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Home My WebLink About01-25-08 (2) -', .. Ci-L~~-'W" -.{ -.J 15056051058 REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Number Date of Death OFFICIAL USE ONLY ~ou~ty C~de Year INHERITANCE TAX RETURN RESIDENT DECEDENT File Number 21 07 0566 Date of Birth 377-44-4157 05/30/2007 10/08/1945 Decedent's Last Name Suffix Decedent's First Name MI Carl T Baranski (If Applicable) Enter Surviving Spouse's Information Below Spouse's LastName. Suffix First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Ce;J 1. Original Return C:1 2. Supplemental Return C) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate ctl C) 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit(date of death C.;;) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name NumbM 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received ...L. 8. Total Number of Safe Deposit Boxes C) John M. Eakin First line of address Market Square Building Second line of address -0 :l: I_I ~- - I N W City or Post Office State ZIP Code DATE FILED Mechanicsburg PA 17055 Correspondent's e-mail address: quare Building, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY '" . DATp' r" c....s.( ~ ,?.;- , L 15056051058 Side 1 15056051058 ---.J ~ 15056052059 REV-1500 EX Decedent's Social Number Decedent's Name: Carl T Baranski RECAPITULATION 1. Real estate (Schedule A). .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 145,000.00 250,447.37 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 399,406.61 61,604.60 6. Jointly Owned Property (Schedule F) c::::> Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::::> Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 856,458.58 56,027.20 9,505.90 65,533.10 790,925.48 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . .. ... .. .... .. ...... .. . ..... . ... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)X.0_. 15. 16. Amount of Line 14 taxable at lineal rate X.O _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 790,925.48 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 790,925.48 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT c::::> L 15056052059 Side2 15056052059 --.J REV 1500 EX Page 3 File Number - j r-n-:;-j ,.... ....--~-... ........m .. W.,<'.'.O'n_A______'__,'__.,,,,' . I 21 1 07 10566 , Decedent's Complete Address: ".........._n. .~"".,.,..,'"."",'.^o^W>."._,,, '<'W'^,N^"" .O~", ,,,,.,, ""'~ DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Carl T Baranski 377-44-4157 STREET ADDRESS 7825 Molly Pitcher Highway CITY I STATE I ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 94,911.06 75,000.00 3,947.25 Total Credits ( A + B + C ) (2) 3. InterestJPenalty if applicable D. Interest E. Penalty 78,947.25 TotallnterestJPenalty ( 0 + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (3) (4) (5) (5A) (5B) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 15,963.81 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 15,963.81 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the Lise or income of the property transferred;.......................................................................................... D ~ b. retain the night to designate who shall use the property transferred or its income; ............................................ D ~ c. retain a reversionary interest; or.......................................................................................................................... D [i/ d. receive the promise for life of either payments, benefits or care? ...................................................................... D [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D [iJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [K] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 PS. ~9116 i[a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers 10 or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDE/IIT ESTATE OF FILE NUMBER Baranski Carl. T. 21 07 0566 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 wming buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. ,Real property which is jointly-owned with riaht of survivorship must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION Southhampton Township, Franklin County, single family brick residence, lot 110 x 200 7825 Molly Pitcher Highway, Shippensburg VALUE AT DATE OF DEATH 145,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 145000.00 . REV-1503 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Baranski. Carl T FILE NUMBER 21 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 07 0566 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH See Attachment Page(s) TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 250447.36 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, T. Decedent's Name Page 1 21 07 0566 File Number Schedule B - Stocks & Bonds ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. DESCRIPTION Series I Bond, 1 @ $5,000.000 + interest $588.00 or Susan M. Hill, located in bank box VALUE AT DATE OF DEATH 5,588.00 Series HH Elond, 2 @ $1,000.00 or Deborah L. Hill, located in bank box 2,000.00 Series HH Eland, 4 @ $1,000.00 pod Deborah L. Hill 4,000.00 Series I Bonds, 5 @ $1,000.00 + interest $1,914.00 pod David C. Hill 6,914.00 Series I Bonds, 5 @ $1,000.00 + interest $1,914.00 pod Deborah L. Hill 6,914.00 Series I Bonds 1 @ $5,000.00 + interest $1,984.00 pod Susan M. Hill 6,984.00 Series EE Bonds, 88 @ $500.00 + interest $30,530.00 or Julia A. Hill, predeceased Carl T. Baranski 74,530.00 Series EE BI:>nds, 142 @ $50.00 + interest $12,964.72 or Julia A. Hill, predeceased Carl T. Baranski 20,064.72 Series EE Bonds, 1 @ 25.00 + interest $35.74 or Julia A. Hill, predeceased Carl T. Baranski 60.74 Series EE Bonds, 2 @ $100.00 + interest $544.16 or Julia A. Hill, predeceased Carl T. Baranski 744.16 Series EE. Bonds, 19 @ $250.00 + interest $6,587.00 or Julia A. Hill, predeceased Carl T. Baranski 11,337.00 Series E Bonds, 14 @ $37.50 + interest $3,227.74 or Julia A. Hill, predeceased Carl T. Baranski 3,752.74 Series E Bonds, 58 @ $75.00 + interest $24,185.48 or Julia A. Hill, predeceased Carl T. Baranski 28,535.48 Series E. Bonds, 7 @ $150.00 + interest $6,269.12 or Julia A. Hill, predeceased Carl T. Baranski 7,319.12 Series E. Bonds, 3 @ $375.00 + interest $7,150.60 or Julia A. Hill, predeceased Carl T. Baranski 8,275.60 SUBTOTAL SCHEDULE B 187,019.56 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, T. Decedent's Name Page 2 21 07 0566 File Number Schedule B - Stocks & Bonds ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 16. Series E Bonds, 5 @ $750.00 + interest $21,510.40 25,260.40 or Julia A. Hill, predeceased Carl T. Baranski 17. Series I Bonds, 8 @ $1,000.00 + interest $4,906.00 12,906.00 or Julia A. Hill, predeceased Carl T. Baranski 18. Series EE Bond, 1 @ 250.00 + interest $143.00 393.00 or Stella A. Baranski, predeceased Carl T. Baranski 19. Series EE Bonds, 4 @ $250.00 + interest $488.00 1,488.00 Stella A. Baranski, deceased or Carl T. Baranski 20. Series EE Bonds, 4 @ $500 + interest $966.40 2,966.40 Stella A. Baranski, deceased or Carl T. Baranski 21. Series HH Bonds, 2 @ $5,000.00 10,000.00 or Julia A. Hill, predeceased Carl T. Baranski 22. Series HH Bonds, 3 @ $1,000.00 3,000.00 or Julia A. Hill, predeceased Carl T. Baranski 23. Series HH Bonds 1 @ $500.00 500.00 or Julia A. Hill, predeceased Carl T. Baranski 24. Series I Bonds, 5 @ $1,000.00 + interest $1,914.00 6,914.00 pod Susan M. Hill SUBTOTAL SCHEDULE B 63,427.80 GRAND TOTAL SCHEDULE B $ 250,447.36 REV-150B EX + (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Baranski Carl T 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. 