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HomeMy WebLinkAbout10-31-06 REV -1$00 EX + (6~0) w .... ,,~lIl Ul>:" Wo..U ,,00 Ul>:..J 0.. CD 0.. 00: *' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between ___ ~31:91 andJ,1-95j LTHIS. SECTIONr.1UST BE COMFr!1ETED.ALL CQRRESPONDEt.j~!: ANI)CONfID!SNTj~I..' TAXI!\l"QR,,"TIONSHOUI..D_BEDI~EctE~TO~____ NAME ! COMPLETE MAILING ADDRESS John B. Fowler, III, Esquire COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280801 HARRISBURG, PA 17128-0601 .... z w c w u w c -- -- DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) STEIGLEMAN, Grace N. FILE NUMBER 21 06 Q9__UNTY ,<-ODE YEAR SOCIAL SECURITY NUMBER 00712 NUMBER DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 203-10-6782 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death prior to 12-13-82) o o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11 Election to tax under Sec. fl113(A)(Attach Sch 0) Ten East High Street Carlisle, P A 17013 (1 ) None CJ (2) 166,383.70 (3) None (4) None (5) 1,005.50 (6) 2,512.41 (7) 27,600.82 (8) (9) 20,599.25 (10) 2,508.08 o 197,502.43 08/02/2006 04/11/1915 (11 ) 23,107.33 t (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST,RRST AND MIDDLE-INITIAL) ~ 1. Original Return o ~ o 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) fl. Litigation Proceeds Received .... z w c z o 0.. FIRM NAME (If applicable) Martson Deardorff Williams & Otto (12) 174,395.10 :rELEPHONE NUMBER 717/243-3341 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o ;:: S => .... ii: 00: U W l>: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6_ Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 174,395.10 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 16. Amount of Line 14 taxable at lineal rate 174,395.10 .045 (16) 0 x ;:: 00: .... => (17) 0.. 17. Amount of Line 14 taxable at sibling rate x .12 :0 0 U ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) .... 19. Tax Due (19) 7,847.78 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 7,847.78 -- >>BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<< ~-~~~.--~----------- Copyright 2000 form software only The Lackner Group. Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 700 South Hanover Street CITY Carlisle I STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 7,847.78 392.39 Total Credits (A + B + C) (2) 392.39 3. InteresUPenalty if applicable D. Interest E. Penalty B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) 0.00 (4) (5) 7,455.39 (5A) (5B) 7,455.39 TotallnteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax 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 ~ ~: ~:~::~ :h~e~;~;i:~~~s:~:~s~~~. .~~~~~ .~.~.~. .t.~~. :.~.~:.~.~:. .~~~.~.~.f.~~~~.~. .~.~ .i.t~. ~~.~.~.~~~.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'::::::::::::.' ......... B ~ 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 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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. illS true, correct and complele Declarallon preparer other than theflersonal representative is ~ased on_all information oh'lhich E,-eparerhas any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS "~fE:~:~ '""'" i~~~n~e~~I~n ~F~ DATE /CJ/,fL~ /0/; DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE John B. Fowler, III, Esquire ADDRESS DATE Ten East High Street Carlisle, PAl 7013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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. Decedent's Complete Address: STREET ADDRESS CITY Carlisle STATE PA 17013 ~ 700 South Hanover Street ZIP I Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 7,847.78 392.39 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 392.39 Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPA YMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) 0.00 (4) (5) 7,455.39 (5A) (5B) '7,455.39 A. Enter the interest on the tax 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;.............................n.............................................. D ~ ~: ~::::~ :h~e~~~;i~~:~s:~~e~~s~~~. .