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HomeMy WebLinkAbout07-21-08 (2)15056041147 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 8 0 2 7 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 142 03 3386 03 05 2008 07 23 1909 Decedent's Last Name Suffix Decedent's First Name MI JURGENSEN CHARLES A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's 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 ~XJ 1. Original Retum CC 2. Supplemental Return L~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ ~, 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) ~(- 6. Decedent Died Testate f ~', ~ Decedent Maintained a Living Trust (Attach Copy of Will) L- - (Attach Copy of Test) 0 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received i 1 D. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) ~~ (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D. FLOWER, JR. ESQ 717 243 6222 Firm Name (If Applicable) SAIDIS, FLOWER & LINDSAY First line of address 26 WEST HIGH STREET Second line of address City or Post Office State ZIP Code CARLISLE PA 17013 Correspondent's a-mail address: J. Craig Jurgensen Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and comp~e. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. hILINIi Kt I UKN 9 Sherwood~9cive, Carlisle, PA 17013 IATURE OF PREPARER OTHER THAN REPRESENTATIILE 6 West High Street, Carlisle, PA 17'g'13 1505604114? REGI~R OF WILL~SE ONLY r: , . ,~ w -:~ c__ "T7 r° `f . C`' r s r--- U~ -Y` _ t r~ i : -Tj '., ~J l~r '7l - ~1TE FILHD~ a c -o James D. Flower Jr. Side 1 DATE ~2.L.- 15056041147 v 15056042148 REV-1500 EX Decedent's Social Security Number oecedenYsNeme: Charles Andrew Jurgensen 14 2 0 3 3 3 8 6 _-- -- --- -- - RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 8 8, 2 7 4. 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank De osits & Miscellaneous Personal Pro e ) p p rty (Schedule E ................ 5. 1 8 5 , 4 9 0 . 0 6 6. Jointly Owned Property (Schedule F) ] Separate Billing Requested ............. 6. nter- ivos ans ers & Miscellaneous Non- Probate Property - f 1 (Schedule G Separate Billing Requested ............. 7, 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 2 7 3, 7 6 4 0 6 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 1 7 , 8 9 5 . 9 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 1 , 2 41.3 1 11. Total Deductions (total Lines 9& 10) ...................................................................... 11. 1 9, 1 3 7 3 0 12• Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 2 5 4 , 6 2 6 . 7 6 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 1 4 , 0 0 0 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 2 4 0 , 6 2 6 . 7 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) x .o0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 2 4 0, 6 2 6. 7 6 16. 10 , 8 2 8. 2 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18• 0. 0 0 19. Tax Due ..................................................................................................................... 19. 10 , 8 2 8 . 2 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 15056042148 15056042148 J REV-1500 EX Page 3 File Number 21-08-0272 Decedent's Complete Address: Charles Andrew Jurgensen - -_ __ _ -- - -- - -- -- STREET ADDRESS _ _- 210 Big Spring Road -- -- CITY ~-STATE ZIP Newville PA ~ 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 1 0,828.20 2. Credits/Payments - __ A. Spousal Poverty Credit B. Prior Payments 10 , 0 0 0.0 0 C. Discount 526.32 3. Total Credits (A + B + ~) Interest/Penalty if applicable (2) 10 526.32 p. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) -- Check boz on Page 2 Line 20 to request arefund - --- -- -- - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 301.88 A. Enter the interest on the tax due. - (5A) _ __ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) - -- 3 01.8 8 Make Check Payable to: REGISTER OF WILLS, AGENT ' y 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 :.................................................................................. ~ ~~; b. retain the right to designate who shall use the property transferred or its income :.................................... x ~ ~~ c. retain a reversionary interest; or ..................................... L~ x~ d. receive the promise for life of either payments, benefits or care? ............................ ................................ ~ ' ~x ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ~1 f 3. Did decedent own an "in trust for" or payable upon death bank account or securi at his or her death?......... _ ty z 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..................................................................... ................................................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. r ., ~_ _~ 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 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 zero (0) percent [72 P.S. §9116 (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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent [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. Rev1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Jurgensen, Charles Andrew 21-08-0272 All property Jnlntlyawned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 800 shares of Exxon Mobile -Common Stock 87.19 69,752.00 2 120 shares of International Business Machines 115.33 13,839.60 Corporation -Common Stock 3 100 shares of Public Service Enterprise Group 45.95 4,595.00 Incorprated -Common Stock 4 U. S. Savings Bond -Serial Number L202620274EE 25.00 Accrued interest on Item 4 through date of death 62.40 TOTAL (Also enter on Line 2, Recapitulation) 88,274.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Jurgensen, Charles Andrew 21-08.0272 Include the proceeds of litigation and the date the proceeds were received by the estate. Afl property )ointlyrowned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Cash -Reimbursement for overpayment of costs from J. Craig Jurgensen 1,282.00 2 Northern Trust Company -Pension 54.00 3 Redemption of Traveler's Checks 110.00 4 Rutgers University Foundation - Fnd Gift Annuity-Replacement check 720.00 5 Adams County National Bank CD Account #169097 79,022.93 6 M & T Bank Certificate of Deposit Account #031003910979821 7,124.56 Accrued income on Item 6 through date of death 166.51 7 M & T Bank Certificate of Deposit Account #031003911001194 27,811.37 Accrued income on Item 7 through date of death 369.73 8 M 8 T Bank Certificate of Deposit Account #031003913122279 12,623.23 Accrued income on Item 8 through date of death 350.23 9 M 8~ T Bank Certificate of Deposit Account #031003916445173 44,209.99 Accrued income on Item 9 through date of death 338.37 10 M & T Bank Checking Account #1188151 11,306.95 Accrued interest on Item 10 through date of death 0.19 TOTAL (Also enter on Line 5, Recapitulation) 185,490.06 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV•1151 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS tJ I A 1 t OF FILE NUMBER Jurgensen, Charles Andrew 21-08-0272 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached I 8,580.59 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Saidis, Flower & Lindsay 8,300.