0566 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH See Attachment Page(s) TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheels of the same size) 399 978.97 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, T. Decedent's Name Page 2 21 07 0566 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. DESCRIPTION Bank of Montreal Account #2431 8049-433, see attached VALUE AT DATE OF DEATH 813.96 Pentagon Federal Credit Union Account #165589-01-1, see attached 234.10 Pentagon Federal Credit Union Account #165589-02-9, see attached 2,634.72 Pentagon Federal Credit Union Account #1597681-03-8, see attached 57,077.80 Pentagon Federal Credit Union Account # 1723798-22-7, see attached 1,363.42 Pentagon F,ederal Credit Union Account # 1798027-22-1, see attached 1,282.00 Pentagon Fl3deral Credit Union Account #1930350-22-6, see attached 2,756.09 Pentagon FE~deral Credit Union Account #1723800-47-8, see attached 1,363.42 Pentagon FE~deral Credit Union Account #178028-47-6, see attached 3,205.01 Pentagon FE!deral Credit Union Account #4020452-47-2, see attached 3,894.16 Orrstown Bank Account #102000416, see attached 58,726.38 Patriot Federal Credit Union Account #2100-00 Prime Share Account, 03-"Old House" Savings Acct., 04-New Car Savings Acct., 10-Vacation Club, 25-DraftAcct., 31-3 mon IRA Cert, 33-Roth IRA 1 year, 40- Roth IRA 1 year, see attached State Farm Bank Account #1005436199, see attached 87,851.57 5,268.35 Sovereign Bank Account # 3561006175, see attached 15,822.95 Sovereign Bank CD #3535150381, see attached 11,157.17 SUBTOTAL SCHEDULE E 253,451.10 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, T. Decedent's Name Page 3 21 07 0566 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 16. M&T Bank Checking Account #10222883, see attached 23,390.28 17. M& T Bank Savings Account #015004208643955, see attached 330.62 18. Computer Sciences Corporation CSC Matched Asset Plan, see attached 89,229.34 19. Computer Sciences Corporation CSC Employee Pension Plan, see attached 10,903.66 20 Cash 3,877.11 21 Met Life Refund 235.89 22 Refund AN'::..., Comcast, State Farm 59.53 23 Sale of Coins, U.S. News Refund, Cash 5,649.08 24 2005 Chrysler 12,000.00 25 Personal Property- empire dresser, blanket chest and stool 280.00 SUBTOTAL SCHEDULE E 145,955.51 GRAND TOTAL SCHEDULE E $ 399,406.61 5878 B~IO e Bank of Montreal Charlene Drouillard Financial Services Co-Ordinator Everyday Banking BMO Bank of Montreal 3100 Howard Avenue Windsor, Ontario N8X 3Y8 Tel.: (519) 972-4629 Fax: (519) 972-1190 \ llWllltJ"I.O[' B.\to 0 Financial GrOllp Your Branch DEVONSHIRE MALL WINDSOR Transit number: 2431 For questions about your statement call (519) 973-3360 Direct Banking 1-800- 363-9992 www.bmo.com POBOX 706 SHIPPENBURG PA 17257 UNITED STATES Your Everyday Banking statement For the period ending June 18, 2007 Summary of your account Total Total Closing Opening amounts amounts = balance ($) on THANK YOUI + A((ount balance ($) deducted ($) added ($) June 18, 2007 We appreciate your business. Interest CheQuin~ Account # 2431 8049-43 813.96 1.00 0.03 812.99 Here's what happened in your account Dale Description Amounts deducted from your account ($) Balance ($) Amounts added to your account ($) ~ Interest Chequing Account # 2431 8049-433 Owner: MR CARL T BARANSKI May 19 Opening balance 813.96 May" 31'" Sicitenlerli 'Fee'" . ... . , . . .. . ... ,. . . . .. . .. , ....... . , . ...' . ,. .. '1:00" . , . .. ... . .. . . .. . . . ,. . . , ... . , .. . 'Ma'y' 31' . . interesi '[arned . . . , . . . . . . . . . . . . . . , . . . , . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . --~-LOO- MR lAbJ/,!Xt.),{r June 18 closing tlotals Please check this statement and report any errors or omissions within 30 days of deliver . ......-0( ,\ :\ . . ! , \ - t. ,! _,I).. . C , ; \ U "'J" ....;\ I Page 1 of 2 {' (~ .~ "',I t ~\::- '"', i:"'" I.,,' "'~' 1/ ~ \ !, 'i' .J" , J- HAICOO-Q1-4-5FO , I . \~, r, II " ~ lJ ~ \ \, , I :,,~'I\ \..... ;ZoO" '!:>O ~,,~ ~ ~,~ I ~ I \, '--r \ .~.+_.......\ \ ,i " -",/'" /1 , (! ,}'- -1- ., ...... (..' 'i-__'-ti., , i,-.,....- , .-, Ji '.... ;-' Pentagon Federal Credit Union PO Box 247009, Omaha, NE 68124-7009 Superior Rates. Proven Service.