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HomeMy WebLinkAbout05-05-06 (2) r~--------------- --- i I "II' .' -.J 15056041046 REV-1500 EX (05-04) PA Department of Revenue '* Bureau of Individual Taxes ~ ..~. Dept. 280601 . Harrisburg, PA 17128-0601 p-{ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT ~...I o.s 0....... OS 7i..2.. Date of Birth ~ 0 3 ~o 'fSo ...., f) " .. I f) Decedent's Last Name Suffix MI Decedent's First Name 1{UCK.E;L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return 2. Supplemental Return c:::::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c:::::> c:::::> 4a. Future Interest Compromise (date of death after 12-12-82) c:::::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:::::> 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 Number c:::::> 4. Limited Estate c::> - 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes c:::::> CHA-I<L6S E I Firm Name (If Applicable) ,JIlt First line of address " CLOUSE/( t<:b Second line of address City or Post Office liT E e " A- J/ I C S 8 IJi{{G Correspondent's e-mail address: be am e. r c oS @ ep j x. net- 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 hich preparer has any knowledge. 3. ~6 Side 1 L ---l 15056041046 15056041046 c --.J REV-1500 EX 15056042047 Decedent's Name: ~/L!:eAJ E: /21((!kt:L . Decedent's Social Security Number ~(){3 '.~O .iI's- 0 , RECAPITULATION 1. Real estate (Schedule A). .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) <:::) Separate Billing Requested. . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <:::) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets ................................... 8. 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/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value 12 minus Line . . . . . . . . . . . . . . . . . . . . . . . . 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 .O~ 16. Amount of Line 14 taxable at lineal rate X.O!1..S 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 15. 16. 17. 18. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C) L 15056042047 Side 2 15056042047 --.J r . ,~EV-1500,EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Iff (... E'EN E. fJ-UC!<EL File Number 2/- 0 5'- S7;( STREET ADDRESS b f!) 0 CEN T/lA-t. 57. CITY IY/ Et!JI ,filiI C c:st!JU 12. G STATE P/I- ZIP 17{)$'E Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payment? A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) t/l7~ 7. :z 'S o () o Total Credits ( A + B + C ) (2) o 3. Interest/Penalty if applicable D. Interest E. Penalty o () (3) 0 (4) 0 (5) ~7'7" 2~ (5A) t) (5B) -,g71>7.:/S- Total Interest/Penalty ( D + E ) 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 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; .......................................................................................... D I ~: ;:::~ :h~e~;~i:~:~s:~t:~::;:~.S.h~II.~~~ .t~~. ~r~~~~ t~a.n.s~e~r~~. ~r.lt~ .inc.o.~.e.;. ::::::: ::::::::::::::: ::::: ::::::::::::::::: 8 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 [XI 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)].. S'\\D For dates of death on or after January 1, 1995, the ti 30 . \ . lsfers to or for the use of the surviving spouse is zero (0) percent [72 PS. 99116 (a) (1.1) (ii)]. The statute does not ex€ . . U U m tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the survivir ~ (; For dates of death on or after July 1, 2000: ~. ( The tax rate imposed on the net value of transfers fro C1' 0 lUhJ.. adoptive parent, or a stepparent of the child is zero (0) ~ 11'\ V D The tax rate imposed on the net value of transfers to IV Tl 72 PS. 99116(1.2) [72 PS. 99116(a)(1)]. f age or younger at death to or for the use of a natural parent, an G~ leneficiaries is four and one-half (4.5) percent, except as noted in 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.1503 Ex + (1-97) '. '* SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF t<.UCj(.FL, /f/Lei:# E FILE NUMBER .21-oS-S7,<. