HomeMy WebLinkAbout97-00762
PETITION FOR PROBATE and GRANT OF LETTERS
No. ~_aJ:::J!J'I!1-0?uZ-
To:
EI/Ut,. of -.Mi.ldI:u(LC._Koob._u...
also kilo"''' U!i ______._u._____.__________
_~_._.._..___.. ...~u..". ....._.n___.__.._ RegislCr of Wills for Ihe
De{'oos,'" Counly of _<:umbcrlilnd in the
s-;;(i~1 S;;;.;;-;ii.~.N7;.~fl~:j6--5678. . Conullouweuhh of Pennsylvaniu
The pelilion of the undersigned respectfully represenls that:
Your pelitioner~). who is/lnce<18 yeurs of age or older unth~ execut trix
inlhe lasl will of thc ahove deel'dent. dmed __~" June 2b
and codicil(s) dmed ___ Non!,!
n~rved
,19_
('I:lh.' rclc\:1Il1 dn,:ll"l'..lanc~s. l.',~. rt'lIl1fldariflll, death 01' l.'\cctllur, Cll:.)
Decendenl wus domiciled ut deuth in Borough of Camp Hill / ~lht~,1ennsYlvunia. with
h er IllSt family or principal residence at 119 November Dr., Apt. 3
(l..A1Yl.P IhL.L BllR9. CamP HIlL PA 17011
(IiSl stn.'CI, numher i1ntllllllndpality)
Decendenl, then 83 years of age, died September 3 . 19 97
at East Pennsboro 'lWp., Cumberland County, PA
Except as follows, decedent did nOlmarry, was not divorced and did not have a child born or adopted
afler execution of the will offered for probate; wus noi the victint of a killing and wus never adjudicated
incompetent: none
Decendenl at death owned property wilh estimated values as follows:
(I f domiciled in Pu.) All personul property
(If nnt domiciled in Pa.) Personal property in Pennsylvaniu
(If not domiciled in Pu.) Personul property in County
Value or real estale in Pennsylvania
situatcd as follows:
WHEREFORE. petilioner(~ respeclfully
presented herewilh and the grunl of iellers
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112,000.00
requesl(s) the probate of Ihe lasl will ~)
Testamentary
(lcstamcntary: mlll1ini~lnllion C.t.:I.; administration d.b.n.c.l.a.)
_Sal~~~~rsp~qtl'fIYYlr;m ,
~~p=r Creek Dnve
Mechanicsburq, PA 17055
OA TH 01.' PERSONAL REPRESENT A TlVE
COMMONWEALTH OF PENNSYLVANIA ) "
r ::;::;
COUNTY OF CllMRRRTAND )
The pelilioner(s) above.named swear(s) or affirm(s) Ihm the statements in the foregoing petition arc
true and correCI to the best of the knowledge und belief of pelitioner(s) and that as personal represen-
"'Iivet') of Ihe ahove decedent petitioner(s) will well und truly udminister Ihe eslate according to law.
~O!(t;,. /6 Ir}'),?tJi/o-
~c;;, 11 Y R Spri'lgl1P
1102 Copper Creek Drive
M:>chanicsburg,_PA 17055
Sw?rn tn ~r i':ftwd
hclon: me thiS
SEP'l'EMBE
and
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No.
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Estate of _' Mildred C. Koob
, Deceased
DECREE Of' PROBATE AND GRANT OF LETTERS
SEP'I'. 17 97
AND NOW 19_, in consideration of the petition on
the reverse side hereor, satisfactory proof having been presented berore me,
IT IS DECREED that the instrumcnt(s) dated June 26, 1991
described therein be admitted to probatc and riled of rccord as thc last will of
Mildred C. Koob
and Letters Testamentary
are hereby granted to Sally B. Spri1\jIJp.
FEES
~VU{o.~p.AV~
R't rW'11 . LEWIS
~. eglscro IS
( . d
19475
235.00
6.00
15.00
5.00
261:.00
Probate, Letters, Etc. .., . . . . ., $
Sb'oft~Tt1hcates( 5) ." .. .. ." $
Renunciation ................ $
JCP $
TOTAL _ $
SEPT. 17, 1997
ATT N Y (Slip. Ct. 1.0. No.)
W. M:lin st., Shirenanstown, PA 17011
ADDRESS
(717) 737-8761
PHONE
Filed
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OF
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MILDRED c. ROOD
I, MILDRED C. KOOB, of 119 November Drive, Apartment 6,
Camp Hill, cumberland county, pennsylvania, make, publish and
declare this as and for my Last Will and Testament, hereby
revoking all other wills and Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, in equal shares, to
my children, NANCY L. BROWNE, and SALLY B. SPRAGUE, provided that
should any of my children predecease me, I give and bequeath such
child'S share unto her issue per stirpes by representation, and if
there be a failure of same, then I give and bequeath such deceased
child's share to my surviving child as provided herein.
SECOND: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all property,
exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease, for
any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or condi-
tions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and to
receive the proceeds of any disposition of it.
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(B) To partition, subdivide, or improve real estate and
~ to enter into agreements concerning the partition, subdivision,
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improvement, zoning or management of real estate and to impose or
extinguish restrictions on real estate.
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(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee stock
ownership plan, or any other type of qualified plan) to the extent
the plan or the law permits them to do so, and to exercise any
other rights which they may have under the plan, in whatever
manner they consider advisable.
THIRD: I direct that all inheritance, estate, transfer,
succession and death taxes, of any kind whatsoever, which may be
payable by reason of my death, whether or not with respect to
property passing under this will, shall be paid out of the princi-
pal of my residuary estate.
FOURTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distributable,
2
shall not be subject to attachment, execution or sequestration for
any debt, contract, obligation or liability of any beneficiary,
and furthermore, shall not be subject to pledge, assignment,
conveyance or anticipation.
FIFTH: I nominate and appoint SALLY B. SPRAGUE,
Executrix of this, my Last will and Testament. In the event of
the death, resignation or inability to serve for any reason
whatsoever of the said SALLY B. SPRAGUE, I nominate and appoint
NANCY L. BROWNE, Executrix of this, my Last will and Testament. I
direct that my Executrix, and her successors, shall not be
required to post security or a bond for the performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
to this, my Last will and Testament, this ~) G.
day of ,j.<.,..,-'-'-
'!
1991.
-lh-<X__ju_t c .ok c--\-C-
MILDRED C. KOOB
(SEAL)
signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the presence
of each other, have hereunto subscribed our names as attesting
witnesses.
Address
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Address
3
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REGISTER OF WILLS OF CUMBEHLAND COUNTY
OATH OF SUBSCRIBING WITNESS
James D. Bogar and Joan E. Brothers
JB\~t'ir:
(each) a subscribing witness to the will presented herewith. (each) being duly qualified according to
law, depose(s) and say(s) that they were present and saw
Mildred C. Koob
the testat rix ,sign the same and that thpy signed as a witness at the
request of testal in ,'- presence and (in the presence or each other) (in<tbl[llC<leJl=flt~
1S~lS~Hllili~~l(1fdSR(6)). ,0 /;,
Sworn to or arrirmed and subscribed berore -;Z~f} ~~
me this 12th day or Ja es D. B g /Name)
SEPTEMBER 97.
