HomeMy WebLinkAbout10-24-06
--.J
150560510515
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
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
'I
(11 \ C '-Q
File Number
'::', ({f~~j
Date of Birth
160-10-9471
06/11/2006
09/03/1913
Decedent's Last Name
Suffix
Decedent's First Name
MI
Zeeb
Edwin
A
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Zeeb
Ella
C
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
. Original Return
Z. Supplemental Return
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4. Limited Estate
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
o
8. Total Number of Safe Deposit Boxes
. 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
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
Carl G. Wass, Esquire
Firm Name (If Applicable)
(717) 232-7661
Caldwell & Kearns, P.C.
:"-)
REGISTER QF~.:wILLS USE ONLY
::-'
First line of address
~.
3631 North Front Street
"'- ')
Second line of address
11 i
City or Post Office
State
ZIP Code
GATE FILED
f-' )
Harrisburg
PA
17110
(
L.')
Correspondent's e-mail address:Cwass@caldwellkearns.com
Under penalties Df perjury, I declare that J have examined this return, including accDmpanying schedules and slalements, and tD the best Df my knDwledge and belief,
it IS true, correct and cDmplete. DeclaratlDn Df preparer Dther than the persDnal representative is based Dn all infDrmatiDn of which preparer has any knDwledge.
::2z~'O~'.']'::r,"G "no""
241 Messiah Circle, Me anicsburg, PA 17055
OTHER TH N REPRESENTATIVE
DATE
l b - / ~t:Lb__nn____
ADDRESS
3631 North Front Street, Harrisburg, P A 17110
PLEASE USE ORIGINAL FORM ONLY
/ DATE
l<:l/I~ Db
I
Side 1
L
15056051058
15056051058
--.J
---I
15056052059
REV-1500 EX
Decedent's Name'
Edwin
A Zeeb
RECAPITULATION
Real estate (Schedule A).
2 Stocks and Bonds (Schedule B) .
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 (total Lines 1-7). . . 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 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) xoJL 23,278.69
15.
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
16.
17.
18.
19 TAX DUE.
.. . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L
15056052059
Side 2
Decedent's Social Security Number
160-10-9471
1.
2.
33,00734
398.16
6,92943
40,335.06
16,997.37
59.00
17,056.37
23,278.69
0.00
23,278.69
0.00
0.00
15056052059
.--1
ReV-1500 eX Page 3
File Numoer
Decedent's Complete Address:
DECEDENTS NAME
Edwin A Zeeb
STREET ADDRESS
241 Messiah Circle
DECEDENTS SOCIAL SECURITY NUMBER
160-10-9471
CITY
Mechanicsburg
-------r=-----
I STATE
PA
I ZIP
i 17055
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
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)
5. If line 1 + Line 3 IS greater than Line 2, enter the difference. Tnis is the TAX DUE. (5)
A. Enter the interest on the tax due.
B. Enter tne total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
0.00
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 ~
b. retain the right to designate who shall use the property transferred or jts income; ........................................... D ~
c. retain a reversionary interest; or.......................................................................................................................... 0 [XJ
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [XJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .......................................................................................................... 0 lKJ
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. 0 !KJ
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................... [t(J 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. S9116 (a) (1.1) (i)).
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. S9116 (a) (1.1) (ii)J. 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. s9116(a)(1.2)J.
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. s9116(a)(1)J.
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)J. 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+ (6-98) \"
I~' ~~
COMMONWE.l\LTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Zeeb, Edwin A
FILE NUMBER
21-06-0605
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION
VALUE AT DATE
OF DEATH
Oppenheimer Funds, Ace. #74-174-10058894, 2,588.821 shares at $12.75 on 61111 06 Exhibit "1"
33,00747
TOTAL (Also enter on line 2, Recapitulation) i $
I
33,00747
(If more space is needed, insert additional sheets of the same size)
REV-15G8 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISe.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zeeb, Edwin A.