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 360.00 5. Accountant's Fees 365.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 290.40 TOTAL (Also enter on line 9, Recapitulation) I 17,895 99 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev1502 EX+ (6.98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-A FUNERAL EXPENSES continued ESTATE OF (FILE NUMBER Jurgensen, Charles Andrew 21-08-0272 ITEM NUMBER DESCRIPTION AMOUNT 1 Ewing Brothers Funeral Home -Funeral services $1,590.00; Copies of death 3,504.10 certificates $72.00; Urn $960.00; Obitiary $882.10 2 Ewing Memorials LLC -Monument-Reimbursement made to Alice Jurgensen Struck 3 George's Flowers -Flowers for the funeral 4 J. Craig Jurgensen -Reimbursement for funeral expenses (music, clergy, sexton, travel) 5 J. Craig Jurgensen -Reimbursement for luncheon after funeral services 6 J. Craig Jurgensen -Reimbursement for final funeral bill from Ewing Cementary 7 St. John's Episcopal Church -Reimbursement for Dickinson Lucheon 932.50 205.64 1,382.00 1,566.45 769.40 220.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Subtotal ~ 8,580.59 Form PA-1500 Schedule H-A (Rev. 6-98) Rev1512 EX+ (8.98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Jurgensen, Charles Andrew 21-08-0272 Include unreimbursed medical expenses. ~r~~~ ~~ ~~~~..~w auuiu~iiai Naye~ or me same s¢e) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN B E N E FI C IARI E S RESIDENT DECEDENT ESTATE OF Jurgensen, Charles Andrew FILE NUMBER 7~ _nQ nee NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE Do Not Llst Trustee s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal dlstnbutlons, and transfers under Sec. 9116(a)(1.2)] 1 Melissa Armstrong Granddaughter Three 3 000.00 3450 Jamison Boulevard North Thousand , Flagstaff, AZ 86004 Dollars 2 Heather Ann Jurgensen Granddaughter Five Thousand 5 000.00 Hermann-Behn Weg 6 Dollars , 20146 Hamburg Germany 3 Charles A. Jurgensen, II Son Fifty percent 105 313 38 23 Village Road (50%) of the , . Florham Park, NJ 07932 Residue 4 John Christian Jurgensen Grandson Five Thousand 5 000 00 389 Park Place Dollars , . Brooklyn, NY 11238 5 Mark Christian Jurgensen Grandson Three 3 000 00 505 Carriage House Lane Thousand , . Harleysville, PA 19438 Dollars See continuation schedule attached Continuation 119,313.38 Total 240,626.76 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cover sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS See continuation schedule(s) attached 14,000.00 TOTA L OF PART II - FNTFR TnTnl nlnr.l_TnYeQ~ ~ nicTOioi ~T~.,.~~ .......~~ .,..._ _._. .. ___ _ _..__ _ - - ---- -•-- • • ••--~ • •,-• ~~ ~.....~.~- ~., v~ r~cv- ~ ouu i.wtn arltt I 74,000.UU Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Charles Andrew Jurgensen 03/05/2008 142-03-3386 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) o ~ ~moiny ~.nanes Jurgensen Grandson Three Thousand 3,000.00 4705 Philco Drivw Dollars Austin, TX 78745 7 Susan Jurgensen Somers Granddaughter Five Thousand 5,000.00 8412 Zell Lane Dollars Richmond, VA 23229 8 Ann Marie Strack Sterner Granddaughter Three Thousand 3,000.00 247 Kilburn Road Dollars 9 Alice J. Strack Daughter Fifty percent (50%) of 105,313.38 Wood River Village the