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 'II ShaftS ,,/ ~A1/}2IJ-" s/;Gk 6f Me.t L//e ~tlS;jJ #: t:J~1 9;e Sf/IS-I> ,elf) h; 1t".I3 jp. t-I.J 3. S5 =- ave. ~ J. 8t./ (See Y4/Jl4h#11 Shett q/fAc,krl) X iff Sh. - 'I. l' 7. '11./ TOTAL (Also enter on line 2, Recapitulation) $ II 7 '17. '-It.! (If more space is needed, insert additional sheets of the same size) MET: HistOI -.1 Prices for METLlFE INC - Yahoo! Finance 03/07/2006 09:28 AM Yahoo! My Yahoo! Mill! Make Yahoo! your home oaae Search . thE: Web ! (Search] YAaoo', FI NANC E ~~~~s~~ ~ Finance Home - Help Tuesday, March 7, 2006, 9:25AM ET - U.S. Markets open in 5 minutes. Dow -0.570/0 Nasdaq +0.000/0 Home Investing News & Commentary Retirement & Planning Banking & Credit Loans Taxes My Portfolios Market Overview Market Stats Stocks Mutual Funds ETFs Bonds Options Industries Currency Education , ( GO ) Symbol Lookup I Finance Search Get Quotes : MetLife Inc. (MET) '''-''''---.-.-''''-'.'-.--'--'--.. ~ ^~ $7 stock trades On Mar 6: 48.97 0.00 (0.00%) _ H ..-. +3 AMERITRADE IRA Get Microsoft'>> Money 2006 Deluxe Plus 15 free trades FREE MONEY~) Monev Maoazine Trade for less. Historical Prices .(GO~ Get Historical Prices for: i SET DATE RANGE ADVERTISEMENT http://finance.yahoo.com/ q/ hp?s=MET&a=05&b= 10&c= 2005&d= 05&e = 10&f= 200 5&g =d Page 1 of 3 REV.1508 EX + (1-97) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I<tlC/l.FL." ;f-IL.~AJ E: FILE NUMBER ;l/-LJS- S 72. 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. ~. DESCRIPTION ,4e~(JNrs A-i /JAIl!. 13/fA'K / /VA : A-.) (!/1ee!<J'r ~ ,M,.. .50 7 ~~ S' sr~ 91 /!J.) .Int.. /J&er. ~ K.~.~ Nt /~ /I .' t,) 54;///1f5 /kd: ~. 50S ()PO 3 / ~S-- lJ.) x"t 4~cr. Ii 1l'.6.eI. ~~ "Z~ e.: (j~e r~/U4ht?A ~ q#nd~ ) &A //1 WIlI/tt f ::r" r;, /!It)fe: /Vo /I1".s~e/loI1et'J".s ,/emS DP 1'.er>"Aa/~ /n .;& Ilalur~ cI ~rnlk~J etz. are t;sfe.d Sint:t!. I.'te/,'me 3. i~ts ~p ft. sa~e were mack 1.; c1e.e.e.den1s c/a'14!vj JIII1&1r4 /filch/, ~I " ~~ tlteeded ~l.t:/et/ ~r k4t4 &vJ,r It> k, Iw, dt,Idre/l / /Jamal ht fdu/, J: k~/n~ Tunt J~ /'!f!'1 (lJ~~t:I /.> fe(!OMt!/ /h /Peetll'der al lJeecls t)ff/u /n eUIH~"/4HJ aU,,? h/ ibed &01< .:?o.:{~ fJ~ 31~ J. VALUE AT DATE OF DEATH ~ ;(~ /) S ,. :l S- ,02, ~ 2~ "'It!", 33 ~ ;;'. 35 1} 9, 23 TOTAL (Also enter on line 5, Recapitulation) $ ~ 5, q 7 '1, ~ I- (If more space is needed, insert additional sheets of the same size) SEP-01-2005 18:46 PHCBAH~< 412 768 3458 P.131/'131 o PNCBAN< Sept~mber 2, 2005 Charles E Shields, m Attollley at Law 6 Clouser Rd. Cotiler of Trindle and Clouser Rds. Yvlc..;IH flicsburg, PA 170.55 Iscp RE: Estate of Aileen Ruckel (Deceased) SSN: 376-40-8459 DOD: 06-10-2005 Deaf Mr. Shields: In response to your request for Date of Death balances for the customer noted above, our records show the following: eh ~c"ji1g Account Account #5070084441 Established 0 1-01-1979 AILEEN RUCKEL DOD halance: $2,059.28 -I- $0.02 accrued interest Snv;ngs Account Account #5030003125 Established 01..01.1979 AILEEN E RUCKEL DOD hAlsnce: $23,898.38 + $2.35 accrued interest Th~ de~edent did not maintain any safe deposit box at PNC Bank. Pltw. ~e !lote that this office only provides date of death balances for deposit accounts (B"{As, CDs, Checking and Savings accounts). We do Dot procels auy tinancial tran~actjons or provide statements. If you need assistance with any of these items, pJca~c call1.888..PNC-BANK (1..888..762?"2265) or stop by your local PNC Bank branch Offi.<'~f;;. S i llcerel y , ~ ':l.~ En~~;:1 L Sc.hlegel ] -800~762"] 775 p';'. F' FS(\04..P 500 t-l('S{ Ave. Pill~llu;'&h PA 15219 Member FDIC REV-1511 EX+ (12-99) . , ~,.