~ 1-800-247-5626 www.PenFed.org August 3" 2007 Mr. Paul L Zablocki 57 Sample Bridge Road Mechanksburg, P A 17050 RE: Carl Thomas Baranski File # 165589 Dear Mr. Zablocki: We are writing in response to your letter dated July 27, 2007. We are very sorry to learn that Ms. Stella A Baranski and Ms. Julia Hill are also deceased. We understand there are many things requiring your attention at this time, but we do need your assistance for the necessary documents required for closing the accounts. Please forward the following as soon as possible: L IRA Form 735. Required to distribute the IRA funds from the accounts. Since Ms. Baranski and Ms. Hill both predeceased Mr. Baranski, the accounts on which they were listed are now considered individually owned. Since we have received the Death Certificates and the Court Appointment, we are required by Virginia law to advertise for potential claimants in a newspaper for four consecutive weeks. The funds cannot be disbursed for another 30 days after the publication of the last of this series of advertisements. The cost of this advertising will be deducted from the balance in the account prior to settlement by check to the Estate. (The current cost is $60.00). We have sent the ad placem~llt ltoday. .,," Please also complete and return the enclosed IRA Forms 735, required to disburse the IRA funds to tht~ Estate. Please find below the date of death values for Mr. Baranski's accounts per your request: Account Number Principal Balance Dividend Accrued Total DOD Balance 165589-01-1 $ 234.05 $ 0.05 $ 234.10 165589-02-9 $ 2,634.60 $ 0.12 $ 2,634.72 1597681-03-8 $ 57,037.44 $ 40.36 $ 57,077.80 Page 2 RE: Carl Thomas Baranski File # 165589 Account Number Principal Balance Dividend Accrued Total DOD Balance 1645748-40-9 $ 0.00 $ 0.00 $ 0.00 1723798-22-7 $ 1,361.85 $ 1.57 $ 1,363.42 1798027-22-1 $ 1,280.57 $ 1.43 $ 1,282.00 1930350-2:2-6 $ 2,753.52 $ 2.57 $ 2,756.09 1723799-43-1 $ 0.00 $ 0.00 $ 0.00 1723800-47-8 $ 1,361.85 $1.57 $ 1,363.42 178028-47--6 $ 3,201.44 $ 3.57 $ 3,205.01 4020452-4'7-2 $ 3,890.42 $ 3.74 $ 3,894.16 We are returning the Death Certificates and Short Certificate as we have verified the Seals and made l:opies for our files. A business reply envelope is enclosed for your convenience. To help us serve you better, please include the above mentioned account number. If you have any questions, please call us toll-free at 1-800-247-5626. Sincerely, Lauriel L Nelson Estate Accounts Specialist Enclosures U') = V) .-. N .-. = = = 0.0 = 0.0 = ...... = I .-. = = I .-. = = I .-. N .-. = =0.0 == I 0.0 N= =...... == I...... V) U') a<N a<...... 0.-. - ~ '" '" '" ORRSTOWNBANK A Traditioll of Excellence P.O. Box 250 Shippensburg, PA 17257 ORRS Date 6/05/07 Primary Account Enclosures Page 1 102000411: - iiiiiiiiiiiiiii 1...111...1..1.1.1.1.1...111...1...111....11..11....11..1.1..1 121 0.6804 AV 0.312 TR00001 - - - - - Carl T Baranski POBox 706 Shippensburg PA 17257-0706 - Building? Buying? Remodeling? We can help! 1.888.0RRSTOWN - orrstown.com CHECKING ACCOUNTS Account Title Carl T Baranski RMA Checking Account ---~--~ Account Num:ber-~ Previous Balance 2 Deposits/Credits 1 Checks/Debits Service Fee Interest Paid Current Balance Check Safekeeping Statement Dates s--{O-7/<)7---Chru Days In The Statement Period Average Ledger Average Collected Interest Earned Annual Percentage Yield Earned 2007 Interest Paid 10200 ()>t It1~- 73,726.38 2,814.75 15,000.00 .00 11. 54 61,552.67 6/05/07 30 70,195.50 70,195.50 11. 54 0.20% 69.89 ACTIVITY :rN DATE ORDER Date Description 5/29 Check 161 6/01 CIVIL SERV US TREASURY 312 PPD 6/01 H/HH INTST BUR OF PUB DEBT PPD 6/05 Interest Deposit Amount 15,000.00- 2,774.75 Balance .,.~~ /':2'tr':~8 61,501.13 40.00 61,541.13 11.54 61,552.67 Date Clzeck No 5/29 161 * Denotes missing check numbers CHECK SUMMARY Amount 15,000.00 Interest 1i~ate Summary 5/06 0.200000% .__':" ':'. ..".::.,o,r.~-' ";,.,~:~:,-,-...'~.",.".,'r..,..;:,,....i.'c,~~',:"~"',,":-'""" .C.."" ......,..-....,....." ..",., . Bffi~ MEMBER'S STATEMENT OF ACCOUNT:~ 95$3.4n7 \\\\\\'1"1/1111 ,\\\\ 50 60 1111'1 '-.'1 40 I;)'J ~'30 MPI-I ''l ~ 80 ~ ~ ",,"" ..... 20 ie' 90Q,P" ~ I 'w "" if ~~ ~;::. =:-10 j ':~~~ij~;! Ar!lH! 100' 1/ -~..