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HomeMy WebLinkAbout05-14-08 REV-1500 EX + (6-00) .... Z W C W o W C COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICiAl USE ONLY FILE NUMBER ~k - ~EAR\ ~ L~~R-- SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 1 95- 0 7 - 7 969 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 09/13/2007 06/21/1916 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) w ~ l.::-Ul (,)O:::lI:: wQ.(,) :r::~g (,)Q.a:t ~ 00 1. Original Retum o 4. Limited Estate 00 6. Decedent Died Testate (Attach copy of W1K) o 9. Litigation Proceeds Received SOCIAL SECURITY NUMBER o 2. Supplemental Retum o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (AttachcopyofTrusl) o 10. Spousal Poverty Credit (dale of death be\ween 12-31-91 and 1-1-95) o 3. Remainder Retum (date of dealh prior to 12-13-82) o 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) I- Z W o z o Q. '" W 0::: 0::: o (,) TH1$SISCTIONi",,:OS"I'$E:CaMPI,.IS"I'ISDliAl,.l,.iCQRRIS$PONI:>6NGi:.ANI:>iCQNFII:>ISN;J"lAl...TAx..lNFORMAi'IQN)$H()UI,.O.iIi$6iiOIREGTEO..,.O: NAME COMPLETE MAILING ADDRESS James H. Turner Es uire 4415 N. Front Street FIRM NAME (If Applicable) Turner & O'Connell TELEPHONE NUMBER 717-232-4551 Harrisbur PA 17110 z o i= :5 :::>> .... 0:: c( o W 0::: z o i= ~ :::>> ~ :IE o o >< c( .... 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. JoinUy Owned Property (Schedule F) (6) o 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 Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) OFFICIAL USE ONLY 3,005.31 23,076.57' r--..> = = e::o :~ :;:- -< .:::0 ;n, ' ~~ ~ t..,., C-) C) ~?3 ;2~ J iTl ..,.'J '~J , C} ';'1 ,--r"', -n .-' ::~ + -0 ".,:; 0"\ (8) 26,081.88 4,389.58 10,365.88 (11) (12) (13) 14,755.46 11 ,326.42 14. Net Value SUbject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 11 ,326.42 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 11 ,326.42 X .045 (16) 509.69 0.00 X .12 (17) 0.00 0.00 X .15 (18) 0.00 (19) 509.69 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < o d t' C Add ece en s omplete ress: STREET ADDRESS 244 Ewe Road CITY r STATE I ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 509.69 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 0.00 T otallnterestlPenalty ( 0 + E ) 4. If Une 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 line 20 to request a refund (3) (4) 0.00 5. If Line 1 + U!'e 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... 0 IKI b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IKI c. retain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?........ .......................................... ...... ......... .... " .......... ............. 0 IKI 3. Did decedent own an 'in trustfor" or payable upon death bank account or security at his or her death? ................. 0 IKI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 IKI 0.00 509.69 509.69 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. InQer penalties of pe~ury, I declare that I have examined this relum, including accompanying schedules and statements, and to the besl of my knowledge and belief, it is true, correct and complete. 1Claration of preparer other than the personal representative is based on all information of which preparer has any knowledge. 3NATURE OF P-ERSON RESPON IBL FOR FILING RETURN DATE }'y\.. ()..,r-- h1 lDRESS PA PA 17110 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)). For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)). The statute does not exemot 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 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. s9116(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. s9116(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-1503 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Rosenberry. Josephine S. FILE NUMBER ITEM NUMBER 1. All property jointly-owned with right of sUNivorship must be disclosed on Schedule F. . DESCRIPTION VALUE AT DATE OF DEATH 3,005.31 Prudential 33 shares at $91.07/share TOT At (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3.005.31 REV-15GB EX + (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rosenberry. Joseohine S. FILE NUMBER 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. ITEM NUMBER 1. 