Residue 3200 Bensalem Boulevard Bensalem, PA 19020 10 Peter Richard Strack Grandson Three Thousand 3,000.00 40 Richards Road Dollars Reading, MA 01867 Total 119,313.38 1 Rev-1502 EX+ (6.98) COMMONWEALTH OF PENNSYLVANIA INHERfTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J-IIB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued ESTATE OF FILE NUMBER Jurgensen, Charles Andrew 21-08-0272 ITEM NUMBER DESCRIPTION AMOUNT 1 Flemington Rotary Club 2,000.00 P. O. Box 751 Flemington, NJ 08822 2 Friends of Locktown Stone Church, Inc. 3 Greenridge Village Fund 210 Big Spring Road Newville, PA 17241 4 Rutgers University Foundation Winants Halt 7 College Avenue New Brunswick, NJ 08901 5 Society of the Divine Word 1901 Waukegan Road P. O. Box 6000 Techny, IL 60082 6 St. John's Episcopal Church P. O. Box 612 North Hanover Street Carlisle, PA 17013 7 Trinity Episcopal Cathedral 601 West State Street Trenton, NJ 08618-5390 Subtotal 1,000.00 2,000.00 5,000.00 1,000.00 2,000.00 1,000.00 14,000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J-IIB (Rev. 6-98) I, CHARLES A. JURGENSEN, of 103 Green Ridge Lane, Newville, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executor or Executrix, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: During my lifetime I have made contributions to the Rutgers University Foundation of New Brunswick, New Jersey, for the establishment of the Charles A. Jurgensen Family Fund, also referred to as the Jurgensen Family Fund. These contributions include cash contributions and annuities .made by Charles A. Jurgensen and Ann C. Jurgensen for the establishment of the Jurgensen Family Fund and include additional and subsequent funds, contributed or to be contributed, by other family members. All scholarship contributions made before the formal establishment of the Family Fund have been internally transferred at my request to the Charles A. ~. ~,.,._ ~ T... ,, , z ~~. ~. p r Jurgensen Family Fund. The Charles A. Jurgensen Family Fund is to be administered by the Office of Financial Aid of Rutgers, the State University of New Jersey, in accordance with terms and provisions set forth in a statement entitled "The Jurgensen Family Fund", signed and dated June 7, 1993, by Charles A. Jurgensen and Ann C. Jurgensen, and June 14, 1993, by J. Craig Jurgensen and Joan E. J:_~rgensen, which statement has been accepted by Rutgers, the State University of New Jersey. The Charles A. Jurgensen Family Fund is an endowment fund, the income from which is to be used for scholarship purposes. In addition to those funds which have already been contributed to said fund, I give $5,000.00 to the Charles A. Jurgensen Family Fund. THIRD: I make the following additional specific bequests: A. I give to the Flemington Rotary Club, of Flemington, New Jersey, the sum of $2,000.00, for application to the Student Loan Fund of the Flemington Rotary Club, in appreciation for assistance rendered to me during my student years at Rutgers University; B. I give to St. John's Episcopal Church, of Cariisie, Pennsylvdriia, the sum of $2,000.00, for application to the St. John's Episcopal Church Endowment Fund. C. I give to the Greenridge Village Fund, an affiliated fund held by Presbyterian Homes, Inc., with administrative offices in Camp Hill, Pennsylvania, the sum of $2,000.00. ~-^-^5 i = _ ~.. ~~, ~ '~) }¢- a+^~4~5'^s~[1CS*b'~ Yz*~n'~'~1WRwniaib9~6F~~ D. I give to the Trinity Episcopal Cathedral of 601 West State Street, Trenton, New Jersey 08618-5390, the sum