~~("~pkWm1~JJ.h~ 1 W M'nn C;j' (~dd~:S:;,pm"nd"'..n. PA
SWORN to and sub~cribed Register W~ t.. &1?Ct...t.1.~
before me this /,;t:ii day of September, 1997 .:&Ian E. Brot}7w;tlio)
.'? ~/1 ".'_'_'_ 1 W. Main St., Shiremanstown, PA
Notary Public L/ NOTARIAL SE-\L i (Address)
My '" .. . CATHERlNEJ. BARR.~, NOTARYPUOllC "
\.ommsswn Expues 1 S!IIREMANSTOViN 80RO. CUMBERLAND CO PA.
I MY COMMISSION EXPIIIES SeplO, IO~~
!i..._._____+~, __~
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a scriber hereto, (each) being duly qualified according to law, depos
ramiliar with the signature pr
codicil
testat_
-----
that
subscribing witnesses to) the presented herewith and
codicil
on the will is in the handwriting or
to the best or
Sworn to or arrirmed and subscribed bero
me this
Register
(Name)
(Address)
17011
17011
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Mildred C. Koob, Deceased, No. 1997-00762
TO: Nancy L. Browne
5950 West cinnamon Ridge Drive
Homosassa, FL 34448
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below. You may
have a beneficial interest in the estate as follows:
See attached copy of Will - Clause FIRST
Name of decedent: Mildred c. Koob
Last known address of decedent:
119 November Drive, Apt. 3
Camp Hill, PA 17011
Date of death: September 3, 1997
Place of death: East pennsboro TownShip, Cumberland County, PA
county of grant of original letters: cumberland county
Decedent died X testate intestate.
A copy of the will X is is not attached.
Name(s), address (es) and telephone number(s) of all personal
representatives appointed:
Name
Address Telephone
Sally B. sprague
1102 copper Creek Drive (717) 761-5554
Mechanicsburg, PA 17055
Name(s), address (es) and telephone number(s) of all counsel:
Name
Address
Telephone
James D. Bogar, Esquire 1 W. Main street (717) 737-8761
Shiremanstown, PA 17011
Additional information may be obtained from the undersigned.
Date:
september 25, 1997
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James D.
1 West M 'n S reet
Shiremans w, PA 17011
(717) 737-8761
Personal Representative
X Counsel for Personal
Representative
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INVENTORY OF THE REAL AND PERSONAL ESTATE OF
Mildred C. Koob, deceased
PERSONAL PROPERTY
1.
2.
3.
4.
5.
6.
500.00
Personal property and contents of home
Commerce Bank savings Account No. 430018148,
date of death balance $2,791.91, accrued
interest $1. 35
2,793.26
Harris Savings Bank Certificate No. 30-58-
295131, date of death balance $57,407.47,
accrued interest $545.58
57,953.05
Pennsylvania State Bank Certificate of Deposit
No. 4901, date of death balance $12,909.72,
accrued interest $61.54
12,971.26
CNA LTC - Refund
2,327.50
Erie Insurance - Refund
14.00
TOTAL
$76,559.07
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COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
sally B. sprague, being duly sworn according to law, deposes and says
that she is the Executrix of the Estate of Mildred C. Koob, late of Camp
Hill, Cumberland County, pennsylvania, deceased, and that the within is an
inventory made by her, the said Executrix of the entire estate of said
decedent, consisting of all the personal property and real estate, except
real estate outside the Commonwealth of pennsylvania, and that the figures
opposite each item of the Inventory represent its fair value as of the date
of decedent's death.
\ )Ofl~' ~ fJj}~f{(J -
Sally . Sp ag e
1102 Copper Creek Drive
Mechanicsburg, PA 17055
Sworn and subscribed before me,
Expires:
NOlarial Soal
Joan e. Brothers. NOlary Publlo
Shlremanst9wn BolO. Cumberland Coun~.
My Commission e'pir.s Feb. 12.1GB!'
iJ<Jr. PannsyivSJ1laAssoclation of No'
Date of Death 3rd Seotember 1997
Day Month Year
No. 1997-00762
INVENTORY
OF THE
PERSONAL PROPERTY
AND REAL ESTATE
OF
MILDRED C. KOOB
Late of Camp Hill,
cumberland County, pennsylvania, Deceased
Filed
$
Book
Page
James D. Boqar. Esquire
Attorney
REV.1500 EX. 17.QA,
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
COMMONWEAltH Of PENNSYlVANIA
DEPARTMENT Of REVENUE
DEPT 280601
HARRISBURG. PA 17128.0601
DECEDENT'S NAME (lAST, fIRST. AND MIDDlE INITIAl)
Koob, Mildred C.
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SOCI....L SECURITY NUMaER
DATE Of OEATH
DATE Of BIRTH
09/06/13
Count
115-36-5678
09/03/97
(If A"UCA'lf) SU.VIVING S'OUSl'S NAIl! IIASI, '1.51 AND MIl/OIII"llIALI
[Xl 1. Original Return
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1. Real ElIote (Schedule A) (I 1
2. Stocks and Bonds (Schedule BI ( 2 1
3. Closely Held Stock/Partnership Inlerest (Schedule C) ( 3 )
4. Mortgages and Noles Receivable (Schedule D) I 4 )
5. Cosh, Bank Deposits & Miscellaneous Personal Property ( 5 I
(Schedule E)
6. Jointly Owned Property (Schedule F) ( 6 1
7. Tronsfe" (Schedule G) (Schedule L) (7)
8. Tolal Gross Assets (total Unes 1-7)
Q, Funeral Expenses, Administrative Casls, Miscellaneous ( 9)
Expenses (Schedule H)
\0, Debts, Mortgage liabilities, liens (Schedule II (10)
11. Total Deductions (total Unos 9 & 10)
12. Net Value of Estate (line 8 minus Une 11)
13. Charitable and Governmental Bequests (Schedule Jl
Net Value Subiect to Tax {line 12 minus Une 131
Spousal Transfers (for dotes of death after 6.30-94)
See Instructions for Applicable Percentage on Reverse (15)
Side, (Include values from Schedule K or Schedule M.l
Amount of Une 1.4 taxable 01 6% rate (16)
(Include values from Schedule K or Schedule M.l
Amount of line 1.4 taxable at 15% rote (17)
(Include values from Schedule K or Schedule M.l
Principal tax duo IAdd tax from Unes 15, 16 and 17.)
Credits Spousal Poverty Credit Prior Payments
+ 12,873.28+
14.
15.
16.
17.
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fOR DATES Of DEATH AFTER 12/31/91 CHECK HIRI
If A SPOUSAL
POVERTY CRIDIT IS CLAIMED 0
fill NUMBER
21
1997
0762
COUNTY CODE
YEAR
NUMBER
DECEDENT'S COMPLETE ADDRtSS
119 November Dr., Apt.
Camp Hill, PA 17011
76,559.07
157,465.59
6,825.20
14,841.22
161.0,7
225,847.07
3
AMOUNT RECEIVED ISEE INSTRUCTIONS)
03.
05.
-0- B.
Remainder Relurn
lfor doles of death prior to 12.13.82)
Federal Estate Tax Roturn Required
Total Number of Safe Deposit Boxes
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[J 2. Supplemental Return
o 4. limited Estate 0 40. Future Interest Compromise
lfor dates of dealh aher \ 2.12.821
IX! 6. Decedent Died Teslole 0 7. Decedent Maintained a living Trust
(Alloch copy of W;III (Alloch copy 01 Trust)
ALL'.CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAME COMPLETE MAILING ADDRESS
James D. Bogar, Esquire One W. Main St;
lElEPHONENUM8ER Shiremanstown, PA
737-8761
17011
I B 1
240,849.86
(11)
(12)
(131
(14)
15,002.79
225,847.07
225,847.07
x._=
x .06 =
13,550.82
x .15 =
(IBI
Discount Interest
677.54
(191
(20)
13,550.82
If Une 19 is greater than line 18, enter the difference on line 20. This is the OVERPAYMENT.
aD
-0-
(211
(21AI
(21B)
-0-
If Une 18 is greater than Une 19, enter the difference on line 21. This is the TAX DUE.
