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Home My WebLink About08-15-08 (2)A 15056041147 REV-1540 ex {06-05) OFFICIAL USE ONLY PA Department of Revenue County code near F;le Number Bureau of Individual Taxes INHERITANCE TAX RETURN 21 0 8 0 3 9 5 PO 60X.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 180 O1 8350 11 19 2007 10 15 1914 Decedent's Last Name Suffix Decedent's First Name MI KRACZYK HELEN L (If Applicable) Enter Surviving Spouse's information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Retum ^ ^ 4. Limited Estate X^ 6. Decedent Died Testate ^ (Attach Copy of WiN) MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4a. Future trnerest Comprwnise ^ 5. Federal Estate Tax Retum Required (date of death after 12-12-82) ~ Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Ariach Copy of Trust) 9. Litigation Proceeds Received 1 p. Spousal Poverty Credd (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 JENNIFER B. HIPP 717 737 8761 Firm Name (If Applicable) BOGAR AND HIPP LAW OFFICES First line of addn~ss 1 WEST MAIN STREET Second line of address City or Post Office SHIREMANSTOWN State ZIP Code PA 17011 ~ REGISTER ~ Vy)LLS USE~lLY ``~~~, a..~. i c~ ~- i r f._. ,- -- ~;? --, t,.. i =; .; _ '_~:i ~, t~ Correspondents e-mail address: Under penalties of perjury, 1 deGare that I have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief, it is trurY..Correct 2nd complete. De~ratioD.ef~feparer otj~,er tjaan the personal representative is based on all information of which preparer has any knowledge. Barbara L. Cutillo ~ - i ~ -L? 416 Prowell Drive, Camp Hill, PA 17011 SIG TU E OF PRE, PEER OTHER THAN REPRESENTATIVE DATE U~~ Jennifer B. Hipp ~ _ I ~._~ ~ 0 One Vl~est Main Street, Shiremanstown, PA 17011 - 15056041147 Side 1 15056041147 J ~1~~; ~~ ~ ~ f T REV-1500 EX ~ecedenPsName: Helen L. Kraczyk Decedent's Social Security Number 180 O1 8350 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 1 1 3 , 2 0 1 . 1 7 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 1 1 3 , 2 01.1 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) ...................................................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 13, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . ................................................ 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X .00 0 0 0 15. 16. Amount of Line 14 taxable 17 013 10 8 1 s. at lineal rate X .045 . , 17. Amount of Line 14 taxable 17 at sibling rate X .12 0 . 0 0 . 18. Amount of Line 14 taxable 18 at collateral rate X .15 0 0 0 . 19. Tax Due ..................................................................... ................................................ 19. 20. FILL IN THE OVAL 1F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15056042148 15056042148 $Ide 2 4,281.00 907.00 5,188.00 108,013.17 108,013.17 0.00 4,860.59 0.00 0.00 4,860.59 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-0395 DECEDENTS NAME Helen L. Kraczyk STREET ADDRESS 416 Prowell Drive CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit g. Prior Payments C. Discount 3. InteresUPenalty if applicable p. Interest E. Penalty 275.92 0.00 Total Credits (A + B + C) (1) 4,860.59 (2) 275.92 Total InteresUPenalry (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. 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 + 5A. This is the BALANCE DUE. (3) (4) (5) 4,584.67 (5A) (5B) 4,584.67 Make Check Payable to: REGISTER OF WILLS, AGENT _~.,.~. ~.~ .a~ ~.,;_.,.~ ~~ ~ ~ . 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 ........................................................................................................:......... ^ x d. receive the promise for life of either payments, benefits or care? ............