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HomeMy WebLinkAbout10-08-08 (2)15056041147 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue county code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 8 0 5 9 9 PO BOX.280601 Harrisburg, PA 17126-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 176 34 8356 04 20 2008 12 18 1930 Decedent's Last Name Suffix Decedent's First Name MI COTSARELIS HELEN (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI COTSARELIS ELIAS N Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~, 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) `~ 4. Limited Estate ~ 4a. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) X ~ 8 Decedent Died Testate ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes ~--~ (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 1p, Spousal Poverty Credit date of death n t 1,Election to tax under Sec. 9113(A) hetwean 12-31-91 and -1-951 CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number LEONARD TINTNER ESQUIRE 717 236 9377 ~., Firm Name (If Applicable) BOSWELL, TINTNER, PICCOLA First line of address 315 N. FRONT STREET/PO BOX Second line of address City or Post Office HARRISBURG State ZIP Code REGISTER O~=S USE ~LY ~_r- -; rt I ,. , t r:'~ ,_t -_7 C.J _~, --t .. DATI~FILED `^~ PA 17108-0741 Correspondent's a-mail address: I t i n t n e r@ b t p a l a w. C 0 m _.r, -I --, -; -'; ;_. _> ~^ _> f'7 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ~~~ ~ C ~ _ ~ ELIAS N. COTSARELIS ~ ~- a a(~,Qg- ADDRESS 3817~QPPER KEnI F I?^~..~. CAMP HILL. PA 17011 PREPARER LEONARD TINTNER ESQUIRE 315 N. FRONT STREETlPO BOX 741 ,HARRISBURG, PA 17108-0741 DATE Side 1 15056041147 15056041147 J 15056042148 REV-1500 EX Decedent's Social Security Number oeceaenYs Name: HELEN C O T S A R E L I S 17 6 3 4 8 3 5 6 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 & Notes Receivable (Schedule D) ........................................................ 4. 167,342.24 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested............ 6. 3 2 , 5 6 2 . 4 3 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested............ 7, 9 7 , 19 4 9 7 8. Total Gross Assets (total Lines 1-7) ..................................................................... g. 2 9 7, 0 9 9. 6 4 26,465.54 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. 2 6 . 4 6 5 . 5 4 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... . 12. 270,634.10 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. 270,634.10 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15 6 , 9 2 9 . 2 3 15. 16. Amount of Line 14 taxable 1 1 3, 7 0 4. 8 7 16 at lineal rate X .045 . 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 Q 0 Q 18. 19. Tax Due ................................................ ................................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 5,116.72 0.00 0.00 5,116.72 Side 2 15056042148 15056042148 Rev-7508 EX+(6~8) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER COTSARELIS, HELEN 21-08-0599 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly4wned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 MID PENN BANK -SAVINGS ACCOUNT #9004146 1,418.12 2 INTEGRITY BANK -CERTIFICATE OF DEPOSIT #0001017582 87,971.28 3 MEMBERS 1ST FEDERAL CREDIT UNION -SAVINGS ACCOUNT #240597-00 2,483.49 4 PNC BANK -CHECKING ACCOUNT #5140175884 2,196.66 5 STERLING FINANCIAL CORPORATION -SAVINGS ACCOUNT #21501812 3,170.93 6 STERLING FINANCIAL CORPORATION -CERTIFICATE OF DEPOSIT #9150001834 70,101.76 TOTAL (Also enter on Line 5, Recapitulation) I 167,342.24 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-7509 EX+(g-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER COTSARELIS, HELEN 21-08-0599 If an asset was made joint within one year of the decedent's date of death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. NICHOLAS COTSARELIS 904 WILLCLIFF DRIVE Son Mechanicsburg, PA 17055 B C. 