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HomeMy WebLinkAbout04-18-06 --1 15056051058 REV-1500 EX (06-05) PA Department of Revenue '*' Bureau of Individual Taxes . PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 21 06 00176 Date of Birth 180-05-0640 01/16/2006 05/02/1917 Decedent's Last Name Suffix Decedent's First Name MI Wolfgang Genevieve T (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix First Name MI Spouse's Social Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ':.:; 1. Original Return C=> 2. Supplemental Return L-:::::J 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate (.) (:::J 4a. Future Interest Compromise (date of death after 12-12-82) c::::J 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C=:J 10. Spousal Poverty Credit (date of death C:;) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name ~~ytilTle Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received . ....9.... 8. Total Number of Safe Deposit Boxes Paul Taneff, Esq. (717) 564-5833 C.... ..REG"ISTER' OF.VVILLsuse. ONLY I 1 ! ~ I ! Firm Name Ricci & Taneff First line of address 4219 Derry Street Second line of address City or Post Office Harrisburg State ZIP Code DATE FILED 17111 Correspondent's e-mail address:taneff@earthlink.net Under penalties of pe~ury. 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. SIGNATUR OF P RSON ~ESPONS LE FOR ILlNG RETURN DATE /t~ . 04/18/06 ADDRESS 4000 Derry Street, Harrisburg, PA 17111 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 ---1R,( J -1 15056052059 REV-1500 EX Decedent's Social Number Decedent's Name: Genevieve T Wolfgang 180-05-0640 RECAPITULATION 1. Real estate (Schedule A). ............................................ 1. 0.00 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 0.00 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6,349.37 0.00 6. Jointly Owned Property (Schedule F) c:=; Separate Billing Requested . . . . . " 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <:.:) Separate Billing Requested.. . . . . .. 7. 0.00 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 6,349.37 6.349.37 342,122.03 348,471.40 -342,122.03 0.00 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 0.00 16. 0.00 17. 0.00 18. 0.00 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15056052059 --' REV-1500 EX Pa~e 3 Decedent's Complete Address: DECEDENT'S NAME Genevieve T Wolfgang STREET ADDRESS West Shore Health & Rehab Center fJI.'.N~Il"lJ),.r. 00176 DECEDENT'S SOCIAL SECURITY NUMBER 180-05-0640 770 Poplar Church Road CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 0.00 Total Credits (A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) A. Enter the interest on the tax due. (5A) (5B) 0.00 0.00 0.00 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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;.......................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~ c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ... ....... ...... ...... ........... ........... ................. ................................................. 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............ ............................................................................................................ 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. - Rev-1502EX + (1-97) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG FILE NUMBER 2006-00176 All real property owned solely or as a tenant in common must be reported at fair market 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE $0.00 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $0.00 Rev-1503EX + (1-97) . . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG FILE NUMBER 2006-00176 All propert .ointl ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. NONE $0.00 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) $0.00 Rev-1507EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE D MORTGAGES & NOTES RECEIVABLE GENEVIEVE T. WOLFGANG FILE NUMBER 2006-00176 DESCRIPTION VALUE AT DATE OF DEATH 1. NONE $0.00 TOTAL (Also enter on line 4, Recapitulation) (If more space is needed, insert additional sheets of the same size) $0.00 Re~-1508EX + (1,-97) SCHEDULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG FILE NUMBER 2006-00176 Include proceeds of litigation & the date proceeds received by estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH BANK ACCOUNTS: A. PNC Bank, National Association Checking Account No.: 5140160682 (Account Closed March 8, 2006) $2,280.37 2. CERTIFICA TES OF DEPOSIT: None $0.00 3. IRREVOCABLE BURIAL TRUST: A. Wiedeman Funeral Home, Inc., Trustee $4,069.00 357 South 2nd Street, Steelton, PA 17113 Established and Funded January 20, 1995 4. MOTOR VEHICLES: None $0.00 5. HOUSEHOLD GOODS AND FURNISHINGS: Decedent was residing in an assisted living facility at time of death and owned no household goods or furnishings at the time of her death. $0.00 6. CLOTHING & PERSONAL EFFECTS: The decedent died seised of clothing and personal effects, the value of which was less than the cost to have such property valued and sold in the opinion of the Executor. And, therefore the Executor abandoned any interest the estate had in such property. $0.00 7. MISCELLANEOUS RECEIPTS & REFUNDS: None $0.00 TOTAL (Also enter on line 4, Recapitulation) (If more space is needed, insert additional sheets of the same size) $6,349.37 Re~-1509EX + (.1-97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG FILE NUMBER 2006-00176 If an asset was made joint within one year of the decedent's death, it must be reported on Schedule G. JOINTLY-OWNED PROPERTY: LTR DATE FOR JT MADE TEN JT DESCRIPTION OF PROPERTY Attach Deed for jtly held real estate. DATE OF DEATH ASSET VALUE % OF DECO'S INTEREST DATE OF DEATH VALUE OF DECO'S INTEREST ITEM NO. Include name of financial institution, account number. 1. A. N/A NONE $0.00 50.000/0 $0.00 TOTAL (Also enter on line 6, Recapitulation) (If more space is needed, insert additional sheets of the same size) $0.00 Re~-1509EX + (~-97) SCHEDULE F-(CONT1D.) JOINTL V-OWNED PROPERTY COMMONWEALTH OF PA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG FILE NUMBER 2006-00176 ear of the decedent's death, it must be re orted on Schedule G. L TR FOR JOINT TENANT NAME OF SURVIVING JOINT TENANT(S) A. NONE ADDRESS OF SURVIVING JOINT TENANT(S) RELATIONSHIP TO DECO Re~-1510 EX + (~-97) COMMONWEALTH OF PA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 2006-00176 This schedule must be completed and filed if the answer to any of the questions 1-4 on reverse side of REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM NO. 1. Include name of transferee, relationship to decedent & transfer date. Attach copy of Deed for real estate. DATE OF DEATH ASSET VALUE $0.00 % OF DECD'S INTEREST 100.00% EXCLUSION (If Applicable) $0.00 TAXABLE VALUE $0.00 NONE TOTAL (Also enter on line 7, Recapitulation) (If more space is needed, insert additional sheets of the same size) $0.00 Rev:1511 EX + (1-97) COMMONWEALTH OF PA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 2006-00176 Debts of the decedent must be reported on Schedule I. ITEM NO. DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Wiedeman Funeral Home, Inc., 357 South 2nd Street, Steelton, PA 17113 (See Irrevocable Burial Trust, Schedule E) $4,069.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions A. Monsignor Hugh A. Overbaugh c/o St. Catherine Laboure Church 4000 Derry Street, Harrisburg, PA 17111 Social Security No.: 170-24-1557 Fees Paid: 2006 $320.00 2. Attorney Fees - Ricci & Taneff, 4219 Derry St., Harrisburg, PA 17111 $1,810.37 3. Probate Fees Filing Fee - Register of Wills Cumberland County/Open Probate Additional Fees - Register of Wills Cumberland County/Close Probate Additional Fees - Register of Wills Cumberland County/Inventory & Inherit. Ret. $70.00 $25.00 $30.00 4. Tax Return Preparer's Fees - None $0.00 5. Advertising Fees: Paxton-Herald Dauphin County Law Reporter $0.00 $0.00 8. Miscellaneous: Photocopies - Ricci & Taneff, 4219 Derry Street, Harrisburg, PA 17111 $25.00 9. Reserves For Contingent Liabilities: None $0.00 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $6,349.37 Rev;1512EX + (1:97) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENE~EVET.WOLFGANG FILE NUMBER 2006-00176 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. TAXES: Decedent not required to file either federal or state income taxes. $0.00 2. DEBTS OF DECEDENT (Listed In Order of Priority): A. Class 3 Claims Excluding Funeral: (1) Commonwealth of Pennsylvania, Dept. of Public Welfare Estate Recovery Program P.O. Box 8486 Harrisburg, PA 17105 $22,809.83 B. Class 6 Claims: (1) Commonwealth of Pennsylvania, Dept. of Public Welfare Estate Recovery Program P.O. Box 8486 Harrisburg, PA 17111 $319,312.20 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) $342,122.03 Rev~1513 EX + (1.