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HomeMy WebLinkAbout02-0059PETITION FOR PROBATE and GRANT OF LETTERS Estate of J. a~,ttg~e-t: 1.. Ido-g~'b'2.lr,_. gK. No. also known as To: ~ Deceased. SocialSecurityNo. [? ¥ - ~1_~ - ~ qrl ~ .0.!-o.2 -.5.q Register of Wills for the County of C q ,~ ~£e.t^~_b Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executl~ t x/ in the last wilt of the above decedent, dated ~ ~ ~ ' ~-- ~ 3 and codicil(s) dated in the named ,-4-9 _2 o~o (state relevant circnmstances, e.g. renunciation, death of executor, etc:) Decendent was domiciled at death in ~. u ~,, ~L .v,-~ ~ ' 'County, Pennsylvania, with // (list street, number and muncipality) Decendent, then ~ years of age, died Except as follows, decedent did not marry, was not divorced and did~not have a child born or adopted after execution of the will offered forprobate; was not the victim of a killing and was never adjudicated incompetent: ~J [ ~ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All' personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: ,,-tg- ~.oo ~, WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) (testamehtary; administration c.t.a.; administration d.6. n.c.t.a.) OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF The petitioner(s), above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best' of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed' and subscribed befo~nn~% t~h~s 17th day of No.- 21~2002-0059 Estate Of Lawrence L. Kostelac, Sr. , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND'NOW Januar~ i7th 1~_ 2_~.0_0_2 in consideration of ~:he petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED.that the instrument(s) dated April 13th, 2000 described therein be admitted to probate :'rd filed of record as the last will of La~ce _L.. Kostelac ; and Letters :'..., ..... -Te i ..... are hereby granted to Fortuna Panza kostelac FEES Probate, Letters, Etc .......... $ 70.00 Short Certificates(5) .......... $. 15.00 Renunciation ................ $ x-Pages (7) $ 21.00 5O0 JCP TOTAL_ Slll:O0 Filed . Januory..17th~ 2QO 2 .............. Register of Wills Mar~/ C.. Lewis ATTORNEY (Sup. Cc. I.D. No.) ADDRESS PHONE CALL EXECTYI~R'wHEN LE~IWERS ARE FINISHED~737-3787 21-2002-0059 LAST WILL AND TESTAMENT OF LAWRENCE L. KOSTELAC~ SR. I, LAWRENCE L. KOSTELAC, SR., now of Shiremanstown, Cumberland County, Pennsylvania, do hereby declare this to be my Last Will and Testament and revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just and currently due debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid fi.om my estate as soon as practical after my decease as a part of the administrative expenses of my estate. ITEM II. I give my stock in Koste Seven, INC., to my daughter, LYNN MARIE FROMM, as Trustee, in trust, to pay to herself all of the income and such amounts of principal as necessary for her welfare, comfort and support during her lifetime. At her death, the trust shall terminate and the principal and any undistributed income shall be paid to such of her children as she may designate by her Will and, in absence thereof, shall be paid to her children, TAYLOR MARIE FROMM and BRINLEY MARIE FROMM, or the survivor of them. Should my daughter, LYNN MARIE FROMM, fail or cease to act as Trustee and unless she has designated a successor Trustee in her Will, I then appoint my wife, FORTUNA PANZA KOSTELAC, as her successor Trustee. Should she also fail or cease to act as successor Trustee, I then appoint my son, LAWRENCE L. KOSTELAC, JR., as her successor Trustee. Lawrence L. Kostelac, Sr. ITEM III. I give and devise a life estate to my wife, FORTUNA PANZA KOSTELAC, with the remainder interest to her, as Trustee, in trust, to hold the same in equal shal;es for my children, LAWRENCE L. KOSTELAC, JR., KATHLEEN M. KINDLER, KENNETH L. KOSTELAC, LYNN MARIE FROMM and MATTHEW J. KOSTELAC, in the properties I own at 122 Hampden Avenue,. Camp Hill (Hampden Township), Pennsylvania and 9A Glenwood Drive, Camp Hill (East Pennsboro Township), Pennsylvania. During the lifetime of my wife, FORTUNA PANZA KOSTELAC, as life tenant and trustee for the remaindermen, may mortgage said properties and sell and convey the entire interest in said properties to a purchaser on her signature as life tenant and Trustee without the joinder of the remaindermen. At my wife's death, the trust shall terminate and the remaindermen shall own the property outright, free of trust. ITEM IV. I give and devise all of the rest, residue and remainder of my estate of every nature and wherever situate to my wife, FORTUNA PANZA KOSTELAC. Should she predecease me, I giVe the same in equal shares to my five children, LAWRENCE L. KOSTELAC, JR., KATHLEEN M. KINDLER, KENNETH L. KOSTELAC, LYNN MARIE FROMM and MATTHEW J. KOSTELAC, and my wife's three children, LOUIS CHIP RUSSELL, JAMI NANETTE FENCEL and FORTUNA GINA CLARK, or their respective issue, per stirpes. Should any of my or my wife's children predecease me without issue surviving, I give such deceased child's share, in equal shares, to my and my wife's other children, or their issue, per stirpes. Lawrence L. Kostelac, Sr. ITEM V. Explanatory_ Statement. I have on my life a One Htmdr~l Thousand ($100,000.00) Dollar plus paid up additions life insurance policy on which I have named by daughter, LYNN MARIE FROMM, as the beneficiary of twenty-six (26%) percent thereof. I have done this so that she has cash available to pay the bills of Koste Seven, Inc., and provide for the orderly transition of the business from my ownership to hers. I have named my wife, FORTUNA PANZA KOSTELAC, as the beneficiary often (10%)percent thereof. I have done this so that she has cash available to pay my funeral expenses and other obligations sh6uld .funds not be available to pay the same from my estate. I have designated as beneficiaries of the remainder of said policy, in equal shares, my other children, LAWRENCE L. KOSTELAC, JR., KATHLEEN M. KINDLER, KENNETH L. KOSTELAC and MATTHEW J. KOSTELAC, with each to receive sixteen (16%) percent thereof. ITEM VI. If any income or principal shall be payable to any person who shall be under the age of twenty-five (25) or who shall be incapacitated for any reason, my personal representative, as trustee, shall hold such income and principal and Shall apply such income and principal to the health, maintenance, support and education of such person until age twenty-five (25) or during incapacity, without the appointment of any guardian or committee or any authority of court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act, or to the person. Any remaining income and principal to which such person shall be entitled shall be paid and distributed to such person upon attaining age twenty-five (25) or termination of incapacity. Law~ce L. Kostelac, ~-r. / 3 ITEM VII. I appoint my wife, FORTUNA PANZA KoSTELAC, Executrix, of this my Last Will and Testament. Should she fail to qualify or cease to act in such capacity, I than appoint my son, LAWRENCE L. KOSTELAC, JR., and my wife's son, LOUIS CHIP RUSSELL, Contingent Co-Executors o~fthis my Last Will and Testament. No bond shall be required of my personal representative(s), in any jurisdiction. ITEM VIII. In addition to the powers given by law to my personal representa- tive(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of any trust(s) created herein, they shall have the following discretionary powers applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be 'bound to see to the application of any monies paid. C. To manage, operate, repair, improve, mortgage or lease for any term [even if beyond the duration of the trust(s)] any real estate at any time held or owned by them as fiduciaries. Lawrence L. Kostelac, Sr. 4 property. D. To hold investments in the name of a nominee and exercise and dispose of E. To engage in litigation and compromise, arbitrate or abandon claims and F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fiduciaries. H. To borrow money, including the fight to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. I. To join in any merger, reorganization, voting trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then awrence L. Kostelac, Sr.~ entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. · K. In general, to exercise all powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon' such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with re. ference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. N. All principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any bene- ficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. Lawrence L. Kostelac, Sr. / - of 'IN WITNESS WHEREOF, I have hereunto set my hand and seal this , ooo. day The preceding instrument, consisting of this and four other typewritten pages, identified by the signature of the testator, as on the day and date thereof signed, published and declared by Lawrence L. Kostelac, the testator therein named, as and for his last Will, in the presence of us, who, at his request, in ~S_~l~resence and in the presence of each other, subscribed our names as witnesseshe to. 7 ACKNoWLEI)GMENT COMMONWEALTH OF PENNSYLVANIA · · SS. COUNTY OF DAUPHIN · I, LAWRENCE L. KOSTELAC, SR., 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 I signed it as my free and volUntary act for the purposes therein expressed. Lawrence L. K'~stelac, ~r. -./ - ~ testator, this /S,~hm or affirm~,d to and acknowledged before me, by Lawrence L. Kostelac, day of ~t~r}' ] ,2000. Not~ Public El . NOTARIAL ~y Co~ission ~pzr~LLY S. KIRK, Notary AFFIDA~T [My Commi..s~on Exoires Feb COMMONWEALTH OF PENNSYLVANIA - 'SS. COUNTY OF DAUPHIN · witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depgse and say that we were present and saw testator sign and execute the instrument as his last Wi!l; that he 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 tetatc~rq on di~Sa.t_;i..r~i~,~.eo~ more years of age, of sound mind and under n~o~n~r~ntbr'i~n~0adflfluence. the Will as witnesses; and that to the best of o~ kn~.o.,wleCge the testator was at / .... ,., Swom to and subscribed before me this day of r~ 2000. -; ~., ~ 105.805 REV 9~86 NING:~ COMMONWEAI,:TH OI STOWN.,, .... i ~omphcm~ons w~Ch c OF HEALTH~,, I ~ermanent TEL: (7 ! ?) '761-5800 FAX: ('7 ! '7) '76 ! -$008 SCOTT M. DI N N E R, ES. QU RE 31 17 CHESTNUT STREET CAMP HILL, PA 17011 April 4, 2002 Mary C. Lewis Register of Wills and Clerk of the Orphans' Court Hanover and High Streets Carlisle, PA 17013 Re: Estate of Lawrence L. Kostelac, Sr. #21-02-0059 Ms. Lewis: Enclosed please find a check in the amount of $6,500. payable to 'Register of Wills, Agent', as prepaymem of the Pennsylvania inheritance tax for the above referenced estate. Scott M. Dinner, Esquire enclosure cc: Fortuna Panza Kostelac, Personal Represemative ~Hand Delivered~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA i7128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-11 62 EX(11-96) ,CD O01 O36 SCOTT M DINNER ESQUIRE 3117 CHESTNUT STREET CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 184-26-3978 FILE NUMBER: 2102-0059 DECEDENT NAME: KOSTELAC LAWRENCE L SR DATE OF PAYMENT: 04/04/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 01/04/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $6,500.00 TOTAL AMOUNT PAID: $6,500.00 REMARKS: FORTUNA PANZA KOSTELAC SEAL CHECK//181 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ~ P~ ,aa 0. 1~. ~ ~Lz' }--' k o ~'T/~LA" C- Date of Death: O]I 0 c-[ J O ~ WillNo. ~ 00'2 - O0 0,3~q Admin. No. ~1~, iuO. .9-[-0~) - O0,ffq To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on O/] t h* ( o a._ : Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ~/~.'y/ O~~-, ~'~n..,~,-.~-- Signature Address .~- 3 ~nm eac_.=r bL?,/~- I Telephone (Qtrl) t),3 r/ _ CapacitY: X Personal Representative ~ ~r /r't O Il Counsel for personal representative _EV-15OO EX 'e (6-OO) 1~~ 4'; ~ ' · ' ~[k, . ~'(~?O¥;1MONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 · HARRISBURG, PA 17128-0601 Z LU REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 1 -0 2 COUNTY CODE YEAR 0 0 5 9 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL SOCIAL SECURITY NUMBER KOSTELAC, LAWRENCEL. SR. 1 8 4- 2 6--3 9 7 8 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS DATE OF DEATH (MM-DD-Year) '1 DATE OF BII~TH (MM-DD-Year 01/04/2002 \\I 04/17/1935 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FI~RST, AND MIDDLE INITIAL) KOSTELAC, FORTUNA P. ~ r~l. Original Return r~4. Limited Estate r~-]6. Decedent Died Testate (Attach copy af W~[I) E~9. Litigation Proceeds Received. E~] 2.. Supplemental Return E~4a. Future Interest Compromise (date of death atter 12-12-82) r~7, Decedent Maintained a Living Trust {NtachcopyefTrust) · E~, 10. Spousal Poverty Credit (date ef death b~veen 12-31-9't and 1-1-95) SOCIAL SECURITY NUMBER E~ 3. Remainder Return (date of death pdorto 12-13-82) [r--'~' 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes E~] 11. Election to tax under Sec. 9113(A) (Attach Sch NAME FORTUNA P. KOSTELAC FIRM NAME (If Appicable} TELEPHONE NUMBER 717-737-3787 ' iCOMPLETE MAILING ADDRESS 323 SOMERSET DRIVE SHIREMANSTOWN PA 17011 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 (S~hedule D} (4) $. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) '(6) ] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ' (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 172,220.00t 34,860.54 64,0;10,54 98,904,98 OFFICIAL USE ONLY (8) 444,166.06 17,538.64 6,892.87 (11), 24,431.51 (12) 419,734.55 ¢3) (1~,) 419,734.55 SEE INSTRUCTIONS ON REVERSE 'SIDE FOR APPLICABLE RATES 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 Eine 14 taxable at collateral rate 19. Tax Due 20. 252,595.73 x .0 (15) 167,141.82 x .045 (16) X .12 X .15 (17) (18) (19) 7,521.38 7,521.38 Decedent's Complete Address: STREET ADDRESS 323 SOMERSET DRIVE CITY STATE SHIREMANSTOWN PA ziP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 6~500.00 342.53 Interest/Penalty if applicable D. Interest E. Penalty '4. ¢) Total Credits (A+ B + C ) (2) Total Interest/Penalty ( D + E ) (3) (4) (5) (5A) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. 7,521.38 6,842.53 678.85 678.85 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; ...................................... [] [] c. retain a reversionary interest;.or. ................................................................................................. · [] [] d. receive the promise for life of either payments, benefits or caret ......................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate considera~n? ............................................ : .................. : .......................... [] , [] 3. Did decedent own an "in frust for" or payable upon death bank account or secudty at his or her death2 ............... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation2 .................. · ................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pequry, I decbre that I have examined this return, incbding accompanying schedules and statements, and to the best of my knowbdge and belef, il is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ' ADDRESS g23 SOMERSET DRIVE SI-~E. MANSTOWI~ //~ ADDRESS 1 51 3 CEDAR C~F DRIVE CAMP HILL PA 17O11 PA 17011 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (0]. ' For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse rrom 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. {}9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {}9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER KOSTELAC, LAWRENCE L. SR, 21 02 0059 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 beNveen a willing 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 right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Single Family Dwelling, 9A Glenwood Dr., Cumberland County, East Pennsboro Twp Parcel: 09-16-1050-294 Lot: No 8-x, Deed Book 0032H Pg. 00131 Date of Purchase 11/05/86 Assessed Value Single Family Dwelling, 112 Hampden Avenue, Cumberland County, Hampden Twp, Parcel: 10-21-0279-180 Lot: No. L-0156 Assessed Value TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 76,360.00 95,860.00 172,220.0(~ FacetWin Screen Print for public, from "CAMA~L0gin" 01/22/2002 10:12:08 A/~ CIIMBERLA/qD COUNTY ASSESSMENT OFFICE CONTROL % 09004256 DISTRICT: 09 - EAST PENNSBORO' TWP SD: Short Name : KOSTELAC, LAWRENCE L LAST NAME : KOSTELAC FIRST NAME : LAWRENCE L C/O NAME : & KARL J SCHWAB ADDRESS1 .' : C/O K & S ENTERPRISES ADDRESS2 : 323 SOMERSET DRIVE POST OFFICE: SHIREMANSTOWN STATE & ZIP: PA 17011 Situs: 9A GLENWOOD DRIVE Prop Descrip.: RIDLEY PARK LAND USE TYPE: 101 NEIGHBORHOOD: 350 DEEDED ACRES: .09 5 PARCEL: 09-16-1050-294. SPEC ID: LOT: LOT 81X I Tback: ] PROPERTY TYPE: R : SALES. DEED BK/PG ..... 0032H-00131 DATE OF SALE...ll/05/1986 SELLING PRICE: 39500 Fair Market L - 12080 B - 64280 T - 76360 CURRENT VALUES · ~ Assessed IFMV - 76360 C&G - approved? - > Screen 1 Number -Switch Screens, Down Arrow -Next Entry, Enter Selection > Record: 17078 X -Exit, J -Jump Mode,. F -Forms, I -Image Up Arrow -Previous Entry, ?.