-.., ;. (1 Send Inquiries to: P.O. Box 778 Chambersburg, PA 17201 FEDERAL CREDIT UNION Honest, Straightforward Answers *- ..... ---- ---- N;;;;;;;;;;;;; ---- "'- 0- 0- * 4777 1 AV 0.312 I...III...I..I.I.IIII.I...III...I...III....II..J 1....11..1.1..1 CARL T BARANSKI PO BOX 706 SHIPPENSBURG PA 17257-0706 :'0 11 0 ..:::: Sign up for a vehicle loan now through June 30 and you will save ONE PERCENT off our regular rate. It'll mean big savings for you and your family! Stop by any branch for details. www.patriotfcu.org. Patriot Federal Credit Union. 717-263-4444 . SMARTLine: 717-263-8468 CHECK OUT OUR: JUNE VEHICLE LOAN SPECIAL. SAVE ONE ANNUAL PERCENTAGE RATE OFF OUR REGULAR RATE FROM JUNE 1 - 30, 2007. PFCU AND YOU. LET'S GROW OUR FUTURE TOGETHER. Account Number XXXXXX21 00 Page 1 of 2 Statement Period 05-01-07 thru 05-31-07 SUMMARY OF YOUR STATEMENT INFORMATION PRIME SHARE ACCOUNT - 00 1,644.79 "OLD HOUSE" SAVINGS ACCOUNT -03 18,085.49 NEW CAR SAVINGS ACCOUNT - 04 10,993.16 VACATION CLUB - 10 10,733.08 DRAFT ACCOUNT - 25 3 MONIRA CERTIFICATE - 31 ROTH IRA 1 YEAR - 33 ROTH IRA 1 YEAR - 40 0.00 29,039.14 5,211.48 12,144.73 PRIME SHARE ACCOUNT - 00 Dividends Earned YTD: $92.21 Eft Trans ~ ~ Amount Balance 05-01 1,644.79 05-31 1,644.79 "OLD HOUSE" SAVINGS ACCOUNT - 03 Description Balance Forward Ending Balance Dividends Earned YTD: $33.37 Eft Trans _. __ .~ ~.. AmouJ;!t _ Balan~ 05-01 18,085.49 05-31 18,085.49 NEW CAR SAVINGS ACCOUNT - 04 Eft Trans Date ~ 05-01 05-31 VACATION-CLUB - 10 Eft Trans ~ ~ 05-01 05-31 DRAFT ACCOUNT - 25 Amount Balance 10,993.16 10,993.16 Amount Balance 10,733.08 10,733.08 l?~scriDtion. _~~~____~__ Balance Forward Ending Balance Dividends Earned YTD: $20.29 Description Balance Forward Ending Balance Dividends Earned YTD: $6.61 Description Balance Forward Ending Balance Amount Dividends Earned YTD: $0.00 Eft Trans ~ ~ 05-01 05-31 Balance 0.00 0.00 Description Balance Forward Ending Balance .~~~ atrlot Account Number: XXXXXX2100 Statement Period: 05/01/2007 - 05/31/2007 Page 2 of 2 FEDERAL CREDIT UNION Honest, Straightforward Answers 9654 .4m 3 MON IRA CERTIFICATE. 31 Dividends Earned YTD: $374.58 Eft Trans _ Date Date >I- 05-01 ~ N~ 05-31 ~ N - ~ "'- o _ ROTH IRA 1 YEAIA - 33 - o Eft Trans >I- ~ Date 05-01 05-31 Amount Balance Descriotion 29,039.14 Balance Forward 29,039.14 Ending Balance 3 MON IRA CERTIFICATE will mature on 07/10107 Dividends Earned YTD: $58.15 Amount Balance Descriotion 5,211.48 Balance Forward 5,211.48 Ending Balance ROTH IRA 1 YEAR will mature on 03/28/08 ROTH IRA 1 -YE-AB. 40 . n DivideRds-Eamed-~D: $150.43. .. Eff Trans Date ~ Amount Balance Description 05-01 12,144.73 Balance Forward 05-31 12,144.73 Ending Balance ROTH IRA 1 YEAR will mature on 04/09/08 ---. - --. . -- -. - -,- .--........-.-...--.-.---.---.--.-.------ -,.--.----.-----. ----- --~---------_.,----_._,. "-_._.~-~.---~ Document2 STATE FARM . .,. Bank~ INSURANCE @ July 19, 2007 John MEakin Attorney at Law Market Square Building Mechanicsburg, PA 17056 Re: State Farm Bank@ Account Number(s) 1005436199 Dear Mr. Eakin: We recently received your request regarding the account number(s) listed above. Carl Baranski had one account with State Farm Bank. Our records indicate Carl Baranski's date of death as 05/30/2007. The balance as of that date is as follows: Account ~ Balance Interest ENP 1005436199 CD $5,268.35 $5.22 If you have any questions, please contact State Farm Bank toll-free at 1-877 -SF4-BANK (1-877-734-2265) and ask to speak to a Bank Service Specialist. Sincerely, State Farm: Bank Operations Center Special Accounts Unit/J22M MEMBER FDIC P.O. Box 2316 BLOOMINGTON, ILLINOIS 61702-2316 G:r EQUAL HOUSING LENDER ~,;~,~1)'"'911,.~~~''.:'"':"-.f'''-'''I!"~;'~q'..."..~,,~~~..t'~''' ~~~ereign Bank: -"'-'""'"."-~"'~'." ,., ""',,,,"'-.'~> ''''-'--'.'',:''_'''''':'':''':''''<'.'' .. STATEMENT OF ACCOUNTS page 3 of3 3561006175 _Sovereign BanK STATEMENT OF ACCOUNT~ page 3 of3 3561006175 m1M&TBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 July 10, 2007 John MEakin Attorney At Law Market Square Building Mechanicsburg, Pennsylvania 17055 Re: Estate of: Carl T Baranski Social Securitll:. 