2. 3. 4. 5. DESCRIPTION Pennsylvania State Employees Credit Union - 18 Month Certificate 1 Credit Union Place, Harrisburg, PA 17110-2990 P.O. Box 67013, Harrisburg, PA 17106-7013 Pennsylvania State Employees Credit Union - 18 Month Certificate 1 Credit Union Place, Harrisburg, PA 17110-2990 P.O. Box 67013, Harrisburg, PA 17106-7013 Pennsylvania State Employees Credit Union - 24 Month Certificate 1 Credit Union Place, Harrisburg, PA 17110-2990 P.O. Box 67013, Harrisburg, PA 17106-7013 Pennsylvania State Employees Credit Union - regular shares 1 Credit Union Place, Harrisburg, PA 17110-2990 P.O. Box 67013, Harrisburg, PA 17106-7013 Wachovia Bank - Checking account 1525 West W.T. Harris Blvd., Charlotte, NC 28288-0376 VALUE AT DATE OF DEATH 2,615.44 2,588.85 2,380.72 1,739.62 13,751.94 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 23.076.57 REV-1511 EX + (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rosenberry. Joseohine S. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representa!!ve (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Turner & O'Connell 500.00 3. Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) 3,500.00 Claimant Betsv J. BinQaman Street Address 244 Ewe Road City Mechanicsburg State P A Zip 17055 Relationship of Claimant to Decedent dauQhter 4. Probate Fees Cumberland County - Register of Wills 140.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. The Sentinel Publication Costs 174.58 8. Cumberland law Journal Publication Costs 75.00 TOTAL (Also enter on fine 9, Recapitulation) $ 4 389.58 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) . SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Rosenberry. Joseohine S. FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Thornwald Home 442 Walnut Bottom Road, Carlisle, PA 17013 nursing home expenses - account number: 1070 2. Holy Spirit Hospital 503 N. 21st Street, Camp Hill, PA 17011 hospital expenses - account number: 1409747 3. The State Employees' Retirement System 30 N. 3rd Street, Room 319, Harrisburg, PA 17101 reimbursement from 9/14/07 - 9/30/07 4. MiIlenium Pharmacy Systems, Inc. 12450 Perry Highway, Suite 200, Wexford, PA 15090 prescriptions 5. Philhaven P.O. Box 550, Mt. Gretna, PA 17064 consult - older adult - account number: 246992 VALUE AT DATE OF DEATH 9,855.08 82.77 288.65 114.85 24.53 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10365.88 REV-"" ",. ",* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER rrv .Im:p.nhinp.~. RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1. Betsy J. Bingaman Lineal 244 Ewe Road Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II _ 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) ~____c-=,," LAST WILL AND TESTAMENT OF JOSEPHINE S. ROSENBERRY I, JOSEPHINE S. ROSENBERRY, of Newberry Township, York County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revok- ing all former wills by me at any time heretofore made. ITEM I. I direct that all inheritance and estate taxes . . becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property shall be paid by my Executrix out of the property passing under ITEM II of this Will, as an expense and cost of administration of my estate. My Executrix shall have no duty or obligation to obtain reimburse- ment of