FILE NUMBER
21-06-0605
Include the proceeds of litigation and the date Ihe proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F
ITEM
NUMBER
DESCRIPTION
Demutualization cash, Bureau of Unclaimed Property, Treasury Department, Commonwealth of PA
VALUE AT DATE
OF DEATH
398.16
Exhibit "2"
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
39816
REV-1510 EX+ (6-98) f
,!jk
COMMONWEALTH OF PENNSYLVANIA
INHERiTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISe. NON-PROBATE PROPERTY
ESTATE OF
Zeeb, Edwin A
FILE NUMBER
21-06-0605
This schedule must be compleled 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 DATE OF DEATH % OF DE CD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST IIF APPLICABLE) VA~UE
1. Prudential Financial Annuity Contract No. DOS430605-A, Exhibit "3" 6,929.43 100 0.00 6,929.43
I
,
TOTAL (Also enter on line 7 Recapltuiatlon) $ I
(If more space is needed, inserl additional sheets of the same size)
6,92943
~EV-1511 EX+ (12-99)w
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zeeb, Edwin A.
FILE NUMBER
21-06-0605
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
2
FUNERAL EXPENSES:
HetricK Funeral Home, Inc, Harrisburg
Rev. Marilyn Ebersole, Honarium
Olympia Cafe, post-funeral luncheon
11,71452
200.00
290.28
3
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
2.
3.
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
ca.J.d...ell & KffirrE
950.00
Family Exemption (If decedent's address is not the same as claimant's, attach explanation)
3,500.00
Claimant Ella C. Zeeb
Street Address 241 Messiah Circle
City Mechanicsburg
Stale P A
Zip 17055
Relationship of Claimant to Decedent Spouse
4
Probate Fees cmterlarrl ChJnty R3:j:i..st:eL of Wills
128.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7
,.
Cumberland Law Journal - Legal Advertisement
The Patriot-News - Legal Advertisement
Hetrick Funeral Home, Inc, Harrisburg, Additional Death Certificates
Register of Wills - Additional Short Certificates
51.57
7500
7200
16.00
16.99737
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
'<EV-1512 EX+ (12-03)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zeeb, Edwin A
FILE NUMBER
21-06-0605
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM I VALUE AT DATE
NUMBER DESCRIPTION i OF DEATH
1
Pinnacle Health Services - Medical Bill
59.00
TOTAL (Also enter on line 10, Recapitulation) $
59.00
(If more space is needed, inserl addilional sheets of the same size)
'lEV-1513 EX, i9-001
,tt~
SCHEDULE J
BENEFICIARIES
CCMMONWEA'_TH OF PENNSYLV.'INIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Zeeb, Edwin A.
FILE NUMBER
21-06-0605
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal dislributions, and transfers under
Sec. 9116 (a) (1.2)]
1 Ella C. Zeeb Spouse 100%
241 Messiah Circle
Mechanicsburg, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 1$
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT OF
EDWIN A. ZEEB
I, EDWIN A. ZEEB, of # 110 Rose Court, Shillington, Berks County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do
hereby make, publish and declare this to be my Last Will and Testament, hereby re-
voking any Wills and Codicils heretofore made by me.
ITEM I.
I direct my hereinafter named executrix to pay all
my just debts and funeral expenses as soon after my decease as may be convenient.
ITEM II.
I give, devise and be~ueath all the rest, residue
and remainder of my estate, real, personal or mixed, of whatsoever nature or kind
and wheresoever the same may be situate or over which I now have or shall have at
my death a power of appointment unto my wife, ELLA C. ZEEB.
IT~l III. Should, however, my wife, ELLA C. ZEEB, predecease
me or should we die simultaneously or within thirty (30) days of one another, then
and in that event, I give, devise and be~ueath all the rest, residue and remainder
of my estate unto my children, ELLA C. CAPPER and ELAINE M. TURNER, e~ually, or
their issue per stirpes.
ITEM IV.
Should, however, any beneficiaries taking under this,
my Last Will and Testament, be under the age of twenty-one (21) years at the time
of my death, then and in that event, I give, devise and be~ueath their share unto
NATIONAL CENTRAL BANK, in trust, under the following terms and conditions:
My trustee shall invest and reinvest the corpus of
the trust, using the income and so much of the principal as may be necessary for
the care, maintenance and education of said minors, including their advanced
education at an institution of higher learning.