of $1,000.00. E. In honor or my wife, ANN C. JURGENSEN, and consistent with her desires and sentiments, I give to the SOCIETY OF THE DIVINE WORD, 1901 Waukegan Road, P. O. Box 6000, Techny, II(inois 60082, the sum of One Thousand ($1,000.00) Dollars, in loving memory of the Reverend Robert C. Hunter, SVD, and the Reverend William R. Hunter, SVD, cousins of Ann Jaeger Jurgensen, to be dedicated for the purpose of housing and caring of retired priests in Techny, Illinois. F. I give to the Friends of Lochtown Stone Church, Inc., a not for profit corporation dedicated to the restoration and appropriate use of the Old School Baptist Church built in 1819, near Flemington, New Jersey, the sum of $1,000.00. FOURTH: I make the following specific bequests to my grandchildren: A. The sum of $5,000.00 to HEATHER ANN JURGENSEN; B. The sum of $5,000.00 to SUSAN JURGENSEN SOMERS; C. The sum of $5,000.00 to JOHN CHRISTIAN JURGENSEN; D. The sum of $3,000.00 to I!'iARK CHRISTIAN JURGENSEN; E. The sum of $3,000.00 to TIMOTHY CHARLES JURGENSEN; F. The sum of $3,000.00 to MELISSA JURGENSEN ARMSTRONG; G. The sum of $3,000.0 to PETER RICHARD STRACK; H. The sum of $3,000.00 to ANN MARIE STRACK STERNER; -, J My gifts to the children of my son, J. CRAIG JURGENSEN, are slightly larger than to my other grandchildren, in deference to the facfi that I make no bequest to him, as set forth in more detail below. FIFTH: All the rest, residue and remainder of my estate, be it real, personal or mixed, of whatsoever kind and wheresoever situate, 1 hereby give, devise and bequeath to my wife, ANN C. JURGENSEN, for the remainder of her life, provided she shall survive me by thirty days. My wife shall have the right to consume principal as well as income of said funds for her care and comfort during her life. For the reasons set forth below in paragraph SEVENTH, at her death, all of the remainder of said funds shall be paid in equal shares, per stirpes, to my daughter, ALICE M. STRACK, of Titusville, New Jersey, and my son, CHARLES A. JURGENSEN, II, of Florham Park, New Jersey. SIXTH: My son, J. CRAIG JURGENSEN, and his wife, JOAN, have expressed a desire to me that that portion of my residuary estate which I would otherwise have left to them, be used for the benefit of other family members or general purposes as I may choose. Consequently, believing that my son, J. CRAIG JURGENSEN, and his wife, JOP,N, are well cared for financially, if my wife fails to sur~~ive me by thirty days, hereby give, devise and bequeath all the rest, residue and remainder of my estate, be it real, personal or mixed, of whatsoever kind and wheresoever situate, in -equal shares, per stirpes, to my two remaining children, ALICE M. STRACK, of Titusville, New Jersey, and CHARLES A. JURGENSEN, (I, of Florham Park, New Jersey. 4 LASTLY: I nominate, constitute and appoint my son, J. CRAIG JURGENSEN, to be the Executor of this my Last Will and Testament. Should my son be unable to act for any reason whatsoever, then I appoint my daughter-in-law, JOAN E. JURGENSEN, to act as Executrix in his place and stead. No executor shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~3 ~~~ day of ,, '~ ~~;~~ r.~u;.~.. , 2002. r .