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................... ^ ^ ........................................................................................ x 3. Did decedent own an "in trust forr or payable upon death bank account or security at his or her death?......... ^ ~~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^ C~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. .... For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 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. SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF (FILE NUMBER Kracryk, Helen L. 21-08-0395 Han asset was made joint within one year of the decedenPs date of death, It must bs roporiW on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Barbara L. Cutillo 416 Prowell Drive Daughter Camp Hill, PA 17011 Rw-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT B. C. ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTIONAND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A 11/1/2001 Commerce Bank -Checking Account No. 731.56 50.000% 365.78 513327858; principal balance - $731.43; accrued interest - $0.13 2 A 2/13/1991 Fox Chase Bank -Certificate of Deposit 12.344.95 50.000% 6.172.48 No. 240827212 CD; principal balance - $12,319.79; accrued interest $25.16 3 A 1/10/1991 Fox Chase Bank -Certificate of Deposit 16.032.68 50.000% 8.016.34 No. 24081547 CD; principal balance - $16,000.00; accrued interest - $32.68 Total of Continuation Schedules See attached pa es JOINTLY OWNED PROPERTY: TOTAL (Also enter on Line 6, Recapitulation) I 113,201.17 (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 F (Rev. 6-98) Rev-1508 EX+ (6-88) SCHEDULE F COMMONVVE4LTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERfiANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF (FILE NUMBER Kracryk, Helen L. 21-08-0395 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTIMION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASS % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 4 A 1R/2004 MBNA n/kla Bank of America - 60 Month 60,000.00 50.000% 30,000.00 CD Account No. 4020525-9; date of issue 01107104; maturity date 01107/09; balance $60,000.00. (See attached statment.) Multiple requests have been made to MBNA and Bank of America to provide date of death valuations for this account. To date no such information has been provided. We believe that interest did not accumulate in this account, but was paid out on a monthly basis. We believe that said interest was transferred to Ms. Kracryk's PNC Checking Account No. 8597396963. 5 A 3/12/2004 MBNA n/k/a Bank of America - 60 Month 25,000.00 50.000% 12.500.00 CD Account No. 40-384717-5; date of issue 03112/04; maturity date 03/12/09; balance $25,000.00. (See attached statment.) Multiple requests have been made to MBNA and Bank of America to provide date of death valuations for this account. To date no such information has been provided. We believe that interest did not accumulate in this account, but was paid out on a monthly basis. We believe that said interest was transferred to Ms. Kracryk's PNC Checking Account No. 8597396963. Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1509 p(+ (698) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERRANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF (FILE NUMBER Kracryk, Helen L. 21-08-0395 If an asset was made joint within one year of the decedent's date of death, it must lie reported on schedule G. JOINTLY OWNED PROPERTY ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 6 A 6/23/2005 MBNA n/k/a Bank of America - 36 Month 10,000.00 50.000% 5.000.00 CD Account No.10-210509-6; date of issue 06/23/05; maturity date 6/23108; balance $10,000.00. (See attached statment.) Multiple requests have been made to MBNA and Bank of America to provide date of death valuations for this account. To date no such information has been provided. We believe that interest did not accumulate in this account, but was paid out on a monthly basis. We believe that said interest was transferred to Ms. Kracryk's PNC Checking Account No. 8597396963. 