6342 12/12/2005 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 1 John M. Adams, Jr. Other 10,000.00 Post Office Box 265 Columbus, MS 39703 2 Karen S. Lencioni Niece 4,000.00 3 Wetherburn Drive Enola, PA 17025 3 Christian Maguire Nephew 4,000.00 4 Fieldstone Estates Newmarket, NH 03857 4 Jerry I. Maguire Nephew 7,000.00 2221 Summerfield Lane Harlingen, TX 78550 5 Matthew D. Wilson Nephew 4,000.00 39 Circle Drive Camp Hill, PA 17011 6 Michael B. Wilson Nephew 4,000.00 5742 Woodfount Glade New Market, MD 21744 7 Ronald M. Wilson Nephew Remainder of Estate 105 Linden Drive Camp Hill, PA 17011 Total 33,000.00 1 STATE OF NORTH CAROLINA LAST WILL AND TESTAMENT COUNTY OF MECKLENBURG I, EVELYN G. McAULAY, of Mecklenburg County, North Carolina, do hereby revoke all former wills made by me, and do hereby make, publish and declare this to be my last will and testament in manner anf form as follows: 1. I direct my executrix, hereinafter named, to pay all of my just debts and funeral expenses as soon after my death as possible. 2. I will and bequeath the sum of $10,000.00 to John M. Adams, Jr. 3. I will and bequeath the sum of $7,000.00 to my nephew, Rev. Jerry I. Maguire. 4. I will and bequeath the sum of $4,000.00 to my nephew, Michael B. wilson. 5. I will and bequeath the sum of $4,000.00 to my nephew, Matthew D. Wilson. 6. I will and bequeath the sum of $4,000.00 to my niece, Karen W. ~=<L~___. ' i.r../c.,r (J I'{ I f: /:.r III 7. I will and bequeath the sum of $4,000.00 to my nephew, Christian Maguire. 8. All the remainder of my property of every sort, kind and description, both real and personal, I will, devise and bequeath to my sister, Thelms E. Wilson, absolutely and in fee simple. In the event that my sister, Thelma E. Wilson, is not living at the time of my death, I will, devise and bequeath all of the property my sister would have taken if living to my nephew, Ronald M. Wilson, absolutely and in fee simple. 9. I hereby constitute and appoint my sister, Thelma E. wilson. as Executrix of this my last will and testament, and I 1ereby glve and grant unto her full power and authorlty to sell ~ny of my property, or do any other act, without Order of Court, and without Bond, which in her opinion is for the best interest C)f my estate. And I do further provide that if my sister is not living at the time of my death, or be for any reason unable to act, then and thereafter, Ronald M. Wilson shall become, be and act as the Executor of this my last will and testament with all the duties, powers and authority as herein given to my original Executrix. I, EVELYN G. McAULAY, the testatrix, sign my name to this instrument this 17Th day of December, 1991, and being first duly sworn, do hereby declare to the undersigned authority that I sign and execute this instrument as my last will and that I sign it willingly, that I execute it as my free and voluntary act for the purposes therein expressed, and that I am eighteen years of age or older, of sound mind, and under no constraint or undue influence. k'l, W .~.... L; ; (' - ) lJ1iJCJ )Wu,Cfi.vLlmLI EVELYN G. ~. AULAY (I \J We J,teJdH 1< C;T1? II Vv'N -,' J ,C R i?1>=:- .~..J -r:::- , ~.. _1..E;.1:~~_ the witnesses, sign our names to this instrument, being first duly sworn, and do hereby declare to the undersigned authority that the testatrix signs and executes this instrument as her last will and that she signs it willingly, and that each of us, in the presence and hearing of the testatrix, hereby signs this will as witnesses to the testatrix's signing, and to the best of our knowledge the testatrix is eighteen years of age or older, of sound mind, and under no constraint or undue influence. fl;4,S~~&aLL~~~_ Witn~s ~ '0 J Cu\u Wlt~ ' 1.\l\J.K.l-n L.H..KVLl. ("'/1. COUNTY OF MECKLENBURG Subscribed, sworn to and acknowledged before me by EVELYN G. McAULAY, the testatrix, and subscribed and sworn to before mE by ;:TFJ~'iC'il::.