~" 1t1(\I(fd/ ~ '%~'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF /J / . IU4CKi:L, A-IL~EA/ E: FILE NUMBER .:2/-05- S7;? Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION 1. FUNERAL EXPENSES: fY\YE>fS F=uNFtU+L HomE', of Meeht:t.nicsbCA~ L unc.hun a{ n-DI1t 'l-re..~t $f4.h'ol1 J 4. ffell" c.ID~ina Df trAve F."l.tJ1era! h1~al p}- ..f!Dfl"'e~ I3ed l,fl!ef, l11eeJ,4",'t:..s ht.&Y'8 JCI"I4Ie.rs, /?"y'e,rj;rI~ C'e/J1eft!,'Y" A/or/iUlltiJl,rI4H.."/ <jrave t:(JIJHin!l ~es fr"r flub. ufr. 8/;,'/Ua.,..J., lJud::s (J,~nf; CDu.r-J'er-Ti'r}tL..f ~. 3. i. s: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 2. 3. 4. 5. 6. 7. f, Cf. ID. II. I~. Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: Attorney Fees (!'/{A-/l.L.~ E: c5f1I/:Z,[)~ yr Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant .:5A-/J/j)~ /I. tluCKEl. Street Address '- 1)0 e E7II T/l/fL 51: City In E" t!II AIIII (!,,S /.B II A::'~ Relationship of Claimant to Decedent -::DA-tt GH Te:7e State~Zip /1oSS Probate Fees tAM.d ""~l1al i~5ue "f ,slJIP,.t fJerf/h'ceL-kt: Accountant's Fees J JlUlet t3t'Ac.tb; If I Hi-If 8/oek, (J1"tfJ cJoSt,-Duf lot/OJ Tax Return Preparer's Fees /01.(' . t11r Lil est.'",. /f~d/Ildltell ;5/tt;rt eerf/hCa.!es t1~rl/fl~lIa1 PNJbale Il~ F///ItJ /te fi,,. hI" 7k< Rehtr" /rJ I?W' pI tv/11.s /l-t/yutiS;'W i It "" f Ullt bu/"",.; /.4 III .:7& Imz-"; /JlfYl,.tis/nt ;n ~ C'ttr//slt. Sehhne/ , tfe/IIIJurse/JJM15 G CIItlrles Sh:~:l!f-/.!o~~/J/e5, /P~7 IJ-) e~t;,c. /J{.r,hA,.s;d". tes,.. AMOUNT ~ 3, SS/,. DO ~ 1/)',7/ ~ 'T!"~, 30 , ;;Z 7S: tU) ,r /, tf". r;o iJJA' V E.D.. ~ J , q J'. fDo JK'~S7)O.t)O .. 7~, 00 12so.00 7' ~OO 9 bO.IJD 111 IS: 60 .". 7S:orJ ~ / :l~,SI 1- t29!:/0 TOTAL (Also enter on line 9, Recapitulation) $ /0) "3 S, .3 2 (If more space is needed, insert additional sheets of the same size) D& H tNLIA SCOTTIES 710 w}lAIN sr/s .J SCOTT MECMBNICSBURG, PA i7055 FRONT STREET STATION Date: 6/18/2005 Time: 1 :J9:39 PM i~17 -'~97 - 5024 AplJroved 15G'i9rJ _.' _"__.._.'_ ___I L,,-,~,_.,.', _..~..-i'..2!. '~., Visa 9/3U/2006: 48U213L475165158 SvJ i pe 52 HICHELLE Me T abl e 41 Check 152 (39 6 Covet's 1 People Rll(): EL/BAFmy flry?6~~;~i~n~~QQ~~ ~QSi 1 ;i..I~ '.JJ.tq,Jt:1t1...:,,,,,-,1.' :"':~:: __ __ _.. DATE 06/17/05 TInt i:JH ~ ~j P!'! ITEM~ 018 VIS PRE SALE SVR; 00~2 ;"....... #' :; . ..... ..,... t" au .lo. 'i _ =-...... .'.i. L,:: ......,~:...,......!..:..... '.=--.'.:. nLe.}:: }~~{;.~;.~;~~;.;)..;~;...;.:.~\}:.J :SD d" .. ~ , RESP~ AUTH/TKT 1561B5 AMOUNT: $ 486~3~ I c;c; , i GRATUITY: $~~~~~___ AMOUNT BF ,1 TIP ___ 2.a~ (1 J r:la~:J( TOTAL~ $-~~~_____ T 0 T.~ L 'l I flGREE TD PAY ABO~& ~~Tii~ _~~~~~!_ HC'.~DR_~!~~B .~D _~f;.:~D.~~r~H;+"-"_ \, ..~t'RP'HH~JTU&~,tPAf:fth>Ti ',;'l\t:!J L I . \1 '. r i r'\,r~ .~. ""i'~~')' ~1_1 ';/'.. ./ .\: .. , . ~ if..... _ _ _ :~.r:(.:.. _ __ _ _ _ _ _ _ _ __ I AGREE TO COMPLY WITH THE CARDHOLDER AGREEMENT SIGNATURE , TOP COPY-MERCHANT BOTTuM COPY-CUSTtintt CII:JTUW I.' UJPV ~--_. -----------------~ -- -- ~ 0 <5' ~ ~, 0 ~~~ ~ :T ~ :CDS ~~~ 5' ~ g. _Ulro ~~Ul ro 0 ~~~ ~~-g. 6:~~ ro :J '- <0 UlmO :JO mo.o. <0 Ul ~ & OJ 3 ~ :J ~~~ ~ - Ul s:~ ~, -roo ~3'~ if35 c__ ro~~ ~ CD ([> [jffi x~ o :r: o ~ V> Ci z ~ ~ V> ~ n o ~ ~ o }> z o ~ ~ ,}> n ~ o s: "'C o :c -I )> z :-:f :D m -I )I- Z -I ::J: en (j o "C -< ." o :D -< o c: :D :D m (j o :D C ~ '0 -....I o > -< en =n III r > Z " en z o -t 'TI r= r m o .3 z )>O)>Z "T1(")"T10 -fJJ-fC/) mmm)> :CCJJr- I ~I : C(")C~ )>::r::)>:c -<)>-<Z C/)ZC/)m . m. C (J) E~ ~~ CARDHOLDER COpy ~s z ~ -I o Z ~ - E: r- III 2:'~ ~Z 5~ -" "" ~ ~ ~ ~ ()1 (i,...: C""j C....' o L ~ r's' ~ I-'''"'~ ~ 6 z Myers Funeral Home, Inc. Boyd L. Myers Jr., Supervisor 37 East Main Street Mechanicsburg, Pennsylvania 17055 (717) 766-3421 Fax (717) 795-7291 A standard of excellence in Central