any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. In the absolute discretion of my Executrix, such taxes may be paid immediately, or the Executrix may postpone the payment of taxes on future or remainder interests until the time possession thereof accrues to the beneficiaries. Page 1 of 2 pages ITEM II. I give, devise and bequeath all the rest, residue and remainder of my estate to my husband, Clarence C. Rosenberry, provided that he survives me by thirty (30) days. In the event my husband should predecease me or not survive me by thirty (30) days, then I give, devise and bequeath my entire estate to my daughter, Betsy J. Bingaman, of Mechanicsburg, Pennsylvania. In the event Betsy J. Bingaman should predecease me, I give, devise and bequeath my estate to my son-in-law, George C. Bingaman. In the event both Betsy J. Bingaman and George C. Bingaman should predecease me, I direct that my estate be distributed in equal shares among my grandchildren, Matthew Bingaman, stephen Bingaman, Daniel Bingaman and Mark Bingaman, or the survivors of them. ITEM III. I, nominate, constitute and appoint my daughter, Betsy J. Bingaman, as Executrix of this, my Last Will and testament. In the event she is unable to act, I appoint George C. Bingaman to so serve. It is my desire that my Executrix serve without bond. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, typewritten on one (1) other page, this 13th day of October, 1998. 2 COMMONWEALTH OF PENNSYLVANIA . . SS COUNTY OF DAUPHIN I, JOSEPHINE S. ROSENBERRY, testatrix 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 Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein contained. Sworn or affirmed to and acknowledged before me, by JOSEPHINE S. ROSENBERRY, the testatrix, is 13th day of 0 to er, 1998. : SS COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN . . We, James H. Turner and stacy A. Bolonski, the Witnesses, respectively, 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 testatrix sign and execute the instrument as her Last will and Testament; that JOSEPHINE S. ROSENBERRY signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix was at that time eighteen or more years of age, of sound mind and under no con- straint or undue influence. Sworn or affirmed to and subscribed to before me by James H. Turner and Stacy A. Bolonski, the witnesses, this 13th day of October, 1998. 3 Statement United Church of Christ Homes Thornwald Home 442 Walnut Bottom Road Carlisle, PA 17013 Statement Date: 01/01/2008 Betsy Bingaman 244 Ewe Road Mechanicsburg, PA 17055 Due Date: 01/25/2008 Re: Josephine S Rosenberry Account Nr: 1070 -------------------------------------------------------------------------------- Date Description Days Quant Rate Charges PaYments Balance ---------------------------~---------------------------------------------------- BALANCE FORWARD 11/27/07 PAYMENT 12/12/07 PAYMENT 11/30/07 Medical Supplies 10,020.08 142.02 9,855.08 10,020.08 9,878.06 22.98 .00 -1.00 22.98 -22.98 It's a new year. If you have new insurance information on a resident, please bring it in. THANK YOU STATEMENT OF PHYSICIAN SERVICES SPIRIT PHYSICIAN SERVICES JOSEPHINE ROSENBERRY 1 of 2 205 GRANDVIEW AVE STE 210 244 EWE ROAD CAMP HILL PA 17011 MECHANICSBURG PA 17055-4872 STATEMENT DATE: 11110107 lAST STATEMENT ACCOUNT # 1409747 DATE: 10/06107 IF ANY QUESTIONS, PLEASE CONTACT: SPIRIT PHYSICIAN ....i.J;,iP PERFORMED BY: AIIITI DESAI MD PLACE DF SVC: 21 PERFDIItED AT: lIS 05125107 99232 575.0 SlBSEQUENT taSP, LEVEL II 73.00 06/28107 ~ARE ERA PMT 49..55- 06/28107 ~ARE ERA CONrRIAOJ 11.06- 08131/07 BLUE CROSS MAtlJAL TRANSF 12.39 PERFORMED AT: lIS 05126/07 99231 575.0 SlBSEQUENT IOSP, LEVEL I 49.00 06/28107 II:ARE ERA PMT 27.64- 06128107 ~ARE ERA CONrRI ADJ 14.45- 08131/07 BlUE CROSS MAtlJAL TRANSF 