A. Enter the interest on the balance due on line 21 A.
B. Enter the total of line 21 and 21A on Une 21B. This is the BALANCE DUE.
Make Check Payable to: Regl..ar of Wills, Agent
\t,('.'(;,..... ~.>-. BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -C'-C. " .
Under penalties of perjury, I declare that I hove examined this rei urn, including accompany'ing schedules and stotements, and to the best of my knowledge and belief,
it is true, correct and complete. I declare that 011 real estate has been reported at true market value. Declaration of preporer other than the personal representative is
based on 011 information of which preporer has any knowledge.
SIGNATU, OfP RSONAESPO~~lE OR FiliNG RETURN ADDRESS 1102 Copper Creek Dr. DATE
o ~J ~ Mechanicsbur ,PA 17055 11/21/97
SIGN~URE.O REPARERfPT R THIA ADDRESSOne W. Ma in St. DATE
L-- ~/J, Shiremanstown, FA 17011 11/21/97
Jam.s D. Bo a , Esqu~re
Clieck here if you ore requesting a refund of your overpayment. . '
Act .48 of 1994 p.ovide. for the reduction of tho tax rate. impo.ed on the net value of tranafe,. to or for
the u.e of the spou.e. The rate. a. pre.crlbed by the .tatute will be:
e 3% (.03) will be applicable for e.tote. of decedenl. dying on or after 7/1194 and before 1/1/96
e 2% (.02) will be applicable for e.late. of decedent. dying on or after 1/1/96 and before 1/1/97
e 1% (.01) will be applicable for e.tate. of decedents dying on or after 111197 and before 1/1/98
e Spou.GI trGnafe,. occurring on or after 1/1198 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (..0-) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and:
x
a. retain the use or income of the property transferred, .......................................................
b. retain the righl to designate who shall use the property transferred ar its income, ...............
x
x
c. retain a reversionary interest; or ...................................................................................
x
d. receive the promise for life of either payments, benefits or care? .......................................
2. If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate consideration? If death occurred after
December 12, 1982, did decedent transfer property within one year of death withaut receiving
adequate consideration?.......................................................................... ........................
x
x
3. Did decedent own an 'in trust for'. bank account at his or her death?.....................................
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
UV.lJOIU+ 12.111
~
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Please Print or 1 e
FILE NUMBER
COMMONWEAlTH 0' PENNSYLVANIA
INHIIITANCI TAX IITUIN
.UIDINT Dle.DINT
ESTATE OF
Mildred C. Koob
21-1997-0762
(All property lolntly-owned wIth the Righi of Survlvorlhlp must b. disclosed on Sch.dule F)
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
DESCRIPTION
VALUE AT
DATE OF DEATH
Personal property and contents of home
Commerce Bank Savings Account No. 430018148,
date of death balance $2,791.91, accrued
interest $1. 35
Harris Savings Bank certificate No. 30-58-
295131, date of death balance $57,407.47,
accrued interest $545.58
Pennsylvania State Bank Certificate of Deposit
No. 4901, date of death balance $12,909.72,
accrued interest $61.54
500.00
2,793.26
57,953.05
12,971.26
CNA LTC - Refund
2,327.50
Erie Insurance - Refund
14.00
TOTAL (Also enter on line 5, Recapitulation) S
76,559.07
(Attach addjtionol aV2" X 11" sheels if more spoce is needed.)
.... -0--. _~~_.____
.' .'......'"..~, .,:....~..-I.----,.._._.-....r~~z:-._:.,.:.
,
-
\
llV.l509lX+ 112.111
'*
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mildred C. Koob
Joint tonont(')1
NAME
A. 1
Sa ly B. sprague
B. Nancy L. Browne
C.
Jolntly-ownod proporty:
SCHEDULE F
JOINTLY -OWNED PROPERTY
FILE NUMBER
21-1997-0762
-~.--- .-.------ ----~ ---~_.._-+-- ._~------
ADDRESS
RELATIONSHIP TO DECEDENT
1102 Copper Creek Dr.
Mechanicsburg, PA
17055
5950 West Cinnamon
Ridge Dr.
Homosassa, FL 34448
Daughter
Daughter
ITEM LEnER DATE
NUMBER FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF
JOINT OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
1. I '/23/96
A. onmerce Benk Checking AccolXlt No. 14,021.51 OX 7,010.76
32065641, date of deeth balance
14,006.34, accrued Interest $15.17
2. A. 108/97 arrls Savings Bank Certificate No. 23,408.56 OX 11,704.28
0'55-310057, date of death balance
23,318.53, accrued Interest $90.03.
his Certificate was purchased with
he redemption funds from a jolntly-
wned Certificate of Deposit account
pened on 05/03/96 with CoreStates
ank, being Certlflcete No. 5626587.
copy of the Jointly.owned CoreStates
ertificate, renewal notice and
edemptlon check dated 08/08/97 are
ttached hereto and Incorporated
erein. As such, the above Harris
Bvings eccount represents a roll-over
rom a prior jolntly'owned account of
lldred C. Koob and Sally B. Sprague,
aid account dating prior to one year
",fore the date of death of Hi ldred C.
oob.
3. A. 123/96 ennsylvaniD State Bank Certificate of 53,676.23 OX 26,838.12
eposlt No. 5161, date of death bal-
nee $53,400.48, accrued interest
275.75
TOTAL (Also enter on lina 6, Recapitulation) S (Caltinued)
,ffl/lC';';""..tl,..~..,~..~,.."-'""--~~.' ,.
i
l
-,.....,-""',._,,,."".
. -... __I,..' ~',_'--'-:''''''l
,')"
(If more space ;s needed insert additional sheets of same size)
\,
",~.,.,...,.
SCHEDULE .,
JOINTLY-OWNED PROPERTY
(continued)
ESTATE OF FILE NUMBER
Mildred C. Koob 21-1997-0762
LETTER TOTAL DOLLAR
ITEM FOR OATE VALUE DECo'S VALUE OF
MUMBER JOINT MADE DESCRIPTION OF PROPERTY OF % INT. DECEDENT'S
TENANT JOINT ASSET INTEREST
4. A. 12/31196 Pennaylvanla Stete Benk Certlflcete of 12.568.31 50% 6.284.16
Depoalt No. 5435. dete of d.eth bel.
enee $12,512.16. eccrued lntereat
$56.15. Aa per the etUched letter
from Pennsylvania State Bank, this
account was. roll.over of pennsylva-
nle Stete Benk CD No. 3627 which wea
laaued In the nomea of Mildred C. Koob
or Selly B. SpregUl on 10131194. Aa
such, the above Pennsylvania State
Bank account represents 8 roll-over
from e prior Jointly-owned occount of
Mildred C. Koob ond Solly B. Sprogue,
said account dating prior to one year
before the dete of deoth of Mildred C.
Koob.
