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Home My WebLink About08-21-06 ~ 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY County Code Year File Number PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisbur , PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT 5 QII :s Decedent's Last Name Suffix Date of Birth 04081921 Decedent's First Name MI ETHEL S. Spouse's First Name MI EUGENE S. 215-12-2273 11062005 SCHLOSNAGLE (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix SCHLOSNAGLE Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW W 1. Original Return D 2. Supplemental Return D 4. Limited Estate D 4a. Future Interest Compromise (date of death after 12-12-82) o 3. Remainder Return (date of death " prior to 12-13-82) IT] 5. Federal Estate Tax Return Required W 6. Decedent Died Testate (Attach Copy of Will) D 9. Litigation Proceeds Received D o 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) o o 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT M. FREY Firm Name (If Applicable) 717-243-5838 .'~-' First line of address -n FREY & TILEY 5 SOUTH HANOVER STREET Second line of address ,- ... , '.J City or Post Office State ZIP Code DATE FILED e'1 ~ ~:~; CARLISLE PA 17013 PENNSYLVANIA 17241 DATE CARLISLE, PENNSYLVANIA PLEASE USE ORIGINAL FORM ONLY 6/a Side 1 L 15056041114 15056041114 -.J -.J 15056042115 REV-1500 EX Decedent's Social Security Number Decedent's Name: ETHEL S. SCHLOSNAGLE RECAPITULATION 215-12-2273 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. NONE 2. 3. NONE 4. NONE 5. NONE 6. 7. 8. 9. 988102.00 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) DSeparate Billing Requested. . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . . . 100531. 00 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34173.00 1122806.00 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . . 41489.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . 10. NONE 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 41489.00 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. 1081317.00 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.O L 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of Line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 0.00 1081317.00 3 7 9 6 95 . 0 0 15. 0.00 701622.00 16. 17. 31573.00 0.00 0.00 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 31573.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT w Side 2 L 15056042115 15056042115 -.J REV-1500EX Page 3 215-12-2273 Decedent's Complete Address: DECEDENT'S NAME ETHELS.SCHLOSNAGLE STREET ADDRESS 1100 WALNUT STREET File Number 21-05-01115 CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 31573.00 30328.00 1596.00 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits ( A + B + C ) (2) 31924.00 TotallnteresVPenalty ( 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) 0.00 351.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 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 a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . " D c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D D D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. D 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No o o o o o o 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 D 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. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 39116 (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. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116{1.2) [72 P.S. ~9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~9116(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. 