Upon each beneficiary attaining the age of twenty-one
each one his or her respective
(21) years, then my trustee shall dist~ibute unto
share of principal and accumulated income.
Page One
- - ,.._,~,-"' "__'_"."""""'''_'"'''-1";ii\C~",;'l",,,W~:;+~~:. ~.~,:;.,ci'J:,i~i;;!,.~ .~v!iy)!JI.
I
.,,-
ITEM V.
I order and direct that all inheritance, transfer
or legacy taxes, both State and Federal, upon or on account of any gift, devise or
bequest, made by me in or any right of inheritance or succession under this, my
Will, shall be paid out of the residue of my estate.
ITEM VI.
I hereby nominate, constitute and appoint my
wife, ELLA C. ZEEB, as executrix of this, my Last Will and Testament, provided she
is willing and able to do so. However, should she predecease me or fail to qualify
as executrix, then and in that event, I nominate, constitute and appoint my
children, ELLA C. CAPPER and ELAINE M. TURNER, as substitute executrices of this,
my Last Will and Testament.
ITEM VII.
I direct my heretofore named executrix to employ
JOHN A. HOFFERT, JR., ESQUIRE, as the sole attorney in the administration of my
estate.
. f.A..-
-1 'I
IN WITNESS WHEREOF, I have hereunto set my hand and seal this r
day of
1. " . ~ " .,
ya.lrLl"CL.{/v<-7
f
, A.D. 1973.
C' I .
..? ct..tY1/VL
tZ.
.~1'J
)/Q2/~
\
(SEAL)
Signed, sealed, published and declared by EDWIN A. ZEEB, testator
herein named, to be his Last Will and Testament, in the presence of us, the under-
signed, who, at his request and in his presence, and in the presence of each other,
have hereunto set our names as witnesses.
~;Q". Z c~
Page Two
~ OppenheimerFullds.
W The Right Way to Invest
Account Statement
Statement Period: January 01, 2006 - March 31, 2006
Page 1 of 1
Wn -- z.,S-S -Z, 770
013073
Your Financial Advisor:
RICHARD K AUGUSTIN
IFMG SECURITIES INC
C/O SOVEREIGN BANK
12 PARKSIDE AVE
SHilLINGTON, PA 19607-1124
(610) 685c1025
EDWIN lEEB
241 MESSIAH CIR
MECHANICSBURGPA 17055-8619
1111111111111'11.1.1..1.1.11111.11'11'1111.111.11.1"1111.1111
Market Value on March 31, 2006
Market Value on December 30, 2005
Change since last statement
$33,111.02
$32,903.91
$207.11
o
-
ro
24-llOur automated service: 1~800-CAi.L-OPP (225-567'1)
Representatives available Mon.' Fri. 8 am - 9 pm ET
and Sat. 10 am -4 pm ET (Jan. . Apr.)
Total Account Value
Visit us online atwww.oppenheimerfunds.com
Oppenheimer Pennsylvania Municipal Fund Class B
Account Number 741 7410058894
Account Registration EDWIN lEEB'
Fund Symbol OPABX
Fund Category Municipal Bond
Value on March 31 , 2006
Market Value
Shares .OWned
Share Price
$33 , 111 .02
2,588.821
$12.79
year-To';DateSummary
Dividends
$342.80
Year-lo-Date TransactlonDetall
Transaction
Date Transaction Description
Dollar Share
Amount Price
Number
of Shares
Ending
Share Balance
01/24/06
02/21/06
03/28/06
Dividend Paid in . Cash
Dividend Paid in Cash
Dividend Paid in Cash
$117.80 $12.74
$115.02 $12.81
$109.98 $12.83
2,588.821
2,588.821
2,588.821
y ear-to~DateAccountSumlT1ary
Date
Market Value
$32,903.91
Additions
+ $0.00
Withdrawals
":'$0.00
Change In
Value/Earnings.