--=2~1LL\[ ____ and _ 'J , !--,--{J3e7l:.;,:{?~L-:;J"'__~_' witnesses, this _/7/~ day of December, 1991. ___iJ&Zt~.~ ~r;~._ Notary Public My commission expires: _/ --/l~~- ~~__ Register of Wills, Cumberland County, Pennsylvania INVENTORY - , Deceased No. 21-06-0032 Date of Death 12/12/2005 Social Security No. 559-34-6342 Estate of Evelyn G. McAulay also known as Ronald M. Wilson .. .--..-.. --- .... . ----- -- --- ----..-... -- ---- --.. ---- ---------- The PersonaTRepresentative(s) of the above Estate, deceased, verify that the items appearing inthe foTiowlnglnventory include all of the personal assets wherever situate and all of the real estate located 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 the 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 that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Michael L. Bangs Personal Represent~~ / ~ ? r-I _ Signature: .~ ~ f'" $~.4J~ Ronald M. Wilson Signature: 1.0. No.: 41263 Signature: Firm: Address: 429 South 18th Street Cam~ HiII,!,A.1?011 Telephone: 717/730-7310 Address: 105 Linden Drive Camp Hill, PA 17011 ---- Telephone: 717 -737 -7973 -?d1j~~.___.___ Dated: Personal Property Cash............................................................................................... Personal Property.......... ....... ...... ...... ................ ....... ..................... Stocks/Listed ....... ............. ............. ...... ................... ....................... Stocks/Closely Held ........ ..... ...... .......... ......................................... Bonds.. ....... ..... ............... ..... ...................... .... ................ ........ ...... ... Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... All Other Property........... ..................... ................... ...................... 149,807.41 829,978.11 15,500.00 Total Personal Property......................................... 995,285.52 Total Real Property.......... .... ............... ...... ............. 995,285.52 I Total Personal and Real Property......................... Total Out-of-State Real Property.......................... BAN6S LAW OFFICE 4-29 SOUTH 18TH STREET CAMP HILL, PA 17011 E-mail: mikebangs@verizon.net PHONE: 717-730-7310 FA}(: 717-730-7374 MICHAEL L. BANGS, Attorney-at-Law WENDY K. STRAUB, Paralegal WILLIAM E. MILLER, JR. Of Counsel April 14, 2006 Glenda Farner Strasbaugh, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Evelyn G. McAulay File No. 21-06-0032 Dear Mrs. Strasbaugh: Enclosed you will find the following: 1. The original and one copy of the Pennsylvania Inheritance Tax Return; 2. A check in the amount of$150,490.12 to pay the tax shown to be due; 3. The original Inventory; and 4. A check in the amount of $30.00 to pay the filing fee for these documents. Kindly file the tax return and send 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: ML Ronald M. Wilson CUMMUNWtALI H UF PENN::;YlVANIA 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 BANGS MICHAEL l 429 S 18TH STREET CAMP Hill, PA 17011 ____un told ESTATE INFORMATION: SSN: 559-34-6342 FILE NUMBER: 2106-0032 DECEDENT NAME: MCAUlA Y EVELYN G DATE OF PAYMENT: 04/17/2006 POSTMARK DATE: 04/14/2006 COUNTY: CUMBERLAND DATE OF DEATH: 12/12/2005 NO. CD 006563 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $150,490.12 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#100 SEAL INITIALS: MG RECEIVED BY: REGISTER OF WILLS $150,490.12 GLENDA FARNER STRASBAUGH REGISTER OF WillS oS? OOc:<" ~~a~ ~0g'?J 'f;..o~.-n <" c: ?J ~ ~>-d S. ~ ~ )? 0 0.... c: r:fl ......'8.g.<;:t -.l ';:j?J Or:fl<-+-~ ...... ,.p <.:< v vJ c: 0 ~ ~g.~ s<~ o <" ~ as. <" 'A ~ g., ~ ,.... ~ (/1 -\ o .' ~ ';i1' lJ.l?- Z S ~ \~ 'C ~ ~ g;. % > eO ~;. 0 "'" ~ -' '!: ~ .cl "" .-. c '" ~ ~~ ~ "1 o! '!\.. ~~ <:> ... <:> ",. o ~ ~ o ~! :::- ~ =- f - =- - - =- - =- =- =- t:l t'" . - c.