Loading...
HomeMy WebLinkAbout11-09-07 . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -0 7 0 1 6 5 COuNTYCOOE -VEAR- - - NuMsER- - I- Z W C W o w c DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 1 78- 1 4 - 0 4 0 9 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 02/08/2007 09/20/1921 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER W I- l!l: :SII) olll:l!l: wa.o :c 00 o fal a. 00( IX] 1. Original Return D 4. Limited Estate IX] 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Retum o 4a. Future Interest Compromise (dale of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trusl) o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) D 3. Remainder Return (dale of death priorlD 12-13-82) D 5. Federal Estate Tax Retum Required Q.. 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE !! DIRECTED TO: NAME COMPLETE MAILING ADDRESS Joel R. Zullin er 14 North Main Street, Suite 200 FIRM NAME (If Applicable) Zullin er Davis P.C. TELEPHONE NUMBER 717264-6029 Chambersbur PA 17201 I- Z W Q Z o a. II) w Ill: Ill: o o z o i= :5 ::) l- n: <C o w 0:: z o i= ~ ::) D.. :E o o >< ~ 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) OFFICIAL USE ONLY 225,376.99 361,114.82 223.472.411, 25,813.54 c:...-, I. .~ (8) 835,777.76 86,660.04 1,766.97 (11) (12) (13) 88,427.01 747,350.75 506,059.14 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 241,291.61 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 0.00 X _(15) 0.00 0.00 X _(16) 0.00 0.00 X .12 (17) 0.00 241,291.61 X .15 (18) 36,193.74 (19) 36,193.74 20. 00 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESll0NS ON REVERSE SIDE AND RECHECK MATH < < Decedents Com lete Address: ST EET ADDRESS 625 Brenton Street CITY Shippensburg STATE PA ZIP 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 36,193.74 37.601.81 1.979.05 Total Credits (A + B + C) (2) 39,580.86 3. Interest/Penalty if applicable D. Interest E. Penalty 4. Total Interest/Penalty (D + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) 0.00 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF 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 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ D 00 c. retain a reversionary interest; or ...................................................................................................... D 00 d. receive the promise for life of either payments, benefits or care? ............................................................. D 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................. D 00 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 00 D (4) (5) (5A) (5B) AGENT 3,387.12 0.00 5. 0.00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS PA 17257 DATE ADDRESS 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. ~9116(a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV;1502 EX <"e". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kaluoer Georoe 21 07 0165 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real Drooertv which is iointlv.owned with riaht of survlvorshlD must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION Gross proceeds from sale of real estate situate at 625 Brenton Street, Shippensburg, PA, to Elizabeth Effenberger VALUE AT DATE OF DEATH 225,000.00 2. Received on proration of real estate taxes on above sale 376.99 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 225376.99 REV;1503 EX.. '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF KaluQer. GeorQe FILE NUMBER 21 07 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0165 ITEM NUMBER 1, DESCRIPTION Investment Account #50000178005, Orrstown Bank, consisting of investments as shown on attached date of death valuation Accrued income on above investment account 2. VALUE AT DATE OF DEATH 358,250.83 2,863.99 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 361 114.82 REV-'508 EX .,(0-. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kaluger. George FILE NUMBER 21 07 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with right of survivorship must be disclosed on Schedule F. 0165 VALUE AT DATE OF DEATH 5,601.50 16,370.65 642.47 28,007.70 6.61 5.62 53,674.87 5.06 71,575.67 24,943.50 226.71 9,438.75 109.92 14.44 811.12 2.65 ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. DESCRIPTION Checking Account #502448, Orrstown Bank, including interest accrued to date of death Certificate of Deposit #400011466, Orrstown Bank, including interest accrued to date of death Regular shares in Account #0178140409, Pennsylvania State Employees Credit Union, including interest accrued to date of death Certificate of Deposit in Account #0178140409, Pennsylvania State Employees Credit Union, including interest accrued to date of death Money Handler in Account #0178140409, Pennsylvania State Employees Credit Union Regular shares in Account #1178140409, Pennsylvania State Employees Credit Union, including interest accrued to date of death Certificate of Deposit in Account #1178140409, Pennsylvania State Employees Credit Union, including interest accrued to date of death Prime Share Account #361780, Patriot Federal Credit Union, including interest accrued to date of death Certificate of Deposit held in Account #361780, Patriot Federal Credit Union, including interest accrued to date of death Gross proceeds from sale of personal property by Dan Hershey Auction Service, LLC Refund from Fogelsanger Bricker Funeral Home on prepaid funeral bill Refunds, Highmark Blue Shield Refund, Reader's Digest Refund, Time, Inc. Pro-rated benefit payment, Shippensburg University Refund, AT&T TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 220 732.41 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Kaluger, George Decedent's Name Page 1 21 07 0165 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 17. Refund, Antietam Health Services 75.00 18. Prorated benefit payment, PA State Employees' 817.34 Retirement System 19. Refund, National Georgraphic Society 19.00 20. Veterans burial benefits 100.00 21. Refund, Comcast Cable 28.52 22. Refund, U.S. Treasury tax refund 8,255.31 23. Travel Memorabilia appraised by Dan Hershey's 2,740.00 Auctioneering Service SUBTOTAL SCHEDULE E 12,035.17 GRAND TOTAL SCHEDULE E $ 223,472.41 REV-,510 EX 1 '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF KaluQer. GeorQe SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY FILE NUMBER 21 07 0165 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INClUDE THE NAME OF THE TRANSFEREE, THEIR RElATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF APPliCABLE) VALUE 1. Annuity Contract with lNG, with estate as named beneficiary 4,929.26 100. 