7 A 12/2/1983 PNC Bank -Checking Account No. 2,288.14 50.000% 1.144.07 8597396963; principal balance - $2,288.02; accrued interest - $0.12 8 A 2/1/2006 Susquehanna Valley Federal Credit 5.00 50.000% 2.50 Union -Share savings account -principal balance $5.00; accrued interest $0.00 9 A 2/1/2006 Susquehanna Valley Federal Credit 100,000.00 50.000% 50,000.00 Union -Share Certificate Account - principal balance $100,00.00; accrued interest $0.00 TOTAL (Also enter on Line 6, Recapitulation) I 113,201.17 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) July 28, 2008 Jennifer B. Hipp James D. Bogar Attorney at Law One West Main St Shiremanstown PA 17011 RE: Estate of: Helen L. Kraczyk Tax Identification Number: 180-01-8350 Date of Death: November 19, 2007 To Whom It May Concern: Commerce CBank This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking (Joint with Right of Survivorship) Account Number: 513327858 Date Opened: November 1, 2001 Primary Owner: Barbara Cutillo Secondary Owner: Helen L. Kraczyk Date of Death Balance: $731.56 Accrued Interest: $.13 Principal Balance: $731.43 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, Cindy Shultz Support Associate/Deposit Services Commerce Bank Commerce Bank /Harrisburg, N.A. PO Box 4999 3801 Paxton Street Harrisburg, PA 17111-0999 commercepc.com Fox C~sE Bic July 17, 2008 James D. Bogar One West Main Street. Shiremanstown, PA 17011 RE: Estate of Helen L. Kraczyk ,deceased on November 19, 2007. Account Number 240827212 CD Title Helen L. Kraczyk Barbara L. Cutillo Date Opened 02f 13/91 Title Changed n/a Date Changed n/a Principal $12,319.79 Interest to D.O.D. $25.16 Balance $12,344.95 Interest from 01/01/07 thru 11/19/07 $395.72 Other: There was no information on file for Account #241345677 Sincerely, \,~' C Melissa Landue Deposit Services 4390 Davisville Road • Hatboro, PA 19040 • (215) 682-7400 k ,~ _ ~~ ~~ Fox C~asE Bar July 17, 2008 James D. Bogar One West Main Street Shiremanstown, PA 17011 RE: Estate of Helen L. Kraczyk ,deceased on November 19, 2007. Account Number 24081547 CD Title Helen L. Kraczyk Barbara L. Cutillo Date Opened 01/10/91 Title Changed n/a Date Changed n/a Principal $16,000.00 Interest to D.O.D. $32.68 Balance $16,032.68 Interest from 01/01/07 thru 11/19/07 $555.85 Other: There was no information on file for Account #241345677 Sincerely, -~..~'~~ Melissa Landue Deposit Services 4390 Davisville Road • Hatboro, PA 19040 • (215) 682-7400 MBNA AMERICA BANK, N.A. P. O. Box 15103 ,.;. WILMINGTON, DE 19850-5103 .~.... mbna Y l - (800) -348-4632 HELEN KRACZYK BARBARA CUTILLO 416 PROWELL DR CAMP HILL PA 17011 ACCOUNT NUMBER 40-320525-9 FOR CHANGE OF ADDRESS, PLEASE USE THE REVERSE SIDE OF THIS FORM. NEA-SPONSORED CD ACCOUNT PAGE 1 - STATEMENT PER i OD FROFi 5/v i /u^6 TFii~~UGH 9/2i j 06 kCCOUNT NUriBER 40- 20"'2 3 7 5-~ NUMBER OF DAYS 21 ACCOUNT SUMMARY INFORMATION TERM 60 MONTHS CALENDAR YTD INTEREST PAID 1,926.58 ISSUE DATE 01/07/04 CALENDAR YTD WITHHOLDING 0.00 MATURITY DATE O1/07/0 CALENDAR YTD ~ PENALTY 0.00 INTEREST RATE 4.2 J~ TRANSACTION HI-STORY INFORMATION POST EFF TRANSACTION TRANSACTION BALANCE DATE DATE DESCRIPTION AMOUNT 9/01 BEGINNING BALANCE 60 000.00 9/07 9/07 INTEREST PAYMENT 217.98 , 217 60 98 9/07 9% O DESIGNATED ACCT A H R 217.98- , . 