~~~~~ .~.~.~. .t.~~. :.~.~:.~.~:. .~~~.~.~~.~~~~.~. .~.~ .i.t~. ~~.~.~.~~.;".'.'.'.'.'.'.'.'.'.'.'.'.'.'~~::::::::::: ......... ~ ~ d. receive the promise for life of either payments, benefits or care?........................................................... 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................ .............................. on................................................... 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?................................................................................................................ ~ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. --- - - __ ___n_._____________________.____.._ ____ _ _ __ _ _ __ 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 preparer oth-"rtha"-,hep~sonal rep~sentative ~~as~on~informa~n of which preparer has i3r1J'_kno'oYlecl\,!e. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Edgar J. Steigleman, Jr. DATE - - - -- SIGNATURE OF PERSON RESPONSIBLE FO-R FILING RETURN ADDRESS 5257 Glenn Ellen Drive J<:ugen~ O~ DATE SIGNAT RE OF PREPARER OTHER THAN REPRESENTATIVE John Fowler, III, Esquir ADDRESS DATE --. At. Ten East High Street Carlisle, P A 17013 /l:J / 'T /c} (e F 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 urviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (Ii)]. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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. . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. FILE NUMBER 21 - 06 - 00712 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION UNIT VALUE 21.57 VALUE AT DATE OF DEATH 84,257.81 3906.25 shares, Vanguard Wellesley Income Fd., CUSIP 921938106 2 4286.32 shares, Deleware Group Equity Fds, Large Cap Value A CUSIP 245907100 19.16 82,125.89 TOTAL (Also enter on line 2, Recapitulation) 166,383.70 . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. FILE NUMBER 21 - 06 - 00712 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 The Sentinel, refund DESCRIPTION VALUE AT DATE OF DEATH 127.50 2 Carlisle Regional Medical Center, refund 124.00 3 US Treasury, Social Security benefits for July 2006 754.00 TOTAL (Also enter on Line 5, Recapitulation) 1,005.50 *' SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. FILE NUMBER 21 - 06 - 00712 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 Edgar J. Steig1eman, Jr. 5257 Glenn Ellen Drive Eugene, OR 97402 Son B Sandra 1. Hoffman 921 Stoney Creek Road Dauphin, P A 17018 Daughter JOINTLY OWNED PROPERTY: ITEM LETTER NUMBER FOR JOINT TENANT DESCRIPTION OF PROPERTY 'X OF D TE OF DEAT ~~b~ Incl~d~ n~me <?f financial institution and bank .a?count numberi DATE OF DEATH DECD'S A VALUE OF H JOINT or similar Identifying number. Attach deed for JOintly-held real ,VALUE OF ASSET INTEREST DECEDENT'S INTEREST ,estate. ; i . 108/28/1964. M&T checkmg account 81672578 7,537.31 33.333% 2,512.41 A&B TOTAL (Also enter on line 6, Recapitulation) 2,512.41 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. FILE NUMBER 21 - 06 - 00712 ITEM NUMBER This schedule mu~t be completed~nd filed if t~e answer ~o any of questions 1 throu~h 4 on page 2 is yes. , DESCRIPTION OF PROPERTY 'DATE OF DEATH % OF Include the name of the transferee, their relationship to decedent and the date of transfer. V U 0 AS E 'I DECO'S i EXCLUSION TAXABLE VALUE Attach a copy of the deed for real estate. AL E F S T I NTEREST (iF APPLICABLE) M&T CD #031003913121958; made joint with Sanda J. Hoffman ( daughter) 02/27/2006 30,600.82 100% 3,000.00 27,600.82 TOTAL (Also enter on line 7, Recapitulation) 27,600.82 *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. , FILE NUMBER 21 - 06 - 00712 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Ewing Brothers Funeral Home, Carlisle, Pa 2 Reimbursement to family members traveling from CO, OR and AK to plan and attend funeral, including airfare, lodging and car rental B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. Social Security Number(s) I EIN Number of Personal Representative(s): 2. Street Address City Year(s) Commission paid Attorney's Fees Martson Deardorff Williams & Otto (estimated) State Zip 3. Family Exemption: (If decedent's address is not the sarne as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Cumberland County Register of Wills Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Register of Wills, filing fee, Inheritance Tax return 2 Short Certificates Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 6,641.15 4,100.00 9,500.00 306.00 15.00 20.00 17.10 20,599.25 *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. 