-Screens, B -Browse Facet~in Screen Print for public, from "CAMA_Login" 01/22/2002 10:13:26 AM CUMBERLAND COUNTY ASSESSMENT OFFICE . CONTROL # 10007909 DISTRICT: 10 - HAMPDEN TOWNSHIP SD: Short Name : KOSTELAC, LAWRENCE L & WIFE LAST NAbiE : KOSTELAC FIRST NAME : LAWRENCE L & WIFE C/O NAME : ADDRESS1 : 323 SOMERSET DRIVE ADDRESS2 : POST OFFICE: SHIREMANSTOWN STATE & ZIP: PA 17011 Situs'~ 112 HAi~PDEN AVENUE Prop Descrip.: CLEARVIEW FARMS LAND USE TYPE: 101 NEIGHBORHOOD: 257 DEEDED ACRES: .21 PARCEL: 10~21-0279-180. SPEC ID: LOT: L-0156 I Tback: PROPERTY TYPE: R SALES DATE OF SALE... SELLING PRICE: · CURRENT VALUES Assessed Fair Market FMV.- . 95860 L - 23100 C&G - B - 72760 approved? -> T - 95860 Screen' 1 Enter Selection > Number -Switch Screens, X -Exit, J -Jump Mode, Down Arrow -Next Entry, Up Arrow -Previous Entry, Record: 27647 F -Fol-ms, I -Image . ? -Screens, B -Browse REV-1503 L~* 1'97 ~, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ' SCHEDULE B STOCKS & BONDS ESTATE OF KOSTELAC, L'AVVRENCE L, SR~ All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER' 21 02 0059 ITEM NUMBER 1. . VALUE AT DATE DESCRIPTION OF DEATH SalomOn Smith Barney Acct. No. 652-056-41-1-0 5,923.50 150 Sh. Pfizer Inc. @39.49 1190.335 Sh. Smith Barney'Lg. Cap. Val. Fd. (~24.31 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insed additional sheets of the same size) 28,937.04 34,860.54 SALOMON SMITH BARNEY A member of otlgroup"~ February 28, 2002 (REVISED: April 2; 2002) 215-854-6000 · 800-233-1414 Mrs. F0rtuna P. Kostelac 323 Somerset Drive . Shiremanstown, PA 17011-6539 La~rence L.. Kostelac · ACCOUNT NUMBER: 652-05641-1-0 Date of Death: January 4, 2002 The tn~o~mat!o, contained hemtn was prepared ~(0,'m,a~n imrpo,~s on~ and d~s no~ re~res~nl offi~at-statement o~ your accounl at ~o ~-f~ soumes ~eJieved roll.lo, but ~¢ Dear Mrs. Kostelac: .. The following are the date of death values for the above referenced account. QUANTITY SECURITY HIGH LOw CLOSE 150 Pfizer, Inc. 39.880 39.100 39.400 '1,190.33500 LCVFA (Smith Barney Large Cap. Value Fund) 24.400 24.220 24.350 ANNUITIES POLICY # DESCRIPTION VALUE AS OF 01/04/02 BENEFICIARY 710312424 ITT Hartford $13,562.49 Estate 710312430 ITT Hartford $12,732.56 Estate 710312434 77-7700-207143 ITT Hartford MSF Sun Life $13,562.49 $14,815.48 Estate Fortuna Kostelac 77-7700-207125 MFS Sun Life $14,822.37 Fortuna Kostelac 77-7700-207107 MSF Sun Life $14,821.73 Fomma Kostelac SALOMON SMITH BARNEY INC. 1650 Market Street, 45th Floor, Philadelp, hia, PA 19103-7301 FAX 215-854-6125 THE INFORMATION SET FORTH WAS OBTAINED FROM SOURCES WHICH WE BELIEVE RELIABLE BUT WE DO NOT GUARANTEE liS ACCURACY OR COMPLETE- NESS. NEITHER THE INFORMATION NOR ANY OPINION EXPRESSED CONSTITUTES A SOLICITATION BY US OF THE PURCHASE OR SALE OF ANY SECURITIES. Should you have any questions please feel free to give our office a call. Sincerely, Anita T. Caserio Sr. CSA for John J. Sodaski, Jr. cc: Mr. Charles SulliVan 15.13 Cedar CliffDrive Camp Hill, PA 17011 717-737-5466 REV-1504EX~(1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECE~D~NT SCHEDULE C CLOSELY-HELD coRPORAi'ION, PARTNERSHIP or SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER KOSTELAC. LAWRENCE L, SR. 2;t 02 0059 Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a so[e-proprietorship. See instructions for the suppoding information to be submitted for sole-proprietorships, ITEM NUMBER 1. VALUE AT DATE DESCRIPTION OF DEATH 1000 Shares Common Stock, Koste Seven, Inc. 24,130.00 TOTAL (Also enter on line 3, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 24,130.00 REV-1505EX*(1-07) ~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE,C-1 CLOSELY-HELD CORPORATE STOCK INFORMAT)ON REPORT ESTATE OF FILE NUMBER KOSTELAC. LAWRENCE I~, SRI 21 02; 0059 1. Name of Corporation Koste Seven, Inc. State of Incorporation .PA Address 323 Somerset Drive Date oflncorporation 7/31/1986 City Shiremanstown State PA ZipCode 17011-6539 Total Number of Shareholders 1 2. Federal Employer I.D. Number . Business Reporting Year 6/30 3. Type of Business Restaurant Product/Service Food Service 10. 11. TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE STOCK Voting / Non-Voting ' SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK Common Voting 10OO .01 1000 $ 24130 Preferred $ 12. 6. · Was the Corporation indebted to the decedent?. If yes, provide amount of indebtedness $ Provide all rights and restrictions pertaining to each class of stock. Was the decedent employed by the Corporation? [] Yes [] No If yes, Position President Annual Salary $ 13000 , Time Devoted to Business 100 [] Yes' [] No 7. Was there life insurance payable to the corporation upon the death of the decedent? [] Yes [] No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8. Did the decedent sell or transfer stock of this company within one year prior to death or within two years if the date of death was prior to 12-31-827 [] Yes []. No If yes, [] Transfer [] Sale Number of Shares Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales. 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? [] Yes [] No If yes, provide a copy of the agreement. Was the decedent's stock sold? [] Yes [] No If yes, provide a copy of the agreement of sale, etc. Was the corporation dissolved or liquidated after the decedent's death? [] Yes [] No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. Did the corporation have an interest in other corporations or partnerships? [] Yes [] No If yes, report the necessary information on a-separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. Charles E Sullivan Certified Public Accountant Certified Financial Planner 1513 Cedar Cliff Dr. Camp Hill, PA17011 717-737-5466 May 30, 2002 To Whom It May Concern: We have performed accoUnting and tax services for Koste Seven, Inc. for the past four years.' As part of the filing of Schedule C of the Pennsylvania Inheritance Tax Return we have been requested to render an opinion on the fair market value of the common stock of the corporation. This is required b~cause of the death of the sole shareholder, Lawrence L. Kostelac on 1/4/02. We have considered three different methods of placing a value on this business: 1. Book Value 2. Capitalization o f earnings 3. Straight capitalization The complete analysis of the Business Valuation is attached herewith. On the basis of our use of the methods described in this report, we have concluded that the estimated investment value of the 1,000 shares of issued common stock of Koste Seven, Inc. is: $24,130. Very sincerely, ~arles F. Su~ ~,~' CPA CFP Member American Institute of Certified Public Accountants Pennsylvania Institute of Certified Public Accountants BUSINESS VALUATION ...... ~_~_~ .... KOSTE SEVEN INC. This analysis illustrates three different methods of placing a value on an operating business. 1. Book Value . 2. Capitalization of earnings 3. Straight capitalization Book Value (assets less liabilities) .......... . ..... $ 20 000 Capitalization of Earnings: Average annual earnings ........... : .... Plus salaries in excess of replacement.. Less estimat~ed return on book value ..... 4,616 '(3,000) Equals excess earnings ................ $ 1,616 Goodwill = earnings times .1 1,616 Plus Book value ....................... 20,000 EqUals total capitalized 'earnings value ........... $ Straight Capitalization: Average annual earnings ................. 4,616 Plus salaries, excess of replacement ..... Equals adjusted annual earnings ......... 4,616 Capital needed to yield this return' $ (at 15. O0 ~°) The .average of the three methods is ' $ 21, 616 30, 773 24;130 Assuming future growth rate continues @' At end of ' 5.yrs. 10 yrs. Future value ..... $ .26,641 29,414 2.00 15 yrs. 32,4'76' % annually 20 yrs. 35,856 BUSINESS VALUATION The value of your business comes into question when it is transferred due to sale, gift or inheritance. It will be extremely helpful in planning for those events to have some idea of your current business value. Three methods of valuation are illustrated. 