60 OOb 00 2i END NG BA ANCE , . 60,000.00 1 OF 4 90B 225 MEMBER FDIC ' MBNA AMERICA BANK, N.A. ACCOUNT NUMBER 40-384717-5 -_= P. o. BOx 15103 .•. W I LM I NGTON, DE 19850-5103 ~ ;~ mbna •Y 1- (800) -348-4632 ____ ____ ____ HELE N KRACZYK BARB ARA CUTfLLO -- 416 PROWELL DR CAMP HILL PA 17011 -~ ~_ FOR CHANGE OF ADDRESS, PLEASE USE THE REVERSE SIDE OF THIS FORM. NEA-SPONSORED CD ACCOUNT PAGE 4 STATEMENT PERICG FROM 9/01/06 THROUGH 9Iz1lo6 ACCOUiiT rUFiBcR 40-.384717-5 NUMBER OF DAYS 21 ACCOUNT SUMMARY INFORMATION TERM 60 MONTHS CALENDAR YTD INTEREST PAID 785.79 ISSUE DATE 03/12/04 CALENDAR YTD WITHHOLDING 0.00 MATURITY DATE 03/12/0 CALENDAR YTD PENALTY 0.00 INTEREST RATE 4.1 $ TRANSACTION HISTORY INFORMATION POST EFF TRANSACTION TRANSACTION BALANCE DATE DATE DESCRIPTION AMOUNT 9/01 BEGINNING BALANCE 88 91 25,000.00 91 088 25 9/12 9/12 9/12 /12 . INTEREST PAYMENT PREAUTH TRSF TO DESIGNATED ACCT 88.91- . , 25,000.00 9/21 ENDING BALANCE 25,000.00 IMPORTANT NEWS WE RECENTLY INFORMED YOU OF THE MERGER OF MBNA AND BANK OF AMERICA. THIS IS YOUR FINAL MBNA STATEMENT, WHICH REFLECTS ALL TRANSACTIONS SINCE YOUR MGST REGENT STATEMENT. GOING FORWARD YOU WILL NOT RECEIVE STATEMENTS, HOWEVER YOU WILL BE ABLE TO VIEW YOUR ACCOUNT SUMMARY ONLINE OR YOU MAY CONTACT US BY PHONE. SEE THE MATERIALS WE RECENTLY MAILED TO YOU FOR MORE INFORMATION. THIS SUMMER ADD THE PERFECT COMPLEMENT TO YOUR NEA CD DEPOSIT ACCOUNT BY OPENING AN NEA MONEY MARKET ACCOUNT. YOU'LL EARN A GREAT RETURN WITH SOME OF THE HIGHEST YIELDS IN THE NATION. PLUS, YOU'LL HAVE ACCESS TO YOUR FUNDS AND THE SAFETY QF FDIC INSURANCE. TO OPEN AN ACCOUNT, CALL 1- 00-215-2727. 4 OF 4 90B 225 MEMBER FDIC ' MBNA AMERICA BANK, N.A. P. o. sox 15103 ~~~:. WILMINGTON, DE 19850-5103 ..,.. m na Y 1- (800) -348-4632 HELEN KRACZYK BARBARA CUTILLO 416 PROWELL DR CAMP HILL PA 17011 ACCOUNT NUMBER to-210509-6 FOR CHANGE OF ADDRESS, PLEASE USE THE REVERSE SIDE OF THIS FORM. NEA-SPONSORED CD ACCOUNT PAGE 3 STATEi1ENT PERI OD FROi1 7/G1/06 THROUGH g/21106 ACCOUNT NUMBER 10-210509-6 NUMBER OF DAYS 83 ACCOUNT SUMMARY INFORMATION TERM 36 MONTHS CALENDAR YTD INTEREST PAID 281.43 ISSUE DATE 06/23/055 CALENDAR YTD WITHHOLDING 0.00 MATURITY DATE 06/23/08 CALENDAR YTD PENALTY 0.00 INTEREST RATE ~+.22~ TRANSACTION HISTORY INFORMATION POST EFF TRANSACTION TRANSACTION BALANCE DATE DATE DESCRIPTION AMOUNT /O1 BEGINNING BALANCE 10,000.00 /22 /23 INTEREST PAYMENT 34.75 10,034.75 /22 /23 INTEREST PAID BY CHECK 34.75- 10,000.00 /23 123 INTEREST PAYMENT 35.90 10,035.90 /23 8/2~ INTEREST PAID BY CHECK 35.90- 10,000.00 9/2 ENDING BALANCE 10,000.00 3 OF 4 908 225 MEMBER FDIC Aug.'1. 2C08 8,18AM PNC BANK 412-705-2747 ~~ lI:ACI~IG tHE W/lY August 11, 2008 Jennifer B Hipp Attorney at Law One West Main St Shiremanstown, pA 17011 RE: Helcn L Kraczyk SSN: 180-01-8350 DOD: 11-19-2007 Dear Ms. Hipp: Na.8884 P. 1 In response to your rec}uest for Date of Death (DOD) balances for the customer noted above, our records show the following: Checking Account Account # 8597396963 Established: 12-02-1983 HELEN L KRACZYK BARBARA L CUTII.LO DOD balance: $ 2,288.02 + 0.12 accrued interest . Please note that tbis•offce provides date of death balances for deposit accounts (IlZAs, CDs, Checking and Savings). We do not process any financial transactions or provide statements. ff you need assistance with any of these hews, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bamk b~aach office. sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 0l 1 USQUEHANNA ALLEY FEDERAL CREDIT UNION Jennifer B Hipp Attorney at Law One West Main St Shiremanstown, PA 17011 Re: The Estate of Helen L Kraczyk Dear