217 REV-1503 EX+ (6-98) SCHEDULE 8 STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF FILE NUMBER Ethel S. Smeltzer SchlosnaQle 21-05-01115 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. DESCRIPTION Scudder Investment, Acct #00003879275 The Vanguard Group, Acct #09791370859 Tamarach Funds, Acct #524742 Delaware Investments, Acct #00267086250-MAINT Aim Investments, Acct #0006263560 Fidelity Funds, Acct #2 BY-494330 Fidelity Funds, Acct #2 BY-4943321, IRA VALUE AT DATE OF DEATH 139,787 257,313 53,706 170,554 16,950 346,966 2,826 TOTAL (Also enter on line 2 Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 988 1 02 Delaware Investments'M A member of Lincoln Financial Group. March 17, 2006 Frey & Tiley Attn: Robert M. Frey 5 S. Hanover Street Carlisle, PA 17013 2005 Market Street Philadelphia, PA 19103-7094 Re: Delaware Tax-Free Pennsylvania Fund A #7-5077170141 Ethel S. Schlosnagle - 00267086 250-MAINT Dear Mr. Frey: We are writing in response to your recent correspondence to Delaware Investments. Thank you for providing us with the Death Certificate and Short Cer'tificate. We will keep these documents on file until your further notice. In order to transfer or liquidate and release account information to a third party, we require the following documentation: · A letter from the Executor requesting the transfer or liquidation containing their signature(s) accompanied by a Medallion 'STAMP' (Securities Transfer Agents Medallion Program) signature guarantee. The letter must include the executor(s) date of birth, Social Security number and residential address. ~ If the executors wish to liquidate the account, the letter should indicate the name(s) and address to which we will issue the check. ~ Before we can release account value information to a third party, a statement authorizing us to release account information to you must be included in the letter. Medallion 'STAMP' signature guarantees are used across the investment industry to protect shareholder accounts from any unauthorized activity. You can obtain a Medallion 'STAMP' signature guarantee from a bank or brokeragefirm where you maintain an account. We are unable to accept a notarized signature in place of the signature guarantee, as notarization does not provide the legal protection required to complete this type of request. · To transfer the account to a new registration, a New Account Registration Form completed with the new registration information. In your correspondence, you also requested the value as of the date of death. We will be happy to provide you with that information. Because the date of death occurred on a Sunday, we used the net asset value of the Fund as of the last business day of Friday, November 4, 2005. On November 6,2005, Ethel S. Schlosnagle owned 21,252.2380 shares of the Delaware Tax-Free Pennsylvania Fund A. The net asset value of the Fund on that day was $8.01. Therefore, the value of this account on the date of death was $170,230.43. This fund earns daily dividends, which are paid monthly. Dividends not paid as of date of death amounted to $323.08. Therefore, the value of this account on the date of death was $170,553.51. Delaware Investrnents is the marketing name for Delaware Management Holdings, Inc. and its subsidiaries. www.delawareinvestments.com I...,.. I , STMENTS Transaction Confirmation Statement Date: 01/04/2006 Page 1 of 1 -- - >00041 4362814 001 008116 JANE SCOWDEN & CAROL ANN BRADFORD 1100 WALNUT STREET CARLISLE PA 17013-3556 - - ~ ~ ~ == -- ~ This check number. 