1. Book Value = 2. Capitalization of Earnings = 3. Straight Capitalization = Divided by Assets - Liabilities Book Value + Goodwill Annual Earnings 15.00 percent 'Definitions Reduced salary expense = the difference between owner compen- sation and the cost to hire a replacement. Estimated return on book value = ~ 'Book Value times 15.00 % COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOS)TS, & MISC, PERSONAL PROPERTY ESTATE OF FILE NUMBER KOSTEL~AC, LAwRENcE L. SR, 2~1 02 0059 Include the proceeds of I!tigat[on and the date the proceeds were received by the estate. All property jointly.owned with the ~ight Of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. VALUE AT DATE DESCRIPTION OF DEATH 997 Lincoln Town Car Sedan " 12,450.00 984 Lincoln Town Car Sedan )NC Back, Checking Acct. No. 5140367'982 ITT Hartford Annuity Poi. # 710312424 - 13562.49 ITT Hartford Annuity Poi. # 710312430 - 12732.56 ITT Hartford Annuity,Poi. #710312434 - 13562.49 Beneficiary: Estate Beneficiary: Estate Beneficiary: Estate TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) .1,175.00 10,528.00 39,857.54 64,010.54 -' :~ADA. Appra~aal Guides - Get a Value - Officitil fJsed C~ Guide - Domestic Page 1 of 2 Your Destmatl n for Free Vehicle Information __. ] I ____ . .o... . . ~~'::~-'.. ~:~, ~:~}~:~?~}~:~, ..::~:~:~::~: ,~>~:~:~::::~:~:~:~:~:~:" .~:::~:~:~i:~::~:~;~. ,~i;~<~'-"~<~<~<~<,-"~< Free Price Quote ] Find aCar I Find a Dealer ] Buya Vehicle I Sell a Vehicle ] Finance J Insurance Warranty I Consumer Tips I New Car Reviews I Credit Repo~s I The Recbgnized Authori~ ~[I.~.~S.~.~.?...~..~S.~ C ar ~iJ Loan ~ount ~i ~;;;' ....... ~i~~~~ Used Car Consumer PriCing 1992 to 2001 LINCOLN 1997 TOWN CAR-V8 - Rear Wheel Drive Body Style: Model Number: Weight: Average Trade-In: Average Retail: Sedan 4 Door Signature 82 3,977 $12,450 $15,000 Reported Mileage: 20,000 Add $2,175 Optional Equipment Add Aluminum/Alloy Wheels: $200 Add Compact Disc Player: $100 Add JBL Stereo System (Std. Carder, Mark): $200 Add Power Sunroof: $575 Totals Total Average. Trade-In: (*)Total Average Retail: $15,700 $18,250 Average Retail Price represents a clean vehicle in good condition and is assumed to have a Clean Title History. If you are looking to purchase a new car Click Here for a free quote from a dealer near you. Click Here for Low Rates when Financing Your Vehicle Options included in valuation am: Automatic Transmissmn Air Conditioning B_g_y_ a New Ve Free Finance Free Insurance Free Warrant Click below on the first letter of the Manufacturer's Name. [BI_CIDIEIEI LIMI O I_~ I S_] [ Domestic Cars I Import Cars I Trucks, Vans & SUVs ] You have received 1 of the 5 free daily values for Official Used Car Guide - Domestic http ://www2. nadaguides, c omJValueRep orr. asp ?Us erID=054B 623 ED 87&DD=37274&Typ e=I) .1 / 18/02 Page 1 of 1 NADA'Appraisal Guides - Get a Value - Older Used Cars - Domektic Appraisal Report Older Used Cars - Domestic Consumer Edition January 18, 2002 www. NADAg uides.com Older Used Car Consumer Pricing 1983 to 1991 LINCOLN 1984 TOWN CAR BodyStyle: Sedan 4 Door Model Number: 96 Weight: 4,062 Low Retail: $1,175 Average Retail: $2,050 High Retail: $2,700 ' Low Retail Value -- A Iow retail vehicle may have extensively visible wear and tear. The body may have dents and other blemishes. The buyer can expect to invest in bodywork and/or mechanical work. It is likely that the seats .and Carpets will have visible wear. The vehicle should be able to pass local inspection standards and be in safe running condition. Low retail vehicles usually are not found on dealer lots. Average Retail Value -- An average retail vehicle should be Clean and without glaring defects. Tires and glass should be in good condition. The paint should match and have a good finish. The interior should have wear in relation to the age of the vehicle. Carpet and seat upholstery should be clean, and all power options should work. The mileage should be within the acceptable range for the model year. An Average Retail ve. hicle on a dealer lot may include a limited warranty or guarantee, and possibly a current safety and/or emission in§pection (where applicable). High Retail Value -- A high retail vehicle should be in flawles§ condition. All power equipment should be functional. The paint should match and have a high gloss finish. The carpet and seat upholstery should be clean and have minimal wear. The engine should start quickly and run smoothly. The tires should be like new with a spare and jack. The mileage should be significantly below the acceptable mileage range for the model year. A high retail vehicle on a 'dealer lot should be fully reconditioned and is likely to include a warranty, guarantee or manufacturer certification and current safety and/or emission inspection (where applicable). ©Copyright 2002 NADA Appraisal Guides, Inc. All Rights Reserved The information in this report was obtained from NADAguides.com and is intended for the personal use of the customer only and may not be sold or transmitfed to another party. We assume no responsibility for errors or omissions. http://www2'nadaguides-c°m/ValueReport, asp?UserlD=054B623ED87&DID=37274&Mode~t 1/18/02 COMMONWEALTH ~ ~ OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURg~ PA 171Z8-0601 ZNFORMATZON' NOTZCE .... ,.. AND TAXPAYER RESPONSE FILE NO. 21 02-0059 ACN 02110293 DATE 03-15-2002 KARL J scHWAB 323 SOMERSET DR SHIREMANSTOWN PA 17011 .TYPE OF ACCOUNT EST. OF LAWRENCE L KOSTELAC [] SAVINSS S.S. NO. 18q-26-3978 [] CtiECKTNg DATE OF .DEATH' 01-0q-2002 [] TRUST COUNTY CUMBER LAND [] CERTIF. REHIT PAYHENT AND FORHS TO: RESISTER OF WILLS CUMBERLAND C0 COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commoneealth o'f P~nnsylvenia. Questions a~y be COMPLETE PART ! SELOW ~ ~ ~ SEE REVERSE SIDE FOR FILiNG'AND PAYMENT INSTRUCTIONS Account No. 51q0367982 Account Balance Percent Taxable Amount Sub,oct to Tax Tax Rata Potential Tax Due Data 01-30-1987 Establ/shad 10,528.q6 x 16.667 1,75fi.78 x .15 265.22 To insure proper credit to your account, two (Z) capias of this notice must accompany your payment to the Register of Hills. Hake check payable to: "Register of gills, Agent". NOTE: If tax payments are made within three (5) months o~ the decedent's date'of death, you may deduct a 52 discount of the tax due. Any inheritance tax due wiZl become delinquent nine (93 months after the date of death. PART . TAXPAYER RESPONSE CHECK 'ONE BLOCK ONLY PART TAX LINE A. ~ The above information and tax due is correct. 1. You may cheese to remit payment to the Register of Hills ~ith two copies of this notice to obtain a discount or avoid interest, ar you may check box "A" and return this notice to the Register of ~ills end an o~ficial assessment will be issued by the PA Department of Revenue. B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return' to be fi~ed by the decedent's representative. C. [~] The above information i~ incorrect and/or debts and deductions were paid by you. You must complete PART [] and/mr PART If you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS l. Date Established 2. Account Balance Z $. Percent Taxable ~ X q. Amount SubSect to Tax q S. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE PA1. D DEBTS AND DE]3UCT~:ONS CLATMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line S of Tax Computation) Under penalties of perSury, I declare that the facts. Z- have reported-above ara true, correct and complete to /the best of ay KnqwZadge and belief.' ,~__~ ..~ ;~ ~/ HOME ( ) WORK c TAXPAYER ~I~NATUEE TELEPHONE NUMBEE DATE SALOMONSMITH BARNEy A member of c~t~group--~' February 28, 2002 (REVISED: April 2, 2002) 215-854-6000 · 800-233-1414. Mrs. Foftuna P. Kostelac · 323 Somerset Drive Shiremanstown, PA 17011-6539 Lawrence L. Kostelac ACCOUNT NUMBER:. 652-05641-1-0 Date of Death: January 4, 2002 ,The, intormat~o~, contained hemtn was prepared ¢nJ'(~,mmt~n purposes only arid does ~ol re~resent of~i~at' statement o¢ your acceun} at *he ¥ rm ~?~, p~cas, prolecdcns, ~Eof statistics hav~ Dear Mrs. Kostelac: The following are the date of death Values for the above referenced account. QUANTITY SECURITY '. . HIGH LOW CLOSE 150 Pfizer, Inc. 39.880 39.100 39.400 1,190.33500 LCVFA 24.400 24.220 24.350 (Smith Barney Large Cap. Value Fund) POLICY # ANNUITIES DESCRIPTION VALUE AS' OF 01/04/02 BENEFICIARY 710312424 ITT Hartford $13,562.49 Estate 710312430 ITT Hartford $12,732.56. Est~e 7 t 0312434 ITT Hartford ,$13,562.49 Estate 77-7700-207143 MSF Sun Life $14,81.5.48 Formna Kostelac 77-7700-207125 MFS Sun Life $14,822.37 Fortuna Kostelac 77-7700-207107 MSF Sun Life $14,82.1.73 Fortuna Kostelac SALOMON SMITH BARNEY INC. 1650 Market Street, 45th Floor, Philadelphia, PA 19103-7301 FAX 215-854-6125 THE INFORMATION SET FORTH WAS OBTAINED FROM SOURCES WHICH WE BELIEVE RELIABLE BUT WE DO NOT GUARANTEE ITS ACCURACY OR COMPLETE- NESS. NEITHER THE INFORMATION NOR 'ANY OPINION EXPRESSED CONSTITUTES A SOLICITATION BY US OF THE PURCHASE OR SALE OF ANY SECURITIES. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER KOSTELAC. LAWRENCE I~, SR. 21 - If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. 02 0059 SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Matthew J. Kostelac 20 Deer Lane Son Carlisle, PA JOINTLY-OWNED PROPERTY: . LEi I b_N DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for joint¥-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1. A. Single Famiiy Dwelling and Land 20 Deer Lane, Carlisle PA Silver Spring Twp Cumberland County conveyed unto Lawrence L. Kostelac Sr. and Matthew J. Kostelac on November 17, 1987. Further transferrred to Lawrence L. Kostelac, Sr. and Matthew J. Kostelac as joint tenants with the right of survivorship. 100,080.00 50. 50,040.0(: TOTAL (Also e. nter on line 6, Recapitulation) $ 50,040.00 (If more space ~s needed, insert additional sheets of the same size) Facetwin' Screen Print for public, from "CAMA_LOgin" 3/19/02 10:35:33 AM CUMBERLAND COUNTY ASSESSMENT OFFICE CONTROL # 38000143 DISTRICT: 38 - SILVER SPRING TWP SD: Short Name : KOSTELAC,. LAWRENCE L SR LAST NAME :: KOSTELAC FIRST NAME : LAWRENCE L C/O NAME : &.MATTHEW 3 KOSTELAC ADDRESS1 : 323 SOMERSET DRIVE ADDRESS2 : POST OFFICE: SHIREMANSTOWN STATE & ZIP: PA 17011 SJtus: 20 DEER LANE Prop DescrJp.: LAND USE TYPE: 101 NEIGHBORHOOD: 38 DEEDED ACRES: 7.60 pARCEL: 38-05-0433-005. SPEC ID: LOT: ~ Tback: SR PROPERTY TYPE: R SALES' IDEED BK/PG ..... 00221-00627 DATE OF SALE...05/19/2000 · SE~LING PRICE: 1 CURRENT VALUES Assessed Fair Market FMV - 100080 L - 62440 C&G - B - 37640 approved? -> T - 100080 Screen 1 Enter Selection > Record: Number -Switch Screens, x -Exit, 3 -Jump'Mode, F -Forms, Down Arrow -Next Entry, Up Arrow -Previous Entry, ? -Screens, 61587 I -Image B -Browse REV-I~IO F.X * (J-97) ~'. 'COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSj~i~R$ & MISC, NON-PROBATE PROPERTY ESTATE OF FILE NUMBER KOSTELAC. LAWRENCE L, SR. 21 02 0059 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is /es. DESCRIPTION OF PROPERTY % OF iTEM INCLUDETHE NAME OF THE TRANSFEREE. THEIRRELATIONSH]PTODI;CEDENTANDTHEDATE OFTRANSFER, DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACHACOPY OFTHI: DEED FOR REAL ESTATE' VALUE OF ASSET INTEREST (IFAPPLICABLE) 1. MLPF & S Cust FPO 11,595.00 100. 11,595.0( Lawrence L. Kostelac IRA Beneficiaries - 5 Children 2. Members 1st Federal Credit Union Acct No. 24356 4~.,850.40 100.. 42,850.4( IRA Savings - 3181.86 IRA 4-Yr. CD - 19662.99 IRA 5-Yr. CD - 20005.45 3. Annuities: 44,459.58 100. 44,459.5~ MSF SunLife Poi. # 77-7700-207143 - 14815.48 Beneficiary: Fortuna Kostelac MSF SunLife Poi. # 77-7700-207125 - 14822.37 Beneficiary: Fortuna Kostelac MSF SunLife Poi. # 77-7700-207107 - 14821.73 Beneficiary: Fortuna Kostelac TOTAL (Also enter on line 7, Recapitulation) $ 98,904.98 (If more space Is needed, insert additional sheets of the same size) 'Merrill Lynch. Statement of Pierce,. Fenner & smith Inc. Member, Securities Investor Protection Corporation (SIPC) --ACCOUNT #11sR#IJPAG~ #1SOCIAL SEC. # 500 ..A52 I 10~0 la.-26-3978 STATEMENT PERIOD ElM NUMBER o9/29/ol To 12/31/ol oo-oo0oooo SERVICE CONTACT ACCOUNT, INVESTOR SERVICES TYPE · 1-888-MLINVEST~,~i~,¢~~, , , IRA OFFICE SERVING YOUR ACCOUNT PO BOX 30125 NEW BRUNSWICK NJ 08989-0125 Retirement AcCount MLPF& S CUST FPO LAWRENCE L' KOSTELAC IRA 'FBO LAWRENCE L KOSTELAC :SZ~ SOMERSET DR SH]~RENANSTOWN PA 17011-65:~0 ACCOUNT SUMMAR~ PRICED PORTFOLIO >...'~· AS OF 12/3!/O1. ..'~ ../- AS OF 09/28/01 ....  1'1,G6~..83 10,464.83 DIVIDEND/INTEREST '~THIS STATEMENT..7 ..... '-''~ $283,~3CR" THIS YEAR .... ........ $~39.71CR CONTRIBUTION INFORMATION ***** TAX YEAR 2000 TAX YEAR 2001 $.oo $.oo DISTRIBUTION INFORMATION DATE 09 10 10 12 12 12 12 12 18 12 31 I TAX YEAR 2000 TAX YEAR 2001 S.oo $.oo DAILY ACCOUNT ACTIVITY ***** TRANSACTION 29 OPENING BALANCE 29 ' Funds'Received 29 Journal En=~y 18 *Dividend 18 Reinvestment 18 *Sh Tm Cap. Gain 18 Rei,nvestment 18 Divd Eeinv - Divd Reinv CLOSING BALANCE 22 DESCRIPTION PRICE CUSTODIAL FEE PAYMENT 2001' CUSTODIAL FEE ML GEOBAL ALLOCATION, D ML GLOBAL ALLOCATION D ML GLOBAL ALLOCATION O ML GLOBAL ALLOCATION D ML GUOBA['"A[LOCATiON ~ 'AGENT AS OF 12/12/01 REINV AMOUNT ' $6.69 ' REINV PRICE $12.69 QUANTITY DOT .5270 ML GLOBAL ALLOCATION D AGENT AS OF 12/12/01 REINV AMOUNT $276.7~ REINV PRICE S12.69 QUANTI~Y'BOT 21.8080 AMOUNT S.83CR $35.00CR $35.oo $276.7~CR $276.7~ $6.69CR $6.69 $.83CR CURRENT PORTFOLIO QUANTITY INVESTMENT DESCRIPTION 885.7720. ML GLOBAL- ~LLOCATION D TOTALS FOR PRICED INVESTMENTS CURRENT PRICE '12.830 MARKET CURR. EST. VALUE YIELD INCOME. $3i36~ 3.97 $~51 S~136U -00001711'~ DECEMBER, 2001 PiAase aQvise your F~nanciat Advisor immediately of any discrepancies on your statement ~r if you contemplate changing your address. When making inquiries, please, mention your Account number and address ali correspendence~to the office servicing your account, Please retain this statement for your tax records. See reverse side for explanation oi~ key ~erms. CODE 5029R (R9-01) ~ Merrill ltynch :7 'Merrill Lynch Pierce, Fenner & Smith Inc. Member, Securities Investor Protection Corporation {SIPC) 500 44A52 1010 18b,-26-3978 'Statement of Retirement Account. MLPF& S CUST FPO LAWRENCE L KOSTELAC IRA IN CALCULATING MANDATORY DISTRIBUTIONS, OR FOR THE PURPOSE OF COMPLETING IRS FORM 860~ YOU MUST USE THE VALUE OF YOUR ACCOUNT AS OF 12/31/01. THIS VALUE SHOULD INCLUDE YOUR PRICED PORTFOLIO TOTAL AND THE VALUE OF CERTAIN LIMITED PARTNERSHIPS AND OTHER DIRECT INVESTMENTS, AS WELL AS ANY SECURITIES THAT. WE ARE UNABLE TO PRICE - MARKED "UNAVAI'LABLE". THE "YEAR-END PLAN VALUE" BELOW CONSISTS OF YOUR PRICED PORTFOLIO TOTAL PLUS THE ESTIMATED VALUE OF LIMITED PARTNERSHIPS OR OTHER DIRECT INVESTMENTS REPORTED ON YOUR YEAR-END STATEMENT. YEAR-END PLAN VALUE AS OF 12/31/01: $11,364.83 FOR IRA, IRRA AND SEP/IRA ACCOUNTS, THE'YEAR-END PLAN VALUE REPRESENTS THE VALUATION WE MUST FURNISH TO YOU AND THE INTERNAL REVENUE SERVICE AS PART OF THE IRS FORM 5498 REPORTING REQUIREMENTS. FROM ALL OF US AT MERRILL LYNCH .... THANK YOU FOR THE OPPORTUNITY TO SERVE YOU AND YOUR FINANCIAL NEEDS. ALL THE BEST FOR A HAPPY AND PROSPEROUS NEW YEAR. END OF STATEMENT DECEMBER, 200' Please advise your Financial Advisor immediately of Any discrepancies on your statement or if you contempiate changing your address. When making inquiries, please, mention your account number and address all correspondence to the office servicing your account. Please retain this statement for your tax records. See reverse side for explanation of key terms. CODE 5029R (R9-01) ~ Merrill l,ynch .M- rnbers] lrEI~Elt.&I., CII.E~IT l/lqlON 23 sEND ALL INQUIRi::S TO THE CREDIT UNION-AT THE ADDRESS SHOWN ON PAGE # 1 1074.42 Fi SUFFIX:lb IRA 4 YEAR CERTF aw IMPORTANT TAX RETURN INFORMATION INCLUDED '~* DIVIDEND FAIR MARKET VALUE OF ACCOUNT AS OF DECEMBER 31, 200]: THE IRS WILL BE FURNI-SHED THIS INFORMATION Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 4.75~ ANNUAL. PERCENTAGE YIELD EARNED / 4.75~ 0 ISSUE DATE:08050] MATURITY DATE:0804( CERT NO: 1265.01 Fi SSU.E DATE:O.80697 MATURITY DATE:0805( 77.35 ]9662.99 ]9662.99 ~RFEITURES: .00 )5 D1.V RATE: 4.6500 19894.78 SUFFIX:lC IRA 5 YEAR CERTF '' ,** IMPORTANT TAX RETURN INFORMATION INCLUDED DIVIDEND FAIR MARKET VALUE OF ACCOUNT ,As OF DECEMBER 31', 2001: THE IRS W1. LL BE FURNISHED THIS INFORMATION Y-T-D DIVIDENDS: 'TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 6.75-~ ANNUAL PERCENTAGE .YIELD EARNED / 6.75~ CERT NO: 0 110.67 20005.45 ~RFEITURES: 2 DIV RATE: 20005'.45 .00 · ,i':' ' ' *. IRA YTD D,I.V I DEN'DS '. 2436 ..O8 · . .. . ' TOTA~L ,"**F'I',NANCE 'CHARGE:',.* .PA I. D · 'r/: . "' ,,i .... .',- - ' i:;-.-:-' .-'!..; i' .:,¢~:": ~ ' 4'. ~,":.; ,, ,'..:?...-:,~:-.,. ':-,4,. ;_'.' .. ". '"i': '?'~':"'""~ ?'':''; '?'' i;'5'~:':'' .... I :~1(;;~¢~.~¢;:::r 15, ','::' ?' ~:,' 3 I;:::: t., 7 '~ ~... · ....... ~, .......... , ................... ~, .............. .................. %: ..' ', '.:...: ', I 7 / / * OTHER YTD DIVIDENDS DIV 2 1o.. 3 787.13 TOTAL YTD * TOT DENDS -WITH! 4746.61 ~L YTD ~ TOT ~OLDING FOR .00 ' AL YTD * :E I TURES .00 ' 5000 Louise Drive Mechanic~burg, PA ,17055 E~]}ERAL CllJ~DIT t)'N'ION www.membemlst, grg ' Mai~ switchboard: (717) 697-1161 o[ (800) 283-2328 Ca11-24: (717) 697-4372 or (800) 283-4372 TDD: (717) 697-5312 or (800) 283-2328 ext. 5312 TeleE~ranch: (717) 795-6049 or (800) 237-7288 LAWRENCE L KOSTELAC 323 SOMERSET DR SHIREMANSTOWN PA 17011-6939 Member's Statement of Adcobht 438 1 · Account Number From TO I Page 243.56 12201-01 12-31-01 '1 of SUFFIX:lO I*RA'SAVINGS· IMPORTANT TAX RETURN NFORMATION INCLUDED DIVIDEND :AIR MARKET vALuE OF .ACCOUNT AS OF- DECEMBER'31, E I. RS WILL BE FURNI'SHED~: TH. IS'IN:FO:RMA:TI, ON Y-T- D, EI:V:'IDENDS: · ' .. TRUT~i .IN: SAV;I.NGS I:N;FORMAT'I~QN ~. 