Ms. Hipp; Helen L Kraczyk did have an account with the credit union at the time of her death. She had a share savings account that was opened on February 1, 2006 in the name of Helen L Kraczyk and Barbara L Cutilla as the joint owner, and a share certificate also opened on February 1, 2006 in the same names. The share savings had a balance of $5.00 on November 19, 2007, and the share certificate had a balance of $100,000.00 on November 19, 2007. Both accounts have been closed out in December 2007. If you should have any more questions, please feel free to call our office. Thank you. Sincerely, /~~ ~~! ar et W Fisher SVFCU Operations Manager ~~~ 3850 HARTZDALE DRIVE • CAMP HILL, PA 17011-7809 (~ LOCAL: (717 737-4152 TOLL FREE: 800 948- 4 - \~~ ( ) 1 54 FAX: (717) 737 0589 ~~ REV-1151 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Kracryk, Helen L. 21-08-0395 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached ~ 1,706.00 B. ADMINISTRATIVE COSTS: 1. 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 Bogar and Hipp Law Offices 1,845.00 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 5. Accountant's Fees 230.00 6. Tax Return Preparer's Fees 7. Other Administrative Costs 500.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 4,281.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1b02 EX+ (6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Kracryk, Helen L. 21-08-0395 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule H-A (Rev. 6-98) Rev1 b02 EX+ (6.88) SCHEDULE H-B5 ACCOUNTANT'S FEES continued COMMONWEALTH OF PENNSYLVANIA WHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Kracryk, Helen L. 21-08-0395 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B5 (Rev. 6-98) Rw-7b02 EX+ (6.98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA continued INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kracryk, Helen L. _ 21-08-0395 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rav-1512 p(+ (698) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS COMMONNiE.4LTH OF PENNSYLVANl4 WHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Kracryk, Helen L. 21-08-0395 Include unroirnbursad nad-cal expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Pennsylvania Department of Revenue - 2007 Personal Income Tax 369.00 2 U.S. Treasury - 2007 Personal Income Taxes; $800.00 was paid prior to filing of the 538.00 Return ; a refund of $262.00 is anticipated. TOTAL (Also enter on Line 10, Recapitulation) I 907.00 (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 I {Rev. 6-98) ~„_ ,~, SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Kraczyk, Helen L. 21-08-0395 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not List Tru (Words) ($$$) ~~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Barbara L. Cutillo Daughter One hundred 416 Prowell Drive percent of rest, Camp Hill, PA 17011 residue and remainder Total Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on Rev 1500 cove r sheet II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR JVHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART Il -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 73 OF Rtv-~ 5ou t;vvttt ~ntt I i u.vv Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) LAST WILL ,AND TESTAMENT OF HELEN L. I~RACZYIf 1, I-IELEN L. I~RACZYI~, of 416 Prowell Drive, Camp Hill, (Hampden Township), Cumberland County, Pennsylvania, zeal<:e, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: 1 direct that au inheritance, estate, txansfer, succession and death taxes, as well as my just debts and funeral expenses, of any kind whatsoever, which nay be payable by reason of my death, shall be paacl out of the principal of my estate