4,929.26 2. Ameriprise Annuity Contract #930020904601004, 20,884.28 100. 20,884.28 beneficiary Shippensburg University Foundation TOTAL (Also enter on line 7 Recapitulation) $ 25,813.54 (If more space is needed, insert additional sheets of the same size) REV-1511 EX.",. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kaluger Geon~e ITEM NUMBER A. 1. B. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 07 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Orrstown Bank Social Security Numbe~s)/EIN Number of Personal Representative(s) 23-0934350 Street Address 75 East KinQ Street City ShippensburQ State PA Zip 17257 Yea~s) Commission Paid: Attorney Fees Joel R. Zullinger Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip Probate Fees Register of Wills - Probate Petition 460.00; Will 15.00; Codicil 15.00; short certificates 40.00; JCP fee 10.00; automation fee 5.00; filing return 14.00 Accountanfs Fees Tax Return Prepare~s Fees Magisterial District No. 09-03-01, citation for failure to remove snow and ice Nancy's Lock & Key Service, changing locks at residence Hawkins Construction Company, snow removal for February and March 2007 Tracy McMichael, work at residence following decedent's death Amy Yeagy, work at residence following decedent's death Lefler Energy, utility services Penelec, utility services Lefler Energy, utility services Borough of Shippensburg, utility services Penelec, utility services Penelec, utility services Penelec, utillitv services TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0165 AMOUNT 30,100.00 27,500.00 0.00 559.00 86.00 84.99 315.00 196.00 250.00 173.00 207.25 173.00 94.85 65.71 29.05 44.08 86 660.04 Kaluger, George Decedent's Name Continuation of REV-1500 Inheritance Tax Return Resident Decedent Page 2 21 07 0165 File Number Schedule H - Funeral Expenses & Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. Lefler Energy, final bill for utility services Penelec, final bill for utility services Valley Heating & Cooling, LLC, maintenance at residence Glenn Nave, lawn maintenance at residence S.W. Barrett Real Estate & Appraisals, appraisal of real estate Dan Hershey, appraisal of travel memorabilia Comcast Cable, balance due on account Cumberland Law Journal, advertise letters News-Chronicle, advertise letters Orrstown Bank, fee for preparation of personal income tax returns for decedent Dan Hershey Auctioneering, commission and expenses sale of personal property Sailhamer Real Estate, commission on sale of real estate Notary fees on sale of real estate Fee for deed preparation sale of real estate Realty transfer tax on sale of real estate Borough of Shippensburg, final utilities sale of real estate Angela Facchinei, 2007 County & Borough real estate taxes, sale of real estate 1,020.47 81.03 665.56 100.00 325.00 150.00 28.52 75.00 101.75 250.00 7,015.02 13,500.00 12.00 100.00 2,250.00 195.93 911.83 SUBTOTAL SCHEDULE H.B7 26,782.11 REV-1512 EX l (6-98) \ . SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Kaluaer. George FILE NUMBER 21 07 0165 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Shippen Cleaners, balance due on account VALUE AT DATE OF DEATH 14.10 2. Comcast Cable, balance due on account 28.52 3. Equipped for Life, balance due on account 36.00 4. Fayetteville Volunteer Fire Department, balance due on ambulance service 470.00 5. Franklin County Medical Associates, balance due on account 61.94 6. WSEMS-Chambersburg ALS/BLS, balance due on ambulance service 286.02 7. Embarq, balance due on telephone service 42.96 8. AT&T, balance due on telephone service 6.11 9. PA Department of Revenue, tax due on 2006 personal return 183.00 10. News-Chronicle, balance due on account 17.00 11 . MetLife, check written prior to death but not processed through decedent's account until after death 64.40 12. Check written from decedent's personal account for home nursing services prior to death but not processed through the account until after death 556.92 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,766.97 ""-:'" "'. '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER 21 07 0165 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS [include OUtri~ht s~usal distributions, and transfers under Sec. 9116 (a (1. )] 1. Valerie Drogus Collateral 93,835.62 660 Nobel Drive 1-C 17.5% of residue Santa Cruz, CA 95060 2. Carol Ann Drogus Collateral 93,835.62 14 Marvin Street 17.5% of residue Clintoon, NY 13323 3. Jhan Mason Collateral 18,767.13 4472 Casa Sierra Vista 3.5% of residue Paradise, CA 95969 4. Daniel Weitzel Collateral 13,405.09 6971 Mauna Loa Lane 2.5% of residue Naples, FL 34113 5. Sally Leith Beals Collateral 13,405.09 1651 Coral Terrace 2.5% of residue North Ft. Lauderdale, FL 33068 6. John Roddick Collateral 8,043.06 601 Baltimore Road 1.5% of residue Shippensburg, PA 17257 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. Shippensburg University Foundation; specific bequest per THIRD A; net