2001: 96.65 · 5.48 3181 ~86 3176.38 3181...86 SALOMON SMITH BARNEY A mem bet of cmqroup~ February 28, 2002 (REVISED: April 2, 2002) . 215-854-6000- 800-233-1414 Mrs. Fortuna P. Kostelac 323 Somerset Drive Skiremanstown, PA 17011-6539 Lawrence L. Kostelac ACCOUNT NUMBER: 652-05641-1-0 Date of Death: JanUary 4, 2002 Dear Mrs. Kostelac: The lniermal~r} contained heroin ~S prepared o~i~ai statement ~ your acceunt at the ~irm. d~eS, prices, proje~[cns, ~'or statistics have ~..fmm souses ~eiie~;,ed re¢i~le, but ~e The following are the date of death values for the above referenced account. QUANTITY SECURITY HIGH LOW CLOSE - 150 Pfizer, Inc. 3~.880 39.100 39.400 1,190.33500 LCVFA 24.400 24.220 24.350 (Smith Barney Large cap. Value Fund) ANNUITIES POLICY # DESCRIPTION VALUE AS OF 01/04/02 BENEFICIARY 710312424 ITT HartfOrd $13,562.49 Estate 710312430 ITT Hartford $12,732.56 Estate 710312434 ITT Hartford $13,562.49 Estate 77-7700-207143 MSF Sun Life $14,815.48 Fortuna Kostelac 77-7700-207125 MFS Sun Life $14,822.37 Forttma Kostelac 77-7700-207107 MSF SunLit' $14,821.73 Fortuna Kostelac. SALOMON SMITH BARNE~ INC. 1650 Market Street, 45th Floor, Phiiadelphia, PA 19103-7301 FAX 215-854-6'125 THE INFORMATION SET FORTH WAS OBTAINED FROM SOURCES WHICH WE BELIEVE RELIABLE BUT WE 00 NOT GUARANTEE iTS ACCURACY OR COMPLETE- NESS. NEITHER THE INFORMATION NOR ANY OPINION EXPRESSED CONSTITUTES A SOLICITATION BY US OF THE PURCHASE OR SALE OF ANY SECURITIES. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF KOSTELAC. LAWRENCE~ L,, SR. Debts of decedent must be reported on Schedule I. FILE NUMBER 2;1 02; 0059 ITEM NUMBER DESCRIPTION FUNERAL EXPENSES: Wiedeman Funeral Home Inc. 8; 9. 10. 11. Rillo~s Restaurant (Post Funeral Reception) Brachendorf Memorials (Headstone Engraving) ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address ~ity State Year(s) Commission Paid: Attorney Fees Scott' M. Dinner, Esq. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant Zip Street Address · City State Zip Relationship of Claimant to Decedent Probate Fees' Register of Wills ~ Cumberland County Accountant's Fees Charles F. Sullivan, CPA - PA Inheritance Tax Return Tax Return Preparer's FeesCharles F. Sullivan CPA Legal Advertising: West Shore Shopper 31.50 Cumberland Law Journal 75.00 The Paxton Herald 35.50 Postage - Executrix Real Estate Taxes Paid Schedule A P¢operties Doctor Bills - AndreWs & Patel AsSoc. Transfer Tax/Recording Fees for 9A Glenwood Dr. (see attached realty transfer tax TOTAL (Aisc enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 7,610.00 3,240.00 195.00 1,125.00 163.00 3,000.00 450.00 142.00 102.00 447.94 273.60 $ 17,538.64 ' Corttinuation of REV-1500 Inheritance Tax Return Resident Decedent KOSTELAC, LAWRENCE L. SR. 21 02 Paqe 1 Schedule H - Funeral Expenses & Administrative Costs - B7. O059 ITEM NUMBER statement of value) DESCRIPTION SUBTOTAL SCHEDULE H-B7 AMOUNT 790.10 790.10 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULe: ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF KOSTELAC. LAWRENCE L. SR, Include unreimbursed medical expenses. ITEM . NUMBER 1. DESCRIPTION Members 1st Federal Credit Union Account No. 24356 Vehicle Loan FILE NUMBER 21 02 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of Be same size) O059 AMOUNT 6,892.87 6,892.87 CREDIT UNION SEND ALL I~QUIRES TO THE CREDIT UNION-AT THE ADORESS SHOWN ON PAGE # 1 SUFFIX:I.5 IRA 4; YEAR CERTF IMPORTANT TAX RETURN INFORMATION INCLUDED DIVIDEND IR. MARKET VALUE OF ACCOUNT AS OF DECEMBER 31, 200t: E IRS WILL BE FURNISHED THIS INFORMAT ON Y-T-O DIVIDENDS: TRUTH IN SAVINGS INFORMATION . " ANNUAL PERCENTAGE YIELD / 4.75~. ANNUAL PERCENTAGE YIELD EARNED / 4.75~ · 77.3~ 19662.99 gERT NO: 1074.42 F ITURES: 0 ISSUE .DATE:080501 MATURITY DATE:0804,5 D'I'V RATE: SUFFIX:lC IRA 5 YEAR CERTF '' IMPORTANT TAX RETURN INFORMATION INCLUDED. D I V'l DEND IR MARKET VALUE OF ACCOUNT AS OF DECEMBER 31', 2001: E IRS W1LL BE FURNISHED THIS INFORMATION Y-T-D DIVIDENDS: TRUTH IN SAVINGS INFORMATION' ANNUAL PERCENTAGE YIELD / 6.75~ ANNUAL PERCENTAGE-YIELD EARNED / 6.75~; 110.67 20005.45 1265.01F IRFEITURES: CERT NO: 0 ISSUE DATE:O.80697 MATURITY DATE:0805,~2 DIV RATE: SUFFIX:'07 USED VEHICLES ~*ANNUAL PERCENTAGE RATE*,"= 8.1900~ DAILY PERIODIC RATE .0224384~ PREVIOUS LOAN BALAIICE ~*FINAN~E CHARGE** PRINCIPAL 'TD EINANCE CHARGE PAID: 787.13 NEW LOAN BALAIICE ' FOR',. ·2001 TOTA~L **F'I, NANCE 'CHARGE~.~ .PA I.D IRA YTD '* OTHER YTD * TOTAL YTD * TOT, iL YTD' ~ TOT DI,.VIDENDS DI'VlDENDS DIVIDENDS - W THItOLDING FOR 2436.,08 '231,0.53 4746.61 .00' 787.13 ]9662.99 .00 4.6500 19894.78 2ooO '.45 .00 6.5500 6892.87 6892.87 ~L YTD * EITURES .00 ' REV- ~ GOMMONVVEALTH OF PENNSYLVANIA INHERITANGE TAX RETURN RESIDENT DECEDENT SCHEDULE.J BENEFICIARIES ESTATE OF KOSTEL ~,C. LAWRENCE L, SR, NUMBER 1. 2. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)] ' F0rtuna Panza Kostelac 323 Somerset Drive Shiremanstown, PA ~17011 Lynn Marie Fromm 600 Lavina Drive Mechanicsburg, PA 17055 FILE NUMBER 21 02 RELATIONSHIP TO DECEDENT Bo Not List Trastee(s) Spouse Daughter O059 AMOUNT OR,HARE OF ESTATE Certain Real Estate and Residuary Estate Koste Seven Inc. St'ock ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN/~BOVE ON LINES 15 THROUGH 18, AS APPROPRIATE ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART li - 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) P~V-1514 EX. (1-97) ~, COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (Check Box 4 on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER KOSTELAC. LAWRENCE L,, SR, 2;1 05 0059 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to'5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. , [] Will [] Intervivos Deed of Trust r--] Other NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE' Fortuna Panza Kostelac 6/9/1935 67 r'-~Life or E~]Term of Years ~ E~Life or E~Term of Years [] Life or [] Term of Years · r"-lLife or E]Term of Years 1. Value of fund from which life estate is payable $ 172,220.00 2. Actuarial factor per appropriate table .52273 Interest table rate - [] 3 1/2% [] 6% [] 10% [] Variable Rate 52.27% 3. Value of life estate (Line 1 mUltiplied by Line 2) $ 90,024.56 NAME(S) OF NEAREST AGE AT TERM OF YEARS ANNUITANT(S} DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE E]Life or E~]Term of Years [] Life or [] Term of Years [] Life or I-'~erm of Years []Life or []Term of Years __ 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding (number) Frequency ofpayout- [] Weekly (52) [] Bi-weekly (26) E]Monthly (12) [--} Quarterly (4) [-"] Semi-annually (2) E] Annually (1) r-~ Other ). 3. Amount of payout per period $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate [---] 3 1/2% r--I 6% [] 10% [] Variable Rate % 6. Adjustment Factor (see instructions) 7. Value of annuity- If using 3 1/2%, 6%, 10%, or if va. riable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6) + Line 3 $ NOTE: The values of the funds which create the above future interests must'be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15~ 16 and 17. (If more space is needed, insert additional sheets of the same size) 21-2002-0059 LAST WILL AND TESTAMENT OF LAWRENCE L. KOSTELAC, SR. I, LAWRENCE L. KOSTELAC, SR., now of Shiremanstown, Cumberland County, Pennsylvania, do hereby declare this to be my Last Will and Testament and revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my just and currentlydue debts and funeral expenses, including the cost0fmy gravemarker, if any, shall be paid from my estate as soon as practical after my decease as a part of the administrative expenses of/ny estate. ITEM II. I give my stock in Koste Seven, Inc., to my. daughter; LYNN MARIE FROMM, as Trustee, in trust, tO pay to' herself all of the income and such mounts of principal as necessary for her welfare, comfort and support duhng her lifetime. At her death, the trust shall terminate and the principal and any undistributed income shall be paid to such of her children as she may .designate by her Will and, in absence thereof, shall be paid to her children, TAYLOR MAR/E FROMM and BRINLEY MARIE FROMM, or the survivor of them. Should my daughter, LYNN MARIE FROMM, fail or cease to act as Trustee and unless she