Pennsylvania since 1910 Sunday, June 12, 2005 Sandy Ruckel 600 Central Sreet Mechanicsburg, Pa. 17055 Dear Ruckel, Thank you for selecting our funeral home to provide services for your family during your bereavement. I hope that you found our services to be of the highest standards and that they met your needs and those of your family and friends. The following is a summary of the service charges as previously explained and provided in written form and herein indicated as PAID-IN-FULL. Aileen Ruckel SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED LESS: Credits granted LESS: Total Payments CURRENT BALANCE $4,766.60 1,208.60 3,558.00 $0.00 Credits Granted: $73.60 Early Pay Discount $1,135.0 Package Price Discount If there are any questions or concerns that remain unanswered, please call me. ?~~ (717) 766-3421 Myers Funeral Home, Inc. Boyd L. Myers Jr.. Supervisor 37 East Main Street MechanicsburQ. Pennsylvania 17055 105 Fax (717) 795-7291 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges are only for those items that you selected or that are required. If we. are required by law or.by a. ceJ?1etery or crematory to use any items~ we will explain in writing below. If you selected a funeral that may reqUire embalming, such as a funeral with viewing, you may have to pay for embalming. You do not have to pay for embalming you did not approve if you selected arrangements such as direct cremation or immediate burial. Ifwe charge you for an embalming, we will explain why below. For Services of Charge to Sandy Ruckel Name Aileen Ruckel A. CHARGE FOR SERVICES SELECTED: 1. PROFESSIONAL SERVICES Services of Funeral Director and Staff Embalming Casketing, dressing, cosmetology Other Preparation of body Hairdresser / Barber Autopsy Remains SUB-TOTAL PROFESSIONAL SERVICES 2. USE OF FACILITIES AND SERVICES For visitation / wake service For funeral ceremony For memorial service Equipment & services for graveside servi~ $ $ $ $ $ SUB-TOTAL FACILITIES AND EQUIPMENT 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home Hearse (Casket Coach) Flower Car / Floral Distribution Family Car Lead Car / Clergy Car Utility Car Out of town transportation $ $ $ $ $ $ $ $ SUB-TOTAL AUTOMOTIVE EQUIPMENT TOTAL SERVICES, FACILITIES, AUTOMOBILE B. CHARGES FOR MERCHANDISE SELECTED Casket $ Other Receptacle Cardboard Cremation $ Outer Burial Container $ Acknowledgment Cards $ Register Book $ Memorial Folders $ Prayer Cards $ Temporary Grave Markers $ Burial Clothing $ Other Clothing $ Cremation urn White Marbleon $ Temporary $ $ SUMMARY OF CHARGES TOTAL ABOVE ITEMS (A,B.C.D) $ 4,766.60 Sales Tax (if App) @ % $ 0.00 $ $ $ $ $ Date Of Death 600 Central Sreet Address June 10, 2005 Date of Contract Mechanicsburg, Pa. CIty State June 12, 2005 ]7055 Zip C$ $ $ $ $ $ $ $ $ $ $ Family 300.00 200.00 100.00 48.00 63.60 25.00 225.00 $ $ $ $ $ $ $ C. SPECIAL CHARGES Forwarding Remains to other Funeral Hom~ $ Receiving Remains form other Funeral Hom~ $ Immediate Burial $ Direct Cremation $ $ D$ 961. 60 1895.00 95.00 Al$ ] ,990.00 SUB-TOTAL OF SPECIAL CHARGES D. CASH ADVANCED Opening Grave/Crypt Newspaper Patriot Newspaper Sunbury Clergy / Mass Offering Certified Copies of Death Certificate 8 Family Flowers Coroner's Authorization Fee Crematory Fee 4,766.60 1,135.00 3,631.60 A late charge of 1.5% per month on the outstanding balance (annual rate of 18%) will be added to the balance. 