3776337, dated 01/04/06 for the amount of $16,936.69 is being sent to you by: ETHELSSCHLOSNAGLE 1100 WALNUT ST CARLISLE PA 17013-3556 If you have a question regarding this transaction, you can talk to an AIM Client Services Representative at 800-959-4246 from 7:30 a.m. to 7:00 p.m. CST. 00041 436281400004200008200001/00001 k00041 ~/ ~ TAMARACK FUNDS INVESTMENT SUMMARY ETHEL S SCHLOSNAGLE 1100 WALNUT ST CARLISLE PA 17013-3556 For the period 07/01/05 thru 09/30/05 Page 1 of 2 Dealer Address TAMARACK DISTRIBUTORS INC A TTN MUTUAL FUNDS 100 S 5TH ST STE 2300 MINNEAPOLIS MN 55402-1230 003309 /111" /11'" 111111. " II "'11 " 11/'/11/'/11 " II " III "111/'/11/ CONTACT US , e 1-800-422-2766 ~ www.tamarackfunds.com G P.O. Box 219757, Kansas City, MO 64121-9757 INDIVIDUAL ACCOUNT - EQUITY FUNDS Large Cap Growth CI S (TLESX) Total Equity Funds 422/524742 Percent 09/30/05 Total of Each Shares NAV Account Value Portfolio 4,995.9320 $10.75 $53,706.27 100% $53,706.27 $53,706.27 100% F und/ Account Number TOTALS .- Total Withdrawals Account Value Total and/or Cash Total Appreciation/ Fund Name on 12/31/04 Additions" Distributions" Earnings" Depreciation" Large Cap Growth CI S $54,006.02 $0.00 $0.00 $0.00 -$299.75 TOTALS $54,006.02 $0.00 $0.00 $0.00 -$299.75 *Additions represent purchases, transfers and exchanges into accO'Unts within your portfolio. Withdrawals and/or Cash Distributions represent redemp- tions, transfers and exchanges, as well as cash dividend and cash capital gains distributions, out of accounts within yO'Ur portfolio. Earnings represent dividend and capital gain distributions. Appreciation/Depreciation represents the market appreciation or depreciation of yO'Ur investment. Fund Name Income/ Dividends Short- Term Capital Gains Long-Term Capital Gains Total Earnings Large Cap Growth CI S $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS :nm:"_~:::=::::::=: ...-..-.....-............-. ...-.--...-.-......-...... m~1:ffiHL~~~[~~~ 529965 WSJ.com Stock Charting for nESX 6/5/06 1 ;09 PM amarack:Lg Cp Eqty;S (TLESX) (FUND) U.S. Dollar Date Price High Low Volume 2 M.:mth (Daily) @8igCharts.com 11/3/05 10.9 n/a n/a n/a ('>-./ 11.25 .__/-- 11 . 00 \ \ "'l~ 10.75 \;-""J-./V \ 10.50 No Splits Get another quote any day after 1/2/1970 1/2/1970 Symbol: L~ Date: 111/03/2005/ [;':PJ(jJ N.:II.... 1 mo 2mo 3mo 6mo .!y!: ~ 2Y!: Copyright @ 1999-2006 BiQCharts.com Inc. All rights reserved. Please see our Terms of Use. Historical and current end-of-day , data provided tly FT Interactive Data. - What commodity is likely to break out next? MarketWatch Global Resources Trader Copyright @ 2006 Dow Jones & Company, Inc. All Rights Reserved h ttp;/ /www.bigcharts.com/c ustom/ws j i e/ ws j bb. histori cal. asp? sy m b=TL ESX&c lose _ date= 11 %2F03 %2F2005 &x=O& y=O Page I of I Eugene S. Schlosnagle Atty-In-Fact Ethel S. Schlosnagle 1100 Walnut St Carlisle, PA 17013-3556 THEVanguard::iRour. July 19,2005 Dear Voyager Client: Re('.~ntly we anno....Jnc.ed that it's become a lot easier for you to mxm our lower-cost AdrrJml1M Shares. We've reduced the minimum account balance for Admiral Shares from $250,000 to $] 00,000, and that means one or more of your accounts now qualify for the substantial savings these shares provide. Our innovative Admiral Shares have expense ratios that are 18% to 50% below those of our alr.eady low-cost Investor Shares, leaving you more money to invest __ an advantage that can compound over time. Your accounts listed below are eligible for Admiral Shares and will be automatically converted fi"om Investor Shares to Admiral Shares, beginning in two weeks: Fund Fund Account Number Name Number 0022 \Vindsor Flmd Investor 09791370859 Balance as of July 18, 2005 $257,312.88 Please note that: · You don't have to do a thing to convert these accounts. We take care of the process for you and will mail you a confirmation once the changeover is complete. · If you don't want your accounts automatically converted, simply call us within ten business days of the date of this letter. · Any checkwriting privileges you had with your LrlVestor Shares account will transfer to your ^drniral Shares accOlUlt, and you will receive a new checkbook. · ConversJOfiS [rom Investor Shares to Admiral Shares of the same fund are tax-free. At Vanguard, we're committed to giving you the highest quality service at the lowest reasonable costs. Admiral Shares are just one more way we demonstrate that corrunitment to you. If you have questions about the Admiral Shares or the upcoming automatic conversions, you can visit www.vallguard.com. or call your Voyager Service team at 800-284-7245. (over, please) Post Office Box 2600 Valle For e Penns Ivan' Scudder Investments Service Company P.O. Box 219151 Kansas City MO 64121 January 3, 2006 Frey & Tiley Attn Robert M Frey 5 South Hanover Street Carlise PAl 70 13 Inquiry #: Fund: Account #: 20630350 Scudder Money Market Fd 00003879275 Dear Robert M. Frey: We are writing in response to your request for information regarding the value of Ethel S. Schlosnagle'saccounts. Please accept our condolences for your loss. The information below is only for the date you requested, November 6,2005: FUND NAME(S) NUMBER OF SHARES 17,764.635 8,102.396 SHARE PRICE $1.00 $15.06 ACCOUNT BALANCE $17,764.64 $122,022.08 Scudder Money Market Scudder Mid Cap Growth We understand that it can be difficult to settle financial matters when you experience a loss. If you have any questions, please call us toll free at 1-800-621-1048, Monday through Friday from 8:00 a.m. to 5:00 p.m., Central Time. We will be happy to assist you. Sincerely, ~cI~ Candace Thomas Lead Mutual Fund Representative o o ~ = i<;;;;;; sa o==:; ..= ~ ~= : "--= 0= ..= == '"- .,:;; 0= 0;:; """"" -:::::; -:::::; := 5 o en o I\) o (Xl o o o I\) ~ (,) en ~ ~ en ....., en o (,) o ~ o o o II III <0 CD 2- en -1-1-1-1 o III III III - X X x !!!.6.m~ CD x - - CD CD !!1 3 m"E. a. * '" I>> W c.l~ I>>.j::> 0,0, CO.j::> -Efl I\) U'I... W\O:: o 0:> .. -...J .j::> 11 ~ :p. S' WI\)a. * ..... 1>>..... 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O.....m )>....-1 :DgI !::~f!! ~)>en m'en llZO )>CI ....-1, -...Jeno O-len .... Z Cf )> (.V G) U'I , ~ m -. ::s " o .. .. .... o - -. o < I>> - C CD < I>> - C CD c:r '< J> n n o c ::s "' ll"O ~ )>::1 s.en= CD -1::1 ~~m ~1Il ~3 :D...... 11>)> -c: =t.o CD3 3 III m_ ::1m -0.. en-l CDm <- _.m 0-0 11>:J 1Il0 ::I m 0:> 0:> gg" o,o,~ ~~~ .j::>~;+' , ''< en U'I . U'I<.nO en<.nO U'I<.n3 (:z:] ::s < lD ...... o '0 lD ...... W (J1 o ...... ...... (J1 -..J 0\ " m 0- 2 III -< .0:> I\) o o en " o m r --l -< " :D "' "1'1 III :D :D III C :D III ... - ::rJ III i: III Z ... (f) m :0 < o m (f) .. 3 ~ ~ ~~ ~I: :l{ il Z o < m 3 0- !!1 .... .... ::s < CD en I"' 3 CD ::s "' I\) o o U'I :D CD 'a o .. "' 217 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Ethel S. Smeltzer SchlosnaQle FILE NUMBER 21-05-01115 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Eugene S. Schlosnagle 1100 Walnut Street Carlisle, Pennsylvania 17013 Spouse B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST NUMBER 1. A. M&T Bank, Account #75895714 7,971 50.00% 3,986 2. A Miscellaneous Household Contents 1,500 50.00% 750 3. A 1100 Walnut Street, Borough of Carlisle, Cumberland County 191,590 50.00% 95,795 TOTAL (Also enter on line 6 Recaoitulation) $ 100531 (If more space is needed, insert additional sheets of the same size) TAX YEAR 2<>05-06 ~~I;:^l ESTATE TAX NOTIC.E , , CARLISLr- AREA SCHOOL MAKE CHECKS PAYABLE TO: DA~LENE L. MOYER, cIa cica J 9 S HANOVER 'S'f. t SUITE 102 PO' BOX 128 .,. C I~ R lIS l E, P A II 1 7.0 1 3- 0 128 ,: , " . .... .'