real estate 211,147.21 Shippensburg, PA proceeds 208,407.21; memorabilia 2740.00 2. Shippensburg University Foundation, to be added to the George and Meriem F. Kaluger 128,688.84 Academic Enrichment Fund Shippensburg, PA 24% of residue 3. Shippensburg University Foundation, to be added to the George and Meriem Kaluger 42,896.28 Human Heritage Fund Shippensburg, PA 8% of residue TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 506059.14 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Kaluger, George Decedent's Name Page 4 21 07 0165 File Number Schedule J - Beneficiaries - 2B B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 4. Shippensburg University Foundation, to be added to the Kaluger and Sweely Scholarship Fund Shippensburg, PA 3% of residue 5. Shippensburg University Foundation, to be added to the Fashion Archives Fund Shippensburg, PA 1 % of residue 16,086.10 5,362.03 6. Slippery Rock University Foundation, to be added to the George and Meriem Kaluger Academic Award Fund Slippery Rock, PA 3% of residue 7. Grace United Church of Christ, to be used for general church purposes 121 East Orange Street Shippensburg, PA 8% of residue 8. St. Elie Romanian Orthodox Church, to be used for general church purposes Ellwood City, PA 1 % of residue 16,086.10 42,896.28 5,362.04 9. Shippensburg Historical Society, to be used for general society purposes 52 West King Street Shippensburg, PA 5% of residue 10. Shippensburg Civic Club c/o Mrs. William J. Fay, 220 N. Prince Street, P.O. Box Shippensburg, PA 1% of residue 11. Shippensburg Rotary Club, to be used for the establishment of a Rotary Foundation Paul Harris Fellow award in memory of George Kaluger c/o John A. Scott, III, P.O. Box 572, Shippensburg, PA 1% of residue 26,810.18 5,362.04 5,362.04 SUBTOTAL SCHEDULE J.2B 123,326.81 BREAKDOWN OF RESIDUARY ESTATE Net value of estate subject to tax Less specific bequests as set forth in paragraph THIRD, Subparagraph A of will: Gross proceeds from sale of real estate, including amount received on proration of real estate taxes less the following: commission on sale notary fees deed preparation transfer tax final utilities County & Borough taxes 13,500.00 12.00 100.00 2,250.00 195.93 911.83 Travel memorabilia Residuary estate to be distributed among named beneficiaries 225,376.99 -16.969.70 $747,350.75 -208,407.21 - 2.740.00 $536,203.54 ( :;:1 ~ ~ JRZ - 5.1 kaluger.l January 23, 2004 LAST WILL AND TESTAMENT I, George Kaluger, of 625 Brenton Street, Shippensburg, . Pennsylvania, being of sound and I disposing mind, memory and understanding, do hereby declare this to be my will, hereby revoking any arid all former wills and. codicils thereto by me heretofore made. FIRST I direct that all my just debts and funeral expenses, including all expenses of my last illness,. shall be pa~ from gny =0 -.J estate as soon as practicable after my decease as a p~~qgr;Sf tfj]e expense of the administration of my estate. _\~~~~ g; SECOND _On ::-3 ~ .~~ I -..., :0..2 ==i o .::- :l> -- --'-'.Ir. I give, devise and bequeath the residue of my estate of every nature and wherever situate to my wife, Meriem F. Kaluger, providing she shall survive me by thirty days. THIRD Should my wife, Meriem F. Kaluger, predecease me or die on or before the thirtieth day following my death I give, devise and .-:J~ :~Q~~ ..: ~ l~': ~J :.~8 ~:- ;:~; c-r:~ _0-- -'001 ~-_:::. (-"'j .- ," (~. ':.' <~) -71 bequeath the residue of my estate of every nature and wherever situate as follows: .A. I give my home situate at 625 Brenton Street, Shippensburg, Pennsylvania, my travel-artifacts, various collections of objects, paintings, pictures and slides and series. of books to the Shippensburg UnilVersity Foundation, Shippensburg, Pennsylvania. In the event the Shippensburg University Foundation does not want some or all of the aforementioned artifacts, then the same shall next be offered to the Shippensburg Historical Society, Shippensburg, Pennsylvania. Finally, in the event all of the aforementioned items have not been retained by either the Shippensburg University Foundation or the Shippensburg Historical Society, the Shippensburg Public Library of Shippensburg, Pennsylvania, shall have the option to receive the remaining articles. B. The balance of the residue of my estate of every nature and wherever situate shall be distributed as follows: 1. Twenty-four percent to the Shippensburg University ~ Foundation, Shippensburg, Pennsylvania, to be added to fund the George and Meriem F. Kaluger Academic Enrichment Fund; 2. Eight percent to the Shippensburg University Foundation, Shippehsburg, Pennsylvania, to be added to the George and Meriem Kal uger Human Heri tage Fundi Page 2 3. Three percent to Shippensburg University Foundation, Inc., Shippensburg, Pennsylvania, to be added to the Kaluger and Sweely Scholarship Fundi 4. One percent to the Shippensburg University Foundation, Inc., Shippensburg, Pennsylvania, to be added to the Fashion Archives Fundi s. Three percent to the Slippery Rock University Foundation, Slippery Rock, Pennsylvania, to be added to the George and Meriem Kaluger Academic Award Fundi 6. Eight percent to the Grace United Church of Christ, Shippensburg, Pennsylvania, to be used for general church purposes; 7. One percent to the St. Elie Romanian Orthodox Church, Ellwood City, Pennsylvania, to be used for ~ ~ y. r ~ general church purposes; 8 . Five percent to the Shippensburg Historical Society, Shippensburg, Pennsylvania, to be used for general society purposes; 9. One percent thereof to Shippensburg Civic Club, Shippensburg, Pennsylvania, to be used for general club purposesi 10. One percent thereof to the Shippensburg Rotary Club,Shippensburg, Pennsylvania, to be used for the establishment of a Rotary Foundation Paul Harris Fellow award in memory of George Kaluger; Page 3 11. Seventeen percent thereof to Valerie Drogus,if she survives me; 12. Seventeen percent thereof to Carol Ann Drogus, if she survives me; 13. Three percent thereof to Jhan Mason, if she survives me; . 