350.00 lncl DISCLAIMER OF WARRANTIES Our funeral home makes no representations or warranties regarding caskets or outer burial containers. The only warranties, expressed or implied, granted in connection with goods sold with the funeral service are the express written warranties, if any, extended by the manufacturer thereof. No other warranties including the implied warranties of merchantability or fitness for particular TOTAL MERCHANDISE SELECTED B $ 425.00 purpose are extended by the seller. I agree that I have examined the items of goods and services selected above and found them to be correct and according to the arrangements I have requested. I acknowledge receipt of a copy of this Statement of Funeral Goods and Services Selected. I represent that I have sufficient funds available for payment of the cash price for the goods and services selected. I also agree to make payment of $ 3631.60 within 30 days. I agree to be jointly and severally liable with anyone else who signs below. A LATE CHARGE of 1.5% per month (18% per annum) Will be applied to the unpaid balance beginning 30 days after the date of this contract. I will also pay the Funeral Director all reasonable costs paid by the Funeral Director to collect amounts I owe under this agreement. Those costs may include attorney fees and court costs. Any items requested after the date of this agreement will be considered part of this agreement and will be reflected on fhe final bill. 450.00 395.00 A2 $ 845.00 (Seal) Purchaser (Seal) Purchaser 350.00 SUB-TOTAL OF CASH ADVANCED We charge you for our services in obtaining the following: NONE Incl Incl ] 95.00 A3 $ A$ TOTAL OF ALL SECTIONS LESS: Payment Made LESS: Credits Pending LESS: Credits granted BALANCE DUE 545.00 3,380.00 lncl Package Price Discount Ju112,2005 Incl 75.00 Incl REASON FOR REQUIRED SERVICES OR MERCHANDISE I ~~ Citizens Bank 1-888-910-4100 Call Citizens' PhoneBank anytime for account information, current rates and answers to your questions. Images for account 620317-615-3 Circle Account Statement . OF 5 Beginning June 14, 2005 through JuLy 14, 2005 6e.rlt( i"e ALCd(el ll:.ZIU. .Jltll't! 2. ~ 20~ 3lIP W' 10 TIlE t: I' l OlUlD OF 4-, '1 s I s .).2 , 00 II P/ve-II'IIlJ,~'/} Tw~"dy -lit-It:) ~ DOLLARS I Ii C CITIZENS BANK I: I · PE.~SSYL\'.'\.~lA . !1oQIO ~_ I J l ':0 ~ &0 'Hd so.: I7C!ri ."0000052 i!OO..' ! , ; o 06/27/2005 $522.00 -=-~_ ,,_;~~':;"';_;"*=*-"':" ___,;,"~.:..::....~.~,;,..;_ .._-...4_;....--:.-,.....-;.....:.. '.:.:.. ,. ~ BARn, flUCKEL D'RRtRUC:KE1. :II COII&Y &Nil! MElLLAHD 'A 1866 483 ~ ,. ~ II. 20'QS"" Solllv.l!ll D'Ie: 7 ~ J III 07/11l1 =~~~~~: ';~,:.:==- c Cll1lENS BA1~K '-- Cil!w2s Circk ,\<<O~r frw 'wC.:;::t...M:...~! &S-g,. '<. ~,~ 12~~ ':O~'01r.J.501: 'Z03l?~153" 0&..83 '''O~lOOOO,'' 483 06/1 Sl2OO5 $100.00 486 ~ BARRY RUCKEL 07J03 ~ GeRR'RUeKE1. =~~_ Dm ,(-/.:r-"r ~. TELLER #15w :::t. . 1'ICJ21t/tN f;;Ih:.e,e: !fEAl.r1 I $ /'''0. tJd ~ _~JY~ ..-l- FDolhn m === e Cl"ftZENsB.\NK STURD~rl:.~ I'cllN)l-arlia ./? ~ Far ,,98 tJr:eN.I l~-Y-~ .t'fJ~ '!! ':0 i GtO?~ I. 50.: 'i!0 ~ l?L Ii S:to- O"SI:. ,1'0000 J.QOOoa..' ,.111"* m 486 06/20/2005 $1900.00 ~ BARRY RUCKEL GERRtRUCKEL :B c;ova LAHE HlJLUHD PI. .- 488 01.G3 Dale h - ,,2 7--0';- ."I~ C,tfPlls" .:It. 08 Dr ,~ ~~oIl1." & ~ c;:iaiRJn. Ordc ~.l =:~ IlL $8-. tlyiC/iriIJ -?1!'.:.~ .. " ~,,-~ ~ C CitiZENS 8a\....K ~.... ~ Jtbf.,to - f' ~ dtJ 3 Far .:03.&0 ? b a. SQ.: b i!O lit ?&;a .. 5 ~II' 4~ 4L-e. O~a8 10000003&081 488 06/23/2005 _aSlQIIDlhll- III ft~::'~~~: : r---- _._..._._~-lJ;-~~lile764 "~i!DS -:-1 ~:H ia:::::~:.;.;.::: ~ Gaol ~ ,:I 05lXJ87~"~ ~ ..utd .... lit&' a' ,,'."1 .... g stttlEYLIf .....a. ~...;::,.,.... tQI.IlNlJ.p,..,...... ~ ~ :.":' GII MA:;JPCAIW ~:a...ru= ~~'--_...... ........_ ..... PJl~ tD2tl,t tn!ll n-.nDfl"'~ -~ :..--::::...". - ~ - CQ~~07~'50~ ~ZO;~?bI5)r o~,D~CpOOl500QD~ "":OU"D"?'" 'so': ""20:l~,}'15}Ii'O..qD "'ODDOhDOOO~ 490 06123/2005 $2500.00 !:L;I;;H'~ i j}l f ~~') J /III; j l.r'lni "" I (u,rJ,~.- ~ :'::~Hf ia r /''7' A-t'1 e Ld.. . lil-I",t~~ _I C ClT~,~~~...~!NK f2 aj MEMO 1"k2 U7 (1<""'1 ~ . j .:0 ~ bO '1 Gt 1501: b ~O ~ ~ 7 b I. 5 ~n' ,? ~ I .,. 20F sl/ot[ {Jt7 l! I () J ~l.l~' ! i ~~ II . . ..-00000 lOOOO," . ,,-- - -- ... o 07/11/2005 $100.00 -.. -."