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 ALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 2/3/2004 MEMBERS 1ST FEDERAL CREDIT UNION 65,124.85 50.000% 32,562.43 - CERTIFICATE OF DEPOSIT #240597-40 TOTAL (Also enter on Line 6, Recapitulation) 32,562.43 (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-1510 EX+ (g~8) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER COTSARELIS, HELEN 21-08-0599 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 yes. ITEM NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET %OFDECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 COMMERCE BANK -CERTIFICATE OF DEPOSIT 97,194.97 100.000 0.00 97,194.97 #303122 TOTAL (Also enter on Line 7, Recapitulation) I 97,194.97 (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 G (Rev. 6-98) REV-1151 Ex+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER COTSARELIS, HELEN 21-08-0599 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 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 BOSWELL, TINTNER, PICCOLA 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant ELIAS N. COTSARELIS Street Address 3817 COPPER KETTLE ROAD City Camp Hill State PA Zip 17011 Relationship of Claimant to Decedent SpOUSe 12,016.02 0.00 10,000.00 3,500.00 4. Probate Fees 614.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Other Administrative Costs 335.52 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 26,465.54 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (BA8) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER COTSARELIS, HELEN 21-08-0599 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (8.98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER COTSARELIS, HELEN 21-08-0599 ITEM NUMBER DESCRIPTION AMOUNT 1 BOSWELL, TINTNER 8~ PICCOLA -REIMBURSEMENT POSTAGE, PHOTOCOPY 50.00 FEES 2 CUMBERLAND COUNTY REGISTER OF WILLS -SHORT CERTIFICATES 12.00 3 CUMBERLAND LAW JOURNAL -ADVERTISE ESTATE 75.00 4 THE SENTINEL -ADVERTISE ESTATE 198.52 Subtotal 335.52 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REV•1513 EX+ (9-00) SCHEDULE J COMMNHERITANCEOTAX RETURLN ANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER VU 1 JAKtLI,, F1tLtN 21-08-0 599 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Tnistee s I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] ELIAS N. COTSARELIS Husband 100% OF 3817 COPPER KETTLE ROAD RESIDUE CAMP HILL, PA 17011 GEORGE COTSARELIS Son BENEFICIARY PA OF CD AT COMMERCE BANK NICHOLAS COTSARELIS Son JOINT 904 WILDCLIFF DRIVE CERTIFICATE Mechanicsburg, PA 17055 OF DEPOSIT - MEMBERS 1ST Total Enter dollar amounts for distributions shown above on lines 5 through 18, as appropr iate, on Rev 1500 cove r sheet II. 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) ~Oop~ LAST WILL AND TESTAMENT OF HELEN COTSARELIS Introductory Clause. I, HELEN COTSARELIS, a resident of and domiciled in Camp Hill, County of Cumberland and Commonwealth of Pennsylvania, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils at any time heretofore made by me. I am married to ELIAS N. COTSARELIS. I have three living children: NICK COTSARELIS of Mechanicsburg, Pennsylvania, GEORGE COTSARELIS of Berwyn, Pennsylvania and FRAN (FRANCIS) COTSARELIS KANEALY of Louisville, Kentucky. ITEM I Direction to Pa~Debts. I direct that all my legally enforceable debts, secured and unsecured, be paid as soon as practicable after my death. ITEM II Direction to Pay All Taxes from Residuary Estate. I direct that all estate, inheritance, succession, death or similar taxes (except generation-skipping transfer taxes) assessed with respect to my estate herein disposed of, or any part thereof, or on any bequest or devise contained in this my Last Will (which term wherever used herein shall include any Codicil hereto), or on any insurance upon my life or on any property held jointly by me with another or on any transfer made by me during my lifetime or on any other property or interests in property included in my estate for such tax purposes be paid out of my residuary estate and shall not be charged to or against any recipient, beneficiary, transferee or owner of any such property or interests in property included in my estate for such tax purposes. ITEM III ~ecific Devise of Residential Property. I give and devise to ELIAS N. COTSARELIS, if he shall survive me, any interest which I own at the time of my death real estate and dwelling in New Avorani and Agrinion, Greece. If he shall not survive me, then I give and bequeath said property to the surviving issue per stirpes of Elias N. Cotsarelis. Page 1 ITEM IV Outright Gift of All Property to Husband Contingent Gift to Issue. I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description (including lapsed legacies and devises) wherever situate and whether acquired before or after the execution of this Will, absolutely in fee simple to my husband, ELIAS N. COTSARELIS, if he shall survive me. If he shall not survive me, then I give, devise and bequeath all of the property to my surviving children in equal shares, provided, however, the then living issue of a deceased child of mine shall take per stirpes the share their parent would have taken had he or she survived me. ITEM V Naming the Personal Representative Personal Representative Succession, Personal ReRresentative's Fees and Other Matters. The provisions for naming the Personal Representative, Personal Representative succession, Personal Representative's fees and other matters are set forth below: (1) Naming an Individual Personal Representative. I hereby nominate, constitute, and appoint as Personal Representative of this my Last Will and Testament ELIAS N. COTSARELIS and direct that he shall serve without bond. (2) Naming Individual Successor or Substitute Personal Representative. If my individual Personal Representative should fail to qualify as Personal Representative hereunder, or for any reason should cease to act in such capacity, the successor or substitute Personal Representative who shall also serve without bond shall be NICK COTSARELIS. (3) Fee Schedule for Individual Personal Representative. For its services as Personal Representative, the individual Personal Representative shall receive reasonable compensation for the services rendered and reimbursement for reasonable expenses. ITEM VI Definition of Personal Representative. Whenever the word "Personal Representative" or any modifying or substituted pronoun therefor is used in this my Will, such words and respective pronouns shall include both the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Personal Representative named herein and to any successor or substitute Personal Representative acting hereunder, and such successor or substitute Personal Representative shall possess Page 2 all the rights, powers and duties, authority and responsibility conferred upon the Personal Representative originally named herein. ITEM VII Powers for Personal Representative. By way of illustration and not of limitation and in addition to any inherent, implied or statutory powers granted to Personal Representatives generally, my Personal Representative is specifically authorized and empowered with respect to any property, real or personal, at any time held under any provision of this my Will: to allot, allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract with respect to, continue any business of mine, convey, convert, deal with, dispose of, enter into, exchange, hold, improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect to, take possession of, pledge, receive, release, repair, sell, sue for, to make distributions or divisions in cash or in kind or partly in each without regard to the income tax basis of such asset, and in general, to exercise all the powers in the management of my Estate which any individual could exercise in the management of similar property owned in his or her own right, upon such terms and conditions as to my Personal Representative may seem best, and to execute and deliver any and all instruments and to do all acts which my Personal Representative may deem proper or necessary to carry out the purposes of this my Will, without being limited in any way by the specific grants of power made, and without the necessity of a court order. ITEM VIII Discretion Granted to Personal Representative in Reference to Tax Matters. My Personal Representative as the fiduciary of my estate shall have the discretion, but shall not be required when allocating receipts of my estate between income and principal, to make adjustments in the rights of any beneficiaries, or among the principal and income accounts to compensate for the consequences of any tax decision or election, or of any investment or administrative decision, that my Personal Representative believes has had the effect, directly or indirectly, of preferring one beneficiary or group of beneficiaries over others; provided, however, my Personal Representative shall not exercise its discretion in a manner which would cause the