6.91 PERFDRttED AT: lIS 05127/07 99232 575.0 SlBSEQUENT IOSP, LEVEL II 73.00 06128107 II:ARE ERA PMT 49..55- 06128107 II:ARE ERA CONrRI AOJ 11.06- 08131/07 BLUE CROSS MAtlJAL TRANSF 12.39 PERFQ.RMED AT: lIS 05128107 99231 578.0 Sl8SEQUENT IIJSP, LEVEL I 49.00 06128107 II:ARE ERA PMT 27.64- 06/28107 ~ARE ERA CONrRIADJ 14.45- 08131/07 aLUE CROSS MAtlJAL TRANSF 6.91 PERFDRtIEO BV: FARSHAD SEPAHPANAH MD MD PERFDAHED AT: lIS 05129/07 99231 578.0 Sl8SEQUENT IOSP, LEVEL I 49.00 08/16/07 ~ARE ERA PMT 27.64- 08116/07 II:ARE ERA CONrRI AOJ 14.45- 118131/07 BLUE CROSS MAtlJAL TRANSF 6.91 PERFDRI1ED AT: lIS 0SI30I07 99231 578.0 Sl8SEQUENT IOSP, LEVEL I 49.00 08116/07 !CARE ERA PMT 27.64- 08116/07 II:ARE ERA CDNTRI ADJ 14.45- 08131/07 BLUE CROSS MAtlJAL TRANSF 6.91 PERFOIItED AT: f6 05131/07 99233 276.8 Sl8SEQUENT ImP, LEVEL II 102.00 08116/07 ICARE ERA PMT 70.82- 08116/07 tl:ARE ERA CCJmVADJ 13.48- 118131/07 BLUE CROSS MAtlJAL TRANSF 17.70 PERFDRMED AT: f6 06101/07 9CJZ38 276.8 IIJSPITAL DISCHARGE <30 HI 100.00 08116/07 ICARE ERA PMT 50.59- 08116/07 ~ARE ERA almVADJ 36.76- 08131/07 BLUE CROSS MAtlJAL TRANSF 12.65 BALKE: JOSEPHINE RDSYERRY ta2.77 THIS ACClIM' IS SERIULY PAST 1lJE. IF PAYMENT IS ' ReCEI.gD YCIJR BALANCE MILL 8E REFERRED FOR COLLECTION ACTION AND DISCHARSE FRIll PRACTICE MAV OCCUR. PLEASE RaIIT IlltEDIATELV. g~~:~"\~:::;~ ;:?:>~;~'~ ~~(/~?Zi~'f." ,~. 'l'.:3fJBI!.......-....---.-- ~;r.~~.;t::,~..l/~!~J:~"Y.~: .~"~}J~i CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK r J[ J~ i~ g~ i~ a ;;::S, tJ' "" 55 0 S' tJ' <1l 0 ~ ~ o ~ ff ~ <1l .... s: Q ~ g ,. ,po : "'C o > 3 ~ o 0\ -l>o , -l>o 16 .g:'"" 3 g 2: ~ 11.<> 'Tl po :1 p., 00 o o 3 ~ 00 o o --- '0 w N b ", VI '0 m ~ , 00 o N .g:'-l>o 3 ~' ...., ... ":E'::i -..,::::i ::r'-' N ~ '? N ~ "" r~l 'I [~I li::li Iz 181 ~ 1~1i' ~ I!~ ! I ~ i ., lpo I I W ;2-: ( 3. :~l In I I ~ I r-' I 1JJ i c> 1-' 'Ii ; I' I~' jl ~ · :i I ~ i Ii !; : ,,1M I Ii I r;; i II IH~I--f II ~> ~I, a I i' i .a 11.<> e:..1 .. I "O~....,I~ I I ~ I ~I~ I' I ~,~ ;;;! \'';' II, .., 0'< ..... ~ I ~ is.;' g' I I I ~ s ~I I I i :~ I~,I" i I i I: I'~'I ~_I5;-+~ I I I ~ I I> (j I I I Ii I ""I a cr I! 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"l:I )- ~ .... :3 '" o 0 ~ S ~ ~ ~ = ~ff8~ o (') :;:l ::::! 0 0 w ::I '" _ '" (1) N c:: ::I o ~ g- ~ 9 ~ Q.. . ~ ~ ~ ~ c -g.. ...... ::i" /II (/l ~ .-... p ~ ~ 0"1 0.0 (j \0 ; N .. '-' tl: 8 /II = ... Q .. "l:I ~ '< a ~ :s .... '" V. /II ~ ~. '" ~ Q ., -<: Q c: "'l ~ '" Q a If> :;:l:l ~ n ~ ~' ~ Q. 1JJ 5' n ~ t" ~ '" .... 1JJ ~ t:C 0 III ~ ; 3 ;' 0 g ; Ol ~ :-:- ~ f{ ~ "l:I ., ~ Q' = '" ~ ~ ;- 1JJ a s- III .... = /ll .... = /ll :I .... QI'l QI'l N N QI'l QI'l "" .j>. = ~ v.!J.QQ (,W~~~ ~~ -< <: ('0 ('0 3 3 r::r r::r ('0 ~ .., N .Cf\ - N N o 0 o 0 ~ ~ "'tl r- ~ en m ;;0 m s: :::j ~ s: m z -l -l q ~ r- ~ ~ <:: s: '"'0 S ::0 ~ o -<: cn rJj iT! s: $I> ~ ~I; ~I> :O:IiI!:: + ~m ~ ~ . ~n t:l t-3 I-' o :::JIl c:: t:l I-' o:l:lJl (') N *m 1-3 :s: . ~i: H trJ w >:Ot:lN :::::::::::Z ~ (f.l la):i :~:i :::~:::::::::::: :--.:.:-:::::::: 1 + tJ c:: trJ ~Jli (') ~ ":.:".: i;S t:l oi<~ N :~;i'~ ~~ ilii. i I@ m; ::~t::. t i.::;.. ~ ;iii: :>K: t :: ':::1' ~ '; rJ \I~ :'.S~ 8~ ... .. ~ l> ~ * * :::j::3:;: I: I-'g I-'::i!r I!:>:':li{ ~I: ..... "" 4ll. ~ '"'0 ~ ::0 -<: ~ Ci) ::t: ~ :< en s;; n:I "" 8 gl I-' I-' UJ I-' lJ1 ~ ::8:. .:~.: 'E1' @o .:....::0 l- \{ ol= ol= C ~ ~ ~ ~ i!