37-7.444157 Date of Death: Mall 30, 2007 Dear Sir or Madam: Per a memo from Barry Sheller at M&T Bank, dated July 06, 2007, please be advised at the time of death, the ballillce on the above referenced account was: 1. Type of Account Checking Account Account Number 10222883 Ownership (Names oj) Carl T Baranski * Opening Date 04/01/76 Closed 07/06/07 $23,390.21 Balance on Date of Death Accrued Interest $ 0.07 Total $23,390.28 2. Type of Account Savings Account Account Number 015004208643955 Ownership (Names oj) Carl T Baranski * Opening Date 08/25/75 Closed 07/06/07 $ 330.61 $ 0.01 Balance on Date of Death Accrued Interest Total 330.62 * For further account information, regarding ownership, closures and/ or reimbursement of funds, etc., please contact the Mechanicsburg Office # 717-697-1515. M &T Bank DOD Unit / Records Management Computer Sciences Corporation wWW.CSC.COIll 20 July 2007 The Estate of Carl Baranski c/o Paul Zablocki 57 Sample Bridge Road Mechanicsburg, P A 17050 SUBJECT: CSC Matched Asset Plan CSC Employee Pension Plan rrr ....,.. Dear Mr Zablocki: Thank you for the requested documents - beneficiary address information and death certificate for Carl Baranski. The following is the valuation data that you had requested. CSC Matched Asset Plan vested account value as of May 30,2007 was $89,229.34. CSC Employee Pension Plan value of contributions and interest as of June 1, 2007 was $10,903.66. These accounts will be split in accordance with the Designation of Beneficiary form that is on file and I willi be sending letters of notification to each of the beneficiaries. If you have any questions, please contact me at 858.794.2745 or ifogel@csc.com. Sincerely, /) y If0.J ',1 i.L 1 ~I'Lt_ 1 j 7 ,fit Joanne Fogel Administrator CSC Corporate Retirement Plans .2] O() East Grand Avenue PI Segundo, California <)()245 .3\0.6150:\\1 , REV-150Q EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN . RESIDENT DECEDENT ESTATE OF 8ara~ski Carl T SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21 07 0566 If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Deborah L. Hill 2605 Rutledge Street Trenton, MI48183 Niece B David C. Hill 5437 Steadman Street Dearborn, MI 48123 Nephew c Susan M. Hill 2965 Rosewood Street Trenton, MI 48183 Niece JOINTLY-OWNED PROPERTY: LEITER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE IINCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER A IT ACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST Sl~e Attachment Page(s) TOTAL (Also enter on line 6, Recapitulation) $ 61,604.60 (If ome space IS needed, Insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, T. Decedent's Name Page 5 21 07 0566 File Number Schedule F-2 - Jointly-Owned Property LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 1/2002 Series I Bonds 2 @ $5,000.00 + Interest $2,736.00 12,736.00 50. 6,368.00 2. A 1/2003 Series I Bonds 2 @ $5,000.00 + Interest $1 ,956.00 11,956.00 50. 5,978.00 3. A 5/2004 Series I Bond 1 @ $5,000.000 + Interest $588.00 5,588.00 50. 2,794.00 4. A. 1/2002 Series EE Bond 1 @ $2,500.00 + Interest $498.00 2,998.00 50. 1,499.00 5. A. 4/2002 Series EE Bonds 2 @ $5,000.00 + Interest $1,856.00 11,856.00 50. 5,928.00 6. A. 1/2002 Series EE Bonds 4 @ $500.00 + Interest $398.40 2,398.40 50. 1,199.20 7. A. 4/2002 Series EE Bond 1 @ $500.00 + Interest $92.80 592.80 50. 296.40 8. A. 1/2003 Series EE Bonds 10 @ $500.00 + Interest $704.00 5,704.00 50. 2,852.00 9. A. 1/2003 Series EE Bonds 2 @ $2,500.00 + Interest $704.00 5,704.00 50. 2,852.00 10. A 1/2003 Series EE Bond 1 @ $5,000.00 + Interest $704.00 5,704.00 50. 2,852.00 11. B 1/2002 Series I Bonds 2 @ $5,000.00 + Interest $2,736.00 12,736.00 50. 6,368.00 12. B. 1/2003 Series I Bonds 2 @ $5,000.00 + Interest $1,956.00 11,956.00 50. 5,978.00 13. B. 5/2004 Series I Bond 1 @ $5,000.00 + Interest $588 5,588.00 50. 2,794.00 14. C. 1/2003 Series I Bonds 2 @ $5,000.00 + Interest $1,956.00 11,956.00 50. 5,978.00 15. C. 1/2002 Series I Bonds 2 @ $5,000.00 + Interest $2,736.00 12,736.00 50. 