loss or reduction of the marital deduction as may be herein provided. In determining the state or federal estate and income tax liabilities of my estate, my Personal Representative shall have discretion to select the valuation date and to determine whether any or all of the allowable administration expenses in my estate shall be used as state or federal estate tax deductions or as state or federal income tax deductions and shall have the discretion to file a joint income tax return with my husband. Page 3 ITEM IX Definition of Children. For purposes of this Will, "children" means the lawful blood descendants in the first degree of the parent designated; and "issue" and "descendants" mean the lawful blood descendants in any degree of the ancestor designated; provided, however, that if a person has been adopted, that person shall be considered a child of such adopting parent and such adopted child and his or her issue shall be considered as issue of the adopting parent or parents and of anyone who is by blood or adoption an ancestor of the adopting parent or either of the adopting parents. The terms "child;' "children;' "issue;' "descendant" and "descendants" or those terms preceded by the terms "living" or "then living" shall include the lawful blood descendant in the first degree of the parent designated even though such descendant is born after the death of such parent. The term "per stirpes" as used herein has the identical meaning as the term "taking by representation" as defined in the Pennsylvania Probate Code. ITEM X Definition of Words Relating to the Internal Revenue Code. As used herein, the words "gross estate," "adjusted gross estate;' "taxable estate;' "unified credit," "state death tax credit," "maximum marital deduction;' "marital deduction;' "pass;' and any other word or words which from the context in which it or they are used refer to the Internal Revenue Code shall have the same meaning as such words have for the purposes of applying the Internal Revenue Code to my estate. For purposes of this Will, my "available generation kipping transfer exemption" means the generation~skipping transfer tax exemption provided in section 2631 of the Internal Revenue Code of 1986, as amended, in effect at the time of my death reduced by the aggregate of (1) the amount, if any, of my exemption allocated to lifetime transfers of mine by me or by operation of law, and (2) the amount, if any, I have specifically allocated to other property of my gross estate for federal estate tax purposes. For purposes of this Will if at the time of my death I have made gifts with an inclusion ratio of greater than zero for which the gift tax return due date has not expired (including extensions} and I have not yet filed a return, it shall be deemed that my generation-skipping transfer exemption has been allocated to these transfers to the extent necessary (and possible) to exempt the transfer(s) from generation-skipping transfer tax. Reference to sections of the Internal Revenue Code and to the Internal Revenue Code shall refer to the Internal Revenue Code amended to the date of my death. Page 4 ITEM XI Statement by Testatrix of Intent Not to Exercise Power of Aynointment. I hereby refrain from exercising any power of appointment that I may have at the time of my death. ITEM XII Simultaneous Death Provision Presuming Beneficiary Predeceases Testatrix. If any beneficiary and I should die under such circumstances as would make it doubtful whether the beneficiary or I died first, then it shall be conclusively presumed for the purposes of this Will that the beneficiary predeceased me. Testimonium Clause. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal this ~ day of April, 1997. -;gip-(!~1.. ~~.C~~SEAL) HELEN COTSARELIS Attestation Clause. The foregoing Will was this day of April, 1997, signed, sealed, published and declared by the Testatrix as and for her Last Will and Testament in our presence, and we, at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses on the above date. _ of ,-~i~l ~ _ of ~ A (1 Page 5 PROOF OF WILL Commonwealth of Pennsylvania .vim'=t-f~- ~- County of Self-Proving Affidavit We, HELEN COTSARELIS, and Leonard Tintner Denise L. Foster and Carol A. Ely ,the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, and in the presence of each other, signed the Will as witness and to the best of our knowledge the Testatrix was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. Witness Subscribed, sworn to, and acknowledged before me by HELEN COTSARELIS, the Testatrix and subscribed and sworn to before me by Leonard Tintner , Denise L. Foster and Carol A. Ely ,witnesses, this 2nd day of April, 1997. ~ -.