has designated a successor Trustee in her Will, I then appoint my wife, FORTUNA PANZA KOSTELAC, as her iuccessor Trustee. S.hould she also fail or cease to act as successor Trustee, I then apl~oint my son, LAWRENCE L. KOSTELAC, JR., as her successor Trustee. Lawrence L. Kostelac, Sr. ITEM III. I give and devise a life estate to my wife, FORTUNA PANZA KOSTELAC, with the remainder interest to her, as Trustee, in trust, to hold the same in equal sha~es for my children, LAWRENCE L. KOSTELAC,'JR., KATHLEEN M. KINDLER, KENNETH L. KOSTELAC, LYNN MARIE FROMM and MATtHEw J. KOSTELAC, in the · properties I own at 122 Hampden Avenue, Camp Hill (Hampden Township), Pennsylvania and 9A Glenwood Drive, Camp Hill (East Pennsboro Township), Pennsylvania. During the lifetime of my wife, FORTUNA PANZA KOSTELAC, as life tenant and trustee' for the remaindermen, may mortgage said-properties and sell and convey the entire interest in said properties to a purchaser on her signature as life tenant and Trustee without the joinder of the remaindermen. At my wife's death, the trust shall terminate and the remaindermen shall own the property outright, free of trust. ITEM IV. I give and devise all of the rest, residue and remainder of my estate of every nature and wherever situate to my wife, FORTUNA PANZA KOSTELAC. Should she predecease me, I give the same in equal shares to my five children, LAWRENCE L. KOSTELAC, JR., KATHLEEN M. K/NDLER, KENNETH L. KOSTELAC, LYNN MARIE FROMM and MATTHEW J. KOSTELAC, and my wife's three children, LOUIS CHIP RUSSELL, JAMI NANETTE FENCEL and FORTUNA GINA CLARK, or their respective issue, per stirpes. Should any of my or my wife's children predecease me without issue surviving, I give such deceased child's share, in equal shares, to my and my wife's other children, or their issue, per stirpes. Lawrence'L. Kostelac, ITEM V. Explanatory Statement. I have on my life a One Hundred Thousand ($100,000.00) Dollar plus paid up additions life insurance policy on which I have named by daughter, LYNN MARIE FROMM, as the beneficiary of twenty-six (26%) percent thereof. I have done this so that she has cash available to pay the bills of Koste Seven, Inc.,'and provide for the orderly transition of the business from my owners.hip to hers. I have named my wife, FORTUNA PANZA KOSTELAC, as the beneficiarY often (10%)percent thereof. I have done this so that she has cash available to pay my funeral expenses and other obligations should funds not be available to pay the same from my estate. I have designated as beneficiaries of the remainder of said policy, in equal shares, my other children, LAWRENCE L. KOSTELAC, JR., KATHLEEN M. KINDLER, KENNETH L. KOSTELAC and MATTHEW J. KOSTELAC, with each to receive sixteen (16%) percent thereof. ITEM VI. If any income or principal shall be payable to any person who shall be under the age of twenty-five (25) or who shall be incapacitated for any reason, my personal representative, as trustee, shall hold such income and principal and shall apply sUch income and principal to the health, maintenance, support and education of such person until age twenty-five (25) or during incapacity, without the appointment of any guardian or committee or any authority of Court, and shall be entitled to make direct application hereunder or to make application by payment thereof to the parent or other person in charge of such person, or to his or her guardian or to a custodian under the Uniform Transfers to Minors Act, or to the person. Any remaining income and principal to which such person shall' be entitled shall be paid and distributed to such person upon attaining age twenty-five (25) or termination of incapacity. .- Lawrence L. K°stelac,~-r. / 3 ITEM VII. I appoint my wife, FORTUNA PANZA KOSTELAC, ExecUtrix, of this my Last Will and Testament. Should she fail to qualify or cease to act in such capacity, I the..n appoint my son, LAWRENCE L. KOSTELAC,.JR., and my wife's son, LOUIS CHIP RUSSELL, Contingent Co-Executors of this my Last Will and Testament. No bond shall be required of my personal representative(s) in any jurisdiction. ITEM VIII. In addition to the powers given by law to my personal representa- five(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of any trust(s) created herein, they shall have the following discretionary powem applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distribution. A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. B. To sell or otherwise dispose of any Property, real 'or personal, at any time forming a'part of my estate or the trust estate, for cash or upon credit, in such manner and on such' terms as they see fit, and no one dealing with the fiduciaries shall be bound to see .to the application of any monies Paid. C. To manage, operate, repair, improve, mortgage or lease roi- any term [even if beyond the duration of the trust(s)] any real estate at any time held or owned by them as ' fiduciaries. Lawrence L, Kostelac, Sr.. / -' / 4 property. D. To hold investments in the name of a nominee and exercise and dispose of E. To engage in litigation and comprbmise, arbitrate or abandon claims and F. To conduct any business in which I am engaged or in which I have an interest at the time of my death for such period as the fiduciaries deem advisable, wi,'th the power to borrow money and to pledge the assets of the business and to do all other acts which I, in my lifetime, could have done, or to delegate such poWers to a parmer, manager or employee without liability for any loss occurring therein-. G. To allocate items of receipt or disbursement between principal and income, as 'the fiduciaries deem equitable regardless of the character given such items by law; to distribute in cash or kind or partly in each at valuations fixed by the fiduciariesl H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock ifa corporate trustee. I. To join in any merger, reorganization, voting trust plan or other concerted. action of security holders, and to delegate discretionary duties with respect thereto. \ J. Should the principal of any trust herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then Lawrence L. Kostelac, Sr. " entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an.interest as succeeding income.beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the trust estate which any individual could exercise in the management of similar property owned in his own right, upon' such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this will or any trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the' fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, inca~)acity or other change in the absence of information deemed reliable without liability for disbursements made on such assumpiions. N. All principal and income shall, until actual distribution to any beneficiary, be 1See of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any,levy, attachment, execution or sequestration while in the hands of any bene- ficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. · Lawrence L. Kostelac, Sr. / _ / of IN WITNEss WHEREOF, I have hereunto set my hand and seal this/.-~ day · Lawrence L. Kost~lac,'Sr. - - / ' The preceding instrument, consisting of this and four other typewritten pages, identified by the signature of the testator, as on the day and date thereof signed, published and declared by LaWrence L. Kostelac, the testator therein named, as and for his last Will, in the presence of us, who, at his request, in his_.__~resence and in the presence of each other; subscribed our names as . ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA · 'SS. COUNTY OF DAUPHIN - I, LAWRENCE L. KOSTELAC, SR.,"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 insmament as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Lawrence L. K~stelac, g~. - / - - testator; this Sworn or affirm[d to and acknowledged before me, by Lawrence L. Kostelac, Sr., /.~ day of (~] ,2000. ' ' t / Notary Public [. NOTARIAL SEAL My Commission E:~prrer~,~LLY S. KIRK, Notary Public I- · Harrisburg, Dauphin County ~ A_FFIDA'VIT I'My Commi.,sJon Expires Feb. 15, ,.003 COMMONWEALTH OF PENNSYLVANIA · 'SS. 'COUNTY OF DAUPHIN · witnesses whose names are signed to d al according to law, do depose and say that we were present and saw testator sign and execute the instrument as his last Will; that he 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 .kn...o_~wled~g,e the testator was at ' that time 18 or more years of age, of sound mind and unde~~:nt.br U~~uence. Sworn to and subscribed before me this__/'-~ pr~ day of ~ r5 / , 2000. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001378 KOSTELAC FORTUNA PANZA 323 SOMERSET DRIVE SHIREMANSTOWN, PA 17011 ........ fold ESTATE INFORMATION: SSN: 184-26-3978 FILE NUMBER: 2102-0059 DECEDENT NAME: KOSTELAC LAWRENCE L SR DATE OF PAYMENT: 07/05/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/04/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 . $678.85 TOTAL AMOUNT PAID: $678.85 REMARKS: FORTUNA P KOSTELAC SEAL CHECK# 300 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWF. ALTH OF PENNSYLVANIA' COUNTY OF CUMBERLAND Fortuna P. Kostelac being duly appointed according to law, deposes and says thatshe is the Executrix of the ~tate of Lawrence L. Kostelac, Sr. late of Lower Allen Township ., Cumi~e~iand County, Pa., deceased and fha+ +he wifh;n is an ;nven+o~/ made by Fortuna P_ Koste]ac , +he sa;d. Executrix of the entire estate of said decedent, 'cons;sting of all the personal property a~d real estate, except real'estate Ou~s;de the Commonwealth of Pen~?lvania, and that the figures opposite each item of the Invenfow represent it's fa;~ ~alue as of fh~ date of decedent s death. - ; ' ' ' ~ .... . ~ ~¢¢~ and subscribed before me, e , ,:: De 4th January Fortuna P. Kostelac Exocufor - Adm;n;sfrafor 323 Somerset Drive Shiremanstown, PA 1701 Address 2002 '- ;,' '- ~ - Day , · Month Year INSTRUCTIONS I. An invenfo~ musf be filed wlfh~n fhree monfhs ~ffer ~ppolnfmen{ of personel represen{~five. 2. A supplement inventory must be filed withln th;Hy days of discove~ of additional 3. Additional sheets may be affached as +o personalty or real~ 4. See A~icle IV, Fiduciaries A~ of 1949. - assets. C Inventory of the real and personal estate of Lawrence L. Kostelac, Sr. deceased 1 .' Single .Family Dwelling, 9A GlenwOod Dr., E Pennsboro'Twp.- Single Family Dwell~gg, 112 Hampden Ave., Hampden Twp. 150 Sh'i..Pfizer, Inc. @ 39.49 1190,335 Sh Smith Barney Lg. Cap. Val · Fd. @ 24'.31 6. 7. 8. 9. 1000 Sh ~emmo~~ S~toCk,. go's~...'S,even, inc. 1997 Lincoln Town Car S~dan 1984 Lincoln..Town Car Sedan Bank Checking Acct. No. 5140367982 PNC!, ~.~I ; ITT Harford Annuity Po1.,{710312424~ ~710312434 76,360 95,860 5,923 28;937 24,130 12-,450 175, 101528 ,~. '7~o}1 .~,,, ~- =: o,'- 39,851,' O0 O0 50 O4 00 00 00 00 BUREAU OF ZNDZVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG,, PA 171Z8-0601 COHHONNEALTH OF pENNSYLVANZA DEPARTMENT OF REVENUE NOTZCE OF /NHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX '02 f UG _30 ;I1:54 FORTUNA P KOSTEIAC SOMERSET DR SHIREMANSTONN ~,.PlI,~.l'7nl I :-"' ·" BATE 08-Z6-ZOOZ ESTATE OF KOSTELAC DATE OF DEATH 01-Oq-ZOOZ FZLE NUHBER Z1 0Z-0059 COUNTY CUMBERLAND ACN 101 LANRENCE L Amoun'~ ReeA'l:'l:ed I MAKE CHECK PAYABLE AND REN'rT PAYHENT TO: REGTSTER OF MILLS CUMI~ERLAND CO COURT HOUSE CARLTSLE, PA 1701:5 CUT ALONG THZS LZNE ~'~ RETAZN LONER PORT'rON FOR YOUR RECORDS DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF KOSTELAC LANRENCE L FZLE NO. 21 02-0059 ACN 101 DATE 08-Z6-ZOOZ TAX RETURN NAS: (X} ACCEPTED AS FILED (, ) CHANGED RESERVAT'rON CONCERNZNG FUTURE 'rNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) ,2. S~ocks and Bends (Schedule B) $. Closely Held S~ock/Par~nership In~eres~ (Schedule C) ~. Mortgages/No,es ReceAvable (Schedule D) $. Cash/Bank Deposits/MAsc. Persona/ Proper~y (Schedule E) 6. JoAn~ly O~ned Proper~y (Schedule F) i 7. Transfers (Schedule G) 8. To~al Asse~s APPROVED DEDUCTZONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Costs/MAsc. Expenses (Schedule H) 10. Debts/Hot,gage LAabilA~Aes/LAens (Schedule I) 11. To~al Deductions 12. Ne~ Value of Tax Re~urn (1) 172/220.00 ($) 2~/1:50.00 (q). .00 (5) 6~/010.5~ (6) 50/ORO.O0 (7) 98/90q.98 (8) NOTE: To Ansura proper credit ~o your account, submi~ ~ha upper portion of ~hLs form wASh your ~ax payment. qqq,166.06 (9) (10) 17,5:58.6q 6/892.87 (11) 2~.~1.5] (12) fi19,7:sq.55 13. lq. NOTE: CharA~able/Governmen~al Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0 Ne~ Value of Es~a*a Sub,ac* *o Tax (1~) ~1C), 7:5~. 55 :Zf an assessment ~as issued previously, 11nos 1~, 15 and/er. 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. (15) 252,595.7:5 x O0 = .00 (16) 167,1ql.82 x Oq5= 7,521.$8 (17) .00 x 1'2 = .00 (18) .00 x 15 = .00 (19)= 7,521 .:58 ASSESSMENT OF TAX: 15. Amount of LAne lq a~ Spousal ra~e 16. Amoun~ of Llne lq *axable a~ Lineal/Class A ra~e 17. Amoun~ of LAne lq a* SAblAng ra~e 18. Amoun~ of LAne lq ~axable a~ Collateral/Class B ra*e 19. PrAncApal Tax Due TAX CREDZTS: PAYMENT . RECE~rl DZ$COUNT DATE NUMBER INTEREST/PEN PAID (-~ 0q-0q-Z00Z CD0010:56 $qZ.11 07-05-2002 CD001:578 .00 AMOUNT PAID 6,500.00 678.85 TOTAL TAX CREDZT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. 7,520.96 .qZ .00 .qZ ( IF TOTAL DUE IS LESS THAN $1~ NO PAYMENT ZS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDZT' (CR), YOU NAY BE DUE A'REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.) RESERVATION: PURPOSE oF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before Decembe~ 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the deCedent after the eXpiration Of any estate for life or for years, the Commonwealth hereby expressly reseryes the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on ~ny 'such futura interest. To fulfill the requirements of Section 21q0 of tho Inheritance and.Estatm Tax Act, Act 25 of 2000. (7Z P.S. ' Section 91q0). Detach the top portion of this Notice and submit ~ith your payment to the Register of Hills printed on the reverse sida~ --Make check or money order payable to: REGISTER OF NILLS, AGENT · A refund of a tax credit, which ~ms not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estatm Tax" (REV-ISiS). Applications ara available at'the Office of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special 2C-hour ansmering service for forms ordering: 1-800-362-2050; services for taxpayers with'special hearing and / or speaking needs: 1-800-¢¢7-3020 (TT only); ~ ' Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (incZuding discount or interest) as shamn on this Notice must object aithin sixty (60) days of receipt of this Notice by: .. --~rittan protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court.. Factual errors discovered on this assessment should be addressed Jn mritihg to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an axpZanatisn of administratively correctable errors. If any tax due is paid mithin three (3) calendar months after the decedant's death, a five percent (52) discount of .the tax paid is allowed. The 1SI.tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is' appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. IntereSt is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became datinquent before January 1, 1982 bear interest at the rate of six (61) percent per annum calculated at a daily rate of .00016¢. A11 taxes which became delinquent on and after January 1, 1982 w]11 bear interest at a rate mhich mill vary from calendar year to calendar year mith that rate announced b~ the PA Department of Revenue. The applicable interest rates for 1982 through 2002 ara: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZOZ . 0005¢8 1991 91 . 0001¢7 1983 162 · 000¢38 1993-199¢ - 72 · 000191 198¢ 11Z . 000301 1995-1998 9X . 000Z¢7 1985 131 . 000356 1999 71 . 000192 1986 l'bX . O00Z7fi ZODO 81 . 000219 1987 97. . O00Zq7 2001 9Z . O002¢7 1988-1991 11Z .000301 zoog 67. .00016¢ --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DATLy INTEREST FACTOR --Any Notice issued after the tax'becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment.. If payment is made after the interest computation date shown on the Notice, additional interest mustbe calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Lawrence L. Ko?~elac, Sr. Date of Death: 01/04/2002 Will No. 21-02-0059 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the e9tate is complete: Yes xx No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to'No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No xx b. The separa'~e-~-O'~phahs' Cou~:-N0~.~ii~f 'any')-~fo'~ the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes xx No d. Copies of receipts, ~rel'ea-~ses','-~i'~'~'~a'nd'' · approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to 'this report. DEC 1.8 003 Date~ ~ ~ - ~ -_J ~ Sign~dre / ~ ' - Scott M. Dinner, Esq. ~ s Name (Please type or print) ? ? ~ J~ ........ 3117'Chestnut St , Camp Hill, PA e~. ;. ~ .. ~ Address ' ': ' Counsel ~or personal representat&ve (~H' rmf/~3)