6,368.00 SUBTOTAL SCHEDULE F.2 60,104.60 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, T. Decedent's Name Page 6 21 07 0566 File Number Schedule F-2 - Jointly-Owned Property LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTSINTERES 16. A. 12/2002 Series HH Bonds 2 @ $1,000.00 2,000.00 50. 1,000.00 17. A. 1/2002 Series HH Bond 1 @ $1,000.00 1,000.00 50. 500.00 SUBTOTAL SCHEDULE F-2 1,500.00 GRAND TOTAL SCHEDULE F-2 $ 61,604.60 T REV-1511 EX+(12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN , RESIDENT DECEDENT ESTATE OF Baranski Carl T. ITEM NUMBER A. B. 1. 2, 1. 2. 3. 4. 5. 6. 7. 8. 9, 10, 11, 12, 13, 14, 15, 16, 17. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 07 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: Cremation Service Inc. Auer Crernation- Urn ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Paul L. Zablocki Social Security Number(s)/EIN Number of Personal Representative(s) 379.44-1280 StlreetAddress 57 Sample BridQe Road City MechanicsburQ State PA Zip 17055 YEiar(s) Commission Paid: 2008 Attomey Feles John M. Eakin Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Stlreet Address City Relationship of Claimant to Decedent State Zip Probate Fees Letters Testamentary Accountanfs Fees Tax Return Pre parer's Fees Orrstown Bank -estate checks Mike Clark -house cleaning Waste Management- dumpster Charles E. Garner, Real Estate Appraisal Cumberland Law Journal, estate notice The Sentinel, estate notice Register of Wills, Filing Fee Spruce it Up - Lawn maintenance Bank of Montreal Service Charge Carolyn Greeg Cost of Selling Real Estate - 1 % Transfer Tax -1450.00 Brokers Comm. 5.5% -7975.0 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 0566 AMOUNT 1,500.00 99.00 20,000.00 20,000.00 488.00 23.60 1,470.00 1,400.00 350.00 75.00 190.34 15.00 742.00 69.26 180.00 9,425.00 56 027.20 REV-1512 EX + (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Baranski. Carl. T. FILE NUMBER 21 07 0566 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH See Attachment Page(s) TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9505.90 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, T. Decedent's Name Page 4 21 07 0566 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 1. Shippensburg Health Care Center 2,831.00 2. Critical Carle, medical bill 188.95 3. Chambersburg Hospital 414.68 4. Embarq, phone bill 274.31 5. Chambersburg Anesthesia Association, medical bill 123.00 6 Guilford Water, water bill 103.00 7 State Farm Auto, auto insurance bill 373.23 8 WSEMS Ambulance 273.31 9 Chambersburg Pathology, medical bill 8.30 10 Millennim (L TC) System, medical bill 197.09 11 Franklin COlmty Heart Center, medical bill 34.00 12 Urology Association, medical bill 34.80 13 Pleasant Halll Fire Department, ambulance 531.32 14 Cumberland FMA, Sewer 156.00 15 Penelec, electric 188.09 SUBTOTAL SCHEDULE I 5,731.08 Continuation of REV-1500 Inheritance Tax Return Resident Decedent Baranski, Carl, 1. . Decedent's Name Page 5 21 07 0566 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16 Shipley Energy, oil 1,129.01 17 State Farm Visa 426.19 18 Carlisle Re!gional Medical Center 16.79 19 Shippensburg EMS 50.00 20 Pulmonary Association, medical bill 70.20 21 Keystone Medical 57.00 22 Parkway Nl3uroscience 19.90 23 C.v. Nephrology 39.20 24 Cumberland Valley Association 137.05 25 Balhara Medical 15.00 26 Heat Center 83.50 27 Shippensburg Real Estate Taxes 1,517.73 28 PA Department of Revenue- Tax 125.55 29 Medical Bill 87.70 SUBTOTAL SCHEDULE I 3,774.82 GRAND TOTAL SCHEDULE I $ 9,505.90 '''V'''''''''w COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER . r.::Irl T 21 07 O"ihh RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS pnclude OUtri3ht spousal distributions, and transfers under Sec.9116(a (1.2)] 1. Deborah Lynm~ Hill Niece 1/3 of net residue 2605 Rutledge Street Trenton, MI 48183 2. Susan Marie Hill Niece 1/3 of net residue 2965 Rosewood Street Trenton, MI 48183 3. David Carl Hill Nephew 1/3 of net residue 5437 Steadman Street Dearborn, MI 48126 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. TOTAL