14. Three perceI1;t thereof to Cornell Kaluger, if he survives me; 15. Two percent thereof to Daniel Weitzel, if he survives me; 16. Two percent thereof to Sally Leath Beals, if she ' survives me; 17. One percent thereof to Jack Roddick, if he survives me; I ...7 t ~ 18. In the event any of the aforementioned beneficiaries named in subparagraphs 11 through 17 should predecease me or die on or before the sixtieth day following my death, his or her share shall be distributed equally among my remaining beneficiaries named in subparagraphs 11 through 17. FOURTH In the event that my wife and I should die in a common disaster, which for purposes of this will shall be defined as dying within sixty days of each other, in order to distribute the entire Page 4 t ~ ~ bulk of our estate, including jointly held assets and individually held assets, in a manner that conforms to the above distribution set forth in paragraph Third, it is my desire that all assets held jointly and individually by me and my wife shall be combined and after the payment of all expenses of both estates, and the distribution of any specific bequest, the residue shall be' divided equally between the two estates and my one-half share shall be distributed in accordance with paragraph Third above. Specifically as to the amounts bequeathed to an institution or organization, the maximum amount shall be considered the maximum to be received from both of the estates of myself and my wife, Meriem F. Kaluger. The total amount received from both estates shall not exceed the maximum set forth in each of our wills. It is my intent that these bequests not be doubled by considering each will separately, but rather that the maximum be considered the maximum for both wills. FIFTH Any fiduciary under this will shall have the following powers in addition to those vested in them by law and by other provisions of my will applicable to all property whether principal or income, including property held for minors, exercisable without Court approval, and effective until actual distribution of all property: A. To retain any and all of the assets of my estate, real or personal, without regard principle of to any diversification of risk. Page 5 B. To invest in all forms of property including stock, common trust funds and mortgage investment funds without restriction to investments authorized for Pennsylvania fiduciaries as they deem proper, without regard to any principle of diversification of risk. C. To sell at public or private sale, to exchange 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 or conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. E. To compromise any claim or controversy. F. To distribute in cash or in kind or partly in each. J ~ ~ G. To hold property in their names without designation of any fiduciary capacity or in the name of a nominee or unregistered. SIXTH: I direct that all taxes that may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. Page 6 SEVENTH I appoint my wife, Meriem F. Kaluger, as executrix of this my will. Should my wife predecease me, fail to qualify or cease to act, I appoint Dr. Francis Norton andOrrstown Bank, with principal offices in Shippensburg, Pennsylvania, as co-executors of bhis my will. EIGHTH No bond shall be required of any fiduciary hereunder in any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my last will and testament, consisting of eight typewritten pages, the first six of which bear my signature in the margin for the purpose of identification this ~_~aYOf~~~'~ b'/ /. ~~ ,2~. (SEAL) Signed, sealed, published. and declared by the above-named testator as and for his last will and testament in our presence, who in his presence, at his request and in the presence of each our han~~;:;;J:n;;:;~~/d. ji- 9 /. '''kIf)or ' u'~>4 Page 7 We, George ~~, I Kaluger, \~</~~ and and the witnesses respectively, the testator whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will and testament and that he execu~ed it as his free and voluntary act for the purposes therein expressed and that each of the witnesses, in the presence and hearing of the said testator signed the will as witnesses and to the best of their knowledge said signer was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ,~~ ~/ Subscribed, sworn to and acknowledged before me by the above-named signer and subscribed and sworn to befo~me by the above-named 'tnesses this day of , 2~/ I .... }~~~darSe~r ._~.. '.. -'" : {';,",:n L llsh~el's t~ot!lrv fublie (('>':.-..........!"':..,._t....".,. ..... .... . ~ . I ""~--....,,."-.."'.91 8....00>> rrtJ.~l:gil'1l COl.mt'" r.,! ('_~"":',...:. r!.. t f . ' ~ ./ ;.2 ~"-,,,.,,~....',~,'l ~!:M'~~ E"~!'J! !3, ~Jm5) Page 8 CODICIL .I,George IKaluger of 625 I Brenton Street, Shippensburg, Pennsyylvania being of sound and disposing mind, memory and understanding, do hereby declare this to be a codicil to my will dated February 2, 2004. I. I hereby revoke paragraph Seventh of my said will. o c- s,g -'-0 -1~~ C)("j _ .;,;d .:n :"--- :u --l ::J' "~ Cl IN LIEU THEREOF, I direct that the following be substitute~ I appoint Orrstown Bank with principal offices in Shippensburg, Pennsylvania Executor of this my will. II. In all other respects I hereby ratify, confirm and republish my will dated February 2, 2004 together with this codicil as and for my will. ~ <:::::> = --.J ""'!j f"T1 CD N a I! -.:iTl F'i-oO ~-:;. .~, .::) :~::~~ ::;::; ::::J '. .>c~ :'~~ ~~ '-~-ITl 'J)O -....; :to- ::;;:: IN WITNESS WHEREOF, I have hereunto rlv .. 