~, ~ -(Seal) Notary Public for Pennsylva~ is My Commission Expires: /~_~~j7~~' ~~,~,_ _ C ~ ~~ST Page 6 5~~'~`,~-~ a `!~~ ~CJi(!.'z~3tiDC~f F4a ~.si3V,, ~t y`; e..'3u~"il'd $! .,~ ..................~..,..~.....~...-..,a.-...~...' June 30, 2008 Denise Foster Boswell, Tintner, Piccola & Alford 315 N Front St PO Box 741 Harrisburg, PA 17108-0741 RE: Estate of: Helen Cotsarelis Tax Identification Number: 176-348356 Date of Death: April 20, 2008 To Whom It May Concern: Commerce Bank 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: 6 Month CD Account Number: 303122 Date Opened: October 24, 2007 Primary Owner: Helen Cotsarelis Primary Beneficiary: George Cotsarelis Date of Death Bafance: $97,194.97 Accrued Interest: $344.38 Principal Balance: $96,850.59 YTD Interest: $1,455.48 Interest on Date of Death: 4.64% Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, Cindy Shultz Support Associate/Deposit Services Commerce Bank Commerce Bank /Harrisburg, N.A. PO Box 4999 3801 Paxton Street Harrisburg, PA 17111-0999 commercepc.com ~- N ~ ~ ~ ~ ` ~ m m =~ 'gy'p N rn O \ '" ) n, (D (D N -~s m n, m :.. ~ 6 m 0 .~ (D N, N« 47 m -o m' N (D n O 9~ CU 0: -.1 y -.1 =.1 W CP .P to '' Z~ w HWo~ c a o a. _ ~, ~ ~ -1 c -~ ~ ~ ~ ~ ~~t~D 'd "' "d q N _. y ~ o ~ ~' ... ~ O TDDIAV TD DISPLAY AVAILABLE BANR 1878 ( F9D } ACCOUNT NUMBER 0001017562 BRANCH 0001 TYPE 0009 12 - 23 NONTM CD TITLE HELEN COTSARELIS STATUS ACTIVE DATE OPENED 09/17/07 LAST DEP09IT DATE/AMOUNT 09/17/07 85,000.00 ENTER Y P'OA DETAIL CURRENT BALANCE 87,971.28 ( N ) TOTAL HOLDS .00 i TODAY'5 ACTIVITY .00 ~ ATM ACTIVITY TODAY .00 ~ ~ TELLER TERMINAL ACTIVITY TODAY .00 ~ ACCRUED INTEREST 236.56 ~~ ~ ~ ~' PENDING ACCROAL9 .00 •, i ~ ~ ( I { ~ A ) tTNP05TED ITEMS TODAY .00 ~I i ~ ~; .~~ CONTINGENCY 11ITHHOLDING .00 ,•• ~ L' ;~' i AVAILABLE BALANCE 2,971.28 ( N ) ADD SPECIAL IASTRUCTIONS OR HEMO POST TRANSACTIOAS IISE TDSAIN TO VIEW STANDARDS FOR CALCULATING AVAILABLE BALANCE. G/S 6066026GTG lung A~?.Iba~uI ydy G£ ~ 00 LO-unf-8002 ` TDREST TD REQUEST STATEMENT BANK 1876 ( LST ~ ACCOUNT NUMBER 00 01017582 TITLE HELEN COTSARELIS PREVIOUS STATEMEN T BALANCE .00 DATE LAST STATEMENT 00/00/00 PLUS DEPOSITS AND CREDITS 87,971.28 LESS W ITHDRAWAL S AND DEBITS .00 CURRENT STATEMENT BALANCE 87,971.28 EEF DATE POST DT IRA TC AMOUNT DESCRIPTION ITEM SEQII$NCE NBR 05/17/08 05/16 00 17 371.94 INTEREST PAYMBNT 060-060-001-002517 04/17/06 09/17 00 17 382.66 INTEREST PAYMBNT 060-060-001-000802 .03/17/08 03/17 00 17 356.51 INTEREST PAYMENT 060-060-001-000725 02~/17/0B 02/15 00 17 379.43 INTEREST PAYMENT 060-060-001-003323 .,01/17/08 01/17 00 17 378.27 INTEREST PAYMENT 060-060-001-000690 i.~'~ 'i12~/17/07 ' 12/17 00 17 365.03 INTEREST PAYMENT 060-060-001-000643 w !~1~17/07 ~'~'j 11/16 00 17 375.55 INTEREST PAYMENT 060-060-001-002181 ~','?I, 10/17/07 10/17 00 17 361.89 INTEREST PAYMENT 060-D60-001-000710 i i 109/17/07 J! ,i ! ~ I' i' i ! ~ ~' ' I : I ~ 09/17 00 38 85000.00 TIME DEPOSIT 201-200-000-354568 t' ~4 i} L' J~ i" i~. J.M III ~ I I ! f 1' ~ ~ I i , i ~ ~~ i i ~~ ~ i I i. ~ ~ , i ~. ~;. .~ ; . ;i~ ~ j ~ { ~ '~ ,, I G/9 ~~ b06~0Z6GTL KuDg ~S~T.1ba~uI y~y G£ ~ 00 LO-uflf-8002 i i j ~, }~ f'~ CIDIAP CI DISPLAY APPLICATION RELATIONSHIPS SANK 1898 ,~ ~ ~ ;.( IiLST I , ~ ~QPLLCATION TINE DEPOSITS i! 110COUNT NUMBER 0000000001017582 ~'~i, i HELEN COTSARELIS SSNJTAX LD 176348356 S 3817 COPPER K14TTLE ROAD HONE PHONE 717-737-4189 CARP HILL PA 17011-1420 DAY PHONE 717-737-9189 1. PRIMARY ONNER HELEN ~COTSARELSS 2. PRIMARY BENEF FRZAN "COTSARELIS 3. NO DESC IMAGE 0001000002283400 ( ) ENTER THE NDMBER OF THE CUSTOMER OR APPLICATION TO ACCESS 606~0Z6GTG dung B~t.