as the same can conveniently b~~ done. SECOND: Y give, devise and bequeath all the rest, residue and rezYiainder of my estate of whatever nature and wherever sit~zate, including any property over which 1 hold power of appointment ~znd together with any insurance policies thereon, unto my daughter, BARBARA L. CUTILLO, of Camp Hill, Pennsylvania. THIRD: Should BARBARA. L. CUTILLO predece~.se me or die on or before the thirty-first {31st) day following my death, I give, devise and bequeath alI the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which 1 hold power of appointment and together with any insurance policies -.z ~ thereon, as follows: (a) Five thousand dollars 05,000.00) to my friend, PATRICLA. POLE, of Philadelphia, Pennsylvania; and (b) Five thousand dollars ($5,000.00) to my friend, jACQUIE LYONS, of Philadelphia, Pennsylvania; and (c} Five thousand dollars ($5,000.00) to my friend, THELMA PETRILLI, of Philadelphia, Pennsylvania; and (d) Twenty thousand dollars ($20,000.00) to my frif;nd, JAMES MILLER, of Collegeville, Pennsylvania; and (e) Rest, residue and remainder of my estate to my friend, DIANA. MA.RTLEW, of Camp Hill, Pennsylvania. FOUR'T'H: In addition to all powers granted to them. by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval. and effective until actual distribution of all property: (A} To sell at public or private sale, ox to lease, for any pex-iod of tuYle, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms {includu1g cr. edit, with or without security) or conditions as axe deemed proper. This includes the power to give legally sufficient instruments for tran,~fer of the property azld to receive the proceeds of any disposition. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, irnproveznent, zoning or management of real estate and to impose or extinguish restric- ~--,f tiozls on real estate. 2 (C) To compromise any claim ox controversy and to aba~ldon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduciaries, as are deen~~ed proper, without regard to any principle of diversification, risk or productiv- ity. (E) To exercise any option, right or privilege granted in ins~.zrance policies or inother investments. (F) To exercise any election or privilege given by they Federa.( and other tai. laws, including, but not necessarily being limited to, person- al income, gift and estate or inheritance tax Iaws. (G} To make distributions to my herein named bent~ficiaries in cash or in kind or partly in each. (H) To borrow money fro~;~ themselves or others iii order to pay debts, taxes, or estate or trust administration expenses, to p rotect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualifies( retire- nlent plan (pension plan, profit sharing plan, employee stock o~n~~ership pla~z, or any other type of qualified plan} to the extent provided for by the plan or the law. FIFTH: I nominate and appoint BARBARA, L. CU'I'II,L,O, Executrix, of this, my Last Will and Testament: In the event of the death, 3 resignation or inability to serve for any reason whatsoever of BARBARA L. CUTILLO, ~ nominate and appoint DIANA MARTLEW, E~:ecutx-i~-, of this, my Last Will and Testament. I direct that my Executrix and her successor shall not be required to post security or a bond for the pexforznance of their duties in any jurisdiction. ZN WITNESS WHEREOF, I have hereunto set my hand and seal to this, zny Last Will and Testament, this ~ ~ day of .A.p~il, 2005 . °~• ~~.atih-Il~ (SEAL) HELEN L. ICRACZYK ~ Signed, sealed, published and declared by the above-named Testa- trix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as .attesting witnesses. 7a ~ ~. ~ ~ Address ~?a ~' Addres~ ~7a ivame v f ~~~ ~ti?.~~-c~ N~ 4