-". ..... --:"""':...-....... .. . ~ BARRY R\fCKEl DflQ3 ~ GEARI RUCkf,~ ~ ~1l966 D,.r 6 -.ziJ - flS- 10...1"-: ::I;lhe c:;:,4-I I S /.,r.d. 5 ~~~-M~ -#oolkn e=:- C~C't'rflENS'8A~K..i.::.;- r ~'J03 ~l;:;rdtA~' .'!;;:'; n$lJ 'T.:l?7:r,03 _a '_~._~ .:03[.0 'lb 1.50.: Es ~o:u vt. LS 3.1- 01.,85 ".00000....05t.... 485 485 06/20/2005 $140.56 f ~:.:.~-...:..'-,,_.: " :....:...:.: ----=-.:~':_._--=-. .-=-:--:::'._~":-'~" ~.~- --~.:_-=-..: 487 ~ BARRY RUCKEL ~rm ~ GalIU flUCKEL ~~:. D,ne b-rr-Or ~"I"= ~y ~e)d-fl'irW ~~ J $ ~75: !! 7~~~-~ O""C~,,1lars d\=-~ C ClnZENS BAo"lK r CllUcal Circk "-lUl' _ .47~~ k~ ,gP-4 ~ 1= ___.~--- .:0:1 '0'1 b ~ 501: b i!D 3 1 ? b 15:1" OlaB'? ...00000 i!? 500." 487 07/01/2005 $275.00 ~ BARRY RUCKEL . GERRIRUCKEL .JII QOvE'i' lANE HOUAND PA UllI6& 489 O'Im DUI t~ZZ .."r ~ d~W~ /A-:Jt$ 15: ~ _~" _ ~_ DoIbn 1lJ ===- . C CITIZENS IM.:'lK it~2.3aZr5 eeeC'l36"il!f8?" 9'9'!t561723 ..iIt.o':i:zO(} 'f'l'J .a/1,<.j a ~ IU _," ---~-------~ ':O:lI7;O?4;d.SOI: b203~?bi.S3" oa..aq ...00000015...&.... ~JllllrM ,,, $36.08 489 06/24/2005 $15.41 . .. .-.... ~.- .. . -- - --'" -.- .. :.......~: :..~.-.-:.._-- ~.~...-...:-:.=.- ~.:.... --- ==":":'..~ .;....-:......__":.-: ~ BARRY RUCKEL GERRIRUCKEL .- IXJVE'I' lArIE tc)U.AlIID PA .89Ii& 491 fI1/(fJ Dat~ b-.2 '1~sr- """'= :J::: ~ AWo 11#. /JAr. .g"A,u~ fC3. P-2. ~~ ~ "5~~ -fte.e ~t 1~lIan ~ ~ C CITIZENS BA."IK Ortuftl CiadrA.a.-owlt ,.. 'FIlO -rrT 0 L/S- ~ ~ 1:0 :U;O 7 E. 150': E. 20 ~ a. 7 b 1 S :il' Oa..ql ~000005~~q2t 491 06/29/2005 $563.92 ~EV-1512~)( + (1-97) ~ -~ , ..." " . " . d"~ ~ ~{. >=- COMMONWEALTH OF PENNSYLVANIA INH~~~i~~~~OT:2E~~~~RN MORTGAGE LIABILITIES, & LIENS ESTATE OF ' " . ' R. U C~ETL, A-I L e FN F. SCHEDULEl DEBTS OF DECEDENT, FILE NUMBER ~J-OS-.s-7Z Include unreimbursed medical expenses. ITEM NUMBER 1. l{/J/f~ wahr ~. fJ,o L DESCRIPTION AMOUNT , I S". 4/ 1'7 r2. 7~ TOTAL (Also enter on line 10, Recapitulation) $ & 8'. I fo (If more space is needed, insert additional sheets of the same size) . I REGISTER ANY QUESTIONS OR COMPLAINTS ABOUT THIS BILL PRIOR TO THE DUE DATE TO: UNITED WATER PENNSYLVANIA 8189 ADAMS DRIVE HUMMELSTOWN, PA 17036 PHONE: 717-564-3b62 TOLL FREEt 1-888-299-8972 METER READINGS 05/02/05 0510 06/01/05 0512 CONSUMPTION 2 MGL CURRENT BILL CHARGES: WATER CHARGES SERVICE CHARGE W-DSICSRCH TOTAL CURRENT CHARGES $8.33 $6.50 $0.74 $15.57 $O.16CR $15.41 W-STASSRCH TOTAL AMOUNT DUE I ~~/l~ YVV UWPA WILL BE CONDUCTING THEIR SPRING FLUSHING PROGRAM EFFECTIVE 4/4/05 THROUGH MID JUNE 2005. APPROXIMATE STATE TAX INCLUDED IN THIS BILL $0.71 06/02/05 600 CENTRAL ST REGISTER ANY QUESTIONS OR COMPLAINTS ABOUT THIS BILL PRIOR TO THE DUE DATE TO: UNITED WATER PENNSYLVANIA 8189 ADAMS DRIVE HUMMELSTOWN, PA 17036 PHONE: 717-564-3662 TOll FREE: 1-888-299-8972 METER READINGS 08/02/05 0517 09/02/05 0519 CONSUMPTION 2 MGL AnHHH1~ due 00200999561723 15.41 RESIDENTIAL -----------BILLING S~MMARV----------- PRIOR BILL AMOUNT $15.41 PAYMENTS THRU 09/06/05 $15.41CR BALANCE FORWARD $0.00 CURRENT BILL CHARGES: WATER CHARGES SERVICE CHARGE W-DSICSRCH TOTAL CURRENT CHARGES W-STASSRCH $8.33 $6.50 $0.74 $15.57 $O.16CR TOTAL AMOUNT DUE $15.41 ,\L ')J.J.. \ 0.: FOR YOUR CONVENIENCE, UNITED WATER NOW ACCEPTS CREDIT/DEBIT CARDS AND CHECKS BY PHONE. THERE IS A $3.00 FEE FOR THIS SERVICE. $0.71 APPROXI.MATE .STATE TAX INCLUDED IN THIS BILL 09/06/05 600 CENTRAL ST 00200999561723 15.41 ... I PPL Electric Utilities Electric Service For: AILEEN RUCKEL 600 CENTRAL ST MECHANICSBURG PA 17055 Questions about this bill? Please contact us by Jul 6 at 1-800-342-5775 or 484-634-4900 or write to: Custolller Service 827 Hausman Rd. Allentown, P A 18104-9392 www.pplelectric.com I I J ',I,' '......