OF PART][I - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space IS needed, Insert additional sheets of the same size) J LAST WILL AND TESTAMENT OF CARL T. BARANSKI I, Carl T. Baranski, of7825 Molly Pitcher Highway, Shippensburg, Franklin County, Pennsylvania, being or sound and disposing mind, memory, and understanding, do hereby declare this as and for my last will and testament hereby revoking all wills and codicils previously made by me. FffiST I direct payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. SECOND I give my entire estate to the following named individuals in the following proportions: A. I give one-half of my estate unto my sister, Julia Ann Hill, per stirpes. B. I give one-half of my estate to be divided into three equal shares, unto my niece, Deborah Lyqn Hill, my niece, Susan Marie Hill, and my nephew, David Carl Hill. THmD I direct that any and all Inheritance, Estate and Transfer Taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. FOURTH In addition to the powers conferred by law, I authorize my personal representative in their absolute discretion: . .- .~ A To retain in the form received, and to sell either at public sale or private sale any real or personal property, and to distribute to heirs either in cash or in kind. B. To manage real estate. C. To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principle of diversification. D. To exercise any option or rights arising from ownership of investments. E. To compromise claims without court approval and without the consent of any beneficiary. FIFTH I nominate, constitute, and appoint my friend, Paul L. Zablocki, as Executor of this my last will and testament. In the event of the renunciation, death, resignation, or inability to act for any reason whatsoever of my said friend, Paul L. Zablocki, I nominate, constitute and appoint my sister, Julia Ann Hill, or ifunable to act for any reason whatsoever, my niece, Deborah Lynn Hill, as surviving Executrix of this my last will and testament. I hereby relieve my personal representative from the necessity of posting security in connection with their duties as such in any jurisdiction in which they may be called upon to act insofar as I am able by law to do so. IN WITNESS ~HEREOF, I hav~her~uryto set my hand and seal to this my last will and testament, this ,/ 'I day of '/9li/l~! Ai. ' 2~02. d / /. ./;; I I . l / f ./ i. I / /........ y' './ / [ /., ". 'i /.," i' "/'., // ~' ,"':';;;;". ./ /"/".,.,, /".,: ;:,({- I),t... /1...."\. ,/ , Carl T. Baranski Signed, sealed, published and declared by the above named testator, Carl T. Baranski, ,as and for his last will and testament in the presence of us, who, at his request, in his sight J and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ><::::::::/ "-~"'" ~ - ." .' ;.''Y..../1.'<~..17 . '. / ~~//./;'(d.~--9''\.~ /~. "/;{~?"'- residing at .;:::;-;;;2:;,:;;?z;?<tZ!!k~') "-./::J .A......../ ,;;7 /~ 1/ .~ :<'vl /.)',."/j/"I2:"." '. / residing at 6ee"'"".;-/f, /.It . ~ COMMONWEALTH OF PENNSYL VANIA SS COUNTY OF FRANKLIN I, Carl T. Baranski, the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. We, the undersigned, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his last will; that the testator signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the will as a witness; and that to the best of our knowledge the testator was at that time eighteen (18) or more years of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and acknowledged before me by Carl T. Baranski, the testator, and ~om to or affirmed and s~bscribed t." b~fI1~ bY. /, (ii,. ,", ;/'::., /". '" '"j and ;;(:, ,C,,' /' j/!/i. . WItnesses, thIS ;,J (lay of: ',.l 2002. . , .-I i / I / i /<"'~/L.) ~>,;~:;;,;?/?;~;3'>0z_' :k!'" WITNESS ,f ( ,.J' ." . '- "<Ct. !;.,><:!'/ac-, \y) WITNESS; / .",- ( " i ,/ ....'., './ (." "\ / ff-.' .' ," . ---,q >{ -'1 /-, c - ,- ,,' C', ,'" NOT Y Notarial Seal Carol J. Varner, Notary Public Chambersburg 80ro, Franklin County My Commission Expires Apr. 4, 2005 .~ CjlO v'll j -))~ 800, ot I\Po 15U ,,(f) if: J Yro