5. A. 09112/88 PNC Bonk Checking Account No. 1.710.69 50% 855.35
514027354B. dote of deeth belenee
$1.709.79. occrued Interest $0.90
6. A. 06112/B9 PNC Bank Savings Account No. 21.450.23 50% 10.725.12
5130212805. dote of deoth bel once
S21.442.99. occrued Interest S7.24 i
7. A. 86 U.S. Series EE Sovlngs Bonds, ,
,
S1.000.00 denomination, as follows: ,
i
01190 Ml1786822EE 779.20 50% 389.60 [
01190 Ml1786823EE 779.20 50% 389.60 ~
01190 Ml1786824EE 779.20 50% 389.60
01190 M31786817EE 779.20 50% 389.60
01190 Ml1786818EE n9.20 50% 389.60
01190 M31786819EE 779.20 50% 389.60
01190 Ml1786820EE 779.20 50% 389.60
01190 Ml1786821EE 779.20 50% 389.60
01190 M31786812EE n9.20 50% 389.60
01190 M31786813EE n9.20 50% 389.60
01190 M31786814EE 779.20 50% 389.60
01190 Ml1786815EE 779.20 50% 389.60
01190 M31786816EE 779.20 50% 389.60
01190 M31786807EE 779.20 50% 389.60
01190 M3178680BEE n9.20 50% 389.60
01190 M31786809EE 779.20 50% 389.60
01190 Ml1786810EE 779.20 50% 389.60
01190 M31786811EE 779.20 50% 389.60
01190 Ml1786802EE 779.20 50% 389.60
01190 Ml1786803EE 779.20 50% 389.60
01190 M31786804EE 779.20 50% 3B9.6O
01190 M31786805EE 779.20 50% 389.60
01190 Ml1786806EE 779.20 50% 389.60
01190 Ml1786797EE 779.20 50% 389.60
01190 H31786798EE 779.20 50% 389.60
01190 M31786799EE 779.20 50% 389.60
01190 M31786800EE 779.20 50% 389.60
01190 M31786801 EE n9.20 50% 389.60
01189 M26970803EE 826.80 50% 413.40
01189 M26970804EE 826.80 50% 413.40
01189 H26970805EE 826.80 SOX 413.40
01190 M31786795EE 779.20 50% 389.60
01190 M31786796EE n9.20 50% 389.60
SCHEDULE F
JOINTLY-OWNED PROPERTY
(continued)
ESTATE OF FILE NUMBER
Mildred C. Koob 21-1997-0762
LETTER TOTAL DOLLAR
ITEM FOR DATE VALUE DECO'S VALUE OF
NlJ48ER JOINT MADE DESCRIPTION OF PROPERTY OF X INT. DECEDENT'S
TENANT JOINT ASSET INTEREST
7. A. 01/90 M31786791EE 779.20 SOX 389.60
Cont 01/90 M31786792EE 779.20 SOX 389.60
'd. 01/90 M31786793EE 779.20 SOX 389.60
01/90 M31786794EE 779.20 SOX 389.60
01/90 M31786786EE 779.20 SOX 389.60
01/90 M31786787EE 779.20 50X 389.60
01/90 M31786788EE 779.20 SOX 389.60
01/90 M31786789EE 779.20 SOX 389.60
01/90 M31786790EE 779.20 SOX 389.60
01/90 M31786781EE 779.20 SOX 389.60
01/90 M31786782EE 779.20 SOX 3M.6O
01/90 M317867B3EE 779.20 SOX 389.60
01/90 M31786784EE 779.20 SOX 389.60
01/90 M3178678SEE 779.20 SOX 389.60
01/90 M31786776EE 779.20 SOX 389.60
01/90 M31786777EE 779.20 SOX 389.60
01/90 M31786778EE 779.20 SOX 389.60
01/90 M31786779EE 779.20 SOX 389.60
01/90 M31786780EE 779.20 SOX 389.60
01/90 M31786771EE 779.20 SOX 389.60
01/90 M31786772EE 779.20 SOX 389.60
01/90 M31786mEE 779.20 SOX 389.60
01/90 M31786774EE 779.20 SOX 389.60
01/90 M31786775EE 779.20 SOX 389.60
01/90 M31786766EE 779.20 SOX 389.60
01/90 M31786767EE 779.20 SOX 389.60
01/90 M31786768EE 779.20 SOX 389.60
01/90 M31786769EE 779.20 SOX 389.60
01/90 M31786770EE 779.20 SOX 389.60
01/90 M3178676SEE 779.20 SOX 389.60
08/88 M30627368EE 851.60 SOX 425.80
08/88 M30627369EE 851.60 SOX 425.80
08/88 M30627370EE 851.60 SOX 425.80
08/88 M30627363EE 851.60 SOX 425.80
08/88 M30627364EE 851.60 SOX 425.80
08/88 M3062736SEE 851.60 SOX 425.83
08/88 M30627366EE 851.60 SOX 425.80
08/88 M30627367EE 851.60 SOX 425.80
08/88 M306273S8EE 851.60 SOX 425.80
08/88 M306273S9EE 851.60 50X 425.80
08/88 M30627360EE 851.60 SOX 425.80
08/88 M30627361EE 851.60 SOX 425.80
08/88 M30627362EE 851.60 50X 425.80
08/88 M306273S3EE 851.60 SOX 425.80
08/88 M306273S4EE 851.60 SOX 425.80
08/88 M306273SSEE 851.60 50X 425.80
08/88 M306273S6EE 851.60 SOX 425.80
08/88 M306273S7EE 851.60 50X 425.80
08/88 M283S9S98EE 851.60 50X 425.80
08/88 M30627349EE 851.60 50X 425.80
08/88 M30627350EE 851.60 50X 425.80
08/88 M30627351 EE 851.60 50X 425.80
08/88 M30627352EE 851.60 50X 425.80
SCHEDULE F
JOINTLY-OWNED PROPERTY
(continued)
ESTATE OF FILE NUMBER
Mildred C. Koob 21-1997-0762
LETTER TOTAL DOLLAR
ITEM FOR DATE VALUE DECD'S VALUE OF
NUMBER JOINT MADE DESCRIPTION OF PROPERTY OF % INT. OECEDENT'S
TENANT JOINT ASSET INTEREST
8. A. 8 u.s. Series EE 58\,;ng5 Bonds,
$5,000.00 denomination, a8 follows:
01/89 V1670158EE 4,134.00 50% 2,067.00
01/89 V1670159EE 4,134.00 50% 2,067.00
01/89 V1670154EE 4,134.00 50% 2,067.00
01/89 V1670155EE 4,134.00 50% 2,067.00
01/89 V1670156EE 4,134.00 50% 2,067.00
01/89 V1670157EE 4,134.00 50% 2,067.00
01/89 V1670152EE 4,134.00 50% 2,067.00
01/89 V1670153EE 4,134.00 50% 2,067.00
9. A. 10 u.s. Series EE Savings Bonds,
5500.00 denomination, as follows:
08/88 o 1947Z290EE 425.80 50% 212.90
08/88 D1947Z291EE 425.80 50% 212.90
08/88 D1947Z292EE 425.80 50% 212.90
08/88 D1947Z293EE 425.80 50% 212.90
08/88 D1947Z294EE 425.80 50% 212.90
08/88 D1947Z285EE 425.80 50% 212.90
08/88 DI947Z2B6EE 425.80 50% 212.90
08/88 01947Z287EE 425.80 50% 212.90
08/88 DI947Z2B8EE 425.80 5D% 212.9D
08/88 D1947Z289EE 425.80 50% 212.90
10. B. 8 U.S. Series EE Savings Bonds,
55,000.00 denomination, as follows:
01/89 V1670161EE 4,134.00 50% 2,067.00