-97) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GENEVIEVE T. WOLFGANG FILE NUMBER 2006-00176 Enter dollar amounts for distributions shown below on Lines 15 - 17, as a NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ro riate, on REV-1500 Cover Sheet. RELATIONSHIP AMOUNT OR TO DECD SHARE ESTATE I. TAXABLE DISTRIBUTIONS (Include spousal distributions) Specific Bequests: 1. Monsignor Hugh A. Overbaugh c/o St. Catherine Laboure Church 4000 Derry Street, Harrisburg, PA 17111 (Item 2 & Item 4, Last Will and Testament) Parish Priest $0.00 2. Elsie Harlan 333 Gettysburg Pike, Mechanicsburg, PA 17055 (Item 3, Last Will and Testament) Friend $0.00 Residuary Estate: Charities (Item 5, Last Will and Testament) 1. Food For The Poor, Inc. 550 S.W. 12th Avenue, Deerfield Beach, FL 33442 Charity 33.330/0 2. Father Baker's Victory Homes 780 Ridge Road, Lackawanna, NY 14218 Charity 33.33% 3. Catholic Church Extension Society 150 South Wacker Drive, 20th Floor, Chicago, IL 60606 Charity 33.330/0 Decedent's estate was insolvent. As a result, no distributions of any money or property were made to the beneficiaries listed above. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTION UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1 . None $0.00 B. CHARITABLE & GOVERNMENTAL DISTRIBUTIONS 1 . None $0.00 TOTAL OF PART 11- 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) $0.00 ~ (.0) ~ c.... ::0 Pl 01 Z >- I\) J: 8 ITI )> -< ~ z c )> () J! t7j (J) Z ID (J) CJ U'J c " :u 0 () .(1) :u 0 ~ ." -1 C Z ITI (I) Z z (j) Z I ITI to l> F 5 > ~ :tJ ::0 (; 0 0 01 l> )> tt: CJl 0 -i ~ :E -'I LAST WILL AND TESTAMENT OF GENEVIEVE T. WOLFGANG I, GENEVIEVE T. WOLFGANG, of the Township of Upper Allen, County of Cumberland, and State of Pennsylvania, being in good bodily health and of sound and disposing mind and memory, and not acting under duress, menace, fraud, or undue influence of any person whomsoever, merely calling to mind the frailty of human life, and being desirous of disposing of my worldly goods while I have the strength and capacity so to do, I do make, publish and declare this my LAST WILL AND TESTAMENT. I hereby revoke, cancel and annul all my former Wills and Testaments, including codicils thereto, by me at any time made, and declare this alone to be my LAST WILL AND TESTAMENT. AS TO SUCH ESTATE AS IT HAS PLEASED GOD TO ENTRUST ME WITH IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ: ITEM 1. I direct that my Executors hereinafter named pay and discharge all of my just debts, funeral and testamentary expenses. ITEM 2. -- I give, devise and bequeath the sum of Five Thousand Dollars ($5,000.00) , free from tax, to MONSIGNOR HU~!:! A. OVERBAUGH, per stirpes. It is my hope that Monsignor Overbaugh will from time to time place flowers on my late Husband's grave, as well as my grave. ITEM 3. I give, devise and bequeath the sum of Five Thousand Dollars ($5,000.00), free from tax, to MRS. ELSIE HARLAN, per stirpes. ITEM 4. I give, devise and bequeath my mobile home and shed, as well as contents therein, to MONSIGNOR HUGH A. OVERBAUGH, per stirpes. >- ..,~.. _' ~. < .' ,- .t-"~_f'/ /.~7 ,;.:7 _ .GE'NEtI'~\~t ~ L:"~~G1;t-'7fg.<:? 1 ITEM 5. All the rest, residue and remainder of my entire estate, wheresoever situate and whatsoever it may consist of, I give, devise and bequeath, absolutely and in fee, to the following named organizations, share and share alike, per stirpes: A. FOOD FOR THE POOR, INC. B. FATHER BAKER'S VICTORY HOMES OF CHARITY C. THE CATHOLIC CHURCH EXTENSION SOCIETY ITEM 6. I hereby nominate and appoint MONSIGNOR HUGH A. OVERB~UGH as Executor of this my last Will. ITEM 7. I direct that my personal representatives, as well as their successors, shall not be required t give bond for the faithful performance of their duties in any jurisdiction. ITEf\1 8. -- I direct that all estate, succession, legacy, inheritance or other transfer taxes, however designated that shall become payable by reason of my death in respect of all property comprising my gross estate for tax purposes, whether or not such property passesunder this Last Will, shall be paid by my Executor out of my residuary estate. ITEM 9. I grant to my personal representatives herein named, in addition to, but not in