3 EVP, online stock valuation 4 Postage ScheWIe H Funeral Expenses & Pdninistrative Costs continued FILE NUMBER 21 - 06 - 00712 Page 2 of Schedule H j 3.10 14.00 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. Include unreimbursed medical expenses. ITEM NUMBER 1 3 4 5 DESCRIPTION Outstanding checks on date of death, M&T Bank checking account #81672578 2 Chapel Pointe at Carlisle, account payable Millennium Physician System East, account payable West Shore EMS, account payable Embarq, account payable FILE NUMBER 21 - 06 - 00712 TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 206.00 2,188.00 13.23 96.85 4.00 2,508.08 REV-1513 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF STEIGLEMAN, Grace N. FILE NUMBER 21 - 06 - 00712 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT _Do NotLlstJ'rostee(s) I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Edgar J. Steig leman, Jf. 5257 Glenn Ellen Drive Eugene, OR 97402 Son 2 Thomas W. Steigleman 5560 Galena Drive Colorado Springs, CO 80918 Son 3 Sandra J. Hoffman 921 Stoney Creek Road Dauphin, PA 17018 Daughter 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 AMOUNT OR SHARE OF ESTATE One-half Sch. F Item I -+- one-third of estate residue One-third of estate residue One-half Sch. F Item 1 + Sch. G, Item 1 -+- one-third of estate residue ~<' r::-,-, ~\ [S-=-"; \\, /7 _./~~' \ \'..../.' r--' \/ """.,,,' " ! LAST WILL AND TESTAMENT OF GRACE N. STEIGLEMAN I, Grace N. Steigleman, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke all Wills and Codicils previously made by me. ITEM I: I direct that all my legally enforceable debts and funeral expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II: I bequeath any automobiles or motor vehicles I may own at my death, my personal effects, household goods, and other tangible personal property of like nature (not including cash or securities), together with any existing insurance thereon, to such of my children as are living on the thirtY-first day after my death, to be divided among them with due regard for their personal preferences in as nearly equal shares as practical. I direct that any of the foregoing articles not selected by such children shall be sold at public or private sale by my personal representative(s), and I further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to my children, provided that the share of any child who predeceases me or dies on or before the thirtieth day following my death shall be distributed to his or her issue, per stirpes, living on the thirtY-first day following my death, and in default of any such , \," ,-. ,. \ \ . .,,-\ / ' ~ ~ \ \ \ then living issue, such share shall be added to the share or shares for my other children. ITEM IV: I appoint Dauphin Deposit Bank and Trust Company, of Carlisle, Pennsylvania, guardian of any property which passes, either under this Will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal, as well as income, from time to time for the minor's support, health and medical care, and education (including college education), or to make payment for these purposes, without further obligation or responsibility to see to the proper expenditure thereof, directly to the minor or to the minor's parent or to any person taking care of the minor. ITEM V: All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether passing under this Will or otherwise, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my residuary estate without apportionment or right of reimbursement. ITEM VI: I appoint my son, Edgar J. Steigleman, Jr., Executor of this my last Will. Should my said son fail to qualify or cease to act as Executor, I appoint my other son, Thomas W. Steigleman, Executor of this my last Will. Should my said other son fail to qualify or cease to act as Executor, I appoint my daughter, Sandra J. Hoffman, Executrix of this my last Will. Should my said daughter fail to qualify or cease to act as l.'