- ..... .' , DATE. ASSESSMENT BILL NO. *'t<SCHOOl*~. JUL. 1, 200~i 191,590 4763 DlST~CTI .. . , ~ . MO~OAY n:30 AM - 4:00 PM ~ . TUf~,'OA,( - FRIDAY 8%00 M1 - 4 :()OpA' o PHONE 717-2~3-3725 (1'. NO SAT t SUN UR HULHlAYS r,r. -------.----.-- %P .M %P 0 M OP M 0 .... .. ('.~ I , . f'. .: I' I I' I' t " .~ ,/. I' t ,: ~ '. '20050047630~l' , i SCHLD$NAGLE, t~tENt S. f.,' E'THt~L .~' ~CI:JLn~~;\GLf UOO."~t.rml 5T.RE~T . ! CARLISLE' '4. .2. 299 ~08 2,52:8.99 PA 170,1 3 ::t: (...) ,...., ...0 C. r"'-_ '<t'-'J: CL.. I IF UNPAID -,BY 12/12/05 l'AXES .'Will TURNED OVER TO CUMBERlANQ co. ,'7 ~l X . C l A I!'!. r U f1: E /\U . ~CCT NO 04-a9-0~7~-001 lIon WtLNUTST~EET' b~!I~t~~iAr6BCil~i~G YOUR MmiTGAGf: c.mWANY .l-: '. . ," ." ...." ".' .". ......,. . 0' j t.., ~~I-tI('~"1""''''t'MI:l:l'.:I.III:I:l-1-"1::(f):(Wl:U-'':1:1_ _ '-, r, I~l: n t~cr;uw f-~.;~rs 'jIll TO $1.00 FEE FOR ADO'l RECefPTS REQUfSTfO TAXES ARE ESCROWED, FORWARD THIS BILL TO YOUR ORTGAGE co. $1.00 FEE FOR EACH ADDITIONAL RECEIPT DARLENE L. MOYER, C/O CTCB 19 S HANOVER ST, PO BOX 128 CARLISLE, PA 17013-0128 ,- TAXPAYER COpy Bill No: 4761 Control No: 004- 000001 2005 Statement of Real Estate Taxes Bill Date: 3/01/2005 Assessed Land Improvement Mineral Total Values 44 000 147 590 0 191 590 COUNTY OF CUMBERLAND Discount Face Penal Rates .00200600 .00200600 2 % 10 % COUNTY R/E 88.26 296.07 376.64 384.33 422.76 Rates .00018000 .00018000 2 % 10 % COUNTY LIB 7.92 26.57 33.80 34.49 37.94 BOROUGH OF CARUSLE Rates .00281000 .00281000 2 % 10 % MONIC. R/E 123.64 414.73 527.60 538.37 592.21 TAX AMOUNT DUE-> $938.04 $957.19 $1,052.91 YASLE '0: SC: MAP NO: 04-08-0579-001 1100 WALNUT STREET ACRES 1.000 LOT 2 PB 86 PG 134 Residential BUilding RESIDENTIAL 'IX (ER SCHLOSNAGLE, EUGENE S & ETHEL S SCHLOSNAGLE 1100 WALNUT STREET CARLISLE PA 17013 'ICE MONDAY 8:30AM-4:00PM JRS: TUESDAY-FRIDAY 8:00AM-4:00PM CLOSED HOLIDAYS PHONE: (717) 243-3725 12/12/2005 .. SEE REVERSE SIDE OF BIll FOR A BREAKDOWN OF YOUR COUNTY TAX DOLLARS .. 4761CH PAID 957.19 056/99 06/21/05 Retum Bill with Payment. For a Receipt, Enclose Self Addressed Stamped Envelope. -=--= ~ "'Y.I.OU, .LICUU\.. :.;..c,:..:......:...'.:: ..,_1!/fl1i;,~2j~~iJJI:~1fij~~~ : "..';STATEHENf:PEthooi.' NOV.05-DEC.06,2005 75895714 '...::.... · ACCOUNT ; TYf'E ..:... HIT SELECT WITH INTEREST DO o 04319H NH Il7 73 EUGENE S SCHLOSNAGLE OR MRS ETHEL S SCHLOSNAGLE 1100 WALNUT ST CARLISLE PA 17013-3556 INTEREST PAID YEAR TO DATE . . 15.05 HIGH STREET-CARLISLE 1 OF 4 ACTIVITY · .DEPOSITS..INTEREST · CHECKS & .OTHER. .'DAILY:. ..&. 'OTHER .AIiIitTtONS .. '.SUBTRACTIONS. ........ ..'BAlANCi:. 7,970.58 11-05-05 BEGINNING BALANCE 11-07-05 COMCAST CENTRAL CENTRAL PA 11-15-05 SPRINT-PA(12J PHONE BILL 11-16-05 DEPOSIT 11-16-05 CHECK NUMBER 2670 11-16-05 PP ELEC BILL 11-17-05 SYMETRA SYMETRA 11-17-05 CHECK NUMBER 2673 11-18-05 UGI UTILITIES UGI BILL 11-21-05 NORTH AMERICAN L BENEF PYMT 11-21-05 NORTH AHERICAN L BENEF PYMT 11-21-05 CHASE AUTOPAY 11-22-05 CHECK NUMBER 2672 11-22-05 CHECK NUMBER 2674 11-25-05 DELAWARE TAX-FRE DELAWARE T 11-29-05 CHECK NUHBER 2675 11-29-05 CHECK NUMBER 2671 12-01-05 PENNFIELD CORPOR PAYROLL 12-02-05 US TREASURY 310 SOC SEC 12-02-05 US TREASURY 310 SOC SEC 12-05-05 CHECK NUMBER 2679 12-06-05 INTEREST PAYMENT L2-06-05 CHECK NUMBER 2676 L2-06-05 CHECK NUMBER 2678 l2-06-05 CHECK NUMBER 2681 l2-06-05 CHECK NUMBER 2677 624.88 102.95 911.00 420.00 0.92 ENDING BALANCE LD08A (1/03) . 