+$207.11
Market Value on
March 31,2006
= $33, 111. 02
01/01/06
*_Doesnot include dividends and/or capital gains paid in cash (not reinvested) totaling: Year-to-Date: $3~2.80
=
co
co
~,
OppenheimerFundsN ews
On selling your shares, you may pay a sales charge. For the charge and.otherfees, SBe the prospectus.
EXHIBIT
...
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11111111111I11111111111111111111111
npP..dJ' 10~.00067070 12.13013.13073.EO IOPPP 1.0550106040 IP 101174174\005889<1. ....741.....7410058894
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Oppenheimer PA Municipal A (OPA TX)
!ill] AMERITRADE
On Sep 22: 12.95 f 0,02 (0.'
:~~TF..t:'11 C Ii -; i'I::)P I/.}}"" R :-,
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5
2006
2006
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20Q3
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Monthly
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End Date: Jun
20
Get Prices
First I Pre\! I Next I Last
PRICES
Date Open High Low Close Volume Adj
Close'
20-Jun-06 12.68 12.68 12.68 12.68 0 12.53
19-Jun-06 12.69 12.69 12.69 12.69 0 12.54
16-Jun-06 12.70 12.70 12.70 12.70 0 12.55
15-Jun-06 12.71 12.71 12.71 12.71 0 12.56
14-Jun-06 12.73 12.73 12.73 12.73 0 12.58
13-Jun-06 12.75 12.75 12.75 12.75 0 12.60
12-Jun-06 12.75 12.75 12.75 12.75 0 12.60
9-Jun-06 12.76 12.76 12.76 12.76 0 12.61
8-Jun-06 12.75 12.75 12.75 12.75 0 12.60
7 -Jun-06 12.74 12.74 12.74 12.74 0 12.59
6-Jun-06 12.74 12.74 12.74 12.74 0 12.59
5-Jun-06 12.75 12.75 12.75 12.75 0 12.60
. Close price adjusted for dividends and splits.
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ADVERTISEMENT
Commonwealth of Pennsylvania
Treasury Department
Bureau of Unclaimed Property
1111/11/111111111111111111111111111111111111111111
~~~/'
,
99647876
.~/
tJ
ZEES EDWIN W
(B) Original Owner's Address as Reported
1107 DYRE ST PHilADELPHIA PA 19124-2501
(A) Original Owner's Name
(C) Holder Reporting Funds
PRUDENTIAL FINANCIAL INC DEMUTE KI
(E) Holder Address and Contact
(0) Last Transaction Date
01/25/2002
150 ROYALL STREET
CANTON NJ 02021
(F) Type of Funds Reported
230210106341598
(G) Certificate, Policy or Check Number
Demutualization Cash
(H) Amount Reported
$398.16
0.0000
Total Cash Claimed
Total Shares Claimed
$398.16
O\''VNER CLAIM FORM
c;[1AIMAN'l"INE0RM.4.J110Nm'.......
PLEASE COMPLETE All INFORMATION BELOW:
NAME OF CLAIMANT: Estate of Edwin W. Zeeb (Ella Zeeb. Executrix)
SOCIAL SECURITY NUMBER: rrTl\[ '37- 6 2 2-141 3 DATE OF BIRTH: n I a
ADDRESS: 741 Mpc::c::ir:ln l'irr-lp, -'--~
CITY: Mpr.nr:ln; r.c::hllrC] STATE: PA ZIP: 17055-8619
PHONE NUMBER: 717-7gS-R470 EMAllADDRESS:
I certify that I am legally entitled to c1,!im the property, as stated, that has been reported and delivered to the Treasury
Department, Bureau of Unclaimed Property.
I further certify that the information provided, herein, is true and correct and subject to the penalties of 18 C.S. Sec.
4904, relating to unsworn falsification to authorities.
SIGNATURE OF CLAIMANT (IN INK):
SIGNATURE OF ADDITIONAL CLAIMANT (IN INK):
DATE:
DATE:
State law limits the fee a third party can charge an owner for the recovery of unclaimed property to 15 percent of the
property value. Please contact the Bureau of Unclaimed Property at 1-800-222-2046 with any additional questions.