01/89 V1670167EE 4,134.00 50% 2,067.00
01/89 V1670162EE 4,134.00 50% 2,067.00
01/89 V1670163EE 4,134.00 50% 2,067.00
01/89 V1670164EE 4,134.00 50% 2,067.00
01/89 V1670165EE 4,134.00 50% 2,067.00
01/89 V1670166EE 4,134.00 50% 2,067.00
01/89 V1670160EE 4,134.00 50% 2,067.00
11. 8. 60 u.s. Series EE Savings Bonds,
",000.00 denomination, os follows:
02190 M3583317 5EE 779.20 50% 389.60
03/90 M35833193EE 779.20 50% 389.60
03/90 M358331B8EE 779.20 50% 389.60
03/90 M35833189EE 779.20 5D% 389.60
03/90 M35833190EE 779.20 50% 389.60
03/90 M35833191EE 779.20 50% 389.60
03/90 M35833192EE 779.20 50% 389.60
03/90 M35833178EE 779.20 50% 389.60
03/90 M358331B4EE 779.20 50% 389.60
j 03/90 M35833185EE 779.20 50% 389.60
,
I 03/90 M358331B6EE 779.20 50% 389.60
: 03/90 M35833187EE 779.20 50% 389.60
03/90 M35833073EE 779.20 50% 389.60
03/90 M35833074EE 779.20 50% 389.60
03/90 M35833075EE 779.20 50% 389.60
03/90 M35833076EE 779.20 50% 389.60
03/90 M35833077EE 779.20 50% 389.60
03/90 M35833069EE 779.20 50% 389.60
03/90 M35833070EE 779.20 50% 389.60
03/90 M35833071EE 779.20 50% 389.60
03/90 M3583307ZEE 779.20 50% 389.60
SCHEDULE F
JOINTLY-OWNED PROPERTY
(Continued)
ESTATE OF FILE NUMBER
Mildred C. Koob 21-1997-0762
LETTER TOTAL DOLLAR
ITEM FOIl DATE VALUE DECIl'S VALUE OF
NUMBER JOINT MADE DESCRIPTION OF PROPERTY OF X INT. DECEDENT'S
TENANT JOINT ASSET INTEREST
11. B. 02/90 11358331 mE 779.20 50X 389.60
Cont 02/90 M35833178EE 779.20 50X 389.60
'd. 02/90 M35833179EE 779.20 50X 389.60
02/90 M35833180EE n9.20 50X 389.60
02/90 M35833181EE 779.20 50X 389.60
02/90 M358331nEE 779.20 50X 389.60
02/90 M35833174EE n9.20 50X 389.60
02/90 M35833175EE n9.20 50X 389.60
02/90 M35833176EE 779.20 50X 389.60
08/88 M28359595EE 851.60 50X 425.80
08/88 M28359596EE 851.60 50X 425.80
08/88 M28359597EE 851.60 50X 425.80
01/89 M26970806EE 826.80 50X 413.40
01/89 M26970807EE 826.80 50X 413.40
08/88 M28359590EE 851.60 50X 425.80
08/88 M28359591EE 851.60 50X 425.80
08/88 M28359592EE 851.60 50X 425.80
08/88 M2B359593EE 851.60 50X 425.80
08/88 M28359594EE 851.60 50X 425.80
08/88 M28359585EE 851.60 50X 425.80
08/88 M28359586EE 851.60 50X 425.80
08/88 M28359587EE 851.60 50X 425.80
08/88 M28359588EE 851.60 50X 425.80
08/88 M28359589EE 851.60 50X 425.80
08/88 M28359580EE 851.60 50X 425.80
08/88 M28359581EE 851.60 50X 425.80
08/88 M2B359582EE 851.60 50X 425.80
08/88 M283595B3EE 551."" " 50X 425.80
08/88 M28359584EE 851.60 50X 425.80
08/88 M28359575EE 851.60 50X 425.80
08/88 M28359576EE 851.60 50X 425.80
08/88 M253595mE 851.60 50X 425.80
08/88 M28359578EE 851.60 50X 425.80
08/88 M28359579EE 851.60 50X 425.80
08/88 M28359570EE 851.60 50X 425.80
08/88 M28359571EE 851.60 50X 425.80
08/88 M28359572EE 851.60 50X 425.80
08/88 M28359573EE 851.60 50X 425.80
08/88 M28359574FE 851.60 50X 425.80
TOTAL 5157,465.59
This certltles thaI the amount below
has been deposited al this bank's
olflce at
659 - CAMP HILL
MILDRED C KOOB
SALL Y B SPRAGUE
119 NOVEMBER DR APT 6
CAMP HILL, PA 17011
CUSTOMER NUMBER
CERTlFICA iE NUMBER
5626587
200116804
011766 659
The principal amount shown is
payable upon prasenhnenl of lhis
cenl1icale at CoreStales Bank, N.A.
'1!i provtrl..,..; by !h~ l"'.J!es 3M
regulations lOt' this certifICate which
by reference are made as parr hereof.
Federal Regulations specify a
lubstandal penalty for premature
redemption or: :MlhdrawaJ of all or
any pitt of ~ .tlme deposit.
115365678
0000
A RG
CERTIFICATE
OF DEPOSIT
TRANS COOE REOEMPTlON AMOUNT
~
CoreStates
9
AMOUNT DEPOSITEO
$21,832.40
ANNUAL PERCENTAGE
INTEREST RATE
5.26 X
IELD 5.40 %
INTEREST EARNED WILL
BE PAID AS FOLLOWS
CoreStates Bank NA
.~ember FDIC
....
,
~ ;I,l7LkL',',:',' ,.' '
1.),,"".,'
A~ORIZED SIGN.o;TURE' '. '
.~ """;,' .'
ISSUE DATE
05/03/96
MATURrTY CATE
08/03/97
TYPElTERM
324- 15 MONTHS
AUTO-RENEWAL
CAPITALIZE
ANNUAL,L Y
11'51; 21;58'/11' ,:1;1;1;1;",'/'/'/'/1:
301,
t'f --:, '
'."." ....?.
]
s
CORESTATES BANK, N.A.
PO BOX 8630
PHILADELPHIA, PA. 19101-8630
MILDREO C K006
SALLY B SPRAGUE
119 NOVEMBER DR APT 6
CAMP HILL PA 17011
AUTOMATIC RENEWAL NOTICE H
CUSTOMER 200116804
CERTIFICATE 324-5626587
ISSUE DATE 05/03/96
MATURITY DATE 08/03/97
REDEMPTI ot!
VALUE 23,318.53
DEAR CUSTOMER
THANK YOU FOR SAVING WITH CORES TATES BANK. THIS LETTER IS TO INFORM YOU THAT
YOUR CERTIFICATE OF DEPOSIT, DESCRIBED ABOVE, WILL MATURE ON THE DATE NOTED ABOVE
AND WILL AUTOMATICALLY RENEW FOR A TERM OF 15 MONTHS, WITH A NEW MATURITY DATE
OF 11/03/96. WHILE THE INTEREST RATE AND ANNUAL PERCENTAGE YIELD HAVE NOT YET 8EEN
DETERMINED, YOU WILL RECEIVE THE INTEREST RATE ANO ANNUAL PERCENTAGE YIELD IN EFFECT AS OF
THE ~lATURITY DATE UNLESS YOU ADVISE US OIFFERENTLY. THE INTEREST RATE WILL BE PAID ON THE
CERTIFICATE UNTIL THE NEW MATURITY OATE. 10 OBTAIN THE INTEREST RATE ANO A,mUAL
PERCENTAGE YIELD WHICH WILL APPLY TO YOUR CERTIFICATE WHEN AUTOMATICALLY RENEWED, OR
FOR ANY OTHER AVAILABLE TERM, PLEASE CALL THE BANK AT 1-800-GET-RATE ON THE DATE OF
MATURITY.