~ imi ~} ~ co c::. PSE(~ November 28, 2007 Account # 0195XXXXXX JAMES H. TURNER 4415 NORTH FRONT ST HARRISBURG,PA 17110 Dear MR. TURNER: The following is the status of JOSEPHINE S. ROSENBERRY's account with PSECU as of the date of death. Joint Owner's Name Date of Death Date of Birth NONE 09.13.2007 06.16.1916 Share SOl S 04 C 50 C 50 C 50 Description Regular Shares MoneyHandler 18 Month Certificate 18 Month Certificate 24 Month Certificate Open date 10.16.1963 10.16.1963 08.28.2000 06.27.2000 04.11.2002 Balance $1,739.62 0.00 2,615.44 2,588.85 2,380.72 Accrued Dividend $0.71 0.00 4.36 4.51 3.37 The dividend earned from January 1,2007 through the date of death was $249.36. The decedent had no loans with us. We do not have safe deposit boxes for our members. Betsy Bingamin was removed February 22, 2007as joint tenant with right of survivorship; she had been added as joint owner on Febraury 27, 1995. If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Pennsylvania State Employees Credit Union Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 . 717.234.8484 . 800.237.7328 . Moiling Address: P.O. Box 67013, Harrisburg, PA 17106-7013 . 717.777.2100 (TO D) . 800.472.1967 (TOD) This credit union is federally insured by the Notional Credit Union Administration. Equal Opportunity Lender www.psecu.com ~ax Transmittal 11/20/2007 12:50 PM PAGE 1/002 Fax Server =:~~ ..,- ~ ......- "'WAcHOVl'A Reference ID: 2242526 Wachovia Bank N.A. Balance Confirmation Services POBox 40028 Roanoke, VA 24022-7313 November 20,2007 TURNER & OCONNELL ATTN: JAMES TURNER ATTORNEYS AT LAW 4415 NORm FRONT STREET HARRISBlJRG, P A 17110 SUBJECT: Verification / Confirmation of Account and Balance Information provided for: Customer: JOSEPHINE S ROSENBERRY (SSN# XXX-XX-7969) Date of Death: September 13,2007 DeDosit Account Information Account Type Account. Number Date of Dead I Balance Average Balance" Date Opened Maturity Int.erest. Accrued YTD Date Date Rate Interest Interest Paid Closed CHECKING XXXXXXXXX3083 LEGAL TITLE: JOSEPHINE S ROSENBERRY CLOSING BALANCE: S13751.94 $13,751.94 1/211950 9/18/2007 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Receipt Date: Rece~pt Time: Recelpt No. : 9/18/2007 12:32:24 1049918 ROSENBERRY JOSEPHINE S Estate File No. : Paid By Remarks: 2007-00851 BETSY BINGAMAN JA ------------------------- Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST WILL AUTOMATION FEE SHORT CERTIFICATE JCP FEE Check# 2946 Total Received......... 90.00 15.00 5.00 20.00 10.00 ---------------- $140.00 $140.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 December 7, 2007 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: James H. Turner, Esquire Josephine S. Rosenberry Estate RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. ============================================== Advertisement inserted on following dates: November 23, November 30, and December 7, 2007 Advertising Cost 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 75.00 Total Amount Due $ 0.00 ------- ----- Becky H. Morgenthal, Executive Director c.n o e::: o u w e::: e::: ::> o >- e::: o u... ;2 o i= e::: o a.. c.n :c t- ;2 <C t- W e::: N t- ot< I'-z 0 05 LO ole .........~ . ~ 0'\ <( 0'1 <( N Vl 0 <JlN 0......... ~ N ~~ D.. r-! a: ~ r-! C) ::; Vl ....:I ....:I t- <:0 <:0 0 ~ I'- I'- zLOLO 0 <:0 ~o wO ::> . . LO <(......... t-......... o I'- I'- I'- . 0 00'1 <(LO ~\O\O ~ t) C)N Or-! t- r-! r-! 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UJ.Q ~I :>,UUJ Vl ~ 'Ol'ClI-lE-i l'Cl w ::e ~ l'Cl ::l ><;:!Q) a> M.!:l UJ l'Cl0r-l E-i o r-! E-!-n HE-! 1X.l~~ a: w l- LL. <( * ~ ,/ v/ TURNER AND O'CONNELL Attorneys at Law 4415 NORTH FRONT STREET HARRISBURG, PA 17110 Telephone 717/232-4551 800/870-3859 Facsimile 717/232-2115 The enclosed documents are submitted for filing with your office. check(s) for the required feels are enclosed please return time-stamped copies in the envelope provided please certify _ copy(ies) and forward to the Sheriff for service Turner & O'Connell By o ~~ ::fO ~~~ Fn ......~~ -\ .' C") r) ,>)9~ J<....- : :D .0-1 "po f'-.;) = <::;) c::o :x :l:Joo -< -'="" -0 ::x ca ~_._"'"" '..-/ "I"J .",--i C5 r-- i""-I C"/').__J , ' CJ 0'\