DO.NOT WRITE IN THIS BOX - TREASURY USE ONL Y .
0.0000
$398.16
PROCESSED BY:
APPROVED BY:
DATE:
DATE:
EXHIBIT
j Z
RETURN CLAIM FORM AND DOCUMENTATION TO:
Bureau of Unclaimed Property P.O. Box 1837, Harrisburg, PA 17105-1837
99647876
Joseph DiGilarmo
Demutualization
Prudential ~ Financial
Audrey Nazulme
Vice President, Annuity Services
The Prudential Insurance Company of Americ
A Prudential Financial company
Annuity Services
P.O. Box 7960
Philadelphia, PA 19176
(888) 778-2888
www.prudential.com
ELLA C lEEB
241 MESSIAH CIR
MECHANICSBURG PA 17055
Owner: EDWIN A lEEB
ANNUITANT: EDWIN A lEEB
Contract Number: DOS430605-A
September 7,2006
Dear ELLA C lEEB,
Thank you for notifying us of EDWIN A ZEES's death. Please accept our sincere condolences
for your loss. Our goal is to make the processing of your request for benefits as prompt and
convenient for you as possible.
According to the terms of this contract, the remaining benefits are payable as a lump sum
payment in the amount of $6929.43.
Our records indicate that the beneficiary(ies) for any benefits payable under this contract are as
follows:
Estate of EDWIN A ZEEB
We would appreciate your help in obtaining the following information:
· Claiming Insurance Benefits form
· A certified copy of the death certificate
. The Contract or Claim Settlement Certificate (if it is available)
We have enclosed a reply envelope for your convenience in returning these forms. Once we
receive them, we can start the claim process.
EXHIBIT
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Registered Representative
American Skandia Mar1<eting. Inc
A Prudential Financial company
One Corporate Drive
She~on. CT 064B4'()BB3
CALDWELL & KEARNS
A PROFESSIONAL CORPORATION
.JAMES R. CLIPPINGER
CHARLES .J. DEHART. 1/1
.JAMES D CAMPBELL. .JR.
.JAMES L. GOLDSMITH
P. DANIEL ALTLAND
.JEFFREY T. MCGUIRE.
STANLEY J. A. LASKOWSKI
DOUGLAS K. MARSICO
BRETT M. WOODBURN
RAY .J. MICHALOWSKI
DOUGLAS L. CASSEL
ATTORNEYS AT LAW
OF COUNSEL
RICHARD L. KEARNS
CARL G. WASS
3631 NORTH FRONT STREET
HARRISBURG. PENNSYLVANIA 17110-1533
THOMAS D. CALDWELL. .JR.
/1928-20011
October 20, 2006
717-232-7661
FAX, 717-232-2766
thefirm@caldwellkearns.com
.BOARD CERTIFIED CIVlL TRIAL ADVOCATE
Glenda F. Strausbaug, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
Re:
Estate of Edwin A. Zeeb
Social Security No. 160-10-9471
Date of Death: June 11,2006
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Dear Ms. Strausbaug:
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Enclosed herewith please find an original and a copy of a Pennsylvania Inheritance Tax Re!Ern
which we request you accept for filing with regard to the Estate of Edwin A. Zeeb. The entire
assets of the Estate were bequeathed by Will of Mr. Zeeb to his surviving widow; therefore, no
tax is due and payable. Nevertheless, we enclose herewith the required filing fee for the
Inheritance Tax Return, (our check for $15.00) and we submit an extra, unsigned copy of the
Inheritance Tax Return.
I respectfully request that you time-stamp the extra copy and return that copy back to the
undersigned in the enclosed self-addressed, stamped envelope. Your receipt for payment for the
filing fee may also be included in that envelope.
Thank you.
Very truly yours,
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Carl G. Wass
Caldwell & Kearns
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Enclosures
cc: Ella Zeeb
Harry M. Capper
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Glenda F. Strausbaug, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
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