\...::./4/ ~ ppl J~~: " tu Page 1 :t:jj~:j~3t::j;::i:HYQU1:::B.i l:A:Cco(lnfNiimWriht,::::::'~::;:: 34420-82003 Summary Page Balance as of Jun 2, 20~S CharMs: TotafPPL ELECTRIC UTILITIES Charges Total Charges r'~ i $36.67 - V .'/~ C,$ 36.08 $ 72.75 f~~ ~ fA ~ I {}It ,.r\ \l Account BalanCer tffS tfJ t-( ( Electric Use This graph shows your electric use over the last 13 months. Types of Meter Readings: Actual - Estimated I~~ Y.'!'.. "" Customer D 30 KWH - Average Per Day Meter Reading Infonnation 25 Actual 12352 Actual 12037 20 KWH BlUed --n3 15 Average -Jun 2004 2005 Twnerature 67F 60F K Per Day 12 11 10 Yearly Use: Total Avera~ 5 Use Montlt Jul2003 - Jun 2004 6741 56 0 Ju12004 - Jun 2005 5912 4~ JJASONDJFMAMJ 2004 Months 2005 Other important information on back ... REV-1513 EX + (1-97) SCHEDULE J BENEFICIARIES ... .' - COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF J') ,.. AIL ~ "Uc.-KI:L1 ".. C"~N .1::-: NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 1. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. -SJI.#IJI2A,4.. {GU C/C.EZ- 600 (!tWlJ?.al Sr- lJ1ee!tutlcSbU7'1'-"I 1705'S ~ L3A-/Ut.y T. ~CI~e:z.. bOO een~1 cSt: /J1eehan /C.5 h fA. J"J' P'+ no ss- (.fLe ~{ly t9f 1t),'1! a/IRcALd) ~ Il"fi,: X-bn zr (4) real fJ/'O/le.r/j hi l3or~HfIJ bf /J6rM/'{Alber/~ HJIl$ C!.tJovep4 Ilway A/ell flh{,r Ie> d~eleI1r; cia/;. t?! duM. FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) ~h+er So~ 2J...{) s- ~-7:L AMOUNT OR SHARE OF ESTATE Yz Y:t ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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) I . WIlJJI~~i~,(..~~ I, AILEEN E. RUCKEL, of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do here- by Inake, publish and declare this to be Iny Last Will and Testament, hereby revoking and making void any and all \i\Tills by Ine at any time heretofore made: ITEM L I direct that all my just debts and funeral expenses be paid as soon as conveniently may be after my death. ITEM II. I give, devise and bequeath my entire estate, real and personal, wheresoever situate, to my beloved husband, IRVING RUCKEL, his heirs and assigns, forever; conditioned, however, that in the event of his death in iny lifetime or in the event of his death within thirty (30) days after Iny death, the said devise and bequest shall lapse or be divested, and in either event, I give, devise and bequeath my entire estate as follows: (a) I give and devise unto Iny daughter, SANDRA A. RUCKEL, the real estate at 247 Sixth Street, in the Borough of Northumberland, NorthuInberland County, Pennsylvania, all as rnore fully described as Parcel t~o. 1 and Parcel No. 2 in Deed dated January 6, 1982, and entered in Deed Book 580, Page 90, together with all furnishings, all household goods, and all other tangible personal property contained on, in or about the premises, including all policies of insurance thereon, and ~ stirpes to her issue if she predeceases Ine. If she has died ,vithout issue, then this device shall lapse and said real real estate shall become a part of the residue of my estate. /_.., ;'.1 r:." /1/1.J')'H-1'"/(/"- ~.' '_, /. t ./'? }",'I",' k', ,(", '.. ""-~ (/ '/ . ,,,,7 '/ / L ((,/' ,\_- C" ,.; . I . (b) I give, devise and bequeath all the rest, residue and remainder of my estate to my son, BARRY I. RUCK.EL, and to illY daughter, SAN])RA A. R UCI(EL, in two equal shares, share and share alike, and ~ stirpes to the issue then living of such of theln as shall be then dead leaving issue living at my death, so that the issue of any child predeceasing me shall take between them only the share \-vhich their parent \vauld have taken if living. I declare it to be my intention that should my said husband be living at the expiration of thirty (30) days from the date of my death, the estate hereby devised and bequeathed to him shall vest in him absolutely and in fee simple, free of all con- ditions. I