7 day Of9~A"'AA'''''.O~' 2 M'1- G e.. "JP-. set my hand and seal this hiS X Ko..{vJu 01Ct.V' t (SEAL) Signed, sealed, published and declared by the above-named testator as and for his codicil in our presence, who in his presence, at his request and in the presence of each other hereunto set our hands as attesting witnesses. 1'I<{l ,yr~A--/~-~t/'J ,I( · 9'fN r;aJ'~, (J11~l1w:J.f/J Page 2 ...:-. . OMS NO. 2502-0265 "-r A. \ B. TYPE OF LOAN: U.~. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1-DFHA 2-DFmHA 3.~CONV. UNINS. 4-DVA 5. DCONv. INS. 6. FILE NUMBER: 17. LOAN NUMBER: /11 SETTLEMENT STATEMENT 2007060067 61596466 8. MORTGAGE INS CASE NUMBER: { III C. NOTE: Th/s fom! is furnished 10 give you e statement of ectua/ settlement costs. Amounts paid 10 and by the settlement agent are shoWh/ Items marked "[POCr were paid outside the closing; they are shown here for informational purposes and are not /ncluded in the Io/a/s. 1.0 :we (2007060067 ,PFOl2007060(67161) D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Elizabeth Effenberger First Horizon Home Loans 625 Brenton Street The Estate of George Kaluger and 1555 W. Walnut Hill Lane, Suite 200 Shippensburg, PA 17257 The Shippinsburg University Foundation Irving, 1)( 75038 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT DATE: 625 Brenton Straet Chelsea SetUement Services Shippensburg, PA 17257 July 19, 2007 Cumberland County, Pennsylvania PLACE OF SETTLEMENT 494 East King Street Shippensburg, PA 17237 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 225,000.00 401. Contract Sales Price I 225 000.00 102. Personal ProDerIY 402. Personal ProDerIY 103. SetUement CharQes to Borrower (Line 1400) 9452.09 403. 104. Pawff Mortoaoe 404. 1 05. Pawff Mortoaae 405. Adjustments For Items Paid By Saller in advance Adjustments For Items Paid By Seller in advance 106. CountvlBoro Taxes 07/19107 to 01101108 376.99 406. CountvlBoro Taxes 07119/07 to 01101/08 I 376.99 107. School Taxes to 407. School Taxes to 108. Assessments to 408. Assessments to 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 234,829.08 420. GROSS AMOUNT DUE TO SELLER 225,376.99 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. DeDos~ or earnest monev 2,500.00 501. Excess DeDosit (See Instructions) 202. Princioal Amount of New Loan(s) 213,750.00 502. SetUement Charaes to Sailer (Line 1400 16969.76 203. Existina loan s taken subiect to 503. Existing loan s taken subject to 204. 504. Payoff of first Mortgage 205. 505. Pavoff of second Mortaaae 206. 506. 207. 507. (DeDos~ disb. as Droceeds) 208. 508. 209. 509. Adjustments For Items Unaaid Bv Seller Ad'ustments For Items Unaaid Bv Saller 210. CountvlBoro Taxes to 510. CountvlBoro Taxes to 211. School Taxes 07/01/07 to 07/19/07 98.36 511. School Taxes 07/01/07 to 07/19/07 98.36 212. Assessments to 512. Assessments to 213. 513. 214. WalerlSewerrrrashlRecycling 58.05 514. Water/SewerrrrashlRecvclina 58.05 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER ; 216,406.41 520. TOTAL REDUCTION AMOUNT DUE SELLER 17,126.17 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TOIFROM SELLER: 301. Gross Amount Due From Borrower (Line 120 234,829.08 601. Gross Amount Due To Seiler (Line 420 225,376.99 302. Less Amaunt Paid BvlFor Borrawer (Line 220) ( 216,406.41) 602. Less Reductions Due Seller (Line 520) ( 17,126.1 303. CASH ( X FROM) ( TO) BORROWER 18,422.67 603. CASH ( X TO)( FROM) SELLER 208,250.82 I 'C"7 L (..t.L[/t{)::./ - (J The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any /' L. SETTLEMENT CHARGES 700. TOTAL COIllMISSION Based on Price $ 225000.00 @ 6.0000 % 13,500.00 PAID FROM PAID FROM , Division of Commission line 700 as Follows: BORROWER'S SELLER'S 701. $ 13,500.00 to Sailhamer Real Estate, Inc. FUNDS AT FUNDS AT 702. $ to Sailhamer Real Estate, Inc. SemEMENT SETTLEMENT 703. Commission Paid at Settlement 13,500.00 704. to BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN B01. Loan Ori ination Fee % to B02. Loan Discount % to B03. Appraisal Fee to Schilling Appraisals POC:B300.00 B04. Underwriting Fee to First Horizon Home Loans 250.00 805. Tax Service Fee to Total Mtg. Solutions 90.00 806. Morloaoe Broker Fee to America's Lendina Source 750.00 807. Processing Fee to America's Lending Source 500.00 808. MERS Fee to MERS 3.95 809. Funding Fee to First Horizon Home Loans 45.00 810. Flood Detennination to Federal Flood 26.00 811. Commitment Fee to First Horizon Home Loans 250.00 812. Yield Spread Premium to America's Lending Source POC:1603.13L 813. 814. 815. 816. 817. 818. 819. 820. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 07/19/07 to 08101107 @ $ 39.336000/day ( 13 days %) 511.37 902. Mortaaae Insurance Premium tor months to 903. Hazard Insurance Premium tor 1.0 Years to Erie Insurance Exchanoe POC:B502.00 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 3.000 months $ 53.50 per month 160.50 1002. Mort';s"e Insurance 0.000 months $ 138.94 oar month 1003. Counlv/Boro Taxes 6.000 months $ 69.08 per month 414.48 1004. SchoolTaxes 2.000 months $ 157.94 per month 315.88 1005. Assessments months @ $ per month 1006. months @ $ per month 1007. months l1ll $ oer month 1008. Aoor""ate Adlustment months l1ll $ per month -329.84 1100. TITLE CHARGES 1101. Transnortation Fee to Outsource Out ot Office 250.00 1102. Trtle Search Fee to 1103. Title Examination Fee to 1104. Title Insurance Binder Fee to 1105. Document Preoaration Fee to Joel R. Zullinger Esa. Deed Preo. 100.00 1106. Notarv Fee to Chelsea Settlement Services 20.00 12.00 1107. Attomey's Fees to includes ebove item numbers: 1108. TiUe Insurance to Chelsea Settlement Services 1 483.75 7ineludes above item numbers: ) 1109. Lende(s Coverage $ 213,750.00 1110. Owner's Coverage $ 225,000.00 1,483.75 1111. AL T A Endorsements to Chelsea Settlement Services 8.1/1001300 150.00 1112. Bankruptcy Search Fee to Chelsea Settlement Services 15.00 1113. 