~ ~ Ch,~les A. Jurgensen SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: ._ - ~'=: ,~ ;, ~~ ~~ ~ - s COMMONWEALTH OF PENNSYLVANIA ss , { COUNTY OF CUMBERLAND I, CHARLES A. JURGENSEN, 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; that I signed it willingly; and that !signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and ac4~nowledge~ before me, by CHARLES A. JURGENSEN, the Testator, this ,-.,~ ~ (~ day of > , 2002. _--~ Charles A. J ~ rge sen, estator NOTARUIL SEAL MERLENE J. MARHEVIGA. NOTARY PUBLIC CARLISLE. CUMBERLAND COUNTY, PA $ Ar1Y COMMISSION EXPIRES JUNE 8, 2002 6 COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND We, Jarles U. flower, Jr. and Sharon Simpson 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 Testator sign and execute the instrument as his Last Will; that CHARLES A. JURGENSEN signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by James v. Flower, Jr. and Sharon Si?~pson this ~~~~ day of ~~ , 2002, ,;, ` ~ ,`,J ~ f. ,~:` Witness ,~ r, .~ c ~ ~; ~~~ Witness 7 NOTARIAL SEAL MERLENE J. AAARHEVKA, NOTARY PUBLIC CARLISLE, CUMBERLAND COUNTY, PA !sM COMMISSION EXPIRES JUNE 8, 2002 XOM: Investors: historical price lookup E+~n~a~r 7alCing on the world's toughest energy ~hallenges°' historical price lookup Symbol XOM (Common) Lookup Date March__ _ -.>, 05 ~.~ 2008 a=.? __ ___.._ . ~ Up- Look Res u Its Date Requested March 05, 2008 Closing Price $87.19 Volume 30,835,1 DO Split Adjustment Facto r1:1 Open $86.80 Day's High $87.62 Day's Low $86.05 Copyright C~ 2007 MarketWatch, Inc.t All rights reserved. Please see our Terms of Use2. Marke±Watch, the MarketWatch logo, and BigCharts are registered trademarks of MarketWatch, Inc. Intraday data is provided by Interactive Rea! Time Services Data3 and subject to the Term of Use 4. Changes in price and volume are subject to market activity. Page 1 of 1 Exxon Mobil Corporation does not own or maintain the Exxon Mobil Historical Price Lookup Page on this Web site. ThomsonlCCBN owns and maintains this page. 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To see all exchange delays, please see disclaimer. ©2008 Google Google Home -Help -Privacy Policy -Terms of Service Historical Price Lookup n~~ Hams I C,antact LFS ~ r~~te'~J Careers Page 1 of 2 _.__ . Quick Search Keyword ~ Quick Links: I want to find out about.. r InveStOr RCIatiOnS Public Service Enterprise Group (PSEG) ~ Overview ^Financiai Information ~ HIStOt•ical Price Loo~illr3 ~ Corporate Governance 0 ^Stockholder Services Stock Quote I St~ck.Cfi~rt ~ Dividend. History ~ Historical Price Lookup I ^StocK information f~l ?mestmenl Calcula(gr ^ Presentations and Webcasts Symbol ^ Calendar PEG (Common Stock) -' ^RequestInformation ~ --------------------____.._ _____.._...__._~_ ^ Forward cooking Statements Lookup Date .March _ 05 - 2008 Look Up;j Date Requested 03J05/08 Closing Price $45.95 volume 2,559,800 Split Adjustment Factor 1:1 Open $45.87 Day's High $46.09 Day's Low $45.25 Copyright ©20D7 Ma1'ketWatch,_InC, Atl rights reserved. Please see our Term_s_o..f_Us_e.. MarketWatch, the MarketWatch logo, and BigCharts are registered trademarks of MarketWatch, Inc. Intraday data is provided by Interac~v_e__Real Timg_Seryic_.es._Da~a and subject to the Termo.f}J.~e_. Changes in price and volume are subject to market activity. Prni: I ®E-,r_pail.,_Pa.ge. I ~_RSS....F~.e~~. I "~ ZR....Gonta..~~s Environment News PSEG Stock_Quote_(NYSE) Price $44.06 05)22/08 1:22 p.m. Ems' Minimum 20 minute delay kr a~U- What's New L~ ''f-~je~~~ ~ ~~~ T S _~I d..i 'In ~i X00$ PSEG ~arm7gs _ ~ -- LL ,~' L~~I T fiCC l_~Ii...Clri 4°Je~~.