~ba~uI yd~l L£' 00 GO-unt-8002 St MEMBERS 1St FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/ Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CERTIFICATES OF DEPOSIT: Account Number/Suffx Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established 240597-00 02/03/2004 $2,482.20 $1.29 $2,483.49 None 240597-40 02/03/2004* $65,000.00 $124.85 $65,124.85 Nicholas Cotsarelis 02/03/2004 `Purchased by transfer of funds from 240597-00. Estate of: HELEN COTSARELIS Date of Death: April 20, 2008 Social Security Number: 176-34-8356 BERS 1ST FEDER CRyE~DI~TUNION • 1...XJ1~ arnelle A. line Insurance Services Specialist August 21, 2008 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283--2328 wwwmemberslst.org ~ /Yf'~ MID PENN K Making things happen for you. June 24, 2008 Boswell, Tintner, Piccola & Alford Denise L. Foster 315 North Front Street PO Box 741 Harrisburg, PA 17108-0741 Dear Denise Foster, This letter is in response to your request for information regarding an account for Helen Cotsarelis. Exact Account Title -Helen Cotsarelis Date Account Opened - Apri107, 2000 No changes of account ownership or registration since account opening Interest Rate .25°./0 No withdraws within sixty days of the date of death Death Balance $1,418.12 Interest Accrued $1.70 Should you have any questions or concerns please contact me at 717-761-2480. /. f r ~r f~~~. /. ~ ' ana 'McGuire Branch Manager Carlisle Pike Office Member FDIC Corporate Headquarters: 349 Union Street, Millersburg, PA 17061 • (717) 692-2:133 • www.midpennbank.com Print Page 1 of 2 Savings 9004146 -HELEN COTSARELIS Rel Birthdate Phone Tax Identification [01] HELEN COTSARELIS P ********** ********** ********** 3817 COPPER KETTLE ROAD CAMP HILL PA 17011 Tax Name: [1] HELEN COTSARELIS Summary Memo Ledger Balance: $1,418.12 Last Deposit Oct 22, 2007: $324.82 Memo Available Balance: $1,418.12 Last Withdrawal Sep 17, $6,000.00 2007: Current Ledger Balance: $1,418.12 Date Opened: Apr 07, 2000 Current Available Balance: $1,418.12 Transfer Minimum Balance: $0.00 Interest Balance: $1.70 Transfer Maximum Balance: $0.00 Current Effective Rate: 0.2500% Interest Current Accrued Interest: $1.70 Current Effective Rate: 0.2500% Date Accrued Through: Jun 23, 2008 Deposit Rate Index: j23] STATEMENT SAVINGS Date Next Interest: Compounding Code: Simple Interest Payment Frequency: Cycle Date Reg DD Compound Interest Frequency Frequency: Interest Cycle: [79] Jun 30, Dec 31 Interest Reporting Code: Reportable Interest Payment Method: Compound Withholding Code: No Withholding Days Into This Period: 175 Rate Change Frequency: None Previous Accrued Interest: $1.69 Rate Change Method: [I] Rate Index Last Interest Dec 31, 2007: $4.18 Maturity Rate Method: Current Rate Balance Last Interest: $1,418.12 Net Interest Adjustment: $0.00 Monthly Minimum Balance: $1,418.12 Average Monthly Minimum $1,418.12 Balance: Months Minimum Balance: 5 Rate Date Balance Type Rate Structu re Rate Tier Amount Rate Jan O1, 2008 Available [1] Tiered Rate $100.00 0.2500% Service Charge Date Last Service Charge: May 30, 2008 Service Charge Code: 31 Average Ledger Balance: $1,418.12 Service Charge Cycle: [30] Month-End Average Available Balance: $1,418.12 Charge To Account: Not Transferred Average Monthly Minimum $0.00 Waiver Service Charge Code: [O] Balance: Months This Period: Waiver Sales Tax: Waive Sales Tax Monthly Minimum Balance: $1,418.12 Days Into This Period: 24 Date Minimum Balance: Jun 02, 2008 Minimum Balance: $1,418.12 Charge http://10.0.0.75/SAV_SAV 1 151 /SAV 1151.ASPX?Action=QUICKPRINT&XMLGuid=E9... 6/24/2008 vu ~. L7. tvvo i i : v7nivi riu~ nnivn 41 L'!U7'L f41 ~ PNCBANC The Thiaktag 6chlnd The Money ]uly 29, 2008 Denise L Foster Attorney at Law 315 N lrrom St POBox741 Harrisburg, PA 17I0$-7172 ItE: Holm cotsarclis SSN:176-3483 ~6 DOD: 0420-2008 Dear Ms. Foster. No, 8161 P. 1 In response to your request for Date of Beath balances for the customer noted above, our records show the following: Checking Account Account # 5140175884 Established 03-04.1991 HELEN COTSARELIS DOD balance: $ 2,I9b.57 + 0.09 accrued interest Interestpaid of-oi-loos thru 04-2o-zoos a o.07 ~ Please note that this office only provides date of death balances far deposit accounts (IlZAs, CDs. Checking and Savings accounts). We do not praeeas any 13nAneial tranaactiona ar provide statements. If you coed assistance with any of these items, please call 1-888-PNC-BANK (1-888-762 2265) or stop by your local PNC Bank branch o~co. Sin erely, ULiG. u~.P/tca~~. Lori Robertson 1-800-762-1775 P7 PFSC-04-F 500 First Ave Pittsbtugb, PA 15219 Member FDIC Page 1 of 1