1114. Express Overnight Fee to Cheisea Settlement Services 17.00 1115. Closing Protection Letter Fee to Stewart TiUe Guaranty Co. STEWART 35.00 1116. Wire Fee NA 1117. Tax Certification Fee 1118. E-Mail Fee to Chelsea Settlement Services 25.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ ; Mortgage $ 80.50; Releases $ 80.50 1202. Cilv/CounlvTaxlStamns: Deed 2,250.00' Mortaaae Convevance Fee 1,125.00 1,125.00 1203. State Tax/Stamos: Revenue Stamos 2 250.00; Mortoaoe 1125.00 1125.00 1204. Deed Recordina Fee to Chelsea Recordino Account 43.50 1205. Recordino Service Fee to Chelsea Recording Account 20.00 1300. ADDmONAL SETTLEMENT CHARGES 1301. Survey to 1302. Pest Insoection to Chamberlin Pest 75.00 1303. WaterlSewerfTrashlRelOVclino to Borouoh ot Shiooansburo RE: #4003500-0 4003500-0 195.93 1304. Est 2007108 School Tax to Elizabeth Effenberaer 32-34-2413-247 2,000.00 1305. 2007 CountylBorough Taxes to Angela Facchinei RE: #32-34-2413-247 32-34-2413-247 911.83 1400. TOTAL SETTLEMENT CHARGES IEnter on Unes 103, Section J and 502, Section K -" 9,452.09 16,969.76 By '''''01g pag.' oflhi............Ih....,.Iori.. -- _;ptof."'mp_COPYofpago2oflh"two~ ./ L U,(('1~t--.- Chelsea Settlement Services 0 Certified to be a true copy. Settlement Agent (2oo7060067 1200706lX167 /61 ) Page 2 ORRSTOWN FINANCIAL ADVISORS A Tradition. of E:rcelIence Account.: 5000 0178005 GEORGE AND MERIEM F KALUGER INVESTMENT HOLDINGS AS OF 2/8/2007 (DOD) CUSiD No. Security Name Shares I Par DOD Value 000 Price Accrued Income 04344099T 06 TIME DEPOSIT OPEN 52,669.6600 $ 52,689,88 1.00 $35.70 31331 QMZ7 FFCB 5.05 12/27/12 10.000.0000 $ 9,721.90 $ 97.22 $57.51 31331TE64 FFCB 3.06 5/11/07 15,000.0000 $ 14,796.40 $ 98.66 $110.92 3133XOXP9 FHLB 5.5 9/12/13 30,000,0000 $ 29,475.00 $ 98.25 $689.17 3133X1P27 FHLB 410/27/08 25,000.0000 $ 24.250,00 $ 97.00 $260.56 3133X66F8 FHLB 3.565 4/30/0B 20,000.0000 $ 19.471.90 $ 97,36 $194,09 3133X6WJ1 FHL6 5% 5/10/11 15,000.0000 $ 14.683.65 $ 97,B9 $163,33 3133XAZQ3 FHL9 /I 6129/07 10.000.0000 $ 9,900.00 $ 99.00 $43.33 3133XO:?S9 FHLB 5% 9/22/10 15,000.0000 $ 14,725,80 $ 98.17 $263,33 70914'IWJO PA STATE 5% 5/1/20 25.000.0000 $ 26,379.68 $ 105,52 $336.81 951605852 W BRANCH PA 4,8% 20 15.000.0000 $ 15,326.05 $ 102.19 $286,00 MBCD1799A M6NA CD 3.86 6/18/07 27,626.2400 $ 27,626.24 $ 1.00. PFCD1799A F'FCU CD 4.9 10/4/08 71,221.2500 $ 71.221,25 $ 1.00 $354.42 PSCD1799A PSECU CD 4.58/17/09 27,978.8800 $ 27.978,88 $ 1,00 $28.62 TOTALS $ 358,250.83 $2,863.99 DATE: BY: . ORRSTOWNBANK A Tradition of Excellence May 1, 2007 77 Ea...t King Street P.O. Box 250 Shlppcnsbwg, PA 17257 To: Daniel Baer 77 East King Street Shippenshurg Pa 17257 From: Traci Shaffer Orrstown Bank Customer Service Center PO BOX 250 Shippensburg, Pa 17257 Re: Estate of George Kaluger Date of death February 8,2007 IT TS HERER.BY CERT1FJED THAT THE ABOVE NAMED DECEDENT. ON THE A BOVE DATE. HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK. CHECKiNG ACCOUNT Account # Title of Account /502448 George Kaluger Meriem F Kaluger Date ooened Principle Accrued Interest 05/01/81 5601.12 0.38 SA VJNGS ACCOUNT Account # Tjt!e of Account Date opened Principle Accrued Interest CERTIFICATE OF DEPOSTT Account # Title of Account 400011466 George Kaluger Date Opened Princinle 7110/06 16319.61 Accrued Interest 51.04 x 30050726 George Kaluger IRREVOCABLE BURIAL FUND 'jPSE(~ .4"--' u, -':::':":':=:=:... ...., .-.. . ..- .,... March 27, 2007 ACC01.mt # 0178140409 & 1178140409 DANIEL K BAER TRUST OFFICER ORRSTOWN BANK PO BOX 250 SHIPPENSBURG P A 17257 DiZar MR BAE.R! .. The followin~ is tbe status ofGEORCE KULUGER's primary account (0178140409) with rSECU as of the date of death. Joi.nt Owner's Name Date of Death Date of Birth NONE 02.08.2007 09.20.1921 Share SOl ~~ Description Regular Shares MoneyHandler 24 Month Certificate Open date 07.15.1978 Balance $ 642.32 6.16 27,978.88 Accrued Dividend $ 0.15 0.00.' 28.82 / 08.22.2006 The dividend earned from January 1,2007 through the date of death was $156.68. The decedent had no loans with us. We do not have safe deposit boxes for our members. The following is the status of GEORGE KULUGER's prefix account (1178140409) with PSECU liS of the date of death. Joint Owner's Name Date of Death Date of Birth NONE 02.08.2007 09.20.192 ] Share Description Open date Balance Accrued Dividend SOl Regular Shares 05.05.1993 $ .5.49 $ 0.13 S 04 MoncyHandlcr 05,05.1993 I /.E--=:>~ 0.00 t/C 50 60 Month Certificate 05.05.1998 V ( 53,634.44 40.43 The dividend earned from January 1, 2007 through the date of death wa 2.J..!U=1:/ ~"t bdd t....!.&- l)~ . Jfyou have any questions, please ea11234.8484 in Harrisburg 01' our toll-free number, (800) 237.7328. At the menu prompt, enter 6 and then extension 2227. Mea ie Fa' x Member Service Representative Finance Support Unit '..... (~l. Pennsylvania State Employees Crec:lit Union I Main Addn:M$: I Credit Union Place, Harrisburs;!. PA 17110.2990 . 717.234,6484 . 800.237.73281 'Ti,i5c'r~dir'~,;j;Re-ceTve-rTI m-e;~-&?f~!~i'6:~;rfCSr 14'.p ~:i~~~~~fq~f!g~~~;~i~Al~~~;?6-~91 ~ ~. _?l_?.:!_Z.!~?-! qO@QL:. 80~~;e~;:C~~'+ - .. FEDERAL CREDIT UNION April 1.1, 2007 Orrstown Financial Advisors ATTN: Daniel K Baer PO Box 250 Shippensburg, P A 17257 - RE: Estate of Dr. George Kaluger .-. , To Whom It May Concern: I am writing in response to your request for date of death values on the above referenced member. This account was owned jointly with his wife Meriem Kaluger. Account 361780 Prime Share 00 36 Month CD $50K 40 Date of Death Princi a) $5.05 $71,221.25 Accrued Interest $0.01 $354.42 Joint Owners Meriem KaIu er Meriem Kalu er If you have any questions with regard to the above balances, or need additional information, please feel free to contact a Membership Officer at 71.7-263-4444. Sincerely, Patriot Federal Credit Union 800 Wayne Avenue, Chambmburg, "A. * (717) 263-4444" Mailll1l,;Add.ress: P.O. Box 778, ChambcfSbu~, PA 17101.0778 Received Time oct. 10. 