IF YOUR CERTIFICATE WAS COMPOUNDING SIMPLE OR CONTINUOUS INTEREST, EFFECTIVE WITH THE
RENEWAL OF YOUR CERTIFICATE, THE COMPOUNDING FREQUENCY WILL CHANGE TO DAILY FOR
PRINCIPAL ANO ACCRUED INTEREST.
YOU MAY REDEEM YOUR EXISTING CERTIFICATE OR CHANGE THE AMOUNT OR TERM WITHIN 10 CALENDAR
OAYS AFTER MATURITY WITHOUT PENALTY BY FOLLOWING THE INSTRUCTIONS ON THE ENCLOSED
CERTIFICATE REINVESTMENT FORM OR 8Y VISITING ANY CORESTATES BANK OFFICE.
THESE CONOITIONS WILL APPLY TO YOUR NEW CERTIFICATES AS WELL.
THE FOLLOWING CONDITIONS WILL APPLY TO YOUR RENEWED CERTIFICATE:
* THE MINIMUM OPENING DEPOSIT IS $ 500.
* PRINCIPAL AND ACCRUED INTEREST WILL BE COMPOUNOEO ON A DAILY BASIS. IF YOUR
CERTIFICATE TERM IS ONE YEAR OR GREATER, INTEREST WILL BE CREDITED TO YOUR
CERTIFICATE ON AN ANNUAL 8ASIS. IF YOUR CERTIFICATE TER~I IS LESS THAN ONE YEAR,
INTEREST WILL BE CREDITED TO YOUR CERTIFICATE AT MATURITY. THE INTEREST RATE AND
THE ANNUAL PERCENTAGE YIELD ASSUME THAT INTEREST WILL REMAIN ON DEPOSIT UNTIL
MATURITY. ANY WITHDRAWAL OF INTEREST WILL REDUCE EARNINGS.
* THE OAILY BALANCE METHOD IS USED TO CALCULATE THE INTEREST ON YOUR ACCOUNT. THIS
METHOD APPLIES A DAILY PERIODIC RATE TO THE PRINCIPAL PLUS ACCRUED INTEREST I'~ THE
ACCOUNT EACH DAY.
* INTEREST BEGINS TO ACCRUE ON THE FIRST BUSINESS DAY YOU DEPOSIT FUNDS.
* YOUR CERTIFICATE WILL AUTOMATICALL Y RENE~I AT '~ATURITY.
* YOU MAY NOT MAKE DEPOSITS INTO THIS CERTIFICATE UNTIL THE MATURITY DATE.
* IF YOU REOEEM THE CERTIFICATE PRIOR TO MATURITY, YOU WILL INCUR AN EARLY
WITHORAWAL PENALTY ACCORDING TO THE SCHEDULE BELOW:
IF THE REMAINING TERM OF THE CERTIFICATE IS: INTEREST FORFEITURE IS:
-------------------------------------------
----------------------
LESS THAN 1 YEAR
1 YEAR TO LESS THAN 3 YEARS
3 YEARS TO LESS THAN 5 YEARS
5 YEARS TO LESS THAN 7 YEARS
7 YEARS OR LONGER
FOR ADDITIONAL INFORMATION ON SAVINGS OPPORTUNITIES AT
CALL 215-973-1000, OR 1-800-426-6900 FROM TOLL CALLING
CONVENIENT NEIGH80RHOOD OFFICE FOR FURTHER DETAILS.
CORESTATES 8ANK, N.A.
3 MONTHS
6 MONTHS
12 MONTHS
18 MONTHS
24 r~ONTHS
CORES TATES BANK
AREAS, OR STOP INTO ANY
C.J01J SIBS
A CoreStates Bank Member FDIC
i
I
,
,
I
,
I
I
I
I
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PENNSYLVANIA
rATE BANK
2148 Mariti SI"tI
PO. BOl: 481
Camp Hill. p^ 11001.0481
111.131-1212
FAX: 111.131.1216
Coloni41 Pori O(fict
500 Coloni41 Rood
Harri,bur8. p^ 11112
111.541.0500
FAX: 117.541.0510
September 25, 1997
James D. Bogar
Bogar & Sheely
One West Main Street
Shiremanstown, P A 17011
RE: Estate of Mildred C. Koob - Date of Death September 3, 1997
Dear Mr. Bogar:
Below is the information that was requested on the above named deceased.
Certificate of Deposit as of 09-03-97
NAME ACCOUNT # OPENED BALANCE ACCRUED
Mildred C. Koob 4901 10-31-96 $ 12,909.72 $ 61.54
Mildred C. Koob or 5161 07-23-96 $ 53,400.48 $ 275 75
Sally B. Sprauge
5435 12-31-96 $ 12,512.16 S 56.15
If you have any questions, or if [can help in any other way, please do not hesitate to contact me.
Sincerely,
Pennsylvania State Bank
~./f:cL{f (21~~
GiGi Cullen
Customer Service Representative
PENNSYLVANIA
TATE BANK
Octob~r 10. 1997
James D. Bogar
Bogar & Sheely
One West Main Street
Shiremanstown, P A 170 II
RE: Estat~ of i\lildred C Koob - Date of Death September 3, 1997
Dear MI'. Bogar
Below is the information that was reqllested 011 the above named dec~ased.
2/48 .II.,ltt 5'",'
PO. SOl 481
Camp //ill, PA 11001.0481
1/1.131.1212
FAX: 111.13/.1216
Cowni41 Part OffiCI
500 Co/.mi41 Road
Harri.b"l. PA 11112
111.541.0500
FAX: 111.541.0510
Certiticate of Dc posit ;I 5435 for 512,00051 was a rollover of CD #3627 which was issued in the
names of Mildred C. Koob -01'- Sally B Sprauge 011 10-31-9.:\ in the amount of$10,923.56. This
CD was always in both namcs.
If you have any questions. 01' if 1 can help in any other way, please do nor hesitate to contact me.
Sincerely,
Pennsylvania Stall' Bani,
~t2J
' ,/
(/( . . /'i-~"--
GiGi Cullen .
Banking Sales Specialist
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COMMONWEALTH OF P(NN!lYLVM~I^
INHEAIIANCI TAX AnUAN
RESIDENT DICEDINT
SCHEDULE G
TRANSFERS
ESTATE OF
Mildred C. Koob
PLEASE PRINT OR TYPE
FilE NUMBER
21-1997-0762
THIS SCHEDULE MUST BE COMPLETED AND FilED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OFTHE COVER SHEET IS YES.
ITEM I DESCRIPTION OF PROPERTY , TOTAL VALUE DECO. DOllAR VALUE ---
EXcLUSION % OF DECEDENT'S
NUMBER Include nome 01 'he rronl'e,ef', '",m rltlolionshrp '0 decr!dlJnt, dolll o/lronsfe( OF ASSET INT. I,,!TEREST
I.
U.S. Serlo. EE Savings Bond No. D4S1D3525EE,
$500.00 ~Inatlon, Is.ued 04/95, POD Nsney Lym
Ffnger (Granddaughter)
3 U.S. Sorfe. EE Sevlng. Bonds, $1,000.00 denomi-
nation, POD Noney lym Finger
(Grenddaughter), e. follow.:
No. M66719362EE, I.sued 03/96
No. M66719363EE, Issued 03/96
No. M26970799EE, Issued 01/89
U.S. Serle. EE Sevlngs Bond No. D45103527EE,
$500.00 denomination, Issued 01./95, POD Richerd R.