limitation of those powers vested by law, to be exercised without prior application to or approval of any court, the power and authority to retain indefinitely any property, to invest and reinvest any assets or the proceeds derived from the sale of assets, although said investments may not be of the character prescribed by law, to sell, convey, assign, transfer and encumber any property, to pay, settle or compromise all claims, to make distribution or divisions in cash or in kind, and in general to exercise all powers in the management of any property hereunder which any individual could exercise in the management of similar property owned in his own right, and to execute and deliver any and all instruments and to do all acts which may be deemed necessary and proper. 1-"/ ---.") 1/' ...-</\._L;-?'L.LZ L.-<.e ';.-'2./ .>1:;::_.u}'(; "',~- .;~C7 GENEVIEVE T. WOLFGANG ,;.77./:- ,/ --__~~n_____________________________ COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND I, GENEVIEVE T. WOLFGANG ,TESTATRIX, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my LAST WILL; that I signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. Sworn or affirmed to and acknowledged hefore me, by ~ENEVIEVE T. WOLFGANG , the TESTATRIX, this 12th Jay of June , 19.2]. - jO... j,\i" NO~Y .~~~~--~ Mechanicsburg, PA My Commission Expires: " .'. I: ill; ~.f-!. ~ ~" j . Iii ',~ 1.."1' ! /1'), '/;,,):; The preceding instrument consisting of this and two (2) other typewritten pages, identified by the signature of the TESTATRIX, was on the date thereof signed, published and declared by GENEVIEVE T. WOLFGANG, the TESTATRIX thereLl named as and for her LAST WILL AND TESTAMENT. Residing at 352 S. Sporting Hill Road Meehan icsburg, PA._l:2Q55. ~ /-t-~ CHRISTINE M. FORTI Residing at 352 S. Sporting Hill R~~D Mechanicsburg, PA 17055 A F F I D A V I T COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 55 We G LAD Y S B. S P RAM ELL I and C H R 1ST I NL_~.J.J___ ' t Ii ..~ witnesses whose names are signed to the attached or forP-C]oin(1 instrument, being duly qualified according to law, do d(~pi):';r' and say that we were present and saw TESTATRIX sign and ex0.Cu!:;: U!(, ins t rum en t a s 11 e r LAS 'r WI L L; t hat she s i g n e d w i 11 i n I] 1 Y and t Ii ;1~. ,; :1 e x e cut e d ita she r f r e e and vol un tar y act for the p l.l r po set. 11 i:'. JJ: .i.; , expressed; that each of us in the hearing and f.>ight of the T EST A T R I X s i g n e d the WI L Las wit n e sse s; and t hat tot h e bE's +.: () f () l1 i knowledge the TESTATRIX was at the time 18 or more years or (1(11,0, (if sound mind and under no constraint or undue influence. Sworn olr affirmed to and subscribed to before me by GLADYS B. SPRAMEI.LI and CHRISTINE M. FORTI witnesses, this 12th ,day of June , 1991. f--..~.." .i'_ NO f Me My 3 Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of: GENEVIEVE T. WOLFGANG also known as N/A, Deceased No. 2006-00176 Date of Death: Jan. 16, 2006 Social Security No. 180-05-0640 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. l!We verify that the statements made in this inventory are true and correct. l!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. Name of Attorney: Paul Taneff, Esq. Attorney I.D. No.: 63777 Address: 4219 Derry Street, Harrisburg, PA 17111 Phone: (717) 564-5833 Personal Rep.rece(s): ~ d O':L Y. Monsignor Hugh A. Overbaugh Dated: April 18, 2006 Description Value 1. REAL ESTATE: SCHEDULE A 2. STOCKS AND BONDS: SCHEDULE B $0.00 $0.00 $0.00 3. CLOSELY HELD CORPORATION, PARTNERSHIP OR SOLE PROPRIETORSHIP: SCHEDULE C 4. MORTGAGES & NOTES RECEIVABLE: SCHEDULE 0 $0.00 5. CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY: SCHEDULE E 6. JOINTLY OWNED PROPERTY: SCHEDULE F $6,349.37 $0.00 $0.00 $6,349.37 7. INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY: SCHEDULE G or L 8. TOTAL GROSS ASSETS 9. FUNERAL EXPENSES & ADMINISTRATIVE COSTS: SCHEDULE H $6,349.37 $342,122.03 10. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS: SCHEDULE I 11. TOTAL DEDUCTIONS N/A 12. NET VALUE OF ESTATE N/A 13. CHARITABLE AND GOVERNMENTAL BEQUESTS: SCHEDULE J N/A 14. NET VALUE SUBJECT TO TAX N/A TOTAL GROSS ASSETS: $6,349.37 NOTE: The Memorandum of real estate outside of the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item but such figures should not be extended into the total of the inventory. RW-8 RK