authorize my personal representative to payout of the income or principal of my estate reasonable amounts for the support and maintenance of iny said husband during such period of thirty (30) days, and as \-vell the reasonable expense of his funeral and gravestone should he die within the said period of thirty (30) days. ITEM Ill. I appoint my daughter-in-Ia\-v, GERALDINE RUCKEL, guardian of any property \vhich passes, by reason of my death, whether under this vVill or other- ,vise, to a beneficiary under twenty-one (21) years of age, and with respect to which I alTI authorized to appoint a guardian and have not otherwise specifically done so. Such guardian shall have the power to use principal as "well as income from time to time for the beneficiary's education, support and welfare (without regard to the abili- ty of any person taking care of the beneficiary to provide for such education, support and \velfare), or to make payment for these purposes, without any further responsibil- i ty to the beneficiary or to the person taking care of the beneficiary. Any such guardianship shall tennina te when the beneficiary attains the age of t\ven ty-one (21) ye ars. ("7 "/) , " l ./ 0 .k:./ A,-, 1,,--,,/ (" f:~ "'I 1 'I If.~. ~.!J , ,,/1 (/'.,.r./p./__ " r - 2 - .. # , .. ITEM IV. I nominate, constitute and appoint my husband, IRVING RUCI(EL, Executor of this my Last ';Vill and Testalnent. In the event of his death, other dis- ability, or renunciation hereunder, or should he cease to serve in such capacity, I nominate, constitute and appoint my son, BARF..Y I. RUCKEL and my daughter, SAI\JDRA A. RUCI(EL or the survivor of then1, to serve as Co-Executors of this my Last Vvill and Testament. ITEM V. I expressly authorize my personal representative in his sole and ab- solute discretion: to sell, transfer, conveyor otherwise dispose of any and all property at any time forming a part of my estate, in such manner, at such times, for such purposes, for such prices and upon such terms, credits and conditions as he may deem advisable; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; and to execute and deliver such instruments as may be necessary to carry out any of these powers. ITEM VI. All estate, inheritance, legacy, succession or transfer taxes (includ- ing any interest and penalties thereon) imposed by any domestic or foreign laws now or hereafter in force 'Nith respect to all property taxable under such laws by reason of my death, whether or not such property passes under this my Will and .whether such taxes be payable by my estate or by the recipient of any such property, shall be paid by my personal representative out of my general estate as part of the expenses of the administration thereof .with no right of reimburseluent frOITI any recipient of any such property. {1" /1 1/ -.. 'I -<... .A ...{' .;> . J/ / ./ .\ r- ?~ C>. g /.;; "/----~.. - I~ A,.., fi / " .,..." .~I'" . ,....... ....;r'. - 3 - .. . l . ITEM YD. I direct that no personal representative or other fiduciary hereunder shall be required to give any bond, and that if, not'.vithstanding this direction, any bond is required by any law, statute, rule of court, or otherwise, no sureties be required thereon. IN WITNESS WHEREOF, I have set my hand and seal to this Iny Last vVill and Testament, consisting of four pages, to each of which I have affixed Iny signature, this '7 ':#1 day of UC-C.C1'(:il-f"/.:!. , 1993. , .., ( I {/ Lf...:! ~ LL 'LI. ./ ,,-: r- \ ,."." . /~ A i/" /tj"f /:'~. i..-"0't. Signed, sealed, published, and declared by the above-named AILEEN E. RUCKEL, 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 wi tnesses thereto. ~;J.~ Address: 135 Chestnut Street, Sunbury, Pa. ~ j ....~.- /' ...:"5 62// t' ck..#' at' J' / ~<) t~7 Address: 135 Chestnut Street, Sunbury, Pa. - 4 -