84 0.92 " " ..ENPINC.... ..SAlANCF.... 11,522.17 $7,970.58 7,933.39 7,894.97 10,233.26 11,524.36 11,458.03 12,271.55 12,186.15 12,811.03 11,563.56 11,666.51 12,997.51 12,497.51 11,522.17 $11,522.17 217 REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF Ethel S. Smeltzer SchlosnaQle SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-05-01115 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE, VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. North American Company, Certificate L01 0498480(Annuity) 34,173 100.00% 34,173 TOTAL (Also enter on line 7 Recaoitulation) $ 34 173 (If more space is needed, insert additional sheets of the same size) j NORTH AMERICAN COMPANY FOR LIFE AND HEALTH INSURANCE CHICAGO, ILLINOIS OVVNER AS STATED IN THE ENROLLMENT FORM FOR THIS CERTIFICATE, UNLESS CHANGED IN ACCORDANCE WITH CERTIFICATE PROVISIONS. ANNUITANT ETHEL 5 SCHLOSNAGLE 67 FEMALE AGE AND SEX CERTIFICATE NUMBER La 1 0498480 PLAN SINGLE PREMIUM DEFERRED ANNUITY OCTOBER 19, 1988 ISSUE DATE $ 140. 11 LIFETIME MONTHLY ANNUITY INCOME We will pay a monthly annuity income to the Annuitant beginning on the Maturity Date .if the Annuitant and the Owner are then I iYing. We will continue to pay a monthly annuity income so long as the Annuitant lives, but for at least 10 years. We will pay the Annuity Vaiue to the Beneficiary when We receiVe due Proof of the Owner's or Annuitant's death Occurring before the Maturity Date. This certificate is Issued in consideration of the payment of the premiUm required and the completed Enrollment Form. It is for the exclusive benefit of the Annuitant and the Benefi- ciaries and is nonforfeitable. Payment.is subject to the terms of this certificate. Right to Examine Certificate. You may return this certificate for any reason within 20 days after you receive it. It can be returned by deliyering or mailing it to us at Chicago, Illinois, or to the Insurance agent through whom it was purchased. If returned. this certificate will be considered to be Void from the beginning. The Single Premium, less any loans or withdrawals, will then be refunded. This certificate is issued by North American Company for Life and Health Insurance, a stock company, at its Home Office, Chicago, illinOis in conformance with the Master Contract. This certificate is subject to the laws of the jurisdiction in which the Master Contract was issued. SECRETARY . 4.?5(d p?- / {I"'--- PRESIDENT Single Premium Deferred Annuity Certificate. Monthly Annuity Income Payable at Maturity Date Non-Participating-Not Eligible for Dividends ~A 1886 3C -42A 217 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Ethel S. Smeltzer SchlosnaQle FILE NUMBER 21-05-01115 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home, Funeral Services 825 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 36,162 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant EUQene S. SchlosnaQle Street Address 1100 Walnut Street City Carlisle State P A Zip 17013 Relationship of Claimant to Decedent Spouse 3,500 4. Probate Fees 652 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Register of Wills, Filing Fee for the Pennsylvania Inheritance Tax Return 15 8. Cumberland Law Journal, Advertising 75 9. The Sentinel, Advertising 144 10. Register of Wills, (4) Short Certificates 16 11. Register of Wills, Additional Probate Fee 100 TOTAL (Also enter on line 9 Recaoitulation) $ 41 489 Debts of decedent must be reported on Schedule I. (If more space is needed, insert additional sheets of the same size) , . \'F LAST WILL AND TESTAMENT OF ETHELS.SCHLOSNAGLE I, ETHEL S. SCHLOSNAGLE, of lIDO Walnut Street, in the Borough of Carlisle Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executrices to pay all of my just debts and funeral expenses as Soon after my death as may be found convenient to do so. 2. I give and bequeath all of my interest in household goods and furnishings and all automobiles which I may own at the time of my death, and all of my articles of personal use and adornment, to my husband EUGENE S. SCHLOSNAGLE 3. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath to my hereinafter named Trustees, in trust, to receive and to invest the same, and subject to the terms, conditions, powers, and duties hereinafter set forth, as follows: The Trustees shall hold and manage the property and securities, together with such other property as may be acquired during the existence of this trust, all of which said property will hereinafter be referred to as the "Trust Estate" upon the terms and conditions, and for the uses and purposes, and with the duties and powers hereinafter set forth, as follows: To hold and manage the said Trust Estate and pay to or for the benefit of my husband, Eugene S. Schlosnagle so long as he shall live, all of the net income arising therefrom at least annually, and upon his death if he shall survive me, or immediately upon my death if he shall fail to survive me, the Trust shall terminate and the same shall be divided equally between my daughters who are JANE S. COWDEN and CAROL A. BRADFORD, provided each of them shall survive both me and my husband, EUGENE S. SCHLOSNAGLE, by a period of ninety (90) days, but should either of my said two daughters fail to so survive both my husband and me, then the share which would have been distributed to such deceased daughter of mine shall lapse and be added to the share of my other daughter. Should neither of my said two daughters survive both my husband and me by a period of ninety (90) days, then in such event the Trustees shall terminate said trust and divide the same as follows: One-half to my son-in-law, WILLIAM K. COWDEN, provided he shall survive both my husband and me by a period of ninety (90) days, but should he fail to so survive me then the same shall be added to the balance thereof and the balance thereof shall be divided equally among such of my husband's 10 brothers and sisters as shall survive me by a period of ninety (90) days, but if any of them shall fail to so survive me then the share such deceased brother or sister would have received shall pass to such of his or her issue who shall survive me by a period of ninety (90) days, per stirpes, but if there be no such issue the same shall lapse and be divided equally among the shares of my other brothers and sisters. No title in the Trust Estate hereby created or in the income accruing therefrom or in its accumulation, shall vest in any beneficiary and no beneficiary shall have the right or power to transfer, sign, anticipate of encumber his or her interest in said Trust Estate, or the income therefrom, prior to the actual distribution thereof by the Trustees to said beneficiary. Further, neither the income nor the principal of the said Trust Estate shall be liable in any manner in the possession of the Trustees, for the debts, contracts or engagements of any of the beneficiaries. 4. I hereby nominate, constitute and appoint my said two daughters, JANE S. COWDEN and CAROL ANN BRADFORD and the survivor of them as Trustees, but should both of the become deceased or desire to cease serving as such then a successor Trustee shall be selected by them subject to approval by the Cumberland County Court having jurisdiction of the Trust. . -- 5. I hereby nominate, constitute'-and appoint my said two daughters, JANE S, COWDEN and CAROL ANN BRADFORD and the survivor of them as Executrices of this my Last Will and testament and direct that neither of them shall be required to post any bond to secure the faithful performance of her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. €H d .3, .