1:24PM - . ~_ '~t,. I I : . . . ' . ,DAN HERSHEY'S AUCTION SERVICE, LLC 582-4647 - Steve Ege Cell: 717-385-5438 Chris Bream Cell: 717-226-1920 SELLERS NAME E5t-uf~ of ~orq C? K~l U.9 ~,r DATE 5-'6 -0 '7 - 1 ADDRESS ~tiw\ ()a.,Y\ BeA.r (0)0 a6'o 5~ippff\'5~{9 '7a1,HONE 5~o -3 qQ3 OTHER ~\). \~ ~\\&\\f\'\ 14 ('1\ t,,~t5 p~r ~otki ~t( It\o..f\ AUCTIONEER % \ S ... AUCTION DA TEILOCA TION CLERK % DESCRIPTION OF MERCHANDISE \ ;;(, ffo."(\5~f1\Q ~~~-) J. \\1~r,,~ollt\ \ s[fr ff'I\:(~51 -tlq1 f.c.)Q~F 5(>t (~f~(alAcf :,AJde(1 ~) ~~ ,,~ps{ql (6oK~,"'\t(O~~~ f<'ii~II\~6/() ~o(j ItrY\O~\1"a(Je"()II~ 50~ \~ .' :l~ (~\ (o(O( lV. 1\.1.~~ ~-k~E'''' 1qbf~(4) i kit (hc...,'y ~ R-f(o~'j, vCR. ~ ft\qp(~ (\AJ~iQ"'c\ ~Wf"'~ S~~q ~,^\V\q ~h.OOo..Y\" {j ~eelf\ -to.1l.e. \,JlichA,,'Y5, ~ho9~ ql\~r'\ '\'\11\ IOfV1oy I 1\ cl,rt;{O I M',{fOrr f..CP" ~ ( \ ' . , I \ \\ 5ih)f'f P fft\. 5~ ~ iv'C\Y \.tJih"W\ "bqtyA) I [L\q'O cqb,~er I LVI h. ~ (~to".5 fffn(~ ~t 501,\ e, ~er , . . ,- ~~r;p. , ~tt \\"tr Plc...\\O W~~\ d~e('" 5 ~\.\~,lY\eh Ie tc\,'y\ q u.1\(1'~ (lo(K.' (odf.?.A v.ff'\,'((or , - . . A Qf\t~r ~" pl~~ tlcrl-lV ~\l,,0\.\~1- nt~holCl~ V tl)ee desK H,~~ ("t5+,cJr(1$~rlv{."rfOr ~tl'\C \ - I 5 q""" W~~r ~'l, \ofr ~t b4.by ~)q\l', WOV< IDft.tft\fll" I ( ~.l ktVl (4. t . bl<<c;. D~t1 qld ~~("k.dt$f'~ '~"^tr I , '. · J I , 7 .....(c~(V' :)0..\ ~~"':t~ \'-~i - ~(> ~~e'S Dl J tnC.llll\. ,ldwqr\/) 5f't'(..t.J(lJ'( ~cJI.\~e, po-t'\'l:> ~or\\i 5~(~ ( I fioH 5 .feV { ~U\U\\~'Jt-\ ~e'^t-efj ~~ Oli.\\ ~~ I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or lluthorized represen. tative of the merchandise, goods and or property and bave good title and the right to sell and that they are free from all incumbrances. 1 agree to accept all responsibility for providing merchantable tj,tle and for delivery of title to the purchaser. I agree to hold hannles. the Auctioneers .g~ of tho ""ure marred to in 7~~/ ~O AUCTION SION'ATURE 'J......~ErS SIGNA'tURE Total Sales (Clerking Tickets Attached) $ 2 t.f Q'13. SO Less Sale Expense: IS % Commission Auctioneer $ 3 7 '-II . 's z % Cotnmission Clerks $ OTHER: R~;ldi"C'4 (<:'ert-bJ 1..10, (;.)~ L Cbe,{'" Z 'Ie, 7, so flJu r'7C,,!ilSL- ~ Ir;; '\ h 2 ~:>. 6l'':> TOTAL SALE EXPENSE DEDUC'rED $ 70 1ft 0 z..- SELLERS NET $ 17 Cf Z Pi. t./ 8 . . ~~O - 1 ........24-PM AuR e c e i ve d T I me'lOct. 1. : SELLERS SIGNATURE . J- .......... JoV "''''WI ro. VV.vg ,I' f'H^ NU. \. Appraisal Report Travel Memorabilia George Kaluger. decMsed For BstBIa ofOeorge XaI~ Aloe August~2007 By: Dan~. AllCtioDew Service StaYeQ E. Ese aDd Cbrls Bream Auctioneer j; Appraiser 190 West High Street. Carlisle, P A 17013 717..532--4647 Received Time Oct. 22. 10:04AM P, 03 fD)~fCJJW~~ !I1lGG - 8 ~7 J}; S.lI. FOurJDATION - ,. I '. .. .'~' ,:j~ . Art Dr.partIDen$ VIrious PIIbUiap/Ph:tum.from the Ori-n (1 J) VariOll& Books (16) CMwd B1tpbant Orienbd ClMna PD_aiD Bowl wlStaad (lIp1MM) PaiDted Ivmy Piece (J1lpIMIe) Folded lapmeae P4iD.tlDa Small MJsceu..au Pieces (7) Small OmatDeotal CoDtaiDers _IUds (5) Small om.tWAI Bow1J (BlUs) ()) GoldlWbito 'apmsae Plate wlStaad CatYed Ivory Piece Painted ~ Box wlLitl. Camd Jig wlSiIad C8md Ivory Fipns (p.) IJ'Gft Pipe - H-.l u is ara. F18'R Anim81 Piple Whim Hone on Base DrIp1 r.. OD. Staod san BINs Pip Golden Pi.- wlStabd Small c.v.t.lbw Small CaIwd Box w/Mcmbla LW sman COJll* PJab Metal OWl 0riIIJ!I1 Soldta' on HOl'P wlFlag Smell B1'8I8 Tee Pot (lQdJa) lade Horse Fipre (Type) Wood ~ (BirdIOwI) MamIe Owls Figure (Poq( Side by Side) smaU WoocI&D Tadle Small Wooden Pipn Small ~Pl'O Grcca Ida.! Bell MIlItIl Pl_ w/BaUdy 8rowD.H~g;~TapIStIy-Woval I?ntr1ecl Tapestry l.atp CbD:se IW Pabad Bark Slab Premed 0armsIPiDB (4 CMes) ~ BaakIt of Shells Bro'M\ Caned Paee CHMPns) Wooden BpcMwlPis1A'e OIlEad Carwd Piah w/PiJh Received Time Oct. 22. 10:04AM $11 0.00 S 3OJ)O S 5.00 S 10.00 S 20.00 S 30.00 S 20.00 $ 20.00 S 50.00 S 20.00 S 10.00 S 50.00 S 15.00 S 10.00 . 50.00 S 10.00 S 10.00 $ lO.OO $ 20.00 S 15.00 S $.00 S 15.00 S to.OO $ 15.00 S 10.00 $ 5.00 $ 50.00 S 5.00 S 2S.00 S 20.00 S 40.00 $ s.oo S 5.00 S 5.00 II 15.00 $ 20.00 S 25.00 $ 20.00 I 10.00 $ 10.00 $100.00 S 25.00 . 25.00 S 20.00 S 10.00 . AI1 Deparnn_ c.tbu1td RoIId Carviat-OPeainI at Top (From Mexico) 12 inch Carwd Fapre Wooden Carved Huntar WbitePaintedBlepl1ar4 wt1l ~"I~ (LoqINarrow) Wall HJl!QIi.-'I'bree: Mask llauad Inm CanIster Woodal Bene.... LayiDg Dowa 0rianta1 Marionette Doll II'G'WI1 Elepb- Wooden Carved T1Il1:Ie Small bier Size WoodeD c.ved Ptecea Carved WoodeD BUd Tall WoodID bird Oamug Necldloe- WoodeD CatvlDc BIIdIrd N... VarimIB JewUy"" RecVYc&l1ow Wma Pa B1ackIBro~ ClothF. Stone Q1rvI4 PiIb. MUBic Iascrummt wlBird Small B,. Liatd P-9l'lSWoodeaMaak Wovea MIlk Woodell Carved FJoa LaDg N8I'IOW c.vect Turda Metal Bugs (PTam MCIIDCaO) MeIa1Fieh WocdeD ButuI,y WoodeD Fi&ure SmokiDB a.~ Wooden CIrwd Basket SmaD Wood.eQ Carved tUrtle loDgINsnow Carved MIlk lbsdIGMn PaiDtccl Mask Wooden MasicallasCrUm_ Phpbant Ie ~.,. '10m HualcllOrasa c.ved StniD8 Utxtuil (PIIJIl\ Mali) smalt Brue ARlope Qned~~ Hone S1BtDe TotBl Received Time oct. 22. 10:04AM . 05 S 15.00 S 15.00 S 15.00 S 20.00 S 25.00 S 30.00 S 15.00 S 2$.00 S 2$.00 S 10.00 $ 10.00 S 2$.00 S 10.00 S 20.00 $ 10.00 S 10.00 S 25.00 S S.OO $ 5.00 S 10.00 S 25.00 S S.OO S 20.00 S 20.00 $ 10.00 S 15.00 S 20.00 S 10.00 $ 5.00 S 10.00 S 10.00 S 5.00 S 10.00 S 10.00 S 20.00 $ 25.00 S 15.00 S 5.00 $ 10.00 S 10.00 $1595.00 ) ~t'O~""~- ~~01-'V~ ""'4~'" ~~~ ~ 't\sb. io..u - s-n~'- ""-\ ~ co\OtfG\ ~ ::: ~ ,. fIO'I''' 00.