Browne (Grsnd.on)
3 U.S. Serle. EE Sev;ngs Bonds, $1,000.00 denomi-
nation, POD Richard R. Browne (Grandson), as
follows'
No. M66716731EE, Issued 03/96
No. M66716732EE, Issued 03/96
No. M26970798EE, issued 01189
U.S. Serle. EE Ssvlngs Bond No. M26970798EE,
$1,000.00 denomination, issued 01/89, POD Ceren
Diloreto (Grsnddsughter)
U.S. Series EE Sevlngs Bond No. M269708D1EE,
$1,000.00 denomination, Issued 01/89, POD Derryl
C. Sprsgue (Grendson)
U.S. Serle. EE Sevlngs Bond No. M26970802EE,
$1,000.00 denomination, Issued 01/89, POD Jeffrey
W. Sprsgue (Grendson)
2.
3.
4.
5.
6.
7.
.0-
275.20
100%
275.20
.0.
-0-
-0-
.0-
535.20
535.20
826.80
275.20
100%
100%
100%
100%
535.20
535.20
826.80
275.20
-0- 535.20 100% 535.20
-0- 535.20 100% 535.20
-0- 826.80 100X 826.80
-0- 826.80 100% 826.80
-0- 826.80 100X 826.80
-0- 826.80 100% 826.80
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.._____.. _..._ . ~~_T~~J~_~~__ e_~.I~.~ _~~~n~~~~ec:opilu!~_I~..1 S
(If more spoce is needed, insert additional sheels of some size.)
6.825.20
_, I ~..._-'---"'-..,' ..-~',',
ESTATE OF
Mildred C. Koob
ITEM
NUMBER
A. Funeral Expens..,
UV,15I1'X. (7.",
-!~
COMMONWEALTH 0' PENNSYLVANIA
INHUITANCe: TAX RETURN
RUIDI!NT DI!CI!DI!NT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Please Print or ~yp~ __
fiLE NUMBER
21-1997-0762
DESCRIPTION
AMOUNT
1.
Myers Funeral Home - Funeral expense
5,856.00
65.00
2.
Barre Memorials - Grave marker
B. Administrative COltl'
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
1.
Sally B. Sprague
106 - 34
- 6933
Personal Representative Commissions
Sociol Security Number of Personal Representative:
Year Commissions paid 1998
4,170.00
2.
Attorney Fees - James D. Bogar, Esquire as per agreemen t
4,000.00
3.
Family Exemption
Cloimant
None claimed
Relationship
Address of Claimant at decedent's death
Street Address
City
State
Zip Code
Probate Fees - Cumberland Co. Register of Wills
261.00
Mllcellaneaul Expenles:
U.S. Postal Service - Registered mail/bond transmitt 1
15.22
Mellon Bank - Check printing charge
24.00
RESERVES: Costs to conclude administration of
Estate including filing of PA Inheritance Tax Return
and Inventory, filing fee for First and Final Accoun
'and Statement of Distribution and preparation of
personal and fiduciary income tax returns
450.00
TOTAL (Also enter on line 9, Recapitulation)
$ 14,841.22
(If more space II needed, Insert additional sheets of same size.)
""""'" I'.'" .. =_J~ SCHEDULE I
COMMONW""" O"'NN'n"NIA DEBTS OF DECEDENT,
"'~:::~~~~'O\~~~:~~'N MORTGAGE LIABILITIES AND LIENS
E~1~J:ed C. Koob
ITEM
NUMBER
1.
L
Ploal. Print or TVPo
FILE NUMBER
21-1997-0762
DESCRIPTION
AMOUNT
2.
Good Hope Family Physicians - Medical bill
PP&L - Electric
15.12
3.
25.24
4.
AARP - Final health insurance premium
Bell Atlantic - Telephone
119.25
1.96
TOTAL (Also enter on line 10, Recapitulationl
$
161.57
(If more space is neededl insert additional shee's of same size.)
_!V!5lJfI.I7I'1
W
COMMONWIAITH 0' ,tNN!lYLVAtlIA
INHUnAHCI lAX .nU'N
USIOIH' OICIOIH'
SCHEDULE J
BENEFICIARIES
ESTATE OF
Mildred
FILE NUMBER
C. Koob
21-1997-0762
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
A. Taxable Bequests:
I.
Nancy L. Browne
5950 West Cinnamon Ridge Drive
Homosassa, FL 34448
Daughter
One-half (1/2) of
rest, residue
and remainder
2.
Sally B. Sprague
1102 Copper Creek
Mechanicsburg, PA
Daughter
One-half (1/2) of
rest, residue
and remainder
Drive
17055
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmental Bequests:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAlso ontor on lino 13, Rocopitulotionl S
(If more space is needed, In.ert additional .h.et. of sam. lize)
. .
:tEa!.;t ]~Iill aub ml'~tht11tl'ut
or
HILDRIlD C. IIOOD
I, MILDRED C. Rooe, of 119 November Drive, Apartment 6,
Camp Hll1, Cumberland County, Pennsylvania, make, publish and
declare this as and for my Last Will and Testament, hereby
revoking all other Wills and cOdicils heretofore made by me.
~: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance pOlicies thereon, in equal shares, t~
my children, NANCY L. BROWNE, and SALLY B. SPRAGUE, provided that
should any of my children predecease me, I give and bequeath such
child.s share unto her issue per stirpes by representation, and if
there be a failure of same, then I give and bequeath such deceased
child's share to my surviving child as provided herein.
SECOND: In addition to all powers granted to them by
law and by other provisions of this will, I give the fiduciaries
acting hereunder the following powers, applicable to all property,
exercisable without court approval and effective until actual
dietribution of all property:
(A) To sell at pUblic or private sale, or to lease, for
any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or condi-
tions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and to
rG~eive the pr~ceedB of any diBpo~ltion of it.
.J,
t (8) To partition, subdivide, or improve real estate and
'\~ to enter into agreements concerning the partition, subdivision,
)
1
'\
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r<;:
improvement, zoning or management of real estate and to impose or
extinguish restrictions on real estate.
~. ....."""'=-.--.-.. .." ...--..
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make dietributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee stock
ownership plan, or any other type of qualified plan) to the extent
the plan or the law permits them to do so, and to exercise any
other rights which they may have under the plan, in whatever
manner they consider advisable.
~: I direct that all inheritance, estate, transfer,
succession and death taxes, of any kind whatsoever, which may be
payable by reason of my death, whether or not with respect to
'f prcperty pasBing under this Will., shall be paid out of the princi-
r;,
) pal of my residuary estate.
"K
~ ~: All interests hereunder, whether principal or
j income, which are undistributed and in the possession of the
"
~ fiduciaries acting hereunder, even though vested or distributable,
.~
'"
2
FOLD HERE
COMMONWEALTH OF PENNSYLVANIA
DEPAHTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128.0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
.
NO. AA 2424 97 REvile? EX 111.'61
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
JAMES D BOGAR ESQUIRE
101
$12.873.28
1 W MAIN STREET
SHIREMANSTOWN. PA
17011
ESTATE INFORMATION:
FilE NUMBER
21-1997-0762 SSN 115-36-5678
NAME OF DECEDENT (lAST) (FIRST) (MI)
Kooa MILDRED C
DATE OF PAYMENT
11/25/1997
POSTMARK DATE
0/00/0000
COUNTY
CUMBERLAND
DATE OF DEATH
9/03/1997
REMARKS SALL Y B SPRAGUE
C/O JAMES 0 BOGAR ESQUIRE
SEALCHECKIi 1006
,
FOlD HERE -,
,
,
.