$chl o,s rtA"'r) L Page 1 qf3 IN WITNESS WHEREOF, I have hereunto set I!!)' l;1l:\nd and seal to this my Last Will and Testament written on three (3) pages, this Xtt.. day of \j~(, 2001. E.t\1d ~ ~~hLDSIL~\E- Ethel S. Schlosnagle (SEAL) Signed, sealed, published, and declared by ETHEL S. SCHLOSNAGLE the: Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~7n,~ ~ AcL:: ", ", Page 3 of3 REV-1514 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE EST A TE, ANNUITY & TERM CERTAIN Check Box 4 on REV-1500 Cover Sheet ESTATE OF FILE NUMBER Ethel S. Smeltzer Schlosnagle 21-05-01115 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. 00 Will 0 Intervivos Deed of Trust 0 Other Eu ene S. Schlosna Ie 12/18/1921 84 o Life or 0 Term of Years _ o Life orD Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ 1. Value of fund from which life estate is payable .................................. $ 2. Actuarial factor per appropriate table ......................................... Interest table rate - 031/2% 06% 010% [K]Variable Rate 5% 3. Value of life estate (Line 1 multiplied by Line 2) ...............................$ 1,081,317 0.2582 279.164 o Life or 0 Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ 1. Value of fund from which annuity is payable .................................... $ 2. Check appropriate block below and enter corresponding (number) .................. Frequency of payout - D Weekly (52) 0 Bi-weekly (26) 0 Monthly (12) o Quarterly (4) D Semi-annually (2):] Annually (1) 0 Other ( ) 3. Amount of payout per period ................................................$ 4. Aggregate annual payment, Line 2 multiplied by Line 3 ........................... 5. Annuity Factor (see instructions) Interest table rate - 0 3 1/2% 06% 0 10% 0 Variable Rate 6. Adjustment Factor (see instructions) .......................................... 7. Value of annuity -If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 .................. $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 .......................................... $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If more space is needed, insert additional sheets of the same size) 217 REV-1649 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 0 ELECTION UNDER SEC.9113(A) (SPOUSAL DISTRIBUTIONS) ESTATE OF FILE NUMBER Ethel S. Smeltzer SchlosnaQle 21-05-01115 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the EUQene S. SchlosnaQle Trust (marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survivinQ spouse under a Section 9113(A) trust or similar arranQement. Description Value Life Estate of Eugene S. Schlosnagle, DOB 12/28/1921, in Trust Fund of $1 ,081 ,317.00 to $279,164.00. Schedule B-Stocks and Bonds($988,1 02.00) Schedule F-Jointly Owned Property($100,531.00) M&T Bank, Acct#75895714 Household Contents Real Estate, 1100 Walnut Street, Boro of Carlisle, Cumberland County PA Schedule G-Inter-Vivos Transfers & Misc. Non-Probate (34,173.00) North American Company, Certificate L01 0498480(Annuity) 279,164 Part A Total $ 279,164 Part B: Enter the description and value of all interests included in Part A for which the Section 9113(A) election to tax is being made. Description Value Part 8 Total $ (If more space is needed, insert additional sheets of the same size)