~~ ;~ Executive Commentary Green Initiatives 2007 Annual Report, 10K and Proxy Statement k*n Investor Fact and Dividend Sheets IU.S. Savings Bond Redemption Receipt Branch ID: 10 Transaction Number: 0832-714255836410 Est of Charles A Jurgensen 26-6288218 Redemption Date: 03/27/2008 26 West High Street Carlisle, PA 17013 Teller ID: dmichels Issue Interest Redemption Serial Number Series Denom Date Issue Price Earned Value 202620274-EE~ EE ~ $50', 01/1985 i $25.00 I $62.40 $87.40 Total number of bonds redeemed: 1 ~ , ~~~i C st mer Si nature Total Price Total Interest Total Value $25.00 562.40 $87.40 Customer ID: 17559466 .;-~~~ ~~ 7, yv ._.~_~~.r.,~, ~~`' ~`?~~~.: Easy-:- ~-.,~, ,~ C ~ F,~ 17(191 sv D w i`1 Sterling Financial Corporation 1097 Commercial Ave PO BOX 38 East Petersburg, PA 17520 800-225-5252 Page 1 Of 1 C ~. (D a *c~~,D o-a~a 0 0 0 0 ~ awn. aN.~.~. m°i°'~ ~ cncnD n~~D~ °' m' m' io ~N ~ o_ Q~o~ ~! mrnn I o !~ !~ o I m~~cnC~! xmmn~- ~ ~ ~ v; ~ _ O 'i ~ ~ C ~. d ~ (~ ~ ~ CD Q d .-. d __ _- (D p7 ~, C J O N -~ p O (n ~ ' ~'^ S~ _ ~ (D (D _ • O_ a-m ~Z~'' o~~'rn ~ c '~ av ~~ . ~,~ ~ o ~ m ~~axi m o- ° U' ~ m07aZO _.~~o~~ ~ a ~ o_ ~ ~ QTm ~.~~m~ a- m °1 ~ X W Q l7 ~ X O O O O_X ~ ~~ ~ (D ~ ~ Q ~ ~ ~ ~ O ~' ~p 7 ~ C ~ 7 O N .-. _ n.~2 ~o~Zo n ~_ - O N O `~ ~ ~ ~ ~ O Q a~== (D = O. O n ~ (D j (D ~ d Q ~ ~ ~ O O O n-~G ~ am~~ n. ~ cn a- Qv~ ~ m m~~'~ ~ ~ o ~ a~ n_ v cn m O 0 ~ ~ IO - ---~ --~ 0 v C'1 ~ ~ N CJt O O ~_ ~D N N :A 0 m c m v .A O ~~ O ~~~IQ Q. ~ ~ ~m~~ m m I~ 'O I I i~ ~ ~~~o "' i 3 ,oi IN ~ ~ I N ~~ N'Z ~ ~ '~I~ ~m im,~ ~ o _ ~ ~ ~~1a1 N ~ e~ = i QD ' ~ ~ i I CJ1 ~ I i~f7 N ~ '~j o 'T7 (D ~ -D -, c~' ~ p cn ~ O N ~ .. .~ (D O .. W O W (O ~ ~ N N O O O O ~ ~ D ~ CD '~ ~ ~ (D ~ ~ O ~ 'G 0 ~_ 7lt~lU~ ~71t~~1'~~~1~} ~~..~I`''~ ~":~- vl~d ~Ji~al ~ AT THE MATl1RITV HEREDF WILL PAY ~~?Y~p~;k~1ERlf ~~~~ C" S~ ~Sj 7a lu2-U3-33fb N:~;;T T€:~~kT~~t~ r~,~ DE~a~U LlC' {,r'-~fr C L~~'1~t.1~1~~1~' sER~ES EE ~~ .~~~,=~..E~.,~,~.,E ~ ~..E~~~,~.e.~.~~aw,.o o...a mow, ti....tic 5 ~~.., t ISSUE DATE WHICH IS iNE FIR57 DA t' Gf JAi= ~ ~~~ ~"El`'. ~t~5~ F~~4tdK E~~~7~r~~ tti;~. i r.` i S ~y ~nGEi~~~ H o4AT1`lilNG 6T..~,F i ~b ~2?t~~-?ir~7u L 20~ 6~~ ~-,~ EE APR 0 ? 2008 - .AD~~-75 CO NATIONAL Bf1NK April 3, 2008 Saidis, 'lower °: Lindsay 26 West High Street Carlisle, PA 17013 Re: Estate of Charles A Jorgensen Dear Mr. Flower: The following information is being provided as per your request: Acct. Type Account No. Account Accrued Ownership Date Opened Principal on Interest to D.O.D. D.O.D. C.D. 169097 $79,022.93 $742.32 Individual 11/02/06 Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company at 1-800-368-5948. If you need any additional information, please contact me at (717)339-5116.. Sincerely, ~1 Lois A Kime Deposit Services APR 0 3 2048 © M&T Bank 499 Mitchell Road, Millsboro, DE ]9966 Mail Code DE-ML3-12 Law Offices Saidis Flower & Lindsay 26 West High Street Carlisle, Pennsyl~~ania 17013 Re: Estate of Charles A Jur e Social Security: 142-03-3386 Date ofDeath: March OS, 2008 Phone (888) X02-4349 Fax (302) 934-29» Apri] 1, 2008 Dear Sir or Madam: Per your inquiry dated March 26, 2008; please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of~Account Checking Account Account Number 11881 ~1 D~~nership (_IJames ofd Charles A Jurgensen Opening Date 09/23/93 Closed 03i27/O8 Balance on Date ofDeath $11,306.95 Accrued Interest $ 0.19 Total $11, 307.14 ------------------------------ 2. Type of Account Account Number Ownership (Names o~ Opening Date Balance on Date ofDeath Accrued Interest Total Certificate of Deposit 031003910979821 Charles A Jurgensen 08/18/00 Closed 03/27/08 $7,124.56 $ 166.51 $ 7, 291.07 -------------------