- ".~ " " , Executrix, I appoint Dauphin Deposit Bank and Trust Company, of Carlisle, Pennsylvania, Executor of this my last Will. ITEM VII: I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this '\ i_~~_ day of November, 1993. 'v,' ."\. , " , \ ," , , '. , '\_"'" ,~ [SEAL] \. The preceding instrument, consisting of this and two (2) other typewritten pages, each identified by the signature of the Testatrix, was on the date thereof, signed, published and declared by Grace N. Steigleman, the Testatrix therein named, as and for her last Will, in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses hereto. .~_,/ ( -) /~/~~,1 ,// ..f :0<- . J ; "'0'(J..:'....l ; .''" ,." 11-) I'I ./.. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS We, Grace N. Steigleman, John B. Fowler, III, and Mary M. Price, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that she has signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ......:" ..... '-~' - . ~ A , \ '~" Tesf~trix ~ ,j,' '-. '\ /Ir / (;~ / / ....- ' > .', //_- '_.~'\ '- .,-"-~r' '-t;:"....,;1 ',.~ Witne~; - ' , - . ,/ / 1:7 /'1' ) '_'/;'(."1~_"-_ Witness Subscribed, sworn to and acknowledged before me by Grace N. Steigleman, the Testatrix, and subscribed and sworn to before me by John B. Fowler, III, and Mary M. Price, witnesses, this I -t._ day of November, 1993. Notary Public Estate Valuation Date of Death: 08/02/2006 Valuation Date: 08/02/2006 Processing Date: 08/30/2006 Shares or Par Security Description High/Ask Low/Bid 1 ) 3906.25 VANGUARD/WELLESLEY INCOME FD (921938106; VWINXj COM Mutual Fund (as quoted by NASDAQ) 08/02/2006 21.57000 Mkt 2) 4286.32 DELAWARE GROUP EQUITY FDS II (245907100; DELDX) ,-,RG CAP VAL A Mutual Fund (as quoted by NASDAQ) 08IJ2/2006 19.16000 Mkt Tota~ Value: Total Accrual: Total: $166,383.70 Page 1 Estate of: Grace N. Stvwinxeig1eman Report Type: Date of Death Number of Securities: 2 File IC: 11025.1.evp Mean and/or Div and Int Adjustments Accruals Security Value 84,257.81 82,125.89 $166,383.70 SO.OO This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) cS ~i!ddL (j J~<J I f- 2.. 21. 570000 19.160000 08/21/2005 15:00 302-934-2135 M AND T BANK RECORDS PAGE 02/03 m M&TBank 499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12 AUgust 17, 2006 Edgar J Steigleman Jr, Executor Estate of; Grace N Steigleman 5257 Glenn Ellen Drive Eugene, OR 97402 Re: Esta.teof: Grace N SteialemQ.n ACcolLnt Number: 81672578 and 031003913121958 Da.te of Death: AUgust 2. 2006 Dear Sir or Madam: Per a memo from Kathy Zengerle at M& T Bank, dated August 11, 2006, please be advised at the time of death, the balance on the above referenced account was: 1. Type of Account Checking Account Account Number 81672578 Ownership (Names of) Grace N Steigleman, Edgar J Steigleman Jr, Sandra J Hoffman" y 08/28/64 . f\ L.~ ~ I $7,537.13 ()~ Opening Date Balance on Date of Death Accrued Interest $ 0.18 Total --S7)53':;:3rnn.m._m.. ~ ., ....-- u__________~______~.,' ,.....,I"_'.n _.________.. 2. Type of Account Certifica.te of Deposit Account Number 031003913121958 Ownership (Names oj) Grace N Steigleman, Sandra J HOffman!) -h I 02/27/06 <.. f\ L.lt--& V $30,000.00 cJ~ $ 600.82 Opening Date Balance on Date of Death Accrued Interest Total $30,600.82 ..........""" ',OJ ,,_,....,...,..~.____..___,..__ . ....... ....." "~'I".. ....,........___.....____...__...... ~,.,..".. ......".." ,.", * For further account information, regarding ownership, closures and! or reimbursement of funds, etc., please contact the Carlisle Office at -# 717-240-6717. M &TBank DOD Unit I Records Management