- ~..V'C~oG~ -.1 '81:BI8 ~ \.... _fttd ~\. Clt"eA J;'Je-- M_~f~ _ 14.- -ae\\ ~\.. '" W~'t~fQP' ~~~ '-1 !tal ~ ~~~ ~~~Of~.~i\eVa1WY ~~_'1~_ ;;"_,Clfd($'l'OP __ wOO'l8O _-~~t;~-C&2& 01\ 'tot -\1l~~1o--. --.3. ~ seal -.\ s-n ,eat\ ~ '1\. ""'-..\~fot ~ ,.-Y\-- of. af1III& ~"oodJSl '&eel ""'-l --~ f\I\>>':"" ~ ~-a\tclS . 'l'r.\1 VI........ ~~ ~ 1.'IiDI'" _-.\'Qo\1~ uosn ~ -- ~ "B\d.~MCl --...\ "__'OpeO~-- ~~ . ~ ~atlO'ft~ -..s d._~.l4~\e lAO. ~~~~ ~ leal flOl\\~ Ta\l.& ~~ fot QoIS& -...\ ~ '90\\ for Sb88P vado\\li 3~Y ~ -V.no-1'OO\CI (4\6) 1'otal . j 'rime octn. \~..~4~"^ Rece\'HU \ $ \0.00 $ 15.00 $ l.O.()1) , \5,00 $ \0.00 $ \0.00 $ \0.00 , 5.00 S 5.00 , \0.00 , 10.00 $ \0.00 S 5,00 , 10.00 , \0.00 S '),0.00 S \0.00 , \0.00 $ to.oo , ~S.OO , S.an S \5.00 S \0.00 $~'OO $ \S.oG S \5.00 $ S.OO , \0.00 , ~.OO , ~.OO $ ~O.oo s '25.00 $ 5.00 , \0.00 , ,.00 $ \0.00 , \5.00 $ 21).00 S '}.5.00 S 'lO.00 S \5.00 $ 15.00 $\50.00 $110.00 ~ , . - _____. ..... _..... ......_ .. I r HlI l'4U. . . CeepaplQtJEartJa Seieace DtpfIJ bMIIt ~ RocbIMkwal SaalpIes (6) ~ Apte BoobDds (Pq-) '''-I Vari0a8 Videos ""l AsIortecl SbdII ........ Book - Gboat T~ af'tbc W. $ 50.00 S 25.00 S 20.00 S 25.00 S '.00 5125.00 Total BIoIou' ne.p4 t.._t Assortment otVarlaus SheBa Ship,.,..... UIIIV......, ArttIns -.I Collection of~ ofthf t1JdverIity ~ CoO_em. ofCUerleadiDc Pictures, *- ...) BoodaJiom ~ ~.hintlnp -- SU~ Tofal S 25.00 S 25.00 $100.00 $125.00 It is our opinion that the ~ IlRcm-va1ue ofb above itlms is s~ 740 as of August 2, 2007. s~~~ 4lL~ Christopher A Bream, auc:doneerl1. appraiser Received Time oct. 22. 10:04AM p, 07 Xm~rjprise ct .Financial RlvorSource L1fl! Insurance Company RiverSource Funds Amerlprise C<<tificate Company Amerlpri$e Brokl!rage 70100 Ameriprlse Financial Center Minneapolis, MN 55474 July 5, 2007 MERIEM F KALUOBR 625 BRENTON RD SHIPPENS13URG, PA 17257.2113 RE: GEORGE KALUGER Cheu,t ID; ]0311537 Dear MERIEM F KALUGBR: Upon review of our files, we detennined that documents we previously requested bave not yet been received for tlle accounts in which GEORGE KALUGER is listed as owner, insuTed, annuitant, or fiduciary. Please submit the required documents at your earliest convenience. Please note: If a beneficiary chooses to not complete a claim at this time, it is essential we are notified so we may update our records accordingly. If you are in receipt of this lc::tter as a legal representative of tbe 'elltate, please forward to us any information which will enable us to directly contact the bcnl!:ficjary(ies). More information regarding thc R'ltate Settlement process is available 0.0 the Ameriptise.com web~ite. To view the "Estate Settlement Frequently A~k:ed Questions" page on the website, type "Estate Settlement FAQs" in the search field on the web:;ite bomepage. press tbe "Enter" key and :;elect the fU'st item on the "GJ...()BAL" list. Tfyou have any que:;tions, please contact the AlDeriprisc financial advisor, . at or contact u:; at tbe phone number listed below. Thank you for your assistance. fhy Sincerely, Christine Meath Deatb Settlements Processi.ng Team ""9 70100 A me.l'iprise Financial Center M.inneapolis, MN 55474 1-800-862-7919, Option 5,1 " ..... j: I .;:;; ~ . l~ . ! ';i:::::(';::!~.:nl.l. ".r:. :::,.; :'j1:: f' I,. ~."~I\: :t..!/.,q ;;,':1 ."..\'-, Hi'",~. fih"; ", . /..: . ~ta-6 I IV ~ ~ -~UAj", arC Jl4Yl-~?iA ~ ~~~,.~::!.!;7f~ ~ S-~VT :.:;", :. !':'>;1':>"';\~';:~'::;" ' ':~'~/";';""i~;"'V::"-1 '~'.!J.;/ "', I: ,'II',': ~;::'., '. ",' I, ,,", ..::,,1; \1' : ~~. ~e6'; ~ . : 1\ i.. ~., :. C:', :"''', .:'. " ; ~ ,: .j;r:,~, :.":. -,':"i Insuranae and annuities <'ll'e issued by RiverSource Life Insurance Company, an AmeripriRe An/lll'lciQI company. Amerlprlse Brokerage is provided by Ameriprise financial Services. Inc. Arneriprise Financial ServlCQs. Inc. Member NASD. Received Time Oct. 22. ,10:04AM SHIPPBNSBURO POUNDA TION AnN RHONDA HURST 1871 OJ..D MAlN DR SHIPPENSBURG, PA 172S7 R.e: Abtluity Contract Number 93002090460 1 004 . ....-.- _I. ._1..... II'.... Oar SHIPPENSBURG FOUNDATION: We ba~l approved your reqt.lGSt for tht: Sbippensburg University FoUftdalion to continue to rective payments IU beDCficWy orrha above aDDWI)' ooD1ract. As part of our process, we have c;hanged the owner anll taxpayer Toles to the fQU11dations. PlmallO keep this letter as a record oC this cJuuge aud oC the infonoation outlinM below. Under sc~te QOver, a cheek bas been issued for the $-1-07 tbrollgb 8-1-07 payment(s) that accumulated iD the account after the date we were Mdfied" of the death. In additioD. the foundation is also eIltit1ed to the g.1.07 and 4-1-07 paymcm(s) that generated after the date of death, b\l1: prior to Our being notified. Please COl:Ulct the. estate of GBORGB KALUGBR for reimbLtnC1Dent. Iu per tile termll of1be contract/endorsement, the foUadatiODS will receive 5183..55 monr.bJy until1()'1-2018, the last guaranteed payment date. These paymentl will be made on QrbefoTc the due dare. ACC:Ordilll!: to tax treatment rules outline4 by the Inmul Revenue Service, we have clctenniucd thtt fA)CfJ$lU'e due on this contract in the CL1IICOt year. If you blwe any questions or fUrther service noeds, please contact this office at the Ullephone number listed below. Sinoerel;v. Sally Campion Deferred .J\muitization 701~ Ametiprise Financial Center Minneapolis, MN 55474 1-800-8(;2- 7919, Option S, 1 I, ',' .... ',.;;:, ." , " , ",' ,"" ", ". ~ .' I ~ , , ," "', . I " 'I ". . '~: I' I ~ ,''' '. . I ~" . :"1 r: . ";'0 ~ I~ I. "I,. ., 1'1'. .: Received Time oct. 22. 10:04AM lneuranoe oI'll'lCl "nnll~le!l 8M IULH)C! I:ly FIlverSOIJI'C Life Insurance Company. an Amer1I)l'lM Financial oomP8l'lY. Al'lleriprlse Brol<&ragQ Is prGIItdlllCl by A",etlpriN Financicll ServIces, Ino. Amerlprise Flnenolat ServlO&$, Inc:. ' ~cor NASCl ' .