TOTAL AMOUNT PAID
$12,873.28
.~
.
,
. '
REGiSTER Or- WI~LS
:;~-------------.- .-- ___ ~_ n_. ____
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PEPT. za0601
HARRISBURC, PA 111za~0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-02-98
KOOB
09-03-97
21 97-0762
CUMBERLAND
101
JAMES D BOGAR
1 W MAIN ST
SHIREMANSTOWN
ESQ
A~ount Renitt.d
-*
I[V-Ud II lIP CU.'1I
MILDRED
C
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ii"EV:is4j-EiCAf'p--njii=97Y"NOYicEnOF-YNHERiiiN-CE-YA'X-A'ppRA'isEHENT-;-ALLOWANCE-OR---m-mm----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KOOB MILDRED C FILE NO. 21 97-0762 ACN 101 DATE 03-02-98
PA 17011
TAX RETURN liAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Re.l Est.t. (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held stock/P.rtn~rship Interest (Schedule C)
4. Hortgegas/Notes Receivable (Schedule DJ
5. Cash/Bank Deposits/Hisc. Parsonal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Ass.ts
( ) CHANGED
III
(2)
131
(4)
ISI
(6)
171
.00
.00
.00
.00
76.559.07
157 .465.59
6.825.20
IS)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hise, Expens.s (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule X)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
14,841. 22
161.57
Illl
(l21
(l3)
(l41
(9)
(lOI
NOTE: To insure proper
credi t to your account,
sublli t the upper portion
of this forn with your
tax pay..ent.
240,849.86
1". DD;> 79
225,847.07
.00
225,847.07
If an assessment was issued previOUSly, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spousal rat. (15)
16. Amount of Line 14 taxable at Lin..l/Class A rat. (16)
17. A~ount of Line 14 taxable at Collateral/Class 8 rate (17)
18. Principal Tax Due
NOTE:
TAX CREDITS:
PAYMENT
DATE
11-25-97
RECEIPT
NUMBER
AA242497
DISCOUNT 1'1
INTEREST/PEN PAID (-)
677.54
.00 X .00=
225,847.07 X .06=
.00 X .15=
(lS)
AHOUNT PAID
12,873.28
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
13,550.82
.00
13,550.82
13,550.82
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH FDR INSTRUCTIONS. I
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RESERVATION: Estete. of decedent. dying on or bafora Oac..bar 12, 1982 .- If any future Inter..t In the 8,tat. Is transfarrad
In pass.sslon or enjoy.ant to Class B (collata,.all ban.fIe!erl.. of the decedent after the expiration of any ..tate for
11f. or for ye.rs, the Co..onwaalth hereby expre.slY r...rve. th_ right to appraise and ass.ss transfer Inheritanca Taxas
at the lawful Class B (collataral) rat. on any .uch future Intere,t.
PURPOSE OF
NOTICE: To fulfill the require.ants of Sectlon ,2140 of thll Inheritance and Estete Tille Act, Act 21 of 1995. (7Z P,S.
Sectlon 9140).
PAVMENT: Oatl!lch the top portion of this Notica l!!lnd sub.it with your pay.ant to the RlIglstllr of Wills printed on the rel/llr.. tide.
--Make check or .oney order payable to: REGISTER OF MILLS, AGENT
REFUND (CR): A refund of a tax crlldit, which wal not raquestad on the Tax Rllturn, .ay bll rllquII.tlld by co.plllting an ~Appiication
for Rllfund of PlInnsyil/ania Inhllritancll and Estotll Tax~ (REV-13l3). Applications ara al/ailabill at thll OffiCII
of the Register of Wills, any of the 23 RIIVlInUII District Offices, or by cailing thll special 24-hour
answering sllrvica nu.ber. for for.s ordering: In PlInnsylvanla i-800-362-2050, outside Pllnnsylvania and
within local Harrisburg area (111) 181-8094, TOOt (111) 172-2252 (Hearing I.pairlld Oniy).
OBJECTIONS: Any party in intllrllst not satisfied with the appraise.llnt, aiiowancll or disallowance of deductions, or assass.lInt
of tax (including discount or interest) as shown on this Notice .ust object within sixty (60) days of recllipt of
this Notice by:
--written protllst to thll PA Dllpartmllnt of RlIl/enue, Board of Appeals, Dept. 281021, Harrisburg, PA 11128-1021, OR
--lIlllction to have the .atter dllter.ined at audit of the account of tho personal represllntativlI, OR
--appeal to the Orphans' Court.
ADMIN
ISTRATlVE
CORRECTIONS:
Factual errors discovered on this asslIss.lInt should be oddresslId in writing to: PA Depart.lInt of Revllnue,
Bureau of Individual Taxlls, ATTN: Post AssesslIlInt Review Unit, Dept. 280601, Harrisburg, PA 11128-0601
Phone (111) 181-6505. See page 5 of the bookll1t ~Instructions for Inheritance Tax Return for a Residant
D.cedent~ (REV-I501) for an explanation of adlIinistrativeiY correctable IIrrors.
DISCOUNT:
If any tax due is paid within three (3) call1ndar .onths after the declldent's death, a five percent (51.) discount of
thll tax paid is ailowed.
PENALTY:
The IS" tax a."GlIty non-participation panal ty is cOIIPuted on thll total of thll tax and interut assllSSlId, and not
paid bllforll January 18, 1996, the first day after thll end of the tax a.nosty pgdod. This non-participation
penalty is apPllalabl11 in the salle .anner and In the the sallll ti.e period as you would appoal thll tax and interest
thet has boen assessed nlJ indlcetlld on this notice.
INTEREST:
Interest I. charged beginning with first day of delinquencY, or nine (9) .onths and one (1) day fro. the date of
death, to thll date of paYllant. Texes which bacallll del1nqullnt before January 1, 1982 baar Interest et thll rete of
six (61.) percent per annuli calculated at a dallY rete of .000164. All taxes which becalle delinquent on and aftllr
January 1, 198Z will bllar interest at e rata which will vary fro. calendar yaer to calendar year with that rato
ennounced by the PA DlIpartDlInt of RAvenuII. Thll applicable lntllrost retlls for 1982 through 1998 are:
'!!!!: Intnrest Reto Daily Intorut Factor !2r Intllrest Rata Daily Intarut Factor
1982 201. .000548 1987 9Z .000241
1983 161. .000438 1988-1991 ll~ .000301
19&4 ll~ .000301 199Z 91. .000241
1985 15~ .000356 1993-1994 n .000192
1986 10;: .000214 1995-1998 91. .000241
--Interut is celculatlld .. follows:
INTEREST = BALANCE OF TAX UNPAID X NU"BER OF OAYS DELINQUENT X DAILY INTEREST FACTOR
--Any NoticII issulld after the tux bocollos daUnqullnt 101111 refillct an Intllrcut calculation to fIftalln (15) days
beyond the dfite of the assuSIIent. If pay.lInt Is madll aftllr tho interllst cOlllputation datil shown on the
Notice, additional interest .ust be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Mildred C. Koob
Date of Death: September 3, 1997
Will No. 21-97-0762
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes x No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No x
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes x No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:
I-\,LV6I~lfl
L--'d01717~
Signa ture
'0$
w:-.::
q;::
N
':'!"
C"')
0...
James D. Boqar, Esquire
Name (Please type or print)
One West Main St.
Shiremanstown, PA 17011
Address
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(717) 737-8761
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